기독교인의 신앙치료에 대한 태도 조사

김준호,변원탄,김명정 大韓神經精神醫學會 1984 신경정신의학 Vol.23 No.1

기독교 평신도들의 신앙치료에 대한 태도와 이와 관련한 신앙태도를 알아보기 위하여 부산시내에 거주하는 평균 연령 25세의 고 교육층 기독교 평신도 358명을 대상으로 설문 조사를 실시하여 다음과 같은 결론을 얻을 수 있었다. 대상자들의 신앙치료에 대한 개념을 초자연적 개념과 심리적 개념으로 나누어 조사해 본 결과 심리적 신앙치료의 개념보다는 초자연적 신앙치료 개념에 더 많은 찬성의 태도를 보였다. 그러나 심리적 신앙치료 개념에 대해서도 약 반수에서 찬성의 태도를 보였다. 또한 이들이 초자연적인 신앙치료 개념을 가지고 있지만 축사, 정벌등의 무속적이고 부정적인 측면보다 그것을 축복과 은혜로 본다든지 기독교의 전파의 기능을 갖는다는등 긍정적인 측면에서 받아들이고 있었다. 이러한 신앙치료 개념은 신앙관과 밀접한 상관성을 띄고 있었는데 초자연적 신앙치료 개념은 보수적 신앙태도와 상관관계가 높았고 반대로 심리적 신앙치료 개념은 현실적 신앙태도와 상관관계가 높았다. 또한 초자연적 신앙치료 개념과 심리적 신앙치료 개냠 사잉에는 역 상관관계가 있었다. 그 밖에 연령층과 교회내의 직분 유무에 대한 차이가 있었는데 나이 많은 계층의 신도들에서는 나이 적은 계층보다 초자연적 신앙치료 개념과 보수적 신앙태도가 더욱 현저했고 교회내 직분이 있는 사람들이 없는 쪽보다 더욱 초자연적 신앙치료 개념과 보수적 신앙태도가 두드러졌다. 대상자들에게 정신질환의 원인을 물어본 결과는 위의 태도와는 대조적으로 초자연적인 원인보다는 심리학적인 혹은 생물학적인 원인으로 본 경우가 더 많았다. 이러한 모순점은 정신질환에 대한 개념이 지적인 측면에서는 상당히 합리적이면서도 그 치료 개념에서는 신앙의 영향을 받아 초자연적인 태도를 갖고 있는것으로 이해되었다. 이와같은 결과에서 저자는 우리 사회에서 무분별하게 시행되고 있는 신앙치료를 올바르게 유도하고 또한 향후 보다 건전한 신앙치료 개념을 정착시키기 위해서는 교회 밖에서의 사회 문화적인 영향도 중요하지만 교회 내어서의 건전한 신앙과 올바른 신앙치료에 대한 교육이 더욱 중요하다고 본다. In order to evaluate christians' attitude toward faith healing, the author conducted a survey by questionnaire method to 358 young christians with relatively high educational background who are living in Busan city. The results obtained were as follows; Their concept of faith healing was more supematural than psychological. However, approximately one half of the subjects also showed psychological concept of faith healing. Contrary to the previous notion that christian faith healing is totally shammanistic and primitive, even the attitude toward supernatural concept was positive in several ways: they saw the faith healing as a blessing or grace from God and as having a function of spreading their faith. Their concept of faith healing had a significant correla tion with their attitudes religion: supernatural healing concept was positively correlated with conservative attiude and psychological healing concept with realistic attitude. There was some variation difference toward the concept of faith healing according to their age and presence or absene of mission in church; the older age group was more inclined to supernatural healing concept and conservative attitude than the younger group, and those with mission in church also showed the same trend. However, there was no difference in their attitudes toward faith healing according to sex or duration of their faith. When the subjects were asked about their perceived causes of mental disorders, their answers showed a more rational or scientific understandings; they saw the causes of mental disorders as psychological or biological ones rather than supernatural ones. This trend was seen as contradicting to the above mentioned heavily supernatural attitude toward faith healing. Thus it was suggested that their attitude toward mental disorders was rational in intellectual level but their attitude to ward faith healing was still supernatural. From these results, the author suggests, for the eastablishment of healthier concept of faith healing in the future, that mental health education in the churches as well various socio-cultural influences outside of the churches, is very impotant.

정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구

조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.

정신분열병 환자에서의 한국어판 사회적응 척도의 개발 : 신뢰도 및 타당도 연구

김철권,서지민,김상수,조진석,하준선,김정옥,변원탄 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 정신분열병 환자의 사회적응 정도를 측정하는데 사용되는 사회적응 척도의 한국어판을 개발하기 위함이다. 방 법: 사회적응 척도를 번역한 후 정신분열병 환자 67명과 정상인 78명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과: 자료분석 결과 검사-재검사 신뢰도는 0.85, 검사자간 신뢰도는 0.89, 내적 일치도는 0.87로 높은 수치였다. 변별 타당도를 검증하기 위하여 정신분열병 환자군과 정상 대조군을 비교한 결과 정신분열병 환자군에서 사회적응 정도가 유의하게 낮았다. 구성 타당도를 알아보기 위하여 10개 영역간의 상관관계를 측정한 결과 성적적응 영역을 제외한 모든 영역들에서 유의한 상관관계를 보였다. 본 척도의 전반적 평가 영역 결과와 GAF 결과간의 상관성을 통해 간접적으로 검증한 공존 타당도 역시 유의하였다. 결 론: 한국판 사회적응 척도는 우수한 신뢰도와 타당도가 입증되었고 나아가 정신분열병 환자의 사회적응 정도를 평가하는데 유용하게 사용되어질 수 있을 것이다. Objectives: The purpose of this study was to develop the Korean version of the Social Adjustment Scale Ⅱ-Revised Version(KSAS Ⅱ-RV) in the schizophrenics. Methods: KSAS Ⅱ-RV was administered to 67 schizophrenic patients and 78 matched normal controls for examining the reliability and validity. Results: Data analysis showed statistically significant reliabilities and validities of KSAS Ⅱ-RV. The test-retest reliability, inter-rater reliability, and internal consistency for total scores of KSAS Ⅱ-RV were 0.85, 0.89. and 0.87, respectively. Evidence for discriminant validity of KSAS Ⅱ-RV comes from the results that the mean scores of schizophrenic patients were significantly high than those of normal controls. Construct validity was assessed by calculating the 10 inter-subareas correlations of the KSAS Ⅱ-RV, and all except the sexual adjustment area were statistically significant. Significant correlations between the global area scores of KSAS Ⅱ-RV and those of Global Assessment of Functioning Scale lend support for the concurrent validity of this instrument indirectly. Conclusions: KSAS Ⅱ-RV was found to be a valid and reliable instrument which can be used to evaluate the degree of social adjustment in the schizophrenic patients.

Global prevalence of depression and anxiety in patients with hepatocellular carcinoma: Systematic review and meta-analysis

Darren Jun Hao Tan,Sabrina Xin Zi Quek,Jie Ning Yong,Adithya Suresh,Kaiser Xuan Ming Koh,Wen Hui Lim,Jingxuan Quek,Ansel Tang,Caitlyn Tan,Benjamin Nah,Eunice Tan,Taisei Keitoku,Mark D. Muthiah,Nichola 대한간학회 2022 Clinical and Molecular Hepatology(대한간학회지) Vol.28 No.4

Background/Aims: Depression and anxiety are associated with poorer outcomes in patients with hepatocellular carcinoma (HCC). However, the prevalence of depression and anxiety in HCC are unclear. We aimed to establish the prevalence of depression and anxiety in patients with HCC. Methods: MEDLINE and Embase were searched and original articles reporting prevalence of anxiety or depression in patients with HCC were included. A generalized linear mixed model with Clopper-Pearson intervals was used to obtain the pooled prevalence of depression and anxiety in patients with HCC. Risk factors were analyzed via a fractional-logistic regression model. Results: Seventeen articles involving 64,247 patients with HCC were included. The pooled prevalence of depression and anxiety in patients with HCC was 24.04% (95% confidence interval [CI], 13.99–38.11%) and 22.20% (95% CI, 10.07–42.09%) respectively. Subgroup analysis determined that the prevalence of depression was lowest in studies where depression was diagnosed via clinician-administered scales (16.07%;95% CI, 4.42–44.20%) and highest in self-reported scales (30.03%; 95% CI, 17.19–47.01%). Depression in patients with HCC was lowest in the Americas (16.44%; 95% CI, 6.37–36.27%) and highest in South-East Asia (66.67%; 95% CI, 56.68–75.35%). Alcohol consumption, cirrhosis, and college education significantly increased risk of depression in patients with HCC. Conclusions: One in four patients with HCC have depression, while one in five have anxiety. Further studies are required to validate these findings, as seen from the wide CIs in certain subgroup analyses. Screening strategies for depression and anxiety should also be developed for patients with HCC.

Atypical Ductal Hyperplasia of the Breast on Core Needle Biopsy: Risk of Malignant Upgrade on Surgical Excision

Tiffany Sin Hui Bong,Jun Kiat Thaddaeus Tan,Juliana Teng Swan Ho,Puay Hoon Tan,Wing Sze Lau,Tuan Meng Tan,Jill Su Lin Wong,Veronique Kiak Mien Tan,Benita Kiat Tee Tan,Preetha Madhukumar,Wei Sean Yong 한국유방암학회 2022 Journal of breast cancer Vol.25 No.1

Purpose This study identified factors predicting malignant upgrade for atypical ductal hyperplasia (ADH) diagnosed on core-needle biopsy (CNB) and developed a nomogram to facilitate evidence-based decision making. Methods This retrospective analysis included women diagnosed with ADH at the National Cancer Centre Singapore (NCCS) in 2010–2015. Cox proportional hazards regression was used to identify clinical, radiological, and histological factors associated with malignant upgrade. A nomogram was constructed using variables with the strongest associations in multivariate analysis. Multivariable logistic regression coefficients were used to estimate the predicted probability of upgrade for each factor combination. Results Between 2010 and 2015, 238,122 women underwent mammographic screening under the National Breast Cancer Screening Program. Among 29,564 women recalled, 5,971 CNBs were performed. Of these, 2,876 underwent CNBs at NCCS, with 88 patients (90 lesions) diagnosed with ADH and 26 lesions upgraded to breast malignancy on excision biopsy. In univariate analysis, factors associated with malignant upgrade were the presence of a mass on ultrasound (p = 0.018) or mammography (p = 0.026), microcalcifications (p = 0.047), diffuse microcalcification distribution (p = 0.034), mammographic parenchymal density (p = 0.008). and ≥ 3 separate ADH foci found on biopsy (p = 0.024). Mammographic parenchymal density (hazard ratio [HR], 0.04; 95% confidence interval [CI], 0.005–0.35; p = 0.014), presence of a mass on ultrasound (HR, 10.50; 95% CI, 9.21–25.2; p = 0.010), and number of ADH foci (HR, 1.877; 95% CI, 1.831–1.920; p = 0.002) remained significant in multivariate analysis and were included in the nomogram. Conclusion Our model provided good discrimination of breast cancer risk prediction (C-statistic of 0.81; 95% CI, 0.74–0.88) and selected for a subset of women at low risk (2.1%) of malignant upgrade, who may avoid surgical excision following a CNB diagnosis of ADH.

High-throughput Screening Strategy Used for Enhanced Production of Pigment by Monascus purpureus D39-4

Jun Tan,Ju Chu,Wenjuan Shi,Cheng Lin,Yuanxin Guo,Ying-ping Zhuang,Siliang Zhang,Tadayuki Imanaka 한국식품과학회 2012 Food Science and Biotechnology Vol.21 No.6

Most of the fermentation experiment designs were limited by the low-throughput of shake flask, especially for the medium optimization. A simple high-throughput screening system was developed for the determination of pigment in Monascus purpureus fermentation samples. This downscaled system was designed to optimize medium composition combined with statistical methods. The total 29 experiments designed by the Box–Behnken were used to study the 4 most important operating variables on pigment production. The analysis revealed that the optimum concentrations of glucose, peptone, NaNO3, and KH2PO4were 51.42, 4.91, 1.00, and 1.00 g/L, respectively. A production of 69.5 U/mL was achieved in agreement with the prediction (68.9 U/mL) fermented in 24-deep-well microtiterplates. Furthermore, the fermentation medium optimized in the high-throughput system was verified in shake flasks, and the pigment production could be enhanced from 206.5 U/mL in un-optimized medium to 265.8 U/mL,giving nearly 1.30-fold increase in production.

A New Examination Method for Anatomical Variations of the Flexor Digitorum Superficialis in the Little Finger

Jun Tan,Chul-Ho Kim,Hyun-Joo Lee,Jing Chen,Qing Zhong Chen,전인호 대한정형외과학회 2013 Clinics in Orthopedic Surgery Vol.5 No.2

Background: Current examination methods to assess the anatomical variations of flexor digitorum superficialis (FDS) tendon in the little finger necessitate a strong external force applied by the examiner and cause false negatives. A new examination method was designed to detect the variations more accurately. Methods: We examined the little fingers of 220 adult hands (110 subjects) by 2 methods: the expanded examination method advocated by Tan et al., and a new examination method. Variations of the FDS in the little finger were examined by both methods and categorized separately as having independent FDS function, FDS connection to the tendons of the ring finger or of the multiple adjacent fingers, and functional substitution of the flexor digitorum profundus (FDP) with or without tendinous connection to the ring or multiple adjacent fingers. By our new method, we could further divide the FDS connection or FDP substitution with connection to the ring finger into 2 subtypes: loose and close connections. Data were reported as case numbers and percent. Date on symmetry were statistically analyzed by matched case-control studies. Results: Among 220 hands, 113 hands (51.4%) had independent FDS function by the new examination method, which was lower than the incidence (55.5%) detected with the existing expanded examination method. In the hands with connections between FDS tendons of the little and the ring fingers, 32 hands (14.5%) demonstrated loose and 37 (16.8%) close connections. Three hands (1.4%) had loose and 19 (8.6%) had close FDP substitution with tendinous connection to the ring finger. Among 110 hands without independent FDS function, variants of 42 hands (38.2%) were asymmetric. There was no statistical significance in symmetry of variations. Conclusions: This new examination method offers other assessment variations of FDS tendon in the little finger. We recommend using this test to assess the variations and function of the FDS of the little finger.

<i>Premnagrandipaniculata</i> ( Lamiaceae , Premnoideae ), a remarkable new species from north Myanmar

Tan, Yun-Hong,Li, De-Rong,Zhou, Shi-Shun,Chen, Yong-Jun,Bramley, Gemma L.C.,Li, Bo Pensoft Publishers 2018 PhytoKeys Vol.94 No.-

<P>Abstract</P><P>A remarkable new <I>Premna</I> species from Myanmar, <I>P.grandipaniculata</I> Y.H.Tan & Bo Li (Lamiaceae), is here described and illustrated. It differs from all known congeneric taxa by having huge complicated panicles which have tertiary branches formed by spike-like thyrses. In <I>Premna</I>, such a spike-like thyrse is found in <I>P.bracteata</I> and <I>P.interrupta</I>, but those species can be easily distinguished from <I>P.grandipaniculata</I> by their habit, indumentum, leaf size and inflorescence structure.</P>

Combination of FDG PET/CT and Contrast-Enhanced MSCT in Detecting Lymph Node Metastasis of Esophageal Cancer

Tan, Ru,Yao, Shu-Zhan,Huang, Zhao-Qin,Li, Jun,Li, Xin,Tan, Hai-Hua,Liu, Qing-Wei Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.18

Background: Lymph node metastasis is believed to be a dependent negative prognostic factor of esophageal cancer. To explore detection methods with high sensitivity and accuracy for metastases to regional and distant lymph nodes in the clinic is of great significance. This study focused on clinical application of FDG PET/CT and contrast-enhanced multiple-slice helical computed tomography (MSCT) in lymph node staging of esophageal cancer. Materials and Methods: One hundred and fifteen cases were examined with enhanced 64-slice-MSCT scan, and FDG PET/CT imaging was conducted for neck, chest and upper abdomen within one week. The primary lesion, location and numbers of metastatic lymph nodes were observed. Surgery was performed within one week after FDG PET/CT detection. All resected lesions were confirmed histopathologically as the gold standard. Comparative analysis of the sensitivity, specificity, and accuracy based on FDG PET/CT and MSCT was conducted. Results: There were 946 lymph node groups resected during surgery from 115 patients, and 221 were confirmed to have metastasis pathologically. The sensitivity, specificity, accuracy of FDG PET/CT in detecting lymph node metastasis were 74.7%, 97.2% and 92.0%, while with MSCT they were 64.7%, 96.4%, and 89.0%, respectively. A significance difference was observed in sensitivity (p=0.030), but not the others (p>0.05). The accuracy of FDG PET/CT in detecting regional lymph node with or without metastasis were 91.9%, as compared to 89.4% for MSCT, while FDG PET/CT and MSCT values for detecting distant lymph node with or without metastasis were 94.4% and 94.7%. No significant difference was observed for either regional or distant lymph node metastasis. Additionally, for detecting para-esophageal lymph nodes metastasis, the sensitivity of FDG PET/CT was 72%, compared with 54.7% for MSCT (p=0.029). Conclusions: FDG PET/CT is more sensitive than MSCT in detecting lymph node metastasis, especially for para-esophageal lymph nodes in esophageal cancer cases, although no significant difference was observed between FDG PET/CT and MSCT in detecting both regional and distant lymph node metastasis. However, enhanced MSCT was found to be of great value in distinguishing false negative metastatic lymph nodes from FDG PET/CT. The combination of FDG PET/CT with MSCT should improve the accuracy in lymph node metastasis staging of esophageal cancer.

Radiographic Assessment of Humeral Rotation withLandmark of Lesser Tuberosity Projection

Jun Tan,ImanWidyaAminata,Hyun-Joo Lee,Jae-Myeung Chun,In-Ho Jeon 대한견주관절의학회 2012 대한견주관절학회 학술대회논문집 Vol.2012 No.11