항정신병약물로 유발된 추체외로증상에 대한 Amantadine과 Benztropine의 효과비교

오동열,양병환,김상욱 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.2

Clinically anticholinergic antiparkinsonian drugs are the most commonly used medication in drug induced extraphramidal symptoms treatment, and amantadine, a drug developed as an antiviral agent, also is known to be effective in drug induced extrapyramidal symptoms. A double blind cross-over study was performed to compare the effect between amantadine and benztropine on drug induced exptrapyramidal symptoms. The subjects was 32 female schizophrenic patients who developed exprapyramidal symptoms after discontinuing antiparkinsonian drug medication. The procedure was proceeded for a period of 5 weeks using KiMascio extrapyramidal symptom rating scale and Simpson & Angus extrspyramidal symptom rating scale. The results are as followings; 1) Both amantadine and benztropine had significant effect on exprapyramidal symptoms na dno difference in effectiveness was found between the two drugs. 2) Amantadine and Benztropine were effective in extrapyramidal symptoms from the 1st and 3rd day except for dystonia. 3) Both drug were effective in dystonia, but did not show the significant effect on dystonia as far as duration of use is concerned.

알콜 관련성 간질에 관한 임상적 고찰 : 유병율과 위험인자를 중심으로 for the Aspects of Prevalence Rate & Risk Factors

오동열,박병희,이충경 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.5

본 연구에서는 국립서울정신병원 알콜병동 입원환자를 대상으로 알콜 관련성 간질의 유병율을 조사하고 그 위험인자를 알아보았다. 1년간 알콜전문병동에 입원한 434명의 알콜장애 환자 중 8.5%인 37명에서 알콜 관련성 간질(ARS)의 경험을 확인하였다. 선행연구에 의거한 위험인자의 조사결과 이들은 알콜 섭취량, 알콜 섭취기간, 진전성 섬망 경험 여부, 두부외상력 등에서 모두 간질 비경험군에 비해 유의하게 높은 수치를 나타냈다(p<0.05). 알콜 관련성 간질의 임상적 특징 중 중첩 간질 발작은 12명(32.4%)에서 나타났다. 뇌파검사에서 이상소견은 2명에서만 나타났다.이러한 결과는 여러 선행 연구에서 보고와 거의 일치하는 결과이고 단 중첩 간질 발작의 빈도가 외국의 경우에 비해 적은 양상을 나타냈다. 이는 급성 해독기관에서 주로 조사된 외국의선행 연구들과는 달리 입원상황과 과거 간질력을 모두 조사 대상에 포함시켰고 금단 증상에 대한 예방 조치가 이루어진 상황 후라는 점에서 직접적인 비교는 어려울 것으로 생각된다. 알콜 관련성 간질의 원인으로 Victor는 금단현상과 이후의 잦은 해독작용 등을 주장하고 Ng는 알콜자체의 독성을 주장하는데 본 연구에서는 두 연구 모두에서 제시하는 소견이 포함되어 있어 하나의 원인 보다는 알콜 자체의 독성과 함께 금단 후의 과정도 관련된 복합적인 요인들의 결과라고 추론된다. 임상적특징을 보건데 알콜 관련성 간질임이 확인되면 좋은 예후를 예측할 수 있으므로 중독 초기의 적극적인 평가와 급성 알콜중독 환자에 대한 철저한 치료과정이 필요하다고 하겠다. Objects : Increasing numbers of alcoholics takes burdens of physical problems and one of the most serious complication is alcohol related seizure. This study was conducted to assess the prevalence of alcohol related seizures(ARS) in alcoholic patients and also the risk factors associated with ARS. Method :434 male alcoholic patients who were admitted to the alcohol inpatient unit on Seoul National Mental Hospital were studied. Patient interview and chart review was performed to take alcohol and seizure histories at the time of admission and also at the point of seizure attack during admission. Neurological examination and brain study was performed to each one of the patient group. Results : Prevalence of alcohol withdrawal seizure was 8.5%. Variables associated with alcohol related seizure were duration of drinking, amount of drinking, comorbid delirium tremens, histories of minor head trauma. Most of subjects were neurologically free. Among the total 37 subjects, grand mal seizures were developed in 36 subjects and in 25 subjects seizure were developed within 48 hours. All of them experienced delirium tremens and 12 of them were attacked by recurrent seizures within 6 hours. Conclusion : Alcohol related seizure(ARS) was related to severity of alcoholic symptoms. Further studies are needed to find out the pathophysiology, the ways of management and prevention of alcohol withdrawal seizure for increasing risk of alcohol problems today.

정신과 입원환자의 다음증에 관한 연구

오동열,서현주 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.4

본 연구는 첫째, 국립서울정신병원 입원환자의 다음증유병율과 그 측정방법에 관하여 알아보고 둘째, 다음증환자의 특성을 알아보기 위해 다음증군과 대조군의 임상특성 및 생물학적 지표를 비교하였다. 국립서울서울정신병원에 입원중인 환자 634명을 대상으로 다음의 진단 기준 (1)(2)(3)중 하나라도 만족시키는 환자를 다음증 환자로 결정하였다. (1) 치료진의 보고상 입원 중 다음증으로 인한 물중독의 삽화가 명백히 있는 경우 (2) 3회 연속 뇨비증이 1.008이하이면서 하루 3리터 이상의 물을 섭취하는 경우 (3) 3회 연속 뇨비증이 1.008이하이면서 혈중 나트륨 농도가 135mEq/L이하인 경우 위 진단기준을 만족시키는 환자는 총 24명으로 전체 환자의 3.79%였다. 다음증군 20명과 대조군 20명의 임상특성 및 생물학적 지표의 비교를 통하여 다음증 환자의 특성을알아보았다. 연구 결과는 다음과 같다. 1) 유병기간, 항정신병약물 용량, 경련, 전기경련치료, 흡연, 기타 약물 사용은 두 군간에 차이가 없었다. 2) 다음증군에서 대조군보다 뇨비증이 더 낮았고 물 섭취량이 더 많았다. 일중 체중변화(normalized diu-mal weight gain)는 두 군간에 차이가 없었다. 3) 다음증군에서는 혈중 항이뇨 호르몬(antidiuretic hormone 이하 ADH)이 정상범주에 들었으나 대조군에서는 정상범주보다 높았다. 또한 다음중군에서는 혈중능동삼투농동(osmolality 이하 Osm)가 정상범주보다 낮았으나 대조군은 정상범주에 들었다. 본연구의 결과를 전체적으로 종합한다면, 저자들의 진단기준에 따른 국립서울정신병원 입원환자의 다음증 유병율은 3.79%이며 다음증 측정방법으로 치료진의 보고, 뇨비증, 혈증 나트륨 농도, 물 섭취량의 측정 등을 제시할 수 있겠다. 그리고 다음증군과 대조군의 비교에서 유병기간, 항정신병약물 용량, 경련, 전기경련 치료, 흡연, 기타 약물 사용 등의 임상특성의 차이는 없었으나 뇨비증, 물 섭취량, 혈중 ADH와 Osm 같은 생물학적지표는 분명한 차이를 보임으로서 다음증군의 특성을 나타낸다고 할 수 있겠다. We attempted to estimate the prevalence of polydipsia in psychiatric inpatients in Seoul National Mental Hospital and to find out the identification method for polydipsic patients. We also compared the clinical and biological characteristics of polydipsic patients with those in nonpolydispic patients. Methods &Results : The following inclusion criteria were applied to the study subjects for estimating the prevalence of polydipsia among psychiatric inpatients at Seoul National Mental Hospital. 1) By staff report, that a objective clinical evidence of water intoxication during hos-pitalization was noted. 2) Three consecutive urine specific gravities were all less than 1.008 and also water intake was more than 3 liters per day. 3) Three consecutive urine specific gravities were all less than 1.008 and also serum sodium level was less than 135 mEq/L. By these inclusion criteria, we found 24 polydipsic patients among 634 hospitalized psychiatric inpatients, with the prevalence of 3.79%. Comparison of the clinical characteristics and biological determinants between 20 polydipsic and 20 nonpolydipsic patients produced the following results : 1) No differences were found in duration of illness, dosage of neuroleptics, seizure history, electroconvulsive therapy history, smoking, use of medications other than neuroleptics, between the groups. 2) There was no difference in normalized diurnal weight gain. But polydipsic patients showed more water intake and lower urine specific gravities than nonpolydipsic ones. 3) Plasma antidiuretic hormone levels were within normal range and osmolalities were lower than normal range in polydipsic patients. BUT plasma antidiuretic hormone levels were higher than normal range and osmolalities were within normal range in nonpolydipsic patients. Conclusion : The prevalence of the polydipsia was 3.79%. We suggest that staff report, urine specific gravity, serum sodium level, and oral water intake can be identification markers for polydipsta. Clincal characteristics such as duration of illness, dosage of neuroleptics, seizure history, electroconvulsive therapy history, smoking, and use of medications other than neuroleptics did not differ between polydipsic and nonpolydipsic patients. But biological determinants such as urine specific gravity, oral water intake, plasma antidiuretic hormone level, and osmolality differed beween the groups. Therefore these biological determinants could be adopted as biological markers for polydipsia.

마약과 환각제의 임상양상

吳東烈 대한의사협회 1998 대한의사협회지 Vol.41 No.4

유한요소법을 이용한 Sputtering Coating 장치용 진공용기의 응력해석

이동명,오택열,한경천 경희대학교 산학협력기술연구원 1995 산학협력기술연구논문집 Vol.1 No.-

In this study, stress analysis of the vacuum chamber of sputtering coating equipment was performed and its safely was confirmed. In order to enhance the self-analysis ability of the manufacturer, computer program was developed using finite element technique. Since door and chamber flanges are known to be the weakest parts of the vacuum chamber, the flanges were meshed as bilinear rectangle elements and analyzed. The results are confirmed by commercial software, NASTRAN. The calculated stresses are low enough to modify the chamber structure. This study is expected to be the motivation and the foundations of computer analysis and design technique of the manufacturer.

電磁調理器용 ZVS 고주파 인버터의 특성해석

김동희,심광열,오승훈,신수국 嶺南大學校 工業技術硏究所 1996 工業技術硏究所論文集 Vol.24 No.1

In this paper, we proposed a form of load resonant inverter made which use of soft switching technology to reduce stress and turn on/off loss at switching and described about its principle operation with coupling coefficient. The general operation characteristic of the inverter is depicted by introducing normalized control variables. The characteristic of the inverter are evaluated by load time constant and a coupling coefficient. When the load changes suddenly from steady state operation, the characteristics are analyzed. Based on the characteristics value, a method of circuit design is proposed. In addition, the results of its characteristics analysis are compared with that of pspice's simulation and experimental waveform are compared with theoretical ones.

정신병환자 가족의 걱정에 관한 조사

이정식,오동열,김광일 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.3

Opinions about the family burden of psychotic in-patient were collected from 207 caretakers of psychotic in-patient admitted to the Seoul National Mental Hospital from December 1989 to February 1990 through individual informal interview. Each respondent was asked to varbalize initially all the worries concerning the patients. and their care and then to choose two serious worries among them. Form these opinions, the authors tried to identify the family burden of psychotic in-patient and the relevance between family burden and demographic variables. and to discuss the issues arising from this investigation. The results were as follows : 1) The caretaker's worries could be classified into six areas. “The future and outcome” of the patient was the most frequent worrying area. being 64.3%. The worry about “Family was 45.4% ; Care and support”.42.5% : “Mental health support”. 14.5% ; “Shame and stigma”. 12.6% ; “Neighborhood”. 4.8%. 2) The parents worried much more about “The future and outcome” of the patient whereas the spouse and the siblings worried more about “Family” and the offsprings worried about “Neighborhood”. especially. The caretakers who inhabit in the metropolis worried more about “Care and support” and worried especially about “care and responsibility” among the “Care and supports” area while the caretakers in the other areas worried more about “Neighborhood ” and worried especially about “financial burden” among the“Care and support” area. The caretakers of the famale patient worried more about “everyday life of patients” among “The future and outcome area”. The higher the education level of the caretakers. the more they worried about “future of patient” among “The future and outcome” area and “influence on offspring” among the “Family” area. Male caretakers worried more about “drug” while female caretakers worried more about “policy and institution” among the “Mental health supports area”. There were three problems regarding family's burden of psychotic in-patient : Caretaker's loading in all areas : Caretaker's devastated emotion by the long-standing burden ; A lack of helpers.

정신분열병 환자의 임상반응에 따른 혈장 Homovanillic Acid와 혈장 할로페리돌의 변화

구자일,오동열,양병환 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.1

Nineschizophrenic inpatients were studied under halopendol treatment for the purpose of evaluating the possible correlation between plasma HVA, leuels(P-HVA) plasma halopendol levels (P-haloperidal) and clinical symptom changes. The authors measured plasma HVA and plasma haloperidol levels, and checked BPRS and SAPS scores at baseline, 7th day. 28th day and 56th day of treatment. 1) P-HVA concentrations of total patients were highest on 7th day, then returned to baseline levels on 28th day. but that of drug responder group(6 patients) were highest on pretreatment then decreased below baseline levels on 7th day and continued to decrease till 56th day of treatment. 2) P-HVA concentrations of total patients showed positive correlations with BPRS scores (r=0.28, p<0.l) and-with SAPS scores(r=0.36, p<0.05) and that of drug responder group showed also positive correlations with BPRS scores(r=0.24, p=NS) and with SAPS scores (r=0.45. p<0.0l). 3) P-haloperidol concentrations of total patients showed significant positive correlation with haloperidol doses(r=0.73, p<0.00l) and that of drug responder group showed positive correlation with haloperidol doses(r=0.53. P<0.01). P-haloperidol concentration of drug responder group showed significant negative correlation with BPRS scores(-0.72, P<0.01) and with SAPS scores(-0.59. P<0.001) but that of total patients did not. 4) The haloperidol doses of drug responder group showed meaningful negative correlations with P-HVA(r=-0.38. p=0.03) and with BPRS scores (r=-0.50. P<0.01) and with SAPS scores(r=-0.47. p=0.0l) but that of total patients did not. The authors discussed the meaning of above results.

알코올 사용과 스트레스와의 관련성

전진용,오동열,구민성,이준석,천근아,박웅섭,김상아 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Objectives : This study was designed to assess the relationship between alcohol use and stress. Methods : The study subjects were 1,261 people who drink among the 2,565 people who lived in Gangneung. We investigated the sociodemographic characteristics, Short Form-12 (SF-12), Global Assessment of Recent Stress (GARS) and Alcohol Use Disorder Identification Test (AUDIT). Results : In Problem drinking group the GARS was significantly positively associated with the AUDIT (p=0.02). In Social drinking group sex (p<0.001) and age (p=0.02) is significantly associated with the AUDIT. Conclusion : This study showed the significantly positively association between stress and alcohol use. We think that the intervention and active management of the stress can prevent the alcohol problem.

성격장애 진단준거 개발을 위한 전형성 분석

황순택,조연규,오동열,김창현,양병환 漢陽大學校 精神健康硏究 1994 精神健康硏究 Vol.13 No.-