증례 : 순환기: 젊은 연령의 신증후군 환자에 발생한 심인성 쇼크를 동반한 급성 심근경색

김규연 ( Kyu Yeun Kim ),배명환 ( Myung Hwan Bae ),박상미 ( Sang Mi Park ),김홍년 ( Hong Nyun Kim ),양영애 ( Young Ae Yang ),장세용 ( Se Yong Jang ),권상훈 ( Sang Hoon Kwon ) 대한내과학회 2016 대한내과학회지 Vol.90 No.4

급성 심근경색은 소아나 젊은 연령에서는 매우 드문 질환이지만 몇몇 기저질환을 가지고 있는 경우 그 발병률이 증가할 수 있고 신증후군도 그 원인 중의 하나이다. 신증후군에서 나타나는 응고항진상태와 동맥경화의 악화가 급성 심근경색의 원인으로 제시되고 있다. 본 증례는 잘 조절되지 않는 미세변화 신증후군을 가지는 젊은 환자에서 발생한 심인성 쇼크를 동반한 ST상승 심근경색을 보고하였다. Acute myocardial infarction (AMI) is very rare in young adults. Nephrotic syndrome is an uncommon cause of AMI in young adults and is characterized by excessive proteinuria, hypoalbuminemia, hyperlipidemia, and generalized edema. The hypercoagulable state and accelerated atherosclerosis in patients with nephrotic syndrome may be associated with the development of AMI in young adults. We report herein a case of ST-segment elevation myocardial infarction with sudden cardiac arrest in a young patient with minimal change disease. (Korean J Med 2016;90:326-329)

『 풀잎은 노래하고 있다 』 에 나타난 의식의 상승 작용

김규연(Kyu Yeun Kim) 한국현대영미소설학회 1999 현대영미소설 Vol.6 No.1

The Grass is Singing has been seen by many critics as being mainly about the issue of racial discrimination. The novel records the decay and disintegration of both society and the individual owing to a lack of balance at both levels. This paper analyses the increase in consciousness attained by the main character in The Grass in Singing, Mary Turner, through her distress and misery. Doris Lessing has been consciously concerned with understanding and exploring the relationship between the individual and the collective, revealing her belief that the hope for man lies in the balance between his private and social selves. Her insistence on the importance of descent-of developing the inner realm of consciousness as an initial step in order to achieve a healthy relationship with the collective-forms the pivot of this early novel, where Mary Turner`s failure to understand her inner self-interests interacts with the oppressive social pressure of her environment. This interaction is the cornerstone to understanding the tragedy developed in The Grass is Singing. Later she moved to another outsider position, to that of antipsychiatry, for example, and more recently to that of Sufi mysticism, an interest now at last twenty years old. Yet Lessing`s example is radical. Her determinedly antimodernist practice is only in part related to her Maxist commitment. Lessing`s profoundly dialectical consciousness or her competing codes, have been central to the interpretations of major Lessing critics. These interpretations imply a view of the dialectic that needs to be made more explicit. They have not been specifically Marxist; instead they have assumed that the dialectic refers to the conflict between opposites, a conflict that can involve interaction as well as polarity. Although Jung generously sprinkles his work with paired opposites and his influence on Lessing has been assumed by much American criticism, it would be a shock if Lessing`s work failed to register an awarness of Freud`s precedence. Freud`s whole theory of mental life is of course a theory of conflict. In fact she probably finds the pschoanalytic theory of dreams, both the Freudian and the Jungian, more usable than any other aspect of psychoanalystic thought. The use of Oedipal theory is most marked in The Grass is Singing, Developing an inner realm which can combat society becomes the task of later heroines. The Grass is Singing, therefore, sets the pivot of the crucial test which all her later heroines face with varing degrees of success in their relationship with their community. In The Grass is Singing, however, Mary never undertakes this arduous journey that the later heroines must undergo. She therefore reaps negative results from her lack of equilibrium. However, this undeveloped challenge of facing the inner self clearly becomes the task of the protagonist of a later Lessing novel, The Golden Notebook

PD-1 유전자 제거 마우스에서 홍역바이러스 감염

전진경,김규연,허지애,강동원,김기환,김동수,Chun, Jin Kyong,Kim, Kyu Yeun,Hur, Ji Ae,Kang, Dong Won,Kim, Ki Hwan,Kim, Dong Soo 대한소아감염학회 2013 Pediatric Infection and Vaccine Vol.20 No.3

목적: 아급성경화범뇌염은 퇴행성 신경질환으로 홍역바이러스의 지속적 중추신경계 감염으로 나타난다. 저자들은 마우스 모델을 통해 아급성경화범뇌염 발병에서 만성 바이러스 감염에 관여하는 PD-1 유전자의 역할을 알아보고자 하였다. 방법: 3주령의 동형 PD-1 유전자 제거 마우스, 이형 PD-1 유전자 제거 마우스, 야생 BALB/c 마우스를 대상으로 측뇌실내 홍역바이러스를 주입하여 동물 모델로 하였다. 바이러스 주입 3개월 후, 마우스의 뇌 조직학적 소견을 관찰하고 혈청을 분리하여 IL-21의 혈청 농도를 ELISA kit을 통해 측정하였다. 결과: 야생 BALB/c 마우스에서 가장 많은 국소적 뇌백질의 괴사 및 성상세포의 증가가 관찰되었다. 이형 마우스에서 뇌실질의 병변은 적었으며 동형 마우스는 거의 보이지 않았다. 세 그룹에서 모두 혈청 IL-21의 증가는 보이지 않았다. 결론: 이 결과는 PD-1 유전자가 만성 바이러스 감염에 중요한 역할을 함을 시사한다. Purpose: Subacute sclerosing panencephalitis (SSPE) is a neurodegerative disease due to persistent measles virus infection. We investigated the role of programmed death-1 (PD-1) molecule which is related with chronic viral infection in developing SSPE in mouse. Methods: We adopt the $PD-1^{-/-}$, $PD-1^{-/+}$, and wild type BALB/c 3 week old mice to make an animal model of SSPE by injecting measles virus (SSPE strain) intraventricularly. Three months after infusion of virus, the mice were sacrificed and examined if the typical pathologic lesions had been progressed. The sera were collected from each group of mice and the serum level of IL-21 was measured with ELISA kit. Results: The necrotic lesions on white matter and gliosis were found in focal areas in wild type BALB/c. The extent of lesion was smaller in heterotype BALB/c. Scanty lesions were found in $PD-1^{-/-}$ mice. The sera level of IL-21 was not elevated in all three groups. Conclusion: Our data suggest that the PD-1 molecule may play a role in persistent viral infection.

AGL 유전자 검사로 확진된 제 3a형 당원병 1례

서정환,구교연,김규연,이철호,양정윤,이진성,Suh, Junghwan,Koo, Kyo Yeon,Kim, Kyu Yeun,Lee, Chul Ho,Yang, Jeong Yoon,Lee, Jin-Sung 대한유전성대사질환학회 2012 대한유전성대사질환학회지 Vol.12 No.2

제 3형 당원병 (Glycogen Storage disease, Type III: OMIM #232400)은 상염색체 열성 유전을 하는 매우 드문 유전 질환으로, 1p21 염색체에 존재하는 AGL 유전자 (OMIM *610860)로부터 전사되는 글리코겐을 분해하는 효소인 가지제거효소(amylo-1,6 Glucosidase; EC 3.2.1.33 and 1,4-${\alpha}$-D-glucan 4-${\alpha}$-D-glycosyltransferase; EC 2.4.1.25)의 결함으로 인해 유발되는 질환이다. 제 3형 당원병의 환자들은 분해되지 못한 글리코겐이 조직에 축적되면서 증상이 발생하는데, 효소가 분포하던 조직에 따라 그 증상은 다양하게 나타난다. 제 3a형 당원병에서 간비대, 저신장, 그리고 저혈당증 증상은 아동기에 주로 나타나나 나이가 들면서 증상이 호전되어 사춘기를 전후하여 정상이 되는 경우가 많으며, 심근병증 및 근무력감, 운동발달지연 등의 근질환 증상은 영아기나 아동기에는 뚜렷하지 않지만 나이가 들면서 심해져 30-40대 이후 성인기에 나타나는 경우가 많다. 저자들은 간비종대, 심근 약화 증상, 근무력증 등의 전형적인 제 3a형 당원병의 임상증상 및 생화학적 특성이 관찰된 25세 여환에게서, AGL 유전자의 분석을 통해 제 3a형 당원병을 확진하였기에 이를 보고하는 바이다. Glycogen storage disease type III (GSD type III, OMIM #232400) is a rare autosomal recessive disease caused by a deficiency of the glycogen-debranching enzyme (GDE) with a mutation in the AGL gene (OMIM *610860). It is known to be bifunctional enzyme, that is, having two independent catalytic activities; 1,4-${\alpha}$-D-glucan 4-${\alpha}$-D-glycosyltransferase (EC 2.4.1.25) and amylo-1,6-glucosidase (EC 3.2.1.33) that occur at separate active sites on a single polypeptide chain. Most patients with GSD type III usually have symptoms related to decreased glycogenolysis in liver and muscles, such as hepatomegaly, hypoglycemia, failure to thrive, hyperlipidemia, muscle weakness and cardiomyopathy (type IIIa), however some patients show symptoms restricted to liver (type IIIb). GSD type III is diagnosed by enzyme test through liver or muscle biopsy or mutation analysis of the AGL gene. We report the case of GSD type III proven by gene study after liver biopsy, which revealed c.476delA, c.3444_3445insA in exon 6, 27 of AGL gene in Korean patient.

「황금 노트북」에 나타난 안나의 의식구조분석

김규연 조선대학교 인문학연구소 2003 인문학연구 Vol.29 No.-

The Golden Notebook tells the story of Anna Wulf's transformation of personal and political consciousness, and it makes as well a transformation Lessing's artistic identity. With this novel, the writer who once held the view that the realist novel, the realist story, is the highest form of prose writing and higher than and out of the reach of any comparison with the greatest nineteenth writers, suddenly and emphatically rejects both the conventional novel and the modernist novel as model for her own. Seemingly overnight, the traditional novelist becomes not merely a modern novelist, but a postmodern novelist in this view and powerful identity, Lessing reshapes the form of the novel, giving it a postmodern order. Doris Lessing's The Golden Notebook operates on two principle modes, the outer and inner action. Towards the end of the Golden Notebook section that false dichotomy is resolved as Anna participates in practical life by negotiating with an inner voice. The novel consequently requires both linear and non-linear reading. The reader must employ his or her analytic faculties in comparing and elucidating different parts. The aim is the transcendence of the one-dimensional mode of experiencing reality so that a new equilibrium may become possible. The great power of the book comes from the way it interweaves all its levels and combines all its parts into balanced whole. Its structure builds a comprehensive and compelling picture, which fulfils its meaning hough both form and content. The form of Lessing's novel embodies this saving schizophrenia in that a many times split, yet in such a way as to reveal the underlying-saving- shape of one woman's experience. That shape is not a fixed form but a continual movement away from outworn form into chaos and toward new form. Acceptance this creative flus is one of the prerequisites of postmodern art The creation of a text patterned and textured so as to express it is Lessing's triumph in The Golden Notebook.

『종』에 나타난 자유와 사랑

김규연 한국현대영미소설학회 1997 현대영미소설 Vol.4 No.2

The aim of this thesis is to investigate the idea of individual recognition as found in the novel The Bell. This idea is expressed in three ways. First as a failure of opacity of the people who do not do their duty for others or truly love them but rather act out of a desire for recognition by others. Second, it is a pursuit of the spirit which, in the process of understanding the existence of others and loving them, they experience through their failure. Those within the lay community are all dedicated to reaching the highest quality of spiritual experience of which they are capable: "As wise as serpents, as harmless as doves." This spiritual problem forms one of the basic themes of the novel in that the problem of duty as regards spiritual life recurs in the lay sermons preached by James and Michael, the two leading mentors of the community. Two clear signs exist that James's sermon is antithetical to the implied values of the novel and of the author. First, he opposes the very idea of personality, of preoccupation with self, and merely regards it as "interesting", and, as is pointed out, the assumption of the importance of personality is one of the foundation stones of Murdoch's art. Secondly, Catherine's attempted suicide is directly related to her deeply repressed love for Michael, one almost certainly based, in part, on her knowledge of Michael's prior relationship with her brother. Thus Catherine's seeming innocence and saintliness mask a profoundly complicated and maladjusted personality that erupts in self-destructive violence which necessarily requires treatment. Michael said, "The chief requirement of the good life is that one should have some conception of one's capacity so that by cunning, introspections and calculation they can learn to take high advantage of their strength and to avoid those situations that pander to their weakness." This theoretical disagreement between the two natural leaders of the community attains its expression in action at the climax of the novel. Michael loved Nick intensely, and even though the rules state that sodomy is forbidden, this form of love is implanted in Michael's nature and it must come, however mysteriously, from God. But because he wants to purify himself and keep his own soul untainted, frequently silent, repulsive, tortured gestures come from him. Michael and Dora are real and unexpected individuals - Michael appears as a homosexual idealist, schoolmaster-cum-priest, a type met often enough before in literature while Dora is a character less easy to absolutely stereotype but possibly much easier to make into a fairly interesting variation on a stock theme of the life-loving girl, not yet grown up, and carelessly ill-behaved. Michael is Miss Murdoch's first attempt to come to grips with the complex interrelations of religion and morals, freedom and restraint from inside. In Murdoch we have a study of the area where fantasy overlaps the spiritual world, as earlier we have seen fantasy overlapping the aesthetic world and the world of love between humane beings.

Thomas Hardy의 문학관 : 소설을 중심으로

金奎堧 한국영어영문학회 1993 영어 영문학 Vol.39 No.1

Thomas Hardy의 자연과 인간 : The Return of the Native를 중심으로

金奎堧 한국영어영문학회 1991 영어 영문학 Vol.37 No.1

토마스 하디의 '진화적 개선론'에 대한 연구 : [테스]와 [박명의 쥬드]를 중심으로

김규연 조선대학교 인문과학연구소 1995 인문과학연구 Vol.17 No.-

Thomas Hardy's pessimism seeks to bring the true life to light, and his eagerness to make a clear life struggles to attain the conquest of tragedy and save man from sufferings. So increasingly Hardy tends to see an opposition between spontaneity of nature and legal rigidities of social institutions and conventions. He, therefore, presents an evolutionary meliorism in his nove In his later novels, Hardy frequentry introduce Mills' first cause and Schopenhauer's pessimism. For this reason Tess, the innocent victim of a seducer, is executed to give the reader an eteral feeling of grief amd Jude is cruelly destroyed but also aligned with some of most austere of moralists and enabled, agnostic though he was, to persist in the assertion of such traditional and officially Christian values as charity and what he himself called "loving kindness" at a time when those values were undergoing erasion and vulgarization, and when he himself was being vilified for their betrayal. Hardy develops, however, an evolutionary melioristic view of the world, believing that human immorality can eventually be overcome to hopefully make people's thought and the world better. In his last novel, Jude the Obscure, he therefore writes "where Jude ends, the rainbow begins."

유사학과 조정 및 교양교과과정개편에 관한 연구

이종범,김규연,전지용,이춘의,홍석주 朝鮮大學校 1995 교과교육연구 Vol.17 No.-