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      • 도시지역 보건사업에서 컴퓨터의 활용방안에 관한 연구

        염용태,이명숙,조병희,송동빈 고려대학교 의과대학 1990 고려대 의대 잡지 Vol.27 No.2

        Nacessity of new communication media in information society is repidly increasing in many fields of Korea. It includes the field of primary helath care in the courses of collecting informations on demographic feature, social characteristics and health behavior of peoples. In light of above reasons, the authors attempted to utilize personal computers for the primary health services to promote health of unban people as a pilot study in Guro-6- Dong, Seoul. Five nurses working in Guro-6-Dong Health Subcenter completed family health records of 3,930 households among the total of 4,270. A total of 3,904 family health records among 3,930 were computerized and sorted out in categories of population characteristics, population dymanics, characteristics of householders, housing, family planning, maternal and child health(M.C.H), health status of residents and of others. Names of risky category in M.C.H, and family planning were listed and the lists were handed to the nurses concerned in order to practice proper cares in time. Sorted data were compared with ones of City of Seoul, average of other cities, and ones of nationwide. With the results of above practice, in terms of utilization of computer in uban primary health sevices, the following strategy was proposed. In order to provide proper health services the unban people demanded, efficient devices of information collection, processing and interpretation systems on health were urgently needed in every dong unit(health subcenter) of health centers. Recommended was personal computer network as a new communication media. Additional advantages of the devices were continuity and efficiency in services, and utilization in evaluation of health services and analysis of cost -effectiveness.

      • KCI등재후보

        조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

        김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

        Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

      • KCI등재
      • 강릉 연안에서 어획한 오징어의 간장 중 일반성분 및 지질 조성의 계절변화

        조순영,전미정,주동식,전중균,이미희,정인학 강릉대학교동해안지역연구소 1999 東海岸硏究 Vol.10 No.2

        연간 어획량으로 볼 때 오징어는 다른 어종 못지않게 중요한 종류이다. 오징어는 몸통뿐 아니라 내장과 간장 또한 이용가치가 매우 뛰어남에도 불구하고 그동안에는 사료용으로만 약간 사용되고 나머지는 대부분 폐기하였다. 본 연구에서는 이들 간장의 이용도를 넓힐수 있는 기초자료를 확보하고자 간장 중 일반성분과 지질 클래스의 변화를 월별로 조사하였다. 우선, 주문진항에서 4월에서 10월까지의 매월 한차례씩 살아있는 오징어를 구입하여 이들의 체중과 체장, 그리고 내장과 간장의 무게를 재고, 간장은 일반성분과 지질분석을 하였는데, 월별 체중 및 체장은 7월을 기점으로 여름철에 증가하며 체중도 같은 경향을 나타내었다. 그리고 간장의 무게도 체중의 증가와 비례하여 증가하였다. 비만도는 체장의 증가율에 비해 체중의 증가율이 높은 5월이 비만도가 가장 높았다. 같은 기간 중 일반성분의 변화를 보면, 수분은 대체로 감소하는 경향이고 단백질은 7월에서 9월 사이에 증가하는 경향을 보였다. 지질은 단백질과는 반대로 7월에서 9월 사이에 감소하는 경향을 보였으며, 회분은 매월 일정한 값을 나타내었다. 이러한 결과로 어체의 성장이 활발한 여름철에 단백질의 양이 증가하고 반면에 지질의 함량은 감소하는 것으로 나타났다. 한편, 지질 클래스에서 단순지질의 경우 NL은 봄철에서 가을로 가면서 점차 증가하는 경향을 보였고, 반면 S, PL은 감소하는 경향을 보였다. PL에서는 대부분 PC만이 검출되었으며, 계절적으로는 봄에서 가을로 갈수록 감소하는 경향을 보였다. Squid is one of the most popular species over the East coast of Korea and sold as raw or processed one at the market. However, the liver and intestine occupied more than 20% of whole body are discarded wastefully at present. At this point of view, we analyzed lipid classes and fatty acid composition of liver, and tried to develop the utilities on the useful components of liver and intestine of squid. Alive squids were collected at the port of Jumunjin, Kangwon-Do, Korea, from April to Oct., 1988, and measured the body length, body weight and liver weight. Chemical composition of liver was analyzed by general method. Moreover, lipid class of total lipid was analysed using Iatroscan. As a results of this study, body weight, body length and liver weight increased after July, and hepatosomatic index(HSI) increased after May. Moreover, condition factor was maintained at moderate level after May. Among chemical components, water content had negative correlation with lipid and concentrations of protein and ash were not changed remarkly. In analysis of lipid class, it was proved that neutral lipid(NL) fraction of total lipid(TL) contained triacylglyceride(TG), sterol ester(SE) and free fatty acid(FFA) while polar lipid (PL) fraction of TL contained phosphatidylcholine(PC) dominantly.

      • KCI등재
      • KCI등재

        Random Amplified Polymorphic DNA Typing에 의한 동물과 사람 유래 Vancomycin 내성 장구균의 유전학적 비교

        조윤상,이희수,김종만,류판동,박용호,유한상,이문한 한국수의공중보건학회 2003 예방수의학회지 Vol.27 No.1

        It has been recently reported the possibility in the transfer of antimicrobial resistant to other animals and humans. In particular, the occurrence of vancomycin resistant enterococci (VRE), which have been known as a principal antimicrobial resistant bacteria in humans, has been increased as a pathogen of nosocomial infections. And then animal VRE were suspected as an origin of human VRE. In this work, we investigated the relatedness between VRE from animals and humans through random amplified polymorphic DNA (RAPD) typing. The genetic relatedness of vanA, vanB, vanC-1 and vanC-2 genotypes was examined by RAPD typing, respectively. van4 genotypes have not been shown high genetic relationship each other, containing VRE from humans (n = 8) and chickens (n = 5). In vanB genotypes from humans (n = 3), 2 isolates were made up one cluster, shown 77.8% homology. Chicken isolates of vanC-1 genotypes (n = 11) were constituted 2 clusters and the homology of 2 clusters was 81.8% and 80.0%, respectively. In case of vanC-2 genotypes (n = 19), 2 isolates from pigs have been shown 76.9% homology. But, between VRE from animals and humans, the isolates of high genetic relationship could not be found and RAPD typing was a useful epidemiological method that could be confirmed the genetic relationship among VRE.

      • 의료복지용 센서 및 시스템의 개발(Ⅱ)

        조진호,강희동 경북대학교 센서기술연구소 1997 연차보고서 Vol.1997 No.-

        본 연구에서는 향후 중요한 의료 복지시스템으로 국내외에서 널리 쓰이게 될 MSGC형 온라인 X선 촬영 사진 촬영 장치를 개발하고자 하였다. MSGC형 은라인 X선 촬영장치는 기존의 X선 필름에 비해 조사선량을 크게 낮출 수 있으며 계조도(gray level)및 범위가 디지털 x-ray 시스템에 비해 훨씬 넓다. 그리고 MSGC형 센서는 비슷한 메카니즘으로 작동되는 MWPC형 위치검출센서 보다 높은 해상도를 얻을 수 있으며 센서제작에 대량화와 간편성을 동시에 제공할 수 있는 잇점이 있다. 본 연구는 MSGC센서를 제작하여 이로부터 X선 조사선량에 관계되는 기체 증폭펄스를 얻기 위한 연구 분야와, 이 센서를 이용하여 영상이 얻어질 수 있도록 시스템을 제어하고 영상을 재구성 및 처리하는 두 가지 연구 분야로 나누어 진행된다. MSGC형 센서개발에서는 해상도가 높고 기체증폭이 안정적으로 일어날수 있는 센서를 설계 제작하였고 다양한 실험자료를 수집하였다. MSGC형 센서 개발에서 핵심부분은 기판의 재질과 마이크로스트립형 전극 그리고 챔버 및 기체 증폭이 일어났을 때의 펄스를 샤프하게 분리시켜 계수할 수 있는 기술이다. 디지털 X선 장치 제어 및 영상처리 연구에서는 1차 년도에 제작된 제어 컴퓨터와 X-ray 인터페이스 회로가 가진 수동 조작의 불편함, 타이밍 제어시 오차 발생 및 X-선 Expose속도의 한계 등의 문제점을 개선시킨 인터페이스 보드를 개발하였다. We have developed the MSGC type on-line digital radiography system that will used widely in medical welfare system in future. The MSGC type can reduce the X-ray exposure to the object significantly as compared with X-ray film and its the dynamic range of gray level is more wide than the conventional digital X-ray system. And the MSGC type sensor can obtain much higher resolution than the position detecting sensor of MWPC type which has a similar mechanism to MSGC type and also it can provide an advantage of mass-production and a simplicity to produce the sensors. We divided into two research fields. One is the field of implementing the MSGC sensor and measuring pulses produced by gas multiplication related with the X-ray. The other field is developing the method of controlling digital image acquisition part, image reconstructing, and processing. In the development of MSGC type sensor, we designed and implemented the sensor with a high resolution and a stable gas multiplication. And we collected various experimental data. In the development of MSGC type sensor, the core parts are the materials of substrate, microstrip type electrode and chamber, and technique to split the pulses of gas multiplication sharply and count them. In the field of system controlling and image processing, we developed the new-interface board which has been improved some problems in the first research step, i.e. inconvenient operations of control computer and X-ray interface circuit, error occurrence in timing control, and the limitation of X-ray expose velocity.

      • KCI등재

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

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

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

      • KCI등재

        한국 주요정신장애의 유병률 및 관련요인 : 2006 전국정신질환역학조사

        조맹제,장성만,함봉진,정인원,배안,이영문,안준호,원승희,손정우,홍진표,배재남,이동우,조성진,박종익,이준영,김진영,전홍진,이해우 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.3

        Objectives The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. Methods The Korean Epidemiologic Catchment Area study Replication (KECA-R) was Conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target Population included all eligible residents aged 181o 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). Results A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of Specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nicotine use disorder, 9.0% and 6.0% ; 3) specific phobia, 3.8% and 3.4% ; 4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. Conclusion The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.

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