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자해와 자살행동 메타분석 연구 개관: 생물심리사회모델에 따른 위험 및 보호요인을 중심으로
김성연(Kim, Seong-Yeon),양모현(Yang, Mo-Hyun),박효은(Park, Hyo-Eun),김지윤(Kim, Ji-Yun),이동훈(Lee, Dong-Hun) 한국교육치료학회 2023 교육치료연구 Vol.15 No.1
메타분석 연구는 특정 주제와 관련하여 여러 개별연구에서 다룬 변인들을 객관적이고 체계적인 방식으로 포괄하는 장점이 있다. 본 연구는 상호 연관성이 높음에도 그간 분리되어 연구된 자해와 자살의 영향요인을 통합적으로 살펴보고자 자해 및 자살 관련 메타분석 연구 문헌을 고찰하여 생물심리사회모델에 따라 영향요인을 개관하였다. 국내외 12개 학술 데이터베이스를 이용하여 17편(자해 3편, 자살 14편)의 메타분석 논문을 최종 선정하였다. 분석 결과, 청소년 자해와 자살에서 공통으로 연구된 위험요인은 10개, 보호요인은 3개, 청소년 자해에만 연구된 위험요인은 22개, 보호요인은 7개, 청소년 자살에만 연구된 위험요인은 10개, 보호요인은 12개가 확인되었다. 전체연령 대상 연구에서 자해와 자살의 공통 위험요인은 7개, 자살에만 연구된 위험요인은 24개가 확인되었고, 보호요인은 확인되지 않았다. 이처럼 자해와 자살 연구의 영향요인은 공통되는 요인과 차별적으로 연구된 요인이 확인되어 향후 공통 및 차별 영향요인을 통합적으로 고려할 필요가 있겠고, 위험요인에 비해 밝혀진 보호요인이 현저히 적어서 보호요인에 대한 활발한 탐색과 검증이 필요하겠다. Meta-analysis research encompasses the variables dealt with in several individual studies objectively and systematically. To comprehensively examine the factors influencing self-injury and suicide, this study analyzed 17 meta-research literature that was searched through domestic and abroad databases. As a result, ten risk factors and three protective factors were commonly identified in youth self-injury and suicide, 22 risk factors and seven protective factors were identified in youth self-injury only, and ten risk factors and 12 protective factors were identified in youth suicide only. In the study for all ages, seven common risk factors for self-injury and suicide, 24 risk factors were identified only for suicide, and no protective factors were identified. Many common and discriminatory influencing factors were placed, and the factors that have been differentially studied need to be considered in an integrated way in the future.
본태성고혈압 환자의 적혈구 Na+-Li+ Countertransport 와 Na+-K+ Cotransport 에 대한 연구
김성연(Seong Yeon Kim),김원배(Won Bae Kim),박성욱(Seong Wook Park),오병희(Byung Hee Oh),박영배(Young Bae Park),최윤식(Yun Shik Choi),이홍규(Hong Kyu Lee),서정돈(Jung Don Seo),이영우(Young Woo Lee),고창순(Chang Soon Koh),민헌기(Hun Ki 대한내과학회 1990 대한내과학회지 Vol.39 No.5
N/A To observe membrane Na+ transport abnormalities in erythrocytes of patients with essential hypertension and to verify genetic tendency of these membrane Na+ transports, we measured erythrocyte Na cancentration, Vmax of Na+-Li+ countertransport and Vmax of Na+-K+ cotransport in erythrocytes of 50 hypertensive patients, 30 normotensive controls and 5 normotensives with a family history of hypertension. The results were as follows. 1) Vmax of Na+-Li+ countertransport and Na+-K+ cotransport were significantly higher in male normotensive controls than in female normotensive controls but erythrocyte Na concentrations showed no significant difference. 2) There were no differences in erythrocyte Na concentration, Vmax of Na+-Li+ cauntertransport and Vmax of Na+-K+ catransport between the hypertensive patients and the normotensive controls regardless of a family history of hypertension. 3) The differences in clinical, biochemical and Na+ transport parameters except for serum uric acid level were not found between the hypertensive patients with normal and increased Na+-Li+ countertransport. 4) In multiple linear regression analysis erythrocyte Na concentration was significantly correlated with HDL-cholesterol, Vmax of Na+-Li+ countertransport with serum uric acid and triglyceride levels, and Vmax of Na+-K+ cotransport with HDL-cholesterol among total study population. 5) A weak but significant correlation was found between Vmax of Na+-Li+ countertransport and Na+-K+ cotransport. These results indicate that membrane Na+-Li+ countertransport and Na+-K+ cotransport in erythrocytes may not be useful as genetic marker for essential hypertension in Korea and their pathophysiologic roles in hypertension remain questionable, However, the result that there were considerable jnterindividual differences in these erythrocyte Na+ transports in hyper-tensive patients and a small portion of the hypertensive patients (12%) had increased Na+-Li+ countertransport activity suggests that essential hypertension is heterogenous in etiology.
뇌하수체 미세선종에 의한 쿠싱병의 접형골경유 수술의 치료성적
이윤용(Yun Yong Lee),김진성(Jin Seong Kim),문병술(Byeong Sul Mun),신찬수(Chan Soo Shin),김성연(Seong Yeon Kim),조보연(Bo Youn Cho),이홍규(Hong Kyu Lee),고창순(Chang Soon Koh),정희원(Hee Won Joeng),한대희(Dae Hee Han),한문희(Moom Hee 대한내과학회 1997 대한내과학회지 Vol.53 No.6
N/A Background: Cushing's disease is a hypercortisolic state attributable to hypersecretion of ACTH at pituitary gland Most of these diseases are due to pituitary microadenoma. Selective removal of adenoma by transsphenoidal microsurgery is the treatment of choice for Cushing's disease. We evaluated 25 cases to analyze results of transsphenoidal microsurgery and to identify prognostic factors that may predict successful outcome. Methods: From 1989 to 1995, 25 patients were diagnosed as having Cushing's disease in Seoul National University Hospital. They were underwent pituitary microsurgery and confirmed to have pituitary microadenoma radiologically and pathologically. About these patients. retrospective evaluation was done. Results: The patients consist of 21 females and 4 males and the age was ranged from 23 to 49 years. 19 patients (76%) were judged as immediate remission. The preoperative clinical, hormonal, and radiological characteristics of the remission and failure groups were similiar The patients who were immediate remission were followed from 3 months to 72 months. 3 patients had recurrences(15.8%) at 4, 8, 49 months after operation. The pre and postoperative clinical, hormonal, and radiological characteristics of the long-term remission and recurrence groups were similiar. We could not find any predictable factors of surgical outcome. Conclusion: The first line trearment of Cushing's disease is transsphenoidal microsurgery. However considering relative late and high rate of recurrence of Cushing's disease following curative surgery, careful longterm follow up is mandatory.
증례 : 후신경모세포종에 합병된 이소성 부신피질자극 호르몬 증후군 1예
구보경 ( Bo Kyung Koo ),구윤희 ( Yun Hyi Ku ),김진택 ( Jin Taek Kim ),김홍일 ( Hong Il Kim ),이유진 ( You Jin Lee ),조영민 ( Young Min Cho ),김성연 ( Seong Yeon Kim ) 대한내과학회 2006 대한내과학회지 Vol.71 No.3
요약하면 본 증례는 후신경모세포종에 병발한 이소성 ACTH 증후군에 대한 보고로서 국내에서는 첫 보고이다. 고 코르티솔 혈증에 의한 면역 기능 약화로 주폐포자충 폐렴 및 거대세포바이러스 폐렴에 이환되었으며 부신의 스테로이드 합성 억제 및 TMP/SMX 투약 후 회복되었다. 이소성 ACTH 증후군에서 원인 질환의 조속한 치료와 더불어 내인성 코르티솔 과잉 상태의 해결이 필요함을 시사하는 증례이다. We here present the case of a 37-year-old woman who suffered from adrenocorticotrophic hormone (ACTH)-dependent Cushing`s syndrome due to an olfactory neuroblastoma. The patient`s clinical course was complicated by co-infection with cytomegalovirus and Pneumocystis jirovechi, which improved with appropriate antimicrobial therapy and suppression of endogenous steroidogenesis with ketoconazole and octreotide. Radiation to the mass in the nasal cavity resulted in reduction of tumor size and remission of the Cushing`s syndrome. This is the first report of the ectopic ACTH syndrome resulting from olfactory neuroblastoma in Korea.(Korean J Med 71:309-315, 2006)
다꾸지법을 이용한 구리와 타이타늄 마찰압접부의 용접변수의 영향에 관한 연구
金成演,延倫模,鄭承富,徐昌濟 대한금속재료학회 2002 대한금속·재료학회지 Vol.40 No.7
This paper describes a fundamental investigation of the friction welding condition for the pure copper/ pure titanium joining and the effect of friction time, upset pressure on the mechanical and metallurgical properties of the joint. Taguchi method has been adopted for investigating the contribution of welding variables. Under a constant upset pressure, the tensile strength have a little difference with an increase in friction time. At a constant friction time, the tensile strength increased with an increase in the upset pressure. The tensile fracture of Cu to Ti joint occurred at the Cu base material near the interface.
TSH 자극에 의한 FRTL-5 세포에서 p66 Shc의 발현 조절 기전
박영주,박은신,김태용,이윤용,이선화,박도준,신찬수,박경수,김성연,이홍규,조보연 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.1
연구배경: 갑상선종은 임상적으로 매우 흔하게 나타나지만, 아직까지 그 발생기전에 대하여 알려진 바가 적다. 갑상선 세포의 TSH 수용체 신호 전달 체계가 갑상선종의 발생에 중요한 역할을 할 것으로 생각되고 있으나, 기존에 잘 알려진 신호전달 기전인 AMP/A 단백질 활성화효소 (PKA) 체계나 PKC 체계만으로는 설명하기 어려운 점이 많다. 최근 TSH가 갑상선 세포에서 p66 Shc 단백질의 발현 증가를 유도하는 것이 보고되어, p66 Shc이 TSH에 의한 세포 증식 신호전달에 있어서 중요한 역할을 담당할 가능성이 시사되었다. 목적: 본 연구에서는 TSH 자극에 따른 갑상선 세포에서의 p66 Shc의 발현 변화를 관찰하여, p66 Shc 단백질과 갑상선 세포의 증식 신호와의 연관성을 알아보고자 하였다. 또한 TSH가 p66 Shc 단백질의 발현을 조절하는 것과 연관된 신호전달 과정을 살펴보아, TSH의 p66 Shc 발현 조절 기전을 밝히고자 하였다. 방법 및 결과: FRTL-5 세포에서 TSH에 의해서 p66 Shc의 발현의 증가하고, TSH를 제고하였을 때에는 다시 기저 수준으로 감소하였다. TSH에 의한 p66 Shc의 발현 증가는 TSH 수용체 차단항체에 의하여 경쟁적으로 억제되었다. TSH에 의한 p66 Shc의 발현은 TSH를 처리한 시간과 농도에 의존적으로 증가하였고, 이러한 현상은 p66 Shc mRNA의 발현에서도 동일하게 관찰되었다. 콜레라 독소는 p66 Shc의 발현을 증가시켰으나 백일해 독소는 TSH에 의한 p66 Shc의 발현에 아무런 영향을 미치지 못하였다. cAMP/PKA 자극제(8-bromo-cAMP, forskolin)를 처리하였을 때 p66 Shc의 발현이 증가하고 cAMP/PKA 억제제(H89)에 의하여 TSH에 의한 효과가 억제되었으나, C단백질 활성화 효소 억제제(PMA, GF109203X)는 아무런 영향을 미치지 못하였다. 결론: FRTL-5 세포에서는 TSH 자극에 의존적으로 p66 Shc의 발현이 조절되었으며, 이러한 TSH의 p66 Shc 발현 조절은 주로 TSH 수용체 - Gs 단백질 - adenylate cyclase - cAMP - PKA의 신호 전달 경로를 통하여 이루어지는 것으로 생각되어진다. Background: Thyroid goiters are very common, however, the mechanism of development is not fully understood. A TSH receptor has been known to activate two different signaling pathways the cAMP/protein kinase A(PKA) and phospholipase C(PLC)/protein kinase C(PKC) systems. However, both systems are limited in the degree to which they explain the discrepancy between a goiter and TSH receptor activation. It has recently been reported that the expression of p66 She was increased by TSH stimulation in thyrocytes, suggesting that the p66 Shc molecule may play a critical role in the transition of the TSH-induced growth signals. Methods & Results: In this study, we examined the expression of p66 Shc by stimulation of TSH, and the regulatory mechanisms of the TSH-induced expression of the p66 Shc in FRTL-5 cells. In FRTL-5 cells, TSH could increase the expression of the p66 Shc, and the this expression was decreased to basal levels after the removal of TSH. The TSH-induced p66 Shc expression was competitively inhibited by TSH receptor blocking antibodies. The increments of the expression of the p66 Shc protein caused by TSH were both time and concentration dependent, and it was same in the mRNA levels. Cholera toxin increase the expression of the p66 Shc, while pertussis toxin did not. The activators of the cAMP/PKA pathway (8-bromo-cAMP and forskolin) also stimulated the expression of p66 Shc, and the PKA inhibitor H89 decreased the expression, while the inhibition of the PKC pathway by GF109203X, or PMA, affected the expression of p66 Shc very little. Conclusion: Our data suggests that p66 Shc may play an important role in regulation the growth of thyrocytes. The TSH receptor - Gs protein - adenylate cyclase - cAMP - PKA pathway mainly mediates the TSH effects on the expression of p66 Shc molecules (J Kor Soc Endocrinol 18:45∼55, 2003).