정신보건관련시설 입원(소)자의 주요 정신장애 유병률 : 전국 20개 시설의 입원(소)자를 대상으로

조성진,조맹제,서동우,함봉진,홍진표,배재남,이준영,이동우,박종익,전홍진,김성주,김용익 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.6

Objectives : One of the objectives of this study is to estimate the prevalence rates of psychiatric diagnoses in the combined populations of psychiatric hospitals, psychiatric nursing facilities and homeless asylums using the Korean version of the Composite International Diagnostic Interview (K-CIDI), which is a comprehensive and fully standardized interview schedule to assess psychiatric disorders for diagnosis. The Other objective is to compare with previously studied prevalence rates of Psy-chiatric diagnoses using the results of this study. Methods : The study subjects, aged from 181o 64 years, were randomly selected from 64,582 institutionalized population of psychiatric hospitals, Psychiatric nursing facilities and homeless asylums as of 30, June, 2001. Twelve trained interviewers administered the K-CIDI to the selected respondents. A total of 1,875 respondents (male 1,194, female 681) completed the interview. Results : The lifetime and one year prevalences of any diagnosis excluding nicotine dependence · withdrawal, anxiety disorder, eating disorder, somatoform disorder were 88.2% (male 88.1%, female 88.3%), and 65.8% (male 62.7%, female 73.7%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were 78.5% (male 75.3%, female 83.7%), and 56.8% (male 51.9%, female 64.8%), respectively. The lifetime and one year prevalences of alcohol use disorder (dependence/abuse) were 26.7% (male 37.9%, female 8.3%), and 8.7% (male 12.8%, female 2.1%), respectively. The lifetime and one year prevalences of mood disorder were 18.1% (male 13.5%, female 25.8%), and 10.4% (male 7.2%,female 16.9%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were comparable with the 2001 community survey by 1.19% to 1.32%, and 0.51% to 0.61%, respectively. The lifetime and one year prevalences of schizophrenia were also comparable by 0.16% to 0.28%, and 0.16% to 0.25%, respectively. There were no significant changes of prevalence rates when correction were applied to other psychiatric diagnosis. Conclusion : The results of this study could be used for evaluating the distribution of psychiatric diagnoses in mental health related facilities and for planning mental health policies.

한국어판 Composite International Dianostic Interview(K-CIDI)의 개발

조맹제,함봉진,서동우,홍진표,배재남,김장규,이동우,조성진 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.1

연구목적 : 본 연구는 국제적인 정신장애 진단도구인 Composite International Diagnostic Interview(CIDI)를 한국의 사회문화적 상황에 적합하게 번역하고 신뢰도 및 타당도를 평가하여 한국어판으로 개발하기 위한 것이다. 방 법 : CIDI는 정신장애를 평가하고 진단할 수 있는 포괄적이고, 완전히 표준화된 진단도구로 훈련받은 일반인들이 적용할 수 있기 때문에 대규모 역학조사에 적합하다. 세계보건기구에서 제공하는 CIDI 번역 지침에 따라 한국어판 CIDI(K-CIDI)를 제작하였다. 영어권과 한국의 언어 및 사회문화적 차이를 고려하여 번역 및 개정을 하였고 역번역을 통하여 원본의 의미와 일치하는지를 확인하였다. 임상환자를 135명과 일반인 5명을 대상으로 신뢰도와 타당도 검사를 실시하였다. 두 명의 평가자가 K-CIDI를 이용하여 동일한 대상자를 동시에 면담하고 일주일 뒤에 재검사를 실시하였다. K-CIDI로 검사를 받은 대상자들을 정신과 전공의와 임상심리사가 한국어판 Structured Clinical Interview for DSM-Ⅳ를 이용하여 진단을 내렸다. 두 가지 진단의 일치도에 대한 kappa값을 산출하였다. 결 과 : CIDI의 번역에서 한국어 표현이 복잡하고 긴 문항은 두 개의 문장으로 분리하였고, 성과 관련된 표현과 의료체계 및 의료추구행태에서 사회문화적 차이를 반영하였다. 공포장애의 대상과 알코올 및 물질의 종류도 한국의 실정에 맞게 조정하였다. 현장 검사와 역번역 과정에서 K-CIDI가 적절하게 제작된 것으로 평가되었다. K-CIDI의 평가자간 신뢰도 검사는 140명에 대하여 이루어졌고 kappa값은 진단에 따라 0.86∼1.00범위였다. 검사/재검사 신뢰도 검사는 47명에 대해 이루어졌고 kappa값은 진단에 따라 0.42∼0.89였다. K-CIDI의 타당도 검사는 50명에 대해 이루어졌고 kappa값이 진단에 따라 0.50∼1.00의 범위였다. 결 론 : K-CIDI는 한국의 사회 문화적 배경에 적합하게 제작되었고 신뢰도 및 타당도 검사에서 역학연구에 적절한 진단도구로 평가되었다. Objectives : This study aims to develop a Korean version of the Composite International Diagnostic Interview(K-CIDI). Methods : The Composite International Diagnostic Interview(CIDI) is a comprehensive, fully standardized interview that can be used to assess psychiatric disorders and provide diagnoses. The K-CIDI was developed according to the guidelines provided by the WHO. The reliability and validity of the K-CIDI was evaluated by examining 135 psychiatric patients and five community residents. Subjects were jointly interviewed twice with a one-week interval. A psychiatric resident and clinical psychologist jointly determined clinical diagnoses using the Structured Clinical Interview for DSM-Ⅳ. Results : Notable modifications were done on sex-related expression, health system and help seeking behavior, subjects for phobic disorder, and kinds of alcohol and substance. Long and complex questions were divided into two or more questions. Field test and back-translation of the K-CIDI confirmed the appropriateness of the translation of the CIDI. The inter-rater reliability, test/retest reliability, and validity of the K-CIDI indicated kappa values ranging from 0.86-1.00, 0.42-0.89, and 0.50-1.00, respectively. Conclusion : The K-CIDI was deemed to be appropriate for the sociocultural background of Koreans. The reliability and validity of the K-CIDI were judged to be exceptionally acceptable.

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.

한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

Thrombopoietin이 제대혈의 CD34 양성 조혈모세포의 거핵구계 세포분화에 미치는 영향

서진태,조경삼,윤휘중,김시영,이우인 경희대학교 2000 慶熙醫學 Vol.16 No.2

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

온라인 게임 환경에서 PPL 브랜드 태도에 미치는 요인들에 관한 연구

서문식,안진우,조상리,조성문 釜山 大學校 經營 經濟 硏究所 2007 經營 經濟 硏究 Vol.26 No.1

사망진단서(사체검안서) 상의 선행사인으로부터 사망통계의 원사인이 선정되는 비율 : 3개 대학병원에서 교부된 사망진단서를 중심으로

박우성,박석건,정철원,김우철,탁우택,김부연,서순원,김광환,서진숙,부유경 한국의료QA학회 2004 한국의료질향상학회지 Vol.11 No.1

Background : To exatnine the problems intolved in writing practice of death certificates, we cotnpated the determination of underlying cause of death for wital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 rnortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record wpecialists. And causes of death determined at ministry of statistics for national vita statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificaties sere analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. Ane the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions tha caused death too. Conclusion : When we examined the correctness of death certificate writing practice using abpve methods, cortectness of writing could not be told as satisfactory. There was difference in correctness of writing between hospotals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

Papain 유도 호흡기 염증모델에서 인삼패독산(人蔘敗毒散)의 항염증 효과

우연주, 유준상, 이동혁, 서진우, 김주희, 권보인 상지대학교 한의학연구소 2023 尙志韓醫論文集 Vol.11 No.1

Objectives: Insampaedok-san and its main components have been used for treatment of fever, joint pain, cough, headache and pain. Using a respiratory inflammation model, we intend to investigate the anti-inflammatory effect and its mechanism of Insampaedok-san. Methods: We induced the actue respiratory inflammatory mouse model by papain treatment. BALB/C mice (female, 8 weeks old) were divided into three groups as follows: saline control (SC): papain treated group (vehicle): papain and Insampaedok-san (200mg/kg) treated group (n=4). To demonstrate the ani-inflammatory effect of Insampaedok-san water extracts, inflammatory cell infiltration was evaluated in bronchoalveolar lavage fluid (BALF) and nasal lavage fluid (NALF). In addition, immunogloblin (Ig)-E level was measured by using ELISA. Results: Insampaedok-san extracts administration decreased inflammatory cell infiltration in BALF and NALF. Especially, eosinophil infiltration was dramatically reduced. Furthermore, total Ig-E level was diminished in BALF and serum by Insampaedok-san administration. Conclusions: Our findings revealed Insampaedok-san extracts have anti-inflammatory effects by inhibiting inflammatory cell, especially eosinophil infiltration and Ig-E level.

우리나라에서 분리되는 Haemophilus influenzae의 9종 항균제에 대한 시험관내 감수성

장우현,최명식,석종성,정윤섭,서진태 대한화학요법학회 1989 대한화학요법학회지 Vol.7 No.2

To assess the occurrence of antimicrobial resistance among clinical isolates of H. influenzae in Korea, a total of 238 isolates were tested for their in vitro susceptibitlity to ampicillin and cefaclor by disc diffusion and 105 isolates were tested against nine antimicrobial agents-by the agar dilution method recommended by NCCLS. The antimicrobial agents sued for testing were ampicillin (Sigma A-9518, U.S.S.), cefaclor (Daewoong Lilly, Korea), cephalexin (Sigma C-4895, U.S.A.), cephradine (Sigma C-8395, U.S.A.), cephalothin (Sigma C-4520, U.S.A.), cefadroxil (Sigma C-7020, U.S.A.), erythromycin (Sigma E-6376, U.S.A.), teracycline (Sigma T-3383, U.S.A.) and cefatrizine (Dong-A Pharmaceutical Co., Korea). The isolation rate of H. influenzae from various clinical samples was 18.9%. Using the disc diffusion test, the resisant rates to ampicillin and cefaclor were shown to be 21.9% and 3.4%, respectively. Among the 52 ampicillin-resistant strains, 42 were susceptible to cefaclor (80.8%), and only two strains wre resistant. The MIS_(s) of ampicillin ranged from <0.125 ㎍/㎖ to >128 ㎍/㎖, and its MIC_(90) was 1 ㎍/㎖. Ampicillin showed the lowst MIC_(90) among the tested antivicrobial agents. The MIC_(90) of the tested cephalosporins ranged from 9.2㎍/㎖ to > 128. Among them, cefaclor showed the lowest MIC_(90) and its MIC_(90) was 9.2 ㎍/㎖. The MIC_(90) of tetracycline and erythromycin were 2.5 ㎍/㎖ and 14.4 ㎍/㎖, respectively. By the MIC, the resistant for ampicillin, cefalor, cephalexin, cephracine, cephalothin, cefadroxil, erythromycin, tetracycline and cefatrizine were 9.5%, 1.9%, 61.9%, 76.2%, 3.8%, 68.6%, 65.7%, 13.3% and 5.7%, respectively. There was no evidence that the MIC_(s) of cefaclor for the ampicillin-resistant strains differed significantly from those of cefaclor obtained with the ampicillin-susceptible strains. Except two islates, all of the multiple-esistant strains of H. influenzae were suceptible to cefaclor.