혈액성분제제 품질관리 자료의 통계학적인 비교

김종암 ( Chongahm Kim ),서동희 ( Dong Hee Seo ),권소영 ( So Yong Kwon ),오영철 ( Yuong Chul Oh ),임채승 ( Chae Seung Lim ),장충훈 ( Choong Hoon Jang ),김순덕 ( Soonduck Kim ) 대한임상검사과학회 2004 대한임상검사과학회지(KJCLS) Vol.36 No.1

According to increase of domestic blood components use, the quality control of blood components is necessary to support good products. The purpose of this study is used to provide the producing index of the good product as compared with the accuracy and validity for the distribution of the quality control data. The value of mean, standard deviation, 95% confidence interval and degree of normal distribution of data were calculated by univariate procedure, the value of monthly mean of each blood centers per items were compared by Analysis of Variance(ANOVA) test for the degree of distribution. When there was difference among the mean values, the Duncan``s multiple range test was done to confirm the difference. Finally, methods for accessing accuracy and validity of the quality data was done by the Contingency table test. The quality data of five blood centers was showed to the normal distribution and it was in a acceptable range. For each blood centers, the monthly means of Hematocrit(Hct), Platelet(PLT) and pH were not significantly different except Hct of C center, PLT of B, D center and pH of A center. The quality data per items was graded according to quality to six level. As a result of the comparative analysis, the monthly means of Hct of C and E center was significantly different higher than that of D, B and A center. The monthly means of PLT of A center and pH of C center was significantly different higher than that of the others. In the accuracy and validity of the quality control data, C center for Hct, A center for PLT and C center for pH were better than the other. The C blood center was most satisfiable and stable in the quality control for blood component. If the quality control method used in C blood center is adopted in other blood centers, the prepared level of the blood component of the center will be improved partly.

일개 종합병원 중환자실에서의 병원성 혈류감염에 관한 연구

김기숙(Ki Sook Kim),김순덕(Soonduck Kim),지선미(Sunmi Ji),이제숙(Jesuk Lee) 한국역학회 2007 Epidemiology and Health Vol.29 No.1

  Purpose: Despite of the development of recent medical technology, bloodstream infection (BSI) still has significant influences on mortality and morbidity of patients admitted to the ICU. The BSI has the second most frequent site. Especially BSI in ICU have higher infection rate than general ward. This study was investigated the incidence rate of the nosocomial BSI, risk factors and bacterial pathogens of BSI in ICU for a general hospital.<BR>  Methods: This study was carried out for those 443 patients in ICU of general hospital during the period from March 2002 to February 2003. The definition for BSI was based on that of CDC. Data was collected by questionnaire, medical record review. The statistical SPSS(ver. 10.0) was used to analyze data that included chi-square, t-test and logistic regression.<BR>  Results: In the incidence rates of the BSI were 76.7 in 1,000 per patients, 7.0 in per 1,000 patients days and 32.1 in per 1,000 patients with central lines, 3.2 in per 1,000 cental line days. In the incidence rates of the BSI by type of ICU showed MICU 10.1, SICU 2.9 in per 1,000 patients days. The significant risk factors were identified as type of ICU(OR=5.119, p=0.001), length of stay(OR=1.039, p=0.001). The causal microbes of the BSI were CNS 35.5%, MRSA 23.6%. The bacterial pathogens of central catheter-related BSI were CNS 50%, MRSA 50%.<BR>  Conclusion: The occurrence of ICU-acquired infection was significantly related to the increase in morbidity and mortality. Ongoing targeted surveillance and infection control strategies is necessary to control this problem.

소아의 비강내 지역사회획득 Methicillin-resistant Staphylococcus aureus 감염실태 조사

박지영(Jiyoung Park),김순덕(Soonduck Kim),이제숙(Jesuk Lee) 한국역학회 2006 Epidemiology and Health Vol.28 No.2

  Purpose: Methcillin-resistant Staphylococcus aureus(MRSA) is known as a major cause of hospital acquired infection. The infection with MRSA bacteria is becoming frequent in the community because there are many people who have risk factors with low immunity. This study is intended to investigate the prevalence of MRSA in children and determine risk factors using genetic analysis.   Methods: Children aged between 3 and 7 years were recruited from six preschool institutions from Nov. 2004 to Feb. 2005 based in Seoul, Gyeonggi Province and Gyeongsang Province. A questionnaires was distributed to 1,000 parent of these children along with the letter of consent. A total of 242 questionnaires were collected and used for this study. Nasal secretion samples were collected using sterilized specimen containers and incubated in culture medium using mannitol salt agar to separate S. aureus. MRSA samples were identified through coagulase test and MICRO SCAN. PCR was performed on MRSA isolates to detect genetic sequence specific of MRSA.   Results: Of total 242 respondents, 16(6.6%) were found to be positive for MRSA. By residence area, 2(1.9%) out of 103 were positive in Seoul, 4(10.3%) out of 39 were positive in Gyeonggi Province and 10(10.0%) out of 100 were positive in Gyeongsang Province, showing a significant difference(p=0.037). A logistics regression was performed to evaluate the influences of variables that were significant. Gyeongsang Province had prevalence of MRSA(OR=5.520), and Gyeonggi Province(OR=5.710). Based on PCR, the distribution of genotypes of MRSA showed various patterns. But there was no difference between regions.   Conclusions: MRSA infection was high in children when one of their parents were working in hospital or when one of their family members have underlying disease. This study provided evidence that the prevalence of MRSA is largely influenced by individual element such as family and health condition.

CS₂ 暴露 勤勞者의 進行性難廳 1例

李恩一(Eunil Lee),金順德(Soonduck Kim) 한국농촌의학 지역보건학회 1990 농촌의학·지역보건 Vol.15 No.2

A Study on Improvement for Service Proliferation Based on Blockchain

유순덕,김기흥,Yoo, Soonduck,Kim, Kiheung The Institute of Internet 2018 한국인터넷방송통신학회 논문지 Vol.18 No.1

본 연구는 블록체인 기반 서비스의 확산을 위한 방안 연구로서 블록체인 기술에 대한 한계요인과 이를 개선하는 방안에 대해 전문가의 의견을 수렴하는 델파이 기법으로 연구하였다. 한계요인과 개선방안을 기술, 서비스, 법 제도 측면으로 분류하였다. 첫째, 기술측면에서 기술 관련 표준화 부재, 통합성 미비, 확장성 미비, 취소, 정정 정책 부재, 거래 검증비용 과다발생, 보안미비를 한계요인으로 제시했다. 이를 개선하기 위해 각 관련 기관이 협력하여 표준화 확보, 시스템의 통합성 확보 및 확장성 확보, 각 적용되는 데이터에 대한 취소, 정정 정책 수립, 검증비용 효율화와 보안 대비 방안으로 모색하여야 한다. 둘째, 서비스 측면에서 한계요인은 초기단계로 활용성 미비, 보안위협 대응 미비, 전문 인력 부족을 제시하였다. 이에 대한 개선방안으로 다양한 서비스에 적용할 수 있는 지속적인 활용방안에 대한 연구가 이루어져야 하며 서비스에 대한 철저한 보안대응 방안을 준비하고 전문 인력 양성을 통해 시장에서 필요로 하는 인재를 확보할 수 있어야 한다. 셋째, 법제도 측면은 법적대응 미비, 규제의 불확실성 및 관련 규정미비의 한계점이 있다. 서비스 활성화를 위한 가장 중요한 영역인 법 제도는 정부의 관련 부처에서 법적대응 안 마련, 규제의 명확성 및 대응 방안 수립이 필수적으로 동반되어야 한다. 본 연구는 블록체인 기술 관련 연구에 도움이 될 것으로 기대된다. This study investigates the limitations of blockchain technology and the ways to improve it by using Delphi technique. Limit factors and improvement measures are classified into technology, service, and legal system. First, from a technical point of view, lack of standardization of the technology, insufficiency of integration, lack of scalability, unclear cancellation or correction policy, excessive cost of transaction verification, insufficient personal information protection and not enough to respond to hacking defense were the limiting factors. In order to improve these, the followings; ensuring standardization, securing integration and scalability, establishing cancellation of each applicable data, establishment of correction policy, efficiency of verification cost, the protection of personal information and countermeasure against hacking are provided. The related technology development and countermeasures must be established to effectively introduce the blockchain technology to the market. Second, in the early stage of blockchain service, it showed lack of utilization of the blockchain, security threat, shortage of skilled workers, and lack of legal liability. As a solution to these problems, it is necessary to suggest various applications, against security threat, training professional manpower, and securing legal responsibility. It should also provide a foundation for providing institutionally stable services. Third, from as legal system point of view, inadequate legal compliance, lack of relevant regulation, and uncertainty in the regulation were the limiting factors. Therefore establishing a legal system, which is the most important area for activating the service, should be accompanied by the provision of legal countermeasures, clearness of regulations and measures to be taken by relevant governmental authorities. This study will contribute as a reference for a research, related to the blockchain.

스키어와 스노보더의 손상에 관한 연구

장우성(Woosung Chang),김순덕(Soonduck Kim),이제숙(Jesuk Lee) 한국역학회 2007 Epidemiology and Health Vol.29 No.1

  Purpose: To calculate the injury rate of skiers and snowboarders, to document the risk factors affecting injury, and to investigate the characteristics of the cause, kind and region of injury.   Methods: A questionnaire survey was conducted at 4 major Kangwon - province ski resorts during the 2004 - 2005 winter season with 373 skiers and snowboarders. The statistical SPSS was used to analyze data that included chi-square, fisher"s exact test, and multiple logistic regression. The mean mark of the safety rule by separating the skiers and snowboarders was compared between the two groups.   Results: The injury and wound experience rates of the snowboarders (46.5%, 34.2% respectively) were higher than those of the skiers (33.2%, 25.5% respectively). The proportion of injury and wound for the skiers was 76.7% and for the snowboarders was 73.6%. The occurrence of injuries was higher among those with ski career of 5 to 9 years (p=0.012), those with a higher level of ski skills (p=0.002), those who used the higher slope (p=0.002) and those who skied 15 to 19 times(p=0.004). Based on the results of logistic regression analysis, the significant risk factors for skiers were career, level, slope and visit number. Leg injuries accounted for 40.9% of total injuries among skiers, which was followed by arm injuries (35.9%) and head injuries (15.4%)(p=0.033).   Conclusions: The study therefore emphasizes safety training for individual skiers and overall conditions of ski resorts.

일개 대학병원에서 손상의 특성에 관한 연구

신연수(Younsu Shin),김순덕(Soonduck Kim),이제숙(Jesuk Lee) 한국역학회 2007 Epidemiology and Health Vol.29 No.2

  Purpose: This study was performed to provide the basic data in the establishment of preventive countermeasures for injury by analyzing the characteristics of injury, and risk factors of injury.   Methods: From 2,059 injury patients among 19,947 patients admitted between January and December, 2004 at a university hospital located in Gyeonggi-do, 500 injury patients were sampled randomly by systematic sampling. A total of 500 questionnaires was collected and used for this study. The statistical SPSS was used to analyze data that included chi-square, fisher"s exact test.   Results: Injury patients among total admission patients was 10.3%. In both general characteristics of injury and non-injury patients, gender, age, length of stay was significant. As the cause of injury were compared with those of injury external causes, type, place, site, and time of injury were significant. As the cause of injury were compared with the characteristics of related-injury, surgery, multiple injuries, mental history, consciousness at the time emergency room visit, length stays were significant.   Conclusion: With regard to general characteristics, injury external causes, injury-related causes, and factors such as sex, age, occupation, and educational background were related to each other. Injury does not occur by accident or unexpectedly. Therefore, if preventive attention is focused on individuals with high risk factors of injury, the incidence rate will be diminished.

우리나라 자살률의 추세변동에 관한 연구

박종순(Jongsoon Park),김순덕(Soonduck Kim),지선미(Seonmi Ji),이제숙(Jesuk Lee) 한국역학회 2003 Epidemiology and Health Vol.25 No.2

Purpose :This study was conducted to analysis the trends and states of suicide mortality in Korea from 1983 to 2001. Methods: This study was based on data published in 1983-2001 from the annual report of the cause of death statistics of National Statistical Office. Results: First, both of annual suicide rate and adjusted suicide rate rapidly went up in 1996 and hit the highest in 1998. Second, since 1983 only when the suicide rate was the highest in the ages 20-24 rather than other age groups, the suicides have been continuously shown to be the highest in the old age group. Third, the seasonal percentages of suicides were generally high in spring and summer, the seasons when the percentage of sunshine is relatively high, in both results for men and women. Fourth, men have most frequently committed suicide through hanging while their suicide through falling from a high site have least frequently occurred but currently tends to gradually increase. Meanwhile, women have most frequently done suicide generally by using insecticide. Conclusion: In Korea, the suicide rate and suicide percentage of the old people have been yearly increasing, and their suicide rate is also shown to the highest rather than those of other age groups. Therefore, it is necessary to prevent the suicide of the old people through a systematic analysis. Moreover, it is necessary to verify the risk factors and defensive factors for the suicide impulse and suicide attempt. On the basis of this, the construction of a nationwide social safety network for the national mental health is very important to find and treat the problems of the mental health to lead the people to suicide.

국내 의학 학술지의 대장암 관련 연구 분석 - 1967년부터 2004년까지

백은경(Eunkyoung Paik),김순덕(Soonduck Kim),이제숙(Jesuk Lee) 한국역학회 2007 Epidemiology and Health Vol.29 No.2

  Purpose: The study analyzed and categorized the colorectal cancers related medical journals published in Korea by the name of the journal, research materials, study method, statistical method and by content of study for the quality improvement of colorectal cancers related studies.   Methods: The authors reviewed a total of 567 colorectal cancer-related studies published in the Korean medical journals during the period 1967 and 2004 and kept in the National Assembly Library. The distribution of research materials, study method, statistical method and content of these studies were analyzed by the 5 year publication interval.   Results: By study period, the number of published studies steeply increase during the period between 2000 and 2004. As the research materials, hospital patients(64.6%) and In-vitro(16.6%) were the most prevalently used research materials, but health adults were the lowest research materials by only taking up 0.4% In study methods, patient follow up studies(28.7%) and human in vitro experimental(27.9%) were prevalent, and human in vitro experimental were relatively the most popular performed studies during the years of 1990-1994. As the statistical method, life table and survival analysis(27.0%) were the mostly performed methods, and the use of statistical method was applied in nearly all studies. The contents of the studies mainly focused on the patient prognostic estimations(27.6%) of therapeutic safety & efficacy(25.6%), but only the 4.1% of risk factors studies. Among the 109 studies which analyzed the survival term 78.9% of the studies mainly used the 5 year term in the analysis of survival rates.   Conclusion: The results of the study could be utilized as the basic data for the quality improvement of further colorectal cancers related studies.

공복혈당장애와 제 2형 당뇨병의 위험요인 - 데이터마이닝을 이용하여

류종선(Jongseon Ryu),김순덕(Soonduck Kim),박종순(Jongsoon Park),이제숙(Jesuk Lee) 한국역학회 2006 Epidemiology and Health Vol.28 No.2

  Purpose: This study aimed to contribute to overall public health by examining the prevalence rates of impaired fasting blood glucose and type 2 diabetes mellitus and developing a model to predict high risk factors for impaired fasting blood glucose and type 2 diabetes mellitus.   Methods: The 1998 Public Health Nutrition Survey data was used for this study. Subjects were 7,702 adult at the age of 20 or over. The frequency analysis, chisquared test was performed. A decision tree was utilized to define a model designed to predict high risk factors for impaired fasting glucose and type 2 diabetes mellitus.   Results: The prevalence rates of impaired fasting blood glucose was 10.8% and prevalence rates of type 2 diabetes mellitus was 9.4%. The decision tree analysis exhibited that age was strong factors for impaired fasting blood glucose. HDL cholesterol and kind of economic activities were high risk factors for impaired fasting blood glucose and type 2 diabetes mellitus on those in 20s. BMI, total cholesterol level, marriage status, sex for impaired fasting blood glucose and type 2 diabetes mellitus on those in 30s. The total cholesterol level, drinking and waist size were identified as risk factors on those in 40s. BMI, education level and hypertension seemed to have an impact on those in 50s. The waist size, sex and income had an impact on those in 60s.   Conclusions: This study underscores the need for the public health infrastructure to improve various health promotion programs for those who have risk factors for impaired fasting blood glucose and type 2 diabetes mellius. The implementation of effective nutrition, workout and anti-drinking programs will boost public health.