정신분열병 환자의 가족부담 척도 개발에 대한 예비연구

김철권,조진석,서지민,김용관,김호찬,김현수,김상수,제영묘 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적 : 정신분열병 환자의 가족이 느끼는 부담을 측정하기 위한 가족부담 척도를 개발하기 위함이다. 방 법 : 200명의 정신분열병 환자 가족과의 비구조적 면담과 외국 부담척도 고찰을 통하여 94문항을 수집하였고 그 다음에 전문가들과 가족들이 문항 및 영역을 분류하고 통합하여 최종적으로 36문항을 선정하였다. 그리고 정신분열병 환자의 가족 135명, 불안장애 환자의 가족 22명, 기분부전장애 및 신체화 장애 환자의 가족 26명, 치매 환자의 가족 49명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과 : 자료분석 결과 검사-재검사 신뢰도, 내적 일치도, 감별타당도 모두 높게 나타났으며, 요인분석을 통해 다섯 가지 구성요인이 추출되었다. 결 론 : 본 가족부담 척도는 정신분열병을 포함한 만성 정신질환을 앓고 있는 환자의 호전과 가족의 부담을 덜어주기 위한 다양한 프로그램의 효과를 검증하는데 유용하게 사용되어질 수 있을 것이다. Objectives : This preliminary study was carried out to develop the Family Burden Scale(FBS) of the schizophrenics. Methods : Ninety-four items were collected by interviewing in a free unstructured format with one relative of each 200 schizophrenic patients and reviewing foreign FBS's. Several professionals and relatives were asked to group and integrate them into several categories. Finally 36 burden items were chosen to constitute a FBS. The FBS was administered to the relatives of 135 schizophrenic, 22 anxiety disorder, 26 dysthymic disorder and somatization disorder, and 49 dementia patients for examining the reliability and validity. Results : The FBS showed high test-retest reliability, internal consistency, and discriminant validity. The results of the factor analysis revealed five-factor solution. Conclusion : The FBS can be used to evaluate the effectiveness of various programs intended not only to reduce decompensation among schizophrenics, but also to alleviate family burden.

대퇴동맥을 통한 경피적 관동맥 중재시술 환자의 천자부위 지혈을 위한 Angioseal^(�) 사용과 고식적 용수 압박법의 비교 : 전향적 연구

김용훈,권현철,김필호,안석진,유철웅,최진호,이상철,김준수,김덕경,전은석,이상훈,홍경표,박정의,서정돈 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 경피적 관동맥 중재술은 최근 양적 및 질적으로 급격한 발전을 보였지만 시술 시 천자부위의 혈관 합병증은 아직 해결해야 할 문제점이다. 저자들은 대퇴동맥을 통한 경피적 관동맥 중재술을 환자에게 천자부위 지혈을 위한 혈관폐쇄기구인 안지오실의 안전성과 유용성을 고식적인 용수 압박법과 비교 연구하고자 하였다. 방법 : 2002년 4월부터 2003년 5월 사이에 삼성서울병원 심장혈관센터에서 대퇴동맥을 통한 경피적 관동맥 중재술을 성공적으로 시행한 200명의 환자(안지오실 사용군: A군, 100명, 고식적 용수압박법 사용군 B군, 100명)를 대상으로 시술 후 주요 합병증 및 경한 합병증, 지혈 후 환자가 자리에 앉기까지의 시간, 보행개시 가능시간, 총 재원 기간과 시술 1주 후의 합병증을 전향적으로 조사하여 비교 연구하였다. 결론 : 두 군에서 연령, 성별, 기저질환, 심혈관 질환의 위험요소, 시술의 종류, 시술 중 사용한 헤파린의 양, clopidogrel의 양, ticlopidine의 양, 지혈 시 수축기와 확장기혈압, ACT (activated clotting time)는 차이가 없었다. A군이 B군에 비해 시술 후 자리에 앉기까지의 시간 (A군: 4.3±0.3시간, B군: 13.7±0.8시간, p=0.004) 및 보행개시까지의 시간(A군: 6.8±0.5시간, B군: 18.8±2.1시간, p=0.013)이 유의하게 짧았다. 시술 후 주요 합병증은 두군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 A군에서 유의하게 적었다(A군: 28명, B군: 19명, p=0.003). 반상출혈의 경우는 A군에서 유의하게 낮았지만(A군: 3명, B군: 12명, p=0.01), 혈종, 출혈의 발생은 두군간에 차이가 없었다. 총 재원기간에는 두 군간에 차이가 없었다(p=0.239). 시술 1주 후 경과관찰에서 주요합병증은 역시 두 군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 두 군에서 차이가 없었다(A군: 15명, B군: 13명 p=0.418), 반상출혈의 빈도는 차이가 없었지만 혈종의 발생은 A군에서 더 낮았다(A군: 2명, B군:6명, p=0.004). 두 군 모두에서 출혈은 발생하지 않았다. 결론 : 대퇴동맥을 통한 경피적 관동맥 중재술을 시행한 환자에서 안지오실의 사용은 고식적 용수 압박법에 비해 환자의 침상 안정시간을 줄여 조기 활동개시가 가능하게 하였으며 국소합병증의 위험도를 일부 낮추어, 시술에 따른 환자의 불편을 현저하게 감소시킬 수 있다고 할 수 있을 것으로 기대된다. Background : Although the number and the quality of percutaneous coronary intervention have been recently increased dramatically, the vascular complication at puncture site is still the major cause of patients' morbidity. We evaluated the safety and efficacy of newly of newly-developed collagen-based arterial closure device, Angioseal after transfemoral percuatenous coronary intervention. Methods : This study was designed as a prospective single center non-randomized comparative study. A total 200 patients undergoing transfemoral percutaneous coronary intervention were enrolled between April 2002 and May 2003. They were divided into two groups; Angioseal group (group A, n=100) and manual compression group (group B, n=100). The baseline clinical and angiographic characteristics were reviewed. The time to sit up, the time to ambulation, the duration of hospital stay, major and minor vascular puncture site complications were monitored. The patients were followed-up for 1 week after procedure by telephone. Results : The baseline clinical characteriwtics, clinical diagnosis, cardiocascular risk factors, typesof procedure, doses and numbers of anticoagulants were similar between two groups. The blood pressure and activated clotting time were also similar. The time to sit up (group A: 4.3±0.3 hours, group B: 13.7±0.8 hours, p=0.004) and the time to ambulation (group A: 6.8±0.5 hours, group B: 18.8±2.1 hours, p=0.013) were shorter in group A. No major vascular complications were noted. The incidence of hematoma and bleeding were not significantly different between two groups. The incidence of ecchymosis, however, was significantly lower in group A (group A:12%, group B: 3%, p=0.001) The duration of gospital stay was similar between groups. During 7 days of follow-up period incidence of hematoma was significantly lower in group A (p=0.004). Although the incidence of ecchymosis was not significantly different between two groups. Conclusion : The angioseal may be associated with earlier ambulation and less patients' morbidity with low incidence of local complication rate compared to manual compression after transfemoral percutaneous coronary intervention.

고삼투압성 비케톤성 상태의 예후인자

안성훈,김양원,김미란,진헌철,안지영,이상래,류석용,김홍용,김성준,이병권,김경환 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Background: A hyperosmolar nonketotic state has been known to have a high mortality, and even now, despite this high mortality, only a few studies of this disease have been performed. We studied the prognostic factors for the hyperosmolar nonketotic state. Methods: We retrospectively studied the cases of 40 patients who were in a hypersomolar nonketotic state when admitted to Sanggye Paik Hospital during the 6-year Period from 1995 through 2000. We divided the hyperosmolar nonketotic patients into two groups, the complete recovery group and the incomplete recovery group, and compared the clinical features, the laboratory findings, and the precipitating factors between two groups. Results: 1) A total of 40 patients were studied: 24 in the complete recovery group and 16 patients in the incomplete recovery group. The mortality rate was 32.5%. 2) No significant statistical difference existed among the clinical features of the two groups, except for the sex(p<0.01). 3) Among the laboratory findings of both groups, analysis revealed that the effective osmolarity was significantly higher among those in the incomplete recovery group(p<0.01). Serum sodium concentration was also significantly higher among those in the incomplete recovery group(p<0.01). Serum creatinine was also significantly higher among those in the incomplete recovery group(p<0.05). Serum bicarbonate concentration, on the other hand, was significantly lower among those in that group(p<0.05).4) Infection was identified as the most common precipitating factor(62.5%). Among the precipitating factors of the two groups, there were significant statistical difference in pneumonia, UTI, and inappropriate glucose control. 5) A significant statistical difference existed among the initial level of consciousness of both groups(p<0.05). 6) The only significant independent factor responsible for prognosis of nonketotic hyperosmolar state patients was the sex. Conclusion: The sex was only significant independent prognostic factor of nonketotic hyperosmolar state patients.

사망진단서(사체검안서) 상의 선행사인으로부터 사망통계의 원사인이 선정되는 비율 : 3개 대학병원에서 교부된 사망진단서를 중심으로

박우성,박석건,정철원,김우철,탁우택,김부연,서순원,김광환,서진숙,부유경 한국의료QA학회 2004 한국의료질향상학회지 Vol.11 No.1

Background : To exatnine the problems intolved in writing practice of death certificates, we cotnpated the determination of underlying cause of death for wital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 rnortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record wpecialists. And causes of death determined at ministry of statistics for national vita statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificaties sere analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. Ane the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions tha caused death too. Conclusion : When we examined the correctness of death certificate writing practice using abpve methods, cortectness of writing could not be told as satisfactory. There was difference in correctness of writing between hospotals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

브로콜리 추출물의 향장활성 효과

김대용ㆍ조석철ㆍ권혁선ㆍ김미경(Dae Young KimㆍSeok chul ChoㆍHyuk sun KwonㆍMee Kyung Kim) 한국인체미용예술학회 2016 한국인체미용예술학회지 Vol.17 No.1

In this study, we investigated the anti-oxidative effects, antimicrobial, and anti-inflammatory activities of the extracts from broccoli to evaluate its use as a functional ingredient in cosmetics. The extracts are WE (water extract at RT), MWE (mineral water extract at RT), EE (70% ethanol extract at RT), and USEE (heat process for 12 hours at 60℃ after ultrasonification for six hours with 70% ethanol). The measurements of the total polyphenol content from broccoli extracts were highest in EE at 425.24±13.9 mg/g dry. The result of electron donating ability of EE was the highest at 10,000 ㎍/㎖ as 97.81% and increased in a concentration-dependent manner. The ferric reducing antioxidant powder (FRAP) of EE was the highest at 10,000 ㎍/㎖ as 1235.6 μM. In an antimicrobial activity test, the EE showed significant antimicrobial activity against S. epidermidis, S. aureus, E. coli, P. acnes, and P. ovale. Furthermore, broccoli extract exhibited no cytotoxicity in RAW 264.7 cells. Also anti- inflammatory activity by NO assay showed LPS-induced NO was significantly inhibited following treatment with EE of 1,000 ㎍/㎖. Therefore, the broccoli ethanol extract can be used as a resource of natural cosmetic material for functional cosmetics.

박스-젠킨스법을 이용한 소양호 수질변화 시계열분석

김범철,윤용운,정태영,박석순 이화여자대학교 환경문제연구소 1997 이화환경연구 Vol.1 No.-

Statistical models were developed using the Box-Jenkins time series analysis to simulate changes of water qualities in Soyang Lake. The water qualities included in the models are total phosphorus(TP) and chlorophyll-a(CA). The model development was based on the data obtained from Feb. 1987 to Oct. 1992 for TP and from Mar. 1985 to Oct. 1992 for CA, and followed the typical procedures of the Box-Jenkins method including identification, estimation, and diagnostic check. From the computed autocorrelation function (ACF) and partial autocorrelation function(PACF), it was determined that the TP model should have two autoregression (AR) parameters and one moving average(MA) parameter, and two seasonal AR parameters and one seasonal MA parameter. The CA model was determined to have two AR parameters and two MA parameters, and two seasonal AR parameters and on seasonal MA parameter. Both models had seasonality of twelve months and were formulates as SARIMA(2,1,1)×(2,1,1)₁₂for TP and SARIMA(2,0,2)×(2,1,1)₁₂ for CA. The models were validated by testing normality and independency of the residuals. The model prediction ability was tested using the data collected from Nov. 1992 to July 1994 both for TP and CA. There were good agreements between the model predictions and the field measurements. Most of the predicted values were located within the 95% confidence limits except certain period of chlorophyll-a. It was concluded from this study that the Box-Jenkins time series analysis would be an effective tool to understand and simulate the long term variations of water qualities in Soyand Lake.

알레르기성 비염환자에서 레이저 하비갑개 소작술의 증상개선효과에 관한 연구

김경래,이형석,박철원,이승환,박준수 한양대학교 의과대학 2000 한양의대 학술지 Vol.20 No.1

Allergic rhinitis is conventionally treated with anti-histamine or immunotherapy, although in many cases the results are unsatisfactory. Using a CO_2 laser we have succeeded in relieving the symptom of rhinitis by thermocoagulating only the inferior turbinate, making this a quick and effective form of treatment. The subjects were 82 patients with house-dust induced allergic rhinitis presented to the out-patient clinic of the otolaryngology department of Hanyang University Hospital. There were 37 men and 45 women ranging in age from 16 to 47 years. Patients were irradiated at an output of 7-9 W of CO_2 laser. Prior to the procedure, surface anesthesia was applied using 10% lidocaine. The irradiation was completed in three time. The effects of this therapy were evaluated using 4 points to express the degree of subjective symptoms and intranasal findings. From one week before surgery the patients was asked to record symptoms (sneezing, rhinorrhea and obstruction). After surgery, the effects were evaluated by adding up the total scores for sneezing, rhinorrhea and obstruction at one week intervals. Full effect including disapprearance of symptoms, was obtained in 80%, good effect in 10%, fair effects in 5% and no effect in 5%.

고립성 폐결절의 조직학적 진단에 있어서 경기관지폐생검의 진단적 가치

김치훈,김정주,왕준호,연규민,김형수,리원연,용석중,신계철 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

Transbronchial lung biopsy(TBLB) is a relatively simple and convenient diagnostic tool in solitary pulmonary nodule(SPN) on chest radiograph, which is cannot be diagnosed through routine tests. To investigate the diagnostic value and diagnostic rate of TBLB according to the variable factor, we analyzed 69 patients with radiologically SPN lesion on chest radiograph which was confirmed histologically. A histologic diagnosis of TBLB was made in 47 of 69 patients(68.1%), in which 26 of 37(70.3%) with malignancy and 21 of 32(65.6%) with benign lesion. There were no significant differences in diagnostic yield according to age, sex and location of the lesion. The diagnostic rate tended to increase with the more than 5 pieces to acquired by TBLB. When the size of SPN was less than 3 ㎝, it cannot be diagnosed. In conclusion, TBLB is a diagnostic procedure with good yield and safety, but percutaneous needle aspiration, transbronchial needle aspiration, and bronchial washing fluid cytology may be a complementary procedure to overcome the limitation of TBLB and get higher diagnostic yield for SPN.

CMOS VLSI의 IDDQ 테스트세트 간략화에 관한 연구

김강철,송근호,한석봉 진주산업대학교 1996 論文集 Vol.35 No.-

This paper proposes a dynamic compaction algorithm which can detect intra-bridging faults for IDDQ testing in CMOS VLSI. X_gates which have X(don't care) values in the input of the gate may exist in the circuit after a test pattern in chosen. The compaction algorithm assigns the logic value 1 or 0 that can be applied to the primitive fault pattern to X in the X_gate, and it detects all detectable faults for a test pattern. The simulation results in the benchmark circuits show that the fault coverage of this dynamic compaction algorithm is much enhanced compared with the conventional static compaction algorithms, and the resulting test vector reduction is up to 30%.

파킨슨병 환자에서 Selegiline과 SSRI 병용에 의해 발생한 중추성 세로토닌 증후군

김철호,권석범,정산,윤성희,황성희 최신의학사 2003 最新醫學 Vol.46 No.11-12