심근경색의 위험인자로서 Thrombomodulin유전자변이의 의의

박현영,김영미,권혁문,지선하,조승연,정남식,심원흠,장양수 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.6

Hydrogen Peroxide 농도와 적용시간이 Hydroxyapatite discs의 미백과 물리적 성질에 미치는 영향

양연미,이두철,백병주,김재곤,신정근 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.1

법랑질의 주성분인 hydroxyapatite 분말을 성형하고 소결하여 착색을 유발한 다음 과산화수소의 농도와 적용 기간의 변화에 따라 나타나는 미세 조직과 기계적 성질의 변화 및 미백 효과 등에 관한 연구를 통해 다음과 같은 결론을 얻었다. 1. 과산화수소의 농도와 적용시간이 증가함에 따라 미백 효과가 증가되었다. 2. 표면조도는 15% 과산화수소 10일, 30% 과산화수소 7, 10일 적용 시 유의한 차이로 증가하였다(p<0.05). 3. X-선회절 분석결과 미백처리 전·후의 결정상의 변화는 관찰되지 않았으나, 주사전자현미경 관찰시 표면의 미세구조는 과산화수소 농도와 적용시간의 증가에 따라 미세기공이 증가하였다. 4. 2축 굽힘강도는 30%농도의 과산화수소로 7, 10일 적용하였을 때 유의한 차이로 감소되었다(p<0.05). 5. 미소 경도값은 15% 과산화수소 10일과 30% 과산화수소 3, 7, 10일 적용 후 유의한 차이로 감소되었다(p<0.05) The purpose of this study was to evaluate the effect that various concentration and application time of hydrogen peroxide had on tooth whitening and physical properties. The hydroxyapatite (HA) discs of 12 mm (Φ) x 1.2 mm (t) in dimensions were made by compression (100 kg/㎠) and sintering (at 1350℃ for 2 hours). All specimens were polished sequentially with #240 through #2000 emery paper and one side of each specimen was polished finally with 0.3 ㎛ alumina paste. The discs were placed in sterile whole stimulated saliva overnight at 37℃ in order to form an in vitro pellicle layer. Then the discs were rinsed with distilled water and soaked into staining broth at 37℃ for 7 days. These stained specimens were bleached with hydrogen peroxide according to the change of concentration (3∼30%) and application time (3∼10 days). The specimens were analyzed with a spectrophotometer, X-ray diffractometer (XRD), scanning electron microscope (SEM), surface roughness tester, microhardness tester and biaxial flexural strength. The results of present study can be summarized as follows: 1. The bleaching effect was increased with the increased concentration and the extended application time of hydrogen peroxide. 2. The surface roughness was significantly increased from the specimen bleached with 15% hydrogen peroxide for 10 days and with 30% for 7 and 10 days respectively (p<0.05). 3. The changes of crystal phase observed by XRD between before and after bleaching weren' t shown of any difference, but microporous structure of surface observed by SEM was shown of increase with the increased concentration and the extended application. 4. The biaxial flexural strength was significantly decreased from bleaching of specimen with 30% hydrogen peroxide for 7 and 10 days respectively (p<0.05). 5. Microhardness was significantly decreased from bleaching with 15% hydrogen peroxide for 10 days and with 30% for 3, 7 and 10 days respectively (p<0.05). Although the tooth bleaching effect was greater when the high concentration was applied, further in vivo experiment will be needed to prove it s safety.

서울시내 고등학교 위탁급식의 급식비와 투자비의 실태 및 위탁업체의 기대수준 비교 분석

양일선,배환미,김현아,신서영,조미나,박수연,차진아,이보숙 한국식생활문화학회 2002 韓國食生活文化學會誌 Vol.17 No.5

The purposes of this study were to a) find out the operational characteristics of the contract-managed highschool foodservice in Seoul, b) investigate the expected level of meal-price and facilities investment cost perceived by contract-managed highschool foodservice managers c) compare the present level and expected level of meal-price and facilities investment cost. From October 12 to November 13 in 2001, the questionnaires were mailed to 249 high schools which was managed by contract foodservice company with respondent rate 40.2%. Data were analyzed using SPSS Win(10.0) for descriptive analysis and one group paired t-test. The results of this study were as follows ; 1. The student enrollment of highschools run by contract-managed foodservice was 1,243 with 72.6% participation rate of school lunch program. The average meal-price was 2,138 won. The average annual period of school foodservice operation was 156.78 days per year. The average contracting period was about 3 years. 2. The average cost concerned in the facilities investment amounts 169,578,180 won at the initial investment and 25,204,092 won at the repairs and maintenance cost in the course of operation. 3. The present level of meal-price and facilities investment cost were respectively 2,136won/meal and 171,157,336.72 won. And expected level.of meal-price and amount of facilities investment cost were 2,418.75 won and 121,353,215.19 won. Comparing the present level with expected level of the meal-price and facilities investment cost, expected level of meal-price was significantly higher than the present level of meal-price(p<.001) and expected level of facilities investment cost was significantly lower than present level of facilities investment cost(p<.001).

정상, 낭종 및 법랑아세포종 세포에서의 유전자 발현 차이 분석

양철희,김재곤,백병주,양연미 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.1

법랑아세포종은 1868년에 처음 보고된 이래 명칭, 발생기전, 분류 그리고 치료 방법 등에 관하여 수 많은 논란이 있어 왔는데 이는 법랑아세포종이 양성종양임에도 불구하고 종양자체의 진행이 파괴적이고, 외과적 처치를 한 후에도 재발이 잘되며, 흔하지는 않지만 악성종양과 유사하게 전이를 보이는 등 독특한 특성을 지니고 있기 때문이다. 정상세포와 암 세포 간에 차이를 보이는 유전자 혹은 정상세포에서 변형이 일어날 때 특이적으로 발현하는 유전자의 분리 및 분석하는 것은 암세포의 생성과정을 이해하는데 있어서 중요한 열쇠를 제공할 수 있다. 이에 본연구는 RNA differential display 방법 중 재연성과 반복성이 개선된 Ordered differential display(ODD)RT-PCR과 보다 개선된 GeneFishing™기술을 이용하여 악성과 양성종양 사이의 유전자 발현의 차이를 조사하고, 특이 유전자의 profile을 확보하고자 하였다. GeneFishing™기술과 RT-PCR을 수행한 결과 nasopharyngeal carcinoma gene을 제외한 9개의 유전자는 악성에서 특이적으로 발현되는 것을 확인하였다. 따라서 GeneFishing™을 이용하면 각 시료간의 mRNA 상에서 발현차이를 보이는 DEG를 비교 분석하면 암관련 유전자, 항생제 내성 유전자, 그리고 분화 관련 유전자들에 대한 연구가 용이하게 수행할 수 있을 것으로 생각된다. Ameloblastoma is the most commonly occurring odontogenic tumor in oral cavity. Although most are benign epithelial neoplasm, they are generally considered to be locally aggressive and destructive, exhibiting a high rate of recurrence. The biological behavior of this neoplasm is a slowly growing, locally invasive tumor without metastasis, therefore malignant neoplasm, changed its histological appearance to carcinoma or showed distant metastasis, is only defined clinically. In this study, we identified the differentially expressed genes(DEGs) in stages under benign or malignant ameloblastoma compared with normal patient using ordered differential display(ODD) reverse transcription(RT)-PCR and GeneFishing™ technology. ODD RT-PCR is rather effective when the investigation of samples containing very small amounts of total RNA must be accomplished. ODD RT-PCR used the means of amplification with anchored T-primer and adaptor specific primer, bearing definite two bases at their 3' ends and so this method could display differential 3' -expressed sequence taqs(ESTs) patterns without using full-length cDNAs. Compared with standard differential display, ODD RT-PCR is more simple and have enough sensitivity to search for molecular markers by comparing gene expression profiles. However, this method required much effort and skill to perform. GeneFishing™ modified from DD-PCR is an improved method for detecting differentially expressed genes in two or more related samples. This two step RT-PCR method uses a constant reverse primer(anchor ACP-T) to prime the RT reaction and arbitrary primer pairs(annealing control primers, ACPs) during PCR. Because of high annealing specificity of ACPs than ODD RT-PCR, the application of GeneFishing™ to DEG discovery generates reproducible, authentic, and long(100bp to 2kb) PCR products that are detectable on agarose gels. Consequently, various DEGs observed differential expression levels on agarose gels were isolated from normal, benign, and malignant tissues using these methods. The expression patterns of the some isolated DEGs through ODD RT-PCR and GeneFishing™ were confirmed by Northern blot analysis and RT-PCR. The results showed that these identified DEGs were implicated in ameloblastoma neoplasm processes. Therefore, the identified DEGs will be further studied in order to be applied in candidate selection for marker as an early diagnosis during ameloblastoma neoplasm processes.

위선암에서 p53, MMP-2 및 TIMP-2의 표출

황호현,김의한,오미혜,조현득,양승하 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

Gastric adenocarcinoma is the most common malignant tumor in Korea. Many oncogens have been found in malignant tumor cells. Among these oncogene, MMP-2 and TIMP-2 show important role in invasivness and metastasis of malignant tumor cells. P53 is regulator of cellular proliferation, and the over expression of p53 relate to malignant transformation and prognosis. To evaluate the expression of MMP-2, TIMP-2, and p53 according to histopathologic features and the relation between these antigens and prognosis in gastric adenocarcinoma, we have performed immune staining, using mouse anti-MMP-2, mouse anti-p53, and mouse anti-TIMP-2 for 91 cases. The results were as follows; 1) The expression rates of MMP-2, TIMP-2, and p53 in gastric adenocacinoma were 58.2%, 57.1%, and 49.5%, respectively. 2) MMP-2 and TIMP-2 in gastric adenocarcinoma showed reverse correlation.(p<0.001) 3) MMP-2 showed more higher expression rates in intesinal type and sell differentiated form of gastric adenocarcinoma, and in cases showing more deeper invasion and metastasis to lymph nodes in advanced carcinoma. 4) TIMP-2 in advanced carcinoma showed more lower expression rates in cases showing more deeper invasion and metastasis to lymph nodes. 5) MMP-2 expression and TIMP-2 non-expression showed more higher frequency in intestinal type of gastric adenocarcinoma and in cases showing more deeper invasion depth in advanced carcinoma. 6) p53 in advanced carcinoma showed more higher expression rates in cases more deeper invasion and metastasis to lymph nodes. Above results indicated that MMP-2 and TIMP-2 in gastric adenocarcinoma shows reverse correlation, and may be show reverse relation according to progression, type, invasion depth, and metastasis to lymph node. The expression of p53 may be related to metastasis to lymph nodes and degree of depth in advanced carcinoma.

신규간호사와 프리셉터가 인지하는 프리셉터의 교수효율성 비교

김지양,김영선,김춘실,박현숙,신미영,윤연숙,조유숙,박미미,유문숙 한국간호과학회 간호행정학회 2009 간호행정학회지 Vol.15 No.2

Objective: The purpose of this study was to compare preceptors and new graduate nurses on their perception of preceptor teaching effectiveness. Methods: The participants were 90 new nurses and 90 preceptors who worked in A medical center. The data were collected from July 1 to September 30, 2008. A cross-sectional descriptive survey was done using a structured questionnaire. Results: New nurses' perception (4.07±.44) of the preceptor teaching effectiveness was significantly higher than perception of the preceptors (3.57±.37). Fifty five percent of new graduate nurses reported a lack of coherence in the preceptor's practice guidelines. For 5 causal factors classified on the teaching effectiveness, the factor of 'Professional knowledge and ability' showed the highest score, but 'Interpersonal and communication skill' got lowest score for both group. Preceptors responded that they did not have enough time to teach well because of their heavy workloads. Conclusions: These results suggest that the preceptors need appropriate compensation and education opportunities, and new graduate nurses need consistent education by the teaching professionals. Therefore, it is important to give preceptors full charge of the preceptorship. Also, it will be necessary to develop education programs to enhance interpersonal and communication skill for preceptors and new nurses.

외상성 고막 천공에 관한 임상적 고찰

유연창,정관기,양미경,장철호 최신의학사 1990 最新醫學 Vol.33 No.10

소아의 치아와 지지조직 외상에 관한 분석

백병주,양연미,양철희,김재곤 大韓小兒齒科學會 2001 大韓小兒齒科學會誌 Vol.28 No.4

본 연구는 소아의 외상에 관한 실태를 파악하여 외상의 예방 및 치료법을 확립하고자 전북 대학교병원 소아치과에 1998년 4월 1일부터 2000년 3월 31일까지 2년간 외상을 주소로 내원한 212명(치아수:431개)의 환자를 대상으로 설문지 및 구강검사를 통하여 연령, 성별분포, 발생원인, 초진시 처치, 치아외상의 세부항목을 조사, 분류하여 다음과 같은 결론을 얻었다. 첫째, 모든 나이군을 통해, 남아가 여아보다 치아외상의 더 높은 빈도를 보인다. 둘째, 환자방문이 가장 높은 나이는 유치에서는 1-2세, 영구치에서는 8-9세이다. 셋째, 외상원인으로 유치는 넘어짐, 추락, 충돌이고, 영구치는 넘어짐, 충돌, 사고, 타박 등이다. 외상빈도는 계절적으로 유치는 5월, 영구치는 3월에 가장 많으며, 유치에서는 수요일에, 영구치는 화요일과 목요일에 많다. 치아외상은 주로 오전에 발생한다. 넷째, 어린아동들은 넘어지거나 가구에 부딪혀서 가정에서 주로 손상을 받는다. 나이든 아동들은 가정밖인 학교등에서 스포츠나 사고등에 의해 외상이 증가한다. 다섯째, 가장 흔히 손상받는 부위는 상악유중절치, 상악중절치이다. 유치에서 손상은 동요·진탕이 많고, 영구치는 치관파절이 많고 또한 동요·진탕도 많다. 여섯째, 상하순 및 상악치은 열상이 가장 흔한 연조직 손상으로 나타난다. 일곱째, 초진시 처치는 유치에서 경과관찰과 발치가 가장 흔한 치료법이며, 영구치에서는 주로 수복처치와 정복고정이 시행된다. The purpose of this study is concerned wit an investigation of the actual condition of traumatic injuries of teeth and supporting structures in children to set up possible criteria for prevention and treatment of injured teeth. The materials consisted of the clinical records of 431 traumatically injured teeth of 212 children, accumulated during two years from the first of April in 1998 to the end of March in 2000, supplied from the Dept. of Pediatric Dentistry, Chonbuk National University Hospital. The incidence of injuries in boys was extremely high for permanent teeth, twice as high as in girls. Accidents to primary teeth were most common from 1 to 2 years of age and to permanent teeth were most from 8 to 9 years of age. The most common cause of trauma was a fall for both primary and permanent teeth, followed by collision. The anterior teeth in maxilla was most frequently affected by trauma in both the primary and permanent teeth. The most common type of trauma were loosening for the primary teeth, followed by luxation types which included the intrusion, displacement and extrusion and complete avulsion types. For the permanent teeth, the most common type of trauma were tooth fracture. The most common trauma of soft tissue was laceration of upper lip, lower lip and gingiva of maxilla Concerning treatment at the first visit, primary teeth with only loosening and concussion were not usually treated. Permanent teeth were often treated by crown restorations for crown fractures and by endodontic procedures for pulpal exposure. Though we could elucidate actual condition of traumatic injuries of teeth in children, we should make a follow-up survey to ensure the prognosis of injured teeth and establish the most desirable criteria for traumatized teeth in children.

담도폐쇄증 환아의 치과치료 : 증례보고

김재곤,양연미,백병주,이승익 大韓小兒齒科學會 2000 大韓小兒齒科學會誌 Vol.27 No.1

Intra-& extra-hepatic duct system의 경화를 야기하는 Biliary atresia는 출생시 1:10,000의 발생빈도를 보이며, 5년 이하의 생존율을 나타내는 예후가 좋지 않은 질환이다. 담도폐쇄증의 원인은 아직 명확하지 않으나, 유전적인 요소나 발육성 원인으로 믿고 있다. 임상적 특징으로 두드러진 황달, 간비증대, 가려움증, 지방변, 황색종, 성장지연, 문맥압항진증, 출혈, 골연하증, 복수 그리고 호흡기계 감염 등을 나타낸다. 구강내 소견으로 녹색을 띄는 변색치아, 유치의 확장된 치수강과 치근관, 치아맹출지연, 법랑질 형성부전, 그리고 심한 치아 우식 등이다. 담도폐쇄증은 조기진단과 수술에 의해 사망률이 감소되고, 성장과 발달이 정상으로 돌아오며 생존율도 향상되었으나 여전히 그 원인과 치료에 대한 연구가 계속되어야 할 것이다. 이에 저자는 전북대학교 치과병원에 내원한 2명의 담도폐쇄증환아에 대해 임상, 방사선학적 특징 및 적합한 처치에 대하여 보고하고자 한다. Congenital biliary atresia with pregressive sclerosis of the intra-and extra-hepatic duct system occurs in 1:10,000 live births, and has a poor prognosis with an expected survival of less than 5 years. Etiology of biliary atresia is unclear, however, it is believed a genetic or developmental cause. The clinical characteristics include pronounced jaundice, hepatosplenomegaly, pruritus, steatorrhea, xanthomas, growth retardation, portal hypetension, bleedings, ascites and respiratory infections. Oral manifestations have seldom been reported in patients with biliary atresia, but there may be enamel hypoplasia, delayed tooth eruption, and green teeth. Early diagnosis and surgical intervention have decreased morbidity, returned growth and development to normal and improved the prognosis for survival. Authors report the clinical and radiologic characteristics, proper managements about two cases with biliary atresia.

혼합치열기의 miniscrew를 이용한 교정치료

임수민,양연미,김재곤,백병주,이용훈,신정근 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

Anchorage plays an important role in orthodontic treatment, Skeletal anchorage like the miniscrew is considered a more effective method in anchorage control than conventional anchorage which needs much patient s cooperation. The miniscrew offers many advantages. 1) It is easy to insert and to remove. 2) It can endure the force needed for moving teeth. 3) It can be immediately loaded and 4) Patient cooperation is not needed. 5) It is economic compared to other skeletal anchorage systems, In comparison to adult's bones, children s bones have comparatively poor bone quality and quantity. Therefore, it is hard to obtain primary stability in younger patients. However, if the miniscrew can be retained successfully, it will be effective in many orthodontic treatments. In these cases we used the miniscrew in correcting of diastema, in aligning dental midline, and in rendering a forced eruption of impacted tooth in mixed dentition patient. We obtained satisfactory results. 교정치료 시 고정원은 항상 염두에 두면서 치료를 진행해야 하는 중요한 요소이다. 전통적인 고정원을 이용한 치료는 환자의 적극적인 협조를 필요로 하고 원하는 치아이동에 대한 반작용이 나타날 수 있는 등의 부작용을 가지고 있다. 그러므로 보다 견고한 구강 내 고정원이 요구되어져 왔으며 이를 위해 miniscrew가 임상에서 흔히 이용되고 있다. Miniscrew를 통한 고정원의 확보는 구외력 의존도 감소,치료기간의 단축,식립 후 즉시 교정력 적용,환자의 협조도 불필요,식립의 간편성,저렴한 비용 등의 장점을 가지고 있다. 그러나 성장기 환자는 성인에 비해 골질이 좋지 않아 miniscrew의 성공률이 성인에 비해 낮다. 그러나 일단 고정에 성공하면 많은 교정치료 시 매우 유용하게 이용할 수 있다. 본 증례는 흔합치열기 환자를 miniscrew를 이용하여 정중이개 및 정중선 불일치,매복치에 대한 양호한 교정치료를 하였기에 보고하는 바이다.