수면량과 집중력의 상관관계

김병우,류지근,박우진,박계원,김미정,임지은,백대현,최재덕,최윤호,이가현,이관,김덕수 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

수면, 기억 그리고 학습의 연관성은 실제 매우 복잡하다. 많은 연구에도 불구하고 명확한 연구결과는 아직 없다. 우리는 이 연구에서 평소와는 달리 시험 전날 수면 변화 양상이 집중력에 어느 정도 영향력을 미치는지 알아보고자 하였고, 이를 이용해 효율적인 수면 관리를 할 수 있는 기초자료로 삼고자 하였다. 동국대 의대 본과 1학년생 중 지원자 30명과 본과 2학년생 10명을 대상으로 평상시 상태와 시험 직후 수면이 부족한 상태에서 각각 K-PES TEST를 실시하여 총 8항목에 걸쳐 암기력, 판단력, 단순반응의 변화정도를 검사하였다. 또 설문조사를 병행하여 결과에 영향을 미칠 수 있는 다른 인자들도 파악하였다. 수면량에 대한 부호 숫자 짝짓기(순간 판단력)을 검사한 결과, 인간의 최대 생리학적 기능은 꼭 수면부족에 의해 좌우되는 것은 아니다. 그러나, 수면감소는 피로를 증가시키고, 동기부여를 감소시키나 단, 새로운 사실을 학습하는 데에는 큰 영향을 끼치지 않는다. 즉, 수면부족으로 장시간 깨어있는 것은 정확성과 반응성을 떨어뜨린다. 흡연에 대한 부호 숫자 짝짓기(순간 판단력)을 검사한 결과, 니코틴의 수면에 대한 상호관계는 알려지지 않았고, 인간의 감정이나 의식, 인식에 영향을 주는 것으로 알고있지만, 장기적은 측면에서 흡연이나 알코올은 인식능력과 무관한 것 같다. 카페인에 대한 숫자 외우기(암기력)검사 결과, 카페인은 spacial selective attention에는 특별한 영향을 주지 않지만 지각과정이나 주의 집중에 큰 효과를 주며, 인간의 의식 수행에 긍정적인 효과를 준다. 즉 카페인은 활력, 혼란, 피로상태를 변화시키고 visual analog scales에서 휴식상태에 가까운 양상을 나타낸다. 또 48시간 동안 수면을 취하지 않은 사람에게 카페인은 집중력과 장시간의 좋은 기분을 유지하게 하였다. 그러나 규칙적, 비규칙적으로 먹는 사람간에는 인지수행력의 차이를 보이지 않으며 상용자에서는 상당한 내성이 보인다. 수면패턴에 대한 숫자 더하기(순간 판단력)검사 결과, 집중력은 수면패턴에 의해서도 영향을 받고, 수면패턴이 바뀌게 되면 순간판단력을 저하시킨다. This study was performed to evaluate relationship of sleep and attention, and to control sleep effectively. We conducted a K-PES test of 40 medical students. K-PES contains eight elements, for example, simple response, selective response, color pairing, OddEven discrimination, number addition, number-symbol matching, memory, right-tapping, left tapping. Through these, we tested changes of memory, judgement, simple response. And we conducted a questionnaire survey to exclude bias. Results are as follows. As a results of number-symbol matching test, we know that sleeplessness is not complete responsible for physiologic function for humans. But, decreased sleep increases fatigue and decreases motivation, but no influence on learning new materials. So, long term sleeplessness decreases precision and responsibility. As a results of number-symbol matching test on smoking, a relationship of nicotine and sleep is not certain. A point of view in long term period, smoking and drinking is not related cognition, even if we know that those influence mood, consciousness and cognition. As a results of memory work test on caffeine, caffeine does not influence spacial selective attention, but mainly does perception, attention and consiousness process. Namely caffeine changes energetic activities, chaos, fatigue states and shows resting state in visual analog scales In sleeplessness for 48 hours, caffeine produced attention and good mood for a long time. But, in case of cognitive process no significance shows in regular or irregular diet. Regular diet shows high resistance. As a results of number addition test on sleep patterns, seep patterns influence attention, changes of sleep patterns decrease a moment judgement.

필리핀 여행 후 발생한 쯔쯔가무시병 1예

김계형,김낙현,김문석,김충종,전재현,박완범,장원종,박상원,김익상,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Infectious diseases imported from other countries have increased as more and more Koreans are going abroad for various purposes. Tsutsugamushi disease from other endemic area such as Southeast Asia is important, because it can occur in any season and eschar may be absent. We report a case of imported tsutsugamushi disease acquired in the Philippines. A patient presented with fever, headache, and maculopapular skin rash. However, eschar was absent. Polymerase chain reaction (PCR) for 56-kDa gene of Orientia tsutsugamushi using buffy coat was positive. Serum indirect immunofluorescent antibody assay was initially negative but became positive with a titer of 1:320 at follow-up, Sequencing analysis revealed the strain to be 100% identical to the TW73R strain identified in Taiwan. After the patient received doxycycline, body temperature normalized in 12 hours. Tsutsugamushi disease is one of the differential diagnoses that should be included for patients with fever who have recently returned from Southeast Asian countries. PCR for O. tsutsugamushi using patient's buffy coat was useful for early diagnosis.

Mycobacterium mageritense에 의한 당뇨병성 족부 감염증 1예

김충종,김낙현,김문석,김계형,전재현,박문석,박경운,박완범,박상원,김홍빈,김남중,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Diabetic foot infection is one of the important complications in patients with advanced diabetes mellitus. Limb threatening infections such as osteomyelitis, abscess, and necrotizing fasciitis are frequently accompanied by the disease. Non-tuberculous mycobacterium (NTM) is a rare causative organism of diabetic foot infection. Thus, if one is not suspicious or meticulous, infection due to NTM will be easily overlooked and this will result in delayed diagnose and treat. Therefore, it is necessary to consider NTM as the causative organism if the wound does not respond to the conventional antibiotic treatment and the culture from the adequately obtained specimen reveals atypical acid-fast bacilli. We present a case of diabetic foot infection with osteomyelitis and abscess due to Mycobacterium mageritense, one of the rapid growing mycobacteria, that was successfully treated with surgical debridement and appropriate antibiotic treatment.

일렬 자가조혈모세포이식을 받은 다발성 골수종 환자에서 발생한 뇌 톡소포자충증 1례

김계형,송경호,전재현,박완범,박상원,김홍빈,김남중,김인호,오명돈 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Toxoplasmosis is a rare but fatal complication in hematopoietic stem cell transplant recipients, usually associated with allogeneic hematopoietic stem cell transplantation (HSCT). We report a case of cerebral toxoplasmosis in a patient with multiple myeloma, following tandem autologous stem cell transplantation. A 55-year-old Korean male presented with weakness in both legs that had progressed to both arms. A magnetic resonance imaging scan of the brain revealed multiple, variablesized ring-enhancing lesions with surrounding edema in the cerebral hemispheres and brain stem. Stereotactic biopsy revealed bradyzoites of Toxoplasma gondii in the brain tissue. The patient received trimethoprim-sulfamethoxazole, followed by pyrimethamine and sulfadiazine, accompanying treatment for progressive multiple myeloma. Cerebral toxoplasmosis should be considered as one of the differential diagnoses in patients with neurologic signs following autologous HSCT.

다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

난소의 이행상피암종 : 1예 보고 A case report

김희경,권계원,고은석 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Transitional cell carcinoma of the ovary is a recently recognized subtype of ovarian surface epithelial-stromal carcinoma, and studies of its morphology are few. We report a case of primary transitional cell carcinoma of the ovary in a 30-year-old woman. Histologically, the tumor was composed of a papillary pattern or solid nested pattern similar to TCC of the bladder and thick bands of atypical cells. The tumor cells appeared relative monomorphic and evenly spaced at low magnification. Their nuclei were oblong or round, and has large, eosinophilic nucleoli, and the cytoplasm was pale and granular and usually moderately abundant. The degree of cellular atypia was moderate to marked. The tumor had neither benign nor borderline Brenner elements. Immunohistochemically, the tumor cells were immunoreactive for cytokeratin 7, EMA, CA-125 but not reactive for cytokeratin 20.

고립성 폐결절의 조직학적 진단에 있어서 경기관지폐생검의 진단적 가치

김치훈,김정주,왕준호,연규민,김형수,리원연,용석중,신계철 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

Transbronchial lung biopsy(TBLB) is a relatively simple and convenient diagnostic tool in solitary pulmonary nodule(SPN) on chest radiograph, which is cannot be diagnosed through routine tests. To investigate the diagnostic value and diagnostic rate of TBLB according to the variable factor, we analyzed 69 patients with radiologically SPN lesion on chest radiograph which was confirmed histologically. A histologic diagnosis of TBLB was made in 47 of 69 patients(68.1%), in which 26 of 37(70.3%) with malignancy and 21 of 32(65.6%) with benign lesion. There were no significant differences in diagnostic yield according to age, sex and location of the lesion. The diagnostic rate tended to increase with the more than 5 pieces to acquired by TBLB. When the size of SPN was less than 3 ㎝, it cannot be diagnosed. In conclusion, TBLB is a diagnostic procedure with good yield and safety, but percutaneous needle aspiration, transbronchial needle aspiration, and bronchial washing fluid cytology may be a complementary procedure to overcome the limitation of TBLB and get higher diagnostic yield for SPN.

인공 산성비 용액 함침 및 경사평면법에 의한 옥외용 실리콘 고무의 열화 특성 평가

김정호,정규원,유영식,양계준,박용관 成均館大學校 科學技術硏究所 1999 論文集 Vol.50 No.1

We investigated the effect of acid rain on the surface aging, and resistance to tracking and erosion of silicone rubber materials : First, we measured the contact angle, SEM, EDX, and weight reduction to investigate the surface aging caused by immersion in the artificial acid rain solution. From the results of a series of experiments, we concluded that the acid rain attacked the base polymer of the surface, and lead to the depolymerization. Second, we adopted Inclined-Plane Method to measure the resistance to tracking and erosion of silicone rubber, and rather not observably affected the immersed specimen in the tracking resistance than in the erosion resistance.

폐에서 발생한 광범위 상피모양육아종을 동반한 MALT형의 변연부 B 세포 림프종 : 1예 보고 A case report

김희경,권계원,고은석 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Epithelioid granulomas have been reported in association with a wide range of neoplasm including malignant lymphoma. In lymphoma, this refers mainly to Hodgkin's lymphoma and T-cell derived non-Hodgkin's lymphomas where a granulomatous reaction is probably evoked by aberrant cytokine production in the tumor cells or other cells composing the tumor background. Here we report a case of primary pulmonary extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue(MALT) with concomitant extensive epithelioid granulomas. Histologically, the tumor cells were admixed with numerous epithelioid cells that formed clusters and granulomatous lesions. No microorganisms could be detected at the tissue level, and there were no clinical of laboratory indications of an underlying immunodeficiency. The tumor cells were composed of centrocyte-like cells, plasmacytoid lymphocytes, and plasma cells that formed lymphoepithelial lesions and exhibited a lymphangitic growth pattern.

한국판 Edinburgh Postnatal Depression Scale의 임상적 적용

김용구,허지원,김계현,오강섭,신영철 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.1

Objectives : The EPDS (Edinburgh Postnatal Depression Scale) is a lO-items self-report scale designed as a specific instmment to detect postnatal depression by Cox et al. (1987). This study was to determine the optimal cut-offpoint ofthe K-EPDS for postpartum depression in Korea. Methods : The 239 pregnant women assessed their own psychiatric features with the Korean version of the Edinburgh Postnatal Depression Scale (K.-EPDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Rosenberg Self-Esteem Scale (RSES) and Marital Satisfaction Scale (MSS) at 6 months ofpregnancy, 1 week after delivery, and 6 weeks after delivery. Subjects above 9 points of K-EPDS at 6 week after delivery were interviewed with Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to confirm postpartum depression. Results : The prevalence of postpartum depression was 12.6% (30/239 pregnant women) in our study. The total scores of K-EPDS at 6 weeks after delivery were higher significantly than those of nonnal group. The score gap of K-EPDS between the depressed pregnant group and the normal pregnant group was increased after the delivery. However, there were no differences in the epidemiological characteristics and the BDI scores at 6 weeks after delivery between groups. Using the AUC (area under the curve), the optimal point to assess the postpartum depression was revealed as 6 weeks after delivery (AUC=85.8%) or 24 weeks of pregnancy (83.7%). The cut-offpoint of K-EPDS to detect postpartum depression among pregnant women was 9/10score of K-EPDS (AUC= 81.8%). Conclusion : In the K-EPDS, cut-off score of 9/10 was optimal to assess the postpartum depression, and K-EPDS at 6 weeks of delivery was more useful than any other point of time. K-EPDS administrated during pregnancy may be a useful tool to find the vulnerability on the postpartum depression.