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지표 개발을 통한 우리나라 교통 SOC 스톡의 국제비교
신의철,이재민(Lee, Jae-Min),심양주 대한교통학회 2004 대한교통학회 학술대회지 Vol.46 No.-
사회간접자본(SOC)은 교통, 통신, 전력 등 국가전체의 경제활동에 필요한 기반을 제공하는 공공시설로 정의되는데, 국가 예산상으로는 도로, 철도, 지하철, 공항, 항만 등 교통시설 외에 다목적댐, 치수, 용수사업을 SOC사업으로 분류하고 있다. 우리 경제의 경쟁력 강화를 위해서는 주요 사회간접자본 특히, 도로, 철도, 항만, 공항 등의 교통 인프라를 적기․적소에 공급하여 물류비용을 절감시켜 효율적인 생산 및 소비활동을 뒷받침해야 한다. 사회간접자본 부족을 타개하기 위한 정부 노력의 결과, 교통부문 SOC투자의 경우 2003년에 13.9조원으로 지난 5년간 32.7% 증가하였다. 그러나 이러한 교통부문 SOC 투자규모 대해서, 국가경제 규모에 비해 과잉 투자가 이루어지고 있으므로 줄여야 한다는 견해와 향후 일정기간 지속적으로 현재의 교통 SOC 투자가 유지되어야 한다는 견해가 대립되고 있는 실정이다.
Comparative Analysis of Liver Injury-Associated Cytokines in Acute Hepatitis A and B
신의철,신소연,정숙향,성필수,이진오,김형준,이현웅 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.3
Purpose: Acute hepatitis A (AHA) and acute hepatitis B (AHB) are caused by an acute infection of the hepatitis A virus and the hepatitis B virus, respectively. In both AHA and AHB, liver injury is known to be mediated by immune cells and cytokines. In this study, we measured serum levels of various cytokines and T-cell cytotoxic proteins in patients with AHA or AHB to identify liver injury-associated cytokines. Materials and Methods: Forty-six patients with AHA, 16 patients with AHB, and 14 healthy adults were enrolled in the study. Serumlevels of 17 cytokines and T-cell cytotoxic proteins were measured by enzyme-linked immunosorbent assays or cytometric bead arrays and analyzed for correlation with serum alanine aminotransferase (ALT) levels. Results: Interleukin (IL)-18, IL-8, CXCL9, and CXCL10 were significantly elevated in both AHA and AHB. IL-6, IL-22, granzyme B, and soluble Fas ligand (sFasL) were elevated in AHA but not in AHB. In both AHA and AHB, the serum level of CXCL10 significantlycorrelated with the peak ALT level. Additionally, the serum level of granzyme B in AHA and the serum level of sFasL in AHB correlated with the peak ALT level. Conclusion: We identified cytokines and T-cell cytotoxic proteins associated with liver injury in AHA and AHB. These findings deepen the existing understanding of immunological mechanisms responsible for liver injury in acute viral hepatitis.
의료보험자료 상병기호의 정확도 추정 및 관련 특성 분석 -법정전염병을 중심으로-
신의철,박용문,박용규,김병성,박기동,맹광호,Shin, Eui-Chul,Park, Yong-Mun,Park, Yong-Gyu,Kim, Byung-Sung,Park, Ki-Dong,Meng, Kwang-Ho 대한예방의학회 1998 Journal of Preventive Medicine and Public Health Vol.31 No.3
This study was undertaken in order to estimate the accuracy of disease code of the Korean National Medical Insurance Data and disease the characteristics related to the accuracy. To accomplish these objectives, 2,431 cases coded as notifiable acute communicable diseases (NACD) were randomly selected from 1994 National Medical Insurance data file and family medicine specialists reviewed the medical records to confirm the diagnostic accuracy and investigate the related factors. Major findings obtained from this study are as follows : 1. The accuracy rate of disease code of NACD in National Medical Insurance data was very low, 10.1% (95% C.I. : 8.8-11.4). 2. The reasons of inaccuracy in disease code were 1) claiming process related administrative error by physician and non-physician personnel in medical institutions (41.0%), 2) input error of claims data by key punchers of National Medical Insurer (31.3%) and 3) diagnostic error by physicians (21.7%). 3. Characteristics significantly related with lowering the accuracy of disease code were location and level of the medical institutions in multiple logistic regression analysis. Medical institutions in Seoul showed lower accuracy than those in Kyonngi, and so did general hospitals, hospitals and clinics than tertiary hospitals. Physician related characteristics significantly lowering disease code accuracy of insurance data were sex, age group and specialty. Male physicians showed significantly lower accuracy than female physicians; thirties and fortieg age group also showed significantly lower accuracy than twenties, and so did general physicians and other specialists than internal medicine/pediatric specialists. This study strongly suggests that a series of policies like 1) establishment of peer review organization of National Medical Insurance data, 2) prompt nation-wide expansion of computerized claiming network of National Medical Insurance and 3) establishment and distribution of objective diagnostic criteria to physicians are necessary to set up a national disease surveillance system utilizing National Medical Insurance claims data.
우리나라 노인의 저작불편 호소율의 지역 간 변이와 관련 특성
신의철,김란희,김지만,박종연,박근영,이창우 한국보건의료기술평가학회 2018 보건의료기술평가 Vol.6 No.2
Objectives: The purpose of this research is to investigate regional variations of mastication difficulty rates in the elderly over 65 in 229 primary autonomous districts in Korea and explore relevant characteristics. For the research data, local community health survey conducted in 2015 and data from Ministry of the Interior and Safety, Ministry of Health & Welfare, National Health Insurance Service and Statistics Korea were used. Methods: Frequency analysis was conducted for general characteristics and mastication difficulty rates of each region, and distribution of mastication difficulty rates was displayed for each town, city and province by mapping them. Extremal quotient (EQ), coefficient of variation (CV) values were calculated for regional variations, and logistic regression analysis was performed to reveal the relationship between each independent variable and mastication difficulty rates. Results: The average of standardized mastication difficulty rate was 46.78%, and regional variations were significant with EQ 3.46, CV 0.18. Characteristic factors that have significant effects on mastication difficulty rate included sex ratio, elderly population and the number of dentists per 10000 people. Conclusion: As a result, there were variations among mastication difficulty rates in 229 primary local governments across the country, and the distribution of health care resources by the characteristics of the local environment by region affected mastication difficulty rates. Accordingly, it is required to provide political supports to overcome regional inequality of oral health levels and develop cooperative system between local governments and local dentists.