아동기 경계선 장애 : 8 CASES 8증례

신민섭,이정섭,홍강의 대한소아·청소년정신의학회 1995 소아청소년정신의학 Vol.6 No.1

요 약 아동에서의 경계선 장애는 현실감각의 불안정, 대인관계의 장애, 충동조절의 장애, 심 한 기능의 변동, 발달상의 불균형, 불안등을 보이며 현재의 진단 체계로는 진단하기 어려운 환아를 의미한다. 본 논문에서는 Bemporad등과 Vera등이 제안한 '경계선 아동'에 부 합하는 7세에서 11 세사이의 8명의 소아정신과를 내원한 아동들을 대상으로 37개의 병인들을 비교하여 다음 과 같은 결과를 얻었다. 1) 임상적인 특징으로는 모든 환아들이 다 남아였으며, 현재의 진단체계에서는 진단을 내리기가 어려웠고, 공존정신과적인 진단이 많았다. 주소는 산만하고 또래와 어울리지 못한다는 것 이 많았다. 현실과 환상사이의 경계가 불명확한 것과 사고의 장애가 특징적인 증상이었다. 2) 심리학적 및 신경생리학 검사상 지능은 보통수준이었으며, 동작성 지능이 언어성 지능보다 우수한 경향이 있었다. 투사법 검사에서는 사고 장애의 지표를 보였으며, 정서적으로 불안 정하고 공격성이 심하였다. 반수에서 주의력 검사상 주의력결핍을 시사하였다. 기질적인 요인은 뚜렷하지 않았다. 3) 발달력 및 가족력상 원하지 않았던 아이가 많았고, 주 양육자는 어머니였으나, 양육 방식에 중등도의 문제가 있었다. 부모간에 불화가 많았고, 사회 경제적으로는 중하가 많았다. 언 어발달은 대부분에서 지연이 되었거나, 성장하면서 점차로 정상이 되었다. 공격적이어서 또래들로 부터 따 돌림을 많이 받았다. 4) 치료 및 경과상 6세경에 처음 병원에 방문하였으며,평균 치료 기간은 2년이었고,주 로 외래에서 치료를 받았다. 약물치료에 대한 반응은 뚜렷하지 않았으며, 장기 놀이치료의 필요성이 암 시되었 다. 본 연구 방법에 여러가지 제한점이 있으나, 앞으로 이 장애의 명확한 진단 기준을 확 립하고 역학 및 치료에 대한 연구들이 이루어져야 할 것이다. ABSTRACT The so-called borderline children are characterised by disturbances in the sense of reality and interpersonal relationships, lack of control, fluctuation of functioning, uneven development and excessive anxiety. But the concept of borderline disorder of childhood is very difficult to define and diagnose in current classification system. The present study adapted the consensus symptoms in borderline children by Bemporad and Vera. Eight cases aged 7-11 were examined in 37 variables. Results are as follows. 1) All subjects are boys and can hardly be diagnosed in current diagnostic system and have many concurrent diagnoses. Common chief complaints are hyperactivity and poor peer relation. The most prominent clinical feature is disturbances in the sense of reality. 2) In KEDI-WISC test, the borderline children showed average intelligence, but performance IQ tends to be higher than verbal IQ. In Rorschach test. they showed high thought disorder index, emotional instabilities and aggressive impulses. The results of TOVA suggested attentional deficit in half of the subjects. The organicity is not prominent. 3) Many of the borderline children were unwanted baby. Although primary care takers of all the subjects were their mothers, there were moderate problems in caring attitude of their children and marital relationship with their husbands. Socioeconomic status was generally below middle class. Most of all subjects have delayed language development, but have overcome subsequently. Many subjects were rejected by peers because of their aggression. 4) The first visit of the subjects was about 6 years of age. Average duration of treatment was 2 years. All of them were treated in the outpatient basis except one. The effect of pharmaco- therapy was doubtful and the necessity of long term play therapy was suggested. Although there were many limitations of method in present study, it was suggested that further research is needed for diagnostic criteria, epidemiology and treatment.

트레드밀 운동시 흡기근 테이핑이 폐활량에 미치는 영향

김민지,신수영,송월섭,조수진,최동락,황미진,황진규,박진현,김경,Dennis W. Fell 대구대학교 특수교육재활과학연구소 2011 再活科學硏究 Vol.29 No.1

이 연구는 트레드밀 운동과 키네시오 테이핑의 효과에 따른 폐활량의 변화를 알아보기 위해 26명의 비흡연자가 참가하였으며 키네시오 테이핑을 적용하지 않은 그룹과 키네시오 테이핑을 적용한 두 그룹으로 무작위로 배정하고 각 군들을 주 3회 6주간의 트레드밀 훈련을 실시하였다. 실험 전과 후, 스파이로미터를 사용하여 키네시오 테이핑의 적용 따른 폐활량 변화 효과를 측정하였다. 이 연구의 결과를 종합해보면 키네시오 테이핑을 적용 그룹에서 적용하지 않은 그룹에 비해 FVC, FEV1에서 유의한 증가를 보였다. 이러한 결과는 건강한 성인에서 키네시오 테이핑을 적용한 경우 키네시오 테이핑을 적용하지 않고 트레드밀 운동을 한 경우보다 폐활량의 향상에 효과적이라고 생각되어진다. The purpose of this study was to investigate the variation of vital capacity(VC) according to the effects of kinesio taping with treadmill exercise. Twenty-six non-smokers were participated in this research and these subjects were randomly assigned into two groups. To measure the VC variation effects of kinesio taping, spirometer was used. The collected data were analyzed statistically by using a paired Mauchly test and repeated measure ANOVA. The results of this study were as follows; A group: treadmill with kinesio taping B group: treadmill without kinesio taping. Between A and B, there were significant differences. In the case of A group, there was 11.66% increase of VC, during 3 weeks experiment(p<.01). In the case of B group, there were significant differences, 3.35% increase of VC, during 3 weeks taping intervention(p<.01). After 6 weeks experiment, the improvement of VC shown a significant difference with intergroup (p<.05). From this result, it was revealed that treadmill exercise with kinesio taping was effective to improve VC to healthy adult than treadmill exercise without kinesio taping.

척수 손상 장애인의 삶의 만족도 영향요인 : 장애정체감의 매개효과 검증 연구

이익섭,신은경,이민규,이범석 한국장애인고용촉진공단 고용개발원 2007 장애와 고용 Vol.17 No.2

본 연구는 척수손상 장애인의 삶의 만족도에 영향을 미치는 요인을 구조방정식 모형으로 검증한 것이다. 손상정도와 접근성, 그리고 삶의 만족도와의 관련성을 장애정체감을 매개변수로 구성하여 검증하였다. 척수손상 장애인 총 397명을 응답대상으로 한 구조모형 검증결과, 본 연구에서 설정한 손상정도와 접근성, 장애정체감과 장애인의 삶의 만족도의 관계에 관한 모형의 적합도가 TLI .911, RMSEA .054(90% 신뢰구간 : .047-.062)로 나타나 연구의 측정모형의 적합도는 좋은 것으로 나타났다. 검증된 구조방정식의 관계구조를 보면, 손상정도와 삶의 만족은 직접효과가 통계적으로 유의미하지 않다고 검증되었고, 그 외에 손상정도가 장애정체감에 미치는 영향과 접근성이 장애정체감에 미치는 영향, 장애 정체감이 삶의 만족도에 미치는 영향, 그리고 접근성이 삶의 만족도에 미치는 영향은 모두 통계적으로 유의미한 영향을 미치는 것으로 나타났다. 또한 장애정체감의 매개효과에 관한 Arion 검증(Baron and Kenny, 1986) 결과, 장애정체감의 매개효과가 통계적으로 유의미한 것으로 나타났다. 따라서 척수손상 장애인의 삶의 만족도를 높이기 위해서는 사회심리적 개입전략이 요청된다고 할 수 있다. The purpose of this study was to examine factors affecting the life satisfaction of the persons with spinal cord injury using the structural equation model. Thus, this was attempted to examine the direct effect of disability severity, accessibility and mediating effect of disability identity on the life satisfaction. Actually 397 samples were analyzed for the research model. Finding in this study are as follow : First, This model showed the reasonable fitness in the analysis of structural equation model(TLI.911, RMSEA .054). Second, the disability severity indirectly exerts on the life satisfaction of the persons with spinal cord injury. But results show accessibility, directly and indirectly, affect on the life satisfaction of the persons with spinal cord injury. Third, Through Arion test, the result shows that the disability identity has a mediating effect between disability severity, accessibility and the life satisfaction of the persons with spinal cord injury. In conclusion, this study confirmed that in order to enhance the life satisfaction of the persons with spinal cord injury, social work practice must consider psycho-social intervention.

柴胡桂枝湯의 臨床治驗에 關한 小考

이민섭,김동희,신순식 대전대학교 한의학연구소 2000 한의학연구소 논문집 Vol.9 No.1

Precise and detailed clinical research and evaluation based on objective standards are imperative factors in securing reliability of a clinical test. Built on this principle, this clinical test has been conducted during the period between March 1999 and March 2000 dealing with 31 outpatients treated with ShiHo-GuizhiTang or ShiHo-GuizhiTang modify and ShiHo-GuizhiTang mixed prescriptions at the Sung-bo ORIENTAL MEDICAL CLINIC. A variety of information relating to those patients has been collected and analyzed under such criteria as precise diagnoses and their clinical effectiveness. The analysis was duly based on "The theory of cold syndrome". Then, the 31 patients' individual clinical information was compared one another by breaking down the results into sub-categories including gender, age, disease, main symptom, blood pressure, pulse beats, syndrome of abdomen, treatment period, modify and mixed prescription, and evaluation. The result of this clinical test can be summarized as follows; First, ShiHo-GuizhiTang appears to be more frequently prescribed in the case of female patients than in the case of male patients despite the fact that it does not necessarily need to be applied only to female. In addition, the numbers of prescriptions of ShiHo-GuizhiTang in the two age groups consisting of elementary school children and economically active adults respectively were the highest among other age groups. Second, ShiHo--GuizhiTang proved to be most effective in treatment for respiratory ailments and arthritis. Third, ShiHo-GuizhiTang brought down blood pressure of hypertension patients and at the same time benefited patients with normal or lower-than-normal blood pressure who were vulnerable to diseases due to low disease-resistance. Fourth, ShiHo-GuizhiTang was effective in the case of frequent pulse(rapid pulse) and thereby indicating the fact it carries Taiyang superficies syndrome. 지맥 arises from suppressed immune responses owing to adrenocortical hormones. ShiHo-GuizhiTang controls and revitalizes those suppressed immune systems which stem from slow pulse and, as a consequence of that process, helps them return to normal condition of pulse. Fifth, from the standpoint of syndrome of abdomen, feeling of obstruction in the epigastrium serves as an important standard in the process of diagnosing diseases and evaluating effectiveness of treatments. Sixth, according to the results of the clinical test with the 31 patients, a total of 81 percent of test subjects benefited from the treatment. The figure is the sum of 52 percent of Ⅰ-class (both main symptom and accompanying symptoms had been eliminated) and 29 percent of Ⅱ-class (part of main symptom and accompanying symptoms had been eliminated) respectively. All told, it is safe to say that ShiHo-GuizhiTang can elect to be a viable clinical treatment. In conclusion, it is estimated that this clinical study has drawn up guidelines for objective diagnostic standards and evaluation on specific treatments' effectiveness. This will lead to more general application of ShiHo-GuizhiTang. On top of that, this study could also provide an opportunity to stress the significance of ShiHo-GuizhiTang and ShiHo-GuizhiTang modify and ShiHo-GuizhiTang mixed prescriptions as an alternative treatment for collagen disease which comes from environmental degradation and pollution.

Tourette 장애 소년에서 자기공명영상을 이용한 기저핵의 용적 분석

선우영경,신용범,이명지,김지영,배재남,강민희,김철응,이정섭 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.4

Objectives : The purpose of this study was to investigate the regional differences of the basal ganglia volume between the boy subjects who have Tourette's disorder and the control group who don't have this disorder by using Brain MRI. Methods : Sixteen subjects who were diagnosed as Tourette's disorder using DSM-IV criteria, and sixteen healthy subjects were selected. For analysis the coronal slice images of the basal ganglia were collected and collected MR images were analyzed with NIH Image (version 6.1 ppc). Resuls : The total brain volume in the subjects with Tourette's disorder were smaller than control group by 6.2% (F=6.2, d.f.=1, P=0.019). The right putamen volume in boys with Tourette's disorder were significant smaller than control group statistically (F=3.2, d.f.=3, P=0.040). The asymmetry (1eft>right) in the globus pallidus decreased significantly in the boys with Tourette's disorder (p=0.06) were found from this experiment. Conclusion : These findings suggest that boys with Tourette's disorder may have neuropathological abnormalities in the basal ganglia. Moreover, the present findings point out the important role of basal ganglia, especially putamen, in Patho-physiology of Tourette's disorder. More studies about the structural and functional analysis of the basal ganglia in Tourette's disorder are highly required.

한국판 아동용 Leyton 강박증 척도의 개발

홍강의,신민섭,이정섭 대한소아ㆍ청소년정신의학회 1994 소아청소년정신의학 Vol.5 No.1

요 약 소아의 강박증 평가 도구인 아동용 레이톤 강박증 척도를 한국판 집단용 지필 검사로 개발하기 위하여 본 연구를 시행하였다. 국민학교 4학년부터 고등하교 3학년까지 127 명을 대상으로 한국어로 번역한 지필 검사 양식의 아동용 레이톤 강박증 척도를 실시하였고, 검사- 재검사 신뢰도 검증을 위하여 3주뒤에 82명에게 재검사를 시행하였다. 또한 전 대상 군에 신뢰도와 타당도가 이미 입증된 간이진단검사(SCL90-R)를 함께 실시하여 공존타당도가 있는 지를 알아 보았 고, 강박환아군과 정신과 환아대조군 그리고 정상대조군을 9명씩 비교하여 진단 변별력이 있는 지를 보 았다. 검사-재검사 신뢰도, 내적 일관성 등은 상당히 만족스러운 수준이었고, 간이진단검사와의 공존 타당도도 비교적 높게 나왔다. 강박환아군이 정신과 환아대조군이나 정상 대조군보다 유의하게 높은 점수가 나와서 변별력 또한 높은 것으로 나타났다. 요인분석상 문항들을 5개의 요인 으로 묶을 수 있었다. 한편 증상과 저항척도에서 여아가 남아보다 유의하게 높은 점수를 보고하였 으며, 특히 국민학교 여아에서 높은 점수를 보여 주었다. 결론적으로 한국판 아동용 레이톤 강박척도는 실시하기 간편하고, 신뢰도와 타당도가 좋은 척 도임 이 입증되 었다. 향후 전국 규모의 규준을 작성하고, 미흡한 부분을 보완한 후속 연구가 필요하다. ABSTRACT Objects : This study was carried out to develop the Korean form of Leyton Obsessional Inventory-Child Version(LOI-CV) designed to assess the obsessive compulsive symptoms in children and adolescents. The LOI-CV was modified into a paper-and-pencil form in order to administer it to group. Methods : We applied the Korean form LOI-CV to 127 elementary, middle and high school children, and retest it to 82 children with 3 weeks interval. Togather with LOI-CV, Korean form of SCL-90-R which had been proved its reliability and validity, were administered to the all subjects for examininig of concurrent validity And then we examined whether this scale discriminates between obsessive patients, psychiatric controls and normal controls in the level of obsessive symptoms. Results : Test-retest reliability, internal consistency were very satisfactory. Concurrent validity with SCL-90-R was moderate level. And obsessive patients was scored significantly higher than psychiatric and normal controls in the level of obsessive symptoms. In factor analysis, items are clustered to 5 factors. In the global obsessive symptom, obsessive scores of female elimentary school students were higher than that of male students. Conclusions : These results indicate that the Korean form of LOI-CV is a reliable and valid self-rating scale to assess the obsessive-compulsive symptoms in Korean children and adolesce- nts. Author suggests that future research is needed for Korean version standardization study in normal and clinic-refered population.

만화 과제를 이용한 정신분열병 환자의 사회인지 능력의 측정

오정은,나명현,하태현,신용욱,노규식,홍순범,이경진,신민섭,이영호,권준수 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.3

Objectives : This study is to investigate the hypothesis that schizophrenic patients have difficulty in inferring mental state of others. Methods : Twenty schizophrenic patients and twenty normal subjects were administered to the Cartoon Task required inferring the character's intention in a given context. Results : The schizophrenic patients showed a statistically significant impairment in the Cartoon Task. Both groups chose the card depicting a frequent everyday action significantly more rather than the similar card to the last picture in each story for wrong answers. Conclusion : These preliminary results suggest that schizophrenia is associated with a specific deficit of the cognitive ability referred to as social cognition, and this deficit can be detected not only in the acute phase as found in previous research studies, but also in remission. Also when subjects fail to appreciate what is going on in the minds of other people, they seem to rely on a socially familiar experience.

HIV-1 Tat-mediated protein transduction of human brain creatine kinase into PC12 cells

( Min Seop Jeong ),( Dae Won Kim ),( Min Jung Lee ),( Yeom Pyo Lee ),( So Young Kim ),( Sun Hwa Lee ),( Sang Ho Jang ),( Kil Soo Lee ),( Jin Seu Park ),( Tae Cheon Kang ),( Sung Woo Cho ),( Oh Shin Kw 생화학분자생물학회 2008 BMB Reports Vol.41 No.7

Transplantation Outcome after Pig to Mouse Intra-Portal Islet Transplantation

Shin, Jun-Seop,Yoon, Il-Hee,Min, Byoung-Hoon,Kim, Jong-Min,Ha, Jongwon,Kim, Sang-Joon,Park, Chung-Gyu Wolters Kluwer Health, Inc. All rights reserved. 2018 Transplantation Vol.102 No.7

INTRODUCTION: Islet transplantation is considered a promising curative therapy for type 1 diabetes, but shortage of donor organ limits its wide adoption in the clinic. Porcine islets are potential source for allogeneic human islets, but the xenogenic immune responses remain a major hurdle for clinical application. Pig to mouse islet transplantation has been widely used to understand the xenogeneic immune responses to porcine islets, but its transplantation route has been different from that in clinical settings in most cases (kidney subcapsule vs. portal vein). Here we established clinically relevant intra-portal porcine islet transplantation model and examined the pattern of islet distribution and survival duration. The immune responses to porcine islets were compared with those from mouse allo-islet transplantation. MATERIALS AND METHODS: Islet isolation and transplantation: Pig islets were isolated from designated pathogen-free SNU miniature pigs (n=3) using semi-automation method by Ricordi. Mouse islet was isolated from Balb/c mice using collagenase digestion and Ficoll gradient centrifugation. Porcine and murine islets were transplanted into the liver via a cecal vein into streptozotocin-induced diabetic C57B6 mice. Blood glucose levels were measured in tail vein by a glucometer.Immunosuppression: Diabetic mice were intraportally transplanted with porcine islets (7500 IEQ/each, n=10) or allogeneic murine islets (500 IEQ/each, n=6). The half of the mice from each group were treated with MR1 antibody and the other half were vehicle treated. Anti-CD154 antibody (500 mg/mouse, MR1, BioXcell, Inc.) was i.p. injected at 0, 1, 3, 5, and 7 day post-transplantation. RESULTS: The number of the isolated porcine islets was 10,872±8,567 IEQ/g pancreas and purity was 90%. Upon porcine islet transplantation into the diabetic C57B6 mice, blood glucose levels were dropped to normoglycemia at 1 day post-transplantation, but increased to hyperglycemia over 250 mg/dl within 4~5 days regardless of MR1 treatment. In contrast, allogeneic murine islets maintained normoglycemia within 2 weeks and upon MR1 treatment they could prolong the normoglycemia over 100 days (Fig. 1). CONCLUSION: In this study, the procedure for pig to mouse islet transplantation into the liver was established. Pig islets sustained only 4~5 days after intraportal transplantation into diabetic mice, whereas mouse islets maintained normoglycemia over 100 days upon T cell co-stimulation blockade treatment (MR1 antibody). This finding suggests that porcine islets have inherent survival inability in the liver upon intraportal islet transplantation.(Figure is included in full-text article.)

진동대 실험을 통한 대각 가새형 마찰댐퍼의 내진보강효과

신지원(Shin, Ji-Won),신혜민(Shin, Hye-Min),권기혁(Kwon, Gee-Hyuk),이준섭(Lee, Jun-Seop),신경재(Shin, Kyung-Jae) 한국강구조학회 2020 한국강구조학회 학술대회 발표집 Vol.31 No.1