• 근관절건강학회지
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• 제11권2호
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• pp.187-198
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• 2004

Purpose: The purpose of this study was to identify differences of BMI, pain, depression, self-esteem and self-efficacy between rheumatoid arthritis and osteoarthritis patients. Method: The study subjects were 135 persons having chronic arthritis at rheumatology clinic and the department of orthopedic surgery of the C university hospital in D city. The data were collected from February 19th to April 7th, 2003. The data analysis consisted of $X^{2}-test$, t-test, Pearson Correlation Coefficient, and multiple regression using SPSSWIN 10.0 program. Result: 1. There were significant differences in age(p=0.000), occupation(p=0.015), marriage(p=0.028), duration of illness(p=0.000), BMI(p=0.006) and Self-efficacy(p=0.017) between rheumatoid arthritis and osteoarthritis patients. 2. In rheumatoid arthritis, the BMI and self-esteem(r=-0.239, p=0.05) were significantly correlated and also pain and self-esteem(r=-0.402, p=0.01), pain and self-efficacy(r=-0.455, p=0.01) were significantly negatively correlated. The self-esteem and depression(r=-0.622, p=0.01), self-efficacy and depression(r=-0.729, p=0.01) were significantly negatively correlated and also pain and depression(r=0.432, p=0.01), self-esteem and self-efficacy(r=-0.476, p=0.01) were significantly positively correlated. In osteoarthritis, the pain and self-esteem(r=-0.225, p=0.01) were significantly negatively correlated and also pain and self-efficacy(r=-0.493, p=0.01), self-esteem and depression(r=-0.692, p=0.01), self-efficacy and depression(r=-0.566, p=0.01) were significantly negatively correlated. The pain and depression(r=0.290, p=0.05), self-esteem and self-efficacy(r=0.383, p=0.01) were significantly positively correlated. 3. The factors influenced by the self-efficacy, the depression and age in rheumatoid arthritis explained 56.2%, the depression and pain in osteoarthritis explained 43.9%. The factors influenced by the BMI, the self-esteem in rheumatoid arthritis explained 5.7%, but there was no significantly variable in osteoarthritis. Conclusion: The results support the importance of different nursing intervention focused on BMI and self-efficacy in patients with rheumatoid arthritis and osteoarthritis. There is a need for further studies to identify relation of variables in different diseases related to arthritis.

• 생명과학회지
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• 제20권2호
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• pp.314-320
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• 2010

트라이애슬론은 수영, 사이클, 달리기로 구성된 스포츠로 단일종목의 스포츠에 참가할 때 보다 잠재적인 의학적 위험요인을 더 많이 포함하고 있다. 과사용은 스트레스의 증가와 뼈, 관절, 근육, 건 또는 신경의 손상을 일으키며, 지금까지 트라이애슬론 훈련과 경기 중에 발생될 수 있는 과사용 부상은 목통증, 요통, 근육과 건 부상, 인대부상, 만성적인 통증 등이며, 대부분의 과사용 부상은 달리기 훈련시 가장 많이 발생된다. 또한 트라이애슬론 참가자들은 다양한 자연환경과 경기거리에서 완주해야 하는 만큼 부상 이외의 의학적 문제에 직면할 수 있으며, 현재까지 트라이애슬론과 관련하여 보고되고 있는 의학적 위험요인들은 저체온증, 저나트륨혈증, 일사병, 자외선에 과도한 노출, 면역억압, 심리적인 탈진현상, 용혈증 등을 포함하고 있다. ID 경기 중에 발생 할 수 있는 의학적 문제들 가운데 가장 빈번하게 발생하는 증상은 탈진과 탈수현상이며, 그 다음으로 나타나는 문제점들은 저나트륨혈증, 열부상, 저혈압, 화상과 물집, 근육경련 등이다. 그러나 SD와 OD 경기 중에는 달리기 속도가 빠르고 더 높은 강도에서 경기가 진행되기 때문에 일사병의 발생 위험이 더 높고, 경기 시간이 짧은 관계로 저나트륨혈증은 발생하지 않는다. 본 연구는 트라이애슬론 훈련과 경기 중에 발생 될 수 있는 과사용 부상과 의학적 위험 요인에 대한 연구문헌들을 고찰하여 스포츠 활동에 직접 참여하는 엘리트 선수 및 동호인 그리고 스포츠 현장에서 선수들을 지도하는 코치와 대회를 주최하는 관계자들에게 트라이애슬론과 관련된 과사용 부상과 의학적 위험요인에 대한 기초자료를 제공하여 이러한 위험요인들을 미연에 예방하거나 감소시키는데 도움을 줄 수 있는 기초자료를 제시하고자 한다.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.347-357
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• 1996

Although occupational low back pain accounts for $20\sim40%$ of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and funcional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. We estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson (1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of $30\sim45%$, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.

• 재활치료과학
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• 제1권1호
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• pp.71-79
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• 2012

목적 : 외상성 뇌손상 환자를 대상으로 대인관계 능력과 일상생활활동 수행능력의 상관관계를 알아보고자 하였다. 연구방법 : 대구에 소재한 K병원의 외상성 뇌손상 환자 20명을 대상으로 2012년 3월부터 2012년 4월까지 대인관계 능력과 일상생활활동 수행능력을 평가하였다. 연구도구로 대인관계 능력을 위해 대인관계 변화척도(Relationship Change Scale; RCS), 일상생활활동 수행능력을 위해 기능적 독립척도(Functional Independence Measure; FIM)를 사용하여 평가하였다. 결과 : 첫째, RCS는 결혼여부와 유병기간에서 유의한 상관관계를 보였다. 둘째, RCS는 FIM 총점과 FIM 인지영역과는 유의한 상관관계를 보였지만, FIM 운동영역과는 유의한 상관관계를 보이지 않았다. 결론 : 본 연구의 결과, TBI 환자의 대인관계 능력은 결혼 상태와 유병 기간이 영향을 미치고, 대인관계 능력이 일상생활활동 수행능력에 영향을 미친다는 것을 알 수 있다. 사회인지 기능의 장애는 손상 후 재활을 어렵게 하는 요소로 이 기능의 손상은 일상생활에서 인간관계에 부정적인 영향을 주는 요인으로 TBI 손상 후 대인관계 능력에 대한 정확한 평가와 더불어 치료가 발병초기부터 재활치료에 병행된다면 보다 많은 환자의 사회인지 및 일상생활활동 수행능력의 향상을 기대할 수 있을 것이다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권4호
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• pp.273-278
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• 2015

Objectives : We retrospectively investigated the efficacy and tolerability of risperidone monotherapy in subjects with autism spectrum disorder (ASD). In addition, we did mixed effect model analysis of the effects of risperidone in patients with ASDs naturalistically treated in a routine clinical setting to determine whether the clinical effects were maintained and the side effects were tolerable. Methods : This retrospective study assessed children and adolescents with ASD, who were on risperidone monotherapy from July 2010 to July 2011 at the Child and Adolescent ASD Clinic at Seoul National Hospital. Outcome measures included the Clinical Global Impression-Severity of Illness (CGI-S) and the CGI-Improvement (CGI-I) scales along with other clinical indices: dosage, target symptoms, and side effects. Results : The mean dose of risperidone in 47 children and adolescents with ASD (40 males, 7 females; age range 5-19 years) who were on risperidone monotherapy was $1.6{\pm}0.8mg/day$, and the mean duration of the treatment period was $20.2{\pm}17.3months$. Aggressive behavior, stereotypic behavior, irritability, and self-injurious behavior were the most frequent target symptoms of risperidone. The most common side effects were weight gain followed by somnolence and extrapyramidal symptoms. In a mixed effects model analysis of CGI-I scores, the mean CGI-I score at the 1 month follow-up was significantly different from the mean CGI-I score of the 3-month follow-up (p=.046), and the CGI-I scores were equally maintained over 3 to 48 months [F(6, 28.9)=4.393, p=.003]. Of the 47 patients, 33 patients (70.2%) were identified as the response group, showing an end point CGI-I rating of 3 or under and having continued risperidone treatment for at least 6 months. The baseline CGI-S score showed significant association with clinical response to risperidone (p=.005), the mean baseline CGI-S was higher in the response group compared to the non-response group. Conclusion : In this study, clinical improvement of risperidone stabilized around 3 months and was equally maintained up to 48 months with tolerable side effects, supporting maintenance of risperidone treatment in children and adolescents with ASDs.

• 한국콘텐츠학회논문지
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• 제16권1호
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• pp.676-687
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• 2016

본 연구는 지역사회에 거주하는 파킨슨병환자의 운동기능, 우울, 낙상공포의 관계를 파악하고 낙상공포에 미치는 영향요인을 규명하기 위한 것이다. 대상자는 편의표집에 의해 선정된 파킨슨병환자 180명이다. 수집된 자료는 IBM SPSS Statistics 20.0을 이용하여 기술통계, t-test, ANOVA, Pearson correlation coefficient와 multiple linear regression으로 분석하였다. 그 결과, 파킨슨병환자는 여성, 직업이 없는 경우. 보행보조기구 사용자, 2회 이상 낙상 경험자, 파킨슨병 4단계 환자, 유병기간이 9년을 초과한 경우, 항고혈압제 복용 환자, 독립적 운동수행력 하위군, 우울이 있는 경우 낙상공포가 더 높게 나타났다. 낙상공포는 운동기능 및 우울과 유의한 순상관관계를 나타냈다. 파킨슨병환자의 낙상공포의 영향요인은 우울, 낙상횟수, 파킨슨병 단계, 성별, 항고혈압제, 운동기능으로 변량의 36.0%의 설명력을 나타냈으며 영향요인 중 우울이 가장 강력한 요인으로 나타났다. 따라서 지역사회 거주하는 파킨슨병환자의 낙상공포를 예방하기 위해서는 영향요인에 대한 체계적 간호사정과 함께 우울을 완화할 수 있는 중재전략이 필요함을 제시해 주었다.

• 생물정신의학
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• 제5권2호
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• pp.243-247
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• 1998

28명의 항정신병약물을 복용중인 정신분열병환자를 연구대상으로 하여 혈장 HVA의 주간변동과 insulin 투여후의 변동을 알아보았다. 주간변동을 알아보기 위해 오전 8시에 기저혈액을 채혈하고 그후 30, 60, 90분 시점에 연속적으로 채혈하였다. Insulin 투여후의 변동을 알아보기 위해 오전 8시에 기저 혈액을 채혈하고 insulin(0.1 uiti/kg)을 투여한 30, 60, 90분 시점에 채혈하였다. 두번 측정한 기저치농도로 미루어 같은 시대간의 농도는 일일 간 변동이 거의 없는 결과를 얻었다. 혈장 HVA는 개인간의 차이는 크지만, 개인별로는 같은 시간대의 농도는 대단히 일치하는 것을 알 수 있었고, 혈장 HVA 농도는 신뢰성있는 생물학적 지표가 될 수 있음을 확인하였다. 혈장 HVA 농도는 정상적인 주간변동시에는 서서히 감소한 반면 insulin을 투여한 후에는 점차 증가하다가 60분후 정점에 달하고 다시 감소하는 것을 볼 수 있었다. 투여후 60분에 가장 증가율이 높은 것을 확인하였으며 앞으로의 연구에서 활용할 계획이다. 임상변수에 따라 대상환자를 구분하여 변동을 보았을 때 음성군은 insulin 투여후의 증가율이 다소 높은 경향을 보인 것은 선행연구결과와 일치하나 통계적 유의성은 없었다.

• 국제물리치료학회지
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• 제5권1호
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• pp.661-667
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• 2014

This study is a cross-sectional study for conscripts with chronic low back pain, where it is designed to investigate general characteristics that conscripts with chronic low back pain carry, and it is also aimed to analyze the correlation as well as discrepancy within pain, depression and body mass index depending on their ranks. In this study, 90 Korean conscripts with chronic low back pain participated. And in order to analyze general characteristics as well as pain, depression and body mass index of the subjects, this study adopted a survey questionnaire upon general characteristics, and it also employed Visual Analogue Scacle(VAS) and Center for Epidemiological Studies Depression(CES-D) Scale which have proven their credibility, where BMI values for the subjects were calculated based on 'Asian Pacific standard' Body Mass Index(BMI). From the general characteristics exhibited by the subjects through this study, average age and average height of the subjects were $20.78{\pm}1.41$ and $175.97{\pm}5.34$ respectively; and corporals displayed the highest ratio of 42% with the chronic low back pain while 40% of the total subjects experienced the duration of the illness less than 6 to 9 months. Moreover, 57.8% of all subjects were reportedly suffering moderate pain, and 48% exhibited depression while 49% carried BMI value between 18.5 and $22.9kg/m^2$(normal range). Based on the analysis of correlation among pain, depression, discrepancy of BMI depending on the ranks and each independent variable, it appears that there is no significant difference amongst the ranks, and there is no correlation between independent variables; however, it was obvious that all groups divided by the ranks had a moderate pain(45-74mm), depression(${\geq}16$) and BMI value in normal range(18.5-22.9).

• 대한두경부종양학회지
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• 제15권1호
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• pp.70-75
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• 1999

Objectives: This study was designed to evaluate the methods of diagnosis and treatment of thyroid nodules. Materials and Methods : We performed a clinical review of patients with thyroid nodules, who were surgically treated at the Department of Surgery, College of Medicine, Chosun University from January 1996 to December 1998. Results: 1) The patients were divided into two groups; 65 patients(80.2%) with benign nodular disease and 16 patients(19.8%) with malignant disease. 2) The sex distribution showed a preponderance of females with a ratio of 5.2:1 in benign nodular disease and 3:1 in malignant disease. Benign nodules were more prevalent in patients in their 40's as compared to malignant nodules in patients in their 50's and 60's. 3) The most common duration of illness was 3 months, occurring in 45.7% of the total cases. 4) The most prominent symptom and sign was a palpable nodule in the anterior aspect of the neck. 5) The location of the nodule was ; 41 cases in the right lobe, 29 cases in the left lobe, and 11 cases in both lobes. 6) Thyroid scanning of 40 patients revealed cold nodules in 90.6% of benign nodules and in all malignant disease. 7) Fine needle aspiration cytology were performed in 32 cases of the 81 patients. Comparing with postoperative pathological findings, the results were the same in 87.5% of 32 cases. 8) Intra-operative frozen section study was performed in 56 cases of the 81 patients. Comparing with postoperative pathological finding, the results were same in 96.4% of the 56 cases. 9) The histopathological classification revealed that adenomatous goiters were the most common benign disease and papillary carcinomas were the most common malignant disease. 10) The most frequently employed operation for benign nodules and malignant disease was unilateral total lobectomy. When the metastasis was confirmed, lymphadenectomy and radical neck dissection was performed in malignant disease. 11) Important postoperative complications were transient hoarseness, transient hypocalcemia, hypothyroidism, wound bleeding, and hoarseness. Conclusions: The results of this study suggest that palpable nodules in anterior aspect of neck is revealed cold nodule by thyroid scanning and malignancy by fine needle aspiration cytology, which should be removed surgically. There is no difference in complication and survival rate with type of operation and lymphatic dissection. Therefore, procedure of operation is dependent on the site of nodule and involvement of lymph node.

• 대한핵의학회지
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• 제12권2호
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• pp.33-40
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• 1978

Clinical features of 147 patients with biopsy-proven thyroid carcinomas were investigated from January, 1972 to April, 1978 at the Seoul National University Hospital with the following results. 1) The incidence of thyroid carcinomas according to their histopathological classification revealed 76.2% of papillary carcinoma, 19.0% of follicular carcinoma, and 3 cases of occult sclerozing carcinoma, 1 case of giant cell carcinoma and 1 case of metastatic melanoma. 2) The ratio of male to femle patients was 1:8.3 and showed no difference between papillary and follicular carcinomas. 3) The age distribution showed the peak incidence in the fourth decade (29.3%) followed by the fifth and sixth decades. 4) The average duration of illness from the onset of symptoms was about 5 years while it was 4.4 years and 7.6 years in the papillary and follicular carcinomas respectively. 5) The diameter of the thyroid masses was smaller than 5 cm in 53.6% of the patients, from 5 cm to 10 cm in 40.0% and larger than 10 cm in 6.4%. 6) In 36.4% of the patients with thyroid carcinomas the thyroid masses were fixed to adjacent tissues. 7) Metastasis to the regional lymph nodes was noted in 40.0% of the total cases, and in 45.2% and 17.6% of the papillary and follicular carcinomas respectively, while the lung and bone metastases were found in 10.0% and 4.4% in each type respectively. 8) 88.9% of the patients showed cold areas in the thyroid scans using $^{131}I$. 9) Typical psammoma bodies were observed in 21.3% of the cases in the microscopic examination of the pathological specimens. 10) The initial diagnosis of thyroid malignancy could be made before histological confirmation in 64.5% of the patients. 11) The clinical staging slightly modified from Schulz method revealed 43.6% of the patients in stage I, 26.4% in stage II, 20.9% in stags III and 9.1 % in stage IV. 12) The association with Hashimoto's thyroiditis was noted in 4 cases, with nodular goiter in 3 cases, and with follicular adenoma in 1 case.