정신보건법의 주요 쟁점 조항에 대한 선진국과의 사례 비교

홍진표,황순찬,박수빈,서동우,정은기,김진학,박종익,안주연,김수정,장홍석 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.2

Objectives The Mental Health Act is an initiative aimed at changing and shaping mental health services and protecting human rights of persons with mental disorders. Since the Mental Health Act was legislated in 1995, four amendments have been made according to the issues that arose from public concerns. However, there are still many debates about the human rights protection of the mentally iII. This study aimed to provide information regarding major aspects of the Mental Health Act by comparing them among several developed countries. Methods Current Mental Health Acts of the state of Michigan in the United States, Scotland in England, the state of Victoria in Australia, and Japan were reviewed. Issues regarding the Korean Mental Health Act were collected from seminar materials, news media contents, and mental health professionals Results The definition of subjects in Korean Mental Health Act was more inclusive than other countries and was derived from a medical classification of mental illness. Family members or guardians were granted important responsibilities for deciding the involuntary admission of mentally ill patients in Korea and Japan. In Western countries, Mental Health Review Tribunals or courts have the primary responsibility for important decisions about mentally ill patients. The regulation of immediate dis- charge after request by voluntarily admitted patients was not enacted in all countries except Korea. The mandatory procedure for involuntary admission in Western countries includes an individual case review with personal interview by a Mental Health Review Tribunal or court. Conclusion The Korean Mental Health Act appears to meet the basic standards of Guidelines from international organizations. Our traditional culture and inherent health systems seem to influence the legal regulation of mental health service and might be related to the problems of human rights protection of mentally ill patients in Korea.

pH순환 모델에서 과포화 용액의 초기 우식 법랑질에 대한 재광화 효과

홍석진,김소라,이찬영,노병덕,금기연 대한치과보존학회 2001 Restorative Dentistry & Endodontics Vol.26 No.4

Dental caries is the most common oral disease. There are many factors contributing to its development. but complete understanding and prevention are not fully know. However, it is possible to remineralize the early enamel carious lesion by fluoride containing remineralization solution. Recently the pH-cycling model has been used to examine the effect of fluoride solution on remineralization of artificial caries in vitro as it can closely simulate the conditions encountered in vivo within a carefully controlled enviroment.

간접 적응 극배치 제어기의 설계에 관한 연구

홍연찬 순천향대학교 1991 논문집 Vol.14 No.1

In this paper, an indirect adaptive pole placement controller for an unknown linear time-invariant single-input single-output nonminimum phase plant is proposed. To estimate the parameter vectors and state vector, an adaptive observer is incorporated into this indirect adaptive pole placement controller. This adaptive observer based upon the exponentially weighted least-squres algorithm is implemented. A series of simulations for a nonmonimum phase plant is presented to illustrate some features of the output response of this adaptive pole placement controller.

법량질 표면의 탈회 및 재광화 후 EPMA (electron probe micro-analysis)를 이용한 칼슘, 인, 불소 변화의 정량적 분석

홍경식,허복,이찬영,금기연 대한치과보존학회 2001 Restorative Dentistry & Endodontics Vol.26 No.5

The aim of this in vitro study was to analyze the composition of human tooth enamel in terms of there components, Ca, P, and F after demineralization and remineralization in acid buffer solution. A total of 8 human premolars without any defects and cracks were selected and buccal and lingual sides of the teeth were cleaned with an ultrasonic device and pumice without fluoride. 5×5mm windows were opened, and other areas were completely covered with 3-coats of nail varnish to prevent from being in contact with demineralized and remineralized solutions. After demineralization process, each tooth was sectioned into two slices, highly polished one of them withγ-alumina, and then analyzed the composition of the demineralized tooth with EPMA(electron probe micro-analyzer) . The ocher slices were put into the remineralized solution for 10 days, polished, and analyzed in the same manner. These data were statistically analyzed with one sample t-test(p<0.05) . The results were as follows. 1. Normal tooth enamel consists of 49.76% Ca, 39.80% P, and 0.28% F. 2. After demineralization, percentage of Ca and P ratio were decreased by about 5.57 and 5.07% respectively. Percentage of F ratio was also decreased by about 0.01%, which was not statistically significant. 3. After remineralization, percentage of Ca, P increased about by 4.47 and 4.35% respectively. Percentage of F decreased by about 0.01%, which was not statistically significant. In conclusion, remineralized solution used in our study has the potential to induce the uptake the Ca and P into the pore sites of the demineralized enamel. But, in the oral cavity, there were rapid temperature change, organic matrix that inhibits the movement of the ions, and limitation of continuous contact with this remineralized solution. Therefore, further in vivo study is necessary.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

한국인에서 5-HT_(1Dβ) 유전자다형성과 성격 특성

김세주,김찬형,최낙경,홍현주,김성준,조대연,이홍식 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : Recently, there has been a growing enthusiasm in biological approach to personality ; the identification of genes responsible for particular personality traits. The aim of this study was to investigate the association between the 5-HT_(1Dβ) G861C polymorphism and personality traits. Methods : We recruited 218 normal subjects. The Korean version of the Temperament and Character Inventory (TCI) was used to assess personality traits. From blood samples taken from the subjects, DNA was isolated using standard techniques and the HT_(1Dβ) G861C polymorphism was genotyped by means of polymerase chain reaction and Homogeneous MassEXTEND method. We classified the subject into the GG, CG, and GG groups according to their genotypes. The differences in the temperament factors of the TCI between homozygote group (GG+CC genotype) and heterozygote group (CG genotype) weretested. Results : The heterozygote group had significantly lower Harm avoidance (HA) scores and higher Self-directedness scores(SD) than the homozygote group. Conclusion : In conclusion, we found some associations between the 5-HT_(1Dβ) G861C polymorphism and the personality dimension HA and SD in a normal population.

강박장애와 세로토닌 수송체 유전자다형성과의 관련성

김세주,김찬형,조대연,이홍식 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.1

Objectives : The definite cause of obsessive-compulsive disorder (OCD) is still unknown, Evidences from familial, twin and segregation studies support the role of a genetic factor. There also are growing evidences indicating that OCD has specific neurochemical and neuroanatomical basis. Derived from the effectiveness of serotonin reuptake inhibitors in OCD treatment, several candidate genes related to serotonin regulation have been hypothesized to play on important role in the development of OCD. One of them is the serotonin transporter gene. The aim of this study was to investigate the association between serotonin transporter gene and OCD. Methods : 124 OCD patients and 119 normal controls participated in this study. Genomic DNA was extracted from their blood. The genotypes and allele frequencies of the 5-HTTLPR polymorphism between OCD group and control group were compared.And we investigated the association between 4 factors derived from YBOCS checklists and 5-HTTLPR polymorphism. Results '. In this case-control study, we could not find any association between 5-HTRLPR polymorphism and development of OCD. In OCD group, patients with L (l/s+s/s) genotype had higher scores for the religious/somatic factor than those with S genotype. Conclusion : In this study, there was no difference in genotype distributions of 5-HTTLPR between OCD and control groups. But, L genotype of 5-HTTLPR polymorphism had negative effects on some factors of the obsessive-compulsive symptoms.

한국인에서 도파민 D4 수용체 다형성과 Novelty Seeking 성격 특성의 연관성

이헌정,이홍석,강화연,김린,이민수,서광윤,변영찬 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.4

연구목적 : 저자들은 한국인에서 도파민 D4 수용체(DRD4) 유전자의 다형성과 성격의 관련성을 알아보고자 본 연구를 시행하였다. 방 법 : 173명의 건강한 한국인 여자 청소년(13.88±0.29세)을 대상으로 하여 성격 기질 설문지(Temperament and Character Inventory : TCI)를 작성하도록 하였으며, 이들에서 DRD4 exon Ⅲ 48-bp VNTR(variable numbers of tandem repeats) 다형성을 분석하였다. 결 과 : DRD4 exon Ⅲ Vntr에서 긴 대립유전자(≥5 repeats)를 가진 군이 긴 대립유전자를 가지지 않은군에 비하여 Novelty Seeking 척도 점수가 유의하게 높았다(t=2.11,p=0.037). 결 론 : 본 연구 결과는 DRD4-exon Ⅲ의 긴 대립유전자가 Novelty Seeking 성격과 관련이 있다는 기존의 외국에서의 연구결과를 다시금 확인해주는 것이다. Objectives : We investigated the relationship of personality traits with dopamine D4 receptor(DRD4) exon Ⅲ polymorphism in a Korean population. Methods : We analysed DRD4 exon Ⅲ 48-bp repeats polymorphism in 173 Korean heakthy female adolescents(age=13.88±0.29years) who also completed Temperament and Charater Inventory(TCI). Results : Novelty seeking score of the TCI was significantly higher in the subjects with DRD4 long alleles(≥5 repeats) compares with the subjects without these (t=2.11, p=0.037). Conclusion : The present study supports the previous reports that long repeats of the DRD4-exon Ⅲ polymorphism are relatedwith Novelty Seeking personality.

민들레 추출액 농도에 따른 민들레 코팅쌀밥의 품질에 관한 연구

유경미,이연경,김세희,황인경,이부용,김성수,홍희도,김영찬 한국조리과학회 2005 한국식품조리과학회지 Vol.21 No.1

Washed rice was coated by spraying aqueous dandelion (Taraxacum officinale) extracts at 20, 30, 40 'Brix and dried at room temperature. The coating procedure was conducted 5 mL/min for 10min. Property changes in the dandelion coated rice and un-coated cooked rice were observed during 2 days of storage. Increasing the coating concentration was associated with lower color values (L, a value) and moisture contents. Sensory and texture properties generally decreased in the cooked rice coated with dandelion more than the control (non-coated rice). But, D-20(20 °Brix of the dandelion concentration) resulted in better textural properties and s ensnry scores for hardness and overall acceptability in cooked rice. Compared to the control, the washed rice roated with 20 °Brix for 0 and 2 days showed better quality in sensory activities, a lower gel consistency and better textural activities. It was concluded that the optimum coating ration of rice and added dandelion extract for cooking were 20 °Brix and 5% respectively, in proportion to the total weight of raw rice.

좌측흉수로 발현된 Boerhaave 증후군 1예

이준,변유미,조민근,조주연,원경준,김영대,박찬국,김만우,유재근,서홍주,이석기 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

구토 후 발생한 토혈을 주소로 내원한 환자에서 좌측 늑막 삼출 동반 시 식도 파열의 가능성을 고려하여 흉수 천자 및 지속적인 흉부 단순 촬영의 추적관찰이 필요하며 식도 파열이 배제된 후 환자의 생체 징후 및 토혈 양을 파악하여 내시경 검사 시기를 신중히 결정하는 것이 좋을 것으로 생각된다. 본 증례는 토혈을 주소로 내원하여 Mallory-Weiss 증후군 의심 하에 내시경을 통한 치료 시행 후 추적 관찰에 의해 진단된 Boerhaave 증후군을 경험하였기에 보고하는 바이다. Boerhaave's syndrome is a spontaneous perforation of the esophagus most commonly resulting from a sudden increase in intraesophageal pressure combined with negative intrathoracic pressure caused by straining or vomiting. Surgery should generally be performed within 24 hours because mortality approached 30 to 50 percent in which surgery was delayed. Therefore, early diagnosis and prompt surgical repair are critical for survival. We have experienced a case of Boerhaave's syndrome in a patient presenting with hematemesis with left pleural effusion without any signs or symptoms of pneumomediastinum or pneumothorax.