총체적 언어중재가 다운증후군 아동의 발화에 미치는 효과

권형지,박선희,강수균 대구대학교 특수교육재활과학연구소 2005 특수교육재활과학연구 Vol.44 No.3

본 연구는 총체적 언어중재가 다운증후군 아동의 발화 자율성의 증가, 의사소통 의도의 변화, 그리고 전반적 언어능력이 향상되었는지를 알아보고자 하였다. 이를 위하여 생활연령이 9.9~13.2세 범위이고, 약물 복용이나 다른 신체적 장애가 없는 다운증후군 아동 3명을 대상으로 언어중재를 실시하였다. 이를 위하여 사전 - 사후 설계를 적용하였고, 사전 평가 단계, 중재 단계, 사후 평가 단계의 과정으로 실시하였다. 본 연구의 결과 첫째, 총체적 언어중재가 다운증후군 아동의 발화에서 발화의 자율성이 증가되었다. 둘째, 총체적 언어중재가 다운증후군 아동의 발화에서 의사소통 의도가 변화되었다. 셋째, 총체적 언어중재가 다운증후군 아동의 전반적 언어능력을 증가시켰다. 이상과 같은 결과를 바탕으로 총체적 언어중재가 다운증후군 아동의 언어능력에 긍정적인 영향을 미쳤다는 것을 알 수 있다. The purpose of this study was to examine the effect of a whole language intervention in the utterance development in children with Down syndrome. Three boys with Down syndrome, who were in the range of 9.9 years to 13.2 years old, participated in the study. None of subjects showed visual, hearing, emotional, and/or behavioral problems besides Down syndrome. To investigate each subject's language ability, 3 examination tools were administered: The production of voluntary utterances, the variety of conversational intension, and the Preschool Receptive-Expressive Language Scale(PRES). This study used pre-post treatment design. The results of study were as follow: First, the whole language intervention improved the subjects' mean of production of voluntary utterances. Secondly, the whole language intervention improved the subjects' mean of variety of conversational intension. Thirdly, the whole language intervention improved mean of the overall language development for all the subjects. As described above, the whole language intervention improved semantic, syntactic, pragmatic ability of language for all the subjects.

정신분열병 환자에서의 한국어판 사회적응 척도의 개발 : 신뢰도 및 타당도 연구

김철권,서지민,김상수,조진석,하준선,김정옥,변원탄 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 정신분열병 환자의 사회적응 정도를 측정하는데 사용되는 사회적응 척도의 한국어판을 개발하기 위함이다. 방 법: 사회적응 척도를 번역한 후 정신분열병 환자 67명과 정상인 78명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과: 자료분석 결과 검사-재검사 신뢰도는 0.85, 검사자간 신뢰도는 0.89, 내적 일치도는 0.87로 높은 수치였다. 변별 타당도를 검증하기 위하여 정신분열병 환자군과 정상 대조군을 비교한 결과 정신분열병 환자군에서 사회적응 정도가 유의하게 낮았다. 구성 타당도를 알아보기 위하여 10개 영역간의 상관관계를 측정한 결과 성적적응 영역을 제외한 모든 영역들에서 유의한 상관관계를 보였다. 본 척도의 전반적 평가 영역 결과와 GAF 결과간의 상관성을 통해 간접적으로 검증한 공존 타당도 역시 유의하였다. 결 론: 한국판 사회적응 척도는 우수한 신뢰도와 타당도가 입증되었고 나아가 정신분열병 환자의 사회적응 정도를 평가하는데 유용하게 사용되어질 수 있을 것이다. Objectives: The purpose of this study was to develop the Korean version of the Social Adjustment Scale Ⅱ-Revised Version(KSAS Ⅱ-RV) in the schizophrenics. Methods: KSAS Ⅱ-RV was administered to 67 schizophrenic patients and 78 matched normal controls for examining the reliability and validity. Results: Data analysis showed statistically significant reliabilities and validities of KSAS Ⅱ-RV. The test-retest reliability, inter-rater reliability, and internal consistency for total scores of KSAS Ⅱ-RV were 0.85, 0.89. and 0.87, respectively. Evidence for discriminant validity of KSAS Ⅱ-RV comes from the results that the mean scores of schizophrenic patients were significantly high than those of normal controls. Construct validity was assessed by calculating the 10 inter-subareas correlations of the KSAS Ⅱ-RV, and all except the sexual adjustment area were statistically significant. Significant correlations between the global area scores of KSAS Ⅱ-RV and those of Global Assessment of Functioning Scale lend support for the concurrent validity of this instrument indirectly. Conclusions: KSAS Ⅱ-RV was found to be a valid and reliable instrument which can be used to evaluate the degree of social adjustment in the schizophrenic patients.

실내사무환경의 환경성담배연기(ETS)의 지표물질에 관한 연구

하권철,백남원,박동욱,윤충식,김원,최상준,박지영,최인자,김신범,강태선 한국산업위생학회 2003 한국산업보건학회지 Vol.13 No.2

The purpose of this research is to evaluate indoor office environment using the concentrations of nicotine, 3-enthenyl-pyridine(3-EP), and respirable suspended particulate(RSP), which are indicators for environmental tobacco smoke(ETS) and the correlations between indicators and environmental conditions(smoking density, smoking index). The mean air charge per hour (ACH) in smoking rooms was 10.4 and most of the smoking rooms showed non-compliance withe ASHRAE standard value except only one smoking rooms. The concentrations of RSP, 3-EP, nicotine showed log=normal distributions, and became different statistically depending on smoking condition(p〈0.01). The geometric mean concentration of RSP in smoking room was 441.7 ug/㎡ that is far exceeded environmental standard(150 ug/㎡). This implies that fine particulate in smoking room should be carefully controlled considering smoking density and ventilation fate. The mean concentrations of nicotine and 3-EP were 93.4 ug/㎥, respectively. The correlation coefficients between RSP and SI, 3-EP and SI, and Nicotine and SI were 0.67, 0.84 and 0.74, respectively. The correlation coefficient between nicotine and 3-EP, nicotine and RSP, and RSP and 3-EP were 0.76,0.78 and 0.57 respectively.

실험동물에서의 내분비계 교란물질인 DEHP, DBP의 생체내 영향

정지윤,이성호,박영석,박병권,김병수,김상기,박창식,강경선,이영순 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

The major protocol features of the rodent uterotrophic assay have been evaluated using a range of reference chemicals. The protocol variables considered include the selection of the test species and route of chemical administration, the age of the test animals, the maintenance diet used, and the specificity of the assay for estrogens. The rodents were ovariectomized under general anesthesia via bilateral flank incisions and randomly assigned to groups of 5 animals. This study investigated the estrogenic effects of phthalates, which are DEHP and DBP, suspected as endocrine disruptors. It is concluded that three daily subcutaneous administration of test chemicals, which are di-ethylhexyl phthalate(DEHP) and di-n-butyl phthalate(DBP), to 9 week-old rodents. The results revealed that DEHP & DBP show similar uterotrophic activity in the rat and the mouse, using subcutaneous administration. DEHP and DBP failed to affect any of these parameters, which are body weight, mammary gland, vaginal and uterus histopathology. but, DBP increased uterus weight to only one rat of 1.0 g/kg group. The results conform the need for rigorous attention to experimental design and criteria for assessing estrogenic activity.

기억력 저하를 호소하는 노인들을 대상으로 INM176를 3개월간 임상시험한 후의 치료성적 및 부작용 평가 보고

김지혜,고선규,고효정,권영아,김성환,김재경,김태은,박재우,서민영,송영란,이인수,김도관 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2

Objectives : We examined the effects of INM 176 (K-l107) compared with placebo on the cognitive functions of 92 old aged subjects with cognitive impairment. Methods : This was a prospective, 12 week, double-blind, Placebo-controlled clinical trial. The elderly who achieved a score of less than 25 points on the K-MMSE or showed a high risk of Alzheimer's disease from the 7-Minute Neurocognitive Screening Battery were considered to have objective impairment and were selected as subjects for this study. The subjects were randomized to placebo or INM 176 group. The outcome measures were from the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog), the Instrumental Activities ofDaily Living (IADL) and the Korean Geriatric Depression Scale (KGDS) and two kinds of computerized priming tests. After setting the total error score in the Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog) as the repeated measurement factor, an analysis of variance of the combined factor design was done between the placebo and INM 176 group. Results : The interaction effect of time (pre- and post-trial) and group (placebo and INM 176 group) was significant in the analysis of the ADAS-cog's total error score. The INM 176 group's total error score in the ADAS-cog decreased significantly (p<0.01), whereas the placebo group showed a slight increase. The mean changes in IADL and GDS from baseline scores favored in the INM 176 group than in the placebo group. Outcome changes ofADAS-cog, IADL, KGDS scores during the 12 week clinical trail ofINM 176 and placebo demonstrated favorable responses in the INM176 administered group. Conclusions : This is a preliminary clinical trial result of INM176 as a memory pill. Based on these results, INM176 may be a candidate molecule for the improvement of cognitive functions, including memory, Further clinical trial should demonstrate its efficacy.

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.

일부 흡연 대학생의 지각된 스트레스와 흡연실태에 대한 상관관계 연구

강초록,권시내,권혜림,박수경,송인혜,오해인,이미지,한승아,황선아,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

In spite of the seriousness of smoking harm has been developed these days. the increase of national smoking rate and that the people in the twenties are especially leading the rise of national smoking rate is an important issue of national health. Smoking of the university students can occur health problem and cause loss of manpower and expenses in their social activity period. So then the actual state for prevention of smoking and development of a program to prohibit smoking has to be seized urgently and starting with the study of the realities of university students, the effort to find a related fluent of smoking has to be studied. Related to this, the purpose of this study is to seize the general characteristics of smoking university students and to find out the relationship between perceived stress and smoking status among smoking university students. In addition, by collating the relationship between perceived stress and smoking status among smoking university students we have the purpose to furnish the basal data of stress care, the best way to cope with stress through group training and the plan for nursing implementation to decrease the smoking rate. For this study, a survey was conducted for 204 smoking university students of 13 universities in Seoul from 9th of May to 16th of May, 2003. The collected data was analyzed by t-test, Pearson Correlation and ANOVA in the statistical packages SPSS/PC. Major findings of this study are as follows; 1. Of the 204 respondents 85.4% of them were male and 14.6% of them were female. The average age of the sample was 23.19 years old and 41.8% of them were in senior, 21.4% in junior, 16.9% in sophomore, 19.9% in freshman grade. The major motivation to start smoking was 'because of curiosity'(33.8%) and the first smoking experience was at 'senior high school' (41.9%) and at 'college' (41.9%). 2 The highest scored stress factor of smoking university students were stresses about school work. 3. 72.7% had experience to quit smoking at least one or more times. Most of the reason to keep on smoking was 'short will to quit'(51.0%) and the smoking place was usually at 'school' (41.4%). Most respondents for the number ofsmoking friends were '5 people and above' (73.2%). 4. There was a negative relationship between the general characteristics and the entire perceived stress, however, there was a positive relationship between the general characteristics and the perceived stress in 4 categories which is 'sex distinction', 'major of study', 'residence form' and' inmate'. 5. There was a negative relationship between the general characteristics and the entire smoking status, however, there was a positive relationship between the general characteristics and the smoking status in 2 categories which is 'presence of hobby' and 'number of smoking friends'. 6. There was a negative relationship between the perceived stress and the smoking status. Through this study we have seized the relationship between the general characteristics, perceived stress and the smoking status of smoking university students. There was a positive relationship between some of the general characteristics with the perceived stress and the smoking status of smoking university students. Also there was a negative relationship between the perceived stress and the smoking status.

젊은 성인에서 흡연에 의한 상완동맥 내피기능의 부전에 관한 연구

이상철,권영주,방덕원,이선해,이보영,김지욱,김영훈,온영근,현민수,김성구 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Background and Objectives : Cigarette smoking is a major factor and the most modifiable risk factor for atherosclerosis. Endothelial dysfunction is an early event in atherosclerosis, before the structural change of the systemic arteries. We hypothesized that endothelial dysfunction might be present in the systemic arteries of young adult smokers and that this might be dose-dependent phenomenon. Therefore, we try to certify that smoking is associated with endothelial dysfunction in healthy young adults without other risk factor of atherosclerosis. Subjects and Methods : we studied noninvasively 29 subjects aged 3 to 4 decades without other risk factor of atherosclerosis, they were composed of the two groups, current smokers(n=15) and nonsmokers(n=14). Smoking history varied from 3 to 20 pack years. Using high-resolution ultrasound, vessel diameter and mean flow rate were measured at rest, during reactive hyperemia(with flow-mediated endothelium-dependent dilation), and after sublingual nitroglycerin(NG-induced endothelium-independent vasodilation). Result : Flow mediated endothelium dependent dilation was observed in the control subjects (9.4±3.44%) but was impaired in the smokers(5.8±2.51%)(p=0.004). NG-induced endothelium independent dilation is no difference in all subjects. Conclusion : Cigarette smoking is associated with endothelial dysfunction in healthy young adults.

대유행인플루엔자 대비를 위한 의료기관-바탕 탁상훈련 : 고안 및 평가

설희윤,김지량,권보란,목정하,이선희,곽임수,정진우,김정수,고옥배,조은희,김성순,신상숙,이상원 대한감염학회 2008 감염과 화학요법 Vol.40 No.2

목적 : 의료기관의 범유행 인플루엔자에 대한 효과적인 대비를 위한 훈련방법으로서 의료기관-바탕 탁상훈련 (hospital based tabletop exercise)의 유용성과 순응도를 평가하기 위해서 시행되었다. 재료 및 방법 : 탁상 훈련은 부산대학교 병원에서 시행되었으며 병원의 주요의사결정권자 및 주요부서 대표자, 실무자 42명이 지휘부, 진료부, 지원부 3그룹으로 나뉘어 훈련에 참가하였다 탁상훈련의 시나리오는 의료기관의 자체 훈련을 위해서 고안하였으며 현재 동남아에서 유행하고 있는 H5N1 인플루엔자가 국내에 처음으로 유입되어 확산되는 과정에서 의료기관에서 발생할 수 있는 상황을 3가지 모듈로 구성하였다. 훈련 평가는 훈련 전후에 각각 익명의 설문조사를 시행하였다. 결과 : 훈련에 초청된 참여자 42명 중 37명(88%)이 실제 당일 훈련에 참여하였다. 훈련에 참여한 37명의 직원 중에서 훈련 전 시행한 설문에 27명(73%)이 응답하였다. 훈련 전 정가에서는 훈련을 통해 획득하고 싶은 지식이나 기술의 우선 순위를 물었으며, 참여자들이 가장 중요하다고 생각하는 항목은 대유행인플루엔자 바이러스에 대한 지식 향상 22%, 병원 각 부서가 취해야 할 계획 및 의사소통과 관련된 지식 향상 19%, 지역사회 병원들 간의 상호협력을 향상시킬 전략 계발이 19%이었다. 그룹토의 동안에는 환자의 조기 발견 이후 대응에 대한 토론이 많았지만, 구체적인 부분이 미흡하였고, 대유행 인플루엔자에 대한 기본적인 이해가 부족하였다. 훈련에 참여한 37명의 직원 중에서 훈련 후 시행한 설문에 21명(57%)이 응답하였다. 훈련 후 평가에서 탁상훈련의 전반적인 만족도에 대한 질문에서 81%가 만족하였다고 답변을 하였고, 새로운 것을 배우는데 유용했는가 대한 질문에도 86%가 유용했다고 답변하였다. 결론 : 탁상훈련은 의료기관의 대유행인플루엔자 대비에 효과적인 훈련방법이라고 생각되며 훈련을 통해 의료기관 내의 여러 부서들이 각 의료기관의 특성에 맞는 현실적이고 실제적인 대비 계획을 수립하는데 도움을 줄 것으로 기대된다. 그러나 향후 토른 촉진, 구체적인 결과에 도달을 유도할 수 있는 질문, 끼워넣기 개발, 적절한 시간 등에 대한 연구가 필요할 것으로 생각된다. Background : To evaluate the usefulness and compliance of a hospital-based tabletop exercise in setting of pandemic influenza in hospitals. Materials and Methods : Tabletop exercise was held in Pusan National University Hospital and forty two hospital employees were invited to participate in the exercise. The scenario for hospital-based tabletop exercise was designed. It consisted of three modules, which simulated the influx and outbreak of H5N1 influenza that was epidemic in Southeast Asia. Pre-, post-exercise surveys were completed by anonymous questions. Results : Thirty-seven (88%) of 42 invited participants attended exercise. AII members of the administration group and the ancillary services group participated. But, only 77% members of the clinical services group participated. In pre-exercise survey, priorities of eight goals regarding skills and knowledge during exercise were inquired., The highest priorities pointed out by the respondents were "Increase the knowledge of pandemic influenza" (22%), "Development of strategies for optimal communication among employees within specific department" (19%) and "Development of strategies for improved coordination between facilities within the health system" (19%). Twenty-one (57%) of participants completed the post-exercise surveys. At post-exercise surveys, 81% of the participants stated that the tabletop exercise was extremely or very useful, 86% of the participants also stated that it increased their knowledge of pandemic influenza. Conclusion : Tabletop exercise is an effective modality for increasing pandemic influenza preparedness in hospitals, and this method is useful for guiding preparedness activities within the hospital environment. Further studies to determine the appropriate method of discussion, questionnaire, duration of exercise and injection are needed.

임상실습에 임하는 학생들의 비강 및 피부에 분포된 포도구균과 환자병소에서 분리된 포도구균에 대한 병원성의 연관성에 관한 연구

최대경,김홍선,백태현,권지순 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

The authors have studied the pathogenecity of staphylococci isolated from 96 patients in Chungnam National University Hospital and Staphylococci isolated from nose and axilla of 50 medical and 50 nursing students in Chungnam National University. The authors conducted the survey from January 1986 to June 1986. The results obtained were as follows : 1. Out of staphylococci isolated from 96 patients, Staphylococcus aureus and Staphylococcus epidermidis were 59.4%, and 32.3%, respectively. In staphylococci isolated from nose of medical and nursing students, Staphylococcus aureus was 13.6^(male), 17.2%(female) and Staphylococcus epidermidis was 61.0%(male), 75.9%(female), respectively. 2. In the biotype of Staphylococcus epidermidis isolated from patients, the rate of biotype 1 was 93.5%. In the staphylococcus epidermidis isolated from nose of medical and nursing students, the rate of biotype 1 was 55.6%(male), 31.8%(female). In the axilla, the rate of biotype 1 was 56.5%(male), 52.6%(female), respectively. 3. In the biotype 1 of Staphylococcus epidermidis isolated from patients and control groups, enzymatic activities were more active than other biotypes. 4. Crystal violet ring test of Staphylococcus epidermidis isolated from patients, biotype 1 was WR type 22.6%, SR type 67.7% and DR type 3.2%. 5. To the antibiotic activities of staphylococci isolated from patients, Staphylococcus aureus was resistant to gentamycin(96.5%), penicillin(78.9%), lincomycin(47.4%) and erythromycine(35.1%). In the nose of medical students, Staphylococcus aureus was resistant to penicillin(11.9%), gentamycin(11.9%), lincomycin(6.8%) and tetracycline(5.1%). 6. In the multiple antibiotic resistance of staphylococci isolated from patients, Staphylococcus aureus was resistant to 2 antibiotics(35.1%), 3 antibiotics(17.5%), 5 antibiotics(15.8%) and, Staphylococcus epidermidis was resistant to 3 antibiotics(32.3%), 4 antibiotics(19.4%) and 5 antibiotics(16.1%).