Early Bile Duct Cancer Detected by Direct Peroral Cholangioscopy with Narrow-Band Imaging after Bile Duct Stone Removal

김희경,문종호,최현종,김희경,민슬기,박종규,조영덕,박상흠,이문성 거트앤리버 소화기연관학회협의회 2011 Gut and Liver Vol.5 No.3

Cholangioscopy not only enables the direct visualization of the biliary tree, but also allows for forceps biopsy to diagnosis early cholangiocarcinoma. Recently, some reports have suggested the clinical usefulness of direct peroral cholangioscopy (POC) using an ultra-slim endoscope with a standard endoscopic unit by a single operator. Enhanced endoscopy, such as narrow band imaging (NBI), can be helpful for detecting early neoplasia in the gastrointestinal tract and is easily applicable during direct POC. A 63-year-old woman with acute cholangitis had persistent bile duct dilation on the left hepatic duct after common bile duct stone removal and clinical improvement. We performed direct POC with NBI using an ultra-slim upper endoscope to examine the strictured segment. NBI examination showed an irregular surface and polypoid structure with tumor vessels. Target biopsy under direct endoscopic visualization was performed, and adenocarcinoma was documented. The patient underwent an extended left hepatectomy, and the resected specimen showed early bile duct cancer confined to the ductal mucosa.

Effect of the amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics

김희경,김성훈,이재봉,한중석,여인성,하승룡 대한치과보철학회 2016 The Journal of Advanced Prosthodontics Vol.8 No.1

PURPOSE. This study investigated the effect of amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics. MATERIALS AND METHODS. One-hundred sixty-five monolithic zirconia specimens (16.3 mm × 16.3 mm × 2.0 mm) were divided into 5 groups (Group I to V) according to the number of A2-coloring liquid applications. Each group was then divided into 11 subgroups by reducing the thickness up to 1.0 mm in 0.1-mm increments (Subgroup 0 to 10, n=3). Colors and spectral distributions were measured according to CIELAB on a reflection spectrophotometer. All measurements were performed on five different areas of each specimen. Color difference (ΔE* ab) and translucency parameter (TP) were calculated. Data were analyzed using one-way ANOVA and multiple comparison Scheffé test (α=.05). RESULTS. There were significant differences in CIE L* between Subgroup 0 and other subgroups in all groups. CIE a* increased (0.52<R2<0.73), while CIE b* decreased (0.00<R2<0.74) in all groups with increasing thickness reduction. Perceptible color differences (ΔE*ab>3.7) were obtained between Subgroup 0 and other subgroups. TP values generally increased as the thickness reduction increased in all groups (R2>0.89, P<.001). CONCLUSION. Increasing thickness reduction reduces lightness and increases a reddish, bluish appearance, and translucency of monolithic zirconia ceramics.

Effect of polishing and glazing on the color and spectral distribution of monolithic zirconia

김희경,김성훈,이재봉,한중석,여인성 대한치과보철학회 2013 The Journal of Advanced Prosthodontics Vol.5 No.3

PURPOSE. The aim of this study was to evaluate the effect of polishing and glazing on the color and spectral distribution of monolithic zirconia. MATERIALS AND METHODS. Forty-five monolithic zirconia specimens (16.3 mm × 16.4 mm × 2.0 mm) were fabricated and divided into 5 groups according to the number of A2-coloring liquid applications (Group I to V). Each group was divided into 3 subgroups according to the method of surface treatments (n=3): N: no treatment; P: polishing; G: glazing. Color and spectral distribution of five different areas of each specimen were measured according to CIELAB color space in the reflectance mode relative to the standard illuminant D65 on a reflection spectrophotometer. Data were analyzed using one-way ANOVA followed by Tukey’ HSD test, Pearson correlation and regression analysis (α=.05). RESULTS. There was a significant difference in CIE L* between Subgroup N and P, and in CIE b* between Subgroup P and G in each group. Spectral reflectance generally decreased in Subgroup P and G in comparison with Subgroup N. Color differences between Subgroup P and G were within the perceptibility threshold (ΔE*ab< 3.7) in most groups. Highly significant correlation was found between CIE b*and each subgroups as the number of coloring liquid applications increased (R2>0.88, P<.001). CONCLUSION. A perceptible color difference can be detected after polishing of monolithic zirconia. Polishing decreases the lightness, and glazing also decreases the lightness, but increases the yellowness of monolithic zirconia.

Comparison of the optical properties of pre-colored dental monolithic zirconia ceramics sintered in a conventional furnace versus a microwave oven

김희경,김성훈 대한치과보철학회 2017 The Journal of Advanced Prosthodontics Vol.9 No.5

PURPOSE. The purpose of this study was to compare the optical properties of pre-colored dental monolithic zirconia ceramics of various thicknesses sintered in a microwave and those in a conventional furnace. MATERIALS AND METHODS. A2-shade of pre-colored monolithic zirconia ceramic specimens (22.0 mm × 22.0 mm) in 3 thickness groups of 0.5, 1.0, and 1.5 mm were divided into 2 subgroups according to the sintering methods (n=9): microwave and conventional sintering. A spectrophotometer was used to obtain CIELab color coordinates, and translucency parameters and CIEDE2000 color differences (ΔE00) were measured. The relative amount of monoclinic phase (Xm) was estimated with x-ray diffraction. The surface topography was analyzed by atomic force microscope and scanning electron microscope. Statistical analyses were conducted with two-way ANOVA (α=.05). RESULTS. There were small interaction effects on CIE L*, a*, and TP between sintering method and thickness (P<.001): L* (partial eta squared ηp2=0.115), a* (ηp2=0.136), and TP (ηp2=0.206), although higher b* values were noted for microwave sintering regardless of thickness. Color differences between two sintering methods ranged from 0.52 to 0.96 ΔE00 units. The Xm values ranged from 7.03% to 9.89% for conventional sintering, and from 7.31% to 9.17% for microwave sintering. The microwave-sintered specimen demonstrated a smoother surface and a more uniform grain structure compared to the conventionally-sintered specimen. CONCLUSION. With reduced processing time, microwave-sintered pre-colored dental monolithic zirconia ceramics can exhibit similar color perception and translucency to those by conventional sintering.

一部都市 低所得層의 就學前의 어린이의 營養實態에 관한 硏究(家族計劃 變數를 中心으로)

金姬京,牟壽美 대한보건협회 1979 대한보건연구 Vol.5 No.1

In order to evaluate the nutritional status of preschool children in relation to family planning variables such as the number of sibling, birth order and birth interval from preceding and next sibling, a dietary survey of 246 preschool children, ranging from one to five years old was performed in low income families in the suburbs of Seoul. The survey was conducted from June to August 1977. This study includes analytic data on dietary intake, physical status and prevalence of angular stomatitis. Dietary intake level was measured by the 24 hour recall method with interview of children's mothers or other family members caring for the children. The calculated nutrient intakes were expressed as a percentage of recommended dietary requirements for age 1 through 5 respectively. and the height, weight and arm circumference were used as physical measurement. The observed height and weight were compared with the Korean standards of 1975 report, and the arm circumferences with the Jelliffe's standard. Then, the physical growth values below 90% of each standard were classified accordiug to family planning variables. 1. Dietary intake The larger the number of sibling and the later the birth order, the lesser the nutrient intakes were obseriled. Thus, the energy, protein, calcium and riboflavin intakes were proportionally decreased(P<0.01). The longer the birth interval the lesser the nutrient intakes were also detected, but the effect of birth interval on nutrient intakes was not so great as those of the number of sibling and birth order. 2. Physical status The larger the number of sibling and the later the birth order, the poorer physical condition was observed (below 90% of standards), relative to height and weight, but the arm circumference for age was inverse. And the shorter the birth interval from preceding sibling and the longer the birth interval until next sibling, the poorer development in weight and arm circumference was observed. 3. The prevalence of angular stomatitis The occurrence of angular stomatitis trends to reflect the nutritional status.

중등 과학교사의 감정노동과 교수 실행: 물리 전공 교사를 중심으로

김희경,김희진 한국물리학회 2018 새물리 Vol.68 No.4

The purpose of this study is to investigate how the emotional labor of secondary science teachers appears in the classroom. For their purpose, we collected emotional diaries, class videos, and in-depth interviews for two physics teachers. First, the teachers had both positive and negative emotional display rules, and they thought negative emotions had to be expressed for the education goal. Second, the emotional display rule was perceived as a voluntary attempt to realize the intended purpose of the teaching. The difficulties caused by emotional labor depended on the difference between the teacher's emotional expression rules and emotional labor practice level. Third, emotional labor contributed to providing a stable learning environment for students, but became problematic when cumulative negative emotions could not be properly released. Fourth, the failure of emotional labor led to negative emotions to blame oneself. After strong emotional labor, the teachers experienced negative emotions, but they experienced positive emotions when attaining the educational goals due to emotional labor. In the case of physics lessons, the difference between emotional display rules and reality was large due to the low interest and participation of the students, so emotional labor was strong. 본 연구는 중등 과학교사의 감정노동이 수업에서 어떻게 나타나는지 알아보기 위해 2명의 물리교사 사례를 대상으로 감정일지와 수업 동영상, 심층면담 자료를 수집 분석하였다. 분석 결과, 첫째, 교사들은 긍정적, 부정적 감정표현규칙 모두 가지고 있었으며, 교육적으로 부정적 감정표현도 필요하다고 하였다. 둘째, 감정표현규칙은 교사가 의도하는 교수 목적을 실현하기 위한 자발적인 시도로 인식하였다. 감정노동으로 인한 어려움은 교사의 감정표현규칙과 감정노동 실행 수준의 차이가 중요하였다. 셋째, 감정노동은 학생들에게 안정적인 학습 환경을 제공하는데 기여하였지만 누적된 부정적 감정의 출구가 없을 경우 문제가 되었다. 넷째, 감정노동의 실패는 자신을 탓하는 부정적 감정으로 이어졌다. 강한 감정노동 후에는 부정적 감정을 경험하였으나 감정노동으로 인해 교수 목적을 달성할 때는 긍정적 감정을 경험하였다. 물리수업의 경우 학생들의 낮은 흥미와 참여도로 인해 감정표현규칙과 현실의 차이가 컸고, 이에 의한 감정노동도 컸다.

개방형 집단치유 프로그램을 경험한 알코올중독자 부인의 경험 : 문제 및 욕구파악, 변화과정 중심

김희경,이미형,이인숙 알코올과 건강행동학회 2017 알코올과 건강행동연구 Vol.18 No.1

Objectives: The purpose of this study was to explore and describe the experience of participating in open group therapy that supports wives of alcoholics. Method: Qualitative research was used to describe wives’experiences in open group therapy. In total, 30 wives of alcoholics were purposefully sampled from alcohol counseling centers. The open group therapy was an unstructured program pertaining specifically to wives. Data were collected from group therapy sessions held for 120 minutes twice a month, and analyzed using Fullilove's problem-oriented analysis. Results: Experiences were described as “endlessness helpless,” “to find a way,” “moving toward change,”and “moving toward self-growth.”Wives further expressed that they had gained self-awareness through participation. Conclusion: These results revealed that wives of alcoholics that participated in open group therapy experienced healing and growth, and validated the necessity of developing direct nursing intervention.

탈북 여성에서 MMPI-2의 진단적 유용성: 정신과 내원군과 정상 대조군의 비교

김희경,전진용 한국심리학회 2010 한국심리학회지 일반 Vol.29 No.2

The purpose of this study was to examine the diagnostic efficiency of MMPI-2 when it was applied to North Korean female refugees. The study has been conducted based on the observation of 210 female refugees who were benefited from the treatment provided by Psychiatry of Hanawon (Settlement Support Center for North Korean Refugees) from June 2008 to June 2009. The psychiatric outpatient group consists of anxiety group (100), depression group (30), somatization group (80). In comparison, the normal control group consists of 210 female refugees who were in the same age and received the same level of education with the psychiatric outpatient group. The means of T scores from validity scales and clinical scales of MMPI-2 were compared among the groups. Moreover, a series of logistic regression analysis have been conducted in order to clarify predictors of influencing on differences between groups. In addition, based on the Receiver Operating Characteristic (ROC) analysis, the sensitivity, specificity, and the diagnostic efficiency of predictors were compared in each T score of the final predictors. The analysis represented that the anxiety group showed mild elevation on Pa and Pt scales and the depression group had high scores on D, Pt, and Si scales. In the somatization group, there were no scales over 60T in any clinical scales, but they had relatively higher T scores in D, Pt, and Si scales than in the rest of the scales. As a result of logistic regression analysis, Hy, Hs, and Sc scales proved to be the most powerful predictors in distinguishing the anxiety group from the normal control group. D, Hs scales in the depression group; Hs and D scales in the somatization group. According to the results of the ROC analysis, Hy scale (with the diagnostic efficiency of 45T) showed the highest efficiency in distinguishing the anxiety group from the normal control group. D scale (59T) had the most effective efficiency in the depression group; Hs scale (50T) in the somatization group. Finally, the required attention in therapeutic intervention for North Korean female refugees and the possibility of applying MMPI-2 to clinical setting were discussed, and implications and limits, future study were suggested. 본 연구는 탈북 여성에서 MMPI-2의 진단적 유용성을 살펴보고자 하였다. 연구 대상은 2008년 6월부터 2009년 6월까지 하나원 정신과에서 치료를 받은 탈북 여성 210명(불안군 100명, 우울군 30명, 신체화군 80명)이었고, 연령과 교육 수준에서 대응되는 동수의 탈북 여성을 정상 대조군으로 선정하였다. 각 집단 간에 MMPI-2의 타당도 척도와 임상 척도의 T점수 평균을 비교하였고, 이들을 효과적으로 변별할 수 있는 예측 변인을 알아보기 위하여 로지스틱 회귀분석을 실시하였으며, Receiver Operating Characteristic(ROC) 분석을 통해 최종 예측 변인의 T점수별 민감도와 특이도, 진단 효율성을 비교하였다. 분석 결과, 불안군은 Pa와 Pt 척도의 T점수가 60점 이상으로 경미하게 상승하였고, 우울군은 D, Pt, Si 척도에서 높은 점수를 보였다. 신체화군에서 60T 이상으로 상승한 임상 척도는 없었지만, D, Pt, Si 척도의 T점수가 다른 척도들에 비해 높았다. 로지스틱 회귀분석에서 불안군과 정상 대조군을 효과적으로 변별해주는 최종 예측 변인은 Hy, Hs, Sc 척도였으며, 우울군과 정상 대조군 변별에서는 D, Hs 척도, 신체화군과 정상 대조군의 변별에서는 Hs, D, Ma 척도로 나타났다. ROC 분석 결과, 불안군과 정상 대조군 변별에서 가장 효율성이 높은 것은 Hy 척도(45T)였고, 우울군과 정상 대조군에서는 D 척도(59T), 신체화군과 정상 대조군에서는 Hs 척도(50T점)였다. 끝으로 탈북 여성에 대한 치료적 개입에서 주의할 점과 임상 장면에서 MMPI-2의 활용 가능성을 논의하였고, 본 연구의 의의 및 제한점, 후속 연구의 방향에 대해 제안하였다.

『죽천이공행적록』, 바닷길로 떠난 중국 사행

김희경 한국박물관학회 2016 博物館學報 Vol.- No.31

국립해양박물관 소장『죽천이공행적록』은 1624년 인조(仁祖, 재위 1623-1649) 왕권 승인을 위해 주청사로 명나라에 다녀온 죽천 이덕형(李德泂, 1566-1645)의 한글 필사본 사행록이다. 표제는 “?쳔니공?ㅣ?녹”이고 크기는 세로 34cm, 가로 23cm이다. 대체 로 각 면 11행, 각 행 20자씩 배자되어 있으며 총 155쪽 분량의 글로 이루어졌다. 책 에는 1624년 6월 20일부터 1625년 4월 2일까지의 사행과정 중 1624년 10월 13일까지 의 내용만 기록되어 있다. 따라서 별도의 책수가 표시되어 있진 않지만 내용 전개상 원래 전?후반 두 편으로 구성되었을 것으로 보이며『죽천이공행적록』은 전반부에 해당 되는 것으로 파악된다.

Generation of an Arginine Auxotrophic Mutant of Colletotrichum acutatum as a Recipient Host for Insertional Mutagenesis

김희경,이선희,김흥태,윤성환 한국식물병리학회 2009 Plant Pathology Journal Vol.25 No.3

Colletotrichum acutatum was the main cause of the recent outbreaks of anthracnose on pepper fruit in Korea. To facilitate molecular analysis of C. acutatum, we generated an arginine auxotrophic mutant of the C. acutatum strain JC24 using a targeted gene replacement strategy. A 3.3-kb genomic region carrying an ortholog (designated CaARG2) of the fungal gene encoding Nacetylglutamate synthase, the first enzyme of arginine biosynthesis in fungi, was deleted from the fungal genome. The mutant exhibited normal growth only when arginine was exogenously supplied into the culture medium. Transformation of the arginine auxotrophic mutant with a plasmid DNA carrying an intact copy of CaARG2, which was smaller than the deleted region in the mutant, not only caused random vector insertions in the fungal genome, but also recovered both hyphal growth and pathogenicity of the mutant to the wild-type level. Using this new selection system, we have successfully developed a restriction enzyme-mediated integration procedure, which would provide an economically efficient random mutagenesis method in C. acutatum.