만성 간성 뇌 증상 환자에서 Neomycin 과 Lactulose 의 효과에 관한 비교

김정룡 ( Chung Yong Kim ),임정순 ( Jung Soon Im ),이정균 ( Jung Kyoon Lee ) 대한내과학회 1980 대한내과학회지 Vol.23 No.5

정신분열증환자의 연성 신경학적 증상과 임상변인과의 관련성

채정호,함웅,이정균,Chae, Jeong-Ho,Habm, Woong,Lee, Chung-Kyoon 대한생물정신의학회 1995 생물정신의학 Vol.2 No.1

This study was performed to know the relationship between neurologic soft signs (NSS) and clinical variables such as psychopathology. history of illness, and premorbid social adjustment in patients with schizophrenia. The authors evaluated NSS in 31 patients with schizophrenia using the structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale- Korean Version(NES-K). Relationships between NSS and clinical variables such as duration of illness, intensity of precipitating stressors, duration of outpatient treatment, schooling, peer relationship, total duration of unemployment, total days of psychiatric admission, age, total days of being medicated, age at the first psychiatric admission, frequency of admissions, content of treatment, social adjustment, and severity of symptoms were analyzed. Differences between paranoid and non-paranoid schizophrenics were examined. In addition, Differences between patients with schizophrenia who have predominant positive symptoms and who have predominant negative symptoms were examined too. Total scores of NES-K were correlated with lower schooling (${\gamma}$=0.44, p<0.01). Scores of motor coordination subcategory were correlated with poor peer relationship(${\gamma}$=0.67, p<0.001). Other clinical variables were not correlated with any scores of NES-K. Paranoid and non-paranoid schizophrenics were not different in scores of NES-K. Also positive and negative schizophrenics were not different in scores of NES-K. Most clinical variables except schooling and peer relationship were not related with NSS. This results indicated that the meaning of these signs was not fully be understood. Introduction of the new classification concepts such as deficit or non-deficit syndrome will be helpful to elucidate the meaning of NSS in patients with schizophrenia.

흰쥐에서 혈청 (血淸) Fructose - 1 , 6 - Diphosphatase 측정에 의한 문맥주위 (門脈周圍) 및 간소엽중심부 (肝小葉中心部) 괴사의 (壞死) 판별

이효석(Hyo Suk Lee),이정균(Chung Kyoon Lee),깅정룡(Chung Yong Kim) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.2

N/A In order to test the hypothesis that periportal(acinar zone 1) and pericentral(acinar zone 3) necrosis can be differentiated by measurement of serum fructose-l, 6-diphosphatase (FDP) which has been reported to be predominanely distributed in the periportal zone of the acinus, the enzyme was assayed in serum during periportal necrosis induced by allyl alcohol(0.62m mole/kg, dissolved in 0.9% NaCl Itraperitoreally) and during pericentral necrosis by bromobenzene(3.80m mole/kg, dissolved in corn oil, intraperitoneally), and the activities were compared in two conditions. Serum FDP activities in normal saline control, allyl alcohol-treated normal histologic finding, minimal, moderate and severe periportal necrosis groups were 0.005+-0.018, 0.048+-0.018,0.090+-0.009,0.113+-0.029 and 0.140+-0.010 unit/ml, respectively. The levels in moderate and severe periportal recros group were significantly(p<p.01) elevated in comparison with those of normal control. Serum FDP activities in normal corn oil control, bromobenzene treated normal histologic finding, minimal, moderate and severe pericentral necrosis groups were 0.056+-0.014, 0.048+-0.014. 0.059+-0.021, 0.078+-0.021 and 0.124+-0.12 unit/ml, respectively, and it showed that the levels in minimal and moderate necrosis groups were nearly the same as those in normal control, and only those in group of severe necrosis showed significant (p<0.0l) elevation. The ALT and FDP activities between two groups have significantly correlated (r=0.665, r = 0.724), but the regression equation that is y=0.0085 x+0.069 or y=0.01 x +0.04 respectively, was significantly different. These results indicated that at least experimental necrosis of the periportal and perice- ntra! Zones in the rats can be differentiated by measurement of serum FDP. And it was suggested that simultaneous measurements of either serum beta-hydroxybutyric dehydrogenase or pyruvate kinase which was reported to be predominantly distr ibuted at the pericentral zone would help to differentiate more precisely.

정신분열증에서의 연성 신경학적 증상과 항정신병 약물 치료의 관련성

채정호,정찬호,함웅,이규항,이정균,Chae, Jeong-Ho,Chung, Chan-Ho,Hahm, Woong,Lee, Kyu-Hang,Lee, Chung-Kyoon 대한생물정신의학회 1994 생물정신의학 Vol.1 No.1

정신분열증 환자에서 연성 신경학적 증상이 많이 나타나는 것은 많은 연구에서 확인된 바 있으나 이것이 항정신병 약물 복용 등에 의하여 발생하는 부수적인 현상일 가능성이 배제되지 않고 있다. 본 연구는 항정신병 약물 복용군과 비복용군간의 연성 신경학적 증상 발현의 차이를 알아보고자 시도되었다. 항정신병 약물을 전혀 복용하지 않은 28명과 현재 항정신병 약물로 치료 중에 있는 31명의 정신분열증 환자에서 연성 신경학적 증상을 구조화된 평가척도인 한국어판 신경학적 평가척도로 조사하였고 약물용량과 투여기간 및 부작용과의 관계도 알아보았다. 항정신병 약물 비복용군의 신경학적 평가척도의 총점은 $27.14{\pm}5.66$점으로 복용군의 $19.58{\pm}6.55$점보다 유의하게 높았다 (t=-4.76, P<0.001). 하위 기능영역 중에서도 운동조정(t=-5.52, P<0.001), 복합운동활동 순서화(t=-2.20, P<0.05), 기타 항목(t=-5.14, P<0.001)등의 점수는 비복용군에서 높았다. 감각통합 영역은 약물 복용군과 비복용군 사이에 유의한 차이가 없었다. 약물 용량, 연령, 성별 등을 통제한 후의 조사에서는 총점(F=11.13, P=0.00), 운동조정(F=28.46, P=0.00), 기타 항목(F=10.79, P=0.00)등은 약물 비복용군에서 높았으나 복합운동활동 순서화는 이들 공변량의 영향을 받아 약물 복용군과 비복용군사이에 유의한 차이가 없었다. 약물 복용군에서 현재의 항정신병 약물 복용량은 신경학적 평가척도 점수 중 운동 조정 영역과만 유의한 상관성을 보였으며 약물 복용기간, 부작용 등은 연성 신경학적 증상과 상관성이 없었다. 위와 같은 결과로 항정신병 약물은 정신분열증의 신경학적 증상 발현에 상대적인 영향만을 준다고 할 수 있었으며 연성 신경학적 증상이 정신분열증의 주요한 형질 표지자의 하나가 될 가능성이 있다고 하겠다. 또한 향후 보다 통제된 집단에서의 추적연구가 필요할 것으로 생각되었다. This study was performed to examine the role of neuroleptics may in the development of neurologic soft signs in patients with schizophrenia. Neurologic soft signs were evaluated in 28 neuroleptic naive patients with schizophrenia or schizophreniform disorder and 31 neuroleptic non-naive patients with schizophrenia using a structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale-Korean version(NES-K). Relationship to dose, duration and neurological side effects of neuroleptic treatment were also evaluated. Total scores of NES-K in neuroleptic naive group were significantly higher than those of non-naive group. Scores of motor coordination, sequencing of complex motor acts and others items in functional subcategories were also significantly higher in drug-naive patients. The sensory integration item was not different between two groups. After controlling covariates such ac dose of neuroleptics, age and sex, total scores, motor coordination and others items of NES-K were significantly higher in neuroleptic naive group. However there was no difference between drug naive and non-naive group in the sequencing of complex motor acts item due to effects of these covariates. In neuroleptic non-naive group the dosage of neuroleptics correlated with the motor coordination item, nor were there relationships between duration and side effects of neuroleptic treatment and neurologic soft signs. These findings suggest that neuroleptic treatment may play a only relative role in the development of neurologic soft signs in patients with schizophrenia and these abnormalities may be one of possible trait markers of schizophrenia. To elucidate this opinion, well-controlled, prospective study in same subjects will be helpful.

감마나이프 방사선수술 후 발생한 급속 순환성 이차성 조증 1예

정찬호,채정호,김임렬,이정균,이규항,Chung, Chan-Ho,Chae, Jeong-Ho,Kim, Im-Ryol,Lee, Chung-Kyoon,Lee, Kyu-Hang 대한생물정신의학회 1996 생물정신의학 Vol.3 No.2

A case of rapid cycling mania secondary to gamma-knife radiosurgery for the treatment of refractory epilepsy was reported. A 21-year old woman who had a gamma-knife radiosurgical operation for the treatment of refractory seizure two years ago was admitted because of manic episodes. Although seizure was relieved, manic symptoms like decreased need for sleep, elated mood, unprovoked laughing, grandiose delusion and bizarre behaviors were developed 11 months after the operation. These symptoms recurred lour rimes for eight months. There were no past personal and family history of mood disorders. Laboratory examinations including electroencephalogram ana endocrinological study did not show any abnormal findings. The rapid cycling secondary manic was relieved by lithium. She was then discharged after 5 months. Mood change was not significant during follow-up while hypomania emerged by dose reduction. The secondary mania seemed to be caused or triggered by the right temporal lobe damage induced by gamma-knife radiosurgery.

韓國人의 身體症狀에 關한 疫學的 硏究

李定均,崔鎭沃,韓辰熙 大韓神經精神醫學會 1986 신경정신의학 Vol.25 No.1

Despite of low prevalence rate of somatization disorder by 'DIS-Ⅲ Korean Version'(0.03% in Seoul. 0.2% in Rural area), many patients with somatic complaints have wanted psychiatric help. To explor the characteristics of somatic symptoms in general population the author, analysed 5,147 epidemiologic data of DIS-ⅢA Korean Version on somatization in detail(3,163 in Seoul and 1984 in rural area). The results were as follows. 1) Females had more somatic symptoms than males. The average numbers of symptoms were 1.75 in females and 0.72 in males. 2) The order age group had more symptoms than the younger age group. The average numbers of symptoms were 0.78 in age, 18-24, 1.14 in 25-44, and 1.60 in 45-65. 3) The average number of symptoms in rural area(1.52) was higher than that in Seoul(1.09). Especially, sickly, pain and cardiopulmonary symptoms were significantly higher in rural area. 4) The most frequent symptoms were headache, pain and cardiopulmonary symptoms had higher frequency relatively. 5) The proportion of the sujbect, havig 5 or more symptoms(risk group) was 6.8% of all population and that of higher risk group(having 10 or more symptoms) was 1.1% As the number of symptoms increased, female was more prevailing. 6) Comparing the education level between the risk group and fewer symptom group, the members of risk group had more low educational experience and those of fewer group had more high educational experience. 7) Comparing the occupational distribution between two groups, risk group was significantly prevailing in unemployer and had lower rate in clerical and related workers. 8) In risk group, sex difference of each symptoms was not revealed. The diference among three age groups was noticed in some symptom categories. In 'sickly' symptom, the older age group was significantly more prevailing than the younger age group. The symptoms of gastrointestinal and female-reproductive system had a tendency to decrease in older age group.

알코올중독 환자의 예후 예측에 관한 연구(Ⅱ) : 가족력 및 DRD₂와의 관계를 중심으로

성상경,차성조,이규항,이정균 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.6

알코올중독 환자의 예후인자를 알아보기 위해 나이와 성별을 통제하여 음주군과 단주군 남자환자 각각 30명을 대상으로 비교 연구하였다. 양군간의 인구통계학적 특성, 음주력, 가족력, 자아강도 등의 차이 및 도파민 D2수용체 유전자 분포를 비교하였으며, 질병경과, 가족력 및 도파민 D2수용체 유전자와의 관련성을 알아보았다. 그 결과는 다음과 같다. 1) 단주군은 음주군에 비해 기혼율이 높았으며, 높은 경제상태, 높은 학력 등이 중요한 요소였으나 직업의 종류 및 종교에 있어서는 차이가 없었다. 2) 단주군은 음주군에 비해 과거 음주력상 최대 단주기간이 길었으나 평균 음주량이 더 많았다. 또한 음주군은 단주군에 비해 사회경제적 스트레스 및 정신적 불안정이 주된 음주 이유인 경우가 많았으나 음주기간, 음주양상, 음주시기, 음주시작 연령, 술의 종류에 있어서는 차이가 없었다. 3) 알코올중독의 가족력에 따른 비교에서 단주군과 음주군 사이에 유의한 차이는 없었다. 4) 단주군은 음주군에 비해 자아강도의 평균점수가 더 높았다. 5) 도파민 D2수용체 유전자의 A1 대립유전자 비교에서 단주군에서 A1 대립유전자의 이환율은 70%, 음주군에서는 60%였다. A1 대립유전자의 빈도는 각각 0.38과 0.42로 양군간에 차이는 없었다. 6) 알코올중독 가족력에 따른 도파민 D2 수용체 유전자분포 비교에서 가족력이 있는 군에 A1 대립유전자의 이환율은 70%, 빈도는 0.43이었고, 가족력이 없는 군에서는 이환율이 61%, 빈도는 0.38로 양군간에 유의한 차이는 없었다. 가족력이 있는 경우에 음주시작의 연령이 더 낮았으며 문제음주도 보다 일찍 나타났다. 그러나 평균 음주기간은 가족력이 없는 경우에 더 길었으며, 평균 음주량, 최고 단주기간 및 NAST 비교에서는 차이가 없었다. 결론적으로 알코올중독 환자의 긍정적 예후인자로 기혼, 높은 학력 및 경제상태, 과거 음주력상 보다 긴 단주 기간 및 강한 자아강도를 들 수 있었다. 반면에 직업, 종교, 알코올중독 가족력 유무, 음주기간, 음주양상, 음주시작 연령, 술의 종류 및 도파민 D2수용체 유전자 A1 대립유전자 분포 등에서는 알코올중독의 예후의 의미 있는 상관관계가 없었다. Objectives : The purpose of the study was to identify the prognosis-predicting indicators is alcoholics by the correlation between prognosis and demographic characteristics, ego strength, family history and distribution of dopamine D2 receptor gene A1 allele. Methods : The subjects were composed of 60 alcoholics including 30 psychiatric inpatients(drinking group) and 30 alcoholics abstinent for 6 months or more after discharge(abstinent group). They were investigated with interview, questionnaire, blood sample and review of their charts. Results : The results were as follows ; 1) The abstinent group had higher rate of married state, higher economic status and longer education years than the drinking group. There were no differences in occupation and religion between the two groups. 2) There were no differences between the abstinent group and drinking group according to alcoholic family history. 3) The abstinent group had higher mean score in ego strength scale than the drinking group. 4) In comparision of dopamine D2 receptor gene A1 allele, the prevalence of A1 allele was seventy percent and the frequency was 0.38 in the abstinent group. The prevalence of A1 allele was sixty percent and the frequency was 0.42 in the drinking group. Both groups were not significantly different in A1 allele prevalence and frequency. 5) In comparision of dopamine D2 receptor gene A1 allele according to alcoholic family history, the prevalence of A1 allele was seventy percent and the frequency was 0.43 in the family history positive group. The prevalence of A1 allele was sixty-one percent and the frequency was 0.38 in the family history negative group. Both groups were not significantly different in A1 allele prevalence and frequency. Conclusions : With the above results, the authors think that successful prognostic indicators of alcoholics are married state, higher economic status, longer education years, longer abstinenence period in past history, and strong ego strength. But family history and distribution of dopamine D2 receptor A1 allele were not significantly related to the prognositc indicators of alcoholics.

정신분열병 환자의 계절별 출생에 관한 예비적 연구

황광민,이정균 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.3

We collected data from the psychiatric inpatient records of Seoul National University Hospital to test the hypothesis that schizophrenic patients are born in winter more frequently than would be expected by chance. Three hundreds and eighteen records of schizophrenic patients were reviewed and the results were as follow ; 1) No evidence of seasonal variation of birth for schizophrenic patients was found. 2) Season of birth was unrelated to the sex of the patient, birth order, clinical subtypes, diagnostic cirteria, marital status, birth place, social class, age on the first admission, total duration of admission, or family history.

精神分裂病의 5年 追跡調査 : 後向性 硏究 Retrospective Study

李定均,金容植,崔珍淑 大韓神經精神醫學會 1987 신경정신의학 Vol.26 No.4

To explore the possible factors affecting the course of schizophrenia and to clarify some questions on the nature of schizophrenia, a structured retrospective study was carried out to 142 patients (male 74, female 68) discharged from psychiatric department of Seoul National University Hospital during July, 1st 1981 - June, 30th 1982. The study group consisted of 97 patients diagnosed as schizophrenia according to DSM-Ⅲ and 45 controls, who met the following screening criterias, i.e., ⅰ) between the ages of 16 and 65, ⅱ) no evidence of organic, drug related or alcoholdisorder, iii) psychotic symptoms not due to any other mental disorders, such as manic episode, or atypical psychosis, or factitious disorder, etc. The data at index discharge were obtained from clinical records and filled up by one of researchers. Five year follow-up assessment was performed by 4 trained medical students, blind to clinical records, from Jan, 20th through Feb, 28th 1987. Among them 78 patients (male 40, female 38) were able to be traced and successfully interviewed. The average duration of follow-up was 62.2±7.2months(mean±S.D.). To investigate the prognostic significance and specific relations between predictors and outcome variables, 49 predictor variables were chosen from clinical records and 18 outcome variables were selected and grouped by 5-outcome dimensions. Outcome variables were length of rehospitalization during follow-up period, rehospitalization during the last one year, quality of social contact during the last one year, deterioration of work performance during the last one year, severity of psychopathology during the last one year. Results demonstrated some differences between schizophrenia and control groups in clinical records and follow-up assessments. Schizophrenia group definitely showed poorer outcomes than control group. Correlations of individual predictor variables with outcome were calculated, although significant statistically (P<0.05) were modest in their magnitude. Multiple regression analysis of the presenting predictor variables to the outcome dimensions showed correlation .29 -.77, thus explaining statistically about 8-59% of the outcome variance in schziophrenia group. Among them some predictor variables, i.e, work performance during the last one year, social contacts during the last one year, etc, presented high correlations with these outcome variables. Intercorrelations among the 5 outcome dimensions for schizophrenia group were calculated, dimensions correlated each other to a minimal or moderate degrees. Among them social contact correlated highly with individual outcome dimensions.

"Emotional Blunting Scale"의 臨床的인 有用性에 對한 硏究

李定均,曺洙哲 최신의학사 1983 最新醫學 Vol.26 No.6