외안각 절제술과 경결막 절개에 의한 안와 접근법

정종철,김성범,서지훈,송민석,전창훈,최세훈,김현민 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4

Various surgical approaches to the orbits have been used. But the transconjunctival approach, also called the inferior fornix incision, provides adequate access to the orbital floor with esthetic results. Additionally, transconjunctival approach with lateral canthotomy allows more wide surgical field and good access to the orbital area. Generally, preseptal approach is more used rather than postseptal approach in the transconjunctival incision for the prevention of fat herniation during surgery. There are some complications in transconjunctival approaches but these complications can be prevented with careful surgical techniques. We report clinical results in 12 patients who were treated by preseptal transconjunctival incision with lateral canthotomoy for the treatment of orbital trauma. We were satisfied with this technique for reduction and reconstruction of the orbital trauma and we could also observe relatively good esthetic results.

선택적 NCMA 방법을 이용한 분할 블라인드 적응 등화기의 성능 분석

홍지훈,장태정 江原大學校 産業技術硏究所 2001 産業技術硏究 Vol.21 No.B

In this paper, the selective normalized constant modulus algorithm(SNCMA) is applied to a fractionally spaced equalizer. The fractionally spaced equalizer is insensitive to the sampling timing because it processes received signals with the sampling rate larger than the symbol rate. The SNCMA improves the convergence rate by using the large step size for the most outer covering symbol belonging to the trust-level. This blind equalizer exhibits a fast start-up convergence rate as well as a reduced steady-state residual error compared to the fractionally spaced blind equalizer and the T-spaced blind equalizer using conventional blind algorithms.

정신분열병 환자에서 Risperidone에 의해 유발된 조증 2례

정두훈,윤도준,유희정,송지영 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

저자들은 정 신분열병 환자에서 risperidone에 의해 유발된 조증, 경조증 각 1례를 경험하였기에 국내에서는 최초로. 문헌고찰과 함께 보고한다. 증례 1은 22세의 여자 긴장형 정신분열병 환자로 3년전 발병 당시 약물치료후 유지요법 없이 지내다가 4∼5개월 전부터 사회적 위축, 식사량 저하. 말수가 줄어드는 등의 음성증상이 심해져 외래에서 risperidone 2mg을 일 주일간 처방하였다. 환자는 약물순응도가 낮아서 모두 6회에 걸쳐 억지로 투약하여 이 기간에 총 6∼8mg복용후 2∼3일 만에 조증이 발생되었다. 입원후 risperidone을 중단하고 lithium과 고용량의 정형 항정신병약물(chlorpromazine 1200mg 또는 haloperidol 20mg)을 10일간 투여하여 일부 조증이 호전되었다. 증례 2는 29세 남자로 3년 전부터 피해망상, 독극망상을 보이는 망상형 정신분열 병으로 항정신병약물을 처음 투여한 환자였다. 38일간 2mg 사용 시에는 양성증상 및 음성증상의 호전을 보이다가 3mg으로 증량된 후 일 주일만에 뚜렷한 경조증을 보였다. Risperidone을 중단하고 chlorpromazine 300mg을 투여하자 5일 만에 경조증이 완전히 회복되었다. 두 예 모두 risperidone 단독투여에 의한 것이었고, 기분안정제 병합투여, 약물남용 정신질환의 병력이나 가족력, 동반 신체질환은 없었다. Risperidone의 세로토닌(5-HT₂) 차단효과는 도파민(D₂) 차단작용과 함께 정신분열 병에서 음성증상과 정동중상을 호전시킬 뿐 아니라 항우울효과를 나타내며. 일부 환자에서 조증 및 경조증을 유발시키는 것으로 보인다. 기분장애와 분열정동장애에서도 risperidone에 의해 조증이 유발 또는 기존 조증중상이 악화되었다는 증례보고가 있고. 강박장애 등 다른 정신질환으로도 적응증이 확대되고 있으므로, 임상의들은 드물지만 이런 정신과적 부작용의 발생 가능성에 대해 알아야 하겠고. 특히 기분장애나 분열정동장애에서 사용할 경우 기분안정제의 병합투여와 최소 치료용량으로 서서히 증량할 것을 권하는 바이다. 또한 조증유발의 위험인자가 있는 경우는 기분안정효과가 있는 clozapine의 사용이 권장된다. We report the first two cases of manic and hypomanic episodes respectively induced by risperidone treatment done to schizophrenics in Korea. One case was a 22-year-old woman with catatonic schizophrenia. Since 3 years ago, she had shown psychotic symptoms, but with was poor treatment compliance. She had mainly negative symptoms such as social withdrawal, decreased food intake, mutism, and symptoms had been worsened since last 4-5 months. Prior to closed ward admission, she was prescribed 2mg/d of risperidone for a week at OPD. Two days artier taking medicine totally 6-8mg, she revealed manic features. After hospitalization, risperidone was discontinued and then, lithium 900mg/d and high dosage of conventional antipsychotics(chlorpromazine 1200mg/d or haloperidol 20mg/d) were prescribed . About on the l0th day of hospitalization, there was limited improvement of her manic symptoms. The other case was a 29-year-old man with a 3-year history of paranoid schizophrenia. He was never exposed to antipsychotics before. His main symptoms were delusions of being poisoned and of persecution. His positive and also negative symptoms were alleviated by 38 days of risperidone 2mg/d trial. However, one week after dosage increment to 3mg/d, hypomanic symptoms appeared. Risperidone medication was discontinued and was replaced by chlorpromazine 300mg/d. The hypomanic episode was resolved over 5 days. In both of the two cases, manic episodes occurred by monotherapy of risperidone without mood stabilizer, and there were no history of substance abuse and other psychiatric disorders, family history of psychiatric disorders, and comorbid physical illnesses. It is hypothesized that the potent blockade effect on serotonin(5-HT₂) receptor of risperidone causes antidepressant effect as well as therapeutic effect for negative and affective symptoms in schizophrenia. Risperidone would induce manic or hypomanic features in schizophrenic patin of preexisting manic symptoms by risperidone treatment in mood disorder and schizoaffective disorder. Risperidone is being used more widely, even for obsessive-compulsive disorder and other psychiatric disorders. It is necessary for clinicians to recognize manic switch, one of psychiatric side effects by risperidon trial. It is recommended that the combination of mood stabilizer wish risperidone or usage of talc minimum effective dose of risperidone may bewefal especially in the patients with mood disorders or schizoaffective disorders. Clozapine which has mood-stabilizing properties is also beneficial in risk groups of risperidone-induced mania.

한국에서의 양극성장애와 Borna Disease Virus와의 관련성

김지관,정성훈,이유철,조유진 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

It has been known that Borna disease virus(BDV) naturally infects horses and sheep, and causes a sporadic neurological disease. There have been many studies of the relation between this virus and human neurological and psychiatric disease, but the definite result remains uncertain, yet. Here, by using a nested reverse trancription-polymerase chain reaction (RT-PCR) technique in the p40 regions, we tried to demonstrate that BDV RNA was present in the peripheral blood mononuclear cells of bipolar patients. In an examination of a total of 38 bipolar patients from 4 different hospitals in Taegu, Republic of Korea, BDV genomic RNA was detected in the p40 region in only one case. These data do not support an etiologic association between BDV infection and bipolar disorder in humans.

여수국가산업단지 인근 지역 대기오염물질 농도에 영향을 미치는 요인분석

김민영,변정훈,이영훈,이건영,한지은,이예림,임지현,장봉기 순천향대학교 기초과학연구소 2022 순천향자연과학연구 논문집 Vol.28 No.1,2

Eight monitoring stations in the Yeosu National Industrial Complex will determine the concentration of air pollutants measured every hour in 2019, analyze what factors affect them, and how they correlate with the air pollutant measurements. Six air pollutants (SO2, NO2, O3, CO, PM-10 and PM-2.5) measured at eight monitoring stations around Yeosu National Industrial Complex (Seogang-dong, Wolnae-dong, Munsu-dong, Yeocheon-dong, Deokchung-dong, Hwayang-myeon, Yulchon-myeon, Samil-dong) the measurement data for each hour of the year were downloaded to analyze the concentration by weather condition, time zone, season, separation distance from Yeosu Industrial Complex, and separation distance from Gwangyang Industrial Complex. SO2, NO2, and CO concentrations were significantly higher in winter, significantly lower in summer, and O3, PM-10, and PM-2.5 concentrations were significantly higher in spring. SO2, CO, PM-10, and PM-2.5 concentrations were significantly higher between 10 a.m. and 12 p.m., NO2 concentrations were significantly higher between 7 a.m. and 9 a.m., and O3 concentrations were significantly higher between 13 p.m. and 15 p.m.(p<0.001). The concentration of air pollutants (SO2, NO2, CO, PM-10, PM-2.5) excluding O3 was found to have a negative (-) correlation with weather condition, and in the case of O3, it was found to have a positive (+) correlation with PM-10, PM-2.5, temperature and wind speed. It was confirmed that the concentration of air pollutants emitted from the Yeosu National Industrial Complex differs depending on the season, time and distance to the industrial complex. This study aims to establish measures to minimize health damage to residents living relatively close to the industrial complex and contribute to the establishment of management and response measures according to the properties of substances to reduce the concentration of air pollutants in the future.

말기신부전 환자에서 혈액투석 전후의 QT간격분산 비교

강대웅,정지용,윤나라,안치용,김종오,신병철,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Background: Some cases of QT interval, corrected QT interval (QTc), QT dispersion (QTd) and corrected QT dispersion (QTcd) have been reported in ESRD, but these results are variable and the influence of a hemodialysis is still controversial, In this study, we investigated the effect of hemodialysis on QT and QTc interval and QT and QTc dispersion in patients with ESRD 15 min before and 15 minute after each hemodialysis. Methods: Sixty-seven patients with ESRD (men 33 & women 34) on three-times stable hemodialysis (>3 months) were randomly enrolled. Fifty control subjects with a similar age and normal renal function were enrolled from this hospital. Routine biochemical studies were measured pre- and post dialysis, at the time of the ECG. Plasma Na+, K+, BUN, creatinine, ionized calcium and phosphate were checked. Twelve-lead electrocardiographs were performed at 10㎜/mv and 50㎜/s using a HewIett-Packard Pagewriter 100, before and after a single hemodialysis session.The QT interval was measured from the onset of the QRS complex to the end of the T wave. If the end of the T wave was not clear in a particular lead then it was excluded from analysis. When U waves were present, the end of the T wave was taken as the nadir between the T and U waves. Each QT interval was corrected for heart rate using Bazett's formula (QTc==QT/√(RR)) (ms). The difference between maximal and minimal QT interval duration was defined as QT dispersion (QTd) in each of the 12 leads. Result: This study demonstrates that QT, QTd, QTcd is higher in hemodialysis patients compared with control subjects, and QT and QTd rise postdialysis to levels comparable to those seen acutely following myocardial infarction, when patients are at greatly increased risk of potentially fatal ventricular arrhythmias, Conclusions: QT interval and QT dispersion, markers of risk for arrhythmias and sudden death, are elevated in hemodialysis patients, and rise postdialysis. QT interval and QT dispersion is an easily obtainable, noninvasive, simple, inexpensive, and widely available method of risk stratification in uremic patients receiving chronic dialysis. Additional studies are needed to clarity whether increased postdialysis QT dispersion results in an increased occurrence of arrhythmias.

혈액투석중인 말기신부전 환자에서 Fludrocortisone acetate (FCA) 투여 후 혈청 칼륨 저하 효과

류봉관,강대웅,정지용,윤나라,신병철,박경희,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.1

Background: Hyperkalemia is a commonly encountered problem in dialysis patients with end-stage renal disease. In this study we evaluated the effect of mineralocorticoid therapy (fludrocortisono acetate) on serum potassium level in the serum of hyperkalemic end-stage renal disease patients. Methods: Fourteen patients on hemodialysis receiving fludrocortisone acetate (FCA) 0.1 mg/day were observed for 2 months periods. Consecutive monthly biochemical profiles were compared for the druration of the pre-and post-treatment of FCA. Result: Fourteen patients with mean age (±SE) of 51.5 years (4 males and 10 females) and mean hemodialysis period of 51.9 months were studied. Mean serum potassium levels significantly fell (p<0.05) during the post-FCA period (5.2±0.66 mEq/L) compared with potassium levels during the pre-FCA (5.8±0.43 mEq/L) period. Pre-and post-FCA values were not different for sodium, chloride, protein, albumin, AST/ALT, glucose, blood nitrogen, creatinine, phosphate and calcium. Conclusions: FCA appears to decrease serum potassium value in patients with end-stage renal disease. These results suggested that FCA could be effective to treat hyperkalemia without any adverse effect in patients undergoing hemodialysis.

GC-ECD를 이용한 유기염소계 및 Pyrethroid계 농약 동시 분석법

김우성,이선화,김재이,정지윤,이명자,박영채,이영자,정성욱,이봉헌,박흥재 한국환경과학회 2003 한국환경과학회지 Vol.12 No.4

Pesticides were extracted from samples with 70% acetone and methylene chloride in order, and then cleaned up via open-column chromatography apparatus packed with florisil, and finally analyzed simultaneously the organochlorine and pyrethroid pesticides using GC(ECD). An ultra-2 fused silica capillary column was used to separate and identify the products. The resolution between the last isomeric peak of cypermethrin(59.987min) and the first isomeric peak of flucythrinate(60.043min) was not satisfactory. The last isomeric peak of fenvalerate(62.344min) and the first isomeric peak of fluvalinate(62.397min) were overlapped. Recoveries of soybean sample for the most pesticides were 73.3% to 102.4%. Detection limits were between 0.004 and 0.063 ㎍/㎎ when this method was used.

임상가를 위한 외상후 스트레스 장애 척도의 신뢰도, 타당도 연구

이병용,김임,이선미,은헌정,김동인,김지연 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적 : 본 연구의 목적은 임상가를 위한 외상후 스트레스 장애 척도의 신뢰도와 타당도를 알아보고자 하는 것이다. 방 법 : 28명의 PTSD 군, 30명의 Non-PTSD군, 36명의 정상군에 대하여 임상가를 위한 외상후 스트레스 장애 척도를 실시하였다. 면담자간 신뢰도를 평가하기 위하여 10명의 외상후 스트레스 장애 환자를 2명의 검사자가 동시에 평가하였다. 타당도를 평가하기 위하여 모든 피검자들을 대상으로 사건 충격 척도, Beck의 우울 검사, Spielberger의 상태 특성 불안 검사 Ⅰ, Ⅱ를 시행하였다. 결 과 : Cronbach's α와 면담자간 일치도는 각각 .95와 .89였다. 임상가를 위한 외상후 스트레스 장애 척도는 각각 사건 충격 척도(r=.80), Beck의 우울 검사(r=.70), Spielberger의 상태 특성 불안 검사 Ⅱ(r=.56)와 높은 상관을 가지고 있었다. 그러나 Spielberger의 상태 특성 불안 검사 Ⅰ(r=.20)과는 상관을 보이지 않았다. 임상가를 위한 외상후 스트레스 장애 척도는 임상 진단과 82.1%의 일치도를 보였다. 결 론 : 임상가를 위한 외상후 스트레스 장애 척도는 충분한 신뢰도와 타당도를 가지고 있었다. 임상가를 위한 외상후 스트레스 장애 척도는 외상후 스트레스 장애를 진단하기에 유용한 도구라 할 수 있다. Objectives : The purpose of this study was to examine the reliability and validity of A Clinician-Administered PTSD Scale (CAPS). Methods : CAPS was administered to 28 PTSD subjects, 30 non-PTSD subjects, and 36 normal subjects, Interrater reliability for the CAPS was established by interviewing 10 PTSD subjects. The interviews were conducted by 2 interviewers simultaneously. The authors administered to all the subjects Impact of Event Scale(IES), Beck Depression Inventory(BDI), State Trait Anxiety InventoryⅠ, Ⅱ(STAI-I, Ⅱ) for measuring concurrent validity. Results : The value of Cronbach's α and interrater agreement were .95 and .89, respectively. The CAPS was highly correlated with IES(r=.80), BDI(r=.70), STAI-Ⅱ(r=.56). But the CAPS was not correlated with STAI-I(r=.20). The CAPS showed an overall agreement with clinical diagnosis of 82.1%. Conclusions : The CAPS shows a reasonable degree of reliability and validity. The CAPS could be a valuable tool to diagnose PTSD.

정신분열병 또는 정신분열형장애를 가진 입원환자에서 Risperidone과 Olanzapine의 효과의 비교 : 6주간의 개방적 전향적 연구 6 Weeks, Open-Labelled, Prospective Study

김찬우,이동건,강승훈,조지현,이수진,조동환,김정기 대한생물치료정신의학회 2003 생물치료정신의학 Vol.9 No.2

Objectives : Risperidone and olanzapine, which are atypical antipsychotics. are widely used in the treatment of schizophrenia as the 1st line drug, proving their effectiveness for both positive and negative symptoms. They also have many advantages even from the side effects. However, they show differences with the chemical structure and pharmacokinetics and they work differently to receptors. Researchers have studied the effect and side effect during the acute phase of schizophrenia as an open prospective study. Methods : Forty subjects with DSM-IV schizophrenia or schizoaffective patients including 1) 1st onset schizophrenia patient, 2) patient who has been treated by the prior antipsychotics and not improved or even worse to be admitted again, were assigned to receive risperidone or olanzapine for 6 weeks. Psychopathology, adverse effect. weight change, fasting serum glucose, and drug cost were compared within and across groups. Results : After 6 weeks later both treatment groups showed the significant decrease in PANSS positive, general psychopathology and total score while they did not show any significant difference between two groups. Risperidone group, however. showed the significant decrease in PANS negative score, which olanzapine group did not. In terms of adverse effect risperidone group showed more extrapyramidal symptom than olanzapine group. Body weight rised significantly after Gweeks, but no significant difference between two treatment groups. There were no significant indrease of fasting serum glucose level. Conclusions : Risperidone and olanzapine are effective drugs which can be used during the acute phase of schizophrenia. Risperidone is expected to shorten the admission day and remission of the symptom of acute phase, mile olarizapine is more advantage in a neurologic side effect than rispendone.