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자살시도자의 정신건강의학과 치료 연계 형태에 따른 동반질병 심각도의 차이
이혁,오승택,김민경,이선구,석정호,최원정,이병욱,Lee, Hyeok,Oh, Seung-Taek,Kim, Min-Kyeong,Lee, Seon-Koo,Seok, Jeong-Ho,Choi, Won-Jung,Lee, Byung Ook 한국정신신체의학회 2016 정신신체의학 Vol.24 No.1
연구목적 자살시도자는 일반적인 경우에 비해 의사결정 능력이 떨어지며, 다시 자살을 시도할 위험성이 높기 때문에 재시도 전에 정신건강의학과 치료로 연계하는 것이 중요하다. 특히 신체적 질병이 있는 사람은 자살시도를 할 확률이 높고, 사망률 역시 높아진다. 이 연구는 자살시도자의 특성을 조사하고, 자살시도 후 응급실에 방문하여 정신건강의학과 치료를 받기로 결정하는 데 신체적 질병이 어떤 영향을 주는지 분석하였다. 방 법 2012년 1월부터 12월까지 경기도의 일 종합병원 응급실에 내원한 132명의 자살시도자를 대상으로 하였다. 환자의 의무 기록을 후향적으로 검토해 인구통계학적, 임상적 요인을 조사하였고 정신건강의학과 치료 연계여부에 따라 분석하였다. 결 과 입원과 외래 상관 없이 정신건강의학과 치료를 받는 것에 영향을 주는 요인은 정신건강의학과 진단 유무, 직업 유무, 정신건강의학과 치료 과거력, 자살시도 과거력이었다. 정신건강의학과 치료 형태를 입원과 외래로 나누어 동반된 의학적 질병의 심각도(Charlson comorbidity index)를 비교했을 때, 입원을 통해 정신건강의학과 치료를 받은 자살시도자와 치료 자체를 거부한 자살시도자는 외래에서 치료를 받은 자살시도자보다 동반된 의학적 질병의 심각도가 높게 나타났다. 결 론 이 연구 결과 응급실에 내원한 자살시도자에게 동반된 의학적 질병의 심각도(Charlson comorbidity index)가 정신건강의학과 치료 형태에 영향을 미친다는 점을 알 수 있었다. 따라서 정신건강의학과 의사는 응급실에 내원한 자살시도자에 대해 의학적 동반질병의 여부 및 심각도를 평가하여 동반된 의학적 질병이 상대적으로 심각함에도 불구하고 자의퇴원을 진행하려고 하는 자살시도자에게 좀 더 합리적인 의사결정을 할 수 있도록 도움을 줄 수 있어야 한다. Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.
이혁,김영통,서광원,김서희,신형철,한건수,김일영,이혜경,Lee, Hyeok,Kim, Young-Tong,Seo, Kwang-Won,Kim, Seo-Hee,Shin, Hyeong-Cheol,Han, Kun-Soo,Kim, Il-Young,Lee, Hye-Kyung 대한영상의학회 1997 대한영상의학회지 Vol.37 No.6
Purpose:To analyse the ultrasonographic findings normal thymus in infants and determine the pathologic findings. Materials and Methods:Forty two infants without a history of chronic disease, tumor or steroid therapy were scanned in the axial planes with a 7.0 MHz sector transducer. Bilaterality, homogeneity, and the types, namely bilobate, quadragular or triangular. The intensities of thymic echogenicity were compared with those of the liver and spleen under the same conditions(time-gain compensation, depth and gain). Results:Bilaterality was seen in 36 cases, homogeneity in 35, homogeneity and bilaterality in 29, inhomogeneity and bilaterality in seven, and homogeneity and unilaterality in six. No case showedinhomogeneity and unilaterality. The shape was bilobate in 23 case, quadrangular in 13 and triangular in six, while the other border was convex in 29 cases and straight in 13. In no case wasechogenicity of the thymus greater than that of the liver or spleen. Transverse diameters were echogenicity of the thymus greater than that of the liver or spleen. Transverse diameters were 21-47mm(mean, 37.0mm;SD, 9.4mm) and depths were 10-37.5mm(mean, 25.8mm;SD, 5.9mm). Conclusion:The usual findings of normal thymus in infants are bilaterality and homogeneity, convex or shaight outer border, and echo intensity less than or equal to that of the liver and spleen. The possibility of thymic pathology is suggested when ultrasonography shows uniaterality, inhomogeneous echogeneity, and echogenicity greater than that of the liver and spleen.
생체 모방 기술에 응용 가능한 형상기억합금 선이 삽입된 복합재 해석
이혁(Hyeok Lee),이종구(Jonggu Lee),류정현(Junghyun Ryu),송성혁(Sung-Hyuk Song),안성훈(Sung-Hoon An),조맹효(Maenghyo Cho) 대한기계학회 2014 대한기계학회 춘추학술대회 Vol.2014 No.11
In this study, to imitate turtle’s wing, SMA(Shape memory alloy) embedded composite that has various stacking sequence is used. Bending and twisting deformation is induced by large phase transformation strain and recovering stress of SMA. In order to predict the deformation of composite, finite element method and analytical method based on the classical laminated plate theory are used. To represent the behavior of SMA, Lagoudas model is used. From this study, the bending curvature and twisting angle is estimated with respect to various stacking sequences and angles. The result obtained by analytical method shows a good agreement with the result obtained by FEM.
이혁 ( Hyeok Lee ),곽경환 ( Kyung Hwan Kwak ),김진국 ( Jin Kuk Kim ) 한국고무학회 2012 엘라스토머 및 콤포지트 Vol.47 No.1
새로운 스타폴리머인 바이오폴리부타디엔은 리빙 음이온중합이라는 고분자의 정밀 합성법을 통하여 분자량, 분자량분포, 조성 및 세부구조를 제어하였다. 리빙 음이온중합에 의해 n-BuLi으로 개시된 polybutadienyllithium (PBDLi)의 연쇄말단이 ESO(Epoxidized Soybean Oil)의 기능성 그룹과 커플링 반응을 일으키며 스타폴리머를 합성한다. 분자량이 1,000/5,000/10,000(g/mol)인 PBDLi을 중합하여 THF존재하에서 반응 후 GPC에 의한 분자량 및 arms분석과 1H-NMR, FT-IR에 의한 고분자 구조 분석을 통하여 바이오폴리부타디엔의 합성을 확인하였다. Novel bio-polybutadiene polymers with controlled molecular weight (MW), MW distribution, chemical composition and micro structure were synthesized by a living anionic polymerization of butadiene and the subsequent coupling reaction of the thus obtained living polybutadiene and a vegetable oil. Anionic polymerization of butadiene was carried out in THF solvent using n-BuLi initiator. The resulting living polybutadienyllithium polymer was then reacted with epoxidized soybean oil (ESO) to obtain a star-polymer of polybutadiene and vegitable oil. Three different bio-elastomers were prepared by coupling living polybutadienes of MWs 1000, 5000 and 1000g/mol with ESO. The molecular structure and MW of the polybutadienes and bioelastomers were characterized by 1H-NMR, FTIR and GPC techniques.