한국어 판 WHO-CIDI(Composite International Diagnostic Interview)-Alcohol의 개발:신뢰도 및 타당도 검사

남궁기,유계준,조은영,송선미,이희상,길계선,조현상,우용일 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.6

CIDI-Alcohol의 한국어 판 개발을 위해 이를 우리말로 번역, 수정하고, 정신병원에 입원한 환자 90명과 일반인 50명에게 시행한 후 임상 진단과 비교하여 일치도를 봄으로써 그 신뢰도 및 타당도를 조사하였다. 결과는 다음과 같다. 1) 주정 사용 각 진단 범주에 대한 한국어 판 CIDI-Alcohol의 일반 면담자간 진단 일치도는 97%∼100%의 높은 일치도를 보였다. 2) 임상 진단을 기준으로 한 한국어 판CIDI-Alcohol의 주정 사용 장애의 진단 일치도는 각 진단 범주별로 kappa치가 0.43∼0.55로 기존의 연구에 비해 비교적 낮았다. 3) CIDI-Alcohol의 진단 기준을 변화시켜, 각 진단 범주에 대한 임상 진단과의 일치도를 알아본 결과 ICD-10/harmful use는 진단 기준 항목의 수를 2개 이상으로 하였을 때, DSM-Ⅲ-R/주정 의존은 진단 기준 항목의 수를 4개 이상으로 하였을 때 임상 진단과 가장 일치하였다. 이런 결과는 한국어 판 CIDI-Alcohol의 진단 기준이 대체적으로 민감도는 높으나, 특이도가 떨어지는 것으로 생각할 수 있으며, 따라서 본 연구자들에 의해 작성된 한국어 판 CIDI-Alcohol는 일반인구 집단을 대상으로 하는 역학 조사보다는 주정 사용 장애로 이루어진 순수한 실험군의 연구에 적합하다고 생각된다. he authors translated a CIDI-Alcohol, a highly structured diagnostic interview, into Korean and examined the validity and reliability of the Korean version of CIDI-Alcohol. In order to examine the validity and reliability of CIDI-Alcohol, the authors calculated the degree of agreement of CIDI-Alcohol diagnoses between the two lay interviewers and sensitivity, specificity, kappa coefficient between clinical and lay CIDI-Alcohol diagnoses. The results were as follows: 1) Agreement rates of CIDI-Alcohol diagnoses between the two lay interviewers ranged from 97% to 100%. The kappa coefficient for each diagnosis was quite high(0.96-1.0). 2) The kappa value of agreement between clinical and lay CIDI-Alcohol diagnoses ranged from 0.43 to 0.55, which was lower than those of other studies. 3) With canging the diagnostic criteria of CIDI-Alcohol, The highest agreement rate between clinical and CIDI-Alcohol diagnoses was acquired when the authors used two or more diagnostic criteria of ICD-10/harmful use and four or more diagnostic criteria of DSM-Ⅲ-R/ alcohol dependence.

통합심리치료의 인지분화훈련이 정신분열병 환자의 기초 인지기능에 미치는 영향

이희상,현명호,조현상,이연희,김태용,장순아,노규식,정기립,이만홍,유계준 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

연구목적 : 정신분열별 환자들을 대상으로 통합심리치료의 소프로그램인 인지분화훈련을 실시하여 실행기능, 개념형성능력, 언어능력 및 추론력에 대한 훈련이 보다 더 하위단계의 인지기능인 주의력, 기억력, 반응시간 등을 호전시킬 수 있는 지를 알아보고자 하였다. 연구방법 : DSM-IV상 정신분열병으로 진단된 24명의 입원환자를 무작위로 양분하여 한 군은 인지분화훈련군으로 다른 한 군은 대조군으로 나누었다. 훈련군은 4주동안 1주일에 3회(매회 60분간)로 총 12회의 통합심리치료의 인지분화훈련을 받았으며 대조군은 동일한 시간동안 정신건강교육을 받았다. 훈련전후에 훈련군과 대조군을 대상으로 개정판 Wechsler 기억검사로 주의집중력, 장·단기 기억력을 측정하였고 Vienna test system중 결정반응시간검사로 반응시간, 반응결정시간, 반응운동시간을 평가하였다. 연구결과 : 1) 주의집중력에서는 훈련군과 대조군사이에 집단간 효과, 집단내 효과 및 상호작용 효과가 없었다. 2) 단기기억력에서는 훈련군과 대조군사이에 집단내 효과는 있었으나(F(1,24)=10.46. p〈.05). 집단간 효과, 상호작용 효과는 없었다. 3) 장기기억력에서는 훈련군과 대조군사이에 집단내 효과는 있었으나(F(1,24)=15.09. p〈.05). 집단간 효과, 상호작용 효과는 없었다. 4) 반응시간에서는 상호작용 효과(F(1,24)=5.18, p〈.05)가 있었다. 5) 반응운동시간에서는 집단간 효과, 집단내 효과 및 상호작용 효과가 없었다. 6) 반응결정시간에서는 상호작용 효과(F(1.24)=6.00, p〈.05)가 있었다. 결 론 : 통합심리치료의 인지분화훈련은 정신분열병 환자에서 하위단계의 인지기능 중 반응시간(특히 반응결정시간)을 단축시키는 효과가 있었다. Objectives : The purpose of this study was to investigate the effects of cognitive differentiation training of Integrated Psychological Therapy(a training program of executive function, concept formation, language, and abstraction) on micro-level cognitive function such as attention, memory and reaction time in patients time in patients with schizophrenia. Methods : Twenty-four inpatients diagnosed as schizophrenia using DSM-IV were randomly assigned to 2 groups. The training group went through a total of 12 sessions of cognitive differentiation training for 4 weeks. The control group received psychoeducation program during the same period. Wechsler Memory Scale-Revised and Decision-Reaction Timer of Vienna Test System were administered to all patients, both before and after the training program. Results : 1) In the attention and concentration scores of Wechsler Memory Scale-Revised, between group, within group and interaction effects of training were not significant. 2) In the short-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=10.46, p〈0.05), but the between group and interaction effects did not reach significance. 3) In the long-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=15.09, p〈0.05), but the between group and interaction effects did not reach significance. 4) In the reaction time scores of Decision-Reaction Timer, interaction effect of training was significant(F(1,24)=5.18, p〈0.05). 5) In the motor time scores of Decision-Reaction Timer, between group, within group and interaction effects of training were not significant. 6) In the decision time scores of Decision-Reaction Timer, interaction effect of training was significant(F(1,24)=6.00, p〈0.05). Conclusion : Our findings suggest that cognitive differentiation training of Integrated Psycho-logical Therapy is partly effective on improving micro-level cognitive functions such as reaction time(especially, decision time) in patents with schizophrenia.

MMPI에 의한 알코올 의존의 통계적 아형분류

남궁기,조현상,김병천,현명호,안혜리,이희상,유계준 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.5

목적 및 방법 : 본 연구에서는 알코올 의존으로 진단된 남자 환자 75명을 대상으로 MMPI 점수를 이용하여 군집 분석으로 아형 분류를 시도한 후, 사회인구학적 특성과 음주와 관련된 변인으로 그 분류가 판별 타당성이 있는지를 알아보았다. 결 과 : 군집 분석 결과 전체 대상은 6(Pa)-7(Pt)-8(Sc) 프로파일의 정신병적 아형(21.4%), 2(D)-3(Hy)-1(Hs) 프로파일의 신경증적 아형(49.3%), 그리고 정상 프로파일 아형(29.3%)의 세 아형으로 분류되었다. 이 세 아형간의 연령, 학력, 결혼 상태, 음주로 인한 입원 경력, 주당 평균 음주 일수, 음주시 평균 음주량, 음주 시작 연령, 직계가족상의 알코올리즘의 가족력 유무의 차이를 비교한 결과 통계적으로 유의한 차이는 없었다. 결 론 : 본 연구의 결과는 통계학적으로 유의한 세 아형으로 분류되었으나 이 아형 분류가 판별 타당성을 갖추지 못했음을 시사한다. Obects & Methods : The authors tried to classify 75 male patients with alcohol dependence by using cluster analysis of their MMPI data, to identify the characteristics of each subtype classified through that process and to evaluate the discriminant validity of the classification. Results : The subjects were divided into 3 subtypes by K-means cluster analysis of MMPI scores : a psychotic subtype of 6(Pa)-7(Pt)-8(Sc) profile(21.4%), a neurotic subtype of 2(D)-3(Hy)-1(Hs) profile(49.3%), a normal subtype(29.3%). But, there were no statistically significant differences of age, educational level, marital status, admission history due to alcoholic problems, number of drinking day per week, average amount of ethanol consumed per drinking occasion, age at onset of drinking and family history of alcoholism among these three subtypes. Conclusion : It seems that the subjects with alcohol dependence could be classified into three subtypes with statistical significance, but this statistical classification does not constitute any evidence of discriminant validity.

투시영상기 조영하에서 외부 강선견인술을 이용한 관골궁 골절의 비관혈적 정복술

조경호,유석근,유병표,최현준 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.1

Recently, facial traumas are increasing due to expansion of motor vehicles and complexity of social life pattern. The zygoma bone is a prominent part of the midface and prone to be traumatized. Numerous approaches for reduction and fixation of zygomatic fractures have been described. Each reduction method has its advantages and disadvantages. The authors employed the extemal wire traction with fluoroscopy in cases of non-comminuted zygomaticarch fracture. The advantages of this method are a more accurate reduction under direct vision and takes a very short time. This procedure also can reduce the pain and edema after postoperation and possible under local anesthesia. With such method, we obtained satisfactory results cosmetically and functionally.

합병증이 동반된 Meckel씨 게실 2례 보고

정병욱,박동일,이준희,서정욱,원유홍,김웅,신현종,권영무 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

합병증이 동반된 Meckel씨 게실을 가진 환자의 치료에 대한 필요성은 과정이 문제이다. 하지만 우연히 만나는 게실의 처치는 논란 중이다. 부수적인 게실 절제술(incidental diverticulectomy)의 제안자는 증상이 있는 게실의 외과적 처치는 중요한 이환 및 사망률은 지적한다. 이를 반대하는 사람들은 전 생애를 통해 합병증의 위험성이 낮게 나타나므로 필요가 없다고한다. 게실의 예방적 제거는 개복술시 우연히 발견 될 때 시행한다. 이는 남아있는 게실이 나중에 합병증을 일으키는 것보다 술후 합병증의 위험성이 매우 적음을 알 수 있다. 저자들은 합병증이 동반된 Meckel씨 게실 2예를 경험하였기에 문헌 고찰과 더불어 보고하는 바이다. The necessity for therapy with complicated Meckel's diverticular is a matter of course.However, management of the incidentally encountered diverticulum is controversial. Proponents of incidental diverticulectomy point to the significant morbidity and mortality rates of surgical treatment of symptomatic divenicular. Other authors base their opposition to incidental diveniculectomy on the low risk of complications developing during lifetime. Prophyillctic removal of the diveniculum is indicated when it is found incidentally at laparotomy, because there are few postoperative complications and the risk exists that the remaining diverticulum may be the cause of later complication. The 2 cases of complicated Meckel's diverticulum are reported with a brief review of literature.

Expression of PSD95 in the Rat Sciatic Nerve

Hyun Jin Yoo,Ik Hyun Cho,Jong Hwan Lee,Nong Hoon Choe,Tae Young Kang,Byung Joon Chang 대한수의학회 2003 Journal of Veterinary Science Vol.4 No.2

Insecticide Resistance of Field-collected Populations of Culex tritaeniorhynchus (Diptera: Culicidae) in the Republic of Korea

Hyun Kyung Kim,Seong Yoon Kim,Dae Hyun Yoo,Mi Yeon Park,E-Hyun Shin,Dong Kyu Lee,Young Joon Ahn,Kyu Sik Chang 한국응용곤충학회 2012 한국응용곤충학회 학술대회논문집 Vol.2012 No.05

Toxicities of 10 insecticides were examined against late third instars of Culex tritaeniorhynchus using the direct-contact mortality bioassay. Six geospatially distant field mosquitoes were collected from Chuncheon-si (designated CC-CT), Hwaseong (HS-CT), Seosan (SS-CT) Jeonju (JJ-CT), Daegu (DG-CT), and Busan (BS-CT) in the Republic of Korea (ROK). Marked regional variations of insecticide susceptibility were observed. Field populations of SS-CT, JJ-CT and DG-CT from agricultural areas showed higher to extremely higher insecticide susceptibility to pyrethroids than those of CC-CT, HS-CT and BS-CT strains from none agricultural areas. Extremely high to low levels of susceptibility were measured: bifenthrin, susceptible ratio (SR) = 2.7–896.3; β-cyfluthrin, SR = 1.8–633.3; α-cypermethrin, SR = 1.2–1,051.9; deltamethrin, SR = 1.3–711.1; permethrin, SR = 1.5–1,053.4 etofenprox, SR = 2.2–29.3; chlorfenapyr, SR = 5.1–103.6; chlorpyrifos, SR = 2.3–337.0; fenitrothion, SR = 2.0–142.3 and fenthion, SR = 1.4–186.2. Culex tritaeniorhynchus populations from rice paddies had been under heavy selection pressure due to the agricultural insecticides and that’s why the mosquito species demonstrated high resistance to pyrethroids which were used for a long time to control agricultural pests in the localities. These results indicate that careful selection and rotational use of these insecticides mayresult in continued satisfactory control against field populations of Japanese encephalitis vector mosquitoes.

Efficacy of Bedside Respiratory Muscle Training in Patients With Stroke: A Randomized Controlled Trial

Yoo, Hyun-Joon,Pyun, Sung-Bom Wolters Kluwer Health, Inc. All rights reserved. 2018 AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITA Vol.97 No.10

<P>Accreditation The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.</P>

Ankle-Brachial Index(ABI)로 말초혈관질환이 진단된 60세 이상 당뇨병 환자에 있어서 말초혈관질환의 위험인자와 영양상태와의 관계

김현규,유재명,박성우,유형준,임성희,김두만,최문기,정유선,서승오 대한당뇨병학회 1999 Diabetes and Metabolism Journal Vol.23 No.6

Etoposide induces a mixed type of programmed cell death and overcomes the resistance conferred by Bcl-2 in Hep3B hepatoma cells

YOO, SEUNG HEE,YOON, YOUNG GEOL,LEE, JEE SUK,SONG, YEON SUK,OH, JOON SEOK,PARK, BONG SOO,KWON, TAEG KYU,PARK, CHEOL,CHOI, YUNG HYUN,YOO, YOUNG HYUN Spandidos Publications 2012 International journal of oncology Vol.41 No.4

<P>The Bcl-2 protein is known to exert not only anti-apoptotic but also anti-autophagic activities. Numerous studies have demonstrated that etoposide, which is one of the most widely used cancer chemotherapy agents, induces apoptotic cell death. However, the exact molecular mechanism leading to cell death by etoposide remains to be resolved. This study aimed to dissect the mode of cell death induced by etoposide in Hep3B hepatoma cells. Furthermore, this study was conducted to examine whether etoposide overcomes the resistance conferred by Bcl-2 in Hep3B hepatoma cells. We observed that Hep3B cells treated with etoposide show not only apoptotic but autophagic phenotypes. Autophagy inhibition by 3-methyladenine (3MA) and caspase inhibition by zVAD-fmk effectively decreased autophagic and apoptotic phenotypes, respectively. However, either zVAD-fmk or 3MA only partially prevented cell death. These data indicate that etoposide concomitantly induces autophagic cell death and apoptosis in Hep3B cells. Importantly, etoposide can effectively induce cell death in Bcl-2-overexpressing Hep3B cells. Conversely, staurosporine, which exclusively induces apoptosis in Hep3B cells, did not efficiently induce cell death in Bcl?2?overexpressing Hep3B cells. Staurosporine-treated Hep3B cells also showed an autophagic phenotype. While autophagy is cell death-inducing in Hep3B cells treated with etoposide, it is cytoprotective in Hep3B cells treated with staurosporine. To this end, we observed that etoposide-induced mixed type of programmed cell death is associated with the dissociation of Bcl-2 from Beclin-1. Taken together, etoposide induces a mixed type of programmed cell death and overcomes the resistance conferred by Bcl-2 in Hep3B hepatoma cells.</P>