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        공황 장애 환자의 공황 발작 증상의 특성

        임기영,김창기,노재성 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.4

        공황 장애가 새로운 질병으로 분류된지 16년이 경과하였으나 공황 발작과 공황장애의 본질과 특성에 관해서는 아직 명확히 알려져 있지 않다. 또한 현재의 DSM-IV 진단 기준 역시 공황 발작과 공황 장애의 정의 및 진단에 대해 상호 모순되는 기술을 하고 있음을 발견할 수 있고 공황 발작의 각 증상에 대해서도 나열에 그치고 있을 뿐 어떤 것이 더 중요하고, 어떤 것이 최초 증상인지 등을 밝혀 주지 못하고 있다. 따라서 저자들은 공황 장애 환자들의 공황 발작 증상의 특성을 보다 자세히 알아보기 위하여 아주대학교 병원 정신과 외래 및 응급실로 내원한 40명의 공황 장애 환자들을 대상으로 공황 발작 설문지, 불안 민감도 검사, 상태-특성 불안 검사, Beck의 불안 검사를 실시하여 다음과 같은 결과를 얻었다. 1) 공황 장애 환자들이 공황 발작시 최초로 경험하는 증상들은 대부분 신체 증상(90%)이었으며, 공황 발작의 인지 증상과 신체 증상은 높은 상관관계(0.741, P<0.01)가 있었다. 2) 인지 증상(0.695, P<0.01)과 신체증상(0.599, P<0.01) 모두는 임소공포증적 회피의 정도와 유의한 정적 상관 관계를 나타내었다. 그러나 신체 증상을 통제 변인으로 하여 인지 증상과 임소공포증적 회피와의 부분상관을 구한 결과는 유의한 상관이 있었으나(0.467, P=0.003), 반대로 인지 증상을 통제변인으로 하여 신체 증상과 임소공포증적 회피의 부분 상관을 구한 결과는 통계적으로 의미 있는 상관 관계가 없었다.(0.173, P=0.291). 3) 인지 증상은 ASI상의 불안 민감도 (0.563, P<0.01), STAI상 상태(0.324, P<0.05) 및 특성 불안(0.484, P<0.01), BAI상의 불안(0.456, P<0.01)과 정적 상관을 보였다. 신체 증상은 ASI 상의 불안 민감도(0.528, P<0.01), STAI 중 특성불안(0.411, P<0.01), 그리고 BAI 상의 불안(0.348, P<0.05)과는 정적상관을 나타내었으나, STAI 중 상태 불안(0.171)과는 의미 있는 상관이 나타나지 않았다. 4) 인지 증상과 신체 증상과 신체 증상 각각에 대해 상대 증상을 통제 변인으로 하여 부분 상관을 구해 본 결과, 신체증상은 각종 불안 검사상의 불안 및 민감도와 통제적으로 의미 있는 상관을 보이지 않았지만 인지 증상은 의미 있는 상관을 나타내었다. 이상의 결과들은 공황 발작이 본질적으로 신체증상이 선행되고, 인지 증상이 부수되는 복합현상이며, 인지증상의 정도에 따라 심리적 불안의 정도와 불안 민간도가 높아져서 공황 증세로 진행되고, 역시 인지 증상의 정도에 따라 임소공포증적 회피가 결정됨을 시사한다. 따라서 공황 발작의 13가지 진단 기준 항목은11가지 신체 증상만으로 줄이고, 2가지 인지 증상(죽을 것 같은 공포 및 미치거나 자제력을 잃게 될 것 같은 공포)은 공황 장애의 진단 기준에 포함시키며 이때 공황이 일어난 상황으로부터 벗어나려는 생각을 공황 장애의 인지 증상에 추가하는 것이 보다 정확한 진단 기준이 될 것으로 판단된다. It has been 16 years since panic disorder was first classified as a psychiatric disease entity. However, the nature and characteristics of panic attacks and panic disorder are not fully understood yet. The Diagnostic and Statistical Manual, Fourth Edition(DSM-IV) carries conflicting statements regarding the definitions and diagnostic criteria of the panic attacks and panic disorder. Moreover, the DSM-IV only checks the presence or absence of each symptom, while failing to clarify which of each panic symptom are the earlier or more important symptoms. This study was designed to investigate the nature and characteristics of the panic attack symptoms. Forty outpatients diagnosed with DSM-IV panic disorder criteria were the subjects. All the subjects completed Panic Attack Questionnaire, Anxiety Sensitivity Index, State-Trait Anxiety Inventory, and Becks Anxiety Inventory. Results were as follows : 1) Majority(90%) of the subjects experienced somatic symptoms as the first symptom of their panic attack, and there was a significant correlation (0.741, P<0.01) between the somatic symptoms and the cognitive symptoms of panic attack. 2) Both cognitive symptoms(0.695, P<0.01) and somatic symptoms(0.599, P<0.01) showed significant correlation with agoraphobic avoidance. However, in partial correlation using somatic and cognitive symptoms as control variables for each other, only cognitive symptoms showed significant correlation with agoraphobic avoidance(0.467, P=0.003). 3) Cognitive symptoms showed significant correlation with the anxiety sensitivity(0.563, P<0.001), state anxiety(0.324, P<0.05), trait anxiety(0.484, P<0.01), and Becks anxiety(0.456, P<0.01). Somatic symptoms also showed significant correlation with the anxiety sensitivity(0.528, P<0.01), trait anxiety(0.411, P<0.01), Becks anxiety(0.348, P<0.05), but not with the state anxiety(0.171). 4) In partial correlation using somatic and cognitive symptoms as control variables for each other, cognitive symptoms showed statistically significant correlation with anxiety sensitivity and anxiety levels, while the somatic symptoms did not show such correlations. These results suggest that panic attack is a complex phenomenon in which the somatic symptoms are "triggers", and the cognitive symptoms are secondary reactions to the somatic symptoms. Psychological anxiety and anxiety sensitivity increase in proportion to the cognitive symptoms of the panic attack, which are important in the clinical process of panic disorder. The severity of cognitive symptoms also determines the development of agoraphobic avoidance. The authors propose to revise the diagnostic criteria of panic attack by the somatic symptoms only, and include cognitive symptoms, such as the desire to escape from the scene of panic attack, as necessary diagnostic criteria for panic disorder.

      • 全北地域의 工場 새마을 QC分任組活動의 運營方法에 關한 硏究

        이성택,殷載基,柳鵬植 圓光大學校 1979 論文集 Vol.13 No.1

        The intentions of these studies aim at giving useful materials for effectively evolving QC Circle activities of enterprise and in establishing driving organizaiton for QC Circle by the Government and government agencies concerned. This will be accomplished through: surveying improved measured to the extent of manager's cognition and participation of and in QC Circle activities the establishment of a cooperative system, human relations, education and training, the selection of theme, the composition of the circle, and the inconveniences of members. The study method selected here is an experimental analysis method : mainly centered on questionaire method and personal interview method given to 611 "The Factory-Saemaul QC circles" of Jeon buk province which were registered at the end of March, 1978. In order that QC circle activites may operate more efficiently, it is necessary that : Firstly, the true role that QC and QC circle activities will carry out, should be focused on, with lonterm standpoint, spiritual and material rationalizaiton which make it possible to do their best under the precondition of higher knowledge and technology and new investment for structural change. Secondly, we must secure enough presentation and appealing to evolve as a methodology of the Factory-Saemaul movement in its characteristics and contents and then QC circle needs more systematic continuous presentations and full-dress studies pertinent to the industrial situation of korea rather than directly following foreign exampes. Thirdly, we must insure that the QC movement may be developed in a sustained fashion bearing substantial fruit from the long-term plan, The development of a more positive attitude and initialtive leadership of businessmen and top managers are also necessary. If such positive attitudes and leaership should be realized through natural growth, some momentums to be deeply conscious of the actuality and future of businessmen an dtop managers will continuously exist. Fourthly, for the sake of sublimating our enterprise into a suitable movement, more positive studies and development are required. Because the movement cannot become effective in all enterprises and business enviroment, studies which can always supplement it, especially on the problems of dimensional application, must follow up. Fifthly, in order that the movement may be developed continuously without vanishing like a passing vogue, some systematic arrangements should keep abreast with it. For example, the establishment or reorganizaiton of a new system ; enactment of new provision and stadards. Finally, to easily attain the above mentioned tasks, incessant and scientific support of the Government support is expected through more down-to-earth study and reserch programs.

      • 학교체육 활성화 방안에 대한 연구(Ⅰ) : 강원대학교 교양체육 운영방법의 개선을 중심으로

        이광재,문병용,노성규,박기동,홍관이,한상준,유옥재,엄기진,정청자,오수일,김윤래,박장평,부기원 江原大學校附設 體育科學硏究所 1986 江原大學校附設體育科學硏究所論文集 Vol.- No.11

        Try to find a scheme for activation to College Physical Education, this Report informs the various kinds of Survey and process those were projected for improvement of management methods on Cultural Physical Education in Kang Weon National University. From experimentally carried out "Sports events Choosing System" not as usual be inforced "Total practical Skill System", Following Positive effects and sujestions were Presented; 1. "Sports events choosing system" gave birth to more students' interesting and more voluntary participation to the sports events they chose, and sports skill and instruction level was elevated due to charge of expert according to each sports events. This system would be managed continuously hereafter for it related to life sports. 2. This System needs to closed cooperations between College and Community, for the facilities of community are utilized by college. 3. To complete the plan for activation of college Physical Education, additionally, the successional study ; namely "autonomous extracurricular sports activity" should be excuted hereafter.

      • 방해석의 복굴절에 의한 편광

        李原鎭,成德鏞,全永基,申再鉉 대구산업정보대학 1998 논문집 Vol.12 No.2

        It was investigated the variation of polarization by the double refraction of light for a calcite crystal. In a calcite there is a single direction called the optics axis, which is an axis of symmetry with respect to both the crystal form and the arrangement of atoms. For a point in calcite, there are three principal sections, one for each pair of opposite crystal faces. A principal section always cuts the surfaces of a calcite crystal in a parallelogram withe angles of 71˚ and 109˚. When a beam of plane-polrized light is directed along the optic axis of calcite crystal, the plane of polarization turns steadily about the direction of the beam and emerges vibrating in some other plane than that at which it entered. The law of Malus is ralationship how the intensity transmitted by the analyzer varies with the angle that its plane of transmission makes with that of the polarizer. The pane polarization, θ was obtained from the law of Malus was 20.2˚

      • 운동선수의 임장불안에 대한 연구

        홍관이,이광재,김두경,부기원,노성규,한상준,박기동,오수일,문병용,이철규,박장평,엄기진,박남환 江原大學校附設 體育科學硏究所 1984 江原大學校附設體育科學硏究所論文集 Vol.- No.9

        This study is designed to grasp the elements and situations of stage fright in order to propose a part of ways to cope with it. We make 511 top-class high school players, male and female, in the central districts (Seoul, Inchon, Kyungki, Chungbuk, and Kangweon Province) on object of questionnaire, and get the following results. Through players generally have all-round characters they show weakness in the superiority and emotional stability while showing strength in the sonformity. This fact comes to be related to the elements which cause stage fright. Physiological changes also have many effects on the symptom of stage fright. Especially, stage fright increases when players show sensitive reaction to the self-consciousness of final consequence which comes from the tension or uneasiness of sympathetic nerve, Thus, it turns out that players make use of reducing psychological burden by physical exercise or adjusting the level of demanded result in order to release the stage fright.

      • 스마트폰 부재와 분실을 대비한 어플리케이션

        조시현;문상수;김기환;도민균;서재현;김태공 인제대학교 2012 仁濟論叢 Vol.27 No.1

        Recently, as the Smart Phone is rapidly disseminated worldwide, it is emerging as an important digital communication media changing the communication types of users. We use the Smart Phone in all aspect of daily life besides communication. The Smart Phone is indispensible tool that has a great ripple effect on our daily life. Therefore, if the Smart Phone users lose or do not bring their phones, they were troubled. In this paper, we make users available to use the Smart Phone, even if they lose or do not bring their phones. To do this end, we develop features that search the phone in case of not knowing where it is, that contact another phone in case of not bringing their phone, that lock the phone in case of losing it. We expect these features promote a expansion and a vitality of the Smart Phone market.

      • KCI등재

        대뇌 피질 신경 세포 일차 배양에서 6-hydroxydopamine에 의한 신경세포사멸의 특성

        정재훈,강효정,손성향,정영기,곽병주,노재성 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.3

        연구목적 : 본 연구는 생쥐 태자 대뇌 피질 세포 일차 배양에서 파킨슨씨병의 동물 모델을 만드는데 사용되는 신경독성 물질인 6-hydroxydopamine(6-OHDA)에 의한 신경세포 사멸의 특성을 관찰한 것이다. 방 법 : 생쥐태자의 신경세포를 배양하여 6-OHDA를 처리하고 이와 더불어 여러가지 신경세포 사멸에 영향을 주는 물질을 투여하여 신경세포의 사멸을 정량적으로 분석하고 형태학적 분석을 전자현미경을 통하여 관찰하였다. 결 과 : 배양한 신경세포에 6-OHDA를 처리하면 투여 양에 비례하여 신경세포의 사멸이 증가하여 50μM 66-OHDA를 24시간 투여하여 일으킨 신경세포 사멸의 형태학적 특징은 세포질의 수축 및 염색질의 응축(nuclear chromatin condensation) 및 핵질의 fragmentation을 동반하는 고사(apoptosis) 형태이다. 이 때의 신경세포의 사멸은 항고사 물질인, 1㎍/ml cycloheximide와 caspase 억제제인 10μMzVAD-fmk에 의해 약화되었으나 글루타메이트 길항제(10μM MK-801 혹은 50μM CNQX)나 항산화제 (100μM trolox 혹은 100μM N-acetyl-cysteine)는 6-OHDA에 의한 신경세포의 사멸을 막지 못했다. 결 론 : 이상의 형태학적 및 약물학적 특징은 6-OHDA가 고사성 신경세포 사멸을 유도한다는 것을 의미하고, 항산화제들이 효과가 없다는 것과 caspase 억제제가 보호효과가 있다는 것은 6-OHDA에 의한 고사성 신경세포 사멸에는 산화적 스트레스보다는 caspase cascade와 관여된 기전이 기여한다는 것을 시사한다. 또한 6-OHDA에 의한 신경세포의 사며른 도파민성 신경세포에 선택적이지 않으며, 일차 대뇌피질 신경세포 배양 시스템이 6-OHDA에 의한 신경세포사멸인구에 사용될 수 있음을 보여준다 Objectives : We examined the patterns of cell death induced by the 6-hydroxydopamine, a selective dopaminergic toxin that used to produce Parkinson's disease model. Method : Neocortices from 14 - or 15-day-old fetal mice for neuron-glia co-cultures were used for this experiments. Results : Cortical cell cultures exposed to 10-100μM 6-hydroxydopamine for 24 hr underwent neuronal death without injuring glia. The degenerating neurons showed hallmark of apoptosis featuring cell body shrinkage, nuclear chromatin condensation and aggregation, nuclear membrane disintegration with intact plasma membrane, and prominent internucle- osomal DNA fragmentation. Neither the glutamate antagonists (10μM MK-801 and 50μM CNQX) nor antioxidants(trolox, 100μM, N-acetyl-cysteine, 100μM prevented the 6-OHDA induced neuronal injury. The death was attenuated by addition of two different anti-apoptotic agents, 1㎍/ml cycloheximide and caspase inhibitor(100μM zVAD-fmk). Conclusion : These features suggest that 6-OHDA induced apoptotic type of neuronal death in cortical neuronal culture. Considering the protective effect of caspase inhibitors, a mechanism involing caspase cascade rather than oxidative stress is responsible for the 6-OHDA-induced neuronal apoptosis. In addition, our results showed that 6-OHDA-induced apoptosis is not confined to dopaminergic neurons and the primary cortical culture system so this system is suitable for the study of 6-OHDA-induced neuronal apoptosis.

      • KCI등재

        할로페리돌로 유도한 신경세포 고사에 대한 신경성장인자 및 인슐린 유사 성장인자의 억제효과

        강효정,강지윤,곽병주,정영기,노재성 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

        연구목적: 본 연구는 생쥐 태자의 대뇌피질 세포 일차 배양을 이용하여 할로페리돌로 유도한 신경세포의 사멸에 대해 신경 성장인자인 brain-dervied neurtrophic factor(BDNF), Neurotrophin 4/5(NT 4/5)와 인슐린 유사 성장인자인 insulin-like growth factor Ⅰ(IGF-Ⅰ)및 IGF-Ⅱ의 조절효과를 실험한 것이다. 방법: 생쥐 태자의 신경세포를 배양한 후 할로페리돌을 처리하여 신경세포의 사멸을 유도하고 이에 대한 성장인자의 효과를 정량적으로 분석하였다. 결과: 30M의 할로페리돌을 배양한 일차 대뇌 신경세포에 24시간 처리하면 광범위한 신경세포의 사멸이 유도된다. 이때 신경세포는 세포의 응축, DNA의 단편화와 응집, 세포막보다 핵막의 이른 붕괴 등 고사 형태의 신경세포 사멸 특성을 보인다. 할로페리돌과 더불어 신경성장인자인 BDNF, NT 4/5 및 인슐린 유사 성장 인자인 IGF-Ⅰ 혹은 IGF-Ⅱ를 동시에 처리할 경우 용량 의존적으로 신경세포의 사멸을 억제한다. 결론: 본 연구의 결과는 할로페리돌에 의한 신경독성이 성장인다들에 의해 억제될 수 있음을 보여주는 것이며, 장기적인 항정신병약물의 사용 후에 발생하는 부작용인 지발성 운동장애의 한가지 원인 가설로 대두되고 있는 항정신병 약물에 의한 신경독성을 신경성장인자에 의해 억제할 수 있을 가능성을 제시하는 것이다. 중심단어:할로페리돌·고사·세포사멸·고사·BDNF·NT-4/5·IGF-Ⅰ·IGF-Ⅱ. Objectives: We examined the effects of neurotrophins and insulin-like growth factors on cell death induced by haloperidol, a typical anti-psychotic agent. Method: Neocortices from 14- or 5-daysold fetal mice for neuron-glia co-cultures were used for this experiment. Result: Twenty-four hours treatment of mouse cortical cell cultures with 30 M haloperidol-induced wide spread neuronal apoptosis characterized by cell body shrinkage, DNA frag-mentation and condensation. Concurrent treatment with growth factors, BDNF, NT4/5, IGF-Ⅰand IGF-Ⅱ, protect the neurons from the haloperidol-induced neuronal apoptosis(HINA) in a dose dependent manner(10-100ng/ml). Conclusion: The present study suggests the possibility that haloperidol toxicity can be hampered with growth factors. Further study about the mechanism underlying the protective capacity of the growth factors on HINA may lead to the development of the new protective strategy for tardive dyskinesia. KEY WORDS:Haloperidol·Apoptosis·Neuronal death·BDNF·NT4/5·IGF-Ⅰ·IGF-Ⅱ.

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