열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

결합조직형성 법랑모세포종의 방사선학적 소견 : 증례보고 3례

최다혜,허경회,문제운,이원진,허민석,이삼선,최순철,박관수 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.37 No.1

Desmoplastic ameloblastoma is a rare histologic variant of ameloblastoma. It shows important differences in anatomic distribution, histologic appearance, and radiographic findings compared with the general type of ameloblastoma. It is histologically characterized by an abundance of densely collagenous stroma and radiographically a mixed radiolucent-radiopaque lesion. We present three cases of desmoplastic ameloblastoma. All the patients complained on buccal swelling with or without pain and the sites of occurrence were the anterior and the premolar region. Plain radiographs showed mixed radiopaque-radiolucent lesion with ill-defined or diffuse sclerotic margin and no external root resorption. Additionally, CT scans revealed buccal expansion and relatively well-defined margin of the lesions. The clinical and radiographic features of the presented cases were compared with those of the desmoplastic ameloblastoma in the previous literatures. (Korean J Oral Maxillofac Radiol 2006; 36 : 63-8)

총담관결찰이 담세관에 미치는 영향에 관한 투과 및 주사전자현미경적 연구

최경우,신영철 대한해부학회 1994 Anatomy & Cell Biology Vol.27 No.4

구강악안면영역의 3차원 CT 영상 재형성시 역치 및 불투명도에 대한 연구

최문경,이삼선,허경회,이원진,최순철 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.1

Purpose : This study was designed to determine a proper threshold value and opacity in three-dimensional CT volume rendering of oral and maxillofacial area. Materials and Methods : Three-dimensional CT data obtained from 50 persons who were done orthognatic surgery in department of oral and maxillofacial radiology of Seoul National University retrospectively. 12 volume rendering post-processing protocols of combination of threshold (100HU, 150HU, 221HU, 270HU) and opacity (58%, 80%, 90%) were applied. Five observers independently evaluated image quality using a five-point range scale. The results were analyzed by receiver operating characteristic curves, ANOVA and Kappa value. And three oromaxillofacial surgeons chose the all images that they thought proper clinically in the all of images. Results : Analysis using ROC curves revealed the area under each curve which indicated a diagnostic accuracy. The highest diagnostic accuracy appear with 100HU and 58% opacity. and the lowest diagnostic accuracy appear with 221HU and 58% opacity that are being used protocol in department of oral and maxillofacial radiology of Seoul National University. But, no statistically significant difference was noted between any of the protocols. And the number of proper images clinically that chosen by three oromaxillofacial surgeons is the largest in the cases of protocol 8 (221HU, opacity 80%) and protocol 11 (270HU, opacity 80%) in one after the other. Conclusion : Threshold and opacity in volume rendering can be controled easily and these can be causes of making an diagnostic accuracy. So we need to select proper values of these factors.

납중독 흰쥐에서 뇌조직 부위별 Biogenic Amine 함량 변화

최경규,이병철 梨花女子大學校 醫科大學 醫科學硏究所 1992 EMJ (Ewha medical journal) Vol.15 No.4

Lead is an neurotoxic substance and its clinical effect on the central nervous system has been well known since several decades ago. As the development of industry becomes more rapid and widespread in the world, we can expect the amount of lead and its harmful effect On the human life would increase in the future. We think the behavioural effect of lead on the central nervous system might be the result of the change of the neurotransmitters in the central nervous system. We studied the change of neurotransmitter amount in the cnetral nervous system of rats after lead intoxication. There was a significant neurotransmitter(catecholamine and 5 hydroxytryptamine) change after lead intoxication in our study.

의료환경 변화에 대비한 의학기술부문의 교육방향

최종학,윤범철,조경진,이준협,임국환,고성진,최경호 高麗大學校 倂設 保健大學 保健科學硏究所 2003 保健科學論集 Vol.29 No.1

Under the pressure to open the service market as proposed by World Trade Organization, we can easily expect our educational systems for allied health professions will experience a lot of changes in near future. Accordingly, we compared our current educational systems for allied health professions with the foreign ones and mapped out some strategies predicting the forthcoming enormous changes. Major investigations and analysis are summed up as follows, The educational programs for allied health professions which was started in 1963 in Korea are stilled remained as 2 to 3 school years, while the systems in advanced countries have already been changed or been changing from 2 year to 4 year college levels. We can hardly find the uniform educational system or school years for the allied health professions in the world except for Korea. Fortunately, university level four-year programs for the profession was established in 1979 in Won-joo for the first time in Korea. However, there are still only few four-year programs in this country. To meet the rapidly changing needs we have faced in the health areas we should supply appropriate health personnel through various efforts. Now we would like to suggest followings, <Educational goals for the allied health professions> 1) reconfirming characteristics for the educational goals of health professions 2) extending school years for the allied health professions 3) strengthening clinical training and internship 4) expanding opportunities for the continuing education through lifelong education 5) upgrading from old-fashioned technologies to advanced technologies 6) cultivating competencies of health professionals for the global competition <Suggestions for the Development of Allied Health Professions> 1) reforming the school years of educational programs for the allied health professions to meet the global standards 2) expanding the role of junior college programs for the allied health professions through the development of intensive courses in the professions. 3) diversifying and specializing the allied health professions mainly through 4 year B.S. degree programs.

HRTF(머리저달함수)의 샘플링률 변환에 따른 입체음향 플레이어

오재경,이동재,임철수,최범석,이원돈 호서대학교 반도체제조장비국산화연구센터 2001 반도체장비학술심포지움 Vol.2001 No.-

본 논문에서는 3D사운드 생성 기술 중 대표적인 방법인 원음에 HRTF(머리전달함수)를 콘볼루션(convolution하는 방식으로 음상정위 모듈을 구현하였으며 음장감을 부여하기 위하여 잔향(reverberation)효과를 추가하고 크로스토크 현상을 제거하기 위하여 트랜스오럴 필터를 추가하였다.본 논문에서는 sampling rate conversion을 사용하여 decimation과 interpolation을 수행하여 44.1KHz의 sampling rate로된 coefficient를 downsample하거나 upsample한 HRTR(머리전달함수)를 사용하여 콘볼루션(convolution)을 수행했다.본 논문에서는 3D사운드 생성과정에서 필요한 연산과정을 최소화하여 일반 PC의 computing power로도 sampling rate conversion된 데이터를 처리하여 줄 수 있는 알고리즘을 제시하고 구현하였다.

정신분열병의 경과 중 발생하는 우울증

곽경환,박두병,최태영,민경준,이영식,기백석,나철 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.3

연구목적 : 정신분열병을 음성증상군과 양성증상군으로 나누어 두 군 사이에 우울증이 차이가 있는지를 조사하고 정신분열별의 증상과 우울증과의 연관과 정신분열병의 경과 중 보이는 우울증사의 특징에 대해서 알아보고자 하였다. 방 법 : 중앙대학병원에 입원한 총 31명(남자 13명, 여자 18명)의 정신분열병 환자를 대상으로 PANSS, BDI, HDRS와 Simpson Angus Scale을 시행하였다. 결 과 : 1) BDI 21점 이상을 기준으로 했을 때, 정신분열병의 경과 중 우울증이 발생한 환자는 총 18%였으며, 양성증상군과 음성증상군 간에 차이는 없었다. 2) 양성증상군과 음성증상군 간에 BDI, HDRS 그리고 PANSS-D 등의 점수의 차이는 없었다. 3) 주관척도인 BDI와 객관척도인 HDRS와 PANSS-D 사이의 연관은 없었다. 결 론 : 정신분열병의 우울증은 양성증상이나 음성증상의 한 부분으로 생각하기보다는 또 다른 영역으로 받아들여야 할 것으로 보인다. 임상적으로 정신분열병에서 우울증은 발생되는 비율의 정도를 고려할 대 다른 증상과 더불어 집중적인 관심이 필요하며 이와 함께 우울증으로 인한 결과와 예후의 심각성을 고려할 때 우울증에 대한 인식 및 진단과 치료에 더 많은 진전이 있어야 한다. Objective : The heterogeneity of symptomatology within the group of schizophrenias is still a major obstacle for defining clinically useful subgroups of these disorders. One of these symptoms is depression. Recently there is a growing evidence suggesting that depressive symptoms and related mood disturbances are important in treating schizophrenia. This so because of the improvement of such side effects as extraphramidal symptoms with increasing use of atypical antipsychotics. Althought depression is known to be a serious problems of many schizophrenic patients, the nature and course of depression in schizophrenia remain unknown. Methods : The author examined the depressive features in 31 patients with schizophrenia. Rating on the PANSS, BDI and HDRS were obtained. Eighteen percent of the total patients had BDI score above 21, considered depressed. Results : There were no difference in BDI, hDRS and PANSS-D between positive symptoms group and negative synptom group. There was also no correlation between subject scale(BDI) and objective scales(HDRS, PANSS-D). Conclusions : Depression in schizophrenia needs intensive studies. It is also considered as another hereogeneous domain beside negative or positive symptom domain. Out of respect for the high prevalence and serious outcome of depression in schizophrenia, a more differentiated assessment, analysis, and treatment of depressive symptom is recommended.

비후성 유문 협착증 환아에서 유문부 두께에 미치는 인자에 관한 연구

허경열,문철,최은창 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.1

The infantile hypertropic pyloric stenosis is the most common surgical condition during period of one to three months after birth, and is diagnosed without difficulty by symptoms of projectile nonbilious vomiting, visible gastric waves and palpation of olive shaped mass and confirmed by upper G-I series and abdominal ultrasonogram if symptoms were not diagnostic. It's treatment performing Fredet-Ramstedt pyloromyotomy is relatively easy. But, considering some serious complications such as dehydration, electrolyte imbalance, malnutrition, persistence of symptoms, duodenal perforation and hemorrhage developing during or after operation, it is necessary to study the size of the pyloric muscle and relating clinical factors for secure and safe pyloromyotomy. The purpose of this study is to assess the affecting factors associated with thickness and length of pyloric muscle in infantile hypertrophic pyloric stenosis. 60 cases of infantile hypertrophic pyloric stenosis had analysed, who had been treated with pyloromyotomy from November 1993 to December 1997 in Mok-dong Hospital, Ewha Womans Medical College. The results were as follows; (1) By ultrasonographic measurement, the thickness and length of pylorus were 5.7±1.6mm(ranges 3.5 ∼ 10mm)and 18.9±3.4mm(ranges 14 ∼ 30mm). These values were greater than normal control group of acute gastroenteritis. The thickness and length of pylorus in infant with acute gastroenteritis were 3.4±0.5mm and 7±0.4mm respectively. (2) Major symptoms were non-bilous vomiting and olive shaped mass. In those with major symptoms of non-bilious vomitng and olive shaped mass, the thickness and length of pylorus were consistent with the mean value of entire group of patients. In those cases with symptoms of only simple nausea and vomiting, the thickness and length of pyloric muscle were smaller than mean value of entire group. But, in cases with symptoms of jaundice, the thickness and length were greater than the mean value of entire group. (3) In cases with symptom duration for 1 week, the thickness and length of pyloric muscle were less than the mean value of the group of 2 weeks duration. But, there was no significant difference between groups of 2 weeks and 3 weeks of symptom duration. (4) Heavier the body weight at the same age, the larger the thickness and length of pylorus. (5) In cases with breast feeding, the thickness of pyloric muscle was greater than that of milk feeding group or mixed feeding group. But there was no difference in the length of pyloric muscle between types of feeding. (6) Electrolyte imbalance were hypochloremia, hypokalemia and metabolic alkalosis. In patients with hypokalemia less than 3.2mEq/L, there was significant increase in the thickness and length of pyloric muscle. But there was no difference in thickness and length of pyloric muscle according to the level of serum chloride. (7) With the group of positive IgG of H.pylori by ELISA test, the thickness and length of pyloric muscle were significantly larger than that of negative group. From these results, it may be concluded that the thickness and length of pyloric muscle were affected by following factors; pattern of cardinal symptoms of nonbilious vomiting and olive sized mass, symptom duration of more than 2weeks, heavier body weight, breast feeding, hypokalemia and presence of H.pylori infection.

결핵의 진단법으로서 중합효소 연쇄반응 검사의 가치

서상철,은상진,김한길,송경은,서장수,최성만,이원길,김재식,김중명 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.1

목적 : 결핵균 동정을 위한 중합효소 연쇄반응을 임상병리검사로서 적용하기 위한 기초 실험으로 분석학적 예민도와 특이도를 알아보고 검토된 조건에 의한 중합효소 연쇄반응을 실제 임상 가검물에 적용하기 위함이다. 재료 및 방법 : Ziehl-Neelsen염색 양성인 객담, 뢰벤스타인-젠센(Loewenstein-Jensen) 배지에서 분리된 결핵균 및 M. tuberculosis H37Rv를 비롯한 항산균 표준균주 11주와 비항산균 10주를 사용하여 2가지 DNA의 분리법, 3set 프라이머, 3종류 중합효소, 2가지 미량 원심시험관 및 Easy-Cycler^R(Ericomp사, 미국)와 수조형으로 검사를 시행하여 DNA 증폭 산물을 비교하였다. 또한 이미 지일-닐슨 염색법에 의한 선별검사에서 음성을 나타낸 객담 53예, 소변 101예, 삼출액 128예, 뇌척수액 54예 등 총 370예의 임상가검물을 대상으로 하여 위에서 검토된 중합효소 연쇄반응 조건으로 검사한 성적과 지일-닐슨 염색법, 배양법 성적과 비교하였다. 결과 : DNA분리방법 2가지와 3가지 중합효소는 분석학적 예민도와 5fg로 나타나 차이를 발견할 수 없었으며, 프라이머 P1, P2쌍은 예민도가 5fg, 프라이머 INS1, INS2쌍과 프라이머 Pt3, Pt6쌍의 예민도는 0.5fg이었다. Easy-Cycler^R가 수조형에 비해 높고, 미량 원심시험관은 Robbins사 제품이 Sarstedt사 제품에 비해 높은 분석학적 예민도를 나타냈다. 프라이머 P1, P2쌍과 프라이머 INS1, INS2와 Pt3, Pt6 2쌍의 프라이머의 특이도에 있어서는 항산균 표준균주 중 M. tuberculosis H37Rv, M. tuberculosis ATCC 27294, M. bovis ATCC 29312의 3주에서 특이 증폭 띠를 관찰할 수 있었다. 그러나 비결핵성 항산균 8주에는 특이 증폭 띠를 나타내지 않았다. 또 비항산균 10주에도 특이 증폭 띠가 관찰되지 않았다. 따라서 Robbins사의 미량 원심시험관과 proteinase-K법에 의한 DNA분리방법에 Easy-Cycler^R를 사용하여 프라이머 INS1, INS2쌍으로 일차 중합효소 연쇄반응을 시행한 후 프라이머 Pt3, Pt6쌍으로 이차중합효소 연쇄반응을 시행하는 방법을 370예의 임상가검물에 시행하였고 지일-닐슨 염색법과 결핵균배양검사도 동시에 시행한 결과 중합효소 연쇄반응 양성은 106예(28.6%), 배양 양성은 27예(7.3%) 및 염색 양성은 18예(4.9%)였으며, 결핵환자는 141명(38.1%)였다. 370예의 임상 가검물로 시행한 중합효소 연쇄반응의 진단학적 예민도와 특이도, 양성결과 예측치 및 음성결과 예측치는 68.8%, 96.1%, 91.5% 및 83.3%로 각각 나타났다. 결론 : 결핵균 동정을 위한 중합효소 연쇄반응은 배양검사에 비해 신속하며, 분석학적인 예민도와 특이도가 뛰어나므로 결핵 진단을 위한 임상병리검사로서 유용하다고 사료됨. In this study, We investigated the optimal conditions of polymerase chain reaction(PCR) assay for the rapid identification of Mycobacterium tuberculosis in clinical specimens as routine laboratory test. So we have compared two DNA isolation methods, 3 polymerases, 2 set of primer, 2 kinds of thermocycler and 2 microtubes. We evaluated two DNA isolation methods, bead-beating method and proteinase-K method, the latter was more sensitive than the former. In comparision of two sets of primers, P1 and P2 primers detecting 123-base pair fragment of IS6110 made from Biosnthesis(U. S. A.) and INS1 and INS2 primers detecting 245-base pair fragment of IS986 showed equally sensitive results ie. 5fg. Specificity of primers were tested and INS1 and INS2 primers gave 245-base pair product from M. tuberculosis H37Rv, M. tuberculosis ATCC 27294 and Mycobacterium bovis ATCC 29312 but not from 8 nontuberculous mycobacterial strains such as M. kansasii ATCC 12478, M. terrae ATCC 15755, M. intracellurae ATCC 13950, M. avium ATCC 25281, M. gordonae ATCC 14470, M. fortuitum ATCC 6841, M. smegmatis ATCC 19420, M. scrofulaceum ATCC 19981. Coagulase-positive staphylococcus, coagulase-negative staphylococcus, streptococcus, Esccherichia coli, Serra-tia marcescens, Klebsiella pneumoniae, Enlerobacter aerogenes, Enterobacter cloacae, Acinetobacter calcoaceticus, Pseudomonas aerugonosa showed no 245-base pair amplification product. PCR by the P1 and P2 primers showed 123-base pair amplification product from M. tuberculosis H37Rv, M. tuberculosis ATCC 27294 and Mycobacterium bovis ATCC 29312 but not from 8 nontuberculous mycobacterial strains such as M. kansasii ATCC 12478, M. terrae ATCC 15755, M. intracellularae ATCC 13950, M. avium ATCC 25281, M. gordonae ATCC 14470, M. fortuitum ATCC 6841, M. smegmatis ATCC 19420, M. scrofulaceum ATCC 19981. Coagulase-postive staphylococcus, coagulase-negative staphylococcus, streptococcus, Escherichia coli, Serratia marcescens, Klebsiella pneumoniae, Enlerobacter aerogenes, Enterobacter cloacae, Acinelobacler calcoaceticus, Pseudomonas aeruginosa showed no 123-base pair amplification product. In comparision of polymerase, Taq DNA polymerase^R(Promega Co., U. S. A.) was more cost effective than Ampli Tag^R(Perkin-Elmer Cetus, U. S. A.), but these two were equally sensitive and specific in the detection of M. tuberculosis-specific DNA. Tac polymerase (Korea'Biotech, Korea) showed many nonspecific bands. In comparision of thermocycler, Easy-Cycler^R(Ericomp, U. S. A.) was more sensitive than water-bath type and in that of microtubes Robbin's were more sensitive than Sarstedt's PCR results were compared with results of culture for M. tuberculosis and Ziehl-Neelsen stain in 370 clinical specimens that were negative by initial Ziehl-Neelsen stain. There were 27 specimens(7.3%) that were positive for M. tuberculosis by culture, 18(4.9%) specimens that were positive by Ziehl-Neelsen stain, and 106 specimens(28.6%) that were positive for PCR and 141 cases that were positive for tuberculosis. Overall sensitivity, specificity, positive predictive value and negative predictive value were 68.8, 96.1, 91.5 and 83.3% respectively, for PCR; 19.1, 100, 100, and 66.8%, respectively for culture; and 12.8, 100, 100, and 59.0% respectively for Ziehl-Neelsen stain.