위암 수술 환자의 건강결과 측정을 위한 동반상병 측정도구의 유용성 연구

황세민,윤석준,안형식,안형진,김상후,경민호,이은경,Hwang, Se-Min,Yoon, Seok-Jun,Ahn, Hyeong-Sik,An, Hyong-Gin,Kim, Sang-Hoo,Kyeong, Min-Ho,Lee, Eun-Kyoung 대한예방의학회 2009 예방의학회지 Vol.42 No.1

Objectives : The purpose of the current study was to evaluate the usefulness of the following four comorbidity indices in gastric cancer patients who underwent surgery: Charlson Comorbidity Index(CCI), Cumulative Illness rating scale(CIRS), Index of Co-existent Disease(ICED), and Kaplan-Feinstein Scale(KFS). Methods : The study subjects were 614 adults who underwent surgery for gastric cancer at K hospital between 2005 and 2007. We examined the test-retest and inter-rater reliability of 4 comorbidity indices for 50 patients. Reliability was evaluated with Spearman rho coefficients for CCI and CIRS, while Kappa values were used for the ICED and KFS indices. Logistic regression was used to determine how these comorbidity indices affected unplanned readmission and death. Multiple regression was used for determining if the comorbidity indices affected length of stay and hospital costs. Results : The test-retest reliability of CCI and CIRS was substantial(Spearman rho=0.746 and 0.775, respectively), while for ICED and KFS was moderate(Kappa=0.476 and 0.504, respectively). The inter-rater reliability of the CCI, CIRS, and ICED was moderate(Spearman rho=0.580 and 0.668, and Kappa=0.433, respectively), but for KFS was fair(Kappa=0.383). According to the results from logistic regression, unplanned readmissions and deaths were not significantly different between the comorbidity index scores. But, according to the results from multiple linear regression, the CIRS group showed a significantly increased length of hospital stay(p<0.01). Additionally, CCI showed a significant association with increased hospital costs (p<0.01). Conclusions : This study suggests that the CCI index may be useful in the estimation of comorbidities associated with hospital costs, while the CIRS index may be useful where estimatation of comorbiditie associated with the length of hospital stay are concerned.

군 폐렴 증가 원인에 관한 연구

황세민 ( Se-min Hwang ),오경식 ( Kyung Sik Oh ),이희경 ( Hee Kyeong Lee ),배은경 ( Eun Kyoung Bae ),황점숙 ( Jeom Suk Hwang ),천병철 ( Byung Chul Chun ),김민자 ( Min-ja Kim ) 국군의무사령부 2010 대한군진의학학술지 Vol.41 No.1

Objectives: The purposes of this study are to research regarding to the cause of increasing military pneumonia in 2009, among Influenza A(H1N1), Vaccination of seasonal influenza, Reporting bias, Pneumococcus, Leptospirosis, Orientia tsutsugamushi, Hemorrhagic Fever Renal Syndrome Methods: This study subjects were 200 soldiers for survey of questionnaire and investigation of medical record from 15 military hospital and 11 medical department of an army devision from July 2009 to February 2010, we examined the cause of increasing military pneumonia of the questionnaire for 37 military physicians, 32 military nurses, 7 other Healthworker, 32 patients of pneumonia. Difference for response of this survey by occupations were assessed with Χ2 test or Fisher exact test. Proportion of Influenza A(H1N1) for military pneumonia was evaluated 92 patients from The Armed Forces Capital Hospital. Results: According to response of this survey, The 'Increasing diagnosis by mass media and an official notice, education of Influenza A(H1N1)' comprised of 53%(mean by military hospital and medical department of an army devision) followed by the ' Increasing Influenza A(H1N1)' comprised of 25.2%, respectively. and response by occupations were different from military hospital survey(p value=0.004). Proportion of Influenza A(H1N1) for military pneumonia(46 case) was as same as the other pneumonia(46 case). Conclusions: This study suggested the most important cause of increasing military pneumonia in 2009 was increasing diagnosis by mass media and an official notice, education of Influenza A(H1N1). therefore we have need to manage reporting bias for new infectious disease.

군대 훈련 중 흡입항원에 대한 감작률과 알레르기질환 유병률의 변화

황세민 ( Se Min Hwang ),김희경 ( Hee Kyung Kim ),김성화 ( Seoung Hwa Kim ),강점숙 ( Jum Sook Kang ),주영훈 ( Young Hoon Joo ),이상민 ( Sang Min Lee ) 대한천식알레르기학회 2012 천식 및 알레르기 Vol.32 No.4

Background: The objective of this study was to evaluate changes in the prevalence of sensitization to inhalant allergens and allergic disease among young army conscripts during a 35-day military training course. Methods: Fifty-four young soldiers who conscripted into the Korean army on April 29, 2011 were enrolled after their informed consent. Their sera were sampled on day 1 to measure total immunoglobulin E and allergen-specific immunoglobulin E to common inhalant allergens using UNICAP(R) and the Multiple Allergen Simultaneous Test(R), respectively. Their sera were sampled again on day 35 to evaluate temporal changes in total immunoglobulin E and allergen-specific immunoglobulin E. Subjects were also requested to respond to the modified International Study of Asthma and Allergies in Childhood questionnaire on day 35 to evaluate the prevalence of allergic diseases. Results: The number of subjects sensitized to birch/alder increased from 1 (1.9%) to 4 (7.4%) during military training; however, the difference was not statistically significant. The status of sensitization to other allergens and serum total immunoglobulin E levels did not change significantly. Of the 54 subjects, 9 (16.7%) experienced new onset or exacerbation of allergic disease. However, most of subjects were not diagnosed with allergic diseases by a physician, nor did they receive proper treatment for their symptoms. Conclusion: A 35-day course of military training was insufficient to change the inhalant allergen sensitization status; however, some young army conscripts suffered from new onset or exacerbation of allergic diseases during military training that were not diagnosed or treated appropriately.

전시 화생방 대비 의료대응능력 파악 및 개선방안에 관한 연구

황세민 ( Se-min Hwang ),박동언 ( Dong-ean Park ),강점숙 ( Jum-sook Kang ),조민수 ( Min-su Cho ),신현진 ( Hyun-jin Shin ),이희경 ( Hee-kyeong Lee ),오수미 ( Su-mi Oh ) 국군의무사령부 2011 대한군진의학학술지 Vol.42 No.1

Objectives: The purpose of this study is to research the medical defensive capacity of chemical, biological and radiological warfare in military hospitals, such as Anthrax, Plague, Smallpox, Botulism, Viral hemorrhagic fever, Tularemia, Cholera, Typhoid fever, Nerve agents, Vesicants, and Nuclear terrorism. Methods: The subjects of this study were 281 soldiers that consisted of 100 military physicians, 104 military nurses, 77 other Healthworker for survey of questionnaire and evaluation of Bioterrorism agents from 15 military hospital from December 2010 to July 2011. Difference for response of this survey by occupations were assessed with Χ2 test or Fisher exact test. two sample t-test and the number of infection for health care personnel was evaluated by Graphic Information System in military hospital . Results: According to review of reference, Smallpox and Anthrax are considered fatal biological weapons. From a cognitive point of view, Tularemia is the most difficult disease to detect, The maximum military healthcare personnel required for the defense of biological warfare is 22 persons, 24 persons are required for the defense of chemical warfare, and 25 persons are required for the defense of radiological warfare, The most dangerous area is TAEJON for defense of biological warfare. Conclusions: This study suggested the most efficient medical defensive capacity of biological warfare, Otherwise radiological warfare is the most difficult to manage in military hospitals. therefore we need to prepare defense against an chemical, biological and radiological attack for these problem.

한국군에서의 한타박스^® (HFRS국내백신)의 효용성에 대한 연구

손민정 ( Min-jeong Son ),황현철 ( Hyun-chul Whang ),양병윤 ( Byeon-yun Yang ),최강원 ( Kang-won Choe ),박영준 ( Young-joon Park ),황세민 ( Se-min Hwang ),채동완 ( Dong-wan Chae ) 국군의무사령부 2011 대한군진의학학술지 Vol.42 No.1

Introduction: Hemorrhagic fever with renal syndrome (HFRS), although its incidence is decreasing, reveals severe renal clinical course and high mortality. Military croups have many outdoor activities, so soldiers cannot avoid to exposure of Hantan virus in epidemic area in Korea. Therefore, soldiers in epidemic area were scheculed to vaccinate HantavaxⓇ which is intoxicated vaccine. this study aims that HantavaxⓇ can influence with the clinical course of HFRS. Methods: Twenty nine male patients ,who were diagnosed HFRS in the Armed Forces Capital Hospital, were retrospectively enrolled from March 2009 to July 2010. Patients have positive results in Hantan virus antibody using with rapid chromatography test and they have no history of vaccination within three month recently. Nephrology specialist diagnosed the HFRS in patient and enrolled them in study group. All patients were confirmed the vaccination history which is based on public record of his croup, not his memory's. Researchers could check patient's precise vaccination history, the day and the times. We classified patients by non-vaccination patients (group 1) and vaccination patient (group 2) and investigated clinical course of both groups. Results: Eleven patients (37.9%) had been vaccinated previously and eighteen patient had not had vaccination. None of study patients was died. six patients of group 1 must have been dialysis treatment during acute status and none of group 2 were not dialysis treatment. Eleven patients of group 1 experienced oliguria, but only one patient of group 2 have oliguric phase. These clinical course shows stastically different from group 1 and group 2(p=0.032, p=0.011). These results are announced that vaccination might have protective effect against the HFRS. Admission day, titer of antibody, hematologic and chemical test were not different among two groups. Conclusion: Vaccination group of HantavaxⓇ in patients had better clinical course than non-vaccination group. Additional study should be needed for evaluating of renal protective effect of HantavaxⓇ.

디자인경영의 유형별 전략모델에 관한 연구

이해묵 ( Lee Hai-mook ),황세민 ( Hwang Se-min ),김규진 ( Kim Gyu-jin ) 경기대학교 산업디자인연구소 2010 조형논총 Vol.7 No.-

최근 들어 기업들은 디자인 혁신을 통한 새로운 제품개발 방식을 추진하는 사례가 늘고 있다. 이는 글로벌 경쟁시대에 단순한 기술력 중심의 제품개발 만으로는 경쟁력이 부족하며 이를 보완하기 위한 방법으로 디자인경영을 통한 제품 혁신 (Product Innovation)이 그 대안으로 대두되고 있기 때문이다. 하지만 국내 기업들의 디자인경영에 대한 마인드와 활용 사례를 분석해 보면 아직 명확한 디자인경영에 대한 답을 찾기 보다는 단순히 디자인에 대한 지원을 강화하는 방향으로 지원하는 사례가 많고, 정부 주도하의 디자인 지원 정책들이 나오고 있지만 단순 한 연구 차원에서의 보고서를 중심으로 연구가 이루어지고 있어 실증적 차원의 기업 지원을 위한 선진국의 다양한 사례를 통해 국내 실정에 맞는 디자인지원 사업의 정책 방향을 수립하는 것도 한 가지 대안이 될 수 있을 것이다. 따라서 본 연구에서는 이러한 차원에서 중소기업을 중심으로 선진국의 디자인 지원정책이 기업에 어떠한 경쟁력을 제고시키고 이를 어떻게 활용하고 있는지에 대한 검토와 이를 국내 정책과 비교하여 올바른 디자인 지원 정책으로서의 디자인경영에 대한 새로운 방법을 제시하고자 한다. 중소기업의 경쟁력 강화를 위한 시책들이 그 동안 기술 및 경영혁신(Technology & Management Innovation)의 육성 및 활성화에 치우쳐 있었고, 이는 많은 시간과 비용이 들어 기업의 경쟁력 차별화에 큰 도움을 주지 못했고, 이에 대한 대안으로 디자인의 차별화를 통한 혁신적 제품 개발을 통한 경쟁력 강화가 더 짧은 시간과 비용의 투자로 이어진 다는 최근의 성과를 바탕으로 디자인 경영의 성공적인 성과를 위한 가치 요인들을 분석해 보고자 한다. Recently, the companies developing new products with innovative designs that cases are increasing. Era of global competition in technology-driven products indude a simple lack of competitiveness and as a way to achieve this through design, product development management has been recognized as a new way. Currently the design support policies under governmental leading are coming out, the report from the research dimension which is simple the research is become accomplished in the center and the instance which the advanced nation for the enterprise support of positive dimension is various leads and will be the possibility establishing the politic direction of the design support enterprise which to the domestic actual condition hits becoming one kind alternative. From the research which sees from like this dimension the small and medium enterprise in the center the design support policy of advanced nation raises what kind of competitive power at the enterprise and applies this how about design management with from proper design support policy and investigation and this domestic policy and compares under presenting boil a new method. The renovation product development which leads the discrimination of design is joined together with investment of the time when the competitive power enforcement which leads is shorter and expense and result of recent times the reporter to analyze the values for the result which design management is successful with character does.

군견에서 광견병 백신종류에 따른 효과 차이에 관한 연구

주영훈 ( Young-hoon Joo ),황세민 ( Se-min Hwang ),송상헌 ( Sang-hun Song ),홍성휘 ( Sung-hwe Hong ),권태선 ( Tae-sun Kwun ) 국군의무사령부 2013 대한군진의학학술지 Vol.44 No.1

Objectives : Rabies is a contagious disease which can be found in every warm-blooded animal, and be transmitted through bites of infected animals. if a person did not formed antibody, his vulnerability to hydrophobia would increase, therefore, The purposes of this study is to compare effectiveness of live vaccine with those of non-live vaccine. Methods : This study subjects were 20 military working dogs and each ten dogs were injected with live vaccine (Group A) and non-live vaccine (Group B) at the Army Dog Training Center from March 2011 to September 2011. We evaluated blood samples after three months and six months after injection. After separating blood serum from blood samples, we tested them by using enzyme-linked immuno sorbent assay (ELISA) and The fluorescent antibody virus neutralization test (FAVNT). Difference for rate of serum antibody titers by two sorts of vaccine were assessed with Mann-Whitney U test. Results : The antibody titers of ELISA in Groups A and B were 3.727 EU/ml and 0.133 EU/ml on three months after the first dose(titers of effectiveness ≧ 0.51), 2.897 EU/ml and 0.125 EU/ml on six months(titers of effectiveness ≧ 0.448), respectively, Titers of FAVNT in Groups A and B were 6.010 EU/ml and 0.170 EU/ml on three months after the first dose(titers of effectiveness ≧ 0.5), 10.45 EU/ml and 0.500 EU/ml on six months(titers of effectiveness ≧ 0.5). Conclusions : This study suggested both vaccines formed antibodies, but live vaccine showed more rapidly increase rate of serum antibody titers of effectiveness. Moreover, live vaccine's antibodies lasted longer. It seems clear that military contemporary rabies immunization by using live vaccine is more effective than using non-live vaccine in terms of budget and effect.

2018년 중부지방 일개 대학에서 집단 발생한 클로스트리듐 퍼프린젠스 감염증

배은주(Eun-Joo Bae),황세민(Se-Min Hwang),권근용(Guen-Yong Kwon),이무식(Moo-Sik Lee) 한국농촌의학 지역보건학회 2020 농촌의학·지역보건 Vol.45 No.2

2018년 5월 25일 10:00경 세종시 소재 일개 대학교 학생 40여명 정도가 설사 및 구토 증상 등을 주된 증상으로 하는 집단 발생으로 시청콜센터와 보건소를 통해 발생 신고가 접수되었다. 우리는 즉각 역학조사반을 구성(위생과 포함)하여 당일 14:30분에 현장 역학조사를 실시하였다. 역학조사결과, 최종 발생규모는 153명중 86명(56.2%) 등 이었다. 추정위험 노출시간은 전날 12시로, 원인은 체육대회 당일 점심으로 제공된 도시락의 유통·저장 과정에서 오염된 것으로 추정되었으며, 평균잠복기 13시간이었다. 발생은 5월 28일 종결되었으며, 검사결과는 6월 11일 통보 되었는데 동정된 세균은 클로스트리듐 퍼프린젠스(Clostridium perfringens)이었다. 이러한 조사결과를 통하여 클로스트리듐 퍼프린젠스에 의한 식중독이 집단 급식, 도시락의 유통 및 저장과 전달과정에서 오염 가능성과 발생이 가능함을 확인하였다. 세종특별자치시의 검사의뢰전달체계의 구축이 필요하고, 향후 보건환경연구원 등 지역지원 임상병리 검사기관의 설치운영이 시급한 과제이다. 아울러 충분한 검사 예산과 이에 따른 신속한 검사지원체계의 구축이 필요하다. 클로스트리듐 퍼프린젠스에 의한 식중독이 집단 급식, 즉 도시락의 유통 및 저장과 전달과정에서 오염 가능성과 발생이 가능함을 확인하였다. Purpose: This study was conducted to provide the results of the epidemiological investigation for outbreak of Clostridium perfringens enteritis among students at a college in Sejong City. Methods: This investigation was performed between May 25 and May 28, 2018. The Sejong City public health authority received a complaint which was about 40 university students experienced vomiting or diarrhea. We immediately set up an epidemiological investigation team and conducted a field epidemiological investigation. Results: The overall incidence was 86 out of 153 (56.2%). The estimated risk exposure time was 12 o"clock on the previous day, and the cause was contaminated during distribution and storage of the lunch box provided for lunch on the day of the athletic competition, with 13 hours of average incubation period. The outbreak was closed on May 28, and the identified pathogen was Clostridium perfringens. Conclusions: It was proposed that food poisoning by Clostridium perfringens was likely and contaminated during group meal.

室內디자인의 새로운 方向摸索에 관한 小考

권영성(Young-Sung Kwon),황세민(Se-Min Hwang) 한국디자인학회 1992 디자인학연구 Vol.- No.5

위암환자에서 의무기록과 행정자료를 활용한 Charlson Comorbidity Index의 1년 이내 사망 및 재원일수 예측력 연구

경민호,윤석준,안형식,황세민,서현주,김경훈,박형근,Kyung, Min-Ho,Yoon, Seok-Jun,Ahn, Hyeong-Sik,Hwang, Se-Min,Seo, Hyun-Ju,Kim, Kyoung-Hoon,Park, Hyeung-Keun 대한예방의학회 2009 예방의학회지 Vol.42 No.2

Objectives : We tried to evaluate the agreement of the Charlson comorbidity index values(CCI) obtained from different sources(medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay(length of stay). Methods : Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. Results : The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree(kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables($\beta$ = 0.112, 95% CI = [0.017-1.267]). Conclusions : There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.