골다공증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이남수,이상건,이상범,이상우,이선정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : As the average lifespan of human increases, osteoporosis and osteoporosis-related fractures have become major health care problems. Despite recent advances in medical treatment, few studies have assessed the recognition of osteoporosis in general adults. This study examined the recognition of osteoporosis and analyzed the relating factors. Method : A population-based sample of 1086 adults in Asan-city, Korea was investigated with questionnaires and height, weight, Information regarding the general characteristics(gender, age, economic state), lifestylef exercise, smoking, alcohol),medical history(progestin, GH, steroid, calcitonin, PTH), demographic parameter, obesity, stress, and family history was collected through an interview using a structural questionnaire. The level of obesity was measured by the body mass index(BMI). BMD(Bone mineral density) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry. Osteoporosis was considered to be T-score below -2.5. Results : The prevalence of osteoporosis increased progressively with age, decreased with BMI and predominant in women by the result of x^(2) -test, T-test. Age, weight, BMI were significantly correlated with osteoporosis by the result of Pearson correlation ana1ysis(P<0.05). And age, gender, BMI, family history of osteoporosis were proved to be significant risk factors of osteoporosis by the result of multiple logistic regression(P<0.05). Conclusion : These results suggest that age, gender, BMI might be the most important risk factors of osteoporosis. And the history taking about family history of osteoporosis is helpful for diagnosing osteoporosis.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

노래부르기 음악프로그램이 정신질환자의 자아존중감과 대인관계에 미치는 영향

홍상희,윤지원,이재금,김지연 병원간호사회 2006 임상간호연구 Vol.11 No.2

Purpose: The objective of this study was to verify the effects of the Singing program for psychiatric patients on their self-esteem and interpersonal relationship, and to provide data for the nursing intervention that is necessary for making their life better. Method: The subjects were 10 in-patients with psychotic disorders at C university hospital in Seoul, from july 3 to September 18 im 2005, and the methodology was one group pre experimental- post experimantal design. The instrument for the measurement of self-esteem is Rosenberg Self-Esteem Scale(1973), which was translated by Chun Byung Jae(1974) and the measurement of interpersoral relationship is Schleim & Guerney Relationship Change Scale(1971) which was translated by Mun Seok Mo(1980) and revised by Chun Seok Gyun(1994). SPSS program was used for the analysis of the collected data, which were analyzed by the paired t-test and one-way ANOVA. Result: Singing therapy had an effect on improvement of the self-esteem, and seemed to be more effective as the frequency of the program increased. Singing therapy had an effect on improvement of the interpersonal relatinship, and seemed to ne more effecive as the frequency of the program increased. Comclusion: Singing therapy is found out to be effective program affecting the improvement of both the self-esteem and interpersonal relationship of the psychiatric patients. Therefore the nurses can use the Singing therapy as the nursing intervention for imtrovement of the self-esteem and interpersonal relationship of the psychiatric patients in clinical practice.

3DFT-CISS를 이용한 감각신경성 난청 환자의 MBI

김성원,여상원,김상후,김종수,조재흥,이동희,이승균 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.7

한국에서의 간질의 사회적 낙인

이상암,유희정,허경,박형국,신동진,송홍기,정원영,권오영,이성수,김요식,김성은,이병인 대한간질학회 2002 대한간질학회지 Vol.6 No.2

소뇌뇌교각종양에서 수술중 전기생리학적 신경계집중감시의 변화

서대원,박관,안재영,이상구,정진상,홍승봉,이원용,김병준,김종현 대한신경과학회 1999 대한신경과학회지 Vol.17 No.1

인터페론 치료에 반응이 없었던 예들을 포함한 만성 B형 간염 환자에서 lamivudine의 단기 치료 효과

이상우,이엄석,김선문,서승원,양현웅,성재규,이승민,이병석,김남재,이헌영 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

The efficacy and safety of lamivudine administration according to the presence or abscence of past history of interferon treatment were studied in 22 patients with chronic active hepatitis B who were diagnosed at ChungNam National Univerity Hospital. Nine of these patiens were no responders to interferon treatment. The change of HBV DNA, serum ALT and HBeAg values was analyzed during 12 weeks of lamivudine treatment. The results were as follow : 1. The mean values of HBV DNA and serum ALT were significantly reduced from 1793 9 to 2.0 pg/ml and from 202.5 to 36.3 IU/L after lamivudine treatment (p<0.001). The mean reduction rates of serum HBV DNA and serum ALT were 99.7% and 70.4%. 2. HBV DNA was undetectable in 18 patierits(81.8%) and serum ALT was normalized in 16 patients(68.2%%) after 12 weeks of lamivudine treatment. But there were temporary elevations of serum ALT value comparing to pretreatment value in 5 patients. 3. HBeAg was undetectable in 4 patients(18.1%) and in these 4 patients, anti-HBe was detected after 12 weeks treatment. 4. There was no significant difference of HBV DNA clearance rate and normalization rate of serum ALT between above and below 200 pg/mI group according to pretreatment HBV DNA values(p=0.74, p=0.08). 5. Each clearance rates of HBV DNA in patients without previous interferon treatment and patients with previous interferon treatment were 84.6% and 77.8%(p=0.68). Each clearance rates of HBeAg in patients without previous interferon treatment and with previous interferon treatment were 15.5% and 22.2%(p=0.683). 6. During the treatment periods, adverse effects of lamivudine were negligible in most patients except temporary leukopenia in one patient. Conclusively, lamivudine treatment over the short term period for patients with chronic active hepatitis B was effective in suppression of viral replication and improvement of abnormal serum ALT. Also the efficacy of lamivudine treatment was out of all relation to previous interferon treatment and adverse effects of this drug were negliable. But further study for the efficacy of long term period-lamivudine treatment and appearance of mutant shoud be necessary.

흰쥐 성장기간에 따른 Xylene의 독성에 관한 연구

이혜자,이상희,전태원,이상일,윤종국 대한의생명과학회 2000 Journal of biomedical laboratory sciences Vol.6 No.3

실험동물에 있어서 연령 차이에 따라서 xylene 독성이 어떠한 차이가 있는지를 검토하는 일환으로 5주령 및 12주령 흰쥐에 50% m-xylene을 체중 100 g 당 0.25 ml씩 1회 투여한 다음 24시간 후에 처치하여 다음과 같은 결과를 얻었다. Xylene 투여로 인한 요 중 methylhippuric acid 함량은 5주령군이 12주령군에 비해 현저하게 높게 나타났다. 그리고 간조직 중 cytochroms P-450 함량은 대조군에 있어서 5주령군이 12주령군 보다 약 50% 정도 낮게 나타났으나 xylene 투여로 인한 cytochrome P-450 함량 증가율은 12주령군 보다 5주령군에서 높게 나타났다. 간 alcohol dehydrogenase 활성치도 대조군에 있어서는 5주령군이 12주령 보다 약 35% 정도 낮게 나타났으나 xylene 투여로 인한 본 효소의 활성 증가율은 5주령군에서 오히려 높게 나타났다. 그러나 간 aldehyde dehydrogenase 활성치는 대조군 및 xylene 투여군 모두 5주령과 12주령간에 유의한 차이를 나타내지 않았다. 한편 xylene 투여시 체중 당 간무게, 간조직 malondialdehyde 함량 및 혈청 ALT 활성 변동을 통하여 간손상 정도를 상호 비교 관찰하였을 때, 12주령군이 5주령 실험동물 보다 간손상이 다소 심하게 나타남을 알 수가 있었다. 이상 실험결과는 연령에 따라 xylene에 의한 간손상의 차이는 이물질의 생체내 대사율이 달리 나타나기 때문일 것으로 생각된다. To evaluate an effect of aging on the xylene toxicity, 50% m-xylene in olive oil (0.25 ml/100 g body wt.) was administered to 5 week and 12 week-old rats one times intraperitoneally and sacrificed at 24 hrs afterwards. The increasing rate of urinary H-methylhippuric acid concentration was higher in 12 week-old rats than 5 week-old rats by the treatment of m-xylene. On the liver function findings, i.e., liver weight/body weight (%), serum levels of ALT activity and hepatic malondialdehyde content, 12 week-old rats showed more severe liver injury than 5 weeks those in xylene-treated rats. And the hepatic cytochrome P-450 contents was higher in 12 weeks rats than those of in 5 week-old rats, but the increasing rate of that was lower in 12 week-old rats. Hepatic alcohol dehydrogenase activity was also higher in 12 week-old rats than in 5 week-old rats whereas the increasing rate of that was higher in 5 week-old than those in 12 week-old rats by the xylene treatment. Furthermore, the hepatic aldehyde dehydrogenase activities were no differences between the 5 and 12 week-old rats both in the control and xylene-treated group, In conclusion, age may influences upon the hepatotoxicity with xylene and it may be responsible for xylene metabolism in rats.

The Longitudinal Trend of Cardiac Surgery in Korea from 2003 to 2013

Lee, Kyeong Soo,Kim, Chang Suk,Park, Jong Heon,Hwang, Tae Yoon,Kim, Sang Won,Sim, Sung Bo,Lee, Kun Sei The Korean Society for Thoracic and Cardiovascular 2016 The Korean Journal of Thoracic and Cardiovascular Vol.49 No.sup

Background: The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery. Methods: Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013. Results: There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high. Conclusion: Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.

안성시 간이급수시설에 대한 연구

이웅,이상수,이상훈,유원석,박규홍 중앙대학교 건설환경연구소 2001 環境科學硏究 Vol.12 No.1

The condition of operation and maintenance for selected small water systems in An Sung was surveyed. Eight small water systems were selected among one hundred ninety systems in An Sung. The environment, especially contaminant source around the systems was reevaluated. Questionnaire was also conducted to find out the recognition of inhabitants and/or managers for the operational difficulty and management problems of the systems. Twenty percent of the respondents was not satisfied with the flow rates of the supplied water and 16% with the water quality. Eighty percent of the respondents wanted to enhance the existing treatment facilities by installing additional filtration and/or disinfection process. Only 13% of the managers of the small systems were regularly paid. The limit of their role and responsibility seemed unclear and the development of practical and responsible management program for small water systems is expected.