身體 微細畸形 및 産科的 合倂症과 精神分裂症의 家族歷

홍경수,주연호,김용식,신철진,강웅구,이중서,정희연,주은정 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.4

저자들은 정신분열병의 일부에서는 태생기 동안 유전 외적인 환경적 요인이 크게 작용할 것이라는 가정 하에 형제 정신분열병 환자군(남 15. 여 7)과 산발성 정신분열병 환자군(남 16, 여 7) 및 정상 대조군(남 16, 여 7)을 대상으로 가족력에 따른 산과적 합병증과 신체 미세 기형을 비교하였다. 산과적 합병증은 Lewis 척도를 이용하여 연구 대상의 어머니와 면담하여 평가하였고 신체미세기형은 Waldrop 척도를 이용하여 측정하였다. 또한 산과적 합병증 및 신체 미세기형과 가족력에에 따라 발병 연령 등의 임상 양상들이 차이를 보이는지 비교함으로써 정신분열병을 좀 더 동질적인 아형으로 나눌 수 있는지를 검토하였다. 1) 형제 환자군, 산발성 환자군 및 정상 대조군의 세균에서 산과적 합병증의 개개의 항목 및 전체 점수의 유의한 차이는 없었다. 신체 미세기형의 경우 입의 미세기 형에서 유의한 차이가 있었으나 그 외에 각 부위별 점수 및 전체 점수에서는 세 군간에 유의한 차이가 없었다. 그러나 대부분의 신체 미세기형 세부 항목 및 전체점수에서 산발성 환자군이 형제 환자군에 비해 높은 신체 미세기형의 점수를 보이는 경향이 있었다. 2) 산과적 합병증의 전체 점수와 신체 미세기형의 전체 점수 사이에 상호 연관성을 찾아볼 수 없었다. 3) 발병연령·정신병리·약물에 대한 반응·병전 기능수준·지연성 운동장애 유무 등의 임상 양상들을 비교하였을때 산발성 환자군과 형제 환자군간에 유의한 차이가 없었다. 4) 산과적 합병증 및 신체 미세기형과 임상 양상들을 비교하였을 때, 형제 환자군에서 분만시간과 회복시 전반적 기능수준간에, 산발성 환자군에서 산과적 합병증의 전체 점수와 발병 연령간에 상관관계가 있었으나 전체적으로 일관된 결과가 도출되지는 못하였다. 위와 같은 결과를 종합하여 볼 때, 산과적 합병증이나 신체 미세기형이 정신분열병의 원인을 밝히는데 유익한 도구가 될 수는 있지만, 가족력 유무에 따라 정신분열병을 보다 동질적인 아형으로 구분하기 힘들다고 생각되었다. In order to test the hypothesis that familial schizophrenics have fewer chances of receiving organic insults during the fetal neural development than sporadic schizophrenics, the authors compared obstetric complications, minor physical anomalies, and other clinical features in sibling schizophrenics, sporadic schizophrenics and controls. Obstetric complications were evaluated by the scale of Lewis, and minor physical anomalies were measured by the Waldrop scale. Sporadic schizophrenics had a significantly higher Waldrop score for mouth than sibling schizophrenics. Although there was some tendency of higher total scores for minor physical anomalies in sporadic schizophrenics, there were no statistically significant differences in obstetric complications and the other minor physical anomalies among three groups. There was no significant correlation between obstetric complications and minor physical anomalies. The clinical features such as age of onset, psychopathology, response to drugs, premorbid functioning, and tardive dyskinesia were not significantly different between sibling and sporadic scizophrenics. In conclusion, while the obstetric complications and minor physical anomalies were suggested to be useful in the search for the cause of schizophrenia, it was difficult to categorize schizophrenics into more homogeneous groups according to family history of schizophrenia using the parameter of obstetric complications and/ or minor physical anomalies.

외과적 노축과 교정력에 의한 매복 상악 견치의 치험례

정수연,한세현 大韓小兒齒科學會 1993 大韓小兒齒科學會誌 Vol.20 No.2

Each patient with an impacted maxillary canine must undergo a comprehensive evaulation of the malocclusion. There are several methods to treat impacted canine. Surgical exposure of the canine and orthodontic treatment to bring the tooth into the line of occlusion is considered the most desirable approach. Conservative exposure, light movement, and light force will minimize the undesirable effects such as devitalization, ankylosis, root resorption, gingival recession, and alveolar bone loss. Three cases are repoted, which were treated with surgical intervention and orthodontic tooth movement.

화학적 변성전분 및 라면 전분질의 In Vitro 소화율

김수연,이서래 이화여자대학교 생명과학연구소 1994 생명과학연구논문집 Vol.5 No.-

식품에 사용되는 화학적 변성전분류와 acetyl화 전분이 사용된 라면의 돼지 췌장 a-amylase에 의한 in vistro소화율 (37℃에서 6시간)을 비교하였다. Native potato starch와 acetylated potato starch의 가수분해율은 각각 64.5%와 59.3%, native와 hydroxypropylated corn starch는 70.5%와 60.4%, 그리고 native와 hydroxypropylated corn starch는 70.5%와 60.4% 그리고 native와 hydroxypropylated high amylose corn starch는 65.2%와 57.3%로서 native한 것들이 유도체들보다 높았다. Waxy corn starch들의 소화율은 pregelatinized(74.3%)>native(72.1%)>acetylated(66.5%)>acetyl distarch adipate(56.4%)hydroxypropyl distarch phosphate(50.7%)의 순으로 감소하였다. 국내에서 생산, 판매되고 있는 5개 회사의 봉지라면과 용기라면에 대한 실험에서는 실제 조리조건에서 소화율에 유의적 차이를 보이지 않았다. 결론적으로 화학적 변성전분의 소화율은 천연전분보다 낮지만 상용식품에서의 사용량이 매주 낮으므로 식품 섭취에 따른 전분질의 소화율에서 큰 영향을 미치지 않을 것으로 판단된다. The hydrolyzability of chemically modified starches and ramen staches was determined by hog pancreatic a-amylase in vistro test. The extents of hydrolysis were 64.5% and 59.3% in native and acetylated potato starch, 70.5% and 60.4% in native and hydroxypropylated corn starch, and 65.2% and 57.3% in native and hydroxypropylated high amylose corn starch, respectively. The hydrolysis extents of waxy corn starch derivatives were shown in the descending order of pregelatinized (74.3%)>native (72.1%)>acetylated (66.5%)>acetyl distarch adiphate (56.4%)>hydroxypropyl distarch phosphate (50.7%). In the test on starches of container and regular ramen cooked by practical way, no significant difference was observed between ramen products of five different makers. Althrough the hydrolysis rate and extent of chemically modified starches were lower than those of native starches, the digestibility of ramen seemed to be not affected in the common diet as the use level of modified starch was relatively low.

어린이의 치과치료시 사용되는 행동조절 방법에 대한 보호자의 태도에 관한 연구

한세현,정수연 大韓小兒齒科學會 1994 大韓小兒齒科學會誌 Vol.21 No.1

The purpose of this study was to evaluate the attitudes of parents toward behavior management techniques used in pediatric dentistry. These techniques were tell-show-do, voice control, HOM, active restraint by dental personnel, passive restraint by Papoose Board, premedication, N₂O-O₂relative analgesia, and general anesthesia, Seventy-six parents of very uncooperative children under 6 ages were selected who visited Department of Pediatric Dentistry of Seoul National University Hospital. The subjects were asked to indicate their degree of acceptability before and after viewing a scrapbook which provided explanations of these techniques. The following results were obtained: 1. There were significant differences in parental acceptability according to each behavior management technicque(p<0.01). 2. Psychological or physical methods were more acceptable than pharmacological techniques(p<0.01). The most acceptable method was tell-show-do, and the least one was general anesthesia. 3. Statistically significant differences in acceptability with prior explanations were seen in all methods except tell-show-do and physical restraint by dental personnel(p<0.01). 4. Girls´parents were significantly more accepting for tell-show-do after explanation than boys', and mothers were more accepting for physical restraint by dental personnel and Papoose Board before explanation than fathers, and middle school graduated parents were more accepting for premedication after explanation than college graduated parents(p<0.05).

성남시 지역주민의 정신질환에 대한 태도 연구

고영,신수경,황태연,이충순,박연수,김인숙,황은숙,정원재 용인정신의학연구소 1999 용인정신의학보 Vol.6 No.1

노년기 치매와 우울증의 유병률 및 위험인자

서국희,김장규,연병길,박수경,유근영,양병국,김용식,조맹제 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

경기도 연천군에 거주하는 만 65세이상 노인 1,037명을 대상으로 1996년 12월부터 1997년 8월까지 9개월간에 걸쳐 치매와 노년기 우울장애의 유병률과 위험인자에 관한 이 단계 역학조사(일차선별검사후 이차 진단적 면접)를 수행하였다. 다단계 층화집락표본추출에 의한 확률표본법으로 대상자 선정을 하였고, 반응률은 85.2%이 었다. 일차선별검사에는 노인정신장애 평가척도 한국어판(K-PAS)을 사용하였고, 일상생활 능력척도(ADL) 및 수단적 일상생활 능력척도(IADL)를 사용하여 기능을 평가했고, 지지도 척도(APGAR)를 사용하여 사회적 지지정도를 평가하였다. 이차 진단적 면접에서는 진 신장애의 진단 및 통계편람 제3판 개정판(DSM-III-R)의 진단기준을 따라 임상 진단을 확정하였다. 감별진단 및 장애 정도의 평가를 위하여 보조적인 진단도구들을 사용하였다. 1) 연령 보정된 치매의 유병률(%)[95% 신뢰구간]은 6.83[6.12∼7.54](남자 6.34[5.29∼7.40], 여자7.09[6.14∼8.04]이었다. 이중 알쯔하이머형 치매의 유병률(%)[95% 신뢰구간]은 4.17[3.61∼4.74] (남자 2.42[1.76∼3.08], 여자 5.31[4.48∼6.14]이었고, 혈관성치매의 유별률(%)[95% 신뢰구간]은2.38[1.95∼2.81](남자 3.46[2.67∼4.25], 여자 1.63[1.16∼2.10])이었다. 2) 연령 보정된 우울장애의 유병률(%)[95% 신뢰구간]은 10.99[10.11∼11.87](남자 7.59[6.44∼8.73], 여자 13.46[12.20∼14.73])이었다. 진단별로는 주요 우울장애의 유병률(%)[95% 신뢰구간] 이 7.50[6.76∼8.26](남자 4.42[3.54∼5.31], 여자 9.78[8.68∼10.88]), 기분부전장애의 유병률(%)[95% 신뢰구간]이 2.02[1.62∼2.42](남자 1.37[0.86∼1.87], 여자 2.46[1.88∼3.03], 달리 특정되지 않은 우울장애 유병률 (%)[95% 신뢰구간]이 1.49[1.15∼1.83](남자 1.85[1.47∼2.23], 여자 1.28[0.96∼1.60])이었다. 3) 알쯔하이머형 치매의 통계적으로 유의한 5가지 위험인자는 85셍상의 고령(O.R.= 10.27), 무학(O.R.= 4.01), 흡연[흡연년수 0.1∼30년(O.R.= 3.11), 흡연년수 30년 이상 (O.R.= 4.60)], 알코올남용(O.R.= 2.98)과 치매의 가족력 (O.R.= 4.85)이었다. 4) 혈관성 치매의 통계적으로 유의한 3가지 위험인자는 '무학' (O.R.= 3.78), 흡연[40년 이상 흡연년수 (O.R.= 11.15)]과 '뇌졸중의 과거력 (O.R.= 26.76)'이었다. 5) 우울장애의 통계적으로 유의한 3가지 위험인자는 '75∼79세 연령군' (O.R.= 2.87), '뇌졸중의 과거력' (O.R.= 3.33)과 '우울장애의 가족력' (O.R.= 7.16)이었다. 중심단어:알쯔하이머형 치매·혈관성 치매·우울장애·유병률·위험인자·흡연. An epidemiological survey was conducted to estimate the prevalence of and identify the risk factors of dementia and depression in the elderly between December 1997 and August 1998 in Yonchon County, Korea. A total of 1,037 elderly aged 65 years and over underwent a two phase diagnocstc procedure. Multiple stage, random cluster sampling method was used to select the subjects. Response rate was 85.4%. For the Ist stage screening survey, the Korean Psych-ogeriatric Assessment Scale was used as a primary screening tool, which had already been standardized in Korea, and functioning and social support were assessed by ADL, IADL and APGAR. At the 2nd stage, diagnoses were confirmed according to the DSM-Ⅲ-R. And several other scales were used as supporting information for differential diagnoses and for evaluating severity. 1) Age-sex adjusted prevalence(%)[95% C.I] of dementia was 6.83[6.12-7.54](male 6.34 [5.29-7.40], female 7.09[6.14-8.04]). Prevalence of the dementia of the Alzheimer's type was 4.17[3.61-4.74](male 2.42[1.76-3.08], female 5.31[4.48-6.14]) and that of the va-scular dementia was 2.38[1.95-2.81](male 3.46[2.67-4.25],female 1.63[1.16-2.10]). 2) Age-sex adjusted prevalence(%)[95% C.I.] of depressive disorder was 10.99[10.11-11.87](male 7.59[6.44-8.73], female 1346[12.20-14.73]. Among depressive disorders, prev-alence(%)[95% C.I.] of major depressive disorder was 7.50[6.76-8.26](male 4.42[3.54-5.31], female 9.78[8.68-10.88]), that of dysthymic disorder was 2.02[1.62-2.42](male 1.37[0.86-1.87], female 2.46[1.88-3.03]) and that of depressive disorder NOS was 1.49[1.15-1.83](male 1.85[1.47-2.23], female 1.28[0.96-1.60]). 3) Five statistically significant risk factors of the dementia of the Alzheimer's type were identified : age over 85(O.R. = 10.27), illiteracy (O.R. = 4.01), alcohol abuse (O.R. = 2.98), smoking [0 < pack year ≤30(O.R. = 3.11), pack year>30(O.R. = 4.60)] and family history of dementia (O.R. = 4.85). 4) Three statistically significant risk factors of the vascular dementia were identified : illiteracy (O.R. = 3.78), history of CVA(O.R. = 26.76) and smoking over 40 pack year(O.R. = 11.15). 5) Three statistically significant risk factors of the depressive disorder were identifed : age between 75 and 79(O.R. = 2.87), past history of CVA(O.R. = 3.33) and family history of depressive disorder(O.R. = 7.16). KEY WORDS:Dementia of the Alzheimer's Type·Vascular dementia·Depressive disorder·Prevalence·Risk factor·Smoking.

급성 신우신염이 선행된 Escherichia coli 농흉 1예

차치운,조준형,김미진,오윤정,연재우,이성규,오미정,채지영,김수연 대한감염학회 2009 감염과 화학요법 Vol.41 No.5

We experienced a case of acute pyelonephritis which progressed to Escherichia coli bacteremia and later complicated by empyema in a 65-year-old female. She was successfully treated with intravenous antibiotic therapy and percutaneous drainage of empyema.

Ziprasidone의 자연적 임상경험에 대한 후향적 조사 연구 : 3개 대학병원의 경험

이승재,강도형,홍경수,주연호,김남식,권준수 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.3

Objectives : This naturalistic retrospective study investigated the effectiveness of ziprasidone measured by mean improve-ments of the Cltnical Global Impression (CGI-I). Secondary objectives included prescribing patterns, tolerability and safety. Methods : From May to July 2006, 98 psychiatric patients who have been taking ziprasidone for at least 2 weeks were selected. Their current clinical statuses were assessed by the interview and laboratory tests including electrocardiogram (ECG). Data on DSM-IV diagnoses, dosing, concomitant psychotropic medications, clinical changes, adverse effects, and laboratory findings were collected retrospectively. Results : Ziprasidone was mostly prescribed for a switch from another antipsychotics for the treatment of schizophrenia. Two main reasons for a switch were unsatisfactory efficacy and poor tolerance, especially weight gain, of the preceding anti-psychotic medication, Participants as a whole showed mean 2.7±1.0 of the CGI-Improvement. Significant weight reduction after switching to ziprasidone occurred, which was related to the clinical improvement. No significant increase of the QTc interval except one case was observed. Conclusion : The present study confirmed previous tolerability and safety data of ziprasidone as well as the results of its effectiveness.

Single port laparoscopic surgery reduces postoperative pain in women with benign gynecologic disease, really?

( Sue Yeon Park ),( Jeong Min Eom ),( Jung Hwa Ko ),( Joong Sub Choi ),( Jung Hun Lee ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

The primary objective of this study is to compare postoperative pain between women underwent single port laparoscopic surgery (SP-LS group) or conventional-laparoscopic surgery (conventional-LS group). The secondary objective is to evaluate the difference of postoperative pain between SP-LS group and conventional-LS group according to whether or not hysterectomy has been performed This prospective case-control study was performed at University teaching hospital. For postoperative pain, a total of 399 women were enrolled and of these 116 were in the SP-LS group and 283 in the conventional LS group. We evaluated the pain score, number of patients administered of intravenous or intramuscular pain medication, and number of patients with nausea or vomiting at 2, 4, 6, 12, 24, 48 and 72 hours after surgery Clinical characteristics and operative outcomes were similar in both groups. The postoperative pain score except for the time of postoperative 2 hours after was similar in both groups. According to the type of operation, SP-LS reduced postoperative pain in the group of SP-LS not including laparoscopically assisted vaginal hysterectomy (LAVH). SP-LS didn`t provide significant advantage compared with conventional LS in terms of postoperative pain. But SP-LS reduced pain on postoperative 2 hours after and when performed not including LAVH. To confirm these results, additional large, randomized trials more specifically controlled are needed.

Case Reports : Laparoscopic management of pelvic splenosis

( Sue Yeon Park ),( Ji Ye Kim ),( Jung Hun Lee ),( Joong Sub Choi ),( Jung Hwa Ko ),( Seon Hye Park ) 대한산부인과학회 2014 Obstetrics & Gynecology Science Vol.57 No.1

Splenosis is defined as heterotopic autotransplantation of spleen tissue following traumatic rupture of the spleen, or surgery. It is a benign disease that is generally without any symptoms and is discovered incidentally. Surgical intervention is recommended if symptoms are present. We report the successful laparoscopic management of a 49-year-old Korean woman with splenosis-associated symptoms who had undergone splenectomy.