도시 거주 노인 수면 습관 및 불면증상의 요인 : 인구학적,질병 및 정신증상의 관련성

홍진표,안준호,윤영국,박종익,이소영,함봉진,김장규,한오수,조맹제 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 본 연구는 국내 노인의 습관을 조사하고 불면 증상과 연관 있는 인구학적, 질병학적 요인을 알고자 했다. 방 법 : 1997년 12월부터 1998년 1월까지 약 1개월에 걸쳐 2단계 층화집락표본추출의 역학조사법을 통해 선정된 3개 4개동 거주의 만 65세 이상 노인을 대상으로 수행되었다. 대상자 중 723명에서 등답을 받았으며 응답률은 73.8였다. 대학생인 설문조사요원들을 훈련시킨 뒤, 이들로 하여금 대상지역의 노인거주가정을 방문하여 개개 노인을 대상으로 반구조화된 면담으로 수면습관 및 불면증상 설문을 실시하였으며 그 외 한국어판 노인정신장애평가척도, 삶의 질 척도를 이용한 설문조사와 과거 질병력을 청취조사하게 하였다. 결 과 : 국내 노인들은 평균 오후 10시 16분에 자리에 누워 오전 5시22분에 일어나서 총 7시간 6분의 수면시간을 보였다. 노인의 11.7%가 거의 매일 밤 불면증을 14.8%가 간헐적 불면증을 호소하였다. 남자에서는 연령이 증가할수록 침상에 누워있는 시간이 증가하고, 또, 입면시까지 소요되는 시간과 수면 중의 각성회수가 증가되었으나 여성에서는 명확하지 않았다. 단변수 분석에서 요통, 중풍 병력의 환자에서 불면증상이 심했다. 다변량분석 결과 불면 증상과 관련 깊은 요인으로 남자에게서는 고령과 우울증상이 여자에게서는 남자의 위험요인에다 신체통증과 피부병력이 추가로 관련이 있었다. 결 론 : 지역 거주 노인에서 불면 증상은 매우 흔한 증상이며 우울증상과 명확한 상관관계를 보이고 있었다. 불면증을 극복하기 위해 불면증 위험요인의 인과관계에 대한 추후 연구가 필요하다. Objectives : The purpose of this study is to analyze sleep habit and investigate the association between insomnia and demographic, health and psycho-behavioral symptomatology in Korean urban elderly Method : A total of 723 community residents aged 65 years or older were surveyed by two stage, random cluster sampling method. The response rate was 76.2%. Interviewers performed door to door visits and administered a questionnaire about sleep, past medical history, and several scales as the Psychogeriatric Assessment Scale(PAS), the short form Quality of Life Scale (SF-36) and etc. Results : The mean scores are as follows : retiring time was ten-sixteen p.m., wake-up time was five twenty two a.m., duration of sleep was seven hours and six minutes. Among the elderly, 11.6% and 14.8% of the subjects reported chronic and intermittent difficulty in sleeping, respectively. The patients with back pain and history of stroke complained of more insomnia symptoms in univariate analysis. In ANCOVA analysis, insomnia symptoms were associated with an old age, depressive symptoms in male. Bodily pain and history of dermatologic disease were additional risk factors in female. Conclusions : The data suggest insomnia is one of most common health problems among elderly Koreans living in the community. Strong positive relationship between depressive symptoms and insomnia were found. Further research is needed to explore the causal relationship between insomnia and risk factors.

비정형 향정신병약물을 투여 중인 정신분열병 환자의 주관적 삶의 질 : 정신병리, 약물 부작용 및 약물에 대한 주관적 반응과의 관련성

김종훈,윤정희,이자영,노경희,홍성극,윤세창,강웅구,김용식 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2

Objectives : The purpose of this study was to evaluate the characteristics of psychopathology, adverse drug effects, and Subjective response to drugs that have a significant impact on the subjective quality of life in schizophrenic patients receiving atypical antipsychotics. Methods : One hundred and one schizophrenic patients, who were receiving maintenance treatment with atypical antipsychotics, were evaluated. Subjective quality of life was assessed using the standardized Korean modification of a self-rating scale to measure subjective well-being under neuroleptics (KmSWN). Patients' psychopathology was evaluated using the Positive and Negative Syndrome Scale. Adverse effects and subjective response to drug were evaluated using the Liverpool University Neuroleptic Side Effect Rating Scale and the Drug Attitude Inventory-10, respectively. Correlation analysis and stepwise multiple regression analysis were conducted. Results : In psychopathology, the severity of depression and anxiety showed the most significant correlation with the score ofKmSWN. In adverse drug effects, the severity of psychic side effect and extrapyramidal side effect showed the most significant correlation with the score ofKmSWN. Regarding subjective response to drug, significant correlation was observed between the severity of subjective negative response and the score of KmSWN. Stepwise multiple regression analysis revealed that psychic side effect, extrapyramidal side effect, and depression contributed significantly to the total score of KmSWN. These variables accounted for 59.7% of the total variance. Conclusion : The results of the present study suggest that psychic side effect, extrapyramidal side effect and depressive symptom are the clinical characteristics that are significantly associated with the subjective quality of life. An effective management strategy for these variables should be established in developing a treatment program to enhance the quality of life of patients with schizophrenia.

방광질루 치험

황선태,이종찬,양상국,김홍섭,노용수 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

Vesicovaginal fistula is a distressing complication which may follow hysterectomy, prolonged labor, chemical cauterization due to uterine prolapse, radiation therapy and cervix cancer. The management of vesicovaginal fistula still remains controversial in regard to the type of approach and timing of repair but the classic opinion is to wait 3 to 6 months to allow the surgical inflammatory reaction to subside. We experienced 4 cases of vesicovaginal fistula which were as follows; Case 1: 51-year-old The vesicovaginal fistula, about 3.0cm in diameter, after laparascopic hysterectomy 15 days ago was repaired with interposition of a gracilis muscle flap via the transvaginal route. Case 2: 38-year-old The vesicovagianl fistula, about 2.5cm in diameter, after Cesarean section 5 years ago was repaired with interposition of the omental flap via the transabdominal route because she had been accompanied by an overian cyst. Case 3: 46-year-old The vesicovaginal fistula, about 2.5cm in diameter, after manual self abortion at home 30 years ago was repaired with interposition of fibro-fatty tissue in labia via the transvaginal route. Case 4: 43-year-old The vesicovaginal fistula, about 2.0cm in diameter, after prolonged labor 12 years ago was repaired with interposition of the fibro-fatty tissue in labia via the transvaginal route. There noted no complications or recurrence during the minimal 1 year follow-up.

쇄골 중간부 골절후 불유합 및 지연 유합의 원인

윤정로,심재익,김택선,이성종,김영배,김학준,안국환,장재영,홍명표 대한골절학회 2002 대한골절학회지 Vol.15 No.4

쇄골 중간 1/3 부위의 골절은 치료 결과가 양호하여 보존적 치료가 원칙적으로 받아 들어지고 잇으며 불유합에 대한 빈도도 낮은 것으로 되어 있다. 그러나 최근 전위 및 단축의 정도가 심할 경우 높은 불유합의 결과와 불량한 임상 결과를 보고하고 있어 이런 예에 대해선 수술적 치료를 권장하고 있다. 저자들은 단축 및 전위의 정도와 불유합의 연관성을 알아보고자 하였다. 연구 대상 및 방법 : 1993년 2월부터 2002년 1월까지 본원에 내원 했던 성인 중간부 쇄골 골절 환자 194명 중 완전 전위를 보인 78례를 조사하여 이중 63례를 대상으로 분석하여 후 향적 연구를 시행하였다. 4개월 추시 후에도 방사성 사진상 유합 소견이 관찰되지 않으면 불유합의 유의성을 알아보고자 하였다. 결 과 : 63례 중 불유합 및 지연 유합을 소견을 보인 환자는 15(23%)례였다. 골유합을 보인 48례의 단축은 평균 8.6㎜(2㎜-17㎜)였고, 전위는 평균 9.7㎜(2-22㎜)였다 .불유합 및 지연 유합을 보였던 15례에서 단축은 평균 14.5㎜(3㎜-37㎜), 전위는 평균 17.3㎜(4-25㎜)였다. 18㎜이상 단축이 있었던 경우 불유합의 발생과는 통계학적으로 유의성을 나타내었고(Fisher's exact test, p<0.01), Chi-square test상 16㎜ 이상의 전위를 보였던 경우 불유합 발생과 통계학적으로 의미가 있었다(p<0.01). 결 론 : 쇄골 골절 특히 중간 1/3의 골절은 비교적 보존적 치료에 결과가 좋은 것으로 되어 있으나, 전위 및 단축이 심한 경우 불유합에 대한 가능성이 높이 때문에 보다 경과 관찰시 유합의 진행이 없으면 적극적인 치료를 고려해야한다. Purpose : Because the prognosis of the mid 1.3 clavicle fracture is good, the conservative treatment with a figure of 8 bandage is the gold standard and the nonunions are rare. However, recently surgical treatment is recommended when the shortening and displacement is severe because of the high nonunion rate and the poor clinical result. This study was undertaken to evaluate that the shortening and displacement at fracture site are associated with the development of nonunion. Materials and Methods : We analysed the 194 fractures of mid 1/3 clavicle in adults which had been treated conservatively from February 1993 to January 2002 and did the retrospective study. Of these, 78 cases were originally in the middle third of the clavicle and had been completely displaced. We reviewed 63 of these cases. The shortening and displacement at the fracture site was measured on the initial roentgenogram. And the analysis of the patients' chart was done for another predisposing nonunion factors. Nonunion and delayed union are considered to be present when there has been little or no progression of clinical or radiographic healing at a minimum of 4 months after injury. Results : 15 of the 63 cases had developed nonunion.. The average 8.6㎜(2㎜-17㎜) shortening and average 9.7㎜(2-22㎜) in the union patients. The average 14.5㎜(3㎜-37㎜) shortening and average 17.3㎜(4-25㎜) in the nonunion patients. We found that initial shortening ≥18㎜(Fisher's exact test, p<0.01) and initial displacement ≥ 16㎜(Chi-square test. p<0.01)at the fracture site were significantly associated with the development of nonunion. Conclusion : The conservative treatment with figure-80-bandage is the gold standard in the clavicle middle one third fracture. However, the nonunion is commonly occurs in the cases of more of severely shortened and displaced fractures. If there are no signs of callus formation and the patient complains of pain after several week, osteosynthesis should be considered.

Mega-scale glacial lineations formed by ice shelf grounding in the Canadian Beaufort Sea during multiple glaciations

Hong, Jong Kuk,Jin, Young Keun 극지연구소 2022 극지연구소 초록집 Vol.- No.-

The International Bathymetric Chart of the Arctic Ocean Version 4.0

Hong, Jong Kuk 극지연구소 2021 극지연구소 초록집 Vol.- No.-

The International Bathymetric Chart of the Southern Ocean Version 2

Hong, Jong Kuk 극지연구소 2023 극지연구소 초록집 Vol.- No.-

Mega-scale glacial lineations formed by ice shelf grounding in the Canadian Beaufort Sea during multiple glaciations

Hong, Jong Kuk,Jin, Young Keun 극지연구소 2022 극지연구소 초록집 Vol.- No.-

The International Bathymetric Chart of the Southern Ocean Version 2

Hong, Jong Kuk 극지연구소 2023 극지연구소 초록집 Vol.- No.-

Reflection Seismology in the Southern Ayu Trough, a Slow-spreading Divergent Boundary

Hong, Jong-Kuk,Lee, Sang-Mook Korea Institute of Ocean ScienceTechnology 2002 Ocean and Polar Research Vol.24 No.3

A multichannel seismic survey was conducted in the southern Ayu Trough which is the only spreading boundary between the Philippine Sea and Caroline plates. The seismic system used in this study comprises of 2.46-l sleeve gun and a 12-channel streamer with a group interval of 6.25m. Migration technique was used to analyze seismic velocity, and poststack depth migration was applied to the stacked data. The sediment thickness obtained from the depth section tends to increase with distance from the spreading axis. Sedimentation rates are poorly constrainted in the study area. The apparent half-spreading rates estimated from the sediment thickness and sedimentation rate from DSDP hole on the caroline plate are 4.7mm/yr and 7.9mm/yr at $1^{\circ}24'N\;and\;0^{\circ}42'N$, respectively, which are fester than Previously suggested. On the basis of new oblique spreading geometry, the recalculated spreading rates are 5.4mm/yr and 9.1mm/yr at $1^{\circ}24'N\;and\;0^{\circ}42'N$, respectively. Seismic sections show that the topography is asymmetric across the Ayu Trough and the acoustic basement is rough. These features are consistent with the earlier suggestion that the Ayu Trough is a slow-spreading divergent boundary. A detailed examination of seismic profiles away from the axis shows that sediments can be divided into two layers which implies a possible change in the spreading rate anuor sedimentation condition during the formation of the trough.