정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구

조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.

영아 천식의 임상적 고찰 : Asthma prospective score에 의한 Based on Asthma Prospective Score

양은석,노영일,문경래,박영봉,박상기,변주남 조선대학교 부설 의학연구소 1999 The Medical Journal of Chosun University Vol.24 No.1

A Clinical study was made on 40 patients for infantile asthma less than 2 years old who had been admitted to the Department of Pediatrics of Chosun University Hospital from January 1997 to December 1998. We evaluated family history of allergic diseases, clinical features, serum IgE level, eosinophilia, chest radiologic findings and response to bronchodilator. The results obtained were as follows ; 1) The male to female ratio of patients studied was 4 : 1. 2) Eighteen of the 40 patients (45.0%) had a family history of allergic diseases, of which 10 patients had maternal allergic diseases. 3) Atopic dermatitis was the most common disease (37.5%) among the associated allergic diseases. 4) Thirty two of the 40 patients (80.0%) showed high serum total 19E levels. 5) Only 5 of the 20 patients who were examined by MAST showed positive reaction. 6) The frequency of chest radiologic findings observed in these patients was as follows ; hyperinflation (52.5%), increased bronchovascular marking(30.0%), no pathologic findings(25.0%), and pneumonic infiltration(25.0%). 7) In response to bronchodilator 28 cases(70.0%) were effective. 8) When we divided the 40 patients into two groups by the diagnostic criteria of Asthma prospective score (AP score), 30 patients(75.0%) were included in a compatible group. On the basis of AP score, family history of major or minor allergic dieases and the responsiveness to bronchodilator were important factors for the diagnosis of asthma.

Motion Control of an Omnidirectional Mobile Robot with Steerable Omnidirectional Wheels

Kyung-Seok Byun,Jae-Bok Song 제어로봇시스템학회 2002 제어로봇시스템학회 국제학술대회 논문집 Vol.2002 No.10

제어신호가 제한된 모델기준제어를 위한 가변기준모델

변경석(Kyung-Seok Byun),송재복(Jae-Bok Song) 제어로봇시스템학회 2000 제어·로봇·시스템학회 논문지 Vol.6 No.3

가변 바퀴 배치 기구부를 갖는 4륜 전방향 이동로봇의 무단변속기 제어

변경석(Kyung-Seok Byun),송재복(Jae-Bok Song) 대한기계학회 2002 대한기계학회 춘추학술대회 Vol.2002 No.5

An omni-directional mobile robot equipped with four independent omni-directional wheels can perform 3<br/> DOF motion and has one redundant DOF. This redundancy can be used to drive the mechanism enabling the<br/> wheel arrangement to vary, which can function as a continuously -variable transmission (CVT). The variable<br/> wheel arrangement mechanism is proposed to increase the range of velocity ratio for the CVT from the wheel<br/> velocities to robot velocity, which may improve performance of the mobile robot. In this research, a control<br/> method for CVT using VWAM, which considers efficiencies of the motors, is discussed. And various tests<br/> have been conducted to demonstrate the validity and feasibility of the proposed method.

12주간 즉각적인 운동학적 자료를 제공한 보행훈련이 여성 노인들의 보행 균형 능력 향상에 미치는 영향

변경석(Byun, Kyung-Seok),오은영(Oh, Eun-Young),최혜원(Choi, Hye-Won),신성휴(Shin, Sung-Hyu) 한국체육과학회 2013 한국체육과학회지 Vol.22 No.2

This study aims to examine the effects of the gait training providing immediate kinematical data for 12 weeks for the improvement of the elderly female’s gait balance ability. The subjects of this study were the Training Group (TG, n=10) and Control Group (CG, n=10). For an examination of this research, the repeated measures ANOVA was conducted by using SPSS 18.0. The conclusions of this research are summarized as follows: 1. After a gait training for 12 weeks, TG, CG showed significant increase of the gait velocity, and there was no difference between groups; 2. After the 12-week gait training, the difference in both feet step time rate was significantly decreased in TG compared to CG; 3. After the 12-week gait training, the difference in feet stride rate was significantly decreased in TG compared to CG; and 4. After the 12-week gait training, the difference in the time required for both feet stance phase did not show a significant result, but the difference in the time required for both feet swing phase was significantly decreased in TG compared to CG. As a result of the study, gait training conducted by TG that provided with immediate kinematical data was more effective than general gait training conducted by CG for the improvement of the gait balance ability.

Reverse J-Curve Relationship Between On-Treatment Blood Pressure and Mortality in Patients With Heart Failure

Lee, Sang Eun,Lee, Hae-Young,Cho, Hyun-Jai,Choe, Won-Seok,Kim, Hokon,Choi, Jin-Oh,Jeon, Eun-Seok,Kim, Min-Seok,Hwang, Kyung-Kuk,Chae, Shung Chull,Baek, Sang Hong,Kang, Seok-Min,Choi, Dong-Ju,Yoo, Byun American College of Cardiology 2017 JACC. Heart failure Vol.5 No.11

<P><B>Graphical abstract</B></P><P>[Figure]</P><P><B>Abstract</B></P><P><B>Objectives</B></P><P>This study aimed to assess the relationship between on-treatment blood pressure (BP) and clinical outcomes of patients with heart failure (HF).</P><P><B>Background</B></P><P>Lower BP has been reported to be related to increased mortality in various cardiovascular diseases. The optimal BP level for patients already experiencing HF is contentious.</P><P><B>Methods</B></P><P>The Korean Acute Heart Failure registry prospectively enrolled a total of 5,625 consecutive patients hospitalized for acute HF in 10 tertiary university hospitals in Korea between March 2011 and February 2014. Clinical profiles including BP were collected at admission, discharge, and during outpatient follow-up. Mean on-treatment BP was calculated from BP at discharge and at each follow-up visit. We evaluated the effects of mean on-treatment BP on the clinical outcomes of patients.</P><P><B>Results</B></P><P>Patients were followed up for a median 2.2 years. One-year mortality after discharge was 18.2%. The relationship between on-treatment BP and all-cause mortality followed a reversed J-curve relationship. A nonlinear, multivariable Cox proportional hazard model identified a nadir of systolic and diastolic BPs of 132.4/74.2 mm Hg in patients, for whom the mortality rate was lowest (p < 0.0001). The relationship with increased mortality above and below the reference BP was more definitive for diastolic BP and for HF with a preserved ejection fraction.</P><P><B>Conclusions</B></P><P>Systolic and diastolic BPs <130/70 mm Hg at discharge and during follow-up was associated with worse survival in HF patients. These data suggest that the lowest BP possible might not be an optimal target for HF patients. Further studies should establish a proper BP goal in HF patients. (Registry [Prospective Cohort] for Heart Failure in Korea [KorAHF]; NCT01389843)</P>

서울 바이러스에 의한 출혈성 신증후군의 임상상에 관한 연구

변관수,서재붕,이명석,김영훈,강경호,김준석,박승철,이호왕 대한감염학회 1986 감염 Vol.18 No.1

Seoul virus was identified in 1983. by Department of microbiology College of medicine, Korea University, and registered in American Arbovirus Catalogue in 1985. Feb. There were previousy reports of urban type Korean hemorrhagic fever, but there were no reports of clinical features of Seoul viral infection which is serologically diagnosed. So we evaluated the clinical findings in 29 patients with Seoul viral infection with hemorrhagic fever with renal syndrome who were diagnosed by hemagglutination inhibition test. We compared clinical findings of Seoul viral infection with previously reported iclinical fiedings of Korean hemorrgagic fever. The results were as followings: 1) Objects were 29 cases of Hemorrhagic fever with renal syndrome which were diagnosed serologically as Seoul virus, and observation period was from 84, Jan to 84, Dec. 2) Disease was dominant in Seoul area and in fall season. 3) Major symptoms were fever, abdominal or flank pain, vomiting, and myalgia, 4) Major physical findings were petechia, CVA tenderness, pharyngeal injection, but findings of bleeding tendency were less common than Korean hemorrhagic fever. 5) In laboratory findings, platelet count and WBC count abnormalities were milder than Korean hemorrhagic fever and treatments were mainly conservative and mortality was zero in observed cases.

Single Oral Dose Toxicity Study of Aqueous Extracts of Binso-san in ICR Mice

Kyung Park,Dae Jun Kim,Joon Seok Byun 한의병리학회 2010 동의생리병리학회지 Vol.24 No.1

Soil Properties of Horqin Sandy Land in Inner Mongolia , China

(Kyung Choi),(Seok Kweon Kim),(Jae Kyung Byun),(Choon Sig Kim) 한국임학회 2001 한국임학회 정기학술발표논문집 Vol.2001 No.-