Acute exacerbation of interstitial lung disease; subgroup analysis for causes, risk factors for mortality rate, and steroid responsiveness

( Seung Hyun Yong ),( Ah Young Leem ),( Song Yee Kim ),( Kyung Soo Chung ),( Ji Ye Jung ),( Young Ae Kang ),( Young Sam Kim ),( Joon Chang ),( Moo Suk Park ),( Hye Jin Jang ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Background: Interstitial Lung Disease (ILD) has known as a poor prognosis disease, particularly idiopathic pulmonary fibrosis (IPF). Corticosteroid is widely used for treatment of acute exacerbation (AE)-ILD. This study aims to clarify efficacy of corticosteroid use, and compare the mortality rate depending on the subgroups of ILD. Materials and Methods: We collected the data from the patients who have diagnosed ILD and visited emergency room (ER) with the respiratory symptoms from January 1, 2016 to December 31, 2018. We classified AE-ILD patients into 3 groups depending on methylprednisolone dose per kilogram. Also, we compared the mortality of IPF patients to that of non-IPF patients. Results: A total case of AE-ILD visited ER from 2016 to 2018 was 209 cases, including IPF cases (n=122) and non-IPF cases (n=87). We divided total patients (n=209) into three groups depending on steroid use, and these include group 1 of 0-0.49 mg/kg (n=78), group 2 of 0.5-0.99 mg/kg (n=58), and above 1.0 mg/kg (n=41), each. We found poor prognosis from the cases of IPF compared to non-IPF cases (p=0.029, OR 2.463). Furthermore, there was significant differences of mortality rate according to steroid dose (p=0.036, OR 1.712), CRP elevation (p=0.016, OR 1.004), and intubated case (p=0.000, OR 8.152). Also, we categorized IPF (n=122) to non-IPF cases (n=87) and analyzed the mortality rate. Most of the patients were death from ILD itself (n=23, 63.9%), Pneumonia(n=8, 22.2%), and Lung cancer (n=5, 13.9%). Bacterial infection (n=26) was dominant cause of AE, followed by fungal infection (n=15), and viral infection (n=10). Conclusions: This retrospective analysis of corticosteroid treatment shows more fatal outcome when we use high dose steroid in AE-ILD cases, and there was significant difference in mortality rate depending on the subgroup of ILD and medical background, such as intubation status, higher CRP level, and IPF cases.

예비 가족창업자의 창업동기 및 가족관련 특성

강미욱,김영순,황미애 誠信女子大學校 生活文化硏究所 2008 生活文化硏究 Vol.23 No.1

The main purpose of this study is to examine the characteristics of nascent family entrepreneurs in order to understand differences of motivations, type of family involvement, family related characteristics. The study sample consists of 336 individuals in seoul and kyung-gi province. The major reasons of family entrepreneurship were to fulfill the financial needs and to prepare retirement. Gender differences are exist: Women are more likely to start their family businesses in terms of developing themselves and running at-home businesses than men. Compared to other age groups, individuals over age 40 have great motivation to start-up family businesses as their after-retirement insurances.

특수교육 보조원제 운영 방안 연구

강경숙,강영택,김성애,정동일 국립특수교육원 2002 연구보고서 Vol.- No.1

최근 중도장애학생들의 취학이 늘어나고 통합교육이 강조됨에 따라 특수교육 현장에서 장애학생을 지원하는 보조인력에 대한 필요성이 절실해 지고 있다 우리나라의 경우 교사 1인당 담당학생수가 과다하여 특수학교는 물론 일반학교의 특수학급과 통합학급 모두 장애학생의 특별한 요구를 적절히 지원할 수 없는 실정이다. 이에 본 연구는 특수교육 상황에서 보조원 운영의 현황을 파악하고 그 요구를 분석하여 특수교육 보조원리 자원 및 역할, 선발 및 교육과 배치, 복무 및 관리를 중심으로 한 특수교육 보조원 운영방안을 우리나라 실정에 맞게 제시하는 데 그 목적이 있다. 이러한 목적을 달성하기 위해 본 연구는 문헌연구를 통해 국내외 자료를 분석하여 우리나라와 외국의 사례 및 관련 정책을 소개하고, 설문조사와 면담조사를 통해 특수교육 현장에서의 특수교육 보조원 운영실태 및 그에 대한 요구를 분석하였다. 이외에 좌담회, 특수학교(급)교사 분임 토의, 전문가토론회 등 협의회를 개최하여 특수교육 보조원제 운영에 대한 관련인의 의견을 적극 수렴하고자 노력하였다. 국외의 특수교육 담당교사 보조인력 활용실태에 대해서는 미국, 독일, 호주를 중심으로 조사하였고 일본과 캐나다의 내용을 부가하여 법적 토대(관련법률), 자원 및 역할, 훈련 및 배치, 활용 및 관리방법을 고찰하여 우리 실정에 적합한 특수교육 보조원제 시행을 위한 시사점을 도출하였다. 그 내용으로서는 외국의 경우, 대부분 법적·제도적인 장치가 마련되어 예산을 투자함으로써 특수교육 현장에 유급으로 특수교육 보조원을 지원하고 있다. 그 활용형태에 있어서는 장애학생의 일대일 도움 뿐 아니라 통합교육을 위한 지원과 중증 장애학생의 독특한 특수교육적 서비스 제공을 위한 다양한 지원형태가 이루어지고 있었다. 국내의 특수교육 보조원 운영에 대한 실태 조사 결과로서 대부분의 특수학교, 특수학급,통합학급에서는 교사 외 보조인력의 중요성을 인식하고 대학생 자원봉사자, 학부모 등을 중심으로 활용하고 있으나 자원봉사자 확보의 어려움, 자원봉사자의 일회성 봉사 등으로 지속적인 활용의 어려움을 호소하고 있었다. 일부 학교나 교육청에서는 자원봉사자 외 공익근무요원, 공공근로자, 사회봉사명령자 등을 활용하여 통합교육과 특수교육의 질적 저하를 방지하기 위해 특수교육 현장에 보조인력을 투입하고 있었다. 특수교육 보조원제 운영방향으로는 첫째, 모든 가용인력 자원을 활용함을 원칙으로 하되 급료 지급여부에 따라 무급과 유급 보조원으로 구분하고 둘째, 급료지급 여부에 따라 특수교육 보조원의 자격과 역할, 훈련 및 배치, 그리고 복무관리 방안을 달리 하며 셋째, 특수교육보조원제 운영에 대한 제반 행·재정적 지원은 국가 및 지방자치단체에서 담당하는 것을 원칙으로 한다. 또한 본 연구를 통해 제안된 보조원 운영방안은 다음과 같다. 첫째, 특수교육 보조원의 자원 및 역할에 대해 자원봉사자와 같은 무급 보조원인 경우 자격에 제한을 두지 않는 것을 원칙으로 하나, 유급 보조원인 경우 육체적, 정신적 또는 심리적으로 그 역할을 수행할 능력이 있다고 판단된 자로서 남녀 구분 없이 고졸 이상으로 하는 등 자격에 제한을 둔다. 특수교육 보조원의 역할은 정규교사의 고유업무를 침해하지 않는 범위 내에서 정규교사의 교육활동을 보조하는 것을 원칙으로 하며 그 내용은 개인적 욕구지원, 교수-학습활동 지원, 문제행동 개선을 위한 지원으로 한다. 둘째, 특수교육 보조원의 선발 및 교육과 배치에 대해 특수교육 보조원의 선발은 시·도교육청 및 시·군·구교육청의 특수교육지원센터가 담당한다. 특수교육 보조원을 위한 교육 및 훈련은 무급 보조원은 해당 학교에서 필요에 따라 훈련 내용과 기간을 정하여 직접 실시하고, 유급 보조원은 시·도 교육청 및 시·군·구교육청에서 교육을 담당한다. 그리고 특수교육보조원의 배치는 시·도 교육청에서 배치함을 원칙으로 한다. 셋째, 특수교육 보조원의 활용과 관리에 대한 방안으로 특수교육 보조원의 복무관리는 해당 학교에서 함을 원칙으로 하나 시·도 교육청에서 복무지침을 마련한다. 한편, 보조원제시행을 위한 행·재정적 지원 방안은 사회봉사명령자, 공익근무요원, 공공근로자, 그리고 유급 고용인력으로 나누어 지원함을 원칙으로 한다. 본 연구의 결론 및 시사점으로는 특수교육 보조원제 운영이 특수교육이 당면한 현안과제,즉 학급당 인원수 감축, 특수교육 전공교사 배치 등과 상반되는 문제가 아니기 때문에 균형을 이루어 추진되어야 한다는 점이다. 또한 국가에서 특수교육 보조원제를 도입하기 위한 예산 확보에 전력을 기울여야 하나 전적인 예산확보가 어려운 경우, 지방자치단체와의 협조와 타 기관과의 공조체제 마련에 대한 방안을 강구해야 한다는 것이다. 즉 자원봉사자, 사회봉사명령자, 공익근무요원, 공공근로자 등의 단순한 배치만이 아니라 그들에게 적절한 기본교육을 실시하여 장애학생을 실제로 지원하고 도움을 주며, 장애인과 더불어 체험하는 일반인으로서의 경험을 확대하여 장애인의 통합을 이루기 위해 국가 전체적인 인적자원 효용성에 대한 논의를 활발히 전개해야 할 것이다. Recently the need for teacher-aide in special education has gradually increased as the inclusive education and the school attendance of students with severe disabilities are paid great attention. In our country, the number of students with disabilities(case-load)for a teacher in special education field is too large, so the special need of the students cannot be appropriately supported in special schools or in the special and inclusive classes in regular schools. The purpose of this study was to propose a management of teacher-aide system in special education which is proper to the actual conditions of our country, focusing on the qualifications and roles of teacher-aide, training and arrangement, and duty and administration. For this, I analyzed the present condition and the need for the teacher-aide in the special education field of our country. In order to achieve this purpose, I investigated the current trends, the cases and the policy of teacher-aide through literature reviews in foreign countries and surveys of the demands on the assistants for special education using questionnaires and interviews. In addition, the opinions of related persons of special education are collected at the symposium, at the conference, or at the discussion where special education teachers, general teachers, administrators, professors, parents of students with disabilities, teacher-aide and so on attended. As for the use of assistants in foreign countries such as America, Germany, Australia, Japan and Canada, they have already settled down the devices of law and the teacher-aide systems, and now they support the special education by investing the budgets. There are various supporting forms of assistance not only for the students with disabilities in the inclusive education, but for the students with severe disabilities who need unique services including one-on-one assistance. From this, the implications have been drawn for an introduction and a management of teacher-aide system in our country. The results of collecting data on application of teacher-aide in domestic special education are as follows: It is recognized the importance of the assistant for the students with disabilities, thus the university student volunteers and parents of the students with disabilities were used as assistants in most special education institutes, but it's not easy to use them consistently because of the difficulties in ensuring or maintaining volunteers and of their tentative service. Some special schools and Metropolitan and Provincial Offices of Education utilize the various assistant manpower such as public service agent, public sector laborers, and the persons with ordered social service in addition to the volunteers, to prevent the inclusive education and special education from quality deterioration. The direction of management of the teacher-aide system makes it a rule ( i ) to classify into paid and non-paid teacher-aide according to whether or not paying the salary (ii) to differ qualifications and duties, training and arrangement, service management plan on teacher-aide (iii) to be charged with the administrative and financial support by the central and the local government. The management plan of teacher-aide system in special education proposed in this study are as follows: First, the qualifications of non-paid teacher-aide such as volunteers are not limited, but the paid teacher-aide has to get a qualification of graduation of a high school, and they should be physically, mentally and psychologically healthy to perform the role. The role of teacher-aide is to support the educational activities of teachers within a range of not interfering with teachers' work, and the content is to help the personal need, to support the teaching and learning activities, and to improve inappropriate behaviors. Second, the special education support centers in local governments take charge of selecting teacher-aide. For the education and training of the non-paid teacher-aide, the school personnels are in charge of training contents and duration as they need. And as for the paid teacher-aide, the offices of education in local governments take charge of training them. Third, for the use and administration of teacher-aide, the schools supervise the teacher-aide and the offices of education prepare the service regulations. The administrative and financial support is differentiated depending on the kinds of assistants such as the persons with ordered social service, public service agent, public sector laborers, and paid teacher-aide. The implication of this study is to keep the balance the teacher-aide system and the pending issues such as reducing the number of students per class or arranging the teachers having degrees in special education. And the national efforts have to be devoted to get budget for this matter, teacher-aide. If all kinds of human resources helped and supported the students with disabilities through experiencing voluntary works and understanding special needs of students with various kinds of disabilities, they could be the most efficient supporters for special education. So there has to be the national enhancement of utilization of all kinds of persons for the inclusion of people with disabilities in the community.

Antegonial notch depth 에 따른 하악골 성장에 관한 두부방사선 계측학적 연구

강신애,유영규 대한치과교정학회 1989 대한치과교정학회지 Vol.19 No.1

The purpose of the present study were to disclose whether the depth of the mandibular antegonial notch can be used as an indicator of mandibular growth potential. The patients composed of 76 samples and were classified following 3 groups, based on the depth of mandibular antegonial notch : Deep notch group (more than 3mm), Neutral notch group (1-3mm), Shallow notch group (less than 1mm) For each case, the first lateral cephalograms were taken prior to the start of treatment and the second films 3-4 years after. The results were as follows; 1. Deep notch group had a shorter corpus, less ramus height and greater gonial angle than did Shallow notch group. 2. Deep notch group had a more retrusive mandibular position than Shallow notch group. 3. Deep notch group had longer total anterior facial height and longer anterior lower facial height group. 4.Deep notch group grow vertical clockwise growth pattern, while Shallow notch group grow horizontal counterclockwise growth pattern. 5. Deep notch group had less mandibular growth than Shallow notch group during observation period.

일 간호대학의 지역사회 방문간호사업 사례

강윤숙,최양자,고영애,전시자,조갑출,이옥철,주혜경,신기수,안은숙 적십자간호전문대학 2000 적십자간호전문대학논문집 Vol.22 No.-

베체트병에서 비스테로이드성 소염진통제에 의해 발생한 대량 소장출혈 1예

강인숙,류연주,장지은,정성애,이지수,조영주,이경은,이지희 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

Bechet's disease(BD) is a chronic inflammatoroy condition involving several organs inclu-ding gastrointestinal tract. Gastrointestinal tracts involvement in BD has been identified throughout the entire alimentary tract and commonly accompanies ulcerative lesions in the small and large bowel. It is debatable whether BD could be included among seronegative spondyloarthropathy (SPA).SPA usually occurs without overt sign of intestinal inflammation, but significant number of patients have asymptomatic intestinal inflammation, usually affecting ileum. Since most patients with SPA in-cluding BD are treated with NSAIDS. However, NSAID may play a role in aggravation or provo-cation of intestinal inflammation. Special attention to asymptomatic intestinal inflammation is needed, especially when NSAIDs are used for management of arthritic symptom in SpA. We experienced a case of BD which was complicated by a massive small bowel bleeding precipitated by NSAID use. 저자들은 베체트병 환자에서 비스테로이드성 소염진통제 사용 후 발생한 대량 소장 출혈의 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

편측성 만성 부비동염의 해부학적 유발 인자

김영배,최광석,강보승,김남표,김종애 침례병원 1998 浸禮病院學術誌 Vol.14 No.-

건강한 지원자에 있어서 타이록신 캡슐 경구투여 후의 체내 동태

이현애,강영숙 숙명여자대학교 약학연구소 2005 약학논문집-숙명여자대학교 Vol.22 No.-

The pharmacokinetics of orally administered cefroxadine (500 mg) was studied in human. Analytical method of cefroxadine was developed and validated using HPLC with UV detector. After the validation of this method, we conducted bioavailability study by administering two Tiroxin capsules (250 mg of cefroxadine capsule) to 9 healthy volunteers (male 7, female 2) orally after overnight fasting. Blood samples were taken at 0, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, and 6 hrs following an oral administration of the drug and the concentrations of cefroxadine in plasma were determined. The pharmacokinetic parameters such as AUCt (the area under the plasma concentration-time curve from time zero to 6 hours), C_(max) (maximun plasma drug concentration), T_(max) (time to reach C_(max)) , K_(e), (elimination rate constant), t_(1/2) (half-life) were calculated using the 'K-BE test 2002 (BA Calc 2002) program. The calculated average pharmacokinetic parameters were as follows; AUCt (39.6 ± 8.02 μg·hr/mL), C_(max) (21.3± 4.76 μg/mL), T_(max)(1.25± 0.38 hr), K_(e), (0.621 ± 0.100 hr^(-1)), t_(1/2) (1.25 ± 0.38 hr).

척수장애자에 관한 실태조사

이영애,이강목 大韓再活醫學會 1983 Annals of Rehabilitation Medicine Vol.7 No.1

유아교육기관 운영의 효율화를 위한 기초

김영애,강숙현 서강정보대학 1989 論文集 Vol.8 No.-

The purpose of this thesis is to study the recognition of the organizational characteristics of early childhood programs in social system, to analysis the contents of Likert's Profile of Organizational Characteristics. The results of study are as follows : Organizations are products of society. The school organizational system which develop in a society or social system are expressions of value system in relation to human systems, the organizational task, and the perceived situation. The nature of on organization's management system will be determined by both the larger socio-cultural system and the organization's production technology. The organizational characteristics of early childhood programs are a smallscale, simplify of educational activity, amateurism, and openness. Likert's Profile of Organizational Characteristics construct 8 components : leadership, motivation, communication, interaction, decision making, goal setting, control, goal achievement and trainning. These characteristics adress 51 questionnaire. In accordance with profile, organizational system devided 4 types : Explotive-Authoritative ; Benevolent-Authoritative ; Consultative Participative ; and Group-Participative type. The best is type 4 ; Group Participative.