정신분열병 입원 환자에서 단축형 증상관리 훈련의 효과:예비적 연구

최충식,채정호,우동원,최영희,함웅,이규항,장미화 대한신경정신의학회 2001 신경정신의학 Vol.40 No.1

연구목적: 정신분열병 환자에서의 재활치료는 개인의 극복 기술과 능력을 향상시키고 재발을 유발시킬 수 있는 스트레스의 부정적인 영향을 중화시킴으로써 질병의 만성화를 막고 사회기능을 호전시킬 수 있기에 점차 그 중요성이 대두되고 있다. 본 연구는 만성 정신분열병 입원 환자에서 재활치료의 하나인 단축형 증상관리 훈련이 정신장애에 대한 자기 인식에 미치는 효능을 알아보기 위하여 시행되었다. 방법: 정신분열병으로 진단받고 입원 중인 환자들에게 재발경고징후를 규명하는 것, 재발경고징후를 관리하는 것, 지속증상을 극복하는 것, 술과 불법 약물을 피하는 것 등으로 구성된 승인-UCLA 사회기술 및 독립적인 생활기술훈련 단위 중 증상관리단위를 기초로 한국실정에 맞게 축약한 증산관리 훈련을 주 1회, 60분씩, 4∼5주간 실시하였고 실시 전후에 전신장애 비인식 평가 척도(Scale to Assess Unawareness ofMental Disorder; 이하 SUMD)로 자신의 정신장애에 대한 인식을 평가하였으며 임상적 전반적 인상(Clinical Global Impression;이하 CGI)로 임상 상태를 조사하였고 각 인구학적 변인들을 조사하였다. 결과: 환자 30명이 훈련을 완수하였으며 이들의 평균 연령은 36.6±7.6세였고 남자가 14명(46.7%), 여자가16명(53.3%)이었다. SUMD 점수는 훈련 전 16.9±4.0점에서 훈련 후 12.9±4.2점으로 유의하게 줄어 정신장애에 대한 자기 인식 정도가 향상되었으며(p<0.01), CGI도 훈련전의 3.7±0.9점에서 훈련 후 2.8±0.8점으로 유의하게 호전되었다(p<0.01). 환자의 연령, 발병시 연령, 유병 기간, 입원 기간, 항정신병약물 사용 용량, 교육 정도, CGI로 평가한 임상 상태등은 정신장애의 자기 인식 정도와는 관련성이 없었다. 결론: 정신분열병 입원 환자에서 단축형 증상관리 훈련은 정신장애에 대한 자기 인식을 증가시킬 수 있는 방법이 될 가능성을 확인하였으며 이 방법이 정신분열병 재활치료의 중요한 요소가 될 수 있음을 알 수 있었다. Objectives : The purpose of this study was to examine whether Symptom Management Module-Korean Brief Version(SMM-B) is effective as a psychosocial treatment of the inpat-ients with chronic schizophrenia. We also questioned which of demographic and clinical characteristics could be predictors of differential treatment response. Methods : The subjects were composed of 30 inpatients with chronic schizophrenia, who were trained with weekly session of SMM-B for 5 weeks. Before and after the training, the level of psychopathology, knowledge about schizophrenia were assessed as dependent variables by using Clinical Global Impression(CGI) and Scale to Assess Unawareness of Mental Disorder(SUMD). Results : Overall, patients showed improvement over the treatment period on psychopath-ology as well as knowledge about psychosis. Total scores of SUMD were changed from 16.9±4.0 before training to 12.9±4.2 after training(p<0.01) and scores of CGI were improved from 3.7±0.9 to 2.8±0.8<p<0.01). Howver age, gender, years of education, age of onset, duration of illness, duration of admission, numbers of psychiatric admission, and clinical status evaluated by CGI were not correlated with unawareness of psychosis. Conclusion : These results suggest that SMM-B could be a reliable method to improve self-aw-areness of psychosis in patients whth chronic schizophrenia and one of important elements in rehabilitation.

응급의료센터에서 신경색의 조기진단

최경호,오동렬,이원재,박규남,박승현,황두영,김형국,정시경,김영민,김세경 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

To evaluate appropriate diagnostic studies for renal infartion in emergency medical center, we analysed 33 patients of renal infarction treated in this hospital for last 8 years. Eleven patients, 4 trauma associated and 7 aortic disease associated patients were excluded. They are 11 males and 11 females with a mean age of 51 years. Fourteen came to the emergency medical center and seven came to the outpatient department, in the other one patient renal infarction was developed during hospitalization with other disease. On their past history they had hypertension in 9, valvular heart disease in 5, and diabetic mellitus in 4 patients. Abdominal or flank pain was noted in 17 of 22(77%). The other symptoms were vomiting, nausea, fever and so on. On microscopic examination of initial urine in hospital, 5 patients showed more than 10 red blood cells by high power field examination. The mean lactic dehydrogenase level was 1,239 I.U/L(normal range 218-472 I.U/L), while the mean aspartate aminotransferase and mean alanine aminotransferase were 51 I.U/L(normal range 13-36 I.U/L) and 44 I.U/L(normal range 5-33 I.U/L). Abdominal ultrasonography showed positive findings in 5 of 16(31%), of which 3 were confirmed by Doppler ultrasonography. In 18, computed tomography was done and all those showed positive findings of renal infarction(100%). In conclusion, it is important that identify the elevated lactic dehdrogenase level in case of any suspicion about renal infarction and confirm by computed tomography.

흰쥐에서 심정지후 Pentoxifylline이 뇌의 허혈-재관류 손상에 미치는 효과

정시경,김영민,오동렬,최경호,박승현,이운정,박규남,유은영,이원재,김세경 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: Two major events occurring in the cerebral hemodynamics after successful resuscitation from cardiac arrest are reactive hyperemia and postischemic hypoperfusion. In this study, we examined the effect of Pentoxifylline(PTX) on the rat brain following cardiac arrest. Methods: Fourteen rats were anesthetized and artificially ventilated. Cardiac arrest was produced by chest compression and clamping of tracheal tube for 3 minutes in ketamine anesthetized rats. Circulation was restored by standard cardiopulmonary resuscitation methods. In 7 rats, PTX 10mg/kg was infused at 10min after cardiac arrest(PTX group). In the other 7 rats, same amount of normal saline was infused(control group). Results: In both groups, hemodynamic variables, neurologic deficit(ND) score and histopathologic findings of hippocampal CA1 neurons were observed. Hemodynamic variables and ND score were not significantly different between two groups. Delayed ischemic neurons of hippocampal CA1 were decreased in PTX group(2.2±2.4%) compared with control group(9.1±1.2%). Conclusions: We conclude that PTX prevented development of delayed ischemic neurons in hippocampal CA1 after cardiac arrest. PTX may be useful in emergency situations following cardiac arrest.

선형 최적제어 관측기와 연관된 다항식 급수분석(Ⅰ)

최규정,車仁洙 조선대학교 기초과학연구소 1989 自然科學硏究 Vol.12 No.1

In this paper, a reduced-order compensatory observer can be effectively used to dicrease the gap between original states and observed states. The three polynomial expression (ie. Legendre, Laguerre, Talyor series) were used to approach the reduced-order compensatory observer states. The results of this study show that expansion coefficients truncated the first to the third term and that they are efficient enough to calculate errors in the original and observed states.

정밀부품 및 기기에 대한 환경시험기술

최만용,박정학,윤규택 한국비파괴검사학회 2001 한국비파괴검사학회지 Vol.21 No.6

정밀부품이나 기기는 개발과정이나 완료단계에서 부적절한 설계에 의하여 발생할지도 모르는 잠재적인 결함을 방지하기 위하여 시험평가를 실시하게 된다. 본 논문에서는 신뢰성 기술 분야의 기초가 되는 환경시험기술을 소개 하였으며 엔코더, 교통신호제어기, 계측기기 및 위성항법 수신기 등 제품단위의 대상품에 대한 시험조건 및 방법 등을 기술하고 시험사례를 보고하였다. 이러한 사례를 통하여 제품의 신뢰성 향상을 위한 복합환경시험의 중요성을 강조하였고 최근 환경시험기술에 대한 인식이 날로 증대되면서 시험기술자 양성, 지그설계기술 그리고 고장해석 및 대책기술의 확보가 매우 필요함을 제안하였다. Precision parts and instruments are tested to evaluate performance in development-process and product-step to prement a potential defect due to a failure design. In this paper, Environmental test technology, which is the basis of reliability analysis, is introduced with examples of test criterion, test method for products, encoder and traffic signal controller, and measuring instruments. Recently, as the importance of the environmental test technology is recognized, It is proposed that tranining of test technician and technology of jig design and failure analysis are very essential.

신사구체 경변증을 나타내는 FGS/NgaKist mice 간장에서 사이토크롬 P4501A1/2 단백질 발현

정규식,현병화,이철호,박상준,최양규,류시윤,이차수,민병길 대한해부학회 1997 Anatomy & Cell Biology Vol.30 No.2

결핵균 단세포군항체에 의한 항산균항원의 면역화학적 분석에 관한 연구

최대경,백태현,박정규,김화중 충남대학교부설 생명공학연구소 1991 생물공학연구지 Vol.1 No.-

β-antigen is one of the major protein of Mycobacterium tuberculosis. We purified reference β-antigen from the unheated culture filtrate of Mycobacterium tuberculosis by serial ammonium sulfate precipitation, gel filtration on Sephacryl S-200 column and preparative polyacryamide gel electrophoresis. Nine monoclonal antibodies against β-antigen were produced by hybridoma technique. The nine monoclonal antibodies were divided into two groups according to their reaction patterns on Western blots. Four monoclonal antibodies(group Ⅰ) reacted with two major bands of 83 and 52 kDa, and two minor bands of 110 and 56 kDa molecules while the other five monoclonal antibodies(group Ⅱ) reacted with a major band of 83 kDa and a minor and of 110 kDa molecule. The interspecies reactivities of nine monoclonal antibodies on the sonicated antigens from 21 species of mycobacteria were also examined by dot blots. Two monoclonal antibodies, designated 4G5E10(group Ⅰ) and 5F3F2(group Ⅱ), showed a specificity restricted to Mycobacterium tuberculosis complex. β-antigien from the cell extract of Mycobacterium tuberculosis was purified by affinity chromatography with 5F3F2 monoclonal antibody and checked its molecular characterization. Affinity purified β-antigen showed two distinct bands of 83 and 52 kDa molecules on SDS-PAGE. These results indicating that β-antigen is a associated protein with molecular weights of 83 and 52 kDa, and contains at least two different specific epitopes for Mycobacterium tuberculosis complex on β- antigen molecules. Affinity purified and reference β- antigens were applied for its potential diagnostic utility for determination of LgG antibody in the cerebrospinal fluids and sera of tuberculosis patients by ELISA. The mean ELISA values of IgG antibody activities to affinity purified β-antigen at the CSF dilution of 1 : 5 were 0.866±0.607 in 12 patients with tuberculous meningitis and 0.058±0.040 in 24 controls(P<0.001). The mean ELISA values of IgG antibody activities to reference β-antigen at the serum dilution of 1 : 100 were 0.861±0.350 in 97 patients with minimal tuberculosis, 1.052±0.443 in 51 patients with moderately advanced, 1.381±0.396 in 49 patients with far advanced and 0.454±0.248 in 138 controls(P<0.01). An indirect sandwich ELISA using specific biotinylated 5F3F2 monoclonal antibody as tracer was designed to detect β-antigen in the culture filtrate of Mycobacterium tuberculosis and sputum samples from patients with pulmonary tuberculosis. The detection limit of indirect sandwich ELISA was 0.1㎍ culture filtrate/㎖. The mean ELISA values of β-antigen reactivities in sputum samples from 52 patients with pulmonary tuberculosis and 25 controls were 0.766±0.404 and 0.453±0.133(not significant).

질소-산소 주개 거대고리 리간드와 Cd(Ⅱ) 이온 간의 착물 형성에 관한 ??-NMR 연구

최규성,김정 慶南大學校 附設 基礎科學硏究所 1993 硏究論文集 Vol.5 No.-

1, 15-diaza-3, 4 : 12, 13-dibenzo-5, 8, 11-trioxacycloheptadecane(NenOdienH₄) 와 카드뮴(II)이 온간의 착물 형성 반응에 대한 반응 속도론적 성질을 카드뮴-113NMR분광법으로 N, N'-dimethylformamide(DMF) 용액에서 조사하였다. 스핀-스핀 이완 시간을 측정하여 반응 속도 상수와 활성화 에너지를 계산하였는데, 활성화 에너지는 9.8kcal/mol 이었고 교환 반응은 해리 메카니즘으로 일어남을 알 수 있었다. The kinetic properties of the exchange reaction of 1, 15-diaza-3, 4: 12, 13-dibenzo-5, 8, 11-trioxacycloheptadecane(NenOdienH₄) with Cd(II) ion were studied in N, N'-dimethylformamid by cadmium-113 NMR spectroscopy. The rate constants and activation energies of dissoociative reaction were calculated from transverse relaxation times. The activation energy for dissociation was 9.8kcal/mol and dissociative mechanism was dominant in the exchange reaction.

통일, 그것은 정신적 통일이어야 한다

최용철,임규정 군산대학교 현대이념연구소 1997 現代理念硏究 Vol.12 No.-

Cu(Ⅱ) 이온과 질소-황을 가진 포단드와의 착물 형성에 관한 연구

최규성,정징운 慶南大學校 附設 基礎科學硏究所 1996 硏究論文集 Vol.8 No.-

The stability constants, enthalpy, and entropy changes of complexation of Cu(Ⅱ) ion with sulfur-containing podand ligands such as tri(phenylthio-2-ethyl)amine(Podand Ⅰ), tetra(phenylthio-2-ethyl)ethylendiamine (Podand Ⅱ) have been determined by uv-vis spectrophotometer in 95% MeOH at various temperature. From the results, the followings have been obtained. Cu(Ⅱ) ion forms a 1:1 complex with these ligands, the order of stability constants and enthaply changes is Podand Ⅰ <Podand Ⅱ, entropy changes is Podand Ⅰ> Podand Ⅱ.