폐쇄성 수면 무호흡증의 심각도와 심박동 변이율 : 탈경향변동분석

주가원,신철진,박두흠,Ju, Gawon,Shin, Chul-Jin,Park, Doo-Heum 대한생물정신의학회 2009 생물정신의학 Vol.16 No.2

Objectives : The detrended fluctuation analysis is one of the nonlinear methods for the investigation of biological time series. It quantifies the fractal scaling properties and is known to be useful in the evaluation of long-range correlations in time series. The heart rate variability(HRV) of obstructive sleep apnea syndrome (OSAS) patients during nighttime was analyzed by detrended fluctuation analysis to assess its relationship with the severity of the symptoms. Methods : Fifty nine untreated male OSAS patients with moderate to severe symptoms(mean age=45.4${\pm}$11.7 years, apnea-hypopnea index, AHI${\geq}$15) underwent nocturnal polysomnography. Moderate(AHI=15-30, N=22) and severe(AHI>30, N=37) OSAS patients were compared for the indices derived from detrended fluctuation analysis and frequency domain analysis of HRV. Results : In the detrended fluctuation analysis, the alpha values were 0.75${\pm}$0.11 and 0.82${\pm}$0.07 for the severe and the moderate OSAS groups respectively. The difference was significant(p<.01). The alpha value had negative correlation with AHI(r=-.425, p=.001). Negative correlation coefficients were also found in the relationships between the alpha values and very low frequency(VLF)(r=-.425, p=.001), low frequency(LF)(r=-.633, p= <.001) and the LF/HF ratio(r=-.305, p=.019) respectively. LF/HF ratio(p=.005) was higher in the severe OSAS group compared to that of the moderate OSAS group. Conclusion : In this study, the detrended fluctuation analysis showed the significant difference between the two OSAS groups classified according to their severity of symptoms. The scaling exponent showed the negative correlation with AHI and indicies of frequency domain analysis. This result suggests that detrended fluctuation analysis can be helpful to estimate the severity of OSAS.

자동화 프로그램을 이용한 아동의 전체두개강내용적 평가

이정환,김지은,임성진,주가원,김시경,손정우,신철진,이상익,김혜리,Lee, Jeonghwan,Kim, Ji-Eun,Im, Sungjin,Ju, Gawon,Kim, Siekyeong,Son, Jung-Woo,Shin, Chul-Jin,Lee, Sang-Ick,Ghim, Hei-Rhee 대한생물정신의학회 2014 생물정신의학 Vol.21 No.3

Objectives Total intracranial volume (TIV) is a major nuisance of neuroimaging research for interindividual differences of brain structure and function. Authors intended to prove the reliability of the atlas scaling factor (ASF) method for TIV estimation in FreeSurfer by comparing it with the results of manual tracing as reference method. Methods The TIVs of 26 normal children and 26 children with attention-deficit hyperactivity disorder (ADHD) were obtained by using FreeSurfer reconstruction and manual tracing with T1-weighted images. Manual tracing performed in every 10th slice of MRI dataset from midline of sagittal plane by one researcher who was blinded from clinical data. Another reseacher performed manual tracing independently for randomly selected 20 dataset to verify interrater reliability. Results The interrater reliability was excellent (intraclass coefficient = 0.91, p < 7.1e-07). There were no significant differences of age and gender distribution between normal and ADHD groups. No significant differences were found between TIVs from ASF method and manual tracing. Strong correlation between TIVs from 2 different methods were shown (r = 0.90, p < 2.2e-16). Conclusions The ASF method for TIV estimation by using FreeSurfer showed good agreement with the reference method. We can use the TIV from ASF method for correction in analysis of structural and functional neuroimaging studies with not only elderly subjects but also children, even with ADHD.

관점 획득과 관련된 청소년에서의 뇌 활성화 : 성인과의 차이

박성경,손정우,이승복,김혜리,이상익,신철진,김시경,주가원,Park, Seong Kyoung,Son, Jung-Woo,Lee, Seungbok,Ghim, Hei-Rhee,Lee, Sang-Ick,Shin, Chul-Jin,Kim, Siekyeong,Ju, Gawon 대한생물정신의학회 2019 생물정신의학 Vol.26 No.2

Objectives The purpose of this study was to investigate the differences between adolescents and adults, in the perspective-taking ability, as well as the brain activation patterns during the perspective-taking situation. Methods We recruited healthy adolescents aged 13 years to 15 years (n = 20) and adults aged 19 years to 29 years (n = 20). All the subjects were scanned while performing the perspective-taking task, in which an emotional situation was presented in the form of statements comprising first person, as well as third person perspectives. Differences in brain activation between groups were assessed by contrasting neural activity during the tasks. Results In the between-group analysis, while performing the third-person perspective-taking task, the adolescent group showed greater neural activities in the middle frontal gyrus and precentral gyrus as compared to the adult group. Positive correlation was observed between the activity in the frontal areas (Brodmann area 6/9) and the score of scales related to perspective-taking and social cognition in the adolescent group. Conclusions This study suggests that several frontal brain areas of adolescents needs to be overactivated in order to compensate for low perspective-taking ability when they ought to take another person's point of view.

성별에 따른 조현병 환자의 공감 능력 및 얼굴 정서 인식 능력의 차이

김기창,손정우,김혜리,이상익,신철진,김시경,주가원,엄진섭,정명숙,박민,문은옥,천영운,Kim, Ki-Chang,Son, Jung-Woo,Ghim, Hei-Rhee,Lee, Sang-Ick,Shin, Chul-Gin,Kim, Sie-Kyeong,Ju, Gawon,Eom, Jin-Sup,Jung, Myung-Sook,Park, Min,Moon, Eunok,Che 대한생물정신의학회 2014 생물정신의학 Vol.21 No.1

Objectives The aim of the present study was to investigate gender difference in empathic ability and recognition of facial emotion expression in schizophrenic patients. Methods Twenty-two schizophrenic outpatients (11 men and 11 women) and controls (10 men and 12 women) performed both the scale of Empathic Quotient (EQ) and facial emotion recognition test. We compared the scores of EQ and the facial emotion recognition test among each group according to diagnosis and gender. Results We found a significant sex difference in the scores of EQ and the facial emotion recognition test in the schizophrenic patients. And there were significantly negative correlation between the score of the facial emotion recognition test and the scores of Positive and Negative Symptom Scale (PANSS) in female schizophrenic patients. However, in male schizophrenic patients, there were no significant correlations between the score of each test and the scores of PANSS. Conclusions This study suggests that the sex difference in empathic ability and facial emotion recognition would be very important in chronic schizophrenic patients. Investigation of sex effects in empathic ability and facial emotion recognition in chronic schizophrenic patients would present an important solution for constructing optimal rehabilitation program.

알코올 의존 환자에서 시상 세부 영역들의 위축

이정환(Jeonghwan Lee),정승원(Seungwon Chung),박혜미(Hyemi Park),주가원(Gawon Ju),손정우(Jung-Woo Son),신철진(Chul-Jin Shin),이상익(Sang Ick Lee),김시경(Siekyeong Kim) 대한생물치료정신의학회 2020 생물치료정신의학 Vol.26 No.3

Objectives:Chronic alcohol ingestion is associated with structural alterations in the brain. In patients with alcohol dependence, thalamic volume is frequently diminished, commensurate with the amount of alcohol consumption, duration of illness, and cognitive impairment. Since the thalamus is composed of histologically and functionally distinct nuclei, we aimed to investigate volumetric changes of these nuclei in patients with alcohol dependence. Methods:Twenty-three participants with alcohol dependence who had abstained from drinking for at least 3 months (alcohol group) and 21 age-matched healthy controls (control group) underwent 3T magnetic resonance imaging. The volumes of 50 individual thalamic nuclei were reconstructed using FreeSurfer 6.0.0. We compared normalized volumes of thalamic nuclei between the two groups using analysis of covariance, controlling for age. The p-values were corrected using False Discovery Rate (p<0.05). Results:The alcohol group demonstrated atrophy of the whole thalamus and nuclei in the anterior, ventral, intralaminar, and medial thalamus. However, the volumes of bilateral lateral geniculate, medial geniculate, suprageniculatelimitans, pulvinar lateral, and right pulvinar inferior nuclei which are included in posterior thalamus, were not significantly different between the two groups. Conclusion:In the alcohol group, atrophy of most thalamic nuclei which are associated with language processing, visuospatial memory, autobiographical memory, executive function and attention were not normalized after 3 months of sobriety. Furthermore, thalamic nuclei volumes, which are associated with visual and auditory information processing, were not significantly different compared to controls. We suggest that this could be microstructural evidence of relatively preserved visual attention and auditory startle response in patients with alcohol dependence.

성 역할 정체감과 기질 성격 유형이 미용 성형 수술 의도에 미치는 영향

박혜미(Hyemi Park),이상익(Sang Ick Lee),신철진(Chul-Jin Shin),손정우(Jung-Woo Son),김시경(Siekyeong Kim),주가원(Gawon Ju) 대한생물치료정신의학회 2016 생물치료정신의학 Vol.22 No.3

Objectives:The aim of this study was to investigate the factors that determine the intention to receive cosmetic plastic surgery, with particular attention to gender role identity and temperament character. Methods:A total of 226 university students completed the self-rating scale, including cosmetic surgery intention and experience. The Korean Sex Role Inventory(KSRI), Multidimensional Body Self Relation Questionnaires(MBSRQ), Brief Body Dysmorphic Questionnaire(BBDQ), and Temperament and Character Inventory(TCI) were also measured. To evaluate the difference of body image and cosmetic surgery intention, according to sex and gender role identity, chi-square test and one-way analysis of variance were performed. To find the influential TCI dimension for cosmetic surgery intention, multiple regression analysis was performed. The mediating effect of body image in a relationship between gender role identity score, temperament character and cosmetic surgery intention was also evaluated by multiple regression analysis. Results:Body satisfaction was different according to gender role identity. The androgyny types were more satisfied with their appearance than the undifferentiated types, in both sexes. Cosmetic surgery intention was significantly different according to sex only, but not gender role identity. High masculinity and femininity scores were significantly associated with body image satisfaction, but these were not associated with intention to receive cosmetic surgery. There was a full mediating effect of body image on the relationship between cosmetic surgery intention and increased harm avoidance(HA), decreased self-directedness(SD), and decreased cooperativeness(C). Conclusion:These results show that innate difference of sex might be more important to cosmetic surgery intention than acquired gender role identity. Moreover, individuals with high HA, low SD, and low C may have difficulty in forming positive body image due to vulnerable temperament and low self-acceptance character. Negative body image, along with these characteristics would likely lead to cosmetic surgery intention.

응급실에 내원한 자살 시도자의 추적 진료 순응도와 관련된 요인

이민제(Min-Je Lee),신철진(Chul-Jin Shin),이상익(Sang Ick Lee),손정우(Jung-Woo Son),김시경(Siekyeong Kim),주가원(Gawon Ju),이준기(Jun-Ki Lee) 대한생물치료정신의학회 2017 생물치료정신의학 Vol.23 No.3

Objectives:The purpose of this study is to research factors which affect the compliance of psychiatric outpatient follow-up treatment to the suicide attempting patients in the emergency room. Methods:We reviewed the medical records of 346 suicidal attempters who were discharged from emergency center of the Chungbuk National University Hospital from January 1, 2014 to December 31, 2015. They were divided into two groups : patients who came for outpatient department(OPD) follow up treatment and patients who did not. We gathered a data including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. After classifying the patients, we compared and analyzed the factors which could influence each group. Results:After being discharged, 233 patients did not show up for OPD follow up treatment and 113 patients came for OPD follow up treatment. There were significant differences between the two groups in the drunken status, lethality of Suicide Attempt, time of presentation to emergency room(ER), and OPD waiting time. But sociodemographic characteristics, medical condition did not influence the outpatient follow up compliance. Conclusion:There were significant differences in factors that affect the outpatient follow up compliance between the two groups. Additional research is required to increase outpatient follow up compliance.

자폐스펙트럼장애 환자에서의 인지적 공감 및 정서적 공감의 신경 상관물

정승원(Seungwon Chung),손정우(Jung-Woo Son),이승복(Seungbok Lee),김혜리(Hei-Rhee Ghim),이상익(Sang-Ick Lee),신철진(Chul-Jin Shin),김시경(Siekyeong Kim),주가원(Gawon Ju),최상철(Sang Cheol Choi),김양렬(Yang Yeol Kim),구영진(Young Jin K 대한소아청소년정신의학회 2016 소아청소년정신의학 Vol.27 No.3

Objectives: Individuals with autism spectrum disorder (ASD) are considered to have problems with empathy. It has recently been suggested that there are two systems for empathy; cognitive and emotional. We aimed to investigate the neural response to cognitive and emotional empathy and elucidate the neurobiological aspects of empathy in patients with ASD. Methods: We recruited patients with ASD (N=17, ASD group) and healthy controls (HC) (N=22, HC group) for an functional magnetic resonance imaging study. All of the subjects were scanned while performing cognitive and emotional empathy tasks. The differences in brain activation between the groups were assessed by contrasting their neural activity during the tasks. Results: During both tasks, the ASD group showed greater neural activities in the bilateral occipital area compared to the HC group. The ASD group showed more activation in the bilateral precunei only during the emotional empathy task. No brain regions were more activated in the HC group than in the ASD group during the cognitive empathy task. While performing the emotional empathy task, the HC group exhibited greater neural activities in the left middle frontal gyrus and right anterior cingulate gyrus than the ASD group. Conclusion: This study showed that the brain regions associated with cognitive and emotional empathy in ASD patients differed from those in healthy individuals. The results of this study suggest that individuals with ASD might have defects both in cognitive empathy and in emotional empathy.

중증 흡연자들의 금연 성공과 관련된 흡연행태와 심리상태

곽찬용(Chan-Yong Kwak),박종혁(Jong-Hyock Park),김소영(So Young Kim),이상익(Sang Ick Lee),신철진(Chul-Jin Shin),손정우(Jung-Woo Son),주가원(Gawon Ju),김시경(Siekyeong Kim) 한국중독정신의학회 2018 중독정신의학 Vol.22 No.2

Objectives : The purpose of this study was to determine the factors affecting smoking cessation rate of heavy smokers. Methods : Typically, 81 participants enrolled in the smoking cessation camp at Chungbuk National University Hospital from April 2016 to November 2016 were included in the present study. The psychological factors related to group classification and the factors related to the success of smoking cessation were analyzed. Results : After 24 weeks of leaving the camp, 57 out of 81 participants successfully quit smoking and 24 failed in doing so. In the successful group, depression scale, stress scale, and various smoking-related factors exhibited intercorrelation and in the failure group, no significant correlation was observed. However, a comparison of correlation coefficients showed no significant difference. In addition, smoking cessation success rate was low when exhaled CO concentration was high at the time of admission when the smoking initiation age was juvenile, and when the smoking type was A (stimulus seeking type). Conclusion : Exhaled CO concentration at the time of admission, smoking initiation age, and smoking type A (stimulus seeking type) were associated with smoking cessation success.