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부분적 간질에서 SPECT Subtraction을 이용한 발작 중 뇌혈류 변화에 대한 연구
이향운(Hyang Woon Lee),홍승봉(Seung Bong Hong),태우석(Woo Suk Tae),김상은(Sang Eun Kim),서대원(Dae Won Seo),정송철(Seung Cheol Jeong),이지영(Ji Young Yi),홍승철(Seung Chyul Hong) 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.3
N/A Purpose: To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Materials and Methods: lnterictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Bath positive images showing ictal hypoperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hypoperfusion, hypoperfusion-plus, combined hypoperfusion-hypoperfusion, and focal hypoperfusion only. Results: The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hypoperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hypoperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hypoperfusion alone was seen only in mesial TLE while lateral temporal hypoperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hypoperfusion in the neighboring brain regions where ictal discharges propagated. Conclusion: Hypoperfusion as well as hypoperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanisrn of ictal hypopertusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it. (Korean J Nucl Med 2000;34:169-82)
Narcolepsy Variant Presented with Difficult Waking
이향운,홍승봉,Lee, Hyang-Woon,Hong, Seung-Bong KOREAN ACADEMY OF SLEEP MEDICINE 2000 수면·정신생리 Vol.7 No.2
목 적 : 십년 이상 각성장애를 보인 20세 남자환자를 분석하였다. 환자는 두통, 만성피로, 경한 주간졸리움증을 호소하였으나 조절할 수 없는 수면발작, 탈력발작, 입면시 환각이나 수면마비의 병력은 없었다. 방 법 : 야간 수면다원검사 (PSG), 반복적 수면잠복기 검사 (MSLT) 및 조직적합성 유전자검사 (HLA-typing)를 시행 하였다. 결 과 : PSG상 수면잠복기가 짧고 (4분), 렘수면잠복기도 감소하였고 (2.5분), 각성지표 (arousal index)가 시간당 15.7로 약간 증가되었으며, 수면 중 주기적 사지운동지표 (PLMS index)가 시간당 8.1로 관찰되었으나 운동과 연관된 각성지표 (movement arousal index)는 시간당 2.1로 높지 않았다. 잠효율은 (sleep efficiency)는 97.5%로 정상이었다. MSLT상 수면잠복기는 15분 21초로 정상이었으나 sleep-onset REM (SOREM)은 5회의 낮잠 시도 중 4회에서 관찰되었다. HLA-typing에서 DQ6-양성이었는데, 이는 기면증 환자에서 대개 관찰되는 유전자 위치인 DQB1*0602, DQA1*0102와는 다른 DQB1*0601 부위에 상응하였다. 결 론 : 일차성 각성장애의 원인이 되는 여러 질환 특히 일주기리듬장애나 기면증, 원발성 다면증과의 감별진단이 필요하며, 수면검사와 유전자검사 상 기면증의 새로운 변종일 가능성을 배제할 수 없다. Objectives Summary: A 20-year-old man was presented with a history of difficult waking for 10 years. He suffered from morning headache, chronic fatigue and mild daytime sleepiness but had no history of irresistible sleep attack, cataplexy, hypnagogic hallucination or sleep paralysis. Methods: Night polysomnography (PSG), multiple sleep latency test (MSLT) and HLA-typing were carried out. Results: The PSG showed short sleep latency (4.0 min) and REM latency (2.5 min), increased arousal index (15.7/hour), periodic limb movements during sleep (PLMS index=8.1/hr) with movement arousal index 2.1/hr and normal sleep efficiency (97.5%). The MSLT revealed normal sleep latency (15 min 21 sec) and 4 times sleep-onset REM (SOREM). HLA-typing showed DQ6- positive, that corresponded at the genomic level to the subregion DQB1*0601, which was different from the usual locus in narcolepsy patients (DQB1*0602 and DQA1*0102). Conclusion: Differential diagnosis should be made with circadian rhythm disorder and other causes of primary waking disorder. The possibility of a variant type of narcolepsy could be suggested with an unusual clinical manifestation and a new genetic marker.
저점도형 고성능 감수제가 다양한 혼화재 종류 및 치환량 조건에서 고성능 시멘트 페이스트의 레올로지 성능에 미치는 영향 분석
전종운 ( Jeon Jong-woon ),손배근 ( Son Bae-geun ),이향선 ( Lee Hyang-sun ),한동엽 ( Han Dong-yeop ) 한국건축시공학회 2018 한국건축시공학회 학술발표대회 논문집 Vol.18 No.2
High performance concrete with low water-to-cement ratio has been widely used with increased demand of high rising buildings and huge scaled structures. Additionally, for high performance concrete, various SCMs are replaced to improve its performance from fresh state to hardened state. With the drawback of increased viscosity of the concrete mixture for high performance concrete, low-viscosity typed high range water reducer is the relatively new admixture. Therefore, as a goal of the research, under using various SCMs with wide range of content, the performance of low-viscosity typed high range water reducer was evaluated. Especially, in this research, the influence of low-viscosity typed high range water reducer on rheological properties including plastic viscosity and yield stress were assessed. As a result of the research, it is expected to provide a fundamental information of low -viscosity typed high ranged water reducer on high performance concrete with various conditions of SCMs.
뇌전증 소아청소년 환아와 가족의 삶의 질에 영향을 주는 요인에 관한 연구
이명은,김가은,이향운,김의정,Lee, Myong Eun,Kim, Ga Eun,Lee, Hyang Woon,Kim, Eui-Jung 대한생물정신의학회 2019 생물정신의학 Vol.26 No.2
Objectives The aim of this study was to investigate the impact of clinical and psychological factors on the quality of life of children and adolescents with epilepsy and their families. Methods Children and adolescents with epilepsy and their families (n = 63, age range = 6-17 years) completed questionnaires on epilepsy-related variables, quality of life, children's depressive symptoms, children's anxiety, children's behavioral problems, children's attention problems, parental stress, and parental anxiety. Stepwise regression analysis was performed to determine the significant predictive variables that affect quality of life. Results In the correlational analysis, children's attention problems (r = 0.363, p = 0.004), parental anxiety (r = 0.377, p = 0.003), parental stress (r = 0.564, p < 0.001), and children's behavioral problems (r = 0.503, p < 0.001) showed a significant correlation with quality of life. Parental stress (β = 0.415, p = 0.001, adjusted R<sup>2</sup> = 0.345) and children's behavioral problems (β = 0.285, p = 0.02, adjusted R<sup>2</sup> = 0.345) were significantly related to the quality of life. Conclusions Clinicians should pay attention to parental stress and children's behavioral problems, which affect quality of life in families with pediatric epilepsy.
국내병원 간호사의 인수인계 실무표준, 표준지침 및표준화된 항목 개발에 대한 연구
김은만 ( Eun Man Kim ),유미 ( Mi Yu ),이향열 ( Hyang Yuol Lee ),고지운 ( Ji Woon Ko ),조의영 ( Eui Young Cho ),김을순 ( Eul Soon Kim ) 병원간호사회 2014 임상간호연구 Vol.20 No.1
간호사의 인수인계는 환자 안전의 중요한 요소로 본 연구는 인수인계 실무 표준, 표준지침과 표준화된 항목을 개발하여 적절성 여부를 검증한 서술적 조사연구이다. 연구대상자는 국내 종합병원에 근무하는 207명의 수간호사와 697명의 간호사로 개발된 실무표준은 인수인계 ‘목적’ 2항목, ‘정책’ 5항목, ‘환경’ 3항목, ‘과정’ 5항목, ‘내용’ 7항목, ‘평가’ 3항목, ‘교육기능’ 1항목의 총 26항목으로 구성되었으며, 도출된 표준화된 인수인계 항목은 Patient, Assessment, Situation, Safety concerns, Background, Action, Recommendation이었다. 본 연구결과는 국내 병원의 인수인계를 표준화하고 구조화된 시스템 개발의 기초자료로 사용될 수 있을 것이다. Addressing current status of nursing handoff provides information as to where to change practice for improvement in patient care. The aim of this study was to develop nursing a handoff practice guideline and standards for Korean hospitals. Methods: A questionnaire was used to collect data in a cross-sectional survey with 207 head nurses and 697 nurses working in general hospitals. Results: The practice guideline consisted of 2 items on purpose of handoff, 5 items on policy, 3 on environment, 5 on process, 7 on content, 3 on evaluation, and 1 on the function of education, for a total 26 of items. Standard instruction was developed related to Patients, Assessment, Situation, Safety concerns, Background, Actions, and Recommendations. Conclusion: The findings of this study indicate that the guideline can be applied in real nursing practice to improve the effectiveness of handoff procedures. It can be used to guide nurses to follow the standardized content, which presents patient details clearly. The guideline provides consistency and structure for the information that is handed over.