연구논문 : 만성 바이러스간질환에서 간섬유화의 다양한 비침습 혈청표지자검사의 비교

김선민 ( Sun Min Kim ),손주현 ( Joo Hyun Sohn ),김태엽 ( Tae Yeob Kim ),노영욱 ( Young Wook Roh ),은창수 ( Chang Soo Eun ),전용철 ( Yong Cheol Jeon ),한동수 ( Dong Soo Han ),오영하 ( Young Ha Oh ) 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.4

목적: 만성 바이러스간질환에서 병의 경과와 예후를 평가하고 치료반응을 예측함에 있어 간섬유화의 진단은 중요하다. 최근 간섬유화 평가에 표준방법이지만 침습적 간생검을 대신하여 여러 가지 비침습적 진단법이 이용되고 있고, 또한 새로운 검사법들이 개발되고 있다. 저자들은 만성 B형 및 C형간염 환자를 대상으로 임상에서 광범위하게 흔히 시행하는 혈액검사와 임상 소견을 이용한 아래와 같은 진단법들만으로 간섬유화를 얼마나 정확하게 평가할 수 있는지 알아보고, 단일 검사로 간섬유화를 평가하는 데 유용하다고 알려져 있는 hyaluronic acid(HA)와 IV형 콜라겐 농도와 비교하여 그 임상적 유용성을 평가하였다. 대상과 방법: 2002년 3월부터 2007년 2월까지 만성 바이러스간 질환으로 간생검을 시행받은 225명의 환자(HBV 180명, HCV 43명, HBV+HCV 2명)를 대상으로 분석하였다. 간생검을 시행하는 날에 말초혈액검사, 혈액응고검사, 혈청생화학검사를 시행하고, 혈중 HA, IV형 콜라겐 농도를 측정하였다. 간섬유화의 정도는 F0(섬유화가 없음), F1(문맥역 섬유화), F2(문맥주변부 섬유화), F3(섬유성 격막) 및 F4(간경변증)의 4단계로 구분하였다. 대상 환자를 F0-1, F2-4 혹은 F0-2, F3-4의 두 집단으로 분류하여 두 집단을 구분하고자 할 때 AAR(AST/ALT ratio), API(age-platelet index), APRI(AST to platelet index), CDS(cirrhosis discriminant score), platelet count, HA, IV형 콜라겐의 예측능을 area under the receiver operating characteristic curve (AUROC)값을 이용하여 비교하였다. 결과: 대상환자의 섬유화의 단계는 F0 집단은 17명, F1 집단은 40명, F2 집단은 61명, F3 집단은 74명, F4 집단은 33명이었다. 의미 있는 간섬유화를 F2 이상으로 판단할 때, 의미 있는 섬유화의 예측에 대한 AUROC 값은 APRI=0.822, CDS=0.776, platelet count=0.773, API=0.756, HA=0.749, IV형 콜라겐=0.718, AAR=0.642 순이었고, F3 이상의 광범위한 섬유화 예측에 대한 AUROC값은 CDS=0.835, platelet count=0.795, API=0.794, HA=0.766, AAR=0.711, IV형 콜라겐=0.697, APRI=0.691 순으로 관찰되었다. 결론: 만성 바이러스간질환에서 간섬유화를 평가하는 데 임상 소견 및 혈액검사를 이용한 방법들이 비침습적 진단법 중 단독 검사로도 유용한 것으로 알려져 있는 혈중 HA와 IV형 콜라겐 농도와 비교하여 우월하거나 대등하였다. 특히 APRI는 다른 인자들에 비해 F2 이상의 의미 있는 섬유화를 예측하는 데 가장 유용하였고, CDS는 F3 이상의 광범위한 섬유화를 예측하는 데 가장 유용하였다. Background/Aims: The aim of this study was to determine the clinical performances of noninvasive serum markers for the prediction of liver fibrosis in chronic viral liver diseases. Methods: We analyzed a total of 225 patients with chronic viral liver diseases (180 with hepatitis B virus, 43 with hepatitis C virus, and 2 with hepatitis B+C virus) who underwent a liver biopsy procedure at the Hanyang University Guri Hospital between March 2002 and February 2007. Serum was also obtained at the time of liver biopsy. Liver fibrosis was staged according to the scoring system proposed by the Korean Study Group for the Pathology of Digestive Diseases. Various noninvasive serum markers were evaluated, including the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR), age-platelet (AP) index, AST/platelet ratio index (APRI), cirrhosis discriminant score (CDS), platelet count, hyaluronic acid (HA), and type IV collagen. Results: There were 17, 40, 61, 74, and 33 patients at stages F0, F1, F2, F3, and F4, respectively. The overall diagnostic accuracies of each marker, as determined by the area under receiver operating characteristics curves, were APRI=0.822, CDS=0.776, platelet count=0.773, AP index=0.756, HA=0.749, type IV collagen=0.718, and AAR=0.642 for predicting significant fibrosis (≥F2); and CDS=0.835, platelet count=0.795, AP index=0.794, HA=0.766, AAR=0.711, type IV collagen=0.697, and APRI=0.691 for predicting extensive fibrosis (≥F3). Conclusions: Conclusions: All noninvasive serum markers evaluated in this study were useful for predicting significant or extensive liver fibrosis in chronic viral liver diseases. In particular, APRI was most useful for the prediction of significant fibrosis, and CDS was most useful for the prediction of extensive fibrosis. (Korean J Hepatol 2009;15:454-463)

Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

보건관리자 직무평가도구의 개발

하은희,박혜숙,김영주 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

Objectives : The purpose of this study is to deliver effective worksite health management by specifying job of occupational physician, occupational nurse, occupational hygienist and making job reference manual and health performance audit. Therefore, We can contribute to disease prevention and health promotion of workers by enhancing quality of worksite health management. Method : The methodology of making performance audit is comprised of developing audit questions and weighting the questions. Measures are made by scoring the values. The question-naires were grouped by the categories and sections. This occupational audit was distributed to the health personnel of 350 workplaces by mail. The self-administered results were returned and analyzed, Results : We plot the field of occupational health service by basic policy, preventive health service, health care, administration, and other services. We gave the weight A on the primary job, B on the supplementary job, and C on the minor job. This weight was made through the delphi procedures where 30 specialists joined. Basic policy got score of 16.1% preventive health service got 36.5%, health care 20.4%, administration 10.9%, and other services 10.1%. Further weightings on the questionnaire sections were made through the survey on specialists and final weighting on each questionnaire was made by making formula considering weights of each stage. The audit was composed of 96 questions which has dichotomos scales and full score was 1,000. Person-nels from 80 workplaces (23%) replied the audit and the scores of physicians, nurses, and hygienists were 608.6, 587.1 and 535.4, respectively, all a little higher than 500. Discussion : The health performance audit can be used by the sorksite health personnels providing health service. However, this work would not be complete without further comprehe-sion and application in the real settings. 목적: 본 연구에서는 사업장 보건과리를 활성화하기 위하여 사업장에서 수행되고 있는 산업보건관리직무를 객관적으로 평가할 수 잇는 사업장 보건관리직무 평가항목과 평가척도를 개발하고자 하였다. 방법: 평가항목은 산업보건서비스의 내용별로 대항목, 소항목, 세부항목으로 구분하였다. 평가도구의 타당성을 검증하고 실제 사업장에서의 직무활동을 평가하여 평가의 기준을 현실에 맞게 설정하고자 위의 과정을 거쳐 만들어진 평가도구를 350개 사업장의 보건관리자에게 설문조사를 통해 적용하였다. 연구대상자는 산업간호사와 산업위생관리기사의 경우 한국산업안전공단 안전교육원에서 실시하는 보수교육자 이수자명단을 이용하였으며 설문실시기간은 1996년 7월 24일부터 8월 24일가지로 하여 우편설문의 형식을 취하였다. 결과: 1차 설문조사결과 산업보건의사, 산업간호사, 산업위생관리기사의 평균점수를 보면 기본방침 14.5%, 예방보건 서비스 39.0%, 치료서비스 18.0%, 관리 및 행정서비스 17.2%, 기타서비스 10.3%로 예방보건서비스가 가장 높은 점수를 보였다. 이 결과를 다시 1차 설문에 응하여준 응답자에게 통보하고 2차 Delphi를 시행한 결과 기본방침 16.1%, 예방보건서비스 36.5%, 치료서비스 20.4%, 관리 및 행정서비스 16.9%, 기타서비스 10.1%로 예방보건 서비스의 점수는 다소 낮아지고 기본방침과 치료서비스의 점수가 올라가는 결과를 보여주었다. 산업보건학계, 대행기관, 사업장 실무 인력인 산업보건의사 10인, 산업간호사 10인, 산업위생관리기사 10인을 대상으로 한 설문조사를 통해 대항목 각각을 100%로 하였을 때의 소항목의 점수(백분율)를 구하였다. 기본방침 중에서는 기본방침의 설정이 가장 높은 점수를 보였으며 예방보건서비스중에서는 건강상담 및 보건교육이 가장 높은 점수를 보였다. 치료서비스 중에서는 환자치료가 관리 및 행정 서비스에서는 기록 및 보고가 높은 점수를 보였다. 우편설문을 보낸 350개 사업장중 85개 사업장, 110명의 보건관리자에서 직무평가설문에 응답하였으며 응답사업장 보건관리자들의 직종별 인원수는 의사 41명, 간호사 78명, 산업위생관리기사 24명, 환경관리기사 65명, 기타 2명으로 산업위생관리기사 대신 환경관리기사를 채용한 사업장이 많았다. 응답사업장의 업종은 대부분이 제조업이었으나 매우 다양하였고 규모별로는 300인 미만이 38.5%, 300~999인 사업장이 32.5%, 1000인 이상이 28.8%었다. 결론: 본 평가도구가 개발목적에 부합되기 위해서는 사업장에 실제로 적용하여 사업장에서 실제 사용해 보고 이 결과를 바탕으로 사업장 규모별, 업종별로 내용을 분석하여 직무를 평가함으로써 문제를 파악하고 특히 보건관리 인력을 얼마만큼 투입할 것인가를 결정할 때에 반영되어야 할 것이다. 그리고 보건관리자의 직무 즉, 사업장내 산업보건서비스를 올바로 수행하기 위한 보건관리자의 교육훈련제도지에 대한 정책이 마련되어야 할 것이다.

우리 나라 보건관리대행서비스 평가 연구

하은희,조수헌,김선민,주영수,한상환,하미나,권호장,홍윤철,김창엽 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.1

Group occupational health service programme started in 1990 is one of the measures to cope with limited human and financial resources in occupational health. The programme has expanded rapidly to include 52 institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. This study has aims to develop the criteria to assess the quality of newly developed group occupational health service programme, and to investigate the quality of institutions, and finally to develop policies for the quality improvement. 1) Criteria development : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, followings are included as core elements of qualitative occupational health programme; accessibility, continuity, comprehensiveness, technical quality, intersectoral collaboration, emphasis on preventive services, community participation, and adequacy. Again each element is divided into five major components of national health system infrastructure developed by the World Health Organization; development of health resources, organized arrangement of resources, delivery of health care, economic support, and management. In turn, each component is categorized into three aspects of quality assessment, structure, process and outcome. Expert panel selected several criteria for each category to evaluate the programme. Criteria were modified according to each group of interviewees, to produce two sets of questionnaire, one for chief operating officer and another for nurses in the institutions, and the chief operating officer and workers in the workplace. 2) Subject : Of all 52 institutions, 25 voluntarily participated in the survey. At individual institution, chief operating officer and practicing nurses were interviewed in depth. After intensive education for interviewees, every interviewees, every interview was performed with standardized guideline and questionnaire. The quality of the 'Group occupational health service programme' was found to be lower than expected. Especially in continuity, comprehensiveness, technical quality, community participation and adequacy, lower quality in structural aspect was commonly identified throughout all the institutions,. Quality in terms of accessibility and continuity highly varied among institutions., To improve quality of the programme, more comprehensive and systematic programme such as accreditation has to be introduced. In addition, human resources, governmental fund and information systems for individual workers are to be developed. As a long range plan, integration of occupational health services into the national health systems and pooling of financial resources and planned allocation should be considered.

건강증진학교 모형개발 : Based on Health Center of University 대형 보건소 활동을 중심으로

하은희,조희숙,윤영옥,강명근 韓國學校保健學會 2001 韓國學校保健學會誌 Vol.14 No.1

Objectives: The purpose of this study is to develop a health-promoting program centered on the university-health center and to provide a developed program for students and faculties. Methods: A survey was conducted of 719 female students and 238 faculties concerning their health-promoting programs. Based on the results of the survey, we developed programs that could be applied to students and faculties. After operating the programs, we developed further models by evaluating the effectiveness and satisfaction. Conclusions: We selected a comprehensive health-promoting program that included weight control, preventive inoculation, sex education and control of disease based on repsective needs. We also applied programs developed through collaboration with other departments from September 1998 to August, 1999. Users of the preventive inoculation-program increased by one point five during the year. Also, participants were generally satisfied with the weight control program and succeeded in reducing weight We hope that we can set up this program and expand it by developing various other projects in Korea. Key Words: Modeling, Health-Promoting School, Health Center of University

人蔘이 卵巢摘出로 誘發된 흰쥐의 骨多孔症 예방에 미치는 효능

정국영,서부일,이은숙,변부형,신순식,박지하 대한본초학회 2004 大韓本草學會誌 Vol.19 No.1

Objectives : The present study has been undertaken to investigate the effects of Ginseng Radix on prevention of osteoporosis in ovariectomized rats. Methods : In this experiment, the rats were ovariectomized. Rats were administered by 2 kinds of medicine, Estradiol, Ginseng Radix. The levels of bone mineral density, osteocalcin, ALP, phosphorus, calcium in serum, deoxypyridinoline in urine, calcium, phosphorus, ash weight of bone, body weight and uterus weight were measured. Results : The levels of spinal bone mineral density was significantly increased in comparison with OVX group at 8 weeks in Ginseng Radix group. The levels of serum didn t show significant change in comparison with OVX group in Ginseng Radix group. The levels of urine deoxypyridinoline showed significant decrease in comparison with OVX group in Ginseng Radix group. The levels of femoral and fibula-tibial ash weight didn t show significant increase in comparison with OVX group in Ginseng Radix group. The levels of femoral and fibula-tibial calcium showed significant increase in comparison with OVX group in Ginseng Radix group. The levels of femoral and fibula-tibial phosphorus showed significant increase in comparison with OVX group in Ginseng Radix group. The levels of body weight didn t show significant changes in comparison with OVX group in Ginseng Radix group. The levels of uterus weight didn t show significant changes in comparison with OVX group in Ginseng Radix group. Conclusions : Reviewing these experimetal results, it appears that Ginseng Radix have efficacy on prevention of osteoporosis. And further study should be conducted to illustrate in depth the curing and prevention of osteoprosis.

상지 단순반복작업 근로자의 수근관 증후군 유병률에 관한 조사

손지언,장태원,김윤규,홍영습,정갑열,김동일,이강진,하남진,김상범,김준연 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 본 연구는 수근관 증후군의 발생위험이 높은 작업형태에 종사하는 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장과 목재소 근로자에서 근전도검사를 이용하여 수근관 증후군의 유병률을 조사하고자 하였다. 방법 : 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장 근로자 69명과 목재소 근로자 17명을 실험군으로, 관리직, 경리, 경비등 상지의 단순반복작업이 없는 근로자 28명을 대조군으로 선정하여, 작업적 및 병력조사, 이학적 검사와 근전도검사를 통해 수근관 증후군의 유병률을 조사하였다. 결과 : 수근관 증후군의 유병률은 육류 및 어류 가공 사업장과 목재소에서 각각 26.09 % (18명)와 29.41 %(5명)로 조사되었으며, 육류 및 어류가공사업장과 목재소 근로자를 '7년 이상과 미만의 작업기간'으로 층화하여 비교한 결과 '상지부위의 통증 호소 유무', 'Visual Analogue Scale(VAS: 총 10점) 4점 이상 여부', 'Tinel teat 양성 유무', 'Phalen test 양성 유무'는 모두 단기 작업근로자군에서 양성의 빈도가 증가되었고 '수근관 증후군 유무'는 장기작업근로자군에서 양성의 빈도가 증가되었다. 결론 : 육류 및 어류 가공 사업장과 목재소의 수근관 증후군 유병률은 각각 26.09 %와 29.41 %로 육류 및 어류 가공 사업장과 목재소는 1996년 OSHA가 지정한 바와 같이 위험한 작업요인이 있는 작업장으로 분류하여 관리되어야 할 것으로 생각된다. Objectives : This study was carried out to survey on the prevalence of Carpal Tunnel Syndrome(CTS) in high risk jobs(meat and fish processing plant and wood plant), by application of Nerve Conduction Study(NCS), a confirmatory diagnostic method. Methods : Experimental group was 69 workers sampled from meat and fish processing plants and 17 workers sampled from wood plants, who were simple, repetitive workers using upper extremities and control group was 28 workers sampled from managers, secretaries and keepers. All employees were examined through work history, physical examination and NCS. Results : 18 workers(26.09%) in meat and fish processing plants, and 5 workers(29.41%) in wood plants had compatible findings to NIOSH diagnostic criteria for CTS. The experimental group had more symptoms (complaint of upper extremities, Visual Analogue Scale ≥4(VAS: total 10 point)), signs(Tinel and Phalen test) and prevalence of CTS than control group(p<0.05). The prevalence of symptoms and signs were higher in short term workers(<7 years), but the prevalence of CTS was higher in long term workers(≥7 years). Conclusions : The prevalence of CTS in meat and fish processing plant and wood plant were 26.09% and 29.41% respectively. Authors propose that meat and fish processing and wood plants should be managed as a risk job category which were designated by OSHA in 1996

대구시 대규모시설 이전적지의 개발에 관한 연구 : 아파트 개발 사례지를 중심으로

이지은,최영은,최판길,하재명 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

The purpose of this study is to examine the condition of the transferred site in Daegu. The conditions of the case study areas were investigated with the change of use, the density and the infrastructure in the survey area. The results of this study are as follows ; First, the transferred site is developed rapidly into high-density without urban planning control. So, it causes the lack of infrastructure capacity. Second, park and green space is required because most of residual space is used as a parking lot. Third, as high-rise apartment buildings were constructed in transferred site, the conditions around that areas get worse. So, the development of transferred site has to be harmonized with its surroundings.

강박장애 환자에서 Sertraline 치료반응의 예측인자에 관한 연구

유은정,우행원,김영철,연규월,김종원,임원정 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 1980년 중반부터 강박장애의 치료로 SSRIs가 널리 쓰이고 있으나 치료반응의 예측인자에 대한 연구는 미비한 실정이다. 본 연구에서는 sertraline 투여후 호전군과 비호전군의 인구학적 특성, 발병연령, 이환기간, 과거의 강방장애에 대한 투약경력, 정신과 질환의 가족력, 증상의 심각도, 임상양상 등의 변수들을 관찰하여 sertraline 치료반응과의 상관관계를 살펴보았으며 치료방응을 예측 할 수 있는 인자를 알아보았다. 방법: 연구 대상은 이대부속 동대문병원 정신과에 입원 또는 외래치료를 받은 환자들 중 정신과 진단 편람제 4판 진단 기준에 의거하여 강박장애로 진단 받은 31명(남자 10명, 여자 21명)이었다. 연구 방법은 sertraline을 하루 50mg씩 투약하면서 Y-BOCS, NIMHOCS, CGI로 강박증상의 변화를 평가하였고, HAM-A로 불안정도의 변화를 측정하여 투약 전 점수와 비교하였다. 결과: 1) Y-BOCS 점수 40%이상 감소와 함께 CGI 점수 2점 이상 감소를 보인 호전군은 대상환자 31명중 17명(54.8%)이었고, 비호전군은 14명이었다. 호전군이 비호전군에 비해 늦은 나이에 발병하는 경향을보였고(p<0.1), 이환기간이 짧았으며(p<0.05), 과거의 강박장애에 대한 투약경력은 적었다(p<0.05), 정신과 질환의 가족력은 두 집단간에 차이가 없었다. 2) 호전군에서 투약 전 Y-BOCS의 강박행동 점수가 유의하게 낮았으며(p<0.05), 기타 다른 평가척도에서는 두 집단간에 유의한 차이가 없었다. 3) 평균 Y-BOCS 점수는 투약 전에 비해 sertraline 투약 12주째 43.5%가 감소하였다. 투약 전과 비교하여 투약 2주째부터 불안을 평가하는 HAM-A 점수가 유의하게 감소하였고, 투약 4주째부터 Y-BOCS, NIMHOCS, CGI 점수가 유의하게 감소되기 시작하여 12주까지 지속되었다.(p<0.01). 4) 호전군에서 오염에 대한 강박사고와 씻음의 강박행동의 유의하게 많았으며(p<0.05), 셈의 강박행동은 없었다(p<0.05), 병적 의심은 비호전군에서 많은 경향을 보였다(p<0.1). 결론: 이상의 결과를 종합하면, 질병의 이환기간이 짧으며 과거의 강박장애에 대한 투약경력이 적고 투약 전강박행동이 심하지 않으며, 주된 임상양상이 오염에 대한 강박사고와 씻음의 강박행동인 경우 sertra-line에 좋은 치료반응을 보이지만, 셈의 강박행동이 있는 경우에는 치료반응이 좋지 않다고 예측할 수 있다. Objectives: The pharmacologic treatment of obsessive-compulsive disorder(OCD) with serotonergic antidepressant agents is well established in clinical psychiatry on the basis of serotonin hypothesis. Studies on predictive factors of treatment reponse to OCD are relatively scarce. The author compared the demographic factors, age of onset, length of illness, family history of mental illness, previous drug history for OCD, severity and type of symptoms between the drug reponders and non-responders to find out the predicitive factors that may be related to treatment response. Methods: The subjects were 31, both inpatients and outpatients who met the diagnostic criteria for OCD by DSM-IV and scored 20 or higher on the Yale-Brown Obsessive-Com-pulsive Scale(Y-BOCS) completed 12-week trial of sertraline. Y-BOCS, National Institute of Mental Health Obsessive-Compulsive Scale(NIMHOCS), Clinical Global Impression Scale(CGI) were scored to measure the changes of obsessive-compulsive symptoms, and Hamilto Anxiety Scale(HAM-A) was measured at each visit. Results: 1) The responders, defined as achieving at least a 40% decrease in the Y-BOCS total score and more than a 2 point decrease in CGI score, were 17(54.8%), and non-responders were 14(45.2%). Responders tended to show later onset(p<0.1), and shorter duration of illness(p<0.05), and less previous drug therapy for OCD(p<0.05) than non-responders. There were no significant differences in family history of mental illness between the two groups. 2) The basline Y-BOCS compulsive score was significantly lower in responders(p<0.05), although there was no significant difference in the basline severity of other measures. 3) The obsession of contamination and washing behaviors were more frequent, but compulsive counting was not shown, in responders(p<0.05). The pathological doubt tended to be more common in nonresponders(p<0.1). Conclusions: In summary, the patients with shorter duration of illness, less prior drug ther-apy for OCD, and less severe compulsive behaviors, and the obsession of contamination and washing behaviors are expected to be better outcome with sertraline, whereas compulsive counting are the predictor of poor response.

대구시 도심의 접근특성과 가로이용특성에 관한 연구

최영은,하재명 대한건축학회 2003 대한건축학회논문집 Vol.19 No.5

The purpose of this study is to examine the access characteristics of people visiting at the urban street and district. In this study, the access characteristics were classified into three factors, a access method, a visiting aim and a visitor's character. The case study areas were selected the nine streets and districts which crowded with stores dealing with similar goods in Daegu CBD. The results of the case study has been summarized as follows; Firstly, in the individual districts dealing with a specific goods, the access characteristics appeared differently. Secondary, the visitors' visiting aim in the case study areas affected the selection of a access method. Thirdly, the street behavior according to a operational situation appeared differently. And in the interview with visitors, the subjects answered that the urgent problems in the case areas are the traffic confusion and the shortage parking space.