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      • KCI등재
      • KCI등재

        우리나라 의료의 생의학적 모델 어떻게 할 것인가? - 생의학적 모델에서 생물정신사회적 모델로 -

        이상열,Lee, Sang-Yeol 한국정신신체의학회 2012 정신신체의학 Vol.20 No.1

        Understanding the biopsychosocial model of illness is crucial for any meaningful advance of health. The maintenance and promotion of health is achieved by different combinations of physical, mental, social and spiritual well-being. Health is not an objective of living. It is not only a state, but also a resource for everyday life. Health is a positive concept that emphasizes personal and social resources, as well as physical capacities. Understanding the biopsychosocial model of health and disease is very important in the medical system. George Engel challenged the medical profession to reconsider a strict biomedical approach to medical education and care, and to embrace a "new medical model," the biopsychosocial model. He argued that humans are at once biological, psychological, and social beings who behave in certain ways that can promote or harm their health. Although understanding the biopsychosocial model of illness is important, Korea's medical system have mainly been focusing on the biomedical model of illness. I would like to highlight the importance of biopsychosocial model of illness for Korea's medical system and real clinical field according to the 20th anniversary of Korean Society of Psychosomatic Medicine.

      • KCI등재

        $GABA_A$-Benzodiazepine 수용체 이상과 불안장애

        이상열,박민철,강희자,Lee Sang-Yeol,Park Min-Cheol,Kang He-Ja 대한불안의학회 2005 대한불안의학회지 Vol.1 No.1

        In the 40 years since the first benzodiazepine was brought into clinical use there has been a substantial growth in understanding the molecular basis of action of these drugs and the role of their receptors in anxiety disorders. Benzodiazepine receptors are present throughout the brain with the highest concentration in cortex, and it potentiate and prolong the synaptic action of the inhibitory neurotransmitter GABA. Central benzodiazepine receptors and $GABA_A$ receptors are part of the same macromolecular complex. Abnormalities of these $GABA_A$-benzodiazepine receptors as a result of drug challenge tests and neuroimaging studies may underlie some anxiety disorders. The role of $GABA_A$-benzodiazepine receptors in the action of benzodiazepine and as a factor in anxiety disorder, in both animal and humans including knock-out and knock in technique, may lead to new anxiolytics that have potentially significant therapeutic gains without unwanted side effects.

      • SCOPUSSCIEKCI등재

        성견에서 수직적 골결손부에 골이식후 교정력 적용시기에 따른 치주조직의 반응

        이상열,이기헌,황현식 대한치과교정학회 2001 대한치과교정학회지 Vol.31 No.3

        본 연구는 수직적 골결손부에 골이식을 시행한 후 교정력 적용시기에 따른 치주조직의 반응을 알아보고자 시행하였다. 체중 15 kg 내외의 성견 9마리에서 상악 좌우측 제3절치의 원심 치근면에 수직적 골결손을 형성하고 치주질환을 유발시킨2주 후 치주판막술을 시행하고 골결손 기저부 수준의 치근면에 기준 흠을 형성하였다. 골이식 후 치유기간에 따라 2주군, 4주군, 6주군으로 각각 3마리씩 분류하고 우측 제3절치는 치주판막술만 하는 비이식측으로, 좌측 제3절치는 치주판막술과 골이식을 병용한 이식측으로 설정하여 양측 모두 술후 2주, 4주, 또는 6주부터 120 gm의 교정력을 적용하여8주 동안 치체이동 시킨 후2주간 보정하였다. 이후 동물을 희생시키고 조직표본을 만든 후 치주조직의 반응을 비교 관찰하여 다음과 같은 결과를 얻었다. 1. 모든 실험동물에서 비이식측에 비해 이식측의 골재생양이 많이 나타났다. 2. 6주군에서는 홈에서 백악-법랑 경계부까지 거리의 1/2이상 치조골과 백악질이 재생되었고 상피의 하방증식없이 결합조직대가 치근면과 부착을 이루었다. 3. 4주군에서는6주군과 유사한 치주조직 재생소견을 보였으나 그 양은 더 적게 나타났다. 4. 2주군의 경우 골재생이 양측 모두 홈에 한정되어 나타났으며 상피의 하방증식이 홈의 기저부까지 연장되고 백악질과 결합조직의 재생은 관찰되지 않았다. 이상의 결과는 치주질환에 의한 수직적 골결손 환자에서 치주판막술과 골이식을 시행하고 교정적 치아이동을 할 경우 교정력 적용시기에 따른 치주조직의 반응이 차이가 있음을 시사하였다. (주요 단어 : 수직적 골결손, 골이식, 교정력 적용시기, 치주반응) The aim of this study was to investigate the periodontal response according to the timing of orthodntic force application after bone graft into the angular bony defect. Nine dogs were divided into three groups, 2, 4, and 6 weeks, according to the timing of orthodontic force application after bone graft. Periodontal angular bony defects were created surgically at the distal aspect of both maxillary third incisors. Two weeks later, flap operation was performed to eliminate inflammation and reference notch was made on the root surface at the level of the bottom of each defect. Demineralized freeze-dried bone was implanted on the left side whereas only debridement was done on the other side. Experimental tooth movement was executed during 8 weeks on both graft and non-graft sides. After 2 weeks of retention period, animals were sacrificed for histologic specimens. The results were obtained as follows : 1.New bone formation was more pronounced in the graft side than in the non-graft side in all experimental animals. 2.In the 6-week group, new bone and cementum formation was observed in more than half from the notch to the cemento-enamel junction, and the zone of connective tissue attachment was found without apical migration of junctional epithelium. 3.In the 4-week group, the amount of new bone formation was smaller than in the 6-week group whereas the overall remodeling pattern was similar. 4.New bone formation was confined to around the notch and the junctional epithelium migrated apically to the level of the notch with no connective tissue attachment and cementum formation in the 2-week group. The results of the present study suggest that periodontal response may be influenced by the timing of orthodontic force application after bone graft into angular bony defect. Key words : Angular bony defect, Bone graft, Timing, Periodontal response

      • KCI등재

        기능성 상부 위장관 증상을 호소하는 환자의 스트레스, 불안 및 우울

        이상열,신성훈,최석채,Lee, Sang-Yeol,Shean, Sung-Hun,Choi, Suk-Chei 한국정신신체의학회 1998 정신신체의학 Vol.6 No.1

        Objective : The sensation of dysphagia, heartburn, globus hystericus, and functional dyspepsia are common symptoms of the functional upper gut disorders. This study was designed to investigate quantity of perceived stress, depression, and anxiety in the patients with functional upper gut symptoms whose esopahgeal manometry(EM) and gatroesophageal reflux (GERT) test were normal. Methods : A total of 38 patients who complained of the symptoms had been tested with 24-hour ambulatory EM and conventional GERT in our gastrointestinal clinic. Thirty patients whose tests had been normal(patients group) were assessed with Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), and Spielberger Stait-Trait Anxiety Inventory(STAI) and compared with 30 patients(control group) without functional upper gut symtpoms in the hepatobiliary clinic. The two groups were also assessed by quantity of perceived stress during the last year through self-report. Results: 1) These patients tended to be predominently female, older, and possessed a lower education than control group. 79% of 38 patients who had been tested were normal. 2) Compared to the control group, the patients had significantly higher mean scores on four subscales(somatization, depression, anxiety, and positive symptom distress index). 3) The patient group had significantly more perceived stress than the control group. 4) The patients group had significantly higher levels of depression than the control gorup, but there was not any significant difference in the STAI. 5) There were significant positive correlations between the BDI score and the STAI-trait, the STAI-stait and the STAI-trait, the quantity of perceived stress and the STAI-trait. Conlusion : The patients with functional upper gut symptoms displayed more, psychological distress, sornatization, anxiety, and deperssion. Among them, patients had higer depression than control group. Functional upper gut symtoms could be more appropriately viewed as somatic symptoms of depression. These findings suggest that such patients need to have psychiatric intervention and treatment.

      • 형태학적 영상 분할을 위한 재구성 필터의 VLSI 구조 설계

        이상열,정의윤,이호영,김희수,하영호,Lee, Sang-Yeol,Chung, Eui-Yoon,Lee, Ho-Young,Kim, Hee-Soo,Ha, Yeong-Ho 대한전자공학회 1999 전자공학회논문지SC (System and control) Vol.s36 No.12

        본 논문에서는 형태학적 영상 분할을 위한 재구성 필터의 새로운 VLSI 구조를 제안한다. $h_{max}$ 연산에 기반한 재구성 필터는 영역의 경계정보는 보존하면서 영역 내부만을 평탄화하는 단순화 필터이다. 제안한 구조에서는 분할 메모리 구조와 효과적 영상 스캔 방법을 도입하여 연산량과 시간을 줄였다. 분할 메모리 구조는 연산에 필요한 데이터의 동시 접근을 가능하게 하여 병렬 데이터 처리를 가능하게 하며, 확장된 화소 연결관계를 통해 스캔에 의한 단순화 정도를 높인다. 제안한 선택적 순방향 스캔은 간단한 연산부의 도입을 통해 hmax 연산이 영상의 밝기값에 의존적인 단점을 극복하여 잡음제거와 동시에 적은 연산량으로 단순화를 수행할 수 있게 한다. 제안한 구조는 VHDL을 이용하여 기술하였으며, CAD 툴인 Mentor를 이용한 실험 결과 기존의 방법에 비해 18%정도의 연산만으로도 효과적 영상 단순화를 수행함을 확인하였다. In this paper, the new VLSI architecture of a reconstruction filter for morphological image segmentation is proposed. The filter, based on the $h_{max}$ operation, simplifies the interior of each region while preserving the boundary information. The proposed architecture adopts a partitioned memory structure and an efficient image scanning strategy to reduce the operations. The proposed memory partitioning scheme makes it possible that every data required for processing can be read from each memory at a time, resulting in parallel data processing. By the extended connectivity consideration, the operation is much decreased because more simplification is achieved in scanning stage. The selective raster scan strategy endows the satisfactory noise removal capability with negligible hardware complexity increase. The proposed architecture is designed using VHDL, and functional evaluation is performed by the CAD tool, Mentor. The experiment results show that the proposed architecture can simplify image profile with less than 18% operations of the conventional method.

      • SCOPUSKCI등재

        피부밑이마당김술

        이상열,Lee, Sang-Yeul 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.3

        Purpose: The purpose is to present an useful and simple surgical method to improve the aging of upper third face in patients with high frontal hairline as well as low frontal hairline. Methods: Forty eight female patients were treated with subcutaneous forehead lift using an anterior hairline incision over 14 years. This surgical technique is performed under direct vision utilizing a beveled incision made 4 to 5 mm into the anterior hairline with subcutaneous dissection, which is continued near to eyebrow, sometimes extended to supraorbital rim to remove corrugator and procerus muscles. In patients with high frontal hairline, excess forehead skin anterior to incision line is removed. On the contrary in the patients with low frontal hairline, scalp posterior to incision line is removed. Results: This technique provided constant and good results with the forty six patients, who were satisfied with eyebrow elevation and removal of wrinkles in forehead and glabellar region. However two patients were undercorrected, and focal alopecia developed in another two patients. One patient complained of pruritus over one year, but subsided spontaneously without any treatment. Temporary paresthesia developed in the forehead and frontal scalp of all cases after operation but permanent sensory loss never occurred in all the patients. Conclusion: Subcutaneous forehead lift using an anterior hairline incision is suggested to be one of the effective surgical methods to improve the aging of upper third face in the patients with high frontal hairline as well as low frontal hairline.

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