주의력결핍 과잉행동장애 아동의 연령에 따른 특성비교

정영철,이종범,박형배,정성덕,성형모,사공정규 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

Objectives : This study is to verify the developmental changes of ADHD symptoms and functions with aging from 7 to 12 year-old. Method : The subjects of this study were 120 children(108 boys and 12 girls) who were diagnosed as ADHD by DSM - IV at department of neuropsychiatry of Yeungnam University Medical Center. Multidementional tests(K-ABC, ADDES-HV, CAP, CPT, KPl-C, WCST) were carried out to evaluate the change of ADHD symptoms and functions. Results : In K-ABC, children with ADHD showed statistically significant increased "Reading and Understanding" ability(p<.001) with age. In ADDES-HV, They showed decreased inattention (p<.05) and hyperactivity(p<.05) but, not showed significant change of impulsivity symptom with age. In CAP, They showed decreased hyperactivity(p<.001) and inattention (p<.05) and lower total score(p<.05) with age. their result were similar with ADDES-HV. In CPT, They showed decreased hit reaction time(p<.001) and hit reaction time standard errors(p<.01) and variability of standard errors(p<.05) with age. In KPI-C, They showed decreased anxiety(p<.01), depression(p<.001), somatization(p<.05), delinquency(p<.05) and hyperactivity(p<.01) with age. Social relationship(P<.05) was improved, as well as decreased psychoticism(p<.05) and autism (p<.001). In WCST, They showed increased completed categories(p<.001), total corrects(p<.001) and fewer total errors (p<.001) with age. Conclusion : Above findings indicate that symptoms of inattention and hyperactivity in school-aged ADHD children tend to decline with age, but age was less associated with decline in impulsivity symptom . In additions, Their executive functions were improved notably and they appeared stability of emotion, close social relationship and decreased delinquency.

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.

Identification of Genes Modulated by High Extracellular Calcium in Coculture of Mouse Osteoblasts and Bone Marrow Cells by Oligo Chip Assay

Kim, Hyung-Keun,Song, Mina,Jun, ji-Hae,Woo, Kyung-Mi,Kim, Gwan-Shik,Baek, Jeong-Hwa The Korean Academy of Oral Biology 2006 International Journal of Oral Biology Vol.31 No.2

Calcium concentration in the bone resorption lacunae is high and is in the mM concentration range. Both osteoblast and osteoclast have calcium sensing receptor in the cell surface, suggesting the regulatory role of high extracellular calcium in bone merabolism. In vitro, high extracellular calcium stimulated osteoclastogenesis in coculture of mouse osteoblasts and bone marrow cells. Therefore we examined the genes that were commonly regulated by both high extracellular calcium and 1,25(OH)_(2)vitaminD_(3)(VD3) by using mouse oligo 11 K gene chip. In the presence of 10 mM[Ca^(2+)]e or 10 nM VD3, mouse calvarial osteoblasts and bone marrow cells were co-cultured for 4 days when tartrate resistant acid phosphatase-positive multinucleated cells start to appear. Of 11,000 genes examined, the genes commonly regulated both by high extracellular calcium and by VD3 were as follows; 1) the expressions of genes which were osteoclast differentiation markers or were associated with osteoclastogenesis were up-regulated both by high extracellular calcium and by VD3; trap, mmp9, car2, ctsk, ckb, atp6b2, tm7sf4, rab7, 2) several chemokine and chemokine receptor genes such as sdf1, scya2, scyb5, scya6, scya8, scya9, and ccr1 were up-regulated both by high ectracellular calcium and by VD3, 3) the genes such as mmp1b, mmp3 and c3 which possibly stimulate bone resorption by osteoclast, were commonly up-regulated, 4) the gene such as c1q and msr2 which were related with macrophage function, were commonly down-regulated, 5) the genes which possibly stimulate osteoblast differentiation and/or mineralization of extracellular matrix, were commonly down-regulated;slc8a1, admr, plod2, lox, fosb, 6) the genes which possibly suppress osteoblast differentiation and/or mineralization of extracellular matrix, were commonly up-regulated;s100a4, npr3, mme, 7) the genes such as calponin 1 and tgfbi which possibly suppress osteoblast differentiation and/or mineralization of extracellular matrix, were up-regulated by high extracelluar calcium but were down-regulated by VD3. These results suggest that in coculture condition, both high extracellular calcium and VD3 commonly induce osteoclastogenesis but suppress osteoblast differentiation/mineralization by regulating the expression of related genes.

40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

완전 방실차단을 동반한 급성 심근염

이유선,정진옥,박용규,박형서,노상필,정승현,김정희,이재환,최시완,성인환 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

급성 심근염환자에서 발행한 완전 방실차단을 영구 심장박동 조율기로 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Myocarditis, an inflammatory process involving the myocardal wall, may be caused by most infectious agents. Irrespective of its etiology, it presents commonly with evidence of heart failure, hypotension, and various electrocardiographic abnormalities. Patient with myocarditis may be asymptomatic or may have a rapidly progressive fatal disease. Medical management of patients with myocarditis includes specific therapy for underlying infection and control of the complication of myocarditis such as congestive heart failure and arrhythmia. Recently we had experienced myocarditis with complete atrioventricular block in 37-year-old man. Although he had shown complete recovery of heart failure, he had shown complete atrioventricular block, so we inserted permanent pacemaker. We report it with review of the literature.

성음(聲音)과 언어(言語)에 관(關)한 문헌적(文獻的) 고찰(考察)

정희재,오태환,정승기,이형구,Jeong, Hee-Jae,Oh, Tae-Hwan,Jung, Sung-Gi,Rhee, Hyung-Koo 대한한방내과학회 1991 大韓韓方內科學會誌 Vol.12 No.1

The results of the investigation of literature were summerized as follows ; 1. Information of voice, the pharynx, the larynx, the epiglottis, the uvula and the hyoid bone were concerned. 2. In disorders of voice and speech, Lung channel, Stomach channel, Spleen channel, Heart channel, Liver channel, Kidney channel, Im channel (任脈), and Chung channel (衝脈) were concerned. 3. The disorders of voice and speech were showed as follows ; aphonia, ashasia, seong-shi (?嘶), seom-eo(?語) kwang-eo (狂語), jeong-seong (鄭?), dok-eo (獨語) and chak-eo (錯語). 4. The cause of Aphonia and Aphasia were freauently as follows ; abnormal rising of Liver energy (肝邪暴逆), excessive heart fire (心火太過), deficiency of heart-blood (心血太虛), apoplexy of heart spleen (心脾俱中風), consumption of lung fluid caused by heat evil (肺津被灼), deficiency of lung energy (肺氣虛寒) and dificiency of kidney energy (腎虛). 5. The cause of seom-eo, kwang-eo, Jeong-seong were as follows ; the heart of stomach (胃中熱), the heat evil attach the blood chamber (血人血室) and the consumption of healthy energy (精氣奪). 6. In disorders of voice and speech, flaceid tong with aphasia (舌?) and aphasia due to throat disease (喉?) were divided.

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.

라운드 리클라이너 개발을 위한 정적 강도 해석 및 안전성 평가

정윤구,임재규,김형종 江原大學校 産業技術硏究所 2004 産業技術硏究 Vol.24 No.A

Seat is one of the most important part of an automobile for passenger's safety especially when an accident happens. A recliner is a part of the seat assembly, having the function of adjusting the back-plate angle of a seat. Recently, many kinds of vehicles have adopted the round recliner module rather than the conventional types of recliners because of its broad compatibility and structural simplicity. In this study a two-dimensional finite element strength analysis has been performed using a commercial code ABAQUS/Standard for the purpose of developing a new round recliner model. The loading condition for the analysis is the same as the FMVSS 301 regulation. The finite element result for the round recliner has been compared with that for the conventional type.

다랑 토혈 후 발생한 뇌경색으로 인하여 간질중첩증을 보인 간성 뇌중 1예

오형근,정두신,이경복,양광익,박형국 순천향의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.1

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효율적인 객체 지향 분석 방법에 관한 연구

정철원,고형대,고광신 木浦大學校 情報産業硏究所 1996 情報産業硏究誌 Vol.4 No.-

Various methodologies have been studied for producing complex software.Object-oriented technique has proposed in eighties and used in various fields. There are active on going researches on object-oriented method to use it as a software development technique. Applying this mothod in this analysis step of development life-cycle reduce the developers efforts. The proposed Object-oriented analysis method build natural object model based on dynamic behavior of each object. Visibility of a system, a easiness of maintenance and reusability of produced objects will be improved if we use this mothod along with the improved design method.