한국인에게서 그레이브스병 약물치료의 적정기간

이형숙,이동훈,정희선,이종우,김정은,신승수,정윤석,이관우,김현만 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.1

연구배경: 그레이브스병의 치료에는 항갑상선제, 수술 및 방사성 요오드법이 선택되어 사용되고 있다. 이중 항갑상선제는 가장 많이 선호되고 있으나 낮은 관해율과 높은 재발율로 장기간 치료기간이 요구된다. 저자들은 그레이브스병 환자에게서, 선택되는 치료법의 선호도와 각 치료법의 관해율을 조사하고자 본 연구를 시행하였다. 또한 본 연구에서는 항갑선제 치료의 적정기간을 평가하고자 하였다. 방법: 아주대학교병원에 내원한 환자 중 1년 이상 추적관찰이 가능한 205명의 그레이브스병 환자를 대상으로 조사하였다. 항갑상제군, 수술군 및 방사성 요오드군은 각각 170명, 29명 그리고 6명이었다. ROC curve를 이용하여 약물치료의 예후예측인자를 분석하였다. 결과: 1) 그레이브스병 환자의 치료 방법의 선택은 항갑상선제군, 수술군 및 방사성 요오드군 각각 170명(83.0%), 29명(14.1%) 그리고 6명(2.9%)으로 항갑상선제 치료가 가장 선호되었다. 2) 그레이브스병의 관해율은 항갑상선제군, 수술군 및 방사성 요오드군에서 각각 60.0%(102/170명), 96.5%(28/29명) 그리고 83.0%(5/6명)으로 수술군이 가장 높았다. 3) ROC curve의 AUC는 치료기간과 진단시 TBII가 각각 0.709 및 0.648이었고 적절한 약물투여 추적 관찰기간은 26개월이었다. 결론: 그레이브스병의 일차 치료법으로는 항갑상선제가 선호되고 있으나 수술 및 방사성 요오드 치료군에 비해 상대적으로 낮은 관해율을 보였다. 따라서 항갑상선제 치료로 26개월 이상 관해가 되지 않을 경우에는 치료 방법의 변경을 고려하는 것이 관해율을 높이는데 도움이 될 것으로 생각된다. Background: Graves' disease in an organ specific autoimmune disease. Three kinds of therapeutic modalities (antithyroid drugs, ablation with radioactive iodine and subtotal thyroidectomy) are frequently performed for the management of this disease. The most popular therapeutic policy for the disease in Korea is antithyroid treatment. We analysed and compared the remission rates of all three modalities for Graves' disease, and evaluated the antithyroid modality to determine the correct duration of treatment. Subjects & Methods : The medical records of 205 patients with Graves' disease were reviewed. For the evaluation of the antithyroid modality medical treatment, antithyroid drugs were administered for more than 1 year. The prognostic factors associated with remission were analysed by means of an ROC curve. Results: 1) Of the 205 patients, proportions that received medical therapy, subtotal thyroidectomy and radioiodine therapy were 83.0, 14.1 and 2.9%, respectively. 2) The remission rates of the medical therapy, surgery and radioiodine therapy were 60.0, 96.5 and 83.0%, respectively. 3) The remission rate of the medical therapy was associated with the duration of medication and TBII activity. The determined proper duration for the antithyroid treatment was 26 months from the ROC curve analysis. Conclusion: The above results suggest that the proper duration of antithyroid treatment for Graves' disease is 26 months, after which time the subtotal thyroidectomy or radioiodine therapy should be considered if the disease has not remitted (J Kor Soc Endocrinol 18:24∼31, 2003).

장상피화생과 Helicobactor pylori와의 상관 관계에 관한 연구

이복희,김대수,이현숙,진영주,윤세진,송형근,성노현,정현용,이동호 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

In 1965 Lauren divided advanced gastric carcinoma into two main types-namely, "intestinal" and "diffuse" type carcinoma, which differ not only morphologically but also in their clinical and epidemiological characteristics. Moreover, a different histogenetic process has been postulated by many authors that intestinal type gastric carcinoma might arise from areas with intestinal metaplasia. Since Warren and Marshall reported the presence of Helicobacter pylori in the stomach in 1983, strong evidence has been obtained that there is a close relationship between Helicobacter pylori and chronic gastritis, atrophic gastritis, intestinal metaplasia, and intestinal type gastric carcinoma. To study the relationship between intestinal metaplasia and Helicobacter pylori infection, we performed gastroscopic biopsies and CLO tests taken from patients with epigastric pain. Only 87 patients with macroscopically suspected antral gastritis were included. The prevalence of intestinal metaplasia in gastric antral biopsies increased from 33.3% in the age group<30 years to 63.6% in the age group 60 years. When all patients were divided into two age groups-namely, (i)<50 years(n=41) and (ii)≥ 50 years(n-=46), intestinal metaplasia was found significantly more often in patients ≥ 50 years. ((i) 39.2%, (ii) 54.3%, p<0.0001). The prevalence of Helicobacter pylori in gastric antral biopsies decreased from 66.7% in the age group<30 years to 62.5%, in the age group in the age group 50 to 59 years. When all patients were divided into the same two age groups-namely(i)<50 years and (ii)≥50 years, the prevalence of Helicobacter pylori did not differ between two groups in a statistically significant way. The mean age of intestinal metaplasia positive patients who were also Helicobacter pylori positive was 48±11.0(mean±S.D.)years, whereas the mean age of intestinal metaplasia positive patients who were Helicobacter pylori negative was 52±9.7(mean±S.D.)years. In conclusion. although our data do not prove a causal relationship between Helicobacter pylori infection and the histogenesis of intestinal metaplasia, we suggest that Helicobacter pylori plays an important role in the development of intestinal metaplasia in the gastric mucosa. Whether Helicobacter pylori has to be present at all times during this process or is only necessary as a 'trigger', needs further research.

따뜻한 사람과 아름다운 자연이 조화를 이룬 나라 호주

이현숙 忠北大學校 敎育.生活硏究所 2002 한국교육논총 Vol.23 No.2

태권도 수련이 삶의 질과 정신건강에 미치는 영향

이한경,남승현,김석일 龍仁大學校 武道硏究所 1997 武道硏究所誌 Vol.8 No.2

The purpose of this research was to analyze the mental status of a Taekwondo participant and a non-participant. The following were the results. 1) The analysis of Taekwondo participant´s relationship to life and quality were satisfacy at job, leisure, daily life, and steady manage. Consistency in Taekwondo training reduces job stress and physical fatigueness. 2) Taekwondo participant, who trains frequently finds quality of life more satisfying as a hobby and a genuine effect of the art. 3) Taekwondo participant, who trains consistently in one´s qality of life can attain affirnation of positive effects, depending on the individual. 4) In Taekwondo training, there are 9 mental health existence and non-existence. Sometization Obsessive-compulsive, Interpersonal-sensitive, Anxiety, Hastility. Phobic anxiety are all positively effective through Taekwondo training, However, the rest of the following fectors (Depression, paranoid ideation, Dsychoticism) are not effcetive.

濟州道 菜蔬·花卉園藝의 生産實態, 育成方案 및 流通構造改善에 관한 硏究

李宗錫,吳現道,蘇寅燮,張田益,姜志勇 濟州大學校 亞熱帶農業硏究所 1986 亞熱帶農業硏究 Vol.3 No.-

濟州道의 施設을 理用한 菜蔬類와 球根切花類 및 洋蘭類의 재배실태를 調査한 結果는 다음과 같이 要約할 수 있다. 1. 作目이 토마토와 오이에 編重되어 있어 딸기等을 첨가하여 作目이 多樣化하여야 할 것으로 思料되었다. 2. 施設內의 土壤管理에 대한 認識이 不足하며, 均衡施肥가 施行되지 않고 있었고 土壤酸度도 矯正해야 할 농가가 많았다. 3. Mg이 缺乏된 施設이 대부분이므로 이의 是正이 時急한 課題였다. 4. 施設內 土壤에서 鹽類集積의 被害가 우려되는 곳은 거의 없었으나 裁培年限이 5年以上된 施設에서는 土壤改良이 이뤄저야 할 것으로 思料되었다. 5. 作付體係를 改善해서 年 2期作 體係가 確立되어야 겠으며 施設管利技術이 普及, 育苗技術의 改善 및 共同育苗를 施行해서 健全苗의 養成이 重要課題였다. 6. 濟州道內에서 産業的으로 栽培되고 있는 蘭類 中에서 熱帶産 Cymbidium類가 全體 洋蘭 栽培量의 67.8%로 가장 많았는데 그 中에서도 Eiko, sharnell-5, Kenny가 數的으로 많았다. 7. 溫帶産蘭(東洋蘭)類 中에서는 새우난초類가 數的으로 가장 많았고, 나도풍난, Dendrobrum moniliforme, Cymbidium 風蘭의 順位이었으며, 自生寒蘭은 대 40,396촉이 栽培되고 있었다. 8. 供試 5種의 球根類들은 virus 감염이 甚하여 全量이 virus 無病株로 대체되어야 할 것으로 판단되었다. 9. 서귀포지역의 土壤은 害蟲이 많이 分布하여 球根切花栽培에 큰 위협조건으로 나타났으며 앞으로 도양소독에 대하여 보다 집약적이고 효율적인 方法이 개발되어야 하겠다. 10. 한라산의 고냉지를 利用한 球根의 低溫處理 效果에 對하여 많은 적응시험이 요망되며 道當局은 고냉지의 개발과 利用에 적극적인 지원을 투여하여야 할 것이다. 11. 植栽되고 있는 5種의 球根類 모두 50% 以上이 外國수입에 의존하고 있으므로 國內의 組織培養技術을 利用한 virus 無病良質球根의 生産이 절실히 요망된다. Studies on various cultural practices of vegetable crops, and orchids have been conducted in Chejudo. Followings are the results of such studies. 1. Too much importance has been given to Tomato and Cucumber crops. An additional crop such as Strawberry should be included to broaden the studies. 2. In general, lack of informations on soil managements appear to be prevailing; scheduled fertilization, for instance, has not been performed and pH level must be adjusted on many farm lands. 3. Mg deficiency has been very much in common, therefore, is corection are matter of utmost importance. 4. Problems arising from salt accumulation were nearly unimportant, however, soil improvements through various cultural practices are recommended for those soils which have been continuous cropping for more than 5 years. 5. Planting system should be improved so as to establish 2-crops/year system. In addition, proper extention of various soil management techniques and improvement on nursing techiques are of inportant matters. Commonly sharing community nursing practices must be accompanied in order to provide healthy-seedlings. 6. Among commercially growing orchid species in Chejudo, the tropical Cymbidium species found to be the most widely grown, nearly 67.8% 'Kiko', 'Sharnell-5', 'Kenny' appear to be most in common. 7. Among oriental orchids, Calanthe spp are found to be most prevalent followed in the order of Aerides japonica, Dendrobium moniliforme, Cymbidiums, respectively. 8. The total number of the shoots of Cymbidium kanran being cultivated in Chejudo were found to be 40,396. 9. Virus infections appear to be universal in all 5 species of bulbs studied therefore, virus-free stocks must be essential. 10. Sogwipo-soil, in general, heavily infected by soil-born insects of various kinds are badly affecting bulb productions. More efficient methods of soilsanitations must be studied and introduced in the future. 11. The studies of low temperature treatment on bulb crops by utilizing the high altitude growing in the area of mountain Halla are in great need. An extensive assistance from the provincial government are very much in need in order for the development and utilization of the high-altitude cultivation. 12. More than 50% of the bulbs of the 5 species grown are being imported. Domestic production utilizing 'meristem culture' which enable the virus free stocks are in great demand.

스포츠 센터 평생 회원들의 체련장 이용 실태에 관한 연구

이한경,유호길,김미정,김석일,남승현 龍仁大學校 1998 용인대학교 논문집 Vol.15 No.-

The purpose of this study is to analyze privileged mass' use of the sport for all facilities. The subject was members of five in hotel, who answered a questionnaire. The main results of this study are as follows : 1. It was found that comsumers of fitness center were at 40-50 age, and the mean of using period is longer than 3 years. 2. The membership card motivated members to improve, their health and in the older members losed self-health condition. 3. The members were used lower at facilities less. The mean of using frequency is one per four days. 4. It was found that sauna room was the most utilized facilities in fitness center. 5. It was fecund that training room was utilized less, because of lack of time. 6. The participant of training room not showed lower facility use at higher age. 7. The participator of trainning room did showed satisfaction for instructor and facilities. As started above, the turn of recognition which answers the purpose is needed for a privileged mass' use of facilities for sports for all, and a positive motivation of the managements of commercial sports center must be prepared indispensably. Also, a consideration for a resasonable and step by step remedy for all age groups is deeply demanded.

상악골 급속확장술식 전후 두경부 자세와 설골위치의 변화에 관한 연구

배현철,차경석,이진우 대한치과교정학회 1997 대한치과교정학회지 Vol.27 No.4

본 연구는 상악골 급속확장술식 후 호홉변화와 연관된 두경부 자세의 변화와 이에 따른 설골 위치 변화의 양상을 알아보기 위하여 시행하였다. 평균연령이 12세 9개월이고 Hellman stage Ⅲc에서 adult stage까지의 인두강이 정상적이며 상악골 급속활장술식을 시행한 Angle씨 Ⅲ급 골격양상의 남녀환자 32명을 대상으로 하여 이들 중 상악골 급속확장술식 시행 후 두경부각도가 증가된 군을 A군으로, 감소된 군을 B군으로 분류하였고 대조군은 연구대상과 동일한 Hellman stage이며 평균연령 12세 7개월의 Angle I급 골격양상을 띠는 남녀환자 23명으로 이들을 C군으로 하여 골격양상과 인두강크기, 두경부자세, 설골 위치에 대한 항목을 연구하여 다음과 같은 결론을 얻었다. 1. 골격양상과 인두강 비교 1) A, B군의 치료 전후 비교에서, 두 군 공히 하악이 하방경사되었고 인두강 크기는 변화가 없었다. 2) 세 군간의 치료 전후를 각가 비교한 결과, A, B군의 PMV에 대한 골격 양상과 인구강의 크기는 정상이었다. 2. 두경부 자세비교 1) A, B군의 치료 전후비교에서, A군은 두경부 각도가 상방으로 B군은 두경부 각도와 하악하연이 하방으로 경사됨을 보였다. 2) 세 군간의 치료 전후를 각각 비교한 결과, 치료전에 두경부 각도가 A군은 정상적이었으며, B군은 정상보다 상방 경사짐을 보였다. 치료후에는 A, B군 모두 정상적인 두경부각도를 보였다. 3. 설골 위치 비교 1) A, B군의 치료 전후 비교에서, 두군 공히 설골장축 각도의 변화가 없었고 전후방적으로 A군은 설골이 후방위치되었으며 B군은 변화가 없었다. 수직적으로는 A군의 APHFH가 증가되었을 뿐 나머지 항목에서는 두 군 모두 변화가 없었다. 2) 세 군의 치료 전후를 각각 비교한 결과, 설골장축 각도는 A, B군 모두 정상적이었으며, 전후방적으로 치료전에 A군이 B, C군보다 설골이 전방에 위치되었으나 치료후에는 A, B군 공히 정상적 위치였었다. 설골의 수직적 위치는 치료 전후에 A, B군 모두가 정상적이었다. The present study assessed the effects of Rapid Maxillary Expansion on head posture and hyoid bone position. For this study, 32 Angle's class Ⅲ patients - hellman 3c ~ adult, mean age 12y9m - were selected and divided into two groups, A,B according to craniocervical angulation. Crantiocervical angulation Increased in Group A and decreased in Group B after the therapy. And 23 Angle's class I persons ~ same hellman state, mean age 12y7m ~ were selected for the control group. Cephalometric analysis of skeletal pattern, pharyngeal space, head posture, hyoid bone position was performed. The results were as follows, 1. Comparison of skeletal pattern and pharyngeal space 1) All two group(A,B) had Mandibular plane inclined inferiorly and no pharyngeal space change was observed after RME therapy. 2) Skeletal pattern and pharyngeal space of Group A,B were normal before and after treatment. 2. Comparison of head posture 1) Cranicoervical angulation of Group A was increased after treatment. That of Group B was decreased and mandibular plane was inclined inferiorly after treatment. 2) Before treatment, craniocervical inclination was normal in Group A but larger than normal in Group B. After treatment, all two group(A,B) had normal craniocervical angulation. 3. Comparison of hyoid bone position. 1) After treatment, long axis of hyoid in Group A,B was not changed. Antero-posteriorly, hyoid position was changed posteriorly in Group A but no change was founded in Group B after treatment. Vertically, hyoid bone position were not changed in two groups except in crease in APHFH in Group B after treatment. 2) Long axis of hyoid bone was normal in Group A, B before and after treatment. Anteroposteriorly, hyoid bone positon was more anterior than Group B, C before treatment but all the position of two groups had normal position after treatment. Vertical position of hyoid bone was normal in all two groups before and after treatment.

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.

창의성 개발을 위한 교과 교육 과정설계 원리와 방향

강현석,김창호,이재순 경북대학교 사범대학부속 중등교육연구소 2003 중등교육연구 Vol.51 No.2

The purpose of this study is to study principles and orientations of curriculum design for developing creativity. Creativity education is a key issue in the realm of curriculum revision and education reform in pursuit of improving the quality of education. But there is no theoretical consensus and conceptual definition about creativity and creativity education. So we need to seek nature and theoretical trends of creativity. Creativity education is in general implemented through subject education at various levels. We try to search nature of creativity, to study its implication to subject education, and further to develop curriculum design for improving creativity. The strategies of subject education studied were structure of knowledge, curriculum compacting, and curriculum infusing etc. On the basis of studying the nature and definition, research trends and its implication to subject education, and strategies and design template of creativity are as follows: constructiveness, interactivity, reflexivity, integration and connectivity, Doll`s 4R, and hypertext. Theses principles and orientations are differently operated according to the nature of subject at the levels of teaching. Creativity education should be changed from sporadic psychic orientation to practical and concrete subject education on the basis of curriculum design template.

Ethionine의 시간투여로 인한 Rat의 간과 신장의 지질과산화와 지질량의 변화 연구

김은석,김현아,이주연,이주현,한정희 曉星女子大學校 藥學大學 學生會 1990 曉星藥誌 Vol.5 No.-

The present studies were undertaken to evaluate the effect of Schedule administration of ethionine on the change of lipid peroxidation, total lipid, phospholipid, total cholesterol, and triglycerides of liver and kidney in male rats. The result obtained were summarized as follows ; 1) Hepatic and renal lipid peroxidation were significantly increased 18hr and 24hr after ethionine I.P. injecion. The change of hepatic and renal lipid peroxidation was maximal 18hr after ethionine I.P. injection. 2) Hepatic total lipid and triglycerides were significantly increased 12hr, 18hr, and 24hr after ethionine I.P. injection. The accumulation of total lipid and triglycerides was maximal 18hr after ethionine I.P. injection.