혈액암환자에서 조혈모세포 이식 후 따르는 헤르페스 바이러스 감영 양상

이호섭,탁희상,신성훈,김양수,남성진,김혜수,박진희,정수현,김성빈,김예나 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.1

배경 : 헤르페스바이러스과에는 단순포진 바이러스(HERPES SIMPLEX VIRUS, HSV), 수두대상포진 바이러스 (VARICELLA-ZOSTER VIRUS, VZV), 엡스타인-바 바이러스 (EPSTEIN-BARR VIRUS, EBV), 그리고 거대세포 바이러스 (CYTOMEGALOVIRUS, CMV) 등이 있다. 헤르페스바이러스 감염은 혈액암환자에서 조혈모세포 이식 환자에서 전파 (dissemination), 이차감염, 세균 중복 감염의 심각한 합병증을 일으킬 수 있다. 하지만 항암약물치료를 받는 림파종 환자에서 항 바이러스 약제의 사용 용량과 기간에 대한 concensus는 없다. 헤르페스바이러스 감염에 대한 발생율과 위험인자를 후향성으로 분석하였다. 방법 : 고신대학교 복음 병원에서 1995년 6월부터 2009 년 2월 사이에 새롭게 진단되어 조혈모세포 이식을 받은 전체 58명의 환자들이 후향적으로 현 연구에 등록했다. 헤르페스 바이러스 감염은 임상적 진단, 혈청학적 검사 또는 병리학적 진단에 기초하여 확진한다. 환자들의 특성은 다음과 같다: 평균 연령은 44세 (범위 19-62세)였고 남녀비는 30:28이었다. 등록된 질환은 백혈병 (n=9, 15.5%), 림프종 (n=30, 51.7%), 다발성 골수종 (n=12, 20.7%), 재생불량성 빈혈 (n=6, 10.3%) 그리고 골수이형성증후군 (n=1, 1.7%)이 포함되었다. 결과는 chi-squre test나 independent samples T test를 사용하여 분석되었다. Multivariate analysises에 대해 logistic regression test를 사용하였다. 결과 : 15명의 환자들 (25.9%)에서 조혈모세포 이식후 헤르페스 바이러스 감염이 발생하였다. 조혈모세포 이식 5년간 누적 발생율은 53.9%였다. Univariate analyses에서 헤르페스 바이러스 감염에 대한 유의한 위험 인자는 없었다. 하지만 조혈모세포 이식후 생존 기간(40.18 ± 30.14 months vs 20.06 ± 26.67 months, p=0.018)은 헤르페스 바이러스 감염의 낮은 발병율과 유의한 관련성이 있었다. 이식 편대 숙주질환 (GVHD)의 존재 (37.5% in developed GVHD vs 0% in no GVHD, p=0.200), 동종조혈 모세포 이식에서 면역억제요법의 기간 (15.98 ± 14.02 months vs 6.78 ± 3.67 months, p = 0.374)은 헤르페스 바이러스 감염에 대한 위험인자가 아니었다. 결론 : 조혈모세포 이식 후 생존 기간은 어사이클로비어 예방을 받은 혈액암 환자에서 헤르페스 바이러스 감염의 낮은 발병율과 연관성이 있는 것으로 보인다. 저용량의 어사이클로비어 예방은 헤르페스 바이러스 감염의 고위험군인 조혈모세포 이식을 받은 혈액암 환자에 필요하리라 생각된다. Background : Herpesviridae family includes herpes simplex virus, varicella zoster virus, Epstein-Barr virus, and cytomegalovirus, etc. Herpesviridae viral infection (HVI) can lead to serious complications including dissemination, secondary infection, bacterial superinfection in patients with hematologic malignancy following hematopoietic stem cell transplantation (HSCT). But there was no consensus on the dose and duration of antiviral agents prophylaxis in patients undergoing chemotherapy. We retrospectively analyzed the incidence and the risk factors for HVI. Method : A total of 58 patients who newly diagnosed and received HSCT with prophylaxis of acyclovir at the Kosin University Gospel Hospital, Busan, Korea between June 1995 and February 2009 were enrolled retrospectively in the current study. HVI was confirmed based on clinical diagnosis, serologic test or pathologic diagnosis. The characteristics of the patients were as follows: the median age was 44 years (range 19-62 years) with a female-to-male ratio of 30:28. The enrolled diseases included leukemia (n=9, 15.5%), lymphoma (n=30, 51.7%), multiple myeloma (n=12, 20.7%), aplastic anemia (n=6, 10.3%) and myelodysplastic syndrome (n=1, 1.7%). The results were analyzed using a chi-square test and independent samples T test. For the multivariate analysis, we used logistic regression test. Results : Fifteen patients (25.9%) developed HVI after HSCT. The cumulative incidence of HVI was 53.8% at 5 years after HSCT. In univariate analysis, there was no significant risk factor for HVI. The presence of graft-versus-host disease (GVHD) (37.5% in developed GVHD vs. 0% in no GVHD, p=0.200), duration of immunosuppressive therapy (IST) in allo-SCT (15.98 ± 14.02 months vs. 6.78 ± 3.67 months, p = 0.374) were not risk factors for HVI. Conclusion : The incidence of HVI was similar to that in historical other studies. There was no risk factor associated with development of HVI. Most of the HVI occurred within the first 24 months after transplantation. So long term use of antiviral prophylaxis may be needed to prevention of HVI after HSCT.

간호대학생이 지각하는 임상실습지도자의 교수효율성과 임상실습만족도의 관계

황현아,김희진,김예지,이규희,이영롱,박성희,손수빈 이화여자대학교 간호과학대학 2012 이화간호학회지 Vol.- No.46

Purpose: The purpose of this study was to investigate the relationship between teaching effectiveness and clinical practice satisfaction among nursing students. Method: The subjects of this study were 107 junior and senior nursing students in E university. Data were collected using self-reported questionnaire including general and practicum related characteristics, teaching effectiveness of clinical instructors and clinical practice satisfaction from September 12 to September 21, 2011. Collected data were analyzed by SPSS 19 program using t-test, ANOVA with Scheffe test, and Pearson`s correlation coefficients. Result: The mean score of teaching effectiveness was 3.35(±.51), and mean of clinical practice satisfaction was 3.19±.47. There were significant differences of teaching effectiveness of clinical instrutor by satisfaction of overall clinical practicum(F=8.332, p<.001), satisfaction of practice hour(F=3.230, p=.044), and satisfaction of major(F=9.883, p<.001). There were significant differences of clinical practice satisfaction by grade(t=2.274, p=.025), motive of choosing nursing science as a major(F=3.329, p=.007), satisfaction of overall clinical practicum(F=17.437, p<.001), satisfaction of practice hours(F=9.925, p<.001), and satisfaction of nursing major(F=12.748, p<.001). Relationship between teaching effectiveness of clinical instructor and clinical practice satisfaction showed positive correlation(r=.704, p<.001). Conclusion: In this study, teaching effectiveness of clinical instructor was related with clinical practice satisfaction. Therefore, we should consider improving teaching effectiveness of clinical instructor to improve clinical practice satisfaction.

Carotenoids 식이와 알코올이 혈액학적 성분과 간조직에 미치는 영향에 관한 연구

조만희,김연선,이상한,우기민,장예진,김창세 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Alcohol is well known agent which can damage the human tissues such as liver via stimulating lipid peroxidation and storage, denaturation of macromolecules, and inhibiting protein metabolism. On the other hand, carotenoids in addition to vitamins A, C, E and lipoic acid, play important roles in protecting these oxidative damages as well as preventing the production of free radicals. This study was carried out to elucidate the precise effects of alcohol administration into rats on the antioxidative functions of dietary carotenoids and isolated β-carotene, and to find out any parameters to uncover more detailed biochemical mechanisms of these agents. For these purposes, two different approaches were performed: 1) examination of the changes in hematological parameters (e.g., total proteins, A/G ratio, ALT/AST et. al) and statistical correlations among inter- and intragroups, 2) examination of the histopathological changes by an electron microscope. The results were analyzed and summarized as following; (1) Carrot diet for one week caused a slight increase in albumin. A/G ratio and AST levels, and a slight decrease in ALT, ALP, BUN and uric acid levels. Two-week alcohol administration following carrot diet increased total proteins, albumin A/G ratio and BUN levels. However, both groups were shown to have little significant changes in cholesterol concentrations. (2) Cheese diet for one week caused a significant increase in total proteins, albumin, AST, ALP, uric acid and total cholesterol levels, and a significant decrease in A/G ratio and glucose concentrations. However, two-week β-carotene diet following cheese intake increased total proteins albumin, A/G ratio, BUN and total cholesterol levels, whereas AST, ALT, ALP and uric acid levels were decreased. (3) Alcohol administration for one week caused an increase in AST activities and a decrease in total proteins, albumin, ALT, ALP and BUN levels. A successive β-carotene diet following alcohol administration increased total proteins, albumin, ALT, ALP and BUN levels, whereas decreased AST and uric acid levels. However, there were not significant changes in A/G ratio, glucose and total cholesterol levels in both groups. (4) β-carotene diet for one week caused a slight increase in albumin, glucose, AST and uric acid levels, and a slight decrease in ALP and BUN levels. Two-weeks alcohol administration following β-carotene diet increased albumin, glucose, BUN and total cholesterol levels, whereas decreased AST, ALT, ALP and uric acid levels. (5) Although the pathological investigation on the liver did not reveal significant changes, cheese diet group (CH-BC/1-CH) was shown to have some lipid deposits. Some results were unexpected and different from typical hematological changes shown by other researchers. Nonetheless, these results strongly suggest that the liver damage or hepatism caused by alcohol intake affects many kinds of biochemical metabolisms, which results in significant changes in many hematological parameters. In addition, dietary carotenoid and isolated β-carotene were shown to have protective roles against the biochemical changes by alcohol intake.

모빅 캡슐(멜록시캄 7.5㎎)에 대한 멜락스 캡슐의 생물학적동등성

이예리,염승복,고연정,고정길,김호현,이희주,이경률 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.5

A bioequivalence of Melax capsules (Chong Kun Dang Pharm., Korea) and Mobic™ capsules (Boehringer Ingelheim Korea) was evaluated according to the guideline of Korea Food and Drug Administration (KFDA). Single 15 mg dose of meloxicam of each medicine was administered orally to 24 healthy male volunteers. This study was performed in a 2 x 2 crossover design. Concentrations of meloxicam in human plasma were monitored by a high-performance liquid chromatography. AUC, (the area under the plasma concentration-time curve from time zero to 72 hr) was calculated by the linear trapezoidal rule method. C_(max) (maximum plasma drug concentration) and T_(max) (time to reach Cma,.) were compiled from the plasma concentration-time data. Analysis of variance was performed using logarithmically transformed AUC, and C_(max). No significant sequence effect was found for all of the bioavailability parameters. The 90% confidence intervals of the AUCt ratio and the C_(max) ratio for Melax™/Mobic™ were 0.95 - 1.04 and 0.98 - 1.14, respectively. This study demonstrated a bioequivalence of Melax™ and Mobic™ with respect to the rate and extent of absorption.

사람의 혈장 아포지단백질 A-I에 대한 단일클론항체 A-I4-18의 생성 및 특성 분석

장예진,이상한,김동연,조만희,우기민 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

본 연구는 사람의 고밀도 지단백질을 구성하는 아포지단백질 A-I에 특이적인 single-chain Fv를 클로닝하여 대장균 세포에서 발현시킬 목적으로, 먼저 단일클론항체 A-I4-18을 제조하였으며 이항체의 특성을 분석하였다. 아포지단백질 A-I을 BALB/c 생쥐에 면역한후 얻어진 비장세포를 Sp2/O myeloma세포주와 융합한 후 융합세포를 생쥐의 복강내에 주입하였으며, 복수를 채취하여 protein A Sepharose CL-4B크로마토그래피법으로 단일클론항체를 분리하였다. Isotyping결과 heavy chain은 subgroup IIa이며 κ형의 light chain을 나타내었으며 항원과의 결합특이성은 ELISA와 Western blotting법으로 확인하였다. Indirect ELISA법으로 얻어진 해리상수 (Kd)값은 8.33x10의 마이너스8승이었다.

임부의 연령에 따른 보완대체요법에 관한 인식 태도 경험 비교 연구

김연진,김지연,노경민,신혜리,유예지,이지민,장희조,정아인,최소정,강숙정,이향연,민혜영 이화여자대학교 간호과학대학 2016 이화간호학회지 Vol.- No.50

Purpose: This study aims to test if the age of pregnant women affects the perception, experience, and attitude towards complementary alternative therapy (CAT), by investigating the perception, experience, and attitude of pregnant women under the age of 35, and above 35 (Advanced Maternal Age). The study will 1) find the general characteristics of pregnant women under and over the age of 35 2) compare the perception, behavior, and experience of pregnant women under and over the age of 35, and 3) find the comparison of the perception, behavior, and experience according to the general characteristics of pregnant women under and over the age of 35. Method: The subjects of this study are composed of 44 women under the age of 35 and 44 women above the age of 35, totaling 88 pregnant women visiting midwiferies, obstetrics and gynecology, and baby fairs in Seoul and Gyeong-Gi area. Data for this study was collected from November 28, 2015 to January 6, 2016 for 40 days. The collected data analyzed mean, standard deviation, t test, ANOVA, and chi-square by using SPSS 23.0. Result Results show that there is a significant difference in the perception, attitude, and experience of the two-sample groups in the use of CAT. The question of “what is most necessary when applying CAT in a hospital clinical environment” for the perception criteria came out with the results of t=9.980, p<.05. For the attitude, results showed that the answers of pregnant women under the age of 35 displayed a more positive attitude towards CAT. (t=2.421, p<.05) Lastly, in the experience section, pregnant women under the age of 35 showed more CAT use than the other sample group. Conclusion Results have shown that there is a difference in the perception, behavior, and experience between the two sample groups. Therefore further research on the efficacy and the adverse effects of CAT needs to be done.

미세알부민뇨를 동반한 인슐린 비의존성 당뇨병 환자에서 혈장 Endothelin의 변화

서예경,정상원,남직화,신병호,전종민,김정국,김동희,하승우,김보완 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.3

목적 : 혈관내피세포에서 생성되는 endothelin(ET)는 강력한 혈관수축작용을 가진 펩타이드로 당뇨병 환자에서 혈관내피세포의 손상여부에 따라 혈중 농도가 증가할 수 있으며 혈관합병증과 관련이 있다는 보고가 있다. 그러나. 혈중 ET치의 상승과 당뇨병성 합병증의 상관성에 대해서는 논란이 많다. 이에 저자들은 인슐린 비의존성 당뇨병 환자에서 미세알부민뇨의 동반유무에 따른 혈중 ET치의 변화 및 혈장 ET치와 요중 알부민 배설률과의 상관성을 검토하였다. 대상 및 방법 : 인슐린 비의존성 당뇨병 환자중 미세알부민뇨를 보인 22명과 정상알부민뇨를 보인 43명을 대상으로 하였으며 혈장 ET를 측정하여 요중 알부민 배설률, 당뇨병성 망막증 및 당뇨병 관련인자들과의 관계를 비교하였다. 결과 : 당뇨병성 망막증이 합병된 군에서 망막증이 합병되지 않은 군에 비하여 혈장 ET치가 유의하게 높았던 반면 (각각 1.9±0.66, 1.5±0.76pg/㎖, p<0.05) 미세알부민뇨를 보인 군과 정상알부민뇨를 보인 군사이에 혈장 ET치는 통계학적으로 유의한 차이가 없었다(각각 1.9±1.14, 1.7±0.69pg/㎖). 또한 요중 알부민 배설률과 혈장 ET치 사이에 유의한 상관관계는 없었으며 미세알부민뇨를 동반한 인슐린 비의존성 당뇨병 환자군에서 혈장 ET치는 당뇨병의 관련인자들과도 유의한 상관관계가 없었다. 결론 : 인슐린 비의존 당뇨병 환자에서 혈장 ET치가 초기 당뇨병성 신증의 합병여부나 미세알부민뇨의 정도를 반영하기는 어려울 것임을 시사한다. Background : Endothelin(ET), a potent vasoconstritor peptide released from vascular endothelial cells, is known to be increased in diabetic patients with vascular damage and related with diabetic angiopathy. However, whether plasma ET levels may be related to diabetic complications is controversial. We studied the change of ET levels in non-insulin dependent diabetics with microalbuminuria and relation between ET and urinary albumin excretion rate. Methods : Plasma ET levels of 22 non-insulin dependent diabetics with microalbuminuria and 43 patients with normoalbuminuria were measured and relations of plasma ET to diabetic complications such as urinary albumin excretion rate, retinopathy and other associated factors were studied. Results : Plasma ET levels were significantly higher in patients with diabetic retinopathy than those without retinopathy(1.9 ± 0.66 vs 1.5 ± 0.76 pg/㎖. p<0.05). The difference, however, between diabetics with and without microalbuminuria was not significant(1.9 ± 1.14 vs 1.7 ± 0.69 pg/㎖). There were no correlations of plasma ET to urinary albumin excretion rate and to the other associated factors in non-insulin dependent diabetics. Conclusion : These results suggest that plasma ET levels may not seem to act as a predictor of diabetic nephropathy or microalbuminuria in non-insulin dependent diabetics.

알코올 및 베타 카로틴이 혈액 성분에 미치는 영향에 관한 연구

조만희,우기민,김창세,장예진,이상한,조성호 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

Human take in many kinds of foods, and also are exposed to various chemicals which may be harmful. Especially, some food and chemicals may give rise to free radicals during metabolism in the tissues. These free radicals, such as superoxide. hydroxy radical and hydrogen peroxide, induce oxidations of the macromolecules, which can cause a variety of damages in the body. But human have anti-oxidative mechanisms well developed against these damages. Anti-oxidants such as vitamines A, C, E, and β-carotene are believed to have a major role in these mechanisms acting as a cofactor of anti-oxidative system. On the basis that alcohol is one of the most common chemicals that induce oxidative damages in liver, this study was carried out to elucidate biochemical changes of blood after alcohol administration as well as to investigate the effects of β-carotene on the alcohol-injected Sprague-Dawley rats. The following results were obtained from this study. At first, the number of WBC after one week were lowest in the alcohol-treated group. But, β-carotene treatment by oral injection was shown to diminish the increasing rate of WBC in the alcohol-treated group. Second, RBC was increased all the time in all groups tested with alcohol and/or β-carotene. It is of interest that there was a sudden increase of RBC in the alcohol-treated group. Third, Hb was increased in the alcohol-treated groups on the second week. On the other hand, the groups of β-carotene treatment showed more higher rate of increase in Ht and MCV. It is of note worthy that these effects were maximized in the group of β-carotene treatment followed by diet with cheese for a week. Finally, alcohol had little or no effect on MCH and MCHC, although β-carotene showed atypical effects. These results made it clear that alcohol can cause damages in liver, resulting in inflammation and increase of RBC. Also β-carotene is believed to protect liver from oxidative effects by alcohol. In according to these results, it is suggested that diet of anti-oxidants such as Vt. A, B, C, E, and β-carotene is strongly recommended to prevent certain diseases caused by oxidative damages.

태권도 옆차기 동작의 우수자와 비우수자간의 운동학적 비교 분석

이호진,한재희,김륜건,홍예은,우상연 순천향대학교 기초과학연구소 2022 순천향자연과학연구 논문집 Vol.28 No.1,2

The purposes of this study were to analyze the kinematic variations between skilled and unskilled individuals and obtain the data needed to improve effective side kick skill in Teakwondo. We used a video analysis program to collect performance time, changes in movement of the center of the body, angle, and angular velocity. The results were as follows : 1) in unskilled cases, side kick motion occurred for more time than in unskilled cases, 2) to make a stronger kick, the skilled group increased the joint speed of the legs and unskilled athletes have smaller angles than experienced athletes. As a result, the total performance time of side kicks was shorter for skilled people and was consistent with other previous studies. The angle of the knee joint and hip joint had a great influence on the side kick.The range of motion of the hip and knee joints should be increased so that the desired hitting point can be quickly reached.

노인과 대학생의 낙상 위험 분석

정다현,김예희,김지은,이예영,강현주 순천향대학교 기초과학연구소 2021 순천향자연과학연구 논문집 Vol.27 No.1.2

The purpose of this study was to analyze risk of falls between elderly people and college students. The subjects of this study were 25 people aged 70 years or older and 17 college students located in Asan. We measured sensory, integrated balance, nervous, musculoskeletal system and HQR by FRA system (Inbody, Korea). The results of measurement showed significant differences in sensory system (p<.01), integrated balance (p<.001), nervous system (p<.001), and musculoskeletal system (p<.001) between groups. These results suggest that aging makes difference of function of these systems. In our view, counterplans need to be implemented, including exercise intervention to prevent decreases of fall risk,