130 research outputs found

    ๊ฐ‘์ƒ์„ ์•”์˜ 18F-Fluorodeoxyglucose PET ์„ญ์ทจ ์œ ๋ฌด์— ๋”ฐ๋ฅธ ์ž„์ƒ์†Œ๊ฒฌ, ๋ณ‘๋ฆฌ์†Œ๊ฒฌ ๋ฐ ์ดˆ์ŒํŒŒ ์†Œ๊ฒฌ์˜ ๋น„๊ต์— ๋Œ€ํ•œ ๊ณ ์ฐฐ

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    PURPOSE: We wanted to investigate the incidence and the clinicopathologic and sonographic characteristics of thyroid cancers that exhibit positive PET scans. MATERIALS AND METHODS: From January 2007 to February 2008, 156 patients with thyroid cancer underwent both sonography and FDG-PET for the purpose of staging the cancer. We conducted a retrospective review of their clinical, radiologic and pathologic records and we evaluated the incidence of PET-positive thyroid cancer, as well as the associated clinicopathologic aggressiveness and the sonographic features. RESULTS: The incidence of PET-positive thyroid carcinoma was 78.2% (122/156). On univariate analysis, PET-positive thyroid cancer was significantly associated with tumor size, extracapsular invasion and central lymph node metastasis, but there was no association between the sonographic features of the thyroid cancer or the sonographic features of the 2 groups of tumor (1. probably benign and 2. suspicious for malignancy) and the FDG uptake. Multivariate logistic regression analysis showed a significant association between PET positivity and both extrathyroidal extension and a higher cancer stage (III/IV) (p < 0.05). CONCLUSION: The incidence of PET positive thyroid carcinoma is high (78.2%) and PET positivity is significantly associated with tumor size, extracapsular extension and a higher stage. However, there is no significant association between PET positivity and the sonographic features of thyroid carcinomaope

    ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์™€ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์˜ ๊ด€๊ณ„์— ๋Œ€ํ•œ ์—ฐ๊ตฌ

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    ํ•™์œ„๋…ผ๋ฌธ (๋ฐ•์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› ์‚ฌ๋ฒ”๋Œ€ํ•™ ์ฒด์œก๊ต์œก๊ณผ, 2017. 8. ๊ถŒ์ˆœ์šฉ.Campbell, 1999Patton, 1990, 2002)์— ๊ทผ๊ฑฐํ•˜์—ฌ, ๋ฌด์šฉ๊ณ„์—์„œ ํ‰๊ท  20๋…„ ์ด์ƒ์˜ ๊ฒฝ๋ ฅ์„ ์ง€๋‹Œ ๊ตญ๋‚ด์™€ ํ•ด์™ธ์˜ ์ถค ๊ต๋ฅ˜์— ๋Œ€ํ•œ ์ „๋ฌธ์ง€์‹์ด ์žˆ๋Š” ์ž๋กœ์จ ๋ฌด์šฉ ์˜์—ญ์—์„œ ๋‚˜ํƒ€๋‚˜๋Š” ์ „์ง€๊ตฌํ™” ํ˜„์ƒ๊ณผ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์— ๋Œ€ํ•ด ๊ตฌ์ฒด์ ์ด๊ณ  ๋‹ค์–‘ํ•œ ์ฐจ์›์—์„œ ์„ค๋ช…ํ•  ์ˆ˜ ์žˆ๋Š” ํ˜„์žฅ ์ „๋ฌธ๊ฐ€ 19๋ช…(๋ฌด์šฉ ์˜ˆ์ˆ ๊ฐ€ 7๋ช…, ๋ฌด์šฉ ํ‰๋ก ๊ฐ€ 6๋ช…, ๋ฌด์šฉ ๊ธฐํš ๋ฐ ์ œ์ž‘์ž 6๋ช…)์„ ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž๋กœ ์„ ์ •ํ•˜์˜€๋‹ค. ์ž๋ฃŒ ์ˆ˜์ง‘์€ ๋ฌธํ—Œ ์กฐ์‚ฌ ๋ฐ ๊ณ ์ฐฐ, ์˜ˆ๋น„ ๋ฉด๋‹ด, ์‹ฌ์ธต ๋ฉด๋‹ด, ์ „๋ฌธ๊ฐ€ ํšŒ์˜๋ฅผ ํ†ตํ•ด ์ด๋ฃจ์–ด์กŒ๊ณ , ์ˆ˜์ง‘๋œ ์ž๋ฃŒ๋Š” ์ „์‚ฌ, ์„ธ๊ทธ๋ฉ˜ํŒ…, ์ฝ”๋”ฉ, ๋ฒ”์ฃผํ™”, ๋ถ„์„์˜ ์ ˆ์ฐจ๋ฅผ ํ†ตํ•ด ๋ถ„์„ ๋ฐ ํ•ด์„ํ•˜์—ฌ ๊ฒฐ๊ณผ๋ฅผ ๋„์ถœํ•˜์˜€๋‹ค. ์ž๋ฃŒ์˜ ์ˆ˜์ง‘๊ณผ ๋ถ„์„ ๋ฐ ํ•ด์„ ๊ณผ์ •์—์„œ ํƒ€๋‹น๋„์™€ ์‹ ๋ขฐ๋„๋ฅผ ๋†’์ด๊ธฐ ์œ„ํ•ด ์—ฐ๊ตฌ์ž์˜ ์„ฑ์ฐฐ, ์ „๋ฌธ๊ฐ€ ํšŒ์˜, ์‚ผ๊ฐ ์ธก์ •๋ฒ•, ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž ํ™•์ธ ๋“ฑ(Lincoln & Guba, 1985)์„ ์‹ค์‹œํ•˜์˜€๊ณ , ์—ฐ๊ตฌ์˜ ์œค๋ฆฌ์  ์ˆ˜ํ–‰์„ ์œ„ํ•ด CITI Program ์ˆ˜๋ฃŒ, ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž๋“ค์˜ ๊ถŒํ•œ๊ณผ ๊ถŒ๋ฆฌ ๋ณดํ˜ธ, ๊ฐœ์ธ ์ •๋ณด ๋ฐ ๋ฉด๋‹ด ๋‚ด์šฉ์˜ ์œ ์ถœ ์ฃผ์˜, ์ƒ๋ช… ์œค๋ฆฌ๋ฒ• ์ค€์ˆ˜ ๋“ฑ์— ์œ ์˜ํ•˜์˜€๋‹ค. ์ด์ƒ์˜ ๊ณผ์ •์„ ํ†ตํ•ด ๋„์ถœ๋œ ์—ฐ๊ตฌ๊ฒฐ๊ณผ ๋ฐ ๋…ผ์˜๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. ์ฒซ์งธ, ๋ฌด์šฉ ์ „๋ฌธ๊ฐ€๋“ค์€ ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”๋ฅผ ์ถค์˜ ๋ฌธํ™”์ƒํ’ˆํ™”, ์ถค์˜ ์ •๋ณดํ†ต์‹ ํ™”, ์ถค์˜ ๋„คํŠธ์›Œํฌํ™”, ์ถค์˜ ์ปจํ…œํฌ๋Ÿฌ๋ฆฌํ™”, ๊ทธ๋ฆฌ๊ณ  ์ถค์˜ ์—ญ์„ค๊ณต์กดํ™”์˜ ๋‹ค์„ฏ ๊ฐ€์ง€๋กœ ์ธ์‹ํ–ˆ๋‹ค. ์ถค์˜ ๋ฌธํ™”์ƒํ’ˆํ™”๋Š” ์ „์ง€๊ตฌํ™”์˜ ๋ณธ์งˆ์ด ์ž๋ณธ์ฃผ์˜ ์‹œ์žฅ๊ฒฝ์ œ๋ผ๋Š” ์ (Waters, 1995, 2001), ์ถค์˜ ์ •๋ณดํ†ต์‹ ํ™”๋Š” ํ†ต์‹ ์˜ ๋ฐœ๋‹ฌ๋กœ ์ธํ•ด ๋ฌผ๋ฆฌ์ ์ธ ์‹œยท๊ณต๊ฐ„์ด ์ „์ด๋˜๊ณ  ์‘์ถ•๋˜๋ฉด์„œ(Giddens, 1990, 1994Robertson, 1992, 2014Steger, 2003) ์›๊ฑฐ๋ฆฌ์—์„œ์˜ ๊ต๋ฅ˜๊ฐ€ ๊ฐ•ํ™”๋˜๊ณ  ์žˆ๋‹ค๋Š” ์ , ์ถค์˜ ๋„คํŠธ์›Œํฌํ™”๋Š” ๊ฐ ์ง€์—ญ์˜ ์ƒํ˜ธ์—ฐ๊ฒฐ์ด ์ฆ๋Œ€๋จ์— ๋”ฐ๋ผ ๊ตญ๊ฐ€ ๊ฐ„์˜ ๋„คํŠธ์›Œํฌ๊ฐ€ ๋”์šฑ ์ด˜์ด˜ํ•ด์ง€๊ณ  ์žˆ๋‹ค๋Š” ์ (Tomlinson, 1999), ์ถค์˜ ์ปจํ…œํฌ๋Ÿฌ๋ฆฌํ™”๋Š” ์„ธ๊ณ„ ๊ฐ๊ตญ์˜ ์ถค์ด ์ปจํ…œํฌ๋Ÿฌ๋ฆฌํ™” ๋˜๊ณ  ์žˆ๋‹ค๋Š” ์ (๊น€์˜ํฌ ์™ธ, 2014์žฅ๊ด‘๋ ฌ, 2014์žฅ์ธ์ฃผ, 2005Carino, 2004Fraleigh, 2010Gonales, 2011Solomon & Solomon, 1995Ya-ling, 2012๋ณธ ์—ฐ๊ตฌ์˜ ๋ชฉ์ ์€ ๋ฌด์šฉ์˜ ๊ตญ์ œ ๊ต๋ฅ˜ ํ˜„์žฅ์—์„œ ํ™œ๋™ํ•˜๋Š” ์ „๋ฌธ๊ฐ€๋“ค์ด ์ธ์‹ํ•˜๋Š” ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์™€ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ ๊ทธ๋ฆฌ๊ณ  ์ด ๋‘˜์˜ ๊ด€๊ณ„๋ฅผ ํƒ์ƒ‰ํ•˜๋Š” ๊ฒƒ์ด๋‹ค. ์—ฐ๊ตฌ๋ฌธ์ œ๋Š” ์ฒซ์งธ, ๋ฌด์šฉ ์ „๋ฌธ๊ฐ€๋“ค์€ ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”๋ฅผ ์–ด๋–ป๊ฒŒ ์ธ์‹ํ•˜๊ณ  ์žˆ๋Š”๊ฐ€? ๋‘˜์งธ, ๋ฌด์šฉ ์ „๋ฌธ๊ฐ€๋“ค์€ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์„ ์–ด๋–ป๊ฒŒ ์ธ์‹ํ•˜๊ณ  ์žˆ๋Š”๊ฐ€? ์…‹์งธ, ๋ฌด์šฉ ์ „๋ฌธ๊ฐ€๋“ค์€ ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์™€ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์˜ ๊ด€๊ณ„๋ฅผ ์–ด๋–ป๊ฒŒ ์ธ์‹ํ•˜๊ณ  ์žˆ๋Š”๊ฐ€? ์ด๋‹ค. ์ด์™€ ๊ฐ™์€ ์—ฐ๊ตฌ๋ฌธ์ œ๋ฅผ ๋ฐํžˆ๊ธฐ ์œ„ํ•ด ์งˆ์  ์—ฐ๊ตฌ๋ฐฉ๋ฒ•์„ ์‚ฌ์šฉํ•˜์˜€๊ณ , ํ˜„์ƒํ•™, ํ•ด์„ํ•™, ๊ทผ๊ฑฐ์ด๋ก ์˜ ์—ฐ๊ตฌ ๋…ผ๋ฆฌ์™€ ๊ธฐ๋ฒ•์— ๋”ฐ๋ผ 2014๋…„ 3์›”๋ถ€ํ„ฐ 2017๋…„ 5์›”๊นŒ์ง€ ์ด 3๋…„ 2๊ฐœ์›” ๋™์•ˆ ์—ฐ๊ตฌ๋ฅผ ์ˆ˜ํ–‰ํ•˜์˜€๋‹ค. ์ „ํ˜•์  ์‚ฌ๋ก€ ํ‘œ์ง‘, ์ค€๊ฑฐ ํ‘œ์ง‘, ์ด๋ก ์  ํ‘œ์ง‘(Glaser & Strauss, 1967Yang, 1995), ๋™์งˆยท๋‹ค์–‘, ์ „ํ†ตยทํ˜„๋Œ€, ๋ชจ๋ฐฉยท์ฐฝ์กฐ, ๋ณดํŽธยท๋…์ฐฝ์ด๋ผ๋Š” ์—ญ์„ค์ ์ธ ํŠน์„ฑ์ด ๊ณต์กดํ•˜๋Š” ์ถค์˜ ์—ญ์„ค๊ณต์กดํ™”๋Š” ์„ธ๊ณ„์˜ ๋ฌธํ™”๋Š” ํ•œํŽธ์œผ๋กœ ์ ์  ์œ ์‚ฌํ•ด์ง€๊ณ  ๋‹ค๋ฅธ ํ•œํŽธ์œผ๋กœ๋Š” ์ ์  ๋‹ค์–‘ํ•ด์ง€๊ณ  ์žˆ๋‹ค๋Š” ์ (Breidenbach & Zukrigl, 1998/2003), ์„ธ๊ณ„ ์—ฌ๋Ÿฌ ๋‚˜๋ผ์—์„œ ์ „ํ†ต์ถค์„ ํ˜„๋Œ€์  ๊ฐ๊ฐ์„ ํˆฌ์˜ํ•จ์œผ๋กœ์จ ์ƒˆ๋กญ๊ฒŒ ์žฌํ•ด์„ํ•˜๋Š” ๋…ธ๋ ฅ๋“ค์ด ์ด๋ฃจ์–ด์ง€๊ณ  ์žˆ๋‹ค๋Š” ์ (Fraleigh, 2010Hahn, 2014), ๊ตญ์ œ๋ฌด๋Œ€์— ์ง„์ถœํ•˜๋Š” ์—ฌ๋Ÿฌ ์ถค ์ž‘ํ’ˆ๋“ค์ด ๊ด€๊ฐ๊ณผ ์†Œํ†ตํ•  ์ˆ˜ ์žˆ๋Š” ๋ณดํŽธ์„ฑ๊ณผ ์˜ˆ์ˆ ์  ๋…์ฐฝ์„ฑ์„ ํ•จ๊ป˜ ์ง€๋‹ˆ๊ณ  ์žˆ๋‹ค๋Š” ์ (๊น€ํƒœ์›, 2011์‹ฌ์ •๋ฏผ, 2007์žฅ๊ด‘๋ ฌ, 2014)์—์„œ ๊ทธ ํƒ€๋‹น์„ฑ์„ ๊ฐ–๋Š”๋‹ค. ๋‘˜์งธ, ๋ฌด์šฉ ์ „๋ฌธ๊ฐ€๋“ค์€ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์„ ์–‘์‹์  ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ, ์˜ˆ์ˆ ์  ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ, ๊ฐ€์น˜์  ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์˜ ์„ธ ๊ฐ€์ง€๋กœ ์ธ์‹ํ–ˆ๋‹ค. ์–‘์‹์  ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์€ ์ •์‹ ยท๋ฏธํ•™ยท๊ธฐ๋Šฅ์  ์ฐจ์›์—์„œ ํ•œ๊ตญ์ถค ์–‘์‹์ด ์ง€๋‹ˆ๋Š” ํŠน์„ฑ์œผ๋กœ, ์ •์‹ ์  ์ฐจ์›์˜ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์€ ํ•œ๋ฏผ์กฑ์˜ ์‚ฌ์ƒ๊ณผ ์ •์‹ , ํ•œยทํฅยท์‹ ๋ช…์˜ ์ •์„œ์ด๊ณ , ๋ฏธํ•™์  ์ฐจ์›์˜ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์€ ์ •์ค‘๋™, ๊ณก์„ ๋ฏธ, ์กฐํ™”์„ฑยท์ฆ‰ํฅ์„ฑยท์ƒ์ง•์„ฑยทํ‘œํ˜„์„ฑ ๋“ฑ์ด๋ฉฐ, ๊ธฐ๋Šฅ์  ์ฐจ์›์˜ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์€ ์›€์ง์ž„ยทํ˜ธํก, ์žฅ๋‹จยท์Œ์•…, ์˜์ƒยท์†Œํ’ˆยท์†Œ๋„๊ตฌ ๋“ฑ์ด๋‹ค. ์˜ˆ์ˆ ์  ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์€ ์˜ˆ์ˆ ๊ฐ€์˜ ์ถค ์ฒ ํ•™์ด ์‹ค์ œ์ ์ธ ์ถค ํ–‰์œ„(์ถค ํ˜น์€ ์•ˆ๋ฌด)๋กœ ๋“œ๋Ÿฌ๋‚˜๋Š” ์˜ˆ์ˆ ์  ํŠน์„ฑ์ด๋‹ค. ๊ฐ€์น˜์  ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์€ ์ถค์„ ํ†ตํ•ด ์ถ”๊ตฌํ•˜๋Š” ์ด๋…์  ๊ฐ€์น˜๋ฅผ ๊ตฌ์ฒด์ ์ธ ์˜ˆ์ˆ  ํ–‰์œ„๋กœ ์‹ค์ฒœํ•˜๋Š” ๊ฒƒ์„ ์˜๋ฏธํ•œ๋‹ค. ๊ฒฐ๊ตญ, ๊ฐœ์ธ ์˜ˆ์ˆ ๊ฐ€ ๋ฐ ์ง‘๋‹จ์ด ์ถค์„ ํ†ตํ•ด ์ถ”๊ตฌํ•˜๋Š” ๊ฐ€์น˜์™€ ์ฒ ํ•™์€ ๊ตฌ์ฒด์ ์ธ ์˜ˆ์ˆ ์  ์ถค ํ–‰์œ„๋ฅผ ํ†ตํ•ด ๋“œ๋Ÿฌ๋‚˜๋ฉฐ, ์ด๋Š” ์ •์‹ , ๋ฏธํ•™, ๊ธฐ๋Šฅ์  ์ฐจ์›์—์„œ ๊ณ ์œ ํ•œ ํŠน์„ฑ์„ ์ง€๋‹Œ๋‹ค๋Š” ์ ์—์„œ ์–‘์‹์  ์ธก๋ฉด, ์˜ˆ์ˆ ์  ์ธก๋ฉด, ๊ฐ€์น˜์  ์ธก๋ฉด์˜ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์€ ์œ ๊ธฐ์ ์œผ๋กœ ์—ฐ๊ฒฐ๋œ๋‹ค. ์…‹์งธ, ๋ฌด์šฉ ์ „๋ฌธ๊ฐ€๋“ค์€ ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์™€ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์€ ํ•„์ˆ˜์ ์ธ ์˜ํ–ฅ๊ด€๊ณ„๊ฐ€ ์žˆ๋‹ค๋Š” ์ƒ์‘๊ด€๊ณ„, ๊ธ์ •์ ์ธ ํ˜ธํ˜œ๊ด€๊ณ„, ๋ถ€์ •์ ์ธ ๊ธธํ•ญ๊ด€๊ณ„์˜ ์„ธ ๊ฐ€์ง€๋กœ ์ธ์‹ํ–ˆ๋‹ค. ๋ชจ๋“  ์ „๋ฌธ๊ฐ€๋“ค์ด ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”๊ฐ€ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์„ ์‹œ๋Œ€์˜ ๋ณ€ํ™”์— ๋”ฐ๋ผ ์ƒˆ๋กญ๊ฒŒ ๊ตฌ์ถ•๋˜๋Š”์ƒ์„ฑ์  ์ •์ฒด์„ฑ์ด ๋˜๋„๋ก ์˜ํ–ฅ์„ ์ค€๋‹ค๋Š” ์ ์—์„œ ์ด ๋‘˜์˜ ๊ด€๊ณ„๋ฅผ ์ƒ์‘๊ด€๊ณ„๋กœ ์ธ์‹ํ–ˆ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ „๋ฌธ๊ฐ€๋“ค์˜ ์˜๊ฒฌ์€ ์ƒ์‘๊ด€๊ณ„ ๋‚ด์—์„œ๋„ ๊ธ์ •๊ณผ ๋ถ€์ •์œผ๋กœ ๋‚˜๋‰˜์—ˆ๋Š”๋ฐ, ๋Œ€๋ถ€๋ถ„์˜ ์ „๋ฌธ๊ฐ€๋“ค์€ ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”๊ฐ€๊ธ์ •์  ์ž๊ทน์ œ๋กœ์„œ ํ•œ๊ตญ ์ถค์˜ˆ์ˆ ์˜ ์žฌ์ฐฝ์กฐ๋ฅผ ์žฅ๋ คํ•œ๋‹ค๋Š” ์ ์—์„œ ๋‘˜์˜ ๊ด€๊ณ„๋ฅผ ํ˜ธํ˜œ์  ๊ด€๊ณ„๋กœ ๋ณด์•˜๊ณ , ์ผ๋ถ€ ์ „๋ฌธ๊ฐ€๋“ค๋งŒ์ด ์ถค์˜ˆ์ˆ ์˜ ๋™์งˆํ™”๋ฅผ ์˜ˆ๋กœ ๋“ค๋ฉฐ ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์™€ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์˜ ๊ด€๊ณ„๋ฅผ ๊ธธํ•ญ์ ์œผ๋กœ ์ธ์‹ํ–ˆ๋‹ค. ๋ฌธํ™”๋Š” ์ง€์†์  ๊ฒฐํ•ฉ๊ณผ ๋ถ„๋ฆฌ์˜ ๊ณผ์ •์„ ํ†ตํ•œ ๊ฐ€๋ณ€์  ํŠน์„ฑ์„ ์ง€๋‹ˆ๋ฉฐ(Pongs, 1999/2003), ์ „์ง€๊ตฌํ™”๋Š” ๋ฌธํ™”์  ์ฐจ์ด๋ฅผ ๋“œ๋Ÿฌ๋‚ด๋Š” ๋ฐฉ์‹๋งŒ์„ ์œ ์‚ฌํ•˜๊ฒŒ ๋งŒ๋“œ๋Š” ๊ฒƒ(Breidenbach & Zukrigl(1998/ 2003)์ด๋ผ๋Š” ์ , ๊ทธ๋ฆฌ๊ณ  ์„ธ๊ณ„๋กœ ํ™•์‚ฐ๋œ ๋ฌธํ™”๋Š” ๊ฐ ์ง€์—ญ์— ๋”ฐ๋ผ ๋‹ค์–‘ํ•œ ๋ฐฉ๋ฒ•์œผ๋กœ ํก์ˆ˜ยทํ•ด์„ยท์†Œ๋น„๋˜๊ธฐ ๋•Œ๋ฌธ์— ๋ฌธํ™”๋Š” ๋™์งˆํ™”๋  ์ˆ˜ ์—†์œผ๋ฉฐ ์ฐจ๋ณ„ํ™”๋˜๊ณ  ๋‹ค์–‘ํ™”๋œ๋‹ค(Roberton, 1995). ๊ฒฐ๊ตญ, ์„ธ๊ณ„ ์ถค์€ ๋ฏธ๊ตญ๊ณผ ์œ ๋Ÿฝ ์ฃผ๋„์˜ ์ปจํ…œํฌ๋Ÿฌ๋ฆฌํ™” ๊ฒฝํ–ฅ์„ ๋”ฐ๋ฆ„์œผ๋กœ์จ ๋™์งˆํ™”๋˜๊ณ  ์žˆ๋Š” ๊ฒƒ์ฒ˜๋Ÿผ ๋ณด์ด์ง€๋งŒ ์ด๋Š” ๊ธฐ๋Šฅ์ ์ด๊ณ  ํ˜•ํƒœ์ ์ธ ๋ชจ์Šต์ผ ๋ฟ์ด๋ฉฐ, ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์€ ํ•œ๊ตญ์˜ ๋ฌธํ™”์  ํŠน์„ฑ์„ ๋ฐ”ํƒ•์œผ๋กœ ์˜ˆ์ˆ ๊ฐ€๋“ค์˜ ๊ฐ๊ธฐ ๋‹ค๋ฅธ ๊ฒฝํ—˜๊ณผ ์ฒ ํ•™์— ์˜ํ•ด ์—ฌ์ „ํžˆ ๊ทธ ์ฐจ๋ณ„์„ฑ์„ ์ง€๋‹Œ๋‹ค. ๋„ท์งธ, ๋ฌด์šฉ ์ „๋ฌธ๊ฐ€๋“ค์€ ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์— ๋”ฐ๋ฅธ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ ์žฌ๊ฐœ๋…ํ™”๊ฐ€ ํ•„์š”ํ•˜๋‹ค๊ณ  ์ธ์‹ํ–ˆ๋‹ค. ์ด๋Š” ์„ธ ๊ฐ€์ง€๋กœ, ์ถค์˜ ์–‘์‹์  ์ธก๋ฉด์—์„œ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์„ ๋ฒ—์–ด๋‚œํ•œ๊ตญ์˜ ์ถค ์ •์ฒด์„ฑ, ์ถค์˜ ์˜ˆ์ˆ ์  ์ธก๋ฉด์—์„œ ๋ฌด์šฉ์˜ˆ์ˆ ์„ ๋ฒ—์–ด๋‚œ๊ณต์—ฐ์˜ˆ์ˆ  ์ •์ฒด์„ฑ, ์ถค์˜ ๊ฐ€์น˜์  ์ธก๋ฉด์—์„œ ์ „ํ†ต๊ณผ ํ˜„๋Œ€๋ฅผ ์•„์šฐ๋ฅด๊ณ  ํ•œ๊ตญ์ธ์˜ ๋ฌธํ™”์œ ์ „์ž๋ฅผ ๋“œ๋Ÿฌ๋‚ด๋Š”๋ฏผ์กฑ๋ฌธํ™” ์ •์ฒด์„ฑ์ด๋‹ค. ์ „๋ฌธ๊ฐ€๋“ค์€ ํ•œ๊ตญ ์ถค ์ •์ฒด์„ฑ ๊ตฌ์ถ•์ด ๊ตญ์ œ๋ฌด๋Œ€์—์„œ ๊ฒฝ์Ÿ๋ ฅ์„ ํ‚ค์šฐ๊ณ  ํ•œ๊ตญ์˜ ์ถค ์˜ˆ์ˆ ์„ ๋ฐœ์ „์‹œํ‚ฌ ์ˆ˜ ์žˆ๋Š” ๊ฐ€๋Šฅ์„ฑ๊ณผ ๊ธฐํšŒ๋ฅผ ์ œ๊ณตํ•ด ์ค€๋‹ค๋Š” ์ ์—์„œ ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”๋ฅผ ํฌ๋ง์ , ์ฃผ์ฒด์ , ์ ๊ทน์ ์œผ๋กœ ๋ฐ”๋ผ๋ณด์•˜๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋ฅผ ํ†ตํ•ด ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”๋Š” ์ถค์ด๋ผ๋Š” ์˜ˆ์ˆ ์„ ํŠน์ • ์žฅ๋ฅด ์•ˆ์— ๊ฐ€๋‘๋Š” ๊ฒƒ์ด ์•„๋‹Œ ์—ด๋ฆฐ ์‚ฌ๊ณ ์™€ ๋˜ ๋‹ค๋ฅธ ๊ฐ€๋Šฅ์„ฑ์„ ์œ„ํ•œ์ž์œ ์™€ ์†Œํ†ต์˜ ๊ณผ์ •์ด๋ผ๋Š” ๊ฒƒ, ๊ทธ๋ฆฌ๊ณ  ๋ฌด์šฉ ์ „์ง€๊ตฌํ™” ๊ณผ์ • ์†์˜ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์€ ์ „ํ†ต์ ์ด๊ณ  ๋ฏผ์†์  ๊ด€์ ์˜ ๊ฐœ๋…์—์„œ ๋ฒ—์–ด๋‚˜ ๋™์‹œ๋Œ€์  ์ฐจ์›์˜ ์˜ˆ์ˆ ๋กœ, ํ•œ๊ตญ์ด๋ผ๋Š” ๊ณต๊ฐ„์—์„œ ํ•œ๊ตญ์ธ์— ์˜ํ•ด ๋ฐœ์ „๋˜๋Š” ๋ชจ๋“  ์ถค์ด๋ผ๋Š” ๊ด‘์˜์  ๊ฐœ๋…์œผ๋กœ ์ดํ•ด๋˜์–ด์•ผ ํ•จ์ด ๋“œ๋Ÿฌ๋‚ฌ๋‹ค. ํ•œ๊ตญ ์ถค ์ •์ฒด์„ฑ๊ณผ ๊ด€๋ จํ•˜์—ฌ ๋ชจ๋“  ์˜ˆ์ˆ ๊ฐ€๋“ค์—๊ฒŒ ํ•„์š”ํ•œ ๊ฒƒ์€ ํ•œ๊ตญ์ธ ์˜ˆ์ˆ ๊ฐ€๋กœ์„œ ์ถค์„ ๋ฐ”๋ผ๋ณด๋Š” ๊ด€์ ๊ณผ ์ฒ ํ•™์˜ ๊ธฐ์ €์— ์œ„์น˜ํ•œ ํ•œ๊ตญ์˜ ์ „ํ†ต๋ฌธํ™”์— ๋Œ€ํ•œ ์˜ฌ๋ฐ”๋ฅธ ์ง€์‹๊ณผ ๊ทธ ๊ฐ€์น˜๋ฅผ ์†Œ์ค‘ํžˆ ์—ฌ๊ธฐ๋Š” ์ž์„ธ๋‹ค. ํƒ€ ๋ฌธํ™”์˜ˆ์ˆ ์„ ์ˆ˜์šฉํ•˜๋Š” ์—ด๋ฆฐ ์ž์„ธ๋Š” ์ „์ง€๊ตฌํ™”๋ฅผ ์‚ด์•„๊ฐ€๋Š” ์šฐ๋ฆฌ์—๊ฒŒ ์žˆ์–ด ํ•„์ˆ˜์ ์ธ ๋ฏธ๋•์ด์ง€๋งŒ, ์ด์™€ ํ•จ๊ป˜ ๊ฐ•์กฐ๋˜์–ด์•ผ ํ•  ๊ฒƒ์€ ์ž๊ตญ์˜ ๋ฌธํ™”์— ๋Œ€ํ•œ ์ž๋ถ€์‹ฌ์œผ๋กœ, ํ•œ๊ตญ ์ „ํ†ต์ถค์„ ํฌํ•จํ•œ ์ „ํ†ต๋ฌธํ™”๊ฐ€ ์†Œํ™€ํžˆ ๋‹ค๋ฃจ์–ด์ ธ์„œ๋Š” ์•ˆ ๋œ๋‹ค. ํ•œ๊ตญ ์ถค ์ •์ฒด์„ฑ ๊ตฌ์ถ•์€ ์˜ˆ์ˆ ๊ฐ€๋“ค๋งŒ์˜ ๋ฌธ์ œ๊ฐ€ ์•„๋‹ˆ๋ฉฐ, ์‚ฌํšŒ๋ฌธํ™”์˜ ์ „๋ฐ˜์  ํ™˜๊ฒฝ๊ณผ ๋ฐ€์ ‘ํ•˜๊ฒŒ ์—ฐ๊ฒฐ๋œ๋‹ค. ๊ทธ๋ ‡๊ธฐ ๋•Œ๋ฌธ์— ๊ต์œก์ œ๋„, ์ง€์›์ œ๋„, ๊ณต์—ฐ์˜ˆ์ˆ ํ˜„์žฅ, ์ €๋„๋ฆฌ์ฆ˜, ์ถค์˜ˆ์ˆ ์„ ๋ฐ”๋ผ๋ณด๋Š” ์‚ฌํšŒ๋ฌธํ™”์  ์ธ์‹์ด ์ผ์ •ํ•œ ์ˆ˜์ค€์œผ๋กœ ๋ฐœ์ „ํ•˜๊ณ  ์œ ๊ธฐ์ ์œผ๋กœ ์กฐํ™”๋ฅผ ์ด๋ฃฐ ๋•Œ ํ•œ๊ตญ ์ถค ์ •์ฒด์„ฑ์€ ๋ณด๋‹ค ๋ฐœ์ „์ ์ธ ๋ฐฉํ–ฅ์œผ๋กœ ํ˜•์„ฑ๋  ์ˆ˜ ์žˆ๋‹ค. ํ•œ๊ตญ ์˜ˆ์ˆ ๊ณ„ ์ „์ฒด์˜ ๋ฐœ์ „์„ ์œ„ํ•ด์„œ๋Š” ๋ฌด์šฉ๊ณ„์˜ ๋ฐœ์ „์ด ์ด๋ฃจ์–ด์ ธ์•ผ ํ•˜๊ณ , ๋ฌด์šฉ๊ณ„์˜ ๋ฐœ์ „์„ ์ด๋ฃจ๊ธฐ ์œ„ํ•ด์„œ๋Š” ๋ฌด์šฉ๊ณ„์— ๋ชธ๋‹ด๊ณ  ์žˆ๋Š” ๋ชจ๋“  ์ด๋“ค์˜ ๋…ธ๋ ฅ์ด ๋ชจ์•„์ ธ์•ผ ํ•œ๋‹ค. ์ง‘๋‹จ์  ์ด๊ธฐ์ฃผ์˜๋ฅผ ์ง€์–‘ํ•˜๊ณ  ์„œ๋กœ๊ฐ€ ์„œ๋กœ๋ฅผ ์ธ์ •ํ•ด์ฃผ๊ณ  ๊ฒฉ๋ คํ•ด์ฃผ๋Š” ์˜ˆ์ˆ ๊ณต๋™์ฒด์˜์‹, ์ถค๊ณผ ์˜ˆ์ˆ ์„ ์‚ฌ๋ž‘ํ•˜๋Š” ๋งˆ์Œ, ๊ทธ๋ฆฌ๊ณ  ๋‹ค๋ฅธ ์ด๋“ค์˜ ์žฅ์ ์„ ์ˆ˜์šฉํ•˜๊ณ  ๋ฐ›์•„๋“ค์ž„์œผ๋กœ์จ ๋ฐœ์ „ํ•ด ๋‚˜๊ฐ€๋Š” ์—ด๋ฆฐ ๋งˆ์Œ์€ ํ•œ๊ตญ์˜ ์ถค์˜ˆ์ˆ ์„ ์„ฑ์žฅ์‹œํ‚ฌ ์ˆ˜ ์žˆ๋Š” ์—ด์‡ ๋‹ค. ํ›„์† ์—ฐ๊ตฌ๋Š” ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์™€ ํ•œ๊ตญ ์ถค ์ •์ฒด์„ฑ์˜ ๋‘ ๊ฐ€์ง€ ์ฃผ์ œ๋ฅผ ๋ถ„๋ฆฌํ•ด์„œ ์ง„ํ–‰ํ•  ์ˆ˜ ์žˆ๋‹ค. ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์— ๊ด€ํ•œ ํ›„์† ์—ฐ๊ตฌ๋กœ๋Š” ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์— ๊ด€ํ•œ ๊ตญ๋‚ด ๋ฌด์šฉ ์ด๋ก ๊ฐ€, ๋ฌด์šฉ ์ „๊ณต ํ•™์ƒ, ์ผ๋ฐ˜์ธ, ํ•ด์™ธ ๋ฌด์šฉ ์ „๋ฌธ๊ฐ€ ๋“ฑ์„ ์ค‘์‹ฌ์œผ๋กœ ํ•œ ์ธ์‹ ์—ฐ๊ตฌ, ์ถค์˜ ๋ฌธํ™”์ƒํ’ˆํ™”ยท์ •๋ณดํ†ต์‹ ํ™”ยท๋„คํŠธ์›Œํฌํ™”ยท์ปจํ…œํฌ๋Ÿฌ๋ฆฌํ™”ยท์—ญ์„ค๊ณต์กดํ™”์— ๊ด€ํ•œ ์ธ์ง€ ์ˆ˜์ค€์„ ๋ฐํžˆ๋Š” ์–‘์  ์—ฐ๊ตฌ ๋“ฑ์ด ์žˆ๊ณ , ํ•œ๊ตญ ์ถค ์ •์ฒด์„ฑ์— ๊ด€ํ•œ ํ›„์† ์—ฐ๊ตฌ๋กœ๋Š” ํ•œ๊ตญ ์ถค ์ •์ฒด์„ฑ์˜ ๊ตฌ์ถ•๊ณผ์ •๊ณผ ์˜ํ–ฅ ์š”์ธ์„ ๋ฐํžˆ๋Š” ์—ฐ๊ตฌ, ๋ฌด์šฉ ์˜ˆ์ˆ ๊ฐ€ ๋ฐ ๋ฌด์šฉ ๋‹จ์ฒด๋“ค์˜ ํ•œ๊ตญ ์ถค ์ •์ฒด์„ฑ์— ๊ด€ํ•œ ์–‘์  ์—ฐ๊ตฌ, ๊ฐœ์ธ ๋ฐ ์ง‘๋‹จ์˜ ํ•œ๊ตญ ์ถค ์ •์ฒด์„ฑ์— ๋Œ€ํ•œ ์‚ฌ๋ก€์—ฐ๊ตฌ ๋“ฑ์ด ์žˆ๋‹ค.โ… . ์„œ ๋ก  1 1. ์—ฐ๊ตฌ์˜ ํ•„์š”์„ฑ 1 2. ์—ฐ๊ตฌ์˜ ๋ชฉ์  5 3. ์—ฐ๊ตฌ๋ฌธ์ œ 6 4. ์šฉ์–ด์˜ ์ •์˜ 6 5. ์—ฐ๊ตฌ์˜ ์ œํ•œ์  7 โ…ก. ์ด๋ก ์  ๋ฐฐ๊ฒฝ 8 1. ์ „์ง€๊ตฌํ™” 8 ๊ฐ€. ์ „์ง€๊ตฌํ™”์˜ ์ •์˜ ๋ฐ ๊ฐœ๋… 8 ๋‚˜. ์ „์ง€๊ตฌํ™”์˜ ์—ญ์‚ฌ 18 ๋‹ค. ์ „์ง€๊ตฌํ™”์˜ ์ฐจ์› 22 1) ๊ฒฝ์ œ์˜ ์ „์ง€๊ตฌํ™” 22 2) ์ •์น˜์˜ ์ „์ง€๊ตฌํ™” 24 3) ๋ฌธํ™”์˜ ์ „์ง€๊ตฌํ™” 26 ๋ผ. ์ „์ง€๊ตฌํ™”์— ๋Œ€ํ•œ ๊ด€์ : ๋ฌธํ™”์˜ ๋™์งˆํ™” vs. ๋‹ค์–‘ํ™” 29 1) ๋ถ€์ •์  ๊ด€์ : ๋ฌธํ™”์˜ ๋™์งˆํ™” 29 2) ๊ธ์ •์  ๊ด€์ : ๋ฌธํ™”์˜ ๋‹ค์–‘ํ™” 31 2. ๋ฌด์šฉ ์ „์ง€๊ตฌํ™” 36 ๊ฐ€. ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์˜ ์ดํ•ด 36 1) ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์˜ ๊ฐœ๋… 36 2) ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์— ๋‚ด์žฌ๋œ local๊ณผ global์˜ ๊ด€๊ณ„์„ฑ 37 ๋‚˜. ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์˜ ์—ญ์‚ฌ 39 1) ํ•œ๊ตญ์ถค ์ „์ง€๊ตฌํ™”์˜ ์—ญ์‚ฌ 41 2) ๋ฐœ๋ ˆ ์ „์ง€๊ตฌํ™”์˜ ์—ญ์‚ฌ 46 3) ํ˜„๋Œ€๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์˜ ์—ญ์‚ฌ 47 ๋‹ค. ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์˜ ํŠน์ง• 52 1) ์ง€์—ญ ์ถค์˜ ๋ณ€ํ™” 52 ๊ฐ€) ์ง€์—ญ ์ถค์˜ ์œ„์ถ•ยท์†Œ๋ฉธ 53 ๋‚˜) ์ง€์—ญ ์ถค์˜ ์žฌ๋ถ€ํฅยท๊ฐ•ํ™” 54 ๋‹ค) ์ง€์—ญ ์ถค์˜ ๋ณ€ํ˜•ยท์žฌ์ฐฝ์กฐ 56 2) ์ง€์—ญ ์ถค๊ณผ ์˜ˆ์ˆ ๊ฐ€์˜ ํ•ด์™ธ ์ง„์ถœ ์ฆ๊ฐ€ 58 ๊ฐ€) ์ง€์—ญ ์ถค์˜ˆ์ˆ ์˜ ํ•ด์™ธ ์ง„์ถœ ์ฆ๊ฐ€ 58 ๋‚˜) ์ง€์—ญ ๋ฌด์šฉ์˜ˆ์ˆ ๊ฐ€ ๋ฐ ๋‹จ์ฒด์˜ ํ•ด์™ธ ์ง„์ถœ ์ฆ๊ฐ€ 59 3) ๋ฌด์šฉ ๊ตญ์ œ๊ต๋ฅ˜ ๋ฐ ๋„คํŠธ์›Œํฌ ๊ฐ•ํ™” 62 ๊ฐ€) ๊ตญ์ œ๋ฌด์šฉ์ด๋ฒคํŠธ 64 (1) ๊ตญ์ œ๋ฌด์šฉ์ถ•์ œ 64 (2) ์•„ํŠธยท๋Œ„์Šค ๋งˆ์ผ“ ๋ฐ ํ”Œ๋žซํผ 70 (3) ๊ตญ์ œ ๋ฌด์šฉ ๊ฒฝ์—ฐ๋Œ€ํšŒ 73 (4) ๊ธฐํƒ€ ๊ตญ์ œ๋ฌด์šฉ์ด๋ฒคํŠธ 75 ๋‚˜) ๋ฌด์šฉ ๊ตญ์ œ๊ต๋ฅ˜ ์‚ฌ์—… 76 (1) ๊ตญ์ œ ๋ ˆ์ง€๋˜์‹œ ํ”„๋กœ๊ทธ๋žจ 76 (2) ๊ตญ์ œ ๋ฌด์šฉ๊ต๋ฅ˜ ํ”„๋กœ๊ทธ๋žจ 80 ๋‹ค) ๊ตญ์ œ ํ˜‘์—… 82 ๋ผ) ๊ตญ์ œ๋ฌด์šฉ๊ธฐ๊ตฌ ๋ฐ ์ปค๋ฎค๋‹ˆํ‹ฐ 84 4) ํ˜ผ์„ฑ์  ๋ฌด์šฉ์ž‘ํ’ˆ ์ฆ๊ฐ€ 88 ๊ฐ€) ์›€์ง์ž„ ์œตํ•ฉ 90 ๋‚˜) ๋ฌธํ™”์˜ˆ์ˆ ์  ์š”์†Œ ์œตํ•ฉ 90 5) ์ •๋ณดํ†ต์‹ ๊ธฐ์ˆ (ICT)์˜ ๋‹ค์–‘ํ•œ ํ™œ์šฉ 92 ๊ฐ€) Computer Technology ํ™œ์šฉ 94 ๋‚˜) Internet Media๋ฅผ ํ†ตํ•œ ์ถค์ •๋ณด ๊ณต์œ  ๋ฐ ์†Œํ†ต ๊ฐ•ํ™” 94\ 3. ์ •์ฒด์„ฑ 97 ๊ฐ€. ์ •์ฒด์„ฑ์˜ ๊ฐœ๋… 97 ๋‚˜. ๋ฌธํ™” ์ •์ฒด์„ฑ 99 1) ๋ฌธํ™” ์ •์ฒด์„ฑ์˜ ๊ฐœ๋… 99 2) ์ „์ง€๊ตฌํ™”์™€ ๋ฌธํ™” ์ •์ฒด์„ฑ 101 4. ์ถค ์ •์ฒด์„ฑ 106 ๊ฐ€. ์ถค ์ •์ฒด์„ฑ์˜ ๊ฐœ๋… 106 ๋‚˜. ์ถค์˜ ๋ณธ์งˆ์  ํŠน์„ฑ 107 ๋‹ค. ์ถค ์ •์ฒด์„ฑ์˜ ์ฐจ์› 110 1) ์–‘์‹์— ๋”ฐ๋ฅธ ์ถค ์ •์ฒด์„ฑ 111 ๊ฐ€) ๋ฐœ๋ ˆ์˜ ์ •์ฒด์„ฑ 111 ๋‚˜) ํ˜„๋Œ€๋ฌด์šฉ์˜ ์ •์ฒด์„ฑ 112 ๋‹ค) ์ปจํ…œํฌ๋Ÿฌ๋ฆฌ ๋Œ„์Šค์˜ ์ •์ฒด์„ฑ 113 2) ๋Œ€์ƒ์— ๋”ฐ๋ฅธ ์ถค ์ •์ฒด์„ฑ 114 ๊ฐ€) ์ง‘๋‹จ์  ์ฐจ์›์˜ ์ถค ์ •์ฒด์„ฑ 114 (1) ๊ตญ๊ฐ€์˜ ์ถค ์ •์ฒด์„ฑ 116 (2) ๋ฌด์šฉ ๋‹จ์ฒด์˜ ์ถค ์ •์ฒด์„ฑ 119 ๋‚˜) ๊ฐœ์ธ์  ์ฐจ์›์˜ ์ถค ์ •์ฒด์„ฑ 121 (1) ๋ฌด์šฉ์ˆ˜์˜ ์ถค ์ •์ฒด์„ฑ 122 (2) ์•ˆ๋ฌด๊ฐ€์˜ ์ถค ์ •์ฒด์„ฑ 123 3) ์ž‘ํ’ˆ์— ๋”ฐ๋ฅธ ์ถค ์ •์ฒด์„ฑ 126 ๋ผ. ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์™€ ์ถค ์ •์ฒด์„ฑ 129 5. ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ 132 ๊ฐ€. ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์˜ ๊ฐœ๋… 132 ๋‚˜. ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์— ๋Œ€ํ•œ ๊ด€์  132 1) ์ „ํ†ตยท๋ฏผ์†ํ•™์  ๊ด€์  133 2) ๋™์‹œ๋Œ€์  ๊ด€์  169 ๋‹ค. ์™ธ๊ตญ์ธ๋“ค์ด ์ธ์‹ํ•˜๋Š” ํ•œ๊ตญ์ถค์˜ ํŠน์ง• 143 ๋ผ. ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์™€ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ 152 โ…ข. ์—ฐ๊ตฌ ๋ฐฉ๋ฒ• 156 1. ์—ฐ๊ตฌ์˜ ๋…ผ๋ฆฌ ๋ฐ ๊ธฐ๋ฒ• 156 2. ์—ฐ๊ตฌ์˜ ์ ˆ์ฐจ ๋ฐ ๋‹จ๊ณ„ 157 3. ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž 160 ๊ฐ€. ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž ํ‘œ์ง‘ ๋ฐฉ๋ฒ• 160 ๋‚˜. ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž ์„ ์ • ๊ธฐ์ค€ 161 ๋‹ค. ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž ์ •๋ณด 162 4. ์ž๋ฃŒ ์ˆ˜์ง‘ 162 ๊ฐ€. ๋ฌธํ—Œ ์กฐ์‚ฌ ๋ฐ ๊ณ ์ฐฐ 162 ๋‚˜. ์˜ˆ๋น„ ๋ฉด๋‹ด 165 ๋‹ค. ์‹ฌ์ธต ๋ฉด๋‹ด 165 ๋ผ. ์ „๋ฌธ๊ฐ€ ํšŒ์˜ 167 5. ์ž๋ฃŒ ๋ถ„์„ ๋ฐ ํ•ด์„ 168 6. ์—ฐ๊ตฌ์˜ ์ง„์‹ค์„ฑ๊ณผ ์œค๋ฆฌ 169 โ…ฃ. ์—ฐ๊ตฌ๊ฒฐ๊ณผ ๋ฐ ๋…ผ์˜ 171 1. ๋ฌด์šฉ ์ „์ง€๊ตฌํ™” 171 ๊ฐ€. ์ถค์˜ ๋ฌธํ™”์ƒํ’ˆํ™” 173 ๋‚˜. ์ถค์˜ ์ •๋ณดํ†ต์‹ ํ™” 177 ๋‹ค. ์ถค์˜ ๋„คํŠธ์›Œํฌํ™” 178 ๋ผ. ์ถค์˜ ์ปจํ…œํฌ๋Ÿฌ๋ฆฌํ™” 183 ๋งˆ. ์ถค์˜ ์—ญ์„ค๊ณต์กดํ™” 189 1) ๋™์งˆ ยท ๋‹ค์–‘ 189 2) ์ „ํ†ต ยท ํ˜„๋Œ€ 193 3) ๋ชจ๋ฐฉ ยท ์ฐฝ์กฐ 197 4) ๋ณดํŽธ ยท ๋…์ฐฝ 199 2. ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ 203 ๊ฐ€. ์–‘์‹์  ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ 205 1) ์ •์‹ ์  ์ฐจ์› 206 ๊ฐ€) ํ•œ๋ฏผ์กฑ์˜ ์‚ฌ์ƒ๊ณผ ์ •์‹  206 ๋‚˜) ํ•œ, ํฅ, ์‹ ๋ช…์˜ ์ •์„œ 207 2) ๋ฏธํ•™์  ์ฐจ์› 208 ๊ฐ€) ์ •์ค‘๋™ 208 ๋‚˜) ๊ณก์„ ๋ฏธ 209 ๋‹ค) ์กฐํ™”์„ฑ, ์ฆ‰ํฅ์„ฑ, ์ƒ์ง•์„ฑ, ํ‘œํ˜„์„ฑ ๋“ฑ 209 3) ๊ธฐ๋Šฅ์  ์ฐจ์› 211 ๊ฐ€) ์›€์ง์ž„ ยท ํ˜ธํก 211 ๋‚˜) ์žฅ๋‹จ ยท ์Œ์•… 214 ๋‹ค) ์˜์ƒ ยท ์†Œ๋„๊ตฌ ยท ์†Œํ’ˆ 215 ๋‚˜. ์˜ˆ์ˆ ์  ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ 217 1) ์ฒ ํ•™์  ์ฐจ์› 218 2) ์‹ค์žฌ์  ์ฐจ์› 221 ๋‹ค. ๊ฐ€์น˜์  ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ 228 1) ์ด๋…์  ์ฐจ์› 229 2) ์‹ค์ฒœ์  ์ฐจ์› 233 3. ๋ฌด์šฉ ์ „์ง€๊ตฌํ™”์™€ ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์˜ ๊ด€๊ณ„ 237 ๊ฐ€. ์ƒ์‘๊ด€๊ณ„ 238 ๋‚˜. ํ˜ธํ˜œ๊ด€๊ณ„ 241 ๋‹ค. ๊ธธํ•ญ๊ด€๊ณ„ 244 4. ํ•œ๊ตญ์ถค ์ •์ฒด์„ฑ์˜ ์žฌ๊ฐœ๋…ํ™” 250 ๊ฐ€. ์–‘์‹์  ์ธก๋ฉด: ํ•œ๊ตญ์˜ ์ถค ์ •์ฒด์„ฑ 253 ๋‚˜. ์˜ˆ์ˆ ์  ์ธก๋ฉด: ๊ณต์—ฐ์˜ˆ์ˆ  ์ •์ฒด์„ฑ 256 ๋‹ค. ๊ฐ€์น˜์  ์ธก๋ฉด: ๋ฏผ์กฑ๋ฌธํ™” ์ •์ฒด์„ฑ 259 โ…ค. ๊ฒฐ๋ก  ๋ฐ ์ œ์–ธ 265 1. ๊ฒฐ๋ก  265 2. ์ œ์–ธ 266 ์ฐธ๊ณ ๋ฌธํ—Œ 270 ๋ถ€ ๋ก 300 Abstract 314Docto

    ๋ฉ•์‹œ์ฝ” ์‚ฌํŒŒํ‹ฐ์Šคํƒ€ ์›์ฃผ๋ฏผ๋“ค์˜ ๋ฒฝํ™”

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    ๋ฒฝํ™”์˜ ๋‚˜๋ผ ๋ฉ•์‹œ์ฝ”. ์ง€๊ธˆ๋„ ๊ทธ๊ณณ์— ๋Š” ๊ด€๊ณต์„œ๋‚˜ ์ง€ํ•˜์ฒ ์ด๋‚˜ ๋Œ€ํ•™์ด๋‚˜ ์ผ๋ฐ˜ ๊ฑด๋ฌผ์— ๊ฐ€๋ฉด ์†์‰ฝ๊ฒŒ ๋ฒฝํ™”๋ฅผ ๋งŒ๋‚  ์ˆ˜ ์žˆ ๋‹ค. ์ด๋Ÿฐ ๋ฉ•์‹œ์ฝ”์— ์ „ํ˜€ ๋‹ค๋ฅธ ๋ฒฝํ™”๊ฐ€ ๋‚˜ ํƒ€๋‚ฌ๋‹ค. ๋ฐ”๋กœ ๋ฉ•์‹œ์ฝ” ์น˜์•„ํŒŒ์Šค ์ฃผ์˜ ์‚ฌ ํŒŒํ‹ฐ์Šคํƒ€ ๋ฒฝํ™”์ด๋‹ค. ์ด ๋ฒฝํ™”๋Š” ์ง€๋ช…๋„ ๋†’์€ ์˜ˆ์ˆ ๊ฐ€๋“ค์ด ๊ณต๊ณต์˜ ๋ฒฝ์— ํŽผ์ณ๋†“์€ ๊ณต์ธ๋œ ๋ฉ•์‹œ์ฝ”๋ฒฝํ™”ํ•˜๊ณ ๋Š” ๊ทธ ํƒœ์ƒ๋ถ€ํ„ฐ ๊ฐ€ ๋‹ค๋ฅด๋‹ค. ์ด๋ฆ„ ์—†๋Š” ๋ฏผ์ดˆ๋“ค์ด ํ•˜๋‚˜๋‘˜ ์”ฉ ๋ชจ์—ฌ์„œ ํ—ˆ๋ฆ„ํ•œ ๋ฒฝ๋Œ์ง‘ ์™ธ๋ฒฝ์— ๋“ค์ญ‰๋‚  ์ญ‰ ์•Œ๋ก๋‹ฌ๋กํ•˜๊ฒŒ ๊ทธ๋ ค๋†“์•˜๊ธฐ ๋•Œ๋ฌธ์ด๋‹ค..

    Components in methanol extracts from yuja seeds and yuja seed oil and their anti-proliferative effects on HT-29 human colon cancer cells

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์‹ํ’ˆ์˜์–‘ํ•™๊ณผ, 2014. 8. ํ™ฉ๊ธˆํƒ.์œ ์ž(Citrus junos)๋Š” ๋‹ค์–‘ํ•œ ์ƒ๋ฆฌํ™œ์„ฑ ๊ธฐ๋Šฅ์„ ๊ฐ–๊ณ  ์žˆ์–ด ํ•œ๊ตญ์„ ํฌํ•จํ•œ ์•„์‹œ์•„ ์ง€์—ญ์—์„œ ๋„๋ฆฌ ์†Œ๋น„๋˜๊ณ  ์žˆ๋Š” ๊ฐ๊ทค๋ฅ˜ ๊ณผ์ผ์ด๋‹ค. ๊ตญ๋‚ด์—์„œ ์†Œ๋น„๋˜๋Š” ์œ ์ž์˜ ๋Œ€๋ถ€๋ถ„์€ ์œ ์ž์ฒญ์˜ ํ˜•ํƒœ๋กœ ๊ฐ€๊ณต๋˜์–ด ์ด์šฉ๋˜๊ณ  ์žˆ๋‹ค. ์ด ๊ณผ์ •์—์„œ ๋ถ€์‚ฐ๋ฌผ๋กœ ์ƒ์„ฑ๋˜๋Š” ์œ ์ž์”จ๋Š” ์ง€์งˆ์„ ๋‹ค๋Ÿ‰ ํฌํ•จํ•˜๊ณ  ์žˆ์–ด, ์œ ์ž์”จ์—์„œ ์œ ์ง€๋ฅผ ์ฐฉ์œ ํ•˜์—ฌ ์‹์šฉ๊ณผ ๋ฏธ์šฉ์— ์ด์šฉ๋œ๋‹ค. ๋ณธ ์—ฐ๊ตฌ์˜ ๋ชฉ์ ์€ ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€ ์ถ”์ถœ๋ฌผ์˜ ์ธ๊ฐ„ ๋Œ€์žฅ์•”์„ธํฌ(HT-29)์— ๋Œ€ํ•œ ์•”์„ธํฌ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ๋ฅผ ํ™•์ธํ•˜๊ณ , ์ด ์–ต์ œ ํšจ๊ณผ์— ์˜ํ–ฅ์„ ์ฃผ๋Š” ์ฃผ์š” ๋ฌผ์งˆ์„ ํ™•์ธํ•˜๋ฉฐ, ์ด๋ฅผ ํ†ตํ•˜์—ฌ ์‹ํ’ˆ๊ณผ ์˜์•ฝ ์‚ฐ์—…์—์„œ์˜ ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€์˜ ํ™œ์šฉ์„ ์œ„ํ•œ ๊ธฐ์ดˆ๋ฅผ ์ œ๊ณตํ•˜๊ณ ์ž ํ•˜๋Š” ๊ฒƒ์ด๋‹ค. ์œ ์ž์”จ์™€ ํ—ฅ์‚ฐ ์ถ”์ถœ ์œ ์ž์”จ ์œ ์ง€์™€ ๋ƒ‰์••์ฐฉ ์œ ์ž์”จ ์œ ์ง€๋กœ๋ถ€ํ„ฐ 60% ๋ฉ”ํƒ„์˜ฌ์„ ์ด์šฉํ•˜์—ฌ ์ถ”์ถœ๋ฌผ์„ ์–ป์€ ํ›„, HPLC-MS๋กœ ์ถ”์ถœ๋ฌผ์˜ ์กฐ์„ฑ์„ ๋ถ„์„ํ•˜๊ณ , HT-29 ์„ธํฌ์—์˜ ์ฒ˜๋ฆฌ๋ฅผ ํ†ตํ•ด ์ถ”์ถœ๋ฌผ์˜ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ๋ฅผ ํ™•์ธํ•˜์˜€๋‹ค. ๊ทธ๋ฆฌ๊ณ  preparative LC๋กœ ์ถ”์ถœ๋ฌผ์„ ๋ถ„ํšํ•˜์—ฌ ๋ถ„ํš๋ฌผ์˜ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ์™€ ์กฐ์„ฑ์„ ํ™•์ธํ•˜์˜€๋‹ค. ๋˜ํ•œ, ํšจ๊ณผ๊ฐ€ ์žˆ๋Š” ๋ถ„ํš๋ฌผ ๋‚ด์˜ ์ฃผ์š” ์„ฑ๋ถ„์˜ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ์™€ ์กฐ์„ฑ์„ ํ™•์ธํ•˜์˜€๋‹ค. ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€ ์ถ”์ถœ๋ฌผ์„ ๋ถ„์„ํ•œ ๊ฒฐ๊ณผ, limonin glucoside, deacetyl nomilinic acid glucoside, isoobacunoic acid glucoside, deoxylimonol, nomilin glucoside, obacunone glucoside, bergapten, isopimpinellin, isoobacunoic acid, byakangelicin limonin, calamin, ichangensin, nomilin ๋“ฑ์ด ์กด์žฌํ–ˆ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์œ ์ž์”จ ์ถ”์ถœ๋ฌผ์—๋Š” limonin๊ณผ nomilin์ด ๊ฐ๊ฐ 111.4ยฑ15.2์™€ 103.4ยฑ6.5 mg/100 g dry seed์ด ์กด์žฌํ•˜์˜€๊ณ , ๋ƒ‰์••์ฐฉ ์œ ์ง€ ์ถ”์ถœ๋ฌผ์—๋Š” ๊ฐ๊ฐ 52.2ยฑ3.4์™€ 93.0ยฑ7.3 mg/100 g oil์ด ์กด์žฌํ•˜์˜€์œผ๋‚˜, ํ—ฅ์‚ฐ ์ถ”์ถœ ์œ ์ง€ ์ถ”์ถœ๋ฌผ์—์„œ๋Š” ๊ฑฐ์˜ ๊ฒ€์ถœ๋˜์ง€ ์•Š์•˜๋‹ค. ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€ ์ถ”์ถœ๋ฌผ์˜ HT-29 ์„ธํฌ์— ๋Œ€ํ•œ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ๋ฅผ ํ™•์ธํ•œ ๊ฒฐ๊ณผ, ํ—ฅ์‚ฐ ์ถ”์ถœ ์œ ์ง€์˜ ์ถ”์ถœ๋ฌผ๊ณผ ๋ƒ‰์••์ฐฉ ์œ ์ง€์˜ ์ถ”์ถœ๋ฌผ ๋ชจ๋‘์—์„œ ์œ ์˜์ ์œผ๋กœ ์•”์„ธํฌ ์ƒ์žฅ์ด ๊ฐ์†Œํ•˜์˜€๋‹ค(IC50(24์‹œ๊ฐ„): ํ—ฅ์‚ฐ ์ถ”์ถœ ์œ ์ง€: 0.176 mg/mL, ๋ƒ‰์••์ฐฉ ์œ ์ง€: 0.182 mg/mLIC50(48์‹œ๊ฐ„): ํ—ฅ์‚ฐ ์ถ”์ถœ ์œ ์ง€: 0.116 mg/mL, ๋ƒ‰์••์ฐฉ ์œ ์ง€: 0.114 mg/mL). ๋ฐ˜๋ฉด, ์œ ์ž์”จ ์ถ”์ถœ๋ฌผ๊ณผ limonin, nomilin์€ 24์‹œ๊ฐ„๊ณผ 48์‹œ๊ฐ„ ์ฒ˜๋ฆฌ ํ›„์— ์•”์„ธํฌ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ๊ฐ€ ์—†์—ˆ๋‹ค. ํ—ฅ์‚ฐ ์ถ”์ถœ ์œ ์ง€์˜ ๋ฉ”ํƒ„์˜ฌ ์ถ”์ถœ๋ฌผ์„ ๋ถ„ํšํ•œ 6๊ฐœ์˜ ์ถ”์ถœ๋ฌผ(A-F)๊ณผ ๋ƒ‰์••์ฐฉ ์œ ์ง€์˜ ๋ฉ”ํƒ„์˜ฌ ์ถ”์ถœ๋ฌผ์„ ๋ถ„ํšํ•œ 4๊ฐœ์˜ ์ถ”์ถœ๋ฌผ(I-IV) ์ค‘์—์„œ ํ—ฅ์‚ฐ ์ถ”์ถœ ์œ ์ง€ ์ถ”์ถœ๋ฌผ์˜ C, E, F ๋ถ„ํš๋ฌผ๊ณผ ๋ƒ‰์••์ฐฉ ์œ ์ง€ ์ถ”์ถœ๋ฌผ์˜ III, IV ๋ถ„ํš๋ฌผ์ด ์•”์„ธํฌ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ๊ฐ€ ์žˆ์—ˆ๋‹ค. ๋ถ„ํš๋ฌผ C, E, F, IV๋Š” 24์‹œ๊ฐ„๊ณผ 48์‹œ๊ฐ„ ์ฒ˜๋ฆฌํ•˜์˜€์„ ๋•Œ ์œ ์˜์ ์œผ๋กœ ์•”์„ธํฌ ์ƒ์žฅ์„ ๊ฐ์†Œ์‹œ์ผฐ๊ณ , ๋ถ„ํš๋ฌผ III๋Š” 48์‹œ๊ฐ„ ์ฒ˜๋ฆฌํ•˜์˜€์„ ๋•Œ ์œ ์˜์ ์ธ ๊ฐ์†Œํšจ๊ณผ๊ฐ€ ์žˆ์—ˆ๋‹ค(IC50(24์‹œ๊ฐ„): C: 63.9 ฮผg/mL, E: 57.8 ฮผg/mL, F: 72.5 ฮผg/mLIC50(48์‹œ๊ฐ„): C: 33.9 ฮผg/mL, E: 48.9 ฮผg/mL, F: 30.6 ฮผg/mL, IV: 61.1 ฮผg/mL). ๋ถ„ํš๋ฌผ์˜ ๋ถ„์„ ๊ฒฐ๊ณผ, ํ—ฅ์‚ฐ ์ถ”์ถœ ์œ ์ง€ ์ถ”์ถœ๋ฌผ์˜ ๋ถ„ํš๋ฌผ C๋Š” heptadecyl methoxybenzoate์™€ isoobacunoic acid๊ฐ€, ๋ถ„ํš๋ฌผ E๋Š” isopimpinellin, bergapten, ichangensin์ด, ๋ถ„ํš๋ฌผ F๋Š” ichangensin์ด ์ฃผ์š”ํ•œ ๋ฌผ์งˆ์ผ ๊ฒƒ์œผ๋กœ ์ถ”์ •๋œ๋‹ค. ๋ƒ‰์••์ฐฉ ์œ ์ง€ ์ถ”์ถœ๋ฌผ์˜ ๋ถ„ํš๋ฌผ III๋Š” deoxylimonol์ด, ๋ถ„ํš๋ฌผ IV๋Š” heptadecyl methoxybenzoate๊ฐ€ ์ฃผ์š” ๋ฌผ์งˆ์ผ ๊ฒƒ์œผ๋กœ ์ถ”์ •๋œ๋‹ค. ์œ„์˜ ์•”์„ธํฌ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ๊ฐ€ ์žˆ๋Š” ๋ถ„ํš๋ฌผ ๋‚ด์˜ ๋ฌผ์งˆ ์ค‘์—์„œ ichangensin์„ HT-29 ์„ธํฌ์— ์ฒ˜๋ฆฌํ•˜์˜€์„ ๋•Œ ์œ ์˜์ ์ธ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ๋ฅผ ๋ณด์˜€์œผ๋‚˜, isopimpinellin๊ณผ bergapten์€ ์–ด๋Š ์ •๋„ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ๋ฅผ ๋ณด์˜€์œผ๋‚˜ ์œ ์˜์ ์ด์ง€๋Š” ์•Š์•˜๋‹ค. ๊ฒฐ๋ก ์ ์œผ๋กœ, ์œ ์ž์”จ ์œ ์ง€ ์ถ”์ถœ๋ฌผ๊ณผ ๊ทธ ๋ถ„ํš๋ฌผ์˜ ์ผ๋ถ€๊ฐ€ HT-29 ์„ธํฌ์— ๋Œ€ํ•œ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ๋ฅผ ๋ณด์ž„์„ ํ™•์ธํ•˜์˜€๋‹ค. ํšจ๊ณผ๊ฐ€ ์žˆ๋Š” ๋ถ„ํš๋ฌผ ๋‚ด์— ์žˆ๋Š” ๋ฌผ์งˆ์„ ํ™•์ธํ•œ ๊ฒฐ๊ณผ, isopimpinellin, bergapten, ichangensin์ด ์œ ์ž์”จ ์œ ์ง€๋‚ด์˜ ์ฃผ์š” ์•”์„ธํฌ ์ƒ์žฅ ์–ต์ œ ๋ฌผ์งˆ์ด๋ฉฐ, ichangensin์ด ๊ฐ€์žฅ ๋†’์€ ํ™œ์„ฑ์„ ๋ณด์˜€๋‹ค. ๋”ฐ๋ผ์„œ, ๋ณธ ์—ฐ๊ตฌ๋ฅผ ํ†ตํ•˜์—ฌ ์œ ์ž์”จ ์œ ์ง€๋Š” ๊ธฐ๋Šฅ์„ฑ ์†Œ์žฌ๋กœ์„œ์˜ ์ƒˆ๋กœ์šด ์‹ํ’ˆ ์ž์›์œผ๋กœ์˜ ํ™œ์šฉ ๊ฐ€๋Šฅ์„ฑ์„ ์•Œ ์ˆ˜ ์žˆ๋‹ค.๊ตญ๋ฌธ ์ดˆ๋ก ๋ชฉ์ฐจ List of Tables List of Figures โ… . ์„œ๋ก  1. ์œ ์ž์˜ ์ด์šฉ๊ณผ ์œ ์ž์”จ ์œ ์ง€ 2. Limonoids 3. Furanocoumarins 4. ์—ฐ๊ตฌ ๋ชฉ์  โ…ก. ์žฌ๋ฃŒ ๋ฐ ๋ฐฉ๋ฒ• 1. ์‹คํ—˜ ์žฌ๋ฃŒ 2. ์œ ์ž์”จ์˜ ์ผ๋ฐ˜ ์„ฑ๋ถ„ ๋ถ„์„ 2.1. ์ˆ˜๋ถ„ ํ•จ๋Ÿ‰ ์ธก์ • 2.2. ์กฐ์ง€๋ฐฉ ํ•จ๋Ÿ‰ ์ธก์ • 3. ์œ ์ž์”จ ์œ ์ง€์˜ ์ง€๋ฐฉ์‚ฐ ์กฐ์„ฑ ๋ถ„์„ 4. ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€๋กœ๋ถ€ํ„ฐ ํ—ฅ์‚ฐ ๋˜๋Š” ๋ฉ”ํƒ„์˜ฌ ๊ฐ€์šฉ๋ฌผ์งˆ ์ถ”์ถœ 4.1 ์œ ์ž์”จ๋กœ๋ถ€ํ„ฐ ํ—ฅ์‚ฐ ๊ฐ€์šฉ๋ฌผ์งˆ ์ถ”์ถœ 4.2 ์œ ์ž์”จ๋กœ๋ถ€ํ„ฐ ๋ฉ”ํƒ„์˜ฌ ๊ฐ€์šฉ๋ฌผ์งˆ ์ถ”์ถœ 4.3. ์œ ์ž์”จ ์œ ์ง€๋กœ๋ถ€ํ„ฐ ๋ฉ”ํƒ„์˜ฌ ๊ฐ€์šฉ๋ฌผ์งˆ ์ถ”์ถœ 4.4. ์œ ์ž์”จ ์œ ์ง€ ์ถ”์ถœ๋ฌผ์˜ ๋ถ„ํš 4.5. ์œ ์ž์”จ ๋ฉ”ํƒ„์˜ฌ ๊ฐ€์šฉ ์ถ”์ถœ๋ฌผ๋กœ๋ถ€ํ„ฐ์˜ ichangensin ๋ถ„ํš 5. ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€์˜ ๋ฉ”ํƒ„์˜ฌ ์ถ”์ถœ๋ฌผ์˜ HPLC๋ฅผ ์ด์šฉํ•œ limonin๊ณผ nomilin์˜ ์ •๋Ÿ‰ ๋ถ„์„ 6. ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€์˜ ๋ฉ”ํƒ„์˜ฌ ์ถ”์ถœ๋ฌผ๊ณผ ๋ถ„ํš๋ฌผ์˜ HPLC-ESI-MS ๋ถ„์„ 7. ์„ธํฌ๋ฐฐ์–‘ 8. ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ ์ธก์ • 9. ํ†ต๊ณ„๋ถ„์„ โ…ข. ๊ฒฐ๊ณผ ๋ฐ ๊ณ ์ฐฐ 1. ์œ ์ž์”จ์˜ ์ˆ˜๋ถ„ ๋ฐ ์กฐ์ง€๋ฐฉ ํ•จ๋Ÿ‰ 2. ์œ ์ž์”จ ์œ ์ง€์˜ ์ง€๋ฐฉ์‚ฐ ์กฐ์„ฑ 3. ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€์˜ ๋ฉ”ํƒ„์˜ฌ ์ถ”์ถœ๋ฌผ์˜ limonin๊ณผ nomilin์˜ ํ•จ๋Ÿ‰ 4. ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€์˜ ์ถ”์ถœ๋ฌผ์˜ ์กฐ์„ฑ 5. ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€์˜ ๋ฉ”ํƒ„์˜ฌ ์ถ”์ถœ๋ฌผ์˜ ์•”์„ธํฌ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ 6. ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€์˜ ๋ฉ”ํƒ„์˜ฌ ์ถ”์ถœ๋ฌผ์˜ ๋ถ„ํš๋ฌผ์˜ ์•”์„ธํฌ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ 7. ์œ ์ž์”จ์™€ ์œ ์ž์”จ ์œ ์ง€ ๋ฉ”ํƒ„์˜ฌ ์ถ”์ถœ๋ฌผ์˜ ๋ถ„ํš๋ฌผ์˜ ๋ถ„์„ 8. Isopimpinellin, bergapten, ichangensin์˜ ์•”์„ธํฌ ์ƒ์žฅ ์–ต์ œ ํšจ๊ณผ โ…ฃ. ๊ฒฐ๋ก  ์ฐธ๊ณ  ๋ฌธํ—Œ AbstractMaste

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    ํ•™์œ„๋…ผ๋ฌธ (๋ฐ•์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์‚ฌ๋ฒ”๋Œ€ํ•™ ๊ต์œกํ•™๊ณผ, 2018. 2. ๊น€๊ณ„ํ˜„.๋ณธ ์—ฐ๊ตฌ์˜ ๋ชฉ์ ์€ ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ๊ณผ์ •์—์„œ ์ง„๋กœ ๋ชฉํ‘œ ๋‹ฌ์„ฑ์„ ์œ„ํ•ด ํ–‰๋™์„ ์กฐ์ ˆํ•˜๋Š” ๋™๊ธฐ์ฒด๊ณ„์™€ ๊ฐ ๋™๊ธฐ์ฒด๊ณ„์— ๋งž๋Š” ์ ‘๊ทผ์ˆ˜๋‹จ์˜ ์ผ์น˜(fit) ์—ฌ๋ถ€๊ฐ€ ์ง„๋กœ ์„ ํƒ์— ๋Œ€ํ•œ ์ •์„œ ๋ฐ ์ธ์ง€ ๋ฐ˜์‘์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์„ ๋น„๊ตํ•˜๋Š” ๋ฐ ์žˆ๋‹ค. ์ง„๋กœ์ƒ๋‹ด ๋ฐ ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ์ดˆ๊ธฐ ์—ฐ๊ตฌ๋“ค์€ ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ •์˜ ์–ด๋ ค์›€์„ ์ง„๋กœ๋ฏธ๊ฒฐ์ •์œผ๋กœ ๊ทœ์ •ํ•˜๊ณ  ์ง„๋กœ๋ฏธ๊ฒฐ์ •์„ ์ง„๋กœ ๋ฌธ์ œ๋กœ ๋ณด์•˜๊ธฐ์— ์ง„๋กœ๋ฏธ๊ฒฐ์ •์˜ ์›์ธ๊ณผ ๋ฏธ๊ฒฐ์ •์ž์˜ ํŠน์„ฑ์„ ํŒŒ์•…ํ•˜๋Š” ๋ฐ ์ฃผ๋ ฅํ•˜์˜€๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ์šฐ๋ฆฌ๋‚˜๋ผ ๋Œ€ํ•™์ƒ๋“ค์—๊ฒŒ์„œ ๋ฌธ์ œ ์žˆ๋Š” ์ง„๋กœ๊ฒฐ์ •์ž์˜ ์กด์žฌ๋ฅผ ์–ด๋ ต์ง€ ์•Š๊ฒŒ ๋ฐœ๊ฒฌํ•  ์ˆ˜ ์žˆ๋‹ค. ๊ตญ๋‚ด ๋Œ€ํ•™์ƒ์€ ๋ฏธ๊ตญ์˜ ๋Œ€ํ•™์ƒ์— ๋น„ํ•ด ์ง„๋กœ๊ฒฐ์ •์ž๊ฐ€ ๋” ๋งŽ๊ณ , ์ด๋“ค ์ค‘์—๋Š” ์ž์‹ ์˜ ์ง„๋กœ ์„ ํƒ์— ๋ถˆํŽธํ•จ์„ ๋Š๋ผ๋Š” ์‚ฌ๋žŒ๋“ค์ด ๋งŽ๋‹ค. ๋Œ€ํ•™์ƒ์˜ ์ง„๋กœ์ƒ๋‹ด ์‹ค์ œ์—์„œ๋„ ์ž์‹ ์˜ ์ง„๋กœ ๊ฒฐ์ •์˜ ์ ์ ˆ์„ฑ์— ๋Œ€ํ•œ ํ™•์‹  ๋ถ€์กฑ์œผ๋กœ ์‹ฌ๋ฆฌ์  ์–ด๋ ค์›€์„ ํ˜ธ์†Œํ•˜๋Š” ๋Œ€ํ•™์ƒ์„ ๋งŒ๋‚˜๋ณผ ์ˆ˜ ์žˆ๋‹ค. ๋ฌธ์ œ ์žˆ๋Š” ์ง„๋กœ๊ฒฐ์ •์€ ๊ทธ ์ž์ฒด๋กœ ๊ฐœ์ธ์—๊ฒŒ ์‹ฌ๊ฐํ•œ ์ŠคํŠธ๋ ˆ์Šค์›์œผ๋กœ ์ž‘์šฉํ•  ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ์ดํ›„ ์ง์—… ์ ์‘ ๋ฐ ์ง๋ฌด ๋งŒ์กฑ์—๋„ ์˜ํ–ฅ์„ ๋ฏธ์น  ์ˆ˜ ์žˆ๊ธฐ ๋•Œ๋ฌธ์— ์ง„๋กœ๊ต์œก ๋ฐ ์ƒ๋‹ด์—์„œ ์ง„๋กœ๊ฒฐ์ •์ž์— ๋Œ€ํ•œ ๊ฐœ์ž…์ด ํ•„์š”ํ•˜๋‹ค. ์ดํ›„ ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ์—ฐ๊ตฌ๋“ค์€ ์ง„๋กœ ๊ฒฐ์ •์˜ ์—ฌ๋ถ€๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ์ง„๋กœ๊ฒฐ์ •์˜ ์งˆ์„ ๊ณ ๋ คํ•ด์•ผ ํ•จ์„ ๊ฐ•์กฐํ•˜๋ฉด์„œ ์ง„๋กœ๊ฒฐ์ •๊ณผ ๊ด€๋ จ๋œ ์ค‘์š”ํ•œ ์š”์ธ์„ ํ•จ๊ป˜ ๊ณ ๋ คํ•˜์—ฌ ์„œ๋กœ ๋‹ค๋ฅธ ์ฐจ์›์˜ ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ์œ ํ˜•์„ ๋ฐœ๊ฒฌํ•˜๊ณ  ๊ทธ ํŠน์„ฑ์„ ์ดํ•ดํ•˜๊ณ ์ž ํ•˜์˜€๋‹ค. ํ•˜์ง€๋งŒ ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ์ƒํƒœ๋ฅผ ๋ถ„๋ฅ˜ํ•˜๊ณ  ์œ ํ˜•๋ณ„ ํŠน์„ฑ์„ ๊ธฐ์ˆ ํ•˜๋Š” ๋ฐ ๊ทธ์ณค์„ ๋ฟ ํŠน์ • ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ์ƒํƒœ์— ์ด๋ฅด๊ฒŒ ๋œ ๊ทผ๊ฑฐ๋ฅผ ์„ค๋ช…ํ•˜์ง€๋Š” ๋ชปํ–ˆ๋‹ค. ๋”๋ถˆ์–ด ์ง„๋กœ์ƒ๋‹ด ๋ฐ ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ์—ฐ๊ตฌ๋“ค์€ ์˜ค๋žซ๋™์•ˆ ์ž์‹ ๊ณผ ์ง์—…์„ธ๊ณ„์— ๋Œ€ํ•œ ์ธ์ง€์ ์ธ ์ดํ•ด๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ ์ž์‹ ๊ณผ ์ง์—…์˜ ํ•ฉ๋ฆฌ์  ๋งค์นญ์„ ์ฃผ์š” ์ฃผ์ œ๋กœ ๋‹ค๋ฃจ์–ด์™”๊ธฐ ๋•Œ๋ฌธ์— ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ๊ณผ์ •์—์„œ ์ธ์ง€์  ์—ญํ• ์„ ๊ฐ•์กฐํ•˜์˜€๊ณ  ์ •์„œ์˜ ์—ญํ• ์— ๋Œ€ํ•ด์„œ๋Š” ์ƒ๋Œ€์ ์œผ๋กœ ๊ด€์‹ฌ์„ ๊ธฐ์šธ์ด์ง€ ์•Š์•˜๋‹ค. ํ•˜์ง€๋งŒ ์ตœ๊ทผ ์ง„๋กœ์ƒ๋‹ด ์ด๋ก  ๋ฐ ์—ฐ๊ตฌ์—์„œ๋Š” ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ๊ณผ์ •์€ ์ธ์ง€์  ๊ณผ์ •์ธ ๋™์‹œ์— ์ •์„œ์ ์ธ ๊ณผ์ •์ด๋ฉฐ ํ•ฉ๋ฆฌ์„ฑ์„ ๊ฐ•์กฐํ•œ ๋ชจ๋ธ๋งŒ์œผ๋กœ๋Š” ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ๊ณผ์ •์˜ ๋ณต์žก์„ฑ์„ ์ถฉ๋ถ„ํžˆ ์ดํ•ดํ•  ์ˆ˜๊ฐ€ ์—†๋‹ค๋Š” ๋…ผ์˜๊ฐ€ ๊พธ์ค€ํžˆ ์ด๋ฃจ์–ด์ง€๊ณ  ์žˆ๋‹ค. ์ด์— ๋ณธ ์—ฐ๊ตฌ๋Š” ํšจ์šฉ๊ทน๋Œ€ํ™”(utility maximization)๋ฅผ ์œ„ํ•œ ํ•ฉ๋ฆฌ์„ฑ์„ ๋Œ€์‹ ํ•˜์—ฌ ์ œํ•œ๋œ ํ•ฉ๋ฆฌ์„ฑ(bounded rationality)์— ์˜ํ•˜์—ฌ ์ ๋‹นํžˆ ๋งŒ์กฑ์Šค๋Ÿฌ์šด ๋Œ€์•ˆ์„ ์ถ”๊ตฌํ•˜๋Š”(satisfying) ๊ฒƒ์œผ๋กœ ์ธ๊ฐ„ ํ–‰๋™์„ ๋ฌ˜์‚ฌํ•˜๊ณ  ์žˆ๋Š” ํ–‰๋™๋ก ์  ์˜์‚ฌ๊ฒฐ์ • ์ด๋ก ์„ ๋ฐ”ํƒ•์œผ๋กœ ์ง„๋กœ๋ฅผ ์„ ํƒํ–ˆ์œผ๋‚˜ ์ž์‹ ์˜ ์ง„๋กœ ์„ ํƒ์— ๋ถˆํŽธ๊ฐ์„ ๋Š๋ผ๋Š” ๊ตญ๋‚ด ๋Œ€ํ•™์ƒ์˜ ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ๊ณผ์ •์„ ํƒ๊ตฌํ•˜๊ณ ์ž ํ•˜์˜€๋‹ค. ๊ตฌ์ฒด์ ์œผ๋กœ ๋ณธ ์—ฐ๊ตฌ๋Š” Higgins(2000)์˜ ์กฐ์ ˆ์ดˆ์ ์ด๋ก (regulatory focus theory)์—์„œ ์ œ์‹œํ•œ ์กฐ์ ˆ์ ํ•ฉ์„ฑ ํšจ๊ณผ(regulatory fit effect)์˜ ๊ฐœ๋…์„ ๋ฐ”ํƒ•์œผ๋กœ ์ง„๋กœ ์„ ํƒ์— ๋Œ€ํ•œ ๋ถˆํŽธ๊ฐ์„ ์ดˆ๋ž˜ํ•˜๋Š” ๊ธฐ์ œ์˜ ์ผ๋ถ€ ๊ฐ€๋Šฅ์„ฑ์— ๋Œ€ํ•ด ์„ค๋ช…ํ•˜๊ณ ์ž ์‹œ๋„ํ•˜์˜€๋‹ค. Higgins(1997)์˜ ์กฐ์ ˆ์ดˆ์ ์ด๋ก ์€ ์˜์‚ฌ๊ฒฐ์ •๊ณผ์ •์—์„œ ๋ชฉํ‘œ ๋‹ฌ์„ฑ์„ ์œ„ํ•ด ํ–‰๋™์„ ์กฐ์ ˆํ•˜๋Š” ๋™๊ธฐ์ฒด๊ณ„์ธ ์กฐ์ ˆ์ดˆ์ (regulatory focus)๊ณผ ์˜์‚ฌ๊ฒฐ์ •๊ณผ์ •์—์„œ ์‚ฌ์šฉ๋˜๋Š” ์กฐ์ ˆ์ „๋žต(regulatory means) ๊ฐ„์˜ ์กฐ์ ˆ์ผ์น˜(regulatory fit) ์—ฌ๋ถ€๊ฐ€ ์„ ํƒ์— ๋Œ€ํ•œ ๊ฐ€์น˜ ์ง€๊ฐ์— ์˜ํ–ฅ์„ ๋ฏธ์นœ๋‹ค๊ณ  ์„ค๋ช…ํ•œ๋‹ค. ์ฆ‰, ๊ฐœ์ธ์˜ ๋ชฉํ‘œ์ถ”๊ตฌ ์ƒํ™ฉ์—์„œ ๋ชฉํ‘œ ๋‹ฌ์„ฑ์„ ์œ„ํ•œ ๋™๊ธฐ์ฒด๊ณ„์— ๋ถ€ํ•ฉํ•˜๋Š” ์ˆ˜๋‹จ์„ ์‚ฌ์šฉํ•˜๋ฉด ๊ทธ๋ ‡์ง€ ์•Š์„ ๋•Œ๋ณด๋‹ค ์ž์‹ ์˜ ํ–‰์œ„์— ๋Œ€ํ•ด์„œ ์ง€๊ฐ๋œ ๊ฐ€์น˜๊ฐ€ ๋†’๋‹ค๋Š” ๊ฒƒ์ด๋‹ค. Higgins(2000)๋Š” ์กฐ์ ˆ์ดˆ์ ๊ณผ ์กฐ์ ˆ์ „๋žต์ด ์ผ์น˜ํ•˜๋ฉด ๋ชฉํ‘œ ์ˆ˜ํ–‰์— ํฅ๋ฏธ๋ฅผ ๋Š๋ผ๋ฉฐ ๊ทธ ํ–‰์œ„๊ฐ€ ์˜ณ๋‹ค๋Š” ๋Š๋‚Œ(feel right)์„ ๊ฒฝํ—˜ํ•œ๋‹ค๊ณ  ์„ค๋ช…ํ•˜์˜€๊ณ , ์ด๋ฅผ ์กฐ์ ˆ์ ํ•ฉ์„ฑ ํšจ๊ณผ๋ผ๊ณ  ํ•˜์˜€๋‹ค. ์กฐ์ ˆ์ ํ•ฉ์„ฑ ํšจ๊ณผ๋Š” ์„ ํƒ์— ๋Œ€ํ•œ ๊ฐ€์น˜๋ฅผ ์ž์‹ ์˜ ํ˜„์žฌ ์กฐ์ ˆ ๋™๊ธฐ ์„ฑํ–ฅ๊ณผ ์˜์‚ฌ ๊ฒฐ์ •์ด ์ด๋ฃจ์–ด์ง€๋Š” ์ „๋žต ๊ฐ„์˜ ํ•จ์ˆ˜ ๊ด€๊ณ„์— ๋ฐ”ํƒ•์„ ๋‘๊ณ  ์žˆ๋‹ค๊ณ  ๋ณด๊ณ , ์กฐ์ ˆ์ดˆ์ ๊ณผ ์กฐ์ ˆ์ „๋žต์˜ ์ผ์น˜ ์—ฌ๋ถ€๊ฐ€ ์„ ํƒ๊ณผ ๊ฒฐ์ •์˜ ๊ฒฐ๊ณผ๋ฅผ ์–ด๋–ป๊ฒŒ ํ‰๊ฐ€ํ•˜๋Š”์ง€์— ์˜ํ–ฅ์„ ์ค€๋‹ค๋Š” ๊ฒƒ์ด๋‹ค. Higgins(1997)๋Š” ์ธ๊ฐ„์€ ๋ชฉํ‘œ๋‹ฌ์„ฑ์„ ์œ„ํ•ด ์ž์‹ ์˜ ํ–‰๋™์„ ์กฐ์ ˆํ•˜๋Š” ํ–ฅ์ƒ์ดˆ์ (promotion focus)๊ณผ ์˜ˆ๋ฐฉ์ดˆ์ (prevention focus)์˜ ๋‘ ๊ฐ€์ง€ ๋™๊ธฐ์ฒด๊ณ„๋ฅผ ๊ฐ–๋Š”๋‹ค๊ณ  ์ œ์•ˆํ•˜์˜€๊ณ , ํ–ฅ์ƒ์ดˆ์ ์„ ๊ฐ€์ง„ ๊ฐœ์ธ๋“ค์€ ํš๋“(gain) ๋˜๋Š” ํš๋“ํ•˜์ง€ ๋ชปํ•จ(non-gain)์— ๋ฏผ๊ฐํ•œ ๋ฐ˜๋ฉด, ์˜ˆ๋ฐฉ์ดˆ์ ์˜ ๊ฐœ์ธ๋“ค์€ ์†์‹ค(loss) ๋˜๋Š” ์†์‹ค ์—†์Œ(non-loss)์— ๋ฏผ๊ฐํ•˜๋‹ค๊ณ  ํ•˜์˜€๋‹ค. ๊ทธ๋Ÿฌ๋ฏ€๋กœ ํ–ฅ์ƒ์ดˆ์  ๊ฐœ์ธ๋“ค์€ ์†์‹ค์ด ๋ฐœ์ƒํ•  ๊ฐ€๋Šฅ์„ฑ์ด ์žˆ๋”๋ผ๋„ ์ด๋ฅผ ๊ฐ์ˆ˜ํ•˜๊ณ  ์ด๋“์„ ์„ฑ์ทจํ•˜๋Š” ์—ด๋ง์ „๋žต(eagerness means)์„ ์‚ฌ์šฉํ•˜๋Š” ๋ฐ˜๋ฉด, ์˜ˆ๋ฐฉ์ดˆ์  ๊ฐœ์ธ๋“ค์€ ์„ค์‚ฌ ์ด๋“์ด ์žˆ๋”๋ผ๋„ ์†์‹ค์„ ํšŒํ”ผํ•˜๊ณ  ๋ถ€์ •์ ์ธ ๊ฒฐ๊ณผ๋ฅผ ์˜ˆ๋ฐฉํ•˜๋Š” ๊ฒฝ๊ณ„์ „๋žต(vigilance means)์„ ์‚ฌ์šฉํ•˜์—ฌ ๋ชฉ์ ์„ ์ด๋ฃจ๊ณ ์ž ํ•œ๋‹ค๊ณ  ์„ค๋ช…ํ•˜์˜€๋‹ค. ์ด๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ ๋ณธ ์—ฐ๊ตฌ๋Š” ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ๊ณผ์ •์—์„œ ํ–ฅ์ƒ์ดˆ์ ์ด ํ™œ์„ฑํ™”๋œ ์ƒํƒœ์—์„œ๋Š” ๊ฒฝ๊ณ„์ „๋žต ๋ณด๋‹ค๋Š” ์—ด๋ง์ „๋žต์„ ์‚ฌ์šฉํ•  ๋•Œ ์ž์‹ ์˜ ์ง„๋กœ์„ ํƒ์— ๋Œ€ํ•ด ์ธ์ง€์ ยท์ •์„œ์ ์œผ๋กœ ๋ณด๋‹ค ๊ธ์ •์ ์ธ ๋ฐ˜์‘์„ ํ•  ๊ฒƒ์ด๋ผ ์˜ˆ์ƒํ•˜์˜€๋‹ค. ๋ฐ˜๋Œ€๋กœ ์˜ˆ๋ฐฉ์ดˆ์ ์ด ํ™œ์„ฑํ™”๋œ ์ƒํƒœ์—์„œ๋Š” ์—ด๋ง์ „๋žต ๋ณด๋‹ค ๊ฒฝ๊ณ„์ „๋žต์„ ์‚ฌ์šฉํ•  ๊ฒฝ์šฐ์— ์ž์‹ ์˜ ์ง„๋กœ์„ ํƒ์— ๋Œ€ํ•ด ์ธ์ง€์ ยท์ •์„œ์ ์œผ๋กœ ๋ณด๋‹ค ๊ธ์ •์ ์ธ ๋ฐ˜์‘์„ ํ•  ๊ฒƒ์œผ๋กœ ์˜ˆ์ƒํ•˜์˜€๋‹ค. ์ฆ‰, ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ๊ณผ์ •์—์„œ ์กฐ์ ˆ์ ํ•ฉ์„ฑ ํšจ๊ณผ๊ฐ€ ๋‚˜ํƒ€๋‚  ๊ฒƒ์œผ๋กœ ์˜ˆ์ƒํ•˜๊ณ  ์ด๋ฅผ ์‹คํ—˜์ ์œผ๋กœ ๊ฒ€์ฆํ•˜๊ณ ์ž ํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ์˜ ๊ฐ€์„ค์„ ํ™•์ธํ•˜๊ธฐ ์œ„ํ•ด์„œ ์กฐ์ ˆ์ดˆ์ -์กฐ์ ˆ์ „๋žต์˜ ์ผ์น˜(fit) ๋˜๋Š” ์ƒ์ถฉ(non-fit)์„ ์กฐ์ž‘ํ•œ ํ›„ ์ง„๋กœ์„ ํƒ์— ๋Œ€ํ•œ ์ •์„œ ๋ฐ ์ธ์ง€ ๋ฐ˜์‘์˜ ์ฐจ์ด๋ฅผ ๋น„๊ตํ•˜์˜€๋‹ค. ๋จผ์ €, ์กฐ์ ˆ์ดˆ์  ์กฐ์ž‘์„ ์œ„ํ•œ ๊ณผ์ œ๋ฅผ ๊ฐœ๋ฐœํ•˜์˜€๋‹ค. ์ด๋ฅผ ์œ„ํ•ด ์„ ํ–‰์—ฐ๊ตฌ๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ ๋ชฉํ‘œ ๋‹ฌ์„ฑ์„ ์œ„ํ•œ ํ–‰๋™์„ ์กฐ์ ˆํ•˜๋Š” ๋™๊ธฐ์ฒด๊ณ„ ์ฆ‰, ํ–ฅ์ƒ์ดˆ์ ๊ณผ ์˜ˆ๋ฐฉ์ดˆ์ ์˜ 2๊ฐ€์ง€ ์กฐ์ ˆ์ดˆ์ (regulatory focus) ๋™๊ธฐ๋ฅผ ํ™œ์„ฑํ™”์‹œํ‚ค๋Š” ๊ฐ€์ƒ์˜ ์‹œ๋‚˜๋ฆฌ์˜ค๋ฅผ ๊ตฌ์„ฑํ•œ ํ›„ ๋Œ€ํ•™์ƒ๋‹ด์„ผํ„ฐ์—์„œ ๊ทผ๋ฌดํ•˜๋Š” ์ƒ๋‹ดํ•™ ์ „๊ณต ์„ยท๋ฐ•์‚ฌ์˜ ํ‰์ •์„ ๊ฑฐ์ณ ์‹œ๋‚˜๋ฆฌ์˜ค๋ฅผ ์ˆ˜์ •ยท๋ณด์™„ํ•˜์˜€๋‹ค. ๋˜ํ•œ ์˜ˆ๋น„์—ฐ๊ตฌ๋ฅผ ๊ฑฐ์ณ ๊ฐ€์ƒ์˜ ์‹œ๋‚˜๋ฆฌ์˜ค์— ๋Œ€ํ•œ ํ”ผํ—˜์ž๋“ค์˜ ํ”ผ๋“œ๋ฐฑ์„ ๋ฐ˜์˜ํ•˜์—ฌ ์ตœ์ข… ์ˆ˜์ •ํ•˜์˜€๋‹ค. ๋‹ค์Œ์œผ๋กœ ์ง„๋กœ ์„ ํƒ ํ›„์˜ ์ž์‹ ์˜ ์„ ํƒ์— ๋Œ€ํ•œ ๊ฐ€์น˜ ํŒ๋‹จ์„ ํ™•์ธํ•˜๊ธฐ ์œ„ํ•ด ๋ชจ์˜์ง„๋กœ์„ ํƒ ๊ณผ์ œ๋ฅผ ๊ฐœ๋ฐœํ•˜์˜€๋‹ค. ์ด๋ฅผ ์œ„ํ•˜์—ฌ ์‹คํ—˜ ์ฐธ์—ฌ์ž๋“ค์ด ํ‰์†Œ์— ๊ณ ๋ คํ•˜๊ณ  ์žˆ๋˜ ์ด 9๊ฐœ์˜ ์ง„๋กœ ๋Œ€์•ˆ ์ค‘ ์ตœ์ข…์ ์œผ๋กœ ํ•˜๋‚˜์˜ ์ง„๋กœ๋ฅผ ์„ ํƒํ•˜๋Š” ๋ชจ์˜์ง„๋กœ์„ ํƒ ๊ณผ์ œ๋ฅผ ๊ฐœ๋ฐœํ•˜๊ณ , ๊ณผ์ œ๋ฅผ ์ˆ˜ํ–‰ํ•˜๋Š” ๊ณผ์ •์—์„œ ๋ชฉํ‘œ ๋‹ฌ์„ฑ์„ ์œ„ํ•œ ์กฐ์ ˆ์ „๋žต ์ฆ‰, ์—ด๋ง์ „๋žต๊ณผ ๊ฒฝ๊ณ„์ „๋žต์„ ๋ฌด์„ ํ• ๋‹นํ•˜์—ฌ ์ฒ˜์น˜ํ•œ ํ›„ ์กฐ์ ˆ์ดˆ์ -์กฐ์ ˆ์ „๋žต ์ผ์น˜ ์—ฌ๋ถ€๋ฅผ ์กฐ์ž‘ํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ์ด 138๋ช…์˜ ๋Œ€ํ•™์ƒ๋“ค์„ ๋Œ€์ƒ์œผ๋กœ ๋ฉด๋Œ€๋ฉด ์‹คํ—˜์„ ์ง„ํ–‰ํ•˜์˜€๋‹ค. 2๊ฐœ์˜ ์กฐ์ ˆ์ดˆ์ (ํ–ฅ์ƒ์ดˆ์ , ์˜ˆ๋ฐฉ์ดˆ์ )๊ณผ 2๊ฐœ์˜ ์กฐ์ ˆ์ „๋žต(์—ด๋ง์ „๋žต, ๊ฒฝ๊ณ„์ „๋žต)์˜ 2ร—2 ์ง‘๋‹จ ๊ฐ„ ์‹คํ—˜์„ค๊ณ„๋ฅผ ์‚ฌ์šฉํ•˜์˜€๊ณ , ๊ฐ ์กฐ์ ˆ์ดˆ์  ๋‚ด์—์„œ ์กฐ์ ˆ์ดˆ์ -์กฐ์ ˆ์ „๋žต ์ผ์น˜ ์—ฌ๋ถ€์— ๋”ฐ๋ฅธ ์ •์„œยท์ธ์ง€ ๋ฐ˜์‘์˜ ์ฐจ์ด๋ฅผ ๋น„๊ตํ•˜์˜€๋‹ค. 138๋ช…์˜ ์‹คํ—˜ ์ฐธ๊ฐ€์ž ์ค‘ ๊ธฐ์ €์„  ๊ฒ€์‚ฌ์™€ ์กฐ์ž‘์ ๊ฒ€์„ ํ†ตํ•ด ์—ฐ๊ตฌ์— ์ ํ•ฉํ•˜์ง€ ์•Š์€ ๊ฒƒ์œผ๋กœ ํŒ๋‹จ๋œ 18๋ช…์„ ์ œ์™ธํ•œ ์ด 120๋ช…์˜ ์ž๋ฃŒ๋ฅผ ๋ถ„์„ํ•˜์˜€๋‹ค. ์—ฐ๊ตฌ ๊ฒฐ๊ณผ ์ฒซ์งธ, ํ–ฅ์ƒ์ดˆ์ ์ด ํ™œ์„ฑํ™”๋œ ์ƒํƒœ์˜ ๊ฒฝ์šฐ ์กฐ์ ˆ์ดˆ์ -์กฐ์ ˆ์ „๋žต ์ผ์น˜ ์—ฌ๋ถ€์— ๋”ฐ๋ผ ์ •์„œยท์ธ์ง€ ๋ฐ˜์‘์˜ ์ฐจ์ด๊ฐ€ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๋จผ์ € ์ •์„œ ๋ฐ˜์‘์„ ์‚ดํŽด๋ณด๋ฉด, ์กฐ์ ˆ์ดˆ์ -์กฐ์ ˆ์ „๋žต์˜ ์ผ์น˜(ํ–ฅ์ƒ์ดˆ์ -์—ด๋ง์ „๋žต)๊ฐ€ ์ƒ์ถฉ(ํ–ฅ์ƒ์ดˆ์ -๊ฒฝ๊ณ„์ „๋žต)์— ๋น„ํ•ด ์ตœ์ข… ์ง„๋กœ ์„ ํƒ ์งํ›„์˜ ํ˜ธ๊ฐ๋„, ์ •์ ์ •์„œ ์ ์ˆ˜๊ฐ€ ์œ ์˜๋ฏธํ•˜๊ฒŒ ๋†’์•˜๊ณ , ์šฐ์šธ๊ณผ ์ ์˜ ์ ์ˆ˜๊ฐ€ ์œ ์˜ํ•˜๊ฒŒ ๋‚ฎ์•˜๋‹ค. ๋‹ค์Œ์œผ๋กœ ์ธ์ง€ ๋ฐ˜์‘์„ ์‚ดํŽด๋ณด๋ฉด, ์ผ์น˜๊ฐ€ ์ƒ์ถฉ์— ๋น„ํ•ด ์ž์‹ ์˜ ์ง„๋กœ์„ ํƒ์— ๋Œ€ํ•œ ํ™•์‹ ๋„ ์ ์ˆ˜๊ฐ€ ์œ ์˜ํ•˜๊ฒŒ ๋†’๊ฒŒ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ฆ‰, ํ–ฅ์ƒ์ดˆ์ ์ด ํ™œ์„ฑํ™”๋œ ์ƒํƒœ์—์„œ๋Š” ์ •์„œยท์ธ์ง€ ๋ฐ˜์‘ ์ผ๋ถ€์—์„œ ์กฐ์ ˆ์ ํ•ฉ์„ฑ ํšจ๊ณผ(regulatory fit effect)๋ฅผ ํ™•์ธํ•  ์ˆ˜ ์žˆ์—ˆ๋‹ค. ๋‘˜์งธ, ์˜ˆ๋ฐฉ์ดˆ์ ์ด ํ™œ์„ฑํ™”๋œ ์ƒํƒœ์—์„œ ์กฐ์ ˆ์ดˆ์ -์กฐ์ ˆ์ „๋žต ์ผ์น˜ ์—ฌ๋ถ€์— ๋”ฐ๋ผ ์ •์„œยท์ธ์ง€ ๋ฐ˜์‘์˜ ์ฐจ์ด๊ฐ€ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ผ์น˜(์˜ˆ๋ฐฉ์ดˆ์ -๊ฒฝ๊ณ„์ „๋žต)๊ฐ€ ์ƒ์ถฉ(์˜ˆ๋ฐฉ์ดˆ์ -์—ด๋ง์ „๋žต)์— ๋น„ํ•ด ํ˜ธ๊ฐ๋„, ํ†ต์ œ๊ฐ๊ณผ ์ •์ ์ •์„œ ์ ์ˆ˜๊ฐ€ ์œ ์˜๋ฏธํ•˜๊ฒŒ ๋‚ฎ์•˜๊ณ , ๋ถ€์ ์ •์„œ, ๋ถˆ์•ˆ, ์šฐ์šธ ์ ์ˆ˜๊ฐ€ ์œ ์˜๋ฏธํ•˜๊ฒŒ ๋†’๊ฒŒ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๋˜ํ•œ ์ธ์ง€์  ๋ฐ˜์‘์„ ์‚ดํŽด๋ณด๋ฉด, ์ผ์น˜๊ฐ€ ์ƒ์ถฉ์— ๋น„ํ•ด ์ง์—…์ •๋ณด์— ๋Œ€ํ•ด ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•˜๊ฒŒ ๋” ๋งŽ์€ ๊ธฐ์–ต๋Ÿ‰์„ ๋ณด๊ณ ํ•˜์˜€๋‹ค. ์ฆ‰, ์˜ˆ๋ฐฉ์ดˆ์ ์ด ํ™œ์„ฑํ™”๋œ ์ƒํƒœ์—์„œ๋Š” ์ •์„œ ๋ฐ˜์‘์—์„œ๋Š” ์กฐ์ ˆ์ ํ•ฉ์„ฑ ํšจ๊ณผ(regulatory fit effect)๊ฐ€ ๋‚˜ํƒ€๋‚˜์ง€ ์•Š์•˜๊ณ  ์˜คํžˆ๋ ค ๊ฐ€์„ค๊ณผ ๋ฐ˜๋Œ€์˜ ๊ฒฐ๊ณผ๊ฐ€ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์กฐ์ ˆ์ดˆ์ -์กฐ์ ˆ์ „๋žต์˜ ์ƒ์ถฉ(์˜ˆ๋ฐฉ์ดˆ์ -์—ด๋ง์ „๋žต)์ด ์ผ์น˜(์˜ˆ๋ฐฉ์ดˆ์ -๊ฒฝ๊ณ„์ „๋žต)์— ๋น„ํ•ด ์ •์„œ์ ์œผ๋กœ ๊ธ์ •์ ์ธ ๋ฐ˜์‘์„ ๋ณด์˜€๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ์ธ์ง€ ๋ฐ˜์‘์—์„œ๋Š” ์กฐ์ ˆ์ดˆ์ -์กฐ์ ˆ์ „๋žต ์ƒ์ถฉ์ด ์ผ์น˜์— ๋น„ํ•ด ์ง์—… ์ •๋ณด์— ๋Œ€ํ•œ ๊ธฐ์–ต๋Ÿ‰์ด ๋” ๋งŽ์•˜๋‹ค. ์š”์•ฝํ•˜์ž๋ฉด ์˜ˆ๋ฐฉ์ดˆ์ ์ด ํ™œ์„ฑํ™”๋œ ์ƒํƒœ์—์„œ์˜ ์ •์„œ ๋ฐ˜์‘์—์„œ๋Š” Higgins(2000)์˜ ์กฐ์ ˆ์ ํ•ฉ์„ฑ(regulatory fit) ๊ฐ€์„ค์ด ์ง€์ง€๋˜์ง€ ์•Š์•˜๊ณ , ์ธ์ง€์  ๋ฐ˜์‘์—์„œ๋Š” ์ผ๋ถ€ ์ง€์ง€๋˜์—ˆ๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ์‹คํ—˜์„ค๊ณ„๋ฅผ ํ†ตํ•ด ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ๊ณผ์ •์—์„œ ์กฐ์ ˆ์ดˆ์ -์กฐ์ ˆ์ „๋žต ์ผ์น˜ ์—ฌ๋ถ€์— ๋”ฐ๋ฅธ ์ง„๋กœ์„ ํƒ์— ๋Œ€ํ•œ ๊ฐ€์น˜ ํŒ๋‹จ์˜ ์ธ๊ณผ์  ์˜ํ–ฅ๋ ฅ์„ ํ™•์ธํ•˜๊ณ ์ž ํ•˜์˜€๋‹ค. ๊ตฌ์ฒด์ ์œผ๋กœ ์กฐ์ ˆ์ผ์น˜ ์—ฌ๋ถ€์— ๋”ฐ๋ฅธ ์ง„๋กœ์„ ํƒ์— ๋Œ€ํ•œ ์ •์„œ ๋ฐ ์ธ์ง€ ๋ฐ˜์‘์˜ ์ฐจ์ด๋ฅผ ์ฆ๋ช…ํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋ฅผ ํ†ตํ•ด์„œ ๋ฐํ˜€์ง„ ์ง„๋กœ์˜์‚ฌ๊ฒฐ์ • ๊ณผ์ •์—์„œ์˜ ์กฐ์ ˆ์ดˆ์ -์กฐ์ ˆ์ „๋žต ์ผ์น˜ ํšจ๊ณผ๋Š” ํ–ฅํ›„ ๋ฌธ์ œ ์žˆ๋Š” ์ง„๋กœ๊ฒฐ์ •์ž๋“ค์˜ ์ง„๋กœํƒ€ํ˜‘์— ๋Œ€ํ•œ ์‹ฌ๋ฆฌ์  ์ ์‘ ํŠนํžˆ, ์ •์„œ์  ์ ์‘์„ ๋•๋Š” ์ง„๋กœ์ƒ๋‹ด์˜ ๊ฐœ์ž…์— ์œ ์šฉํ•œ ์‹œ์‚ฌ์ ์„ ์ œ๊ณตํ•ด ์ค„ ๊ฒƒ์œผ๋กœ ๊ธฐ๋Œ€๋œ๋‹ค.โ… . ์„œ๋ก  1 1. ์—ฐ๊ตฌ์˜ ํ•„์š”์„ฑ ๋ฐ ๋ชฉ์  1 2. ์—ฐ๊ตฌ๋ฌธ์ œ ๋ฐ ๊ฐ€์„ค 10 3. ์šฉ์–ด์˜ ์ •๋ฆฌ 12 โ…ก. ์ด๋ก ์  ๋ฐฐ๊ฒฝ 13 1. ์ธ์ง€์  ์ •๋ณด์ฒ˜๋ฆฌ ์ด๋ก  13 2. ์กฐ์ ˆ์ดˆ์  ์ด๋ก  20 โ…ข. ์—ฐ๊ตฌ๋ฐฉ๋ฒ• 26 1. ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž 26 2. ์—ฐ๊ตฌ ์„ค๊ณ„ ๊ฐœ์š” 27 3. ์—ฐ๊ตฌ๋„๊ตฌ 30 4. ์—ฐ๊ตฌ์ ˆ์ฐจ 37 1) ์—ฐ๊ตฌ์ ˆ์ฐจ ๊ฐœ๊ด€ 37 2) ์‹คํ—˜์ž๊ทน ๊ฐœ๋ฐœ 38 3) ์˜ˆ๋น„ ์‹คํ—˜ 50 4) ๋ณธ ์‹คํ—˜ 51 5. ์ž๋ฃŒ๋ถ„์„ 59 โ…ฃ. ์—ฐ๊ตฌ๊ฒฐ๊ณผ 60 1. ๊ฒฐ๊ณผ๋ถ„์„์„ ์œ„ํ•œ ์ž๋ฃŒ๊ฒ€ํ†  60 1) ์‚ฌ์ „ ๋™์งˆ์„ฑ ๊ฒ€์ฆ 60 2) ์กฐ์ ˆ์ดˆ์  ํ™œ์„ฑํ™” ์กฐ์ž‘ ํ™•์ธ 61 3) ์ง‘๋‹จ๋ณ„ ์ตœ์ข…์ง์—…์„ ํƒ ๋น„์œจ 71 3. ์—ฐ๊ตฌ๊ฒฐ๊ณผ - ํ–ฅ์ƒ์ดˆ์  72 1) ์ •์„œ๋ฐ˜์‘ 72 2) ์ธ์ง€๋ฐ˜์‘ 76 4. ์—ฐ๊ตฌ๊ฒฐ๊ณผ - ์˜ˆ๋ฐฉ์ดˆ์  78 1) ์ •์„œ๋ฐ˜์‘ 78 2) ์ธ์ง€๋ฐ˜์‘ 82 โ…ค. ์š”์•ฝ ๋ฐ ๋…ผ์˜ 84 1. ํ–ฅ์ƒ์ดˆ์  ํ™œ์„ฑํ™” ์ƒํƒœ์—์„œ์˜ ์กฐ์ ˆ์ ํ•ฉ์„ฑ ํšจ๊ณผ 84 2. ์˜ˆ๋ฐฉ์ดˆ์  ํ™œ์„ฑํ™” ์ƒํƒœ์—์„œ์˜ ์กฐ์ ˆ์ ํ•ฉ์„ฑ ํšจ๊ณผ 89 โ…ฅ. ์˜์˜ ๋ฐ ์ œ์–ธ 95 1. ์—ฐ๊ตฌ์˜ ์˜์˜ ๋ฐ ์‹œ์‚ฌ์  95 2. ์ œํ•œ์  ๋ฐ ํ›„์† ์—ฐ๊ตฌ๋ฅผ ์œ„ํ•œ ์ œ์–ธ 98 ์ฐธ๊ณ ๋ฌธํ—Œ 100 ๋ถ€๋ก 115 Abstract 136Docto

    Magnetization-tagged MRI is a simple method for predicting liver fibrosis

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    BACKGROUND/AIMS: To assess the usefulness of magnetization-tagged magnetic resonance imaging (MRI) in quantifying cardiac-induced liver motion and deformation in order to predict liver fibrosis. METHODS: This retrospective study included 85 patients who underwent liver MRI including magnetization-tagged sequences from April 2010 to August 2010. Tagged images were acquired in three coronal and three sagittal planes encompassing both the liver and heart. A Gabor filter bank was used to measure the maximum value of displacement (MaxDisp) and the maximum and minimum values of principal strains (MaxP1 and MinP2, respectively). Patients were divided into three groups (no fibrosis, mild-to-moderate fibrosis, and significant fibrosis) based on their aspartate-aminotransferase-to-platelet ratio index (APRI) score. Group comparisons were made using ANOVA tests. RESULTS: The patients were divided into three groups according to APRI scores: no fibrosis (โ‰ค 0.5; n=41), moderate fibrosis (0.5-1.5; n=23), and significant fibrosis (>1.5; n=21). The values of MaxDisp were 2.9 ยฑ 0.9 (mean ยฑ SD), 2.3 ยฑ 0.7, and 2.1 ยฑ 0.6 in the no fibrosis, moderate fibrosis, and significant fibrosis groups, respectively (P<0.001); the corresponding values of MaxP1 were 0.05 ยฑ 0.2, 0.04 ยฑ 0.02, and 0.03 ยฑ 0.01, respectively (P=0.002), while those of MinP2 were -0.07 ยฑ 0.02, -0.05 ยฑ 0.02, and -0.04 ยฑ 0.01, respectively (P<0.001). CONCLUSIONS: Tagge d MRI to quantify cardiac-induced liver motion can be easily incorporated in routine liver MRI and may represent a helpful complementary tool in the diagnosis of early liver fibrosis.ope

    Morphologic Change of Pulmonary Arteries and Right Ventricular Outflow Tract after Total Correction of Tetralogy of Fallot : Risk Factors for Pulmonary Artery Junctional Stenosis

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    Background and Objectives: Recently, the result of total correction in tetralogy of Fallot(TOF) is improved dramatically. But, residual anatomical changes of right ventricular outflow tract(RVOT) and pulmonary artery junctional stenosis result in bad prognosis. Therefore we sought to analyze risk factors for pulmonary artery junctional stenosis after correction of TOF. Methods: From 1991 to 1998, 146 patients underwent the follow-up catheterizations after total correction of TOF in our institution and were analysed risk factors for pulmonary artery junctional stenosis. Of this patients group [age on operation 20.1ยฑ19.8 months, follow-up duration after operation 13.9ยฑ5.0 months, male(64%)], 20 cases(13.7%) had a PDA and 26 cases(17.8%) had a systemic-to-pulmonary shunt operation before total correction of TOF. Results: 1) Residual PS is correlated significantly with post-operative RVP/LVP(r=0.776, p<0.01) and post-operative RVEDP(r=0.196, p<0.05). 2) Post-operative RVP/LVP and residual PS increased significantly in grade โ…ก of residual PI than grade โ…ขโˆผโ…ฃ. 3) The left pulmonary artery junctional stenosis(LPAJS) was observed in 31 cases, this group decreased significantly in pre-operative LPA diameter(p<0.01), increased in post-operative RVP/LVP(p<0.01), and increased in post-operative RPA diameter(p<0.01), decreased in post-operative LPA diameter(p<0.01) and was more severe in post-operative PI(p<0.01) than the other group respectively. 4) Of the patients group which went patch enlargement of RVOT to LPA junction, the pressure gradient on LPA junction increased significantly in PDA and false aneurysmal change. 5) Factors significantly associated with pulmonary artery junctional stenosis were patch enlargement of RVOT to LPA junction, aneurysmal change of RVOT, PDA, systemic-to-pulmonary shunt and pre-operative LPAJS. 6) LPAJS(pressure gradient, ใŽœHg)=5.43+16.24ร—[false aneurysmal change of RVOT]+14.13ร—[RVOT patch enlargement to LPA] + 16.89ร—PDA. Conclusion: Several factors significantly associated with pulmonary artery junctional stenosis influenced each other. And the LPAJS led to secondary changes (volume overload of RV, increasing diameter of RPA, et. al) therefore more active diagnosis and treatment after total correction is recommended.ope

    Dual-Phase CT Collateral Score: A Predictor of Clinical Outcome in Patients with Acute Ischemic Stroke

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    BACKGROUND AND PURPOSE: The presence of good collaterals on CT angiography (CTA) is a well-known predictor for favorable outcome in acute ischemic stroke. Recently, multiphase CT has been introduced as a more accurate method in assessing collaterals. The aim of this study was to assess the ability of dual-phase CT to evaluate collateral status and predict clinical outcome. METHODS: Forty-three patients who underwent both dual-phase CT and transfemoral cerebral angiography (TFCA) for occluded intracranial internal carotid artery (ICA) and/or middle cerebral artery (M1 segment) were recruited from a prospectively collected database. The collateral status on dual-phase CT was graded by using a 4-point scale: grade 0 = no collaterals; 1 = some collaterals with persistence of some defects; 2 = slow but complete collaterals; and 3 = fast and complete collaterals. Univariate and multivariate analysis were performed to define the independent predictors for favorable outcome at 3 months. RESULTS: Dual-phase CT collateral status (ฯ = 0.744) showed higher correlation with TFCA collateral status than CTA collateral status (ฯ = 0.596) and substantial interobserver agreement (weighted ฮบ = 0.776). In the univariate analysis, age, history of hypertension, collateral scores on CTA, dual-phase CT, and TFCA, occlusion in intracranial ICA, final infarct volume, and symptomatic hemorrhage were significantly associated with outcome. Among them, only the dual-phase CT collateral score was an independent predictor for favorable outcome (OR = 26.342 (2.788-248.864); P = 0.004) in the multivariate analysis. CONCLUSIONS: The collateral status on dual-phase CT can be a useful predictor for clinical outcome in acute stroke patients, especially when advanced CT techniques are not available in emergent situations.ope

    Sema4D Knockout Mouse์˜ ๋Œ€์‚ฌ ํ‘œํ˜„ํ˜• ์—ฐ๊ตฌ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ) -- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์ˆ˜์˜๊ณผ๋Œ€ํ•™ ์ˆ˜์˜ํ•™๊ณผ, 2020. 8. ์„ฑ์ œ๊ฒฝ.Semaphorin 4D is a group 4 Semaphorin that is related to B cell development and class switching. Effects of B cell differentiation in adipose tissue inflammation and glucose homeostasis have not been clearly understood. Obesity is known to induce B cell activation and pathogenic antibodies from activated B cells accelerate adipose tissue inflammation and insulin resistance. Here, we report that Semaphorin 4D deficiency improved glucose dysfunction in high-fat diet-induced obese mice. Inflammation was decreased in high-fat diet fed Semaphorin 4D knockout mice and the production of class switched immunoglobulin IgG2c was also reduced. Consistently, adipose tissue inflammation was also alleviated and the sizes of adipocytes and the masses of adipose tissues were reduced as well, which resulted in decreased body weight. These were confirmed by the decreased expression of genes related with lipid metabolism and adipogenesis and improved respiratory exchange ratio. In summary, these data indicate Semaphorin 4D as a crucial regulator in metabolic homeostasis and glucose metabolism via B cell development.Semaphorin 4D (Sema4D, CD100)๋Š” 150kDa์˜ ํฌ๊ธฐ๋ฅผ ๊ฐ€์ง„ semaphorin์˜ ํ•œ ์ข…๋ฅ˜๋กœ์จ, B cell ๋ฐ˜์‘์„ ์กฐ์ ˆํ•˜๋Š” ๋ฉด์—ญ semaphorin (immune semaphorin)์˜ ํ•œ ์ข…๋ฅ˜๋กœ ์•Œ๋ ค์ ธ ์žˆ๋‹ค. Sema4D๋Š” ํŠนํžˆ T cell ํ‘œ๋ฉด์—์„œ ๋งŽ์ด ๋ฐœํ˜„๋˜๋Š”๋ฐ, B cell ํ‘œ๋ฉด์— ์กด์žฌํ•˜๋Š” Sema4D์˜ ์ˆ˜์šฉ์ฒด์ธ CD72์— ๊ฒฐํ•ฉํ•˜์—ฌ B cell ํ‘œ๋ฉด์—์„œ CD23์„ ์ œ๊ฑฐํ•จ์œผ๋กœ์จ IgE๋‚˜ IgG๋กœ์˜ ๋ฉด์—ญ ๊ธ€๋กœ๋ถˆ๋ฆฐ ์ข…๋ฅ˜ ๋ณ€ํ™˜ (immunoglobulin class switching)์„ ์œ ๋„ํ•œ๋‹ค. Sema4D๋Š” ๋ฉด์—ญ ์ž๊ทน์— ์˜ํ•ด ๊ทธ ๋ฐœํ˜„์ด ์ฆ๊ฐ€ํ•˜๋Š”๋ฐ, ์ฆ๊ฐ€๋œ Sema4D๊ฐ€ B cell ๋ฐ˜์‘์„ ์ด‰์ง„์‹œํ‚ด์œผ๋กœ์จ ๋ฉด์—ญ ์ž๊ทน์— ์˜ํ•œ ์ฒด์•ก ๋ฉด์—ญ ๋ฐ˜์‘(humoral immune response)์„ ์œ ๋„ํ•˜๋Š”๋ฐ ์žˆ์–ด ์ค‘์š”ํ•œ ๋ถ„์ž๋กœ ์ž‘์šฉํ•œ๋‹ค. ๊ทธ๋ ‡๊ธฐ ๋•Œ๋ฌธ์— Sema4D๋Š” ํ˜„์žฌ๊นŒ์ง€ ๋ฅ˜๋งˆํ‹ฐ์ฆ˜๊ณผ ๊ฐ™์€ ์ž๊ฐ€๋ฉด์—ญ ์งˆํ™˜๊ณผ ๊ด€๋ จ๋˜์–ด์„œ ์ฃผ๋กœ ์—ฐ๊ตฌ๊ฐ€ ์ง„ํ–‰๋˜์–ด ์™”์œผ๋ฉฐ, ๋‹น๋‡จ๋‚˜ ์ธ์Š๋ฆฐ ์ €ํ•ญ์„ฑ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์— ๋Œ€ํ•ด์„œ๋Š” ๋ณด๊ณ ๋œ ๋ฐ”๊ฐ€ ์—†๋‹ค. ๊ทธ๋Ÿฌ๋‚˜, ์•„ํ”„๋ฆฌ์นด ์‚ฌ๋žŒ๋“ค ์ค‘ ๋น„๋งŒ์ธ ๊ฒฝ์šฐ์— ํ˜ˆ์ค‘ soluble Sema4D์˜ ๋†๋„๊ฐ€ ๋†’๋‹ค๋Š” ์ž„์ƒ ๊ฒฐ๊ณผ๊ฐ€ ๋ฐํ˜€์กŒ์œผ๋ฉฐ, B cell ๋˜ํ•œ ๋น„๋งŒ์—์„œ ํฌ๋„๋‹น ๋‚ด์„ฑ (glucose tolerance)๊ณผ ์ธ์Š๋ฆฐ ๋ฏผ๊ฐ๋„ (insulin sensitivity)์— ์˜ํ–ฅ์„ ๋ฏธ์นœ๋‹ค๋Š” ์„ ํ–‰ ์—ฐ๊ตฌ๋“ค์ด ์ง„ํ–‰๋˜์—ˆ๋‹ค. ์ด์— ๋ณธ ๋…ผ๋ฌธ์—์„œ๋Š” Sema4D๊ฐ€ ๋น„๋งŒ์ธ ๊ฒฝ์šฐ์— B cell ๋ฐ˜์‘์„ ํ†ตํ•˜์—ฌ ํฌ๋„๋‹น ํ•ญ์ƒ์„ฑ (glucose homeostasis)์„ ์กฐ์ ˆํ•  ๊ฒƒ์ด๋ผ๋Š” ๊ฐ€์„ค์„ ํ†ตํ•ด ๋น„๋งŒ ํ™˜๊ฒฝ์—์„œ Sema4D์˜ ์—ญํ• ์— ๋Œ€ํ•ด ์—ฐ๊ตฌ๋ฅผ ์ง„ํ–‰ํ•˜๊ณ ์ž ํ•˜์˜€๋‹ค. ์ด์— ๋”ฐ๋ผ WT ๋งˆ์šฐ์Šค์™€ Sema4D KO ๋งˆ์šฐ์Šค๋ฅผ ์ด์šฉํ•˜์—ฌ ๊ณ ์ง€๋ฐฉ์‹์ด (high fat diet)๋ฅผ ๋จน์—ˆ์„ ๋•Œ์˜ Sema4D ๋ฐœํ˜„ ์—ฌ๋ถ€์— ๋”ฐ๋ฅธ ๋Œ€์‚ฌ, ์ƒ๋ฆฌ์  ๋ณ€ํ™”์™€ ์—ผ์ฆ ๋ณ€ํ™”๋ฅผ ํ™•์ธํ•˜์˜€๋‹ค. Sema4D KO ๋งˆ์šฐ์Šค๋Š” ๊ณ ์ง€๋ฐฉ์‹์ด๋ฅผ ๋จน์€ ๊ฒฝ์šฐ WT ๋งˆ์šฐ์Šค์— ๋น„ํ•ด ๋ชธ๋ฌด๊ฒŒ์˜ ์ฆ๊ฐ€๊ฐ€ ๋”๋””๊ณ , ์ง€๋ฐฉ์˜ ๋ฌด๊ฒŒ ๋ฐ ํฌ๊ธฐ ๋˜ํ•œ ๊ฐ์†Œ๋˜์–ด ์žˆ์Œ์„ ํ™•์ธํ•˜์˜€๋‹ค. ๋˜ํ•œ, ๊ณ ์ง€๋ฐฉ์‹์ด์— ์˜ํ•œ ํฌ๋„๋‹น ๋ถˆ๋‚ด์„ฑ๊ณผ ์ธ์Š๋ฆฐ ์ €ํ•ญ์„ฑ ๋˜ํ•œ ๊ฐœ์„ ๋จ์„ ํ™•์ธํ•˜์˜€๋‹ค. ์ด์— ๋”ฐ๋ฅธ ์ด์œ ๋ฅผ ์ฐพ๊ธฐ ์œ„ํ•ด C/ebp-ฮฑ ๋“ฑ๊ณผ ๊ฐ™์ด ์ง€๋ฐฉ ํ•ฉ์„ฑ (adipogenesis)์„ ์œ ๋„ํ•˜๊ฑฐ๋‚˜, Hsl ๋“ฑ๊ณผ ๊ฐ™์€ ์ง€๋ฐฉ์‚ฐ ํ•ฉ์„ฑ์„ ์œ ๋„ํ•˜๋Š” ์ง€์งˆ ๋Œ€์‚ฌ (lipid metabolism) ๊ด€๋ จ ์œ ์ „์ž๋“ค์˜ ๋ฐœํ˜„์„ ์‚ดํŽด๋ณด์•˜์„ ๋•Œ ๊ณ ์ง€๋ฐฉ์‹์ด๋ฅผ ๋จน์€ Sema4D KO ๋งˆ์šฐ์Šค์—์„œ ๊ทธ ๋ฐœํ˜„์ด ๋‚ฎ์€ ๊ฒƒ์„ ํ™•์ธํ•˜์˜€๋‹ค. Sema4D๋Š” ๋ฉด์—ญ ์ž๊ทน์— ์˜ํ•ด ๊ทธ ๋ฐœํ˜„์ด ์ฆ๊ฐ€ํ•˜๋Š” ๊ฒƒ์ด ์•Œ๋ ค์ ธ ์žˆ๋Š”๋ฐ, ๊ณ ์ง€๋ฐฉ์‹์ด๋ฅผ ์‹ค์‹œํ•œ ๊ฒฝ์šฐ์—๋„ ๋น„์žฅ์—์„œ ๊ทธ ๋ฐœํ˜„์ด ์ฆ๊ฐ€ํ•˜๋Š” ๊ฒƒ์„ ํ™•์ธํ•˜์˜€๋‹ค. ๋˜ํ•œ, B cell์— ๊ตญํ•œ์ ์œผ๋กœ ๋ฐœํ˜„๋˜๋Š” Sema4D์˜ ์ˆ˜์šฉ์ฒด์ธ CD72๊ฐ€ Sema4D์˜ ๋ฐœํ˜„์ด ์ผ์–ด๋‚˜๋Š” ๋น„์žฅ์—์„œ ๊ฐ™์ด ๋ฐœํ˜„์ด ๋˜๋Š” ๊ฒƒ์„ ํ™•์ธํ•˜์˜€๊ธฐ ๋•Œ๋ฌธ์—, ๋น„์žฅ์—์„œ Sema4D์˜ ๋ฐœํ˜„ ์œ ๋ฌด ๋ฐ ์–‘์  ์ฐจ์ด์— ๋”ฐ๋ฅธ ์—ผ์ฆ์˜ ๋ณ€ํ™” ์—ฌ๋ถ€๋ฅผ ํ™•์ธํ•˜์˜€๋‹ค. ๊ทธ ๊ฒฐ๊ณผ, ๊ณ ์ง€๋ฐฉ์‹์ด๋ฅผ ๋จน์€ Sema4D KO ๋งˆ์šฐ์Šค์˜ ๋น„์žฅ์—์„œ๋Š” WT ๋งˆ์šฐ์Šค์˜ ๋น„์žฅ์— ๋น„ํ•ด ์—ผ์ฆ์ด ์ค„์–ด๋“  ๊ฒƒ์„ ํ™•์ธํ•˜์˜€์œผ๋ฉฐ, ์ด๋Š” B cell์˜ ๋ถ„ํ™”๊ฐ€ ๋”๋””๊ธฐ ๋•Œ๋ฌธ์ธ ๊ฒƒ์œผ๋กœ ํ™•์ธํ•˜์˜€๋‹ค. ์‹ค์ œ๋กœ ๊ณ ์ง€๋ฐฉ์‹์ด๋ฅผ ๋จน์€ Sema4D KO ๋งˆ์šฐ์Šค๋Š” CD72์— ์˜ํ•œ B cell ํ•˜์œ„ signaling์ด ๊ฐ์†Œํ•˜์˜€์œผ๋ฉฐ, ์ด์— ๋”ฐ๋ผ ๋ฉด์—ญ ๊ธ€๋กœ๋ถˆ๋ฆฐ ์ข…๋ฅ˜ ๋ณ€ํ™”๊ฐ€ ์ผ์–ด๋‚œ ๋ฉด์—ญ ๊ธ€๋กœ๋ถˆ๋ฆฐ์ธ IgG2c์˜ ์ƒ์„ฑ๋Ÿ‰์ด WT ๋งˆ์šฐ์Šค์— ๋น„ํ•ด ์ ์€ ๊ฒƒ์„ ํ™•์ธํ•˜์˜€๋‹ค. ๋งˆ์ง€๋ง‰์œผ๋กœ ์ด๋Ÿฌํ•œ ๋ณ€ํ™”๊ฐ€ ์ง€๋ฐฉ์— ์–ด๋–ค ์˜ํ–ฅ์„ ์ฃผ๋Š”์ง€ ํ™•์ธํ•˜๊ธฐ ์œ„ํ•˜์—ฌ ์ง€๋ฐฉ์—์„œ์˜ ์—ผ์ฆ์„ ํ™•์ธํ•˜์˜€๋‹ค. ๊ณ ์ง€๋ฐฉ์‹์ด๋ฅผ ๋จน์€ Sema4D KO ๋งˆ์šฐ์Šค์˜ ์ง€๋ฐฉ์—์„œ WT ๋งˆ์šฐ์Šค์— ๋น„ํ•ด ์—ผ์ฆ์„ฑ ์‚ฌ์ดํ† ์นด์ธ์˜ ์–‘์ด ๊ฐ์†Œํ•˜์˜€์œผ๋ฉฐ, ์ง€๋ฐฉ์œผ๋กœ์˜ ๋Œ€์‹์„ธํฌ ์œ ์ž… ๋˜ํ•œ ๊ฐ์†Œํ•จ์„ ํ™•์ธํ•˜์˜€๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ง€๋ฐฉ์—์„œ ์—ผ์ฆ์„ฑ์ด์ž ๋ณ‘์›์„ฑ์œผ๋กœ ์•Œ๋ ค์ง„ ๊ธ€๋กœ๋ถˆ๋ฆฐ์ธ IgG2c์˜ ์–‘์ด ๊ฐ์†Œํ•œ ๊ฒƒ์„ ํ™•์ธํ•˜์˜€๋‹ค. ๊ฒฐ๊ณผ์ ์œผ๋กœ, Sema4D KO ๋งˆ์šฐ์Šค๋Š” ๊ณ ์ง€๋ฐฉ์‹์ด๋ฅผ ํˆฌ์—ฌํ•˜์˜€์„ ๋•Œ, Sema4D์— ์˜ํ•œ CD72 ํ•˜์œ„ B cell signaling์ด ๊ฐ์†Œํ•˜์˜€๊ณ , ์ด๋กœ ์ธํ•˜์—ฌ B cell์˜ ๋ถ„ํ™”๊ฐ€ ๋”๋””๊ฒŒ ์ผ์–ด๋‚ฌ๋‹ค. ๋”ฐ๋ผ์„œ, ์ „์ฒด์ ์ธ ์—ผ์ฆ ๋ฐ˜์‘์ด ๊ฐ์†Œํ•˜์˜€๊ณ , ๋ณ‘์›์„ฑ ๋ฉด์—ญ ๊ธ€๋กœ๋ถˆ๋ฆฐ์˜ ์ƒ์„ฑ ์–‘ ๋˜ํ•œ ๊ฐ์†Œํ•˜์˜€๋‹ค. ๋ณ‘์›์„ฑ ๋ฉด์—ญ ๊ธ€๋กœ๋ถˆ๋ฆฐ์ธ IgG2c์˜ ์ƒ์„ฑ ๊ฐ์†Œ๋กœ ์ธํ•˜์—ฌ ์ง€๋ฐฉ์—์„œ์˜ IgG2c ์–‘ ๋˜ํ•œ ๊ฐ์†Œํ•˜์˜€๋Š”๋ฐ, ์ด์— ๋”ฐ๋ฅธ ๋Œ€์‹ ์„ธํฌ์˜ ์œ ์ž… ๋ฐ ๋Œ€์‹ ์ž‘์šฉ์ด ๊ฐ์†Œํ•˜์˜€๋‹ค. ๋Œ€์‹ ์ž‘์šฉ์€ ์—ผ์ฆ์„ ์ฆ๊ฐ€์‹œํ‚ค๊ณ , ์ฆ๊ฐ€๋œ ์—ผ์ฆ์€ ํฌ๋„๋‹น ๋ถˆ๋‚ด์„ฑ๊ณผ ์ธ์Š๋ฆฐ ์ €ํ•ญ์„ ์ฆ๊ฐ€์‹œํ‚ค๋Š”๋ฐ, ๊ณ ์ง€๋ฐฉ์‹์ด๋ฅผ ํ•œ Sema4D KO ๋งˆ์šฐ์Šค์—์„œ๋Š” ์ด๋Ÿฌํ•œ ๋Œ€์‹ ์ž‘์šฉ์ด WT ๋งˆ์šฐ์Šค์— ๋น„ํ•ด ๊ฐ์†Œ๋˜์–ด ์žˆ์—ˆ๋‹ค. ์ด๋กœ ์ธํ•ด ์ง€๋ฐฉ์—์„œ์˜ ์—ผ์ฆ์ด ๊ฐ์†Œํ•˜์˜€๊ณ , ํฌ๋„๋‹น ๋ถˆ๋‚ด์„ฑ๊ณผ ์ธ์Š๋ฆฐ ์ €ํ•ญ์„ฑ ๋ฐ ์ง€๋ฐฉ๊ณผ ์ฒด์ค‘ ์ฆ๊ฐ€์— ์žˆ์–ด์„œ ๊ฐœ์„ ๋˜๋Š” ํšจ๊ณผ๋ฅผ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค.INTRODUCTION 1 MATERIALS AND METHODS 6 RESULTS 16 DISCUSSION 41 CONCLUSION 47 REFERENCES 48 ๊ตญ๋ฌธ์ดˆ๋ก 57Maste

    ์•ˆ๋ฉด์ „๊ธฐ์ž๊ทน์„ ์œ„ํ•œ ๋“ฑ์ฒ™์„ฑ๋ถ€ํ•˜์˜ ์ ์šฉ

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ) --์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :์˜ํ•™๊ณผ ์žฌํ™œ์˜ํ•™ ์ „๊ณต,2007.Maste
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