• 정신신체의학
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• 제20권1호
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• pp.14-17
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• 2012

1960년대부터 지금까지 정신신체의학의 교육에 대한 관심이 있었지만 의학 교육에서 정신신체의학이 차지하는 비중은 적은 편이었다. 현재에도 대학마다 배정된 시간과 비율이 다르고 일정한 틀과 일치된 목표도 없이 교육이 실시되고 있다. 임상적으로도 자문-조정 정신의학에 대한 인식과 교육은 여전히 비체계적이고 미흡하였다. 앞으로 의과대학의 교육에서, 전공의 교육, 전임의 제도, 세부 전공 제도로 이어지는 지속적이고 체계적인 교육의 틀이 확립되어야 할 것이다. 자문-조정 의학의 활성화, 종사자 훈련에 이르는 임상 교육 체계도 정립되어야 한다. 다른 나라의 정신신체의학의 교육 지향점을 참고하여 생물-정신-사회적 모델에 기초한전인적 질병 개념과 치료 주관을 가진 의사를 양성하고 이를 정신신체의학 교육의 목표로 정립하는 것이 필요하다. 또 목표를 담을 수 있는 교육 내용을 통일되게 규정하고 그 교육 과정이 지속적이고 효율적으로 이루어질 수 있게 체계화해야 한다.

• 대한한방내과학회지
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• 제33권4호
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• pp.485-497
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• 2012

Objectives : The aim of this study was to systematically investigate herbal-drug-associated adverse drug reactions (herbal ADRs) reports submitted by a single oriental hospital and to analyze the general characteristics, causative agents, clinical manifestations, severity and types of herbal medicines which caused herbal ADRs. Methods : This study proceeded with IRB approval. The data on herbal ADR were collected prospectively from January 2008 to February 2012 by EMR of Dongguk University Ilsan Oriental Hospital. The World Health Organization (WHO)-Uppsala Monitoring Center (UMC) criteria was used to determinate causality for each herbal ADR. WHO-Adverse Reaction Terminology (WHO-ART) System Organ Class (SOC) code and WHO severity category were also used in this study. Results : A total of twenty eight cases were reported. Twenty two cases were assessed to have over possible relations with herbal medication. The gender ratio of these cases were 64.6 percent female and 36.4 percent male, demonstrating no statistical significance. Patients aged over 60 were 59.1%. Gastro-intestinal system was reported to be the most frequently affected organ (38.8%), and followed by psychiatric system (22.4%), and integumentary system (22.4%). The most common clinical symptom was headache (12.2%), followed by diarrhea (10.2%), and pruritus (10.2%). The severity of most cases was assessed to be mild (89.8%). The percentage of moderate ones was 10.2%, and there were no severe cases. Conclusions : Progressive study and further analysis on herbal ADRs are warranted for safety in the clinical use of herbal medicines.

• Journal of Preventive Medicine and Public Health
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• 제45권5호
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• pp.283-290
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• 2012

Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

• 동의신경정신과학회지
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• 제20권3호
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• pp.249-259
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• 2009

Objectives : Anxiety is a symptom that many psychiatric patients experience. And in the traditional Korean medicine, anxiety is often categorized as a Gyeong Gye(驚悸) and Jung Choong(怔忡). In this case report, we will show the effective method in treatment of anxiety. Methods : First, We treated the patient with anxiety by the differential diagnosis of blood stasis(瘀血) that is summarized as stasis of blood, pollutant of blood and external blood of vessel. And we gave him Hyeolbuchukyeo-tang(血府逐瘀湯) whose effect is to eliminate blood stasis. And Second, we treated the patient with anxiety in the viewpoint of analytic psychology that claims anxiety has a meaning that makes patient be aware of the problem of himself. Results : The patient's symptom improved significantly. And this patient also can insight himself via the symptom of anxiety. It also help the patient improve. Conclusions : In the treatment of anxiety, the approach by the differential diagnosis of blood stasis(瘀血) can be helpful to improve patient's symptom. And treatment should include the insight of patent by the meaning of anxiety.

• 생물정신의학
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• 제6권2호
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• pp.253-258
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• 1999

The fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and obsessive-compulsive disorder(OCD). This has been known as one of the most safest medication. But since the advent of this drug, there have been several reports of side effects-the mania and suicidal ideation-encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced a case of 20 years old male OCD patient who developed into abrupt manic state and also was preoccupied with intense suicidal ideation following fluoxetine use. He was a only child in his family and his father had a history of alcoholism about 15years ago. Our patient's obsessive-compulsive symptoms have been occured since puberty. His OCD symptoms and anxiety were aggravated since joining the army. Beside these facts, we could not find any other psychiatric history such as depressive disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and increased to 40mg at second week. About 3 weeks after the treatment, he developed sudden manic symptom and more aggravated suicidal ideation without any OCD symptoms. He felt vitalized and energetic without having enough sleep and food. These symptoms were ceased over two weeks by stopping medication. Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation is unclear. But somehow the fluoxetine has effects on serotonin receptor and serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the serotonin unbalanced patients. We think this would be the first report to remark on fluoxetine's suicidal and manic side effects in Korea. So here we present the case with the summary of reviewed articles.

• 한국콘텐츠학회논문지
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• 제11권4호
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• pp.458-467
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• 2011

본 연구는 무용/동작치료가 입원중인 정신분열증 환자의 정신건강 변화에 미치는 효과를 알아보고자 STAXI, BDI, STAI, PANSS 비교분석 하였다. 대상자는 대전 J병원에서 입원치료를 받고 있는 정신분열증 환자 중 선정기준에 적합한 38명을 무용/동작치료군 18명, 대조군 20명씩 할당하여 분노는 STAXI, 우울은 BDI, 불안은 STAI로, 양성 및 음성증상은 PANSS를 사용하여 비교분석하였다. 상태 분노가 유의하게 감소하였고, 분노 표현 중에서 분노 통제가 유의하게 증가하였다. 우울은 유의하게 감소하였으며, 음성 증후군 척도에서 유의한 호전을 보였다. 결과적으로 입원한 정신분열병 환자에게 무용/동작치료는 상태 분노를 감소시키고, 분노 통제를 증진시켰고, 우울을 감소와 음성 증상에 긍정적 효과가 나타났다.

• 대한한의학회지
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• 제39권3호
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• pp.41-50
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• 2018

Objectives: The study is aimed to utilize Taesikbub and Lung-doyinbub described in "Dong-Ui-Bo-Gam" as a Korean Traditional Pulmonary Rehabilitation Exercise. Methods: We preliminary researched pulmonary rehabilitation exercise using domestic and international databases and old literatures of Korean Medicine. Then made a draft of Korean Traditional Pulmonary Rehabilitation Exercise based on "Dong-Ui-Bo-Gam". After organizing expert group for verifying the draft of the exercise, we developed the final Korean Traditional Pulmonary Rehabilitation Exercise. Results: The Korean Traditional Pulmonary Rehabilitation Exercise is composed of 5 actions including breathing method, flexibility exercise, percussion and hitting teeth. This exercise is recommended twice a day for at least 5 days per week under the supervision of specialist. It is expected to improve physical activity, dyspnea, health-related quality of life (HRQoL) as well as psychiatric symptoms by breathing deep and slow and exercising the thorax and upper limb muscles. Conclusion: Taesikbub, Lung-doyinbub in "Dong-Ui-Bo-Gam" may be suggested as a better pulmonary rehabilitation exercise for patients of chronic lung disease.

• Toxicological Research
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• 제31권4호
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• pp.347-354
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• 2015

Excess manganese (Mn) is neurotoxic. Increased manganese stores in the brain are associated with a number of behavioral problems, including motor dysfunction, memory loss and psychiatric disorders. We previously showed that the transport and neurotoxicity of manganese after intranasal instillation of the metal are altered in Hfe-deficient mice, a mouse model of the iron overload disorder hereditary hemochromatosis (HH). However, it is not fully understood whether loss of Hfe function modifies Mn neurotoxicity after ingestion. To investigate the role of Hfe in oral Mn toxicity, we exposed Hfe-knockout ($Hfe^{-/-}$) and their control wild-type ($Hfe^{+/+}$) mice to $MnCl_2$ in drinking water (5 mg/mL) for 5 weeks. Motor coordination and spatial memory capacity were determined by the rotarod test and the Barnes maze test, respectively. Brain and liver metal levels were analyzed by inductively coupled plasma mass spectrometry. Compared with the water-drinking group, mice drinking Mn significantly increased Mn concentrations in the liver and brain of both genotypes. Mn exposure decreased iron levels in the liver, but not in the brain. Neither Mn nor Hfe deficiency altered tissue concentrations of copper or zinc. The rotarod test showed that Mn exposure decreased motor skills in $Hfe^{+/+}$ mice, but not in $Hfe^{-/-}$ mice (p = 0.023). In the Barns maze test, latency to find the target hole was not altered in Mn-exposed $Hfe^{+/+}$ compared with water-drinking $Hfe^{+/+}$ mice. However, Mn-exposed $Hfe^{-/-}$ mice spent more time to find the target hole than Mn-drinking $Hfe^{+/+}$ mice (p = 0.028). These data indicate that loss of Hfe function impairs spatial memory upon Mn exposure in drinking water. Our results suggest that individuals with hemochromatosis could be more vulnerable to memory deficits induced by Mn ingestion from our environment. The pathophysiological role of HFE in manganese neurotoxicity should be carefully examined in patients with HFE-associated hemochromatosis and other iron overload disorders.

• Journal of Chest Surgery
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• 제31권3호
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• pp.286-290
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• 1998

누두흉은 하부흉골과 인접늑연골이 함몰되는 선천성 기형으로 흉벽기형중 가장 흔한 질환이다. 대부분 미용적인 이유로 수술이 시행되어지며 수술시기는 신체적 및 정신적인 면을 고려할 때 학동기 이전에 하는것이 바람직한 것으로 되어있다. 최근 Ravitch술식에 의한 흉골거상법과 Wada술식에 의한 흉골반전법이 누두흉의 치료에 좋은 성적을 보이고 있다. 이에 본 교실에서는 누두흉의 외과적 치험례를 후향적으로 조사하여 적절한 수술치료 방향에 도움을 얻고자 본 연구를 시도하게 되었다. 본 연구에서는 1981년 1월부터 1996년 7월까지 누두흉의 외과적치료를 받은 24례의 환자들을 대상으로 성별및 연령별 분포, 주소, 동반질환유무, 변형의 정도, 심전도소견, 술후 합병증, 술후 환자 및 보호자의 만족도등을 분석하였다. 변형의 교정치는 일부에서 웰치지수(welch index)를 이용하여 술전 및 술후 변화를 관찰하였고, 만족도는 Humphreys 평가기준에 따라 분류하였다. 술후 합병증은 창상감염 2례, 기흉 2례, 재발 1례있었으며, 창상감염은 정기적인 dressing으로 치료되었고, 기흉은 폐쇄식 흉관삽관술을 시행하여 치료되었다. 재발 1례는 Ravitch술식후 발생하였으며 이는 다시 변형 Wada술식으로 교정하였다. 웰치지수(welch index)는 술전 평균 5.86이었으며 술후 4.10으로 의미있게 감소하였다(P<0.05). 환자의 만족도는 Humphreys 평가기준상 excellent 17례, good 4례로 만족스런 결과를 얻었다.

• 대한의용생체공학회:의공학회지
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• 제29권6호
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• pp.477-483
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• 2008

The observations of difference and similarity in brain activities involved in processing different languages have fundamental importance in cognitive neuroscience. The purpose of this study was to investigate the difference and similarity in temporal brain activation patterns due to the language difference during visual perception of Korean and English words under priming. Especially, we tried to find the difference in evoked spectral power in gamma-band, which is known to reflect feature binding. The stimulation was visually presented as word pairs belonging to same or different categories so that N400 event-related potential(ERP) was evoked. Average ERP analysis and spectral analysis of gamma-band activity(GBA) were performed on 12 normal Korean subjects. Several ERP components such as P1, N1, N400, and P600 could be identified consistently, and the differences in N1, N400, and P600 were observed. From the spectral analysis, we found that the evoked GBA(eGBA) was significantly larger for English at ${\sim}100$ ms poststimulus. The latency of the eGBA was also considerably delayed for English. Overall, the results on the ERP components and eGBA analyses seem to be commensurate with subjects' familiarity of each language, and the difficulty of perceiving words of each language. The methods of this study can also be applied for clinical purposes considering that the language-related processing can be greatly altered for the patients with neurological or psychiatric diseases.