지역주민의 삶의 질에 관한 주관적 의식 분석

이지은(Lee, Ji-Eun),이재완(Lee, Jae-Wan) 한국지방정부학회 2014 지방정부연구 Vol.18 No.1

이지은(Lee, Ji-Eun), 이재완(Lee, Jae-Wan) 본 연구의 목적은'삶의 질'에 대한 지역주민의 인식을 유형화하고 분석하는 데 있다. 지역주민의 삶의 질에 관한 주관적 인식을 분석하기 위해 Q방법론을 활용하였다. 지역주민을 대상으로 한 인터뷰 및 선행연구 검토를 통해 Q진술문을 작성하였고, P샘플은 서울시에 거주하고 있는 지역주민 40명을 대상으로 하였다. 분석 결과, 삶의 질에 대한 주민인식은 ① 기본적 요건 지향, ② 물질적 요건 지향, ③ 비물질적 요건 지향으로 유형화되는 것으로 나타났다. 본 연구는 삶의 질에 관한 인식이 지역주민마다 다를 수 있으므로, 지방자치 수준에서 숙의민주주의를 실현할 수 있는 공론의 장을 마련할 필요가 있다는 점을 시사한다. 지방정부가 지역주민들의 삶의 질을 향상시키는 정책을 수립할 때 다양한 주민들의 인식과 의견이 반영될 수 있도록 하여야 할 것이다. The objective of this study is to classify and analyze citizens' perceptions on 'quality of life'. In order to examine quality of life as perceived by citizens, Q-methodology was used. A set of Q-statements was constructed with reference to field interviews of citizens and literature review of the precedent study, and it was rated by 40 citizens residing in Seoul. The results of this study revealed that citizens' perceptions of quality of life could be classified in terms of three perspectives: 1. Basic conditions orientation, 2. Material conditions orientation, and 3. Non-material conditions orientation. Based on the analysis results, this study suggests that as citizens' perceptions of quality of life can be diverse, there is a need to develop a public sphere where deliberative democracy would be realized and advanced at local government level. By creating and developing public spheres, local governments would be able to take citizens' perceptions and opinions into account better when establishing policies for improving citizens' quality of life.

태양인(太陰人) 청혈강기탕(淸血降氣湯) 투여 후 호전된 시멘트 접촉 만성 피부염 환자 치험 1례

강기완,김민지,강세영,Kang, Ki-wan,Kim, Min-ji,Kang, Sei-young 대한한방내과학회 2015 大韓韓方內科學會誌 Vol.36 No.1

Objectives : The purpose of this report is to investigate the effect of Taeeumin Cheonghyeolgangki-tang on chronic contact dermatitis caused by cement. Methods : A 52-year-old male patient was diagnosed with contact dermatitis with the Questionnaire for Sasang Constitutional Classification-II (QSCC-II) as well as the four methods of diagnosis (四診), and treated with Taeeumin Cheonghyeolgangki-tang (qīngxuèjiàngqí-tāng). We observed redness and scaling on both palms, and recorded photographs of any changes during the inpatient and outpatient treatment period. Results : The symptoms of contact dermatitis on both palms were significantly improved. Scaling and cracked skin disappeared and the redness almost resolved. Conclusions : Therefore, Taeeumin Cheonghyeolgangki-tang ( qīngxuèjiàngqí-tāng ) is effective on chronic contact dermatitis caused by cement.

대량의 각혈로 사망한 장티푸스 1예

한상우,유진홍,권순석,김성훈,박지찬,홍은정,최경성,박용완,장준희,안지원,박유경,강지영,박상미,신완식 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

We experienced a 25 year-old male patient with typhoid fever complicated with massive hemoptysis. Pulmonary complication in typhoid fever is very rare and to our knowledge, there has been no report of hemoptysis as a main cause of death with this disease. We herein report a rare case of typhoid fever.

Slide Session : OS-IFD-07 ; Infectious Disease : In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus

( Myung Jin Lee ),( Kye Hyung Kim ),( Jong Youn Yi ),( Su Jin Choi ),( Chung Jong Kim ),( Nak Hyun Kim ),( Kyoung Ho Song ),( Pyoeng Gyun Choi ),( Ji Hwan Bang ),( Wan Beom Park ),( Eu Suk Kim ),( San 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus Myung Jin LEE1, Kye-Hyung KIM1, Jongyoun YI2, SuJin CHOI1, Chung-Jong KIM1, Nak- Hyun KIM1, Kyoung-Ho SONG1, Pyoeng Gyun CHOI1, Ji-Hwan BANG1, Wan Beom PARK1, Eu Suk KIM1, Sang-Won PARK1, Hong Bin KIM1, Nam Joong KIM1, Myoung- Don OH1 Seoul National University College of Medicine, Korea1, Pusan National University School of Medicine, Korea2 Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Bunyavirus, severe fever with thrombocytopenia syndrome virus (SFTSV). No effective antiviral therapy is proven yet, but clinical use of ribavirin (RBV) has been tried. We investigated the antiviral effect of RBV against SFTSV in vitro. Methods: To test for cytotoxicity of RBV, Vero cells were treated with different concentrations of RBV (3.90 to 500 μg/mL, two-fold dilution) and analyzed by cell viability MTS assay 48h post-infection. To determine antiviral activity of RBV against SFTSV, Vero cells were infected with SFTSV strain Gangwon/Korea/2012 at 100 TCID50 (50% tissue culture infective dose) per well in a 96-well plate, and RBV was added at the concentrations showing no or minimal cytotoxicity. Viral RNAs were extracted from the culture supernatants and quantifi ed using one-step real-time reverse transcription- PCR to amplify the partial large segment of SFTSV. Statistical analysis was done by one-way ANOVA with Tukey`s post hoc test. Results: Cytotoxicity due to RBV was not observed at RBV concentration =31.3 μg/ mL. Viral RNAs at 24h post-RBV treatment were reduced with increasing RBV concentrations (1-32 μg/mL), compared with those of mock-treated cells (P <0.01, Figure). Half maximal inhibitory concentration (IC50) of RBV was 3.69 μg/mL at 24h post-RBV treatment. Conclusions: Our study shows that RBV has antiviral effect against SFTSV in a dose-dependent manner. Further studies are required to evaluate the effi cacy of RBV in SFTS.

복귀돌연변이시험을 이용한 이온화에너지 처리 우유 및 아이스크림의 유전독성학적 평가

유지숙, 한선경, 신명수, 구본철, 최지현, 이주운, 조철훈, 함준상, 이완규 충북대학교 동물의학연구소 2008 Journal of Biomedical and Translational Research Vol.9 No.1

본문참고

알부민이 첨가된 시험관내 약역학 감염모델을 이용한 폐렴알균 치료에서 Ceftriaxone 일일 1회 요법

허지안,전혜선,박선희,최수미,김시현,이동건,최정현,유진홍,신완식 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

배경 : Penicillin 내성 폐렴알균이 증가하는 지역에서 대안 중의 하나로 사용되는 ceftriaxone (CTR)의 적절한 용법, 용량을 파악하는 것이 중요하다. 본 연구는 임상에서 분리된 폐렴알균을 대상으로 시험관내 약역학 감염모델을 이용하여 알부민이 첨가된 경우와 첨가되지 않은 경우 CTR의 일일 1회 요법의 효과를 비교해 보고자 하였다. 재료 및 방법 : Penicillin 감수성(SM24), 중간내성(SM47), 내성(SM60)주를 대상으로 2-구획 시험관내 약역학 감염모델을 적용하였다. CTR 주입은 2 g씩 24시간마다로 사람의 약동학을 모의하였다. 알부민은 모델에서 4g/ dL가 유지되도록 하였다. 살균효과는 0, 2, 4, 6, 24, 30, 48시간째 집락수 변화로 측정하였다. 결과 : 모든 균주에서 알부민이 첨가되지 않은 경우 6시간 이내에 살균력이 관찰되었다. 최저억제농도 및 알부민 첨가유무에 관계없이 3주 모두 24시간째 살균력이 관찰되었고, 48시간째는 모두 측정한계 이하의 집락수로 감소하였다. 전 실험과정에서 CTR에 대한 내성주는 출현하지 않았다. 결론 : CTR의 일일 1회 요법은 알부민이 첨가되었을 때, 감수성, 중간내성, 내성주 모두에서 살균력 발현이 지연되었으나 최종효과는 알부민이 없을 때와 다르지 않았다. 앞으로 알부민 결합효과와 관련된 기초적인 추가 연구가 필요할 것으로 생각된다. Background : During the era of increasing penicillin resistant Streptococcus pneumoniae, it is important to have knowledge about adequate dosage and dosing interval of ceftriaxone (CTR). We examined efficacies of once-daily CTR and compared results in an in vitro pharmacodynamic infection model (IVPDIM) supplemented with albumin and those without albumin. Methods : Using three clinically isolated S. pneumoniae that were susceptible (SM24), intermediate (SM47) and resistant (SM60) against CTR, we utilized a two-compartment IVPDIM. CTR 2 g was administered intravenously every 24 h. Human albumin was added with concentration of 4 g/dL. Samples were removed at multiple time points over a 48-h period to determine the colony counts. Results : In SM24 and SM60, bactericidal effects were observed within 6 hours in groups without albumin. The number of colonies during 1st 6 hours were more decreased in albumin-free groups than in albumin-supplemented groups (P<0.05). In SM47, similar results were found during 1st 6 hours (P=0.03). But, regrowth was observed in albumin supplemented group at 30 h. Irrespective of results of minimal inhibitory concentrations and albumin supplementation, bactericidal effects were shown at 24 h in all 3 strains. All groups were decreased below the detection limit at 48 h. Development of resistance was not detected throughout the entire study period in either strain. Conclusions : Although extents of killing in albumin supplemented broth of once-daily CTR dosing were delayed in all 3 strains compared with those of albumin free broth, final efficacies were not different between the two groups.

뇌동정맥기형에 관한 임상적 연구 : 187례의 임상분석 Clinical Analysis of 187 Cases

이지영,이상형,오창완,한대희 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.10

In an effort to understand the clinical symptomatology of intracranial arteriovenous malformations(AVMs), to determine their best management policy, and to accumulate our clinical data, a retrospective clinical analysis of 187 patients with intracranial AVMs which were diagnosed by neuroradiological studies or histopathologically was performed during the period from January 1983 to May 1994. Among the 187 patients of whom four patient with dural type AVM and eight referral Patients were excluded, 120 patients were treated surgically and the other 55 patients, managed conservatively. The outcome of all patients were analysed and their post-ictal status was followed for an average of 31.7 months. The results were as follows : 1) The peak incidence of intracranial AVMs was in the third decade(mean age 28.9 years) followed by the second decade and the fourth decade. The male to female ratio was 1.9:1. 2) The presenting symptoms were mainly Intracranial hemorrhage(50.3%), seizure(33.2%) and headache(9.6%). Among the types of intracranial hemorrhage, intracerebral hematoma was the most frequent, and of the seizure type, generalized seizure was seen most frequently. 3) The locations of intracranial AVMs were hemispheric(78%), deep seated(14%), posterior fossa(6%), and dural(2%). 4) The presenting symptoms of intracranial hemorrhage and seizure depended significantly on the size of the AVM; 71% of small AVMs(<3cm) presented with hemorrhage, while 53% of large ones(> 6cm) presented with seizure. 5) The rate of rebleeding was 21%(20 of 94) and the associated mortality rate was 5%(1 of 20). 6) Concomitant aneurysms were found in 14 cases(7.5%). 7) In surgically treated cases, the mortality rate was 2.5% and its morbidity rate, 26.7%. In conservatively treated cases, the mortality rate was 3.6% and its morbidity rate, 27.3%. 8) The clinical outcome of children was similar to that of adults. 9) Patients with seizures showed a bitter outcome than those with hemorrhages and the clinical outcome did not depend on the methods of treatments in either patients with hemorrhages or those with seizures. 10) With respect to the Spetzler-Martin grade, the surgical outcome improved significantly as the grade became lower. 11) There was a marked tendency for postoperative neurological deficits to improve with time during the mean follow-up period(31.7 months). As such, early morbidity rate was 50% and late morbidity rate decreased to 26.7%. 12) Preoperative embolization was effective for a safe surgical removal of the AVMs with a poor grade. 13) Of the patients who did not have seizures before surgery, 7.9%(6/76) had late seizures in whom all were not well controlled with medication. Of the patients who had seizures before surgery, 82.9%(29/35) were either cured or controlled with medication.

3년간 계속 재발을 보이는 ENL 증례 1예

이지현,최현성,임철완 대한나학회 2003 대한나학회지 Vol.36 No.2

국내 의료기관의 항생제 사용 실태와 규제 시스템 조사

방지환,송경호,박완범,김성한,조재현,김홍빈,김남중,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 이전 연구들에 따르면 아직까지 국내에서 불필요한 항생제 사용은 무시할 수 없는 수준이며, 특히, 수술환자들에 대한 예방적 항생제 투여가 문제로 지적되고 있다. 많은 병원에서 불필요한 항생제 처방을 제한하려는 노력을 하고 있지만 구체적인 현황에 대한 자료는 적은 실정이다. 이에 본 연구자 등은 국내 의료기관의 항생제 규제 시스템의 현황과 수술시 예방적 항생제 사용의 적정성을 알아보고자 한다. 재료 및 방법 : 전임 감염내과 전문의가 근무하는 의료기관 55곳에 대해 설문조사를 시행하였다. 설문의 내용은 적정한 항생제 사용을 유도하기 위한 정책 및 규제 프로그램, 실제 각 의료기관의 예방적 항생제 사용 현황 등으로 이루어져 있다. 결과 : 55개의 의료기관에 보낸 설문 중 44개가 회수되었다. 회신한 의료기관에서 항생제 처방 관리는 제한항생제 시스템을 가장 많이 이용하고 있었고(95.5%), 항생제에 대한 교육(79.5%), 전산시스템에서 관리(59.1%), 감염내과에 의뢰(54.5%), 항생제 사용 실적 검토(52.3%) 등의 순이었다. 대개의 병원에서 glycopeptides (100.0%), carbapenems (93.0%), quinupristin/dalfopristin 또는 linezolid(93.0%), 4세대 cephalosporin (74.4%), caspofungin 또는 voriconazole (62.8%), liposomal amphotericin B (60.5%) 등을 제한항생제로 분류하여 관리하고 있었다. 모든 의료기관에서 위절제술 및 유방절제술시에 불필요하게 예방적 항생제를 사용하고 있었다. 슬관절치환술의 경우 2세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았으며(30.2%), 관상동맥우회술의 경우 3세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았다(47.2%). 예방적 항생제의 투여 기간을 살펴보면 위절제술시 70.5%에서 4일을 초과하여 사용하고 있었고, 유방절제술시에는 63.6%에서, 슬관절치환술시에는 81.8%에서, 관동맥우회술시에는 81.1%에서 4일을 초과하여 장기간 예방적 항생제를 투여하고 있었다. 한편, 예방적 항생제 투여시 aminoglycoside계 항생제를 병용하는 경우도 많았다. 결론 : 아직까지 국내 의료기관에서 항생제 오남용을 막기 위한 노력이 더 필요할 것으로 생각되며, 특히 수술시 예방적 항생제의 올바른 투여에 많은 관심이 필요하다. Background : Previous studies in Korea showed that unnecessary antibiotic use could not be neglected, especially in prophylactic use. Currently many hospitals employ diverse antibiotic stewardship programs, but there are few studies on surveillance of such programs. So, we planned this study to evaluate current status of antimicrobial stewardship and adequacy of antimicrobial prophylaxis in surgery. Materials and Methods : We sent questionnaires about policy on antibiotic usage, control program for adequate antibiotic prescription, and actual status of prophylactic antibiotic usage to 55 infectious disease physicians in each hospital. Results : Of 55 contacted infectious diseases clinicians, 44 answered the questionnaire. Majority of hospitals employed restricted antimicrobial system (95.5%), education (79.5%), control by order communicating system (59.1%), consult to infectious disease physicians (59.1%), and review of cumulative antimicrobial usage (52.3%) to prevent inadequate antibiotic use. Glycopeptides were designated as a restricted antimicrobial agent in 100.0% of hospitals; carbapenems, 93.0%; quinupristin/ dalfopristin or linezolid, 93.0%; the 4th generation cephalosporins, 74.4%; caspofungin or voriconazole, 62.8%; liposomal amphotericin B, 60.5%, and so on. Unnecessary perioperative prophylactic antimicrobial agents were prescribed in gastrectomy and mastectomy in all the hospitals. The second generation cephalosporins and the third generation cephalosporins were the most commonly prescribed prophylactic antimicrobial agents in total knee replacement arthroplasty (TKRA) and coronary artery bypass graft surgery (CABG) respectively. In 70.5% of institutes they use prophylactic antimicrobial agents more than four days in gastrectomy; 63.6% in mastectomy; 81.8% in TKRA; 81.1% in CABG. Unnecessary combination of aminoglycosides with other antimicrobial agents for prophylactic use was another common problem. Conclusion : This study shows that more effort is required to diminish antimicrobial misuse or overuse, especially in prophylactic use for surgical patients.

철봉 내리기 공중 동작의 운동학적 분석(I)

최지영,김용이,진영완 한국운동역학회 2002 한국운동역학회지 Vol.12 No.2

본 연구는 철봉운동에서 기본이 되는 동작인 몸펴 한번 뒤돌아 내리기 동작을 단계적으로 분석한 후, 이를 토대로 하여 현재 시합상황 중 가장 널리 사용되는 응용동작인 몸펴 두 번 뒤돌아 내리기 동작과 몸펴 두 번 뒤돌며 한번 비틀어 내리기 동작의 운동학적 분석을 수행하여 개개분절 간의 상호작용을 해부학적 3차원 각운동과 각속도로 설명하고 이해할 수 있는 운동학적 자료를 제시하는데 있다. 피험자들은 현재 K대학교에 재학중이며 대학 대표선수인 남자 기계체조 선수 7명을 선정하였으며, 연구에 사용된 인체의 모델은 Zatsiorsky와 Seluyanov(1983, 1985)이 사용한 16개의 분절로 이루어진 인체의 모델을 사용하였다. 신체무게중심이 이동방향을 설명할 수 있는 투사각도 및 투사속도는 공중동작의 회전수가 증가할수록 신체무게중심이 투사되는 각도가 증가되며, 이렇게 증가된 신체무게중심의 투사각도는 신체무게중심의 최고점을 증가시키는 경향을 보였다. 3차원 투사속도를 살펴본 결과 Z방향(수직방향)은 공중돌기 회전수가 증가할수록 증가하는 경향이 나타났으나, 운동진행 방향인 Y방향 속도와 좌우측 기울기를 설명할 수 있는 X방향 속도에서는 의미 있는 차이를 보이지 않았다. 철봉 내리기 공중동작에서의 신체분절 및 각도 변화도 중요하지만 각운동량을 만들어내기 위한 동작준비구간의 각도 변화가 더욱더 중요하다고 할 수 있다. 즉, 상체가 철봉 아래 봉과 수직될 때부터 릴리즈 순간까지의 각도 변화에 주목해야 하는 데, 회전수가 증가할수록, 어깨관절 각도와 엉덩관절 각도 변화가 두드러지게 나타나 준비구간의 추기기 동작(Whip swing)의 주된 관절로 작용을 한다. 관성좌표계에 대한 상체의 움직임을 나타내는 3차원 방향의 각도 즉, 뒤돌기(somersault)각도, 틀기(twist)각도 그리고 기울기(tilt)각도로 설명이 되는데, 본 연구의 결과 릴리즈시 뒤돌기 각은 세가지 내리기 동작 유형에 따라 평균 57,7도, 38.8도 그리고 39.7도로 나타났으며, 기울기 각은 평균 -1.5도, -5.4도 그리고 -8.4도로 유의한 차이를 보이고 있으며, 틀기각도는 평균 13.4도, 10.6도 그리고 23.3도로 몸펴 두번 뒤돌며 한번 비틀어 내리기 경우 가장 큰 수치를 나타냈다. The purpose of this study was to investigate the relations between the segments of the body, the three dimensional anatomical angle and the angular velocity of the air born phase and understand the control mechanism of the high-bar movement, the somersault, the double somersault, the double somersault with full twist. For this study seven well trained university gymnastic volunteered, Zatsiorky and Seluyanov(1983, 1985)' sixteen segment system anatomical model was used for this study. For the movement analysis three dimensional cinematographical method(Arial Performance Analysis System : APAS) was used and for the calculation of the kinematic variables a self developed program was used with the LabVIEW 5.1 graphical profromming(Johnson, 1999) program. By using Eular's equations the three dimensional anatomical Cardan angles of the joint and angular velocity were defined. 1. As the rotation of the body increased in the air born phase the projection angle of the CM of the total increased, this resulted the increased of the max hight of the CM. 2. In three dimensional angular velocity the Z axis(vertical direction) projection angular velocity increased as the rotation of the body increased in the airborn phase, but the Y axis and the X axis projection angular velocity did not show significant differences. 3. As the rotation of the body increased in the air born phase the angular movement of the shoulder and the hip showed significant change. These movement act as the starter in the preparation phase. 4. The somersault angle, the twist angle, the tilt angle of the upper body related to the global reference frame in the releas phase the average somersault angle of the three types of high-bar movement was 57.7˚ , 38.8˚ , 39.7˚ , the average tilt angle was -1.5˚ , -5.4˚ , -8.4˚ , the average twist angle was 13.4˚ , 10.6˚ , 23.3˚ . This result showed that the somersault with full twist had the largest movement.