평생교육을 위한 웹 기반 학습에서 상호작용 유형에 따른 효과 분석

정인성 ( In Sung Jung ),임철엘 ( Cheol Il Lim ),최성회 ( Seong Hee Choi ),임정훈 ( Jung Hoon Leem ) 한국교육공학회 2000 교육공학연구 Vol.16 No.1

Question-generation training is a strategy that students practice making questions. Through this practice, students can learm how to study and construct. their own knowledge. The characteristics of question-generation training are that students learn through their dialogue and teachers or other colleague``s scaffolding is necessary and so on. The results of researches have informed that question-generation training improves students`` reading and problem solving ability and verbal interaction. Especially, the effect on problem solving performance is examined in this study. The difference between this research and others is to apply question-generation training in CMC learning environment. Two sessions of which are for collective education and six of are for distance education. During collective education period, experimental group was informed of the meaning of question and was guided in using strategic questions while control group was noL During distance education period, experimental group was encouraged to use strategic questions while control group was not. But two groups shared the same web program and students could see strategic questions by clicking ``question card`` button in the program which was designed for this experiment After education period, two more sessions were progressed for verifying the effect of question-generation training on problem solving performance. Different problems were provided in each session and students had to solve the problems collaboratively by using chatting program. After the experiment, an analysis about the message contents of student``s dialogue was conducted and problem solving process and the results of examinations for measuring problem solving ability were analyzed as well In the analysis of message contents, experimental group``s frequency of questions and resJXlnses was higher than that of control group. Besides, experimental group provided much evidence for problem solving and solved well than control group. However, no significant difference between two groups was in the examination for measuring problem solving ability. This research proves that question-generation training is helpful to improve the frequency of questions and interaction between students and that it helps students to show much evidence for problem solving and to access problems effectively. Further research is needed to apply question-generation training to more field studies and to find effective strategies in CMC learning environment.

한국형 노인우울검사(Korean Form of Geriatric Depression Scale;KGDS) 표준화 연구

정인과(In-Kwa Jung),곽동일(Dong-Il Kwak),조숙행(Sook-Haeng Joe),이현수(Hyeon-Soo Lee) 대한노인정신의학회 1997 노인정신의학 Vol.1 No.1

본 연구는 한국형 노인우울검사(KGDS)에 대한 표준화 연구로, 예비 연구에서 제기되었던 문항 내용 및 길이, 표집의 문제를 개선하여 최종적으로 30문항을 확정한 후 신뢰도와 타당도를 검증하였다. 연구대상은 60세 이상의 노인 450명으로, 우울환자 군은 129명(남자 28명, 여자 119명)이었고 대조군은 321명(남자 276명, 여자 194)이었다. KGDS의 신뢰도를 검증한 결과, Cronbach의 계수는 .88, 반분신뢰도는 .79, GDS와의 상관은 .87로서 만족스러운 수준이었고 두 집단의 평균의 차이를 검증해본 결과 α=.001 수준에서 유의하였다(환자군 평균 17.82(10.52), 대조군 평균 10.52(5.12), t=12.07). KGDS의 구성타당도와 내적 구조를 파악하기 위해 실시한 요인분석에서는 정서적 불편감(Emotional discomfort), 비관적 사고 및 불행감(Negative thinking and Unhappiness feeling), 신체적 약화 및 기력쇠퇴(Physical weakening and decreased vitality), 인지기능 저하(Cognitive dysfunction), 사회적 관심과 활동저하(Decreased social interest and activity) 등 총 5개의 구성요인이 밝혀졌고 총 설명변량은 53.72%였다. 마지막으로 KGDS의 판별력과 최적 절단점수를 확인하기 위해 판별분석 및 민감도, 특이도의 지표를 구하여 본 결과 전체판별률은 75%이었고 최적 절단점수는 14점이 제안되었으며 고전적인 백분위점수분포를 추가적으로 고려하여 14∼18점 사이는 경계선수준 및 경도의 우울증, 19∼21점 사이는 중등도의 우울증, 22점 이상은 심도의 우울증으로 분류할수 있을 것으로 기대되었다. 결론적으로, 기존의 노인 우울검사(GDS)의 낮은 진단 변별력을 개선시키고자 새로이 만든 한국형 노인우울검사(KGDS)는 기존 검사에 비해 진단변별력이 10% 가량 향상되었을 뿐 아니라 신뢰도, 타당도도 만족스러운 수준을 보여 노인우울 진단용 검사로 유용하게 쓰일 수 있을 것으로 여겨진다. This study was aimed to standardize the Korean Geriatric Depression Scale (KGDS). In order to slove the unsatisfied discriminating power of Geriatric Depression Scale (GDS:Yesavage et al. 1983) presented in Korean studies, the authors made KGDs. The preliminary KGDS was costructed of 40 items selected from GDS, BDI, SDS, MMPI-D, CES-S and had satisfied reliability and validity, but had some problems in item contents, number of times, and sampling. Thus by correcting these problems, the authors made new KGDS of 30 item, and tested the reliability and validity of the final version of KGDS. The values of Cronbach's α and Split-half reliability were .88 and .79 respectively, and correlational coefficent with GDS was .87. The differences of means was signified at α=.001 level (patients group mean=17.82 (10.52), control group mean=10.52 (5.12), t=12.07). On factor anlaysis, 5 factors in KGDS were extracted. They were labeled Emotional discomfort (factor 1), Negative thinking and Unhappinesss feeling (factor 2), Physical weakening and decreased vitality (factor 3), Cognitive dysfunction (factor 4), Decreased social interest and activity (factor 5), which represent depressive features of the elderly in thought, emotional, cognitive, physical, social aspects. The total percentage of variance of 5 factors was 53.72%. The result of discriminatin anlaysis showed that hit ratio of KGDS was 75%, and the score of 14 was suggested as the optimal cutoff score. Additionally, by use percentile score distribution of control group (normal) subjects, each of the score of 14-18, 19-21, over 22 suggested borderline or mild depression, moderate depression, severe depression, respectively. Conclusively, the final version of KGDS not only improved diagnostic discriminatory power approxtimately 10% than GDS, but also showed satisfiable reliability and validity. So the KGDS could be a useful tool for evaluaion of elderly depression.

불응성 정신분열증환자의 Clozapine 치료효과

이민수,정인과,곽동일,Lee, Min-Soo,Jung, In-Kwa,Kwak, Dong-Il 대한생물정신의학회 1995 생물정신의학 Vol.2 No.1

Clozapine, on atypical antipsychotic drug, has been estimated to be a major improvement in the treatment-refractory schizophrenic patients. We evaluated the clozapine efficacy in the treatment of schizophrenic patients who are refractory to classic neuroleptics. The patients were assigned in a prospective, open, comparative trial for 12 weeks. Following an dose titration, 33 inpatients with treatment-refractory schizophrenia diagnosed according to DSM-III-R were given a clozapine(N=17, approximate 300-600mg/day) or haloperidol(N=16, approximate 20-30 mg/day) for 12 weeks. The clinical state was assessed before treatment, and 1st, 4th, 8th and 12th week during treatment using Brief Psychiatric Rating Scale(BPRS) and Positive and Negative Syndrome Scale(PANSS). Assessment of side effects were mode weekly using Simpson-Angus Scale for Extrapyramidal Side Effects and Adverse Events-Somatic Symptoms. Clozapine produces significant improvement than haloperidol on the BPRS and PANSS scores. 77% (13/17) of the clozapine-treated patients were categorized as responders, who showed at least 20% decrease in total BPRS scores, compared with 31% (5/16) of haloperidol-treated patients. Extrapyramidal side effects occurred in only one patient in clozapine group, but nine patients in haloperidol group. Salivation, sleepiness, constipation and hypotension were most frequent adverse effects observed in clozapine group. There was no significant changes in total WBC and neutrophil during clozapine treatment. These findings suggest that clozapine is on effective antipsychotic drug for the Korean treatment-refractory schizophrenic patients, who are nonresponsive to or unable to tolerate classcal antipsychotic drugs due to extrapyramidal side effects.

양극성장애 입원환자에서 항정신병약물치료와 관련된 임상요인 - 리스페리돈과 전형적 항정신병약물과의 비교를 중심으로 -

임세원,이민수,곽동일,정인과,Lim, Se-Won,Lee, Min Soo,Kwak, Dong-Il,Jung, In-Kwa 대한생물정신의학회 2000 생물정신의학 Vol.7 No.1

Background : In spite of relative high risk of extrapyramidal side effect and tardive dyskinesia, it is common clinical practice to use antipyschotics in treatment of bipolar I disorder. But in Korea, there has been few study about clinical factors related with antipsychotics treatment in bipolar disorder patients. So the author studied about the clinical factors related with antipsychotics treatment in bipolar inpatients focusing on the comparison of risperidone and classical antipsychotics. Method : By reviewing medical record retrospectively, datas about patient-related, illness-related, and treatment-related clinical factors on antipsychotics use were collected. Association between antipsychotics dose and duration and clinical factors were analysed by statistical method. Results : Aggressive behavior was only statistically significant factor associated with antipsychotics use. And in the case of aggression, maintenance dose of risperidone was not changed(p=0.84), but dose of classical antipsychotics was increased significantly(p=0.005). Total hospital days and antipsychotics treatment duration showed no difference between risperidone and classical antipsychotics treatment groups. Conclusion : Clinical factors associated with antipsychotics use was aggressive behavior. In the case of aggression, risperidone required lesser dose increment compared with classical antipsychotics.

GATA-3 is a Key Factor for Th1/Th2 Balance Regulation by Myristicin in a Murine Model of Asthma

이규,이창민,정인덕,정영일,천성학,박희주,최일환,안순철,신용규,이상율,염석란,김종석,박영민,Lee, Kyu,Lee, Chang-Min,Jung, In-Duk,Jeong, Young-Il,Chun, Sung-Hak,Park, Hee-Ju,Choi, Il-Whan,Ahn, Soon-Cheol,Shin, Yong-Kyoo,Lee, Sang-Yull,Yeom, S Korean Society of Life Science 2007 생명과학회지 Vol.17 No.8

Myristicin, l-allyl-3,4-methylenedioxy-5-methoxybenzene, was one of the major essential oils of nutmeg. However, its anti-allergic effect in the Th1/Th2 immune response was poorly understood. Recently, it was shown that T-bet and GATA-3 was master Th1 and Th2 regulatory transcription factors. In this study, we have attempted to determine whether myristicin regulates Th1/Th2 cytokine production, T-bet and GATA-3 gene expression in ovalbumin (OVA)-induced asthma model mice. Myristicin reduced levels of IL-4, Th2 cytokine production in OVA-sensitized and challenged mice. In the other side, it increased $IFN-{\gamma}$, Th1 cytokine production in myristicin administrated mice. We also examined to ascertain whether myristicin could influence eosinophil peroxidase (EPO) activity. After being sensitized and challenged with ovalbumin (OVA) showed typical asthmatic reactions. These reactions included an increase in the number of eosinophils in bronchoalveolar lavage fluid, an increase in inflammatory cell infiltration into the lung tissue around blood vessels and airways, and the development of airway hyper-responsiveness (AHR). The administration of myristicin before the last airway OVA challenge resulted in a significant inhibition of all asthmatic reactions. Accordingly, these findings provide new insight into the immunopharmacological role of myristicin in terms of its effects in a murine model of asthma.

상지 동맥의 급성 혈전색전증

이진욱(Jin Wook Yi),정인목(In Mok Jung),이태승(Taeseung Lee),민승기(Seung-Kee Min),민상일(Sang Il Min),박양진(Yang Jin Park),하종원(Jongwon Ha),정중기(Jung Kee Chung),김상준(Sang Joon Kim) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.6

Purpose: Acute ischemia of the arm is uncommon compared with events in the leg and much less attention has been paid to the management of acute arterial thromboembolism of the upper extremities. The aim of this study was to evaluate the clinical aspects and treatment outcomes of acute upper extremity thromboembolism. Methods: From January 2007 to March 2010, seven patients underwent the management of upper extremity thromboembolism in three Seoul National University (SNU)-affiliated hospitals. We retrospectively reviewed the medical records. Results: The mean age was 64.6 years (range 48∼93 years) and 4 patients (57.1%) were female. Distribution of the thromboembolism were 4 in brachial, 1 in axillary plus brachial, 1 in ulnar and radial, and 1 in axillary artery, respectively. Time from symptom onset to presentation was 3.5 days (range 1∼10 days). Primary treatment modality were Fogarty catheter embolectomy in 3 cases, bypass surgery in 1 case, and urokinase thrombolysis in 2 cases. A patient without symptoms was treated conservatively. Patients receiving primary thrombolytic therapy underwent surgical approach due to recurred thromboembolism during admission. In our 11.2 months of mean follow-up, there was recurrence but 1 patient died from cerebral infarction after 1.5 year of discharge. Conclusion: In this study, functional outcome of acute upper extremity ischemia following appropriate treatments was excellent. Key features of treatment are shortening the time interval of diagnosis to primary treatment, proper anticoagulation, and treatment of underlying conditions. Larger-volume, long-term results and meta-analysis of upper extremity thromboembolism are required to establish standardized treatment in Korea.

한국인 바렛식도에서 p53과 Ki-67 단백의 면역조직화학 발현

김창환 ( Chang Whan Kim ),이보인 ( Bo In Lee ),김병욱 ( Beung Wook Kim ),김진일 ( Jin Il Kim ),박수헌 ( Soo Heon Park ),김재광 ( Jae Kwang Kim ),한석원 ( Sok Won Han ),정인식 ( In Sik Jung ),선희식 ( Hee Sik Sun ),이아원 ( A Won L 대한소화기학회 2005 대한소화기학회지 Vol.46 No.3

Background/Aims: Barrett`s esophagus is a premalignant lesion of the esophagus in which normal squamous epithelium is replaced by intestinalized columnar epithelium. In Korea, adenocarcinoma associated with Barrett`s esophagus is rare compared with that of Western country. The purpose of this study was to investigate the immunohistochemical expression of p53 and Ki-67 in Barrett`s esophagus which had predictive value for cancer risk in Korea. Methods: Ninety five patients (43 male and 52 female, median age 44, range 21-75) who have been suspected to have Barrett`s esophagus by endoscopic assessment were enrolled in this study. Alcian blue (pH 2.5) and high ion diamine stain for the evaluation of specialized intestinal metaplasia (SIM) and immunohistochemical stain for p53 and Ki-67 were done. Results: 57.9% (55/95) of biopsies from the columnar lined esophagus showed SIM, but no dyspalsia. 56.4% (31/55) of Barrett`s esophagus showed sulfomucin positive colonic metaplasia. The p53 expression was observed in 10.9% (6/55) of the patients of Barrett`s esophagus and all of them showed colonic metaplasia. Ki-67 labeling index showed no difference significantly. Conclusions: In Korea, 10.9% of Barrett`s esophagus had p53 mutation and moreover all of them had colonic metaplasia. Consequently, we expect that these patients have high risk of developing dysplasia and adenocarcinoma and need careful follow-up. (Korean J Gastroenterol 2005;46:189-195)

배우자와 사별(死別)한 노인의 우울증상

김진세(Jin Se Kim),이현수(Hyun Soo Lee),정인과(In Kwa Jung),곽동일(Dong Il Kwak) 대한노인정신의학회 1998 노인정신의학 Vol.2 No.1

사별은 노인에 있어 우울증 발현의 중요한 요소로 연구되고 있다. 그러나 우리나라의 경우는 서구와 다르게 사별로 인한 배우자의 상실이 보다 지속적으로 유지되는 실정이고 우리나라 노인의 우울증상은 사회문화적 차이로 인해 서구의 노인과는 다르므로, 우리나라 노인을 대상으로 표준화된 노인 우울 척도인 KGDS를 이용하여 사별이 노인 우울증상에 미치는 영향을 조사하였다. 60세 이상의 노인 175명을 대상으로 KGDS를 시행하여, 사별군과 비사별군을 비교하고, 사별군의 성별, 연령, 동거자녀 유우에 따른 비교 및 사별시의 나이, 사별기간과 KGDS와의 상관관계를 분석하였다. 연구 결과, 사별군이 비사별군 보다 KGDS 점수가 유의하게 높았으며, 특히'요소 1','요소 2','요소 4'는 통계적으로 유의하였다. 사별군에서 여성의 KGDS 점수가 유의하게 높았으며, 특히'요소 2','요소 3','요소 5'는 통계적으로 유의하였다. 사별군에서 통계적 유의성은 없었으나, 동거자녀가 있는 군의 KGDS 점수가 동거자녀가 없는 군보다 높았다. 사별시 대상의 연령.사별기간과 KGDS와의 상관관계에서, 젊은 나이에 사별을 하고 사별기간이 길수록 KGDS 점수가 높았으며,'요소3'은 통계적으로 유의하였다. 본 연구에서 배우자와 사별한 노인은 배우자가 있는 노인보다 우울증상이 많았으며, 주된 우울증상은 감정적 불편감, 부정적 사고 및 불행감, 그리고 인지기능이상이었다. 저자들은 우리나라의 노인에서도 서구와 마찬가지로 사별은 우울증의 중요한 유발인자이고, 사별군에서는 여성, 사별한 나이가 젊고 사별기간이 길수록 우울증의 고위험이 있으며, 우리나라의 경우 사별 기간이 긺으로서 사별이 지속적인 우울요인으로 작용할 수 있다는 것을 제시하였다. There are many studies of the spousal bereavement as an important etiologic factor of depression in elders. But there are some differernt natures of spousal bereavement between the Korean and the western elderly. The problems of spousal bereavement in Korean would be more persistent than that in western. And the depressive symptoms of Korean elders are different with that of western elders due to the differences of sociocultural background. The authors studied the effect of the spousal bereavement to the depressive symptoms of elders by using KGDS (Korean Form of Geriatric Depression Scale), which already has been standardized in Korea. The subjects were consist of one hundred seventy-five, 60 years and older. The authors compared KGDS and its 5 factors in the spousal bereaved subjects group (SBG) with those in the spousal non-bereaved subjects group (SNG), and also investigated the differences according to sex and children living with the subject in the SBG. And the authors analysed the correlations between ages at spousal death, durations after spousal death and KGDS in the SBG. The mean KGDS scores in the SBG were significantly higher than that of the SNG, and especially Factor 1, Factor 2 and Factor 4 were significant. In the SBG, the mean KGDS scores of the female were significantly higher than that of the male, and especially Factor 2, Factor 3, and Factor 5 were significant. And in the SBG, the mean KGDS scores of the subjects living with children were slightly higher than those of the subjects living without children. And also in the SBG, there were negative correlations between KGDS scores and ages at spousal death, and positive correlations between KGDS scores and durations after spousal death. The authors found that the spousal bearevement could be an important etiologic factor of geriatric depression, and the risk factors of depression were female, younger at spousal death and longer duration after spousal death in bereaved elders, as the earlier studies in the western. However, the authors found that, in Korea, there were some different results from the western, such as the longer duration after spousal death and higher ratio of the widower to the widow than that in the western, the spousal bereaved elders living with children were rather depressive than who living without children.

Naringin Protects Ovalbumin-induced Asthma through the Down-regulation of MMP-9 Activity and GATA-3 Gene

Chang-Min Lee(이창민),Jeong Hyun Chang(장정현),In Duk Jung(정인덕),Young-Il Jeong(정영일),Noh Kyung Tae(노경태),Hee-ju Park(박희주),Jong-Suk Kim(김종석),Yong Kyoo Shin(신용규),Sung Nam Park(박성남),Yeong-Min Park(박영민) 한국생명과학회 2009 생명과학회지 Vol.19 No.6

Naringin은 레몬, 오렌지에서 발견되는 flavonoid계열에 속하는 물질로 여러 식물과 과일에 다량 함유되어 있다. 항암, 항산화 작용을 하는 것으로 알려져 있는 Naringin을 ovalbumin (OVA)으로 유도한 천식(asthma) 생쥐모델을 이용하여 치료효과를 알아 보았다. 기관지 폐포 세척액을 회수하여 백혈구의 수적 변화, 제2형 협조T세포(Th2 cell)가 생산하는 IL-4, IL-5의 생산에 미치는 영향과 폐조직에서 matrix metalloproteinase (MMP)-9 활성을 측정하였다. 또한, 최근에 Th1/Th2 전사인자로서 GATA-3가 밝혀졌는데 이번 실험에서 Naringin이 ovalbumin (OVA)으로 유도한 천식(asthma) 생쥐모델에서 Th1, Th2 싸이토카인과 유전자 발현을 조절할 수 있는가에 대하여 알아보았다 그 결과 기관지 폐포 세척액에서 OVA로 감작하여 천식을 유도한 실험군에서는 호산구의 현저한 증가, Th2 형 싸이토카인(IL-4, IL-5)의 증가가 관찰되었다. 그러나 Naringin을 투여한 그룹에서는 OVA의 감작에 의하여 증가한 각종 염증성 지표들이 감소하거나 정상화 되었다. 또한 OVA에 의하여 증가된 기도저항성이 Naringin 투여에 의하여 감소하였으며 폐조직의 염증성 소견도 뚜렷하게 감소되었다. 이와 같은 연구 결과는 Naringin이 천식의 치료에 유용하게 쓰일 수 있음을 시사해준다. The common word flavonoids is often used to classify a family of natural compounds, highly abundant in all higher plants, that have received significant therapeutic interest in recent years. Naringin is associated with a reduced risk of heart disease, neurodegenerative disease, cancer and other chronic diseases; however the molecular basis of this effect remains to be elucidated. Thus we attempted to elucidate the anti-allergic effect of Naringin in ovalbumin (OVA)-induced asthma model mice. The OVA-induced mice showed allergic reactions in the airways. These included an increase in the number of eosinophils in bronchoalveolar lavage (BAL) fluid, an increase in inflammatory cell infiltration into the lung around blood vessels and airways, airway luminal narrowing, and the development of airway hyper-responsiveness (AHR). The administration of Naringin before the last airway OVA challenge resulted in a significant inhibition of all asthmatic reactions. Accordingly, this study may provide evidence that Naringin plays a critical role in the amelioration of the pathogenetic process of asthma in mice. These findings provide new insight into the immunopharmacological role of Naringin in terms of its effects on asthma in mice.

Helicobacter pylori 감염과 위액내 비타민 C 농도와의 관계

방춘상(Choon Sang Bang),장은덕(Eun Deok Chang),정인식(In Sik Jung),김진일(Jin Il Kim) 대한소화기학회 1997 대한소화기학회지 Vol.30 No.1

Background/Aims: Helicobacter pylori has been recognized as a important risk factor for gastric cancer, but its precise role in gastric carcinogenesis is not known. Accumulated evidence suggest that high dietary vitamin C reduces gastric cancer risk. The aim of this study was to assess the relationship between H. pylori infection and vitamin C concentraion in gastric juice. Another objective is to determine whether eradication of H. pylori affect the concentraion of vitamin C in gastric juice. Methods: Vitamin C concentration in gastric juice and plasma were measured by high performance liquid chromatography in 50 subjects without ulcer or cancer. In 20 H. pylori positive patients, eradication was attempted with amoxicillin 1000 rng, omeprazole 20 mg and clarithromycin 500 mg two times a day for 10 days. Results: There were 38 H. pylori positive and 12 negative patients. Total vitamin C and ascorbic acid concentraion of gastric juice in H. pylori positive patients were significantly lower than that in H. pylori negative patients(1.23mg/dL vs 2.22 mg/dL, 0.49mg/dL vs 0.86mg/dL). Eradication was achieved in 16(80%) of 20 H. pylori positive patients. In these 16 patients, gastric juice total vitamin C and ascorbic acid concentraion and the ratio of vitamin C in gastric juice to plasma rose and the dehydroascorbic acid proportion of total vitamin C in gastric juice reduced after treatment. But, in 4 patients in whom H. pylori infection persisted, no significant changes were observed in vitamin C concentraion of the gastric juice or plasma. Total vitamin C and ascorbic acid concentraion in gastric juice was influenced by gastric pH with significantly low values in patients with high gastric juice pH(pH >4). Conclusions: This study confirmed that H. pylori infection reduce vitamin C concentraion in gastric juice and successful eradication of H. pylori improves it. (Korean J Gastroenterol 1997; 30:18 - 29)