한국 해병에 있어 징집병과 지원병의 불안성향 비교

전태연 최신의학사 1986 最新醫學 Vol.29 No.3

한국 자문조정 정신의학의 동향

전태연,방승규 최신의학사 1987 最新醫學 Vol.30 No.11

양극성 장애 1형에서 종양괴사인자 베타 유전자 다형성

전태연,이경욱,배치운,김원,우영섭,채정호,박원명 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : Bipolar disorder is known to have a high genetic predisposition. Recently, the main focus of etiologic studies in bipolar disorder has been concentrated on molecular genetic approach including gene polymorphism analysis. The present study was conducted to investigate whether TNFB polymorphism is associated with bipolar I disorder in the Korean population. Methods : 89 bipolar I disorder patients diagnosed by DSM-IV criteria were assigned as the patient group and 202 normal population, matched on age and sex from Catholic hemopoietic stem cell bank (Seoul, Korea), were enrolled as the control group in this study. Genotyping was performed by a polymerase chain reaction-restriction fragment length polymorphism method. All data was analyzed by x² test. Results : There were no significant differences in frequency of TNFB*1/1,TNFB*1/2 and TNFB*2/2 between bipolar I disorder patient group and normal control group. The frequency of TNFB*1 was not statistically different between bipolar I disorder patient group and normal control group. Conclusion : The difference of frequency in TNFB*1/TNFB*2 gene between the bipolar I disorder gropup and the normal contro1 could not be verified. The present result suggested that the gene polymorphism of TNFB may not play a significant role in susceptibility to bipolar I disorder. Studies with a larger number of subjects from different ethnic backgrounds, considring clinical phenotype and controlling various factors, should be launched to further determine the role of TNFB in bipolar I disorder.

정신과 입원환자의 공격행동 특성

전태연,권용실,도규영,장계호 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.3

저자들은 1994년 1월 1일부터 1995년 6월 31일까지 가톨릭대학교 의과대학 의정부성모병원 정신과에 입원했던 환자들 중세서 공격행동을 보인 환자(공격군) 72명과 공격행동이 없었던 환자(비공격군) 215명의 임상적 특성에 관한 조사를 하여 다음과 같은 결과를 얻었다. 1) 공격행동을 보인 환자는 72명으로 전체 조사 환자의 25.1%이었다. 2) 성별, 연령, 종교, 결혼 상태와 정신과 질환의 가족력 등에 따른 공격행동의 발생비율의 차이는 유의하지 않았다. 3) 교육 정도와 직업에 따른 공격군의 비육에 유의한 차이가 있었다(p<.05). 4) 진단별로는 공격군에서 조증, 기질성 정신장애, 정신분열증의 빈도가 높았으나 진단에 따른 의미 있는 차이는 없었다. 5) 공격행동의 기왕력은 공격군에서 더 많았고 비공격군과 비교시 의미 있는 차이를 보였으며(p<.001), 입원 형태는 공격군에서 타의 입원의 빈도가 유의하게 높았다(p<.005). 7) 입원시 정신병리는 초조-흥분과 적대감-의심에서 공격군의 빈도가 높았으며 정신병리에 따른 의미 있는 차이를 보였다(p<.001). 8) 총 재원 일수는 공격군에서 평균 59.3일이었고 비공격군이 평균 38.4일로 유의한 차이를 보였다(p<.001). 9) 공격행동의 유형은 말로한 경우가 가장 많았고 물건을 대상으로한 행동, 타인을 대상으로 하는 행동의 순으로 나타났다. 10) 공격행동 직전 행동 특징은 활동증가, 시끄러움, 욕설, 분노, 적대적이었던 경우가 가장 많았다. 11) 공격행동은 정오에서 오후 6시 사이, 휴식시간에 가장 많이 나타났다. 12) 입원 후 1주일 이내에 공격행동의 62.3%가 나타났다. 13) 총공격 점수에 의미 있게 영향을 주었던 변인들로는 종교(p<.05), 교육 정도(p<.05), 직업(p<.05), 입원형태(p<.005), 진단(p<.001), 입원시 정신 병리(p<.001), 공격행동의 기왕력(p<.001) 등으로 나타났다. To evaluate the characteristics of violent behavior of psychiatric inpatients the authors reviewed clinical records of psychiatric patients who had admitted at UiJong Bu St. Mary's Hospital from January 1994 to June 1995. We divided the 287 subjects into violent and nonviolent group according to the presence of violent behaviors in psychiatric ward. We assessed demographic variables, clinical characteristics and violent behaviors using Overt Aggression Scale and compared these variables of violent group with nonviolent group. The results were as follows : 1) The number of violent patients was 72(25.1% of the total). 2) In terms of demographic variables, the differences between two groups in education and occupation were significant(p<.05). 3) In psychiatric diagnoses, violent group were more likely to have mania, schizophrenia and organic mental disorder in sequence but there were no differences between violent and nonviolent group. 4) The history of violent behavior was greater in violent group(p<.001) and the mode of admission was significantly different between two groups(p<.005). 5) In cluster of psychopathology on admission, more frequently found clusters of psychopathology in violent group were agitation-excitement and hostile- suspiciousness and there were significant differences between two groups(p<.001). 6) The length of stay in violent group(59.3 days)was significantly longer than nonviolent group(38.4 days)(p<.001). 7) The types of violent behavior were verbal aggression, physical aggression against objects and physical aggression against other people in frequency sequence. 8) The most frequent type of behavioral clue before violent behavior was hyperactive, loud, verbally abusive, angry, hostile(68.1%). 9) Most of violent behaviors were presented between midday and 6 pm. in resting time. 10) 62.3% of total violent behaviors were occurred within first week following admission. 11) The variables which showed significant effects on total aggression score were religion, educational status, occupation, mode of admission, psychiatric diagnosis, psychopathology on admission and history of violent behavior before admission. In summary, these results showed similar trends compared to previous studies on characteristics of psychiatric inpatients. And we found that more important predictors of violent behavior in practice were likely to be history of violent behavior, psychopathology on admission and behavioral cue before violent behavior.

단순 및 연성전기충격요법에 의한 혈청 Cortisol, Prolactin 및 성장 Hormone 값들의 변화

전태연,백인호 大韓神經精神醫學會 1982 신경정신의학 Vol.21 No.2

Recently it has been shown in numerous experimental studies that a series of electroconvulsive therapy(ECT) affects neurohormonal function in man, though the results of the studies have not yet confirmed the mechanisms of ECT. The authors measured serum cortisol, prolactin and growth hormone(GH) values before and after the induction of plain and softening ECT to trace if there is any significant quantitative change. The subjects consisted of 26 cases of plain ECT group and 9 cases of softening ECT group. ECT was induced by the application of 110 volts for a period 0.3-2.0 sec., using bitemporal electrodes. Serum cortisol, prolactin and GH were measured by radioimmunoassay technique. The results were as follows; 1. It was revealed that cortisol value in the female group and the GH value in the male group increased significantly following ECT, while prolactin value of both sex groups increased almost equally. 2. In plain ECT group, cortisol value and GH value increased significantly at 15,30,60 minutes following the treatment. In the softening ECT group, significant increases were noted in the cortisol value at 15,30,60 minutes following the treatment and GH value at 15,30,60 and 120 minutes following the treatment, while prolactin value increased without statistical significance. 3. It was considered that while the changes in the values of cortisol and of prolactin following ECT might be regarded as non-specific, the increases in the value of GH after ECT might have some specific meanings which may well require further verification.

주요 우울장애에서 Cytotoxic T Lynphocyte Antigen(CTLA-4) 유전자의 다형성

전태연,배치운,김병균,채정호,박원명,김광수,유태열,한훈 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

연구목적 : 세포의 면역 기능 조절에 관여하는 CTLA-4의 유전자 다형성을 분석하여 주요 우울장애와의 면역 유전학적 관련성을 알아보고자 하였다. 방 법 : DSM-Ⅳ진단 기준에 따라 주요 우울장애로 진단된 환자 77명을 선정하였으며 가톨릭대학교 의과대학 조혈모세포은행에서 보유하고 있는 149명의 정상 한국인 자료를 대조군으로 사용하였다. 전혈에서 DNA를 추출하였으며 중합효소반응으로 CTLA-4유전자 exon 1 부위를 증폭한 후 SSCP방법으로 유전?? 형별 분석하였다. 결 과 : 대조군과 주요 우울장애 환자군 사이의 CTLA-4 유전자형과 대립유전자의 발현 빈도를 비교시 유의한 차이가 없었다. 결 론 : 본 연구 결과 exon 1 CTLA-4 유전자형 및 대립유전자의 발현빈도는 주요 우울장애 환자군과 정상 대조군 사이에 차이가 없어, exon 1 영역은 후보 유전자로서의 가능성이 없었다. 향후 연구에서는 다양한 변인들에 따라 대상군을 임상적으로 동질성을 지닌 집단으로 세분하여 조사대상 유전자와의 관련성에 대한 연구가 이루어져야 하겠다. Objectives : This study was carried out to explore the relationship between major depressive disorder and CTLA-4 which is related to the immunologic function such as T cell regulation. Methods : Among the korean patients diagnosed as major depressive disorder according to DSM-Ⅳ, 77 patients without neurological illness, hormonal disorder, or comorbid mental illness were selected. The stored data of 149 normal Koreans from the Catholic Hemopoietic Stem Cell Bank of Korea, were used as a normal control group. The data of Korean control group were compared with those of the studies of different ethnics. DNA was extracted from whole blood and the exon I region of CTLA-4 gene was amplified by polymerase chain reaction. Gene typing was performed by using SSCP and then, the results were assessed. Results : There were no significant differences in genotype frquencies of CTLA-4*G/G, CTLA-4*G/A, and CTLA-4*A/A between the patients with major depressive disorder and the control group in Korean population(48.1% vs 46.3%, 41.6% vs 39.6%, 10.3% vs 14.1%, respectively).There were no significant differences in allelic frequencies of CTLA-4*G and CTLA-4*A between the patients with major depressive disorder and the control group in Korean population(68.8% vs 66.1%, 31.2% vs 33.9%, respectively). Conclusion : Considering negative result for the association of the exon I polymorphism of CTLA-4 gene with major depressive disorder in this study, the exon I polymorphism does not appear to be possible candidate gene for major depressive disorder. Moreover, further systematic researches including diverse clinical variables would required.

정신과 입원환자에서의 혈청 콜레스테롤 농도와 공격행동

전태연,도규영,정종현,권용실,김석범 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 혈청 콜레스테롤 농도와 자살 등의 공격행동간의 연관성에 관한 여러 연구가 있었으나 일치된 결과를 보이고 있지 못하다. 이에 저자들은 다양한 진단의 정신과 입원 환자들 중 공격행동을 보인 환자의 콜레스테롤 농도를 정상 한국 성인에서의 혈청 총 콜레스테롤의 성별, 연령별 평균 및 표준편차와 percentile분포에 맞추어 공격행동 및 자살시도와 혈청 콜레스테롤 농도간의 연관성을 알아보기 위하여 본 연구를 시행하였다. 방 법 : 본 연구는 1994년 1월 1일부터 1995년 6월 31일까지 18개월간 카톨릭대학교 의정부성모병원 정신과 병동에 입원하였던 환자 중 콜레스테롤 농도를 얻을 수 있었던 127명을 대상으로 하였다. 대상 환자는 공격행동의 유무에 따라 공격군과 비공격군으로 분류하여 공격군 35명과 비공격군 92명의 자료를 얻었으며, 공격군은 Overt Aggression Scale을 사용하여 평가하였다. 측정된 각 환자의 콜레스테롤 농도는 정상 한국 성인에서의 혈청 총 콜레스테롤의 성별, 연령별 평균 및 표준편차와 percentile분포에 맞추어 4개의 군으로 나눈 후 공격행동 발생비율, 자살시도간의 차이를 알아보았다. 또한 공격행동을 보인 군에서도 각 콜레스테롤군 간의 총 공격 점수를 비교하였다. 결 과 : 1) 각 콜레스테롤군 간의 공격행동 발생비율에는 유의한 차이가 없었다. 2) 공격군에서 각 콜레스테롤군 간의 총 공격 점수는 유의한 차이를 보이지 않았다. 3) 각 콜레스테롤군 간의 자살시도 빈도는 유의한 차이가 없었다. 결 론 : 정신과 입원 환자의 혈청 콜레스테롤 농도를 정상 한국 성인에서의 혈청 총 콜레스테롤의 성별, 연령별 평균 및 표준편차와 percentile분포에 맞추었을 때 혈청 콜레스테롤 농도와 공격행동 및 자살시도에 유의한 연관이 없었다. Objectives : An association between serum cholesterol concentration and violent behavior has been suggested, but has not been consistently demonstrated. This study was conducted in order to evaluate the relation between serum cholesterol concentration and violent behavior in psychiatric inpatients who had been admitted at Uijongbu St. Mary's Hospital, the Catholic University of Korea from January 1994 to June 1995. Methods : We divided the 127 subjects into violent(35 subjects) and non-violent group(95 subjects). According to the percentile distribution of serum total cholesterol in healthy Korean adults, the subjects were classified into four subgroups : Group 1, subjects Whose cholesterol concentrations were below 26% of percentile distribution, Group 2, from 26% to 50%, Group 3, 51% to 75% and Group 4, above 75%. In the four cholesterol subgroups, the authors examined the incidence of violent behaviors and suicidal attempts. Within the violent group, total aggression score of four cholesterol subgroups was compared. Results : 1) Among the four cholesterol subgroups, there were no significant differences in the violent behavior. 2) Within the violent groups, total violent score of the four cholesterol subgroups showed no significant difference. 3) Among the four cholesterol subgroups, there were no significant differences in suicidal attempt. Conclusion : When the serum cholesterol concentrations of psychiatric inpatient applied to the percentile distribution of serum total cholesterol in healthy Korean adult, no association was found between serum cholesterol concentration and violent behavior and suicide attempt.

척수압박으로 발현된 급성 골수성 백혈병에 동반된 과립구성 육종 1 례

윤상준,김영곤,김희종,박유환,정춘해,김양수,김태균,박영진,전호종 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

저자들은 척수압박으로 하지마비를 보인 환자에서 수술 후에 급성 백혈병에 동반된 과립구성 육종으로 진단된 환자 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Granulocytic sarcoma(GS) is an uncommon tumor composed of immature cells of the granulocytic series. Most case of GS occur in the course of acute leukemia and the blast crisis of chronic leukemia, Rarely, however, it may present before leukemia becomes clinically apparent. It may also occur in patients with myeloproliferative disoders. GS has been reported that it occurs in 3% to 9% of patients with acute myelogenous leukemia(AML) and the incidence of GS is reported to be higher in patients with t(8;21). GS occurs relatively commonly in africa and has been reported to affect 10-25% of black children presenting with AML. This is very rare case of granulocytic sarcoma with AML(FAB M5) presented with spinal cord compression which was supported by decompression laminectomy.

주요 우울증에서 종양괴사인자-베타 유전자의 다형성

전태연,배치운,김영호,장계호,이정태,박원명,김광수 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 주요 우울증은 역학적 유전연구 등을 통하여 유전적 영향이 높은 것으로 알려져 있으며 최근에는 분자 유전학적 연구로 유전자 다형성과 질병의 연관성을 밝히는 것이 정신질환의 유전학적 연구에서 중요한 부분을 차지하고 있다. 이에 본 연구는 중추신경계와 면역계간의 상호작용에 관여하는 싸이토카인 중 TNF-β 유전자의 다형성을 분석하여 주요 우울증과의 유전학적 관련성을 알아보고자 하였다. 방 법 : DSM-IV에 의하여 주요 우울증으로 진단된95명을 환자군으로 선정하였고 가톨릭조혈모세포정보은행에서 보유하고 있는 정상 한국인 202명의 자료를 정상 대조군으로 사용하였다. 전혈에서 DNA를 추출하고 TNF-β 유전자 부위를 증폭한 후 제한효소 Nco Ⅰ으로 절단하여 555bp와 185bp의 절편을 갖는 TNFB*1과 Nco Ⅰ절단부가 없는 740bp의 절편 TNFB*2등 2가지 대립유전자의 제한효소절편길이 다형성을 조사하였다. 모든 자료의 분석은 x²검증을 이용하였다. 결 과 : 1) 주요 우울증과 정상 대조군 간에 TNFB유전자인 TNFB*1/1, TNFB*1/2 및 TNFB*2/2의 발현 빈도에는 유의한 차이가 없었다. 2) 두 군 간에 TNFB*1 과 TNFB*2 두 대립유전자의 빈도에는 유의한 차이가 없었다. 결 론 : 본 연구에서는 주요 울울증군과 정상 대조군 간에 TNFB*1과 TNFB*2의 두 대립유전자 발현 빈도에 유의한 차이를 발견하지 못하였다. 따라서 TNFB 유전자다형성과 주요 우울증과의 유전학적인 연관성이 없었다. 향후 연구에서는 다양한 임상변인을 포함하여 보다 통합적이고 체계적인 연구가 이루어져야 할 것으로 생각되었다. Objective : Major depressive disorder is known to have high genetic predisposition and the main focus of recent genetic studies in major depressive disorder has been concentrated on association studies between genetic polymorphism and disease, since molecular genetic methods have been developed. This study was designed to investigate the relationship between major depressive disorder and immunogenetic influences by analyzing polymorphism of TNFB gene, which is involved in interaction of immune system and CNS. Method : 95 persons who had been diagnosed of major depressive disorder were assigned as patient group and, 202 data obtained from Catholic hemopoietic stem cell bank, College of medicine, the Catholic University of Korea, were used as normal controls in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by Nco Ⅰ.After that procedure, we obtained and assessd restriction fragment length polymorphism of two alleles, TNFV*1 which has 555bp and 185bp fragments and carries the Nco Ⅰ restriction site, and TNFB*2 of 740 bp fragment lacks the Nco Ⅰ restriction site. All data were analyzed by x²test with two-tailed Fisher's exact test. Results : 1) The frequencies of TNFB*1/1, TNFB*1/2, and TNFB*2/2 were not statistically different between major depressive disorder patients and control group. 2) The frequencies of TNFB*2 and TNFB*1 were not statistically different between major depressive disorder patient group and normal control group. Conclusion : We did not verified the differences of frequency in TNFB*1/TNFB*2 gene between the major depressive disorder and normal controls, respectively. Consequently, there is no genetic relationship between major depressive disorder and gene polymorphism of TNFB. We do suggest that further systematic studies including various clinical variables should be conducted.

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