Ticlopidine 복용후 발생한 심한 호중성백혈구 감소증이 G-CSF투여 후 빠른 회복을 보인 1예

강지은,정춘해,박치영 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.2

Ticlopidine is a antiplatelet agent used to prevent acute thromboembolic artery occlusion. It is a thienopyridine derivative that inhibits platelet aggregation through an adenosine 5'-diphosphate(ADP) -dependant pathway. Ticlopidine has been associated with serious hematologic effects. Neutropenia has been seen with ticlopidine with an incidence of 2.1% and 0.8% incidence of severe neutropenia. We reported here, one case of severe neutropenia developed after use of ticlopidino. Patient suffered from an acute cerebral infarction. Hr developed neutropenia 1 year after treatment with 100 mg ~ 500 mg/daily. After stopping riclopidine, he was recieved Granulocyte Colony Stimulating Factor (G-CSF). In two days after G-CSF administration, neutropenia was quickly improved.

일 도시 고등학생의 음주동기와 음주문제

강혜영,신경은,장현지,나영화,조은희 韓國學校保健學會 2004 韓國學校保健學會誌 Vol.17 No.2

Purpose : The purpose of this study was to investigate drinking motives and the drinking-related problems of Korean high school students at a city in Jeonbuk province. Methods : There were 657 students from two academic and two vocational high schools at J city in Jeonbuk province. The sample was collected using a stratified sampling method and the data was collected from June 30th to July 16th 2003. The study instrument used to examine drinking motive was a 20.item summated scale (Cronbach's α = .95) and for drinking-related problems was an 18 item summated scale (Cronbach's α = .91). The data was analyzed using SPSS/PC+ by percentage, χ2.test, t-test and correlations. Results : 1. Drinking experience: Among the high school students, 74.3% of them had drinking episodes. Female students started drinking later (χ2 = 12.857, p = .002) and had more drinking friends (χ2 = 7.785, p = .020) than males. Vocational school students drank more frequently (χ2 = 32.138, p = .001), had more heavy drinking episodes (χ2 = 40.370, p = .001). 2. Drinking motives & Drinking-related problems: The mean score of drinking motives was 31.2 ± 11.12 out of 80 and that of drinking-related problems was 21.8 ± 5.85 out of 72 points. Neither score were stronger was significantly different according to gender and grade. On the other hand, both drinking motives (t = .4.077, p = .001) and drinking-related problems (t = .3.423, p = .001) were stronger in vocational school students than in academic school students. The correlation between drinking-related characteristics and problems were weak (from r = .286 to r = .520) but the correlation within the subcategories of drinking motives was high such as between enhancement and coping (r = .822) and enhancement and social motives (r = .822). Conclusion : The majority of Korean high school students start to drink during their junior high school days. Drinking motives and drinking-related problems were not serious but the drinking motives and the drinking-related problems are stronger among vocational school students. As a result, school-based health education and counseling programs should focus on solving drinking motives than on drinking-related problems.

일부 흡연 대학생의 지각된 스트레스와 흡연실태에 대한 상관관계 연구

강초록,권시내,권혜림,박수경,송인혜,오해인,이미지,한승아,황선아,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

In spite of the seriousness of smoking harm has been developed these days. the increase of national smoking rate and that the people in the twenties are especially leading the rise of national smoking rate is an important issue of national health. Smoking of the university students can occur health problem and cause loss of manpower and expenses in their social activity period. So then the actual state for prevention of smoking and development of a program to prohibit smoking has to be seized urgently and starting with the study of the realities of university students, the effort to find a related fluent of smoking has to be studied. Related to this, the purpose of this study is to seize the general characteristics of smoking university students and to find out the relationship between perceived stress and smoking status among smoking university students. In addition, by collating the relationship between perceived stress and smoking status among smoking university students we have the purpose to furnish the basal data of stress care, the best way to cope with stress through group training and the plan for nursing implementation to decrease the smoking rate. For this study, a survey was conducted for 204 smoking university students of 13 universities in Seoul from 9th of May to 16th of May, 2003. The collected data was analyzed by t-test, Pearson Correlation and ANOVA in the statistical packages SPSS/PC. Major findings of this study are as follows; 1. Of the 204 respondents 85.4% of them were male and 14.6% of them were female. The average age of the sample was 23.19 years old and 41.8% of them were in senior, 21.4% in junior, 16.9% in sophomore, 19.9% in freshman grade. The major motivation to start smoking was 'because of curiosity'(33.8%) and the first smoking experience was at 'senior high school' (41.9%) and at 'college' (41.9%). 2 The highest scored stress factor of smoking university students were stresses about school work. 3. 72.7% had experience to quit smoking at least one or more times. Most of the reason to keep on smoking was 'short will to quit'(51.0%) and the smoking place was usually at 'school' (41.4%). Most respondents for the number ofsmoking friends were '5 people and above' (73.2%). 4. There was a negative relationship between the general characteristics and the entire perceived stress, however, there was a positive relationship between the general characteristics and the perceived stress in 4 categories which is 'sex distinction', 'major of study', 'residence form' and' inmate'. 5. There was a negative relationship between the general characteristics and the entire smoking status, however, there was a positive relationship between the general characteristics and the smoking status in 2 categories which is 'presence of hobby' and 'number of smoking friends'. 6. There was a negative relationship between the perceived stress and the smoking status. Through this study we have seized the relationship between the general characteristics, perceived stress and the smoking status of smoking university students. There was a positive relationship between some of the general characteristics with the perceived stress and the smoking status of smoking university students. Also there was a negative relationship between the perceived stress and the smoking status.

솔잎추출유의 산화 안정성 및 추출유를 이용한 맛김의 관능적 평가

정혜경,최창숙,이지현,장문정,강명화 한국식생활문화학회 2003 韓國食生活文化學會誌 Vol.18 No.2

생·찐솔잎에 콩기름과 올리브유를 첨가하여 추출한 솔잎추출유의 저장기간에 따른 산패도를 측정하였고 솔잎추출물을 김에 발라 제조한 맛김에 대한 관능검사 결과는 다음과 같다. 1.저장기간에 따른 중량변화 특정 결과, 콩기름은 14일째 생·찐 솔잎추출유는 21일째 생·찐 올리브유 솔잎추출유는 14일부터 중량이 서서히 증가하여 28일에 중량이 가장 크게 증가하는 것으로 나타났다. 2.TVARS 생성량도 저장기간 14일째 콩기름에 비해 콩기름에 생·찐 솔잎을 첨가할 경우 TBARS의 함량이 유의적으로 낮았고, 28일째 올리브유도 생·찐 솔잎을 첨가할 경우 TBARS의 함량이 유의적으로 낮게 나타났다. 3.시방산 산화의 2차 생성률은 aqueous layer에서 저장기간에 다라 감소하였고 특히 14일째에 다른 추출유에 비해 콩기름이 크게 감소한 것으로 나타났다. 한편 organic layer는 저장기간 14일째 콩기름에서 가장 크게 증가하였고 솔잎을 첨가할 경우 유의적으로 감소한 것으로 나타났다. 올리브유의 경우도 솔잎을 첨가한 올리브 솔잎 추출유에서 2차 생성률이 감소한 것으로 나타났다. 4.제조된 생·찐 솔잎 추출유를 김에 발라 7점 기호척도법을 이용하여 관능검사를 실시한 결과 향, 맛 전반적인 기호도 모두 유의적인 차이가 나타나지 않아 솔잎추출유를 김에다 바를 경우 거부감을 주지 않는 것으로 조사되었다. 이상의 경우 솔잎에 콩기름과 올리브유를 첨가하여 추출한 솔잎추출유는 원유보다 산화에 대해 안정한 것으로 나타났고, 이를 이용한 맛김도 좋은 것으로 평가되어 솔잎추출유의 식품에 이용 가능성이 시사되었다. In order to evaluate the oxidative stability and sensory evaluation for the pine needle extracted oils, we prepared the pine needle extracted oils by the autoclave method with soybean and/or olive oils. The lipid peroxidation was monitored by measuring the formation of 2-thiobarbituric acid reactive substances(TBARS). In addition, the secondary reaction products of lipid oxidation were measured by fluorescence spectroscopy. A weight changing was decreased in oils added pine needle during storage periods. The formation of TBARS was the lowest in olive pine needle oils after 14 days storage, whereas it was the highest in soybean oil. The levels of fluorescent products in extracted oils added pine needle were also decreased in organic layers. According to the sensory evaluation, the scores of fragrance, taste and overall preference in savored laver using an pine needle extracted oils were no significant differences. Overall results suggest that the pine needle extracted oils can be developed to functional oil resources.

Bandom Amplified Polymorphic DNAs 기법을 이용한 Bifidobacteria의 신속한 동정

왕지원,민해기,장영효,강국희 성균관대학교 생명과학자원연구소 1995 生命資源科學硏究 Vol.2 No.1

Random Amplified Polymorphic DNAs (RAPD) has been applied to the identification of human intestinal anaerobic Bifidobacteria. Recently, The RAPD technique has been used to analyse DNA polymorphism of genomic DNA from eukaryotes such as plants and animals(1, 3, 4, 10, 11). But there were only several reports on the polymorphism of prokaryotic genomic DNA by using this method(2,7). Total 100 random sequence primers were used in screening of species-specific primer. The oligonucleotide primers were ten bases long and designed to have average G+C contents of 60 mol %. Eight species of Bifidobacteria from human feces were selected. According to conventional method genornic DNA were extracted from each bifidobacterium and then RAPD-PCR was performed. Four primers have produced distinct electrophoretic band patterns, RAPD markers. Especially arbitrary primer # 101 showed species-specific DNA polymorphism for each of Bifidobacterial genomic DNA tested. The arbitrary primer # 101 showed good reproducibility when the PCR conditions were optimized. And also primer # 156, # 174, # 183, have produced amplified PCR products but not for all of the strains tested. Better DNA polymorphism was observed when two arbitrary primers were used in combination.

자가면역 용혈빈혈의 임상적 분석

박치영,강지은,박상곤,김상현,김형선,정춘해 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Background: Autoimmune hemolytic anemia (AIHA) is a very uncommon disorder with the incidence between one and three cases per a hundred thousans a year. There have been very few studies about AIHA in Korea because of its low incidence. Most AIHA studies in Korea were about case history. The aim of this study was to review the clinical features, therapy and outcome of AIHA patients in single institution clinic. Methods: We reviewed retrospectively the medical records of AIHA patients from December 2002 to December 2006. Results: Twelve patient with AIHA were identified, and their median age was 49 years (range 27-75). Male to female ratio is 9:3. The median hemoglobin level was 5.0 g/㎗ (range 2.5-8.2). Warm type AIHA was most common (8/12), cold type was three, and mixed type was one. There was histories of associated disease in six patients. Two patients were complicated by systemic lupus erythematosus and mycoplasma infection and one patient by idiopathic myelofibrosis and solid tumor. Oral steroid was used as the first-line treatment in nine patients. An initial response was observed in eight patients with complete response. One patient had not responded to the initial steroid treatment, and then showed complete response with rituximab. Two relapsed patients were treated with rituximab and partial splenic embolization. Conclusion: The majority of patients can be treated with steroid. Rituximab can improve the response rate in relapsed and refractory AIHA.

cis-platin에 의한 급성구토예방의 Dexamethasone의 4가지 정주량의 비교

김원,강지은,서영선,이동민,서정균,신병철,정기영,박유환,정춘해 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

B5-hydroxytryptamine _3수용체(5-HT_3) 길항제와 dexamethasone의 동시투여가 cis-platin에 의한 급성 구토를 막는데 가장 효과적이다. 그러나 현재까지 가장 적절한 정주dexamethasone의 용량이 알려져 있지 않았다. 이에 dexamethasone의 4가지 다른 용량을 투여하여 그 효과를 비교하였다. 환자는 임의 추출되어 cis-platin 투여 45분전에 15분 동안 정주로 각각 dexamethasone 5, 10, 15, 20 mg을 투여 받았다. cis-platin 투여 30분전에는 ondansetron 8 mg이 부가하여 정주 되었다. 1999년 3월부터 2000년 2월까지 54명의 환자가 연구에 등록되어졌고 53명의 환자가 연구 대상으로 실험에 4군 (dexamethasone 5 mg 13명, 10 mg 14명, 15 mg 13명, 20 mg 13명)으로 나뉘어 평가 되어졌다. 급성구토와 구역질의 완전한 예방은 dexamethasone 5 mg을 투여 받은 환자에서 각각 69.2%, 60.9%, dexamethasone 10 mg을 투여 환자에서 69.1%, 61%, dexamethasone 15 mg 투여 환자에서 78.5%, 66.9%, dexamethasone 20 mg을 투여 환자에서 83.2%, 71.0%로 나타났다. 구토로부터 완전한 예방은 dexamethasone 20 mg을 투여 환자에서 5, 10 mg을 투여 환자와 비교하여 높았고, dexamethasone 15 mg을 투여 군에 비교하여서는 약간 우수한 효과만 있었다. 구역질으로부터의 완전한 예방도 월등한 것은 아닐지라도 20 mg을 받은 환자에서 높았다. 항 구토 치료는 특별한 불편 없이 조절되었고, 부작용의 발생에서 4가지그룹간에는 커다란 차이가 발견되지 않았다. Dexamethasone의 20 mg 정주양이 cis-platin으로 인한 급성구토를 예방하는데 가장 효과적인 예방량으로 사료되어진다. Background and objective: A 5-hydroxytryptamine _3(5-HT_3) receptor antagonist plus dexamethasone is the most efficacious antiemetic prophylactic treatment for the prevention of cis-platin induced acute emesis, but the optimal intraveous (Ⅳ) dose of dexamethasone is unknown. This prompted us to perform a randomized, double-blind, dose-finding study that compared four different doses of dexamethasone. Materials and Methods: Patients were randomized to receive dexamethasone, either 5, 10, 15, 20 mg, administered by 15-minute Ⅳ infusion 45 minutes before cis-platin. Ondansetron 8 mg was added to dexamethasone and was administered Ⅳ 30 minutes before cis-platin. From March 1999 to February 2000, 54 patients were enrolled onto the study and 53 were assessable according to the intention-to-treat principle (13 patients received 5 mg; 14 patients, 10 mg; 13 patients, 15 mg and 13 patients, 20 mg of dexamethasone). Results: Complete protection from acute vomiting and nausea was achieved by 69.2% and 60.9% of patients, respectively, who received 5 mg of dexamethasone, by 69.1% and 61.0% of those who received 10 mg, by 78.5% and 66.9% of those who received 15 mg, and by 83.2% and 71.0% of those who received 20 mg of dexamethasone. Complete protection from vomiting was significantly superior in patients who received 20 mg compared with those who received 5 and 10 mg of dexamethasone (P<05) and was superior, but not significantly, compared with those who received 15mg. Complete protection from nausea was superior, but not significantly, in patients who received 20 mg of dekamethasone. Multifactorial analysis confirmed these results. Antiemetic treatment was well tolerated, and no significant difference was found among the four groups in the incidence of adverse events. Conclusion: A 20mg single Ⅳ dose of dexamethasone should be considered the most efficacious prophylactic dose for the prevention of ois-platin induced acute amesis in treatment of cancer.

직무 스트레스 평가를 위한 측정도구 개발 및 표준화 연구(Ⅱ) : 인구통계학적 변인의 영향 및 규준 수립 Demographic Variables and Norm

이동수,김지혜,한우상,우종민,강동우,고영건,연병길,김이영 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 본 연구에서는 Osipow와 Spokane(1992)의 직무 스트레스 모형에 기초한`직무 스트레스 검사(Occupational Stress Inventory)`를 표준화하고 규준을 작성하기 위해서 성별, 연령, 직업기간, 직종 등의 인구통계학적 변인에 따라서 직무 스트레스의 경험이 어떤 차이가 있는지를 확인하기 위한 분석을 실시하고, 이에 따라 규준을 작성하였다. 방 법: 한국직업사전 직업분류에 따라서 7개 직종군의 805명(남성 76.5%, 여성 23.5%)에게 직무 스트레스 검사를 실시하였다. 성별, 연령, 연봉, 직업기간, 일반직종, 직급 차이, 일반직/특수직, 사무직/근로직에 따라 직무 스트레스의 경험과 반응이 어떻게 달라지는지를 살펴보았다. 이후, 이러한 결과에 기초하여 남성, 여성 집단 각각의 규준을 작성하였다. 결 과: 1) 남성과 여성은 직무 스트레스의 경험, 스트레스에 대한 반응, 대처 행동에서 서로 차이가 있었다. 전반적으로 여성은 직무 자체의 특성에 따른 스트레스 수준이 높았는데, 남성집단에 비해 역할 불충분(RI), 역할 모호성(RA), 사회적 지지(SS), 직무 긴장(VS) 척도의 수준이 높았으며, 남성은 여성에 비해 역할 과부하(RO), 책임감(R) 척도의 수준이 높았다. 2) 다음으로 연속변인으로 측정한 연령, 연봉, 직업기간과 직무 스트레스와의 상관분석을 실시한 결과, 일반적으로 연령이 많고, 연봉이 높고, 직업에 종사한 기간이 길수록 직무로 인한 스트레스와 그에 따른 문제가 적고, 적절한 대처자원을 가지고 있었다. 3) 일반적인 직종에 따라서 직무 스트레스의 경험에 차이가 있는지를 확인하기 위해서 연령, 연봉, 직업기간을 통제한 공변량분석(ANCOVA)을 실시하였는데, 남성집단, 여성집단 모두에서 일반적인 사무직종 내에서는 직무 스트레스의 경험이 유사한 것으로 나타났으며, 동일한 직종 내에서 직급에 따른 고유한 효과는 없었다. 다음으로 일반 사무직종 이외에 경비회사 직원, 직업군인(장교)과 같은 특수 직종에 종사하는 사람들의 직무스트레스 경험이 일반 회사원과 차이가 있는지를 확인하기 위해서 공변량분석을 실시하였을 때, 직종간 유의미한 차이가 존재하였으며, 일반 사무직과 기능 근로직에 대한 비교에서도 직종에 따른 차이가 유의미하게 나타났다. 이러한 결과를 종합하여 보면, 일반 사무직종 내에서 직종에 따른 직무 스트레스 경험의 차이는 적지만, 특수직종과 기능직을 비교하였을 때는 직종에 따라서 전반적으로 유의미한 차이가 있음을 확인할 수 있었다. 마지막으로 앞선 분석결과에서 가장 의미 있는 차이가 나타난 변인인 성별을 기준으로 한국판 직무 스트레스 검사의 규준을 작성하였다. 결 론: 직무 스트레스에 대한 개인의 경험과 반응은 성별, 연령, 연봉, 직업기간, 직종, 직급 등의 여러 인구통계학적인 변인에 따라 서로 유의미한 차이가 있는 것으로 나타났다. 이러한 결과는 한 개인의 스트레스 경험과 반응을 객관적으로 이해하기 위해서는 그 개인의 인구 통계학적인 특성에 대한 폭넓은 탐색이 필요하다는 점을 시사한다. 한편, 본 연구를 통해서 개발된 규준을 이용하여, 개인의 스트레스 경험을 상대적으로 비교할 수 있으며, 검사의 결과를 적절한 임상적 개입을 위한 지표로 사용할 수 있을 것이다. Objectives: This study examined the effects of demographic variables on the job stress experience and established the norms of the Korean version of Occupational Stress Inventory. Methods: The normative group consisted of 805 adult workers who represent seven major job class in Korea. K-OSI were administered to normative group and data were analyzed by subjects demographic variables. Results: To explore the effects of demographic variables on K-OSI, we considered several factors such as age, sex, duration of employment, job class, job position and so on. The results were as follows : 1) We found significant sex difference in K-OSI. Compared with men, women showed higher scores in Role Insufficiency, Role Ambiguity, Social Support, Vocational Strain Scales and men showed higher scores in Role Overload, Responsibility Scales. 2) Generally, a person who was older, earned higher salary, more duration of employment experienced job stress and had more coping resources. 3) In general, white-collar workers, job classes and job position had little effects on job stress. But other workers such as security guards, military officers were different from general white-collar workers in K-OSI. Conclusions: Because men and women showed significant difference in K-OSI, we constructed norms according to sex. K-OSI would be an useful instrument to identify one`s job stress experience and develop intervention plan.

공황장애에서 Paroxetine 단기약물치료가 심리적 상태에 미치는 영향

이소영,김지혜,김율리,강은호,이동수,유범희 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.3

Objectives : This study was designed to evaluate clinical effect of paroxetine treatment and to explore psychological Pre-dictors of treatment response. Methods : Patients (n=26) who met DSM-IV criteria for panic disorder with or without agoraphobia were treated by Pa-roxetine for 12 weeks. We assessed symptom improvement using Clinical Global Impression (CGI), and clinical characteristics using Anxiety Sen&itivity Index (ASI), Anxious Thoughts and Tendencies (AT & T), Agoraphobic Cognition Questionnaire (ACQ), Body Sensation Questionnaire (BSQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). T-test, correlation analysis, and stepwise multiple regression analysis were performed. Results : Panic patients showed significant improvement in seventy of illness and each clinical characteristic after 12 weeks of paroxetine treatment. There were significant correlations among severity of illness, anxiety, and depression, and subjective seventy was related with catastrophic thoughts. The more catastrophic thoughts and the higher sensitivity of body sensation, Patients had the worse symptom improvement they shorved. Multiple regression analysis showed that catastrophic thought related to agoraphobia was the best predictor of symptom improvement (22%). Conclusion : This study suggests that short-term treatment of paroxetine is effective in panic disorder with or without ago-raphobia, and that catastrophic thought could be a predictor of poor treatment response. Thus cognitive intervention on Catastro-phic thoughts may play an important role in symptom improvement in panic disorder.

벌 자상에 의해 발생한 횡문근융해증과 급성신부전

박상곤,김영대,강지은,신정현,신병철,박차영,정춘해 朝鮮大學校 附設 醫學硏究所 2003 The Medical Journal of Chosun University Vol.28 No.2

Rhabdomyolysis is a syndrome characterized by muscle necrosis and release of intracellular muscle constituents into the circulation. The spectrum of causes is quite broad and included disorders of traumatic, metabolic, infectious and toxic origin. However, rhabdomvolvsis and acute renal failure following bee sting is rare and its pathogenesis is not well known. We experienced a case of 63-year-old man with acute renal failure and rhabdomyolysis caused by bee sting. He was stung by bee on scalp and neck. Oliguria was developed within several hours. He has fully recovered after general supportive care including fluid therapy and diuretics. This case demonstrates that rhabdomvolysis with consequent acute renal failure are able to developed by bee sting.