한 대학한방병원에 입원한 뇌졸중환자의 입원경로를 중심으로 한 기술역학적 고찰

김송,박종,김기순,이철갑,류소연,정영 조선대학교 부설 의학연구소 1998 The Medical Journal of Chosun University Vol.23 No.2

To find the characteristics of stroke patients and the relation between the pathway of admission and characteristics, of the patients including general characteristics, progression of disease and subjective complaints, an analysis was made from the medical record of 291 inpatients due to stroke admitted to a oriental medicine university hospital in 1997. 1. Diagnosis categories of analyzed Patients were 50 cerebral hemorrhage and cerebral infarction. 2. Sex distribution of patients showed 125 male and 165 female and age distribution showed peak 33.7% at 60-69 year old group, 26.5% at 70-79 year old group in descending order(p<05). 3. Thirty four percent of stroke patients had family history of stroke and male showed significantly higher rate of family history of than female(p<05). 4. The type of physical constitution was classified as Tea-Eum-In(太陰人) 43,6%, So-Eum-In(少陰人) 29.9%, So-Yang-In(少陽人) 26.1%, Tea-Yang-In(太陽人) 0.3% in descending order of frequency. 5. Hypertension was the preceding condition for 36.4% of cerebral hemorrhage and 42.7% of cerebral infarction. 6. Sixty nine point four percent of the patients of the patients suffered from the stroke for the first time and 25.4% for the recurred stroke. Major subjective complaints of the patients were motor disturbance, speech difficulty and headache in descending order. 7. As the institution for medical care to this admission, 138 person(47.4%) used western type hospital or clinics, 137 persons(47.1%) passed oriental medicine clinics or hospitals, 6 persons(2.1%) used both type of western medicine and oriental medicine and 10 person(3.4%) used pharmacy folk medicine. 8. As pathway of medical care for cerebral hemorrhage 71.2% of patients used western type hospital or clinic and 26.9% used oriental type of care where as for cerebral infarction 42.3% used western type and 51.5% used oriental type. 9. While admitted to this hospital within one day after occurrence of the disease used oriental type by 87.5% and western type by 14.3%, patient admitted in one week after occurrence of the disease used western type by 66.9% and oriental type by 27.1%. The above results showed that the pathway of medical care for the stroke patients was complicated and make many problems due to delay in the arrival to medical care. So effective health care delivery system for the stroke patients must be made for more efficient medical care.

다중지능이론을 적용한 디자인 교육활동이 유아의 지능에 미치는 영향

박소연(Park So Yeon),송민정(Song Min Jung) 한국디지털디자인협의회 2012 디지털디자인학연구 Vol.12 No.4

현대사회는 탁월한 성취, 창의성 등을 두루 갖춘 창조적인 인재상을 추구한다. 이에, 창의적 인재양성을 위한 창의적 교수학습법이 화두가 되고 있다. 창의적 교수학습법의 일환으로 창의성, 자율성, 개별화 교육, 자기주도적 학습 등이 핵심 키워드로 거론되고 있으며, 이는 획일주의 교육에서 벗어나 다차원적 관점에서 바라보는 다양한 교육방법의 필요성과 중요성이 있음을 시사하고 있다. 이에 본 연구에서는 개인차 고려, 통합교과과정 적용, 학습자중심 교육을 지향하는 다중지능이론을 적용한 교수학습안을 설계하고, 학습자에게 적용 후, 학습자에게 미치는 영향에 대해 알아보고자 한다. 다중지능이론은 Howard Gardner박사가 정립한 것으로, 인간의 지능은 총 8가지 언어지능, 논리수학지능, 시각공간지능, 자연탐구지능, 개인내적지능, 대인관계지능, 음악지능, 운동지능 등으로 측정?평가할 수 있다고 한다. 그는 다중지능이론을 통해 획일화된 교육이 아닌 개인차를 고려한 학습자중심 교육의 접근법이 이루어져야 한다고 주장한다. 특히 유아의 다중지능 특성을 유아기 초기부터 발견하고 이에 적합한 개별교육이 수행된다면 유아의 흥미와 자아를 존중하는 전인교육이 수행되는 것이며 이러한 교육을 받은 유아들은 미래 사회에서 자신만의 쟁력을 갖춘 성인으로 성장할 수 있다고 지적하고 있다.1)유아교육과정의 원리요소 미루어 보아 놀이 개념의 디자인 중심 학습활동이 유아의 흥미 및 동기유발, 통합적 교과과정의 원리 측면에서 효율적인 교육적 도구가 될 수 있다. 이에 본 연구는 다중지능이론에 근거한 유아 디자인프로그램 및 교수학습안을 만들어 프로그램 적용 전?후의 결과를 비교함으로써 첫째, 유아의 디자인 교육의 필요성과 중요성에 대해 알아보고, 둘째, 다중지능이론을 적용한 디자인프로그램이 유아의 각 지능에 미치는 영향에 대해 살펴보고자 한다. In the modern society, a variety of sciences and technologies are fused to create new knowledge and value. Because of it, a creative teaching-learning method is continuously mentioned for cultivation of creative talent. Recently, creativeness, approach centered on learners and self-directed learning all of which are being emphasized in educational circles strongly indicate that each individual needs to aggressively introduce their own multiple intelligence profiles for teaching-learning process. It is the very Multiple Intelligence Theory developed by Howard Gardner that has suggested a new direction for education. He not only defined the human intelligence as standardized and single intelligence from the cognitive viewpoint but also categorized it into the total 8 fields intelligences. Howard Gardener points out that if the nature of children’s multiple intelligence can be found from early childhood and the individual education appropriate to it is to be carried out the so-called whole-rounded education respecting their interest and egos will be accomplished and those children receiving the education will grow to adults with their own competitiveness in the future. Through design education among children’s learning domains, children can find out the designs which are everywhere in our daily lives, explore the possibility of various expressions and have both convergent and divergent thoughts. Accordingly, the design education is an excellent teaching medium to make children expand the width of thought and cultivate the logic thought. Thus, for this study, a program for children’s design activities by applying Multiple Intelligence Theory will be made to figure out what influence it will have on children’s multiple intelligences.

교통사고에 의해 발생한 뇌내 좌상 1례

박혜연,전소분,김선아,정금선,조종기,송근호,이영원 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

A two years old intact female Minature Schnauzer was referred to the Veterinary Medical Teaching Hospital of Chungnam National University with an intermittent seizure by traffic accident. No specific finding was found by radiography and computer tomography (CT). Hematologic and blood chemical examination revealed that PCV (62.5%), BUN (72.6 mg/dl), CK (1769 U/l), ALT (169 U/l) and ALP (353 U/l) were increased. This dog was recovered by medical treatment.

동아시아에서의 HIV/AIDS 역학

신소연,최준용,김영근,박윤선,김연아,김명수,송영구,Shuzo Matsshita,Taisheng Li,Hsi-Hsun Lin,Patrick Li,김준명,동아시아 HIV 네트워크(East-Asia Network on HIV; EAN-HIV) 대한감염학회 2007 감염과 화학요법 Vol.39 No.1

목적 : 최근 동아시아에서의 HIV 감염자 수의 급속한 증가는 여러 가지 심각한 문제를 야기하고 있다. 따라서 이지역에서의 HIV/AIDS 역학에 대해서 정확한 조명 및 분석이 무엇보다 필요하다. 이에 저자들은 동아시아 HIV 네트워크(East Asia Network on HIV; EAN-HIV)를 통하여 동아시아 HIV/AIDS 유행의 시작, 변천 및 현황에 관하여 알아보고자 한다. 재료 및 방법 : 동아시아에 HIV/AIDS가 처음 유입된 1984년부터 2005년까지 한국, 일본, 중국, 대만, 홍콩의 HIV/AIDS 관련 역학 자료를 동아시아 HIV 네트워크(East Asia Network on HIV; EAN-HIV)를 통하여 수집하고 분석하였다. 결과 : 동아시아에서의 HIV/AIDS 유행은 1980년대 중반에 시작되었다. 2005년 말까지 한국에서는 3,829명, 일본에서는 7,078명(혈우병 환자 제외), 대만에서는 10,423명,홍콩에서는 2,825명의 HIV 감염자가 보고되 었으며, 중국에서는 141,241명이 보고되었으나 실제로는 84만명 이상의 감염자가 존재할 것으로 추정하고 있다. 주사마약사용, 혈장매매, 성접촉에 의한 감염이 주를 이루고 있으며, 감염자중 남자가 많고 20-30대가 다수를 차지하였다. 중국이나 대만의 경우에는 최근 감염자 수가 급증하고 있으며 주사마약사용에 의한 감염이 주로 문제가 되고 있는 반면, 한국, 일본, 홍콩의 경우에는 남성동성애자에 의한 전파가 주가 되고 있다. 동아시아에서 유행하는 HIV의 주 아형은 B, C, CRFO1_AE 형이며, 최근에는 CRF07_BC형이 확산되고 있다. 결론 : 동아시아의 HIV 감염률은 빠르게 증가하며, 또한 HIV/AIDS 역학도 빠르게 변화하고 있다. 이 지역의 유행은 중국이 부분적으로 커다란 영향을 미치고 있다. Background : Recent predictions of catastrophic epidemic surge of HIV infection in East Asia concern experts and governmental organizations. As in many other areas, countries in East Asia show diversities in their HIV epidemics, both geographically and temporally. However, they have similar regional, cultural and racial characteristics which allow them to have certain common factors. Having a clear picture of the current extent and feature of HIV/AIDS in this region is a very difficult task largely due to the fast pacing of expending epidemic and difficulty in data-sharing among countries in the region. Hence, we decided to study the epidemiologic feature of HIV/AIDS in East Asia through East Asia Network on HIV (EAN-HIV). Materials and Methods : The epidemiological patterns of HIV/AIDS in East Asian countries were investigated by collecting data through EAN-HIV. Results : The HIV/AIDS epidemic in East Asia started relatively late at mid 1980s. Since then, the number of newly infected HIV/AIDS cases has been steadily increasing with stiffer escalation in recent years. In China and Taiwan, IDU plays an important part in the swiftly growing HIV epidemics; however, in other regions like Korea, Japan, and Hong Kong, MSM (men who have sex with men) seems to be more of a problem. The major subtypes of HIV in East Asia are subtype B, C, and CRF01_AE, and rapidly evolving circulating recombinant forms (CRF) between subtypes such as CRF07_BC give dynamic change to the current status. Conclusion : The incidence of HIV/AIDS is rapidly increasing in East Asia. The epidemic pattern has undergone dynamic changes over time. China seems to be the leading source of HIV/AIDS epidemic in East Asia due to its large population and rapidly growing epidemics.

말티즈견에서 발생한 승모판폐쇄부전 1례

전소분,박혜연,김선아,정금선,이영원,박성준,김덕환,송근호 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

A 10 years old, intact male, Maltese dog with clinical signs of labored respiration, exercise intolerance and increasing of coughing was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. Physical examination revealed tachycardia, panting and mild cyanosis. This case was diagnosed as mitral valve insufficiency by clinical signs, ascultation, blood chemistry, radiography and electrocardiography. This dog was treated with ACE inhibitor (enalapril), diuretics (furosemide) and bronchodilator (aminophylline) for 14 days. After treatment, clnical signs were disappeared and also this dog was needed to be continuous monitoring and sodium restricted diet.

젊은 성인 남자의 흡연과 혈청 지질과의 관련성

조선,류소연,박종,강명근,김은숙,김형철,박광희,윤혜은,노희송 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Objectives: This study was performed to find the association of cigarette smoking and blood lipid profiles in healthy young adults. Methods: The data was collected by a self-administered questionnaire and health examination in 489 professional soldiers from 6 to 12 May, 2004. The status of cigarette smoking was classified by non-smoking, ex-smoked, ≤4.9, 5-9.9, and ≥10 pack-years. The statistical analysis were used by chi-square test, analysis of variance and analysis of covariates. Results: In status of subjects cigarette smoking, current smoking, ex-smoked, and non-smoking were 71.8%, 11.2%, and 17.0%, respectively, In distribution by amount of smoking, non-smoking, ex-smoked, ≤4.9 pack-years, 5-9.9 pack-years, and ≥10 pack-years were 17.0%, 11.2%, 37.4%, 21.3%, and 13.1%, respectively. At other confounding variables were controlled, total cholesterol and LDL-cholesterol were increased significantly when amount of smoking was increased. However, triglyceride and HDL-cholesterol did not showed statistically significant differences, Conclusion: Smoking has relevant to total cholesterol and LDL-cholesterol and it is need to perform the further study for finding how blood lipid profiles are affected its level by cigarette smoking and to find an influence of cigarette smoking on cardiovascular disease.

국내 HIV 감염자에 있어서 Highly Active Antiretroviral Therapy (HAART)의 치료효과 및 영향분석

김명수,신소연,박윤선,김연아,구남수,김준형,김영근,최준용,송영구,김준명 대한감염학회 2007 감염과 화학요법 Vol.39 No.3

목적 : 전 세계적으로 에이즈 감염자가 4,000만명을 넘고 우리나라에서도 최근 하루에 2.1명의 신규 감염자가 발생하며 2006년까지 누적 감염자가 4,500명을 넘고 있다. 여러 가지 항레트로바이러스제가 개발된 이후 우리나라에서는 1997년부터 HIV 감염자에 대한 3제 병합요법이 시작되었으나 그 효과에 대한 우리나라의 연구는 미미한 실정으로 이에 대해 알아보고자 하였다. 재료 및 방법 : 연세대학교 의과대학 세브란스병원에서 2005년 12월까지 진료한 HIV 감염자 중 1997년 10월이후 항레트로바이러스 치료제를 투여 받은 환자 가운데 이전의 항레트로바이러스에 대한 치료력이 없으면서, 1년 이상 HIV-RNA 및 CD4+ T 림프구 수의 정기적인 측정인 가능한 141명의 환자를 대상으로 후향적 의무기록 분석을 통해 임상적인 특징과 6개월과 12개월째 HAART에 대한 치료효과를 분석하고 이와 관련된 요인을 찾고자 하였다. 결과 : 세브란스병원에서 2005년 12월까지 451명이 에이즈로 진료를 받았고, 1997년 이후 HAART를 시행받으면서 1년 이상 HIV RNA 및 CD4+ T 림프구수의 정기적인 측정이 가능한 환자는 141명으로 127명(90.1%)이 남자였다. 연령별 분포를 보면 30대가 50명(35.5%), 40대가 50명(35.5%)로 가장 많았다. HAART 시작 당시에 28명(19.9%)이 에이즈 정의질환을 동반하고 있었고, 74명(52.5%)은 에이즈 정의질환은 아니지만 기회감염을 동반하고 있었다. 121명(85.8%)의 환자에게 단백분해효소억제제를 기반으로 하는 처방이 이루어졌고, 20명(14.2%)의 환자에게는 비뉴클레오시드 역전사억제제를 기반으로 하는 처방이 이루어졌다. 치료 시작 당시 CD4+ T 림프구수는 평균 207/mm³(IQR 73-299)였고, 평균 HIV RNA는 70,800 copies/mL (4.85 log copies/mL)였다. HAART 시행 12개월 후에 평균 CD4+ T 림프구는 143 cells/mm³증가하였고, 96명(68.1%)에서 100 cells/mm³이상의 증가를 나타냈다. 치료반응에 따라 두 군으로 나누어 분석한 결과 12개월 후 100 cells/mm³이상 증가한 군이 초기 CD4+ T 림프구수가 적었다(P=0.01). HIV RNA 바이러스는 치료 당시보다 6개월후에 1.76 log copies/mL만큼 감소하였고, 12개월 후에는 1.88 log copies/mL만큼 감소한 결과를 보였다. 그리고, HAART 시행 후 HIV RNA는 6개월째 103명(73%)이 400 copies/mL 미만의 결과를 보였고, 12개월 후 90명(63.8%)에서 50 copies/mL 미만으로 측정되지 않는 결과를 나타냈다. HIV RNA를 치료반응에 따라 두 군으로 나누어 비교한 결과 6개월째는 두 군간의 차이가 없었으며, 12개월 후에는 50 copies/mL 미만인 군이 나이가 더 많은것으로 나타났다(P=0.009). 대상 환자 141명 가운데 초기처방을 중간에 변경한 경우가 57명(40.4%)이었고, 처방 변경의 주된 이유는 약제 부작용과 관련된 것이었다. 결론 : 국내에서 에이즈 감염자가 지속적으로 증가하고 있는 상황에서 HAART의 치료효과를 분석한 결과 기존의 치료 결과와 유사한 성적을 보였다. 앞으로 대규모의 코호트 연구를 통해 국내 에이즈 환자들의 특성 규명과 이에 알맞은 치료에 대한 연구가 더 필요하겠다. Background : Recently, 2.1 persons per day are reported to be HIV infected and totally more than 4,500 HIV infected persons have been officially reported until 2006 in Korea. We started highly active antiretroviral therapy (HAART) for HIV patients from 1997. Data on the efficacy of antiretroviral therapy are limited in Korea. Materials and Methods : HIV infected patients treated with HAART for more than 1 year were included. We studied the therapeutic response of antiretroviral therapy in patients with AIDS and without previous antiretroviral therapy who were treated until Dec 2005 in Severance hospital. Results : More than 450 were diagnosed as HIV infected in Severance hospital. Among these HIV infected patients, 141 patients including 14 females were included. 121 of the 141 patients (85.8%) were treated with PI based regimen, and 20(14.2%) were treated with NNRTI based regimen. The initial mean CD4 T cell count was 207/mm³ (IQR 73-299) and the mean HIV RNA level was 70,800 copies/mL. After 6 months of HAART, 103 patients (73%) had fewer than 400 copies of HIV RNA copies/mL. After 12 months of HAART, 90 patients (63.8%) had fewer than 50 copies of HIV RNA copies/mL. The mean increase in the CD4 T cell count from baseline to 12 months was 143 cells/mm³. After 12 months, 96 patients (68.1%) had increased more than 100 cells/mm³. Conclusion : This report the therapeutic response of HAART in Korea which the prevalence of HIV infection is now increasing. Overall, the outcomes are similar to those in other developed countries. Further large scale prospective cohort study is needed.

중합효소연쇄반응을 통해 확진되고 Atovaquone과 Azithromycin으로 치료한 Human Babesiosis 1예

윤기태,김연아,구남수,김준형,정세진,김홍정,송경호,최유경,신소연,김영근,김명수,박윤선,최준용,송영구,김준명 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

저자들은 국내에서 처음으로 중합효소연쇄반응 검사를 통하여 B. microti에 의한 인체 바베시오시를 진단하였으며, atovaquone과 azithromycin 병합요법을 사용하여 치유한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Human babesiosis is a tick-borne infectious disease caused by Babesia species. The clinical diagnosis is difficult because of nonspecific symptoms like flu. Rapid diagnosis of human babesiosis is microscopic examination in peripheral blood smear (Giemsa-stain) which reveals characteristic forms of an intracellular quadruplet parasite. But differentiation between Babesia microti and Plasmodium species can be quite difficult because of the morphologic similarity. We experienced a case of human babesiosis. The patient was a 62-year old Korean male who had been in New Jersey, U.S.A for 2 months. We initially diagnosed as malaria infection because the peripheral blood smear revealed intracellular single ring form organism. But the patient was not improved significantly by the treatment with chloroquine regimen. Finally we confirmed human babesiosis by polymerase chain reaction for Babesia microti. We treated the patient successfully with a regimen of atovaquone and azithromycin which has fewer adverse reactions than a regimen of clindamycin and quinine.

입원 중인 베트남 참전 군인의 삶의 만족도와 관련된 요인

김애리,박종,김율,노희송,박광희,김은숙,김형철,홍강식,류소연,강명근,김기순 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Background and Objectives: The aim of the study was to identify the factors associated with life satisfaction of hospitalized Vietnam veterans. Material and Methods: The data were collected from 200 hospitalized Vietnam veterans of 5 veterans hospitals in Korea from September 13 to 23, 2004. Information of general characteristics, health behavior, disease history, family function, depression and life satisfaction were collected by structured questionnaire. Results: The mean of life satisfaction was 21.48(±6.03), and the mean of depression was 53.10(±9.64). The prevalence of depression was mild depression 24.0%, moderate depression 43.5% and severe depression 25.0%. Depression was associated with life satisfaction and depression was higher, life satisfaction was lower. Family function and age were positively associated with life satisfaction, Conclusion: Life satisfaction was affected by depression and family function in hospitalized Vietnam veterans. Therefore, it was thought that psychosocial approaches such as improve depression and family function in care of hospitalized Vietnam veterans is required.

돼지고기육종의 방사선 유래 휘발성 물질 분석

차용준,박지영,김훈,김소정,정연정,소양순,유영재 창원대학교 생활과학연구소 2000 생활과학연구 Vol.4 No.-

Bacillus cereus KCTC 3674 produced at least two kinds of extracellular proteases. Two major bands of the protease activity with molecular weights of approximately 100 and 38 kDa were obtained after gelatin-SDS-PAGE. The production of extracellular proteases occurred during the logarithmic growth phase and was greatest when cultures reached the stationary growth phase. On the other hand, the growth of B. cereus KCTC 3674 and the production of its extracellular proteases were severely inhibited by the addition of protonophore carbonylcyanide m-chlorophenylhydrazone (CCCP). Thus, it was concluded that the growth of B. cereus KCTC 3674 and the production of its extracellular pretenses were strongly affected by a H+ electrochemical potential.