말기신부전 환자의 혈색소 순환 : 투석 방식에 따른 양상 비교 및 관련 인자들에 대한 고찰

최재혁,김준섭,원기범,박준형,탁우택,이정호 동국대학교 의학연구소 2009 東國醫學 Vol.15 No.2

혈색소 순환은 말기신부전 환자에서 인체 재조합 적혈구 조혈 인자를 투여하여 빈혈을 치료하는 동안 빈번히 관찰되며 이는 환자의 입원과 사망률과 관계가 있다고 알려져 있다. 이에 저자는 투석중인 말기 신부전 환자를 대상으로 혈색소 순환 양상과 이와 연관된 인자들을 알아보고자 하였다. 혈색소 순환의 관련 인자들을 알아보기 위하여 투석 치료를 받고 있는 환자 40명 (혈액투석 환자군: 20형, 복막투석 환자군: 20명)을 대상으로 투석 시작부터 1년 동안의 환자의 나이와 성별, 투석시작 1년간의 평균 Hb, 수혈 횟수, 총입원 횟수, 감염으로 인한 입원 횟수, 혈청 ferritin 농도, 혈청 transferrin saturation (TSAT), 철분제제 복용 유무, 일주일 동안 투여된 rHuEPO 양, rHuEPO의 변화량, 알부민, C-reactive protein (CRP) 및 입원 원인 등을 후향적으로 조사하였다. 전체 환자 40명 중 33명 (82.5%)에서 혈색소 순환이 관찰되었다. 혈액투석 환자군에 비해 복막투석 환자군에서 혈색소 순환 첫수가 유의하게 높았다 (p=0.037).혈색소 순환 발생군과 혈색소 순환 미발생군의 관련인자들을 비교하였을 경우 혈색소 순환 발생군에서 총 입원 첫수 (p=0.01), 감염으로 인한 입원 횟수 (p=0.036)가 유의하게 많았으며, 혈중 알부민 수치는 유의하게 낮았다 (p=0.003).그러나 두 군간의 나이, 성별, 수혈 횟수, 혈청 ferritin농도, 혈청 transferrin saturation (TSAT) 및 혈청 철분 농도는 유의한 차이가 없었다. 혈색소 순환의 빈도는 일주일 동안 투여된 r-HuEPO변화량과 양의 상관관계를 보였고 (p=0.003),혈중 알부민 수치와 음의 상관관계를 보였다 (p=0.013). 복막투석 환자군에서 혈액투석 환자군에 비해 혈색소 순환이 유의하게 높게 발생하였다. 일주일 동안 투여된 r-HuEPO 변화량, 입원 및 혈청 알부민 수치는 투석 시작부터 1년 동안의 혈색소 순환과 관련이 있었다. Hemoglobin cycling is frequently observed during treatment of anemia with recombinant human erythropoietin (r-HuEPO) in patients with end stage renal disease (ESRD) it is also reported to be associated with hospitalization and morbidity. We analyzed hemoglobin cycling and potential associated factors in patients on dialysis. Forty new dialysis patients (20 hemodialysis, HD and 20 peritoneal dialysis, PD) were recruited during their first year. Age, gender, mean hemoglobin level, frequency of transfusion, frequency of hospital admission, frequency of admission due to infection, serum ferritin, transferrine saturation, iron levels, rHuEPO dose per week, serum albumin, and c-reactive protein were retrospectively evaluated in order to examine the possible correlations with hemoglobin cycling. Thirty-three patients (82.5%) were identified in the hemoglobin cycling group. The PD group had a higher frequency of hemoglobin cycling than did the HD group (p=0.037). The hemoglobin cycling group showed a significantly higher frequency of hospital admission (P=0.001), admission due to infection (p=0.036) and a lower serum albumin level (p=0.003) than the other group, but there was no significant difference between the groups for age, gender, frequency of transfusion, serum ferritin, transferrine saturation, and iron levels. The frequency of hemoglobin cycling showed a positive correlation with the i-HuEPO dose variation per week (p=0.003) and a negative correlation with serum albumin level (p=0.013). The PD group had a higher frequency of hemoglobin cycling than the HD group, and the change of rHuEPO dose per week, hospitalization and serum albumin were associated with the hemoglobin cycling during the first year of dialysis.

초등학교에서 에너지의 합리적 사용을 위한 STS 프로그램의 개발과 적용 효과

최상길,김채복,최준섭 韓國實科敎育硏究學會 2002 實科敎育硏究 Vol.8 No.1

The purpose of this study was to develop STS teaching-learning program which focuses on real-life experiences for reasonable energy usage, and to verify how STS teaching-learning program affects the understanding knowledge concerned energy and the attitude towards saving energy. The subjects of this study were students of the 6th grade at an elementary school in Kyong-Ju. They were divided into two groups, an experimental group and a control roup. The developed STS teaching-learning program had been applied to the experimental group. However, the traditional teaching-learning process had been employed to the control group for four weeks. The main results of this study are as follows : (1) The developed STS teaching-learning program consists of following subjects ; energy resources, growing energy consumption, heat-energy transfer, energy and environment, saving energy, efficient usage of electricity and opening ‘ANABADA’ market. (2) In the understanding of knowledge concerned energy, there was no difference between the experimental group and control group. (3) In the attitude toward saving energy, there was a considerable significant difference between he experimental group and control group. However, there was no difference between male and female students, respectively.

미국의 과제중심 진로지도 프로그램

최준섭,권차미,왕소랑 한국교원대학교교육연구원 2006 敎員敎育 Vol.22 No.3

이 연구는 예비공학교육을 통한 미국의 국가 경쟁력 제고를 위하여 만들어진 프로그램의 내용을 살펴보는데 있다. 미국의 PLTW(Project Lead The Way)는 대학의 공학을 준비하기 위한 예비 공학 프로그램으로서 정규 교육 과정으로서가 아니라 공학을 위한 지식과 직업과 관련된 기본적인 경험을 제공하는 프로그램이다. 주요 내용은 미국의 과제중심 진로교육(PLTW)을 소개하고 초ㆍ중ㆍ고등학교 프로그램을 조사함으로써 우리나라 교육과정에 도입, 적용하는 방안을 모색하는데 있다. 이 연구에서 조사된 내용을 종합하여 다음과 같은 결과를 얻었다. 첫째, PLTW는 교육 시스템으로부터 졸업한 공학자와 공학 기술자의 양과 질을 늘이기 위한 공립 초ㆍ중ㆍ고등학교, 단과 대학 및 종합 대학의 고등 교육 기관과 민간 부문 사이의 협력을 맺은 프로그램이다. 둘째, PLTW는 예비공학 프로그램으로 6-12학년(초등학교 6학년~고등학교 3학년) 학생을 위해 공학에 기초 훈련을 제공한다. 이 프로그램은 공학과 공학 기술을 위해 2-4년제 대학이나 공업학교(technical school)에 입학하기 위한 필요한 것으로 학생들에게 제공하는 프로그램이다. 셋째, PLTW는 공학과 공학 기술 프로그램을 추구하여 2-4년제 공과 대학의 학위를 필요로 하는 학생 수를 증가시키고, 성(gender)이나 인종적 태생과 관계없이 배우고자 하는 학문적 자격 있는 학생들에게 공정하게 모든 기회를 제공하여, 미래에 공과 대학이 감소하는 비율이 작아지도록 하는데 필요한 프로그램이다. 넷째, 우리나라도 실업계 및 공과대학 인력 흡인책으로 PLTW와 같은 프로그램을 초ㆍ중ㆍ고등학교 교육과정의 도입을 검토할 필요가 있다고 인식된다. The purpose of this study was to investigate the Program which was made to enhance the national competitive of America through Pre-engineering eduction. PLTW(Project Lead The Way) of America is Pre-engineering Program to prepare engineering of the university, not as a regular school curriculum but as a Program offering basic engineering knowledge and occupation related with essential experience. The main contents of this study were consisted of introduction of PLTW, and to survey the Program of elementary, middle and high school of U. S. A and furthermore using the above results, we try to reasonably find the way to apply the U. S. A PLTW to our schooling system The main findings of this research were as follows: l) PLTW is the Program forming partnerships among Public schools, higher education institutions and the private sector to increase the quantity and quality of engineers and engineering technologists graduating from education system. 2) PLTW as Pre-engineering Provides basic training of engineering for 6-12 grade student(i.e., 6th grade of elementary school- 3rd grade of high school in Korea). This Program was made to give opportunity to the students who wish to enter to two-and four-year college or technical school. 3) PLTW was made to increase the number of students who wish to earn bachelor or associate bachelor of engineering, to fairly give equal opportunity to all the students regardless of gender and race who wish to study engineering field in the future, and then to make the rate of reduction of the application for engineering colleges less than before. 4) PLTW is also required for the our schooling systems in order to increase the application and technical high schools and engineering college in Korea.

영재반 중학생의 설계과정(Design Process) 기반 창의적 문제해결 질적 사례 연구

유재영,최준섭 부산대학교 과학교육연구소 2012 교사교육연구 Vol.51 No.3

The purpose of this study was to provide an empirical model of the design process that is used by gifted middle school students in problem solving. In order to achieve this purpose, research questions were in four areas: First, what is the design process that students use for problem solving? Second, is it possible for students to solve problems through ‘sketching’, ‘conceptual drawing’, and ‘part drawing’? Third, what are the difficulties faced by the students when at the construction stage of the design process? Fourth, what is the observed design process model used by the students during the problem solving? The following results were obtained from this study: First, it was possible for students to solve problems through the design process model and the process in each stage was iterative. The most difficult problem solving process observed in this research was during the brainstorming-sketching process. Conceptual drawing and sketching a process for solving the problem was performed repeatedly, requiring much time and effort from the students. Second, while students would engage in ‘sketching’, ‘conceptual drawing’, and ‘part and elements drawing’ in their problem solving, they perceived that ‘sketching’ was the most important process. Third, students had the most difficulty during the construction stage of the problem solving process as they were the lack of ability to use the tools necessary to build and construct their work. Fourth, the study concluded that the model identified in the students’ design process based problem solving was: 1)problem 2) brainstorming (idea creation) 3) sketching 4) conceptual drawing 5) part drawing 6) making 7) problem solving, feedback existed on some stage. 이 연구의 목적은 학생들이 어떤 설계과정을 통해 문제해결을 하는지에 관한 경험적 설계과정 모형을 제공하는 것이며, 이러한 연구의 목적을 달성하기 위해 첫째, 문제해결을 위해 학생들은 어떤 설계과정을 거쳐 왔고, 설계과정 이동경로의 특징은 무엇인가?, 둘째, 스케치, 구상도, 부품도를 통한 문제해결은 가능한가?, 셋째, 설계과정 중 제작을 통한 문제해결 사례에서 학생들이 어려워했던 점은 무엇인가?, 넷째, 설계과정 기반 문제해결을 통해 확인된 설계과정 모형은 무엇인가? 에 대한 연구 문제를 제시하여 다음과 같은 연구 결과를 얻을 수 있었다. 첫째, 설계과정을 통한 문제해결을 하는 동안 각 단계별로 반복적인 순환과정이 존재함을 확인할 수 있었고, 문제해결을 위해 JH팀과 SD팀 모두 문제해결을 위해 브레인스토밍-스케치 단계에서 가장 많은 그림을 그렸고, 또한 스케치-구상도, 제작-스케치 과정에서는 문제해결을 위한 반복 작업을 수행하여 가장 많은 시간과 노력을 투자하고 있음을 확인할 수 있었다. 둘째, 스케치, 구상도, 부품도를 통한 문제해결은 가능하며, JH, SD팀 모두 스케치를 설계과정에서 가장 중요한 단계로 인식하고 있었다. 셋째, 제작을 통한 문제해결 단계에서 학생들이 가장 어려워했던 것은 작품 제작 시에 사용되는 공구사용의 미숙으로 파악되었다. 넷째, 학생들의 설계과정 기반 문제해결을 통해 확인된 모형은 비선형(nonlinear) 모형으로 나타났으며, 모형에서 나타나는 단계는 문제-브레인스토밍(아이디어 생성)-스케치-구상도-부품도-제작-문제해결 과정을 거치는 것으로 파악되었다.

초등학교 6학년에서 수질환경 교육을 위한 STS 수업 모형의 적용효과

김혜순,최준섭 韓國實科敎育硏究學會 2001 實科敎育硏究 Vol.7 No.1

The purpose of this study is to present a prospective teaching-learning method for environmental education of water quality, and to identify the effects of the STS instruction methods. Two 6th grade classes in D elementary school in Anyang City, Kyunggi district were chosen as an experimental group and a control group, respectively. The experiment was carried out for 2 months by teaching the control group water conservation in the elementary curriculum by traditional teaching-learning methods, and the experimental group by the STS instruction method. The main results of this study were become as follows: (1) When comparing the statistics between the STS and traditional method, the significant level p was 0.173, there is no significant difference under significant level of 0.01. And thus STS method was not much more effective with teaching knowledge related to water pollution(p was less than 0.05). (2) By using the STS teaching method, t became 2.288 and p became 0.025, there was a considerable significant difference under the significant level of 0.01. Application for STS teaching-learning model showed more effective on attitude for environment-conservation than the traditional method(p was less than 0.05).

초등학교 3·4학년의 진로 인식에 관한 연구 : 경기도 지역을 중심으로 Focused on Kyung-gi Province

김자성,최준섭 한국실과교육연구학회 2001 實科敎育硏究 Vol.7 No.2

The purpose of this study is to provide necessary data and information to career education by analyzing the future career cognition level of elementary school students in Kyong-gi province district. The students to the number of 437 of the 3rd and 4th grade students of elementary schools in Kyong-gi province were served as subjects for this study. They were selected by random stratified sampling from their living area. The results of this study were as follows: (1)Many students took pride of doing, and their own aims, original characters or talents. And also they had a tendency to take cognizance of their own original characters or talents as bettor as high economic status. (2)A number more than half students preferred professionals. Most students are interested in computer or playing in the air, and there are different tendencies according to gender. (3)The period of career cognition became earlier and earlier when they themselves first thought about their future career appeared to be the 1st grade and 2nd grade(43.7%). (4)The motives for career selection were ① mass-communication(39.6%) and ②parents ㆍ family ㆍ relatives(32.7%). But very few students(2.7%) wanted to take counsel with their teachers about their career problems.

초등학교 학생의 진로 인식에 관한 연구 : 강원도 지역을 중심으로 Focused on Kang-won Province

성낙철,최준섭 韓國實科敎育硏究學會 1999 實科敎育硏究 Vol.5 No.2

The purpose of this study is aimed to provide necessary data and information to career education by analyzing the future career cognition level of elementary school students in Kang-won province district. The students to the number of 461 of the 5th and 6th grade students of elementary schools in Kang-won province were served as subjects for this study. They were selected and classified according to their living area, gender, learning achievement, and economic status. The main results of this study were as follows: (1) The students had their own talent(63.2%), and jobs were indispensable elements to sustain our society. The children to tell the 30 kinds of jobs or so are over 50% (2) The criteria to choose their future jobs was ability and aptitude(91.8%), and the purpose of their job is to develop their own talent, hobby and to serve their society. (3) The order of motives on career selection were decided by 峯 TV 峰 parents 捧 reading 棒 teacher, and the teaching method for career instruction must be reconsidered. (4) The 63.7% of students were in consensus of opinions to develop the future career problems between their parents and students. If their opinions about their future career problems were in discord with their parents, the 22.3% of students will consult with their teacher to resolve the conflicts.

중추성 요붕증이 동반된 랑게르한스 세포 조직구증 1예

김진호,문준성,문선중,이지은,최재원,은미정,천경아,조인호,윤지성,원규장,이경희 신덕섭,이형우 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Central diabetes insipidus (DI) is a syndrome characterized by thirst, polydipsia and polyuria. Langerhans cell histiocytosis is one of the etiologies of DI. Recently we experienced a central DI associated with Langerhans cell histiocytosis. The 44 years old female patient complained right hip pain polydipsia and polyuria. We carried out water deprivation test. After vasopressin injection, urine osmotic pressure was increased form 109mOsmol/Kg to 327mOsmol/Kg (300%). Brain MRI showed a thickened pituitary stalk and at hot bone CT.CT guided biopsy revealed abnormal histiocytes proliferation and abundant lymphocytes, The final diagnosis was central DI associated with systemic Langerhans cell histiocytosis invading hip bone, L-spine and pituitary stalk. Desmopressin and etoposide chemotherapy were performed to the patient.

New Paradigm of Technology Education in the Information Age : Development of WBI for Solar Energy Learning in Technology Subject of the Secondary Schools

(Jun Seop Choi),(Hea Don Jung) 한국기술교육학회 2001 New Paradigm of Technology Education in the Inform Vol.- No.-

밀폐형 유동층을 이용한 태양광 고온가스 가열장치의 연구

최준섭(Choi Jun-Seop) 한국태양에너지학회 1992 한국태양에너지학회 논문집 Vol.12 No.1

태양광 고온가스가열 장치를 위하여 후레넬렌즈면적 0.5㎡를 갖는 소형태양집열 및 추적시스템과 고급의 소형 밀폐형 유동층 태양광 수열기를 개발하였다. 개발된 태양광 수열기는 개방형 유동층의 단점인 SiC입자의 유출과 열사이폰효과를 개선하였다. 공기의 최대 도달온도는 1140K이며, 최대 열효율은 64%얻어졌다. 본 연구에서 개발한 태양광 수열기는 기존의 평판이나 관형의 고체표면을 갖는 태양 집열기와 비교할 때 아주 고온에서 효율좋게 작동된다. A small-scale solar collector and tracking system, using a Fresnel lens of 0.5』, and novel compact fluidized-bed solar receiver[FBRJ of closed type has been developed for high temperature solar gas heating. The FBR was improved in carrying over of SiC powder and thermo siphon effect. The maximum outlet air temperature of 1140K and the maximum thermal efficiency of 64 % were obtained. The present FBR's operated efficiently at extremely high temperatures in comparison with conventional solar receivers, composed of flat or tubular solid surfaces.