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전기경련치료(ECT)시 뇌파의 비선형 분석 : 단일증례 연구 A Single Case Study
강웅구,이운철,정선주,윤세창,조맹제,이상훈,김용식 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5
연구목적 : 비선형 분석을 통해 전기경련 치료(ECT)의 적절성 및 효과를 판정할 수 있는 새로운 변인을 추출해 낼 가능성을 탐색하기 위하여 한 여성 우울증 환자에서 ECT중 기록한 뇌파의 단일증례 분석을 하였다. 방 법 : 1주일 간격을 둔 두 ECT 회기에서 치료전 안정상태, 마취후-경련전상태, 경련상태, 경련후 뇌파억제상태, 치료후 안정상태의 다섯 상태에 따른 뇌파를 디지털 기록한 데이터를 분석하였다. 결 과 : 분석의 결과 1) 뇌파가 10차원 이하 저차원의 결정론적 성질을 가지고있으며 2) 뇌파는 비정상적(non-stationary)이지만 비선형 지수들이 각 상태 뇌파를 안정적으로 구분해 줄 수 있고 3) ECT 회기의 진행에 따라 경련중 뇌파의 결정론적 성질이 증가하며 4) ECT 회기의 진행에 따라 치료전후 안정상태 뇌파의 최대발산지수(PLE) 및 상관차원이 증가한다는 사실을 관찰할 수 있었다. 결 론 : 단일증례에 대한 다양한 비선형 분석의 결과는 ECT의 치료효과를 정량화할 수 있는 변인으로서 PLE, 상관차원 등 비선형 변수들이 사용될 수 있을 가능성을 제시한다. Objectives : In order to search for new parameters for the evaluation of the adequacy of electroconvulsive therapy(ECT), the authors performed a non-linear analysis of electroencephalogram(EEG) recorded during the course of electroconvulsive therapy(ECT) in a single female patient with depression. Methods : Digitized EEG recordings from two ECT sessions spaced one week were analyzed at five different stages ; pretreatment stable, postanesthetic-preictal, ictal, postical suppression and posttreatment stable stages. Results : Our analysis showed that 1) EEG signals had low dimensional(below 10 dimensions) deterministic characteristics 2) although EEG was nonstationary signal, non-linear parameters could reliably differentiate between various stages we examined. 3) the deterministic property of ictal EEG increased according to the progression of sessions and 4) the primary Lyapunov exponent(PLE) and correlation dimension of pre- and post-treatment stable stage EEG increased according to the progression of sessions. Conclusion : In this single case study, results of various non-linear analyses suggested that non-linear variables extracted from EEG recordings during ECT may have utilities as tools for the quantitative evaluation of ECT.
라플라시안 경계강조에 의한 MRI 영상의 3차원 입체모델의 구현
배상진,최철웅,강인준 釜山大學校生産技術硏究所 1996 生産技術硏究所論文集 Vol.50 No.-
초음파, 단층촬영(CT:Computed Tomography), 그리고 자기공명영상(MRI:Magnetic Resonance Imaging)등이 3차원 입체모텔을 정확하게 표시하기 위하여 실제 환자들의 해부를 통하여 개발되어져왔다. 3차원 입체모델은 대상물의 체적, 위치, 형태등 중요한 정성적, 정량적 정보를 제공할 수 있다. 그러나 자기공명영상은 2차원 다층구조와 복합구조로 구성되어 있어 실제적인 3차원 모습을 알기 어렵다. 본 논문에서는 자기공명영상을 수치데이타화하여 영상처리기법으로 경계선을 추출하고 사진측량기법의 좌표변환으로 동일좌표화 하였으며, Ray Tracing기법에 의하여 3차원 입체모델을 구현하였다. A Method has been developed which allows accurate modeling of 3-Dimension image data such as CT or MRI, with the anatomy of the actual patient. 3-D modelling give some important qualitative and quantitative information about object volume, location and type etc. But the MRI images have 2-D multi-layer and complex constructure, so it is difficult to know real 3D shape. In this paper, MRI images are enhanced of edge by image processing and digitized to digital data. The coordinate of object is transformed to same coordinate system by photogrametry technique and 3-D modelling is made to 3D model by ray tracing technique.
비정형 향정신병약물을 투여 중인 정신분열병 환자의 주관적 삶의 질 : 정신병리, 약물 부작용 및 약물에 대한 주관적 반응과의 관련성
김종훈,윤정희,이자영,노경희,홍성극,윤세창,강웅구,김용식 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2
Objectives : The purpose of this study was to evaluate the characteristics of psychopathology, adverse drug effects, and Subjective response to drugs that have a significant impact on the subjective quality of life in schizophrenic patients receiving atypical antipsychotics. Methods : One hundred and one schizophrenic patients, who were receiving maintenance treatment with atypical antipsychotics, were evaluated. Subjective quality of life was assessed using the standardized Korean modification of a self-rating scale to measure subjective well-being under neuroleptics (KmSWN). Patients' psychopathology was evaluated using the Positive and Negative Syndrome Scale. Adverse effects and subjective response to drug were evaluated using the Liverpool University Neuroleptic Side Effect Rating Scale and the Drug Attitude Inventory-10, respectively. Correlation analysis and stepwise multiple regression analysis were conducted. Results : In psychopathology, the severity of depression and anxiety showed the most significant correlation with the score ofKmSWN. In adverse drug effects, the severity of psychic side effect and extrapyramidal side effect showed the most significant correlation with the score ofKmSWN. Regarding subjective response to drug, significant correlation was observed between the severity of subjective negative response and the score of KmSWN. Stepwise multiple regression analysis revealed that psychic side effect, extrapyramidal side effect, and depression contributed significantly to the total score of KmSWN. These variables accounted for 59.7% of the total variance. Conclusion : The results of the present study suggest that psychic side effect, extrapyramidal side effect and depressive symptom are the clinical characteristics that are significantly associated with the subjective quality of life. An effective management strategy for these variables should be established in developing a treatment program to enhance the quality of life of patients with schizophrenia.
Moon, Sung-Ung,Kim, Jin Won,Sung, Ji Hea,Kang, Mi Hyun,Kim, Se-Hyun,Chang, Hyun,Lee, Jeong-Ok,Kim, Yu Jung,Lee, Keun-Wook,Kim, Jee Hyun,Bang, Soo-Mee,Lee, Jong Seok Korean Cancer Association 2015 Cancer Research and Treatment Vol.47 No.3
<P><B>Purpose</B></P><P>p21-activated kinases (PAKs) are involved in cytoskeletal reorganization, gene transcription, cell proliferation and survival, and oncogenic transformation. Therefore, we hypothesized that PAK expression levels could predict the sensitivity of pancreatic cancer cells to gemcitabine treatment, and PAKs could be therapeutic targets.</P><P><B>Materials and Methods</B></P><P>Cell viability inhibition by gemcitabine was evaluated in human pancreatic cancer cell lines (Capan-1, Capan-2, MIA PaCa-2, PANC-1, Aspc-1, SNU-213, and SNU-410). Protein expression and mRNA of molecules was detected by immunoblot analysis and reverse transcription polymerase chain reaction. To define the function of PAK4, PAK4 was controlled using PAK4 siRNA.</P><P><B>Results</B></P><P>Capan-2, PANC-1, and SNU-410 cells were resistant to gemcitabine treatment. Immunoblot analysis of signaling molecules reported to indicate gemcitabine sensitivity showed higher expression of PAK4 and lower expression of human equilibrative nucleoside transporter 1 (hENT1), a well-known predictive marker for gemcitabine activity, in the resistant cell lines. Knockdown of PAK4 using siRNA induced the upregulation of hENT1. In resistant cell lines (Capan-2, PANC-1, and SNU-410), knockdown of PAK4 by siRNA resulted in restoration of sensitivity to gemcitabine.</P><P><B>Conclusion</B></P><P>PAK4 could be a predictive marker of gemcitabine sensitivity and a potential therapeutic target to increase gemcitabine sensitivity in pancreatic cancer.</P>
Factors predictive of the failure of medical treatment in patients with pleural infection
( Sung Kyoung Kim ),( Chul Ung Kang ),( So Hyang Song ),( Deog Gon Cho ),( Kyu Do Cho ),( Chi Hong Kim ) 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.5
Background/Aims: The clinical outcomes of some patients with pleural infectionmay be favorable with medical treatment alone, but in others, the diseaseprogresses and requires additional surgical treatment. However, little is knownabout the factors affecting this difference. The aim of this study was to investigatethe factors predictive of failure of medical treatment in patients with pleuralinfection. Methods: A cohort of 127 consecutive patients who were admitted to the hospitalwith pleural infection was studied. Clinical manifestations and laboratory findingsin patients in whom medical treatment succeeded or failed were reviewed. Results: In univariate analysis, the significant factors associated with medicaltreatment outcome were age, smoking history, duration of chief complaint, serumalbumin level, and pleural fluid glucose and lactate dehydrogenase levels (p <0.05). Multivariate logistic regression analysis identified age and duration of chief complaintas independent predictive factors for failure of medical treatment, withodds ratios of 0.871 (p = 0.013) and 0.797 (p = 0.026), respectively. Receiver operatingcharacteristic curve analysis determined cutoff values of 50.5 years for age and 4.5days for duration of chief complaint. Conclusions: We demonstrated that a younger age < 50.5 years and shorter durationof chief complaint < 4.5 days were independent predictive factors for thefailure of medical treatment in patients with pleural infection. This suggeststheir role as evaluative criteria in setting indications for the optimal treatment inpatients with pleural infection. A larger, prospective study is required to confirmthese findings.
ung-Hoon Kang,June-Ho Byun,Su-Jin Sung,Bong-Wook Park 대한구강악안면외과학회 2017 대한구강악안면외과학회지 Vol.43 No.3
A surgical approach involving the retromolar trigone, posterolateral maxilla, and pterygoid region is the most challenging in the field of maxillofacial surgery. The upper cheek flap (Weber-Ferguson incision) with subciliary extension and the maxillary swing approach have been considered as alternatives; however, neither approach provides sufficient exposure of the pterygoid region and the anterior portion of the mandibular ramus. In this report, we describe two cases in which a lower cheek flap approach was used for complete tumor resection in the retromolar trigone and the anterior mandibular ramus. This approach allows full exposure of the posterolateral maxilla and the pterygoid region as well as the retromolar trigone without causing major sensory disturbances to the lower lip. A mental nerve anastomosis after tumor resection was performed in one patient and resulted in approximately 90% sensory recovery in the lower lip. The lower cheek flap approach provides adequate exposure of the posterolateral maxilla, including the pterygoid, retromolar trigone, and mandibular ramus areas. If the mental nerve can be anastomosed during flap approximation, postoperative sensory disturbances to the lower lip can be minimized.