정신증적 증상을 보인 장티푸스 1례

손현균 대한생물치료정신의학회 1998 생물치료정신의학 Vol.4 No.2

장티푸스의 여러 합병증 중에 정신증적 증상은 드문 임상양상이다. 장티푸스와 정신증상과의 인과관계는 아직 명확히 알려진 바는 없으나, 장티푸스 환자 중 어떤 화자가 정신증상을 나타내고 어떤 화자는 증상이 나타나지 않는 지에 대해서는 아직 밝혀진 바가 없다. 발병하는데 기여하는 요인으로 장티푸스 감염, 고열, 독소, 대사결핍, 효소 결핍, 비타민 결핍, 소인이 있는 성격 경향 등이 추정된다. 저자는 정신증상을 보인 34세 된 남자 장티푸스 환자를 치료할 기회가 있었고 그 환자는 입원당시에는 정신분열병과 같은 증상을 나타냈었다. 그래서 이에 대한 증례보고와 함께 장티푸스 환자의 정신과적 증상에 대한 문헌고찰을 하여보았다. Among the various complications in typhoid fever, the psychotic symptoms are rare clinical manifestation. The causal relationship between typhoid fever and the psychiatric symptoms is not yet clear. The causative factors of psychiatric symptoms could be the typhoid infection, high fever, toxin, metabolic deficiency, enzymatic defect, vitamin deficiency, predisposing personality. The author experienced a 34 year old male of typhoid fever accompanied with psychotic symptoms, whose symptoms and signs were like that of schizophrenics on admission, and then author reported this patient and reviewed related articles antipsychotics frequently used to relieve psychotic and behavior symptom during acute manic episode before mood stabilizer have an effect on, and it have been suggested that antipsychotics immediately discontinue when to be relieve acute manic symptom is theoretically the best choice.

항정신병약물 악성증후군에 병발된 Lithium 중독 1례

손현균 최신의학사 2000 最新醫學 Vol.43 No.11-12

한국의 동반자살 : 신문보도를 통해본 동반자살의 분석 A Review of Newspaper Reports

손현균,김이영,안동현 漢陽大學校 精神健康硏究 1997 精神健康硏究 Vol.16 No.-

알코올 의존과 세로토닌 수송체 유전자 다형성의 연관

손현균,최인근,채영규,최미란,김재환,양병환,김석현,성승모,Son, Hyun-Gyun,Choi, Ihn-Geun,Chai, Young-Gyu,Choi, Mi Ran,Kim, Jae Hwan,Yang, Byung-Hwan,Kim, Seok Hyeon,Sung, Seung Mo 대한생물정신의학회 2003 생물정신의학 Vol.10 No.2

Objective:Under the hypothesis that 5-HTTLPR polymorphism plays some role in the susceptibility or vulnerability of some subgroup of alcohol dependence, associations of 5-HTTLPR polymorphism with alcohol dependence were examined. Method:This association analysis included 109 Korean alcohol dependent and 113 Korean control subjects. DNA of all subjects were genotyped for the biallelic functional polymorphism in the 5-HTTLPR. Considering the likelihood of heterogeneity in the alcohol dependence phenotype, alcohol dependent subjects were subgrouped by onset age, family history of alcohol dependence and severity of withdrawal symptoms. Results:There were no significant differences in the frequencies of either the 5-HTTLPR genotype or the short vs. long allele in alcohol dependent and control subjects. The frequency of the S allele and S-carrier (LS or SS genotype) was significantly increased in the early onset alcohol dependent subjects and the familial alcohol dependent subjects compared with that in the control subjects. Conclusion:The results suggest that the 5-HTT 'S' promoter polymorphism is associated with an increased susceptibility or vulnerability to develop early onset alcohol dependence and familial alcohol dependence, which characterize Cloninger's type 2 alcohol dependence.

뇌사에 대한 의사와 일반인의 태도 조사

손현균,김광일,김이영 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.1

In this attitude survey using Q-methodology, the authors attemped to identify the physician`s & public attitudes toward brain death. Thirty three statements related to attitude toward brain death were Q-sorted by 71 physicians & 71 laymen. The data were statistically analysed by Q-factor analysis. Five factors in physician group and six factors in layman group could be extracted. Characteristic features of five factors in the physicians were as follows: Factor A: Physicians of this factor positively approve of brain death by pragmatic reason. They agree to organ transplantation, but they resist donation of their own organs in organ transplantation. They are selfish and treasure their body. These people could be named as 「The egoistic brain death advocators」. Factor B: Physicians of this factor approve of brain death for organ transplantation. Most of them are religious. These people could be named as「The humanitarian brain death advocators」. Factor C: Attitude toward brain death in this group is vague. They agree to organ transplantation and also have intention of donation of their own organs and receipt of others. These people could be named as 「The transplantation devotees」. Factor D: These physicians are indifferent in attitude brain death and organ transplantation basically. These people could be named as「The bystanders」. Factor E: These physicians have no trust in phsysicians, religion and modern medicine. They agree to organ transplantation but strongly oppose to brain death. These people could be named as「The doctor mistrustees」. Characteristic features of factors in the laymen were as follows: Factor A: Subjects of this factor positively approve of brain death. They also agree to organ transplantation. They want to receive organs from others but do not intend to donate their own organs because they selfish and treasure their body. These people could be named as「The egoistic brain death advocators」. Factor B: People of this factor approve of brain death and organ transplantation. They are will to donate their own organs. They are mostly post graduated, single females. These people could be named as「The active brain transplantation advocators」. Factor C: People of this factor have somewhat negative attitude toward brain death but approve of organ transplantation. They have no intention of donation of their own organs in viewing traditional concept and attitude. They are mostly religious. These people could be named as 「The traditionals」. Factor D: These persons have no trust in physicians and religion. They have somewhat negative attitude toward brain death. They have no conspicuous opinion toward brain death and organ transplantation. These people could be named as「The doctor mistrustees」. Factor E: This factor was polarized. 「The extreme opposites to brain death」versue「The extreme brain death advocators」were named.「The extreme opposites to brain death」strongly oppsed to brain death and organ transplantation. Attitude of「The extreme opposites to brain death」are mirror image of「The extreme brain death advocators」. Discussion was carried out on the various attitude toward brain death in physicians and laymen.

Liquid permeability through the packed bed of spheres with bidisperse size distribution

손현진,구상균 한국공업화학회 2010 한국공업화학회 연구논문 초록집 Vol.2010 No.-

이분산 구형 입자로 구성된 충전층을 흐르는 점성 유체 흐름의 투과도

손현진 ( Hyun Jin Sohn ),구상균 ( Sang Kyun Koo ) 한국화학공학회 2012 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.50 No.1

본 연구에서는 크기가 다른 두 종류의 단단한 구형 입자들로 충전된 이분산(二分散) 충전층을 지나는 비압축성 유체 흐름의 투과도를 실험적으로 측정하고 이론적으로 예측하는 문제를 다룬다. 작은 입자에 대한 큰 입자의 크기 비 λ가 1.25와 2인 두 가지 경우에 대해 여러 가지 입자 혼합 비율로 충전층을 만들고 그 공극률과 유체 흐름의 투과도를 측정하였다. 이분산 충전은 입자 크기가 일정한 단분산 충전에 비해 공극률이 감소하고 투과율이 감소하나 입자들의 크기 비 λ나 혼합 비율 γ에 따라 다르게 나타난다. 두 가지 입자의 혼합 비율에 따른 공극률의 변화와 투과율의 변화형태는 서로 일치하지 않는다. 개별 충전 입자에 걸리는 항력 계산에 기초한 모델을 고안하여 투과도를 예측하는 간단한 이론식을 유도하였고 이 식을 이용한 예측값을 실험 결과 및 선행 연구 결과들과 비교한 결과, 이 이론식에 의한 투과도 예측값이나 입자 혼합 비율에 따른 투과도 변화 경향이 실험값에 가장 근사하였다. 이 이론식을 이용해 이분산 충전층을 지나는 유체 흐름의 투과도를 간단하고 정확하게 예측할 수 있음을 보였다.

The effect of the bidispersity on liquid permeability through the packed bed with sphere packings

손현진,구상균 한국공업화학회 2010 한국공업화학회 연구논문 초록집 Vol.2010 No.1

한국어판 DIS-IV의 개발과 표준화

서국희,손현균,최상섭,이미경,이중서,최인근,방현숙,연병길 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

연구목적 : DSM-Ⅲ-R의 개정판이라기 보다는 새로운 진단 기준으로 간주될 정도였던 DSM-Ⅳ의 출현은 정신장애의 진단분류체계에 매우 큰 영향을 미쳤다. DSM-Ⅳ의 변화를 반영하여 정신과적 진단을 내릴 수 있도록 DIS-Ⅲ를 개정하여 DIS-Ⅳ가 개발되었다. 본 연구는 국내에서의 정신의학적 연구를 더욱 활성화하고 활발하게 국제 공동연구가 이루어질 수 있도록 DIS-Ⅳ 한국어판을 개발하고 이를 표준화하는 데 그 목적이 있다. 방 법 : 번역 위원회에서 번역, 역번역, 어의적 정확성 확인, 한국어 용법에 맞도록 수정한 후 예비 연구를 거쳐 한국어판 DIS-Ⅳ가 완성되었다. 의과대학생 4명에게 Washington University DIS-Ⅳ training course와 동일한 내용과 방법으로 교육을 실시하였다. 두 명의 조사요원들이 한 환자를 DIS-Ⅳ를 사용하여 동시에 검사한 후의 진단을 비교하여 검사자간 신뢰도를 측정하고, 정신과 의사가 독립적으로 DIS-Ⅳ를 사용하여 검사한 후의 진단과 비교하여 절차 타당도를 평가하였다. 조사 대상은 2000년 1월부터 8월까지 2개 대학 병원 정신과 및 국립감호정신병원에서 치료중이던 환자 124명이었다. 결 과 : 평가자간 신뢰도의 kappa값 평균은 0.74였다. 양극성 Ⅰ장애, 범불안장애, 우울장애, 강박장애, 반항장애, 동통장애, 병적 도박, 외상후 스트레스 장애, 특정공포증 및 대부분의 물질 사용 혹은 관련 장애의 kappa값이 0.7 이상이었다. 정신과 의사의 진단과 조사요원의 진단의 일치도를 비교한 절차 타당도를 살펴보면 다음과 같다. 전체적인 sensitivity는 67.6%, specificity는 98.3%, kappa 값은 0.69이었다. 물질 사용 장애 및 물질 관련 장애의 SE는 79%, SP는 98.6%, kappa 값은 0.77이었다. 이를 제외한 나머지 정신 장애의 SE는 60.5%, SP는 98%, kappa 값은 0.64이었다. 본연구의 결과는 Robins 등에 의해 최초로 보고된 DIS의 신뢰도 및 타당도와 거의 비슷한 수준이었다. 결 론: 한국어판 DIS-Ⅳ가 높은 신뢰도와 타당도를 지닌 것으로 생각된다. 이 도구를 통해 물질 사용 및 관련 장애를 타당도와 신뢰도 높게 진단할 수 있다는 점이 매우 중요하다. 향후 정신장애의 진단 능력을 향상시키고 임상연구를 활성화하고 국제적인 학술적 교류를 늘리는데 일조할 수 있을 것이다. Objective : Appearance of DSM-Ⅳ has influenced greatly on the nosological classification of mental disorder, not considered as revised one of DSM-Ⅲ-R but a new criteria. DIS-Ⅳ has been developed after revision of DIS-Ⅲ in consideration of various changes in DSM-Ⅳ. This study is to develop and validate the DIS-Ⅳ, Korean version to activate Korean psychiatric research much more and to modivate more frequent international collaborative study. Method : Translation committee produced DIS-Ⅳ, Korean version through all the procedures of translation, back-translation, confirmation of retained original meaning of the English version, adaptation to Korean linguistic usage and preliminary study. Four medical students were trained during DIS-Ⅳ training course that retained the same contents and methods as of Washington University. Inter-rater reliability was measured by comparison between two diagnoses made from two interviewer who rated one patient at the same time. Procedural validity was measured by comparison between lay-interviewer's diagnosis and psychiatrist's diagnosis which were made after independent DIS-Ⅳ using interview. Subjects were 124 patients who were being treated at two University Hospital and National Forensic Psychiatric Hospital between January, 2000 and August, 2000. Results : Average kappa value of inter-rater reliability was 0.74. Diagnoses showing over 0.7 in kappa value were bipolar I disorder, generalized anxiety disorder, depressive disorder, obsessive-compulsive disorder, oppositional defiant disorder, pain disorder, pathological gambling, post-traumatic stress disorder, specific phobia and almost all substance use disorder or substance-related disorder. Procedural validity, that compared lay-interviewer's diagnosis and psychiatrist's diagnosis, were as follows: For all diagnoses, sensitivity, specificity and kappa were 67.6%, 98.3% and 0.69. For diagnoses of substance use disorder or substance- related disorder, sensitivity, specificity and kappa were 79%, 98% and 0.77. For other diagnoses except substance use disorder or substance- related disorder, sensitivity, specificity and kappa were 60.5%, 98% and 0.64. This results are almost at the same level as that of Robins and her colleagues who tirst reported reliability and validity of DIS. Conclusion : We think that DIS-Ⅳ, Korean version has higher reliability and validity. It is very important that diagnoses of substance use disorder and substance-related disorder can be made reliably and validly by this instrument. We expect that it can help to improve diagnosability of mental disorder, activate clinical research and increase international scientific communication.

알코올 금단과 혈중 아질산염 농도

이병철,손현균,최인근,Lee, Boung Chul,Son, Hyun-Gyun,Choi, Ihn-Geun 대한생물정신의학회 2004 생물정신의학 Vol.11 No.1

Objective:Nitric oxide(NO) has been known to be associated with tolerance and preference to alcohol. It has also been known to affect various alcohol drinking behavior, alcohol withdrawal symptoms and alcohol- induced brain damage. The purpose of this study was to determine the difference, among alcohol dependence group, alcohol drinking group and abstinence group, in serum concentration of nitrite, a stable metabolite of NO, and it's relationship to clinical and biochemical markers of alcoholism. Methods:Forty subjects diagnosed as alcohol dependence according to DSM-IV diagnostic criteria were evaluated for the clinical characteristics and biochemical markers of alcohol dependence including nitrite with their CIWA-Ar scores checked just after admission. Thirty-nine healthy controls were also evaluated, divided into twenty-three alcohol drinking group and sixteen abstinence group. Clinical characteristics were evaluated by CIWA-Ar, CAGE and AUDIT questionnaires. Aspartate aminotransferase(AST), alanine aminotransferase (ALT), gamma glutamyltransferase(GGT) and mean corpuscular volume(MCV) were used as the biochemical markers of alcohol dependence. Serum nitrite concentrations were measured by Griess reaction. Results:1) The concentrations of nitrite in alcohol dependence patients were not different from those in the control subjects. 2) There were no significant association between the nitrite concentrations and the CIWA-Ar scores in alcohol dependence patients. 3) Nitrites are significantly increased in alcohol dependence group and alcohol drinking group compared with abstinence group. Conclusions:These findings suggest that serum nitrite concentration has no relation with alcohol withdrawal symptoms, but alcohol drinking increases serum nitrite concentration influenced by general condition of the body.