• 한국산학기술학회논문지
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• 제20권10호
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• pp.303-308
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• 2019

65세 남자환자에서 전신마취하 관절경 어깨 수술후 갑자기 발생한 사지 마비 증례를 보고하고자 한다. 환자는 술 후 급격한 사지 마비 증상을 보였으며 마취 관리상 특별한 문제는 없었다. 환자의 수술시 자세와 관련하여 마취 유도시에 기관삽관을 위한 과도한 경추 신전은 시행되지 않았으며 수술중 자세에서도 경추부의 과도한 회전이나 신전 또한 진행되지 않았다. 그러나 수술이 종료된 후 근이완의 완전한 회복과 의식 및 자발호흡은 확인되었으나 사지 마비 증상 및 배뇨장애 증상을 보였다. 신속히 시행한 경추부 자기공명 영상에서 경추간판에 의한 척수 신경 압박 소견 보이는 척추성 경추증 증상을 보였다. 환자는 21일간의 고농도 스테로이드 정주 요법을 포함한 보존적 치료 후에 감각 및 운동신경의 완전한 회복을 보이고 다른 신경학적 이상 소견은 보이지 않은 채로 퇴원하였다. 외상과 관련 없이 사지 마비로 나타나는 수술후 척추성 경추증의 발생은 흔하지 않다. 본 증례를 통해 수술후 발생한 비외상성 척추성 경추증 발생에 대해 타 증례 보고와 비교 분석하여 고찰해 보고자 한다. 임상 의사는 60세 이상의 노년층에서의 수술후 사지 마비에 대해 척추성 경추증의 원인 기여에 대해서도 고려하기를 권고한다.

• 대한한방내과학회지
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• 제31권1호
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• pp.1-10
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• 2010

Objectives : It is necessary that the international classification of diseases (ICD) be examined in order to comprise the third revision of the Korean Classification of Disease on Oriental Medicine (KCD-OM) and disease classification in the oriental internal medicine field. It is essential that the selection, classification and definition of disease and pattern names of oriental concepts in internal medicine be clear. Since 2008, the fifth revision of the Korean Classification of Disease (KCD-5) has been used in Korea. It was required to use the reference classification from the Oriental medicine area based on the ICD-10. Methods : In this review, the necessity for, meaning of and content of the third revision are briefly described. The ICD system was reviewed and KCD-OM was reconstructed. How diagnosis in the oriental internal medicine area had changed is discussed. Review and Results : In 1973, the disease classification of oriental medicine was established the basis on the contents of Dongeuibogam. It was irrespective of the ICD. As to the classification system in the Oriental internal medicine field, systemic disease was comprised of wind, cold, warm, wet, dryness, heat, spirit, ki, blood, phlegm and retained fluid, consumptive disease, etc. Diseases of internal medicine comprised a system according to the five viscera and the six internal organs and followed the classification system of Dongeuibogam. The first and second revisions were of the classification system based on the curriculum in 1979 and 1995. In 1979, in the first revision, geriatric disease and idiopathic types of disease were deleted, and skin disease was included among surgery diseases. This classification was expanded to 792 small classification items and 1,535 detailed classification items to the dozen disease classes. In 1995, in the second revision, it was adjusted to 644 small classes and 1,784 detailed classification items in the dozen disease classes. KCD-OM3 did KCD from this basis. It added and comprised the oriental medical doctor's concept names of diseases considering the special conditions in Korea. KCD-OM3 examined the KCD-OMsecond revised edition (1994). It improved the duplex classification, improper classifications, etc. It is difficult for us to separate the disease names and pattern names in oriental medicine. We added to the U code and made one classification system. By considering the special conditions in Korea, 169 codes (83 disease name codes, 86 pattern name codes) became the pre-existence classification and links among 306 U codes of KCD-OM3. 137 codes were newly added in the third revision. U code added 3 domains. These are composed of the disease name (U20-U33, 97 codes), the disease pattern name (U50-U79, 191 codes) and the constitution pattern name of each disease (U95-U98, 18 codes). Conclusion : The introduction of KCD-OM3 conforms to the diagnostic system by which oriental medical doctors examine classes used with the basic structure of the reference classification of WHO and raises the clinical study and academic activity of the Korean oriental medicine and makes the production of all kinds of nation statistical indices possible. The introduction of KCD-OM3 promotes the diagnostic system by which doctors of Oriental medicine examine classes using the association with KCD-5. It will raise the smoothness and efficiency of oriental medical treatment payments in the health insurance, automobile insurance, industrial accident compensation insurance, etc. In addition, internationally, the eleventh revision work of the ICD has been initiated. It needs to consider incorporating into the International Classification of Diseases some of every country's traditional medicine.

• 수면정신생리
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• 제3권1호
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• pp.56-67
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• 1996

Objectives : This study was designed to find clinical factors that could be differentiated by the lateralization of lesion and also find clinical factors to predict the lateralization of lesion. Methods : The subjects were 65 cooperative inpatients and outpatients with non-traumatic subcortical cerebrovascular disease without neurologic and psychiatric history from January 1995 to September 1995 ; 48 patients in Kyung Hee University, Oriental Medicine Hospital, 35 patients in Anam Hospital, Korea University were examined as subjects, but authors excluded 20 patients whose data were incomplete or who had uncertain lesions on brain CT or MRI. The 65 patients were divided into three groups-group with left hemispheric lesion, group with right hemispheric lesion, group with both hemispheric lesion-according to the finding of brain imaging study. Their cognitive functions were evaluated by the Benton Neuropsychological Assessment(BNA), their subjective neurobehavioral symptoms by Symptom Check List-90-R(SCL-90-R), their objective neurobehavioral symptoms by Neurobehavioral Rating Scale, and their daily living functions by Geriatric Evaluation by Relative's Rating Instrument(GERRl) and Instrumental Activities of Daily Living Scale(IADLs). Results : The results were as follows : 1) The results of cognitive function test indicated that the group with right hemispheric lesion showed low functions in Tactile Form Perception(left), the group with left hemispheric lesion showed low functions in Finger localization(right), the group with right hemispheric lesion showed low functions in Finger Localization(left). 2) Though, there were little significant differences in subjective neurobehavioral symptoms, the group with right hemispheric lesion showed higher scores in all symptoms except hostility. 3) Though, there were little significant differences in objective neurobehavioral symptoms, the group with both hemispheric lesion showed higher scores in cognition, guilty/disinhibition, the group with left hemispheric lesion showed higher scores in lability of mood, the group with right hemispheric lesion showed highest scores in psychotism, neurotism, agitation-hostility and decreased motivation/emotional withdrawal. 4) There were little significant differences among three groups in Daily Living Functions, but the group with right hemispheric lesion showed the lowest functions in Instrumental Activities of Daily Living. 5) As a result of discriminant analysis on each factor's contribution to the prediction of lesion, Finger Localization(left), Phoneme Discrimination and Tactile Form Perception(right) showed that they had the potentiality to predict lesion. Conclusion : The results suggest that there are little significant differences among the groups of three non-traumatic subcortical cerebrovascular disease in cognitive functions, but the group with right hemispheric lesion showed more serious and various changes in subjective and objective neurobehavioral symptoms, and showed low functions in Instrumental Activities of Daily Living. This results suggest the possibility that the decline of the daily living function in the group with right hemispheric lesion were due to various symptoms, not due to cognitive dysfunction. The confirmation of the possibility should be worked out through the follow-up study of some groups containing cortical lesion. Apart from these findings, Finger Localization, Tactile Form Perception(right) and Phoneme Discrimination suggest that they can be used as clinically valuable cognitive parameters that predict the lateralization of lesion in non-traumatic cerebrovascular disease.

• 정신신체의학
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• 제4권2호
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• pp.170-181
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• 1996

Objective : This study was tried to investigate the specific relationships among cognitve function, neurbehavioral symptoms, and daily living functions, as well as provide the guidline of more proper clinical approches for patients with subcortical cerebrovascular disease. Objects and Methods Subjects were 85 patients whose diagnosis was confirmed by brain CT or MRI and controls were 195 normal persons matched by educational level with the subjects. The cognitive functions were evaluated by BNA(Benton neuropsychiatric assessment), subjective neurobehavioral symptoms by SCL-90-R(Sympton Check List-90-Revised), objective neurobehavioral symptoms by NRS(Neurobehavioral Rating Scale), and daily living function symptoms by NRS(Neurobehavioral Rating Scale), and daily living function by GERRI(Geriatric Evaluation by Relative's Rating Instrument) and IADL(Instrumental Activities of Daily Living Scale). Results: 1) Subjects showed significantly lower cognitive functions than controls in all tests of BNA except Lt-Rt Orientation Test(p=0.09) and facial Recognition Test(p=0.186). 2) In subjective neurobehavioral symptoms, subjects showed significantly lower scores in all symptoms except anxiety(p=0.059), hostility(p=0.159), and phobic anxiety(p=0.849). But in objects neurobehavioral symptoms, subjects showed significantly higher in scores in psychoticism (p=0.000) and neuroticism(p=0.025) of NRS. 3) The score of social functioning of GERRI(p=0.000) and that of IADL(p=0.000) were significantly higher in subjects than in controls. 4) for correlation between cognitive and daily living functions, there were significant correlations between the scores of all items on BNA and the score of cognitive or social function of GERRI and the socre of MDL in corntrols, whereas in subjects, there were significant correlations only between the scores of BNA and the score of IADL. 5) for correlation between neuroehavioral symptoms and daily living functions, there were significant correlatons between the socre of subjective neurobehavioral symptoms and the scores of all subscales of GERRI and the score of MDL in controls. On the contrary, in subjects, there were significant correlations between the score of social function of GERRI and the score of objective neurobehavioral symptoms such as psychoticism, agitiation-hostility, and decrease d motivation-emotional withdrawl. Conclusion : Above results suggest that disturbances in specific function of brain may play a role as a predictor of impairments with specific daily living functions and also suggest that specific correlations among various functions may be useful as clinical parameters for setting of the treatment goal and for assessing the ongoing process in the treatment and rehavilitation of the patients with subcortical cerebrovascular disease.

• 한국융합학회논문지
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• 제7권4호
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• pp.199-208
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• 2016

본 연구의 목적은 노인에게 10주 동안 주 2회씩 60분간의 웃음치료프로그램을 적용하여 노인의 성공적 노화와 스트레스에 미치는 영향을 알아보는 것이다. 연구대상자는 선정기준에 따라 실험군은 S시 소재의 문화원에서 비교군과 대조군은 S시 소재의 노인정에서 각 그룹당 25명씩 편의 표집하였다. 자료 분석은 SPSS 19.0을 이용하여 공변량 분석을(ANCOVA) 하였다. 10주 동안의 웃음치료프로그램을 실시한 결과, 실험군은 비교군과 대조군보다 노인의 성공적 노화를 향상시키고, 스트레스를 감소시키는 것으로 나타났다. 따라서 다양한 노인 문제가 부각되는 현 실정에서 본 연구를 통하여 웃음치료프로그램의 과학적인 근거를 검증하고 적용할 수 있는 근거를 마련하였다.

• 지역사회간호학회지
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• 제14권2호
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• pp.287-298
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• 2003

The purpose of the study was to develop an integrated prevention program to strengthen elders self-care capability and to examine its effectiveness on their psychological condition. This study used one group pre- and post-test design. Subjects were 85 elderly residents (over 65 years of age) who lived alone, and received free basic medical care and social welfare services in a rural community in Korea. Subject eligibility criteria for this study were to an elders who 1) is not currently taking any anti-depressant medication 2) is able to communicate, and 3) agrees to participate in this study. The integrated program was composed of horticulture, reminiscence, and friendship activities. Twelve sessions were provided for 12 weeks in community-based partnerships to achieve better outcomes. The intervention was case-managed by a public health nurse and aided by six volunteers. The main outcome variable was depression, which was assessed by using 15 items selected from the Geriatric Depression Scale-short form Korean version. Socio-demographic characteristics, functional status, and satisfaction with social support were used as covariates. Results showed that there was a significant intervention effect at post-intervention time point compared to pre-intervention time point(E.S. 0.94). Multiple linear regression analysis showed significant interaction effects between intervention and satisfaction with social support. These findings must be interpreted within the context that an effects of an integrated program could be more synergistically increased when social support factor is considered in the program. A community-based integrated prevention program of depression is effective for vulnerable rural elderly. It is suggested that randomized controlled trials within community setting for better methodological strength as well as multi-level outcomes on community need to be conducted in future.

• 지역사회간호학회지
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• 제13권1호
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• pp.30-38
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• 2002

The purpose of this study was to compare the Depression levels of the poor and elderly as well as the elderly who were residents in a community. The author studied the Depression levels of 117 poor and elderly individuals and 183 elderly individuals all 65 years or older living in Suwon City. This study has been done using a direct-interview structured Questionnaire and Korean Form of Geriatric Depression Scale (KGDS) from May to July in 1999. The results can be summarized as following: 1. With Case and Control group there was no significant difference with respect to gender, age, education level, or religion. But was significantly different regarding marriage state, if subjects were living together, type of residency, province, and place of toilet(P<0.05). 2. Smoking and Hwa-pyung was a large number of case group more than control group. and alcohol was more control group than case group(P<0.05). 3. There was a similiar taking medicine and kind of body symtom of case and control group. 4. The mean score of perceived KGDS of the poor elderlys was 17.87+/-5.97 out of 30. and that of the elderlys was 13.35+/-6.00 out of 30(P<0.001). 5. In a simple correlation analysis of elderlys. education, marital status. residency, son and daughter, position of toilet, elderly center, alcohol, Wha-byung, disease. 6. In a multiple regression analysis, Hwa-byung, elderly center, education, smoking, disease, son and daughter.

• 보건행정학회지
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• 제9권3호
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• pp.95-112
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• 1999

The objectives of this study were to develop the therapeutic recreation programs for relieving depressive symptoms of the elderly and to verify the effect on their psychological condition. The key elements of these programs, which consisted of 9 sessions. were aerobic exercises, group dynamics. and making fun. These programs were developed through a multidisciplinary approach with social workers and the faculties of preventive medicine. The social workers gave these programs to fifteen elderly people at the community center, so called noinjung, for 9 weeks. Before intervention of this program for the experimental group, the baseline was measured by GDS(geriatric depression scale). After intervention for 9 weeks, GDS as an outcome was measured to evaluate the effects of the program. This data was analyzed by $X^2$-test and Wilcoxon signed rank test. and the results were as follows: 1. Based upon the cutting point(GDS = 5) which could distinguish between depression group and normal group, the number for the normal group increased, while the number for the depression group decreased slightly after intervention with the therapeutic recreation programs, however, there was no significant change(p〉0.05). 2. The score of GDS decreased significantly after intervention with the therapeutic recreation programs(p〈0.05). 3. The scores of GDS decreased in widow(or) group and in female group compared to those of the married group and the male group, respectively(p〈0. 05). 4. The score of GDS increased in groups with similar labor and emotional support compared to those of groups with sufficient or less support, respectively(p〈0.05), These findings indicate that the therapeutic recreation programs might be effective for relieving depressive symptoms of the elderly. It is, therefore, suggested that this program be modified and standardized through review of the intervening process, experimental results, and responses of clients for appling in other noinjungs.

• 재활간호학회지
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• 제10권2호
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• pp.141-146
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• 2007

Purpose: This study was conducted to estimate the prevalence rate, and related factors,of fatty liver in male industrial workers. Method: Fatty liver was diagnosed using ultrasonography. The data for abdominal ultrasonography, BMI, smoking, alcohol drinking, exercise, liver enzymes, and lipid profiles were collected in 4,604 male who were examined with a health screening program in 2005. Prevalence rate and associated factors of fatty liver were analyzed using SPSS v. 12.0. Results: Overall prevalence of fatty liver was 34.1% and higher in the 30-39 year male group. Age, body mass index(BMI), hypertriglyceridemia, hypercholesterolemia, HDL cholesterol, r-GTP level were independently associated factors with presence of fatty liver in logistic regression analysis. Conclusion: The prevalence of fatty liver and tendency of associated factors were similar to those in the western world. To prevent development of this hepatic disorder, which may result in end-stage liver disease, risk factors such as obesity and dyslipidemia must be monitored and controlled within normal levels. The results of this study suggested maintenance of a healthy lifestyle, including diet, exercise, and behavioral change, as fundamental rehabilitation nursing implications.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3907-3912
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• 2015

Purpose: To investigate the antitumor activity and mechanism of chloroquine (CQ) in combination with cisplatin (DDP) in nude mice xenografted with gastric cancer SGC7901 cells. Materials and Methods: 35 cases of gastric cancer patients with malignant ascites were enrolled and intraperitoneal cisplatin injection was performed. Ascites were collected before and 5 days after perfusion for assessment of autophagy levels in cancer cells. In addition, 24 tumor-bearing mice were randomly divided into control, DDP, CQ and CQ + DDP groups. Results: In 54.3% (19/35) of patients the treatment was therapeutically effective (OR), 5 days after peritoneal chemotherapy, 13 patients had the decreased ascites Beclin-1 mRNA levels. In 16 patients who had NR, only 2 cases had decreased Beclin-1 (P=0.001). Compared with the control group, the xenograft growth in nude mice in the DDP group was low, and the inhibition rate was 47.6%. In combination with chloroquine, the inhibition rate increased to 84.7% (P<0.01). The LC3-II/I ratio, and Beclin1 and MDR1/P-gp expression were decreased, while caspase 3 protein levels increased (P<0.05). Conclusions: Antitumor ability of cisplatin was associated with autophagy activity and chloroquine can enhance chemosensitivity to cisplatin in gastric cancer xenografts nude mice.