한국인에서 일광 노출의 유해성에 대한 인지도와 일광 차단제의 이용 행태에 대한 연구

김상태,김기호,오선진,이승철,강세훈,윤재일,김진준,박석범,김홍용 대한피부과학회 1999 大韓皮膚科學會誌 Vol.37 No.6

Background: Although deleterious effects of sunlight have been increased recently, the surveillance of the attitudes toward sun-exposure and the behavioral aspect of using sunscreens in Koreans has hot been carried out. Objective: Our purpose was to evaluate the attitude toward the harmfulness of sun-exposure and behaviors of using sunscreens in Korea. Method: Five hundred and fifty-two subjects were surveyed to assess the attitude toward sun-exposure, as well as the subjects knowledge about, and the use of sunscreens. Underlying data including demographic data, skin colors, skin types, occupation, and sun-exposure, were obtained. Results: Fifty-four percent of subjects believed that sun-exposure is bad for their skins, but, on the contrary, 12.5% believed it to be beneficial. Fifty-two percent of subjects used sunscreens. Almost all subjects(93.8%) knew why to use sunscreens but 62.7% of subjects did not know the meaning of sun protective factors(SPF). Women, indoor workers, subjects less than 40 years old, with less sun-exposed, fair colored skin, or with skin type I, II, III tended to know the deleterious effects of sunlight and the meaning of SPF and used more sunscreen. Conclusion: High risk population-men, outdoor workers, subjects oider than 40 years old, with more sun-exposed, dark colored skin, or skin type VI, V could be targeted with campaigns that promote attitudinal and behavioral changes.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Application of Antioxidant Transgenic Mice

Sun?Uk Kim,Hee-Young Yang,Sun-Hee Ahn,Suhee Kim,Dae?Yeul Yu,Dong?Seok Lee,Tae-Hoon Lee 한국실험동물학회 2014 한국실험동물학회 학술발표대회 논문집 Vol.2014 No.8

김치유래 젖산균의 균체지방산 분석을 이용한 분류학적 연구

이정숙,정민철,김우식,이근철,김홍중,박찬선,이헌주,주윤정,이근종,안종석,박완,박용하,민태익 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.2

표준균주를 포함한 230여개의 김치유래 젖산균에 대한 균체지방산(FAMEs)을 분석하였다. FAMEs profiles는 Euclidian Distance 17.5에 의해 7개의 Major Cluster와 1개의 Single Cluster로 나뉘어졌다. 이중 A, B, C 및 Cluster는 Leuconostoc속으로 분석되어졌고, F는 Lactobacillus속으로 분석되어졌다. 그리고 E와 G cluster는 두개의 Genus가 혼재되어 나타났으며 보충적인 연구가 필요하다. 앞으로 김치유래 젖산균의 균체지방산 분석결과를 기반으로 한 데이타베이스에 95가지 탄소원을 이용하는 수치분류학적 접근방법 및 Pyrolysis Mass Spectrometry 등의 화학적 분석 방법과 분자친화적 연구를 통한 종합적 분류정보 체계가 갖추어지면 젖산균의 신속, 정확한 동정 및 연구에 활발히 이용되어질 것이다. Two hundreds and thirty lactic acid bacteria, mostly isolated from Kimchi, including type strains were sued for analysis of cellular fatty acids. The 230 test strains were recoverd in 7 major and 1 single clusters defined a Euclidian distance of 17.5. These aggregate taxa were equivalent to the genus Leuconostoc (aggregate group A, B, C and D), and the genera Leuconostoc and Lactobacillus (aggregate group G). It is concluded as evident that FAMEs (Fatty Acid Methyl Esters) profile of cell can be used as a criterion in classification of lactic acid bacterial from kimchi. Additional comparative taxonomic studies need to be carried out on well chosen representative strains to determine the most appropriate methods of value.

급성백혈병의 화학요법에서 조혈간세포 보충요법

이규보,배선근,손상균,이재태,이건수,이경혜,서장수 경북대학교 병원 1997 경북대학교병원의학연구소논문집 Vol.1 No.1

1. 목적 급성백혈병의 화학요법에 있어서 관해유도 요법시에 보다 더 강력한 항암화학요법을 시행하고 골수억제의 회복을 위하여 말초혈액에서 채취한 조혈모세포의 투여로 그 효과를 증대시키고자 시도하였다. 2. 방법 관해유도 화학요법후에 골수억제시기로부터 회복단계로서 백혈구감소증이 호전도면서 단핵세포가 증가될 때에 말초혈액에서 조혈간세포(stem cell)로 인정되고 있는 CD34+세포의 함유량이 1% 이상되는 시기를 찾아내고 그 때부터 평균 4차례의 단핵구를 분리채집을 하여 -74。C에 냉동보관하였다가 제2차 화학요법후에 해동시켜서 정맥주입하였다. 3. 결과 대상 급성백혈병환자는 6명에 23회의 조혈간세포를 함유한 단핵구 채집을 시행하였고 유효한 단핵구의 채집은 4례에서 가능하였고 2례에서는 유효한 채집이 못되었다. 채집효율은 39.0-74.5%로서 평균 49.8%였다. 채집 후에 혈액학적 변화는 혈색소의 약간 감소 (평균 1.34g/dl)와 혈소판의 감소 (평균20.25%)를 나타내었다. 해동 단핵구를 투여할시에 일과성인 불쾌감, 기침, 흉부압박감, 호흡곤란 등이 있었다. 4. 결론 자가골수이식에서 자기말초혈액조혈간세포이식으로 관심이 이행되는 현시점에 자가조혈간세포를 채집하여 수혈하는 기술이 확립되는 기초를 이루었다고 본다. 이번 대상들은 재발된 금성백혈병들에 시행하였으나, 향후에는 초발시에 제일차 관해유도 화학요법 과정에 시도해야할 것으로 생각한다. Object: Peripheral blood stem cells(PBSC) were collected after remission induction chemotherapy and reinfused after intensified chemotherapy in order to increase the chemotherapeutic efficacy. Method: Collection of mononuclear cells (MNC) was started when CD34+ cells above 1% and WBC above 1,000/ul with mononuclear cell percentage above 30%, the collection procedures were done 2-6 time in each patient of total 6 cases. The collected MNCs were stored in - 750C and reinfused after thawing in the water bath at 370C Results: Twenty three collection procedures from the 6 cases of acute leukemia had made effective MNC collection in 4 cases and mean collection efficiency was 49.8%(from 39.0% to 74.5%). Hematological changes after the procedure were mean reduction of hemoglobin 1.34g/dl and mean 20.25% of decreased platelet count. There were noticed transient symptoms of discomfort, coughing, chest tightness and dyspnea in association with the infusion of stored cells. Conclusion: The basic process for the peripheral blood stem cell transplantation (PBSCT) was accomplished with this supportive care for the consolidation chemotherapy of acute leukemia. Effective PBSCT would be warrented with more qualified process and high does chemotherapy. (Korean J Blood Transfus 6(2) : 41~47,1995)

일 도농복합지역 저소득층 노인의 건강문제 분석 : 보건소 방문간호사업 대상자 중심으로

고일선,,이태화,이경자,이정렬,임미혜,천의영,주윤미,이계철 노인간호학회 2005 노인간호학회지 Vol.7 No.2

Purpose: The purpose of this study was to analyze the health problems of low-income aged with chronic illness living in urban-rural composite area. Method: The sample consisted of 440 aged who were receiving home care services from a public health center. MDS-HC was applied to analyze the health problems of the aged. Data were collected through a face- to-face interview by six trained interviewers from June 28 to July 15, 2004. Result: Subjects had average number of 8 health problems in both urban and rural area. Lack of preventive health care measure, pain, and visual function were the most frequent health problem. The rural aged had more pain, bowel management problems, compared to the urban aged having more urinary incontinence and indwelling catheter. There were many health problems related to falls and pressure ulcers with middle-old aged in urban, and old-old aged in rural area. Conclusion: The results of this study showed strategies for care intervention of low-income elderly to put in practice. Therefore, tailored-service for each subject should be provided.

BEZ235 (PIK3/mTOR inhibitor) Overcomes Pazopanib Resistance in Patient-Derived Refractory Soft Tissue Sarcoma Cells

Kim, Hee Kyung,Kim, Sun Young,Lee, Su Jin,Kang, Mihyeon,Kim, Seung Tae,Jang, Jiryeon,Rath, Oliver,Schueler, Julia,Lee, Dong Woo,Park, Woong Yang,Kim, Sung Joo,Park, Se Hoon,Lee, Jeeyun Neoplasia Press 2016 Translational oncology Vol.9 No.3

<P><I>BACKGROUND:</I> Although pazopanib treatment has become the standard chemotherapy in salvage setting for metastatic sarcoma patients, most patients progress after pazopanib treatment in 4 to 6 months. After failure to pazopanib, patients have limited options for treatment. Therefore, subsequent therapy in patients who failed to pazopanib is urgently needed and the use of patient derived cells or patient derived tumors for accompanying testing with various pharmacological inhibitors could offer additional treatment options for these patients. <I>METHODS:</I> Patient derived tumor cells were collected from ascites at the time of progression to pazopanib and a 13-drug panel was tested for drug sensitivity. We confirmed the results using <I>in vitro</I> cell viability assay and immunoblot assay. We also performed the genomic profiling of PDX model. <I>RESULTS:</I> The growth of patient derived tumor cells was significantly reduced by exposure to 1.0 μM AZD2014 compared with control (control versus AZD2014, mean growth = 100.0% vs 16.04%, difference = 83.96%, 95% CI = 70.01% to 97.92%, <I>P</I> = .0435). Similarly, 1.0 μM BEZ235 profoundly inhibited tumor cell growth <I>in vitro</I> when compared to control (control versus BEZ235, mean growth = 100.0% vs 7.308%, difference = 92.69%, 95% CI = 78.87% to 106.5%, <I>P</I> < .0001). Despite the presence of CDK4 amplification in the patient-derived tumor cells, LEE011 did not considerably inhibit cell proliferation when compared with control (control vs LEE011, mean growth = 100.0% vs 80.23%, difference = 19.77%, 95% CI = 1.828% to 37.72%, <I>P</I> = .0377). The immunoblot analysis showed that BEZ235 treatment decreased pAKT, pmTOR and pERK whereas AZD2014 decreased only pmTOR. <I>CONCLUSION:</I> Taken together, upregulation of mTOR/AKT pathway in sarcoma patient derived cells was considerably inhibited by the treatment of AZD2014 and BEZ235 with downregulation of AKT pathway (greater extent for BEZ235). These molecules may be considered as treatment option in STS patient who have failed to pazopanib in the context of clinical trials.</P>

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

일 간호대학의 간호환경시스템 통합실습방안 적용 : 간호관리학과 지역사회간호학의 통합

김광숙,이경자,김의숙,이정렬,김인숙,이태화,조윤희,정제인,이현정,배선형,김은현 대한간호학회 간호행정학회 2008 간호행정학회지 Vol.14 No.1

Purpose: Integrated curriculum has been considered as a desirable method in health related school course. The present study was conducted to develop practice curriculum which integrates nursing management and community health nursing and measure the education effect. Method: Literature review and scores of professional meeting were carried out to generate main educational goals, contents, operating principle, and evaluation item. Student evaluation was done by survey and in-dept interview in right after practicum and three months respectively. Results: Six concepts were derived as main component of the integrated curriculum. From 2 to 3 sub-categories were matched to each main component as well. Subsequently, practice contents were suggested on the basis of sub-categories. Attainment of practicum goal scores ranged from 2.82 to 3.54 in four points index. Students expressed that they found nursing manager's role in the community setting. Conclusion: This new approach encouraged students to ascertain relationship between hospital oriented and community based practice. Additionally, they can be prepared to comprehend diverse health care environment.

급성 심근경색 : Gd-DTPA 조영증강 자기공명영상 Gd-DTPA Enhanced Magnetic Resonance Imaging

정경일,김제현,이창호,이영주,김한수,소동문,이영돈,박경주,왕희정,탁승제,이철주,김선용,김옥화,임태환,문창현,최병일,서정호 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

This study was undertaken to determine the value of gadolinium dimeglumine (Gd-DTPA) enhanced MRI in the diagnosis of acute myocardial infarction. Seven cats were subjected to 2 hours of left anterior descending coronary arteryocclusion (group 1) and 8 cats to 1 hour of occlusion (group 2). Reperfusion was followed by taking Tl-weighted MR images at 5, 15, 30, 45, 60 minutes after Gd-DTPA (0.2 mmol/kg) injection. Myocardial enhancement patterns were categorized into three zones (central ischemic, peripheral ischemic, and normal) or two zones (ischemic and normal) and the presence of injured myocardium in each zone was confirmed by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Signal intensity (SI) of each zone was evaluated relative to back muscle in regard to its chronological changes and difference among the zones. Group 1 displayed three zones of enhancement in 6 cats whereas 1 cat in group 1 and all in group 2 showed two zones of enhancement. Intermediate SI central zone was compatible but smaller than TTC nonstained area, and determined to be a persistently occlusive injury. High SI peripheral zone in group 1 and high SI ischemic zone in group 2 were stained and determined as reperfused injury although reversibility was not definite. The peak SI, occurring 15 minutes after Gd-DTPA injection, of 2.47±0.48 at peripheral zone was greater than that of 1.66±0.36 at central zone in group 1 and of 1.81±0.41 at ischemic zone in group 2 (p < 0.05). SI of injured myocardium increased more rapidly and decreased more gradually than that of normal myocardium. That the features of SI change with time in injured myocardium was compatible with the results of other studies using different contrast agents. Gd-DTPA enhanced MRI differentiated persistently occlusive injury as central intermediate SI, and reperfused injury as homogenous high SI, with the maximal contrast between the two at 15 minutes after contrast injection, thus indicating the value of Gd-DTPA enhanced MRI in the diagnosis of acute myocardial infarction.