痙攣性 腦電氣衝擊이 Reserpinized Rat Brain內의 Norepinephine, Dopamine 및 Serotonin含量에 미치는 영향

禹鍾仁,金明石 최신의학사 1981 最新醫學 Vol.24 No.2

東醫寶鑑에 나타난 精神障碍의 藥物療法

禹鐘仁 大韓神經精神醫學會 1976 신경정신의학 Vol.15 No.4

As a preliminary research for the prescriptions applied to the mental disorders in the field of the traditional medicine, this thesis tries to study of prescriptions for the mental disorder explained in the Book of Tong-Eui-Po-Kam. (Manual for the Traditional Korean Medicine and Therapy). The prescriptions for mental disorders mentioned in this manual were rearranged according to the descriptive indication, and also the herbs used as the prescriptions were specified in relation with phytotomy. The result is as follows: 1. The total number of the prescriptions for mental disorders are 98, and the total number of the herbs 156. 2. Among the herbs, chemically unconstrued herbs are 18, obnoxious 30, and almost all of them are used mainly for the "Jeonkan", "Jeonkwang", and "Sasu". 3. Among the herbs, 35 herbs are clearly testified their pharmacological functions through the animal experiments and careful investigation showed the sedative effects among the 6 of the above 35.

Tardive Dyskinesia 에 대한 Sodium Valproate 의 치료효과에 관한 연구

禹種仁,權俊壽,洪澤裕 大韓神經精神醫學會 1987 신경정신의학 Vol.26 No.4

We performed the double-blind placebo-controlled study to investigate the therapeutic effect of sodium valproate known as GABA-ergic agent on tardive dyskinesia. 15 out of 31 patients were treated with sodium valproate (maintenance dose: 1500-2700㎎) and the rest of them were treated with placabo over 8 weeks. We checked the severity of tardive dyskinesia by TDRS (Tardive Dyskinesia Rating Scale, Simpson et al, 1979) just before treatment, the 4th week, the 8th week and the 12th week following beginning of treatment. We checked the serum level of sodium valproate at the 4th weeks and the 8th weeks since the beginning of treatment. The results were as follows: 1) Both TDRS scores of 4th week and 8th week were significantly low compared with those of pretreatment in the group treated with sodium valproate (P<0.001), but TDRS scores returned to the pretreatment score at 12th week (4 weeks after withdrawal of medication). There was no significant relationship between serum level of sodium valproate and TDRS total scores. 2) All of the TDRS scores of 4th week, 8th week, and 12th week were significantly low compared with those of pretreatment in the group treated with placebo.(P<0.01) 3) TDRS scores of the group treated with sodium valproate were not significantly different from those of the group treated with placebo at the time prior to treatment, 4th week, 8th week and 12th week.

精神科 患者의 拒逆退院에 關한 考察

禹鍾仁 최신의학사 1978 最新醫學 Vol.21 No.7

강박증 환자에서의 인격장애 공존병리에 관한 연구

이동우,강웅구,류인균,정도언,조맹제,우종인,김용식,권준수 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : 강박증의 동반인격장애에 관한 연구들은 기존의 개념과 달리 강박성 인격장애와 강박증 간에는 특이적인 관계가 없으며, 강박증 환자들은 다양한 인격장애를 동반한다는 결과를 보여주었다. 그러나 이러한 연구들은 동반 인격장애에 관한 기술적인 분석에 그쳤고, 강박증 환자군의 임상 증상과 동반 인격장애 양상간의 연관성에 관한 분석을 시행하지 않았다. 본 연구의 목적은 강박증 환자군에서의 동반 인격장애를 평가하고 강박증 환자의 다양한 증상과 동반 인격특성 간의 연관성에 대해 연구하는 것이다. 방 법 : DSM-IV의 강박증의 진단기준을 만족하는 59명의 환자군과 32명의 정상대조군을 대상으로 인격장애 질문지를 적용한 후 4∼6점의 절단점을 기준으로 인격장애의 진단이 내려졌다. 먼저 환자군과 정상대조군 간의 특정 인격장애 빈도의 차이를 알아보기 위하여 Fisher's exact test를 시행한 후, 두집단 간에 유의한 차이가 있는 것으로 밝혀진 인격장애 척도 점수에 미치는 Y-BOCS,BDI,BAI점수의 영향을 알아보기 위하여 다중선형회귀 분석을 시행하였다. 결 과 : 1) Fisher's exact test 결과 강박증 환자군은 정상 대조군에 비해 경계성 인격장애(18.6%vs 0%, p=0.007). 회피성 인격장애(55.9% vs 18.8%, p=0.001), 우울성 인격장애(40.7% vs 0%, p=0.000)의 비율이 유의하게 높았다. 2) 다중선형회귀분석 결과 Y-BOCS 점수 (t=2.10, p=0.043)와 BAI점수(t=2.60, p=0.014)는 경계성 인격장애 점수에 유의한 영향을 주는 것으로 나타났다. 또한 BAI점수(t=3.23, p<0.003)는 회피성 인격장애 저수에, BDI점수 (t=3.08, p=0.004)는 우울성 인격장애 점수에 유의한 영향을 주는 것으로 나타났다. 결 론 : 강박증 환자군은 정상 대조군에 비해 회피성 인격장애, 우울성 인격장애, 경계성 인격장애의 동반율이 높고, 강박증이 경계성 인격장애의 심각도에 유의한 영향을 미치는 것으로 사료된다. The purpose of this study was to assess the comorbid axis-Ⅱ disorders of obsessive compulsive disorder(OCD) patients and to investigate the relationship between symptoms of OCD and the comorbid personality traits. The subjects were 59 patients who met DSM-IV criteria for obsessive-compulsive disorder and 32 normal controls. All subjects completed personality Disorder Questionnaire-IV(PDQ-IV). The patients completed Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI), and were rated with Yale-Brown Obsessive Compulsive Scale(YBOCS). The results were as follows. 1) The OCD patients showed significantly higher prevalence of avoidant, depresssive and borderline personality disorder(p<0.01) compared to controls. 2) The BAI score had significant effect on the avoidant personality score(t=3,23, p<0.003). The BDI score had significant effect on the depressive personality score(t=3.08, p=0.004). The YBOCS(t=2.10, p=0.043) and BAI(t=2.60, p=0.014) scores had significant effects on the borderline personality score. We found that OCD patients had higher prevalence of avoidant, depressive, and borderline personality disorders. We also found that obsessive-compulsive symptoms have significant effect on the severity of borderline personalty traits. We suggest that it would be very helpful to consider Axis-Ⅱ disorders for managing patients with obsessive-compulsive disorder.

精神分裂病에서의 血小板 Monoamine Oxidase 活性度와 血漿 Estradiol, Progesterone 및 Testosterone의 相關關係에 關한 硏究

金種億,李定均,禹鐘仁,朴贊雄 大韓神經精神醫學會 1984 신경정신의학 Vol.23 No.1

The hypothesis that certain central dopaminergic systems may be overactive in schizophrenia has quite generally accepted by many investigators. Studies of monoamine oxidase (MAO), the major degradating enzyme of biogenic monoamine, have provided a focus for recent biological in schizophrenia. This study was set up to determine the alteration of platelet MAO activity and its sexual differences, the change of plasm sex hormone levels and the correlation between platelet MAO activity and plasma sex hormone levels, in 130 schizophrenics, comparing with 197 normal healthy subjects. Platelet MAO activity was determined fluorometrically by the modified method of Kraml, measuring the deamination of kynuramine to 4-OH quinoline, and was expressed as nanomoles of quinoline produced per milligram of platelet protein per hour. At the same time, plasma estradiol, progesterone and testosterone levels wers determined by radioimmunoassay technique, Following results were obtained. 1. Platelet MAO activity is not different in acute schizophrenics, but is low significantly in chronic schizophrenics (63.7% of normal control group). 2. Platelet MAO activity is lower in male chronic schizophrenics(56.06% of control group) than female(64.69%), and the sex difference is significant. 3. Plasma estradiol level is significantly low in male chronic schizophrenics(71.82%). 4. The correlation coefficient between platelet MAO activity and plasma sex hormone levels reveal negative correlation between platelet MAO activity and plasma testosterone level in female chronic schizophrenics. From the results of the study, it is strongly suggested that the sex difference of platelet MAO activity in chronic schizophrenia is related to the alteration of plasma sex hormone levels.

抗精神病藥物이 血淸 Dopamine-β-Hydroxylase 活性度에 미치는 影響 : 慢性 精神分裂病患者를 中心으로

薛玹旭,禹鍾仁,李定均 大韓神經精神醫學會 1983 신경정신의학 Vol.22 No.2

To investigate the effect of antipsychotic drugs directly, the serum dopamine-beta-hydroxylase activty was measured before and after three weeks' washout period in chronic schizophrenics. Total number of subjects were eighty-two chronic schizophrenics, consisting of forty-eight male and thirty-four female patients. The diagnostic criteria was based on DSM-Ⅲ and duplicated assay was applied by modified Udenfriend method. The results were as follows; 1. After three weeks' washout period, the serum dopamine-beta-hydroxylase activity was 13.50±2.12 in male, 11.72±2.12 in total patients. Serum dopamine-beta-hydroxylase activity of female patients were significantly lower than in male patients.(p<0.001) 2. The range of serum dopamine-beta-hydroxylase in total patients was from 8.45 to 18.45㎛ol/min/1, which is relatively small compared with previous reports in the literature. 3. During the three weeks' washout period, the percent change was -8.81±17.35% in male (p<0.01), 1.94±20.92% in female(N.S), and -4.35±19.64%(p<0.05) in total patients compare to the serum dopamine-beta-hydroxylase activity of three weeks' washout period. The difference between male and female(p<0.02) is not clear. 4. During the three weeks' washout period, the absolute value of percent change was 16.48±10.36% in male, 17.71±13.93% in female, and 16.57±11.40% in total patients. (all, p<0.001) 5. The percent change of serum dopamine-beta-hydroxylase activity did not seem to be related to the type of drugs, dose of drugs, age, hospital duration, duration of illness, and the presence of active symptom. 6. In summary, the current findings suggest that the interpretation of data indicating low serum dopamine-beta-hydroxylase activity in medicated schizophrenics should be made with caution.

家族性 정신분열병과 非家族性 정신분열병과의 比較硏究

金圭泰,禹鐘仁 大韓神經精神醫學會 1987 신경정신의학 Vol.26 No.1

Since Kraerelin described dementia preaecox, Schizophrenia has been widely considered to be a heterogenous syndrome. Various approaches have been taken in attempting to subdivide this disorder into more homogenous groups. In addition, it also has considered that genetic factor may contribute to schizophrenia predisposition and schizophrenia may be genetically heterogenous. The existence of a characteristic that expresses a genetic predisposition to schizophrenia would be helpful in defining a genetically more homogenous group. So, this study was performed to evaluate assumptions that schizophrenia could be differentiated on the basis of family history. We compared two groups of patients distinguished by the presence or absence of family history. each groups included 34 schizophrenic patients matched by age and sex. these two groups of patients were evaluated on the aspect of psychopathology, neruomotor function abnormality and pathologic reflex. The results are as follows : 1) There was no significant difference in age of onset, duration of illness, frequency of hospitalization and dosage of drug detween two groups. 2) At the time of admission, there was no significant difference in the psychopathology between two groups. 3) As for the present psychopathology, most patients had remitted from active psychotic symptoms, patiens with family history had significantly more negative symptoms than those without family history. and patients with family history showed singificantly more increasement in negative symptoms from the time of admission to the present than those without family history. 4) We divided the schizophrenia into three subtypes : postive, negative and mixed schizophrenia. At the time of admission there was no significant difference in the rate of these three subtypes between two groups but at present, the proportion of negative schizophrenic patients were increased in the group of patients with family history and that of mixed schizophrenic patients were increased in the guoup of patients without family history. 5) The total score of neuromotor function test were not significantly different between two groups. In the individual test the group of patients with family history showed significantly more abnormal patients in the heel to tap test, and significantly slower speed in the successive finger opposition and heel to tap test. 6) There was no significant difference in the pathologic reflex between two groups. 7) Among patients without family history, there was signiticant correlation berween negative symptoms and neuromotor function abnormality.

甲狀腺炎과 Lithium 治療에 의한 甲狀腺機能低下症

鄭道彦,禹鍾仁,李定均,趙普衍,高昌舜,金勇一 大韓神經精神醫學會 1982 신경정신의학 Vol.21 No.2

A case of a female Manic Depressive Illness patient with goitrous hypothyroidism is presented. After ten and half months of lithium maintenance therapy starting during her first psychiatric admission, she was admitted again due to acute recurrent manic episode. On admission, she complained of easy fatigability and cold intolerance, and thyroid gland was palpable and enlarged in moderate degree. Thyroid function test revealed markedly increased TSH and moderately decreased thyroxine levels. TRH stimulation test showed an exaggerated response. Needle biopsy specimen revealed chronic lymphocytic and immune complex thyroiditis. However, antithyroglobulin and antimicrosomal antibodies were negative. In pretreatment thyroid evaluation on her first admission, neither goiter nor thyroid function abnormality was detectable and no signs of underlying thyroid disease or hereditary predisposition to hypothyroidism were present. Within three weeks of discontinuation of lithium, goiter was no more palpable and within five weeks, thyroid function test returned to normal range. The possibility that patients with underlying thyroiditis may be particularly susceptible to a rapid onset of lithium-induced hypothyroidism is discussed.

急性精神分裂障碍患者의 Haloperidol 治療時 臨床 好轉度와 血中 Prolactin 濃度의 關係

김성윤,주진형,우종인 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.2

저자들은 혈청 PRL농도가 급성 정신증에서의 haloperidol의 치료 반응에 대한 지표로서 임상적으로 이용가능한가를 규명하기 위하여 22명(남자 4, 여자 7)의 초발 정신분열양장애 환자들을 대상으로 하여 이 중 10명의 남자 환자군에 대해서는 11명의 남자 대조군과 기저 혈청 PRL치의 비교를 하였고 경구 haloperidol 치료를 받은 11명(남자 4, 여자 7)에 대해서는 치료전과 4주째의 혈청 PRL치와 haloperidol의 혈중 농도를 측정하고 동시에 Positive and Negative Syndrome Scale(PANSS)로 정신병리를 평가하였다. 결과는 다음과 같다. 1) 남자 환자군 10명의 치료전 혈청 PRL치는 정상 대조군의 혈청 PRL치와 유의한 차이를 보이지 않았다. 환자군에서 치료 개시전 PANSS로 측정한 정신상태 중 음성증상 subscale만이 혈청 PRL치와 유의한 상관관계(r=0.6636, p<0.05)를 보였다. 2) 4주간의 치료후 PANSS 점수 변화율은 기초 및 4주째의 혈청 PRL치와 유의한 상관관계를 보이지 않았고 PRL치의 변화율 및 변화치와도 유의한 상관관계를 보이지 않았다. 3) 4주간의 HALOPERIDOL 치료를 통해 PANSS 전체 점수는 유의한 감소를 보였으며(p<0.05), 양성증상(p<0.05)과 일반정신병리(p<0.05) subscale 점수상에서도 유의한 감소를 보였다. 혈청 PRL치도 기초 측정치에 비하여 4주째 혈청 PRL치, PRL치의 변화율 또는 변화치와 통계적으로 유의한 상관관계를 보이지 않았다. Objects : The authors investigated to evaluated the clinical utillity of serum prolactin(PRL) level as a therapeutic index of haloperidol treatment for acute psychotic patients. Methods : 22 patients(10 males, 12 females) first-onset schizophreniform disorder were studied. Among them 10 male patients' baseline PRL levels were compared to those of 11 agematched male volunteers and 11 patients who were treated with oral haloperidol(4 males, 7 females) were studied by measuring baseline and 4the week levels of serum PRL and haloperidol and administering Positive and Negative Syndrome Scale(PANSS) concurrently. Results : 1) The serum PRL level of 10 male patients showed no statistical difference from 11 healthy males. Only the patients' pre-treatment PANSS negative subscale score had significant correlation with the baseline serum PRL level. 2) Percentage of PANSS score change didn't show significant correlation with the baseline and 4th-week serum PRL level nor with amount and percentage of serum PRL level change. 3) The total PANSS score decreased significantly after 4 week treatment with haloperidol s well as positive symptoms subscale and general psychopathology(all, p<0.05), and 4th-week serum PRL level significantly increased(p<0.01) compared with the baseline. 4) The 4th-weeks plasma haloperidol level didn't show correlation with serum PRL level nor with amount and percentage of serum PRL level change. Conclusions : The findings suggest that serum PRL level has limitation for use as therapeutic index of haloperidol treatment for acute psychotic patients.