• 정신신체의학
• /
• 제21권1호
• /
• pp.27-43
• /
• 2013

연구 목적 일반 인구에서 스트레스, 우울 정도, 신체질환 간의 관계와 우울증의 위험 요인을 확인하고자 연구를 진행하였다. 방 법 2009년 1월부터 2009년 12월까지 고려대학교 구로병원 건강검진센터에 내원한 일반인 1,764명에서 인구역학 자료를 조사하고 PSS와 PHQ-9 설문지를 시행하였다. 스트레스군, 우울군, 신체질환군을 구분하여 스트레스, 우울, 신체질환 간의 상관분석과 로지스틱 회귀분석을 시행하였다. 결 과 1,476명의 연구 대상자 중 198명(11.8%)이 우울군에 해당되었으며, 평균 PSS 점수(23.19점)와 평균 PHQ-9 점수(12.95점) 모두 정상군에 비해 높았다. 스트레스가 높을수록, 신체질환이 많을수록 우울 점수도 증가하였다. 여성, 최근의 건강이상으로 내원한 사람, 불규칙적인 운동과 흡연력, 협심증과 뇌경색 기왕력이 있는 군에서는 우울증의 위험도가 증가하였다. 결 론 본 연구에서 PSS, PHQ-9은 건강검진센터에서 정신건강 선별검사를 시행할 수 있는 유용한 기회를 제공하였다. 스트레스를 많이 받고 신체질환이 많을수록 우울증의 위험도가 증가하므로, 신체질환이 동반되었거나 건강하지 못한 생활습관을 지닌 개인에서 정신질환 선별검사가 필요하겠다.

• Journal of Korean Neurosurgical Society
• /
• 제63권5호
• /
• pp.590-597
• /
• 2020

Objective : Covered stenting is an optional strategy for traumatic carotid pseudoaneurysm, especially in malignant conditions of potential rupture, but the long-term outcomes are not clear. Our aim was to determine if covered stenting is an effective option for traumatic carotid pseudoaneurysm with promising long-term outcomes. Methods : Self-expanding Viabahn and balloon-expandable Willis covered stents were separately implanted for extra- and intracranial traumatic carotid pseudoaneurysm. The covered stent was placed across the distal and proximal pseudoaneurysm leakage under roadmap guidance. Procedural success was defined as technical success (complete exclusion of the pseudoaneurysm and patency of the parent artery) without a primary end point (any stroke or death within 30 days after the procedure). Long-term outcomes were evaluated as ischemic stroke in the territory of the qualifying artery by clinical follow-up through outpatient or telephone consultation and as the exclusion of the pseudoaneurysm and patency of the parent artery by imaging follow-up through angiography. Results : Five patients with traumatic carotid pseudoaneurysm who underwent covered stenting were enrolled. The procedural success rate was 100%. No ischemic stroke in the territory of the qualifying artery was recorded in any of the five patients during a mean clinical follow-up of 44±16 months. Complete exclusion of the pseudoaneurysm and patency of the parent artery were maintained in all five patients during a mean imaging follow-up of 39±16 months. Conclusion : Satisfactory procedural and long-term outcomes were obtained, suggesting that covered stenting is an effective option for traumatic carotid pseudoaneurysm.

• 한국산학기술학회논문지
• /
• 제19권4호
• /
• pp.342-352
• /
• 2018

이 연구는 중년여성의 심뇌혈관질환 예방관련 지식, 신체활동 실천율이 건강행위에 미치는 영향요인을 확인하기 위한 연구이다. 자료수집은 경북 북부지역 24개 읍면동지역에 거주하는 중년여성 142명을 대상으로 구조화된 설문지를 이용하여 시행되었다. 연구기간은 2017년 10월부터 11월까지 2개월간 시행되었다. 수집한 자료는 기술통계와 t-test, ANOVA, Pearson 상관분석, 위계적 다중회귀분석으로 분석하였다. 연구결과 건강행위에 영향을 미치는 요인은 심뇌혈관질환 예방관련지식의 음주(${\beta}=0.15$, p=.009), 식이(${\beta}=0.16$, p=.003), 고강도의 신체활동 실천율(${\beta}=0.14$, p=.011), 일반적 특성의 결혼상태(${\beta}=0.19$, p<.001), 본인건강관심도(${\beta}=0.23$, p<.001), 자신의 건강을 나쁘게 인식하는 경우 (${\beta}=0.31$, p<.001)이었다. 이러한 변수들은 건강행위와 유의한 변수를 보정변수로 추가하여 분석한 것으로 회귀식의 적합도는 통계적으로 유의한 것으로 나타났다(F=16.46, p<.001). 주요 변수 간의 관계에서 건강증진행위는 심뇌혈관질환 예방관련 지식(r=.41, p<.001)과 신체활동 실천율(r=.44, p<.001)과 유의한 양적 상관관계를 나타내었다. 따라서 연구결과를 바탕으로 추후 중년 여성의 건강행위 증진을 위하여 질환 예방 지식과 신체활동 실천율 지지를 반영한 실천적인 중재프로그램의 개발과 적용이 필요하겠다.

• 한방안이비인후피부과학회지
• /
• 제24권1호
• /
• pp.142-170
• /
• 2011

Objective : The purpose of this study is to investigate dizziness of Plain Questions $\ll$素問$\gg$ and Miraculous Pivot $\ll$靈樞$\gg$. Methods : We conducted a study on the original text paragraphs of Internal Classic $\ll$內經$\gg$ containing the dizziness and analysis of Yang, Ma, Zhang, Wang etc. We drew a parallel between dizziness from Internal Classic $\ll$內經$\gg$and matching diagnoses from western medicine. Results : The results were as follows. 1. Dizziness in Ok Ki Jin Jiang Ron <玉機眞藏論> and Pyo Bon Byeong Jeon Ron <標本病傳論> had relation to liver and was similar to dizziness caused by tension, hypertension, anemia and cerebrovascular accident etc. in western medicine. 2. Dizziness in Ja Yeol<刺熱>, O Sa<五邪> and Hai Ron<海論> had relation to kidney and was similar to dizziness caused by aging and peripheral vertigo concurrent with tinnitus and difficulty in hearing in western medicine. 3. Dizziness in O Sa<五邪> had relation to heart(pericardium) and was similar to dizziness caused by cardiac output loss and psychogenic dizziness in western medicine. 4. In Internal Classic $\ll$內經$\gg$ the main etiology of dizziness was infirmity(虛), which were Qi(氣) of the upper portion of the body being insufficient(上氣不足), blood depletion(血枯), deficiency of marrow-reservoir(髓海不足) etc. 5. In Dae Hok Ron<大惑論> etiology and pathogenesis of dizziness were mentioned and dizziness was similar to dizziness caused by eye disorder, psychogenic dizziness and central dizziness in western medicine. 6. In Internal Classic $\ll$內經$\gg$ the meridian of acupuncture points which was used much for dizziness was Bladder Meridian. Aqupunture points used in treatment of dizziness were Ch'onju(天柱), Kollyun(崑崙), Taejo, Chok-t'ongkok(足通谷) etc. Conclusion : We found out etiology, pathogenesis, treatments of dizziness in Internal Classic $\ll$內經$\gg$. Further we compared with western medicine to develop better understanding of dizziness.

• Journal of Chest Surgery
• /
• 제51권4호
• /
• pp.266-272
• /
• 2018

Background: Limited comparative data are available on the efficacy of cryoablation versus radiofrequency ablation in patients with atrial fibrillation. This study aimed to compare radiofrequency ablation and cryoablation with regard to clinical outcomes and the restoration of sinus rhythm or atrial contractility. Methods: A total of 239 patients who underwent surgical ablation between August 2003 and December 2016 at our institution were included. The patients were divided into 2 groups according to the energy device that was used (group A: n=140, radiofrequency ablator; group B: n=99, cryoablator). Echocardiographic data, overall survival, and major cardiovascular and cerebrovascular event (MACCE)-free survival were compared between the 2 groups. Results: At 1 year of follow-up, the atrial contractility recovery rate was 32.2% (19 of 59) in group A and 48.8% (21 of 44) in group B. In addition, cryoablation was found to be a predictive factor for the recovery of atrial contractility (cryoablation vs. radiofrequency ablation: odds ratio, 2.540; 95% confidence interval, 1.063-6.071; p=0.036). The left ventricular ejection fraction was significantly higher in group B ($53.1%{\pm}11.5%$ vs. $59.1%{\pm}6.3%$, p=0.001). The median follow-up duration was 36 months. The 5-year overall survival rate was $80.1%{\pm}3.6%$ in group A and $92.1%{\pm}2.9%$ in group B (p=0.400). The 5-year MACCE-free survival rate was $70.3%{\pm}4.0%$ in group A and $70.9%{\pm}5.6%$ in group B (p=0.818). Conclusion: Cryoablation was associated with a higher atrial contractility restoration rate and better left ventricular function than radiofrequency ablation. However, no significant relationship was observed between the energy source and overall or MACCE-free survival.

• Radiation Oncology Journal
• /
• 제29권3호
• /
• pp.156-163
• /
• 2011

Purpose: To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. Materials and Methods: We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-five patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Results: Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing's disease). Amenorrhea was abated in 7 of 10 patients, galactorrhea in 8 of 8 patients, acromegaly in 7 of 11 patients, Cushing's disease in 4 of 4 patients. Long-term complication was observed in 4 patients; 3 patients with cerebrovascular accident, 1 patient developed dementia. Of these patients, 3 of 4 received more than 60 Gy of irradiation. Conclusion: EBRT is highly effective in preventing recurrence and reducing mass effect of non-secreting adenoma. Effort to improve tumor control of secreting adenoma is required. Careful long-term follow-up is required when relatively high dose is applied. Modern radiosurgery or proton RT may be options to decrease late complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제29권5호
• /
• pp.330-337
• /
• 2003

This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.

• 농촌의학ㆍ지역보건
• /
• 제34권1호
• /
• pp.34-46
• /
• 2009

이 연구는 비교적 간단하면서도 객관성과 타당성이 높다고 평가되는 자료와 산출방식을 적용하여 보건사업의 가중치를 산출함으로써 지방자치단체 보건사업의 자원 배분과 평가에 용이하게 활용할 수 있는 계량적 기준을 제시하고자 하는 목적으로 수행되었다. 이를 위해 먼저 HP 2010에서 제시한 중점과제를 기초로 선행연구의 결과와 보건복지부 사업담당자들의 의견을 반영하여 분류안을 구성하였다. 다음으로 선행연구 결과들을 검토하여 각 보건사업과 관련된 질병부담 자료를 수집하였고, 전문가 의견 조사를 실시하여 각 보건사업과 관련된 문제의 심각도와 사업의 추정 효과를 파악하였다. 그리고 이와 같은 과정을 통해 수집된 자료들을 BPRS 방식에 적용하여 보건사업의 가중치를 산출하였다. 수집된 자료들을 BPRS 공식에 대입하여 가중치를 산출한 결과 전염성질환이 58.97%로 가장 높았고, 금연이 14.07%로 두 번째로 높았다. 그 다음은 고혈압(3.87%), 당뇨(3.40%), 암(2.90%), 심 뇌혈관질환(2.86%), 운동(2.10%), 절주(2.07%), 건강검진(1.92%), 정신건강증진(1.72%), 중증정신질환(1.62%), 영양(1.52%), 구강위생관리(1.15%), 구강질환(1.10%), 중독(0.73%) 순으로 나타났다. 이 연구의 결과는 중앙정부가 지방자치단체 보건사업에 자원을 배분할 때 계량적 기준으로 활용할 수 있으며, 평가점수 산정 시 상대적으로 더 중요한 사업에 더 높은 점수를 부여하여 사업의 효과성을 정책적으로 향상시킬 수 있을 것으로 기대된다.

• 대한한의학회지
• /
• 제27권1호
• /
• pp.204-219
• /
• 2006

Objectives : This study is to report the proceeding of the project sponsored by the ministry of science and technology of Korea for the stroke study titled as 'fundamental study for standardization and objectification of differentiation and pattern identification of symptoms of Oriental Medicine in stroke'. Methods and Results : We works for clinical research and molecular epidemiology center and we are in charge of the development of case report form, education of the investigators, data entry, data validation, and analysis. In the process of this project, we need to development of standard operating procedures for development and education for the case report form. Conclusions : This study is to let researchers for Traditional Korean Medicine and clinical research know how to develop of case report form and standard operating procedures in clinical researches and maintain the resource document and data.

• 대한한의학회지
• /
• 제27권3호
• /
• pp.107-131
• /
• 2006

Background and Aims: Dansamtongmek-tang (DSTMT) and Dansamsengmek-san (DSSMS) have been used for many years as therapeutic agents for the acute stage of cerebrovascular disease, hypertension and hyperlipidemia in Oriental medicine, but the effects of DSTMT and DSSMS on hyperlipidemia and safety for cell damage are not yet well-known. This study was done to investigate the effects of DSTMT and DSSMS on hyperlipidemia. Methods: In vivo test: after administering DSTMT and DSSMS to SHR and ICR occurred hyperlipidemia for 3 weeks, we analyzed body weight, cholesterol levels. TG, HDL-chol, LDL-chol, LDH in plasma, brain, liver and kidney tissue, and DNA by RT-PCR. In vitro test: after administering DSTMT and DSSMS to human hepatocellular carcinoma in hypoxia, we observed cell cohesion by light microscope, analyzed the inflow of Ca2+ by confocal laser scanning microscope and DNA by RT-PCR. Results: DSTMT significantly decreased the levels of triglyceride and increased the levels of HDL-cholesterol in SHR, and significantly decreased the levels of LDL-cholesterol and body weight and increased the levels of HDL-cholesterol in ICR. DSSMS significantly decreased body weight, total cholesterol levels, LDL-cholesterol, LDH and cardiac risk factor (CRE) in SHR and significantly decreased the levels of total cholesterol, triglyceride, LDL-cholesterol, LDH and CRF in ICR. DSTMT had an effect on protecting cells from damage by inhibiting production of p53 mRNA, and in DSSMS, by inhibiting production of p53 mRNA and p21 mRNA after hypoxia. DSTMT effectively blocked off Ca2+ at low density, but DSSMS effectively blocked off Ca2+ at high density. Both DSTMT and DSSMS had an effect on inhibiting lipid metabolism by blocking off production of apo B mRNA. Conclusions: These results suggest that DSTMT and DSSMS might be usefully applied for treatment of hyperlipidemia and suppression of brain damage.