소아 흉통의 원인질환에 따른 임상양상

장국찬,김은영,노영일,양은석,문경래,박영봉 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

목적: 소아에서의 흉통은 흔히 접하게 되며 일반적으로 좋은 경과를 보인다. 가장 흔한 원인으로 특발성, 골격계이상, 위장관계 질환 등이 다양하게 언급되고 있으며 감별진단이 쉽지 않아 여러 검사를 시행하게 된다. 자세한 병력청취와 진찰이 진단에 가장 중요하다고 하지만 통계적 의의를 보고한 바는 드물다. 이에 흉통 원인을 분류하고 각각의 임상양상을 파악하여, 병력 청취와 진찰소견의 감별진단에 대한 유용성과 시행 검사들의 의의를 알아보고자 하였다. 방법: 2004년 3월 부터 2007년 8월 까지 조선대학교 병원 소아청소년과에 흉통을 주소로 방문한 환아 77명을 대상으로 하였다. 연령, 성별, 흉통의 위치, 지속시간, 양상, 빈도, 방문까지 걸린 시간, 동반증상, 유발인자의 각 항목과 원인 질환과의 관련성을 분석하였다. 흉부방사선, 심전도, 심초음파, 24시간 Holter, 운동부하 심전도, 상부 위장관 조영술, 24시간 pH 검사, 위내시경, 심근효소를 검사 하였다. 결과: 평균 나이는 10.2±2.8세로 6세에서 11세까지가 48명(62.3%)으로 가장 많은 분포를 보였고 남아 42명(54.5%), 여아 35명(45.5%)이었다. 흉통의 위치는 좌측이 32명(41.6%), 양상은 콕콕 찌르는 것이 27명(35.1%)으로 가장 많았고 지속시간은 1분미만이 36명(46.8%), 1-5분 사이가 28명(36.4%)으로 대부분 5분 미만이었다. 흉통 원인은 특발성이 27례(35.1%)로 가장 많았고, 위장관 질환 23례(29.9%), 늑골 연골염 12례(15.6%), 심혈관 질환 7례(9.1%), 정신신체화 질환 6례(7.8%), 폐질환 2례(2.6%)였다. 여아에서 연령이 높을수록 정신신체화 질환의 빈도가 높았다(P= 0.046). 흉골 하부 통증을 호소한 17명 중 13명(76.5%)이 위장관 질환으로 통계적으로 유의하였다(P= 0.023). 정신 신체화 질환은 6명에서, 위장관 질환도 20명(86.9%)에서 흉통지속시간이 5분 미만이었으나 통계적 의의는 없었다. 흉통 양상 중 타는 듯한 양상을 호소한 7명중 6명에서 위장관 질환이 원인이었으나 통계적 의의는 없었다. 선택 시행 검사 중 심초음파는 32명중 3례(9.4%), 24시간 Holter 검사는 13명중 5례(35.7%), 24시간 pH 검사는 28명 중 16례(57.1%)에서 이상소견을 보였다. 결론: 소아 흉통 환자 중 연령이 높은 여아에서는 정신 신체화 장애를, 흉골 하부 통증을 호소한 경우는 위장관 질환을 먼저 생각하는 것이 좋다고 판단된다. 흉통원인으로 위장관 질환의 빈도가 높고 시행검사들의 진단율을 볼때, 소아 흉통 환아 에서는 상부 위장관 조영술 등 위장관 질환의 검사를 기본적으로 시행하는 것이 좋을 것으로 생각된다. Purpose: Chest pain in children is usually benign. Chest pain in children results from a wide variety of causes. Differential diagnosis of causes is not easy and then many diagnostic approach is trying. Careful history and physical exams must guide the assessment of children with chest pain. The purpose of this study intends to evaluate children with chest pain and usefulness of careful history, physical examination and several diagnostic examinations. Methods: From March 2004 to August 2007, 77 patients presented with chest pain were enrolled. we evaluated age, sex, characteristics of chest pain (location, duration, description, frequency), accompanying symptoms, increasing reasons and relationship with cause of chest pain. Chest x-ray and ECG were checked in all patients. Cardiologic and gastrointestinal evaluations were checked when considered necessary. Results: The male and female ratio was 0.55:0.45, mean age 10.2 ± 2.8 year. Common ages of chest pain were 10 to 12 years old (38case, 49.3%). The location was on the left precordium in 32cases (41.6%) of the patients. The most common diagnostic findings of chest pain were idiopathic(27cases, 35.1%), gastrointestinal disorder (23cases, 29.9%), costo chondritis (12cases, 15.6%), cardiovascular disorder (7cases, 9.1%), psychosomatic disorder(6cases, 7.8%) and pulmonary disorder (2cases, 2.6%). Older children in female were more likely to have a psychosomatic cause (P= 0.046). The patients complained chest pain on substernal area were 17cases and 13cases (76.5%) were diagnosed as gastrointestinal disorder (P= 0.023). Positive findings of echocardio graphy, 24hr Holter ECG and 24hr pH monitoring were present in 3 (9.4%), 5 (35.7%) and 16 (57.1%) of the patients respectively. Conclusion: Gastrointestinal disorders are common causes and positive diagnostic rate of gastrointestinal evaluation is relatively high in children with chest pain. Old girls are more likely to have a psychosomatic disorder and substernal pain is the reliable sign to be considered as a gastrointestinal disease in children with chest pain. Hence, Diagnostic approach of gastrointestinal disease such as upper GI should be performed basically in mostly children with chest pain.

18–30세 사이에 발생하는 뇌경색의 특징, 다기관 레지스트리 연구

장윤경,송태진,김용재,허지회,이경열,김영은,장민욱,조수진,강석윤 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.3

Objectives: Although there have been several reports that described characteristics for young age stroke, information regarding very young age (18–30 years old) has been limited. We aimed to analyze demographic factors, stroke subtype, and 3-month outcome in acute ischemic stroke patient who have relatively very young age in multicenter stroke registry. Methods: We evaluated all 122 (7.1%) consecutive acute ischemic stroke (within 7 days after symptom onset) patients aged 18 to 30 from 17,144 patients who registered in multicenter prospective stroke registry, 1997 to 2012. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria. Stroke severity was defined as National Institutes of Health Stroke Scale (NIHSS) and stroke outcome was defined by modified Rankin scale (mRS) at 3 months after index stroke. Results: The mean age of all included patients was 25.1±3.7 years and 76 patients (62.2%) were male. The median NIHSS at admission was 4. Considering stroke subtype, 37 patients (30.3%) had stroke of other determined etiology (SOD), 37 (30.3%) had undetermined negative evaluation (UN) and 31 (25.4%) had cardioembolism (CE) were frequently noted. After adjusting age, sex and variables which had P<0.1 in univariable analysis (NIHSS and stroke subtype), CE stroke subtype (odds ratio, 4.68; 95% confidence interval, 1.42–15.48; P=0.011) were significantly associated with poor functional outcome (mRS≥3). Conclusion: In very young age ischemic stroke patients, SOD and UN stroke subtype were most common and CE stroke subtype was independently associated with poor discharge outcome.

Age-dependent differences of treadmill exercise on spatial learning ability between young- and adult-age rats

Jun-Jang Jin,Il-Gyu Ko,Sung-Eun Kim,Lakkyong Hwang,Man-Gyoon Lee,Dae-Young Kim,Sun-Young Jung 한국운동재활학회 2017 JER Vol.13 No.4

전쟁문학론의 전개와 폭력의 내면화-식민지 말과 한국전쟁기 문학론을 중심으로-

장은영(Jang, Eun-Young) 우리문학회 2020 우리文學硏究 Vol.0 No.66

한반도가 경험한 두 번의 전쟁, 식민지 말의 태평양전쟁과 한국전쟁은 전쟁의 시기와 주체가 다르다는 점에서 단절되어 있다. 그러나 근대 국가의 권력이 최대로 응집되었던 두 번의 총력전은 당시 문화인들의 인식에서 나타나듯이 연속적 사건이었으며 전쟁에 대한 문학적 대응에 있어서도 연속성이 발견된다. 이 논문은 두 시기에 대한 문학사적 단절을 넘어서서 한국 전쟁문학론의 전개 양상을 살펴보고자 했다. 먼저 식민지 말 조선의 문인들이 전쟁문학론을 공론화하기 시작하게 된 계기는 일본의 보고문학 『보리와 兵丁』의 번역본 출간을 비롯한 박영희의 『전선기행』, 임학수의 『전선시집』 출간이다. 전장의 체험을 생생하게 담은 이 작품들은 이른바 보고문학이라고 명명되었고, 이에 대한 조선 문단의 반응은 두 갈래로 나누어졌다. 전쟁 경험을 생생하게 전달하고 조선인들에게 전쟁을 환기한다는 호평과 달리 보고문학은 예술성을 담보하지 못하고 문학적으로 가치가 떨어지며 전쟁을 소재화한다는 비판적 의견도 등장했다. 그러나 태평양전쟁이 발발하고 조선인 징병제 실시가 발표되자 징병제를 환영했던 일제 협력 문인들은 소극적인 태도를 버리고 적극적으로 전쟁동원을 도모하는 결전문학으로 전환하기 시작했다. 결전문학은 전쟁의 승리와 일본의 대동아공영을 위해서 문학을 비롯한 문화 활동이 국가에 종속되어야 하며 문화인의 창작 행위도 국가가 통제해야 한다며 강력한 국가주의를 드러내면서 문학의 도구화를 주장했다. 결전문학은 일본의 패전 그리고 해방과 함께 사라지는 듯 보였지만 한국전쟁이 발발하자 전시 문단에서 되살아났다. 자발적으로 전시체제에 협력하고자 한 문인들은 전쟁 동원과 선전에 앞장서서 무기로서의 문학을 주장하며 결전문학의 논리를 펼쳤다. 그들의 즉각적인 전시체제 돌입은 식민지 말 총동원체제에 대한 경험 위에서 가능한 것이었다. 문인들은 식민지 시기의 보고문학을 비판하면서도 국가와 민족을 절대 이념으로 삼는 결전문학의 논리는 그대로 수용한 전쟁문학론을 펼쳤다. 그러나 한국전쟁이 막바지를 향해 가면서 전쟁문학론은 차츰 결전 의지나 전쟁 동원보다는 전쟁의 문학적 형상화 문제로 전환되었고 탈이념화의 목소리도 제기되었다. 문인들은 전쟁의 무기로 전락한 결전문학의 한계를 자각하고 작품성에 의구심을 품으며 전쟁의 문학적 형상화를 위해서는 전쟁에 대한 거리 두기가 필요하다는 점을 인정하기 시작했다. 한국전쟁기에 국한된 전쟁문학론은 사실상 극단적인 국가주의를 근간으로 한 일본의 총동원체제 이념으로부터 자유롭지 않다. ‘파시즘의 시대’였던 식민지 말의 전쟁문학론은 한국전쟁기 전쟁문학론에서 재생산되어 문학을 초월하는 국가주의로 나타났다. 여기에 국민 통합 이념으로써 반공주의가 결합하면서 전쟁문학은 개인을 국가에 종속시키는 데서 나아가 배제와 선별을 거친 인간, 즉 이념적으로 순수한 반공주의적 인간을 옹호하는 기형적 휴머니즘에 봉착했다. 전쟁문학론은 전시 기간에 일시적으로 등장했던 문학 담론이었지만 전쟁문학의 기반이 된 극단적, 초월적 국가주의는 다른 이념들과 결합하며 전쟁기 한국 문학장의 기저를 형성했다. Koreans remember two wars. But the two wars are remembered as disconnected from each other. One is the Pacific War experienced during the colonial period, and the other is the Korean War after the liberation of Joseon. The connection between the two wars have been denied and been considered different events. But the two wars are connected ideologically and culturally. But the two wars are connected ideologically and culturally. Especially in the literary realm, the two wars are linked. In fact, the starting point for the discourse of war-literature during the Korean War was the discourse of war-literature during the Pacific War. At t he e nd o f 1930s, a f ew t he K orean w riters w ho cooperativ e with Japanese colonial policy began discussing war literature after publishing Hino Ashihei’s Barley and S oldier(a Korean translation), Park Young-hee’s Jeonsun-kihang, Lim Hak-soo’s Jeonsun-sijip. These works, which are close to records, were called ‘Bogo-Munhak’. The reactions of the Korean writers were divided into two parts about ‘Bogo-Munhak’. Some people think highly of ‘Bogo-Munhak’. while others say that ‘Bogo-Munhak’ does not guarantee artistry and literary value. When the conscription system for Koreans began in 1943, the discourse of war-literature began to shift to the fascism, extreme nationalism. Some Writers argued that literature should be subordinate to the state and the creative activities of cultural people should be controlled by the state. They argued that literature was needed to win the war. That is a ‘decisive warliterature’. The discourse of war-literature at the end of the colonial period disappeared with the Korean liberation but was revived again as soon as the Korean War broke out in 1950. Korean writers wanted to be a cultural entity that actively cooperated with all-out efforts through the war. They accepted the discourse of war-literature the colonial era and advocated war-literature as a weapon. T he d iscourse o f war-literature e mphasized v ictory i n war and mobilization of war, focusing only on content rather than form. But as the Korean War neared its end, the discourse of war-literature had gradually expanded its subject-matter to the literary formalty. Moreover writers began to pay attention to how would themselves make the nation after war. They recognized the limitations of war-literature which had degenerated into weapons of war. The writers was able to distance literature from war at the end of the war. In a word the cultural control of the total mobilization system during the colonial period was based on fascism and the discourse of war-literature also was based on fascism. Unfortunately, Korean writers reproduced the discourse of war-literature during the Korean War by imitating the discourse of war-literature during the colonial period. As a result the violence of totalitarian national ideology and identity had spread to Korean war-literature.

Articulation Patterns of Children who Developed Articulation Disorders Associated with Ankyloglossia

박선영(Sun-Young Park),심선희(Sun-Hee Shim),장은실(Eun-Sil Jang),엄태훈(Tae-Hoon Eom),김영훈(Young-Hoon Kim),이순주(Soon-Ju Lee) 대한소아신경학회 2013 대한소아신경학회지 Vol.21 No.3

목 적 : 설소대와 조음장애의 관련성과 설소대 환아에서 조음장애 유무를 감별하는데 필요한 임상지침을 제시하기 위해 조음장애를 동반한 설소대 환아의 조음양상의 특징을 알아보고자 하였다. 방 법: 2002년 1월부터 2012년 12월까지 의정부성모병원 소아청소년과 외래를 방문한 124명의 환아 중 설소대를 제외한 다른 조음기관의 해부학적 이상, 신경학적 질환이나 발달/언어지연을 가진 46명의 환아를 제외한 총 78명을 설소대 유무에 따라 각각 환자군 23명과 대조군 55명으로 나누어 그림자음검사를 통해 조음양상을 비교분석하였다. 결 과 : 두 군에서 조음오류를 보인 자음유형에 따라 집계한 각 환자수는 연구개비음의 경우에만 차이를 보였다. 하지만 자음유형에 따른 조음오류의 환자별 관찰빈도수의 총합은 양순파열음, 연구개파열음과 연구개비음에서 유의한 차이를 보였다. 조음오류의 변화유형에 따라 집계한 환자수는 두 군에서 차이를 보이지 않았다. 하지만 조음변화 유형에 따른 환자별 관찰빈도수의 총합은 환자군에서 전설음화와 마찰음화가 낮게 관찰되었고, 경음화와 격음화과 높게 관찰되었다. 결 론 : 본 연구를 통해 설소대를 동반한 조음장애 환아의 일부에서 해부학적 이상을 동반하지 않은 기능적 조음장애 환아와 구별되는 특징을 보이는 결과를 관찰할 수 있었지만, 이를 설소대를 동반한 모든 조음장애 환아로 일반화할 수는 없었다. 따라서 설소대와 조음장애의 관련성은 여전히 논란의 여지가 있으며, 또한 수술적 치료를 포함한 설소대 치료를 결정하는데 주의를 기울여야 할 것으로 사료된다. Purpose : We investigated articulation patterns in children with ankyloglossia who developed articulation disorders in order to determine the relationship between ankyloglossia and articulation disorders, and to clinically detect children who have articulation disorders associated with ankyloglossia. Methods : The participants of this study were 23 children with articulation disorders that accompanied ankyloglossia and 55 controls with functional articulation disorders independent of anatomical problems, who were admitted to our hospital from January 1, 2002 to December 31, 2012. All children underwent speech-language pathologic evaluation using the Picture Consonant Articulation Test (PCAT; Young-Tae Kim, 1994). We retrospectively compared collected data between the subject and control groups using Fisher's exact test and odds ratio tests with a 95% confidential interval for categorical variables and the independent Mann-Whitney U-test for continuous variables. Results : The number of patients with articulation errors in the velar nasal was lower significantly only in the subject group (P =0.038). The total numbers of articulation errors in the bilabial plosive, velar plosive and velar nasal also were lower (P=0.007, P˂0.001, and P=0.034, respectively). There were no differences in the numbers of patients with articulation errors according to phonological changes between the two groups. However, the total numbers of fronting and frication were lower in the subject group (both P˂0.001), but the total numbers of plosivation and tensing were higher (P =0.002 and P =0.008, respectively). Conclusion : This study showed that the relationship between an articulation disorder and ankyloglossia is doubtful, although some results suggest that ankyloglossia may cause articulation errors only in certain individuals. Therefore, clinicians should be careful when determining the relationship between ankyloglossia and articulation disorders and use caution when making a treatment decision.

물질남용 치료프로그램 후 재범여부에 대한 예비적 추적조사 연구

김현수,조선미,오은영,임기영,정영기,윤웅장,이영미 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 본 연구는 물질사범에게 시행되는 수강명령 프로그램의 효과를 재범률을 중심으로 살펴보고자 한 것이다. 방 법: 이 연구의 대상집단은 보호관찰소에서 의뢰받은 물질남용자집단이다. 이들은 법원으로부터 보호관찰, 수강명령, 치료명령, 사회봉사 등을 부과받았다. 총 104명의 대상자집단을 치료프로그램을 이수한 수강군과 비수강군으로 나누었으며 이들에 대한 재범률을 조사하였다. 결 과: 프로그램을 이수한 수강군이 비수강군에 비해 재범률이 낮았다(p<.05). 또한 단기 수강군과 장기수강군의 재범률의 차이를 조사하였는데 대상자 집단의 수가 적기 때문에 장기 수강군의 효과가 통계적으로 입증되지는 않았다. 결 론: 우리는 물질남용자에 대한 정책이 보다 교육적으로 변화할 것을 본 논문을 통하여 제시하려 하였으며 정부 및 법무부는 물질남용자에게 교육과 치료를 제공해주어야만 한다. Objectives: Using recidivism rate, we investigated the outcome after our substance abuse treatment program had been implemented. Methods: Our target population was substance abuse criminals referred by probational office. They either received the parole and probation order, treatment order or social service order from the court. We divided 104 substance abuse criminals into treatment group and non-treatment group. We examined their recidivism rate. Results: We reached a conclusion that treatment group had lower recidivism rate than non-treatment group(p<.0.5). We examined the effectiveness of short-term and long-term programs. However, no effectivess of long-term program was found because the sabject number was too small. Conclusion: We suggest that the strategies for substance abuse should be changed to more educative ones. The Government and Ministry of Justice must provide education and treatment to the substance abuse criminals.

학교도서관의 매체이용교육에 관한 연구 : 부산지역의 고등학교 도서관을 중심으로 A survey of high school libraries in Busan

장은숙,김영귀 신라대학교 교육과학연구소 2002 교육과학연구 Vol.- No.7

The purpose of this study is to investigate and to analyze of existent circurnstances of education of the using method of media in the school library. The object of analysis in to know which users how to utilize various media and how to learn using method of media and then to suggest a direction of systematic and effective education of using method of media in the school library. The method of this study is a questionnaire to the librarians in the high school library The results of this study are as follows : ① Librarians' work experiences which within 2 years was 63.87%. ② School library which had 2000∼5000 volumes as an own collections was 32.77%. ③ Regular teachers who are teaching the using method of media was 71.43%. It shows that school library is very hard to accomplish systematic education of using methods of media. ④ Respondents who answered that teaching librarians and professionals should educate the using method of media was 74.99%. ⑤ 90.11% of respondents answered that they didn't have a opportunity to learn the using method of media but they recognized that the education is essential. ⑥ The main reason which librarians doesn't educate the using method of media to the students was that they doesn't have a curriculum of media education. ⑦ The format of education of using methods of media was printed materials (38.78%) and remains are online catalogs, databases, CD-ROM, audio-visual materials, computers and internet. ⑧ The reason which librarians had a difficulty of media education was shorts of media (52.10%). ⑨ School library which does not subscribe periodicals was 57.26%. It was very disappointed result with the neglect of the importance of periodicals as an excellent education media. ⑩ The collection grade of a audio-visual materials was computer (40.51%) and videotape (30.75%). ⑪ When is the appropriate time to educate the using methods of education? Respondents answered that the period of student orientation (32.69%) was the first and then the request of teachers was (15.38%). ⑫ 81.51% of respondents answered that the recognition and budget assistance of school authority affected the education of using methods of media.

3차원 적층패키지의 Cu-Cu 접합부의 정량적 접합강도 평가 및 향상에 관한 연구

장은정,김재원,Kim, Bioh,Thorsten Matthias,현승민,이학주,박영배 한국공작기계학회 2009 한국공작기계학회 춘계학술대회논문집 Vol.2009 No.-

The quantitative interfacial adhesion energy of Cu-Cu direct thermo-compression specimen with bonding temperature and wet pre-treatment was measured by using 4 point bending test for 3-D IC integration. The evaluated interfacial adhesion energy was 2.79±0.82, 3.46±0.87, 4.93±0.2 J/㎡ bonding temperature 300, 350, 400℃ and 0.29, 1.28, 1.64, 1.17 and 0.43 J/㎡ acetic acid pre-treatment at 35℃ for 0, 1, 5, 10, and 15 min. From the result, 5 min treated Cu to Cu thermo-compression bonding has the highest interfacial adhesion energy at 350℃.

혼합방식을 사용한 OFDM의 PAR 경감방식의 성능 해석

장은영,전제훈,김성곤,변건식 동아대학교 정보기술연구소 2003 情報技術硏究所論文誌 Vol.10 No.2

OFDM should be used for the fourth generation communication for high speed communication. Because of high spectral efficiency and high tolerance to fading channel, OFDM is applied to many high speed wire and wireless communication such as DAB(Digital Audio Broadcast), DVB(Digita1 Video Broadcast), IMT 2000 etc. Inter-modulation, however, is derived from PAR(Peak to Average Power Ratio) of OFDM signals. The paper describes PTS(Partia1 Transmit Sequence) and SLM(Se1ect Mapping) of an existing methods which can reduce PAR. And then this papers proposed the new method that is called "Combine method". The method proposed in this paper is to combine PTS and SLM. As a result of the simulation, Combine PAR method is better than the existing methods.

Improving Foreign Language Education in Korea and China: Focusing on Foreign Language Education Policy

Jang,Eun-Young 경인교육대학교 교육연구원 2020 The Journal of Education Vol.3 No.1

This study examined the current situation of foreign language education, teacher training, and education in Korea and China. The analysis and comparison of both countries’ educational policies, problems, and improvement strategies revealed several aspects that require attention. When foreign language education policies are established and enforced in the future, more attention should be given to the rigorous systematization of foreign language curriculum. Furthermore, in the context of intensifying globalization, it is necessary to provide diverse foreign language subject options to allow students to learn various foreign languages and improve their multicultural awareness. Finally, foreign language teacher training and education should be promoted more intensively to empower teachers with the competence and qualifications necessary to make them excellent agents in delivering foreign language education to learners.