지역주민의 한방의료 이용성향과 진료만족도

서호석,남철현,김재돈,김성진,류장근,전봉천,김미애,Suh, Ho-Suk,Nam, Chul-Hyun,Kim, Jae-Don,Kim, Sung-Jin,Ryu, Jang-Gun,Jun, Bong-Chun,Kim, Mi-Ae 대한예방한의학회 2007 대한예방한의학회지 Vol.11 No.2

The purpose of this study was to identify a tendency in patients who seek oriental medical service and factors influencing patient satisfaction. The study was conducted with 1,520 residents of a community during the period from February 5, 2005 through June 30, 2005 using a questionnaire. This study results are summarized as follows : 1. Of subjects who sought oriental medical service, 66.2% had musculoskeletal disorder and connective tissue disease, 18.9% had digestive tract disease, 16.4% had respiratory disease, 8.2% had endocrinemetabolic disease, 7.5% had circulatory disease and the remaining subjects had other diseases(p<0.001). 2. Of subjects who sought oriental medical service for the treatment of musculoskeletal disorder, 84.9% preferred acupuncture. Of those who had digestive tract diseases, 47.0% preferred packaged herbal medicine. Of those who had respiratory disease, 63.0% preferred packaged herbal medicine. 3. Acupuncture was the most often sought by subjects with musculoskeletal disorder. Packaged herbal medicine was sought by subjects with respiratory disease, digestive tract disease, endocrine-metabolic disease or circulatory disease. Tablet-type herbal medicine was sought by subjects with musculoskeletal disorder or digestive tract disease. Combined therapy was sought by subjects with musculoskeletal disorder, digestive tract disease, hematopoietic disease or immune disorder. 4. The level of satisfaction with oriental medical service was higher in subjects with circulatory disease, subjects with digestive tract disease, subjects with neurological disorder and subjects with musculoskeletal disorder in descending order. Of total subjects, 39.4% experienced side effects of oriental medical care, 38.1% experienced side effects of herbal medicine. About 51.9% considered the price of herbal medicine costly while 23.2% considered it reasonable. 5. Subjects' knowledge of herbal medicine was measured as $29.2{\pm}3.83$ out of 42 scores or 69 out of 100 points, indicating a low knowledge level. Subjects' knowledge was influenced by occupation, religion, side effects, sex, age, residence area, the type of insurance. These variables explained 15.2% of the variance. 7. Of total subjects, 56.8% were satisfied with oriental medical service. Patient satisfaction varied with occupation, religion, the type of insurance, health state and treatment outcomes. These variables explained 37.3% of the variance. Conclusion : The majority of subjects were satisfied with oriental medical service. However, oriental medical care are not widely used to treat all kinds of diseases while its use skews to a small categories of diseases. It is therefore necessary for the government and oriental medical service providers to develop new therapy approaches for the treatment of a broader range of diseases.

가정주부의 한약에 대한 지식수준과 관련요인

서호석,남철현,박찬우,김성진,이미경,하은필,Suh Ho-Suk,Nam Chul-Hyun,Park Chan-Woo,Kim Sung-Jin,Lee Mi-Kyung,Ha Eun-Pil 대한예방한의학회 2002 대한예방한의학회지 Vol.6 No.1

This study was conducted to examine housewives' knowledge level of herb medicine and its related factors in Korea. Data were collected from 667 housewives from April 1, 1999 to June 30, 1999. The results of this study are summarized as follows. 1. According to general characteristics of the subjects, 29.1% of the subjects was over fifties. 28.6% was primary school graduate. while 25.5% was high school graduate. In case of job, the unemployed was 67.0% and professional/clerical worker was 19.6%. 82.0% had spouses and 45.7% believed in Buddha. 50.8% of the subjects lived in big cities and 76.7% was the middle class. In case of their health condition, 33.4% was in good health, while 51.1% suffered from certain diseases and 43.9% was not satisfied with health conditions. 2. The proportion of experience in taking herb medicine was 86.4%. The marital status and health condition were significantly related to the experience in taking herb medicine. When the respondents took diseases, 68.0% of them were experienced in folk remedy. The variables of age and religion were significantly related to experience in folk remedy. 3. According to the respondents opinions of the effect of the folk remedy, 'effective' was 78.5% and 'common' was 17.6%, while 'not effective' was 3.9%. 59.3% of the respondents thought that the folk remedy had scientific basis. 4. In case of information sources on herb medicine, 59.7% of the respondents obtained the information from TV or Radio. 13.7% of them got it from magazines related to Oriental medicine and 13.3% of them obtained it from newspapers or related books. The information sources were significantly related to age and health condition. The knowledge level of herb medicine was $20.76{\pm}2.66$ point on the basis of 30 points. The knowledge level was significantly related to age, occupation, health condition, information sources, experience in taking herb medicine, and opinions of scientific basis of the folk remedy. 5. The respondents marked $2.23{\pm}0.64$ points on the basis of 3.0 points in the question of the effect of taking herb medicine in summer, $2.30{\pm}0.61$ points in the question of the relationship between taking deer antlers and becoming clear-headed, $2.72{\pm}0.56$ points in the question of ginseng, $2.51{\pm}0.56$ points in the question of the relationship between taking herb medicine and being harmful to the liver, $1.94{\pm}0.74$ points in the question of taking herb medicine during the period of pregnancy, $1.84{\pm}0.78$ points in the question of the relationship between menstrual irregularity and motherwort, $2.00{\pm}0.83$ points in the question of the relationship between taking herb medicine and getting fat, $1.76{\pm}0.89$ points in the question of the relationship between Ssanghwatang and cold, $2.15{\pm}0.76$ points in the question of taking honey, and $1.45{\pm}0.77$ points in the question of selecting foods during the period of taking herb medicine. 6. The factors influencing decision of taking herb medicine were experience of taking herb medicine, intention of receiving treatment by folk remedy, occupation, health condition, and age. As seen in the above results, the knowledge level of taking herb medicine during the period of pregnancy, the relationship between menstrual irregularity and motherwort, Ssanghwatang, honey, and selecting foods during the period of taking herb medicine was very low. Therefore, it is necessary to develop education programs in order to provide community residents with basic knowledge of herb medicine. In doing so, the government, Oriental medical doctors, and associations related to herb medicine must make great efforts.

위축성 여드름 흉터의 치료에 따른 피부 확대경 소견의 차이 고찰: Pilot Study

채웅석 ( Woong Suk Chae ),성준영 ( Jun Young Seong ),정하나 ( Ha Na Jung ),공숙현 ( Sook Hyun Kong ),서호석 ( Ho Seok Suh ),최유성 ( Yu Sung Choi ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.1

Background: Dermoscopy has been suggested as a useful tool for diagnosing various skin diseases. Recently, thepossibility of using dermoscopy to predict the response to treatment has emerged. Objective: The purpose of this study was to determine whether dermoscopic findings corresponded to clinical acnescar types. This study also aimed to discover which dermoscopic findings predict the response to acne scartreatment. Methods: The dermoscopic findings of 39 participants undergoing atrophic acne scar treatment with fractionalphotothermolysis were evaluated. Patients were divided into two groups according to the duration of acne scarpersistence. Results: Patients with a relatively short duration of acne scar persistence usually achieved better treatment outcomes. Dermoscopic findings showed no obvious differences according to clinical acne scar type. But high hair follicledensity can be considered a predictive factor of treatment effects. Conclusion: Our study indicated that acne scar improvements can be predicted by dermoscopically observing hairfollicle density. (Korean J Dermatol 2015;53(1):23∼29)

불안 및 우울 장애에 있어서 불확실성에 대한 불내성의 역할

이준엽,이상혁,서호석,Lee, Jun-Yeob,Lee, Sang-Hyuk,Suh, Ho-Suk 대한불안의학회 2013 대한불안의학회지 Vol.9 No.1

Intolerance of uncertainty (IU) is defined as the tendency to react negatively on an emotional, cognitive, and behavioral level to uncertain situations and events. However, this definition is somewhat categorical and does not explain the phenomenology of IU. Intolerance of uncertainty scale (IUS), the standard measure of IU, was considered to have two factors : 'unacceptability and avoidance of uncertainty' and 'uncertainty leading to the inability to act'. IU may be a cognitive vulnerability factor for clinical worry and generalized anxiety disorder (GAD). A number of moderators and mediators including cognitive avoidance, experiential avoidance and rumination influence the relationship between IU, worry, obsessive-compulsive symptoms, anxious and depressive symptoms. IU may be more strongly related to the symptoms of GAD than to symptoms of other anxiety disorders including obsessive-compulsive disorder (OCD), and major depressive disorder. IU may serve as an important transdiagnostic feature across anxiety and depressive disorders. Incorporating IU-specific treatment components into therapeutic protocols may result in pervasive benefits, and not only for those with GAD or OCD, but for people with any anxiety disorder or with depression.

전신 스테로이드 치료에 저항을 보인 백반증 환자에서 사이클로스포린 사용으로 치료에 도움이 된 경험 1예

채웅석 ( Woong Suk Chae ),이단비 ( Dan Bi Lee ),정하나 ( Ha Na Jung ),서호석 ( Ho Seok Suh ),최유성 ( Yu Sung Choi ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.2

위축성 여드름 흉터에서 두 가지 국소 화학 박피술의 치료 효과 ; 100% TCA CROSS와 Phenol CROSS의

채웅석 ( Woong Suk Chae ),서호석 ( Ho Seok Suh ),최유성 ( Yu Sung Choi ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.5

Atrophic acne scars have been treated using various modalities. The CROSS (Chemical Reconstruction of Skin Scars) technique using 100% TCA has the advantage of reconstructing acne scars by focusing on dermal thickening and collagen production. However, the phenol CROSS technique is not widely used for acne scarring. Objective: The purpose of this study was to evaluate the clinical effectiveness and safety of 100% TCA CROSS and phenol CROSS in the treatment of facial atrophic acne scars. Methods: Twenty-four participants were randomly and equally divided into 2 groups: group 1 received 2 sessions (8 weeks apart) of 100% TCA CROSS, while group 2 received 2 sessions (8 weeks apart) of phenol CROSS. The severity of atrophic acne scarring and treatment efficacies were evaluated by standardized photography, patient satisfaction, physician global assessment, and the ECCA grading scale. Side effects were assessed at the 8- and 20 week visits. Results: At the 0-, 8-, and 20-week visits, both groups showed an acceptable improvement in patient satisfaction and physician global assessment. ECCA grading scale scores improved by a mean of 22.2% (p<0.05) in group 1 and 19.1% (p<0.05) in group 2. The between-group difference in the degree of ECCA score improvement was not statistically significant (p=0.392). Complications such as pain, crust, postcrust erythema, postcrust dryness, and postinflammatory hyperpigmentation were observed in both treatment groups. However, no severe side effects occurred in either group. Conclusion: Both 100% TCA CROSS and phenol CROSS are effective treatment modalities for atrophic acne scarring without significant side effects. (Korean J Dermatol 2014;52(5):293∼301)

공황장애 약물 치료에 대한 한국형 알고리듬 개발(3) - 인지행동치료 -

이상혁,양종철,윤세창,서호석,김찬형,유범희,김민숙,Lee, Sang-Hyuk,Yang, Jong-Chul,Yoon, Se-Chang,Suh, Ho-Suk,Kim, Chan-Hyung,Yu, Bum-Hee,Park, Min-Sook 대한불안의학회 2008 대한불안의학회지 Vol.4 No.1

Objective : A working group of psychiatrists from the Korean Academy of Anxiety Disorders was established to determine the appropriate medication algorithm for treating patients with panic disorder. In this article, we discussed the consensus among psychiatrists regarding the use of cognitive behavior therapy (CBT) in the development of a treatment algorithm for panic disorder in Korea. Methods : Based on the guidelines or algorithms published by the American Psychiatric Association, National Institute for Clinical Excellence, and Canadian Psychiatric Association, we constructed questionnaires regarding the core components and contents of CBT for patients with panic disorder. Fifty-four experts in panic disorder completed the questionnaires. Results : There was statistically significant consensus among the experts in the belief that cognitive reconstruction and psychological education are the core components of CBT for the treatment of patients with panic disorder. However, there was some inconsistency between the opinions of some experts regarding the content and frequency of CBT and the results of studies published outside of Korea. Conclusions : CBT, especially the psychological education and cognitive reconstruction components, should be considered when treating patients with panic disorder. However, further consideration needs to be put into the design of a more detailed treatment guideline for the use of CBT in the treatment of patients with panic disorder.

Bcl - 2 단백을 이용한 면역조직학적 방법에 의한 기저세포암과 모낭 상피종의 감별

이상협 ( Sang Hyub Lee ),서호석 ( Ho Suk Suh ),최지호 ( Jee Ho Choi ),성경제 ( Kyung Jeh Sung ),문기찬 ( Kee Chan Moon ),고재경 ( Jai Kyoung Koh ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.1

Background: It is important to distinguish trichoepitheliomas from basal cell carcinomas because, despite the similarity of clinical and histological findings, the treatments and prognoses are different. bcl-2 is a newly characterized protooncogene that has been shown to suppress programmed cell death(apoptosis), which is involved in tumorigenesis, and its expression has been demonstrated within tumor cells in a variety of neoplasms. Objective : We tried to evaluate the staining pattern of bcl-2 protooncogene in basal cell carcinomas and trichoepitheliomas. Methods : We examined cases of basal cell carcinomas and trichoepitheliomas with the immunohistochemical method of labelled streptavidin-biotin complex in paraffin-embedded sections using the antigen retrieval method. Results : 1. The bcl-2 staining pattern in basal cell carcinomas was diffuse throughout the tumor lobules, but multifocal absences of bcl-2 staining were identified in sites of follicular differentiation. Also, inhomogeneous staining patterns were observed around the cystic, glandular structure of several subtypes of basal cell carcinoma. 2. The trichoepitheliomas showed staining of tumor cells limited to the outer layers of the tumor lobules. 3. Normal skin showed staining of basal keratinocytes, rnelanocytes in the epidermis, and eccrine gland secretory cells, basal layer of follicular structures, and dermal hair papilla in the dermis. Conclusion : The immunohistcchemical bcl-2 staining is helpful for the differentiation of basal cell carcinomas from trichoepitheliomas particularly in borderline cases and the explanation of different biologic courses for the two diseases. Further investigation of bcl-2 staining in other malignant skin diseases should be undertaken, and its practical adaptation should be more widely used in borderline cases. (Kor J Dermatol 1996;34(1): 31-37)

노년기 비만군과 정상 체중군 간의 우울 성향 비교

문준식,이용호,전세일,서호석,Mune, June-Sik,Lee, Yong-Ho,Chun, Sae-Il,Suh, Ho-Suk 대한불안의학회 2007 대한불안의학회지 Vol.3 No.2

Objective : Obesity has been considered to be associated with numerous physical, mental and psychological diseases. Depression, which is a major psychological factor affecting occurrence and treatment of obesity, can be a cause of obesity as well as can be triggered by obesity. This study aimed to find out the need of positive consideration to the existence of depressive mood in the management of obesity. Methods : A total of 101 subjects were enrolled among those who were 60 years old and over at one local clinic. Obese group (n=49) was defined as BMI${\geqq}$25 and normal weight group (n=52) as 20<BMI<23. Their depressive disposition was evaluated by Geriatric Depression Scale Short Form Korea Version (GDSSFK). Those who had previous history of psychological diseases like depression or are suffering from severe medical diseases were excluded. Results : The mean GDSSF-K score of the obese group ($5.2{\pm}2.5$) was significantly higher than that of the normal weight group ($3.8{\pm}1.7$)(p<0.05). In male subjects, there was no significant difference in the mean GDSSF-K score between both groups, but in female subjects, the mean GDSSF-K score of the obese group, $6.4{\pm}2.6$ was significantly higher than that of the normal weight group ($4.0{\pm}1.8$)(p<0.05). Conclusion : The elderly obese group showed higher depressive scale score than elderly normal weight group, especially in female elderly. Since the elderly obese female group had a depressive predisposition, comprehensive management including mental and psychological approach is required in obesity control programs.

공황장애 인지행동치료의 최신 지견

서호준,이강수,이상혁,서호석,Seo, Ho-Jun,Lee, Kang-Soo,Lee, Sang-Hyuk,Suh, Ho-Suk 대한불안의학회 2016 대한불안의학회지 Vol.12 No.1

30% of patients with panic disorder (PD) show treatment-resistant and chronic waxing and waning course. Therefore, adequate treatment strategies for PD by evidence based pharmacotherapy and combined cognitive behavioral therapy (CBT) are recommended. Regarding how and why CBT for PD works, three hypotheses include the cognitive theory, anxiety control theory, and behavioral theory were discussed. The recent findings that the altered activation in frontal lobe is normalized after CBT, suggest a reduction of an altered top-down fear processing in the neural correlates of CBT in PD. In order to improve accessibility to CBT, brief CBT and internet based CBT for PD were suggested. Despite limitations of sample sizes and study design, most of studies suggest that brief CBT is more effective than control conditions, and even as equally effective as standard CBT. The evidences suggest that internet based CBT may not be significantly different from face-to-face CBT in reducing anxiety. Several advances within the field of third-wave CBT for PD have led to the development of new techniques based on mindfulness, such as mindfulness-based cognitive therapy and acceptance and commitment therapy. Based on Korean algorithm project for panic disorder, especially the psychological education and cognitive reconstruction components were recommended in CBT with PD.