• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.3
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• pp.174-181
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• 2010

Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

• The Magazine of the IEIE
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• v.28 no.7
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• pp.49-55
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• 2001

1970년대에 개발된 마이크로 프로세서는 제어기기 분야 및 소형 컴퓨터에서 주로 사용되어 오다가 1980년대에 이르러 RISC(Reduced Instruction Set Computer) 구조의 도입으로 중대형 컴퓨터에 이르기까지 광범위하게 사용되고 있다. 또한 반도체 기술의 급격한 발전으로 슈퍼스칼라 구조가 마이크로 프로세서에서도 적용되고 있으며 동작 속도도 수백 MHz에 이르고 있다. 마이크로 프로세서는 프로그램을 수행하기 위해서 프로그램과 데이터를 메모리로부터 읽어 와야 한다. 그런데 메모리 용량은 빠른 속도로 증가하고 있지만 동작 속도는 마이크로 프로세서의 동작 속도에 크게 미치지 못하고 있다. 1980년에 DRAM의 접근 속도는 250nsec이었으나 1998년에 RDRAM의 동작속도는 300MHz로 70여배 빨라졌다. 그러나 마이크로프로세서는 1980년에 8086의 동작 속도가 8MHz이던 것이 1998년에는 팬티엄-2가 500MHz에 이르고 있다. 더욱이 팬티엄-2는 슈퍼스칼라 구조이므로 이를 감안하면 1GHz 이상에 이르러 120여 배 빨라진 것을 알 수 있다. 이와 같은 메모리 속도와 마이크로 프로세서 속도 차이에 더하여, 메모리와 마이크로 프로세서를 인쇄 회로 기판에서 연결하는데 따른 물리적 특성은 변화하지 않으므로 데이터 전송 폭을 넓히는 것에는 한계가 있다. 따라서 향후 컴퓨터 성능 발달을 제한하는 주요 요소 중 하나는 마이크로 프로세서와 메모리 사이의 데이터 전송 폭이다. 프로그램과 데이터가 메모리에 저장되는 본 뉴먼 방식의 컴퓨터에서 데이터 전송 폭을 줄이기 위해서는 코드 밀도(Code Density)가 높은 컴퓨터 구조를 연구하는 것이 필요하다. 한편 마이크로 프로세서는 실장 제어용으로 거의 모든 전자 제품 및 자동화 기기에서 채용하고 있다. 특히 냉장고, 에어콘, 전축, TV, 세탁기 등 가전기기와 Fax, 복사기, 프린터 등 사무용기기와 자동차, 선박, 자동화기계 등 사무 및 산업용 기기와 PDA(휴대용 정보 기기), NC(Network Computer) 등 정보 기기 그리고 각종 오락기, 노래 반주지 등 정보 기기 등에서 사용하는 실장 제어용 마이크로 프로세서 시장은 매년 10% 이상씩 성장하고 있으며, 21세기 산업을 주도하는 핵심 기술로 자리 매김하고 있다. 이러한 실장 제어용 기기는 마이크로 프로세서와 메모리 및 입출력 자이가 하나의 반도체에 집적되는 경우가 많다. 그런데 반도체 가격은 반도체 크기에 따라 결정되며, 가장 넓은 면적을 차지하는 것은 메모리이다. 따라서 반도체 가격을 낮추기 위해서는 메모리 크기를 줄여야 하며, 이를 위해서 또한 코드 밀도가 높은 컴퓨터 구조에 대한 연구가 필요하다. 최근에는 322비트 RISC 명령어를 16비트 명령어로 축약한 구조가 연구되었다. ARM-7TDMI는 ARM-7의 16비트 축약 명령어 구조이며, TR4101은 MIPS-R3000의 16비트 축약 명령어 구조이다. 이들 16비트 축약 명령어 RISC는 종래 RISC와의 호환성을 위하여 2가지 모드로 동작하므로 구조가 복잡하고, 16비트 명령어에서는 8개의 레지스타만을 접근할 수 있으므로 성능이 크게 떨어지는 단점을 가진다.

• Journal of the Ergonomics Society of Korea
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• v.33 no.5
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• pp.395-405
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• 2014

Objective: The aim of this study is to investigate 1) somatotopic arrangement of the second and third fingers in SI area 2) difference of neural activation in the SI area produced by stimulation with different frequencies 3) correlation between the intensity of tactile perception by different stimulus intensity and the level of brain activation measurable by means of fMRI. Background: Somatosensory cortex can obtain the information of environmental stimuli about "where" (e.g., on the left palm), "what" (e.g., a book or a dog), and "how" (e.g., scrub gently or scrub roughly) to organism. However, compared to visual sense, the neural mechanism underlying the processing of specific electrotactile stimulus is still unknown. Method: 10 right-handed subjects participated in this study. Non-painful electrotactile stimuli were delivered to two different finger tips of right hand. Functional brain images were collected from 3.0T MRI using the single-shot EPI method. The scanning parameters were as follows: TR and TE were 3000, 35ms, respectively, flip angle 60, FOV $24{\times}24cm$, matrix size $64{\times}64$, slice thickness 4mm (no gap). SPM5 was used to analyze the fMRI data. Results: Significant activations produced by the stimulation were found in the SI, SII, the subcentral gyrus, the precentral gyrus, and the insula. In all participants, statistically significant activation was observed in the contralateral SI area and the bilateral SII areas by the stimulation on the fingers but ipsilaterally dominant. The SI area representing the second finger generally located in the more lateral and inferior side than that of the third finger across all the subjects. But no difference in brain area was found for the stimulation of the fingers by different frequencies. And two typical patterns were observed on the relationship between the perceived psychological intensity and the amount of voxels in the primary sensory cortex during the stimulation. Conclusion: It was possible to discriminate the representation sites in the SI by electrotactile stimulation of digit2 and digit3. But we could not find the differences of the brain areas according to different stimulation frequencies from 3 to 300Hz. Application: The results of the study can provide a deeper understanding of somatosensory cortex and offer the information for tactile display for blinds.

• Proceedings of the KSMRM Conference
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• 2001.11a
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• pp.137-137
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• 2001

Purpose： The purpose of this study was to identify cerebral cortices related with sexual arousal fro visual sexual stimulation in healthy males using BOLD-based functional MR imaging Method： Sixteen male volunteers with sexually potent(mean age：24) were examined for thi study. Functional MRI was performed on a 1.5T MR scanner(GE Signa Horizon) with birdcage-type head coil. In this study, blood oxygenation level dependent(BOLD) technique was utilized to create fMR image reflecting local brain activities. The BOLD-based fMRI d were obtained from 7 oblique planes using gradient-echo EPI with $90^{\circ}$flip angle, 50ms TE 6000ms TR, $26cm{\times}26$ cm FOV, $128{\times}128$ matrix, and 10mm slice thickness. The sexual stimulation paradigm consisted of two alternating periods of rest and activati and it began with a 1 minute rest, followed by a 2 minute stimulation by a documentary a erotic video film. Brain activation maps were generated by cross-correlation of imag acquired during rest and activation periods. The index of activation was used to compare t number of pixels activated by each task in each volunteer, where the significance of th differences was evaluated by using Students t-test.

• Investigative Magnetic Resonance Imaging
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• v.4 no.1
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• pp.14-19
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• 2000

Purpose : This study was to present the functional brain mapping of both functional magnetic resonance imaging(MRI) and transcranial magnetic stimulation(TMS) in a case of schizencephaly. Materials and methods : A 28-year-old man, who had left hemiplegia and schizencephaly in right cerebral hemisphere, was exacted with both functional MRI and TMS. Motor function of left hand was decreased whereas right hand was within normal limit. For functional MRI, gradient-echo echo planar imaging($TR/TE/{\alpha}$=1.2 sec/90 msec/90) was employed. The paradigm of motor task consisted of repetitive self-paseo hand flexion-extension exercises with 1-2 Hz periods. An image set of 10 slices was repetitively acquired with 15 seconds alternating periods of task performance and rest and total 6 cycles (three ON periods and three OFF periods) were performed. In brain mapping, TMS was performed with the round magnetic stimulator (mean diameter; 90mm). The magnetic stimulation was done with 80% of maximal output. The latency and amplitude of motor evoked potential(MEP)s were obtained from both abductor pollicis brevis(APB) muscles. Results : Functional MRI revealed activation of the left primary motor cortex with flexion-extension exercises of healthy right hand. On the other hand, the left primary motor cortex, left supplementary motor cortex, and left promoter areas were activated with flexion-extension exercises of left hand. In TMS, magnetic evoked potentials were induced in no areas of right cerebral hemisphere, but in 5 areas of left corebral hemisphere from both abductor pollicis brevis. Latency, amplitude, and contour of response of the magnetic evoked potentials in both hands were similar. Conclusion : Functional MRI and TMS in a patient with schizencephaly were successfully used to localize cortical motor function. Ipsilateral motor pathway is thought to be secondary to reinforcement of the corticospinal tract of the ipsilateral motor cortex.

• Korean Journal of Biological Psychiatry
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• v.20 no.3
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• pp.111-117
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• 2013

Objectives We investigated the effectiveness and safety when treated in schizophrenics with paliperidone palmitate, a long acting injectable antipsychotic. Methods This was a 24-week open-label study, performed at one center in Korea. The eligible patients with schizophrenia diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria were enrolled. Patients received long-acting paliperidone palmitate injection (234 mg, baseline; 156 mg, week 1 ; then once 4 weeks flexible dosing). Effectiveness assessments were measured by the Positive and Negative Syndrome Scale (PANSS), The Clinical Global Impression Severity Scale (CGI-S), The Personal and Social Performance (PSP) at baseline, week 1, every 4 weeks untill 24 weeks or endpoint. Safety assessments were measured by The Extrapyramidal Symptom Rating Scale (ESRS), body weight (BW) and incidence of adverse events. Oral antipsychotics were stopped or tapered off within next 14 days. Results Of 20 patients recruited, 9 patients (45%) completed the study. Paliperidone palmitate produced a significant improvement in PANSS total score from baseline to endpoint. The response rate was 75% [mean change (${\pm}SD$) $-25.9{\pm}14.4$, all p < 0.001]. The CGI-S and PSP total scores significantly improved during 24 weeks (All p < 0.001). Eighty percent of patients reported adverse events and most common adverse events (${\geq}10%$) in paliperidone palmitate were anticholinergic adverse event, extrapyramidal symptoms, weight gain, akathisia, insomnia, headache, agitation, anxiety and GI trouble. ESRS score is not statistically significant, but tends to get better at the end of the study when compared to baseline. Conclusions Our study results demonstrated maintained effectiveness and safety of paliperidone palmitate treatment in schizophrenics. And provides both clinicians and patients with a new choice of treatment that can improve the outcome of long term therapy. Their potential effectiveness and safety should be better addressed by future randomized-controlled trials.

• The Korean Society of Law and Medicine
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• v.13 no.2
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• pp.217-261
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• 2012

Die Zeugen Jehovas lehnen Bluttransfusionen ab. Wiederholt haben Todesf$\ddot{a}$lle unter Jehovas Zeugen, die mit der Ablehnung von Bluttransfusionen in Verbindung gebracht werden, in den Medien f$\ddot{u}$r Aufsehen gesorgt, da die Zeugen Jehovas die $\ddot{U}$bertragung von fremdem Blut aus religi$\ddot{o}$sen Gr$\ddot{u}$nden entschieden ablehnen. Medizinische Behandlungen, auch Bluttransfusionen bed$\ddot{u}$rfen grunds$\ddot{a}$tzlich der Einwilligung des Patienten. Wenn sich ein Zeuge Jehovas gegen eine Transfusion entscheidet, ist dies zu respektieren. Ist ein erwachsener Patient Mitglied der Zeugen Jehovas und tr$\ddot{a}$gt dieser eine Patientenverf$\ddot{u}$gung bei sich, die eine Bluttransfusion ablehnt, weil es dadurch zu einer "Zerst$\ddot{o}$rung der Pers$\ddot{o}$nlichkeit" des Menschen aus religi$\ddot{o}$sen Gr$\ddot{u}$nden komme, so ist auch diese Verf$\ddot{u}$gung verbindlich, sofern sie ernsthaft ist. Bei Minderj$\ddot{a}$hrigen ist die Einwilligungsf$\ddot{a}$higkeit durch den Gesetzgeber bislang nicht geregelt. Minderj$\ddot{a}$hrige k$\ddot{o}$nnen grunds$\ddot{a}$tzlich selbst zustimmen, wenn sie ihrer geistigen und sittlichen Reife nach einsichtsf$\ddot{a}$hig sind. Bei Jugendlichen ab dem 16. Lebensjahr muss der Arzt ermitteln, wie einsichtsf$\ddot{a}$hig sie sind und inwiefern sie selbst in die medizinische Behandlung einwilligen k$\ddot{o}$nnen. Einwilligung kann aber nicht eingeholt werden, wenn der Patient einwilligungsunf$\ddot{a}$hig ist. Bei Kindern bis zum 16. Lebensjahr ersetzt die Einwilligung der Eltern in die medizinische Behandlung die Einwilligung der Kinder. Ob die Entscheidungen der Eltern $\ddot{u}$ber ihre unm$\ddot{u}$ndigen Kinder im Fall lebensbedrohlicher Krankheitsverl$\ddot{a}$ufe von den behandelnden $\ddot{A}$rzten akzeptiert werden m$\ddot{u}$ssen, ist umstritten. Die Ablehnung einer Bluttransfusion f$\ddot{u}$r ein transfusionsbed$\ddot{u}$rftiges Kind w$\ddot{a}$re eine Kindeswohlgef$\ddot{a}$hrdung. Bei Kindern ist der Weg $\ddot{u}$ber die $\ddot{U}$bernahme des Sorgerechts durch das Gericht unvermeidlich, falls die Eltern auf der Ablehnung einer lebensnotwendigen Transfusion beharren. Im Rahmen der objektiven Interessenabw$\ddot{a}$gung ist der Grundsatz "in dubio pro vita" zu beachten. Bei erheblicher unmittelbarer Gefahr ist allerdings ein direktes Eingreifen n$\ddot{o}$tig.

• Toxicological Research
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• v.28 no.1
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• pp.5-9
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• 2012

It has been shown that the accumulation of prion in the cytoplasm can result in neurodegenerative disorders. Synthetic prion peptide 106-126 (PrP) is a glycoprotein that is expressed predominantly by neurons and other cells, including glial cells. Prion-induced chronic neurodegeneration has a substantial inflammatory component, and an increase in the levels of matrix metalloproteinases (MMPs) may play an important role in neurodegenerative development and progression. However, the expression of MMPs in PrP induced rat astrocytes and microglia has not yet been compared. Thus, in this study, we examined the fluorescence intensity of CD11b positive microglia and Glial Fibrillary Acidic Protein (GFAP) positive astrocytes and found that the fluorescent intensity was increased following incubation with PrP at 24 hours in a dose-dependent manner. We also observed an increase in interleukin-1 beta (IL-$1{\beta}$) and tumor necrosis factor alpha (TNF-${\alpha}$) protein expression, which are initial inflammatory cytokines, in both PrP induced astrocytes and microglia. Furthermore, an increase MMP-1, 3 and 11 expressions in PrP induced astrocytes and microglia was observed by real time PCR. Our results demonstrated PrP induced activation of astrocytes and microglia respectively, which resulted in an increase in inflammatory cytokines and MMPs expression. These results provide the insight into the different sensitivities of glial cells to PrP.

• Toxicological Research
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• v.28 no.1
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• pp.39-49
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• 2012

We investigated the effect of zinc on the formation of colonic aberrant crypt foci induced by azoxymethane (AOM) followed by dextran sodium sulfate (DSS) in mice with high iron diet (HFe; 450 ppm iron). Sixweek old ICR mice were fed on high iron diets with combination of three different levels of zinc in diets, low-zinc (LZn; 0.01 ppm), medium-zinc (MZn; 0.1 ppm), and high-zinc (HZn; 1 ppm) for 12 weeks. Animals were received weekly intraperitoneal injections of AOM (10 mg/kg B.W. in saline) for 3 weeks followed by 2% DSS (molecular weight 36,000~50,000) in the drinking water for a week. To confirm the iron storage in the body, the hepatic iron concentration has been determine chemically and compared with histological assessment visualized by Prussian blue reaction. Aberrant crypt (AC) and aberrant crypt foci (ACF) were analyzed in the colonic mucosa of mouse fed high dietary iron. Superoxide dismutase (SOD) activity and thiobarbituric acid-reactive substances (TBARS) level were also investigated. Apoptosis in the preneoplastic lesion was determined by terminal deoxynucleotidyl transferase-mediated dUTP nickend labeling (TUNEL). In addition, immunohistochemistry of ${\beta}$-catenin was also performed on the mucous membrane of colon. The number of large ACF (${\geq}4$ AC/ACF), which possess greater tumorigenic potential, was significantly lower in MZn and HZn groups compared with LZn group. Cytosolic SOD activity in the liver was significantly higher in HZn group compared with LZn group. Hepatic MDA level was decreased significantly in HZn group compared with MZn and LZn groups. Apoptotic index was significantly higher in HZn group. Taken together, these findings indicate that dietary zinc might exert a protective effect against colonic preneoplastic lesion induced by AOM/DSS in ICR mice with high iron status, and suggest that dietary supplement of zinc might play a role in suppressing colon carcinogenesis in mice.

• Toxicological Research
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• v.28 no.1
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• pp.25-31
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• 2012

The purpose of this study was to determine the acute pulmonary toxicity of metallic silver nanoparticles (MSNPs, 20.30 nm in diameter). Acute pulmonary toxicity and body distribution of inhaled MSNPs in mice were evaluated using a nose-only exposure chamber (NOEC) system. Bronchoalveolar lavage (BAL) fluid analysis, Western blotting, histopathological changes, and silver burdens in various organs were determined in mice. Mice were exposed to MSNPs for 6 hrs. The mean concentration, total surface area, volume and mass concentrations in the NOEC were maintained at $1.93{\times}10^7$ particles/$cm^3$, $1.09{\times}10^{10}\;nm^2/cm^3$, $2.72{\times}10^{11}\;nm^3/cm^3$, and 2854.62 ${\mu}g/m^3$, respectively. Inhalation of MSPNs caused mild pulmonary toxicity with distribution of silver in various organs but the silver burdens decreased rapidly at 24-hrs post-exposure in the lung. Furthermore, inhaled MSNPs induced activation of mitogen-activated protein kinase (MAPK) signaling in the lung. In summary, single inhaled MSNPs caused mild pulmonary toxicity, which was associated with activated MAPK signaling. Taken together, our results suggest that the inhalation toxicity of MSNPs should be carefully considered at the molecular level.