서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

DNA 감지를 위한 MOSFET형 전하검출센서의 제작 및 특성

정용택,김동선,류홍근,박혜정,신장규,최평,이종현,임근배 경북대학교 센서기술연구소 2002 센서技術學術大會論文集 Vol.13 No.1

정신병적 증상이 동반된 기면병 1예

홍승철,송정민,정종현,권용실,한진희,이성필 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.5

Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations and disrupted nocturnal sleep. We report a patient with a diagnosis of schizophrenia who was subsequently diagnosed as narcolepsy. A case of a 22-year-old woman with concomitant narcolepsy and psychotic symptoms was discussed from a perspective of the diagnosis and therapeutic challenges, particularly on pharmcological treatment dealing with issues raised by their coexistence.

탈력발작 유무에 따른 기면병 환자의 비교 : 임상변인, HLA-DQB1*0602, Hypocretin

정종현,홍승철,신윤경,한진희,이성필 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.1

Objectives : Narcolepsy is a sleep disorder, characterized by excessive daytime sleepiness, cataplexy, sleep paralysis and hypnagogic hallucination. Among these symptoms, cataplexy is one of the most pathognomonic symptoms in narcolepsy. This study was designed to investigate the clinical features, frequency of DQB 1 *0602 and CSF hypocretin levels in Korean narcolep-tics with cataplexy to compare with those who have not cataplexy. Methods : From August 2003 to July 2005, we selected 72 patients who have narcolepsy confirmed by nocturnal Polysomno-graphy and multiple sleep latency test (MSLT) as well as their history and clinical symptoms at Sleep Disorders Clinic of St. Vincent's Hospital, Catholic University of Korea. Patients were divided into 56 cataplexy-positive group (narcolepsy with cataplexy group) and 12 cataplexy-negative group (narcolepsy without cataplexy group). HLA typing was done in all patients for the presence of DQB 1*0602, and patients received spinal tapping to measure the level of CSF hypocretin. Clinical variables were examined by semi-structured interview for narcolepsy patients. Results : 1) In cataplexy-positive group, compared with cataplexy-negative group, the frequency ofHLA-DQB 1*0602 was found to be significantly increased (50 subjects, 89.3% vs. 8 subjects, 50.0%) (p=0.000). 2) tn 48 out of 56 cataplexy-positive patients (85.7%), hypocretin levels were decreased (≤110 pg/mI) or were below the detection limit of assay (≤40 pg/ml).However, only 6 out of 16 cataplexy-negative patients (37.5%) exhibited decreased hyopcretin level. The difference between two groups were statistically significant (p=0.000). 3) Cataplexy-positive group, compared to cataplexy-negative group, re-ported more frequent hypnagogic hallucinations (36 subjects, 64.3% vs. 4 subjects, 25.0%) (p=0.005). However, there were no significant differences in frequency or seventy of daytime sleepiness, sleep paralysis and demographic data. 4. In nocturnal polysomnography and MSLT findings, there were no significant differences in all sleep parameters between two groups. Conclusion : Higher frequency of HLA-DQB 1*0602, and lower hypocretin levels in cataplexy-positive groups than Cata-pelxy-negatives suggest that narcoleptics with cataplexy might be a etiologically different disease entity from narcoleptics without cataplexy. Additionally, Current criteria prevail for the diagnosis of narcolepsy need to be reclassified according to the presence of cataplexy or not.

정신보건법의 주요 쟁점 조항에 대한 선진국과의 사례 비교

홍진표,황순찬,박수빈,서동우,정은기,김진학,박종익,안주연,김수정,장홍석 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.2

Objectives The Mental Health Act is an initiative aimed at changing and shaping mental health services and protecting human rights of persons with mental disorders. Since the Mental Health Act was legislated in 1995, four amendments have been made according to the issues that arose from public concerns. However, there are still many debates about the human rights protection of the mentally iII. This study aimed to provide information regarding major aspects of the Mental Health Act by comparing them among several developed countries. Methods Current Mental Health Acts of the state of Michigan in the United States, Scotland in England, the state of Victoria in Australia, and Japan were reviewed. Issues regarding the Korean Mental Health Act were collected from seminar materials, news media contents, and mental health professionals Results The definition of subjects in Korean Mental Health Act was more inclusive than other countries and was derived from a medical classification of mental illness. Family members or guardians were granted important responsibilities for deciding the involuntary admission of mentally ill patients in Korea and Japan. In Western countries, Mental Health Review Tribunals or courts have the primary responsibility for important decisions about mentally ill patients. The regulation of immediate dis- charge after request by voluntarily admitted patients was not enacted in all countries except Korea. The mandatory procedure for involuntary admission in Western countries includes an individual case review with personal interview by a Mental Health Review Tribunal or court. Conclusion The Korean Mental Health Act appears to meet the basic standards of Guidelines from international organizations. Our traditional culture and inherent health systems seem to influence the legal regulation of mental health service and might be related to the problems of human rights protection of mentally ill patients in Korea.

전수면박탈이 정상인의 생리기능과 인지기능에 미치는 영향

정종현,송후림,신윤경,한진희,이성필,홍승철 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Purpose of this study was to investigate physiological and neurocognitive effects of total sleep deprivation by using laboratory blood tests and the computerized neurocognitive function test in healthy subjects. Methods : Sixteen healthy volunteers participated in this study. Subjects were recommended to remain awake for 48 hour sunder continuous surveillance. Lab tests of cortisol, Prolactin, thyroid hormone, growth hormone, and immunoglobulin (IgG, IgA, IgM, IgD, IgE), CBC, BC and the Vienna test were performed before and after 48 hours of total sleep deprivation. Results : Concentration of T3 and T4 significantly increased after deprivation. In the reaction test, distribution reaction time significantly increased, and correct reaction significantly decreased. In the vigilance test, amount of correct reaction Signifi-cantly decreased, and the mean value of correct reaction time was significantly delayed. Level of fasting blood sugar, total protein, albumin, alkaline phosphatase and potassium significantly increased, respectively, except for the level of total bilirubin which was decreased. After total sleep deprivation, WBC counts significantly increased. Regarding immunoglobulin level, IgG,IgA and Ag M concentrations appeared to decrease, but the results were not statistically significant. Conclusion : The effect of total sleep deprivation on physiological function was significant in the level of thyroid hormone. Although statistically not significant, the results of growth hormone and the immune system showed a trend in relations to the effect oftotal sleep deprivation. Results of blood chemistry suggest that sleep dephvation may influence metabolism Of hepato-biliary system. Cognitive impairment was also seen in reactive and vigilant functions after total sleep deprivation.

혈액투석 환자에게서 발생한 재생불량성 빈혈 1예

정지용,윤나라,강대웅,오종찬,장재현,선길홍,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

Aplastic anemia is a disease characterized by pancytopenia in the peripheral blood and hypocellular bone marrow with the fatty infiltration. The causes of the acquired aplastic anemia were usually related to drugs and immune-related diseases. A 34-years old man was admitted due to general weakness. He has been going hemodialysis for 2 years because of end stage renal disease (ESRD) due to chronic glomerulonephritis. At admission, laboratory tests showed hemoglobin 6.2 g/dL, hematocrit 18.0 %, WBC 5,710mm (neutrophil 71.8%, lymphocyte 19.1%, monocyte 5.9%), reticulocyte 1.9%, platelet 93,000/mm, Fe 12.8 ug/dL, TIBC 204 ug/dL, ferritin 941.47 ng /ml, haptoglobin 0.72 g/L, vitamin B12 508.17 pmol/L, folate 24 ng/mL, total protein 6.54 g/dL, albumin 3.76 g/dL, Alk. pohsphatase 79 IU/L, AST 30.0 IU/L, ALT 39.7 IU/L, total bilirubin 0.57 mg/dl, BUN 79.4 mg/dl and creatinine 10.18 mg/dl. Peripheral blood smear showed the normocytic normochromic anemia with anisocytosis. Anemia was diagnosed but it was irresponsive to the recombinant human erythropoietin (EPO) and blood transfusion. In the bone marrow aspiration smear were there the hypoplastic myeloid and erythroid precursors. The bone marrow biopsy section showed the hypoplasia of all components (10-20%) and the fatty infiltration. We have experienced one case of the idiopathic aplastic anemia in a patient going through hemodialysis and we just report it with documentary records. 저자들은 혈액 투석 중인 환자에서 약물, 면역계 이상등의 원인을 발견할 수 없었음에도 재생 불량성 빈혈이 발생한 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다.

Creutzfeldt-Jacob병 1례

홍승철,한진희,정종현,김소양,허균,이성필 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

저자들은 Creutzfeldt-Jacob병 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 약 4개월에 걸친 비교적 짧은 기간 동안 중증의 인지 기능 장애와 시각 장애, 보행장애와 하지의 약화, 불수의적 운동 등과 함께 섬망상태에까지 이르게 되어 본원 정신과에 입원하게 되었다. 정신상태 검사상, 반응시간의 지체, 언어장애와 보속증, 시간에 대한 지남력 장애, 주의 집중력 장애, 단기 및 장기 기억 장애, 추상적 사고능력 장애 등의 소견을 보였고, 이러한 증상들은 입원후 치료에도 불구하고 빠르게 악화되었다. 뇌파검사상 지속적인 다발초점성 서파가 모든 전극에서, 특히 우측 전두부에서 현저하게 나타나는 소견을 보였고, 병리조직학적 검사상 대뇌 피질에 신경손실을 동반한 해면화와 신경교 증식증을 나타냈다. 이상의 소견들은 모두 CJD의 진단에 합당하였다. We report a case of Creutzfeldt-Jacob disease and review the relevant literatures. This 56-year-old male patient was admitted to our hospital with a history of rapidly progressing cognitive dysfunction, visual disturbance, gait disturbance, weakness, involuntary movement of lower extremities, and the symptoms of delirium. On mental status examination, he showed psychomotor retardation, speech disturbance, perseveration, disorientation, impairment of short-term and long-term memory, and inability of abstract thinking. He had a rapid downhill course, along with shakiness of trunk, rigidity of the limbs, myoclonus, confusion, and finally, inability to speak or move on the bedside. On electroencephalogram(EEG), continuous multifocal show delta activities were found in all leads, especially in the right frontal areas. Brain biopsy showed, spongiosis with neuronal loss and gliosis noted at the cerebral cortex. These findings were compatible with Creutzfeldt-Jacob disease.

전치 태반의 임상적 고찰

홍관표,이성동,김왕수,정종일,장하종,정혁,한세준 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1

This study was undertaken for the clinical evaluation and statistical analysis on the 38 cases of placenta previa who were admitted and treated from March 1, 1988 to Feb. 28, 1991. The results were as follows : 1. The incidence of placenta previa was one per 53 deliveries or 1.90% 2. There were 57.9 % total placenta previa, 21.1 % partial placenta previa, 13.1 % low-lying placenta previa and 7.9% marginal placenta previa. 3. Placenta previa has occured more often in multipara (63.2%) than primigravida 4. More than one-third (38.8%) cases of placenta previa had delayed admission until labor occured for some time following vaginal spotting has first time been noticed. More instructive prenatal education should be emphasized 5. Lower segment transverse section rate was 63.2%, classical cesarean section rate was 15.8% and cesarean hysterectomy was 9.8%. The rest of them were treated by vaginal deliveries of 5 cases(13.2%) 6. The perinatal loss associated with placenta previa was considered still higher : the premature death was 15.8% and term death was 2.6%. The problem of prevention of prematurity still remains to be studied. 7. There was no maternal mortality in our study

국내에서 분리된 Extended-Spectrum β-Lactamase 생성 Escherichia coli와 Klebsiella pneumoniae의 빈도 및 유형

홍성근,김선주,정성훈,장철훈,조성란,안지영,신종희,이혜수,송원근,어영,염종화,용동은,이경원,정윤섭 대한임상미샐물학회 2003 Annals of clinical microbiology Vol.6 No.2