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홍차넷
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티타임
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- 다양한 주제에 대해 자유롭게 글을 작성하는 게시판입니다.
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전체기타일상/생각꿀팁/강좌방송/연예도서/문학영화의료/건강문화/예술경제생활체육과학/기술철학/종교정치요리/음식역사여행육아/가정IT/컴퓨터음악창작게임스포츠사회오프모임
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| Date |
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| Name | 열한시육분 |
| Subject | 4가지 각도에서 보는 낫적혈구병 |
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1. 중등교육 과학 시간: 첫 만남 겸형적혈구빈혈증은 적혈구의 존재를 배우고 몇 년 후 멘델유전과 우성, 열성에 대해 배울 때 대표적으로 접하게 되는 유전질환입니다. 우성이 좋은 것이고 열성이 못난 것이 아니라는 선생님들의 잔소리를 들으며, 훌륭한 과학자들이 어떤 유전자를 찾아서 그 유전자 두 짝 모두에 돌연변이가 생기면 (=상염색체 열성 유전) 적혈구가 낫 모양으로 된다는 사실을 밝혔다는 것을 배웁니다. 그리고 단백질 이름 (베타글로빈)이나 악독한 경우 아미노산 자리나 이름 (6번 아미노산이 글루탐산에서 발린으로) 같은 것이 시험에 나오죠. 아무튼 이렇게 형태가 변화한 적혈구는 뭉치기가 쉬워 혈류에 지장을 초래하고 수명도 짧아 빈혈도 옵니다. 돌연변이 하나가 이렇게 중요하고 이렇게 큰 변화를 일으킬 수 있다는 메세지를 전달하면서 학생들을 생명공학과로 이끄는 대표적인 예시로 잘 알려져 있습니다. 2. 고등교육에서의 두 번째 만남 그렇다면 이러한 유전질환의 존재의 이유는 있을까? 그저 불운한 사람들이 세상에 존재하듯이 삶의 한 부분으로 받아들일 뿐일까? 아무래도 존재의 이유가 있어보인다는 점을 대학 교육에서 배우게 됩니다. 두 짝 모두가 돌연변이 유전자가 아니고 한 짝만 돌연변이 유전자일 경우, 말을 살짝 바꿔서 낫적혈구형질(sickle cell trait)이라고 하는데 이는 낫적혈구병과 달리 일상생활에는 큰 지장을 주지 않고, 다만 생리적 스트레스를 심하게 받았을 때에만 증상이 발생하게 됩니다. 이 형질이 장점인 점은, 예전부터 사람들을 괴롭혀온 말라리아에 강하면서도 일상생활에서까지 빈혈과 혈관 막힘 등으로 지장을 받지는 않는다는 점입니다. 말라리아 원충은 처음에 간으로 침투했다가 이후 적혈구를 중심으로 계속 생활사를 도는데, 이때 낫적혈구형질을 가진 사람에서 비율이 높아지는 낫형 적혈구가 말라리아원충이 침투하기에는 별로인 적혈구라 생존에 유리합니다. 결국 운빨 게임으로 상염색체 열성 유전이 된 사람은 인생이 골치 아프지만, 더 많은 수의 단일유전자 보유자는 인생에서 죽을 위기를 유전자 덕택에 넘길 수 있는 것입니다. 생물학적인 내용에 추론이 섞인 매력적인 내용이라 이런 내용은 논술이나 면접 주제로도 종종 등장합니다. 3. 라디오 스토리에서의 세 번째 만남 위와 같은 이유로 이 돌연변이 유전자는 적자생존에 의해 사라지지 않고 오히려 일정 숫자가 보존되어 현대에도 존재하며, 말라리아라는 예에서 보듯이 대표적으로 미국에서는 아프리카계 미국인들이 많이 가지고 있습니다. 지금도 어딘가에는 낫적혈구병을 가진 사람들이 살아가고 있습니다. 그러면 중등교육 교과서에도 등장하는 희귀병이니만큼 치료제도 잘 되어있고 빈혈이야 뭐, 철분제 더 먹고 운동 열심히 하면 해결 되겠지? 라고 생각하면 그것은 안타깝게도 오산입니다. 일단 빈혈이 문제가 아니고, 예상치 못하게 매우 아픕니다. 뭉친 낫형 적혈구들이 작은 혈관들을 막고 특히 뼈로 가는 혈관을 막으면 뼈가 허혈 때문에 매우 많이 아픕니다. 뼈도 생명이고 허혈로 아픈 대표적인 때는 심근경색인데 같은 종류의 통증이죠. 통증의 타이밍은 예측이 안되고 발생시에 할 수 있는 것도 통증 조절 같은 대증치료들입니다. 낫형적혈구가 생기는 비율을 줄여주는 작용기전 미상의 약제가 있기는 합니다. 하지만 이 환자들은 어릴 때부터 갑작스럽게 몸 어딘가가 (ex. 척추뼈, 손가락뼈 등) 매우 아프게 되다보니 학교나 직장에서 자주 빠지게 되고, 의기소침해지고 우울해지기가 쉽습니다. ("적혈구 품질 불량(Bad cell service)", https://www.thisamericanlife.org/732/transcript) 옛날에는 마귀가 나를 습격한다거나 저주를 받았다거나 하는 식으로밖에 생각하지 못했을 테니 그것보다는 나은 듯합니다. 이러한 사실을 담담하게 이야기하는 화자는 자신이 이러한 사실을 밝히는 것보다 숨기고 사는 것이 낫다고 여기고 살아왔다가, 코로나 대유행을 계기로 주변사람들에게 말해보기 시작했다고 합니다. 4. 다큐멘터리에서의 예상치 못한 네 번째 만남 불쌍한 유전병 환자들, 그렇게 아플 때 병원에 가면 그래도 잘 치료받을 수 있겠죠? 라고 생각했는데, 사실 이렇게 글로 생각을 정리하게 된 계기는 이것입니다. 청소년 환자가 뉴욕 Lenox Hill 병원 응급실에 왔습니다. (동명의 다큐멘터리, 넷플릭스) 나는 낫적혈구병 환자고 지금 매우 아프니까 진통제 좀 달라고 하는데, 응급의학과 의사 표정이 뭔가 동정심과는 거리가 멀어요. 환자에게 처방된 진통제 처방력을 뭔가의 시스템에서 조회해보더니 왜 평소 처방을 받던 약국으로 가지 않았는지 따지듯 되묻습니다. 존재가 잘 알려진 유전병인데 대체 왜 이렇게 쌀쌀맞게 대할까, 그건 낫적혈구병의 심한 통증을 경감시키는 것은 마약성 진통제이기 때문입니다. 처음에는 정말 아플 때 통증 때문에 먹었지만, 그 다음에 남은 마약성 진통제를 호기심에 먹을 수도 있고, 겸사겸사 생활이 어려울 때 팔아서 용돈을 벌 수도 있고, 통증의 존재는 객관적으로 증명이 어렵고... 하여 이 청소년 환자와 응급의학과 의사는 서로가 서로에게 불만과 불신을 갖게 됩니다. 이 환자의 경우 결국 진통제 처방을 받긴 했던 것 같은데, 하지만 환자도 표정이 좋지 않고 의료진도 의심하지 않고 싶지만 어쩔 수 없다는 착찹한 심경을 토로합니다. 단순하고 중학교 수준이라고 생각했던 내용도 다른 각도에서 보면 또 새로워서, 마치 장님이 코끼리 만지듯 한다는 것이 이런 느낌인가 싶어 종종 생각해보게 됩니다. Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 135 Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 148 Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 163 10 이 게시판에 등록된 열한시육분님의 최근 게시물
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Warning: Use of undefined constant memo - assumed 'memo' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 213
Warning: Use of undefined constant use_comment - assumed 'use_comment' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 530
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 532
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 533
Warning: Use of undefined constant memo - assumed 'memo' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 535
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 566
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 567
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 567
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 567
Warning: Use of undefined constant grant_delete - assumed 'grant_delete' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 567
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 502
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 512
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 514
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 595
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 595
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 597
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 597
Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 605
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 613
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 613
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 621
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 622
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 623
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 624
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 625
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 626
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 627
Warning: Use of undefined constant HTTP_HOST - assumed 'HTTP_HOST' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 643
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 647
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 649
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 649
Warning: Use of undefined constant HTTP_HOST - assumed 'HTTP_HOST' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/cmt_replace.php on line 3
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 6
Warning: Use of undefined constant file_name - assumed 'file_name' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 28
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 69
180479 class="iamcmt" style="display:none;"> Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 70
180479 class='vcm '>
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 74
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 75
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 84
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 85
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 86
180479'> the
Warning: Use of undefined constant mod_date - assumed 'mod_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 98
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 105
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 105
Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 107
22/12/18 18:21
180479>삭제 주소복사
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 115
그래서 낫이 한자로 겸인걸 알았죠.
鎌 (낫 겸)
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 123
Warning: Use of undefined constant password - assumed 'password' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 135
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 140
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 141
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 141
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 142
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 142
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 142
鎌 (낫 겸)
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 123
Warning: Use of undefined constant password - assumed 'password' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 135
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 140
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 141
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 141
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 142
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 142
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 142
180479>
180479>
