• 동의신경정신과학회지
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• 제26권2호
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• pp.79-88
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• 2015

Objectives: The purpose of this study is to investigate the effects of the M&L Trauma Psychotherapy Program on: Impact of Event Scale - Revised (IES-R-K); Euro QOL-5 Dimension (EQ5D); Five-facet Mindfulness Questionnaire (FFMQ); and psychological tests. Methods: Eight middle-aged women subjected to domestic violence participated in the two-day M&L Trauma Psychotherapy Program. The Program was executed 5 times 2 days for about 3 hours. We evaluated IES-R-K, EQ5D, FFMQ, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), State-Trait Anger Expression inventory (STAXI) and SUDS before the Program and for four weeks afterwards, to analyze the effects of the M&L Trauma Psychotherapy Program. Results: The scores of IES-R-K, BDI, STAI-S, STAI-T, Hwa ST and Hwa CT decreased significantly (p<0.05). EQ5D scores increased significantly (p<0.05) and overall physical condition scale (VAS) increased. In the FFMQ scores, all five facet scores increased slightly. Scores of SUDS decreased significantly right after the program, and remained decreased four weeks later, rather than before the Program (p<0.05). Conclusions: The results suggested that the M&L Trauma Psychotherapy Program improved post-traumatic stress, quality of life and mindfulness skills, and had positive responses to psychological problems - depression, anxiety, anger and distress.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제25권4호
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• pp.356-360
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• 1999

PURPOSE : This is to review the complicated jaw fractures that had been referred for revision of the unsatisfactory results, and to provide proper managements for the easily complicated jaw fractures. MATERIALS & METHODS : Twenty-nine patients who had been revised due to malunion or complicated fractures of facial bones for last 3 years were reviewed. The main problems required for revision, type of fractures complicated, the primary managements to be reclaimed, the specialties to be involved, the management to be reclaimed, time elapsed to seek reoperation, type of revision surgeries, residual complication were analysed with medical records, radiographs and final examinations. RESULTS: The major complaints were malocclusion(79.3%), facial disfigurement(41.3%), TMJ problems (13.7%), neurologic problems(10.3%), non-union(10.3%), and infection(6.8%). Unsatisfactory results were occurred most frequently after improper management of the multiple fractures of the mandible (62.2%), combined fractures of maxilla and mandible (20.6%), fracture of zygomatico-maxillary complex and midpalate (17.2%). The complications to be corrected were widened or collapsed dental arches (79.3%), improperly reduced condyles (41.3%), painful TMJ (34.4%), limited jaw excursion (31.0%), over-reduction of zygoma (13.7%), and nonunion with infection(13.7%). and dysesthesia (10.3%). The primary managements were nendereet by plastic surgeons in 82.7%(24/29) and by oral surgeons in 7.6%(2/29). Main causes of malunion are inadequate ORIF in 76%, unawareness & delay in 17%, and delayed due to systemic cares in 17%. 76% of 29 patients had been in state of intermaxillary fixation for over 4 weeks. Revision were done by means of "refracture and ORIF"in 48.2%(14/29), orthognathic osteotomies with bone grafts in 55.1%(16/29), and camouflage countering & alloplastic implantations in 37.9%(11/29), TMJ surgeries in 17.2%, micro-neurosurgeries in 11.6%. Residual complications were limited mouth opening in 24.1% (7/29), paresthesia in 13.7%, resorption of reduced condyle in 10.3%. CONCLUSIONS : Failure of initial treatment of jaw fractures is due to improper diagnosis and inadequate treatment with lack of sufficient knowledge of stomatognathic system. It is crucial to judge jaw fracture and patients accurately, moreover, the best way of treatments has to be selected. Consideration of these factors in treatment could minimize the complication of jaw fractures.

• 생물정신의학
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• 제18권3호
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• pp.148-158
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• 2011

Objectives The eye movement (EM) has been reported to play a role in enhancing the retrieval of episodic memories and reducing effects of fearful episodes in the past and worries for the futures. However, it is still unclear in the mechanism of EM in normal subjects. We examined the horizontal eye movement (HEM) effect using an aiding apparatus on mental health indices including negative and positive psychological factors, and psychophysiological measures such as heart rate variability and quantitative electroencepaholography (qEEG) in healthy subjects. Methods Twenty eight healthy subjects were recruited and randomly allocated into two groups : active HEM group and control group. The active HEM group conducted the HEM training with usual stress management audio-intervention using the apparatus inducing eye movement once a day for 14 days. The control group also conducted the same training once a day for 14 days, however, the saccadic eye movement was not included in this training. Psychological measurements, neurocognitive function tests, heart rate variability measurement and qEEG were conducted before and after the training in both groups. Results In the active HEM group, sleep status using Sleep Quality Scale (SQS) positive factors significantly increased after the training. By contrast, scores on the negative items of Psychological Well-Being Scale (PWBS), and negative items of the Life Orientation Test-Revised (LOT-R) were significantly decreased after the training. The percentage of delta amplitude (1-3 Hz) in qEEG significantly decreased after the HEM training. The percentage of alpha amplitude (8-12 Hz) significantly increased after HEM training. The change of delta amplitude in the active HEM group was positively correlated with the change of sleep satisfaction of Visual Analogue Scale (VAS), and the change of alpha amplitude was negatively correlated with depression of VAS, anxiety of VAS and Beck Anxiety Inventory (BAI). Conclusions The HEM training improved sleep quality and well-being, and sense of optimism. The HEM training also increased alpha amplitude and decreased delta amplitude in qEEG. The qEEG changes were well correlated with subjective improvement of mental health indices in healthy subjects. These results suggest some evidences that HEM training using the apparatus that induces EM would be helpful in improving subjective mental health in healthy subjects. Further study with larger samples size would be needed.

• 대한세포병리학회지
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• 제12권1호
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• pp.1-15
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• 2001

The Bethesda System (TBS) was first developed in 1988 for the need to enhance the communication of the cytopathologic findings to the referring physician in unambiguous diagnostic terms. The terminology used in this reporting system should reflect current understanding of the pathogenesis of cervical/vaginal disease so the framework of the reporting system should be flexible enough to accommodate advances in medicine including virology, molecular biology, and pathology. Three years after the Introduction of TBS, the second Bethesda workshop was held to set or amend diagnostic criteria for each categories of TBS. TBS 1991 is now widely used. The third Bethesda workshop, The Bethesda System 2001 Workshop, was held in National Cancer institute Bethesda, Maryland from April 30 to May 2, 2001. Again, the goals of this workshop were to promote effective communication and to clarify in reporting cervical cytopathology results to clinicians and to provide with the information to make appropriate decisions about diagnosis and treatment. Nine forum groups were made and there were Web-based bulletin board discussions between October, 2000 and the first week of April, 2001. On the basis of bulletin board comments and discussions, the forum moderators recommended revised terminologies in the Workshop. Hot discussions were followed after the presentation by forum moderators during the workshop. Terminologies confusing clinicians and providing no additional informations regarding patient management were deleted in the workshop to clarify the cervicovaginal cytology results. Any informations related to the patient management were encouraged to add. So 'Satisfactory for evaluation but limited by...' of 'Specimen Adequacy' catergory was deleted. Terminology of 'Unsatisfactory' was further specified as 'Specimen rejected' and 'Specimen processed and examined, but unsatisfactory'. Terminologies of 'Benign Cellular Change' and 'Within Normal Limits' were combined and terminology was changed to 'Negative for intraepithelial lesion or malignancy'. In General categorization, category 'Other' was newly inserted and the presence of 'Endometrial cells' in women over 40 years old can be checked. Although the category 'Benign Cellular Change' was deleted, the organisms or reactive changes of this category can be listed in the descriptive diagnoses. Terminologies of ASCUS and AGUS were changed to atypical squamous cell and atypical glandular cell, respectively. Diagnostic term of 'Adenocarcinoma in situ', which is highly reproducible with reliable diagnostic criteria, was newly Inserted. The category of hormonal evaluation was deleted. Criteria for liquid-based specimen were discussed. Reporting by computer-assisted cytology was discussed and terminology for automated review was newly inserted. This is not the final edition of Bethesda 2001. The final document can be prepared before the ASCCP meeting in which Consensus Guidelines for the Management on Cytology Abnormalities and Cervical Precursors will develop in September 2001.

• 정신신체의학
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• 제10권1호
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• pp.48-54
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• 2002

연구목적: 종합 병원 건강 증진 센터를 내원한 일반 성인들을 대상으로 생활 스트레스, 신체적 및 정신적 증상, 그리고 신체 이학적 지표들을 측정하여 스트레스와의 관련성을 알아보고자 하였다. 방법: 2000년 7 월부터 12월까지 종합병원 건강증진센터에 내원한 성인 남녀 중 186명을 대상으로 하여 생활 스트레스 측정도구, 간이정선진단검사, 건강 검진 문진표를 사용하여 대상들이 지각하는 생활스트레스와 신체적 및 정신적 증상을 조사하였으며, 건강 진단에 통상적으로 시행되는 검사 중 스트레스와 관련이 있다고 생각되어지는 신체 이학적 지표를 선정하여 분석하였다. 전체 연구 대상을 생활스트레스지각의 정도에 따라 스트레스 낮은 군과 높은 군으로 나누어 두 군간에 연구변인들의 유의미한 차이가 있는지 분석하였다. 결과: 스트레스가 낮은 군과 높은 군 사이에 간이정신진단검사의 모든 소항목 점수들은 모두 유의미한 분포의 차이를 보였으며, 주관적인 신체증상에서도 불안, 우울 증상과 그와 관련된 자율신경계 증상들이 유의미하게 분포함을 알 수 있었다 그러나 성인병의 지표라 볼 수 있는 신체이학적 검사자료에서는 두 군간에 유의미한 차이가 없었다. 결론: 생활 스트레스는 일반 성인남녀에서 정신적 증상 및 신체생리 증상들을 야기할 수 있지만, 고혈압, 당뇨병, 고지혈증, 심장병 등의 스트레스성 성인질환으로 진행되기까지는 스트레스가 상당기간 지속되어야 함을 시사하였다.

• 의료법학
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• 제19권1호
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• pp.81-111
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• 2018

최근 우리나라에서는 연속적으로 발생한 환자안전사건으로 인해 환자안전에 대한 사회적 관심이 높아졌다. 더불어 환자안전사건 발생 후 의료인 및 의료기관의 대응방식이 논란이 되면서, 사과법 및 디스클로져법 도입의 필요성이 제기되고 있다. 본 연구에서는 미국의 사과법과 디스클로져법 내용을 분석하고, 우리나라의 입법 움직임에 대하여 비판적으로 검토하고자 한다. 먼저 사과법은 의료인 등이 환자측에게 불편감, 통증, 손상, 사망 등에 대해 사과나 위로, 공감 등을 표하는 경우, 사과 등의 표현은 민사재판 및 행정절차에서 법적인 증거로 사용할 수 없도록 하는 것을 그 주요 내용으로 한다. 사과법은 실수, 오류, 잘못, 책임, 법적 책임의 표현과 같은 규범적 평가요소를 증거법의 보호 범위에 포함하는지 여부에 따라 '완전한 사과법'과 '부분적 사과법'으로 구분된다. 한편, 디스클로져법은 의료기관이 심각한 위해가 발생한 사건 등에 있어 사건의 공개, 발생원인, 보상계획, 재발방지대책 등에 관하여 환자 측과 소통하는 것을 법률상 강제하거나 자율적으로 유도하는 것을 그 주요 내용으로 한다. 한편, 최근 우리나라에서도 환자안전사고에 관한 관심이 증폭되고, 의료인 측과 환자측의 의사소통의 중요성이 인식되면서, 위와 같은 미국의 사과법 또는 디스클로져법을 수용한 "환자안전법" 개정법률안이 국회에 제출되기도 하였다. 본 연구에서는 미국의 사과법 및 디스클로져법의 분석을 토대로 위 개정법률안의 내용을 비판적으로 검토함으로써 향후의 입법방향에 시사점을 제시하고자 한다.

• 대한영상의학회지
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• 제84권1호
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• pp.51-74
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• 2023

다발성 골수종(multiple myeloma)은 단일 클론에서 기원한 형질세포의 증식성 질환으로 비호지킨림프종에 이어 두 번째로 흔한 악성 혈액종양질환이다. 과거에는 'CRAB'이라는 임상 소견과 일반 촬영을 통한 골격계 조사(skeletal survey)에 의존하여 진단하였으나, 최근 International Myeloma Working Group의 개정된 가이드라인에 영상의학적 진단기준이 새로 제시되었다. 이에 병변의 조기 발견이 가능한 전신자기공명영상(whole-body MRI; 이하 WB MRI)의 임상적 유용성이 강조되고 있다. 또한 WB-MRI의 확산강조영상(diffusion-weighted image)과 딕슨 기법을 이용한 지방함량 정량화(fat quantification) 영상을 이용한 정확한 치료반응 평가가 가능하다. 이러한 추세에 따라 표준화된 영상 획득 및 보고를 위한 다기관, 다학제적 컨센서스인 Myeloma Response Assessment and Diagnosis System (이하 MY-RADS)가 발표되었다. 본 종설은 다발성 골수종의 전신자기공명영상 및 MY-RADS의 임상 적용에 대하여 최신 지견을 중심으로 종합적 기술하고자 한다. 이에 더하여 한계점과 추후 개선 방향에 대해서도 고찰하고자 한다.

• Mycobiology
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• 제46권2호
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• pp.101-113
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• 2018

Lichen genus Stereocaulon (Schreb.) Hoffm is distributed throughout the world. Although 15 Stereocaulon species have been recorded in Korea, no detailed taxonomic or revisionary research has been conducted for nearly two decades. In this study, we collected 260 putative Stereocaulon spp. samples and identified the species based on morphological, chemical, and molecular characteristics. From the collected samples, 10 species of Stereocaulon were identified, nine of which had already been reported, although this was the first report for the tenth, S. octomerellum Hue, in Korea. General characteristics of Stereocaulon spp. include coralloid phyllocladia and tubercular cephalodia; however, the specimen first collected in Korea was a rare species with tomentum on the pseudopodetia. The specimen of S. octomerellum is characterized by the presence of a primary thallus, granule to short coralloid phyllocladia, and pseudopodetia up to 1 cm in size, with tubercular cephalodia. To determine the phylogeny of the specimens, we compared the ITS sequences of ribosomal DNA and the b-tubulin gene sequences. Phylogenetic analysis showed that the Korean Stereocaulon species were monophyletic and placed in the previous phylogenetic classification. Species of S. intermedium and S. exutum, however, were polyphyletic, and are morphologically variable and widespread species. Overall, we present here detailed morphological and chemical descriptions of each species identified and a revised key of all known Stereocaulon species in South Korea.

• Nutrition Research and Practice
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• 제5권6호
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• pp.560-568
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• 2011

Consumption of a diet consistent with dietary guidelines is believed to have a beneficial effect on the prevention of chronic diseases and the promotion of general health. This study was conducted to explore the relationship between adherence to the Korean Food Guidance System (KFGS), which was based on the 2010 revised KDRIs, and the risk of metabolic abnormalities. Five hundred and ninety-six Korean adults between 30 and 59 years of age were recruited by advertisement to the Bundang Jesaeng General Hospital (BJGH), and those not taking regular medications and without diagnoses of fulminant disease were included. Data were collected on anthropometric measurements, diagnostic parameters for metabolic syndrome (MetS), and 3-day dietary intakes from individuals in the study. The number of servings consumed from each food group was compared to the KFGS recommended servings for each of the 6 food groups. Poor adherence to the recommendations for servings of milk and dairy products (OR: 2.038, 1.128-3.682) was associated with a higher risk of MetS, and poor adherence to the guidelines for fruit consumption (OR: 1.849, 1.027-3.329) was associated with a higher risk for the existence an elevated waist circumference. Conversely, the consumption of meat, fish, eggs, and beans above the recommended number of servings was associated with a lower risk of having an elevated waist circumference (OR: 0.523, 0.288-0.950), and the consumption of vegetables above the recommended number of servings was associated with a reduced risk of having elevated fasting glucose (OR: 0.533, 0.298-0.954). These results suggest that adherence to the KFGS guidelines helps to prevent the development of MetS, but this association needs to be confirmed by prospective studies.

• 대한영상의학회지
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• 제84권1호
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• pp.92-109
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• 2023

갑상선 결절 환자에서 초음파 검사는 일차적 영상 진단법으로 정립되어 있으며 치료 결정을 위한 핵심적인 진단 역할을 갖는다. Korean Thyroid Imaging Reporting and Data System(이하 K-TIRADS)는 초음파 유형에 기초한 암 위험도 분류체계로서 실시간 초음파 검사를 시행하면서 쉽게 결절 진단이 가능하다는 장점을 갖고 있다. 개정된 2021 K-TIRADS는 결절의 초음파 분류 기준을 보다 명확히 하였고, 고위험 갑상선암의 의심 소견이 없는 환자에서 병리진단검사를 결정하는 결절 크기 기준을 개정하여 불필요한 병리진단검사를 최소화하고 적절한 갑상선암 진단 예민도가 유지되도록 개정하였다. 갑상선영상의학진료는 갑상선 결절 환자의 진단 및 비수술적 치료를 수행하는 중요한 임상적 역할을 가지고 있으며, 적절한 환자 진료를 위해서는 표준적 진료 지침에 근거하여 진료가 수행되어야 한다.