A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea

Yong Sung Choi,정성훈,김은선,Eun Sun Kim,Eunhee Lee,Euiseok Jung,So-Yeon Lee,이우령,Hye Sun Yoon,Yong Joo Kim,Ji Kyoung Park,Son Moon Shin,Ellen Ai-Rhan Kim 대한신생아학회 2022 Neonatal medicine Vol.29 No.1

Purpose: Pediatricians have a significant responsibility to educate mothers about the importance of breastfeeding. However, there have been minimal efforts in the courses of resident training in Korea. The purpose of this study is to evaluate the change in knowledge and attitude before and after a 4-week breastfeeding educational intervention among multicenter residents. Methods: Prospective interventional educational research was designed for residents at eight training hospitals in Korea. Institutional reviews were obtained in each hospital. The education curriculum consisted of 14 courses regarding breastfeeding theory and practice. These materials were used to teach pediatric residents for 4 weeks. Knowledge-based tests were administered before the course, and re-tests were administered after the course using different test items of similar levels. Test scores and survey responses were compared before and after the intervention. Results: A total of 73 residents (1st year 20, 2nd year 23, 3rd year 16, and 4th year residents 14) from eight training hospitals completed the intervention. Their average age was 30.3±2.9 years, 17 (23.3%) were male, 22 (30.1%) were married, and eight had more than one child of their own. The mean pre-test score was 61.8±13.4 and the mean post-test score was 78.3±7.5 (P<0.001). The inter-grade difference in the score was significant in the pre-test (P=0.005), but not significant in the post-test (P=0.155). There were more responses of obtaining confidence after the intervention (P<0.001). Conclusion: In our study, pediatric residents showed improvement in their knowledge and confidence level after 4 weeks of the breastfeeding curriculum. This will provide a basis for future policymaking in the training of pediatric residents regarding breastfeedReceived: 6 January 2022 Revised: 15 February 2022 Accepted: 15 February 2022 Correspondence to: Ellen Ai-Rhan Kim, MD Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3390 Fax: +82-2-3010-6978 E-mail: arkim@amc.seoul.kr A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea Yong-Sung Choi, MD,PhD1, Sung-Hoon Chung, MD, PhD2, Eun Sun Kim, MD, PhD3, Eun Hee Lee, MD4, Euiseok Jung, MD5, So Yeon Lee, MD, PhD5, Wooryoung Lee, MD6, Hye Sun Yoon, MD, PhD7, Yong Joo Kim, MD, PhD8, Ji Kyoung Park, MD, PhD9, Son Moon Shin, MD, PhD9, and Ellen Ai-Rhan Kim, MD, PhD5 1Department of Pediatrics, Kyung Hee University Hospital, Seoul, Korea 2Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea 3Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea 4Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea 5Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 6Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Korea 7Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea 8Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea 9Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 pISSN 2287-9412 . eISSN 2287-9803 Copyright(c) 2022 By Korean Society of Neonatology This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Original Article 29 Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 ing in Korea.

Evaluating the effects of honey bee (Apis mellifera L.) venom on the expression of insulin sensitivity and inflammation-related genes in co-culture of adipocytes and macrophages

Kim Hee‐Yeon,Jo Min Jeong,Nam So Yung,Kim Kwang Min,Choi Moon Bo,Lee Yong‐Ho 한국곤충학회 2020 Entomological Research Vol.50 No.5

Obese adipose tissue is characterized by adipocyte hypertrophy and a massive macrophage infiltration. The interaction between macrophages with mature adipocytes releases pro-inflammatory cytokines. This chronic inflammatory state can contribute to obesity-related complications, such as insulin resistance, type 2 diabetes and cardiovascular disease. Therefore, we can attempt to prevent and treat obesity-related diseases by inhibiting macrophage infiltration and blocking their interaction with adipocytes. Honey bee (Apis mellifera) venom (BV) has been reported to have anti-inflammatory effects. Although BV is used to treat chronic inflammatory diseases, few studies have addressed its use in obesity-associated inflammation. This study examines the inhibitory effects of BV on lipid accumulation in differentiating preadipocytes, inflammation, and insulin resistance in macrophages and adipocyte-macrophage co-culture system. We treated 3 T3-L1 preadipocytes with BV during differentiation. We later measured lipid accumulation and gene expression of master adipogenic transcription factors. After RAW264.7 and 3 T3-L1 cells were pretreated with BV, RAW264.7 cells were activated with LPS or co-cultured with pretreated 3 T3-L1 cells. Gene expression of pro-inflammatory cytokines and insulin sensitizing genes was measured in these cells. BV inhibited lipid accumulation and C/EBPα and PPARγ gene expression during intermediate and late 3 T3-L1 cell differentiation. BV also suppressed gene expression of pro-inflammatory cytokines (COX-2, iNOS, MCP-1, TNF-α, IL-1β and IL-6) in LPS-stimulated macrophages, and in co-culture of 3 T3-L1 adipocytes and RAW264.7 macrophages. However, adiponectin and GLUT-4 expression were both significantly increased by BV in co-culture. These findings demonstrate that BV attenuates adipocyte hypertrophy and improves obesity-related inflammation and insulin resistance in obese adipose tissue.

정신분열병 환자에서 가족력, 산과적 합병증 및 신체미세기형의 관련성에 관한 연구

안용민,김용식,정희연,신지용,윤세창,배안,이중서,주은정,이창인 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구목적 : 저자들은 태생기 동안에 받는 유전외적 요인, 즉 환경적 요인이 산발성 정신분열병 환자들의 발병에 크게 관여할 것이라고 가정하였다. 이를 검증하기 위하여 형제 중 1인 이상이 발병하여 가족력을 분명히 알 수 있는 정신분열병 환자군(이하 형제 환자군)과 가족력이 없는 산발성 정신분열병 환자군(이하 산발성 환자군) 및 정상대조군을 대상으로 산과적 합병증, 신체미세기형 및 정신분열병의 임상 양상을 비교하였다. 방 법 : 연구 대상은 형제 환자군 43명(남 22명, 여 21명), 산발성 환자군 43명(남 23명, 여 20명), 정상대조군 43명(남 20명, 여 23명)이었다. 산과적 합병증은 Lewis 척도를 이용하여 평가하였고 신체미세기형은 Waldrop 척도를 이용하여 측정하였다. 임상 양상으로서 발병 연령, 병전 기능 수준, 정신병리, 약물에 대한 반응, 회복시의 전반적 기능 수준, 지연성 운동장애의 유무를 평가하였다. 결 과 : 정상대조군과 정신분열병 환자군 전체를 비교하였을 때 산과적 합병증과 신체미세기형의 총점과 각 소항목의 점수에 차이가 없었다. 산발성 환자군과 형제 환자군을 비교하였을 때 산과적 합병증의 전체 점수에서는 유의한 차이가 없었으나, 출생 당시에 태아가 받은 스트레스 항목의 점수가 산발성 환자군에서 유의하게 높았다. 신체미세기형에서는 전체 점수 및 입의 미세기형 점수가 산발성 환자군에서 유의하게 높았다. 신체미세기형의 전체 점수가 4점 이상인 환자수도 산발성 환자군에서 높은 경향성을 보였다. 산과적 합병증과 신체미세기형 사이의 상호 연관성은 찾을 수 없었다. 정신분열병의 임상 양상 중에서는 Krawiecka 척도의 총점 및 양성 증상 점수와 회복시의 전반적 기능 수준만이 형제 환자군에 비해 산발성 환자군에서 유의하게 높았다. 성별에 따라서는 형제 환자군에서 남자 환자의 산과적 합병증이 유의하게 높았다. 결 론 : 본 연구를 통해 산과적 합병증 및 신체미세기형 연구가 정신분열병의 원인을 규명하기 위한 유용한 방법임이 시사되었지만, 가족력, 산과적 합병증 및 신체미세기형의 관련성에 대해서는 분명한 결론을 내리지 못하였다. The authors hypothesized that sporadic schizophrenic patients had more chances of receiving environmental insults during the fetal neural development compared with familial schizophrenics. We tested our hypothesis by comparing obstetric complications(OCs), minor physical anomalies(MPAs) and other clinical features, and examining the correlation between OCs and MPAs in schizophrenic patients who had one or more sibling with schizophrenia(sibling group) and sporadic schizophrenics(sporadic group) and normal controls. OCs were evaluated by the scale of Lewis, and MPAs were measured by the Waldrop scale. There were no significant difference in OCs and MPAs between schizophrenic and control groups. Sporadic group had significantly higher fetal distress, total Waldrop score and Waldrop score for mouth than sibling group. And there was a tendency that the number of subjects having the Waldrop score over 4 points was greater in the sporadic group. No significant correlation was observed between CCs and MPAs. The scores of initial psychopathology and post-treatment functioning were much higher in the sporadic group, but the other clinical feature showed no difference. Although male patients had more OCs than female patients in sibling group, no sex difference were observed as a whole. Our results suggest that, if the methodological weakness were complemented, OCs and MPAs would be useful tools in the search for the cause of schizophrenia.

박목월의 시 <나그네>의 예술가곡화 연구

이지연 ( Lee Ji-yeon ),김용범 ( Kim Yong-bum ) 한민족문화학회 2016 한민족문화연구 Vol.56 No.-

본 논문은 박목월의 시 <나그네>의 예술가곡화에 대한 연구이다. 예술가곡이란 18세기 독일어권에서 완성된 음악 양식으로, 시인의 시와 작곡가의 작곡 그리고 성악가에 의한 가창으로 표현되는 예술로 문학과 음악이라는 두 가지의 예술 장르가 합일된 문화융합의 산물이다. 이러한 예술가곡이 우리나라에 도입정착 된 후 1920년에 우리나라 최초의 가곡 홍난파의 <봉선화>가 작곡되지만 한국예술가곡의 효시 작품에 대한 논란이 존재하였고 독일 예술가곡의 개념과 정의 및 조건에 입각한 필요충분조건을 모두 갖춘 한국최초의 예술가곡으로는 정지용 작시, 채동선 작곡의 <고향>(1932)으로 비정하고 있다. 특히 1920년대는 음악이나 시문학이 아직은 확고하게 예술장르로 자리 잡지 못한 시기였음으로 시인과 작곡가가 협업을 통해 창작해야하는 예술가곡의 시기로서는 상호 불완전했었다 할 수 있었고 한국문학은 1930년대에 이르러 시인들이 자신들의 창작 행위에 대한 뚜렷한 자의식을 갖게 된다. 그 중 본고가 주목하는 것은 한국 시문학사의 독보적 위상을 차지하고 있는 시인 박목월과 그의 시를 가사로 한 예술가곡들이다. 박목읠의 초기시가 가지고 있는 서정성과 율성 즉 음악성은 작곡가들에게 주목받아 김연준을 비롯하여, 김성태, 김순애, 이수인, 윤이상 등에 의해 많은 예술가곡이 탄생하였는데 예술가곡 작품들을 일별하는 과정에서 유독 <나그네>를 대상으로 작곡된 작품이 많았음을 발견하고 음악적, 문화융합론적, 언어기호학적 관점에서 그 이유를 분석 및 규명해보았다. 시의 정형리듬을 형성하려는 계산에서 이루어진(artificial const-ruction)박목월의 <나그네>는 예술가곡의 작곡에서 조성, 박자, 악절과 결합하기에 최적의 조건이었고 두드러진 유음의 사용은 성악의 발성을 용이하게 하는 요소로 작용된다. 따라서 시인의 시와 작곡가의 작곡뿐 아니라 예술가곡의 필요충분조건의 하나인 노래 불려 져야 한다는 가창의 조건으로 볼 때 나그네가 가지는 예술가곡의 적합성은 예술가곡성립의 필요충분조건과 자질을 모두 갖추고 있음을 알 수 있다. 한 시인의 특정한 작품에 14명의 작곡가가 곡을 붙였다는 것은 우리 예술가곡사 상 특이한 사례에 속하며 이는 박목월 <나그네>의 문학적 가치를 넘어선 문화융합의 새로운 가치를 의미하는 것이다. This study aims to examine the capability of Mok-wol Park`s poetry, "Naguenae", as an art song. The art song, originally developed in Germany in the eighteenth-century, is a genre of art that unites poetry and music; the composers put a melody on poems so that singers could sing the songs. As an outcome of cultural convergence, the two independent forms of art, literature and music, came to converge into a completely single genre, heralding a birth of a new musical style. Korean poetry began to mature in the 1930s and Mok-wol Park, the most representative poet throughout the history of Korean literature, shows lyrical and rhythmical features on his early poems. This musicality was valuable to be used as text for art songs by many contemporary composers such as Yeon-jun Kim, Sung-tae Kim, Sun-ae Kim, Soo-in Lee, and I-sang Yoon. In the process of categorizing their art songs, we discovered that there are numerous songs using particularly "Naguenae" as a text. This study mainly explores and analyzes reasons from musical and glossematic perspectives, as well as from viewpoint of the theory of cultural convergence. Mok-wol`s "Naguenae" written based on a calculation of its regular rhythmic patterns has the optimum condition as a text for the musical setting in which a tonal center, rhythm, and phrasing can be combined without any disturbances. Moreover, his use of liquid sound aids a singer`s vocalization. Therefore, in view of the fact that a song is to be sung, which is a necessary and sufficient condition for an art song, together with a text and musical setting, "Naguenae" qualifies all conditions. The fact that one particular poem written by one poet was used as a text for an art song by fourteen different composers is unusual case in Korean history of art songs. In addition, Mok-wal Park`s "Naguenae" is not only literary valuable, but means a new step of cultural convergence.

위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구

노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.

직장암 환자의 술 전 병기 결정에 있어서 전산화 단층 촬영의 의의

신용덕,백승언,신연명,오경승 대한대장항문학회 1995 Annals of Coloproctolgy Vol.11 No.3

인체 유방암종에서 Cyclic-Dependent Kinase Inhibitor, p27^Kip1 발현의 의의

송상용,김덕환,서연림,고영혜,김대식,남석진,양정현 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.12

국내 5개 종합병원에서 분리된 주요 원내감염 세균에 대한 Cefepime의 시험관내 항균력

용동은,김현숙,박연준,홍석일,구선회,이경원,정윤섭 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.3

목적 : Enterobacter, Citrobacter, Serratia, A. baumannii 및 P. aeruginosa 등의 원내 감염균은 AmpC β-lactamase 과량 생산으로 인하여 여러 가지 β-lactamase 항균제에 내성인 균주가 많다. Cefepime은 제 4세대 cephalosporin으로 AmpC β-lactamase 과량 생산균에 대한 항균력이 우수하고, oxacillin 감수성 포도구균과 penicillin 내성 S. pneumoniae에도 항균력 있는 것으로 알려져 있다. 그러나 국내분리균주에서 cefepime의 항균력은 시험된 바 적다. 본 연구에서는 우리나라 병원에서 분리되는 원내감염 세균에 대한 cefepime의 항균력을 다른 광범위 β-lactamase 항균제의 항균력과 비교하고자 하였다. 방법 : 1999년 전국 5개 병원에서 분리한 원내 감염세균에 대한 항균제 감수성을 각각의 병원에서 Etest strip (AB Biodisk, Solna, Sweden)으로 시험하였다. 시험 균주는 균종별로 약 10주씩이었고, 대상균종은 E. coli, Klebsiella spp., C. freundii, Enterobacter spp., Serratia spp., Indole-positive Proteeae, Acinetobacter spp., P. aeruginosa, oxacillin-suspectible S. aureus, and oxacillin-suspectible coagulase-negative Staphylococcus이었다. 시험 항균제는 cefepime, cefpirome, ceftazidime, ceftriaxone, imipenem, oxacillin 그리고 piperacillin-tazobactam이었다. 결과 : 총 407주 그람음성 간균에서 cefepime의 MIC_(90)는 E. coli에 대하여 0.75㎍/mL, Klebsiella spp. 12㎍/mL, C. freundii 2㎍/mL 및 E. cloacae 48㎍/mL로서 imipenem을 제외한 다른 시험항균제의 MIC_(90)보다 낮았다. 전체 균종의 감수성율은 imipenem 89%, cefepime 78%, cefpirome 74%, ceftazidime 66%, piperacillin-tazobactam 65% 및 ceftriaxone 51%이었다. Oxacilin 감수성 포도구균의 감수성율은 cefepime, cefpirome 및 imipenem에 대해 100%이었다. 결론 : Cefepime의 원내감염 세균에 대한 시험관내 항균력은 imipenem을 제외한 다른 광범위 항균제보다 우수하여, 이 항균제는 원내감염증 환자의 치료에 유용할 것으로 판단되었다. Background : Common nosocomial pathogens such as Pseudomonas aeruginosa, Acinetobacter baumannii, and species of Enterobacter, Citrobacter, and Serratia, are often resistant to various β-lactam antibiotics by Amp C β-lactamase hyperproduction. Cefepime, a fourth generation cephalosporin, has been reported to have higher activity against AmpC β-lactamase-producing strains. It is also reported to be active against oxacillin-susceptible S. aureus, and penicillin-resistant S. pneumoniae. However, few studies were reported with Korean isolates. The purpose of this study was to compare the in vitro activities of cefepime and other broad-spectrum β-lactam antibiotics against nosocomial pathogens isolated in Korean Hospitals. Methods: In 1999, each of five participating hospitals in Korea tested the antimicrobial susceptibility for nosocomial pathogens using Etest strip. The number of isolates tested were about ten per species, which were E. coli, Klebsiella spp., C. freundii, Enterobacter spp., Serratia spp., Indole-positive Proteeae, Acinetobacter spp., P. aeruginosa, oxacillin-susceptible S. aureus, and oxacillin-susceptible coagulase-negative Staphylococcus. Antimicrobials used were cefepime, cefpirome, ceftazidime, ceftriaxone, imipenem, oxacillin and piperacillin-tazobactam. Results: A total of 407 isolates were tested. The MIC_(90s) of cefepime were 0.75 ㎍/mL for E. coli, 12 ㎍/mL for Klebsiella spp., 2 ㎍/mL for C. freundii, and 48 ㎍/mL for Enterobacter spp., which were generally lower than those of other antibiotics except imipenem. The following were the susceptibility rates of gram-negative bacilli to various antimicrobials, respectively: imipenem, 89%; cefepime, 78%; cefpirome, 74%; ceftazidime, 66%; piperacillin-tazobactam, 65% and ceftriaxone, 51%. To cefepime, cefpirome and imipenem, 100% of oxacillin-susceptible S. aureus were susceptible. Conclusion: The higher in vitro activities of cefepime than other broad-spectrum β-lactam antibiotics except imipenem suggests cefepime is useful for the treatment of patients with nosocomial infections.

저소득 독거노인의 생활만족도 관련요인

강지연,전만중,유병철,이용환 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Background : To access the influential factors of life satisfaction in low-income and living alone old people for solving the problem of the estranged elderly. Method : We conducted a questionnaire survey during the period from June 2007 till September 2007. Investigation subjects were 152 elderly people registered in two welfare centers in Busan. We measured life satisfaction of low-income and living alone old people and analyzed with descriptive analysis, t-test, one-way ANOVA and dummy variable regression analysis using SPSS Win(ver 12.0k) program. Result : The mean score of life satisfaction in low-income and living alone old people was 2.52 ± 0.56. Life satisfaction in low-income and living alone old people was relatively high in groups of 65-69 years old, elementary school graduates, subjectively healthy, exercise, hobby or leasure activity, regular repast, 3 times repast per day and income satisfaction. Life satisfaction in low-income and living alone old people was influenced by age, religion, satisfaction of income, subjective health conditions and regular repast. Conclusion : From the result, we can concluded that life satisfaction in low-income and living alone old people was low and influenced by various social and economic factors. Therefore, methods for improving life satisfaction level of low income and living alone old people are required for discerning our society's equality and healthiness.

크로마토그래피-유도 결합 플라스마 원자방출 분광법을 이용한 희토류 원소들의 연속적 분석 및 직교형과 초음파분무기의 비교

연평흠,박용남 한국교원대학교 환경과학연구소 2004 환경연구논문집 Vol.- No.8

이온교환 크로마토그래피와 유도결합 플라스마를 연결하여 회토류 원소들을 연속적으로 분리 검출할 수 있었다. 특히 HPLC와 주사형 분광기를 사용하여 파장을 옮기면서 여러 회토류 원소를 동시에 측정하는 것이 가능하였음을 보여주었다. 현재의 분리에서는 8개의 원소에 대하여 주사형 분광기로도 분리 가능하나 용리액기울기를 더 잘 활용한다면 모든 원소들에 대하여서도 연속적분리가 가능할 것으로 예측한다. 기존의 직교형 분무기로도 HPLC-ICP의 희토류연구에 충분하지만 초음파 분무기가 더 유용하며 바탕의 증가등으로 감도와 분해능은 예상된 결과에는 미치지 못하였으나 감도는 수배 가량의 개선됨을 알 수 있었다.