• Applied Microscopy
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• 제22권2호
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• pp.15-29
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• 1992

The gallbladder is known to have the function of the storage and the concentration of the bile produced by the liver. This function is carried out by the removal of water and inorganic electrolytes. Extrahepatic cholestasis or the impairment of excretion of the bile leads to the distension and loss of the function of the gallbladder. The purpose of this study was to examine the ultrastructural characteristics of the normal gallbladder epithelial cells, and their structural changes induced by the ligation of common bile duct of the rabbit. Common bile duct ligation was performed under ether anesthesia. The rabbits were sacrificed on the 1st, 3rd, 5th, 7th and 14th day, respectively after operations. The tissue blocks of the gallbladder were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde prior to fixation in 1% osmium tetroxide, and embedded in the araldite mixture, and observed with JEM 100 CX-II electron microscope. The results were as follows: 1. The normal gallbladder epithelium of adult rabbit demonstrated two cell types, the ordinary epthelial cell and the dark cell. The dark cells have electron dense cytoplasm, and were found much infrequently, whereas ordinary epthelial cells were found quite numerous. 2. The ordinary epthelial cells of normal gallbladder were provided with the regular microvilli at the free surface and the images of pinocytotic activities in the apical cytoplasm, and exhibit highly convoluted lateral surfaces with elaborated microfolds. These figures of the cells suggest that they are resorptive in functional activity. 3. In the early stages (1st, 3rd, 5th day groups) following the ligation, the apical cytoplasm of some cells is protruding from the free surface and lost their microvilli. Numerous mucous granules filled in the apical and supranuclear cytoplasm compactly. 4. In the late stages (7th, 14th day groups) following the ligation, many light cells containing mumerous mucous granules are seen, between the ordinary epthelial cells. Mucous granules are fused each other, and are discharged into the lumen from the apical cytoplasm. The lateral membranes are straight or undulating without any interdigitations. From the above results, it was concluded that in the cholestasis induced by the common bile duct ligation, there is a tendency for the mucosal epithelium of the rabbit gallbladder to have secretory rather than an absorptive function.

• Archives of Pharmacal Research
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• 제23권4호
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• pp.353-359
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• 2000

${\alpha}_2$-Adrenoceptor antagonists, which can enhance synaptic norepinephrine levels by blocking feedback inhibition processes, are potentially useful in the treatment of disease states such. as depression, memory impairment, impotence and sexual dysfunction. (10bS)-1,2,3,5,6,10b-Hexahydropyrrolo[2,1-a]isoquinoline oxalate (YSL-3S) was evaluated in several in vitro biological tests to establish its pharmacological profile of activities as an ${\alpha}_2$-adrenoceptor antagonist. Saturation binding assay revealed that$^{3}[H]$rauwolscine bound to the $\alpha$$_2$-adrenoceptors with a Kd value of 6.3$\pm$0.5 nM and a Bmax value of 25l$\pm$39 fmol/mg protein in rat cortical synaptic membranes. Competitive binding assay showed that YSL-3S inhibited the binding of$^3[H]$rauwolscine (1 nM) in a concentration-dependent manner with a Ki value of 98.2$\pm$12.1 nM while it did not inhibit the binding of [$^3$H]cytisine (1.25 nM) to neuronal nicotinic cholinergic receptors. The Ki values of yohimbine, clonidine and norepinephrine for $^3[H]$rauwolscine binding were 15.8$\pm$1.0, 40.1$\pm$5.9 and 40.0$\pm$11.5 nM, respectively. In addition, the binding affinity of YSL-3S for ${\alpha}_2$-adrenoceptors was higher than that of its antipode and the racemic mixture. The functional activity of YSL-3S at the presynaptic ${\alpha}_2$-adrenoceptors was assessed using the prostatic portion of the rat vas deferens. Clonidine inhibited field-stimulated contractions of the vas deference in a dose-dependent manner. The presence of YSL-3S or yohimbine caused a parallel, rightward the dose-response curve of clonidine in a dose-dependent manner, indicating an antagonistic action at the presynaptic ${\alpha}_2$-adrenoceptors. The $pA_2$values of yohimbine and YSL-3S were 7.66$\pm$0.13 and 6.64$\pm$0.18, respectively. The results indicate that YSL-3S acts as a competitive antagonist at presynaptic ${\alpha}_2$ -adrenoceptors with a potency approximately ten times lower than yohimbine, but is devoid of binding affinity for neuronal nicotinic cholinergic receptors.

• 디지털융복합연구
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• 제14권9호
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• pp.515-523
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• 2016

본 연구는 유방암절제술환자 대상으로 가정치료융합프로그램을 실시하여, 유방암절제술환자의 팔 기능, 작업수행력, 삶의 질, 우울감에 미치는 영향에 대해 알아보았다. 대상자는 유방암절제술환자 20명을 대상으로 12주간 주 2회 40분간 외래로 작업치료실에 방문한 환자를 실시하였다. 중재 전과 후의 팔 기능을 알아보기 위해, 한국형 상지 장애 척도(Korean version of the Disability of the Arm, Shoulder, and Hand; K-DASH)와 부종을 줄자로 측정하였고, 작업수행력을 알아보기 위해 캐나다작업수행측정(Canadian Occupational Performance Measure, COPM)실시하였으며, 삶의 질을 알아보기 위해 Functional Assessment Cancer Therapy-Brest(FACT-B)을 사용하였으며, 우울감을 알아보기 위해 자기평가 우울척도(Beck Depression Inventory, BDI)를 이용하였다. 중재 결과 팔 기능은 유의하게 증가하였으나, 부종은 유의하게 감소하지 않았으며, 작업수행력, 삶의 질에서 유의하게 향상하였으며, 우울감은 유의하게 감소하였다. 따라서 가정치료융합프로그램은 유방암절제술환자의 팔 기능, 작업수행력, 삶의 질 우울감에 긍정적인 영향을 미친다는 사실을 알 수 있었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.18.1-18.6
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• 2018

Background: Clefts in newborns are associated with severe morphological and functional impairment. Especially the lip is of importance as if the treatment result is unsatisfactory, it can lead to psychological changes in the patient. Different operative procedures have been developed over the last decades. The aim of the presented study was the comparison of the surgical techniques according to Millard and Pfeifer regarding the temporal development of the postoperative symmetry of the lip height and mouth width. Methods: Digitized photographs of patients from the department of oral and maxillofacial surgery at the University of Göttingen were evaluated from 1979 to 1996. With a video analysis program, the lip height and mouth width were analyzed regarding the symmetry. We demonstrated the symmetry values over a period of 8 years in order to show the influence of growth on postoperative results. Results: The development of the vertical symmetry of the Philtrum and the lip vermillion on the cleft side in comparison to the healthy side behaves differently depending on Pfeifer and Millard. The lip height of the cleft lip was shorter in both techniques than on the healthy side, but Pfeifer's difference was significantly more pronounced. The lip vermillion height on the cleft side was slightly shorter in the Millard group and markedly larger in the Pfeifer group. Both techniques can achieve good symmetry results for the vertical dimension of the lip. According to Pfeifer, the development of the horizontal dimension on the cleft side is bigger within the first 4 years than on the healthy side; according to the Millard technique, the horizontal development is smaller. These differences are greater within the first 6 years and approach between the 6th and 8th year. Conclusions: The Millard technique demonstrates better results concerning the philtrum and vermillion symmetry during growth within the first 6 years. Over the whole study period, growth corrects the philtrum and vermillion symmetry within the Pfeifer group.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제3권1호
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• pp.46-55
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• 1992

발달성언어장애는 학령기 아동에서 약 $3{\sim}10%의$ 높은 빈도로 발견이 되며 그대로 방치할 경우 열등감, 좌절감, 우울증 등의 정서적인 문제를 일으키며 이차적인 학습장애를 동반한다. 이러한 발달성언어장애의 원인으로서는 사회환경적인 영향, 언어발달시기에 생긴 전도성청음장애로 인한 청각자극의 결핍, 유전적인 영향, 국소적인 뇌의 손상 등 때문으로 주장되지만 아직까지 정확한 기전은 밝혀지지 않고 있다. 이에 본 연구는 뇌전산화단층촬영이나 뇌파검사 등에는 나타나지 않는 국소적인 기질적인 병변이 존재하기 때문이라는 가설을 세우고, 뇌의 기능적인 이상을 알 수 있는 '단일광자방출전산화단층촬영'을 시행한 결과, 61.9%(26/42)에서 혈류의 감소가 있음을 발견하였다. 이상소견이 발견된 뇌의 부위가운데에서 대뇌피질이 47.6%(20/42)로서 가장 많았고, 그 다음으로는 시상부위가 33.3%(14/42)로 많았다. 이러한 결과로 미루어 볼 때 발달성언어장애가 뇌혈류의 이상소견과 관련된 뇌기능장애와 관련되어 나타날 가능성이 있음을 알 수 있었다. 향후 동일한 대상 환아군들을 추적 조사하여 증상이 호전된 후에 다시 단일광자방출전산화단층촬영을 실시하여 본 연구결과와 비교연구를 시행한다면 보다 정확한 원인 규명이 가능할 것으로 판단된다.

• 한국임상약학회지
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• 제19권1호
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• pp.18-22
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• 2009

Oxaliplatin is a tolerable and effective drug of choice in the treatment of advanced or metastatic gastric cancer. However, it has many dose-limiting neurotoxicities. This study was performed to assess the incidence and types of oxaliplatin-related neurotoxicities. Sixty-four patients receiving oxaliplatin-involved regimen as salvage therapy on metastatic gastric cancer or as the first-line therapy on advanced gastric cancer were evaluated during the period between September 1, 2006 and February 29, 2008. The patients were treated with oxaliplatin 100 $mg/m^2$ and leucovorin 100 $mg/m^2$ simultaneously as 2-hour-lasting infusion on Day-1 followed by 5-FU 1200 $mg/m^2$ as a 22-hour-lasting continuous infusion both on Day-1 and Day-2 by every other week. We developed questionnaires to evaluate patient-recognized neurotoxic symptoms rather than the observer-described events. Surveys were completed at bedside or via telephone interview. Acute and chronic neurotoxicities were graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC, version 3) as well as the Oxaliplatin-specific Neurotoxicity Scale. The Grade-3 neuropathy was reported in 19% of the patients (n=12) and grade-1/2 neuropathy occurred in 70% (n=45). The most common symptom was cold-related dysesthesia (83%) regarded as nociperception by the patients. Some patients (19%) experienced functional impairment affecting activities of daily living such as writing, buttoning, and walking. Even though 74% of the patients (42/57) were prescribed with gabapentin to reduce these peripheral symptoms, it did not appear to derive any benefit from this medication. It is suggested that notify the patients about their oxaliplatin-associated, debilitating symptoms, and educate them any self-care strategy at the initiating phase of the chemotherapy. Moreover, it needs to design the intervention studies regarding the prevention and management of the peripheral neuropathy.

• 정신신체의학
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• 제3권2호
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• pp.115-125
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• 1995

Reports about the prevalence of premenstrual symptoms state that occurs in 20 to 100% of most reproductive-age women. There is a close association between premenstrual syndrome and affective disorders as well as same some other psychiatric disorders. Late luteal phase dysphoric disorder (LLPDD) is a premenstrual condition defined in DSM-III-R by severe mood changes and other symptoms that repeatedly occur only in the luteal phase of the menstrual cycle. However, DSM-III-R does not specify how to compute the change from the follicular to the luteal phase or how to determine when the amount of change is great enough to warrant the diagnosis nor how to determine occupational or social functional impairment. This study was conducted to evaluate the nature, severity and magnitude of premenstrual syndrome in women with current psychiatric disorders by using prospective Daily Rating Form(DRF), and to measure symptom changes according to three scoring methods for diagnosing LLPDD. Our study obtains the data about premenstrual changes estimated by DRF from 22 women with psychiatric disorders who had met criteria for major depressive syndrome on the Premenstrual Assessment Form (PAF). The data was scored by each three methods and was determined to meet criteria A for LLPDD. The results are as follows: 1) the subjects, when scored according to the percent change method, effect size method and absolute severity method, met the DSM-III-R criteria A for LLPDD in 36.4% (8 subjects), 14% (3 subjects) and 4.5% (1 subject) of the cases respectively. 2) The items of irritability, anger and impatience were occurred most frequently on the DRF, when it was scored according to the three scoring methods. And the item of breast pain was next frequent according to the effect size method and the percent change method but according to the absolute severity method. 3) The PAF item of impaired social functioning was reported by 16 (73%) of the subjects. 4) 4 (18%) of the subjects met criteria A for LLPDD and reported impaired social functioning. The prevalency of LLPDD according to each method varied. The percent change method yielded the greatest (36.4%), and the absolute seventy method yielded the laest (4.5%), The effect size method yielded an intermediate frequency (14%). Therefore, for maximizing the diagnostic accuracy of LLPDD, a diagnostic procedure including a measure of change (e.q., effect size method, percent change method) as well as confirmed diagnosis by DRF, will be needed. Also, an accurate tool to evaluate impaired social functioning will be required.

• 대한핵의학회지
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• 제33권4호
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• pp.381-387
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• 1999

목적: 직업성 질병은 원인 규명과 함께 병의 진행정도를 정확히 평가하는 것이 중요하여 ILO에서 흉부 X-선 소견을 기준으로 국제표준화를 시행하여 왔으나 사진의 질에 영향을 받을 수 있고, 초기 병변을 발견하기에는 어려움이 많다. 본 연구자들은 Ga-67의 섭취정도를 규폐증의 진행 정도를 나타내는 지표로 이용하기 위하여 폐기능검사 및 흉부 X-선 소견에 의한 임상적 병기 분류와의 상관관계를 보고자하였다. 대상 및 방법: 25명의 규폐증 환자를 대상으로 Ga-67 신티그라피를 분석하였으며 10명의 정상인을 대조군으로 하였다. 검사방법은 Ga-67 citrate, 5 mCi를 정맥 주사한 후 48시간 후 전신 스캔 및 흉부, 복부 스캔 영상을 얻어 후면상에서 간과 폐병변의 최대 섭취 부위의 관심영역을 설정하여 픽셀당 방사능 섭취 정도의 비를 구하여 임상적 병기 분류와의 상관관계를 비교 분석하였다. 결과: L/L Ratio 값은 정상군 0형(n=10): $0.3948{\pm}.0692$0, 1형(n=10): $0.5763{\pm}$0.1837, 2형(n= 11): $0.6849{\pm}0.1459$, 3형(n=4): $0.9913{\pm}0.0712$였으며 흉부 X-선의 분류형과 서로 유의한 상관관계를 보였다(r=0.618, p<0.05). 그러나 L/L Ratio 값과 폐기능검사 지표와는 통계적으로 유의하지 않았다. 결론: 저자들의 연구에 따르면 규폐증의 진행과정을 평가하여 환자의 병기를 결정하는 데 Ga-67 신티그라피의 정량적인 분석이 도움을 주었다. 그러나 폐기능과는 상관관계가 없어 폐기능을 평가하는 지표가 되지 못하였다.

• 정신신체의학
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• 제26권2호
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• pp.194-200
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• 2018

연구목적 뇌 자기공명영상에서 발견된 백질변성의 소견은 인지기능 저하와 관련이 있다고 알려져 있지만 이의 중요성은 명확하게 밝혀진 바 없다. 본 연구는 뇌 자기공명영상에서 관찰되는 백질변성이 섬망의 심각도나 경과에 미치는 영향을 규명하기 위해 시행되었다. 방 법 섬망 삽화 전후에 뇌 자기공명영상이 촬영된 42명의 섬망 환자에 대하여 반정량적인 시각평가척도를 이용하여 뇌실주위 백질 고강도신호와 심부백질 고강도신호를 평가하였다. 이 고강도신호의 등급과 섬망평가척도 점수 간의 상관 관계를 분석하였고, 등급이 높은 군과 낮은 군으로 나누어 군에 따른 섬망평가척도 점수의 변화 차이를 추가로 분석하였다. 결 과 후두엽의 심부백질 고강도신호 등급과 섬망평가척도의 총점, 심각도 항목, 인지 항목 및 비인지 항목의 합과 양의 상관관계를 보였다. 또한 첫 평가와 추적 평가를 비교하였을 때 뇌실주위 백질 고강도신호의 등급이 낮은 군이 높은 군보다 섬망평가척도의 인지 항목 점수가 유의미한 경사로 가파르게 감소하였다. 결 론 뇌 백질 고강도신호 등급에 따라 섬망의 심각도와 호전 속도에 차이를 보이는 것은 뇌 백질변성이 대뇌 기능 연결성의 단절을 초래하여 유발한 결과로 볼 수 있다. 본 연구는 뇌 자기공명영상에서 발견된 고강도신호의 등급의 평가를 통해 섬망의 심각도와 경과를 예측해 볼 가능성이 있다는 점에서 임상적으로 유용할 수 있다.

• 재활치료과학
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• 제10권3호
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• pp.43-56
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• 2021

목적 : 본 연구에서는 허약노인의 정의를 정리하고, 허약노인 선별 시 사용되는 도구들을 분석함으로써 허약의 구성 요소를 제시하고자 한다. 연구방법 : 고령자에게 허약 선별 평가가 실시된 문헌을 검색하기 위해 CINAHL, Embase, Medline Complete, PubMed를 사용하였다. 검색어는 "assess" AND "frailty" AND "screening" AND ("frail elderly" OR "elderly")를 사용하였다. 결과 : 검색 결과로 얻은 539편의 문헌 중 선정기준에 부합하는 11편의 연구가 최종적으로 도출되었다. 본 고찰을 통해 허약은 다차원적 요인의 기능 저하로 인해 발생하며, 허약노인은 '건강 악화·기능손상·장애 발생의 가능성이 높고, 생명에 대한 위협 수준이 높은 사람'으로 정의되었다. 11편의 문헌 중 허약 선별 평가도구는 총 7종류로 Phenotype of frailty가 5편(45.4%)으로 가장 많이 사용되었다. 7개의 선별 평가도구에서 제시된 허약의 구성 요소는 신체적 요소(신체적 기능), 활동참여(일상생활활동, 수단적 일상생활활동), 영양상태(체중감소, 체질량 지수), 정신적 요소(인지, 정서), 사회적 요소(사회적 상호작용, 사회적지지, 사회적 환경), 전반적 건강 및 나이로 나타났다. 결론 : 본 연구를 통해 허약의 정의 및 구성 요소를 제시하였다. 이는 향후 허약노인 선별을 위한 표준화된 선별 평가도구 및 중재 프로그램 개발에 대한 기초자료가 될 것으로 사료된다.