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姜英豪,金仁達 서울大學校 保健大學院 1968 公衆保健雜誌 Vol.5 No.2
A study was conducted by the author in September 1968 towards the infants and young children in some underprivileged rural villages of Korea by employing such methods as clinical assessment, nutritional biometry, and biochemical tests, in an attempt to evaluate their nutritional status with possible reference to protein calorie malnutrition (PCM). The infants and young children examined totaled 232 of whom 111 were boys and 121 were girls. The results are as follows: Ⅰ. Clinical Assessment The prevalence rates of the signs suggestive of PCM turned out to be as below : 1) Cases with dyspigmented hair were observed with 4.5% of the 45 infants examined. and 18.8% of the 187 young children examined. Cases with thin and sparse hair were seen with 22.8% of the infants, 14.0% of the young children, and l5.2% of both the infants and young children. 2) Prevalence of the pale conjunctiva rated 28.6% of the infants. 32.3% of the young children, and 30.4% of both the infants and young children. 3) Keratomalacia cases were found in 0.5% of the young children only and they corresponded, in turn, to 0.4% of the whole examined. 4) Cases with angulostomatitis rated 14.0% of the young children only, who constituted 10.0% of the total examined. 5) Those with moon-face were observed only with 2.3% of the infants, rating 0.4% of the total. 6) Cases with flaky-paint dermatosis were observed with 2.3% of the infants, 0.5% of the young children, and 0.9% of both the infants and young children. 7) Those who were found to have such skin lesions as fissure of the ear lobe, tender sores, or moist groin rash rated 15.9% of the infants, 20.4% of the young children, and 19.6% of both the infants and children. 8) Rate of those with muscles wasted was 11.4% of the infants, 25.8% of the young children, and 23.0% of both the infants and young children. 9) Those with edema were observed only with 0.5% of the young children. rating 0.4% of the total. 10) Psychomotor changes (apathetic, miserable, inert, withdrawn, or anorexic) rated 7.0% of the young children only, and 5.7% of the whole examined. 11) Prevalence rate of diarrhea precipitating dehydration and such other conditioning infections as thrush was found to be 20.5% of the infants, 7.5% of the young children, and 10.0% of both the infants and young children. 12) The results of clinical assessment led the author to the following findings: (1) Those corresponding to 29.1% of the whole examined had one or two combined signs suggestive of PCM. (2) Those with three or more signs combined rated 1.3% of the total children examined. (3) No clinically obvious kwashiorkor was found, but each of the component signs which, in constant combination, characterize it (edema, muscle-wasting, and psychomotor changes) was separately observed mainly with the young children as presented in table 2. (4) Those who impressed the author with clinically obvious nutritional marasmus were 6.7% of the infants, 3.2% of the young children, and 3.9% of both the infants and young children. Ⅱ. Nutritional Biometry 1) The mean heights. weights, chest circumference, and head circumference obtained were as shown in table 3. 2) The mean triceps skin-fold thickness, upper mid-arm-circumference. and upper-mid-arm-muscle circumference were as presented in table 4. 3) Distribution of the heights by four levels of 10% intervals indicated underweights in the light of Korean general standard, as shown in table 10. 4) Distribution of the weights contrasted likewise with the Korean general standard were as shown in table 11. 5) The underweights demonstrated by cases of mild-moderate PCM computed at four levels of 10% intervals as against the Korean general standard, rated 42.2% of the infants, 42.8% of the young children, and 42.7% of both the infants and young children. by the criteria Dr. Jelliffe suggested ??. The severe PCM cases were comprised 31.1% of the infants, 7.5% of the young children. and 12.1% of both groups of them. In the light of the above rates, more than a half of the children examined were found to be affected with PCM ascribable to deficiency of both the protein and calorie. 6) The cases with "Chest circumference/Head circumference Ratio being below 1 after the first 6 months of life" suggestive of the wasting of pectoral muscles which is attributable to PCM corresponded to 57.1% of the infants, 25.1% of the young children, and 29.3% of both the infants and young children as shown in table 13. Ⅲ. Biochemical Tests 1) Hemoglobin levels were found to be anemic (level less than 10.8gm%) with 13.8% of the 80 children examined as presented in table 5. 2) Serum total protein and serum albumin levels were as shown in tables 6 and 7, respectively. The serum albumin levels turned out to be normal with 75.9%, and "low"(2.80gm%∼3.51gm%) with 24.1% of the examined. No deficiency level (less than 2.80gm%) was found among the 29 children. 3) Serum iron content and total serum iron-bindin capacity (TIBC) were as shown in table 8. The deficiency levels of serum iron content less than 50 microgram % comprised 33.3% of the 21 children examined. Those corresponding to 25% and 75% of the 16 children examined had values of TIBC within normal range (300 microgram %∼400 microgram %) and values below the normal range (less than 300 microgram %), respectively, and no case exceeded over the range of normality inspite of the low serum iron content, suggesting the possible ascription to chronic protein deficiency ??. 4) "Urinary Urea-nitrogen / Creatinie-nitrogen excretion Ratios" regarded as an approximte index of dietary adequacy related to muscle storage of protein were obtained as presented in table 9. The cases with the ratios "30 or less" (an indication of malnutrition related to dietary adequacy of protein) rated 58.8% of the 34 children examined.
幼兒文學敎育 實態에 관한 基礎硏究 : 慶南地域 幼兒敎育機關을 中心으로
姜仁彦,金英淑 진주여자전문대학 1988 論文集 Vol.10 No.-
The purpose of this study is to examine the actual condition of the literature education of young children in Gyeong Sang Nam Do, The specific problems of this study are as follows : 1. What is the goal of young childrens's literature education? 2. What is the criteria for the selection of young children's literature books? 3. What is trends of use and interest for media of young children's literature? 1) What is trends of use and interest for fairy tales and creative tales? 2) What is trends of use and interest for picture-tales? 3) What is trends of use and interest for kinds of puppets? 4) Have you ever taken a chance of a puppet-show? 5) Have you ever taken a chance of children's drama? 6) Have you ever used the children's verse in a classroom? 4. How many books of young children's literature do they stock in kindergarten and what is the teacher s viewpoint for these? 5. How is YES or NO of the teacher s experience for a creative activity of young children's literature? 6. For fairy tales : 1) What is the title of fairy tale most used in kindergarten? 2) What is the title of fairy tale which kindergarten-boys are most interested in? 3) What is the title of fairy tale which kindergarten-girls are most interested in? 4) What is the title of fairy tale which kindergarten-teachers are most interested in? 7. What do you want in the class allocated for young children's literature in college? 8. What is the problem in young cildren's literature education? For this study 27 nursery schools, 20 kindergarten attached to elementary schools and 78 private kindergarten in Kyeong Sang Nam Do were randomly sampled. The total subject of the study were 125 teachers. The instrument used for this study was a questionnaire. It was distributed to the teachers and filled out by them. Chi-square was used to analyze by the data obtained from the questionnaire. The results of this study are as follows : 1. For the goal of young children's literature education : 'to be helped creative and expressive activities to literature in various ways' was regarded to be the most important in general. 2. For the criteria for selection of young children's literature books ; 'the contents related a unit was regarded to be the most important in general. 3. For the trends of use interest fot the media of young children s literature ; 'picture-tale' and 'picture-books' are the descending order responded. 4. For books of young children's literature and teacher s viewpoint for those ; '100 books and below them' and 101-200 books' are the descending order responded and answered 'proper' for these. 5. For the YES or No of the teacher's experience for a creative activity of youg children's literature ; 'NO' was regarded to be the most in general. 6. For fairy tales and the title of fairy tale most used in kindergartens ; 'Heungbu-Jean', 'Hokburi-younggam' and 'Hae wa Dali Deun O-nui' are the descending order responded by boys. 'Kongzui and patzui' and 'Baek-seol Princess' are the descending order responded by girls. And 'Hae wa dali Deun O-nui' and 'Hokburi-younggam' are by teachers. 7. For the request to the class allocated for young children's literature in college ; 'the manufacture technique for media of young children's literature and communiate method 'and' the guidance of the creative education to the genre of young children's literature' are the descending order responded by teachers. 8. For the problem in young children's literature education ; 'the problem of manufacture technique for media', 'The difficulty of selection for a literary work and the poor of a subject matter' and 'the poor of teaching materials' are the descending order responded by teachers.
김영준,류현모,김신윤,신홍인 경북대학교 병원 2002 경북대학교병원의학연구소논문집 Vol.6 No.1
gp130,a subunit for serveral cytokine signal transducing receptors, mediates diverse activities including osteoclastogenesis. In vitro obaervations suggest that PTH also triggers the gp130-mediated signal for bone resorption by stimulating secretion of IL-6,IL-11 and LIF from osteoblast/stromal cells. Though this gp130 signaling is required for full activation of bone resporption by PTH in vitro, the relationship between PTH and gp130 signaling pathway in vitro is not yet clanified. To address the importance of gp130 as a mediator of PTH action in osteoclast activation, the blood ionized calium and blood serum PTH level was investigated in gp130-/- and wild type mice at E18.5 using a CIBA/Coming 634 Ca^+2/pH analyzer and rat intact PTH Kit, respectively.In addition, calium transport efficiency was assessed from gp130 mice at E17.5. The resorptive activity of osteoclasts from intact calvariae by a ^45Ca release assay and the osteoclastic developmental condition in tibiae were also analyzed, respectively.The gp130-/- micerevealed significantly lower ionized calcium level(1.44±0.03 vs1.77±0.03 mmol/ℓ, p<0.001)and significantly higher blood serum PTH(251.8±5.3 VS 20.5±5.3 pg/㎖,p<0.001) compared to wild type littermates.There was no remarkable pathologic change of placenta in gp130-/- and the ^45Ca transport though placenta was accelerated in gp130-/- compared to wild type littermates(%to Het 83%in -/- vs 148% in +/+).The gp130-/- embryos had small skeletons with bones containing little primary spongiosa, and large multinucleated TRAP+ cells along the lower border of the growth plate. Release of ^45Ca from prelableled calvarial bone(E18.5)in response to either 10^-7 M hpTH(1-34)or 20 ng/㎖ sRANKL was lower in gp130-/-calvarial bone compared to gp130+/+ calvarial bone (PTH 1.83±0.6 fold over basal in-/- vs 2.79±0.6 in +/+and sRANKL1.3±0.4 in -/- vs 2.79±0.6 in +/+ and sRANKL1.3±0.4 in -/- vs 2.0±0.4 in +/+,p<0.5). These result strongly support the hypothesis that PTH activates bone resortion,in part, by stimulating ostedtrophic cytokine secretiom from osteoblast/stromal cells, which tirggers gp130-mediated signaling for osteoclastic activation.
Kim, Sung-Soo,Cho, Young-Seok,Kim, Hyung-Keun,Shin, Ok-Ran,Chae, Hiun-Suk,Choi, Myung-Gyu,Chung, In-Sik The Korean Society of Gastroenterology 2010 대한소화기학회지 Vol.55 No.4
<P>Background/Aims: Ligands for peroxisome proliferator-activated receptorgamma (PPARgamma), a member of the ligand-activated nuclear receptor superfamily, exhibit anti-tumoral effects and are associated with de novo synthesis of proteins involved in regulating the cell cycle and cell survival/death. Helicobacter pylori (H. pylori) is an etiologic agent for gastric adenocarcinoma, and raises the cell turnover of gastric epithelium. The aim of this study was to investigate the effect of PPARgamma ligand rosiglitazone on the cell proliferation and the expressions of p27 and Skp2 protein in H. pylori infected gastric epithelial cells. Methods: We examined the expression of PPARgamma by Western blot in H. pylori infected AGS human gastric epithelial cells. The effect of rosiglitazone on the survival of H. pylori infected AGS cells was assessed by cell viability assay. After the treatment of rosiglitazone in H. pylori infected AGS cells, the expressions of p27 and Skp2 were assessed by Western blot. Results: The expression of PPARgamma protein was increased in H. pylori infected AGS cells. Cell growth was inhibited and decreased in dose- and time- dependent manner in H. pylori infected AGS cells treated with rosiglitazone. A decrease in Skp2 expression and a reciprocal increase in p27 expression were found in dose- and time-dependent manner in H. pylori infected AGS cells treated with rosiglitazone. Conclusions: Rosiglitazone inhibited the growth of H. pylori infected AGS cells. Rosiglitazone attenuated Skp2 expression, thereby promoting p27 accumulation in H. pylori infected human gastric epithelial cells. Further studies will be needed to find the effects of accumulation on cell turnover in H. pylori infection and the role in the H. pylori-associated gastric carcinogenesis.</P>
Kim, Jong Hun,Chun, Byung Chul,Song, Joon Young,Kim, Hyo Youl,Bae, In-Gyu,Kim, Dong-Min,Choi, Young Hwa,Jun, Yoon Hee,Choi, Won Suk,Kang, Seong Hee,Kwon, Hyun Hee,Jeong, Hye Won,Kee, Sae Yoon,Hur, Jia Elsevier Ltd. 2019 Vaccine Vol. No.
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population.</P> <P><B>Methods</B></P> <P>For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100.</P> <P><B>Results</B></P> <P>We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3.</P> <P><B>Conclusions</B></P> <P>This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization program for PPV23 for the elderly was implemented in Korea. </LI> <LI> PPV23 was effective against IPD and NBPP for young elderly patients aged 65–74. </LI> <LI> Effectiveness of PPV23 against IPD was higher for PPV23 unique serotypes. </LI> <LI> PPV23 was non-protective against IPD caused by PCV13 serotypes. </LI> </UL> </P>
김영진,남순현,김현정,이재문,이인정 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.2
유치 및 초기 영구치의 치수신경분포 및 변화를 평가하기 위하여 교정치료를 위해 발치한 치근흡수가 비교적 적은 유치,정상 탈락기의 유치,맹출중인 교합하지 않은 제 1소구치,맹출이 완료되어 교합하고 있는 1소구치를 대상으로 neurofilament protein(NEP)을 이용한 면역조직화학적 방법으로 관찰하여 다음과 같은 결과를 얻었다. 치근흡수가 비교적 적은 유치에서도 영구치와 유사한 신경총의 존재와 신경분포 형태가 관찰되었으나,영구치에 비해 그 신경분포 밀도가 낮았으며 분지형성 또한 미약하게 나타났고,전상아질로 진입하는 섬유의 수가 적었다. 정상탈락기의 유치에서는 신경의 변성으로 소포(vesicle),단절(fragmentation)등이 관찰되었으며,그 신경분포가 현저히 감소되어 나타났고,총상의 형태도 소실되었다. 교합하지 않은 제 1소구치에서 치수내의 신경은 말단가지의 숫자가 적고,치수 조상아 세포 경계에 도달하였으며,비교적 가는 신경 섬유가 많았다. 교합하고 있는 제 1소구치에서 치수내의 신경은 말단이 조상아층으로 진출하고,어떤 신경섬유는 전상아질층까지 진입하였으며,비교적 굵은신경 섬유의 분포가 많아졌다. The purpose of this study was to investigate the distribution of nerves in the dental pulp of early extracted primary teeth,normal exfoliated teeth,partially-erupted,nonfunctional,premolars,and erupted,functional,premolars.Numbers of sample were 10 teeth in each group. The distribution of nerves in the dental pulp were investigated by means of immunohistochemistry for detection of neurofilament protein(NFP). The results were as follows: The early extracted primary teeth exhibited patterns of innervation similar to those observed for young permanent teeth.The plexiform arrangement of fibers was not evident in the primary teeth.Most nerves appear to terminate about the odontoblasts. As primary teeth began to undergo root resorption,degenerative changes such as vesicles and fragmentation appear in nerves.The quantity of neural tissue also decreased.In teeth in which the roots were almost completely resorbed only a small number of nerves remain. There was a decrease in the number of terminal branches in the pulp of the partiallyerupted,nonfunctional,premolars and those present reached the pulpo-odontoblastic border. The nerve terminals in the pulp of the erupted,functional,premolars were traced to the dentinal tubule and a few nerve fibers formed loops in the predentin.
김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1
Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.
교통사고후 정신과로 장애감정 의뢰된 환자의 임상적 특징
김병철,김성곤,박제민,김명정,정영인 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2
1994년 1월부터 1996년 12월까지 3년간에 걸쳐 교통사고후 법원으로부터 장애감정 의뢰되어, 부산대 학교병원 정신과에서 정신장애감정을 받았던 88명의 환자를 대상으로 임상적 특징을 조사하였던 바. 그 결과를 다음과 같이 요약할 수 있었다 1) 대상 환자 88명 가운데 58명(65.9%)이 남자, 30명(34.1%)이 여자였다. 낮은 교육과 사회경제적 수준을 가진 환자가 많았으며, 21세에서 50세까지의 사회 활동층이 과반수를 넘었다. 2) 수상당시 환자의 71.6%에서 뇌37상이 있었고, 다음으로 두개골 골절(36.4%), 뇌출혈(33.7%), 뇌혈종(26.1%). 뇌진탕(12.6%) , 축삭손상(10.2%) 등이 있었으며. 대상 환자의 9.1%에서는 뇌손상의 증거가 없었다. 3) 환자나 환자의 보호자가 주관적으로 호소하는'자각적 증상은 인지증상이 가장 많아 전체 대상 환자의 85.2%에서 있었고. 다음으로 신체증상(83.0%), 행동증상(69.3%), 정서증상(58.0%) 순이었던 반면에, 감정의가 판단한 탄각적 증상은 정서증상(80.7%7)이 가장 많았고, 다음으로 행동중상(77.3%). 인지 증상(63.6%), 신체증상(40.9%) 순이었다 4) 대상 환자의 48.8%에서 수상후 1개월과 6개월 사이에 정신의학적 증상이 발현하였고.6개월 이후에 나타난 경우는 9.1%에 불과하였다. 또한, 대상 환자의 61.4%에서는 증상이 있음에도 불구하고 감정 당시까지 정신의학적 치료를 받은 적이 없었고. 정신의학적 치료를 받았던 환자의 23.5%에서는 증상 발현 후 6개월이 경과한 뒤에야 치료를 받았다. 5) 감정시 모든 대상 환자에서 뇌영상겋사와 뇌파검사가 실시되었고, 이들 가운데 47.7%에서 비정상적인 뇌영상 소견을 보였다. 이상소견으로서는 뇌연화증이 가장 많았고, 다음으로 뇌위축, 축삭손상. 낭종 등의 순이었다. 뇌파는 환자의 86.4%에서 정상소견을 보였고, 뇌파 소견과 뇌영상 소견간에는 유의한 상관관계가 있었다. 6) 감정당시 대상 환자의 95.5%에서 최종적으로 정신장애가 확인되었고, 이중 두부외상에 의한 인격 변화가 가장 많았으며, 다음으로 두부외상에 의한 치매, 적응장애, 두부외상에 의한 우울장애, 뇌진탕후장애. 외상후 스트레스 장애 등의 순으로 많았다. 정신장애가 확인되었던 환자의 38.1%에서는 추후 계속적인 정신의학적 치료의 필요성이 인정되었다. 7) 외상 후유증으로 인한 지능의 변화 정도에 있어서 두부외상 관련인자 유무간에 차이가 있는지를 알아본 결과. 수상당시의 의식소실 유무간이나 외상후 섬망 유무간에는 차이가 있었고, 감정당시 실시되었던 뇌 영상검사상의 이상소견 유무간에도 차이가 있었다. In an attempt to obtain the basic data for mental disability evaluation in psychiatric casualties by traffic accidents,88 cases referred from the court for the purpose of mental disability evaluation for 3 years from 1974 to 1996 were surveyed. The results are summarized as fellows : 1) Among the 88 cases, 58 cases(65.9%) were male and 30(34.1%) were female. Cases with low educational and socioeconomic levels outnumbered those with high educational and socioeconomic levels. More than half of the cases were in socially active group with ages of 21 to 50years. , 2) At the time of accidents,11.6% of the whole cases were diagnosed as cerebral contusion, Which was the most common diagnosis. The next common diagnoses were skull 7acture(36.4%), brain hemorrhage(33.0%), brain hematoma(26.1%), cerebral concussion(12.6%), and axonal injury(107%) in order of frequency. In 9.1% of the cases there was no definite evidence of head injury was found. 3) During talc period of mental disability evaluation, the most common symptom was cognitive symptom(85.2%), and the next common symptoms were somatic(83.0%), behavioral(69.3%), and affective(58.0%) ones in order of frequency. On the other side, the most common psychopathology recognized by talc psychiatrists was affective symptom, which was present in 80.7% of the cases manifested during the period of evaluation, and the next common psycho-pathologies were behavioral(77.3%), cognitive(63.6%), and somatic(40.9%) symptoms in order of frequency. 4) Nearly half(48.8%) of oft whole patients manifested psychiatric symptoms such as cognitive, affective, behavioral, and somatic symptoms between the first and sixth months after traffic accidents. Only 9.1% of the cases developed psychiatric symptoms after six months of traffic accidents. Meanwhile,61.4% of the cases were never given psychiatric treatments despite the presence of psychiatric symptoms, and 23.5% of the cases given psychiatric treatments visited psychiatrists after six months of symptom development. 5) All of the cases took neuroimging studies such as brain CT or MRI and EEG during the period of mental disability evaluation. In 47.7% of the cases there were abnormal findings in neuroimaging studies among which encephalomalacia was the most frequent. The next abnormal findings were brain atrophy, axonal injury, cyst, and so on in order of frequency. On file other hand, in 86.4% of the cases EEG findings were within normal limit. 6) In 95.5% of the cases, mental disorders were confirmed, among which personality change due to head trauma was the most common, and the next common mental disorders were dementia due to head trauma, adjustment disorder, depressive disorder due to head trauma, postconcussional disorder, posttraumatic stress disorder, and so on in order of frequency. Mere than one third of the casts(38.1%) given psychiatric diagnoses were considered to need continuous psychiatric treatments at the time of mental disability evaluation. 7). Posttraumatic decline in intelligence tended to be affected by loss of consciousness and delirium, but not b? skull fracture and brain surgery. In brain imaging .and EEG studies performed during the period of mental disability evaluation, posttraumatic decrease in intelligence tended to be influenced by abnormal findings on brain imaging, but not EEG findings.
김수인,연규월,하은희,우행원,김영철 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3
연구목적 : 최근 산업재해(이하 산재) 및 교통사고 발생이 증가하면서 사고 후유증으로 치료받는 환자들이 늘어나고 있다. 산재를 포함한 각종 사고들은 환자의 신체적 상태를 변화시킬 뿐 아니라 이로 인한 사회적, 직업적, 경제적 문제들을 초래하게 되고 환자의 삶 전체를 변화시킬수 있다. 본 연구에서는 산재가 환자들에게 미치는 정신적 영향을 알아보기 위해 산재 환자들과 대조군에서 삶의 질, 자살사고 및 우울증상을 비교하였다. 방 법 : 연구대상은 1999년 12월 21일부터 12월 30일 사이에 경상남도 울산 마산·창원지역의 입원한 산재환자 169명이었고 정상 대조군은 울산의 공업단지 내 일반근로자 166명이었다. 평가군과 대조군 모두 남성이었고, 19세에서 60세였다. 모든 대상에서 일반 인구학적 특성, 삶의 질, 자살사고, 우울 증상을 평가하였고, 산재 환자군의 경우 사고일시, 사고원인, 치료기간, 손상부위를 추가로 조사하였다. 주관적 삶의 질은 한국판 스미스클라인 비챰 삶의 질척도로 평가하였고, 자살사고는 Beck의 자살사고(思考)척도로 평가하였으며, 우울증상은 PRIME-MD를 개선한 Patient Problem Questionaire의 우울증 척도로 평가하였다. 결 과 : 산재환자군과 대조군간 일반 인구학적 요인에서 통계적으로 유의한 차이 없었다. 산재환자군이 대조군에 비해 유의하게 낮은 삶의 질 척도 점수를 나타냈고, 유의하게 높은 자살사고와 우울증상을 나타냈다(p<.05). 산재환자군에서 연령, 결혼상태, 치료기간과 삶의 질 점수는 관련이 있었다. 30대 이상의 연령에서 유의하게 낮았고 10∼20대 연령에서 유의하게 높았으며, 미혼이거나 이혼, 별거중인 경우 유의하게 삶의 질 점수가 낮았고, 치료기간이 길수록 낮았다. 치료기간과 자살사고가 관련있었으며, 치료기간이 길수록 자살사고가 많았다. 산재환자군에서 손상부위에 따라 삶의 질 점수, 자살사고 점수와 우울증상이 유의한 관련이 있었다. 삶의 질 점수는 요추부 손상군에서 높았고, 경추부 손상군과 다발성 좌상환자군에서 낮았다(p<0.01). 자살사고 점수는 경추부손상군과 다발성 좌상 환자군에서 높았고, 요추부 손상군에서 낮았다(p<0.01). 연구 대상군에서 삶의 질 점수, 자살사고 점수, 우울증상간 유의한 상관관계가 있었다. 결 론 : 본 연구 결과 산재환자들은 일반 근로자들과 비교하였을 때 삶의 질이 낮다고 느끼고 있었으며, 주관적으로 우울감과 자살사고를 많이 나타냈다. 따라서 산재로 인한 우울 및 자살등의 증상을 예방하기 위해서는 조기 정신과적 치료 중재가 반드시 필요하다고 생각된다. Objective : As the occupational and traffic accidents are increased, patients who are treated for complications of accidents have been increased in recent years. Accidents including industrial injury affect the physical state of the patients and make social, vocational, and economic problems, so that they can affect the whole life of the patients. We performed this study to compare subjective evaluation of quality of life, depressive symptoms, and suicide ideation in both industrial injury patients and control subjects in order to know how industrial injury affect patients in psychiatric aspect. Method : The subjects were 169 inpatients who met the inclusion criteria of industrial injury patients and 166 healthy control subjects. All subjects were male and their age is from 19 to 60 years old. Demographic variables, quality of life, depressive symptom, suicide ideation were assessed in subjects. The types of injury and duration of treatment were assessed in patients. The quality of life was measured using the Korean version of SmithKline Beecham 'Quality of Life' Scale(KvSBQOL), and the suicide ideation was measured using the Scale for Suicide Ideation(SSI), and the depressive symptom was measured using the Dpression scale of Patient Problem Questionaire(PPQ) which were devised from Primary Care Evaluation of Mental Disorder(PRIME-MD). Results : 1) There were no significant differences in the general demographic variables between industrial injury patients and control subjects. 2)Scores of KvSBQOL were significantly lower, and SSI and Depression scale of PPQ were significantly higher in the industrial injury patients than control subjects(p<0.05). 3) In industrial injury patients, there was a correlation between the age and the scores of KvSBQOL(p<0.01). The scores of KvSQOL were lowest in older than 30's, highest in 10's-20's. No significant correlation was recognized between the age and the suicide ideation, the depressive symptoms. Threre was a correlation between the marital status and the scores of KvSBQOL(p<0.01). In unmarried, divorced or separated state, the scores of KvSBQOL were significantly lower than married state. There was a correlation between the the duration of treatment and the scores of KvSBQOL, the suicide ideation. As the duration of treatment was longer, the scores of KvSBQOL were significantly lower(p<0.01), and the scores of SSI were significantly higher(p<0.01). 4) In industrial injury patients, there was a significant correlation between the type of injury nd the scores of KvSBQOL, the suicide ideation, and the depressive symptoms. The scores of KvSBQOL were highest in the L-spine injury patients, lowest in the C-spine injury and multiple contusion patients(p<0.01). The scores of SSI were higher in the C-spine injury and multiple contusion patients, lowest in the L-spine injury patients(p<0.01). 5) In subjects, there was significant correlation between the scores of KvSBQOL, the scores of SSI, and the Depression scale of PPQ. Conclusion : Industrial injury patients feel bad about the quality of life and have more depression and suicide ideation. As a results, psychiatric intervention is needed for prevention of depression and suicide due to industrial injury.
급성 중독 환자에 대한 역학적 고찰 : 서울과 지방의 비교
김성중,김인병,최성욱,김경수,이영수,Choi, Jong Moo 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2
Study objective: To compare patients with acute poisoning between urban and rural areas Design: Retrospective chart review of 217 patients with acute poisoning Setting: Two University Hospital EDs Methods: patients were divided into two groups according to hospital. The group A was 109 patients who came to ED of Asan Medical Center and the group B was patients who came to ED of Ajou University Hospital from June 1994 to February 1995. We analysed the age and sex distributions, poisoning substances. causes of poisoning and the past history of psychiatric problems in patients of the two groups. Results: Total number of patients with acute poisoning were 109 in the group A and 108 in the group B. Female was more prevalent than male in the group A and male was more than female in the group B. There was a significant difference in sex distribution between two groups. The mean age of the group A was 27.7 years which was significantly different from the mean age of the group B, 33.7 years. The age incidences in both group were highest in 2nd decade. The accidental poisoning cases were 37% in the group A and 31% in the group B. The rates of committed suicide were 7% in the group A and 22% in the group B. The most common agent of poisoning was therapeutic drug in the group A and agricultural or industrial chemical in the group B. The overall mortality was 5% in the group A and 15% in the group B. Conclusion: There were significant differences in age and sex distributions. poisoning substances, causes of poisoning and the past history of psychiatric problems between two groups.