Electrical properties and deep traps spectra of a-plane GaN films grown on r-plane sapphire

Polyakov, A.Y.,Smirnov, N.B.,Govorkov, A.V.,Markov, A.V.,Sun, Q.,Zhang, Y.,Yerino, C.D.,Ko, T.S.,Lee, I.H.,Han, J. Elsevier 2010 Materials science & engineering. B, Advanced funct Vol.166 No.3

Electrical properties, deep traps spectra and luminescence spectra were studied for two undoped a-plane GaN (a-GaN) films grown on r-plane sapphire using metalorganic chemical vapor deposition and differing by structural perfection. For sample A, the a-GaN film was directly deposited on AlN buffer. A two-step growth scheme was implemented for sample B, including an initial islanding growth stage and a subsequent enhanced lateral growth. Preliminary detailed X-ray analysis showed that the stacking faults density was 8x10<SUP>5</SUP>cm<SUP>-1</SUP> for sample A and 1.7x10<SUP>5</SUP>cm<SUP>-1</SUP> for sample B. Electrical properties of a-GaN films were largely determined by deep traps with a level near E<SUB>c</SUB> -0.6eV, with other prominent traps having the activation energy of 0.25eV. The Fermi level was pinned by the E<SUB>c</SUB> -0.6eV deep traps for sample A, but shifted to the vicinity of the shallower 0.25eV traps for sample B, most likely due to the reduced density of the 0.6eV traps. This decrease of deep traps density is accompanied by a very pronounced improvement in the overall luminescence intensity. A correlation of the observed improvement in deep traps spectra and luminescence efficiency with the improved crystalline quality of the films is discussed.

「玉匣夜話」의 構造分析

金仙雅 숙명여자대학교 대학원원우회 1983 원우논총 Vol.1 No.-

"Oc-kab-ya-hwa"(「玉匣夜話」) which has the structure with 'Huh-Saeng-Jeon'(「許生傳」) as its internal story, is a frame story in which the first six tales work as an introduction, and 'epilogue(後識) Ⅰ.Ⅱ' as the conclusive frame, respectively. The reason is that in all of the first six tales and 'epilogue Ⅰ.Ⅱ', the descriptive point of view is focused on the embodiment of the idea of justice and morality, the theme of 'Huh-Saeng-Jean' (「허생전」), especially that both of 'epilogue Ⅰ.Ⅱ' exist only as the epilogue of 'Huh-Saeng-Jeon'(「許生傳」). Therefore "Oc-Kab-ya-hwa"(「玉匣夜話」) is grasped in its unique confirmative frame to objectify the relation between the writer and the internal stories. By putting the origin of 'Huh-Saeng-Jeon'(허생전) on the folk literature and analyzing it by the method of structure analysis, I have studied its artisticiy and oriented meaning. That is, 'Huh-Saeng-Jeon'(허생전) is composed of three independent unit-episodes in each of which the subject is the embodiment of the idea. And it is shown that these three unit episodes stand in the close systematic tense relation with the continuous opposition and trouble and, that they carry the theme (the orientation) and the intention of writing the novel. Through the temporal and spacial rising and extension experienced by Huh-Saeng(許生), a ruined nobleman(양반), it is pointed out in 'Huh-Saeng-Jeon'(허생전) that the real problem lies on the status where the ideas are not realized. Even though the richness is presupposed for the realization of the ideas, it is only a means. Then, what are the ideas which he would embody concretely? They are the ideas of Confucian morality, such as confidence, justice, etc. The actual feudalizm of the social structure at that time, and the purification and acceptance of the Confucian ideas are problems for him. The six episodes of "Ok-kab-ya-hwa"(「玉匣夜話」) which work as an introductive frame are said to center around the ideas of justice and morality. "No matter how valuable ten thousand nyang may be, how can it fatten up morality?", it speaks for everything. The internal discord being under the restriction and control of the external discord, throughout the whole story, the descriptive point of view for the realization of the ideas carries the tense relation between the two sides. These discords are elevated and extended from the real and individual dimension to the social yet unreal and ideal one, and further to the actual, national and social dimension to take a concrete shape. But the escapism, a solution arrived at by the hero through the frustration, shows on the one hand how an individual with a good purpose can becrushed into pieces in the social irrationality by a sudden breaking of the tense relation which has been heated utmost, and on the other hand it is insisted throughout the story that the ideas must be embodied in the society. In other words, Huh-Saeng(許生), a strong-willed man, brings to an end through the self-breaking the tense relation existing in the discords opposing between himself and the social reality. Even though Huh-Saeng(許生), both a live person and a strong-willed man, failed at last and gave up the reality and _the society, it is clear that, he, a scholar with a critical mind in such an ultra conservative Confucian society of the Lee dynasty, was a revolutionary type of man in a transitional period of modernization.

DACUM 기법에 의한 병원 임상영양사의 직무기술서 개발

차진아 ( Jin A Cha ),김강은 ( Kang Eun Kim ),김은미 ( Eun Mi Kim ),박미선 ( Mi Sun Park ),박유경 ( Yoo Kyoung Park ),백희준 ( Hee Joon Baek ),이송미 ( Song Mi Lee ),최수경 ( Soo Kyong Choi ),서정숙 ( Jung Sook Seo ) 대한영양사협회 2013 대한영양사협회 학술지 Vol.19 No.3

본 연구에서는 DACUM 기법을 통해 국내 병원 임상영양사의 직무를 조사 및 분석하고 그 결과를 바탕으로 도출된 임상영양사의 직무기술서를 평가함으로써 병원 임상영양사를 위한 직무기술서를 개발하고자 하였다. 2011년 7월초에 DACUM 워크숍을 통해 1차적으로 직무기술서를 도출하고 전문가 집단의 자문회의와 Delphi 조사 방법을 적용한 표적집단 면접을 통해 수정 및 보완 작업을 거쳐 직무기 술서를 도출하였다. DACUM 위원회의 패널로는 3차 의료기관에 종사하고 있는 현직 임상영양사 9인과 임상영양학을 전공하는 교수 4인, 직무분석을 담당하는 교수 1인 등 총 14명이 참여하였다. 전문가 자문단을 별도로 구성하였으며, 의사 1인, 간호사 1인, 임상영양분야 실무자 및 교수 5인이 포함된 전문가의 의견을 추가적으로 수렴하였다. 도출된 직무기술서는 2011년 7∼8월까지 전국 500병상 이상의 종합 병원 90개 중 설문조사에 응답한 46개 병원에서 각각 임상영양 실무책임자 1인으로부터 수집한 자료를 분석하여 현장 적합성을 평가하였다. 본 연구의 결과를 요약하면 다음과 같다. 1. 본 연구에서 DACUM 기법에 의해 처음 도출된 직무는 총 8개의 직무, 33개의 과업, 114개의 과업요소였으나 수정 보완작업을 거쳐 총 7개의 직무, 27개의 과업과 93개의 과업요소로 재분류되었다. 최종적으로 병원 임상영양사의 직무는 영양판정(A), 영양진단(B), 영양중재(C), 영양모니터링ㆍ평가(D), 자문ㆍ협력(E), 영양연구(F), 자기계발(G)로 도출되었다. 2. 각 직무영역별로 세부내용을 보면, (A) 영양판정은 A1. 영양 초기평가하기, A2. 식품영양관련 자료 수집·평가하기, A3. 의학적 자료 점검하기, A4. 신체계측 자료 수집·평가하기, A5. 신체증상 자료 점검하기, A6. 개인력 및 과거력 점검하기, A7. 영양 요구량 결정하기, A8. 영양판정 기록하기의 8개의 과업으로 구분하였다. (B) 영양진단은 B1. 영양진단 도출하기, B2. 우선순위 정하기, B3. 영양진단 기록하기로 나뉘었고, (C) 영양 중재는 C1. 영양중재 계획하기, C2. 영양처방 관리하기, C3. 영양상담하기, C4. 영양교육하기, C5. 영양집중지원하기, C6. 영양중재 기록하기로 구분 하였다. (D) 영양모니터링·평가는 4개의 과업으로 D1. 영양상태 모니터하기, D2. 영양중재과정 모니터하기, D3. 영양중재 결과 평가하기, D4. 영양모니터링·평가 기록하기로 구분하였다. (E) 자문·협력은 E1. 영양자문하기, E2. 협력관계 구축 및 유지하기로 (F) 영양연구는 F1. 질 향상 활동하기, F2. 연구 활동하기로 분류하였다. 마지막으로 (G) 자기계발은 G1. 전문성 향상, G2. 자기관리가 포함되었다. 3. 도출된 임상영양 직무기술서에 대한 평가를 위해 설문조사에 참여한 대상 병원의 유형은 상급종합 병원이 65.2%를 차지하였으며, 종합병원은 34.8%였다. 병원의 재원일수는 8.0±1.5일이었으며 병원 조직에서 영양부서는 6곳을 제외한 39개의 병원에서 진료부서 또는 진료지원부서에 속하였다. 또한 병원에서 영양부서가 단독으로 편제되어 있는 경우가 93%로 높은 비율을 보였다. 병원 임상 영양사의 성별은 여자가 100%로 나타났으며, 연령별 분포는 40∼49세가 가장 높은 비율을 보였다. 근무경력은 10년 이상인 경우가 50% 이상을 차지하였고 최종학력은 석사졸업이 가장 높은 것으로 나타났다. 4. 전체 과업요소의 인지된 중요도를 비교하면 6개의 과업요소를 제외한 대부분의 과업요소들이 4.0점 이상이었고 총 7개 직무영역에 대한 중요도는 ‘영양중재’가 4.6±0.6점으로 가장 중요도가 높게 나타났으며, ‘영양진단’과 ‘영양모니터링·평가’의 직무가 4.5점 이상으로 비교적 높게 조사 되었다. 전체 과업요소 중 수행도가 4.5점 이상으로 매우 자주 수행되는 과업요소가 13개, 4.0점 이상의 자주 수행되는 과업도 29개의 과업요소로 나타났으며, 직무영역 중 ‘영양중재’가 4.2±1.0점으로 높게 나타났다. 직무영역별 난이도를 조사한 결과에서는 ‘영양연구’ 업무가 4.1±0.9점으로 가장 높게 조사되었다. ‘영양진단’과 ‘자문·협력’은 각각 3.8±1.0점, 3.7±0.9점으로 비교적 어렵게 인식되는 직무로 나타났다. 직무영역별 과업요소 전체의 중요도, 수행도, 난이도의 평균은 각각 4.5±0.8점, 3.7±1.3점, 3.5±1.0점으로 나타났으며 유의적인 차이가 나타났다(P<0.001). 5. 임상영양사 업무의 중요도와 수행도 사이의 관계를 나타낸 격자도 분석에서 영양 초기평가하기, 영양요구량 결정하기, 영양판정 기록하기, 영양진단 도출하기, 영양중재 계획하기, 영양처방 관리하기, 영양교육하기, 영양집중지원하기, 영양중재 기록하기, 영양상태 모니터하기, 영양중재 과정 모니터하기는 중요도와 수행도가 모두 높은 영역(doing great)에, 식품영양관련 자료수집·평가하기, 의학적 자료 점검하기, 신체계측 자료수집·평가하기, 신체증상 자료 점검하기, 개인력 및 과거력 자료 점검하기, 영양진단의 우선순위 정하기, 영양진단 기록하기, 영양상담하기, 영양 모니터링·평가 기록하기는 수행도는 높으나 중요도가 낮은 영역(overdone)에 속하였다. 중요도가 높으나 수행도가 낮은 영역(focus here)에는 협력관계 구축 및 유지하기, 질 향상 활동하기가 속하였고, 중요도와 수행도가 모두 낮은 영역(low priority)은 영양중재 평가하기, 영양 자문 활동하기, 연구 활동하기, 전문성 향상하기, 자기관리하기가 속하는 것으로 나타났다. 이상의 결과를 볼 때, 본 연구에서 DACUM 기법에 의해 개발된 병원 임상영양사의 직무기술서는 현장에서 임상영양서비스를 수행하는데 가이드라인으로 사용될 수 있을 것으로 여겨지며, 인지된 중요도가 평균 이상으로 높지만 그에 비해 수행도가 미흡한 과업들에 대하여는 임상영양사에 대한 교육 실시, 업무 분담, 적정인원 배치 등 제도적인 뒷받침을 마련하여 수행도를 높일 수 있는 방안이 강구 되어야 할 것이다. 또한 질병별 맞춤형 임상영양 업무에 관한 후속연구를 통하여 보다 전문적인 환자 영양치료가 가능할 것으로 여겨진다. The present study was conducted to develop a standardized job description for clinical dietitians working in hospitals. A developing curriculum (DACUM) method was used for the job analysis of clinical dietitians. Based on DACUM analysis with 14 members, including clinical dietitians and professors majoring in clinical nutrition and job analysis, information on the duties, tasks, and task elements of clinical dietitians was determined. To verify the job descriptions derived from DACUM analysis, a total of 46 tertiary and general hospitals with over 500 beds were recruited for the survey. The final developed job description for clinical dietitians included 7 duties, 27 tasks, and 93 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, nutrition monitoring·evaluation, consultation·cooperation, nutrition research, and self-development. The mean scores of perceived importance, performance, and difficulty on the clinical dietitian`s task elements (out of a maximum score of 5.0) were 4.5, 3.7, and 3.5, respectively, with significant differences between the items (P<0.001). The perceived importance and performance grid of clinical dietitian`s tasks showed that “construction and maintenance of collaboration” (E2) and “activity of quality improvement” (F1) received relatively low scores for performance despite their high importance scores; thus the performance of these tasks requires significant improvement. In conclusion, the job descriptions of clinical dietitians developed from this study are useful for the qualitative improvement of clinical nutrition services in hospitals.

자궁 내 감염 관련 유전자 및 산화 스트레스 관련 유전자와 조기분만의 연관성

유시연 ( Si Yeon You ),김정명 ( Jung Myung Kim ),이경아 ( Kyung A Lee ),박미혜 ( Mi Hye Park ),김영주 ( Young Ju Kim ),전선희 ( Sun Hee Chun ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.7

목적: 조기 분만과 자궁 내 감염 관련 유전자 (IFN-γ, interleukin [IL]-10) 및 산화 스트레스 관련 유전자 (CYP1A1)와의 연관성을 알아보고자 한다. 연구 방법: 2007년 1월부터 2008년 12월까지 이대 목동병원 산부인과에서 산전 검사 및 분만을 시행한 산모 중 37주 이전에 분만한 조산군 164명과 37주 이후에 분만한 대조군 305명을 대상으로 하였으며, 임신 주수 24주 미만, 태아의 선천성 기형, 다태아 분만, 사산의 경우를 제외하였다. 참여자는 입원 시 키, 몸무게 측정 및 혈액 채취를 시행하였고 임신 주수는 최종 월경일 또는 초음파 측정을 통해 계산 되었다. 산모의 혈액에서 IFN-γ, IL-10, CYP1A1 유전자형을 PCR과 SNaPShot method를 사용하여 검사하였으며 카이제곱 검정과 다중 로지스틱 회귀분석을 사용하여 통계분석 하였다. 결과: 조기 분만군과 만삭 분만군 사이에 임신 주수, 태아 체중에 통계적으로 유의한 차이가 있었다(P<0.0001). IFN-γ, IL-10, CYP1A1 유전자형의 빈도와 조기 분만 사이에는 유의한 상관성이 없었다(P>0.05). 결론: 본 연구에서 IFN-γ (874A/T) 및 IL-10 (1082A/G), IL-10 (819C/T), IL-10 (592A/C)와 CYP1A1 (T6235C), CYP1A1 (Ile462val [A/G]) 유전자형의 빈도는 조산과 관련이 없었다. Objective: To investigate the association between preterm birth and cytokine genes (IFN-γ, interleukin (IL)-10) in intrauterine infection and enzyme gene (CYP1A1) in oxidative stress response. Methods: This study involved a case-control study conducted at Ewha Womans University Hospital in Seoul, Korea. Subjects with preterm deliveries (<37 weeks of gestation) and normal controls with term deliveries (≥37 weeks of gestation) were selected from gravidas who had undergone prenatal examinations in the hospital and were followed until infant delivery. The weight, height, and blood samples of each participants were obtained according to standard protocols. We included subjects who gave birth to a singleton infant and had a gestational age between 24 and 42 weeks. Mutiple births, stillbirths, and congenital anomalies were excluded. Finally, 164 gravidas with preterm births and 305 normal controls with term deliveries were enrolled in the present study. Results: Preterm delivery group and term delivery group had significant difference in gestational age and neonatal body weight (P<0.0001). There were no statistically significant association between preterm birth and IFN-γ, IL-10, CYP1A1 genes (P>0.05). Conclusion: In this study, IFN-γ (874A/T), IL-10 (1082A/G), IL-10 (819C/T), IL-10 (592A/C) and CYP1A1 (T6235C), CYP1A1 (Ile462val [A/G]) genes had no significant association with preterm birth.

Cytological analysis of pregnancy-associated plasma protein-A expression in porcine neonatal testis

Ji-youn Kim,Keon Bong Oh,Sung June Byun,Sun-A Ock,Hwi-Cheul Lee,황성수,SangHyun Park,Wootae Ha,Jae-Seok Woo,Hyuk Song 한국수정란이식학회 2018 한국동물생명공학회지 Vol.33 No.3

The identification of biomarkers of a living tissues is essentially required to understand specific functions of the cells. In previous study, we reported IGFBP 3 as one of the putative biomarkers, by showing specific expression at porcine spermatogonial stem cells (SSCs) of early stage of porcine testis. In this study, we analyzed the expression of seven members of IGFBP family (IGFBPs) in SSCs and histological expression pattern of pregnancy-associated plasma protein-A (PAPP-A), which plays a role on the growth promoting enzyme by cleavage of IGFBPs in testis of 5 days old pig. RT-PCR analysis showed that IGFBP 1, 2, 3, 4, and 6 were expressed at high level specifically in porcine SSCs compared with whole testis. We performed immunohisotochemical staining of testis sections with PAPP-A and protein gene product 9.5 (PGP9.5) which are the known biomarkers for SSCs. We were not able to find co-expression of PAPP-A and PGP9.5; PAPP-A was expressed only in Sertoli cells and PGP9.5 expression was confirmed in spermatogonium. Additionally, we were able to confirm the GATA4 expression in Sertoli and Leydig cells as a regulator of Sertoli cell function was not detected PGP9.5 expressing cells, indicating indirect evidence of that cytolocalization of PAPP-A expression is limited in Sertoli cells. These results suggested that the PAPP-A expressed in Sertoli cells may play role on regulation of development and differentiation of testicular cells through the IGF axis in neonatal porcine testis.

부산지역 유흥업소 종사여성으로부터 분리된 HPV16형의 발암유전자(E6/E7) 돌연변이 유형 분석

민상기(Sang-Kee Min),김성순(Sung Soon Kim),최병선(Byeong-Sun Choi),장대호(Dai-Ho Jang),이미옥(Mee-Ok Lee),최성화(Seung-Hwa Choi),김남호(Nam-Ho Kim),박연경(Yon-Koung Park),정영아(Yeong-A Jeong),김성준(Seong-Joon Kim),빈재훈(Jae-Hun Bi 한국생명과학회 2009 생명과학회지 Vol.19 No.6

HPV-16형의 염기배열 변이는 지역적, 인종적으로 특징적인 차이가 있으며 특히 HPV-16형 E6/E7 유전자의 특정 염기서열변이는 자궁경부암 및 자궁상피내 신생종양물의 발생을 일으키는 고위험 요인으로 알려져 있다. 본 연구는 2007년 부산지역 유흥업소 종사여성으로 분리된 HPV-16형 19건을 대상으로 E6/E7 유전자 영역(nt 34-880)을 표적으로 지역적 염기서열 변이를 조사하였다. nucleotide 수준에서 HPV16형 E6 유전자는 T178G (n=11), T178A (n=1), T350G (n=4), A442C (n=2), A104T, A111G, C116T, G145T, T183G, C335T, G522C 등 11종의 변이주가 발견되었고, E7 유전자는 A647G (n=12), A645C, A777C, G663A, T732C, T760C, A775T, T789C, T795G 등 9종의 변이주가 발견되었다. 아미노산 수준에서는 HPV-16형 E6 단백질의 경우 D25E (n=12), L83V (n=4), E113D (n=2), M1L, Q3R, P5S, Q14H, D25N, I27R, H78Y, C140S 등 11종의 변이주를, HPV16형 E7 단백질의 경우 N29S (n=12), L28F, T72S 등 3종의 변이주를 관찰할 수 있었다. 본 연구 결과, 부산지역의 HPV-16형 E6/E7 우점 돌연변이주는 E6 D25E (75%), E7 N29S (78%)로 각각 나타났다. 앞으로 자궁경부암 환자 및 일반여성을 포함한 더 많은 모집단을 대상으로 HPV-16형 E6/E7의 intratypic variants를 비교 조사하여 실제 HPV-16형 E6/E7 어떤 변이주가 자궁경부암 유발 위험성과의 관련성은 더 많이 연구되어져야 할 것으로 사료된다. Recent studies have reported that the distribution of HPV-16 sequence variation differs geographically, and more specifically that HPV-16 E6/E7 intratypic variants might carry a high risk for development of ICC (invasive cervical cancer) and CIN (cervical intraepithelial neoplasia) in a given population. To investigate the genetic diversities of HPV-16 E6/E7 oncogene by region, we collected nineteen HPV-16 isolates from sexually high-risk women in Busan, and analyzed the HPV-16 E6/E7 coding regions (nt 34 to 880) with HPV-16 E6/E7 specific PCR amplification. At the nucleotide level, eleven variants of the E6 genes and nine variants of the E7 genes were identified as follows: E6 T178G (n=11), E6 T178A (n=1), E6 T350G (n=3), E6 A442C (n=2), E6 A104T, E6 A111G, E6 C116T, E6 G145T, E6 T183G, E6 C335T, E6 G522C and E7 A647G (n=12), E7 A645C, E7 A777C, E7 G663A, E7 T732C, E7 T760C, E7 A775T, E7 T789C and E7 T795G, respectively. At the amino acid level, the isolated HPV-16 E6 and E7 genes showed eleven E6 variants: E6 D25E (n=12), E6 L83V (n=4), E6 E113D (n=2), E6 M1L, E6 Q3R, E6 P5S, E6 Q14H, E6 D25N, E6 I27R, E6 H78Y, E6 C140S and three E7 variants: N29S (n=12), L28F, T72S. HPV16 E6 L83V, the dominant variant in the Caucasian population, showed relatively low frequencies in our study population. We elucidated that the dominant HPV-16 E6/E7 variants were HPV-16 E6 D25E (63.2%) and HPV-16 E7 N29S (63.2%), which were phylogenetically included in Asian lineage. Further study is needed to evaluate the risk of cervical cancer related HPV-16 E6/E7 intratypic variants in the Korean population.

한국인에서 5,10-Methylenetetrahydrofolate Reductase 유전자 다형성 분석 및 임신의 결과에 미치는 영향

김아리 ( Ari Kim ),강은지 ( Eun Ji Kang ),이경아 ( Kyung A Lee ),박세나 ( Se Na Park ),박종순 ( Jong Soon Park ),박보현 ( Bo Hyun Park ),박혜숙 ( Hyesook Park ),박미혜 ( Mi Hye Park ),전선희 ( Sun Hee Chun ),안정자 ( Jung Ja Ahn ) 대한주산의학회 2006 大韓周産醫學會雜誌 Vol.17 No.3

목적: 본 연구는 한국인 임신 여성에서 MTHFR 유전자형 변이와 혈청내 호모시스테인 및 엽산의 농도와 이들이 임신에 미치는 영향을 알아보고자 하였다. 방법: 임신부 600명에게서 혈액을 채취하여 얻어진 DNA로 MTHFR C677T와 A1298C 유전자의 다형성을 PCR-RELP로 분석하였고 혈청내 호모시스테인은 HPLC 방법으로, 엽산은 RIA 방법으로 측정하였다. 결과: 혈청내 호모시스테인은 MTHFR C677T 유전자형이 C/C형이나 C/T인 군에 비해 T/T인 군에서 유의하게 높았으며 MTHFR A1298C 유전자형이 A/C형이나 C/C인 군에 비해 A/A인 군에서 역시 유의하게 높았다( p<0.05). 혈청 호모시스테인은 모든 MTHFR 유전자형에서 혈청 엽산농도와 역상관관계를 보였으나, 변이형 유전자형(T/T와 A/A유전자형)에서 더 큰 역 상관관계를 보였다. 15?mol/L 이상의 고호모시스테인혈증의 임신부에서 임신 주수와 출생체중이 36.1주, 3053.8 g으로 15 ?mol/L미만인 군의 38.3 주, 3215.3 g 보다 유의하게 낮았다( p<0.05). 결론: 혈청 호모시스테인의 농도는 MTHFR C677T와 A1298T 유전자의 다형성에 의해 영향을 받으며, MTHFR C677T와 A1298T 유전자의 다형성과 혈청 호모시스테인은 모두 임신주수와 신생아의 체중에 영향을 미친다. Objective: The purpose of this study was to analyze MTHFR polymorphism among the Korean population and to evaluate the relationship between serum levels of homocysteine and MTHFR polymorphism and also to investigate the effect on pregnancy outcomes. Methods: DNA was extracted from whole blood of 600 pregnant women. All samples were genotyped for the C677T and A1298C polymorphisms in MTHFR gene by PCR-RELP assay. Serum levels of homocysteine and folate were measured by high performance liquid chromatography for homocysteine and radioassay for folate. Pregnancy outcomes were estimated by gestational weeks and birth weights of newborns. Results: Serum homocysteine was higher in women with the T/T genotype than those with the C/T or C/C genotype of the MTHFR C677T polymorphism (p<0.05). And also serum homocysteine was higher in women with the A/A genotype than those with the A/C or C/C genotype of the MTHFR A1298C polymorphism (p<0.05). Serum homocysteine was negatively correlated with serum folate in all MTHFR genotypes, especially prominent in T/T genotype of MTHFR C677T polymorphism and A/A genotype of MTHFR A1298C polymorphism. Gestational age and the birth weight of infant from hyperhomocysteinemic mothers whose homocysteine levels higher than 15 μmol/L were 36.1 weeks, 3053.8 g, respectively, which were significant lower than those from normohomocysteinemic mothers (38.3 weeks, 3,215.3 g) (p<0.05). Conclusion: Serum homocysteine was influenced significantly by MTHFR C677T polymorphism and MTHFR A1298C polymorphism. MTHFR C677T and A1298C polymorphism and serum homocysteine levels affect pregnancy outcomes, although not mainly by serum folate level.

자아성장 프로그램이 여중생의 자아개념에 미치는 영향

정선아,이정숙 대한간호학회정신간호학회 2001 정신간호학회지 Vol.10 No.3

The aim of the study is to develop self-growth program fitting middle-school girls' developmental stage and by examining what self-growth program influence on self-concept change of middle-school, to provide nursing intervention for the purpose of improving youth' mental health in school study field. Total 155 first grade students, female, at H(experimental group, 75) and W(control group, 80) middle school in K city were sampled for this study for convenience, experimental group were divided into a group of 13~14 students and three counselors proceeded self-growth program by the planned module. This program had been administerd for 5 weeks(1 hour/week) in the morning (May, 15~Jun, 14). While, after one month. The control group was only surveyed two times before and after a five-week period in between. Self-growth program administered in the research was developed by a joint effort of Mental Heath Center in Seo-district, Kwangju Metropolitan city researcher, based on Personality Education Program(Kim, 2000). The self-concept measuring tool is questionaries amended and complemented by researcher using perceptual self (20 items) by Choi Jung hun (1972) and self esteem (10 items) by Rosenberg (1983). Cronbach's α of the this measure is .87. The PC-SAS package program was used to analyze the data along with percentage, χ^2-test, t-test. The results of the study were as follows: 1) hypothesisⅠ; experimental group with educated self-growth program will show more positive change in perceptual self than the control group was accepted. as perceptual self scores of the experimental group turned out to be 64.4 and the control group, 57.6, two group's perceptual self scores show significant difference(t=3.75, p=.000). 2) hypothesisⅡ; experimental group with educated self-growth program will show more positive change in self-growth than the control group was accepted. as self-esteem scores of the experimental group turned out to be 30.6 and the control group. 26.8, two group's self-esteem scores appear significant difference(t=3.75, p=.000). 3) Students' response along the self-growth program include; 'The entering the meeting' influenced on a domain of the faith and self opening, 'Who am I?" influenced on a self-exploration, self-esteem and valuable-valueless, 'I will become this sort of person!' influenced on a self-understanding, self-esteem and capable-incapable, 'Good fellowship' influenced on a self-exploration, self-understanding, self-discovery, and friendly-Isolated and 'The commending a friend' influenced on self-discovery, self-esteem, friendly-Isolated and accepted-rejected positively. This study showed the self-growth program fitting middle-school girl's developmental stage influenced on the self-concept of the middle school girls positively, this program will contribute to positive self concept function in adolescence life. Therefore, it considered necessary to proceed this self-growth program regularly as a part of the school personality education course.

직업적 노출에 의한 스티븐스-존슨 증후군에서 트리클로로에틸렌의 노출수준 : 3예의 사례와 문헌고찰을 중심으로

이선웅,김은아,김대성,고동희,강성규,김병규,김민기 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.2

배경: TCE는 심각한 전산적 피부염과 관련 있는 것으로 몇몇 사례들을 통해서 보고되어 왔으나,기존의 사례 보고들에서 노출평가가 수행된 사례는 드물었고 추정되는 노출량 역시 매우 다양하였다. 본 연구에서는 TCE 노출에 의한 것으로 판단되는 스티븐스-존슨 증후군 3예를 확인하고 각 사례들에 대한 작업재연을 통해 노출수준을 추정하였으며,이를 통해 TCE의 직업적 노출수준과 스티븐스-존슨 증후군을 포함하는 전신적 박탈성 피부염 발생의 관계를 이해하고자 하였다. 증례: 사례 1은 24세 필리핀인 여자로 TCE를 이용한 탈지작업을 시작한 35일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스 존슨 증후군과 독성간염으로 진단되었고 증상발생 39일 간부전으로 사망하였다. 증상발생 전 약물 복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준 은 TWA 21.9 ppm과 32.3 ppm이었다. 사례 2는 47세 한국인 남자로 TCE를 이용한 탈지 작업을 시작한 20일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 중독성 표피괴사증 또는 스티븐스 -존슨 증후군, 전격성간염 및 동반된 패혈증으로 진단되었고 증상발생 42일 간부전 및 패혈증으로 사망하였다. 증상발생 전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 30.1 ppm이었으며 세척조 주위의 지역시료는 TWA 116.5 ppm∼229. 7 ppm 이었다. 사례 3은 22세 베트남인 여자로 TCE를 이용한 탐지작업을 시작한 30일 후 발전을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스-존슨 증후군 및 동반된 독성간염으로 진단되었고 증상발생 37일 증세 호전되어 퇴원하였다. 증상발생전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 107.2 ppm이었다. 고찰: TCE에 노출된 일부의 사람들에서 노출 후 2주에서 5주 사이에 심각한 급성 간염이 동반되는 스티븐스­존슨 증후군이 발생할 수 있음을 확인 하였고,이번의 연구결과와 기존의 연구를 종합 할 때 TCE에 대한 감수성이 있는 사람의 상당수는 노출기준 이상의 고 노출에 노 출 후 스티븐스- 존슨 증후군이 발생함을 확인할 수 있었다. 따라서. TCE에 대한 고 노출을 막기 위해 TCE 세척작업에 대한 작업환경 확인과 개선이 우선적으로 필요하며,동시에 노출 후 증상발생기간의 일관성과 노출기준 이하의 저 노출에서의 감작 가능성을 배제할 수 없음을 고려하여,작업시작 후 1개월경의 특수건강검진 역시 고려되어야 할 것으로 판단된다. Back ground: Trichloroethylene (TCE) has been reported to be related to severe generalized exfoliative dermatitis frequently accompanied by toxic hepatitis. The measurements of environmental exposure were limited in the previous case reports and the reported exposure values were also diverse. We reviewed three cases of Stevens-Johnson syndrome associated with TCE. The work environment was measured by the Korea Occupational Safety and Health Agency (KOSHA) after the cases occurred. From the study results, we intended to clarify the relationship between TCE exposure level and Stevens-Johnson syndrome. Case report: Case 1. A 24-year-o1d Filipino female worker developed a skin rash 35 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. She died of hepatic failure 39 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 22.0 to 32.3 ppm (Personal exposure level) with TWA. Case 2. A 47-year-o1d Korean male worker developed a skin rash, 20 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. He was diagnosed with Stevens-Johnson syndrome, toxic hepatitis and sepsis. He died of hepatic failure and sepsis 42 days after the onset ofthe first symptom. He had no previous history of taking medicine or viral infection. The work environment measured 30.1 ppm (Personal exposure level) and 116.5∼229.7 ppm (area exposure level close to the degreasing rnachine) with TWA. Case 3. A 22-year-old Vietnamese female worker developed a skin rash 30 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. Her symptoms improved and she was discharged 37 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 107.2 ppm (Personal exposure level) with TWA. Discussion: These three case reports and the previously reported cases indicated that the majority of people susceptible to TCE develops Stevens-Johnson syndrome after high-level TCE exposure (above the TWA occupational exposure limit of 50 ppm). Therefore, work environmental survey and improvements to the TCE degreasing process are essential to prevent high exposure. Furthermore, considering the consistency of the latency period in symptoms and the possibility of sensitization in low-level exposure, we recommend that the first specific health examination also should be conducted 1 month after workers have commenced working.

S-510 A case of peritoneal dialysis-associated peritonitis caused by Agromyces mediolanus

( Ju Hwan Oh ),( Min Woo An ),( Hyun Kwon Ju ),( Na Yun Kang ),( A Young Cho ),( In O Sun ),( Kwang Young Lee ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

Introduction:?Agromyces mediolanus (A.mediolanus) is an unusual pathogen in human infection. No case of peritoneal dialysis (PD)-associated peritonitis by A.mediolanus has been reported. This is the first case report of PD-associated peritonitis by A.mediolanus in the world. We describe a case of PD-associated peritonitis by A.mediolanus that was cured after catheter removal.?Case: A 59-year-old man who had been treated with CAPD was admitted to our hospital because of turbid peritoneal effluent accompanied by constant diffuse abdominal pain. The patient had an exit-site infection with purulent secretion. The laboratory findings showed PD peritonitis: the white blood cell (WBC) count of the peritoneal effluents was 1157/mm3 with a neutrophil predominance (91.3%). Cefazolin and ceftazidime were given intraperitoneally per day. The peritoneal WBC decreased, but the patient’s clinical condition didn’t improve on the 5th day after starting intraperitoneal antibiotics. Culture of the peritoneal dialysate revealed Agromyces species, which was susceptible to meropenem, imipenem, vancomycin, but resistant to ceftriaxone. Thus, we changed antibiotics to intraperitoneal vancomycin and meropenem on the 5th day. Despite the intraperitoneal antibiotics for 4 days, the patient’s abdominal pain persisted and the peritoneal WBC count became elevated. Therefore, we removed the PD catheter and the patient was switched to hemodialysis on the 9th day. Vancomycin and imipenem was continued for another 2 weeks and the patient’s clinical condition improved. The patient has been maintained on hemodialysis.?Conclusions: There is no previous report of peritonitis associated with A.mediolanus in a CAPD patient. In this case, we used intraperitoneal cefazolin and ceftazidime and changed to vancomycin and imipenem according to the result of peritoneal dialysate. However the patient improved after removal of catheter. Therefore, early removal of the PD catheter in A. mediolanus related peritonitis without prompt reaction to antibiotic therapy should be considered.