Transtheoretical model을 적용한 국내 연구 동향 분석

이평화(Pyung Hwa Lee) 한국보건교육건강증진학회 2017 보건교육건강증진학회지 Vol.34 No.5

음악요법이 응급실 환자의 불안에 미치는 영향

이평화(Lee Pyung Hwa),서인선(Suh In Sun),정승희(Chung Seung Hee) 한국성인간호학회 2008 성인간호학회지 Vol.20 No.3

프로이트 정신분석을 적용한 상담과정과 상담기법에 관한 연구

이평화 ( Pyung-hwa Lee ),김보기 ( Bo-ki Kim ) 산업진흥원 2022 산업진흥연구 Vol.7 No.2

본 연구는 프로이트의 정신분석에 기반을 두고 이를 적용한 정신분석상담을 실제를 다루고자 한다. 특히 상담과정과 상담 기법에 대하여 연구하고자 한다. 연구결과는 다음과 같다. 상담과정은 내담자를 선정하고 상담상황을 구성하면, 다음과 같이 시작, 전이발달, 훈습, 전이해결의 4단계를 거친다. 시작단계에서는 내담자의 중요한 과거 역사에 대하여 청취한다. 전이발달 단계에서는 전이가 나타나는 시기부터이다. 훈습단계는 내담자가 통찰한 것을 실제 생활로 옮겨서 변화를 일으키는 단계이다. 전이해결 단계는 전이분석과 해석이 종결되는 시기다. 상담기법은 자유연상, 공감, 저항, 전이와 역전이, 해석 등이 있다. 자유연상(free association)은 정신 분석적 치료의 핵심 기법이고, 분석적 틀을 유지하는 과정에서 중요한 역할을 한다. 공감은 치료자 자신을 내담자와 동일시하고 치료자의 공감적인 경험을 내담자에게 전달하는 능력은 그 자체로 변화의 핵심적인 기제이다. 저항이란 내담자가 상담에 협조하지 않는 모든 행위를 말한다. 전이와 역전이는 정신분석의 주요한 기법이다. 왜냐하면 정신분석자는 치료과정에서 내담자로 하여금 전이를 유도하고 전이를 해결하는 작업을 수행하기 때문이다. 해석이란 내담자의 사고나 감정, 행동의 이면에 감추어진 욕구나 의미, 동기 등을 파악해서 이런 것을 내담자가 깨닫도록 하기 위해 언어적으로 대응하는 기법을 말한다. 결론적으로 정신분석상담의 상담과정은 내담자를 선정하고 상담상황을 구성하여 효과적인 상담을 시행하고자 함을 말한다. 또한 상담기법에서 정신분석의 원리는 사례의 성질에 따라 다양하게 변하는 치료절차에 적용되며, 동일한 내담자를 치료하는 동안에도 가변적으로 적용될 수 있다. This study is based on Freud's psychoanalysis and intends to deal with the actual psychoanalytic counseling applied to it. In particular, I would like to study the counseling process and counseling techniques. The research results are as follows. The counseling process goes through four stages: initiation, transfer development, training, and transfer resolution as follows after selecting a client and constructing a counseling situation. In the beginning phase, the client listens to important past histories. In the metastasis development stage, it is from the time when metastasis appears. The training phase is the phase in which the client's insight is translated into real life to bring about change. The transfer resolution stage is the period when transfer analysis and interpretation are completed. Counseling techniques include free association, empathy, resistance, transference and countertransference, and interpretation. Free association is a key technique in psychoanalytic therapy and plays an important role in maintaining the analytical framework. Empathy is the ability of the therapist to identify herself with the client and the ability of the therapist to convey the empathic experience to the client itself is a key mechanism for change. Resistance refers to any behavior in which the client does not cooperate with counseling. Transference and countertransference are the main techniques of psychoanalysis. This is because the psychoanalyst induces and resolves the transference of the client during the treatment process. Interpretation refers to the technique of responding verbally in order to understand the needs, meanings, and motives hidden behind the client's thoughts, feelings, and actions. In conclusion, the counseling process of psychoanalytic counseling refers to the purpose of effective counseling by selecting a client and constructing a counseling situation. In addition, the principles of psychoanalysis in counseling techniques are applied to treatment procedures that vary according to the nature of the case, and can be variably applied while treating the same client.

췌장 점액성 낭성 종양과 감별이 어려웠던 췌장내 부비장의 유표피 낭종

박평화 ( Pyung Hwa Park ),조재희 ( Jae Hee Cho ),장필규 ( Pil Kyu Jang ),한정윤 ( Jung Yoon Han ),이승익 ( Seung Ik Lee ),김연석 ( Yeon Suk Kim ) 대한췌장담도학회 2014 대한췌담도학회지 Vol.19 No.3

An epidermoid cyst arising from intrapancreatic accessory spleen (ECIPAS) is a rare disease. Most patients with an ECIPAS are detected incidentally and could be misdiagnosed as a pancreatic cystic neoplasm such as mucinous cystic neoplasm (MCN) or intraductal p ancreatic mucinous neoplasm (IPMN). We described an ECIPAS with high cystic fluid carcinoembryonic antigen (CEA), which was misdiagnosed as a MCN of pancreas. Fifty one-year-old female was presented with a 2 cm sized nonenhancing pancreas cystic mass on the outside CT scan. Endoscpic ultrasonography (EUS) guided aspiration was performed. It showed a 2.3 × 1.9 cm unilocular cyst nearby 1.6 × 1.1 cm homogenous hypoechoic mass in pancreas tail, and cystic fluid CEA was 1564.18 ng/mL. On the basis of EUS results with elevated fluid CEA level, the presumptive diagnosis is likely to MCN of pancreas, and she underwent a laparoscopic distal pancreatectomy. The final pathology was the epidermal cyst in the intrapancreatic accessory spleen.

항공기용 동력전달축의 진동시험 및 유한요소해석

박진호(Jin Ho Park),김평화(Pyung Hwa Kim),박정선(Jung Sun Park),이지만(Lee Ji Man) 한국항공우주학회 2018 한국항공우주학회 학술발표회 논문집 Vol.2018 No.11

내시경적 큰풍선확장술을 이용한 어려운 담관 결석 추출 시풍선확장시간에 대한 비교 연구

이승익 ( Seung Ik Lee ),장승준 ( Seung Jun Jang ),한송이 ( Song Yi Han ),박평화 ( Pyung Hwa Park ),이연희 ( Yeon Hee Lee ),장필규 ( Pil Kyu Jang ),김주현 ( Ju Hyeon Kim ),조재희 ( Jae Hee Cho ),김연석 ( Yeon Suk Kim ) 대한췌장담도학회 2014 대한췌담도학회지 Vol.19 No.4

Background/Aims: The ballooning time in endoscopic papillary large balloon dilation (EPLBD) remains controversial. The aim of this study was to evaluate the significance of the ballooning time comparing an immediate balloon deflation method with a conventional ballooning time of > 45 seconds. Methods: Between January 2010 and December 2010, 126 patients with bile duct stones treated with EPLBD and endoscopic sphincterotomy were divided according to the ballooning time: the immediate deflation group (n=56) and the conventional inflation group (ballooning time 45s to < 60s) (n=70). Results: The overall success rate and the success rate of the first attempt of ERCP (endoscopic retrograde cholangio-pancreatography) were 96.4% (54/56) and 80.4% (45/56) in the immediate group and 97.1% (68/70) and 77.1% (54/70) in the conventional inflation group. There were no statistically significant differences in the overall success and the first attempt of ERCP success rate (p=0.99, p=0.66). The frequency of mechanical lithotripsy was 0% in the immediate deflation group and 7.1% in the conventional inflation group (p=0.065). Complications occurred in 3.6% (2/56) patients in the immediate deflation group and 8.6% (4/70) patients in the conventional inflation group (p=0.298). Conclusions: The ballooning time in EPLBD does not affect the outcomes of the treatment for bile duct stones. And the feasibility of the immediate deflation method in EPLBD is acceptable. Korean J Pancreatobiliary 2014;19(4):182-188

口蓋形成에 대한 Triamcinolone Acetonide의 畸形原的 效果

李柱元,崔平和,全容赫 고려대학교 의과대학 1985 고려대 의대 잡지 Vol.22 No.3

Glucocorticoids in conjuction with other hormones or growth factors are known to be essential for the normal development of the secondary palate, a series of closely timed and finely tuned processes, and while on the other hand, it is well established that these steroids, when administered in therapeutic doses to several experimental animals, inhibit closure of the fetal secondary palate. But various strains of inbred mice exhibit different degrees of susceptibility to glucocorticoid-induced cleft palate and the mechanisms by which it causes this effect remain controversial. Therefore, teratogenic effect of triameinolone acetonide on DDY mouse fetuses in vivo. following intramuscular injection twice for each on days between 12.5-15.5 of gestation with successive 12 hour interval, were analysed especially on stage response or sensitive period for TAC-induced cleft palate and correlation between fetal growth retardation, maternal weight loss and incidence of cleft palate and observed abnormal process of palatal development proceeding cleft palate histologically. The results obtained are as follows: 1. The most sensitive stage to cleft palate induction in DDY mice following TAC treatment was early stage of palatogenesis but during the period, early development of The palatal shelves in treated fetuses proceeded normally and palatogenesis was resistant to the effects of TAC before 13 and after 14.5 day of gestation. 2. The frequency of cleft palate induction was increased in proportion to the degree of decreased maternal and fetal weight gain following TAC treatment which suggest that there was a close correlation between fetal growth retardation and maternal weight loss and induction of cleft palate. 3. No difference was seen histologically between control and treated in the changes of the palatal medial edge epithelia and shelf mesenchyme but administration of TAC changed the shape of palatal shelves to thicker, shorter and blunt in their edges. 4. With the results, it may be considered that TAC-induced cleft palate is possibly due to a direct action of the steroid on the developing palatal shelves and consequent failure to make contact itself with opposing shelves.

新生兒의 血淸 Alpha-Fetoprotein値에 對하여

李圭殷,崔平和 고려대학교 의과대학 1980 고려대 의대 잡지 Vol.17 No.1

In order to evaluate the role of AFP in the estimation of gestational age, AFP in cord sera was determined by radioimmunoassay (PEG method) from 117 newborn infants at various gestational age of whom pregnant women known their exact. LMP were delivered. Cord blood samples were collected from newborn infants immediately after delivery. The results obtained were as follows: 1. The majority of maternal age were in age group of 25-29 years, 64 cases (54.7%) 2. Among the total number of 117 cases 64 cases (54.7%) were male and 53 cases (45.3%) female. The gestational ages were distributed from 28 weeks to 44 weeks. The majority were in gestational age of 39-40 weeks, 37 cases (31.6%). Among 117 cases studies, 63 cases (53.9%) were fullterm infants, 43 cases (36.7%) premature infants and 11 cases (9.4%) postterm infants. 3. Birthweight of newborn infants was in a range of 1300 to 4100gm. The most frequent birth weight of newborn infants was ranged from 3001 to 3500gm, 42 cases (35.9%). 4. The maximum level of AFP in cord serum determined in the present study was 45.0㎎/㎗ and the minimum level 3.2㎎/㎗. The average maximal serum AFP levels were 35.75±13.06㎎/㎗ in the gestational age of less than 30 weeks, and thereafter AFP levels decreased with increasing gestational age. The average levels of serum AFP between 39 and 40 weeks of gestation were 5.84±2.68㎎/㎗. 5. There was a close negative correlation between AFP in cord serum and gestational age (r= -0.645, p<0.001) and the regression line can be derived from the formula y= -0.28x+88.47. 6. Also there was a negative correlation between AFP in cord serum and birth weight (r= -0.6085, p<0.001). This was less pronounced than for AFP in cord serum versus gestational age. The regression equation was y= -8.975x+36.441. 7. The AFP levels were significantly higher in preterm AGA infant than those in term AGA. However there were no significant differences between term SGA and term AGA. 8. The coefficient of correlation between AFP in cord serum and gestational age was slightly higher than that between AFP and birthweight. In this point of the above results, the further investigation should be carried out for exact assessment of gestational age by means of AFP in cord blood.

제대혈중 Lipid치 및 High-Density Lipoprotein 분포에 관한 연구

이명숙,최평화 고려대학교 의과대학 1987 고려대 의대 잡지 Vol.24 No.1

The purpose of this study is to evaluate the relationship between the high-density lipoprotein (HDL) size distribution and levels of cholesterol and triglyceride in cord blood. The HDL subclass was examined in 154 human cord blood sample and determinations of triglyceride, total cholesterol and HDL cholesterol level were performed. The results obtained were as follows: Three distinct pattern were recognizable. The first pattern, termed the normal pattern, was distinguished by prominent double peak in the HDL_(2a) and HDL_(3b) lesions. Minor peaks were also seen in the HDL_(2b) and HDL_(3c) regions. This pattern was associated with normal lipid levels for cord blood plasma. The second pattern, termed the 2b pattern, contained a major peak in the HDL_(2b) region, while the HDL_(2a), HDL_(3b), HDL_(3c) region were less pronounced. This pattern was associated with elevated total cholesterol and HDL-C levels. The third pattern, termed the 3b pattern, was characterized by a single peak in the HDL_(2b) region, and either relative increase in the HDL_(3b) region, or increase in both HDL_(3b) and HDL_(3c). This pattern was associated with elevated triglyceride levels and decreased HDL-C levels. Although the triglyceride and cholesterol levels in the newborn are much lower than those in adults, they are seems to be the important factors associated with HDL subclass distribution. Elevated cholesterol was related to increased particle in the HDL_(2b) region while elevated triglyceride levels were associated with a decrease in HDL_(2b)+_(2a) particle and a concomitant increase in HDL_(3b) particles.

小兒의 泌尿器系疾患의 臨床的所見 및 無症狀細菌尿에 對한 臨床細菌學的 觀察

李光哲,獨孤英昌,崔平和 최신의학사 1983 最新醫學 Vol.26 No.12