자살시도자의 정신건강의학과 치료 연계 형태에 따른 동반질병 심각도의 차이

이혁,오승택,김민경,이선구,석정호,최원정,이병욱,Lee, Hyeok,Oh, Seung-Taek,Kim, Min-Kyeong,Lee, Seon-Koo,Seok, Jeong-Ho,Choi, Won-Jung,Lee, Byung Ook 한국정신신체의학회 2016 정신신체의학 Vol.24 No.1

연구목적 자살시도자는 일반적인 경우에 비해 의사결정 능력이 떨어지며, 다시 자살을 시도할 위험성이 높기 때문에 재시도 전에 정신건강의학과 치료로 연계하는 것이 중요하다. 특히 신체적 질병이 있는 사람은 자살시도를 할 확률이 높고, 사망률 역시 높아진다. 이 연구는 자살시도자의 특성을 조사하고, 자살시도 후 응급실에 방문하여 정신건강의학과 치료를 받기로 결정하는 데 신체적 질병이 어떤 영향을 주는지 분석하였다. 방 법 2012년 1월부터 12월까지 경기도의 일 종합병원 응급실에 내원한 132명의 자살시도자를 대상으로 하였다. 환자의 의무 기록을 후향적으로 검토해 인구통계학적, 임상적 요인을 조사하였고 정신건강의학과 치료 연계여부에 따라 분석하였다. 결 과 입원과 외래 상관 없이 정신건강의학과 치료를 받는 것에 영향을 주는 요인은 정신건강의학과 진단 유무, 직업 유무, 정신건강의학과 치료 과거력, 자살시도 과거력이었다. 정신건강의학과 치료 형태를 입원과 외래로 나누어 동반된 의학적 질병의 심각도(Charlson comorbidity index)를 비교했을 때, 입원을 통해 정신건강의학과 치료를 받은 자살시도자와 치료 자체를 거부한 자살시도자는 외래에서 치료를 받은 자살시도자보다 동반된 의학적 질병의 심각도가 높게 나타났다. 결 론 이 연구 결과 응급실에 내원한 자살시도자에게 동반된 의학적 질병의 심각도(Charlson comorbidity index)가 정신건강의학과 치료 형태에 영향을 미친다는 점을 알 수 있었다. 따라서 정신건강의학과 의사는 응급실에 내원한 자살시도자에 대해 의학적 동반질병의 여부 및 심각도를 평가하여 동반된 의학적 질병이 상대적으로 심각함에도 불구하고 자의퇴원을 진행하려고 하는 자살시도자에게 좀 더 합리적인 의사결정을 할 수 있도록 도움을 줄 수 있어야 한다. Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.

광 연결을 이용한 신경회로망 제작의 기존기술과 전망

이혁,Lee, Hyuk 한국광학회 1991 한국광학회지 Vol.2 No.3

무치악 환자에서 의치장착에 따른 치조점막의 조직학적 변화 및 Langerhans세포의 분포에 관한 연구

이혁,이호용,Lee, Hyeog,Lee, Ho-Yong 대한치과보철학회 1991 대한치과보철학회지 Vol.29 No.2

This study was aimed to observe the histological changes of the edentulous and denture wearing alveolar ridge mucosa. The distribution of Langerhans cells was also observed to investigate the mucosal immune response by denture wearing. The mucosal tissues were obtained from of 12 cases of edentulous nondenture wearers(NDW), 7 cases of denture wearers(DW), and 12 cases of flabby tissues(FT). For the identification of Langerhans cells of the mucosal epithelia, the immunohistochemical stain for S-100 protein was applied. The results were as follows : 1. 7 cases among 12 cases of NDW showed hyperkeratosis, and 5 cases were covered by parakeratosis, whereas 3 cases among 7 cases of DW showed hyperkeratosis, and 4 cases showed parakeratosis on the mucosal epithelium. All cases of both DW and NDW demonstrated epithelial hyperplasia, except. 2 cases of DW, which showed epithelial atrophy. The content of glycogen in the epithelial layer showed the decrease in the group of DW. 2. Both NDW and DW showed the infiltration of chronic inflammatory cells. The collagen fibers tended to be arranged densely and irregularly in cases of denture wearing period more than 10 years. 3. FT showed variable epithelial changes from epithelial atrophy to marked hyperplasia, and the pattern of keratinization was also variable. The collagen fibers tended to be arranged irregularly. 4. The distribution of Langerhans cells showed the increase of 1.84-1.96 times in the group of DW compared with NDW group.

영아에서 정상 흉선의 초음파 소견에 대한 분석

이혁,김영통,서광원,김서희,신형철,한건수,김일영,이혜경,Lee, Hyeok,Kim, Young-Tong,Seo, Kwang-Won,Kim, Seo-Hee,Shin, Hyeong-Cheol,Han, Kun-Soo,Kim, Il-Young,Lee, Hye-Kyung 대한영상의학회 1997 대한영상의학회지 Vol.37 No.6

Purpose:To analyse the ultrasonographic findings normal thymus in infants and determine the pathologic findings. Materials and Methods:Forty two infants without a history of chronic disease, tumor or steroid therapy were scanned in the axial planes with a 7.0 MHz sector transducer. Bilaterality, homogeneity, and the types, namely bilobate, quadragular or triangular. The intensities of thymic echogenicity were compared with those of the liver and spleen under the same conditions(time-gain compensation, depth and gain). Results:Bilaterality was seen in 36 cases, homogeneity in 35, homogeneity and bilaterality in 29, inhomogeneity and bilaterality in seven, and homogeneity and unilaterality in six. No case showedinhomogeneity and unilaterality. The shape was bilobate in 23 case, quadrangular in 13 and triangular in six, while the other border was convex in 29 cases and straight in 13. In no case wasechogenicity of the thymus greater than that of the liver or spleen. Transverse diameters were echogenicity of the thymus greater than that of the liver or spleen. Transverse diameters were 21-47mm(mean, 37.0mm;SD, 9.4mm) and depths were 10-37.5mm(mean, 25.8mm;SD, 5.9mm). Conclusion:The usual findings of normal thymus in infants are bilaterality and homogeneity, convex or shaight outer border, and echo intensity less than or equal to that of the liver and spleen. The possibility of thymic pathology is suggested when ultrasonography shows uniaterality, inhomogeneous echogeneity, and echogenicity greater than that of the liver and spleen.

다중회전체와 요철형라이너가 장착된 복합마쇄장치를 이용한 건식 콘크리트용 순환골재 제조기술(환경신기술 인증 366, 검증153호)

이혁,Lee, Hyuk 한국건설순환자원학회 2017 한국건설순환자원학회지 Vol.12 No.2

Volume Hologram을 이용한 신경망 구현기술

이혁,Lee, Hyeok 한국통신학회 1992 정보와 통신 Vol.9 No.11

환경신기술 인증 제366호 다중회전체와 요철형라이너가 장착된 복합마쇄장치를 이용한 건식 콘크리트용 순환 굵은골재 제조기술

이혁,Lee, Hyuk 한국건설순환자원학회 2012 한국건설순환자원학회지 Vol.7 No.2

국산 CAE 소프트웨어의 현황과 향후 전망

이혁,Lee, Hyuk 대한기계학회 2002 기계저널 Vol.42 No.12

하다마드 변환의 적응적 적용을 이용한 고속 움직임 예측 알고리즘

이혁,김종호,진순종,정제창,Lee, Hyuk,Kim, Jong-Ho,Jin, Soon-Jong,Jeong, Je-Chang 한국통신학회 2007 韓國通信學會論文誌 Vol.32 No.8c

본 논문에서는 $4{\times}4$ 단위의 하다마드 변환을 이용한 새롭고 효과적인 움직임 예측 알고리즘을 제안한다. 하다마드 변환은 덧셈과 뺄셈으로만 이루어져 있기 때문에 고속 알고리즘에 적합하다는 장점이 있다. 제안하는 알고리즘은 세 단계로 이루어져 있다. 먼저 하다마드 DC(Direct Current) 계수를 이용하여 움직임 추정의 조기종결여부를 블록의 특성에 적응적으로 적용하고 이전 프레임의 움직임 벡터를 이용할지를 결정한 다음, 하다마드 AC(Alternating Current) 계수를 이용하여 영상의 복잡도를 구하여 정합 스캔 순서를 적응적으로 결정한다. 마지막으로 제안하는 알고리즘을 MVFAST와 PMVFAST 알고리즘에 적용했다. 모의 실험 결과 제안하는 알고리즘은 계산 속도와 PSNR(Peak Signal-to-Noise Ratio) 면에서 MVFAST와 PMVFAST 알고리즘에 비해 매우 효율적임을 나타냈다. In this paper, we propose a new, effective, fast motion estimation algorithms using $4{\times}4$ pixels Hadamard transform. The Hadamard transform has the advantage of simplicity because it uses only addition and subtraction. Motion estimation is composed of three stages. First, it should be decided whether to terminate the search early and use a previous motion vector with DC(Direct Current) coefficients. Then the adaptive matching scan order for motion estimation should be determined according to the image complexity using AC(Alternating Current) coefficients. Experimentally, we adapted this algorithms to MVFAST and PMVFAST algorithms, and the proposed algorithms turn out to be very efficient in terms of computational speed while remaining almost the same in terms of PSNR(Peak Signal-to-Noise Ratio) compared to MVFAST and PMVFAST algorithms.

급속 열처리시 실리콘 웨이퍼의 온도분포와 슬립 현상의 해석

이혁,유영돈,엄윤용,신현동,김충기,Lee, Hyouk,Yoo, Young-Don,Earmme, Youn-Young,Shin, Hyun-Dong,Kim, Choong-Ki 대한기계학회 1992 대한기계학회논문집 Vol.16 No.4

본 연구에서는 텅스텐 할로겐 램프를 이용한 급속 열처리 장치로 웨이퍼를 가 열할 때 시간에 따라 변하는 웨이퍼의 2차원 온도 분포와 온도 구배에 의해 발생하는 열응력을 실리콘 웨이퍼의 결정방향에 따라 다른 값을 갖는 탄성계수를 고려하여 계산 하고, 슬립의 발생 시기, 웨이퍼의 가열속도와 슬립량의 관계, 그리고 웨이퍼에 발생 한 슬립의 진전 특성에 대하여 살펴보고 실험결과와 비교하였다. A numerical solution of temperature and thermally induced stress in a wafer during rapid thermal processing (R.T.P) is obtained, and an analysis of onset and propagation of slip is performed and compared with experiment. In order to calculate temperature distribution of a wafer in R.T.P system, heat conduction equation that incorporated with radiative and convective heat transfer model is solved, and the solution of the equation is calculated numerically using alternating direction implicit (A.D.I) method. In dealing with radiative heat transfer, a partially transparent body that absorbs the radiation energy is assumed and this transparent body undergoes multiple internal reflections and absorptions. Two dimensional (assuming plane stress) thermoelastic constitutive equation is used to calculate thermal stress induced in a wafer and finite element method is employed to solve the equation numerically. The stress resolved in the slip directions on the slip planes of silicon is compared with the yield stress of silicon in order to predict the slip. The result of the analysis shows that the wafer temperature at which slip occurs is affected by the heating rate of the R.T.P system. It is observed that once slip occurs in the wafer, the slip grows.