정신과 환자 집단간 추상화 추론(Abstract Reasoning) 능력 비교 : SPM(Standard Progressive Matrices) 중심으로

이지화,신동균,이수정,이민수 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.2

고위인지기능 중 시자극에 대한 지각적 관계를 파악하고 유추에 의해서 추론하는 능력을 측정한다고 알려진 SPM(Standard Progressive Matrics)검사를 통해, 추론 기능의 취약성이 예측되는 정신과 환자 집단(기질적 뇌손상, 우울증, 정신분열병)과 정상통제집단에, 추론 기능을 중심으로 고위 인지 기능 손상의 특징적 양상을 비교해 보고자 한다. 방법: 정신분열병 환자 29명, 우울증 환자 22명, 뇌손상 환자 32명을 대상으로 SPM을 실시하여, 집단간의 수행 양상의 차이를 비교하되, SPM 총점과 5개의 소검사 점수를, 변량분석 및 사후 검증을 통해 비교하였다. 정상 집단과 뇌손상 집단간 SPM 소검사의 판별분석을 시행하였다. 결과: 정신과 환자 집단의 SPM 수행 결과에 있어 뇌손상환자, 우울증환자, 정신분열병환자 세 집단 모두 정상집단에 비해 유의미하게 낮았으며, 특히 뇌손상환자는 우울증환자, 정신분열병환자보다도 유의미하게 낮은 수행을 나타냈다. B,E 소검사가 뇌손상 집단과 정상 집단을 가장 잘 변별해주는 소검사로 판별되었다. 정신분열병환자와 우울증환자간에 유의미한 차이는 관찰되지 않았으며, 모양의 배열과 조합을 추론해야하는 D 소검사에서는 우울증환자와 뇌손상환자간에 유의미한 차이를 나타냈으나, 정신분열병환자와 뇌손상환자간에 유의미한 차이를 보이지 않았다. 결론: 추상화 추론 기능을 중심으로한 고위인지기능 저하가 예상되는 우울증, 정신분열병, 및 뇌손상환자간에 인지적 손상의 특징적 양상을 SPM 검사가 잘 변별해 줌을 보여주었다. 뇌손상 환자의 인지적 손상은 정신분열병 및 우울증 환자의 인지적 손상과는 질적으로 차이가 있음을 시사하는 것이며, SPM이 지능 검사의 대체 검사뿐만 아니라 신경 심리 검사로서 활용될 수 있음을 확인한 것이다. Objectives: This study was aimed to compare abstract reasoning in patients with mental disorders ; Depression, Schizophrenia, Organic Brain Syndrome(OBS), and normal control group using Standard Progressive Matrices(SPM), known as a test measuring visual pattern matching ability and reasoning ability by analogy. Method: SPM test in Vienna Test System□ was administered to 82 normal adults, 29 schizophrenic patients, 22 depression patients, and 32 OBS patients. SPM total score and 5subtest scores in four groups were compared, using ANOVA and post-hoc comparison. SPM subtest scores in OBS and normal group were compared, using discriminant function analysis. Results: SPM total score and all subtest scores in mental disorders group(schizophrenia,depression, OBS) were lower than in normal control group. SPM total score and all subtest scores in OBS group were lower than in schizophrenia and depression group. No difference between SPM total score in Schizophrenia and depression group was found. Discriminant function of B, E subtest was the hightest. Conclusions: The impairment of higher cognitive function, especially abstract reasoning impairment in OBS, was qualitatively defferent from that of schiophrenia and depression. SPM can differentiate specific pattern of abstract reasoning impairment in mental disorders, so SPM can be used not only as a substitute for intelligence test but also as a neuropsychological test.

여성 간질 환자에서 항경련제 복용에 따른 대사 및 생리주기의 변화

김지영,이진화,김숙희,이향운 이화여자대학교 의과대학 2005 EMJ (Ewha medical journal) Vol.28 No.2

Background & Objectives : Women with epilepsy(WWE) are at risk for reproductive and metabolic disorders. This study was performed to investifate whether WWE are more likely to have menstual or metabolic abnormalities, and whether some antiepileptic drugs(AEDs) more likely provoke those problems. Methods : WWW aged 15-50 years old, taking one or more AEDs for at least 6 months, were recruited. Subjucts checked their oral temperature each morning. Body mass index(BMI : kg/㎡) and waist to hip (W/H) ratio were calculated as obesity markers. Hirsutism index, as a marker of polycystic ovary syndrome, was calculated by Ferriman-Gallwey score(hirsutism if score>8). Serum tests ofr gonadotrophins, steroid hormones, sex hormone binding globulins (SHBG), lipid profiles, insulin were performed on menstrual cycle days 3 to 5. Results : Among 54 patients, 18 women were diagnosed as primary generalized epilepsy(PGE) and the other 36 were localoization-related epilepsy(LRE). Also, 21 women(38.9%) were treated with carbamazepine(CBZ), 14 women(25.9%) with valproate(VPA), and 19(35.2%) with lamotrigine(LTG) or topiramate(TPM). Menstrual disturbance was found in 60.0% of PGE versus 30.6% of LRE patients(p=0.050), while 64.3% of VPA and 28.6% of CBZ-treated patients(p=0.036). The W/H ratio and BMI were higher in VPA, than in CBZ-treated patients(p=0.048 and 0.018). The total and HDL-cholesterols decreased in the VPA group compared to the CBZ group(p=0.025 and 0.009). Conclusion : WWE are more likely to experience menstrual and metabolic alterations. WWE with VPA tend to have abdominal obesity and alterations in lipid metabolism.

문제중심학습(Problem Based Learning; PBL) 패키지 개발 : 지각·조정장애상황을 중심으로

김애리,김영경,송영선,신경림,안혜정,이지순,조계화 성인간호학회 2001 성인간호학회지 Vol.13 No.3

The Purpose of this study is to present an actual example for procedures for developing a PBL package based on philosophical backgrounds derived from Problem-based learning. To perform a systemic study on the operations of an intergrated curricula under multi-disciplines, a research team made up of several professors with different academic backgrounds was formed. Among the four situations for the patients with perception-adjustment disorder, especially a procedure for the development of PBL package which can be used in the emergency room situation has been proposed. The little(2000)'s PBL package model has been applied for this study. Tha package includes course objectives, learning objectives, concept map, situation scenario. tutor guide, and evaluation method. It is believed that learning objectives achievement procedures designed as a part of a problem-based learning package development procedures for the nursing of patients with perception-adjustment can be achieved at the same level as the learning objectives for the science of nursing founded by the Korean Nurses Association.

KAAACI Guidelines for Allergen Immunotherapy

Lee Hwa Young,이상민,강성윤,Kim Kyunghoon,Kim Ju Hee,Ryu Gwanghui,Min Jin-Young,Park Kyung Hee,Park So-Young,Sung Myongsoon,Lee Youngsoo,Yang Eun Ae,Jee Hye Mi,Ha Eun Kyo,Shin Yoo Seob,Chung Eun Hee,Choi Su 대한천식알레르기학회 2023 Allergy, Asthma & Immunology Research Vol.15 No.6

Allergen immunotherapy (AIT) is a causative treatment for various allergic diseases such as allergic rhinitis, allergic asthma, and bee venom allergy that induces tolerance to offending allergens. The need for uniform practice guidelines in AIT is continuously growing because of the increasing discovery of potential candidates for AIT and evolving interest in new therapeutic approaches. This guideline is an updated version of the Korean Academy of Asthma Allergy and Clinical Immunology recommendations for AIT published in 2010. This updated guideline proposes an expert opinion by allergy, pediatrics, and otorhinolaryngology specialists with an extensive literature review. The guideline deals with basic knowledge and methodological aspects of AIT, including mechanisms, clinical efficacy, patient selection, allergens extract selection, schedule and doses, management of adverse reactions, efficacy measurements, and special consideration in pediatrics. The guidelines for sublingual immunotherapy will be covered in detail in a separate article.

Foreign Body Ingestion in Children: Should Button Batteries in the Stomach Be Urgently Removed?

Lee, Jun Hee,Lee, Jee Hoo,Shim, Jung Ok,Lee, Jung Hwa,Eun, Baik-Lin,Yoo, Kee Hwan The Korean Society of Pediatric Gastroenterology 2016 Pediatric gastroenterology, hepatology & nutrition Vol.19 No.1

Purpose: Foreign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children. Methods: We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications. Results: Coins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (${\geq}1.5cm$, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (<1.5 cm, 1.5 V) (p=0.001). All endoscopies were conducted within 24 hours after ingestion. Conclusion: The type and voltage of the battery should be considered when determining whether endoscopy is required to remove a BB in the stomach. For lithium battery ingestion in young children, urgent endoscopic removal might be important in order to prevent complications, even if the child is asymptomatic and the battery is smaller than 2 cm.

Original Article : Role of 15-hydroxyprostaglandin dehydrogenase down-regulation on the prognosis of hepatocellular carcinoma

( Jee Eun Yang ),( Eun Ji Park ),( Hyo Jeong Lee ),( Hyo Jeong Kang ),( Kang Mo Kim ),( Eun Sil Yu ),( Dan Bi Lee ),( Ju Hyun Shim ),( Young Suk Lim ),( Han Chu Lee ),( Young Hwa Chung ),( Yung Sang L 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.1

Background/Aims: The role of prostaglandin E2 (PGE2) in the modulation of cell growth is well established in colorectal cancer. The aim of this study was to elucidate the significance of 15-hydroxyprostaglandin dehydrogenase (15-PGDH) down-regulation on the prognosis of hepatocellular carcinoma (HCC) patients. Methods: The expression of 15-PGDH in HCC cell lines and resected HCC tissues was investigated, and the correlation between 15-PGDH expression and HCC cell-line proliferation and patient survival was explored. Results: The interleukin-1-β-induced suppression of 15-PGDH did not change the proliferation of PLC and Huh-7 cells in the MTS [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay. The induction of 15-PGDH by transfection in HepG2 cells without baseline 15-PGDH expression was suppressed at day 2 of proliferation compared with empty-vector transfection, but there was no difference at day 3. Among the 153 patients who received curative HCC resection between 2003 and 2004 at our institution, 15-PGDH expression was observed in resected HCC tissues in 56 (36.6%), but the 5-year survival rate did not differ from that of the remaining 97 non-15-PGDH-expressing patients (57.1% vs 59.8%; P=0.93). Among 50 patients who exhibited baseline 15-PGDH expression in adjacent nontumor liver tissues, 28 (56%) exhibited a reduction in 15-PGDH expression score in HCC tissues, and there was a trend toward fewer long-term survivors compared with the remaining 22 with the same or increment in their 15-PGDH expression score in HCC tissues. Conclusions: The prognostic significance of 15-PGDH down-regulation in HCC was not established in this study. However, maintenance of 15-PGDH expression could be a potential therapeutic target for a subgroup of HCC patients with baseline 15-PGDH expression in adjacent nontumor liver tissue. (Clin Mol Hepatol 2014;20:28-37)

Mitochondrial Genetic Diversity and Phylogenetic Relationships of Siberian Flying Squirrel(Pteromys volans) Populations

Lee, Mu-Yeong,Park, Sun-Kyung,Hong, Yoon-Jee,Kim, Young-Jun,Voloshina, Inna,Myslenkov, Alexander,Saveljev, Alexander P.,Choi, Tae-Young,Piao, Ren-Zhu,An, Jung-Hwa,Lee, Mun-Han,Lee, Hang,Min, Mi-Sook The Korean Society for Integrative Biology 2008 Animal cells and systems Vol.12 No.4

Siberian flying squirrel, an endangered species in South Korea, is distributed through major mountain regions of South Korea. The number of Siberian flying squirrel(Pteromys volans) in South Korea has decreased and their habitats are fragmented and isolated because of anthropogenic activities. So far no molecular genetic data has, however, been available for their conservation and management. To obtain better information concerning genetic diversity and phylogenetic relationships of the Siberian flying squirrel in South Korea, we examined 14 individuals from South Korea, 7 individuals from Russia, and 5 individuals from northeastern China along with previously published 29 haplotypes for 1,140 bp of the mtDNA cytochrome b gene. The 14 new individuals from South Korea had 7 haplotypes which were not observed in the regions of Russia and Hokkaido. The level of genetic diversity(0.616%) in the South Korean population was lower than that in eastern Russia(0.950%). The geographical distribution of mtDNA haplotypes and reduced median network confirmed that there are three major lineages of Siberian flying squirrel, occupying; Far Eastern, northern Eurasia, and the island of Hokkaido. The South Korean population only slightly distinct from the Eurasia, and eastern Russian population, and is part of the lineage Far Eastern. Based on these, we suggest that the South Korean population could be considered to belong to one partial ESU(Far Eastern) of three partial ESUs but a different management unit. However, the conservation priorities should be reconfirmed by nuclear genetic marker and ecological data.

Case Reports : Primary granulocytic sarcoma of ovary

( Jee Young Jung ),( Min Jung Jung ),( Jee Young Oh ),( Mi Hyang Kim ),( Hang Goo Yun ),( Young Lim Oh ),( Tae Hwa Lee ),( Chun June Lee ),( Won Gyu Kim ) 대한산부인과학회 2010 Journal of Womens Medicine Vol.3 No.2

Primary granulocytic sarcoma of ovary is extremely rare presentation of acute non-lymphatic leukemia. Absence of high suspicion, it is often misdiagnosed with other ovarian malignancies. We describe a case of 37-years-old woman with ovarian mass who is identified as primary granulocytic sarcoma of ovary without any coexisting hematologic disorders.

Subspecific Status of the Korean Tiger Inferred by Ancient DNA Analysis

Lee, Mu-Yeong,Hyun, Jee-Yun,Lee, Seo-Jin,An, Jung-Hwa,Lee, Eun-Ok,Min, Mi-Sook,Kimura, Junpei,Kawada, Shin-Ichiro,Kurihara, Nozomi,Luo, Shu-Jin,O'Brien, Stephen J.,Johnson, Warren E.,Lee, Hang The Korean Society of Systematic Zoology 2012 Animal Systematics, Evolution and Diversity Vol.28 No.1

The tiger population that once inhabited the Korean peninsula was initially considered a unique subspecies (Panthera tigris coreensis), distinct from the Amur tiger of the Russian Far East (P. t. altaica). However, in the following decades, the population of P. t. coreensis was classified as P. t. altaica and hence forth the two populations have been considered the same subspecies. From an ecological point of view, the classification of the Korean tiger population as P. t. altaica is a plausible conclusion. Historically, there were no major dispersal barriers between the Korean peninsula and the habitat of Amur tigers in Far Eastern Russia and northeastern China that might prevent gene flow, especially for a large carnivore with long-distance dispersal abilities. However, there has yet to be a genetic study to confirm the subspecific status of the Korean tiger. Bone samples from four tigers originally caught in the Korean peninsula were collected from two museums in Japan and the United States. Eight mitochondrial gene fragments were sequenced and compared to previously published tiger subspecies' mtDNA sequences to assess the phylogenetic relationship of the Korean tiger. Three individuals shared an identical haplotype with the Amur tigers. One specimen grouped with Malayan tigers, perhaps due to misidentification or mislabeling of the sample. Our results support the conclusion that the Korean tiger should be classified as P. t. altaica, which has important implications for the conservation and reintroduction of Korean tigers.

Endometrial profilin 1: A key player in embryo-endometrial crosstalk

Lee, Chang-Jin,Hong, Seon-Hwa,Yoon, Min-Ji,Lee, Kyung-Ah,Ko, Jung-Jae,Koo, Hwa Seon,Kim, Jee Hyun,Choi, Dong Hee,Kwon, Hwang,Kang, Youn-Jung The Korean Society for Reproductive Medicine 2020 Clinical and Experimental Reproductive Medicine Vol.47 No.2

Objective: Despite extensive research on implantation failure, little is known about the molecular mechanisms underlying the crosstalk between the embryo and the maternal endometrium, which is critical for successful pregnancy. Profilin 1 (PFN1), which is expressed both in the embryo and in the endometrial epithelium, acts as a potent regulator of actin polymerization and the cytoskeletal network. In this study, we identified the specific role of endometrial PFN1 during embryo implantation. Methods: Morphological alterations depending on the status of PFN1 expression were assessed in PFN1-depleted or control cells grown on Matrigel-coated cover glass. Day-5 mouse embryos were cocultured with Ishikawa cells. Comparisons of the rates of F-actin formation and embryo attachment were performed by measuring the stability of the attached embryo onto PFN1-depleted or control cells. Results: Depletion of PFN1 in endometrial epithelial cells induced a significant reduction in cell-cell adhesion displaying less formation of colonies and a more circular cell shape. Mouse embryos co-cultured with PFN1-depleted cells failed to form actin cytoskeletal networks, whereas more F-actin formation in the direction of surrounding PFN1-intact endometrial epithelial cells was detected. Furthermore, significantly lower embryo attachment stability was observed in PFN1-depleted cells than in control cells. This may have been due to reduced endometrial receptivity caused by impaired actin cytoskeletal networks associated with PFN1 deficiency. Conclusion: These observations definitively demonstrate an important role of PFN1 in mediating cell-cell adhesion during the initial stage of embryo implantation and suggest a potential therapeutic target or novel biomarker for patients suffering from implantation failure.