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        [18F]FDG PET을 이용한 강박증 환자에서 뇌 포도당 대사의 이상에 관한 연구

        권준수,이동우,이재성,최정임,이동수,정준기,조맹제,이명철,류인균 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

        연구목적: 강박증에 대한 기능적 뇌영상 연구들에서 강박증 환자들의 안와전두엽과 미상핵의 대사율 증가 소견이 비교적 일과되게 발표되어 왔으며, 전두-피질하 회로의 이상이라는 이론이 수립되기도 하였다. 그러나 기존의 연구들은 강박증의 유병기간에 따른 구분없이 시행된 연구였고, 영상분석 방법에 있어서도 관심영역 방법을 이용했다는 한계를 지니고 있다. 본 연구의 목적은 첫째, 강박증의 유병기간에 따라 환자군을 구분하여 PET 영상소견을 분석함으로써 유병 기간에 따른 차이가 있는지를 조사하였으며, 둘째, 강바증 환자의 포도당 양전자방출 단층촬영(18-Fluor-deoxyglucose Positron Emission Tomography : FDG-PET) 영상분석에 통계적 매개변수 지도법(Statistical Parametric Mapping : SPM)을 이용함으로써 강박증의 병인기전 및 강박증상과 뇌기능 간의 관계를 명확히 규명하고자 하였다. 방법: 구조적 면담도구(Structured clinical interview for DSM-IV : SCID-IV)를 적용하여 진단된 12명의 강박증 환자들과 10명의 정상 대조군에 대해 FDG-PET을 촬영하여 SPM으로 분석하였다. PET 촬영 전 적어도 4주 동안에는 약물복용을 하지 않은 상태였다. 결과: 1) 환자군과 대조군의 비교 : 강박증 환자군은 대조군에 비해 양측 두정 영역의 대사율이 유의하게 감소되어 있었으며(P<0.01). 대사증가를 보인 영역은 없었다. 강박증의 유병기간이 10년 이상인 만성강박증 환자 4명은 양측 안와전두엽에서 유의한 대사증가 소견을 보였으며(P<0.01), 양측 두정영역에서 유의한 대사감소 소견을 보였다 (P<0.01), 유병기간이 10년 이하인 환자에서는 전체 환자군의 분석에서와 마찬가지로 대조군에 비해 유의한 대사증가 소견을 보인 영역은 없었으며, 양측 두정엽 부위에서 유 의한 대사 감소 소견을 보였다.(P<0.01). 2) 강박증상의 심각도와의 상관관계 분석 : 우측 두정엽의 대사율은 강박장애 척도 점수와 유의한 음의 상관관계를 보였으며(p<0.01), 양측 시상 영역의 대사율은 예일-브라운 강박장애 척도의 강박장애척도 점수와 유의한 양의 상관관계(p<0.01)를 보였다. 결론: 본 연구는 결과는 기존의 연구들에서 보고된 안와전두엽의 대사 증가 소견이 강박증의 만성화로 인해 나타나는 2차적 장애이며, 두정엽의 대사 저하가 보다 1차적인 장애일 가능성을 시사한다. Baxter가 수립한 전두-피질하 회로 이론은 두정엽의 이상을 포함하는 전두-두정엽 복합체 이론으로 확장되어야 할 것이다. Objectives: Functional imaging studies on obsessive-compulsive disorder(OCD) subjects have repeatedly reported increased metabolism in orbitofrontal lobes and caudate nucleus, resulting in the "frontal-subcortical" circuit abnormality theory. Limitations of the previous studies to date include little consideration for the duration of illness, and the use of regions of interest methods, as an image analysis method. Our study objectives are 1) to include the duration of illness as an important study variable, and 2) to use Statistical Parametric Mapping(SPM) method in order to tap relations between the brain function and the psychopathology and symptoms of OCD. Methods: The [18] fluorodeoxyglucose positron emission tomography(FDG-PET) scans of OCD subjects and normal comparison subjects, as diagnosed by the Structured Clinical Interview for DSM-IV(SCID-IV), were analyzed using SPM. Results: 1) Comparison of OCD and control groups : OCD subjects had significantly decreased metabolism in both parietal lobes and didn't have any areas of increased metabolism in comparison to comparison subjects(p.<0.01). four OCD subjects with the illness duration of 10 years or longer, had significantly increased metabolism in both orbitofrontal lobes<p<0.01). OCD subjects whose illness duration is shorter than 10 years didn't have any areas of increased metabolism and had significantly decreased parietal lobe metabolism, as in the analyses of all subjects(p<0.01). 2) Correlation analysis between areas and symptom severity : Metabolism of both thalamic sreas showed significant positive correlation with Yale-Brown Obsessive-Compulsive Scale(Y-BOCS) scores(p<0.01). Metabolism of right parietal area showed significant negative corre lation with Y-BOCS scores(p<0.01). Conclusions: The current findings suggest that the increased metabolism in orbitofrontal lobe, previously rported, may be a secondary phenomenon due to the extended illness dur- ation and that decreased metabolism in the parietal lobes are primary abnormality in OCD subjects. Thus Baxter's fronto-subcortical circuit theory should be extended into "fronto-pari-etal" complex theory, which includes the parietal lobes.

      • 절수에 의한 Mongolian Gerbil 장기중량변화에 관한 분석연구

        김무강,이기훈,이강이,송치원,이경열,권효정,박미선,정승혁,이행연,김명철 충남대학교 수의과대학 동물의과학연구소 2000 動物醫科學硏究誌 Vol.8 No.-

        In this study, authors measured the each organ weight of the long term water deprived Mongolian gerbil, after then we calculated the mean, standard deviation, variance coefficient of the real measured organ weight and induced the organ weight change quantity, rate of quantity, deviation between measured and theological organ weight, deviation rate, sum of deviation rate, organ weight change rate, rate of organ weight by the mathematical formula. The results obtained as follow 1. The weight of the brains, lung, and testis were abruptly decreased after water deprived until the 5th day, after then slowly decreased until the 20th day. 2. The weight of the heart was decreased gradually from the first day until the 20th day. 3. The weight of the liver was abruptly decreased until the 10th day, after then the more slowly decreased until the 20th day. 4. The weight of the thymus, spleen, kidney, and pancreas were abruptly decreased until the 15th day, after then increased slowly until 20th day but the weight of the kidney was abruptly increased from the 10th day. 5. The organ weight change rate and the rate of the each day organ weight were very diversified.

      • 양전자방출단층촬영을 이용한 초점주의와 작동기억의 뇌 활성화 양상 비교

        김재진,조상수,김명선,손정우,이재성,이동수,이명철,권준수 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.2

        연구목적: 단순 초점주의 과제와 보다 고도의 집중을 요하는 작동기억 과제를 수행하는 동안의 뇌 활성화 양상을 비교하여, 두 인지기능 과정을 매개하는 정상적 신경회로의 특성과 차이를 알아보는 것을 목적으로 하였다. 방법: 정상인 14명을 대상으로 시각처리 대조 과제, 단순 초점주의 과제, 작동기억 과제 등 세 가지 인지과제를 주고, 과제 수행 동안 [□O]H₂O를 추적자로 한 양전자방출단층활영을 실시한 후 감산분석을 통해 초점주의와 작동기억의 신경회로 지도를 작성하여 비교분석하였다. 결과: 초점주의 동안 활성화되는 부위는 좌측으로 편측화되고 산발적으로 분포하는 양상이었고, 특히 전대상이랑과 운동영역을 포함한 전두엽, 일차 및 이차 시각피질 등의 활성화가 특징적이었다. 작동기억 동안의 뇌 활성화 역시 산발적 분포와 좌측 편측화 양상이 관찰되었으나, 시각피질보다는 전두엽의 활성화가 우세하였고, 특히 우측 전대상이랑의 현저한 활성화가 특징적이었다. 결론: 초점주의와 작동기억은 개념적으로 공통점과 차이점을 내포하고 있는 것처럼 매개 신경회로에서도 공통 혹은 특이한 영역을 각각 가지며, 전대상이랑의 역할이 두 기능에 공통적으로 중요하고, 이차 시각피질과 전전두피질이 두 기능 각각에 더 중요하게 작용하는 것 같다. Objectives:This study was undertaken to identify neural substrates for simple focused attention and more highly-focused working memory i normal people and investigate their characteristics and differences. Method: Fourteen normal subjects were studied with [□O]H₂O positron emission tomography during a visual processing baseline task, simple focused attention task and working memory task. Results were analyzed with the subtraction analysis to map the neural correlates of focused attention and working memory. Results: Activated areas during focused attention tended to be lateralized to the left and scattered over various regions including the anterior cingulate, motor area, and primary and secondary visual cortices. While the areas activated during working memory also show the left lateralization and scattered distribution, activation prevailed more in the frontal lobe than in the visual cortex, and was particularly remarkable in the right anterior cingulate. Conclusions: Focused attention and working memory do not have only conceptually commonalities and differences but also have common and specific areas in their neural substrates. The anterior cingulate may commonly play an important role in both cognitive functions, whereas secondary visual cortex and prefrontal cortex seem to be predominantly implicated in each function, respectively.

      • 서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

        김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

        Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

      • 개에 있어서 耳根部의 Lidocaine 水針에 의한 全身 無痛覺의 誘發

        권현주,유건주,이상은,이정연,송근호,김명철,정성목,박성준,김덕환 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

        Twelve clinically healthy mongrel dogs were used to clarify the possibility of general analgesia induction by lidocaine aquapuncture to auricular root area in the present study. The experimental animals were devided into control (6 heads) and experimental groups (6 heads), respectively. Physiological salines (3 ml/kg) were injected into both auricular root areas in control group. Lidocaine hydrochlorides (3 ml/kg) were injected into both auricular root areas in experimental group. Superficial pain, the changes of vital signs and blood leukocytes, and PCV were examined on pre, 5 min., 15 min., 30 min, and 60 min. after injection in control and experimental groups, respectively. Analgesia was not detected at all in control group, however, all experimental animals were recumbent and analgesia was generally detected in the auricles, noses, dorsal parts, ventral areas, limbs and tails from 5 to 30 minutes after injection with lidocaine hydrochloride into auricular root areas in experimental group. As for the change of vital signs, body temperature showed decreasing tendency from 5 minutes after lidocaine injection in experimental group. Heart rates and respiration rates were increased on 5 minutes after lidocaine injection and then they showed decreasing tendency in experimental group. No significant difference were found among groups. As for the changes of hematological findings, the numbers of blood leukocytes were increased till 15 minutes after lidocaine injection and then they showed decreasing tendency. PCV values were increased on 5 minutes after lidocaine injection, and then they showed decreasing tendency. However, no significant differences were observed among groups. Considering the above findings, it was thought that general analgesia was possible by aquapuncture with lidocaine hydrochloride into auricular root areas and lidocaine aquapuncture didn’t affect so much to the changes of vital signs and blood.

      • SCOPUSSCIEKCI등재

        지방척수수막류 14례의 임상 분석 : Clinical Analysis of 14 Cases

        이정호,신규만,김명현,송준혁,박향권,김성학,박동빈 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.6

        Lipomyelomeningocele is the most common malformation leading to spinal cord tethering. Nonetheless, these lesion continues to pose a challenge in patient management. The purpose of this study was to identify the clinical feature, candidate for surgical repair, and outcome of lipomyelomeningocele in young children and adults. We studied the magnetic resonance images and/or lumbar myelo-CT of lipomyelomeningocele performed between January 1987 and September 1995 at our institutions and reviewed the pertinent medical records and radiologic studies to determine clinical feature, surgical candidate, and outcomes of these patients. Of the 14 cases(11 female and 3 males) studied, the most common factor that caused these patients to seek help was the cosmetic effect of the mass on their back, followed by urinary incontinence, and weakness of lower extremities. The patients' age ranged from 2 months to 21 years(mean, 5.0 years). All the patients underwent immediate surgical management that consisted of removal of lipoma, untethering of the cord, and complete dural sac repair. Follow up for these patients ranged from 6 to 82 months(median, 54 mo). None of the patients that underwent surgical correction before the emergence of neurological deficit had ever developed neurological deficits at the end of the follow up. However a few of the patients, despite presented with neurological deficits or urinary incontinence at the time of surgery, improved significantly. In conclusion, early detection and prophylactic surgery is imperative to prevent permanent neurological deficits and urinary dysfunction.

      • 1,2-벤조디아진-3-카복서마이드 유도체 합성 및 진통작용

        권순경,송윤신,장은성,이명숙 德成女子大學校 藥學硏究所 1997 藥學論文誌 Vol.8 No.1

        Seven new 7-H(or bromo)-4-hydroxy-2H(or methyl)-N-(5-aralkyl-3-aminohydantoinyl) -1,2-benzothiazine-3-carboxamide-1,1-dioxide derivatives were synthesized through the condensation of 7-H(or bromo)-4-hydroxy-2H(or methyl)-1,2-benzothiazine-3-carboxylic acid methyl ester 1,1-dioxides with 5-substituted-3-aminohydantoins. The analgesic activities of the synthesized compounds were investigated by Randall-Selitto assay. Most compounds exhibited lower activities but compound 6 and 7 showed higher analgesic activities than piroxicam.

      • 한국인 심부전증 환자 심근에서의 인형 거대 세포 바이러스 감염

        이명용,이무용,김영권,한성식,최성준,김효수,이영우,서정돈 단국대학교 1998 論文集 Vol.33 No.-

        Objectives: In order to evaluated the prevalence and the site of infection of cytomegalovirus in terminally failing heart, cytomegaloviral DNA was detected in the explanted hearts of transplantation recipients. Methods: DNA extractions were performed from explanted failing hearts(N=22) and normal hearts(N=5) and polymerase cain reactions(PCRs) were done for detection of late gene sequence coding pp150 glycoprotein. The products were confirmed by electrophoresis on the 1% agarose gel. n order to improve the detectability of cytomegaloviral genome, nested PCRs were executed with the primers designed for the original 607 bp products. In situ PCRs also were done with the samples which were confirmed as positive for CMV viral genome by nested PCRs. Results: All patients had IgG anti-cytomegalovirus antibody and did not have IgM anti-cytomegalovirus antibody. Cytomegaloviral genomes in myocardium were detected by polymerase chain reaction. The 607bp products by PCRs were found in both explanted failing heart(3 cases/22. 13.5%) and normal hearts( 1 case/5, 20.0%). In nested PCRs, 186bp products were found in both failing hearts(LV 4/22, LA 3/2, RV 4/22, RA 0/17) and normal hearts(LV 2/5, LA 1/4, RV 2/5, RA 2/5). These was no significant change in positivity of cytomegaloviral DNA genome between failing and normal hearts. Total positivity of cytomegaloviral genome in explanted hearts was 44.4% according to the nested PCR results. The positivity of cytomegaloviral DNA by n situ PCR was 33.3%(4/12), and the site of positive reaction was the nuclei of the myocardial cells. Conclusion: Cytomegalovirus was rarely observed in explanted hearts of terminal heart failure and nested PCR could enhance the sensitivity of cytomegaloviral genome detection. The result of the in situ PCR showed the site of the cytomegaloviral infection was nuclei of the myocardial cells. Cytomegalovirus, however, might have no direct causal relationship in the development of terminal heart failure.

      • 대규모 도시시설의 주변지역에 발생하는 지역시설의 분포실태와 그 변화에 관한 연구

        이명권,박찬돈,이상관 경운대학교 산업기술연구소 2000 産業技術硏究論文誌 Vol.3 No.1(B)

        The aim of this study is to develope a method of prediction of the distribution and changes of community facilities through the analysis of those of community facilities according to the times; the past and the present. In this study, we surveyed several areas around railway station in the city of Osaka, Japan. It clarified that the distribution patterns of facilities mainly depend on the size of the large scale facility and threshold population. As a result, patterns of facilities distribution was found four different types-decreasing, unchanged, increasing and exceptional. And, in this cases, decresing type is popular around a large scale facility.

      • 宅地開發事業에 있어서 計劃的 都市構成 要素와 事業施行後 나타나는 構成과의 差異點에 關한 硏究

        권준오,김재원,정명희,이도범 조선대학교 국토개발연구소 1997 국토개발연구 Vol.17 No.1

        The writer has studied the differences between the original plan and real problems occurred in the working process of developing housing lots around Bijun District and Jungui District carried by KLDC according to the housing site development special law. And I has analyzed the reasons, and suggest methods for improvement; First, in the point of creating cities : In calculating planned population, various conditions of the city should be totally reviewed; population utilizing the facilities should be considered in the light of prospect of future development; in location planning of facilities, bus service route, present state of utilizing the neighbored lands and planning should be considered. Second, in the point of utilizing land : To make up the esale right for the buildings which are against land categories; to make different division of lots according to the width of neighbored loads and its distance from central facilities, and it will lead to the change of using land. Third in the point of traffic : To reflect bus service route in establishing street plann and land use plan : to make sure of street network and to control direct connection between main route and readjusted route.

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