저체중 출생아에서 초음파를 이용한 두개강내 출혈의 진단과 추적

최진옥 전북대학교 대학원 2009 국내석사

목적: 신생아 뇌초음파가 환아의 생존율 추정과, 추적 검사를 통하여 신격학적 장해와의 관계를 추정하고 치료에 도움을 주고자 본 연구를 시작하였다. 대상과 방법: 최근 8 개월간 신생아 중환자실에 입원하였던 출생체중 2500gm 미만의 112 명을 대상으로 뇌초음파를 실시하였고, 이상소견이 없는 경우에는 검사를 중지하였고, 이상소견이 있는 경우에는 1 개월까지는 매주마다 그 후에는 1 개월 간격으로 추적검사를 실시하였다. 두개강내 출혈의 등급은 Grade I ~ IV 로 분류하였다. 출혈의 발생 위치를 좌/우/양측으로 구분하였고, 출생시 신생아의 체중을 나누어 각각의 발생빈도를 조사하였고, 재태연령에 따른 출혈의 발생빈도를 조사 하였다. 추적검사로 출혈의 변화를 관찰하여 신경학적 장해 발생과의 관계를 보고자 하였다. 결과: 54.5%인 61 예에서 두개강내 출혈이 있었고 Grade I 과 II 가 각각 25 예(41%), Grade III 5 예(8.1%), Grade IV 6 예(9.9%)였다. 발생부위는 양측인 경우가 45 예(74%), 우측과 좌측이 각각 8 예(13%)였다. 1000gm 이하 2 예에선 2 예(100%), 1001-1500gm 16/22 (72%), 1501-2000gm 18/35 (51%), 2001- 2500gm 25/53 (47%)에서 뇌출혈이 발생하였다. 25-28 주 6/7 (85.7%), 29-32 주 17/26 (65.4%), 33-36 주 30/52 (57.7%), 37 주 이상은 8/27 (29.6%)의 빈도를 보였다. 추적검사상 61 예 중 25 예에서 출혈이 완전히 흡수되었는데 모두 Grade I 과 II 였다(Fig. 2, 3). 재출혈은 5 예, 낭성변화는 24 예(Fig.4), 뇌실확장은 9 예, 뇌수종은 7 예(Fig.5)에서 발생하였다. 결론: 뇌 초음파를 이용한 두개강내 출혈의 진단과 정도의 관찰은 미숙아의 생존율을 예측하게 하고, 추적검사를 통해 향후 신경학적 장해를 추정할 수 있어 임상적 치료를 도울 수 있을 것이다. Purpose : GMH/IVH(Germinal matrix-Intraventricular hemorrhage) is an important factor that influences on the mortality rate of low-birth-weight infants. The real-time high resolution sonography with a mechanical sector scanner is a convenient and useful method for the detection and follow-up study of intracranial hemorrhage in low-birth-weight infants. Materials and Methods : The study was analyzed 112 cases of neurosonographic findings in low-birth-weight infants, weighing less than 2, 500gm. The stuey was evaluated the incidence, grade. hemorrhagic onset, overall mortality, and the fellow up neurosonographic findings. Results: The incidence of GMH/IVH was 54.5%. The severity of GMH/IVH was classified into 4 grades(I-IV) and their percentages were 41%, 41%, 8.1%, and 9.9%, respectively. The onset of GMH/IVH was within the first week after birth in 75.4% of cases. The overall mortality rate of low-birth-weight infants with GMH//IVH was 18%(4% for grade I, 12% for grade II, 40% for grade III, and 83% for grade IV). In the follow-up study of 61 cases, complete absorption was seen in 25 cases, rebleeding in 5 cases, cystic change in 24 cases, ventriculomegaly in 9 cases, and hydrocephalus in 7 cases. The incidence of GMH/IVH in neonates with pathologic lung conditions was 82.5% and that with normal lung conditions was 39%. Conclusion: sonography is very useful in the diagnosis and follow-up of GMH/IVH in low-birth-weight infants. The study is the first step in the further study of the relationship between GMH/IVH and neuromotor outcome.

폐석고를 혼입한 콘크리트의 특성에 관한 실험적 연구

최진옥 전북대학교 산업기술대학원 2006 국내석사

As amount of waste matter rapidly increases with fast growth of cities and industry, how to dispose them has arisen as an important problem. Current policy of the government on disposal of waste is repressing generation of waste itself and in case of already generated waste, resource cycle waste management system that recycles waste after proper environmental process is getting established. Therefore recycling of waste and industrial by-products is rising hugely. One of largely wasted matters is waste gypsum, which was categorized as designated waste but changed to general since 1994. Due to disposal cost and lack of impurities removal technology, recycling of it was quite low. However, as impurities removal technology using semi-dried desulfurization process is developed lately, study on recycling of waste gypsum is going on lively. This study examines possibility of utilizing waste gypsum as alternative for concrete cement and analyzed attributes of waste gypsum before and after ball mill process to find out proper alternation ratio, and conducted strength and property tests on concrete subject whose percentage of cement use is substituted with 0, 5.0, 7.5, 10.0 and 12.5% of waste gypsum.

1860年代의 民亂에 관한 硏究

최진옥 梨花女子大學校 大學院 1978 국내석사

장애유아 통합교육에 대한 유치원교사의 태도와 역할지각 및 그 상호관계

최진옥 대진대학교 2005 국내석사

결핵환자의 초치료 중단 위험 사정 도구개발

최진옥 경상대학교 대학원 2013 국내석사

Objective: This study identifies the reasons why tuberculosis (TB) patients discontinue treatment in a bid to develop a nursing assessment scale to select patients who needs nursing intervention in the early stage and decrease the risk of discontinuation of treatment. This methodological study grasps the TB patients’ experience of discontinuing primary treatment, and based on this, develops a nursing assessment scale for the risk of discontinuing primary treatment. Method: Among patients at a national tuberculosis specialist hospital in City C, Gyeongsangnam-do, the patients who have an experience of discontinuing primary treatment and have restarted the treatment and the patients who are currently receiving the primary treatment. The period of collecting the data was from August 1, 2012 to September 31, 2012. A semi-structured interviewing tool was developed for this study and an in-depth interview was given to the patients under retreatment to learn about their experience with discontinuation of primary treatment. For the in-depth interview, a qualitative analytical method was used to prepare questionnaire, and a total of 67 questions were selected as the final pre-scale after a group of experts confirmed the validity of their content. The questionnaire was given to 191 patients under primary treatment. Through the factor analysis, the construct validity was confirmed, and the concurrent validity was examined using the depression scale. The internal consistency reliability was examined, as well. Ultimately, 50 questions were finalized. Result: 1. The factor analysis on the assessment scale on the risk of discontinuing primary treatment for TB patients identified a total of 11 factors: Relational difficulties after having TB, loss of confidence, loss of importance of continuing the treatment, difficulty in overcoming side effects of medicines, failure of the treatment, inconvenience of using the medical facility, difficulty of self-care, embarrassment about the disease, decrease in the physical ability to continue treatment, negative perspective on TB, and psychological pressure from using medicines. The cumulative variance equaled to 69.4%. Considering the meaning of the 11 factors, they were categorized into 4 different subgroups: stigma about being a TB patient, loss of role as a TB patient, disability to continue treatment, and loss of willingness to continue treatment. 2. The concurrent validity test using the depression scale showed that the risk of discontinuing primary treatment and the level of depression had a positive relationship (r=.540). The higher the level of depression, the higher risk of discontinuing treatment. 3. The internal consistency reliability test showed that the reliability of the assessment scale for subgroups was over .80. The confidence coefficient, Cronbach's alpha, was .954. Conclusion: The assessment scale for the risk of treatment discontinuation for TB patients was confirmed to have a relatively high validity and reliability. The scale in this study will be used to examine the risk of treatment discontinuation for TB patients and to act as important basic resource for nursing intervention to support the patients to continue treatment until the end. Key words : TB Patients, Assessment Scale for the Risk, Treatment Discontin uation.

한국과 멕시코의 가족문화 비교 연구

최진옥 韓國外國語大學校 國際地域大學院 2010 국내석사

This study aims to increase comprehension of the mutual socio-culture between Korea and Mexico. Specifically, this thesis is based on the study of family culture because 'family' is considered as one of the standard units for analyzing a society. To approach the value and thoughts about ‘family’ in Korea and Mexico, literatures were thoroughly analyzed from a comparative viewpoint. A research survey also was carried out. The research is based on G. Hofstede’s cultural aspects concerning the 20s’ sense of value about ‘family’ in both countries. The results of literature review combined with the survey research are as follows: Firstly, according to G. Hofstede’s cultural dimension theory, generally speaking Korea and Mexico have similarities in the features of family culture. However, there is difference in the historical background of familism, the basic ideology of family. In Korea, familism was created as an ideology for national sovereignty, so it spread out top-down. On the other hand, it was naturally grown up as Mexicans struggling with Spanish conqueror and colonialization. Thus, the Mexican familism spread out bottom-up as a confrontation system. In the thesis, Section Ⅱ analyzes the previous research documents about family culture in Korea and Mexico by the comparative method. Secondly, when comparing Korean and Mexican family culture, Korean family tends to more vertical in relationship, whereas Mexican family tends to be more collective. Targeting the 20s of both countries, the survey research was performed. As a result, though the tendencies between two countries are different, it is still believed that the family relationship is important in both countries. However, the concept of ‘family’ was different in the two countries. While in Mexico the relatives belong to the family category, in Korea only direct line is regarded as family. In the thesis, Section Ⅲ deals with the details of the survey and discusses the outcome of the research.

칠레 한인의 ‘글로벌 세미노스’(Global semi-North) 정체성

최진옥 한국외국어대학교 국제지역대학원 2017 국내박사

‘Global semi-North’ Identity of Korean Immigrants in Chile This dissertation aims to critically research into the lives of Korean immigrants in Chile by focusing on their interactions with the Chilean society. Instead of perceiving them as simply an ethnic Korean migration to this country, this research specifically treats them as one of the international migration phenomena that need to be retold. So far the international migration has been perceived as a phenomenon driven by economic inequalities that brought about the so-called Global North and Global South dichotomies. However, in the changing international position and Korea’s economic status, Korea no longer fits into either dichotomy. Thus, this research proposes that Korea’s position should currently be regarded as in the Global semi-North category. By acknowledging this new position, Korean migration to Chile can be better understood as a phenomenon that occurred not simply due to their personal reasons, rather as a reflection of the changing international position. In order to comprehend how Korean immigrants as migrants, residents, and employers in Chile interact with other migrants and how such interaction works its way within Chilean society, this research carried out deep interviews and participant observations into the lives of twelve Korean immigrants in Chile. The research results suggest that first, Korean immigrants in Chile cannot mingle into Chilean society, but they are ‘adrift’ while maintaining their ‘present-time’ life as migrants. They decided to come to Chile not as permanent settlers, but regarded their migration experience as being temporary and instrumental for the next step. Hence, they are ‘actively adrift’ while not trying hard to adapt into Chilean society. They maintain the so-called ‘present-time’ life since they need to keep on negotiating their relation with Korea as their country of origin; with Korean society in Chile; and within Chilean Society as a whole. Second, as residents, Korean immigrants in Chile have a sense of national superiority of being Koreans despite their economic and social position limitation within Chilean society. Basically, Korean immigrants in Chile wished to migrate into the Global North countries in the first place. At the same time, Korea managed to upgrade its economic position in the international arena. This situation led them to denigrate Chile and started to reconsider their retirement as well as the future of their descendants. However, although they are superficially high class in term of consumption level, in fact they are economically unstable. Moreover, within the Chilean hierarchical structure, the social position of independent wholesale and retail business man is relatively low with little chance of change. Third, as employers, they can be considered as ‘new master’ with a sense of hierarchical superiority over migrant domestic workers by demonstrating the use of domination and obedience. At this point, Korean immigrants used two methods of treating domestic workers by ‘Distinction’. First, they criticized the latter’s ethics and demanded their obedience by inflicting their sense of inferiority in order to create a sense of hierarchy. The other one, they wanted to affirm a differing social stratum by demonstrating a special dispensation and treatment over the domestic workers by which they created a sense of good character image and dignity by themselves. In reality, however, Korean employers realized that their relationship with the domestic workers is nothing but ‘imperfect master’ and at the same time constructing a new habitus of ‘new master’. Through complex hierarchical relations as migrants, residents, and employers, the Korean immigrants are shaping their hierarchical identity as a group of people wishing to pursue the Global North with a sense of inferiority while at the same time being a group of people wishing to dominate the Global South with a sense of superiority. Especially, this kind of identity is strikingly visible among Korean immigrants residing in Chile reflected hierarchical characteristics of Chilean society. This identity is not the ‘result’ of their residing in Chile; rather, it is within the shaping ‘process’ that vibrates the relation between the Global South and the Global North where they live. For Korean immigrants in Chile, they are shaping an identity of ‘Global semi-North’.

중·소규모 사업장의 안전보건교육 실태 및 개선 방안에 관한 연구

최진옥 충주대학교 산업대학원 2010 국내석사

산업이 발달하고 안전보건에 관한 근로자의 의식이 점점 높아지고 있는 현실에서 안전보건교육은 재해예방의 가장 중요한 요소로 인식되고 있다. 국내 각종 크고 작은 사고에 대한 예방과 안전보건에 관한 근로자 의식수준 향상 차원에서 산업안전보건교육체제의 방향설정과 그에 따른 중장기 발전방안 수립은 매우 중요한 일이다. 그러나 국내제조업의 안전사고는 줄지 않고 지속적으로 증가하는데 비해 중·소규모 사업장의 안전관리는 열악한 작업환경과 저임금, 3D현상으로 인한 대체인력 부족현상으로 신규채용자와 외국인 근로자의 생산현장 투입으로 인한 미숙련공으로 새로운 환경의 부적응과 높은 작업강도로 인해 산업재해가 좀처럼 줄어들지 않고 있다. 이에 본 연구를 통하여 충북북부권 중·소규모 사업장에서 실시되고 있는 안전보건교육 실태와 문제점을 설문조사를 통해 분석해 보았으며, 그 결과 많은 사업장의 근로자들이 안전보건교육의 필요성을 느끼고는 있으나 제대로 안전보건교육이 실시되고 있지 않은 것으로 조사되었으며, 근로자 정기안전보건교육을 제외하고는 신규채용시교육과 특별안전보건교육, 작업내용변경시교육은 거의 실시되지 않고 있었으며, 실시되어도 형식적이고 일방적 주입식 교육으로 진행되고 있어 근로자의 적극적 참여를 유도하지 못하고 있는 것으로 조사되었다. 중·소규모 사업장의 안전보건교육의 문제점을 근로자의 안전의식 문제, 안전보건교육의 내용·방법 문제 그리고 법적·제도적 문제점으로 접근하여 원인을 분석한 결과 다음과 같은 개선방안을 도출하여 제시하였다. 첫째 - 노사의 의식개혁 이다. 둘째 - 강사의 강의능력 향상과 교육내용의 질적 향상이다. 셋째 - 산업안전보건법에 명시된 산업안전보건교육이 사업장에서 효과적이고 실질적인 교육이 될 수 있도록 지원 방안이 필요하다. 넷째 - 안전보건교육의 효과적이고 지속적인 교육이 될 수 있도록 관리감독 강화와 지도방안이 필요하다. As industries have developed and the workers' awareness on Safety and health has increased, safety health education has been recognized as the most important factor in the prevention of safety accidents. It is very important to set the system direction of industry safety health education and to establish the mid and long-term development plans in terms of the workers' consciousness raising. However, the safety accidents have not decreased, but have continuously increased in industries. Also, the safety accidents have not decreased because of inferior working conditions, low income and new employment of unskilled workers due to the lack of alternative human resources from 3D evasion or the foreign workers' maladjustment in new environment in the view of safety management. This study has researched the status of safety health education and the problems in small and medium sized enterprises in the north area of Chungcheongbukdo through the questionnaire. As a result, a lot of workers feel the necessity of safety education, but the genuine safety health education has not been performed. The improvement plans have been derived and suggested from the result of the analysis based on the problems of safety health education in terms of the workers' safety awareness, the content and method of safety health education and the legal and institutional problems. First - the awareness reformation of labor and management The active participation of labor and management is necessary so that the safety health education cannot be a cursory and result-centered education in that the safe behaviors come from the awareness and attitude. Second- the improvement of instructors' ability and the education contents The most important factors in safety health education are an instructor and education contents. The instructor should be an experienced manager in the field to perform field-based education featuring direct or indirect fields in harmful danger or professional education about the work. In addition, it is necessary for the government to publish and distribute the materials of safety health education to work places in cooperation with professional institutes by departmentalizing into accidents cases, industrial classification, process and unit works. Third - the support plan is necessary so that the safety and health education stated in Industrial Safety and Health Act can be effective and actual. First of all, the safety health education for new employees should be intensified. As a result of analysis on the status of industrial accidents based on "tenure", it should be reinforced considering that new employees account for 50.16% among industrial disaster victims. Also, the completion of all members accounts for only 22% considering the completion of manager and supervisor education. Therefore, the legal criteria about supervisors should be definite depending on the dangerous work or the number of workers. Fourth - it is necessary to intensify management and supervision and to make plans for instruction so that safety health education can be effective and consistent. Regaridng the work places where accidents appeared, especially serious ones, the legal and institutional plans are insisted;for instance, they should take the course of penal safety health education. Furthermore, the duty supervision should be necessary and the sanctions are essential such as imposing a fine for a default on not performing the safety health education to reform the reality that the safety and health education stated in Industrial Safety and Health Act has not been performed actually. Lastly, safety and health education must be the precondition of safety health activities and the factor for positive prevention in industrial disaster. Therefore, the active efforts of the government, an academic community, professional institutes and work places are necessary so that it can be realistic and field-based and take root in small and medium sized enterprises by operating the suggested reformation plans.

유아를 위한 움직임교육의 이론탐색 및 지도모형설계에 관한 일 연구

최진옥 이화여자대학교 교육대학원 1992 국내석사

Efficacy of recombinant adeno-associated virus 2/8-mediated gene transfer in fabry mice

최진옥 이화여자대학교 대학원 2010 국내박사

연구 배경: 파브리 질환은 라이소좀의 효소인 α-galactosidase A (α-Gal A)의 유전적인 결핍에 의해 내피세포들(endothelial cells)에 비정상적인Gb3(glycosphingolipids) 축적의 결과 신부전증과 심장과 뇌혈관 질환을 일어나게 한다. 연구 방법: 본 연구에서는 pseudotyped rAAV2/8 벡터에 α-Gal A cDNA (rAAV 2/8-hAGA) 인코딩하여 생성하였고, 18주 파브리 마우스의 꼬리 정맥을 통해 주입하였다. 유전자 치료의 효능을 확인하기 위해 치료 후 6주, 12주, 24주 실험하였다. 간, 비장, 신장, 심장, 뇌 조직에서 Gb3 level과 α-Gal A 효소의 활성을 측정하였다. 유전자 치료 마우스와 효소 치료 마우스의 expression level을 비교 실험 하였다. 간과 신장에서의α-Gal A 단백질 양을 측정하기 위해 Western blotting을 수행하였다. 신장에서의 α-Gal A 와 CD77/Gb3 단백질의 면역조직화학상을 관찰하기 위해 포르말린 고정과 파라핀 표본과 frozen section을 사용하여 실험을 하였다. 전자 현미경 실험은 파브리 마우스의 epon 표본 블록을 만들어 수행하였다. 연구 결과: 재조합 AAV 2/8-hAGA를 치료한 파브리 마우스는 간과 비장과 신장과 심장과 뇌와 같은 조직에서 Gb3의 축적이 감소하였으며, α-Gal A효소 활성도 측정에서도 증가함을 확인하였다. 효소 활성도는 60주까지 지속되었다. 더욱더 치료 후6주, 12주, 24주 에서는 Gb3 level 이 Control 파브리 마우스와 비교하였을 때 감소됨을 확인 하였다. Western blotting 분석으로 재조합 AAV 2/8-hAGA를 치료 후 6주, 12주, 24주에 α-Gal A 단백질의 expression을 확인 하였다. 신장의 근위혈관과 사구체에서 면역조직화학실험을 통하여 α-Gal A의 양상을 확인하였고 CD77/Gb3의 축적이 감소함을 확인 하였다. 유전자 치료는 신장의 혈관(proximal tubules)과 사구체내의 족세포(podocyte)에서 Gb3의 축적을 확실하게 감소시킨다. 또한 재조합AAV 2/8-mediated 유전자 치료는 간의 독성이 없음을 확인 하였다. 연구 결론: rAAV 2/8-hAGA-mediated α-Gal A의 유전자 치료는 파브리 마우스 모델의 치료 효과를 증명하였다. 더욱더 신장에서는 재조합 된AAV 2/8-hAGA-mediated 의 expression이 효소 치료보다 더욱더 효과적임을 보여주었다. 이 자료를 통하여 파브리 질환의 치료를 위한 마우스에서의 실험방법 효율성을 평가하는데 사용 할 수 있다. Background: In Fabry disease, genetic deficiency of lysosomal enzyme α-galactosidase A (α-Gal A) results in abnormal Gb3 (glycosphingolipids) accumulation in endothelial cells, which leads to renal failure, cardiac and cerebrovascular disease. Methods: In this study, a pseudotyped rAAV2/8 vector encoding α-Gal A cDNA (rAAV2/8-hAGA) was generated and injected into 18-week-old male Fabry mice through the tail vein. The efficacy of the gene therapy was characterized at 6, 12 and 24 weeks after treatment. Liver, spleen, kidney, heart, and brain tissues were examined for Gb3 levels and α-Gal A enzyme activity. Gene therapy mice expression levels were compared to ERT mice. The amount of α-Gal A protein in the liver and kidney were measured by Western blotting. The renal expression was immunohistochemically identified in formalin-fixed, paraffin-embedded, frozen sections using antibodies against the α-Gal A and CD77/Gb3 proteins. The electron microscopic study was performed on the epon-embedded block from Fabry mice. Results: Treatment of Fabry mice with rAAV 2/8-hAGA resulted in the clearance of accumulated Gb3 in tissues such as liver, spleen, kidney, heart, and brain with concomitant elevation of? α-Gal A enzyme activity. Enzyme activity was elevated for up to 60 weeks. In addition, Fabry mice at 6, 12 and 24 weeks after treatment exhibited decreased Gb3 levels compared with control Fabry mice. Expression of the α-Gal A protein was identified in the presence of rAAV 2/8-hAGA vector at 6, 12 and 24 weeks after treatment. Immunohistochemical study showed α-Gal A expression in proximal tubules and glomerulus and decreased CD77 (Gb3) deposition. The α-Gal A gene transfer significantly reduced the accumulation of Gb3 in tubules and podocytes of kidney. Conclusions: The rAAV 2/8-hAGA-mediated α-Gal A gene therapy provided improved efficiency in the Fabry mouse model compared to ERT. Resulted in furthermore, recombinant AAV2/8-hAGA-mediated expression showed greater effect in kidney than enzyme replacement therapy. The data were used to evaluate the effectiveness of this approach for curing mice with Fabry disease.