1995년 대한폐경학회 연수 심포지움 : 갱년기 정서장애

우행원 대한폐경학회 1995 연수심포지움 Vol.- No.-

Due to increasing aveage lift time length, most of women must to face menopause which induces much somalic and psychological reaction. Although physiohgical chages are similar in climacteric women, their somatic and psychologic reactians are much different among women. attempts to summarize biological, psychosocial, psychodynamic aspect of menapause and common psychiatric disarder at that time were made through review of articles. As a result, many somatic symptoms and psychological symptoms are interrelated each other, especialty irritability is influenced by menorrhagia, sexual dysfunction is influened by vaginal atrophy, and insomnia is influenced by night sweat. There is a suggestion of a peak in the excess of females over males in tbe onset of first attacks of affective disarder and minor peak in the prevalence of psychiatric disorder in the peri menopausal yaus. It is uncertain why psychiatric disarders are incereased at tbat time. Maybe dysfunctional hypothalamic feedback mechanisms, poor premorbid adjustment, empty nest syadrome, marital dysharmony, cultural factors ate attribute to psychological symptoms and psychiatric illness at peri-menopausal year. The most impartant treatments are adequate psychialric consultation and adequate educations about menopause to climacteric women.

우울증 환자에서의 호중구 및 임파구 기능장애

우행원 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.4

Regulation of the quantity of different types of leukocytes has not been adequately investigated in patients with psychiatric illness. Kronfol et al have noted a significant association between leukocyosis, neutrophilia, and mania, and lymphopenia and depression. In this study, leukocytes especially neutrophills and lymphocytes were counted in 20 untreated depressive patients, 43 untreated schizophrenic patients and 36 neurotic patients. A significant increase numbers of neurophils and significant decrease in the numbers of lymphocytes were found in the depressive patients. Furthermore, when compared to normative values from the general population, depressive patients showed higher frequencies of both reutrophilia and lymphopenia than the schizophrenic and neurotic patients. Glucocorticoids have for a long time been associated with hematologic changes consisting of neutrophlia and lymphopenia. Changes very similar to this, were observed in depressed patients in this study. Since depression is more frequently associated with hypercortisolemia than are the schizoprenic disorder and neurosis, it is reasonable to attribute the hematologic differences between depression and, schizophrenic disorder and neurosis, at least in part, to excess cortisol in the depressive patients. However, since cortisol levels were not obtained in my patients, this issue remains a matter of speculation but regardless of the mechanism involved, the present data indicate significant differencs in the regulation of blood cell elements in depressive, schizoprenic and neurotic patients.

동기간에 발생한 정신분열병환자들의 임상적 연구 : 가족역동과 가족병리를 중심으로 Focusses on Familydynamic and Familial Psychopathology

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1985 EMJ (Ewha medical journal) Vol.8 No.4

Author attempted of find out whether there were any characteristic findings in the sibling schizophrenics family(family in which more than two members of sibling were schizophrenia) including clinical features, interpersonal relationship and some of sociodemographyic aspects. Data for the sample were obtained 17 schizophrenics from 8 sibling schizophrenics families who were admilted to neuropsychiatric department EWHA Womens University Hospital from March 1st 1973 to February 28th 1983. Results obtained were summerized as follows; The members of sibling were larger in the schizophrenics families than that of normal and the first born childrens and last born childrens were affectes more frequently than subseguent ones. Sibling schizophrenics were tended to be heigh educates, no employed and low middle socioeconomic class. In the familial history, sibling schizophrenic's father proband had more frequently affectes than mother proband. Usually mother's characters were found to be over protective and active but father's were indifferent and passive. Their father and mother had mother dominent and hostile relationship. Interpersonal relationship between sibling schizophrenics had relative affective(41.2%) in the majority. Comparative analysis of the above finding showed no differences from the family in which only one child was afflicted schizophrenia.

양극성 정동장애에서 Lithium 투약에 따른 혈청 칼슘, 이온화 칼슘 및 인산염의 변화

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1992 EMJ (Ewha medical journal) Vol.15 No.4

This study was conducted to investigate the effect of lithium treatment on the serum total calcium, ionized calcium and phosphate in bipolar disorder. The subjects were 20 patients. The total calcium, ionized calcium and serum phosphate were measured before and after lithium treatment, and the values were statistically analyzed. The results are summarized as follows: 1) Serum total calcium level was significantly increased after lithium treatment(p<0.01). 2) Ionized calcium level was significantly increased after lithium treatment(p<0.05). 3) Phosphate level was significantly increased after lithium treatment(p<0.05).

Alzheimer병의 약물치료

우행원 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.3

Neuropathologic investigations of Alzheimer's disease(AD) have shown that cholinergic neuronal loss is seen in the nucleus basalis of Meynert, and activities fo choline acetyltransferase and acetylcholine esterase are decreased in the cerebral cortes. These findings led to attempts to correct the deficiency with cholinomimetic agents and those attempts was effective in some patients. However, there have been no pharmacologic agent proved to be successful. Donepezil is the reversible acetylcholine esterase inhibitor with long half-life and high affinity to CNS, and was found to great improvement in cognitive function in clinical trials in Europe and US without compromized hepatotoxicity. The other pathophysiology of AD includes wide range fo neurotransmitter imbalances and cortical atrophy, so that combined treatment approach such as cholinergic/serotonergic drug and cholinergic/somatostatinergic drug should be considered. As a preventive approach, neurotrophic factor, which may delay degenerative process of cholinergic neuron, is clinically valuable when administrated directly into ventricles. In many cases, amyloid deposits are seen as the distinctive neuropathology of AD, and the presence of amyloid precursor protein gene on chromosome 21 will lead to the gene therapy. As the disease advances, various degrees of neuropsychiatric disturbances become so marked and may be reduced by treatment of associated depression, anxiety, disruptive behaviors, and psychotic symptoms with appropriate psychotropic medications, However, these drugs may make patients confused, requiring reduction or withdrawal of the medication.

정신분열증환자와 일반환자의 복용약물 認知에 관한 비교연구

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1979 EMJ (Ewha medical journal) Vol.2 No.1

Fifty schizophrenic inpatients receiving antipsychotic medications were evaluated as informed and or consenting drug consumers by means of structured interview, in comparison with a matched group of medical inpatients receiving nonpsychotrpic drugs. Medical patients were better informed about positive aspects of medication, such as relationship of drug treatment to a specific diagnosis and not better informed about positive aspects of medication, such as name and dose. Schizophrenic patients, however, were significantly better informed about side effects and risks. Although both groups felt that their medication had helped them, 84% of the medical patients but only 72% of the schizophrenic patients said they would take the medication if they had choice. The fact that schizophrenic inpatients readly shared their reluctance to take medication with an interviewer may offer an avenue for detection and intervention improve prospects for outpatient compliance.

과거 10년간 이화대학병원 정신과 외래 소아환자에 대한 임상적 고찰

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1978 EMJ (Ewha medical journal) Vol.1 No.4

In view of the absence of any systematic study of the psychiatric disorders among the children (16 years and younger) in this country, the author reviewed 325 child psychiatric patients seen at the department of neuropsychiatry, Ewha Womans University Hospital during 10 years(from 1968~1977). In this paper the study group of 325 child psychiatric patients were studied with special emphasis on diagnostic distribution, age sex distribution, family back ground, sibiling order and course and purpose of visiting hospital. The results are as follows: 1) 325(8.7%) new child patients visited to neuropsychiatric department among the total 3,736 new patients from 1968 to 1977. 2) The number of the new child patients had increased year after year. 3) Most frequent diagnosis was neurosis followed by epilepsy, schizophrenia and special symptoms in that order. 4) 163 cases (50.1%) were male and 162 cases were female. Most prevalent age distribution was 12~16 year group(53.8%) 5) 16 patients (4.9%) had the history of paternal loss. 6) In sibling order, most prevalent was middle sibilings(18.6%). followed by last(17%), and first(16.6%). 7) Most patients were referes via O.P.D. 8) Purposes of visiting hospital were symptom treatment(55.1%), and psychiatric evaluation(44.9%).

응급실을 통하여 입원한 정신과 환자에 대한 임상적 고찰

우행원 梨花女子大學校 醫科大學 醫科學硏究所 1988 EMJ (Ewha medical journal) Vol.11 No.4

Hospital records of neuropsychiatric patients admitted to Ewha Womans University Hospital via the emergency room from January 1, 1982 to December 31, 1986 were reviewed, and the following results were obtained. 1) Patients admitted via the emergency room comprised 6.65% of total neuropsychiatric admission The rate of emergency admission were 3.98% at 1982, 3.48% at 1983, 8.5% at 1984, 7.9% at 1985, 9.4% at 1986 which seems increasing tendency. 2) The male : female sex ratio of the patients was 1 : 1.03. 43% of the emergency room admission patients were in their twenties and 20% of the patients were thirties, 63% of them were in their twenties or thirties. 3) 82% of them were in the middle class of socioeconomic level, 46% of the patients had college education level and 51% of them were married status. 4) Presenting problems, in the order of frequency, were delusion and hallucination, somaticsymptom, anxiety and phobia, exciting and assultive behavior, convulsion, suicide attempt, behavior disorder, sleeping disturbance, consciousness disorder and homicide tendency. 5) In most cases the duration of hospitalization was 2 weeks or less for neurosis and over 2 weeks in schizophernic disorders. 6) 21.5% of the emergency room patients were diagnosed as schizophrenic disorder which was the most frequent diagnosis in all patients. 7) 23% of the emergency room patients were discharged against medical advice.

Alcoholism과 우울

우행원 大韓神經精神醫學會 1986 신경정신의학 Vol.25 No.1

Alcoholism and depression are major psychiatric problems and any evidence pointing toward a shared etioloical factors should have great impact on the practice of psychiatry, the burden of cost, and suffering born by society, patients, and their families. Then the author intented to evaluate the correlation between those researches on alcoholism and depression. With a thorough review of the literatures, the author reached the following results. Before looking at research findings, we must be careful about the meaning of terms. The word "depression" used in broad scale: a sad or dysphoric mood, insomnia, anorexia, loss of concentration or psychomotor retardation. Alcohol dependence syndrome used in broad scale also: alcoholism, alcoholics and alcohol intoxication. Other definition of the word will must be specified. Symptom that are similar to some of those of depressive illness are common in both the drinking and withdrawal alcoholic. These however, are not typical of serious endogenous illness. They are marked by dysphoria and mixed with the anxiety. Response to medication aften used in the treatment of depression(antidepressants, neuroleptics and lithium) is seen but is not yet demonstrably specific. Among those alcoholic patients who do suffer from serious depressive illness and a high rare of suicidal behavior, a family background of serious depressive illness is more common than expected. Furthermore, a subset of families in whom alcoholism is prevalent tends to have a large numbers of family members especially female, who suffer from depression alone and not alcoholism. This depression is essentially, indistinguishable from that seen in a typical endogenous depression. Some unstable personality characteristics and a chaotic social life tend to characterize these patients. Bipolar affective disease has yet to be linked with alcohlism conclusively.

진정한 사랑과 성을 누리려면

우행원 새가정사 1998 새가정 Vol.490 No.-