TP-16 : 폐쇄성 폐질환에서 수술 전후 스테로이드 사용이 수술 후 폐합병증 발생에 미치는 영향

허은영,임효정,박성수,김덕겸,정희순 대한결핵 및 호흡기학회 2013 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.116 No.-

목적: 만성 폐쇄성 폐질환은 수술 후 폐합병증의 독립적인 위험인자로 알려져 있다. 그러나 이런 환자들에서 전신 스테로이드 사용이 수술 후 폐합병증을 줄이는지에 대해서는 연구가 부족한 실정이다. 따라서 본 연구는 폐기능 검사상 폐쇄성 장애를 보이는 환자들에서 수술 전후 전신 스테로이드 투여가 수술 후 폐합병증 발생에 영향을 미치는지 알아보고자 한다. 방법: 2011년 보라매 병원 일반 외과에서 수술을 시행한 환자 중 호흡기 내과에 자문 의뢰가 된 환자들을 대상으로 하였다. 이들 중 수술전 폐기능 검사에서 FEV1/FVC <70%인 환자들의 의무기록을 후향적으로 분석하였다. 수술 후 폐합병증은 기관지연축, 천명음, 기관지염, 폐렴, 무기폐 및 호흡 부전으로 정의하였다. 성적: 105명의 일반 외과 환자들이 수술 전 호흡기 내과 자문 의뢰가 되었고, 이들 중 폐기능 검사상 FEV1/FVC<70%를 만족하는 환자는 총 41명이었다. 남성이 38명으로 대부분을 차지하였으며, 흡연자는 28명(68.3%), 연령의 중앙값은 70세였다. 41명 중 33명(80.5%)이 전신 마취로 수술을 하였으며 12명(29.3%)의 환자에서 수술 전후 전신 스테로이드가 투여되었다. 전신 스테로이드가 투여된 12명 중 4명(33.3%)에 서 수술 후 폐합병증이 발생하였으며, 스테로이드가 투여되지 않은 29명 중 7명(24.1%)에서 수술 후 폐합병증이 발생하였다(P=0.55). 전신 스테로이드가 투여되지 않은 28명의 평균 FEV1(%)는 74.32였고, 스테로이드가 투여된 12명의 평균 FEV1(%)는 50.58로 유의한 차이가 있었는데(P<0.05), 이를 보정해 보아도 전신 스테로이드의 투여가 수술 후 폐합병증에 미치는 유의한 효과는 관찰되지 않았다. 결론: 수술 전후 전신 스테로이드의 투여는 폐쇄성 폐기능 장애를 가진 환자들에서 수술 후 폐합병증을 줄이는데 유의한 효과를 보이지는 않았다.

가정 내 경제 및 문화자본과 유아의 전자미디어 사용

허은영,나종혜 한국아동학회 2019 한국아동학회 학술발표논문집 Vol.2019 No.11

P-90 Blocking beta adrenergic signaling may be a target for overcoming EGFR TKI resistance - preliminary data

허은영,이명진,이정실,박주희,이정규,김덕겸,정희순 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.-

Objectives: Elevated expression of IL-6 has been detected in various cancers and high Il-6 levels are correlated with a poor clinical prognosis. EGFR mutations in lung adenocarcinoma cells cause an increase in IL-6 expression and secretion. Therefore, we studied beta-adrenergic blocking agent may be a target for overcoming EGFR TKI resistance by controlling IL-6 expression in EGFR mutated lung adenocarcinoma cells. Methods and results: We used PC9 (EGFR exon 19 deletion), H1975 (L858R with T790M double mutation), H1650 (EGFR exon 19 deletion with primary resistance to TKIs), A549 (EGFR WT), BEAS-2B cell lines. When we added norepinephrine 10uM to H1975, PC9, A549, BEAS 2B cells, IL-6 expression was increased in EGFR mutant cell lines (H1975, PC9), but in A549 cell, IL-6 expression was decreased. After norepinephrine, we treated cells with propranolol 10uM, IL-6 expression was totally suppressed in EGFR mutant cell lines. We compared mTOR, p-mTOR, AKT, p-AKT expressions after norepinephrine with propranolol or norepinephrine with gefinitib. Only gefitinib treated PC-9 cell showed decreased p-mTOR, p-AKT expression. However, in H1975 cell line, p-ERK, p-STAT3 expression was decreased under norepinephrine with propranolol but not under norepinephrine with gefitinib. Conclusion: Targeting beta-adrenergic signaling pathway may be a new approach for overcoming EGFR TKI resistance

Effect of Prophylactic Use of Silymarin on Anti-tuberculosis Drugs Induced Hepatotoxicity

허은영,김덕겸,오소희,이경규,박주희,정희순 대한결핵및호흡기학회 2017 Tuberculosis and Respiratory Diseases Vol.80 No.3

Background: The first line of anti-tuberculosis (TB) drugs are the most effective standard of drugs for TB. However, the use of these drugs is associated with hepatotoxicity. Silymarin has protective effects against hepatotoxicity of anti-TB drugs in animal models. This study aims to investigate the protective effect of silymarin on hepatotoxicity caused by antiTB drugs. Methods: This is a prospective, randomized, double-blind and placebo-controlled study. Patients were eligible if they were 20 years of age or order and started the first-line anti-tuberculosis drugs. Eligible patients were randomized for receiving silymarin or a placebo for the first 4 weeks. The primary outcome was the proportion of patients who showed elevated serum liver enzymes more than 3 times the upper normal limit (UNL) or total bilirubin (TBil) > 2× UNL within the first 8 weeks of anti-TB treatment. Results: We enrolled a total of 121 patients who silymarin or a placebo to start their anti-TB treatment, for the first 8 weeks. The proportions of elevated serum liver enzymes more than 3 times of UNL at week 2, week 4, and week 8 did not show any significant difference between the silymarin and placebo groups, at 0% versus 3.6% (p>0.999); 4.4% versus 3.6% (p>0.999); and 8.7% versus 10.8% (p=0.630), respectively. However, patients with TBil >2× ULN at week 8 were significantly low in the silymarin group (0% versus 8.7%, p=0.043). Conclusion: Our findings did not show silymarin had any significant preventive effect on the hepatotoxicity of anti-TB drugs.

초등학교 실과 ‘가정생활’영역 교육 내용에 터한 다문화 실과교육 프로그램 개발

허은영,최지연 한국실과교육학회 2011 한국실과교육학회지 Vol.24 No.2

The purpose of the study is to develop practical arts education program of the multi-cultural education based on the contents of the 'home life' of the practical arts education course for elementary school. To achieve the purpose of this study, the concept of Multi-cultural Education, its characteristics, direction of its education has been reviewed through various texts in building a foundation for the basic contents of multi-cultural education program in the practical arts education. And based on the theoretical study, an educational program is developed in three phases such as preparation phase, development phase, improvement phase in accordance with selected development model consisted of setting up aim of education, selection of contents of education, organization of education contents, presentation of education objective, organization of education program. for which a proof is obtained from specialists in this field and finally the program is completed through secondary inspections from specialists regarding overall program development procedure against revised and secured program. The result obtained from the study are as follows;First, The concept model to develop multi cultural education program is assumed first dimension(X axle) to be approached the contents factor of multi cultural education, second dimension(Y axle) is approached to 'home life', and 'technological world' with the area of practical education, third dimension(Z axle) is set knowledge, function, value, attitude the objective of multi cultural education. Second, The multi cultural education program that has been developed through selection of subject, development of lecturing, instruction of study, program development is complemented and revised through research & development by field teacher, counselling from professionals. Through which as being a mpprrial for teachers in charge of multi cultural piratical arts education for the elementary school teacher or reference mpprrial for teachers the concept of study contents offered the study contents of 17 classes based on 5 fields with which it is offered the overview of program, detail of activities, projected p ax, appraisal p ax, draft of education program, and based on which there showed a ntsitive effect in enhancing multi culture through education p ax, study paper, and evaluation tool and other reference materials. In conclusion of the study, the multi cultural practical science education program added to the elementary school practical education field showed to have enhanced the knowledge as well as understanding of multi culture. 이 연구의 목적은 실생활, 노작활동, 통합이라는 실과 고유의 특성이 결합된 직접적 실천을 통한 다문화 교육을 실현하기 위해 초등학교 실과 ‘가정생활’ 영역의 교육 내용에 터한 다문화 실과교육 프로그램을 개발하기 위한 것이다. 이 연구의 목적을 달성하기 위하여 다문화교육의 개념, 성격, 교육방향에 대한 문헌을 탐색하여 다문화 교육 프로그램의 내용의 기초를 마련하고 이론적 고찰을 토대로 선정된 개발 모형에 따라 준비 단계, 개발 단계, 개선단계의 세 단계로 나누어 교육프로그램을 개발하여, 전문가를 대상으로 타당도를 검증받았고 수정․보안된 프로그램에 대한 검토와 전체적인 프로그램 개발 절차에 대한 2차 전문가 검토를 거쳐 프로그램이 개발되었다. 개발된 초등학교 실과 ‘가정생활’영역에 교육 내용에 터한 다문화 실과교육 프로그램은 다음과 같은 특징을 가지고 있다. 첫째, 실과 다문화교육 프로그램 개발을 위한 개념 모형은 1차원(X축)은 다문화교육 내용요소로 접근, 2차원(Y축)은 실과교육내용 영역인 가정생활, 기술의 세계로 접근, 3차원(Z축)은 다문화교육 목표로 지식, 기능, 가치․태도로 설정하였다. 또한 교육과정 개발모형 및 다문화 교육 중심 교육의 개발 모형을 탐색하여 실과의 다문화교육 프로그램 개발 모형을 준비단계, 개발단계, 개선단계로 구성하였다. 둘째, 실과 다문화교육 프로그램은 주제 선정, 교수․학습 지도안 개발, 프로그램을 개발하여 현장 교사에 대한 조사 연구와 전문가의 자문을 받아 수정하고 보완하였다. 이를 통해 초등학교 실과 ‘가정생활’영역을 교육할 교사들을 위한 다문화 실과교육을 운영하는 지도 교사를 위한 자료로 교사용 참고 자료로 5개 영역을 바탕으로 17차시의 학습내용의 개요를 제시하여 프로그램의 개관, 활동 내용, 전개 계획, 평가 계획, 차시별 수업과정안(개요)등을 제시하였다. 이러한 연구 결과를 통해 초등학교 실과 ‘가정생활’영역 교육 내용에 터한 다문화 실과교육 프로그램은 프로그램을 통해 다문화에 대한 인식을 제고하고 다문화에 대한 초등학생들의 소양을 함양하는데 적합할 것으로 평가되었다.

2007년 상반기를 되돌아보며

허은영 노동사회과학연구소 2007 정세와노동 Vol.- No.26

지방재정 질의회신 사례

허은영 한국지방재정공제회 2020 지방재정 Vol.2020 No.4

지방재정 질의회신 사례

허은영 한국지방재정공제회 2020 지방재정 Vol.2020 No.5

Veno-arterial extracorporeal membrane oxygenation may be useful in critically ill COVID-19 patients with suspected cardiac injury

허은영,오세진,이현우,이정규,김덕겸,박상원 대한중환자의학회 2020 Acute and Critical Care Vol.35 No.3

초등학생의 빛과 그림자에 대한 개념 이해 수준 조사

허은영,사현주,유병길 부산교육대학교 과학교육연구소 2005 科學敎育硏究 Vol.30 No.-

The purpose of this research is to inspect students' understing level and to get basic information to build proper teaching and learning strategies to meet students' different perception levels on their grades about light and shadow, which is very closely related to out usual lives. For this research, 125 students offour classes from 3rd grade to 6grade(one class per each grade) were randomly chosen. The questionaire was consist of 10 questions and each question have picture explaining the situation. Students could choose the numbers of right answers for questions. It was composed of the questions to get information for students' perception about a light source(a straight drive of light), the sizes of shadow in accordance with parallel light or divergent light, the sizes of shadow according to the solar height, the sizes of shadow in accordance to the locations of two kinds of light source-those of parallel and divergent light. The result is as followings. First, 6th grade students had the highest understanding level for concept about light and shadow and meaningful differences with 3rd, 4th and 5th grade students. Second, 3rd and 6th grade students understood right about a straight drive of light. Third, about the sizes of shadow made from parallel light driving slantly, 3rd grade students answered light more than any other grade students. About slant light, 6th grade students showed higher understanding but students of every grade showed low understanding(lower than 50%) about shadow made by straight light just above their heads. Sixth, about the sizes of shadow by the location of parallel light, lower than 18% of students of each grade answer right. On the other hand, about those of shadow by the divergent light, approximately 50% of students of each grade answered right and for 3rd grade students, 68%. Seventh, the curriculum of school play a very important role for students' concept perception. The more students made experiments and had experiences, the more right they answered. But they didn't answer right if they didn't have chances to learn at school, although they experiences often in their daily lives. And also, even though they studied in their 3rd grade classes, they were forgetting when they didn't have chances to study continually. When they were in 6th grade and study about light and shadow again, they recalled what they learned and got know more exactly and more extensively. These propose as followings. ⑴ We need to develop many methods to understand light sources and to make experiments to find out principles for how shadows were made by various light sources. They will make students apply the principle to the phenomenon which they observe in their daily lives. ⑵ We need to develop the methods to minimize students' losing memory.