문제가 문제가 출제되는데 문제가 다어려운것은 아닙니다. 문
제중에는 공부를 전혀 한 적이 없는 수험생도 풀수있는 아주쉬운 문제도 있고 평범
한 문제도 있고 난이도가 높은 문제도 있습니다.
다시말해서, 문제에는 다양한 문제가 섞여 있는것입니다. 시험은 절대평가가 아니라
상대평가라는게 중요합니다. 예를들어
커트라인이 3~4년전보다 20~25점정
도 하락했는데 그얘기는 3~4년전에는 92점을 맞았는데도 떨어졌고 올해는 70점대를 맞
았는데도 합격을 했다는것입니다. 50대1의 시험이라 가정해서 다른수험생들(49명)도 풀
수있는 쉽고 평범한 문제는 합격을 좌우하지는 못한다는것입니다. 내가 아닌 다른 49명
이 틀리고 나만이 풀 수 있는 문제가 있을때 그문제가 나의 합격을 보장해주는것입니다.
물론 쉬운문제를 놓쳐서는 절대 안되겠지요.
(실수를 용납하지않는 시험이 요즈음의 시험입니다)
구체적으로 말하면 쉽고 평범한 문제를 실수하지 않고 난이도 있는 어휘에서 1문제 정
도, 문법과 영작의 1~2문제정도, 독해의 1~2문제 정도를 어떻게 푸는가가 합격을 좌우한
다는 것입니다. 정말로 합격을 위하여 공부하시려면.......................................먼저어휘는 아
침, 점심, 저녁으로 10여분씩 매일 단어암기를 생활화하시면 쉬운 어휘로 실수하는 불상
사도 없을것이고 보다 난이도 있는 문제도 해결할 수 있을것이라 확신합니다.
시중의 모든어휘책과 모든 학원의 어휘강의가 어근, 어미, 접두어를 따져서 강의를 하는
데 실제시험은 그러한 어휘들이 출제되지 않습니다.
접두어, 어근, 어미를 따져보면 전반적인 영어의 단어를 바라보는 안목은 분명히 넓어지
는 것만은 사실입니다.
하지만 여러분이 생각해보면 바로 알수 있듯이 어휘성문제가 9문제정도
출제되고 3~4문제가 출제되는데 출제자가 수험생들이 그단어의 뜻을 모르는데 접
두어, 어미, 어근만 보면 뜻을 알수있는 그런문제를 출제할까요? 출제하지 않습니다.
아마 여러분에게 행자부에서 어휘문제를 출제해달라고 부탁을하면 여러분도 그런문제
는 절대로 출제하지 않을것입니다.
본인의 주장이 믿기지 않으시다면 인근서점에가셔서 10년동안 출제되었던 문제중
에서 어휘문제만 모아보면 바로 알수 있습니다.
제 생각에는 접두어, 어미, 어근을 아는것도 중요하지만 시험에서 보다 더 중요한것은 응
시하고자 하는 시험에 얼마나 더 적절하게 공부해야하는가가 훨씬 더 중요합니다.
접두어, 어근,어미에 너무 치중하지말고 매일 아침, 저녁으로 어휘 반복하시고 문법은 절
대로 불규칙은 출제되지 않습니다. 규칙만출제되므로 규칙을 암기하시고 문제에 적용시
키는 적용훈련을 하시면 모든 영어시험에 자신있으리라 생각됩니다. 단, 영작은 대개
문법과 구문이 많이 출제되므로 문법과 구문을 암기하시면 쉽게 해결되고 영작은
구문을 비롯하여 문법..... 요즈음은 특히 단어의 흐름과 관련된 영작이 많이 출제되고 있
습니다. 독해는 쉬운 문제는 누구나 풀수있어서 합격을 좌우하지는 못하지만 그래도 실수
하면 안되므로 한번정도는 Reading skill을 읽히시는게 바람직하다고 생각됩니다.
또한, 요즈음 문제추이가 지문이 긴 장문형태이므로 속독연습 또한 게을리 하면 안될 것
입니다.
그러나, 무엇보다도 더욱더 중요한것은 합격을 좌우하는 난이도있는 1~2문제를 해결하
는것이 관건이겠지요.
난이도있는 독해는 Reading skill이 통하지 않습니다. 문장속에 어려운 단어 몇 개가 들
어있어서 그단어를 해결하고 전반적인 내용을 정확하게 파악할때 난이도 있는 독해문제
가 풀리게 되어 있습니다.그러므로 독해의 정확도를 높이기위하여 또는 합격을 좌우하는
난이도 있는 문제를 해결하려면 독해와 관련된 문법을 읽히면서 정독도 꼭 필요함니
다. 물론, 단어를 모르면 독해는 불가능하기때문에 독해공부의 70%는 단어암기라해도
과언이 아닐것입니다.
지금부터 다음 시험일까지 아침, 점심, 저녁으로 매일 10여분씩 단어를 암기하시면 다음
에 있을 시험에서는 독해문제를 풀때 단어가 막히는 일은 절대로 발생하지 않을것이며
합격을 좌우하는 한 두개의 독해문제까지 해결되어 반드시 합격할 수 있을리라 생각됩니
다. 무더운 여름에 공부하느라 고생하는 수험생들에게 도움될까해서 적어봤는데 두서없
게 느껴지네요.
말로하면 잘 전달할수있을것 같은데 글 재주가없어서 여러분께 도움이 될런지 모르겠네
요. 더더욱, 컴퓨터 타이핑이 서툴려서 이글을 적는데 1시간10분이걸린것이니까 ...두서
없어도 읽어보시고 공부하는데 참고하여 합격하는데 도움이 되었으면 합니다..........
..............................................................................................................................................................
(참고)최근5~6년간기출문제분석할때 어휘문제만모아보고 독해문제만모아보고 문법영작
문제만모아보면 어휘는 어떻게출제되고 독해는 어떻게출제되고 문법영작은 어떻게출제
되는지 출제유형이 바로분석됩니다. 서점에가서 분석해보시고 그분석에 맞추어 공부하십
시오.그러면 반드시 합격하리라 믿습니다.
To determines the prevalence of positive serology for Helicobacter pylori in workers of to zinc´s refinery. Material and Methods: We included employees that had to their vacational check-up between July and September 2003. Of 501 workers, we recollected 92 participants, dwells than the sample size calculated in 80 workers (with to confidence level of 99,99%). The ELISA for test was used the quantitative detection of IgG against Helicobacter pylori (GAP-IgG ELISA, Biomerica, the USA) in the venous blood of the workers. There were reported ace positive those values > 20 U/ml, negative < 12,5 U/ml and inconclusive those values between 12,5 and 20U/ml. Only 4 were women, because of that we didn't analyze the results by sex. Results: 57 (61.96%) had to positive serology against Helicobacter pylori, 22 (23.91%) were negative, and 13 (14.13%) had an inconclusive result. (Rev Med Hered 2004;15:151-154).
KEYWORDS: Helicobacter pylori, serology, prevalence.
SUMMARY
Objective: To determine the prevalence of positive serología for Helicobacter pylori in workers of a zinc refinery. Material and Methods: They included in the study the workers who went for their pre-vacacional control between the months of July to September of the 2003. Of 501 workers, they were selected to 92, obtaining a so large sample of 80 people at a level of confidence of the 99.99%. For the serológico examination, the test of ELISA for quantitative detection of specific IgG against Helicobacter was used pylori (GAP-IgG ELISA, Biomerica, the USA) by means of venous blood of the participants. Was considered like positives to 20 values > U/ml, negatives < 12,5 U/ml and suspects between 12,5 and 20 U/ml. Only 4 were of feminine sex, reason by which, the study was not done separating groups by sex. Results: Of 92 workers, 57 (61.96%) they presented/displayed positive serología for Helicobacter pylori, 22 (23.91%) were negative, whereas 13 (14.13%) had a doubtful result (suspicious). (Rev Med Hered 2004;15:151-154).
KEY WORDS: Helicobacter pylori, serología, prevalence.
INTRODUCTION
In 1984 Marshall and Warren they isolated negative a Gram bacillus, espirilado, movable, flagellated, in the gastric mucosa of patients with diagnosis of gastritis and peptic ulcer (1). This finding was received with interest by some Universities in Europe, the United States of North America and in South America, specifically in Peru, by the Peruvian University Cayetano Heredia (2). At its moment, the report of Marshall and Warren, was received with much skepticism at world-wide level. But at the present time it is accepted that this germ, today known like Helicobacter pylori, is the causal infectious agent of the chronic gastritis B type and peptic ulcer (3,4), that antibiotic treatment for its eradication requires (4). In addition one is involved in some types of gastric cancer (5). , most of people nevertheless infected (> 70%) they are asintomáticos (6).
Is group of Physiology Gastrointestinal of University Peruvian Cayetano Heredia and of University of Johns Hopkins the one that it has made the greater contributions to national Literature on data epidemiologists of the distribution of this germ in different groups from the Peruvian population (2.4.5.7.8), whose results agree with the described thing in the Literature of approximately 60% of positividad, for a 9.10.11.12 population developing average of countries. As it is well-known, the prevalence of the infection by Helicobacter pylori, is greater in populations of few resources (by which is greater in countries developing with respect to industrialized countries). In addition the age to which the contact happens to the germ is much smaller in countries developing. It is for that reason that using serología to determine the prevalence of infection in Peruvian children, Leon, Recavarren and Ramirez they find that 60% are infected before the 10 years (2).
With the aid of invasive methods, at beginnings of 90´s one determined that the frequency of infection by Helicobacter pylori was similar in dispépticos patients of the different regions from the country and in the different socioeconomic levels (2).
More recent studies in developed countries show to the diminution of the infection by Helicobacter pylori and therefore the diminution of the diverse associate pathologies (2,13). Of the same form, the Peruvian population pertaining to the socioeconomic groups would be behaving average and high, that also show to a diminution of the prevalence of infection by Helicobacter pylori (14).
Because it is not had global population studies to national level, it is important to document socioeconomic data in different geographic regions, times and layers.
The objective of the present study was to determine the prevalence of positive serología for Helicobacer pylori, in workers of a zinc refinery.
MATERIAL And METHODS
A nonrandom sample of the workers of a zinc refinery, located in the district of San Juan de Lurigancho-Chosica, province of Lima studied, department of Lima. This refinery has 501 workers, who by their levels of monthly income are located in the socioeconomic class average or discharge. Using the formula for nonrandom population studies, a so large sample of 80 people at a level of confidence of the 99.99% was obtained. For the selection of the participants, one took venous blood samples to all the workers who went to the Medical Service for their pre-vacacional control between the months of July to September of the 2003, being able to collect 92 participants. It is possible to stand out that the company determines in that month their pre-vacacionales examinations will pass the workers, not used them.
For the serológico examination, the test of ELISA for quantitative detection of specific IgG against Helicobacter was used pylori (GAP-IgG ELISA, Biomerica, the USA). According to indications of the manufacturer, one considered positives to the 20 values > U/ml, negatives < 12,5 U/ml and suspects between 12,5 and 20 U/ml. The test was made by trained personnel in the handling of kit respective, in the laboratory of the Medical Service of the refinery.
For the analysis of the data program EPI-INFO was used version 5.3.
RESULTS
The studied sample included 92 workers who correspond at average or high socioeconomic level. Only 4 people were of feminine sex, reason by which, the study was not done separating groups by sex.
Of 92 workers, 57 (61.96%) they presented/displayed positive serología for Helicobacter pylori, 22 (23.91%) were negative, whereas 13 (14.13%) had a doubtful result (suspicious).
The distribution by etáreos groups of the cases with positive serología, is detailed in the N°1 table.
DISCUSSION
The Helicobacter pylori is one of the pathogenic bacteria more common in the human being. Seroepidemiológicos retrospective studies show that the infection, mainly is acquired in the childhood (13). The primary infection in adults, or reinfección after the satisfactory eradication is little common in developed countries, with a present incidence of 0.30.7% (6). Esteem that in countries in via of development, the reinfección incidence is between 614% (6). Nevertheless, national studies demonstrate that the reinfección can arrive at as high numbers as from 23% after an eradication with effective antibiotic treatment, in population of socioeconomic layer under (15).
Although the Helicobacter pylori does not enter direct bonding with the weave, he is able to trigger a severe inflammation in the gastric mucosa and to cause in blood a reaction of antibodies of different quantifyable intensity and (2, 13).
The Helicobacter pylori can be detected by means of invasive methods like in endoscopía by histología, culture or test of ureasa; and noninvasive methods like serológicas tests, test of úrea in the breath, test of fecal antigen (2, 13). The numerous serológicas tests available, are based on the ELISA technique that detects levels of IgG, inmunoglobulina that has one more a more intense answer, than the one of IgA or IgM. The fast result, the easy accomplishment and low cost are the main advantages of this test (2, 13). Because one has demonstrated to his utility in studies epidemiologists of population groups, including retrospective studies to determine the prevalence and incidence of this infection (2,13); and in the pursuit after treatment (16), with a sensitivity and specificity near 91% in average for both (17), it was chosen as the test to be used in this study.
It is possible to emphasize that studies exist that combine serológicas tests and endoscopía in greater of 50 years (18), soon to initiate treatment; but in minors of 50 years the treatment frequency post endoscopía is low, generally only with serológicas tests begins treatment (18).
According to the national studies, the prevalence of Helicobacter pylori is in 60% of the population, oscillating between 30 to 90% around. Our study finds a prevalence of 61,96% in the studied workers, which agrees with other studies (2,4,8,13). It is possible to emphasize that if we considered to the suspects like positives, the prevalence would be of 76,09%, value that still would be considered like expectable for our population.
When analyzing the positividad by etáreos groups, we see that comparing the group of 40 to 49 years with the one of 50 to 59 years, demonstrates an increase of 14,04%, which is coherent with other studies, that find greater prevalence to greater age (11). The number of workers between 35 to 39 years, as well as the one of 60 to 64 years is very small like making inferences of these groups.
BIBLIOGRAPHICAL REFERENCES
1.Marshall B, Warren R. Unidentified curved bacilli in the stomach of with gastritis and peptic ulceration. Lancet 1984;1:1311-15.
2.Leon R, Recavarren S, Ramirez A. The Peruvian contribution to the investigation on Helicobacter pylori. Rev Med Hered 1991;2(4):73-181.
3.Nomura To, Stemmermann Grant N, Po-Huang Chyou, Perez-Perez G, Blaser M. Helicobacter pylori Infection and the Duodenal for Risk and Gastric Ulceration. Annals of Internal Medicine 1994;120: 977-981.
4.Rami'rez-Ramos To, Recavarren S, Leon-Baru'a R, ET to. Pilórico Campylobacter, chronic gastritis, chronic duodenitis, gastric ulcer and duodenal ulcer Arq Gastroenterol Sao Paulo 1987; 24 (1): 10-15.
5.Leon-Baru'a R. The pilórico Campylobacter and the Gastroduodenal Pathology. Latin American Gastroenterológica Act 1985;17:35-42.
6.Logan RPH, Walker MM. Epidemiology and diagnosis of Helicobacter pylori infection. BMJ 2001;323:9202.
7.Gilman RH, Leon-Baru'a R, Cok J, ET to. Rapid identification of Campilobacter pylori in peruvian patients. Dig Dis Sci 1986;31:1089-94.
8. Rami'rez-Ramos To, Gilman R, Spira W, Recavarren S. Ecology of H. pylori in Peru. Infection rates in coastal, high altitude, and jungle communities. Gut 1992;23:604-5.
9. Rami'rez-Ramos To, Gilman R, Watanabe J, ET to. H. pylori infection in long - term and short - term Japanese visitors to Peru. Lancet 1994;344:1017.
10. Rami'rez-Ramos To, Stolen Or, Rodriguez C, ET to. Pilórico Campylobacter and socioeconomic level. Act Gastroent Latinoamer 1987;17:35-42.
11. Gastrointestinal Physiology Working Group. H. pylori and gastritis in Peruvian patients: Relationship to socioeconomic level, age and sex. A.m. J Gastroent 1990; 85(7):819-23.
12. Ramirez-Ramos To, Gilman R, Recavarren S, ET to. Some characteristics of the infection by H. pylori in Peru. Act Gastroent Latinoamer 1991;21(4):211-19.
13. Ramirez Branches To Editorial: Helicobacter pylori in Peru. Changes in the time in its prevalence and relation with the Gastroduodenal Pathology. Rev Gastroenterol Peru 2003; 23(1):1-3.
14. Ramirez To, Chinga and, Mendoza D, Leey J, Segovia MC, Otoya C. Variacio'n of the prevalence of H. pylori in Peru - Period (1985-2002); in a population of average and high socioeconomic level. Rev Gastroenterol Peru 2003; 23: 92-98.
15. Grove G, Baptist CT, Roth OF, Gilman RH, Velapatino B, Ogura M, Dailide G, Razuri M, Rocks R, Katz Or, Monath TP, Berg OF, Taylor DN. Gastrointestinal Physiology Working Group in Peru. Helicobacter pylori reinfection is common in Peruvian adults to after antibiotic eradication therapy. J Infect Dis 2003;188(9):1263-75.
16. Mégraud F. for Diagnosis and candidates treatement of Helicobacter pylori infection. How should Helicobacter pylori infection be diagnosed? Gastroenterology 1997;113:93-8.
17. Cuttler FA, Havstad S, Blaser MJ, Perez G, Scgubet T. Accuracy of invasive and noninvasive diagnosed Helicobacter test pylori infecction. Gastroenterology 1995; 109:136-41.
18. Delaney BC, Wilson S, Roalfe To, ET to. Trial Randomised controlled of for Helicobacter pylori testing and endoscopy dyspepsia in primary care. BMJ 2001;322 (7291): 898.
Correspondence:
Lizeth Diaz Ledesma
Av. Aviation 4796
Urb. Higuereta - Furrow
It files 33 - Peru
smedico@cajamarquilla.com.pe
lidile2002@yahoo.com
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