혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

전수면박탈이 정상인의 생리기능과 인지기능에 미치는 영향

정종현,송후림,신윤경,한진희,이성필,홍승철 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Purpose of this study was to investigate physiological and neurocognitive effects of total sleep deprivation by using laboratory blood tests and the computerized neurocognitive function test in healthy subjects. Methods : Sixteen healthy volunteers participated in this study. Subjects were recommended to remain awake for 48 hour sunder continuous surveillance. Lab tests of cortisol, Prolactin, thyroid hormone, growth hormone, and immunoglobulin (IgG, IgA, IgM, IgD, IgE), CBC, BC and the Vienna test were performed before and after 48 hours of total sleep deprivation. Results : Concentration of T3 and T4 significantly increased after deprivation. In the reaction test, distribution reaction time significantly increased, and correct reaction significantly decreased. In the vigilance test, amount of correct reaction Signifi-cantly decreased, and the mean value of correct reaction time was significantly delayed. Level of fasting blood sugar, total protein, albumin, alkaline phosphatase and potassium significantly increased, respectively, except for the level of total bilirubin which was decreased. After total sleep deprivation, WBC counts significantly increased. Regarding immunoglobulin level, IgG,IgA and Ag M concentrations appeared to decrease, but the results were not statistically significant. Conclusion : The effect of total sleep deprivation on physiological function was significant in the level of thyroid hormone. Although statistically not significant, the results of growth hormone and the immune system showed a trend in relations to the effect oftotal sleep deprivation. Results of blood chemistry suggest that sleep dephvation may influence metabolism Of hepato-biliary system. Cognitive impairment was also seen in reactive and vigilant functions after total sleep deprivation.

인터리버를 이용한 eHDR-WPAN 시스템의 성능 분석

정승희,이현재,오창헌 한국기술교육대학교 2006 論文集 Vol.12 No.1

In this paper, we propose a performance of improvement method for eHDR-WPAN system with Interleaver. The pattern of burst error caused by fading in indoor wireless channel. For the reason, using of Interleaver(make burst error to random error) can be enhanced to error-rate in eHDR-WPAN system. Interleaver at the simulation considered Convolutional, Block and Random, respectively. Available symbol spacing of Interleaver is assumed 9 and 27. In results, Block-Interleaver is shown that a performance of improvement about 0.6dB of E_(b)/N_(o) at 10^(-4). Therefore, the suitable Interleaver for eHDR-WPAN system was 9 symbol spacing of Block Interleaver.

정신분열병, 기분장애와 보르나 바이러스

정성훈,원승희,김상헌 대한생물치료정신의학회 1998 생물치료정신의학 Vol.4 No.2

Borna disease virus is a unique neurotropic agent that appears to have a predilection for the limbic area of the brain. In some animal species, it can produce a behavioral syndrome characterized by aggressive and passive phases. These two characteristics has suggested the relationship between schizophrenia, mood disorder and Borna disease virus. Borna disease virus can infect human brain tissue possibly contributing to the pathophysiology of specific human neuropsychiatric disorders. The authors reviewed several articles suggesting an association of Borna disease virus with schizophrenia and mood disorder.

군집분석과 다차원척도법으로 본 유치열의 우식패턴

정승열,이광희,라지영,안소연,김윤희 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.2

The purpose of this study was to identify patterns of caries in the dentition of preschool children using cluster analysis and multidimensional scaling. 815 preschool children aged 36-71 months old were examined for caries experience. The first four clusters in the cluster analysis were (1) molars, (2) upper incisors, (3) lower 1st molars, and (4) upper 1st molars in teeth, (1) occlusal surfaces of lower molars and upper 2nd molars, (2) mesial surfaces of upper central incisors, (3) occlusal surfaces of lower 1st molars, and (4) separation between occlusal surfaces of upper and lower 2nd molars in tooth surfaces, and (1) proximal surfaces of upper anterior teeth, (2) occlusal surfaces of lower molars, (3) buccolingual surfaces of upper anterior teeth and (4) buccolingual, proximal, and occlusal surfaces of upper molars and buccolingual and proximal surfaces of lower molars in tooth surfaces groups. In the multidimensional scaling analysis, teeth could be divided into lower 1st molars, upper 1st molars, upper central incisors, upper lateral incisors, lower 2nd molars, upper 2nd molars, and the rest(canines, lower incisors), tooth surfaces could be divided into occlusal surfaces of lower molars, mesial surfaces of upper central incisors, occlusal surfaces of upper molars, and the rest, and tooth surface groups could be divided into proximal surfaces of upper anterior teeth, buccolingual surfaces of upper anteiror teeth, occlusal surfaces of lower molars, and the rest in the order of the distance from others. In the cluster analysis and the multidimensional scaling analysis, caries patterns were different according to the age. 유치열에 존재하는 우식패턴을 연구하기 위하여 유치열을 가진 유아들을 대상으로 치면별 우식경험도 조사를 실시하고 군집분석과 다차원척도분석을 실시하였다. 연구대상은 367H 월 이상 71 개 월 이하의 어린이 815명 이 었다. 군집분석에서 먼저 분리된 네 개의 군집은, 유치는 (l) 유구치, (2) 상악 유절치, (3) 하악 제1유구치, (4) 상악 제1유구치, 유치면은 (1) 하악 유구치 교합면과 상악 제 2유구치 교합면, (2) 상악 유중절치 근심면, (3) 하악 제1유구치 교합면, (4) 상하악 제2유구치 교합면의 분리, 유치면군은 (l) 상악 유전치 인접면, (2) 하악 유구치 교합면, (3) 상악 유전치 협설면, (4) 상악 유구치 협설면, 인접면, 교합면 및 하악 유구치 협설면과 인접면이었다. 다차원척도분석에서 상호간에 가장 멀리 떨어진 순서로 보았을 때, 유치는 하악 제 1유구치 , 상악 제 1유구치 , 상악 유중절치, 상악 유측절치, 하악 제 2유구치, 상악 제 2유구치, 기타 유치(유견치, 하악 유절치)로 나눌 수 있었고, 유치면은 하악 유구치 교합면, 상악 유중절치 근심면, 상악 유구치 교합면, 기타 유치면으로 나눌 수 있었으며, 유치면군은 상악 유전치 인접면, 상악 유전치 협설면, 하악 유구치 교합면, 기타 유치면군으로 나눌 수 있었다.

뇌손상 후 인지기능장애에 대한 메칠페니데이트의 효과-이중맹검 위약대조 연구-

김연희,나승용,신용일,서정환 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.4

탈력발작 유무에 따른 기면병 환자의 비교 : 임상변인, HLA-DQB1*0602, Hypocretin

정종현,홍승철,신윤경,한진희,이성필 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.1

Objectives : Narcolepsy is a sleep disorder, characterized by excessive daytime sleepiness, cataplexy, sleep paralysis and hypnagogic hallucination. Among these symptoms, cataplexy is one of the most pathognomonic symptoms in narcolepsy. This study was designed to investigate the clinical features, frequency of DQB 1 *0602 and CSF hypocretin levels in Korean narcolep-tics with cataplexy to compare with those who have not cataplexy. Methods : From August 2003 to July 2005, we selected 72 patients who have narcolepsy confirmed by nocturnal Polysomno-graphy and multiple sleep latency test (MSLT) as well as their history and clinical symptoms at Sleep Disorders Clinic of St. Vincent's Hospital, Catholic University of Korea. Patients were divided into 56 cataplexy-positive group (narcolepsy with cataplexy group) and 12 cataplexy-negative group (narcolepsy without cataplexy group). HLA typing was done in all patients for the presence of DQB 1*0602, and patients received spinal tapping to measure the level of CSF hypocretin. Clinical variables were examined by semi-structured interview for narcolepsy patients. Results : 1) In cataplexy-positive group, compared with cataplexy-negative group, the frequency ofHLA-DQB 1*0602 was found to be significantly increased (50 subjects, 89.3% vs. 8 subjects, 50.0%) (p=0.000). 2) tn 48 out of 56 cataplexy-positive patients (85.7%), hypocretin levels were decreased (≤110 pg/mI) or were below the detection limit of assay (≤40 pg/ml).However, only 6 out of 16 cataplexy-negative patients (37.5%) exhibited decreased hyopcretin level. The difference between two groups were statistically significant (p=0.000). 3) Cataplexy-positive group, compared to cataplexy-negative group, re-ported more frequent hypnagogic hallucinations (36 subjects, 64.3% vs. 4 subjects, 25.0%) (p=0.005). However, there were no significant differences in frequency or seventy of daytime sleepiness, sleep paralysis and demographic data. 4. In nocturnal polysomnography and MSLT findings, there were no significant differences in all sleep parameters between two groups. Conclusion : Higher frequency of HLA-DQB 1*0602, and lower hypocretin levels in cataplexy-positive groups than Cata-pelxy-negatives suggest that narcoleptics with cataplexy might be a etiologically different disease entity from narcoleptics without cataplexy. Additionally, Current criteria prevail for the diagnosis of narcolepsy need to be reclassified according to the presence of cataplexy or not.

T1 강조 영상에서 선조체 고신호강도를 보이는 당뇨 환자에서의 편측무도증

정승철,이병철,김상윤,배재천,황성희,도화범,박종호 대한신경과학회 1997 대한신경과학회지 Vol.15 No.1

유아에서 발생한 재발성 외음부 콘딜로마 1례의 치료

홍정희,문성택,김윤숙,전섭,최승도,선우재근,배동한 순천향의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.2

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