03. (종설) hwp

Size: px
Start display at page:

Download "03. (종설) hwp"

Transcription

1 종설 손은희김병준 a 충남대학교병원신경과, 성균관대학교의과대학삼성서울병원신경과 a Clinical Scale for Neuropathic Pain Eun Hee Sohn, MD, Byoung Joon Kim, MD a Department of Neurology, Chungnam National University Hospital, Daejeon, Korea Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea a Neuropathic pain caused by a lesion or disease of the somatosensory nervous system is underdiagnosed and difficult to treat. Questionnaires based on self-reported symptoms have improved diagnosis and management of neuropathic pain. Visual analog scale and numeric rating scale are most well-known unidimensional pain questionnaires. Multidimensional questionnaire or specialized questionnaire for neuropathic pain are more useful to diagnose neuropathic pain. Screening questionnaires help to identify neuropathic pain easily, and assessment questionnaires make it possible to create phenotypic profiles of neuropathic pain and determine an efficacy of management. J Korean Neurol Assoc 39(2 suppl):24-36, 2021 Key Words: Pain, Neuralgia, Questionnaire, Scale 서 론 만성통증은발병기전에따라통각통증 (nociceptive pain) 과신경병통증 (neuropathic pain) 으로구분할수있다. 1 통각통증은조직의손상, 외상, 염증등에의해발생하는통증으로정상감각신경계를통해전달된다. 관절염이나힘줄염, 외상에의한통증이대표적이며, 조직을보호하는중요한역할을한다. 이와달리신경병통증은감각신경계의손상이나질환으로발생하는통증으로대상포진후신경통, 당뇨병말초신경병에동반된통증등이대표적이다. 1,2 신경병통증은비정상적통증으로, 수면장애나우울증을유발하여삶의질을저하시킨다. 약물이나중재시술로신경병통증을치료하지만, 아직까지만족할만한치료법이없으며, 치료에도불구하고만성화되는경우가많아초기에신경병통증을진단하고치료를시작하는것이중요하다. 따라서만성통증을호소하는환자에서신 Received September 28, 2020 Revised December 18, 2020 Accepted December 18, 2020 Address for correspondence: Byoung Joon Kim, MD Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel: Fax: 경병통증의동반여부를확인하여적절히치료하는것이중요하다. 신경병통증의진단을위해서는우선신경병통증이동반되었는지확인하는과정이필요하며, 환자가작성하는설문지나검사자의인터뷰를통해동반여부와통증양상을파악한다. 현재까지통증과관련된다양한설문지가개발되어있으며, 신경병통증을진단하기위해서는통증평가설문지와신경병통증에특화된설문지를사용하고있다. 통증평가설문지는한가지증상에대해정량평가하는단순평가설문지 (unidimensional pain questionnaire) 와통증을포함한다양한증상에대해평가하는다면평가설문지 (multidimensional pain questionnaire) 가있다. 3 신경병통증에특화된설문지는크게선별검사설문지 (screening questionnaire) 와평가설문지 (assessment questionnaire) 로구분할수있다. 4 대개의만성통증환자는신경병통증과통각통증이혼재되어있는경우가많기때문에만성통증환자에서신경병통증동반여부를파악하기위해선별검사설문지를사용하며, 신경병통증의치료효과를판단하기위해평가설문지를사용한다. 24 대한신경과학회지제 39 권제 2 호부록 1, 2021

2 본론 1. 통증평가설문지 1) 단순평가설문지단순평가설문지는통증의정도를환자가표시하게하는가장단순한방법으로이해하기쉽고수행하는시간이오래걸리지않으므로빠르게통증의정도를판단하기에좋은방법이다. 그러나통증의정도외에여러가지다양한통증의양상이나빈도등다른정보를알지못하는단점이있고, 환자가한번보고하는것에의존하므로신뢰도가떨어질수있는단점이있다. (1) 시각통증등급 (Visual Analogue Scale, VAS) VAS는길이가정해진선위에통증의정도를환자가스스로표시하도록하는방법이다 (Appendix 1) mm 선을긋고, 선의시작부분은 통증이전혀없는상태 이고 100 mm 끝부분은 상상할수있는가장심한통증 으로가정하여현재통증이얼마나심한지선위에표시하도록하여통증의정도를측정한다. 선의시작부분부터환자가표시한부분까지길이를측정하여길이가 0-4 mm 이내인경우는통증이없는상태, 5-44 mm는경미한통증, mm는중등도통증, mm는심한통증으로판독하기도한다. 5 VAS를수행하기위해서는훈련을할필요가없고간편하게할수있는장점이있지만, 인지기능이떨어지는환자에서는검사의신뢰도가떨어지고전화로시행할수없는단점이있다. (1) 맥길통증척도설문지 (MPQ) MPQ는현재또는지난 1주일간의평균적인통증에대해검사자가환자에게인터뷰를통해시행하는설문지이다. 통증을자세하게표현하기위해아래의여러영역별설문항목이있다. 1) 통증의부위를신체그림에표시하고, 2) 통증의양상을감각 (sensory), 감정, 평가 (evaluative) 그리고기타 (miscellaneous) 의 4개의하위범주로구분하여각각범주에맞는증상을나열하여확인하며, 3) 통증의정도를범주형으로표시한다. 8 MPQ는통증의양상을다양한용어로표현함으로써통증의양과질을적절히평가하며, 관절통을포함한다양한통증에서신뢰도가입증되었다. 9,10 또한신경병통증의양상을표현하는용어가많이포함되어있어신경병통증과통각통증의구별에도도움을준다. 3 그러나사용하는용어가많아서시간이오래걸리며, 환자가용어를이해할수있도록설명이필요하다는단점이있다. (2) 단축형맥길통증척도설문지 (Short-Form McGill Pain Questionnaire, SF-MPQ) SF-MPQ는용어가너무많은 MPQ의단점을보완하기위해감각범주에서 11개의용어와감정범주에서 4개의용어를뽑아각각의심한정도를확인하고, 전체통증의정도를측정하도록고안되었다 년에는신경병통증을감별하기위해신경병통증에해당하는 7개의항목을추가하여총 22항목을 0-10까지수치로척도화하도록한 SF-MPQ-2 가고안되었다. 12 다양한통증을유발하는질환과여러언어에서유용성이입증되었으며, 13,14 SF-MPQ 한국어판도신뢰도가입증되어있다 (Appendix 2). 15 (2) 수치통증척도 (Numerical Rating Scale, NRS) NRS는 VAS를수치화하여 0-10까지숫자로표현한것이다 (Appendix 1). 즉환자에게 0은 통증이전혀없는상태 이고 10은 상상할수있는가장심한통증 으로가정하도록하여현재통증의정도를숫자로말하도록한다. 6 만성통증환자들에서 NRS가이해하기쉽고수행하기쉬워 VAS보다더선호한다는연구결과가있었다. 7 또한 NRS는말로표현할수있기때문에전화를이용한설문조사에서사용할수있는장점이있다. 2) 다면평가설문지통증의정도뿐만아니라통증의위치와양상, 정동 (affect) 등의다양한면을평가할수있도록고안된설문지이다. 여러가지설문지가고안되었으나, 맥길통증척도설문지 (McGill Pain Questionnaire, MPQ) 가신경병통증에가장널리사용되고있다. 2. 신경병통증설문지신경병통증은자극없이가만히있는상태에서발생하는자발통증 (spontaneous pain) 과자극에의해발생하는유발통증 (evoked pain) 으로나타날수있다. 자발통증은저리다, 찌릿하다, 따끔거린다, 화끈거린다, 시리다, 둔하다, 아프다등의다양한말로표현하며, 16 계속지속되기도하지만간헐적혹은돌발적으로나타날수도있다. 유발통증은기계적 (mechanical) 자극, 차갑거나뜨거운온도자극에의해유발되는통증으로통각과민 (hyperalgesia) 이나무해자극통증 (allodynia) 으로나타난다. 따라서신경병통증을진단하고정도를평가하기위한설문지는이런다양한증상의정도와통증부위, 빈도등을확인하도록구성되어있다. J Korean Neurol Assoc Volume 39 No. 2 Supplement 1,

3 손은희김병준 1) 선별검사설문지대부분의신경병통증설문지는선별검사를위해개발되었으며, LANSS (Leeds Assessment of Neuropathic Symptoms and Signs), 17 신경병통증설문지 (Neuropathic Pain Questionnaire, NPQ) 18 DN4 (Douleur Neuropathique 4 Questions), 19 ID통증 (ID pain TM Pfizer Inc.), 20 paindetect 21 등이이에해당된다. 선별검사설문지들은모두신경병통증진단에높은민감도 (67-85%) 와특이도 (74-90%) 를보이고있으며, 4 그중 LANSS, DN4와 paindetect (Appendix 3) 가세계여러나라에서주로사용되고있다. 22 선별검사설문지는다양한증상에대한내용과신체진찰로이루어져있으며, 서로중복되는항목이있으므로목적에맞는적절한설문지를선택하여사용하도록한다 (Table 1). 선별검사설문지를사용하면비통증전문가도복합통증환자에서신경병통증을쉽고빠르게발견할수있는장점이있는반면, 신체진찰이포함되지않거나적게포함되어있어설문지만으로는진단의정확도가떨어지는단점이있다. 따라서선별검사설문지를시행하여신경병통증이동반되었음이의심되는환자는신경계진찰을시행하여신경의손상여부를확인하는것이필요하다. 또한선별검사설문지는특정부위의통증에국한해서설문조사를하므로전신에퍼져있는통증의정도를판단하지못하고, 삼차신경통진단에는사용할수없는단점이있다. 4 2) 평가설문지신경병통증을임상양상에따라분류하고치료에대한반응을판단하기위해평가설문지를사용한다. 과거발병기전에따라신경병통증을치료하려던시도는발병기전을밝히기어려워서실패하였고, 최근에는임상양상에따라신경병통증환자를분류하여이에맞는치료를하려는시도가이루어지고있다. 임상양상에따 Table 1. Components of screening and assessment questionnaires for neuropathic pain Questionnaire Screening Assessment LANSS NPQ DN4 ID pain paindetect NPS NPSI Symptoms reported Spontaneous symptoms Prickling, tingling, pins & needles Electric shocks, shooting Hot or burning Numbness Painful cold or freezing pain Dull, squeezing Evoked by Light touching Mild pressure + + Heat or cold + + Change in weather + Itching Pain limited to joints - Temporal patterns Radiation of pain + Autonomic change + Physical examination Brush allodynia + + Raised soft touch threshold + pinprick thresholdraised + + The minus sign (-) indicates items that reduce the score. LANSS; Leeds Assessments of Neuropathic Symptoms and Signs, NPQ; Neuropathic Pain Questionnaire, DN4; Douleur Neuropathique 4 Questions, NPS; Neuropathic Pain Scale, NPSI; Neuropathic Pain Symptom Inventory. 26 대한신경과학회지제 39 권제 2 호부록 1, 2021

4 라신경병통증환자를분류하기위해서는다양한증상에대한평가가필요하며, 이를위해서신경병통증의평가설문지와정량감각검사 (quantitative sensory testing) 를시행한다. 신경병통증척도 (Neuropathic Pain Scale, NPS) 23 와신경병통증증상목록 (Neuropathic Pain Symptom Inventory [NPSI]) 24 이평가설문지로개발되어신뢰도가입증된대표적인예이다. 이들은선별설문지와유사한증상을평가하고있으나무감각 (numbess) 과같은음성증상 (negative symptom) 에대한평가를하지않는단점이있다 (Table 1). paindetect는선별검사설문지로개발되었으나여러연구들에서평가설문지로도사용될수있음이입증되었으며, 25,26 한국어번역본의신뢰도도입증되었다. 27 SF-MPQ-2는신경병통증뿐만아니라다양한통증에서평가를위한설문지로널리알려져있다. 3) 한국어신경병통증설문지 (Korean Neuropathic Pain Questionnaire, KNPQ) 국내다기관신경과연구자들이모여 2012년 LANSS, 17 NPQ, 18 DN4, 19 ID통증, 20 NPS 23 와 NPSI 24 를한글로번역하고중복되는항목은삭제하여총 25문항으로구성된 KNPQ를개발하였다 (Table 2, Appendix 4). 28 신경병통증과비신경병통증으로나뉘는환자 120명을대상으로 KNPQ를시행하여 KNPQ의신뢰도를확인하였고, 각항목중신경병통증의선별검사에유용한항목과평가에유용한항목을모아추가설문지를제작하였다. 이후 KNPQ를이용한후속연구는없어추가연구가필요한상태이지만, 신경병통증의선별과평가를위해한국어로신뢰도가입증된유용한설문지로생각된다. Table 2. KNPQ items from 4 screening tools and 2 rating scales KNPQ item LANSS item NPQ item DN4 item ID pain item NPS item NPSI item , 10-2 a , 10-2 a 6 4, 10-1 b b b KNPQ; Korean Neuropathic Pain Questionnaire, LANSS; Leeds Assessment of Neuropathic Symptoms and Signs, NPQ; Neuropathic Pain Questionnaire, DN4; Douleur Neuropathique 4 Questions, NPS; Neuropathic Pain Scale, NPSI; Neuropathic Pain Symptom Inventory. NPS item 10 consists of 2 subunits (10-1 b and 10-2 a subitems). J Korean Neurol Assoc Volume 39 No. 2 Supplement 1,

5 손은희김병준 결 론 신경병통증은다양한증상으로나타나며, 다른통증과복합되어나타나는경우가흔하므로만성통증환자에서신경병통증을찾아내고적절히치료하는것은중요하다. VAS와 NRS는빠른시간내에통증의정도를파악할수있는장점이있지만, 그외의정보는알수없는단점이있다. 다양한증상을확인하고통증정도를파악하기위해서는 SF-MPQ 같은다면평가척도가필요하다. 만성통증을호소하는환자에서신경병통증혼재여부를확인하기위해 LANSS, DN4, paindetect와같은선별검사설문지를활용하고, 신경병통증이의심되는경우병력청취와신경계진찰을통해신경병통증을되도록빨리진단하는것이통증조절에중요하다. 신경병통증을적절히치료하기위해서임상양상에따른분류가도움이되므로 NPS나 NPSI 같은신경병통증평가설문지를시행하여임상양상에따라통증을분류할수있으며, 또한평가설문지는치료전후를비교하여치료의효과를판단하는데에도움을줄수있다. paindetect는신경병통증의선별검사와평가에모두사용할수있으며, 한국어로번역되어신뢰도가입증된설문지이다. KNPQ는여러가지를한국어로번역하고조합하여신경병통증의선별과평가를위해개발된임상척도로, 한국인의신경병통증진단과치료에유용할것으로생각된다. 본원고에서소개한한국어판설문지인 SF-MPQ, paindetect, KNPQ는개인적으로환자진료를위해사용시허가를받거나사용요금을내지않아도되므로임상진료에도움이될것으로생각된다. Acknowledgements 이논문은 2005년대한신경과학회지별책으로발간된 ' 근신경계질환임상척도 에게재된종설을개정보완한것이다. REFERENCES 1. Interantional Association for the Study of Pain (IASP). IASP Terminology. [online] [cited 2017 Dec 14]. Available from: URL: 2. McCarberg B, D'Arcy Y, Parsons B, Sadosky A, Thorpe A, Behar R. Neuropathic pain: a narrative review of etiology, assessment, diagnosis, and treatment for primary care providers. Curr Med Res Opin 2017;33: Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form mcgill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res (Hoboken) 2011;63 Suppl 11:S240-S Attal N, Bouhassira D, Baron R. Diagnosis and assessment of neuropathic pain through questionnaires. Lancet Neurol 2018;17: Jensen MP, Chen C, Brugger AM. Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain 2003;4: Rodriguez CS. Pain measurement in the elderly: a review. Pain Manag Nurs 2001;2: de Williams AC, Davies HTO, Chadury Y. Simple pain rating scales hide complex idiosyncratic meanings. Pain 2000;85: Melzack R. The McGill pain questionnaire: major properties and scoring methods. Pain 1975;1: Papageorgiou AC, Badley EM. The quality of pain in arthritis: the words patients use to describe overall pain and pain in individual joints at rest and on movement. J Rheumatol 1989;16: Gandhi R, Tsvetkov D, Dhottar H, Davey JR, Mahomed NN. Quantifying the pain experience in hip and knee osteoarthritis. Pain Res Manag 2010;15: Melzack R. The short-form McGill pain questionnaire. Pain 1987;30: Dworkin RH, Turk DC, Revicki DA, Harding G, Coyne KS, Peirce-Sandner S, et al. Development and initial validation of an expanded and revised version of the short-form McGill pain questionnaire (SF-MPQ-2). Pain 2009;144: Dworkin RH, Turk DC, Trudeau JJ, Benson C, Biondi DM, Katz NP, et al. Validation of the short-form McGill pain questionnaire-2 (SF-MPQ-2) in acute low back pain. J Pain 2015;16: Hasvik E, Haugen AJ, Haukeland-Parker S, Rimehaug SA, Gjerstad J, Grøvle L. Cross-cultural adaptation and validation of the norwegian short-form McGill pain questionnaire-2 in low back-related leg pain. Spine (Phila Pa 1976) 2019;44:E774-E Choi SA, Son C, Lee JH, Cho S. Confirmatory factor analysis of the Korean version of the short-form McGill pain questionnaire with chronic pain patients: a comparison of alternative models. Health Qual Life Outcomes 2015;13: Boureau F, Doubrère JF, Luu M. Study of verbal description in neuropathic pain. Pain 1990;42: Bennett M. The LANSS pain scale: the Leeds assessment of neuropathic symptoms and signs. Pain 2001;92: Krause SJ, Backonja MM. Development of a neuropathic pain questionnaire. Clin J Pain 2003;19: Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 2005;114: Portenoy R. Development and testing of a neuropathic pain screening questionnaire: ID pain. Curr Med Res Opin 2006;22: Freynhagen R, Baron R, Gockel U, Tölle TR. paindetect: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin 2006;22: Bouhassira D, Attal N. Diagnosis and assessment of neuropathic pain: the saga of clinical tools. Pain 2011;152:S74-S Galer BS, Jensen MP. Development and preliminary validation of a pain measure specific to neuropathic pain: the neuropathic pain scale. Neurology 1997;48: 대한신경과학회지제 39 권제 2 호부록 1, 2021

6 24. Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E, et al. Development and validation of the neuropathic pain symptom inventory. Pain 2004;108: Keller T, Freynhagen R, Tölle TR, Liwowsky I, Möller P, Hüllemann P, et al. A retrospective analysis of the long-term test-retest stability of pain descriptors of the paindetect questionnaire. Curr Med Res Opin 2016;32: Packham TL, Cappelleri JC, Sadosky A, MacDermid JC, Brunner F. Measurement properties of paindetect: Rasch analysis of responses from community-dwelling adults with neuropathic pain. BMC Neurol 2017;17: Sung JK, Choi JH, Jeong J, Kim WJ, Lee DJ, Lee SC, et al. Korean version of the paindetect questionnaire: a study for cultural adaptation and validation. Pain Pract 2017;17: Yun DJ, Oh J, Kim BJ, Lim JG, Bae JS, Jeong D, et al. Development of Korean neuropathic pain questionnaire for neuropathic pain screening and grading: a pilot study. J Korean Neurol Assoc 2012;30: J Korean Neurol Assoc Volume 39 No. 2 Supplement 1,

7 손은희김병준 Appendix 1. Scales on a single dimension Visual Analog Scale (VAS) Instruction: Mark on the line below the amount how strong your pain is right now. No pain at all The worst pain imaginable Numeric Rating Scale (NRS) Instruction: Choose a number from 0 to 10 which indicates how strong your pain is right now. No pain at all The worst pain imaginable Adapted from Hawker et al. 3 with permission of John Wiley and Sons. Appendix 2. Short-Form McGill Pain Questionnaire (SF-MPQ) A. 지난한주동안당신이느낀통증양상을표시해주시기바랍니다. 각항목당한개의칸에만표시해주시기바랍니다. 전혀없음 약한통증 중간정도의통증 심한통증 욱신거리는 쿡쿡쑤시는 찌르듯이아픈 날카로운양상의 뒤틀리듯이아픈 갉아먹는듯이아픈 화끈거리는 아리는 뻐근한 누르면아픈 쪼개지듯이아픈 피곤하고기진맥진한 ( 구역질나게 ) 메스꺼운 그런통증을다시겪는다고생각하기만해도겁나는 통증이있을때는마치내가벌을받고있는것같이비참한 B. 지난한주동안느꼈던당신의통증정도를 ( ) 표시해주세요 상상가능한가장심한통증 C. 현재느끼는당신의통증강도에대해표시해주세요. 0 (no pain) 1 약한정도의통증 (mild) 2 불편한혹은불쾌한정도의통증 (discomfort) 3 괴로운정도의통증 (distressing) 4 고통스러운정도의통증 (horrible) 5 극도로심하게고통스러운통증 (excruciating) SF-MPQ-2 R. Melzack and the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT), 대한신경과학회지제 39 권제 2 호부록 1, 2021

8 Appendix 3. paindetect 주된통증부위를표시하십시오. 통증이신체다른부분으로퍼집니까? 예 아니오 예인경우, 통증이퍼지는방향을그려주십시오. 지금현재귀하의통증이어느정도라고평가하시겠습니까? 없음 최대 지난 4주간가장심한통증이얼마나심했습니까? 없음 최대 지난 4주간통증이평균적으로얼마나심했습니까? 없음 최대 귀하의통증경과를가장잘설명하는그림에표시하십시오. 약간의기복이있는지속적인통증 통증발작이있는지속적인통증 통증발작사이에는통증이없음 통증발작사이에통증이있음 J Korean Neurol Assoc Volume 39 No. 2 Supplement 1,

9 손은희김병준 Appendix 3. Continued 표시한부위에타는듯한느낌 ( 예 : 쏘는통증 ) 이있습니까? 통증부위에저리거나따끔거림 ( 개미가기어가는듯하거나전기로인해찌릿함 ) 을느끼십니까? 이부위에가볍게닿으면 ( 옷, 담요 ) 통증을느끼십니까? 통증부위에전기충격과같은갑작스러운통증발작이있습니까? 차가움또는열 ( 목욕물 ) 로인해이부위에종종통증을느끼십니까? 표시한부위가무감각합니까? 이부위를약간눌러도 ( 예 : 손가락으로 ) 통증이있습니까? 통증설문조사채점 전혀없음거의없음약간중간정도심함매우심함 합산한점수 / 총 35 점 표시한통증양상및통증퍼짐에따라다음숫자를가감하십시오. 이를다합하여최종점수를계산하십시오. 약간의기복이있는지속적인통증 통증발작이있는지속적인통증 표시된경우, 또는 통증발작사이에는통증이없음 통증발작사이에통증이있음 표시된경우, 또는 표시된경우 통증퍼짐? 표시된경우 최종점수 32 대한신경과학회지제 39 권제 2 호부록 1, 2021

10 Appendix 3. Continued 최종점수 없음불분명있음 신경병증성통증가능성이적음 (<15%) 결과가확실하지않으나, 신경병증성통증가능성이있음 신경병증성통증가능성이큼 (>90%) Adapted from Sung et al. 27 with permission from Pfizer. J Korean Neurol Assoc Volume 39 No. 2 Supplement 1,

11 손은희김병준 Appendix 4. 한국어신경병통증설문지 (Korean Neuropathic Pain Questionnaire, KNPQ) 지난일주일동안느낀통증의감별과평가를위한질문들입니다. 질문에해당하는통증이없는경우에는 0 에표시하시고, 통증이있는경우그정도를해당하는숫자에표시해주세요. 1. 핀이나바늘로찌르듯따끔거리는통증입니까? 2. 칼이나송곳으로후벼파는듯한통증입니까? 3. 전기오듯이찌릿찌릿한통증입니까? 4. 화끈거리는통증입니까? 5. 시린통증입니까? 6. 뻐근하거나묵직한통증입니까? 7. 꽉죄는듯한통증입니까? 8. 눌리는듯한통증입니까? 34 대한신경과학회지제 39 권제 2 호부록 1, 2021

12 Appendix 4. Continued 9. 통증부위가가볍게닿아도통증이유발되거나악화됩니까? 10. 누르면통증이유발되거나악화됩니까? 11. 차가운것이닿으면통증이유발되거나악화됩니까? 12. 피가안통할때처럼저리는통증입니까? 13. 통증부위가치과에서마취한듯남의살같거나감각이둔합니까? 감각둔함없음 전혀감각을느끼지못함 14. 통증부위가벌레가기어가는듯하거나가렵습니까? 가려움없음 상상할수있는최대가려움 15. 통증부위를만지면더아프게 ( 예민하게 ) 느껴집니까? 예민함없음 상상할수있는최악의예민함 16. 통증부위의피부색깔이정상부분과다릅니까? 다르지않음 완전히다름 J Korean Neurol Assoc Volume 39 No. 2 Supplement 1,

13 손은희김병준 Appendix 4. Continued 17. 통증의정도가얼마나심합니까? 18. 통증때문에얼마나힘들거나불편합니까? 불편하지않음 상상할수있는최악의불편한통증 19. 평소견딜수없이아파서통증때문에일상생활에지장을받습니까? 지장없음 상상할수있는최악의일상생활지장 20. 날씨에따라통증이심해집니까? 심해지지않음 상상할수있는최대로심해짐 21. 통증이관절에만있습니까? 예 / 아니오 22. 지난 24 시간동안저절로발생한통증이얼마나오랫동안지속되었습니까? ( ) 1 지속적으로 2 8 시간 ~12 시간미만 3 3 시간 ~8 시간미만 4 1 시간 ~3 시간미만 5 1 시간미만 23. 지난 24 시간동안통증이얼마나자주발생하였습니까? ( ) 1 21 회이상 2 11 회 ~20 회 3 6 회 ~10 회 4 1 회 ~5 회 5 통증이없었다 24. 지난일주일동안느끼신통증을느낀대로표현해주세요. ( 예 : 화닥거린다, 우리하다등 ) Adapted from Yun et al. 28 with permission. 36 대한신경과학회지제 39 권제 2 호부록 1, 2021

저작자표시 - 비영리 - 동일조건변경허락 2.0 대한민국 이용자는아래의조건을따르는경우에한하여자유롭게 이저작물을복제, 배포, 전송, 전시, 공연및방송할수있습니다. 이차적저작물을작성할수있습니다. 다음과같은조건을따라야합니다 : 저작자표시. 귀하는원저작자를표시하여야합니다. 비

저작자표시 - 비영리 - 동일조건변경허락 2.0 대한민국 이용자는아래의조건을따르는경우에한하여자유롭게 이저작물을복제, 배포, 전송, 전시, 공연및방송할수있습니다. 이차적저작물을작성할수있습니다. 다음과같은조건을따라야합니다 : 저작자표시. 귀하는원저작자를표시하여야합니다. 비 저작자표시 - 비영리 - 동일조건변경허락 2.0 대한민국 이용자는아래의조건을따르는경우에한하여자유롭게 이저작물을복제, 배포, 전송, 전시, 공연및방송할수있습니다. 이차적저작물을작성할수있습니다. 다음과같은조건을따라야합니다 : 저작자표시. 귀하는원저작자를표시하여야합니다. 비영리. 귀하는이저작물을영리목적으로이용할수없습니다. 동일조건변경허락. 귀하가이저작물을개작, 변형또는가공했을경우에는,

More information

Lumbar spine

Lumbar spine Lumbar spine CT 32 111 DOI : 10.3831/KPI.2010.13.2.111 Lumbar Spine CT 32 Received : 10. 05. 23 Revised : 10. 06. 04 Accepted : 10. 06. 11 Key Words: Disc herniation, CT scan, Clinical analysis The Clinical

More information

Rheu-suppl hwp

Rheu-suppl hwp Objective: This paper reviews the existing Korean medical and public health, and nursing academy articles on disease-specific and domain-specific quality of life, and provides recommendations for the universally

More information

012임수진

012임수진 Received : 2012. 11. 27 Reviewed : 2012. 12. 10 Accepted : 2012. 12. 12 A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar

More information

975_983 특집-한규철, 정원호

975_983 특집-한규철, 정원호 Focused Issue of This Month Gyu Cheol an, MD Department of Otolaryngology ead & Neck Surgery, Gachon University of College Medicine E - mail : han@gilhospital.com Won-o Jung, MD Department of Otolaryngology

More information

139~144 ¿À°ø¾àħ

139~144 ¿À°ø¾àħ 2 139 DOI : 10.3831/KPI.2010.13.2.139 2 Received : 10. 04. 08 Revised : 10. 04. 26 Two Case Report on Wrist Ganglion Treated with Scolopendrid Pharmacopuncture Accepted : 10. 05. 04 Key Words: Wrist Ganglion,

More information

* ** *** ****

* ** *** **** * ** *** **** - 47 - - 48 - - 49 - - 50 - - 51 - 구분범주빈도 ( 명 ) 비율 (%) 성별연령장애유형장애정도 남자 92 65.71 여자 48 34.28 3~6세 ( 학령전기 ) 70 50.00 7~10세 ( 학령기 ) 70 50.00 자폐성장애 53 37.85 지적장애 71 50.71 기타 16 11.42 경미한정도 31

More information

페링야간뇨소책자-내지-16

페링야간뇨소책자-내지-16 야간뇨의진단과치료 - 실제적접근 - Reference 1. Choo MS, Ku JH, Park CH et al. Prevalence of Nocturia in a Korean Population Aged 40 to 89 Years. Neurourol Urodyn 2008; 27:60-64. 2. Weiss JP. Prevalence

More information

Abstract Background : Most hospitalized children will experience physical pain as well as psychological distress. Painful procedure can increase anxie

Abstract Background : Most hospitalized children will experience physical pain as well as psychological distress. Painful procedure can increase anxie Volume 12, Number 1, 92~102, An Intervention Study of Pain Reduction during IV Therapy in Hospitalized Children Myo-Jin Kim 1), Joung-Hae Bak 1), Won-Seok Seo 2) Mi-Young Kim 3), Sun-Kyoung Park 3), Jai-Soung

More information

(

( 317 318 319 320 1 3 5 5 5 5 2 321 : 1.,,,,, 06 2. X-ray beam penetration (density) (contrast) 03 3. patch coating, precipitation, flaking 03 4. centering 03 5. Esophagus, cardia, fundus, body, angle, antrum,

More information

A 617

A 617 Special Issue Diabetic Retinopathy Won Ki Lee, M.D. Department of Ophthalmology The Catholic University of Korea College of Medicine Kangnam St. Mary s Hospital E mail : wklee@catholic.ac.kr Abstract R

More information

16(1)-3(국문)(p.40-45).fm

16(1)-3(국문)(p.40-45).fm w wz 16«1y Kor. J. Clin. Pharm., Vol. 16, No. 1. 2006 x w$btf3fqpsu'psn û w m w Department of Statistics, Chonnam National University Eunsik Park College of Natural Sciences, Chonnam National University

More information

04조남훈

04조남훈 Received : 2011. 11. 16 Reviewed : 2011. 11. 25 Accpeted : 2011. 12. 5 A Case Report of Prescribing Yanghyeolgeopung-tang(yangxuequfeng-tang) to Two Patients with Cervical Disc Herniation and Headache

More information

노인정신의학회보14-1호

노인정신의학회보14-1호 제14권 1호 통권 제23호 www.kagp.or.kr 발행인 : 정인과 / 편집인 : 이동우 / 발행처 : 정인과 (152-703) 서울특별시 구로구 구로동 80번지 고려대학교 구로병원 정신과 / TEL : 02-818-6608 / FAX : 02-852-1937 발행일 : 2008년 4월 30일 / 제 작 : (주)엠엘커뮤니케이션 140-846 서울특별시

More information

01.내지완완

01.내지완완 6 7 9 10 11 12 15 16 17 18 19 23 24 25 26 27 28 29 30 33 34 35 36 37 38 39 40 41 42 43 44 45 46 49 50 51 52 53 54 55 56 59 60 61 65 66 67 68 69 70 71 72 73 74 75 76 77 진료기록부번호 : 기록날짜 : 년/ 월/ 일 아래의 증상이

More information

ECG & EP CASES Young-Keun On, MD, PhD Division of Cardiology, Department of Medicine Cardiac & Vascular Center, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea A case of

More information

........-55..9.30

........-55..9.30 MYONGJI ST. MARY S HOSPITAL EXCELLENT STROKE TREATMENT CENTER The president of Myongji St. Mary s Hospital M.D. HUH, CHOON WOONG Graduated from Seoul Catholic Medical College. Achived M.D. in Neurosurgeon.

More information

109~120 õÃʾàħ Ä¡·á

109~120  õÃʾàħ Ä¡·á 109 DOI : 10.3831/KPI.2010.13.3.109 Received : 10. 08. 13 Revised : 10. 09. 06 A Case Study Of Patients With Knee Joint Pain Treated With Rubiae Radix Pharmacopuncture Accepted : 10. 09. 07 Key Words:

More information

ÀÇÇа�ÁÂc00Ì»óÀÏ˘

ÀÇÇа�ÁÂc00Ì»óÀÏ˘ Common Allergic Diseases in Children Sang - Il Lee, M.D. Department of pediatrics Sungkyunkwan University School of Medicine, Samsung Medical Center E - mail : silee@smc.samsung.co.kr Abstract Allergy

More information

A Study on the Relationships between Self-Differentiation and Adaptability Factors for Senior Dementia Patients Care Givers Department of Social Welfare, Seoul Welfare Graduate University Full-time Lecturer

More information

433대지05박창용

433대지05박창용 Recent Changes in Summer Precipitation Characteristics over South Korea Changyong Park* JaYeon Moon** Eun-Jeong Cha*** Won-Tae Yun**** Youngeun Choi***** 1958 2007 6 9 6 9 10 10 10 10 10 Abstract This

More information

Jkcs022(89-113).hwp

Jkcs022(89-113).hwp 대한배뇨장애 및 요실금 학회지 J. Korean Continence Society 2004;8:89-113 Bristol Female Lower Urinary Tract Symptom 설문지의 한국어 번역 및 번역본의 언어 타당도 Seung-June Oh*, Hyung Geun Park*, Sung Hyun Paick, Won Hee Park and Myung-Soo

More information

<283732372D3733312920B4D9C3CAC1A120BCD2C7C1C6AEC4DCC5C3C6AEB7BBC1EEC0C720B3EBBEC8C0C720BDC3B7C2BAB8C1A4BFA120B4EBC7D120C0AFBFEBBCBA20C6F2B0A1283035292E687770>

<283732372D3733312920B4D9C3CAC1A120BCD2C7C1C6AEC4DCC5C3C6AEB7BBC1EEC0C720B3EBBEC8C0C720BDC3B7C2BAB8C1A4BFA120B4EBC7D120C0AFBFEBBCBA20C6F2B0A1283035292E687770> 대한안과학회지 제 49 권 제 5 호 2008 J Korean Ophthalmol Soc 49(5):727-731, 2008 DOI : 10.3341/jkos.2008.49.5.727 다초점 소프트콘택트렌즈의 노안의 시력보정에 대한 유용성 평가 김현경 1 김효명 2 정성근 1 가톨릭대학교 의과대학 성모병원 안과학교실 1, 고려대학교 의과대학 안암병원 안과학교실

More information

Àå¾Ö¿Í°í¿ë ³»Áö

Àå¾Ö¿Í°í¿ë ³»Áö Disability & Employment 55 Disability & Employment 56 57 Disability & Employment 58 59 Disability & Employment 60 61 Disability & Employment 62 63 Disability & Employment 64 65 Disability & Employment

More information

03이경미(237~248)ok

03이경미(237~248)ok The recent (2001-2010) changes on temperature and precipitation related to normals (1971-2000) in Korea* Kyoungmi Lee** Hee-Jeong Baek*** ChunHo Cho**** Won-Tae Kwon*****. 61 (1971~2000) 10 (2001~2010).

More information

386-390.hwp

386-390.hwp 386 HANYANG MEDICAL REVIEWS Vol. 29 No. 4, 2009 우리나라 미숙아의 통계와 의료비용 Statistics and Medical Cost of Preterm in Korea 윤혜선 을지대학교 노원을지병원 소아청소년과학교실 Hye Sun Yoon, M.D., Ph.D., Department of Pediatrics, Nowon

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA 27(2), 2007, 96-121 S ij k i POP j a i SEXR j i AGER j i BEDDAT j ij i j S ij S ij POP j SEXR j AGER j BEDDAT j k i a i i i L ij = S ij - S ij ---------- S ij S ij = k i POP j a i SEXR j i AGER j i BEDDAT

More information

12이문규

12이문규 Review on Conservative Treatment of Spinal Scoliosis Moon-kyu Lee, O.M.D., Gil-jae Lee, O.M.D., Yun-kyung Song, O.M.D., Hyung-ho Lim, O.M.D. Dept. of Oriental Rehabilitation Medicine College of Oriental

More information

충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~ Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교

충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~ Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교 충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~5 2017 Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교의과대학마취통증의학교실, 의학연구소 (28644), happycat19@hanmail.net

More information

원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현

원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 지도김석원교수 이논문을석사학위논문으로제출함

More information

- i - - ii - - iii - - iv - - v - - vi - - 1 - - 2 - - 3 - 1) 통계청고시제 2010-150 호 (2010.7.6 개정, 2011.1.1 시행 ) - 4 - 요양급여의적용기준및방법에관한세부사항에따른골밀도검사기준 (2007 년 11 월 1 일시행 ) - 5 - - 6 - - 7 - - 8 - - 9 - - 10 -

More information

서론 34 2

서론 34 2 34 2 Journal of the Korean Society of Health Information and Health Statistics Volume 34, Number 2, 2009, pp. 165 176 165 진은희 A Study on Health related Action Rates of Dietary Guidelines and Pattern of

More information

2009;21(1): (1777) 49 (1800 ),.,,.,, ( ) ( ) 1782., ( ). ( ) 1,... 2,3,4,5.,,, ( ), ( ),. 6,,, ( ), ( ),....,.. (, ) (, )

2009;21(1): (1777) 49 (1800 ),.,,.,, ( ) ( ) 1782., ( ). ( ) 1,... 2,3,4,5.,,, ( ), ( ),. 6,,, ( ), ( ),....,.. (, ) (, ) Abstract Kim Dal-Rae, Kim Sun-Hyung* Dept. of Sasang Constitutional Medicine, College of Oriental Medicine, Kyung-Hee Univ. *Dept. of Sasang Constitutional Medicine, East-West Neo Medical Center, Kyung-Hee

More information

±èÇ¥³â

±èÇ¥³â 533 Fig. 1. Dead zone. Nine echoes are positioned 2-10 mm below the scan surface with 1 mm distance. All nine echoes are clearly visualized. 534 Fig. 2. Vertical and horizontal measurement. 10 cm distance

More information

대한한의학원전학회지24권6호-전체최종.hwp

대한한의학원전학회지24권6호-전체최종.hwp 小兒藥證直訣 의 五臟辨證에 대한 小考 - 病證과 處方을 중심으로 1 2 慶熙大學校大學校 韓醫學科大學 原典學敎室 ㆍ 韓醫學古典硏究所 白裕相1,2*1)2) A study on The Diagnosis and Treatment Using The Theory of Five Organs in Soayakjeungjikgyeol(小兒藥證直訣) 1 Dept. of Oriental

More information

Analysis of objective and error source of ski technical championship Jin Su Seok 1, Seoung ki Kang 1 *, Jae Hyung Lee 1, & Won Il Son 2 1 yong in Univ

Analysis of objective and error source of ski technical championship Jin Su Seok 1, Seoung ki Kang 1 *, Jae Hyung Lee 1, & Won Il Son 2 1 yong in Univ Analysis of objective and error source of ski technical championship Jin Su Seok 1, Seoung ki Kang 1 *, Jae Hyung Lee 1, & Won Il Son 2 1 yong in University & 2 Kang Won University [Purpose] [Methods]

More information

16_이주용_155~163.hwp

16_이주용_155~163.hwp 사상체질의학회지 2008;20(2):155-163 J of Sasang Constitutional Medicine Vol. 20, No. 2, 2008:155-163 http://www.esasang.com 腦 梗 塞 으로 발생한 少 陽 人 半 身 舞 蹈 病 患 者 치험 1례 이주용 이한얼 한경수 안택원 Abstract 대전대학교 한의과대학 사상체질과 A Soyangin

More information

A Study on Married Female Immigrants Life Style and Marriage Satisfaction in Terms of Preparing Their Old Age in Chungcheongnam-do Department of Gerontology, Hoseo University Doctoral Student : Hi Ran

More information

( )Kjhps043.hwp

( )Kjhps043.hwp Difference of Fistula Maturation Degree and Physical Property by the Types of Tube Material: An Experimental Study Sang Koo Kang, M.D. 1, Hee Chul Yu, M.D. 1,4, Woo Sung Moon, M.D. 2,4, Ju Hyoung Lee,

More information

1..

1.. Volume 12, Number 1, 6~16, Factors influencing consultation time and waiting time of ambulatory patients in a tertiary teaching hospital Jee-In Hwang College of Nursing Science, Kyung Hee University :

More information

<B0E6C8F1B4EBB3BBB0FAC0D3BBF3B0ADC1C E687770>

<B0E6C8F1B4EBB3BBB0FAC0D3BBF3B0ADC1C E687770> 개원의와함께하는임상강좌 2011 역류성식도질환제대로이해하기 Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea Jae-Young Jang, M.D., PhD. 개원의와함께하는임상강좌 2011 109 최신치료

More information

Pharmacotherapeutics Application of New Pathogenesis on the Drug Treatment of Diabetes Young Seol Kim, M.D. Department of Endocrinology Kyung Hee Univ

Pharmacotherapeutics Application of New Pathogenesis on the Drug Treatment of Diabetes Young Seol Kim, M.D. Department of Endocrinology Kyung Hee Univ Application of New Pathogenesis on the Drug Treatment of Diabetes Young Seol Kim, M.D. Department of Endocrinology Kyung Hee University College of Medicine & Hospital E mail : ycell2@yahoo.co.kr Abstract

More information

ver5- 속표지 _ 레이아웃 오후 2:15 페이지 1 The Korea Society of Chronic Pelvic Pain

ver5- 속표지 _ 레이아웃 오후 2:15 페이지 1 The Korea Society of Chronic Pelvic Pain ver5- 속표지 _ 레이아웃 1 16. 6. 14. 오후 2:15 페이지 1 The Korea Society of Chronic Pelvic Pain 대한만성골반통학회 제 6 차 Preliminary Scientific Meeting Program P R O G R A M 일시 : 2016 년 6 월 18 일 ( 토 ) 오후 3 시 30 분 장소 : 그랜드힐튼서울본관

More information

Microsoft PowerPoint - 발표자료(KSSiS 2016)

Microsoft PowerPoint - 발표자료(KSSiS 2016) Sang Jun Kim, MD, PhD Application of 3D Printing in the Orthotic Fields Hallux Valgus, Charcot Marie Tooth, ADL Kit, Foot Insole, Wrist Pain, Foot Drop Development of Automated Program for Ankle Foot Orthosis

More information

04김호걸(39~50)ok

04김호걸(39~50)ok Journal of Environmental Impact Assessment, Vol. 22, No. 1(2013) pp.39~50 Prediction of Landslides Occurrence Probability under Climate Change using MaxEnt Model Kim, Hogul* Lee, Dong-Kun** Mo, Yongwon*

More information

???? 1

???? 1 The Korean Journal of Applied Statistics (2013) 26(1), 201 208 DOI: http://dx.doi.org/10.5351/kjas.2013.26.1.201 A Note on Model Selection in Mixture Experiments with Process Variables Jung Il Kim a,1

More information

,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012). (2007) 26%., (,,, 2011;, 2006;

,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012). (2007) 26%., (,,, 2011;, 2006; ,,.. 400,,,,,,.,,, -, -, -., 3.. :, Tel : 010-9540-0640, E-mail : sunney05@hanmail.net ,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012).

More information

44-4대지.07이영희532~

44-4대지.07이영희532~ A Spatial Location Analysis of the First Shops of Foodservice Franchise in Seoul Metropolitan City Younghee Lee* 1 1 (R) 0 16 1 15 64 1 Abstract The foodservice franchise is preferred by the founders who

More information

005송영일

005송영일 Received : 2015. 12. 09 Reviewed : 2015. 12. 16 Accepted : 2015. 12. 16 Sternal Fracture occurred after Thai Massage : A Case Report Young-Il Song, K.M.D. 1, Dong-Eun Kim, K.M.D. 1 1 Department of Rehabilitation

More information

Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp DOI: : Researc

Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp DOI:   : Researc Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp.251-273 DOI: http://dx.doi.org/10.21024/pnuedi.27.2.201706.251 : 1997 2005 Research Trend Analysis on the Korean Alternative Education

More information

- i - - ii - - iii - - iv - - v - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 - - 9 - - 10 - - 11 - - 12 - - 13 - - 14 - - 15 - - 16 - - 17 - - 18 - - 19 - α α - 20 - α α α α α α - 21 - - 22 - - 23 -

More information

대한한의학원전학회지26권4호-교정본(1125).hwp

대한한의학원전학회지26권4호-교정본(1125).hwp http://www.wonjeon.org http://dx.doi.org/10.14369/skmc.2013.26.4.267 熱入血室證에 대한 小考 1 2 慶熙大學校大學校 韓醫學科大學 原典學敎室 韓醫學古典硏究所 白裕相1, 2 *117) A Study on the Pattern of 'Heat Entering The Blood Chamber' 1, Baik 1

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 2, pp DOI: IPA * Analysis of Perc

Journal of Educational Innovation Research 2018, Vol. 28, No. 2, pp DOI:   IPA * Analysis of Perc Journal of Educational Innovation Research 2018, Vol. 28, No. 2, pp.45-72 DOI: http://dx.doi.org/10.21024/pnuedi.28.2.201806.45 IPA * Analysis of Perception and Needs on Teaching Competencies of Faculty

More information

Abstract Musculoskeletal Symptoms and Related Factors for Nurses and Radiological Technologists Wearing a Lead Apron for Radiation Pro t e c t i o n Jung-Im Yoo, Jung-Wan Koo 1 ) Angio Unit, Team of Radiology,

More information

Analysis of teacher s perception and organization on physical education elective courses Chang-Wan Yu* Korea Institute of curriculum and evaluation [Purpose] [Methods] [Results] [Conclusions] Key words:

More information

27 2, 17-31, , * ** ***,. K 1 2 2,.,,,.,.,.,,.,. :,,, : 2009/08/19 : 2009/09/09 : 2009/09/30 * 2007 ** *** ( :

27 2, 17-31, , * ** ***,. K 1 2 2,.,,,.,.,.,,.,. :,,, : 2009/08/19 : 2009/09/09 : 2009/09/30 * 2007 ** *** ( : 27 2, 17-31, 2009. -, * ** ***,. K 1 2 2,.,,,.,.,.,,.,. :,,, : 2009/08/19 : 2009/09/09 : 2009/09/30 * 2007 ** *** (: dminkim@cau.ac.kr) 18 한국교육문제연구제 27 권 2 호, 2009. Ⅰ. (,,, 2004). (,, 2006).,,, (Myrick,

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 3, pp DOI: The Effect of Caree

Journal of Educational Innovation Research 2018, Vol. 28, No. 3, pp DOI:   The Effect of Caree Journal of Educational Innovation Research 2018, Vol. 28, No. 3, pp.325-349 DOI: http://dx.doi.org/10.21024/pnuedi.28.3.201809.325 The Effect of Career Preparation Behavior Before and After Major Transitions

More information

슬라이드 1

슬라이드 1 Proposed Korean guideline for the diagnosis of BPH Hyun Woo Kim The Catholic University of Korea BPH Guideline AHCPR guideline on BPH (1994) AUA guideline on BPH (2003) EAU guideline on BPH (2004) International

More information

<31325FB1E8B0E6BCBA2E687770>

<31325FB1E8B0E6BCBA2E687770> 88 / 한국전산유체공학회지 제15권, 제1호, pp.88-94, 2010. 3 관내 유동 해석을 위한 웹기반 자바 프로그램 개발 김 경 성, 1 박 종 천 *2 DEVELOPMENT OF WEB-BASED JAVA PROGRAM FOR NUMERICAL ANALYSIS OF PIPE FLOW K.S. Kim 1 and J.C. Park *2 In general,

More information

4 5 6 7 8 9 10 11 12 13 14 15 조 희 영 선 생 님 고 맙 습 니 다 16 17 18 19 가정간호 장선미 간호사님 감사합니다 20 21 22 23 24 25 U l 26 27 p SEOUL MEDICAL CENTER NEWS 28 29 30 31 32 33 34 35 36 37 홍보실장이란 신동규 원고를 기다립니다

More information

54 한국교육문제연구제 27 권 2 호, I. 1.,,,,,,, (, 1998). 14.2% 16.2% (, ), OECD (, ) % (, )., 2, 3. 3

54 한국교육문제연구제 27 권 2 호, I. 1.,,,,,,, (, 1998). 14.2% 16.2% (, ), OECD (, ) % (, )., 2, 3. 3 27 2, 53-70, 2009. (Nursing Home) * ** (Nursing Home). 5 50 5 2 1,,,,, SPSS t.,,,,,,,. :,, : 2009/08/27 : 2009/09/24 : 2009/09/30 * ** (: hjkim@daelim.ac.kr) 54 한국교육문제연구제 27 권 2 호, 2009. I. 1.,,,,,,, (,

More information

The Window of Multiple Sclerosis

The Window of Multiple Sclerosis THE WINDOW OF MULTIPLE SCLEROSIS Vol.2 No.1 MAR 2009 Topic Review Article Review 01. 02. 03. 04. Case Review The Window of Multiple Sclerosis THE WINDOW OF MULTIPLE SCLEROSIS The Window of Multiple Sclerosis

More information

Ⅲ Ⅲ Ⅰ Ⅰ Ⅰ α < < < < < χ χ Ⅰ Ⅱ Ⅲ Ⅰ Ⅲ Ⅰ Bagozzi, R., & Dholakia, U. (2002). Intentional Social Action in Virtual Communities. Journal of Interactive Marketing, 16(2), 2-21. Borkovec, T. D. (1976).

More information

<C7D1B1B9B1B3C0B0B0B3B9DFBFF85FC7D1B1B9B1B3C0B05F3430B1C733C8A35FC5EBC7D5BABB28C3D6C1BE292DC7A5C1F6C6F7C7D42E687770>

<C7D1B1B9B1B3C0B0B0B3B9DFBFF85FC7D1B1B9B1B3C0B05F3430B1C733C8A35FC5EBC7D5BABB28C3D6C1BE292DC7A5C1F6C6F7C7D42E687770> 기혼 여성이 사이버대학에서 상담을 전공하면서 겪는 경험 방기연 (고려사이버대학교 상담심리학과 부교수) * 요 약 본 연구는 기혼 여성의 사이버대학 상담전공 학과 입학에서 졸업까지의 경험을 이해하는 것을 목적으로 한 다. 이를 위해 연구참여자 10명을 대상으로 심층면접을 하고, 합의적 질적 분석 방법으로 분석하였다. 입학 전 에 연구참여자들은 고등교육의 기회를

More information

서론

서론 - i - - ii - - iii - - iv - - v - - vi - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 - - 9 - - 10 - - 11 - - 12 - - 13 - - 14 - - 15 - - 16 - - 17 - - 18 - - 19 - - 20 - - 21 - - 22 - - 23 - - 24 - -

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA e- 비즈니스연구 (The e-business Studies) Volume 17, Number 1, February, 28, 2016:pp. 3~30 ISSN 1229-9936 (Print), ISSN 2466-1716 (Online) 원고접수일심사 ( 수정 ) 게재확정일 2016. 01. 08 2016. 01. 09 2016. 02. 25 ABSTRACT

More information

27 2, 1-16, * **,,,,. KS,,,., PC,.,,.,,. :,,, : 2009/08/12 : 2009/09/03 : 2009/09/30 * ** ( :

27 2, 1-16, * **,,,,. KS,,,., PC,.,,.,,. :,,, : 2009/08/12 : 2009/09/03 : 2009/09/30 * ** ( : 27 2, 1-16, 2009. * **,,,,. KS,,,., PC,.,,.,,. :,,, : 2009/08/12 : 2009/09/03 : 2009/09/30 * ** (: jjhkim@cau.ac.kr) 2 한국교육문제연구제 27 권 2 호, 2009 Ⅰ.,. 2008 3,536, 10 99.9% (, 2008). PC,, (, 2007). (, 2008),.,

More information

KIM Sook Young : Lee Jungsook, a Korean Independence Activist and a Nurse during the 이며 나름 의식이 깨어있던 지식인들이라 할 수 있을 것이다. 교육을 받은 간 호부들은 환자를 돌보는 그들의 직업적 소

KIM Sook Young : Lee Jungsook, a Korean Independence Activist and a Nurse during the 이며 나름 의식이 깨어있던 지식인들이라 할 수 있을 것이다. 교육을 받은 간 호부들은 환자를 돌보는 그들의 직업적 소 1 의사학 제24권 제1호(통권 제49호) 2015년 4월 Korean J Med Hist 24 ː1-34 Apr 2015 c대한의사학회 http://dx.doi.org/10.13081/kjmh.2015.24.1 pissn 1225-505X, eissn 2093-5609 간호부 이정숙의 독립운동 김숙영* 1. 서론 2. 본론 1) 출생에서 정신여학교 수학시절까지

More information

노인의학200303.PDF

노인의학200303.PDF Assisted Living 9,, ( ) ( ) 1. 6) 2. 5. 3. 1) 4. 2) 1) 6. : 2) 1) 3) 2) 4) 3) 5) 4) (1998) 21 2025 80 73.,. 1980..?,,.,.,, 130 ,,.,.,,,. (managed care),,,.,.,,,.,,,,.,.,,,,,.,..,. 131 1. 2010 - -,,,,,...,

More information

THE JOURNAL OF KOREAN INSTITUTE OF ELECTROMAGNETIC ENGINEERING AND SCIENCE. vol. 29, no. 10, Oct ,,. 0.5 %.., cm mm FR4 (ε r =4.4)

THE JOURNAL OF KOREAN INSTITUTE OF ELECTROMAGNETIC ENGINEERING AND SCIENCE. vol. 29, no. 10, Oct ,,. 0.5 %.., cm mm FR4 (ε r =4.4) THE JOURNAL OF KOREAN INSTITUTE OF ELECTROMAGNETIC ENGINEERING AND SCIENCE. 2018 Oct.; 29(10), 799 804. http://dx.doi.org/10.5515/kjkiees.2018.29.10.799 ISSN 1226-3133 (Print) ISSN 2288-226X (Online) Method

More information

untitled

untitled 대한마취과학회지 2008; 55: 190~6 Korean J Anesthesiol Vol. 55, No. 2, August, 2008 임상연구 대한민국의 마취통증의학 임상실습 현황 연세대학교 의과대학 마취통증의학교실 및 마취통증의학연구소 장동진ㆍ안소운ㆍ안지원ㆍ김종훈 The current status of anesthesiology clerkship in Korea

More information

<313120B9DABFB5B1B82E687770>

<313120B9DABFB5B1B82E687770> 한국민족문화 40, 2011. 7, 347~388쪽 1)중화학공업화선언과 1973년 공업교육제도 변화* 2)박 영 구** 1. 머리말 2. 1973년, 중화학공업화선언과 과학기술인력의 부족 3. 1973년 전반기의 교육제도 개편과 정비 1) 계획과 개편 2) 기술교육 개선안과 인력개발 시책 4. 1973년 후반기의 개편과 정비 5. 정비된 정규교육제도의 특징

More information

- 최원희ㆍ 김명희: 중년후기 여성의 집단회상 경험과 효과에 대한 연구 - 에 직면하며 심리 사회적인 역할갈등, 고립, 위축, 상실 감 등을 경험하게 된다. 이 시기동안 위기에 잘 대처하 지 못하면 자신에 대하여 실망하며 두려움과 슬픔 등 을 겪으면서 자아존중감이 낮아

- 최원희ㆍ 김명희: 중년후기 여성의 집단회상 경험과 효과에 대한 연구 - 에 직면하며 심리 사회적인 역할갈등, 고립, 위축, 상실 감 등을 경험하게 된다. 이 시기동안 위기에 잘 대처하 지 못하면 자신에 대하여 실망하며 두려움과 슬픔 등 을 겪으면서 자아존중감이 낮아 한국모자보건학회지 제15권 제1 호(2011년 1 월) J Korean Soc Matern Child Health 2011;15(1):48-59 E 1) 중년후기 여성의 집단회상 경험과 효과에 대한 연구 최 원 희ㆍ김 명 희 1 경남대학교 간호학과, 부산대학교 간호대학 1 = Abstract = The Experience and Effects of Group

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 4, August, 30, 2016:319~332 Received: 2016/07/28, Accepted: 2016/08/28 Revised: 2016/08/27, Published: 2016/08/30 [ABSTRACT] This paper examined what determina

More information

72 순천향의과학 : 제14권 2호 2008 Fig.1. Key components of the rehabilitation evaluation of patients with the rheumatic diseases. The ICF provides a good frame

72 순천향의과학 : 제14권 2호 2008 Fig.1. Key components of the rehabilitation evaluation of patients with the rheumatic diseases. The ICF provides a good frame Journal of Soonchunhyang Medical Science 14(2) p.71~82 December 2008 71 류마티스 관절염의 재활치료 오 기 영 순천향 대학교 의과대학 재활의학교실 Rehabilitation Interventions for the Patient with Rheumatoid Arthritis Ki-Young Oh Department

More information

03-ÀÌÁ¦Çö

03-ÀÌÁ¦Çö 25 3 (2004 9 ) J Korean Oriental Med 2004;25(3):20-31 1), 2), 3) 1) 2) 3) Grope for a Summary Program about Intellectual Property Protection of Traditional Knowledge (TK)etc. Discussed in WIPO Hwan-Soo

More information

학습영역의 Taxonomy에 기초한 CD-ROM Title의 효과분석

학습영역의 Taxonomy에 기초한 CD-ROM Title의 효과분석 ,, Even the short history of the Web system, the techniques related to the Web system have b een developed rapidly. Yet, the quality of the Webbased application software has not improved. For this reason,

More information

. 45 1,258 ( 601, 657; 1,111, 147). Cronbach α=.67.95, 95.1%, Kappa.95.,,,,,,.,...,.,,,,.,,,,,.. :,, ( )

. 45 1,258 ( 601, 657; 1,111, 147). Cronbach α=.67.95, 95.1%, Kappa.95.,,,,,,.,...,.,,,,.,,,,,.. :,, ( ) . 45 1,258 ( 601, 657; 1,111, 147). Cronbach α=.67.95, 95.1%, Kappa.95.,,,,,,.,...,.,,,,.,,,,,.. :,, (402-751) 253 E-mail : yspark@inha.ac.kr ,. (, 2011),, 1980 5 49.9%, 4 (20.3%). 1985, 5 (39.0%), 4 (25.3%).

More information

YI Ggodme : The Lives and Diseases of Females during the Latter Half of the Joseon Dynasty as Reconstructed with Cases in Yeoksi Manpil (Stray Notes w

YI Ggodme : The Lives and Diseases of Females during the Latter Half of the Joseon Dynasty as Reconstructed with Cases in Yeoksi Manpil (Stray Notes w 497 의사학 제24권 제2호(통권 제50호) 2015년 8월 Korean J Med Hist 24 ː497-532 Aug 2015 c대한의사학회 http://dx.doi.org/10.13081/kjmh.2015.24.497 pissn 1225-505X, eissn 2093-5609 역시만필( 歷 試 漫 筆 ) 의 사례로 재구성한 조선후기 여성의 삶과 질병

More information

< FB5B5BAF1B6F32C20B8F1C2F D34292E687770>

< FB5B5BAF1B6F32C20B8F1C2F D34292E687770> Case Report J Sasang Constitut Med 2014;26(4):379-388 http://dx.doi.org/10.7730/jscm.2014.26.4.379 Abstract A Case Study of Soyangin Patient with Hyperhidrosis Treated Successfully with Hyungbangsabaek-san(

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 6, December, 30, 2016:275~289 Received: 2016/12/02, Accepted: 2016/12/22 Revised: 2016/12/20, Published: 2016/12/30 [ABSTRACT] SNS is used in various fields. Although

More information

untitled

untitled 대한수혈학회지:제권 제호, 0 한 대학병원의 혈액 폐기 분석 김병철ㆍ서영익ㆍ채금란ㆍ신정원ㆍ최태윤 = Abstract = 순천향대학교 의과대학 서울병원 진단검사의학교실 Analysis of Discarded Blood Components at a University Hospital in Korea Byung Chul Kim, Young Ik Seo, Gum Ran

More information

ePapyrus PDF Document

ePapyrus PDF Document Introduction 373 374 Definition of Child Abuse 375 376 Current Status of Child Abuse 377 378 Causes of Child Abuse 379 Signs and Sequelae of Child Abuse 380 A B C 381 382 383 384 385 Clinical Evaluation

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA e- 비즈니스연구 (The e-business Studies) Volume 17, Number 3, June, 30, 2016:pp. 3~26 ISSN 1229-9936 (Print), ISSN 2466-1716 (Online) 원고접수일심사 ( 수정 ) 게재확정일 2016. 06. 11 2016. 06. 23 2016. 06. 26 ABSTRACT e- 비즈니스연구

More information

한국성인에서초기황반변성질환과 연관된위험요인연구

한국성인에서초기황반변성질환과 연관된위험요인연구 한국성인에서초기황반변성질환과 연관된위험요인연구 한국성인에서초기황반변성질환과 연관된위험요인연구 - - i - - i - - ii - - iii - - iv - χ - v - - vi - - 1 - - 2 - - 3 - - 4 - 그림 1. 연구대상자선정도표 - 5 - - 6 - - 7 - - 8 - 그림 2. 연구의틀 χ - 9 - - 10 - - 11 -

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 6, December, 30, 2016:237~251 Received: 2016/11/20, Accepted: 2016/12/24 Revised: 2016/12/21, Published: 2016/12/30 [ABSTRACT] Recently, there is an increasing

More information

2012 MARFPR Vol.92 0304 World Best Safety, Global INHA 2012. 03+04 C O N T E N T S Mar.Apr Vol.92 02 04 06 09 12 14 16 18 20 22 24 27 28 30 31 32 33 38 04 2012_ Mar + Apr 05 06 2012_ Mar + Apr 07 08 2012_

More information

제5회 가톨릭대학교 의과대학 마취통증의학교실 심포지엄 Program 1 ANESTHESIA (Room 2층 대강당) >> Session 4 Updates on PNB Techniques PNB Techniques for shoulder surgery: continuou

제5회 가톨릭대학교 의과대학 마취통증의학교실 심포지엄 Program 1 ANESTHESIA (Room 2층 대강당) >> Session 4 Updates on PNB Techniques PNB Techniques for shoulder surgery: continuou 제5회 가톨릭대학교 의과대학 마취통증의학교실 심포지엄 (Room 2층 대강당) >> Session 4 Updates on PNB Techniques PNB Techniques for shoulder surgery: continuous vs single injection, interscalene vs supraclavicular approach 의정부성모병원

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA e- 비즈니스연구 (The e-business Studies) Volume 17, Number 1, February, 28, 2016:pp. 293~316 ISSN 1229-9936 (Print), ISSN 2466-1716 (Online) 원고접수일심사 ( 수정 ) 게재확정일 2015. 12. 04 2015. 12. 24 2016. 02. 25 ABSTRACT

More information

1. Korea Centers for Disease Control and Prevention. The fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1) 2010. Cheongwon: Korea Centers for Disease Control and Prevention; 2012.

More information

7.ƯÁýb71ÎÀ¯È« š

7.ƯÁýb71ÎÀ¯È« š J KMA Special Issue Myelodysplastic Syndrome June Won Cheong, MD Yoo Hong Min, MD Department of Internal Medicine, Yonsei University College of Medicine E mail : jwcheong70@yumc.yonsei.ac.kr minbrmmd@yumc.yonsei.ac.kr

More information

<30372EC0CCC0AFC1F82E687770>

<30372EC0CCC0AFC1F82E687770> 산전 초음파상 진단된 단독 대조확장증의 출생 후 예후 울산대학교 의과대학 서울아산병원 산부인과학교실 이유진 원혜성 박상민 조현진 정 의 김선권 심재윤 이필량 김 암 Yu-Jin Lee, M.D., Hye-Sung Won, M.D., Sang-Min Park, M.D., Hyun-Jin Cho, M.D., Eui Jung, M.D., Sun-Kwon Kim,

More information

04_이근원_21~27.hwp

04_이근원_21~27.hwp 1) KIGAS Vol. 16, No. 5, pp 21~27, 2012 (Journal of the Korean Institute of Gas) http://dx.doi.org/10.7842/kigas.2012.16.5.21 실험실의 사례 분석에 관한 연구 이근원 이정석 한국산업안전보건공단 산업안전보건연구원 (2012년 9월 5일 투고, 2012년 10월 19일

More information

歯49손욱.PDF

歯49손욱.PDF 2002 14 C Inventory An Estimation of 14 C Inventory on Each Unit of Wolsong NPP,,, 103-16 14 C 14 C Inventory 14 C Inventory 14 C 14 C, [Inventory] = [ 14 C ] - [ 14 C ] 14 C 14 C 13 C, 14 N 17 O [ 13

More information

歯1.PDF

歯1.PDF 200176 .,.,.,. 5... 1/2. /. / 2. . 293.33 (54.32%), 65.54(12.13%), / 53.80(9.96%), 25.60(4.74%), 5.22(0.97%). / 3 S (1997)14.59% (1971) 10%, (1977).5%~11.5%, (1986)

More information

2 1896 2 26 ( ) 2 7-20 2) 1897 1898 ( )3) 6 1902 8 1904 10 10 (19 05-1914 ) ( ) ( ) 4) 1915 ( ) ( ) 1917 2) 3) 4) 285

2 1896 2 26 ( ) 2 7-20 2) 1897 1898 ( )3) 6 1902 8 1904 10 10 (19 05-1914 ) ( ) ( ) 4) 1915 ( ) ( ) 1917 2) 3) 4) 285 13 2 ( 25 ) 2004 12 Korean J Med Hist 13 284 296 Dec 2004 ISSN 1225 505X 1) * ** ** 1 1920 1930 40 ( 1896-1973) 80 * ** 1) 2003 284 2 1896 2 26 ( ) 2 7-20 2) 1897 1898 ( )3) 6 1902 8 1904 10 10 (19 05-1914

More information

THE JOURNAL OF KOREAN INSTITUTE OF ELECTROMAGNETIC ENGINEERING AND SCIENCE Sep.; 30(9),

THE JOURNAL OF KOREAN INSTITUTE OF ELECTROMAGNETIC ENGINEERING AND SCIENCE Sep.; 30(9), THE JOURNAL OF KOREAN INSTITUTE OF ELECTROMAGNETIC ENGINEERING AND SCIENCE. 2019 Sep.; 30(9), 712 717. http://dx.doi.org/10.5515/kjkiees.2019.30.9.712 ISSN 1226-3133 (Print) ISSN 2288-226X (Online) MOS

More information

example code are examined in this stage The low pressure pressurizer reactor trip module of the Plant Protection System was programmed as subject for

example code are examined in this stage The low pressure pressurizer reactor trip module of the Plant Protection System was programmed as subject for 2003 Development of the Software Generation Method using Model Driven Software Engineering Tool,,,,, Hoon-Seon Chang, Jae-Cheon Jung, Jae-Hack Kim Hee-Hwan Han, Do-Yeon Kim, Young-Woo Chang Wang Sik, Moon

More information