경주지역 여고생의 초경과 체성장간의 관계

김준섭,권오구,박진석,오종수,박정현,박제식,안세한,이용환,서정호,신태섭,최영배,김덕수,이관,박수경 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

본 연구는 경주지역 1개 고등학교 3학년 여고생을 대상으로 초경 시작 전인 초등학교 4학년부터 고등학교 2학년까지의 키, 몸무게, 가슴둘레 수치와 초경 연령을 파악하여 여성의 초경이 빠를수록 체성장 속도의 변화가 있을 것이라는 가설을 기초로 두 요인간의 관련성을 파악하고자 시행되었다. 경주시 1개 여자고등학교 3학년생 총 317명에 대해 ㅊ경 나이, 초경시 심리 상태, 초경이 시작되었을 때의 상담 여부와 상담하였던 사람, 부모 신장과 초경전후의 식사 규칙성, 다이어트 경험, 수면시간, 스트레스, 음주/흡연 여부, 질병력 등에 대한 설문 조사를 시행하였고, 초등학교 4학년부터 고등학교 2학년까지의 키, 몸무게, 가슴둘레에 대한 정보는 건강기록부에서 확보하였다. 상기 대상자 중 건강기록부가 분실된 39명, 초경나이에 대해 응답하지 않았던 29명 및 결석 등으로 조사를 하지 못하였던 42명을 제외한 조사 대상자는 206명으로 선정하였다. 대상자들의 초경연령 평균값(Mean±SD)은 13.0±1.11이었고, 초등학교 4학년부터 고등학교 2학년까지의 초경 이후 신장 성장률은 감소하였으며, 초경연령이 빠른 군이 초등학교 때는 신장에 있어서 우위를 차지하나 고등학교에 오면서 신장은 비슷한 수준이 되었다. 초경후 1-2년 사이에 체중과 흉위의 증가율은 감소하였고, 초경연령이 빠른 군이 초등학교와 고등학교 사이에 체중과 흉위에서 모두 우위를 차지하였다. 본 연구의 결과는, 흔히 이차 성징의 시작 시점 혹은 사춘기의 시작 시점으로 보고있는 초경 연령이 청소년기의 성장과 밀접한 관련성이 있고, 특히 체중과 흉위의 성장 속도와 밀접한 관련성이 있음을 시사한다. To understand the onset of menarche in relation to changes in physical growth that take place during female adolescence, especially the changes in height and weight velocity. The 207 senior in one women high school of Kyongju were investigated in April 3 to 8, 2001. We collected the information, relation in the age at menarche, height & weight of parents, regularity of eating, and obesity diet, duration of sleeping, sickness & stress near age at menarche, by self-recording. The status of height, weight & chest circumference between the 4th grade of primary school and the junior of high school was collected by individual Health Record. The results were followed; The average age at menarche was 12.95±1.11 years old and the most frequent age of menarche is 13 years. After menarche, the velocity of height, weight and chest circumference were decreased. The most rapid group of menarche hold dominant position in height during elementary school. As time passed, they dont hold dominant position in height. The most rapid group of menarche get an advantage in the weight and the girth of chest after elementary school. The height of subjects is directly proportional to the height of their parents. These results suggest that the starting age at menestuation can be closely associated with physical growth and development.

골격근 근형질세망의 ATPase활성도에 대한 Vanillylnonanamide의 영향

박경섭,홍장희,류영수,성지연,허강민,임종호,이재흔,석정호 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.2

To investigate the effect of vanillylnonanamide(VN) on the ATPase activity of the sarcoplasmic reticulum(SR) of the skeletal muscle, we prepared the SR vesicles from the back muscle of the rabbit, and measured ATPase activity. The results as follows: Ca-ATPase activity was about 50% in the total ATPase activity of skeletal muscular SR. In the reaction mixture with calcium, 100μM VN increased ATPase activity to 20%, and 100 nM and 10 μM thapsigargin(THP) inhibited the ATPase activity to 50% and 60%, respectively. And 100 μM VN plus 100 nM or 10 μM THP more inhibited ATPase activity than THP alone did it. However, without calcium, 100μM VN did not affect ATPase activity, and 10 μM THP inhibited it to 41%, but VN plus THP inhibited it to 31%. The above results show that VN in the reaction mixture with or without calcium has the different action to ATPase activity when it is used alone or together with Ca-ATPase inhibitor THP. This suggests that VN might increase or decrease the skeletal SR Ca-ATPase activity through affecting the lipid membrane around the Ca-ATPase.

인지도 조사에 의한 건국의대 의학과 교육목적 및 교육목표의 평가

박수경,김진국,김소정,김형수,이건세,장성훈 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

This study was conducted to survey the recognition and accuracy for educational goal and objectives of College of Medicine, Konkuk University on students and professors with using 18 items of questionnaire from May 15 through June 30, 2004. The recognition for educational goal of College of Medicine, Konkuk University in participating students and professors were 93-95%. And recognition for 3 objectives of College of Medicine, Konkuk University on participating students and professors were 84-87%, 95% respectively. However the accuracy for detail educational objectives using other college of medicine were 46-59% in first student survey, 44-67% in second student survey and 58-72% in professor survey. Therefore it is need to advertize 3 objectives to students and professors. And it is also necessary to refine the contents of educational objectives to more suggesting directions than broad goal of ideal.

지방정치에서 정당의 역할과 한계 : 한 도시 이야기

박종민,신수경 고려대학교 정보학연구소 2001 정부학연구 Vol.7 No.1

위험요인 변동에 따른 유방암의 인구집단 귀속위험도 분율과 누적위험도의 측정

박수경 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

To establish the prevention strategy breast cancer in Chungcheongbuk-do female population, we estimated the population attributable risk percent (PARP) according to population exposure fraction of risk factors and the cumulative risk until 64 years, using previous data in Korean. The cumulative risks until 64 years old for breast cancer were calculated by the age-specific incidence rate (Yoo et al., 1998; Appendix 2), the population exposure fraction of breast cancer (Appendix 3) and the odds ratios of risk factors in hospital breast cancer case-control study (Yoo et al 1998; Appendix 4), through the formula suggested in Kleinbaum et al., (1982) and IARC (1992). The PARP by exposure fraction status were calculated by previous data of the odds ratios and population exposure fraction of breast cancer, through the formula suggested in Cole and Macmahon (1971) and Kelsey et al. (1986). And protective fraction percent (PFP) was calculated through the formula suggested in Miettinen (1974). Based on three criteria (1. PARP > ±10%, 2. the significance of 95% confidence interval of odds ratios, 3. cumulative risk ratio (CRR)>1.5 or CRR<0.7), we suggest that high risk group by breast cancer prevention strategy in Korea should be selected as the women with BMI>26 kg/m2, regular menstruation, & alcohol drinking, and parous women having over and at 2 children.

기존자료의 정확성 및 보정 분률에 따른 선천성 다지증의 출생시 발생률 추정

박수경 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

연구목적 : 본 연구는 전국단위의 의료보험자료를 기초로 하여 다지증이 의심되는 대상자들을 선정하고 이들을 중심으로 의료보험자료의 정확성 분률 및 보정 분률(전체 환자 중 조사된 환자가 차지하는 분률)에 따른 다지증 발생률을 추정하는 것이다. 연구 대상 및 방법 : 전국의료보험연합회의 의료보험수진청구자료 중 확보된 1991-1996년 자료를 이용하여 의료보험 청구 자료상의 다지증 환자들을 선별하였는데, 1994년 출생아(n=721,848) 중 다지증이 의심되는 경우(질병분류 ICD-9 code 755 (Other congenital anomalies of limbs), ICD-10 code Q69 (Polydactyly))를 가진 경우는 모두 1,551명이었다. 그 중 3개 종합병원을 선정하여 선별된 다지증 의심 환아들의 의무기록지를 확인하여 의무기록상의 정확성 정도(accuracy fractiono)를 계산하였다. 모든 연령대의 다지증 환자 중 만 0-2세의 다지증 환아의 분률, 즉 보정분률(correction fraction)을 추정하기 위하여 의료보험청구기록 상에서 다지증이 의심되는 모든 연령대의 환자 중 연도별 만 0-2세 분률의 변화를 산출하였고, 최소값과 최대값으로써 보정분률의 범위를 산출하였다. 따라서 전체 의심 환자 ( n=1,551)에서 정확성 정도와 보정분률을 보정함으로써 다지증의 출생시 발생률이 최종적으로 산출되었다. 연구결과 : 다지증의 출생시 발생률은 1000명 출생아당 0.9-2.0명으로 추산되었다. 고찰 : 본 연구는 선천성 수부 기형 중 가장 많은 것으로 알려져 있는 본 질병의 발생 규모를 예측하게 할 뿐 아니라 선천성 기형에 대한 발생률 추정에 방법론을 제시하는데 도움이 될 것으로 사료된다. Study objective - The aim of this study was to estimate the incidence rate of congenital polydactyly to use medical utilization database of the National Health Insurance Corporation in Korean. Material and methods - Base population for the estimation of incidence rate are selected from the total children born in 1994 (n=721,848). The presumptive cases of polydactyly are selected from the base population with polydactyly disease criteria (n=1,551) born in 1994 from medical utilization databases. The diagnoses of polydactyly in the claims included one of the following diagnostic codes ; ICD-9 code 755(Other congenital anomalies of limbs), ICD-10 code Q69 (Polydactyly). All the case of three General hospitals have been confirmed as having a polydactyly through a medical record review and through the results, the accuracy fraction by disease codes has been calculated. The fraction of the cases aged 0-2 year for all polydactyly cases (correction fraction) was predicted as the cross-sectional medical utilization data of presumptive polydactyly patients. The range of congenital polydactyly incidence at birth was estimated by the accuracy fraction and correction fraction. Results - The estimated incidence rate are minimum 0.9 per 1,000 birth to maximum 2.0 per 1,000 birth by considering for correction fraction and accuracy fraction. Discussions - Validity of these estimates is discussing in comparison with registry data of congenital anomalies and prospective follow-up study of estimation of incidence rate. Therefore, it could be very important for estimation of accurate incidence rate to perform birth cohort study or disease registry.

FGF-mediated FGFR signaling 이 두개봉합부의 초기형태발생 및 유지기전에 미치는 영향

남순현,김영진,서경환,김현정,박미현,유현모 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.4

두개봉합부의 조기융합으로 알려진 Craniosynostosis는 두개봉합부 주위 조직들 사이의 조화로운 상호 작용이 파괴되었을 때 야기될 수 있다. 흥미롭게도 FGF receptor들, 특히 FGFR2의 point mutation은 여러 가지 형태의 craniosynostosis 증후군과 연관되어 있어, FGFR가 두개봉합부를 포함한 두개골 성장 발달과정에 중요한 유전자임을 시사하고 있다. Mouse 두개봉합부의 초기형태발생시 FGFR 유전자들의 기능을 알아보기위해, in situ hybridization 방법을 이용하여 FGFR2(BEK) 및 골아세포분화의 초기표지자인 osteopontin이, 태생기(E15-18)에서 출생후(P1-P3)까지, 두개골의 시상봉합부에서의 발현양상을 조사하였다. FGFR2(BEK)은 osteogenic front에 강하게 발현되었으며, osteopontin은 parietal bone의 exo-, endocranial부위에서 발현되었으나, parietal bone의 성장가장자리인 osteogenic front에서는 관찰되지 않았다. 두개봉합부에서의 FGF-mediated FGFR signaling의 역할을 좀더 심도깊게 조사 하기위해 E15.5 mouse의 두개골을 이용하여 in vitro 실험을 시행하였다. 흥미롭게도 osteogenic fronts 및 시상봉합부의 간엽조직 중앙에 FGF2 - soaked beads를 점적하여 36시간 기관배양한 결과, bead주위 조직들의 두께 및 세포수가 증가되었으며, osteogenic fronts 상에 FGF4 beads를 올려놓은 경우, 시상두개봉합부 중앙에 점적된 FGF4 beads나 BSA control beads에 비해, 골성장이 촉진되어 시상두개봉합부의 부분적인 소멸을 관찰할 수 있었다. 이와 더불어 FGFR2 beads는 osteopotin 및 Msxl 유전자의 발현을 유도하였다. 이 결과들을 종합해 볼 때, FGF - mediated FGFR signaling이 발육중인 두개골과 두개봉합부에서 세포의 증식과 분화의 균형을 조절하는데 중요한 담당하고 있음을 시사해주고 있으며, 이 과정중 FGF signaling이 osteopontin 및 Msxl 유전자의 발현을 조절하므로써 막내골 성장 및 두개봉합부의 유지기전에 기여할 것으로 사료된다. Craniosynostosis, the premature fusion of cranial sutures, presumably involves disturbance of the interactions between different tissues within the cranial sutures. Interestingly, point mutaions in the genes encoding for the fibroblast growth factor receptors(FGFRs), especially FGFR2, cause various types of human craniosynostosis syndromes. To elucidate the function of these genes in the early morphogenesis of mouse cranial sutures, we first analyzed by in situ hybridization the expression of FGFR2(BEX) and osteopontin, an early marker of osteogenic differentiation, in the sagittal suture of calvaria during embryonic (E15-E18) and postnatal stage (P1 - P3). FGFR2(BEK) was intensely expressed in the osteogenic fronts, whose cells undergo differentiation into osteoprogenitor cells that ultimately lay down the bone matrix. Osteopontin was expressed throughout the parietal bones excluding the osteogenic fronts, the periphery of the parietal bones. To further examine the role of FGF-mediated FGFR signaling in cranial suture, we did in vitro experiments in E15.5 mouse calvarial explants. Interestingly, implantation of FGF2 soaked beads onto both the osteogenic fronts and mid-mesenchyme of sagittal suture after 36 hours organ culture resulted in the increase of the tissue thickness and cell number around FGF2 beads, moreover FGF4-soaked beads implanted onto the osteogenic fronts stimulated suture closure due to an accelerated bone growth, compared to FGF4 beads placed onto mid-mesenchyme of sagittal suture and BSA control beads. In addition FGF2 induced the ectopic expression of osteopontin and Msxl genes. Taken together, these data indicate that FGF-mediated FGFR signaling has a important role in regulating the cranial bone growth and maintenance of cranial suture, and suggest that FGF-mediated FGFR signaling is involved in regulating the balance between the cell proliferation and differentiation through inducing the expression of osteopontin and Msxl genes.

노년기 치매와 우울증의 유병률 및 위험인자

서국희,김장규,연병길,박수경,유근영,양병국,김용식,조맹제 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

경기도 연천군에 거주하는 만 65세이상 노인 1,037명을 대상으로 1996년 12월부터 1997년 8월까지 9개월간에 걸쳐 치매와 노년기 우울장애의 유병률과 위험인자에 관한 이 단계 역학조사(일차선별검사후 이차 진단적 면접)를 수행하였다. 다단계 층화집락표본추출에 의한 확률표본법으로 대상자 선정을 하였고, 반응률은 85.2%이 었다. 일차선별검사에는 노인정신장애 평가척도 한국어판(K-PAS)을 사용하였고, 일상생활 능력척도(ADL) 및 수단적 일상생활 능력척도(IADL)를 사용하여 기능을 평가했고, 지지도 척도(APGAR)를 사용하여 사회적 지지정도를 평가하였다. 이차 진단적 면접에서는 진 신장애의 진단 및 통계편람 제3판 개정판(DSM-III-R)의 진단기준을 따라 임상 진단을 확정하였다. 감별진단 및 장애 정도의 평가를 위하여 보조적인 진단도구들을 사용하였다. 1) 연령 보정된 치매의 유병률(%)[95% 신뢰구간]은 6.83[6.12∼7.54](남자 6.34[5.29∼7.40], 여자7.09[6.14∼8.04]이었다. 이중 알쯔하이머형 치매의 유병률(%)[95% 신뢰구간]은 4.17[3.61∼4.74] (남자 2.42[1.76∼3.08], 여자 5.31[4.48∼6.14]이었고, 혈관성치매의 유별률(%)[95% 신뢰구간]은2.38[1.95∼2.81](남자 3.46[2.67∼4.25], 여자 1.63[1.16∼2.10])이었다. 2) 연령 보정된 우울장애의 유병률(%)[95% 신뢰구간]은 10.99[10.11∼11.87](남자 7.59[6.44∼8.73], 여자 13.46[12.20∼14.73])이었다. 진단별로는 주요 우울장애의 유병률(%)[95% 신뢰구간] 이 7.50[6.76∼8.26](남자 4.42[3.54∼5.31], 여자 9.78[8.68∼10.88]), 기분부전장애의 유병률(%)[95% 신뢰구간]이 2.02[1.62∼2.42](남자 1.37[0.86∼1.87], 여자 2.46[1.88∼3.03], 달리 특정되지 않은 우울장애 유병률 (%)[95% 신뢰구간]이 1.49[1.15∼1.83](남자 1.85[1.47∼2.23], 여자 1.28[0.96∼1.60])이었다. 3) 알쯔하이머형 치매의 통계적으로 유의한 5가지 위험인자는 85셍상의 고령(O.R.= 10.27), 무학(O.R.= 4.01), 흡연[흡연년수 0.1∼30년(O.R.= 3.11), 흡연년수 30년 이상 (O.R.= 4.60)], 알코올남용(O.R.= 2.98)과 치매의 가족력 (O.R.= 4.85)이었다. 4) 혈관성 치매의 통계적으로 유의한 3가지 위험인자는 '무학' (O.R.= 3.78), 흡연[40년 이상 흡연년수 (O.R.= 11.15)]과 '뇌졸중의 과거력 (O.R.= 26.76)'이었다. 5) 우울장애의 통계적으로 유의한 3가지 위험인자는 '75∼79세 연령군' (O.R.= 2.87), '뇌졸중의 과거력' (O.R.= 3.33)과 '우울장애의 가족력' (O.R.= 7.16)이었다. 중심단어:알쯔하이머형 치매·혈관성 치매·우울장애·유병률·위험인자·흡연. An epidemiological survey was conducted to estimate the prevalence of and identify the risk factors of dementia and depression in the elderly between December 1997 and August 1998 in Yonchon County, Korea. A total of 1,037 elderly aged 65 years and over underwent a two phase diagnocstc procedure. Multiple stage, random cluster sampling method was used to select the subjects. Response rate was 85.4%. For the Ist stage screening survey, the Korean Psych-ogeriatric Assessment Scale was used as a primary screening tool, which had already been standardized in Korea, and functioning and social support were assessed by ADL, IADL and APGAR. At the 2nd stage, diagnoses were confirmed according to the DSM-Ⅲ-R. And several other scales were used as supporting information for differential diagnoses and for evaluating severity. 1) Age-sex adjusted prevalence(%)[95% C.I] of dementia was 6.83[6.12-7.54](male 6.34 [5.29-7.40], female 7.09[6.14-8.04]). Prevalence of the dementia of the Alzheimer's type was 4.17[3.61-4.74](male 2.42[1.76-3.08], female 5.31[4.48-6.14]) and that of the va-scular dementia was 2.38[1.95-2.81](male 3.46[2.67-4.25],female 1.63[1.16-2.10]). 2) Age-sex adjusted prevalence(%)[95% C.I.] of depressive disorder was 10.99[10.11-11.87](male 7.59[6.44-8.73], female 1346[12.20-14.73]. Among depressive disorders, prev-alence(%)[95% C.I.] of major depressive disorder was 7.50[6.76-8.26](male 4.42[3.54-5.31], female 9.78[8.68-10.88]), that of dysthymic disorder was 2.02[1.62-2.42](male 1.37[0.86-1.87], female 2.46[1.88-3.03]) and that of depressive disorder NOS was 1.49[1.15-1.83](male 1.85[1.47-2.23], female 1.28[0.96-1.60]). 3) Five statistically significant risk factors of the dementia of the Alzheimer's type were identified : age over 85(O.R. = 10.27), illiteracy (O.R. = 4.01), alcohol abuse (O.R. = 2.98), smoking [0 < pack year ≤30(O.R. = 3.11), pack year>30(O.R. = 4.60)] and family history of dementia (O.R. = 4.85). 4) Three statistically significant risk factors of the vascular dementia were identified : illiteracy (O.R. = 3.78), history of CVA(O.R. = 26.76) and smoking over 40 pack year(O.R. = 11.15). 5) Three statistically significant risk factors of the depressive disorder were identifed : age between 75 and 79(O.R. = 2.87), past history of CVA(O.R. = 3.33) and family history of depressive disorder(O.R. = 7.16). KEY WORDS:Dementia of the Alzheimer's Type·Vascular dementia·Depressive disorder·Prevalence·Risk factor·Smoking.

통합적 림프부종 간호중재 개발 연구

조명옥,정향미,전점이,손수경,우영자,노미영,박순옥 성인간호학회 2003 성인간호학회지 Vol.15 No.2

The purpose of this study was the development of a comprehensive nursing intervention program for the client with acute lymph stasis and stage I lymphedema. Method: The Quasi-experimental design using a non-equivalent control group was used. The subjects were 22 stroke patients with lymph stasis in the control group and 23 patients in the experimental group. The complex physical therapy of Casley-Smith was carried out to the control group for 0 hours, and comprehensive nursing intervention for the experimental group was carried out for 60 minutes. The data for this study was gathered from Feb. 2002 until June 2002 and pertains knowledge about lymphedema, self-care for managing lymphedema, and circumferences of affected limbs. Data was analyzed by mean, standard deviation, x^2-test. And t-test. Result: The changes in knowledge about lymphedema, self-care practices, and circumference of affected limbs after nursing intervention did not show significant differences between control group and experiment group. Conclusion : It can be concluded that comprehensive nursing intervention had more efficiency than complex physical therapy in the treatment of edema for stroke patients because of it’s simplicity and time saving. Thereby, the comprehensive nursing intervention program developed in this study would be a useful therapy for the clients with lymph stasis and early stage lymphedema.

림프부종 환자의 자가관리에 관한 실태 조사

조명옥,정향미,전점이,손수경,우영자,노미영,박순옥 성인간호학회 2003 성인간호학회지 Vol.15 No.3

Purpose : The purpose of this descriptive study was to gain basic data to develop a self-care protocol for the lymphedema patients. Method : The subjects of this study consisted of 115 patients with lymphedema from 8 hospitals and two community health and welfare centers in Busan and Seoul. The data was collected with questionnaire by self reporting of patients between March 2001 and December 2001. Data was analyzed by mean and percentage. Result : For self-care activities in daily life, compliance of 'use skin care preparations', 'use heat and cold', 'protect from local compression on affected limbs', 'protect from insect biting', 'use aids to protect affected limbs', 'take diuretics and take protein diet' did not reach to 50%. For self-care activities related to complex physical therapy, 28.7% of subjects complied with compression garment, 14.8% with manual lymph drainage and 13.0% with exercise, 20.0% of subjects tried to treat with acupuncture and 13.9% with heat therapy. Conclusion : From this study, it is suggested that patients need to get a self-care education with correct information about self care activities and health care professionals need to develop more convenience self-care techniques of massage and exercise.