봉독약침이 류마티스 관절염 환자의 관절 통증, 종창 및 급성 염증 반응에 미치는 영향

이상훈,이현종,백용현,김수영,박재경,홍승재,양형인,김건식,이재동,최도영,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective In order to study the effects of bee venom(BV) on the pain, edema, and acute inflammatory reactant of rheumatoid arthritis(RA) patients. Methods Patients with RA who met the ACR(American College of Rheumatology) 1987 revised criteria for the diagnosis of RA were treated with the BV therapy twice a week for 3 months. Tender Joint counts, swollen joint counts, Visual analog scale(VAS), morning stiffness, ESR. C-reactive protein(CRP) were analyzed before and after BV therapy. Results The results as follows. 1. Tender joint counts in patients after BV therapy were significantly lower than those before BV therapy(9.0±7.9 vs 15± 11.4, p=0.002). 2. Swollen joint counts of the patients after BV therapy were significantly lower than those before BV therapy(50±61 vs 15±23, p=0.001). 3. VAS in patients after BV therapy was significantly lower than those before BV therapy(608± 17.6 vs 380± 159, p=0.000). 4. Duration of morning stiffness in patients after BV therapy was significantly reduced compared with that before BV therapy(119.1± 112.6 min vs 59.0±89.7 min, p=0.009). 5. ESR and CRP were not significantly changed before and after BV therapy, suggesting BV itself could make inflammatory reaction as well as therapeutic effect. Conclusions BV therapy improved tender joint counts, swollen joint counts and duration of morning stiffness in this study, and further study is needed on long-term effect of BV therapy.

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.

봉독약침이 류마티스 관절염 환자의 기능회복 및 삶의 질에 미치는 영향

이상훈,이현종,박상민,김수영,박재경,홍승재,양형인,이재동,최도영,김건식,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective: To evaluate the effects of bee venom acupuncture(BVA) on the rehabilitation and quality of life in rheumatoid arthritis(RA) patients Methods: Patients with RA were treated with the BVA therapy twice a week for 3 months. Tender joint counts, swollen joint counts, morning stiffness, Erythrocyte Sedimentation Rate(ESR), C-reactive protein(CRP), patient global assessment, physician global assessment, Korean health assessment questionnaire(KHAQ) were estimated and analyzed before and after BVA therapy. Results: Tender joint counts, swollen joint counts, morning stiffness showed significant decrease after BVA therapy. But, as acute inflammatory reactants, ESR showed no significant difference and CRP showed significant increase after BVA therapy. Patient global assessment physician global assessment, and KHAQ index showed significant improvement after BVA therapy. Conclusions: BVA therapy can improve rehabilitation and health-related quality of life RA patients as well as clinical symptom and signs. Further study is required in more population with large scale including acute inflammatory reaction of BVA therapy.

뇌졸중 후 중추성 통증 환자에 대한 동서협진이 진통과 재활에 미치는 영향

이현종,김수영,이상훈,서동민,이두익,김건식,이재동,이윤호,양형인,박재경,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Purpose : In order to study the effectiveness of East-West pain treatment on central poststroke pain(CPSP), we evaluated its effect on alleviation of pain and rehabilitation of CPSP Patients who were treated with electroacupuncture and west pain treatment for four weeks. Methods : Twenty four patients diagnosed by their pain characteristics of central pain from stroke were treated with sympathetic nerve block, gabapentin, amitriptyline, and electroacupuncture for four weeks. Pain intensity through the visual analogue scale(VAS), and improvements of mobility and rehabilitation through the modified Barthel index(MBI) and Rankin scale(RS), respectively, before and after pain treatment were also assessed. Results : VAS pain scores were significantly improved from 7.7±1.7 to 4.4±2.0 with pain treatment(p<0.05). In accordance with improvement of pain scores, RS and MBI scores were also improved from 2.88±0.95 to 2.13± 1.01 and from 83.0± 16.9 to 94.7±9.5(p<0.05), respectively, with pain treatment(p<0.05). Conclusions : It was suggested that the active pain treatment was contributed to the rehabilitation of CPSP patients, resulting in improvement of quality of life of CPSP patients. Futhermore, East pain treatment in combination with West pain treatment may be useful modality to alleviate CPSP.

전격성 경과를 취한 만성 호산구성 폐렴 환자 1예

윤호상,진춘조,유광하,이상엽,이수인,정상만,김선두,이순제,이길도,전혜정 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

Chronic eosinophilic pneumonia(CEP) is a rare disease of unknown etiology characterized by chronic infiltration of the lung with eosinophils. It presents with profound systemic symptoms comprising fever, night sweats, weight loss, dyspnea and blood eosinophilia with nonsegmental air-space consolidation confined to the outer third of the lung, the "photographic negative of pulmonary edema". Histopathologic features of chronic eosinophilic pneumonia are intraalveolar and interstitial infiltrations with eosinophils, histiocytes, giant cells, scattered lymphocytes and plasma cells. Glucocorticoid therapy cause prompt resolution of symptoms as well as disappearans of blood eosinophils, elevated serum Ig E levels and the roentgenographic lesions. Infrequent radiographic findings include nodular infiltrates, consolidations, cavitations, atelectasis and pleural effusions. Deaths from CEP although rare, have been reported, but the majorities of CEP have benign courses and do not need a therapy with ventilator. We report a case of chronic eosinophilic pneumonia, which had a sudden course associated with diffuse pneumonic consolidations on the both lung and bilateral pleural effusion.

한국재래흑염소에서 발정 및 과배란 유도와 외래유전자 주입에 적합한 1세포기 수정란의 채취

신상태,이두환,김명철,이운규,이철상,한용만,이경광 충남대학교 수의과대학 동물의과학연구소 1998 動物醫科學硏究誌 Vol.6 No.-

Three different treatments for induction of estrus in Korean native black goats were compared: follicle stimulating hormone(FSH, FSH-p^TM), FSH combined with MAP(intravaginal impregnated sponges, Veramix^ⓡ, containing 60 ㎎ medroxy progesterone acetate for 14 days), and FSH combined with progesterone(Ovaron^ⓡ, 10 ㎎ IM for 10 days) and PGF_2α(Lutalyse^ⓡ, 3 ㎎ IM at first FSH injection). FSH for inducing estrus and superovulation was given a total 20 ㎎ intramuscularilly in decreasing dosage injections twice daily over 4 days. The MAPs were withdrawn at the 3rd day of FSH injection. Estrus observations were conducted every 6 hours from last FSH injection for 24 hours by placing the does with fertile male goats. Estrus and superovulation were more successfully induced with treatment of MAP + FSH than other treatments(FSH only, or progesterone + PGF_2α + FSH) (estrus induction; 100 vs 42.8 and 71.4%, ovulation points; 11.4 vs 5.4 and 4.4, respectively). The effect of gonadotropin releasing hormone(GnRH) on the ovulation rate was also examined. However, no difference was observed for inducing ovulation with treatment or dosage(100 ㎍ 200 ㎍) of GnRH. Low midline laparotomies were performed, and then ovarian responses (ovulations and follicular development) were examined by exteriorization of the reproductive tracts. Ova were recovered from oviducts by retrograde flushing 60-146 hours after MAP removal, and were classified the developmental stages. Overall 66.1% (236/357) of recovery rate was obtained from 30 superovulated does. The optimal recovery time of microinjectable 1-cell zygotes was approximately 72-76 hours after MAP removal.

사상체질에 따른 류마티스 관절염 환자 대조군 연구

김수영,이상훈,이현종,이두익,이윤호,이재동 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2004 東西醫學硏究所 論文集 Vol.2004 No.-

Objective: The purpose of this study is to examine the susceptibility of the patients diagnosed by rheumatoid arthritis to Sasang Typology. Methods: This study are planned to detect the susceptibility of the patients diagnosed by rheumatoid arthritis to Sasang Typology. In order to analyze the susceptibility of rheumatoid arthritis to Sasang Typology, 147 rheumatoid arthritis patients and 147 matched controls are assessed with QSCCⅡ question for Sasang Typology. Then the frequencies of patients by Sasang constitution are compared to those of control, which are statistically analyzed and adjusted by age, sex, smoking status, alchol intake, BMI, and economic status. Results: The demographic characteristics of the study population are similar in sex and age distribution, smoking status, and alcohol intake(p>0.05). 147 rheumatoid arthritis patients and 147 matched controls are assessed with QSCCⅡ question for Sasang constitution. Soeumin is die most susceptible to rheumatoid arthritis compared to Taeumin or Soyangin(Crude OR [95% Cl] ; 3.82 [2.19-6.64]). lt is statistically significant after adjusting age, sex, smoking status, alcohol intake, BMI, and economic status(Adjusted OR [95% Cl] ; 3.01 [1.47-6.15]). Conclusions: lt is suggested that the specific Sasang Typology associated with rheumatoid arthritis is used as its susceptibility marker and further as basic date to prevent the risk factors for rheumatoid arthritis.

수입각증후군에 의한 급성 복증 1례

정은욱,지삼룡,이영태,박지훈,김동기,제인수,채두근,박성재,박은택,이연재,이상혁,설상영,정정명 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Afferent loop syndrome is an uncommon complication of a gastrectomy and Billroth Ⅱ reconstruction. It may cause symtoms at any time from the first postoperative day to many years after the gastrectomy. Afferent loop syndrome is characterized by abdominal pain, vomiting and elevation of serum amylase. Thus, it is difficult to differentiate afferent loop syndrome from other cause of acute pancreatitis. However, the history of gastrectomy can be an important clue for diagnosing afferent loop syndrome. We experienced one case of chronic afferent loop syndrome with acute pancreatitis. After appropriate management, the abdominal pain disappeared and serum amylase level decreased. We report this case with a review of relevant literatures.

도시 간선가로의 공사중 교통특성에 관한 연구

이상관,홍성우,이두진 경운대학교 산업기술연구소 2001 産業技術硏究論文誌 Vol.3 No.2(C)

This study analyzed the variation of delay time to speed and traffic volume on various comparative and analytic methods, link construction in Daegu City's urban street as the basic data on traffic management counterplan under road construction. The delay time at the link is calculated by applying three methods of capacity analysis, shockwave theory and gueueing theory. While the result of the capacity analysis is similar to that of shockwave theory. The result of the queueing theory shows that v/c increases rapidly at 0.4 and increases slowly from 0.7 The results of comparative-analysis between the outcoming of the shockwave theory, queueing theory and capacity analysis at two or three-lane-road like and underwood value, the actual field survey outcoming are as follows : The queueing theory shows the most suitable reliability at two-lane-road and capacity analysis shows the most suitable reliability at three-lane-road.

발달장애학생을 위한 학교중심 통합교육과정의 편성과 운영에 관한 연구

이유훈,김영미,윤광보,홍성두 국립특수교육원 2001 연구보고서 Vol.- No.7

본 연구는 발달장애학생들의 심리적 특성에 적합한 통합교육과정을 특수학교 현장에서 보다 효율적으로 편성·운영할 수 있도록 지원하기 위해서 시도되었다. 이를 위해 본 연구에서는 통합교육과정의 이론적인 배경을 밝히고, 제 7차 특수학교 기본교육과정을 분석하여 통합교육과정과의 관련성을 알아보았다. 그리고 전국의 정신지체 및 정서장애학교를 대상으로 통합교육과정의 편성·운영방안에 대한 현장 교사들의 의견을 수렴하였다. 이러한 자료를 통해 얻어진 요구와 시사점을 토대로 발달장애학생들을 위한 학교중심 통합교육과정의 편성·운영방안을 제시하였다. 본 연구에서 다룬 연구내용별 주요 연구결과를 정리하면 다음과 같다. 통합교육과정의 이론적 고찰 21세기 지식정보화사회에서 요구하는 인간상은 창의력과 비판적 문제해결 능력을 가진 사람이다. 이런 창의적인 사람을 기르기 위해서는 삶의 맥락에서 문제를 해결하고 스스로 의미와 가치를 생성하여 자신의 세계를 열어가도록 하여야 한다. 그래서 교육과정은 이 시대 사회에서 요구하는 창의성과 협동성을 기르기 위해 삶을 중심으로 통합되어야 한다. 그리고 이러한 통합교육과정은 구성주의적인 관점과 다중지능이론의 입장에서 볼 때, 발달장애학생들의 신체적, 지적, 심리적, 인성적인 제 측면에서 교과단위의 분과교육과정에 비해보다 큰 교육적 의의를 가지고 있다는 점에서 그 필요성을 정당화시킬 수 있다. 일반적으로 통합교육과정은 통합의 수준과 방식에 따라 여러 가지 유형이 있을 수 있으나, 우리 나라 교육체제에서 볼 때 단위학교에서의 실효성 있는 운영을 위해 발달장애학생들을 위한 통합교육과정은 교육내용 구조면, 통합의 중심 내용면, 수업 운영면에서 고려되어져야 한다. 즉 주어진 학년 또는 학교급별 등의 전체 교육과정 속체서 통합의 아이디어를어떤 체제로 투입시킬 것인가 하는 교욱내용 구조면과 통합의 핵심 또는 통합을 통해서 강조하고자 하는 목표를 어디에 둘 것인가 하는 통합의 중심 내용면, 그리고 통합교육과정을 어떻게 운영할 것인가 하는 수업 운영면을 고려하여야 한다. 그리고 통합교육과정의 편성준거는 그 통합방식이 어떠하던 간에 교육적으로 의의가 있어야 하고, 또한 학교라는 시간과 공간의 제한된 상황에서 실천 가능성이 있어야 한다. 따라서 통합교육과정의 편성은 지적인 준거와 실제적인 준거가 모두 반영되어야 한다. 제 7차 특수학교 기본교육과정과 통합교육과정 발달장애학생들의 사회적응능력은 종합적이고 통합적인 성격이며, 그들이 적응하며 살아가야 하는 사회 자체가 종합적인 시각에서 파악되어야 할 대상이기 때문에 교과의 내용을 통합적으로 지도해야 한다. 그래서 제 7차 특수학교 기본교육과정에서는 교과군별로 통합시수를 배정하고 필요에 따라 교과를 통합하여 운영할 수 있도록 하고 있으며, 교과용 도서 교과내 및 교과간 내용을 생활영역 중심으로 연결시켜 필요에 따라 언제든지 통합교육과정으로 편성ㆍ운영할 수 있도록 전자도서로 개발하였다. 그러나, 국가수준의 교육과정이 통합되어 있지 않으며 교과서 또한 통합교과서로 개발되어 있지 않기 때문에, 통합교육과정을 학교중심 교육과정으로 문서화하는 방안과 학급에서수업의 필요에 따라 통합단원 지도안을 구안하여 교과통합지도를 하는 방안에 대한 연구가이루어져야 한다. 특히, 제 7차 특수학교 기본교육과정 전자도서에서 연결시키고 있는 관련 과제와 활동을 활용하여 주제별 통합단원을 구성하여 지도하는 방안에 대한 연구가 필요하다. 통합교육과정의 편성 · 운영실태통합교육과정의 편성 ·운영실태 조사에서 특수학교 대부분이 통합교육과정에 대해 높은관심을 보이고 있고, 또한 그 필요성을 느끼고 있음에도 불구하고 통합교육과정을 편성 운영하는 데에는 많은 어려움을 느끼고 있었다. 그 이유로는 교수·학습자료의 부족, 통합교육과정의 편성·운영경험 및 수행능력의 부족, 교과별 시간배당 기준 준수의 어려움, 생활장면으로의 전환 및 학생의 학업성취도 평가에 대한 어려움 등을 원인으로 들고 있었다. 이를'위해서는 통합교육과정에 대한 다양한 정보제공과 전문적인 연수가 제공될 필요가 있고, 아울러 효율적인 통합교육과정 편성·운영을 위해서는 시설·설비 및 교수·학습자료의 확충이 시급한 문제라고 할 수 있다. 한편, 통합교육과정 편성·운영에 대한 요구에서 있어서는 통합교육과정의 편성 운영주체로는 담임교사와 통합교과 팀을 들고 있다. 그리고 통합교육과정의 조직형태는 하나의 주제를 중심으로 여러 교과분야에서 관련 내용을 끌어다 새로운 내용을 구성하는 주제중심 통합과 학습자의 생활경험을 중심으로 하는 통합을 가장 선호하였으며, 통합교육과정의 모형으로는 연간계획에서 생활단원명을 설정하고 단원 내에서 관련 교과를 통합하는 모형과 교과의 선을 넘어서 관련 있는 몇 개의 교과를 묶는 교과간의 통합을 선호하였다. 그리고 통합교육과정을 효율적으로 운영하기 위해서 개선되어야 할 점으로는 교사의 연수기회 확대, 지도교사의 증원 등을 요구하고 있었다. 특히, 학교환경 개선사항으로는 학급당인원수를 줄이고 학습자료와 매체를 보다 많이 구비해야 한다는 .의견을 제시하였다 통합교육과정을 위한 평가방법으로는 지필검사는 기초학습기능에 관련된 내용에 대해서만 실시하고, 나머지는 행동관찰을 포함한 여러 가지 평가방법을 활용하자는 의견이 지배적이었다. 통합교육과정의 편성·운영 방안 통합교육과정 편성·운영방안에서는 단위학교에서 통합교육과정을 편성·운영할 때 도움이 될 수 있도록 통합교육과정 편성의 일반적인 절차와 고려해야 할 점을 제시하였고, 통합교육과정의 여러 모형 가운데에서 특수학교에서의 적용이 용이한 4가지의 통합교육과정 모형을 중심으로 교육과정 개발의 일반적인 절차인 편성, 운영, 평가과정에 대한 실제적인 방안을 제시하였다. 이를 정리하면 다음과 같다. 첫째, 학교에서 통합교육과정을 편성할 때 거쳐야 할 과정으로서 계획, 설계, 소규모 시행, 적용이라는 4단계를 제시하였고, 특히 통합교육과정을 설계할 때 따라야 할 단계를 통합의 주제 결정, 브레인스토밍을 통해 주제와 관련된 아이디어 수집 및 정리, 제시된 아이디어들과 교육과정 목표의 내용영역과 관련 지우기, 제시된 아이디어들의 교과별 관련성 찾기, 제시된 아이디어들의 다른 교과 아이디어와의 관련성 찾기, 아이디어들과 교육과정 목표의행동수준 관련 지우기, 활동계획안 작성 등의 전과정을 구체적으로 제시하였다. 둘째, 통합교육파정을 편성할 때 고려해야 할 사항으로 지원체제, 의사결정 구조, 교사의역할인식 변화, 참여동기 부여, 조직 풍토 등을 세부적으로 제시하였다. 셋째, 통합교육과정에 대한 이론적 배경과 설문조사 결과를 토대로 통합교육과정의 편성 ·운영을 위한 기본지침을 조직형태, 통합방법, 통합유형, 교육활동 계획안 개별화 교육계획안 수업시간표 작성, 평가방법 등의 측면에서 제시하였다. 넷째, 완전 통합교육과정 모형, 교과간 통합교육과정 모형, 주제중심 통합교육과정 모형, 교과내 통합교육과정 모형 등 4가지 모형을 조직형태, 통합방법, 통합유형, 교육활동 계획안, 개별화 교육계획안, 수업시간표 작성, 평가방법에 따라 편성 ·운영 ·평가의 여러 가지 가능한 방안과 예시자료를 제시하였다. 다섯째, 일반학교 통합교육과정 사례와 특수학교 통합교육과정 사례를 정리하여 부록에제시하여 실천자료를 참고할 수 있도록 하였다. This study was designed to help teachers to organize and implement integrated curriculum which is adequate for the psychologitcal characteristics of students with developmental disabilities at special school sites. For this purpose, we presented the theoretical background of integrated curriculum, and by analyzing the 7th Special School Basic Curriculum, examined its relationship with integrated curriculum. We collected opinions about methods for the organization and implementation of integrated curriculum from the teachers of special schools for students with mental retardation and emotional disturbances across the country Based on the needs and suggestions revealed through these data, we proposed strategies for the organization and implementation of school-based integrated curriculum for students with developmental disabilities. The major results according to each topic are as follows: Theoretical Background of Integrated Curriculum The ideal people needed by the 21st knowledge-based society is those who have creativity and critical problem-solving abilities. For rearing this kind of people, we have to require people to solve problems within real-life contexts and open their own world by spontaneously generating new meanings and values. Therefore curriculum should be integrated revolving on real-life concerns to develop creativity and cooperation demanded by this society. Also, in the light of constructivistic perspectives and multiple intelligence theory, integrated curriculum can be justified in that it has more educational meaning in physical. intellectual, psychological, and dispositional aspects than subject-oriented curriculum has. Typically, in integrated curriculum, there can be many forms according to the level and methodology of integration. However, when considering our current educational system, we have to take the structure of contents, core contents of integration, and class management into consideration to efRcientlyimplement integrated curriculum withi.n each school contexts . The structure ofcontents refers to how and with what system the idea of integration will beembedded into the whole curriculum at given grade or school level. Corecontents of integration mean where the core of integration or goals that wewould like to emphasize through integration will be placed, and classmanagement refers to how to rrianage integrated curriculum. ,The criteria for integrated curriculum organifation have to be meaningfuleducationally regardless of the ways of integration. and should be set in orderto be implemented in the settings of schools where time and space arelimited. Hence, the organization of integrated curriculum have to reflect boththe intellectual and practical criteria.7th Special School Basic Curriculum and Integrated CurriculumBecause the social adaptation abilities of students with developmentaldisabilities have comprehensive and synthetic characteristics and because thesociety itself where students with developmental disabilities adapt themselves and live is the object to be understood from the comprehensive perspectives,the subject contents have to be educated synthetically. Therefore according tothe 7th Basic Curriculum, the number of hours for integration is allocated bysubject areas, subjects can be implemented by integrated approach ifnecessary. and textbooks were developed in the form of electronic ones so thatwithin- and between-suhjects contents can be organized based on real-lifeconcerns and implemented by integrated approach whenever it is necessary.However, research on the ways how to transform integrated curriculum intowritten school-based curriculum, and how to design integrated unit teachingplans according to lesson demand in classrooms and implement integratedsubjects should be conducted because both the Basic Curriculum at nationallevel and textbooks were not developed in integrated form. Especially,research on strategies for forming and teaching integrated units by theme,vsing related tasks and activities with which electronic textbooks that areadopted in the 7th Basic Curriculum associate, is necessaryCurrent Status in the Organization and Implementation of IntegratedCurriculumThe results of the study showed that even though most special educationteachers are highly interested in and feel the necessity of integratedcurriculum, they have many difficulties in its organization and implementationon account of the lack in teaching-learning materials ; lack in the teachers'experiences with organizing and implementing integrated curriculum andabilities to carry out it; difficulty in adhering to time allotment standards foreach subject; difficulty in students'transition to daily life settings, andproblems with evaluating students'academic achievement Thus, it is neededto provide various information on and professional in-serfce training inintegrated curriculum. In addition, it is imperative to expand educationalfacilities and equipments, and teaching and learning materials in order to efHciently organize and ,implement integrated curriculum.Meantime, accordini: the results, the special school teachers demand thatthe organization and implementation of integrated curriculum should be madethrough team approach. And among the organizational forms of integratedcurriculum, theme-centered integration ir which teachers select relatedcontents from several subject matters based on a theme and then constructnew contents, and learners'life experience-centered integration are the mostpreferred. As (or integrated curriculum model, models by which teachers setthe titles of life vnits in the really plan and then integrate related subjectmatters within the units. and by which teachers integrate related subjectsbeyond their borders are preferred.The results also showed that increase in opportunity for teacher trainingand the number of teachers is required in order to efnciently implementintegrated curriculum. Especially. for the improvement of school environment,it was proposed to reduce the number of students per class and to beequipped with more learning materials and media. As for the methodology for.evaluating integrated curriculum, it was'predominantly reported thatpaper-and-pencil tests have to be used only for contents related to basiclearning skills , and various ways of evaluation including behaviour observationhave to be utilized for the , other contents.Strategies for the Organization and trnplernentation of IntegratedCurriculumAt flrst, we presented the general procedures of and considerations in theorganiBation of integrated curriculum to help each school to organize andimplement it. And based on four types of integrated curriculum models whichare easy to adopt within special school contexts, we provided practicalstrategies for organizing. implemen?ing. and evaluating integrated curriculumas the general procedures of curriculum development. The details are as follows : First, we present 4 steps, that is, planning, designing, Performing in asmall way, and adapting, as the procedul·e needed to 9o through whenorganizing the integrated curriculum. Furthermore , we also concretely presentthe steps that have to be followed in designing the integrated curriculum. Thesteps are 1) deciding the topic of integration; 2) collecting and arrangingideas related to the topic through brainstorming; 3) establishing therelationship between the su99ested ideas and the corltent areas of thecurriculum goals ; 4) searching the relevance of the su99e~3ted ideas accordingto subject; 5) looking for relation between the suggested ideas and the ideasfrom other suhjects; 6) connecting the ideas to behavior level of thecurriculum goals ; 7) drawing out the activity plan.Second, as the things to be considered when organizing the integratedcurriculum, we Present the support system. the structure of decision making.change in recognition about teacher's role, encouragement for participation,organization climate, and so on.Third, based on survey and theoretical background about the integratedcurriculum, we propose the basic guidelines for the organization andmanagement of the intesrated curriculum from the various aspects such asorganizational form, way and type of integration, plan for educationalactivities , individualized education program, class schedulir19, and methodologyfor evaluation.Fourth, we present the diverse possible plans arid examples aboutorganiBing, managing, and evaluating such models as full integratedcurriculum model, between-subjects integrated curriculum model,topic-centered integrated curriculum model, and within-subject integratedcurriculum model according to organizational form, way and type ofintegration, plan for educational activities , individualized education program,class scheduling. and methodology for evaluationFinally, we arrange the cases of integrated curriculum in both general andspecial schools, and put them in the appendix for later reference.