• 제목/요약/키워드: internal medicine

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A Reliability and Validity Study of the Korean versions of the Eating Disorder Examination Questionnaire version 6.0 (EDE-Q version 6.0) and the Clinical Impairment Assessment Questionnaire (CIA) (한국판 섭식장애검사-자기보고형 6.0 (EDE-Q version 6.0) 및 한국판 임상손상평가(CIA)의 신뢰도와 타당도 연구)

  • Bang, Eun Byul;Han, Cho Long;Kim, Yu Ri;Kim, Mirihae;Lee, Young Ho;Heo, Si Young;Kim, Youl-Ri
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.152-163
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    • 2018
  • Objectives : The Eating Disorder Examination Questionnaire, version 6.0 (EDE-Q version 6.0) and the Clinical Impairment Assessment Questionnaire (CIA) measure attitudes and behavioral features of eating disorders and impairments secondary to eating disorders, respectively. The aims of this study were to examine the reliability and the validity of the Korean versions of the EDE-Q version 6.0 and the CIA. Methods : Four hundred nineteen participants (370 female university students and 49 women with eating disorders) completed the EDE-Q version 6.0, the CIA, the Body Shape Questionnaire (BSQ) and the Weight Concern Scale (WCS). Results : Excellent internal consistencies were obtained for the EDE-Q version 6.0 (Cronbach's ${\alpha}=0.92$) and the CIA (Cronbach's ${\alpha}=0.91$). Exploratory factor analysis of CIA extracted the 3 factors of personal, social, and cognitive impairments, as the original CIA had. The EDE-Q version 6.0 and the CIA were well correlated with the BSQ and the WCS, in respect to their contextually concordant variables. Patients with eating disorders had higher scores both in the EDE-Q 6.0 and the CIA than university women had, supporting good discriminant validity. Conclusions : The EDE-Q version 6.0 and the Korean versions of the CIA had adequate reliability and validity. These data will help clinicians and researchers to use the EDE-Q and the CIA in diagnosis, prevention and intervention of eating disorders in Korea.

A Development and Validation Study of the Web-based Korean Version of the Eating Disorder Diagnostic Scale DSM-5 (웹 기반 한국판 섭식장애진단척도 DSM-5의 개발 및 타당화 연구)

  • Lee, Hye Rin;Kwag, Kyung Hwa;Lee, You Kyung;Han, Soo Wan;Kim, Youl-Ri
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.185-193
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    • 2020
  • Objectives : The aim of this study was to develop and to verify the Korean version of the Eating Disorder Diagnosis Scale DSM-5 (K-EDDS) as a web-based diagnostic system, which enables rapid diagnosis of patients for early intervention. Methods : A total of 119 persons participated in the study, including patients with eating disorders (n=38) and college students (n=81). Along with the paper-and-pencil SCOFF, all participants completed the web-based K-EDDS, the Eating Disorder Examination-Questionaire (EDE-Q), and the Clinical Impairment Assessment Questionnaire (CIA). The semi-structured interview using the Eating Disorder Examination Interview (EDE) was conducted for participants with two or more SCOFF scores. Within two weeks, the web-based K-EDDS, the EDE-Q, and the CIA were re-tested. Results : In the exploratory factor analysis, four factors were extracted : body dissatisfaction, binge behaviors, binge frequency and compensatory behaviors. The four subscales of the web-based K-EDDS had significant correlation with each of the four subscales of the EDE-Q. The internal consistency of the web-based K-EDDS was highly satisfactory (Cronbach's alpha=0.93). The diagnostic agreement between the web-based K-EDDS and the EDE was excellent (96.83%), and the web-based K-EDDS's test-retest diagnostic agreement was fairly good (92.86%). The web-based K-EDDS and the CIA also showed significant differences between patients and general population, supporting discriminant validity. Conclusions : This study suggested that the web-based K-EDDS is a valid tool for assisting diagnosis of eating disorders based on DSM-5 in clinical and research fields.

Characteristics and Significance of the Huirang Daesa Sculpture at Haeinsa Temple in Hapcheon (합천(陜川) 해인사(海印寺) 희랑대사상(希朗大師像)의 특징과 제작 의미)

  • Jeong, Eunwoo
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.98
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    • pp.54-77
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    • 2020
  • Produced during the Goryeo period (718-1392), the statue of the monk Huirang Daesa at Haeinsa Temple in Hapcheon is almost life-size, with a height of 82.4 cm, a width of 66.6 cm at the knees, and a maximum width of 44 cm at the torso (front and back). Notably, it is the only known example of an East Asian Buddhist sculpture made from wood and dry lacquer that was formed by joining the front and back halves. However, a similar technique was used on a dry lacquer statue of the Medicine Buddha at Cheongnyangsa Temple in Bonghwa, which is estimated to date from the late Goryeo or early Joseon period. As such, this technique is thought to represent this particular time period. In an eighteenth-century travelogue about a trip to Mt. Gayasan, the author describes a sculpture that is believed to be the statue of Huirang Daesa at Haeinsa Temple, based on various unique features that closely correspond to the sculpture's current appearance. For example, the sculpture is said to have a hole in the chest and rough, knobby tendons and bones, two features that can still be seen today. Another sculpture of a Buddhist monk who was active in the western regions during the third and fourth century also has a hole in the chest, which is said to be a symbol of spiritual strength. The travelogue also states that the statue was lacquered black at the time, which means that it must have been painted with its present colors some time in the nineteenth century. Over time, the sculpture has been enshrined in various halls of Haeinsa Temple, including Haehaengdang, Jinsangjeon, and later Josajeon (Hall of the Patriarchs), and Bojangjeon. Records show that images of Buddhist monks, or "seungsang," were produced in Korea as early as the Three Kingdoms period (18 BCE-660 CE), but few of these works have survived. At present, only four such sculptures are extant, including the images of Huirang Daesa from the Goryeo period, and those of Monk Naong and Uisang Daesa from the Joseon period. Of these, the sculpture of Huirang Daesa has special significance for its early production date (i.e., CE. tenth century), outstanding production techniques, and superb artistic quality, realistically capturing both the external appearance and internal character of the subject. The tradition of producing, sanctifying, and worshipping statues of monks was prevalent not only in Korea, but also in China and Japan. However, each country developed its own preferred materials and techniques for producing these unique images. For example, while China has a large number of mummified Buddhist images (yuksinbul), Japan produced diverse images with various materials (e.g., dry lacquer, wood, clay) according to period. But despite the differences in materials and techniques, the three nations shared the same fundamental purpose of expressing and honoring the inherent spirituality of the monks.

Factors influencing health and quality of life among allergy and asthma patients: With specific focus on self-efficacy, social support and health management (건강과 삶의 질에 영향을 주는 요인에 대한 분석: 자기효능감, 사회적 지원 및 질병관리를 중심으로)

  • Uichol Kim ;Chun-soo Hong ;Jeung-Gweon Lee ;Young-Shin Park
    • Korean Journal of Culture and Social Issue
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    • v.11 no.2
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    • pp.143-181
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    • 2005
  • This article examines factors that influence health and quality of life. In addition to the symptomatology and physiological functioning, the influence of the psychological functioning and interpersonal relationship on the overall health and quality of life are also investigated. Using a case-study approach, a total of 70 patients suffering from allergy or asthma were interviewed using a semi-structured questionnaire developed by the present authors. It assessed the following six areas: Cause and onset of illness, psychological functioning, health management, trust, social support received and overall health and quality of life. Based on the transactional model (Bandura, 1997; Kim & Park, 2005), the results of the case studies have been integrated and divided into three aspects: (1) Cause and onset of illness that includes physiological and environment factors; (2) mediating influences that includes psychological functioning, health management, interpersonal relationship and social support received; and (3) outcome factor that includes symptomatology, health and quality of life. The psychological functioning includes self-efficacy (self-regulated efficacy, efficacy for enlisting social support, efficacy for managing the environment, and efficacy for overcoming difficulties), positive outlook, life goals, experience of stress, and proxy control. Interpersonal relationship includes trust of family members and the physician. Health management includes receiving proper health assessment, following the advice and prescription given by the physicians, control of the environment and maintaining a healthy lifestyle. The results indicate that physiological, psychological, relational and environment factors interact with each other and affect individual's overall health and quality of life. Self-efficacy, social support received from family members, trust of physicians, and the health care system are key factors promoting healthy lifestyle and quality of life. The results indicate the need for further interdisciplinary, indigenous and cultural psychological research.

The Use of Radioactive $^{51}Cr$ in Measurement of Intestinal Blood Loss ($^{51}Cr$을 사용(使用)한 장관내(賜管內) 출혈량측정법(出血量測定法))

  • Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.1
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    • pp.19-26
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    • 1970
  • 1. Sixteen normal healthy subjects free from occult blood in the stool were selected and administered with their $^{51}Cr$ labeled own blood via duodenal tube and the recovery rate of radioactivity in feces and urine was measured. The average fecal recovery rate was 90.7 per cent ($85.7{\sim}97.7%$) of the administered radioactivity, and the average urinary excretion rate was 0.8 per cent ($0.5{\sim}1.5%$) 2. There was a close correlation between the amount of blood administered and the recovery rate from the feces; the more the blood administered, the higher the recovery rate was. It was also found that the administration of the tagged blood in the amount exceeding 15ml was suitable for measuring the radioactivity in the stools. 3. In five normal healthy subjects whose circulating erythrocytes had been tagged with $^{51}Cr$, there was little fecal excretion of radioactivity (average 0.9 ml of blood per day). This excretion is not related to hemorrhage and the main route of excretion of such an negligible radioactivity was postulated as gastric juice and bile. 4. A comparison of the radioactivity in the blood and feces of the patients with $^{51}Cr$ labeled erythrocytes seems to be a valid way of estimating intestinal blood loss.

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The Effects of Preoperative Radiation Therapy in Resectable Rectal Cancer - in view of pathologic aspects - (절제 가능한 직장암에서 수술전 방사선 치료의 효과 -병리 조직학적인 연구를 중심으로-)

  • Choi, Ihl-Bong;Jang-Ji-Young;Kim, In-Ah;Shinn-Kyung-Sub;Lee, Jong-Suh;Chang-Suk-Kyun;Choi, Kyu-Young;Kim, Young-Ha;Kim, Jun-Gi;Chun-Chung-Soo;Kay-Chul-Seung
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.49-56
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    • 1997
  • Purpose : To evaluate the pathologic effects of preoperative radiotherapy o the resectable distal rectal cancer, we analyzed the results of postoperative pathologic findings for the patients with preoperative radiotherapy ant surgery Materials and Methods: From July 1995 to April 1996, we treated sixteen patients of resectable rectal cancer with preoperative radiation therapy and curative surgery At diagnosis, Thomas Jefferson (TJ) system was used for the clinical stage of the Patients. We treated the patients with conventional radiation therapy of 4500~5000cGy before surgery. The surgery was carried out 4 weeks after completion of radiation therapy. Modified Astler Coller (MAC) system was used for the postoperative pathologic stage. We analyzed the pathologic stages and findings according to preoperative clinical stage and compared with those of the control group in similar clinical stages. Result : All patients were treated with sphincter preservation surgery after Preoperative radiation therapy. Pathoiogic complete response (CR) was shown in 1 case $(6.3\%)$. We compared the results between preoperative radiation therapy group (Preop.RT group) and surgery only group (control group). In TJ stage II, among nine patients of Preop.RT group, 8 patients $(88.9\%)$ were in MAC stage 8 except 1 CR patient, but among 17 patients of control group. 11 patients$(64.7\%)$ were in MAC stage B and 6 Patients $(35.3\%)$ in MAC stage C. In TJ stage III, among 7 patients of Preop.RT group, 4 patients $(57.1\%)$ were in MAC stage B and 3 patients$(42.9\%)$ in MAC stage C. Among 14 Patients of control group, 4 patients $(28.6\%)$ were in MAC stage B and 10 Patients $(71.4\%)$ in MAC stage C. Above results showed that postoperative Pathologic stage was decreased in Preop.RT group with statistical significance (P=0.049). The postoperative Pathologic findings (blood vessel invasion. Iymphatic vessel invasion, perineural invasion) were decreased in the Preop.RT group compared with those of control group. But statistical significance was found only in Iymphatic vessel invasion (p=0.019). Conclusion : The Postoperative pathologic stages and adverse Prognostic pathologic findings were decreased in preoperative radiation therapy group. The Iymphatic vessel invasion and MAC stage C findings were abruptly decreased in Preoperative radiation therapy group. The preoperative radiation therapy was found to be effective in resectable rectal cancer. The patients group in our study was very small and long term follow up was not done. Therefore, further study about this issues is needed.

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Comparison of Left Ventricular Volume and Function between 46 Channel Multi-detector Computed Tomography (MDCT) and Echocardiography (16 채널 Multi-detector 컴퓨터 단층촬영과 심초음파를 이용한 좌심실 용적과 기능의 비교)

  • Park, Chan-Beom;Cho, Min-Seob;Moon, Mi-Hyoung;Cho, Eun-Ju;Lee, Bae-Young;Kim, Chi-Kyung;Jin, Ung
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.45-51
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    • 2007
  • Background: Although echocardiography is usually used for quantitative assessment of left ventricular function, the recently developed 16-slice multidetector computed tomography (MDCT) is not only capable of evaluating the coronary arteries but also left ventricular function. Therefore, the objective of our study was to compare the values of left ventricular function quantified by MDCT to those by echocardiography for evaluation of its regards to clinical applications. Material and Method: From 49 patients who underwent MDCT in our hospital from November 1, 2003 to January 31, 2005, we enrolled 20 patients who underwent echocardiography during the same period for this study. Left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), stroke volume index (SVI), left ventricular mass index (LVMI), and ejection fraction (EF) were analyzed. Result: Average LVEDVI ($80.86{\pm}34.69mL$ for MDCT vs $60.23{\pm}29.06mL$ for Echocardiography, p<0.01), average LVESVI ($37.96{\pm}24.52mL$ for MDCT vs $25.68{\pm}16.57mL$ for Echocardiography, p<0.01), average SVI ($42.90{\pm}15.86mL$ for MDCT vs $34.54{\pm}17.94mL$ for Echocardiography, p<0.01), average LVMI ($72.14{\pm}25.35mL$ for MDCT vs $130.35{\pm}53.10mL$ for Echocardiography, p<0.01), and average EF ($55.63{\pm}12.91mL$ for MOCT vs $59.95{\pm}12.75ml$ for Echocardiography, p<0.05) showed significant difference between both groups. Average LVEDVI, average LVESVI, and average SVI were higher in MDCT, and average LVMI and average EF were higher in echocardiogram. Comparing correlation for each parameters between both groups, LVEDVI $(r^2=0.74,\;p<0.0001)$, LVESVI $(r^2=0.69,\;p<0.0001)$ and SVI $(r^2=0.55,\;p<0.0001)$ showed high relevance, LVMI $(r^2=0.84,\;p<0.0001)$ showed very high relevance, and $EF (r^2=0.45,\;p=0.0002)$ showed relatively high relevance. Conclusion: Quantitative assessment of left ventricular volume and function using 16-slice MDCT showed high relevance compared with echocardiography, therefore may be a feasible assessment method. However, because the average of each parameters showed significant difference, the absolute values between both studies may not be appropriate for clinical applications. Furthermore, considering the future development of MDCT, we expect to be able to easily evaluate the assessment of coronary artery stenosis along with left ventricular function in coronary artery disease patients.

Radiation Therapy and Chemotherapy after Breast Conserving Surgery for Invasive Breast Cancer: An Intermediate Result (침윤성 유방암에서 유방보존수술 후 방사선치료 및 항암화학 병용치료의 성적 및 위험인자 분석)

  • Lee, Seok-Ho;Choi, Jin-Ho;Lee, Young-Don;Park, Heoung-Kyu;Kim, Hyun-Young;Park, Se-Hoon;Lee, Kyu-Chan
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.16-25
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    • 2007
  • [ $\underline{Purpose}$ ]: Breast conserving surgery (BCS) followed by chemotherapy (CTx.) and radiation therapy (RT) is widely performed for the treatment of early breast cancer. This retrospective study was undertaken to evaluate our interim results in terms of failure patterns, survival and relative risk factors. $\underline{Materials\;and\;Methods}$: From January 1999 through December 2003, 129 patients diagnosed with invasive breast cancer and treated with BCS followed by RT were subject to retrospective review. The median age of the patients was 45 years (age distribution, $27{\sim}76$ years). The proportions of patients according to their tumor, nodes, and metastases (TNM) stage were 65 (50.4%) in stage I, 41 (31.7%) in stage IIa, 13 (10.1%) in stage IIb, 9 (7.0%) in stage III, and 1 patient (0.8%) in stage IIIc. For 32 patients (24.8%), axillary node metastasis was found after dissection. BCS consisted of quadrantectomy in 115 patients (89.1%) and lumpectomy in 14 patients (10.6%). Axillary node dissection at axillary level I and II was performed for 120 patients (93%). For 7 patients (5.4%), only sentinel node dissection was performed with BCS. For 2 patients (1.6%) axillary dissection of any type was not performed. Postoperative RT was given with 6 MV X-rays. A tumor dose of 50.4 Gy was delivered to the entire breast area using a tangential field with a wedge compensator. An aditional dose of $9{\sim}16\;Gy$ was given to the primary tumor bed areas with electron beams. In 30 patients (23.3%), RT was delivered to the supraclavicular node. Most patients had adjuvant CTx. with $4{\sim}6$ cycles of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens. The median follow-up period was 50 months (range: $17{\sim}93$ months). $\underline{Results}$: The actuarial 5 year survival rate (5Y-OSR) was 96.9%, and the 5 year disease free survival rate (5Y-DFSR) was 93.7%. Local recurrences were noted in 2 patients (true: 2, regional node: 1) as the first sign of recurrence at a mean time of 29.3 months after surgery. Five patients developed distant metastases as the first sign of recurrence at $6{\sim}33$ months (mean 21 months). Sites of distant metastatic sites were bone in 3 patients, liver in 1 patient and systemic lesions in 1 patient. Among the patients with distant metastatic sites, two patients died at 17 and 25 months during the follow-up period. According to stage, the 5Y-OSR was 95.5%, 100%, 84.6%, and 100% for stage I, IIa, IIb, and III respectively. The 5Y-DFSR was 96.8%, 92.7%, 76.9%, and 100% for stage I, IIa, IIb, and III respectively. Stage was the only risk factor for local recurrence based on univariate analysis. Ten stage III patients included in this analysis had a primary tumor size of less than 3 cm and had more than 4 axillary lymph node metastases. The 10 stage III patients received not only breast RT but also received posterior axillary boost RT to the supraclavicular node. During the median 53.3 months follow-up period, no any local or distant failure was found. Complications were asymptomatic radiation pneumonitis in 10 patients, symptomatic pneumonitis in 1 patient and lymphedema in 8 patients. $\underline{Conclusion}$: Although our follow up period is short, we had excellent local control and survival results and reaffirmed that BCS followed by RT and CTx. appears to be an adequate treatment method. These results also provide evidence that distant failure occurs earlier and more frequent as compared with local failure. Further studies and a longer follow-up period are needed to assess the effectiveness of BCS followed by RT for the patients with less than a 3 cm primary tumor and more than 4 axillary node metastases.

Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer (III 기 비소세포성 폐암에서 Cisplatin-방사선동시병합요법의 효과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Jie Young;Song Jung Sub;Lee Sun Hee;Kuak Mun Sub;Shinn Kyung Sub
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.27-36
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    • 1997
  • Purpose : This study was tried to evaluate the Potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate. overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250 cGy given 10 times up to 2500 cGy) was combined with $6mg/m^2$ of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up Period ranged from 36 months to 105 months with median of 62 months. Result : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%, CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%. The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for Patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a Prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs 6% and bone marrow toxicities (25% vs. 15.6% were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%. The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%. In analyses for relationship of field size and Pulmonary toxicity, the Patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

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