身體 微細畸形 및 産科的 合倂症과 精神分裂症의 家族歷

홍경수,주연호,김용식,신철진,강웅구,이중서,정희연,주은정 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.4

저자들은 정신분열병의 일부에서는 태생기 동안 유전 외적인 환경적 요인이 크게 작용할 것이라는 가정 하에 형제 정신분열병 환자군(남 15. 여 7)과 산발성 정신분열병 환자군(남 16, 여 7) 및 정상 대조군(남 16, 여 7)을 대상으로 가족력에 따른 산과적 합병증과 신체 미세 기형을 비교하였다. 산과적 합병증은 Lewis 척도를 이용하여 연구 대상의 어머니와 면담하여 평가하였고 신체미세기형은 Waldrop 척도를 이용하여 측정하였다. 또한 산과적 합병증 및 신체 미세기형과 가족력에에 따라 발병 연령 등의 임상 양상들이 차이를 보이는지 비교함으로써 정신분열병을 좀 더 동질적인 아형으로 나눌 수 있는지를 검토하였다. 1) 형제 환자군, 산발성 환자군 및 정상 대조군의 세균에서 산과적 합병증의 개개의 항목 및 전체 점수의 유의한 차이는 없었다. 신체 미세기형의 경우 입의 미세기 형에서 유의한 차이가 있었으나 그 외에 각 부위별 점수 및 전체 점수에서는 세 군간에 유의한 차이가 없었다. 그러나 대부분의 신체 미세기형 세부 항목 및 전체점수에서 산발성 환자군이 형제 환자군에 비해 높은 신체 미세기형의 점수를 보이는 경향이 있었다. 2) 산과적 합병증의 전체 점수와 신체 미세기형의 전체 점수 사이에 상호 연관성을 찾아볼 수 없었다. 3) 발병연령·정신병리·약물에 대한 반응·병전 기능수준·지연성 운동장애 유무 등의 임상 양상들을 비교하였을때 산발성 환자군과 형제 환자군간에 유의한 차이가 없었다. 4) 산과적 합병증 및 신체 미세기형과 임상 양상들을 비교하였을 때, 형제 환자군에서 분만시간과 회복시 전반적 기능수준간에, 산발성 환자군에서 산과적 합병증의 전체 점수와 발병 연령간에 상관관계가 있었으나 전체적으로 일관된 결과가 도출되지는 못하였다. 위와 같은 결과를 종합하여 볼 때, 산과적 합병증이나 신체 미세기형이 정신분열병의 원인을 밝히는데 유익한 도구가 될 수는 있지만, 가족력 유무에 따라 정신분열병을 보다 동질적인 아형으로 구분하기 힘들다고 생각되었다. In order to test the hypothesis that familial schizophrenics have fewer chances of receiving organic insults during the fetal neural development than sporadic schizophrenics, the authors compared obstetric complications, minor physical anomalies, and other clinical features in sibling schizophrenics, sporadic schizophrenics and controls. Obstetric complications were evaluated by the scale of Lewis, and minor physical anomalies were measured by the Waldrop scale. Sporadic schizophrenics had a significantly higher Waldrop score for mouth than sibling schizophrenics. Although there was some tendency of higher total scores for minor physical anomalies in sporadic schizophrenics, there were no statistically significant differences in obstetric complications and the other minor physical anomalies among three groups. There was no significant correlation between obstetric complications and minor physical anomalies. The clinical features such as age of onset, psychopathology, response to drugs, premorbid functioning, and tardive dyskinesia were not significantly different between sibling and sporadic scizophrenics. In conclusion, while the obstetric complications and minor physical anomalies were suggested to be useful in the search for the cause of schizophrenia, it was difficult to categorize schizophrenics into more homogeneous groups according to family history of schizophrenia using the parameter of obstetric complications and/ or minor physical anomalies.

인지도 조사에 의한 건국의대 의학과 교육목적 및 교육목표의 평가

박수경,김진국,김소정,김형수,이건세,장성훈 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

This study was conducted to survey the recognition and accuracy for educational goal and objectives of College of Medicine, Konkuk University on students and professors with using 18 items of questionnaire from May 15 through June 30, 2004. The recognition for educational goal of College of Medicine, Konkuk University in participating students and professors were 93-95%. And recognition for 3 objectives of College of Medicine, Konkuk University on participating students and professors were 84-87%, 95% respectively. However the accuracy for detail educational objectives using other college of medicine were 46-59% in first student survey, 44-67% in second student survey and 58-72% in professor survey. Therefore it is need to advertize 3 objectives to students and professors. And it is also necessary to refine the contents of educational objectives to more suggesting directions than broad goal of ideal.

중학생들의 흡연 및 간접흡연 실태와 태도

손수경,이지현 韓國學校保健學會 2002 韓國學校保健學會誌 Vol.15 No.1

This study was aimed at identifying on the state and knowledge toward smoking and passive smoking in middle school students. The data were collected from 6th. to 18th. August, 2001. Subject were 125 middle school students who were participated in the Smoking Cessation Program of S Health Agency in Busan. The collected data were analyzed by SPSS program for frequency, percent, mean, and chi-square test. The smoking related state and attitude of subjects were as follows; the number of the smoking students are 10(8.0 %) at present, 19(15.2 %) at past experience, 53(42.4 %) having at present smoking friends, 73(58.4 %) having at present smoking family. Also the smoking starting time of present or past smoking experience was the middle school; 12(9.6 %) and elementary school; 11(8.8 %). They started because of the peer group members; 12(9.6 %), curiosity; 8(6.4 %), and looking good; 7(5.6 %). The passive smoking related state and attitude of subjects were as follows; the number of the passive smoking aware rates are very well level; 71(56.8 %), well level; 54(43.2 %). The exposed experience to passive smoking was always; 38(30.4 %), sometimes; 86(68.8 %), not experience; 1(0.8 5). The place of exposure to passive smoking was game rooms; 67(53.6 %), house; 30(24.0 %), fast food place or cafeteria; 10(8.0 %), and street or in a vehicle ; 3(2.4 %). The main smoker to passive smoking exposure was unknown person; 61(48.8 %). grand parents or parents; 43(34.4 %), brothers or friends; 8(6.4 %), teachers; 4(3.2 %). The chief complant of passive smoking exposure was dyspnea; 36(28.8 %), coughing; 34(27.2 5), dizziness; 21(16.8 %), no symptom; 18(14.4 %). The mostly affected smoker to passive smoking exposure was parents; 52(41.6 %), brothers or friends; 48(38.4 %). The health affected perception to passive smoking exposure was very affected; 109(87.2 %), not affected; 3(2.4 %). In conclusion, it can be well recognized that considerable number of middle school students is exposed to the passive smoking in their homes and by unknown persons, but, their knowledge and attitude toward the exposure to passive smoking is not effective. Therefore, it is hoped that regular smoking education program at school and restriction campaign in home and the public place is necessary.

부정교합 분류에 따른 초경시기와 골성숙도에 관한 연구

김경호,백형선,손은수 대한치과교정학회 1998 대한치과교정학회지 Vol.28 No.4

부정교합 환자에서 사춘기 성장 가속화시기의 치료는 악안면 골격 부조화의 교정과 안모의 개선에 상당한 영향을 미치므로 사춘기의 성장을 예측하고 성장 잠재력을 평가하는 것은 매우 중요하다. 따라서 교정학에 있어서 개개인의 성장 가속화시기와 연관해서 신체의 성장 발육상태를 평가하는 것은 매우 중요하며 교정치료시 반드시 고려되어야 한다. 이에 본 연구에서는 부정교합 분류에 따라 초경시기에 차이가 있는지와 초경시 골성숙도를 조사하기 위해, I급 부정교합자 64명, II급 부정교합자 51명, III급 부정교합자 38명의 초경 전후 3개월 이내의 수완부골 방사선 사진을 이용하여 골성숙도를 평가한 결과 다음과 같은 결론을 얻었다. 1. 초기 평균 연령은 12.50±1.01세 였다. 2. 각 군별 초경연령은 I급 부정교합군이 12.36±1.04세, II급 부정교합군이 12.81±1.03세, III급 부정교합군이 12.32±0.82세로서, II급 부정교합군이 I급 부정교합군 과 III급 부정교합군에 비해 늦은 초경연령을 보였다. 3. 초경시 수완부 골성숙도는 부정교합에 따른 차이가 없었다. 4. 초경시 수완부 골성숙도는 SMI 7이 45.10%, SMI 8이 27.45%, SMI 9가 10.46%, SMI 6이 7.84%, SMI 10이 7.84%, SMI 5가 1.31% 였다. 5. 초경연령과 수완부 골성숙도는 통계적으로 유의한 상관관계를 보였다 (p<0.05, r=0.25430). In order to correct a maxillofacial-skeletal disharmony sucessfully and achieve a favorable facial profile, orthodontic treatment must begin at pubertal growth spurt. Therefore predicting the pubertal growth pattern and evaluating the growth potential is very important. For an orthodontist, estimating skeletal maturity in relation to one`s personal growth spurt is essential and it must be considered into the treatment. The objective of this study was to find out whether there was a difference in menacheal age among different malocclusion groups and to evaluate the skeletal maturity at menarche. The subjects were 64 Class I malocclusion patients, 51 Class II patients and 38 Class III patients. Skeletal maturity was estimated from handwrist radiographs of these patients. Handwirst radiographs were taken between 3 months before and after the menarche. The results were as follows. 1. The mean chronologic age of menarche was 12.50±1.01 years. 2. For the Class I malocclusion group the mean age of menarche was 12.36±1.04 years, for Class II 12.81±1.03 years and for Class III 12.32±0.82 years. According to these results Class II malocclusion patients started mensturation later than Class I and Class III malocclusion patients. 3. No difference was found considering the skeletal maturity at menarche among the malocclusion groups. 4. The skeletal maturity index at menarche was SMI 7 for 45.10%, SMI 8 for 27.25%, SMI 9 for 10.465, SMI 6 for 7.84%, SMI 10 for 7.84% and SMI 5 for 1.31% patients. 5. Statistically there was a significant correlation between skeletal maturity estimated by handwrist radiographs and menacheal age (p<0.05, r=0.25430).

정신분열병 환자에서의 主觀的 症狀 평가 및 척도의 개발

洪經穗,李符永 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.2

The purposes of this research are l) to develop a valid and reliable rating scale to assess the subjective symptoms of the Korean schizophrenic patients. 2) to identify frequently experienced subjective symptoms among Korean schizophrenic and neurotic patients. 3) to test the clinical usefulness of the developed rating scale in discriminating schizophrenics from neurotic patients, and 4) to investigate the relationship between subjective and objective symptoms of schizophrenics. The Subjective Symptom Rating Scale with 35 items was developed through preliminary studies, and semi-structured interview was done with 60 remitted schizophrenic patients (by DSM-III-R) and 30 neurotic patients. The results are following ; 1) The schizophrenic patients are experiencing various subjective symptoms and the remitted patients can report them reliably. 2) The inter-rater reliability of the rating scale was 0.78. and the test-retest reliability was 0.81. The Cronbach alpha for internal consistency was 0.8706 and 0.8121 for the schizophrenic and the neurotic patients, respectively. 3) At least 30% of the schizophrenic patients reported that they have frequently or continuously experienced all except 3 items and at least 50% of the schizophrenic patients have reported that they have frequently or continuously experienced 19 items among 35 items(54.3%). 4) 27 items were experienced more frequently by the schizophrenics than the neurotic patients. 5) The items with high correlations with the objective symptoms such as emotional bluting, avolition and social withdrawal were extracted. 6) The 13 items with high discriminat function coefficient were extracted. The methodological issues and the influence of the illness factors in assessing the subjective symptoms of the schizophrenics were discussed. The usefulness of the subjective symptoms in clinical practice and research of the schizophrenia was discussed.

위험요인 변동에 따른 유방암의 인구집단 귀속위험도 분율과 누적위험도의 측정

박수경 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

To establish the prevention strategy breast cancer in Chungcheongbuk-do female population, we estimated the population attributable risk percent (PARP) according to population exposure fraction of risk factors and the cumulative risk until 64 years, using previous data in Korean. The cumulative risks until 64 years old for breast cancer were calculated by the age-specific incidence rate (Yoo et al., 1998; Appendix 2), the population exposure fraction of breast cancer (Appendix 3) and the odds ratios of risk factors in hospital breast cancer case-control study (Yoo et al 1998; Appendix 4), through the formula suggested in Kleinbaum et al., (1982) and IARC (1992). The PARP by exposure fraction status were calculated by previous data of the odds ratios and population exposure fraction of breast cancer, through the formula suggested in Cole and Macmahon (1971) and Kelsey et al. (1986). And protective fraction percent (PFP) was calculated through the formula suggested in Miettinen (1974). Based on three criteria (1. PARP > ±10%, 2. the significance of 95% confidence interval of odds ratios, 3. cumulative risk ratio (CRR)>1.5 or CRR<0.7), we suggest that high risk group by breast cancer prevention strategy in Korea should be selected as the women with BMI>26 kg/m2, regular menstruation, & alcohol drinking, and parous women having over and at 2 children.

기존자료의 정확성 및 보정 분률에 따른 선천성 다지증의 출생시 발생률 추정

박수경 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

연구목적 : 본 연구는 전국단위의 의료보험자료를 기초로 하여 다지증이 의심되는 대상자들을 선정하고 이들을 중심으로 의료보험자료의 정확성 분률 및 보정 분률(전체 환자 중 조사된 환자가 차지하는 분률)에 따른 다지증 발생률을 추정하는 것이다. 연구 대상 및 방법 : 전국의료보험연합회의 의료보험수진청구자료 중 확보된 1991-1996년 자료를 이용하여 의료보험 청구 자료상의 다지증 환자들을 선별하였는데, 1994년 출생아(n=721,848) 중 다지증이 의심되는 경우(질병분류 ICD-9 code 755 (Other congenital anomalies of limbs), ICD-10 code Q69 (Polydactyly))를 가진 경우는 모두 1,551명이었다. 그 중 3개 종합병원을 선정하여 선별된 다지증 의심 환아들의 의무기록지를 확인하여 의무기록상의 정확성 정도(accuracy fractiono)를 계산하였다. 모든 연령대의 다지증 환자 중 만 0-2세의 다지증 환아의 분률, 즉 보정분률(correction fraction)을 추정하기 위하여 의료보험청구기록 상에서 다지증이 의심되는 모든 연령대의 환자 중 연도별 만 0-2세 분률의 변화를 산출하였고, 최소값과 최대값으로써 보정분률의 범위를 산출하였다. 따라서 전체 의심 환자 ( n=1,551)에서 정확성 정도와 보정분률을 보정함으로써 다지증의 출생시 발생률이 최종적으로 산출되었다. 연구결과 : 다지증의 출생시 발생률은 1000명 출생아당 0.9-2.0명으로 추산되었다. 고찰 : 본 연구는 선천성 수부 기형 중 가장 많은 것으로 알려져 있는 본 질병의 발생 규모를 예측하게 할 뿐 아니라 선천성 기형에 대한 발생률 추정에 방법론을 제시하는데 도움이 될 것으로 사료된다. Study objective - The aim of this study was to estimate the incidence rate of congenital polydactyly to use medical utilization database of the National Health Insurance Corporation in Korean. Material and methods - Base population for the estimation of incidence rate are selected from the total children born in 1994 (n=721,848). The presumptive cases of polydactyly are selected from the base population with polydactyly disease criteria (n=1,551) born in 1994 from medical utilization databases. The diagnoses of polydactyly in the claims included one of the following diagnostic codes ; ICD-9 code 755(Other congenital anomalies of limbs), ICD-10 code Q69 (Polydactyly). All the case of three General hospitals have been confirmed as having a polydactyly through a medical record review and through the results, the accuracy fraction by disease codes has been calculated. The fraction of the cases aged 0-2 year for all polydactyly cases (correction fraction) was predicted as the cross-sectional medical utilization data of presumptive polydactyly patients. The range of congenital polydactyly incidence at birth was estimated by the accuracy fraction and correction fraction. Results - The estimated incidence rate are minimum 0.9 per 1,000 birth to maximum 2.0 per 1,000 birth by considering for correction fraction and accuracy fraction. Discussions - Validity of these estimates is discussing in comparison with registry data of congenital anomalies and prospective follow-up study of estimation of incidence rate. Therefore, it could be very important for estimation of accurate incidence rate to perform birth cohort study or disease registry.

암환자의 피로와 수면의 질과의 관계

손수경 성인간호학회 2002 성인간호학회지 Vol.14 No.3

Purpose: The purpose of this study was to identify the relationship of fatigue and quality of sleep in patients with cancer. Method: The data was collected from January to February 2001. Study objects were recruited K university hospital in Busan, Korea. Their fatigue was measured using the Revised Piper Fatigue Scale developed by Piper et. al(1998), and quality of sleep was measured using Quality of Sleep Questionare by Oh et. al(1998). Result: 1) The fatigue score was mean 114.80±34.88(range: 22-220). The sub dimension that showed behavior/severity score at 33.70±13.89, affective score at 24.23±3.33, sensory score at 27.74±12.51, and cognitive/mood score at 29.11±3.71. And sleep quality score was mean 37.32±8.18. 2) There was a significant difference in religion(F=4.157, P=.008), present therapy(F=2.536, P= .043), past therapy(F=6.625, P= .000), major caregiver(F=3.133, P= .028), and change of weight (F=7.965, P= .006), according to general characteristics in the fatigue in patients with cancer. 3) There was a significant difference in present pain(t=-2.103, P= .037) and change of weight(F=5.484, P= .005), according to general characteristics in the sleep quality in patients with cancer. 4) There was a significant negative correlation between fatigue and quality of sleep(r=- .340. P= .000). Conclusion: Patients with cancer experience in fatigue. Increase in fatigue are associated with decreases in quality of sleep. Nurses must provide patients with nursing care about the occurrence of fatigue and interventions to deal with sleep disturbance.

골격근 근형질세망의 ATPase활성도에 대한 Vanillylnonanamide의 영향

박경섭,홍장희,류영수,성지연,허강민,임종호,이재흔,석정호 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.2

To investigate the effect of vanillylnonanamide(VN) on the ATPase activity of the sarcoplasmic reticulum(SR) of the skeletal muscle, we prepared the SR vesicles from the back muscle of the rabbit, and measured ATPase activity. The results as follows: Ca-ATPase activity was about 50% in the total ATPase activity of skeletal muscular SR. In the reaction mixture with calcium, 100μM VN increased ATPase activity to 20%, and 100 nM and 10 μM thapsigargin(THP) inhibited the ATPase activity to 50% and 60%, respectively. And 100 μM VN plus 100 nM or 10 μM THP more inhibited ATPase activity than THP alone did it. However, without calcium, 100μM VN did not affect ATPase activity, and 10 μM THP inhibited it to 41%, but VN plus THP inhibited it to 31%. The above results show that VN in the reaction mixture with or without calcium has the different action to ATPase activity when it is used alone or together with Ca-ATPase inhibitor THP. This suggests that VN might increase or decrease the skeletal SR Ca-ATPase activity through affecting the lipid membrane around the Ca-ATPase.

위암환자의 피로와 영양상태의 관계

손수경,한영인,김경희 고신대학교 전인간호과학연구소 2003 전인간호과학연구 학술모음집 Vol.2 No.-

Purpose. The purpose of this study was to identify the relationship between fatigue and nutritional status in patients with gastric cancer. Design. A orrelational and crossectional study design was used Method. The data was collected from July to August 2002. 59 subjects with gastric cancer were recruited K university hospital in Busan, Korea. Fatigue was measured using the Revised Piper Fatigue Scale developed by Piper et. al (1998). The parameters for nutritional status included body weight, body mass index, hemoglobin, Hct, total protein, albumin and lymphocyte count. Result. 1) The fatigue score was mean 94.31±22.08(mean average 4.48±1.00) The subdimension that showed behavior/severity score at 34.15±8.76, cognitive/mood score at 22.00±7.93, sensory score at 21.67±5.56, and affective score at 20.81±6.69. And among the parameters for nutritional starus, BMI, Hb, Hct were not included normal rage. 2) There was a significant difference in present diet(F=3.343, P= .026) according to general characteristics in the fatigue in patients with gastric cancer. 3) The disease-related characteristics such as Age, treatment type, after period diagnosis, care giver, payment were frequently related to poorer nutritional status. Subjects received chemotherapy showed lower lymphocyte level than subjects received operation, and the subjects were diagnosis less than 1 month, were showed lower Hematocrete level. 4) There was a significant negative correlation between fatigue and nutritional status(r= -.371, P=.004). Conclusion. Patients with gastric cancer experience in fatigue. Considering the relationship between fatigue and nutritional status, nurses can identify the risk group most vulnerable to fatigue and malnourishment in order to provide appropriate interventions for them