한국 주요정신장애의 유병률 및 관련요인 : 2006 전국정신질환역학조사

조맹제,장성만,함봉진,정인원,배안,이영문,안준호,원승희,손정우,홍진표,배재남,이동우,조성진,박종익,이준영,김진영,전홍진,이해우 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.3

Objectives The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. Methods The Korean Epidemiologic Catchment Area study Replication (KECA-R) was Conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target Population included all eligible residents aged 181o 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). Results A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of Specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nicotine use disorder, 9.0% and 6.0% ; 3) specific phobia, 3.8% and 3.4% ; 4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. Conclusion The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.

공기소총 사격시의 생체변화 분석

엄기진,이철규,박장평,이광재,문병용,홍관이,노성규,오수일,박기동 江原大學校附設體育科學硏究所 1985 江原大學校附設體育科學硏究所論文集 Vol.- No.10

This study conducted for analyze the process of physiological variation during shooting, and produce the basic data for training prescription to the performance improvement in Air Rifle Shooting, 9 Elite Rifle shooters )College 3, High School 3, Middle School 3) in GangWeon province were tested the physiological parameter which are Electrocardiograph(E.C.G), Heart-rate(H.R), Respiratory pattern, and Trigger time by polygraph system 8 channel from Sept. 1st to Sept. 10th, 1985. Analyzed experimental results are as follows; 1. Firing at T-P wave in E.C.G, 77.68bpm in H.R)16.68% by resulting H.R), the deep size of inspiration-expiration was low, and 8.34 sec of trigger interval were appeared when the shooter acquired high score. 2. The most effective factor among physiological parameters for excellent shooting score is the inspiratory volume with decresc breathing pattern. 3. Shooting performances correlated with stability and static-dynamic balance, but flexibility effected on negative correlation.

피부와 외래환자와 일반인의 진균질환 역학조사

문현주,문재동,이지범,김성진,원영호,이승철 全南大醫大 2001 전남의대학술지 Vol.37 No.4

표면근전도와 적외선체열촬영을 이용한 요통의 평가

이강진,최인성,이소영,한재영,이삼규,채홍재,이성과,문재동 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 요통환자에서 요통의 유무와 강도를 평가하고자 표면근전도를 이용하여 근육 활동성의 차이를 검증하였고 적외선체열촬영을 이용하여 제표면 온도의 변화를 측정하였다. 방법 : 요통환자군 16명과 대조군 16명에 대하여 요부에 부착한 표면전극에서 얻은 근전도 신호와 적외선체열촬영 결과를 비교하였다. 교란요인의 영향을 배제하기 위하여 연령과 성별 그리고 비만도에 따라 정상 대조군과 요통환자군을 짝짓기하여 각각 16명씩 선정하였다. 결과 : 정적표면근전도 실시 결과 우측의 경우 중앙값이 요통환자군에서 198.1 ㎶, 정상대조군에서는 161.3 ㎶로 통계적으로 유의한 차이가 있었고(p<0.01), 좌측은 요통환자군에서 194.2 ㎶, 정상대조군에서 180.5 ㎶로 유의한 차이는 없었다. 동적표면근전도 실시 결과 재신전시와 굴곡시 근전위의 비가 우측의 경우 요통환자군에서 중앙값이 1.12였고 정상 대조군은 1.39로서 두 군간에 유의한 차이가 있었고(p=0.027), 좌측의 경우도 요통환자군에서는 1.08이었고 정상 대조군에서는 1.21로 유의한 차이가 있었다(p=0.036). 적외선체열촬영결과 ΔT가 0.5 ℃ 이상의 차이가 있을 때 이상이 있는 것으로 정하면, 요통환자군에서는 16명 모두 이상자로 판정되었고, 정상 대조군에서는 16명중 3명이 이상자로 판정되어 민감도는 100 %, 특이도는 81.3 % 였다. 표면근전도를 이용한 요통의 진단은 민감도가 78.6 %이고 특이도가 72.2 %였으며, 적외선체열촬영은 민감도가 100 %였고 특이도가 87.5 %였다. 결론 : 이러한 결과로 볼 때 표면근전도 검사법과 적외선체열촬영은 요통을 간접적으로 평가하는데 도움이 되는 검사법이며, 적외선체열촬영이 표면근전도검사법에 비하여 보다 정확한 검사법으로 판단된다. Objectives : We studied the efficacy of surface electromyography(SEMG) and digital infrared theimographic imaging (DITI) in the assessment of low back pain both(LBP) Methods : We compared electromygraphic signals from electrodes placed in the lumbar area and the digital theimographic images in 16 LBPpatients and 16 control subjects. The LBP patients and the control subjects were matched for age, gender, and body mass index(BMI) to adjust for any confounding effects Results : In the static analyses of SEMG, median value was 198.1 ㎶ for the controls on the right side, and they were 194.2 ㎶ and 180.5㎶ on left side respectively. There was a statistically significant difference between the two groups on the right side(p<0.01), but not on the left side. In the dynamic analyses of the SEMG, the median values of the extension per flexion ratio of right side were 1.12 for LBP patients and 1.39 for controls. and those on the left side were 1.08 and 1.21 respectively. There were statistically significant differences in both sodes(p<0.05). The sensitivity and specificity were 100% and 81.3% in DITI, 78.6% and 72.2% in SEMG. Conclusions : These results indicate that SEMG and DITI are useful methods for indirect assessments of LBP, and that DITI is more sensitive and specific than SEMG.

폐굴껍질을 산성토양 적용시 토양의 화학적 특성변화에 관한 기초 연구

임진희,문종익,김성우,성낙창,이영형,윤태경 동아대학교 환경문제연구소 1999 硏究報告 Vol.22 No.2

Oyster shell has caused environmental problems in the coast. But it is possible to be used as an acidic soil amendment because it is the alkalic material of pH 9.0. In order to evaluate the utility of the crushed oyster shell as a soil amendment, acidic sandy loam soil was amended with it and then Chinese cabbages were cultivated in pots. The amount of the oyster shell was ⅰ)none, ⅱ)0.5kg/㎥, ⅲ)1.0kg/㎥, ⅳ)1.5kg/㎥, ⅴ)2.0kg/㎥ and ⅵ)2.3kg/㎥. The particle size of oyster shell consists of 34.88% of 40∼100mesh and 14.98% of larger than 100 mesh. It increased pH and the contents of available P₂O_(5) and SiO₂ and exchangeable Ca in used soil The application of oyster shell also increased the height and diameter of Chinese cabbages.

주폐자충 폐렴으로 발현된 Felty 증후군 1예

김성호,남대근,문재현,김지홍,김보석,안진광,문태건,안병재,김성일 全南大醫大 2001 전남의대학술지 Vol.37 No.3

제7차 교육과정에 따른 고등학교 과학(화학단원) 교과서에 대한 연구 : 교육목표, 탐구활동을 중심으로 Emphasizing the Analysis of Educational Purposes and Inquiry Activities

이영진,이석희,문성배 부산대학교 사범대학 과학교육연구소 2002 科學敎育硏究報 Vol.29 No.-

The purpose of this study is to provide the basic data of educational activities on the school scene, by finding the extent of agreement between the educational purposes of high school science textbooks by the 7th curriculum and those of science curriculum, and by analysing the purposes, contents and context of inquiry activities in the textbook, and by dividing the contents of STS into the subject and activity area. In the study, the educational purposes of the curriculum, the learning purposes of the textbooks, and the learning purposes and contents of inquiry activity were comparatively analyzed on the basis of Klopfer's Taxonomic system that emphasizes on the process of inquiry. And the inquiry state was analyzed on the basis of the 4th Testing Frame of NAEP. The contents of STS were analyzed by the topics of Piel, and student activities of SATIS. The educational purposes of the 7th curriculum include all the category except manual skills(G.0) of Klopfer's Taxonomy of Educational purposes. But the study revealed that the part of Knowledge and Comprehension including the Process of Scientific Inquiry(category A.0~E.0) amounted to 82.1% of the educational objectives for the science textbooks of the 7th curriculum respectively, and the affective domain didn't agree with the purposes required by the curriculum and the learning purposes of the textbooks.

7개 대학 병원에서 조사한 지역사회 폐렴의 원인균

정문현,김성민,강문원,최희정,정희진,이경원,한성우,송재훈,신형식,김의종,최강원,김민자,박승철,배현주,정윤섭,김준명,백경란,신완식,이규만,김양리 대한감염학회 1997 감염 Vol.29 No.5

목 적 : 폐렴은 많이 발생하면서 사망률이 크게 줄지 않는 질환이며, 이를 적절히 치료하기 위해서는 원인균의 상대적 빈도, 기저 질환에 따른 변화, 항균제 내성률, 사망에 관련된 인자들을 알아야 한다. 원인균의 빈도는 지역마다 차이가 있고 국내에서는 항균제 내성률이 높아 지역사회에서 발생한 폐렴을 치료하기 위한 경험적 항균제 선택에 도움이 되기 위해 서울 소재 6개 대학 병원과 천안의 1개 대학 병원이 참여하여 위의 사항들에 대해 조사를 하였다. 방 법 : 1995년에 내과에 입원했던 16세 이상 환자를 대상으로 했다. 퇴원 진단명이 폐렴 또는 폐결핵인 병록지을 찾았고, 이중에서 병원 감염을 제외하였다. 특이도를 높이기 위해, 이들 중에서 호흡기 증상이 있고 발열이나 저체온이 있으면서 흉부 X-선에서 이상 음영이 있는 환자만을 대상으로 했다. 폐결핵은 위의 기준에 입원 초기에 항균제 치료를 하고 입원 7일 이후에야 항결핵제가 투여된 경우만을 폐렴의 원인균으로 하였다. 혈액 배양에서 양성, 객담에서 항상균이나 M. tuberculosis가 증명된 경우, 혈청학적으로 항체가가 4배 이상 증가된 경우, 조직에서 원인균이 진단된 경우는 확정(definitive) 원인균으로 하였고, 객담에서 배양된 균이 그람 도말과 일치할때, 항결액제에 대한 반응으로 진단한 폐결핵, 단일 항체가 양성이고 이에 대해 항균제를 사용했을 때는 가능(probable) 원인균으로 정의하였다. 다세균 감염균은 각각 다 른 원인균으로 처리하였다. 임상 조사와 함께 임상병리과에서 S. pneumoniae, H. influenzae, M. catarrhalis, mycoplasma, 항상균에 대해 검사 의뢰 건수, 배양 양성수, 항균제 감수성 결과를 조사하였다. 결 과 : 폐렴의 증례 정의에 부합하지 않은 135명과 폐결핵의 정의에 해당하지 않는 230명을 제외하고 남은 246명의 평균 나이는 58.2세이고 남성이 142명(58.2%) 이었고, 71%의 환자에서 기저 질환이 있었다. 진단 방법의 시행 횟수는 혈액 배양 77.6%, 혈청 검사 18.3%, 기관지경 검사는 4.1%였고, 세균의 항원 검사를 한 예는 없었다. 원인균이 밝혀진 예는 77명(31.3%)이었다. 다세균 감염이 4명에서 있었고, 원인균의 상대적 빈도는 결핵 20명(확정 17, 가능 3: 6개 병원 자료), 폐렴구균 18(확정8 가능 10)명과 폐렴구균이 아닌 Streptococcus 3명 (모두 확정), H. influenzae 11명(모두 가능), 그람음성간균 11명(확정 7, 가능 4) (K. pneumoniae 8건), Mycoplasma 5명(확정 1, 가능 4), S. aureus 4명(확정 2, 가능 2), mucormycosis 1명(확정)이었다. 평균 입원 기간은 19일이고, 중환자실 입원률과 인공 호흡기 사용율은 각각 18%와 9.3%였다. 사망률은 13.8%였고 사망까지 평균 기간은 14.6일 이었다. 다변량 분석에서 사망을 예측할 수 있는 인자는 저체온과 빈호흡이었다. 임상병리과에서 배양되었던 모든 폐렴구균의 Penicillin 내성률은 서울 3개 병원에서 82-88%, 천안에서 72%였다. 폐렴 환자의 혈액에서 배양된 7주는 모두 Penicillin에 감수성이 있었다. K. pneumoniae 8주 모두 cefotaxime과 gentamicin에 감수성을 보였다. 결 론 : 후향적 조사이고 병원마다 원인균 진단에 차이가 있지만, 원인이 밝혀진 경우에는 결핵과 폐렴균이 흔하였고, 무균 부위에서 배양된 폐렴구균의 항균제 내성률은 낮았다. 원인이 밝혀지지 않은 경우가 많고, 혈청검사로 진단되는 원인균이 드물며, 분리균주가 적어 항균제 내성 정도를 추정하기 어려워, 이를 밝히기 위한 전향적 조사가 필요하다. Background : Community-acquired pneumonia (CAP) is one of the leading causes of mortality and morbidity, but its management is still challenging. The limitation of diagnostic methods to identify etiologic agents rapidly make it necessary to use empiric antibiotics in almost all patients, and furthermore the discovery of new respiratory pathogens and the emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric regimen. To clarify the factors necessary for the optimal choice of empirical antibiotics, such as the frequency of etiologic agents, the attributable rates to death and antimicrobial resistance rates in the community, six university hospitals in Seoul and one university hospital in Cheonan were participating in this study. Methods : medical records of adults (>15 years of age) hospitalized for CAP or pulmonary tuberculosis between April 1995 and March 1996, were reviewed. Patients who satisfied all of the following criteria were included in the study: (1) fever or hypothermia; (2) respiratory symptoms; and (3) pulmonary infiltrates on chest roentgenogram. To exclude cases of pulmonary tuberculosis whose roentgenographic features were so typical that it could be easily differentiated from conventional pneumonia, two additional criteria were required for inclusion: antibiotic treatment during the first week of hospital admission and initiation of anti-tuberculosis medications thereafter. Organisms isolated from sterile body sites, acid-fast bacilli or Mycobacterium tuberculosis isolated from sputum, pathogens diagnosed by a 4-fold rising titer of antibodies to “atypical”pathogens, or pathogens revealed by histopathology were defined as definitive cause of pneumonia; isolates from sputum withcompatible Gram stain, pathogens diagnosed by a single diagnostic titer plus use of a specific antimicrobial agent, or tuberculosis diagnosed by clinucal response to anti- tuberculosis medications were considered probable cause of pneumonia. The records of the clinical microbiology were reviewed for isolates of S. pneumoniae, H. influenzae, M. catarrhalis, Mycobacterium or acid-fast bacilli, and Mycoplasma. Then the frequency of these agents, antimicrobial resistance rates of resiratory pathogens from all body sites, and their clinical significance were evaluated. Results: After excluding 365 patients (230 with pulmonary tuberculosis and 135 with CAP) who were screened for inclusion but did not meet the inclusion criteria,246 persons were enrolled in this study. Their mean age was 58.2 years old with slight male predominance (58.2%), and 171(71%) patients had underlying illnesses. Blood cultures were performed on 191 (77.6%) patients and serologic tests on 44(18.3%) patients. The etiologic agents were identified in 31.3%, and the list of individual agents, in decreasing order, was pulmonary tuberculosis (17 definite and 3 probable: data of six hospitals), S. pneumoniae (8 definite and 10 probable), non-pneumococci (3 definite), aerobic gram-negative bacilli (7 definite and 4 probable), Haemophilus spp. (11 probable), mycoplasma (1 definite and 4 probable), polymicrobial infections (2 definite and 2 probable: E. coli and S. agalactiae, M. tuberculosis and S. aureus, S. pneumoniae and H. influenzae and A. baumannii and K. pneumonias), S. aureus (2 definite and 2 probable) , and mucormycosis (1 definite). Among gram-negative bacilli, K. pneumoniae was the most common agent (8isolates). therates of admission to the intensive care unitand of using assisted ventilation were 18% and 9.3%, respectively. The mortality was 13.8% and logistic regression analysis showed that hypothermia and tachypnea were associated with death. Hospital stay averaged 19 days. Susceptible rates of S. pneumoniae isolated from all body sites to penicillin ranged from 8% to 28% but seven isolated from blood of patients with pneumonia were susceptible to penicillin. Also all 8 isolated of k> pneumoniae from patients with pneumonia were susceptible to cefotaxime and gentamicin. Conclusion: In Korea, in addition to S. pneumoniae, M. tuberculosis is an important agent causing community-acquired pneumonia. The low incidence of etiologic diagnosis is probably related to infrequent requesting of test "atypical" pathogens and does not represent the true incidence of infections by "atypical" pathogens, which well be answered by a prospective study. The antimicrobial resistance rates of major respiratory pathogens from sterile body sites are low, however, because of a small number of the isolates this result needs confirmation by a nationwide surveillance of antimicrobial resistance.

제7차 교육과정에 따른 고등학교 과학(화학단원) 교과서 STS 내용분석

이영진,이석희,문성배 부산대학교 사범대학 과학교육연구소 2002 科學敎育硏究報 Vol.29 No.-

The purpose of this study is to provide the basic data of educational activities on the school scene, by finding the extent of agreement between the educational purposes o high school science textbooks by the 7th curriculum and by dividing the contents of STS into the subject and activity area. In the study, the contents of STS were analyzed by the topics of Piel, and student activities of SATIS. The STS contents in textbooks showed average value of 50.7%, which was increased in quantity in comparison with the 6th curriculum, and as contents in detail by the distributional order of subject matter, environmental quality and natural source takes 39.2%, sociology of science 34.7%, effect of technological development 19.0%, human technology 5.0%, population 2.2%, space research and national defense 0.2% and energy 0.0%. As the order of activity areas, case study takes 40.1%, investigation study 16.1%, data analysis 13.0%, structured discussion 8.2%, simulation 6.5%, practice activity 5.1%, problem solving and decision making 4.8% research design 4.8%, and role play 1.0%.

올란자핀

김문두,정성훈,김철진 대한생물치료정신의학회 1997 생물치료정신의학 Vol.3 No.1

현재까지의 전통적인 항정신병약물은 음성증상에는 거의 효과가 없었고, 양성증상에만 효과가 있었으며, 그마저도 약 30-40%의 환자들에서는 치료적인 효과가 없었다. 또한 추체외로 증상이나 지발성 운동장애 등의 부작용이 많았다. Olanzapine은 이와 같은 기존의 전형적인 항정신병 약물의 제한점이 크게 개선된 약이며 clozapine과는 달리 무과립구증을 유발하지 않으므로 현재 임상적으로 기대가 크다. Olanzapine은 세로토닌 5-HT2A/C, 도파민 D1, D2, D3, D4, 무스카린M1-5, 아드레날린 alphal, 히스타민 H1수용체에 친화도가 높다. 세로토닌 5-HT2 차단작용이 도파민 D2 차단작용보다 강하여 추제외로 증상의 빈도가 적고 지발성 운동장애의 위험이 적다. 항콜린성 작용과 세로토닌 5-HT2A/C 수용체에 대한 길항작용, 상대적으로 약한 D2길항작용으로 양성 증상 뿐만 아니라 음성증상에도 유의한 효과가 있다. Olanzapine의 주된 대사 경로는 cytochrome P-450-CYPIA2, flavincontaining monooxigenase(FMO 3 system), N-glucuronidation이며, 그외에도 cytochrome P-450-CYP2D6, CYP2C19등으로도 대사가 되기 때문에 어느 한가지 효소에 의해 대사나 약력학이 영향을 받지 않으므로 약물 상호작용도 적다. Olanzapine은 정신분열증의 양성과 음성증상에 모두 효과가 있고 장기 유지치료에도 효과가 있다. 또한 치료불응성 정신분열증에도 치료효과가 있다는 보고들이 있다. 또 정신분열증 뿐만 아니라 분열정동장애, 정신분열양 장애, 양극성 장애, 물질 유도성 정신병적 장애에 모두 사용 가능하다. 용량은 5-20㎎이 추천된다. 치료후 첫 3-6개월에 양성, 음성증상의 호전이 있고 대개는 1년에 고평부(plateau)에 이른다. 그래서 최소 6개월은 사용후 그 효과를 판단해야 한다. Traditional antipsychotics have lack of efficacy in 30% to 40% of patients with schizophrenia, lack of efficacy in the treatment of negative symptoms of psychosis, and are primarily effective in ameliorating the positive symptoms of schizophrenia. Also these agent have a number of side effects, such as extrapyramidal symptoms and tardive dyskinesia. Olanzapine is new drug that has much difference from traditional antipsychotics in view of these limitations of traditional antipsychotics and is spared some of clozapine's major difficulties, such as agranulocytosis. olanzapine has affinity for serotonin 5-HT2A/C receptors, dopamine D1, D2, D3, D4 receptors, muscarinic M1-5 receptors, adrenergic alpha1 receptors, histamine H1 receptors. Olanzapine's ability for blockade of serotonin 5-HT2 receptor is greater than it's ability for blockade of dopamine D2 receptors and olanzapine has low incidence of extrapyranmidal symotoms and low risk for developing tardive diskinesia. Olanzapine also has anticholinergic effect and antagonist actions for serotonin 5-HT2A/C receptor, relatively weak antagonistic actions for dopamine D2 receptor, so olanzapine has significant efficacy for not only positive symptoms but also negative symptoms. The most important pathways for olanzapine metabolism are cytochrome P450-CYP1A2, flavin-containing monooxigenase(FMO 3 system),N-glucuronidation. Minor pathways include cytochrome P450-CYP2D6, CYP2C19. Olanzapine has minimal drug interaction due to it's multiple metabolic pathways. Olanzapine has efficacy for both positive and negative symptoms of schizophrenia, long-term maintenace treatment. Olanzapine also has efficacy for treatment refractory schizophrenia, schizoaffective disorder, schizophreniform disorder, bipolar disorder, substance induced psychotic disorder. Recommended does are 5-20㎎/day. We should decide for effectiveness for olanzapine after using 1 year, since improvements in positive and negative symptoms seen in the first 3 to 6 months often plateaued within 1 year.