• 제목/요약/키워드: Health states

검색결과 1,108건 처리시간 0.025초

정신질환자의 타해(他害)사고와 의료과오책임 (Psychotherapist's Liability for Failure to Protect Third Person)

  • 손흥수
    • 의료법학
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    • 제11권1호
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    • pp.331-393
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    • 2010
  • Psychiatrists who treat violent or potentially violent patients may be sue for failure to control aggressive outpatients and for the discharge of violent inpatients. Psychiatrists may be sued for failing to protect society from the violent acts of their patients if it was reasonable for the psychiatrists to have known or should have known about the patient's violent tendencies and if the psychiatrists could have done something that could have safeguarded in public. The courts of a number of jurisdictions have imposed a duty to protect the potential victims of a third party on persons or institutions with a special relationship to that party. In the landmark case of Tarasoff v Regents of University of California, the California Supreme Court held that the special relationship between a psychotherapist and a patient imposes on the therapist a duty to act reasonably to protect the foreseeable victims of the patient. Under Tarasoff, when a therapist has determined, or under applicable professional standards should determine, that a patient poses a serious threat of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. In addition to a Tarasoff type of action based on a duty to warn or protect foreseeable victims of psychiatric outpatients, courts have also imposed liability on mental health care providers based on their custody of patients known to have violent propensities. The legal duty in such a case has been stated to be that where the course of treatment of a mental patient involves an exercise of "control" over him by a physician who knows or should know that the patient is likely to cause bodily harm to others, an independent duty arises from that relationship and falls on the physician to exercise that control with such reasonable care as to prevent harm to others at the hands of the patient. After going through a period of transition, from McIntosh, Thompson and Brady case, finally, the narrow rule of requiring a specific or foreseeable threat of violence against a specific or identifiable victim is the standard threshold or trigger element in the majority of states. Judgements on these kinds of cases are not enough yet in Korea, so that it may be too early to try find principles in these cases, however it is hardly wrong to read the same reasons of Tarasoff in the judgements of Korea district courts. To specific, whether a psychiatric institute was liable for violent behavior toward others depends upon the patients conditions, circumstances and the extent of the danger the patients poses to others; in short, the foreseeability of a specific or identifiable victim. In this context if a patient exhibit strong violent behavior toward others, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly attack others or unidentifiable victim. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only requires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. All these principles have been established in cases of the U.S.A and Japan. In this article you can find the reasons which you can use for psychotherapist's liability for failure to protect third person in Korea as practitioner.

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특약매입과 콘사인먼트 비교분석 (A Comparative Analysis of Teukyakmeip and Consignment)

  • 김동호;김성수;정명희;윤명길
    • 유통과학연구
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    • 제12권4호
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    • pp.5-9
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    • 2014
  • Purpose - The purpose of this study was to compare and contrast the applicability and effectiveness of both teukyakmeip contracts of Korea and consignment contracts of the United State to demonstrate the effectiveness and practicability of teukyakmeip in Korea. These are popular contract agreements between large retailers and their suppliers and vendors. In recent years, teukyakmeip was critically examined and scrutinized by the politicians, the media, and the public of Korea. Consequently, this paper focusesheavily on identifying and analyzing different types of contract agreements between large retailers and their suppliers that currently exist in Korea and compares and contrasts those analyzed contract agreements with teukyakmeip. The article also comparesand contrasts teukyakmeip with the consignment agreements of the United States to identify similarities and differences. Research design, data, and methodology - This study is a descriptive study and has used personal interviews to collect and analyze the data. This study also fits the definition of the case study wherein it is entirely focused on investigating a real-life event: analyzing and examining contract agreements in the distribution industry. Both randomly selected management and vendor representatives from the three major department stores, Lotte, Hyundai, and Shinsegae, in Korea were interviewed between July and September 2013. The analysis of the consignment agreement was conducted based on existing secondary data. Results - Although the evidence of the abuse of teukyakmeip and consignment by large retailers from both countries clearly exists, the findings suggestthat both contract agreements would remain as the most relevant and effective legal contracts between large retailers and their suppliers. Based on the comparisonanalysis of teukyakmeip and consignment, both contracts indicated that suppliers are fully responsible for inventory and inventory management. If sales person is necessary for promoting special product, then suppliers are responsible for providing a sales person and their wages under both contracts. However, American department stores, those located outside urban area, tend to use their own employees to perform special product and sales promotion. The retailersare fully responsible for any interior or floor design or redesign of the retail store to accommodate the products from vendors under consignment; however, both suppliers and retailers share the cost of designing and redesigning the interior to accommodate vendors'products under teukyakmeip. Suppliers are responsible for pricing and supplying the quantity of the products under both agreements. Both contracts allow special sales commission as long as vendors agreed. Vendors use this special commissionto introduce their new products or apply market penetration strategy. Conclusions -The findings of this study showed the changing pattern of contract agreements between large retailers and their suppliers from both countries. Furthermore, this study evidently generated policy implications of teukyakmeip which recently became the major social issue in Korea and attracted many policymakers to gain political points by criticizing the teukyakmeip system and the large retailers. The findings of the study would be valuable to policy makers in making appropriate decisions and to large retailers and vendors in making beneficial agreements. The major implication of this study is that teukyakmeip and consignment agreements include very similar or almost identical characteristics, and they are popular among department stores and suppliers. The issue of abolishing teukyakmeip in Korea needs to be examined cautiously because teukyakmeip is the best one available at the moment, and the study suggests that no one benefits from abolishing this system.

EU의 관세 및 비관세 장벽 이해를 통한 EU시장 개척 방안 (A Study on the Practical Approach of European Union's Market Access through the Understanding of Tariffs and Non-Tariff Barriers in European Union)

  • 정재우;이길남
    • 통상정보연구
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    • 제16권4호
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    • pp.191-225
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    • 2014
  • 유럽연합(European Union)은 1952년 7월, 파리조약(Treaty of Paris)을 체결한 이후 1958년 1월 로마조약, 유럽공동체(EC 조약), 1993년 11월 마스트리히트 조약(Treaty of Maastricht), 1999년 5월 암스테르담 조약(Treaty of Amsterdam), 2002년 10월 니스 조약(Treaty of Nice), 2009년 12월 리스본 조약(Treaty of Lisbon) 조약을 체결하여 유럽의 정치 및 경제적 통합을 모색하여 왔다. 현재 EU는 28개 회원국을 두고 있으며 2012년 기준으로 총 5억 명 이상의 인구, 역내 GDP가 16조 6,090억 달러에 이르며 세계 GDP의 3분의 1을 차지하는 세계최대의 경제권이다. 우리나라와는 3위의 교역상대국이다. 지금까지 우리나라는 주로 EU에 자동차, 반도체, 휴대폰, 조선과 그 부품 등의 공산품을 수출하여 왔다. 그러나 EU가 최근 미국과 FTA를 적극 모색하고 러시아와도 경제 협력을 도모하며 중국 기업들도 EU로의 진출을 적극 추진하고 있어 우리 기업의 입지가 위축될 여지가 있는 실정이다. 또한 EU는 평균 수입관세율이 낮고 비교적 가장 개방된 거래 시장이지만 크고 작은 진입장벽은 상존하여 EU의 관세 및 비관세 장벽에 대한 이해가 필요하다. 이에 본 연구는 EU 시장 개척을 위한 가장 초보적이고 기초적인 연구로 EU의 관세 및 비관세 장벽(Non-Tariff Barriers)에 관해 검토하여 우리나라 기업에게 시사점을 제시하기 위해 연구되었다.

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수정에 의한 Mouse egg의 세포막전류 변화 (Changes in the inward current and membrane conductance after fertilization in the mouse eggs)

  • 홍성근;박춘옥;한재희;김익현;하대식;권종국
    • 대한수의학회지
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    • 제32권2호
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    • pp.157-164
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    • 1992
  • Changes in the both inward current and conductance of membrane by the fertilization were observed using the one microelectrode voltage clamp(or switch clamp) technique. Unfertilized eggs and both 1- and 2-cell stage eggs after fertilization were donated from the superovulated mouse (ICR, more than 6 weeks old) treated with PMSG(pregnant mare serum gonadotropin, Sigma) and HCG(human chorionic gonadotropin, Sigma) and naturally mated ones, respectively in this experiment. Membrane potential was held at -90mV and the voltage step was applied from -80mV to 50mV with interval of 10mV or 20mV for 300ms. since both of amplitudes and time courses in the membrane currents were various according to the states of cells and clamping condition, results were presented by their $averages{\pm}SEM$(standard mean error)and ratios or percentages. Inward currents began to appear in response to the step depolarization from -60mV and reached its maximum at -50mV. However, since the potential was not clamped evenly during the voltage step, current-voltage(I-V) relationship might be positively shifted 10 or 20mV. From the steady-state currents plotted in the I-V curve, outward rectification was markedly observed. Peak inward currents$(i_{in})$ at -50mV were $-0.62{\pm}0.23nA$(n=4),$-0.52{\pm}0.25nA$(n=5) and $-0.37{\pm}0.25nA$(n=6), in the 1-cell stage, 2-cell stage fertilized eggs and in the unfertilized eggs, respectively. Pure inward current (difference between steady-state and peak, $i_{in. pure}$) were $-1.01{\pm}0.23nA$, $-0.69{\pm}0.43nA$ and $-0.68{\pm}0.29nA$, respectively in the 1-cell stage fertilized eggs, unfertilized eggs and 2-cell stage fertilized eggs. These results suggested that the outward current in fertilized eggs of 2-cell stage was more increased than those in the unfertilized eggs. Pure inward currents in the all stages of eggs showed a similar fashion in the I-V relationship from -50mV to 50mV and reversal potential at 50mV. Time constant of inactivation$({\tau})$ in the inward current was decreased as the membrane potential was depolarized in the unfertilized and 2-cell stage eggs but in the 1-cell stage eggs t was not likely to be affected significantly. Slope conductances were 14.2nS, 8.9n5 and 7.7nS in the 1-cell, 2-cell stage fertilized eggs and the unfertilized eggs, respectively. Membranes between two cells within a zona pellucida seem to be electrical-connected in the 2-cell stage eggs from the observation made in the analysis for the electronic spread and decay to the current stimuli. Both of inward current and membrane conductance were increased after fertilization in the mouse eggs. Inward current seems to be carried by the same ion or through the same channels up to the 2-cell stage and ion that carried inward current was thought to play important function after fertilization in the mouse eggs.

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유아식품(乳兒食品)의 소화율(消化率)과 영양적(營養的) 의의(意義) (Digestibility of Infant Food and its Nutritional Meaning)

  • 홍기욱;유재자
    • Journal of Nutrition and Health
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    • 제7권1호
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    • pp.17-23
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    • 1974
  • 밀가루, 보리가루, 감자가루, 고구마가루 등 재료용(材料用)가루 4종과 비스켓, 크랙카, popped-cake (corn-flour), 식빵, 카스테라, 라면과자, 이유식(離乳禽)(I), 이유식(離乳食)(II)등 전분질(澱粉質) 식품(食品) 8종(種)에 대(對)해서${\beta}-Amylase$에 대(對)한 소화율(消化率)을 30분(分), 1시간(時間), 3시간(時間)등 경시적으로 측정(測定)한 결과(結果)와 설문지법에 의한 유아식품(乳兒食品)의 기호도(嗜好度)를 조사(調査)한 결과(結果)는 다음과 같다. (1) 재료용(材料用) 가루들의 소화율(消化率)은 생분(生粉)의 경우 $5{\sim}11%(3hrs)$였고, 고구마가루가 가장 낮았으며, 호화처리(糊化處理)한 가루들은 $20{\sim}30%(3hrs)$로 상승(上昇)하였고, 역시 감자가루, 고구마가루가 보리가루, 밀가루보다 낮은 편이다. (2) 비스켓, 크랙카, popped cake (corn-flour)의 소화율(消化率)은 호화처리(糊化處理)를 하지 않은 경우, 비스켓, 크랙카는 popped cake(corn-flour) (29%)에 비(比)하며 크게 떨어지고, 비스켓 ,크랙카를 호화처리(糊化處理)하면 $19{\sim}29%(3hrs.)$${\alpha}$화(化) 재료분(材料粉)에 비슷하였다. (3) 식빵, 카스테라의 소화율(消化率)은 $21{\sim}32%$${\alpha}$화(化) 재료분(材料紛)과 비슷하였고, 카스테라보다 식빵이 높았다. (4) 이유식(離乳食)의 소화율(消化率)은 이유식(離乳食)(I)이 24.1%(3hrs.)에 비(比)하여, 이유식(離乳食)(II)는 15%(3hrs.)로 크게 낮았다. (5) 제조(製調) 시기(時期)가 $1{\sim}2$개월(個月) 경과한 일부(一部) 과자류에서는 소화율(消化率)이 떨어지는 경향이며, 시판(市販) 이유식(離乳食) 중(中)에는 소화율(消化率)이 크게 낮은 것도 있다. (6) 어머니들이 아기들의 이유식(離乳食)을 선택(選擇)할 때 양양가(營養價)(42%), 소화율(消化率)(27%)을 많이 고려하며, 집에서 이유식(離乳食)을 만들어 주는 경우, 쌀가루(41%), 밀가루(23%)가 높은 빈도수를 보이고, 소화정도(消化程度)는 쌀가루가 49%, 밀가루가 23%로 그 다음이다. (7) 소화(消化)가 잘 된다고 생각되는 이유식(離乳食)으로서는 밥류(16%)와 시판이유식(市販離乳食)(13%)이 다소 높은 편이고, 선택성(選擇性)이 비교적(比較的) 높은 간식(間食)으로는 비스켓류(類)(44%)이었다.

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항 백혈병작용에 관련된 천연물의 자료조사 (Review of Anti-Leukemia Effects from Medicinal Plants)

  • 배현옥;임창경;장선일;한동민;안원근;윤유식;전병훈;김원신;윤용갑
    • 동의생리병리학회지
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    • 제17권3호
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    • pp.605-610
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    • 2003
  • 인삼, 호장근, 상산 등에서 분리한 성분들이 HL60, HL-60, Jurkat, Molt-4에 대한 억제작용이 있는 것으로 조사되었고, 익모초의 Leonunrine, 대청엽의 Indirubin, 천문동의 Aspargus polysaccharideA.B.C.D, 백합의 Colchicnamile, 익모초의 Lenunrine, 산두근, 자초근 추출물이 여러유형의 백혈병 환자에 대한 백혈병 억제효과가 있는 것으로 조사되었으며, mouse의 P388, L1210, L615, L120, S-180 등에 항 백혈병 효과가 있는 것으로는 완화, 로회, 원지, 오수유, 파두, 뇌공등, 석산, 백출, 단삼, 산약, 목단피, 청대, 감초, 당귀에서 분리한 성분들이 있으며 백굴채, 마전자, 가시오가피, 천초 추출물들이 동물실험에서 항암작용이 있는 것으로 조사되었다. 또 천연물에서 분리한 성분이 항백혈병 작용이 있는것으로는 ginsenoside Ro, ginseonoside Rh2, Emodin, Yuanhuacine, Aleemodin, phorbocdiester, Triptolide, Homolycorine, Atractylol, Colchicnamile, Paeonol, 당귀다당체, Aspargus polysaccharideABCD, Indirubin, Leonunrine, Acinosohic acid, Trichosanthin, G2 132, Schizandrin, allicin, Indirubin, cmdiumlactone chuanxiongol, 18A glycyrrhetic acid, Kansuiphorin A, 13 oxyingenol Kansuiphorin B 등이 조사되었고, 추출물이 항 백혈병 작용이 있는 것으로는 원지, 오수유, 백굴채, 대황, 산두근, 마전자, 가시오가피, 천초 등이 조사되었다.

장개빈(張介賓)의 <구정록(求正錄)>에 관한 연구(硏究) (A Study on the Qiu Zheng Lu (求正錄) of Zhang J ie Bin (張介賓))

  • 박혁규;맹웅재
    • 한국의사학회지
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    • 제18권2호
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    • pp.137-187
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    • 2005
  • This thesis study of the medical concept Qiu Zheng Lu (求正錄) is discussed in the Lei Jing Fu Yi (類經附翼), a book authored by Zhang Jie Bin (張介賓) a medical doctor during the Chinese Ming (明) dynasty (1368-1683). The meaning of Qiu Zheng Lu (求正錄) is "searching for the rightness." In his book Zhang Jie Bin (張介賓) intended to clarify Qiu Zheng Lu (求正錄) by delineating the concept into four categories. These are: Sanjiao Baoluo Mingmen Bian (三焦包絡命門 辨) the theory of the triple warmer, the Pericardium, the Gate of Life ; Da Bao Lun (大寶論) the theory of the great treasure of the human body; Zhen Yin Lun (眞陰論) the theory of true-yin fluid; and Shi Er Zang Mai Hou Bu Wei Lun (十二臟脈候部位論) the theory of the part of the pulse and its condition in regards to the twelve viscera. Sanjiao Baoluo Mingmen Bian (三焦包絡命門辨), the theory of the triple warmer, the Pericardium, the Gate of Life. The triple warmer (三焦: Sanjiao) is composed of three parts: the upper, middle, and lower. This concept is also connected with the functions and roles of the vital organs. The upper burner is related to the heart and lungs. The middle burner is related to the liver and spleen. Whereas, the lower burner is related to the kidneys. Bao-Luo (包絡) is the Pericardium, the envelope of the heart, serving as the protector of the heart. Ming-Men (命門) is the Gate of Life, reffering to the vitals of life. It functions as kidney-yang which is considered as the origin of yang-energy of the human body, and serves partly as the function of cortico-adrenal gland in modern medicine. Zhang Jie Bin (張介賓) discussed the Da Bao Lun (大寶論) as the most important function in the human body because the Da Bao (大寶/great treasure) is the true-yang (眞陽) which is the affective force for physiological functions, and as the source of energy for life activities. Moreover, true-yang (眞陽) functions both as a heater and thermometer that warms the human body and indicates vitality by levels of body warmth respectively. The Zhen Yin Lun (眞陰論) theory states that if true-yang (眞陽) is energy, then true-yin (眞陰) is the source of energy. This can be likened to a tree with roots which absorbs nutrients from the ground (source), and spreads the nutrients (energy) through its branches. Thus, true-yin (眞陰) is the root cause for later functional activities of true-yang (眞陽). In Shi Er Zang Mai Hou Bu Wei Lun (十二臟脈候部位論) the theory of the pulse (脈 /Mai) and its condition in regards to the twelve viscera, Zhang Jie Bin (張介賓) insisted that when a diagnoses by the pulse is made the five vital organs and the six viscera (五臟六腑) of a human body should be harmoniously arranged in accordance with its respective part of the pulse. Furthermore, Zhang Jie Bin (張介賓) supported his theory with evidence from earlier Chinese medical doctors. And, by stating that human beings must cultivate and preserve their true-yin (眞陰) and true-yang (眞陽) energies he therefore created four new prescriptions called: Zuoguiyin (左歸飮), Youguiyin (右歸飮), Zuoguiwan (左 歸丸), Youguiwan (右歸丸). To further clarify his theory Zhang Jie Bin (張介賓) considered that the function of true-yang (眞陽) and true-yin (眞陰) is expressed by Ming-Men (命門). This theory is that for humans to be spiritually and physically healthy they must live in accord with natural law. Also, within the framework of natural law, astronomical and geographical factors must be considered for complete, holistic, health. Thus, Ming-Men is the basis for healthy living in the modern world.

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고지방 사료 급여 마우스에서 인진쑥 추출물의 항비만 효과 (Anti-Obestic Effects of Artemisiae Capillaris Herba, Artemisia Capillaris Stem Aqueous Extracts on the High Fat Diet Supplied Mice)

  • 김홍태;김대동;구세광;김주완;장광호;오태호;이근우
    • 한국임상수의학회지
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    • 제27권4호
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    • pp.348-365
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    • 2010
  • Artemisia capillaries THUNB is a perennial herb that belongs to the family compositae spp. and the most common plant among the various herbal folk remedies used in treatment of abdominal pain, hepatitis, chronic liver disease, jaundice and coughing in Korea. The object of this study is to observe the dosage-dependent anti-obestic effects of an aqueous extracts of dried aqueous extracts of stems of Artemisia capillaris Thunberg. [Artemisiae capillaris Herba, In-Jin in Korean, INJ] on 45%/Kcal high fat diet (HFD) supplied mice. 45%/Kcal rodent HFD are supplied to ICR mice from 1 week before initiation of INJ administration throughout the 12 weeks, and after the end of 12 weeks of 62.5, 125 and 250 mg/kg/day of INJ administration, the efficacy was divided into five categories 1) hypoglycemic, 2) hepato-protective, 3) nephroprotective, 4) hypolipemic, and 5) anti- obesity effects. The effects were compared to those of simvastatin (for hypolipemic activity), silymarin (for hepatoprotective and free radical scavenger effects) and metformin (for hypoglycemic and related anti-obesity effects). 7 animals per group (8 groups; total 56adapted mice on HFD were selected base on the body weight at 6 days after initiation of HFD supply) were used in this experiment. INJ and all three different reference drugs were directly suspended or dissolved in distilled water, and administered at a volume of 10 mL/kg, once a day for 84 days from 1 week after HFD supply. As results of 91 days of continuous HFD supply, mice showed marked obese states, hyperglycemia, hyperlipemia, liver damages and kidney damages. These mean the obesity, diabetes, diabetic hepatopathies, nephropathies and hyperlipemia were induced by HFD supply. After end of 84 days of continuous treatment of three different dosages of INJ, all diabetes related complications were inhibited; relatively favorable anti-obesity, hypolipemic, hepatoprotective, hypoglycemic and nephroprotective effects. These favorable effects showed relatively good dose-relations between all three different dosages of INJ treated, and INJ 250 mg/kg showed enough favorable effects on diabetes and related four complications tested as compared with one of each three different references. Otherwise, the efficacy of 62.5 and 125 mg/kg of INJ was somewhat slighter than those of all three reference drugs. Therefore, the suitable effective dosage of INJ is considered as 250 mg/kg/day in the present study. The overall anti-obesity effects of INJ 250 mg/kg-treated group was similar or more favorable than those of metformin 250 mg/kg-treated group, and INJ 250 mg/kg showed slighter hypoglycemic effects with silymarin 100 mg/kg and metformin 250 mg/kg, similar hypolipemic effects with simvastatin 10 mg/kg, and similar hepatoprotective effects with silymarin 100 mg/kg, and similar nephroprotective effects with that of silymarin 100 mg/kg and metformin 250 mg/kg, respectively. Obese, hyperglycemia, hyperlipemia, steatohepatitis and related nephropathies induced by HFD supply were dramatically inhibited by 84 days of continuous treatment of all three different dosages of INJ. It is, therefore expected that INJ extracts will be a favorable alternative agent for diet-related diabetes and complications.

인공호의 부영양화에 따른 피라미(Zacco platypus) 개체군의 전장-체중 관계 및 비만도 지수 (Length-Weight Relations and Condition Factor (K) of Zacco platypus Along Trophic Gradients in Reservoir Ecosystems)

  • 고대근;한정호;안광국
    • 생태와환경
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    • 제45권2호
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    • pp.174-189
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    • 2012
  • 본 연구는 인공호의 영양 단계에 따른 피라미 개체군의 전장-체중 관계 및 비만도 지수 (K)의 차이를 알아보기 위해 2008년~2010년까지 부안호, 양양호, 진양호, 금풍지, 예당지 및 마산지 등의 6개 인공호를 대상으로 실시하였으며, 광범위한 분포 특성과 섭식 특성을 보이는 피라미(Zacco platypus)를 본 연구의 대상 어종으로 선정하였다. 총인 (TP)과 엽록소-a (Chl-a)를 이용한 영양상태지수(TSI) 분석 결과 양양호와 부안호는 빈영양(30~40), 진양호와 금풍지는 중영양 (40~50), 예당지와 마산지는 부영양 (50~70)상태로 나타났다. 6개 호수에서 총 47종 26,226개체의 어류가 채집되었으며, 빈영양호 (양양호, 부안호)에서는 민감종이 우세한 현상을 보였다. 한편, 중영양호 (진양호, 금풍지)와 부영양호 (예당지, 마산지)에서는 내성종이 우세한 것으로 분석되어 호수의 영양 상태에 따라 우세종의 내성특성에 차이를 보이는 것으로 나타났다. 전장-체중 관계 분석 결과에 따르면, 회귀계수 b값은 중 영양호(3.07~3.17)와 부영양호(3.15~3.21)에 비해 빈영양호 (2.77~2.79)에서 낮은 값을 보였다. 이러한 결과는 호수의 영양상태가 피라미 개체군의 성장도에 영향을 주는 것으로 사료된다. 전장에 따른 비만도 지수 (K) 관계 분석 결과 중영양호와 부영양호에서는 양의 기울기를 보인 반면, 빈영양호에서는 음의 기울기를 나타내 호수의 영양상태에 따라 차이를 보였다. TSI (TP), TSI (Chl-a)와 회귀계수 b값의 상관관계를 분석한 결과 b=0.012*TSI (TP)+2.395 ($R^2$=0.797, p=0.017), b=0.013*TSI (Chl-a)+2.367 ($R^2$=0.822, p=0.013)으로 나타나 높은 상관관계를 보였다. 한편, 부영양화가 진행될수록, 비정상개체의 비율이 증가하는 것으로 나타났다. 결론적으로, 전장-체중 관계와 비만도 지수 분석에 의한 피라미 개체군의 성장도는 영양염류나 식물플랑크톤의 생체량과 같은 영양상태를 반영하는 것으로 사료되며, 과도한 부영양화는 수환경의 오염을 초래하여 피라미 개체군의 성장과 건강도에 부정적인 영향을 미치는 것으로 사료된다.

소아청소년정신과영역의 새로운 항우울제 (NEW ANTIDEPRESSANTS IN CHILD AND ADOLESCENT PSYCHIATRY)

  • 이수정
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제14권1호
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    • pp.12-25
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    • 2003
  • 새로운 항우울제가 다량 개발되어 임상에 도입되면서 항우울제의 약리 작용에 대한 이해도 넓어졌다. 그에 따라 얻어진 새로운 정보와 이론을 소아청소년기 우울증 치료에 반영할 필요가 있다. 소아청소년기 최신지견에 따라 합리적인 우울증 치료 지침 마련을 위하여 고려하여야 할 주요 사항들과 새로운 항우울제의 특징들을 살펴보고자 하였다. 전자문헌 데이터베이스 검색 도구를 사용하여'new', 'antidepressant', 'children'의 검색어로 얻어진 97개 고찰 문헌 가운데 특히 치료 지침과 새로운 항우울제의 정신약리작용에 관한 것을 선별하여 중점적으로 고찰하였다. 아울러 새로운 항우울제 각 약물에 대한 치료 효과에 대한 문헌을 추가로 선택 참고하였다. 또 약물상호 작용과 안전성에 관하여 미국 식품보건국과 보건후생부의 공식사이트에서 제공되는 문헌을 참고하였다. 1) 우울 장애의 임상 경과, 치료 기간, 및 치료 효과는 성인기 치료 지침에서 제시된 바를 채택한 경우가 많았다. 2) 소아청소년기 우울증에 대한 항우울제의 효과에 대한 연구 결과는 TCA가 효과와 부작용에서 SSRI보다 뒤져서 소아청소년 우울장애의 일차 치료제로 권장 된다. 3) 새로운 항우울제는 아직 소아청소년에게 치료 경험과 임상 연구 결과가 부족하다. 4) SSRI와 새로운 항우울제들은 두 개 이상을 병용할 때 약동학적 및 약력학적인 상호작용이 있을 수 있다. 5) 소아청소년기 항우울제의 임상적 효과가 성인기와 다른 것은 발달적 측면에서 설명할 수 있겠으나 직접적인 증거가 좀더 쌓일 필요가 있다. 소아청소년기 우울증의 약물 치료 지침은 임상 연구 소견과 임상적 경험을 종합하여 세울 수 있다. 그러나 약물 치료 지침은 임상가가 합리적인 판단을 내릴 수 있도록 하는 참고 자료이며 그 목적을 다하기 위하여 새로운 연구 결과가 있을 때 마다 새로 개정 되어야 할 것이다. 중 외톨이-왕따에 해당되는 청소년의 어머니는 비외톨이 청소년의 어머니보다 자녀들의 사고 문제 및 우울/불안 등의 정서적 문제를 더 높게 평가하였다. 그러나, 자녀들에 대한 양육 태도에 대해서는 차이를 두지 않는 것으로 보인다. 향후 보다 많은 환자들을 대상으로 한 추가 연구가 필요할 것이다. 강압적인 양육행동을 변화시키기 위해서는 주의력결핍과잉행동장애 아동 부모의 양육 스트레스, 아동에 대한 역기능적 사고 및 양육 효능감을 다루어야 할 뿐 아니라, 부모의 우울감을 치료 시 고려해야 할 것이다.순차처리항목과 계산능력에서 유의하게 높았고(p<.05), KEDI-WISC를 이용한 평가에서는 ADHD- HI형은 대상수가 소수여서 비교할 수 없었으며, ADHD-C형과 ADHD-Ⅰ형 사이에 유의한 차이는 보이지 않았다. CPT, WCST, SST를 이용한 신경심리학적 실행기능의 비교에서 아형간 계량적인 차이는 있었으나 통계적으로 유의한 차이는 보이지 않았다. 결 론:결론적으로 ADHD 세 아형은 임상적으로 뚜렷한 차이를 보였지만, 실행기능상 유의한 차이를 발견할 수 없었다. 향후 보다 잘 고안 된 연구와 발달중인 아동에 적절한 신경심리 평가 도구의 개발을 통해 결과를 보완해야 할 것으로 사료된다.었으나, 주의력에서는 전두엽의 실행능력(executive function)과 관련되는 검사들에서 산소흡입이 특이한 효과를 보여준다는 것이 확인되었고, 기억능력에서는 단기기억능력 평가에서 산소흡입군이 대조군보다 유의한 효과를 보여주는 것으로 평가되었다. 이러한 연구결과는 산소흡입이 전두엽과 관련된 수행능력, 작동기억능력 향상에 도움이 될 가능성이 있음을 시사하는 결과라고 생각된다.증 1명(5%)이었다. 모든 대상 아동이 주 진단 이외의 2∼6개 이상의 다양한 공존진단을 보였다. 공존진단에는 주의력결핍-과잉운동장애, 우울병, 경계선지능 및 정신지체, 학습장애,

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