야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

정신분열병 환자에서 통계적 확률 해부학 지도를 이용한 확산텐서영상 연구 : 겉보기 확산 계수 지도를 이용한 고찰

홍순범,신용욱,김대진,문원진,정은철,이재성,박해정,권준수 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Objectives : Diffusion tensor imaging (DTl) studies of schizophrenia, thus far, have mainly focused on white matter abnormalities reflected in anisotropy indices such as fractional anisotropy (FA), but recently, new implications of apparent diffusion coefficient (ADC) have been proposed. This is. to our knowledge, the first study to analyze ADC maps of schizophrenic Patients using statistical parametric anatomical mapping (SPAM). Methods : DTl was performed in 20 schizophrenic patients and an equal number of age- and sex-matched healthy controls. ADC maps were then generated, from which 98 volumes of interest were extracted using SPAM. Probability-weighted mean values of ADC were calculated from each volume of interest and compared between the two groups. Results : Significantly higher mean ADC values were observed in patients with schizophrenia compared to healthy controls in the following volumes of interest: bilateral hippocampal formation, bilateral uncus, nght thalamus, light temporal lobe white matter, right superior temporal gyrus, bilateral insula and right lateral ventricle. Conclusion : The results support the recently proposed assertion that regionally increased ADC may reflect cortical brain atrophy. In addition, a new possibility is raised that a neuropathological event involving both the gray and the white matter may also play a role.

주의력결핍 과잉운동장애 환아에서 주의력 과제와 관련된 대뇌의 기능적 국소화

신동원,송동호,전덕인,남궁기,이만홍,이홍식,민성길 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 주의력결핍 과잉운동장애는 주의력에 결함이 있는 장애이다. 주의력에 주로 관여하는 부위는 전두엽과 두정엽으로서 이전 연구에서 주의력결핍 과잉운동장애 환자의 전두엽과 두정엽의 이상에 대하여 보고되어 왔으나, 대부분 안정상태에서 정상인과 비교한 연구들이다. 이에 본 연구는 주의력결핍 과잉운동장애 환자가 주의를 요하는 과제를 실행하는 동안 활성화되는 뇌의 양상을 정량화 뇌파를 이용하여 파악하고, 활성화 양상에 있어 정상인과의 차이점을 확인해 주의력결핍 과잉운동장애 환자의 주의력 결함과 관계된 뇌의 국소적 병태를 밝히고자 하였다. 또한 주의력결핍 과잉운동장애 환자의 주의력 결함과 관계된 뇌의 국소적 병태를 밝히고자 하였다. 또한 주의력결핍 과잉운동장애의 치료제인 methylphenidate를 주의력결핍 과잉운동장애 환자에게 투여하여 주의력 과제 중에 활성화되는 뇌 양상의 변화를 알아보고, 치료제가 주의력을 높이는 기전에 대한 이해를 넓히고자 하였다. 방 법 : 연구 대상자는 환자 20명, 정상인 20명으로 총 40명이었다. 두 군은 성별, 나이, 손잡이, 지능에 있어서 차이가 없도록 선발되었다. 정상인은 안정 상태와 주의력 과제를 실행하는 동안 정량화 뇌파를 측정하였다. 환자군은 methylphenidate를 투여한 상태와 투여하지 않은 상태에서 각각 안정 상태와 주의력 과제를 실행하는 동안 정량화 뇌파를 측정하였다. 결 과 : 본 연구의 결과는 다음과 같다. 1) 집중력 검사상, 정상대조군이 투약 전 환자군에 비해 목표자극에 대한 정반응 시간과 목표 자극에 대한 정반응 시간의 표준편차에 있어 유의하게 낮은 점수를 보여 집중력이 좋음을 알 수 있었다. 환자군은 누락 오류, 목표 자극에 대한 평균 정반응 시간, 표준편차에 있어 투약 전에 비해 투약 후에 유의하게 낮은 점수를 얻어, 투약 후 집중력이 유의하게 호전됨을 확인하였다. 정상 대조군과 투약 후 환자군 사이에 집중력 검사상 차이는 없었다. 2) 안정상태에서 얻은 정량화 뇌파의 모든 파 영역에서 환자군은 정상군에 비해 유의하게 뇌파의 전위가 증가해 있었다. 3) 정량화 뇌파의 delta 파 영역에서 뇌파를 분석한 결과, 정상 대조군의 경우, 주의력 과제 중에는 안정상태에 비하여 두정-후두엽 부위의 전위가 유의하게 증가하였으나, 환자군에서는 주의력 과제 중에 유의하게 전위가 증가하는 부위가 없어, 국소화한 뇌 활성 변화를 관찰할 수 없었다. 4) Theta 파 영역에서, 정상 대조군의 경우, 주의력 과제 중에는 안정상태에 비해 우측 전두엽, 우측 측두엽, 양측 두정-후두엽 부위에서 전위가 유의하게 증가하였다. 그러나 환자군에서 투약하기 전에는 유의하게 증가하는 부위가 없었다. 환자군에서 투약 후에는 우측 전두엽, 우측 측두엽, 양측 두정-후두엽 부위에서 유의하게 전위가 증가해, 정상 대조군과 유사한 뇌활성도의 변화 양상을 보였다. 5) Alpha 파 영역에서, 정상 대조군의 경우, 주의력 과제 중에는 안정상태와 비교해 두정-후두엽 부위만이 유의하게 뇌파가 증가하는 반면, 투약하지 않은 환자군의 경우 광범위한 부위에서 유의하게 뇌파가 증가하여 뇌 활성 변화 부위가 국소화되지 않았다. 6) Beta 파 영역에서, 정상 대조군의 경우 안정상태에 비해 주의력 과제 중에는 좌측 전두엽과 Cz 부위만이 유의하게 전위가 증가하는 반면, 투약 하지 않은 환자군의 경우 거의 모든 뇌부위에서 전위가 유의하게 증가해 뇌의 활성 변화 부위가 국소화되지 않았다. 투약한 후에는 좌측 전두엽과 양측 측두엽의 뇌파가 유의하게 증가해 국소화한 뇌 활성 변화 양상을 보였다. 결 론 : 주의력결핍 과잉운동장애 환자는 안정상태에서 정상인과 비교해 뇌파상 비정상적으로 활성화되어 있다. 정상인의 경우, 공간 자극에 관계된 주의력 과제 실행시 주로 전두엽과 두정-후두엽이 활성화되었으나 주의력결핍 과잉운동장애 환자는 국소적인 뇌활성화에 실패하였다. 주의력결핍 과잉운동장애 환자의 주의력 결함은 전두엽과 두정-후두엽 부위의 병태와 관련이 있을 것으로 사료된다. Objectives : The attentional deficit is a core symptom in attention deficit hyperactivity disorder. The major brain areas related to attention are frontal and parietal lobes. Abnormalities of frontal and parietal lobes in attention deficit hyperactivity disorder have been reported in previous researches. But, most of the researches are based on comparing patients and controls while they are in resting condition. Further research on functional changes related to performance of attentional task is needed to understand the attentional dysfunction in attention deficit hyperactivity disorder. In this study, the localized functional changes of the brains related to attentional task in patients with attention deficit hyperactivity disorder and the differences of them between patients and normal controls were examined. Also the effect of the methylphenidate on functional changes related to attentional task in patients with attention deficit hyperactivity disorder was examined. Method : Quantitative electroencephalography(QEEG) was applied to examine the fuctional changes related to attentional task. Subjects of this study consisted of 20 patients with attention deficit hyperactivity disorder and 20 controls who were matched age, sex, handedness, intelligence. QEEG was recorded on eye open resting condition, and on performing computerized attentional task. In cases of patients, after taking of methylphenidate, QEEG was recorded on both conditions. Results : 1) In attention test, normal controls had better scores in response time and variabilities of response time than those of patients with attention deficit hyperactivity disorder without taking methylphenidate. After taking medication, scores of omission, response time and variabilities of response time were significantly improved, comparing to scores without taking medication. No differences were recognized between the controls and patients with taking medication in scores of attention test. 2) In resting condition, spectral EEG revealed baseline activity levels of patients were significantly increased comparing to those of controls. 3) Analysis of delta wave revealed that amplitudes of controls were significantly elevated in parieto-occipital area during performance of attentional task. But in patients, localized activated area related to attentional task was not remarkable. 4) Theta activity of controls were significantly elevated in right frontal, right temporal, and both parieto-occipital areas during performance of attentional task. But in patients without taking medication, localized activated area related to attentional work was not remarkable. After taking medication, right frontal, right temporal, and both parieto-occipital areas were significantly activated. 5) Alpha activities of controls were significantly increased in parieto-occipital area during performance of attentional task, but those of patient without taking medication were increased in broad area. 6) Beta activities of controls were significantly increased in frontal area during attentional performance, but those of patients without taking medication were significantly increased in most of the brain areas. After taking medication, significantly increased activities related to attentional task were recognized in left frontal, and both temporal areas. Localized activated patterns similar to those of controls were recognized. Conclusion : Based on the results of this research, it is suggested that patients with attention deficit hyperactivity disorder have increased baseline brain activity. In controls, brains showed localized response to a attentional stimuli, and functional changes related to attentional stimuli were recognized in frontal, and parieto-occipital areas. But, patients failed in showing appropriate localized activated response to attentional stimuli. It is concluded that frontal and parieto-occipital areas have some deficit responsible for the attentional dysfunction of attention deficit hyperactivity disorder.

古代의 韓ㆍ中ㆍ日 醫藥交流 : 「일본서기」를 중심으로 indicated in 「Ilbonseogi」

신순식,최환수,양영준,홍원식 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

『Ilbonseogi』(edited A.D.720) was studied to investigate the medical and pharmaceutical exchange among ancient Korea, China and Japan. It seemed that Korean and Chinese traditional medicine was introduced to Japan through Korea. It was also shown in 『Ilbonseogi』 that Koreans who lived in China and Japan during that time seemed to have active medical idea exchange. From various facts indicated in 『Ilbonseogi』, it was believed that Korean and Chinese traditional medicine was the basis for the foundation of Japanese traditional medicine.

무증상으로 발견된 담낭-담관 누공을 동반한 Mirizzi 증후군 1예

홍진희,전태주,서지영,서동대,오태훈,신원창,최원충,신은아,김기환 인제대학교 2009 仁濟醫學 Vol.30 No.-

Mirizzi's syndrome is a rare complication of the gallstone disease, characterized by narrowing of the common bile duct (CBD) due to chronic extrinsic compression of an impacted gallstone in the cystic duct or the neck of the gallbladder. The impacted gallstone may erode into the bile duct, causing cholecystocholedochal fistula. The patients generally have history of repeated attacks of jaundice and abdominal pain. But there is no report about asymptomatic Mirizzi syndrome with cholecystocholedochal fistula which were found incidentally. So herein we present our clinical experience with a case of asymptomatic Mirizzi syndrome with cholecystocholedochal fistula in a young female.

우리나라 船舶管理業의 서비스마케팅 戰略에 관한 연구

辛瀚源,金洪暎,申喜澈 한국해양대학교 국제해양연구소 2001 韓國海洋大學校 人文社會科學論叢 Vol.13 No.1

Abstract This is an empirical study on the Marketing Strategies of the Ship Management Business in Korea based on the previous studies or reference books, and the results are derived as follows. First, far the recognition of SWOT, generally there are different views on the recognition of merit points between 2 types of Ship Management Companies: Style A (Crew Management only) and Style B (Integral Management - Crew and Ship Management). Second, for the recognition of marketing strategy far consumer products is just the same fur ship management style in which it is affected by the price, distribution and marketing promotion. This meant there are differences between the crew management and the intergrated management. It is believed to be of some usage of the marketing strategy. In line with this study, the conception of ship management nationwide is still at the beginning stage. Third, far ship management operation, different results come from various company styles but it has no difference whatsoever between groups of companies.

더블 팬터그래프형 매니퓰레이터의 설계 및 수평위치제어

홍대선,신중호,정원지,김성철 國立 昌原大學校 産業技術硏究所 1998 産技硏論文集 Vol.12 No.-

In this paper, a double pantograph type manipulator activated by two slider joints is proposed for a fuel handling machine in atomic power plants. The manipulator consists of two parallelogrammic structures considered as simplified 2-DOF linkage systems. The linkage motion is controlled in such a manner that the joint rates of two linkages are constant and the movement of end-effector is horizontal, because the constant joint rates have advantages for the stable movement of the system. In addition, the static deflection of the proposed mechanism was analyzed using a transfer-stiffness matrix method.

Pulmonary Aspergilloma : 1 수술 치험례 A Case

신원창,손광현,홍성란 인제대학교 1985 仁濟醫學 Vol.6 No.4

심한 객혈을 동반한 우측 상엽부의 mycetoma 병조를 절제한 후 임상 경과 완쾌되었다. 병리조직학적 검사상 Aspergilloma의 균사 및 아포로 구성된 fungus ball이 증명되었다. Pulmonary aspergilloma with massive hemoptysis is an occasionally fatal condition. A 43 year old house wife has had a severe recurrent hemoptysis for about 3 months. She received various medical treatment including anti-tuberculous measures without improvement. Roentgenographic findings were multicystic and soft patchy appearance at the posterior segment of the right upper lobe by A-P and lateral tomogram and also in computed tomogram. Pre-operatively fungus in the sputum culture was identified at the laboratory. Choice of surgical excision of the involved lobe was decided. Specimen showed beautiful fungus ball in the cavity and bronchiectasis of the communicated bronchi. Pathologic examination showed beautiful aspergillus fumigatus involving the lung parenchyma. Post-operatively hemoptysis was disappeared and 6th months follow up showed good recovery, For the reasons of the complex clinical pictures of the patient, authers report the case with a literature reviews.

국내에서 분리된 Extended-Spectrum β-Lactamase 생성 Escherichia coli와 Klebsiella pneumoniae의 빈도 및 유형

홍성근,김선주,정성훈,장철훈,조성란,안지영,신종희,이혜수,송원근,어영,염종화,용동은,이경원,정윤섭 대한임상미샐물학회 2003 Annals of clinical microbiology Vol.6 No.2

Metallo-β-lactamase 생성 Pseudomonas aeruginosa 및 포도당 비발효그람음성간균의 검출방법에 관한 연구

신경섭,김원식,손재철,홍승복,최재운,형성민 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

연구목적: Metallo-β-lactamse (MBL)는 carbepenem를 포함하는 대부분의 β-lactam 항균제를 가수분해할 수 있으므로 MBL 생성균의 확산은 이들 균에 의한 감염의 치료에 큰 문제를 야기할 수 있다. 따라서 MBL 생성균에 의한 감염의 확산을 막기 위해 이들 균의 조기 검출이 필요하다. 저자들은 MBL 생성균을 검출할 수 있는 세 가지 방법을 PCR 방법과 비교하여 보았다. 재료 및 방법: Imipenem의 MIC가 8 μg/mL 이상인 50개의 포도당 비발효 그람음성 간균을 대상으로 EDTA-double disk synergy test (EDTA-DDS), Etest MBL, Hodge 변법을 시행하였으며 대조 검사로 IMP-1, VIM-1, VIM-2에 대한 PCR을 시행하였다. 결과: 총 50 균주 중 MBL 생성균은 Pseudomonas aeruginosa 1 균주, Alcaligenens xylosxidans 7 균주 등 8 균주(16%)가 검출되었다. 이들 균주는 모두 VIM-2 형이었으며, EDTA-DDS, Etest MBL은 PCR 방법과 100% 일치하였다. Hodge 변법은 8 MBL 생성균주 중 2 균주를 검출하지 못했다. 결론: 50 균주 중 8 균주가 MBL 생성균이었고 모두 VIM-2 형이었다. Etest MBL은 가격이 비싸 검사실에서는 EDTA-DDS가 적당할 것으로 사료된다. Purpose: Because metallo-β-lactamase (MBL) has activity to hydrolysls against most β-lactam drugs, dissemination of MBL producing bacteria may cause problems of treatment of infection by their microorganisms. Early detection or screening for MBLs will contribute to prevent further spread of resistance. Authors compared three MBL detection methods with PCR for MBLs. Materials and Methods: For 50 isolates of g1ucose nonfermentative gram negative bacilli with reduced susceptability against imipenem (MIC≥8 μg/mL), EDTA-double disk synergy (EDTA-DDS), Etest MBL and modified Hodge test were compared with PCR detection method for MBLs. Results: Among 50 isolates of glucose nonfermentative microorganisms, eight MBL producers including a Pseudomonas aeruginosa and 7 Alcaligenes xylosoxidans were detected. Those isolates were VIM-2 producer. The results of EDTA-DDS and Etest MBL completely agreed with PCR for MBL detection. Two isolates among eight MBL Producers were not detected in modified Hodge test. Conclusion: All of MBL producing bacteria were VIM-2 genotype. In conclusion, EDTA-DDS may be useful method for MBL detection in clinical laboratory due to high cost of Etest MBL strip.