일 대학병원에 입원한 노년기 양극성 장애 환자의 인구학적 및 임상적 특징

조숙현(Sook Hyun Cho),정한용(Han Yong Jung),권영준(Young Jun Kwon),이소영(So Young Lee),김양래(Yang Rae Kim),김윤정(Yun Jung Kim) 대한노인정신의학회 2006 노인정신의학 Vol.10 No.2

Objectives : As the elderly population is continuing to increase, psychiatric diseases of the elderly are becoming an important social issue. This study looks into the demographical and clinical features of the elderly patients diagnosed with bipolar disorder in a University hospital. Methods : The study subjects include patients admissioned in the closed wards of Soonchunhyang Seoul hospital and Cheonan hospital from March, 2000 to February, 2005 who met the DSM-IV-TR criteria for bipolar disorder at the time of discharge. A total of 146 patients (76 men, 70 women) medical records were studied retrospectively. Subjects older than the age of 50 at time of admission were grouped as the old age group, whereas those who were younger than 50 as the young age group. Also among the old age group, those who had the first onset of episode under the age of 50 were grouped as the early onset group, whereas those who had the first onset after the age 50 were grouped as the late onset group. Results : The number of bipolar disorder patients in the young age group and old age group were 73 and 73 respectively. The number of early onset group and late onset group were 46 and 23 respectively. The old age group had a relatively higher incidence of bipolar II disorder than the young age group. Also in the old age group there was a higher incidence of hypomanic or depressive episode rather than manic episode compared to the young age group. And in the old age group psychotic symptoms were less common and the mean admission length shorter than the young age group. Additionally in the old age group treatment with Lithium monotherapy or with no mood stabilizers at all were relatively common. Among the old age group, late onset group had a higher rate of bipolar II disorder than the early onset group. Conclusion : This study shows differences in the demographical and clinical features among different age groups. But additional research would be required to determine whether the bipolar disorders in the elderly or late onset group are actually a different type of disorder from those of the young.

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.

Hepatocellular Carcinoma in the Elderly: Clinical Characteristics, Outcomes and Treatment Efficacy, Safety in Older than 75 Years

( Ji Ho Seo ),( Sunmin Kim ),( Eunae Cho ),( Chung Hwan Jun ),( Sun Young Park ),( Sung Bum Cho ),( Chang Hwan Park ),( Hyun Soo Kim ),( Sung Kyu Choi ),( Jong Sun Rew ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) has been increasing because the increase in the longevity of the general population. But there is no proper management based on age stratification in elderly patients. We compared clinical characteristics, outcomes and treatment efficacy, safety between oldest-old (aged more than 85 years), middle-old (aged between 80 and 85 years) and young-old (aged between 75 and 80 years) patients with HCC. Methods: We conducted a retrospective cohort study, from January 2010 to December 2016, at Chonnam National University Hospital. A total of 550 elderly patients whose data included demographics, co-morbidity, etiology of liver disease, presence of cirrhosis, staging of HCC, treatment modality and treatment related adverse event were evaluated retrospectively. Also overall survival was assessed in enrolled patient. Results: Fifty one patients (oldest-old; median 87 years old), 153 patients (middle-old; median 82 years old) and 346 patients (young-old; median 77 years old) were diagnosed with HCC. Both oldest- and middle-old patients, compared to young-old patients had significantly lower rate of alcohol-related disease (13.7% vs 20.9% vs 34.1%, P = 0.001). There were no significant difference in underlying sex, body mass index, presence of co-morbidity, hepatitis C-related disease and stage of HCC. The Child-Pugh class (CPT class A 88.9% vs 84.1% vs 83.6%, CPT class B 11.1% vs 15.9% vs 15.0% and CPT class C 0.0% vs 0.0% vs 1.3%, respectively, P = 0.912) and Model for End Stage Liver Disease score (mean MELD score 7.22±3.34 vs 5.88±3.01 vs 5.77±3.14, P = 0.166) were no significant difference between the patients with active treatment. The modified UICC staging (stage I 5.6% vs 17.1% vs 18.6%, stage II 55.6% vs 46.3% vs 47.3%, Stage III 22.2% vs 24.4% vs 24.8%, Stage IV-A 11.1% vs 6.1% vs 4.9% and Stage IV-B 5.6% vs 6.1% vs 4.4%, respectively, P = 0.826) and Barcelona Clinic Liver Cancer staging (stage 0 5.6% vs 9.8% vs 9.3%, stage A 16.7% vs 17.1% vs 22.1%, stage B 27.8% vs 29.3% vs 24.8%, stage C 50.0% vs 43.9% vs 41.2% and stage D 0.0% vs 0.0% vs 2.7%, respectively, P = 0.878) were no significant difference between the patients with active treatment. Furthermore, there were no difference between the age groups in treatment modality (Surgical resection 0.0% vs 3.3% vs 5.2%, P = 0.166; Radiofrequency ablation 2.0% vs 8.5% vs 11.0%, P=0.113; Transcatheter arterial chemoembolization 21.6% vs 34.6% vs 41.6%, P=0.014; Best supportive care 62.7% vs 40.5% vs 29.2%, P < 0.001), adverse event related treatment (P = 0.731) and disease-free survival days (329 .3±309.1 days vs 271.7 ± 414.2 days vs 357.2 ± 511.6 days, P = 0.336). Multivariate analysis showed that age, performance status, CTP class, MELD score, modified UICC staging, presence of portal vein thrombosis and ruptured HCC are risk factors for mortality. Conclusions: Clinician should make an active treatment in elderly patients with HCC not a age but performance status, liver function and disease status of cancer.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

운동선수의 체간부 등속성 근기능 및 유연성과 요통과의 관계

전종귀,박희근,송영민,조병준 충남대학교 체육과학연구소 2000 體育科學硏究誌 Vol.18 No.1

The relationships of the isokinetic muscle functions and the flexibility of body trunk to low back pain(LBP) were investigated in 16 female ahtletes aged 21.5 years. Some of them were suffering from LBP syndrome without clinical signs of lumbosacral nerve root irritation or compression. The isokinetic muscle functions of subject's body trunk were evaluated using Cybex770. The peak torques of trunk extensors and flexors were measured at 60˚ /sec, respectively. The powers and the total works of trunk extensors and flexors were measured at 180˚ /sec, respectively. The back strength and the trunk flexibility of the subjects were measured with dynamometer and flexormeter. The frequency scale, the visual analogue scale(VAS), and the verbal rating scale(VRS) of subject's LBP were evaluated by interview. The Pearson' Rs between the variables and their significances were calculated for statistical analysis. The coclusions were as follows. 1.The frequency of LBP in female athletes was once in four months. 2.The VAS(0-10) of LBP in female athletes was 2.62. 3.The VRS(1-7) of LBP in female athletes was 2.81(weak). 4.The significant negative correlations were observed between the frequency of LBP and the muscle mass, the trunk flexibility, and back strength of subject. 5.The weak correlations exist between the VAS of LBP and the age of subject, between the VRS of LBP and the trunk flexibility of subject. 6.There were not any significant correlations between the variables of LBP and the isokinetic muscle functions, and other physical and physiological variables.

Er:YAG laser 조사에 의한 치은연하치석 제거효과

조인구,김영준,김병국,정현주 전남대학교 치의학연구소 2002 구강과학 Vol.14 No.3

The purpose of this in vitro study was to evaluate the efficiency of Er:YAG laser on calculus removal and the morphologic changes and hardness of the irradiated surface at different power settings. This experiment used human teeth which were extracted due to periodontal disease and had a band of calculus. Forty root slabs (5x5mm^2) were made and divided into control group and irradiated groups. Experimental groups were as follows;Control group (root planing), Group 1 (irradiated with laser at 30mj), Group 2(irradiated with laser at 60mJ). and Group 3(irradiated with laser at 100mJ). Twelve root slabs embedded in resin block were used in each group. Er:YAG laser was applied under water irrigation with the tip held perpendicular to the root surface in contact mode. The treatment time was measured until the calculus was removed completely under naked eyes. The efficiency of calculus removal was evaluated by the time for removal. Morphological changes of laser irradiated site were observed under SEM and the surface hardness was measured using a VH tester. The results were as follows; 1. The efficiency of laser scaling was increased with increasing the energy level of irradiation. (p<0.05) 2. The morphological changes such as carbonization, crater and scale-like defects in the irradiated root surface were frequently observed with increasing the energy level. 3. The surface hardness tended to increase at 60mJ and 100mJ irradiated groups than that of control group. From the results evaluting on the efficiency, morphological change, and surface hardness, lower energy level was suggested f'or the clinical application of the Er:YAG laser in scaling.

통합적 림프부종 간호중재 개발 연구

조명옥,정향미,전점이,손수경,우영자,노미영,박순옥 성인간호학회 2003 성인간호학회지 Vol.15 No.2

The purpose of this study was the development of a comprehensive nursing intervention program for the client with acute lymph stasis and stage I lymphedema. Method: The Quasi-experimental design using a non-equivalent control group was used. The subjects were 22 stroke patients with lymph stasis in the control group and 23 patients in the experimental group. The complex physical therapy of Casley-Smith was carried out to the control group for 0 hours, and comprehensive nursing intervention for the experimental group was carried out for 60 minutes. The data for this study was gathered from Feb. 2002 until June 2002 and pertains knowledge about lymphedema, self-care for managing lymphedema, and circumferences of affected limbs. Data was analyzed by mean, standard deviation, x^2-test. And t-test. Result: The changes in knowledge about lymphedema, self-care practices, and circumference of affected limbs after nursing intervention did not show significant differences between control group and experiment group. Conclusion : It can be concluded that comprehensive nursing intervention had more efficiency than complex physical therapy in the treatment of edema for stroke patients because of it’s simplicity and time saving. Thereby, the comprehensive nursing intervention program developed in this study would be a useful therapy for the clients with lymph stasis and early stage lymphedema.

광주의 한 이차병원에서 조사한 결핵약제 내성과 관련인자

조준호,김강,최상철,이경록,정종필,고영춘 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.3

연구목적: 우리나라의 결핵약제에 대한 내성은 지속적으로 감소되고 있음에도 불구하고 여전히 적지 않은 환자를 보유하고 있는 상황에서 치료 실패의 중요한 요인이 되고 있다. 이에 결핵 내성률에 영향을 미칠 수 있는 인자들을 파악하고 이에 대한 예방 대책을 수립하는 것이 내성률 발생의 예방에 도움이 될 것으로 사료된다. 이에 저자들은 광주 소재의 한 2차 병원에서 결핵 약제 내성률 및 위험인자로 판단되는 요소들과의 상호관계를 조사하였다. 대상 및 방법: 2005년 3월 부터 2006년 2월 까지 광주 기독 병원 내과에서 치료받은 결핵 환자중 객담 결핵균 배양 검사상 양성으로 판명되어 약제 감수성 검사를 확인할 수 있었던 346명을 대상으로 의무기록, 면담 등을 통한 후향적 조사를 시행 하였다 결과: 346명중 한가지 이상의 약제에 내성을 보인 경우는 150명(43.4%)였고, 다제 내성 결핵은 72명(20.8%)였다. 조사 요인의 유무별로 약제 내성률을 조사하였을 때 흉부 사진의 침범 정도에 따른 약제 내성률 및 다제 내성률은 경증에서 36.3%와 6.2%, 중등도에서 36.1%와 22.6%, 중증에서 61.0%와 35.0%였다. 병변의 공동성 병변 유무에 따른 약제 내성률은 공동이 있는 군에서는 49.8%, 공동이 없는 군에서는 34.0%였다. 과거의 치료력 여부에 따른 약 제 내성률은 치료력이 없는 군에서는 19.7%였고, 치료력이 있는 군에서는 81.2%였다. 항 결핵제 복용의 규칙성 여부에 따른 약제 내성률은 규칙적 복용군은 31.7%, 불규칙적 복용군은 59.7%로 나타났다. 결론: 광주 소재의 한 2차 병원에서 조사한 약제 내성률 및 다제 내성률은 전국 평균치를 훨씬 상회하였다. 한편 과거 치료병력 및 약제의 불규칙 복용은 약제 내성률을 높이는 데에 기여하는 인자가 될 것으로 사료된다. 흉부방사선 사진 상의 폐 침범 정도, 공동성 병변의 존재도 약제 내성률 증가와 관련이 있는 것으로 보이나 보다 정확한 선후관계 분석을 위해서는 추가적인 전향적 연구가 필요하다. Background and objectives: Drug resistance is a major obstacle to the treatment of pulmonary tuberculosis (TB). This study was conducted to determine the prevalence of drug-resistant tuberculosis and its associated factors at a secondary hospital in Gwangju. Materials and Methods: A retrospective one-center analysis was conducted, with 346 pulmonarytuberculosis patients who underwent drug susceptibility tests for M. tuberculosis at Gwangju Christian Hospital from March 2005 to February 2006. Results: The following percentages of subjects were found to be resistant to at least one drug and to have multidrug-resistant tuberculosis (MDR-TB), respectively: 43.4% and 20.8% of all the subjects; according to the severity of the chest X-ray findings, 36.3% and 6.2% in the mild group, 36.1% and 22.6% in the moderate group, and 61.0% and 35.0% in the far- advanced group; according to the presence of a cavitary lesion, 49.8% in the cavitary-lesion group and 34.0% in the noncavitary-lesion group and according to the history of previous tuberculosis treatment, 81.2% in the group who have had treatment and 19.7% in the group who have never had treatment. The resistance rate according to the regularity of antituberculosis drug medication was 31.7% in the regular medication group and 59.7% in the irregular medication group. Conclusion: The drug resistance rate was increased by the history of previous tuberculosis treatment and the irregular medication. As to whether the severity of chest X-ray findings and the presence of cavitary lesions have a correlation with drug resistance, prospective studies are needed for more accurate results.

EEG 바이오피드백 훈련에 따른 주의유형 변화

조동진,심준영 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.1

This study conducted training with program for 30 min per session, four times a week through eight weeks with five rifle shooters of girls' high school in order to examine the influence of EEG(electroencephalogram) bio-feedback training on attentional styles. Attention type test used TAIS (test of attentional and interpersonal style) and result of total three measurements were analyzed. Consequently, BET (broad external attention) and BIT (broad internal attention) of six sub-factors of TAIS showed significant increase. This conclusion suggested that EEG bio-feedback training affected broad external and internal attention and could be helpful in giving affirmative influence on functional condition of brain. In addition, additional researches on analysis of EEG by frequency of EEG bio-feedback and its methods should be performed on the basis of findings of this study.