정신보건관련시설 입원(소)자의 주요 정신장애 유병률 : 전국 20개 시설의 입원(소)자를 대상으로

조성진,조맹제,서동우,함봉진,홍진표,배재남,이준영,이동우,박종익,전홍진,김성주,김용익 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.6

Objectives : One of the objectives of this study is to estimate the prevalence rates of psychiatric diagnoses in the combined populations of psychiatric hospitals, psychiatric nursing facilities and homeless asylums using the Korean version of the Composite International Diagnostic Interview (K-CIDI), which is a comprehensive and fully standardized interview schedule to assess psychiatric disorders for diagnosis. The Other objective is to compare with previously studied prevalence rates of Psy-chiatric diagnoses using the results of this study. Methods : The study subjects, aged from 181o 64 years, were randomly selected from 64,582 institutionalized population of psychiatric hospitals, Psychiatric nursing facilities and homeless asylums as of 30, June, 2001. Twelve trained interviewers administered the K-CIDI to the selected respondents. A total of 1,875 respondents (male 1,194, female 681) completed the interview. Results : The lifetime and one year prevalences of any diagnosis excluding nicotine dependence · withdrawal, anxiety disorder, eating disorder, somatoform disorder were 88.2% (male 88.1%, female 88.3%), and 65.8% (male 62.7%, female 73.7%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were 78.5% (male 75.3%, female 83.7%), and 56.8% (male 51.9%, female 64.8%), respectively. The lifetime and one year prevalences of alcohol use disorder (dependence/abuse) were 26.7% (male 37.9%, female 8.3%), and 8.7% (male 12.8%, female 2.1%), respectively. The lifetime and one year prevalences of mood disorder were 18.1% (male 13.5%, female 25.8%), and 10.4% (male 7.2%,female 16.9%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were comparable with the 2001 community survey by 1.19% to 1.32%, and 0.51% to 0.61%, respectively. The lifetime and one year prevalences of schizophrenia were also comparable by 0.16% to 0.28%, and 0.16% to 0.25%, respectively. There were no significant changes of prevalence rates when correction were applied to other psychiatric diagnosis. Conclusion : The results of this study could be used for evaluating the distribution of psychiatric diagnoses in mental health related facilities and for planning mental health policies.

정신보건 관련 시설의 재원 기간 및 관련 요인에 대한 연구

조성진,이병조,조맹제,김용익,서동우,정인과 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Object : This study was aimed to find the contributing factors that influence the length of stay in mental health related facilities and to present future direction for the mental health policy. Methods : The 1,875 patients who are aged between eighteen and sixty-five are chosen by the stratified random sampling from ten psychiatric hospitals, six psychiatric nursing facilities and five homeless asylums. We investigate about length of stay of all subjects by sociodemographic characteristics, socioeconomic status, functional status, disease related characteristics and analyse contributing factors. Results : From total subjects, average length of stay was 1,906 days, and facilities, where subjects are institutionalized, explains 40% of length of stay. Other related factors are female, old age, single, lack of supportive system before admission and after discharge, medical assistance type I, unavailable of public transportation and utility, long duration of illness, and psychotic disorder. Conclusion : For lowering the rate of long-term hospitalization, evaluation of appropriateness is needed for admission to nursing facility and homeless asylum and make up for the medical payment system and the supportive system from family and community.

소아 대퇴골 간부 골절에 대한 조기 고수상 석고 고정술

이한용,유기원,정진영,손문익,김창기,강용구 대한골절학회 2003 대한골절학회지 Vol.16 No.1

목 적 : 소아 대퇴골 간부 골절의 여러 가지 치료 방법 중 조기 고수상 석고 고정술의 유용성을 알아보고자 시행하였다. 대상 및 방법 : 대퇴골 간부 골절로 1997년 1월부터 2000년 12월까지 보존적 방법으로 치료를 시행받았던 10세 미만의 소아 중 심각한 동반 손상이 없고, 추시 기간이 최소 12개월이었던 환아를 대상으로 하였다. 총 27명, 27예 이었으며, 조기 고수상 석고 고정군(조기군)이 12예, 견인 후 고수상 석고 고정군(견인군)이 15예 이었다. 두 군에 대하여 각각 수상 시 연령, 성별, 수상 기전 등의 기본 자료를 분석하였으며, 재원 기간, 견인 및 고수상 석고 고정 기간, 재원 기간 동안의 방사선 촬영횟수, 고수상 석고 고정 직후와 최종 추시 소견에서의 각 변형 및 하지 부동 등의 임상적 및 방사선학적 자료와 입원 기간 중의 총 진료비를 비교 분석하였다. 결 과 : 평균 연력은 조기군은 4.2세, 견인군은 5.3세 이었으며, 전체 연구 대상 중 남아가 24예로 88%를 차자하였고, 수상 기전은 교통사고가 20예(71%)로 가장 많았다. 재원 기간은 조기군이 평균 7.8일 이었으며, 견인군은 25.8일로 나타나 유의한 차이를 보였다. 수상 일로부터 석고 제거가지의 기간 즉 침상 안정기간은 각각 44.2일과 65.1일 이었다. 재원 기간 중 방사선 촬영 횟수는 조기군은 수상 직후 및 고정 후 각각 1회의 방사선 촬영을 하였으며, 견인군은 견인 및 정복의 정도를 파악하기 위하여 평균 6.9회의 방사선 검사를 시행하였다. 두 군 모두 최종 추시 때의 관절 운동 각도는 정상 범위에 속하였고, 고수상 석고 고정 직후와 최종 추시 소견 상 각 변형은 허용 범위 내에 있었으며, 하지 부동이 각 군에서 3예 씩 발생하였다. 총 입원 진료비는 견인군이 재원 기간의 증가로 인하여 약 2.4배의 비용이 더 필요하였다. 결 론 : 소아 대퇴골 간부 골절에 대한 조기 고수상 석고 고정술은 견인 후 고수상 석고 고정술과 비교하여 임상적 및 방사선학적 결과에서 유의한 차이가 없었으며, 재원 기간의 단축과 고정 기간의 감소를 통한 의료비 절감 및 환자 순응도를 높일 수 있었고, 방사선 촬영 횟수 감소로 소아 생식기에 대한 위험을 줄일 수 있었으므로 유용한 치료 방법이라고 판단되었다. Purpose : To evaluate an efficacy of immediate closed reduction and hip spica casting in pediatric patients with femoral shaft fractures. Materials and Methods : 27 cases of 27 pediatric patients who had seen treated conservatively for the femoral shaft fractures under 10 years of age were retrospectively reviewed. The cases with serious associated injuries were excluded. The hospital stay, duration of traction and hip spica cast, frequencies of plain radiographs, clinical and radiological outcomes at the final follow-up, and financial aspects were evaluated comparatively between the groups of immediate hip spica casting(12 cases) and traction-casting(15 cases). Results : The patients treated with immediate hip spica casting had a mean hospital stay of 7.8 days, compared with a mean of 25.8 days for those treated with traction and casting. The mean duration of immobilization were 44.2 days in the group of immediate hip spica casting, and 65.1 days in the group of traction and casting. The radiologic examinations were performed 2 times and 6.9 times respectively. The clinical and radiological outcomes at the final follow-up were good in both groups. Insignificant leg length discrepancies were seen in 3 cases each group. The total charges of traction and casting was 2.4 times higher than that of immediate hip spica casting. Conclusion : The immediate hip spica casting seems to be an effective method of treatment in femoral shaft fractures without serious associated injuries under 10 years of age because there are several advantages such as satisfactory result, shortened hospitalization and immobilization, reduction of total charges, and lowered the risk of radiologic exposures.

중증 만성정신질환자 수의 추산 : Through Two Community Surveys 두 지역사회 조사를 중심으로

홍진표,김윤,배재남,정유진,강영호,양병국,김용익,김병후,이철,조맹제 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

국내 중증 만성정신질환자 수를 추정하기 위하여 일 농촌 및 대도시 지역의 지역의료보험 및 의료보호 대상자 중 1993년 1년간 의료기관에서 정신증 상병(ICD-9 code 상 290-299) 및 알콜 남용/중독, 성격장애 및 정신박약 진단하에 치료를 받은 적이 있는 사람에 대해 설문조사를 실시하였다. 연구자들이 개발한 진단도구를 이용하여 진단을 평가하고, Strauss-Carpenter scale 등을 이용하여 기능 장애를 평가하고 유병기간 등을 조사하였다. 결과를 요약하면 다음과 같다. 1) 진단평가상 정신분열병군(61.1%)이 가장 많았으며, 정동장애군(23.7%), 알콜장애군(11.2%), 기질성 정신장애군(4.0%)의 순서이었다. 2) 직업활동정도는 진단군별로 차이가 많았다. 지난 1년간 직업활동이 6개월 미만이거나 전혀 없는 환자 비율이 정신분열병군은 67.2%, 알콜장애군 52.0%, 정동장애20.8%의 순으로 정신분열병군이 가장 불량하였다. 3) 사회활동도 진단군별로 차이가 많아서 지난 1년간 의도적, 사회활동이 없는 비율이 정신분열병군이 가장 높았고(72.3%), 알콜장애군(32.0%), 정동장애군(20.7%)의 순이었다. 4) 국내 의료보험 및 사회복지시설 이용 자료 등을 토대로 본 조사 결과를 적용한 결과 국내중증 만성 정신질환자의 수는 약 8만 7천명으로 추산되었다. Objectives: The purpose of this study was to estimate the number of serious and persistent mentally ill patients in Korea. Methods : Study populations were recruited from medical insurance data of two district areas ; one rural and the other urban areas. Subject were all mentally ill who had ever visited any hospital in 1993 and were diagnosed as having psychosis, personality disorder and drug abuse. We conducted a home visiting survey applying semi-structured diagnostic interview, assessing the level of social adjustment with Strauss-Carpenter Scale, and past psychiatric history by the trained researchers, in October and November,1994. Results : According to diagnostic assessment schizophrenic patients constituted the major portion(61.1%) of study subjects. The distribution of occupational functions and social contacts was variable according to diagnosis. Most schizophrenic patients were unemployed or worked less than 6 months in the previous year(67.2%), and showed poor social contact(72.3%). But affective disorder patients were relatively independent in job maintenance and social relationship. Alcoholic patients lay between those of schizophrenic and affective disorder groups. It was estimated that about 87,000 adult Koreans were suffering from chronic mental disorders which seriously interfere with their daily life. Conclusions : Serious and persistent mentally ill patients were common in Korea. Community support program should be provided for them.

제주도 해안의 수중소음- I : 제주항과 추자도사이

정용진,변창익,서두옥 제주대학교 해양연구소 1986 해양자원연구소연구보고 Vol.10 No.-

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

요골 두 아탈구와 동반된 상완골 내 상과 골절 : 1예 보고 A Case Report

이한용,유기원,정진영,송주현,고해석,강용구,손문익 대한골절학회 2003 대한골절학회지 Vol.16 No.2

주관절 손산 중 상완골 내 상과 골절은 단독으로 혹은 주관절 탈구와 동반되어 발생하는 것이 일반적이다. 저자들은 15세 남자 환자의 좌측 요골 두 아탈구가 동반된 상완골 내 상과 골절을 경험하였다. 도수 정복을 시도하였으나 요골 두 아탈구의 정복을 얻을 수 없어 관혈적 정복술로 치료하엿다. 6개월추시 결과 후휴증이 없는 정상적인 관절 상태를 확인할 수 있었다. 연령, 원인 , 손상 기전으로 분석해 보면 이 동반 손상은 발생하기 매우 어렵고, 문헌 탐색 결과 현재까지 동일한 증례를 찾아볼 수 없었으므로 보고하는 바이다. It has been known that fracture of medial epicondylar apophysis of distal humerus may be isolated of associated with elbow deslocations. We have experienced a case which medial epicondylar fracture of the distal humerus was associated with subluxation of the radial head. Initially, we had tried reduction of subluxated radial head by closed method, but failed. Finally open reduction gad been performed. At 6 month after open reduction, clinical and radiological result were excellent. As it is difficult for those associated injuries to occur simultaneously and the similar cases never have been reported yet, we would like to present this case with a review of the literature.

일 농촌지역의 우울 증상에 관한 역학연구 -위험요인 및 요인구조분석

하양숙,홍진표,김한규,이군희,한경자,조맹제,김용익,송미순,박성애,김창윤 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구목적 : 세계적으로 널리 사용되는 우울증 척도인 the Center for Epidemiologic Studies Depression Scale(CES-D)을 이용하여 지역사회 주민의 우울증상의 정도를 평가하고, 우울증상의 위험요인을 분석하고, 한국인에서 우울증상의 요인구조를 알기 위해 본 연구를 실시하였다. 방 법 : 경기도 일 농촌 지역의 30세 이상 주민에 대해 무작위 군집 집락 추출을 실시하였고, 훈련된 면담원들이 가정 방문을 통하여 면접 및 자기보고 검사인 CES-D를 실시하였다. 총 1,315명에서 응답을 하였고 응답율은 59.3%이었다. 결 과 : CES-D에 의한 우울증 점수는 0∼5점이 57%정도를 차지하였고, 평균 점수는 남자 7.8점 여자 9.5점으로 비교적 낮은 편이었다. ANCOVA 분석 결과 비결혼, 저학력, 여성이라는 위험요인은 독립적으로 우울증상을 악화시키는 요인이었으나 연령은 통계적으로 유의하지 않았다. CES-D 결과를 요인분석을 시행한 결과 4가지 요인이 추출되었는데 우울증상 및 신체증상이 한 개의 요인으로, 다른 나라에서 보고되지 않는 정서적 고통이 별도의 요인으로 추출되었다. 결 론 : 국내 역학 조사에서도 외국과 유사한 우울점수 및 위험요인이 확인되었으나 우울증의 요인에서는 특이한 요인이 추출되었다. 한국인에 독특한 우울 반응에 관한 추가 연구가 필요하다. Objectives :The rates, correlates, and factor structure of depressive symptoms in a Korean rural sample were examined using Korean version of the Center for Epidemiologic Studies Depression Scale(CES-D). Methods : Door to door visiting survey was conducted by trained interviewers. A random cluster sample of 1,315 respondents, aged 30 and over completed the CES-D scale along with additional sociodemographic questionnaire. Results : In this sample, mean CES-D score of male and female were 7.8 and 9.5, respectively which were lower than those reported previously. Symptoms of depression were most common among the less educated, non-married and female according to ANCOVA. Age was not a significant risk factor for depressive symptoms. Different factor structures emerged from this sample as compared to other studies using this approach. Somatic symptoms and affective symptoms were combined as one factor and emotional hardship emerged as a separate factor. Conclusion : Symptoms scores and risk factors were similar to the results reported in other countries but unique factor structures were found in this study. Further research is needed about the Korean depressive symptomatology and related areas.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

설악산 국립공원의 어류분포

장민호,조가익,하진용,정광석,박성배,주기재 한국어류학회 2002 韓國魚類學會誌 Vol.14 No.4

설악산 국립공원지역 산간계류의 17개 지점에서 2000년 6월부터 2001년 6월까지 어류상 및 이화학적 요인을 계절별로 총 4회에 걸쳐 분석하였다. 모든 조사지점은 1~3차의 하천으로 비교적 물리·화학적 교란이 적었으며 하천폭은 5~30 m 정도였다. 채집된 어류는 총 18과 42종 2,557개체였고, Cyprinidae는 16종으로 84.7%의 상대풍부도를 나타냈으며, Gobiidae 4종, 5.0?의 상대풍부도를 보였다. Cyprinidae는 전체 채입종의 37.2%를 나타냈다. 우점종은 Zacco temminck로 10개 지점에서 738개체가 채집되어 28.9%의 상대풍부도를 나타냈으며, 아우점종은 Rhynchocypris kumkangensis와 Z. platypus로 각각 4개 지점 648개체(25.3%)와 7개 지점 344개체(13.5%)로 나타났다. 한국고유종(Korean endemic species)은 모두 4과 11종 781개체로 30.5%의 상대풍부도를 나타냈으며, 고유화 빈도는 25.6%로 한국의 평균 고유화 빈도와 유사하게 나타났다. 본 조사에서 외래어는 채집되지 않았다. 국립공원 내에 서식하는 어류의 다양성 유지와 회복을 위해서는 공원 내는 물론 경계지역 하천의 체계적인 관리가 요구된다. The fish fauna of mountain streams in the Seorak National Park area was investigated from June 2000 to June 2001 (4 times). All 17 sites were relatively undisturbed 1st to 3rd order streams. A total of 2,557 individuals were collected and classified into 17 families and 43 species. Cyprinidae accounted for 37.2% (16 species) of the total fish species and 84.7% (2,165 ind.) of the total abundance. Subdominant families were Gobiidae (4 species, 5.0%) and Balitoridae (3 species, 3.4%). Zacco temmincki (RA 28.9%, 10 sites) dominated. Subdominant species were Rhynchocypris kumkangensis (25.3%, 4 sites) and Zacco platypus (13.5%, 7 sites). Eleven of the species are endemic to Korea (4 families, 30.5%). Exotic species were not collected in this survey. Fish diversity was higher in streams around the boundary area than in the national park. Therefore, management of streams in the boundary area to protect the fish biodiversity can be efficiently conducted. Habitat degradation should be reduced for the conservation and restoration of fish diversity.