정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구

조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.

Staphylococcus lugdunensis에 의한 감염성 심내막염 1예

최성호,박현구,변승운,구동회,강호석,장항제,김양수,우준희,김영휘,최상호 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CNS) that is commonly found on the human perineal skin. Contrary to other CNS, S. lugdunensis is a rare contaminant in cultures and has the potential to cause clinically significant infections, including infective endocarditis. Infective endocarditis due to S. lugdunensis have been known to resemble endocarditis due to S. aureus because of its aggressive clinical course and high mortality. We report a case of infective endocarditis caused by S. lugdunensis in a 21-year-old woman. She was cured of the infection with surgical and antibiotic therapy. S. lugdunensis에 의한 감염성 심내막염은 국내에서보고가 없었던 매우 드물지만 다양한 합병증과 높은 사망률을 보이는 감염증이다. 저자들은 S. lugdunensis가 수술적 치료와 항생제 치료로 완치된 감염성 심내막염 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Clinical benefit of botulinum toxin injection for scar treatment

( Hyun Jeong Byun ),( Se Jin Oh ),( Seung Hwan Oh ),( Ji-young Jun ),( Ji-hye Park ),( Dong-youn Lee ),( Joo-heung Lee ),( Jun-mo Yang ),( Jong Hee Lee ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2

Background: Laser treatment for thyroidectomy scars has been proven to be effective in minimization of hypertrophic changes in these scars. However, fibrotic scars with tension and adhesion would not respond well to the laser treatment alone. Objectives: This study was designed to evaluate the clinical efficacy of combination treatment with botulinum toxin and laser treatment (BTL) on the fibrotic thyroidectomy scars. Methods: Twenty four patients with fibrotic thyroidectomy scars who received BTL treatment were analyzed. Ablative fractional laser was applied first, and on the very day of laser treatment or in a week after the laser, botulinum toxin was injected to the scars. Two blinded assessors graded the degree of improvement using photographs based on the Vancouver Scar Scale (VSS). Patients were divided into two groups according to their initial height and pliability of the scars. The differences of the VSS before and after BTL between two groups were also analyzed. Results: Vascularity(p=0.001), pliability(p<0.0001), height(p<0.0001), and total VSS score(p<0.0001) showed statistically significant improvement after BTL treatment. Comparing difference of the score before and after BTL treatment, group A (higher score in initial scar height and pliability) showed larger difference in height (p=0.0032) and total VSS(p=0.0555) than group B. Conclusion: Botulinum toxin injection combined with laser treatment may provide clinical benefit for the treatment of the fibrotic thyroidectomy scars.

[Poster] Great saphenous vein aneurysm : uncommon experience of vascular anomaly

Jun Suk Byun,Ju Ik Moon,Yu Mi Ra,Sang Eok Lee,In Seok Choi,Won Jun Choi,Dae Sung Yoon,Hyun Sik Min 대한외과학회 2011 대한외과학회 학술대회 초록집 Vol.2011 No.11

A Remained Useful Lifecycle Prediction with Bayesian Mixture Model

( Jun Hyun Byun ),( Min Su Hong ),( Jihoon Kang ) 한국품질경영학회 2021 한국품질경영학회 학술대회 Vol.2021 No.-

현대에 이르러 산업이 빠른 발전속도로 인해 제조 공정이 갈수록 복잡해짐에 따라 기존의 고장물리(Failure Physics) 기반 잔여수명(Remained Useful Lifecycle : RUL) 예측 방법론의 일반적 활용이 어려워지고 있다. 이에, 센서 데이터를 기반으로 한 머신러닝 모델링을 활용하는 잔여수명 예측 방법론이 광범위하게 개발되었으나, 데이터 기반의 잔여수명 예측 방법론은 주로 단일모델의 예측성능에 의존되는 경향이 있어 이로 인한 불확실성이 존재한다. 이에, 본 연구에서는 확률적 수명분포를 활용해서 다양한 패턴의 시뮬레이션 데이터를 생성하고, 실제 데이터와 각 시뮬레이션 데이터 분포의 적합성을 확률 가중치로 조합하는 혼합모델(mixture model)을 제안하였고, 잔여수명 패턴변화에 대한 불확실성을 줄이기 위해서 베이지안 업데이트 기법을 활용, 적합성 확률을 실시간으로 업데이트하는 방식을 제안하였다. 본 수명예측 방법론의 성능 검토를 위해 일반적으로 널리 활용되는 지수함수 가중치를 반영한 가중선형회귀(exponentially weighted linear regression) 모델과 비교해서 정확도를 검증하였다.

다중모드 신호를 활용한 모바일용 위성단말 시스템의 안테나 추적성능 연구

변준수(Byun Jun Su),박도현(Park Do Hyun),송충호(Song Choong Ho),안성준(Ahn Sung Joon),전찬원(Jun Chan Won),이호정(Ho Jung Lee) 한국통신학회 2012 한국통신학회 학술대회논문집 Vol.2012 No.6

Pseudoinvasion in an Adenomatous Polyp of the Colon Mimicking Invasive Colon Cancer

Tae Jun Byun,Dong Soo Han,Sang Bong Ahn,Hyun Seok Cho,Chang Soo Eun,Yong Cheol Jeon,Joo Hyun Sohn,Young Ha Oh 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2009 Gut and Liver Vol.3 No.2

Pseudoinvasion or pseudocarcinomatous invasion in an adenomatous polyp of the colon can be unfamiliar to an endoscopist. Pseudoinvasion in an adenomatous polyp represents prolapse of the adenomatous epithelium into its stalk. In most cases its morphology does not differ from of general adenomatous polyps, but in some cases it can morphologically mimic a malignant polyp with submucosal invasion due to masslike lesioning of its stalk. This makes it difficult for endoscopists to differentiate pseudoinvasion in an adenoma from an invasive carcinoma by conventional endoscopy; instead, endoscopic ultrasonography can provide useful information for differentiating these conditions. We report on an 82-year-old man who presented with a large pedunculated polyp with a thick stalk in the sigmoid colon, which mimicked a submucosal invasive carcinoma. The patient was diagnosed with pseudoinvasion in an adenomatous polyp after segmental resection of the sigmoid colon. (Gut and Liver 2009;3:130-133)

A Review of the Direction for Establishing an Environmental Education City Based on the Analysis of the Current Status of Environmental Education in Korea : Focused on the Metropolitan City

Yi, Byun Jun,Ju, Hyun Jung,Kim, Ji Hyun 한국성인계속교육학회 2021 성인계속교육연구 Vol.12 No.4

<i>Candida auris</i> Clinical Isolates from South Korea: Identification, Antifungal Susceptibility, and Genotyping

Kwon, Yong Jun,Shin, Jong Hee,Byun, Seung A,Choi, Min Ji,Won, Eun Jeong,Lee, Dain,Lee, Seung Yeob,Chun, Sejong,Lee, Jun Hyung,Choi, Hyun Jung,Kee, Seung Jung,Kim, Soo Hyun,Shin, Myung Geun American Society for Microbiology 2019 Journal of clinical microbiology Vol.57 No.4

<P><I>Candida auris</I> is an emerging worldwide fungal pathogen. Over the past 20 years, 61 patient isolates of <I>C. auris</I> (4 blood and 57 ear) have been obtained from 13 hospitals in Korea.</P><P><I>Candida auris</I> is an emerging worldwide fungal pathogen. Over the past 20 years, 61 patient isolates of <I>C. auris</I> (4 blood and 57 ear) have been obtained from 13 hospitals in Korea. Here, we reanalyzed those molecularly identified isolates using two matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) systems, including Biotyper and Vitek MS, followed by antifungal susceptibility testing, sequencing of the <I>ERG11</I> gene, and genotyping. With a research-use-only (RUO) library, 83.6% and 93.4% of the isolates were correctly identified by Biotyper and Vitek MS, respectively. Using an <I>in vitro</I> diagnostic (IVD) library of Vitek MS, 96.7% of the isolates were correctly identified. Fluconazole-resistant isolates made up 62.3% of the isolates, while echinocandin- or multidrug-resistant isolates were not found. Excellent essential (within two dilutions, 96.7%) and categorical agreements (93.4%) between the Clinical and Laboratory Standards Institute (CLSI) and Vitek 2 (AST-YS07 card) methods were observed for fluconazole. Sequencing <I>ERG11</I> for all 61 isolates revealed that only 3 fluconazole-resistant isolates showed the Erg11p amino acid substitution K143R. All 61 isolates showed identical multilocus sequence typing (MLST). Pulsed-field gel electrophoresis (PFGE) analyses revealed that both blood and ear isolates had the same or similar patterns. These results show that MALDI-TOF MS and Vitek 2 antifungal susceptibility systems can be reliable diagnostic tools for testing <I>C. auris</I> isolates from Korean hospitals. The Erg11p mutation was seldom found among Korean isolates of <I>C. auris</I>, and multidrug resistance was not found. Both MLST and PFGE analyses suggest that these isolates are genetically similar.</P>

A study of primary cancers developed in patients with cutaneous malignant melanoma: a single institution retrospective study

( Hyun Jeong Byun ),( Jongeun Lee ),( Chan Seong Park ),( Youngkyoung Lim ),( Ji-hye Park ),( Jong-hee Lee ),( Dong-youn Lee ),( Joo-heung Lee ),( Jun-mo Yang ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Considering hypothesized genetic and environmental risk factors for melanoma, research on the relevance of other primary cancers is necessary. It has been described that Caucasians with melanoma have a risk of developing secondary primary cancer in several studies. However, studies of Asians are few. Objectives: The objectives were to assess the incidence of primary cancers according to the site and the stage of melanoma, and compare mortality rates between patients with primary cancers and those without. Methods: Patients were divided according to the primary skin site, and stages of melanoma. The risk of developing primary cancer was estimated by calculating standardized incidence ratio(SIR). Results: Among 924 patients diagnosed as cutaneous malignant melanoma, 71(7.68%) patients developed 75 primary cancers. Thyroid cancer accounted for 21.33%, followed by stomach cancer, breast cancer, and LGI cancer. Age and sex adjusted SIR for primary cancers was 6.02(95% CI 4.70-7.59). The prevalence of primary cancer was not significantly different among the primary sites of melanoma, and it was significantly higher in regional metastasis group compared to patients with distant metastasis. The mortality risk was significantly lower in patients with other primary cancers than in those without primary cancers. Conclusion: Further studies are needed for more reliable results. Also, screening for cancers according to the schedule should be strongly recommended for additional cancer incidence.