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      • 중국거주 조선족 여성의 영적 안녕정도가 정신건강에 미치는 영향

        정성덕,이종범,김진성,서완석,배대석,박순재,주열,염형욱,김승원,김구묘,안영록,황대홍,표미자,조창열,정태길 영남대학교 의과대학 2004 Yeungnam University Journal of Medicine Vol.21 No.2

        자아초월 정신의학이 체계화되면서 영성(spirituality)은 인성의 한 부분이라는 이론이 대두되었는데 이 영성은 정신건강에 큰 영향을 미친다고 했다. 인간의 성향 중 영적 안녕 정도를 파악하여 그 정도가 정신건강 중 허위성 경향, 정신병적 경향 및 불안과 우울 경향 등에 어떠한 영향을 미치는지를 조사하고저 본 연구를 실시하였다. 대상은 중국의 연변 조선족 자치구에 거주하는 여성 400명을 대상으로 하여 한국판 영적 안녕척도를 사용하여 영적 안녕정도를 파악하였다. 영적 안녕척도의 총점과 이 척도의 2개 하위 척도인 종교적 안녕과 실존적 안녕 척도 양자로 평가한 성적이 불안-우울통합척도와 정신분열증 척도 및 허위성 척도로 평가한 성적에 미치는 영향을 검증하기 위하여 상관관계분석 및 회기분석을 실시하였다. 그 결과는 다음과 같다. 1) 영적 안녕척도로 평가한 조선족 여성의 총점은 68.29로 한국의 기독교 여성이 평가한 100.65보다 훨씬 낮은 점수였다. 2) 불안·우울통합척도로 평가한 총점은 44.88로 연변노인이 평가한 점수와 일개지역의 한국농촌주민이 평가한 점수와 비슷한 결과였다. 3) 허위성 척도로 평가한 성적은 평균 74.57로 70점 이상이 86%(344명)이었으나 영적 안녕 성적과 허위성 성적 간에는 유의한 상관이 없었다. 4) 영적 안녕총점은 정신분열증 척도로 평가한 정신병적 경향에 유의한 영향을 미치지 않았으나 종교적 안녕하위척도의 성적은 정신병적 경향을 높여준데 비하여 실존적 안녕하위척도의 성적은 정신병적 경향을 낮게 해주었다. 5) 영적 안녕척도의 총점 및 두 하위척도인종교적 안녕과 실존적 안녕은 불안과 우울에유의한 상관을 보였는데 영적 안녕총점이 높을수록 불안·우울 총점이 다소 낮아지는 경향을 보였다. 6) 종교적 안녕 하위척도와 불안과 우울과의 관계는 종교적 안녕점수가 높을수록 불안과 우울을 각각 다소 유의하게 높여주었으며 이에 비하여 실존적 안녕하위척도와 불안과 우울과의 관계는 실존적 안녕정도가 높을수록 불안 및 우울점수는 유의하게 낮아졌다. 이와 같은 성적을 미루어볼 때 연변에 거주하는 조선족 여성이 평가한 영적 안녕정도는 정신병적 경향과 불안 및 우울에 유의한 상관을 보였으면 이 척도의 하위 척도인 종교적 안녕정도는 정신건강에 부정적인 영향을 미치는 반면 실존적 안녕정도는 정신건강에 긍정적 영향을 미친 결과로 평가되었다. 이러한 결과는 공산주의 사회에서 실존적 안녕은 긍정적인 가치관으로 평가되는 반면 종교적 안녕은 정신건강에 부정적으로 작용한 것을 입증해 주었다고 하겠다. Background: Spirituality has been an important part of Transpersonal Psychology and is believed to have a large effect on the mental health because it has been systematized. The aim of this study was to determine the level of spiritual disposition on human beings along with its effects on one's mental health. Materials and Methods: The study targeted 400 women residing in Youn-Gil city of JiLin Prov., which is a district of the Cho-Sun tribe in China. Their spiritual well-being was studied using the Spiritual Well-being Scale-Korean Version. The spiritual well-being scale consists of 2 sub-scales of religious well-being and existential well-being. The study was evaluated using a lie scale, psychotic trend, and a combined anxiety-depression scale. The results were considered to be factors of one's mental health. The correlation between the spiritual well-being and each tendency was analyzed by regression analysis. Results: The total score of the Cho-Sun tribal women according to the spiritual well-being scale was 68.29 which was much less than the 100.65 of Korean Christian women. There was no significant correlation between the spiritual well-being and the Lie trend. However, it was found that 86%(344) of Cho-Sun tribal women scored above 70 in the Lie trend with a mean score of 74.57 which is higher than normal populations. Regarding the correlation between the spiritual well-being and psychotic trend, the psychotic trend became significantly higher when the religious well-being was at a high level. On the other hand, the psychotic trend became significantly lower when the existential well-being was at a high level. Regarding the correlation between the spiritual well-being and anxiety, the anxiety was significantly higher when the religious well-being was at a high level. However, the anxiety level was significantly low when the existential well-being was at a high level. Regarding the correlation between the spiritual well-being and depression, the depression level was somewhat significantly high when the religious well-being was at a high level. However, the depression level was significantly low when the existential well-being was at a high level. Conclusion: This study evaluated the effects of spiritual well-being on a person's mental health among Cho-Sun tribal women in Youn-Gil city of JiLIn Prov., P.R. of China. The results found that the religious well-being, which is a sub-scale of spiritual well-being, had negative effects while the existential well-being had positive effects on the mental health. These results proved that a person's religious disposition had negative effects on their mental health in a communitarian society.

      • KCI등재

        한국인 정신분열병과 HLA-DRB1 대립유전자의 관련성

        황나영,김종원,오흥범,조지희,오선영,홍진표,박종익,이동은 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

        연구목적: 유전이 정신분열병의 중요한 원인이라는 것은 널리 인정되어 왔다. 본 연구는 한국인 정신분열병과HLA-DRB1 유전자좌와의 관련성을 알아보고 외국인 대상의 보고들과 비교함으로써 한국인 정신분열병의 유전적 특성을 밝히고자 시행하였다. 방법: 정신분열병 환자 70명을 대상으로 HLA-DRB1 대립유전자를 고해상도 수준까지 분석하였다. 저해상도 수준의 HLA-DR결과는 정상 한국인 2,000명의 연구 보고와 비교하였으며 고해상도 수준의 HLA-DRB1 결과는 정상 한국인 229명의 연구 보고와 비교하였다. 결과: 저해상도 수준에서는 HLA-DR11이 정신분열병 환자군에서 9.0%, 정산인에서는 3.8%의 빈도를 보여 환자군에서 통계적으로 유의하게 높은 빈도를 보였으며(p=0.005), 고해상도 수준에서는 HLA-DRB1*1101이 환자군에서 9.0%로 정상인의 1.8%보다 유의하게 높은 빈도를 보였다(p<0.001). 결론: 본 연구에서는 한국인 정신분열병과 HLA-DR11(HLA-DRB1*1101)이 양적 상관관계를 보여 백인에서 DR4와 부정적 상관관계를 보인 결과나 일본인에서 DR1(DRB1*0101)과 양적 상관관계를 보인 결과와 상이하였다. 이러한 한국인 정신분열병 환자의 유전적 특성은 가족연구 혹은 더 많은 수의 환자를 대상으로 한 관련연구를 통하여 재확인되어야 할 것이다. 중심단어:정신분열병·HLA-DRB1·관련연구. Objective: A genetic predisposition is widely accepted in schizophrenia. This study was intended to fine any association of HLA-DRB1 alleles with korean schizophrenics and thereby compare the results of other ethni groups. Method: The subjects were 70 unrelated Korean patients. Low and high resolution typing of HLA-DRB1 alleles were performed. The comparison groups were 2,000 unrelated healthy Koreans for low resolution HLA-DR and 229 unrelated healthy Koreans for HLA-DRB1 alleles. Results: Gene frequencies of HLA-DR11(patients 9.0%, healthy control 3.8%, p=0.005) and HLA-DRB1*1101(patients 9.0%, healthy control 1.8%, p<0.001) were significantly higher in Korean schizophrenics. Conclusion: The frequency of HLA-DR11(HLA-DRB1*1101) is significantly higher in Korean schizophrenics than in healthy Koreans. HLA-DR4 and HLA-DR1, which were known to be associated with Caucasian and Japanese schizophrenics, respectively, did not show statistical association with Korean schizophrenics. This association need to be reassured though further studies with families or association study with larger numbers of subjects. KEY WORDS:Schizophrenia·HLA-DRB1·Association study.

      • 한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

        최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

        The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

      • KCI등재

        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.

      • KCI등재

        재채혈된 검체를 이용한 허용 Hemolysis Index에 대한 연구

        Hong Bum KIM,Dong Il Won,Kyoung Ae SON,Jin Man KIM,Yu Jin WOO 대한임상검사과학회 2024 대한임상검사과학회지(KJCLS) Vol.56 No.1

        본 연구는 용혈의 영향과 허용 hemolysis index (HI)를 조사하기 위해 용혈된 검체와 재채혈된 검체의 결과를 비교하였다. 용혈 전ㆍ후, alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), amylase (Amy), direct bilirubin (D-bil), total bilirubin (T-bil), creatine phosphokinase (CK), gamma glutamyl transferase (GGT), iron, potassium (K), lactate dehydrogenase (LDH), magnesium (Mg), phosphorus (Phos), total protein (TP), uric acid (UA) 항목에서 유의미한 결과를 보였다. LDH, K, iron, AST, CK, GGT, TP, Amy, Phos는 용혈 정도와 결과 사이에 높은 상관관계가 있었다. Quality control (QC) high standard deviation (SD)을 이용하여 구한 허용 HI, HIQChigh를 비교했을 때 AST, D-bil, CK, LDH는비슷했지만 Amy, GGT, K, iron, Phos, TP는 장비의 cut-off HI보다 낮은 HI에서부터 영향 받았으며 ALP, ALT는 높게 나왔다. 그리고 paired t-test를 통해 유의미한 결과가 없었던albumin, cholesterol, triglyceride 항목에서도 HI>200에서는 유의미한 결과가 나왔기 때문에 재채혈하는 것이 바람직하다고 생각되며 HI<100일 때 영향을 받는 항목들이 있었던 연구 결과를 기반하여 약한 용혈이 나타나는 HI>50부터 용혈 기준을 설정하는 것을 권장한다. This study compared the results of hemolyzed samples and re-collected samples to investigate a hemolysis influence and an acceptable hemolysis index (HI). Before and after hemolysis, alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), amylase (Amy), direct bilirubin (D-bil), total bilirubin (T-bil), creatine phosphokinase (CK), gamma glutamyl transferase (GGT), iron, potassium (K), lactate dehydrogenase (LDH), magnesium (Mg), phosphorus (Phos), total protein (TP), and uric acid (UA) showed significant results in the paired t-test. LDH, K, iron, AST, CK, GGT, TP, Amy and Phos had a high correlation between the degree of hemolysis and the results of samples. When comparing Roche’s cut-off HI with HIQChigh obtained using quality control (QC) high standard deviation (SD), AST, D-bil, CK, and LDH were similar, but Amy, GGT, K, iron, Phos, and TP were lower than the cut-off HI of Roche, while ALP and ALT were higher. Some analytes which showed no significant results in the paired t-test, were found to have significant results in HI>200. Hence, it is suggested that the hemolyzed sample should be rejected if HI>200. Based on this study that some analytes were affected when HI<100, we recommend to set the standard of hemolysis starting from HI>50.

      • SCISCIESCOPUS

        A cluster of lung injury associated with home humidifier use: clinical, radiological and pathological description of a new syndrome

        Hong, Sang-Bum,Kim, Hwa Jung,Huh, Jin Won,Do, Kyung-Hyun,Jang, Se Jin,Song, Joon Seon,Choi, Seong-Jin,Heo, Yongju,Kim, Yong-Bum,Lim, Chae-Man,Chae, Eun Jin,Lee, Hanyi,Jung, Miran,Lee, Kyuhong,Lee, Moo BMJ Publishing Group Ltd 2014 Thorax Vol.69 No.8

        <P><B>Background</B></P><P>Over a few months in the spring of 2011, a cluster of patients with severe respiratory distress were admitted to our intensive care unit (ICU). Household clustering was also observed. Extensive laboratory investigations failed to detect an infectious cause.</P><P><B>Methods</B></P><P>Clinical, radiological and pathological investigations were conducted and the Korean Center for Disease Control performed epidemiological studies.</P><P><B>Results</B></P><P>The case series consisted of 17 patients. Their median age was 35 (range 28–49) years. Six were pregnant at presentation and four had given birth 2 weeks previously. All presented with cough and dyspnoea. In the majority of patients (14/17), multifocal areas of patchy consolidation were identified in the lower lung zones on the initial CT. As the condition progressed, the patchy consolidation disappeared (10/13) and diffuse centrilobular ground-glass opacity nodules started to predominate and persist. Pathological specimens (11/17) showed a bronchiolocentric, temporally homogenous, acute lung injury pattern with sparing of the subpleural and peripheral alveolar areas. Ten patients required mechanical ventilation, eight of whom subsequently received extracorporeal life support. Four of the latter underwent lung transplantation. Five of the six patients in the ICU who did not receive lung transplantation died. An epidemiological investigation revealed that all patients had used humidifier disinfectants in their homes.</P><P><B>Conclusions</B></P><P>This case series report showed that lung injury and respiratory failure can occur as a result of inhaling humidifier disinfectants. This emphasises the need for more stringent safety regulations for potentially toxic inhalants that might be encountered in the home.</P>

      • SCOPUSKCI등재

        출혈성 쇽의 소생 시 Dopamine 과 Dobutamine 이 혈역학 및 점막 관류에 미치는 영향

        최진환,최용우,문세호,홍성진,정동석,이지영,김종분 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.3

        The Comparative Effects of Dopamine and Dobutamine of Hemodynamics and Gastrointestinal Perfusion in Resuscitation of Hemorrhagic Shock Sung Jin Hong, M.D., Ji Young Lee, M.D., Jin Whan Choi, M.D. Yong Woo Choi, M.D., Se HO Moon, M.D., Dong Suk Chung, M.D. and Jong Bun Kim, M.D. Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea Background: Preservation of intestinal perfusion is considered the goal of resuscitation because derangement of gut perfusion is the major factor in multi-organ dysfunction. Gut intramucosal pH measured by tonocap, has been proven to be the sensitive monitor of gut mucosal perfusion. The effects of vasoactive agents on regional blood flow and cellular metabolism remain unclear. This study was done to examine the effects of dopamine or dobutamine on systemic hemodynamics and splanchnic perfusion assessed by gastric intramucosal pH (pHi) during resuscitation of hemorrhagic shock. Methods: Thirty anesthetized dogs were bled to 30-40 mmHg of mean arterial pressure (MAP) and maintained at the shock state for 90 minutes. Cardiac output and arterial and mixed venous blood gas data was measured for the global assessment of circulation and oxygenation. Gastric intramucosal pH(pHi) and CO_2 tension (P_rCO_2) and the difference of arterial and gastric intramucosal CO_2 tension (CO_2gap) were measured for the assessment of splanchnic perfusion. Dogs were resuscitated with shed blood and a crystalloid solution at the maintenance dose (control group, n = 10). Dopamine (4 ㎍/kg/min, dopamine group[, n = 10) or dobutamine (7 ㎍/kg/min, dobutamine group, n = 10 ) was added from the start of volume replacement and maintained for a follow-up period of 180 minutes. Results: Cardiac index and global oxygen delivery and consumption were increased after resuscitation in all groups. These parameters were significantly higher in the dopamine or the dobutamine groups than in the control group (P < 0.05), and significantly higher in the dopamine group than in the dobutamine group (P < 0.05). The pHi, P_rCO_2) and CO_2 gap were not improved from the values of shock state after volume resuscitation in the control group. The pHi, P_rCO_2 and CO_2 gap were significantly improved from the values of shock state after resuscitation in the dopamine group (P < 0.005), but not different from the control group. The pHi, P_rCO_2 and the CO_2 gap were significantly improved from the value of shock state after resuscitation in the dobutamine group and maintained significantly higher than in the control group for the follow-up period (P < 0.05). Compared to the dopamine group, the pHi increased early and was higher in the dobutamine group (P < 0.05). Conclusions: We conclude that dobutamine is effective in improving gut mucosal oxygenation during early resuscitation of hemorrhagic shock. Dopamine has little effect on the restoration of gut mucosal oxygenation. Considering the better recovery of cadiac index and global oxygenation parameters in the dopamine group, this finding could be explained by the redistribution of cardiac output or imbalance of oxygen metagolism occuring in the dopamine group. (Korean J Anesthesiol 2001; 41: 365~377)

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