일 대학병원에 입원한 노년기 양극성 장애 환자의 인구학적 및 임상적 특징

조숙현(Sook Hyun Cho),정한용(Han Yong Jung),권영준(Young Jun Kwon),이소영(So Young Lee),김양래(Yang Rae Kim),김윤정(Yun Jung Kim) 대한노인정신의학회 2006 노인정신의학 Vol.10 No.2

Objectives : As the elderly population is continuing to increase, psychiatric diseases of the elderly are becoming an important social issue. This study looks into the demographical and clinical features of the elderly patients diagnosed with bipolar disorder in a University hospital. Methods : The study subjects include patients admissioned in the closed wards of Soonchunhyang Seoul hospital and Cheonan hospital from March, 2000 to February, 2005 who met the DSM-IV-TR criteria for bipolar disorder at the time of discharge. A total of 146 patients (76 men, 70 women) medical records were studied retrospectively. Subjects older than the age of 50 at time of admission were grouped as the old age group, whereas those who were younger than 50 as the young age group. Also among the old age group, those who had the first onset of episode under the age of 50 were grouped as the early onset group, whereas those who had the first onset after the age 50 were grouped as the late onset group. Results : The number of bipolar disorder patients in the young age group and old age group were 73 and 73 respectively. The number of early onset group and late onset group were 46 and 23 respectively. The old age group had a relatively higher incidence of bipolar II disorder than the young age group. Also in the old age group there was a higher incidence of hypomanic or depressive episode rather than manic episode compared to the young age group. And in the old age group psychotic symptoms were less common and the mean admission length shorter than the young age group. Additionally in the old age group treatment with Lithium monotherapy or with no mood stabilizers at all were relatively common. Among the old age group, late onset group had a higher rate of bipolar II disorder than the early onset group. Conclusion : This study shows differences in the demographical and clinical features among different age groups. But additional research would be required to determine whether the bipolar disorders in the elderly or late onset group are actually a different type of disorder from those of the young.

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.

부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Hepatocellular Carcinoma in the Elderly: Clinical Characteristics, Outcomes and Treatment Efficacy, Safety in Older than 75 Years

( Ji Ho Seo ),( Sunmin Kim ),( Eunae Cho ),( Chung Hwan Jun ),( Sun Young Park ),( Sung Bum Cho ),( Chang Hwan Park ),( Hyun Soo Kim ),( Sung Kyu Choi ),( Jong Sun Rew ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) has been increasing because the increase in the longevity of the general population. But there is no proper management based on age stratification in elderly patients. We compared clinical characteristics, outcomes and treatment efficacy, safety between oldest-old (aged more than 85 years), middle-old (aged between 80 and 85 years) and young-old (aged between 75 and 80 years) patients with HCC. Methods: We conducted a retrospective cohort study, from January 2010 to December 2016, at Chonnam National University Hospital. A total of 550 elderly patients whose data included demographics, co-morbidity, etiology of liver disease, presence of cirrhosis, staging of HCC, treatment modality and treatment related adverse event were evaluated retrospectively. Also overall survival was assessed in enrolled patient. Results: Fifty one patients (oldest-old; median 87 years old), 153 patients (middle-old; median 82 years old) and 346 patients (young-old; median 77 years old) were diagnosed with HCC. Both oldest- and middle-old patients, compared to young-old patients had significantly lower rate of alcohol-related disease (13.7% vs 20.9% vs 34.1%, P = 0.001). There were no significant difference in underlying sex, body mass index, presence of co-morbidity, hepatitis C-related disease and stage of HCC. The Child-Pugh class (CPT class A 88.9% vs 84.1% vs 83.6%, CPT class B 11.1% vs 15.9% vs 15.0% and CPT class C 0.0% vs 0.0% vs 1.3%, respectively, P = 0.912) and Model for End Stage Liver Disease score (mean MELD score 7.22±3.34 vs 5.88±3.01 vs 5.77±3.14, P = 0.166) were no significant difference between the patients with active treatment. The modified UICC staging (stage I 5.6% vs 17.1% vs 18.6%, stage II 55.6% vs 46.3% vs 47.3%, Stage III 22.2% vs 24.4% vs 24.8%, Stage IV-A 11.1% vs 6.1% vs 4.9% and Stage IV-B 5.6% vs 6.1% vs 4.4%, respectively, P = 0.826) and Barcelona Clinic Liver Cancer staging (stage 0 5.6% vs 9.8% vs 9.3%, stage A 16.7% vs 17.1% vs 22.1%, stage B 27.8% vs 29.3% vs 24.8%, stage C 50.0% vs 43.9% vs 41.2% and stage D 0.0% vs 0.0% vs 2.7%, respectively, P = 0.878) were no significant difference between the patients with active treatment. Furthermore, there were no difference between the age groups in treatment modality (Surgical resection 0.0% vs 3.3% vs 5.2%, P = 0.166; Radiofrequency ablation 2.0% vs 8.5% vs 11.0%, P=0.113; Transcatheter arterial chemoembolization 21.6% vs 34.6% vs 41.6%, P=0.014; Best supportive care 62.7% vs 40.5% vs 29.2%, P < 0.001), adverse event related treatment (P = 0.731) and disease-free survival days (329 .3±309.1 days vs 271.7 ± 414.2 days vs 357.2 ± 511.6 days, P = 0.336). Multivariate analysis showed that age, performance status, CTP class, MELD score, modified UICC staging, presence of portal vein thrombosis and ruptured HCC are risk factors for mortality. Conclusions: Clinician should make an active treatment in elderly patients with HCC not a age but performance status, liver function and disease status of cancer.

중환자에서 APACHE Ⅲ score와 사망율과의 관계

조준필,김준식,이영주 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

To evaluate the relationship between APACHE Ⅲ score and mortality in critically ill adult ICU patient, we studied the 548 patients who were admitted to the ICU from June 1, 1994 to January 31, 1995. We did not include patients with burn injuries, patients aged less than 15 years, or chest pain patients, in order to rule out myocardial infarction and unsatisfactory data files. There were 120 multiple trauma patients, 68 sepsis patients, 62 hemorrhagic shock patients, 20 multiple organ failure patients, and 120 patients with, among other conditions, durg intoxi-cation, diabetic ketoacidosis, renal failure, hepatic encephalopathy, and cerebral hemorrhage or infarction. The APACHE Ⅲ scores of survivors and non-survivors were analyzed with Chi-square test and compared. The number of nonsurvivors was 168 patients, and the overall mortality rate was 30.7%. there was a positive correlation between a high APACHE Ⅲ score and mortality ; all patients with more than 90 points expired. The average points of the survivors was 34.52 ±15.48 and of nonsurvivors was 77.74 ±31.37. The difference between each group is significant statistically. The average APACHE Ⅲ points was 47.8. The APACHE Ⅲ score is a good prognostic tool to predict the mortality rate in ICU adult patients, and can be used for selection of patients and for ICU admission/discharge. It can also be used to compare the efficacy of intensive care in different hospitals.

珪酸마그네슘의 合成條件에 關한 硏究

전우정,신화우,최광식,안세민,이광표,장영수 원광대학교 식품약품안전성연구소 1993 食品藥品安全性硏究 Vol.6 No.-

Magesium twisilicate is mainly uaed as a nonsytemic antacid andabsrbent. Magnesium trisilicate when teeated with anacid sxuh as diluted hydrochloric acid in gastric juice decomposes to form Magnesium chloride and colloidal Silicates. 2MgO·3SiO_2 + 4Hcl - 2MgCl_2 + H_4Si_3O_8 (or 3SiO_2 + 2H_2O) Colloidal mixture The resultng colloidal silicates can protect ahe ulcer frdm further acid and peptic attack and possibly adsorb the pepsin. It is well known that yield of Magnesium trisilcate produced is greatly affected by the Synthesis condition such as the reactant concentration, reaction temperature and moleatio of reactant solutions as well as by the emperature at which the precipitate is dried and the temperature of washing water, etc. The purpose of this study is to investigate the optimum synthesis conditions of Magnesium trisilicate. A randomized complete block design suggested by G.E.P. Bdx and K.B. Wagnesium sulfate solution with Sodium silicate solution in this study. It was found that optimal synthesis conditidns were: Reaction temperature range : 57-90 ℃. Concentration range of reactants (Sodium silicate and Magnesium sulfate) : 19.1-29% molar ratio of the reactants. [Sodium silicate]/[Magnesium sulfate]: 1.47-1.80. temperature range of washing water: 45-48℃ and drying temperature range: 65-82℃ The antacidic activity of five Magnesium trisilicate samples which shows the maximum antacidic efficacy was tested by pharmacopeia acid consuming capacity test. The five Magnesium trisilicate samples were samples were identified by chemical analysis.

진행암 환자에서 Cisplatin 병용화학요법 시 Ondansetron의 오심 구토 조절 효과

조문준,윤환중,전의건,길준영,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Ondansetron is a novel agent that selectively binds to the 5-hydroxytryptamine_3 receptor, and has been reported to have a prominent effect in the prevention of anti-neoplastic agent induced nausea and vomiting. Twenty solid tumor patients who were scheduled to receive cisplatin containing combination chemotherapy participated in a prospectively open-labeled study to evaluate the antiernetic efficacy and safety of ondansetron. The male to female ratio was 11 : 9 and median age was 49(16-70). The sites of primary neoplasms and number of patients were as following : head and neck 4, metastatic carcinoma of unknown primary site 3, stomach 3, osteosarcoma 2, ovary 2, esophagus 1, melanoma 1, penile 1, bladder 1, cervix 1, and extragonadal germ cell 1. Ondansetron was given as an 8mg loading dose IV before chemotherapy followed by 8mg IV every 8 hours until 24 hours after chemotherapy completion. Complete or major control(0 to 2 emetic episodes) of emesis was achieved in 17 of 20 patients(85%;complete 50%, major 35%) receiving ondansetron during the first 24hrs of chemotherapy. During the period of day 2 through clay 5 of chemotherapy, 14 of 20(75%) patients had complete or major control of emesis(complete 35%, major 35%). No severe side reactions were recorded in ondansetron treated patients, while mild to moderate headache was noted in 20% of patients. These results show that ondansetron is effective in the control of cisplatin induced nausea and emesis, and can be administered safely with minimal side effects.

WordNet상에서 유사성 측정을 이용한 개념 기반 이미지 검색

조미영,최준호,김판구 조선대학교 전자정보통신연구소 2003 電子情報通信硏究所論文誌 Vol.6 No.1

Semantic interpretation of image IS incomplete without some mechanism for understanding semantic content that is not directly visible For this reason, human assisted content-annotation through natural language is an attachment of textual description (ie a keyword, or a simple sentence) to image However, keyword-based retrieval is in the level of syntactic pattern matching In other words, dissimilarity computation among terms is usually done by using string matching not concept matching In this paper, we present a solution for qualitative measurement of concept-based retrieval of annotated image We propose a method for computerized conceptual similarity distance calculation in WordNet space. Also we have introduced method that applied similarity measurement on concept-based image retrieval When tested on a image set of Microsofts Design Gallery Live, proposed method outperforms other approach.

방사선치료 조사영역 내에 발생한 설암 환자에서 입체조형방사선치료 경험 : 증례보고

조문준,장지영,김기환,김병국,송창준,김준상,김재성 충남대학교 암연구소 2003 암연구소 업적집 Vol.3 No.-

Objectives : We report an interim result of conformal radiotherapy in a patient with early stage cancer at the base of the tongue, which developed in a previously irradiated area. Materials and Methods : A 64-year-old male patient was diagnosed with T4NOMO supraglottic cancer. He received 72Gy of radiation therapy from 21 November 1988 to 24 February 1989. He had local failure and underwent a salvage total laryngectomy on 28 August 1989. Subsequently, he did well. In early 1999, he suffered from throat pain. He had a 2.5cm ulcerative mass at the base of his tongue, in the area that had been irradiated previously. Biopsy showed squamous cell carcinoma. After workup, he was diagnosed with base of tongue cancer with T2NOMO. Surgery was not feasible because the morbidity was not acceptable. Since it was difficult to re-irradiate the area with a curable dose using conventional 2D radiation therapy with an acceptable morbidity, we decided to try conformal radiotherapy. We used 7 static beam ports with field sizes from 7×6.4 to 8×8㎠, using 6 and 10MV photons. The fractionation regimen was 1.8Gy, 5 times per week. He received 64.8Gy in 36 fractions from 9 April 1999 to 1 June 1999. Results : In the 21 months since radiotherapy, the patient has not experienced any acute or chronic complications, such as xerostomia. He experienced relief of pain shortly after the start of radiotherapy, showed a complete response, and is still doing well. Conclusion : Conformal radiotherapy can be used to treat cancer that develops within a previously irradiated field, with curative intent.