한의과대학의 예방(사회)의학 관련 교과목의 교육과정 및 표준화방안

고성규,신용철,Ko, Seong-Gyu,Shin, Yong-Cheol 대한예방한의학회 2008 대한예방한의학회지 Vol.12 No.2

The rapid change of the health and medical environment and the globalization of medicine has driven doctors to converge and analyse of new and up-to-date medical information and decide to what to make decision for diagnosis and treatments in clinical practice. Medical environment goes with the changes with social environment such as rapid increase of aging population, changes of disease pattern, formation of new area of experts except doctors, government intervention for the medical system, medical insurance of the charges of medical treatment, a increased desire for human rights. These trends should be adopted rapidly to the education system for the students of medical school. The learning objectives of the preventive medicine was developed in 1995 and underwent necessary revision of the contents to create the first revision in 2006. However, the required educational contents of health promotion and disease prevention have been changed by the new trends of medical education such as PBL and integrated curriculum and the 2006 revision does not satisfy these needs. We formed a task force which surveyed all the Western and Traditional Korean medical colleges to describe the state of preventive medicine education in Korea, analyzed the changing education demand according to the change of health environment and quantitatively measured the validity and usefulness of each learning objective in the previous curriculum. With these results, for the good education for preventive medicine, each Traditional Korean medicine schools need more preventive medicine faculties and teaching assistants and opening of some required subjects such as Yangsaeng and Qigong. And future studies of the learning process and ongoing development of teaching materials according to the new learning objectives should be undertaken with persistence in order to ensure the progress of preventive medicine education.

비만지표와 혈청지질 및 혈압과의 관련성

고성규,Ko, Seong-Gyu 대한한방내과학회 2000 大韓韓方內科學會誌 Vol.21 No.3

Objective : To assess the relationship and prevalence rate among hypertension, dyslipidemia and the four commenest anthropometric measurements for obesity(body mass index(BMI), waist-hip ratio(WHR), waist circumference(WC) and body fat) in Korean adults. Methods : We studied the cross-sectional association of the anthropometric indicies and hypertension, dyslipidemia in 70 Korean adults. Hypertension was defined as blood pressure ${\ge}160/95$mmHg and classification of JNC IV, Dyslipidemia were defined as total cholesterol ${\ge}200$ mg/dl, HDL-cholesterol ${le}35$ mg/dl, LDL-cholesterol ${\ge}160$ mg/dl, triglyceride ${\ge}200$ mg/dl. Infromations on life-style factors were obtained from personal interview. Results : BMI and WHR, BMI and WC, BMI and Fat(%), WHR and WC, WC and Fat(%) had high partial correlation coefficients after age adjustment. BMI and Systolic Blood Pressure had r=0.385 coefficients, WHR and HDL-cholesterol had r=-0.360 coefficients. All four anthropomtric indicies and hypertenstion groups by JNC IV classsification had signifiant differences in women, but only fat(%) and hypertension had significant difference in men. In women, in the relationship of four anthropomtric indicies and serum lipids, total cholesterol ${\ge}200$ mg/dl group with fat(%) had a signifiant difference for normal cholesterol group, and also the group of HDL-cholesterol ${\le}$ mg/dl with WC had significance. But in men, there were no significant differences in all anthropomtric indicies and serum lipids groups. Conclusions : Korean women are more significant than Korean men in the relationship between anthropometric indicies and serum lipids, or blood pressure. But this study's samples are small, so the results are some different with results of other studies. We should study more specifically about anthropometric indicies and serum lipids, anthropometric indicies and blood pressure with many samples.

대한한방내과학회지에 투고된 논문들의 경향성

고성규,Ko, Seong-Gyu 대한한방내과학회 2002 大韓韓方內科學會誌 Vol.23 No.1

Objective : We analyzed the published and contributed manuscripts of the journal of Oriental Internal Medicine in 2001. Methods : We analysed 120 manuscripts contributed to the editorial board of Journal of Oriental Internal Medicine from January to December 2001. Each manuscript was reviewed by three judges, was reviewed by two editors of the board and who took notes on the coding sheet. The variables of surveying were yes or no of acceptance, total scores, score of each 9 item, the number of writers and institutes, and languages. Statistical methods were used such as descriptive analysis, independent samples t test, ANOVA, multiple composition, multivariate logistic regression analysis. Results : THe odds ratio in vivo, in vitro study for clinical study were 5.15(95% CI 1.93-13.71), and case series or case-control study for case report were 3.78(95% CI, 1.28-11.19) Conclusions : Although in vivo, the in vitro study had more possibility of acceptance to publish than the clinical study, we should identify that these results are assuming high inter-reviewer reliability.

허혈경계부의 감소를 보인 뇌졸중 환자에 대한 증례보고

고성규,Ko, Seong-Gyu 대한한방내과학회 2000 大韓韓方內科學會誌 Vol.21 No.2

I have treated one ischemic stroke patient in acute stage with Seonghyangjeonggi-san, and observed remarkable reduction of the size ischemic portion in brain CT, notable improved motor power of patient. So I report this case of stroke patint. The ischemic penumbra, simply stated, is the part of the brain that is sandwiched brain regions committed to die and those that receive enough blood to communicate. Therefore, it is ischemic brain tissue that has just enough to communicte and function. The life expectancy of the penumbrais short. Although the penumbra is an elegant concept, in practice, it has been a difficult one to exploit. Up to now, a lot of research worker have tried to develop the method to make a accurate diagnosis. and then we know that PET and Xenon CT is available for the diagnosis for the ischemic penumbra. But those are not perfect to diagnose of penumbra. The case in my case report was confirmed as ischemic penumbra with CT. I know that CT is not prefect to diagnose penumbra, but I just want to raise the interest in penumbra of oriental medicine researcher and my report will be benificial to the penumbra researcher.

한의학회지의 뇌졸중 관련논문을 통한 한의학 연구동향과 질적 메타분석

고성규,Ko, Seong-Gyu 대한한방내과학회 2001 大韓韓方內科學會誌 Vol.22 No.2

Objective : There have not been studies on the oriental medicine research trends and qualitative analysis of Korean oriental medicine articles in Korea, particularly in the oriental medicine area. This study's purpose is to appreciate Korean oriental medicine's research trends and assess the quality of the Korean oriental medical journals' level. This study will help upgrade Korean oriental medical journals. Method : We found 93 stroke-related articles in the Journal of Korean Oriental Medicine, published between 1980(Volume 1) and 2001(Volume 45). We surveyed the institutes involved in each study, and the number of people in each study. We seperated by epidemiological study design, the studies into categories. Campbell and Stanley's study design into 6 categories, statistical methods into 13 categories. Next, we assessed the 41 articles by a checklist, which had 10 categories. The quality score was analyzed by survey variables over the period, which were divided by the date of publication: the 1980s, the first half of the 1990s, second half of the 1990s and 2000s. Results : 46.3% od the studies didn't use statistical methods. 56.1%, were case series studies by classification of epidemiological study design, and 53.6% were one-shot case studies designed by Campbell and Stanley's study design. The quality score was 58.33 point 60 is average. In quality level by Browman GP etc.'s, 83.0% of the studies were included in V levels. But, the quality scores were significant by presence of reviewer system, statistical method's usage, and over the period. Conclusion : The Journal of Korean Oriental Medicine needs to improve the quality its articles. To improve the quality of oriental medicine related articles, the following are necessary: working together, joint work of inter-educational system, strengthening of reviewer system, use of statistical methods, and consulting to the expert of research at the stage of study design.

뇌졸중환자의 연하장애에 관한 임상적 연구 (1)

고성규,Ko, Seong-Gyu 대한한방내과학회 1997 大韓韓方內科學會誌 Vol.18 No.1

Dysphagia generally has a good prognosis after stroke involving cerebral hemisphere or braibstem, but it could have serious consquence with dehydration leading to haemoconcentration, renal failure and aspiration leading to pneumonia. This preliminary report was written for main report. The main report will be written to give an objective guide post of management and treatment in stroke patient with dysphagia. The objective guide posts were follows as, 1. Close examination for relationship between dysphagia in stroke patients and other neurological deficits 2. Influence on the prognosis of dysphagia in stroke patients by the grade of dysphagia at admission time. 3. The realtionship between the site and size of brain damage and the grade and prognosis of dysphagia 4. The frequency and prognosis of dysphagia in stroke patients according to sex and age. 5. The rate and speed of recovery with dysphagia after stroke. 6. Frequency and process of complications, aspiration pneumonia, weight loss, sore, in stroke patient group with dysphagia.

Correlation Analysis with Modified Barthel Index and Motor Assessment Scale in Stroke Patients

고성규,전찬용,Ko, Seong-Gyu,Jun, Chan-Yong The Society of Korean Medicine 1999 대한한의학회지 Vol.20 No.1

연구목적 : 뇌졸중환자에 기능회복도의 측정을 위해 가장 신뢰도가 높은 MBI에 대해서 순수하게 뇌졸중환자의 운동기능평가만을 위해 고안된 MAS의 상관성을 각 기간별로 분석하여 MAS의 운동기능평가척도로서의 객관성에 대해 연구한다. 또 한편으로 경과시간에 따른 운동기능 회복도의 차이를 전체그룹과 사상그룹에서 평가한다. 연구방법 : 1998년 1월부터 1998년 6월까지 6개월에 걸쳐 상지대학교 한의과대학 부속한방병원 내과에 입원하여 뇌졸중으로 진단된 환자 중 의식과 언어상태가 명료한 32명을 대상으로 하였다. 입원직후 사상의학과에 의뢰하여 QSCCII 시스템에 의하여 체질진단을 받은 후 본원 운동기능평가실에서 입원직후, 입원 후 2주와 4주 등 3회에 걸쳐 Modified Barthel Index(MBI)와 Motor Assessment Scale(MAS)을 시행하였다. 각 환자에 대한 검사는 2명의 한방순환기내과 전문의와 전공의에 의해 환자에 대한 사전 정보 없이 이루어졌다. 연구결과 : 통계처리는 상관분석을 위해서는 Pearson correlation coefficient, 사상체질에 있어서 각 경과시간에 따른 점수변화는 Repeated ANOVA, 일반적특성 분석에는 Descriptive analysis가 사용되었고, 프로그램은 SPSS/PC+ 7.5 version을 사용하였다. 1. 뇌졸중 환자의 사상의학적인 분포는 태음인이 56.3%로 가장 많았고, 소양인이 28.1%, 소음인이 12.5%, 태양인이 3.1%이었으며, 연령별로는 50대가 32.6%로 가장 많았으며, 평균연령은 60.9세였다. 2. 경과시간에 따른 사상체질간의 MBI, MAS 평균점수변화는 MBI, MAS 모두 반복측정 분산분석 결과 입원당시와 2주 후, 입원당시와 4주 후에서 모두 P<0.001의 범위에서 통계학적으로 유의하게 증가하였고, 경과시간과 사상체질간의 교호작용은 없었다. 3. MBI, MAS 모두 각 항목과 기능별 분류군에서도 경과시간에 따른 평균점수의 변화는 P<0.001 범위에서 통계학적으로 유의하게 증가하여 한방치료의 효과가 있음을 보여주었다. 4. MBI와 MAS의 경과시간별 Pearson 상관성 분석결과 입원당시의 MBI와 입원당시의 MAS에서, 2주 후의 MBI와 입원당시, 2주 후, 4주 후의 MAS에서, 4주 후의 MBI와 입원당시, 2주, 4주 후의 MAS에서 모두 높은 상관성을 보여, 두 평가방법 간에는 상관성이 높다고 본다.

웹기반 교육에 관한 연구

고성규,신용철,Ko, Seong-Gyu,Shin, Yong-Cheol 대한예방한의학회 2007 대한예방한의학회지 Vol.11 No.2

The Internet is increasingly changing our lives and enables the ordinary person to have access to never-ending quantities of information and knowledge. Technology and the Internet empower individuals and facilitate a more active role in the educational process. The webcast is a media file distributed over the Internet using streaming media technology and is used extensively in the commercial sector for investor relations presentations, in e-learning, and for related communications activities. And relating to computers, technology, and news are particularly popular and many new shows are added regularly. Especially e-learning is a general term used to refer to computer-enhanced learning and has the ability to level the learning playing field. So that the e-learning experience will be second nature to the growing Internet population. And this study intends to develop web-based education.

암환자의 방사선 요법 및 화학요법 치료 후 발생된 백혈구감소증의 치료에 관한 중의학 임상논문의 문헌적 고찰

고성규,정용수,부송아,박경훈,선승호,Ko, Seong-Gyu,Jung, Yong-Soo,Bu, Song-Ah,Park, Kyoung-Hoon,Sun, Seung-Ho 대한한방내과학회 2002 大韓韓方內科學會誌 Vol.23 No.1

Objective : We conducted this study to analyze some of the trends of treatments from the recent Chinese medical journals and contribute them to the oriental medical experiments and clinical research for the future. Methods : By referring to the Chinese medical journals that were published in China from 1999 to March, 2002, we analyzed the effective rates on frequency, methods, medical treatment, and diseases. Result : The average effective rate was 90.93%, which was very high. Lately, there have been no big changes in the methods of treatment. The methods of coordinating stomach-Qi, supplying Yin element, replenishing bone marrow, tonifying essence of life, and removing blood stasis are used by means of reinforcing Qi, producing blood, tonilying spleen, and replenishing the kidney. Conclusions : The decreased in bone marrow and leucopenia, and the side effects of radiotherapy and chemotherapy were more effectively treated when we used Korean oriental medical treatments. In addition, more Korean oriental medical experiments and clinical studies are needed in Korea, in the future.

대식세포의 oxLDL 생성에 미치는 강활속단탕의 영향

고성규,정용수,선승호,Ko Seong-Gyu,Jeong Yong-Su,Sun Seung-Ho 대한한방내과학회 2003 大韓韓方內科學會誌 Vol.24 No.2

Objective : As a link in chain of research to confirm the oriental medical prescription which has the anti-atherosclerosis effects, this research evaluated the effects on the macrophage-related factors by using KanghwalSokdantang(KS). Methods : In order to perform this research, we have evaluated the effects on the oxLDL formation from the macrophages, the nitric oxide formation, and the oxidation of macrophages. Thus, with this evaluation, we have investigated the applicapability on the artherosclerosis. Results : KanghwalSokdantang has showed a noticeable reduction of protein oxidation in the process of oxLDL formation, has remarkably restrained phospholipid peroxidation, an index to estimated the phospholipid oxidation and reduction that are formed in the process of macrophage's oxLDL formation, and has increased the nitrite concentration noticeably in the LDL-dealing macrophages. By increasing the survival rate of macrophages, KanghwalSokdantang has restrained the cellular damages. KanghwalSokdantang is ineffective on the LDH outflow from damaged cells. $1{\mu}g/ml$ KanghwalSokdantang sample has increased acid phosphatase activity remarkably. Conclusion : KanghwalSokdantang has the possibility to be used in the prevention and treatment of atherosclerosis, which is formed by the oxLDL formation of macrophages.