자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

Genetic associations of body composition, flexibility and injury risk with ACE, ACTN3and COL5A1polymorphisms in Korean ballerinas

( Jun Ho Kim ),( Eun Sun Jung ),( Chul Hyun Kim ),( Hyeon Youn ),( Hwa Rye Kim ) 한국운동영양학회 2014 Physical Activity and Nutrition (Phys Act Nutr) Vol.18 No.2

Jun Ho Kim, Eun Sun Jung, Chul-Hyun Kim, Hyeon Youn and Hwa Rye Kim. Genetic associations of body composition, flexibilityand injury risk with ACE, ACTN3and COL5A1polymorphisms in Korean ballerinas. JENB., Vol. 18, No. 2, pp.205-214, 2014[Purpose] The purpose of this study was to exam the association of body composition, flexibility, and injury risk to genetic polymorphismsincluding ACEID, ACTN3RX, and COL5A1polymorphisms in ballet dancers in Korea. [Methods]For the purpose of this study,elite ballerinas (n = 97) and normal female adults (n = 203) aged 18 to 39 were recruited and these participants were tested forbody weight, height, body fat, fat free mass, flexibility, injury risks on the joints and gene polymorphisms (ACE, ACTN3, COL5A1polymorphism). [Results]As results, the ACEDD genotype in ballerinas was associated with higher body fat and percentageof body fat than the ACEII and ID genotypes (p< 0.05). In the study on the ACTN3polymorphism and ballerinas, the XXgenotype in ballerinas had lower body weight and lower fat-free mass than the RR and RX genotype (p < 0.005). Also, the meansof sit and reach test for flexibility was lower in the ACTN3XX genotype of ballerinas than the RR and RX genotype of ballerinas(p< 0.05). Among the sports injuries, the ankle injury of the XX-genotyped ballerinas was in significantly more prevalence thanthe RR and XX-genotyped ballerinas (p< 0.05). According to the odd ratio analysis, XX-genotyped ballerinas have the injuryrisk on the ankle about 4.7 (95% CI: 1.6~13.4, p< 0.05) times more than the RR and RX-genotyped ballerinas. Meanwhile, theCOL5A1polymorphism in ballerinas has no association with any factors including flexibility and injury risks. [Conclusion]Inconclusion, ACEpolymorphism and ACTN3polymorphism were associated with ballerinas` performance capacity; COL5A1wasnot associated with any factors of performance of Ballerinas. The results suggested that the ACEDD genotype is associated withhigh body fat, the ACTN3XX genotype is associated with low fat-free mass, low flexibility, and higher risk of ankle-joint injury. [Keyword]ballet, flexibility, body composition, injury risk, ACE, ACTN3, COL5A1

Effects of Phenytoin and Diazepam on the Seizure Activity in the Cortical Dysplasia Animal Models

Kim, Si-Hyung,Choi, In-Sun,Cho, Jin-Hwa,Park, Eun-Ju,Jang, Il-Sung,Choi, Byung-Ju,Kim, Hyun-Jung,Kim, Young-Jin,Nam, Soon-Hyeun The Korean Academy of Oral Biology 2006 International Journal of Oral Biology Vol.31 No.2

Dysplasia-associated seizure disorders are markedly resistant to pharmacological intervention. Relatively little research has been conducted studying the effects of antiepileptic drugs(AEDs) on seizure activity in a rat model of dysplasia. We have used rats exposed to methylazoxymethanol acetate(MAM) in utero, an animal model featuring nodular heterotopia, to investigate the effects of AEDs in the dysplastic brain. Pilocarpine was used to induce acute seizure in MAM-exposed and age-matched vehicle-injucted control animals. Field potential recordings were used to monitor amplitude and numbers population spikes, and paired pulse inhibition in response to stimulation of commissural pathway. Two commonly used AEDs were tested: diazepam 5, 2.5mg/kg;phenytoin 40, 60mg/kg. Diazepam(DZP) and phenytoin(PHT) reduced the amplitude of population spike in control and MAM-exposed rats. However, the amplitude of population spike was nearly eliminated in control rats as compared to the MAM-exposed rats. Pharmaco-resistance was tested by measuring seizure latencies in awake rats after pilocarpine administration(320mg/kg, i.p.) with and without pretreatment with AEDs. Pre-treatment with PHT 60 mg prolonged seizure latency in control rats, but not in MAM-exposed animals. The main findings of this study are that acute seizures initiated in MAM-exposed rats are relatively resistant to standard AEDs assessed in vivo. These data suggest that animal model with cortical dysplasia can be used to screen the effects of potential AEDs.

골분을 이용한 구리 흡착 첨착

김은정,박정훈,김정섭,유현철,이봉섭,곽명화,우성훈,박승조 東亞大學校 環境問題硏究所 2005 硏究報告 Vol.27 No.1

Spent pig bone was consist of hydroxyapatite. And then we thought that it have a possibility as a adsorbent. The preparation of bone char prepared from spent pig bone in this study. We study on the recycling possibility as a adsorbent is able to adsorb copper ion from their single aqueous solutions. The results are summarized as follows. Bone char that prepared from spent pig bone at 105, 400, 700℃. The adsorption removal efficiency of copper ion onto bone char as adsorbent was above 90% for 15 hours. Increase in the initial pH of the copper ion solution result in an increase in the copper ion uptake per unit weight of the adsorbent. Freundlich isotherm model was found to be applicable for the experiment data of copper ion. The results showed that spent pig bone can be used for the absorption of the copper ion.

산후에 발병한 특발성 부갑상선 기능저하증 I 예

김정인,김상용,신병철,김경남,서영욱,이범주,김진화,배학연 朝鮮大學校 附設 醫學硏究所 2002 The Medical Journal of Chosun University Vol.27 No.2

Hypoparathyroidism is usually the result of an inadvertent surgical removal of all the parathyroid glands, In some instances, not all the tissues are removed, but the remainder undergoes vascular supply compromise secondary to the fibrotic changes in the neck after surgery, Previously, the surgery for hyperthyroidism was the most frequent cause of acquired hypoparathyroidism. Idiopathic hypoparathyroidism is a relatively rare disease that is characterized by hypocalcemia and hyperphosphatemia due to a parathyroid hormone deficiency of an unknown cause, It usually develops at a young age, and shows various clinical symptoms and signs accompanied with hypocalcemia. In addition, it is rarely associated with polyglandular autoimmune syndrome during the follow-up. Hypocalcemia and idiopathic hypoparathyroidism associated with labor and lactation are rarely reported condition previously. We here describe a case of a woman in whom the symptomatic severe hypocalcemia appeared after her delivery. We reviewed all the previously reported cases and suggest a possible physiological explanation for the association between pregnancy, lactation, and the appearance of symptomatic hypocalcemia.

초등학교 아동을 위한 리더십 프로그램 개발

김정효,정인숙,김신래,엄화정 이화여자대학교 교육과학연구소 2007 교육과학연구 Vol.38 No.3

학교교육과정에서는 자율성의 확대에 밀려 타인배려와 공동체에 대한 책임의식 교육은 상대적으로 열세의 위치에 처해있다. 그러나 21세기 정보화 산업구조에서는 한개인에게 리더이자 동시에 멤버로서의 역할을 요구하고 있다. 특별히 학령기 아동에있어서는 또래 집단 형성이라는 사회성 발달 과업의 특성이 초등학교아동기에 ‘자신이가진 독특한 자질을 발휘하여 공동체의 유익을 위해 영향을 발휘할 수 있는 능력’ 으로서의 리더십 교육을 필요로 한다. 본 연구에서는 자신자질에 대한 이해를 기반으로 자신감을 가지도록 하는 심리적요소, 자신 뿐 아니라 공동체의 유익을 중요한 삶의 목적이 되어야 한다는 가치적 요소, 그리고 의사소통능력, 대인관계기술 등의 기술적 요소를 기반으로 하는 초등학교고학년 아동을 위한 5일간의 단기 리더십 프로그램을 개발하였다. 서울 시내 한 사립초등학교 5학년을 대상으로 형성평가를 위한 예비실행연구를 하였고, 아동의 자기평가와 교사와의 면담을 통해 개발된 리더십프로그램은 대체로 심리적, 가치적, 기술적요소에 효과를 가지고 온 것으로 보였다. 특히 리더십이란 특정 개인에게만 있는 것이아니라 모두에게 잠재되어 있다는 인식의 전환을 가져옴으로써 자신감과 리더십 개념획득에 두드러진 효과를 가지고 오는 것으로 보였다. This study is to develop a leadership program for elementary school children. Due to extension of freedom, education of responsibility such as taking care ofothers and consideration of community is inferior in the school education. However, in information-oriented society asks for an individual to become aleader and a member at the same time. In addition, specific character of creatingpeer group in children of school age makes it more necessary educate "ability todisplay individual's specific quality for benefit of community". In this study, based on including psychological factor to understand themselvesto bring their confidence, value factor that benefit for the community has to bethe reason for their life and technological factors such as communicating skillsand interpersonal relationship, 5day short-trial for senior students of elementaryschool was developed. A preliminary inspection was held to 5th graders in anelementary school in Seoul. In result, our leadership program gave positive effecton psychological factor, value factor and technological factors. Especially, thisprogram was effective to give confidence and rearranged the definition ofleadership by the idea that leadership is not for the certain individuals buteveryone has their potentials.

남제주 화력발전소의 증설과 저감대대책의 영향 분석

이화운,김유근,정우식,오은주,임헌호,노순아,반수진,최현정,김민선,김헌숙 부산대학교 환경문제연구소 2002 環境硏究報 Vol.20 No.-

In the view of the results investigated the effect of air pollutants that is emitted from a new generator facilities, the total estimated concentration which is the summation of a contributional concentration and observational concentration is much less than that of atmospheric environment criterion for the air pollutants. So we can predict that the operation of the new generator facilities with mitigation equipment don't seriously affect around environment. At the same time, we compared the contributional concentration of before mitigation equipment with that of after it to examine the decreasing amount due to mitigation equipment. The result showed that the concentration of SO2, NO2 and PM-10 is reduced to 25%, 30% and 26% of original value, respectively.

미세알부민뇨를 동반한 인슐린 비의존성 당뇨병 환자에서 혈장 Endothelin의 변화

서예경,정상원,남직화,신병호,전종민,김정국,김동희,하승우,김보완 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.3

목적 : 혈관내피세포에서 생성되는 endothelin(ET)는 강력한 혈관수축작용을 가진 펩타이드로 당뇨병 환자에서 혈관내피세포의 손상여부에 따라 혈중 농도가 증가할 수 있으며 혈관합병증과 관련이 있다는 보고가 있다. 그러나. 혈중 ET치의 상승과 당뇨병성 합병증의 상관성에 대해서는 논란이 많다. 이에 저자들은 인슐린 비의존성 당뇨병 환자에서 미세알부민뇨의 동반유무에 따른 혈중 ET치의 변화 및 혈장 ET치와 요중 알부민 배설률과의 상관성을 검토하였다. 대상 및 방법 : 인슐린 비의존성 당뇨병 환자중 미세알부민뇨를 보인 22명과 정상알부민뇨를 보인 43명을 대상으로 하였으며 혈장 ET를 측정하여 요중 알부민 배설률, 당뇨병성 망막증 및 당뇨병 관련인자들과의 관계를 비교하였다. 결과 : 당뇨병성 망막증이 합병된 군에서 망막증이 합병되지 않은 군에 비하여 혈장 ET치가 유의하게 높았던 반면 (각각 1.9±0.66, 1.5±0.76pg/㎖, p<0.05) 미세알부민뇨를 보인 군과 정상알부민뇨를 보인 군사이에 혈장 ET치는 통계학적으로 유의한 차이가 없었다(각각 1.9±1.14, 1.7±0.69pg/㎖). 또한 요중 알부민 배설률과 혈장 ET치 사이에 유의한 상관관계는 없었으며 미세알부민뇨를 동반한 인슐린 비의존성 당뇨병 환자군에서 혈장 ET치는 당뇨병의 관련인자들과도 유의한 상관관계가 없었다. 결론 : 인슐린 비의존 당뇨병 환자에서 혈장 ET치가 초기 당뇨병성 신증의 합병여부나 미세알부민뇨의 정도를 반영하기는 어려울 것임을 시사한다. Background : Endothelin(ET), a potent vasoconstritor peptide released from vascular endothelial cells, is known to be increased in diabetic patients with vascular damage and related with diabetic angiopathy. However, whether plasma ET levels may be related to diabetic complications is controversial. We studied the change of ET levels in non-insulin dependent diabetics with microalbuminuria and relation between ET and urinary albumin excretion rate. Methods : Plasma ET levels of 22 non-insulin dependent diabetics with microalbuminuria and 43 patients with normoalbuminuria were measured and relations of plasma ET to diabetic complications such as urinary albumin excretion rate, retinopathy and other associated factors were studied. Results : Plasma ET levels were significantly higher in patients with diabetic retinopathy than those without retinopathy(1.9 ± 0.66 vs 1.5 ± 0.76 pg/㎖. p<0.05). The difference, however, between diabetics with and without microalbuminuria was not significant(1.9 ± 1.14 vs 1.7 ± 0.69 pg/㎖). There were no correlations of plasma ET to urinary albumin excretion rate and to the other associated factors in non-insulin dependent diabetics. Conclusion : These results suggest that plasma ET levels may not seem to act as a predictor of diabetic nephropathy or microalbuminuria in non-insulin dependent diabetics.

Brucella abortus 국내 분리주의 36kDa 외막단백을 암호하는 omp2b 유전자의 염기 분석

허지연,김지영,송근호,김명철,박창식,김태용,김정화,전무형 충남대학교 형질전환복제돼지연구센터 2004 논문집 Vol. No.8

B. abortus 국내 분리주의 분자유전학적 성상을 규명하고 분자역학적 연구에 필요한 기초자료를 얻기 위해 36kDa OMP를 암호하는 omp2b 유전자를 PCR법으로 확인하고,그리고 omp2b 유전자의 핵염기 서열과 아미노산 서열을 결정하고 이 결과를 Brucella 표준균주 및 여러 동물에서 분리된 Brucella 분리주와 상호 비교 분석하였던 바 다음과 같은 결과를 얻었다. 1. B. abortus 분리 주 (7주)에 대해 omp2b primers를 이용하여 PCR을 수행한 바 공시한 참조균주와 분 리균주 모두에서 1,251bp의 특이한 DNA 절편이 각각 증폭되었다. 2. omp2b 유전자의 1,089bp에 대한 염기서열과 이에 대한 362개의 아미노산 서열을 결정하였다. 분리 균주의 omp2b 유전자의 염기서열을 참조균주와 비교 분석한 결과 B. abortus 2308 (biovar 1) 및 B abortus B3196 (biovar 5)과는 99.6%∼100% 및 99.5%∼99.9%의 매우 높은 상동성을 나타내었고,B. abortus 45/20 (biovar 1)과는 97.1%~97.4%의 상동성을 나타내었다. 또한 362개의 아미노산 서열에 대해 분석하였던 바,분리균주들은 B.abortustus 2308 (biovar 1) 및 B. abortus B3196 (biovar 5)과는 99.2%∼100%의 매우 높은 상동성을 보였으며,B. abortus 45/20 (biovar 1)과는 96.4%∼ 97.2%의 상동성을 보였다. 3. 본 시험에 공사된 브루셈라균주의 omp2b 유전자 서열과 여러 동물에서 분리된 브루셀라 분리주의 자료를 바탕으로 phylogenetic tree를 작성 한 바,국내 분리주는 B. abortus 2308 (biovar 1),B. abortus B3196 (biovar 5),B. abortus 45/20 (biovar 1),B. suis 1330 (biovar 1),B. melitensis 16M (biovar 1),B. canis NCTC 01854,B. neotomae 5K33과 97.3% 이상의 높은 근연성을 보이며 동일한 cluster에 소속되었으며,omp2b 유전자는 매우 잘 보존됨을 알 수 있었다. omp2b gene of Brucella abortus isolates encoding 36kDa outer membrane protein (OMP) was amplified by polymerase chain reaction (PCR) and the sequences of nucleotide and amino acid were determined and analyzed to obtain the basic data for molecular epidemiological features of brucellosis in Korea. In PCR using omp2b primers for the gene of 36kDa aMP, the specific signals at 1,251bp were demonstrated, The nucleotide sequences of omp2b gene of 1,089bp were sequenced by dye terminator cycle sequencing method, and 362 amino acid sequences were predicted. As compared the nucleotide sequences with those of B. abortus reference strains, the isolates showed the very high homology to the reference strains ranging 97.1%∼100%. The similar results were also obtained in the analysis of the amino acid sequences. In the phylogenetic tree, the isolates clustered with the reference strains and the majority of strains originated from pig, dog, wood rat and cattle.