혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

위암 환자에서 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김삼용,김영건 충남대학교 암연구소 1991 癌共同硏究所 硏究誌 Vol.1 No.1

We performed a variety of lymphocyte stimulation tests, delayed hypersensitivity skin tests, and enumeration of several lymphocyte subpopulations in 21 patients with gastric cancer who did not receive any form of anticancer therapy, and in 20 healthy controls. The gastric cancer patients had significantly decreased number and total score of positive reactions in delayed hypersensitivity skin tests compared with the healthy controls. The percent of CD_(4) positive lymphocytes in the gastric cancer patients was significantly decreased compared to the normal control subjects, but it had no correlation with the total score of delayed cutaneous hypersensitivity reactions. The ratio of helper to suppressor cells was lower in the cancer group. The uptake of 3H-thymidine was markedly depressed in cancer patients when stimulated with various mitogens. There was little correlation between any of the stimulation tests and any of the lymphocyte subpopulation proportions to delayed hypersensitivity cutaneous reactions. Optimal proliferative response was found in lymphocytes stimulated with 10 micrograms of concanavalin-A and 10 microgram of phytohemagglutinin. Advanced stage patients had greatly depressed delayed hypersensitivity skin reactions and proliferative responses to mitogens compared with localized diseases. These results suggest that gastric cancer patients have depressed cellular immune functions, which mainly result from the decreased helper cells and defects in functional proliferative response to mitogens. Interleukin-2 and interferon-gamma restored the in vitro proliferative response of lymphocyte in patients with gastric cancer.

위암 환자에게 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김상용,김영건 忠南大學校 癌共同硏究所 1991 癌共同硏究所 硏究誌 Vol.1991 No.-

유아교육실습 지도교사 교육프로그램 개발 연구

윤기영,정현숙,류칠선 서원대학교 교육연구소 2001 敎育發展 Vol.20 No.2

The purpose of this study was to develop a in-service teacher education program for student teaching in early childhood education center in order to reinforce student teacher's educational role for improving their student teaching. In this paper, the sample consisted of 20 early childhood professionals who have experienced at least 3 years in students teaching program. The survey was administered using the Delphi method. The study explored the objectives, contents, administration and method, and evaluation of the developed program. We also attempt to outline the present conditions and problems on student teaching in early childhood education center. As a conclusion, the program have to assist the able kindergarten teacher for understanding student teacher correctly, to consist and administrate a practicum program with systematic support.

단순반복 작업자의 작업대 및 의자의 형태와 누적외상성질환 증상과의 관계

정현기,노영만,임현우,박정일,정춘화 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

목적 : 단순반복작업 생산직 근로자의 누적외상성질환에 대한 사업주의 건강관리규정 준수상태 및 근로자의 자각증상호소와 의자 및 작업대의 형태를 파악하고 크기를 측정하여 이들과 누적외상성질환 자각증상호소와의 관련요인을 알아보고 대책을 제공하고자 한다. 방법 : 서울 및 경기지역 일부 100인 미만 사업장중 전기, 전자부품 제조업체 7개를 선정하여 생산직 근로자 77명을 대상으로 누적외상성질환에 대한 사업주의 건강관리규정 준수상태와 및 근로자의 자각증상호소에 대한 설문조사를 실시하고 의자와 작업대의 크기를 측정하고 증상과의 관련요인을 알아보기 위하여 로지스틱회귀분석을 실시하였다. 결과 : 의자와 작업대가 작업자세에 영향을 준다고 인식하는 작업자는 85.7 %이였으며 단순반복작업 근로자 작업관리지침에 의한 사업주의 근로자에 대한 관심은 매우 낮았다. 누적외상성질환 자각증상 호소율은 63.6 %이였으며 자각증상 부위는 어깨 37.9%, 목 15.2 %, 등 6.1 %, 팔/팔꿈치 4.6 % 순이였다. 입사 후 초기발생시기는 평균 16.5개월이며 자각증상 호소는 작업대 두께, 작업대높이, 작업대 밑무릎공간, 등받이 높이, 좌석면 높이, 좌석면의 앞뒤길이, 좌석면의 좌우길이, 작업대끝에서 어깨까지의 거리에서 유의한 관련이 있었다. 자각증상호소의 관련요인은 등받이 높이, 좌석면의 높이, 좌석면의 앞뒤길이 이였다. 결 론 : 이상의 결과로 보아 정부는 단순반복작업 작업자의 누적외상성질환 예방을 위하여 사업주에 대 한 철저한 교육 및 관리감독을 해야한다. 사업주는 작업대 및 의자를 작업자의 신체치수와 작업내용에 맞게 높이를 조절할 수 있는 제품을 사용하고 작업전, 후에 정기적인 건강체조 및 휴식을 갖도록 하며 근로자에 대한 실질적인 보건교육이 이루어져야 한다. Objectives : The main purpose of this study was to investigate relationship between cumulative trauma disorders (CTDs) and the types of workstation and chair in workers with repetitive motion tasks. Methods : The study subjects were 77 repetitive motion tasks workers at small manufacturing industries in Seoul and Gyung-gi district area. A questionnaire was used to obtain about health practice for prevention and prevalence of CTDs by worker. The type of Workstations and chairs in workers were measured and analyzed with prevalence of CTDs by logistic regression. Results : Eighty-six percent of workers recognized that work posture was related to workstation and chair, Most employers and employees didn't follow the work practice guidelines for workers with repetitive motion tasks. The prevalence of CTDs was 64% by questionnaire. The prevalence of pain in shoulder, neck, back, and arm were 38%, 15%, 6%, and 5%, respectively, and the pain started after working an average duration of 16.5 months. The CTDs symptoms were significantly related to thickness of workstation, height of workstation, length of knee depth under workstation, height of back rest, height of seat pan, depth of sitting surface, width of sitting surface, and length from workstation surface edge to shoulder. By multiple regression analysis of each risk factor, prevalence of CTDs was highly correlated with height of back rest, height of seat pan, and depth of sitting surface. Conclusions : This study suggests that workstations should be made adjustable for height and chairs should be equipped with seat pan height control, enough sitting surface for depth and width, back rest height and angle control. The workers should use the right working postures, exorcise for health, occupational health education, and rest breaks and the manager of company should be educated for the preventing of CTDs.

기(氣)수련이 정신건강 프로파일에 미치는 효과

정영자,정현익,이명수,서채문 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.20 No.1

This cross-sectional investigation evaluated the trend of psychological changes by Qi-training using a self-report inventory of emotional distress, Symptom Check List-90-Revision (SCL-90-R). Forty-one normal healthy subjects (mean age: 21.0±5.4) and one hundred-twenty-three Qi-trainees (divided into three groups, primary, middle and high level) participated in this study. Primary level group has received 1-4 months Qi-training (mean age: 22.0±7.8, n = 41); middle level group has 5-12 months Qi-training (mean age: 20.0±7.8, n = 41); and high level group has more than 1 year Qi-training (mean age: 22.7± 6.7, n = 41). Our results show that all of psychologucal symptom scales of Qi-trainees over lyear were significantly lower scores compared to controls. In addition, high level group had lower global indexes scores than control. A significant negative correlation was found between the Qi-training period and all SCL-90-R subscales except phobic anxiety. These results suggest that Qi-training is effective in protection as well as reduction of psychological symptomatology.

S.D. Rats를 이용 1, 1-Dichloro-1-fluoroethane의 아민성 흡입독성 연구

김현영,이성배,임철홍,김철우,점용현,한정희,전윤석,최수영,강대봉,이용묵 한국환경독성학회 2002 환경독성보건학회지 Vol.17 No.1

There were no specific effects for test materials on Sprague-Dawley (S.D.) rats in clinical symptoms, amounts of food intakes, weight changes, laboratory findings, and pathology after whole body l, l-Dichloro-1 -fluoroethane (used as coolant, metal cleaner and solvents) exposure(0, 1,500, 3,000, and 6,000 ppm) for 13 weeks (6 hour/day, 5 days/week). However, the loss of capillary vessels in eyeball (pupil) was observed in a female rat among 6,000 ppm group. Though there was a tendency for MCHC (Mean Corpuscular Hemoglobin Concentration) in rat to be decreased (p<0.05), it was not regarded as abnormal because the values were within normal limits. In asthma-stimulation related evaluations, there was also a tendency for inflammatory cell counts in bronchoalveolar lavages to be increased. But it had no statistical significance, and also no dependency on sex and the exposed concentration. Based on this result, the non observed effect level (NOEL) induced by 1, 1-Dichloro-l -fluoroethene inhalation was evaluated in groups with 3,000 ppm below (S .D. Rats, 13 weeks). Finally, it was concluded that the short term exposal of 1, 1-Dichloro-l-fluoroethane is not considered as a asthma stimulant by inhalation despite of some study limitations such as test animals use and short-term exposure .

자색고구마가 사염화탄소 투여에 의한 흰쥐의 간손상 보호에 미치는 영향

조영자,김현아,방미애,오용비,정병춘,문윤호,정우진 한국식생활문화학회 2003 韓國食生活文化學會誌 Vol.18 No.3

The purpose of this study was to investigate the effects of dietary purple sweet potato(lpomoea batatas) powder on serum lipid levels and antioxidative enzymes in normal and pretective effect on hepatotoxicity rats induced by carbon tetrachlolide. Four groups of rats (3-week-old inbred Sprague-Dawley male rats) were normal rats fed control diet(C)_(1) induced hepatotoxicity rats fed control diet(EC)_(1) normal rats fed purple sweet potato diet(P), and induced hepatotoxicity rats fed purple potato sweet diet(EP). Rats were induced by single injection of 50% carbon tetrachloide(0.1 mL/100 g B.W., i.p.). The rats were fed ad libitum each of the experimental diet for 5 weeks. After 5 weeks the rats were sacrificed and activities of antioxidant enzymes and lipid peroxidation products were determined in their liver homogenates. But serum concentrations of lipid was not significant in all groups. Serum alanine aminotransferase(ALT/GPT) and aspartate aminotransferase(ALT/GPT)of the EC and EP groups were heigher than the C and P groups. The hepatic glucose 6-phosphatase(G9Pase) activity of the group fed purple potato diet(P) was lower than the other groups(p<0.05). However, The glutathione peroxidase(GPx) activities was not statistically different between the groups. Renal glutathione S-transferase(GST) activity of the EC and EP groups were lower than the C and P groups(p<0.05). In conclusion, these results suggest that purple sweet potato is believed to be possible protective effect on hepatotoxicity rats induced by carbon tetrachlolide.

백혈병 마우스 모델의 동종골수이식에서 활성화된 자연살해세포들의 보충이 이식편대백혈병효과와 이식편대숙주반응에 미치는 영향

엄현석,한치화,박수정,김소연,정낙균,정대철,진종률,최일봉,양형모,서영훈,송현근,최인표,민우성,김춘추 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: 백혈병에서 동종골수이식 (allogeneic bone marrow transplantation)의 성공적 치료 효과를 얻기 위해서는 이식편대숙주반응 (graft-versus-host disease, GVHD) 발생의 극복과 재발의 방지가 중요한 과제이다. 골수를 역류원심성 세포분리 (counterflow centrifugal elutriation, CCE) 방법으로 분리하여 얻은 rotor off (R/O) 세포분획은 T 세포의 수는 적지만 조혈모세포들을 다량 포함하고 있어 동종골수이식에서 주조직적합복합체 (major histocompatibility complex, MHC) 차이를 극복할 수 있고, 이식편의 생착 성공과 GVHD 발생 예방에 효과적이다. 그러나 골수로부터 T 세포를 제거하면 백혈병세포를 공격하는 이식편대백혈병 (graft-versus-leukemia, GVL) 효과가 감소되기 때문에 백혈병 재발의 빈도가 높다. 자연살해세포 (natural killer cell, NK cell)의 보충 첨가는 동종골수이식 후 GVHD 발생을 줄이면서 충분한 GVL 효과를 얻을 수가 있다. 따라서 저자는 분리 후 IL-2로 활성화시킨 NK 세포들을 골수 R/O 세포분획과 함께 백혈병 마우스 모델에 동종이식함으로써 GVHD와 GVL에 미치는 효과를 관찰하였다. 방법: Balb/c (H-2^(d)) 마우스에서 유래된 A20 (murine B-lymphoma/leukemia cell line, H-2^(d)) 백혈병 세포를 이식 2 일 전에 Balb/c 마우스에 주입하고, 치사량의 전신 방사선을 조사한 직후에 Balb/c 또는 C57BL/6 (H-2^(b)) 마우스의 골수 R/O 세포분획을 꼬리정맥을 통하여 주입하였다. 이들은 모두 이식 후 6-8 주 이내에 사망하였다. 동종이식의 대조군 (n=9)에는 1 × 10^(7)의 R/O 세포분획만을 주입하였고, 실험군 (n=9)에는 C57BL/6 마우스의 비장세포들로부터 단클론항체들을 이용한 negative selection방법으로 분리한 후 IL-2로 활성화된 5 × 10^(5)의 NK 세포분획을 1 × 10^(7)의 R/O 세포분획과 함께 주입하였다. GVL 효과의 판정은 이식 후 14 일과 28 일 째 되는 날 마우스에서 골수, 비장, 간 등을 얻어 백혈병 세포들의 침윤을 조직학적으로 관찰하였으며, GVHD의 정도는 육안적 관찰법으로 평가하였다. 결과: R/O 세포분획만을 이식한 대조군의 골수, 비장, 그리고 간 조직에서는 A20 백혈병 세포의 침윤이 각각 89% (8/9), 78% (7/9)와 22% (2/9)에서 관찰되었고, R/O 세포분획과 NK 세포분획을 함께 이식한 실험군에서는 비장과 간을 제외한 골수에서만 89% (8/9)에서 A20 백혈병 세포의 침윤이 관찰되어 두 군 사이에 장기별 분포의 차이를 볼 수 있었다 (P= 0.0001). 한편 GVHD는 두 군 모두에서 경하게 나타나서 유의한 차이는 없었다. 또한 생착 부전으로 사망한 마우스는 없었다. 결론: CCE를 이용하여 T 세포를 제거한 동종골수이식에서 NK 세포의 보충은 GVHD의 악화는 일으키지 않으면서, 백혈병의 진행을 억제하는 GVL 효과를 얻을 수 있었다. Background: Allogeneic bone marrow transplantation (BMT) with T cell-depleted marrow accompanies engraftment failure and relapse of leukemia by a loss of the graft-versus-leukemia (GVL) effect frequently, while it can prevent GVHD. Supplement of NK cells could prevent GVHD and enhance GVL effect in several murine allogeneis BMT models Roter off (R/O) cell fraction obtained by counterflow centriation elutriatio (CCO) contains small number of T cells and many hematopoietic stem cells. The aim of this study was to determine the effect of R/O cell fraction supplemented with IL-2 activated NK cells on GVL and GVHD within the leukemic mouse BMT model. Methods: Inoculation of A20 (H-2d, murine B-lymphoma/leukemia, Balb/c origin) cells into Balb/c mice via the tail vein 2 days prior to lethal total body irradiation (TBI) and infusion of the Balb/c BM or C57BL/6 (H-2b) R/O fraction were performed. It resulted in 100% mortality within 6 to 8 weeks. The irradiated mice in the control group were injected with 1 × 107 R/O cell fraction alone (n=9) and in the experimental group mice were injected with 1 × 107 R/O cell fraction plus 5 × 105 negatively selected IL-2 activated NK cell fractions of the spleens via the tail vein (n=9). On day 14 and 28 after BMT, the bone marrows, spleens, and livers of mice were harvested for histopathologic analysis of the infiltrations of leukemic cells. We then evaluated the GVHD within the mice. Results: A histopathologic study of the recipients receiving R/O fraction alone showed infiltration of leukemic cells, 89% (8/9) in bone marrows, 78% (7/8) in spleens, and 22% (2/9) in livers. The experimental group of mice showed only the infiltration of leukemic cells 89% (8/9) in bone marrows, not in spleens and livers. There were the organ differences of the leukemic cells infiltrations between the two groups (P=0.0001). There were no obvious differences in the GVHD scores between these two groups, and severe GVHD was not observed. There was no engraftment failure among groups. Conclusion: Thus, our findings suggest that R/O cell fraction obtained by CCE and supplemented with NK cells can promote GVL effect without mediating clinically overt GVHD in allogeneic BMT of mouse leukemia.

상악 제일대구치의 저항중심에 관한 유한요소법적 분석

조정현,이기수,박영국 대한치과교정학회 1993 대한치과교정학회지 Vol.23 No.2

The purpose of this study was to analyse the center of resistance of the maxillary fitst molar using the 3-dimension finite element method. An extracted maxillary first molar of normal shape and average root length was selected and sectioned every 1.5mm parallel to the cementoenamel junction. Each section was traced and digitized to construct 3-D finite element model of the maxillary first molar. After a certain magnitude of counterbalancing moment(M) was applied to the tooth, a varying single force(F) of distomesial direction was applied to a certain point of th tooth until the tooth was translated. The force producing translation(Ft) was substituted to the equation △d=M/Ft to calculate the center of resistance of the maxillary first molar. And reducing the alveolar bone level 1.68mm, and 3.36mm below to the cementoenamel junction, the tooth movement was analysed to see the effect of reducing the alveolar bone level to the location of the center of resistance. The results were as follows ; 1. The center of resistance of the maxillary first molar was 3.72mm apical, 1.10mm buccal, and 0.71mm mesial to the geometric center of the horizontally sectioned surface at the cementoenamel junction. This point was 0.36mm apical, 1.20mm buccal, and 0.71mm mesial to the trifurcation point, indicating that it was not on the tooth root. 2. As the alveolar bone level was reduced, the center of resistance of the maxillary first molar was moved to the apical direction.