확산강조 자기공명영상에서 양측 해마에 작은 고신호 강도 병변을 보인 일과성 전기억상실증 1예

김희철,김경식,손철호 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.5

We report on a patient with transient global amnesia (TGA) showing increased tiny signal intensities at the head of both hippocampi on diffusion-weighted image (DWI) performed on the second day after the onset of symptoms. The T1-weighted image using 3-tesla magnetic resonance imaging (MRl) showed no signal changes, but the T2-weighted image showed slight signal changes at the same portion of both hippocampi. Single photon emission computed tomography (SPECT) performcd on the 4th day after the onset of TGA showed no perfusion abnormalities. This patient experienced an extreme emotional stress before the onset of TGA, and the patient's TGA started by a simultaneous Valsava-like maneuver. We discuss the venous Congestion/ischemia hypothesis for TGA. This case confirms that DWI is a sensitive and useful tool for evaluating the early stage of TGA.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

The inhibitory effect of A20 on the inflammatory reaction of epidermal keratinocytes

SOHN, KYUNG-CHEOL,BACK, SEUNG JU,CHOI, DAE-KYOUNG,SHIN, JUNG-MIN,KIM, SUE JEONG,IM, MYUNG,LEE, YOUNG,SEO, YOUNG-JOON,YOON, TAE-JIN,LEE, YOUNG HO,LEE, JEUNG-HOON,KIM, CHANG DEOK UNKNOWN 2016 INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE Vol.37 No.4

<P>A20 is a negative regulator of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kappa B) signaling, and has been implicated in the pathogenesis of psoriasis through genome-wide association study (GWAS). In the present study, we investigated the putative role of A20 in epidermal keratinocytes. Immunohistochemical analysis showed that A20 was expressed in all layers of the epidermis, with an increasing pattern in the upper layers. In our model of calcium-induced keratinocyte differentiation, A20 expression was increased in a time-dependent manner. To investigate whether A20 affected keratinocyte differentiation, we overexpressed A20 in cultured keratinocytes. As a result, we noted that A20 overexpression did not affect keratinocyte differentiation, suggesting that A20 is not a direct modulator of keratinocyte differentiation. Interestingly, we found that A20 levels were decreased in psoriatic lesional skin compared to non-lesional areas. To investigate whether A20 played a role in the innate immune response of keratinocytes, we overexpressed A20 and then examined poly(I:C)-induced cytokine expression. We noted that A20 significantly inhibited poly(I:C)-induced cytokine production, and this effect was related to the inhibition of NF-kappa B signaling. These results suggest that the downregulation of A20 increased the susceptibility of keratinocytes to external stimuli, thus contributing to the development of psoriasis.</P>

간으로의 다발성 낭성 전이를 보인 위의 간질종양 : A Case report

손주현,이명호,손영우,한동수,전용철,최호순,함준수,박경남,기춘석,장세진 한양대학교 의과대학 1999 한양의대 학술지 Vol.19 No.1

Gastrointestinal stromal tumors(GIST) represent a heterogeneous group of mesenchymal neoplasms that is composed of an immature proliferation of spindle or epithelioid cells arising from the muscle layer of the gastrointestinal tract. They can be categorized into followings by light microscopic, ultrastructural, and immunohistochemical features: myogenic GIST (leiomyoma), neurogenic GIST (schwannoma), gastrointestinal autonomic nerve tumor (GANT), and gastrointestinal stromal tumor not otherwise specified (GIST-NOS), the latter being most common. Although the presence of a high mitotic count is generally accepted as the best indicator of malignancy, their clinical behavior is notoriously unpredictable. Thieir most common site of metastasis is the liver. However, multiple cystic metastasis to the liver is very rare. We report a case of gastric stromal tumor with unusual multiple cystic metastasis on the liver in a 63 year-old man. The tumor showed neither neural nor myogenic differentiation in immunohistochemical study, but CD34 positive.

Orbital-dependent polaron formation in the relativistic Mott insulatorSr2IrO4

Sohn, C. H.,Lee, Min-Cheol,Park, H. J.,Noh, Kyung Joo,Yoo, H. K.,Moon, S. J.,Kim, K. W.,Qi, T. F.,Cao, G.,Cho, Deok-Yong,Noh, T. W. American Physical Society 2014 Physical review. B, Condensed matter and materials Vol.90 No.4

Modeling and Implementation of Context based Annotation for XML Documents

Sohn, Won-Sung,Ko, Myeong-Cheol,Kim, Jae-Kyung,Lim, Soon-Bum,Choy, Yoon-Chul Korea Multimedia Society 2003 멀티미디어학회논문지 Vol.6 No.4

This paper proposed context based annotation model and annotation ambiguity correction methods. The proposed model provides various annotation types, semantic models, and pen-based free drawing interface. Annotation correction method that is specifically based on the context which includes various textual and structure information between free-form marking and annotation. Also, interface for XML environment using the proposed model and correction methods is proposed and possibilities of application is looked at. The results from the implementation of the proposed method show that the annotated areas included in the free-form marking information are more accurate, achieving more accurate exchange results amongst multiple users in a heterogeneous document environment

Epidemiology of Ciprofloxacin Resistance and Its Relationship to Extended-Spectrum β-Lactamase Production in Proteus mirabilis Bacteremia

( Kyung Mok Sohn ),( Cheol In Kang ),( Eun Jeong Joo ),( Young Eun Ha ),( Doo Ryeon Chung ),( Kyong Ran Peck ),( Nam Yong Lee ),( Jae Hoon Song ) 대한내과학회 2011 The Korean Journal of Internal Medicine Vol.26 No.1

Background/Aims: We evaluated the clinical features of ciprofloxacin-resistant Proteus mirabilis bacteremia and risk factors for ciprofloxacin resistance. Methods: From October 2000 to July 2009, 37 patients with clinically significant P. mirabilis bacteremia were identified and data from patients with ciprofloxacin-resistant and ciprofloxacin-susceptible P. mirabilis bacteremia were compared. Results: The most common underlying diseases were neurologic disease (37.8%) and solid tumors (29.7%). The most common site of infection was the urinary tract (35.1%). Ten of the 37 patients (27.0%) were infected with ciprofloxacin-resistant isolates, and univariate analysis revealed a significant relationship between ciprofloxacinresistant P. mirabilis bacteremia and neurologic disease, recent operation, L-tube insertion, percutaneous tube use, and extended-spectrum β-lactamase (ESBL) production (all p < 0.05). ESBL was detected in six of 10 (60%) ciprofloxacin-resistant isolates, while only three of 27 (11%) ciprofloxacin-susceptible isolates produced ESBL (p = 0.005). In a logistic regression analysis, ESBL production remained a significant factor associated with ciprofloxacin resistance, after adjusting for other variables. Conclusions: These data indicate a close association between ciprofloxacin resistance and ESBL-production in P. mirabilis bacteremia. This association is particularly troublesome because the therapeutic options for serious infections caused by ESBL-producing P. mirabilis are severely restricted. (Korean J Intern Med 2011;26:89-93)

대장내시경검사의 전처치로서 항콜린제 사용에 관한 연구 : 전향적, 이중맹검법으로

박경남,한동수,이민호,최호순,박준용,손주현,이오영,함준수,전용철,송승찬,기춘석,윤병철,이종희 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3

Background: Use of antispasmodic medication prior to colonoscopy is controversial but someone believes antispasmodic may improve visualization of colonic mucosa and ease colonoscope insertion. So, we designed a study to assess the effect of premedication with the antispasmodic, hyoscine-N-butyl bromide(Buscopan') on the performance of colonoscopy. Methods: This study was prospective, double blinded, randomized, controlled study, One hundred three consecutive patients were randomized to receive intravenous buscopan lml(n=52) or placebo(n=51) combined with our standard initial medication(me- peridine 50 mg and midazolam 2 mg). Insertion of colonoscopy was timed, and 100 mm visual analogue scales (VAS) were used for asscssing difficulty of procedure, colonic motility, frequency of positional change, frequency of external compression, difficulty of assistance and degree of discomfort experienced by the patients. Results: There were no significant differences of intubation time between buscopan group(mean time, 7.23 min., range 2~15) and placebo group(7.07 min., range 3-25), (p=0.83) and withdrawal time between buscopan group (6.46 min., range 2-22) and placebo group(6.76 min., range 2 25), (p=0.69). Also, there was no significant differences in intubation time between males and females(buscopan; males 7.00 min., females 7.60 min., p=0.34, placebo; males 7.0~5 min., females 7.08 min., p 0.44). The VAS scores checked by endoscopist(p=0.29), assistant(p=0.32) and patient (p=0.15) were not significantly different in both groups. There were no significant differences in intubation time, VAS scores nf endoscopist, assistant, and patients. Conclusion: Premedication with intravenous bu.opan has no advantage on colonoscopy procedure. Use of antispasmodic medication prior to colonoscopy was not considered as recommendable agent.

대장암으로 오인된 장결핵 1예

박경남,한동수,이민호,김진배,최호순,윤병철,손주현,이오영,기춘석,함준수,전용철 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.4

Intestinal tuberculosis is a secondary infection from swallowing of infected sputum of pulmonary tuberculosis patient. The diagnosis is usually difficult there are no specific radiological signs and false negatives are often found in biopsy material obtained by colonoscopy since the process is mainly submucous. A lesion which is visualized on colonoscopic examination is rather confusing in that one will find a firm tumor mass occupying the lumen of the bowel which is most suggestive of carcinoma. We experienced a case of intestinal tuberculosis presenting a ulcerofungating mass occupying the lumen of the ascending colon, confirmed by colonoscopc biopsy in a 36-year-old man. He received anti-tuberculosis medication far 18months. The mass initially found totally disappeared as shown by a follow-up colonoscopy.

Clinical characteristics and survival of colorectal cancer patients in Korea stratified by age

( Sun Kyung Baek ),( Ji Sung Lee ),( In Gyu Hwang ),( Jong Gwang Kim ),( Tae Won Kim ),( Seung Kook Sohn ),( Mi Yeon Kang ),( Sang-cheol Lee ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.4

Background/Aims: This nationwide study was undertaken to determine differences in clinicopathologic characteristics and survival of patients with colorectal cancer (CRC) according to age using big data from the Korean National Health Insurance Service (NHIS). Methods: The NHIS data including quality assessment of CRC by the Health Insurance Review & Assessment Service in Korea between 2011 and 2014 were analyzed. Based on age, patients were divided into three groups: not-old patients (< 65), young-old patients (65 to 74 years old) and old-old patients (≥ 75 years old). Results: We included 71,513 CRC patients. The median follow-up duration was 3.2 years (range, 0.003 to 5.5). Male patients constituted 60%. The median age of patients was 65 years (range, 18 to 102). Colon was the cancer site in 59.8% of not-old patients, 62.9% of young-old patients, and 66.1% of old-old patients. Compared to not-old patients, young-old and old-old patients were more likely to be diagnosed with colon adenocarcinoma and well/moderate differentiation or adequate differentiation (all p < 0.001). Old patients underwent more emergency operation (p < 0.001) and received less adjuvant therapy in stage I-III (p < 0.001). The probability of 3-year survival of young-old or old-old patients was worse than that for not-old patients (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.46 to 1.64) (HR, 3.19; 95% CI, 3.03 to 3.37). Conclusions: Old patients with CRC show different histology from younger patients. They are more frequently to have colon as primary lesion. They undergo less adjuvant therapy. Further studies and evidence-based guidelines for older patients with CRC are warranted to improve their outcome.