• 디지털융복합연구
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• 제15권1호
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• pp.485-495
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• 2017

본 연구는 수용전념치료 프로그램이 월경전증후군을 가진 20대 여성들의 월경 전 증상, 월경에 대한 태도 및 지각된 스트레스에 미치는 효과를 알아보았다. 3~4년제 대학생 263명 중 21명이 참가자로 선발되었다. 참가자들은 월경전증후군 진단을 받았고, 수용전념치료집단 7명, 인지행동치료집단 7명, 통제집단 7명으로 무선할당 되었다. 수용전념치료와 인지행동치료프로그램은 주 2회씩 총 10회로 진행되는 도중 수용전념치료 집단에서 참가자 1명이 개인사정으로 인해서 탈락되었다. 프로그램 종료 후 월경 시작 시점에 사후 검사가 실시되었고, 약 1달 뒤 월경 시점에 추적 조사가 이루어졌다. 그 결과, 월경 전 증상 중 정서요인이 수용전념치료집단과 인지행동치료집단이 통제집단에 비해 유의하게 더 감소되었다. 월경에 대한 태도는 수용전념치료집단에서 통계적으로 유의하지 않았지만 긍정적으로 변화되었고, 인지행동치료집단은 추적조사에서 유의하게 변화되었다. 지각된 스트레스는 수용전념치료 집단이 통제집단과 인지행동치료집단보다 유의하게 더 감소되었고, 그 수준은 추적조사까지 유지되었다. 마지막으로, 본 연구의 의의와 제한점 및 후속 연구에 대한 제언이 논의되었다.

• 정신신체의학
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• 제5권1호
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• pp.52-62
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• 1997

This study was designed to determine the frequency of premenstrual dysphoric disorder in gynecological outpatients, and also attempted to compare premenstrual change characteristics, functional impairment due to premenstrual changes and frequency of risk factors reported by women with confirmed premenstrual changes$(PMC^+)$(n=17) and those without confirmed premenstrual changes$(PMC^-)$(n=23). Forty gynecological outpatients who complained of premenstrual discomforts were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and premenstrual change and functional impairment. The women were also asked to complete a daily rating form based on DSM-IV diagnostic criteria for one menstrual cycle. Absolute severity method, effect size method and percent change method were used to assess changes between follicular phase and luteal phase. The results of the study were as follows: 1) The frequency of premenstrual dysphoric disorder according to each of the three methods was 5% for the absolute severity method, 15% for the effect size method, and 27.5% for the percent change method. 2) The frequently reported symptoms were as follow: physical symptoms(64.7%) : lethargy, easy fatigability, or marked lack of energy(41.2%) : decreased interest in usual activities(29.4%) ; and marked affective lability(23.5%). 3) There were no significant differences in onset ages of premenstrual changes, regularities of premenstrual changes and changes of severity and duration of premenstrual symptoms over time between women with and without confirmed premenstrual changes. However, women with confirmed premenstrual changes reported both physical and emotional symptoms as earliest symptoms most frequently, while women without confirmed premenstrual changes reported only physical symptoms most frequently. 4) functional impairment was significantly higher in women with confirmed premenstrual changes than those without confirmed premenstrual changes, but impairment was not severe. 5) No differences were found between women with and without confirmed premenstrual changes in risk factors including demographic data, menstrual and obstetric and gynecological history. These results suggest that the prevalence of premenstrual dysphoric disorder varies with scoring methods. The women with confirmed premenstrual changes reported physical symptoms most frequently(64.7%). functional impairment was significantly higher in women with confirmed premenstrual changes, but impairment was not severe.

• The Korean Journal of Pain
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• 제8권2호
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• pp.235-243
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• 1995

A retrospective study was performed to evaluate the effects, and side effects, of epidural analgesia for postoperative pain relief of 2,381 surgical patients who received general-epidural, or epidural anesthesia only. Anesthesia records, patients charts, and pain control records were reviewed and classified according to: age, sex, body weight, department, operation site, epidural puncture site, degree of pain relief by injection mode & epidural injectate, and side effects(including nausea, vomiting, pruritus, urinary retention and respiratory depression). The results were as follows: 1) From the total of 2,381 patients, there were 1,563(66%) female patients; 1.032(43%) patients were from Obstetrics and Gynecology. 2) Lower abdomen, thorax, lower extremity and upper abdomen in the operation site; and lumbar, upper, lower thoracic in puncture site were order of decreasing frequency. Length of epidural injection for pain relief averaged $1.72{\pm}1.02$ days. 3) Ninety three percent of the patients experienced mild or no pain in the postoperative course. Analgesic quality was not affected by the kind of epidural injectate. 4) Nausea occurred in 3.2% of all patients, vomiting in 1.1%, pruritus 0.9%, urinary retention 0.6%, respiratory depression 0.08%. 5) Frequency of nausea was higher with female patients compared to male patients(p<0.05). 6) Pruritus frequency was higher with male patients than female patients(p<0.05); and more frequent with patients who received epidural injection with morphine than patients who received epidural injection without morphine(p<0.01). 7) Urinary retention was higher in female patients, and more frequent with patients who had received epidural injection with morphine than epidural injection without morphine(p<0.05). 8) There were two cases of respiratory depression. The course of treatment consisted of: cessation of epidural infusion, then administration of oxygen and intravenous naloxone. We conclude that postoperative epidural analgesia with a combination of local anesthetics and opiate is and effective method for postoperative pain relief with low incidence of side effects. However, patients should be carefully evaluated as rare but severe complications of respiratory depression may ensue.

• 한국미생물·생명공학회지
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• 제42권4호
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• pp.393-401
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• 2014

청국장으로부터 Bacillus cereus에 대한 항균활성이 가장 높은 균주를 분리하여 형태학적, 생화학적 특성과 16S rDNA 염기서열 결정을 통해 Bacillus subtilis HH28으로 동정 및 명명하였다. B. subilis HH28의 생육시기에 따른 항균활성을 측정해 본 결과, 생육이 대수증식기인 9시간부터 생성되어 사멸기인 60시간에 가장 높은 활성(80 AU/ml)을 나타내었고 144시간(6일)까지 항균활성을 유지하였다. 항균물질의 정제는 황산암모늄 침전과 DEAE-sepharose fast flow, sephacryl S-200HR를 이용하였고, 19.7배의 정제도와 38.4%의 수율로 정제되었다. Tricine SDS-PAGE와 directed detection을 통해 항균물질의 분자량이 약 3,500 Da임을 알 수 있었다. 또한 본 연구의 항균물질을 B. cereus 뿐만 아니라 Listeria monocytogenes, Vibrio parahaemolyticus의 식중독 균에서도 우수한 항균활성을 나타내었고, 항균작용의 기작은 미생물을 사멸시키는 살균작용이였다. 또한 온도 안정성 실험에서 $40-80^{\circ}C$까지 안정했고, pH 안정성 실험에서는 pH 2-9까지 안정하여 비교적 온도와 pH에 안정하였다. 효소에 대한 영향 실험에서는 단백질 분해효소에 의해 항균활성이 실활되어 본 연구의 항균물질은 단백질성임을 알 수 있었다. 위와 같은 특성으로 보아 B. subtilis HH28이 생산하는 항균물질은 천연 식품 보존제 및 사료 보존제, 항생제 대체 의약품으로 사용할 수 있는 잠재력을 가지고 있으며, 향후 이 항균물질의 정확한 구조 및 특성 규명 등의 연구가 필요하다.

• 한국전자통신학회논문지
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• 제12권2호
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• pp.401-410
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• 2017

본 연구는 일 종합병원 산부인과 환자를 대상으로 2013년 7월 1일 포괄수가제가 확대시행 전 후의 재원일수와 진료비를 비교 분석하여 포괄수가제 시행의 효과를 파악하고자 수행되었다. G광역시 소재 일 종합병원에서 2013년 1년간 산부인과 포괄수가제 질병군의 수술(자궁 및 자궁부속기 수술, 제왕절개술)을 받고 퇴원한 환자로, 행위별 수가제 적용 대상자는 2013년 1월~6월까지 입원한 환자 204명이었고, 포괄수가제 적용 대상자는 2013년 7월~12월까지 입원한 환자 194명으로 총 398명의 재원일수 및 진료비를 공분산분석(ANCOVA)하였다. 본 연구결과 재원일수는 행위별수가제에서 6.65(0.13)일, 포괄수가제에서 6.40(0.12)일로 감소하였고(p=0.013), 급여총진료비는 행위별수가제에서 1,726,333(46,331)원, 포괄수가제에서 2,271,115(37,069)으로 증가하였고(p<0.001), 보험자부담금은 행위별수가제에서 1,387,142(41,938)원, 포괄수가제에서 1,800,914(28,300)원으로 증가였다(p<0.001). 급여본인부담금은 행위별수가제에서 339,190(8,404)원, 포괄수가제에서 70,201(9,255)원으로 감소하였고(p<0.001), 비급여비용은 행위별수가제에서 642,243(22,039)원, 포괄수가제에서 197,507(9,091)원으로 감소하였고(p<0.001), 환자 총본인부담금도 행위별수가제에서 981,433(25,947)원, 포괄수가제에서 667,708(13,286)원으로 감소하였다(p<0.001). 본 연구결과 산부인과 환자에 대한 포괄수가제 적용은 재원일수, 비급여비용, 총본인부담금을 감소시켰고, 급여본인부담금, 보험자부담금, 급여총진료비를 증가시키는 효과를 보였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권4호
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• pp.306-311
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• 2005

Despite advances in surgery, radiotherapy, and chemotherapy, the survival of patients with oral squamous cell carcinoma has not significantly improved over the past several decades. Gene therapy is currently under investigation and shows us new possibility of cancer curing method. This experiment was undergone to find out the cell growth inhibition effect and evidence of apoptosis by HCCS-1(human cervical cancer suppressor-1), one of the candidates of tumor suppressor gene, transducted to human oral cancer cell line. To determine the efficiency of the adenovirus as a gene delivery vector cell line was transducted with LacZ gene and analysed with X-gal staining. Northern blot was performed to confirm the transfection with HSCC-1 gene and cell viability was assessed by cell cytotoxicity assay using cell count kit(CCK). To show the evidence of apoptosis, DNA fragmentation assay and flow cytometry(FACS) were performed. We had successfully construct the recombinant HSCC-1 adenovirus(Ad5CMV-HCCS-1), and importation efficiency was 20% at 2 MOI(multiplicity of infection), 80% at 20 MOI. Northern blot analysis showed that a single 0.6kb mRNA transcript was expressed in Ad5CMV-HCCS-1 transducted cell lines. As a result of CCK, when comparing to control subjects, transducted group showed 50% growth inhibition. In DNA fragmentation assay, according to increasing of MOI, DNA volume was diminished. In FACS analysis, DNA distribution showed fragmentation. This results imply that HCCS-1gene has growth inhibition effect in human oral cancer cell lines through apoptosis induction.

• Journal of Gastric Cancer
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• 제4권2호
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• pp.126-130
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• 2004

Purpose: A Krukenberg tumor is an ovarian tumor of a signet-ring cell type. This tumor arises more commonly in young women, and the prognosis is poor. The primary focus of this tumor is often found at gastrointestinal malignancy, especially gastric cancer. We tried to identify the clinical characteristics of this tumor, and in that regard, this report might be helpful. Materials and Methods: We reviewed the 61 patients with Krukenberg tumors, who had been diagnosed at our hospital from 1994 to 2002, and retrospectively analyzed the clinical features. Results: The age distribution ranged from 15 to 59 years, and the mean age was 41 years. The most common symptom was a lower abdominal mass ($46\%$). Fourty-two cases ($77\%$) showed bilateral ovarian involvement, and the size of this tumor was variable, but in 24 cases ($4\%$) the size was $5\∼10$ cm for the largest diameter. Among 54 cases, 40 cases had ascites, and the volume of ascites was variable. The median survival of the 61 patients was 10 months, and Krukenberg tumor developed 19.7 months after the primary operation. The median survival durations of recurrence patterns were 20 months for the Krukenberg tumor alone, and 7 months for the Krukenberg tumor with peritoneal seeding. Conclusion: In young women treated with a gastrectomy, especially one for an advanced tumor, closed observation with abdominal ultrasonography or computed tomography to detect a Krukenberg tumor is recommended. The patient with a Krukenberg tumor alone has a better prognosis than one with a Krukenberg tumor combined peritoneal seeding. We will have to consider more progressive treatment for the patient with a Krukenberg tumor alone.

• Advances in pediatric surgery
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• 제16권2호
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• pp.134-142
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• 2010

Malignant ovarian tumors in children are very rare, and consist of about 1 % of all childhood malignant tumors. The purpose of this study is to examine the clinical characteristics, treatment, and prognosis for children with malignant ovarian tumors. We retrospectively reviewed the medical records of children under 15 years of age with malignant ovarian tumors who had been treated surgically at Asan Medical Center between 1989 and March 2009. There were 32 patients, ranged in age at surgery from 2 to 15 years (mean; 10.4 years). The median follow-up period was 64.7 months (from 1 month to 188 months). Pathologic diagnosis were; immature teratoma (n=10), mixed germ cell tumor (n=10), and dysgerminoma (n=6). Tumor stage was classified by the staging system of the International Federation of Gynecology and Obstetrics (FIGO). The number of patients in stage I, II, III, and IV were 24 (75 %), 2 (6.2 %), 4 (12.5 %), and 2 (6.1 %), respectively. The tumor recurred in 4 patients. Seven patients of group 1 did not receive postoperative adjuvant chemotherapy, and in three of them, the tumor recurred. Twenty-five patients (group 2) underwent postoperative adjuvant chemotherapy, and there was only one recurrence. One patient who did not receive postoperative adjuvant chemotherapy and expired 10 months after operation because of tumor recurrence and distant metastasis. The overall 5-year event free survival (EFS) was 84.2 %: group 1 in 44.4 %, and group 2 in 95.7 %. Tumor recurrence was related to the postoperative adjuvant chemotherapy (p=0.004). In conclusion, proper surgical procedures with relevant postoperative adjuvant chemotherapy might improve clinical results in children with malignant ovarian tumors.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권2호
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• pp.103-109
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• 2005

In spite of the ongoing advances, standard therapies for oral cancer still has some limitations in efficacy and in ability to prolong survival rate of advanced disease and result in significant functional defect and severe cosmetic deformity. Currently gene therapy using tumor suppressor gene is considered as a potent candidate for new therapeutic approaches that can improve efficacy and reduce complications. The purpose of this research is to identify the role of adenoviral vector to transfer HCCS-1 tumor suppressor gene in oral cancer cells and to find out whether there is a possibility for it to serve in the field of gene therapy. The human SCC-25 cell line was used for transfection. To determine the efficiency of the adenovirus as a gene delivery vector cell line was transduced with LacZ gene and analysed with X-gal staining. Northern blot was performed to confirm the tranfection with HSCC-1 gene and cell viability was assessed by cell cytotoxicity assay. We had successfully construct the recombinant HSCC-1 adenovirus(Ad5CMV-HCCS-1). DNA extracted from Ad5CMV-HCCS-1 revealed HCCS-1 gene is incorporated. The transduction efficiencies were over than 50% of SCC-25 cells with a MOI of 2 and over 95% with a MOI of 50. Northern blot analysis showed that a single 0.6kb mRNA transcript was expressed in Ad5CMV-HCCS-1 transduced SCC-25 cells. There was no or very low transcription HCCS-1 mRNA in wild and Ad5CMV-LacZ transduced SCC-25 cells. Cells transduced with Ad5CMV-HCCS-1 showed significant growth inhibition. By day 6, Ad5CMV-HCCS-1 treated cell count was decreased to 30% of mock-infected cells, while that of Ad5CMV-LacZ treated cells was 90% of mock-infected cells (p<0.05). Finally, these result suggest that the Ad5CMV-HCCS-1 has potential as a gene therapy tool for oral cancer.

• 생물정신의학
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• 제3권1호
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• pp.96-101
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• 1996

저자들은 1994년 3월부터 1995년 10월까지 중앙대학교 부속병원 폐경기 클리닉에 내원했었던 환자중 폐경군 83명과 대조군 73명을 BDI, STAI로써 우울과 불안정도를 측정하였고, 혈중 E2, LH, FSH 수치를 측정하여 결과는 다음과 같았다. 폐경 여성의 평균 연령은 45.3세였으며 BDI와 STAI 점수 비교에서 폐경군이 대조군에 비해 유의(p<0.01)하게 높아 폐경군이 더 높은 우울 및 불안 성향을 보였으나 폐경 여성이 불안 및 우울감을 더 유발한다는 가설을 뒷받침 하지는 못하였다. 혈중 호르몬의 비교에서 대조군과 폐경군간에 E2치와 FSH치에서 양군간에 유의한 차이(p<0.01)가 있었다. 그리고 대조군에서 STAI, BDI 접수와 호르몬간의 상관관계에서 유의한 상관관계는 없었으며 폐경군에서도 STAI, BDI 접수와 호르몬간의 상관관계에서 유의한 상관관계는 없었다. 즉 폐경기 호르몬의 상태와 우울 및 불안과의 상관관계는 없었다. 폐경기의 심리적 장애의 원인을 생물학적, 사회문화적, 또는 심리적 요인 중 단일 요인으로 성명하기보다 상호 복합적으로 규명해야 하겠다.