Furosemide에 의한 소디움 운반체 발현의 변화

오윤규 ( Yoon Kyu Oh ),나기영 ( Ki Young Na ),이재욱 ( Jay Wook Lee ),장혜련 ( Hye Ryun Chang ),박영선 ( Young Sun Park ),박정환 ( Jung Hwan Park ),주권욱 ( Kwon Wook Joo ),김근호 ( Gheun Ho Kim ),이정상 ( Jung Sang Lee ),한진석 ( 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.2

배경 : 임상에서 흔히 사용하는 이뇨제 furosemide는 비후상행각에서 Na+-K+-2CI- cotranspoter (NKCC2)를 억제하여 NaCl 재흡수를 차단하여 이뇨작용을 나타낸다. Furosemide를 장기간 투여하면 내성과 대사성 알카리증의 부작용이 발생할 수 있는데, 이는 집합관에 도달하는 소디움 증가와 관련 있을 가능성이 있다. 방법 : 저자들은 furosemide의 내성이나 부작용이 집합관 상피 소디움 통로 (ENaC) 단백발현의 변화와 관련이 있는지를 확인하고자, Sprague-Dawley rat에서 farosemide (12 mg/day)을 7일간 지속적 피하 주입한 후 반정량적 immunoblotting과 면역조직화학법을 이용하여 NKCC2, Na +-CL- cotransporter (NCC), ENaC 단백의 발현을 관찰하였다. 실험기간 동안 수분과 전해질 용액 (0.8% NaCl & 0.1% KCl)을 자유롭게 섭취하도록 하여 체액 감소를 방지하였다. 결과 : 부형약 (vehicle)을 투여한 대조군에 비하여, furosemide를 투여한 군에서 각각 요량과 요 소디움 배설이 증가하였으나, 체중, 혈청 알도스테론치 및 크레아티닌 청소율은 차이가 없었다. Furosemid 투여 후 NKCC2 단백은 피질 (151±10 vs. 100±10%, p<0.05)과 외수질 (122±5 vs. 100±3%, p<0.01)에서 증가해 있었다. ENaC 단백은 세 가지 subunit 모두 furosemide 투여 후 대조군에 비하여 피질 (α:187±25 vs. 100±22%, p<0.05; β:155±8 vs. 100±15%, p<0.05; γ:168±16 vs. 100±9%, p<0.05)과 외수질 (α:171±27 vs. 100±17%, p<0.05; β :986±91 vs. 100±33%, p<0.01; γ :242±24 vs. 100±22%, p<0.01)에서 증 가하였다. 면역조직화학법에서도 furosemide를 투여한 군의 집합관 주세포에서 ENaC β-subunit가 더 강하게 염색되었다. 결론 : 이상에서 장기간 furosemide 투여시 집합관 ENaC 발현이 증가하며, 이러한 원위부네프론의 적응 반응이 이뇨제 내성을 유발하는데 기여할 것으로 생각한다. Background : Furosemide inhibit NaCl absorption in the thick ascending limb and produce an increase in distal delivery of Na+. We carried out semiquantitative immunoblotting and immunohistochemistry of rat kidneys to investigate whether chronic furosemide infusion is associated with compensatory increases in the abundance of Na+ transporters in distal nephron. Methods : Osmotic minipumps were implanted into Sprague-Dawley rats to deliver 12 mg/day of furosemide(n=6) with simultaneous administration of 0.8% NaCl and 0.1% KCl in drinking water for 7days. Results : Compared with vehicle infused controls, urine volume and urine sodium amount were increased. However, there were no differences in body weight, serum aldosterone, and creatinine clearance. The abundance of Na+-K+-2CI - cotransporter after furosemide infusion was increased in cortex (151±10 vs. 100±10%, p<0.05) and outer medulla (122±5 vs. 100±3%, p<0.01). In furosemide infusion group, the abundance of all three subunits of epithelial sodium channel (ENaC) was increased both in cortex (α:187±25 vs. 100±17%, p<0.05; β:155±8 vs. 100±15%, p<0.05; γ :168±16 vs. 100±9%, p<0.05) and outer medulla (α:171±27 vs. 100±17%, p<0.05; β :986±91 vs. 100±33%, p<0.01; γ :242±24 vs. 100±22%, p<0.01). Consistent with these results, ENaC β-subunit immunohistochemistry showed a remarkable increase in immunoreactivity in the principal cells of collecting ducts with furosemide treatment. Conclusion : These increases in the abundance of ENaC protein may account for the generation of diuretic tolerance.

대학생의 라이프스타일 유형에 따른 신용카드 사용과 의복구매

나영주,이은희,장경자 한국의류산업학회 2004 한국의류산업학회지 Vol.6 No.5

This study aimed to classify the lifestyles of 1020 college students, and to analyze the effect of the lifestyles on the usages of credit card, price perception, purchasing satisfaction and the number of new clothing. The number of credit cards, total payment of credit cards and the attitude to credit card were different by the 7 clusters of college students, but the frequency of credit card use, the amount of cash service and arrearages were not different. The perception to the apparel price, purchasing satisfaction, and the degree of clothing purchasing varied according to the lifestyle clusters. For example, 6th cluster being highest in the pursuit of appearance showed the highest amount of credit cards usage significantly and tendency of highest arrearage, and used credit cards mostly in clothing purchase.

학습성과 평가를 위한 측정도구 개발 및 양호성 검증

주영주,한상윤,김나영 이화여자대학교 교과교육연구소 2013 교과교육학연구 Vol.17 No.2

교과목의 학습성과는 교육의 결과로서 프로그램을 결정하고 학습자의 교육목표를 설정하는데 있어 매우 중요하다. 이는 비단 교과교육에 국한되지 않으며, 비교과교육인 평생교육에 있어서도 교육목표를 설정하고 성공적인 교육 실현을 이끌어내는 바탕이 된다. 이에 교육의 성공적인 질 관리를 위해서 학습자의 특성을 반영한 학습성과 측정이 중요하다. 본 연구는 학습성과 평가를 위한 측정도구를 개발하고 그 양호성을 검증하려는 목적으로 실시되었다. 측정도구를 개발하기 위하여 우선 국내외 문헌고찰 및 관련 문항들의 검토를 바탕으로 35문항을 개발하였고 내용타당도 검증 및 문항이해도 검토를 통하여 문항 제거 및 수정, 보완을 거쳐 24문항을 선정하였다. 이에 대한 타당도를 검증하고자 E대학 평생교육원의 교육과정에 참여하고 있는 성인학습자 158명을 대상으로 1차 설문조사를 진행하였고, 탐색적 요인분석을 실시하였다. 탐색적 요인분석 실시 결과 최종 측정 도구는 5개 요인, 22개 문항으로 확정되었다. 그리고 최종 측정도구에 대한 적합도 검증을 위하여 263명을 대상으로 2차 설문조사를 진행하여 확인적 요인분석 및 상관과 신뢰도 분석을 실시하였다. 이를 통하여 본 측정도구는 적합한 도구임이 검증되었다. 본 연구는 학습자의 특성을 반영하여 학습성과를 평가할 수 있는 도구를 개발하고 그 양호성을 검증함으로써 이전보다 명확한 학습성과 평가가 이루어 질 수 있도록 한 데 그 의의가 있고, 더 나아가 이는 우리나라 평생교육의 성공적인 질 관리에 기여할 수 있을 것이다. The purpose of this study was to develop a scale to measure learning outcomes. In addition, this study attempted to verify the validity of the scale. Based on the results of a literature review, 35 items are developed. These 35 items were then reviewed by three experts and five adult learners. As a result of this process, the number of items was reduced from 35 to 24 items. For the revised-item analysis, 158 adult learners who had completed a course in a lifelong learning institute were chosen for the survey. Through Exploratory Factor Analysis(EFA), two items were deleted. Finally, 22 items in 5 categories were developed based on EFA. To verify the validity of the scale, Confirmatory Factor Analysis(CFA) was conducted with the 263 participants. The model fit of the scale was good. In addition, the factors were correlated with each other and their reliability was good. This study therefore suggests that the reliability and validity of the scale was appropriate. This scale can help evaluate the learning outcomes of learners in a lifelong education institute.

골반경수술 146예에 대한 임상적 고찰

나준희,김용만,남주현,김영탁,김종혁,목정은 울산대학교 의과대학 1995 울산의대학술지 Vol.4 No.2

Pelviscopic surgery has been reported to have minimal tissue damage and bleeding, and to reduce cost and recovery time for patients undergoing a variety of procedures. The field of gynecologic operations that can be performed by pelviscopic procedures has expanded rapidly. This report is a retrospective review of 146 cases of pelviscopic surgery from January, 1991 to February 1996 to evaluate the efficacy of pelviscopic surgery in gynecologic patients. The results of this review were summarized as follows; 1. The majority of patients was between 21 and 40 years of age(84.2%), mean age was 33.1 years. 2. Preoperative clinical indications were adnexal mass 77 cases(52.7%), ectopic pregnancy 48 cases(33.9%), uterine myoma 9 cases(6.2%), and etc. 3. Types of surgery were salpingectomy 43 cases(29.5%), salpingoophorectomy 41cases(28.1%), LAVH 9 cases(6.2%) and etc. 4. The previous operation history was found in 34 cases(23.3%), and the type of previous operation were Cesarean section 11 cases(32.4%), appendectomy 10 cases(29.4%), and there were 5 cases of previous history of ectopic pregnancy. 5. The mean duration of hospitalization was 5.8 days.

하시모토 갑상선염을 동반한 갑상선 이형성증 1예

정현주,김예나,최영식,박요한 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.1

Thyroid hemiagenesis is a rare congenital anomaly, in which one thyroid lobe fails to develop. It is reported that thyroid hemiagenesis associated with thyroid diseases such as Graves' disease, Hashimoto's thyroiditis, colloidal goiter and thyroid follicular and papillary cancer. However, Thyroid hemiagenesis associated Hashimoto's thyroiditis haven't reported in Korea. A 31-year-old female patient was clinically hypothyroid with a left-sided goiter. Hemiagenesis of right thyroid lobe indicated on 99mTc pertechnete scan and later confirmed on ultrasonography. The authors report this case with literature review.

일측 요관폐쇄에 의한 실험적 수신증에서 신조직내 MCP-1 및 TNF-α유전자 발현

나가량,황평주,김종학,구영선,강민규,서광선,이강욱,신영태 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.2

Early cellular and molecular derangements have been suggested as potential pivotal factors for the development of renal injury, such as interstitial fibrosis after the experimental hydronephrosis. Several recent studies have been demonstrating that one of the initial events taking place in the progressive renal injury process is the mononuclear cell infiltration in the glomeruli and tubulointerstitiuim. In order to evaluate the renal light microscopic findings as well as the renal cortical MCP-1 and TNF-α gene expressions which are modulating inflammatory process and the recruitment of mononuclear cells in many experimental models of renal injury, Sprague-Dawley rats underwent unilateral ureteral obstruction (UUO) and sham operation under the thiopental sodium anesthesia(50 mg/kg intraperitoneal injection). Three and 7 days after surgery, rats were sacrificed. By the competitive RT-PCR, the levels of TNF-α and MCP-1 mRNA in renal cortical tissues were measured. The magnitude of mononuclear cell infiltration and interstitial widening were evaluated by standard point counting method. The level of MCP-1 gene expression was significantly increased in UUO group compared to sham group at 3 and 7 days after surgery(UUO 3 days 8.99 ± 0.45, UUO 7 days 11.2 ± 0.26, sham 3 days 1.00 ± 0.08, sham 7 days 0.94 ± 0.05, p < 0.01, p < 0.01, mean ± SEM, respectively). The level of MCP-1 mRNA at 7 days after surgery was significantly higher than that at 3 days in UUO group. The TNF-α gene expression level of UUO group was also significantly higher than that of sham group at 3 and 7 days after surgery(UUO 3 days 1.73 ± 0.16, UUO 7 days 2.03 ± 0.21, sham 3 days : 1.00 ± 0.06, sham 7 days 1.09 ± 0.03, p < 0.01, p < 0.01, respectively). But there was no significant difference between the levels at 3 and 7 days after surgery in UUO group(p>0.05). On the light microscopic examination, the relative volume of interstitium (RVI) and the total count of infiltrated mononuclear cells(MCC) at 3 and 7 days after surgery in UUO group were also significantly higher than those of sham group(RVI ; UUO 7 days 14.9±1.0%,sham 6.0±0.7%, MCC; UUO 7days 34.0± 1.6, sham 3.7± 0.6, p < 0.01, p < 0.01, respectively). In conclusion, we speculated that the early up-regulation of MCP-1 and TNF-α genes of renal cortical tissue in this experimental hydronephrosis model is closely related to the mononuclear cell infiltration and tubulointerstitial fibrosis.

장기간 보관한 멸균물품의 오염 상태에 관한 연구

주홍순,조순덕,정재심,신동분,임바올라,노은지,이선희,송영미,최정화,백병윤,김미나 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.1

기초직업능력표준 제도화 방안

나승일,정철영,김주섭,구자길,김강호,장현진 한국농업교육학회 2008 농업교육과 인적자원개발 Vol.40 No.2

이 연구의 목적은 기초직업능력표준의 활용성 제고를 위해, 직업교육훈련 및 자격제도에 기초직업능력표준의 도입 방안과 법적·정책적 제언을 하는데 있었다. 연구목적 달성을 위해 문헌고찰, 내용분석, 조사연구, 전문가협의회 등의 연구방법이 활용되었다. 기초직업능력표준 제도화 방안 개발을 위해 기초직업능력표준의 자격도입 및 교육훈련에의 활용에 필요한 인프라를 구축하고 이를 법적으로 규정하는 것을 기본방향으로 설정하였다. 기본 방향에 따라 ① 기초직업능력 자격은 국가기술자격에 표준을 반영하거나 신설하되 응시자격에 제한을 두지 않고, 결과인증 방법을 통해 3등급으로 구분한다. 단, 직업윤리는 등급을 구분하지 않고 합격과 불합격의 단일동급을 적용한다. ② 기초직업능력표준을 학교 교육과정 및 훈련기준에 반영하되 기존 교과에 반영하거나 별도 교과를 신설한다. 이를 위해 학습자, 교육훈련기관, 자격검정기관, 인프라 차원의 지원이 요구된다.③ 기초직업능력 교육훈련과 자격의 연계를 위해 교육훈련이수자에게 자격시험의 일부 또는 전체를 면제하도록 한다. ④ 기초직업능력표준의 관리 · 운영은 한국산업인력공단에서 담당하되 주요 심의사항은 자격정잭심의위원회에서 주관하도록 한다. 제도화 방안의 실제 적용을 위해 자격기본법, 근로자직업능력개발법 등의 관련 법제 정비를 위한 제언을 제시하였으며, 제도화의 효율적인 추진을 위한 정책적 제언을 제시하였다. The purpose of this study was to develop the introduction plan and to identify the revision points of laws and the political implications related with basic competencies standards for improving utilization based on vocational training and qualification. For the purpose, literature reviews, contents analysis, survey and experts council were conducted. This study suggested the basic framework which was building infra and legislation consolidation required on establishment qualifying system and improvement utilization to institutionalize the basic competencies standards. According to this, ① basic competencies qualification should be considered on national technical qualification and be graded 3 levels through summative evaluation without application requirements. But vocational ethics must be under the pass-fail system. ② It should be make the best use of basic competencies standards on schooling curriculum and vocational training standards by means of modifying existing courses or creating new courses. For this, it need to support learners, training and education institutions, qualifying test institutions, and infra. ③ Individuals who complete the course should be exempt on whole or partial exam for linking between training and qualification. ④ Management and operation of basic competencies standards should be controled by Human Resource Development Service of Korea, and the right to deliberate need to be authorized by Qualification Policy Deliberation Committee. To realize institutionalization, this study suggested consolidating the related laws including Framework Act on Qualifications, Workers' Vocational Competency Development Act, and so on. Moreover, it recommended political proposal for effective actualization of institutionalization.

성인 급성 신부전의 원인 및 예후인자 분석

구영선,장윤경,양종오,강민규,황평주,김종학,나기량,이강욱,신영태 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

Acute renal failure is a frequent complication in hospitalized patients and is strongly related to the mortality. The Clinical outcome and prognostic factors of acute renal failure(ARF) have been analyzed by many authors. The present study describes the etiologic and clinical aspects, as well as other factors related to mortality. All the patients suffering from acute renal failure admitted during the period of January 1993 - August 1998 were included in the study. The average age of the patients was 52±17 years and mortality rate was 24%. The causes of acute renal failure were hemorrhagic fever with renal syndrome(HFRS), sepsis, renal hypoperfusion, urinary tract obstruction, acute tubular necrosis, etc. The etiology of ARF was a significant prognostic factor on mortality in ARF. Other significant prognostic factors were oliguria, organ failure, use of vasoconstrictors, hypotension, serum bicarbonate, premorbid conditions, sepsis, neurologic complications, gastrointestinal bleeding. On the other hands, operation, sex, anemia, thrombocytopenia, hypoalbuminemia, BUN, serum creatinine, and hyperkalemia were not significant factors for the mortality. We conclude that major prognostic factors of acute renal failure arc premorbid conditions, sepsis and multiorgan failure, and they are responsible for persistent high mortality of acute renal failure despite of advances of medical care.

서민복식문화에 관한 연구 (Ⅱ) : 경북 금오산 주변지역의 민속조사 결과를 중심으로 Field Research Around the Mt . Kumo Area

홍나영,이은주,임재영 한국의류학회 1995 한국의류학회지 Vol.19 No.1

The authors study on the traditional textile production and the formal dress throuth the field research concerning the folk attitude toward dress style around the Mt. Kumo area. In this area, people produced and wove hemp, cotton, and silk except ramie. Because of poor production of raw materials, they produced textiles only for self-sufficiency. Every household dealt with dyeing on a small scale. In the past, people dyed cloth natually using plants as material. Natural dyeing, however, gradually changed into chemical one since the Japanese rule. The formal dresses, which people wore on particular occasions such as the hundredth day after child's brith, the first birthday, and traditional holidays, were very meager due to poor living standards. People could not see the formal dresses with full decoration. Bride and bridegroom were the village-owned wedding dresses, and if they could not afford to, they simply put cloth on to remember the occasion. People around the Mt. Kumo area, however, provided fully-decorated shroud and ritual robes to the level of other better-off areas. It seemed to be the result of influence of deeprooted Confucianism in Gyungbuk province. This Phenomenon could be found in the folk dress style in other regions as well as the Mt. Kumo area in Gyungbuk province.