• Journal of Korean Academy of Nursing
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• v.30 no.3
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• pp.619-631
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• 2000

This study was conducted to test whether a comprehensive health promotion program for promotion strategies and knowledge about the disease, thus leading to the improvement of health status by using repeated measure of quasi- experiment design. Eighteen RA patients who visited the RA clinic of an university hospital located in Inchon were invited to participate in the CHPPRA. According to the study results, it was shown that the CHPPRA had significant effects on the patients' health status such as pain, depression, and functional disability. Also, that the improvement of health status was achieved by a positive change in the four health promotion strategies, which consisted of goal setting, positive thinking, exercise, and knowledge about the disease. Goal setting, positive thinking, and knowledge about the disease could also affect the patients' depression. Thus it can be interpreted that the improvement of these strategies may result in a remarkable decrease of depression. In addition, alleviation of functional disability may be due to increase of exercise. However although the strategies which were directly associated with pain management were not significantly improved, pain was significantly reduced. On the other hand, the study result showed that the other health promotion strategies included in CHPPRA such as pain management, positive thinking, stress management, asking for assistance and communication were not significantly increased. although the health status such as pain, depression, and functional disability, which are final goals of the program, were significantly improved through the exposition of patients to those health promotion strategies.

• Journal of Oral Medicine and Pain
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• v.31 no.3
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• pp.237-243
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• 2006

The aims of this study was to investigate the clinical and radiographic features of temporomandibular dysfunction in the patients with RA to elucidate whether the RA patients would be a risk group for TMD. The 35 patients with temporomandibular joint dysfunction were included for this study, of which 15 had rheumatoid arthritis diagnosed by a rheumatologist, and other 20 was control group and they didn't have any history or clinical signs related to it. Clinical symptoms and signs of temporomandibular joint disorders, radiographic and MRI findings of temporomandibular joint were investigated. The results were compared between two groups. In RA group bilateral pain, morning stiffness, reduced opening range, and crepitations were more frequently reported than control group. Radiologic findings such as sclerosis and flattening of condylar head, marginal proliferation, and erosion of glenoid fossa were more frequently observed in RA group than control group. Disk destruction, cortical bone erosion, and intraarticular enhancement were more prominenet in RA group. From theses results, it can be concluded that many RA patients will develop TMD symptoms and the structural changes of TMJ is more extensive than the usual TMD cases.

• Korean Journal of Biological Psychiatry
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• v.6 no.1
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• pp.125-134
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• 1999

The purposes of this study were to test the negative association between schizophrenia and rheumatoid arthritis(RA) and to clarify the role of prolactin and estrogen as protective factors in this association. The author compared the prevalence rate of RA between 561 patients with schizophrenia and 222 patients with mood disorder. For investigating the role of estrogen and prolactin, the author checked the plasma prolactin and estradiol level in 80 patients with paranoid schizophrenia and 77 patients with RA. The results were as follows. 1) Epidemiological data The prevalence rate of RA in the schizophrenic group was 0/561 and that of RA in the mood disorder group was 2/222. To compare these results between two groups, the author applied the Binomial test using the average prevalence rate of RA(0.8%) in the general population as a reference rate. The prevalence rate of RA in the schizophrenic group was significantly lower than that of RA in the general population. However, the prevalence rate of RA in the mood disorder group was not significantly different to that of RA in the general population. 2) Comparison of plasma prolactin and estradiol level between two groups The plasma level of prolactin in the schizophrenic group was significantly higher than that of prolactin in the RA group(p=0.000). However, the plasma level of estradiol in the schizophrenic group was significantly lower than that of estradiol in the RA group(p=0.017). These results were not consistent across gender. To contrast with the results in the female group, which were consistent with the results in the total subjects, for the male group, the plasma levels of prolactin and estradiol in the schizophrenic group were significantly higher than those of prolactin and estradiol in the RA group. These results support the results of previous studies which confirm the negative association between schizophrenia and RA. These results also suggest that the elevation of plasma prolactin level in the patients with schizophrenia has a antirheumatic effect while the elevation of plasma estradiol level in the patients with RA has a anti-schizophrenic effect, and that these effects act as a possible mechanism in the negative association between two disorders. However, these results suggest that this association is specific to female patients.

• Nuclear Engineering and Technology
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• v.27 no.4
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• pp.635-643
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• 1995

핵의학(nuclear medicine )이 란 방사성 및 안정 핵종의 동위원소표지 화합물을 인체에 투여하여, 관심장기의 형태 및 기능을 평가하여 해부학적 또는 생리학적 상태를 진단, 치료하는 의학의 전문 분야이다. 핵의학에 이용되던 방사성 핵종은 1960년대 까지만 해도 $^{131}$ I이 주였으나 1970년대 부터는 $^{99}$Mo -$^{99m}$ Tc 발생기와 $^{99m}$ TC으로 표지된 방사성의 약품이 활발히 이용되면서 $^{131}$ I을 대신하게 되었다. 원자로-생산핵종들의 특성은 중성자가 과잉이어 붕괴시 배타입자를 방출하는 점으로, 이것이 각종 질병의 치료에 이용되고 있다. 특히 각종 표시 화합물의 성질을 이용하여 원하는 부위에 방사선을 집중시킬 수 있음이 외부조사보다 유리한 점이다. 방사성핵종을 이용한 악성종양의 치료에 가장 성공적인 것은 분화된 갑상선 암환자에서 $^{131}$ I을 사용한 것이며, 갈색세포종 등에 $^{131}$ I-MIBG도 효과적이다. 악성종양의 골전이 치료에 베타선을 방출하는$^{32}$P, $^{186}$ Re, $^{153}$ Sm 등이 이용되었다. 종양의 동맥에 주입하여 세동맥이나 모세혈관에 걸리는 기름, 교진 또는 입자에 의한 치료에 $^{131}$ I-lipiodol, ethiodol, $^{32}$P 또는$^{90}$ Y흡사 ceramic resin 미소구 $^{166}$ Ho 유산중합체 미소구 등이 이용된다. $^{166}$ Ho, $^{198}$ Au, $^{32}$P, $^{90}$ Y, $^{169}$ Er, $^{186}$ Rc, $^{131}$ I, $^{211}$ At 등 의 방사성 핵종의 교질, 미소구 또는 단세포군 항체표지 형태로 직접 종양내 또는 공동이나 체강에 투여하는 치료법이 있다. 류마치스 관절염의 슬관절에 $^{165}$ Dy colloid를 주사하는 $^{166}$ Ho-MAA도 활발히 이용되고 있다.

• Tuberculosis and Respiratory Diseases
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• v.56 no.2
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• pp.203-209
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• 2004

Background : Methotrexate (MTX) has been used to treat a wide range of malignant and benign diseases including osteosarcoma, advanced stage non-Hodgkin's lymphoma, psoriasis, severe rheumatoid arthritis, sarcoidosis, and Wegener's granulomatosis. MTX-induced lung injury occurs in up to 10% of treated patients. Although both acute and chronic presentations have been described, typical manifestation of MTX-induced lung injury is subacute with symptoms usually developing within several months after starting therapy. Nonspecific interstitial pneumonia (NSIP) is the most common histopathologic manifestation of MTX-induced lung disease, while bronchiolitis obliterans organizing pneumonia (BOOP) and diffuse alveolar damage (DAD) are less common. Granuloma formation is reported in 34.7%. In Korea, Two reports of MTX pneumonitis have been published. The one presented with NSIP and the other with DAD. We recently experienced a case of MTX pneumonitis with presentation of hypersensitivity pneumonitis.

• Journal of Korean Academy of Nursing
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• v.22 no.2
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• pp.248-259
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• 1992

질적 보장은 전문직 종사자에 의하여 수혜받는 대상자를 보호하기 위하여 전적으로 필요한 프로그램이다. 이러한 질적보장을 통하여 전문직의 자율성과 책임을 튼튼히 할 수 있는 의무는 전문직 종사자 모두의 관심사가 되어야 한다. 미국에 있어서 질적 간호에 대한 관심은 이제 새로운 이유가 아니다. Beyers(1988)는 건강체계 지도자 사이에 가장 중요한 문제로 강조하는 것이 수혜자의 이용의 용이성(Access), 숫가(Cost) 그리고 질적인 제공(Quality)이 라고 피력 하였다. 미국 건강사업 평가자와 조정자(Regulator)들은 질(Quality)을 위한 자율적인 프로그램에 많은 에너지를 투입하여 전반적인 건강사업 즉 의료계의 질보장, 더 나아가서는 간호의 질을 향상 시키기 위한 많은 프로그램을 분석 연구한다. 이 논문은 간호에 있어서 질적 보장을 위한 내용으로 주요점은 질적 보장에 사용되는 용어, 역사적 배경, 질적 보장을 강조하는 이유, 질적 보장제도의 개발, 질 사정(euali assessment)과 질적 보장에 있어서 간호 전문직 개입을 차례대로 설명하였다. 구미의 경우 1970년대부터 간호직에 있어서는 질적보장제도개발에 우선순위를 두게되어 미 간호협회에서는 Professional Standards Review Organizations (PSRO)에 근거하여 간호실무를 위한 표준을 내어놓았다. 질적보장을 위한 평가방법으로 구조, 과정, 결과 그리고 수혜자가 간호계획을 세우는데 사정에 참여하는 방법 등 4가지를 간략하게 설명하였다. 질적 보장을 향상시키기 위해서는 전문직과 공공의료기간이 서로 협동체가 되어 중추역할을 해야함을 강조하고 이렇게 서로 협력하므로써만이 비로서 우리의 목적을 성취할 수 있다고 생각된다.구 등이 이용된다. $^{166}$ Ho, $^{198}$ Au, $^{32}$P, $^{90}$ Y, $^{169}$ Er, $^{186}$ Rc, $^{131}$ I, $^{211}$ At 등 의 방사성 핵종의 교질, 미소구 또는 단세포군 항체표지 형태로 직접 종양내 또는 공동이나 체강에 투여하는 치료법이 있다. 류마치스 관절염의 슬관절에 $^{165}$ Dy colloid를 주사하는 $^{166}$ Ho-MAA도 활발히 이용되고 있다. and computed groundwater levels. 본 논문에서는 가파른 산사면에서 산사태의 발생을 예측하기 위한 수문학적 인 지하수 흐름 모델을 개발하였다. 이 모델은 물리적인 개념에 기본하였으며, Lumped-parameter를 이용하였다. 개발된 지하수 흐름 모델은 두 모델을 조합하여 구성되어 있으며, 비포화대 흐름을 위해서는 수정된 abcd 모델을, 포화대 흐름에 대해서는 시간 지체 효과를 고려할 수 있는 선형 저수지 모델을 이용하였다. 지하수 흐름 모델은 토층의 두께, 산사면의 경사각, 포화투수계수, 잠재 증발산 량과 같은 불확실한 상수들과 a, b, c, 그리고 K와 같은 자유모델변수들을 가진다. 자유모델변수들은 유입-유출 자료들로부터 평가할 수 있으며, 이를 위해서 본 논문에서는 Gauss-Newton 방법을 이용한 Bard 알고리즘을 사용하였다. 서울 구로구 시흥동 산사태 발생 지역의 산사면에 대하여 개발된 모델을 적용하여 예제 해석을 수행함으로써, 지하수 흐름 모델이 산사태 발생

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.197-203
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• 2005

Purpose : Changes in metalloproteinases(MMP) activity have been demonstrated in several disease states, including rheumatoid arthritis and tumor metastasis. More importantly, increased myocardial MMP activity has been reported to occur in both clinical and experimental forms of dilated cardiomyopathy. There was no report about MMP in adriamycin(ADR)-induced cardiomyopathy. The purpose of this study was to investigate gene expression of MMP and tissue inhibitor of metalloproteinases(TIMP) in ADR-induced cardiomyopathy and clarify the relationship between MMP and cytokines. Methods : Male Sprague-Dawley rats were divided into two groups. The first group was control. The second group was given intraperitoneal injections of ADR(5 mg/kg) twice a week over two weeks. Serum concentrations of MMP, TIMP, interleukin(IL)-6 and tumor necrosis factor(TNF)-${\alpha}$ were measured. RNA extraction was performed from frozen rat hearts. Reverse transcription polymerase chain reaction(RT-PCR) was employed. cDNA Microarray analysis was performed by using a set of 5,184 sequence-verified rat cDNA clones. Results : Serum MMP and TIMP levels were not significantly different between the two groups. IL-6 was $36.8{\pm}2.8pg/mL$ and TNF-${\alpha}$ $2.2{\pm}2.7pg/mL$ in the ADR group. They were significantly higher than in the control group. Serum MMP correlated significantly with TNF-${\alpha}$(r=0.41, P<0.05). There was no gene expression of MMP, IL-6 or TNF-${\alpha}$ in the hearts of both groups. Gene expression of TIMP was significantly depressed in the hearts of the ADR group. Conclusion : These results suggested a potential role for TNF-${\alpha}$ in the regulation of extracellular matrix remodeling in ADR induced cardiomyopathy. Rapid screening of multiple decreased gene expression by DNA chip may be a useful diagnostic test to detect early cardiac injury before developing ADR induced cardiomyopathy.