초등학교 5, 6학년생의 인터넷 중독과 부모-자녀 애착

Purpose: The purpose of this study was to explore the patterns of internet usage among 5th and 6th grade elementary students, and analyze the correlation between the internet obsessive disorder and parent-child attachment. Method: A total of 303 elementary students in Seoul, Suwon, Ulsan, and Kwangjoo area participated in this study, and responded to self-administrated questionnaires. Results: With regard to the internet addiction, 2.7% of participants were classified as being in a high risk group, and 5.3% were classified as a potential risk group with boys at greater risk than girls, and 6th graders showing higher internet addiction scores than 5th graders. There were significant negative correlations between internet addiction and father-child attachment (r=-.122, p=.040), and mother-child attachment (r=-.154, p=.009). Conclusion: To prevent internet addiction in elementary school students, promoting parent-child interaction needs to be emphasized. More studies for finding affecting variables on internet addiction would be necessary, and different preventive approaches according to gender and grade should be introduced

치료방법이 미분화 갑상선암의 생존 기간에 미치는 영향

Background:Anaplastic thyroid carcinoma represents 2% to 5% of all thyroid cancers and it is one of the most aggressive human cancers. Local extension at the time of diagnosis and distant metastases are almost always the rule. Its lethality is evidenced by a 5-year survival rate of 3.6% and a median survival time of 4 months. We retrospectively reviewed patients with this disease at 4 tertiary referral centers. Methods:From 1990 to 2003, 19 cases(9 men and 10 women, mean age: 65.1+/-7.1 years) of anaplastic thyroid carcinoma were reviewed via the medical records. The overall survival rates according to the prognostic factors and the treatment modalities were analyzed. Results:The presenting symptoms included rapidly enlarged neck masses in 16 patients, shortness of breath in 3 patients, hoarseness in 4 patients, dysphagia in 2 patients and chest wall pain in 1 patient. The mean diameter of tumor was 7.2cm. Local extension was seen in all of the cases that had undergone surgery. Distant metastases(lung 6, bone 2, abdominal carcinomatosis 2, brain 1 and mediastinum 1) were seen in 9 patients. Surgical treatment was performed in 10 patients. Radiotherapy was performed in 9 patients and chemotherapy was done in 5 patients; radiotherapy was performed alone in 2 patients, combination chemo-radiotherapy was performed in 3 patients, postoperative radiotherapy was performed in 2 patients and postoperative combination chemo-radiotherapy was performed in 2 patients. 4 patients were treated cons ervatively after the confirmative diagnosis. The overall median survival time was 123 days(range: 23~621 days); the median survival time was 129 days in the treatment group(n=15), and 27 days in the no treatment group (n=4), and significantly higher survival rates were observed for the treated patients(p=0.02). According to the treatment modalities, patients who underwent surgical treatment and postoperative radiotherapy and/or chemotherapy were observed to have significantly higher survival rates than patients in the radiotherapy and/or chemotherapy group(p=0.03), and also than those patients in the surgical treatment only group(p=0.04). Conclusions:We found that aggressive surgical treatment and postoperative radiotherapy and/or chemotherapy improved the survival rates of patients with anaplastic thyroid carcinoma even though local invasion and distant metastases was generally observed to occur

심장수술 환자의 중환자실 재원일수와 관련 변수에 대한 연구

병원경영환경은 총체적 경쟁시대에 따라 급변하고 있으며 병원경영의 새로운 파라다임에는 새로운 서비스 개발, 병원이미지 제고와 같은 전략이 요구되고 있다. 또한 이러한 병원경영전략의 변화의 평가요소로 입원환자의 재원기간을 포함하고 있다. 입원환자의 재원일수를 단축시키는 것은 병상회전률을 높임으로 많은 사람에게 의료서비스를 제공하면서 동시에 의료수익의 증대에 의하여 경영수지의 개선을 꾀하고 환자와 가족의 부담이나 불안감을 감소시킨다. 현대 한국인의 질병양상도 많이 변하여 고혈압과 관련된 심맥관계질환이 상승하는 추세에 있으며 따라서 이와 관련된 심장수술건수도 증가되는 추세에 있다. 심장수술후 환자가 머무는 중환자실은 고가의 집중적인 처치료와 간호수가로 인해 환자와 가족은 물론 의료인이 부담을 느끼며 가능한 한 중환자실 재원일수를 줄이도록 노력하고 있다. 이에 본 연구자는 심장수술 환자의 중환자실 재원일수에 영향을 미치는 관련 변수들을 파악하고 재원일수 단축에 관련된 적절한 간호중재를 개발하기 위한 계기를 마련하고자 연구를 시도하였다. 연구자료는 A 대학병원에서 심장수술후 중환자실에 입원하였던 환자 99명을 대상으로 1998년 7월1일부터 8월31일까지의 기간동안 자료를 수집하였다. 연구도구는 대상자의 질병관련 특성은 의무기록지를 이용하였고 가족의 지지 및 의료인의 지지도 측정도구는 김옥수의 지지도 측정도구를 수정보완 하였으며 환자교육 측정도구는 Baum과 전명희의 간호중재계획안을 참고로 본 연구자가 수정보완하여 사용하였다. 수집된 자료는 SPSS-PC를 이용하여 질병관련 특성은 실수와 백분율로, 가족의 지지도 및 의료인의 지지도와 환자교육정도는 평균과 표준편차를 구하였으며 제변수와 재원일수와의 관계는 t-test, ANOVA, Pearson s correlation analysis, Multiple regression analysis를 이용하여 분석하였다. 본 연구의 결과는 다음과 같다. 1) 연구대상자의 일반적 특성인 연령, 성별 그리고 흡연여부와 중환자실 재원일수와의 관계는 통계학적으로 유의하지 않았다(P>.05). 2) 연구대상자의 질병관련특성 중 진단명, 수술명, 수술의 긴박성, 타질환동반여부, 합병증 종류와 중환자실 재원일수와의 관계는 유의한 차이가 없었으나(P>.05) 심장수술 기왕력(재수술)여부, NYHA functional class, 좌심실기능, 합병증여부, 심폐기 사용시간과의 관계는 유의하였다(P<.05). 3) 간호중재에 있어서 가족의 지지도, 의료인의 지지도, 환자교육정도와 재원일수와의 관계는 유의하지 않았다(P>.05). 이상과 같은 결과를 통해 심장수술 환자의 중환자실 재원일수와 질병관련 특성간의 관계는 유의하였으나 가족의 지지, 의료인의 지지, 환자교육과는 상관관계가 없는 것으로 나타났다. 보호자가 없는 중환자실의 특성상 의료인의 지지와 환자교육이 재원일수와 관계가 있을 것으로 예측했으나 본 연구결과에서는 이를 지지하지 못하였다. 이러한 결과의 원인을 다음과 같이 살펴보면 먼저 환자교육은 심장수술후 환자에 대한 구조화된 교육이 충분히 이루어지지 못하고 있는 실정이 이러한 결과를 초래하지 않았는가 사료된다. 이에 앞으로 간호사는 환자의 회복을 돕고 수행능력을 향상시킴으로 재원일수를 단축시킬 수 있는 간호중재안으로써 문서화되고 도구화된 환자교육안을 개발하기 위해 더욱 노력해야할 것이다. ; Hospital length of stay(LOS) is an important determinant of the cost of care. Shortening hospitalization duration of the patients provide timely medical care services to more people and reduce financial burden of the patients. This study was designed to identify the relationship between length of stay in intensive care unit following open heart surgery and related factors. The subjects for this study were 99 patients receiving open heart surgery at A Hospital in Seoul. Data collection was done through medical records and questionares from 1 July to 31 August in 1998. The instrument used for this study were the Social Support Scale developed by the researcher, Kim(1993) and A program for teaching cardiac surgery patients education flow sheet developed by the researcher, Jeon(1985) and Baum(1976). These were modified related to open heart surgery. The statistical methods used for data analysis were percentile, t-test, ANOVA, Pearson s correlation analysis and Multiple regression analysis using SPSS-PC program. The results of this study were as follows : 1) The mean length of stay in ICU was 5.6 days. 2) Demographic variables (eg., age, sex, smoking) were not correlated to LOS. 3) Disease-related variables which had significant relationship with LOS were reoperation, NYHA functional class, left ventricular function, postoperative complications and cardiopulmonary bypass time. 4) The relationship among LOS, social support and patient education were not significant. As a conclusion, it is essential to develop LOS-reducing patient education program as an independent nursing intervention.논문개요 = ⅵ I. 서 론 = 1 A. 연구의 필요성 = 1 B. 연구의 목적 = 4 C. 용어의 정의 = 4 D. 연구의 제한점 = 6 II. 이론적 배경 및 문헌고찰 = 7 A. 심장수술환자의 재원일수와 관련 변수 = 7 1. 질병관련특성 = 7 2. 독자적 간호중재 = 11 a. 사회적지지 = 12 b. 환자교육 = 18 III. 연구방법 = 23 A. 연구설계 = 23 B. 연구대상 = 23 C. 측정도구 = 23 D. 자료수집방법 = 25 E. 자료분석방법 = 26 IV. 연구결과 = 27 V . 논의 = 37 VI. 결론 및 제언 = 43 참고문헌 = 45 부록 = 52 영문초록 = 6

Switchover of Mechanism from Direct Oxygen Atom Transfer to Proton-Coupled Electron Transfer in the Phosphine Oxidation with a Nonheme Mn(IV)-Oxo Complex by Binding of Triflic Acid

Direct oxygen atom transfer from a variety of oxidants to triphenylphosphine (Ph3P) has been the most well studied oxidation reaction because of the easy acceptance of oxygen atom. However, there has been no report on an electron-transfer pathway in the thermal oxidation of Ph3P although photoinduced electron-transfer oxidation of Ph3P was reported previously. In this study, we report that reaction mechanism is changed from direct oxygen atom transfer in the absence of acid to proton-coupled electron transfer in the phosphine oxidation with a nonheme Mn(IV)-oxo complex by binding of triflic acid. Direct oxygen atom transfer from a nonheme Mn(IV)-oxo complex ([(Bn-TPEN)MnIV(O)]2+) to Ph3P derivatives occurs, exhibiting significant steric effects of the ortho-substitution of the phenyl group, whereas in the presence of triflic acid, the mechanism is switched to proton-coupled electron transfer from unprotonated Ph3P derivatives to the triflic acid-bound complex ([(Bn-TPEN)MnIV(O)−(HOTf)2]2+), exhibiting no steric effects.;인 (Phosphine; 포스핀)은 쉽게 산화되기 때문에 다양한 산화제로부터 triphenylphosphine (Ph3P)으로의 직접적인 산소-원자 전달 반응은 많은 연구를 통하여 잘 정립되어 있다. 비록 Ph3P의 빛에 유발된 전자-전달 반응을 발표된 바 있으나 전자-전달 경로를 통한 열역학적 Ph3P의 산화반응은 발표된 적이 없다. 본 연구에서는 망간(IV)-옥소 종에 의한 Ph3P 유도체들의 산화반응에서 산이 존재하지 않을 때의 직접적인 산소 원자 전달 경로를 통하는 메커니즘이 산이 존재 할 때는 산이 망간(IV)-옥소 종에 결합함으로써 Ph3P 유도체들의 산화반응이 양자 결합 전자 전달 (proton-coupled electron transfer; PCET) 경로를 통한 메커니즘으로 바뀐다는 사실을 알 수 있었다. 특히, 망간(IV)-옥소 종으로부터 Ph3P 유도체로의 직접적인 산소-원자 전달반응이 진행될 때, Ph3P 유도체 중 ortho-자리의 치환기에 의해 매우 큰 입체 장애를 받는 반면, 산이 존재 할 때는 전자-전달 반응 경로를 통해서 반응이 진행되기 때문에 입체 장애 효과가 더 이상 보이지 않음을 알 수 있었다.Abstract 1 I. Introduction 2 II. Materials and Methods 4 II-1. Materials 4 II-2. Instrumentations 4 II-3. Generation of [MnIV(O)]2+ and [MnIV(O)-(HOTf)2]2+ 5 II-4. Kinetic Measurements 5 III. Results and Discussion 7 III-1. Reactivity of [(Bn-TPEN)MnIV(O)]2+ and [(Bn-TPEN)MnIV(O)-(HOTf)2]2+in the oxidation of Ph3P dervatives 7 III-2. One electron reduction potentials of triphenylphosphine derivatives in the presence of HOTf 16 III-3. The driving force dependence of the rate constant of electron transfer 26 IV. Conclusion 29 V. References 30 국문초록 33 감사의 글 3

(A)Study of nurse manager`s decision-making on human resource management

학위논문(박사)--서울대학교 대학원 :간호학과 간호학 전공,2006.Docto

소뇌발생과정에서 reelin 수용체인 VLDLR 및 ApoER2의 발현 조사

During brain development, reelin, an extracellular matrix protein regulates neuronal migration in the cerebral cortex, hippocampus, cerebellum and many other regions of mammalian brain. In the cortex, reelin is secreted by cajal-Retzius cells in the developing marginal zone and is required for inside-out layering of neurons in the cortical plate. Reelin binds to apolipoprotein E receptor 2 (ApoER2) and very low density lipoprotein receptor (VLDLR) that are members of lipoprotein receptor family, and induces the tyrosine phosphorylation of disabled1 (Dab1), an adaptor protein binding to cytoplasmic domain of reelin receptors. Mice lacking reelin, Dab1, or both VLDLR and ApoER2, show identical phenotype and provide strong evidence for the involvement of these proteins in the same signaling axis. In this study, we examined the correlation between the expression of reelin and VLDLR and ApoER2 during postnatal development of rat and mouse cerebellum. In developing rat and mouse cerebellum, the expression of VLDLR was prominent in developing molecular layer and proximal dendrites of Purkinje cells, whereas ApoER2 expression was mainly confined in Purkinje cells. In postnatal stages, the expression of both receptors was highest at postnatal day 7 and thereafter, significantly decreased. In reelin-deficient mice (reeler), ApoER2 level was not changed compared to wild type. However, VLDLR level in reeler was much higher than in wild type, showing that reelin may regulate the level of VLDLR rather than ApoER2 in cerebellar cortex formation. These results also suggested that VLDLR may primarily involve in the reelin-Dab1 signaling pathway in the postnatal development of cerebellar cortex.세포외 (extracellular) 단백질 reelin은 뇌의 발생과정에서 대뇌의 피질과 해마 그리고 소뇌 등에서 층을 형성하고 신경세포의 이동을 조절하는 중요한 역할을 한다. 이 과정은 reelin이 lipoprotein receptor 계열에 속하는 very low density lipoprotein receptor (VLDLR) 또는 apolipoprotein E receptor 2 (ApoER2)에 결합하여 이들의 cytoplasmic domain에 결합하고 있는 disabled1 (dab1)의 tyrosine에 인산화를 유도함으로써 일어나는 과정으로 알려져 있다. Reelin, dab1 또는 VLDLR와 ApoER2 두 유전자가 모두 결여된 마우스에서 나타나는 대뇌 피질층은 정상과 다르게 역위되어 있고 소뇌의 경우 크기가 작고 foliation이 적게 나타나며 특히 조롱박세포 (Purkinje cell)가 군집하여 과립층의 깊은 곳에 전위되어 나타나는 것으로 관찰된다. 본 연구에서는 마우스와 래트를 이용하여 출생 후 충분한 성장이 관찰되는 소뇌를 통해 reelin과 VLDLR 또는 ApoER2의 발현에 따른 상관관계에 대해 조사하였다. 그 결과 VLDLR는 발생중인 분자층 (molecular layer)과 조롱박세포의 근위 가지돌기에서 높게 발현되었고, 반면에 ApoER2는 조롱박세포체 (Purkinje cell body)에서 제한적으로 발현하고 있음이 관찰되었다. 이 두 수용체의 발현은 생후 7일에서 현저히 증가하며 그 이후 감소하는 것으로 나타났다. 또한 VLDLR의 발현은 정상의 mouse에 비해 reelin 유전자가 결여된 reeler mouse에서 높게 나타났다. 하지만 ApoER2의 발현에는 차이를 보이지 않았다. 이상의 결과를 통해 소뇌피질의 형성에 중요한 reelin-dab1 신호전달과정은 VLDLR를 중심으로 매개되며, 이 수용체 발현은 reelin에 의해 조절될 가능성을 제시한다."국문요약 ················································································· ⅰ 차례 ······················································································ ⅱ 그림차례 ················································································· ⅲ 표차례 ··················································································· ⅳ Ⅰ. 서론 ··················································································· 1 Ⅱ. 재료 및 방법 ······································································· 6 A. 실험재료 ·········································································· 6 B. 실험방법 ·········································································· 7 1. 실험동물 ······································································ 7 2. PCR (Polymerase chain reaction) for genotyping ······ 7 3. 면역조직화학염색법 (Immunohistochemistry) ·············· 7 4. RT-PCR (Reverse transcription polymerase chain reaction) ········· 9 Ⅲ. 결과 ·················································································· 11 A. 뇌발생과정에서 reelin의 발현 ·············································· 11 B. 소뇌피질형성에 따른 VLDLR의 발현 ·································· 13 C. 소뇌피질형성에 따른 ApoER2의 발현 ································ 15 D. VLDLR와 ApoER2의 동시발현 ··············································17 E. Reelin의 발현과 reelin 수용체와의 동시발현 ···················· 19 F. Reeler에서 VLDLR와 ApoER2의 발현 ································ 21 Ⅳ. 고찰 ·················································································· 24 Ⅴ. 결론 ·················································································· 28 참고문헌 ················································································· 29 영문요약 ················································································· 34LIST OF FIGURES Fig. 1. Reelin signaling pathway ········································· 2 Fig. 2. Abnormal development of cerebellum in rln-/- (reeler) and Dab1-/- (yotari) mice ························ 4 Fig. 3. Cajal-retzius cells in cerebral cortex of rat (P7) ···· 12 Fig. 4. Expression of VLDLR during development of rat and mouse cerebellum ························································· 14 Fig. 5. Expression of ApoER2 during development of rat and mouse cerebellum ························································· 16 Fig. 6. The colocalization of VLDLR and ApoER2 in postnatal 7 of rat cerebellum ························································· 18 Fig. 7. Coexpression of reelin and both receptors in the rat cerebellum ···· 20 Fig. 8. Expression of VLDLR, ApoER2 and Dab1 in reeler cerebellum ····· 22LIST OF TABLES Table 1. Sequence of primer and PCR conditions in RT-PCR ················ 10 "Maste

The study of changing smoking status and related factors before and after joining military serviceStudy of changing smoking status and related factors before and after joining military service

역학건강증진학과/석사배경 및 목적 : 흡연은 다양하면서도 치명적인 질환을 유발한다는 것은 이미 잘 알려진 사실이지만 국내외적으로 군인의 흡연율은 일반 성인 남성 흡연율 보다 높은 실정이다. 본 연구를 통해 군 입대 후 흡연 변화 양상을 알아보고 군인 흡연의 관련 요인을 분석하고자 한다. 연구 방법 : 2016년 2월 29일~3월 16일까지 육군 2개 부대를 방문하여 연구 관련 동의를 구하고 설문을 진행하였다. 설문지는 총 520부를 배부하여 519를 회수하였으며 그 중 내용의 오류가 있는 7부를 최종 분석에서 제외시켜 512부를 설문에 이용하였다. 수집된 자료는 입대 후 금연여부 또는 흡연여부에 따라 구분한 후, 변수 간 차이와 관련요인을 확인하기 위해 카이제곱 검정, 다중 로지스틱 회귀분석을 하였고 입대 후 흡연을 시작한 시점을 고려하여 콕스비례위험 회귀분석을 하였다. 연구 결과 : 입대 전 흡연율은 54.3%, 입대 후 흡연율은 50.1%로 입대 후에 흡연율이 4.2% 낮아진 것으로 나타났다. 입대 후 금연한 대상자는 64명(12.7%), 입대 후 흡연을 시작한 대상자는 43명(8.5%)이었다. 입대 전 흡연자가 입대 후 금연할 요인을 분석한 결과, 생활관 흡연자 인원수가 4명 이상일 때보다 0~3명인 경우 금연할 오즈비가 2.15(95% CI:1.06-4.32) 높았고, 상급자의 금연 권유 시 금연 의지가 없는 경우보다 있는 경우 금연할 오즈비가 27.45(95% CI:8.10-93.08) 높았으며, 금연 광고 경험 후 금연 결심을 하지 않은 경우보다 결심한 경우 금연할 오즈비가 2.51(95% CI:1.19-5.29) 높았다. 입대 후 흡연시작시점을 고려한 생존 분석 결과, 입대 후 흡연을 시작한 대상자의 76.2%가 입대 후 4개월 이전에 흡연을 시작하였고 상급자의 흡연권유 시 흡연 의지가 없는 경우에 비해 흡연 의지가 있는 경우 흡연을 시작할 오즈가 21.93(95% CI:10.12-47.80) 높았다. 결론 : 입대 후 흡연율은 입대 전보다 낮았지만 입대 전 비흡연자가 입대 후 흡연을 시작하는 경우가 적지 않았으며 상급자의 흡연 권유 시 흡연 의지가 있으면 흡연을 시작할 위험이 높았다. 따라서 군 금연 사업을 더욱 효과적으로 시행하기 위해서는 비흡연자를 대상으로 한 흡연 예방 활동이 강조되어야 할 것이다.ope

BCH error correction circuits for multi-level cell NAND flash memories

Thesis(master`s) --서울대학교 대학원 :전기. 컴퓨터공학부,2006.Maste