망막분지정맥폐쇄에 합병된 황반부종에서 유리체강내 베바시주맙 주입술이 삶의 질에 미치는 영향

김지욱,최경식,이미리,이성진,Jee Wook Kim,MD,Kyung Seek Choi,MD,PhD,Mi Ri Rhee,MD,Sung Jin Lee,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.10

Purpose: To evaluate the impact of intravitreal bevacizumab injection on visual function and vision-related quality of life (VR-QOL) in patients with branch retinal vein occlusion (BRVO) using the Korean version of the National Eye Institute Visual Function Questionnaire 25 (K-NEI-VFQ-25). Methods: This study included 32 normal control subjects and 32 patients with BRVO. The Korean version of NEI-VFQ-25 was answered by the patients with BRVO before and 3 months after intravitreal bevacizumab injection, as well as by normal control subjects. Clinical data were collected, including central macular thickness (CMT), total macular volume (TMV) (using time-domain optical coherence tomography [OCT]), and best corrected visual acuity (BCVA). Results: Visual acuity, CMT, and TMV significantly improved 3 months after intravitreal bevacizumab injections. No bevacizumab- related systemic or ocular adverse effects following intravitreal drug injections were observed. Significant improvement in the VFQ-25 composite score was observed in patients with BRVO. Subscale scores, including general vision, near activities, distance activities, social functioning, mental health, role difficulties, dependency, and peripheral vision, improved after injection. However, subscale scores regarding general health, ocular pain, driving, and color vision did not improve significantly. Conclusions: Intravitreal bevacizumab injection appears to be an effective treatment for visual function, as well as VR-QOL in macular edema secondary to BRVO. However, improvement of driving function and color vision appears to require a longer recovery time than visual function. J Korean Ophthalmol Soc 2012;53(10):1465-1471

간호학과 학생의 신체변형장애에 관한 연구

김지욱(Jee-Wook Kim),김수영(Soo-Young Kim),강문희(Moon-Hee Gang),이선우(Sun-Woo Lee),김정란(Jeong-Lan Kim),왕성근(Seong-Keun Wang),신윤오(Yun-O Shin),이태경(Tae-Kyung Lee),지익성(Ik-Seung Chee) 대한생물치료정신의학회 2007 생물치료정신의학 Vol.13 No.2

Objectives:The purposes of this study were to examine prevalence, characteristics and comorbidity of BDD in Korean nurse college students. Methods:Korean versions of BDDE-SR, MOCI, BDI, SES, LSAS were applied to 607 Korean nurse college students. Results:1) Five factors were extracted in BDDE-SR by factor analysis with the Varimax rotation. They were‘preoccupation, distress, embarrassment factor’,‘avoidance factor’,‘checking, comparing, camouflaging factor’,‘dissatisfaction factor’,‘importance factor’. 2) Sex differences in dissatisfied body parts on whole body, head hair, whole face, genitals, breasts were significant by chi-square test. 3) Eighteen participants(2.97%) were satisfied with DSM-IV criteria A and B of body dysmorphic disorder(BDD group). 4) The most dissatisfied body part was entire leg, eye, nose, waist-abdomen, calves in BDD group. 5) Differences between BDD group and non-BDD group on age and weight were significant by Mann-Whitney U-tests. 6) Differences between BDD group and non-BDD group on BDI, MOCI, LSAS-anxiety scale, LSAS-avoidance scale, SES were significant by Mann- Whitney U-tests. 7) Differences between men and female on BDDE-SR factor 1, BDDE-SR factor 2, BDDE-SR factor 3, BDDE-SR total factors, LSAS-avoidance scale were significant by Mann-Whitney U-tests. 8) Using multiple regression analysis the most contributing variance toward the total factor score of BDDE-SR of participants was BDI, and others were BMI, LSAS-anxiety scale, age, MOCI, SES in order of contribution. Conclusion:Our results indicate that BDD is a common disorder and is highly associated with depression, anxiety, obsessive-compulsive disorder symptoms, poor self-esteem. The authors suggest that future researches should be directed to obtaining clinical data of the patients with BDD. 목적 : 저자들은 대전지역 간호학과 학생을 대상으로 신체 변형장애의 임상 특성과 관련 심리적 변인을 알아보기 위해 연구하였다. 방법 : 한국판 신체변형장애 척도, 한국판 Maudsley 강박행동 질문지, 한국판 Beck 우울증 척도, 한국판 자아존중감 척도, 한국판 Liebowitz 사회 불안 척도를 607명의 간호학과 학생에게 시행하였다. 결과 : BDD군은 18명(2.97%)이었으며 가장 마음에 들지 않는 신체 부위로 다리 전체, 눈, 코, 허리-배, 종아리 순을 보고하였다. non-BDD군보다 BDD군에서 우울감, 강박증, 자존심 저하, 사회 불안-회피 성향이 유의미하게 높았다. 간호학과 학생 전체를 대상으로 신체 변형장애 성향에 가장 영향을 주는 변인은 우울감이었으며 BMI, 사회 불안 성향, 연령, 강박증, 자존감 순이었다. 여학생의 경우 신체변형장애 성향에 영향을 주는 변인은 우울감, BMI, 사회 불안 성향, 연령, 강박증, 자존감 순이었다. 남학생의 경우 신체변형장애 성향에 영향을 주는 변인은 우울감, 강박증 순이었다. 결론 : 본 연구는 향후 신체변형장애 연구에 유용한 자료로 사용될 수 있을 것이다. 그러나 많지 않은 표본수를 감안할 때 우리의 연구를 실증하기 위해 보다 많은 표본을 대상으로 연구가 시행되어야 할 것이며 신체변형장애 환자들에 대한 임상 특성에 대한 연구가 필요할 것이다.

아메드밸브 삽입술 후 합병증으로 발생한 초기 저안압과 방수유출관 폐쇄의 비수술적 치료 1예

김지욱(Jee Wook Kim),하승주(Seung Joo Ha) 대한검안학회 2011 Annals of optometry and contact lens Vol.10 No.2

목적: 신생혈관녹내장으로 양안의 아메드밸브삽입술을 시행한 후 합병증으로 전방소실을 동반한 초기 저안압과 방수유출관의 폐쇄가 발생하여 각각 조절마비제 점안과 Neodymium:YAG (Nd:YAG) 레이저를 이용한 막제거술로 치료하였기에 이를 보고하고자 한다. 대상과 방법: 51세 여자가 양안의 안통을 주소로 내원하였다. 초진시 안압은 우안 60 mmHg, 좌안 50mmHg이었으며 양안의 홍채혈관신생이 관찰되었다. 신생혈관녹내장으로 진단하여 양안의 아메드밸브삽입술을 시행하였다. 술후 우안은 과도한 섬유성 막으로 인해 방수유출관이 폐쇄되었고 안구지압에도 호전을 보이지 않아 Nd:YAG 레이저를 이용하여 관 입구 부위의 섬유성 막을 제거하였고 이후 안압이 하강하였다. 좌안은 술후 전방소실과 저안압이 발생하여 조절마비제를 하루 3회씩 사용하였으며 2일 후부터 전방깊이가 정상화되었다. 결과: 아메드밸브삽입술 이후에 합병증으로 방수유출관 폐쇄가 발생하였을 때 약물 및 수술적 치료가 어려운 경우 Nd:YAG 레이저를 이용한 막제거술을 이용할 수 있으며 전방소실과 함께 초기 저안압이 발생하였을 경우 조절마비제를 점안하여 수정체-홍채면을 후방으로 이동시키는 것이 치료에 도움을 줄 수 있다. Purpose: To report the case of successful treatment of postoperative complication including hypotony using cycloplegic agent and the valve obstruction using membranectomy with Neodymium:YAG (Nd:YAG) laser after Ahmed valve implantation in a neovascular glaucoma (NVG) patient. Methods: A 51-year-old female visited the hospital with ocular pain in both eyes. During her first visit, intraocular pressure (IOP) was 60 mmHg in the right eye and 50 mmHg in the left eye. In the anterior segment examination, neovascularizations of iris were noticed in both eyes. NVG was diagnosed and Ahmed valves were implanted in her both eyes. The next day after operation, obstruction of the end of the valve with massive fibrous membrane was observed in her right eye. IOP did not decreased sufficiently. Thus, we performed membranectomy using Nd:YAG laser at the end of the valve. Next day, IOP was normalized. Meanwhile in her left eye, three days after operation, hypotony was occurred with shallow anterior chamber. We used cycloplegic agent three times a day, and then the anterior chamber became deeper after two days. IOP was also normalized gradually. Results: We have experienced postoperative complications including valve obstruction and hypotony with shallow anterior chamber simultaneously. And we treated successfully with nonsurgical methods. We observed that membranectomy using Nd:YAG laser is effective to treat the valve obstruction in a patient who is difficult to undergo additional surgery or antifibrotic agent. And cycloplegic agent that induce posterior shift of the lens-iris diaphragm could be the one of the options to treat hypotony with shallow anterior chamber.

망막분지정맥폐쇄에 합병된 황반부종에서 유리체강내 베바시주맙 주입술이 삶의 질에 미치는 영향

김지욱 ( Jee Wook Kim ),최경식 ( Kyung Seek Choi ),이미리 ( Mi Ri Rhee ),이성진 ( Sung Jin Lee ) 한국안전학회(구 한국산업안전학회) 2003 International Journal of Safety Vol.2 No.1

목적: 망막분지정맥폐쇄로 인한 황반부종 환자에서 bevacizumab을 이용한 치료가 시력과 관련된 삶의 질에 미치는 효과를 알아보고자 하였다. 대상과 방법: 망막분지정맥폐쇄로 인한 황반부종으로 bevacizumab 안내주입술을 받은 32명을 대상으로 시술 전과 시술 3개월 후, 최대교정시력, 빛간섭단층촬영, 한국어판 미국 국립안연구센터 시각기능 설문지 25를 이용한 설문조사를 시행하여 그 변화를 관찰하였다. 결과: Bevacizumab 주입 후 3개월째 최대교정시력과 중심황반두께, 황반부용적은 치료 전과 비교하여 유의하게 호전되었다. 설문조사에서는 총점이 유의하게 증가하였으며, 세부항목별로는 전반적 시력, 근거리 시력, 원거리 시력, 사회적 기능, 정신 건강, 역할의 제한, 의존성, 주변부 시력은 유의하게 호전되었고, 전반적인 건강, 눈 통증, 운전과 색각 면에서는 유의한 차이를 보이지 않았다. 결론: 망막분지정맥폐쇄에 합병된 황반부종에서 bevacizumab 주입술은 황반부종을 감소시켜 시력뿐만 아니라 시력과 관련된 삶의질도 효과적으로 향상시켰다. 그러나 다른 세부항목에 비해 운전과 색각에 관련된 삶의 질은 상대적으로 회복 속도가 느린 것을 알수 있다. Purpose: To evaluate the impact of intravitreal bevacizumab injection on visual function and vision-related quality of life (VR-QOL) in patients with branch retinal vein occlusion (BRVO) using the Korean version of the National Eye Institute Visual Function Questionnaire 25 (K-NEI-VFQ-25). Methods: This study included 32 normal control subjects and 32 patients with BRVO. The Korean version of NEI-VFQ-25 was answered by the patients with BRVO before and 3 months after intravitreal bevacizumab injection, as well as by normal control subjects. Clinical data were collected, including central macular thickness (CMT), total macular volume (TMV) (using time-domain optical coherence tomography [OCT]), and best corrected visual acuity (BCVA). Results: Visual acuity, CMT, and TMV significantly improved 3 months after intravitreal bevacizumab injections. No bevacizumab-related systemic or ocular adverse effects following intravitreal drug injections were observed. Significant improvement in the VFQ-25 composite score was observed in patients with BRVO. Subscale scores, including general vision, near activities, distance activities, social functioning, mental health, role difficulties, dependency, and peripheral vision, improved after injection. However, subscale scores regarding general health, ocular pain, driving, and color vision did not improve significantly. Conclusions: Intravitreal bevacizumab injection appears to be an effective treatment for visual function, as well as VR-QOL in macular edema secondary to BRVO. However, improvement of driving function and color vision appears to require a longer recovery time than visual function. J Korean Ophthalmol Soc 2012;53(10):1465-1471

VII 형 교원질 유전자의 돌연변이를 보인 mitis 형 열성 이영양성 수포성 표피박리증 3 예

김지욱(Jee Ook Kim),류영욱(Young Wook Ryoo),이규석(Kyu Suk Lee) 대한피부과학회 2001 대한피부과학회지 Vol.39 No.10

Recessive dystrophica epidermolysis bullosa(RDEB) is rare, chronic non - inflammatory bullous disease of hereditary trait, which produces blister formation in early childhood. A localized, less severe form, often called RDEB-mitis, occurs at birth and usually involves the acral areas, with atrophic scarring of the joint surfaces and nail dystrophy but little mucosal involvement. Severe RDEB is a multilating disease, known also as the Hallopeau-Siemens (HS) varient. We report three cases which developed at birth and infancy, respectively. Bullae, atrophic scars were noted on the knees and ankles, and milia on the both hands and feet. Histologically, sections from the old blister lesion showed characteristic separation of the epidermis from the dermis forming bulla. Identification of the mutations COL7A1 gene was revealed by direct sequencing of each exon. We present three cases of RDEB-mitis considering the abscence of family history with clinical, histological and molecular analysis findings. (Korean J Dermatol 2001;39(10): 1138-1143)

Nicotine 이 배양된 섬유아세포에서 탄력소 유전자 발현에 미치는 영향

김지욱(Jee Ook Kim),류영욱(Young Wook Ryoo),이규석(Kyu Suk Lee) 대한피부과학회 2001 大韓皮膚科學會誌 Vol.39 No.5

N/A Background: The elastic fibers are a major fibrillar component of the extracellular matrix of several organs, and their presence provides elastic properties to these tissues. A variety of cytokines, growth factors, and hormones have been shown to modulate elastin gene expression. So far most interest increased the effects of external environment on elastin metabolism in the skin. It has become generally accepted that cigarette smoking contributes to accelerated coronary and peripheral vascular disease, pulmonary fibrosis and periodontal disease. Nicotine is a major component of the particulate phase of tobacco smoke. Objective : Only little is known about the molecular and cellular mechanism underlying the effect of nicotine on the skin fibroblasts. Our study was performed to determine the effects of nicotine on elastin gene expression. Method: In this study, the effects of nicotine were examined by Northern blot hybridization, chloramphenicol acetyltransferase (CAT) assay, and laser scanning microscopy in cultured human fibroblasts. Results : In Northern blot hybridization, steady-state levels of elastin mRNA were decreased 0.9-fold at 1 ㎍/mL of nicotine, 0.7-fold at 10 ㎍/mL and 0.5-fold at 100 ㎍/mL, compared to untreated control. Nicotine caused a marked alteration in the elastin mRNA expression in a dose-related fashion. In CAT assay, the relative elastin CAT activity was 1.0 in the untreated control, 0.9 at a concenturation of 1 ㎍/mL, 0.3 at 10 ㎍/mL, and 0.2 at 100 ㎍/mL. Nicotine caused a marked decrease on elastin promoter activity. In laser scanning microscopy, the immunosignal for elastin in nicotine-treated fibroblasts shows in less intense than in untreated control. Conclusion: These results indicate that nicotine may be a powerful down-regulator of elastin production, suggesting transcriptional depression of gene expression in cultured skin fibroblasts.

화상 정도 및 CAPS 점수에 따른 타액 코티졸의 변화 양상 비교

김진나,김지욱,최인근,전욱,서정훈,김경자,이병철,Kim, Jin-Na,Kim, Jee Wook,Choi, Ihn-Geun,Chun, Wook,Seo, Cheong Hoon,Kim, Kyung Ja,Lee, Boung Chul 대한불안의학회 2012 대한불안의학회지 Vol.8 No.2

Objective : Cortisol, a product of hypothalamus-pituitary-adrenal axis (HPA axis), is one of our defensive mechanisms in response to stress. The level of cortisol in the saliva is a major biomarker of the stress response by HPA axis and shows diurnal variation. We measured salivary cortisol level and its diurnal variation to compare the pattern of changes by degree of burn and Clinician-Administered PTSD Scale (CAPS) score. Methods : We measured the salivary cortisol levels of 37 subjects hospitalized in the burn center at our facility from March to June 2012. Salivary cortisol levels were measured at 6 : 00 AM and at 7 : 00 PM. All subjects were tested for CAPS to evaluate the severity of posttraumatic stress disorder and the Hamilton Depression Rating Scale to evaluate and to control the coexisting depression. Results : Factorial ANOVA test revealed that there was a statistically significant difference in terms of the effect of the interaction between the degree of burn and the patient's CAPS score. Unlike the mild burn group, in the severe burn group, the patients who had a low CAPS score didn't show a normal diurnal variation and the patients who had a high CAPS score showed the normal diurnal variation. After a few months follow up, we found a greater degree of psychiatric complications in severe burn patients that had a lower cortisol stress response. Conclusion : We suppose that the disappearance of the stress response changes in salivary cortisol seen in the severe burn group may be caused by an impaired stress response. Through followed observation of the subjects, this disruption of cortisol response may cause psychiatric problems afterwards.

알코올의존으로 입원한 환자에서 나이와 성별에 따른 퍼센트 탄수화물-결핍트랜스페린과, 감마-글루타밀전이효소 변화 양상의 차이

진교식,이중서,이병철,김지욱,최인근,Jin, Gyo-Sik,Yi, Jung Seo,Lee, Boung Chul,Kim, Jee Wook,Choi, Ihn-Geun 대한생물정신의학회 2017 생물정신의학 Vol.24 No.4

Objectives This study sought to investigate the relationship between age, sex and alterations in levels of % carbohydrate-deficient transferrin (%CDT) and gamma-glutamyl transferase (GGT) in patients admitted with alcohol dependence. Methods The study retrospectively enrolled 187 patients who were diagnosed with alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth edition (DSM-IV) and were admitted into a closed ward in Hallym University Hangang Sacred Heart Hospital from 2009 to 2012 and Hallym University Kangnam Sacred Heart Hospital from 2012 to 2017. Demographic factors (age, sex) and biochemical markers [%CDT, GGT, mean corpuscular volume (MCV), aspartate transferase (AST), alanine transferase (ALT)] were collected by reviewing medical records. Alterations in the levels of %CDT and GGT in different groups for each demographic factor were compared after correcting for confounding variables (age, initial %CDT, GGT, MCV, AST, ALT). Results Decreased %CDT and GGT were observed during the period of abstinence after admission. The normalization period for %CDT increased with age, while the normalization period for GGT was longer in female patients. Conclusions These results suggest that alcohol-dependent patients that vary in age have different alterations in %CDT, while different sexes have different alterations in GGT. Age and sex can be potential indicators of treatment response after abstinence in patients with alcohol dependence. Further studies are needed to evaluate the relationship between these factors with regards to physiological and hematological changes in alcohol dependence.

병적 도박의 유형별 특징 : 1년 추적 조사

박이진(E-Jin Park),신경철(Kyung-Chul Shin),김지욱(Jee Wook Kim),최영숙(Young-Sook Choi),최용성(Yong-Sung Choi) 한국중독정신의학회 2011 중독정신의학 Vol.15 No.2

Objectives : This study evaluated the characteristics and prognoses of pathological gamblers in accord with the three subtypes of the Pathways Model. Methods : Subjects were inpatients with pathological gambling (N=30). We obtained these subjects’ demographic data, evaluated them using a neuropsychological battery, and investigated their prognoses at their third, sixth, and twelfth months after discharge. Results : The ‘Emotionally vulnerable problem gamblers (EV)’ and ‘antisocial, impulsive prob-lem gamblers (AI)’ subtypes had significantly more depressive illnesses than the ‘behaviorally conditioned problem gamblers (BC)’ subtype had. Moreover, the AI subtype had significantly higher relapse rates at the third, sixth, and twelfth months than either the BC or EV subtypes had. Conclusion : These results suggest the differing Pathway Model subtypes in pathological gambling have different etiologies, progressions, and prognoses, and that problem gamblers of the AI subtype have a high relapse rate. Furthermore, this suggests the Pathway Model of pathological gambling could be useful in the understanding and treatment of pathological gambling.

알코올 의존 환자의 외래 방문 기간에 대한 예측인자로서의 MMPI-2

박기환(Ki-Hwan Park),이중서(Jung Seo Yi),이병철(Boung Chul Lee),김지욱(Jee Wook Kim),최인근(Ihn-Geun Choi) 한국중독정신의학회 2015 중독정신의학 Vol.19 No.2

Background and Objectives : This study sought to identify predictors of the follow-up duration for outpatients with alcohol dependence. Materials and Methods : The study retrospectively enrolled 97 patients who were diagnosed with alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) and who had attended outpatient clinics at Hallym University Hangang Sacred Heart Hospital from 2009 to 2012 and Hal-lym University Kangnam Sacred Heart Hospital from 2012 to 2014. Sociodemographic factors (age, sex, education, marital status, and socioeconomic status), clinical data (onset age of problematic drinking, family history of alcohol dependence, and history of admission) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) profiles were collected by reviewing medical records. The follow-up durations in the normal and elevated MMPI-2 profile groups were compared after confounding variables (sex, onset age of problematic drink-ing, and history of admission) were corrected for. Results : In some MMPI-2 profiles, such as low positive emotion (RC2), introversion (INTR), and social discomfort (SOD), the elevat-ed groups (≥65 score in each profile) had significantly longer follow-up durations compared with the normal groups (<65 score in each profile). Conclusion : These results suggest that alcohol-dependent patients who have different emotional and psychological characteristics have different follow-up durations. High RC2, INTR, and SOD MMPI-2 scores can predict longer treatment duration, which may be characteristic of Cloninger’s type I alcoholism. The MMPI-2 is helpful for predicting follow-up duration in patients with alcohol dependence.