Dimethylnitrosamine 유발 급성 간 손상 흰쥐에서 ^(99m)Tc-Lactosylated Serum Albumin을 이용한 간 기능의 평가

정신영,이재태,서명랑,유정아,배진호,안병철,황재석,정재민,하정희,이규보 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.6

목적: ^(99m)Tc-lactosylated serum albumin (^(99m)Tc-LSA)은 간세포에 특이적으로 결합하는 간수용체 영상용 방사성의약품으로 새로이 합성되었다. 간섬유화를 유발하는 dimethylnitrosamine (DMN)을 투여한 간 손상 휜쥐 모델에서 ^(99m)Tc-LSa의 역동학적인 간섭취를 조사하고 간효소치의 변화와 조직학적 소견을 비교하여, LSA의 간섭취가 간기능의 변화를 반영하는지를 연구하였다. 대상 및 방법: SD계 흰쥐에 DMN를 27 mg/kg으로 복강 내 주사하여 급성 간손상을 유도하고 대조군과 비교하였다. DMN을 주사한 흰쥐를 3일(DMN-3), 8일(DMN-8), 21일(DMN-21)에 ^(99m)Tc=LSA (1,665 mg/kg) 29 MBq를 정맥 주사하여, 30분 동안 동적 영상을 획득하고 간과 신장부위에 관심영역을 설정하여 간과 심장부위의 시간방사능 곡선을 얻었다. 간기능 평가를 위해 시간방사능 곡선을 이용하여 간섭취지수와 혈중제거지수를 구하였고 곡선 최적화를 시행하였다. DMN 투여군과 대조군의 간효소치의 변화와 간조직의 광학현미경 소견을 비교하였다. 결과: 대조군에서는 ^(99m)Tc-LSA가 빠르게 간에 섭취되고 혈중에서 제거되었으나 DMN을 처리한 군에서는 간섭취가 낮았다. 간섭취지수의 비교에서 대조군에 비해 DMN 처리군에서 유의하게 간섭취지수가 낮았다(DMN-3: 0.842, DMN-8: 0.898, DMN-21: 0.91, 대조군: 0.96, p<0.05). 혈중제거지수의 비교에서도 대조군에 비해 DMN 처리군에서 혈중제거지수가 유의하게 높았다(DMN-3: 0.731, DMN-8: 0.654, DMN-21: 0.604, 대조군: 0.473, p<0.05). 비선형 회귀분석에서 R_(2) 값은 0.9이상으로 좋은 일치를 보였고, 대조군에ㅓ K값이 DMN처리군에 비해 크고(DMN-3: 0.28, DMN-8: 0.41, DMN-21: 0.46, 대조군: 0.97, p<0.05), T_(1/2)값은 작았다(DMN-3: 2.5, DMN-8: 1.7, DMN-21: 1.5, 대조군: 0.7, p<0.05). 간효소치의 변화는 DMN-3군에서는 대조군에 비해 상승하였으나 DMN-8, DMN-21군에서는 간효소치의 상승이 관찰되지 않았다. 간조직 소견의 경우 DMN-3군에서 중심정맥 주위에 괴사가 관찰되었으나 DMN-8군, DMN-21군에서는 미약한 정도의 염증세포 침윤만이 관찰되었다. 결론: ^(99m)Tc-LSA 간신티그래피의 간섭취 정도는 간손상과 반비례하였으며 간섭취의 변화는 조직학적 손상이 심한 정도와 간손상후 회복되는 과정을 반영하여 주었다. ^(99m)Tc-LSA 간신티그래피가 간손상을 평가하고 간손상후 회복되는 과정을 추적하는 간수용체 영상용 방사성 의약품으로 사용될 수 있을 것으로 생각된다. Objects: ^(99m)Tc-lactosylated human serum albumin(LSA) is a newly synthesized radiopharmaceutical that binds to asialoglycoprotein receptors, which are specifically presented on the hepatocyte membrane. Hepatic uptake and blood clearance of LSA were evaluated in rat with acute hepatic injury induced by dimethylnitrosamine(DMN) and results were compared with corresponding findings of liver enzyme profile and these of histologic changes. Materials and Methods: DMN (27 mg/kg) was injected intraperitoneally in Sprague-Dawley rat to induce acute hepatic injury. At 3(DMN-3), 8(DMN-8), and 21(DMN-21) days after injection of DMN, LSA injected intravenously, and dynamic images of the liver and heart were recorded for 30 minutes. Time-activity curves of the heart and liver were generated from regions of interest drawn over liver and heart area. Degree of hepatic uptake and blood clearance of LSA were evaluated with visual interpretation and semiquantitative analysis using parameters (receptor index : LHL3 and index of blood clearance : HH3), analysis of time-activity curve was also performed with curve fitting using Prism program. Results: Visual assessment of LSA images revealed decreased hepatic uptake in DMN treated rat, compared to control group. In semiquantitative analysis, LHL3 was significantly lower in DMN treated rat group than control rat group (DMN-3:0.842, DMN-8: 0.898, DMN-21: 0.91, Control: 0.96, p<0.05), whereas HH3 was significantly higher than control rat group (DMN-3: 0.731, DMN-8: 0.654, DMN-21: 0.604, Control: 0.473, p<0.05). AST and ALT were significantly higher in DMN-3 group than those of control group. Centrilobular necrosis and infiltration of inflammatory cells were most prominent in DMN-3 group, and were decreased over time. Conclusion: The degree of hepatic uptake of LSA was inversely correlated with liver transaminase and degree of histologic liver injury in rat with acute hepatic injury.

자발성 뇌출혈 환자의 일상생활동작 수행에 영향을 미치는 인자

정호중,진기은,박희석 고신대학교 의학부 1996 高神大學校 醫學部 論文集 Vol.11 No.1-2

The Modified Barthel Index (MBI) and the Functional Independence Measure (FIM) have been used widely as evaluating tools for Activities of Daily Living (ADL) of the disabled. To obtain the guideline for the evaluation and planning of rehabilitative management, we performed this study by comparative analysis of MBI and FIM about the factors affecting ADL of the spontaneous intracerebral hemorrhage patients. The mean scores of MBI and FIM were 46.0 and 68.9 at the beginning of rehabilitation therapy, and 75.4 and 94.4 at discharge, respectively. Thus the average scores of improvement of MBI and FIM were 29.5and 25.5, respectively, each of which was statistically significant (p<0.05). The mean FIM score at discharge of the patient group with initial MBI score above 50 was significant higher than that of the group with initial MBI score equal to or below 50 (109.6 versus 85.9, p<0.05). According to the amount of initial intracerebral hemorrhage. MBI and FIM scores at discharge were found significantly different by 20cc (p<0.05). In conclusion. MBI and FIM scores are found to be useful to evaluate the factors affecting ADL in patients with spontaneous ICH.

만성 강박장애 환자의 정서처리 특성 : 정신분열병 환자 및 정상인과의 비교

석정호,김재진,전종희,이홍식,안석균,이은,김찬형 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.3

Objectives : Obsessive compulsive disorder (OCD) tends to take chronic course as schizophrenia. Researchers reported that OC patients had idiosyncratic sensitivity to threat-related information, while schizophrenic patients were reported to have affec-tive blunting. We hypothesized that there might be a difference in emotional response between OCD and SPR in cronic phase. Methods : Eight different emotional tasks were done by 25 healthy controls, 21 OCD patients and 25 SPR patients. Visual stimuli were made by pairing two words or pictures. Four kinds of emotional stimuli (positive, negative, combined and neutral)were presented to subjects through monitor and they were asked to report their subjective feelings by pushing mouse button, In the combined condition, a pair of positive words (or pictures) and negative words (or pictures) were presented simultaneously. The responses and response time were recorded and analyzed using SPSS 9.0 package. Results : In the negative condition, OCD group didn't show any deficit compared to healthy group. But SPR group showed significantly lower appropriate response rate than healthy group, In the combined condition, OCD and healthy control group Showed 'negativity bias' which SPR group didn't show. In the positive condition, however, OCD and SPR groups did show Significantly lower appropriate response rate than healthy controls. Conclusion : Our results suggested that OCD patients may not have deficits in the processing of negative emotion even in the chronic phase but to have a specific deficit in positive emotion. This result supports the 'threat-relatedness hypothesis' on attentional bias of OCD.

췌십이지장절제술 후 결과에 영향을 미치는 인자

정희석,정귀애,장정환,김권천,민영돈,김성환 조선대학교 2003 The Medical Journal of Chosun University Vol.28 No.1

`Background : Pancreatoduodenectomy is a widely used technique in the treatment of periampullary, duodenal and cephalic pancreatic disease. Although many improvements have been made in operative technique and posmiddleerative care, pancreatoduodenectomy remains a technically difficult procedure attended by relatively high morbidity and mortality rates. Materials and methods : The hospital records of 51 patients who underwent pancreatoduodenectomy at the Chosun University Hospital between 1994 and 2001 were reviewed. Clinical data and the following morbidity and mortality were recorded The risk factors were analyzed by a Chi-square test. Results : Fifth decade was the most prevalent ages (43.1%) The mean age was 59 years (ranging from 29 to 78) and the male to female ratio was 26 to 1. The periampullary cancer was the most reason to operation (86%) and injury due to trauma, adenocarcinoma of stomach, colon cancer, chronic pancreatitis in order Posmiddleerative complications were developed in seventeen patients and anastomotic leakage was the most common complication Death within a month after operation was 3 (5.8%) and the one of the cause of death was leakage in two patients, the other cause was intraadbominal bleeding in one patients. The cardiovascular disease, pulomnary problem, diabetes, level of bilirubin were checked preoperatively and showed no statistical difference in the posmiddleerative morbidity. The other factors such as amount of bleeding, operation time were not influencing posmiddleerative complications. The occurrence of leakage in eight cases of drainage tuve inserted into the pancreaticojejunostomy site was not different from no tuve insertion statistically Conclusion: old age of the patients, diabetes mellitus and massive intraoperative hemorrhage are the risk factors influencing the results after pancreatoduodenectomy. Morbidity and mortality after pancreatoduodenctomy can be devreased if a prudent selection of paients is made and the operation is performed by accomplushed surgeon.

자발성 뇌출혈 환자의 일상생활동작 수행에 영향을 미치는 인자

정호중,진기은,박희석 高神大學 醫學部 1996 高神大學醫學部 論文集 Vol.11 No.1-2

Clinical Comparison between the Traditional and Otic Capsule Classification Systems of Temporal Bone Fracture : Clinical Research

정희석 외 중앙대학교 의과대학 의과학연구소 2010 中央醫大誌 Vol.35 No.3/4

The traditional classification system (longitudinal vs. transverse) of temporal bone fractures has limited predictability of complications. Recently, some authors reported that the otic capsule classification system (otic capsule-violated vs. -spared) was better for predicting complications of temporal bone fractures. We made a comparison between the two systems. Between January 2002 and May 2008, 43 cases of temporal bone fracture were included in this study. Using the two classification systems we evaluated the incidence of complications such as conductive hearing loss (CHL), sensorineural hearing loss (SNHL), facial nerve (FN) palsy and cerebrospinal fluid (CSF) leakage, etc. With the traditional system, fractures were classified as longitudinal 19 (44%), transverse 12 (28%), and mixed 12 (28%). With the otic capsule system, 35 (81%) were otic capsule sparing and 8 (19%) were violating. With a comparison of the two systems, patients with otic capsule-violating fractures were 1.4 times more likely to have FN palsy, 2.3 times more likely to have CSF leakage. Especially, SNHL in otic capsule-violating fractures was 5.4 times more common than in otic capsule-sparing (p <0.01). Although the traditional system failed to demonstrate clinical predictability in this study, the otic capsule system demonstrated statistically significant predictive power only for SNHL. Thus, it would be better that both traditional and otic capsule classification systems are applied for predicting the complications of the temporal bone fracture.

플레이트를 이용한 냉간성형 각형강관 T형 접합부에 관한 실험적 연구

석희원,박금성,정상민,조성식,배규웅,문태섭 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

The purpose of this paper is to investigate experimentally the strength and deformation of T-joints to evaluate the structural behavior of truss connection consisted in square hollow steel section with plate. There are the branch plate type in T-joint shapes. Principal parameters are the ratio of the chord width to thickness(2ν=31.3, 22.2, 16.7) and the ratio of branch plate thickness to chord width(βp=0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.75, 0.85). The most important result obtained from this experiment is as follows; The ultimate strength of T-joints increase proportionally as the 2ν ratio decrease, and the βp ratio increase. The others, experimental results are summarized for ultimate strength to displacement, initial stiffness and failure mode of each T-joints.

직장암환자에서 복회음병합절제술(Miles' operation)후 발생한 지속적인 배뇨장애의 치료

박희석,김기찬,정호중 高神大學 醫學部 1998 高神大學醫學部 論文集 Vol.13 No.1-2

경직형 마비성 구어장애자의 장애 정도별 음성 특성

박희정,신혜정,정옥란,석동일 한국음성과학회 2004 음성과학 Vol.11 No.4

Spastic dysarthria is a motor speech disorder produced by a damage to the direct (pyramidal) and indirect (extrapyramidal) pathways of the central nervous system. This study attempted to determine the influences of the severity of spastic dysarthria on the stability of voice. A sustained /a/, /a/ produced at the beginning of a sentence and at the end of the sentence were analyzed. The Praat 4.0.51 was used for analysis. The results showed a significant difference between the severe spastic dysarthric group and normal group matched by age and sex at the beginning and the end of the sentence. In addition, the severe group showed a significant difference between the first /a/ and the second /a/ at the end of sentence.

정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구

조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.