한.양방 협진에 대한 의사들의 인식변화 - 국내 문헌에 대한 체계적 고찰 -

민현주,류지선,윤영주,Min, Hyun-Ju,Ryu, Ji-Seon,Yun, Young-Ju 대한예방한의학회 2012 대한예방한의학회지 Vol.16 No.1

Background : With the increase of cooperative practices (CP) between conventional western medicine and traditional Korean medicine, there have been lots of researches on the status of CP and the attitude of doctors. Objective : Since most of the research is cross-sectional, this study aims to figure out the changes in the attitude of doctors toward CP through systematic review. Method : Systematic literature searches were performed on several databases in Korea. They were categorized according to the respondents and question items and analyzed by the context of questions, similarity of respondents and measurement scale. And we analyzed the changes of response regarding to doctors' awareness and attitude to CP. Results : Thirteen survey studies including attitude of doctors toward CP were selected. These studies were conducted between 1997 and 2009 and the number of respondents of each study ranged from 20 to 702. There has been increasing awareness of CP among doctors ; however the positive responses on the necessity of CP has decreased. Regarding the type of illness effectively treated employing CP, there was a shift from neurovascular to musculoskeletal and immune diseases. Most of the studies listed different approaches to disease, prejudice of health care providers and inadequate legal system as major obstacles against CP. Conclusion : In spite of the increase of CP in the last 20 years, there has not been marked positive change in the doctors' attitude toward CP. To promote CP, it is required to confirm the effectiveness of CP through disease models and change the medical legislation policies on CP.

게오르그 짐멜의 사유에서 드러나는 모던과 포스트모던 - <문화의 개념과 비극>을 중심으로 -

민현주 ( Min Hyun Ju ) 전북대학교 인문학연구소 2021 건지인문학 Vol.- No.32

본 논문은 짐멜의 <문화의 개념과 비극>(Der Begriff und die Tragödie der Kultur)을 중심으로 그의 사유에서 드러나는 모던적 면모와 포스트모던적 면모를 분석하는 것을 목표로 한다. 2장 1절에서는 모던적 주체의 성립과 특징을 분석할 것이며 2장 2절에서는 ‘문화의 비극’을 계기로 포착할 수 있는 포스트모던적 주체의 단초를 분석할 것이다. 논의 대상은 짐멜의 근대문화론이 잘 드러나는 에세이인 <문화의 개념과 비극>으로 한정한다. 방대한 양의 간학문적 연구를 수행한 그의 작업을 전부 검토할 수 없기 때문이며 이것이 본 논문의 한계임을 밝힌다. 마지막으로 그간 국내에서 잘 논의되지 않았던 짐멜의 사유를 논의 대상으로 삼음으로써 학문적 논의 가능성을 확대할 수 있음을 기대한다. The purpose of this paper is to examine the modern and postmodern in Georg Simmel’s Der Begriff und die Tragödie der Kultur. Chapter 2, Section 1, examines the establishment and characteristics of modern subjects. In Chapter 2 and Section 2, this paper will analyze the clues of the postmodern subject that can be captured in the wake of the ‘cultural tragedy’. The subject of discussion is limited to Der Begriff und die Tragödie der Kultur, an essay that clearly shows simmel's modern culture theory. This is because it is impossible to review all of his work that has conducted a vast amount of interdisciplinary research, and this is the limitation of this paper. Finally, it is expected to expand the possibility of academic discussions.

내과적 치료 실패가 예상되는 자궁외 임신에서 다회 methotrexate 화학요법

민현주(Hyun Ju Min),한성식(Sung Shik Han),최준원(Jun Won Choi),손성빈(Sung Bin Son),최영숙(Young Suk Choi),이철민(Chul Min Lee),김복린(Bok Lin Kim),최훈(Hoon Choi),조용균(Yong Kyoon Cho),박교훈(Kyo Hoon Park),이홍균(Hong Kyoon Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.11

N/A Objective : The purpose of this study was to determine the efficacy of multiple dose methotrexate (MTX) chemotherapy approved as a primary treatment of ectopic pregnancy in suspected medical treatment failure of ectopic pregnancy. Methods : This study included 77 hemodynamically stable high risk ectopic pregnants diagnosed from January 1995 to June 2000 at department of Obstetrics & Gynecology, Sanggye Paik hospital, Inje university. High risk criteria of our study were adnexal ectopic mass 3.5 cm or serum β-hCG 4,000 mIU/ml or presence of fetal heart beat(FHB) or presence of peritoneal fluid and fresh blood on culdocentesis. Statistics were analyzed with 2-test, Student χ2-test and odds ratio of each risk factors. Results : The response rate of multiple dose MTX chemotherapy was 85.7%(66/70). There was no statistically difference of risk factors between success and failure group except fetal heart beat. Among 11 failure patients, there were 3 patients with adnexal ectopic mass 3.5 cm (odds ratio=1.4, 0.3∼5.7), 3 patients with presence of FHB, 7 patients with presence of peritoneal fluid(odds ratio=1.0, 0.3∼3.8), 8 patients with serum β-hCG 4,000 mIU/ml (odds ratio=2.8, 0.7∼11.6). Conclusion : There results suggest that multiple dose MTX chemotherapy can be treated regardless of ectopic mass size, presence of pretoneal fluid, serum β-hCG level. But we must pay attention to treat ectopic pregnancy with presence of fetal heart beat.

자연적 파열을 동반한 간세포암의 임상적 고찰

민현주 ( Hyun Ju Min ),이옥재 ( Ok Jae Lee ),강도연 ( Do Youn Kang ),이은정 ( Eun Jung Lee ),이지훈 ( Ji Hun Lee ),김현진 ( Hyun Jin Kim ),김태효 ( Tae Hyo Kim ),정운태 ( Woon Tae Jung ),조중현 ( Joong Hyun Cho ) 대한소화기학회 2004 대한소화기학회지 Vol.44 No.3

Background/Aims: Spontaneous rupture of hepatocellular carcinoma (HCC) is known as a rare but life-threatening condition because of massive blood loss into the peritoneal cavity. In the countries with high prevalence, the reported incidence of spontaneous

약인성 간손상의 원인 산정

민현주 ( Hyun Ju Min ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1

The diagnosis of drug-induced liver injury (DILI) is challenging due to the absence of specific biomarkers and noninvasive diagnostic tests for the disease. The diagnosis of DILI is still established on the basis of a careful history-taking and the exclusion of other causes of liver diseases. Some causality assessment methods in DILI have been developed and many surveys concerning their validity, reliability and reproducibility have been carried out as well. Current DILI causality assessment methods can be divided into two major categories: liver specific algorithm or scales and expert opinion. The Roussel Uclaf Causality Assessment Method (RUCAM), the first DILI causality assessment scale, not only has provided mediocre reliability and subjectivity in scoring each items, but it has also been more used in researches rather than in clinical practice. While expert opinion is considered to be the gold standard for diagnosing DILI, it carries inevitable subjectivity and limited reproducibility. The structured expert opinion process that was designed to overcome these limitations by the US Drug-Induced Liver Injury Network (DILIN) also remains incomplete. In this article, the advantages and limitations of causality assessment methods in the clinical setting are discussed with their brief introduction.

엘레나 페란테의 〈나폴리 4부작〉에 나타난 더블과 경계 연구

민현주(Min, Hyun-ju) 영남대학교 인문과학연구소 2021 人文硏究 Vol.- No.96

본 논문은 현존하는 이탈리아 작가 엘레나 페란테(Elena ferrante)의 〈나폴리 4부작〉(Neapolitan Novels)에 나타나는 더블과 경계를 분석한다. 특히 〈나폴리 4부작〉에 나타나는 릴라와 레누의 관계에서 형상화되는 더블(Double)을 단순한 재현이나 복제, 분열을 의미하는 더블이 아니라 이중구속의 특징을 갖는 더블로 분석하는 데에 목적이 있다. 본 논문은 제2장에서 릴라와 레누의 관계에서 긴요하게 작동하는 ‘글’, ‘인형’, ‘딸’이라는 매개를 분석함으로써 이들의 관계가 서로를 침투하고 서로에게 연루되는 이중구속으로의 더블임을 밝힐 것이다. 제3장에서는 〈나폴리 4부작〉에 드러나는 경계를 분석할 것이다. ‘경계’와 ‘경계의 해체’가 〈나폴리 4부작〉의 핵심축임을 밝히며 특히 작품 내에서 드러나는 경계를 구축하려는 힘과 허물어뜨리려는 힘의 역동적인 관계를 작품의 핵심으로 간주하고자 한다. 마지막으로 〈나폴리 4부작〉의 핵심인 ‘경계’가 릴라가 경험하는 ‘경계의 해체’ 현상으로 구체적으로 드러남을 보이며 이것의 의의와 이에 대한 주인공의 이중적 태도를 밝힌다. The purpose of this paper is to examine Double and Boundary in ‘Neapolitan Novels’ that are written by the Italian writer Elena ferrante. This paper does not grasp the relationship between Lila and Lenu in ‘Neapolitan Novels’ as a simple reproduction, reproduction and division. By analyzing the mediums of “writing”, “doll”, and “daughter”, this study reveals that these relationships permeate each other and are a double bound to each other. Next, this study analyzes the boundaries that appear in ‘Neapolitan Novels’ and reveals that “Boundaries” and “dissolving margin” are the core of ‘Neapolitan Novels’. In particular, this study focuses on the dynamic relationship between the forces that appear in the work and the forces that break it down. Lastly, it reveals that the “boundary”, the core of the ‘Neapolitan Novels’ is specifically revealed by Lila’s experience of “dissolving margin” and its significance and the protagonist’s dual attitude toward it.

골반저 근실조에서 전기자극 치료와 바이오피드백 병합 치료의 효과

민현주 ( Hyun Ju Min ),변정식 ( Jeong Sik Byeon ),명승재 ( Seung Jae Myung ),양석균 ( Suk Kyun Yang ),윤인자 ( In Ja Yoon ),권오련 ( Oh Ryoun Kwon ),고정은 ( Jung Eun Ko ),손현영 ( Hyun Young Son ),이형준 ( Hyung Joon Lee ),김정선 대한소화기기능성질환·운동학회 2006 Journal of Neurogastroenterology and Motility (JNM Vol.12 No.2

목적 : 바이오피드백은 골반저 근실조에서 높은 치료 효과를 보이지만 일부 환자는 증상의 호전을 경험하지 못한다. 최근 변실금에서 효과가 알려진 전기자극 치료가 만성변비에서도 효과가 있을 가능성이 제기되고 있다. 저자들은 골반저 근실조에서 전기자극 치료와 바이오피드백 병합 요법의 효과에 대해 알아보고, 이들 치료의 효과에 있어 substance P의 역할에 대해서도 알아보고자 하였다. 대상 및 방법: 골반저 근실조로 진단된 변비 환자를 무작위로 분류하여 EB군은 전기자극 치료 후 바이오피드백을, BE군은 바이오피드백 후 전기자극 치료를 시행하였다. 두 군에 대해 치료 전, 첫 치료 후 및 두 번째 치료 완료 후 증상 및 배변 만족도, 항문직장 내압검사와 직장 점막 조직 생검에서 substance P 면역화학염색 결과 등을 분석하였다. 결과: 40명의 환자가 포함되었으며 EB 군이 20명(21-77세, 남:여=8:12), BE 군이 20명(24-70세, 남:여=7:13)이었고, 치료 전 주관적 증상, 대장통과시간, 항문직장 내압검사와 substance P 발현은 두 군에서 차이가 없었다. EB 군 및 BE 군 모두 각각의 치료 후 배변 만족도 및 증상의 호전을 보였으며, 첫 치료 후 호전율(60% vs. 60%; p=1.000)과 두 번째 치료 완료 후 최종 호전율(85% vs. 80%; p=0.681)에 있어 차이는 없었다. 항문직장 내압검사에서 휴식기 항문괄약근압이 치료 후 감소하는 경향을 보인 이외에 다른 변수의 유의한 변화는 없었다. Substance P의 발현도 두 군 모두에서 치료 전후에 유의한 차이가 없었다. 결론: 전기자극 치료와 바이오피드백은 각각 단독으로 골반저 근실조 환자에서 치료 효과를 보여주었을 뿐 아니라 병합하여 시행했을 때 추가적 증상의 호전을 보여주었다. 따라서, 골반저 근실조 환자에서 전기자극은 표준 치료인 바이오피드백에 반응하지 않거나 충분한 호전을 보이지 않는 경우에 추가함으로써 부가적 치료 효과를 기대할 수 있는 방법으로 생각된다. Background/Aims: Although electrical stimulation therapy (EST) has been tried for treating fecal incontinence, there are only limited reports concerning the application of EST to pelvic floor dyssynergia (PFD). We aimed to evaluate the efficacy of combined EST and biofeedback therapy (BFT) for treating PFD. We also checked the substance P expression in the rectum for evaluating the underlying mechanism. Methods: Constipated patients who were diagnosed with PFD were randomly divided into two groups. In the EB group, the patients first underwent EST and then BFT. In the BE group, BFT was applied first and then EST was performed. In both groups, the measurement the symptoms and performing anorectal manometry and immunohistochemical staining for substance P in the rectal mucosa were done before and after administering therapies. Results: Forty patients were analyzed. The baseline characteristics and substance P expression were not different between the EB and BE groups. The patient`s symptoms were improved after the first and second therapy, and the proportion of improved patients after both therapies did not differ between the two groups. The anorectal manometric parameters with the patient resting anal the sphincter pressure were significantly decreased in the BE group, but, these tended to show decreases in the EB group. The expression of substance P also did not change before and after the therapies. Conclusions: EST alone showed therapeutic efficacy for treating PFD and it produced additional improvement of symptoms when combined with BFT. (Kor J Neurogastroenterol Motil 2006;12:108-116)

게오르그 짐멜의 상품 세계와 도시산책자: 「1896 베를린 무역박람회」와 「대도시와 정신적 삶」을 중심으로

민현주 ( Hyun Ju Min ) 한국비교문학회 2022 比較文學 Vol.- No.87

본 연구는 게오르그 짐멜의 사유에서 드러나는 상품 세계와 도시산책자를 분석한다. 18세기 중반 무렵부터 가속화된 산업과 기술의 발달로 자본주의적 질서는 근대의 일상에 완전히 침투하였고 특히 대도시 공간에서 집약적으로 드러났다. 이러한 가운데 근대의 일상적 경험이란 실상 자본주의적 현실을 체험하는 것과 다를 바 없다. 대도시는 상품으로 가득 찬 시장으로 급격히 변모했으며 근대적 일상의 핵심은 상품이 되었다. 본 연구는 이러한 관점을 견지해 상품과 관련해 짐멜이 근대적 일상을 고찰하는 방식을 분석할 것이다. 특히 파편에서 출발하면서도 총체를 배제하지 않는 그의 독특한 사유에 주목하며 상품 분석에서도 이러한 사유가 일맥상통함을 밝히고자 한다. 이는 짐멜의 에세이 「1896 베를린 무역 박람회」(Berliner Gewerbeausstellung, 1896)를 면밀히 살핌으로써 가능할 것이다. 둘째, 근대 대도시 일상의 담지자로서 짐멜 이론에 나타나는 도시산책자의 군상을 분석할 것이다. 도시산책자의 인격적 구조 형성과 관련해 짐멜 이론 내에서 화폐뿐만 아니라 상품의 위상을 「대도시와 정신적 삶」(Die Großstädte und das Geistesleben, 1903)을 중심으로 검토할 것이다. This study analyzes the commodity and flaneur revealed in Georg Simmel’s theory. With the accelerated development of industry and technology from the middle of the 18th century, the capitalist order completely penetrated into modern everyday life, and was particularly intensively revealed in metropolis. the daily experience of modern life is in fact no different from experiencing the reality of capitalism. The metropolis has rapidly transformed into a market full of commodities, and the core of modern everyday life has become a commodity. Based on this perspective, this study will analyze the way Simmel considers modern everyday life in relation to commodity. His theory start from fragments, but do not exclude the totality. Paying attention to this, This study would like to clarify that these reasons are consistent in commodity analysis as well. This may be possible by closely examining Simmel’s essay “1896 Berliner Gewerbeausstellung”. Second, This study will analyze the flaneur appearing in Simmel’s theory as a bearer of everyday life in a modern metropolis. In relation to the formation of the inner structure of flaneur, the status of commodities as well as money within Simmel’s theory will be examined focusing on “Die Großstädte und das Geistesleben”.

약인성 간손상의 원인 산정

민현주 ( Hyun Ju Min ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

The diagnosis of drug-induced liver injury (DILI) is challenging due to the absence of specific biomarkers and noninvasive diagnostic tests for the disease. The diagnosis of DILI is still established on the basis of a careful history-taking and the exclusion of other causes of liver diseases. Some causality assessment methods in DILI have been developed and many surveys concerning their validity, reliability and reproducibility have been carried out as well. Current DILI causality assessment methods can be divided into two major categories: liver specific algorithm or scales and expert opinion. The Roussel Uclaf Causality Assessment Method (RUCAM), the first DILI causality assessment scale, not only has provided mediocre reliability and subjectivity in scoring each items, but it has also been more used in researches rather than in clinical practice. While expert opinion is considered to be the gold standard for diagnosing DILI, it carries inevitable subjectivity and limited reproducibility. The structured expert opinion process that was designed to overcome these limitations by the US Drug-Induced Liver Injury Network (DILIN) also remains incomplete. In this article, the advantages and limitations of causality assessment methods in the clinical setting are discussed with their brief introduction.

사례보고 : 만성 C형간염 환자에서 Peginterferon α-2b와 Ribavirin 병합치료 중 발생한 돌발성 난청 1예

신민기 ( Min Ki Shin ),김태효 ( Tae Hyo Kim ),주강 ( Kang Ju ),하창윤 ( Chang Yoon Ha ),민현주 ( Hyun Ju Min ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ) 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.3

돌발성 난청은 페그인터페론 치료 시에 발생하는 드문 부작용으로 알려져 있다. 저자 등은 60세 만성 C형간염 환자에서 페그인터페론알파와 리바비린 병합치료 중 42주째에 우측 귀에 돌발성 난청이 발생하여, 페그인터페론 치료를 중단하고 스테로이드 투여 후 완전히 회복된 사례를 경험하였다. 페그인터페론 치료 시 청력에 대한 세심한 관찰이 필요하며, 청력소실 발생 시 치료의 지속 여부에 대해서는 발생 시점, 환자의 치료 의지, 청력소실의 정도 등에 따라 임상의가 주의 깊게 판단해야 할 것으로 생각한다. Combination therapy of pegylated interferon α and ribavirin has been associated with various adverse effects, but sudden-onset hearing loss is uncommon. We report a 60-year-old male patient who developed sudden-onset hearing loss during combination therapy with pegylated interferon α and ribavirin for chronic hepatitis C. This patient had been diagnosed with chronic hepatitis C (genotype Ib) and early-stage liver cirrhosis 3 years previously, and had been treated with conventional interferon-α and ribavirin for 12 months. However, 6 months from the end of the treatment course the patient relapsed and received combination retreatment with pegylated interferon α-2b and ribavirin. He developed sudden-onset right-side hearing loss and tinnitus 42 weeks after the start of this retreatment. Pure-tone audiometry revealed a right-side hearing loss of 60~90dB. The patient consequently immediately discontinued the pegylated interferon therapy and was given prednisone 60 mg/day for 10 days, after which the hearing loss had almost completely recovered. (Korean J Hepatol 2009;15:370-374)