• 정신신체의학
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• 제11권1호
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• pp.3-14
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• 2003

문헌고찰을 통하여 최근 임상에서 문제되고 있는 신체화에 관한 문화정신의학적인 소견과 그 의미를 정리하였다. 신체화는 인류 공통의 범세계적인 정신병리이며 그 빈도나 양상은 문화 따라 차이가 난다. 그러나 단순히 서구-비서구 혹은 전통사회 대 근대화된 사회를 나누어 그 빈도차이를 논하는 것은 의미가 없다. 최근의 황문화적 연구에 따르면 이런 이분법식의 논리는 사실과는 전혀 다르다. 또한 어떤 차이가 나더라도 그 해석에서는 종족 뿐 아니라 그 종족이 처하고 있는 여러 사회문화적인 상황을 중요한 변인으로 고려해야 한다. 그리고 철저한 횡문화적 조사연구를 통하여 발생빈도와 그 의미를 확인해야 한다. 마음의 고통이 신체증상으로 나타나는 과정에서 1) 고통에 대한 문화적 표현양식 즉 문화적 은유, 2) 전통적인 질병개념, 3) 적응을 위한 사회적 매개체로서의 역할, 4) 신체화를 조장하는 의료제도 내지는 의료분위기 등의 문화사회적 요인들이 중요하게 작용하고 있다. 마음의 고통을 호소하는 통로로서 문화가 매채체 역할을 하고 있는 것이다. 세계화되고 있는 사회에서 횡문화적인 진료가 불가피하게 되고 이에 따라 신체화에 대한 이해와 접근기술이 새로운 과제로 등장하고 있다. 횡문화적 치료적 접근 원리에 대하여 간단히 소개하였고 아울러 한국 문화에서 신체화의 원인과 의미를 고찰하였다.

• 대한한의학회지
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• 제39권3호
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• pp.17-27
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• 2018

Objectives: Ukgan-san does not appear in Traditional Korean Medicine classics. However, it has been used in research and clinical applications in Korea. In this paper, we are aiming to examine the records concerned with Ukgan-san to the present, and announce the present usage state in Korea. Methods: We searched and summarized the contents of previous medical books about Ukgan-san. In order to investigate the current status of utilization of Ukgan-san in Korea, a bibliographic database of Korea, a database of clinical researches, and a database of pharmaceuticals of the Korea Food and Drug Administration were searched. Results: As a result of searching Ukgan-san related documents, Ukgan-san has been developed in China (Ming dynasty). However, its clinical application has been expanded by modern Japanese kampo medicine doctors. In Korea, cases of Parkinson's disease, other movement disorders, and psychiatric disorders have been reported, and randomized controlled trials had been done and planned. In addition, some extracts which are consisted of Ukgan-san are also available. Conclusions: In Korea, Ukgan-san has been influenced by Japan and has been used for clinical and research purposes. The utilization rate in Korea is still small, but the utilization rate will increase according to the results of clinical studies.

• 정신신체의학
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• 제4권1호
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• pp.138-145
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• 1996

동일한 질병을 갖고 있거나, 같은 증상을 호소하는 환자의 경우라도 병과 관련된 행동은 사람마다 각기 다르다. 이러한 행동 양식을 잘 이해하는 것은 병의 진단과 치료 방법, 치료 순응도와 치료 효과를 결정하는 데에 중요한 요소가 된다. 비정상적인 질병 행동은 병자 역할이 핵심이 되며, 간혹 병을 부정하거나 무시하는 반대의 경우도 있다. 비정상적인 질병행동에 대한 평가는 기질적 원인이 밝혀지지 않는 여러 기능성 장애를 규명하는 한가지 방법으로 이용될 수 있으며, 인지 치료 내지는 재활, 직업 치료시에도 활용할 수 있는 중요한 개념으로 알려져 있다. 향후 한국인에게 맞는 치료법의 개발을 위해서는 각 질병에 따른 의학 역사적 관점, 사회 문화적 요소가 어우러진 통합적인 질병 행동 연구가 필요하리라 사료된다. 이는 의료 경제 측면에서도 필수적인 내용이 될 것이다.

• 한국임상약학회지
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• 제30권2호
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• pp.81-86
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• 2020

Background: The number of patients with dementia continues to increase as the age of aging continues to grow. Psychiatric symptoms caused by senile dementia are controlled using antipsychotics. However, these antipsychotics can lead to Parkinson's disease, and abuse of dopamine derivatives such as levodopa among Parkinsonian drugs can lead to psychosis. Therefore, we evaluated the patterns of prescribed antipsychotics and antiparkinsonian drugs in patients with senile dementia. Methods: We used data from the sample of elderly patients from the Health Insurance Review and Assessment Service (HIRA-APS-2016). We analyzed the patterns of prescribing antipsychotics and antiparkinsonian drugs including prescribed daily dosage, period of prescription, and number of patients with both antipsychotics and antiparkinsonian drugs for senile dementia. Results: Among the 159,391 patients with dementia included in this analysis, 4,963 patients (3.1%) and 16,499 patients (10.4%) were prescribed typical and atypical antipsychotic drugs, respectively. The most frequently prescribed typical antipsychotic was haloperidol (4,351 patients with dementia), whereas the atypical agent was quetiapine (12,719 patients). The most frequently prescribed antiparkinsonian drugs were in the order of levodopa/carbidopa, benztropine, and ropinirole. In addition, 1,103 and 3,508 patients prescribed typical and atypical antipsychotics, respectively, were co-prescribed antiparkinsonian drugs. Conclusions: Atypical antipsychotics were the preferred prescription in patients with senile dementia. The prescription dose was relatively low; however, the average treatment duration was mostly long-term. Selection of antipsychotics and/or antiparkinsonian drugs should be made carefully in senile dementia and the causal relationship of adverse drug reactions needs further study.

• Journal of Ginseng Research
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• 제42권1호
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• pp.98-106
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• 2018

Panax ginseng has been used since ancient times based on the traditional Asian medicine theory and clinical experiences, and currently, is one of the most popular herbs in the world. To date, most of the studies concerning P. ginseng have focused on specific mechanisms of action of individual constituents. However, in spite of many studies on the molecular mechanisms of P. ginseng, it still remains unclear how multiple active ingredients of P. ginseng interact with multiple targets simultaneously, giving the multidimensional effects on various conditions and diseases. In order to decipher the systems-level mechanism of multiple ingredients of P. ginseng, a novel approach is needed beyond conventional reductive analysis. We aim to review the systems-level mechanism of P. ginseng by adopting novel analytical framework-network pharmacology. Here, we constructed a compound-target network of P. ginseng using experimentally validated and machine learning-based prediction results. The targets of the network were analyzed in terms of related biological process, pathways, and diseases. The majority of targets were found to be related with primary metabolic process, signal transduction, nitrogen compound metabolic process, blood circulation, immune system process, cell-cell signaling, biosynthetic process, and neurological system process. In pathway enrichment analysis of targets, mainly the terms related with neural activity showed significant enrichment and formed a cluster. Finally, relative degrees analysis for the target-disease association of P. ginseng revealed several categories of related diseases, including respiratory, psychiatric, and cardiovascular diseases.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.133-138
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• 2016

Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. Briefly, a 3-year-old girl was admitted to the hospital due to right-sided, complex partial seizures without preceding febrile illness. The seizures evolved into epilepsia partialis continua and were accompanied by epileptiform discharges from the left frontal area. Three weeks after admission, the patient's seizures were reduced with antiepileptic drugs; however, she developed sleep disturbances, cognitive decline, noticeable oro-lingual-facial dyskinesia, and choreoathetoid movements. Anti-NMDAR encephalitis was confirmed by positive detection of NMDAR antibodies in the patient's serum and cerebrospinal fluid, and her condition slowly improved with immunoglobulin, methylprednisolone, and rituximab. At present, the patient is no longer taking multiple antiepileptic or antihypertensive drugs. Moreover, the patient showed gradual improvement of motor and cognitive function. This case serves as an example that a diagnosis of anti-NMDAR encephalitis should be considered when children with uncontrolled seizures develop dyskinesias without evidence of malignant tumor. In these cases, aggressive immunotherapies are needed to improve the outcome of anti-NMDAR encephalitis.

• 대한간호학회지
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• 제30권2호
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• pp.380-390
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• 2000

This study was performed to evaluate the effectiveness of music therapy as one of the psychiatric nursing intervention tools, with addtional information in relieving anxiety during the procedure. Data were collected through nonequivalent pre-and post tests from July 1, 1998 to September 30 1998 in 90 patients (test group A: 28 patients, test group B: 27 patients, control group: 33 patients) who were hospitalized in DongSan Medical Center in order to have cardiac catheterization. The Subjects were informed by educational videos, which were modified according to the sensory information of the 10 study patients. They were based on the informative booklet by Kim keum-soon (1989). The procedural information was also modified according to the hospital`s customs. Provided the music for patients suitable to their tastes, and measured their blood pressure, heart rate, the degree of anxiety using the Spielberger`s measurement device of anxiety, and behavioral response of Finesilver`s. The statistical significance was analyzed using chi-square test and ANOVA. The results of this study were as follows : Hypothesis 1 : There are significant differences in the degree of anxiety among test group A, Test group A was provided only information, Test group B was provided information and the control group was provided neither. Hypothesis 2 : There are significant differences in systolic blood pressure among test group A, test group B, and control group.: non-significant. Hypothesis 3 : There are significant differences in diastolic blood pressure among test group A, test group B, and control group.: significant(F=1.31, p=.27, interaction; F=3.80, p=.00). Hypothesis 4 : There are significant differences in heart rate among test group A, test group B, and control group.: non-significant. Hypothesis 5 : There are significant differences in behavioral responses among test group A, test group B, and control group.: significant(F=10.05, p=.00). Further validation study is required with other subjects and other settings.

• Clinical and Experimental Pediatrics
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• 제58권11호
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• pp.440-445
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• 2015

Purpose: Chest pain is common in children and adolescents and is a reason for referral to pediatric cardiologists. Although most cases of chest pain in these age groups are benign and do not require treatment, timely diagnosis is important not to miss life-threatening diseases requiring prompt treatment. We investigated certain clinical characteristics that may be useful in the diagnosis of such critical diseases. Methods: Patient medical records between July 2006 and September 2013 were retrospectively examined. We included 517 patients who presented with chest pain to the Department of Pediatrics at Kyung Hee University Hospital in Gangdong. Results: Most cases of chest pain were idiopathic in origin (73.6%), followed by cases with respiratory (9.3%), musculoskeletal (8.8%), cardiac (3.8%), gastrointestinal (2.9%), and psychiatric (1.4%) causes. In 6 patients (1.2%) with air-leak syndrome including pneumothorax or pneumomediastinum, the pain was abrupt, continuous, and lasted for a short period of 1-2 days after onset in the older adolescents. Of the patients with cardiac pain, 13 had cardiac arrhythmias (65.0%), 6 had congenital heart diseases (30%), and 1 had coronary aneurysms caused by Kawasaki disease (5.0%). One patient with atrial flutter had only symptoms of syncope and chest pain. Conclusion: The abrupt, continuous chest pain of a short duration in the older children was characteristic of air-leak syndrome. In patients with pneumomediastinum, radiological diagnosis was difficult without careful examination. Combined syncope should not be neglected and further cardiac workup is essential in such patients.

• Biomolecules & Therapeutics
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• 제20권1호
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• pp.125-131
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• 2012

Impulsiveness is an important component of many psychiatric disorders including Attention-deficit/hyperactivity disorder (ADHD). Although the neurobiological basis of ADHD is unresolved, behavioral tests in animal models have become indispensable tools for improving our understanding of this disorder. In the punishment/extinction paradigm, impulsivity is shown by subjects that persevere with responding despite punishment or unrewarded responses. Exploiting this principle, we developed a new behavioral test that would evaluate impulsivity in the most validated animal model of ADHD of the Spontaneously Hypertensive rat (SHR) as compared with the normotensive "control" strain, the Wistar Kyoto rat (WKY). In this paradigm we call the Electro-Foot Shock aversive water Drinking test (EFSDT), water-deprived rats should pass over an electrified quadrant of the EFSDT apparatus to drink water. We reasoned that impulsive animals show increased frequency to drink water even with the presentation of an aversive consequence (electro-shock). Through this assay, we showed that the SHR was more impulsive than the WKY as it demonstrated more "drinking attempts" and drinking frequency. Methylphenidate, the most widely used ADHD medication, significantly reduced drinking frequency of both SHR and WKY in the EFSDT. Thus, the present assay may be considered as another behavioral tool to measure impulsivity in animal disease models, especially in the context of ADHD.

• 보건행정학회지
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• 제29권4호
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• pp.445-453
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• 2019

Background: This study is to investigate the association between the distribution of multimorbidity and length of stay and medical expenses among inpatients in a municipal hospital to achieve an integrated care setting. Methods: We used the exploratory factor analysis and the generalized estimating equation model to analyze the data from patients living in the northeast region of Seoul, who were hospitalized from January 2017 to December 2017 in a municipal hospital. Results: As a result of the factor analysis, seven types of multiple chronic diseases were classified. Among the elderly patients admitted to municipal hospitals, the burden of medical expenses was mainly influenced by the length of stay (B=310,719, p-value <0.0001), not the type of disease (all not significant). Length of stay were mainly due to psychiatric illness (factor 1: B=4.323, p-value <0.0001) related to the brain and metabolic diseases (factor 2: B=2.364, p-value=0.003). Conclusion: This study showed that the medical expenses of the elderly patients were largely due to prolonged hospitalization, not multimorbidity. Therefore, it is necessary to develop an integrated care paradigm strategy cope with the multimorbidity of the elderly in the community and to alleviate the socio-economic burden.