정신질환 환자에 대한 전산화 인지재활치료의 효과성 분석: 체계적 고찰 및 메타분석

송승일 ( Song Seung-il ),이선민 ( Lee Sun-min ),김환 ( Kim Hwan ),송정헌 ( Song Jeong-heon ),박소원 ( Park So-won ),박수향 ( Park Su-hyang ) 대구대학교 특수교육재활과학연구소 2020 특수교육재활과학연구 Vol.59 No.4

본 연구는 전산화 인지재활치료의 필요성과 정신 건강 분야에서의 작업치료사의 참여와 역할에 대한 기초 자료를 제시하고 있으며, 한국보건의료연구원 및 PRISMA 지침을 기반으로 체계적 고찰과 메타 분석 방법을 사용하여 향후 통합된 정신건강 치료서비스를 제공하고 국가 정신 건강을 증진하는 것을 목적으로 한다. 체계적 고찰을 위한 문헌의 질 평가는 공동 저자를 포함하여 작업치료 석사 학위를 가진 10년 이상 임상 경험을 가진 2명의 작업치료사에 의해 Van Tulder 척도를 사용하여 평가되었으며 최종결과는 연구책임자 1명이 검토하였다. 메타분석은 Revman manager 5.3 프로그램을 이용하여 문헌 결과별로 데이터를 입력 및 분석하였으며 표와 그림을 통해 결과를 시각적으로 제시하였다. 본 연구 결과를 통해 전산화 인지재활치료를 적용하여 기존 인지재활치료 한계점 보완과 정신질환 환자 인지기능 개선 효과를 알 수 있었다. 따라서 본 연구의 의의는 정신건강의학 분야에서 전산화 인지재활치료의 효과를 증명하여 통합적인 의료서비스의 제공 및 작업치료사의 역할 확대에 대한 근거자료로써 의미가 있다. This study is presenting basic data on the need for computerized cognitive rehabilitation and the participation of occupational therapist and the expansion of their roles in the field of mental health. This aims to provide integrated mental health treatment services and to promote national mental health. This aims to provide integrated mental health treatment services and to promote national mental health. Based on the NECA and PRISMA guidelines for conducting research through systematic review and meta-analysis methods. The quality evaluation of literature for systematic review was evaluated by two occupational therapists with more than 10 years of clinical experience with master`s degree in occupational therapy, including co-author, using Van Tulder scale, one responsible researcher finally reviewed it. For meta-analysis, the data was input and analyzed separately by literature result using the Revman manager 5.3 program and the results were presented visually through tables and figure. Based on the results of this study, we found that we could supplement the limitations of existing cognitive rehabilitation therapy and clinical usefulness for cognitive improvement effects in patients with mental illness could also be demonstrated. It is meaningful to identify the effects of computerized cognitive rehabilitation treatment in the mental health field and to prepose a high-quality integrated medical provision method by expanding the participation of occupational therapists.

폐쇄성 수면 무호흡증의 외과적 치료

송승일(Seung Il Song),이호경(Ho Kyung Lee) 대한치과의사협회 2014 대한치과의사협회지 Vol.52 No.10

폐쇄성 수면 무호흡증(OSAS)환자의 외과적 치료(surgical treatment)로는 다양한 방법들이 있고 수술 방법의 선택시 여러 인자들을 고려해서 선택해야 한다. 즉, 수술은 폐쇄성 수면 무호흡증(OSAS)을 조절하는데 있어 보존적 치료 (non surgical treatment)의 좋은 대체 방안(alternative chance)이 될 수 있기에, 증상(OSAS)의 주관적(subjective), 객관적(objective) 심각성(severity)을 해부학적 이상(anatomic abnormality) 정도와 연관시켜 적절한 수술법(surgical procedure)을 선택해야 한다. 수술 방법은 한가지 방법을 사용(single level)하는지, 여러 수술 방법을 통합하여 사용(multi level)하는지에 따라 다양하며, 그 예후도 각각 다르다. 중요한 점은 다단계 폐색(multilevel obstruction)이 있는 경우에는 다단계 치료(multilevel treatment) 방법이 가장 추천된다는 것이며, 이는 단지 증상(OSAS)의 심각성(severity)을 기준으로만 평가해서는 안되며 경도나 중등도(mild to moderate)의 환자에서도 필요시 보존적 치료(non surgical treatment)를 시행하기 전에 다단계 외과적 치료(multilevel surgical treatment) 방법을 적극적으로 고려해야 한다. 비록 다단계 치료(multilevel treatment)방법은 상대적으로 짧은 임상 기간을 거쳤지만, 앞으로 지속적인 연구 결과(evidence based data)를 이어간다면, 개개 환자에 맞는 최적의 치료 방법(optimal surgical intervention)을 제시할 수 있을 것이다. Obstructive sleep apnea syndrom(OSAS) is defined by total or partial collapse of the upper airway during sleep. In the presence of specific anatomic features, OSAS is potentially amenable to surgical treatment. Initially, the only treatment available for these patients was a tracheotomy that bypassed the obstruction and resulted in a 100% cure. However, this was not readily accepted by most patients, and surgical methods other than tracheotomy were developed to successfully maintain adequate upper airway patency during sleep by comparing to postoperative polysomnography(AHI,RDI etc). In this paper, I would like to provide an overview of some of the multilevel surgical techniques available for treating OSAS as well as the necessary preoperative considerations.

게임 프로그램이 뇌졸중 환자의 우울과 자기효능감, 재활동기에 미치는 영향

송승일 ( Song Seung Il ),이종민 ( Lee Jong Min ) 대구대학교 특수교육재활과학연구소 2014 특수교육재활과학연구 Vol.53 No.3

본 연구는 게임 프로그램이 뇌졸중 환자의 우울과 자기효능감, 재활동기에 미치는 영향을 알아보고자 하였다. 대구 소재 K병원에서 입원하여 치료를 받는 50명의 뇌졸중 환자를 대상으로 실험군과 대조군 각각 25명씩 무작위로 배분하였다. 실험군은 게임 프로그램을 적용하였고, 대조군은 작업치료 중재를 적용하였다. 치료 중재 전ㆍ후의 우울을 비교하기 위하여 우울척도(Beck Dpression Inventory; BDI)를 시행하였고, 자기효능감을 비교하기 위하여 일반적 자기효능감 척도와 구체적 자기효능감 척도를 시행하였으며, 재활동기를 비교하기 위하여 재활동기 척도를 시행하였다. 실험군과 대조군의 치료 중재 후 뇌졸중 환자의 우울은 감소하였고, 자기효능감과 재활동기가 향상되었으며, 실험군이 대조군에 비해 우울이 감소하였고, 자기효능감과 재활동기가 향상되었다. 뇌졸중 환자를 위한 치료적 활동으로 게임을 적용한다면 환자의 심리사회적 문제를 해결하는데 도움이 될 것이라 사료되고, 이를 통해 뇌졸중 환자의 성공적인 재활을 위해 작업치료와 더불어 임상에서 유용하게 적용될 수 있을 것이다. To purpose of the this study was to investigate the effect of game program on depression and self-efficacy, rehabilitation motivation for patients with stroke. fifty stroke patients were participated voluntarily and were assigned randomly into the experimental and control groups. The experimental group formed game program and the control group performed occupational therapy. To compare depression before and after intervention we undertook Beck Depression Inventory and performed Self-efficacy scale and Rehabilitation scale for comparing self-efficacy, rehabilitation motivation. The result of the present study was experimental group and control group presented significant differences before and after intervention on depression and self-efficacy, rehabilitation motivation. And the experimental group demonstrated more improve than control group in depression and self-efficacy, rehabilitation motivation. Therefore, when applying a game program for therapeutic activities for stroke patients, They are believe to help resolve psychosocial problems of the patient, This will be usefully applied in clinical and occupational therapy for the successful rehabilitation of stroke patients.

구강암 발암과정에서 genistein의 혈관형성 억제에 관한 연구

송승일(Seung-Il Song),김명진(Myung-Jin Kim) 대한구강악안면외과학회 2004 대한구강악안면외과학회지 Vol.30 No.5

Angiogenesis inhibition is major concern to cancer chemotherapy and many studies about compound inhibiting angiogenesis is in progression. The long-known preventive effect of plant-based diet on tumorigenesis and other chronic diseases is well documented. Especially soy extract, genistein, is known to be potent angiogenesis inhibitor and prevent development and progression of tumor. In the present study, the effect of angiogenesis on tumorigenesis and chemopreventive effect of genistein by angiogenesis inhibition in hamster buccal pouch oral carcinigenesis model induced by 7.12-dimethylbenza(a)nthracene (DMBA) was studied. Forty eight Syrian Golden young adult hamsters (150-200 gm) were divided into two groups. In control group, 0.5% DMBA in heavy mineral oil was applied to hamster buccal pouch three times a week and in experimental group, 0.1 mg of genistein is administered orally everyday in addition to DMBA application. The animals were euthanized from 2 weeks to 16 weeks with interval of 2 week. H&E staining and immunohistochemistry was performed to evaluate microvessel density by using factor VIII-related antigen and avidin-biotin technique. Microvessels per area was quantified and compared between control and experimental group statistically. The results were as follows. 1. Microvessel density was increased time dependently in both groups and especially the increase was significant from 12 weeks to 16 weeks. 2. When comparing both group, the experimental group showed significantly low microvessel density than control group in 12 weeks (p=0.043), 14 weeks (p=0.050), 16 weeks (p=0.037). Based on these results, it was concluded that genistein influenced oral carcinogenesis by angiogenesis inhibition.

Outfracture osteotomy sinus graft technique의 유용성에 관한 임상적 고찰

송승일,정혜린,김형모,이정근,Song, Seung-Il,Jeong, Hye-Rin,Kim, Hyung-Mo,Lee, Jeong-Keun 대한구강악안면외과학회 2009 대한구강악안면외과학회지 Vol.35 No.5

Purpose: The purpose of this study was to evaluate the feasibility of the outfracture osteotomy sinus graft technique with the evaluation of 5-year survival rate of the implants placed in the atrophic edentulous posterior maxillary area. Materials and methods: One hundred and thirteen cases of 96 patients who visited our center from Aug 2004 to July 2009 and were diagnosed as atrophic edentulous maxillary alveolar ridge, were selected and underwent augmentation sinus surgery with outfracture osteotomy technique. Feasibility of the outfracture osteotomy technique was investigated with clinical and radiographic evaluation to assess the survival rate of the total dental implants in augmentation sinus surgery of this new kind. Total fixture number available in follow-up period was 179, in which the lost 10 patients were excluded out of 96 patients. Results: Five-year cumulative survival rate was 97.2% with 5 failures of total 179 fixtures. The average follow-up period was 29 and a half months, with the minimum and maximum follow-up periods of 4 months 21 days and 59 months 14 days, respectively. Conclusion: Traditional infracture technique is a popular method for an augmentation sinus surgery. The authors modified this classical method by outfracturing and readapting the bony window after sinus graft, with excellent treatment results evidenced by high survival rate of 97.2% (174 out of 179 fixtures), which proves the feasibility of the newly-designed outfracture osteotomy sinus graft technique.

거대설 치료를 위한 혀 중앙부 절제술 :

정일혁(Il-Hyuk Chung),송승일(Seung-Il Song),김은석(Eun-Seok Kim) 대한구강악안면외과학회 2003 대한구강악안면외과학회지 Vol.29 No.3

Macroglossia can cause dentomusculoskeletal deformities, instability of orthodontic and orthognathic surgical treatment, and create masticatory, speech and airway management problems. To determine whether a reduction glossectomy is necessary, it will important to identify the signs and symptoms of macroglossia. Development of dentoskeletal changes directly related with tongue size, such as an anterior open bite or a Angle Class III malocclusion tendency, would indicate that reduction glossectomy may be beneficial. For reduction glossectomy, several techniques have been reported. However, in most techniques the tip of tongue is removed. So its excision causes the loss of most mobile and sensitive portion of the tongue, and creates ankylosed, globular tongue. To avoid such problems, central tongue reduction technique have been proposed. This article will introduce central tongue reduction for anterior openbite case associated with macroglossia.

한국 정신질환자에서의 자살시도와 인터넷 중독 간의 연관성에 관한 환자-대조군 연구

손태혜,송승일,권국주,지현승,최광연,Sun, Tai hui,Song, Seung Il,Kweon, Kukju,Chee, Hyun Seung,Choi, Kwang-Yeon 대한불안의학회 2021 대한불안의학회지 Vol.17 No.2

Objective : Current study investigated the association between internet addiction and suicidal attempts in psychiatric patients. Methods : Patients who visited emergency department or psychiatry outpatient unit of Chungnam National University Hospital from January 2020 to July 2021 were included in this study. Total of 192 participants, 96 suicidal attempt cases and 96 psychiatric control patients without history of suicidal attempt were matched by gender and baseline diagnosis. Depression and internet addiction were assessed by using Patient Health Questionnaire-9 (PHQ-9) and Young's Internet Addiction Test (IAT). Independent t-tests, and logistic regression analyses were conducted. Results : IAT scores were significantly higher in suicidal attempt case group (41.09±18.196 years) compared to psychiatric control patients without history of suicidal attempt (36.63±17.016 years) (p=0.040). Internet addiction (adjusted Odds Ratio [aOR]=2.049, 95% Confidence Interval [CI]=1.004-4.539, p=0.0493) was an independent risk factor for suicidal attempt in psychiatric patients after controlling age, gender, and sociodemographic factors, such as marital status, education level and employment status. Conclusion : This is the first study to investigate the relationship between internet addiction and suicidal attempt in psychiatric patients in Korea. Internet addiction is significantly associated with suicidal attempt in psychiatric patients, after adjusting sociodemographic variables. This study provides evidence to future studies to further investigate on causality of internet addiction and suicidality in psychiatric patients.

임프란트 표면 처리에 따른 공명주파수 변화에 대한 연구

배상범,이성현,송승일,Bae, Sang-Bum,Lee, Seong-Hyun,Song, Seung-Il 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.2

Purpose: The aim of this study is to compare the stability between Mg-incorporated implant, TiUnite and Machined implant. Materials and Methods: Premolars of 3 Mini pigs (24 months) were extracted. After 2 months later, total 27 fixtures of implants (9 of each design : Machined/ TiUnite/ Mg-incorporated) were inserted into the mandible of 3 mini-pig. Implant stability was estimated by RFA in installation to 2, 4 & 6 weeks. Statistical analysis of RFA values was performed with time and between groups using repeated measure ANOVA and turkey's multiple comparison test. Results: In analyzing the mean value for the observation periods, three types of implants yielded a slight decrease in RFA mean value after 2 week, followed by increase at 4-6 weeks. Mg incorporated oxidized implants demonstrated significantly higher RFA mean values at 6 weeks comparing other groups. The difference of RFA value with time and between groups was statistically significant. Conclusion: We concluded that Mg implants may reduce failure rates of clinical implants In the early period of bone healing and Mg implants may shorten the bone healing time from surgery to functional loading.

뇌손상 후 발생한 이갈이증과 근육긴장이상에 대한 보튤리눔 독소 A와 교합안정장치를 이용한 치료 증례 -증례 보고-

김태완,백광우,송승일,Kim, Tae-Wan,Baek, Kwang-Woo,Song, Seung-Il 대한치과마취과학회 2010 Journal of Dental Anesthesia and Pain Medicine Vol.10 No.1

Bruxism is nonfunctional jaw movement that includes clenching, grinding and gnashing of teeth. It usually occurs during sleep, but with functional abnormality of brain, it can be seen during consciousness. Oromandibular dystonia (OMD) can involve the masticatory, lower facial, and tongue muscles and may result in trismus, bruxism, involuntary jaw opening or closure, and involuntary tongue movement. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown, Untreated, bruxism and OMD cause masseter hypertrophy, headache, temporomandibular joint destruction and total dental wear. We report a case of successful treatment of bruxism and OMD after brain injury treated with botulinum toxin A and occlusal appliance. The patient was a 59-year-old man with operation history of frontal craniotomy and removal of malformed vessel secondary to cerebral arteriovenous malfomation. We injected with a total 60 units of botulinum toxin A each masseteric muscle and took impression for occlusal appliance fabrication under general anesthesia. On follow up 2 weeks and 2 months, the patient remained almost free of bruxism. We propose that botulinum toxin A and occlusal appliances be considered as a treatment for bruxism and OMD after brain injury.

Outfracture Osteotomy Sinus Graft에 대한 임상적 연구

서은우,이호경,송승일,이정근,Seo, Eun Woo,Lee, Ho Kyung,Song, Seung Il,Lee, Jeong Keun 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.2

Purpose: The purpose of this study was to evaluate the feasibility of the outfracture osteotomy sinus graft technique with the evaluation of 8.5 year survival rate of the implants placed in the atrophic edentulous posterior maxillary area. Methods: One hundred and seventy-six cases of 145 patients who visited our center from August 2004 to February 2013 and were diagnosed as atrophic edentulous maxillary alveolar ridge, were selected and underwent sinus graft with outfracture osteotomy sinus graft technique. Feasibility of the outfracture osteotomy sinus graft technique was investigated with clinical and radiographic evaluation to assess the survival rate of the total dental implants in augmentation sinus surgery. Total fixture number available in follow-up period was 320, in which the lost 15 patients were excluded out of 160 patients. Results: Eight point five year cumulative survival rate was 95.6% with 14 failures of total 320 fixtures. The average follow-up period was 28 months 16 days with the minimum and maximum follow-up periods of 4 months 5 days and 94 months 10 days, respectively. Conclusion: Traditional infracture technique is a popular method for an augmentation sinus surgery. The authors modified this classical method by outfracturing and readapting the bony window after sinus graft, with excellent treatment results evidenced by high survival rate, which proves the feasibility of the newly-designed outfracture osteotomy sinus graft technique.