Immunostimulatory Effects of Silver Nanoparticles in Immune Cells and their Relevance to Atopic Dermatitis

의과대학/박사Engineered nanomaterials (NMs) are increasingly used in numerous consumer products and biomedical applications that affect humans directly and indirectly. However, in vitro and in vivo studies have revealed that nanomaterials can result in toxicity. The immunostimulatory effect of silver nanoparticles (AgNPs) is dependent on particle size and the production of reactive oxygen species (ROS). Although these products have many opportunities to contact with the skin, the toxicity of AgNPs has not been clearly defined. Mast cells are potent effectors of the allergic response. They play an important role in asthma, atopic dermatitis (AD) and other allergic reactions. In this study, RBL2H3 mast cell viability was dependent on the particles size. Granule release, Ca2+ influx, the production of hydrogen peroxide and superoxide and mitochondrial membrane damage were used to evaluate cytotoxicity of AgNPs. To evaluate the synergistic effect of AgNPs on the induction of allergic reactions in animals, NC/Nga mice were used in this study. NC/Nga mice spontaneously develop an eczematous AD-like skin lesion when kept under conventional conditions, but not when maintained under specific pathogen-free (SPF) conditions. They are considered an appropriate animal model for AD. Macrophages are active phagocytic cells present in many tissues. The internalization of nanoparticles by phagocytic cells can occur through phagocytosis/macropinocytosis, receptor-mediated endocytosis and passive penetration. Phagocytosis and macropinocytosis are mediated by actin polymerization, which causes cell membrane ruffling. The process is inhibited by cytochalasin D. Endocytosis can occur as clathrin-dependent endocytosis and caveolae-dependent endocytosis. Clathrin-dependent endocytosis is inhibited by chlorpromazine, a cationic amphiphilic drug that prevents the recycling of clathrin. Caveolae-dependent endocytosis is inhibited by nystatin, an antibiotic and sterol-binding agent that removes membrane cholesterol, which is important for maintaining and sealing the membrane of caveolae. In this study, the ability of AgNPs to evoke allergic immune responses was investigated in mast cells and macrophages (in vitro) and atopic animal model (in vivo) to assess. Cytotoxicity in mast cells was evaluated using Cell Counting Kit-8 (CCK8). Cell death was induced by 5 nm AgNPs, but not by 100 nm AgNPs. Granule release was evaluated with the β-hexosaminidase assay. Granule release in RBL2H3 cells was induced by 5 nm AgNPs, but not by 100 nm AgNPs. N-acetylcystein (NAC) at 5 mM inhibited granule release in RBL2H3 cells. To assess intracellular Ca2+ levels, RBL2H3 cells were prestained with Fluo4-AM and then treated with AgNPs in HBSS with and without Ca2+. In both groups with and without Ca2+, 5 nm AgNPs but not 100 nm AgNPs increased the fluorescence intensity. To evaluate the effect of intracellular Ca2+ levels on granule release, RBL2H3 cells were pretreated with thapsigargin and then treated with AgNPs. Thapsigargin inhibited the granule release induced by 5 nm AgNPs. In addition, the production of hydrogen peroxide and superoxide was assessed by staining RBL2H3 cells with CM-H2DCFDA or MitoSOX, respectively. Treatment with 5 nm AgNPs increased the fluorescence intensity of CM-H2DCFDA and MitoSOX in a dose-dependent manner. In addition, JC-1 staining was performed to assess mitochondrial depolarization. JC-1 fluorescence intensity decreased in cells treated with 5 nm AgNPs. To investigate the synergistic effect of AgNPs on the induction of AD, ear thickness was measured once a week and the severity score of the AD-like skin lesions was evaluated once a week. Ear swelling was more severe in mice treated with 5 nm AgNPs + Ad Biostir when compared with that in the AD control group. The severity score of the skin also increased in mice treated with 5 nm AgNPs. Epidermal thickness in the group treated with 5 nm AgNPs + Ad Biostir was thicker when compared to that of the Ad Biostir-only group. The number of infiltrated mast cells in skin lesions was higher in the group treated with 5 nm AgNPs + Ad Biostir than in the Ad Biostir-only group. Total IgE levels in the serum increased in the group treated with 5 nm AgNPs + Ad Biostir. The viability of U937 cells declined abruptly when cells were treated with 5 nm AgNPs. The effects of AgNP endocytosis or phagocytosis on cell death were then evaluated. After treatment of U937 cells with AgNPs, neither chlorpromazine, cytochalasin D, nor nystatin prevented cell death. At relatively high concentrations, chlorpromazine, cytochalasin D and nystatin partially inhibited the production of IL-8 following exposure to AgNPs. These findings were confirmed with real-time RT-PCR assays. Collectively, it was suggested that these immunostimulatory effects has contributed to causing AD. These inflammatory effects should be considered and evaluated in addition to cytotoxicity when studying the effects of AgNPs exposure in human physiology.ope

A Study on Aggregate Volatility Risk and Lottery Effect in Korea Market

학위논문(석사)--서울대학교 대학원 :경영대학 경영학과,2020. 2. 김정욱.국내외 여러 연구에서 복권형 주식이 다음 기에 낮은 수익률을 갖는 현상을 보여주고 있다. Bali et. al.(2011)은 지난 달 극단적인 높은 수익률과 기대 수익률은 음의 상관관계를 가진다는 최대효과를 보였고, Boyer et al.(2010)은 개별 회사의 왜도와 미래 수익률이 음의 상관관계를 가진다는 왜도효과를 보였다. 이들을 복권효과라 하며 Barinov(2018)는 복권형 주식이 종합 변동성 위험을 헤지하므로 이러한 효과들이 발생하는 것이라고 설명하고 있다. 본 연구는 Barinov(2018)를 바탕으로 한국 주식시장에서 시계열 및 횡단면 분석을 통해 종합 변동성 위험이 복권효과를 설명하는지 살펴보았다. 지난 월 최대 수익률(Max) 또는 기대 왜도(ES, Expected Skewness)로 Low부터 High까지 5개의 랭킹 포트폴리오를 구성한 후 Low-High 포트폴리오의 수익률을 가격결정모형으로 시계열 분석을 한 결과, 최대효과는 존재한 반면 왜도효과는 비유의적으로 존재하였다. 한편, 가격결정모형에 FVKOSPI 요인을 추가하여 같은 분석을 실시하였으나 알파가 유의하게 감소하지 않았다. 또한 주식의 미래수익률을 FVKOSPI 베타, 복권특성변수(Max, ES) 및 통제변수로 매월 횡단면 분석을 실시한 결과, 복권특성변수는 FVKOSPI 베타가 통제되더라도 계수값을 유지하였다. 추가적으로 복권효과가 강하게 나타나는 소표본에 대하여 같은 분석을 실시하였으나 결과는 동일하였다. 결론적으로, 시계열 및 횡단면 분석 결과 한국 주식시장에서 종합 변동성 위험은 복권효과에 대하여 설명력이 없었다. 미국과 달리 이러한 결과가 나타난 가능성으로 1) FVKOSPI 요인을 구성하는 방법 자체가 한국에서는 제대로 작동하지 않을 수 있으며, 2) 한국 시장에서는 복권형 주식 거래 비중의 90% 이상을 노이즈 투자자로 여겨지는 개인이 차지하기 때문일 수 있으며, 3) 적은 표본 수로 인해 노이즈가 제대로 제거되지 않았기 때문일 수도 있다. 본 연구는 복권효과를 효율적 시장 관점에서 증명하려는 것을 국내 연구에서 처음 시도했다는 점에서 그 의의가 있다.Several studies at South Korea and abroad have shown that lottery-like stocks have low returns forward. Barinov(2018) explains this phenomenon by pointing out that lottery-like stocks hedge aggregate volatility risk. This study applied methodology of Barinov(2018) to the Korean KOPSI market. I constructed a ranking portfolio by past maximum return(Max) or expected skewness(ES). By regressing value-weighted portfolio return on asset-pricing model, maximum effect and skewness effect exists. After adding FVKOSPI factor on models, alphas of Low-High portfolio did not reduced significantly. Also, I made a cross-sectional regression analysis including FVKOSPI beta and lottery variables(Max, ES) conducted on portfolio-level and firm-level. By regression, betas of lottery variables did not reduced after controlling FVKOSPI betas. In conclusion, no evidence was found that aggregate volatility risk explains lottery effect through time-series and cross-sectional regressions. The reason why the result is different from U.S. could be 1) that the method to form FVKOSPI factor does not work in Korea market, 2) individuals, known as noise traders, account for more than 90% of lottery-type stock trading in Korean market, or 3) the small number of samples did not remove noise properly. This study is meaningful in that it is the first attempt in domestic research to prove lottery effect from an efficient market perspective.Ⅰ. 서론 1 Ⅱ. 데이터 5 Ⅲ. 연구 결과 7 1. 기초 통계량 7 1.1. FVKOSPI 요인 7 1.2. 복권형 주식의 성격 10 2. 시계열 분석 12 2.1. 종합 변동성 위험과 복권효과 12 2.2. 복권효과와 옵션 성격 16 3. 횡단면 분석 19 4. 소표본 검정 23 5. 강건성 검정 31 Ⅳ. 결론 34 참고문헌 35 부록 37Maste

양악수술 후 입술과 횡적 교합평면의 기울기 변화의 연관성에 관한 연구

학위논문 (석사)-- 서울대학교 대학원 : 치의학과, 2012. 2. 백승학.Objective: To evaluate the amount of canting correction in the anterior (AMTOP) and posterior maxillary transverse occlusal plane (PMTOP) and to investigate which is more related with the change of lip canting (LC) in two-jaw orthognathic surgery (TJOS) cases. Patients and Methods: The samples consisted of eight young adult patients (3 males and 5 females, mean age=24.1±4.5 years-old) who had skeletal Class III malocclusion (CIII), facial asymmetry (FA), and LC and underwent TJOS. Lateral and posteroanterior (PA) cephalograms and three-dimensional (3D) facial scanning were taken one-week before (T1) and six-months after TJOS (T2). Three linear and three angular variables were used to measure the LC, AMTOP, PMTOP, and their amounts of change. Wilcoxon signed rank test, Mann-Whitney test, and Pearson correlation analysis were performed for statistical purpose. Results: In the linear and angular evaluation at T1 and T2 stages, there were significant canting correction of AMTOP (1.7mm vs. -0.3mm; 3.0˚ vs. 0.1˚, both P0.05), linear change ratio of ΔLC/ΔAMTOP was significantly higher than linear change ratio of ΔLC/ΔPMTOP (1.67 vs. 0.74, P<0.05). Significant correlation was found between angular change of ΔLC and ΔAMTOP (P<0.05). Linear change of ΔLC was significantly correlated with both angular and linear changes of ΔAMTOP (P<0.05, all). Therefore, the amount of LC change was more related with canting correction of the AMTOP rather than that of the PMTOP. Conclusion: In TJOS cases with CIII, FA, and LC, the amount of canting correction of the AMTOP should be considered to predict the actual LC change in addition to that of the PMTOP.목적 : 입술 경사(Lip canting, LC)를 보이는 안면비대칭 증례에서 양악수술 전후의 전방 상악 횡적 교합평면(anterior maxillary transverse occlusal plane, AMTOP)과 후방 상악 횡적 교합평면(posterior maxillary transverse occlusal plane, PMTOP)의 교정량을 평가하고 입술 기울기(LC)와의 연관성에 대해 조사한다. 연구대상 및 방법 : 양악 수술(LeFort I osteotomy for the maxilla, bilateral sagittal split ramus osteotomy for the mandible)을 시행한 골격성 III급 부정교합환자 중 안면 비대칭을 가진 환자를 대상으로, 술전 1주일(T1), 술후 6개월(T2) 에 3차원 얼굴 스캔, 정면두부계측방사선사진, 측모두부계측방사선사진을 촬영하였다. LC, AMTOP, PMTOP 에 대해 선형과 각형 변수를 측정하였고 각각의 연관성을 분석하기 위하여 wilcoxon signed rank test, Mann-Whitney test, Pearson 상관계수분석법을 사용하여 통계적으로 분석하였다. 결과 : 선형과 각형 분석을 통해 AMTOP (1.7mm vs. -0.3mm; 3.0˚ vs. 0.1˚, both P0.05), AMTOPdp 대한 LC의 선변화율(linear change ratio)은 PMTOP 에 대한 LC의 선변화율(linear change ratio)보다 유의성 있게 높았다(1.67 vs. 0.74, P<0.05). LC 와 AMTOP의 각변화량(angular canting change)은 유의성있는 상관관계를 보였고(P<0.05), LC의 선변화량(linear canting change)은 AMTOP 의 선변화량(linear canting change) 및 각변화량(angular canting change)에 대해 유의성있는 상관관계를 보였다(P<0.05). 따라서 LC 의 변화량은 PMTOP 보다 AMTOP의 교정량에 더욱 연관성을 보였다고 할 수 있다. 결론 : 입술기울기를 가진 안면 비대칭 환자의 입술기울기를 교정하기 위한 양악수술에서는 LC의 변화량을 정확히 예상하기 위해서는 PMTOP 뿐만 아니라 AMTOP 의 변화량도 반드시 고려해야 한다고 할 수 있다.Maste

흑백카메라 백색광 간섭계에서 컬러 이미지 획득에 관한 연구

학위논문 (석사)-- 서울대학교 대학원 : 공과대학 기계항공공학부, 2018. 2. 박희재.In this research, it is suggested to acquire a color image using a monochrome camera from white-light scanning interferometer without any hardware modification and addition. Previous research is necessarily required to install a color camera and other optical system change. Therefore, this research aims to obtain the spectral intensity of interferogram by Fourier transform from existing monochrome camera. Since the intensity also includes reference mirror component, it is removed by measuring silicon sample which is known its reflection coefficient. After RGB filtering of acquired sample intensity, it is converted to 8-bit digital value and the whole surface is expressed as color image by applying the above process to each pixel. Lastly, 3 sample’s color images are obtained and they are evaluated by PSNR. It is verified that the color can be recognized by color acquisition method meeting up at least 24dB. This research is expected to reduce hardware cost and obtain color image by the software process. The acquired color image helps understanding of sample intuitively and can be utilized for sample review, target positioning and pattern matching.1. Introduction 1 1.1 Background 1 1.2 Previous Research 2 1.3 Purpose of Research 5 2. Theoretical Background 6 2.1 Principles of Interferometer 6 2.1.1 Equation for a Coherence Signal 6 2.1.2 White-Light Scanning Interferometry (WSI) 8 2.2 Spectral Resolved Method – Fourier Transform 11 2.3 Color CCD Camera 13 2.3.1 Color Filter 13 2.3.2 Post-Processing 15 3. Color Acquisition Method 16 3.1 Acquisition of Reference Mirror Component 16 3.2 Calculation of Sample Component 18 3.3 RGB Filtering 19 3.4 Converting Intensity to Digital Value 20 3.5 Flow Chart 22 4. Experimental Results 24 4.1 Acquired Color Images of Samples 24 4.2 Performance Evaluation 28 5. Conclusion 30Maste

Development of prosthetic arm & its control by bioelectric signals

Maste

Development and effectiveness evaluation of interprofessional communication education in healthcare

학위논문(석사)--서울대학교 대학원 :의과대학 의학과,2019. 8. 신좌섭.Cooperation and effective communication between physicians, nurses, and other health care workers in a clinical setting is essential to ensure patients safety and restore their health. In many medical schools in overseas emphasize interprofessional communication education and related studies are actively carried out. However, medical communication education in Korean medical schools is mostly focused on communication between patients and doctors, and interprofessional communication education is relatively rare. Therefore, Seoul National University College of Medicine introduced a Communication between healthcare professionals in the clinical field training program as a part of the Human-Society-Medicine 5 course in the first semester of the 2018 school year and the Human-Society-Medicine 6 course in the second semester of the same year. The effectiveness of this interprofessional communication program was evaluated and compared after each training was completed. The training sessions lasted for a total of 6 hours with 3 hours per each semester, and constituted of two example cases of conflict between healthcare providers to the students, followed by students producing a video of group role-play, and discussions in small groups and by the whole class. We used Kirkpatricks 4-level evaluation model to evaluate the effectiveness of our interprofessional communication training program. Among the items of the Kirkpatricks 4-level model, our evaluation was limited to the reaction and learning stages, which can be evaluated immediately after the training sessions. In order to evaluate the specific effectiveness of the training, the interpersonal communication skills of each students at three different stages (before the practice, after the first session, and after the second session) were measured using the Global Interpersonal Communication Competence Scale (GICC-15) questionnaire and compared. In addition, we surveyed the students on the importance of learning interprofessional communication and the appropriateness of content and methods used in the training sessions. Students were also asked to gice any other comments and suggestions about the program after the first and second sessions. 137 out of 149 available students who completed the GICC-15 questionnaire and answered the question about the importance of interprofessional communication education for all three periods were analyzed by repeated measure analysis of variance (RM ANOVA). The appropriateness of content and methods of the class scores that were obtained after the first and second sessions were analyzed by paired t-test. The results showed that total GICC-15 sores increased after the first session compared to the scores taken before the beginning of training. After the second training session, total GICC-15 scores decreased compared to the scores after the first session, but they were still higher than scores before the beginning of training (p-value <0.05). The 15 subcategory scores of GICC-15 demonstrated a similar overall pattern throughout the three periods, although results for some subcategories were statistically insignificant. The scores regarding the importance of interprofessional communication education increased after the first training compared to scores before the beginning of training, but scores taken after the second session decreased compared to both the scores after the first session and also before the beginning of training, but all scores at three periods were relatively high with numbers higher than 4 points (p <0.05). The scores regarding the appropriateness of the content and methods of training decreased after the second training session compared to scores taken after the first session, but scores at both periods were still relatively high with numbers reaching almost 4 points (p < 0.05). The question asking for any other comments and suggestions on the program was answered by 20 students after the first training session and 10 students after the second session, and there were many opinions that the sessions were beneficial and interesting. Based on these results, it can be interpreted that our interprofessional communication program demonstrated a positive overall effect in both the reaction and learning stages of Kirkpatricks 4-step model. We believe that selecting effective teaching methods such as producing a video-recording of group role-play and small group discussions contributed to maximizing the educational effect despite the relatively short training time of 6 hours. Our study is also meaningful because we evaluated the effects of interprofessional education, which has, to this day, rarely been implemented in Korean medical schools, by comparing pre- and post-practice evaluations. However, the fact that the most questionnaire scores dropped after the second training session compared to scores after the first session will need to be further discussed in future studies, along with some of the limitations of this study such as applying almost the same program in both sessions, only providing example cases involving conflict between doctors in the second session, and the relatively short hours of training. In conclusion, our trial implementation of Communication between healthcare professionals in the clinical field program which was the first interprofessional communication education attempted at the Seoul National University College of Medicine demonstrated generally positive and favorable educational effects. Based on these results and limitations, we expect to develop our schools interprofessional education program more systematically and with more diverse themes in the future. In addition, it would be necessary to conduct further longitudinal studies on the effect of these interprofessional education programs and it would be even better to investigate how interoprofessional education experienced at medical school affects the performance of students when they work as clinical doctors in the future.환자의 생명을 다루는 것을 주업으로 하고 있는 의사, 간호사 및 기타 보건의료인 간의 효과적인 의사소통은 환자의 안전 및 건강의 회복에 있어서 매우 중요하다. 이에 따라 해외의 의과대학들은 전문직 간 의사소통 교육을 강조하고 있으며 이와 관련된 연구들도 활발히 진행 중이다. 하지만 국내 의과대학에서의 의료커뮤니케이션 교육은 대부분이 환자-의사 간의 의사소통 교육에 치중되어 있으며 전문직 간 의사소통에 관한 교육은 거의 없었다. 이에 따라 서울대학교 의과대학에서는 2018년도 의학과 3학년 학생(총 149명)들을 대상으로 1학가인간 사회 의료 5수업과 2학기인간 사회 의료 6수업의 일부에서 임상 현장에서의 보건의료인 간의 의사소통실습을 도입하여 진행하였으며 그 교육 효과를 평가하였다. 실습은 회당 3시간이었으며, 각 실습마다 보건의료인 간의 갈등 사례를 두 가지 제시한 후 조별 역할극 촬영, 소그룹 토론 및 전체 토론을 진행하였다. 상기 실습에 대한 교육 효과 평가는 커크패트릭 4단계 모형 중 현재 시점에서 평가 가능한 반응 및 학습 단계의 평가를 시행하였다. 교육 효과 평가를 위해 실습 전, 1차 실습 후 및 2차 실습 후 총 3차례에 걸쳐 대인관계 의사소통 능력을 포괄적 대인의사소통 능력 척도(Global Interpersonal Communication Competence Scale: GICC-15) 설문을 통해 비교하였으며, 이 외에도 전문직 간 의사소통 수업의 중요성에 대한 인식, 실습의 내용 및 방법의 적절성에 대한 설문(1차 실습 후 및 2차 실습 후)과 기타 건의사항을 주관식 설문으로 조사하여 비교하였다. 세 차례의 객관식 설문을 모두 완료한 137명의 학생들을 대상으로 하여 세 시점의 GICC-15 점수 및 전문직 간 의사소통 실습의 중요성 점수는 반복측정 분산분석으로, 1차 실습 후와 2차 실습 후의 두 시점의 실습 내용·방법의 적절성 점수는 대응표본 t 검정으로 분석하였다. 분석 결과 GICC-15 총점은 실습 전에 비해 1차 실습 후에 증가하였으며 2차 실습 후에는 1차 실습 후에 비해 총점이 감소하였으나 실습 전에 비해서는 높은 수준을 유지하였다(p값 <0.05). 세 시점의 GICC-15 세부 항목 점수들 역시 일부 통계적으로 유의하지 않은 항목들이 있었으나 전반적으로 GICC-15 총점과 유사한 양상의 변화를 보였다. 전문직 간 의사소통 수업의 중요성 점수는 실습 전에 비해 1차 실습 후 증가하였으나 2차 실습 후에는 실습전보다도 감소하였다. 하지만 세 시점 모두에서 4점 이상의 비교적 높은 점수를 보였다(p <0.05). 실습 내용 및 방법의 적절성을 묻는 점수도 1차 실습 후에 비해 2차 실습 후에 감소하였으나 두 차례 실습 후 모두 3점대 후반의 점수를 보였다(p < 0.05). 주관식 설문은 1차 실습 후에는 20명의 학생들이, 2차 실습 후에는 10명의 학생들만이 응답을 주었으며 실습이 유익하고 흥미로웠다는 의견이 다수 있었다. 이러한 결과들을 종합해볼 때 실습의 교육 효과는 커크패트릭 4단계 모형의 반응 및 학습 단계 모두에서 긍정적인 효과가 있었다고 생각되며 이렇게 짧은 시간의 실습만으로 양호한 결과를 가져올 수 있었던 것은 역할극 촬영 및 소그룹 토론과 같은 효과적인 교수법을 채택했기 때문으로 생각된다. 또한 본 연구는 그 동안 국내 의과대학에서는 거의 다루지 않았던 전문직 간 교육 프로그램의 효과를 실습 전과 후로 비교했다는 점에서 의미가 있다. 다만 1차 실습 후에 비해 2차 실습 후의 설문 점수들이 하락한 점에 대해서는 실습 시간이 짧았던 것, 두 차례의 실습에 동일한 프로그램을 적용한 점, 2차 실습에서는 의사직 간의 갈등 사례만을 제시한 것과 같은 한계점들과 더불어 추가적인 논의가 필요하다. 결론적으로 서울대학교 의과대학에서 처음 시도해보았던 전문직 간 의사소통 실습은 전반적으로 긍정적이고 양호한 교육 효과가 있었다고 판단된다. 이러한 결과 및 한계점들을 토대로 추후 보다 체계적이고 다양한 주제의 전문직 간 교육 프로그램을 개발하여 의학과 교육과정에서 도입하고 그 효과를 종적으로 평가해야 할 것이다. 또한 이렇게 의과대학에서 전문직 간 교육을 경험한 학생들이 실제 임상 의사의 역할을 수행함에 있어서 그들의 성과에 어떤 영향을 미치는지를 알아볼 수 있다면 더욱 의미 있을 것이라 기대한다.목 차 I. 서론 1 1. 연구의 필요성 1 2. 연구 목적 5 3. 용어의 정의 6 II. 이론적 배경 9 1. 전문직 간 교육의 개념 및 정의 9 2. 전문직 간 교육의 학습 과정 17 3. 문화 역사적 활동 이론과 전문직 간 교육 25 4. 전문직 간 교육의 항목 32 5. 전문직 간 교육의 평가 및 효과 36 6. 갈등에 관한 이론적 배경 39 III. 연구절차 및 방법 48 1. 연구 설계 48 2. 연구 환경 50 3. 연구 가설 56 4. 연구 대상 57 5. 실습 평가 58 6. 연구 도구 59 7. 통계적 분석 66 8. 연구 윤리 67 IV. 연구 결과 68 1. 연구 대상자의 기본적 특성 68 2. 실습 전후 포괄적 대인의사소통 능력 점수 비교 70 3. 전문직 간 의사소통 실습의 중요성 및 적절성 점수 비교 74 4. 전문직 간 의사소통 실습의 주관식 설문 결과 76 V. 고찰 77 1. 전문직 간 의사소통 실습 효과 평가 77 2. 연구의 의의 84 3. 연구의 한계점 85 VI. 결론 및 제언 88 참고문헌 91Maste