양극성 정동장애와 혈청 Inositol-1-phosphatase 활성도 변화

조현주,김영철,우행원,연규월,조기승 대한생물치료정신의학회 1998 생물치료정신의학 Vol.4 No.2

Objects : Several lines of possibilites have been oroposed about the etiology of bipolar attective disorder in biological, genetic and psychosocial aspect. The purpose of this study is to inspect the etiology of bipolar affective disorder in biological aspect by measuring the changes of serum inositol-1-phosphatase activity and investing a causal relationship between clinical symptoms and serum inositol-1-phosphatase activities in patients with bipolar affective disorder. Methods : The subjects were 18 inpatients who met DSM-IV diagnostic criteria for bipolar I affective disorder, manic episode and 15 normal controls. Inositol-1-phosphatase activities were measured in serum by using spectrophotometer. Clinical symptoms of patients were assessed by YMRS at admission day and after 2 weeks lithium treatment. Results : 1) Inositol-1-phosphatase activities of the patients were increased to about 2 times as compared with those of normal controls. And the activity levels were decreased gradually to the normal at 14 days. 2) Young's Mania Rating Scale(YMRS) scores were decreased significantly by lithium treatment. 3) Statistical significance could not be found between the change of YMRS scores and the levels of inositol-1-phosphatase activity. Conclusion : In this study, statistical significance could not be found between clinical improvement and inositol-1-phosphatase activities, but the fact that lithium treatment improve the clinical manifestation shown by YMRS score changes, and reverse the increased inositol-1-phosphatase activities suggests the strong association between pathophysiology of bipolar affective disorders and inositide metabolism.

운동 종료 후의 당질·단백질·지질의 혼합물 섭취가 근 글리코겐 회복에 미치는 효과

육조영,송영주,류기성,장창현,김한수,김대경 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.5

In this study 8 male athletes and 8 female athletes for matches requiring endurance were examined for the purpose of comparison and analysis on the effect of absorption of sugars and effect of absorption of sugars+protein+fats restoration of muscular glycogen after elapse of 4 hours subsequent to closing 90 minutes exercise. (Amount of energy absorbed was same). Examinees were tested with 3 kinds of performance such as CPF Performance whereby they were made to take ① sugars (0.75 g/㎏) and protein (0.1g/㎏) and fats (0.02 g/㎏) after elapse of 1 hour subsequent to long hours of exercise and CHO Performance whereby examines were made to take ② sugars (1g/㎏) alone and Performance whereby they were made to take ③ placebo (which does not contain any sugars, protein or fats). Also the examinees took meals which had same amount of energy and nitrogen during the Performance on the date prior to experiment or on the date of experiment. Women during the exercise showed significantly higher rate of oxidation of fats, basic element of energy than that of men. In CHO Performance and CPF Performance value of blood sugar and density of insulin were significantly higher in comparison with performance with placebo. At such cases there was no difference between different genders. Same kind of phenomena were confirmed with restoration of muscular glycogen. From such fact it could be observed that absorption of fats alone and absorption of sugars+protein+fats in comparison with absorption of placebo after exercise promoted relatively higher level of restoration of muscular glycogen for both men and women.

GIS를 활용한 주거용 적지분석에서의 절차적,방법론적 합리성 2: 용인시를 사례로

조규영 ( Kyu Young Cho ),옥진아 ( Jin A Ok ),서주환 ( Joo Hwan Suh ) 한국도시지리학회 2002 한국도시지리학회지 Vol.5 No.2

This study applies the proposed conceptual model for the land use suitability analysis. The study area is Young-In city which is one of the new housing development concentrated regions in the Seoul Metropolitan area. The purpose of this study is to compare the residential planning of the Yong-In City Master Plan (2001) with the proposed conceptual model application. The comparison is based on as follows: 3 methods (simple overlay method; linear standardization and AHP; Fuzzy and AHP) with 4 alternatives (city structural efficiency; environmentally sound development; and equal growth) and their conflict resolutions. The results are slightly different from each other; and very hard to conclude which method is superior. Rather, we may insist on that land use suitability analysis in Yong-In City Master Plan needs to be based on a well guided procedural model. The analysis of the plan is too naive to draw a future plan of the citizens. This may be the same in many other plans, but we need to scrutinize this subject and develop very practical and procedural analysis guidelines and manuals in order to have more rational plans.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

고도비만 환자에서 복강경 위소매절제술 후 발생한 누공의 내시경 치료 1예

류민선,심기남,조원영,김찬용,강현주,김미연,안소영,이윤표,조형원,정성애,이주호 이화여자대학교 의과학연구소 2013 EMJ (Ewha medical journal) Vol.36 No.2

Laparoscopic sleeve gastrectomy can reduce morbidity and mortality in patients with morbid obesity, but it can cause complications such as a gastrointestinal leak. A 30-year-old morbidly obese female who had type 2 diabetes mellitus and hypertension with estimated body mass index of 40.2 kg/m2 was admitted. Laparoscopic sleeve gastrectomy was performed. On postoperative day 19, a leak was suspicious on physical examination and radiologic findings. Conservative management was performed, but the patient was hemodynamically unstable and imminently septic. After laparoscopic drainage procedure, esophagogastroduodenoscopy was performed and revealed the fistula opening at staple line just below gastroesophageal junction. Fibrin tissue adhesive was injected around the fistula and the esophageal covered stent was inserted to cover the leak. At 14th days after stent insertion, the barium study confirmed no more leak. In this case, we experienced that the esophageal stent insertion with fibrin tissue adhesive injection may reduce recovery time of the fistula developed after laparoscopic sleeve gastrectomy

Clinical Significance of Classification of Graves` Disease According to the Characteristics of TSH receptor Antibodies

(Won Bae Kim),(Hyun Kyung Chung),(Young Joo Park),(Do Joon Park),(Hong Kyu Lee),(Bo Youn Cho) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.3

N/A Background:It has been widely accepted that the epitope (s) and/or functional characteristics of thyrotropin receptor antibodies (TSHRAb) from Graves` patients are heterogenous among patients. However, the clinical significance of such heterogeneity has not been systematically evaluatedyet. We were to elucidate and find the clinical significance of heterogeneity for TSH receptor antibodies in Graves` disease. Methods:We measured stimulating TSHRAb (TSAb) activities using CHO-hTSHR cells, FRTL-5 cells and chimeric receptor expressing cells (Mc1+2 and Mc2), specific blocking TSHRAb (TSBAb) activities using Mc2 cells and TBII activities using porcine thyroid membrane in 136 patients with untreated hyperthyroid Graves` disease. Results: Based on various TSHRAb activities from each patient, the patients could be categorized into 7 subgroups by cluster analysis; 1) Group 1 (n=41) was characterized by moderate TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, typical TSAb epitope, rare blocking antibodies and high TBII activities. 2) Group 2 (n=16) was characterized by the presence of blocking TSHRAb in most patients, albeit the other characteristics were the same as those in Group 1. 3) Group 3 (n=19) patients had low TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, seldom had blocking TSHRAb, but they had high TBII activities. 4) Group 4 (n=30) could be categorized as `mild disease` group, as they had low activities in all kinds of TSHRAb assay and had low antim icrosomal antibody activities. 5) Group 5 (n=14) was characterized by moderate TSAb activities with atypical epitope (s), rare blocking TSHRAb and moderate TBII activities. 6) Group 6 (n=10) patients had veryhigh TSAb activities with typical epitopes, seldom blocking TSHRAb and low TBII activities. 7) Group 7 (n=6) was characterized by very high TSAb activities with atypical epitopes and high TBII activities. Pretreatment serum thyroid hormone level was low only in group 4 patients compared to the other 6 groups (p<0.05). The size of goiter was significantly larger in those in group 1 and group 3 (p<0.05) compared to the other 5 groups. The prevalence of clinically significant ophthalmopathy was higher in group 2 patients than the other 6 groups (50%vs.27.5%,p=0.06). Among 6 kinds of TSHRAb activities, only the blocking TSHRAb activity was significantly associated with the presence of ophthalmopathy in multivariate analysis. Conclusion:These results suggest that the differences inepitopes for TSAb or the presence of blocking TSHRAb is not a major factor in determining the degree of thyrotoxicosis in Graves` disease. Although the pathogenic mechanism is not clearyet, we suggest that patients with ophthalmopathy have different TSHRAb repertoire from those without ophthalmopathy in Graves` disease.

만선신부전 환자에서 관상동맥조영술 소견에 관한 연구

한대희,김성구,박상호,김성한,조원영,방덕원,조윤행,정의룡,은영근,권영구 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background : Patients with chronic renal fialure have a substantially elevated risk of death from cardiovascular diseases than do the general population. the patients with chronic renal failure are at significantly increased freqeuncy of hypertension, hyperlipidemia, and diabetes mellitus which are known to the risk factors of the coronary artery diseases, and the prevalence of the coronary artery diseases in chronic renal failure patients is highly associated with the hemodynamic disorder and metabolic abnormalities. therefore we expected that the coronary angiographic findings in patients with chronic renal failure should be different from the general population (control groups) and investigated the risk factors contributing to coronary artery diseases. Method : we have retrospectively compared the coronary angiographic findings of 44 patients with chronic renal failure on hemodialysis with that of 88 patients in the general population and investigated the factors contributing to the development and acceleration of coronary artery diseases in patients with chronic renal failure Result : Hypertension and diabetes mellitus which is risk factors for coronary artery disease is significantly increased in patients with chronic renal failure, in coronary angiographic finding the severity of the lesion is worse. the incidence of PCI or CABG of patients with chronic renal failure is more than that of control group but statistically no difference between patients with chronic renal failure and control group. the sex, the duration of disease, the duration of dialysis, serum creatinine in patients with chronic renal failure have no correlation to the prevalence of coronary artery disease and severity of lesion. hyperglycemic patients with chronic renal failure have high incidence of coronary artery disease and are worse in the severity of lesion Conclusions : There is significantly increased the pevalence and severity of involving multiple coronary artery diseses in hyperglycemic patients with CRF.

Bernard Bass의 變形리더십 이론에 관한 연구

趙柱瑩 東亞大學校 大學院 1994 大學院論文集 Vol.19 No.-

Leadership research over the last forty years has been on transactional leadership. Transactional leaders clarify for followers their responsibilities, the expectations they have, the tasks that must be accomplished and the rewards followers will receive for fulfilling the contract or agreement with the leader. It is not, however, sufficient to explain the full range of effort and performance that some leaders are able to extract from their followers Followers may produce far beyond what is expected of them because of their commitment to the leader, their trust in the leader's vision, and their desire for change. Consequently, a new model of leadership is required to explain such higher order effects on followers and their organization. Transformational leaders motivate followers to do more than they originally expected. Original performance expectations are enhanced by increasing each follower's level of confidence. The process of transforming followers does not involve merely empowering or delegation to followers the responsibility to take on a goal ; rather, followers develop their capability to determine the appropriate course of action. Transformational leaders are characterized by Burns(1978) as raising the consciousness levels of followers about the importance and value of designated objectives and pointing out ways of achieving them. They also help followers to transcend their own selfpinterests for the sake of the mission and vision of the organization. Transformational leaders are likely to become charismatic in the eyes of their followers and to be seen as holding much referent power and influence. Followers want to identify with them and their mission and view such leaders can occur without charismatic identification. Inspirational leaders can articulate in simple ways shared goals and a mutual understanding of what is appropriate and important to consider. They provide visions of what is possible and how to attain specific goals. Individualized consideration is a distiguishing characteristic of transformational leadership. It means understanding and sharing in the follower's concerns and developmental needs, while treating each follower uniquely. It also represents an attempt on the leader's part to both recognize, understand and satisfy current needs of his or her followers, while also elevate those needs to develop followers to higher levels of potential. In addition to charisma, inspiration and individualized consideration, transformational leadership also involves the intellectual stimulation of follower' ideas, attitudes and values. Through intellectual stimulation, transformational leaders help followers think about old problems in new ways. The process by which charismatic leaders arouse enthusiasm and commitment in followers is still not cler, but an important comonent is the leader's articulation of an appealing vision that taps the conscious or unconsciouss needs, values, and feelings of followers. Transformational leadership increases follower motivation by activating oranizational policies, structures, and culture, thus greatly improving the overall performance of both individual members and the organization as a whole. Increased transformational leadership and its effects can occur at every organizational level.

중환자에서 APACHE Ⅲ score와 사망율과의 관계

조준필,김준식,이영주 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

To evaluate the relationship between APACHE Ⅲ score and mortality in critically ill adult ICU patient, we studied the 548 patients who were admitted to the ICU from June 1, 1994 to January 31, 1995. We did not include patients with burn injuries, patients aged less than 15 years, or chest pain patients, in order to rule out myocardial infarction and unsatisfactory data files. There were 120 multiple trauma patients, 68 sepsis patients, 62 hemorrhagic shock patients, 20 multiple organ failure patients, and 120 patients with, among other conditions, durg intoxi-cation, diabetic ketoacidosis, renal failure, hepatic encephalopathy, and cerebral hemorrhage or infarction. The APACHE Ⅲ scores of survivors and non-survivors were analyzed with Chi-square test and compared. The number of nonsurvivors was 168 patients, and the overall mortality rate was 30.7%. there was a positive correlation between a high APACHE Ⅲ score and mortality ; all patients with more than 90 points expired. The average points of the survivors was 34.52 ±15.48 and of nonsurvivors was 77.74 ±31.37. The difference between each group is significant statistically. The average APACHE Ⅲ points was 47.8. The APACHE Ⅲ score is a good prognostic tool to predict the mortality rate in ICU adult patients, and can be used for selection of patients and for ICU admission/discharge. It can also be used to compare the efficacy of intensive care in different hospitals.

組織 硏究에서의 狀況理論(Contingency Theory)의 有用性과 限界

趙柱瑩 東亞大學校 大學院 1991 大學院論文集 Vol.16 No.-

Basically, the contingency approach theorizes that different situations and conditions required different management approach. The contingency theory is characterized as follows : (1) build up of macro organization theory between organization and environment, (2) holistic theory of organization with open system, (3) attachment of importance on design and strategy of organization theory, (4) orientation to the integration theory on axis of relation of organization and environment. And it is an accumulated proposition, which is able to positive study of organization, which is to make an itegrated theory. The theory shows a new way of managemnt and organization theory. To analysis effectively the impacts of the technology on the orgznizational structure, it is severely required to establish more sophisticated model which incorporates various demensions of the technology and the organizational structure. To analysis more effectvely the impacts of the organizational size on the structure of organization, it is required to consider both formal and informal aspects of organizational structure concurrently. The contingency theory of organization in wider sense deals with the relationship between environment and organization. The envrionment-structure relationship is complicated, but we concluded that (1) the envrionment's effect on an organization is a function of dependence, (2) a dynamic envrionment has more influence on structure than does a static one, (3) complexity and envrionmental uncertainty are directly related, (4) formalization and envrionmental uncertainty are inversely related, (5) the more complex the envrionment, the greater the decentralization, and (6) extreme hostility in the envrionment leads to temporary centralization. Recent research suggests that there are three key to any organization's envrionment. They are labeled : complexity, routineness, and volatility. Given this three-dimensional definition of envrionment, we can offer some general conclusions. The more complex the envrionment, the more participational a structure should be. High envrionmental routineness can be managed more effectively in bureaucratic (mechanistic) structures. High envrionmental volatility can be managed more effectively in Organic Structures (Adhocracy). In spite of this contribution, however, it has some deffects. Adoption of open-defined contingency variables make the theory always true. This cannot fulfill the Popper's criterion of science that a scientific statement must be falsifiable. In fact a researcher could select the envrionmental factors arbitrarily, and be could set up the uncertainty on those factors. Moreover, its true implication is controlling the organization, and the standard of organizational performance is exclusively effectiveness or perofitability, so the contingency theory is criticized as a product of the conservative ideology. The contingency theory of organization must diminish the the weight of contingency variables.