전문적 지지모임이 정신분열병 환자 가족의 자기효능감과 부담감에 미치는 영향

현명선 ( Myung Sun Hyun ),김혜용 ( Hyue Yong Kim ),남경아 ( Kyoung A Nam ),윤선희 ( Sun Hee Yun ),이현아 ( Hyun Aha Lee ),추자희 ( Ja Hee Chu ) 한국정신간호학회 2004 정신간호학회지 Vol.13 No.2

N/A Purpose: This study examined the effects of the professional support group on self-efficacy and burden of the family members with a schizophrenic patient. Method: This study used a non-equivalent control group pre-post design. The data was collected from April, 2002 to December, 2002. The subjects consisted of 21 family members. The experimental group(n=11) participated in a support group that consisted of 3 sessions(3-week period); the control group(n=10) did not participate in. To examine the effects of the professional support group, self-efficacy and burden of the family were measured before and after the program. Result: In the experimental group, there was no significant change in self-efficacy after the program (Z=-.059, p=.953). The scores of burden increased after the program but did not significantly change (Z=-1.572, p=.116). In the control group, there was no significant change on self-efficacy after the intervention period (Z=-.339, p=.735). The scores of burden increased after the program but did not significantly change (Z=-.722, p=.440). Conclusion: Although the professional intervention that aims to increase self-efficacy and decrease burden for family with mentally ill relatives is important.

비전이성 골육종환자에서 술전 Cisplatin, Adriamycin 복합항암화학요법의 효과

오현아 ( Hyun A Oh ),이구 ( Gu Lee ),강희정 ( Hee Jung Kang ),이재련 ( Jae Lyun Lee ),이경희 ( Kyung Hee Lee ),현명수 ( Myung Soo Hyun ),신덕섭 ( Duk Sub Sin ),배성화 ( Sung Hwa Bae ),류헌모 ( Hun Mo Ryoo ) 대한내과학회 2003 대한내과학회지 Vol.65 No.1

목적 : 골육종환자에서 cisplatin과 adriamycin을 사용한 술전 화학요법을 시행하여 반응율 및 생존율을 알아보고자 하였다. 방법 : 골육종 환자 24명 중 보조요법만 시행한 4명의 환자를 제외한 20명의 환자를 대상으로 술전 화학요법과 술후 화학요법을 시행한 14명의 환자군을 A군으로 하고 술후에 화학요법을 시행한 6명의 환자군을 B군으로 하였다. A군 중 12명은 사지구제술을 시행하고 2명은 진행하여 사지절단술을 시행하였고 B군 중 사지외 Background : Adjuvant chemotherapy is the most accepted treatment for localized osteosarcoma. We studied the effectiveness of preoperative cisplatin and adriamycin combination chemotherapy in non-metastatic osteosarcoma. Methods : Twenty four cases of pat

단전이성 뇌종양의 임상 양상과 예후 인자

이재련(Jae Lyun Lee),신창진(Chang Jin Shin),강희정(Hee Jeong Kang),오현아(Hyun Ah Oh),이구(Gu Lee),최재혁(Jae Hyuk Choi),배성화(Sung Hwa Bae),이경희(Kyung Hee Lee),현명수(Myung Soo Hyun),신세원(Sei One Shin),류헌모(Hyun Mo Ryoo) 대한내과학회 2002 대한내과학회지 Vol.62 No.4

목적 : 전이성 뇌종양은 성인 악성 종양환자의 흔한 합병증이다. 저자 등은 전이성 뇌종양의 임상적인 특징, 치료 효과, 생존에 영향을 미치는 예후 인자를 알아보고자 하였다. 대상 및 방법 : 1991년 1월부터 1997년 12월까지 본원에서 전이성 뇌종양으로 진단 받은 97예의 환자를 대상으로 하여 후향적으로 분석하였다. 결과 : 뇌전이의 원발종양으로는 폐암 (61예, 63%)이 가장 흔하였으며 그 외 원발 불명 전이성 뇌암 (15예, 16%), 위장관암 (13예, 13%), 유방암 (6예, 6%), 신장암 (2예, 2%) 순이었다. 단일성 뇌전이는 44예 (45%)였으며 다발성 뇌전이는 53예 (55%)였다. 치료 유무 및 종류를 고려하지 않을 경우 중앙생존기간은 3개월이었으며 1년 생존율은 8%였다. 생존율에 영향을 미치는 유의한 예후인자로는 진단당시 활동능과 신경손상의 정도 (p< 0.01)였다. 어떠한 치료도 시행하지 않는 군에 비해 스테로이드를 포함한 치료를 시행한 군에서 유의한 생존기간의 증가를 관찰할 수 있었다 (1.1개월 대 3.7개월). 스테로이드 단독 치료에 비해 전뇌 방사선 조사를 추가한 군에서 유의하게 생존기간이 연장되었다 (2.2개월 대 4.8개월). 추가적인 항암화학요법은 유의한 생존기간의 향상을 가져오지는 못하였다. 수술적 절제술을 시행한 군의 중앙생존기간은 8.8개월로 스테로이드와 전뇌 방사선치료만 시행한 군에 비해 유의한 생존기간의 증가를 보였다. 결론 : 전이성 뇌종양 환자에서 전뇌 방사선치료와 스테로이드는 유용한 완화치료 방법이며 진단 당시 활동능과 신경손상의 정도가 중요한 예후 인자로 분석되었다. 후향적인 연구로 인해 결과 해석에 한계가 있으나 수술적 절제 및 항암화학요법이 일부 선택된 환자 치료시 중요한 수단이 될 것으로 사료된다. Background : Brain metastasis is a common complication in cancer patients. We evaluated the clinical characteristics, treatment outcome and prognostic factors for patients with metastatic brain tumor. Methods : The records of 97 patients with metastatic brain tumor during the period from January 1991 to November 1997 were reviewed retrospectively. Results : The most common primary tumor is lung cancer (61 cases, 63%) followed by metastatic cancer unknown primary site (15 cases, 16%), gastrointestinal cancer (13 cases, 13%), breast cancer (6 cases, 6%) and renal cancer (2 cases, 2%). There were 44 patients with a single brain metastasis and 53 patients with multiple brain metastases. The median survival was 3.0 months and one-year survival rate was 8% irrespective of treatment. Favorable prognostic factors which affect survival were ambulatory status (p<0.01) and functional neurologic class 1, 2 (p<0.01). Median survival was 3.7 months for patients with steroid therapy and 1.1 months with no therapy (p<0.01). Median survival was 4.8 months for patients with steroid therapy plus whole brain radiotherapy (WBRT) and 2.2 months with steroid therapy alone (p<0.01). Additional chemotherapy did not appear to affect the survival. The patients treated with surgery had median survival time of 8.8 months compared with 2.5 months for patients treated with steroid therapy plus WBRT (p<0.05). Conclusion : In present study, we confirmed that whole brain irradiation and corticosteroid administration are effective palliative treatment for patients with metastatic brain tumor. Initial performance status and neurological function were identified as important prognostic factors. Although confounded by the limitations of retrospective study, more aggressive treatments including surgery and chemotherapy could be regarded to have a significant role to achieve better treatment outcome in some selected cases.(Korean J Med 62:444-452, 2002)

야간성 기관지천식 환자에서 체위에 따른 Peak Expiratory Flow Rate 의 변화와 그 기전의 고찰

이경희(Kyung Hee Lee),김태년(Tae Nyeon Kim),김필영(Pill Young Kim),현명수(Myung Soo Hyun),이영현(Young Hyun Lee),정재천(Jae Chun Chung),이현우(Hyun Woo Lee) 대한내과학회 1988 대한내과학회지 Vol.34 No.6

N/A Nocturnal attacks of brochospasm is a well-known phenomenon in bronchial asthma. In spite of numerous studies to indentify Its mechanism, its positional effect have not been carefully studies. 8 patients of bronchial asthma with history of nocturnal attack and 7 healthy comparable control patietns were evaluated for changes of PEFR on the different body positions, and found that PEFR was 1) lower at supine than sitting position (218+35 vs 253+61) 2) decreased progressively by keeping on supine position 3) lowest at 90 minutes of supine position 4) partially recovered on left lateral position (190+50 vs 211+61) 5) fully recover~3 immediately after return to sitting position In conclusion, PEFR was significantly influenced by changes of body postion and it should be one of the mechanisms of nocturnal attack of bronchospasm in bronchial asthma.

당뇨병성 심혈관계 자율신경병증 환자에서 Corrected QT 간격 연장에 관한 연구

박종선(Jong Seon Park),이찬우(Chan Woo Lee),전준하(Jun Ha Jeun),정성복(Seong Pok Cheong),원규장(Kyu Chag Won),이충기(Choong Ki Lee),현명수(Myung Soo Hyun),최수봉(Soo Bong Choi),이현우(Hyun Woo Lee),이인규(In Kyu Lee) 대한내과학회 1992 대한내과학회지 Vol.43 No.1

N/A Background: Diabetic cardiac autonomic neuropathy may result in sympathetic imbalance and QTc interval prolongation, predisposing these patients to arrhythmias and sudden death. A simple method for evaluating alterations in cardiac sympathetic innervation may be measurement of the QTc interval. We investigated the relations between QTc interval and diabetic cardiac autonomic neuropathy. Methods: Fifty five patients with type-II diabetics were separated into 4 groups based on the presence and degree of cardiac autonomic neuropathy (CAN) with noninvasive cardiovascular autonomic reflexes and blood pressure response. None of the patients had evidence of ischemic heart disease, or the idiopathic long QT interval syndrome. The corrected QT interval (QTc) was determined at rest with Bazett`s formula. Results: Diabetic patients with ³ 1 abnormality had a prolonged QTc interval compared with a control group of 55 healthy non-diabetic subjects (mean±SD 401±2msec) (p<0.001) and diabetic patients with ³2 abnormalities of cardiac autonomic function had a longer QTc interval than those with no evidence of CAN. There was a direct linear relationship between the severity of CAN and the QTc interval (r=0.559, p<0. 001), and the frequency of prolonged (>434msec, normal mean+2SD) resting QTc interval increased with the increasing number of abnormalities (CAN score 0, 1, 2, ³3:0%, 8%, 54%, and 63%), respectively. 15 patients had a prolonged QTe interval (mean 447msec) and 40 patients had a normal QTc interval (mean 414msec). The two groups were comparable in age (56 vs. 58yrs), and duration of diabetes (9 vs. 8yrs) and not comparable in degree of glycemic control (HbA1c 11.6 vs. 14.3%). All of 15 patients with a prolonged QTc interval had evidence of CAN. However, 32% (15 of 47) of patients with CAN had a prolonged QTc interval. Conclusion: These results suggest that the resting QTc interval may be an additional, noninvasive diagnostic tool in the assessment of CAN in patients with diabetes mellitus.

여자 청소년의 흡연행위의 변화단계에 따른 변화전략

현명선 ( Myung Sun Hyun ),강희선 ( Hee Sun Kang ),이영자 ( Young Ja Lee ) 한국정신간호학회 2007 정신간호학회지 Vol.16 No.3

여자 청소년의 흡연행위 변화기전 연구

현명선 ( Myung Sun Hyun ),이영자 ( Young Ja Lee ),남경아 ( Kyoung A Nam ) 한국정신간호학회 2004 정신간호학회지 Vol.13 No.3

N/A Purpose: This study was to identify the change mechanism that female adolescents use to progress through the smoking behavior change. Method: This study used a cross-sectional survey design. The data was collected from December, 2003 to January, 2004. The subjects included in this study were 125 female high school students in smoking or in smoking cessation. To identify the change mechanism, the factor analysis of the change mechanism (40 items) suggested by Prochaska et al.(1988) was conducted. Result: Nine factors of change mechanism were identified - emotional appraisal, counter conditioning, self-regulation, reinforcement management, helping relationship, self-determination, environmental reevaluation, social liberation, consciousness raising. Self-regulation change mechanism among those nine factors was found to include items related to both experiential and behavioral dimensions, therefore, this change mechanism can be considered as transitional one. Conclusion: Those change mechanism that female high school students use to progress through behavior change in this study identified in this study can provide the framework in developing programs for helping smoking cessation among female adolescents.

간경변 및 간암과 혈청 구리와 아연농도와의 관련성

현명수,서석권,윤능기,이종영,이승훈,이무식,Hyun, Myung-Soo,Suh, Suk-Kwon,Yoon, Nung-Ki,Lee, Jong-Young,Lee, Seoung-Hoon,Lee, Mu-Sik 대한예방의학회 1992 예방의학회지 Vol.25 No.2

현재까지도 완전히 규명되지 못한 간질환과 혈청 구리 및 아연농도와의 관련성을 밝히고, 이들의 진단적 가치를 알아보고자 1990년 10월에서 1991년 8월 사이에 대구시 소재 모 대학병원 내과와 건강진단센터에 내원한 사람들 중에서 무작위로 선정한 정상 63명, 간경변 60명 그리고 간암 33명을 대상으로 일반적 특성을 조사하였고, 체내 일일 변동을 고려하여 공복시 오전 9시에서 11시 사이에 혈액을 채취하여 간기능검사의 생화학적 표지자와 혈청 구리 및 아연농도의 분석에 사용하였다. 혈청 구리의 평균농도는 대조군 $91.97{\pm}4.76{\mu}g/dl$, 간경화군 $106.21{\pm}2.73{\mu}g/dl$ 그리고 간암군 $127.05{\pm}0.77{\mu}g/dl$이었고, 대조군과 간경화군 사이에 통계적으로 유의한 차이는 없었으나, 간경화군과 간암군사이에는 통계적으로 유의한 차이를 보였다(p<0.05). 아연에 있어서는 대조군 $110.82{\pm}7.24{\mu}g/dl$,간경화군 $68.10{\pm}5.43{\mu}g/dl$ 그리고 간암군 $63.78{\pm}2.20{\mu}g/dl$로 나타났고, 간경화군과 간암군 사이에 통계적으로 유의한 차이는 없었으나, 대조군과는 두 군 모두 통계적으로 유의한 차이를 보였다(P<0.05). Cu/Zn비는 세 군 사이에 모두 통계적으로 유의한 차이가 있었다(p<0.05). 간기능검사의 생화학적 표지자들 중에 총 단백, 알부민, ALP 그리고 총 빌리루빈은 세 군 간에 모두 통계적으로 유의한 차이가 있었으나(p<0.05), ALT와 AST의 간경화군과 간암군 간의 차이는 통계적으로 유의하지 않았고, 직접 빌리루빈은 대조군에 대해 간암군에서 통계적으로 유의한 차이가 없었다. 헐청 구리와 아연농도 그리고 Cu/Zn비와 통계적으로 유의한 상관관계를 보인 표지자는 세 군에서 다양하게 나타났다. 다중 로지스틱 회귀분석에서 간경화 및 간암에 대한 odds ratio는 혈청 아연농도만이 각각 0.951, 0.952로 통계적으로 유의하였고(p<0.05), 혈 청 구리 농도와 Cu/Zn비는 통계적인 유의성이 없었다. 세 군에 대한 판별분석에서 구분을 위한 주요변수로 선정된 것은 알부민, ALP, 혈청 아연농도, 나이 그리고 총 빌리루빈이었고, 이를 적용하여 판별한 결과 바른구분의 백분율은 대조군 95.4%, 간경변군 73.4%, 간암군 75.7%로 총 84.0% 였다. 본 연구는 아연이 간질환에 대해 독립적으로도 억제하는 효과가 있을 것이며, 혈청 아연농도의 측정은 간질환의 진단에 유용하게 이용될 수 있을 것임을 시사하고 있다고 생각된다. This study was done to identify the association between serum copper and zinc levels and the cirrhosis and hepatocellular carcinoma(HCC), and to evaluate its diagnostic value on liver diseases. Sixty-three healthy persons, 60 patients with cirrhosis and 33 patients with hepatocellular carcinoma were rendomly selected and investigated for their general characteristics from October 1990 to August 1991. For analysis of the biochemical markers in liver function test and the serum copper and zinc levels, their fasting venous blood were sampled at 9:00 to 11:00 in the morning and centrifuged to separate the serum within one hour. All the samples were immediately analysed for biochemical markers and stored at $-20^{\circ}C$ in polypropylene tubes further copper and zinc analysis. Mean of serum coppper levels was $91.97{\pm}4.76{\mu}g/dl$ in control, $106.21{\pm}2.73{\mu}g/dl$ in cirrhosis and $127.05{\pm}0.77{\mu}g/dl$ in HCC. The value of HCC was statistically significantly higher than that of the control and cirrhosis(p<0.05). Serum zinc levels were $110.82{\pm}7.24{\mu}g/dl$ in control, $68.10{\pm}5.43{\mu}g/dl$ in cirrhosis and $63.78{\pm}2.20{\mu}g/dl$ in HCC. The values of cirrhosis and HCC were statistically significantly lower than that of control(p<0.05). The Cu/Zn ratio was statiatically significantly different among three groups(p<0.05). Test total protein, albumin, ALP and total bilirubin of biochemical markers of liver function were statistically significantly different among three groups(p<0.05). Differences between cirrhosis and HCC for ALT and AST, and between the control and HCC for direct bilirubin were not statistically significant. Biochemical markers statistically significantly correlated with serum copper and zinc levels and Cu/Zn ratio(p<0.05), were variable in three groups. In multiple logistic regression, odds ratio of serum copper level and Cu/Zn ratio had no statistical significance on the cirrhosis and the HCC, but that of serum sinc was statistically significant as 0.951 and 0.952(p<0.05). Serum copper and zinc levels and Cu/Zn ratio were not statistically significantly different between the cirrhosis and HCC. H\Albumin, ALP, zinc, total bilirubin and age among all variables were selected as main variables for three-group discriminant analysis. Percentage of 'grouped' cases correctly classified by these five variables was 98.4 for control, 73.4 for cirrhosis, 75.7 for HCC and 84.0 for all subjects. This study suggests that zinc level is considered to play a role as diagnostic marker on the hepatic disorders and be more useful than serum copper level and Cu/Zn ratio in diagnosis of the liver diseases.

濟州 自生 새우란, 금새우란, 왕새우란의 원예품종화

현명력(Hyun Myung-Ryuk),최지용(Choi Ji-Yong),서정남(Suh Jung-Nam),소인섭(So In-Sup),이종석(Lee Jong-Suk) 한국원예학회 1999 원예과학기술지 Vol.17 No.3

여자 청소년의 흡연행위의 변화단계에 대한 판별요인 -의사결정균형과 자기효능감을 중심으로-

현명선 ( Myung Sun Hyun ),이영자 ( Young Ja Lee ) 한국정신간호학회 2007 정신간호학회지 Vol.16 No.4