소아 뇌수막염에서 뇌척수액 Ferritin의 변도

염미희 全南大學校 2000 국내석사

Witold Lutosławski 『Symphony No.2』작품서법의 미적 접근 연구

염미희 대구가톨릭대학교 대학원 2013 국내석사

As human life undergoes change, so too does art develop according to the flow of history. Music in the twentieth century has been more about trying to bring about a contribution to the development of new styles of music by innovating, finding new forms of musical application, and incorporating diversity rather than simple musical purity. What, then, is musical beauty? How can we evaluate the artistic value of musical works? These are questions people have asked throughout the ages. Up until the present day, if we may posit that beauty experienced through music has been beautiful, has had a sweet tune, struck an emotional cord in human listeners, and otherwise been able to move human emotions, then twentieth-century composers have not been bound up by the traditional meaning of emotions and have pursued it from a variety of different aesthetic angles. This thesis will approach and examine the aesthetics of applying changes through new musical forms and musical styles, within certain aesthetic boundaries, instead of the fundamental concepts of aesthetics. Within those boundaries of traditional meaning, a new dimension in musical time, know as "contingent music," can enable us to see the beauty in a time-limited and 'momentary' piece of art. In contrast to John Cage, the structure, style, tonal system, rhythm and emotional and psychological aspects of Symphony No. 2 by Witold Lutoslawski, who invented 'Limited Tychism,' can be examined from an aesthetic angle. This composition can be performed in under thirty minutes and is composed of two movements. Lead by the short Introductory Movement, it is followed by the extremely spread out Main Movement. Although the two musical acts are quite clearly separated, the end of the first movement is connected via an attacca that may be seen as one expression of musical beauty. Using cords and tunes, it is composed of two steps, complete four steps, and even complete five step tunes. A twelve-note harmony constituted this way includes one, two, or even three notes in separate and distinct units that are bound and divided into parts. If the general change in speed and tempo is examined, the rapid and diverse tempo changes in the first act create a sense of expectation for a new tempo, while the second act hints at a sense of adherence for a new speed. As far as rhythm is concerned, the first act contains a slow and irregular rhythm which changes into a fast and regular rhythm in the second act that highlights the contrast between the two. The two acts have different musical structure as well. The first act is a monody while the second act is polyphonic. In addition, the two acts differ in tone. While the first act induces a homogenous tone via a strongly affinitive vertical arrangement of musical instruments, the second act emphasizes a strong contract in musical tone by arranging the instruments both vertically and horizontally. As this symphony was composed using revolutionary techniques and structure, it is very different from traditional symphonies. In spite of its hugh scale and extreme spread, it does not feel carelessly put together. It creates an expectation for a different result compared to a traditional symphony by using the techniques of 'ad libitum' and 'limited contingency.' The incorporation of rhythm derived from 'Limited Tychism' ensures that it is played differently every time it is performed. This enables listeners to hear the beauty related to time-limited art within the multiple scopes of twentieth-century aesthetics. This type of composition by Lutoslawski is not at first familiar to the listener, and the psychological, philosophical, and aesthetic factors cannot be heard or seen superficially, but can inform us of the existence of another artistic and aesthetic dimension that we cannot be told to listen for. As an inquiry into a work of composition from the viewpoint of the aesthetics of structure and harmony, this thesis creates a deep appreciation of Lutoslawski that will raise his status within the world of music and also advance the new creation of composition techniques and help in the research of the aesthetics of music.

소아 뇌수막염에서 뇌척수액 Ferritin의 변동

염미희 전남대학교 대학원 2000 국내석사

목적: 세균성 수막염에 의한 사망률과 이환율의 발생빈도는 강력한 항생제의 개발에도 불구하고 감소하지 않는 실정이며 조기에 적절한 항생제의 사용이 예후를 결정하는 가장 중요한 인자이다. 이에 저자는 임상경과와 더불어 뇌척수액 ferritin치 변동을 관찰함으로써 뇌수막염의 진단과 치료에 도움이 되는 지표를 제시하고자 본 연구를 시행하였다. 대상 및 방법: 1996년 5월에서 1999년 7월까지 전남대학교병원 소아과를 방문한 환아중 급성 뇌수막염을 의심하여 뇌척수액 검사를 시행하고 ferritin을 측정하였던 3 일에서 15세까지의 84명의 환아를 대상으로 하였다. 대상환아는 각각 대조군(20), 무균성 수막염군(40), 세균성 수막염군(24)의 세 군으로 나누어 뇌척수액의 세포수, 단백질, 당, ferritin치를 비교분석하였고 세균성 수막염 환아는 임상경과에 따른 ferritin치의 변동을 검토하였다. 결과: 대조군의 ferritin치의 평균값(±SD)은 3.01(±2.52)ng/mL 이었고 무균성 수막 염군은 5.26(±2.07)ng/mL, 세균성 수막염군은 52.94(±3.19)ng/mL 로 무균성 수막염군과 대조군간에 유의한 차이는 없었고 세균성 수막염군은 대조군과 무균성 수막염군 모두에 유의한 통계학적 차이를 보였다(p<0.05). 세균성 수막염 환아는 24명으로 19명에서 균이 증명되었고 19명에서 합병증이 관찰되었으며 합병증 유무에 따른 뇌척수액 ferritin치의 차이는 없었다. 무균성 수막염군에서의 뇌척수액 ferritin치는 0.8-23ng/mL이었고 세균성 수막염군에서는 19례에서 24ng/mL 이상이었다. 2회이상 뇌척수액 ferritin을 측정하였던 세균성 수막염 20례중 17례에서 2주이상 24ng/mL 이상이 관찰되었다. 세균성 수막염과 무균성 수막염을 구별하는 지표로서의 뇌척수액 ferritin의 cut off value는 ROC curve상 9.20ng/ml (sensitivity: 92%, Specificity: 81%)가 적절한 값으로 사료되었다. 뇌척수액의 ferritin은 단백질(r=0.734), 세포수 (r=0.699)와 양의 상관관계를 보였으며 뇌척수액 당성분(r=-0.609)과는 음의 상관관계를 보였다(p<0.01). 결론: 뇌척수액 ferritin은 세균성 수막염의 진단에 유용한 지표로 사료되었다. Purpose: Despite advent of new and more potent antibiotics, mortality and morbidity rates by the bacterial meningitis remain stagnant. Rapid detection of microorganism and early antibiotics treatment are the most important prognostic factors of bacterial meningitis. For early diagnosis of bacterial meningitis biochemical markers such as LDH, lactic acid, CRP have been measured in cerebrospinal fluid. Ferritin is a large spherical molecule with propensity of oligomer formation which causes low concentration in CSF. Patients and methods: From May 1996 to July 1999 CSF ferritin was serially measured in 84 children who were admitted to Chonnam Natuional University Hospital pediatric department to evaluate the diagnostic value of CSF ferritin in bacterial meningitis. They were divided into three groups- control(20), aseptic(40), bacterial(24)- according to the inclusion criteria for each group. Result: CSF ferritin level in bacterial meningitis(52.94±3.19ng/mL) was much higher than those of aseptic (5.26±2.07ng/mL), and control(3.01±2.52ng/mL) groups(p<0.05). CSF ferritin level of 9.20ng/mL was suggested as a cut off value for bacterial meningitis on ROC curve(sensitivity: 92%, specificity: 81%). CSF ferritin levels were positively correlated with CSF WBC(r=0.699) and protein(r=0.734), and negatively correlated with CSF glucose(r=-0.609) (p<0.01). Conclusion: CSF ferritin could be a good indicator for bacterial meningitis in children.

소근육 운동이 쓰기장애 아동의 자형 교정에 미치는 효과

염미희 대구대학교 특수교육대학원 2004 국내석사

Kainate로 유발한 측두엽 간질 모델에서 Midkine의 간질 억제 효과

염미희 전남대학교 대학원 2003 국내박사

Midkine (MK)은 배아기 신경세포의 분화와 발달에 중요한 역할을 하고 다양한 신경영양 활성을 가지는 성장인자로서 retinoic acid 반응 유전자의 산물이다. 생체 내에서 신경세포의 손상을 억제하는 MK의 효과를 알아보기 위해 저자는 흰쥐의 뇌실내로 kainate (KA)를 주입해서 유발되는 측두엽 간질모델에서 해마 신경원세포 손상 및 간질성 발작에 대한 MK의 효과를 측정하였다. KA 주사 후 10주째에 생존한 흰쥐에 간질성 발작은 8시간씩 3일간 발작 양상을 관찰하였고, 신경독성은 Nissl 염색에 의한 해마 신경원세포 및 ghutamic acid decarboxylase-67 (GAD-67)에 양성인 신경원세포를 측정하여 알아보았다. 간질성 발작은 KA군 (70.5%)에 비해 KA/MK군(18.7%)에서 감소하였으며, 경련의 횟수와 기간도 KA군 (8=3.5회, 7=5.3초)에 비해 KA/MK군(3=1.3회, 2=1.5초)이 더 낮았다. Nissl 염색 하에 생존하는 해마 신경원세포의 수를 관찰한 결과 KA군은 대조군에 비해 신경 원세포가 감소하였고, KA/MK군은 KA군에 비해 신경원세포가 덜 감소하였으며, 이러한 변화는 CA3와 Hilus에서 통계적으로 유의하게 잘 관찰되었다. GAD-67에 대한 면역조직화학 염색에 의해 GABA성 신경원세포의 변화를 확인한 결과 KA군은 대조군에 비해 GAD-67 양성 신경원세포가 감소하였고, KA/MK군은 KA군에 비해 GAD-67 양성 신경원세포가 덜 감소하였으며, 이러한 변화는 CA1, CA3, Hilus 등에서 통계적으로 유의하였다. 이러한 결과로 보아 MK은 KA에 의해 유도된 해마 신경원세포 손상에 대해 신경보호 효과를 가지며 이를 통하여 측두엽 간질에 대해 항경련효과를 가지는 것으로 사료되었다. Midkine (MK), the product of a retinoic acid responsive gene, is a growth factor with neurotrophic activities. To invetigate in vivo neurotrophic activity of MK, the effect of MK was evaluated in a TLE model induced by intraventricular injection of kainate in rats. The antiepileptogenic effect of MK was evaluated by monitoring behavioral signs. In surviving rats at 10 weeks after injection, the neurotoxic effect was estimated by measuring the number of surviving hippocampal neurons and glutamic acid decarboxylase-67 (GAD67) posivive neurons. Epileptic seizures were decreased in KA/MK group compared with those in KA group. The number of surviving and GAD67+ hippocampal neurons of KA group was significantly decreased more than those of control group, and the number of surviving and GAD67+ hippocampal neurons of KA/MK group was significantly increased higher than those of KA group, especially in the CA3 and hilus. These findings suggest that MK has the neuroprotective effect on delayed hippocampal neuronal death, and the antiepileptogenic effect on temporal lobe epilepsy induced by kainate.