미숙아, 부당 경량아 및 과체중아에서 생후 2개월까지의 철상태에 관한 연구

윤신원,임인석,김철하,이동근,최응상,유병훈 중앙대학교 의과대학 의과학연구소 1995 中央醫大誌 Vol.20 No.2

The iron status of neonatal perioand shows variable changes dependent upon gestational age and birth weight. In general, compared with TAGA(term appropriate for gestational age), prematurity has been known to have exacerbated from of physiologic anemia and one of the possible contributable factor have been thought to e the lowered iron storage. But the iron status of TSGA(term small for gestational age) and TLGA(term large for gestational age) in early few months of life has not been clearly known yet. The purpose of this study was to compare the changes four groups. The iron status of the newborn was assessed cord blood hemogloin, corrected reticulocyte count, iron, TIBC, ferritin in TAGA(n=20), TSGA(n=11), TLGA(n=22) and prematurity(n=50) that were admitted to the Department of pediatrics, Chung-Ang University Hospital from June 1994 to February 1995. The follow up examinations were performed at 1, 2 months of postnatal period. The results are as follows 1) Mean cord blood hemoglobin levels in TAGA, prematurity, TSGA, TLGA at birth were 15.6±1.4 g/dl, 16.3±1.4 g/dl, 17.8±2.2 g/dl, 16.4±1.5 g/dl. There was statistical significances between TAGA and other three groups(P<0.05). 2) Mean cord blood iron level in TAGA, prematurity, TSGA, TLGA at birth were 229±48㎍/dl, 194±14㎍/dl. But there was no statistical significances. 3) mean cord blood TIBC levels in TAGA, prematurity, TSGA, TLGA at birth were 194±71㎍/dl,, 210±60㎍/dl, 280±80㎍/dl, 304±96㎍/dl. There was statistical significances between TAGA and other three groups(P<0.05). 4) Mean cord blood ferritin levels in TAGA, prematurity, TSGA, TLGA at birth were 170±48㎍/dl, 107±87㎍/dl, 108±68㎍/dl, 170±48㎍/dl. There was statistical significances TAGA and other three groups(P,0.05). 5) As a results of 2 months follow-up examination, the hemoglobin, corrected reticulocyte count, iron, ferritin levels were decreased and TIBC levels were increased in all groups and compared with TAGA, there was significant differences the othere three groups(P<0.05). In conclusion, blood hemoglobin, corrected reticulocyte count, iron, ferritin levels were significantly decreased and TIBC levels were significantly increased not only prematurity but also in TSGA, TLGA, so the marked impaired iron storage was noted in these groups in early few months of life. Further studies need to assess the postnatal affect of prolonged iron redistribution on fetal tissue, to prevent the exacervated form of iron storage and metabolic derangement, we speculate that this particular group of infant may be candidates for early few months of life iron supplementation.

「바리공주」 改作 作品의 談話 構造 分析 -年齡代別 改作 基準 마련을 위한 一考察-

윤신원 한국어문교육연구회 2010 어문연구(語文硏究) Vol.38 No.4

In literary works, the target readers' age group becomes the greatest factor in the transformation of a rewritten pieces. In rewriting the shamanistic mythology 「Barigongju」, the story structures of rewritten pieces for preschool children are simply arranged centering on the kernel, and they use a hearer-directivity style. The rewritten pieces for upper elementary school grades are composed of a story structures with the addition of various characters and incidents, and they use a speaker- directivity style. Also, in terms of the superficial narration of contents emphasized, the pieces for preschool children are developed with a process statement, the pieces for upper elementary school grades use both a process statement and a stasis statement; which exhibits a clear discourse difference. This implies that the rewriter considers a discourse factor, namely, the characteristic of readers by age group in rewriting the shamanistic mythology 「Barigongju」. Such a complex discourse suggests that valuable literary works may be consistently re-created as various rewritten pieces suited to readers by age group. 문학 작품을 兒童用으로 改作하는 데 있어 대상 아동의 年齡代는 개작 작품 變形의 가장 큰 요인이 된다. 本考에서 살펴본 무속신화 「바리공주」의 兒童用 개작 작품 중 幼兒用 작품의 이야기 구조는 核事件 중심으로 단순하게 배열되고, 聽者 指向的인 文體의 사용으로 口語的인 특징을 갖는다. 初等學校 高學年用 작품은 다양한 人物과 事件이 추가되어 이야기 구조가 구성되며, 話者 指向的인 文語的 文體를 사용한다. 또한 작품에서 강조하는 내용의 표면적인 서술에 있어서도 유아용은 行爲 陳述 중심으로, 초등학교 고학년용은 行爲 陳述과 靜態 陳述을 함께 사용하여 談話的 차이가 명확하게 나타난다. 이는 改作者가 무속신화 「바리공주」를 개작하는 데 있어 특정 연령대별 독자의 특성이라는 談話 要因을 염두에 두고 있음을 알 수 있다.

아동 독서 관련 유튜브 방송의 파라텍스트 기능 탐색

윤신원 한국사고와표현학회 2022 사고와표현 Vol.15 No.2

This study analyzed how Youtube children’s reading contents for children as paratext in digital media affects the children’s reading. As a result, first, the functions for text comprehension appeared as the front and structure of the maintext, reading the main idea, and visual devices. Second, the function to present a framework for interpretation appeared as the subject of text, some contents, title, visual device, individual experience, and other texts. Finaly, the function to induce interest in text appeared as an introduction to author and text, history of awards, format of text, visit to the location, and curriculum. Therefore, the results of this study can be used as a factor to enhance the reading behavior of children.

Congenital heart disease in the newborn requiring early intervention

윤신원 대한소아청소년과학회 2011 Clinical and Experimental Pediatrics (CEP) Vol.54 No.5

Although antenatal diagnostic technique has considerably improved,precise detection and proper management of the neonate with congenital heart disease (CHD) is always a great concern to pediatricians. Congenital cardiac malformations vary from benign to serious conditions such as complete transposition of the great arteries (TGA),critical pulmonary and aortic valvular stenosis/atresia, hypoplastic left heart syndrome (HLHS), obstructed total anomalous pulmonary venous return (TAPVR), which the baby needs immediate diagnosis and management for survival. Unfortunately, these life threatening heart diseases may not have obvious evidence early after birth,most of the clinical and physical findings are nonspecific and vague,which makes the diagnosis difficult. High index of suspicion and astute acumen are essential to decision making. When patent ductus arteriosus (PDA) is opened widely, many serious malformations may not be noticed easily in the early life, but would progress as severe acidosis/shock/cyanosis or even death as PDA constricts after few hours to days. Ductus dependent congenital cardiac lesions can be divided into the ductus dependent systemic or pulmonary disease, but physiologically quite different from each other and treatment strategy has to be tailored to the clinical status and cardiac malformations. Inevitably early presentation is often regarded as a medical emergency. Differential diagnosis with inborn error metabolic disorders, neonatal sepsis, persistent pulmonary hypertension of the newborn (PPHN)and other pulmonary conditions are necessary. Urgent identification of the newborn at such high risk requires timely referral to a pediatric cardiologist, and timely intervention is the key in reducing mortality and morbidity. This following review deals with the clinical presentations,investigative modalities and approach to management of congenital cardiac malformations presenting in the early life.

가와사끼병에서 혈중 지질과 지단백의 변화와심장 합병증에 미치는 영향에 관한 연구

윤신원,이호석,김동운,이강원,정영수 대한소아청소년과학회 2005 Clinical and Experimental Pediatrics (CEP) Vol.48 No.12

Purpose : Delineation of serum lipid and lipoprotein values in children after Kawasaki disease(KD) is important because of the predilection of this disease for the coronary arteries. Methods : The KD group was composed of 51 patients who were hospitalized from Jan. 2002 to Dec. 2003. Control was 25 patients with non-KD febrile illness. The levels of total lipid, phospholipid, triglyceride, HDL-cholesterol(HDL-C), LDL-cholesterol, total cholesterol, apolipoprotein A1(apo A1), apolipoprotein B, and Lipoprotein(a) were measured and compared with Echocardiographic findings. Measurements were obtained in four time periods: acute febrile, subacute, convalescent phase and 1 year after KD. Results : HDL-C(33.64±7.49 mg/dL vs 50.43±14.41 mg/dL, P<0.01) and apo A1(99.75±6.39 mg/dL vs 113.34±11.35 mg/dL, P<0.05) were decreased more in the acute febrile period of KD than in the control, but these changes were not correlated with cardiac complications. All lipid profiles were markedly elevated in the subacute stage and normalized in the convalescent stage; there were no changes until 1-year follow up. There were no significant differences in the changes of lipid profiles, including Lp(a) and coronary dilatation, in any time periods. Conclusion : KD is associated with important abnormalities in lipid metabolism, but these changes were transient and appear to be due to the disease itself. These data lead us to infer that KD dose not cause such permanent changes in lipid abnormalities as to be considered a risk factor for atherosclerosis, beyond that caused by the disease itself. 목 적 : 가와사끼병에서의 지질대사의 변화는 특히 이 병이 관상동맥을 직접 침범하는 질환이므로 특히 중요하다고 하겠다. 성인에 있어서 TC의 증가 및 HDL-C의 감소, Lp(a)의 증가는 죽상경화증의 중요한 위험인자의 하나로 알려져 있다. 이에 가와사끼병에서의 혈중 지질성분 및 지단백, Lp(a)의 시기별 변화와 관상동맥 병변과의 상관관계를 알아보고자 하였다.방 법 : 2002년 1월부터 2003년 12월까지 중앙대학교병원에서 가와사끼병으로 진단되어 고농도 감마글로불린으로 치료한 환아 51명을 대상으로 TL, PL, TG, HDL-C, LDL-C, TC, apo A1, apo B, Lp(a) 등을 급성발열기, 아급성기인 발열 2주, 회복기인 2개월, 1년 후 각각 측정하였고 초음파 검사 소견에 따라 비교분석 하였다. 또한 대조군으로는 나이와 성별을 고려한 가와사끼병이 아닌 급성발열성 질환으로 입원한 25명을 대상으로 삼았다.결 과 : 가와사끼병에서 급성 발열기에 대조군에 비하여 HDL- C(33.64±7.49 mg/dL vs 50.43±14.41 mg/dL, P<0.01)과 apo A1(99.75±6.39 mg/dL vs 113.34±11.35 mg/dL, P<0.05)이 통계적으로 의미있게 감소하였다. 그러나 관상동맥 확장이나 심염 등 심합병증 여부에는 큰 차이는 없었다. 아급성기에는 모든 지질성분이 통계적으로 의미있게 증가를 보였으며 발열 2개월째에는 모든 지질성분이 정상화되었고 발병 1년 후에 역시 정상범위였으며 어느 시기에서도 관상동맥 확장이 있었던 군과 정상인 군에서 지질성분의 통계적 차이는 없었다.결 론:가와사끼병의 급성발열기에 HDL-C의 및 apo A1의 감소를 보였으며 발병 2주째에는 모든 지질성분이 일시적으로 통계적으로 의미있게 증가하였다. 그러나 이런 변화는 발열 2달째에는 모두 정상화되었으며 1년 경과 후에도 계속 정상소견을 보였다. 어느 시기에도 관상동맥병변이 있었던 군과 정상관상동맥을 보였던 군에서 지질성분의 의미있는 차이는 없어 이러한 급성기의 일시적인 HDL-C과 apo A1의 감소는 가와사끼병의 관상동맥 병변 여부나 장기적인 예후와는 직접적인 큰 상관은 없고 급성혈관염이라는 염증 반응의 하나의 현상으로 사료된다. 그러나 이들이 후에 성인이 되었을 때 동맥경화발현에 미치는 영향에 대해서는 더 많은 연구가 필요하리라 생각된다.

아동 독서를 위한 파라텍스트의 활용 연구 - 독서 관련 유튜브 방송을 중심으로

윤신원 한국문화융합학회 2023 문화와 융합 Vol.45 No.5

This study aims to find a reading method that can apply youtube reading contents for children, treating a new type paratext that appeared in the digital media environment. Through this, it is intended to confirm the new value and utility interacting between paratext in the digital media environment and reading behavior. As a result, youtube reading contents for children interacts with the maintext and constructs the meaning of the text, provides scaffolding to the reader's reading behavior, and becomes a literacy sponsor in the reading process. Therefore, the results of this study are meaningful in that they recognized media and reading behavior as a complementary relationship and suggest that it is necessary to study the various interactions between the digital media and the reading behavior.

그림책의 시각적 장치에 따른 읽기 방식 특성 연구

윤신원 한국어린이문학교육학회 2019 어린이문학교육연구 Vol.20 No.1

본고의 목적은 그림책의 시각적 장치가 독자의 읽기 방식에 어떠한 영향을 미치는지에 대해 고찰하여, 읽기 방식의 차이를 발생시키는 그림책의 다양한 시각적 장치들에 대해서 면밀하게 고려해야 함을 제안하는 데 있다. 이에 글과 그림이 동일한 백희나의 『구름빵』과 번역 그림책인 『Cloud Bread』의 시각적 장치에 따른 읽기 방식을 분석하여, 글과 그림이 동일하더라도 다양한 시각적 장치의 차이로 인해 독자의 읽기 행위는 상이하게 나타남을 알 수 있었다. 『구름빵』의 시각적 장치들은 텍스트와 독자 사이의 일정한 거리를 유지하게 하여 독자가 텍스트의 내용을 접할 때 객관적인 태도와 동일시하는 태도를 공존하게 한다. 이에 비해 『Cloud Bread』의 시각적 장치들은 텍스트와 독자 사이의 거리를 가깝게 유도하여 독자가 역동적으로 텍스트의 의미를 구성하게 하고 텍스트의 주요 내용에 몰입하게 한다. 대중매체의 발달로 새로운 형태의 그림책이 출현하고 있는 현시점에서 시각적 장치에 따른 읽기 방식의 차이를 검토한 본고의 결과는, 글과 그림 뿐 아니라 그림책의 다양한 시각적 장치들이 독자의 읽기 방식과 관련하여 반드시 고려되어야 함을 시사한다. This study analyzes how the visual device of a picturebook affects the reading acts of the reader, and suggests that the various visual devices of picturebooks which cause differences in the reading acts, should be carefully considered. Thus, reading behaviors were analyzed according to the visual devices of Beak, Heena's "Gureumppang" and a translation of the picturebook "Cloud Bread". As a result, even though the text and pictures are the same, the reading acts differed because of the differences in the various visual devices. "Gureumppang"'s visual devices keep a constant distance between the text and the reader. Thus, the reader reads the text objectively and gets closer to the character. The visual devices of "Cloud Bread" bring the distance between the text and the reader closer. Thus, the reader dynamically composes the meaning and immerses himself in the main content of the text. Therefore, the results of this study suggest that the various visual devices of picturebooks as well as texts and pictures should be considered in relation to the reading acts.

설명 텍스트의 연령대별 담화 구조 분석- 초등학교 1, 6학년 읽기 교과서 대비 고찰

윤신원 한국텍스트언어학회 2012 텍스트언어학 Vol.33 No.-

This study were analyzed expository text for Grade1 and Grade6 in the by rhetorical structure theory. The primary rhetorical relations of the expository text for Grade1 are joint and elaboration. Also there is characterized by repeating the same structure. It is important to present to the topic of the explanation simply and clearly,and is necessary to understand the content through repetition. The primary rhetorical relations of the expository text for Grade6 are evaluation and cause/result. And also it shall be described to the background and circumstance for the topic of the explanation. Because old children have appeared in the variety of perspectives on the description of the topic and they are interested in analyzing of the text which is presented more logically. The rhetorical structure theory clearly can be shown the discourse structure of children's texts by the age group and it’s also useful creating the text.

시민단체와 연계한 환경교육

윤신원 한국환경교육학회 2018 한국환경교육학회 학술대회 자료집 Vol.2018 No.12

7차 교육과정 사회과 통합에 대한 비판 : 지리과의 입장

윤신원 역사교육연구회 2001 역사교육 Vol.79 No.-