• Journal of Chest Surgery
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• v.32 no.10
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• pp.863-873
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• 1999

배경: 혈전 생성은 심혈관계 삽입물이나 순환 보조장치의 발전에 있어서 중요한 문제이므로 이러한 장치들의 혈전성에 대한 평가는 필수적이다. 따라서 이러한 장치들의 혈전성 연구를 시행하기 위한 효과적인 생체 외 실험 방식이 개발되어 원심성 순환 펌프의 발전에 큰 도움이 되고 있으며, 최근 엄밀하게 혈액과 공기의 접촉을 차단하는 방식이 믿을 수 있는 생체 외 실험 방식으로 강조되고 있다. 본 논문에서는 모의 순환 회로를 이용하여 기존에 행해진 연구 방법 상의 공기 접촉에 따른 핼액 응고 기전의 활성화 여부를 알아보기 위하여 공기 접촉 여부에 따른 혈액 인자의 변화를 관찰하여 확인하고, 또한 회로 내에서 생성된 혈전을 생체 내에서 형성된 혈전과 비교 분석하여 이 모의 순환 회로를 이용한 생체 외 검사가 새로 고안된 심혈관계 장치들의 혈전성을 평가하는데 있어서 동물실험을 대신할 수 있다는 기존의 주장을 검증하고자 하였다. 연구재료 및 방법: 바이오펌프를 이용한 같은 모의 순환 회로 한 쌍을 준비하고 동일 개체에서 얻은 헤파린을 첨가한(1u/$m\ell$) 신선한 혈액을 공기와 접촉시키지 않도록 한 A-회로와 공기와 접촉시킨 B-회로에 충전시켜 실험을 동시에 진행하여 결과를 얻었으며 총 12번 시행하였다. 회로에 충전한 혈액의 activated clotting time(ACT)은 정상의 3~5배였으며 ACT가 정상 범위의 1.5배가되면 실험을 끝냈고, Hematocrit(HCT), 혈소판, 동맥혈가스분석(ABGA), factor Ⅷ, factor \ulcorner, 섬유소원, thromboxane B2(TXB2), free hemoglobin(fHb) 등을 측정하였다. 실험이 끝난 후 A-회로와 B-회로에서 얻은 각 검사를 평가하고 분석하였으며 생성된 혈전을 생체 내에서 생성된 혈전과 조직 검사로 비교하였다. 본 연구의 자료분석은 SPSS 통계 프로그램을 이용하였고 유의수준 0.05를 기준으로 유의도를 판단하였다. 결과: 정상 ACT는 186.9$\pm$20.5초(평균$\pm$표준편차)이었고, 헤파린을 넣은 초기 ACT는 982.2$\pm$165.5초이었으며, 실험시간은 보통 60분에서 180분 사이였다. HCT, fHb, 혈소판, TXB2, factor Ⅷ, factor \ulcorner, 섬유원소의 초기값은 35.5$\pm$3.2%, 12.4$\pm$6.5 mg/dL, 354$\pm$56($\times$103)/$\mu$L, 72.6$\pm$15.1 mg/dL, 29.3$\pm$1.2%, 137.9$\pm$42.1 mg/dL, 그리고 17.7$\pm$9.7%이었다. 공기 접촉에 따른 차이를 보았을 때 ACT(p=0.398), HCT(p=0.988), fHb(p=0.898), 혈소판 (p=0.904), TXB2(p=0.985), factor Ⅷ(p=0.872), factor \ulcorner(p=0.489), 섬유원소(p=0.973)으로 전 예에서 통계적 유의성이 없었다. 실험 후 양 군에서 생성된 혈전의 현미경 소견은 B-회로의 혈전에 여러 군데 공기 방울이 관찰되는 것 이외에 A-회로에서 생성된 혈전과 차이가 없었고, 생체에서 생성된 혈전과 비교했을 때 그 양상이 같았다. A-회로와 B-회로에서 생성된 혈전의 총 량은 8.4$\pm$3.7 mL와 9.4$\pm$3.1 mL로 통계상 유의성은 없었다. (p=0.624). 결론: 모의 순환 회로를 이용한 혈전성 평가를 위한 생체 외 실험에 있어서 공기와의 접촉 여부는 혈액 응고 기전의 활성화나 혈전 생성에 별다른 영향을 미치지 않는다. 모의 순환 회로에서 형성된 혈전과 문헌에 있는 인체 내에서 형성된 혈전을 비교한 결과 그 형태가 일치하므로 이 모의 순환회로를 이용한 실험이 동물실험을 대신할 수 있다고 판단된다.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.153-160
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• 2010

Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

• Journal of Hospice and Palliative Care
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• v.15 no.2
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• pp.68-76
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• 2012

Purpose: The study was designed to verify effects of aromatherapy on depression, anxiety and the autonomic nervous system in breast cancer patients who are undergoing adjuvant radiotherapy. Methods: Data were collected from November 2006 through March 2007 at the C university hospital in Seoul. The study included 33 patients and they were assigned to three groups. Group I had aroma oil inhalation for 2 minutes per time, three times a day for six weeks whereas Group II and a control group inhaled aroma oil for 2 minutes per time, once a day for six weeks. For Groups I and II, a mixture of lemon, lavender, rosewood and rose essential oils were used while control group inhaled tea tree oil. Results: Depression was significantly decreased in patients in the experimental groups only. In Groups I and II patients, anxiety level was lower than that in control patients. Patients in Groups I and II also showed stronger physical resistance to stress than control group patients. Conclusion: Aromatherapy should be considered as a method that can significantly decrease depression in breast cancer patients who are undergoing adjuvant radiotherapy.

• Journal of the Korean Chemical Society
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• v.44 no.5
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• pp.403-409
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• 2000

The formation and dissociation rates of $Zn^{2+}$ Complexes with l,4,7,10-tetraaza-13,16-diox-acyclooctadecane-N,N',N",N'"-tetraacetic acid (1), 1,4,7,10-tetraaza-13,16- dioxacyclooctadecane-N,N',N",N'"-tetramethylacetic acid (2), and 1,4,7,10-tetraaza-13,16- dioxacyclooctadecane-N,N',N",N'"-tetrapropionic acid(3) have been measured by stopped-flow and conventional spectrophotometry. Observations were made at 25.0$\pm$0.1 $^{\circ}C$ and at an ionic strength of 0.10 M NaClO$_4$. The formation reactions of $Zn^{2+}$ ion with 1 and 2 took place by the rapid formation of an intermediate complex (ZnH$_3L^+$) in which the $Zn^{2+}$ ion is incompletely coor-dinated. This might then lead to be a final product in the rate-determining step.ln the pH range 4.76-5.76, the diprotonated (H2L2-) form is the kinetically active species despite of its low concentration. The stability con-stants (log$K_{(ZnH$_3$3$L^+$)}$) and specific water-assisted rate constants (koH) of intermediate complexes have been deter-mined from the kinetic data. The dissociation reactions of $Zn^{2+}$ complexes of 1,2, and 3 were investigated with $Cu^{2+}$ ions as a scavenger in acetate buffer. All complexes exhibit acid-independent and acid-catalyzed con-tributions. The effect of buffer and $Cu^{2+}$ concentration on the dissociation rate has also been investigated. The ligand effect on t dissociation rate of $Zn^{2+}$ complexes is discussed in terms of the side-pendant armsand the chelate ring sizes of the ligands.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.31-35
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• 2006

Purpose: A primary adenosquamous carcinoma of the stomach is relatively rare, accounting for only about 0.5% of all gastric cancers. However, its histopathologic characteristics are still unclear, and the most appropriate form of therapy has not been established yet. Materials and Methods: We retrospectively reviewed the clinicopathologic features of 8 patients with pathologically confirmed primary adenosquamous carcinomas out of 8,268 patients who underwent gastric cancer surgery at Samsung Medical Center between September 1994 and December 2004. Results: The median age of the 8 patients was 49 ($41{\sim}69$) years, and the male : female ratio was 5 : 3. In 3 patients, the tumor was located at the mid body of the stomach, and in 5 patients, at the lower body or antrum. The tumor sizes were $2.5{\sim}8cm$. Seven patients showed metastases to the regional lymph nodes. The UICC stage distribution were: 5 stage II, 2 stage III, and 1 stage IV. In the stage IV patient, a palliative gastrojejunostomy was performed, and he died 5 months after surgery. Of the 7 patients who underwent a radical gastrectomy and adjuvant chemotheratpy, the median survival was 34 ($12{\sim}66$) months, 2 patients died of cancer recurrence, and 4 patients are being followed up without evidence of recurrence. Conclusion: As for an adenocarcinoma of the stomach, a radical gastrectomy including regional lymph node dissection and postoperative adjuvant therapy should be performed for appropriate treatment of an adenosquamous carcinoma of the stomach.

• Tuberculosis and Respiratory Diseases
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• v.63 no.2
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• pp.128-138
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• 2007

Backgrounds: Mutations of katG and inhA (ORF and promoter) are known to be related to isoniazid (INH) resistance of Mycobacterium tuberculosis. Because reports on these mutations in Korean isolates are limited (i.e. only the frequency of katG codon 463 was evaluated.), we tried to know the kinds of mutations of two genes and their frequencies in INH resistant Korean M. tuberculosis strains. Methods: PCR was performed to amplify katG (2,223 bp), inhA ORF (-77~897, 975 bp), and inhA promoter (-168~80, 248 bp) from 29 multidrug resistant M. tuberculosis (MDR-TB) DNAs prepared by bead beater-phenol method. Their sequences were determined and analyzed by ABI PRISM 3730 XL Analyzer and MegAlign package program, respectively. Results: All of the isolates had more than one mutation in katG or inhA gene. Twenty seven (93%) of 29 tested strains had katG mutations, which suggests that katG is a critical gene determining INH resistance of M. tuberculosis. Amino acid substitutions, such as Arg463Leu and Ser315Thr, due to point mutations of the katG were the most frequent (62.1% and 55.2%) mutations. In addition, deletion of the katG gene was frequently observed (17.2%). Analyzed Korean MDR-TB isolates also had variable inhA mutations. Point mutation of inhA promoter region, such as -15 ($C{\rightarrow}T$) was frequently found. Substitution of amino acid (Lsy8Asn) due to point mutation ($AAA{\rightarrow}AAC$) of inhA ORF was found in 1 isolate. Interestingly, 14 point mutated types that were not previously reported were newly found. While four types resulted in amino acid change, the others were silent mutations. Conclusions: Although it is not clear that the relationship of these newly found mutations with INH resistance, they show marked diversity in Korean MDR-TB strains. It also suggests their feasibility as a molecular target to supplement determining the INH resistance of clinical isolates because of the possible existence of low-level INH resistant strains.

• Tuberculosis and Respiratory Diseases
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• v.55 no.3
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• pp.287-296
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• 2003

Background : Drowning represents the third most common cause of all accidental deaths worldwide. Although few studies of submersion injury were done in Korea, the subjects were mainly pediatric patients. The purpose of this study is to describe the clinical feature of submersion injury in adults. Methods : The medical records of 31 patients with submersion injury who were >15 years of age and admitted to Kyungpook National University Hospital from July 1990 to March 2003 were retrospectively examined. Results : The most common age-group, cause, and site of submersion accidents in adults were 15-24 years of age, inability to swim, and river followed by more than 65 years of age, drinking, and public bath respectively. The initial chest radiographics showed bilaterally and centrally predominant distribution of pulmonary edema at lung base in about 90% of patients with pulmonary edema represented by submersion injury but at only upper lung zone in 10%. Eventually, 25 patients (80.6%) survived without any neurologic deficit and 2 patients (6.5%) with significant neurologic deficit, and 4 patients (12.9%) died. Age, arterial gas oxygenation, and mental status among baseline variables showed significant difference for prognosis. Conclusions : More than 65 year of age, drinking, and occurrence in public bath were relatively important in submersion injury of adults, and the successful survival of 80.6% of patients suggests that cardiopulmonary resuscitation should be intensively done in even adults.

• Journal of The Korean Association For Science Education
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• v.21 no.2
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• pp.357-384
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• 2001

In this paper, we described practical teaching-learning plans based on three different theoretical approaches to Integrated Science Education (ISE): a knowledge centered ISE, a social problem centered ISE, and an individual interest centered ISE. We believe that science teachers can understand integrated science education through this paper and they are able to apply simultaneously our integrated science teaching materials to their real instruction in classroom. For this we developed integrated science teaching-learning plans for the topic of energy which has a integrated feature strongly among integrated science subject contents. These modules were based upon the teaching strategies of 'Energy' following each integrated directions organized in the previous paper (Three Strategies for Integrated Science Teaching of "Energy" Applying Knowledge, Social Problem, and Individual Interest Centered Approaches) and we applied instruction models fitting each features of integrated directions to the teaching strategies of 'Energy'. There is a concrete describing on the above three integrated science teaching-learning plans as follows. 1. For the knowledge centered integration, we selected the topic, 'Journey of Energy' and we tried to integrate the knowledge of physics, chemistry, biology, and earth science applying the instruction model of 'Free Discovery Learning' which is emphasized on concepts and inquiry. 2. For the social problem centered integration, we selected the topic, 'Future of Energy' to resolve the science-related social problems and we applied the instruction model of 'Project Learning' which is emphasized on learner's cognitive process to the topic. 3. For the individual interest centered integration, we selected the topic, 'Transformation of Energy' for the integration of science and individual interest and we applied the instruction model of 'Project Learning' centering learner's interest and concern. Based upon the above direction, we developed the integrated science teaching-learning plans as following steps. First, we organized 'Integrated Teaching-Learning Contents' according to the topics. Second, based upon the above organization, we designed 'Instructional procedures' to integrate within the topics. Third, in accordance with the above 'Instructional Procedures', we created 'Instructional Coaching Plan' that can be applied in the practical world of real classrooms. These plans can be used as models for the further development of integrated science instruction for teacher preparation, textbook development, and classroom learning.

• Journal of the Korean Geographical Society
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• v.28 no.4
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• pp.321-355
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• 1993

This paper focuses on the geographical pattern of financial activities in the Korean urban system during 1975-1990, based on the assumption that financial activities can reveal control points in Korea's urban economy. In terms of spatial evolution of financial insitutions, different locational characteristics are revealed among different types of financial institutions, implying the role of urban hierarchy. Financial resources are highly concentrated in the capital region, Seoul and Kyonggi Province. Both centralization trends into the large metropolitan cities and relative declines of medium and small cities within the Korean urban system, have been experienced over the study period. Financial activities sustain relatively stable hierarchical structure in the urban hierarchy. Regarding the financial flows, dominant flow zones centered on major metropolitan cities are identified, clearly showing a prominant role of Seoul in financial flows in the entire urban system.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.4
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• pp.451-461
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• 2009

The purpose of this study is to provide fundamental information for snack development contributing to physical growth of children with cerebral palsy. The study was conducted on the children with cerebral palsy of age 1 to 7 by investigating their food behavior, physical growth development, nutritional status, and snack intake. As a result of assessing physical growth by WLI (Weight-Length Index), the proportions of the children with cerebral palsy were the following: underweight 45.5%, normal 45.5%, overweight 6.0%, and obesity 3.0%. The mothers of the children with cerebral palsy mainly bought milk and dairy products for their children's snacks (43.5%) as well as fruits (33.3%). They wanted development of new snacks that helped growth development (50.5%), and preferred more development of the following snacks: Korean rice cakes (47.5%), biscuits (24.2%), bread (22.3%). The result of dietary intake showed that the percentage of RI in zinc and folic acid did not reach the RI in every age categories. The proportion of subjects with less than 75% of RI was 76.8% for the zinc and folic acid, and 52.4% for the calcium and iron. These results indicate that children with cerebral palsy had slower physical development and lesser nutrition intake than normal children. Hence, this study provided the basis to develop the snack for the malnutrition state children with cerebral palsy which helped their physical development. The shape of new snack considered was a rice cake which included zinc and folic acid that were insufficient in RI in children with cerebral palsy.