Glucotoxicity in the INS-1 Rat Insulinoma Cell Line Is Mediated by the Orphan Nuclear Receptor Small Heterodimer Partner

Park, Keun-Gyu,Lee, Kyeong-Min,Seo, Hye-Young,Suh, Ji-Ho,Kim, Hye-Soon,Wang, Li,Won, Kyu-Chang,Lee, Hyoung-Woo,Park, Joong-Yeol,Lee, Ki-Up,Kim, Jung-Guk,Kim, Bo-Wan,Choi, Hueng-Sik,Lee, In-Kyu American Diabetes Association 2007 Diabetes Vol.56 No.2

<P>Prolonged elevations of glucose concentration have deleterious effects on beta-cell function. One of the hallmarks of such glucotoxicity is a reduction in insulin gene expression, resulting from decreased insulin promoter activity. Small heterodimer partner (SHP; NR0B2) is an atypical orphan nuclear receptor that inhibits nuclear receptor signaling in diverse metabolic pathways. In this study, we found that sustained culture of INS-1 cells at high glucose concentrations leads to an increase in SHP mRNA expression, followed by a decrease in insulin gene expression. Inhibition of endogenous SHP gene expression by small interfering RNA partially restored high-glucose-induced suppression of the insulin gene. Adenovirus-mediated overexpression of SHP in INS-1 cells impaired glucose-stimulated insulin secretion as well as insulin gene expression. SHP downregulates insulin gene expression via two mechanisms: by downregulating PDX-1 and MafA gene expression and by inhibiting p300-mediated pancreatic duodenal homeobox factor 1-and BETA2-dependent transcriptional activity from the insulin promoter. Finally, the pancreatic islets of diabetic OLETF rats express SHP mRNA at higher levels than the islets from LETO rats. These results collectively suggest that SHP plays an important role in the development of beta-cell dysfunction induced by glucotoxicity.</P>

입원진료비 상승요인 분석

한혜경 ( Hye-kyung Han ),이필도 ( Pil-do Lee ),노인철 ( In-chul Noh ) 한국보건사회연구원 1990 保健社會硏究 Vol.10 No.2

입원진료비의 상승은 높은 약제비 비중, 병원의 높은 수술률, 종합병원 이상의 검사비 등의 영향을 받는 것으로 나타났으며, 횡단면 다중회귀분석에 의한 입원진료비 결정요인은 입원일수, 전문의수, 의료장비수, 연령, 수술여부 등인 것으로 나타났다. 앞으로 45세이상 연령층의 만성질환으로 인한 입원진료비가 더욱 증가할 것이라는 전망에 따라 약제비 및 검사비에 대한 대책, 의료자원의 효율적인 사용을 위한 병원기능의 전문화 등 입원진료비의 경제성을 도모하기 위한 다양한 대책이 요구된다. The rapid increase in medical care costs have become a growing problems since health insurance was introduced. In particular, medical care costs for in-patients have tended to rise at a faster pace than those for out-patients. For example, while the out-patient costs in 1989 increased 3.32 times over those in 1983, the hospital care costs increased 3.75 times during the same period. Furthermore, the scale of hospital care costs continued to rise from about 33 percent in 1983 to 36 percent of the total expenditure in 1989. The principal cause of these increase was related to a considerable rise in medical care costs for out-patients less than 14 years old. Recently, however, the ratio of in-patient costs has risen markedly due to a sharp increase in the costs related to cancer and to chronic diseases of the circulatory system for those over 45. Since this age group continues to increase, it is expected that this pattern will continue as a leading factor in the increase in medical care costs. The concern over rising costs and a search for ways to control these costs are now stimulating interest in the development of public policies. The purpose of this study is, therefore, to examine factors giving rise to the cost escalation of hospital medical care and also to provide insight into the policy implications for containment of these costs. The data used here was obtained from a survey of the monthly insurance bills (13,532 cases) presented to the National Federation of Medical Insurance in February 1990. This group represented the employees and dependents of private companies as well as self-employed people. The main results and their implications are as follows : 1. The important factors which have influenced the increase in the medical care costs for in-patients was revealed as a high medication ratio, more examinations, a longer stay, and a high frequency of surgical procedures in the hospitals. 2. The portion of medication and injection costs was found to be extremely high. Medications constituted 37 % of total hospital care costs in excess of 500,000 Won per case. These extraordinarily high expenditures are due to excessive consumption and high prices. One alternative to limit expenditures on drugs is to establish a list of essential drugs as chosen for cost-effectiveness (low price with equal efficacy). Thus drugs not on this list would not be cove-red by insurance. Also important is the control of pharmacists` mark-ups, drug prices, and advertising expenditures by pharmaceutical firms for sales promotion. 3. The ratio of examination costs was about 30% of the total medical care costs per in-patient case, which was observed to be correlated mainly with the length of stay and the number of examinations, and the quantity of medical equipment in hospitals, so that in recent years the problem of excessive examinations has emerged particularly in both tertiary and general hospitals. The tertiary hospitals are prohibited from offering out-patient care. A committal order written by a physician in a clinic is required for a patient to receive hospital medical care. Both because of the poor flow of information between primary physicians and hospital physicians, and because outside physicians do not have access to superior hospital equipment, hospitals repeat many diagnostic examinations already performed by physicians prior to hospitalization. In fact, such duplication adds to the length of stay and ultimately to medical care costs. In addition, excess investments in such high- tech equipment as CT Scanner, MRI, and heart transplant equipment tend to result in new cost increases, so specialized central examination facilities with high-tech equipment should be established at the district level, both to share inforamtion and their use and to avoid duplication or excessive use of medical procedures and diagnostic tests. 4. The portion of medical procedure and operation costs in hospitals was relatively higher than those in both general hospitals and tertiary hospitals, which appeared to be associated with the high frequency of surgical produres in hospitals. The costs of medications and examinations were, however, shown to be highest in general and tertiary hospitals. One interesting result indicates that there is a negative correlation between surgical procedure costs and examination costs, suggesting that more examinations might reduce the frequency of surgery. 5. To cope with the soaring medical care costs, less expensive service facilities as are used in the developed countries ought to be developed or introduced into the health care sector. For example, there are day care centers, geriatric day hospitals, hospice systems, ambulatory surgical centers, nursing home care and home health care, which can be substituted for expensive hospital services. In addition, surgery and hospital admission and discharge can be managed in a rational manner to curb long-term hospital stays. For example, admission and discharge adjudication committees, composed of doctors including physicians in charge, and nurses and other medical care personnel should be set up in each hospital to check the condition of in-patients periodically to decide on whether they can be discharged.

백서 혈관평활근 세포에서 α-Lipoic acid가 PAI-1 발현, 세포의 증식, 주유능 및 신생내막 형성억제에 미치는 효과

신동우,이동욱,이상준,김혜순,강효경,안종덕,이인규 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:당뇨병의 혈관 합병증의 발생에 있어서 산화스트레스는 중요한 역할을 하는 것으로 알려져 있다. 혈관 평활근세포에서 고혈당은 안지오텐신Ⅱ와 더불어 활성산소족(ROS)을 증가시키며, 산화스트레스에 민감한 전사인자들을 활성화시켜 동맥경화증을 유발하는 것으로 알려져 있다. 이에 저자들은 항산화제로 알려진 알파­리포산이 혈관 평활근세포의 증식속도와 이주에 미치는 영향과 PAI­1발현에 미치는 영향을 조사하였고 이와 동시에 백서의 혈관 손상 모델을 이용하여 알파­리포산이 신생내막 증식을 억제시킬 수 있는지를 알아보았다. 방법:In vitro 실험은 백서의 대동맥 평활근세포를 고농도의 포도당(22mM)과 100nM의 안지오텐신Ⅱ로 4시간 배양하였다. 알파­리포산을 처리 후, PAI­1 mRNA의 발현을 보기 위해 노던 블롯을 시행하였고 평활근세포의 유주능과 증식속도에 미치는 영향을 보기 위해 성장속도의 유주능 분석을 시행하였다. 또한 평활근세포의 유주능에 NF­μB 경로가 미치는 영향을 보기 위해 겔 지연 분석과 NF­μB 보고 유전자 분석을 시행하였다. In vivo 실험으로 백서의 혈관손상 모델을 이용하여 알파­리포산 처리 후 혈관의 신생내막 두께를 비교하였다. 결과:In vitro 실험에서 고농도 포도당과 안지오텐신Ⅱ에 의해 유도된 PAI­1 mRNA 발현증가는 알파­리포산 처리에 의하여 용량에 비례하여 억제되었다(p<0.05). 알파­리포산 처리로 혈관 평활근세포의 유주능은 유의하게 억제되었으나(p<0.01),증식속도는 유의하게 억제되지 않았다. 또한 알파­리포산 처리로 NF­μB 발현도 유의하게 억제되었다(p<0.01). In vivo 실험에서 알파­리포산을 주입한 군에서 혈관손상에 의한 신생내막의 증식이 유의하게 억제되는 것을 보여주었다(p<0.01). 결론:알파­리포산은 백서의 대동맥 평활근 세포의 증식속도는 억제하지 못했으나 유주능은 유의하게 억제하였으며, 혈관 손상 모델에서 신생 내막 증식도 유의하게 억제함을 확인할 수 있었다. 이러한 작용은 알파­리포산에 의한 NF­μB 경로의 억제와 연관이 있는 것으로 사료된다. Background : Exposure to large amounts of glucose causes a characteristic dysfunction and morphologic changes of the endothelium by an increased production of reactive oxygen species(ROS) in diabetes. The plasminogen activator inhibitor-1(PAI-1), which modulates fibrinolysis and cell migration may influence proteolysis and neointimal formation in vascular smooth muscle cells(VSMC). Antioxidants have been proposed to inhibit multiple proatherogenic events. This study investigated the effect of α-lipoic acid on PAI-1 expression and VSMC proliferation and migration both in vivo and in vitro. Methods : In the in vitro study, cultured rat aortic smooth muscle cells(RASMC) were incubated in a medium containing high glucose (22 mM) and 100 nM angiotensin Ⅱ for 4 hour. After α-lipoic acidtreatment, a -migration and growth assay of the RASMC, and a gelmobility shift assay and reportergene analysis for nuclear factor- иB(NF- иB) and northern blot analysis for PAI-1 were performed. In the in vivo study, the effect of α-lipoic acid on neointimal hyperplasia in a rat carotid balloon injury model was evaluated. Results : RASMC migration was inhibited significantly by α-lipoic acid (p<0.01), but their prolife ration was not inhibited. The NF-иB DNA binding activity and NF-иB promoter activity was inhibited by α-lipoic acid significantly (p<0.01). α-lipoic acid inhibited PAI-1 mRNA expression by high glucose and angiotensin Ⅱ in dose dependent manner (p<0.05). In the rat carotid artery balloon injury model, neointimal formation was reduced by α-lipoic acid treatment in a dose dependent manner significantly (p<0.01). Conclusion : α-lipoic acid suppresses migration, but not prolife ration in RASMC. α-lipoic acid also reduce neointima formation in a rat carotid balloon injured model. This effect might be related to the blocking of NF-иB which increase the expression of the genes associated with atherosclerosis including TNF-α, IL-1, IL-6, endothelin-1, MCP-1, VCAM-1, ICAM-1, E-selectin, tissue factor(J Kor Diabetes Asso 25:446~459, 2001).

Probing the Issue of Informed Consent in Health Care in Korea―Concept Analysis and Guideline Development

Won-Hee Lee,In-Sook Kim,Byung-Hye Kong,Sue Kim,Sunhee Lee 한국간호과학회 2008 Asian Nursing Research Vol.2 No.2

Purpose The purpose of the study was to identify how informed consent is conceptualized by patients, family members, physicians, and nurses in Korea, and to develop guidelines for clinical practice in Korea. Methods This study employed the hybrid model to define the concept of informed consent through theoretical and fieldwork phases. For the theoretical phase, attributes of informed consent were identified through a review of the literature, and in-depth interviews were conducted for the fieldwork phase to develop attributes from the data and to verify the attributes identified from the literature review. Purposive sampling was done for 48 participants (12 patients, 12 family members, 12 physicians, 12 nurses), who were interviewed from selected units (orthopedics, cardiothoracic surgery, obstetrics/gynecology) from two university hospitals in Seoul and Kwangju, Korea. Attributes and processing issues of informed consent were extracted from both phases. Results Core attributes of informed consent include the patient’s self-directed decision-making, fulfillment of legal responsibility, focusing on forging a trusting relationship, assuming active responsibility for explanations (physicians) and granting consent (patient), factors related to sufficient explanation, and the role of family. Findings were integrated into a set of guidelines for patients and family and health care professionals. Conclusion The guidelines developed in the present study offer empirical parameters for an effective process of obtaining informed consent in Korea by seeking to decrease the gap in perceptions of informed consent among patients, family members, physicians, and nurses. The importance of advocating patients and developing a trusting relationship between health care providers and patients is especially noteworthy. [Asian Nursing Research 2008;2(2):102–112] Purpose The purpose of the study was to identify how informed consent is conceptualized by patients, family members, physicians, and nurses in Korea, and to develop guidelines for clinical practice in Korea. Methods This study employed the hybrid model to define the concept of informed consent through theoretical and fieldwork phases. For the theoretical phase, attributes of informed consent were identified through a review of the literature, and in-depth interviews were conducted for the fieldwork phase to develop attributes from the data and to verify the attributes identified from the literature review. Purposive sampling was done for 48 participants (12 patients, 12 family members, 12 physicians, 12 nurses), who were interviewed from selected units (orthopedics, cardiothoracic surgery, obstetrics/gynecology) from two university hospitals in Seoul and Kwangju, Korea. Attributes and processing issues of informed consent were extracted from both phases. Results Core attributes of informed consent include the patient’s self-directed decision-making, fulfillment of legal responsibility, focusing on forging a trusting relationship, assuming active responsibility for explanations (physicians) and granting consent (patient), factors related to sufficient explanation, and the role of family. Findings were integrated into a set of guidelines for patients and family and health care professionals. Conclusion The guidelines developed in the present study offer empirical parameters for an effective process of obtaining informed consent in Korea by seeking to decrease the gap in perceptions of informed consent among patients, family members, physicians, and nurses. The importance of advocating patients and developing a trusting relationship between health care providers and patients is especially noteworthy. [Asian Nursing Research 2008;2(2):102–112]

Uncoupling Protein 3의 골격근 세포내 과발현이 OLETF 백서 및 배양된 골격근 세포에서 포도당대사에 미치는 영향

한정희,박혜선,고정민,김하영,강호경,이인규,박중열,홍성관,이재담,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:Uncoupling protein(UCP)는 미토콘드리아의 내막에 위치하는 단백질로 세포내의 과다한 에너지를 열로 발산시키는 기능을 가진다. 최근 동물의 갈색지방조직에만 존재하는 UCP와 유사성을 가진 아형들(UCP2,3)이 사람에게도 존재함이 알려져 큰 관심을 끌도 있는데 이중 UCP3는 그 발현이 골격근세포와 갈색지방조직에만 국한된다. 본 연구에서는 UCP3가 체내 인슐린 감수성을 결정하는데 가장 중요한 조직인 골격근에 국한되어 발현되는 점에 착안하여 UCP3를 골격근세포에 과발현시켰을 때 포도당 대사에 어떠한 영향이 나타나는 지를 조사하였다. 방법:25주령의 8마리의 OLETF 백서를 대상으로 하여 4마리는 골격근에 adenovirus 2mL(1×10¹²pfu/mL)를 주사하여 대조군으로 하였고 4마리는 골격근에 재조합법으로 제작된 adenovirus­UCP3 2mL(1×10¹²pfu/mL)를 주사하였다(UCP3 과발현군). UCP3를 투여한 백서에서 먹이섭취가 증가하는 경향이 있어 그 전날 대조군이 먹은 야의 먹이만큼 투여하였다. 골격근에 adenovirus를 주사한 10일 후에 euglycemic hyperinsulinemic clamp를 시행하였다. Adenovirus­UCP를 C2C12 골격근 세포에 transfection시켜 UCP3를 C2C12 골격근 세포에 transfection시켜 UPS3­C2C12를 만들고 C2C12 골격근 세포와 UPS3­C2C12 골격근 세포에서 포도당 수송 및 당원합성을 측정하였다. 결과:UCP3 과발현 OLETF에서 체중이 감소하는 경향을 보였고 인슐린 감수성이 증가하였다. C2C12세포에서 기저상태 포도당 수송은 1.28±0.17μmol/L/min였고 100nM 인슐린으로 2시간 처리한 후 2.67±0.20 μmol/L/min로 증가하였다. UCP3­C2C12 세포에서는 기저상태 포도당 수송이 3.98±0.13μmol/L/min로 증가되었고 인슐린 처리 후 5.74±0.44μmol/L/min로 증가하였다. 인슐린을 처리한 UCP3­C2C12 세포에 P13K 억제제인 wortmannin을 첨가하였을 때 포도당 수송활성이 3.81±0.20μmol/L/min로 감소하였다. 기저상태 당원합성은 C2C12 세포에서 0.25±0.01μmol/L/min였고 인슐린 처리 후 0.45±0.01μmol/L/min로 증가하였다. UCP3­C2C12 세포에서는 기저상태 당원합성이 0.62±0.01μmol/L/min였고 인슐린 처리 후 1.26±454μmol/L/min로 증가하였다. UCP3­C2C12세포에 wortmannin을 첨가하였을 때 당원합성율이 0.80±0.04μmol/L/min로 감소하였다. 결론:UCP3 과발현이 OLETF 백서에서 인슐린 감수성을 증가시켰고 골격근세포에서 포도당 수송 및 당원합성을 증가시켰다. wortmannin을 첨가하였을 때 포도당 수송 및 당원합성이 감소함으로 보아 이 과정이 인슐린 신호전달체계인 P13K에 일부 의존함을 알 수 있었다. Background : UC P3 is a mitochondrial membrane protein expressed selectively in the skeletal muscle and brown adipose tissue. Since the skeletal muscle is the main organ determining insulin sensitivity in the body, it was hypothesized that UCP3 overexpression in skeletal muscle cells would improve glucose metabolism. Methods : An adenovirus-UCP3 was produced by a recombinant DNA method. OLETF rats were divided into 2 groups. Four rats were injected with the adenovirus-UCP3 (UCP3 group) and others were injected with the adenovirus(control group) in the skeletal muscle. The UCP3 group was provided with the same quantity of food as that consumed by the control group on the previous day. Insulin sensitivity was evaluated by the euglycemic hyperinsulinemic clamp method. In a separate experiment, glucose transport and glycogen synthesis we evaluated in C2C212 cells transfected with ether an adenovirus or the adenovirus-UCP3. Results : The insulin sensitivity improved significantly and the body weight decreased in the UCP3 group. The glucose transport and glycogen synthesis were higher in the UCP3-C2C12 skeletal muscle cells at the basal state. After insulin treatment, glucose transport and glycogen synthesis were also higher in the UCP3-C2C12 cells but the increments were reduced after treatment with wortmannin, a PI3K inhibitor. Conclusion : Insulin sensitivity was higher in the UCP3-overexpressed OLETF rats in the in vivo study. UCP3 transfection also increased glucose transport and glycogen synthesis in the cultured skeletal muscle cells by a PI3K dependent mechanism(J Kor Diabetes Asso 25 :460~468, 2001).

절제된 정상위벽의 자기공명영상기법에 관한 연구:조직소견과의 비교

서보경,설혜영,이남준,차인호,정규병,김정혁,박철민,이지영,Seo, Bo-Gyeong,Seol, Hye-Yeong,Lee, Nam-Jun,Cha, In-Ho,Jeong, Gyu-Byeong,Kim, Jeong-Hyeok,Park, Cheol-Min,Lee, Ji-Yeong 대한영상의학회 2001 대한영상의학회지 Vol.45 No.5

목적:급속자기공명영상기법을 이용하여 절제된 정상위벽을 관찰하고,이를 조직소견과 비교 연구하여,위벽의 관찰을 위한 최적기법을 찾고자 하였다. 대상과 방법:25명 환자의 모두 41개 절제된 정상위조직을 수술후 수지(polyethylene)통에 넣고,생리식염수로 채워 자기공명영상을 시행하였다.T1강조FLASH,지방억제T1강조FLASH, T2강조TSE와 True-FISP 등 4가지 기법으로 위조직의 영상을 얻었다.자기공명영상에서는 위벽의 층수와 각층의 신호강도를 관찰하였고,이를 조직소견과 비교하였다.자기공명영상소견을 조직소견과 비교한 후 위벽 각층의 명확성과 각층간의 구분,및 전체 영상의 질에 대하여 비교하였다.4가지 기법 중 가장 좋은 방법은 3,가장 나쁜 방법은 0으로 하여 등급을 판정하였다. 결과:자기공명영상에서 위벽의 층수는 T1강조FLASH에서 2층이 41예 중 6예(14.6%),3층 31예(75.6%),및 4층 4예(9.8%)였고,지방억제T1강조FLASH에서 2층 6예(14.6%)와 3층 35예(85.4%),T2강조TSE에서 3층 24예(58.5%),4층 11예(26.8%),및 5층 6예(14.6%)였으며,True-FISP에서 1층 2예(4.9%),2층 8예(19.5%),3층 23예(56.0%),4층은 4예(9.8%), 및 5층 4예(9.8%)이었다.위벽의 신호강도는 T1강조FLASH와 지방억제T1강조FLASH에서 2층으로 보인 예는 위내강으로부터 고-중등도,3층인 경우는 고-저-고/중등도,4층인 예는 고-저-고-중등도신호강도였다.T2강조TSE에서는 3층으로 보인 예는 등도/고-저-중등도,4 층인 경우는 중등도-저-고-중등도/저,5층인 예는 저-고-저-고-저신호강도였다.자기공명 영상소견을 조직소견과 비교하였을 때 위벽이 3층으로 보인 경우 이것은 “점막층-점막하층-근층 ”에 해당하였다.관찰한 3가지 면 모두에서 T1강조FLASH,지방억제T1강조FLASH,T2강조TSE 기법이 True-FISP보다 통계적으로 유의하게 우수하였다(p=0.001).점막층의 명확성에 있어서 가장 우수한 기법은 T1강조FLASH와 지방억제T1강조FLASH이었고(p<0.05),점막하층의 명확성과 점막하층과 근층간의 구분은 T2강조TSE가 가장 우수하였다(p<0.05).전체적인 영상의 질은 T1강조FLASH와 T2강조TSE에서 가장 우수하였다(p<0.05). 결론:자기공명영상은 위벽의 각 층을 구별할 수 있는 우수한 검사로 조직소견과 높은 연관성을 보이며,전체 영상의 질,점막하층의 명확성 및 점막하층과 근층간의 구분이 T2강조TSE에서 가장 우수한다. Purpose: To evaluate normal human gastric wall layers in vitro using magnetic resonance*(MR) imaging, to correlate the results with the histologic findings, and to determine the optimal technique for evaluation of the gastric wall. Materials and Methods: Forty-one normal resected gastric specimens obtained from 25 patients were dissected and placed in a polyethylene tube filled with normal saline. MR imaging with four MR sequences, T1-weighted FLASH*(T1FLASH), fat-saturated T1-weighted FLASH, T2-weighted TSE*(T2TSE), and True-FISP, was performed. The number of gastric wall layers and signal intensity of each layer were determined, and after correlating MR images with the histologic findings, the conspicuity of each layer*(mucosa, submucosa, and muscle), the distinction between each layer, and overall image quality were assessed. results: The gastric wall was shown by TIFLASH to have two (n=6, 14-6%), three (n=31, 75.6%) and four layers (n=4, 9.8%); by fat-saturated TIFLASH to have two (n=6, 14.6%) and three (n=35, 85.4%) ; by T2TSE to have three (n=24, 58.5%), four (n=11, 26.8%), and five (n=6, 14.6%); and by True-FISP to have one (n=2, 4.9%), two (n=8, 19.5%), three (n=23, 56%), four (n=4, 9.8%), and five (n=4, 9.8%) . The signal intensity of each layer at T1FLASH and fat-saturated T1FLASH was high-intermediate from the lumen in two-layer cases, high-low-high/intermediate in three-layer cases, and high-low-high-intermediate in four-layer cases. The signal intensity of each layer at T2TSE was intermediate/high-low-intermediate in three-layer cases, intermediatelow-high-intermediate/low in four-layer cases, and low-high-low-high-low in five-layer cases. Three-layered gastric wall corresponded mostly to mucosa, submucosa, and muscle from the inner to outer layers, respectively. T1FLASH, fat-saturated T1FLASH, and T2TSE were superior to True-FISP in evaluating the gastric wall. T1FLASH and fat-saturated T1FLASH were the best sequences for demonstrating mucosa (p<0.05), and T2TSE was the best for submucosa and the distinction between this and muscle (p<0.05). Both T1FLASH and T2TSE provided the best overall image quality (p<0.05). Conclusion: In-vitro MR imaging is an excellent technique for the evaluation of layers of normal gastric wall. T2TSE is the sequence which best demonstrates the conspicuity of submucosa, the distinction between submucosa and muscle, and overall image quality.

일부 흡연 대학생의 지각된 스트레스와 흡연실태에 대한 상관관계 연구

강초록,권시내,권혜림,박수경,송인혜,오해인,이미지,한승아,황선아,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

In spite of the seriousness of smoking harm has been developed these days. the increase of national smoking rate and that the people in the twenties are especially leading the rise of national smoking rate is an important issue of national health. Smoking of the university students can occur health problem and cause loss of manpower and expenses in their social activity period. So then the actual state for prevention of smoking and development of a program to prohibit smoking has to be seized urgently and starting with the study of the realities of university students, the effort to find a related fluent of smoking has to be studied. Related to this, the purpose of this study is to seize the general characteristics of smoking university students and to find out the relationship between perceived stress and smoking status among smoking university students. In addition, by collating the relationship between perceived stress and smoking status among smoking university students we have the purpose to furnish the basal data of stress care, the best way to cope with stress through group training and the plan for nursing implementation to decrease the smoking rate. For this study, a survey was conducted for 204 smoking university students of 13 universities in Seoul from 9th of May to 16th of May, 2003. The collected data was analyzed by t-test, Pearson Correlation and ANOVA in the statistical packages SPSS/PC. Major findings of this study are as follows; 1. Of the 204 respondents 85.4% of them were male and 14.6% of them were female. The average age of the sample was 23.19 years old and 41.8% of them were in senior, 21.4% in junior, 16.9% in sophomore, 19.9% in freshman grade. The major motivation to start smoking was 'because of curiosity'(33.8%) and the first smoking experience was at 'senior high school' (41.9%) and at 'college' (41.9%). 2 The highest scored stress factor of smoking university students were stresses about school work. 3. 72.7% had experience to quit smoking at least one or more times. Most of the reason to keep on smoking was 'short will to quit'(51.0%) and the smoking place was usually at 'school' (41.4%). Most respondents for the number ofsmoking friends were '5 people and above' (73.2%). 4. There was a negative relationship between the general characteristics and the entire perceived stress, however, there was a positive relationship between the general characteristics and the perceived stress in 4 categories which is 'sex distinction', 'major of study', 'residence form' and' inmate'. 5. There was a negative relationship between the general characteristics and the entire smoking status, however, there was a positive relationship between the general characteristics and the smoking status in 2 categories which is 'presence of hobby' and 'number of smoking friends'. 6. There was a negative relationship between the perceived stress and the smoking status. Through this study we have seized the relationship between the general characteristics, perceived stress and the smoking status of smoking university students. There was a positive relationship between some of the general characteristics with the perceived stress and the smoking status of smoking university students. Also there was a negative relationship between the perceived stress and the smoking status.

다양한 진로모색을 위한 치위생학과 학생과 선배 치과위생사의 심층면담

경혜인 ( Hye In Kyung ),김영우 ( Young Woo Kim ),엄제현 ( Jae Hyun Eom ),이지희 ( Ji Hui Lee ),조은정 ( Eun Jung Cho ),박고은 ( Go Eun Park ),김남희 ( Nam Hee Kim ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.2

The aim of this study was to provide practical information regarding career exploration to dental hygiene students. This study interviewed 15 senior dental hygienists (graduates of Y University Dental Hygiene program) who have worked in non-clinical fields for about three months from January 14, 2014 to April 28. The most frequently mentioned pieces of information that the senior dental hygienists wanted to convey to dental hygiene students were as followed. Contrary to popular belief, clinical experience was also required in non-clinical fields as the importance of clinical experience was quite often and widely emphasized and applied in such fields. High academic excellence and clinical performance were expected of junior dental hygienists and the senior dental hygienists expressed their hope for their juniors to pioneer new fields and areas of work that a dental hygienist can do. Most of the senior dental hygienists pointed out that to develop technical tools for career exploration as early as possible, such as during undergraduate years and to think about which career path to take, whether it is clinical or academic were significantly important factors for desirable career outcomes. Based on the results of this study, undergraduate dental hygiene students should be provided with opportunities to consider and explore various career paths during their undergraduate years and to communicate with their seniors for hands-on experience-based advices. This would in turn broaden each student`s perspective beyond their knowledge or thought about the professional filed of dental hygiene. It was found that the majority of the senior dental hygienists agreed that their clinical experience was the source of their self-competence as a dental hygienist. Our study could be utilized as a valuable resource for future dental hygienists who wish to work in non-clinical fields.

Quantitative Proteomic Analysis Identifies AHNAK (Neuroblast Differentiation-associated Protein AHNAK) as a Novel Candidate Biomarker for Bladder Urothelial Carcinoma Diagnosis by Liquid-based Cytology

Lee, Hyebin,Kim, Kwangsoo,Woo, Jongmin,Park, Joonho,Kim, Hyeyoon,Lee, Kyung Eun,Kim, Hyeyeon,Kim, Youngsoo,Moon, Kyung Chul,Kim, Ji Young,Park, In Ae,Shim, Bo Bae,Moon, Ji Hye,Han, Dohyun,Ryu, Han Suk American Society for Biochemistry and Molecular Bi 2018 Molecular and Cellular Proteomics Vol.17 No.9

<P>Cytological examination of urine is the most widely used noninvasive pathologic screen for bladder urothelial carcinoma (BLCA); however, inadequate diagnostic accuracy remains a major challenge. We performed mass spectrometry-based proteomic analysis of urine samples of ten patients with BLCA and ten paired patients with benign urothelial lesion (BUL) to identify ancillary proteomic markers for use in liquid-based cytology (LBC). A total of 4,839 proteins were identified and 112 proteins were confirmed as expressed at significantly different levels between the two groups. We also performed an independent proteomic profiling of tumor tissue samples where we identified 7,916 proteins of which 758 were differentially expressed. Cross-platform comparisons of these data with comparative mRNA expression profiles from The Cancer Genome Atlas identified four putative candidate proteins, AHNAK, EPPK1, MYH14 and OLFM4. To determine their immunocytochemical expression levels in LBC, we examined protein expression data from The Human Protein Atlas and in-house FFPE samples. We further investigated the expression of the four candidate proteins in urine cytology samples from two independent validation cohorts. These analyses revealed AHNAK as a unique intracellular protein differing in immunohistochemical expression and subcellular localization between tumor and non-tumor cells. In conclusion, this study identified a new biomarker, AHNAK, applicable to discrimination between BLCA and BUL by LBC. To our knowledge, the present study provides the first identification of a clinical biomarker for LBC based on in-depth proteomics.</P>

종합병원 간호사의 밤번 근무에 영향을 미치는 요인에 관한 연구

박혜자,유인영,이영미,정문희 한국보건통계학회 2003 보건정보통계학회지 Vol.28 No.1

This study is conducted to find influencing factors on unrse's night shift works. From 20th July to 20th August, the survey was performed in a general hospital located at Kyunggi-do area, by the use of questionnaire. Collected 204 data were analysed through SPSS/Win 11.0. Results are as follows: 1. It was shown that night shifting word periods in special ward is longer than that in general ward. Exactly, shifting periods of night nurse work is 28.7days, 16.7days in special and general ward, individually. But numbers of night nurse worker are 3.4 and 2.48 persons in special and general ward, individually. And there were more patients in general wards than that in special ward. Namely, 54.3 patients in general ward and 19.3 patients in special ward. And off duty days and overtime on average in general ward were more much than that in special ward. The preference about night nurse works, the general ward was higher than that in general wards. In case of avoiding the night nurse work, the reasons that were mental stress. excess of duty, the burdens on work by oneself in general wards were shown much more frequency than that in special ward. 2. Physical-mental, social conditon of nurse worker's health in special wards were better than that in general wards. The stress level of nurse workers in general ward was higher than that in special ward. The factors of the influence on the preference on social-mental conditions of health were number of off duty days on average per month, number of night nurse working, and income of all family. Therefore, theses results were shown that the stress of nurses in general ward was much more than that in special ward. And the preference on night nurse work in general ward was lower than that in special ward. Accordingly, It was shown that the policy for support were need. The nurse administrator have to prepare complementary systems in organized level, to develop the positive recognition about night nurse work. For example have to reduce the dissatisfaction with systematic improvement, in other words control of off duty bonus, reasonable overtime and night nurse work bonus, and night working periods, and with control nursing human power and policy for reduction of overstres according working conditions and characters of business in various types of ward.