혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

당뇨병 백서의 간세포에서 Glucokinase 활성도 및 유전자 발현에 대한 인슐린의 영향

강성이,팽정령,서광식,안규정,우정택,김성운,양인명,김진우,김영설,김광원,최영길 경희대학교 유전공학연구소 1993 遺傳工學論文集 Vol.5 No.-

목적 당대사의 조절 상태에 따른 생체 변화를 분자 수준에서 이해하고자 식이 조건을 달리한 정상 백서와 화학적으로 유도된 당뇨병 백서의 간조직에서 혈당수준과 인슐린치료 정도에 따라 나타나는 글루코키나제 활성도 및 유전자 발현을 분석하였다. 방법 스트렙토조토신 정맥투여 후 당뇨병의 유발을 확인하고, 인슐린을 1일 3회 3일간 복강내로 투여하여 상태를 안정시킨 후, 인슐린 투여군은 인슐린 투여 6시간이내에 그리고 인슐린 비투여군은 24시간 후 단두하여 채혈하고 복강을 열어 간조직을 채취하였다. 채취한 간조직에서 글루코키나제 활성도는 인산화된 포도당에서 NADH의 형성을 형광분광계로 측정하였으며, 글루코키나제 유전자 mRNA발현은 Northern 분석법을 이용하였다. 성적 정상 백서에서 공복상태와 식이를 섭취한 경우에 간조직의 글루코키나제 효소의 활성은 차이가 없었으나, 글루코키나제 유전자 mRNA 발현은 증가되었다. 당뇨병이 유발된 백서의 간조직에서 글루코키나제 효소의 활성 및 글루코키나제 유전자의 mRNA 발현은 정상 백서에 비하여 낮았다. 인슐린 투쳐 후 글루코키나제 효소의 활성 및 글루코키나제 유전자의 mRNA 발현이 증가되었고, 특히 혈당이 정상화된 경우에서 글루코키나제 유전자의 mRNA 발현이 증가도었다. 결론 인슐린에 의한 간조직에서 글루코키나제 효소의 활성 및 글루코키나제 유전자의 mRNA을 증가를 볼수 있었다. 당뇨병 백서에서 인슐린 투여 후에 혈당조절이 안된 경우 간조직의 글루코키나제 유전자의 mRNA 발현이 증가가 없는 것으로 보아 글루코키나제 mRNA의 발현에는 인슐린 이외의 다른 요소가 관여할 것으로 생각된다. The liver-specific hexokinase isoenzyme, referred to as glucokinase, is thought to play a key reglulatory role in hepatic glucose metabolism. The glucokinase gene is, therefore, of interest both because of its tissue-specific expression and because of the several regulatory processes that can be analyzed. The level of hepatic glucokinase activity appears to be determined essentially by regulation of the rate of enzyme synthesis, with insulin playing a leading role as an inducer. We investigated the role of insulin for the induction of glucokinase in the liver of diabetic rats. Experimental diabetes was induced by injection of streptozotocin 7 days before the experiment. Regular insulin was given by three days intraperitoneal injection at 8-h interval. The glucokinase mRNA in the liver was estimated by Nothern blot assay, as well as by fluorometric enzyme activity assay. Glucokinase activity was not reduced in the liver of normal fasting rats as compared to normal fed rats. And glucokinase activity was reduced in the liver of diabetic rats as compared to normal rats. In diabetic rats treated with insulin, glucokinase enzyme activity were increased. But glucokinase mRNA expression was only increased in normoglycemic diabetic rat with treated with insulin as compared to hyperglycemic rat. These data indicate that insulin stimulates hepatic glucokinase enzyme activity and mRNA expression. But other hormonal or metabolic factors may be contribute to regulation of glucokinase mRNA expression.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

감마 분광 분석을 이용한 환경 시료 중 ^(226)Ra 및 ^(232)Th 방사능농도 검증

강태우,고정대 제주대학교 방사선응용과학연구소 2008 방사선응용과학연구소논문집 Vol.22 No.-

The objective of this study was to get the reliable data and to improve nuclear analytical techniques. The gypsum and soil samples was obtained from Korea Institute of Nuclear Safety(KINS), the measurement of ^(226)Ra and ^(232)Th activities were performed by gamma-ray spectrometry system consisted with a high purity germanium(HPGe) detector. Their activities showed a good agreement within the confidence intervals and were evaluated to be reliable. Therefore, the results obtained in this study can be useful for measurement of ^(226)Ra and ^(232)Th activities in the environmental sample using HPGe gamma-ray spectrometry. 본 실험은 환경방사능 분석 기술의 능력 검증과 신뢰도를 확보하기 위하여 석고와 토양 시료를 KINS로부터 제공받아 고순도 게르마늄 검출기로 구성된 감마 분광계를 이용하여 분석하였다. 분석 핵종은 석고 중 ^(226)Ra과 토양 중 ^(232)Th 감마핵종이었으며, 이들 분석 값들은 모두신뢰도 범위내의 값을 보였다. 따라서 고순도 게르마늄검출 시스템을 이용한 환경 시료 중 ^(226)Ra과 ^(232)Th 방사능 농도를 분석할 수 있는 능력을 갖출 수 있었다.

중학교 수준별 과학교육을 위한 힘과 운동 단원의 실험 체계 연구

강정우,강동식,임재린 濟州大學校 師範大學 科學敎育硏究所 1998 科學敎育 Vol.15 No.-

The degree of difficulty of learning in the primary ten items of experiments (experiments in the chapter of force and motion) chosen in the eight kinds of middle school science-textbooks which are used in the 6th cumculum, and the necessity of level-study are analyzed. Making science teachers an object of questions, a degree of interest of students and a view of science teachers for learning are inquired, the system of learning, the method of study and the secondary tools for study are proposed. Putting these results of Investigation, the level-study, in order to induce an interest for sudents and develop student's ability, must be done, therefore the level- learning instruments and the standard of test are prepared. Contents of learning in textbooks are analyzed according to the level of students and reconstructed, the various complementary tools of learning, the model of teaching and learning are developed and supplied. In order to develop and preserve the desire of learning of various students at school, the study and training of teachers and the expansion of the related education facilities are needed.

8년간(1992~1999) 산업안전보건연구원에 의뢰된 직업병 심의 사례 분석

강성규,김규상,김양호,최정근,안연순,진영우,최병순,양정선,김은아,채창호,최용휴,김대성,박정선,정호근 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Pneumoconisis and noise-induced hearing loss (NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardio-cerebrovascular accident (CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). Methods : The local office of the Korea Labor Welfare Corporation (KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. Results : Male was 80.7 % of the requested cases. Their mean age was 42 years old and 75.5 % of them were more than 35 years old. The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50.7 %. The majority of requested cases were respiratory diseases(22.4%), cancers(18.5%), Neuropsychiatric problems(14.5%), and musculoskeletal problems(13.5%). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73.6% of them were caused by chemical agents, especially 28.5 % were by organic solvents. 67% of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. Conclusions : A claim was common in workers whose age was over 35 years old and exposure history was over 10 years. The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.

컴퓨터 프로그램을 이용한 과학실험 자료해석

강동식,강정우 濟州大學校 師範大學 科學敎育硏究所 1997 科學敎育 Vol.14 No.-

The appropriate uses of the computer programs in science tend to quick looks at relatively simple or idealized situations involving limited data. All students check the calculations done by any software package before using it to analyze their data

보조학습도구로서 Mathematica를 이용한 학습모형 개발

강동식,강정우 제주대학교 1994 논문집 Vol.38 No.-

보조학습도구로서 컴퓨터는 매우 유용한 도구이다. 학생들은 문제의 중간과정에 많은 노력을 투자함으로서 문제분석이나 결과해석에 치중하지 못하는 경향이 있다. Mathematica를 이용하여 그런 노력을 완화시킬 수 있으며, 보다 많은 경우에까지 응용할 수 있어 물리개념을 확고하게 정립할 수 있다. 수업모델로써 세가지 예, 즉 Ohm의 법칙, 감쇠진동, 파의 중첩들을 제시하였다. As the assistant learning instruments, computer is a very usefoul tool. Students make great efforts in processing intermediate mathematical steps in solving the Physical probelem. Mathematica alleviates such efforts and students can make a further motice to the analysis of problems and to the interpretation of results. We propose the three learning models utilizing Mathematica as the assistant learning instrument:the Ohm's the damped oscillation, the superposition of waves.

生物敎科書에 나오는 植物種類와 鎭海市 初·中·高等學校 庭園樹木과의 比較

姜東萬,鄭宇珪,成敏雄 慶尙大學校 기초과학연구소 1989 基礎科學硏究所報 Vol.5 No.-

학교 정원의 교재원화를 위한 기초조사로써 1984년 3월부터 1988년 10월까지 국민학교 자연, 중학교 과학, 고등학교 생물 교과서에 출현하는 관다발식물과 진해시내 19개 초·중·고등학교의 정원에 식재되어 있는 수목의 종류와 빈도 등을 조사한 결과는 다음과 같았다. 1. 생물 교과서에 출현하는 전체 관다발 식물은 91과 182속 192종 21변종 1품종 총 214종이었다. 이들 중에는 국민학교 33종 중학교 63종 고등학교에 208종이 포함되었다. 생물 교과서에 나오는 목본 식물은 전체 37과, 58속, 68종, 8변종 1품종 총 77종이었고 이들 중에는 국민학교 8종, 중학교 22종, 고등학교에 73종이 포함되었다. 2. 생물 교과서에 나오는 관다발 식물의 총빈도는 1576이고 국민학교 238, 중학교 268, 고등학교 1074였다. 종당 평균 출현회수는 전체 74회, 국민학교 7.2회, 중학교 7.2회 고등학교 2.5회였다. 3. 진해시내 19개 학교 정원에 식재되어 있는 수목은 전체 53과 96속 126종 33변종 6품종 총 165종이었고 10개 국민학교에 139종, 4개 중학교에 77종, 5개 고등학교에 114종이 식재되어 있었다. 4. 10개교에 식재된 종의 총빈도는 1019이고 종당 평균빈도는 6.2였다. 전체 학교에 식재된 수목은 개입깔나무, 가이쓰카 향나무, 둥근향나무, 장미, 회양목, 무궁화, 사철나무, 개나리의 8종이고 은행, 편백, 서리화백, 측백, 두꺼운 잎유카, 버짐나무, 왕벚나무, 꽝꽝나무, 단풍나무, 동백, 아왜나무 11종이 빈도 80%이상이었다. 5. 19개교의 총개체수는 24531주, 학교당 평균 개체수는 1291주, 국민학교 1562주, 중학교 1445.5주, 고등학교 625.8주였다. 종당 평균 개체수는 전체학교에서 148.7주, 국민학교 112.4주, 중학교 75주, 고등학교 27.4주였다. 1000주 이상 식재된 수목은 측백(4075), 개나리(1986), 사철나무(1915), 연산홍(1730), 무궁화(1509), 편백(1295), 둥근향나무(1112), 회양목(1043)이었고 이들 8종이 전체의 43.2%를 차지하였다. 나자식물이 종수에 있어 21.2%, 개체수에 있어 43.0% 였고 상록수가 종수에 있어 43.0%, 개체수에 있어 74.2%였다. 6. 19개교의 총종수는 165종이고 학교당 평균 종수는 53.4종이었고 국민학교 59.8종, 중학교 37.2종 , 고등학교 53.6종이었다. 가장 종수가 많은 학교는 진해 고등학교로 84종이었고, 가장 적은 학교는 진해종합고등학교로 21종이었다. 7. 진해시 학교 정원에 식재된 수목 165종중 생물 교과서에 나오는 수종은 46종으로 관다발 식물의 21.0%, 수목의 59.7%였다. 그러나 생물 교과서에 나오는 식물중에서 학교 정원에 식재되어 있는 학교당 평균 종수는 국민학교 4.6종, 중학교 3.2종, 고등학교 12종이었다. 이 수치는 생물 교과서에 나오는 목본식물의 수에 각각 57.5%, 14.1%, 16.4% 였고, 관다발식물의 수에 비해 각각 13.9%, 5.1%, 5.8%에 해당하였다. 8. 진해시 학교 정원에 식재된 수목은 교육적 기능보다는 관상 위주로 식재되었고 침엽수와 상록수가 지나치게 많이 식재되어 적절한 조정이 필요하다. This paper was carried out to investigate the kinds of vascular plants and their frequencies appearing in the books of the elementary school; "wise life" and "nature". in the books of the high school; "biology". These investigations were compared the kinds of the garden trees and their frequencies of 10 elementary. 4 middle. and 5 high schools and total 19 schools in chinhae city and the vasular plants writtern in the biology text books as a basic research for the teaching gardenization of school gardens from March. 1984 to August. 1988. The results were summarized as follows: 1. The biology text books appeared total 214 kinds of the vascular plants. According to classification, they were 91 families, 182 genera, 192 species, 21 varieties , and 1 forma. These consisted of 33 kinds in the books of the elementary school; "wise life" and "nature " , 63 kinds in the books of the middle school; "general science", and 208 kinds in the books of the high school; "biology". In all the biology text books the woody plants were total 77 kinds or 37 families, 58 genera, 68species, 8 varieties, and 1 form. Among them, the woody plants of 8 kinds in the elementary school, 22 kinds in the middle school, and 73 kinds in the high school were contained. 2. Total frequency of vascular plants appearing in the biology text books was 1576 times. Among them, the vascular plants of 238 times in the elementary school, 268 times in the middle school, and 1074 times in the high school appeared. Average frequency per species was 74 times in total species of all the biology text books, 7.2 times in the wise life and nature text books of the elementary school, 7.2 times in the general science text books of the middle school, 2.5 times in the biology text books of the high school. 3. The woody plants in school garden in Chinhae city were 165 kinds. According to classification, they were 53 families, 96 genera, 126 species, 33 varieties, and 6 forma in the gardens of total 19 schools. The woody plants of 139 kinds in the gardens of 10 elementary schools, 77 kinds in the gardens of 4 middle schools, and 114 kinds in the gardens of 5 high schools were planted. 4. Total frequency of kinds planted in 19 schools and average frequency per species was 1019 times 6.2 times. The woody plants appearing in the garden of schools were 8 kinds of Cedrus deodara, Juniperus chinensis var. kaizuka, J. chinensis var. globosa, Rosa hybrida. Puxus microphylla var, koreana, Hibiscus syriacus, Euonymus japonca, and Forsythia koreana, 11 kinds of Ginkgo biloba, Chamaecyparis obtus, C. pisifera var. squarrosa, Thuja orientalis, Yucca recurrifolia, Platanus orientalis, Prunus yedoensis, Ilex crenata var. microphylla, Acerplantanum var. palmatum, Camella japonica, and Viburnum aieabuki were 80% or over in frequency appearing in the gardens of 19 schools. 5. Total individuals appearing in the gardens of 19 schools were 24531 trees. Average individual number per school was 1291 trees in all the schools, 1562 trees in the elementary schools, 14455 trees in the middle schools, and 625.8 in the high schools. Average individual number per species was 148.7 trees in all the schools, 112.4 trees in the elementary schools, 75 trees in the middle school and 27.4 trees in the high schools. The greatest individual number among 19 schools in Chinhae city was 3994 in Daeya elementary school. The smallest individual number among 19 schools in Chinhae city was 271 in Chinhae comprehensive senior high school. 6. The woody plants appearing 1000 trees or over in the gardens of 19 schools were T. orientalis(4075), F. koreana(1986), E. japonica(1915), Rhododendron obusum(1730), H.syriacus(1509), C. obtus(1294), J.chinensis var. globosa(1112), and P. microphylla var. koreana(1043). These 8 species were 43.2% of total individual number. The ever green trees appeared 43.0% in the species numbers and 74.2% in the individual number. 7. The woody plants in all the school garden were 165 species in total. Average species number in each school were 53.4 species in total schools, 59.8 species in the elementary schools, 37.2 species in the middle schools, and 53.6species in the high schools. The greatest species number among 19 schools in Chinhae city was 84 species in Chinhae senior high school. The smallest species number among 19 schools was 21 species in Chinhae comprehensive senior high school. The woody plants appearing in the biology text books among 165 species growing in the school gardens in Chinhae city were 46 species. These species numbers were under 21.0% of vascular plants and 59.7%of woody plants appearing in the biology text books. These species number of the woody plants growing in 19 school gardens among the woody plants appearing in the biology text books were 4.6 species in the elementary schools, 3.2 species in the middle schools, and 12 species in the high schools. These species numbers were under 57.7%, 14.1%, and 16.4% in the numbers of woody plants of the biology text books and 13.9%, 5.1% and 5.8% in the number of vascular plants of the biology text books. 8. The authors could find out that the plants planted in the school garden were not suitable to use for the teaching material plants because of planting only the woody plants of school garden for landscape rather than plants for teaching materials. Therefore some of the improvement for the teaching material garden of school were issused in the discussion.

등방성 매질에서의 활성상수

강창현,강동식,강정우 濟州大學校 師範大學 科學敎育硏究所 1997 科學敎育 Vol.14 No.-

The physical significance of the activity constant ζ, which is needed to describe electrodynamics of an isotropic medium, is discussed in electroconductive media and non-electroconductive media. In non-electroconductive media, where the sources of the charge density ℓ and current density J , and the conductance σ vanish, the speed of propagation and the refractive index of two circularly polarized transverse modes are different, and the physical phenomena called as the optical activity take place. Also in electroconductive media, in which energy of electromagnetic wave through the medium is damped, the phase velocity and the absorption coefficient of the electromagnetic waves depend on ζ . The skin depth and the angular frequency also depend on ζ .