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.

Evaluation of the Efficacy and Safety of DA-9601 versus Its New Formulation, DA-5204, in Patients with Gastritis: Phase III, Randomized, Double-Blind, Non-Inferiority Study

Choi, Yoon Jin,Lee, Dong Ho,Choi, Myung-Gyu,Lee, Sung Joon,Kim, Sung Kook,Song, Geun Am,Rhee, Poong-Lyul,Jung, Hwoon-Yong,Kang, Dae-Hwan,Lee, Yong Chan,Lee, Si Hyung,Choi, Suck Chei,Shim, Ki-Nam,Seol, KOREAN ACADEMY OF MEDICAL SCIENCE 2017 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.32 No.11

<P>This study compared the efficacy of DA-9601 (Dong-A ST Co., Seoul, Korea) and its new formulation, DA-5204 (Dong-A ST Co.), for treating erosive gastritis. This phase III, randomized, multicenter, double-blind, non-inferiority trial randomly assigned 434 patients with endoscopically proven gastric mucosal erosions into two groups: DA-9601 3 times daily or DA-5,204 twice daily for 2 weeks. The final analysis included 421 patients (DA-5204, 209; DA-9601, 212). The primary endpoint (rate of effective gastric erosion healing) and secondary endpoints (cure rate of endoscopic erosion and gastrointestinal [GI] symptom relief) were assessed using endoscopy after the treatment. Drug-related adverse events (AEs), including GI symptoms, were also compared. At week 2, gastric healing rates with DA-5204 and DA-9601 were 42.1% (88/209) and 42.5% (90/212), respectively. The difference between the groups was −0.4% (95% confidence interval, −9.8% to 9.1%), which was above the non-inferiority margin of −14%. The cure rate of gastric erosion in both groups was 37.3%. The improvement rates of GI symptoms with DA-5204 and DA-9601 were 40.4% and 40.8%, respectively. There were no statistically significant differences between the two groups in both secondary endpoints. AEs were reported in 18 (8.4%) patients in the DA-5204 group and 19 (8.8%) in the DA-9601 group. Rates of AE were not different between the two groups. No serious AE or adverse drug reaction (ADR) occurred. These results demonstrate the non-inferiority of DA-5204 compared to DA-9601. DA-5204 is as effective as DA-9601 in the treatment of erosive gastritis. Registered randomized clinical trial at ClinicalTrials.gov (NCT02282670)</P>

한국어판 Composite International Dianostic Interview(K-CIDI)의 개발

조맹제,함봉진,서동우,홍진표,배재남,김장규,이동우,조성진 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.1

연구목적 : 본 연구는 국제적인 정신장애 진단도구인 Composite International Diagnostic Interview(CIDI)를 한국의 사회문화적 상황에 적합하게 번역하고 신뢰도 및 타당도를 평가하여 한국어판으로 개발하기 위한 것이다. 방 법 : CIDI는 정신장애를 평가하고 진단할 수 있는 포괄적이고, 완전히 표준화된 진단도구로 훈련받은 일반인들이 적용할 수 있기 때문에 대규모 역학조사에 적합하다. 세계보건기구에서 제공하는 CIDI 번역 지침에 따라 한국어판 CIDI(K-CIDI)를 제작하였다. 영어권과 한국의 언어 및 사회문화적 차이를 고려하여 번역 및 개정을 하였고 역번역을 통하여 원본의 의미와 일치하는지를 확인하였다. 임상환자를 135명과 일반인 5명을 대상으로 신뢰도와 타당도 검사를 실시하였다. 두 명의 평가자가 K-CIDI를 이용하여 동일한 대상자를 동시에 면담하고 일주일 뒤에 재검사를 실시하였다. K-CIDI로 검사를 받은 대상자들을 정신과 전공의와 임상심리사가 한국어판 Structured Clinical Interview for DSM-Ⅳ를 이용하여 진단을 내렸다. 두 가지 진단의 일치도에 대한 kappa값을 산출하였다. 결 과 : CIDI의 번역에서 한국어 표현이 복잡하고 긴 문항은 두 개의 문장으로 분리하였고, 성과 관련된 표현과 의료체계 및 의료추구행태에서 사회문화적 차이를 반영하였다. 공포장애의 대상과 알코올 및 물질의 종류도 한국의 실정에 맞게 조정하였다. 현장 검사와 역번역 과정에서 K-CIDI가 적절하게 제작된 것으로 평가되었다. K-CIDI의 평가자간 신뢰도 검사는 140명에 대하여 이루어졌고 kappa값은 진단에 따라 0.86∼1.00범위였다. 검사/재검사 신뢰도 검사는 47명에 대해 이루어졌고 kappa값은 진단에 따라 0.42∼0.89였다. K-CIDI의 타당도 검사는 50명에 대해 이루어졌고 kappa값이 진단에 따라 0.50∼1.00의 범위였다. 결 론 : K-CIDI는 한국의 사회 문화적 배경에 적합하게 제작되었고 신뢰도 및 타당도 검사에서 역학연구에 적절한 진단도구로 평가되었다. Objectives : This study aims to develop a Korean version of the Composite International Diagnostic Interview(K-CIDI). Methods : The Composite International Diagnostic Interview(CIDI) is a comprehensive, fully standardized interview that can be used to assess psychiatric disorders and provide diagnoses. The K-CIDI was developed according to the guidelines provided by the WHO. The reliability and validity of the K-CIDI was evaluated by examining 135 psychiatric patients and five community residents. Subjects were jointly interviewed twice with a one-week interval. A psychiatric resident and clinical psychologist jointly determined clinical diagnoses using the Structured Clinical Interview for DSM-Ⅳ. Results : Notable modifications were done on sex-related expression, health system and help seeking behavior, subjects for phobic disorder, and kinds of alcohol and substance. Long and complex questions were divided into two or more questions. Field test and back-translation of the K-CIDI confirmed the appropriateness of the translation of the CIDI. The inter-rater reliability, test/retest reliability, and validity of the K-CIDI indicated kappa values ranging from 0.86-1.00, 0.42-0.89, and 0.50-1.00, respectively. Conclusion : The K-CIDI was deemed to be appropriate for the sociocultural background of Koreans. The reliability and validity of the K-CIDI were judged to be exceptionally acceptable.

한국 주요정신장애의 유병률 및 관련요인 : 2006 전국정신질환역학조사

조맹제,장성만,함봉진,정인원,배안,이영문,안준호,원승희,손정우,홍진표,배재남,이동우,조성진,박종익,이준영,김진영,전홍진,이해우 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.3

Objectives The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. Methods The Korean Epidemiologic Catchment Area study Replication (KECA-R) was Conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target Population included all eligible residents aged 181o 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). Results A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of Specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nicotine use disorder, 9.0% and 6.0% ; 3) specific phobia, 3.8% and 3.4% ; 4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. Conclusion The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.

한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

후복막강내 발생한 Castleman병 1례

남성진,이동욱,박찬규,정시욱,김추성,조성래,구본천,양사규,이일웅,박정자 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

Castleman' s disease is a rare, reactive lymphoid proliferation of unknown cause and pathogenesis. Depending on histololgic findings, it has been divided into two distinct histologic subtypes that include hyaline-vascular type(90%) and plasmacell type(10%). This disease occurs most commonly in mediastinal lymph nodes and cervical lymph nodes, inguinal lymph nodes respectively. But occurs rarely in retroperitoneum. We report a case of hyaline-vascular type asymptomatic Castleman' s disease of the retroperitoneum in a 47-year-old man.

大田市 住宅의 外形的 脈絡에 관한 硏究

남회진,김동찬,송용호 忠南大學校 地域開發硏究所 1989 地域開發論叢 Vol.1 No.-

조대술에 의한 하마종의 치료

강동균,황경문,김은정,김현정,김영진,남순현 大韓小兒齒科學會 2006 大韓小兒齒科學會誌 Vol.33 No.1

하마종은 구강저에 발생하는 점액 남종으로 주로 설하선과 관련된다. 즉, 하마종은 설하선 분비도관의 파열로 인하여 타액이 분비도관에서 빠져나와 주위의 연조직 내에 저류됨으로써 발생하는 가성 낭으로 정의 되며, 원인은 설하선 도관의 파열이나 폐색이다. 하마종의 임상소견은 청색의 투명한 종창이 구강저의 소대를 중심으로 편측으로 발생하며, 무통성이며, 촉진시 파동성을 나타낸다. 조직소견은 결합 조직 내 와동이 형성되지만, 낭 벽은 상피세포가 아닌 육아조직으로 구성되는 가성 낭을 관찰할 수 있다. 하마종의 첫 번째 치료법으로는 하마종의 내벽이 구강점막의 일부가 되도록 만들어 주는 조대술을 고려할 수 있다. 본 증례는 특징적인 하마종의 임상소견을 보이는 환아에게 gauze-packing등을 동반한 조대술을 이용하여 치료한 증례로써 양호한 치료결과를 보여 보고하고자 한다. Ranula is a mucocele which occurs at the mouth floor and mostly related to sublingual gland. In other words ranula is definded as a pseudocyst which occurs as the secretion duct of sublingual gland is destructed there as the saliva from the the secretion duct flows out and retention in the soft tissue. The cause of ranula is destruction or obstruction of the duct. The clinical findings of ranula is a painless, unilateral bluish transparent swelling around the frenum and shows fluctuation when palpated. Histological finding represent a formation of cavity inside the connective tissue. but a pseudo-cyst can be seen which the wall of the cyst is composed of granulation tissue rather than epithelial cells. The first treatment of ranula can be considered as marsupialization. which induces the inner wall of the Ranula to be a part of oral mucosa. This case report shows a treatment of marsupialization with gauze packing in a young patient representing a clinical finding of characteristic ranula.

점액성 대장 및 직장암의 임상 병리학적 고찰

신동우,김남규,민진식,김호근,양우익 대한대장항문학회 1997 Annals of Coloproctolgy Vol.13 No.3

환기정도에 따른 수술실용 신발 종류가 수술실 오염에 미치는 영향 : How to Choose Suitable Shoes?

남경동,정혜선,박영신,원진희,주미자,성화신,이지혜,이병희,조경숙,배재춘 한국의료QA학회 2000 한국의료질향상학회지 Vol.7 No.1

Background : Various types of protective footwear have been used to minimize bacterial contamination in operating rooms. In recent years, debate has arisen concerning the need for use of such protective footwear. This study was designed to provide useful data about choosing shoes most suitable for the surgical environment. Methods : Between November, 1999 and January, 2000, we performed this experimental study by comparing effect of three types of shoes (i.e., disposable shoescover, operating room-restricted shoes, and ordinary shoes) on bacterial contamination of operating rooms equipped with two different ventilation systems (i.e., high air-change, low air-change) respectively. Data were collected during two-hour sham operations in which subjects and their activities were strictly standardized. Bacterial flora were sampled from the study area floor and air colony-counts were measured. Results : In experiments involving high air-change ventilation system, there was a significant difference of floor contamination between three types of shoes, but no difference of air contamination. Under low air-change system, there was a significant difference of both floor and air contamination between three types of shoes. Conclusion : The results show that protective footwear would be unnecessary in the operating room with high air-change ventilation system, but it is important to choose suitable shoes carefully under low air-change system. Therefore, the use of outdoor shoes can be considered under high air-change system, but it would seem sensible to apply their first use in less bloody operations at the day surgery center or out-patient department to prevent transfer of body fluid into the outside environment.