아스피린을 장기 복용한 환자의 갑상선 결절에서 초음파 유도하 세침흡인생검 후 생긴 심한 출혈

정혜경,김은경,김민정,곽진영,박정수<SUP>1<,SUP>,Hae-Kyoung Jung,Eun-Kyung Kim,Min Jung Kim,Jin Young Kwak,and Cheong Soo Park,<SUP>1<,SUP> 대한갑상선-내분비외과학회 2007 The Koreran journal of Endocrine Surgery Vol.7 No.1

Ultrasound-guided fine needle aspiration biopsy (USFNA) is a very useful procedure for the diagnosis and management of thyroid diseases. It is very safe procedure and complications have been rarely reported. We experienced a case of an extensive hemorrhage after USFNA of the thyroid nodule in a patient undergoing long-term aspirin therapy. We emphasize that it is very important to obtain a patient history carefully before performing a USFNA. (Korean J Endocrine Surg 2007;7:39-41)

Bone Morphogenetic Protein 2 가 두개골 성장 및 두개봉합부의 초기형태발생에 미치는 영향

정혜경,박미현,유현모,남순현,김영진,김현정,Jung, Hae-Kyung,Park, Mi-Hyun,Ryoo, Hyun-Mo,Nam, Soon-Hyeun,Kim, Young-Jin,Kim, Hyun-Jung 대한소아치과학회 2003 大韓小兒齒科學會誌 Vol.30 No.2

뇌와 두개골의 조화로운 성장 발육은 성장 중인 두개골과 이 뼈들을 연결하는 두개봉합부들 그리고 발육중인 뇌사이의 일련의 상호작용에 의해 이루어진다. 두개봉합부의 조기융합으로 알려진 craniosynostosis는 이러한 상호균형적인 관계가 파괴될 때 야기될 수 있다. Bone morphogenetic protein의 하나인 Bmp2는 골 각각의 형태와 골격의 상대적인 비례성을 조절하는데 관여하고 있으며, Bmp의 하부 유전자로 알려져 있는 Msx2 homeobox 유전자의 돌연변이는 Boston-type craniosynostosis를 야기한다 이와 함께 Dlx5 homozygote mutant mouse의 표현형은 두개골 골화의 지연을 포함한 다양한 두개안면의 이상을 나타낸다. 이러한 사실들은 Bmp2, Msx2, Dlx5 유전자들이 두개봉합부의 형태발생과정에 중요하게 작용할 수 있음을 시사하고 있다. Mouse 두개봉합부의 초기형태발생과정에 위 유전자들의 기능을 알아보기 위해, 태생기 동안의 시상봉합부에서의 Bmp2, Msx2, Dlx5 유전자들의 발현양상을 in situ hybridization 방법을 이용하여 분석하였다. Bmp2 mRNA는 osteogenic front에서 강하게 발현되었으며, parietal bone의 골막에서도 관찰되었다. Msx2 mRNA는 시상봉합부의 미분화 간엽조직에서 강하게 발현되었으며, osteogenie front 및 dura mater에서도 관찰되었다. Dlx5 mRNA는 osteogenic front와 parietal bone에서 강하게 발현되었다. 두개봉합부에서의 Bmp signaling의 역할을 알아보기 위해 태생 15.5일 mouse의 두개골을 이용하여 in vitro 실험을 시행하였다. Bmp2-soaked beads를 osteogenic fronts에 올려놓고 48시간 기관배양한 결과 BSA 대조군에 비해 Bmp2 beads 주위 조직의 두께와 세포수가 증가하였으며 Msx2와 Dlx5 유전자들의 발현을 유도하였다. 그러나 FGF2 beads주위로는 이들 유전자들의 발현이 관찰되지 않았다. 이러한 결과들을 종합해 볼 때, Bmp2 유전자는 두개골 성장과 두개봉합부의 초기 형태발생을 조절하는데 중요한 역할을 담당하고 있으며, Bmp signaling은 Msx2, Dlx5 유전자들을 조절함으로써 두개골의 골화와 두개봉합부의 유지에 관여하고 있음을 제시해 주고 있다. Co-ordinate growth of the brain and skull is achieved through a series of tissue interactions between the developing brain, the growing bones of the skull and the sutures that unite the bones. Craniosynostosis, the premature fusion of cranial sutures, presumably involves disturbance of these interactions. Bmp2, one of bone morphogenetic proteins (Bmps), is involved in the regulation of the shapes of individual bones and the relative proportions of the skeleton. Mutations in the homeobox gene Msx2, known as a downstream gene of Bmp, cause Boston-type human craniosynostosis. The phenotype of Dlx5 homozygote mutant mouse presents craniofacial abnormalities including a delayed ossification of calvarial bone. These facts suggest important roles of Bmp2, Msx2 and Dlx5 genes in the cranial bone growth and suture morphogenesis. To elucidate the function of these molecules in the early morphogenesis of mouse cranial sutures, we first analyzed by in situ hybridization the expression of Bmp2(E15-18), Msx2 and Dlx5 genes in the developing sagittal suture of calvaria during the embryonic stage. Bmp2 mRNA was intensely expressed in the osteogenic fronts and also at the low level in the periosteum of parietal bones during embryonic stage, Msx2 mRNA was intensely expressed in the sutural mesenchyme and mildly expressed in the dura mater during the embryonic stage. Dlx5 mRNA was intensely expressed osteogenic fronts and parietal bones. To further examine the role of Bmp signaling in cranial suture, we did in vitro experiments in E15.5 mouse calvarial explants. Interestingly, implantation of Bmp2-soaked beads onto the osteogenic fronts after 48 hours organ culture resulted in the increase of the tissue thickness and cell number around Bmp2 beads, compared to BSA control beads. In addition Bmp2 induced etopic expressions of Msx2 and Dlx5 genes. On the other hand, overexpression of FGF2 did not induce the expression of Msx2 and Dlx5. Taken together, these data indicate that Bmp2 signaling molecule has a important role in regulating the cranial bone growth and early morphogenesis of cranial suture. We also suggest that Bmp signaling is involved in all the stages of osteogenesis of cranial bones and the maintenance of cranial suture by regulating Msx2 and Dlx5 genes, and that Msx2 and Dlx5 genes are specific transcription factors of Bmp signaling pathway.

성인에서 발생한 대장의 저신경절증

강민정 ( Min Jung Kang ),정성애 ( Sung Ae Jung ),정지민 ( Ji Min Jung ),김성은 ( Seong Eun Kim ),심기남 ( Ki Nam Shim ),정혜경 ( Hye Kyung Jung ),구혜수 ( Hea Soo Koo ),유권 ( Kwon Yoo ),문일환 ( Il Hwan Moon ),정규원 ( Kyu Won C 대한소화기기능성질환·운동학회 2008 Journal of Neurogastroenterology and Motility (JNM Vol.14 No.1

Hypoganglionosis is a rare form of intestinal neuronal malformation, which is characterized by scarce ganglia and a reduced number of parasympathetic nerves in the intestinal wall. Enteric nervous system can be damaged during postnatal period by ischemic, inflammatory, autoimmunologic process or neurotoxic agent. Acquired hypoganglionosis is usually late onset and characterized as degeneration of ganglion cells and gliosis histologically. We report a case of adult type ypoganglionosis, which is assumed to be an acquired type with the review of literature. The patient with a history of chronic constipation and ileus presented with intestinal obstruction and went on surgical management successfully.

염증성 장질환 환자에서의 골밀도 저하의 위험인자 분석

박재정 ( Jae Jung Park ),정성애 ( Sung Ae Jung ),노영욱 ( Young Wook Noh ),강민정 ( Min Jung Kang ),정지민 ( Ji Min Jung ),김성은 ( Seong Eun Kim ),정혜경 ( Hye Kyung Jung ),심기남 ( Ki Nam Shim ),김태헌 ( Tae Hun Kim ),유권 ( Kw 대한소화기학회 2010 대한소화기학회지 Vol.55 No.4

목적: 염증성 장질환에서 골밀도 감소는 비교적 흔한 합병증이며 이와 연관된 위험인자들이 보고되고 있으나, 한국의 염증성 장질환 환자에서의 연구는 미미하다. 본 연구는 염증성 장질환 환자에서의 골밀도 감소의 유병률 및 위험인자를 알아보고자 하였다. 대상 및 방법: 30명의 염증성 장질환 환자를 대상으로 X-선 골밀도 측정기에 의해 골밀도를 측정하였다. 혈청 인, 칼슘, 오스테오칼신과 데옥시피리디놀린을 포함한 인자들을 측정하였다. 의무기록을 후향적으로 검토하여 질병의 유병기간, 활성도, 약물력, 체질량지수 등을 조사하고 골감소와의 연관성을 분석하였다. 결과: 전체 환자의 63.3%에서 골밀도 감소가 있었으며 크론병과 궤양성 대장염에서의 유의한 차이는 없었다. 골밀도 감소와 임상적 지표들 간의 유의한 연관성이 없었고, 골대사의 지표들과 골밀도 사이에 유의한 상관관계가 없었다. 골밀도검사 전 글루코코르티코이드를 사용하지 않았던 염증성 장질환 환자의 50.0%에서 골밀도 감소를 보였다. 결론: 한국의 염증성 장질환 환자에서도 서구와 마찬가지로 골밀도 감소가 빈번하며, 이러한 골감소의 원인은 명확하지는 않지만 다양한 인자들이 복합적으로 관여할 것으로 여겨진다. 따라서, 글루코코르티코이드 사용 여부와 상관없이 염증성 장질환 환자에서 골밀도 측정이 필요하다. Background/Aims: Several clinical risk factors for low bone mineral density (BMD) in the patients with inflammatory bowel disease (IBD) have been suggested. However, its prevalence and pathophysiology in Korean population have not been fully studied. The aim of this study was to investigate the prevalence and risk factors for low BMD in Korean IBD patient. Methods: BMD of the lumbar spine and femur was evaluated using dual-energy X-ray absorptiometry in 30 patients with IBD. Biochemical parameters of bone metabolism, such as serum calcium, phosphorus, osteocalcin, and deoxypyridinoline were measured. The associations between low BMD and clinical parameters such as disease duration, disease activity, drug history, body mass index (BMI), and others were evaluated retrospectively using medical records. Results: Low BMD at the lumbar spine or femur was observed in 63.3% of the patients, and there was no significant difference between the patients with Crohn`s disease and ulcerative colitis. Clinical and biochemical parameters were irrelevant to BMD. In the patients without glucocorticoid treatment prior to BMD measurement, already 50.0% of patients had low BMD. Conclusions: Low BMD is a common feature in Korean IBD patients, even those who do not use glucocorticoid. The multiple factors may be involved in the pathogenesis of low BMD. Therefore, BMD should be examined in all IBD patients, irrespective of glucocorticoid treatment. (Korean J Gastroenterol 2010;55:237-244)

2011~2013학년도 수능 영어 성적과 학생 및 학교 변인과의 관련성 비교 연구

정혜경(Hye kyung Jung),김인숙(In suk Kim),이명애(Myung a Lee) 한국교육평가학회 2015 교육평가연구 Vol.28 No.1

본 연구에서는 비교적 최근의 수능 자료인 2011~2013학년도 수능 성적 결과를 활용하여 쉬운 수능 정책이 도입된 초기 시기에 학교, 학생 주요 변인과 수능 영어 성적과의 관련성을 살펴보았다. 학생-학년도-학교의 다층 구조를 반영하는 3수준 다층모형을 적용함으로써 학생, 학교 변인과 수능 영어 성적과의 관련성이 학년도 간 차이가 있는지를 살펴보았다. 분석 결과, 도시와 읍면 지역에 대한 수능 점수 차이가 다소 완화되었으나 최근 3년간 쉬운 수능 정책 기조 아래에서 여전히 재수생이 재학생에 비해 수능 성적이 높고, 읍면 지역의 수능 점수가 도시 지역보다 평균적으로 낮으며, 특목고가 일반고에 비해 월등히 수능 점수가 높은 점이 확인되었다. 다만 2013학년도에 비해 상대적으로 쉬웠던 2012학년도 수능에서 시도 간 차이, 재수-재학생 간의 차이, 특목고와 일반고 간의 차이가 다소 완화된 점은 주목할 만하다. Since the 2011 College Scholastic Ability Test (CSAT), the policy of developing CSAT with lower difficulty (hereafter, the Easy-CSAT) was initiated. Based on the 2011-2013 CSAT data administered under the Easy-CSAT policy, we examined the relevance between student- and school variables and CSAT scaled scores using English domain. Three-level multilevel analyses were employed capturing a nested data structure of student-year-school. A key finding in this study includes that the achievement gap between schools in rural areas and schools in urban areas has decreased in the 2012 and 2013 CSATs. However, the gaps between test re-takers and regular students in scaled scores of the CSAT maintained under the Easy-CSAT policy, and it was confirmed that the area size (urban vs. rural) and the type of school (special vs. regular) were still highly associated with the CSAT's English scores. It is noteworthy that the gaps between test re-takers and regular students, between special- and regular- schools, and the average differences among 16 cities slightly decreased in the 2012 CSAT in comparison with the 2013 CSAT. The test difficulty in 2012 was lower than the corresponding difficulty in 2013 English subject.

<창선감의록>에 나타난 눈물의 작용과 의미

정혜경(Jung, Hye-Kyung) 국어국문학회 2012 국어국문학 Vol.- No.161

Changseongameuirok was one of the popular novels of the Joseon dynasty in the 17th century. The reason that people impressed the story was that it provided a moral influence to readers by showing triumph of virtue over vice. Above all, readers could be immersed in the text as the writer effectively manipulates the characters" emotions. For example, the writer repeatedly depicted good people"s struggle including Hawjin, the main character, so the reader realized good people"s emotional states such as sadness, sense of loss, and frustration, and identified with the good characters. In this article, I discussed several studies that examine functions of tears and their effect on Changseongameuirok and a paradox of reconciliation with Haw"s family through the Hawjin"s sadness. The argument noted factors so that readers could enjoy the good characters" position, and evidence for them to forgive evil characters even though they hate their evil deeds as well as covering up the plot of the work. Firstly, tears were chosen among complicated emotional expressions, considering their frequent occurrence, as were various ways of expression, and functions such as supplying of characters" probabilities and logical necessity in the story. Yet, tears express various emotional conditions according to characters" surroundings and relationships with others, so the paper discussed the function of tears, instead of the cause. In section 2 of the paper, I reviewed that Changseongameuirok efficiently used the power of tears as rhetorical methods in the narratives. First of all, excessive crying showed the practice of reinforced ideologies like filial duty at that time. That is, the use of overemotional expressions was forbidden for classical scholars; hence emotional controls were a virtue that could be affirmed by colligating with ethical codes without any damages of masculine images. Next, the writer led to fellow-feeling for characters and social sympathy by the reader, by depicting other characters crying while virtuous people were crying. Other characters, who have sympathy for good people, would have become angry instead of them, like Hawjin, who never complained about his step-mother and brother, although he suffered cruel treatment and humiliation from them. On the other hand, readers had hostility toward Mrs. Sim and Hawchun. Finally, the writer proved true transformation by frequently exhibiting villains" tears and provided the reason why people forgive them. In other words, the story obtained logical grounds through hypocrite"s fake tears that changed into true crying. As a result, readers could enjoy the text on the virtuous characters while they had antipathy toward Mrs. Sim and Hawchun. In the final section of the paper, I focused on the main character"s emotions particularly sadness which had been considered of matter-ofcourse for filial duty because that was able to reveal the real status of Hawjin"s families relationship and his families values. There was a paradox of reconciliation with Haw"s family.

기능성 소화불량증의 진단: 체계적인 문헌고찰

정혜경 ( Hye Kyung Jung ),금보라 ( Bo Ra Keum ),조윤주 ( Yoon Ju Jo ),지삼룡 ( Sam Ryong Jee ),이풍렬 ( Poong Lyul Rhee ),강영우 ( Young Woo Kang ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.5

This review tried to set up an initial diagnostic strategy in patients with functional dyspepsia. Dyspepsia was defined as chronic or recurrent pain, or discomfort centered in the upper abdomen (i.e., epigastrium), excluding heartburn and acute abdominal conditions. We reviewed the available data in order to produce currently applicable recommendations for the diagnosis of dyspepsia in Korea. Two investigators independently conducted an independent literature search of published reports on dyspepsia and diagnosis, including alarm symptoms, Helicobacter pylori (H. pylori) test, empirical pharmacological therapy, and early upper gastrointestinal (GI) endoscopy. The evidence concerning alarm features does not allow clear guideline whether early endoscopy should be performed or not. In Asia, including Korea, the prevalence of H. pylori and gastric cancer are high. Therefore, `H. pylori test and treatment` strategy is not suitable for the initial diagnostic approach for uninvestigated dyspepsia. Long-term empirical pharmacological therapy is not recommended in Korea because of the possibility of missing or delaying the diagnosis of gastric cancer. There have been a lot of evidences showing that early upper GI endoscopy might be more effective than empirical medication, which is different from Western countries. However, cut-off age for early endoscopy is not clear, especially in case of young age. Further research is necessary to define highrisk age for gastric cancer and for a health economic study in the management of patients with dyspepsia in Korea. (Korean J Gastroenterol 2010;55:296-307)

함안성산산성내 퇴적층의 대자율분석을 활용한 고대 이후 고기후 환경변화 연구

정혜경(JUNG, Hea Kyung),박지훈(PARK, Ji Hoon) 한국지역지리학회 2019 한국지역지리학회지 Vol.25 No.3

본 연구는 함안 조남산에 위치한 성산산성 연구 결과를 종합적으로 고찰하여 대자율 변화 특성과 고대의 기후환경변화를 논의하였다. 연구지역내에서는 서로 다른 환경이 적어도 네 번은 있었음을 유추할 수 있다. 6세기 중엽이전 시기 대자율값의 변화는 불규칙적이고 변이가 심하지만 대자율값 자체는 높은 경향을 보이고 있다. 이 시기는 온난습윤한 환경에서 퇴적물의 이동이 있었음을 유추할 수 있다. 6세기 중엽에서 후엽의 시기는 대자율값이 일시적으로 증가하다 감소하고 대자율값은 모든 시기 중 가장 낮다. 이 시기는 건조하거나 추운 환경이었던 것으로 유추된다. 6세기 후엽부터 7세기까지의 시기는 대자율 값이 비교적 꾸준한 증가를 보인다. 이 시기 대자율값의 변화는 기후변화에 따른 급격한 토양화의 변화라기보다는 농경의 영향으로 인한 자성 물질의 변화로 보인다. 7세기 이후부터 8세기~9세기까지 시기는 대자율값이 일시적으로 중가하다 감소하는 경향을 보이고 있고 이는 농경의 진전에 따른 철 함유량 변화에 기인하는 것으로 판단된다. This study comprehensively investigated the results of archaeological studies around Haman Seongsan Fortress in located at Mt. Jonam, and the characteristics of magnetic susceptibility and the change of ancient climate environment were discussed. It can be inferred that there were at least four different environments in the study area and the magnetic susceptibility characteristics are as follows. Changes in magnetic susceptibility values before the mid-6th century are irregular and variable, but large autonomous values tend to be high. This period can be inferred by the movement of sediment in a warm, humid environment. The magnetic susceptibility value temporarily increases and decreases in the late period in the middle of the sixth century and is the lowest of all periods. It is inferred that this was a dry or cold environment. The period from the late sixth century to the seventh century shows a relatively increase in magnetic susceptibility value. The change in the magnetic susceptibility value of this period seems to be a change of magnetic material due to the effects of agriculture, rather than a sudden change in soiling due to climate change. From the 7th century to the 8th to 9th centuries, the magnetic susceptibility value tends to increase temporarily and decrease. This is Inferred to be due to the change in iron content according to the progress of agriculture.

2017 과민성장증후군의 임상진료지침 개정안 소개

정혜경 ( Hye-kyung Jung ) 대한소화기학회 2018 대한소화기학회지 Vol.72 No.5

This guidance is an updated version of the irritable bowel syndrome (IBS) guidelines based on evidence-based medicine. IBS is a common chronic gastrointestinal syndrome that occurs in approximately 10% of the population and causes chronic abdominal pain as well as bowel habit changes, such as stool frequency or consistency. The final diagnosis of IBS is based on the exclusion of organic diseases that would explain the symptoms and the absence of endoscopic abnormalities. IBS can reduce the quality of life and cause a major disease burden, such as repeated examinations and continuous drug use, by mistaking organic diseases including malignancy. The major changes are as follows: 1) when to perform a colonoscopy under the impression of IBS; 2) effect of a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet; 3) impact of probiotics in IBS; and 4) role of antibiotics in IBS. The Korean Society of Neurogastroenterology and Motility recently updated these guidelines to support physicians for qualified medical services and reduce the socioeconomic burden of IBS. (Korean J Gastroenterol 2018;72:252-257)

<현씨양웅쌍린기>의 서사적 힘; 웃음

정혜경 ( Hye Kyung Jung ) 한민족문화학회 2011 한민족문화연구 Vol.37 No.-

조선 후기 국문 장편소설 <현씨양웅쌍린기>는 인간의 감정, 즉, 눈물과 웃음이라는 감정표현소의 적절한 교직을 통해 흥미를 창출해낸 작품이다. 무엇보다 이 작품은 부부갈등을 비롯한 삶의 진지한 문제를 웃음으로 풀어내고 있다. 본고에서는 이 점에 주목하여 무엇이 우스운지, 독자는 왜 웃게 되는지 등 다각도로 고찰하여 <현씨>가 애독될 수 있었던 이유를 구명하고자 하였다. 우선, 텍스트 내에 존재하는 다양한 웃음의 종류를 정리하여 희극적 웃음을 논의의 대상으로 삼고 웃음의 동인과 의미를 탐색하였다. 텍스트 내의 인물들은 상대의 결점과 실수를 마주한 순간 웃는데, 주로 인물의 착각, 무지, 우발적 실수, 무분별한 감정 표출, 그리고 무의식적 실수와 이기적인 삶의 태도 등을 보면서 웃었다. 그런데 <현씨>에서는 순간적으로 유발되는 듯 보이는 웃음이 작품 곳곳에 조화롭게 스며 있으며 부부갈등에도 간여하고 있는 것으로 나타났다. 특히 부부갈등으로 유발된 부정적 정서는 웃음의 작용을 거치면서 사람들로 하여금 즐거운 각성을 일으켜 심각한 갈등을 유쾌한 에피소드로 인식하게 하였다. 또한 <현씨>에서는 사건의 발생 시점과 작중 인물의 처지에 따라 웃는 방식과 태도가 결정되는데, 웃음의 객체는 굿보기와 참여하기를 통해 웃음을 향유하거나 재창출하였다. 후자의 경우, 웃음의 객체와 주체가 전도되는 재미난 현상이 일어났다. 끝으로, 독자의 관심과 몰입을 유도해낼 수 있었던 이유를 작중 인물의 웃음에 주목하여 살펴보았다. 작가는 재미난 캐릭터를 창조하고 그 인물과 이후 서사를 유기적으로 엮어 연달아 웃음이 터지도록 함으로써 독자가 단발적 웃음을 포함해 웃음의 연속성을 경험하며 작품을 즐길 수 있도록 하였다. 아울러 심각하고 피곤한 일상이 작품에서 유쾌한 웃음으로 전환되도록 하여 독자가 부담 없이 작중 인물과 어울려 웃을 수 있게 하였다. HyunShiYangWoongShangLinKi, written in the late 18th century during the Joseon Dynasty period. was a interesting story by using people`s emotion expressions ranging from laugh to tear. The work was especially known for highlighting spousal conflicts though the use of humor. However, previous research has not adequately explained this use of comedy, its functions, and the deeper meaning in the work. The purpose of this study is to find the reason why readers at that time enjoyed the work by examining the context of its humor. First of all, to the observer it is obvious that the work utilizes various kinds of laugh. These will be looked at. The third chapter describes the causes and effects of the laugh. For example, some male characters display amusement as a result of their own egotistic behavior, while others react to women`s physical appearances, obscene behaviors, and/or other deviations from the social norm in during 18th century Joseon Dynasty. In addition, most of the characters(except Hyn`s brothers and their spouses) do not act seriously even though the play encompasses many serious and complex problems. In short, what would normally be seen as a serious situation(such as where Hyn`s brother is engaged in marital conflict)is converted to amusement through the use of comedy. In conclusion, Joseon era readers enjoyed experiences where laughter or consecutive laughter arose as an intended result of the writer who wrote about serious situations portrayed by comical characters and comic events that were continually connected by next narratives. This is especially true in HyunShiYangWoongShangLinKi. Readers of this period enjoyed the work without any social pressure to moralize because serious subjects are treated comically and light-heartedly by the author.