• 한국의료질향상학회지
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• 제8권2호
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• pp.208-217
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• 2001

Background : The objective of this study is proving the basic data for developing a management system for the discharges against medical advice(AMA) by identifying the characteristics of the AMA patients of an university hospital for 10 years. Methods : By using discharge abstract data base, we divided the total discharges(435,254) into two groups, discharge against medical advice and discharge with discharge order. We confirmed the characteristics of AMA group by analyzing discharge abstract data of the both groups by SAS software V6.12 and $x^2$ test. Medical records of AMA patients in the year 2000 were reviewed to identify the reasons for AMA which we couldn't extract from discharge abstract DB. Result : The total number of AMA for 10 years were 9,358(2.15%) and the AMA rate has been continuously decreased for 10 years. Male, admission through emergency room, discharges admission via other hospital, patients without operation during hospitalization, discharges in hopeless or not improved condition showed higher AMA rate. The AMA rate was higher as the age of the patients was higher, and the average length of stay was longer in AMA patients than in those with discharge order. The AMA rate in psychiatry was highest(14.3%) and it was higher in surgery departments than those of medical or other sections. The AMA rate varied by attending physicians even in the same department and it was statistically significant. Patients with the principal diagnosis of "medical observation and evaluation for suspected diseases" showed the highest AMA rate(15.5%), and that of schizophrenia or psychosis was the nest. One hundred twenty-one patients(19.5%) out of 622 AMA in 2000 discharged against medical advice for transfer to order health care facilities. Among them 71 patients(58.7%) discharged with their medical care information, such as copies of medical record, medical certificates, summaries, etc. Written oath of the patients discharged AMA was filed in their medical records in 466 cases(74.9%) although some of them were incomplete. Conclusion : Characteristics of AMA discharge could be used as the basic data in developing a system to manage the patients who have risk factors to leave the hospital against medical advice. By reducing number of patients leaving the hospital against medical advice we can increase satisfaction of medical providers and consumers.

• 정신신체의학
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• 제20권2호
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• pp.105-111
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• 2012

연구목적 : 본 연구는 경도인지장애(Mild cognitive impairment, 이하 MCI)와 알쯔하이머형 치매(Dementia of Alzheimer's type, 이하 AD)의 신경정신증상 빈도와 점수를 조사하고 비교 분석한 뒤, 인지기능과 Korean Neuropsychiatric Inventory(K-NPI) 결과와의 상관관계를 알아보고자 하였다. 방 법 : MCI 또는 AD를 진단받은 163명의 환자들을 세 군으로 분류하였다. K-NPI를 이용하여 MCI 환자 55명, 경도의 AD 환자 56명, 중등도 이상의 AD 환자 52명을 대상으로 신경정신증상을 조사하였고, 세 군간의 K-NPI의 부척도별 빈도와 composite score를 비교하였다. 결 과 : MCI군에서 가장 흔한 증상은 우울/불쾌감, 수면/야간행동, 불안, 과민/불안정 순이었다. 경도 AD군에서의 증상은 초조/공격, 우울/불쾌감, 불안, 무감동/무관심, 수면/야간행동 순으로 빈번하게 나타났다. 중등도 이상 AD 군에서는 무감동/무관심, 우울/불쾌감, 초조/공격, 망상 순이었다. 이 중 망상, 환각, 초조/공격, 무감동/무관심, 이상행동증상, 식욕/식습관의 변화의 빈도는 세 군 간에 통계적으로 유의한 차이를 나타내었다. 총 NPI 점수는 MMSE-KC 점수와는 음의 상관관계를, GDS와는 양의 상관관계를 보였고, 모두 통계적으로 유의하였다. 결 론 : 신경정신증상은 MCI, AD에서 흔히 보이는데, 본 연구에서는 MCI와 경도의 AD에서 이들 증상들이 유사한 양상을 나타내었다. 정신증은 중등도 이상 AD에서 가장 흔하게 나타났고, 이로 인해 더욱 빠른 인지기능의 저하를 초래할 수 있다. 따라서 MCI와 AD의 각 진행 단계에 따른 적절한 치료가 필요하다.

• 한국콘텐츠학회논문지
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• 제11권9호
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• pp.225-237
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• 2011

본 연구에서는 청소년의 자아정체감, 사회적지지와 정신건강과의 관계를 검증하였다. 연구대상은 경기도 지역 K시에 소재한 중 고등학교 각 2개 학교의 중학생 169명, 고등학생 178명으로 총 347명을 대상으로 상관계수와 중다회귀분석을 실시하였다. 그 결과는 다음과 같다. 첫째, 청소년의 자아정체감, 사회적지지, 정신건강 간의 관계를 살펴보면, 청소년의 자아정체감, 사회적지지의 하위변인에서 정신건강의 하위변인 중 강박증과 친구지지, 적대감 및 공포증과 교사지지, 신체화와 미래확신성, 친밀성, 교사지지, 친구지지, 우울증과 미래확신성, 정신증과 미래확신성을 제외한 모든 하위영역에서 상관이 있는 것으로 나타났다. 둘째, 중다회귀분석 결과, 정신건강에 영향을 미치는 가장 높은 변인은 자기수용성, 목표지향성, 부모지지, 친밀성, 주체성 순으로 나타난 반면, 미래확신성, 주도성, 교사지지, 친구지지는 통계적으로 유의미한 예측변인이 아닌 것으로 나타났다. 본 연구의 결과는 자기수용성, 목표지향성, 친밀성, 주체성 수준이 높은 청소년과 부모지지를 높게 지각하는 청소년의 정신건강 수준이 높음을 나타내고 있다.

• 생물정신의학
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• 제5권1호
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• pp.83-94
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• 1998

Objectives : Phencyclidine(PCP) or PCP-like substances such as ketamine have been known to rekindle the cognitive dysfunction in schizophrenia. The aims of this study were to identify whether PCP-like substances can produce cognitive deficit in schizophrenia, to discuss relation with aging process, and finally to speculate underlying neurochemical mecha-nisms by various drug responses. Methods : In experiment I, radial maze tests were done in 24 Sprague-Dawley rats for 3 days to get baseline data. Being divided into 4 groups(6 rats respectively) of normal aged, normal adult controls, atropine-treated and ketamine-treated, the radial maze tests were repeated on every week for 6 weeks, and then the rats were sacrificed by intracardiac perfusion with phosphate-buffered 10% formaldehyde solution for histology. The brain specimen was stained with hematoxylin-eosin to count cells in the prefrontal cortex and hippocampus. In experiment II, radial maze tests were done for 48 rats before any drug treatment and only after ketamine administration. Thereafter, haloperidol, bromocriptine, clonidine, nimodipine, tacrine, valproic acid, naloxone and fluoxetine were intramuscularly injected on every other day in addition to ketamine. Radial maze tests were repeated on every week for 6 weeks, and then rats were prepared by the same procedure for histology. Results : 1) Reaction times of radial maze tests of atropine-treated rats were significantly prolonged than those of normal aged(p<0.05) or normal adult controls(p<0.05). Cell numbers of prefrontal cortex & hippocampus in ketamine-treated rats were significantly reduced than those in normal aged (p<0.05) or normal adult controls(p<0.005). 2) Reduced cell numbers by ketamine became significantly raised by tacrine administration in prefrontal cortex & hippocampus(p<0.05), while there were no significant changes on radial maze tests. Cell numbers also tended to be raised by nimodipine, fluoxetine and haloperidol administration. Conclusions : In conclusion, the visuospatial memory disorders in ketamine-induced psychotic rats might be partly asso-ciated with aging process. Furthermore, the responses to the various drugs suggested cholinergic system might have an important role in the neurochemical mechanism of the cognitive dysfunction in ketamine-induced psychosis. Otherwise, calcium metabolism as well as serotonergic and dopaminergic systems seemed to be possibly related.

• 한국산학기술학회논문지
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• 제13권1호
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• pp.274-283
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• 2012

본 연구는 대학생의 자아존중감과 정신건강과의 관계를 파악하여 대학생활에서 자아존중감을 향상시키고 건전한 정신건강을 유지 향상시킬 수 있도록 효과적인 교육 및 상담 활동을 위한 기초자료로 활용하고자 본 연구를 시도하였다. G시에 소재한 2개 종합대학, 3개 전문대학 재학생을 대상으로 2010년 10월 2일부터 12월 2일까지 설문조사를 실시하여 468부를 최종 분석하였다. 연구결과는 첫째, 일반적 특성과 인지적 자아, 평가적 자아 및 자아존중감 간의 관계에서는 유의하지 않았다. 둘째, 일반적 특성과 정신건강과의 관계에서는 경제상태, 입학동기, 학과 만족도, 교우관계, 건강상태에서 정신건강 하위영역과 유의한 결과를 보이고 있다. 셋째, 인지적 자아, 평가적 자아 및 자아존중감 간에는 순상관관계를 나타내고 있다. 인지적 자아, 평가적 자아 및 자아존중감은 강박증, 적대감, 대인예민, 신체화, 불안, 편집증, 정신증에서 역상관관계가 있은 것으로 나타났다. 결론적으로, 본 연구결과를 기초로 하여 대학생들의 자아존중감을 증진시키고 정신건강을 완화할 수 있는 정규적인 건강교육 프로그램의 개발과 적용이 요구되며, 그에 따른 효과를 검증할 수 있는 후속 연구가 필요하다.

• 정신신체의학
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• 제19권1호
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• pp.41-47
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• 2011

연구목적: 고프로락틴혈증은 항정신병약물로 인한 흔한 부작용이다. 그럼에도 불구하고 이러한 고프로락틴혈증에 대한 임상가들의 관심은 적은 편이다. 왜냐하면 고프로락틴혈증으로 인한 부작용의 심각성이 널리 알려지지 않았기 때문이다. 특히 아미설프라이드로 인한 고프로락틴혈증에 대한 국내 연구는 전무한 실정이다. 본 연구에서는 한국인에서의 아미설프라이드로 인한 프로락틴 수치의 변화를 알아보고자 한다. 방 법: 2008년 1월부터 2010년 12월까지 일산백병원 신경정신과의 외래와 입원 환자 24명을 대상으로 의무기록을 검토하여 자료를 분석하였다. 이를 통해 아미설프라이드 사용 전후의 프로락틴 수치의 변화를 비교하였다. 또한 아미설프라이드 용량, 투약 기간과 프로락틴 수치 변화율과의 상관관계를 통계적으로 분석하였다. 결 과: 아미설프라이드를 투여한 모든 환자에서 고프로락틴혈증이 발생하였다. 아미설프라이드 투여 후의 프로락틴 수치는 투여 전 보다 유의하게 상승하였다(z=-3.702, p=0.000). 아미설프라이드 용량과 프로락틴 상승의 정도는 유의한 상관관계를 보였으나(r=0.61, p=0.002), 아미설프라이드 투여 기간과 프로락틴 상승의 정도는 유의한 상관관계를 보이지 않았다. 또한 아미설프라이드 용량과 프로락틴 수치 변화율은 유의한 상관관계를 보이지 않았다. 결 론: 아미설프라이드를 포함한 항정신병약물은 프로락틴 수치를 증가시켜 장 단기간의 부작용을 발생시킬 수 있다. 따라서 아미설프라이드를 사용하는 임상의는 프로락틴 수치를 정기적으로 측정하여야 하며 고프로락틴혈증과 관련된 부작용을 평가하여야 한다.

• 동의신경정신과학회지
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• 제15권1호
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• pp.175-185
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• 2004

Objective : For investigating correlation among diagnostic types, MMPI results and Sasang constitutions, in out-patients of Oriental Neuropsychiatry. Method: We got the following result by comparing the out-patients' MMPI and QSCCII from 2000/12/1 to 2001/12/30 at Sanbon Hospital of Oriental Medicine, Wonkwang University. Result and Conclusion: 1. A specific character of population for study's objects was that female (128, 68.4%) was twice bigger that the male(59, 31.6%). And their education levels were 52 of college graduate (27.8%), 40 of high school graduate (21.4%), and 14 of middle school graduate (14 %). A distribution of the occupation, there are 62 of labors (33.2%), 62 of white collars (33.2%), 30 of sales (16%), 16 of students (8.6%). Their marrige statuses were 144 of married (77%), 31 of single (16.6%), 4 of divorced (2.1%), and 1 of bereavement (0.5%). 2. In the physical constitutions there were 70 of Soeumin(37.4%), 56 of Soyangin(29.9%) 55 of Taeumin (29.4%), 6 of others (3.2%). A differentiation with their diagnosis, there were 55 of palpitations (29.4%), 45 of depression (24.1%), 18 of women's diseases (9.6%), 14 of insomnia (7.5%), 13 of headache (7%), 8 of pain (4.3%), 8 of hwabyung (4.3%), 7 of psychosis (3.7%), 4 of dizziness (2.1%), and 15 of others(8%). 3. A result of groupling MMPI, we could classify into 4 different groups. Group 1 is a profile of trasition in a neurosis. Group 2 is a proflie of a mental disease. Group 3 is a proflie of $'{\wedge}'$ type neurosis. And group 4 has normal profile. 4. Regarding each group with physical constitution and a distribution of diagnosis, Group 1 is found out 36.4 % of Soeumin, 34.10 % of palpitations. And group 2 showed 43.6% of Soyangin, 25.6% of depression. Group 3 showed 46.4% of Soyangin, 31.90% of palpitations. Group 4 showed the most in 34.3% of Soyangin, and 31.40% of palpitations 5. A result of the study using Chi-square test is that there is no correlation between the 4 different groups and the Sasang physical constitution.

• 대한한방내과학회지
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• 제15권2호
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• pp.318-346
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• 1994

A Bibliographical study was done about lumbago in oriental internal Medicine. The results are as follows. 1. Shenxu,sexual active, senile, Feng, Han, Shi, shiji, Tanyin and Qi lumbago are applicable to internal medical lumbago in oriental medicine, and Shenxu is essential pathogenesis. 2. Shenxu lumbago is characterized by continous pain, improved after chiropsia, deep pulse in Chi pulse, and used QingeWan, LiuweiDihuangWan and AnshenWan in herb-medicine. and Cortex Eucommiae, Radix Rehmanniae Praeparata and Fructus Psoraleae in drugs for the purpose of ZishenYijing, and related to lumbago caused by chronic prostatitis, calculus or tumor in kidney and diabetes mellitus. 3. Sexual active lumbago is dim-aching and weak pain in or after sexual life at low back and knee joint, and classified to Shenyang Buzu, ShenjingKuisun. GanshenYinxu and XinshenBujiao ; Liuwei Dihuang Wan, ZuoguiWan In herb-medicine. Cornu Cervi Pantotrichum, Fructus Lycii and Fructus Corni in drug were used for treatment. 4. Senile Lumbago is a kind of consumptive disease due to exhaused essential energy and caused by lack of Shenjing, Yangqi ; and described as repeated mild dim pain and ErzhiWan, QingeWan and MoyaoGao were used frequently, supposed to connected with osteoporosis, osteomalacia and osteoarthropathy deformons caused by aging. 5. Feng lumbago is attacked by Liuyin, and characterized by chilling and fever. stabbing pain from thoracic and lumbar vertebrae to pedes, and used WujiXan, XiaoxumingTang for treatment. Han lumbago is caused by cold's attacking Shenjing, distinguished for chilling,icing sense improved by heat on low back, and used WujiXan, JiangfuTang. Shi lumbago is caused by damp's inflowing Shenjing, described as stone-like lumbago which was subsided low back pain growing worse by gloomy rain, and used ShenshiTang. ShenzhuTang for the purpose of ZaoshiXingqi. And it is supposed that lumbago occured in the initial of urinary track infection was belong to those of Feng,Han and Sill's. 6. Sillji lumbago is caused by pathogen being in the spleen and the stomach, and used ChenxiangJiangqiTang, PingweiSan for treatment. And it is supposed that it belong to lumbago caused by gastrointerstinal disease such as peptic ulcer. gastroduodenal tumor and colonic inflammatory disease. 7. Tanyin lumbago is caused by Tanyin's flowing meridian, characterized by thoracolumbar verterber's heaviness, covered sense with something on low back and painless massage. Kuaiqi-drug are added to ErchenTang, DaotanTang for treatment, and it supposed that Tanyin lumbago's belong to that accompanied with metabolic disease such as obesity and gout. 8. Qi lumbago is caused by excessive stress such as melancholy and fury, described as multiple stabbing pain, an unexpected on and improvement, ranging back pain until flank and abdomine. Tiaoqi-drugs were added to RenshenShunqiSan, WuyaoShunqiSan for treatment, and it supposed to connecting with emotional lumbago such as hysteria, feigned illness and anxiety psychosis.

• 혜화의학회지
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• 제9권1호
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• pp.745-761
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• 2000

Literatural study for Delirious speech and Fading murmuring, the results were as follows. 1. Delirious speech and Fading murmuring are given at the speech impediment. Derious speech to be out of language's order and slur the end of his words, and Fading murmuring is to repeat in losing conscious. 2. In constrast with Delirious speech and Fading murmuring, Maniac speech is induced by a general term for manic-depressive psychosis. Luoyan is to say in a feeble voice and mumble in a sleeping condition, and Paraphasia and Solioquy are appeared in a clear mental condition. The speech impediment is caused by damages of the nervous system and speech organ, and Yuyancuoluan is appeared in a feverless condition. 3. The symptoms of Delirious speech are to utter ravings and have a loud and heavy voice, and these resemble the delirium which specially has a speech impediment and muddle in the western medical world. The symptoms of Fading murmuring are to speak ambigously, repeatedly, and illogically and so are similar to the Wernicke dysphasia which is caused by a incomprehensible conversation. 4. The causes of Delirious speech are to spread a stomach heat and the lungs pathogenic qi into heart, not to sweat in cold damage, the Three Yang Combination of syndrome, stomach repletion, yang collapse due to excessive sweat, diarrhea, after diarrhea, heat to enter the blood chamer, feces to remain in the stomach, stasis blood to enter the viscera, to carry anger to extremity, and to be constipated. the cause of Fading murmuring is to despair vacuity desertion of vital essence and energy after a serious illness. 5. The causes of delirium are general infection, postoperative states, and metabolism disorders and those of Wernicke dysphasia are disorders of the blood vessel, brain tumors and traumas. 6. Delirious speech is cured with the discrimination of vacuity and repletion. Baitong Tang(白通湯), Chaihu Guizhi Tang(柴胡桂枝湯), Chaihu Jia Longgu Muli Tang(柴胡加龍骨牡蠣湯) are prescribed in case of vacuity, while Chengqi Tang(承氣湯), Baihu Tang(白虎湯), Liangge San(凉膈散) are in case of repletion. Fading murmuring is treated with Xiao Chaihu Tang(小柴胡湯), Fuzi Tang Jiawei(附子湯加味), Shengmai San(生脈散), and Renshen Sanbai Tang(人蔘三白湯). 7. To acupunture Qimen-Xue(期門穴) is required when it is late to prescribe a medical decoction or the hyperactive liver qi attacking the spleen.

• 대한시과학회지
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• 제20권4호
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• pp.483-495
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• 2018

목적 : 본 연구는 안경광학과 학생들의 정신건강에 미치는 요인을 성별에 따라 분석하여 학생 생활지도 및 진로지도에 좀 더 차별화된 도움을 주고자한다. 방법 : 충청지역 안경광학과 학생 132명을 대상으로 한 설문지를 분석하였으며, 성별에 따라 정신건강을 비교 분석하였다. 본 연구는 SCL-90-R의 설문지를 사용하였으며, 모든 통계는 SPSS 18.0을 사용하여 유의수준은 p<0.05로 통계 처리하였다. 결과 : 안경광학과 학생들은 신체화 22.7%, 강박증 28.3%, 적대감 12.8%로 정신건강에 문제가 있는 것으로 나타났다. 우울증과 편집증의 경우 27.7%와 10.2%, 대인 예민증, 정신증, 공포증, 불안증은 각각 14.7%, 10.4%, 5.9%, 17.4%로 높은 수치를 나타내었다. 결론 : 안경광학과의 학생들의 약 28.7%에서 부정적인 정신건강으로 신체화, 강박증, 적대감을 느끼고 있었으며, 모든 변수에서 여학생이 남학생보다 상대적으로 높은 수치를 나타내었다. 이에 차별화된 성별에 따른 학생 상담과 생활 지도가 필요할 것으로 사료된다.