3T Multi Voxel Spectroscopy에서 SENSE와 NEX 변화에 따른 정상인 뇌 대사물질 변화 분석

성열훈,임재동,이재현,조성봉,우동철,최보영,Seong, Yeol-Hun,Rhim, Jae-Dong,Lee, Jae-Hyun,Cho, Sung-Bong,Woo, Dong-Chul,Choe, Bo-Young 한국의학물리학회 2008 의학물리 Vol.19 No.4

자기공명분광법(magnetic resonance spectroscopy: MRS)은 인체내 대사물질을 정량분석하여 병변의 조기진단 및 정밀진단에 도움을 주고 있으며, 최근 임상에 이용되고 있는 자기공명분광법은 single voxel spectroscopy (SVS) 기법과 multi voxel spectroscopy (MVS) 기법이 있다. 본 연구에서는 SENSE와 NEX를 변화시킨 multi voxel spectroscopy (MVS)의 데이터와 기존 single voxel spectroscopy (SVS)의 데이터를 비교 분석하여, 각각의 데이터의 유의성 차이를 평가하고자 하였다. 정상 성인 지원자 13명(남자: 5명, 여자: 8명, 평균 41세, 표준편차 11.65세)을 대상으로 chemical shift image (CSI)를 이용한 MVS검사를 시행하였다. 장비는 3.0T Achieva Release Version 2.1 (Philips Medical System, Netherland)을 이용하였고, 8 channel head coil을 사용하여 brain thalamus 부위에서 CSI spectrum을 1 slice 획득하였다. Scan parameter로는 FOV (field of view): $230{\times}184mm^2$, TR (time to repetition): 2000 msec, TE (time to echo): 288 msec, matrix: $15{\times}12$, VOI(view of interest): $110{\times}110mm^2$, voxel size: $15{\times}15{\times}15mm^3$로 하였다. SENSE factor (S)와 NEX (N)는 S1*N1, S2*N1, S2*N2, S3*N2로 변화하여 스펙트럼을 획득하였고, 각 scan time은 5분 54초, 3분 32초, 6분 20초, 4분 20초였다. 얻은 모든 MRS 데이터는 jMRUI 3.0 Version 프로그램에서 분석하였고, SENSE factor와 NEX를 변화시켜 얻은 MVS data 그룹들이 정상 성인 뇌 대사물질의 변화에 영향을 주는지 검증하기 위해 그룹 간에 ANOVA분석을 실행하여 P 값이 0.05보다 크게 나오면 그룹들 사이에 유의한 차이가 없다고 분석하였다. NAA/Cr과 Cho/Cr의 상대적 비율은 MV와 SVS사이에서는 유의한 차이가 없었다. 즉, SENSE factor와 NEX를 변화시켜 얻은 MVS data에서 정상 성인 뇌조직의 대사물질의 변화를 관찰한 결과, S1*N1의 NAA/Cr은 $1.45{\pm}0.03$, Cho/Cr은 $0.88{\pm}0.03$이고, S2*N1의 NAA/Cr은 $1.44{\pm}0.03$, Cho/Cr은 $0.87{\pm}0.05$, S2*N2의 NAA/Cr은 $1.43{\pm}0.02$, Cho/Cr은 $0.87{\pm}0.04$이며, S3*N2의 NAA/Cr은 $1.45{\pm}0.03$, Cho/Cr은 $0.87{\pm}0.03$으로 나타났다(F-value : 1.37, D.F : 3, P-value : 0.262). 그러나 데이터의 질을 측정하기 위한 MVS 데이터의 NAA Peak line-width는 SVS 데이터의 NAA Peak line-width 보다 약 3배 정도 넓었다. 본 연구에서는 MVS에서 SENSE factor와 NEX 값을 다양하게 변화시킨 MVS의 데이터와 SVS의 데이터가 큰 차이가 없음을 확인하였다. 즉, 어는 특정 부위의 뇌 조직의 대사물질은 MVS와 SVS 기법 모두 큰 차이가 없음을 확인할 수 있었다. 그러므로 MVS는 SVS보다 광범한 부위를 짧은 시간 안에 검사할 수 있으므로 매우 유용한 방법이라고 사료된다. To evaluate the metabolic changes in normal adult brains due to alterations SENSE and NEX (number of excitation) by multi voxel MR Spectroscopy at 3.0 Tesla. The study group was composed of normal volunteers (5 men and 8 women) with a mean ($\pm$ standard deviation) age of 41 (${\pm}11.65$). Their ages ranged from 28 to 61 years. MR Spectroscopy was performed with a 3.0T Achieva Release Version 2.0 (Philips Medical System-Netherlands). The 8 channel head coil was employed for MRS acquisition. The 13 volunteers underwent multi voxel spectroscopy (MVS) and single voxel spectroscopy (SVS) on the thalamus area with normally gray matter. Spectral parameters were as follows: 15 mm of thickness; 230 mm of FOV (field of view); 2000 msecs of repetition time (TR); 288 msecs of echo time (TE); $110{\times}110$ mm of VOI (view of interest); $15{\times}15{\times}15$ mm of voxel size. Multi voxel spectral parameters were made using specially in alteration of SENSE factor (1~3) and 1~2 of NEX. All MRS data were processed by the jMRUI 3.0 Version. There was no significant difference in NAA/Cr and Cho/Cr ratio between MVS and SVS likewise the previous results by Ross and coworkers in 1994. In addition, despite the alterations of SENSE factor and NEX in MVS, the metabolite ratios were not changed (F-value : 1.37, D.F : 3, P-value : 0.262). However, line-width of NAA peak in MVS was 3 times bigger than that in SVS. In the present study, we demonstrated that the alterations of SENSE factor and NEX were not critically affective to the result of metabolic ratios in the normal brain tissue.

양극성 정동장애와 혈청 Inositol-1-phosphatase 활성도 변화

조현주,김영철,우행원,연규월,조기승 대한생물치료정신의학회 1998 생물치료정신의학 Vol.4 No.2

Objects : Several lines of possibilites have been oroposed about the etiology of bipolar attective disorder in biological, genetic and psychosocial aspect. The purpose of this study is to inspect the etiology of bipolar affective disorder in biological aspect by measuring the changes of serum inositol-1-phosphatase activity and investing a causal relationship between clinical symptoms and serum inositol-1-phosphatase activities in patients with bipolar affective disorder. Methods : The subjects were 18 inpatients who met DSM-IV diagnostic criteria for bipolar I affective disorder, manic episode and 15 normal controls. Inositol-1-phosphatase activities were measured in serum by using spectrophotometer. Clinical symptoms of patients were assessed by YMRS at admission day and after 2 weeks lithium treatment. Results : 1) Inositol-1-phosphatase activities of the patients were increased to about 2 times as compared with those of normal controls. And the activity levels were decreased gradually to the normal at 14 days. 2) Young's Mania Rating Scale(YMRS) scores were decreased significantly by lithium treatment. 3) Statistical significance could not be found between the change of YMRS scores and the levels of inositol-1-phosphatase activity. Conclusion : In this study, statistical significance could not be found between clinical improvement and inositol-1-phosphatase activities, but the fact that lithium treatment improve the clinical manifestation shown by YMRS score changes, and reverse the increased inositol-1-phosphatase activities suggests the strong association between pathophysiology of bipolar affective disorders and inositide metabolism.

재발성 류마티즘 환자에서 발작의 유발인자

주유철,이동민,양종태,신병철,임태영,서정균,정기영,최동헌,김원,조영신,고희관 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : Palindromic rheumatism (PR) is known to be triggered without any obviously inciting events in most patients, although, in a few cases, attacks have been noted to relate to another events such as weather change, childbirth, ingestion of certain foods, or over-exercise. The aim of this study was to characterize the triggering factors on palindromic attacks. Materials and Methods : We evaluated sixty-four patients with PR for the presence of triggering factors and the relationship between attacks and triggering factors by interview of patients. We considered that there was an probable association between episodes and PR, if episodes within 24 hours prior to PR had triggered at least 50% of all attacks and a definite association between episodes and PR, if episodes within 24 hours prior to PR had triggered 100% of all attacks. Results : In 15 patients (35.9%), there was a possible association between episodes of PR and initiating events. In 8 patients (12.5%), there was a definite association between episodes of PR and initiating events. The triggering factors were physical over-activity including exercise (19/64: 29.7%), foods, such as rawfish, crab, and chicken, including alcohol (19/96: 19.8%). However, there were no difference between the groups with and without the triggering factor in sex ratio, duration and onset of PR, the positive rate of rheumatoid factor and involved sites. Conclusion : Our observations showed that PR was triggered by physical over-activity more than in previous reports and hypersensitivity to foods was a causative factor in some patients with PR. However, patients with triggering factors had a similiar clinical profile to patients without triggering factors.

브로콜리 추출물의 향장활성 효과

김대용ㆍ조석철ㆍ권혁선ㆍ김미경(Dae Young KimㆍSeok chul ChoㆍHyuk sun KwonㆍMee Kyung Kim) 한국인체미용예술학회 2016 한국인체미용예술학회지 Vol.17 No.1

In this study, we investigated the anti-oxidative effects, antimicrobial, and anti-inflammatory activities of the extracts from broccoli to evaluate its use as a functional ingredient in cosmetics. The extracts are WE (water extract at RT), MWE (mineral water extract at RT), EE (70% ethanol extract at RT), and USEE (heat process for 12 hours at 60℃ after ultrasonification for six hours with 70% ethanol). The measurements of the total polyphenol content from broccoli extracts were highest in EE at 425.24±13.9 mg/g dry. The result of electron donating ability of EE was the highest at 10,000 ㎍/㎖ as 97.81% and increased in a concentration-dependent manner. The ferric reducing antioxidant powder (FRAP) of EE was the highest at 10,000 ㎍/㎖ as 1235.6 μM. In an antimicrobial activity test, the EE showed significant antimicrobial activity against S. epidermidis, S. aureus, E. coli, P. acnes, and P. ovale. Furthermore, broccoli extract exhibited no cytotoxicity in RAW 264.7 cells. Also anti- inflammatory activity by NO assay showed LPS-induced NO was significantly inhibited following treatment with EE of 1,000 ㎍/㎖. Therefore, the broccoli ethanol extract can be used as a resource of natural cosmetic material for functional cosmetics.

정신분열병 환자들의 自己灣入에 관한 예비 연구

박성봉,김영미,전성일,이기철,김영훈,정영조,이영렬,이정호,최영민 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

목 적 : 정 신분열병 환자의 자기만입 정도에 영향을 미치는 인구학적 변인들 및 질병연관 변인들을 규명해 보고자 하였다. 또한. 환자들의 자기만입과 병식 사이의 연관성. 자기만입과 자존심 사이의 연관성을 알아보고자 하였다. 방 법 : 정신과 의사가 병록지와 면담을 통하여 대상 정신분열병 환자들의 인구학적 변인들 및 질병연관 변인들에 관한 자료를 얻고 환자들의 병식 정도를 평가한 후, 환자들로 하여금 자기보고형의 자기만입 척도와 자존심 척도를 시행하게 하였다. 총 111명의 환자가 연구대상으로 선택되었다. 결과: . 1) 여자가 남자보다 유의하게 높은 자기만입 척도 점수를 나타내었다 2) 질병연관 변인들 중 하위집단 사이에 자기만입 척도 점수의 유의한 차이를 보이는 변은 없었다. 3) 자기만입 척도 점수와 병식 점수 사이에 유의한 상관관계가 없었다. 4) 자기만입 척도 점수와 자존심 척도 점수 사이에 유의한 역상관 관계를 보였다. 결 론 : 본 예비 연구의 결과로 보아 정신분열 병 환자의 병식이 부족한 상태에서도 자기만입이 진행될 수 있으며. 자기만입이 심할수록 환자의 자존심이 저하되는 것으로 생각된다. 또한 여자 환자들이 남자 환자들보다 자기만입에 더 취약한 것으로 생각된다. 따라서 정신분열 병 환자의 이해와 치료를 위하여 자기만입에 관한 지속적인 연구가 필요할 것으로 생각된다. objective : This study was conducted to identify demographic variables and illness related variables which may affect the severity of self-engulfment in the patients with schizophrenia. We also studied the relationship between self-engulfment and insight, and the relationship between self-engulfment and self-esteem. Methods : Data on demographic variables and illness related variables for the subjects were gathered from hospital records and clinical interviews by the psychiatrists. Degree of insight for the subjects was assessed through clinical interviews by the psychiatrists. Degree of self-engulfment and self-esteem for the subjects was assessed from the self-engulfment scale and the self-esteem scale respectively. A total of 111 patients with schizophrenia were selected for statistical analysis. Results 1) The females exhibited significantly higher scores than the males on the self-engulfment scale. 2) There was no illness related variable, which exhibited a significant difference among subgroups on the self-engulfment scale. 3) There was no significant correlation between the self-engulfment scores and the insight 4) There was a significantly inverse correlation between the self-engulfment scores and the self-esteem scores. Conclusion : The results of this preliminary study suggest that self-engulfment may develop despite lack of insight and that there was inverse relationship between self-engulfment and self-esteem in the patients with schizophrenia. It also suggests that females are more subject to self-engulfment than males. So, authors suggest that it is valuable to do further studies of self-engulfment in the patients with schizophrenia.

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.

후두 미세 수술전후의 음성기능분석

김영모,조정일,김철호,김영진,하현령 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.9

敎師資源開發에 관한 一硏究

趙誠一,金永出 건국대학교 교육대학원 1994 敎育論叢 Vol.22 No.-

The aim of this study lies in enhancing teacher's speciality by allowing the teacher to learn a systematic experience in learning in educating the teacher. The development of human resources is a set of organized learning activity that attaches importance to the development of human being per se, designed to bring change in behavior to the learner, and divided into domains of training, education and development. Teacher resources development is an experience in learning which places stress on the resources of teachers per se designed to technical skills and changes in behavior to the teacher and divide into three domains such as training concerning the extra-school training and intra-school training, education regarding pre-service education and qualification education and development.

갑상선 종양에서 thrombin receptor (PAR-1)의 발현 양상

박지영,목지오,김여주,박형규,김철희,변동원,서교일,유명희,조현득,오미혜,김상진 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.2

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