경막 내 colistimethate 투여로 치료한 다제 내성 cinetobacter baumannii 뇌실염

홍유아,유진홍,김진진,모은영,안건희,정희경,김진석,이현정,정미향,윤승배 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Acinetobacter species is a non-fermentative aerobic gram-negative coccobacillus that is an important pathogen found in nosocomial infections. Recently, multi-drug resistant Acinetobacter baumannii (MDR-AB) infections have been increasing and pose a serious problem. Most such infections present as bacteremia, pneumonia, or a wound infection; however, CNS infections are very rare. We herein present a case of ventriculitis caused by MDR-AB in a 37-year old man after a neurosurgical intervention. The patient was successfully treated with intrathecal colistimethate.

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.

소아청소년 복합만성질환자 수 및 진료비의 변화: 2011-2021년 건강보험청구자료 분석

오정윤,조수진,정진선,조진숙,박춘선 건강보험심사평가원 2023 HIRA RESEARCH Vol.3 No.2

Background: The number of children and adolescents has decreased by more than 3 million over the past 10 years. We analyzed changes in the number of children and adolescents with complex chronic conditions (CCCs) and their medical expenditures between 2011 and 2021. Methods: We used National Health Insurance claims data of patients under the age of 20 from 2011 to 2021. CCCs were classified as pediatric CCCs by Feudtner et al. Patients who repeatedly utilize medical services due to CCCs were defined as patients who sought medical care twice or more within the past 3 years. Their sex, age, CCC categories, and the number of CCC categories were presented using descriptive analyses. Results: The number of children and adolescents with CCCs increased from 345,320 (3.04%) in 2011 to 451,238 (5.33%) in 2021. Patients who repeatedly utilized medical services due to CCCs increased by 71,889 during the same period. The proportion of patients with two or more CCC categories increased from 35.80% in 2011 to 43.67% in 2021. In 2021, patients with other congenital or genetic defect were most common. Medical expenditures associated with CCCs increased from 475,654 million won (12.34%) in 2011 to 768,467 million won (19.11%) in 2021. Conclusion: The number of patients with CCCs and their medical expenditures increased in Korea between 2011 and 2021. The results indicate that consistent national efforts are required to maintain the specialized pediatric care. Further studies are needed to identify pediatric patients who require specialized medical services through various methods.

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.

고속치환 영상처리를 위한 암호화 기법에 관한 연구

윤정오,이훈재,홍영호,최병진 경운대학교 산업기술연구소 1998 産業技術硏究論文誌 Vol.1 No.1(A)

In this paper, we suggest a new encryption system for high speed permutation image processing. We show how to secure attack relative to redundancy in image data. In addition, by applying the proposed permutation algorithm in image data, we show how to solve problems related to scanning sequence and scraming.

Homomorphic Encryptions at a Long Distance Through Quantum Key Distribution Protocols

JEONG*, Kabgyun,KIM, Yong Jin,YOON, Jong Beom,KIM, Geon Woo,CHO, Gueha,KIM, Suntaek Korean Physical Society 2019 새물리 Vol.69 No.2

공복 시 Caffeine 투여 후 일회성 운동이 흰쥐의 인슐린 및 골격근의 GLUT-4 발현에 미치는 영향

정일규,오명진,김영표,김종오,윤재석,서태범,윤진환 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.5

This study was done to investigate the effects of caffeine ingestion on the expression of GLUT-4 in rats' skeletal muscle(soleus m) and blood insulin level after 12 hr fasting condition and one hour treadmill running. Total 19 rats(Sprague-Dawley) who were 7week Did were used for experimental subjects and raised for 1week in the room controled the air temperature and relative humudity(22℃ and 50%). They were divided three groups ; 12hr fasting group(F group, n=5), fasting+exercise group(FE, n= 7) and fasting+caffeine+exercise group(FCE group, n=7). FG and FCE group performed treadmill running for one hour and the treadmill speed was 18m/min that was supposed to be moderate exercise to rats. Each Dr rats in FCE group was forced to he given the caffeine solution(5mg/kg, Sigma Chemical co.) through stainless steel tube directly to their stomachs one hour before treadmill exercise. Immediately after treadmill running, we anesthetized them with the mixed solution(Ketamin 80g/kg and Rompun 5ml/kg) to draw 3ml blood from heart four insulin analysis and then obtained the rats' soleus muscle for GLUT-4 expression. We found that FCE group showed significantly higher GLUT - expression then the other groups and FE group showed the lowest GLUT-4 expression. This rusults suggest that the endurance type of exercise in fasting condition inhibit the GLUT-4 expression in working muscle and the caffeine helped to facilitate the GLUT-4 expression during endurance type of exercise. The future studies needed to confirm the action of caffeine to increase the GLUT- 4 and the mechanism.

모체 Thyroxine 투여가 태아알코올효과를 가진 흰쥐 대뇌겉질 및 해마에서 NPY함유 신경세포의 생후 발달에 미치는 영향

김복,박상기,박영란,김종중,문정석,김주수,문영민,현영식,천관영,정윤영 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: Maternal alcohol abuse is considered to be one of the most prominent cause of neurobiological malformations in the postnatal and adult life of the offspring. In this study, we investigated the effects of maternal alcohol drinking on the postnatal development of NPY-containing neuron, and, the influence of thyroxine treatment on the cerebral cortex and hippocampus of pups of alcohol abused mother. Materials and Method: Time-pregnant rats were divided into three groups. Alcohol-fed group A received 35 calories of liquid alcohol diet daily from gestation day 6; control pair-fed group B was fed a liquid diet in dextrin replaced alcohol isocalorically: alcohol + T4 group C received 35 calories liquid alcohol diet and exogenous thyroxine subcutaneously. Results: Group C showed prominent NPY immunoreactivity in the cerebral cortex compared to group A and B at P7. In group C, NPY-containing neurons were widely distributed in the all layers of cerebral cortex after P14. Besides, numerical decrease of NPY-containing neuron as age increases was not found in group C. However, the decrease of NPY-containing neuron was clearly observed in group A compared to group C after P14. In hippocampus, group Band C were appeared similar patterns after P7. Additionally, in group C, NPY immunoreactivity was prominently appeared in CA2 and CA3 at P14 as compared to group B. Conclusions: The present results showed the increase of intensity and number of NPY-containing neurons in cerebral cortex and hippocampus of pups of exogenous T₄ supplemented alcohol-exposed dams as compared to control pair-fed and alcohol-exposed pups at P7. It presumably suggest that NPY-containing neurons might be regulated by the early postnatal growth stimulatory effect of the exogenously supplemented T₄. Therefore, the increase of NPY synthesis caused by maternal administration of exogenous thyroxine may ameliorate fetal alcohol effect, one of the ill effects as a result of the dysthyroid state following maternal alcohol abuse.

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.

국가 수준의 중학교 '기술·가정 1'교과의 멀티미디어 교육자료 개발 연구

윤인경,김진수,이수정,신순인 한국 가정과 교육 학회 2003 한국가정과교육학회지 Vol.15 No.1

A purpose of this study is to develop multimedia materials of "Technology and Home Economics" subject matter in a national level. Researchers, writers, examiners, deliverers and developers in order to develop multimedia materials were organized of us with 40 people. First, we analyzed the textbooks of "Technologyㆍ Home Economics" subject matter and made the idea design. Second we got storyboards based on the idea design. Finally, we developed the 1021 multimedia materials based with storyboards. The developed materials were uploaded to the Edunet website. If the materials developed in this study are utilized, students of middle school will be get easily educational motive, and teachers are able to use the multimedia materials to the Technologyㆍ Home 1" subject instruction.