좌측 정중 전두엽과 양측 기저절 경색 후 과잉성욕 증상과 강박 증상을 보인 환자 1례

김세주,김영신,최낙경,이병철,이만홍,Kim, Se Joo,Kim, Young Shin,Choi, Nak Kyung,Lee, Byung-Chul,Lee, Man Hong 대한생물정신의학회 2001 생물정신의학 Vol.8 No.2

60세 남자 환자로 좌측 정중 전두엽과 양측 기저절 경색 후 발생한 과잉성욕 증상과 강박 증상을 주소로 내원하였다. 환자는 뇌졸중 후에 발생한 운동 기능 장애는 시간이 경과하면서 호전되어 발병 1개월 이내에 거의 정상화된 반면 과잉성욕 증상과 강박 증상은 호전되지 않았다. 환자에게 과잉성욕 증상과 강박 증상을 목표로 fluvoxamine과 perphenazine을 처방하였으며 치료 시작 후 2개월이 경과하면서 환자의 과잉성욕 증상과 강박 증상은 서서히 사라졌다. 이 증례는 기저절-시상전두엽 회로가 성적 행동과 강박 증상의 조절에 있어 중요한 역할을 하고 있음을 시사한다고 할 수 있다. 과잉성욕 증상은 임상에서 간과하기 쉽고 또한 일반적으로 성적 활동에 대한 변화는 환자들 스스로 보고하지 않는 경향이 많다. 따라서 뇌졸중 환자, 특히 정중 전두엽이나 기저절 병변을 동반한 환자들의 경우에는 비록 그 병변이 측두엽 침범이 없거나 Kluver-Bucy syndrome의 전형적인 증상을 보이지 않는다 할 지라도 성욕등 성적 활동에 대한 체계적인 조사가 필요할 것으로 생각된다. 또한 과잉성욕 증상과 강박 증상을 함께 가지고 있는 경우 선택적인 세로토닌 재흡수 억제제의 사용이 두 증상 모두를 효과적으로 치료하는 데에 도움이 될 수 있을 것이다. Hyposexuality after stroke has been frequently observed, but hypersexuality as a sequela of stroke has not been commonly documented. We report a patient who exhibited hypersexuality and obsessive-compulsive behaviors after stroke in the region of the left mesial frontal cortex and both basal ganglia. At 2 months after stroke, he visited psychiatric unit due to these symptoms. His motor function was almost full recovered. He was treated with fluvoxamine and perphenazine. With two-month medication, his hypersexuality and obsessive-compulsive behavior disappeared. This case may indicate that basal ganglia-thalamocortical circuit plays an important role in the mediation of sexual behavior and obsessive-compulsive behavior. Since changes in sexual activity may not be spontaneously reported, a systemic inquiry into patient's sexual functioning after infarction in frontal lobe or basal ganglia is warranted.

반사형 광센서를 사용한 저가형 SRM 구동시스템

김세주(Se-joo Kim),윤용호(Yong-ho Yoon),정균하(Gyun-ha Jung),원충연(Chung-yuen Won),김영렬(Young-real Kim) 한국조명·전기설비학회 2004 한국조명·전기설비학회 학술대회논문집 Vol.2004 No.5월

Since rotor position information is necessary to drive the SRM, absolute-encoder, resolver and incremental-encoder is used to detect a rotor position. But, it is not desirable to use a high priced encoder and high efficient microprocessor under the condition of the simple driving system when precision control is not demanded. In this paper, Only using the reflective type 2 photosensors replace the conventional opt interrupter and slotted disk, which not only remove a slotted disk section but drive 3-phase 6/4 SRM bidirectionally. Moreover, as control circuit only is composed of common analog device, economy is maximized.

급성기 양극성우울증 약물치료 전략

김세주(Se Joo Kim) 대한신경정신의학회 2018 신경정신의학 Vol.57 No.4

Of the different phases of bipolar disorder, bipolar depression is more prevailing and is more difficult to treat. However, there is a deficit in systemic research on the pharmacological treatment of acute bipolar depression. Therefore, consensuses on the pharmacological treatment strategies of acute bipolar depression has yet to be made. Currently, there are only three drugs approved by the Food and Drug Administration for acute bipolar depression : quetiapine, olanzapine-fluoxetine complex, and lurasidone. In clinical practice, other drugs such as mood stabilizers (lamotrigine, lithium, valproate) and/or the other atypical antipsychotics (aripiprazole, risperidone, ziprasidone) are frequently prescribed. There remains controversy on the use of antidepressants in bipolar depression. Here, we summarized the evidence of current pharmacological treatment options and reviewed treatment guidelines of acute bipolar depression from recently published studies.

기능성 압박의류 착용이 셀룰라이트 환자의 신체둘레, 피하지방두께 및 체구성에 미치는 효과

김세화 ( Se Hwa Kim ),윤준식 ( Joon Shik Yoon ),김세주 ( Sei Joo Kim ),양승남 ( Seung Nam Yang ),원선재 ( Sun Jae Won ),최윤선 ( Youn Seon Choi ),이승환 ( Sung Hwan Lee ),김재등 ( Jae Deung Kim ),김우경 ( Woo Kyung Kim ) 한국미용학회 2012 한국미용학회지 Vol.18 No.1

The purpose of this study was to estimate the clinical efficacy of compression garments in cellulite patient. For achieving this purpose, we recuited patient with cellulite in the abdomen or thigh, grade 2 or more. 40 patients were divided into 2 groups - experimental group wearing compression garments and control group wearing non-compression garments of same shape. Each subject has worn experimental garments during 5 weeks, more than 4 hours a day. Evaluation included waist and thigh circumference, sonographic subcutaneous fat thickness measurement at the buttok and hip, body composition analysis and Quality of Life Scale at pre and post of 5 weeks` treatment. There were significant decrease on waist and thigh circumference, subcutaneous fat thickness at the buttock, body weight, BMI, body fat mass in experimental group, but there was no change on any variable in control group between initial and follow-up. These results suggested that wearing compression garments should be recommended as an effective method to reduce factors concerning obesity in cellulite patients.

뇌졸중 후 삶의 질에 영향을 미치는 요인

김현철(Hyon Chul Kim),김도훈(Do Hoon Kim),김세주(Se Joo Kim),문유선(Yoo Sun Moon),김홍철(Heung Cheoul Kim) 대한노인정신의학회 2003 노인정신의학 Vol.7 No.1

Objectives:The cerebrovascular diseases including stroke have become prevalent in Korea, ranking first as the cause of death in the aged. The quality of life (QOL) in stroke patients has been studied with growing interest since every aspect of life after stroke is influenced by the sequelae of this illness. This study aimed at 1) describing QOL of stroke patients and 2) identifying predictors of two month QOL after the event in stroke survivors. Method:WHO QOL scale was used to evaluate two month QOL after the stroke in 69 ischemic stroke patients. Data on age at the stroke event, sex, education level, brain MRI (magnetic resonance imaging) findings, symptoms of depression and anxiety, and neurologic disabilities were collected. Analyses were performed to explore the predictors of two month QOL. Results:Stroke survivors with higher number and volume of frontal cortex lesions had lower two month QOL. Also, patients with more severe subcortical gray matter lesions had significantly lower two month QOL. Stroke patients with depression at the event had lower two month QOL than patients without depression. Conclusion:Lesions in frontal cortex and subcortical gray matter hyperintensities on MRI T2 images and depression in acute phase were of paramount importance in predicting two month QOL. Accurate and prompt neurologic and psychiatric interventions are required to improve QOL after stroke.

종 식별 분자 마커 개발을 위한 섬모충류 Euplotes의 small subunit ribosomal RNA 변이성 분석

김선영,김세주,민기식,양은진,유만호,최중기,Kim, Sun-Young,Kim, Se-Joo,Min, Gi-Sik,Yang, Eun-Jin,Yoo, Man-Ho,Choi, Joong-Ki 한국해양학회 2007 바다 Vol.12 No.3

Small subunit ribosomal RNA (18S rRNA)의 loop 부위들의 변이를 분석하여 해양 섬모충류의 종 특이 유전적 마커로써 이용 가능성을 확인하고자 9종의 Euplotes (Hypotrichia : Ciliophora)에 대하여 18S rRNA 유전자의 염기서열 변이성을 조사하였다. 연구 결과에 의하면 V1, V3 그리고 V5 부위는 종간 변이가 없었고, V7과 V8은 종간변이는 높으나 염기서열의 길이가 각각 44 bp와 79 bp로 길이가 짧아서 충분한 유전 정보를 가지기 어렵기 때문에이 부위들은 종특이 분자마커로 적합하지 않았다. 그러나 V2와 V4부위는 $1.75{\sim}20.61%$로 높은 변이성을 보여주었고 종간 계통 관계도 잘 나타내었다. 또한 염기서열의 길이도 각각 123 bp와 306 bp로 마커 개발에 충분한 길이를 가지고 있었다. 따라서 18S rRNA의 V2와 V4부위는 섬모충류의 종 특이 분자 마커 개발에 가장 적합한 부위라는 결론을 얻었다. To verify which loop regions of 18S rRNA gene are suitable as species-specific genetic markers in ciliates, we analyzed the genetic variation of 18S rRNA gene among 9 Euplotes species (Hypotrichia : Ciliophora). In our result, no inter-specific variation was detected from V1, V3 and V5 regions, and the length of V7 and V8 are 44 bp and 79 bp, respectively, which are too short to make genetic marker. In contrast, V2 and V4 may be good candidate segments of species-specific diagnostic molecular markers because these two regions are most variable ($1.75{\sim}20.61%$) and showed good inter-specific phylogeny. Furthermore, the sequences of V2 and V4 are 123 bp and 306 bp, respectively in length which are enough to make species-specific marker.

불안의 생물학적 근원

석정호,김세주,김찬형,Seok Jeong-Ho,Kim Se-Joo,Kim Chan-Hyung 대한불안의학회 2005 대한불안의학회지 Vol.1 No.1

Anxiety is one of the basic emotions which human experiences across different cultures in the world and it can be observed in mammals. Our understanding of the neurobiology of this emotion has made some advances, even though it has not been completed, with the development and advance in the investigation method including neuroimaging, neurochemical, and genetic approaches. In this article, the neuroanatomical and neurochemical basis of anxiety is reviewed. The amygdaloid complex has been known to playa key role in processing of anxiety or fear. It has extensive afferent and/or efferent connections with cortical and subcortical structures. The mesial temporal structures including hippocampus appear to be involved in acquisition of anxiety and related behaviors. The prefrontal cortical structures appear to play important roles in conscious awareness of anxiety and in modulating anxiety and related behavior. The bed nucleus of the stria terminalis (BNST) is known to playa critical role in unconditioned fear response. The central noradrenergic system and hypothalamo-pituitary-adrenal axis are known to play important roles in modulating and expressing anxiety-related responses. Anxiety has been gathering attentions from many investigators and numerous preclinical and clinical investigations of anxiety and anxiety disorders have been done. In particular, neural plasticity in critical period and the psychobiological factors related to resilience to extreme stress and anxiety are important issues in this field.

강박장애 환자의 반응억제 결함

부영준,김세주,강지인,Boo, Young Jun,Kim, Se Joo,Kang, Jee In 대한불안의학회 2015 대한불안의학회지 Vol.11 No.1

Objective : Impaired response inhibition has been suggested to play an important role in the pathophysiology of obsessive-compulsive disorder (OCD). The aim of this study was to evaluate the response inhibition in patients with OCD, by using the Go/NoGo paradigm, and to better understand its associations with clinical symptoms. Methods : The participants included 63 OCD patients and 80 healthy volunteers matched in age and sex. response inhibition was evaluated using computerized Go/NoGo task, in which their commission error rates, omission error rates, and mean response times were measured. The severity of clinical symptoms in the OCD patients was assessed using Montgomery-Asberg Depression Scale and Yale-Brown Obsessive Compulsive Scale. Result : OCD patients showed significantly impaired inhibition and higher omission errors rates despite their slower response time, compared to normal controls. Clinical symptoms were not correlated with commission errors and omission errors. Conclusion : The present results indicate that impairment in response inhibition may play a critical role in the pathophysiology of OCD as a trait. These findings suggest that deficit of response inhibition may contribute to developing and maintaining clinical symptoms such as compelling need to repeat certain actions in patients with OCD.

반복 경두개자기자극술의 우울증 치료효과 및 최신동향에 대한 고찰

김신태,김혜원,김세주,강지인,Kim, Shin Tae,Kim, Hae Won,Kim, Se Joo,Kang, Jee In 대한생물정신의학회 2017 생물정신의학 Vol.24 No.3

본 종설에서는 우울증에서의 rTMS 임상연구를 임상특성과 TMS 적용방법을 고려하여 체계적으로 고찰하였으며 새로운 TMS 치료기법에 대해 살펴보았다. rTMS는 항우울제에 반응이 적은 단극성 우울증 환자의 치료에 병용 혹은 단독요법으로 사용될 수 있는 안전하고 비침습적인 뇌조절술이다. rTMS는 고빈도 좌측 DLPFC, 저빈도 우측 DLPFC, 그리고 양측성 DLPFC 적용방법이 비슷한 수준으로 허위자극에 비해 유의하게 항우울효과를 가지고 있다. 그러나 치료저항성 단극성 우울증에 대한 항우울효과 크기는 작았다. 또한 정신병적 증상이 동반된 우울증의 치료와 양극성 장애의 우울삽화에 대해서는 치료효과가 불분명하다. 기존 rTMS의 항우울효과 크기는 작은 정도로 그 효과를 증진시키기 위해 고용량의 자극, 보다 깊이 자극할 수 있는 코일을 이용한 rTMS 치료, 표적영역에 보다 정확하게 코일을 위치시키는 신경항법 등을 이용한 TMS 적용 등의 새로운 시도들이 진행되고 있다. 또한 세타돌발자극과 자기경련치료와 같은 새로운 치료기법을 이용한 시도가 우울증 치료의 새로운 장을 열고 있다. 비록 현재까지 rTMS의 항우울효과가 만족할 만한 수준은 아니지만 임상양상을 세분화한 치료적용과 개선된 치료기법의 적용 등을 통해 더 많은 후속 연구가 이루어질 필요가 있다. 또한 여러 형태의 TMS 기법에 대해 잘 설계된 허위자극에 대한 통제연구뿐만 아니라 서로의 비교연구를 통해 우울증 치료에서의 근거수준을 높일 수 있을 것으로 기대한다. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique which can change cortical excitability in targeted area by producing magnetic field pulses with an electromagnetic coil. rTMS treatment has been used to treat various neuropsychiatric disorders including depression. In this review, we evaluate the literature on rTMS for depression by assessing its efficacy on different subtypes of depression and different technical parameters. In particular, we focus on the results of randomized clinical trials and meta-analyses for depression after the US Food and Drug Administration approval in 2008, which acknowledged its efficacy and acceptability. We also review the new forms of rTMS therapy including deep TMS, theta-burst stimulation, and magnetic seizure therapy (MST) that have been under recent investigation. High frequency rTMS over left dorsolateral prefrontal cortex (DLPFC), low frequency rTMS over right DLPFC, or bilateral rTMS is shown to be effective and acceptable in treatment for patients with non-psychotic, unipolar depression either as monotherapy or adjuvant. Deep TMS, theta-burst stimulation and MST are promising new TMS techniques which warrant further research.

위험감수와 충동성 및 불확실성에 대한 인내력 부족의 관련성

손성연,강지인,남궁기,김세주,Sohn, Sung Yun,Kang, Jee In,Namkoong, Kee,Kim, Se Joo 대한생물정신의학회 2014 생물정신의학 Vol.21 No.3

Objectives Risk taking has been implicated in the development of various psychiatric disorders. Previous studies have indicated that risk taking behavior is associated with high levels of impulsiveness. Risk taking entail uncertain situation that outcome probability is unknown. This study tested impulsivity, intolerance of uncertainty and risk taking behavior. Methods A total of 73 participants completed a test battery comprised of the UPPS-P scale as a psychometric measurement of five dimensions of impulsivity, Intolerance of Uncertainty Scale, and Balloon Analog Risk Task (BART) as a behavioral measure of risk taking. The Pearson correlation analysis was used. Results The sensation seeking factor was positively correlated with BART measure (r = 0.27, p = 0.02). Specifically, the relationship between sensation seeking and BART was significant in females. Conclusions Among the five factors of UPPS-P, only the sensation seeking factor predicts risk taking propensity.