진주시 수돗물 불소농도조정사업의 11년간 비용편익 분석

김만경 ( Man Kyong Kim ),정지인 ( Ji In Jung ),김민지 ( Min Ji Kim ),전은주 ( Eun Joo Jun ),김한나 ( Han Na Kim ),김세연 ( Se Yeon Kim ),한동헌 ( Dong Hun Han ),정승화 ( Seung Hwa Jeong ),김진범 ( Jin Bom Kim ) 대한예방치과·구강보건학회 2014 大韓口腔保健學會誌 Vol.38 No.2

Objectives: The aim of this study was to estimate the economic costs and benefits of a water fluoridation program in the city of Jinju, Korea. Methods: In 2009, dental surveys were conducted on 2,315 children aged 6-12 years in Jinju, which had been fluoridated for 11 years. The decayed/missing/filled teeth (DMFT) scores of children in Jinju were compared to the DMFT scores of same-aged children in non-fluoridated small- and mediumsized cities in the fourth Korean National Health and Nutrition Examination Survey conducted from 2007 to 2009 by the Korea Centers for Disease Control and Prevention. The reduced number of decayed permanent teeth by the water fluoridation program was estimated as the difference between the DMFT scores of children in Jinju and those in non-fluoridated small- and medium-sized cities. The economic benefits were estimated by the savings from reduced dental treatment costs by using the reduced number of decayed permanent teeth from the water fluoridation program. All annual costs and benefits were calculated from 1998 to 2009. The social rate and untreated rate of decayed teeth were applied as 3% and 20%, respectively. The annual benefit-cost ratio was estimated by using the annual benefits and cumulative program costs. Results: The economic benefit in 2009 from a water fluoridation program was estimated as 57,496,000,000 Korean Won (KRW), and the cumulative cost in 2009 was estimated as 1,387,000,000 KRW. The net present value in 2009 from a water fluoridation program was 56,109,000,000 KRW. The benefit-cost ratio in 2009 was estimated as 41.4. Conclusions: The economic benefit of a water fluoridation program in Jinju city was evaluated as excellent.

이매방 살풀이춤의 ‘여형화(女形化)’에 대한 논의

김기화 ( Kim Ki-hwa ) 한국무용연구학회 2020 한국무용연구 Vol.38 No.1

우리는 이매방의 춤을 이야기할 때 ‘아름답다’, ‘교태적이다’, ‘농염하다’라고 표현한다. 이러한 수사(修辭)는 그의 춤이 다분히 여성적인 속성을 갖고 있기 때문에 붙여진 것이다. 본 연구는 이매방의 살풀이춤이 여형화의 양식체계로 구축되어 있음을 논의하였다. 춤에서 ‘여형화’란 남성이 여성의 모습으로 춤을 추는 형식, 혹은 양식이라고 할수 있다. 이매방의 춤은 다음과 같은 여형화의 특성을 보인다. 첫째, 이매방의 살풀이춤은 경극의 ‘화단’이나 가부키의 ‘게이세이’와 같이 화려하고 교태스런 배역 특성을 보인다. 둘째, 살풀이춤의 복식은 남성과 여성의 구분을 두고 있으되 상당히 장식적인 여성성을 지향하고 있다. 셋째, 이매방의 양성 지향적인 성 정체성은 탐미적인 미의식으로 확장되어 여형화 된 춤 양식 체계로 환원되었다. 넷째, 이매방 살풀이춤의 기법은 가공된 여성의 신체상을 기반으로 구축되었다. 즉, 응축된 근육의 밀도 높은 작용을 통해 신체를 ‘축소’하거나 ‘왜곡’하여 관능적이고 요염한 여성성을 신체상으로 구현하여 춤에 반영하였다. 이상으로 미루어 이매방 살풀이춤은 남성이 추는 여성의 춤, 혹은 기방춤을 전형 특성의 하나로 구축하고 있다고 하겠다. When we talk about Lee Mae-bang's Salpul-i chum, we use the expressions ‘beautiful’, ‘exciting’, and ‘congested’. This knowledge was attached because his dance has a feminine attribute. This study discussed that Lee Mae-bang's Salpul-i chum is constructed as Yeohyeonghwa's aquaculture system. First, Lee Mae-bang's Salpul-i chum exhibits gorgeous and cunning character, such as Peking Opera's 'Huā dàn' or Kabuki's 'Keisei'. In dance[chum], ‘Yeohyeonghwa’ can be said to be a form or style in which men dance in the form of women. Lee Mae-bang's dance shows the following characteristics of Yeohyeonghwa. Second, Salpul-i chum's costumes differentiate between men and women, but aim for a highly decorative femininity. Third, Lee Mae-bang's bisexual sexual identity has been stylized into a feminine attitude through aesthetic pursuit. Fourth, Lee Mae-bang Salpul-i chum's technique expresses the processed female body image. In other words, Salpul-i chum expresses the body of a sensual and fascinating woman by 'shrinking' or 'distorting' the body through the dense action of condensed muscles. In this regard, Lee Mae-bang is said to be constructing a male dance or gibangchum as one of the characteristics of Jeonhyeong[original form].

의료정보 표준에 기반한 EHR 플랫폼의 설계 및 개발

김화선(Hwa Sun Kim),조훈(Hune Cho),이인근(In Keun Lee) 한국지능시스템학회 2011 한국지능시스템학회논문지 Vol.21 No.4

최근 미국의 경기부양 법안이 통과됨에 따라 전 세계적으로 의료 산업분야에서의 EHR 시스템에 대한 관심이 증대되고 있다. 이 법안은 다양한 의료표준을 통해 상호 운용성을 보장하는 EHR 시스템을 도입하는 의원이나 병원에 인센티브를 제공하는 프로그램을 제시하고 있다. 이러한 인센티브 프로그램으로 인해 많은 EHR 시스템이 개발되었고, 또한 많은 의원이나 병원이 CCHIT에서 인증한 EHR 시스템을 도입하고 있다. 미국 의료 산업의 변화에 발맞추어 국내의 일부 기업에서도 국내병원에 EMR 시스템을 구축한 경험을 바탕으로 미국 의료 시장에 진출하려고 노력하고 있다. 그러나 미국과 한국의 의료 환경이 상이하여 개발한 시스템의 개선이 불가피하다. 따라서 본 논문에서는 의료표준화 기술에 기반하여 서로 다른 의료정보 시스템 간의 상호 운용성을 보장하는 통합형 EHR 플랫폼을 설계하고 개발한다. 개발한 플랫폼에서는 전송 표준 및 방법, 용어 표준 및 활용, 의사 결정을 위한 지식 관리 등의 다양한 기반 기술을 통합하여 완성된 하나의 시스템을 구현하였고, 의료정보의 표준화를 위한 표준용어체계와 의료정보의 교환을 위한 HL7 인터페이스 엔진을 탑재하여 의료 데이터의 전자적 처리가 가능하도록 하였다. 개발한 플랫폼에 기반하여 미국 개원의의 외래 진료를 지원하기 위한 EHR 시스템인 SeniCare를 개발하고, CMS에서 제시한 “의미 있는 사용”의 조건의 부합 여부를 확인함으로써 개발한 플랫폼의 효용성을 검증한다. As the ARRA enacted recently in the United States, the interest in EHR systems have been increased in the field of medical industry. The passage of the ARRA presents a program that provides incentives to office-based physicians and hospitals adapting the EHR systems to guarantee interoperability with various medical standards. Thanks to the incentive program, a great number of EHR systems have been developed and lots of office-based physicians and hospitals have adapted the EHR systems certified by CCHIT. Keeping pace with the rapid changes in the market of healthcare, some enterprises try to push in to the United States healthcare market based on the experience acquired by developing EHR systems for hospitals in Korea. However, the developed system must be customized because of the different medical environment between Korea and the United States. In this paper, therefore, we design and develop an integrated EHR platform to guarantee the interoperability between different medical information systems based on medical standard technologies. In the developed platform, an integrated system has been composed by integrating various basic techniques such as data transmission standards and its methods, medical standard terminologies and its usage, and knowledge management for medical decision-making support. Moreover, medical data can be processed electronically by adapting an HL7 interface engine and the terminologies for exchanging medical information and the standardization of medical information. We develop SeniCare, an EHR system for supporting ambulatory care of the office-based physicians, based on the platform, and we verify the usability of the platform by confirming whether SeniCare satisfies the criteria of “meaningful use” issued by CMS or not.

칼만필터를 이용한 4축 X-Y-Z-T(Yaw) 주탕로봇의 유연한 주입동작 속도제어 연구

김진대(Jin-Dae Kim),이상화(Snag-Hwa Lee),김병수(Byeong-Soo Kim),이인태(In-Tea Lee),성민규(Min-Kyu Sung) 제어로봇시스템학회 2017 제어·로봇·시스템학회 논문지 Vol.23 No.1

Recently, a 4-axes robot with XYZ translational and T axis yaw-rotational mechanism have been studied in the casting process. The motion of a pouring-cup attached in the robot"s end-effector should be considered to smoothly pour the melted-iron into the mold. Reducing the residual vibration or kinematic error of this pouring-cup, the robust velocity controller of Y and Z translational axes, orthogonal to the T yaw-axis, is studied to keep the same position of the pouring-cup"s TCP under its constant angular speed condition. However, the proportional velocity controller typically used in industry can lead to overshoot response in transient. The inflection point of velocity caused by very little movement of the Y-axis or Z-axis, or time delay, can also lead to mechanical vibration of the pouring-cup"s head. In this research, to decrease the overshoot response and residual vibration of the pouring-cup"s TCP, the velocity estimator based on the Kalman filter was applied. The field experiment was carried out with two types of velocity controllers. From the experimental comparison, it was shown that the velocity controller with the Kalman filter displays good performance to reduce the kinematic error and vibration of the pouring-cup.

비내시경을 활용한 알레르기 비염에 대한 한의학적 변증 지표의 관찰자간, 관찰자내 신뢰도 연구

김규석,윤영희,박정수,김남권,김경준,김희택,홍승욱,장보형,윤화정,최인화,고성규,Kim, Kyu-Seok,Yun, Young-Hee,Park, Jeong-Su,Kim, Nam-Kwen,Kim, Kyung-Jun,Kim, Hee-Taek,Hong, Seung-Ug,Jang, Bo-Hyeong,Yoon, Hwa-Jung,Choi, In-Hwa,Ko, Seong- 대한한방안이비인후피부과학회 2013 한방안이비인후피부과학회지 Vol.26 No.2

Objectives : We performed a pilot study to investigate inter- and intra-rater reliability of pattern identification using nasal endoscopy for allergic rhinitis(AR). Methods : Eight experts of ophthalmology, otolaryngology and dermatology of Korean medicine evaluated 20 nasal endoscopy photograph cases of AR patients with pattern identification index using nasal endoscopy for AR including the nasal membrane color(pale / hyperemia), nasal membrane humidity(dryness / dampness), rhinorrhea(watery / yellow), and membrane edema (atrophic / edematous) on nasal endoscopy. Results : Intra-rater agreement(%) and Kappa coefficient was generally from 'moderate' to 'good'(% agreement: 73.13-90% / Kappa coefficient: 0.547-0.748). Inter-rater agreement(%) and Kappa coefficient was also from 'moderate' to 'good' (% agreement: 65-85% / Kappa: 0.475-0.778) except 'humidity(dryness / dampness)' item (% agreement: 55.98% / Kappa: 0.340). In findings of subgroup analysis according to affiliation of raters, Inter-rater agreement(%) and Kappa coefficient of raters in same affiliation was higher than inter-rater agreement(%) and Kappa coefficient of raters in different affiliation except 'dryness / dampness' item. Conclusions : It is necessary to improve objectivity and reproducibility of pattern identification using nasal endoscopy for allergic rhinitis(AR) through the development of detail-oriented criteria and enhanced training of clinicians with development of standard operating procedures(SOPs).

좌골신경통에 대한 전침 치료: 체계적 문헌고찰 및 메타분석

김예은 ( Ye-eun Kim ),안정훈 ( Jeong-hoon Ahn ),차윤엽 ( Yun-yeop Cha ),한인식 ( In-sik Han ),허인 ( In Heo ),박인화 ( In-hwa Park ) 한방재활의학과학회 2022 한방재활의학과학회지 Vol.32 No.2

Objectives This study was conducted to evaluate the effect of electro-acupuncture for sciatica. Methods We searched 13 online databases (Kmbase, Research Information Sharing Service [RISS], National Digital Science Library [NDSL], Oriental Medicine Advanced Searching Integrated System [OASIS], Koreanstudies, Koreantk, DBpia, PubMed, Cochrane, EMBASE, Medline, China National Knowledge Infrastructure [CNKI], Jstage) to find randomized-controlled clinical trials (RCTs) that used electro-acupuncture for sciatica. Efficacy rate and visual analogue scale (VAS) were mainly analyzed as a main evaluation criteria. Results Among 583 articles that were searched, 24 RCTs were finally selected and 18 RCTs were statistically analyzed. Electro-acupuncture was more effective than acupuncture in terms of efficacy rate (p<0.00001) and VAS (p<0.00001). Also, Electroacupuncture was more effective than western medication in terms of efficacy rate (p= 0.0005). However, the effectiveness of electro-acupuncture was not identified compared to physical therapy (p=0.42). Electro-acupuncture significantly improved efficacy rate when combined with physical therapy than physical therapy alone (p<0.0001). In addition, electro-acupuncture plus Chuna manual therapy compared to Chuna manual therapy alone showed positive results for efficacy rate (p=0.05) and VAS (p <0.0001). Conclusions Based on results, the effectiveness of electro-acupuncture for sciatica was identified. However, this study has limitations because the RCTs included in this study were small in number and published in a particular region. Although this study could be a groundwork for well designed research for sciatica. (J Korean Med Rehabil 2022;32(2):105-121)

경추성 현훈에 대한 전침 치료: 체계적 문헌고찰 및 메타분석

김예은 ( Ye-eun Kim ),정인채 ( In-che Chung ),차윤엽 ( Yun-yeop Cha ),한인식 ( In-sik Han ),박인화 ( In-hwa Park ) 한방재활의학과학회 2021 한방재활의학과학회지 Vol.31 No.1

Objectives The objective of this study was to appraise the effect of electro-acupuncture (EA) for the treatment of cervical vertigo. Methods We performed a literature search using nine electronic databases up to the end of November 2020. We included randomized controlled trials (RCTs) which appraised the effect of EA in the treatment of cervical vertigo. The risk of bias was evaluated from the Cochrane risk of bias tool. Results Thirteen appropriate RCTs were included and analyzed. The efficacy rate of the EA group was statistically higher compared with the control group treated with western medicine (p<0.00001). EA treatment significantly improved efficacy rate when combined with western medicine than western medicine alone (p<0.0001). Also EA used with combined therapy (traction, traditional chinese medicine, injection) significantly improved efficacy rate compared with combined therapy alone (p=0.02). Meta-analysis of thirteen studies demonstrated positive results for using EA for the treatment of cervical vertigo. Conclusions Based on results, EA treatment could be effective in cervical vertigo. However, it should be noted that the studies included in this research are regionally biased and small in number. Further well-designed research should be required. (J Korean Med Rehabil 2021;31(1):109-118)

DTF를 이용한 아역청탄 촤 가스화 특성 연구

김상인(Sang-in Kim),이병화(Byoung-hwa Lee),임호(Ho Lim),유다연(Da-yeon Yu),송주헌(Ju-hun Song),전충환(Chung-hwan Jeon) 한국연소학회 2011 KOSCOSYMPOSIUM논문집 Vol.- No.43

In order to investigate char gasification characteristics for three different sub-bituminous coals, an experiment was performed at several temperature (from 900 to 1300℃) with carbon dioxide as agent in DTF(Drop Tube Furnace). The char reaction rate was calculated through ash tracer method and the particle temperature was considered as surrounding gas temperature due to endothermic reaction. In addition, the activation energy and pre-exponential factor for each of three sub-bituminous coal chars was also calculated based on Arrhenius equation. The results show that higher the temperature result in higher reaction rate of sub-bituminous coal chars and each of the three sub-bituminous coal chars has different characteristics of gasification.

Weight Gain and Lipid Profile Changes in Koreans with Human Immunodeficiency Virus undergoing Integrase Strand Transfer Inhibitor-Based Regimens

김진,남현주,정유진,이혜정,김성은,Kang Seung-Ji,Park Kyung-Hwa,Chang Hyun-Ha,Kim Shin-Woo,Chung Eun-Kyung,Kim Uh Jin,Jung Sook In 대한감염학회 2022 Infection and Chemotherapy Vol.54 No.3

Background This study explored the relationship between integrase strand transfer inhibitor (INSTI)-based anti-retroviral agents and weight gain over time, and the risk factors for weight gain in Korean people living with human immunodeficiency virus (PLWH). Materials and Methods The study was conducted retrospectively in PLWHs 18 years of age or older who took one of three INSTI-based single-tablet regimens (STRs) (tenofovir disoproxil fumarate/emtricitabine/elvitegravir/cobicistat [TDF/F/EVG/c], tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat [TAF/F/EVG/c], and abacavir/lamivudine/dolutegravir [ABC/3TC/DTG]) for more than 2 years at three university-affiliated hospitals in South Korea from May 2014 to December 2020. Analysis was performed in the treatment-naïve and treatment-experienced groups, respectively. Results Individual INSTI-based STRs were associated with weight gain at the 24-month follow up in both treatment-naïve (n = 179) and treatment-experienced (n = 290) groups. Body mass index (BMI) categories changed over time for TAF/F/EVG/c and ABC/3TC/DTG, with significant increases in the rates of overweight and obesity in treatment-naïve patients, whereas there was no change for TDF/F/EVG/c. TAF/F/EVG/c significantly increased total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) compared to other regimens over 24 months. In the treatment-naïve group, a baseline CD4+ T cell count <100 cells/mm3, human immunodeficiency virus (HIV) viral load (VL) ≥100,000 copies/mL, no physical exercise, and TAF/F/EVG/c (vs. TDF/F/EVF/c) were risk factors for ≥10% weight gain. In the treatment-experienced group, age <45 years, BMI <25 kg/m2, and no physical exercise were risk factors for ≥5% weight gain. Conclusion INSTI-based STR continued to increase body weight at the 24-month follow up in treated and untreated Korean PLWH. Exercise, together with demographic-, HIV-, and anti-retroviral therapy-related factors, influenced weight gain. Therefore, when prescribing an INSTI-based STR, weight gain and metabolic changes should be closely monitored in PLWH with these risk factors.

Xylooligo당이 고콜레스테롤 식이 흰쥐에서 간조직 HMG - CoA Reductase 활성과 지질 조성에 미치는 영향

김성옥(Sung-Ok Kim),최정화(Jeong Hwa-Choi),홍희진(Hee-Jin Hong),주길재(Gil-Jae Joo),이인구(In-Koo Rhee),이순재(Soon-Jae Rhee) 한국식품영양과학회 2001 한국식품영양과학회지 Vol.30 No.6

고콜레스테롤 식이 흰쥐에서 xylooligo당이 간장에서의 콜레스테롤대사에 미치는 영향을 관찰하였다. 실험동물은 100±10 g의 Sprague-Dawley 흰쥐를 이용하여 정상 식이군과 1% 고콜레스테롤 실험군으로 나누고 다시 실험군은 1%의 고콜레스테롤 식이에 xylooligo당을 0%, 5%, 10%및 15% 농도 첨가군(C, C5XO, C10XO 및 C15XO군)으로 나누어 4주간 자유섭식시킨 후 콜레스테롤 대사 개선효과를 알아보았다. 간조직중의 중성지방과 콜레스테롤함량은 정상군에 비해 C군에서는 각각 3.9배, 20배씩 증가되었으며 C군에 비해 C10XO군은 거의 절반으로 감소되었다. 간조직의 HMG-CoA reductase 활성은 정상군에 비해 C군은 45% 감소되었으나, xylooligo당 공급군에서는 정상군 수준이었다. 간조직중의 지방산 조성은 oleic acid(C_(18:1))과 linoleic acid (C_(18:2))은 정상군에 비해 C군에서 유의적(p<0.05)으로 증가되었고, arachidonic acid(C_(20:4))는 감소되었으나 xylooligo당 공급으로 증가되었다. 총포화지방산(SFA)은 정상군에 비해 고콜레스테롤 식이로 인해 감소되었으나, xylooligo당 공급으로 정상화되었다. 고콜레스테롤군에서는 총 단일불포화지방산(MUFA)은 증가되었으나, xylooligo당 공급으로 감소되었다. 항혈전지수인 n-3/n-6 지방산 비는 정상군에 비해 C군에서 감소되었으나, xylooligo당 10% 공급군에서는 C군에 비해 유의적으로 증가하였다. 결론적으로 식이 xylooligo당은 고콜레스테롤 식이로 인한 고콜레스테롤 혈증이나 고지혈증의 위험인자인 콜레스테롤을 감소시킬 수 있는 콜레스테롤 대사 개선기능이 우수하므로 기능성 식품 신소재나 식이섬유의 대용품으로도 활용될 수 있으리라 생각된다. This study was conducted to examine the effects of dietary xylooligosaccharides on HMG-CoA reductase activity and lipid composition of liver in rat fed high cholesterol diet. Sprague-Dawley male rats weighing 100±10 g were randomly divided into groups of one normal diet, and four high cholesterol diet containing 1% cholesterol. The high cholesterol (1%) diet groups were classified into xylooligosaccharides free diet (C group), 5% xylooligosaccharides diet (C5XO group), 10% xylooligosaccharides diet (C10XO group), and 15% xylooligosaccharides diet (C15XO group) according to the levels of dietary xylooligosaccharides supplementation. The experimental diets were fed ad libidum for 4 weeks. The hepatic lipid contents, cholesterol and triglycerides in xylo-oligosaccharides supplemented groups were significantly lower than those of C group. An antithrombosis index, a ratio of n-3 to n-6 fatty acids of liver was significantly increased in 10% xylooligosaccharides supplemented groups compared to that of C group. The activity of hepatic HMG-CoA reductase, a rate limiting enzyme of cholesterol biosynthesis, in xylooligosaccharides supplemented groups was more significantly increased than in C group. These results suggest that dietary xylooligosaccharide may be act as potential substitute for a dietary fiber to improve lipids metabolism in rat fed high cholesterol diet.