• Clinical and Experimental Pediatrics
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• 제51권11호
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• pp.1211-1216
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• 2008

목 적: DBA는 적혈구 저형성증, 선천성 기형, 그리고 암으로 진행할 수 있는 가능성을 지닌 드문 유전성 질환이다. Corticosteroid와 수혈이 주된 치료이다. 본 연구에서는 16년 동안 경험했던 6명의 환아의 임상양상, 혈액학적 특징, 치료 및 경과에 대해 기술하고자 한다. 방 법: 1992년부터 2008년까지 전남대학교병원에서 DBA로 진단 받은 6명의 환아의 의무기록을 후향적으로 고찰하였다. 결 과: 6명 중 3명의 환자는 남아였고, 진단 당시 나이는 2개월에서 18개월(중앙값, 5.5개월)사이였다. 4명의 환자에서 선천성 심장기형이 동반되었고, 그 외 기형으로 다지증이 2명, 사시가 1명에서 발견되었다. 수혈은 2회에서 8회까지 시행되었으며, 진단 후 모든 환자는 스테로이드로 치료를 시작하였다. 치료 시작 후 혈색소 수치가 9 g/dL 이상으로 반응을 보인 시기의 중앙값 12.5일(범위, 7-22일)이었다. 치료 시작 후 3명의 환자는 스테로이드 투약을 점감한 후 투약을 중지하였고, 3명의 환자에서 최소량의 prednisolone (${\leq}5mg$/일)로 투약을 지속하고 있다. 환자들의 추적 관찰기간의 중앙값은 14년이며 추적 관찰 중 저신장을 제외하고 스테로이드와 관련된 부작용이나 암의 발생은 발견되지 않았다. 결 론: DBA 환자의 대부분 스테로이드 치료에 반응을 보이며 저용량으로 혈색소 수치를 유지할 수 있다. 하지만 스테로이드의 장기복용으로 인한 부작용 및 심장기능, 암의 발병 등에 대한 보다 적극적인 추적관찰이 요구되고, 국내 DBA 환자들에 대한 대단위 연구도 병행되어야 할 것으로 생각된다.

• Journal of Preventive Medicine and Public Health
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• 제6권1호
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• pp.133-160
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• 1973

1. Introduction Community medicine with the concept of comprehensive medical care and an ideal medical care delivery system not only for an individual or family but for the whole community has emerged. In April 1970, the Presbyterian Medical Center started a hospital based community health service project in order to improve the health of the people in rural areas. Prior to commencing a comprehensive medical care system, a family survey was needed. The major objective of this survey was to obtain information concerning the people and their environment so as to be able to plan and implement a comprehensive medical care program in Soyang-Myun. 2. Survey Method An interview using a family record form was carried out for each household. This family record form was designed to get information about demography, family planning, environmental sanitation and vital statistics. Prior to beginning, the members of the survey team were trained in interviewing techniques for three days. The team consisted of a public health nurse, four nurse-aides, a sanitarian and four health extension workers who are working in our project, The survey was carried out during the period November 1971 to March 1972. 3. Project area 1) Population of Soyang-Myun was 11,668; male, 5,962 and female, 5,706. Sex ratio: 104.5. 2) Households : 1,858 3) Family size: The average household consisted of 6.3 persons. 4) Educational level of householder a. Illiterate 13% b. No schooling but able to read 10% c. Preschool children 19% d. Primary school 47% e. Middle school 7% f. High school 3% g. College or University 1% 5) Occupational distribution of householders a. Farmer 67% b. Laborer 13% c. Office worker 4% d. Merchant 4% e. Industrial worker 2% f. Unemployed 8% g. Miscellaneous 2% 6) Religious affiliation a. No religion 74% b. Buddhist 12% c. Protestant 10% d. Catholic 4% 4. Survey results Living Environment : a. Home ownership 95% b. Kinds of roofing Straw-thatched house 84% Tile-roofed house 10% Slate-roofed house 5% Other 1% c. Floor space Less than 6 pyong 10% 6-10 pyong 53% 11-15 pyong 24% 16-20 pyong 9% More than 20 pyong 4% d. Radio ownership 80% Environmental Sanitation : a. the source of drinking water public well 49% private well 30% drainage water 9% steam water 8% well pump 3% water distribution system 1% b. Distance between well and toilet more than 16meters 38% 6-10 meter 31% 11-15 meters 14% Less than 6 meters 17% c. The status of well management Bad 72% Fair 26% Good 2% d. General sanitary state of house Bad 37% Fair 51% Good 12% e. House drainage system had no house drainage. 77% Family Planning : a. 24% of the people have used contraceptives, but 12% ceased to use them. 76% have never used contraceptives. b. used methods 1oop 68% oral pill 16% vasectomy 4% condom 1% tubal ligation 1% two or more methods 10% Maternal Health : a. The number of conceptions of housewives under 50 years of age. 11 times 26% 6 times 11% 5 times 11% 4 times 9% b. The place of delivery own house 88% hospital 1% others 11% Treatment of general sickness : a. The place of treatment Soyang Health Center 31% Hospital (private or otherwise) 26% Pharmacy 14% Herb medicine 5% Private care 5% No treatment 12% Miscellaneous 7% b. Usual causes of diseases Unknown 46% Tuberculosis 29% Neuralgia 8% CVA 3% Bronchitis 3% Others 11%

• 대한장애인치과학회지
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• 제13권1호
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• pp.37-42
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• 2017

본 증례는 유구치부의 치아우식증을 주소로 내원한 누난 증후군 환자의 전신마취 하 치과치료에 대한 보고이다. 누난 증후군 환자의 특징적인 안모가 관찰되었으며, 높은 아치형의 구개와 작은 턱이 관찰되었다. 성장 지연, 발달 지연, 가슴 기형, 언어 지연을 보였다. 누난 증후군 환자는 다양한 전신질환을 동반할 수 있으므로, 치과 치료 시 전신적인 상태에 대한 고려가 필요하며 이와 더불어 행동 문제를 보이는 경우가 많아 행동 조절에 대해 고려해야 한다. 누난 증후군 환자의 전신마취 시 기도 문제, 심폐 기능의 손상 등이 문제가 될 수 있으므로, 이에 대한 평가가 필요하다.

• Childhood Kidney Diseases
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• 제3권1호
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• pp.11-19
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• 1999

목 적 : 소아의 미세변화형 신증후군은 원발성 신증후군의 $85\%$이상을 차지하며, 스테로이드 치료로 완전관해가 잘오는 예후가 양호한 질환이다. 그러나 이와 같은 미세변화형 신증후군의 전형적 임상양상은 2-10세에서 주로 나타나며 임상증상과 치료반응이 발병연령이 증가하면서 변화를 보이는데 성인기에는 원발성 신증후군중 비교적 낮은 빈도를 보이며 소아기에 비해 치료에 대한 예후가 불량한 것으로 알려져 있다. 따라서, 본 연구에서는 소아기와 청소년기 미세변화형 신증후군의 임상양상의 차이를 비교하여 청소년기 미세변화 신증후군 환자의 치료에 도움이 되고자 하였다. 방 법 : 미세변화형 신증후군으로 치료받은 216명의 환아를 대상으로 발병연령에 따라 12세미만인 환아군(소아군) 188명과 12세이상 18세미만인 환아군(청소년군)28명으로 구분하여 두 군간의 임상양상의 차이를 비교하였다. 결 과 : 1) 대상기간중 전체 원발성 신증후군은 소아군이 245명, 청소년군이 55명으로 총 300례 였다. 소아군에서는 MCNS 188명($77\%$), FSGS 30명($12\%$), MsPGN 4명($1.6\%$)이었고, 청소년군에서는 MCNS 28명($51\%$), FSGS 12명($22\%$)으로 두 군에서 청소년군에서 MCNS의 빈도가 감소한 반면 FSGS의 빈도는 증가하였다. 2) 평균발병연령은 소아군이 $4.7{\pm}2.7$세, 청소년군이 $14.7{\pm}2.0$세였고 두 군간의 남녀비는 소아군 3.8:1, 청소년군 2.5:1로 차이가 없었다. 3) 혈뇨가 동반된 경우는 소아군 $17\%$, 청소년군 $39.3\%$로 유의한 차이가 있었고(P=0.005),고혈압은 각각 $0.5\%,\;7\%$로 차이가 있었으나 통계학적으로는 의미있는 차이를 보이지는 않았다. 4) 검사소견상 발병당시 24시간 뇨단백량, SPI, albumin, BUN, cholesterol치는 두 군간에 유의한 차이가 없었다. 5) 소아군의 $11.7\%$, 청소년군의 $14.7\%$가 초기 스테로이드 치료로 재발없이 관해가 유지되었으며, 빈발재발형은 각각 $23.9\%,\;14.7\%$, 스테로이드 의존형은 각각 $21.8\%,\;28.6\%$. 스테로이드 저항형은 각각 $13.3\%,\;14.7\%$로 나타났으나 의미 있는 차이는 없었다. 6) 스테로이드 이외의 면역 억제제가 필요했던 경우는 소아군은 $57\%$, 청소년군은 $65\%$였다. 7) 평균재발횟수($0.8{\pm}0.84$회/6개월 Vs $0.8{\pm}0.79$회/6개월) 및 관해에서 첫 재발까지의 기간은($7.7{\pm}8.4$개월 Vs $4.9{\pm}5.8$개월) 두 군간에 의미 있는 차이는 없었다. 결 론 : 소아 미세변화형 신증후군의 임상양상의 비교에서 혈뇨의 빈도는 청소년 환자군에서 의미 있게 높았다. 스테로이드 의존형과 빈발재발형의 비율, 재발의 빈도는 청소년환자군에서 비교적 높게 나타나 치료에 대한 반응성이 떨어지는 양상을 보이므로 청소년기 미세변화형 치료에 있어서 이러한 문제들이 인식되어야 하고 보다 적극적인 면역억제제의 선택이 고려되어야 할 것이다.

• Pediatric Infection and Vaccine
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• 제10권2호
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• pp.208-214
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• 2003

목 적 : 소아에서의 세균성 수막염은 아직도 높은 사망률과 합병증을 나타내는 질환으로, 최근에 내성균의 증가 및 Hib 백신의 보급으로 항생제 치료 효과와 호발 원인균의 변화가 예상되고 있다. 이에 저자들은 최근 7년간 인하대학교병원에 입원하여 세균성 수막염으로 진단 받은 환아를 조사하여 세균성 수막염 환아의 역학 및 동향을 이해하는데 도움이 되고자 한다. 방 법 : 1996년 6월부터 2003년 6월까지 인하대학교병원 소아과에 입원하여 세균성 수막염으로 진단된 43명을 대상으로 하였다. 이들은 뇌척수액 세균배양 검사에서 양성인 31명과 뇌척수액 latex 응집검사로 세균 항원을 진단한 7명, 그리고 뇌척수액 생화학적 소견 및 혈액배양검사에서 양성인 5명이었다. 결 과 : 1) 2개월 미만은 19례(44.2%), 2개월 이상 1세미만은 10례(23.3%), 1세 이상 15세 미만은 14례(32.5%)로 1세 미만이 67.5%로 대부분을 차지하였고, 남녀 성비는 2.6 : 1이었다. 2) 2개월 미만의 원인균주는 19례로 GBS 9례(47.4%), E. coli 4례(21.1%), Klebsiella pneumoniae 4례(21.1%)의 빈도였고, 2개월 이상은 24례로 S. peumoniae 12례(50%), H. influenzae 4례(16.7%), N. meningitidis 4례(16.7%)가 흔한 균주였다. 3) H. influenzae 뇌막염은 5례로 모두 Hib 접종을 안한 환아였고, 2001년도 이후에는 발생이 없었다. 4) 사망한 경우는 2례(4.5%)로 H. influenzae, Klebsiella pneumoniae였으며, 생존한 41례 중 16례(39%)에서 뇌실염 및 수두증, 경막하 삼출, 간질, 뇌경색 등의 합병증을 남겼다. 5) 합병증이 없었던 25례 중 48시간 이전에 치료를 한 경우가 18례(72%)였고, 합병증이 있었던 16례 중 14례(87.5%)에서 모두 48시간 이후에 치료를 한 경우였다. 6) S. pneumoniae 전례에서 penicillin에 내성을 보였으며, ceftriaxone에는 50%의 민감성을 보였다. GBS에서는 ceftriaxone에는 100%의 민감성을, penicillin에서는 44.4%의 민감성을 보였으나 전례에서 penicillin에 반응을 보였다. 결 론 : 세균성 수막염의 예후인자로 치료시기가 중요한 결정인자였고, Hib 백신이 보급되기 시작한 이후 H. influenzae에 의한 수막염의 발생이 감소하였다.

• 한국학교ㆍ지역보건교육학회지
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• 제9권1호
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• pp.47-61
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• 2008

Objectives: This study examined to explain the practical health behaviour and health-related quality of life, and their influencing factors in high school students. Methods: Total of 718 high school students from 1 school in Seoul were assessed with a self-administered questionnaire regarding general characteristics, health related characteristics, obesity index(Height and weight calculated by using the relative weight law: obesity group>20%, overweight group $10{\sim}20%$, normal weight group $-10{\sim}10%$, under weight group <-10%), health behaviour in school-aged children(eating, exercise and weight control) and health-related quality of life(PedsQLTM4.0 Generic Core Scale: physical health, emotional functioning, social functioning, school functioning). Results: Major results were as follows. 1. The rate of obesity by obesity index was 5.3% of high school students. Obesity incidence in adolescents was mainly associated with gender and parents whether obesity. 2. Perceived health status was lower in obese adolescents than in normal adolescents. 3. The rate of miss a breakfast was 37.9%, and obesity group than normal weight group were fruits, vegetables and milk intake at least, a lot of fastfood intake. During the past week, followed by intense physical activity, and overweight consumed a lot of time for TV and the Internet. Overall, under weight group and normal weight group belong to the students evaluated fatter than themselves. Weight control for weight loss, gain and maintain was grater in obesity group than in normal weight group. Weight loss showed highest scores in overweight group which appeared significant difference. 4. Obese adolescents compared with other groups, reported lower total QOL score and all QOL in domain, and especially social functioning showed significant differences. 5. Factors influencing the adolescents's QOL were found to be gender, perceived health status and exercise. Conclusions: High school girls were aware of their bad health status and likely to improve the QOL by practicing health behaviour. But obese adolescents were likely to degrade the quality of life by reducing the practice of health behaviors. So further school-based education about proper practical health behaviors and obesity prevention is necessary.

• 한국환경교육학회지:환경교육
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• 제11권2호
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• pp.118-129
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• 1998

This survey is made to offer the fundamental data for the establishment of practical environmental education plan based on understanding of the change of the environmental awareness of elementary school students under the longitudinal-sectional research design. In this research, the questionnaire made by Kim Jong-ki in 1988 and by Kim Hak-Bong in 1993, is amended and filled up, which is used to the 624 numbers of fifth and sixth grade students lived in Seoul, Pyungtaek and Yangjugu. This research ares are devided into 5 ares which are the environmental general, environmental pollution, living environment, environmental education and consciouness of environmental crisis to humen beings. First, it is grasped general tendency and then is compared and analyzed the level of awareness by residence, sex, grade. stsdard of living parental academic, the background variation of parental job with the status in 1988 and 1933. The results are as follows: 1) The rate of interest for environmental pollution and population is reduced but the rate of interest for animal protection is increased. 2) In spite of reinforcement of environmental education In school, the numbers of the students who became to know some information about that from the class are diminished. 3) Even if the children are aware of sewage seriousely, the numbers of the students who answer it is caused by domestic sewage are a few. 4) On the environmental education area, the various materials of the are not utilized well in a class. 5) On the environmental crisis to the human beings the rate is much increased in 1993 ttan that of 1988 environmental contamination is the important cause of the human beings' crises but now the rate is reduced again. In other variables except the environmental contamination, it is increased the that of 1993 on the war, on population it is showed a tendency of reduction. The results of this study are as follows : 1) It is supposed that the education should be done only not for the knowledge of environmental education but for the practice of that - animal breeding, field experience of the ecological destruction places. 2) The various environmental education materials such as TV, VTR are demanded to give the students proper information about that and to educate sufficently. 3) The course of fields exploration for environmental education should be prepared under cooperation of the authorities concerned. 4) It has to be groped for an epoch-making teaching method and the training and the practice of teachers in order to reform environmental pollution.

• 복식문화연구
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• 제18권4호
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• pp.670-686
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• 2010

This study aims at clarifying the action types of skin management which is base on age, marriage or not, family composition, school career, and income which are demographic variables centering around the lifestyle of middleaged and old age women. As for study method, this researcher executed literature study and questionnaire on adult women over 45 years old who dwell in Seoul and Kyounggi area. Survey period was Mar. 1, 2009 to Jun. 30. And, after distributing 1,000 copies of questionnaire, this researcher used effective 869 copies of questionnaire for analysis out of collected questionnaire, 895 copies. As for analysis method, this researcher executed DUNCAN test with factor analysis, reliability analysis, manin component analysis, K-average, multitude analysis, dispersion analysis and post verification by using SPSS 12.0 program. As for demographic feature for middle aged and old age women, 50~59 years old women were most by age as 302 persons(33.7%). It is emerging that spouse existence is very high as 674 persons(75.3%) in the answer for marriage or not, couple family to live with unmarried children is very high as 483 persons(54.0%) in the answer for family composition, leaving high school in mid-course or gradation of high school are very high as 356 persons(39.8%) in the answer for school career, income from 3 million Won under 4 million won is very high as 260 persons(29.1%) in the answer for monthly income of family members, and women to use under 50 thousand won is very high as 510 persons(57.0%) in the monthly average expense to be used for skin management. In this study, this researcher extracted total 5 factors (economic saving, displaying consumption, confidence inclination, centering around family, and leisure application) by executing factor analysis with 12 question items of lifestyle so as to grasp factor structure of lifestyle of middleaged and old age people, and whole explanatory variable quantity was 70.9%. This researcher named as economic saving type, diplaying consumption style, and type centering around leisure and family, after making multitude analysis about 5 factors analyzed by measuring lifestyle feature. As the result of structure analysis of question items of skin management(pursuit of skin management, life of skin management, and inclination of skin management), this researcher extracted total 3 factors, and whole explanatory variable quantity was 71.30%. Thus, it emerged that there is significant difference among groups.

• 대한소아치과학회지
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• 제49권1호
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• pp.104-112
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• 2022

이 연구의 목적은 생리적 조건에서 파절편 재부착 시 레진재료 및 유지형태에 따른 파절편의 파절저항성을 분석하는 것이다. 발거된 64개의 전치부 치아에 사선 방향의 단순치관파절을 재현하였다. 복합레진 재료에 따라서는 유동성 복합레진 및 응축형 복합레진을 이용하여 재부착을 실시하였다. 유지형태로는 단순 재부착, 1.0 mm × 1.0 mm 순측 chamfer bevel, 1.0 mm × 1.0 mm 설측 chamfer bevel 및 1.0 mm × 1.0 mm circumferential chamfer bevel을 부여한 후 재부착을 실시하였다. 만능재료시험기를 이용하여 재부착된 치아의 설측면에 정상 아동의 절치간각인 125°로 부하를 가하였다. 저작압 조건에서는 유동성 레진과 응축형 레진군 모두 설측 chamfer군의 파절저항강도는 28.28 ± 7.41 MPa과 27.54 ± 4.45 MPa로 단순 재부착군의 파절저항성강도인 17.21 ± 5.87 MPa과 20.10 ± 6.00 MPa보다 유의하게 더 높았다. 생리적인 저작압과 유사한 설측 방향의 힘을 고려 시 파절편 재부착치의 파절편 유지력은 단순 재부착술보다 설측 chamfer 유지형태를 형성하였을 때 유의하게 더 큰 유지력을 나타내었다. 이에 임상가는 파절편 재부착술 시 저작압에 대한 파절 저항성을 향상시키기 위해 설측 chamfer 유지형태의 설계를 고려할 수 있을 것이다.

• 한국식생활문화학회지
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• 제13권4호
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• pp.293-305
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• 1998

According to economical status, under-nutrition and over-nutrition coexist in preschool children in Korea. Subjects consumed more than RDA in most nutrients, and children in of the upper income class tended to have more nutrients than those of the low income class. Especially in case of energy, protein, fat, vitamin $B_2$, and P there were significant differences among the different classes. The mean calorie compositions of carbohydrates, protein and fat were $57{\sim}59:\;16{\sim}17:\;26{\sim}27$ and fat calorie percentage was higher than quantity recommended for Korean adults. Energy, protein, Fe, vitamin A, $B_1$ and C intakes were taken mostly from plant food sources. In the upper income class group, intakes of protein and vitamin $B_2$ from animal food sources were higher than in any other income classes. Intakes of iron, vitamin A, $B_1$ and C were largely provided by plant food group. Especially 44-45% of vitamin A were taken from vegetable and fruits group, which indicated that about 50% of vitamin A intake was the form of ${\beta}-carotene$. Also compared with other groups, in the upper income class group, the intakes of energy, protein, Ca, p, vitamin $B_1$ and vitamin $B_2$ from cereal and potatoes were significantly lower, and those of Ca and P from milks and meats, fishes & eggs were significantly higher(p<0.05). The mean fat intake in all subjects was $38{\sim}43g/day$. Regardless of income class, oleic acid($6.6{\sim}8.4g$) and linoleic acid($6.7{\sim}8.1g$) were the most abundant fatty acids contained in the diet. The upper class group consumed significantly more total saturated fatty acids and total monounsaturated fatty acids(p<0.05). In polyunsaturated fatty acids, there were no differences between 3 different income classes, but intakes of total ${\omega}6$ fatty acids in the upper class tended to be higher and those of total o3 fatty acids in low class tended to be higher. Therefore, ${\omega}6/{\omega}3$ tended to be higher in the upper class group. Regardless of income classes, P/M/S and ${\omega}6/{\omega}3$ ratios in all subjects were $0.9{\sim}l.3/1.0{\sim}1.1/1.0$ and $5.2{\sim}7.4/1.0$, respectively and were in a desirable range. Cholesterol intake of subject was 184-218 mg/day, which was comparable to the value of Korean adult intake.