노인 생활습관 설문서의 신뢰도 및 타당도 평가 연구

박병주,김대성,구혜원,배종면,Park, Byung-Joo,Kim, Dae-Sung,Koo, Hye-Won,Bae, Jong-Myon 대한예방의학회 1998 예방의학회지 Vol.31 No.1

부산지역의 공무원 및 사립학교 교직원 의료보험관리공단의 피부양자중 65세 이상인 16,524명에 대하여 생활습관에 대한 설문서를 발송하여 이중 9,139명으로부터 설문서를 회수하였다. 본 연구는 여기에 사용된 설문서의 신뢰도를 평가하기 위하여 이중 200명을 단순 무작위 표본추출하여 다시 설문서를 발송하였으며 회수된 설문서 110건에 대하여 항목별, 응답자별 신뢰도를 평가하였다. 1) 본인이 두 번 모두 응답한 경우에 있어서 대부분의 항목이 0.6이상의 신뢰도 계수를 가졌으나, '산보', '정원일', '맨손체조', '활동상태'와 같은 육체적 활동과 관계 있는 항목의 일부에 있어서는 낮은 신뢰도를 보였다. 반면 현재의 '현재까지의 흡연여부', '현재까지의 흡연량', '3년전의 흡연여부', '지난 1년간의 음주량', '3년전의 음주량' 등의 흡연 및 음주와 관련있는 항목과 '키', '몸무게', '체격그림'과 같은 체격과 관련 있는 항목, '폐경나이', '낳은 아이의 수'와 같은 산부인과력의 일부항목 등에서는 높은 신뢰도를 보였다. 2) 한번은 본인이 다른 한번은 대리응답자가 응답을 한 32건에 대하여 신뢰도 계수를 계산하였다. 두 번 다 본인이 응답한 경우에 비하여 신뢰도 계수가 크게 하락한 항목은 '청소', '주관적 건강상태', '첫아이를 낳은 나이', '폐경나이', '맵게 먹는 정도', '육식선호정도', '야간수면시간' 등이었으며 본인이 두 번 응답한 경우에 비하여 본인-대리응답에서 신뢰도계수가 더 높게 나타난 항목은 '3년전의 음주여부', '3년전의 홉연량', '산보', '정원일', '활동상태' 등이었다. 3) 응답자의 성별 타당도 분석결과 식생활과 관련된 항목에서는 여자보다 남자에서 타당도가 높았고, '약수터 가기', '정원일', '산보' 등의 일일 활동과 관련된 항목과 음주, 흡연 등의 항목에서는 여자에서 타당도가 높았다. 4) 대리응답자가 가질 수 있는 비뚤림을 파악하기 위하여 쌍체분석을 실시하였다. 분석대상은 본인과 자녀가 번갈아 응답한 19건에 제한하였다. '청소'와 '부엌일'에서 본인의 응답이 자녀의 응답보다 빈도가 더 높은 것으로 나타났다. '키'항목에서는 자녀보다 본인의 응답이 키가 더 작은 것으로 나타났다. The study was done to determine the reliability and validity of a life style questionnaire for the elderly. The questionnaires were sent to 16,524 elderly people who were beneficiaries of Korean Medical Insurance Corporation in Pusan. Among the completed 9,139 questionnaires, 200 were randomly sampled and retested. finally, 110 duplicates were collected. Weighted kappa-value and Pearson correlation coefficients were estimated to measure the reliability. Validity coefficient was estimated by using reliability coefficient. In self-self responses, reliability coefficients of the most of items were over 0.6 except some physical activity related item. Relatively high reliability was observed in smoking, alcohol related items and anthropometric items. In self-proxy responses, most of the physical activity related items were found to be less reliable than self-self responses. Smoking and alcohol related items were consistently reliable. Male showed higher validity in food related item than female. On the other hand, some of the physical activity related items and smoking and alcohol related items were less valid in male than female. With regard to bias of proxy respondents, offsprings tended to underestimate the frequency of house cleaning' and 'kitchen work' and overestimate the height of them. In conclusion, the life style questionnaire was found to be reliable in the most of items. But, some items related with physical activity were found to be somewhat less reliable. Sexual difference on the validity was identified in some items. With regard to bias of proxy respondents, offsprings tended to have bias in part of items of housework and anthropometry.

반복 발작성 긴장성 두통을 호소하는 소양인(少陽人) 태음인(太陰人) 치험 2례

박병주,신현상,강미정,이지원,장현수,이준희,이의주,고병희,Park, Byung-Joo,Shin, Hyun-Sang,Kang, Mi-Jeong,Lee, Ji-Won,Jang, Hyun-Su,Lee, Jun-Hee,Lee, Eui-Ju,Koh, Byeong-Hee 사상체질의학회 2010 사상체질의학회지 Vol.22 No.2

1. Objectives: This study reports two cases of repetitive episodic tension-type headache patients who were each constitutionally typed as the Taeeum type and the Soyang type and respectively treated with Yanggyeoksanhwa-tang and Galgeunhaegi-tang. 2. Methods: The patients' subjective and objective symptoms were observed daily, and the VAS scores for the main symptoms were recorded daily throughout hospitalization period. When deemed necessary, other assessment tools were engaged (Migraine-Specific Quality of Life questionnaire, Migraine Disablity Assessment questionnaire, Headache Impact Test-6, etc.). 3. Results: The Soyang Type patient's headache improved by the end of hospitalization, with a dramatic drop in the VAS score from VAS 10 to VAS 2. The Taeeum Type patient's headache also showed improvement, with an equally dramatic decrease in the VAS score from VAS 10 to VAS 2. 4. Conclusion: Although the two patients were experiencing the same symptoms of repetitive episodic tension-type headache, they were each given different medicinal interventions in accordance to their respective constitutional types. This series of cases is notable in that the two widely different medications (Yanggyeoksanhwa-tang and Galgeunhaegi-tang) were applied to specifically conforming pathologies (the Sogal symptomatology and the Ganyeol symptomatology, respectively) to produce equally dramatic improvements.

한국 여성에서의 자궁경부암 발생률

박병주,이무송,안윤옥,최영민,주영수,유근영,김헌,유하성,박태수,Park, Byung-Joo,Lee, Moo-Song,Ahn, Yoon-Ok,Choi, Young-Min,Ju, Yeong-Su,Yoo, Keun-Young,Kim, Hun,Yew, Ha-Seung,Park, Tae-Soo 대한예방의학회 1996 Journal of Preventive Medicine and Public Health Vol.29 No.4

To estimate the incidence of uterine cervix cancer among Korean women, we have conducted a study using the claim data on the beneficiaries of Korea Medical Insurance Corporation (KMIC). All medical records of the potential cases with diagnosis of ICD-9 180, 181, 182, 199, 219, 233 in the claims sent by medical care institutions in the whole country to the KMIC from January 1988 to December 1989, were abstracted and Gynecology specialist reviewed the records to identify the new cases of uterine cervix cancer among the potential cases during the corresponding period. Using these data, the incidence of uterine cervix cancer among Korean women was estimated as of July 1, 1988 to June 30, 1989. The crude rate was estimated to be 17.34(95% CI: $16.76\sim17.92$) per 100,000 and the cumulative rates for the ages $0\sim64\;and\;0\sim74$ were 1.7% and 2.2%, respectively. The age-adjusted rate for the world population was 19.93 per 100,000 which was higher than those of other Asian countries including China and Japan in $1983\sim1987$. The truncated rate for ages $35\sim64$ was 52.05 per 100,000 which was one of the highest in the world. With increasing age, the incidence rate increased to 78.11 per 100,000 in women aged $55\sim59$ years, then it decreased in the older groups. This finding suggests that detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to inadequate medical care seeking behavior. In the geographical area, the SIR of Jeju province was significantly low but it might be due to statistical unstability by small case numbers.

양격산화탕(凉膈散火湯)의 기원(基源), 변천과정(變遷過程) 및 구성원리(構成原理)

박병주,이준희,이의주,고병희,Park, Byung-Joo,Lee, Jun-Hee,Lee, Eui-Ju,Koh, Byung-Hee 사상체질의학회 2011 사상체질의학회지 Vol.23 No.2

1. Objectives: This paper investigates the origin, the progressive changes and the constructive principles of Yangkyuksanhwa-tang (凉膈散火湯). 2. Methods: Yangkyuksanhwa-tang and other related prescriptions were analyzed in terms of their pathological indications, based on previous literature including "Donguisusebowon Chobongwon (東醫壽世保元 草本卷)", "Donguisusebowon Gabobon (東醫壽世保元 甲午本)", "Donguisusebowon Sinchukbon (東醫壽世保元 辛丑本)" and "Dongmuyugo (東武遺稿)". 3. Results and Conclusion: 1) The Yangkyuksanhwa-tang most likely originates from Sodokeum, Yangkyuksan, Baekho-tang and Indongdeung. 2) Sodoksanhwa-tang introduced in "Donguisusebowon Chobongwon (東醫壽世保元 草本卷)" progressively transformed into Chungyangsanghwa-tang ("Donguisusebowon Gabobon (東醫壽世保元 甲午本)") and ultimately into Yangkyuksanhwa-tang ("Donguisusebowon Sinchukbon (東醫壽世保元 辛丑本)"), a prescription appropriate for usage in the Sangso symptomatology (上消證). 3) Yangkyuksanhwa-tang is composed of 9 herbs. Of these, Schixonepetae herba(荊芥), Ledebouriellae Radix(防風), Forsythiae fructus(連翹), Menthae Herba(薄荷), Gardeniae fructus(梔子) scatter the Hwa-qi(火氣), and Rehmanniae Radix(生地黃), Gypsum fibrosum(石膏), Anemarrhenae(知母) put off the Stomach-heat(胃熱), whereas Lonicerae caulis(忍冬藤) support the prevention of carbunculosis(癰疽).

B형 간염 바이러스 표면 항체 검출을 위한 Passive Hemagglutination (PHA)방법의 정확도에 관한 연구

박병주,Park, Byung-Joo 대한예방의학회 1987 Journal of Preventive Medicine and Public Health Vol.20 No.1

The author investigated the effect of some variables such as age, sex and the experience of past vaccination on the validity of PHA. The changing pattern of the validity with the change of PHA diagnostic criteria, and the relationship between PHA test result and RIA Ratio Unit were also studied. The results obtained were as follow; 1) No statistically significant difference was found in sensitivity, specificity and negative predictability by sex, but positive predictability was significantly higher in male than that in female. 2) Positive predictability was shown to become higher with the increase of age and nagative predictability was found to be significally different among age groups, but no statistically significant difference was found in sensitivity and specificity by age group. 3) Significantly low specificity and high positive predictability were found in past vaccined group, but no statistically significant difference was found in sensitivity and negative predictability between past vaccined group and non-vaccined group. 4) False negative cases by PHA were found to be the weak positive reactors by RIA and false positive rate of PHA was as high as 46.3 per cent. 5) Sensitivity and specificity of PHA at the diagnostic criteria of HBsAb titer 1:2 were 98.4% and 53.8% respectively, but after increasing the HBsAb titer to 1:64 as the diagnostic criteria the results were 60.0% and 95.6% respectively.

사상체질(四象體質)에 따른 주관적(主觀的) 식욕(食慾) 비교(比較) 연구(硏究)

박병주,이의주,고병희,이준희,Park, Byung-Joo,Lee, Eui-Ju,Koh, Byung-Hee,Lee, Jun-Hee 사상체질의학회 2012 사상체질의학회지 Vol.24 No.1

1. Objectives : This investigation compares the subjective appetite ratings across male groups of different Sasang constitutional types. 2. Methods : We recruited 36 male participants aged 20-36 with BMI 18.5-30. The subjective appetite ratings was assessed using VAS before and after standard meal.(6 time points : 30 Minutes Pre-prandial, Immediately before Meal, 15, 30, 60, 120 Minutes Post-prandial) 3. Results : In comparison of subjective appetite ratings between Sasang constitutional types, Soyang-type showed a pattern like high appetite, high hunger, low satiety, high 'how much I can eat', Soeum-type showed a pattern like low appetite, low hunger, high satiety, low 'how much I can eat', and Taeeum-type showed a pattern like low appetite, low hunger. 4. Conclusions : The results of this study suggest that the subjective appetite ratings could be different across different Sasang constitutional types.

암의 집단발병에 관한 역학조사방법

박병주,배종면,안윤옥,유근영,Park, Byung-Joo,Bae, Jong-Myon,Ahn, Yoon-Ok,Yoo, Keun-Young 대한예방의학회 1994 Journal of Preventive Medicine and Public Health Vol.27 No.3

The survey methods for confirming the epidemicity and identifying the possible causes of the cancer epidemic can be different from those for infectious diseases. The procedure for confirming whether the outbreak is epidemic or not is quite different. Household survey for identifying cancer cases and residents actually living at the area should be done. Hospital survey for medical record review should be performed to identify all cancer cases among the residents of the outbreak area and confirmig the final diagnoses of the cancer cases. Comparing the level of cancer incidence or mortality with other areas can be done by using Poisson distribution, or calculating SIR (Standard Incidence Ratio) from cumulative incidence rates. Case-control study can be conducted to identify the etiologic, factors of the cancer epidemic and to establish strategy for preventing further recurrence of the outbreak.

팔물군자탕(八物君子湯)의 기원(基源), 변천과정(變遷過程) 및 구성원리(構成原理)

박병주,권진혁,이준희,이의주,고병희,Park, Byung-Joo,Kwon, Jin-Hyuk,Lee, Jun-Hee,Lee, Eui-Ju,Koh, Byung-Hee 사상체질의학회 2010 사상체질의학회지 Vol.22 No.4

1. Objectives This paper investigates the origin, the progressive changes and the constructive principles of Palmulgunja-tang (八物君子湯). 2. Methods Palmulgunja-tang and other related prescriptions were analyzed in terms of their pathological indications, based on previous literature including "Donguisusebowon Chobongwon (東醫壽世保元 草本卷)", "Donguisusebowon Gabobon (東醫壽世保元 甲午本)", "Donguisusebowon Sinchukbon (東醫壽世保元 辛丑本)" and "Dongmuyugo (東武遺稿)". 3. Results and Conclusions 1) The Palmulgunja-tang most likely originates from Paljin-tang introduced in "Donguisusebowon Chobongwon (東醫壽世保元 草本卷)". Paljin-tang progressively transformed into Seungyangpalmul-tang ("Donguisusebowon Gabobon (東醫壽世保元 甲午本)") and ultimately into Palmulgunja-tang ("Donguisusebowon Sinchukbon (東醫壽世保元 辛丑本)"), a prescription appropriate for usage in the Ulgwang symptomatology (鬱狂證). Also, Seungyangikgi-tang in "Donguisusebowon Sinchukbon (東醫壽世保元 辛丑本)" can be presumed to have been affected by Seungyangpalmul-tang. 2) The variational prescriptions (變方) of Palmulgunja-tang shows increasing Seungyang (升陽) effect in order of Baekhaogunja-tang, Sipjeondaebo-tang, Palmulgunja-tang, and Doksampalmul-tang. 3) Palmulgunja-tang is composed of 8 herbs. Of these, Paeoniae Radix Alba (白芍藥), Glycyrrhizae Radix(甘草), Angelicae gigantis Radix (當歸), and Cnidii Rhizoma (川芎) fortify the Soeumin Spleen Element (脾元). Ginseng Radix (人蔘) and Astragali Radix (黃?) support the ascension of Yang, whereas Atractlodis Rhizoma White (白朮) and Citrus unshiu (陳皮) encourage the descension of Yin.

산소분압(酸素分壓)에 따른 Carboxyhemoglobin의 해리양상(解離樣相) -성인혈(成人血)과 태아혈(胎兒血)의 비교(比較)-

박병주,Park, Byung-Joo 대한예방의학회 1982 예방의학회지 Vol.15 No.1

산모(産母)와 태아(胎兒)에서의 CO 배출양상(排出樣相)의 차이(差異)가 hemoglobin의 CO와의 결합력(結合力)의 차이(差異)에서 기인(起因)된 것인지의 여부(與否)를 산소분압(酸素分壓)에 따른 HbCO의 해리양상(解離樣相)으로써 규명(糾明)하고 이를 토대(土臺)로 임신부(姙娠婦) 및 영아가 CO에 중독(中毒)되었을 때의 적절(適切)한 산소치료방식(酸素治療方式)을 모색(模索)하고자 본(本) 실험(實驗)을 실시(實施)하여 다음과 같은 성적(成績)을 얻었다. 1. 성인혈(成人血)과 태아혈(胎兒血)의 total hemoglobin량(量)은 각각(各各) $16.1{\pm}0.50gm%,\;15.7{\pm}0.32gm%$였으며 fetal hemoglobin 비율(比率)은 각각(各各) $1.2{\pm}0.15%,\;72.7{\pm}3.01%$ 였다. 2. 성인혈(成人血)과 태아혈(胎兒血)을 100% HbCO로 포화(飽和)시킨 뒤 일반대기(一般大氣), 100% $O_2$, 3기압산소(氣壓酸素)에 30분간(分間) 폭로(曝露)시킨 직후(直後)의 혈중(血中) HbCO 포화도(飽和度)는 성인혈(成人血)에서 각각(各各) 96.7%, 70.9% 및 52.8%였으며 태아혈(胎兒血)에서 각각(各各) 98.5%, 76.1% 및 62.2%로 감소(減少)하여 3기압산소(氣壓酸素)에서 가장 현저(顯著)한 감소(減少)를 보여 HbCO의 해리(解離)는 산소분압(酸素分壓)에 비례(比例)함이 확인(確認)되었으며 또 전(全) 실험군(實驗群)에서 성인혈(成人血)보다 태아혈(胎兒血)의 HbCO 해리(解離)가 늦은 양상(樣相)을 보였다. 3. 실험군(實驗群)에 대(對)한 각(各) 산소분압별(酸素分壓別) 폭로(曝露)가 끝난 후(後) $36.5^{\circ}C$의 일반대기하(一般大氣下)에서 시간경과(時間經過)에 따른 성인혈(成人血)과 태아혈중(胎兒血中) HbCO의 해리양상(解離樣相)은 거의 비슷하게 완만(緩慢)하였다. 4. 이상(以上)의 소견(所見)으로 미루어 볼 때 임신부(姙娠婦)의 CO 중독(中毒)은 산모(産母)보다 태아(胎兒)에서 더 큰 위해(危害)를 초래(招來)할 가능성(可能性)이 크며 또 HbF의 구성점유율(構成占有率)이 높은 6개월(個月) 이하(以下)의 영아에서도 그 위해도(危害度)가 클 것으로 간주(看做)된다. 따라서 임신부(姙娠婦) 또는 생후(生後) 6개월(個月) 이하(以下)의 영아가 CO 중독(中毒)되었을 때는 고압산소요법(高壓酸素療法)이 효과적(效果的)인 치료법(治療法)으로 보이며 그 치료시간(治療時間)을 성인환자(成人患者)에 있어서의 그것보다 좀 더 길게하는 것이 CO 중독(中毒)에 의한 위해(危害)를 감소(減少)시켜 줄 것으로 기대(期待) 된다. Breslau's report on the two stillbirths induced by illuminating gas poisoning made many investigators explore the hazards. of carbon monoxide(CO) poisoning to pregnancy. The pregnant woman, her fetus, and the newborn infant have been identified to be particularly vulnerable to CO even in low concentration. Several factors, such as placental barrier, membrane resistance of maternal and fetal red blood cells etc., were considered to be related to the delayed elimination of CO from fetus. Slower elimination of CO from fetus than from mother was confirmed in several in vivo studies. But there are few studies which have confirmed the difference of carboxyhemoglobin (HbCO) dissociation in adult and fetal bloods. Author investigated the effects of hemoglobin itself on the elimination of CO from mother and fetus. By observing the difference of CO dissociation from adult and fetal hemoglobin at the various partial pressures of oxygen, the author tries to suggest the base of the proper treatment measure for the CO poisoning of pregnant woman and newborn infant. The results were as follows: 1. The total hemoglobin amounts of adults and fetal bloods were $16.1{\pm}0.50gm%\;and\;15.7{\pm}0.32gm%$, respectively. The fetal hemoglobin proportions in adult and fetal bloods were $1.2{\pm}0.15%\;and\;72.7{\pm}3.01%$, respectively. 2. Adult and fetal bloods saturated by CO to 100% HbCO were exposed to ambient air$(21%\;O_2),\;100%\;O_2\;and\;3\;ATAO_2$. After 30 minutes exposure, the HbCO saturations of adult blood were 96.7%, 70.9%, and 52.8%, respectively, and those of fetal blood were 98.5%, 76.1%, and 62.2%, respectively. HbCO dissociation was proportional to the partial pressure of oxygen and the most marked dissociation was shown under 3 ATA $O_2$, HbCO dissociation of fetal blood was slower than that of adult blood in all conditions. According to the above results, it is possible that CO poisoning make more serious damage to the fetus and newborn infant than to the adult due to the delayed dissociation of HbCO. Thus in the treatment of CO poisoning of pregnant woman and newborn infant, hyperbaric oxygen therapy seems to be the most eflective treatment measure, but the duration of hyperbaric oxygenation should be lengthened accordingly.

급성일산화탄소중독(急性一酸化炭素中毒)의 신경학적(神經學的) 후유증(後遺症)에 관(關)한 역학적(疫學的) 연구(硏究)

박병주,조수헌,안윤옥,신영수,윤덕로,Park, Byung-Joo,Cho, Soo-Hun,Ahn, Yoon-Ok,Shin, Young-Soo,Yun, Dork-Ro 대한예방의학회 1984 Journal of Preventive Medicine and Public Health Vol.17 No.1

There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 to February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% $O_2$ group(38.0%) 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation ana all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.