일 대학병원 주차장 유료화에 따른 주차장 이용실태 조사

김정희,박진숙,주찬웅,최기철 한국의료QA학회 1997 한국의료질향상학회지 Vol.4 No.1

Background : As parking problem caused by increasing owner-driver and patients concentration to a general hospital is becoming one of the dissatisfactions in medical care. It is time that a general hospital should solve the parking problem in a desirable way. The purpose of this survey is to let the clients understand the basic motivation of the pay parking and develop the better parking system. Methods : Clients of a tertiary care hospital in Chon-ju were surveyed by means of a questionnaire. All in all, 193, subjects answered the questionnaire. Results : In relation to the previous experiences, 39.6% of the subjects experienced inconvenience with confuse parking lot and the shortage of parking space. Under the were more than those who didn't 62.7% of the subjects answered that the y could find the parking lot easily. 33.2% of the subjects mentioned that it was not easy to drive in the parking area ; The reasons were pointed out the shortage of space, disordered parking, and insufficient guide, 12.8% of the subjects satisfied with the current administering system of parking lot. The outpatients were more affirmative than the admitted patients about the charging system. As for the parking fee, 64% of the subjects answered that it is expensive, and 89.5% of the subjects answered that it is expensive, and 89.5% of the subjects thought imposing of parking fee is irrational. Conclusion : To say as a whole, th basic purpose of the charging system are more of less accepted. However, the management details like parking facilities and payment method are dissatisfactory, so it is necessary to improve the management system. It is also noted that the inpatients showed more negative attitude than the outpatients with the charging system. To secure a more convenient parking, the parking system should be considered in relation to the information service, kind guidance, improve facilities, personnel cooperation, fix outpatient scheduling system. etc.

중ㆍ고등학생들의 수학교과 호오도(好惡度)의 변화에 대한 분석

박규홍,박기양,김영국,박윤범,박혜숙,임재훈 서원대학교 교육대학원 2000 교육논총 Vol.4 No.-

In this paper we investigate and analyze the variation of secondary school student's like and dislike the school mathematics lesson. First, we investigate the reason that why students dislike mathematics in the class and we search the point of time when the students dislike mathematics in the class. Next, we investigate and analyze the variation of student's inclination to the school mathematics lesson. In this research we try the followings. 1) We analyze the variation of each level school, student's inclination to the school mathematics class, 2) We analyze the variation of student's inclination to the mathematics for each place where the school located. 3) We analyze and compare between the inclination to the mathematics lesson and to each level school. 4) We analyze and compare between the inclination to the mathematics lesson and to each factors of student's inclination From these investigation and analysis, we have the following conclusion . (1) The student's inclination to the mathematics is depend on the teacher's teaching method and on the fact that how can the mathematics lesson be composed easily. (2) The student's response was seen in the same type from the inquiry about the inclination to the mathematics lesson in the school of Seoul and small country town. This is a passing phase caused by the educational environment in Seoul and the small country town's schools is better than that of the big city or medium city. (3) The student group of the human knowledge in the general high school show the negative response for the inclination to the matheirlatics lessen compare to that of the student group of natural science in the general high school. (4) In the middle school, about half of the students dislike mathematics But such dislike rate of mathematics increased in the high school. (5) Teachers must take into consideration to the student in the first grade high school mathematics course To do this, teachers make adapt the curriculum easily for the student and must teach the mathematics to the students who can take interest in the mathematics.

관동맥질환에서 저밀도 지단백 입자 크기의 분포

임효영,김인숙,승기배,강동헌,전두수,장기육,박준철,이수영,홍순조,최규보 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

대학생의 일반적 건강신념과 미세체계적 환경적 요인의 관계연구

박계숙,곽기우 韓國學校保健學會 1990 韓國學校保健學會誌 Vol.3 No.2

In order to promote the Generalized Health Beliefs between the medical doctors and university students for more comprehensive health control, we researched the Generalized Health Beliefs invented by Dr. Cockburn and microsystemic enviromental factors. As a result, we obtained the following conclusion from the study: 1. Analytically possible answers given by 525 students(92.6%), and among them. 356(67.8%) male students, and 196(32.2%) female students. 2. Items for Generalized Health Beliefs, Which were divided into 4 factors: 4 items for seriousness of health, 3 items for the barrier of medical utility, 4 items for the medical motivation, and 4 item for the control over illness. 3. Cronbach's alpha constant for respective analytic factors revealed that the seriousness of health; 0.92, the barrier of medical utility; 0.94, the medical motivation; 0.44, and the control over illness; 0.76. 4. The seriousness of health was influences by gender, origin of birth, residence, and frequency of visiting a doctor during one year period(〈0.05). 5. The barrier of medical utility differs from origin of birth, residence, and frequency of visiting differs from origin of birth, residence, and frequency of visiting a doctor(〈0.05). 6. Gender was found to be an influencing factor in the medical motivation, and gender and religion in the control over illness(〈0.05).

신동맥 협착 정도에 따른 도플러 초음파 소견

박재성,이혜경,김대호,최득린,권귀향,홍현숙,임한혁,김기정 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

Renal artery stenosis is the one of causes of hypertension in a small percentage of all patients but is only anatomical cause that can be treated by means of surgery and percutanecous transluminal angioplasty. Angiography is the golden standard for diagnosis of renal artery stenosis, but a little invasive. With the advent of abdominal Doppler ultrasonography, renal artery stenosis could be diagnoed noninvasively. The experienced hands appears to be valuable in the doppler examination, ut some investigators consider it almost useless. The authors studied the effect of stenosis of renal artery on the downstream intrarenal blood flow, a snare was placed around renal artery in 12 rabbits and compressed to create stenosis while Doppler ultraonographic curve and flow index were obtained from main renal and interlobar arteries by means of placement of 10-MHz curved linear tranducer directly on the surface of kidney. The Doppler measurements were compared with the percentage of stenosis on angiograms. The results were as follow: 1. Ten satisfactory angiograms and Doppler ultrasonograms were obtained. 2. Three renal arteries were created stenosis below 70% (Group A), Seven were above 70% (Group B). 3. The ranges of RI (resistance index) were 0.61-0.86 (mean 0.78±0.154) at main renal arteries, 0.57-0.85 (mean 0.77±0.231) at interlobar artery. The range of PS (peak systolic velocity) were 13.1-28.8 (mean 21.65±4.445) m/sex at main renal artery, 5.2-18.1 (mean 11.74±4.095) m/sec at interlobar arteries. The RI of rabbits were higher than those of human (mean 0.58±0.05). 4. The range of RI in stenotic arteries of group B were 0.45-0.74 (mean 0.57±0.143) at main renal artery, 0.52-0.65 (mean 59±0.051) at interlobar arteries. The range of PS were 11.2-21.3 (mean 15.04±3.755) m/sec at main renal arte교, 5.7-11.3 (mean 8.24±2.056) at interlobar artery. The difference were statistical y significant (P=0.0302), but without remarkable change in group A. 5. Doppler ultrasonographic curve during progressive compression of renal artery showed dampened systolic waveform and diagonal upstroke at main renal arteries (71.4%) and interlobar arteries (85.7%) in group B, but without remarkable change in group A. 6. Release of the arterial compression caused higher than normal peak systolic velocity initially, at main renal arteries (42.9%) and interlobar arteries (28.6%). but the curve of all rabbits returned to normal within 5 minutes. The Doppler ultrasonographic index and curve were not changed on follow up Doppler ultrasonogram at 5 min. 10 min. 30 min. and 1 hour. The change of the systolic curves that compressed experimentally is identical to change in the pulsus tardus and parvus waveforms seen in both acute and chronic severe renal artery stenosis in humans, can helpul for the diagnosis of renal artery stenosis and the effects of treatment by percutaneous tranluminal angioplasty and surgery.

일반인과 정신과 환자 보호자들의 정신질환에 대한 인식과 태도에 관한 연구

박정우,곽영숙,백기청 大韓神經精神醫學會 1995 신경정신의학 Vol.34 No.4

This study was conducted to examine the knowledge and attitude toward mental illness in the lay people and the psychiatric patients' caretakers from December 1993 to October 1994. 242 lay people who were the parents of the students in an elementary school and 164 psychiatric patients' caretakers at Seoul National Mental Hospital were asked to answer a questionnaire about mental illness. In addition, parent Bonding Instrument(PBI) was used to determine the parental bonding style in 94 psychiatric patients' caretakers. And the results were as follows : 1) the primitive, supernatural concepts toward mental illness were significantly high in caretakers and in low educational group. 2) The psychological, environmental concepts toward mental illness were significantly high in female and in low educational group. 3) The negative attitudes toward the mentally ill were significantly high in female caretakers and in older age group and how educational group. 4) The caretakers' negative attitude toward the mentally ill were significantly associated with increased number of admissions. 5) The Mothers had more psychological, environmental concepts and more negative attitudes toward mental illness than the siblings in caretakers. 6) The negative attitudes toward the mentally ill were significantly associated with high level of parental overprotection and low level of parental care and the primitive, supernatural concepts toward mental illness were significantly associated with high level of paternal overprotection and low level of paternal care. We suggest that educational programs on the mental illness, especially for the primary caretakers, are necessary for early detection and treatment of illnesses, prevention of relapses- and rehabilitation.

연쇄알구균 감염에 의한 급성 인후염 후 반응성 관절염 1예

박은하,도연실,양정채,강미라,서현주,정숙인,손준성,기현균,오원섭,백경란,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

연쇄알구균에 의한 급성 인후염 후 발생한 반응성 관절염은 급성 류마티스열의 개정된 진단기준을 충족하지 못하면서, 지속적 혹은 재발성의 비이동성 관절염과 발열, 홍반성 결절, 일시적 간기능 이상 등을 보이면서 심장염과 무도증을 드물게 동반하는 질환이다. 따라서, 발열을 동반한 급성 관절염 환자에서 감별해야 할 질환 중의 하나이며, 심근염 예방을 위한 페니실린 요법의 적응증 및 기간에 대해서는 아직 이론이 많은 상황으로, 보다 광범위한 연구가 필요하다. 저자들은 연쇄알구균에 의한 급성 인후염 1주 후에 발생한 하지의 다발성 비이동성 관절염과 함께 결절홍반 및 일시적 간기능 이상을 보인 환자에서 PSRA로 진단하고 비스테로이드성 항염증제 및 스테로이드로 성공적인 치료를 하였기에 이를 문헌 고찰과 함께 보고하는 바이다. Poststreptococcal reactive arthritis (PSRA) is associated with recent streptococcal infections. However, PSRA is distinct from acute rheumatic fever by its clinical manifestations: non-migrating arthritis, erythema nodosum or erythema multiforme, and transient elevation of serum transaminases. We experienced a 33-year-old man who presented with fever, arthritis of both knees and ankles, and erythema nodosums on extensor surfaces of lower legs which developed 6 days after the onset of pharyngitis symptoms. Blood and urine cultures were negative. Throat culture was negative for group A β-hemolytic streptococcus. The ASO titers increased up to 2080 IU/mL in sequential monitoring. The result of bone scan was compatible to arthritis of both knees and ankles. There were no signs or symptom of carditis. He showed clinical improvement with anti-inflammatory drugs (naproxen 1,000 mg/day and prednisolone 7.5 mg/d). PSRA should be included in the differential diagnosis of patients presenting with arthritis combined with fever.

다발성 말초신경증이 동반된 불명열로 발현한 혈관내 림프종증

박병배,김갑현,손준성,기현균,정숙인,오원섭,백경란,정철원,송재훈,고영혜 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

불명열의 원인에는 감염, 신생물, 교원섬유혈관질환 등의 여러 가지 질환이 속한다. 불명열 환자를 접하게 되면 그 원인을 밝히기 위한 검사를 시행하게 되는데, 수많은 검사를 시행하고도 그 원인 질환이 진단 안 되는 경우가 5-15% 정도 된다. 불명열의 원인으로서 이전까지 진단이 어려웠던 농양이나 종양은 현대의 방사선적 영상기술 발달로 조기 진단이 가능하게 되었지만, 악성 혈액질환처럼 종괴를 형성하지 않는 질환들의 정확하고 신속한 진단은 여전히 어려운 실정이다. 혈관내림프종증은 림프절 병변을 거의 형성하지 않기 때문에 진단이 매우 어려운 질환이다. 병의 경과가 빨리 진행하여 예후가 좋지 않으므로 신속한 진단이 절실히 요구되는 질환이다. 저자들은 말초신경증이 동반된 불명열을 주소로 내원한 환자에서 흉강내시경 폐생검을 시행하여 혈관내림프종증을 조기 진단할 수 있었기에 이를 문헌 고찰과 함께 보고 하는 바이다. Fever of unknown origin (FUO) is caused by infections (30-40%), neoplasms (20-30%), collagen vascular diseases (10-20%), and numerous miscellaneous diseases (15-20%). The literatures also reveal that 5-15% of FUO cases defy diagnosis, despite extensive studies. Diagnostic advances continuously modify the spectrum of FUO-causing diseases. Modern imaging techniques (e.g., ultrasound, CT scan, MRI) enable early detection of abscesses and solid tumors that used to be difficult to diagnose. But the correct diagnosis can be delayed because the tumor, such as rare hematologic malignancy, is difficult to be detected by various imaging studies. Intravascular lymphomatosis (IVL) is a rare form of non-Hodgkin's lymphoma and generally fatal disease characterized by extensive proliferation of neoplastic mononuclear cells within the lumina of blood vessels. The prognosis is usually extremely poor, with rapid death despite chemotherapy. The diagnosis is most frequently made after biopsy of skin or brain but is often established post mortem. Most patients with IVL present with FUO and nonspecific cutaneous and neurologic manifestations. Peripheral nerve system or pulmonary involvements are not common as initial menifestations. We report a case of intravascular lymphomatosis, presenting as FUO with peripheral polyneuropathy. We made early diagnosis of IVL by video-assisted thoracoscopic lung biopsy. She is improving with good performance after the 4th cycle of chemotherapy till now.

충전재-탄성체 상호작용. 6. 산소 플라즈마 처리가 카본블랙표면특성 미치는 영향

박수진,조기숙,Zaborski, M,S´lusarski, L 한국고무학회 2002 엘라스토머 및 콤포지트 Vol.37 No.2

본 연구에서는 산소 플라즈마 처리에 의한 카본블랙의 표면특성과 카본블랙/고무 복합재료의 기계적 계면물성에 대하여 고찰하였다. 산소플라즈마의 산화반응에 의한 카본블랙 표면특성은 표면산도-염기도와 제타전위, 그리고 X-ray photo-electron spectroscopy (XPS)를 통하여 알아보았으며 카본블랙/고무 복합재료의 기계적 물성은 인열에너지 (GⅢC)를 측정하여 관찰하였다. 본 실험결과로부터 플라즈마 처리에 의해 카본블랙 표면에 카르복시기, 하이드록시기, 락톤, 카르보닐기와 같은 산소를 함유하는 극성관능기들이 플라즈마 처리시간이 증가함에 따라 증가하 는 경향을 나타내었으며, 카본블랙 표면에 산소를 함유한 관능기와 극성고무인 NBR과 높은 상호작용으로 인해 카본블랙과 고무사이의 계면 결합력이 증가하여 카본블랙/고무 복합재료의 기계적 계면물성인 tearing energy가 증가한 것을 확인할 수 있었다. In this work, the surface properties and mechanical interfacial properties of the carbon blacks treated by oxygen plasma were investigated. The surface properties of carbon black by oxidation process of oxygen plasma were studied in acid-base surface value, zeta potential, and X-ray photoelectron spectroscopy (XPS). And their mechanical interfacial properties of the carbon black/rubber composites were evaluated by the composite tearing energy (GⅢC). As a result, it was found that the introduction rate of oxygen-containing polar functional groups, such as carboxyl, hydroxyl, lactone, and carbonyl groups, onto the carbon black surfaces was increased by increasing the plasma treatment time. It revealed that the polar rubber, such as acrylonitrile butadiene rubber (NBR), showed relatively a high degree of interaction with oxygen-containing functional groups of the carbon black surfaces, resulting in improving the tearing energy (GⅢC) of the carbon black/acrlyonitrile butadiene rubber composites.

PC12 세포에서 Sertraline을 위시한 항우울제에 의한 칼슘길항 유사효과

박기창,공인덕,정해숙,한준규,박규상,이중우,백인호 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.3

본 실험에서는 PC12 세포를 신경세포 모델로 형광물질인 fura-2 및 bisoxonol을 이용하여 세포내 유리 칼슘이온 농도 및 막전압을 각각 측정하여 화학구조가 서로 다른 몇몇 항우울제가 막전압 의존성 칼슘통로의 활성화 및 ATP를 통한 수용체 의존성 칼슘통로의 활성화에 미치는 영향을 관찰하여 아래와 같은 결과를 얻었다. 1) 선택적 serotonin 재흡수 억제제의 하나인 sertraline은 60mM KCI 자극 및 100μM ATP 자극에 의한 [Ca²+]i의 증가를 억제하였으며 이때 IC50 값은 각각 2.5μM과 5.3μM이었다. 2) 막전압 의존성 칼슘통로 및 ATP에 의한 수용체 의존성 칼슘통로의 억제효과는 sertraline을 비롯한 선택적 serotonin 재흡수 억제제나 삼환계 항우울제인 경우 크나, 비전형 항우울제인 trazodone 이나 MAO 억제제인 moclobemide의 경우에는 효과가 미미했다. 3) Sertraline 자체는 농도 의존적으로 지속적인 막전압의 탈분극을 유발하였으며 이에 따라 안정시의 세포내 유리 칼슘이온 농도를 일부 증가시켰다. 4) Sertraline에 의한 칼슘이온 농도 증가효과는 일부 세포내 Ca²+ 저장소로부터 동원이 관여하나 주로 세포막을 통한 칼슘유입에 의해 일어난다. 5) 여러 항우울제 중 sertraline에 의한 탈분극 효과가 가장 컸으며 그 외의 선택적 serotonin 재섭취 억제제, 삼환계 항우울제들은 탈분극 효과가 있었으나 비전형 항우울제인 trazodone은 일부의 효과를 그리로 MAO 억제제인 moclobemide는 막전압에 전혀 영향을 주지 않았다. 6) ATP는 일시적인 탈분극을 유발하였는데 sertraline 전처지로 탈분극 효과가 억제되었으며 이때 IC50는 30μM이었다. 7) ATP에 의한 세포내 칼슘이온 농도의 증가는 nimodipine에 의해 일부만 억제되었으나 sertraline을 함께 투여한 경우에는 그 억제 효과가 훨씬 더 증가하였다. 이상의 실험결과로 미루어 보아 항우울제 중에서 sertraline을 비롯한 선택적 serotonin 재흡수 억제제나 삼환계 항우울제들은 신경세포를 지속적으로 탈분극 시키고 세포내 유리 칼슘농도를 증가시키는 한편 막전압 의존성 칼슘통로와 수용체 의존성 칼슘통로를 차단하여 그 효과가 나타나는 것으로 사료된다. It has been known that antidepressants have calcium antagonist-like action in neuronal tissues. However, their mechanisms are still obscure. For the study of neurochemical mechanism of antidepressants, the authors examined the effects of antidepressants(1-100μM) on the intracellular Ca²+ concentration ([Ca²+]i) and the membrane potential in PC12 cells using fluorescent dyes, fura-2/AM and bisoxonol, respectively. The results were as follows : 1) Sertraline, a selective serotonin reuptake inhibitor(SSRI), inhibited the increment of [Ca²+]i induced by high 60 mM KCl and 100μM ATP with an IC50 value of 2.5μM and 5.4μM, respectively. 2) SSRIs(sertraline, paroxetine and fluoxetine) and tricyclic antidepressants(imipramine and amitriptyline) had strong effects on the inhibition of both voltage-dependent Ca²+ channel and receptor-dependent Ca²+channel, whereas atypical antidepressant(trazodone) and MAO inhibitor(moclobemide) had little effects. 3) Sertraline itself depolarized the membrane potential in a sustained manner depending on its own concentration and it also increased the basal level of [Ca²+]i. 4) The increment of [Ca²+]i might be induced partly by the release from the intracellular calcium store, but mostly induced by the calcium transport through membrane. 5) Among those antidepressants tested, sertraline was the most potent one, Other SSRIs(paroxetine and fluoxetine) and tricyclic antidepressants(imipramine and amitriptyline) were moderately potent. Atypical antidepressant(trazodone) had little effects, and MAO inhibitor(moclobemide) had no effect on the depolarization. 6) External application of ATP induced temporary depolarization. This effect was blocked by prior treatment with sertraline with an IC50 value of 30μM. 7) The increment of [Ca²+]i through voltage-dependent Ca²+ channel was almost inhibited by a selective calcium channel blocker(nimodipine). However, the ATP-induced increment of [Ca²+]i was partially inhibited by nimodipine. These inhibitor effects were potentiated by the addition of sertraline. In the light of these results, it is likely that SSRIs and tricyclic antidepressants could show the blocking effects on both voltage-dependent and receptor-dependent calcium channel by depolarizing neuronal cell membrane potential in a sustained manner and by increasing intracellular free calcium level.