경막 내 colistimethate 투여로 치료한 다제 내성 cinetobacter baumannii 뇌실염

홍유아,유진홍,김진진,모은영,안건희,정희경,김진석,이현정,정미향,윤승배 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Acinetobacter species is a non-fermentative aerobic gram-negative coccobacillus that is an important pathogen found in nosocomial infections. Recently, multi-drug resistant Acinetobacter baumannii (MDR-AB) infections have been increasing and pose a serious problem. Most such infections present as bacteremia, pneumonia, or a wound infection; however, CNS infections are very rare. We herein present a case of ventriculitis caused by MDR-AB in a 37-year old man after a neurosurgical intervention. The patient was successfully treated with intrathecal colistimethate.

정신보건관련시설 입원(소)자의 주요 정신장애 유병률 : 전국 20개 시설의 입원(소)자를 대상으로

조성진,조맹제,서동우,함봉진,홍진표,배재남,이준영,이동우,박종익,전홍진,김성주,김용익 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.6

Objectives : One of the objectives of this study is to estimate the prevalence rates of psychiatric diagnoses in the combined populations of psychiatric hospitals, psychiatric nursing facilities and homeless asylums using the Korean version of the Composite International Diagnostic Interview (K-CIDI), which is a comprehensive and fully standardized interview schedule to assess psychiatric disorders for diagnosis. The Other objective is to compare with previously studied prevalence rates of Psy-chiatric diagnoses using the results of this study. Methods : The study subjects, aged from 181o 64 years, were randomly selected from 64,582 institutionalized population of psychiatric hospitals, Psychiatric nursing facilities and homeless asylums as of 30, June, 2001. Twelve trained interviewers administered the K-CIDI to the selected respondents. A total of 1,875 respondents (male 1,194, female 681) completed the interview. Results : The lifetime and one year prevalences of any diagnosis excluding nicotine dependence · withdrawal, anxiety disorder, eating disorder, somatoform disorder were 88.2% (male 88.1%, female 88.3%), and 65.8% (male 62.7%, female 73.7%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were 78.5% (male 75.3%, female 83.7%), and 56.8% (male 51.9%, female 64.8%), respectively. The lifetime and one year prevalences of alcohol use disorder (dependence/abuse) were 26.7% (male 37.9%, female 8.3%), and 8.7% (male 12.8%, female 2.1%), respectively. The lifetime and one year prevalences of mood disorder were 18.1% (male 13.5%, female 25.8%), and 10.4% (male 7.2%,female 16.9%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were comparable with the 2001 community survey by 1.19% to 1.32%, and 0.51% to 0.61%, respectively. The lifetime and one year prevalences of schizophrenia were also comparable by 0.16% to 0.28%, and 0.16% to 0.25%, respectively. There were no significant changes of prevalence rates when correction were applied to other psychiatric diagnosis. Conclusion : The results of this study could be used for evaluating the distribution of psychiatric diagnoses in mental health related facilities and for planning mental health policies.

Critical role of bile acid (BA) in the cellular entry and permissiveness of Hepatitis B virus in vitro

Hong‑Jai Lee,Bo‑Young Shin,Jae‑Seung Moon,Ailyn Fadriquela,Selikem Abla Nuwormegbe,Chun‑Chang Ho,Jin‑Su Shin,Jee‑Sang Yoon,Sang‑Kyou Lee,Soo‑Ki Kim 대한독성 유전단백체 학회 2020 Molecular & cellular toxicology Vol.16 No.3

Background Lack of universal replication system for hepatitis B virus with narrow host range and organ tropism has hampered to uncover the pathogenesis of HBV. Previously, we reported the essentiality of humoral milieu and its components toward HBV and hepatitis C virus survival/viability in vitro. Of these components, the precise role of enterohepatic humoral milieu such as bile acid (BA) on HBV cultivation in vitro and in vivo is unknown. Objective We explored whether BA, specifically taurochenodeoxycholic acid (tCDCA) would directly regulate the viral DNA and surface antigen expression of HBV in vitro, consequently rendering HBV to enter into human or murine immortalized hepatocytes, and non-hepatocytes. Result We found that higher concentration of taurochenodeoxycholic acid (tCDCA) is able to preserve the genomic stability of HBV in cell-free DMEM, showing higher the surface antigenicity than taurocholic acid (tCA). In line, we found that in vitro cell culture condition (100 μmol/L of tCDCA coupled with 1 × 108 g e/mL HBV) would be optimal for HBV entry into target cells. Using this, human (HepG2, Huh7), and rodent (Hepa1c1c7, H4-II-E) hepatoma cell lines were infected by HBV, as evidenced by the presence of HBV biomarkers (HBsAg, and HBV DNA in culture supernatant, as well as HBcAg in cell). Further, cellular entry test revealed that HBV is able to infect 12 different non-hepatic cell lines regardless of species, and organ/tissue, consequently reproducing progeny as confirmed by HBV biomarkers. Last, reinfection test showed that the progenies of HBV from immortalized HepG2, and Hepa1c1c7 cells are able to enter into each or vice versa naïve HepG2, and Hepa1c1c7 cells with or without BA. Conclusion This study demonstrates that enterohepatic humoral milieu such as BA, specifically tCDCA would directly regulate HBV DNA and its surface antigen expression in vitro, consequently rendering HBV to enter into human or murine immortalized hepatocytes, and non-hepatocytes. This is the first note to render HBV permissive to human or rodent hepatic and non-hepatic cells via sole manipulation of humoral milieu, thus establishing the platform for in vitro robust replication system of HBV.

Mongolian Gerbil과 CJU/A Mouse의 와우에서 βNADPH Diaphorase의 발현 양상

추무진,김진섭,송창근,신시옥,진홍률 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.11

정신보건법의 주요 쟁점 조항에 대한 선진국과의 사례 비교

홍진표,황순찬,박수빈,서동우,정은기,김진학,박종익,안주연,김수정,장홍석 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.2

Objectives The Mental Health Act is an initiative aimed at changing and shaping mental health services and protecting human rights of persons with mental disorders. Since the Mental Health Act was legislated in 1995, four amendments have been made according to the issues that arose from public concerns. However, there are still many debates about the human rights protection of the mentally iII. This study aimed to provide information regarding major aspects of the Mental Health Act by comparing them among several developed countries. Methods Current Mental Health Acts of the state of Michigan in the United States, Scotland in England, the state of Victoria in Australia, and Japan were reviewed. Issues regarding the Korean Mental Health Act were collected from seminar materials, news media contents, and mental health professionals Results The definition of subjects in Korean Mental Health Act was more inclusive than other countries and was derived from a medical classification of mental illness. Family members or guardians were granted important responsibilities for deciding the involuntary admission of mentally ill patients in Korea and Japan. In Western countries, Mental Health Review Tribunals or courts have the primary responsibility for important decisions about mentally ill patients. The regulation of immediate dis- charge after request by voluntarily admitted patients was not enacted in all countries except Korea. The mandatory procedure for involuntary admission in Western countries includes an individual case review with personal interview by a Mental Health Review Tribunal or court. Conclusion The Korean Mental Health Act appears to meet the basic standards of Guidelines from international organizations. Our traditional culture and inherent health systems seem to influence the legal regulation of mental health service and might be related to the problems of human rights protection of mentally ill patients in Korea.

Cytokine and Tumor Environments

Jin Tae Hong1*, Ju Kyung Song, Sun Mi Kwon, Byung Woo Ahn, Youngsoo Kim, Sang Bae Han 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.1

Cytokines are known to function as regulatory molecules that can be produced by virtually every nucleated cell type in the body, including lymphocytes, monocytes/macrophages, epithelial cells, fibroblasts, and many others. Cytokines include lymphocyte-derived factors (lymphokines), monocyte-derived factors (monokines), hematopoietic factors (colony-stimulating factors), connective tissue/growth factors, and chemotactic chemokines. Cytokines released in response to infection can affect tumor development in different ways. When exposed to infectious agents, cytokines are secreted by sentinel cells, such as macrophages and dendritic cells. These cytokines include interleukin 1 (IL-1) and tumor necrosis factor-α, as well as others, such as IL-6, IL-12, and IL-18. When released in sufficient quantities, these molecules can cause inflammation. Chronic inflammation is highly associated with tumor initiation, promotion, and progression. In this article, we review the roles and mechanisms of cytokines in tumor development.

고호모시스테인증과 동반된 소뇌출혈 1예

홍석찬,안재영,조수진,정진상,이광호,홍승철,변홍식 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3

급성 골수성 백혈병 환자에서 관해 유도 항암 화학요법 후 발생한 베르니케 뇌증

황진원,정재현,서광원,최병진,송영진,김종윤,이은지,임홍규,이상민 인제대학교 2009 仁濟醫學 Vol.30 No.-

Wernicke's encephalopathy is characterized by the triad of ocular symptoms, ataxia, and mental confusion and neuropsychiatric condition generally caused by acute thiamine deficiency. Although it is common in the severe alcoholics, several other causes also have been identified, such as total parenteral nutrition (TPN) use, hyperemesis gravidarum, anorexia nervosa, hemodialysis, uremia, and acquired immunodeficiency syndrome(AIDS). Chemotherapy in patient with malignanacy and long term total parenteral nutrition following bone marrow transplantation are related with Wernicke's encephalopathy. A 48-year-old woman had been treated with Daunorubicin and Cytarabine for remission induction chemotherapy of acute myeloblastic leukemia and intravenous hyperalimentation due to persistent hematochezia and ileus caused by infiltration of leukemic cell in terminal ileum. She suddenly complained of diplopia, tremor, and mental confusion at 32th day after chemotherapy and generalized tonic-clonic seizure at 34th day after chemotherapy. The diagnosis of Wernicke's encephalopathy was made with clinical presentations and brain MRI. Brain MR T2-weighted & Flair image revealed a high signal intensity lesions bilaterally at the medial thalamus and peri-acueductal grey matter of the midbrain. The patient was successfully treated with vitamin B1. We presented a case of acute Wernicke's encephalopathy developed after remission induction chemotherapy followed by intravenous hyperalirnentation in a patient with acute myeloblastic leukemia.

중·고등학교 청소년의 자살사고 및 자살시도의 유병률과 자살시도의 위험요인에 관한 연구

조성진,전홍진,김장규,서동우,김선욱,함봉진,서동혁,정선주,조맹제 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.6

연구목적 : 지역사회에 거주하고 있는 중·고등학교 청소년들을 대상으로 자살 사고 및 자살시도의 빈도, 성별과 연령(13∼15세 vs 16∼18세)에 따른 자살사고 및 시도의 빈도에 차이가 있는지 여부, 자살사고 및 자살시도가 있는 청소년의 특징, 그리고 자살시도의 위험요인을 알아보고자 하였다. 방 법 : 부천시에 소재하고 있는 중학교 24개교 및 고등학교 20개교의 청소년 71,102명중에서 무작위 집락 표본 추출범으로 청소년 2,203명(남자 1,105명, 여자 1,098명)을 조사대상으로 선정하였다. 자살시도 및 자살사고의 정의에 관한 항목은 Moscicki가 사용한 자살행동에 관한 4항목 중 2항목을 사용하였다. 우울증에 대한 조사도구는 the Center for Epidemiologic Studies Depression Scale, 알코올 의존에 대한 조사도구는 Composite International Diagnostic Interview의 알코올 의존 관련 항목을 사용하였다. 조사자료 통계는 빈도, 백분율, chi-square test, 단변인 및 다변인 로지스틱 회귀분석을 사용하였다. 결 과 : 본 조사연구의 분석결과를 통계적으로 유의한 차이를 보인 항목으로 살펴보면 다음과 같다. 1) 전체 대상자의 자살 사고률은 30.7%, 자살 시도률은 5.3%인 것으로 조사되었다. 남자 대상자의 자살 사고률과 시도률은 26.9%, 3.4%이었고, 여자 대상자의 자살 사고률과 시도률은 34.9%, 7.3%인 것으로 조사되었다. 성별에 따라 자살 사고률과 시도률에 통계적으로 유의한 차이가 있었다. 2) 연령(학년)을 13∼15세(중학교)와 16∼18세(고등학교)의 두 연령층으로 조사하였을 때, 중학생의 자살 사고률과 시도률은 30.1%, 4.3%이었고, 고등학생의 자살 사고률과 시도률은 31.6%, 6.4%인 것으로 조사되었다. 연령에 따른 자살 사고률에는 통계적으로 유의한 차이가 없으나 자살 시도률에는 유의한 차이가 있었다. 3) 전체 조사 대상자를 대상으로 시행한 다변인 로지스틱 회귀 분석 결과에 의하면, 자살 시도의 위험요인이 여자, 알코올 의존, 중등도 및 중증 우울 증상인 것으로 조사되었다. 남녀별로 시행한 단변인 로지스틱 회귀 분석 결과에 의하면, 남자는 알코올 의존이 있을 때, 여자는 알코올 의존, 중등도 및 중증의 우울 증상이 있을 때 자살시도의 위험성이 높았다. 결 론 : 본 연구에서 자살 사고률 및 자살 시도률이 각각 29.6%(남자 25.6%, 여자 33.7%)와 5.31%(남자 3.3%, 여자 7.3%)인 점과 자살시도의 위험요인이 우울 증상의 정도, 알코올 의존인 점을 고려할 때 알코올 의존 및 우울 증상의 조기발견과 치료, 그리고 자살 사고자 및 자살 시도자에 대한 정신의학적 접근과 추적관찰에 대한 방안이 강구되어야 할 것으로 생각된다. Objectives : Aims of this study were 1) to estimate prevalence rates of suicidal ideation and suicide attempt, 2) to find out whether the gender difference and age difference(13-15 years vs 16-18 years) for suicide behaviors exist, 3) to analyse correlates of suicide attempts among junior and high school adolescents aged 13-18 years old. Methods : A self-administered questionnaire was used in a cluster random sample of 2,203 school adolescents(male 1,105, female 1,098). Data were obtained on a wide range of constructs including suicidal ideation and attempts during past 2 weeks, depressive symptoms, symptoms of DSM-IV alcohol dependence, family structure, socioeconomic status, smoking, satisfaction with school achievements, and subjective health status. Chi-square test were done for analysing gender difference and age difference of suicide behaviors. Statistical analyses including uni-variate and multi-variate logistic regression analysis were done for each sex, respectively. Results : 1) The prevalence of suicide ideation during past 2 week was 30.7% in the total sample. The prevalence rates of male and female ideators were 26.9% and 34.9% respectively. The prevalence of suicide attempt during past 2 week was 5.3% in the total sample. The prevalence of suicide attempt in males was 3.4% and 7.3% in females. 2) Gender difference was significant. That is, female respondents showed higher rate of suicidal ideation and suicide attempt. In our study age difference was found only at the rate of suicide attempt. That is, older adolescents(16-18 years) showed only statistically significant higher rate of suicide attempt than younger adolescents(13-15 years). 3) Multi-variate logistic regression analysis revealed that the correlates for suicide attempt were female, moderate to severe depressive symptoms, alcohol dependence in the total sample. In males the correlate for suicide attempt was alcohol dependence. In females, were moderate to severe depressive symptoms, and alcohol dependence. Conclusion : Depressive symptoms, alcohol dependence, presence of suicidal ideation were strong predictors for suicide attempts. This suggest that early detection of treatment of depression and alcohol dependence is important and psychiatric approach and follow-up be needed for the prevention of suicide.

大學綜合試驗 出題에 關한 硏究

卞烘圭,吳鎭坤,申鎔鎭,金泳喆,鄭求福,柳哲鍾,洪允杓 全北大學校 1977 論文集 Vol.19 No.-

The Comprehensive Examination for the undergraduate students is planned to adopt the Jeonbug National University for the purpose of enhancing the quality of its educational outputs. In order to effectively measure and evaluate the level of student progress toward the minimun standard as the students who have finished their general education and basic education for their major field study, the university has decided to make an item pool related to the subjects for the examination. This study is an attempt to make good items of five required courses among general education subjects which are Korean Language, English, Korean History, National Ethics. and Natural Science and are expected to be the subjects of the examination. Instead of making those items separately from the regular examination during the academic semesters, the university plans to collect and use good items from the usual mid-term and final examinations of those subjects. A key concern, in this study, therefore, is to analyze all the items used for the mid-term and final examinations of those subjects during the regular academic semesters. From the data of an about 100 sample in each subject at each time of total three tests, the difficulty index, discrimination index, the response rate of students on each item, and other general descriptive statistics are calculated and then good items are pooled for the future use for the Comprehensive Examination. Anhother important concern in this study is this study is given to the collection and analysis of controversial issues and problems on the process of operating the examination at other universities where the Comprehensive Examination is already adopted. The data from four institutions and from opinions of six participants of this study are used. The following main findidings are summarized : 1. The items have generally shown to be easy while the degree of discrimination is low. 2. Among the five subjects, Korean Language shows the highest rate of right answer (difficulty index) while English the strongest one in the discrimination index. 3. When comparing two types of test between the multiple choice and the short-answer, the latter seems to be powerful in both difficulty and discriminative. 4. The only one question of essay type test reveals clear limitations in scoring and evaluating students progress. 5. All items are constructed under the consideration of content-referenced base, not of the basis on behavioral aspect. 6. The analysis of issues and problems related to the Comprehensive Examination suggests that it is acceptable to test in terms of required subjects of general education and a few most basic subjects of major areas of study. 7. The examination can be functionally operated when it is held at the end of the first year of and before the beginning of the second year of the college years. The length of the examination is usally held from three to five hours. 8. Since the examination should be existed on the idea of criterion-referenced base rather than of norm-referenced one because of its testing the qualification of the entering behavior of students for the further study in their major field, the standard of the pass-and-failure should be set on at least 60 percent of correct answers in each subject. But there must be provided at least two additional opportunities for the make-up examination for those who failed in the first one. 9. A special committee must be established in order to deal with all the details related to the Comprehensive Examination.