정신보건관련시설 입원(소)자의 주요 정신장애 유병률 : 전국 20개 시설의 입원(소)자를 대상으로

조성진,조맹제,서동우,함봉진,홍진표,배재남,이준영,이동우,박종익,전홍진,김성주,김용익 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.6

Objectives : One of the objectives of this study is to estimate the prevalence rates of psychiatric diagnoses in the combined populations of psychiatric hospitals, psychiatric nursing facilities and homeless asylums using the Korean version of the Composite International Diagnostic Interview (K-CIDI), which is a comprehensive and fully standardized interview schedule to assess psychiatric disorders for diagnosis. The Other objective is to compare with previously studied prevalence rates of Psy-chiatric diagnoses using the results of this study. Methods : The study subjects, aged from 181o 64 years, were randomly selected from 64,582 institutionalized population of psychiatric hospitals, Psychiatric nursing facilities and homeless asylums as of 30, June, 2001. Twelve trained interviewers administered the K-CIDI to the selected respondents. A total of 1,875 respondents (male 1,194, female 681) completed the interview. Results : The lifetime and one year prevalences of any diagnosis excluding nicotine dependence · withdrawal, anxiety disorder, eating disorder, somatoform disorder were 88.2% (male 88.1%, female 88.3%), and 65.8% (male 62.7%, female 73.7%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were 78.5% (male 75.3%, female 83.7%), and 56.8% (male 51.9%, female 64.8%), respectively. The lifetime and one year prevalences of alcohol use disorder (dependence/abuse) were 26.7% (male 37.9%, female 8.3%), and 8.7% (male 12.8%, female 2.1%), respectively. The lifetime and one year prevalences of mood disorder were 18.1% (male 13.5%, female 25.8%), and 10.4% (male 7.2%,female 16.9%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were comparable with the 2001 community survey by 1.19% to 1.32%, and 0.51% to 0.61%, respectively. The lifetime and one year prevalences of schizophrenia were also comparable by 0.16% to 0.28%, and 0.16% to 0.25%, respectively. There were no significant changes of prevalence rates when correction were applied to other psychiatric diagnosis. Conclusion : The results of this study could be used for evaluating the distribution of psychiatric diagnoses in mental health related facilities and for planning mental health policies.

Methylation Status and Expression of E-cadherin in Oral Squamous Cell Carcinomas Compared to Benign Oral Epithelial Lesions

Son, Hyun-Jin,Chu, Jung-Youb,Cho, Eui-Sic,Lee, Dong-Geun,Min, Myung-Gee,Lee, Suk-Keun,Cho, Nam-Pyo The Korean Academy of Oral Biology 2006 International Journal of Oral Biology Vol.31 No.2

Expression of invasion/metastasis suppressor, E-cadherin, is reduced in many types of human carcinomas. Although somatic and germline utations in the CDH1, which encodes the human E-cadherin, have frequently been reported in cases with diffuse gastric and lobular breast ancers, irreversible genetic inactivations are rare in other human carcinomas. Recently, it has been well documented that some genes in human cancers may be inactivated by altered CpG methylation. Herein, we determined the expression and methylation status of E-cadherin in oral squamous cell carcinoma (SCC) by immunohistochemistry and methylation-specific PCR. The expression of E-cadherin was significantly higher in the well-differentiated oral SCCs than the moderately or poorly differentiated ones. None of eight tested benign pithelial hyperplasias showed aberrant methylation, whereas five of 12 oral squamous cell carcinomas showed aberrant methylation. When we compared E-cadherin expression with methylation status, oral SCCs with normal methylation showed a higher expression of E-cadherin than those with methylation. These findings suggest that aberrant CpG methylation of CDH1 promoter region is closely associated with transcriptional inactivation and might be involved in tumor progression of the oral mucosa.

한국어판 Composite International Dianostic Interview(K-CIDI)의 개발

조맹제,함봉진,서동우,홍진표,배재남,김장규,이동우,조성진 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.1

연구목적 : 본 연구는 국제적인 정신장애 진단도구인 Composite International Diagnostic Interview(CIDI)를 한국의 사회문화적 상황에 적합하게 번역하고 신뢰도 및 타당도를 평가하여 한국어판으로 개발하기 위한 것이다. 방 법 : CIDI는 정신장애를 평가하고 진단할 수 있는 포괄적이고, 완전히 표준화된 진단도구로 훈련받은 일반인들이 적용할 수 있기 때문에 대규모 역학조사에 적합하다. 세계보건기구에서 제공하는 CIDI 번역 지침에 따라 한국어판 CIDI(K-CIDI)를 제작하였다. 영어권과 한국의 언어 및 사회문화적 차이를 고려하여 번역 및 개정을 하였고 역번역을 통하여 원본의 의미와 일치하는지를 확인하였다. 임상환자를 135명과 일반인 5명을 대상으로 신뢰도와 타당도 검사를 실시하였다. 두 명의 평가자가 K-CIDI를 이용하여 동일한 대상자를 동시에 면담하고 일주일 뒤에 재검사를 실시하였다. K-CIDI로 검사를 받은 대상자들을 정신과 전공의와 임상심리사가 한국어판 Structured Clinical Interview for DSM-Ⅳ를 이용하여 진단을 내렸다. 두 가지 진단의 일치도에 대한 kappa값을 산출하였다. 결 과 : CIDI의 번역에서 한국어 표현이 복잡하고 긴 문항은 두 개의 문장으로 분리하였고, 성과 관련된 표현과 의료체계 및 의료추구행태에서 사회문화적 차이를 반영하였다. 공포장애의 대상과 알코올 및 물질의 종류도 한국의 실정에 맞게 조정하였다. 현장 검사와 역번역 과정에서 K-CIDI가 적절하게 제작된 것으로 평가되었다. K-CIDI의 평가자간 신뢰도 검사는 140명에 대하여 이루어졌고 kappa값은 진단에 따라 0.86∼1.00범위였다. 검사/재검사 신뢰도 검사는 47명에 대해 이루어졌고 kappa값은 진단에 따라 0.42∼0.89였다. K-CIDI의 타당도 검사는 50명에 대해 이루어졌고 kappa값이 진단에 따라 0.50∼1.00의 범위였다. 결 론 : K-CIDI는 한국의 사회 문화적 배경에 적합하게 제작되었고 신뢰도 및 타당도 검사에서 역학연구에 적절한 진단도구로 평가되었다. Objectives : This study aims to develop a Korean version of the Composite International Diagnostic Interview(K-CIDI). Methods : The Composite International Diagnostic Interview(CIDI) is a comprehensive, fully standardized interview that can be used to assess psychiatric disorders and provide diagnoses. The K-CIDI was developed according to the guidelines provided by the WHO. The reliability and validity of the K-CIDI was evaluated by examining 135 psychiatric patients and five community residents. Subjects were jointly interviewed twice with a one-week interval. A psychiatric resident and clinical psychologist jointly determined clinical diagnoses using the Structured Clinical Interview for DSM-Ⅳ. Results : Notable modifications were done on sex-related expression, health system and help seeking behavior, subjects for phobic disorder, and kinds of alcohol and substance. Long and complex questions were divided into two or more questions. Field test and back-translation of the K-CIDI confirmed the appropriateness of the translation of the CIDI. The inter-rater reliability, test/retest reliability, and validity of the K-CIDI indicated kappa values ranging from 0.86-1.00, 0.42-0.89, and 0.50-1.00, respectively. Conclusion : The K-CIDI was deemed to be appropriate for the sociocultural background of Koreans. The reliability and validity of the K-CIDI were judged to be exceptionally acceptable.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

소아의 Adenovirus 호흡기 감염증

표진원,이환종 대한감염학회 1996 감염 Vol.28 No.6

목적 : Adenovirus는 항원성에 따라 42가지 이상의 혈청형이 알려져 있으며, 소아 호흡기 감염의 중요한 병원체의 하나이나, 국내에서는 이에 대한 보고가 아직 없다. 이에 저자들은 비 흡인물(nasal aspirate)에서 임상 양상 및 adenovirus가 분리된 호흡기 감염증 환아들의 임상 양상 및 adenovirus의 혈청형을 분석하여 향후 이 질환의 진단과 치료 및 예방에 도움이 되고자 하였다. 방법 : 1990년 12월부터 1995년 3월까지 호흡기 감염 증상을 주소로 서울대학교 소아병원 소아과에 내원한 환아들의 비 흡인물을 채취하여 단클론 항체를 이용한 면역 형광염색법 및 HEp-2세포를 이용한 바이러스는 적혈구 응집억제 시험으로 혈청형을 결정하였다. Adenovirus가 분리된 59례 중 다른 바이러스와 중복 감염이었던 8례를 제외한 나머지 중 의무기록을 확인할 수 있었던 34명의 환아들의 병록을 고찰하여 그 임상 양상을 분석하였다. 결과 : 34례의 검체 중 23례에서 adenovirus의 혈청형이 확인되었던 바, 2형(8례), 3형(6례), 4형(3례), 5형(3례), 6형(2례) 및 1형(1례) 등이 확인되었다. 연구 기간 중 특별한 유행없이 산발적으로 발생하였고, 환아들의 연령은 6개월에서 5세사이가 23례(67.6%)로 가장 많았다. 임상양상은 폐렴이 23례(67.6%)로 가장 많았고, 모세기관지염이 6례(17.6%), 급성 기관지염이 3례(8.8%), croup과 인두결막열이 각각 1례(2.9%)씩 이었다. 선행 각 질환이 없었던 30명의 환아 중 25명에서 간 기능검사를 시행한 바, 17례(68.0%)에서 간 기능이상을 보였으나 선천성 심질환 등의 선행 질환이 없었던 경우 후유증 없이 정상으로 회복되었다. 폐렴의 흉부 X선 소견은 폐나 폐문주위의 침윤, 과환기, 기관지 공기조영, 흉막 삼출 등의 다양한 형태로 나타났다. 총 34명의 환아 중 3명(8.8%)이 사망하였으며, 2명은 복합성 심장기형이 있었고, 1례는 선천성 갑상선 기능 저하증 환아로 만성 설사를 하고 있었다. 결론 : 이상의 결과에서 adenovirus는 소아 호흡기 감염의 중요한 원인의 하나로서, 주로 6개월에서 5세 사이의 소아에서 시만 호흡기 감염을 일으킬 수 있으며, 특히 선천성 심질환이나 면역 기능이 저하된 환아의 경우는 사망과도 연관되어 있었다. 향후 이에 대한 진단과 치료뿐만 아니라 예방에 대한 연구를 더욱 진행시켜야 할 것으로 사료된다. Background : Adenovirus is an important cause of respiratory tract infections in children and more than 42 serotypes have been recovered from humans. The reports on adenoviral respiratory tract infections of Korean children has not been reported previously. This study was performed to characterize the clinical feature of adenoviral respiratory infection and establish the serotypes of adenovirus isolated from Korean children. Methods : Thirty-four cases of respiratory tract infections associated with isolation of adenovirus from nasal aspirates were reviewed retrospectively. The patients were seen at the Seoul National University Children's Hospital during the period from Dec., 1990 to Mar., 1995. Adenoviruses were isolated in HEp-2 cell culture, and serotyped by hemagglutination-inhibition test. Results : During the study period, adenoviruses were isolated from 59 out of 1,032 episodes of respiratory tract infections. Thirty four cases were reviewed, excluding 8 with mixed infection with other viruses and 17 whose medical records were not available. Of 23 cases serotyped, type 2(8 cases), 3(6 cases), 4(3 cases), 5(3 cases), 6(2 cases) and 1(1 case) were identified. Adenoviruses were isolated sporadically throughout the year without any specific epidemic pattern. Sixty-eight percent of patients were between 6 months and 5 years of age. The spectrum of clinical diagnosis was broad such as pneumonia(67.6%), acute bronchiolitis(13.6%), acute tracheobronchitis(8.8%), croup(2.9%) and pharyngoconjunctival fever(2.9%). Associated symptoms included cough(97.1%), fever(91.2%), sputum(73.5%), rhinorrhea(55.9%), tachypnea(52.9%) and dyspnea(44.1%). Gastrointestinal symptoms such as vomiting and diarrhea in conjunction with respiratory infection also occurred frequently. Conjunctival injection was found in 23.5% of 34 cases. Seventeen (68.0%) of 25 cases without underlying liver disease had elevated liver enzymes such as AST and ALT. Nine cases required oxygen therapy for 1-11 days(mean 6.4 days). Three cases(8.8%) expired, 2 of whom had underlying complex heart disease and one had congenital hypothyroidism with chronic diarrhea. Conclusion : These data confirm that adenovirus is an important cause of respiratory tract infection in pediatric age, and suggest that adenovirus may cause rather severe disease with occasional fatal outcome in the immunocompromised children. Further studies on adenoviral respiratory tract infection are needed to diagnose, treat and prevent this illness.

민간 체육시설 이용자의 만족도에 관한 연구

진중의,김진표,손영학 龍仁大學校 體育科學硏究所 2002 體育科學硏究論叢 Vol.12 No.1

The purpose of this study is on examining closely and precisely the correlations between the realities with using sporting centers and satisfaction of people using them. Firstly, in order to achieve that purpose, I have analyzed the differences in people's satisfaction that are caused by characteristics of the Population Statistics. Then I have studied about effects of realities on people using the sporting centers to the satisfaction. In this research, some health clubs in Teagu have been focused on the frame to be required. I picked 250 people randomly first but excluded 67 people who have been considered as being answered with insincerity or have been omitted due to insufficiency on the final questionnaire, which means finally 193 people were completely answered. This study includes totally 42 questions that are made up of 4 Population statistical questions about tools used as assessments, 3 questions about causes of the realities of sporting activities, and 35 questions about causes of the satisfaction rate by using some analyzing methodologies that are used, such as the frequency analytics, t-test, One way anova, scheffe's post-inspection, interrelationship analytics, regression analytics, and so on. Could get some meaningful results like following with using those methodologies mentioned before. Firstly, I could find out meaningful differences between different categories, amongst the Population Statistics characteristics in people using the sport centers, that were leader's ages, equipment satisfaction differentiated by the standards of education in the sporting programs, equipment satisfaction in the leader's different wages, and so on. Secondly, in the lower leveled realities causes, the equipment satisfaction has been revealed statistically around 5%(actually 8.1%) in frequency of participation whereas the programs have been indicated approximately 5%(actually 7.0%) in the term of participation.

동적 도통각 제어에 의한 SRM의 안정운전에 관한 연구

표성영,최태완,안진우 慶星大學校 1998 論文集 Vol.19 No.2

치수 치근단 병소의 전구 위험요인으로서의 제 2 형 당뇨의 역할에 관한 소고

김진희,배광식,서덕규,홍성태,이윤,홍삼표,금기연 大韓齒科保存學會 2009 Restorative Dentistry & Endodontics Vol.34 No.3

Diabetes Mellitus (DM) is a syndrome accompanied with the abnormal secretion or function of insulin, a hormone that plays a vital role in controlling the blood glucose level (BGL). Type 1 and 2 DM are most common form and the prevalence of the latter is recently increasing. The aim of this article was to assess whet her Type 2 DM could act as a predisposing risk factor on the pulpo-periapical pathogenesis. Previous literature on the pathologic changes of blood vessels in DM was thoroughly reviewed. Furthermore, a histopathologic analysis of artificially-induced periapical specimens obtained from Type 2 diabetic and DM-resistant rats was compared. Histopathologic results demonstrate that the size of periapical bone destruction was larger and the degree of pulpal inflammation was more severe in diabetic rats, indicating that Type 2 DM itself can be a predisposing risk factor that makes the host more susceptible to pulpal infection. The possible reasons may be that in diabetic state the lumen of pulpal blood vessels are thickened by atheromatous deposits, and microcirculation is hindered. The function of polymorphonuclear leukocyte is also impaired and the migration of immune cells is blocked. leading to increased chance of pulpal infection. Also, lack of collateral circulation of pulpal blood vessels makes the pulp more susceptible to infection. These decrease the regeneration capacity of pulpal cells or tissues, delaying the healing process. Therefore, when restorative treatment is needed in Type 2 DM patients, dentists should minimize irritation to the pulpal tissue under control of BGL. 당뇨(Diabetes Mellitus)란 혈당을 조절하는 인슐린의 분비나 기능에 장애를 야기하는 질환으로 인슐린 의존성 여부에 따라 제 1 형과 제 2 형으로 분류된다. 본 종설은 최근 증가 추세에 있는 제 2 형 당뇨가 치수 치근단 병소의 병인 과정에 전구 위험 요인으로 작용할 수 있는지를 평가 하고자 문헌고찰을 통해 당뇨의 병인 과정에서 특징적으로 나타나는 혈관 합병증에 관해 알아보고, 부가적으로 제 2 형 당뇨 쥐 모델에서 인위적인 치수감염 후 얻은 치근단 조직의 조직병리학적 분석을 시행하였다. 조직학적 관찰 결과 제 2 형 당뇨 쥐에서 대조군에 비해 치수 치근단 병소의 크기가 증가하였고, 치수 염증 반응도 심하게 나타난 것으로 보아 당뇨 자체가 숙주를 감염에 취약한 상태로 만드는 전구 위험요소로 작용하였음을 알 수 있었다. 이러한 이유로는 첫째, 당뇨 시 전반적으로 나타나는 혈관 내 죽상 침착(atheromatous deposits)에 의해 혈관 내벽의 두께가 두꺼워져 미세 순환의 장애는 물론 탐식 세포의 기능 저하, 면역 세포의 혈류 이동이 차단되어 치수 감염 시 쉽게 치근단 병소로 이환될 가능성이 높고, 둘째 치수 혈관에서 특징인 측부 순환(collateral circulation)의 부재에 따른 살균성 다형핵 백혈구의 활동 억제를 포함한 미세 혈관계의 취약성으로 인해 치수 조직의 재생능이 저하되어 추가적인 감염원의 공격에 대한 방어 및 치유 저하를 더욱 심화시키기 때문인 것으로 사료된다. 따라서 제 2 형 당뇨 환자의 수복치료 시 치과의사는 당뇨 조절 하에서 치수 조직의 자극을 최소화하기 위한 세심한 처치가 필요하다.

腦轉移巢에서 組織診으로 確定된 Friedman 反應 陰性을 呈한 絨毛上皮腫의 一例

李豹鎭,李台鎬,李東植,張炳國 경북대학교 의학연구소 1964 慶北醫大誌 Vol.5 No.1

Mctastatic brain tumor in a case of choriocarcinoma with negative Friedman reaction has been experienced. There have been a few reports on such negative Friedman reaction in cases of choriocarcinoma. A review from some literatures concerning the matastatic choriocarcinoma in relation to Friedman reaction is discussed.