액티브 러닝 학습방법을 활용한 심전도 개론 및 실습 교과과정의 학습효과와 만족도 조사

김철태,김정선,Kim, Chul-Tae,Kim, Jung Sun 한국응급구조학회 2019 한국응급구조학회지 Vol.23 No.2

Purpose: This study aimed to introduce active learning methods, including flipped, case-based, and team-based learning in an electrocardiography (ECG) course and to investigate outcomes and satisfaction with these methods. Methods: To identify the learning effect of active learning, pre-and post-academic self-efficacy was compared between the experimental and control groups. In the experimental group, pre-and post-knowledge and clinical performance regarding ECG were also assessed. In addition, class satisfaction was investigated after application of active learning methods in the experimental group. Data were collected from 84 paramedic students and analyzed using SPSS 22.0 (IBM, Armonk, NY, USA). Results: The experimental group showed significant improvement in post-academic self-efficacy and knowledge. The experimental group also showed high clinical performance (9.83 out of 10 in ECG checking ability and 9.63 out of 10 in ECG reading ability). The mean satisfaction score was 4.23 out of 5 (responses based on a Likert scale) in the experimental group. Conclusion: Active learning in an ECG course was found to be highly effective and satisfactory. Furthermore, paramedic students can enhance their accountability and judgement with team-based learning through free engagement in discussion.

행동이상 Pogo 마우스 소뇌 Calretinin 면역반응성 홑극붓털세포(Unipolar brush cells)의 분포

김철태(Chul-Tae Kim),박오성(O-Sung Park),한승연(Seung-Yun Han),정재현(Jae-Hyun Jeong),윤대성(Dae-Sung Yoon),이서울(Seoul Lee),Richard Hawkes, 김무강(Moo-Kang Kim),이남섭(Nam-Seob Lee),정영길(Young-Gil Jeong) 대한해부학회 2005 Anatomy & Cell Biology Vol.38 No.4

홑극붓털세포 (Unipolar Brush Cell)은 소뇌 과립층에서 최근 새롭게 발견된 흥분성 사이신경원(excitatory interneuron)으로 포유류 안뜰소뇌(vestibulocerebellum)에 집중적으로 분포한다. 홑극붓털세포는 소뇌외부에서 기원한 이끼섬유(mossy fiber)로부터 내인성 신경연접을 중계하는 역할 뿐만 아니라, GABA성 사이신경세포와 조롱박세포 (Purkinje cell)로 투사하는 흥분성, 글루타민성 사이신경세포로 알려져 있으며, 홑극붓털세포의 가지돌기들은 과립층 내에서 분지하여 이끼섬유, 과립세포 또는 다른 홑극붓털세포들과 시냅스를 형성한다. 본 연구는 새로운 행동이상(ataxia) 모델인 pogo 마우스를 이용하여, 대조군과의 calretinin 양성반응 홑극붓털세포의 분포 양상의 차이를 규명하고, Ca2± 항상성과의 연관관계를 알아보기 위해 시행하였다. 전체적으로 행동이상 pogo 마우스 소뇌에서 calretinin 양성반응 홑극붓털세포는 대조군, 즉 pogo/± 마우스에서의 경우와 동일한 양상으로 소뇌벌레(cerebellar vermis)의 후엽 중 IX, X번 소엽에서 주로 관찰되었다. 그러나 대조군에 비하여 calretinin 면역반응 홑극붓털세포의 전체적인 수의 감소가 관찰되었으며, 대조군에서 홑극붓털세포의 분포가 IX, X 소엽에서 시상면성 배열양상을 보이는 데에 반하여, 행동이상 pogo 마우스 소뇌에서는 시상면성 배열양상을 보이지 않았다. 이와 같은 행동이상 pogo 마우스 소뇌의 calretinin 양성반응 홑극붓털세포수와 배열양상의 비정상성은 소뇌 Ca2± 항상성에 영향을 미칠 것으로 생각되며, 행동이상 pogo 마우스에서 관찰되는 다양한 행동이상과도 밀접한 연관 관계가 있을 것으로 사료된다. Unipolar brush cells (UBCs) are a class of putative interneurons found in the granular layer of mammalian cerebellum and dorsal cochlear nucleus. The unipolar brush cells (UBCs), as with granular cells, which receives afferent synaptic input from extrinsic mossy fiber and whose axons branch in the granular layer and establish a system of cortex-intrinsic mossy fibers, which synapse with granule cells and other UBCs. In general, UBCs have been identified most readily by their expression of the calcium-binding protein, calretinin. The purpose of this study was to provide information about UBCs distributions of the new ataxic animal model, pogo mouse cerebellum using anti-calretinin immunohistochemistry, immunofluorescence and its effect on calcium homeostasis. Through the examination of calretinin immunohistochemistry and immunofluorescence, we observed that many calretinin immunoreactive UBCs were distributed widely throughout the lobules IX and X of the granular layer of both group. But, we found the number of calretinin immunoreactive UBCs of ataxic pogo (pogo/pogo) mouse was decreased and distribution pattern was altered, compared to control mouse. This result also suggest that reduced calretinin expression may effect on cerebellar Ca2± homeostasis, and it may in turn, explain the impaired motor coordination found in the ataxic pogo mice.

신체억제대에 대한 일반인의 인식, 태도, 지식 및 교육경험과 교육요구도 조사

한다연,김철태,Han, Da-Yeon,Kim, Chul-Tae 한국응급구조학회 2018 한국응급구조학회지 Vol.22 No.2

Purpose: This study aimed to investigate recognition, attitudes, knowledge, education experience, and education demand regarding physical restraint among laypersons. Methods: A self-reported questionnaire was completed by 105 randomly recruited laypersons in D city. Excluding 2 incomplete answers, 103 data were analyzed by frequency analysis, t-test, ANOVA, and chi-square test using SPSS 23.0. Results: Laypersons' recognition of physical restraints was rated at 3.37 out of 5 points, and showed a positive perspective. Knowledge on physical restraints was rated at 13.68 out of 18 points and was affected by age and education level (F = 2.845, p = .028)(F = 3.126, p = .029) A majority of the participants had no education on physical restraints. Nevertheless, participants showed intention to receive education in physical restraint to reach further understanding. Conclusion: Education on physical restraints is necessary for lay persons. However, there were education limits for people living in modern times. As an intervention addressing this problem, observing videos on the internet is recommended. Moreover, for advertising/educational purposes, accessing the internet and using smart-phone applications are suggested.

보건계열과 비보건계열 대학생의 자동심장충격기에 대한 인지도

정해영,김숙희,김철태,Jung, Hae-Young,Kim, Suk-Hui,Kim, Chul-Tae 한국응급구조학회 2017 한국응급구조학회지 Vol.21 No.2

Purpose: This study measured awareness of automated external defibrillators (AED) among students majoring in health-related versus non-health-related fields. Methods: A total of 577 students filled out a questionnaire on awareness of AEDs between June 12 and June 28, 2017. Using SPSS 23.0, data were analyzed using descriptive statistics, chi-square tests, and t-tests. Results: In response to a question about awareness of AED, 25.0% of students majoring in a health-related and 38.6% of those majoring in a non-health-related field answered on "I have seen or heard" and "I have no idea". In response to a question on perception on AED use, 82.4% of students majoring in a health-related field and 88.1% of those in a non-health-related field reported that they thought perception of AED use was not universal. In terms of experience with education on the use of AED, 30.2% of health-related majors and 49.7% of non-health-related majors had not received any training on the use of AED. The average overall score regarding knowledge about AED was 8.69 for health-related majors, compared to 7.79 for non-health-related majors. Conclusion: In order to improve awareness regarding AED use, education on importance and necessity of AED should be emphasized and implemented consistently by the mass media.

행동이상 Pogo 마우스 척수 Calbindin D-28K (CALB) 면역반응 Renshaw Cells (RCs)의 감소

김진성(Jin-Seong Kim),김재민(Jae-Min Kim),손진아(Jin-A Son),한승연(Seung-Yun Han)김철태(Chul-Tae Kim),이남섭(Nam-Seob Lee),정영길(Young-Gil Jeong) 대한해부학회 2008 Anatomy & Cell Biology Vol.41 No.4

칼슘결합단백질인 calbindin D-28k (CALB)는 칼슘이온의 완충과 수송 그리고 다양한 효소 조절작용 등의 매우 중요한 기능을 수행한다. 척수에서의 CALB 면역반응 신경세포 일부는 배쪽뿔 운동신경세포 영역으로부터 안쪽 VII번 층판에 위치하고, 최근 해부학적 위치에 근거하여 척수 α-운동신경세포의 되돌림 억제성(recurrent inhibition)을 조절하는 Renshaw Cells (RCs)로 알려져 있다. 본 연구는 운동 시 뒤뚱거리거나 뒤로 넘어지는 비정상적인 보행과 양 사지간의 부조화와 뒷다리의 과도한 폄 운동 등의 행동이상 양상을 보이는 pogo 마우스 척수 허리분절 배쪽뿔 내 운동신경 세포와 높은 수준의 CALB을 함유하고 있는 RCs과의 상관관계를 조사하기 위하여 시행하였다. CALB 면역반응 RCs은 대조군에 비하여 행동이상 pogo 마우스 척수 허리분절 배쪽뿔에서 두드러지게 감소하였으나(p⁄0.05), 등쪽뿔에서는 유사한 발현을 보였다. 더욱이 행동이상 pogo 마우스의 척수 허리분절에서 CALB 단백발현 또한 현저하게 감소하였으나(p⁄0.01), 각 군의 목분절과 가슴분절에서의 CALB 단백발현은 유의한 차이가 없었다. 이와 같은 결과는 뒷다리의 과도한 폄 운동을 보이는 행동이상 pogo 마우스 척수 허리분절 배쪽뿔 내 감소된 CALB 면역반응 RCs이 운동신경세포의 흥분성 조절을 수행하지 못 함으로 인하여 이들 운동신경세포는 더욱 흥분 상태가 될 수 있음을 시사한다. Calbindin D-28K (CALB) is one of the calcium-binding proteins which is assumed to be buffering, transport of Ca2+, and regulation of various enzyme systems. In the spinal cord, a subpopulation of calbindin-immunoreactive neurons located in the ventral portion of lamina VII, medial to the motoneuron column, has recently been proposed to be Renshaw cells (RCs), that mediate recurrent inhibition of spinal α-motoneurons, based on the anatomical location. In this study, we have performed to investigate the correlation between RCs containing high levels of CALB and motoneurons in the ventral horn of lumbar spinal cord of the ataxic pogo mice, that characterized by a failures of interlimb coordination, and prolonged excessive tone of hindlimb extensor muscles. We have shown that CALB immunoreactive RCs was significantly decreased in the ventral horn of lumbar spinal cord of the ataxic pogo mice (p⁄0.05), when compared with the control mice. Whereas, CALB immunoreactivity expression levels were no difference in the dorsal horn. Furthermore, CALB protein was significantly decreased in the lumbar spinal cord of the ataxic pogo mice (p⁄0.01). However, there were no difference in the cervical and thoracic spinal cord of the between control and pogo mice. These results suggest that motoneurons of ventral horn of the lumbar spinal cord might be more excited state, results in the decreased CALB immunoreactive RCs have not mediated a motoneuron excitability, in the atxic mice, pogo.

응급실 응급구조사의 감염노출 예방행위 수행정도에 영향을 미치는 요인

심경율,김지희,이효철,김철태,Sim, Kyung-Yul,Kim, Jee-Hee,Lee, Hyo-Cheol,Kim, Chul-Tae 한국응급구조학회 2018 한국응급구조학회지 Vol.22 No.1

Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in emergency rooms. Methods: A self-reported questionnaire was filled out by 100 EMTs in emergency rooms from June 1 to August 31, 2017. The questionnaire consisted of items concerning the defensive environment for the prevention of infection exposure, perception of preventive behavior, and degree of performance of preventive actions against infection based on a five-point Likert scale. Data were analyzed by descriptive statistics, ${\chi}^2$ test, ANOVA, Pearson's correlation coefficients, and linear regression. Results: The defensive environment for the prevention of infection exposure was 4.12. The perception of preventive action was 4.71, and the degree of performance of preventive actions against infection was 4.54. There was a significant relationship between the degree of performance of preventive actions against infectious exposures and the degree of perception of preventive behavior(r=.506, p=.01) and prevention of infectious exposure(r=.506, p=.01). The protective environment(B=.360, t=3.236, p=.002) and perceived level (B=.904, t=4.662, p=.000) were influenced by the degree of prevention of infection exposure. Conclusion: It is important to manage the protection environment for infection exposure prevention and to enhance the awareness of infection prevention actions against infection exposure among the EMTs in emergency rooms.

Voltage-dependent Calcium Channel (VDCC) α1A Subunit Expression in the Ataxic Mutant, Pogo Mice Cerebellum

이남섭(Nam-Seob Lee),김철태(Chul-Tae Kim),한승연(Seung-Yun Han),김진성(Jin-Seong Kim),김재민(Jae-Min Kim),손진아(Jin-A Son),정영길(Young-Gil Jeong) 대한해부학회 2007 Anatomy & Cell Biology Vol.40 No.4

본 연구는 한국산 야생마우스에서 유래된 선천성 행동이상 Pogo마우스 소뇌 voltage-dependent calcium channel (VDCC) α1A의 발현을 면역조직화학법으로 조사하여 행동이상의 발생과 소뇌 P/Q calcium channel 발현의 상관관계를 밝히고자 계획되어 다음과 같은 결과를 얻었다. 첫째, VDCC α1A 면역반응은 행동이상 Pogo마우스와 대조군 마우스 소뇌겉질 조롱박세포, 과립세포 및 깊은소뇌핵에서 관찰되었다. 소뇌겉질 조롱박세포와 과립세포의 면역반응성은 행동이상 Pogo마우스와 대조군에서 특별한 차이가 관찰되지 않았다. 둘째, 깊은소뇌핵의 VDCC α1A 면역반응은 대조군에 비하여 행동이상 Pogo마우스 소뇌에서 증가됨이 관찰되었다. 깊은소뇌핵의 사이핵과 가쪽핵에서는 VDCC α1A 면역반응성이 증가됨이 뚜렷하였으나 정중핵에서는 대조군과 유사한 면역반응성을 보여 깊은소뇌핵 내에서도 차이가 있음을 관찰하였다. 이상의 결과로 행동이상 Pogo마우스에서 관찰되는 깊은소뇌핵 VDCC α1A 발현의 증가는 소뇌 칼슘 항상성의 변화를 유발하여 행동이상의 발생과 밀접한 연관관계가 있음을 확인할 수 있었다. The pogo mouse is a new ataxic mutant derived from a Korean wild mouse. The pogo mutation is inherited as an autosomal recessive trait on chromosome 8. Mutations in gene coding for the α1A subunit of voltagegated P/Q-type Ca2+ channel have been shown to cause phenotypes in humans and mice, i.e., tottering, leaner, rolling mouse mouse Nagoya. Using immunohistochemistry, the expression of the α1A subunit of voltage-gated P/Q-type Ca2+ channel was examined in pogo mice cerebellum including deep cerebellar nuclei (DCN). We observed α1A immunoreactivity in the cerebellar cortex (Purkinje cell and granule cell) and DCN of ataxic pogo mice and heterozygote control mice. There was no difference in cerebellar cortical α1A immunoreactivity between ataxic pogo mice and heterozygous littermate controls (pogo/+). However, we observed α1A immunoreactivity in the Purkinje cells of control and ataxic pogo mice cerebellum and DCN. We found a significant difference between pogo and heterozygous controls in terms of α1A immunoreactivities in the DCN. α1A immunoreactivity in this nucleus in pogo was much higher than in heterozygous littermate controls. No significant differences were observed in the interposed nucleus between pogo and heterozygous controls, but we found that the α1A subunits were clearer and more abundant in the lateral and medial regions of pogo than in control mice in these regions, where only weak immunoreactivity was observed. This elevated expression of the α1A subunit in deep cerebellar neurons of pogo might be a compensation for the altered function of P/Q type calcium channel and be related with the induction of the ataxic phenotype in pogo mice.

Differences of Zebrin II Expression Pattern Between Normal Balb/C and Ataxic Pogo Mouse Cerebellum

이남섭(Nam-Seob Lee),김철태(Chul-Tae Kim),김기형(Ki-Hyung Kim),김선경(Sun-Kyung Kim),정승혁(Seung-Hyuk Chung),고경옥(Kyong Og Ko),Kazuhiko Sawada, Yoshihiro Fukui, 현병화(Byung-Wha Hyun),원무호(Moo-Ho Won),정영길(Young-Gil Jeon 대한해부학회 2003 Anatomy & Cell Biology Vol.36 No.6

zebrin II는 소뇌 Purkinje 세포에서 발현되는 36-kDa의 호흡효소(respiratory isoenzyme aldolase C)로 지금까지 알려진 가장 대표적인 소뇌구획표지자(cerebellar compartmentation marker)로 알려져 있다. 본 연구는 국내 최초로 발견된 선천성 운동실조 마우스인 pogo 마우스와 Balb/C 마우스 소뇌에서 zebrin II 발현양상의 차이를 확인하기 위하여 시행되었다. zebrin II 면역반응은 pogo 마우스와 Balb/C 마우스 소뇌 Purkinje 세포의 세포질과 수상돌기에서 관찰되었다. pogo 마우스와 Balb/C 마우스 소뇌 zebrin II 면역반응 Purkinje 세포들은 zebrin II에 면역반응을 보이지 않는 Purkinje 세포들과 서로 교대로 위치하여 소뇌의 앞-뒤를 연결하는 parasagittal band 형태로 관찰되었다. 소뇌 전체에 걸쳐 pogo 마우스와 Balb/C 마우스 소뇌 zebrin II 면역반응 Purkinje 세포들의 분포양상은 거의 유사하였다. 그러나, 소뇌 앞부분(anterior zone, AZ)의 lobule III에서는 pogo 마우스와 Balb/C 마우스 소뇌 zebrin II 면역반응 Purkinje 세포들의 분포양상에 차이가 관찰되었다. Balb/C 마우스 소뇌의 lobule III에서는 10~15개 정도의 zebrin II 면역반응 Purkinje 세포들이 모여 parasagittal band를 형성하지만, pogo 마우스의 경우 lobule III의 정중에 위치한 P1 band는 유사하나 P1 band의 양쪽에 위치한 P2 band의 경우 50~60개의 zebrin II 면역반응 Purkinje 세포들이 모여 parasagittal band를 형성한다. 이와 같은 lobule III의 zebrin II 면역반응 Purkinje 세포들의 분포차이는 pogo 마우스와 Balb/C 마우스의 유전적 차이에서 기원하는 것으로 생각되며 본 연구의 결과는 운동실조 pogo 마우스의 소뇌 형태적 연구의 기초적 자료로 이용될 수 있다고 생각된다. The purpose of this study is to identify the differences of zebrin II expression between ataxic pogo and normal Balb/C mouse cerebellum. Zebrin II is expressed by subsets of Purkinje cells that form an array of parasagittal bands that extend rostrocaudally throughout the cerebellar cortex, separated by similar bands of Purkinje cells that do not express zebrin II. Zebrin II immunoreactivity was localized in the perikarya of Purkinje cells, and the dendrites. Distribution of zebrin II-immunoreactive Purkinje cells were very similar pattern in pogo and Balb/C mouse cerebellum. But, in the lobule III, distribution of zebrin II expression was different between pogo and Balb/C mouse cerebellum. In lobule III of Balb/c mouse cerebellum, 10~15 zebrin II-immunoreactive Purkinje cells were observed and clustered to form a parasagittal bands. On the other hand, zebrin II expressions of lobule III in pogo mouse cerebellum showed a little different patterns. In lobule III of pogo mouse cerebellum, three bilateral zebrin IIimmunoreactive parasagittal band were observed. P1 band was almost same with lobule III of Balb/C mouse cerebellum. But, P2 bands were composed of 50~60 Purkinje cells which were immunoreactive with zebrin II. These kind of thickening in zebrin II expression of pogo mouse cerebellum may be due to the genetical difference. Furthermore, these results may provide useful information with further ataxic pogo mice cerebellum studies.