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장성옥 대한간호학회정신간호학회 1994 정신간호학회지 Vol.3 No.1
Mr. Suh, the narrator of this life history was a man who was twenty-nine year sold and was occupied in the field of paramedicine. The narrations of life history present the way a person conceptualized the stream of experience that constitute his life as he knows it, so through analysis of life history, operating characteristics of the context can be identified. The purpose of this paper is to describe the characteristics of the sociocultural context in Korean through a life history of a man being occupied in the field of paramedicine. Nursing is a profession practiced on the basis of humanism. Therefore, nursing science should take its starting point in understanding about context of human being. A human being is always within the world, lives a life through the world and know himself in the word. Interpersonal communications and human behaviors reflect the consensus of social life. The characteristic of life history is subjective. Therefore the datas are analysed by taking perspectives of phenomenology and hermeneutics. In depth interviews and observations were carried out from June, 1992, through June, 1993. and datas were classified by 6 categories ; those were growing process, family view, married view, evaluation of present occupation, evaluation of medicine, and desire of the future. The result presented the view points about : those were 1) the sociocultural background of a man in middle class. 2) the meaning of legitimate field. 3) the changing point of a man 4) the power of money 5) the evaluation about paramedicine in health care system.
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마우스 EAE, GVHD 질환에서 CTLA4Ig 융합단백의 면역치료 효과
장성옥,홍수종,조훈식,정용훈,Jang, Seong-Ok,Hong, Soo-Jong,Cho, Hoon-Sik,Chung, Yong-Hoon 대한면역학회 2003 Immune Network Vol.3 No.4
Background: CTLA4 (CD152), which is expressed on the surface of T cells following activation, has a much higher affinity for B7 molecules comparing to CD28, and is a negative regulator of T cell activation. In contrast to stimulating and agonistic capabilities of monoclonal antibodies specific to CTLA-4, CTLA4Ig fusion protein appears to act as CD28 antagonist and inhibits in vitro and in vivo T cell priming in variety of immunological conditions. We've set out to confirm whether inhibition of the CD28-B7 costimulatory response using a soluble form of human CTLA4Ig fusion protein would lead to persistent inhibition of alloreactive T cell activation. Methods: We have used CHO-$dhfr^-$ cell-line to produce CTLA4Ig fusion protein. After serum free culture of transfected cell line we purified this recombinant molecule by using protein A column. To confirm characterization of fusion protein, we carried out a series of Western blot, SDS-PAGE and silver staining analyses. We have also investigated the efficacy of CTLA4Ig in vitro such as mixed lymphocyte reaction (MLR) & cytotoxic T lymphocyte (CTL) response and in vivo such as experimental autoimmune encephalomyelitis (EAE), graft versus host disease (GVHD) and skin-graft whether this fusion protein could inhibit alloreactive T cell activation and lead to immunosuppression of activated T cell. Results: In vitro assay, CTLA4Ig fusion protein inhibited immune response in T cell-specific manner: 1) Human CTLA4Ig inhibited allogeneic stimulation in murine MLR; 2) CTLA4Ig prevented the specific killing activity of CTL. In vivo assay, human CTLA4Ig revealed the capacities to induce alloantigen-specific hyporesponsiveness in mouse model: 1) GVHD was efficiently blocked by dose-dependent manner; 2) Clinical score of EAE was significantly decreased compared to nomal control; 3) The time of skin-graft rejection was not different between CTLA4Ig treated and control group. Conclusion: Human CTLA4Ig suppress the T cell-mediated immune response and efficiently inhibit the EAE, GVHD in mouse model. The mechanism of T cell suppression by human CTLA4Ig fusion protein may be originated from the suppression of activity of cytotoxic T cell. Human CTLA4Ig could not suppress the rejection in mouse skin-graft, this finding suggests that other mechanism except the suppression of cytotoxic T cell may exist on the suppression of graft rejection.
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LDL-콜레스테롤의 추정: Friedewald 공식과 Martin 방법의 비교
장성옥,손희정,이종석 통계청 2015 통계연구 Vol.20 No.2
Low-density lipoprotein cholesterol (LDL-C) is a major risk factor for cardio-cerebrovascular disease such as myocardial infarction and stoke. While its accurate assessment is important, It is typically calculated using the Friedewald formula as a cost-effective method. In the Korea National Health Screening Program, LDL-C is calculated for subjects accounting for nearly 98% of its total participants when triglycerides are lower than 400 mg/dL. However, previous studies have suggested that the formula underestimates LDL-C, particularly at high triglyceride levels. In a recent study, the Martin Method as an alternative to the Friedewald formula was proposed to improve estimation of LDL-C. The aim of this study was to compare the performance of the Martin method and the Friedewald equation using a sample of 5,665 Korean adults with LDL-C measured by an enzymatic homogeneous assay (LDL-CD). The Friedewald LDL-C (LDL-CF) tended to underestimate LDL-C for subjects with triglycerides of ≥ 100 mg/dL and HDL-cholesterol levels of < 50 mg/dL. Based on the N strata of triglyceride and non-HDL- cholesterol and triglyceride levels, we generated the Martin LDL-C (LDL-CN) estimates including LDL-C5, LDL-C10, LDL-C20, LDL-C25, and LDL-C50. Compared with LDL-CF, each of LDL-CN estimates more closely approximated LDL-CD and exhibited a significantly higher overall concordance in the guideline risk classification with LDL-CD (p < 0.001 for each comparison). Overall concordance was 82.9% for LDL-CF, 85.5% for LDL-C5, and 85.8% for LDL-C25. The Martin method achieved the greatest improvement in concordance with LDL-CD at triglyceride levels of 200-399 mg/dL. In this triglyceride category, concordance was 70.4% for LDL-CF versus 80.0% for LDL-C5. Our findings suggest that the Martin method significantly improves LDL-C estimation when compared to the Friedewald formula. However, the new method requires validation in various populations to evaluate whether improvements over the Friedewald calculation are compelling enough to justify its adoption. LDL-콜레스테롤은 심근경색이나 뇌졸중 같은 심뇌혈관질환의 주된 위험인자로서, 그 정확한 측정값을 임상에 적용하는 것이 중요하다. 하지만 이의 측정은 실측값이 아닌 Friedewald 공식에의한 추정값이 널리 이용되고 있다. Friedewald 공식은 비용-효과적인 장점을 가지지만, 중성지방이 높은 수준에서 LDL-콜레스테롤을 과소평가한다는 문제점이 제기되어 왔다. 본 연구의 목적은 Friedewald 공식의 대안으로서 최근에 제시된 Martin 방법의 성과를 평가하는 것이다. 이를위해 국민건강영양조사 3개년(2009-2011) 자료를 이용하여 20세 이상의 성인 5,665명을 대상으로, 중성지방 농도 400 mg/dL 미만에서 두 가지 추정 방법의 정확도를 비교하였다. Friedewald 공식은 중성지방 농도 100 mg/dL 이상과 HDL-콜레스테롤 농도 50 mg/dL 미만에서 LDL-콜레스테롤을 과소평가하는 경향이 있었다. Friedewald 추정값과 비교했을 때, Martin 추정값들은 LDL- 콜레스테롤 실측값에 더 근접했다(p < 0.001). Friedewald 추정값의 LDL-콜레스테롤 위험수준 분류 일치도는 82.9%인 반면, Martin 추정값들의 일치도는 85.5% 수준이었다(p < 0.001). 특히 중성지방 농도가 200-399 mg/dL일 때 일치도를 크게 향상시켰는데, Friedewald 추정값은 70.4%인반면 Martin 추정값들은 80% 수준이었다. 이러한 결과는 Friedewald 공식과 비교했을 때, Martin 방법이 LDL-콜레스테롤 추정을 유의하게 개선한다는 것을 제시한다. 우리나라 국가건강검진에서 중성지방 농도 400 mg/dL 미만인 사람들에 대해서 Friedewald 추정값을 사용하는데, 이는 전체 수검자의 98% 정도에 해당한다. 향후 Friedewald 공식을 대체할 만큼 Martin 방법이탁월한지에 대한 다양한 표본을 이용한 타당성 평가를 통해, 국가건강검진의 LDL-콜레스테롤 추정에 있어 새로운 방법의 채택을 고려해볼 필요가 있다.
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장성옥,박영주 대한간호학회정신간호학회 1995 정신간호학회지 Vol.4 No.1
This study intended to explore the meaning of physical touch and assess the necessity to educate physical touch in nursing curriculum. The number of the subjects on this study consisted of 34 third year university nursing students in Seoul. All the data & information was collected from Apr. 20 to Apr. 30, 1994. The data analysis was performed by using content analysis. The results as follows ; 1. The meanings of physical touch that surveyed nursing students experience are classified positive, neutral and negative meanings : The positive meanings consists of comfort, protection, self-confidence, frankness, intimacy, satisfaction and stability. The neutral meanings consist of communicating feeling. nonverbal internal language, curiosity, stasis and possession. The negative meanings consist of troublesome, terrible, embarassment, disgusting, discomfort and irritable. 2. The modes of physical touch that nursing students are classified positive, neutral and negative meanings ; The positive & neutral modes consist of shaking hands, stroking head, embracing as mother-child, female-male, friend-friend relationship, confronting head, pulling hands or arms, nurse's procedural touch and grasping hands. The negative modes consisted of interference, hitting, pinching and beating. 3. The nursing students emphasized the necessity including physical touch in nursing curriculum, because it is effective nursing intervention method, an effective emotional supporting method, rapport facilitating method, a therapeutic effect and feeling communicating method. Then they emphasized the inclusion of meaning, psychology, modes, characteristics, techniques, goals, strength, weakness and, effectiveness of physical touch in nursing curriculum and wanted to learn by lecture and practice.
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