공황발작으로 응급실에 내원한 공황장애 환자들의 임상 특징

이창주,남범우,손인기,Lee, Chang-Ju,Nam, Beom-Woo,Sohn, In-Ki 한국정신신체의학회 2021 정신신체의학 Vol.29 No.1

연구목적 본 연구에서는 공황발작을 주소로 응급실에 내원한 공황장애 환자들의 공황발작 관련 데이터와 응급실에서의 처치를 알아보고자 하였다. 방 법 공황발작으로 일 대학병원 응급실에 내원한 공황장애 환자들 중 의무기록에 신체증상이 기재되어 있는 92명을 대상으로 후향적 의무기록 분석을 진행하였다. 인구사회학적 특성 및 공존 질환과 발작 전 데이터로 촉발 스트레스 인자와 음주 유무, 발작 중 데이터로 발작 당시 신체증상, 발작 후 데이터로 심전도 시행 여부와 정신건강의학과 협진 및 입원 여부 그리고 정신작용제 사용에 대한 정보를 조사하였다. 자료의 크기에 따라 카이제곱 검정(Chi-square test) 또는 피셔의 정확검정(Fisher's exact test)을 이용하였다. 수집된 자료는 R 4.03을 이용하여 분석하였다. 결 과 공존 심혈관계 질환이 동반된 경우는 5.4%였고, 공존 정신 질환으로는 92명중 14명에서 동반된 우울장애가 가장 흔했다. 촉발 스트레스 요인 중 남성에서는 여성에 비해 경제적 어려움/직장 관련 스트레스가 유의미하게 많았다(𝛘²=4.322, p<0.005). 발작 시 신체증상으로는 순환기 증상이 65.2%, 호흡기57.6%, 사지 감각기 33.7%, 어지럼19.6%, 소화기 14.1%, 자율신경계 12.0% 순이었다. 순환기 증상이 있을 때 심전도 시행율이 유의미하게 높았다(𝛘²=8.46, p<0.005). 응급실에서 가장 흔히 사용된 정신작용제는 92.1%에서 사용된 로라제팜(lorazepam)이었다. 결 론 본 연구결과, 공황발작 시 가장 흔한 신체증상은 순환기 증상이었고, 남자에게서 가장 흔한 촉발 스트레스 인자는 경제적 어려움/직장 관련 스트레스였다. 공황발작의 처치를 위해 가장 흔히 사용된 정신작용제는 로라제팜(lorazepam)이었다. Objectives : This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods : A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher's exact test was used. Collected data was analyzed using R 4.03. Results : Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (𝛘²=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (𝛘²=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions : The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

정신분열병 환자의 Apolipoprotein E 유전형과 임상변인

서정석(Jeong Seok Seo),문석우(Seok Woo Moon),이상수(Sang Soo Lee),최진영(Jin Young Choi),손인기(In Ki Sohn),남범우(Beom Woo Nam) 대한생물치료정신의학회 2008 생물치료정신의학 Vol.14 No.1

Objectives : In the central nervous system. apolipoprotein E(Apo E) is thought to playa role in neuronal growth and repair. Numerous studies have provided evidence for a genetic association of the Apo E ε4 allele and late onset familial and sporadic Alzheimer's disease. However, previous studies on Apo E genotype distribution in schizophrenia, which would suffer from severe cognitive impairment. have reported conflicting findings. So we have examined the genetic association between schizophrenia and Apo E genotype polymorphism to investigate the possible contribution to schizophrenia. Methods : Genomic DNAs from 100 schizophrenic patients and 60 healthy controls were isolated. The Apo E genotype was determined by the polymerase chain reaction (PCR) with sequence-specific oligonucleotide primers (SSOP) and reverse hybridization using the INNO LiPA(Line Probe Assay) Apo E typing test kit. The frequencies of allele and genotype were compared between patients and controls. And the allele frequencies were compared in terms of positive and negative subtypes according to the PANSS, family history and age of onset. Results : The frequencies of Apo E allele and genotype were not signilicantly different between the patients and controls. But in patients group, the frequencies of allele and genotype between subtypes by PANSS were significantly different. Some other clinical variables such as sex, age of onset and family history were not associated with Apo E genotype. Conclusion : Apo E gene has no causal relation to the development of schizophrenia in Korean population, but it may affect the phenotype of schizophrenia.

알코올리즘 입원치료프로그램 참가자들의 퇴원 후 경과에 대한 연구

최성빈(Sung-Bin Choi),박병권(Byung-Kwon Park),김한오(Han-O Kim),원민혜(Min-Hye Won),손인기(In-Ki Sohn),함 웅(Woong Hahm) 한국중독정신의학회 2006 중독정신의학 Vol.10 No.1

Objectives:The purpose of this study is to evaluate the outcome of alcoholics who participated in an inpatient alcoholism treatment program of a mental hospital. At the same time, We studied the various clinical variables affecting the recovery of alcoholism. Methods:The 261 subjects who were diagnosed as alcohol dependence took part in the treatment program at the alcohol center in Keyo hospital at least for 2 weeks between January 2004 and December 2004. The subjects were followed up by faceto-face or telephone interview, and medical records were reviewed to obtain data on demographic characteristics, alcohol-related clinical characteristics, treatment process, etc. Results:1) the mean follow-up period was 19.67 months. 2) 141 of the 261 subjects were followed up, so the follow-up rate was 54.02% 3) 43 of the 141 subjects (30.5%) were classified into abstinent group, 23 (16.3%) into controlled drinking group, and 75 (53.2%) into relapse group. Abstinent and controlled drinking groups were called recovery group. So 66 (46.8%) of the 141 subjects were classified into recovery group. 4) By the comparison of relapse and recovery groups, education, socioeconomic status, occupation, and marital status are significantly different between groups. 5) Recovery group had a longer duration of abstinence before admission than relapse group. 6) Completion of alcoholism treatment program during admission and a return to work after discharge from hospital were associated with recovery of alcoholism. 7) In a stepwise regression model, four risk factors were significantly correlated with the recovery:a return to work after discharge from hospital, completion of alcoholism treatment program during admission, marital status, and duration of abstinence before admission. Conclusion:The variables above mentioned were thought to be the points to be duly considered for the better outcome of alcoholism.

입대전 흡입제 남용 경험이 있는 군복무자들의 불안과 충동성에 대한 연구

이종훈(Jong-Hun Lee),이영식(Young-Sik Lee),손인기(In-Ki Sohn) 한국중독정신의학회 1999 중독정신의학 Vol.3 No.2

Object:We attempted to investigate the anxiety and impulsiveness of the enlisted men who had the history of gluesniffing or butane-gas inhalation before enlistment. Subject & Method:The authors examined 164 enlisted men from February 1st 1999 to February 24th 1999 according to the history of inhalant abuse. In this study, 95 Subjects had adjustment problem and 69 subjects were normal adjustment soldiers (N-A). In 95 subjects with adjustment problem, there were 32 soldiers with the history of inhalant abuse (I-M) and 63 soldiers without the history of inhalant abuse (N-M). Selfreport questionnaires for demographic data, the scale for anxiety (Zung’s self-rating anxiety scale;SAS) and the scale for impulsiveness (Barratt’s impulsiveness scale;BIS) were given to all subjects. Result:1) I-M soldiers were significantly higher frequency with family problems (p<.05) and legal problems (p<.05) than the others. 2) In I-M soldiers, initiation of inhalation with curiosity was the most common motivation and the next were a pressure of the peer & the betters and solving emotional problem, in order of frequency. 3) In substance-related problem of their parents, 15.6% of fathers and 9.4% of mothers in I-M soldiers had drug and alcohol problems. 4) I-M soldiers were significantly more anxious than N-A soldiers (p<.01). 5) I-M soldiers were significantly more impulsive than the others (p<.01). In subscales, the scores of impulsiveness-nonplanning (p<.05) and impulsiveness-cognitive (p<.01) in I-M soldiers were significantly higher than the others. Conclusion:The enlisted men having inhalant abuse history with adjustment problem were more anxious and impulsive than the others. They had more family problems, legal problems and their parent had more substance-related problem. Therefore special attention is needed for the enlisted men having inhalant abuse history

알코올 의존 환자에서 K-MMSE를 이용한 인지 기능 연구

서승진(Suhng-Jin Suh),최성빈(Sung-Bin Choi),김한오(Han-O Kim),원성두(Sung-Doo Won),손인기(In-Ki Sohn),함 웅(Woong Hahm),신경철(Kyung Chul Shin) 한국중독정신의학회 2009 중독정신의학 Vol.13 No.2

Objectives:This study aimed to characterize the cognitive functions of chronic alcohol dependent patients in their forties as compared to normal controls, via the K-MMSE (Korean version of the Mini-Mental State Examination). Methods:Participants were 25 male volunteers from the curative program at the Keyo hospital alcohol center, recruited from June 2007 to November 2007, and 25 male social drinkers who constituted the normal controls. We compared demographic characteristics, such as age, level of education, occupation, and socioeconomic status, and also K-MMSE results between the two groups. Results:Even though the demographic characteristics showed statistically significant differences between the two groups, their K-MMSE scores were not significantly different. Also, there was no identifiable correlation between demographic variables and K-MMSE total scores and subscales. The alcohol dependent patients varied significantly from the control group with regard to visuospatial area. Conclusion:In this study the cognitive functions and demographical variables such as education, occupation and socioeconomic status were not correlated. The subjects in two groups scored similar on K-MMSE in total score ; they had different scores in the test on their visuospatial area. In conclusion, some specific items of K-MMSE are thought to be applicable to predict whether patients with alcoholic dependence will have disability in their cognitive function.

지열 히트펌프 시스템의 데이터 마이닝 기반 성능 예측 기술

전인기(In-Ki Jun),황민혜(Min-Hye Hwang),김동호(Dong-Ho Kim),손병후(Byonghu Sohn) 대한설비공학회 2015 대한설비공학회 학술발표대회논문집 Vol.2015 No.6

지열 히트펌프 시스템의 데이터 마이닝 기반 성능 예측 기술

황민혜,박명규,전인기,손병후,Hwang, Min Hye,Park, Myung Kyu,Jun, In Ki,Sohn, Byonghu 대한기계학회 2016 대한기계학회 논문집. Transactions of the KSME. C, 산업기술과 혁신 Vol.4 No.1

지열 시스템을 대상으로 데이터 마이닝 기반 성능 예측 모델을 구축하였다. 지열 시스템의 실시간 성능 분석과 예측에 필요한 데이터의 기본 조건을 검토한 후, 데이터베이스의 구조를 설계하였다. 먼저 시스템 성능계수(COP)와 전력 소비량을 분석 대상으로 설정한 후, 이들 물리량의 추출 주기(1분 5분 10분 30분 60분 간격)가 예측 결과에 미치는 영향을 분석하였다. 이어서 범주형과 수치형 의사결정나무 모델을 적용하여 시스템의 성능을 예측하였다. 범주형 의사결정나무 모델을 적용했을 때, 10분 주기의 예측 결과의 정확도는 97.7%로 가장 높았다. 또한 수치형 의사결정나무 분석 결과를 통해 COP가 변하는 순간의 임계값을 찾을 수 있었다. 본 논문에서 제안한 방법은 지열 시스템의 실시간 성능 분석과 운전 상태 등에 적용할 수 있을 것으로 판단된다. This preliminary study investigated data mining-based methods to assess and predict the performance of geothermal heat pump(GHP) system. Data mining is a key process of the knowledge discovery in database (KDD), which includes five steps: 1) Selection; 2) Pre-processing; 3) Transformation; 4) Analysis(data mining); and 5) Interpretation/Evaluation. We used two analysis models, categorical and numerical decision tree models to ascertain the patterns of performance(COP) and electrical consumption of the GHP system. Prior to applying the decision tree models, we statistically analyzed measurement database to determine the effect of sampling intervals on the system performance. Analysis results showed that 10-min sampling data for the performance analysis had highest accuracy of 97.7% over the actual dataset of the GHP system.

양극성 장애의 인지적 병식 및 역기능적 태도와 증상 간의 관계

배정은(Jung Eun Bae),손인기(In-Ki Sohn),김임렬(Im-Yel Kim),양승호(Seung Ho Yang),이종훈(Jong Hun Lee),원성두(Seong-Du Won) 대한생물치료정신의학회 2010 생물치료정신의학 Vol.16 No.2

Objectives : There are several reports that patients with bipolar disorder have the negative cognitive style such as depressive disorder and it affect the course of illness. The insight of his or her own illness is also contribute to the course of it. In this research, We would like to investigate the relationship between symptoms, cognitive insight and dysfunctional attitudes of bipolar disorder. Methods : A total of 29 Bipolar patients and matched normal controls were recruited. All subjects completed the following questionnaires : Korean version of mood disorder questionnaire(K-MDQ), Korean version of Dysfunctional Attitude Style(K-DAS), and Korean version of Beck cognitive insight scale(K-BCIS), Korean version of Young Mania Rating Scales(K-YMRS) and Korean version of Hamilton Depression Rating Scale(K-HDRS) were administered to all patient by clinicians. Results : Compared with normal controls, patients with bipolar disorder showed significantly higher cognitive dysfunctional attitude scores. In subscales, scores of evaluation and perfection were significant differences. K-YMRS scores were negatively correlated with K-MDQ scores and K-BCIS scores. K-YMRS scores and K-MDQ scores had no correlation with scores of the dysfunctional attitudes. But K-YMRS scores were positively correlated with the self-esteem subscale of the dysfunctional attitude. Conclusion :Our results suggest that mood symptoms in bipolar disorder may affect subjective experience and cognitive insight of illness, but may not correlate with dysfunctional attitudes. The cognitive insight also do not correlate with dysfuctioanl attitudes. But compared with normal control, patient with bipolar disorder showed higher cognitive dysfunctional attitudes, especially evaluation and perfection.

Ultracet(R)을 이용한 통증 조절이 암 환자의 삶의 질(QOL)에 미치는 영향

송홍석 ( Hong Suk Song ),도영록 ( Young Rok Do ),박건욱 ( Keon Uk Park ),손인기 ( In Ki Sohn ) 대한내과학회 2005 대한내과학회지 Vol.68 No.5

목적 : 암성 통증의 관리에 있어 Ultracet(R)의 효율성과 부작용을 살펴보고, Ultracet(R)의 치료로 인한 삶의 질에 대한 변화를 알아보고자 실시하였다. 방법 : 2003년 2월부터 2004년 1월까지 계명대학교 동산의료원 혈액종양내과에서 통증 조절을 목적으로 한 97명의 환자를 대상으로 통증 조절의 정도와 삶의 질에 대한 변화를 알기위해 brief pain inventory, WHO QOL-BREF와 EORTC QLQ-C30을 이용한 설 Background : Cancer pain impacts the patient and improved pain management increases the quality of life (QOL) for the patient and entire family. One tablet of Ultracet(R) is composed of 37.5 mg of tramadol hydrochloride and 325 mg acetaminophen. Mechanism

의과대학생들의 성격성향과 관련된 환자중심적 태도

문석우(Seok Woo Moon),남범우(Beom Woo Nam),서정석(Jeong Seok Seo),류은정(Eun Jeong Ryu),권혁중(Hyuk Jung Kweon),손인기(In Ki Sohn),함 웅(Woong Hahm) 한국의학교육학회 2006 Korean journal of medical education Vol.18 No.1

Purpose: The patient-centered attitude is an effort to understand patients themselves as well as their disease. The doctor-oriented approach has been shifting to one where patients and participate in the deciding of medical service. We performed this study to investigate the patient-centeredness and influencing variables associated with personality traits. Methods: We recruited 94 medical students before their psychiatric clinical clerkship, and all subjects were assessed by a structured questionnaire including socio-demographic data, Minnesota Multiphasic Personality Inventory (MMPI), Meyers-Briggs type indicator (MBTI), the patientpractitioner Orientation Scale (PPOS), and the Authoritarian Personality scale (AP), The AP and PPOS questionnaires were repeated after the psychiatric clinical clerkship. Results: After the psychiatric clinical clerkship, the AP scores were significantly lower than before, and the PPOS significantly higher than before. The change in the AP scores were related to MBTI, correlated with MMPI subscales, however, inversely correlated with the changes in PPOS after the clinical clerkship. Conclusion: The authoritarian personality trait was related to, not only the personality trait including MBTI and MMPI subscales, but also to patient-centeredness in medical students.