지난 2년간의 학회지 "신경정신의학" 심사 평가보고

김찬형,김세주,김도관,김성곤,박원명,송동호,박용천,이영문,오강섭,정영철,이상열,김주한,이동영,이헌정,함병주,김율리,김문두,김정진,이강욱,천근아,김재진,홍진표,홍승철 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Identification of Genes Modulated by High Extracellular Calcium in Coculture of Mouse Osteoblasts and Bone Marrow Cells by Oligo Chip Assay

Kim, Hyung-Keun,Song, Mina,Jun, ji-Hae,Woo, Kyung-Mi,Kim, Gwan-Shik,Baek, Jeong-Hwa The Korean Academy of Oral Biology 2006 International Journal of Oral Biology Vol.31 No.2

Calcium concentration in the bone resorption lacunae is high and is in the mM concentration range. Both osteoblast and osteoclast have calcium sensing receptor in the cell surface, suggesting the regulatory role of high extracellular calcium in bone merabolism. In vitro, high extracellular calcium stimulated osteoclastogenesis in coculture of mouse osteoblasts and bone marrow cells. Therefore we examined the genes that were commonly regulated by both high extracellular calcium and 1,25(OH)_(2)vitaminD_(3)(VD3) by using mouse oligo 11 K gene chip. In the presence of 10 mM[Ca^(2+)]e or 10 nM VD3, mouse calvarial osteoblasts and bone marrow cells were co-cultured for 4 days when tartrate resistant acid phosphatase-positive multinucleated cells start to appear. Of 11,000 genes examined, the genes commonly regulated both by high extracellular calcium and by VD3 were as follows; 1) the expressions of genes which were osteoclast differentiation markers or were associated with osteoclastogenesis were up-regulated both by high extracellular calcium and by VD3; trap, mmp9, car2, ctsk, ckb, atp6b2, tm7sf4, rab7, 2) several chemokine and chemokine receptor genes such as sdf1, scya2, scyb5, scya6, scya8, scya9, and ccr1 were up-regulated both by high ectracellular calcium and by VD3, 3) the genes such as mmp1b, mmp3 and c3 which possibly stimulate bone resorption by osteoclast, were commonly up-regulated, 4) the gene such as c1q and msr2 which were related with macrophage function, were commonly down-regulated, 5) the genes which possibly stimulate osteoblast differentiation and/or mineralization of extracellular matrix, were commonly down-regulated;slc8a1, admr, plod2, lox, fosb, 6) the genes which possibly suppress osteoblast differentiation and/or mineralization of extracellular matrix, were commonly up-regulated;s100a4, npr3, mme, 7) the genes such as calponin 1 and tgfbi which possibly suppress osteoblast differentiation and/or mineralization of extracellular matrix, were up-regulated by high extracelluar calcium but were down-regulated by VD3. These results suggest that in coculture condition, both high extracellular calcium and VD3 commonly induce osteoclastogenesis but suppress osteoblast differentiation/mineralization by regulating the expression of related genes.

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

Lidocaine 이 흰쥐 해마박편에서 CA 1 추체세포의 활성에 미치는 영향

김형룡,민승기,김대업,오상천,유형근,김은철,고건일,원진숙 원광대학교 생명공학연구소 1995 생명공학연구소보 Vol.3 No.1

T1b 병기의 신세포암에서 수술 후 예후를 예측할 수 있는 임상 및 병리학적 인자에 대한 연구

오승용, 김영원, 윤형윤, 서성필, 이상근, 김원태, 윤석중, 이상철, 김원재, 김용준 충북대학교 의과대학 충북대학교 의학연구소 2014 忠北醫大學術誌 Vol.24 No.1

연구목적: T1병기의 국소신세포암(localized clear-cell renal cell carcinoma)은 근치적신적출술이 나 부분신절제술이 표준치료이며 수술 후 타 병기에 비해 양호한 예후를 보인다. 하지만, 많은 수의 환 자에서 추적관찰 중 재발 및 사망이 발생하는데, 이는 T1b 병기에서 더 높게 보고되고 있다. 본 연구 에서는 국소신세포암 중 T1b 병기의 신세포암에서 표준적 치료 후 환자의 예후에 영향을 주는 임상 및 병리학적 인자에 대하여 알아보고자 하였다. 대상 및 방법: 1999년부터 2011년 까지 5개 기관에서 근치적신적출술이나 부분신제술을 시행 받은 3567명의 국소신세포암 환자들 중 병리학적 병기가 T1b로 확진 된 702명을 대상으로 하였다. 이들 환자가 가지는 임상 및 병리학적 특성 [연령, 성별, 고혈압, 당뇨, 비만도, European Cooperative Oncology Group(ECOG) 수행도, 증상유무, 수술방법, 종양크기, 분화도, 조직학적 형태 등]을 이용 하여 환자의 예후 [무재발생존율(relapse-free survival), 암특이생존율(cancer-specific survival) 및 전체생존율(overall survival)]에 영향을 미치는 인자에 대하여 다양한 방법으로 비교분석 하였다. 결과: 추적 관찰 기간은 34.0개월 (중앙값, 0-152개월)이었으며, 이 기간 중 재발, 사망 및 암특이사 망은 각각 72례 (10.3%), 57례 (8.1%) 및 24례 (3.4%)에서 발생하였다. 단변량 및 다변량 Cox 비례위험회귀분석에서 다양한 인자들이 무재발생존율(당뇨 유무, 종양크기 및 Fuhrman등급), 암특이 생존율(나이, 체질량지수, 당뇨 유무, 종양크기) 및 전체생존율(나이, 체질량지수, ECOG 수행도, 종 양크기)에 영향을 줄 수 있는 독립적 예후인자였다. 결론: 본 연구결과 국소신세포암의 예후를 예측할 수 있는 다양한 임상 및 병리학적 인자를 확인 할 수 있었다. 이러한 위험인자를 가지고 있는 환자는 보다 적극적인 추적관찰을 통하여 재발을 조기에 발 견한다면 이들의 생존율 향상에 많은 기여를 할 수 있을 것으로 생각한다.

40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

무용과 스포츠 사회화를 통한 무용인과 운동선수들의 사회성에 관한 연구

김인형,이근모 釜山大學校 附設 體育科學硏究所 1998 體育科學硏究所 論文集 Vol.14 No.-

The purpose of study was systematically investigate a difference of the effects on sociality which was found as participation in dance or sports via comparison of participant and non-participant. Data were collected through a questionnaire designed for this study utilized a SAS package. The sample of this study subjects were drawn into dancers(male = 65, female = 415), athletes(male = 320, female = 209), and non-experienced group(male = 134, female = 322). Statistic employed for data analysis were one-way ANOVA and two-way ANOVA for an average identification. Based on data analysis, the conclusions were as follows; 1. A sociality via dance or sports socialization 1) In a question as 'the experience of dancer or sports can be induce a bright personality', the male was more affirmative non-experienced group than dancers and athletes. The female revealed in the more affirmative athletes than non-experienced group and dancers. 2) In respective of gender a question as dance or sports is a help to figure or a posture of correction; revealed in the more affirmative non-experienced group than dancers and athletes. 3) In respective of gender a question as 'I eagerly participate in all work which is related to dance or sports' revealed in the more affirmative dancers and athletes than non-experienced group. 2. General sociality 1) A question as 'I can endure in spite of a hard task' revealed in the more affirmative the male than the female and athletes than dancers and non-experienced group. 2) A question as 'I positively participate for all task' revealed in the more affirmative the male than the female and athletes than dancers and non-experienced group. 3) In a question as 'I don't mind what people think of me', the male revealed in the more affirmative athletes than non-experienced group and dancers. The female revealed in the more affirmative dancers and athletes than non-experienced group.

TRISS Method와 ASCOT Method를 이용한 외상환자의 생존율 분석

김형수,배성만,양혁준,박철완,이근,고영관 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Despite traumatic injuries cause serious problems in our society, there are few adequate and objective scoring system that assess the severtiy of trauma patients. The Major Trauma Outcome Study(MTOS)in United States deisgned the TRISS(Trauma Score & Injury Severity Score)method by means of Revised Trauma Score(RTS),Injury Severity Score(ISS0,and age,while Champion et al deviced ASCOT(A Severtriy Characterizaiton Of Trauma)method to overcome the limitation of TRISS. This study attempted to make a comparison between TRISS and ASCOT by using date for 422 injured patients which were collected form September,1993 to February,1994. Ascot and TRISS were compared in their sensutivity,Specificity,disparity and Z-statistics. 1)Sex ratio of male to female was 2.8:1 and the commonest age of trauma patients was thirties (23.8%). 2)The average probability of survival(Ps)for 442 patient by TRISS method was 0.9228 and that of ASCOT method 0.9356. 3)Disparity of Ps between survival and non-survival using TRISS and ASCOT was relatively low for both indexes as 0.3507 and 0.3296, respectively. 4)The sensitivity rates(number of patients predicted to die who actually died/total who actually died)for the non-survival of both TRISS and ASCOT method were low (35.0%),but the specificity rates(number of patients predicted to live who actually lived/total who actually lived)for the survival of TRISS and ASCOT were 99.1%and 99.6%respectively. 5)Z-statistics(difference between predicted and actual number of death)of both TRISS(1.3224)and ASCOT(1.2234)resulted in positive value which meant that actual number of death exeeded predicted number of death. 6)The ASCOT that have presumed to be more accurate method for patients with head trauma and with multiple injuries to one portion of body,had its intricacy and difficult points in practical application. And the difference between the result of ASCOT and TRISS was not so significant. 7)It is thought that a new, more comprehensive index would like to be developed and thoroughly tested on a variety of data sets in order for it to be used in trauma system quality assurance evaluation.

읽기기술 향상 프로그램이 초등학생의 자기 주도적 학습능력과 학업성취도에 미치는 효과

김현경,유형근 韓國敎員大學校 敎育硏究院 2009 敎員敎育 Vol.25 No.3

본 연구는 읽기기술 향상 프로그램이 초등학생의 자기 주도적 학습능력과 학엽성취도에 미치는 효과를 검증하는데 목적이 있다. 이를 위하여 읽기기술에 대한 선행 연구결과와 학습기술 검사에 포함된 읽기기술 구성요소를 검토하여 공통요소를 토대로 5개의 읽기기술 구성요소를 선정하였다. 이러한 구성요소를 바탕으로 효과적인 읽기기술을 습득하기 위해 읽기의 6단계를 설정하여 초등학교 고학년의 자기 주도적 학습능력과 학업성취도 향상을 위한 11회기의 읽기기술 향상 프로그램을 구안하였다. 본 연구의 가설검증을 위해 초등학교 5학년 2개 학급을 임의로 선정하여 한 학급을 실험집단에, 다른 학급을 통제집단에 28명씩 배치하고 실험집단의 학생에게 프로그램을 실시하였다. 검사 도구는 김명철,정태근(2001)이 초등학교 고학년 학생들에게 맞게 제작한 자기 주도적 학습능력 검사를 사용하였다. 자료처리는 다변량 공분산분석(MANCOVA)을 통해 통계적 분석을 했으며 양적 결과에 대한 해석을 보완하기 위하여 회기별 경험 보고서와 상담일지를 통한 상담자 관찰내용을 분석하였다. 그 결과 읽기기술 향상 프로그램은 초등학생의 자기 주도적 학습능력파 학업성취도 향상에 효과가 있었다. Modem society is information-oriented and requires a learner to acquire a self-directed learning ability for lifetime, which can be fostered through a learning skills training. In particular, reading skills contain a very important meaning, in terms of the point that school learning is implemented by reading study materials or information in printed data such as pictures or writing. The research seeks to prove effects of reading-skills enhancement program in elementary school students' self-directed learning ability and academic achievement. To do this, the research examined results of previous studies on reading-skill and constituent factors of reading-skill included in learning skills examination, and selected 5 reading-skill constituent factors based on common elements. Based on these constituent factors, the research established 6 stages of reading in order to acquire effective reading-skills and formed 11 sessions of reading-skills enhancement program for improving self-directed learning ability and academic achievement of elementary school students enrolled at higher levels. To verify hypothesis, the research selected at random 2 classes in elementary school grade 5 level, placed one class as experimental group, and other class as control group-each class composing of 28 students, and implemented program to students in experimental group. Results showed that reading-skills enhancement program has meaningful effects on lower-ranking elements of upper-grade elementary school students' self-directed learning ability such as learning strategy, learning motive, and enhancement of learning self-concept. Further, reading-skills enhancement program has meaningful effects on upper-grade elementary school students' enhancement of academic achievements in Korean, Social studies and Science subjects.