중증 만성정신질환자 수의 추산 : Through Two Community Surveys 두 지역사회 조사를 중심으로

홍진표,김윤,배재남,정유진,강영호,양병국,김용익,김병후,이철,조맹제 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

국내 중증 만성정신질환자 수를 추정하기 위하여 일 농촌 및 대도시 지역의 지역의료보험 및 의료보호 대상자 중 1993년 1년간 의료기관에서 정신증 상병(ICD-9 code 상 290-299) 및 알콜 남용/중독, 성격장애 및 정신박약 진단하에 치료를 받은 적이 있는 사람에 대해 설문조사를 실시하였다. 연구자들이 개발한 진단도구를 이용하여 진단을 평가하고, Strauss-Carpenter scale 등을 이용하여 기능 장애를 평가하고 유병기간 등을 조사하였다. 결과를 요약하면 다음과 같다. 1) 진단평가상 정신분열병군(61.1%)이 가장 많았으며, 정동장애군(23.7%), 알콜장애군(11.2%), 기질성 정신장애군(4.0%)의 순서이었다. 2) 직업활동정도는 진단군별로 차이가 많았다. 지난 1년간 직업활동이 6개월 미만이거나 전혀 없는 환자 비율이 정신분열병군은 67.2%, 알콜장애군 52.0%, 정동장애20.8%의 순으로 정신분열병군이 가장 불량하였다. 3) 사회활동도 진단군별로 차이가 많아서 지난 1년간 의도적, 사회활동이 없는 비율이 정신분열병군이 가장 높았고(72.3%), 알콜장애군(32.0%), 정동장애군(20.7%)의 순이었다. 4) 국내 의료보험 및 사회복지시설 이용 자료 등을 토대로 본 조사 결과를 적용한 결과 국내중증 만성 정신질환자의 수는 약 8만 7천명으로 추산되었다. Objectives: The purpose of this study was to estimate the number of serious and persistent mentally ill patients in Korea. Methods : Study populations were recruited from medical insurance data of two district areas ; one rural and the other urban areas. Subject were all mentally ill who had ever visited any hospital in 1993 and were diagnosed as having psychosis, personality disorder and drug abuse. We conducted a home visiting survey applying semi-structured diagnostic interview, assessing the level of social adjustment with Strauss-Carpenter Scale, and past psychiatric history by the trained researchers, in October and November,1994. Results : According to diagnostic assessment schizophrenic patients constituted the major portion(61.1%) of study subjects. The distribution of occupational functions and social contacts was variable according to diagnosis. Most schizophrenic patients were unemployed or worked less than 6 months in the previous year(67.2%), and showed poor social contact(72.3%). But affective disorder patients were relatively independent in job maintenance and social relationship. Alcoholic patients lay between those of schizophrenic and affective disorder groups. It was estimated that about 87,000 adult Koreans were suffering from chronic mental disorders which seriously interfere with their daily life. Conclusions : Serious and persistent mentally ill patients were common in Korea. Community support program should be provided for them.

사회체육의 개념 및 그 실천상의 문제점에 관한 연구

임용호,김상홍 啓明大學校 生活科學硏究所 1998 科學論集 Vol.24 No.-

The purpose of this study was to examine the concept, the idea, the development of theoretical research of 'sports for all' and the problems in its practice. The major findings obtained from this study were following: First, it was found that research products in the field of sports for all were in an infant stage and the concept was used confusedly and, that problems with the scope, nature, viewpoint of sports for all were appeared. Second, It was summaried that it was emphosized as the proliferation and integration of educational function through the all of the social-life and the lifelong time, and as the public policy of preparation of the sports for all in the literatural review the theory of sports for all,. Third, it was lack of the disciplinary and scientific research methods. Based upon these findings, it was suggested that it should be taken sports for all as a social phenomena, and the scientific method should be applied more for the better understanding of human leisure and sport behavior.

뇌종양의 악성도 판정을 위한 분열기 세포측정에 관한 연구

한용표,변진수,허철,홍순기,김헌주,조미연,정순희,김호근 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.11

Tissue markers of cellular proliferation have been utilized as prognostic indicators in tumors of the central nervous system. Nucleolar organizer regions represent transcriptionally active sites of ribosomal deoxyribonucleic acid and can be identified by a simple argyrophilic technique. The authors describe a standardized approach to the assessment of these argyrophilic nucleolar organizer regions(AgNORs) in 25 astrocytomas(including 6 glioblastomas), 6 oligodendrogliomas and 1 xanthochromic astrocytoma, which were also estimated in association with 2-year survival post-operatively. Appropriate sections were silver stained and AgNORs were counted in 1000 cells. In cases of astrocytoma, the mean AgNORs/cell count of group survived more than 2 years after operation was significantly different from that survived less than 2 years : 1.93±1.13 vs. ≥ 4.79±3.90. And the mean AgNORs/cell count was 1.53±0.32 in low grade astrocytoma. 2.03±0.59 in grade Ⅲ astrocytoma, and ≥6.64±3.77 in grade Ⅳ astrocytoma. Among the patients with the same grade astrocytoma, the mean AgNORs/cell count was lower in the cases of long survival rather than short survival. The assessment of AgNORs can be easily performed by any surgical pathology laboratory without specialized equipment. It may be used as a valuable and independent prognosticator of biological behavior in cases of astrocytoma.

외경동맥 분지에 발생한 외상성 동맥류 4예 : 증례보고 Report of 4 Cases

황금,허철,홍순기,김헌주,한용표,최윤정 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.4

We report four cases of traumatic aneurysm in the branches of external carotid artery and reviewed other cases from the literature in view of their clinical feature and management.

호산구성 육아종에 병발된 동맥류성 두개골 골낭종 : 증례보고 Case Report

길승배,허철,변진수,한용표,김헌주,홍순기,김명순,홍순원,김윤미 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

A case of aneurysmal bone cyst(ABC1 secondary to eosinophilic granuloma of the skull is reported. In the skull the presence of ABC secondary to eosinophilic granuloma is rare. We reviewed the clinicopathological and radiological features of this type of eocinophilic granuloma at the cranium.

하경추부 손상환자에 대한 임상적 분석

박영록,홍순기,허철,김헌주,한용표 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.6

The authors analyzed 32 cases with lower cervical spine injuries according to their etiologies, the findings of cervical spine X-ray and computed tomography, initial neurological grading scales and time of operation. The results are summarized as follow : 1) Lower cervical spine injuries occurred in 32 of the 49 cervical spine injuried patients. 2) The important factors affecting on outcome were the initial neurological state(p=0.038) and the degree of spinal canal narrowing on cervical computed tomogram(p=0.046). 3) The degree of prevertebral soft tissue swelling and displacement of vertebral body on initial cervical spine X-ray did not significantly affect on outcome(p=0.052). 4) The most suitable operative time for lower cervical spine injuries was 10∼20 days after injuries and the mortality was 9.3%.

외상성 뇌경막하 수낭종에서 병발된 만성 경막하 혈종의 임상적 고찰

황금,허철,홍순기,김헌주,한용표,변진수 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.8

The authors analyzed 9 cases of chronic subdural hematoma which had been originated from traumatic subdural hygroma patients who were admitted to our department from January, 1990 to June, 1991. The results of analysis were summarized as follows : 1) The range was from 23 to 73 years of age, and fifth and sixth decade were two-thirds of all with the sex ratio of male to female 3.5 to 1. 2) The hematoma sites were all the same as those sites of previous subdural hygroma, and all site involved fronatal area. 3) It took on average 8 weeks for the hygroma to convert into hematoma. 4) The major clinical symptoms and signs were headache, alteration of consciousness, motor weakness and dysphasia. 5) The densities of hematoma revealed on brain CT at the time of conversion were all hyperdense. 6) Closed drainage through burr holes resulted in an excellent clinical outcome in all cases at the time of discharge, although still remained subdural hygroma in 3 cases on follow-up brain CT. 7) Patients with traumatic subdural hygroma, even small amount, should be followed for at least 8 weeks and carefully monitored.

뇌 동맥류를 동반한 Takayasu's Arteritis 1례 : 증례 보고 Case Report

이하우,홍순기,한용표,허철,김헌주 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.5

A Case of Takayasu's arteritis associated with intracranial aneurysm is described. We discussed the clinical features, radiologic findings of the case, and reviewed the literatures of this disease entity.

외상성 뇌실출혈의 임상적 분석

김호진,변진수,허철,홍순기,김헌주,한용표 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2

Intraventricular hemorrhage after blunt head trauma, which reflects the severity of head injury, is uncommon. A retrospective study of 109 traumatic intraventricular hemorrhage(TIVH) patients who were admitted between January 1, 1988 and December 31, 1993 was conducted. The results are as follows : 1) Incidence of TIVH and its associated mortality were 2.45% and 28.4%, respectively. 2) TIVH-associated radiological abnormalities were traumatic intracerebral hematoma(62.7%), skull fracture(42.7%), and traumatic subarachnoid hemorrhage(34.5%). 3) Amount of TIVH was related to traumatic intracerebral hematoma(p=0.0003) and traumatic subarachnod hemorrhage(p=0.0385). 4) The poorest prognostic indicator was associated abnormalities, especially corpus callosum or brainstem hemorrhage(p=0.0099). 5) TIVH-associated hydrocephalus was not related to the amount of TIVH(p=0.42), and poor prognosis(p=0.12). 6) Patients with TIVH showed better Glasgow coma scale and Glasgow outcome scale than TIVH-associated abnormalities.

외상성 뇌지주막하출혈을 동반한 두부외상 환자의 예후인자

길승배,김헌주,허철,한용표,홍순기,변진수 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.9

The presence of traumatic subarachnoid hemorrhage on the initial computerized tomographic scans has been known to be associated with worse results. By means of a simple and reliable computerized tomographic grade system proposed by Greene and his colleagues, prognostic factors of the traumatic subarachnoid hemorrhage was significantly related to clinical outcome at the time of discharge from acute hospitalization. Between February 1992 and August 1995, 3975 patients were admitted to our department of neurosurgery due to head injury. Clinical data were retrospectively reviewed to ascertain the relationship of the thickness of traumatic subarachnoid hemorrhage, its location, evidence of mass lesion(s), midline shift, obliteration of the basal cistern, and cortical sulcal effacement to outcome. Additionally initial Glasgow coma scale score, arterial gas study systemic blood pressure and prothrombin time were also analyzed for the same purpose. Among 3975 head-injured patients. 213 patients were identified to have traumatic subarachnoid hemorrhage on the initial computerized tomographic scan. Among 213 traumatic subarachnoid hemorrhage patients, the patients treated with calcium channal blocker(32 patients) and 3 patients lost to follow-up were excluded from this study for a total of 178. The computerized tomographic scan findings were divided into a 3 grade system : Grade 1 indicating only traumatic subarachnoid hemorrhage. Grade 2 indicating traumatic subarachnoid hemorrhage with mass lesion(s). Grade 3 indicating traumatic subarachnoid hemorrhage with mass lesion(s) and midline shift. All these data were compared to Glasgow outcome scale on discharge, and arbitarily these were divided into the good(good recovery and moderate disability) and the bad(severe disability, vegetative state and death). The authors conclude that the contributing factors to outcome at discharge were as follows : 1 midline shift(p=0.002), PT≤70%(p<0.001), obliteration of the basal cistern(p=0.001) and cortical sulcal effacement(p=0.001) were shown to the statistically significant. 2. initial computerized tomographic grade contributed to outcome at discharge.