저소득 독거노인의 생활만족도 관련요인

강지연,전만중,유병철,이용환 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Background : To access the influential factors of life satisfaction in low-income and living alone old people for solving the problem of the estranged elderly. Method : We conducted a questionnaire survey during the period from June 2007 till September 2007. Investigation subjects were 152 elderly people registered in two welfare centers in Busan. We measured life satisfaction of low-income and living alone old people and analyzed with descriptive analysis, t-test, one-way ANOVA and dummy variable regression analysis using SPSS Win(ver 12.0k) program. Result : The mean score of life satisfaction in low-income and living alone old people was 2.52 ± 0.56. Life satisfaction in low-income and living alone old people was relatively high in groups of 65-69 years old, elementary school graduates, subjectively healthy, exercise, hobby or leasure activity, regular repast, 3 times repast per day and income satisfaction. Life satisfaction in low-income and living alone old people was influenced by age, religion, satisfaction of income, subjective health conditions and regular repast. Conclusion : From the result, we can concluded that life satisfaction in low-income and living alone old people was low and influenced by various social and economic factors. Therefore, methods for improving life satisfaction level of low income and living alone old people are required for discerning our society's equality and healthiness.

국내 의료기관의 항생제 사용 실태와 규제 시스템 조사

방지환,송경호,박완범,김성한,조재현,김홍빈,김남중,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 이전 연구들에 따르면 아직까지 국내에서 불필요한 항생제 사용은 무시할 수 없는 수준이며, 특히, 수술환자들에 대한 예방적 항생제 투여가 문제로 지적되고 있다. 많은 병원에서 불필요한 항생제 처방을 제한하려는 노력을 하고 있지만 구체적인 현황에 대한 자료는 적은 실정이다. 이에 본 연구자 등은 국내 의료기관의 항생제 규제 시스템의 현황과 수술시 예방적 항생제 사용의 적정성을 알아보고자 한다. 재료 및 방법 : 전임 감염내과 전문의가 근무하는 의료기관 55곳에 대해 설문조사를 시행하였다. 설문의 내용은 적정한 항생제 사용을 유도하기 위한 정책 및 규제 프로그램, 실제 각 의료기관의 예방적 항생제 사용 현황 등으로 이루어져 있다. 결과 : 55개의 의료기관에 보낸 설문 중 44개가 회수되었다. 회신한 의료기관에서 항생제 처방 관리는 제한항생제 시스템을 가장 많이 이용하고 있었고(95.5%), 항생제에 대한 교육(79.5%), 전산시스템에서 관리(59.1%), 감염내과에 의뢰(54.5%), 항생제 사용 실적 검토(52.3%) 등의 순이었다. 대개의 병원에서 glycopeptides (100.0%), carbapenems (93.0%), quinupristin/dalfopristin 또는 linezolid(93.0%), 4세대 cephalosporin (74.4%), caspofungin 또는 voriconazole (62.8%), liposomal amphotericin B (60.5%) 등을 제한항생제로 분류하여 관리하고 있었다. 모든 의료기관에서 위절제술 및 유방절제술시에 불필요하게 예방적 항생제를 사용하고 있었다. 슬관절치환술의 경우 2세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았으며(30.2%), 관상동맥우회술의 경우 3세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았다(47.2%). 예방적 항생제의 투여 기간을 살펴보면 위절제술시 70.5%에서 4일을 초과하여 사용하고 있었고, 유방절제술시에는 63.6%에서, 슬관절치환술시에는 81.8%에서, 관동맥우회술시에는 81.1%에서 4일을 초과하여 장기간 예방적 항생제를 투여하고 있었다. 한편, 예방적 항생제 투여시 aminoglycoside계 항생제를 병용하는 경우도 많았다. 결론 : 아직까지 국내 의료기관에서 항생제 오남용을 막기 위한 노력이 더 필요할 것으로 생각되며, 특히 수술시 예방적 항생제의 올바른 투여에 많은 관심이 필요하다. Background : Previous studies in Korea showed that unnecessary antibiotic use could not be neglected, especially in prophylactic use. Currently many hospitals employ diverse antibiotic stewardship programs, but there are few studies on surveillance of such programs. So, we planned this study to evaluate current status of antimicrobial stewardship and adequacy of antimicrobial prophylaxis in surgery. Materials and Methods : We sent questionnaires about policy on antibiotic usage, control program for adequate antibiotic prescription, and actual status of prophylactic antibiotic usage to 55 infectious disease physicians in each hospital. Results : Of 55 contacted infectious diseases clinicians, 44 answered the questionnaire. Majority of hospitals employed restricted antimicrobial system (95.5%), education (79.5%), control by order communicating system (59.1%), consult to infectious disease physicians (59.1%), and review of cumulative antimicrobial usage (52.3%) to prevent inadequate antibiotic use. Glycopeptides were designated as a restricted antimicrobial agent in 100.0% of hospitals; carbapenems, 93.0%; quinupristin/ dalfopristin or linezolid, 93.0%; the 4th generation cephalosporins, 74.4%; caspofungin or voriconazole, 62.8%; liposomal amphotericin B, 60.5%, and so on. Unnecessary perioperative prophylactic antimicrobial agents were prescribed in gastrectomy and mastectomy in all the hospitals. The second generation cephalosporins and the third generation cephalosporins were the most commonly prescribed prophylactic antimicrobial agents in total knee replacement arthroplasty (TKRA) and coronary artery bypass graft surgery (CABG) respectively. In 70.5% of institutes they use prophylactic antimicrobial agents more than four days in gastrectomy; 63.6% in mastectomy; 81.8% in TKRA; 81.1% in CABG. Unnecessary combination of aminoglycosides with other antimicrobial agents for prophylactic use was another common problem. Conclusion : This study shows that more effort is required to diminish antimicrobial misuse or overuse, especially in prophylactic use for surgical patients.

치과기공사의 스트레스 증상 관련 요인분석

김지환,이원철,이강숙,이철,진기남 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목 적 : 치과기공사에서의 직무 스트레스 증상과 관련된 요인을 알아보기 위하여 본 연구를 수행하였다. 방 법 : 전국에 등록되어 있는 치과기공사 4861명중 786명을 대상으로 생활습관, 직무에서 오는 스트레스, 사회적 지원, 자아 존중감, 성격 및 스트레스증상 평가를 위한 설문조사를 시행하였다. 결 과 : 스트레스 증상지수는 80 percentile을 기준으로 하위척도들의 절단점을 선정하였으며, Receiver Operating Chacteristic Curve를 그려 민감도 81.5 %, 특이도 86.1 % 되는 55점을 절단점으로 선정하였다. 생활습관 및 상태 항목으로는 흡연자에서 OR=1.49(1.11-2.00), 주관적 건강상태가 좋지 않은 군에서 OR=1,53(1.06-2.21)로 유의하게 스트레스 증상이 높았다. 직업관련 스트레서(stressor)로는 역할 과부하 (OR=6.69, 4.74-9.44), 작업 요구(OR=8.34, 5.82-11.97), 작업과정(OR=9.89, 6.76-14.94), 작업환경(OR=8.27, 5.80-11.79), 대인관계(OR=5.82, 4.04-8.39), 직업갈등(OR=8.34, 5.82-11.97), 봉급(OR=5.70, 4.04-8.04), 역할갈등(OR=7.58, 5.37-10.71) 등이 높은군에서 스트레스 증상이 높았으며, 사회적 지원이 높은 군에서 OR꼰.39(0.27-0.57), 자아 존중감이 높은 군에서 OR=0.41(0.290.60)로 스트레스 증상이 유의하게 낮았다. 결 론 : 직업관련 스트레스 경험을 많이 한 사람일수록 직업성 스트레스 증상의 정도도 높았으며, 사회적 지원을 많이 받고 자아존중감이 높은 사람일수록 스트레스 증상을 느끼는 정도가 낮았다. 직장 내에서는 스트레스를 감소시킬 수 있는 다양한 대처 전략 프로그램의 개발과 개인을 위한 스트레스 관리교육이 필요하며, 전문화된 직장 내에서 근로자가 도움을 받을 수 있는 정보체계와 직장내의 지원이 필요함을 제시하고 있다. Objectives To investigate the factors associated with symptoms from job stress among Korean dental laboratory technicians. Methods : We collected the data of 786 technicians for life-style, job stressor, social support, self-esteem, personality, and various dimension of stress symptoms included roomatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and hostility by self-administerd questionnaire. Global severity index of dental technician (GSID) was calculated by total sum of sub-dimension. Results We used 80 percentile as a cut-off point, and got the 81.5 % of sensitivity, 86.1 % of specificity by receiver operating characteristic curve. The odds ratios of various factors in high group of GSID compared with low group were 1,49(95 % Cl 1.00-2.00) for smoker, 1,53 (1.06-2.21) for unhealthy group, 6,69 (4.74-9.44) for work overload, 8.34(5.82-11.97) for work demand, 9.89 (6.76-74.94) for work process, 8.27 (5.80-11,79) for work environment, 5.82 (4.04-8.39) for interpersonal relationship, 8.34 (5.82-11.97) for occupational conflict, 5.70 (4.04-8.04) for labor remuneration, 7.58 (5.37-10.71) for role conflict, but 0.39 (0.27-0.57) for social support, 0.41 (0.29-0.60) for self-esteem. By multiple logistic regression, factors were significantly associated with GSID were age, working area, role overload, work demand, work procedure, physical environment, occupational conflict, role conflict, social support, personality traits. Conclusions : Factors associated with symptoms from stress were role overload, work demand, work procedure, occupational conflict, interpersonal relationship, labor remuneration and role conflict in Korean dental laboratory technicians. It is suggested that health promotion program to reduce job stress and to enforce social support and self-esteem should be developed.

Ni-Ti 형상기억합금의 전해가공에서 전류효율과 가공특성의 관계

김동환,강지훈,박규열 한국공작기계학회 2000 한국공작기계학회 추계학술대회논문집 Vol.2000 No.-

This study was performed to investigate the electrochemical-machining (ECM) characteristic of Ni-Ti Shape Memory Alloy (SMA). From the experimental results, we could gain optimal electro-chemical co nditions to bound with lesser machining effect and better surface roughness than any other machining methods to workpiece at the same time. At these conditions, current efficiency was, for especially ECM working of Ni-Ti SMA, approximately 100% and high frequency pulse current was detected.

cis-platin에 의한 급성구토예방의 Dexamethasone의 4가지 정주량의 비교

김원,강지은,서영선,이동민,서정균,신병철,정기영,박유환,정춘해 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

B5-hydroxytryptamine _3수용체(5-HT_3) 길항제와 dexamethasone의 동시투여가 cis-platin에 의한 급성 구토를 막는데 가장 효과적이다. 그러나 현재까지 가장 적절한 정주dexamethasone의 용량이 알려져 있지 않았다. 이에 dexamethasone의 4가지 다른 용량을 투여하여 그 효과를 비교하였다. 환자는 임의 추출되어 cis-platin 투여 45분전에 15분 동안 정주로 각각 dexamethasone 5, 10, 15, 20 mg을 투여 받았다. cis-platin 투여 30분전에는 ondansetron 8 mg이 부가하여 정주 되었다. 1999년 3월부터 2000년 2월까지 54명의 환자가 연구에 등록되어졌고 53명의 환자가 연구 대상으로 실험에 4군 (dexamethasone 5 mg 13명, 10 mg 14명, 15 mg 13명, 20 mg 13명)으로 나뉘어 평가 되어졌다. 급성구토와 구역질의 완전한 예방은 dexamethasone 5 mg을 투여 받은 환자에서 각각 69.2%, 60.9%, dexamethasone 10 mg을 투여 환자에서 69.1%, 61%, dexamethasone 15 mg 투여 환자에서 78.5%, 66.9%, dexamethasone 20 mg을 투여 환자에서 83.2%, 71.0%로 나타났다. 구토로부터 완전한 예방은 dexamethasone 20 mg을 투여 환자에서 5, 10 mg을 투여 환자와 비교하여 높았고, dexamethasone 15 mg을 투여 군에 비교하여서는 약간 우수한 효과만 있었다. 구역질으로부터의 완전한 예방도 월등한 것은 아닐지라도 20 mg을 받은 환자에서 높았다. 항 구토 치료는 특별한 불편 없이 조절되었고, 부작용의 발생에서 4가지그룹간에는 커다란 차이가 발견되지 않았다. Dexamethasone의 20 mg 정주양이 cis-platin으로 인한 급성구토를 예방하는데 가장 효과적인 예방량으로 사료되어진다. Background and objective: A 5-hydroxytryptamine _3(5-HT_3) receptor antagonist plus dexamethasone is the most efficacious antiemetic prophylactic treatment for the prevention of cis-platin induced acute emesis, but the optimal intraveous (Ⅳ) dose of dexamethasone is unknown. This prompted us to perform a randomized, double-blind, dose-finding study that compared four different doses of dexamethasone. Materials and Methods: Patients were randomized to receive dexamethasone, either 5, 10, 15, 20 mg, administered by 15-minute Ⅳ infusion 45 minutes before cis-platin. Ondansetron 8 mg was added to dexamethasone and was administered Ⅳ 30 minutes before cis-platin. From March 1999 to February 2000, 54 patients were enrolled onto the study and 53 were assessable according to the intention-to-treat principle (13 patients received 5 mg; 14 patients, 10 mg; 13 patients, 15 mg and 13 patients, 20 mg of dexamethasone). Results: Complete protection from acute vomiting and nausea was achieved by 69.2% and 60.9% of patients, respectively, who received 5 mg of dexamethasone, by 69.1% and 61.0% of those who received 10 mg, by 78.5% and 66.9% of those who received 15 mg, and by 83.2% and 71.0% of those who received 20 mg of dexamethasone. Complete protection from vomiting was significantly superior in patients who received 20 mg compared with those who received 5 and 10 mg of dexamethasone (P<05) and was superior, but not significantly, compared with those who received 15mg. Complete protection from nausea was superior, but not significantly, in patients who received 20 mg of dekamethasone. Multifactorial analysis confirmed these results. Antiemetic treatment was well tolerated, and no significant difference was found among the four groups in the incidence of adverse events. Conclusion: A 20mg single Ⅳ dose of dexamethasone should be considered the most efficacious prophylactic dose for the prevention of ois-platin induced acute amesis in treatment of cancer.

퍼지시스템과 진화알고리즘 기반 지역부하예측 시스템개발

張右晳,指眩旻,姜渙一 명지대학교 산업기술연구소 2006 産業技術硏究所論文集 Vol.25 No.-

This paper proposes a time series prediction method for the nonlinear system using the fuzzy system and the evolutionay strategy and the genetic algorithm. At first, we obtain the optimal fuzzy membership function using the evolutionary strategy or genetic algorithm. With the optimal fuzzy rules and its input differences, a better time prediction series system may be obtained. We obtain a good result for the time prediction of the regional electric load. In addition we implement the graphic user interface for the proposed algorithms.

Luria-Nebraska 神經心理檢査의 韓國版 標準化硏究(Ⅱ)

金在煥,南正鉉,金光日,金二泳,黃淳澤,김지혜,金南奎,朴康圭,林東洙,金圭泰 漢陽大學校 精神健康硏究 1990 精神健康硏究 Vol.9 No.-

정신분열병 또는 정신분열형장애를 가진 입원환자에서 Risperidone과 Olanzapine의 효과의 비교 : 6주간의 개방적 전향적 연구 6 Weeks, Open-Labelled, Prospective Study

김찬우,이동건,강승훈,조지현,이수진,조동환,김정기 대한생물치료정신의학회 2003 생물치료정신의학 Vol.9 No.2

Objectives : Risperidone and olanzapine, which are atypical antipsychotics. are widely used in the treatment of schizophrenia as the 1st line drug, proving their effectiveness for both positive and negative symptoms. They also have many advantages even from the side effects. However, they show differences with the chemical structure and pharmacokinetics and they work differently to receptors. Researchers have studied the effect and side effect during the acute phase of schizophrenia as an open prospective study. Methods : Forty subjects with DSM-IV schizophrenia or schizoaffective patients including 1) 1st onset schizophrenia patient, 2) patient who has been treated by the prior antipsychotics and not improved or even worse to be admitted again, were assigned to receive risperidone or olanzapine for 6 weeks. Psychopathology, adverse effect. weight change, fasting serum glucose, and drug cost were compared within and across groups. Results : After 6 weeks later both treatment groups showed the significant decrease in PANSS positive, general psychopathology and total score while they did not show any significant difference between two groups. Risperidone group, however. showed the significant decrease in PANS negative score, which olanzapine group did not. In terms of adverse effect risperidone group showed more extrapyramidal symptom than olanzapine group. Body weight rised significantly after Gweeks, but no significant difference between two treatment groups. There were no significant indrease of fasting serum glucose level. Conclusions : Risperidone and olanzapine are effective drugs which can be used during the acute phase of schizophrenia. Risperidone is expected to shorten the admission day and remission of the symptom of acute phase, mile olarizapine is more advantage in a neurologic side effect than rispendone.

흰쥐에서 사염화탄소에 의해 유도된 간 상해에 미치는 키토산 올리고당의 영향

이영돈,박승림,강소영,김세재,박지권,고영환 제주대학교 생명과학연구소 1999 제주생명과학연구 Vol.2 No.-

Chitosan is the deacetylated product of chitin. Chitosan and its derivatives have many properties that make them attractive for a wide variety of health applications. We reported recently that water soluble chitooligosaccharides have hepatoprotective effect on ethanol induced liver injury in the mouse. The current study examined the effect of water soluble chitooligosaccharides on CC1₄-induced liver injury in rats. Male Sprague-Dawley rats were orally treated with CC1₄without or with administration of 5% chitooligosaccharides. After 5 weeks after CC1₄treatment, the histological sections and the expression of mRNA of interleukin-12(IL-12), hepatocyte growth factor(HGF), and tumor necrosis factor(TNF- ) were examined. The liver section of rats supplemented with chitooligosaccharides showed attenuated effects of the necrosis, steatosis, cirrhosis compared with those of non-supplemented rats. The level of TNF- mRNA in CC1₄-treated rats were higher than those in the rats supplemented with chitooligosaccharides, while the levels of IL-12 and HGF mRNA were higher in the rats supplemented with chitooligosaccharides than those of in CC1₄-treated rats. These findings suggested that water soluble chitooligosaccharides may have a hepatoprotective activity against CCl₄-induced liver injury in rats.

레트로바이러스의 표면단백질 : 인슐린의존형 당뇨병의 동물모델인 NOD 쥐의 혈청과 반응하는 새로운 자가항원 A New Autoantigen Reactive with Non Obese Diabetic (NOD) Mice Sera

김경수,김기환,김현만,윤지원,강엽 아주대학교 1997 아주의학 Vol.2 No.2

IDDM (Insulin dependent diabetes mellitus) is believed to be an autoimmune disease and characterized by the immune activation against insulin-producing pancreatic beta cell. The identification and characterization of new autoantigens reactive with an activated immune System would heip to elucidate the pathogenic mechanism of this disease. Several autoantigens are trying to apply for diagnosis and prevention of IDDM. The NOD (non obese diabetic) mice have been the best model for studying the pathogenesis of human IDDM. To identify new autoantigens reactive with activated humoral immunity of NOD mice, the lambda gt11 cDNA library was constructed from NOD-derived pancreatic beta cell (MIN6N8a: mouse insulinoma cell) and screened with prediabetic NOD sera. Mine positive dones were selected from 2x10^(5) phage plaques. The 5'-end sequencing and homology searching showed that six clones from nine clones had over 98% sequence homolgy with the retroviral envelope gene. Full sequendng reveated that the cloned gene was a fragment of ecotropic retrovirus (emv-3) envelope gene. To confirm the immunoreactivity of doned retroviral envelope protein, the cloned gene fragment was expressed in an E.coli expression vector System. Western blotting showed that the recombinant envelope protein fragment also reacted with prediabetic NOD sera.