한국 조현병 환자에서 검지-약지 길이비와 발병 연령 및 대사 장애와의 연관성

김홍래,이중선,주연호,원승희,류승형,홍경수,권준수,이승연,오홍석,최준호,이유상,Kim, Hong Rae,Lee, Jung Sun,Joo, Yeon Ho,Won, Seunghee,Ryu, Seunghyong,Hong, Kyung Sue,Kwon, Jun Soo,Lee, Seung Yeoun,Oh, Hong Seok,Choi, Joon Ho,Lee, Yu Sa 대한생물정신의학회 2017 생물정신의학 Vol.24 No.3

Objectives The ratio of second to fourth digit length (2D : 4D) could be a potential epigenetic marker of sexual dimorphism reflecting prenatal testosterone exposure. Testosterone is known to affect the development of the brain through an epigenetic mechanism. The purpose of this study was to investigate the effects of exposure to fetal testosterone on the metabolic syndrome based on 2D : 4D of schizophrenia patients and the relationship with the age of onset of schizophrenia. Methods A total of 214 schizophrenia patients participated in this study. The participant's physical and blood tests were performed according to the American National Cholesterol Education Program's Third Amendment of the Metabolic Syndrome Diagnostic Criteria, and the 2D : 4D was measured by the method designed by McFadden. Data were statistically analyzed by t-test, Pearson's correlation analysis and multiple regression model analysis. Results 2D : 4D was significantly higher in female than male in both hands, and there was a statistically significant negative correlation between 2D : 4D and the age of onset of schizophrenia in male. However, 2D : 4D did not show statistically significant correlation with metabolic factors. Conclusions Fetal testosterone suggests the possibility of affecting the age of onset of schizophrenia through the epigenetic mechanism, but there is no clear relationship with metabolic factors.

구성주의적 접근을 통한 웹 기반의 가상학교의 설계 및 구현

김홍래,송기상 한국컴퓨터교육학회 1998 컴퓨터교육학회 논문지 Vol.1 No.1

본 논문은 구성주의 관점에서의 학습환경을 구축하기 위하여 웹 상에 설계·구현된 가상학교를 기술한다. 컴퓨터와 정보통신 기술의 발달로 인하여 전통적인 교육 패러다임의 전환이 필요하게 되었으며 그것은 학습자 중심의 구성주의를 근간으로 하는 것이다. 이와 같은 관점에서, 시공간의 제약 없이 학습할 수 있는 가상학교는 학습자 중심학습, 상황 학습, 문제 중심 학습 등이 이루어지는 가상의 공간이다. 이러한 학습공간을 구현하기 위하여 구성주의와 웹의 관계를 탐색하였으며 가상학교의 구성요소와 그들 간의 상호작용을 제시한다. 따라서 본 연구는 웹 상에 효율적인 가상의 학습 공간을 구축하는데 응용할 수 있을 것이다.

히카루겐지 스마 퇴거와 스자쿠 천황 어의

김홍래 한국일본학회 2015 日本學報 Vol.104 No.-

본 논문은 스마 퇴거에 있어서 히카루겐지의 독창적인 이야기 구조를 스마 마키의 어의 장면과 스가와라 미치자네 한시를 통하여 분석한 논문이다. 선행연구에 있어서 히카루겐지와 스자쿠 천황은 친밀한 관계를 유지하고 있었다고 분석되어 왔다. 물론 히카루겐지가 신하로 강등되어 왕위계승권이 박탈되면서 표면적으로 고키덴노 오기사키 가문과 평화로운 관계가 유지되고 있었지만, 그가 과거 왕위계승을 둘러싸고 대립했던 적대적 인물이라는 인식은 잠재하고 있었다. 다만 기리츠보 상황의 유언과 붕어를 전후하여 히카루겐지와 스자쿠 천황의 관계가 처음으로 친밀하게 그려지면서 이를 계기로 두 사람의 관계가 획기적으로 개선되고 있다는 것을 알 수 있다. 한편 히카루겐지는 미치자네의 어의 한시를 인용하여 억울하게 지방으로 좌천된 미치자네와 스마로 퇴거한 자신의 모습을 중첩시키며 무고함을 호소하고 있다. 그러나 후지와라 씨족의 음모에 의하여 반역의 누명을 뒤집어쓰게 된 미치자네에 비하여, 히카루겐지는 스자쿠 천황의 아내와 관계를 가진 명백한 사건을 근거로 하고 있다는 점에서 이질감은 오히려 크게 느껴진다. 다만 이러한 이질감은 나레이터에 의하여 스자쿠 천황에게 어의를 실제로 하사받았고 ‘정말로’ 그 어의를 스마 지방까지 가지고 내려갔다고 새삼스럽게 설명되면서 퇴색되고 있다. 무엇보다도 한때 왕위계승권을 둘러싸고 정치적으로 대립했던 고키덴노 오기사키와 우대신이 히카루겐지를 정치적으로 궁지에 몰아넣었다는 객관적인 사실이, 일종의 블랙홀처럼, 히카루겐지와 미치자네를 똑같이 비교해도 되냐는 논리적 문제와, 실제로 후지츠보와 오보로즈키요와 관계를 가진 히카루겐지가 자신의 무고함을 주장하는 것이 도덕적으로 타당한가라는 윤리적 문제들을 빨아들여 소멸시키고 있다. 따라서 스마 지방 어의 장면은 일방적이고 독선적인 히카루겐지의 변론 구조를 드러내는 한편으로, 이에 대한 독자들의 반발을 예측하고 그 반발을 해소하면서 오히려 히카루겐지의 주장을 강화시켜주는 장치로 구상되고 있다. This paper analyses the original defense structure in the eviction of Hikarugenji suma, through the scene of gyoi in suma and the poetry of Sugawara Michizane. Hikarugenji and Seujaku Tenno were analyzed in previous studies and maintained a close relationship after their relegation as officials and being deprived of succession to the throne. However, Hikarugenji was recognized as a potentially hostile man, who was opposed to the throne, notwithstanding that Hikarugenji and Kokiden-Okisaki’s clan maintained a peaceful relationship superficially. Despite this, we can see that the relationship between Hikarugenji and Seujaku Tenno dramatically improved in that the two men first became intimately drawn to each other before and after Kiritubo Tenno’s testament and death. Meanwhile, Hikarugenji has claimed innocence and willingness to take responsibility to Michizane who had been relegated to the province unjustly. However, compared to Michizane who was accused of treason by the machinations of the Fujiwara clan, I feel there is significant reason to believe in the heterogeneity in that Hikarugenji had an apparent relationship with Tenno’s wife. However, this heterogeneity has been fading, as described by the narrator, who said that the Gyoi was deigned to him and really went down with him to Suma. Above all, the objective fact that the Kokiden-Okisaki clan drove Hikarugenji onto a different political path, causing logical problems and ethical issues that were destructive as a kind of black hole. The Suma scene shows a unilateral and self-righteous defense structure of Hikarugenji and it has been envisioned as a device to enhance the claims of Hikarugenji, to predict backlash from readers, and to eliminate the opposition.

LOBIG 로빅

김홍래,김동진 (사)한국인터넷전문가협회 2017 스마트앱 연감 Vol.2017 No.-

Correlations among the Continence Function, Cognitive Function and Activities of Daily Living in Elderly Male Patients with Dementia in a Geriatric Hospital

김홍래,신희준,왕중산 국제물리치료연구학회 2016 Journal of International Academy of Physical Ther Vol.7 No.1

The purpose of this study was to identify correlations among the continence function, cognitive function, and activities of daily living(ADL) in elderly male patients with dementia in geriatric hospitals. The subjects were 64 patients aged 65 or above who were diagnosed with dementia among the hospitalized male patients in a geriatric hospital. For the subjects' cognitive function, a questionnaire developed for the Korean Mini Mental Status Examination(K-MMSE) was used. For the continence function and ADL, data were collected using a patient evaluation table. As a result, a lower level of cognitive function resulted in corresponding higher levels of dependence in all items of ADL except bathing(p<.05), and a lower level of cognitive function led to corresponding declines in the continence function(bowel control, bladder control)(p<.01). In addition, a higher level of dependence in ADL resulted in corresponding higher levels of difficulty in bowel and bladder control(p<.01). This study showed correlations among the cognitive function, ADL, and continence function of elderly men with dementia. The results of this study may be used as basic data for the management and treatment of hospitalized elderly male patients with dementia in geriatric hospitals.

Minimally Invasive Trans-Mitral Septal Myectomy to Treat Hypertrophic Obstructive Cardiomyopathy

김홍래,유재석,이재원 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.6

A 43-year-old man with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) was admitted to our hospital with aggravated exertional dyspnea and successfully treated with robotic transmitral septal myectomy. Minimally invasive transmitral septal myectomy may be a feasible surgical option for the treatment of HOCM in selected cases as an alternative to transaortic myectomy.

Minimally Invasive Approach for Redo Mitral Valve Replacement: No Aortic Cross-Clamping and No Cardioplegia

김홍래,이재원,김관식,유재석 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.2

A 75-year-old woman who had previously undergone a double valve replacement was admitted to Asan MedicalCenter because of severe bioprosthetic mitral valve dysfunction and tricuspid regurgitation. Under hypothermic fibrillatoryarrest without aortic cross-clamping, minimally invasive mitral and tricuspid valve surgery was performedvia a right minithoracotomy.

Risk Analysis of the Long-Term Outcomes of the Surgical Closure of Secundum Atrial Septal Defects

김홍래,정성호,박정준,윤태진,주석중,정철현,이재원 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.2

Background: Closure of a secundum atrial septal defect (ASD) is possible through surgical intervention or device placement. During surgical intervention, concomitant pathologies are corrected. The present study was conducted to investigate the outcomes of surgical ASD closure, to determine the risk factors of mortality, and establish the effects of concomitant disease correction. Methods: Between October 1989 and October 2009, 693 adults underwent surgery for secundum ASD. Their mean age was 40.9±13.1 years, and 199 (28.7%) were male. Preoperatively, atrial fibrillation was noted in 39 patients (5.6%) and significant tricuspid regurgitation (TR) in 137 patients (19.8%). The mean follow-up duration was 12.4±4.7 years. Results: There was no 30-day mortality. The 1-, 5-, 10-, and 20-year survival rates were 99.4%, 96.8%, 94.5%, and 81.6%, respectively. In multivariate analysis, significant preoperative TR (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.09 to 3.16; p=0.023) and preoperative age (HR, 1.04; 95% CI, 1.01 to 1.06; p=0.001) were independent risk factors for late mortality. The TR grade significantly decreased after ASD closure with tricuspid repair. However, in patients with more than mild TR, repair was not associated with improved long-term survival (p=0.518). Conclusion: Surgical ASD closure is safe. Significant preoperative TR and age showed a strong negative correlation with survival. Our data showed that tricuspid valve repair improved the TR grade effectively. However, no effect on long-term survival was found. Therefore, early surgery before the development of significant TR mat be beneficial for improving postoperative survival.

태극사상을 활용한 태극 리더십개발에 관한 연구

김홍래 리더십학회 2011 리더십연구 Vol.3 No.1

우리 사회가 점차 세계화되면서, 리더십 기술의 이해, 사용 및 훈련에 대한 수요가증가하고 있다. 이미 많은 리더십 프로그램을 우리 사회에 적용시키고자 하는 시도가 있어왔다. 그러나 대부분의 이러한 프로그램들은 외국으로부터 온 것이어서, 일반적으로 우리나라 정서에 대한 이해가 적고 더 나아가 우리의 사상과 대치되는 경향을 보이기도 한다. 이러한 사정을 고려해 볼 때, 한국적인, 한국 사람들에 맞는, 한국 사람들을 위한 리더십, 따라서 한국 사람들이 친근하게 느끼고 적용할 수 있는 리더십의 필요성이 대두된다. 이 논문의 주요한 목적은 바로 이 필요성을 충족시키는 데에 있다. 이를 위해, 이 논문에서는 한국인들에게 친숙한 태극기 등을 통하여 자주 접할 수 있는 태극, 그리고 태극사상을 리더십에 접목하여 리더십 과정을 개발하고자 하였다. 더 나아가, 태극기의 형상을 차용하여, 리더십의 간결하고 명확한 상징적 해석을 꾀함과 동시에, 한국인들이 친숙한 이미지를 통하여 학습을 용이하게 할 수 있도록 배려하였다. 그리고 “5-SHIFT”와 같은 개념을 통하여 이를 보충하고 완성하려고 노력하였다. 실제로, 한국의 문화와 다른 외국의 문화가 차이가 있다는 것은 부인하기 힘들다. 또한, 동양의 문화에 비해 서양의 문화와는 더 큰 차이가 난다는 것도 일반적인 사실이다. 이를 고려해 볼 때, 서양에서 정립된 대부분의 리더십 프로그램과는 다른 한국인의 정서에 맞는 리더십 프로그램의 필요성이 부각된다. 이 논문에서 연구하고 있는 “태극 리더십”이 이러한 역할을 충실히 수행하기를 기대한다. 키워드: 리더십, 한사상, 민족원형, 태극, 의식과 잠재의식, 주도력, 비전력, 소통력, 조정력, 자존력, 자아개념 As our society has became globalized, there are more needs to understand, use, and teach leadership skills. Furthermore, there are even many trials to apply such leadership programs for our society. However, since most of those programs are imported from foreign countries, they generally incorporate true-values of Korean culture and sometimes they even are against the general thoughts of Koreans. Considering this situation, the leadership program which reflects true "Koreanhood", is easily understood and applied by Korean public is in great need. The purpose of this study therefore was to present a program that satisfies those conditions. For this goal, we introduced the concept of Taegeuk(the Great Absolute), the spirit of koreans, which is historically familiar to Korean people, and proposed a leadership program that enables to develop the Korean spirit based on our cultural value. In addition, with use of the shape of Taegeukgi(the flag of Korea), we tried not only to find an easy interpretation of the newly-introduced leadership but also to make Korean people accept the concept more easily. Also, in order to enhance the quality of the program, we diversified the contents of the program as in "5-SHIFT". No one could deny that there are clear differences between Koreans' minds and other foreign ones. Based on this assumption, it could be well accepted that leadership for Korean people, different from foreign one, is in absolute need. It is expected that the Han-Taegeuk Leadership, would be the answer which solves such chasms more effectively. Key words: Leadership, Han, National Archetype, Taegeuk, Consciousness, Subconsciousness, Leading Power, Vision Power, Communication Power, Adjusting Power, Self-esteem, Self-concept

Review of Neurosurgical Fluorescence Imaging Systems for Clinical Application

김홍래,이현민,유헌,이승훈,김광기 한국광학회 2016 Current Optics and Photonics Vol.20 No.2

A number of fluorescence imaging techniques for use in the surgical removal of glioma have beendeveloped over the course of the long history of neurosurgery. Various biomarkers, biochemical agents,and detection systems for glioma have also been developed. This review focuses on 5-aminolevulinic acid(5-ALA), which is used to detect glioma. Numerous forms of fluorescence-guided surgery use 5-ALA,which is helpful to the surgeon. The surgical microscope system is the observational method generallyused with 5-ALA, while the loupe, endoscope, and exoscope are simpler alternatives. A system is neededfor minimal resection and other issues that arise during neurosurgery. Such an enhanced system shouldbe able to detect low-grade tumors and provide information on microinvasive diseases, resulting in animproved survival rate and better surgical skills. Development of systems that fulfill certain needs wouldhelp protect the brain function of the patient and broaden the use of such systems in neurosurgery.