갑상샘암 수술환자의 심리 및 신체적 불편감에 미치는 정보교육 프로그램 효과

이양희,정영,박연주,최길순,정지연 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

본 연구는 정보교육 프로그램이 갑상샘암 수술 환자의 심리 및 신체적 불편감 감소에 미치는 효과를 검정하기 위해 실시된 비동등성 대조군 전,후 시차 설계의 유사 실험연구이다. 자료수집 기간은 2006년 6월 17일 부터 9월 19일 까지 3개월간 이었으며, 연구 대상자는 일개 종합병원에 갑상샘암 수술을 받기위해 입원한 환자 가운데 6월 17일 부터 8월 3일 까지 입원환자 29명을 대조군으로 하였고, 8월 5일 부터 9월 19일 까지 입원환자 30명을 실험군으로 하였다. 연구도구는 심리적 불편감을 측정하기 위해 Derogatis 등(14)이 개발한 ‘자기보고식 다차원 증상목록(Multidimensional Symptom Inven- tory)검사를 사용하였고, 신체적 불편감 측정은 McCorkle & Young(16)이 개발한 도구를 사용하였다. 본 연구의 결과는 다음과 같다; 1) 정보교육 프로그램을 받은 실험군은 정보교육 프로그램을 받지 않은 대조군에 비해 심리적 불편감 정도의 차이는 통계적으로 유의한 차이를 보이지 않았다(p= .135). 다만 ‘근심 걱정’요인에서 유의한 불편감 감소효과를 보였다(p= 0.49) . 2) 정보교육 프로그램을 받은 실험군과 정보교육 프로그램을 받지 않은 대조군은 두군 모두 신체적 불편감 정도가 사후 유의한 수준으로 증가함을 보였다(p= 0.90). 결론적으로 본 연구를 위해 만들어진 정보교육 프로그램은 갑상샘암 수술 환자의 신체적 불편감 감소에는 효과적이지 못하였으나 심리적 불편감의 근심걱정 요인을 감소시키는데는 효과가 있음을 알게 되었다. Objectives: This study was designed as a non-equivalent control group pre and post-test quasi-experimental study to examine the effects of education program using information on the psychological and physical discomfort of patients undergoing operation for cancerous thyroid glands. Methods: The study covered for three months from June 17, 2006 to September 19, 2006. The subjects of this study were selected from those patients who were admitted in one of the general hospitals in order to receive the operation for cancerous thyroid glands. They include 29 control group patients who were hospitalized during the period of Jun 17th to August 3rd 2006, and 31 experimental group patients who were hospitalized during the period of August 5th to September 19th, 2006, respectively. The instruments utilized for conducting this study includes the Multidimensional Self-Report Symptom Inventory test originally developed by Derogatis & et al. (1983) for measuring psychological discomfort. And for measuring physical discomfort, the tools developed by McCorkle & Young (1978) was utilized. Results: 1) Hypothesis 1 “The level of psychological discomfort of the experimental group who completed the information education program would be decreased comparing with that of the control group who didn't complete the program” was partly supported (Worry & Anxiety factor: p= .049). 2) Hypothesis 2 “The level of physical discomfort of the experimental group who completed the information education program would be reduced comparing with that of the control group who didn't complete the program” was not supported (p= -.90). Conclusion: The information program provided for this study was proved to be not effective for decrease physical discomfort of the patients undergoing operations for cancerous thyroid glands but proved to be effective for decrease the anxiety factor of psychological discomfort.

위 점막하 종양으로 발현된 동정맥 기형 1예

백순구,조미연,김준명,권상옥,이동기,김윤미,최윤종,김일회 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.4

Arteriovenous malformations (AVM) are an unusual cause of gastrointestinal (GI) bleeding. But most GI AVM can occur with GI bleeding. When conventional diagnostic studies have failed to reveal the source of GI bleeding, AVM have been one of the most common causes. But the incidence of AVM presented as bleeding of a gastric submucosal tumor is very low. A case of gastric submucosal tumor was experienced and reported as an AVM. This case is herein discussed with review of corresponding literature.

맥문동 발효음료의 주요 화학성분에 관한 연구

김순동,구연수,이인자,김미경,박인경 동아시아식생활학회 2000 동아시아식생활학회지 Vol.10 No.4

Major chemical components of sweet drink and vinegar prepared with Liriopis tuber were investigated sensory quality. The contents of total soluble solid, total sugar, non-reducing sugar, total saponin, ash and protein in the processed of Liriopis products ranged 7.71~10,67%, 4.94~9,77%, 1.98~4.67%, 0.80~0.59%, 0.40~0.36%, and 0.44~0.49%, respectively. In addition, levels of succinic, malic and acetic acid in the products ranged 78.9~96,3, 23.6~6.3 and 12.7 ~2686.0㎎/100㎖ respectively, Meanwhile, the sweet drink contained 1.89㎎%(w/v) of hydroxyprolin, 0,39㎎%(w/v) of glutamic acid, 0.22mg%(w/v) of arginine, 0.15㎎%(w/v) of citruline and 0.11㎎%(w/v) of potassium. The vinegar contained 2.89㎎%(w/v) hydroxyprolin, 248.2 ㎍/100ml glutamic acid, 99.2 ㎍/100ml arginine, 205,5 ㎍/100㎖ citruline and 143.46㎍/100㎖ potassium.

우리나라 중부지방의 시설원에 토양 및 지하수 환경

김진호,이종식,김원일,정구복,윤순강,정연태,권순국 한국환경농학회 2002 한국환경농학회지 Vol.21 No.2

연구대상 시설재배지 토양의 물리성은 대부분이 모래의 비율이 높은 sandy loam이나 loam으로 투수성이 양호할 것으로 판단되나, P2나 S1에서는 미사의 비율이 높은 미사 loam으로 투수성 및 통기성이 상대적으로 낮은 것으로 판단된다. 토양의 화학성은 EC의 경우 표토의 대부분이 기준치에 도달하거나, 초과하는 경향이었고, 심토의 경우는 기준치 이하로 조사되었다. 또한 유기물 함량은 적정수준 2~3%보다 조사 대상 지점의 대부분에서 상회하였고, 심토의 일부분도 이 수준을 넘는 곳도 있었다. 조사 대상 지역의 수질 특성 중 시설재배지 지하수의 가장 중요한 염류 지표인 EC는 연평균 0.48 dS/m로 농업용수로서 작물에 미치는 영향은 없는 것으로 판단되나, 수질오염지표인 질산성 질소의 경우 19.1 mg/L 로 농업용수 수질 기준인 20 mg/L에 근접한 수준을 나타내었다. 특히 조사 대상 지점의 36.4%가 수질 기준을 초과하는 것으로 나타났다. 지하수중의 이온의 양과 영양염류의 양을 간접적으로 나타내는 전기전도도인 EC는 양이온인 경우 Mg^(2+), Ca^(2+), Na^+, K^+와 정의상관이 있었으며, 특히 2가 양이온인 Mg^(2+)와 Ca^(2+)간에는 고도의 정의상관을 보이고 있었다. 또한 EC와 음이온간에는 NO_3^-, Cl^-, SO_4^(2-), PO_4^(2-)와 상관을 보이고 있었다. 지하수의 오염지표인 NO_3-N의 경우에는 COD를 제외한 모든 이온들과 상관을 보이고 있었다. 특히 SO_4^(2-), Cl^-, Na^+, Ca^(2+), Mg^(2+)와는 고도의 정의 상관을 보여주고 있다. 이는 NO_3-N는 EC와 함께 지하수오염의 중요한 지표중의 하나임을 보여주고 있다. The objective of this study was to know the qualities of soil and shallow groundwater in plastic film house fields around Central Part of Korea. The study was conducted at 11 sites in Suweon, Hwasung, Pyungtaek, Yongin, and Chuncheon through May to August in 1999. Soil textures of plastic films house were mainly sandy loam or loam. Electric conductivity and organic matter content of surface soils mostly exceeded the critical levels for crop production. Average concentration of N0_3-N in the shallow groundwater was 19.1 mg/L, and it reached almost the limiting level of agricultural groundwater quality (20 mg/L). Moreover about 36% of survey sites exceeded the limiting level of agricultural groundwater quality. Sulfate concentrations also at some sites exceeded agricultural groundwater quality limit level (50 mg/L). Nitrate-N, one of the most important factors in the groundwater quality, had positive correlations with other ions in groundwater.

다량의 하부위장관출혈이 병발된 Vibrio vulnificus 패혈증 1예

최주연,유진홍,한석원,이대훈,최민호,박순민,김연식,김선우,신완식,강문원,강성구 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.2

최근 저자들은 Vibrio vulnificus 감염에 의해 패혈증 및 이차성 피부 병변을 보인 42세의 남자 환자의 치료중 하부 위장관 출혈이 병발된 1예를 경험하였기에 보고하는 바이다. We experienced a case of Vibrop vulnificus septicemia which showed an unusual manifestation such as hematochezia. The patient was a 42-year-old man with chronic liver disease. The blood and wound culture revealed the organism. During intensive care, he suffered from massive hematochezi for several days. Colonoscopy and abdominal CT showed findings suspicious of ischemic colitis. To our knowledge, this is the first unusual case of V.vulnificus infection which showed massive lower gastrointestinal bleeding.

Flavobacterium meningosepticum에 의한 균혈증 1예

장성원,유진홍,진승원,김선우,김연식,박순민,이대훈,최민호,최주연,신완식,강문원,강지민 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.1

1996년 6월 카톨릭대학교 부천성가병원에 뇌경색으로 입원했던 61세 남자 환자의 혈액에서 Flavobacterium meningosepticum을 분리하였다. 환자는 폐렴을 동반한 패혈증의 예로 ceftriaxone과 metronidazole을 투여하였으나 입원 48시간만에 사망하였다. Flabovacterium meningosepticum is a rae cause of nosocomial infection which shows multi-drug resistance. It mainly invades patients with impaired immunity. Recently, we experienced a case of F. meningosepticum bacteremia in a patient with chronic debilitated state owing to stroke. The clinical progress was so rapid that he died within 48 hours. Blood culture revealed F. meningosepticum which showed characteristic yellow colony in blood agar plate.

An Evaluation of Nutrition Support for Terminal Cancer Patients at Teaching Hospitals in Korea

Do Yeun Kim,Sang Min Lee,Kyoung Eun Lee,Hye Ran Lee,김지현,Keun-Wook Lee,Jong Seok Lee,Soon Nam Lee 대한암학회 2006 Cancer Research and Treatment Vol.38 No.4

Purpose: We wanted to analyze the use of nutrition support for terminal cancer patients, the effect of discussing withdrawal of nutrition support and do-not- resuscitate (DNR) consent on the use of intravenous nutrition during the patient’s last week of life and at the time of death.Materials and Methods: The study involved 362 patients with terminal cancer from four teaching hospitals, and they all died between January 1 2003 and December 31 2005. The basic demographic data, the use of intravenous nutrition during the patient’s last week of life and at death, discussion of terminal nutrition withdrawal and DNR consent were evaluated.Results:In the week before death, the patients received artificial nutrition such as total parenteral nutrition (31%), intravenous albumin infusion (25%), and feeding tube placements (9%). A discussion concerning withdrawal of nutrition support was limited to 25 (7%) patients. DNR consent was obtained from 294 (81%) patients. None of the patients were directly involved in any of these decisions. The discussion about withdrawal of terminal nutrition and DNR consent with the patient’s surrogates did not have any effect on reducing the use of parenteral nutrition.Conclusion: The majority of patients dying of terminal cancer were still given potentially futile nutritional support. Modern clinical guidelines and ethical education about nutritional support at the end of life care is urgently needed in Korean medical practice to provide proper administration of terminal nutrition for end of life care. (Cancer Res Treat. 2006;38:214-217)

Molecular Characterization of a Chinese Cabbage cDNA Encoding Thioredoxin-h that is Predominantly Expressed in Flowers

Lee, Seung-Sik,Lee, Kyun-Oh,Jung, Bae-Gyo,Chi, Yong-Hun,Yoo, Ji-Young,Lee, Ji-Yeun,Lee, Jung-Ro,Park, Soo-Kwon,Kang, Soon-Suk,Jang, Ho-Hee,Lee, Sang-Yeol Korean Society for Biochemistry and Molecular Biol 2001 Journal of biochemistry and molecular biology Vol.34 No.4

Even though three isotypes of thioredoxins (-f, -m and -h types) have been identified in a variety of plant cells, there are only a few reports on thioredoxin-h that were recently identified. In this study, a cDNA encoding a h-type of thioredoxin was isolated from a cDNA library of Chinese cabbage, and named here CTrx-h. An open reading frame of the gene contained a polypeptide of 133 amino acids with a conserved active center, WCGPC, which appeared in all of the thioredoxin proteins. A deduced amino acid sequence of the CTrx-h showed the highest sequence identity with those of Arabidopsis thioredoxin-h2 (75.2%) and thioredoxin-h5 (46.6%) proteins, but it shared a low sequence homology to other isotypes of plant thioredoxinm and thioredoxin-f. The CTrx-h protein that is expressed in E. coli represented not only an insulin reduction activity, but also electron transferring activity from NADPH to thioredoxin-dependent peroxidase. A genomic Southern blot analysis using the cDNA insert of CTrx-h revealed that the gene consisted of a small multigene family in Chinese cabbage genome. On the contrary to other thioredoxin-h proteins that were widely distributed in most tissues of the plant, the CTrx-h was predominantly expressed in flowers. The expression was very low in other tissues. The data of the Northern blot analysis suggests that the CTrx-h may have other functions in flower development or differentiation, in addition to its defensive role.

Molecular Characterization of a Chinese Cabbage cDNA Encoding Thioredoxin - h that is Predominantly Expressed in Flowers

Lee, Sang Yeol,Lee, Kyun Oh,Jang, Ho Hee,Lee, Ji Yeun,Lee, Seung Sik,Jung, Bae Gyo,Chi, Yong Hun,Kang, Soon Suk,Park, Soo Kwon,Lee, Jung Ro,Yoo, Ji Young 생화학분자생물학회 1970 BMB Reports Vol.34 No.4

Even though three isotypes of thioredoxins (-f, -m and -h types) have been identified in a variety of plant cells, there are only a few reports on thioredoxin-h that were recently identified. In this study, a cDNA encoding a h-type of thioredoxin was isolated from a cDNA library of Chinese cabbage, and named here CTrx-h. An open reading frame of the gene contained a polypeptide of 133 amino acids with a conserved active center, WCGPC, which appeared in all of the thioredoxin proteins. A deduced amino acid sequence of the CTrx-h showed the highest sequence identity with those of Arabidopsis thioredoxin-h2 (75.2 %) and thioredoxin-h5 (46.6%) proteins, but it shared a low sequence homology to other isotypes of plant thioredoxinm and thioredoxin-f. The CTrx-h protein that is expressed in E. coli represented not only an insulin reduction activity, but also electron transferring activity from NADPH to thioredoxin-dependent peroxidase. A genomic Southern blot analysis using the cDNA insert of CTrx-h revealed that the gene consisted of a small multigene family in Chinese cabbage genome. On the contrary to other thioredoxin-h proteins that were widely distributed in most tissues of the plant, the CTrx-h was predominantly expressed in flowers. The expression was very low in other tissues. The data of the Northern blot analysis suggests that the CTrx-h may have other functions in flower development or differentiation, in addition to its defensive role.

Detection of Lamivudine-Resistant Mutations of HBV DNA Polymerase Gene Using PCR-Direct Sequencing

Lee, Kyung-Ok,Lee, Hye-Jung,Byun, Ji-Young,Lee, Sung-Yeun,Kim, Jeong-Sook,Jung, Na-Young,Chung, Soo-Jin,Seong, Hye-Soon,Kim, Kyung-Tae Korean Society for Clinical Laboratory Science 2006 대한임상검사과학회지(KJCLS) Vol.38 No.3

최근 만성 B형간염의 치료에 B형간염 바이러스 복제를 저해하여 감염력을 약화시키는 lamivudine이 많이 사용되고 있다. 그러나 이 약제를 장기간 복용할 경우 B형간염 바이러스 DNA polymerase 유전자의 YMDD motif에 아미노산 치환을 일으켜 lamivudine 저항성 B형간염 바이러스가 나타나는 점이 문제시 되고 있다. 본 연구의 목적은 lamivudine 치료를 받은 만성 B형간염 환자에서 PCR-direct sequencing 법을 이용하여 B형간염 바이러스 DNA 중합효소 유전자의 YMDD motif(codon 552)와 codon 528에서 돌연변이 출현빈도를 구하고, HBeAg과의 관련성을 보고자 하였다. 방법은 만성 B형간염 환자의 혈청에서 DNA를 추출하고 DNA 중합효소 유전자의 codon 552와 528을 포함하는 부위에서 선택한 두 쌍의 primer를 이용하여 nested PCR을 실시하였다. 증폭된 PCR 산물은 2% agarose gel에서 전기영동을 한 후, 자동염기서열분석기를 이용하여 sequencing을 실시하였다. 총 207명 중에서 돌연변이는 124명(60%)에서 발견되었으며, 남, 녀에서 차이는 발견되지 않았고, 돌연변이군에서 비돌연변이군에 비해 평균나이가 약간 높게 나타났으나 유의성은 없었다. Codon 552에서 단일돌연변이로는 M552I(50.8%)가 가장 높게 나타났고, 다음으로 M552V(43.5%), M552I/V(5.7%)의 순서로 나타났다. Codon 528에서는 67.0%의 L528M 돌연변이가 발견되었다. Codon 552와 codon 528에서 동시에 발생한 중복돌연변이로는 M552V/L528M(43.6%)이 가장 높게 나타났고, 다음으로 M552I/L528(33.1%) 그리고 M552I/L528M(17.7%)의 순으로 나타났다. Codon 552에서 serine 돌연변이(M528S)는 발견되지 않았으며, L528M은 M552V 돌연변이와 거의 동시에 검출되었다. 본 연구에서 만성 B형간염환자에서 HBeAg의 유무와 lamivudine 돌연변이율과의 상관성은 발견되지 않았으며, PCR-direct sequencing법은 고가의 자동염기서열분석 장비와 숙련된 기술자가 필요하다는 문제점은 있으나, 검체 수가 많은 큰 임상검사실에서는 활용성이 클 것으로 판단된다. 향 후 lamivudine으로 인한 HBV 돌연변이형과 환자의 임상결과의 관련성에 대한 연구가 추가적으로 실시되면, lamivudine을 복용하는 만성 HBV 환자의 치료와 예후에 유용할 것으로 사료된다. Treatment of hepatitis B virus (HBV) with lamivudine is effective in suppressing virus replication and results in reduced inflammatory activity. However the most troublesome problem of lamivudine treatment is the emergence of lamivudine-resistant strains with amino acid substitution in the YMDD motif of DNA polymerase gene during the treatment. The aim of this study was to determine the mutation of YMDD motif (codon 552) and codon 528 in chronic HBV patients with lamivudine therapy using PCR-direct sequencing and to investigate the relationship between lamivudine mediated HBV mutation and HBeAg. HBV DNA was extracted from serum samples of HBV patients and amplified by nested PCR with two sets of primer pairs selected in HBV DNA polymerase gene. Amplified PCR product was analyzed by 2% agarose gel electrophoresis and direct sequencing. HBV mutation was detected in 124 out of 207 samples (60%). Single mutation was 50.8% for M552I, 43.5% for M552V, 5.7% for M552I/V and the L528M mutation was 67.0%. Double mutation was 43.6% for M552V/L528M, 33.1% for M552I/L528(wild type), 17.7% for M552I/L528M and 5.6% for M552I/V/L528M. Serine mutation at YMDD motif (M552S) was not found and the L528M mutation frequently accompanied M552V type. In this study, the typical difference of frequencies for HBV mutation depending on HBeAg was not found. Moreover, the PCR-direct sequencing method used in this study might be a powerful tool for the mutation study in clinical reference laboratories with high volume.