Adult invasive pneumococcal disease in the Republic of Korea: Risk medical conditions and mortality stratified by age group

Kim, Jong Hun,Baik, Seung Hee,Chun, Byung Chul,Song, Joon Young,Bae, In-Gyu,Kim, Hyo Youl,Kim, Dong-Min,Choi, Young Hwa,Choi, Won Suk,Jo, Yu Mi,Kwon, Hyun Hee,Jeong, Hye Won,Kim, Yeon-Sook,Kim, Jeong Elsevier 2018 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.74 No.-

<P><B>Abstract</B></P> <P><B>Objectives</B></P> <P>This study aimed to characterize the risk factors for mortality in adult patients with invasive pneumococcal disease (IPD) stratified by age groups, after implementation of the national immunization program of 23-valent polysaccharide vaccine (PPSV23) for those aged ≥65 years in the Republic of Korea (ROK).</P> <P><B>Methods</B></P> <P>Clinical data and pneumococcal isolates from adult patients with IPD (≥18 years of age) were collected prospectively from 20 hospitals through the nationwide surveillance program from March 2013 to October 2015.</P> <P><B>Results</B></P> <P>A total of 319 patients with IPD were enrolled. Median age was 69 years. Overall in-hospital mortality was 34.2%: 17.1% in those aged 18–49 years, 23.7% in those aged 50–64 years, 33.0% in those aged 65–74 years, and 51.0% in those aged ≥75 years (<I>p<</I> 0.001). In particular, early death within 7days of hospitalization accounted for 60.6% (66/109). While old age (≥65 years), higher Pitt bacteremia score (≥4), and bacteremic pneumonia were independently associated with IPD mortality in all age groups, an additional mortality risk factor of immunocompromised status was identified for patients aged 50–64 years. PPSV23 serotypes accounted for 64.4% (122/189) of the pneumococcal isolates serotyped.</P> <P><B>Conclusions</B></P> <P>This study suggests that vaccine-type IPD continues to place a substantial burden on older adults in the ROK, necessitating an effective vaccination strategy for those at higher risk.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization of the elderly with the 23-valent polysaccharide vaccine (PPSV23) was implemented in Korea in 2013. </LI> <LI> Overall in-hospital mortality was 34.2% for adult invasive pneumococcal disease (IPD) and 51.0% for patients ≥75 years of age. </LI> <LI> Mortality risks were older age, higher bacteremia score, and immunocompromised status. </LI> <LI> An effective vaccination strategy for those at higher risk of IPD is needed. </LI> </UL> </P>

가곡 스카른 광상 월곡-선곡 광체의 광물.지구화학적 특성: 성인적 의미

최부갑,최선규,서지은,유인걸,강흥석,구민호,Choi, Bu-Kap,Choi, Seou-Gyu,Seo, Ji-Eun,Yoo, In-Kol,Kang, Heung-Suk,Koo, Min-Ho 대한자원환경지질학회 2010 자원환경지질 Vol.43 No.5

가곡 스카른 광상은 고생대 조선누층군 석회질암을 관입한 백악기 화강암체의 접촉부를 따라 층상으로 교대된 광상으로 구성되어 있다. 관계화성암인 반심성암체는 석영몬조암~화강반암 조성과 함께 I형, 칼크-알카리 계열, 고알루미나질 지화학적 특정을 보이며, 가곡 Zn-Pb 광상에서는 내성스카른과 비하여 외성스카른이 광범위하게 배태되어 있다. 선곡과 월곡 지역의 광체에서 지화학적/광물학적 특성은 관계화성암으로부터 근접성에 의하여 좌우되고 있다. 가곡 광산의 섬아연석에는 Mn, Cd, Cu, In 성분이 미량 함유되어 있고, 정출온도 차이 및 분화과정을 통하여 차별화된 농집 과정이 유도됨으로서 광체에 따라 미량원소의 차이를 보이고 있다. 광석 중 높은 In/Zn비와 Cd/Zn비 그리고 섬아연석 중 낮은 Mn/Zn비는 마그마로부터 공급된 근원물질의 근접성과 밀접한 연관성을 보이고 있다. 따라서, 광석과 섬아연석에 함유된 미량원소의 농집 양상은 정출온도와 광화유체의 근원물질과 관련된 광체의 지화학적/광물학적 차별성을 인지할 수 있는 중요한 지시자로 이용될 수 있다. The Gagok stratabound skarn deposit is the result of the intrusion of the Cretaceous granitic pluton into the Paleozoic calcareous rocks. The subvolcanic intrusion ranges in composition from quartz monzonite to granite porphyry with I-type, calc-alkaline and weakly peraluminous characteristics. Both endoskarn and exoskarn are developed at the Gagok Zn-(Pb) deposit, with more exoskarn than endoskarn. Geochemical and mineralogical characteristics in the Seongok and Wolgok orebodies can be treated in terms of self-organization. Sphalerites in the Gagok ore can also incorporate minor amounts of Mn, Cd, Cu and In. Trace element concentrations in different orebodies vary because fractionation of a given element into sphalerite is influenced by formation temperature and the amount of sphalerite in the ore. A group of high In/Zn and Cd/Zn ratios in ores, and low Mn/Fe ratios in sphalerites are correlated with proximal processes of a magmatic source. The pattern of minor/trace element variations in ores and sphalcrites can be used for petrogenetic interprctation, e.g., orebody zonation related to crystallization temperature and fluid d sources.

Regulation of Hepatic Gluconeogenesis by an ER-Bound Transcription Factor, CREBH

Lee, Min-Woo,Chanda, Dipanjan,Yang, Jianqi,Oh, Hyunhee,Kim, Su Sung,Yoon, Young-Sil,Hong, Sungpyo,Park, Keun-Gyu,Lee, In-Kyu,Choi, Cheol Soo,Hanson, Richard W.,Choi, Hueng-Sik,Koo, Seung-Hoi Elsevier 2010 Cell metabolism Vol.11 No.4

<P><B>Summary</B></P><P>Endoplasmic reticulum (ER)-bound transcription factor families are shown to be involved in the control of various metabolic pathways. Here, we report a critical function of ER-bound transcription factor, CREBH, in the regulation of hepatic gluconeogenesis. Expression of CREBH is markedly induced by fasting or in the insulin-resistant state in rodents in a dexamethasone- and PGC-1α-dependent manner, which results in the accumulation of active nuclear form of CREBH (CREBH-N). Overexpression of constitutively active CREBH activates transcription of <I>PEPCK-C</I> or <I>G6Pase</I> by binding to its enhancer site that is distinct from the well-characterized CREB/CRTC2 regulatory sequences in vivo. Of interest, knockdown of CREBH in liver significantly reduces blood glucose levels without altering expression of genes involved in the ER stress signaling cascades in mice. These data suggest a crucial role for CREBH in the regulation of hepatic glucose metabolism in mammals.</P> <P><B>Highlights</B></P><P>► PGC-1α/GR activates CREBH expression under fasting or insulin-resistant conditions ► CREBH enhances hepatic gluconeogenesis via a CRTC2-dependent manner ► Depletion of CREBH in the liver ameliorates fasting hyperglycemia in diabetic mice</P>

Glucotoxicity in the INS-1 Rat Insulinoma Cell Line Is Mediated by the Orphan Nuclear Receptor Small Heterodimer Partner

Park, Keun-Gyu,Lee, Kyeong-Min,Seo, Hye-Young,Suh, Ji-Ho,Kim, Hye-Soon,Wang, Li,Won, Kyu-Chang,Lee, Hyoung-Woo,Park, Joong-Yeol,Lee, Ki-Up,Kim, Jung-Guk,Kim, Bo-Wan,Choi, Hueng-Sik,Lee, In-Kyu American Diabetes Association 2007 Diabetes Vol.56 No.2

<P>Prolonged elevations of glucose concentration have deleterious effects on beta-cell function. One of the hallmarks of such glucotoxicity is a reduction in insulin gene expression, resulting from decreased insulin promoter activity. Small heterodimer partner (SHP; NR0B2) is an atypical orphan nuclear receptor that inhibits nuclear receptor signaling in diverse metabolic pathways. In this study, we found that sustained culture of INS-1 cells at high glucose concentrations leads to an increase in SHP mRNA expression, followed by a decrease in insulin gene expression. Inhibition of endogenous SHP gene expression by small interfering RNA partially restored high-glucose-induced suppression of the insulin gene. Adenovirus-mediated overexpression of SHP in INS-1 cells impaired glucose-stimulated insulin secretion as well as insulin gene expression. SHP downregulates insulin gene expression via two mechanisms: by downregulating PDX-1 and MafA gene expression and by inhibiting p300-mediated pancreatic duodenal homeobox factor 1-and BETA2-dependent transcriptional activity from the insulin promoter. Finally, the pancreatic islets of diabetic OLETF rats express SHP mRNA at higher levels than the islets from LETO rats. These results collectively suggest that SHP plays an important role in the development of beta-cell dysfunction induced by glucotoxicity.</P>

Endoscopy and Imaging Modalities/Basic Science of Gastrointestinal Disorders/Miscellaneous : Changing Pattern Of Digestive And Liver Disease In Korea, 1990-2006 Year; A Single Center Study

( Jung Hyun Kwon ),( Sang Woo Kim ),( In Sik Chung ),( Myung Gyu Choi ),( Kwan Woo Nam ),( Jung Pil Suh ),( Jae Hyuck Chang ),( Won Haing Hur ),( Yu Kyung Cho ),( Jae Myung Park ),( In Seok Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: Westernization in many Asian countries have changed lifestyles and diets, so once rare diseases have now become prevalent. The aim of this study is to investigate the changing pattern of digestive and liver disease in Korea, from 1990 to 2006. Methods: We extracted data specific gastrointestina (GI) disease based on the International Classification of Diseases code from the in-patients records at the Kangnam St. Mary`s Hospital in 1990, 1996 and 2006. This hospital is a tertiary-care hospital in Seoul, Korea, which has a capacity of 800 beds. Results: The admission rate for GI disease increased between 1990 and 2006. Overall in-patients were 1,623 persons in 1990, 2,368 persons in 1996 and 4,166 persons in 2006. The mean age of in-patients increased as time went by. A stomach cancer was the most common diagnosis during all periods, but its prevalence has decreased. Colon cancer ranked the 7th in 1990, but markedly increased and now ranks the second. The third was a hepatocellular carcinoma. The bile duct and gallbladder cancer, pancreas and esophageal cancer ranking followed with little interval change. In cases of cancer patients, a regular admission dramatically increased for chemotherapy. The number of patients admitted with pre-malignant neoplasm of stomach and colon increased remarkably with the development of endoscopy. The liver transplant, inflammatory bowel discase, and reflux esophagitis emerged form mid-1990s with greater frequencies, yet much below the levels found in the West. The admission rate for peptic ulcer, especially ulcer bleeding remained relatively stable, despite a decreased rate for ulcer perforation. Liver cirrhosis, hepatitis, cholelithiasis with cholecystitis-cholangitis, appendicitis, hemorrhoid and gastritis all decreased. Conclusions: The stomach cancer is the leading cause of admission, despite a recent decline. Colon cancer showed a marked rise. The liver transplant, inflammatory bowel disease and reflux esophagitis were new diagnosis with an increased tendency.

관동맥질환에서 저밀도 지단백 입자 크기의 분포

임효영,김인숙,승기배,강동헌,전두수,장기육,박준철,이수영,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

관상동맥 질환에서 SDF-1α의 농도

김보영,박용규,박형서,노상필,정승현,이유선,이정우,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

Atherosclerosis is now viewed as an inflammatory disease of the vascular system. Expression of several chemokines, including monocyte chemoattractant protein(MCP)-1, MCP-4, RANTES(regulated on activation normal T-cell expressed and secreted), and interleukin-8(IL-8) are increased in human atherosclerotic plaques compared with normal vessels. They are involved in the pathogenesis of atherosclerosis and plaque rupture by activating and directing leukocytes into the atherosclerotic lesions. However, some are involved in homeostatic functions such as normal leukocyte traffic and growth regulation. SDF-la is a multi-functional cytokine that is involved in myelogenesis, hematopoiesis, angiogenesis and injured gastric mucosal regeneration in the gastric ulcer patient. SDF-la is recently shown to be highly expressed in atherosclerotic plaques and a potent platelet agonist. At least in high concentrations, SDF-la may mediate antiinflammatory and matrix stabilizing effects in unstable angina. Many studies are going on to know the function of SDF-la in coronary artery diseases. I investigated the difference of the plasma level of SDF-la between control group and coronary artery disease group. Total 75 subjects were enrolled. The diagnosis of coronary artery disease was confirmed in all patients by coronary angiography. Control subjects in this study were confirmed normal by coronary angiography. Clinical profile and risk factors were also reviewed. Control subjects in this study were 27 (M=10, F=17). Plasma for the study was collected before the angiography and centrifuged. SDF-la analysis was performed by ELISA. Plasma level of SDF-la is significantly increased in patients with stable angina(n=20) and unstable angina group(n=28) compared with healthy control group(n=27). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases. In this study, plasma level of SDF-la is increased in patients with stable angina and unstable angina groups compared with healthy control group(P<0.05). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases.

이행성 협심증 환자에서 운동부하 심전도 검사

이정우,박형서,박용규,노상필,이유선,정승현,김보영,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 관상동맥의 경련에 의한 이형성 협심증환자에 있어서 운동부하 심전도 검사의 결과는 매우 다양하다. 이에 저자들은 충남대학교병원 순환기내과에서 관상동맥조영술상 이형성 협심증으로 확진된 환자를 대상으로 운동부하 심전도 검사를 시행하여 이에 대한 결과를 연구하였다. 방법 : 1995년 1월부터 2002년 3월까지 흉통을 주소로 충남대학교병원 순환기 내과에 입원하여 관상동맥조영술을 시행하여 관상동맥의 내경이 50% 미만의 협착이 있고, 에르고노빈(ergonovine) 유발검사도 이형성 협심증으로 진단을 받은 233명중 운동부하 심전도 검사를 시행 받은 183명의 환자를 연구 대상으로 하였다. 운동부하 심전도 검사 결과의 판독시 발생할 수 있는 오류를 줄이기 위해서 운동부하 심전도 검사를 시행하기전 심전도상 ST분절의 상승(5예)이나 하강(8예)이 있는 경우 EH한 T파의 역위(19예)가 있는 32명의 환자를 제외한 총 151명의 환자를 대상으로 하였다. 운동부하는 Marquette사의 case 15 답차를 이용하였고, Bruce protocol에 따라 증상이 나타날 때까지 최대로 실시하였으며 각 stage 및 운동후의 혈압을 측정하고 12 유도 심전도를 기록하였다. 결과 : 1) 임상적 특성 - 내원시 임상 상은 안정형 협심증이 39예(25.8%), 불안정형 협심증이 103예(68.2%), 심근경색증이 9예(6.0%)이었다. 운동부하 심전도 검사 결과 양성 군과 음성군간에 있어서 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연 여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도, 연축의 수 등을 조사하였는 바 어떠한 인자들도 유의한 차이를 발견할 수 없었다. 2) 운동부하 심전도 검사 - 운동부하 심전도 검사를 시행 받은 151명의 환자중 음성인 경우는 134예(88.8%)이었고, 양성인 경우는 17예(11.2%)이었다. 양성 소견을 보인 환자들중 ST 분절의 상승이 4예(2.6%), ST 분절의 하강이 13예(8.6%)이었다. 3) 관상동맥조영술 - 관상동맥조영술상에서 혈관 경력 위치는 우관상동맥이 70예(46.1%), 좌전하동맥이 44예(28.9%), 좌회선동맥이 17예(11.2%)의 순으로 나타났다. 운동부하 심전도 검사상 ST 분절의 상승이 있었던 예중 Ⅱ, Ⅲ, aVF에서 ST 분절의 상승이 있었던 1예는 관상 동맥조영술상 우관상동맥에서 경련이 발생하였고, V2-V4에서 ST 분절의 상승이 있었던 2예중 관상동맥조영술상에도 좌전하행동맥에서 경련이 나타난 예는 1예이었으며 다른 1예는 좌회선동맥에서 경련이 나타났고, V5-V6에서 ST 분절의 상승이 있었던 1예는 관상동맥조영술상에도 좌회선동맥에서 경련이 나타났다. 운동부하 심전도 검사상 V5 또는 V6에서 ST 분절의 하강이 있엇던 13예중 6예(46.1%)는 관상동맥조영술상 우관상동맥에서 경련이 발생하였고, 3예(23.1%)는 좌전하행동맥에서, 1예(7.7%)는 좌회선동맥에서, 나머지 3예(23.1%)는 2개의 혈관이나 기타 분지에서 경련이 발생하였다. 결론 : 1) 이형성 협심증 환자는 운동부하 심전도 검사에서 11.2%의 양성소견을 보였다. 이중 ST 분절의 상승은 2.6%이었고, ST 분절의 하강은 8.6%이었다. 2) 이형성 환자중 운동부하 심전도 검사를 실시하여 음성을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 3) 이형성 협심증 환자중 운동부하 심전도 검사를 실시하여 ST 분절의 상승을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 4) 운동부하 심전도 검사 결과에 대한 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도 등 어떠한 인자들도 3그룹(ST 분절의 상승, ST 분절의 하강, 음성)간에 유의한 차이를 발견할 수 없었다. 5) ST 분절의 상승 부위와 관상동맥조영술상 관상동맥의 연축이 일어나는 혈관과의 상관관계는 매우 높았다. No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina. 151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed. Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed. Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%). Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.

Poster Session : PS 1015 ; GI Motility : Pegylated-Photosensitizer Enhances the Effi cacy of Photodynamic Therapy Through Escaping of ATPBinding Cassette Subfamily G Member 2 in Pancreatic Cancer Cells

( Jae Myung Park ),( In Wook Kim ),( Ju Hee Kim ),( Tayyaba Hasan ),( Myung Gyu Choi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Porphyrin-based photosensitizers are most commonly used in photodynamic therapy (PDT). However, these drugs are exported extracellularly by a cell-membrane transporter, the ATP-binding cassette subfamily G member 2 (ABCG2), decreasing the PDT-induced cytotoxicity in cancer treatment. In this study, we showed that intracellular level of a porphyrin was increased by its Pegylated form, which enhance the PDT-induced cytotoxicity. Methods: Pancreatic cancer cells, AsPC-1 and MIA PaCa-2, were selected. We also used ABCG2-overexpressed MIA Paca-2 cells. We pretreated them with chlorine e6 (Che6) or its pegylated-Che6, then irradiated with a diode laser emitting at 670 nm wave length with total radiation dose of 6 J/cm2. We measured the intracellular level of Che6 and peglated-Che6 with fl uorescence meter, FACS and confocal microscope. Cell viability and survival was analyzed by MTT assay and clonogenic survival assay, respectively. Singlet oxygen level was quantified with photomultiplier-tube based singlet oxygen detection system. In-vivo PDT effects were investigated with AsPC-1 cell-bearing BALC/nude mice of the Che6 and pegylated-Che6. Results: The intracellular level of Che6 was higher in MIA PaCa-2 than AsPC-1 and MIA PaCa-2/ABCG2 cells. However, intracellular level of Che6 was increased by its pegylated form in AsPC-1 and MIA PaCa2/ABCG2 cells. Cell viability after PDT was signifi cantly decreased in MIA PaCa-2 compared to AsPC-1 and MIA PaCa-2/ABCG2. However, PDT using pegylated-Che6 caused the similar cytotoxicity among the three cancer cell lines. The production level of singlet oxygen was higher in pegylated-Che6 than Che6-treated cells. The tumor volume after PDT using pegylated-Che6 was signifi cant smaller than that of Che6 in AsPC-1-xenograft mouse model. Conclusions: Pegylated-photosensitizer escaped ABCG2 function, which suggests potential improvement of ABCG2-related resistant to porphyrin-based PDT in cancer treatment in pancreatic cancers.

자기개방성 증진을 위한 3D 상담 플랫폼 제안 - 20대의 심리상담 인식 개선을 중심으로

김새별(Sae-byeol Kim),박규희(Gyu-hee Park),신수영(Su-young Shin),장혜린(Hye-rin Jang),조유정(Yoo-jung Cho),최종인(Jon-in Choi),박수이(Su-E Park) 한국정보통신학회 2022 한국정보통신학회 종합학술대회 논문집 Vol.26 No.1

코로나19 이후 현대인이 겪는 정서적 문제가 높아지는 가운데, 심리상담에 대한 부정적 인식과 물리적 한계로 인한 내담자의 부담은 여전히 높다. 이에 본 연구는 비대면 관계에서 관계에 개방적인 20대의 특성을 이용하여 효과적인 상담을 위한 가상 심리상담 플랫폼을 제안하고자 한다. 이를 위해 20대를 대상으로 설문조사를 실시하고 상담사와의 심층 인터뷰를 진행하였다. 이후 Unity를 통해 3D 가상 상담 환경을 조성하여 PC 기반의 서비스를 구상하였다. 연구 결과, 20대가 상담에서 가장 중요하게 생각하는 요소는 상담사의 성향과 부담감 없는 분위기로 나타났으며 이는 심리 상담에서의 자기개방과 밀접한 관련이 있는 것으로 드러났다. 따라서 편안한 분위기로 조성된 3D 공간에서 상담사 캐릭터를 보며 상담에 참여할 수 있도록 하였고 상담 중 상담사와의 다양한 인터랙션 요소를 제공하였다. 본 연구의 의의는 20대 내담자의 자기개방성을 증진해 내담자의 적극적인 상담 참여를 목표로 한다. 이는 원활한 상담을 통해 심리 문제 개선에 큰 도움을 줄 것으로 보인다. As the emotional problems experienced by modern people after COVID-19 have increased, the burden on clients due to negative perceptions of psychological counseling and physical limitations is still high. Therefore, this study proposes a virtual counseling platform for effective counseling using the characteristics of people in their 20s who are open to relationships in non-face-to-face relationships. To this end, a survey was conducted for those in their 20s and in-depth interviews with counselors were conducted. After that a 3D virtual counseling environment was created through Unity to PC-based service. As a result of the study, it was found that the most important factor in counseling in the 20s was the tendency of counselors and an atmosphere without burden, which was closely related to self-opening in counseling. Therefore, it was possible to participate in counseling while looking at the counselor character in a 3D space created in comfortable atmosphere, and various interaction elements with the counselor were provided during counseling. The significance of this study aims to promote self-openness of clients in their 20s and actively participate in counseling. This is expected to greatly help improve psychological problems through counseling.