• Tuberculosis and Respiratory Diseases
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• 제46권3호
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• pp.386-393
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• 1999

연구배경 : 호흡곤란을 호소하는 폐질환 환자에 대하여 답차 및 자전거 운동을 시행하여 각각의 운동 부하 방법에 따른 심폐기능의 변화의 차이점을 알아 보고자 하였다. 방 법 : 호흡곤란을 동반한 남자 17명과 여자 4명을 대상으로 1주일 이상의 간격을 두고 무작위로 Sensor Medics사의 model No. 2900 자전거 작업계 (bicycle ergometer)와 Sensor Medics사의 Vmax29 treadmill을 이용하여 각각 incremental exercise를 실시하였다. 결 과 : 답차를 이용한 운동부하 폐기능 검사상 자전거 운동에 비하여 $VO_2max$, VEmax, 혐기성 역치값은 유의한 상승을 보였으며, 호흡 및 심박수 예비력은 유의한 감소를 보였다. 결 론 : 운동부하 검사 방법에 따라 호흡기 질환 환자에서 심폐기능 검사치의 유의한 차이를 보이므로 어떠한 운동 부하 방법을 사용하였는지에 따라 결과 해석에 고려가 필요할 것으로 사료된다.

• 생물정신의학
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• 제17권4호
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• pp.210-217
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• 2010

Objectives : We investigated a correlation of cognitive function, depression, suicidal idea and serum lipid levels in Korean elderly over 60 years old to find risk factors of deprssion and cognitive decline. Methods : 834 persons participated in this study. Clinical evaluation was done at a point by using Mini-Mental State Examination in the Korean version of CERAD assessment packet(MMSE-KC). We also evaluated 165 persons that agreed to our exact examination for Geriatric Depression Scale(GDS), Scale for Suicidal Ideation(SSI), Hachinski Ischemic Score and serum lipid profile. Correlation analysis was used to evaluate correlation among serum lipid levels, MMSE-KC and SSI. One-way ANOVA was used for comparison of serum lipid levels and cognitive function, depression and SSI. We did a post-hoc analysis. Results : Depression and suicidal ideation were related with cognitive impairment in Korean elderly over 60 years old. Those who have more severe cognitive impairment and depressive symptom, have higher Hachinski ischemic score. We can see high HDL cholesterol levels only in the normal control group. Low total, HDL, LDL cholesterol were related with depression. Conclusion : There was high prevalence of depression in the Korean elderly over 60 years old and low serum lipid level was related with severity of depression and high suicidal ideation. In the normal control group, we can see high HDL cholesterol levels. To confirm this result, we need well-designed and wide range study.

• 대한한방부인과학회지
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• 제31권1호
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• pp.84-98
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• 2018

Objectives: The purpose of this pilot study was to examine the feasibility of recruiting women into a clinical trial designed to examine the effects of acupuncture and electroacupuncture in treating overactive bladder (OAB) in menopause women. We tried to determine if there was preliminary evidence to suggest that acupuncture may be effective in reducing OAB symptoms and improving disease-specific quality of life. We also tried to determine the appropriate treatment duration of OAB, with safety of performing acupuncture and electroacupuncture treatment. Methods: This study was a randomized clinical trial. 7 menopause women were randomly assigned to a electroacupuncture group (EA group) (n=4) or acupuncture group (AC group) (n=3) and received electroacupuncture or acupuncture treatment twice a week (16 sessions) in 8 weeks, and follow up assessment was performed after the end of treatment. Overactive Bladder Symptom Score (OABSS), 3-day bladder diary, and King's Health Questionnaire (KHQ) were performed 4 times (at baseline (visit 0), the middle of treatment (visit 8), after the end of treatment (visit 16), and at 4 weeks of follow-up (visit 17)) and analyzed. 2 subjects were dropped out, and finally 5 subjects completed the study. Statistical analysis was performed using SPSS 18.0 for window program. Results: There was an significant improvement in night-time frequency after the treatment (visit 17) in PP (Per-protocol) group analysis (p=0.042). In additional ITT (Inter-to-treat) group analysis, the OABSS (p=0.042) and night-time frequency (p=p=0.017) were improved significantly after the treatment (visit 17). But there was no significant difference of KHQ before and after the treatment. Also there was no significant difference between EA and AC group after the treatment (visit 16, 17). Conclusions: The results of this pilot study suggested that it was feasible to recruit subjects and perform the study procedures, after reconstructing several details of study protocol in performing further clinical trial.

• Tuberculosis and Respiratory Diseases
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• 제70권1호
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• pp.28-35
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• 2011

Background: The aim of the study was to describe the characteristics, treatments, and outcomes of critically ill patients with pandemic Influenza A/H1N1 2009 at a major medical center in Korea. Methods: This retrospective observational study examined critically ill adult patients with pandemic Influenza A/H1N1 2009, who were admitted to the AMC between August and December 2009. Results: 27 patients with confirmed pandemic Influenza A/H1N1 2009 were admitted to the intensive care unit (ICU) at the Asan Medical Center (AMC). The median age (IQR) was 59 years (41~67), and 66.7% of the patients were older than 51 years. A total of 81.5% of the patients had 2 or more co-morbidities. The median time (IQR) from symptom onset to presentation was 2 days (1~4), and the median time from presentation to ICU admission was 0 days (0~1.5). All patients received oseltamivir (300 mg/day) and 13 patients received triple combination therapy (oseltamivir, amantadine, ribavirin). Twelve patients required mechanical ventilation on the first day of ICU admission. A total of 6 patients (22.2%) died within 28 days of admission. The patients who died had significantly higher acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores at presentation. There were no significant differences in age, co-morbidities, or antiviral regimens between survivors and non-survivors. Conclusion: Critical illness related to pandemic Influenza A/H1N1 2009 was common in elderly patients with chronic co-morbidities. All patients were given high-dose oseltamivir or triple combination antiviral therapy. Nonetheless, patients with critical illnesses associated with pandemic Influenza A/H1N1 2009 had a death rate of 22.2%.

• 정신신체의학
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• 제3권2호
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• pp.115-125
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• 1995

Reports about the prevalence of premenstrual symptoms state that occurs in 20 to 100% of most reproductive-age women. There is a close association between premenstrual syndrome and affective disorders as well as same some other psychiatric disorders. Late luteal phase dysphoric disorder (LLPDD) is a premenstrual condition defined in DSM-III-R by severe mood changes and other symptoms that repeatedly occur only in the luteal phase of the menstrual cycle. However, DSM-III-R does not specify how to compute the change from the follicular to the luteal phase or how to determine when the amount of change is great enough to warrant the diagnosis nor how to determine occupational or social functional impairment. This study was conducted to evaluate the nature, severity and magnitude of premenstrual syndrome in women with current psychiatric disorders by using prospective Daily Rating Form(DRF), and to measure symptom changes according to three scoring methods for diagnosing LLPDD. Our study obtains the data about premenstrual changes estimated by DRF from 22 women with psychiatric disorders who had met criteria for major depressive syndrome on the Premenstrual Assessment Form (PAF). The data was scored by each three methods and was determined to meet criteria A for LLPDD. The results are as follows: 1) the subjects, when scored according to the percent change method, effect size method and absolute severity method, met the DSM-III-R criteria A for LLPDD in 36.4% (8 subjects), 14% (3 subjects) and 4.5% (1 subject) of the cases respectively. 2) The items of irritability, anger and impatience were occurred most frequently on the DRF, when it was scored according to the three scoring methods. And the item of breast pain was next frequent according to the effect size method and the percent change method but according to the absolute severity method. 3) The PAF item of impaired social functioning was reported by 16 (73%) of the subjects. 4) 4 (18%) of the subjects met criteria A for LLPDD and reported impaired social functioning. The prevalency of LLPDD according to each method varied. The percent change method yielded the greatest (36.4%), and the absolute seventy method yielded the laest (4.5%), The effect size method yielded an intermediate frequency (14%). Therefore, for maximizing the diagnostic accuracy of LLPDD, a diagnostic procedure including a measure of change (e.q., effect size method, percent change method) as well as confirmed diagnosis by DRF, will be needed. Also, an accurate tool to evaluate impaired social functioning will be required.

• 임상간호연구
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• 제17권1호
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• pp.113-122
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• 2011

Purpose: This study was conducted to develop and evaluate an oral care protocol for cancer patients receiving chemotherapy. Methods: The participants in this study were cancer patients in Severance hospital in Seoul. A total of 31 patients were assigned to the experimental group, and 29 patients to the control group. Data were collected from August 1 to October 5, 2010. The protocol included definition and symptom of oral mucositis, self-check method of oral status, prophylactic method of oral mucositis (oral care, eating habits, and gargling) and management of oral mucositis. Oral Assessment Guide (OAG) was used as the measurement tool of oral mucositis in this study, Oral Care Performance Scale was used as the measurement tool of oral care performance status. Data were analyzed with a $x^2-test$ and t-test, and repeated measures ANOVA, using SPSS/WIN 18.0 program. Results: Patients in the experimental group receiving the oral care protocol had a significant difference (t=-2.938, p=.005) in the oral care performance compared to the control group. However, there was no significant difference (F=1.255, p=.274) in the oral mucositis status between two groups. Conclusion: This study showed that the oral care protocol could improve oral care performance status for the patients under chemotherapy.

• Asian Spine Journal
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• 제12권6호
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• pp.1010-1016
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• 2018

Study Design: Retrospective cohort study. Purpose: To report on spinal fusion assessment using computed tomography (CT) after adult spinal deformity (ASD) surgery using ultra-low dose recombinant human bone morphogenetic protein 2 (RhBMP-2). Overview of Literature: The reported dose of RhBMP-2 needed for successful spinal posterolateral fusion in ASD ranges from 10 to 20 mg per spinal level. This study reports the use of ultra-low dose of RhBMP-2 (0.07 mg per facet) to achieve spinal fusion in multilevel ASD surgery. Methods: Consecutive patients who underwent ASD surgery using ultra-low dose RhBMP-2 were recruited. Routine postoperative CT analysis for spinal fusion was performed by two spine surgeons. Inter-observer agreement was calculated for facet fusion (FF) and interbody fusion (IBF) at 6 and 12 months after the procedure. Results: Six consecutive ASD patients with a mean age of 62 years (28-72 years) were examined. Each patient received a total dose of 12 mg with an average dose of $0.69{\pm}0.2mg$ (0.42-1 mg) per single FF and $1.38{\pm}0.44mg$ (0.85-2 mg) for IBF. Total 131 FF and 15 IBF were examined in the study, with 88 FFs and nine IBFs being analyzed specifically at 6 months after the surgery. FF and IBF reported by surgeons A and B at 6 months were 97.7% vs. 91.9% FF, respectively (${\kappa}=0.95$) and 100% vs. 100% IBF, respectively (${\kappa}=1$). Two patients underwent longitudinal follow-up CT at 12 months, and the FF rates reported by surgeons A and B were 100% vs. 95.8%, respectively (${\kappa}=0.96$). Five out of nine facet (56%) non-unions were identified at the cross-links. The remaining four facet pseudarthrosis were noted at 1-2 spinal levels caudal to the cross-links. At the final clinical follow-up, there was no rod breakage, deformity progression, neurological deficit, or symptom recurrence. The Oswestry Disability Index improved by an average of $32.8{\pm}6.3$, while the mental component summary of the 36-item Short-Form Health Survey improved by an average of $4.7{\pm}2.1$, and physical component summary improved by an average of $10.5{\pm}2.1$. Conclusions: To our knowledge, this is the first study to report a CT that defined 92%-98% FF and 100% IBF using the lowest reported dose of RhBMP-2 in multilevel ASD surgery. The use of ultra-low dose RhBMP-2 reduces the RhBMP-2 related complications and healthcare costs.

• 대한한방내과학회지
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• 제39권6호
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• pp.1306-1312
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• 2018

Objectives: This study presented the case of a 49-year-old Korean female with phantom limb pain after below right knee amputation and aimed to assess the effectiveness of Korean medicine treatment. Methods: The patient was treated with scalp acupuncture, electroacupuncture and herbal medicine. We executed a numerical rating scale (NRS), conducted a global assessment (G/A), administrated a Short-Form McGill Pain Questionnaire 2 (SF-MPQ-2) and measured total daily sleep time to evaluate symptom improvement. Results: The patient's G/A scores decreased from 10 to 2 and SF-MPQ-2 points decreased from 20 to 6 after treatment. The total daily sleep time did not changed due to anxiety. Conclusions: This study suggests that Korean medicine treatment could be effective in treating phantom limb pain after amputation. Further studies are needed.

• 재활복지
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• 제21권1호
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• pp.213-231
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• 2017

우반구 손상(Right Hemisphere Damage, RHD)에 따른 의사소통장애는 좌반구 손상 환자군과는 다른 양상을 보이며, 좌반구 손상 환자 대상의 실어증 평가에서는 그 장애 정도가 잘 감별되지 않기 때문에 이들에 대한 언어 평가와 중재연구가 적극적으로 이루어지지 않고 있다. 본 연구에서는 최근 10년간 국내외 관련 학술지에서 다루어진 RHD 환자에 대한 연구논문을 분석하여 RHD 환자의 의사소통장애 평가와 중재 방향에 대한 동향을 파악하고, 향후 임상과 연구 영역에서의 시사점을 얻고자 하였다. 국내외 논문 총 75편(국내 논문 13편, 국외 논문 62편)을 대상으로 연구유형과 연구영역으로 나누어 분석을 실시하였다. 연구유형 및 연구영역에서 국내외 동일하게 RHD 환자의 인지-의사소통장애 특성을 비교하고, 언어외적 능력을 가장 많이 살펴본 것으로 나타났다. 그러나 평가도구 개발 연구 및 인지-의사소통 외 능력(예: 일상생활능력, 우울)과 같이 다양한 주제에 대한 연구가 빈번히 이루어져 있는 국외 연구와는 달리 국내 연구는 아직까지 제한적인 범위 내에서만 이루어져 있었다. 본 논문을 통해 파악된 RHD 환자군의 국내외 연구 동향을 통해 향후 국내 RHD 환자를 대상으로 한 임상장면과 연구에서 다양하고 심도 높은 연구가 이루어질 것으로 기대한다.

• 대한불안의학회지
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• 제15권2호
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• pp.101-108
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• 2019

Objective : This study aimed to investigate the associations of anxiety symptoms with behavior and attention in elementary school children with attention-deficit/hyperactivity disorder (ADHD). Methods : A total of 195 elementary school children with ADHD participated in the study. The Korean Version of ADHD Rating Scale (K-ARS) and Behavior Assessment System for Children(BASC-2) were used to measure the children's behavior. Anxiety and attention was assessed with State-Trait Anxiety Inventory for Children (STAIC) and ADHD Diagnostic System (ADS), respectively. Children with ADHD were categorized to two groups of ADHD with low anxiety (ADHD-LA) and ADHD with high anxiety (ADHD-HA) according to the total STAIC scores. Scores on K-ARS, BASC-2 and ADS were compared between two groups of ADHD-LA and ADHD-HA. Results : The Scores on K-ARS total and both subscales in ADHD-HA group were significantly higher than ADHD-LA group. Scores on the BASC-2 subscales including hyperactivity, aggression, conduct problem, anxiety, depression, somatization, withdrawal, attention problems were also significantly higher in ADHD-HA group compared to ADHD-LA group. In contrary, scores on ADS subscales were not significantly different between the both groups. Conclusion : Our study identified that the anxiety accompanied with ADHD was associated with the negative behavioral aspect in children with ADHD. However, the performances on attention task were not affected by the anxiety comorbid with ADHD. Future studies to reveal underlying mechanism are needed for further understanding the association with anxiety and ADHD.