서울지역 치과위생사의 삶의질(Quality of Life)에 관한 분석 연구

김연선 ( Yeun Sun Kim ) 한국치위생과학회 2005 치위생과학회지 Vol.5 No.1

통상적인 투석처방을 받는 혈액투석 환자에서 실제 투석량에 영향을 미치는 인자의 분석

김연선 ( Yeun Sun Kim ),이현희 ( Hyun Hee Lee ),이종호 ( Jong Ho Lee ),김은수 ( Eun Soo Kim ),진경순 ( Kyoung Soon Jin ),김정곤 ( Jung Gon Kim ),유승민 ( Seung Min Yoo ),이준승 ( Joon Seung Lee ),정우경 ( Woo Kyung Chung ),주권욱 대한내과학회 2005 대한내과학회지 Vol.69 No.5

목적 : 적절한 혈액투석의 평가에 요소역동학을 이용한 Kt/V지표가 사용되나 일부 환자에서는 적절한 Kt/V값을 유지하지 못하여 이로 인한 임상적 문제가 발생할 수 있다. 저자들은 통상적인 주 3회, 회당 4시간의 혈액투석을 처방받는 환자에서 처방된 투석량과 전달된 투석량을 조사하고, 부적절한 투석량 전달에 미치는 요인을 분석하고자 하였다. 방법 : 안정된 상태로 투석 중인 97명의 만성신부전 환자를 대상으로 처방된 투석량은 Kt/V공식에서 K값으로 in vitro 요소청소율을 V값으로 Watson 식을 이용한 요소분포용적을 구하여 계산하였고, 전달된 투석량은 Daugirdas의 single pool, variable volume공식을 사용하여 계산하였다. 또, 전달된 투석량에 영향을 줄 수 있는 기술적, 임상적 인자들별로 전달된 투석량의 차이를 분석하였다. 결과 : 처방된 투석량의 평균은 1.37±0.21, 전달된 투석량의 평균은 1.23±0.27로 양의 상관관계는 있었으나 유의한 차이를 보였다(p<0.03). 전달된 투석량이 1.2 미만인 군은 45%였고, 이 군은 체중이 높았으며, 투석 처방량이 낮았다. ΔKt/V값은 헤파린을 사용한 군에서 사용하지 않은 군에 비해 유의하게 낮았으며(0.11±0.16 vs. 0.28±0.20, p<0.002), 저혈압, 투석 중 증상, 투석시간의 단축, 재순환율 등의 인자에 따른 차이는 보이지 않았다. 결론 : 통상적인 투석 처방으로 혈액투석 중인 환자에서 체중, 투석 처방량, 헤파린 사용 여부 등의 인자들이 투석의 적절도에 영향을 줄 수 있으므로 환자에 따른 개별적 처방이 필요함을 알 수 있었다. Background : Although adequate removal of small solutes are essential for effective hemodialysis, many patients are suffering from inadequate delivery of hemodialysis, especially with the conventional fixed regimen of dialysis for 4 hours three times per week. We tried to evaluate actual delivered dose of hemodialysis in patients receiving 4 hours of low-flux hemodialysis, and to analyze factors affecting inadequate delivery of hemodialysis. Methods : 97 stable maintenance hemodialysis patients who were undergoing 4 hours of hemodialysis thrice weekly were included for analysis. Prescribed dose of dialysis was calculated by Kt/V where K was in vitro urea clearance of dialyzer membrane and V was estimated according to the Watson`s formula. Delivered dose of dialysis was calculated according to the Daugirdas equation. To find factors that may impair adequate delivery of hemodialysis, various clinical and technical parameters were analyzed. Results : Prescribed dose of hemodialysis was 1.37±0.21, while delivered dose was 1.23±0.27, and thus, there was a significant difference (p<0.03). In 45% of the patients, delivered dose was less than 1.2. They were heavier and prescribed dose was low. ΔKt/V (Prescribed dose-Delivered dose) was significantly greater in patients who did not use heparin therapy compared to patients who used heparin. Other parameters such as hypotension, missed treatment, sex, type of vascular access and degree of recirculation were not associated with impaired delivery of hemodialysis. Conclusions : Delivered dose of hemodialysis can be affected by patient`s body weight, prescribed dose and heparin use in conventional low-flux hemodilaysis regimen. Therefore, each patient should be prescribed individually for adequate delivery of hemodialysis, and delivered dose should be measured regularly.(Korean J Med 69:510-517, 2005)

제2형 당뇨병환자에서 미세혈관 합병증과 염증 인자들의 연관성

양선미 ( Sun Mee Yang ),김성용 ( Sung Yong Kim ),이기영 ( Ki Young Lee ),김연선 ( Yeun Sun Kim ),남문석 ( Moon Suk Nam ),박이병 ( Ie Byung Park ) 대한당뇨병학회 2007 Diabetes and Metabolism Journal Vol.31 No.6

농촌관광 수요촉진에 관한 연구

노용호(Roh, yong-ho),김연선(Kim, yeun-sun) 한국문화관광학회 2004 문화관광연구 Vol.6 No.1

Rural tourism, which makes use of the farming community and agriculture, aims to contribute to creating off-farm income and economic profits. From this viewpoint, to begin with, as in examples of Britain, Germany, France, and Japan, the government should make proper policies; besides, various associations and organizations in agricultural industry should take the initiative to improve agricultural infrastructure. Secondly, along with the government’s policies, farmers should devise ways to advertise their private accommodations and gain customers’ confidence. Besides, They have to develop local tourist products through thorough understanding of their local areas, and by networking themselves, they need to give various information to consumers or city residents. As life in the city is getting more complicated and hard, rural tourism will establish itself as a future form of tourism as an alternative to experience nostalgia for the past and regain the tender feeling we are unconsciously losing. Consequently, we will have to strive to revive the worsening rural economy through rural tourism, and urban residents can also be able to use it as a means to find entertainment.

교육 및 사회경제적 수준과 당대사와의 연관성

엄영실 ( Young Sil Eom ),양선미 ( Sun Mee Yang ),오병천 ( Pyung Chun Oh ),이정현 ( Jung Hyun Lee ),이기영 ( Ki Young Lee ),김연선 ( Yeun Sun Kim ),이시훈 ( Si Hoon Lee ),임정수 ( Jung Soo Im ),임준 ( Jun Yim ),오대규 ( Dae Kyu Oh 대한당뇨병학회 2008 Diabetes and Metabolism Journal Vol.32 No.4

한국인의 비만형 인슐린비의존성 당뇨병 발생기전에 있어서 β₃아드레날린 수용체 유전자 다형성의 의의

고은미(Eun Mi Koh),안규정(Kyu Jeung Ahn),김경아(Kyoung Ah Kim),김연선(Yeun Sun Kim),정재훈(Jae Hoon Choung),민용기(Young Ki Min),이명식(Myung Shik Lee),이문규(Moon Kyu Lee),김종원(Joung Won Kim),김광원(Kwang Won Kim),김성운(Sung Woon 대한내과학회 1997 대한내과학회지 Vol.53 No.6

N/A Objectives : The β₃adrenergic receptor(β₃-AR) may play an important role in the regulation of energy expenditure and lipolysis. A mutation of the β₃- AR gene(Trp64Arg) has been reported to be associated with early onset of non-insulin dependent diabetes mellitus(NIDDM), obesity and syndrome X which are related with insulin resistance. It is well known that Korean NIDDM patients, in contrast to Caucasians, are mainly non-obese and have experienced severe weight loss during the course of disease. We studied the frequency of the mutation in Korean NIDDM patients and non-diabetics control and evaluated the clinical characteristics of Korean obese NIDDM patients. We investigated the frequency of the mutation in NIDDM patients and clinical characteristics of the patients with the mutation in order to elucidate the significance of the mutation in the pathogenesis of NIDDM in Koreans. Methods: We studied 401 NIDDM patients and 99 controls. The NIDDM patients were divided into two groups, non-obese group and obese group, according to their body mass index at diagnosis of the disease. The Trp64Arg mutation was detected by the PCR/RFLP method using restriction enzyme Mva I. Results: The Trp64Arg allele frequency(16M) of NIDDM did not differ from that(16%) of controls. Although the mutant allele frequency was not different between non-obese and obese group both in NIDDM patients and controls, the frequency of patient with the mutant allele was significantly higher in obese NIDDM patients than in non-obese NIDDM patients(38.5% vs. 26.9%, P=0.04). However, no significant differences were found in clinical and laboratory findings between the NIDDM patients with the mutant allele and those without the mutant allele. Conclusion: These data suggest that β³-AR mutation might be associated with Korean obese NIDDM, and other factors might also be associated with the development of obesity and insulin resistance in NIDDM patients.

Rural Tourism 수요촉진에 관한 연구 : 해외사례 비교 A Case Study of Foreign Countries

노용호,김연선 한국문화관광학회 2004 문화관광연구 Vol.6 No.1

Rural tourism, which makes use of the farming community and agriculture, aims to contribute to creating off-farm income and economic profits. From this viewpoint, to begin with, as in examples of Britain, Germany, France, and Japan, the government should make proper policies; besides, various associations and organizations in agricultural industry should take the initiative to improve agricultural infrastructure. Secondly, along with the government's policies, farmers should devise ways to advertise their private accommodations and gain customers' confidence. Besides, They have to develop local tourist products through thorough understanding of their local areas, and by networking themselves, they need to give various information to consumers or city residents. As life in the city is getting more complicated and hard, rural tourism will establish itself as a future form of tourism as an alternative to experience nostalgia for the past and regain the tender feeling we are unconsciously losing. Consequently, we will have to strive to revive the worsening rural economy through rural tourism, and urban residents can also be able to use it as a means to find entertainment.

(111)Indium Pentetreotide 스캔으로 수술전후 갑상선 수질암의 위치 및 진행정도를 평가한 2예

김광원,이문규,민용기,이명식,고은미,정재훈,안규정,김경아,김연선 대한내분비학회 1996 Endocrinology and metabolism Vol.11 No.1

Medullary carcinoma of the thyroid gland(MTC) constitutes approximatesly 3% to 10% of all malignant thyroid tumors. It appears in both familial and sporadic forms. Metastases are frequently present at diagnosis and are resistant to chemotherapy and radiotherapy. Surgical resection of the primary tumor and the metastases is the mainstay of treatment. Although MTC can be detected by elevated serum calcitonin, localization of residual or metastatic foci may be difficult. Many scintigraphic methods have been used for identification of the residual tumor or metastasis. However, most of them have either low sensitivity or low specificity. MTC frequently secretes somatostatin and may express somatostatin receptors. Recently, somatostatin-receptor imaging has been known to be useful for the detection of residual and recurrent medullary thyroid carcinoma. A 25 year-old woman who was dignosed as medullary carcinoma by biopsy of thyroid mass is presented. Thirteen years ago, she underwent left thyroidectomy due to thyroid cancer(MTC). Laboratory tests revealed an increase in the levels in serum CEA(CEA=557.6 ng/ml) and calcitonin(calcitonin= 720 pg/ml). The second patient, a 30 year-old female, complained of a palpable mass in the left anterior neck. Ten years ago, she underwent a right lobectomy of thyroid gland due to adenomatous goiter. Laboratory tests revealed an increase in the levels in serum CEA(CEA=617 ng/ml) and Calcitonin (Calcitonin=2,300 pg/ml). In both cases, pre- and postoperative In-111 pentetreotide scintigraphy were done and compared with 131I scintigraphy. In-111 pentetreotide scan may be useful for the localization of residual or metastatic medullary thyroid carcinoma. Further study is warranted to define the sensitivity and specificity of the technique(J Kor Soc Endocrinol 11:85-92, 1996).

Down 증후군과 동반된 그레이브스병 1예

김광원,이문규,이명식,고은미,민용기,정재훈,안규정,김경아,김연선,기현균 대한내분비학회 1997 Endocrinology and metabolism Vol.12 No.1

Down's syndrome(trisomy 21) has been frequently associated with thyroid disease, mainly subclinical hypothyroidism(12.5-32.5%). The occurrence of Downs syndrome in conjunction with hyperthyroidism is rare(0.6-2.5%). The mechanism that Down's syndrome was frequently associated with autoimmune thyroid disease is not clear, but T cell maturation defects and overexpression of chromosome 21 products in Down's syndrome have been suggested. A 19-year-old female was transferred because of generalized weakness. She was born to a 42- year-old mother, She had been suffered from heat intolerance, weight loss, palpitation, dyspnea on exertion and neck swelling and had intermittently taken some medication since her age 9. She had mental retardation(IQ 41) and underdeveloprnent. Exophthalmos, upward-outward slant of palpabral fissures, epicanthal folds, lowset ears, and large, protruding, fissured tongue were identified. Short fifth middle phalanges, clinodactyly and small-sized interventricular septal defect were also detected. Thyroid gland was diffusely enlarged four times the normal size, firm in consistency and had a bruit. Serum T concentration was 7.8ug/dL, T2 306ng/dL, and TSH 0.01ulU/mL. She was positive for thyroid autoantibodies(antimicosomal antibody 1,867 IU/mL, antithyroglobulin antibody 106 IU/mL, and TBII 79.6%). Twenty-four hours radioactive iodine uptake was 64%. Chromosomal analysis with T cell culture stimulated by phytohemagglutinin revealed 47XX, 21 trisomy. Pituitary hormones except TSH were fully stimulated by combined pituitary stimulation. She was finally diagnosed as Down's syndrome with Graves' disease and controlled with use of methimazole. (J Kor Soc Endocrinol 12:61-67, 1997)

불현성 갑상선기능 저하증에서 혈청 LP(a) 및 지질 농도의 양상

김광원,이문규,이명식,고은미,민용기,정재훈,안규정,김경아,김연선,이종헌 대한내분비학회 1997 Endocrinology and metabolism Vol.12 No.1

Background: Overt hypothyroidism is well-known cause of secondary hyperlipidemia and atherosclerosis. However, there have been dissenting reports of abnormalities in serum lipid concentrations in patients with subclinical hypothyroidism (SH). Recently, it has been reported that serum Lp(a) concentration, an independent risk factor of atherosclerosis, was increased in patients with SH. Therefore, we analyzed serum Lp(a) and other lipid concentrations to investigate whether they are increased in patients with SH and the correlation between serum Lp(a) and TSH concentrations. Methods: We undertook this study in 53 patients with SH (TSH $gt; 6 uiU/ml) and 197 age-and sex-matched healthy control subjects, They had no abnormalities in liver function, BUN, creatinine, fasting blood glucose, urinalysis, and past medical histories. Serum T3, T4, and TSH concentrations were measured by RIA using commercial kits. Serum concentrations of Lp(a), total cholesterol, triglyceride (TG), and HDL cholesterol (HDL-C) were measured by rate nephelometry and enzyme assay, respectively. Results: There were no significant differences of serum Lp(a), total cholesterol, LDL cholesterol, TG, and HDL-C concentrations in 53 patients with SH and 197 control subjects(25.6+-3.8mg/dL vs. 25.4+-1.5mg/dL ; 204.0+-4.2mg/dL vs. 204.0+-2.4mg/dL ; 127.0+-3.9mg/dL vs. 125.0+-2.3 mg/dL ; 133.0+-8.5mg/dL vs. 130.0+-6.0mg/dL ; 50.0+-1.5mg/dL vs. 53.0+-0.9mg/dL). There was no correlation between Lp(a) and TSH concentrations in SH(r=0.12, p$gt;0.05). Conelusion: Serum Lp(a) concentration as well as total cholesterol, LDL cholesterol, and TG was not increased in patients with SH. There was no correlation between serum Lp(a) and TSH levels in subclinical hypothyroidism. (J Kor Soc Endocrinol 12:11-17, 1997)