정신과 입원환자의 서비스 만족척도의 개발

김철권,이지연,송영선,김규호,김경률,김제원,이동기,최병무 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.3

목적 본 연구의 목적은 국내 정신의료기관(정신병원, 종합병원 정신과)에서 간편하게 사용할 수 있는 신뢰도와 타당도가 검증된 입원환자의 서비스 만족척도를 개발하기 위한 것이다. 방법 여러 단계를 거쳐 국내 실정에 맞는 문항을 개발하였고,정신병원, 종합병원, 대학병원 정신과 병동에서 퇴원하는 348명의 환자들을 대상으로 신뢰도와 타당도를 조사하였다. 요인분석 결과 5개의 요인이 추출되었으며 전체 변량의 63.04%를 설명하였다. 내적 일관성에 대한 신뢰도 계수 (Crohnbach's α)는 0.95로 상당히 높은 수준이었고, 수정된 개별문항-총점 상관계수는 0.50부터 0.72까지의 범위에 속하였다. 요인분석을 통해 추출된 서비스 만족척도의 각 하위척도 점수와 서비스 만족척도에 첨부된 각 영역에 대해 전반적인 만족도를 묻는 세 개의 문항 점수 간의 상관성 역시 유의하게 높았다. 결과 진단명에 따른 서비스 만족척도의 전체 점수에서는 불안/신체형/강박장애 환자군과 기분장애 환자군이 각각 정신분열병 및 기타 정신병 환자군과 알코올중독 장애 환자군에 비하여 유의하게 높은 점수를 보였으며, 입원형태에 있어서는 자발적 입원군이 강제 입원군에 비하여 전체 만족점수가 유의하게 높았다. 그러나 성별, 월수입, 학력, 직업, 종교, 결혼상태 등의 변수에서는 서비스 만족척도의 전체 점수에서 유의한 차이가 발견되지 않았으며, 마찬가지로 연령, 입원일수, 입원횟수, 첫 발병나이, 유병기간 등의 임상적 변수에서도 서비스 만족척도의 전체 점수와 유의한 관계를 보이지 않았다. 서비스 만족척도의 전체점수에서 대학병원 환자군이 정신병원 환자군과 종합병원 환자군에 비하여 각각 유의하게 높았다. 결론 결론적으로 국내 정신의료기관에 입원한 환자들의 서비스 만족을 평가하기 위한 목적으로 개발된 본 척도는 높은 수준의 신뢰도와 타당도를 보였으며, 또 국내 정신의료 환경에 맞는 요인구조를 보였다. 따라서 정신의료 서비스에 대한 정신과 환자의 만족도에 대한 연구가 거의 없는 실정에서 본 척도의 개발은 향후 국내 정신의료의 질과 치료결과를 높이는 도구로 활용될 수 있을 것으로 기대된다. Objectives : To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale : SSS) for routinely assessing the quality of service in psychiatric ward inpatients. Methods : A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and University hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. Results : Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. Conclusion : SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring Satisfaction of psychiatric inpatients in Korea.

오미자 추출물의 추출특성 및 항산화 효과

김현구,나경민,예수향,한호석 한국식생활문화학회 2004 韓國食生活文化學會誌 Vol.19 No.5

The present study was conducted to investigate extraction characteristics and antioxidative activity of Schiznadra chinensis extracts. Schiznadra chinensis was extracted by reflux extraction(RE) under different extraction conditions including solvent. The solid yield, turbidity, color value, titratable acidity, free sugar contents, electron donating ability(EDA) and superoxide dismutase(SOD)-like ability of Schiznadra chinensis extracts were determined. The highest solid yield value was obtained with water of 10 fold. No significant difference in turbidity and color value were found among the extracts prepared with various extraction solvents, 75% ethanol, 50% ethanol and water. The highest titratable acidity was obtained with water extracts of Schiznadra chinensis. The free sugar contents of Schiznadra chinensis extracted with water showed the highest value. Schiznadra chinensis extracts with water included higher contents of free sugar compared with those of the other solvent extracts, 50% ethanol and 75% ethanol extracts. The total polyphenol compound content of Schiznadra chinensis extracted with 50% ethanol showed the highest value. Schiznadra chinensis extracts with 50% ethanol included higher contents of total polyphenol compound compared with those of the other solvent extracts, water and 75% ethanol extracts. The electron donating ability of extracts were 60.87% in water, 57.24% in 50% ethanol, and 55.61% in 75% ethanol.

결명자 추출물의 추출특성 및 항산화 효과

나경민,한호석,예수향,김현구 한국식생활문화학회 2004 韓國食生活文化學會誌 Vol.19 No.5

The present study was conducted to investigate extraction characteristics and antioxidative activity of Cassia tora L. extracts, Casia tora L. was extracted by reflux extraction under different extraction conditions including solvent. The solid yield, turbidity, color value, titratable acidity, free sugar contents, electron donating ability and superoxide dismutase-like ability of Cassia tora L. extracts were determined. The highest solid yield value was obtained with water of 10 fold. No significant difference in turbidity and color value were found among the extracts prepared with various extraction solvents, 75% ethanol, 50% ethanol and water. The highest titratable acidity was obtained with 50% ethanol of Cassia tora L.. The free sugar contents of Cassia tora L. extracted with water showed the highest value. Cassia tora L. extracts with water included higher contents of free sugar compared with those of the other solvent extracts, 50% ethanol and 75% ethanol extracts. The total polyphenol compound content of Cassia tora L. extracted with 50% ethanol showed the highest value. Cassia tora L. extracts with 50% ethanol included higher contents of total polyphenol compound compared with those of the other solvent extracts, water and 75% ethanol extracts.

레크리에이션의 심리학적 연구동향

박준동,김유수,김경두,조재호 東亞大學校 附設 스포츠科學硏究所 1995 스포츠科學硏究論文集 Vol.13 No.-

The recreation reserch held in Korea and other nations is mostly based on a social survey method, employing a theoretical approach to recreation's principles. In the US and Canada, however, the reserch is more practical and academical, including sociology, psychology, economics, urban engineering and ecology. A psychological approach to recreation peaked in 1960s-1970s. The so-called recreation psychology supported by experimental data and case-study came into being in the 1970s. Up to now, then, the psychological tendencies in recreation reserch show the increasing number and areas of appile'd studies, focused on scientific and contributing to the solution of actual problenms of everyday life.

수은화합물이 마우스 복강대식세포와 EMT-6 세포에 미치는 효과

고대하,염정호,기노석,오경재,권근상,김성엽,김남송 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

Balb/c 마우스의 복강대식세포 및 유선암에서 기원한 EMT-6 세포를 배양하는 조건에 여러농도의 수은을 첨가하여 nitrite와 nitrate 생성의 변화를 관찰한 결과는 다음과 같다. 복강대식세포 및 EMT-6 세포가 생성하는 nitrite와 nitrate 양은 배양시작 12시간째의 생성량에 비해 24시간 후에는 2배, 36시간 후에는 3배의 농도로 측정되어 된다. 이때 nitrite와 nitrate 농도사이에는 매우 높은 상관관계를 나타냈다. 수은첨가에 따라 nitrite 및 nitrate 생성량은 용량의존적 관계로 현저한 감소를 보이며, 24시간 또는 36시간 후의 세포생존률도 역시 수은농도에 비례하여 감소되는데, 복강대식세포의 생존률이 EMT-6 세포의 생존률보다 더욱 큰 폭으로 감소하였다. 이상의 결과로 배양조건에 수은의 첨가로 인하여 nitrite 및 nitrate 생성량이 감소하는 바 수은이 면역세포의 대사과정에 영향을 주어 nitric oxide 생 성능을 억제시키며, 결국 세포성 면역을 저하시키는 것으로 사료된다. The effect of treatment of mercury chloride on the nitrite and nitrate synthesis was observed in peritoneal macrophages from Balb/c mice and EMT-6 cells in vitro. The cells were cultured in Dulbecco's modified Eagle's medium (DMEM) with cytokines. Amounts of nitrite and nitrate in the culture media after 24 and 36 hours of culture were about 2-fold, 3-fold of those measured after 12 hours respectively. There were very close associations between the amounts of nitrite and nitrate measured in the culture media, according to culture time. The survival rate of peritoneal macrophages was significantly decreased by mercury chloride added into the media in dose-dependent manner, however the survivals of EMT-6 cells were not influenced by mercury chloride concentration in media. Nitrite and nitrate syntheses were dose-dependently decreased by mercury chloride added in culture media. These results reported here suggest that the disorder of cell mediated immunity by mercurials could be related to the inhibition of nitric oxide synthesis which seems to be caused by the inhibition of metabolism of cells.

백서 뇌의 정상 노화와 병적 노화 과정의 조직학적 차이 및 약물효과

전진숙,한호성,장희경,길영기,김순옥 대한생물치료정신의학회 1997 생물치료정신의학 Vol.3 No.1

Objectives : Besides of malnutrition and neurotoxic effect of alcohol on the prefrontal cortex or subcortical structures, premature aging may be involved in alcohol-induced cognitive disorders. The aims of this study were to evaluate the effect of alcohol on short-term memory function and histology, and to identify the drug responses and an association with aging process to understand a biological mechanism underlying alcoholic dementia. Methods: In experiment 1, T-maze tests were done in 5 aged controls and 5 atropine-treated rats. In experiment 2, T-maze tests were repeated on every week for a month in 5 normal adult and 5 ethanol-treated rats. In experiment 3, T-maze tests were repeated on every week for a month in seven groups of 5 ethanol-treated rats injected with normal saline, fluoxetine, bromocriptine, bethacholine, nimodipine, clonidine and ketamine. After completion of behavioral tests rats were sacrificed by the intracardiac perfusion with phosphate buffered 10% formaldehyde solution, and the brain specimen was stained with hematoxylin-eosin to count cells in prefrontal cortex and hippocampus. Results: 1) Cell numbers of hippocampus(CA1, CA3 and dentate gyrus) and prefrontal cortex were reduced in ethanol-treated rats(P<0.05) without significant changes on T-maze tests. 2)Cell numbers of hippocampus(CA1, CA3 and dentate gyrus) and prefrontal cortex were recovered by bethacholine(P<0.05), while those of hippocampus raised by bromocriptine and clonidine(P<0.05 respectively). There were no significant changes on T-maze tests. 3) Cell numbers of prefrontal cortex in ethanol-treated rats were correlated with those of atropine-treated(r=0.977,P<0.001), and of normal aged(r=0.448, P<0.05) rats. Conclusions : Alcohol-induced memory disorder might be mainly related with cholinergic system as well as adrenergic or dopaminergic ones. Pathological aging process could be involved in a mechanism underlying alcoholic dementia.

디지탈 멀티비젼 ASIC의 설계

류지구,최혁환,차영호,김정헌,조경연 釜慶大學校 1997 釜慶大學校 論文集 Vol.2 No.2

The wide spread of multimedia sysrem deands a large viewing display device which can inform a message to many peoples in open area. This paper is about the design and simulating of a large viewing digital multi-wision control ASIC(Application Specific Integrated Circuit). In this paper. the digital multi-vision ASIC has one channel of imput cideo signal wihich is compliance with CCIR-656 specification and four channels of output video signal which are compliance with CCIR-601 specificarion. It has 2 operating mode. The one is the pass-thro;ugh mode. input vido signal goes to output video signal without any change, and the another one is the expension mode, input video signal is expended by from 2 to 16 times into output video signal. In expension mode. awindow could be programmed and only the input video signal in the window is expended. The 0.6 micron CMOS sEA OF Gate is used to design the ASIC in amount of about 23,000 gates, and it is simulated at 48MHz.

자궁내 성장 지연증 소아에서 혈청 IGF-I, Free IGF-I, IGFBP-1, IGFBP-3 농도에 대한 연구

황일태,박은애,김경희,김호성 대한소아내분비학회 1999 Annals of Pediatirc Endocrinology & Metabolism Vol.4 No.2

무증상 한국인에서 근위부 대장용종의 예측 인자로서 원위부 대장용종의 의미

김진호,최재원,주광로,민영일,김해경,김영민,박의련,홍원선,김도하,정성애,명승재,김석균,양석균,정훈용,조문경,심기남,김기락 대한소화기학회 2000 대한소화기학회지 Vol.36 No.5

Background/Aims: The aim of this study was to examine whether rectosigmoid polyps could be a marker for proximal lesions. Methods: A total of 367 asymptomatic patients with distal colonic polyps (314 adenomatous; 53 hyperplastic) noted on sigmoidoscopy and 134 asymptomatic controls without distal colonic polyps were evaluated with total colonoscopy. No one had risk factors of colorectal cancers or polyps. Results: Incidence of synchronous proximal adenomas was higher in the patients with distal adenomas than in the patients with distal hyperplastic polyps and the controls (30.3% vs 17.0% and 15.7%, p$lt;0.05). It was also higher in the patients with multiple distal adenomas than in the patients with single distal adenoma. Patients with distal adenomas bigger than 5 mm in diameter had a higher risk of synchronous proximal adenomas (42.4% vs 25.8%, p$lt;0.005). Patients with advanced distal adenomas had a higher prevalence of advanced adenomas in the proximal colon than those with non-advanced distal adenomas (9.1% vs 2.1%, p$lt;0.05). Conclusion: Rectosigmoid polyps detected on flexible sigmoidoscopy can be a predictor of proximal neoplasia according to their morphologic characteristics and pathology.

임상 연구 : 한국인 혈액투석 환자에서 내경정맥의 해부학적 다양성에 대한 연구

김현경 ( Hyun Gyung Kim ),김형욱 ( Hyung Wook Kim ),윤성로 ( Seong Ro Yoon ),김병수 ( Byung Soo Kim ),송호철 ( Ho Cheol Song ),김영수 ( Young Soo Kim ),윤선애 ( Sun Ae Yoon ),김용수 ( Yong Soo Kim ),원유동 ( Yoo Dong Won ),김영옥 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.3

목적: 혈액투석 환자에서 내경정맥은 쇄골하정맥이나 대퇴정맥에 비해 협착증이나 감염 등의 합병증 발생 빈도가 낮아 혈액투석 도관 삽입 시 우선적으로 선택된다. 내경정맥은 대부분 경동맥의 전방향-외측방향 (anterior-lateral)에 위치하고 있으나 일부 환자에서 이와는 다른 부위에 위치하고 있어 도관 삽입 시 시술 실패나 합병증의 원인이 될 수 있다. 저자들은 혈액투석 환자를 대상으로 내경정맥의 해부학적 위치 변이에 대해 조사하였다. 방법: 2007년 1월부터 2009년 2월까지 가톨릭대학교 의정부성모병원에서 급성신부전 혹은 만성신부전으로 도플러 초음파 유도 하에 혈액투석용 내경정맥 도관을 삽입한 358명의 혈액투석 환자를 대상으로 하였다. 도플러 초음파 검사를 통해 양측 내경정맥의 해부학적 위치를 경동맥을 기준으로 하여 조사하였다. 해부학적 위치는 경동맥의 전방-정중앙 방향 (anterior), 전방-외측부 방향 (anterior-lateral), 전방-내측부 방향 (anterior-medial), 그리고 경동맥과 평행한 외측부 방향 (lateral)으로 분류하였다. 또한 혈액투석용 도관을 삽입하는데 부적합한 내경정맥을 조사하였다. 결과: 대상 환자 358명의 평균 연령은 57±15세 (14-88세)였고, 남/여 비는 203/155명이었다. 내경정맥이 경동맥의 전방-외측부 방향에 위치한 환자는 좌, 우측이 각각 68.2%, 74.6%이었다. 그 외 전방-정중앙 방향이 좌, 우측 각각 23.7 %, 21.2%, 전방-내측부 방향이 좌, 우측 각각 7.0%, 2.5%, 외측부방향이 좌, 우측 각각 1.1%, 1.7%였다. 좌측 내경정맥에서 크기가 작아 도관 삽입이 부적합한 경우는 23예 (6.4%)였고 폐쇄된 경우는 없었다. 우측 내경정맥에서 도관 삽입이 부적합한 경우는 10예 (2.8%)로서 크기가 작은 경우 5예 (1.4 %), 폐쇄된 경우 5예 (1.4%)이었다. 결론: 한국인 혈액투석 환자의 약 1/3에서 내경정맥이 경동맥의 전방-외측부 방향 이외의 위치에 존재하는, 해부학적 위치 변이가 관찰되었고 (좌측 내경정맥 36.3%, 우측 27.1%) 일부 환자에서는 도관 삽입이 부적합한 내경정맥을 가지고 있었다. Purpose: The internal jugular vein (IJV) is a preferred site for central cannulation for hemodialysis (HD) because of its low incidence of central vein stenosis. Although anatomically IJV is commonly located on the anterior-lateral side of the carotid artery, some patients have anatomical variation of IJV, which can lead to difficulty and complication of cannulation. This study was performed to evaluate the incidence of anatomical variation of IJV in Korean HD patients. Methods: We enrolled 358 patients receiving IJV catheter cannulation for HD using doppler ultrasonography between January 2007 and February 2009. We examined the anatomical positions of IJV in relation to the position of carotid artery (CA) and incidence of anatomical variation on both sides. We also investigated incidence of inadequate IJV for cannulation, Results: The mean age of 358 enrolled patients was 57±15 years (14-88 years) (M:F=203:155). Anatomical variations of the left (Lt) and right (Rt) IJV position relative to the CA were found in 36.3% and 27.1%, respectively. Various anatomical variations of IJV position were discovered in the anterior side (Lt 23.7%, Rt 21.2%), anterior-medial side (Lt 7%, Rt 2.5%), and the lateral side (Lt 1.1%, Rt 1.7%) relative to CA. Inadequate Lt and Rt IJVs for cannulation, which can be too small sized or obstructed, were 6.4% and 2.8%, respectively. Conclusion: About one third of Korean HD patients had anatomical variations of IJV position relative to the CA. This study supports the use of doppler ultrasound guided technique for IJV cannulation in HD patients.