여드름에 대한 문헌적(文獻的) 고찰(考察) -최근(最近) 중의(中醫) 잡지(雜誌)를 중심(中心)으로-

정우병,김장현,Jung, Wu-Byung,Kim, Jang-Hyun 대한한방소아과학회 2007 대한한방소아과학회지 Vol.21 No.1

Objectives : The purpose of this study is to make the oriental medical treatment useful, and to develop the ways of acne cure. Methods : Recent paper about Traditional Chinese medicine of acne was analyzed for this studying. Results : According to the latest researches of Acne treatment with Chinese medicine, oriental medical methods to chronic acne were effective. Conclusions : Oriental medical treatment can be classified into 3 parts; internal cure, external cure, and acupuncture therapy. All of these ways were efficacious to cure chronic Acne.

2020 대한민국 응급의학과 전문의 총조사

김선구,조광현,김인병,이미진,윤유상,박경혜,박송이,김홍재,기동훈,서범석,주영민,지창근,최석재,여인환,강지훈,정우진,임대성,이의선,이형민,왕순주 대한응급의학회 2022 대한응급의학회지 Vol.33 No.4

Objective: This study was carried out to establish a basis for understanding and correcting the problems of the emergency physicians (EP) in Korea by examining the current status through the 2020 emergency physician survey conducted by the Korean Society of Emergency Medicine (KSEM). Methods: An online survey was conducted from January 15 to February 26, 2021, through a website and mobile application. The final questionnaire was classified into three types based on the clinical work in the emergency department (ED), current position, and the year of board certification. The contents of the questionnaire were organized into eight themes, and a subcommittee was put in charge of each. Results: Of the 400 emergency medical institutions surveyed, 295 hospitals (74.2%) had board-certified EPs, and 1,453 EPs (72.5%) out of 2,000 were working in the ED. Of these, on average, 7.2 EPs worked together, and they worked 11.6 days/153.1 hours per month and did night shifts 5.9 days per month. 30.7% showed excessive sleepiness during the day, and only 9.6% said that they could adhere to mealtimes. 27.1% responded that they suffered from depression. The level of satisfaction was 3.2 points, and 43.0% responded that they would choose emergency medicine (EM) again as their major. The most important factor in choosing EM was the availability of adequate free time. Their responses indicated that the retirement age was 59.7 years, and the upper age limit for the night shift was 54.3 years. Conclusion: Though there have been improvements since the first survey in 2010, there was no notable increase in EP satisfaction. Therefore, appropriate future policies should be formulated and implemented based on these survey results.

2020 대한민국 응급의학과 전문의 총조사

김선구,조광현,김인병,이미진,윤유상,박경혜,박송이,김홍재,기동훈,서범석,주영민,지창근,최석재,여인환,강지훈,정우진,임대성,이의선,이형민,왕순주 대한응급의학회 2022 대한응급의학회지 Vol.33 No.4-1

Objective: This study was carried out to establish a basis for understanding and correcting the problems of the emergency physicians (EP) in Korea by examining the current status through the 2020 emergency physician survey conducted by the Korean Society of Emergency Medicine (KSEM). Methods: An online survey was conducted from January 15 to February 26, 2021, through a website and mobile application. The final questionnaire was classified into three types based on the clinical work in the emergency department (ED), current position, and the year of board certification. The contents of the questionnaire were organized into eight themes, and a subcommittee was put in charge of each. Results: Of the 400 emergency medical institutions surveyed, 295 hospitals (74.2%) had board-certified EPs, and 1,453 EPs (72.5%) out of 2,000 were working in the ED. Of these, on average, 7.2 EPs worked together, and they worked 11.6 days/153.1 hours per month and did night shifts 5.9 days per month. 30.7% showed excessive sleepiness during the day, and only 9.6% said that they could adhere to mealtimes. 27.1% responded that they suffered from depression. The level of satisfaction was 3.2 points, and 43.0% responded that they would choose emergency medicine (EM) again as their major. The most important factor in choosing EM was the availability of adequate free time. Their responses indicated that the retirement age was 59.7 years, and the upper age limit for the night shift was 54.3 years. Conclusion: Though there have been improvements since the first survey in 2010, there was no notable increase in EP satisfaction. Therefore, appropriate future policies should be formulated and implemented based on these survey results.

응급의학과 전문의 총조사를 이용한 응급의학 전문의의 근무량

윤유상,손동우,강지훈,조광현,김인병,이미진,이형민,박경혜,박송이,김홍재,기동훈,서범석,주영민,지창근,최석재,여인환,정우진,임대성,이의선 대한응급의학회 2022 대한응급의학회지 Vol.33 No.4

Objective: It has been reported that emergency physicians experience high levels of depression and psychological burnout due to night shifts and tend to consider early retirement. This study intended to check working hours and intensity, individual health, satisfaction, and overall welfare, given the increase in the numbers of emergency physicians. Methods: The study used the results of the ‘2020 Korean Emergency Physician Survey (KEPS)’ conducted from January 15 to February 26, 2021, which targeted 2,138 emergency physicians registered with the Korean Society of Emergency Medicine. The survey was conducted online through the web and mobile application. Results: One thousand three hundred seven out of the 2,167 emergency physicians (60.3%) registered at the society responded. The average age of the respondents was 42.6 years, and there were 1,148 male emergency physicians and 158 female emergency physicians. The average professional experience was 8.2 years, with 325 professors, 122 commissioned doctors, 648 public servants of which 90 had military service, and 45 medical practitioners. Conclusion: In conclusion, the number of working hours of emergency physicians showed a decreasing trend compared to 2010 and 2015. However, emergency physicians often expected early retirement. This suggests that, while the absolute working hours are decreasing, the actual working intensity has not decreased. For the proper development of the emergency medical system, it is necessary to establish a stable working environment for emergency physicians. A systematic study is needed on the working hours and work intensity of emergency physicians.

응급의학과 전문의 총조사 자료를 이용한 응급의학과 의사의 남녀 차이

배경수,박경혜,강지훈,기동훈,김인병,김홍재,박송이,서범석,여인환,윤유상,이미진,이의선,이형민,임대성,정우진,조광현,주영민,지창근,최석재,한재헌 대한응급의학회 2022 대한응급의학회지 Vol.33 No.4-1

Objective: In this study, we compared differences based on the gender of Korean emergency physicians to provide basic data for future emergency medicine development plans. Methods: We used data from the emergency physician survey (2020) conducted by the Korean Society of Emergency Medicine. A total of 1,303 emergency physicians responded to the survey. We adjusted demographic data relating to age, position, and work duration as an emergency physician, which could affect the differences based on gender. After propensity score matching, we compared working hours, work burden, income, motives for applying for emergency medicine, and future plans of the emergency physicians by sex. Results: The total working hours per month and night shifts per month were higher in men compared to the women. The women felt more pressure in the following areas: number of emergency patients, relationships with administrative agencies, insufficient emergency medical technician manpower, patients’ compliance, and relationships with other emergency physicians. Monthly income was higher in men. Women placed a higher value on ‘Acquiring a range of knowledge’ and ‘Degree of interest in working in the emergency room’ than men as motivation for applying for positions in emergency medicine. Regarding future plans, women placed less value on income and more on having enough free time and avoiding burnout. The retirement age was about 3 years lower for women than for men. Conclusion: This study revealed gender differences in working hours, income, motivation for applying for emergency medicine, work burden, and future plans. It is expected that these differences are caused by physical limitations and socio-cultural backgrounds. It is recommended that more detailed investigations be carried out through qualitative research. These results could help in gender considerations while hiring emergency physicians.

The prevalence and related factors of depression in emergency physicians of Korea: results from the 2020 Korean Emergency Physician Survey

임대성,박송이,이형민,조광현,김인병,이미진,윤유상,박경혜,김홍재,기동훈,서범석,주영민,지창근,최석재,여인환,강지훈,정우진,이의선 대한응급의학회 2022 大韓應急醫學會誌 Vol.33 No.4-1

Objective: Emergency physicians are constantly exposed to night shifts and stress due to the nature of their work, resulting in health problems such as substance abuse, depression, and suicidal ideation. To date, depression in Korean emergency physicians has never been investigated. The present study endeavors to identify the prevalence and factors related to depression in emergency physicians in Korea. Methods: The present study retrospectively analyzed data from the 2020 Korean Emergency Physician Survey. The prevalence of depression was evaluated using the PHQ-9 (Patient Healthcare Questionnaire-9). Multivariable logistic regression analysis was used to identify the factors related to depression and other variables. Results: The overall response rate of the survey was 61.3% (1,307/2,138). A total of 1,102 respondents completed the PHQ- 9 and were analyzed. The prevalence of depression was 27.0% (95% confidence interval [CI], 27.8-33.6). Following factors were found to be associated with depression: military service as the type of position (odds ratio [OR], 0.316; 95% CI, 0.126- 0.794), schedule satisfaction (OR, 0.523; 95% CI, 0.356-0.769), health perspective (OR, 0.408; 95% CI, 0.252-0.662), weekly exercise (OR, 0.879; 95% CI, 0.774-0.998), sleep quality (OR, 4.728; 95% CI, 3.329-6.715), regular diet (OR, 0.380; 95% CI, 0.239-0.605), nighttime snacking (OR, 1.607; 95% CI, 1.124-2.298), and job satisfaction (OR, 0.456; 95% CI, 0.305-0.682). Conclusion: More than a quarter of respondents had depression. Job satisfaction, schedule satisfaction, and a healthy lifestyle were negatively related to depression. However, poor sleep quality showed a significantly positive association, which suggests the necessity for a long-term follow-up.

머신러닝 기법을 활용한 응급의학 전문의들의 재선택에 영향을 미치는 요인 분석

박지영,이형민,조광현,김인병,이미진,윤유상,박경혜,박송이,김홍재,기동훈,서범석,주영민,지창근,최석재,여인환,강지훈,정우진,임대성,이의선 대한응급의학회 2022 대한응급의학회지 Vol.33 No.4

Objective: Machine learning is emerging as a new alternative in various scientific fields and is potentially a new method of interpretation. Using the Light Gradient Boosting Machine (LightGBM), we analyzed the factors that influence the rechoice of emergency medicine responders. The survey is a cross-sectional study which provides an accurate understanding of a responder's current status. However, the results may vary depending on the composition, format, and question, and the relationship between the answers may be unclear. Methods: This study evaluated the modified 2020 Korean Emergency Physician Survey raw data. We applied the preferred model for random relationship check, random forest, support vector machine, and LightGBM models. The stacking ensemble model was used for the final decision process. Results: ‘It is fun working in an emergency room’was the most selected response factor for re-choice, followed by ‘interesting major’. The physical burden of age and lack of identity had a negative impact, whereas burnout and emotional stress factors had a lesser effect. Anxiety caused by the coronavirus disease 2019 (COVID-19) is thought to have a significant impact on this decision making. Conclusion: Establishing the identity of emergency medicine and being faithful to its fundamental mission is a way to increase the rate of re-choice. Decreasing the burden of workload modified according to age is recommended to establish career longevity. The method of machine learning presents us with a new possibility of checking the relevance of survey results quickly and easily.

응급의학과 전문의들의 세대별 근무, 삶, 직업인식에 대한 분석

박준세,서범석,조광현,김인병,이미진,윤유상,박경혜,박송이,김홍재,기동훈,이형민,주영민,지창근,최석재,여인환,강지훈,정우진,임대성,이의선 대한응급의학회 2022 대한응급의학회지 Vol.33 No.4

Objective: As the history of emergency medicine grows longer, emergency medicine specialists are observed to comprise various age groups. There have been no prior studies on the generation shift analysis of emergency medicine specialists. Our study is designed to identify the characteristics of each generation and predict the generation shift in emergency medicine physicians. Methods: The analysis was based on the results of the 2020 survey of emergency medicine specialists. The study was conducted on 1,307 respondents and finally, the responses of 967 people were analyzed after excluding 199 who were not in charge of emergency room treatments and 141 who gave incomplete responses. The respondents were divided into four groups based on the following generations: first generation (1996-1999), second generation (2000-2008), third generation (2009-2014), and fourth generation (2015-2020), classified by the year in which they acquired their emergency medicine board license. The intergenerational difference analysis was done using the Kruskall-Wallis test. Results: The first generation was characterized by a high proportion of university hospital professors, large non-clinical activity hours, a few night shifts, higher social contributions, low satisfaction with the training and education environment, and a high retirement age compared to the later generations. In the second generation, the characteristics of the first, third, and fourth generations were generally mixed. The third and fourth generations showed similar characteristics overall, though there were differences in some categories. Conclusion: There were significant differences by generation in the working environments, motivation for application, and retirement age. This is the first study that quantifies generational differences. Considering these trends, a discussion about the work environment needs to be initiated.

유문사친(儒門事親)에 나타난 소아(小兒)와 관련된 이론(理論)과 치법(治法)에 대한 고찰(考察)

김기현,장규태,김장현,정우병,Kim, Ki-Hyun,Chang, Gyu-Tae,Kim, Jang-Hyun,Jung, Wu-Byung 대한한방소아과학회 2005 대한한방소아과학회지 Vol.19 No.2

Objective : Rumenshiqin(儒門事親) was compiled by Zhang Zi Huo(張子和) of the Jin(金) Dynasty of China. He invented unique medical theory and treatment such as three excretive methods(perspiratory, vomitory and purgative therapy). The aim of this study was to make the best use of the therapeutic theory of Rumenshiqin(儒門事親) connected with pediatrics. Methods: We conducted literature search in detail for contents of Rumenshiqin(儒門事親) and reviewed various kinds of books. Results : Zhang Zi Huo(張子和) recognized that children had pure-yang bodies(純陽之體) and emphasized that children need to prevent heat-stagnation(鬱熱) and asthenic yin(損陰). He instructed that a principle of raising such as wearing thin clothes, eating fresh food, harboring little desire and little anger, and taking temperate medicine. He described that pathogenic factors were mistake of rearing, misuse of medicine, exogenous factor, and excessive emotion. Conclusion : According to the above results, it is concluded that his therapeutic theory should be used at present.

응급의학 전문의로 건강하게 일하기 위해서는 무엇이 필요한가?

장민석,이형민,조광현,김인병,이미진,윤유상,박경혜,박송이,김홍재,기동훈,서범석,주영민,지창근,최석재,여인환,강지훈,정우진,임대성,이의선 대한응급의학회 2022 대한응급의학회지 Vol.33 No.4-1

Objective: Unlike the temporary nature of an emergency resident's job, the position of an emergency physician is one of a lifelong commitment requiring stability and persistence. However, it is hard to pursue a healthy lifestyle because of the 24 hours a day, 7 days a week (24/7) working schedule. The emergency room environment demands high physical and mental stamina, and hence the health problems of emergency physicians have a significant impact on the patient’s outcome. Our study was designed to analyze the emergency physician’s health status and influencing factors based on the data from the 2020 Korean Emergency Physician Survey. Methods: Based on the results of the survey, the factors affecting health were classified into several categories, such as personal character, working conditions, lifestyle, and emotional status. Statistical methods have been used to determine whether these factors can affect self-rated health. Results: The self-rated health worsened for emergency physicians in their 40s rather than in their 30s. However, drinking, smoking, and eating patterns had no effect on self-rated health. Also, the actual number of shifts was observed to bear no relationship with health. Sleeping, wellness, and mood affected self-rated health. Physicians who felt they were unhealthy, expected an early retirement because of the burden of night shifts. Conclusion: Emergency physicians in Korea have a low self-rated health status. Mental stress, exercise, and sleep had an impact on the status. Physicians who served long-term night shifts saw a deleterious effect on their sleep and mood, and this damage was cumulative. The career longevity of an emergency physician thus requires a reasonable night shift schedule and age-modified adjustments.