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임현국,배치운,이창욱,Lim, Hyun-Kook,Pae, Chi-Un,Lee, Chang-Uk 대한생물정신의학회 2005 생물정신의학 Vol.12 No.1
Object:Nicotine dependence is the most common substance abuse disorder. One of the characteristics of nicotine dependence is craving. Regional activation of the brain induced by craving for nicotine was evaluated by using functional magnetic resonance imaging to investigate neuroanatomical site of smoking craving. Method:A smoker who satisfied DSM-IV criteria for nicotine dependence and a non smoker was studied. MRI data were acquired on a 1.5T Magnetom Vision Plus with a head volume coil. Two sets of visual stimuli were presented to subjects in a random manner. One was the film scenes of inducing smoking craving and the other was neutral stimuli not related to smoking. There were two fMRI sessions before and after smoking or sham smoking. Data were analyzed using SPM99. Results:fMRI showed significant activated area in anterior cingulate and medial frontal lobes in the smoker during smoking craving. Right dorsolateral prefrontal cortex and parietal lobes were activated in the control during visual stimulation before smoking. After smoking, there was no brain activation during visual stimulation in both of smoker and non smoker. Conclusion:Metabolic activity of the anterior cingulate and medial frontal lobes increased during craving for smoking. This result suggests that fMRI may be a valuable tool in the identification of neurobiological process of craving.
화소 기반 형태분석 방법을 이용한 알츠하이머 치매환자의 회백질 용적감소의 정량적 분석
임현국,최은형,이창욱,Lim, Hyun-Kook,Choi, Eun-Hyung,Lee, Chang-Uk 대한생물정신의학회 2008 생물정신의학 Vol.15 No.2
Objectives : The purpose of this study was to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphpmetry(VBM) analysis for lateralizing clinically significant brain regions in dementia of Alzheimer's type patients compared to healthy group. Methods : MR T1-weighted images of the 20 dementia of Alzheimer's type patients were compared with those of the 20 normal controls. Images were transformed to standard MNI space. In order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was performed using statistical parametric mapping software(SPM2). Results : Gray matter volume was significantly reduced in the bilateral parahippocampal gyri, Lt. anterior cingulate gyrus, Lt. posterior cingulate gyrus, bilateral superior temporal gyri Lt. middle temporal gyrus, Lt. superior, bilateral middle, Rt. anterior frontal gyri and Rt. precuneus in dementia of Alzheimer's type patient group. Conclusions : These VBM results confirm previous findings of temporal lobe and limbic lobe atrophic changes in dementia of Alzheimer's type, and suggest that these abnormalities may be confined to specific sites within that lobe, rather than showing a widespread distribution.
최적화 화소 기반 형태분석 방법을 이용한 알츠하이머 병환자의 회백질 용적감소의 정량적 분석
임현국(Hyun Kook Lim),윤동환(Dong Whan Yoon),원왕연(Wang Youn Won),이철(Chul Lee),이창욱(Chang Uk Lee) 대한노인정신의학회 2009 노인정신의학 Vol.13 No.1
Objective : Optimized voxel based morphometry (VBM) has been increasingly applied to investigate differences in brain morphology between a group of Alzheimer's Disease (AD) patients and control subjects. Optimized VBM permits comparison of gray matter (GM) volume at voxel-level from the entire brain. The purpose of this study was to assess the regional GM volume loss measured by optimized VBM in AD compared to controls Methods : Twenty-three AD patients and 20 cognitively normal elderly control subjects included in this study. To improve the VBM performance, the study specific template and the probability maps were generated from the control subjects. Results : Optimized VBM analysis revealed GM loss, including hippocampus, amygdala, anterior cingulate, posterior cingulate, insula, frontal lobe and middle temporal complex in the AD group as compared to normal control group Conclusion : The VBM results confirmed previous findings of temporal lobe and limbic lobe atrophic changes in AD, and suggest that these abnormalities may be confined to specific sites within that lobe, rather than showing a widespread distribution.
노인 입원 환자에 대한 일 대학 병원의 리스페리돈과 올란자핀의 처방 경향 : 자연적 연구
임현국(Hyun Kook Lim),최은형(Eun Hyung Choi),이영란(Young Ran Lee),오근(Keun Oh),배치운(Chi Un Pae),이철(Chul Lee),백인호(In Ho Paik),이창욱(Chang Uk Lee) 대한노인정신의학회 2007 노인정신의학 Vol.11 No.1
Several studies have reported that either risperidone or olanzapine is effective and tolerable in the elderly patients with psychotic symptoms. However, there is a lack of clinical data of risperidone and olanzapine prescription for elderly patients in the Aisan population. We reviewed retrospectively the medical records of risperidone (n=112) and olanzapine (n=96) treated patients older than age 60 who were admitted to a university-affiliated hospital between October 2005 and August 2006. The mean daily dose of risperidone was 3.4±1.5 mg and olanzapine, 8.8±5.6 mg, respectively. The response rate on the CGI (much and very much improved) appeared to be 67.4% in the risperidone group and 70.8% in the olanzapine group, respectively. Adverse events were reported in 48.2% in the risperidone group and 46.9% in the olanzapine group, without serious adverse events, respectively. This study showed that either risperidone or olanzapine would be effective and tolerable in elderly patients with psychotic symptoms and that provides similar results to those reported from western countries.
알츠하이머 치매 환자에 동반된 정신병적 증상 치료에 관한 아미설프리드와 리스페리돈의 효과와 안정성에 대한 비교 연구
임현국(Hyun-Kook Lim),김수진(Su-Jin Kim),배치운(Chi-Un Pae),이철(Chul Lee),이창욱(Chang-Uk Lee) 대한노인정신의학회 2007 노인정신의학 Vol.11 No.1
This study compared the effectiveness and tolerability of amisulpride and risperidone in patients with psychosis associated with dementia of the Alzheimer’s type (DAT). This 8-week open label study randomized 72 patients with DAT associated psychosis either to amisulpride (n=36) and risperidone (n=36). The effectiveness of the treatments was assessed with the Korean version of Neuropsychiatry Inventory (K-NPI) psychosis subscale and total K-NPI and the Clinical Global Impression-Severity of Illness (CGI-S) scale. The Simpson-Angus Rating Scale, the Barnes Akathisia Rating Scale and the Abnormal Involuntary Movement Scale were used for the assessment of side effects. The K-NPI psychosis subscale, total K-NPI and CGI-S scores were significantly decreased over time in both treatment groups without any significant group difference and time by the group interaction effect. There were no serious adverse events in both groups. This study showed that either amisulpride or risperidone would be effective and tolerable for treating psychotic symptom associated with DAT. Adequately powered studies with a head-to-head comparison design will be mandatory to draw any definite conclusion.
화소 기반 형태분석 방법을 이용한 경도인지장애 환자의 회백질 용적감소의 정량적 분석
유보은,한창태,이창욱,홍승철,임현국,Yoo, Bo-Eun,Hahn, Chang-Tae,Lee, Chang-Uk,Hong, Seung-Chul,Lim, Hyun-Kook 대한생물정신의학회 2011 생물정신의학 Vol.18 No.4
Objectives Optimized voxel based morphometry (VBM) has been increasingly applied to investigate differences in the brain morphology between a group of patients with mild cognitive impairment (MCI) and control subjects. Optimized VBM permits comparison of gray matter (GM) volume at voxel-level from the entire brain. The purpose of this study was to assess the regional GM volume change measured by optimized VBM in MCI subjects compared to controls. Methods Twenty patients with MCI and 20 control subjects with normal cognition were recruited for this study. We applied the optimized VBM protocol to the image data including study-specific template and the modulation of the data with the Jacobian determinants. GM volume differences between the MCI subjects and the control subjects and their correlations with the neuropsychological performances were investigated. Results Optimized VBM analysis revealed GM volume reduction in hippocampus, precentral gyrus, insula and parietal operculum in the MCI group compared to the control group (family wise error corrected p < 0.05). Korean version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) word list recall scores were significantly correlated with the GM volumes of hippocampus, precuneus and posterior cingulate in the MCI group (FWE corrected p < 0.05). Conclusions The results confirm previous findings of atrophic changes in medial temporal lobe and parietal lobe in the MCI group and suggest that these abnormalities may be related with cognitive decline and prognosis in patients with MCI.
조현병 환자에서 불안자극에 대한 선택적 주의 편향과 환청과의 연관성 : 예비 연구
김한석,한진희,홍승절,정종현,임현국,김태원,엄유현,채정호,이경욱,서호준,Kim, Han-Suk,Han, Jin-Hee,Hong, Seung-Chul,Jeong, Jong-Hyun,Lim, Hyun-Kook,Kim, Tae-Won,Um, Yoo-Hyun,Chae, Jeong-Ho,Lee, Kyoung-Uk,Seo, Ho-Jun 대한불안의학회 2016 대한불안의학회지 Vol.12 No.1
Objective : This study was conducted to evaluate the relationships between selective attention bias for fear stimuli and hallucination in patients with schizophrenia Method : A total of 66 patients with schizophrenia admitted to psychiatry clinics were included in the study. Selective attention bias was measured by the dot-probe task. Patient symptoms were measured using the Positive and Negative Symptom Scale, Psychotic Symptom Rating Scale (PSYRATS), Korean version of the Scale to Assess Unawareness of Mental Disorder, and Clinical Global Impression-Severity scale. Results : Selective attention bias was correlated with the hallucination subscale of PSYTATS (r=0.268, p=0.029). No correlation was found between selective attention bias and other clinical measures. There was no significant difference, but a statistical trend was found (p=0.092) in hallucination severities between the biased and non-biased groups. Conclusion : The results suggest that selective attention bias for fear stimuli is associated with auditory hallucination. This preliminary study suggests the possibility of correlation between auditory hallucination in the psychotic domain and anxiety of the affective component.
알츠하이머 치매 환자에 동반된 우울증상의 치료에 관한 Mirtazapine의 효과와 안정성에 대한 개방 연구
최하나(Hana Choi),임현국(Hyun Kook Lim),이철(Chul Lee),이창욱(Chang Uk Lee) 대한노인정신의학회 2009 노인정신의학 Vol.13 No.1
Depression is one of the most devastating behavioral symptoms in demented patients but there is little evidence about effective and safe pharmacotherapy. We aimed to determine the effectiveness and safety of mirtazapine in treatment of depressed patients with Alzheimer's disease (AD). The consecutive patients with AD who have significant depression were assigned to an 8-week open-label, prospective study. Patients received mirtazapine 15-45 mg/day. The changes in Hamilton Depression Rating Scale (HAM-D) scores were primary outcome measurement. The change in Clinical Global Impression-Severity scale (CGI-S) scores and tolerability-safety profile were the secondary efficacy variables. Thirty-two out of 38 (84.2%) patients completed the study. There was a significant reduction in HAM-D and CGI-S between the pre- and post-treatment with mirtazapine (p<0.01). There was no significant side effect and cognitive deterioration. The results of this open-label pilot study suggest that mirtazapine may be an effective choice for treatment of depressed patients with AD.
18F-Florbetaben을 이용한 대조군과 기억성 경도인지장애 및알츠하이머병 환자군의 아밀로이드 침착 패턴 양상 : 복셀 기반 영상분석
조예니(Yeani Cho),엄유현(Yoo Hyun Um),김태원(Tae-Won Kim),서호준(Ho-Jun Seo),정종현(Jong-Hyun Jeong),홍승철(Seung-Chul Hong),한진희(Jin-Hee Han),백인호(In-Ho Baek),임현국(Hyun-Kook Lim) 대한노인정신의학회 2016 노인정신의학 Vol.20 No.2
Department of Psychiatry, 2 Keyo Hospital, Uiwang, Korea Objective:The purpose of the study was to compare cortical amyloid deposition using 18F-florbetaben and positron emission tomography (PET) in healthy controls and subjects with amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD). Methods:We investigated 25 patients : 10 age-matched healthy controls, 10 patients with aMCI and 5 with AD. All participants underwent PET after intravenous injection of 300 MBq of 18F-florbetaben. The 90 min post-injection brain PET data were analysed using statistical parametric mapping. Results:When compared to healthy controls, amyloid deposition was significantly higher in frontal lobe medial frontal gyrus, limbic lobe posterior cingulate, parietal lobe precuneus, sub-loba insula, temporal lobe superior temporal gyrus, parietal lobe inferior parietal lobule, temporal lobe middle temporal gyrus, parietal lobe supramarginal gyrus, occipital lobe middle temporal gyrus of patient group (family wise error correction p<0.05). Conclusion:These results indicate 18F-florbetaben to be an efficacious β-amyloid-targeted tracer. Subjects with aMCI, AD could be easily differentiated from healthy controls by assessment of the PET data.
정서가 및 각성수준에 대한 자가 평가 마네킹 척도개발 및 표준화
강은호,최정은,함병주,석정호,이경욱,김원,이승환,임현국,박영민,양종철,안미경,이재선,채정호,Kang, Eun-Ho,Choi, Jeong-Eun,Ham, Byung-Joo,Seok, Jeong-Ho,Lee, Kyoung-Uk,Kim, Won,Lee, Seung-Hwan,Lim, Hyun-Kook,Park, Young-Min,Yang, Jong-Chul,Ahn 대한불안의학회 2011 대한불안의학회지 Vol.7 No.2
Objectives : The Self-Assessment Manikin (SAM) developed by Bradley and Lang is a non-verbal pictorial assessment tool that measures human emotion and has been widely used. However, the pictures in SAM have not been easy for Korean subjects to understand or relate to. The authors developed a new manikin (Emotional Valence and Arousal Manikin, EVAS) modeling it after Korean faces while modifying and standardizing the SAM. Methods : Forty-one healthy subjects participated in this study. They were asked to rate the emotional valence and level of arousal using both the SAM and EVAS after being exposed to pictures of facial expressions for affective neurosciences-Korean version. The internal consistency of the EVAS and the correlation between EVAS and SAM were examined. Resuts : Internal consistencies of the valence using the EVAS were from 0.63 (surprise) to 0.82 (happiness) and those of the arousal were from 0.90 to 0.95. Correlation coefficients of the valence and arousal between the SAM and EVAS were from 0.61 (both surprise and disgust) to 0.84 (neutral) and from 0.82 (sadness) to 0.94 (fear), respectively. Conclusions : We developed a new manikin (the EVAS) for the Korean population modifying and standardizing the SAM. The EVAS demonstrated a good internal consistency and validity. As such, it can be used in the field of human emotion research.