첫 입원치료 받은 정신분열병 환자들의 삶의 질 추적 연구

한오수,이철,최지욱,홍진표,김창윤 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

울산의대 서울중앙병원 정신과에서 첫 입원 치료를 받고 퇴원하여 2년 혹은 5년이 경과한 정신분열병과 기타 정신병 108명 중 최종 73명(응답을 66%)을 대상으로 Heinrichs등이 고안한 삶의 질 척도(Quality of Life Scale)를 사용하여 현재의 삶의 질을 평가하여 다음과 같은 결과를 얻었다. 첫째, 삶의 질 측면 4가지 측면인 대인관계, 직업적 역할, 정신내적 요소, 및 일상적인 물건 및 행동 모두에서 삶의 질이 전반적으로 저하되어 있음을 관찰할 수 있었다. 대인 관계 영역 중 가족 구성원과의 인적 관계 항목은 다른 항목에 비해 상대적으로 만족도가 높았다. 둘째, 정신분열병군의 삶의 질은 기타 정신병군에 비해 대부분의 삶의 질 항목에서 유의하게 낮은 것으로 나타났다. 셋째, 2년 경과군과 5년 경과군 사이 삶의 질은 유의한 차이를 보이지 않았다. 발병 초기 삶의 질 저하가 상당기간 유지됨을 시사하였다. 넷째. 퇴원 후 삶의 질에 영향을 미치는 변인으로는 첫 입원 치료 기간이 유의한 역상관관계를 보였으며 또한 다변량 회귀 분석에 있어서도 같은 결과를 보였다. 이는 초기 치료에 대한 반응 정도가 부분적으로는 향후 삶의 질을 예측할 수 있음을 시사한다. 기타 첫 입원 당시의 연령, 교육 수준. 사회경제적 수준, 첫 입원하기까지의 이환 기간, 첫 입원 당시 Global Assessment of Functioning 입원 치료시 약물용량 등은 삶의 질과 유의한 상관관계를 보이지 않았다. Objectives : One object of this study is to provide a descriptive level of qua1ity of life(QOL) in a group of the first admired schizophrenic patients through interviews being performed after two or five yeah of fo11ow-up, and comparing them with patients in psychotic disorders other than schizophrenia. Another object is to identify clinical variables on the first admission which correlate to QOL factors, after two or five years of fo11ow up. Methods : A total of 73 subjects of the first admitted patients with schizophrenia(n=57) and psychotic disorders other than schizophrenia(other psychotic disorders group, n= 16) were selected. A Quality of Life Scale(QLS) measuring 21 items of life variables was used. Demographic and psychiatric data were obtained through medical records and psychiatric interviews. Results : Schizophrenia group(n=57) showed moderate decrease(mean 3.7 of 6) in all aspect of quality of life. However, the schizophrenia group displayed a relatively high score in relations with household members(mean=5.2) only among 21 QOL items. Comparison to other psychotic disorders group(n= 16), schizophrenia group showed a significant decrease in almost all aspects of QOL. No significant difference was obtained between the 2 year(n=27) and the 5year(n= 30) group. Duration of the first admission showed a significant correlation with current quality of life in the schizophrenic group. Conclusions : The significantly decreased score of quality of life suggests the need for careful observation and therapeutic concern for the early stage of schizophrenia. The schizophrenic group's relatively high score in relations with household members in this period may provide the importance of rehabilitation to improve their quality of life. Duration of the first admission may be a useful predictor of their subsequent quality of life.

림프관 확장증형 모기질종 1예

김도현,김재욱,이지범,김성진,원영호,이승철 대한피부과학회 2003 大韓皮膚科學會誌 Vol.41 No.2

Pilomatricoma is a benign adnexal tumor differentiating toward elements of the hair matrix and shaft. It typically presents as a solitary, deep, dermal nodule, but other variants, such as anetodermic form and pseudo-bullous form have rarely been reported. A 22-year-old man presented with erythematous 4×5㎝ sized bulla-like nodule of about 1 month history on the upper back. Histopathologic examination of the lesion showed a well-circumscribed dermal nodule composed of basophilic cells, shadow cells, and transitional cells. There were also marked lymphangiectatic dilatations above the tumor in the upper dermis. We diagnosed this case as a lymphangiectatic pilomatricoma with pseudo-bullous appearance. (Korean J Dermatol 2003;41(2) : 258∼260)

Escherichia coli 패혈증 환자에 합병된 대칭적 하지 말단 괴사증 1예

남해성,유진홍,권순석,민준기,조현선,박민경,심병주,남유정,이지인,김진수,길욱현,조근종,신완식 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

We have encountered a rare case of symmetrical peripheral gangrene complicating Escherichia coli sepsis in a 47-years-old male. He was successfully treated with antibiotics, anticoagulants, and vasodilator. To our knowledge, this is the first report on symmetrical peripheral gangrene complicating E. coli sepsis in Korea.

만성골수성백혈병에서의 동종골수이식 : 국내 경험의 후향적 분석 Retrospective Analysis of Korean Experience

이규형,이제환,이정신,김상희,김우건,김춘추,이종욱,김병국,박선양,이홍기,윤성수,김효철,남동기,한지숙,민유홍,현명수,황태주,정익주,박영석,이정애 대한조혈모세포이식학회 1998 대한조혈모세포이식학회지 Vol.3 No.2

연구방법: 국내에서 시행된 만성골수백혈병의 치료를 위한 가족간 동종골수이식의 임상적 특징을 후향적으로 분석하였다. 9개의 병원에서 1986년 9월부터 1997년 6월까지 시행한 137예의 가족간 동종골수이식을 보고하였다. 결과: 전체 환자 중 62%인 85예가 남자였고 연령은 15세에서 50세까지 분포하였다(중앙치 30세). 95예(71%)의 환자는 이식 당시 만성골수성백혈병 만성기의 상태였고 38예(28%)는 가속기 또는 모세포성발증기의 상태였다. 70예(51%)의 환자는 이식전처치로 busulfan+cyclophosphamide (BuCy) 치료를 받았고 42예(31%)의 환자는 cyclophosphamide+전신방사선 조사(Cy-TBI)를 받았다. 환자에게 이식된 단핵구의 수는 0.06-9.5×10^(8)/kg(중앙치 1.2×10^*/kg)였다. 1 예를 제외한 모든 환자에서 이식 후 8-100일(중앙치 17일)에 중성구 500/㎕ 이상의 착상이 관찰되었다. 급성 및 만성이식편대숙주질환은 각각 46%와 43%의 환자에서 관찰되었다. 중앙추적기간 20개월(범위 3-135개월) 경과 후 137예의 환자 중 52예의 환자가 사망하였다. 사망 원인은 감염(27%), 백혈병의 지속 또는 재발(23%), 이식편대숙주질환(21%), 치료독성(15%), 그리고 이식편거부(8%) 등이었다. 환자들의 event-free survival에 영향을 주는 인자로는 이식전 병의 상태(p<0.001)와 환자의 혈청 HBsAg 양성여부(p=0.012)가 중요하였다. Overall survival에 영향을 주는 인자도 이식전 병의 상태와 환자 혈청 HBsAg 양성여부로 나타났다. 결론: 본 연구에서 국내 만성골수성백혈병에 대한 동종골수이식술은 그 시행 예가 급격히 증가하고 있음을 보여주었다. 환자들의 임상 특성과 생존 성적은 외국의 성적과 유사하였다. B형 간염 감염환자의 경우 예후가 유의하게 불량하였고, 이는 추후의 임상연구에서 확인이 필요한 소견으로 사료된다. Background and Methods: Clinical features of allogeneic bone marrow transplantation (BMT) performed for patients with chronic myelocytic leukemia (CML) in Korea were analyzed retrospectively. Nine hospitals reported a total of 137 cases of allogeneic BMT performed between September, 1986 and June, 1997. Results: There were 85 male (62%) and 52 female patients with median age of 30 years (range 15-50). Ninety five patients (71%) were in chronic phase and 38 patients (28 %) were in accelerated/blastic phase of the disease. Seventy patients (51%) received busulfan-cyclophosphamide (BuCy) regimen for preparation and 42 patients (31%) received cyclophosphamide-total body irradiation (Cy-TBI) regimen. The median mononuclear cell dose given to patients was 1.2×10^(8)/kg (range, 0.06-9.5×10^(8)/kg). All but one patient achieved absolute neutrophil count of 500/μl after median 17 days after BMT (range, 8-100 days). Acute and chronic graft-versus-host disease (GVHD) were reported in 61/133 (46%) and in 57/134 (43%) patients, respectively. The median follow-up time of survivors was 20 months (range, 3-135 months). There were 52 deaths (38%). The causes of death were infection (14 patients, 27%), recurrent/persistent disease (12 patients, 23%), GVHD (11 patients, 21%), regimen related toxicity (8 patients, 15%), graft rejection/failure (4 patients, 8%), and unknown (3 patients, 6%). The factors influencing event free survival of the patients were disease status before BMT (p<0.001, by log-rank test) and serum hepatitis B surface antigen status (p=0.012). Longer duration of disease before BMT showed poorer outcome but the difference did not reach statistical significance. The factors affecting overall survival of the patients were disease status before BMT (p=0.009) and hepatitis B surface antigen status (p=0.036). The donor hepatitis B antigen status did not influence event free survival or overall survival of the patients. Conclusion: Clinical features and survival patterns of patients with CML treated with allogeneic BMT in Korea were similar to historical data from other countries. Further data analyses are warranted for the role of hepatitis B virus infection influencing the outcome of allogeneic BMT for CML.

Original Article:Comparison of the Thickness of the Lamina Cribrosa and Vascular Factors in Early Normal-tension Glaucoma with Low and High Intraocular Pressures

( Jee Hyun Kim ),( Tae Yoon Lee ),( Jong Wook Lee ),( Kyoo Won Lee ) 대한안과학회 2014 Korean Journal of Ophthalmology Vol.28 No.6

Purpose: To compare the thickness of the lamina cribrosa (LC) and vascular factors of early normal-tension glaucoma (NTG) patients with high and low intraocular pressure (IOP) that are expected to be associated with the development of glaucoma. Methods: Seventy-one Korean NTG patients with low IOP (the highest IOP <15 mmHg, 40 patients) and high IOP (the lowest IOP >15 mmHg, 31 patients) were included in this study. The thickness of LC and vascular factors were compared. The thickness of the LC was measured using the enhanced depth imaging method with spectral domain optical coherence tomography (Heidelberg Spectralis). Results: The mean thickness of the central LC was 190.0 ± 19.2 μm in the low IOP group and 197.8 ± 23.6 μm in the high IOP group, but there was no statistical significant difference between the two groups (p > 0.05). The prevalence of self-reported Raynaud phenomenon was significantly higher in the low IOP group (33.0%) than the high IOP group (10.3%, p = 0.04). Conclusions: The laminar thickness did not significantly differ between the high and low IOP groups. However, the prevalence of Raynaud phenomenon was higher in the low IOP groups. These results suggest that the development of glaucoma with low IOP patients may be more influenced by peripheral vasospasm, such as Raynaud phenomenon, rather than laminar thickness in NTG.

Incidence of Acute Kidney Injury after Adrenalectomy in Patients with Primary Aldosteronism

Jee Young Lee,Hyoungnae Kim,Hyung Woo Kim,Geun Woo Ryu,Yooju Nam,Seonyeong Lee,Young Su Joo,Sangmi Lee,Jung Tak Park,Seung Hyeok Han,Shin-Wook Kang,Tae-Hyun Yoo,Hae-Ryong Yun 전해질고혈압연구회 2019 Electrolytes & Blood Pressure Vol.17 No.2

Background: Aldosterone-induced glomerular hyperfiltration can lead to masked preoperative renal dysfunction in primary aldosteronism(PA) patients. We evaluated whether PA patients had a higher prevalence of acute kidney injury (AKI) after unilateral adrenalectomy. In addition, we identified risk factors for AKI in these subjects. Methods: This retrospective study included 107 PA patients, and 186 pheochromocytoma patients as a control group, all of whom underwent adrenalectomy between January 2006 and November 2017 at Yonsei University Severance Hospital. The primary outcome was AKI within 48 hours after adrenalectomy. Univariate and multivariate logistic regression analyses were performed to identify predictors of AKI after adrenalectomy. Results: Overall incidence of AKI was 49/293 (16.7%). In PA patients, the incidence of AKI was 29/107 (27.1%). In contrast, incidence of AKI was 20/186 (10.7%) in pheochromocytoma patients. Univariate and multivariate logistic regression analysis both showed a higher risk of postoperative AKI in PA patients compared to pheochromocytoma patients. In addition, old age, diabetes, longer duration of hypertension, lower preoperative estimated glomerular filtration rate, high aldosterone-cortisol ratio (ACR) and lateralization index (LI) were identified as independent risk factors for postoperative AKI in PA patients after unilateral adrenalectomy. Conclusion: Incidence and risk of postoperative AKI were significantly higher in PA patients after surgical treatment. High ACR on the tumor side and high LI were associated with higher risk of AKI in PA patients compared to pheochromocytoma patients.

Treatment of Melasma in Asian Skin Using a Fractional 1,550-nm Laser: An Open Clinical Study

LEE, HYOUN SEUNG,WON, CHONG HYUN,LEE, DONG HUN,AN, JEE SOO,CHANG, HANG WOOK,LEE, JONG HEE,KIM, KYU HAN,CHO, SOYUN,CHUNG, JIN HO Blackwell Publishing Inc 2009 Dermatologic surgery Vol.35 No.10

<P>BACKGROUND</P><P>Melasma is a common hyperpigmentation disorder that can cause refractory cosmetic disfigurement, especially in Asians. Fractional photothermolysis (FP) has been reported to be effective for the treatment of melasma, despite small study populations and short follow-up periods.</P><P>OBJECTIVE</P><P>To evaluate the efficacy and safety of FP for the treatment of melasma in Asians.</P><P>PATIENTS AND METHODS</P><P>Twenty-five patients with melasma received four monthly FP sessions and were followed up to 24 weeks after treatment completion. Efficacy was evaluated using objective and subjective ratings, Melasma Area and Severity Index (MASI), melanin index tracking, and skin elasticity measurements.</P><P>RESULTS</P><P>Investigators observed clinical improvements in 60% and patients in 44% at 4 weeks after treatment, but the figures decreased to 52% and 35%, respectively, at 24 weeks after treatment. Mean MASI scores decreased significantly from 7.6 to 6.2. Mean melanin index decreased significantly after the first two sessions, but it relapsed slightly in subsequent follow-ups. The treatment did not alter skin elasticity. Hyperpigmentation was observed in three of 23 subjects (13%).</P><P>CONCLUSION</P><P>Treatment of melasma with FP led to some clinical improvements, but it was not as efficacious as previously reported at 6-month follow-up. We recommend judicious use of FP for the treatment of melasma in Asian skin because of its limited efficacy.</P>

Guidelines for Cardiovascular Magnetic Resonance Imaging from the Korean Society of Cardiovascular Imaging—Part 2: Interpretation of Cine, Flow, and Angiography Data

Lee Jae Wook,Hur Jee Hye,Yang Dong Hyun,Lee Bae Young,Im Dong Jin,Hong Su Jin,Kim Eun Young,Park Eun-Ah,Jo Yeseul,Kim Jeong Jae,Park Chul Hwan,Yong Hwan Seok 아시아심장혈관영상의학회 2019 Cardiovascular Imaging Asia Vol.3 No.4

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technological advances and the expanded national insurance coverage of CMR assessments. For improved patient care, proper acquisition of CMR images as well as their accurate interpretation by well-trained personnel are equally important. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology. KOSCI has also created a formal Committee on CMR guidelines to create updated practices. The members of this committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.

Guidelines for Cardiovascular Magnetic Resonance Imaging from the Korean Society of Cardiovascular Imaging (KOSCI) - Part 2: Interpretation of Cine, Flow, and Angiography Data

Lee, Jae Wook,Hur, Jee Hye,Yang, Dong Hyun,Lee, Bae Young,Im, Dong Jin,Hong, Su Jin,Kim, Eun Young,Park, Eun-Ah,Jo, Yeseul,Kim, Jeong Jae,Park, Chul Hwan,Yong, Hwan Seok Korean Society of Magnetic Resonance in Medicine 2019 Investigative Magnetic Resonance Imaging Vol.23 No.4

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technology advances and the expanded national insurance coverage of these tests. For improved patient care, it is crucial not only that CMR images are properly acquired but that they are accurately interpreted by well-trained personnel. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology (KSR). KOSCI has also created a formal Committee on CMR Guidelines to write updated practices. The members of this Committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.

In Situ Transmission Electron Microscopy Study on the Reaction Kinetics of the Ni/Zr-interlayer/Ge System

Lee, Jae-Wook,Bae, Jee-Hwan,Kim, Tae-Hoon,Shin, Keesam,Lee, Je-Hyun,Song, Jung-Il,Yang, Cheol-Woong Korean Society of Microscopy 2015 Applied microscopy Vol.45 No.1

The reaction kinetics of the growth of Ni germanide in the Ni/Zr-interlayer/Ge system was investigated using isothermal in situ annealing at three different temperatures in a transmission electron microscope. The growth rate of Ni germanide in the Ni/Zr-interlayer/Ge system was determined to be diffusion controlled and depended on the square root of the time, with the activation energy of $1.04P{\pm}0.04eV$. For the Ni/Zr-interlayer/Ge system, no intermediate or intermixing layer between the Zr-interlayer and Ge substrate was formed, and thus the Ni germanide was formed and grew uniformly due to Ni diffusion through the diffusion path created in the amorphous Zr-interlayer during the annealing process in the absence of any intermetallic compounds. The reaction kinetics in the Ni/Zr-interlayer/Ge system was affected only by the Zr-interlayer.