호산구성 간농양 54예의 임상상

강혜련,권혁수,송우정,이상민,김태범,박혜경,장윤석,김윤근,조상헌,민경업,김유영 대한알레르기학회 2004 천식 및 알레르기 Vol.24 No.2

알코올 금단 섬망 발생의 예측

이충헌,이은,박성혁,정승용,박상진,석정호,남궁기 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : Alcohol withdrawal delirium is a serious clinical condition with high mortality rate if not treated. This study was to examine whether readily available clinical variables can predict the development of alcohol withdrawal delirium. Methods : The authors performed a retrospective study by reviewing charts of 566 patients who had been admitted for alcohol dependence. The cases were divided into two groups: delirium group (n=40) and control group (n=40). We compared baseline characteristics and serum analysis data at admission between two groups. We used logistic regression to predict risk factors for alcohol withdrawal delirium among potential risk factors. Results : The delirium group had significantly lower hemoglobin, hematocht, platelet counts, and potassium level than countrol group, Presence of previous withdrawal delirium history, AST, GGTP, and bilimbin level of delirium group were significantly higher than those of control group. Among potential risk factors, past history of withdrawal delirium, decreased hemoglobin, elevated bilirubin level, and number of previous detoxification were predictable factors of the development of alcohol withdrawal delirium by 72.5%. Conclusion : Our results suggest that the infomation obtained at admission can be useful to predict the development of al-cobol withdrawal delirium. Also, it makes the individualization of detoxification strategies possible.

정서 사진에 대한 정서 반응성 : 평가 공간에서의 분포

이은,강지인,박성혁,전종희,최재혁,김재진,안석균 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.1

Objectives : To investigate the nature of emotional responsiveness in norma) adults, we exam the emotional responses to emotional pictures in an evaluative space defined by arousal and valence. Methods : Subjects were instructed to rate the arousal and valence that they experienced from the presentation of one of two sets of 60 emotional pictures. These two picture sets were comprised of 107 pictures : 101 selected from Intetnational Affective Pictures System and six pictures from our own collection. According to "evaluative space model", the authors set an evaluative space defined by the arousal scores as independent variable and the valence scores as dependent variable. In this evaluative space, one-hundred-and-seven pairs of coordinates representing respective emotional pictures were plotted. With regression analyses, the steepness of the regression lines on the plots with positive emotional responsiveness (n=51) and those with negative emotional responsiveness (n=56) were compared. Results : In the evaluative space, the regression line of negative emotional responsiveness was significantly different from that of positive responsiveness. The slope of negative responsiviveness was significantly steeper than that of positive responsiveness. At a low arousal level, the absolute valence of a positive stimuli was larger than that of a negative picture. Conclusion : This finding indicates that the function of the negative affective responsiveness might be different from that of the positive responsitiveness. IAPS also seems applicable to Korean subjects.

한국어판 정신분열병 삶의 질 척도의 개발과 PANSS와의 관련성

김진훈,임선진,민성길,김승업,손소정,Diane J Wild,박성혁,이황빈 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.5

Objectives : The present study was performed to verify the validity and value of 4th revision of Schizophrenia Quality of Life Scale (SQLS-R4) as an assessment tool in a Korean-language version (SQLS-R4K). Methods : The subjects for present study were 174 patients with a diagnosis of schizophrenia as defined by DSM-IV. The SQLS-R4K was administered together with self-report Korean version of World Health Organization Quality of Life-Brief Scale(WHOQOL-BREF) to assess validity. A subset of respondents also completed the SQLS-R4K for a second time to assess test-retest reliability. To evaluate the relationship SQLS-R4K and clinical characteristics, psychotic symptoms and general functioning were evaluated using the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning Scale (GAF) score respectively. Results : All the scales of SQLS-R4K showed good internal consistency reliability. The correlations of items with their scale total revealed that all items were significantly correlated with their own scale score. In test-retest reliability, paired t-tests indicated that responses did not alter significantly between the two assessment. There was moderate correlation between WHOQOL-BREF sub-scores and SQLS-R4K score total. Also relevant correlations between PANSS, current GAF and SQLS-R4K were proved. Conclusion : From the results of the testing the reliability and validity of the SQLS-R4K, it is concluded that the SQLS-R4K is a simple and reliable scale for measuring quality of life in schizophrenic patients.

한국인 강박장애와 Val-158-Met Catechol-O-Methyltransferase 유전자 다형성 간의 상관성 연구

천근아,김세주,김찬형,구민성,남윤영,박성혁,이홍식 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.5

목적 COMT(Catechol-O-Methyltransferase) 효소는 도파민성과 노어아드레날린성 체계의 조절에서 매우 중요한 작용을 하며 염색제 22q11에 위치해 있다. 일부의 강박장애 환자들은 도파민 차단제에 좋은 치료 반응을 보이며 이런 현상은 COMT가 강박장애의 병인론에 역할을 하고 있을 가능성을 말해준다. Val-158-Met COMT 유전자의 다형성은 효소의 감소를 유도하는 L(저활성) 대림형질, 활성의 증가를 유발하는 H(고활성) 대립형질로 알려져 있으며 L 대립형질 또는 LL 유전형이 강박장애와 연관이 있다는 보고가 있으나, 아직까지 강박장애와 COMT 다형성 사이의 연관성에 대한 연구결과들은 일관되지 않다. 따라서 본 연구에서는 한국인 강박장애 환자들을 대상으로 Val-158-Met COMT 유전자의 다형성과의 연관성을 알아보고자 하였다. 방법 2002년 3월부터 2004년도 2월까지 약 24개월동안 서울지역 일 대학병원과 경기지역 일 대학병원 강박장애 클리닉을 방문하여 강박장애로 진단받은 124명의 환자들을 연구대상으로 하였고 정상 대조군으로는 나이와 성별을 고려하여 자원자 170명이 선별되어 포함되었다. 강박장애군과 정상 대조군의 혈액으로부터 유전자 추출 후 COMT 유전자 형벌 (genotyping)을 시행하였다. 다형성을 H/H 와 H/L, L/L 유전형으로 나눈 뒤 강박장애와 정상대조군 사이의 유전자 빈도를 카이 검정법으로 비교하여 연관성을 관찰하었다. 또한 강박장애 환자들에게 시행한 YBOCS로부터 측정한 강박장애 심각도 및 Hamilton Depression Raing Scale (HDRS) 총점과 COMT 유전자 다형성 사이의 연관성을 비교하였다. 결과 본 연구 결과 한국인 강박장애와 COMT 다형성 간에는 유의한 상관성이 관찰되지 않았다. YBOCS 심각도와 COMT 유전자형과의 유의한 연관성이 관찰되지 않았다. 그러나, 강박장애 환자군들의 COMT 유전자형 세 군 사이의 우울증상 점수에서는 유의한 차이가 관찰되었다. 결론 한국인에서 강박장애와 COMT 유전자 다형성 사이에는 연관성이 없었다. 그러나, COMT의 H 대립형질과 강박장애 군에서 공존하는 우울증상 척도가 유의한 연관성을 보인 현상은 COMT 유전자의 다형성이 강박장애의 공존 우울증상에 영향을 미칠 수 있는 가능성을 시사한다고 생각된다. Objectives : The definite cause of obsessive-compulsive disorder (OCD) is still unknown. Evidences from familial, twin and segregation studies support the role of a genetic factor. There are also growing evidence indicating that OCD has specific neurochemical and neuroanatomical basis. Derived from the effectiveness of treatment with dopamine receptor blocker in certain part of OCD patients (eg. SSRI treatment-resistant OCD), several candidate genes related to dopamine dysregulation have been hypothesized to play an important role in the development of OCD. One of them is the Catechol-O-Methyltransferase (COMT) gene. The aim of this study was to investigate the association between COMT and OCD in Korean population. Methods : 124 OCD patients and 170 normal controls participated in this study. Genomic DNA was extracted from their blood. The genotypes and allele frequencies of the COMT polymorphism between OCD group and control group were compared. We investigated the association between severity of OCD assessed by Yale-Brown obsessive compulsive symptom scale (YBOCS) and Hamilton depression rating scale (HDRS) scores and COMT polymorphism. Results : In this case-control study, we could not find any association between COMT gene polymorphism and development of OCD. In OCD group, patients with H/H genotype had significantly higher scores for the HDRS than those with H/L or L/L genotype. Conclusion : In this study, there was no difference in genotype distributions of COMT between OCD and control groups. However, H/H genotype of COMT gene polymorphism might be related to depressive symptoms in OCD patients.

The Results of B-scan Ultrasonography in Different Positions after Vitrectomy and Gas Tamponade

( Sang Hyouk Park ),( Sung Jin Lee ) 대한안과학회 2007 Korean Journal of Ophthalmology Vol.21 No.2

Purpose: To determine the proper time frame in which to assess retinal attachment status and to evaluate the superior retinal attachment status by performing B-scan ultrasonography in different positions on patients who have undergone pars plana vitrectomy and gas tamoponade. Methods: In this prospective study, 23 patients (23 eyes) who had undergone pars plana vitrectomy and gas tamponade were investigated between June 2005 and February 2006. SF6 (18%) was injected into the vitreous cavity of 15 eyes, and C3F8 (14%) was injected into the vitreous cavity of 8 eyes. At postoperative day 1, day 3, week 1, week 2, and week 4, B-scan ultrasonography was performed in the supine, sitting, prone, right decubitus, and left decubitus positions. Results: The proper time to evaluate the retinal attachment status was three days post-operatively in 10 eyes (66.7%) with SF6 (18%) injections and two weeks post-operatively in six eyes (75%) that had C3F8 (14%) injections. The superior retinal attachment status can be evaluated from the summation of B-scan ultrasonography results performed in the right decubitus and left ducubitus positions. Conclusions: The proper time to evaluate the retinal attachment status was related to the degree of the gas absorption when performing B-scan ultrasonography after pars plana vitrectomy and gas tamponade. To evaluate the entire retina, it is useful to perform B-scan ultrasonograhy in the prone, right decubitus and left decubitus positions. Korean Journal of Ophthalmology 21(2):100-105, 2007

Correlation between the Korean Version of Asthma Control Test and Health-Related Quality of Life in Adult Asthmatics

Kwon, Hyouk-Soo,Lee, So-Hee,Yang, Min-Suk,Lee, Sang-Min,Kim, Sae-Hoon,Kim, Deok-In,Sohn, Seong-Wook,Park, Chang-Han,Park, Heung-Woo,Kim, Sun-Sin,Cho, Sang-Heon,Min, Kyung-Up,Kim, You-Young,Chang, Yoon The Korean Academy of Medical Sciences 2008 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.23 No.4

<P>The Asthma Control Test (ACT) is a patient-completed questionnaire developed to assess asthma control. Health-related quality of life (HRQL) in asthmatics has shown relatively low correlations with parameters of asthma control and the relationship between the ACT and HRQL in asthmatics is yet unclear. Because revalidations of translated versions of questionnaires are critical for its utilization, we first sought to validate the Korean version of ACT and then to evaluate the relationship between the ACT and HRQL. Patients (n=117) completed the ACT and asthma-related quality of life questionnaire (AQLQ) at 3 physician visits. Pulmonary function was measured and an asthma specialist rated asthma control. The Korean version of ACT was found to be reliable, valid, and responsive to changes in asthma control over time up to three consecutive visits. ACT scores correlated significantly (<I>p</I>=0.001) with symptoms domain (r=0.72), activity domain (r=0.65), emotional domain (r=0.69), and environmental domain (r=0.67) of AQLQ. In conclusion, the Korean version of the ACT was found to be a reliable and valid tool for measuring asthma control, and to correlate well with AQLQ scores. Moreover, the ACT was responsive to changes in AQLQ scores over time.</P>

Sensitization of allergen with LPS via intranasal route and following allergen challenge Increases AHR and induces severe airway and Lung parenchymal inflammation

Hyouk Soo Kwon,Hye Kyung Park,Tae Bum Kim,Sung Gyu Jeon,Soo Yeon Lee,Kyoung Mook Kim,Yoon Seok Chang,Yoon Keun Kim,Sang Heon Cho,Kyung Up Min,You Young Kim 대한내과학회 2004 대한내과학회 추계학술대회 Vol.2004 No.1

골시멘트를 사용하지 않는 고관절 전치환술에서 미세 포말형 비구컵의 폴리에틸렌 라이너의 마모에 대한 연구

박상원,우경조,이규혁 고려대학교 의과대학 1997 고려대 의대 잡지 Vol.34 No.2

The debris of polyethylene liner in the acetabular cup is considered to be one of the important reasons for osteolysis and thus loss of fixation and later failure of total hip arthroplasty. The purpose of this study was to measure amount and rate of linear wear of the polyethylene liner of the porous-coated acetabular cup in cementless total hip arthroplsty. The authors devided the 101 cases into two groups according to with or without wear of polyethylene liner; Group Ⅰ (no wear group) and Group Ⅱ (wear group). The follow-up period was ranged from 24 months to 96 months, the average being 34.8 months in Group Ⅰ and 41.2 months in Group Ⅱ. The amount and rate of linear wear of the polyethylene liner in porous-coated acetabular cup were determined by a comparision of the thicknesses of the acetabular cup as measured on the postoperative two weeks and most recent follow-up radiographs. The measurements were corrected for radiographic magnification error by direct measurement of the femoral head diameter of the 28 mm on each radiographs. The patients in two groups to be matched for age, sex, body weight, size of the acetabular cup, duration of the follow-up, Harris hip score and degree of the osteolysis were analysed. The results obtained were as follows; 1. Sixty eight cases(67.3%) were wear of the polyethylene liner and 33 cases(32.7%) were not wear of the polyethylene liner 2. The linear wear were averaged 0.38±0.17mm(range, zero to 1.68) over-all, with a mean rate 0.13±0.09mm (range, zero to 0.84) per year. 3. The linear wear of group Ⅱ(wear group) were averaged 0.57±0.39mm, with 0.2±0.16mm per year. 4. The amount and rate of linear wear of the polyethylene liner of the acetabular cup has positive correlation with incidence of the osteolysis, duration of the follow-up and under 49 years of the age. 5. There was no relationship with the sex, body weight, size of the acetabular cup and Harris hip score. 6. The frequency of the osteolysis were higher in the femoral side than the acetabular side, with higher wear rate of the polyethylene liner. Because the rate of wear of the polyethylene liner is higher in younger age group, these patients should be followed more closely to mimimize the late complications, such as osteolysis and failure of total hip arthroplasty following to excessive wear of polyethylene liner.

고령의 대퇴경부 골절에 시행한 골시멘트를 이용한 이극성 반치환성형술

박상원,변영수,이규혁,김종원 대한골절학회 1997 대한골절학회지 Vol.10 No.3

Elderly patients with femoral neck fracture often have other medical diseases, poor bone quality and poor compliance which make it more difficult to obtain satisfactory results after internal fixation. Therefore, prosthetic replacement is accepted as an appropriate treatment for elderly patients. The purpose of this study was to analize clinical results of cemented bipolar hemiarthroplasty in the femoral neck fractures of elderly patients. The authors analyzed thrity-seven patients with 38 fractures of the femoral neck older than 65 years of age who were treated with cemented bipolar hemiarthroplasty from Jan. 1991 to Dec. 1995. The average follow-up period was three years, ranged from one to five years. The functional results were evaluated according to the criteria of the Hams hip score. The results obtained were as follows: 1. The average Harris hip score was 84.6 points. ranged from 61 to 97 points. 2. The average pain score was 40.3 points. Twelve cases did not complain of pain, slight pain in 26 cases and mild pain in 2 cases. 3. The average limping gait score was 8.9 points. Twelve cases had no limping gait, slight limping in 25 cases and moderate limping in one case. 4. The average support score was 8.4 points. Seventeen cases could be walked without support, sixteen cases did use cane for long walk, two cases did use cane at full time, and three cases did use crutch. 5. Intraoperative complications were partial fracture of greater trochanter in 2 cases and one nondisplaced calcar fracture. 6. Postoperative complications were heterotopie ossification in 2 cases, dislocation of bipolar cup with proximal migration in 1 case and ipsilateral femur fracture below the tip of femoral stem in 1 case. Above results suggest that the cemented bipolar hemiarthroplasty for femoral neck fracture in elderly patients appears to be a method of treatment better than internal fixation for early ambulation and functional recovery.