일산화탄소 중독의 지연성 후유증에 관한 임상적 연구

김원,이대희,서광윤 大韓神經精神醫學會 1987 신경정신의학 Vol.26 No.4

A total of 34 patients admitted to Korea University Medical Center with the diagnosis of delayed sequeale of carbon monoxide intoxication were studied and evaluated in terms of various clinical aspects and compared with 57 control patients randomly selected from a total of 128 patients who had admitted to the Medical Center with the diagnosis of acute carbon monoxide intoxication. The results were as follows: 1) The proportion of the 34 cases of dealyed sequelae to the 128 admitted cases with acute CO intoxication was 26.6% during the same period. 2) In the cases of delayed sequelae, the age of onset ranged from 23 to 79 years (mean age=34.6 years) and the age groups with the highest incidence were in the 50s(35.3%) and the 60s(29.4%). The age of onset of the delayed sequelae group was significantly old than the control(P<0.0005). 3) Compared with the control, the patients with the delayed sequelae showed a much longer duration of impairment of consciousness (P<0.05), were fewer in number who had been administered oxygen therapy (P<0.01), and had more concomitant physical illness (P<0.01) at the time of their acute intoxication. 4) The lucid interval ranged from 3 to 43 days (mean = 16.8 days) and the lucid interval with the highest incidence was in the 2nd week*38.2%) and the 3rd week (32.5%). A possible factor influencing the lucid interval seems to have been the severity of the impairment of consciousness. 5) The characteristic symptoms manifested in patients with the delayed sequelae were mental confusion, impairment of orientation, memory, calculation and judgement, apathy or dullness, and incontinence. 6) The proportion of an abnormal EEG finding in the delayed sequelae cases was 87.5%. Diffuse irregular slow waves of 1.5-6㎐ were prominent on both hemispheres, particulaly predominent on both frontal areas. 7) The proportion of an abonormal brain CT findings in the delayed sequelae cases was 46.7% and the characteristic findings included an enlarged ventricle, low density of cerebral white matter and infarction of basal ganglia. 8) Among the cases of delayed sequelae, 70.6% were discharged in an improved state. As compared with the not improved patients, the improved patients were significantly younger (P<0.05) and had much longer length of stay in the hospital (P<0.005). In addition, the improved patients tended to show evidence of improvement on subsequent EEG follow-up and no observable lesion of basal ganglia on brain CT scan.

주우울증 환자에 있어서 혈중 전해질 농도에 의한 Dexamethasone 억제검사의 예측

원경식,이민수,서광윤 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.1

In this study, the author tried to determine the usefulness of pre-DST serum electrolytes in predicting the result of dexamethasone suppression test in patients with major depression. 26 subjects(6 male and 20 female)met criteria for major depression of DSM-Ⅲ . The results were as follows ; 1) The nine(35%) of 26 subjects nonsuppressors and 17(65%) ware suppressors. 2) The depressive patients tend to show increased serum Na level, but same serum K level, compared to standard Na, K level of normal Korean. 3)There were no significant difference in serum Na level, and K level on pre-DST status between nonsuppressor group and suppressor group. 4) Pre-DST serum Na level was not significantly correlated to post-DST serum cortisol level. 5) Pre-DST serum K level was not significantly correlated to post-DST serum cortisol level.

선천성 척추 후측만증 : 증례 보고

서광윤,신성태 인제대학교 1986 仁濟醫學 Vol.7 No.2

선천성 척추 측만증 및 후만증은 척추의 종적 성장의 불균형을 초래하는 척추 이상에 의한 것으로 이의 만곡도는 성장기 전반을 통해 진행하며 또 만곡이 견고하기 때문에 교정이 어렵다는 특성이 있다. 저자들은 치료 중 특이한 경과를 취했던 측만곡도 47도, 후만곡도 88도의 심한 선천성 척추 후측만증 1 례를 전방 유합술 및 후방 유합술을 시행하여 치료하였으며 최종 만곡도는 측만곡도 37도, 후만곡도 60도였다.

마리화나(大麻草)의존

徐光潤 한국의학사 1984 診斷과治療 Vol.4 No.11

주요우울증 환자의 Interleukin-1β, -2, -6 생산성과 혈청 농도의 변화 및 시상하부-뇌하수체-부신피질축 기능의 상관성

최소현,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.3

주요우울증의 면역기능 이상과 HPA axis 사이의 관계를 규명하고자 본 연구를 시행하였다. DSM-Ⅲ-R 진단기준에 의해 주요우울증으로 진단된 16명의 여러 환자를 대상군으로 하고 대상군과 연령을 일치시킨 16명의 여자를 대조군으로 선택하였다. Basal cortisol 농도와 IL-1β, IL-2, IL-6 생산성 및 형청농도를 두군에서 각각 측정하여 비교하였다. 또한 주요우울증군에서 IL-1β, IL-2, IL-6 생산성 및 혈청농도와 basal cortisol 농도, post-DST cortisol 간의 상관관계를 알아보았다. 그 결과는 다음과 같다. 1) 주요우울증군의 basal cortisol 농도14.4±4.6㎍g/dl, 대조군은 10.1±5.2㎍/dl로 주요우울증군이 정상대조군보다 유의하게 높았다(t=2.47 : df=30, p〈0.05). 2) IL-2 생산성은 주요우울증군 1747.3±387.9pg/ml, 정상대조군 2520.2±884.1pg/ml로 주요우울증군이 대조군보다 유의하게 낮았다(t=-3.08 : df=30, p〈0.05). IL-1β 생산성과 IL-6 생산성은 양군간에 유의한 차이가 없었다. 3) IL-2 혈청농도는 주요우울증군 16명중 12명(75%), 정상대조군 16명중 10명(62.5%)에서 측정이 가능하였으며, 주요우울증군 109.3±22.8pg/ml, 정상대조군 143.8±72.0pg/ml,로 양군간에 유의한 차이는 없었다. IL-1β혈청농도는 양군에서 각각 3명씩 검출이 가능하였고, IL-6 혈청농도는 양군 모두에서 검출되지 않았다. 4) 주요우울증군에서 IL-2 생산성과 post-DST cortisol 농도사이에 유의한 역상관관계가 있었으며 (r=-0.89), IL-2 혈청농도와 post-DST cortisol 농도사이에 유의한 역상관관계가 있었다(r=-0.97). 주요우울증군에서 IL-2 혈청농도와 basal cortisol 농도사이에 유의한 역상관관계가 있었으나(r=-0.65), IL-2 생산성과 basal cortisol 농도사이에 유의한 상관관계는 없었다. 주요우울증군에서 IL-1β, IL-6 생산성과 basal cortisol 농도, post-DST cortisol 농도 사이에 유의한 상관관계는 없었다. 이러한 결과들은 주요우울증에서 면역기능이 저하되어있고 이러한 면역기능저하에 HPA axis 활성화가 관련되어 있다는 가설에 부가적인 자료로 제시될 수 있겠다. The present study was carried out in order to investigate the relationship between immune function and the activity of hypothalamic-pituitary-adrenal(HPA) axis is patients with major depression. The subjects were 16 female major depressives and 16 female healthy controls. We measured mitogen-induced production of IL-1β, IL-2, IL-6 and serum level of IL-1β, IL-2, IL-6 and basal plasma cortisol levels at 8 : 00 a.m. We measured post-DST(dexamethasone suppression test) cortisol levels in 16 major depressive. The results were as follows : 1) Basal cortisol level was significantly higher in the patients with major depression than in the healthy controls(14.4±4.6㎍g/dl, 10.1±5.2㎍/dl, respectively, p〈0.05). 2) IL-2 production was significantly lower in the patients with major depression than in the healthy controls(1747.3±387.9pg/ml, 2520.2±884.1pg/ml, respectively, p〈0.05). There were no significant differences in IL-1β and IL-6 production between the patients with major depression and the healthy controls. 3) Serum level of IL-2 was detectable in 12 to 16 patients with major depression and in 10 of 16 healthy controls. There was no significant difference in serum level of IL-2 between two groups. Serum level of IL-1β was detectable in 3 of 16 patients with major depression and of 16 healthy controls. We could not detect serum level of IL-6 in both groups. 4) There was significant negative correlation between IL-2 production and post-DST cortisol level(r=-0.89) in the 16 patients with major depression. There was significant negative correlation between serum level IL-2 and post-DST cortisol level(r=-0.97) in the 12 patients with major depression. There was significant negative correlation between serum level IL-2 and basal cortisol level(r=-0.65) in the 12 patients with major depression. But there was no significant correlation between IL-2 production and basal cortisol level in the 16 patients with major depression. These finding suggest that immune function is decreased in major depression and the decreased immune function is highly related to the hyperactivity of the HPA axis.

A Staistical Observation on Fractures

徐光倫,李英淳,趙採記,金柱錫 대한외과학회 1963 Annals of Surgical Treatment and Research(ASRT) Vol.5 No.10

시험지옥이 청소년 정신건강에 미치는 영향 : 고3병에 대하여

서광윤 臨床醫學社 1987 臨床醫學 Vol.1987 No.11

정신분열병에 대한 리스페리돈의 효과 및 안정성(장기투여연구)

이민수,김용구,강병조,김광수,김영훈,김희철,나철,노승호,백인호,연병길,오병훈,윤도준,윤진상,이종범,이철,전태연,정인과,정인원,지익성,채정호,한상익,서광윤 대한신경정신의학회 1999 신경정신의학 Vol.38 No.1

연구목적 : 정신분열병의 환자에서 리스페리돈의 장기 치료 효과와 안전성을 조사하기 위해 다기관 개방 연구를 시행하였다. 방 법 : DSM-Ⅳ 진단기준에 의거하여 정신분열병으로 진단된 환자중 리스페리돈 장기투여에 동의한 환자 116명을 대상으로 하였다. 임상 시험전에 연구자들을 대상으로 PANSS workshop을 통해 PANSS, ESRS에 대한 표준화 작업으로 평가기간 신뢰도를 높였다. 1주일간의 약물배설기간후 리스페리돈을 56주간 투여하였으며, 기준점, 8주후, 16주후, 24주후, 32주후, 40주후, 48주후 56주후에 평가되었다. 용량은 제 1일에는 리스페리돈 1㎎씩 1일 2회, 제 2일에는 2㎎씩 2회, 제 3-7일에는 3㎎씩 1일 2회 투여하였고, 이후 환자의 임상 상태에 따라 임의로 증량하였으며, 최대 일일 16㎎을 초과하지 않도록 하였다. 임상증상과 부작용은 PANSS, ESRS, CGI로 평가되었다. 결 과 : 116명중 87명(75%)이 56주의 장기연구를 완결하였다. 치료종결시점인 56주후 PANSS 총점수가 20% 이상 호전된 환자는 87명중 80명(92.0%)이었다. PANSS 총점수는 기준점, 투여 8주후, 16주후, 24주후, 32주후, 48주후에서 각각의 시점사이에 유의한 감소를 보였다. PANSS 양성증상, 음성증상, 일반정신병리점수에서 8주후, 16주후, 24주후, 48주후 각각의 시점사이에 유의한 감소를 보였다. ESRS에서 연구기간동안 모든 항목에서 유의한 변화를 보이지 않았다. 활력징후, 일반혈액학, 생화학, 심전도검사에서 유의한 변화는 없었으나, 체중에서 유의하게 증가하였다. 결 론 : 다기관 개방연구를 통해 정신분열증 환자에 대한 리스페리돈의 장기투여는 양성증상뿐만 아니라 음성에도 효과적이며, 추세외로 부작용이 적었고, 안전하였다. Objectives : The purpose of this study was to evaluate the long-term efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Methods : This multicenter open label study included 116 schizophrenic patients drawn form 19 university hospitals. After a wash-out period of 1 week, the patients were treated with risperidone for 56 weeks and evaluated at 8 points : at baseline, and the 8th, 16th, 24th, 32th, 40th, 48th, 52th weeks of treatment. The dose was started at 2㎎ of risperidone on day 1, and increased to 4㎎ on day 2, and 6㎎ on day 3 - 7 and adjusted to a maximum of 16㎎/day according to the individual's clinical response. The psychiatric and neurological status of the patients was assessed by PANSS. CGI, and ESRS scales. Results : Eighty-seven(75%) of 116 patients completed the 56-week trial risperidone. Clinical improvement(as defined by a 20% of reduction in total PANSS score at end point) was shown by 92.0% of the patients. The mean dose of risperidone was 5.0㎎/day in the 56 week follow-up. PANSS total scores showed significantly improvements between consecutive two points at baseline, 8th, 16th, 24th, 32th, and 48th week of treatment. CGI scores showed significant reductions between consecutive two points at baseline, 8th, 16th, 24th, and 48th weeks of treatment. There PANSS factors(positive, negative, general) showed a significant improvement from the 8th week of treatment, and, after then, remained improved in the rest of the study period. ESRS showed to no significant change the 56 week trial. Laboratory parameters showed no signifiant changes during the course of treatment. Conclusion : This multicenter long-term open study suggests that risperidone is a antipsychotic drug with long term efficacy safely in the treatment of schizophrenic patients.

Ilizarov 술식을 이용한 사지 신장술 : 1년 이상 추시가능하였던 2례 보고 Long Term Follow Up

서광윤,권칠수,김용욱,김형수 인제대학교 1991 仁濟醫學 Vol.12 No.3

사지 신장술은 오랜기간 동안 정형외과 영역에서 추구하여 오던 것이며, 계속 여러 사람에 의해 시행되어 오던 술식이다. 사지신장술에 사용되어진 체외 고정 기구는 학자에 따라 다양한 방법이 소개되고 있으나 특히 일리자로프(llizarov)체외 고정 기구는 생체 역학적으로 사지신장술 및 골절 치유에 유리하며, 사지의 여러 변형을 교정할수 있는 장점이 있다. 이에 저자들은 본원에서 시행한 사지 신장술 2례를 1년 이상 추시 관찰하여 양호한 결과를 얻었기에 증례가 적고 한정된 경험이지만 보고하고자 한다. The Ilizarov external fixator, though developed over 35 years ago in the Soviet Union, is only now gaining popularity in the world. Its design and versatility allow the physician to treat a wider range of limb diseases than any other external fixation systems. The Ilizarov method of fixation also permits treatment of some orthopedic conditions that were previously considered to be untreatable, such as dwarfism. The device can be used to correct limb length discrepancies, manage open and closed fractures, nonunions, and bony or soft tissue deformities. A review of the first 2 cases performed at the Sang-gye Paik Hospital Inje University revealed all which have been successfully and which are still in progress.

交通事故의 一般外科的處置

徐光倫 中央醫學社 1962 中央醫學 Vol.3 No.1