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      • 청소년의 스마트폰 중독과 우울 및 불안과의 관계

        김경은,김필송,민주연,박수경,신서인,이지은,정해인,조호정,최정원,최정인 이화여자대학교 간호과학대학 2013 이화간호학회지 Vol.- No.47

        Purpose: The purpose of this study was to investigate the relationships between the degree of smart phone addiction among adolescents and their depression and anxiety levels. Method: In this study, 379 high school students were selected using the convenient sampling method. The instruments used for this study were smart phone addiction measure, the CES-D (Center for Epidemiological Studies-Depression Scale), and the STAI (State-Trait Anxiety Inventory). Data were analyzed using the SPSS 20.0 program with descriptive statistics, t-test, ANOVA with Scheffe test, and Pearson’s correlation coefficient. Result: The mean score for smart phone addiction was 40.45±17.27, depression was 36.56±9.58, state anxiety was 44.00±9.61, and trait anxiety was 45.70±9.75. There were significant differences between the degree of smart phone addiction and the following variables: gender (t=-4.953, p<.001), hours of smart phone use per day (F=12.259, p<.001), types of frequently used features (F=3.485, p=.008), and satisfaction level for smart phone (F=5.18, p<.001). There were statistically significant relationships (p<.001) among degree of smart phone addiction, depression level, and state and trait anxiety levels. Conclusion: The results of this study suggested that there was a significant relationship between smart phone addiction and mental health, specifically, depression and anxiety among adolescents. Further research is needed to develop nursing strategies to provide care for adolescents who frequently utilize smart phones.

      • 단기간의 저용량 Cytosine arabinoside 치료에 반응하였던 Down 증후군에 병발한 급성골수성백혈병 1례

        김현수,이정호,이정찬,강정현,곽상혁,김철희,배광봉,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

        The incidence of hematologic disorders in patients with Down's syndrome is significantly increased, about 14∼30 - fold higher than in general population and includes neonatal transient abnormal myelopoieis and acute leukemias. The age of onset of leukemia in Down's syndrome is peaking first in the newborn period and then under 4 years of age. Down's syndrome with acute leukemia above the age of 20 is very rare and it's treatment oucome is unclear. The treatment of Down's syndrome with leukemia has been controversial because of toxicity and associated congenital cardiac and other abnormalities. But if treated adequately, children with Down's syndrome show a favorable response to anti-leukemia therapy. A 24-year-old man with Down's syndrome was first seen for the evaluation of anemia and thrombocytopenia. The peripheral blood morphology and bone marrow study revealed acute myelogenous leukemia, cytogenetic study of bone marrow showed trisomy 21. Beacuse of his sicioeconomic condition and medical abnormalities including deafness, visual loss, he was treated with low dose subcutaneous cytosine arabinoside(Ara-C) for 11 days. Complete remission was obtained after 37 days. The complete remission lasted for 5 months. He subsequently relapsed, and died 6 months later.

      • 모반세포성 모반과 악성 흑색종의 CD44 발현에 관한 면역조직화학적 연구

        김정수,김영조,최규철,정병수 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

        CD44 is the major human cell surface receptor for hyaluronate and mediate cellmatrix and cell-cell interactions involved in the mechanisms of tumor invasion and metastasis. Typical acquired melanocytic nevi appear to follow a life cycle characterized by active growth, maturation, and progressive involution, In contrast, congenital melanocytic nevi have a different course and prognosis with potential for development of melanoma, and metastatic spread is very common in malignant melanoma. We investigated the expression of CD44 in acquired and congenital melanocytic nevi, and malignant melanoma by immunohistochemical technique. Formalin-fixed and paraffin-embeded tissue from 5 compound nevi, 6 intradermal nevi, 5 congenital melanocytic nevi, and 5 malignant melanoma were immunolabeled with monoclonal antibodies directed against CD44. All acquired melanocytic nevi showed negative or weak staining for CD44. However, all congenital melanocytic nevi exhibited positive staining for CD44 with minimal irregularities according to location. In malignant melanoma, there was variable intensity of staining for CD44 in different areas of the tumor. These findings suggest that the different expression of CD44 in melanocytic nevi may contribute to different biological behavior between acquired and congenital meanocytic nevi. and CD44 seems to be related to metastasis and tumorigenesis of the malignant melanoma.

      • Vitamin D_(3)가 RAW 세포에 감염된 Mycobacterium marinum의 증식억제에 미치는 기전 연구

        박정규,정샛별,이길수,김수영,송창화,박종호,조현구,조은경,김화중 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

        The natural resistance-associated macrophage protein 1(Nramp1) has been proposed to directly regulate bactericidal or bacteriostatic activity of the macrophage toward pathogens or participate in macrophage activation that lead to microbial elimination in the host. The relationship between Nramp1 and nitric oxide(NO) as an antimicrobial factor has not been precisely defined to date. To devise an in vitro assay for Nramp1 function, this study introduced a wild type Nramp1^(G169) cDKA transfected RAW264.7 macrophages(A8) which bear a homozygous mutant Nramp1^(D169) allele and are permissive to replication of specific intracellular parasites. RAW264.7 and A8 macrophages did not produce NO, but vitamin D_(3)-activated-Mycobacterium marinum-infected RAW264.7 and A8 macrophages pretreated with vitamin D_(3) leaded to the increase of NO production and growth inhibition of M. marinum. Inhibition of NO production by a NO inhibitor, L-NAME, abolished the above effects. The mRNA expression of iNOS in infected macrophages with costimulated vitamin D_(3) was increased. IFN-γ activated macrophages also showed the same results with vitamin D_(3) activated macrophages. These results suggest that bactericidal or bacteriostatic activity in RAW264.7 and A8 macrophages correlated with the production of NO, although NO might not be the only factor responsible for controlling M. marinum infection. The Nrampl gene is considered to be a cofactor in the controlling the replication of M. marinum infection.

      • 동일한 국제예후지표(International Prognostic Index)를 나타내는 미만성 대형 B-세포 림프종에서 Bcl-2와 p16의 임상적 중요성

        박상은,박수진,곽승근,박남숙,천재민,윤환중,조덕연,김삼용,김진만 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

        In Korea, malignant lymphoma is a common cancer, comprising about 2.7% of all malignant neoplasm. Diffuse large B cell lymphoma is the most common lymphoma, representing about 50% of all Non-Hodgkin's lymphoma. Diffuse large B-cell lymphoma is usually considered as heterogeneous group of neoplasms rather than a single clinicopathological entity. Clinical prognostic systems, including the International Prognostic Index (IPI), although useful to assess overall prognosis, embrace patients with heterogeneous prognoses. But International Prognostic Index scoring system is not sufficiently predict the prognosis. It is likely that the prognostic assessment of patients with diffuse large B-cell lymphomamight be improved by using biological features. Bcl-2 protein and p16 protein expression is recognized as useful biologic markers predicting the prognosis of patients with diffuse large B-cell lymphoma. To determine the clinical significance and prognostic value of bcl-2 and p16 proteins expression patterns, we studied 18 patients with de novo DLBL, whose archival pathology specimen were available for immunohistochemistry studies, atChungnam National University Hospital from September 1992 to December 2000. Archival specimens from each patient were immunostained with respective antibodies for bcl-2, p16. The results are as follows; 1) The median age was 54(rage : 37-69). There were 12 male patients(66.7%) and 6 female patients(33.3%) The 'B' symptom was abscentin all patients. The stages were as follows : Ⅰ, 2 patient(11.1%), Ⅱ, 10 patient(55.6%), Ⅲ, 4patient(22.2%) and Ⅳ, 2patient(11.1%). 3 patients(16.8%) had the elevated LDH level, 14 patients(77.8%) had the normal LDH level and 1 patients(5.6%) was not identified the LDH level. 2 patients(11.1%) had the bulky disease and 16 patients(88.7%) had no bulky diease. The distribution of ECOG status were O, 2 patients(11.1%c), 1, 14patients(77.8%) and 2, 2patients(11.1%). 2) Theimmunohistochemistry results are as follows bcl-2:+,10 patients(55.6%), bcl-2:-, 8patinets(44.4%), p16:+,3 patients(16.7%), p16:-, 15patients(83.3%) 3) After a median follow UP durations of 67 months, the median survival time was 57 months with a rage of 7-100+ months. 5-years overall survival rates was 44% by Kaplan-Meier method. 4) Reduced overall survival was demonstrated in the patients who expressed bcl-2 protein(P=0.0174). 5-year overall survivial rate was 12%(bcl-2 expression) versus 88%(no bcl-2 expression) 5) Among diffuse large B-cell lymphoma patients with IPI score 0-1, reduced overall survival was demonstrated with bcl-2 expression(P=0.023). 5-year overall survival rate was 18%(bcl-2 expression group) versus 100%(no bcl-2 expressiongroup) 6) Median survival durtation of diffuse large B-cell lymphoma patients negative for p16 expression was 57 months whereas p16 postive patients' median survival duration was not reached(P=0.4478). In diffuse large B-cell lymphoma patients with identical IPI scores, bcl-2 expression had additional prognostic value.

      • 중증 재생불량성 빈혈 환자에서 신우신염에 대한 광범위항생제치료 중에 속발한 Saccharomyces cerevisiae 진균감염 1예

        김철희,이정호,이정찬,강정현,곽상혁,배광봉,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

        Most patients with aplastic anemia who do not respond to immunosuppressive treatment or are not candidates for bone marrow transplantation die of infection or bleeding. The neutropenia in acute leukemia, aplastic anemia, or occurring subsequently to chemotherapy and bone marrow transplantation increases susceptibility to infection. In general, the number of infectious episodes correlate with the degree and duration of neutropenia. Global immunosuppression produced by conditioning for bone marrow transplantation or graft-versus-host disease, is associated with unusual bacterial and fungal pathogens, or serious viral and protozoan infections. In addition, repeated treatment with broad-spectrum antibiotics is associated with the emergence of resistant organisms and fungal diseases because of the altered microbial microenvironment of the host. The incidence of invasive fungal infection caused by Saccharomycetes eerevisiae in immunosuppressed patients is very rare, compared with that of infection by candida or aspcrgillus species. Cases of Saccharomycetes cerevisiae fungemia occurring in the course of treatment with broad-spectrum antibiotics are reported in patients with extensive burn or with prosthetic valve endocarditis. We experienced a case of urinary tract infection by Saccharomycetes cerevisiae in a 27-year old female patient with severe aplastic anemia. We report the case with a review of relevant literatures.

      • Azathioprine에 반응을 보인 류마티양 관절염에 의한 경막염(Pachymeningitis)1예

        배광봉,이정호,이정찬,곽상혁,강정현,김철희,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

        Rheumatoid arthritis frequently involves the cervical spine and may lead to neurologic impairement. However, direct involvement of CNS structures by inflammatory cells has been reported infrequently. The prevalence of this complication of rheumatoid arthritis is unknown. Inflammatory CNS involvement in rheumatoid arthritis reportedly occurs in the setting of longstanding, active, erosive articular disease and is accompanied by extracranial and extraspinal nodules and vasculitis. This is diagnosed by radiologic finding of CNS nodules or meningeal thickening and by biopsy or autopsy. Treatment with corticosteroid, cytotoxic agent or surgical decompression is helpful. But the majority of patients die within several months of onset of neurologic symptom. Recently, we experienced a case of pachymeningitis caused by rheumatoid arthritis, which resolved repeatedly with azathioprine treatment.

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