서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

기억력 저하를 호소하는 노인들을 대상으로 INM176를 3개월간 임상시험한 후의 치료성적 및 부작용 평가 보고

김지혜,고선규,고효정,권영아,김성환,김재경,김태은,박재우,서민영,송영란,이인수,김도관 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2

Objectives : We examined the effects of INM 176 (K-l107) compared with placebo on the cognitive functions of 92 old aged subjects with cognitive impairment. Methods : This was a prospective, 12 week, double-blind, Placebo-controlled clinical trial. The elderly who achieved a score of less than 25 points on the K-MMSE or showed a high risk of Alzheimer's disease from the 7-Minute Neurocognitive Screening Battery were considered to have objective impairment and were selected as subjects for this study. The subjects were randomized to placebo or INM 176 group. The outcome measures were from the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog), the Instrumental Activities ofDaily Living (IADL) and the Korean Geriatric Depression Scale (KGDS) and two kinds of computerized priming tests. After setting the total error score in the Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog) as the repeated measurement factor, an analysis of variance of the combined factor design was done between the placebo and INM 176 group. Results : The interaction effect of time (pre- and post-trial) and group (placebo and INM 176 group) was significant in the analysis of the ADAS-cog's total error score. The INM 176 group's total error score in the ADAS-cog decreased significantly (p<0.01), whereas the placebo group showed a slight increase. The mean changes in IADL and GDS from baseline scores favored in the INM 176 group than in the placebo group. Outcome changes ofADAS-cog, IADL, KGDS scores during the 12 week clinical trail ofINM 176 and placebo demonstrated favorable responses in the INM176 administered group. Conclusions : This is a preliminary clinical trial result of INM176 as a memory pill. Based on these results, INM176 may be a candidate molecule for the improvement of cognitive functions, including memory, Further clinical trial should demonstrate its efficacy.

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.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

ImmunoDot법에 의한 전신성 류마티스 질환의 자가항체 검사

박성환,김선준,김성일,민준기,이상헌,홍연식,조철수,김호연 최신의학사 1997 最新醫學 Vol.40 No.7

마늘成分이 肝 Glutathione S-Transferase 및 Glutathione peroxidase 活性에 미치는 影響

朴鍾珉,李相日,金善業,許瑾,金碩煥,徐赫珪 嶺南大學校 環境問題硏究所 1985 環境硏究 Vol.5 No.2

Garlic (Allium sativum L.) is a widely distributed plant used in all parts of the world not only as a spice but also as a popular remedy for several thousand years Recent studies have shown that garlic components may regulate the many metabolism in liver. Therefore, the present work was undertaken to study the effect of garlicjuice, allicin fraction and heat-treated allicin fraction on the hepatic glutathione s-transferase and glutathione peroxidase which protect against toxic compound and lipid peroxide in liver. The results obtained were summarized as follows. By the treatment of garlic juice, glutathione s-transferase and glutathione peroxidase activity was increased in hepatic cytosolic fraction compare with control group. The enzyme activtiy is more increased by treatment with boiled garlic juice compared with fresh garlic juice in rats. The effect of allicin fraction and heat-treated allicin fraction on the hepatic glutathione s-transferase was observed that these components inhibited the enzyme activity in vitro, whereas the enzyme activity was strongly inhibited heat-treated allicin fraction than allicin fraction. These observation led us to conclude that the garlic components which are a stable substance in heat may regulate the hepatic glutathione s-transferase and glutathione peroxidase activity.

만경강 유역내 하천의 특성별 영향 평가

윤순강,이종식,정구복,김민경,김선종,고문환,엄기철 한국환경농학회 2002 한국환경농학회지 Vol.21 No.4

본 연구는 만경강 유역의 수질 보전을 위한 기초자료를 얻기 위하여 만경강 본류와 이에 유입되는 지천을 선정하여 2001년 5월부터 11월까지 매월 수질 모니터링을 실시하였다. 만경강 유역내 본류 및 지천의 유기물과 영양염류 함량을 조사한 결과, 본류의 T-N은 3.78~12.68 ㎎/L였으며, 지천중 축산폐수가 유입되는 익산천의 농도가 가장 높았다. 본류의 T-P의 BOD는 각각 0.043~0.864 ㎎/L와 2.59~13.29 ㎎/L였으며, 지천중 익산천이 가장 높았다. 본류의 COD는 12.9~119.5 mg/L였으며, 지천중 도시생활하수가 유입되는 추천이 가장 높았다. 만경강 유역 수질저하의 주 원인은 축산폐수였으며, 도시생활하수가 그 다음으로 중요한 원인으로 평가되었다. 만경강 본류의 T-N과 T-P는 하천의 유량이 증가하는 홍수기인 7~8월보다 장마선 갈수기인 5~6월에 높았고, COD는 장마전 갈수기보다 홍수기에 높았으며 장마가 완전히 끝난 영농후 갈수기인 9~11월에도 수질저하가 지속되었다. 만경강에 유입되는 지천중 전반적으로 수질오염이 심각한 익산천과 추천은 영농후 갈수기에 수질이 가장 저하되었고 상대적으로 홍수기에는 양호하였다. A survey on four tributaries along with Mankyeong River was carried out to get the information for the water quality improvement and control. Typical paddy farming were major agricultural practices in Kosancheon and Soyangcheon. Iksancheon was livestock raising watershed. Chucheon was urban watershed. Water quality in six sites of main stream and four sites of tributaries in Mankyeong River were investigated from May to August in 2001. The concentration of nutrients in main stream of Mankyeong River were in the range of 3.78~12.68 mg/L for total nitrogen, 0.043~0.864 mg/L for total phosphorus, 2.59~13.29 mg/L for BOD and 12.9~119.5 mg/L for COD, respectively. Water quality of Mankyeong River mostly exceeded the standard water quality criteria of Korea. Major causes of water pollution were evaluated as sewage of swine and urban area. Among the four tributaries, water quality in agricultural practices, Kosancheon and Soyangcheon was relatively less polluted. While, the highest level of water pollution measured in Iksancheon was due to livestock The water quality of Iksancheon and Chucheon was generally more polluted in the dry period than in rainy period.

농업인의 농업생산 역량 진단도구 개발

김진모,정철영,주대진,길대환,박종선,송민철 한국농업교육학회 2011 농업교육과 인적자원개발 Vol.43 No.4

급격하게 변화하는 환경에 대응할 수 있는 전문농업인을 체계적으로 육성해야하는 현 시점에서 농업인에게 실제적으로 요구되는 능력 및 역량을 표준화하고 농업인의 능력수준을 체계적으로 파악해야 할 필요성이 제기되고 있다. 이에 따라 본 연구는 농업생산 역량 진단도구 개발을 목적으로 하였다. 이를 위해 문헌 고찰, 전문가 협의회, 전문가 자문, 설문조사 등의 방법을 활용하여 23개 품목별 농업인의 성장단계 및 성취기준을 설정하고, 농업생산 역량모델을 개발한 후 이를 토대로 역량 진단도구를 개발하였다. 농업생산 역량모델은 직무분석 접근방법을 기반으로 하여 직무과제 분석을 실시하였고, 그 결과에 따라 역량 및 행동지표를 개발하였다. 역량 진단도구는 자가진단 방식으로 현재수준을 측정하도록 하였으며, 전문가 패널을 통해 설정한 개발목표 및 중요도와 비교할 수 있도록 구성하였다. 이 연구를 통해 도출된 주요 결과는 다음과 같다. 첫째, 농업인의 성장단계를 초보자, 준전문가, 전문가의 3단계로 규정하였다. 둘째, 농업인의 성장단계별 성취기준을 품목별로 설정하였다. 셋째, 23개 품목별 직무과제 분석을 통해 농업생산 역량모델을 개발하였다. 넷째, 품목별 역량모델의 행동지표를 활용한 문항개발을 통해 농업생산 역량 진단도구를 개발하였다. There are increasing needs to systematically foster professional farmers who can cope with the rapidly changing environment. Therefore, it is important to set competency standards for farmers and to systematically measure levels of farmers competencies. For this reason, the purpose of this study was to develop an assessment tool for farmers agriculture production competency. Through a literature review, council meetings, experts consultation and survey, we set developmental stages and achievement standards of farmers for 23 farming products, developed an agricultural production competency model, and finally developed an agricultural production competency assessment tool. A competency model for agricultural production was developed using job and task analysis, and competency behavioral indicators were developed according to the job analysis result. A competency assessment tool was made to measure farmers’present state of competency level by a self-assessment method and was designed to be able to compare themselves with developmental objectives and level of importance set by the expert panel. The result of this study is as follows: 1) Developmental stages of farmers were determined as three levels: beginners, semi-professionals and professionals; 2) Achievement standards for each developmental stage of farmers were set; 3) Agriculture production competency model was developed using job and task analysis for 23 farming products; 4) Assessment tool for agriculture production competency was developed by developing questionnaire items with competency behavioral indicators.

한국어판 정신증상평가척도의 신뢰도와 타당도

정순민,김미경,이정빈,최진환,정봉주,변원탄 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.3

Objectives : Psychotic Symptom Rating Scale (PSYRATS) is an assessment tool to measure the seventy of different dimen-sions of auditory hallucinations and delusions. The reliability and validity of the Korean version of PSYRATS (K-PSYRATS)were examined in Korean patients with major psychosis. Methods : The inter-rater reliability of the K-PSYRATS was determined from the videotaped interviews of the five Schizoph-renic patients. To measure validity and internal consistency reliability, the 109 patients with auditory hallucinations or delusions were assessed using the K-PSYRATS, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Se-verity (CGI-S) scale. Results : K-PSYRATS was found to have excellent inter-rater reliability (intra-class correlation coefficient of auditory haliu-cination=0.81, P<.001, intm-class correlation coefficient ofde1usion=0.97, P<.001) and internal consistency reliability (Cron-bach's a of auditory hallucination =0.77, Cronbach's α of delusion =0.76). Significant correlation was found between K-PSY-RATS and positive syndrome subscale of PANSS and CGI. Conclusion : K-PSYRATS is a useful assessment instrument for psychotic symptoms in Korea.

Mild Cognitive Impairment 노인군의 점화효과 특성

박재우,김도관,고선규,고효정,김성환,김재경,서민영,이인수,김지혜 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.3

연구목적 : 이 연구에서는 K-MMSE에서 25점 이하를 받은 50대 이상 노인들을 MCI(Mild Cognitive Impairment) 군으로 보고 이들의 인지 기능 특성을 점화 효과를 중심으로 살펴보고자 하였다. 먼저, 점화 효과가 MCI 노인군에서 있어서도 유지되고 있는지를 알아보고, 인지 기능의 손상 정도에 따라 점화 효과가 유의미하게 변화하는 지를 살펴보고자 하였다. 방 법 : 본 연구에서는 K-NAME 점수 25점 이하의 노인 96명으 대상으로 ADAS-Cog와 일종의 간접 기억 검사 도구인 지각적 파악 과제를 제작하여 점화 효과를 측정하여 인지 기능의 퇴행이 시작된 고연령군이 나타내는 암묵 기억 능력 특성을 알아보았다. 점화효과는 컴퓨터 상에 사전 노출된 자극과 그렇지 않은 자극을 순간 노출시켜 미리 노출된 자극에 대해 반응 시간이 줄어들고 정확 반응이 증가하는 정도로써 측정하였다. 이 때 지능이나 연령, 학력 수준과 같은 변인이 미치는 영향을 통제하기 위해 한국판 웩슬러 지능 검사의 <어휘>, <토막> 소검사를 실시하였고, 인구통계학적 변인에 관한 면접을 실시하였다. 통계적 분석 과정에서는 먼저, 연구에서 측정된 점화효과의 특성을 알아보기 점화 효과 측정치의 기술 통계치를 구하였으며 다른 측정 변인들과의 상관 분석을 실시하였다. 마지막으로 측정된 점화효과가 인지 기능의 퇴행 수준에 비례하는 지의 여부를 파악하기 위해 ADAS-Cog 및 나이, 교육 연한 및 지능 수준을 독립변인으로 회귀분석을 실시하였다. 결 과 : 먼저 기술 통계 분석 결과에 의하면 본 연구에 참여한 피보험자들의 경우 점화효과에 의해 미리 노출된 자극을 평균 3.6개 더 정확히 파악하였으며 평균 59ms 더 빠르게 반응한 것으로 나타나 이들 집단에서도 점화효과가 유지되고 있음을 알 수 있었다. 다음으로 변인들 간의 상관 분석 결과에 따르면, 정확 파악 반응 점수에 따른 점화효과는 전반적인 인지 기능을 평가하는 K-MMSE 및 ADAS-Cog와 정적인 상관이 있는 것으로 나타났으며 반응 속도로 측정한 점화효과의 경우에는 나이와는 정적인 상관이, KWIS의 <어휘> 소검사 점수와는 부적인 상관이 있는 것으로 나타났다. 또한, 본 연구에서 사용된 점화 효과 측정치를 종속 변인으로 ADAS-Cog와 KWIS의 어휘 및 코막 소검사로 측정한 지능 수준, 나이와 교육 연한과 같은 인구 통계학적 변인을 독립 변인으로 회귀 분석을 실시한 결과에 따르면 정화간응 점수로 측정한 점화 효과의 경우 상관 분석 결과에서와 같이 ADAS-Cog 변인만이 유의미한 효과를 갖는 것으로 나타났으며 반응 속도로 측정한 점화 효과의 경우 나이의 효과만 유의미한 것으로 나타났다. 결 론 : 이러한 결과는 경미한 인지 기능의 손상이 진행되고 있는 고연령군의 경우에는 외현 기억 능력은 손상이 시작되지만 점화효과로 측정된 암묵 기억이 전반적으로는 유지되다가 인지 기능의 퇴행이 진행됨에 따라 노출된 자극을 더 정확히 파악하는 능력이 저하되고 점화 효과에 의해 인출 속도가 빨라지는 현상이 연령이 증가함에 따라 함께 증가하는 것으로 나타남을 말해 준다. Objectives : In this study, the cognitive characteristics, especially priming effect, of above 50 years old age group who had less than 25 points in K-MMSE were investigated. Methods : In this study, an implicit memory test measuring priming effect was made and administered ti old age people who had less than 25 points in k-MMSe in screening session. To control the effect of age, educational level and intelligence, demograohic variables were measured, and the subjects of KWIS, vocabulary and block design were administered. Descriptive statistical analysis of the two priming measures and correlational analysis between variables were done. To test the effect of cognitive functioning on priming effect multiple regression analysis was done. Results : Correlational analysis revealed priming score obtained from correct identification response was positively correlated with K-MMSE and ADAS-Cog. And priming score obtained from mean reaction time was positively correlated with age and negatively correlated with vocabulary substest of KWIS. The regression analysis results indicated from correct identification response, whereas age has significant effect on priming score obtained from mean reaction time. Conclusions : The results revealed that as cognitive deterioration progresses priming effect which identify primed stimulus correctly diminish, and as one grow older within age 50 to 70, priming effect which identifies primed stimulus quickly increase.