야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

융모성림프구를 보이는 비장변연부 림프종 1예

진한영,손창학,주영돈,박정하,이재익,조영완,이원식 인제대학교 2006 仁濟醫學 Vol.27 No.-

Splenic marginal zone lymphoma is very rare B-cell lymphoma, characterized by an indolent clinical course. Clinical features are moderate-to severe splenomegaly, absolute lymphocytosis, and bone marrow intrasinusoidal infiltration of lymphocyte. We report the case of a 37-year-old male with SMZL. He complained of LUQ pain, who had a massive splenomegaly and moderate lymphocytosis in peripheral blood. Immunophenotyping findings and morphologic findings were consistent with SMZL. He underwent splenectomy and received chemotherapy with cyclophosphamide for eight months. Now, one year later after surgery he has a nearly normal blood count with no treatment.

이트리아 첨가 붕규산염 유리로 제조한 알루미나-유리 복합체의 파괴인성 평가

원대희,이민호,박주미,배태성,진영철 대한치과기재학회 1998 대한치과재료학회지 Vol.25 No.2

The study was performed to evaluate the fracture toughness of dental alumina-glass. Alumina compacts were prepared by press 150㎏/㎠ and sintering at 1100℃ for 2hrs. Dense composites were made by infiltrating partially sintered alumina with four different borosilicate glasses containing 1, 3, 6, 9 mol% Yttria(Y₂O₃) at 1200℃ for 6hrs. Apparent porosity was measured by the KS L 3114 principle method. Fracture toughness values were about ∼4.72 MPa·m½. Porosity rates of alumina-glass composites were about 0.2%. The fracture surface of the alumina-glass composites showed a Palmqvist crack pattern at the fracture origin and indicated a tendency by the frictional interlocking between the microstructurally rough fracture surfaces.

용융침투법으로 제조한 알루미나-유리 복합체의 동적 피로 특성 평가

원대희,안승근,배태성,강동완,진영철 대한치과기재학회 1998 대한치과재료학회지 Vol.25 No.3

The fatigue characteristics of alumina-glass composites were evaluated by biaxial flexure test under the dynamic loading conditions. 88 specimens were tested by tested by testing 22 samples at each of four loading rates : 0.01, 0.1, 1, and mm/min. A Vickers-produced indentation crack was made at the center of the tensile surface with load of 49.0 N, and the microstructural aspects of crack propagation was investigated under statically loaded state in distilled water at 37℃. The results obtained were summarized as follows; 1. The fatigue parameter of alumina-glass composite containing 6 mol % yttria was n=22.2, σf0=319.6 MPa. 2. 10-year failure stress of alumina-glass composite containing 6 mol% yttria was 171.7 MPa. 3. Fracture surface of alumina-glass composite indicated the frictional interlocking of jogs having the tendency of toughening by crack deflection, rather than by crack bridging.

러시아 南沿海州地域의 鳥類

元炳旿,李漢洙,朴眞永 경희대학교 한국조류연구소 1993 연구보고 Vol.4 No.-

본 논문은 1991년 6월 9일부터 1991년 7월 3일까지 러시아 연해주남부지역의 조류를 관찰한 결과를 종합한 것이다. 1. 본 조사를 통해 관찰된 조류는 총 106종 24,047개체이다. 2. 조사지역은 뻬레왈마을과 주변의 습지, 비낀강, 알찬강, 끄라스늬 야르, 한까호 및 까라뜨지나 자연보호지구 등지이다. 3. 뻬레호늬 뻬레왈 마을지역에서는 총 49종 296개체를 관찰하였으며, 우점종은 북방쇠찌르레기(Sturnus sturninus), 귀제비(Hirundo daurica) 및 바늘꼬리칼새(Chaetura caudacuta)등이다. 뻬레호늬 뻬레왈 습지지역에서는 총 32종 151개체를 관찰하였으며, 우점종은 붉은뺨멧새(Emberiza fucata), 큰부리까마귀(Corvus macrorhynchos) 및 검은딱새(Saxicola torquata) 등이다. 알찬강 지역에서는 총 31종 158개체를 관찰하였으며, 우점종은 청둥오리(Anas platyrhynchos), 깝작도요(Tringa hypoleucos) 및 큰부리까마귀(Corvus macrorhynchos) 등이다. 끄라스늬 야르지역에서는 총 28종 162개체를 관찰하였으며, 우점종은 북방쇠찌르레기(Sturnus sturninus)와 큰부리까마귀(Corvus macrorhynchos)등이다. 비낀강 지역에서는 총 33종 198개체를 관찰하였으며, 우점종은 호사비오리(Mergus squamatus), 찌르레기(Sturunus cineraceus) 및 파랑새(Eurystomus orientalis) 등이다. 한까호지역에서 관찰된 조류는 총 31종 951개체였으며, 우점종은 붉은부리갈매기(Larus ridibundus)와 흰죽지갈매기(Sterna leucoptera)이다. 까라뜨지나 자연보호지구에서는 총 12종 22,038개체를 관찰하였으며, 우점종은 팽이갈매기(Larus crassirostris)와 바다오리(Uria aalge)이다. 4. 비낀강 주변의 습지지역은 절종위기에 처한 조류의 번식지로서 매우 중요한 지역이며 국제적으로도 중요성을 지니는 지역이다. 따라서, 이 지역은 하루 속히 자연보호지구로 지정하여 영구보존관리토록 노력하여야 할 것이다. A birding trip to Primorskii region, Russia, was made from June 9 to July 3, 1991. The results of the birding trip are as follows: 1. A total of 24,047 individuals of 106 species was recorded. 2. The survey covered 7 major areas-Perebnui Pereval Village, Perebnui Pereval Wetland, Bikin River, Alchan River, Krasnii Yar, Khanka Lake and Karatzina National Reserve. 3. In Perebnui Pereval Village, a total of 296 individuals of 49 species was sighted, among which dominant species were Sturnus sturninus, Hirundo daurica and Chaetura caudacuta. In Perebnui Pereval Wetland, a total of 151 individuals of 32 species was sighted, among which dominant species were Emberiza fucata, Corvus macrorhynchos and Saxicola torquata. On the Alchan River, a total of 158 individuals of 31 species was sighted, among which dominant species were Anas platyrhynchos, Tringa hypoleucos and Corvus macrorhynchos. In Krasnii Yar, a total of 162 individuals of 28 species was sighted, among which dominant species were Sturnus sturninus and Corvus macrorhynchos. On the Bikin River, a total of 198 individuals of 33 species was sighted, among which dominant species were Mergus squamatus, Sturunus cineraceus and Eurystomus orientalis. On the Khanka Lake, a total of 951 individuals of 31 species was sighted, among which dominant species were Larus ridibundus and Sterna leucoptera. In Karatzina National Reserve, a total of 22,038 individuals of 12 species was sighted, among which dominant species were Larus crassirostris and Uria aalge. 4. The marsh areas around the Bikin River are internationally important wetlands supporting many endangered, species such as Mergus squamatus, Ciconia boyciana, Grus monacha, Porzana paykullii, Porzana pusilla, Turnix tanki, etc. Therefore, this area should be designated as a nature reserve and preserved for effective, continuous protection and management.

漢江의 水鳥類調査

元炳旿,朴眞永,金恩英,金和貞 경희대학교 한국조류연구소 1993 연구보고 Vol.4 No.-

1. 1989년부터 1992년까지 동계에 한강의 서울수계에서 관찰한 조류는 총 39종, 최대 개체수는 27,615개체이며, 우점종은 흰죽지이다. 2. 1993년 2월부터 4월까지 한강하류에서 관찰한 조류는 총 38종, 최대개체수는 110,989개체이다. 최우점종은 흰죽지이며, 청둥오리, 고방오리 및 큰기러기의 순이었다. 3. 1992년 3월부터 5월까지 밤섬에서 관찰한 조류는 38종, 최대 개체수는 2,327개체이다. 최우점종은 청둥오리이며, 흰뺨검둥오리, 쇠오리 및 비오리의 순이었다. 4. 밤섬의 번식조류는 흰뺨검둥오리, 청둥오리 및 깝작도요이며, 꼬마물떼새와 쇠제비갈매기는 번식장소의 감소로 크게 줄어들었다. 5. 조류의 번식기간인 4~7월과 월동기간인 12~2월에는 밤섬의 출입을 엄격히 통제해야 하며, 인공 자갈못의 조성, 인공 새집의 가설, 먹이 공급 등을 통한 장기적인 보호 방안이 필요하다. 6. 행주대교에서 최근에 세워진 오두산통일전망대까지 약 25㎞에 이르는 한강하류지역은 재두루미, 개리, 큰기러기, 쇠기러기 및 말똥가리류, 수리류, 개구리매류 등 맹금류를 포함하는 10만마리 이상의 대집단이 도래하는 지역이다. 따라서 현재 천연기념물지역으로 지정된 한강하구지역은 수금류의 보호를 위해 위에 언급한 지역을 포함하여 확대지정하여야만 한다. 1. A total of 39 species with a maximum individual number of 27,615 of waterbirds was observed on the Han River in Seoul during the winter periods of 1982-1992, among which the most dominant species was Aythya ferina. 2. A maximum count of 110,989 individuals of 38 species were recorded from February to April 1993 on Han River estuary. The most dominant species was Aythya ferina followed by Anas platyrhynchos, A. acuta and Anser fabalis. 3. A maximum count of 2,327 individuals of 38 species were made during the bird census on Pam Islet, among which the most dominant species was Anas platyrhynchos followed by A. poecilorhyncha, A. crecca and Mergus merganser. 4. The species of birds breeding on Pam Islet were Anas platyrhynchos, A. poecilorhyncha and Tringa hypoleucos. The number of Charadrius dubius and Sterna albifrons was greatly declined due to the decrease of their breeding sites. 5. People coming to Pam Islet should be restricted during the breeding season from April to June and the wintering season from December to February. Long-term protection measures, such as artificial gravel pits and nests, and feed, are necessary for the waterbirds inhabiting this islet. 6. The downstream of the Han River stretching about 25㎞ from Haengju Bridge to the Han River estuary, where the unification observatory has recently been erected, becomes the wintering site of more than 100,000 waterfowl including rare spcies such as White-naped crane, Swan goose, Bean goose, White-fronted goose; and birds of prey such as buzzards, eagles, and harriers. Therefore, the present natural monument of the Han River estuary should be expanded by legislation to include the downstream of the Han River mentioned above for the protection of waterfowl.

갑상선 결절의 임상양상과 미세침흡인검사의 의의

원진호,한희정,채수홍,김현진,송민호,김영건 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

We evaluated clinical manifestation of nodular thyroid disease and fine-needle aspiration cytology results to establish an appropriate diagnostic approach to thyroid nodule. We examined 594 patients who visited Chungnam National University Hospital with one or more thyroid nodules between Jan. 1996 and Dec. 1998. Fine-needle aspiration cytology was carried out after clinical evaluation including medical history, physical examination(hardness,size, multinodularity,fixation) and laboratory test(scan, thyroid function test). Among the 594 cases, 53 cases(8.9%) were diagnosed as cancer and 457 cases(77%) were diagnosed as benign nodule. None of these factors - age, sex. soft and firm nodule, multinodularity, thyroid scan, thyroid sonography, and thyroid function test - were significant to predict cancer in our study. The prevalence of cancer was significantly higher in hard nodule(28. 5%,39/137) than firm(3.8%,12/316) or soft nodule(0%,0/72). There was size difference between malignant(24.2±62.8ml) and benign nodules(12.6±26.1ml),but the size difference wasn't shown to an indicator to say whether malignant or benign. The prevalence of cancer in relation to fixation was significantly higher in fixation(50%,19/38) and partial fixation nodule(33%,4/12) than movable nodules(5.8%,28/476). Rapid growing, vocal cord palsy,and lymphadenopathy among the medical history had higher relative risk to cancer (relative risk= 14, 4.8, 10.2. respectively). We also examined 67 cases which were diagnosed by histology after operation and, through comparison between the results of histology and cytology., evaluated the effectiveness of fine-needle aspiration cytology. Sensitivity, specificity, false negative rate, and false positive rate of fine-needle aspiration cytology were 92-100%, 47-63%, 0-20%, 0-50%,respectively. Our data suggests that thyroid nodules of the patients which are characterized firm, fixed, rapid growing, lymphadenopathy, and vocal cord palsy require more careful evaluation for thyroid cancer. We also recommand thyroid aspiration cytology in first step evaluation to rule out thyroid cancer.

성인의 급성 설사에 대한 로페라미드 옥사이드의 효과: 위약과의 무작위 이중 맹검 비교 다시설 시험

박영태,정희진,박중원,이계희,김나영,임선희,윤병철,한동수,이오영 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.31 No.5

운동 유발성 횡문근 융해를 동반한 요로결석 2례

허진,최원혁,조진혁,함영희,홍정범,정성규,김현,허동 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Two men were admitted to hospital with flank pain, hematuria, which was diagnosised as ureteral stone. Elevation of aspartate aminotransferase (AST) without typical pattern of toxic hepatitis was observed. Careful history taking, several laboratory tests, abdominal and pelvis computered tomography was done. Findings from theses examinations supported the clinical diagnosis of ureteral stone complicated of exercised induced rabdomyolysis. Early recognization of rhabdomyolysis in clinical setting is important, because clinical manifestations have ranged from asymtomatic elevation of creatine kinase to acute renal failure which is a life threating medical emergency. Authors report two cases of exercised induced rhabdomyolysis initially admittied as ureteral stone managed with hydration