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      • 젊은 남자에게 발생한 통상성 간질성 폐렴과 동반된 폐암 1예

        박종숙,이준혁,박성우,장안수,박춘식,박재성,백상현,고은석,신화균 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

        Usual interstitial pneumonia(UIP) is relatively rare disease of lung parenchyme under the age of 50. Lung cancer is reported to occur as a complication of UIP, but has not been reported in young age patient with UIP in Korea. A 35-year-old man was admitted to the hospital because of dyspnea, cough and mild fever. He had been suffered from dyspnea during 3 years. The dyspnea worsened recent 1 month ago. He had been treated with pneumonia at another hospital during 4 months before this admission. Chest radiographs and High resolution CT showed subpleural and basal dominant reticular opacities in both lung with no change until now. He was smoker and his occupation was car engine-man dealing with benzene. UIP is suspected by history and radiologic findings. Operation for open lung biopsy was performed to obtain lung specimen via video-assisted thoracoscopic surgery. Patient's pathologic examination showed UIP combined with adenocarcinoma in RLL superior segment and posterobasal segment and RLL lobectomy was done. After operation, the patient has been in cancer free condition so far. We report a case of UIP combined with lung cancer in young man with brief review of the literature.

      • KCI등재후보

        아미노글리코사이드 사용제한에 따른 병원성 균혈증 유발 그람음성간균의 내성변화 및 임상적 의의

        오종택,김신우,손종원,도병훈,한승우,신병철,박지현,이종명,김능수 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

        목적 : 항균제 오남용으로 인한 내성균의 출현, 약물부작용의 발생 및 약제 비용의 증가는 환자 개인뿐만 아니라 사회적으로 문제가 되고 있다. 본 연구는 항생제의 오남용을 막기 위한 제도의 일환으로 시행한 아미노글리코사이드 사용 제한정책의 비용 효과적인 측면을 조사하고 그람음성간균에 의해 병원성 균혈증이 발생한 환자들을 대상으로 이 정책이 항생제 내성률과 환자 사망률에 미치는 영향을 연구하였다. 방법 : 930병상 규모의 3차 병원인 일개 대학병원에서 아미노글리코사이드 사용제한정책이 시행된 직후인 2002년 3월에서 9월 사이에 그람음성간균(Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Serratia marcescens, Stenotrophomonas maltophilia, Burkholderia cepacia)에 의해 발생한 병원성 균혈증 환자 60명(실험군)과, 이 정책이 시행되기 전에 입원한 환자들 중 균주별로 같은 수만큼 선별한 병원성 균혈증 환자 60명(대조군)의 의무기록을 후향적으로 조사하였다. 결과 : 아미노글리코사이드 사용제한정책이 시행된 시기인 2002년 3월에서 9월 사이에 처방된 아미노글리코사이드 사용량 및 비용을 이 정책이 시행되기 전인 2001년 3월에서 9월 사이와 비교한 결과, 아미노글리코사이드의 사용량(antimicrobial utilization density)은 사용제한 후 225.2에서 130.3으로 42% 감소하였고 약제 비용은 44% 감소하였다. 아미노글리코사이드 사용제한 후 병원성 균혈증을 유발한 그람 음성간균의 이 항생제에 대한 내성률은 유의한 변화를 보이지 않았으며 균혈증과 직접 연관된 사망률도 환자의 나이, 성별, 기저질환 및 원발병소 등을 보정할 경우 유의한 차이를 보이지 않았다(40.4% vs. 24.1%, P=0.11). 결론 : 아미노글리코사이드를 5일을 초과한 사용 시 감염전문가의 사전 승인을 필요로 하는 사용제한정책은 아미노글리코사이드의 사용량과 비용을 유의하게 감소시켰다. 또한 이 정책 시행 후 그람음성간균에 의한 균혈증 환자에서 균혈증으로 인한 사망률과 아미노글리코사이드에 대한 내성률은 유의한 차이가 없었다. Objective : To evaluate the effects of an aminoglycoside restriction policy on expenditures for aminoglycosides, antimicrobial resistance rates and clinical outcome of nosocomial bacteremia caused by Gram-negative bacilli (GNB). Methods : Starting in February, 2002, a prior consultation with an infectious disease specialist for using aminoglycoside antibiotics over 5 days was required in a 930-bed university hospital. In retrospective analysis of medical records 7 months after initiation of the aminoglycoside restriction policy, sixty cases of clinically relevant nosocomial bacteremia caused by GNB were found. These bacteremic patients were compared with sixty, species-matched, control patients with nosocomial Gramnegative bacteremia before the policy for total expenditures for aminoglycosides, susceptibility to antibiotics and clinical outcomes of bacteremia. Results : During the same period of 7 months before and after the restriction policy, total expenditures for aminoglycosides decreased by 44% in cost (from 465,030,841 Won to 259,618,337 Won) and the antimicrobial utilization density of aminoglycosides decreased by 42% (from 225,2 to 130.3). On the other hand, the patterns of antibiotic susceptibility and bacteremia-related in-hospital mortality rates after the policy did not show a significant change, compared with those before the policy. Conclusion : Antibiotic restrictions are among the most popular methods to diminish the practice of antibiotic overuse in hospitals. In this study, requirement for prior approval of aminoglycoside use over 5 days led to a significant decrease in the amount and cost of total aminoglycosides without a significant change in susceptibility patterns and bacteremia-related mortality rates.

      • 경주지역 여고생의 초경과 체성장간의 관계

        김준섭,권오구,박진석,오종수,박정현,박제식,안세한,이용환,서정호,신태섭,최영배,김덕수,이관,박수경 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

        본 연구는 경주지역 1개 고등학교 3학년 여고생을 대상으로 초경 시작 전인 초등학교 4학년부터 고등학교 2학년까지의 키, 몸무게, 가슴둘레 수치와 초경 연령을 파악하여 여성의 초경이 빠를수록 체성장 속도의 변화가 있을 것이라는 가설을 기초로 두 요인간의 관련성을 파악하고자 시행되었다. 경주시 1개 여자고등학교 3학년생 총 317명에 대해 ㅊ경 나이, 초경시 심리 상태, 초경이 시작되었을 때의 상담 여부와 상담하였던 사람, 부모 신장과 초경전후의 식사 규칙성, 다이어트 경험, 수면시간, 스트레스, 음주/흡연 여부, 질병력 등에 대한 설문 조사를 시행하였고, 초등학교 4학년부터 고등학교 2학년까지의 키, 몸무게, 가슴둘레에 대한 정보는 건강기록부에서 확보하였다. 상기 대상자 중 건강기록부가 분실된 39명, 초경나이에 대해 응답하지 않았던 29명 및 결석 등으로 조사를 하지 못하였던 42명을 제외한 조사 대상자는 206명으로 선정하였다. 대상자들의 초경연령 평균값(Mean±SD)은 13.0±1.11이었고, 초등학교 4학년부터 고등학교 2학년까지의 초경 이후 신장 성장률은 감소하였으며, 초경연령이 빠른 군이 초등학교 때는 신장에 있어서 우위를 차지하나 고등학교에 오면서 신장은 비슷한 수준이 되었다. 초경후 1-2년 사이에 체중과 흉위의 증가율은 감소하였고, 초경연령이 빠른 군이 초등학교와 고등학교 사이에 체중과 흉위에서 모두 우위를 차지하였다. 본 연구의 결과는, 흔히 이차 성징의 시작 시점 혹은 사춘기의 시작 시점으로 보고있는 초경 연령이 청소년기의 성장과 밀접한 관련성이 있고, 특히 체중과 흉위의 성장 속도와 밀접한 관련성이 있음을 시사한다. To understand the onset of menarche in relation to changes in physical growth that take place during female adolescence, especially the changes in height and weight velocity. The 207 senior in one women high school of Kyongju were investigated in April 3 to 8, 2001. We collected the information, relation in the age at menarche, height & weight of parents, regularity of eating, and obesity diet, duration of sleeping, sickness & stress near age at menarche, by self-recording. The status of height, weight & chest circumference between the 4th grade of primary school and the junior of high school was collected by individual Health Record. The results were followed; The average age at menarche was 12.95±1.11 years old and the most frequent age of menarche is 13 years. After menarche, the velocity of height, weight and chest circumference were decreased. The most rapid group of menarche hold dominant position in height during elementary school. As time passed, they dont hold dominant position in height. The most rapid group of menarche get an advantage in the weight and the girth of chest after elementary school. The height of subjects is directly proportional to the height of their parents. These results suggest that the starting age at menestuation can be closely associated with physical growth and development.

      • KCI등재

        한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

        조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

        Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

      • 한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

        최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

        The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

      • KCI등재

        Elevational Distribution of Breeding Bird Communities in Seoraksan National Park, Korea

        Hwang, Hyun-Su,Lee, Jae-Kang,Eom, Tae-Kyung,Bae, Ho-Kyoung,Lee, Dong-Ho,Lim, Jong-Hwan,Jung, Sung-Cheol,Park, Chan-Ryul,Rhim, Shin-Jae Korean Society of Forest Science 2020 한국산림과학회지 Vol.109 No.1

        In this study, the elevational distribution of breeding birds in Seoraksan National Park, Korea was investigated. Forty-six species of birds were documented from line transect surveys taken from Seorakdong at 230 m above sea level (a.s.l.) to the Daechungbong summit at 1708 m asl. Birdspecies richness and diversity were highest in Seorakdong and lowest at the Daechungbong summit. As elevation increased, bird species richness and diversity decreased, with a humped-shape trend being observed between 700 m and 1200 m a.s.l. Stepwise analyses revealed that breeding bird species diversity indices were significantly negatively correlated with elevation (r<sup>2</sup> = 0.327, P < 0.001) and positively correlated with vegetational coverage (r<sup>2</sup> = 0.324, P = 0.046). Higher elevations supported fewer birds than low and intermediate elevations. Projections at the local scale, including data on behavior and habitat use by birds, will be necessary for optimal conservation and management of the bird communities in Seoraksan National Park.

      • KCI등재

        Elevational Distribution of Breeding Bird Communities in Seoraksan National Park, Korea

        ( Hyun-su Hwang ),( Jae-kang Lee ),( Tae-kyung Eom ),( Ho-kyoung Bae ),( Dong-ho Lee ),( Jong-hwan Lim ),( Sung-cheol Jung ),( Chan-ryul Park ),( Shin-jae Rhim ) 한국산림과학회(구 한국임학회) 2020 한국산림과학회지 Vol.109 No.1

        In this study, the elevational distribution of breeding birds in Seoraksan National Park, Korea was investigated. Forty-six species of birds were documented from line transect surveys taken from Seorakdong at 230 m above sea level (a.s.l.) to the Daechungbong summit at 1708 m asl. Birdspecies richness and diversity were highest in Seorakdong and lowest at the Daechungbong summit. As elevation increased, bird species richness and diversity decreased, with a humped-shape trend being observed between 700 m and 1200 m a.s.l. Stepwise analyses revealed that breeding bird species diversity indices were significantly negatively correlated with elevation (r<sup>2</sup> = 0.327, P < 0.001) and positively correlated with vegetational coverage (r<sup>2</sup> = 0.324, P = 0.046). Higher elevations supported fewer birds than low and intermediate elevations. Projections at the local scale, including data on behavior and habitat use by birds, will be necessary for optimal conservation and management of the bird communities in Seoraksan National Park.

      • 흡연에 의한 급성 호산구성 폐렴 2예

        박종빈,김학렬,주현준,유태양,신성남,신정현,송정섭,황기은,김소영,양세훈,정은택 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

        최근 흡연을 시작한 젊은 성언에서 급성 호산구성 폐렴의 발생에 대한 증례가 보고되고 있다. 급성 호산구성 폐렴은 대개 발열을 동반하기 때문에 초기에는 감염성 폐렴으로 잘못 진단, 치료되는 경우가 많다. 아직 정확한 병태 생리 및 조직학적 소견은 밝혀져 있지 않지만 병력 청취 및 임상 양상, 방사선 소견의 관찰을 통해 급성 호산구성 폐렴을 의심하고, 진단을 위해 기관지 폐포 세척액 검사를 시행한다면 좀 더 쉽게 진단 내릴 수 있을 것이다. 본 저자들은 최근 처음 시작한 흡연에 의해 발생한 급성 호산구성 폐렴을 진단하고, 스테로이드를 투여하여 성공적으로 치료한 환자 2예를 경험하였기에 이를 문헌 고찰과 함께 보고하는 바이다. Acute eosinophilic pneumonia(AEP) is characterized by acute febrile respiratory illness associated with diffuse pulmonary infiltration and pulmonary eosinophilia. The specific etiology for acute eosinophilic pneumonia is elusive. By some investigators, cigarette smoking is suggested as a causative substance which can cause AEP. In recent, the authors experienced two cases of AEP following cigarette smoking. Both cases had characteristic features including age around 20 years, new onset smoking before occurance of AEP, diffuse infiltration on chest radiography, pulmonary eosinophilia based on bronchoalveolar lavage and acute improvement after steroid therapy. These clinical features are resemble with previous smoking induced AEP case reports. Base on these clinical features, cigarette smoking associated AEP could be diagnosed more easily.

      • 밝은社會를 指向하는 指導者 Leadership에 關한 硏究 : 새마을 指導者를 중심으로 With Reference to the Saemaeul Leadership

        朴淳永,申大淳,趙萬濟,金旭卿,金種垠 慶熙大學校 1980 論文集 Vol.10 No.-

        The Saemaeul Undong was launched in 1972 on the basis of the experimental model or Saemaeul pilot projects of the previous year. The Saemaeul Undong is now a nation-wide movement which is based on the fundamental spirits of diligence, self-help and cooperation. Much of the success of the Saemaeul Undong depends on its leaders, who play a pivot role in implementing Saemaeul projects for their community. Popularly elected by the village assembly according to their leadership and faith, the leaders render their services without remuneration, working in the spirit of self-sacrifice. Now, the Saemacul Undong enters upon its tenth year in 1981. If the movement is to continue with renewed momentum, effective training projects for Saemaeul leaders must be worked out. For this purpose, it is then recommended that the research works on the leadership training projects of the Bright Society Movement be referred to. Initially started as a community movement for better life on the campus of Kyung Hee University in 1960's, the Bright Society Movement is now gaining widespread support from national as well as international club members. The goals of the Bright Society Movement are to promote mutual understanding and friendship among members and to construct on earth a truly sound and civilized welfare society that is spiritually beautiful, materially affluent, and humanely rewarding. The main objectives of this study is to propose effective training projects for Saemeaul leaders as well as the Bright Society leaders. 1) Educational courses of leadership training should be offered through the school as well as through the training institution of the community. 2) Educational contents of leadership training should place greater emphasis not only on the spiritual education but also on the technical and practical education related to the welfare of the Community. 3) Public relations education should be strengthened because leaders must work in close cooperation with the community residents for the effective movement. 4) Long-term integrated projects for the community or village unit should be established and the movement should be developed according to them. 5) A special system of regional itinerant education should be established for the effective management of selective leaders. 6) For the welfare of leaders themselves, special favors such as the authorization of leadership careers, scholarships for their sons and daughters, discounts on public charges and the priority on public employment must be offer according to their respective performance.

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