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Burkitt's Lymphoma Representing Periportal Infiltraing Mass on CT
박계영,류정식,윤상욱,박미숙,구자승,김기황 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.4
Imaging findings of secondary hepatic lymphoma have been reported as variable, ranging from single or multiple small nodules to diffuse infiltrative tumor patterns. We hear present a rare case report concerning aggressive B cells, secondary Burkitt's lymphoma in non-AIDS demonstrating a surprising periportal lymphoma infiltration, without upper abdominal lymphadenopathy or splenomegaly on the sonography and CT scans. Clinically, the case was characterized by atypical and highly aggressive course, with the patient presenting an abruptly developed obstructive jaundice with rapidly deteriorating hepatic function that could be indicative of cholestatic hepatitis, which differs in its clinical manifestations from hepatic lymphoma without functional deterioration in respect of its non-tissue destructive growth pattern. We suggest that hepatic lymphoma can sometimes be consistent with periportal infiltrating homogeneous mass, with no lymphadenopathy or splenomegaly on the imaging examination, with a predictable aggressive clinical course of the disease and poor prognosis.
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결핵환자에서 IFN-${\gamma}$ 수용체의 기능적 및 유전적 이상에 관한 연구
박계영,황유진,임영희,안창혁,박정웅,정성환,Park, Gye-Young,Hwang, You-Jin,Lim, Young-Hee,An, Chang-Hyeok,Park, Jeong-Woong,Jeong, Seong-Hwan 대한결핵및호흡기학회 2002 Tuberculosis and Respiratory Diseases Vol.52 No.5
연구배경 : 결핵의 방어면역에서 IFN-${\gamma}$는 매우 중요한 역할을 한다. IFN-${\gamma}$ 수용체의 완전결손이 있는 환자는 Mycobacterium 감염에 감수성이 높아서 매우 치명 적이다. 매우 드문 일부 Mycobacterium 감염에서 IFN-${\gamma}$ 수용체의 완전결손 외에 여러 종류의 부분결손들과 STAT1의 돌연변이들이 알려져 있다. 특히, IFN-${\gamma}$ 수용체의 부분결손이 있는 환자들의 경우 병리학적 소견파 임상적 경과가 일반적 결핵과 유사한 소견을 보이는 것으로 알려져 있다. 방 법 : 임상적 결핵환자에서 IFN-${\gamma}$ 수용체의 기능을 평가하여 대조군과 비교하였다. IFN-${\gamma}$ 수용체의 이상이 있을 가능성이 가장 높은 파종성 결핵환자의 DNA에서 앞서 발표된 증례들에서 확인된 IFN-${\gamma}$ 수용제와 STAT1의 유전적 이상을 확인하였다. 결 과 : 말초혈액 단핵구를 recombinant IFN-${\gamma}$ (100, 1000IU/ml)로 자극하였을 때 대조군과 환자군에 모두 HLA-DR과 CD64의 발현이 증가하였으나, 두 군간의 차이는 없었다. 대조군과 환자군에서 모두 LPS자극하였을 때 TNF-${\alpha}$의 생산이 증가하였으며 IFN-${\gamma}$로 전처치 후에 다시 LPS로 자극하였을 때 TNF-${\alpha}$의 생산은 더욱 더 증가하였다. 그러나, 두 군간의 통계적으로 유의한 차이는 없었다. 파종성 결핵 환자에서 기존에 알려진 IFNgR1과 STAT1의 돌연 변이를 확인하였을 때 특이한 이상소견을 발견할 수 없었다. 결 론 : 임상적 결핵에서 IFN-${\gamma}$ 수용체의 기능적 및 유전적 이상을 확인할 수 없었다. 기존의 연구에서 BCG와 NTM 감염과 관련 있는 것으로 알려진 IFN-${\gamma}$수용체의 이상 만으로는 임상적 결핵의 개체감수성을 설명할 수 없었다. Background : INF-${\gamma}$ plays an important role in the host response to a mycobacterial infection. A complete IFN-${\gamma}$ receptor 1 deficiency is a life threatening condition because it renders patients highly susceptible to a mycobacterial infection. Several mutations in the IFN-${\gamma}$ receptor and STAT1 gene have been identified in the rare mycobacterial infections. These mutations have partial function of the IFN-${\gamma}$ receptor and similar pathologic features to clinical tuberculosis. Materials and Methods : The function of the IFN-${\gamma}$ receptor was evaluated in the patients with clinical tuberculosis. In addition, the DNA coding sequence of the IFNgR1 and STAT1 gene was also analyzed in disseminated tuberculosis patients who might have a defective IFN-${\gamma}$ receptor. Results : The cell surface expression levels of HLA-DR and CD64 in the PMBC after being stimulation with IFN-${\gamma}$ (100IU/ml, 1000IU/ml) were increased in both controls and patients. However, the rate of increase in both groups was similar. The production of TNF-${\alpha}$ in the response to stimulation with LPS was higher in the both groups ($850.7{\pm}687.8$ vs. $836.7{\pm}564.3$ pg/ml). Pretreatment with IFN-${\gamma}$ prior to LPS stimulation resulted in further increase in TNF-${\alpha}$ production between both groups ($2203.5{\pm}242.5$ vs. $2227.5{\pm}560.4$ pg/ml). However, the rate of the increase in TNF-${\alpha}$ production in the both groups was similar. The known mutations in the IFNgR1 and STAT1 coding sequences were not found in the genomic DNA of patients with disseminated tuberculosis. Conclusion : The functional and genetic defects of the IFN-${\gamma}$ receptor were not identified in clinical tuberculosis. This suggests the defective IFN-${\gamma}$ receptor that predispoe patients to a BCG or NTM infection can not alone account for the cases of clinical tuberculosis.
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의과대학 4학년 학생의 임상진료시험(Clinical Practice Examination) 진단고사 성적 예측요인 분석
박계영 한국의학교육학회 2015 Korean journal of medical education Vol.27 No.4
Purpose: Clinical performance examination (CPX) has been used to assess clinical competence as one step of medical license examination. Initial CPX score of the fourth year medical student is important since it indicates how to prepare successfully for the final examination. This study was conducted to assess the predictors of CPX scores of the fourth year medical students who completed core clinical clerkship. Methods: One hundred eleven fourth year medical students took a formative CPX in February. The score was compared with the scores of cognitive area and those of behavioral area which students had acquired in the past. We analyzed the correlation between the scores and determined the predictors of the fourth year CPX score. Results: The fourth year CPX score showed stronger correlation with the scores of behavioral area than those of cognitive area. The significant predictors of fourth year CPX score included third year simple procedure exam score and third year clerkship CPX score. The risk factors for low fourth year CPX score included second year patient-physician interaction (PPI) score and third year CPX score after adjusted for age, sex, and school type. The risk factors of being selected as a low PPI score group of fourth year included low PPI scores of first, second, and third year exams. Conclusion: Our study highlights importance of educational balance between cognitive and behavioral areas. To improve clinical competence of final year medical students, clinical interview training using standardized patient with other modules is to be enhanced and initiated early in the medical curriculum.
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조리전공 학생의 조리실습 교육환경이 교육만족에 미치는 영향에 관한 연구 -진로결정 자기효능감의 매개효과를 중심으로
박계영,김영춘 사단법인 한국융합기술연구학회 2022 아시아태평양융합연구교류논문지 Vol.8 No.10
The purpose of this study is to investigate whether the culinary education environment and career decision self-efficacy of culinary major students have an effect on culinary education satisfaction. The survey was conducted from November 29 to December 17, 2021, targeting students majoring in culinary arts at two-year colleges in Jeollanam-do, Jeonrabuk-do and Chungcheong Province. Change of 230 data collected, 216 valid questionnaires were used as final analysis data. As a result of the analysis, it was found that, first, the satisfaction of culinary education was significantly affected in the order of education program, teaching ability, administrative service, and self-efficacy in career decision. Second, it was found that there was a significant effect on the self-efficacy of career decision making in the order of teaching ability, cooking practice facilities, and educational programs, and administrative services had no effect. Finally, it was verified that career decision self-efficacy plays a partial mediating role in the causal relationship between cooking environment and educational satisfaction, such as cooking education ability, educational programs, cooking practice facilities, and administrative services. Based on the results of this study, the implications for improving the culinary education satisfaction of culinary major students are as follows. First, the contents of the cooking practice lectures should be made into videos so that they can be used continuously while watching the videos and used as educational materials. Second, it is necessary to develop and operate a culinary major certificate acquisition program by sharing opinions with students. Third, there is a need to privide students with career and employment-related information and to give special lectures by inviting seniors or external lecturers related to their major through counseling with students so that they can gain confidence. Fourth, it is important to create various clubs to participate in major-related competitions and various peddlings, to support field training, and to create a scholarship system so that students can participate directly. 본 연구는 조리전공 학생들의 조리 교육환경, 진로결정 자기효능감이 조리교육 만족에 미치는 영향을 미치는지를 규명하는데 있다. 설문조사는 2021년 11월 29일부터 12월 17일까지 전남·북, 충남 지역 2년제 대학의 조리전공학생을 대상으로 실시하였다. 이 중 유효한 216부의 설문지를 최종적인 분석자료로 사용하였다. 분석 결과, 첫째, 교육프로그램, 교수교육능력, 행정서비스, 진로결정 자기효능감 순으로 조리교육 만족에 향을 주는 것으로 나타났다. 둘째, 교수교육능력, 조리실습시설, 교육프로그램 순으로 진로결정 자기효능감에 영향을 미치는 것으로 나타났으며, 행정서비스는 영향을 미치지 않는 것으로 나타났다. 마지막으로 조리교육능력, 교육 프로그램, 조리실습 시설, 행정서비스 등 조리환경과 교육만족 간의 인과관계에서 진로결정 자기효능감이 부분 매개역할을 하는 것으로 검증되었다. 이러한 연구 결과를 바탕으로 조리전공학생들의 조리교육 만족도를 향상시키기 위한 시사점은 다음과 같다. 첫째, 조리실습 강의 내용을 영상으로 만들어 계속적으로 동영상을 보면서 활용하며, 교육자료로 활용할 수 있도록 해야 할 것이다. 둘째, 학생들과 의견을 나누어 조리전공 자격증 취득 프로그램을 개발하여 운영해야 할 것이다. 셋째, 진로 및 취업관련 정보 제공 및 학생들과 상담을 통해 전공관련 선배나 외부강사 초청 특강 등을 진행하여 학생들에게 자신감을 가질 수 있도록 해야 할 것이다. 넷째, 다양한 동아리를 만들어 전공관련 대회 및 각종 행상 참여, 현장실습 지원 및 장학제도를 만들어 학생들이 직접 참여할 수 있도록 해야 할 것이다.
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