농촌 지역 주민들의 주관절부 척골신경병증 유증상군의 1년 후 변화

심영주,임현술,Sim, Young-Joo,Lim, Hyun-Sul 대한예방의학회 2006 예방의학회지 Vol.39 No.5

Objectives: This study examined the natural history of symptomatic patients who did or did not display abnormal results on nerve conduction studies (NCS). Methods: Forty hundred fifty adults were selected among a total of 578 residents who participated in the health examination in a rural Korean district. A symptom questionnaire and NCS were used to diagnose ulnar neuropathy at the elbow (UNE). There were 6.4% of the subjects with UNE, 5.1 % of the subjects showed symptoms without a NCS, and 84.2% of the subjects who were asymptomatic. One year later, 20 symptomatic limbs with an abnormality on the ulnar NCS and 22 symptomatic limbs without any abnormality in the ulnar NCS were enrolled in a follow-up study. The natural history of UNE was evaluated by examining the changes in the clinical and electrodiagnostic examinations. Results: The 1-year follow-up of the enrolled limbs found that for the symptomatic limbs with an abnormality on the NCS, the degree of severe of the clinical grade changed from 20% to 10%. In contrast, for the symptomatic limbs that were without any abnormality in the NCS, the change of the severe degree of the clinical grade was from 0% to 18.2%. Also, for the electrodiagnostic change, only symptomatic limbs without NCS abnormalities showed significant changes in motor latency, amplitude and conduction velocity at the 1-year follow-up. Conclusions: The 1-year follow-up study revealed symptomatic limbs that were without any abnormality on the ulnar NCS were more likely to progress than the symptomatic limbs with an abnormality on the ulnar NCS.

부산지역 중학생의 trans 지방산 섭취 수준과 식행동 조사

심영주(Young-Joo Sim),노경희(Kyung-Hee Noh),이미옥(Mi-Ok Lee),송영선(Young-Sun Song) 한국식품영양과학회 2003 한국식품영양과학회지 Vol.32 No.3

Trans 지방산 섭취 수준을 파악하기 위하여 부산지역 중 학생 800명을 대상으로 식행동 조사와 3일간의 식사기록법을 실시하였다. 식행동 조사에서 조사대상자들의 간식회수는 1일 2회(35.3%)가 가장 많았으며, 간식시 선호하는 식품은 아이스크림(68.2%), 우유(57.0%), 파이(26.4%) 등이었다. 외식시 선호하는 식품으로는 자장면(54.6%), 양념통닭(50.5%), 닭튀김(35.3%) 등의 순이었다. 1일 평균 trans 지방산 섭취수준은 남학생 1.40±0.05 g, 여학생 1.89±0.06 g이며 전체 평균 1.68±0.04 g으로 여학생이 남학생보다 높았으며, 유의적인 차이가 있었다(p<0.001). 우유와 유제품, 육류 및 가공품 등에 포함되어 있는 천연적으로 생성되는 trans 지방산의 섭취수준은 평균 1.04±0.03 g으로 1일 trans 지방산 섭취량의 약 62.1%였으며 인공적으로 생성된 trans 지방산의 섭취 수준은 평균이 0.64±0.02 g이며 총 trans 지방산 섭취량의 37.9%로 나타났다. 남ㆍ여 평균 trans 지방산의 섭취량은 1일 섭취 총 열량의 0.8%, 1일 총 지방의 3.16%였다. Trans 지방산 섭취수준은 여학생일 경우 용돈수준이 4만원에서 5만원미만이 가장 높았으며, 간식빈도는 거의하지 않는 경우(2개월에 2회)가 4.56±1.55 g으로 가장 높았다. Trans 지방산 섭취의 주요 급원은 우유 및 유제품(34.3%), 빵류(18.3%), 어육류와 가공품(16.2%)의 순이었다. 본 연구의 결과, 우리나라 국민 전체의 trans 지방산 섭취수준은 외국에 비해 그다지 높은 수준은 아니지만 현재의 식생활 패턴과 변화 추이를 볼 때 앞으로 trans 지방산 섭취수준은 증가될 것으로 예상되므로 한국인의 trans 지방산 섭취수준에 대한 연구 분석이 계속 진행되어야 할 것으로 사료된다. To assess trans fatty acids (tFAs) intake of middle school students in Busan, behavior of having meals and 3 day's food record were surveyed in 800 subjects. 35.3% of subjects responded to twice a day in frequency of snack intake. Preferred snack items were ice cream (68.6%) and milk (57.0%). Subjects of dining out preferred jajangmyon (54.6%), seasoned chicken (50.5%), fried chicken (35.3%) in order when dined out. Mean daily tFAs intake of subjects was 1.68±0.04 g. Mean daily intake level of girls was 1.89±0.06 g which was significantly higher than that of boys, 1.40±0.05 g (p<0.001). Naturally derived tFAs intake was 1.04±0.03 g which corresponded to 62.1% of total tFAs intake per day and industrially derived tFAs intake was 0.64±0.02 g, 37.9% of total tFAs intake per day. Calorie percentage of tFAs was 0.8% and fat percentage of tFAs was 3.16%. The level of tFAs intake showed a significant difference with monthly allowance (p<0.05) and frequency of snack intake (p<0.001) in girls, which was not the case in boys. The main sources of tFAs were milk and dairy products (34.3%), bakeries (18.3%), and fish and meat products (16.2%), in order. From above results, we can conclude that tFAs intake of middle school student is not as much as that of Western teenagers. However, exact estimation of tFAs intake requires database of tFAs in broad range of processed foods commonly consumed in Korea.

부인암 관련 하지 림프부종의 유병률 및 위험인자

강승훈 ( Seung Hoon Kang ),황기훈 ( Ki Hun Hwang ),심영주 ( Young Joo Sim ),정호중 ( Ho Joong Jeong ),이태화 ( Tae Hwa Lee ),김성한 ( Sung Han Kim ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.8

목적: 한국에서 부인과 관련 암 치료를 받은 환자에서 하지부종의 유병률과 위험 인자의 확인하기 위하여 시행되었다. 연구 방법: 2003년 1월부터 2006년 12월까지 4년 동안 수술적 치료 및 비수술적 치료를 받은 242명의 부인과 암 환자의 의무기록과 면담을 후향적으로 분석하였다. 의무기록 혹은 면담에 의한 기록을 통해 하지부종이 있는 환자를 확인하였고, 그 후 통계학적인 특징, 다른 의학적 병력, 암의 유형과 병기, 림프절의 절제, 수술방법, 항암치료, 방사선치료, 호르몬치료와 혈액검사 결과를 확인하였다. 그리고 이 결과로부터 다중 다변량 회귀분석을 통하여 하지의 림프부종에 대한 위험 요인을 평가하였다. 결과: 242명의 환자 중 48명 (19.8%)에서 하지 림프부종이 있었다. 하지부종이 있는 환자들은 체질량 지수가 더 높았고, 방사선치료, 항암 치료의 병력이 있었으며, 림프절절제와 근치적 자궁절제술을 받았던 경우가 많았다. 다변량 분석을 통해 체질량 지수, 방사선 치료 병력과 림프절절제는 부인과 암치료 후 하지부종에 대한 독립적 위험 인자임을 보였다. 결론: 방사선 치료를 받았거나, 체질량 지수가 25 이상인 경우 그리고 림프절 절제를 시행한 환자는 부인과 암치료 후 하지부종이 발생할 가능성이 있다. 그래서 이들 환자들은 추적관찰 기간 동안 질병의 발생률과 예방법과 치료에 대하여 교육을 받아야 한다. Objective: To identify the prevalence and risk factors for lower limb lymphedema in the patients after gynecologic neoplasms treatment in Korea. Methods: We retrospectively reviewed the medical records and interviewed 242 gynecologic neoplasms patients who have managed surgically and medically over a 4 year period between January 2003 and December 2006. We identified the patients with lower limb lymphedema as described by the medical records or reported by the interviews. We obtained demographic characteristics, other medical history, cancer type, stage of cancer, lymph node dissection, chemotherapy, radiotherapy, hormone therapy and laboratory findings. Multiple logistic regression analysis was done to evaluate the risk factors for lower limb lymphedema. Results: Forty eight (19.8%) patients out of two hundred forty two had lower limb lymphedema. Those patients with lower limb lymphedema had a higher body mass index, radiotherapy history, chemotherapy history and lymph node dissection history, radical hysterectomy. Multivariate analysis revealed that body mass index, radiotherapy and lymph node dissection were independently risk factors for lower limb lymphedema after gynecologic neoplasms treatment. Conclusion: The patients who had radiotherapy, body mass index greater than 25 or lymph node dissection must be considered as potential candidates to have lower limb lymphedema in the patients after gynecologic neoplasms treatment. Therefore, these patients should be informed during the follow-up period about this morbidity, the preventive measures, and the treatments.

급성 구인두 연하곤란으로 발현된 피부근염

송성은 ( Sung Eun Song ),박무인 ( Moo In Park ),문원 ( Won Moon ),박선자 ( Seun Ja Park ),김규종 ( Kyu Jong Kim ),김재현 ( Jae Hyun Kim ),김경미 ( Gyung Mi Kim ),김종국 ( Jong Kuk Kim ),심영주 ( Young Joo Sim ),이정민 ( Jung Min 대한소화기기능성질환·운동학회 2009 Journal of Neurogastroenterology and Motility (JNM Vol.15 No.1

Dermatomyositis is a rare autoimmune disorder afflicting an estimated 6-10 million people worldwide that has a distinct clinical entity identified by a characteristic skin rash and inflammatory myopathy. It can be combined with other connective tissue diseases such as systemic sclerosis or systemic lupus erythematosus. In addition to primary disturbances of limb muscle and skin, extramuscular manifestations include dysphagia, cardiac conduction abnormalities, interstitial lung disease or subcutaneous calcifications. Dysphagia occurs in 12%-54% of those with dermatomyositis, manifests gradually over weeks to months rather than in acutely, and is diagnosed with high-resolution esophageal manometry and video-fluoroscopic monitoring during swallowing. We report a case of dermatomyositis presenting initially with acute oropharyngeal dysphagia and review the available swallowing studies and related literature. (Kor J Neurogastroenterol Motil 2009;15:65-69)

재활의학과적 검사 결과가 임상증상과 차이를 보인 잠수병 환자

심영주,정호중,김기찬 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Decompression sickness is divided into 2 types based on clinical symptoms and severity. Type I decompression sickness involves usually the musculoskeletal system and cardiopulmonary system. Type II decompression sickness involves commonly the central nervous system. We experienced a case of type II decompression sickness involving cervical spinal cord. The patient showed hypesthesia below C5 dermatome and quadriplegia. But the whole spinal magnetic resonance image revealed high signal of the spinal cord below T2 levels and electrodiagnostic study showed thoracic cord level lesion. In decompression sickness, diagnosis of injured spinal cord levels is very delicate problem because in some cases clinical symptoms can be unmatched with magnetic resonance findings and electrodiagnostic study. In this kind of case there are little studies of diagnostic tools and prognostic factors. Therefore, focusing on clinical symptoms need to help more proper treatment and provide better prognosis to decompression sickness patients

일반인에서 자율신경계 기능 평가

심영주,정호중 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.1

Background : To evaluate the autonomic nervous system functions, sympathetic skin response (SSR) and R-R interval variation (RRIV) were tested in general persons. Methods : The SSR and the RRIV were evaluated in 24 subjects with a mean age of 39.56 year (24 ~ 56 year). Bilateral SSRs were recorded on the palm and sole with stimulation of median and tibial nerves. The RRIVs were estimated at rest, during deep breathing and valsalva maneuver. Results : The SSR and the RRIV were obtained from all subjects. The mean latencies of SSR recorded from both palms and soles were 1.41 ± 0.05 sec (right palm), 1.28 ± 0.03 sec (left palm), 1.80 ± 0.09 sec (right sole) and 1.75 ± 0.11 sec (left sole). The mean amplitudes of SSR were 5.98 ± 0.67 mV (right palm), 5.70 ± 0.06 mV (left palm), 3.17 ± 0.45 mV (right sole) and 2.23 ± 0.15 mV (left sole). The mean values of RRIV at rest, during deep breathing and valsalva maneuver were 1.14 ± 0.05, 1.18 ± 0.09 and 1.27 ± 0.22. Conclusion : Functional status of autonomic nervous system is obtained easily with SSR and RRIV. Our results can be a useful basis of control values.

뇌졸중 환자에서 연하장애와 신체기능장애의 연관성

김도성,심영주,김기찬,정호중 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Backgrounds : In almost stroke patients, dysphagia is improved with rehabilitation therapy. But, it is not identified the relationship between dysphagia and physical function recovery in stroke patients. Methods : A total of 21 patients with stroke-caused swallowing disorders based on a videofluoroscopic swallowing study (VFSS) were examined swallowing function and physical function at admission and after treatment for 4 weeks (including Vitalstim). Swallowing function was evaluated by the functional dysphagia scale (FDS) using VFSS before treatment and after treatment. Physical function was evaluated by the motricity index (MI) and modified barthel index (MBI) at admission and after 4 weeks. And the relationship between dysphagia and physical function recovery was evaluated. Results : After treatment for 4 weeks, total score, residue in oral cavity, oral transit time, laryngeal elevation and epiglottic closure, residue in valleculae, residue in piriform sinus, coating of pharyngeal wall after swallow were significantly decreased in FDS (p<0.05). There were a significant improvement in MBI (p<0.05) and the correlation between FDS and MBI. But, MI was not showed correlation with FDS. Conclusions : There was relationships between swallowing function improvement and recovery of physical function in almost FDS factors.

중추신경계 손상 환자의 우울과 삶의 질에 대한 음악요법의 효과

최성복,정호중,심영주 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.1

Objectives: To identify whether music therapy is effective for depression and quality of life (QOL) of patients with central nervous system (CNS) injury, using controlled comparison method. Methods: Twenty nine subjects with CNS injury assigned to one of the two groups, music therapy group (therapy group) or control group. Music therapy was applied to fifteen patients in the therapy group twice a week for 5 weeks (10 sessions) with daily physical and occupational therapy, while only physical and occupational therapy were applied to the control group routinely. Depression of all subjects was assessed by Beck depression inventory (BDI) and Hamiltonrating scale for depression (HRSD). QOL was measured with the use of the world health organization quality of life assessment instrument-brief (WHOQOL-BREF). Each evaluation was assessed at the beginning of this study and after 10 sessions’music therapy. Results: The mean BDI scores reduced in the two groups, but the differences were not significant. In the therapy group, the mean score of HRSD was reduced significantly after song psychotherapy for 5 weeks, from 7.6±5.6 to 3.5±4.1 (p<0.05), while it was not significantly reduced in the control group. The mean scores of WHOQOL-BREF in the therapy group were advanced in every domain. In the control group the mean score of social relationships domain was worsen after 5 weeks comparing the mean score at the beginning of this study. Conclusions : The music therapy relieves patients with CNS injury from depression, and it also seems to be able to improve QOL of them.

만성 폐쇄성 말초동맥질환 후 발생한 만성 허혈성 말초신경병증 1예 : A case report

전재용,심영주,류기형 東國大學校醫學硏究所 2003 東國醫學 Vol.10 No.2

68세 남자 환자가 6년 동안 지속되는 좌측 종아리 통증, 절뚝거림, 감각 이상, 및 작열감을 주소로 전기진단 검사를 위해 내원하였다. 진찰에서 좌측 후 경골 동맥과 족배 동맥 맥박의 촉지 소실과 좌측 대퇴 동맥의 맥박이 감소된 소견이 관찰되었다. 전기진단 검사 소견은 좌측 요천추부 신경총병증 및 우측 심비골 및 천비골 신경병증을 시사하였으며 혈관 조영술에서 좌측 총 장골 동맥과 우측 대퇴 동맥에서 폐쇄 소견이 관찰되었다. 저자들은 만성 폐쇄성 말초 동맥 질환으로 인해 양측 하지의 만성 허혈성 말초신경병증이 발생한 증례 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. A 68-year-old man visited in our laboratory for electrodiagnostic examination. He had suffered from left low leg pain claudication, paresthesia and burning sense for six years. Physical examination showed a loss of pulsation in the left posterior tibial and pea dorsalis artery and decrease strength of pulsation in the left femoral artery. Electrodiagnostic examinations revealed lumbosacral polyneuropathy of both lower extremity. Angiography revealed occlusion of left common iliac artery and right femoral artery. We report a rare case of ischemic peripheral neuropathy of both lower extremities as a result of chronic peripheral occlusive arterial disease.

갑상선 암 수술 방법에 따른 어깨의 기능과 삶의 질

김인택,김정훈,심영주,정호중,김기찬 고신대학교 의과대학 2011 고신대학교 의과대학 학술지 Vol.26 No.1

OBJECTIVES: To determine which factors are changed in the thyroid cancer postoperative care and how quality of life compared between patients who had undergone modified radical neck dissection and selective neck dissection. METHODS: Prospectively, total 151 patients who diagnosed as thyroid cancer and underwent 16 modified radical neck dissection (mRND) or 135 selective neck dissection (SND) were evaluated for shoulder function, neck mobility, and quality of life and degree of depression at baseline, 2 days and 1 week postoperatively. All patients performed neck and shoulder stretching exercise three times a day beginning the morning following surgery. Shoulder function was assessed with the Constant's shoulder scale. Quality of life was assessed with the SF36v2 questionnaire. And depression was assessed with Beck depression inventory (BDI). RESULTS: The disability scores of patients were significantly worse for neck range of motion (ROM), shoulder pain, ADL, shoulder ROM, shoulder abduction power, total score of Constant's shoulder scale, physical function domain in SF-36v2 and BDI score & grade 2 days after the surgeries. SF36v2 domain score was no significantly difference between two groups. CONCLUSION: The mRND and SND are risk factors for neck ROM limitation, shoulder dysfunction, and onset of depression. In comparison between mRND and SND, more deterioration in ADL, shoulder abduction power, total score of Constant's shoulder scale are associated with modified radical neck dissection. More study is needed about usefulness of the stretching exercise in shoulder pain onset through comparison with control group.