• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.3-10
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• 2000

Objectives : The author wanted to summarize the psychiatric and social aspects of the patients with hepatitis B virus infection. Methods : The author reviewed all pertinent citations in the Medline database from 1966 to 1999. Results : Psychiatric problems in this population include delirium, psychotic disorder due to general medical condition(especially mania), anxiety, depression, adjustment disorder, alcohol abuse/dependence, and drug abuse/dependence. Social aspects of the patients with hepatitis B viral infection relate to the stigma of being a carrier, guilty feeling about infection, guilty feeling about increased family burden, impacts of having hepatitis on interpersonal relations, sexual difficulties, and job loss with increased financial burden, and health care worker's refusal. Conclusions : Appropriate early educational counseling interventions regarding the expected course and psychosocial intervention should be tailored to the sociocultural needs of special populations. Those interventions will increase compliance of treatment and prevent progression to hepatocellalar carcinoma from hepatitis.

• The Korean Journal of Nuclear Medicine
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• v.34 no.4
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• pp.312-321
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• 2000

Purpose: The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. Materials and Methods: We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; $27.4{\pm}7.8$ years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class I, II). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec ($32.6{\pm}19.5sec$) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propagation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis Results: CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=0.01) and age (p=0.02) were related to the development of CCH. Conclusion: Crossed cerebellar hyperperfusion in ictal brain SPECT did not help differentiate mesial from lateral temporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.

• The Korean Journal of Nuclear Medicine
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• v.38 no.3
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• pp.233-240
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• 2004

Purpose: We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). Materials and Methods: We studied brain F-18-FDG PET images of 113 epilepsy patients sugically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptrons (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 51 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. Results: The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). Conclusion: We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE.

• Tuberculosis and Respiratory Diseases
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• v.66 no.2
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• pp.141-151
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• 2009

Background: There is limited data on the epidemiology and relative frequency of idiopathic interstitial pneumonia (IIP) worldwide. This survey was performed to assess the epidemiology and relative frequency of IIP in Korea. Methods: The patients with IIP and who were confirmed by lung biopsy, except those patients with idiopathic pulmonary fibrosis, (IPF) over a 5 year period (from Jan. $1^{st}$, 2003 to Dec. $31^{st}$, 2007) were registered by a web-base questionnaire. Results: A total of 3,156 cases were registered, but 970 cases were excluded due to duplicative registration, inadequate data and the unmet ATS/ERS diagnostic criteria. A total of 2,186 cases were analyzed. The male to female ratio was about 2 : 1 and their mean age was 65 (range: 11-94). The most frequent disease was IPF (77.1%), followed in decreasing order by nonspecific interstitial pneumonia (NSIP) (11.9%), cryptogenic organizing pneumonia (COP) (8.5%), acute interstitial pneumonia (AIP) (1.1%), desquamative interstitial pneumonia (DIP) (0.9%), respiratory bronchiolitis-interstitial lung disease (RB-ILD) (0.4%) and lymphocytic interstitial pneumonia (LIP) (0.1%). The mean age of the patients with IPF, NSIP and COP was 67.8, 57.1 and 57.7 years old, respectively. The most frequent symptom was dyspnea on exertion (69%) followed by coughing (61%) and sputum (33%) for the whole population. The three year survival rate was 62% for the patients with IPF and the five year survival rate was 85% in both the NSIP and COP patients. Conclusion: This survey provides helpful information for the management of IIP and to produce management guidelines for this illness in Korea.

• The Monthly Diabetes
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• s.168
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• pp.56-57
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• 2003

당뇨병과 간질환은 우리나라에서 흔히 볼 수 있는 높은 발생 빈도를 갖는 만성질환이다. 두가지 질환을 같이 갖고 있는 환자를 많이 접할 수 있는데, 두 질환이 인과관계로 병존하기도 하고, 서로 관련 없이 각각의 질환을 앓는 경우도 있다.

• Proceedings of the Korean Institute of Intelligent Systems Conference
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• 2002.05a
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• pp.73-76
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• 2002

간질은 대뇌 신경세포의 순간적인 제어되지 않는 과도한 전기방출로 인하여, 발작적으로 몸의 경련이나, 기타 신경증상 등이 몸으로 표출되는 현상으로 이것이 반복되어 나타나는 현상이다. 간질 진단에 필수적으로 사용되는 뇌파에 혼합된 미지의 성분들로부터 각각의 독립적인 성분으로 분리하는 독립성분분석(ICA)을 적용하여 간질 발작파를 분리하고, 발생위치를 추정하였다. 본 연구에서는 부분발작 환자를 대상으로 간질 발작파가 나타나는 뇌파 신호(18개 채널)에 독립성분분석을 적용하여 18개의 독립성분으로 분리하였다. 또한 발작파(예파(sharp), 극파(spike), 예파와 서파를 동반한 극서파(sharp and slow complexes))가 나오는 간질 발작파의 유형을 분리하였다. 2차원 topological map을 이용하여 발작파의 발생위치를 나타내어 간질 진단에 독립성분분석이 적용될 수 있음을 나타내었다.

• Journal of Biomedical Engineering Research
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• v.20 no.6
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• pp.555-560
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• 1999

간질은 신경세포의 일부가 짧은 시간동안 과도한 전기를 발생시킴으로써 일어나는 신경계의 발작적 증상으로 배경 활동파와는 구별되는 극파, 예파, 예파와 서파를 동반한 극서파 복합(sharp and slow complexes)의 뇌파 특징파를 갖는다. 장시간의 뇌파기록에서 시간의 절약과, 정량화를 위해 컴퓨터를 이용한 간질 파형의 자동 검출은 객관성을 높이고 정량적인 해석을 위해 필수적이다. 본 연구에서는 간질 뇌파를 검출하기 위해 웨이브렛 변환과 신경망을 사용하였다. 웨이브렛 변환은 잡음을 제거하고 간질 뇌파의 특징을 강조하며 신경망의 입력노드수를 줄였다. 전문가에 의해서 분류된 간질특성과 정상뇌파를 신경망에 입력시켜 최적의 신경망구조를 선택하였고, 검출 문턱치를 설정하였다. 신경망은 200ms(26개의 데이터포인트)신호의 웨이브렛 결과와 웨이브렛 변환후 데이터 상의 최대, 최소 기울기가 입력되어 전체 28개의 입력 노드로 구성하였다. 은닉층은 18노드, 문턱치값은 민감도와 선택도가 일치하는 0.65가 사용되었다. 결과로 임상 환자 데이터에 입력되어 78.54% 의 검출률을 보였다.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.469-475
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• 1996

목 적 : 측두엽 간질 환자의 발작간 뇌 스캔에서 관찰되는 측두엽 혈류 감소와 같은 쪽 시상 혈류 감소 소견의 빈도를 알아보고 이러한 소견이 간질 병소 국소화에 미치는 유용성에 대해 알아보고자 한다. 대상 및 방법 : Tc-99m-ECD를 이용하여 발작간 뇌 스캔을 시행한 67명의 측두엽 간질 환자에서 편측 측두엽과 같은 쪽 시상에 혈류 감소를 보인 12명의 환자를 대상으로 하였다. 간질 병소는 표면 뇌파 검사, 발작시 뇌파 검사, 심부 뇌파 검사, 자기 공명 영상 그리고 임상적 소견을 종합하여 국소화 하였다. 결 과 : 편측 측두엽과 같은 쪽 시상에 혈류 감소는 18%의 환자에서 관찰되었다. 7명의 환자는 왼쪽 측두엽과 시상에 혈류 감소를 보였다. 이들 7명중 4명은 자기공명영상 소견상 왼쪽 내측 측두엽 경화 소견을 보였다. 5명의 환자는 오른쪽 측두엽과 시상에 혈류 감소를 보였다. 이들 5명중 4 명은 자기공명영상 소견상 오른쪽 내측 측두엽 경화 소견을 보였다. 결 론 : 발작간 뇌 스캔상 관찰되는 편측 측두엽과 같은 쪽 시상의 혈류 감소 소견은 측두엽과 시상사이의 상호 연결에 의한 해리 현상으로 부분 발작의 병태 생리와 밀접한 연관이 있으리라 생각한다. 또한 이러한 소견은 간질 병소 국소화에 도움이 되리라 생각한다.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.415-419
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• 2008

Purpose : Herbal medicine is thought to be widely used by children with epilepsy, but there have been few studies. This study aimed to investigate the perceptions and the actual conditions of usage of herbal medicine by children with epilepsy. Methods : From July to August 2007, three hundred seventy eight questionnaires were completed by parents of epileptic children who visited pediatric neurology clinic of Korea University hospital and Kwangmyung-Sungae hospital. Demographic data and patterns of usage of herbal medicine were investigated. Results : Among 378 patients, sixty five (17.2%) reported using herbal medicine. Major reasons for using herbal medicine were 'to enhance general health' and 'belief that it has fewer side effects'. Majority of respondents did not notify their physician about using herbal medicine because 'they did not need to share this with doctor' and 'they thought their doctor would disapprove'. After taking herbal medicine, 33.3% of patients reported that it did not benefit their seizure but they felt healthier. Usage of herbal medicine was significantly related to number of AEDs (antiepileptic drugs), duration of AED treatment, association with psychosomatic disorders and motivation by other people or by mass media. Conclusion : Considerable numbers of epileptic children were using herbal medicine during treatment with AED and did not inform their physician about usage of it. Physicians should be aware of benefits and harms of herbal medicine and actively intervene in the usage of herbal medicine by epileptic patients.

• The Korean Journal of Nuclear Medicine
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• v.36 no.3
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• pp.155-165
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• 2002

Purpose: The aim of this study was to identify the brain areas whose regional cerebral blood flow (rCBF) was changed in medial temporal lobe epilepsy (mTLE) using ${H_2}^{15}O-PET$. Materials and Methods: 12 patients with mTLE (6 left, 6 right mTLE) and 6 normal controls were scanned during a fixation baseline period and a sensory-motor condition where subjects pressed a button to an upward arrow. A voxel-based analysis using SPM99 software was peformed to compare the patient groups with the normal controls for the rCBF during fixation baseline period and for relative changes of rCBF during the sensory-motor task relative to fixation. Results: During the fixation baseline, a significant reduction of rCBF was found posterior insula bilaterally and right frontopolar regions in right mTLE patients compared to the normal controls. In left mTLE patients, the reduction was found in left frontopolar and temporal legions. During the sensory-motor task, rCBF increase over the fixation period, was reduced in left frontal and superior temporal legions in the right mTLE patients whereas in various areas of right hemisphere in left mTLE patients, relative to normal controls. However, the increased rCBF was also found in the left inferior parietal and anterior thalamic/fornix regions in both right and left mTLE patients compared to normal controls. Conclusion: Epilepsy induced changes were found not only in relative increase/decrease of rCBF during a simple sensory-motor control condition relative to a fixation rest condition but also in the relative rCBF distribution during the rest period.