전문가 진단을 통한 체질별 건강수준과 설문결과의 연관성 연구

이재철,이혜정,이유정,김근호,김상혁,이시우,장은수,김종열,Lee, Jae-Chul,Lee, Hae-Jung,Lee, Yu-Jung,Kim, Keun-Ho,Kim, Sang-Hyuk,Lee, Si-Woo,Jang, Eun-Su,Kim, Jong-Yeol 사상체질의학회 2011 사상체질의학회지 Vol.23 No.1

1. Objectives: We report the relation between the questionnaire and the health state on the Sasang Constitution. 2. Methods: We carried out a clinical test, in which 2 Oriental medical doctors participated to diagnose health state in each Sasang Constitution with 239 subjects. The subjects were divided into 3 subgroups, which are allocated to healthy group, poor health group and disease group. 3. Results: We extracted 4 questions for Taeeumin, 5 questions for Soyangin and 3 questions for Soeumin from the whole 98 questions respectively. Soyangin and Taeeumin share a same question that shows significant difference by health status. For the statistical analysis, we used a Chi-square test. As a result, we found out that Taeeumin showed different distributions of answers in direct/indirect characteristic, perspiration, frequent urination, regular defecation. According to the health status Soyangin showed the different distribution of the answers in color of urination, frequent urination, mouth dryness, abnormal perspiration, discomfort of head. Soeumin showed the different distribution of the answers in cold and chilly feel of abdomen, digestion status and cause of digestion problems when body condition gets worse. 4. Conclusions: This is the first work which reports the relatedness between Questionnaire and Health State in each Sasang Constitutions by an objective clinical test. We found out that several questions have different distributions by health status in each Sasang Constitution. These extracted questions are categorized not only by Wansilmoobyung(완실무병), but also by other symptoms and body status.

한의학의 미병 개념 및 변증과의 연관성에 대한 고찰

이재철,김상혁,이영섭,장은수,이시우,Lee, Jae-Chul,Kim, Sang-Hyuk,Lee, Young-Seop,Jang, Eun-Su,Lee, Si-Woo 대한예방한의학회 2012 대한예방한의학회지 Vol.16 No.2

Objectives : This work is aimed to reveal the relations between concepts of subhealth(mibyung) and Korean medicine patterns. Methods : We carried out a literature searching on Oasis, RISS, DBpia, Pubmed to summarize concepts of Mibyung. CNKI Searching also was performed with keyword related to mibyung(未病), subhealth(亞健康) and syndrome. Results : Korea, China and Japan have different concepts of mibyung. China's mibyung concept is relatively broader and wide which includes healthy, subhealth, development of disease and recurrence avoid. In contrast, Korea and Japan's mibyung concepts are focused on China's subhealth. Though Mibyung's patterns are varied widely depends on studies, China's studies of subhealth and TCM patterns showed that Deficiency patterns are diagnosed at high frequency in clinical study and literature study. Conclusions : This work could contribute to further study of subhealth(mibyung) and their relations to patterns, diagnostic methods and treatment efficacy.

현지 기술 조사활동을 통한 중국의 미병 정책 및 의료서비스 최신 동향 보고

이재철,김동수,장은수,Lee, Jae-Chul,Kim, Dong-Soo,Jang, Eun-Su 대한예방한의학회 2013 대한예방한의학회지 Vol.17 No.1

Objectives : This study aims to report current trend of Mibyeong health policy and service in China from interview of China Technology Research Group. Methods : China Technology Research Group visited Guanganmen hospital, Yanhuang Dongfang Company, Xinjingzhen health center, and Shanghai Shuguang hospital. With an interpreter, We had interviews about Mibyeong health service and policy trend, medical instrument, and research issue. Results :Mibyeong health service was performed based on KY3H system and collaboration with traditional Chinese medicine hospital. Mibyeong health service consists of diagnosis with nine constitutional type, health guide and preventive treatment. Community health center also provide Mibyeong health service, with cooperative treatment of traditional Chinese medicine and western medicine. China's Mibyeong health policy is established by Top-down decision, even though there is not enough evidence for providing health service to consumer. Through constitutional diagnosis, examinations, and treatment, huge data have been stacked; however, assessment and research based on these data are not processed well. Cooperative treatment of traditional Chinese medicine and western medicine is widely provided to patients, and their works are relatively well classified. Conclusions : China plays leading role in Mibyeong service and it seems to be developed more than Korea's. Further study is necessary to establish Mibyeong policy and health service in Korea.

동의수세보원(東醫壽世保元) 경험방(經驗方)에 근거한 사상체질별 설진(舌診)의 문헌연구

이재철,김종열,유현희,김근호,Lee, Jae-Chul,Kim, Jong-Yeol,Ryu, Hyun-Hee,Kim, Keun-Ho 사상체질의학회 2010 사상체질의학회지 Vol.22 No.1

1. Objectives: This study was performed to research the relationship between Sasang Constitution and characteristics of tongue diagnosis based on Donguisusebowon's Experience prescriptions(經驗方). 2. Methods: We searched tongue diagnosis factors in Donguisusebowon and classified this. Based on Donguisusebowon's Experience prescriptions(經驗方), we find tongue diagnosis factors in 6 contemporary Oriental medicine prescription books. 3. Results: Most So-eumin has white thin tongue coating and clear redish tongue color. Yellow tongue coatings are found in symptoms for Yinjinho-tang(Yinchenhao-tang), Soseungki-tang(Xiaochengqi-tang), Daeseungki-tang(Dachengqi-tang). Shortened Tongue is found in So-eumin's experience prescription and So-yangin's treat histroy. It didn't shown that So-eumin's Semen Crotonis included 6 prescritions' factors of tongue diagnosis. So-yangin's white tongue coating is found in Hyungbangpaedok-san(Jingfangbaidu-san), Sipjo-tang(Shizao-tang), Sosiho-tang(Xiaocihu-tang), Shinki-hwan(Shenqi-wan). Most of other So-yangin's tongue coatings are Yellowish and tongue color is deep red. Tae-eumin have thin white tongue coating at the Mahuang-tang(Mahuang-tang). Red tongue color and drying tongue are found at Jowiseungki-tang(Tiaoweichengqi-tang)Daesiho-tang(Dacihu-tang)Saengmaek-san(Shengmai-san) 4. Conclusions: Following So-eumin's Experience prescriptions, So-eumin's tongue color is clear red and tongue coatings are thin white and greasy. Following So-yangin's Experience prescriptions, So-yangin's tongue color is deep red and tongue coatings are yellowish and scarce except Exterior cold disease. And So-yangin has specific symptom of irritability, oral sores. Tae-eumin's tongue has two sides of white thin tongue coatings and Red and drying tongue.

다제 내성 폐결핵 환자의 임상상 및 치료에 대한 고찰

이재철,이승준,김계수,유철규,정희순,김영환,한성구,심영수,Lee, Jae-Cheol,Lee, Seung-Jun,Kim, Gye-Soo,Yoo, Chul-Gyu,Cheong, Hee-Soon,Kim, Young-Whan,Han, Sung-Koo,Shim, Young-Soo 대한결핵및호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.1

연구배경: 다제 내성 폐결핵 환자의 임상적 특성과 약제별 내성률, 치료에 영향을 미치는 인자, 이차 약제로 인한부작용, 치료내용 및 차료성적 등을 살펴 보고자 하였다. 대상: 약제 감수성 검사상 두가지 이상의 일차 약제에 동시 내성을 보이는 환자를 대상으로 후향성 연구를 시행하였다. 치료 결과의 판정은 정기적으로 6개월 이상 추적 관찰이 가능했던 환자만을 대상으로 치료후 호전을 1개월 이상의 간격으로 시행한 가래 검사상 3회 이상 음성이고 방사선 소견이 호전되거나 6개월 이상 변화가 없는 경우로, 치료 실패를 6개월간의 치료에도 균 음전화가 되지 않거나 방사선 소견상 악화를 보이는 경우로 정의하였다. 대상 환자들은 감수성 검사 결과에 따라 감수성 약제를 4제 이상 투여하여 치료받았다. 결과: 1) 총 71예와 환자를 대상으로 조사한 결과 35예(49%)에서 방사선상 공동을 관찰할 수 있었고 평균 4.1개의 약물에 내성을 지니고 있었는데 90%가 INH, RFP 동시 내성을 보였다. 2) 치료 결과의 판정이 가능하였던 55예중 35예(67%)의 환자가 치료후 호전을 보였으며 치료 실패는 18예(33%)이었다. 일차 내성 환자가 5예이었는데 치료 결과 판정이 가능하였던 4예는 모두 치료에 성공하였다. 3) 약제 부작용은 14예(20%)에서 나타났는데 간기능 악화가 6예로 가장 많았고 어지러움증 5예, 고요산 혈증을 동반한 관절통이 3예, 이명 3예 등의 순이었다. 이들 부작용의 절반 이상이 투약후 3개월 이내에 발생 하였다. 4) 약제 감수성 검사를 반복했을 때 INH, RFP의 경우 100% 가까운 일치율을 보였고 EMB, PZA 80% 정도 나머지 약물은 50% 미만이었다. 5) 5예의 환자가 수출을 받았고 이 중 1예는 항결핵 화학 요법의 보조적 치료로 수술을 했는데 균 음전화에 성공하였다. 결론: 다제 내성 폐결핵 환자에서도 규칙적인 약물 복용과 적절한 처방으로 약 2/3 정도에서 호전이 관찰되어 적극적인 항결핵 화학 요법을 시행해야 할 것으로 생각되지만 치료와 예후 판정에 도움이 되는 인자를 찾지는 못하였다. Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

초겨울 大韓海峽에서 形成되는 淺海前線의 構造

이재철,나정연,장선덕,Lee, Jae Chul,Na, Jung Yul,Chang, Sun-Duck 한국해양학회 1984 韓國海洋學會誌 Vol.19 No.1

Mesoscale thermohaline structures of the meandering front in the Korea Strait during November 1976, 1980 and 1982 are studied by means of closely spaced oceanographic observations and the satellite infrared images. Strong thermal and salinity fronts coincide each other and show a wavelike meander motion with wavelengths of 40-60km and amplitudes of, 15-20km. Salinity minimum band of less than 33.0 is found along the onshore edge of the front. Width of the frontal zone corresponds approximately to the internal radius of deformation (R=5-10km) and the slope of density interface is confined to about 2R. A series of satellite infrared images with the interval of 4-5 days show a noticeable growth of frontal meander over the flat shelf west of the Korea Strait. Possible mechanisms of frontal meander and its growth are discussed.

에크린 혈관종성 과오종

이재철,박진주,정은정,박시룡 ( Jae Chul Lee,Jin Joo Park,Eun Chyung Jung,See Ryong Park ) 대한피부과학회 1988 대한피부과학회지 Vol.26 No.2

Eccrine angiomatous hamartoma or sudoriparous angioma is a hamartoma in which histologically, hyperplasia of eccrine sweat apparatus and vascular elements is present in the same lesion and clinically has tenderness and hyperhidrosis over the lesion. We present a case of eccrine angiomatous hamartoma developed on the medial side of the right knee in a 5-year-old female patient.

夏季 韓國 南東海域에서 湧昇과 關聯된 바람, 海水面 및 表層水溫의 變化 TEVARIATIONS OF SEA LEVEL AND SEA SURFACE TEPERATURE ASSOCIATED WITH WIND -INDUCED UPWELLING IN THE SOUTH

이재철,Lee, Jae Chul 한국해양학회 1983 韓國海洋學會誌 Vol.18 No.2

Extensive wind, sea level and sea surface temperature (SST) data collected along the east coast of Korea in 1973-1979 were used to ascribe the variations of sea level and SST associated with wind forcing during summer. Alongshore components of wind were dominant but the offshore components were little significance in the southeast coast in summer. The variations in SST and sea level adjusted barometricallyagreed with the upwelling-downwelling processes and showed a rapid response to wind.Appearance of cold water to the surface in the upwelling region concurred well with te periods of positive y-component wind when the tangential line at Ulgi was takem as the y-axis. In general, SST at Ulgi and Gampo as well as the adjusted sea level at Pohang, Ulsan and Busan decreased significantly when strong winds favorable for upwelling persisted for more then three days whereas they increased during the relaxation or unfavorable periods. The period of an upwelling event, on the average, was about 10 days and the mean speed of alongshore sind was 4.0m/sec.

반응고 성형기술의 연구개발 동향

이재철,이호인 ( Jae Chul Lee,Ho In Lee ) 대한금속재료학회 1997 大韓金屬學會會報 Vol.10 No.2

난치성 결핵 환자의 단핵구에서 IFN-$\gamma$ 활성화 효과 및 IFN-$\gamma$ 수용체의 숫적 변화에 대한 연구

이재철,유철규,이춘택,김영환,한성구,심영수,Lee, Jae-Cheol,Yoo, Chul-Gyu,Lee, Choon-Taek,Kim, Young-Whan,Han, Sung-Koo,Shim, Young-Soo 대한결핵및호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.47 No.3

연구배경: 결핵에 대한 면역 반응은 T-림프구와 단핵 식세포를 주축으로 하는 세포성 면역 반응이 주률 이루는데 여기에 IFN-$\gamma$와 TNF-$\alpha$등의 cytokine 이 관여하고 있다. IFN-$\gamma$는 주로 T-림프구에서 분비되어 활성화된 단핵구에서의 TNF-$\alpha$생성을 증가시키는 기전을 통해 결핵균 증식을 억제하고 치유에 이르는 과정을 매개하는 것으로 알려져 있다. 효과적인 화학요법에도 불구하고 난치성 결핵으로 이행하는 기전에 IFN-$\gamma$가 관여하는지 규명하고자 본 연구를 시행하였다. 대상 및 방법: 정상 대조군과 최근 결핵으로 진단받아 치료를 시작한 환자, 난치성 결핵 환자에서 혈액을 채취하여 단핵구를 분리하고 아무런 자극을 하지 않은 경우, 12시간 LPS($l{\mu}g/ml$)만으로 자극을 한 경우, IFN-$\gamma$($2{\mu}g/ml$)로 2시간 전처치한 후 12 시간 LPS 자극한 경우로 니누어 TNF-$\alpha$의 농도를 측정, IFN-$\gamma$ 활성화 효과에 변화가 있는지를 살펴보았고 IFN-$\gamma$ 수용체 항제를 이용, IFN-$\gamma$ 활성화 효과의 변화가 IFN-$\gamma$ 수용체의 숫적 변화와 관련이 있는지를 확인하였다. 결과: IFN-$\gamma$ 활성화 효과를 알아보기 위해 LPS 만으로 지극한 경우와 IFN-$\gamma$ 전처치 후 LPS로 자극한 경우에 생성된 TNF-$\alpha$의 비를 구하여 보았을 때 정상 대조군 $13.5{\pm}7.6$, 최근 결핵환자로 진단받은 군 $10.8{\pm}6.4$, 난치성 결핵 환자군 $6.7{\pm}3.9$의 결과를 보였다. 난치성 결핵환자군의 경우 정상대조군에 비해 IFN-$\gamma$의 활성화 효과가 통계적으로 유의하게 감소되어 있음을 알 수 있었다 (p=0.002). IFN-$\gamma$ 수용체수의 감소는 대상 환자 중 난치성 결핵 환자 1명에서 관찰되었다. 결론: 난치성 결핵으로의 이행에 있어 단핵구에서의 IFN-$\gamma$ 활성화 효과의 감소가 중요한 역할을 할 것으로 생각되며 IFN-$\gamma$ 활성화 효과의 감소는 일부 환자의 경우, IFN-$\gamma$ 수용체의 감소와 관련되어 생기는 것으로 판단된다. Background: IFN-$\gamma$ plays an important role in host response to intracellular organisms such as mycobacterium. Human infection with mycobacterium leads to a wide variety of outcomes, ranging from asymptomatic infection to widespread and rapidly fatal disease. Recent reports suggest that alteration of the function of IFN-$\gamma$ caused by a defective IFN-$\gamma$ receptor gene can explain different host response to mycobacterium. In this study, we investigated the role of IFN-$\gamma$ in the development of chronic refractory tuberculosis. Methods: The LPS-induced TNF-$\alpha$ production with or without IFN-$\gamma$ priming was compared by using monocytes taken from recently diagnosed tuberculosis, chronic refractory tuberculosis patients and controls. And the IFN-$\gamma$ receptor was measured by indirect fluorescent antibody technique to know whether change in the priming effect of IFN-$\gamma$ is related to IFN-$\gamma$ receptor deficiency or not. Results: The ratio of TNF-$\alpha$ produced in response to stimulation with INF-$\gamma$ and LPS to LPS alone was $13.5{\pm}7.6$ in controls, $10.8{\pm}6.4$ in recently diagnosed tuberculosis patients and $6.7{\pm}3.9$ in chronic refractory tuberculosis patients. The priming effect of IFN-$\gamma$ significantly decreased in chronic refractory tuberculosis patients compared with that in controls(p=0.002). However, IFN-$\gamma$ receptor deficiency was detected in one of chronic refractory tuberculosis patients. Conclusion: The decrease of the priming effect of IFN-$\gamma$ may play an important role in the development of chronic refractory tuberculosis, and in some patients, this may be related to the IFN-$\gamma$ receptor deficiency.