알레르기 ; 알레르기 환자에서 한방 이외의 대체 요법의 사용 현황에 대한 다기관 조사

이현정 ( Hyun Jung Lee ),이재현 ( Jae Hyun Lee ),이용원 ( Yong Won Lee ),김철우 ( Cheol Woo Kim ),동헌종 ( Hun Jong Dhong ),박해심 ( Hae Sim Park ),조영주 ( Young Joo Cho ),조진희 ( Jin Hee Cho ),조상헌 ( Sang Heon Cho ),편복양 ( 대한내과학회 2011 대한내과학회지 Vol.80 No.1

목적: 한국에서 알레르기 질환 치료를 위한 한방 치료뿐만 아니라 대체 요법이 많이 이용되고 있으며, 그 현황에 대하여 다기관 조사를 시행하였다. 방법: 10개의 대학병원 외래로 내원한 647명의 알레르기 환자를 대상으로 설문조사를 시행하였으며, 이 중 510명이 한방 이외의 대체 요법에 응답하였다. 이환되어 있는 알레르기 질환은 천식(50.0%), 알레르기 비염(36.0%), 아토피 피부염(36.0%), 그리고 두드러기(9.3%)였다. 각각 환자들에게 12 문항의 설문조사를 시행하였으며, 한방 이외의 대체 요법의 사용 빈도 및 종류, 대체 요법에 의지하게 된 이유, 비용, 그리고 치료효과에 대한 의견을 물어 보았다. 결과: 16.7%의 알레르기 환자에서 한방 이외의 다른 대체 요법을 받았으며, 평균 1.6종의 한방 이외의 대체 요법을 받았다. 가장 많이 의지하는 대체 요법은 민간 식이요법 (48.6%)이었고, 그 다음이 아로마 요법(23.8%), 지압(14.3%), 건강 호흡법(7.6%), 마인드 컨트롤(5.7%), 목욕요법(5.7%) 순이었다. 대체 요법을 받은 환자 중 마인드 컨트롤(50%), 식이요법(50%), 그리고 건강 호흡법(75%)의 경우 치료 효과가 만족스럽다는 응답이 높았으며, 목욕요법, 아로마 요법, 그리고 지압은 만족도가 각각 33.3%, 28.0%, 26.7%로 저조하였다. 대체 요법 사용자의 63.6%가 5회 미만의 대체 요법을 받았고, 91.8%가 1년 이내로 치료받았으며, 1인당 평균 연 37 만원을 지출하였다. 대체 요법을 선택한 가장 큰 이유는 체질이 개선될 수 있을까 해서(44.2%)였으며, 대체 요법이 몸에 부담이 없어서(31.4%), 면역기능이 강화되어서(22.9%) 순으로 나타났고, 15.7%는 양약치료가 도움이 되지 않아서 대체 요법을 선택하였다고 응답하였다. 결론: 한국에서 알레르기 환자의 상당수가 한방뿐만 아니라 여러 가지의 대체 요법을 사용하고 있음을 알 수 있었다. 대체 요법의 사용 빈도가 증가하고 그 종류가 다양함을 고려할 때, 의료진은 대체 요법의 현황에 대하여 정확히 인지하고 이에 대해 관심을 가지고 환자를 대하여야 하며 올바른 알레르기 질환 치료법에 대해 환자뿐만 아니라 의료인에게 교육하는 것이 필요하다. Background/Aims: The use of unproven complementary/alternative medicine (CAM) to treat allergies is popular in Korea. We conducted a multicenter survey of the current use of CAM other than herbal medication in Korean allergy patients. Methods: This study enrolled 510 adults with allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, and chronic urticaria, from ten hospitals. They underwent a structured questionnaire interview and clinical assessment of the prevalence, motivation, costs, and subjective assessment of CAM. Results: Of the patients, 16.7% used at least one type of CAM to treat their allergic diseases. Common types of CAM were diet (48.6%), aroma therapy (23.8%), massage (14.3%), breathing exercises (7.6%), baths (5.7%), and mind control (5.7%). The therapeutic effects of CAM included improved in patients using mind control (50%), diet (50%), breathing exercises (75%), and baths (33.3%), but worse in patients using aroma therapy (28%), and massage (26.7%). About 36.4% of the patients used CAM more than four times per year, and the average cost per CAM user was 370,000 won/year. The main reason for trying CAM was `hope to improve my constitution`. Conclusions: CAM is used widely for treating allergic diseases in Korea. Detailed knowledge of CAM and patient education are important. Further studies of the clinical efficacy of CAM are needed. (Korean J Med 2011;80:68-77)

국소성 분절성 사구체 경화증의 완전 관해 후 발병한 IgA 신병증 1예

임현민,김현정,박민석,주혜원,최원,김상현,박원도 인제대학교 2006 仁濟醫學 Vol.27 No.-

We report a rare case of primary glomerular disease with IgA nephropathy in a 43-year old man. 7-years ago, he was diagnosed with minimal change nephrotic syndrome. After treatment with steroid for 1-year, azotemia and proteinuria were improved. But, nephrotic range proteinuria was relapsed within 1 week after cessation of steroid. Renal biopsy revealed focal segmental glomerulosclerosis, and achived a complete remission with the use of steroids and cyclophosphamide. Then, he was followed up with normal renal function for 4-years. On admission, the patient showed generalized edema and marked proteinuria. In 3rd renal biopsy, mesangial proliferative glomerulonephritis with diffuse global sclerosis was observed. Electron microscopy showed electron-dense deposit on the mesangium with slight mesangial proliferation, and immunofluoroscence microscopy showed granular deposits of IgA and IgM. These features were consistent with IgA nephropathy, different from results of previous biopsies. The pathogenesis of IgA nephropathy occurred with primary FSGS is not clear, as well as treatment. Now, proteinuria is improving, steroid and cyclophosphamide are probably useful for the disease.

3분과 : 가선집재작업에서의 작업 생산성 및 비용 분석

한원성 ( Won Sung Han ),한한섭 ( Han Sup Han ),김남훈 ( Nam Hun Kim ),차두송 ( Du Song Chu ),조구현 ( Koo Hyun Cho ),민도홍 ( Do Hong Min ),권기철 ( Ki Cheol Kwon ) 한국임학회 2014 한국산림과학회지 Vol.103 No.1

본 연구에서는 임목수확작업에 사용되는 집재기계의 작업효율성을 분석하여 경사가 급한(20° 이상) 작업조건에 적합한 가선계 집재기계를 선정하는데 기초 정보를 제공하고자, 타워야더(RME-300T), 트랙터부착형 집재기(일명: 춘천집재기), 트랙터윈치(FARMI) 등에 의한 집재작업에서의 작업생산성 및 비용을 비교 분석하였다. 평균 흉고직경이 20 cm, 집재거리 60 m, 가로집재거리 10 m, 그리고 기계이용률이 70%인 동일한 작업 조건에서 작업이 이루어질 경우, 타워야더의 1일 집재작업 생산성은 33.04 m3/일, 트랙터부착형 집재기는 38.47 m3/일, 그리고 트랙터윈치는 14.17 m3/일으로 분석되었으며, 이에 따른 집재작업비용은 각각 25,105원/m3, 20,520원/m3, 37,835원/m3으로 나타났다. 동일한 작업조건에서 집재거리에 따른 각 집재기계별 작업효율성을 비교하였을 경우, 집재거리가 40 m 이내로 짧을 경우에는 트랙터윈치에 의한 집재작업이 효율적이며, 40~140 m의 집재거리에서는 춘천집재기가, 140 m 이상의 장거리 집재작업에서는 타워야더가 가장 효율적인 것으로 나타났다. This study was conducted to provide field-based harvesting study information which can be used to select an optimal cable system for certain work conditions on steep grounds (>20° ground slope) in Korea. Toaccomplish this study objectives, we evaluated three cable yarding systems (RME-300T tower-yarder, Chuncheontower-yarder, FARMI tractor winch) working in typical work conditions for their yarding productivity and operational efficiency. Those yarders are commonly used for removing logs or trees on steep grounds in Korea. Under the same work conditions (average DBH of tree to be cut, 20 cm; yarding distance, 60 m; lateral yardingdistance, 10 m; and machine utilization rate, 70%), the average productivities were 33.04 m3/day, 38.47 m3/day, and 14.17 m3/day for RME-300T, Chuncheon tower-yarder, and FARMI, respectively. Our standardized cost comparison study also showed that the yarding cost was highest at 37,835 won/m3 with FARMI, followed byRME-300T at 25,105 won/m3 for the same work conditions. We found the lowest yarding cost with the Chuncheon tower-yarder at 20,520 won/m3 which was resulted primarily from high yarding productivity at theyarding distance (60 m). Our analysis suggested that a small machine such as FARMI could be a low-costyarding machine option for a cable yarding job with a short yarding distance (40 m or less). The Chuncheontower-yarder is well suited for a mid-range yarding distance job in Korea, ranged between 40 to 140 m. Ifyarding distance were longer than 140 m, the RME-300T tower yarder appears to be most cost-effective.

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.

필리핀 여행 후 발생한 쯔쯔가무시병 1예

김계형,김낙현,김문석,김충종,전재현,박완범,장원종,박상원,김익상,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Infectious diseases imported from other countries have increased as more and more Koreans are going abroad for various purposes. Tsutsugamushi disease from other endemic area such as Southeast Asia is important, because it can occur in any season and eschar may be absent. We report a case of imported tsutsugamushi disease acquired in the Philippines. A patient presented with fever, headache, and maculopapular skin rash. However, eschar was absent. Polymerase chain reaction (PCR) for 56-kDa gene of Orientia tsutsugamushi using buffy coat was positive. Serum indirect immunofluorescent antibody assay was initially negative but became positive with a titer of 1:320 at follow-up, Sequencing analysis revealed the strain to be 100% identical to the TW73R strain identified in Taiwan. After the patient received doxycycline, body temperature normalized in 12 hours. Tsutsugamushi disease is one of the differential diagnoses that should be included for patients with fever who have recently returned from Southeast Asian countries. PCR for O. tsutsugamushi using patient's buffy coat was useful for early diagnosis.

用寒遠寒과 用熱遠熱에 대한 考察 : 六元正紀大論에서

채영진,신창환,임현택,여성원,한성규,이재원,정헌영,금경수 한국전통의학연구소 2003 한국전통의학지 Vol.13 No.1

Five elements motion and six kinds of natural factors influence not only human disease but also difference of medicine effect. Because the climate of summer is very hot, that is easy to increase the properties of hot medicines, a doctor must be careful to use it in summer. Also the climate of winter is very cold, that is easy to increase the properties of cold medicines, a doctor must be careful to use it in winter. But in the certain conditions to use diaphoretics or purgatives, in spite of that regulation a doctor can use them.

부산.경남지역의 일부 고등학교 교사들의 물리치료에 대한 인식도 조사

김지원,박상현,주성희,김용권,안덕현,Kim, JI-Won,Park, Sang-Hyeon,Joo, Sung-Hui,Kim, Yong-Kwon,Ahn, Duck-Hyun 대한물리치료과학회 2003 대한물리치료과학회지 Vol.10 No.2

This study randomly chose 10 humanity high schools, which are located in Busan and KyoungNam province. We then examined the recognition rate of physical therapy among 378 teachers who were and still are working in the schools. 1. The recognition grade of physical therapeutics between men and women was significantly different with results of 80.7% of men and 69.7% of women(p<0.05). In the case of experiencing physical therapy, 83.6% of people said they knew the physical therapeutics and in the case of the opposite side, the result was also significantly different with a result of 67.8%(p<0.05). 2. We ranked the people on how much they knew about the physical therapeutics among men and women. With men, the actual experience of physical therapeutic came before what they heard from other people. In the case of women, what they heard from other people came first and the actual experience of physical therapeutic came after. According to the public information from Inje University, the recognition grade is recorded in the 3rd grade department as 21.5% while in the case of experiencing treatment from a physical therapist, the result was 39.1%. In the other department (the 1st grade department), what men and women heard from mass media was recorded at 17.5% and what they heard from other people, it was recorded at 33.8%(p<0.05). 3. The research about the recognition of academic ability of being a physical therapist was that 55.6% of teachers thought that 3-year-college was the best, which made the results different from the recognition grade of the experience of education(p<0.05). 4. In the recognition grade of physical therapeutics, there were significantly differences from 50.2% of men and 45.2% of women were expecting about 1mil ion won to 1.99million won. In case of 25.2% of people who have experience less than 15years at work, they expected about 2million to 2.99million won. The figures were higher than 10.1% of people who have experiences over 15years. About the recognition grade of physical therapists social level in the future is 48.8% of people who had experienced of physical therapy and 63.8% of people who never had experienced of it said it would be better in the future. From these results, the recognition about physical therapeutics and the view of its social status are optimistic and they know well about the level of academic ability of physical therapists. On the other hand, most teachers don't know exactly about physical therapists work. So we have to inform them aggressively for enhancing the recognition of physical therapy because high school students are well affected by their teachers when they face their future or major in university.

우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계

강혜영,강대룡,장영화,박성은,최원정,문성환,양규현,Kang, Hye-Young,Kang, Dae-Ryong,Jang, Young-Hwa,Park, Sung-Eun,Choi, Won-Jung,Moon, Seong-Hwan,Yang, Kyu-Hyun 대한예방의학회 2008 예방의학회지 Vol.41 No.5

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

複合 組織鋼의 引張性質에 미치는 組織學的 因子에 관하여

成章鉉,韓元澤 동아대학교 공과대학 부설 한국자원개발연구소 1984 硏究報告 Vol.8 No.1

Morphological factors affecting tensile properties were investigated by metallography, tensile test and particle analysis after manufacturing Austenite Dual Phase steel (ADP steel) and Intercritical Dual Phase steel(IDP steel) by heat treatment of Fe-Mn and Fe-Mn-Cr systems. 1) The formation of austenite was largely affected by initial structures before intercritical annealing, and austenite grew from the pearlite colony in Fe-Mn system but grew discontinuously along the plate of cementite in Fe-Mn-Cr system. 2) As for the effects of Cr on the tensile properties, tensile strength and elongation are low for step quenching, but tensile strength increased and elongation decreased slightly for intercritical annealing. 3) In Fe-Mn-Cr system tensile strength and elongation of IDP steel were excellent than those of ADP steel due to the discontinuous dispersion of fine martensite particles at the same volume fraction.

색상 측정 기기를 이용한 복합레진 적층 수복과 단일 수복의 색상 비교 분석

송영상,김자현,이빈나,장지현,장훈상,황윤찬,오원만,황인남 大韓齒科保存學會 2012 Restorative Dentistry & Endodontics Vol.37 No.2

Objectives: This study analyzed the difference in color caused by different thickness in enamel layer of composite resins when applied with single and layering placement technique, and evaluated if the results agreed with the shade guide from the manufacturers to verify reliability of the color matching process of the manufacturers. Materials and Methods: For single composite resin samples, 6 mm diameter and 4 mm thickness cylindrical samples were fabricated using Ceram-X mono (DENTSPLY DeTrey) and CIE L*a*b* values were measured with spectrophotometer. Same process was done for layering compositie resin samples, making 3 dentinal shade samples, 4 mm thickness, for each shade using Ceram-X duo (DENTSPLY DeTrey) and enamel shade resins were layered in 2 mm thickness and CIE L*a*b* values were measured. These samples were ground to 0.2 mm thickness each time, and CIE L*a*b* values were measured to 1 mm thickness of enamel shade resin. Results: Color difference (△E*) between single and layering composite resin was 1.37 minimum and 10.53 maximum when layering thicknesses were between 1 mm and 2 mm and 6 out of 10 same shade groups suggested by manufacturer showed remarkable color difference at anythickness (△E* > 3.3). Conclusion: When using Ceram-X mono and duo for composite resin restoration, following the manufacturer's instructions for chossing the shade is not appropriate, and more accurate information for Ceram-X duo is needed on the variation and expression of the shades depending on the thickness of the enamel. (Restor Dent Endod 2012;37(2):84-89)