간경변증 환자의 정신과적 특성 및 아임상적 간성뇌병증 진단을 위한 연구 : 인지기능 및 유발전위를 중심으로 Cognitive Functions and Evoked Potentials

유승호,이소영,김진세,변관수,정인과 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

연구목적 : 본 연구는 명백한 간성뇌병증이 없는 간경변증 환자에서 불안, 우울기분 및 삶의 질 등 정신과적 특징과 신경심리학적인 결손의 양상을 밝히기 위해서 고안되었다. 그리고 아임상적 간성뇌병증의 평가에서 체성감각 유발전위 검사의 역할을 연구하고자 하였다. 방 법 : 간경변증으로 진단된 41명의 환자군과 정상 대조군 31명을 대상으로 하였다. 이들에서 우울기분 및 불안을 평가하기 위해 Beck Depression Inventory와 State & Trait Anxiety Inventory를 시행하였고 삶의 질의 평가를 위해 Health-related Quality of Life Questionnaire를 시행하였다. 또한 어휘검사, 숫자외우기 검사, 토막짜기 검사, 숫자기호 바꿔쓰기 검사 및 선로잇기 검사 A와 B 등 간단하지만 포괄적인 인지기능검사를 시행하였다. 또한 41명의 환자군 중에서 인지기능검사 결과에 의거하여 분류된 13명의 아임상적 간성뇌병증군(SHE군)과 11명의 아임상적 간성뇌병증이 아닌 간경변증 환자군(non-SHE군) 그리고 8명의 정상 대조군에서 체성감각 유발전위를 측정하였다. 결 과 : 간경변증 환자는 정상인에 비해서 우울기분과 특성불안이 유의하게 증가하였다. 또한 건강과 관련된 일상생활의 삶의 질의 수준이 정상인보다 저하되었고, 특히 주의력과 각성이 요구되는 행동에서 수행이 저하되었다. 또한, 간경변증 환자는 숫자기호 바꿔쓰기 검사와 선로잇기 검사에서 정상 대조군보다 저하된 수행을 나타내었다. 또한 이러한 인지기능검사를 통해서 진단한 아임상적 간성뇌병증군에서 6개월 추적조사를 하였을 때, 명백한 간성뇌병증의 빈도가 아임상적 간성뇌병증이 아닌 군보다 유의하게 높았다. 체성감각 유발전위 소견은 N65 잠복기와 N20-N65 IPL의 경우 SHE군, non-SHE군 및 정상 대조군 사이의 유의한 차이가 있었다. 특히 N65는 SHE군만이 정상 대조군과 유의한 차이가 있었고 N95는 숫자기호 바꿔쓰기 검사 및 선로잇기 검사 A와 유의한 상관관계가 있었다. 결 론 : 간경변증 환자에게 우울 및 불안 등 정서적인 어려움에 대한 실제적인 관리 및 삶의 질을 높일 수 있는 치료적 접근이 고려되어야 하겠다. 또한 숫자기호 바꿔쓰기 검사와 선로잇기 검사가 아임상적 간성뇌병증의 조기 진단에 민감하고 유용한 도구로 생각되어 간경변증 환자에서 정례적으로 적용시키는 것이 간경변증 환자의 관리에 도움을 줄 수 있을 것으로 생각된다. 마지막으로, 본 연구에서의 체성감각 유발전위 소견은 간경변증 환자에서 아임상적 간성뇌병증 환자의 진단 및 연구에 중요한 의미를 지닌다고 생각된다. Objectives : This study was designed to elucidate the psychiatric characteristics and nature of the neuropsychological deficits associated with subclinical hepatic encephalopathy(SHE) in patients with non-alcoholic liver cirrhosis. And also the authors prospectively studied the role of somatosensory evoked potentials(SEP) in the assessment of SHE. Methods : Beck Depression Inventory(BDI) for measuring depression, State Trait Anxiety Inventory(STAI) for measuring anxiety, and Health-related Quality of Questionnaire(HQLQ) for measuring quality of life were administered the 41 non-encephalopathic liver cirrhosis patients(NELC) group and 31 carefully matched normal controls. And a prospective study to compare the performance of NELC group and normal controls on a short but comprehensive cognitive tests was conducted. After several cognitive, NELC group was divided into two groups, SHE group and non-SHE group by results of digit symbol substitution test(DSST) and/or trail making test(TMT) A and B. And then median nerve evoked cortical responses in 13 SHE patients group, 11 non-SHE patients group, and 8 normal controls were recorded for latencies of N13, P16, N20, P25, N30, P45, N65, and P95. And also responses for N13-N20 interpeak latency(IPL) and N20-N65 IPL were recorded. Results : There were significant differences between the NELC group and normal controls on BDI, trait anxiety scales in STAI, and almost all HQLQ except for the cognitive function, social interaction and life satisfaction(p<0.05). The NELC group exhibited poor performance in DSST, TMT A and TMT B compared with normal controls(p<0.05). As 17 NELC patients had abnormal cognitive test results, 41.5% of cirrhotic patients had SHE. In SEP assessment, NELC group with SHE and without SHE had higher N20-N65 IPL and only NELC group with SHE had higher N65 latency compared with normal controls(p<0.05). Conclusion : This study suggests that the patients with liver cirrhosis exhibit relatively selective deficits in complex attentional and fine motor skills, with preservation of general intellectual ability, memory, language and visuospatial perception. DSST, TMT A and TMT B seem to be useful screening tests for the detection of SHE. And also it is expected that late components and N20-N65 IPLs of SEP are helpful in the assessment of SHE.

체위변화 및 운동강도에 따른 심폐기능의 변화

윤승호,변정현 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

The effective and controlled functions of cardiopulmonary system lie to supply enough oxygen to and to remove carbondioxide from body tissues. Also, it requires timely reaction on the various metabolic demand. The purpose of this study was to evaluate the cardiopulmonary responses on postural change and intensity of exercise to obtain basic data for rehabilitation diagnosis and management. Twenty male college students without past history of musculoskeletal and cardiopulmonary disease were participated in this study. Oxygen consumption rate, heart rate, and respiration rate were measured respectively using the portable oxygen consumption meter(COSMED K2) in the conditions of resting, exercising, and resting after exercise. The detail results of this study are as follow. 1) In resting, only heart rate was significantly increased in the standing position compared to the supine position(P<0.05). 2) Treadmill test using the "Bruce protocol" showed all test parameters were significantly increased by the intensity of exercise in each stage(P<0.05). 3) During resting after exercise oxygen consumption rate, heart rate and respiration rate were decreased in every minute. Especially, significant decrease was found between 1 and 2 minutes and 2 and 3 minutes. 4) The relationship of heart rate vs. oxygen consumption rate and respiration rate vs. oxygen consumption rate reached to linear regression as following; HR = 2.59 V˚O_2 + 59.39 (r^2=0.83), RR = 0.52 V˚O_2 + 12.24 (r^2=0.60) [HR(beats/min) : heart rate, V˚O_2(ml/Kg/min) : oxygen consumption rate, RR : respiration rate] Posture during rest rarely influenced on the healthy person's cardiopulmonary function. However, greater influence on the cardiopulmonary function was noted in increased intensity of exercise. Considerable recovery was recorded till the first 3 minutes after exercise. Also, regression equation of heart rate and oxygen consumption rate could be used to calculate oxygen consumption rate only from heart rate data.

시멘트의 水和反應에 미치는 石灰石粉末添加의 影響

宋宗澤,邊承鎬 단국대학교 1993 論文集 Vol.27 No.-

Effects of limestone powder on the hydration of cement were studied by measuring non-evaporable water, Ca(OH)_2, remained CaCO_3 and the rate of heat liberation. It was found that the addition of 5% limestone was found to have no significant effect on the hydration of cement. The calcium carboaluminate hydrate(2θ=11.7˚) was identified by XRD in the cement paste contained more than 10% limestone. However, the amount of limestone remained in the paste was almost same as it of mixed limestone.

보행시작의 운동역학적 특성

김봉옥,조강희,변정현,윤승호 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.1

To understand kinetic characteristics during the process of initiation of gait from standing, from the visual cue to toe off of the stance limb, vertical ground reaction forces(GRF) during gait initation period were evaluated with two force platforms placed side by side in thirteen adults(7 males, 6 females, mean age 29.3 years) with no history of neuromusculo-skeletal abnormality. Gait initiation period of swing and stance limbs, percentage of gait initiation period and ratio of the vertical forces to body weight at each peak of the vertical forces of both limbs were measured and described. These data can now be used as a part of databases when initiation of gait in subjects with neuromusculoskeletal abnormalities need to be evaluated.

고호모시스테인증과 동반된 소뇌출혈 1예

홍석찬,안재영,조수진,정진상,이광호,홍승철,변홍식 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3

Effects of Repeated Steroid Injection at Subacromial Bursa With Different Interval

Seung Deuk Byun,Yong Ho Hong,Sung Kyung Hong,Jin Won Song,Seung Beom Woo,Jae Hyun Noh,Jong Min Kim,Zee Ihn Lee 대한재활의학회 2014 Annals of Rehabilitation Medicine Vol.38 No.6

Objective To evaluate the effects of repeated steroid injection at subacromial bursa with different interval for patient with periarticular shoulder disorder.Methods Group A (n=10) received subacromial bursa injection only on their first visit, group C (n=10) received the injection on their first visit and one week later, and group B (n=10) received the injection on their first visit and two weeks later. All injections were done with a combination of 40 mg (1.0 mL) of triamcinolone and 5.0 mL 0.5% lidocaine (6 mL total). We examined the active range of motion (AROM) of the shoulder joint, visual analogue scale (VAS), and shoulder disability questionnaire (SDQ) at baseline at 1, 2, and 4 weeks after the initial injection.Results In VAS, comparing the changes in VAS between groups, group B showed significant improvements compared with group A or C at 4 weeks after the initial injection (p<0.05). In SDQ, comparing the changes in SDQ between the groups, group B and C showed more improvement than group A at 4 weeks after the initial injection, but these results were not statistically significant (p>0.05). In AROM, comparing the changes in AROM of external rotation between groups, group B and C showed significant improvement compared with group A at 4 weeks after the initial injection (p<0.05). Conclusion It may be more effective in pain relief for patients with periarticular disorder to receive subacromial bursa injections twice with 2-week interval, as opposed to once.

Clinical Features and Prognosis of Resectable Primary Colorectal Signet-Ring Cell Carcinoma

( Ho Su Lee ),( Jae Seung Soh ),( Seohyun Lee ),( Jung Ho Bae ),( Kyung Jo Kim ),( Byong Duk Ye ),( Jeong Sik Byeon ),( Seung Jae Myung ),( Suk Kyun Yang ),( Sun A Kim ),( Young Soo Park ),( Seok Byun 대한장연구학회 2015 Intestinal Research Vol.13 No.4

Background/Aims: We attempted to investigate the prognosis of signet-ring cell carcinoma (SRC) patients who underwent curative surgery by comparing them with age-, sex-, and stage-matched non-mucinous adenocarcinoma (NMAC) patients. Methods: Between January 2003 and December 2011, 19 patients with primary SRC of the colorectum underwent curative surgery. Four SRC patients under the age of 40 were excluded, and the clinicopathological data of 15 patients (7 men; median age, 56 years) were reviewed and compared with the data of 75 NMAC patients matched by age, sex, and pathologic stage. Results: The median follow-up duration was 30.1 months for the SRC group and 43.7 months for the NMAC group (P=0.141). Involvement of the left side of the colon (73.3% vs. 26.7%, P=0.003) and infiltrative lesions such as Borrmann types 3 and 4 (85.7% vs. 24.0%, P=0.001) were more common in the SRC group than in the NMAC group. The five-year overall survival rate was significantly lower for patients with SRC than for those with NMAC (46.0% vs. 88.7%, hazard ratio, 6.99; 95% confidence interval, 2.33-20.95, P=0.001). Conclusions: Patients with even resectable primary colorectal SRC had a poorer prognosis than age-, sex-, and stage-matched colorectal NMAC patients. (Intest Res 2015;13:332-338)

전자교과서의 국내외 동향과 개발 절차

변호승 ( Ho Seung Byun ),최욱 ( Wook Choi ) 한국초등교육학회 2002 초등교육연구 Vol.15 No.2

Due to the development of new technologies and emergence of new breed of readers, the interest toward electronics book, has increased. The authors define electronic textbook as electronic book, or ebook that is developed based on school curriculum to be used in the classroom as a primary instructional material. The following are covered in this article: First, the appropriateness of using electronic textbook in terms of user-purpose in summarized. Second, the functions of e-textbook in comparison with traditional paper book is explored. Third, overview of the status of-e-textbook around the world is attempted. The authors also argue that e-textbook should equip with additional functions to that of traditional paper book. Thus, differentiated curriculum, self-directed learning, open education, experience learning, and performance evaluation emphasized in the 7th National Curriculum is essential. The authors recommend that e-textbook should be developed step-by-step, instead of a full-scale development.

일대일 컴퓨팅의 연구 분석을 통한 현장적용 탐색연구

변호승 ( Ho Seung Byun ) 한국교육정보미디어학회 2009 교육정보미디어연구 Vol.15 No.1

The purpose of this study is to understand research studies on implementation and effects of one-to-one computing initiatives that is prevalent in the United States, and analyze effectiveness and the success factors that would throw light on Korean school setting. After screening process, 32 out of 282 studies were selected for synthesis. The number of qualitative studies were twice as much as that of quantitative studies. Quantitative studies lacked in numbers and in rigorous experimental design. Research studies over one year showed positive effects on writing and reading. Achievement scores on core subjects such as Mathematics, Reading, and Science showed inconsistent results to make any conclusion. However, the results showed that one-to-one computing was effective on lower achieving students, regardless of subject matters. Content analysis using coding scheme revealed diverse themes including instructional methods, attitude and motivation, professional development, accountability and achievement tests, interactions between student and teachers, the barriers and success factors, as well as social equity, finance, and teacher identity issues. Success factors identified in this research are professional development, technical and administrative support, teacher beliefs, technological environment. The necessity for quality professional development was ranked high, and hardware problems and its support were considered a highest priority. Accountability mechanism for teachers, leadership, budget, interactions with parents and learning community were also included in the success factors. Suggestions for further studies were long-term implementation and rigorous research studies, providing adequate hardware and technical support system, and leadership and administrative support.

사이버 인문콘텐츠의 수준향상 방안에 관한 연구

변호승 ( Ho Seung Byun ),나민주 ( Min Joo Rah ),이재신 ( Jae Shin Lee ) 한국교육정보미디어학회 2003 교육정보미디어연구 Vol.9 No.1