체간안정화 훈련이 만성 뇌졸중 환자의 호흡기능에 미치는 효과

이경진(Kyeong-Jin Lee),정주현(Ju-Hyeoun Jeong),조명래(Myeong-Rae Jo),김세윤(Se-Yoon Kim),김난수(Nan-Soo Kim) 대한심장호흡물리치료학회 2019 대한심장호흡물리치료학회지 Vol.7 No.1

Purpose : The purpose of this study is to examine the effects of trunk stability training on improving trunk control, respiratory function, and respiratory muscle activation in stroke patients. Methods : The subjects were assigned to two groups: the intervention group (n=15) and the control group (n=15). Both groups participated in a conventional stroke rehabilitation program, but the intervention group also received trunk stability training for 30 minutes a day, 3 times a week, for 6 weeks. The main trunk stability exercise consisted of the dead bug exercise. Trunk control was assessed using a trunk impairment scale, and respiratory function (pulmonary function and respiratory muscle function) was assessed using spirometry. The data were analyzed using the Pearson correlation, independent t-test, and paired t-test. Results : Trunk control was significantly positively correlated with pulmonary function and respiratory muscle strength. Both groups showed a significant increase in trunk control and respiratory function. Conclusion : This study demonstrated that a conventional stroke rehabilitation program and trunk stability training have positive effects on respiratory function and respiratory muscle activation in stroke patients.

외과적 노출술을 이용한 매복된 하악 제 1 대구치의 자발적 맹출 유도

김은정,김난진,조호진,김현정,김영진,남순현 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.4

하악 제 1대구치 매복의 발생 빈도는 전체 인구의 0.01%로 드물게 나타난다. 매복의 원인으로는 맹출 공간의 부족, 과잉치, 치성 종양이나 낭과 같은 맹출로상의 장애물, 유전적 요인, 내분비 질환, 외상 등이 있다. 하악 제 1대구치의 매복으로 인해 하안면 고경의 감소, 낭의 형성, 치관 주위염, 인접치의 치근 흡수, 부정 교합 등의 부작용이 생길 수 있으며, 치료 방법으로는 외과적 노출술, 교정적 견인, 외과적 재위치술, 발거 등이 있다. 다음의 두 증례는 하악 제 1대구치의 미맹출을 주소로 내원한 환아에게 외과적 노출술을 시행하여 원심 경사 매복된 하악 제 1대구치의 자발적 맹출을 유도한 증례들이다. Impaction of mandibular first molar is relatively rare and its overall frequency has been reported to be 0.01%. The etiology of impaction are lack of eruption space, physical obstacles such as supernumerary teeth, odontomas or odontogenic tumors, hereditary factors, functional disturbances of endocrine glands and traumas. Impaction of mandibular first molar can result in a short lower facial height, formation of a follicular cyst, pericoronal inflammation, resorption of the roots of neighboring teeth and malocclusion. The treatment options available for impacted teeth include surgical exposure, orthodontic forced eruption, surgical repositioning and surgical removal of unerupted molar. This report presents two cases of distally tilted and impacted mandibular first molars which were treated by surgical exposure. In these cases, we could observe spontaneous eruption of the impacted mandibular first molars after surgical exposure.

만성관절염과 루푸스의 피로, 통증, 및 통증효능감에 관한 연구

임난영,이은영,양용숙,정순애,차경옥,이여진 대한류마티스 건강전문학회 2000 근관절건강학회지 Vol.7 No.1

This study was designed to distinguish by the characteristic difference and the degree of symptoms such as fatigue, pain, coping to pain, and efficacy on pain, and to offer descriptive data for nursing intervention for improving coping ability to pain along each characteristics of disease in chronic arthritis and systemic lupus erythematosus. The subjects were 135 outpatients in the hospital for rheumatic disease in H-University, Seoul. The data were collected by structural questionnaire, from April 29 to June 29, 1999. The results were that the fatigue score was high in the OA patients while the RA patients and SLE patients experienced middle range of fatigue score, but which was not statistically different. Although the RA patients felt higher pain than other diseases, they have well coped with their pain than the others. In efficacy on pain the SLE patients had higher score than others but all of the disease showed lower score. No statistically significant difference among the three croup was recorded in efficacy on pain. Therefore, pain management in the RA patients was primary nursing intervention because they felt severe pain and have well coped with pain while they had lower pain efficacy score than the others. It is also important that fatigue management and coping strategies on pain for the OA patients and SLE patients are specially supportive in the nursing intervention.

자가 산부식 접착제를 이용한 치면열구전색의 미세누출 평가

김현진,이난영,이상호 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

자가 산부식 접착제는 산부식 과정 후 수세없이 와동을 충전할 수 있다. 움직임이 많고 행동 조절이 어려운 환자의 경우 시술의 절차를 줄일 수 있는 자가 산부식 접착제가 치면열구전색제의 사용을 보다 용이하게 할 수 있다. 그러나 법랑질에 대한 산부식 능력이 인산에 비해 낮아서 충분한 부식이 일어나는지에 대해 논란이 되고 있다. 이에 대해 자가 산부식 접착제의 약한 산부식능을 감안하여 열구성형술과 acidic primer의 도포 시간을 증가시키는 등의 임상 술식을 시행하고 자가 산부식 접착제의 단점이 보완되는지를 알아보고자 하였다. 35% 인산으로 산부식 후 전색술을 시행한 경우와 자가 산부식 접착제를 사용하여 도포한 경우의 미세 누출도를 염색액의 침투도를 비교하고 주사전자현미경을 이용한 산부식상 관찰을 통하여 다음과 같은 결론을 얻었다. 1. 열구 성형술을 시행 후 자가산부식접착제를 도포한 군은 인산 부식 20초를 시행한 군과 자가산부식접착제를 20초,40초 도포한 군보다 미세누출도가 더 낮았다. 2. 자가산부식접착제를 제조 회사의 지시에 따라 20초간 도포한 군과 40초로 늘려 도포한 군 간에 미세누출도의 유의 차가없었다. 3. 주사전자현미경 관찰 시 전형적인 산부식 양상은 인산부식 20초군에서만 관찰되었으며 열구성형술을 시행하고 자가산부식접착제를 도포한 군이 자가산부식접착제만 20,40초 도포한 군보다는 표면 거칠기가 증가하였다. The purpose of this study was to evaluate the effectiveness of fissurotomy and double application time of acidic primer of self-etching adhesive system of acid treatment on enamel surfaces for prevention of microleakage of pit and fissure sealants. The microleakage of pit and fissure sealants was evaluated by measuring the penetration depth of methylene blue solution. Specimens were divided by 4 groups according to the method of treatment. Group I: 35% phosphoric acid etching, 20 seconds. Group II: Priming with self-etching primer, 20 seconds. Group III: Priming with self-etching primer, 40 seconds. Group IV: Priming with self-etching primer, 20 seconds, after fissurotomy. The etched pattern produced on enamel was observed using a scanning electron microscope. Obtained data were analysed statistically using Kruscal-Wallis test followed by Mann-Whitney test for comparison ofgroups. The results are as follows: 1. Microleakage scores of group IV priming with self-etching primer 20 seconds after fissurotomy was the lowest. 2. Microleakage scores between group II and group III were not shown significant difference. 3. Enamel for 20 seconds etching with 35% phosphoric acid was observed the most effective etching pattern. And the etching pattern on the fissure enamel with self-etching adhesive 20 seconds after fissurotomy was more prominent than group II, III only using self-etching primer.

Lipopolysaccharide 로 유발된 생쥐 무릎관절낭 염증에 관한 형태학적 연구 : 윤활관절막과 섬유관절막의 변화를 중심으로 Based on the Morphological Changes of Synovial Membrane and Fibrous Membrane

김진택,안상현,최난희,정재만,박인식,강윤호,김호현,이해풍 동국대학교 한의학연구소 1999 東國韓醫學硏究所論文集 Vol.7 No.2

본 연구는 관절염 유발시 일어나는 관절낭의 형태학적 변화를 조사하기위해 ljpopolysaccharide(LPS)주사로 인위적 관절낭 염증을 유발시킨 후 시간경과에 따른 윤활관절막과 섬유관절막의 형태 변화를 관찰하였다. BALB/C 암컷 생쥐 오른쪽 무릎관절낭에 LPS 300㎍/㎏를 주사한 후 3, 7 그리고 14일에 무릎관절을 얻었다. 무릎관절은 4주동안 EDTA용액에 탈회한 후 통상적 방법으로 paraffin에 포매하였다. 또한 윤활관절막의 미세구조변화는 embed812로 포매한 후 관찰하였다. LPS 주사후 관절연골 인접부위의 윤활관절막에서 시작된 세포과형성(hyperplasia)은 시간 경과후 전체 윤활관절막으로 확대되었다. 윤활관절막내의 미세구조의 변화로는 윤활포식세포(type 1)가 관절강내로의 많은 돌기(filopodia)를 내었고, 잘 발달된 과립형질내세망을 가지는 type 2 윤활분비세포의 숫적 증가가 보였다. 한편 LPS 주사후 섬유관절막에서 나타나는 형태학적 변화는 collagen fiber 생성에 의한 섬유화가 증가되며, 이러한 섬유화를 주도하는 섬유모세포의 이주증가파 관찰되었다. 또한 혈관 주위에서는 백혈구의 이주 증가가 나타났으며, 탈과립형(degranulated type) 비만세포가 많이 관찰되었다. 이상의 결과로 LPS 주사로 관절낭에서 염증이 유발되어 윤활관전막과 섬유관절막에서 형태학적 변화가 나타났다. 이러한 일련의 형태학적 변화는 발병초기 류마티스성 관절염에서 나타나는 병리학적 소건과 동일한 결과로서, 앞으로 진행될 치료제 개발과 유발기전에 관한 해석을 위한 in vivo 실험의 적절한 모델로 기여한 것으로 기대된다. Synovial joint of BALB/C mice were injeced with Lipopolysaccharide(LPS) were observed to investigate the morphological changes of synovial capsule caused by rheumatoid arthritis(RA). The RA on female Balb/c mice were induced by LPS injection, as dose of 300㎍/㎏, into synovial cavity of knee joint. And then these specimen were fixed in 10% neutral buffered formalin and were decalcificated in EDTA solution for 4 weeks. The hyperplasia of synovium were appeared in synovial membrane. The filopodia of phagocytic like synoviocyte(type Ⅰ synoviocyte) projected into synovial cavity and the number of fibroblast like synoviocyte(type Ⅱ synoviocyte) with well-developed endoplasmic reticulum were increased in synovium. In fibrous membrane, the fibrosis induced by synthesis of collagen fiber were enlarged to all fibrous membrane, and the number of fibroblast were increased. A great number of inflammation component cell as Iymphocyte and neutrophil leukocyte were infiltrated around capillary and the degranulate typed mast cell were increased. As results indicated that the hyperplasia of synovium induced by LPS, subsequently to cause the fibrosis, infiltration of imflammation component cell, and increase of degranulated type mast call as same as symptoms of RA.

Cyclosporin A 로 유도된 생쥐 림프절의 세포성 면역억제에 관한 면역조직화학적 연구 : T 림프구, IL-2 수용기 및 NK세포의 변화를 중심으로 Based on the change of T lymphocytes, Il-2 receptors, and NK cells

김진택,박인식,안상현,최난희,김동환 동국대학교 한의학연구소 1998 東國韓醫學硏究所論文集 Vol.6 No.2

본 실험은 cyclosporin A(CsA)에 의한 시간의 경과에 따른 림프절에서의 세포성 면역억제를 조사하기 위해서 시행된 것으로 BALB/C계 생쥐에 10일동안 CsA(45mg/kg/day) 투여 후 림프절에서의 T 림프구, IL-2 수용기 그리고 자연살해(NK)세포의 분포 변화를 관찰하였다. 대조군의 림프절에서는 L3T4(CD4)에 양성반응을 보이는 도움 T림프구, Ly2(CD8)에 양성반응을 보이는 세포독성 T 림프구 그리고 CD25R에 양성반응을 보이는 IL-2 수용기를 가진 세포는 곁피질(paracortex)과 수질동(medullary sinus)에서 분포하였다. CsA투여 후 처음 3일까지는 이들 양성반웅세포의 분포 변화는 없었으며 양성반응성의 변화도 없었다. 그러나 CsA 투여 7일부터 양성반응 세포수의 감소와 양성반응성의 약화가 관찰되기 시작하였으며 이러한 변화는 시간이 경과하여 14일에 이르렀을 때 가장 큰 감소추세로 나타났다. 한편 NKl.1(CD56)에 양성반응을 보이는 자연살해세포는 피질과 수질에 분포하였으며 CsA 투여 후 시간의 경과에 따라 양성반응 세포수가 감소하였으며, 이러한 감소는 14일에서 가장 큰 것으로 나타났다. 이상의 결과로 미루어보아 CsA 투여는 림프절에서의 IL-2 분비저해를 통해 T 림프구와 NK세포의 활성을 차단하여 선택적이면서 효과적인 세포성 면역억제작용을 하고 있는 것으로 사료된다. Cyclosporin A(CsA) is a selective immunosuppressive agent that has been credited with improved survival of solid organ allografts. Lymph node of BALB/C mouse administered CsA immunohistochemically observed to understand immunosuppressive effects of CsA on T lymphocytes, IL-2 receptors, and natural killer NK cells in lymph node. CsA orally administered daily for 10days at the dose 4smg/kg/day/. The lymph node were obtained at day 3, 7, and 14 after CsA administration and embeded with paraffin, and then stained by following ABC method that used monoclonal antibody including L3T4(CD4), Ly2(CD8), IL-2R(CD25), and NK-1.1(CD56). There were little changes of reactive degree and number of helper T lymphocytes, cytotoxic T lymphocytes, IL.-2 receptors, and NK cells at day 3 after CsA administration, but they began to decrease at day 7. These decrease were greatest at day 14. The helper T lymphocytes, cytotoxic T lymphocytes, IL-2 receptors, and NK cells distributed in paracortex and medullary sinus. These results indicated that the secretion of IL-2 began to decrease at day 7 after CsA administration and subsequently to suppress T lymphocytes and NK cell as components of cell-mediated immunity.

어린이집 교사의 우울과 스트레스 대처방식이 자아존중감에 미치는 영향

김난실,이진화 이화여자대학교 교육과학연구소 2016 교육과학연구 Vol.47 No.2

This study sought to investigate relationships between childcare-teachers’ degree of depression, coping strategies, and their self-esteem to provide them with support in early childhood educational settings. For this study, 207 childcare-teachers completed self-reported questionnaires. To analyze the data, mean, standard variation, Pearson’s correlation, and multiple-regression were used. The results are as follows. First, the degree of depression of teachers was relatively higher for younger teachers and among public childcare center teachers than others. Second, the degree of depression of teachers was a significant variable to predict their coping strategies, particularly wishful thinking and emotion-focused coping strategies. Lastly, the degree of depression of teachers and their coping strategies had a relatively higher effect on teachers’ self-esteem. Based on the above results, some implications were discussed including the development of preventive programs for teachers’ depression.

흡연 청소년여학생의 영양소 섭취량과 칼슘배설량, 활동량 및 혈청25-(OH)비타민D와의 관련성

윤진숙,이난조 계명대학교 생활과학연구소 2000 科學論集 Vol.26 No.-

This study investigated the interactions of bone status with smoking in 72 high school attending students. Study subjects consisted with smoking(n=23) and nonsmoking(n=49) group. Dietary nutrients intake were estimated by 24-hr recall method. Daily activity of each subject was estimated by an activity questionnaire. Urinary calcium and creatinine excretion were assayed from subjects' 24 hour urine, while serum 25-(OH)-vitamin D[25-(OH) Vit D] and osteocalcin were measured from subjects' blood. The results of this study were as follows : 1.Average energy intake for smokers was slightly higher than that for nonsmokers. However, calcium and vitamin C intake for smokers were lower than for nonsmokers. 2.There was no significant difference of dietary calcium intake and urinary calcium/creatinine ratio between smokers and nonsmokers. 3. There was no signifcant difference in serum 25-(OH) Vit D3 level observed between two groups. 4.Serum osteocalcin was not significantly different between smokers and nonsmokers. 5.Bone status of study subjects belonged to normal according to urinary calcium/creatinine ratio, serum 25-(OH) Vit D concentration, and serum osteocalcin concentration. 8.Stepwise multiple regression analysis indicated that bone status of subjects were mainly influenced by calcium intake, fiber intake and smoking. KEY WORDS : bone status · urinary calcium/creatinine ratio · serum osteocalcin. serum 25-(OH) Vit D · nutrient intake · smoking.

치면열구전색제의 도포 시 전색제에 따른 기포 발생 양태

김현진,이난영,이상호 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.1

치면열구전색제의 도포 시 발생하는 기포는 전색제의 두께 감소에 의한 강도의 저하로 파절 및 마모를 일으킬 수 있으며 특히 계면부에 발생한 경우 미세 누출 등의 임상적인 문제점을 가져온다. 본 조사에서는 치면열구전색제 중 Teethmate F-1^(®)(Kuraray, Japan), Ultraseal XTplus^(®) (Ultradent, USA), Clinplo^(®)(3M-ESPE, USA), Helioseal^(®)(Ivoclar-Vivadent, Liechtenstein)의 기포 발생 양태를 알아보고자 하였다. 자연치 교합면의 열구를 모방한 표준화된 시편을 제작하고 치면열구전색제를 각 군별 20개의 시편에 전색하고 광중합 시킨 후 열구 중앙을 절단하여 stereoscope(Olympus SZ61, Japan)으로 확대하여 관찰하였고 컴퓨터 영상분석 프로그램(Image Pro plus, Express, Mediacybermetics Co., U.S.A)을 통하여 기포의 발생 양태를 관찰하여 다음과 같은 결론을 얻었다. 1. 기포의 발생 빈도는 Ultraseal XT^(®) plus에서 사용 시간과 관계없이 Helioseal^(®)에 Clinprotip과 metal canula tip을 적용한 경우보다 더 높게 나타났다(p <0.05). 2. 기포의 단면적 당 개수는 Ultraseal XT^(®) plus old가 Clinpro^(®), TeethmateF-1^(®) Helioseal^(®)에 brush tip을 적용한 경우보다 많이 발생하였다(p<0.05). 3. 기포의 평균 단면적은 Teethmate F-1^(®)가 다른 군에 비해 큰 값을 보였다(p<0.05). 4. Clinpro^(®)와 적용 tip을 달리한 Helioseal^(®)의 경우 기포의 발생 빈도, 평균 개수, 평균 단면적 모두 유의차를 보이지 않았다(P>0.05). In clinical practice, air bubbles trapped in the pit and fissure may increase early loss of sealing materials for fracture, wear and microleakage. The purpose of this investigation was to examine the bubble behavior of pit and fissure sealant. The 140 replicas made of epoxy resin were used to this experiment. Following conditioning, light-polymerized sealants were applied and then exposed to the light source. After stereoscopic examination of standarized specimen by grinding, bubble behavior was analysed. The results obtained were as follows: 1. Ultraseal XT^(®) plus grops irrespective of using time were higher than groups of Helioseal^(®) with clinpro tip and metal tip in the frequency of bubble(p <0.05). 2. Ultraseal XT^(®) plus old group was more than Clinpro^(®), Teethmate F-1^(®) and Helioseal^(®) with brush tip in the number of bubble under 200 magnified cross section(p <0.05). 3. The widest mean area of bubble was shown in the Teethmate F-1^(®). 4. No statistically significant difference of the frequency and the site of bubble between Clinpro^(®) and Helioseal^(®) groups(p >0.05).

Smad에 의한 alkaline phosphatase 유전자의 발현 조절기전

김난진,류현모,김현정,김영진,남순현 대한소아치과학회 2001 大韓小兒齒科學會誌 Vol.28 No.2

본 실험은 탁월한 골유도능으로 관심의 대상이 되고 있는 RMP의 세포내 신호 전달자로 알려진 Smad 1과 Smad 5가 조 골세포 초기 분화표지인자인 ALP 유전자의 발현에 미치는 영향 및 그 조절기전을 알아보고자 하였다. BMP 처리 없이도 Smad에 의해 ALP가 발현되는가를 알아보기 위해 Smad 1과 Smad 5가 각각 stably transfection된 C2C12 세포를 3일간 배양후 histochemical assay를 하였고, Smad 1과 Smad 5의 expression vector와 ALP promoter vector를 transient co-transfectiongksgn ALP promoter activity를 측정하였다. Smad에 의한 BMP의 효과를 알아보기 위해서 100ng/ml의 BMP-2를 처리한 군과 처리하지 않은 군으로 나누어 세포를 배양한후 ALP 유전자의 발현을 northern blot analysis로 확인하였다. Smad가 ALP 유전자의 발현을 직접적으로 조절하는가를 알아보기 위여서는 단백질 합성억제제인 cycloheximide를 전처리하여 ALP 유전자의 발현을 northern blot analysis하였다. 이상의 실험결과 다음과 같은 결론을 얻었다. ·Smad 1과 Smad 5가 과발현된 세포에서는 BMP 처리없이도 ALP가 발현된다. ·Smad 1과 Smad 5가 과발현된 세포에서 RMP 처리후 ALP 발현 증가율이 대조군 보다 현저히 높게 나타나 Smad가 BMP 효과를 증가시킨다는 것을 알수있다. ·Smad는 새로운 단백질의 합성을 통해 ALP 유전자를 발현시킨다. Bone morphogenetic proteins(BMPs), members of the transforming growth factor β(TGF-β) superfamily were first identified as the factors that induce ectopic bone formation in vivo, when implanted into muscular tissue. Especially BMP-2 inhibits terminal differentiation of C2C12 myoblasts and converts them into osteoblast lineage cells. In the molecular mechanism of the signal transduction of TGF-β and related factors, intracellular signaling proteins were identified as Smad. In previous study, it has been reported that Smad 1 and Smad 5, which belong to the R-Smad family mediate BMP signaling, were involved in the induction of osteoblast differentiation in C2C12 cells. To understnad the role of Smads involved in osteogenic transdifferentiation in C2C12 cell, in present study, after we stably transfected C2C12 cells with each. Smad(Smad 1, Smad 5) expression vector, cultured for 3 days and stained for alkaline phophatase activity. ALP activity positive cells appeared in the Smad 1, Smad 5 stably transfected cell even in the abscence of BMP. After transiently co-transfected C2C12 cells with each Smad expression vector and ALP promoter, it was excence of MBP. These result suggested that both Smad 1 and Smad 5 were involved in the intracellular BMP signals which induce osteoblast differentiation in C2C12 cells. The effect of BMP on C2C12 cells with Smad 1, Smad 5 transfected were studied by using northern blot analysis. the treatment of BMP upregulated ALP mRNA level in three groups, especially upregulation of ALP was larger in Smad 1, Smad 5 transfected cell than control group. Pretreatment with cycloheximide(10㎍/ml), a protein synthesis inhibitor resulted in blocking the ALP gene expression even in BMP(100ng/ml) treated cell. These results suggested that Smad increased the level of ALP mRNA via the synthesis of a certain transcriptional regulatory protein.