정신분열증 환자에서 지형학적 청각 사건관련전위 P300의 생물학적 표시자로서 임상적 의의

전양환,한상익,방승규 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적: 저자들은 정신분열증 환자에서 지형학적 청각 사건관련전위 P300의 소견이 생물학적 표시자로서 의의가 있는 지를 알아 보고, 이를 임상적으로 상태표시자 또는 성향표시자로서 사용할 수 있는 지에 대하여 조사하였다. 방 법: 대상은 정신분열증 환자군 30명(남자=12명, 여자=18명 ; 나이 30.2±9.9세)과 정상 대조군 30명(남자=12명, 여자=18명 ; 나이 33.5±7.6세)으로 연구하였다. 정신분열증 환자군은 입원후 1주 이내에 첫 검사를 한 초기군과 4주 후 추적검사를 한 추적기군으로 나누었다. 지형학적 청각 사건관련전위 P300과 N100은 표준화된 방법인 "oddball paradigm"으로 검사하였으며, 각 검사 시점에 양성 및 음성 증상 평가척도(Positive and Negative Syndrome Scale)를 사용하여 양성증상, 음성증상, 일반정신병리, 그리고 전체증상 등으로 나누어 임상증상을 평가하였고, 환자군의 초기와 추적기의 변화는 P300과 PANSS의 원점수를 Z 변환으로 표준화하여 사용하였다. 결 과: P300 잠복기는 대조군 315.8±24.2msec, 초기군 403.8±42.3msec, 추적기군 364.7±43.2msec로서, 각 군간의 유의한 차이가 있었으며(p<0.01), N100잠복기, 나이, CCP(correct counted percent) 등을 공변인으로 공분산분석후에도 이러한 차이는 여전히 유의하였다(p<0.01). P300 전위값은 대조군 8.8±2.7μV, 초기군 4.4±1.9μV, 추적기군 4.4±2.5μV로서, 대조군과 초기군, 대조군과 추적기군 간의 유의한 차이가 있었으나(p<0.01), 초기군과 추적기군간의 차이는 없었으며, N100 전위값, 나이, CCP 등을 공변인으로 공분산분석후에도 이러한 차이는 여전히 유의하였다(p<0.01). 정신분열증의 양성증상, 음성증상, 일반정신병리, 전체증상 등은 초기군에 비해 추적기군에서 유의하게 호전되었다.(p<0.01). 임상증상이 호전되면서 P300 잠복기는 감소하였으나, P300 전위값은 변화가 있었다. 결 론: P300은 정신분열증 환자에서 정상인과 다른 양상을 보이고 있었으며, 이러한 소견은 외부자극에 의한 영향을 배제한 뒤에도 나타났다. 정신분열증 환자에서 임상증상이 호전됨에 따라 P300 잠복기는 감소하였으나, P300 전위값은 변화가 없었으며, 이는 P300 잠복기가 정신분열증의 상태표시자이고 P300 전위값은 정신분열증의 성향표시자임을 시사하는 소견으로 생각된다. This study was designed to investigate the clinical availability of topographic auditory event related potential P300 as a biological marker in patents with schizophrenia. The subjects were composed of normal controls(N=30) and patients(N=30) with schizophrenia by DSM-IV. Topographic auditory event related potential P300 and N100 were measured by "oddball paradigm", which was known as a standard method. Schizophrenics were evaluated twice, initial and follow-up, by 4 week interval. P300 latency and N100 latency were determined by Global Field Power. At this time point the maximum amplitude and its location, according to X-Y coordinates, were determined in brain topography. Clinical symptoms were evaluated by Positive and Negative Syndrome Scale(PANSS). P300 latencies of normal controls, initial group of schizophrenics, and follow-up group of schizophrenics were 315.8±24.2msec, 403.8±42.3msec, and 364.7±43.2msec, respectively. P300 amplitudes of normal controls, initial group of schizophrenics, and follow-up group of schizophrenics were 8.8±2.7μV, 4.4±I.9μV, and 4.4±2.5μV, respectively. They had significantly different P300 latencies one another by measuring ANCOVA, of which covariables were N100 latency, age, and CCP(correct counted percent)(p〈0.01). X-Y coordinates was not significant. In P300, there were some different characters between normal controls and schizophrenics even though excluding N100, which was supposed to be exogeneous component by external stimuli. When clinical symptoms were improved, P300 latency was decreased. However, P300 amplitude was not changed. These results suggest that P300 woald be available clinically as biological marker, P300 latency be a state marker, and P300 amplitude be a trait marker in schizophrenia.

인체 지방 및 간장조직 중 유기염소제류의 확인 및 정량기법 체계화

이상기,양자열,인상환,김기욱,이수연,오승민,김미영,정규혁 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-

인체기생 열두조충류의 형태비교 및 진단적 소견

임신영,강성구,양용상,백승한,류장근 THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 1998 Journal of biomedical laboratory sciences Vol.4 No.1

최근 우리 나라는 열두조충과 (Diphyllobothridae)에 속하는 조충류의 인체 감염예가 빈번하게 보고되고 있다. 이는 본 조충류의 감염매체인 어류를 날 것으로 생식할 기회가 많으며, 또한 본 조충류의 제1중간숙주인 물벼룩이 음료수를 통한 인체 감염이 원인일 것으로 추정되고 있다. 조충류의 진단은 충체에 있어 두적과 편절의 형태학적 특징을 감별하여 種의 분류와 진단을 하는 것이 기본적 순서가 될 것이나, 1차적으로 가능한 진단은 환자의 증상 참작과 분변으로부터 충란을 발견 감별하게 된다. 특히 광절열두조충류의 충란에 의한 種鑑別은 환자로부터 편절이나 충체의 확실한 감별을 위한 사전 정보를 가늠하는 뜻에서도 중요성이 있다. 이에 저자들은 환자의 치료와 함께 수집된 Diphyllobothrium latum, D. latum parvum 그리고 Spirometra erinacei의 편절과 충란을 재료로 형태 및 진단적 결과를 분석한 바 그 성적은 다음과 같다. 1. 환자의 분변에서 수집된 충란 50개씩을 각각 선택하여 형태와 크기에 대한 계측을 실시하였다. D. latum의 충란은 난개가 있고 난원형 또는 타원형의 모양으로 관찰되었으며 D. latum parvum은 D. latum에 비하여 더 난원형이면서 작게 관찰되었다. S. erinacei의 충란은 폭이 비대칭적이며 길쭉한 모양으로 관찰되었다. 2. D. latum, D. latum parvum 그리고 S. erinacei의 충란의 크기에서 충란의 평균 길이와 폭은 각각 61.4X41.7㎛, 55.9X41.4㎛ 그리고 66.7X36.4㎛이었다. 3. 각 조충의 편절을 고정한 다음, 첫째 포매하고 microtome으로 절편을 만들어 hematoxylin-eosin 염색을 실시하였고, 둘째 고정과 함께 semicon's aceto-carmine 염색표본을 작성하여 현미경 관찰을 한 결과 D. latum과 D. latum parvum은 생식선이 편절의 중앙선상에 위치하고 개구된 자궁구가 관찰되었다. 그리고 편절의 양측에 난황이 follicle로 관찰되었으며 전형적인 rosette모양을 형성하고 있었다. 그러나 D. latum parvum은 D. latum에 비하여 아주 작은 크기로 관찰되었다. S. erinacei의 편절은 자궁이 나선형으로 5∼7회 이상으로 말려서 관찰되었고 음경낭안에서 저정낭이 이어져 연결되고 있었다. 이로써 본 연구에서는 편절의 형태특징과 함께 충란 크기에 대한 계측과 분석을 하고자 하였으며, 공학현미경에 의한 계측치로 세 종류의 조충 감별에 유의한 참고치를 제기하는 바이다. Recently there have been frequent reports on human infection caused by the Diphyllobothridae in Korea. The adequate opportunities for Koreans to eat raw fish, the primary infection medium of cestodes and the human infection through drinking water by cyclops, the first intermediate host are believed to be main reasons for the infection. The first task of this study was to classify and diagnose the species by differentiating morphological characteristic between scolex and proglottids of cestodes. However, the initially available diagnosis was done with the patient's symptoms and the eggs obtained from his stool. It is important to differentiate the species by the eggs of Diphyllobothrium latum especially in that it can help get advance information for a more reliable analysis in the near future. The morphological and diagnostic results from proglottids and eggs of Diphyllobothrium latum, Diphyllobothrium latum parvum and Spirometra erinacei are as follows; In each kind of cestodes from the patient's stool, the shape and size of 50 eggs were measured. Eggs of Diphyllobothrium latum had an operculum and were ovoidal or ellipsoid to elliptical in shape. Eggs of Diphyllobothrium latum parvum were more ovoidal in shape and smaller in size than Diphyllobothrium latum. And eggs of Spirometra erinacei were asymmetrical in width and long and slender in shape. The average lengths and widths of Diphyllobothrium latum, Diphyllobothrium latum parvum and Spirometra erinacei were 61.4X41.7㎛, 55.9X41.4㎛ and 66.7X36.4㎛, respectively. After the segments of each cestode were fixed, embedding and hematoxylin-eosin dyeing on a microtome-made specimen were done. The micrographs of the semicon's aceto-carmine dyed specimen showed that Diphyllobothrium latum and Diphyllobothrium latum parvum had a centrally-located genital gland and an opened uterine pore. The yolks were observed on both sides of proglottids and had a typical rosette pattern. Yet, Diphyllobothrium latum parvum was shown smaller than Diphyllobothrium latum in the micrograph. Proglottids of Spirometra erinacei displayed that the uterus was rolled spirally more than five to seven times, and connected successively to the seminal vesicle in the cirrus sac. Shown above, this study was performed to measure the size of eggs and analyze the morphological characteristics of proglottids and provided the measurements of three types of cestodes obtained by a light microscope.

급·만성 골수염 및 화농성 관절염 환자에 대한 Pefloxacine의 임상효과

김인,이승구,김양,한창환 최신의학사 1989 最新醫學 Vol.32 No.6

응급실에서의 확산강조 자기공명 영상

정성필,이석우,양영모,하영록,김승환,유인술 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: This study was designed to review the cases of patients who had undergone diffusion-weighted magnetic resonance imaging(DWI) in the emergency department(ED), and to investigate its clinical usefulness and current indications. Methods: We analyzed the cases of 152 consecutive patients who underwent DWI in the ED from Jan to Mar 2001. DWI was obtained with the use of a multislice, single-shot, spin-echo plana imaging technique(GE SignaR). Imaging time was less than one minute. The medical records, the DWI films and the computed topography results were reviewed. We investigated the chief complaint, initial findings of physical examination, final diagnosis, decision-making department, interval from admission to imaging, and DWI findings. Results: DWI showed positive findings of high signal intensity in 84 patients(55.3%). Among the 68 patients who yielded a negative result, false negative occurred with 12 patients(17.6%): 10 lacunar infarctions, a pons infarction, and a brainstem infarction. Eleven patients were determined as having a cerebral hemorrhage, all of whom showed the abnormal finding of a mixed signal in DWI. The sensitivity and the specificity of DWI to rule out stroke were 85.5% and 98%, respectively. Current indications for DWI in our ED are age older than 60, alert mental status, and one of the symptoms or signs among lateralyzing sign, language disturbance, and dizziness/vertigo. Conclusion: DWI was highly specific to rule out stroke, so emergency care professionals should be familiar with this new technology. Further prospective study is required to determine the proper indications and clinical usefulness of DWI in the ED.

주의력결핍 과잉운동장애 아동에서 지형학적 청각 사건 관련 전위의 임상적 의의

임태식,한상익,전양환,방승규 대한신경정신의학회 2001 신경정신의학 Vol.40 No.1

연구목적: 본 연구는 소아정신과 영역에서 가장 흔한 질환인 주의력결핍 과잉운동장애의 생활학적 표지자로서 지형학적 청각 사건관련전위의 임상적 의의를 알아보기 위하여 시도되었다. 방법: 치료 전 주의력결핍 과잉운동장애 아동 22명과 대조군인 정상 아동 20명을 대상으로 지형학적 청각 사건관련전위 N100과 P300의 잠복기와 전위값을 Global Field Power Measurement 방법을 이용하여 결정하였다. 그리고 주의력결핍 과잉운동장애 아동들을 치료제인 methylphenidate로 8주간 치료한 후 동일한 방법으로 N100과 P300의 잠복기와 전위값을 구한 후, 치료 전 후 그리고 정상대조군 세 군간의 N100과 P300의 잠복기와 전위값을 비교하였다. 결과: N100 잠복기는 치료 전 ADHD군과 정상 대조군, ADHD군 치료 전 후, 치료 후 ADHD군과 정상 대조군 등 세 간에 모두 유의한 차이가 있었다. 치료 전 ADHD군의 N100 전위값은 정상 대조군과 차이가 없었다. P300 잠복기와 전위값은 공히 치료 전 ADHD군과 정상 대조군. ADHD군 치료 전 후 간의 유의한 차이가 있었고, 치료 후 ADHD군과 정상 대조군 간의 차이는 없었다. 결론: 지형학적 청각 사건 관련 전위의 N100 잠복기은 주의력결핍 과잉운동 장애의 상태 표지자로서 의의가 있음을 알 수 있었고, P300 잠복기와 전위값은 상태 표지자일 가능성이 있음을 시사하였다. Objectives : This study was carried out to investigate the clinical availability of topographic auditory event related potential P300 as a biological marker in children with attention deficit hyperactivity disorder(ADHD) Methods : The subjects were composed of children with ADHD(n=22 ; 16 boys, 6 girls; mean age=89.8±17.1months) and normal controls(n=20 ; 12 boys, 8 girls ; mean age=90.6±16.8months). Topographic auditory event related potential was measured by "oddball paradigm",and the latencies and amplitudes of P300 of both groups were determined by Global Field Power Measurement. After 8 weeks treatment with methylphenidate, P300 of ADHD children were also measured. Results : Both P300 latency and amplitude were not different between ADHD children after treatment and normal controls, but significantly different between ADHD children before treatment and normal controls, and between before and after treatment of ADHD children. Conclusion : The results implicate that the latency and amplitude of P300 may be considered as state markers of ADHD.

장관골에 발생한 거대세포 종양의 국소 재발에 관한 연구

김인,김정만,이승구,장한,김용식,김성수,한창환,김형관 가톨릭 중앙의료원 가톨릭 암센터 1991 가톨릭 암센터 論集 Vol.5 No.1

Recanalization of Organized Thrombi Demonstrated by Coronary CT Angiography Compared With OCT

Yang, Dong Hyun,Kang, Soo-Jin,Kim, Young-Hak,Kang, Joon-Won,Ahn, Jung-Min,Park, Duk-Woo,Lee, Seung-Whan,Lee, Cheol Whan,Park, Seong-Wook,Park, Seung-Jung,Lim, Tae-Hwan Elsevier Science B.V. Amsterdam 2016 JACC CARDIOVASCULAR IMAGING Vol.9 No.7

유방축소 성형술에 대한 임상적 고찰

양두병,김진환,이승원 大韓成形外科學會 1984 Archives of Plastic Surgery Vol.11 No.4

Recently, reduction mammaplasty is increasing in number among pre-marital status in Korea and number of methods were introduced and deployed by plastic surgeons. To find the most adequate and suitable methods for the Korean woman, we undertaken post-operative evaluation of 15 patients who had had reduction mammaplasty at the Department of Reconstructive Plastic Surgery, SNUH and Eul-Ji General Hospital for the past 5 years; Strombeck technique 4 cases, Pitanguy technique 1 case, McKissck technique 8 cases, Inferior Pedicle technique 2 cases, respectively. Evaluation was done under the items of age distribution, motivation, operative technique, and its pros and cons, grade of satisfaction after surgery etc. The results were as followings. 1. Age distribution of patients were in their twenties mostly after 1979, in comparison with in thirties from 1972 to 1978. 2, In the past, alleviation of symptoms associated with breast weight was principal motivation and on the contrary cosmetic improvement was their major operational goal recently. 3. Advantages and disadvantages were similar with other reports. 4. The larger the breast, patient satisfied with the operative results.

Case Reports : A case of granulomatous Lung disease in a patient with Good`s syndrome

Seung Heon Lee,Sang Min Lee,Seok Chul Yang,Chul Gyu Yoo,Young Whan Kim,Young Soo Shim,Sung Koo Han 대한내과학회 2008 The Korean Journal of Internal Medicine Vol.23 No.4

Good`s syndrome is extremely rare. This adult-onset condition is characterized by a thymoma with immunodeficiency, low B- and T-cell counts, and hypo-gammaglobulinemia. The initial clinical presentation is either a mass-lesion thymoma or a recurrent infection. Patients with Good`s syndrome are very susceptible to infections; common respiratory and opportunistic infections can be life-threatening. There are no reports of granulomatous lung disease in patients with Good`s syndrome, although it has been observed in patients with common variable immunodeficiency, of which Good`s syndrome is a subset. We describe a 53-year-old male thymoma patient who presented with respiratory symptoms caused by granulomatous lung disease and an opportunistic infection. He died of uncontrolled fungal infection despite repeated intravenous immunoglobulin and supportive care. Clinicians should look for evidence of immunologic dysfunction in thymoma patients presenting with severe recurrent infections, especially opportunistic infections.