가족 구성원에서 이환된 서경 (Writer

정재익,최성호,차재관,김상호,김재우 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3

만성두통환자에 대한 동서협진의 임상적 연구

정인태,이상훈,김수영,차남현,김건식,이두익,이재동,임사비나,이윤호,최도영 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : Because the cause and etiology of chronic headache are not yet fully explained, the treatment of this symptom is not simple. In order to study the effectiveness East-West pain treatment on chronic headache, we evaluated its effect of pain alleviation and quality of life improvement on chronic headache patients who were treated with nerve block and acupuncture, and only acupuncture for eight weeks. Methods : 92 clinical experiment participants were gathered and through a questionnaire patients who experienced headache for more than 4 hours a day and more than 15 days per month were qualified as chronic headache patients. The qualified patients were classified into two groups, nerve block and acupuncture group(EW group, n=49) and acupuncture group(E group, n=43). Treatment was applied 2 times a weeks for 8 weeks. The acupoints, GV20, HN23, ST8, HN46, TE17, GB20, LI20, LI11, LI14, ST36, and LR3 were stimulated for 20 minutes. The effects of two groups were analyzed using VAS scores and BPI(Brief Pain Inventory). Results : The VAS and BPI after four weeks of treatment showed significant improvement among two but differences between the three groups was statistically insignificant. The VAS and BPI of the EW group after eight weeks of treatment showed statistically significant improvement compared to the other two groups. Conclusion : The pain treatment for chronic headache might be contributed to improvement of quality of life as well as alleviation of pain of chronic headache patients. It was suggested that the West pain treatment in combination with East pain treatment might be an useful modality to improve the pain and quality of life in chronic headache patients.

만성두통환자에 대한 침치료가 심박변이도에 미치는 영향

정인태,이상훈,김수영,차남현,김건식,이두익,이재동,임사비나,이윤호,최도영 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : The purpose of this study was to assess the effect of acupuncture treatment for chronic headache patients using power spectrum analysis of the heart rate variability(HRV). Methods : 15 clinical experiment participants were gathered and through a questionnaire patients who experienced headache for more than 4 hours a day and more than 15 days per month were qualified as Chronic Headache patients. Treatment was applied 2 times a weeks for 8 weeks. The acupoints, GV20, HN23, ST8, HN46, TE17, GB20, LI20, LI11, LI14, ST36, and LR3 were stimulated for 20 minutes. The effects of acupuncture treatment were analyzed using power spectrum analysis of the HRV, HRV was recorded before and after acupuncture treatment. Results : HRV before and after treatment was compared after 8 weeks of acupuncture treatment. Increase in mean values of SDNN and RMSSD were observed but the increases were not statistically significants. Increase in mean values of TP, LF and HF were observed but, the increase was significant(p<0.05) only in TP. Conclusions : The results suggest that acupuncture treatment on chronic headache patients can increase the activity of autonomic nervous system. Further use of HRV for quantitative analysis of acupuncture treatment on autonomic nervous system related symptoms is suggested.

만성두통환자에 대한 아로마침의 임상적 연구

정인태,김수영,김건식,이두익,이재동,이윤호,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2004 東西醫學硏究所 論文集 Vol.2004 No.-

Objective : Because the cause and etiology of chronic headache is not yet fully explained, the treatment of this symptom is not simple. This study compares the effects of aroma acupuncture and normal acupuncture applied an chronic headache patients, in order to establish a primary data for further studier of new treatments and developments of new practical acupunctures. Methods : 38 clinical experiment participants were gathered and through a questionnaire patients who experienced headache for more than 4 hours a day and more than 15 days per month were qualified as Chronic Headache patients. The qualified patients were classified in to two groups, aroma acupuncture group(Aroma AT group, n=23) and normal acupuncture group(AT group, n=15). Treatment was applied 2 times a weeks for 8 weeks. The acupoints, GV20, HN23, ST8, HN46, TE17, GB20, LI20, LI11, LI14, ST36, and LR3 were stimulated for 20 minutes in both the groups. The effects of both groups were analyzed using VAS scores and BPI(Brief Pain Inventory). Results : The VAS pain scores improved significantly in both groups. The decrease rate was larger in the Aroma AT group(p<0.05). The BPI scores for the both groups also decrease. The improvement in the Aroma AT group was larger(p<0.05). Conclusion : Aroma acupuncture applied on chronic headache patients showed effects of relieving pain, improving general activities, changing the mood, and improving sleeping behaviors. These effects were analyzed using VAS scores and BPI. The Aroma AT group showed significant changes of VAS and BPI compared to the AT group, suggesting that this new practical acupuncture is very effective when treating chronic headaches. Further researches are needed to evaluate the distinct functional mechanism of aroma acupuncture, but this study is meaningful in the sense that it will act as a fundamental study to build on.

세포브러쉬와 면봉도말법에 의한 부인과 세포학적 검사의 효율비교

김정란,김성숙,배한익,김용탁,심재철,임문환,윤혜원,이상식 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

A study was undertaken to evaluate the efficiency of the sytobrush compared with the cotton swab for obtaining cells from the uterine cervix. In 300 patients, the cytobrush technique was employed and in control 300 patients was smeared by the cotton swab. In 12 out of 300 patients(4%) endocervical cells were found on the cotton swab technique. A total of 252 out of 300 cytobrush sampler specimen(84%) contained endocervical cells. With the X²method for statistical comparison, the difference in endocervical cell yield between the cotton swab and the cytobrush sampler was significantly different(p<0.01). This was particularly true in older patients. We conclude from study that the cytobrush sampler is of value for obtaining as adequate cervical cytologic specimen.

견비통의 한·양방 진료 및 협진의 경제성 평가

장혜정,홍상민,박유선,남동우,이두익,이재동,이윤호,임사비나 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2007 東西醫學硏究所 論文集 Vol.2007 No.-

Objectives : The purpose of this study was to evaluate and compare the cost-effectiveness of Eastern, Western and collaborative treatments and suggest a cost-effective approach for patients with frozen shoulder pain. Methods : Using the data of fifty-two patients, treatment effectiveness was measured by CSA, SPADI, and ROM scales and changes from the baseline score were evaluated. Data source for cost estimation was based on the national health insurance (NHI) payment system. Because the price in NHI was differentiated by health care institutions, five collaborative types were considered in assessing costs. Cost-effective ratios were computed tor economic evaluation. Results : Compared with Eastem treatinent, collaborative and Westerm treatments showed better effects on CSA scale after 4 weeks' treatment. The collaborative approach was also the most effective treatment on SPADI and ROM scales The direct cost per patient receiving Eastern treatment was less than other treatments. In general, collaborative treatment dominated Eastern and Western treatments in cost-effectiveness analysis However, the cost-effectiveness ratio of Eastern treatment resulted in \9,0OO compared to W29,OOO of collaborative treatment on SPADI Four different indicators of ROM scales resulted in different approaches as the cost-effective treatment. Conclusiuns : Considering cost-effectiveness ratios, collaborative treatment was the best treatment on CSA and SPADl scales after 4 weeks' treatment As for ROM scales, the recommended altematives were Eastern treatment for patients with abduction and adduction disabilities, Western treatment for those with flexion disability, and collab-orative approach for those with extension disability.

정신분열증에서 공존하는 신체질환에 대하여

지익성,왕성근,신석철,이선우,황선희,신용재,김정란,배경도 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

In order to determine the frequency of physical illness in schizophrenia, 107 schizophrenics were assessed with physical exam and routine laboratoy test. The results were as follows 1) Among the total number of 107 schizophrenics, 31 had the physical illness(29%), and among the schizophrenics with physical illness, female outnumbered male at the rate of 17:14. 2) There was no difference between schizophrenics with physical illness and schizophrenics without physical illness in demographic characteristics. 3) Classification of physical illness were disease of skin 7 (22.6%), musculoskeletal system 5(16. 1%), ENT(ear nose throat) 3(9.7%), endocrine system 3(9.7%), circulatory system 2(6.5%), respiratory system 2(6.5%), digestive system 1(3.2%), genitourinary system 1(3.2%), infection 1(3. 2%), eye 1(3.2%) respectively Authors suggest that physical exam and routine laboratory test should be done for all hospitalized psychiatric patients

급성 출혈성 대장염으로 오인된 궤양성 대장염 1예

문희정,장병익,김승범,이호찬,박재현,은종렬,김태년 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel, Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.

쇄골 중간부 골절후 불유합 및 지연 유합의 원인

윤정로,심재익,김택선,이성종,김영배,김학준,안국환,장재영,홍명표 대한골절학회 2002 대한골절학회지 Vol.15 No.4

쇄골 중간 1/3 부위의 골절은 치료 결과가 양호하여 보존적 치료가 원칙적으로 받아 들어지고 잇으며 불유합에 대한 빈도도 낮은 것으로 되어 있다. 그러나 최근 전위 및 단축의 정도가 심할 경우 높은 불유합의 결과와 불량한 임상 결과를 보고하고 있어 이런 예에 대해선 수술적 치료를 권장하고 있다. 저자들은 단축 및 전위의 정도와 불유합의 연관성을 알아보고자 하였다. 연구 대상 및 방법 : 1993년 2월부터 2002년 1월까지 본원에 내원 했던 성인 중간부 쇄골 골절 환자 194명 중 완전 전위를 보인 78례를 조사하여 이중 63례를 대상으로 분석하여 후 향적 연구를 시행하였다. 4개월 추시 후에도 방사성 사진상 유합 소견이 관찰되지 않으면 불유합의 유의성을 알아보고자 하였다. 결 과 : 63례 중 불유합 및 지연 유합을 소견을 보인 환자는 15(23%)례였다. 골유합을 보인 48례의 단축은 평균 8.6㎜(2㎜-17㎜)였고, 전위는 평균 9.7㎜(2-22㎜)였다 .불유합 및 지연 유합을 보였던 15례에서 단축은 평균 14.5㎜(3㎜-37㎜), 전위는 평균 17.3㎜(4-25㎜)였다. 18㎜이상 단축이 있었던 경우 불유합의 발생과는 통계학적으로 유의성을 나타내었고(Fisher's exact test, p<0.01), Chi-square test상 16㎜ 이상의 전위를 보였던 경우 불유합 발생과 통계학적으로 의미가 있었다(p<0.01). 결 론 : 쇄골 골절 특히 중간 1/3의 골절은 비교적 보존적 치료에 결과가 좋은 것으로 되어 있으나, 전위 및 단축이 심한 경우 불유합에 대한 가능성이 높이 때문에 보다 경과 관찰시 유합의 진행이 없으면 적극적인 치료를 고려해야한다. Purpose : Because the prognosis of the mid 1.3 clavicle fracture is good, the conservative treatment with a figure of 8 bandage is the gold standard and the nonunions are rare. However, recently surgical treatment is recommended when the shortening and displacement is severe because of the high nonunion rate and the poor clinical result. This study was undertaken to evaluate that the shortening and displacement at fracture site are associated with the development of nonunion. Materials and Methods : We analysed the 194 fractures of mid 1/3 clavicle in adults which had been treated conservatively from February 1993 to January 2002 and did the retrospective study. Of these, 78 cases were originally in the middle third of the clavicle and had been completely displaced. We reviewed 63 of these cases. The shortening and displacement at the fracture site was measured on the initial roentgenogram. And the analysis of the patients' chart was done for another predisposing nonunion factors. Nonunion and delayed union are considered to be present when there has been little or no progression of clinical or radiographic healing at a minimum of 4 months after injury. Results : 15 of the 63 cases had developed nonunion.. The average 8.6㎜(2㎜-17㎜) shortening and average 9.7㎜(2-22㎜) in the union patients. The average 14.5㎜(3㎜-37㎜) shortening and average 17.3㎜(4-25㎜) in the nonunion patients. We found that initial shortening ≥18㎜(Fisher's exact test, p<0.01) and initial displacement ≥ 16㎜(Chi-square test. p<0.01)at the fracture site were significantly associated with the development of nonunion. Conclusion : The conservative treatment with figure-80-bandage is the gold standard in the clavicle middle one third fracture. However, the nonunion is commonly occurs in the cases of more of severely shortened and displaced fractures. If there are no signs of callus formation and the patient complains of pain after several week, osteosynthesis should be considered.

정신과 의약분업에 대한 5년 후 추적조사

박정수,정재열,홍진표,백기청,박영현,박종익 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Objectives : This study is designed to discuss the pros and cons related to the 'separation of drug prescription and dispensation' system when 5 years have passed by since the introduction of this system. Methods : The 592 psychiatrists from 1,107 working places took part in nationwide survey by mail or E-mail from June to September, 2005. The response rate was 23.8%, most of respondents came from private clinics. Results : The average age of psychiatrist was 44.6 years old, ranging from 25 to 75, most of them was predominantly male. The main results were as followings : 1) The ratio of psychiatric prescription out of hospital based on out-patients departments was the lowest in clinics, following by hospitals, general hospitals and university hospitals by order. 2) The main reasons of customer's preference for out of hospital prescription were economic advantage and self-awareness of prescription. As for the disliking for it, the most complaints were the anxiety about disclosure of psychiatric treatment, in convenience for delay and concern about drug change. Conclusion : Five years didn't seem to give a change on how the psychiatrists perceive the 'separation of drug prescription and dispensation' system at all. The confidentiality and human right issues on the part of psychiatric patients should never be ignored in order to manage this system successfully.