소아청소년 복합만성질환자 수 및 진료비의 변화: 2011-2021년 건강보험청구자료 분석

오정윤,조수진,정진선,조진숙,박춘선 건강보험심사평가원 2023 HIRA RESEARCH Vol.3 No.2

Background: The number of children and adolescents has decreased by more than 3 million over the past 10 years. We analyzed changes in the number of children and adolescents with complex chronic conditions (CCCs) and their medical expenditures between 2011 and 2021. Methods: We used National Health Insurance claims data of patients under the age of 20 from 2011 to 2021. CCCs were classified as pediatric CCCs by Feudtner et al. Patients who repeatedly utilize medical services due to CCCs were defined as patients who sought medical care twice or more within the past 3 years. Their sex, age, CCC categories, and the number of CCC categories were presented using descriptive analyses. Results: The number of children and adolescents with CCCs increased from 345,320 (3.04%) in 2011 to 451,238 (5.33%) in 2021. Patients who repeatedly utilized medical services due to CCCs increased by 71,889 during the same period. The proportion of patients with two or more CCC categories increased from 35.80% in 2011 to 43.67% in 2021. In 2021, patients with other congenital or genetic defect were most common. Medical expenditures associated with CCCs increased from 475,654 million won (12.34%) in 2011 to 768,467 million won (19.11%) in 2021. Conclusion: The number of patients with CCCs and their medical expenditures increased in Korea between 2011 and 2021. The results indicate that consistent national efforts are required to maintain the specialized pediatric care. Further studies are needed to identify pediatric patients who require specialized medical services through various methods.

Methylation Status and Expression of E-cadherin in Oral Squamous Cell Carcinomas Compared to Benign Oral Epithelial Lesions

Son, Hyun-Jin,Chu, Jung-Youb,Cho, Eui-Sic,Lee, Dong-Geun,Min, Myung-Gee,Lee, Suk-Keun,Cho, Nam-Pyo The Korean Academy of Oral Biology 2006 International Journal of Oral Biology Vol.31 No.2

Expression of invasion/metastasis suppressor, E-cadherin, is reduced in many types of human carcinomas. Although somatic and germline utations in the CDH1, which encodes the human E-cadherin, have frequently been reported in cases with diffuse gastric and lobular breast ancers, irreversible genetic inactivations are rare in other human carcinomas. Recently, it has been well documented that some genes in human cancers may be inactivated by altered CpG methylation. Herein, we determined the expression and methylation status of E-cadherin in oral squamous cell carcinoma (SCC) by immunohistochemistry and methylation-specific PCR. The expression of E-cadherin was significantly higher in the well-differentiated oral SCCs than the moderately or poorly differentiated ones. None of eight tested benign pithelial hyperplasias showed aberrant methylation, whereas five of 12 oral squamous cell carcinomas showed aberrant methylation. When we compared E-cadherin expression with methylation status, oral SCCs with normal methylation showed a higher expression of E-cadherin than those with methylation. These findings suggest that aberrant CpG methylation of CDH1 promoter region is closely associated with transcriptional inactivation and might be involved in tumor progression of the oral mucosa.

어린이 공공전문진료센터의 진료 역량: 상급종합병원과의 비교를 중심으로

오정윤,조수진,정진선,조진숙,박춘선 건강보험심사평가원 2022 HIRA RESEARCH Vol.2 No.2

지방 중소도시 근대건축에 관한 연구 : 충남 공주지역 근대건축의 형성 및 변천과정을 중심으로 Focused on the Formation and the Transition Process of Modern Architecture in Kong-ju

조흥석,오진안,김정동 牧園大學校 建築·都市硏究센터 1999 建築·都市環境硏究 Vol.7 No.-

The local city the fundamental research for the public recognition and architecture-cultural characteristic of modern architecture is very weak. When the characteristic of Korean modern architecture and mutual relation of systematic history is important, in a various side the research for other area is very urgent. From this point of view, the purpose of this research is by considering a positive date for formation and the transition process of existing modern architecture in a Kong-ju from the opening port to classify systematically existing actual condition of modern architecture in Kong-ju. To analyze each functional characteristic of modern architecture in Kong-ju in Korea modern architectural history and finally to establish historical meaning and to endow existing modern architecture with preservable value of Kong-ju architecture.

Thermocouple을 이용한 Buchanan Plugger 표면의 온도상승 분석

조진숙,황윤찬,김선호,황인남,최보영,정영진,정우남,오원만 전남대학교 치의학연구소 2003 구강과학 Vol.15 No.4

This study was performed to confirm the actual temperature rise on the surface of Buchanan plugger by evaluating the temperature rise on the surface of it, the peak temperature of pluggers of various size using thermocouple. The heat carrier system 'System B Heatsource' (Model 1005, Analytic Technologies, USA) and the Buchanan pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200 which Dr. Buchanan's "Continuous wave of condensation" technique recommended on digital display and the power level on it was set to 10. The touch mode was used. Five thermocouples were placed in direct contact with the surface of each size of Buchanan's pluggers at 1 ㎜ increments from the tip to the 4 ㎜ length of shank. Each thermocouple was secured with cyanoacrylate adhesive and orthodontic resin block. The two wire leads of each thermocouple were connected to the appropriate channels of Data Logger. This was configured to simultaneously record input from the five thermocouples. The heat control spring was touched for 1, 2, 3, 4 and 5 seconds, and the temperature rise on the surface of the pluggers were measured at 1 sec intervals for more than 5 seconds with an accuracy of 0.01. Ten trials was determined for each plugger. The average of temperature rise and standard deviation was calculated for each size of plugger. The data were statistically analyzed by one-way ANOVA to determine their significance. The results as follows. 1. The position at which the temperature peaked was approximately at 1∼2㎜ far from the tip of Buchanan plugger (p<0.01). 2. The peak temperature was 215.25±2.28℃ in F plugger, 185.94±2.19℃ in FM plugger, 169.51±9.12℃ in M plugger, and 160.79±1.27℃ in ML plugger and the peak temperature was highest in F type and followed by, in descending order, FM type, M type. ML type showed the lowest peak temperature (p<0.01). This results suggest that the actual temperature on the surface of the pluggers does not correlate well with the temperature set on digital display. Heat concentrates around the tip. The larger plugger reveals lower temperature rise relatively.

한국형 출혈열 환자에서 분리한 한타 바이러스의 핵산 분석

조종태,윤성철,안규리,한진석,김성권,이정상 단국대학교 1998 論文集 Vol.33 No.-

Hemorrhagic fever with renal syndrome(HFRS)is an infectious disease showing diverse clinical manifestations according to different serotypes of hantavirus. On the assumption that the antigenicity, nucleotide and amino acid sequence diversity of hantaviruses, as well as immune response diversity of individual KHF patients may be present, this study was performed to analyse the genetic diversity of hantaviruses isolated from patients with KHF. In the 13 samples hantaviral RNAs were extracted, cDNAs of partial M segment were amplified by RT-PCR using genus-reactive primer, amplified cNNAs were analyzed by direct sequencing method, and then the nucleotide and deduced amino acid sequences were compared with previously known sequences of four serotypes of hantavirus isolated from rodent hosts and each other by the computer assistance. The results were as follows. The nucleotide and amino acid sequences of 11 samples among the 13 human isolates showed 90.3∼95.5%, 86.7∼97.9% the other 1 samples 82.7%, 71.9% homology respectively to those of Hantaan virus 76-118 strain, and another 1 sample showed 83.7%, 75.3% homology respectively to those of Seoul virus B1 strain isolated from rodent host. The nucleotide and amino acid sequences of 7 among 12 Hantaan samples showed differences within 5%, 10% respectively each other and high genetic similarities, but those of the oehr 5 among 12 Hantaan samples showed low genetic similarities each other. In conclusion, hantaviruese isolated from KHF patients showed genetic diversity compared with previously known hantaviruses isolated from rodent hosts.

Ⅱ급 부정교합자에서 액티베이터 사용에 따른 atlas의 위치 변화에 관한 연구

조문기,이진우,차경석,정동화 대한치과교정학회 2007 대한치과교정학회지 Vol.37 No.1

본 연구는 Ⅱ급 부정교합자에서 액티베이터 사용 후, 하악골의 변화에 따른 atlas의 위치 및 형태 변화를 조사하고, 그에 따른 치료 효과를 예측해 보고자 시행하였다. 실험군으로 Ⅱ급 부정교합자로써 액티베이터 치료를 시행한 경우 1군(총30명, 남자 15, 여자 15명), 대조군들로 Ⅱ급 부정교합자로 액티베이터 치료를 받지 않고, 교정치료를 받은 2군(총 22명, 남자 12, 여자 10)과 Ⅰ급 부정교합자로 치료를 받은 환자 3군(총 22명, 남자 12, 여자 10)으로 총 세 개의 군으로 나누었다. 치료 전(T1), 액티베이터 사용 중지 및 치료 중간시기(T2), 치료 종료(T3)시의 측모두부방사선사진을 통해서 골격 형태 계측 및 atlas 형태 계측을 시행하였다. Ⅱ급 액티베이터 사용 결과 액티베이터를 사용하지 않은 Ⅱ급 부정교합자 군에 비해 치료 종료 시 다음과 같은 계측치 들에서 골격적인 효과가 나타났다: ramal height, body length와 effective body length는 증가하였고, ANB는 감소하였다. Overjet은 두 군 사이에서 액티베이터 사용 후 유의한 감소가 일어났으나, 치료 종료 시에는 유의한 변화가 없었다. 세 군 모두에서 FH에 대한 atlas의 시계방향 회전이 나타났으나, 실험군 1군에서 대조군 2, 3군에 비해 유의하게 atlas가 FH에 대해 시계방향 회전되는 결과가 나타났다. 1군이 3군에 비해서 atlas의 유의한 후방이동을 보인 것을 제외하고는 세 군 사이의 atlas의 전, 후방적 위치나, 형태의 크기 변화에 있어 유의한 차이점은 없었다. 위의 결과들을 고려해 볼 때 atlas의 장축의 시계방향 회전은 액티베이터의 사용 효과로 생각되며, 이는 차후 Ⅱ급 부정교합자에서 액티베이터 치료 효과를 판단하는 또 하나의 지표가 될 수 있다고 생각한다. Objective: Previous studies have reported that morphological features of the first cervical vertebra(atlas) have been associated with mandibular growth direction. The purpose of this study was to show the possible positional and morphological changes of the Atlas from activator treatment in Class Ⅱ malocclusion patients. Methods: Lateral cephalometric radiograph tracings were made at initial, middle and final stages of treatment. Angular and linear measurements of skeletal and morphological features were measured on the anatomical landmarks and reference planes. Results: The skeletal effects of activator treatment on Class Ⅱ malocclusion patients were evident on ramal height, body length, effective body length, ANB, and overjet. Clockwise rotation of the long axis of the Atlas was found in Group 1, but there was no inclination change of the Atlas in groups 2 and 3. There was no significant correlation between anterior and posterior positions of the atlas or morphological change in all groups. - except for posterior movements of the Atlas found in group 1. Conclusion: Clockwise rotation of the atlas axis resulted from activator treatment in CI Ⅱ malocclusion patients. Change in atlas axis can be thought of as an indicator for success of activator treatment.

强靭鑄鐵의 熔接性에 關한 硏究

曺東震,韓俊澤,劉憲一,朴龍鎭,金錫胤,慶在浩 弘益大學校 1974 弘大論叢 Vol.6 No.-

The matrix of ductile cast iron are welded by pre-heating it at 300℃ in the room temperature. Through the mechanical, non-desbructive testing and analysis of the composition. the possibility if arc welding of ductile cast iron are studied as follows; 1. L electrode is the best among them in weldability, impact value and machinability. The next is LB electrode followed by S electrode. C electrode is last. However, the tensile strength showed in the following order: LB, S, L, C. 2. LB, S, L, C, all are available for the welding of cast iron. 3. The above experiment showed that L and LB are good in general. In addition LB is low in price, we therefore prospect that it will be widely used as the electrode for cast iron.

전기화상후 Prostaglandin F2a와 Thromboxane B2의 증가에 대한 Flurbiprofen, Prednisolone 및 Gabexate mesilate의 억제효과

조병채,김인규,변진석,백봉수 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.1

This study was conducted to clarify the inhibitory effect of flurbiprofen, prednisolone, and gabexate mesilate on the synthesis of prostaglandin F2a and thromboxane B2 in the tissue of electrical burn. one hundred sixty Sprague-Dawley rats, 250gm of body weight in average, were divided into 4 groups of control, flurbiprofen, prednisolone and gabexate mesilate administred group. Fourty rats of the each group were subdivided into 1st, 2nd, 4th, 7th postburn day with 10 rats in each subgroup. Ten rats were used for normal values of prostaglandin F2a and thromboxane B2. Flurbiprodfen 30mg/kg was given per mouth, and prednisolone acetate 5mg/kg and gabaxate mesilate 50mg/kg were administred intramuscularly 5 minutes after burn injury and then once a day. All but bone tissue of within 2cm area of the current entry were harvested and ground into homogenate. The levels of prostaglandin F2a and thromoboxane B2 were measured by Radioimmunoassay. The results were as followings: In normal rat tissue, the level of prostagland F2a and thromboxane B2 were 15.8±1.8 and 17.6±2.8ng/mg protein in each. In the control group the levels of both prostaglandin F2a and thromboxane B2 increased abruptly to 5 times and 7 thimes in the first day and maintained the same level in the second day. After then they rapidly decreased and returned to a near normal level in the fourth day. The increase of thromboxane B2 was more remarkable than that of prostaglandin F2a. In the flurbiprofen group, the level of thromboxane B2 was not inerease but kept at a normal level. The average level of prostaglandin F2a in the post-burn first and second day was 59.5% lower than of the control group. The average level on the post-burn first and second day was 61% lower in thromboxane B2 and 33% lower in prostaglandin F2a in the prednisolone group, and 68% lower in throboxane B2 and 48% lower in prostaglandin F2a in the gabexate mesilate group, compared to the control group. These findings suggest that electrically injured tissue is vigrously progressive due to rapid increase of thromboxane B2 and prostaglandin F2a, as inflammatory mediators, in the post-burn first and second day, is nonprogressive after the post-burn fourth day. The flurbiprodfen was the most effective of the three drugs(flurbiprofen, gabexate mesilate, prednisolone in order of effectiveness) to suppress the synthesis of thromboxane B2 prostaglandin F2a of the electrieally injured tissue.

퍼지 이론을 이용한 해저면 분류 기법

조진석,윤관섭,박순식,나정열,석등우 한양대학교 이학기술연구소 2003 이학기술연구지 Vol.6 No.-

음파를 이용한 해저면 분류를 위하여 2003년 5월 19-25일까지 남해해역에서 음향 실험을 실시하였다. 실험 해역은 해저 구성물질이 각기 다른 6개의정점을 선정하였으며 5개의 주파수(30,50,80,100,12 kHz)를 이용하여 해저면 반사 신호를 측정하였다. 또한 피스톤 코어를 이용하여 해저 퇴적물의 입도분석을 실시하였다. 해저면의 분류를 위해서는 펴지 이론(fuzzy logic)을 사용하였으먀, 이때의 입력 소속함수(input membership function)는 주파수 종속성을 갖는 해저면 반사손실 모텔(HYBRL, Hanyang University Bottom Reflection Loss)이 이용되었으며 출력 소속함수(out membership function)는 해저면의 평균입도 값으로 출력되도록 구성하였다. 퍼지이론을 통해 역산된 평균입도(mean grain size)와 코어 분석 자료를 비교하여 퍼지이론을 이용한 해저면 분류 방법의 가능성을 확인하였다. Acoustic experiments are performed for seafloor classificaton from 19 May to 25 May 2003. The six differnet sites of bottom composition are settled and the bottom reflecton losses with frequencies(30, 50, 80,100,120 kHZ) are measured. The fuzzy logic is used to classify the seabed. In the fuzzy olgic, HYBRL(HanYang Univ. Bottom Refleciton Loss) of frequency dependence is used as a input Membership functions and the output membership functions are composed of the values of the mean grain size of the bottom. The possibility of the seafloor classsification is verified comparing the inversed mean grain size using fuzzy logic with the results of the coring.