전안부 빛간섭단층촬영으로 측정한 백내장 수술 후 전방깊이와 전방각의 변화

신철진,이주은,김재용,차흥원.Chul Jin Shin. MD. Joo Eun Lee. MD. Jae Yong Kim. MD. PhD. Hung Won Tchah. MD. PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.3

Purpose: To evaluate changes in anterior chamber depth (ACD) and angle after phacoemulsification and intraocular lens implantation using anterior segment optical coherence tomography (AS-OCT). Methods: Seventy-eight eyes of 69 patients had uneventful phacoemulsification and IOL implantation using a clear corneal incision. Anterior segment OCT images of nasal and temporal angle quadrants were obtained before and at one month after surgery. The angle-referenced (ACD1), pupil-referenced (ACD2), lens-referenced (ACD3) ACDs, crystalline lens rise (CLR), nasal and temporal iridocorneal angles, angle opening distance at 500 μm (AOD500), and trabecular iris surface area at 750 μm (TISA750) were measured. Preoperative and postoperative measurements were compared using paired sample t-tests. Results: The mean ACD1 was 3.19±0.24 mm preoperatively and 3.22±0.21 mm at one month postoperatively (P=0.21); ACD2 was 2.99±0.40 mm preoperatively and 3.56±0.28 mm at one month postoperatively (P<0.05); ACD3 was 2.75±0.41 mm preoperatively and 4.00±0.27 mm at one month postoperatively (P<0.05). The mean iridocorneal angles, AOD500, and TISA750 for both nasal and temporal sides increased significantly at the postoperative examinations (P<0.05). Conclusions: Changes in anterior chamber angle after cataract surgery can be objectively quantified by anterior segment OCT. Deepening of the anterior chamber and widening of the nasal and temporal angles after cataract extraction were shown on AS-OCT. J Korean Ophthalmol Soc 2010;51(3):353-358

정신분열병 환자의 임상적 증세 호전에 따른 99m Tc - HMPAO 뇌 SPECT 소견의 변화

신철진,궁성수,정인원 ( Chul Jin Shin,Sung Soo Koong,In Won Chung ) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.3

슬픔과 우울, 그리고 자살의 진화적 의미

신철진,Shin, Chul-Jin 대한생물정신의학회 2016 생물정신의학 Vol.23 No.4

Depression has a relatively high lifetime prevalence rate in spite of a genetic influence on its etiology and a high mortality rate in untreated cases. This suggests the possibility that depression gives us evolutionary benefits which we do not exactly know yet. There have been several hypotheses which tell us what evolutionary advantages depression could give us. The psychic pain hypothesis considers sad or depressed mood as a negative reward just like physical pain which we have to avoid for our protection and survival. The social rank hypothesis holds that depressed mood is very similar to the emotional state of the defeated in social competition which prevents him from further protesting or fighting that might cause additional damage to him. The inclusive fitness hypothesis views suicide as a sacrifice phenomenon to contribute to inclusive fitness. These hypotheses gives us new insights into mood disorders and also some suggestions about the conditions in which depressed mood or suicidal behaviors increase and the ways to reduce them.

뇌파의 비선형 분석을 위한 신호추출조건 및 계산 알고리즘

신철진,이광호,최성구,윤인영,Shin, Chul-Jin,Lee, Kwang-Ho,Choi, Sung-Ku,Yoon, In-Young 대한수면의학회 1999 수면·정신생리 Vol.6 No.1

목 적 : 임상 뇌파의 비선형 분석시, 분석시간을 단축시킬 수 있는 방법과 보다 정확한 상관차원을 얻기 위한 새로운 알고리즘 고안을 시도하였다. 또 뇌파신호 분석을 위한 적절한 신호획득 조건을 결정하는 방법을 제시하기 위하여 여러 상이한 실험조건에서 상관차원을 계산하였으며, 여기서 얻은 결과를 이용하여 각 실험실마다 공통적으로 적용할 수 있는 표준화된 실험 조건을 결정하고자 하였다. 방 법 : 임의의 한 개인을 대상으로 13개의 두피전극에서 얻은 뇌파신호를 대상으로 하였다. 12비트 해상도에서 1000 헤르츠로 32초간 얻은 뇌파신호를 디지털화 하여 각 전극당 32000개의 시계열자료를 얻었다. 이 자료를 10, 20, 30초 간격의 시간단위로 나누고, 각각에 대해 1000, 500, 250, 125, 62.5 Hz 등 5가지 신호추출조건을 달리 하여 각 전극마다 총 15개의 시계열 자료를 만들었다. 여기에 상관차원 계산시간 단축을 위해 고안된 계산 알고리듬 및 상관차원 추정 정확도를 개선하기 위해 적용한 최소절단자승기법을 적용하여 상관 차원을 계산하였다. 이렇게 얻은 상관차원 결과를 신호획득시간과 신호추출빈도에 따라 비교하였다. 또 로그연산을 비트 연산으로 바꾸어 계산시간 단축의 효과를 평가하였으며, 최소 절단자승기법과 최소자승추정기법을 비교하였다. 결 과 : 신호추출시간이 증가함에 따라 상관차원의 값도 통계적으로 유의하게 증가하는 양상을 보였다. 신호추출빈도가 62.5Hz일때는 신호추출시간에 무관하게 높은 상관차원값을 나타냈으나 그밖의 빈도에서는 유사한 상관차원값을 보였다. 본 연구에서 고안된 계산 알고리듬은 종래 사용하던 알고리듬에 비해 통계적으로 유의한 계산시간 단축효과를 보였다. 또 종래의 방법인 최소자승추정에 의한 상관차원에 비하여 본 연구에 적용된 최소절단자승추정법은 보다 안정된상관차원 값을 추정하였다. 결 론 : 본 연구는 다량의 뇌파 시계열 자료를 분석하는데 신속하고 보다 정확한 상관차원 추정에 알맞는 분석방법을 제공하였다. 또한 뇌파 시계열 자료의 상관차원 계산시 12비트의 해상도에서 125Hz의 신호추출빈도로 20초간 뇌파신호를 획득하면 적정한 수준의 상관차원을 계산할 수 있음을 보였다. Objectives: With the object of finding the appropriate conditions and algorithms for dimensional analysis of human EEG, we calculated correlation dimensions in the various condition of sampling rate and data aquisition time and improved the computation algorithm by taking advantage of bit operation instead of log operation. Methods: EEG signals from 13 scalp lead of a man were digitized with A-D converter under the condition of 12 bit resolution and 1000 Hertz of sampling rate during 32 seconds. From the original data, we made 15 time series data which have different sampling rate of 62.5, 125, 250, 500, 1000 hertz and data acqusition time of 10, 20, 30 second, respectively. New algorithm to shorten the calculation time using bit operation and the Least Trimmed Squares(LTS) estimator to get the optimal slope was applied to these data. Results: The values of the correlation dimension showed the increasing pattern as the data acquisition time becomes longer. The data with sampling rate of 62.5 Hz showed the highest value of correlation dimension regardless of sampling time but the correlation dimension at other sampling rates revealed similar values. The computation with bit operation instead of log operation had a statistically significant effect of shortening of calculation time and LTS method estimated more stably the slope of correlation dimension than the Least Squares estimator. Conclusion: The bit operation and LTS methods were successfully utilized to time-saving and efficient calculation of correlation dimension. In addition, time series of 20-sec length with sampling rate of 125 Hz was adequate to estimate the dimensional complexity of human EEG.

새로운 인공수정체를 낭내 삽입한 미세각막절개 백내장 수술의 임상평가

신철진,이주은,김재형,김재용,차흥원,Chul Jin Shin,MD,Joo Eun Lee,MD,Jae Hyung Lee,MD,Jae Yong Kim,MD,PhD,Hungwon Tchah,MD,PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.5

Purpose: To compare visual performance after microincision cataract surgery (MICS) with the implantation of the Akreos MI-60 (MI-60) intraocular lens (IOL) through a 1.8-mm microincision with that after conventional cataract surgery with implantation of the Akreos Adapt-AO IOL (Adapt-AO). Methods: All MICS procedures were performed by the same surgeon. The MI-60 was implanted into 25 eyes, and the Adapt-AO was place in 28 eyes. Best corrected visual acuity (BCVA), total high-order-aberration (HOA), contrast sensitivity, and surgically- induced astigmatism (SIA) were recorded one-week, one-month, and four-months postoperatively. Results: There were no statistically significant differences in BCVA between eyes implanted with the MI-60 or those with the Adapt-AO (MI-60 vs. Adapt-AO, 0.09±0.11 at baseline (logMAR), 0.11±0.08 at one-week, 0.06±0.07, 0.06±0.06 at one-month, 0.05±0.06, 0.06±0.05 at four-months according to the Mann-Whitney U test, p>0.05). Refractive errors were significantly less with the Adapt-AO than with the MI-60 (MI-60 vs. Adapt-AO, -0.50±0.43 at baseline (diopter), -0.06±0.39 at one-week, -0.50±0.41, 0.01±0.57 at one-month, -0.46±0.36, 0.08±0.58 at four-months according to the Mann-Whitney U test, p<0.05). There were no statistically significant differences in total HOA or contrast sensitivity between eyes implanted with the MI-60 and those implanted with the Adapt-AO. SIAs were significantly reduced in eyes implanted with the MI-60 than in those with the Adapt-AO at one-month and four-months postoperatively (Mann-Whitney U test, p<0.05). Conclusions: Implantation with either the MI-60 or the Adapt-AO produced clinically acceptable outcomes, including good spherical aberration and contrast sensitivity. Furthermore, implantation with the MI-60 caused less SIA at one- and four-months postoperation, as compared to that with the Adapt-AO. J Korean Ophthalmol Soc 2010;51(5):677-683

베트남 결혼이주여성의 우울과 불안에 영향을 미치는 요인에 대한 설문연구

홍선엽,신철진,이상익,손정우,김시경,주가원,Hong, Sun-Yeob,Nguyen, Duc Thanh,Shin, Chul-Jin,Lee, Sang-Ick,Son, Jung-Woo,Kim, Sie-Kyeong,Ju, Ga-Won 대한생물정신의학회 2013 생물정신의학 Vol.20 No.4

Objectives The number of marriage immigrant women has been increasing in the past several years in Korea and their adaptations to the new environment have been an important social issue. The aims of this study were to evaluate the psychosocial and mental health statuses of Vietnamese marriage immigrant women (VMIW). We intended to compare the mental health of VMIW with married Vietnamese women living in Vietnam and reveal the demographic or psychosocial factors affecting their mental health. Method Subjects comprised one-hundred-forty-three VMIW who enrolled in multiculture family support centers in Chungbuk Province and forty-eight women from Vinh Phuc province in Vietnam. Marital satisfaction, domestic violence and social support were evaluated as psychosocial factors, and the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and General Health Questionnaire (GHQ) were used to evaluate mental health. Results VMIW had a larger age gap with their husbands but better psychosocial statuses. BDI (p = 0.20), BAI (p = 0.08), GHQ (p = 0.13) scores of VMIW were not significantly different compared to Vietnamese residents. Marriage duration of VMIW affects significantly their marital satisfaction, social support and depressive levels (p < 0.01). The level of domestic violence showed a significant difference according to the educational levels of their husbands, composition of family members and marriage process (p < 0.05). VMIW with older husbands and jobless VMIW had low levels of anxiety (p < 0.01). Conclusion The results suggest that VMIW have no difference in mental health compared to Vietnamese women living in Vietnam which is contrary to general expectations. However, various environmental factors, such as marriage duration, have an effect on the mental health of VMIW. As marriage duration is proven to be important factor on mental health of VMIW, more extended duration of care and interventions are needed to maintain good mental health. Networking system connecting mental health screenings by the multiculture family support center to the local mental healthcare center is needed to care those with poor screening outcomes.

수면발생과정의 뇌파를 대상으로한 탈경향변동분석의 적용

박두흠,신철진,Park, Doo-Heum,Shin, Chul-Jin 대한생물정신의학회 2012 생물정신의학 Vol.19 No.1

Objectives : Much is still unknown about the neurophysiological mechanisms or dynamics of the sleep onset process. Detrended fluctuation analysis (DFA) is a new tool for the analysis of electroencephalography (EEG) that may give us additional information about electrophysiological changes. The purpose of this study is to analyze long-range correlations of electroencephalographic signals by DFA and their changes in the sleep onset process. Methods : Thirty channel EEG was recorded in 61 healthy subjects (male:female=34:27, age=$27.2{\pm}3.0$ years). The scaling exponents, alpha, were calculated by DFA and compared between four kinds of 30s sleep-wakefulness states such as wakefulness, transition period, early sleep, and late sleep (stage 1). These four states were selected by the distribution of alpha and theta waves in O1 and O2 electrodes. Results : The scaling exponents, alpha, were significantly different in the four states during sleep onset periods, and also varied with the thirty leads. The interaction between the sleep states and the leads was significant. The means (${\pm}$ standard deviation) of alphas for the states were 0.94 (${\pm}0.12$), 0.98 (${\pm}0.12$), 1.10 (${\pm}0.10$), 1.07 (${\pm}0.07$) in the wakefulness, transitional period, early sleep and late sleep state respectively. The mean alpha of anterior fifteen leads was greater than that of posterior fifteen leads, and the two regions showed the different pattern of changes of the alpha during the sleep onset periods. Conclusions : The characteristic findings in the sleep onset period were the increasing pattern of scaling exponent of DFA, and the pattern was slightly but significantly different between fronto-temporal and parieto-occipital regions. It suggests that the long-range correlations of EEG have a tendency of increasing from wakefulness to early sleep, but anterior and posterior brain regions have different dynamical process. DFA, one of the nonlinear analytical methods for time series, may be a useful tool for the investigation of the sleep onset period.

산후 우울감을 보이는 산모에서 나타나는 전두엽 뇌파 비대칭에 대한 음악의 영향

임성진,신철진,Lim, Sung-Jin,Shin, Chul-Jin 대한생물정신의학회 2011 생물정신의학 Vol.18 No.3

Objectives Postpartum blues is known to be a major risk factor for postpartum depression and can be associated with the problems of language skills, behaviors or learning skills of their children. Therefore, it is very important for clinicians to evaluate precisely and control postpartum blues. Recent studies have found that music has an effect on depressive mood and the frontal EEG asymmetry of the patients with depression. The purpose of this study was to find out the effects of music on the frontal EEG asymmetry of the mothers with postpartum blues. Method Among one hundred and seventy mothers assessed with Korean version of the Edinburg Postnatal Depression Scale (EPDS), nine mothers with postpartum blues (EPDS ${\geq}$ 10) as postpartum blues group and nine non-depressive mothers (EPDS < 10) as non-depressive mother group were included. Ten non-labored, non-depressive women were also included as a normal control group. The subjects were evaluated with the State Trait Anxiety Inventory (STAI)-X1, the Visual Analogue Scale (VAS) and the Depression Adjective Checklist-Korean version (K-DACL) and EEG twice before and after the music sesssion with the length of twenty minutes and thirty two seconds. The statistical analyses were done for A1 score (log R - log L) which were computed from the alpha powers at F3 and F4. Results No significant difference was noted in demographic data among all three groups. The postpartum blues group had higher scores in the STAI-X1, the VAS and the K-DACL compared to the other groups at baseline, and their A1 scores were lower than those of only normal controls. There was a statistically significant increase of A1 score only in the postpartum blues group after the music session. Conclusion This study suggests that the mothers with postpartum blues may have a frontal EEG asymmetry which is possibly associated with their depressive mood, and the music session can affect the frontal asymmetry positively.

폐쇄성 수면 무호흡증의 심각도와 심박동 변이율 : 탈경향변동분석

주가원,신철진,박두흠,Ju, Gawon,Shin, Chul-Jin,Park, Doo-Heum 대한생물정신의학회 2009 생물정신의학 Vol.16 No.2

Objectives : The detrended fluctuation analysis is one of the nonlinear methods for the investigation of biological time series. It quantifies the fractal scaling properties and is known to be useful in the evaluation of long-range correlations in time series. The heart rate variability(HRV) of obstructive sleep apnea syndrome (OSAS) patients during nighttime was analyzed by detrended fluctuation analysis to assess its relationship with the severity of the symptoms. Methods : Fifty nine untreated male OSAS patients with moderate to severe symptoms(mean age=45.4${\pm}$11.7 years, apnea-hypopnea index, AHI${\geq}$15) underwent nocturnal polysomnography. Moderate(AHI=15-30, N=22) and severe(AHI>30, N=37) OSAS patients were compared for the indices derived from detrended fluctuation analysis and frequency domain analysis of HRV. Results : In the detrended fluctuation analysis, the alpha values were 0.75${\pm}$0.11 and 0.82${\pm}$0.07 for the severe and the moderate OSAS groups respectively. The difference was significant(p<.01). The alpha value had negative correlation with AHI(r=-.425, p=.001). Negative correlation coefficients were also found in the relationships between the alpha values and very low frequency(VLF)(r=-.425, p=.001), low frequency(LF)(r=-.633, p= <.001) and the LF/HF ratio(r=-.305, p=.019) respectively. LF/HF ratio(p=.005) was higher in the severe OSAS group compared to that of the moderate OSAS group. Conclusion : In this study, the detrended fluctuation analysis showed the significant difference between the two OSAS groups classified according to their severity of symptoms. The scaling exponent showed the negative correlation with AHI and indicies of frequency domain analysis. This result suggests that detrended fluctuation analysis can be helpful to estimate the severity of OSAS.

초기 성인기 우울증에 대한 유전적, 환경적 요인의 영향

김시경,이상익,신철진,손정우,엄상용,김헌,Kim, Sie-Kyeong,Lee, Sang-Ick,Shin, Chul-Jin,Son, Jung-Woo,Eom, Sang-Yong,Kim, Heon 대한생물정신의학회 2008 생물정신의학 Vol.15 No.1

우울 장애는 유전적 요인과 함께 환경적 요인이 복합적으로 작용하는 정신 장애이다. 본 연구에서는 세로토닌 체계와 연관된 유전적 요인과 생활사건과 같은 환경적 요인이 초기 성인기 우울 장애 발현에 미치는 영향을 조사함으로써 우울 장애의 원인론에 있어 유전자${\times}$환경 상호작용을 설명할 수 있는 자료를 제시하고자 하였다. 534명의 대학 신입생을 종적으로 추적 조사하여 생활사건 빈도와 중요도, 우울 척도와 불안 척도를 조사하였으며 전화 면담을 통해 DSM-IV 우울 장애 여부를 확인하였다. 최종적으로 150명이 연구에 포함되었으며 이전 연구로 확인된 TPH1 유전형과 함께 보관되어 있던 대상군의 DNA를 이용하여 SNaPshot$^{TM}$ 방식으로 TPH2, 5HTR2A 유전자를 추가 분석하였다. 유전자 정보와 생활사건 특성이 우울 증상에 미치는 영향을 확인하기 위해 로지스틱 회귀 분석과 상관 분석, 카이 자승 분석을 사용하였다. TPH1 유전형 중 C 대립 유전자가 존재하지 않는 집단과 달리 C 대립 유전자가 존재하는 집단에서는 생활사건 빈도가 우울 장애 유발에 유의한 영향을 미쳤다. 이러한 영향은 다른 대립 유전자나 유전형을 보이는 집단에서는 관찰되지 않았다. 본 연구의 결과는 TPH1 유전형은 생활사건 이후 우울 장애 발생의 유의미한 예측 요인임을 시사한다. 이는 우울 장애의 유전${\times}$환경 상호작용에 TPH1 유전자가 작용하고 있음을 제시한다. Objectives : The authors purposed to present data for explaining gene-environmental interaction causing depressive disorder by examining the effects of genetic factors related to the serotonin system and environmental factors such as stressful life events in early adulthood. Methods : The subjects were 150 young adults(mean age 25.0${\pm}$0.54), a part of 534 freshmen who had completed the previous study of genotyping of TPH1 gene. We assessed characteristics of life events, depression and anxiety scale and checked if they had a depressive disorder with DSM-IV SCID interview. Along with TPH1 A218C genotype confirmed in previous study, TPH2 -1463G/A and 5HTR2A -1438A/G genes were genotyped using the SNaPshot$^{TM}$ method. Results : In comparison with the group without C allele of TPH1 gene, the number of life events had a significant effect on the probability of depressive disorder in the group with C allele. Other alleles or genotypes did not have a significant effect on the causality of life events and depressive disorder. Conclusion : The results of this study suggest that TPH1 C allele is a significant predictor of onset of depressive disorder following environmental stress. It means that the TPH1 gene may affect the gene-environmental interaction of depressive disorder.