시각중복장애학생의 교육적 지원 방안 모색

김종인,이완우,이덕순,길태영,노언희,박성우 국립특수교육원 2005 연구보고서 Vol.- No.4

본 연구는 시각장애 학교 교육에서 소외되고 있는 시각중복장애아의 현황과 교육 실태를 알아보고, 시각중복장애아의 교육적 질 향상을 위한 교육개선방안을 모색하는데 연구의 목적을 두었다. 본 연구를 위해 전국의 12개 시각장애 학교의 유치부 · 초등부 · 중학부 · 고등부 재학생 1284명 전수 및 담당 교사 405명 중 130명을 조사 대상으로 하였다. 본 연구의 통계처리는 SAS을 활용하였으며 본 연구에서 사용한 설문지는 이덕순(1997)의 '시각장애학교 중복장애학생의 교육 현황에 관한 연구' 질문지를 기초로 하여 2005년 현재 전국 12개 시각장애학교의 중복장애 현황을 조사하였고, 중복장애아에 대한 학교의 교육적 배치, 교육 실태, 교육운영 지원과 중복장애아에 대한 교육적 대책을 모색하고자 설문지를 작성하였다. 따라서 본 설문지의 구성은 학교용과 교사용으로 구분하였으며 내용은 각각 중복장애아 현황 2문항, 교육복지지원실태 12문항, 교육실태 8문항, 교육운영지원 6문항, 교육대책 9문항으로 총 37문항으로 구성되었다. 본 연구를 통해 얻어진 조사 결과는 다음과 같다. 1. 중복장애 현황 중복장애 현황을 보면 시각장애 학교 재학생 1284명 중 시각장애만을 지닌 학생은 960명 (74.7%)이고, 주장애인 시각장애 외에 다른 장애를 지닌 중복장애아는 324명으로 25.3%의 비율을 보이는 것으로 나타났다. 최근의 우리나라 시각장애 학교 재학생 중복장애아 수의 경우 정확히 조사된 것은 없지만, 국립특수연구원 (1996)에서는 약1/3로 추정하고 있고, 실제로는 그보다 더 높은 비율로 증가하고 있는 추세이기 때문에 시각장애 학교에서 상당 수 차지하고 있는 중복장애아의 장애 영역에 맞는 교육과정 편성과 프로그램 개발을 위해서는 매년 학교 교육계획을 수립할 때 중복장애아 수를 정확히 조사하여 그를 토대로 학교 교육과정을 편성해야 할 것이다. 장애 영역별 중복장애 분포를 보면 시각장애 학교 유치부 · 초등부 · 중학부 · 고등부 재학생 1284명 중 주장애가 시각장애인 장애 영역별 중복장애 분포를 보면 정신지체가 171명(13.31%), 언어장애가 12명(0.93%), 정서장애 52명(4.04%), 지체부자유 및 병허약이 26명(2.02%), 청각장애 5명 (0.38%), 학습장애 11명(0.85%), 기타(세 가지 장애 이상) 장애를 가진 학생이 47명 (3.77%)으로 나타났다. 이 중 정신지체 중복인 경우가 171명(13.31%)으로 가장 높은 비율을 보였고, 그 다음이 정서장애, 기타(세가지 장애 이상), 지체부자유 및 병허약, 언어장애, 학습장애의 순으로 나타났으며, 청각장애가 5명(0.38%)으로 가장 낮은 비율로 나타났다. 또한 과정별 중복장애 분포를 보면 유치부의 경우 81명 중 30명(37.03%), 초등부 374명 중 146명(39.03%), 중학부 265명 중 63명(23.77%), 고등부 564명 중 85명(15.07%)이 중복장애아로 나타났다. 과정별 중복장애 분포를 보면 초등부 39.03%, 유치부 37.03%, 중학부 23.77%, 고등부 15.07% 순으로 중복장애를 보여 학령기 초반부의 저학년일수록 중복장애가 심한 것으로 나타나 이들 과정에 대한 교육 프로그램이 재조정이 필요함을 알 수 있다. 그리고 남녀별 중복장애 분포의 경우 남학생이 210명(16.35%), 여학생이 114명 (8.95%)으로 나타나 남학생이 여학생보다 중복장애 비율이 훨씬 더 높게 나타났다. 2. 중복장애아의 교육 실태 가. 중복장애아에 대한 학교의 교육적 배치 전국 12개교 중 중복장애아를 위한 특수학급이 잇음이 7개교(58.33%)로 나타나 있는 것으로 보아 많이 운영하고 있음을 알 수 있고, 5개교(41.67%)는 없다고 대답을 한 것으로 보아 아직도 중복장애아를 위한 특수학급 운영이 미비하게 나타났다. 이는 교사 배치나 예산 지원, 교육 프로그램 등의 제반 여건이 조성되어 있지 않는 상황에서 이러한 교육 여건을 필요로 하는 중복장애 특수학급을 배정하기가 쉽지 않기 때문임을 알 수 있다. 따라서 시각장애 학교의 중복장애아 비율이 점차 증가하고 있는 추세에서 이들의 교육에 대한 제도적인 조치나 지원 방안이 수립되어야 할 것이다. 중복장애 특수학급을 운영하고 있는 7개교 중 정식으로 인가된 학급으로 운영되고 있는 학교는 1개교(14.28%)로 나타났고, 6개교(85.71%)가 비정규 학급으로 학교 내부적으로 자체 운영하는 것으로 나타났다. 인가 학급의 경우 교사와 예산이 지원되기 때문에 운영상 적절한 교육 여건을 제공하여 교육적 효과를 거둘 수 있는 반면, 비인가 학급의 경우 교사나 예산이 별도로 지원 되지 않아 중복장애아 교육을 효과적으로 하지 못하고 있으므로 이에 필요한 지원 방안으로 교사의 배정이나 예산 지원이 마련되어야 할 것이다. 그리고 중복장애 특수학급을 운영하고 있는 학교의 해당 교육과정을 보면 담당 교사가 개발한 교육과정으로 교육하는 학교가 3개교이고, 개별화교육 프로그램으로 교육하는 학교가 4개교로 나타나 중복장애아에 대한 학교 수준의 교육과정이 마련되지 않고 있는 것으로 나타났다. 나. 중복장애아의 교육실태 각 학급의 중복장애아를 지도하는 교사를 조사한 결과는 담임교사가 담당하는 학급이 55명(45.87%)으로 가장 높은 비율을 보였고, 중복장애 담당 교사가 담당하는 경우가 47명(34.85%), 요육 교사나 양호 교사가 담당하는 경우가 2명(1.57%)으로 나타났다. 중복장애아에 대한 지도 정도를 보면, 아주 잘 이루어지고 있다라고 생각하는 응답자는 2명(1.55%)이며, 대체로 잘 이루어지고 있다가 46명(35.66%), 실시하지 않고 있다가 2명(1.55%)으로 나타났다. 지도는 하고 싶지만 잘 이루어지지 않고 있다가 76명 (58.91%)으로 가장 높은 응답율을 보여 시각장애 학교 교사들의 중복장애아 지도에 대한 교육적 관심도는 높게 나타나지만 제반 교육 여건이 잘 구비되어 있지 않았음을 알 수 있다. 또한 교육 프로그램 운영을 보면 전체 응답자 130명 중 학교 자체에서 개발한 프로그램으로 교육하는 경우가 22명(16.92%), 담임(담당) 교사가 개발한 개별화교육 프로그램이 73명(56.15%)으로 나타나 73.07%가 중복장애아에 대한 교육 프로그램으로 교육을 하고 있는 것으로 나타났으며, 시간마다 임의로 지도하는 경우 28명(21.54%), 특별한 지도를 안하는 경우 2명(1.54%)과 같이 중복장애아에 대한 별다른 교육 프로그램이 없이 교육하고 있는 비율도 23.08%로 나타났다. 이는 시각장애 학교 중복장애아 교육 부재 실태를 단적으로 엿볼 수 있게 하는 것으로, 이에 대한 개선책으로 다양한 중복장애아 교육 프로그램이 개발되어야 할 것이다. 그리고 중복장애의 지도 중점부분은 일상생활 훈련이 102명(80.31%)으로 가장 높은 비율을 보이고 있다. 그 외 기타 8.66%, 교과위주, 점자지도가 5.51%로 나타났다. 다. 중복장애아에 대한 교육 대책 교사들의 중복장애아에 대한 교육적 조치 요구를 보면 '시각장애 학교 내에서 교육적 조치를 취해야 한다'고 응답한 경우가 114명(86.36%)으로 가장 높은 빈도를 보이고 있어, 제도적으로 중복장애아를 적절하게 교육할 수 있는 제발 여건을 조성하여 이들의 교육적 방치 문제를 개선할 수 있을 것으로 생각된다. 그 밖에 '별도의 중복장애아를 위한 교육기관에서 교육해야 한다'고 응답한 경우도 5명(11.36%), 기타의견은 2.27%로 조사되었다. 이중 중복장애아의 교육 형태에 대한 요구에서는 '별도의 중복장애학급을 편성해야 한다'는 의견이 67명(56.30%), '시간제 특수학급을 편성해야 한다'는 의견이 30명(25.21%)으로 81.51%가 장애특성을 고려한 개별적인 교육수준에 맞추어 교육할 수 있는 특수학급 형태를 선호하는 것으로 나타났으며, 그밖에 보조 교사 지원이 15명(12.61%)으로 중증 중복장애아의 교육 보조를 요구하고 있으며, 기타의견은 5.58%로 나타났다. 또한 중복장애아 교육에 필요한 지원책으로 예산지원(43.09%), 교육과정편성(22.76%), 전담교사배치(17.07%), 보조교사 배치(16.26%)순으로 나타났으며 중복장애아의 교육과정 편성에 있어서의 요구를 보면 별도의 교육과정에 61명(48.80%)이 응답을 하였고, 학교 수준의 개별화 교육과정이 45명(36%), 현 교육과정 속에 재편성해야 한다는 의견이 16명(12.80%)으로 현행 교육과정으로는 중복장애아 교육을 적절히 수행하지 못함을 시사하고 있어 교육과정의 재편성이 요구되고 있음을 알 수 있다. 또한 교육과정 편성 시 그 주안점을 어디에 둘 것인가를 보여 주고 있는데, 응답자의 76.81%인 53명이 일상생활 훈련을 중점 영역으로 들었고, 그 다음으로 치료 · 재활 교육 8명(11.59%)의 순으로 나타났는데, 이는 중증 중복장애아의 일상생활 훈련과 치료 · 재활 교육의 중요성을 강조한 것으로 볼 수 있다. 이상의 연구 결과를 바탕으로 시각장애 학교 중복장애 학생의 교육에 대한 정책적 함의 내용은 다음과 같다. 첫째, 중복장애 영역별 특성과 수준을 고려한 교육적 조치와 지원체계를 마련해야 할 것이다. 시각과 정신지체, 시각과 정신장애, 시각과 지체부자유, 시각과 청각 등 중복된 장애 영역별로 판별과 배치 기준, 교과 교재 개발 및 재구성 등을 제도적으로 마련하여 교육의 수월성, 효과성, 효율성을 거둘 수 있게 해야 할 것이다. 둘째, 중복장애아동의 교육은 그 다양성과 필요성의 현실적 문제를 인식하여 그에 맞는 프로그램이 필요하다. 또한 그 장애 아동이 개인간차(個人間差)와 개인내차(個人內差)를 고려한 교육이 필요성이 있는 것이다 .이를 바탕으로 시각중복장애학생과 단순시각장애 학생의 원활한 수업과 교사의 학습 지도를 위하여 시각장애 학교의 중복장애 특수학급 설치의 의무화와 더불어 전담교사 및 보조교사 배치가 요구되는 바이며, 중복장애아를 위한 자체 교육과정 개발이 절실히 요구되며 이를 위하여 예산 지원, 시설 설비 등의 제반 지원 방안이 제도적으로 확보되어야 한다. 셋째, 시각중복장애학생의 특성 연구의 실시로 기본적인 일상생활훈련 뿐만 아니라 더 나아가 단순시각장애 학생을 비롯한 시각중복장애학생에 대하여도 획일적인(안마, 침구등) 교육과정 보다는 진정한 사회통합을 위한 밑거름으로 다양한 접근의 직업재활교육도 함께 이루어 질 수 있도록 직업훈련 강화 및 직업개발도 필요할 것이다. 넷째, 연구과정에 나타난 하나의 문제였던 것은 시각장애 학교의 시각장애인 교사가 시각중복장애학생 지도에 현실적 애로점이 크다는 사실을 발견한 것이다. 이 문제를 해결 · 보완하기 위해서는 보조교사제 도입 및 시행 등도 요청하는 바이며, 또한 이 문제는 향후 계속적인 연구에서 깊이나 넓이를 더하는 연구가 있기를 바란다. 주지한 바와 같이 본 연구는 시각장애 학교 내에서의 중복시각 장애학생의 교육의 질적 향상을 위한 연구로서 위와 같은 개선방안을 제안하였다. 본 연구를 통하여 도출된 내용을 바탕으로 시각장애 학교에서의 시각중복장애학생의 교육적 질 향상에 대한 노력과 자원이 필요하다 할 것이다. This research searches blind multiple disabilities present condition and education actual conditions that is estranged in sight disability booklore, and allowed purpose of research to be effective for educational quality elevation of blind multiple disabilities and grope education improvement way. Infancy department, primary grade departments of national 12 blind disability school for this research, of 130 people of seat of learning, rise department student 1,284 people whole and 405 charge teachers to investigation caravan do. Because figure processing of this research inflected SAS and questionnaire that use by this research applies 'Diagnosis of education for the disability greate box Estimation Judging and choice standard (article 9. The second clauses connection)' of Promotion the Acts of Special Education enforcement ordinance and Education for the disability greate box diagnosis Tool(article 2, The third clauses connection) of estimation' of Promotion the Acts of Special Education enforcement regulations, investigated each child's multiple diabilities present condition, and After reference question earth that use in 'Special school student's multiple disabilities actual conditions and education present condition' of Jeong-ryeol Park, Gyu-sik, Lee (1984) and question earth that use in 'Multiple disabilities student diagrace and disability to this research, used question magazine that supplement correction through preliminary investigation. Composition of questionnaire divided as school and teacher and contents were consisted of 37 item all by multiple disablilties present condition 2 item, education cloth support actual condition 12 item, education actual condition 8 item, education operation support 6 item, education countermeasure 9 item. Through this research, the net result findings is as following. 1. Multiple disabilities present condition If see multiple disabilities present condition, a student who have blind disability of 1284 blind disability school student was expose that Student with multiple disabilities that is 960 people (74.7%), and has other disability beside blind disability that is main disability shows ratio of 25.3% to 324 people. The case of the recent our country blind disability school Student with multiple disabilities trick, there is no examined correctly thing, but is presumeing by about 1/3 in national education for the disability circle(1996), and when establish school education plan every year for program development with correct training courses bias in Student with multiple disabilities sacred ground that is occupying many in blind disability school because is trend that is increading by higher ratio than him actually, must inspect correctly Student with multiple disabilities number and organize school training courses on the basis of him. If see diability area multiple disabilities distribution, of main disability of seat of learning rise department student of 1,284 sight disability school infancy department primary grade department blind disability person disability area multiple disabilities distribution mental retardation 171 people (13.31%), language impairment 12 people (0.93%), emotional disorder 52 people (4.04%), lineage lack of freedom and disease weakness 26 people (2.02%), difficulties 5 people (0.38%), studying disability 11 people (0.85%), a student who have other (more than three disability) disability by 47 (3.77%) appear. Case that is mental retardation redundancy of this showed the highest ratio by 171 (13.31%), and the next time was expose by order of emotional disorder, other (more than three disability), lineage lack of freedom and disease weakness, language impairment, studying hitch and difficuties appeared by the lowest ratio by 5 (0.38%). Also, in infancy department's case if see process multiple disabilities 30 people (37.03%) of 81 people, 146 people (39.3%)s of 374 primary grade department, of 63 people (23.77%)s of 265 seat of learning, 85 (15.07%)s of 564 rise department by Student with multiple disabilities appear. If see process multiple disabilites distribution, primary grade department 39.03%, infancy department 37.03%, of that readjustment of educational programs about these process nees becuase multiple disabilities appears by serious thing is school age flag opening part department's lower classes seeing multiple disabilities as seat of learning 23.77%, rise department 15.07% period of ten days know can. And, in the case of man and woman multiple disabilities distribution, 210 people (16.35%), girl student of boy student appears by 114(8.95%) and multiple disabilities ratio of boy student appeared than girl student much higher. 2. Student with multiple disabilities education actual conditions A. Education arrangement of school about Student with multiple disabilities Can know that see and is operating much that it appears by 7 opening of a schools (58.33%) that class for physically disability and mentally retared children for Student with multiple disabilities of 12 opening of a schools is, and 5 opening of a schools (41.67%) sees that answer that is not and appeared as class for physically disability and mentally retared children operation for Student with multiple disabilities is unprepared yet. Can know that is because this is not easy to assign multiple disabilities class for physically disability and mentally retared children which need these education situation in situation that all sorts situation of teacher arrangement or budget support, educational programs etc. is not make up. Therefore, systematic action or support way about their education may have to be established in trend that Student with multiple disabilities ratio of blind disability school is increasing gradually. School which is operated into class approved between 7 opening of a schools that is operating multiple disabilites class for physically disability and mentally retard children formally appeared by 1 opening of a school (14.28%), and 6 opening of a schools (85.71%) appeared school that operate itself interiorly into rain formality class. In the case of certification class, while can offer suitable education situation at operation and gain educational effect because budget is supported with teacher, but in case of class if is rain instigation or budget being not supported separetely, because is not doing Student with multiple disabilities education effectively, teacher's assignment or budget support may have to be readied by necessary support way hereupon. And school which educate by training courses that charge teacher develops if see relevant training courses of school which is operating multiply disability class for physically disability and mentally retared children is 3 opening of a schools, and school which educate by particularization education program was expose that training courses of school level about Studuent with Multiple disabilities are not readied apearing by 4 opening of a schools. B. Student with multiple disabilities education actual conditions Result that investigate artfulness which guide Studnet with multiple disabilities of each class that teacher in charge takes charge by 55 (45.87%) the highest ratio show, and case that 47 people (34.85%). Therapeutic take care teacher or nurse-teacher takes charge of case that multiple disabilities charge teacher takes charge appeared by 2 (1.57%). If see map true path about Student with multiple disabilities, respondent who think that is consisting excellently is 2 people (1.55%), 46 people (35.66%) while is consisting well on the whole, appeared by 2 (1.55%) while is not enforcing. Map wants to do, but educational interest degree for blind disability school teachers' Student with multiple disabilities map apears high becuase seeing the highest response rate as 76(58.91%) while is not consisting well, but can know that all sorts education situation was not equip well. Also, case that educate by program that develop in school itselves among 130 whole respondent if conduct educational programs operation was expose that 73.07% is educating to educational programs about Student with multiple disabilities bacuase particularization education program that 22 people (16.92%), teacher in charge (charge) teacher develops appears by 73 (56.15%), and ratio that is educating without alternative educational programs about Student with multiple disabilities with 2 (1.54%) when did not 28 people (21.54%), special guidance when guide voluntarily in time appeared by 23.08%. That this does as can look furtively by to weigh blind disability school Student with multiple disabilities education elements actual conditions, various Studuent with multiple disbilities educational programs may have to be developed by reform measure in reply. And map emphasis portion of multiple disabilities routine training by 102 (80.31%) the highest ratio show. Among others etc. 8.66%, subject putting first, Braillewriter type map appeared by 5.51%. C. Education countermeasure about Student with multiple disabilities If see educational action request about teachers' Student with multiple disabilities, case that respond that must take educational action within blind disability school may have to show the highest frequency by 114 (86.36%), make up all sorts situation that can educate Student with multiple disabilities properly systematically and improve their educational leaving alone problem. It is 5 people (11.36%) that respond that must educate him in educational institutions for Student with multiple disabilities and other silk is 2.27%. Request about Student with multiple disabilities education form of this was expose that opinion which opinion which must organize special multiple disabilities study must organize 67 people (56.30%). part-time class for physically disability and mentally retared children prefers trainable class for physically disability and mentally retared children form depending on individual education level that 81.51% considers disability special quality by 30 (25.21%), and assistance teacher support requires serious illness Student with multiple disabilities education assistance by 15 (12.61%) him and other silk appeared by 5.58%. Also, do budget support (43.09%), course of study bias (22.76%), complete charge teacher ship by necessary support policy in Student with multiple disabilities education (17.07%), opinion which was expose by assistance teacher arrangement (16.26%) period of ten days and 61 (48.80%) responded in special training courses if see Student with multiple disabilities request in training courses bias and particularization training courses of schoool level must reorganize in 45 people (36%), present training courses current training courses are previewing that do not achieve Student with multiple disabilities education properly by 16 (12.80%) and can know that reorganization of training courses is required. Also, at training courses bias the essential point is going to put to where show, 53 people that is respondent's 76.81% lifted routine training by emphasis area, and is the next time treatment Expressed emphasis sacred ground by order of rehabilitation education 8 (11.59%). Is this serious illness Student with multiple disabilities routine training and treatment Emphasize the importance of Rehabilitation education. With study finding of something wrong, political intent contents about blind disability school multiple disabilities student education are as following. First, must ready educational action and support system that consider multiple disabilities area special quality and level. Must do as can ready distinction and arrangement standard, subject teaching material development and reconfiguration etc. systematically by duplicate disability area such as blind and mental retardation, blind and mental disorder, blind and lineage lack of freedom, blind and hearing and harvest several months sex of education, effect sex, efficiency. Second, Multiple disabilities child's education recognizes realistic problem of the variety and necessity and need suitable program. Also, there is necessity of education that the disability child considers variance between individual and individual inner variance. Complete charge instigation and assistance teacher arrangement are required along with duty of multiple disabilities class for physically disability and mentally retared children setup of blind disability school for a blind Student with multiple disabilities and smooth class of a simplicity blind disability student and teacher's studying tuition with this, and itself training courses development for Student with multiple disabilities is required urgently and all sorts support way of budget support, equipment etc. should be defined systematically for this. Third, Vocational training enrichment and profession development may need so that vocational rehabilitation education of various access may can achieve together by manure given at sowing time for society integration that is genuine more than singler (massage, invasion etc.) training courses about a blind multiple disability student including a simplicity blind disability student going forward more as well as fundamental everyday life training by enforcement of blind multiple disabilities student's special quality research. Fourth, it finds truth that bilnd person teacher of blind disability school is big realistic bottleneck in blind Student with multiple disabilities guidance that was one problem that appear in research process. To solve this problem and supplement assistance teacher my introduction and enforcement etc. require, also, this problem in hereafter continuous research depth or width there is more research desire. As note, this research proposed improvement way through research for quality elevation of Student with disabilities education in blind disability school. Is going to speak that effort and support about educational quality elevation of a blind Student with disabilities student in blind scdhool need with contents that is drawn through this research.

Helicobacter pylori와 대장균의 Shuttle Vector 개발

조명제,이우곤,이상룡,김경희,안영숙,김성희,김현주,류복덕,최여정,윤영혜,백승철,전영석,이광호 경상대학교 유전공학연구소 1997 遺傳工學硏究所報 Vol.16 No.-

In this study, a vehicle vector using cryptic plasmids was constructed for gene transfer in Helicobacter pylori. pHP51(3.9 kb) and pHP489(1.2 kb) were selected for constructing vectors from cryptic plasmid of H. pylori isolates in Korea. The HindⅢ-digestedDNA fragment(1.2kb) of pHP489 and 1.6kb DNA fragment of pHP51 were ligated with a kanamycin resistance gene(aph3'-Ⅲ) from C. jejuni to produce the recombinant plasmids pHP489K and pHP51K, respectively. Transformation frequency of pHP51K by electroporation was low. But pHP489K could be effectively transformed into various H. pylori strains. In order to design an intermdiate vehicle vector for gene transfer into H. pylori, pBlueHP489K was prepared by recloning pHP489K DNA into pBluescript and pTZ19R vector. This vector permitted the DNA fragment containing pHP489 sequence, aph3'-Ⅲ, and cloned DNA to be cut and self-ligated in the SacⅠ site after cloning. ureA and ureB gene were inserted into pBlueHP489K, resulting in pBlueHP489K/AB. The DNA fragment containing pHP489, kanamycin resistance gene(aph3'-Ⅲ), and urease structural gene was cut away from pBlueHP489K/AB and self-ligated to generate pBlueHP489K/AB. pBlueHP489K/AB made urease-negative H. pylori strains restore their urease activity. By this experiment, pBlueHP489K was confirmed to be the vehicle system for transferring H. pylori genes.

쇄골하정맥을 통하여 중심정맥도관 삽입 실패 후 나타난 혈흉 1예

김대영,김대우,손희원,박상진,이덕희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Central venous catheterization via an internal jugular vein or subclavian vein has become a common procedure in monitonng CVP and managing severely ill patients. However, there have beennumerous reports of complications associated with central venous catheterization. These include vessel injury, pneumothorax, hemothorax, nerve injury, arrhythmias, artriovenous thrombosis, pulmonary embolism, and infection at the insertion site. We report a case of hemothorax after subclavian vein catheterization failure, along with successful treatment.

Paraquat 중독환자의 초기검사로서 sodium dithionite를 이용한 소변내 paraquat검출의 임상적 의의

윤갑준,임경수,이진웅,김영식,이부수,박덕우,김선만,이강현,황성오,안무업 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

Background : Mortality from paraquat intoxication depends upon plasma paraquat concentration. To know the severity of paraquat intoxication is important for directing therapeutic modality and predicting prognosis. Sodium dithionite test for urinary paraquat provides an easy and simple method to determine the severity of paraquat intoxication in emergency department. purpose : To determine whether the result urinary paraquat test by sodium dithionite can predict outcome in patients with paraquat intoxication in emergency department. Subjects : 48 patients(male 31, female 17, mean age 37 years) who had exposure to paraquat and presented within 24 hours after exposure. Result : Thirty five patients were positive in paraquat urine test and thirteen patients were negative. Clinical manifestations were more severe in positive patients than in negatives. Complication was much more in positives than in negatives. 28 of 35 patients(80%) in positives and 2 of 13 patients(15%) in negatives died. Conclusion : Positive test for urinary paraquat is associated with high mortality and morbidity from paraquat intoxication, and qualitative test for urinary paraquat by sodium dithionite is an useful method to determine the severity of paraquat intoxication in emergency department.

Case Report : A Case of Tumor of the Follicular Infundibulum with Sebaceous Differentiation

( Deok Woo Lee ),( Ji Hye Yang ),( Hyung Min Lee ),( Chong Hyun Won ),( Sungeun Chang ),( Mi Woo Lee ),( Jee Ho Choi ),( Kee Chan Moon ) 대한피부과학회 2011 Annals of Dermatology Vol.23 No.2

Tumor of the follicular infundibulum (TFI) is an uncommon benign adnexal tumor that usually presents as a solitary keratotic papule on the face or scalp of elderly patients. Histopathologically, it typically manifests as a plate-like fenestrated proliferation of monomorphic pale-staining cells. A 76-year-old male presented with about a 2 cm, well-defined, yellowish to brownish, slightly elevated, twisted and bent, interrupted, cord-like plaque on his left lower abdomen. Microscopic examination revealed a sharply demarcated plate-like proliferation of pale cells localized in the papillary dermis with multiple connections to the overlying epidermis. The histopathological features were compatible with TFI, except for foci of sebaceous differentiation. There has been one previous case report of TFI with sebaceous differentiation in the English medical literature. Herein, we report on a singular case of TFI with sebaceous differentiation. (Ann Dermatol 23(2) 198∼200, 2011)

Subcutaneous Panniculitis-Like T-cell Lymphoma: A Clinical and Pathologic Study of 14 Korean Patients

( Deok Woo Lee ),( Ji Hye Yang ),( Sang Min Lee ),( Chong Hyun Won ),( Sung Eun Chang ),( Mi Woo Lee ),( Jee Ho Choi ),( Kee Chan Moon ) 대한피부과학회 2011 Annals of Dermatology Vol.23 No.3

Background: Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is a distinctive skin lymphoma characterized by neoplastic T-cell infiltration of the subcutaneous tissue, mimicking panniculitis. Objective: To describe the clinical and pathologic features of SPTL in Korean patients. Methods: Fourteen SPTL patients evaluated over 15 years were retrospectively reviewed. Results: The mean patient age was 35 years (range: 7~73 years), with male predominance (2.5:1). Most patients presented with either nodules or plaques, occurring most commonly on the trunk, with two patients (14%) having hemophagocytic syndrome. Histopathologically, all patients showed infiltrates of small-to- medium pleomorphic cells mimicking panniculitis, with some also showing rimming, bean-bag cells, and fat necrosis. Most patients were positive for CD3 (14/14), CD8 (12/13), TIA-1 (9/9) and βf1 (5/5), but were negative for CD4 (11/12), CD20 (8/8), CD56 (14/14) and Epstein-Barr virus (8/8). Ten patients (71%) received chemotherapy and 2 (14%) died due to the disease, with an average survival time of 4 months. Survival analysis did not reveal any significant prognostic factors. Conclusion: This is the first series of patients with SPTL in Korea. Due to its indolent clinical course and relatively high survival rate, SPTL should be differentiated from cutaneous γδ T-cell lymphoma.

Bilateral Mucinous Eccrine Nevus in an Adult

( Deok Woo Lee ),( Woo Jin Lee ),( Ha Na Bak ),( Sung Eun Chang ),( Mi Woo Lee ),( Jee Ho Choi ),( Kee Chan Moon ),( Jai Kyoung Koh ) 대한피부과학회 2008 초록집 Vol.46 No.10

Cloning of type-1 acetylcholinesterase and identification of point mutations putatively associated with carbofuran resistance in Nilaparvata lugens

Deok Ho Kwon,Deok Jae Cha,Young Ho Kim,Si Woo Lee,Si Hyeock Lee 한국응용곤충학회 2011 한국응용곤충학회 학술대회논문집 Vol.2011 No.10

A carbofuran-resistant strain (CAS) showed ca. 41.1- and 15.1-fold resistance compared to a susceptible strain (SUS) and a non-selected field strain (FM), respectively. Enhanced activities of carboxylesterase and P450 were found as ca. 3- and 1.6-fold higher in CAS strain, suggesting these enzymes play a minor role in carbofuran resistance. Interestingly, the insensitivity of acetylcholinesterase (AChE) to carbofuran was revealed to be ca. 5.5- and 3.7-fold higher in CAS strain compared to, indicating that AChE insensitivity mechanism is associated with carbofuran resistance. In the western blot analysis, two kinds of AChEs were found and type-1 AChE (Nlace1) was identified as the major AChE in N. lugens. The open reading frame of Nlace1 is composed of 2,106 bp (ca. 78 Kd) and revealed 52.5% and 24.3% identity compared with Nephotettix cincticeps and Drosophila melanogaster, respectively. In the screening of point mutations, four amino acid substitutions (G119A, F/S330Y, F331I and H332L) were identified in the CAS strain that likely contribute to the AChE insensitivity. The allele frequencies of these mutations increased in the survived populations following the selection by LC50 of carbofuran, confirming that they are in fact associated with reduced sensitivity to carbofuran in N. lugens. These point mutation can be useful for the monitoring of resistance levels in conjunction with QS methods.

새싹채소 안전생산을 위한 복합가스를 이용한 채소 종자 소독장치 개발

이상우(Sang Woo Lee),이정우(Joung Woo Lee),이상덕(Sang Deok Lee),심상연(Sang Youn Sim),이영석(Young Seok Lee),정혜임(Hae Im Chung),김성기(Sung Kee Kim),임재욱(Jae Wook Lim) 한국원예학회 2012 한국원예학회 학술발표요지 Vol.2012 No.5

A case of rudimentary meningocele(초)

( Deok Woo Lee ),( Ji Hye Yang ),( Oun Jae Park ),( Chong Hyun Won ),( Sung Eun Chang ),( Mi Woo Lee ),( Jee Ho Choi ),( Kee Chan Moon ) 대한피부과학회 2010 초록집 Vol.48 No.10