만성부비동염 환자에서 부비동 단순 X-선 사진과 전산화 단층(CT) 사진 소견의 비교

선동일,윤선호,신민호,서병도,양일권 釜算慶南耳鼻咽喉科學會 1993 임상이비인후과 Vol.4 No.1

대장암 환자의 성격특성과 분노표현방식

손성은,유희정,서병선,김진천,한오수 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.3

연구목적 : 협조적이고 비주장적이며 인내심이 많고 부정적인 감정(특히 분노)을 잘 표현하지 않는 C형 성격 또는 1형 성격특성과 암 발병과의 관련성에 대해서는 일치된 결과가 없는 실정이다. 특히, 대장암 환자를 대상으로 이루어진 연구는 소수이며 분노의 억압 및 부정이 암 발생과 관련을 보였던 연구결과가 보고되었던 것과 대조적으로 공격적 적대감이 대장암 발생과 관련이 있다는 상반된 연구결과가 있다. 본 연구에서는 대장암 환자를 대상으로 1형 성격과 대장암 발병과의 관련성을 살펴보고, 분노의 경험과 표현 특성을 세분화하여 평가해서 암 발병과의 관련성을 밝혀 보고자하였다. 방 법 : 대장암 환자 35명과, 정상인 37명을 대상으로 Grossarth-Maticek의 성격-스트레스 검사 단축형중, 1형 성격을 반영하는 10문항과 Spielberger의 분노 검사 44문항을 이용하여 양군을 비교하였다. 자료 분석을 위해 환자 집단과 정상 집단 간 차이를 보고, 환자 집단과 정상 집단을 가장 잘 판별해줄 수 있는 변인을 찾기위해 판별분석을 실시하였다. 결 과 : 대장암 환자집단이 정상집단에 비해 분노 경험, 상태 분노, 분노 기질의 총점이 유의한 수준에서 높았고 그외의 다른 소척도나 1형 성격 스트레스 검사에 있어서는 유의한 차이는 나타나지 않았다. 판별분석 결과, 분노 기질 변인만 환자집단과 정상집단을 유의하게 판별하였다.(정준상관계수=.33, 판별율=65.8%). 결 론 : 평상시에 특별한 일 없이도 생리적 각성 상태를 동반하는 분노를 자주, 심하게 경험하는 특성과 대장암 발병이 관련성이 있음을 시사한다. Objectives : Although previous studies have suggested that Type 1 or Type C personality may be associated with the development of cancer, the results have not been consistent. There have been some evidences that repression, denial, or non-expression of anger are related with the incidence of colorectal cancer. However, according to the results of recent researches, aggressive hostility was related to the development of colorectal cancer. This study attempted to delineate psychological characteristics or personality patterns of the patients with colorectal cancer based on multidemensions of anger and Type 1 personality for cancer development. Method : The subjects were composed of 35 patients with colorectal cancer and 37 normal controls. Grossarth-Maticek personality questionnaire and the Spielberger state-trait anger expression inventory were administered. Results : In comparison with the normal control group, the colorectal cancer patient group showed significantly higher scores on anger experience, angry temperament and state anger but no significant differences on Type 1 personality scale and other subscales. In the discriminant analysis patients and control groups were classified by means of state anger, angry temperament, angry reaction, anger-in, anger-out and anger control variables. When angry temperament variable was selected as a discriminant variable, 65.8% of cases had been correctly classified. Conclusions : These results suggested the relationship between the disposition to experience and express anger without particular provocation and the development of cancer.

일괄성 뇌허혈후 Amyloid Precursor Protein mRNA와 Amyloid Precursor Protein 발현의 변화

이상형,김혜선,정성진,이영재,서유헌,양희진,정영섭,한대희,조병규 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.11

단순 비만 지표로서의 목둘레의 분별점

강지현,유병연,서희선,심경원 대한비만학회 2002 The Korean journal of obesity Vol.11 No.2

연구배경 : 목둘레는 인슐린저항성과 관련된 여러 질환과 연관되어 있으며 인슐린저항성의 위험이 증가되어 있는 환자들에서 목둘레가 임상적인 선별검사로 유용하게 쓰일 수 있으리라고 제시되어진 바 있다. 따라서 본 연구에서는 목둘레와 비만 관련 지표 및 인슐린저항성의 지표로서의 HOMA score 와의 상관관계를 알아보고, 비만 환자를 예측할 수 있는 최적의 목둘레 분별점을 알아보고자 하였다. 대상 및 방법 : 건양대학병원 종합검진센터에 내원하여 건강검진을 받은 성인 남녀 대상자 364명 (남자 199명, 여자 165명) 중 249명 (남자 136명, 여자 113명) 실험군(test group)로 하여 receiver output curve (ROC) 분석을 통해 체질량지수 25 kg/㎡에 대한 최적의 (optimal) 민감도와 특이도를 가지는 목둘레 분별점을 구하였으며, 나머지 115명 (남자 63명, 여자 52명)을 유효군 (validation group)으로 하여 실험군에서 얻어진 목둘레 분별점을 적용하여 그 유효성을 알아보았다. 또한 묵둘레와 비만 관련 지표 및 인슐린저항성의 지표로서의 HOMA score와의 상관관계를 알아보았다. 결과 : 목둘레는 남녀 대상군 모두에서 허리둘레, 엉덩이 둘레, 엉덩이허리둘레비, 체질량지수, 체지방률, 공복시 혈중 인슐린, HOMA score와 강한 양의 상관관계를 보였으며 실험군에서 비만 환자를 예측할 수 있는 최적의 목둘레의 분별점은 남자에서는 36.6 cm 여자에서는 32.3 cm 였다. 이때의 민감도는 남자 81.92%, 여자 91.5%, 특이도는 남자 77.4%, 여자 69.7%, 정확도는 남자 80.2%, 여자 85%였다. 또한 실험군에서 얻어진 목둘레의 분별점을 유효군에 적용한 결과 남자에서는 민감도 91.9%, 특이도 53.9%, 정확도 76.1%로 나타났으며 여자에서는 민감도 81.25%, 특이도 85%, 정확도 82.69%로 나타났다. 결론 : 본 연구는 측정이 간편한 단순 비만 지표로서의 목둘레와 흔히 사용되는 비만 관련 지표 및 인슐린저항성과의 관련성을 밝혔으며 비만환자를 예측하기 위한 방법으로서 남자 36.6 cm, 여자 32.3 cm라는 목둘레의 분별점을 제시하였다. 향후 보다 일반화할 수 있는 보완 연구가 이루어져야 할 것으로 생각된다. Background : Neck circumference has been reported to be related to the other anthropometric measures of obesity and also associated with the metabolic disorders related to insulin resistance. The measurement of neck circumference could be useful in clinical screening for persons at an enhanced risk for insulin resistance. The aim of this study was to determine whether a single measure of neck circumference might be correlated with other obesity indices and HOMA score and to define neck circumference cutoff levels for obesity. Methods : We examined 364 consecutive persons (199 men and 165 women), who visited konyang university hospital health examination center during August, 2002. To find the optimal, maximal sensitivity and specificity for neck circumference, the receiver output curve (ROC) analysis of cutoff points against BMI (25 kg/㎡) was performed using the test group (136 men and 113 women). We validated the cutoff level using validation group (63 men and 52 women). Other obesity indices and fasting glucose and insulin were measured to find the correlation between neck circumference. Results : Neck circumference was significantly correlated with waist circumference, hip circumference, waist hip ratio, BMI, total body fat percent, fasting insulin and HOMA score. Neck circumference 36.6 cm for men and 32.3 cm for women was the best cutoff levels for determining the subjects with BMI over 25 kg/㎡. In the validation unrelated group, the test characteristics were acceptable with 91.9% sensitivity, 53.9% specificity, and 76.1% accuracy for men, and 81.25% sensitivity, 85% specificity, and 82.69% accuracy for women. Conclusion : Neck circumference as a simple and easy screening method for obesity was strongly correlated with the other conventional obesity indices and HOMA score as a index of insulin resistance and we defined neck circumference cutoff level for obesity according existing BMI cutoff levels.

간질환자의 출생 순위에 관한 임상적 연구

이민수,조숙행,한선호,서광윤,이병윤 大韓神經精神醫學會 1981 신경정신의학 Vol.20 No.2

To provide data on the clinical issues related to the birth order and other characteristic background in epilepsy, 331 idiopathic epileptic patients were evaluated and analyzed phenomenologically. The patients had been treated at the neuropsychiatric department of the Korea University Hospital during 1974 to 1980. The age at onset ranged from 1 to 45 years, with the mean age of 16.65 years. Males were 1.36 times more than females. Seventeen (5.13%) of the subjects had the family history of epilepsy. Attacks in the daytime only occurred in 67.67% (N=224) of the subjects, while 23.56% (N=78) had their seizures only at night, and 8.77% (N=20) had their seizures both at daytime and night. Grand mal was the most frequent type of seizure, followed by psychometer and petit mal. There was a higher incidence among the first born than the subsequent siblings and the children born second had a somewhat higher frequency of epilepsy than the subsequent children.

말초혈액 내 백혈구수와 대사증후군과의 연관성

황상태,김범수,황상준,서정열,김병진,이원영,성기철,강진호,김선우,이만호,박정로 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.3

대도시 지역주민의 흡연실태와 관련요인 분석

김기열,임상규,서인선,강창열,이병직,남철현,위광복 慶山大學校 保健福祉硏究所 1997 保健福祉硏究 Vol.1 No.-

To collect basic data for deveoping education program for quitting smoking, 1200 subjects were selected randomly living in Seoul, Pusan, Taegu and suburban areas and interviewed about their smoking habits and attitudes from June 20 to July 20, 1997. The result of this study was summarized as follows: 1. In the general characterisics of subjects, the proportion of female was the higher(53.8%) than that of male. Among them, the portion of twenties was 46.6%. in level of educational background, the rate of college graduates was 45.2%, that of high school was 35.7%, that of middle school was 11.5%. The highest proportion by occupation was 38.9% of student. The next was 11.7% of technician, 10.1% of unemployed, 9.4% of office worker and 9.3% of salesman. 2. The proportion of the smokers among subjects was 34.3%. The portion of male smokers was 65.7%, that of female smokers was 7.3%, which had tendency to increased. At the rate of smoking by age, 47.6% in over fifties, 43.6% in forties and 38.7% in thirties were showed that the rate of smoking was the higher in the older age. 3. In the quantity of smoking cigarettes, the rate of one park of cigarettes per day was 52.7%, that of a half pack was 31.1% and that of over two 53.2% and that in female was 59.1% which was highest. 4. In smoking period, the rate of smokers for over 20 years was 29.7%, that for 1-4 years was 25.1% and that for 5-9 years was 20.9%. The variables of age, marital status, educational level and occupation were statistically significant(p<0.01). 5. In the intention of quitting smoking, 48.0% of subjects wanted to stop smoking, 33.4% of them wanted to reduce amounts of cigarettes and 82.8% fo them had positive intention to stop smoking, on the other side 18.6% of subjects did not have any intention to stop smoking. 6. The proportion of subjects who tried to stop smoking was 67.9%. By characteristics, the rate of 67.9% in male, 27.3% in female, 90.9% in under nineteens, 73.6% in married group 69.4% in lower social class, 77.8% in high school graduated and 72.3% in Buddist was the higher than that of other groups. 7. The proportion of subjects who succeeded in quitting smoking was 12.0%. By characteristics, the rate of 40.2% in male, 34.8% in over 50 years old, 19.7% in married group, 15.4% in lower social class, 13.9% in apartment resident, 15.7% in high school graduate and 17.1% in Buddist was the higher than that of other group. 8. In the reason of quitting smoking, 81.0% of subjects had quitted smoking for health, 6.0% of them for religion and 13.0% of them for others. By characteristics, the rate of reason for health was 83.5% in male, 100.0% in age of forties, 84.6% in lower social class. 9. In the affecting factors of quitting smoking, 40.7% of subjects was influenced on family which was the highest, 29.6% of them on health education, 14.8% of them on friend's recommandation, 9.9% of them on medical doctor's advice and 4.9% of them on campaign. By age, twenties was affected by friend, thirties by health education and forties by family. 10. The most affecting independent variable of smoking was sexuality (β=0.42055), age(β=0.25285), drinking (β=0.15425), marital status and health condition(R²=44.8%). These results were shown that education program for quitting smoking especially emphasized injurious to health should be continued in the unit of family, school, office and society, particularly education program for female should be strengthened.

국내에서 유행하는 HIV의 전파 경로에 따른 Subtype 분포

이주실,남정구,김성순,강춘,최병선,김옥진,박미선,성봉모,서순덕,전수경,변승옥,신영오,조해월 대한감염학회 2001 감염 Vol.33 No.5

Background : Previous data have been reported that subtype B is prevalent in South Korea, but neither the extent nor the proportion of subtypes could be evaluated. This study was designed to analyze the distribution of HIV-1 subtypes, temporal instructions and transmission dynamics between epidemiological groups. Methods : 1,280 Koreans had been diagnosed as HIV seropositive during the period 1985 to 2000. Among them, 134 individuals were selected for this molecular epidemiological study. 134 DNAs were isolated from uncultured or cultured peripheral blood mononuclear cells. V3-V5 (0.7 kb) fragment of HIV-1 env gene was amplified by nested polymerase chain reaction and was sequenced. Results : HIV-1 isolates from thirty-seven homosexuals were all subtype B (100%). On the other hand, 66 isolates from 94 heterosexuals were subtype B (70%) and 28 were non B subtypes (30% : 13 A, 4 C, 2 D, 8 E , 1 G). Only subtype B strains were isolated from 73 males who were infected with HIV inside Korea while 16 B and 20 non B subtype strains were isolated from 36 males who were HIV infected outside of Korea. However, B and non B strains were isolated half and half from females who were infected inside Korea except one. Conclusion : The HIV-1 subtype B strains are prevalent in Korea from the early HIV infection until present in both homo and heterosexuals. Non B strains have been transmitted from men who were infected outside Korea to their spouses and casual partners. So, we need further study to monitor subtype B and non B HIV transmission in epidemiological groups of Korea, (Korean J Infect Dis 33:311∼318, 2001)

경연 대회를 통한 초ㆍ중고생의 창의력 신장 효과에 관한 연구

이희복,육근철,류해일,김현섭,김희수,박달원,유병환,김선효,김여상,서광수,변두원,서명석,배성효,박종석,심규철,이성희 공주대학교 과학교육연구소 2001 과학교육연구 Vol.32 No.1

미래 사회를 대비하기 위한 개인의 개성을 존중과 창의적인 능력을 지닌 인간을 양성을 목적으로 충청남도 지역의 초 ㆍ 중고등학생들을 대상으로 한 창의력 경연대회가 공주대학교 과학교육연구소에서 개최되었다. 충청남도 초 ㆍ중 ㆍ 고등학생들을 대상으로 실시한 창의력 경연대회는 창조적 아이디어를 내어 스스로 문제를 해결해 나갈 수 있는 교육 프로그램을 제공하는 좋은 기회였음이 확인되었으나, 일부의 팀에서만 참신하고 재미있는 아이디어들이 제안되었다. 여학생의 참가자 수가 상당히 증가하였으며, 대체적으로 입상권의 학생들의 상당 부분이 여학생이라는 것이 특이할만하다. 학년이 올라감에 따라서 창의적인 아이디어를 내는 양이나 질에 있어서 뒤떨어지는 것으로 분석되었으며, 토론 학습의 적응력이 미흡하고 발표력 및 청취력에 있어서도 떨어지는 것으로 나타났다. 따라서 중 ㆍ고등학교의 학교교육에서도 학생들에게 프로젝트형 탐구학습 프로그램의 적용은 물론 토론식 수습을 통한 학생들의 사고의 전환의 기회를 제공해야 할 것으로 사료된다. The creativity competition was held to foster the creativity of elementary and secondary school students in the Institute of Science Education, Kongju national University. It was found that the creativity competition effected on the improvement of inventing creative ideas and problem solving activities. But, only some competitors participated in semifinal and final contests, presented original and interesting ideas. More female students participated in competition than last year. More female participants were awarded a prize than males. Totally, participants were defective in discussion and communication, and presentation and listening ideas. Increasing grades correlated inversely with creativity and originality. There is need of inquiry project teaming programs and presenting opportunities of conversion of thinking by discussing instructions in school

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.