정신분열증 환자의 저나트륨혈증에 의한 rhabdomyoysis 1 예

김경현,장우영,김성훈,김호중,전대원,나경선 대한내과학회 2000 대한내과학회지 Vol.59 No.3

Electrolyte disturbance that can produce rhabdomyolysis include hyperosmolar states, especially with marked hyperglycemia, or hypernatremia, severe hypokalemia, and hypophosphatemia, which is commonly seen in alcholics. Hyponatremia, however, is often an unrecognized initiating factor of rhabdomyoplysis. A 56-year-old man, treated for schizophrenia, developed severe hypotonic hyponatremia (Na:117meq/L) with mental change after several days of compulsive water drinking. Rhabdomyolysis quickly followed with high serum creatine phosphokinease level and myoglobulinuria. Massive hydration and urine alkalization started. Renal failure or compartment syndrome did not complicated. Hyponatremia may cause reduced rate of entry of sodium ions ,and reduces the exchange for calcium ion we thought elevated calcium concentration activated neutral proteases and lipases that serve to destroy the cell.(Korean J Med 59:335-338, 2000)

Pseudomonas fluorescens의 Salicylate hydroxylase를 암호하는 유전자의 클로닝

정유선,민경희,이나리 숙명여자대학교 자연과학연구소 1997 자연과학논문집 Vol.- No.8

Pseudomonas fluorescens SME11로 부터 salicylate hydroxylase를 암호하는 nahG 유전자를 클로닝하기 위하여 NAH플라스미드를 주형으로 하여 PCR을 수행하였다. PCR방법으로 얻은 1.6kb DNA절편을 pT7Blue(R)벡터에 삽입시켜 재조합 플라스미드 pNY1을 제조하였으며 이것을 E. coli에 형질전환하였다. 재조합 DNA를 제한효소로 처리하여 EcoRⅤ, KpnⅠ, PvuⅡ, StuⅠ등이 존재함을 확인하였으며, 이것으로 간단한 제한효소지도를 작성하였고 재조합 DNA를 한 방향으로 deletion하여, nahG유전자를 포함한 DNA절편의 염기서열을 결정하였다. 재조합 플라스미드인 pNY1에는 1,305bp크기의 open reading frame이 존재하였으며, salicylate hydroxylase에 해당하는 434개의 아미노산을 암호하였다. 아미노산서열을 비교한 결과, P.putida KF715와 84.1%, P.putida PpG7과 71.4%, P.putida S-1 과 48.7%의 homology를 보였으며, 또한 Sphingmonas sp.와 26.8%의 homology를 보였다. Pseudomonas fluorescens SME11 carrying NAH plasmid was isolated from wastewater. To clone nahG gene encoding salicylate hydroxylase, 1.6kb DNA fragment of PCR product from NAH plasmid was inserted to pT7Blue(R) vertor and resulting recombinant DNA was named pNY1. The transformants, E.coli SMY1, clone containing the recombinant plasmid pNY1 were able to convert salicylate to catechol and produced dark brown color caused by accumulation and auto-oxidation of catechol. Restriction endonuclease mapping of 1.6kb size of the insert of the recombinant plasmid pNY1 was carried out with EcoRⅤ, KpnⅠ, PvuⅡ, StuⅠ. By means of unidirectional ExoⅢ deletion and dideoxynucleotide chain termination, we determined the nucleotide sequence of the DNA fragment containing nahG gene. One open reading frame of 1,305 bp corresponding to 434 amino acids was found in the insert DNA. Deduced amino acid sequences of the nahG gene showed 84.1%, 71.4%, 48.7%, and 26.8% homologies to those from P.putida KF715, P. putida PpG7, P. putida S-1, and Sphingmonas sp., respectively.

中學 科學敎育의 探究學習에 대한 評價問項 開發 (Ⅱ)

閔庚德,楊洪準,李善行,鄭遠佑,이병교,金裕漢,羅長薰 경북대학교 과학교육연구소 1985 科學敎育硏究誌 Vol.9 No.-

This study was accomplished to develope the evaluation items for inquiry learning in the 2nd grade Middle School Science for the consecutive study of the evaluation items for inquiry learning in the 1st grade Middle School Science(U-Hang Ki et al, 1984). In this study, paper and pencil test items and performance test items are made by analyzing the abilities of inquiry according to the contents and four basic experiments from each unit in the 2nd grade Middle school science. These evaluation items were applied to tke five classes of the 2nd grade of middle school to test their validity. It is desirable that performance test schuld be used for the evaluation for the abilities of inquiry which can not be evaluated by paper and pencil test. In the evaluation methods of performance test, tester evaluation, peer evaluation and self-evaluation can be applied to the science class in a multi-student class. In higher grade, however tester evaluation is more desirable than peer and self evaluation. It is found that peer evaluation and self-evaluation make possible the perfect study by feedback.

프리셉터 경험이 간호업무수행과 직무만족에 미치는 영향 연구

류언나,송혜숙,장은희,서효신,추연화,김인선,나명주,지성애,박경숙 중앙대학교 간호과학연구소 2001 중앙간호논문집 Vol.5 No.2

The purpose of this study was to investigate how preceptor experience has an effect upon preceptor nurses. This study was so designed that it could compare the difference between clinical performance and Job satisfaction of preceptor nurses and those of nonpreceptor nurses. Study subjects were sampled out from those nurses who worked with two university hospitals where preceptor programs were implemented. The number of subjects totaled to 134, including 69 preceptor nurses and 70 nonpreceptor nurses. The score of preceptor nurses' clinical performance and job satisfaction revealed a higher value than that of nonpreceptor nurses. A similar result was also shown in the subdomains. However these difference were not statistically significant. Among all of the preceptor nurses, the highest number of preceptor experience was just one time. Except for five times in preceptor experience, the more the number of times of preceptor experience, the higher score in clinical performance. It was manifested that the number of preceptor experience was not related to job satisfaction. The score of preceptor nurses' clinica1 performance and job satisfaction revealed a higher value than that of nonpreceptor nurses. A similar result was also shown in the subdomains. However these difference were not statistically significant. The reward that preceptor nurses wished most was a reduction of the work load assigned to them. Currently preceptor nurses are only receiving a small quantity of financial reward related with their preceptor role. Most of preceptor nurses (96.8%) were not satisfied with their existing reward. Almost half of the preceptor nurses(43.5%) did not want to play a role as preceptor again. The reason why the scores of clinical performance and job satisfaction were low might be attributed to the inadequate preceptor training program and reward system. Appropriate knowledge and clinical skill are expected to enhance the level of preceptor nurses' clinical performance and appropriate internal and external reward to elevate the level of preceptor nurses' Job satisfaction. Therefore, it is needed for us to develop more effective preceptor education program, financial reward, support of colleague nurses and nursing managers, and adjust workload for the purpose of more effective preceptor programs.

본태성 고혈압쥐에서 Myogenic Tone의 변화:RhoA 단백질 및 Protein Kinase C의 역할

서정필,류성경,강나영,안덕선,이영호 대한순환기학회 2002 Korean Circulation Journal Vol.32 No.3

식도암과 위암이 동시에 발생한 원발성 중복암 1예

윤혜원,심기남,나선경,송도경,정정화,정가영 이화여자대학교 의과학연구소 2012 EMJ (Ewha medical journal) Vol.35 No.2

Double primary cancers are two independently developed cancers in an individual. There have been some reports on double primary cancer since Billroth reported it for the first time in 1879. Double primary cancer of the stomach and esophagus has been revealed a very low incidence worldwide. The incidence of an esophageal cancer with another primary cancer is reported to be 9.5∼27%, but double primary cancers in the esophagus and stomach have been rarely reported to our knowledge. In this study, we present here a case of double primary esophageal and stomach cancer in a 66-year-old man because of progressive dysphagia.

De novo Hyponatremia in Patients Undergoing Peritoneal Dialysis: A 12-month Observational Study

( Hyun Hee Lee ),( Soo Jung Choi ),( Heon Nam Lee ),( Sun Young Na ),( Jae Hyun Chang ),( Woo Kyung Chung ),( Se Joong Kim ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.1

Purpose: Hyponatremia occurs infrequently in patients undergoing peritoneal dialysis (PD). Nevertheless, one must understand its pathophysiology, since the therapeutic strategy differs from that of non-PD-related hyponatremia. This study examined the clinical features of hyponatremia in PD and evaluated the factors that may contribute to its development. Methods: We retrospectively enrolled 51 normonatremic PD patients at Gachon University Gil Hospital, South Korea. Using the plasma sodium levels at month 13, the patients were divided into hyponatremia (Na+<135mEq/L) and normonatremia (Na+≥135mEq/L) groups. Then, the clinical variables of these patients were examined, including peritoneal function and adequacy tests, and biochemical parameters. Results: The de novo hyponatremia (n=8) and normonatremia (n=43) groups had no significant differences in baseline characteristics. At month 1, the serum albumin was lower in the hyponatremia group (p=0.022). In the peritoneal equilibration test analysis, the dialysate-to-plasma ratio for creatinine (D/Pcr) measured after 13 months differed significantly between the two groups (p=0.007), while the maximum dip in sodium did not differ. No significant differences were observed in the normalized protein equivalent of nitrogen appearance, Kt/V, or residual renal function. Conclusion: Our data suggest that the development of hyponatremia is associated with a lower initial serum albumin level and increased D/Pcr in patients undergoing PD. Therefore, the serum sodium levels should be monitored more carefully in these patients.

전문대학 간호과 통합교과과정 개발에 관한 연구

김영희,김정수,김정애,방숙명,배경진,이애경,장은정,정안순,주미경,최나영 경복대학 1998 京福論叢 Vol.2 No.-

교과과정의 조직은 체계적이고 뜻이 있는 순서로 학생들을 가르치기 위해 지식을 어떻게 조직화할 것인지와, 과목들 사이에서 공통된 내용은 통합시켜 중첩되는 일이 없도록 조정할 필요가 있다. 이에 현재 본 대학 간호과에서 운영되었던 97학년도의 17개 전공과목들의 교과과정의 내용을 비교, 분석하여 중복을 줄이며 순차적 지식의 습득을 도모하는 새로운 통합교과과정의 틀을 개발, 제시함으로써 보다 나은 전문직 간호교육이 이루어지도록 하고자 하였다. Most curricula are considered how to teach the student in systematic and meaningful orders. And it is necessary to coordinate the duplicate contents in major subjects in nursing. So this study was designed to set up a new comprehensive curriculum through comparing and ananlyzing each seventeen major subjects in Nursing Department of Kyung-Bok College. Therefore, the purpose of this study is to present the new comprehensive curricula for promoting the efficiency and effectiveness in diploma degree course of nursing education.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.