한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

항파상풍 톡소이드 주사후 항파상풍 항체 역가

이한식,하영록,구홍두,장석준,심호식,김승환,이정운 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

Objective : Tetanus decreased in prevalence since the systemic vaccination began in 1940s. Despite of the improvement in treatment like critical care with ventilatior or antibiotics, the mortality rate resides around 45%. Currently the tetanus prevention protocol recommends immunization in infancy and boosters every tenth years. Thereafter the immunization with toxoid only or toxoid plus immunoglobulin injections is recommended according to the type of injury. In most of ED in Korea, only tetanus immunoglobulin is given without any basis. Previously we proved the effect that passive immunization with the immunoglubulin 250 IU last long for only a month. At this time we measured the effect of the active immunization with toxoid and its effect was compared to the effect of the tetanus immunoglobulin to find out the logical tetanus prevention after an injury. Method: 20 healthy adult volunteers were injected with tetanus toxoid and their anti-tetanus antibody titers measured before the injection, 1 week and 4 weeks after the inection. No volunteers have taken any medication for chronic illness(e.g. hepatits, tuberculosis) or had an tetanus immunization or booster in the last 6 months. Antibody titers were measured by IMMUNOZYM??-TETANUS and t-test was performed on the results, Results: 1. Total 20 volunteers(12 males and 8 females) were participated. 2. Subjects` ages were 21 to 44 years old and there were no relevance to the antibody titer. 3. The antibody titers of before the anti-tetanus toxoid injection and 1 week, 4 weeks after the injection revealed significant difference and the antibody titers of the first and the forth week after the injection also showed a significant difference. Conclusion: Currently in Korea, the tetenus immunoglobulin 250 IU given alone as tetanus prevention was injected, but it did not elevate the anti-tetanus antibody titer for 4 weeks where as tetanus toxoid injected intramuscularly did significantly. Therefore, tetanus toxoid should be given on the dirty injuries with additional tetanus immunoglobulin injection to accomplish the correct method of tetanus, tetanus toxoid prevention.

Comparison Study on Harmonic Loss of MW-Class Wind Generators With HTS Field Winding

Jang Ho Seo,Ki Jin Han,Hong Soon Choi,Se-Hee Lee,Seungyong Hahn,Haigun Lee Institute of Electrical and Electronics Engineers 2014 IEEE transactions on applied superconductivity Vol.24 No.3

<P>This paper investigates the effect of slot-pole combination on harmonic loss such as iron loss and eddy-current loss in wind generators with high-temperature superconductor field winding. In order to study the effect of stator configuration, three wind generators having the same rotor structure but different stators were purposely designed to produce 11 MW. In the analysis, 2-D time-stepped finite element analysis was used to estimate flux density waveforms, and then harmonic iron loss in the stator yoke and rotor eddy-current loss were obtained. From the simulation results, we showed that the harmonic effect on stator iron loss is not significant because magnetic loading by field winding dominates. Meanwhile, we found that the eddy-current loss in the rotor by harmonics of magneto motive force strongly depends on the slot-pole combination.</P>

A gene encoding a protein phosphatase 2C is induced by cold-stress in rice

Ho Il Kim,Jung Sook Lee,Jang Ho Hahn,Young Soon Cha,In Sun Yoon 한국육종학회 2001 한국육종학회 학술발표회 발표요지 Vol.2001 No.9

Paired Ig-Like Type 2 Receptor-Derived Agonist Ligands Ameliorate Inflammatory Reactions by Downregulating beta1 Integrin Activity

Jang-Hee Hahn,이경진,임동영,Yeon Ho Yoo,Eun-Ji Park,Sun-Hee Lee,Birendra Kumar Yadav,Yong-Ki Lee,Jeong Hyun Park,Dae Joong Kim,Kyeong Han Park 한국분자세포생물학회 2016 Molecules and cells Vol.39 No.7

The paired immunoglobulin-like type 2 receptor (PILR) family consists of two functionally opposite members, inhibitory PILR and activating PILR receptors. PILRs are widely expressed in various immune cells and inter-act with their ligands, especially CD99 expressed on activated T cells, to participate in immune responses. Here we investigated whether PILR-derived agonists inhibit 1 integrin activity as ligands for CD99. PILR-derived peptides as well as PILR-Fc fusion proteins prevented cell adhesion to fibronectin through the regu-lation of 1 integrin activity. Especially, PILRpep3, a representative 3-mer peptide covering the conserved motifs of the PILR extracellular domain, prevented the clustering and activation of 1 integrin by dephosphory-lating FAK and vinculin, which are major components of focal adhesion. In addition, PILRpep3 inhibited transen-dothelial migration of monocytes as well as endothelial cell tube formation. Furthermore, upon intraperitoneal injection of PILRpep3 into mice with collagen-induced arthritis, the inflammatory response of rheumatoid arthritis was strongly suppressed. Taken together, these results suggest that PILR-derived agonist ligands may prevent the inflammatory reactions of rheumatoid arthri-tis by activating CD99.

동종 조혈모세포이식 후 급성 이식편대 숙주반응 시 T 세포의 OX-40 표현

장준호,정준원,김진석,서형찬,이승태,민유홍,한지숙,고윤웅 대한조혈모세포이식학회 2000 대한조혈모세포이식학회지 Vol.5 No.2

배경:OX-40은 분자량이 50-kD인 당단백으로 최근 활성화되기 시작한 CD 4+ T 세포에 표현된다. 최근 쥐 모델에서 T 세포의 OX-40 표현과 급성 이식편대 숙주반응과의 높은 연관성이 보고되었으나, 아직까지 사람에 있어 급성 이식편대 숙주반응과 T세포의 OX-40 표현간에 의미 있는 연관성을 보고한 연구는 없는 실정이다. 이에 저자는 동종 조혈모세포이식 후 말초 혈액 내 T세포에서의 OX-40 표현을 측정하여 급성 이식편대 숙주반응과의 상관성 등 그 임상적 의의를 평가하고자 본 연구를 시행하였다. 방법:1998년 12월부터 1999년 9월까지 세브란스 병원에서 악성 혈액종양 및 재생불량성 빈혈로 동종 조혈모세포이식을 시행 받은 16예의 환자와 공여자를 대상으로 하였다. 환자들의 말초혈액은 동종 조혈모세포이식 2주전과 이식 후 10일, 17일, 24일째 채취하였다. 공여자의 말초혈액은 이식 2일 전 채취하였다. 세포는 단클론항체로 염색하여 유세포분석기로 분석하였다. OX-40 표현은 유세포분석기를 이용 정량화 하였으며 OX-40+ T 세포가 환자 혹은 공여자의 유래인지를 확인하기 위해 polymerase chain reaction (PCR)을 이용한 variable number of tandem repeats (VNTR) 검사를 시행하였다. 결과: 1) 대상 환자 16예의 평균 연령은 32세(17~50세)였다. 14예의 환자에서 혈연간 동종 조혈모세포이식이 시행되었고, 이 중 12예는 골수이식, 2예에서는 말초 조혈모세포이식을 시행하였다. 2예에서는 비혈연간 동종 조혈모세포이식을 시행하였다. 2) 급성 이식편대 숙주반응이 발생한 6예에서 CD 4+ T 세포의 OX-40 표현율은 평균 33.9±6.8% (22.1~53.2)로 급성 이식편대 숙주반응이 나타나지 않은 환자군에서의 28.2±7.1% (15.2~42.4)와 비교하여 통계학적으로 유의한 차이는 없었으며(p=0.18). 10일, 17일, 24일째에서도 통계학적으로 유의한 차이를 관찰할 수 없었다(p=0.12, p=0.14, p=0.22). 10예의 조혈모세포 공여자의 CD 4+ T세포의 OX-40 표현율은 평균 8.0 ± 4.6% (1.7~16.9%)였다. 3) CD 4+ T 세포의 OX-40 표현 유무 및 그 정도와 급성 이식편대 숙주반응의 중증도와 임상양상과는 유의한 상관관계를 관찰할 수 없었다. 4) 급성 이식편대 숙주반응의 치료에 따른 CD 4+ T 세포의 OX-40 표현 변화는 관찰되지 않았다(p=0.69). 5) 동종 조혈모세포이식 후 환자의 말초혈액에서 시행한 VNTR-PCR 결과 혼합 키메리즘을관찰할 수 있었다. 결론:동종 조혈모세포이식 후 CD 4+ T 세포에서의 OX-40의 표현은 정상인과 동종 조혈모세포이식 전에 측정한 OX-40 표현율과 비교하여 통계학적으로 유의한 상승을 관찰할 수 있었으나 급성 이식편대 숙주반응이 발생한 군에서의 표현율과 급성 이식편대 숙주반응이 나타나지 않았던 군 간에 통계학적으로 유의한 차이를 관찰할 수 없었고 급성 이식편대 숙주반응이 발생한 군에서 치료에 따른 CD 4+ T 세포에서의 OX-40 표현율의 통계학적 유의성을 관찰하지 못하여 동물실험에서와는 달리 급성 이식편대 숙주반응의 예측인자로써 유의한 연관성을 관찰할 수 없었고, 급성 이식편대 숙주반응의 치료를 판정하는 지표로써의 역할에서도 유의한 연관성을 관찰할 수 없었다. Background:Acute GRAFT-VERSUS-HOST disease (GVHD) is a major and often lethal consequence of allogeneic stem cell transplantation. The OX-40 molecule is a 50-kD glycoprotein that is expressed on recently activated CD4+ T cells. Although recently studies in rat model have suggested an close association between OX-40 expression on peripheral blood CD 4+ T cells and course of acute GVHD, there have been few studies in human yet. This study was performed to investigate whether the kinetics of repopulation of T cells in human recipients of HLA-matched allogeneic stem cell transplantation and their OX-40 expression would be predictive of acute GVHD and/or its response to immunosuppressive therapy. Methods:OX-40 expression on T cells was evaluated in 16 patients with hematologic malignancies or aplastic anemias, who received allogeneic stem cell transplantation between December 1998 and September 1999, at the Yonsei University College of Medicine, Severance Hospital. 10 donors were evaluated for control. Blood samples of the recipients were taken at day 14 before allogeneic stem cell transplantation and +10, +17, +24 after allogeneic stem cell transplantation. Blood samples of the donors were taken at day 2 before allogeneic stem cell transplantation. All staining was performed with monoclonal antibodies and OX-40, CD4, CD8 expression on lymphocytes was analyzed by flow cytometry. Mixed chimerism was determined by using the variable number of tandem repeats (VNTR) by polymerase chain reaction (PCR) in one patient. Results:OX-40 expression on CD4+ T lymphocytes of healthy donors and recipients before stem cell transplantation was with a mean percentage of 8.1±4.6%(1.7~16.9%), 15.5±7.8% (2.4~27.2%). OX-40 expression by CD8+ T lymphocytes of healthy donors and stem cell transplantation recipients was undetectable. The expression of OX-40 as a percentage of the CD4+ cells of recipients after stem cell transplantation was increased at day +10, day +17, day +24 compared with at day -14 (p=0.01, 0.02, 0.01, respectively). Six out of sixteen patients developed GVHD. OX-40 expression on CD4+ T lymphocytes of the patients with GVHD was 33.9±6.8%. But no difference in the kinetics of OX-40 expression by CD4+ T cells was observed between the patients that did or did not develop GVHD, nor did the clinical effect of any treatment given for GVHD correlate with alterations in OX-40 expression by CD4+ T cells. After stem cell transplantation, one patient showed mixed chimerism in peripheral blood cells by VNTR-PCR in one patient analyzed. Conclusion: Our observation do not support the view that OX-40 expression is predictive of GVHD or is a useful tool for monitoring response to GVHD. In addition, earlier suggestions to develop a therapeutic approach aimed at the elimination of CD 4+ OX-40+ lymphocytes are not supported by our findings.

Rice genome sequencing on chromosome 1 and 9 in the International Rice Genome Sequencing Project(IRGSP)

Ho Il Kim,Yong Hwan Kim,Myung Chul Lee,Jang Ho Hahn,Moo Young Eun,Gang Seob Lee,Ung Han Yoon,Doh Won Yun,Choong Hyo Yun,Hung Sook Lee 한국육종학회 2003 한국육종학회 학술발표회 발표요지 Vol.35 No.3

FACScan에 의한 림프구성백혈병 세포의 표지자 및 DNA 검색

한영호,강정아,송경은,서장수,이원길,김재식,이건수,구자훈 대한임상병리학회 1992 대한임상병리학회지 Vol.12 No.4

만성골수염에서 생긴 편평세포암

최장석(Jang Seok Choi),김명호(Myung Ho Kim),배대경(Dae Kyung Bae),한문식(Moon Sik Hahn) 대한정형외과학회 1978 대한정형외과학회지 Vol.13 No.2

서울시 전기차 구매행태에 대한 시장분할 분석

한진석(HAHN, Jin-Seok),이장호(LEE, Jang-Ho) 대한교통학회 2018 대한교통학회지 Vol.- No.-

본 연구에서는 이항로짓모형 기반의 시장분할을 고려한 전기차 선택모형을 추정하여 전기차 잠재 수요층의 전기차 구매행태를 분석하였다. 모형 구축을 위하여 서울시에 거주하는 차량운전자를 대상으로 전기차 구매가격, 공용 충전인프라 구축 수준, 1회 충전 주행가능거리 등의 가상 시나리오에 대하여 전기차 선택여부를 조사하였다. 차급별로 구분하면 경·소형 차급 보유자는 차량 구매가격이 가장 큰 영향을 미치며, 중·대형 차급 보유자는 공용 충전인프라 구축 수준을 중요시하는 것으로 나타났다. 주택유형으로 분할한 경우 공동주택 거주자는 전기차 선택 시 공용 충전인프라 구축 수준을 가장 크게 고려하지만, 단독주택 거주자는 차량 구매가격에 가장 민감한 것으로 분석되었다. 이상의 결과를 토대로 자동차 제작사의 전기차 보급 전략이 전략적 구매층을 어디로 설정하느냐에 따라 달라져야 함을 보여주며, 정부의 전기차 보급정책으로는 공용 충전인프라의 확대가 가장 우선적으로 추진되어야 할 필요가 있다. In this study, we analyzed the electric vehicle (EV) purchasing behavior with market segmentation in Seoul using the binary logit model. For the model estimation, the experimental design of SP survey generated 24 scenarios with purchase price, charging station availability, and driving range of EVs. The results of market segmentation analysis indicated that the owners of subcompact and compact size cars were primarily affected by the purchasing price while those of mid and full size cars were more sensitive to the charging station availability. By housing type, the charging station availability was the most important factor for the residents of apartment while the purchase price was the most important factor to choose the EVs. These results presented that the EV supply strategy of the automobile manufacturer should be diversified according to the marketing target and the expansion of the public charging infrastructure should be the top priority in the government policy.