단기간의 저용량 Cytosine arabinoside 치료에 반응하였던 Down 증후군에 병발한 급성골수성백혈병 1례

김현수,이정호,이정찬,강정현,곽상혁,김철희,배광봉,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The incidence of hematologic disorders in patients with Down's syndrome is significantly increased, about 14∼30 - fold higher than in general population and includes neonatal transient abnormal myelopoieis and acute leukemias. The age of onset of leukemia in Down's syndrome is peaking first in the newborn period and then under 4 years of age. Down's syndrome with acute leukemia above the age of 20 is very rare and it's treatment oucome is unclear. The treatment of Down's syndrome with leukemia has been controversial because of toxicity and associated congenital cardiac and other abnormalities. But if treated adequately, children with Down's syndrome show a favorable response to anti-leukemia therapy. A 24-year-old man with Down's syndrome was first seen for the evaluation of anemia and thrombocytopenia. The peripheral blood morphology and bone marrow study revealed acute myelogenous leukemia, cytogenetic study of bone marrow showed trisomy 21. Beacuse of his sicioeconomic condition and medical abnormalities including deafness, visual loss, he was treated with low dose subcutaneous cytosine arabinoside(Ara-C) for 11 days. Complete remission was obtained after 37 days. The complete remission lasted for 5 months. He subsequently relapsed, and died 6 months later.

중증 재생불량성 빈혈 환자에서 신우신염에 대한 광범위항생제치료 중에 속발한 Saccharomyces cerevisiae 진균감염 1예

김철희,이정호,이정찬,강정현,곽상혁,배광봉,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Most patients with aplastic anemia who do not respond to immunosuppressive treatment or are not candidates for bone marrow transplantation die of infection or bleeding. The neutropenia in acute leukemia, aplastic anemia, or occurring subsequently to chemotherapy and bone marrow transplantation increases susceptibility to infection. In general, the number of infectious episodes correlate with the degree and duration of neutropenia. Global immunosuppression produced by conditioning for bone marrow transplantation or graft-versus-host disease, is associated with unusual bacterial and fungal pathogens, or serious viral and protozoan infections. In addition, repeated treatment with broad-spectrum antibiotics is associated with the emergence of resistant organisms and fungal diseases because of the altered microbial microenvironment of the host. The incidence of invasive fungal infection caused by Saccharomycetes eerevisiae in immunosuppressed patients is very rare, compared with that of infection by candida or aspcrgillus species. Cases of Saccharomycetes cerevisiae fungemia occurring in the course of treatment with broad-spectrum antibiotics are reported in patients with extensive burn or with prosthetic valve endocarditis. We experienced a case of urinary tract infection by Saccharomycetes cerevisiae in a 27-year old female patient with severe aplastic anemia. We report the case with a review of relevant literatures.

예술 창작과 선(禪)

김현숙 ( Hyeon Suk Kim ) 한국영상미디어협회 2015 예술과 미디어 Vol.14 No.1

우리는 선(禪)이란 단어를 흔히 사용하고 그 개념을 어렴풋이 느낌으로 알고 있다. 하지만 선을 정확하게 이해하고 한마디로 표현하는 것은 쉽지 않다. 선에 관해 공부한 사람이라 할지라도 선 사상의 역사와 정신에 대한 질문에 대답은 할 수 있지만, 선을 한마디 말로 정의 하기는 쉽지 않을 것이다. 왜냐하면 선은 스스로의 체험에 의한 깨우침이기 때문이다. 더욱이 불교에서는 ``문자를 앞세우지 않는다`` 라는 뜻의 불입문자(不立文字)를 논하고 있으며, 선이 ``말로 표현이 될 때,그것은 이미 선이 아니다`` 라고 한다. 우리가 명상을 통해 알수 있는 선(禪)은 무엇이며, 명상이란 무엇인가? 명상이란 생각이 멈추거나, 생각하지 않고 있을 때시작된다고 하는데, 언제나 끊임없이 모든 것에 생각을 하며 살고 있는 우리에게, 생각을 멈추라는 말에 의문을 갖게 된다. 서양에서는 선(禪)의 뜻을 명상(meditation)으로 번역하고, 일본식 발음을 따라 젠(zen)으로 사용하고 있다. 또한 선은 종교적인 의미보다는 철학적인 의미로 해석되며, 프랑스의 일상 생활 속에서, ``soyez zen(쑤와이에 젠)``은 ``침착해라``라는 뜻으로 사용된다. 철학적인 의미에서, 명상과 선이 예술 작품과 어떠한 관계가 있는지 알아보기 위해, 선의 의미와 그 선의 근원인 디아나(dhyana)를 구성하고 있는 삼매, 사마타(samatha)와 비파샤나(vipasyana)의 의미를 살펴본다. 우리를 편안하고 고요하게 해주며, 생각을 잠시 멈추게도 해주는 제임스 튀렐(James Turrell)의 작품, <몰입(Mol-Ip)>과 김현숙의 작품, <고요(Calm)>에서 우리는 사마타의 의미를 살펴보고, 수행하는 사람들이나 내면의 세계를 연상시키는 Giusseppe Penone의 작품, <베르사이유의 삼나무(Versailles di Cedre)>에서 비파샤나의 의미를 해석해 본다. 또한 명상하는 사람들을 연상케하는 필립 라메트(Philippe Ramette)의 작품, <비이성적인 관조(Comtemplation irrationnelle)>에서는 선(禪)과 예술 작품, 그리고 명상과 예술 행위와의 연관성에 대해 생각해 본다. 선(禪) 사상처럼 말로 표현되지 않는 여러 쟝르의 예술 작품들은 우리에게 다양한 의미를 전한다. 때로는 작품의 의미들은 선 사상이 전수되었던 방식처럼 마음과 마음을 통해 (이심전심 以心傳心) 그 의미가 전달 되기도 하고, 이해할 수 없는 선사들의 선문답이나, 혹은 달을 가리키는 부처님의 검지를 바라보는 것 처럼,우리의 생각보다 훨씬 앞서 가는 작가의 의도를 우리가 알아채지 못할 때도 있다. 선은 명상을 통한 스스로에 대한 공부이며, 매 순간마다 새로움을 인식하는 것이다. 그래서 예술가들이 개인적으로 불교의 영향을 받지 않았다 하더라도, 그들의 작품이 현실 자체, 있는 그대로의 실체를 바라 볼 줄 아는 현명함을 담고 있다면, 그 예술 작품들은 선 사상과 비교될 수 있다. 더욱이 디아나(dhyana)의 의미처럼, 묵상과 몰입 속에서 이뤄지는 작품 제작과 순간적인 직감에 의한 예술창작 행위는 어딘가 선 사상과 닮아있다. We usually use the word Zen (禪) and we know vaguely about the sens, but it is not easy to accurately describe in short words to express the sense of Zen. Even we study of the Zen, be able to answerthe history and spirit of Zen, but it will not be easy to define the thought of Zen in simple words. Because the Zen is enlighten by our own experience. Moreover Buddhist saying 불입문자 burip munja (不 立文字) which means ``the word can``t precede the Zen`` and also they say ``when Zen represents by words, it``s not already Zen``. What is Zen through we know by meditation, and what is meditation? Thismeditation is thinking stops, starts when you are stops or not thinking. We will have a question about stops thinking, because we live in a constant thinking status about all of the things. In the West, the meaning of Zen is translated meditation, and used as Zen according to the Japanese pronunciation. Also Zen interprets a philosophical sense rather than a religious significance. In daily life in French, ``soyez Zen (be Zen)`` is used to mean ``calm down``. In a philosophical sense, to learn whether there is any relationship with a work of art and Zen, meditation, we search the meaning of Zen and the origin (source) of Dhyana, and we are explored a signification of configure the Dhyana that Samatha and Vipasyana. We look at the meaning of the Samatha in the works, Calm of Hyeon-Suk Kim and Light leading of James Turrell that makes us comfortable, quiet and also stopping to think. And we interpret the meaning of Vipasyana in the works Versailles di Cedre of Giusseppe Penone that evoke inner word, and Also we think about the relationship between the Zen and artworks, the meditation practices and the acts of the artists, in the works Comtemplation irrationnelle of Philippe Ramette that reminds those who meditate and perform. Like Zen, diverse genres of artworks which does not express in words, propose a variety of signification to us. Sometimes, the meaning of artworks allows to deliver us the way of transmission of Zen, through 이심전심 isim junsim (以心傳心heart to heart, mind and mind). And sometimes, such as the baffling dialogue of Zen Master, or such as looking at the index finger of Buddha pointing to the moon, we are also unable to perceive the intentions of the artists, because their thoughts go too far ahead than our thought. The Zen is studied for themselves through meditation, to recognize the now, at the moment and newness of each moment. So even if artists were not affected personally by the Buddhism, if their works contains a wise mind that know to look at the reality and reality as they are, artworks can be compared to Zen. Moreover, as significance of Dhyana, artistic creations that are produced through contemplation, and concentration, and, act of creation artistic by momentary intuition are similar somewhere to a Zen.

항암화학요법을 받는 암 환자에 대한 Nucare^R의 영양지지효과

조덕연,김현수,곽상혁,강정현,김철희,배광봉,김종숙,박상준,윤환중,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

Purpose : The purpose of this study was to evaluate the effect of nutritional support with enteral liquid supplement in cancer patients receving chemotherapy for possible benefit in nutritional, immunologic and golbal function of patients. Patients and Methods : From October 1995 to February 1997, 30 advanced cancer patients receving chemotherapy were divided two roups. The Nycare group, in addition to normal diet, Nucare^R enteral supplement was given for 1week right after chemotherapy for the duration of 2 chemotherapy cycles. Control group received only normal diet without parenteral fluid supplement for 2 chemotherapy cycles. Results : Median ages were 53 end 56 years for Nucare group and Contrl group respectively. Performance scores was less than 2 by ECOG scale. All patients were stage Ⅲ or Ⅳ. The physical parameters, such as weight, arm muscle circumference(AMC) and triceps skin fold(TSF) were decreased in both groups after 2 cycles of anticancer therapy. but it was less severe in Nucare group(p<0.05). Serum transferrin was maintained in mild deficit state in Nucare group, whereas it aggravated form mild to moderate deficit in Control group(p<0.05). Serum albumin level increased in Nucare group without statistical significance. but it decreased from normal to mild deficit in Control group. Serum total protein did not change significantly in Nucare group. but in Control group, serum total protein was decreased from 7.24±0.9 to 6.52±0.5(P<0.05). Total lymphocyte count did not change significantly in both groups. Conclusion : This study shows that the nutritional support with Nucare^R was effective in the prevention of nutritional deficit status in patients receving a nticancer chemotherapy.

Azathioprine에 반응을 보인 류마티양 관절염에 의한 경막염(Pachymeningitis)1예

배광봉,이정호,이정찬,곽상혁,강정현,김철희,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Rheumatoid arthritis frequently involves the cervical spine and may lead to neurologic impairement. However, direct involvement of CNS structures by inflammatory cells has been reported infrequently. The prevalence of this complication of rheumatoid arthritis is unknown. Inflammatory CNS involvement in rheumatoid arthritis reportedly occurs in the setting of longstanding, active, erosive articular disease and is accompanied by extracranial and extraspinal nodules and vasculitis. This is diagnosed by radiologic finding of CNS nodules or meningeal thickening and by biopsy or autopsy. Treatment with corticosteroid, cytotoxic agent or surgical decompression is helpful. But the majority of patients die within several months of onset of neurologic symptom. Recently, we experienced a case of pachymeningitis caused by rheumatoid arthritis, which resolved repeatedly with azathioprine treatment.

남자 만성 정신분열증 환자에서 Risperidone 투여에 의한 치료반응과 혈장HVA 및 5-HIAA 농도와의 관계

김형섭,조숙행,강대엽,박성덕,김광현 용인정신의학연구소 1997 용인정신의학보 Vol.4 No.2

알루미늄과 헤테로폴리산으로 개질된 메조포러스 실리카 상에서의 AKD 합성

김현국,우창수,최재석,박민태,이병민,이호인 한국공업화학회 2003 응용화학 Vol.7 No.1

AKD(alkyl ketene dimer) used widely as a neutral sizing agent is produced industrially by halogenization of stearic acid followed by dimerization of alkyl ketene. In the present work, to suppress the byproduct of hydrochloric acid and to improve reaction pathway. AKD was prepared through of ketene intermediate by dehydration of stearic acid in gas phase using reaction with silanol on silica as active sites of the catalyst SBA-15 showed the highest activity due to the large and open tubular pores. It was found that main products were dimer and trimer. Our goal of the present work was to increase of the selectivity for the dimer.

청소년의 건강행위와 비행에 영향을 미치는 요인에 관한 연구

김현숙 韓國學校保健學會 1997 韓國學校保健學會誌 Vol.10 No.2

In recent years, adolescent issuers including smoking, drinking, drug abuse, juvenile delinquency, deviant sexual behavior, mental health problems, high suicide rate, misconducts and absence without due notice, etc are emerging as serious social problems and the debate on these controversial issues is heating up. Accordingly, the purpose of this study is to analyze factors which are changeable and fixable among the factors influencing the adolescent's health behavior and misconducts and, eventually influencing factors which can be used as the basis to establish health policies and health promotion program to reduce the health risk behavior and misconducts of adolescents. The smoking rates are 34.1% for male students of prep schools and 13.8% for females students of the same school and 55.7% for males, 31.8% for females of the vocational schools and 58.3% for males and 48.8% for females of social institutional schools, which showed the great diffence among the different types of schools and between sex. In particular, male students of social institutional school showed 1.7 times higher smoking rate than those of prep schools and in case of female students, 3.5 times higher rate. The time of initial smoking was most frequently during the middle school days for both males and females. In case of drug abuse, 5.4% of males and 2.7% females of general schools were using adhesives and inhalants which was 2.6 times higher far males and 6.3 times higher for females of social institutional schools.41.8% of males and 30.3% of females of prep schools,41.0% of males and 59.4% of females of vocational schools and 55.1% of males and 36.6% of females of social institutional schools have experienced kissing. Regarding the health promoting behavior and misconducts, female students practiced the health promoting behavior more than male students while male students showed higher rate of health risk behavior and misconducts than female students, which was statistically significant. The group of students who have not attended the health education class, in comparison to those who have attended, were more likely to practice health rick behavior and misconducts. Those with higher academic achievement was more likely to practice the health promoting behavior while those with poor academic achievement were mere likely to practice health rick behavior and misconducts. As the perceived health status was higher and as students experienced less illness, the health promoting behavior was higher.

AIDS의 학교 보건교육 도입에 관한 연구

김현숙 韓國學校保建學會 1996 韓國學校保健學會誌 Vol.9 No.2

AIDS and the spectrum of Human Immunodeficiency Virus(HIV) infections present a monumental challenge to the health of the Korean public. In response to this special challenge, I think public education and voluntary behavior changes are the most effective measures to fight the spread of the disease. Adolescents represent a critical risk group for prevention and intervention programming. Research indicates sexually active adolescents, homosexual contact, illicit drug use are an gradually increasing. These characteristically adolescent risk-taking behaviors suggest the need for schools and communities to mobilize intervention strategies. Schools are highly efficient ways to reach a majority of young people in Korea with HIV prevention programs. These programs inc1ude substantial attention to sexual and drug use behaviors with the long term objective of a multidimensional school health program. Information resulting from risk behavior surveillance activities and guidance on school health curricula is particularly useful. What is needed for adolescents is a revamping of education to give students the critical thinking and analytic skills that allow them to apply knowledge, make decisions, and think independently. The best HIV preventive education provides young people with opportunities to team and practice just those skills. In the early stages of HIV education were focused solely on information Providing information is easy but unfortunately, behavior change is not that simple to activate. Information must be combined with values exploration and skilly building, including responsible decision making, negotiation, refusal, and critical thinking skills. The same knowledge. attitudes and skills needed for effective HIV prevention also prevent or reduce other risks, including other sexually transmitted diseases, unwanted pregnancies, and alcohol or other drug use. The role of other youth serving organizations in HIV prevention is also important: parental and youth involvement is needed; it's important to presidential and governament leaderahip is essential to prevention education; promote integrated adolescent programs, to enhance health and education sector collaboration; and of course, we need to expand research on adolescent health and engage the media in health promotion. Among these changes, a school-based systematic health education of AIDS is certainly one of the essentials.

대학생의 성 경험에 영향을 미치는 요인 분석

김현숙 韓國學校保健學會 1999 韓國學校保健學會誌 Vol.12 No.2

The purpose of this study is analyze the factors which influence the college student sex behavior. The results can be used as the basis to establish health polices and a health promotion program to reduce the risks of sexual behavior of college students. The study subjects were random selected from college students in Kyonggido. The 335 subjects were selected from 4 schools including three colleges and one university. The self-administered questionnaires were distributed to 350 students, 335 of which were analyzed (after excluding the 15 incomplete or inaccurate data). The study took place between December 7-19,1998. Regarding the analysis method, the SPSS program was used. The relationship between social and demographic characteristics and relevant factors was identified through Chi-squared test. The major findings of the study were follows: 1. Of the 335 respondents, thirty seven percent of men and ten percent of women had already experienced sexual intercourse. Significantly more males had experienced sexual experience than women. The majority of students, living with both their parents had less sexually experience than that living without their parents. There were religious differences, that students. Students who reported drinking alcohol frequently had more sexual experience than those who did'nt and it was statistically significant(x2=47.6 df=4 p=0.000). 2. Sexual awareness was relatively low. High level group of sex knowledge were less sexual experience than middle or low level group(x2=6.038 df=2 p=0.049). Women were more sexually aware than men(x2=20.814 df=2 p=0.000). Groups who had sisters and brothers were more sexually aware than those who few sisters and brothers. 3. Sixty one percent of respondents said that chastity before marriage should be kept but twenty four percent of them felt that it was unnecessary. Opponents to chastity before marriage had more sex experience than those for. It was statistically significant (x2=48.967 df=2 p=0.000). Those who agreed with the questionnaire point 'Even if people are not married, if they love each other, they can have sexual intercourse.' had more sexual intercourse than those who did'nt agree. Those who agreed with the questionnaire point Even though people does'nt like, they can still have sexual intercourse. had more sexual intercourse than those who disagree. On this point, men were three times higher of the opinion than women. So we can see the difference in the perception between men and women. As a result of this study, sexual awareness influences sexual attitudes and sexual attitudes influence sexual behavior too. Also, one of the risks of sexual activity includes poor knowledge and uniformed attitudes about sex. Therefore sex education is needed and it is very important to reestablish concepts about sex.