慢性頭痛의 病態生理

田珍淑 藥業新聞社 1984 (月刊) 醫藥情報 Vol.1984 No.2

장수와 치매의 예방

전진숙 대한신경정신의학회 2009 신경정신의학 Vol.48 No.5

Objectives: The aim of this study was to understand pharmacological and non-pharmacological methods of dementia prevention. Methods: An internet searchof literature published from 2006 thru 2008 was done using combinations of the words‘dementia’ and‘prevention’. These publications were subsequently reviewed. Results: 1) Reduction of risk factors:control of vascular risk factors (hypertension, diabetes mellitus, obesity, hypercholesterolemia, smoking, hyperhomocysteinemia, and platelet aggregation) and medical risk factors (head trauma, depression, herpes simplex, hyperthyroidism, and alcohol problems). 2) Pharmacological trial:NSAIDs, selective COX-2 inhibitors, estrogen replacement therapy, and antioxidants. 3) Healthy diet and nutrition:macronutrients (polyunsaturated fatty acid such as omega-3, alpha-linolenic acid, docosahexaenoic acid) and micronutrients (vitamins such as vitamin A, vitamin B1, 3, 6, 9, 12, vitamin C, vitamin D, vitamin E, vitamin K;minerals such as iron, iodine, magnesium, zinc, manganese, copper, cobalt, selenium;trace elements;and non-essential micronutrients such as polyphenols). 4) Regular excercise and activities:physical activities including aerobics, flexibility, and strength exerrcises;Recreational activities including participation in religious or social activities, healthy sex life with partner, and stimulating cognitive activities. Conclusion: The final goal of dementia treatment is primary prevention. However, there is no proven method to achieve this. Therefore, secondary prevention or preventative maintenance through risk reduction and introduction of a healthy lifestyle in an attempt to postpone the onset of disease is a realistic goal. 치매치료의 궁극적 목표는 일차적 예방(primary prevention)이다. 그러나, 아직 이를 위한 치료법은 개발되지 않았다. 치매의 진행을 예방할 수 있는 약물치료나 생활양식은 입증된 것이 없다. 따라서, 현재로서는 이차예방이나 예방적 유지책(환자의 전반적 건강, 정신상태, 기능을 극대화 시킴으로써 과다한 질병을 감소시키는)에 중점을 두는 수밖에 없다. 다시말하면, 위험인자를 감소시키거나, 건강한 생활양식을 도입하여 치매의 발병을 지연시키는 것이다.

정신의학에서의 성 차이 : 인생주기에 따른 정신병리

전진숙 대한정신약물학회 2003 대한정신약물학회지 Vol.14 No.4

신경성 식욕부진증과 우울증에서 시상하부-뇌하수체 기능의 비교 : 증례 및 문헌고찰

전진숙,장환일,한홍무 서울대학교 의과대학 정신과학교실 1985 서울醫大 精神醫學 Vol.10 No.2

자율주행차 AI의 도로교통법 준수 운전능력평가 시나리오 개발 연구

전진숙,정현숙 대한교통학회 2022 대한교통학회 학술대회지 Vol.87 No.-

신경생리학적(神經生理學的) 동물실험(動物實驗)의 기초(基礎)

전진숙,Cheon, Jin-Sook 대한수면의학회 1994 수면·정신생리 Vol.1 No.2

The neurophysiological study has been widely used in the search of the relation between brain and behavior. The basic techniques for the animal experiments of this kind such as stereotaxic techniques, lesioning methods, the methods of electrical stimulation and confirmation of histological location were simply reviewed. Nevertheless, the importance of complementary neurochemical, neuroanatomical and behavioral studies can not be neglected.

신경정신장애의 분자 유전학적 접근

전진숙 고신대학교(의대) 고신대학교 의과대학 학술지 1993 고신대학교 의과대학 학술지 Vol.9 No.1

-Abstract- The molecular genetic techniques including recombinant DNA technology play an important role in modern neuropsychiatric research and practice. The basic concepts of molecular genetics and the clinical applications were reviewed in degenerative disorders including Alzheimer's disease, schizophrenia, mood disorders, and other neurological disorders. The molecular genetic methods seem to have potential value in the following applications; 1. The complete mapping of human genomes 2. The localization and cloning of genes for the hereditary disorders 3. The diagnosis and predictability of risks for the single-gene controlled disorders 4. The identification of gene products, and biochemical and physiological basis for the genetic diseases 5. The development of preventive methods and therapeutic drugs 6. In the future, availability of gene-replacement therapy for the same disorders

Fluoxetine 및 Sertraline으로 유도된 심한 세로토닌 증후군 1예

전진숙,이상신,김성희,조웅,Cheon, Jin-Sook,Lee, Sang-Shin,Kim, Sung-Hi,Cho, Woong 대한생물정신의학회 2001 생물정신의학 Vol.8 No.1

A 54-year old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.

정신분열병의 실험적 모델

전진숙,Cheon, Jin-Sook 대한생물정신의학회 1999 생물정신의학 Vol.6 No.2

동물모형은 정신장애의 연구와 치료에 유용한 도구를 제공할 수 있다. 정신장애의 동물모형으로서의 적합성에 대한 평가 기준은 첫째, 유도된 상태의 유사성, 둘째, 행동상의 유사성, 셋째, 공통된 근저의 신경생물학적 기전, 넷째, 임상적으로 효과적인 치료 기술에 의한 역전 등 4가지이다. 저자는 정신분열병의 연구에 유용한 도구로 사용할 수 있는 실험적 모델을 간략히 소개하였다. 정신분열병의 실험적 모델로서는 L-dopa 모델, phenylethylamine 모델, hallucinogen 모델, amphetamine 모델, phencyclidine(이하 PCP) 모델, NE 보상계병소 모델, 망상계자극 모델, 사회격리 모델, 조건화된 회피반응, catalepsy 시험, paw 시험, 자기자극 paradigm, latent inhibition paradigm, blocking paradigm, 경악반사의 prepulse inhibition, 설치류 상호작용, 원숭이의 사회적 행위, 해마손상, 선택적 breeding을 사용한 모델, 고기압 모델, 각성 모델, 감각운동 gating 모델 등이 제시되고 있다. 저자는 이중에서 특히 정신분열병의 실험적 모델로서 face validity, predictive validity, construct validity가 높은 몇 가지 방법에 대해서 중점적으로 설명하였다. 임상경험 및 동물실험에서 PCP 및 ketamine 등 PCP 유사물질은 양성증상 뿐만아니라 음성증상, 파과형, 인지장애군에 좀 더 가까운 비망상형의 정신분열병에도 적용시키기가 좋은 것으로 알려졌다. 임신이나 출생 시 합병증에 의한 해마병소화, 내재적 신경독성에 의한 NE 보상계 병소, 스테로이드 증가에 의한 해마변화 등에 의해서 정신분열병이 유도될 수 있음은 해마병소화 모델이 정신분열병의 실험적 모델로서의 첫번째 기준을 충족시킴을 입증한다. 해마 병소화 후에 정신분열병 환자에서 흔히 볼 수 있는 주의집중력 장애, 공간 및 문맥 정보의 이해결핍, 기억구성, 인식기억, 고전적 조건화, 일반화, 복합적 학습, 상동적 행동, 미신적 행동, 과잉각성, 소멸과 습관형성, 피부전도 실험 등의 이상이 관찰됨은 정신분열병의 실험적 모델로서 두 번째의 기준에 합당한 것이다. 사후 부검한 뇌조직 및 여러 신경영상화 연구에서 해마의 구조적 이상 및 신경전달물질의 수용체 변화가 보고됨은 세 번째 조건을 만족시키는 것이며, 정신분열병의 여러 치료약물을 투여함으로써 상기 변화가 반전됨은 해마병소화 모델이 정신분열병의 실험적 모델로서 타당도가 높음을 시사한다. 정신분열병의 양성증상, 음성증상, 인지장애를 모두 포괄적으로 반영할 수 있는 실험적 모델로서 ketamine 모델과 해마병소화 모델 등이 보다 유용한 도구로 제시될 수 있다. 그러나 현재까지 어떠한 정신분열병의 모형도 정신분열병 전체를 대표할 수 있는 것은 없다. 따라서 동물모형을 사용한 연구의 결과는 매우 조심스럽게 해석되어야 한다. 또한 동물모형을 발전시키고 타당화 시키려는 노력은 인간에서의 현상을 신빙성있게 측정하는 방법을 규명하는 과정과 공동으로 이루어져야 한다. Animal models can provide a useful tool for the study of some aspects of psychiatric disorders and their treatment. The four criteria for the evaluation of animal models of psychiatric disorders are as following : 1) similarity of inducing conditions 2) similarity of behavioral state 3) common underlying neurobiological mechanisms 4) reversal by clinically effective treatment techniques. Several animal models have been proposed for schizophrenia : phenylethylamine model, L-dopa model, hallucinogen model, cocaine model, amphetamine model, phencyclidine model, noradrenergic reward system lesion model, reticular stimulation model, social isolation model, conditioned avoidance reaction, catalepsy test, paw test, self-stimulation paradigms, latent inhibition paradigms, blocking paradigms, prepulse inhibition of the startle reflex, rodent interaction, social behavior in monkeys, hippocampal damage, high ambient pressure, and models using selective breeding. Among them, animals with bilateral lesion of the hippocampus may provide an adequate animal model for several symptoms of schizophrenia, and ketamine model can reproduce negative symptoms and cognitive deficits as well as positive symptoms of schizophrenia. In conclusion, no model of schizophrenia is entirely representative of the disease, and findings gleaned from model systems must be cautiously interpreted. Furthermore, the process of developing and validating animal models must work in concert with the process to identify reliable measures of human phenomenology.

한국에서 노인용 미시간주정의존선별검사의 적용을 위한 예비연구

전진숙,오병훈,최영태,Cheon, Jin-Sook,Oh, Byoung-Hoon,Choi, Young-Tai 대한생물정신의학회 1999 생물정신의학 Vol.6 No.1

Objectives : The alcohol dependence in elderly people has been prevalent because of increase in geriatric population. However, it is difficult to find out alcohol dependence in the aged, because they have less specific clinical features as compared with adult alcoholics. The aims of this study were to screen alcohol dependence among elderly Koreans and to know the clinical characteristics of Korean delerly alcoholics. Methods : The questionnaires translated into Korean such as Michigan Alcoholism Screening Test(MAST-K), the Brief MAST and the MAST-Geriatirc Version (MAST-KG) were used to screen alcohol dependence in the elderly alcoholic inpatients aged over 60(N=43), adult alcoholic inpatients within 20-59 Yrs of age(N=60), which were compared with age matched normal healthy aged(N=18) or adult controls(N=45). The demographic data such as sex, age, education, occupation, socioeconomic status, marital status, numbers of children, dwelling and religion as well as alcohol history such as duration of alcohol drinking, onset age, family history, impulsivity, somatic illness and motivation were also obtained to identify characteristic features of Korean aged alcoholics by structured interviews. Results : 1) The aged alcoholics had the charateristic features of more in males, lower age, low education levels, more in blue-collar workers, lower socioeconomic class, more in single, few babies, more living alone, having no religion without statistical significance. 2) The onset age of alcohol dependence was significantly higher in the aged alcoholics($45.3{\pm}13.6Yrs$) than in the adult alcoholics($27.7{\pm}8.7Yrs$)(p<0.0001). The duration of problematic alcohol drinking was significantly longer in the aged alcoholics($22.0{\pm}15.1Yrs$) than in adult alcoholics($14.2{\pm}8.4Yrs$)(p<0.01). Otherwise, there were no significant difference between aged and adult alcoholics in the family history, imulsivity, somatic illness and motivation. 3) The mean score of the MAST-K was significantly higher in the aged alcoholics($20.6{\pm}5.4$) than in the normal aged($6.7{\pm}4.4$)(p<0.0001), which was significantly lower than in the adult alcoholics($26.2{\pm}8.0$) and in normal adult controls($9.5{\pm}3.2$)(p<0.05). The mean score of the Brief MAST was significantly lower in the aged alcoholics($9.3{\pm}3.5$) than in the adult alcoholics($14.5{\pm}6.6$)(p<0.0001). The mean score of the MAST-KG was significantly higher in the aged alcoholics($10.6{\pm}3.5$) than in the normal aged($4.8{\pm}4.3$)(p<0.0001). The former was significantly lower than in the adult alcoholics($12.9{\pm}4.3$)(p<0.005), and the mean score was $4.5{\pm}2.8$ in normal adult controls. 4) The items which showed statistically significant differences between aged alcoholics and normal aged controls could be found in 10 items of the MAST-K(items 2, 3, 4, 5, 11, 14, 17, 21, 22 and 23), 2 items of the Brief MAST(items 2 and 9), and 7 items of the MAST-KG(items 6, 13, 18, 19, 22, 23 and 24)(p<0.01). Conclusions : The scores of the MAST-K, the Brief MAST and the MAST-KG were significantly lower in the aged alcoholics than those in the adult alcoholics (p<0.05). The statistically significant differences between aged alcoholics and normal aged controls could be found in 10 items of the MAST-K, 2 items of the Brief MAST and 7 items of the MAST-KG. Therefore, a briefer rating scales around 10 items are needed to screen alcohol dependence among Korean elderly people.