야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

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.

수술후 경막외강에 주입한 ketamine의 진통효과에 관한 연구

정기호,조남수,임경준,유병식,정종달,김용일 朝鮮大學校 附設 醫學硏究所 1993 The Medical Journal of Chosun University Vol.18 No.1

Author divided 60 patients who got lower abdomen or lower extremity surgical operation into three groups. Each group consisted of 20 patients. We injected ketamine 10㎎, 20㎎, and 30㎎ respectively into the epidural space when the patient complained of pain postoperatively and observed the postoperative analgesic effect of ketamine. Finally, we concluded the following : 1) The onset time of analgesic effect. : The analgesic effect appeared within 10 minutes in 3 groups and the significant difference among them was not seen. 2) The duration of analgesic effect : The duration of analgesia was relatively short with less than 1 hour on an average in all 3 groups and was not constant. 3) Cardiopulmonary system. : The significant change of blood pressure, pulse and respiratory rate was not seen in all three groups and and the difference among them also was not seen. 4) Side effects. : Sedative action(16%), nausea(10%), dizziness(5%), headache(3.3%) From above results, the epidural administration of ketamine is not suitable for postoperative pain management because of a lot of side effects as well as short and inconstant duration of analgesic effeet.

파킨슨씨병 환자에 있어서 자가부신수질 이식술

정상섭,박상근,오성훈,김선호,윤도흠,박정수,양우익,최인준,안영수,김경환,박창일,김진수,이현철 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.6

Recent experimental studies and clinical cases have suggested that grafting tissue from the adrenal medulla into the brain may alleviate the symptoms of Parkinson's disease. Autologous adrenal medullary grafts into the striatum was performed stereotactically in two patients with Parkinson's disease. Both patients were bedridden preoperatively, but 4 months after the surgery both became ambulatory and one was even capable of returning to his job. Even though the number of cases was small⑵ and the follow-up period was short, this study shows that adrenal medullary transplantation into the striatum may have some beneficial effects in patient with Parkinson's disease. Further experimental and clinical trials are necessary to see whether this procedure will be a recommendable surgical treatment for patients suffering from Parkinson's disease.

映像커뮤니케이션의 認識論的 考察

鄭壽景 한양대학교 사회과학대학 1983 社會科學論叢 Vol.2 No.-

Information societies are identified by their new media, visualization and informations. Thus the advanced societies are called visual communication societies because their daily life and national affairs are characterized by visual communication, information index, and information value which are newly significant, What distinguishes visual communication societies from are others are not merely such visible image as the transmission of enviroment. Nor are these in themselves "communication". Rather, they are strongly influenced or informationalized in virtual media, culture, and behavior by these visual phenomena.mens. The purpose of this paper is to identify the areas of importance for original and copy communication, sepecially those which have concerned visual communications. Its perspective is comparative, primarily because it embraces both printed and visual media, but also because thes media are influential in the behavior of audiences toward visual informationalization. Comparative communication approach can help to identify the dimensions of communication so that tile concept itself is better understood and utilized in addressing the concerns of socerns of societies, whether visually advanced or not. Some communication scholars are likely to neglect or misunderstand visual communication. Consequently, we must understand what are the similarities which make comparison possible and what are the differences which make it productive. With the viaual informationalization of societies, "the knowledge gap" undergoes qualitative as well as quantative-changes : e.g., individuals become handicapped by their lack of access to visual information, unable to participate in visual communication structure and processes of their society. In this regad, it must be with theme sociocultural concerns that the potential for comparative and collaborative approach seems to be tale great. So far the contradiction of communication approach have been more apparent than real. The printed communication may be distinct and the visual communication is neglected. They demonstrate the effects of printed information affluence and visual communication poverty. In short communication approach, printed or visual, must be complementary and interdependence, because they have appropriate merits and demerits of communication funtion.

자동차용 브레이크 마찰재에서의 환원분철의 마찰특성에 관한 연구

정진오,이경환,김옥삼,김봉수 순천대학교 2000 순천대학교 자연과학논문집 Vol.19 No.1

In most automotive brakes, the friction material is used to convert the kinetic energy into heat. The friction material is a complex composite consisting of a resin, reinforcing fibers, lubricants and filler materials. In an attempt to enhance the friction performance of the friction material, a trial was done to examine the substitution of filler material by the reduction iron powder. In this study, two types of reduction powder M1 and M3 was prepared by the reduction process developed by Hanta M&B Inc. M1 and M3 which has reduction ratio of 1.5 and 92% respectively was used in place of BaSO_4, which was conventionally used as a filler material. The amount of M1 and M3 was varied as 10, 20, 30%, while the other component remains the same except the replaced BaSO_4. For those specimens with different amount of reduction iron powder, friction performance tests such as friction coefficient, rotor compatibility were conducted by using brake dynamometer. The bonding strength and hardness tend to decrease with use of M1 and M3, but specific weight decreased with increase of M1 and M3. The friction coefficient increased with use of M1 up to 10%, but decreased for use of M1 more than 20%. However the use of M3 resulted in a decrease of friction coefficient all the way. The surface roughness decreased with the use of M1 and M3, except for a case of excessive use of M1 of 30%. The rotor surface roughness did not show any correspondence with hardness of friction material in this study.

Dementia 환자에 있어서의 Pyrisuccideanol dimaleate(MOREX^(�))의 임상적 효과

정재우,황성희,김경환,박수철,김진수 최신의학사 1991 最新醫學 Vol.34 No.1

경쟁력있는 지역인재 육성방안 : 학교교육과 사회교육을 중심으로

鄭日煥,楊慶守 대구효성가톨릭대학교 1996 연구논문집 Vol.52 No.1

The purpose of the article is to suggest some policy directions and tasks of fostering competitive manpower for the local development. In order to accomplish this objective, current status and problems of local manpower policies were investigated in terms of educational programs and administrative systems including career education. The society is coping with glabalization and localization at the same time, therefore it is important to establish a variety of system meeting local needs for economic development. In general, industrial and economic development may be effective through manpower supply on time and on place. Competitive manpower, which contributes to local economic development and finally to enhance the quality of life of local residents, can be fostered and supplied by formal schooling with rational local educational administration system and its efficient implementation. This article suggested following policy tasks and alternatives for fostering competitive manpower. First, it should be established sound educational values of parents to their children and rational employment system by industrial employers according to employee's ability and credentials. Second, local educational planning should be based on not a demand-oriented but a supply-oriented. Third, it is necessary to renovate the contents and methods of school education in order to foster creative manpower. Fourth, each local college and university should emphasize and develop its own program considering personnel and material conditions. Fifth, teachers who are working at primary and secondary school should be able and with pride of their teaching to deliver educating high quality of education. Sixth, activation of life-long education and efficient industrial manpower system are needed. Seventh, it is necessary to establish rational local educational governance system to support excellent educational programs. Finally, in order to implement above-mentioned policy tasks efficiently, investment to local education should be increased.

對中國 交易擴大를 위한 광주ㆍ전남지역 輸出産業의 育成方案에 관한 연구

鄭炅樹 여수대학교 1993 論文集 Vol.7 No.-

The purpose of this study is to investigate the promotion device of export industry for extending the trade with China in the situation that the change of international trade environment and the trade conflict among advanced countries are deepened. For this, this study surveys the actual conditions of local economy and industrial structure and analyzes the situations of export and import and export industry in Kwangju-Chonnam regions. To extend the trade with China, the following are required; (1) Priority of technology over China should be secured, (2) High added value ade differentiation of export goods are needed.(3) Thorough understanding of character and structure of Chinese market and (4) the consolidation of maketing system for private demand are required. To the promotion of esport industry, the governmental support devices are as follows; (1) Improvement of export support system and extension of support for improving competitiveness,(2) Adjustment of export industry structure for increasing added value,(3) Consolidation of cooperation for overseas trade and promotion of technology introduction, (4) Selection and cultivation of import substitute items and (5) Stabilization of interests and price and easy fund raising. As the devices in the side of enterprise, (1) the extension of technical development, (2) settlement of quality management system, (3) development of goods with high added value and (4) the construction of prfessional marketing system are required.