관해유도 항암요법을 받는 백혈병 환자에서 진균 감염증의 예방 : 무작위 배정법과 이중 눈가림법에 의한 Fluconazole과 Nystain의 효과에 관한 다기관 공동연구 A Randomized, Double-blind, Multicenter Trial to Compare Fluconazole with Nystatin

최강원,오명돈,배현주,백경란,박선양,김병국,신완식,강문원,진종률,박종원,김춘추,김동집,한지숙,민유홍,이선주,고윤웅 대한화학요법학회 1993 대한화학요법학회지 Vol.11 No.2

Fluconazole의 진균 감염증 예방 효과와 안전성에 관하여 3개 대학병원에서 관해유도화학요법을 받는 급성 백혈병환자를 대상으로 무작위 배정법과 너도나도 누가림법에 의하여 연구하였다. 모두 62명의 환자에게 fluconazole(100㎎ bid) 또는 nystatin(1,000,000IU/day)을 무작위로 투여하였다. 투약은 관해유도화학요법과 같은 날짜에 시작하여 호중구수가 1,000㎣이상으로 회복되거나 진균 감염증이 확인되거나 의심되어 Amphotericin-B를 시작하거나, 약과 관련된 부작용이 나타날 때까지 계속하였다. 진균 colonization은 fluconazole군에서 감소하였으나 nystqatin군에서는 증가하였다, 표재성 진균감염증으로 nystatin군에서 C. albicans 진균혈증 1례와 C.parasilosis 진균혈중 1례가 발생하였다. 경험적 항진균요법으로 Amphotericin-B를 투여한 경우는 fluconazolerns 34명중 7례(21%), nystatinrns 28명중 10례(36%)였다(p<0.05). Fluconazole군과 nystatin군 사이에 부작용이나 사망률에 차이는 없었다. 결론적으로, fluconazole은 관해유도화학요법을 받는 급성 백혈병환자에서 진균의 colonization을 줄이는데 효과적이고 안전한 항진균제이다. We made a randomized, double-blind, multicenter trial to compare the efficacy and safety of fluconazole with nystatin for prevention of fungal infections in patients with acute leukemia. Sixty-two adult undergoing remission induction chemotherapy for cute leukemia were enrolled. Patients were randomly assigned to receive either fluconazole (100㎎ bid) or nystatin(1,000,000IU×6/day) with corresponding placebo. The study drug was started in initiation of chemotherapy and continued until recovery of neutrophil counts(>1,000/㎣), development of proven or suspected invasive fungal infection, or the occurrence of drug-related toxicity. Fungal colonization decreased in fluconazole(F) group, however increased in nystain(n) group. Superficial fungal infection occurred in 1 of 34 F group, whereas invasive fungal infection developed in 3 of 28 N group. Empirical amphotericin-B therapy was given in 7 of 34(21%) F group and 10 of 28(36%) N group(p>0.05). The incidence of drug-related side effects and overall moratlity were similar in both study groups.

CM전문회사의 현장관리조직 운영실태 분석

신원상(Shin, Won-Sang),이강민(Lee, Kang-Min),손창백(Son, Chang-Baek) 대한건축학회 2014 大韓建築學會論文集 : 構造系 Vol.30 No.8

This study is aimed at offering basic data for enhancing the organizational structure and productivity of on-site construction management (CM) employees. To accomplish the objective, the organizational operation system and employee evaluation of domestic CM companies were analyzed by site scale to promote efficient operation. The findings are as follows. First, in terms of CM workforce, the employees handling architecture, electricity, and machines represented the highest proportion. As for qualification, top engineers were dispatched to both large-scale and small-scale CM sites more than any other employee. Second, the results on CM organizational productivity are as follows. The per capita sales increased as the service payment increased. In terms of scale, the site worth less than a billion won had per capita sales of 76 million won, about 5 times less than the site worth 5 billion won or more whose per capita sales were 371 million won. The monthly per capita sales also increased as the service payment increased. However, the difference was minimal, about a half of the difference in per capita sales. These findings would be useful for companies that have no systematic criteria for CM organization selection and evaluation.

Forest therapy program reduces academic and job-seeking stress among college students

Byung-Hoon Kang1 and Won-Sop Shin 인간식물환경학회 2020 인간식물환경학회지 Vol.23 No.3

Background and objective: Recreation or activities in forest are regarded as therapy. Many forest therapy programs have been developed and assessed in the domestic. This study was conducted to investigate the effect of the forest therapy program on academic and job-seeking stress in college students. Methods: Thirty five subjects were selected as the experimental group and 25 as the control group, and 29 subjects in the experimental group and 11 in the control group participated in the follow-up test to verify the persistence of stress reduction effects. The forest therapy program was carried out once a week for 2 hours each from September 4 to December 4, 2018, adding up to total eight sessions. Results: The experimental group showed statistically significant reduction in both academic stress and job-seeking stress, whereas the control group did not. For the persistence of the forest therapy program, the experimental group did not show a statistically significant difference between the posttest and the follow-up test, and thus the stress reduction effect was maintained. Conclusion: This study proved the reduction of academic and job-seeking stress in forest therapy programs and the persistence of the stress reduction effect of the forest therapy program. The result is consistent with the Stress Recovery Theory (SRT) that shows the stress reduction effect of nature. In addition, it has significance in that it has verified that the program using the forest on campus can reduce stress of most college students.

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.

漸進的·急進的 運動負荷가 血液의 pH, Sugar 및 Lactate에 미치는 影響

姜炯基,辛元太,白永守,殷熙寬,宋基成,河哲秀 漢陽大學校 體育科學硏究所 1986 體育科學 Vol.6 No.6

The purpose of this study is to in-vestigate the effects of gradual and radical exercise load on the treadmill for PH, Sugar and Lactate in Blood by selecting 14 subjects in H university, All subjects began exercise by 6mPH for 4 minutes at start and increased exercise speed up to HR 140 by increasing every minute as gradual load. And subjects began exercise by 9mPH at first and increased load up to HR 140 as radical exercise load. The results are as follows: (1) In PH in Blood, gradual exercise load is lower than radical training in all subjects. (p<0.05) (2) In Sugar in Blood, radical exercise load is higher than gradual exercise load in all subjects. (p<0.05) (3) In Lactic Acid in Blood, gradual training is higher than radical exercise load in all subjects. (p<0.01) (4) In Lactic Acid, all subjects showed high value and its is also in Sugar, than the method of exercise load is according to anaerobic energy metabolism.

장애인을 위한 보라매 공원의 무장애 공간화 계획

강태순,김신원 한국식물인간환경학회 2001 인간식물환경학회지 Vol.4 No.2

The city of Seoul set up a 5 year plan of expanding and improving facilities for the disabled and for the old people. This plan started on July of 2000, and the park is a place that is to be facilitated on 2001. A park is a place where people come to get energy throgh amusement and relaxation. There are a lot of people with different characteristics, but despite these differences, they all get together and mix in freely. Therefore, when facilitating the park, we have to take notice of the disabled people. It has to be comfortable for both normal and disabled people, and eventually, they will all get together as one, regardless of the differences. Because of these reasons, 1 set up a Redesign of Boramae Park. Under the motto of 'barrier free', I built a place where all people can have there own place with equity, not just having the opportunity, but really getting the chance. The main place is a place that has a personal, and social therapy function; a sports space and a gardening space. Other than these spaces, there is a center space for events. All people can increase their health through the sports space, and for the disabled, they can get along with their neighbors and fasten their social comeback from the gardening space, they can not only see the plants, but they can personally raise the plants to get mental stability. They can eventually be cured from this experience. Right now, the city of Seoul is working on the 5 year expanding and facilitating plan, but to increase the facility for the disabled, and get sympathy between the disabled and normal people, more effort is needed.The plan has to be not just adding facilities, but making spaces, programs, and more leisure time is needed to do these activity. The Redesign of Boramae Park was planned under these purpose and it only stopped on a study, but these park has to be made to help make social integration and a blessed society.

組織文化 7S 要因의 特性에 따른 組織有效性의 實證分析

姜元植,辛容尊 韓國海洋大學校 人文社會科學大學 1999 韓國海洋大學校 人文社會科學論叢 Vol.- No.6

유기박막 광도파로형 바이오(칼슘이온)센서의 개발

강신원,박이순,김성훈,김창원 경북대학교 센서기술연구소 1955 연차보고서 Vol.1995 No.-

본 연구는 고감도, 빠른 응답특성 및 넓은 센싱범위를 갖는 능동형 유기박막 광도파로형 칼슘이온센서를 개발하였으며, 이와 병행하여 중성 ionophore와 함께 특정 음이온 선택성의 색소(LAD : lipophilic anionic dye)를 설계·합성을 하였다. 유기박막 광도파로형 칼슘이온센서는 감지막 자체를 박막광도파로화 함으로써 빠른 응답시간과 고감도의 특성을 가졌으며, 514㎚ 광원에서 10^-6∼1M의 범위의 Ca^++ 의 농도를 측정할 수 있었다. 또한 새로이 합성된 LAD의 칼륨이온선택성을 분광측정으로 평가한 결과, 광이온센서(optode)들의 변색성 이온감응물질로서 사용이 가능함을 확인하였다. A new approach to the design and construction of thin-film optical waveguide Ca^+2 sensor has been developed by using a copolymer matrixed membrane that incorporates a cation-selective neutral ionophore, H^+-selective neutral chromo-ionophore, and lipophilic anionic sites in the same plasticized copolymer membrane. This sensor is based on absorption measurement, and it makes use of host molecules that change their optical properties through an actual ion-sensitivity recognition process. In parallel, the high ion-selective lipophilic anionic dye(LAD) was synthesized and evaluated. Proposed ion sensor, utilizing thin film membrane which is the waveguide itself, exhibited rapid response time and high sensitivity. And sensor could detect a wide range of Ca^++ concentrations ranging from 10^6 ∼ 1M by measuring the absorbance change at 514㎚ of light. The newly synthesized LAD showed its potential applicability as chromoionophore for optodes and/or thin-film optical waveguide sensors.

OECD 전자상거래 활성화를 위한 주요논의와 정책방향 연구

강신원 국제무역학회 2002 국제무역연구 Vol.8 No.2

전자상거래에 대한 OECD의 논의는 이미 1980년대부터 진행되었으며, 1994년 이후 전자상거래의 응용에 대한 논의가 본격화되고 있다. OECD의 전자상거래 논의는 배경은 정보통신기술의 발달과 인터넷의 상용화에 따라 전자상거래가 급속히 확산되었고 이를 뒷받침해 주는 범세계적 법적, 제도적 장치의 필요성이 커져 OECD의 주요 논의 과제로 부각되었기 때문이다. 한편, OECD에서 논의되는 전자상거래 관련 주요 논의는 우리나라에게도 중요한 영향을 미칠 것이며, 이러한 논의는 많은 정책점 시사점을 줄 것이다. 따라서 본고에서는 OECD의 전자상거래 활성화를 위한 주요논의를 살펴보고 정책방향을 도출해 보았다. The electronic commerce issues discussed in OECD will make a lot of influence on Korea. This paper will examine the main issues in OECD which can activate electronic commerce and will present some police implications. In conclusions, electronic commerce will expand and make enormous effects on social and economic aspects and it is important to establish appropriate polices. To promote electronic commerce, companies and consumers need to build the trust each other and the convenient ways for consumers to use electronic commerce easily should be devised. Therefore, law and systems concerned about electronic commerce should be prepared and the environment to keep electronic commerce secure and stable should be guaranteed. And we should make plans to protect companies and consumers and should make efforts to expand electronic commerce infrastructure.

공원묘지 유실에 의한 대량재해의 개인식별

강신몽,이한영,윤중진,이원태,김종열,이영석,서재관,최득린,서지석,이혜경 大韓法醫學會 1992 대한법의학회지 Vol.16 No.1

Individual identification of severely decomposed or skeletonized bodies is an important part in medicolegal field. 142 bodies were torn up and carried away by flood in a park cemetry, Kwang-Ju, Kyunggi province, Korea at Sept., 10, 1990. The authors examed the 56 bodies, which were gained, through medical, anthropological, odontological, radiological methods, and superimposition for individual identification. Among them, 41 cases were successfully identified, and remaining 15 cases were not identified because of sever destruction and no adequate information.