2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

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.

형벌목적론에서 교육형주의의 의미

정희철 홍익대학교 2009 홍익법학 Vol.10 No.2

목적형주의, 특히 특별예방이론과 밀접한 관련성을 띠고 있는 교육형주의의 지향점이 교육이라고 이해되고 있지만 교육개념을 무엇으로 이해할 것인가에 대해서는 보편타당한 의미는 획득되지 않고 있다. 교육학은 인간을 변화시키는 목적적 활동인 의도적 교육개념을 취하기도 하고, 이런 전통적 개념의 협소함을 극복하기 위해 기능적 교육개념을 제시하기도 한다. 반면 사회학은 교육목적을 사회화로 상정하고, 일정한 집단 내에서 효력을 갖는 사회규범이나 일정한 사회적 지위를 갖고 있는 개인에 지향된 역할기대 및 그런 규범과 기대의 충족에 필요한 능력과 집단의 문화에 속하는 가치와 확신을 학습하고 내면화하는 것이 사회화에서 중요하다고 본다. 형법과 범죄학에서 교육개념을 협소한 교육개념이 아닌 사회화개념으로 보게 되면, 형법체계가 사회문화적 요소나 사회학적 관점에 개방될 수 있는 가능성을 높여 주긴 하지만, 이렇게 교육형주의의 교육개념을 사회화개념으로 보게 되면 그 개념의 외연이 지나치게 넓어지게 되어 교육개념을 더욱 극심한 불확정성에 빠져들게 한다. 특별예방개념은 개인에 대한 위하나 보호처분뿐만 아니라 교육과 재사회화의 요소도 포함한다는 점에서 교육형주의의 교육개념은 넓은 의미의 특별예방에 속하는 것으로 파악될 수 있다. 그러나 특별예방과 교육이 완전히 일치된 의미를 갖는 것은 아니며, 이 점은 교육이 냐면의 정신적 발달이 아직 완결되지 않아 외부의 부조활동을 필요로 하는 사람, 특히 청소년을 대상으로 한다는 전제에서 출발한다는 점을 보면 알 수 있다. 따라서 교육형주의의 교육은 특별예방보다는 더 좁은 의미로 이해해야 하며, 교육형주의의 대상과 영역의 늑수성을 탈각한 채 완전히 특별예방으로 대체하는 것은 바람직하다고 볼 수 없다. Die Jugendkrimianlität ist nach Täterpersönlichkeit und Tat anders als die allgemeine Kriminalität, was zur Eigenständigkeit des Jugendrechts führt. Die Bestrafung von Jugend mit den Strafen des allgemeinen Erwachsenenstrafrechts wäre nicht nur nicht gerechtfertigt, sondern meist auch für deren weiteren Entwicklung gefährlich. Jugendliche, die gefehlt haben, müssen mit den ihrer Persönlichkeit und ihrer Entwicklung angemessenen Maßnahmen wieder in die Gemeinschaft eingegliedert werden. Die Eigenständigkeit des Jugendrechts ist geboten, gekennzeichnet und in ihren Wirkungen insbes. sichtbar durch das Primat der Erziehung. Von diesem Aspekt her gesehen, kann Jugendrecht sowohl als Täter- auch Erziehungsstrafrecht zu kennzeichnen sein. Es gibt keinen allgemeingültigen und die Zeiten überdauernden Erziehungsbegriff. Er hängt ab von dem jeweiligen Menschenbild, so dass weder das rziehungsziel noch die zur Erziehung dienenden Mittel absolut gesetzt werden können. Daher handelt es sich um einen relativen Begriff. Er ist inhaltlich zu konkretisieren. Wenn er deshalb als "offen" bezeichnet wird, so läßt sich dies vertreten. Allein deshalb darf er aber nicht als zu unbestimmt und unanwendbar abwertet werden. Die Offenheit des Begriffs berechitgt daher nicht dazu, über ihn hinwegzulassen. Er ist also nicht frei verfügbar, sondern mit seinem spezifischen Inhalt zu erfassen. Im Jugendrecht ist das Erziehungsziel auf die Legalbewährung zu reduzieren. Und wird der Reduktion des Erziehungsbegriffs auf eine bloße Sozialisation ntgegengetreten. Sie mag zwar als Ergebnis der Bemühungen und damit als ein gleichsam weiterer Begriff im Verhältnis zum Erziehungsziel der Legalbewährung akzeptiert werden können. Nicht findet sich hierdurch aber auch der zu beschreitende Weg hinreichend gekennzeichnet.

제브라피쉬에서 transposon을 이용한 enhancer trap 시스템의 개발

정승현,정근완,김철희 충남대학교 생물공학연구소 2007 생물공학연구지 Vol.13 No.-

The zebrafish (Danio rerio) is a vertebrate model system suitable for fishing/hunting novel functional genes in post-genome era. Researchers are able to observe various developmental stages of transparent zebrafish embryos within 24 hours. Moreover, the genome structure of zebrafish is quite similar to that of mammals, including human. Characterization of various type of mutations revealed that zebrafish is an excellent animal model for the study of various human diseases. For that reason many researchers have used zebrafish in large-scale chemical mutagenesis. So far, a lot of mutants have been made by chemical mutagenesis method. However, it is burdensome and time-consuming to identify the target gene of specific mutant. Recently, insertional mutagenesis was considered as an alternative strategy in comparison with chemical mutagenesis. In this study, we describe the use of zebrafish model system for the experimental possibility of insertional mutagenesis. We have established the enhancer trap vector through Tol2 transposon, which is one of the improvable insertional mutagenesis system. We also introduce several methods of insertional mutagenesis based on Tol2 transposon system. It allows us to easily and quickly screen the target gene of mutant made by Tol2 enhancer trap system, which will be a useful method for the large-scale mutagenesis.

정신분열병 환자의 신경인지 결함의 특성

정성원,김희철,김정범 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.2

Objective : This study compared the neurocognitive functions between schizophrenic patients and normal controls by verbal fluency test, auditory verbal learning test, and Vienna computerized neuropsychological test. Method : The subjects were 19 schizophrenic patients who were hospitalized in Keimyung University Medical Center from February 2001 to July 2001, and were diagnosed as schizophrenia by the DSM-Ⅳ diagnostic criteria. They were all clinically stable and cooperative patients whose drug dosages were not changed at least for 2 weeks. Twenty normal controls were all healthy volunteers who were matched in sex and age to patients group. The cinical symptoms of schizophrenic patients were evaluated with the PASS and BPRS. Results : The neurocognivite functions of schizophrenic group were impaired in verbal fluency, auditory verbal learning test, continuous attention test, perseveration test, standard progressive matrix, reaction text, Corsi block taping test, visual pursuit test, and cognitrone. The performance of Wisconsin Card Sorting Test was not impaired in schizophrenic group. In schizophrenic group, the positive PANSS scores had no relation with any other neurocognitive test, however the negative and general PANSS scores had relation with verbal fluency test, auditory verbal learning test, standard progressive matrices, visual pursuit test, and cognitrone. Conclusions : There results suggest that the schizophrenic patients have more pervasive neurocognitive deficits and the negative symptoms are related with neurocognitive deficits.

유기농업에서의 작물의 양분관리

안난희, 신재훈, 옥정훈, 이상민, 김석철, 사동민 忠北大學校 農業科學硏究所 2016 農業科學硏究 Vol.32 No.2

Soil fertility is fundamental in determining the productivity of all farming systems and is most�ﾠ�ﾠ commonly defined in terms of the ability of the soil to supply nutrients to crops. Organic farming systems rely on the management of soil organic matter to enhance the chemical, biological and physical properties of the soil, in order to optimize crop production. Organic agriculture excludes the use of chemical nitrogen fertilizers, instead requiring a balance between supply and demand nutrients through the use of organic matter. Nutrient management is one of the main challenges facing organic farming. The short term challenge is supplying sufficient nutrients to crops at the correct point in their development to achieve economically viable yield, while in the long term, the difficulty is to balance nutrient inputs and runoffs to avoid nutrient rundown or environmental pollution. This paper reviews information from the literature to investigate strategies of managing nutrients by supplying organic matter in organic agriculture during the major phases of crop growth.

오렌지 껍질로부터 분리된 프라보노이드의 화학요법 감작효과

최철익,변익건,차윤정,김선필,민영돈,유진철,송재경 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : The overexpression of P-glycoprotein (Pgp) or multidrug resistanceassociated protein (MRP) confers multidrug resistance (MDR) to cancer cells. MDR cells could be sensitized to anticancer drugs when treated concomitantly with a chemosensitizer. In this study, orange peel have been screened for the development of chemosensitizers reversing MDR. Materials and methods : Expression of Pgp in AML-2/WT and AML-2/D100 were determined using western blot analysis and RT-PCR. Candidates for chemosensitizers were isolated, purified from orange peel using sephadex LH-20 column chromatography and silica-gel column chromatography, whose structure was determined using ^1H-NMR, ^13C-NMR, ^1H-^1H-COSY, 13C-NMR, EI-Mass, IR. Chemosensitizing effect of NP-28 on AML-2/DX100 over expressing Pgp and MRP was determined by the MTT assay. Membrane toxicity was evaluated by the RBC hemolysis test. Antioxidant effects were examined by using a fluorescence probe (2’-7’-dichlorofluorescein diacetate). Results : A potent candidate, NP-28, has a flavonoid nucleus with some methoxy moiety. NP-28 is believed to have high therapeutic index, being non-transportable inhibitor and possibly, of inhibiting other efflux pumps such as MRP and antioxidant effects. NP-28 is also unlikely to be a substrate of Pgp. NP-28 did not increase Pgp levels. Conclusion : NP-28 has a Chemosensitizing effect to reverse Pgp-mediated MDR by increasing the intracellular accumulation of drugs. Furthermore, they do not increase expression of Pgp, which can allow a long term use without the concern about Pgp activation. NP-28 is anticipated as an ideal second-generation flavonoid chemosensitizer and/or possibly other therapeutic agents by further investigation.

가상현실 기법의 활용이 지식 성취도 향상에 미치는 효과 : 눈의 구조와 기능 내용을 중심으로 The Structure and Function of Eye

심규철,류수정,김현섭,김희수,박영철 한국과학교육학회 2003 한국과학교육학회지 Vol.23 No.1

The purpose of present study was to develop teaching-learning materials based virtual reality technology(VRT), and to examine the effect of it on the knowledge achievement of biology. Authoring tool of virtual reality(VR) was 3D Webmaster made in Superscape Ltd., United Kingdom. Educational materials was developed for the structure and function of eye of life field in the 10th science. It was learner-directed and interactive educational material using the Web-based and desktop VR. The result showed a meaningful improvement on the achievement. Using 3D VR shows the potential of available education media in the next generation as science teaching-aided material, which especially was efficient in the understanding and perception of abstract or difficult to direct experience learning contents.

한·일 초등학교 과학 교과서 삽화 비교 연구

이형철,안정희 한국초등과학교육학회 2005 초등과학교육 Vol.24 No.2

This study was intended to survey and analyze the illustrations of the elementary science textbooks in the 7th revised education curriculum in Korea, and to compare the results with the illustration organization of the elementary science textbooks of Japan. The analysis criterion was composed of two categories, the kind of illustration and the role of illustration. The kind of illustration was divided into five subcategories such as photograph, picture, illustration, cartoon and diagram. The role of illustration was divided into four subcategories such as motive induction, guidance for learning, the supply of material, the presentation of results. According to the analyzing criterion, the frequencies of relevant subcategories of illustrations in science textbooks were checked and arranged and the resultant data were analyzed by grades. The findings of this study were as follows: 1. Korean science textbooks have about 3.29 illustrations per page whereas Japanese ones have 4.11. Compared with Korean science textbooks, Japanese ones have more illustrations. 2. From the analysis of the kinds of the illustrations by grade basis, it was found that the order of percentage of illustrations is photograph, cartoon and picture in both countrys' science textbooks. Korean ones are highly dependent on photograph. As a contrast Japanese ones have more ratio of cartoon and picture than Korean science textbooks. 3. The analysis of the roles of the illustrations by grade basis showed that the role of guidance for learning is major in both countrys' science textbooks. The role of guidance for learning is prominent in Japanese ones, but in Korean ones, the role of guidance for learning is a little higher than that of the supply of material.

看護師의 精神科 諮問에 대한 見解

崔重哲,韓辰熙 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.3

The attitudes of 140 non-psychiatric nurses in a general university hospital towards psychiatric consultation were studied using a questionnaire. The results were as follows : 1)Nurses felt that 15.5% of the medical inpatients had significant psychiatric problems. but they considered that psychiatric was indicated for only 9.2%. 2) Opinions on the occasion of requestion a psychiatric consultation form the nurses view-point appeared as ‘immediately when psychiatric problem is found’(37.8%). ‘on serious problem. but try to handle minor one by myself’(38.7%). and ‘only if I can't deal with the problem’(21.8%). 3) Most common reasons or situation that would need psychiatric consultation were reported as follows : overt psychiatric symptoms(76.4%). risk of suicide or suicidal behaviors (51.4%). previous psychiatric history(31.4%). symptoms suggesting psychoses(26.4%). and diagnostic uncertainty(20.0%). 4) Only 43.7% of nurses were satisfied with currents psychiatric consultation. however their satisfaction with individual aspects of psychiatric consultation (quality of answers to questions. help in understanding the symptoms. and contribution to the patient care) appeared high (ranging from 71.1% to 79.3%). 5) 65.2% of nurses acknowledged the need of post-graduate training on the psychiatric aspects of patient care and. in addition. they want more follow-up work and open communications for practical guide from the psychiatric consultation service.