뇌졸중 후 중추성 통증 환자에 대한 동서협진이 진통과 재활에 미치는 영향

이현종,김수영,이상훈,서동민,이두익,김건식,이재동,이윤호,양형인,박재경,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Purpose : In order to study the effectiveness of East-West pain treatment on central poststroke pain(CPSP), we evaluated its effect on alleviation of pain and rehabilitation of CPSP Patients who were treated with electroacupuncture and west pain treatment for four weeks. Methods : Twenty four patients diagnosed by their pain characteristics of central pain from stroke were treated with sympathetic nerve block, gabapentin, amitriptyline, and electroacupuncture for four weeks. Pain intensity through the visual analogue scale(VAS), and improvements of mobility and rehabilitation through the modified Barthel index(MBI) and Rankin scale(RS), respectively, before and after pain treatment were also assessed. Results : VAS pain scores were significantly improved from 7.7±1.7 to 4.4±2.0 with pain treatment(p<0.05). In accordance with improvement of pain scores, RS and MBI scores were also improved from 2.88±0.95 to 2.13± 1.01 and from 83.0± 16.9 to 94.7±9.5(p<0.05), respectively, with pain treatment(p<0.05). Conclusions : It was suggested that the active pain treatment was contributed to the rehabilitation of CPSP patients, resulting in improvement of quality of life of CPSP patients. Futhermore, East pain treatment in combination with West pain treatment may be useful modality to alleviate CPSP.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

무작위 대조 이중맹검 시험을 통한 봉독 약침의 류마티스 관절염 치료 효과 연구

이상훈,홍승재,김수영,양형인,이재동,최도영,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective : This study was performed in order to evaluate the effect of bee venom therapy on rheumatoid arthritis by randomized controlled double blind method. Method : RA patients were recruited and divided into an experiment group and a control group by random selection. As a double blind test, the experiment group was treated with bee venom injection on acupoints, and the control group was treated with normal saline injection on acupoints twice a week for 8 weeks. Tender joint count, swollen joint count, morning stiffness, pain, health assessment questionnaire, ESR. and CRP were estimated and analyzed at baseline, and at 1 month and 2 months after bee venom therapy Results : Compared to the control group, the experiment group showed significant decrease in tender joint count swollen joint count, morning stiffness, and health assessment questionnaire after 2 months. Pain, ESR and CRP showed significant decrease in the experiment group after 1 & 2 months. Conclusions : These results suggests that bee venom therapy could be an effective method in the treatment of patients with rheumatoid arthritis.

봉독약침이 류마티스 관절염 환자의 관절 통증, 종창 및 급성 염증 반응에 미치는 영향

이상훈,이현종,백용현,김수영,박재경,홍승재,양형인,김건식,이재동,최도영,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective In order to study the effects of bee venom(BV) on the pain, edema, and acute inflammatory reactant of rheumatoid arthritis(RA) patients. Methods Patients with RA who met the ACR(American College of Rheumatology) 1987 revised criteria for the diagnosis of RA were treated with the BV therapy twice a week for 3 months. Tender Joint counts, swollen joint counts, Visual analog scale(VAS), morning stiffness, ESR. C-reactive protein(CRP) were analyzed before and after BV therapy. Results The results as follows. 1. Tender joint counts in patients after BV therapy were significantly lower than those before BV therapy(9.0±7.9 vs 15± 11.4, p=0.002). 2. Swollen joint counts of the patients after BV therapy were significantly lower than those before BV therapy(50±61 vs 15±23, p=0.001). 3. VAS in patients after BV therapy was significantly lower than those before BV therapy(608± 17.6 vs 380± 159, p=0.000). 4. Duration of morning stiffness in patients after BV therapy was significantly reduced compared with that before BV therapy(119.1± 112.6 min vs 59.0±89.7 min, p=0.009). 5. ESR and CRP were not significantly changed before and after BV therapy, suggesting BV itself could make inflammatory reaction as well as therapeutic effect. Conclusions BV therapy improved tender joint counts, swollen joint counts and duration of morning stiffness in this study, and further study is needed on long-term effect of BV therapy.

봉독약침이 류마티스 관절염 환자의 기능회복 및 삶의 질에 미치는 영향

이상훈,이현종,박상민,김수영,박재경,홍승재,양형인,이재동,최도영,김건식,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective: To evaluate the effects of bee venom acupuncture(BVA) on the rehabilitation and quality of life in rheumatoid arthritis(RA) patients Methods: Patients with RA were treated with the BVA therapy twice a week for 3 months. Tender joint counts, swollen joint counts, morning stiffness, Erythrocyte Sedimentation Rate(ESR), C-reactive protein(CRP), patient global assessment, physician global assessment, Korean health assessment questionnaire(KHAQ) were estimated and analyzed before and after BVA therapy. Results: Tender joint counts, swollen joint counts, morning stiffness showed significant decrease after BVA therapy. But, as acute inflammatory reactants, ESR showed no significant difference and CRP showed significant increase after BVA therapy. Patient global assessment physician global assessment, and KHAQ index showed significant improvement after BVA therapy. Conclusions: BVA therapy can improve rehabilitation and health-related quality of life RA patients as well as clinical symptom and signs. Further study is required in more population with large scale including acute inflammatory reaction of BVA therapy.

퇴행성 슬관절염 환자의 증상 중증도 측정을 위한 적외선 체열상의 유용성

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

Objectives: To investigate the applicability of thermography as severity measurement in the patients with osteoarthritis (OA) of the knee. Methods: Data were obtained from 80 patiens with OA of the knee. They were asked to answer two disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index, Lequesne's Functional Index (LEI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), Visual Analogue Scale (VAS) pain intensities in order to assess the severity of disease, quality of life, and degree of pain and taken thermography in standardized environment before and after treatment, respectively. Results: The thermal differences between ipsilateral side and contralateral side in lateral aspect, medial aspect, patella region and suprapatella of both knees were correlated with pain lesion sites. Age, duration of disease, duration of morning stiffness, sex, and crepitus of knee were not correlated with the thermal differences of each regions. And also LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ, were not correlated with the thermal differences of each region. But, the changes of VAS pain intensities were highly correlated with the thermal differences of each regions, especially in patelaa and suprapatella of knees after teratment. Conclusions: Although several specific evaluation indices for osteoarthritis of knee were not correlated with the degree of thermal differences between both knees, the differences of pain intensity (VAS) were quit correlated with thermal differences after treatment. And infrared thermography might be a very useful devices fot the evaluation of OA of knee and its treatment. Further study on the thermography on OA of the knee in more size of patients with appropriate severity grade and the standardization of analysis of thermographic data were recommended.

Evans 증후군 1례

장성익,이의재,황성수,이경일,이원익,이준성 최신의학사 1990 最新醫學 Vol.33 No.1

한국의 의리사상(義理思想)에 대한 접근법

이상익 ( Sang Ik Lee ) 한국철학사연구회 2012 한국 철학논집 Vol.0 No.33

의리사상(義理思想)은 무엇보다도 (정명론正名論)(명분론名分論)을 주축으로 삼고 있다. 조선시대의 의리사상은 정명론(正名論)을 기저로 삼아 예의염치(禮義廉恥)의 기풍을 조성하고, 출(出)?처(處)를 바르게 하며, 불정(不正)에 대한 비판과 저항정신을 발휘하는 데 크게 기여하였다. 그러나 조선시대의 의리사상은 종종 공리(功利)의 측면을 소홀히 한 점이 있으며, 종종 독선(獨善)的 태도를 드러내기도 하였다. 의리사상에 내재된 “부수(復讐)”와 “정의(情義)”에 대해서도 오늘날에는 재고할 필요가 있다. 오늘날 여러 학자들은 우리 사회에서 의리(義理)가 주로 “왕초-똘마니 집단의 의리”로 인식되는 것을 우려하고 있는바, 이러한 의리는 과거의 “부수(復讐)”와 “정의(情義)”의 관념과도 일정한 연관이 있는 것이다. 이러한 부정적 요소들을 비판적으로 극복할 수 있다면, 과거의 의리사상은 오늘날에도 우리 사회를 정화(淨化)시키는 데 크게 기여하는 “소금”이 될 수 있을 것이다. Korean thought of loyalty is based on the premise of right name. The thought of loyalty in Chosun dynasty made an ethos of Yeyiyumchi(禮義廉恥) fostering proper behaviors and spirits of critical resistance against unlawful, corrupt and dishonest behaviors. However, it has some faults in neglecting utilitarian strong points and falling in some narrow-minded and self-righteous trap. Its immanent virtues of revenge and affection should be recasted in a totally different feature. If we make straight these negative weak points, we can make good use of it today.

한국 최초의 근대식 의사 김익남의 가문에 관한 연구

이영아 ( Lee Young Ah ),황상익 ( Hwang Sang-ik ) 아시아문화학술원 2017 인문사회 21 Vol.8 No.4

김익남은 한국 최초의 근대식 의사이자, 근대의학 교육의 선구자이다. 그는 과거시험 폐지 이전에 `가숙(家塾)`에서 3년 동안 한의학을 공부했고, 과거제도가 폐지되자 곧 관립일어학교에 들어갔으며, 뛰어난 일본어 능력과 근대교육에의 적응력으로 당시 파일(派日) 유학생들 중에서도 가장 두각을 나타내어 한국인으로는 최초로 근대의학을 정식으로 배운 의학자가 되었다. 그런데 그동안 전형적인 양반 가문인 청풍김씨 가문의 후손으로 알려져 왔던 김익남의 직계 조상을 조사해 본 결과 그는 기술직 중인 가문의 후예로 보는 것이 타당함을 알 수 있었다. 또한 잡과방목 등에는 그의 직계조상들의 본관이 해주김씨로 기록되어 있었다. 이러한 점에서 김익남은 의과, 역과, 운과(음양과) 등으로 세전되어 온 기술직 중인 가문인 해주김씨의 후손이라는 사실을 발견하게 되었다. 한국근대의학의 선구자인 김익남의 조상들은 지금까지 알려졌던 것과는 달리 약 300년 동안 전형적인 기술직 중인 가문으로 살아왔다. 그리고 김익남이 1890년대 당시로는 쉽지 않았을 일본유학을 결정하고 낯선 유학생활을 무사히 마치고 한국인으로서는 최초로 근대식 의사가 된 데에는 중인 가문 출신이라는 배경이 긍정적으로 작용했을 것이다. Unlike what has been known so far, the ancestors of Dr. Kim Ik-Nam, the most forerunning figure in the modern Korean medical history, had lived not as yangban class but as the typical jungin class for almost 300 years. It is thought that they could incorporate into Kim lineage of Chungpoong, the famous yangban family, through the achievements of successive generations as professional middle class, and their desire of status ascension based upon the achievements. Dr. Kim Ik-Nam`s jungin class background is considered to have positively influenced on the decision of studying abroad to Japan to be the first modern Korean medical doctor, which was very difficult in the 1890s. And it would be the same case to his cousin`s son Kim Kyu-Sik, the famous independence activist.

대산(大山) 리상정(李象靖)의 리주기자론(理主氣資論): 퇴(退),률(栗) 성리설과 대비하여

이사익 ( Sang Ik Lee ) 연세대학교 국학연구원 2008 동방학지 Vol.142 No.-