양극성 장애 급성기 치료에 대한 Lamotrigine과 Lithium의 비교

권영준,정희연,박인준 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

연구목적 : 새로운 항경련제인 lamotrigine의 급성기 양극성장애 조증과 우울증에 대한 치료효과를 lithium과 비교 평가하기 위해 본 연구를 시행하였다. 방 법 : 양극성 장애 조증 환자 47명(남자 26명, 여자 21명)과 양극성 장애 우울증 환자 43명(남자 21명, 여자 22명)에게 각각 무작위로 lamotrigine과 lithium, 그리고 위약을 6주간 투여하였고, 조증 환자는 Young's Rating Scale for Mania를, 우울증 환자는 Hamilton Rating Scale for Depression을 사용하여 매주 그 치료 효과를 평가하였다. 결 과 : 조증 환자들에 대한 lamotrigine의 치료 반응은 첫 3주째 까지는 lithium에 비해 낮고 위약과 유사했으나, 4주 이후에는 lithium과 유사하고 위약에 비해 우수한 치료효과를 보였다. 우울증 환자들에 대한 lamotrigine의 치료 반응은 첫 1주 이후부터 lithium이나 위약에 비해 유의하게 좋았다. Lamo-trigine에 의한 부작용은 피부발진이 1명에서 나타났다. 결 론 : Lamotrigine의 양극성 장애 조증에 대한 치료 효과는 초기에는 lithium 보다 떨어졌으나, 후기에는 lithium에 비견될 만큼 좋았으며, 양극성 장애 우울증에 대한 치료 효과는 lithium에 비해 더 좋은 결과를 나타내었다. Background : To evaluate the efficacy of lamotrigine on bipolar disorder, both manic and depressed episode, the author compared the effects of lamotrigine with lithium and placebo. Method : Forty-seven manic patients with bipolar disorder and 43 depressed patients with bipolar disorder were treated with lamotrigine, lithium or placebo during 6 weeks. Their severity of symptoms were rated weekly using Yong's Rating Scale for Mania and Hamilton Rating Scale for Depression. Results : In manic patients the therapeutic efficacy of lamotrigine was lower than that of lithium during baseline to week 2, but after week 3, lamotrigine was as effective as lithium. In depressed patients the therapeutic efficacy of lamotrigine was superior to lithium from week 2 to endpoint. Most patients tolerated well except that one patient developed skin rashes. Conclusion : Lamotrigine seems to have antimanic and antidepressant effect as lithium in the treatment for acute bipolar disorder.

삼환계 항우울제 투여로 발생한 추체외로계 부작용 1례

권영준,정희연 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A case of tricyclic antidepressant-induced extrapyramidal side effects is reported and the authors review the literature describing these effects. Despite clear case report, these side effects are not well known. Given the wide prescription of tricyclic antidepressants(TCA) and the low number of case reports, the prevalence of these side effects is indeed low, but clinical implications exist. The neurotransmitters that predispose these side effects are not completely understood.

독거노인과 가족동거노인의 신체적 건강상태와 건강행위에 관한 연구

장은희,김후자,권경남,정귀애,김연화,이인혜 영남이공대학 2004 論文集 Vol.33 No.-

Purpose : The purpose of this study was to identify the physical health status and health behavior practice of in-home elderly in order to provide basic data for effective nursing intervention to promote health and quality of life. Method : The subjects for this study were 299 elderly persons in the D city. Data were collected by interview with questionnaires. Result : The ratio of chronic disease was higher for the elderly who live alone than the elderly who live with family. Arthritis was the most common chronic disease of the elderly in spite of the fact that either they live alone or live with family. The physical health status score of the elderly who live with family was statistically higher than the elderly who live alone. The health behavior score of the elderly who live with family was statistically higher than the elderly who live alone. Conclusion : To promote health behavior of the elderly, it is necessary to develop nursing intervention that considers sociocultural tradition and demographic character.

Morgagni 탈장 : 1례 보고

오연희,이창욱,김승현,이성우,정병욱,이준희,박동일,권영무,신현종 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

Morgagni 탈장은 횡격막의 전내측 부위의 발달이상으로 열공을 통하여 장관이나 대망과 같은 복강내 구조물이 흉곽내로 빠져나가는 드문 질환으로 알려져 있다. 저자들은 호흡곤란을 주소로 내원하여 방사선학적 검사와 수술로 확진된 1례를 보고한다. Morgagni hernia is improperly located abdominal viscera into the thoracic cavity through the foramen of Morgagni which is a congenital defect at the anterornedial portion of diaphragm. We report a case of Morgagni hernia diagnosed by radiologic examination and operation.

청소년기 여성의 가족폭력 피해에 관한 연구

김경희,권혜진,최미혜,정연강 韓國學校保建學會 1996 韓國學校保健學會誌 Vol.9 No.2

This study is designed to contribute to the intervention of adolescent domestic violence by understanding the experience of the victims, better. The data were coiiected through a series of interviews with 3 subjects singled out at each stage of research. With the permission of the subjects, the interviews were recorded and transcribed. The interviews lasted from two and a half to 8 hours. The data were analyzed in the framework of grounded theory as mapped out by Strauss & Corbin (1990). The major findings of this research are as follows : The core category was found to be the adaptation of "Jitnulim" or "Being suppressed" . The sub-categories identified in the process of grounded data analysis were 'roughness', 'wildness', 'driving', 'challenging', 'being strapped', 'being pressed', 'erupting', 'being horrified', 'being hardened', 'being connected', 'being seen', 'being helpful', being led', 'sprouting', 'being off , 'being cast out', 'shaking off,' getting out', 'covering-up', 'waiting', 'ruling', 'common placeness', 'overcoming', 'getting united', 'fa11ing behind', 'falling in', 'being mixed up', 'ruthlessness', 'estrangement', 'difficulty', 'being overwhelmed', 'feeling regreful', 'being pressed','hesitating', and 'shying off'. These categories were again grouped into 11 categories including 'threatening', 'straightjacketing', 'alliance', 'phenomenon','pattern of support','system of support','challenging','calming-down','being relieved','being hardened and entangled','being entangled'. The following four theses were confirmed on the basis of the reifetitive relation: 1) If the episodes of violence are frequent and serious, with the resulting straightjacketing being stronger the victim's family relations are coherent and the subject's support pattern is highly mature. Concrete the responses to the straighjacketing regulted in a'calming-down' which gradually relieved. 2) If the episodes of violence were frequent and serious, with the resulting straightjacketing being strong the victim's family relations and incoherent and the suhjects supporter is immature but strong the support type is superficial and the responses to the straightjacketing result in a bouncing-off which gets entangled with the passage of time. 3) If the episodes of the violence are frequent and serious, the straighljacketing is strong, but the family relations are and the subject's support system is mature and strong the responses to the straightjacketing result in a calming-down which gets partly relieved but partly entangled. 4) If the episodes of the violence are frequent and serious with the resulting straightiacketing being strong, the victim's family relations are incoherent, the subject's support system is immature, and the support type is immature the responses to the straightjacketing result in a 'bouncing-off' which gets entangled and partly hardened with time.

국내에서 발생하고 있는 사람 브루셀라증의 임상적 특성

김연숙,최영실,오원섭,권기태,이혁,이선희,손준성,김신우,장현하,정숙인,고관수,박미연,백경란,송재훈 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

배경 : 2002년 내국인에서의 첫 사람 브루셀라증의 증례 보고 이후 국내에서 사람 브루셀라증이 빠른 증가를 보이고 있다. 이에 연구자들은 국내에서 발생하는 브루셀라증의 임상적 특성을 연구하고자 하였다. 방법 : 2003년부터 2006년 7월까지 7개 대학병원에 내원한 환자들을 대상으로 WHO의 진단기준에 의하여 확진된 브루셀라증 환자들의 의무기록을 후향적으로 조사분석 하였다. 배양된 균은 삼성서울병원에 의뢰하여 16S rRNA 유전자 분석방법을 이용하여 종을 확인하였고, 표준시험관응집검사는 국립보건원에 의뢰하여 시행하였다. 결과 : 34예의 환자들이 브루셀라증으로 확진되었고, 31명이 남자였다. 혈액에서 B. abortus가 증명된 경우가 8예, 표준시험관 응집검사상 의미 있는 항체가 상승을 보인경우가 26예이었다. 환자들은 대부분 축산업관련 종사자였고, 추후 브루셀라증으로 확진된 소와의 직접 접촉을 통해 감염된 것으로 여겨진다. 국내 사람 브루셀라증의 가장 흔한 증상은 발열이었고, 위장관계 합병증이 가장 흔히 동반되었다. 치료로는 doxycycline/rifampicin이 24예의 환자에서 doxycycline/aminoglycoside (streptomycin 혹은 gentamicin)이 10예의 환자에서 6주 이상의 기간 동안 투여되었다. 치료에 반응을 보이지 않는 환자는 없었고, 재발이 1예 있었다. 결론 : 국내에서 발생하는 사람 브루셀라증의 원인균으로 현재까지 분리 동정된 것은 B. abortus이며, 소 브루셀라증의 증가로 인해 인체감염사례가 함께 증가하는 것으로 사료된다. 위험 직업군 종사자들에서 감염된 소와의 직접 접촉을 통해 주로 발생하고 있는 브루셀라증의 임상종상은 국외에서 발생하는 경우와 유사한 양상을 보이고 있으며 치료에 대한 반응은 비교적 좋은 편이긴 하나, 추후 보다 많은 환자들을 대상으로 한 연구가 필요하리라 사료된다. 사람 브루셀라증의 조절을 위해서는 소 브루셀라증의 조절이 필수적이며, 브루셀라증의 조절에 성공한 선진국의 사례를 적극적으로 도입해야 할 것으로 생각된다. Background : Since the first Korean case of human brucellosis was reported in 2002, the incidence of human brucellosis has been rapidly increasing. We performed this study to evaluate the clinical characteristics of human brucellosis occurring in South Korea. Materials and Methods : Demographic features, clinical manifestations, and therapeutic outcomes of cases confirmed as brucellosis according to WHO diagnostic criteria were evaluated. Species of Brucella isolates were identified with 16S rRNA gene sequencing method. Serologic diagnosis was performed with standard tube agglutination test (STA). Results : A total of 34 cases were enrolled from 2003 to 2006 in six hospitals. Eight cases were confirmed with the isolation of Brucella from blood and 26 cases were confirmed with titer of antibodies ≥1:160 by STA. Male (31) was predominant and most of the patients were cattle farmers. The most common transmission route was direct contact with infected or their cattle byproducts. Fever was the most prominent symptom and fatigue followed. Gastrointestinal and musculoskeletal systems were commonly complicated. Patients were treated with doxycycline and rifampin or aminoglycosides for more than 6 weeks. All patients responded well to the therapeutic regimens, but one patient relapsed 10 months after treatment. Conclusion : Brucellosis occurring in Korea has been caused by B. abortus, whose preferred natural host animals are cattle. Korean patients were infected through direct contact with bovine brucellosis. Clinical manifestations of brucellosis were similar to those occurring worldwide. Therapeutic outcomes were good among patients with brucellosis in Korea. In order to prevent human brucellosis, measures to eradicate bovine brucellosis should precede.

치과 방문 시 어린이와 부모의 치과 불안도의 상관 관계

김성희,백병주,김재곤,양연미,권병우 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.2

어린이에게 있어서 치과 불안의 문제는 오랫동안 환자 행동조절의 문제로서 여겨져 왔으며 이러한 문제로 인해 치료 시의 비협조도, 치료 악속 취소 및 회피 둥이 발생할 수 있다. 따라서 치과의사 및 치과 팀에게 가능한 한 빨리 어린이의 치과 불안을 인지하여 적절히 대처할 것이 요구 되어진다. 한편, 부모의 치과 불안이 그들의 아이의 치과 불안과 치료 협조도에 영향을 줄 수 있음이 이전의 여러 연구들로부터 언급 되어지고 있다. 또한 치과 방문 결정의 주체가 어린이라기보다는 부모임을 고려할 때, 부모와 어린이 사이의 치과 불안도의 관계 규명이 중요하다 하겠다. 본 연구는 전북대학교 병원 소아치과에 내원한 3~10세(평균 연령 5.27세, 표준 편차 2.172세)의 어린이 78명(남아 45명, 여아 33명)과 그들의 부모 78명을 대상으로 하였으며, 치과 치료 전의 어린이의 치과 불안도 평가를 위해 Venham Picture Scale을, 부모의 치과 불안도 평가를 위해 Corah's dental anxiety scale을 사용하여 두 값을 비교하였다. 또한 어린이의 치료 시 협조도, 기질, 성별, 나이, 부모의 교육 정도를 평가하여 치과 불안도와 비교하였다. 이에 다음과 같은 결론을 얻었다. 1. 어린이의 치과 불안도와 부모의 치과 불안도 사이의 상관 분석 및 회귀분석에서 상호 관계성이 존재하였다(P<0.02). 2. 어린이의 치과 불안도와 치료 협조도사이의 상관 분석 및 교차 분석에서 음의 상호 관계를 나타내었다(P<0.001). 3. 어린이의 치과 불안도와 기질에 관한 Student's t-test에서 낮은 불안도와 높은 불안도 그룹의 네 가지 기질 평균 점수비교 시, 낮은 불안도 그룹에서 모두 약간 낮은 평균 점수를 보였으나 통계학적 유의차는 없었다(P>0.1) 4. 어린이의 치과 불안도와 어린이의 성별, 나이에 관한 Student's t-test에서, 여아에서 높은 불안도, 3~6세의 어린 그룹에서 높은 불안을 보였다(P<0.001). 5. 부모의 치과 불안도와 부모의 학력에 관한, Student's t-test에서, 대학교육을 받지 않은 저학력 부모 그룹에서 더 높은 불안도를 보였으나 통계학적 유의차는 없었다(P>0.1). In children, dental anxiety of dental treatment has been recognized as a source of problems in patient management for many years. Dental anxiety can be causes of negative cooperation, cancel and avoid of dental treatment. Therefore, dentist and dental team should recognize of child's dental anxiety as early as possible and manage appropriately. In previous studies, it is reported that parental dental anxiety affect dental anxiety and cooperation of their child. And it is parental decision which results in a child's visit to the dentist, rather than a child's decision in most cases. Therefore, it is important to identify the relationship of dental anxiety between child and parent. We estimated child's dental anxiety before dental treatment using Venham Picture Scale that is useful even a very young child and parental dental anxiety using Corah's dental anxiety scale. Then, two values above were compared. Child's cooperation, temperament, sex, age, parental education were estimated and compared with dental anxiety, too. The results were as follows: 1. There are positive relationship of dental anxiety between child and parent with the correlation analysis (P<0.02). 2. There are negative relationship of child's dental anxiety and child's cooperation with the correlation and regression analysis (P<0.001). 3. Low anxiety group has lower mean value of four temperament item with the Student's t-test. But, there is no statistical differences (P>0.1). 4. Girl and younger group have higher mean value of dental anxiety than boy and older group with the Student s t-test (P<0.001). 5. Low educated parents have higher mean value of dental anxiety than high educated parents with the Student s t-test (P>0.1).

성폭력 피해여성의 경험에 관한 연구

정연강,권혜진,지순주,남선영,김경희 韓國學校保健學會 1996 韓國學校保健學會誌 Vol.9 No.1

This studies designed to work out a theoretical framework on the experience of sexual abuse from the perspective of grounded theory in an effort to provide more practical and efficient nursing intervention for female victims. The subcategories identified were "sexual abuse", "threatening", "absent mindness", "embarrassment", "horripilation", "dizziness", "wondrousness", "filthiness", "sexual curiousity", "violence level", "victim's age", "neighbors response", "victims personality", "common experience", "sexual abuse information", "family relations", "level of familiarity", "hiding", "suppression", "self-torture", "self-protection", 'avoidance", "asking aid", "withdrawal", "hatred", "confusion", "dodging", "remmant", and "pursuing". The 29 subcategories given above were further integrated into 16 categories such as "victimizedness", "being astounded", "filthiness", "degree", "developmental stage", "response pattern", "personality", "rarity", "infromation availability", "family support", "cover-up", "escaping", "informing", "negative internalization", and "positive pursuit of change". The core categories linked to all the other categories turned out to be "being taken aback" and "filthiness" incorporation the relevant subcategories. A total of 23 theoretical hypothesis emerged in the process of analyzing data. 1. the grater sexual curiosity, the weaker the senses of being taken aback and filthiness. 2. The weaker sexual curiosity, the stronger the senses of being taken aback and filthness. 3. The stronger the level of violence, The more violent the senses of being taken aback and filthiness. 4. The lower the level of violence, the weaker the senses of being taken aback and filthiness. 5. The younger the victims, the stronger the senses of being taken aback and filthness. 6. The older the victims, The weaker the senses of being taken aback and filthness. 7. 'Escaping' will transpire regardless of the given circumstances. 8. The weaker the senses of being taken aback and filthness, the more probable 'informing' and 'escaping' transpire. 9. The stronger the senses of being taken aback and filthness, the more probable 'informing' and 'escaping' transpire. 10. The more protective the response from 'informing' and 'escaping' transpire around, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 11. The more repelling the response from around, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 12. The more open minded the personality of subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 13. The more closed the personality of subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 14. The more frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 15. The less frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 16. The more available information concerning sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 17. The less available information concerning sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 18. The more cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 19. The less cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 20. The more familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 21.The less familiar the subjec is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 22. The more likely the response to 'being taken aback' and 'filthines' is 'informing' and 'escaping', the more positive changes the subject will pursue. 23. The more likely the response to 'being taken aback' and 'filthiness' is 'covering-up' and 'escaping', the more negative changes the subject will pursue. The following four hypothneses were conformed in the process of data analysis. 1) In case the level of violence is strong but 'being taken aback' and 'filthiness' in weak because of strong sexual curiosity and also if information concerning sexual abuse is not readily available and the frequency is low, negative internationalization marked by 'covering-up' and 'escaping' will take place despite the fact the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 2) In case the level of violence is weak but 'being taken aback' and 'filthiness' is weak combined wit weak sexual curiosty and also if information concerning sexual abuse is readily available and the response from around is protective and the frequency is high, the subject will pursue positive changes to 'being taken aback' and 'filthiness' , further aided by the fact that the subject is open-minded, the family is cohesive and the abuser is unfamilar. 3) In case the level of violence is strong but 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is reading available and the response from around is readily available and the response from around is protecvice and the frequency is low, the subject will persue positive changes marked by 'informing' and 'escaping' despit the fact that the family cohesion is weak and the abuser is familiar. 4) In case the level of violence is strong but 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is not readily available and the response from around is respelling and the frequnecy is low negative internalization like 'covering-up' and 'escaping' will take place, further aggravated by the fact that the subject's personality is closed, family cohension is weak, and subject is familiar. On the basis of the above finding, it is recommended that nursing intervention should focus on promoting the milieu conductive to the victims pursuing positive changes along with the adequate aids from protection facilities as well as from the people around them.

강황과 울금 항염중 효과 연구

김영훈, 배덕성, 김정화, 윤현정, 남인영, 김민선, 신희찬, 차현정, 황방연, 이재권 충북대학교 교육개발연구소 2011 한국교육논총 Vol.32 No.3

-본문참고-

일개 농촌지역의 지역사회 영양정보에 관한 조사연구 : 경기도 남양주군 수동면을 중심으로 Su-Dong Myun, Nam Yang-Ju Gun, Kyung-Gi Do

계난이,권계숙,송미희,이연주 이화여자대학교 의과대학 1988 梨花醫學誌 Vol.- No.20

From September to November in 1987, the study was conducted a survey of Su-Dong Myun, Nam Yang-Ju Gun, Kyung-Gi Do, a comprehensive rural care demonstration area of Ewha Womans University. The purpose of this survey has been to examine into community nutrition informathrough preventive medicine training of sophomores of medical course. The result were as follows 1) Female respondent was 88.2% of all whose age was the forties and fifties at the highest rate of 22.6% respectively and whose educational level was uneducated at rate of 31.2%. 2) Agriculture(66.7%) was the common householder's occupation whose main income was from their own farm products(67.7%). 3) A family of five(24.7%) and two generations(e.g parent and children) (55.9%) was the most common family. 4) The housewife(98.9%) was the most common cook and 35.5% of all cook was not able have sufficient time to prepare for their meal. 5) On food purchase, main food was largely self provided(65.6%) and subsidiary food with self-provision and outside purchase(51.6%). 6) On the self sufficient food rice(77.4%) was most common as main food and vegetable(81.7%) as subdiary food. 7) On the frequency of purchasing food, main food was about 2-3 times a month, subsidiary food 1-3 times a week. On the market place, main food mainly self sufficient(59.1%) and subsidiary food was largely purchased from the peddlers and market on the move(35.5%) 8) On the means of transportation of purchased food, main food was conveyed by bus or another kinds of vehicles and subsidiary food(52.7%) was in the same way. 9) On the consumer's difficulty in purchasing food, meat and fish were rated 76.3% and vegetable 78.5%, 76.3% of all consumer had difficulty in purchasing meat and fish, 78.5% in purchasing grocery. 10) 94.6% was in possession of electric refrierator and 89.2% possessed their own wells. 11) The respondent had such fuels for cooking as propanegas(66.6%), wood(18.3%) briquet(10.8%). 12) the present state of nutrition was that the mean points was 2.7 in the group 1, 2.2 in the group 2, 3.9 points in the group 3, 2.8 points in the group 4, 3.1 points in group 5 and 2.7 points in the group 6. 13) Most families' favorite food was kimchi or kimchi soup and distasteful was meat including dog meat. 14) 48.4% of all respondents took no interest in taking in adequate nutrition owing to the lack of money and time to spare.