정신과 문제로 병사용 진단서를 발급받은 환자들의 임상적 특징

장혁진,김학렬,박상학,김상훈,조용래,표경식 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : Most Korean young men should take a military physical examination. This study attempted to search the social, economical and psychological features of Korean youths who have psychiatric problems in taking the military physical examination. So this study was intended to help decide whether the youths enter the military service or not. Materials and Methods : This study analyzed diagnostic features that were grouped by 7 categories (antisocial and borderline personality disorder group, the other personality disorders group, psychosis group, organic mental disorder group, neurosis group, pervasive developmental disorders group, the other groups). The study was conducted from 1994 to May 1999 at Chosun University hospital with about 143 patients who were issued the psychiatric certificate for military affairs. Results : According to the results of the psychiatric examination, the antisocial and borderline personality disorder group had increased more year by year than the other groups. Classified by the residential distribution, the residents of agricultural areas belonged to the psychosis group more than others. Classified by the job distribution, the antisocial and borderline personality disorder group had more gangsters than the other groups. Also the pervasive developmental disorders group included those Who were without an occupation. Classified by visiting companion, those who were included in the antisocial and borderline personality disorder group and pervasive developmental disorders group used to come alone as compared with the other groups. In the case of those who have experienced psychiatric treatment in the past and who have been treated psychiatrically after being given the psychiatric certificate, the psychosis group comprised more than 50% statistically. In the case of the existence of a tattoo and self-injured scars, the antisocial and borderline personality disorder group has more than the others statistically. According to psychological examination, by measure of validity scale of MMPI, the antisocial and borderline personality disorder group appeared as the inverted V shape that L, K value was low and F value was high. And the antisocial and borderline personality disorder group measured by the Pd, Pa measure. Pd, Pa measure value got higher points than the organic mental disorder group statistically. Conclusion : The number of the antisocial and borderline personality disorder patients’ visits increased at the psychiatric hospital year by year and there were many gangsters or persons without regular occupation in that kind of patients’group. And there were many visitors who came by themselves to the hospital. Also they tended to have a tattoo or self-injured scars. And most of patients didn’t do commuting psychiatric care after receiving the psychiatric certificate. In the aspect of the psychological examination, they were likely to exaggerate their symptoms or disguise having psychiatric trouble intentionally.

천식에서 관련 유전자들 사이의 상호작용과 천식에대한 영향

이준혁,박성우,장안수,박춘식 순천향대학교 의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

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중간뇌 중심회색질에서 Calbindin-D_(28K)의 신경해부학적 표지성

김상훈,장혁진,이진 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Purpose: We investigated whether the calbindin-D_(28K) (CB) immunoreactivity could be available as a neurochemical marker to identify different anatomical subdivisions in the midbrain periaqueductal gray (PAG) of laboratory animals. Materials and Methods: Immunohistochemistry for CB and histochemistry for cytochrome oxidase (CO) were carried out on coronally-sectioned midbrain slices of five species of animals including mice, hamsters, rats, rabbits and guinea pigs. Results: In the rat PAG, at the level of nucleus of trochlear nerve, CB immunoreactive perikarya and plexus of fibers were localized in three band-like areas including dorsolateral PAG (DL), the ventral part of lateral PAG (Lv) and the supraoculomotor cap nucleus (Su3C). The similar pattern in the distribution of CB immunoreactivity was noticed also in the rabbit and the guinea pig PAG at the corresponding level, with three areas of DL, Lv and the ventral part of ventrolateral PAG. In all the 5 species of animals, Su3C was readily marked with clusters of CB-immunoreactive perikarya and fibers. In the comparison between the CB-immunoreactivity and the CO activity in the PAG, CB-immunoreactive areas were coincidided with areas of the low CO activity. Conclusion: The present data suggest that the CB immunoreactivity can be regarded as a reliable neurochemical marker for the specific areas within the midbrain PAG.

상악 구치부 회전양상의 평가

이성근,정득룡,장연주,전윤식,정상혁 대한치과교정학회 발행 2005 대한치과교정학회지 Vol.35 No.6

측모두부방사선사진의 중첩만으로는 교합평면상의 치아이동을 알 수 없으며, occlusogram 역시 촬영 및 중첩의 오류를 피할 수 없다. 본 연구는 석고모형의 3차원 영상을 촬영한 후 3차원 영상 소프트웨어를 이용하여 중첩된 영상을 통해 상악 소구치 발치공간 폐쇄 후 상악 구치부 회전양상을 알아보고자 하였다. 성인여성 19명을 연구대상으로 하여 치료 전 석고모형 및 치료 완료후 석고모형의 3차원 영상을 촬영한 후, 상악 경구개면을 기준으로 두 영상을 중첩한 다음, 치료 전후의 상악 구치부의 회전양상을 비교 분석하였다. 연구결과, 구치부의 회전 양상은 매우 다양하였다. 그 주요 원인은 치료 전 상악 구치의 다양한 회전 상태와 치열궁 및 치아의 형태학적인 특성 때문인 것으로 추측되었다. 따라서 발치공간 폐쇄 시 일어나는 구치의 회전 양상을 3차원 영상을 이용하여 정확히 평가하기 위해서는 치료 전후에 일어나는 구치의 회전을 초기 배열 전후의 구치 회전, 발치공간 폐쇄 전후의 구치 회전, 그리고 마무리 단계 전후의 구치 회전으로 세분하여 평가해야 함을 알 수 있었다. Cephalometric superimposition is unable to evaluate tooth movement along the occlusal plane and the errors of photographing and superimposition of the occlusogram is also inevitable. The purpose of the present study was to evaluate the rotational movements of the maxillary posterior teeth following space closure after extraction of maxillary first premolars, using 3D dental images. In 19 adult females, analysis of rotational movements of the maxillary posterior teeth was performed between the initial and final 3D dental images superimposed on the maxillary hard palate. The results showed a diversity of rotational movements of posterior teeth. The causes of various rotational movements may be different rotation of molars in each case at the beginning of treatment. individual characters of the dental arch and tooth morphology. The results of the study indicate that accurate evaluation of retational movements of posterior teeth following space closure after extraction of premolars using 3D dental images can be obtained through the subdivision of tooth movement during the initial aligning, space closure and finishing stages.

Roxithromycin 으로 치료 후 호전을 보인 미만성 범세기관지염 1예

어성준,박성우,이준혁,장안수,박춘식 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Diffuse panbronchiolitis is a clinical pathologic condition characterized by chronic inflammation of respiratory bronchioles, with clinical features that position it as a differential diagnosis among the sinopulmonary syndromes. We experienced 46-year-old male patient who complained of dyspnea and productive sputum for 2 years. Diagnosis was made by the clinical and radiological features and confirmed by transbronchial biopsy. The clinical findings included chronic sinusits, productive cough,dyspnea, rhonchi, and wheezes. High resolution computerized tomography showed a diffuse nodular pattern, airway ectasia, and airway wall thickening. The biopsy showed interstitial accumulation of foam cells and lymphoid cells in the walls of respiratory bronchioles. We treated low does of roxithromycin, After 8 months, the patient nearly improved symptoms and HRCT findings.

만성 C형 간염 환자에서 페그인터페론 알파2a와 리바비린 병합 치료중 발생한 벨마비 1예

김일환,장제혁,유충헌,최규남,고정해,김윤정,서광원,김지현,박성재,박은택,이연재,이상혁,설상영 인제대학교 2008 仁濟醫學 Vol.29 No.-

페그인터페론과 리바비린 병합요법은 만성 C형 간염의 일차 치료법이다. 저자들은 만성 C형 간염 환자에서 페그인터페론 과 리바비린 병합 요법 중에 발생한 벨마비 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 5년 전부터 만성 C형 간염을 앓아온 48세 남자이며, PEG-IFN α-2a 135μgm 피하주사 주1회와 하루 1200㎎의 리바비린을 투여하였다. 치료시작 후 9개월째 환자는 오른쪽 안면의 근력약화를 호소하였으며 벨마비로 진단되었다. 페그인터페론과 리바비린 병합요법을 지속하면서 관찰하였다. 환자의 벨마비는 페그인터페론 치료를 중단하지 않았음에도 3개월후 증상이 회복되고 이후 벨마비 재발 없이 현재 경과관찰 중이다. 만성 C형 간염에서 페그인터페론과 리바비린 병합 요법시 벨마비의 발생 가능성을 염두에 두어야 하겠다. A Case of Bell's Palsy Associated with Combination Therapy of Pegylated Interferon Alfa-2a (PEG-IFN) and Ribavirin for Chronic Hepatitis C Virus Infection Pegylated interferon alfa(PEG-IFN α) and ribavirin therapy is the first line treatment for chronic hepatitis C. Mild complications of the therapy are common, but more serious complications are rare. We report here a case of Bell's palsy that occurred in a patient with chronic hepatitis C virus infection during combination therapy of PEG-IFN α-2a and ribavirin. The patient was 49-year-old man with chronic hepatitis C (genotype 1b) for 8 years. He had compensated liver cirrhosis with splenomegaly. Therapy with PEG-IFN α- 2a 135mcg/week and ribavirin 1200mg/day was initiated. After 9 months of the therapy, the patient showed a loss of muscular tone on the right side of his face. A diagnosis of Bell's palsy was made. The Bell's palsy resolved over 3 months despite continuation of the combination therapy.

추적관찰 중 종괴의 크기가 커진 경화성 혈관종 1례

안형수,장안수,이준혁,박성우,고은석,백상현,박재성,허균,신화균,박춘식 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

We report a case of a sclerosing hemangioma of the lung with increased size during follow up, a rare benign neoplasm of the lung. A 32-year-old woman had round increased opacity in right upper lobe on posteroanterior chest radiograph. That lesion has grown slowly over four years. Computed tomographic scan showed a well circumscribed lung mass in medial aspect of right upper lobe. Radiological differential diagnosis for the lesion included inflammatory pseudotumor, atypical carcinoid, lung cancer and localized fibrous tumor of pleura. Nonspecific findings were shown by the bronchoscopy and percutaneous transthoracic needle aspiration. Anterior and apical segmentectomy was carried out and the lesion was pathologically diagnosed as sclerosing hemangioma of lung.

코일로 치료한 다발성 폐동정맥 기형 1예

김영훈,장재현,권세훈,장재혁,윤성호,이승일 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

A 29 year old female patient came with grade NYHA Fc IV dyspnea of 1 month. No abnormality was heard during auscultation. Arterial blood gas analysis done due to shortness of breath showed a decreased PO_(2) of 64.6 mmHg. Computerized tomography(CT) was checked due to multiple nodules seen in both lower lung fields of the chest X-ray. CT revealed multiple pulmonary arteriovenous malformations in both the mid and lower lung fields. Dyspnea was uncorrected by the application of oxygen. Coil embolization showed improvement of PO2 and dyspnea. The CT follow up at 9 months after the procedure showed no progression of the arteriovenous malformation without any additional symptoms nor dyspnea.

일 대학병원에 입원한 주요우울장애의 증상 특성

이진,김상훈,김학렬,박상학,황걸,장혁진 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Objectives: The purpose of this study was to investigate the frequency and kinds of symptoms and the profile of depressive symptoms and somatic symptoms of admitted patients with major depressive disorder in a university hospital. Methods: The study was cross-sectional study in Chosun university hospital. A total of 299 patients who met the diagnostic criteria of major depressive disorder according to DSM-IV were participated in this study. Forty four item questionnaires were developed to check symptoms and the questionnaires checked from patient's medical record. Results: Common depressive symptoms were the following order: depressive mood (55.2%), initial insomnia (52.8%), anxious/tense (47.8%), tired/no energy (35.1%), suicidal ideation (28.8%). Common somatic symptoms were the following order: decreased appetite (33.1%), headache (22.1%). gastric discomfort (16.7%), palpitation (15.4%), chest discomfort (11.4%). Comparing depressive symptoms and somatic symptoms in terms of gender, anxious/tense, emotional/cry a lot, decreased appetite, gastric discomfort, palpitation, were more frequent in female patients (p<0.05), On the other hand, interpersonal sensitivity, pessimism were more frequent in male patients (p<0.05). Elderly depressed patients showed hypochondriasis symptom more frequently than younger patients (p<0.05). Conclusion: These results suggested that the depressive symptoms showed dissimilar in character according to the gender and age. Therefore proper diagnostic and therapeutic approaches will be needed for each patient's symptom characteristics.

CT 유도하의 경피적 폐생검 : 임상적 의의 및 합병증에 관한 연구 A Study of Clinical Significance and Complication

박재성,백상현,차장규,홍현숙,김대호,박성진,조준희,임한혁,이혜경 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.2

Purpose : To determine the diagnostic accuracy and predicting factor of pneumothorax on CT-guided percutaneous transthoracic needle biopsy. Materials and Methods : Using automated biopsy devices, 107 CT-guided percutaneous needle biopsies of pulmonary lesions were performed. Final diagnosis was made with operation or other methods. We retrospectively analyzed the frequency of complications and diagnostic yields of 107 biopsies. The clinical features, treatment, and courses of complications were reviewed, and risk factors of pneumothorax such as depth and size of lesion, CT emphysema score of whole lung and pathway of needle, and the result of pulmonary function test were analyzed. Result : 96 biopsies(89.7%) yielded sufficient tissue for pathologic evaluation. For cases of malignant and benign disease, sensitivity was 91.5% and 87.5% respectively; the corresponding figures for diagnostic accuracy were 88.1% and 77.1%. So, sensitivity and diagnostic accuracy of percutaneous transthoracic needle biopsy was 89.7% and 83.2%. Eighteen(16.8%) of 107 patients developed pneumothorax and 3 of these required application of chest tube or percutaneous catheter drainage. In the group with pneumonthorax, the lesion was significantly smaller(p=0.029) and higher CT emphysema score of pathway of needle(p=0.032). But there were no significant difference between two groups(with or without pneumothorax) for depth of lesion, pulmonary function test(% predictive value of FEV1 and FEV1/FVC) and CT emphysema score of whole lung. Conclusion : CT-guided transthoracic needle biopsy of the pulmonary lesions is safe and easy method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions. For the prediction of pneumothorax, size of lesion and CT emphysema score of pathway of a needle are significant risk factors.