고위인지기능과 정신질환

이민수,김재진,Lee, Min-Soo,Kim, Jae-Jin 대한생물정신의학회 1997 생물정신의학 Vol.4 No.1

Higher cognitive functions refer to the highest level of human intellectual functioning, including concept formation, reasoning, and executive functions. The executive functions can be conceptualized as having four components : volition, planning, purposive action, and effective performance. Because higher cognitive functions represent the most advanced stages of intellectual development, they are often highly susceptible to the effects of brain injuries and mental disorders. The ability to perform effectively within the environment is determined in large part by an individual's adequacy in performing such higher-order functions. Especially executive functions are necessary for appropriate, socially responsible, and effectively self-serving adult conduct. Threfore, an assessment of the psychiatric patient's performance in these areas will provide useful diagnostic information, as well as information concerning social and vocational prognosis.

항우울제와 연관약물의 약물상호작용

이민수,Lee, Min Soo 대한생물정신의학회 2000 생물정신의학 Vol.7 No.1

As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. This review provides a better understanding of drug-drug interactions often encountered in pharmacotherapy of depression. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In this review, emphasis is placed on antidepressant medications, how they are metabolized by the P450 system, and how they alter the metabolism of other drugs. When prescribing antidepressant medications, the clinician must consider the drug-drug interactions that are potentially problematic.

삼풍 사고 생존자들에서 정신과적 증상의 심각도에 영향을 미치는 요인

이민수,차지현,곽동일,이준상,Lee, Min-Soo,Cha, Ji-Hyun,Kwak, Dong-Il,Lee, Joon-Sang 한국정신신체의학회 1996 정신신체의학 Vol.4 No.2

We studied the factors that would affect the severity of psychiatric symptoms of the Sampoong accident survivors. In this study, the analyzed factors are sex, age, marital status, educational level, loss of consciousness, witness of death, death of related person, duration until the rescue, duration of hospitalization, and psychiatric treatment after the accident. Although our study has some limitations, we found some factors that affect the severity of psychiatric symptoms after the severe traumatic accident.

항정신병 약물에 의한 백서 뇌에서의 c-fos 발현 : 할로페리돌과 클로자핀의 효과 비교

이민수,한창수,김정현,김영태,곽동일,Lee, Min Soo,Han, Chang Su,Kim, Jeung Hyun,Kim, Young Tae,Kwak, Dong Il 대한생물정신의학회 1996 생물정신의학 Vol.3 No.1

To investigate characteristic drug effects on the genetic basis, the authors administered haloperidol- the $D_2$ antagonist- and clozapine -the atypical antipsychotics with few extra- pyramidal side effects- to the rats. Then, we edobtain brain specimen from the striatum, prefrontal cortex, and cortical region and compared the degree of c-fos expression. The results are 1) haloperidol was found to produce a rapid and transient induction of dos mRNA expression in striatum as compared with cortex and prefrontal area. 2) clozapine was found to produce rapid induction of c-fos mRNA in striatum and prefrontal area. From these data, we can concluded that the mechanism of action of haloperidol is different from the mechanism of clozapine in gene expression.

폐렴사슬알균 수막염 환자에서 발생한 양안 내인성 안내염 1예

이민수,장무환,Min Soo Lee,Moo Hwan Chang 대한안과학회 2013 대한안과학회지 Vol.54 No.2

Purpose: To report a case of bilateral endogenous endophthalmitis in a Streptococcus pneumoniae meningitis patient. Case summary: A 45-year-old woman with bacterial meningitis was referred to the ophthalmologic clinic with acute visual impairment in both eyes. The patient`s visual acuities were hand motion in both eyes. Ophthalmoscopy revealed inflammation in the anterior chamber and vitreous opacities in both eyes. Streptococcus pneumoniae was isolated in the cerebrospinal fluid sample, but not in vitreal, blood samples. Vision improved to 70/100 in the right eye and 2/100 in the left eye after 8 days of treatment. Conclusions: Endogenous endophthalmitis constitutes a rare complication of Streptococcus pneumoniae meningitis, and a prompt diagnosis and administration of empirical intravitreal antibiotics can lead to a more favorable visual prognosis.

우세안과 비우세안의 망막신경섬유층 두께, 시신경유두 형태 비교

이민수,조경진,조우형,경성은,장무환.Min Soo Lee. MD. Kyong Jin Cho. MD. Woo Hyung Cho. MD. Sung Eun Kyung. MD. PhD.Moo Hwan Chang. MD. PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.5

Purpose: To investigate the comparison of retinal nerve fiber layer (RNFL) thickness and optic disc parameters measured by optical coherence tomography (Cirrus HD-OCT<sup>®) in dominant and non-dominant eyes. Methods: Seventy-one subjects without underlying ocular disease were recruited for the present study. Ocular dominance was determined using the hole-in-the-card test. Comprehensive standardized eye examinations were performed. Scans of the optic disc and RNFL were performed using OCT. Results: The mean intraocular pressure (IOP) of the dominant eye was higher than its counterpart (p = 0.025). No significant differences were observed in uncorrected visual acuity, refractive error and axial length between dominant and non-dominant eyes (p = 0.235, 0.180, 0.850). No RNFL and optic disc features were identified in the dominant from non-dominant eyes. Conclusions: Although dominant eyes tended to have higher IOP than non-dominant eyes, no consistent ocular structural differences between dominant and non-dominant eyes with the use of OCT were found.

Fluoxetine과 Haloperidol의 병합투여시 정신병리 및 추체외로 증상의 변화

이민수,한창수,김제원,원경식,곽동일,Lee, Min-Soo,Han, Chang-Su,Kim, Jae-Won,Won, Kyung-Sik,Kwak, Dong-Il 대한생물정신의학회 1997 생물정신의학 Vol.4 No.1

본 연구는 정신분열증 환자 38명을 대상으로 하여 haloperidol과 fluoxetine을 8주간 병합투여 하였고, PANSS, CGI, Simpson-Angus 척도를 투여전과 투여후 2, 4, 6, 8주에 시행하여 임상증상 및 추체외로 부작용을 평가하였다. 결과는 다음과 같다. 1) 8주간의 연구기간동안 양성, 음성증상의 유의한 변화가 없었다. 2) 8주의 연구기간동안 추체외로 부작용의 증가가 나타나지 않았다. 이는 기존 연구에서 fluoxetine에 의해 haloperidol의 혈중농도가 증가하여 효과 및 부작용이 증가한다는 연구보고와는 다르며, 이 결과는 haloperidol과 fluoxetine의 병합사용을 안전하게 할 수 있다는 것을 의미한다고 하겠다. Objectives : The authors have intended to know the drug interaction of fluoxetine and haloperidol when coadministering two drugs to the chronic schizophrenics by assessing the changes of positive, negative symptoms and extrapyramidal symptoms. Method : We selected 38 patients, the chronic schizophrenics with no physical problems. they are randomly assigned to placebo group and drug group. And then, placebo or fluoxetine 20mg were administered to the subjects of each group during 8 week period. We have assessed their psychopatholgy and extrapyramidal symptoms using Positive and Negative Syndrome Scale(PANSS), Clinical Global Impression(CGI), Simpson-Angus Scale at 0, 2, 4, 6, 8 week during the period. Results : 38 patients have completed the study during 8 weeks. 1) PANSS, CGI : no significant difference between groups and no significant change according to the times. 2) Simpson-Angus Scale : no significant changes. Conclusion : When co-administering fluoxetine and haloperidol, there were no significant changes of psychopathology and extrapyramidal symptoms. These results suggest that it is safe to coadminister fluoxetine to schizophrenic patients with haloperidol treatmemt.

Tofisopam과 lorazepam의 항불안효과와 안전성에 대한 비교 연구

이민수,김용구,곽동일,Lee, Min Soo,Kim, Yong-Ku,Kwak, Dong-Il 대한생물정신의학회 1997 생물정신의학 Vol.4 No.2

2,3-benzodiazepine계 항불안제인 tofisopam의 항불안 효과 및 안전성을 조사하기 위해 단일맹검 비교연구를 시행하였다. 외래로 내원한 불안 장애 환자 40명을 대상으로 무작위로 tofisopam군과 lorazepam군으로 할당하였으며, 최종 연구를 완결한 환자는 tofisopam군 17명(남자 7명, 여자 10명), lorazepam군은 15명(남자 6명, 여자 9명)이었다. 초기용량으로 tofisopam군은 50mg을 하루 3회 복용하고, lorazepam군은 0.75mg을 하루 2회 복용하도록 하였으며, 임상상태와 부작용에 따라 용량을 임의로 증감하도록 하였고, 일일 최대 용량은 tofisopam군 300mg, lorazepam군 3mg으로 하였다. 임상상태에 대한 평가는 Hamilton rating scale for anxiety(HAM-A)와 Clinical global impression(CGI)으로 하였으며, 약물 투여전과 투여 1주후, 2주후, 4주후에 측정되었다. 결과는 다음과 같다. 1) HAM-A 총점수의 경우, 약물 치료군과 시점을 변인으로 한 two-way repeated-measure ANOVA에서 양군간에 시점에 따른 유의한 차이는 없었다. HAM-A 심리적 불안과 신체적 불안아척도 점수에서 양군간 시점에 따른 유의한 차이는 없었다. 각 군에서 HAM-A 총점수의 시점에 따른 유의한 변화를 나타내었으며, 양군 모두 1주후부터 유의한 감소를 나타내었다. 2) CGI의 질병의 전반적인 심각도에서 약물 치료군과 시점을 변인으로 한 two-way repeated-measure ANOVA에서 양군간에 시점에 따른 유의한 차이는 없었다. 각 군에서 CGI 심각도의 시점에 따른 유의한 변화를 나타내었으며, tofisopam군은 1주후부터 lorazepam군은 4주후부터 유의한 감소를 나타내었다. CGI 호전도에선 각 시점에서"minimally improved"이상을 보인 환자군이 tofisopam군이 94.1%로서 lorazepam군 66.7% 보다 높았다. 3) 안전성 분석에서 각 군에서 생명징후, 혈액학, 생화학, 심전도, 체중에서 유의한 변화를 보이지 않았다. 4) 부작용 면에서 tofisopam군이 lorazepam군보다 각 시점에서 부작용을 호소한 환자수가 적었다. 이상에서 tofisopam은 lorazepam과 유사한 항불안효과를 보였으며, 내약성은 lorazepam에 비해 우수하였다. Objective : A 4-week, single-blind, parallel group study was conducted to evaluate the efficacy and safety of tofisopam and lorazepam in 32 outpatients with anxiety disorder. Methods : Patients were randomized to receive either tofisopam(N=17) or lorazepam(N=15). The starting dose of tofisopam was 50mg t.i.d. daily, which could be increased to a maximum of 100mg t.i.d. according to the patient's clinical response and side effect. The starting dose of lorazepam was 0.75mg b.i.d. daily, which could be increased to a maximum of 1.5mg b.i.d. depending on the patient's clinical response and side effect. Efficacy evaluations at baseline, week 1, 2, and 4 used the 14-item Hamilton Rating Scale for Anxiety(HAM-A) and Clinical Global Impression(CGI). Tolerability was assessed by response to a nonleading question concerning adverse events. Laboratory parameters including vital sign, EKG, hematological, and biochemical values were measured during trial. Results : No significant differences between HAM-A total scores, two HAM-A factors(psychic, somatic) and CGI severity scores were recorded at any point during tofisopam and lorazepam treatments. However, in each group there was a significant decrease in HAM-A total scores, two HAM-A factor s(psychic, somatic), CGI severity scores over time. The pecentages of patients with tofisopam who at least minimally improved increased from 64.7% at week 1 to 94.1% at week 4. The pecentages of patients with lorazepam who at least minimally improved increased from 40.0% at week 1 to 66.7% at week 4. The pecentages of patients with tofisopam who had not any adverse event increased from 58.8% at week 1 to 87.9% at week 4. The pecentages of patients with lorazepam who had not any adverse event were not changed from 46.7% at week 1 to 46.7% at week 4. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial in both groups. Conclusion : These data suggest that tofisopam may be effective in reducing anxiety and is a anti-anxiety drug of identical potency with lorazepam. Tolerability of tofisopam was superior to lorazepam. These findings should be confirmed by using double-blind crossover study with a large member of patients.

중력금형주조에서 기공량에 미치는 경동속도 및 경동각도의 영향

이민수,김기영,김성우 ( Min Soo Lee,Ki Young Kim,Sung Woo Kim ) 한국주조공학회 1994 한국주조공학회지 Vol.14 No.4

N/A Gas is prone to be entrapped in the casting resulting from the reaction of molten metal with mold coating material and resin hardened sand cores during filling in gravity diecasting of aluminum alloys with complex shape. Tilted pouring is known to be one of the method to eliminate the gas defect, in which tilting speed and angle are important as operation variables. Transparent water model was employed to observe the gas entrapment and liberation during pouring of complex shaped casting in this study. As a result, slow tilting combined with movable pouring ladle is recommended to evolute gas effectively in gravity diecasting.

만성 정신분열증환자에 대한 Sertraline병합치료 효과

이민수,김용구,이상규,서광윤,Lee, Min-Soo,Kim, Yong-Ku,Lee, Sang-Kyu,Suh, Kwang-Yoon 대한생물정신의학회 1997 생물정신의학 Vol.4 No.1

Objective : To evaluate the clinical efficacy of adjuvant sertraline treatment in chronic schizophrenic patients, we carried out a double-blind, placebo controlled study. Method : Thirty six inpatients who fulfilled DSM-III-R criteria for chronic schizophrenia were randomly assigned to sertraline and placebo groups in a double-blinded fashion. A history of at least 2 years of illness and at least six months of hospitalization were prerequisities for inclusion in the study. Patients were received sertraline 50mg or placebo for 8 weeks in addition to their routine haloperidol regimen. Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression(CGI), Simpson-Angus Scale(S-A) were evaluated at 5 points ; baseline, 2, 4, 6, and 8 weeks of treatment. Results : The groups were controlled for age, gender, and length of illness. There were no significant differences in three PANSS factros(positive, negative, general), CGI, and S-A scale scores at any between sertaline and placebo treatment. Conclusion : This placebo controlled study showed no significant effects of sertraline on negative and positive symptoms in chronic schizophrenic patients.