한국인 관상동맥의 변화양상에 대한 형태학적 연구

이상용,권태정,정낙은,서중석,이한영,이원태 大韓法醫學會 2002 대한법의학회지 Vol.26 No.1

K 대학병원 서어비스에 대한 소비자 만족도

이태섭,박종원,이무식,윤능기,이충원,서석권 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

Authors administered a questionnaire to 300 clients visited to the K University Hospital during August in 1992 to investigate the degree and related factors of consumer's satisfaction with the hospital services. Clients consisted of 82 in-patients and 158 out-patients, 52.4 percent of them was male. Four dimensions of satisfaction were assessed which were medical management, administration, environment and attitude. In-patients reported as dissatisfied with the waiting time during receipt, investigative medical procedures and pharmacy (64.7%), lack of conveniency facilities for patients and their guardians(48.8%) and provision of conveniency facilities in the ward(42.4%), unsanitary state of out- and in-hospital(41.5%). Out-patients reported dissatisfaction with the course of medical management and the time needed(70.3%), the waiting time during receipt, investigative medical procedures and pharmacy(68.3%), lack of conveniency facilities for patients and guardians(42.4%). But both in-patients and out-patients were satisfied with medical equipments, doctor's diagnosis reliability and medical effects, technician's attitude more than 50%. Canonical correlation analysis was done to find related sociodemographic factors to the four dimensions of satisfaction. Of the four canonical functions, the first was only statistically significant in in-patients. Its eigen value was 0.56 and its canonical correlation coefficient was 0.60. Satisfaction with environment and medical management was selected as important concept in dependent variables. Standardized canonical function of environment and medical management were 0.76 and 0.35 respectively. It was related with woman with high educational attainment and increasing number of hospital visits. In out-patients, the first, second and third function were statistically significant and their eigen values were 0.18, 0.4, 0.08 respectively which were small compared to those of in-patients. Their canonical correlation coefficient were 0.40, 0.35, 0.28 respectively. Low degree of environment but high degree of medical management satisfaction was noted in the first function which was related with old age, woman and professional occupation. Low degree of satisfaction with administration(second function) was related with city resident, non-professional occupation and young age. High degree of medical management but low degree of administration satisfaction(third function) was related with surgical visitor, man and non-professional occupation. The direction of hospital managerial strategies could be planned and general characteristics of dissatisfactory clients might be suggested with these results.

The Longitudinal Trend of Cardiac Surgery in Korea from 2003 to 2013

Lee, Kyeong Soo,Kim, Chang Suk,Park, Jong Heon,Hwang, Tae Yoon,Kim, Sang Won,Sim, Sung Bo,Lee, Kun Sei The Korean Society for Thoracic and Cardiovascular 2016 The Korean Journal of Thoracic and Cardiovascular Vol.49 No.sup

Background: The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery. Methods: Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013. Results: There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high. Conclusion: Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.

기관지 방선균증의 임상 1례

이은영,장태원,정만홍,옥철호,이규원,손창배,이지숙,신은경,서정아,백종현,김영옥 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Actinomycosis is a chronic suppurative infection, whitch infiltrates mucosa-associated tissues. Thoracic, pelvic and cervicofacial infections of actinomyces are not uncommon, but endobronchial actinomycosis is rarely reported. We report a case of a 29 year old man who presented with a recurrent pneumonia and chronic cough. Fiberoptic bronchoscopy revealed occlusion of the right. lower medio-basal segment bronchus with exophytic endobronchial mass. The diagnosis was confirmed histologically by demonstration of sulfur granules in the bronchoscopic biopsy of the mass. Intravenous administration of amoxacillin and clindamycin followed by oral amoxacillin and clindamycin therapy resulted in complete recovery.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

주요우울증이 근로자의 생산성에 미치는 영향 : WHO-HPQ(Health and Work Performance Questionnaire)를 이용한 예비연구

김원,황태연,함병주,이준석,최병휘,김세주,서용진,강은호,우종민 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Major depressive disorder (MDD) causes patients' distress and makes socioeconomic burden, both directly and indirectly. We used the concept of lost productive time (LPT) to estimate the indirect costs and calculated both absenteeism and presenteeism among workers with MDD. Mcthods : Depression group was recruited from workers visiting psychiatric outpatient clinic who had MDD without major physical or mental disorders (N= 106). Age and sex matched healthy control group was also recruited through advertisement (M=100). All participants completed a interview using WHO Health and Work Performance Questionnaire (HPQ), Job Stress Measurement Scale for Korean Employees, and Hamilton Rating Scale for Depression. Statistical analysis was performed with independent t-test or χ² test as characteristics of values (p=0.05). Results : The number of absence (0.94-day/month vs. 0.10-day/month, P=0.015) andthe numberofearly leaving (2.56-day/month vs. 0.24-day/month, P<0.001) were significantly higher in the depression group. Depression group evaluated their Perfor-mance level much lower than controls with significant value (5.16 vs. 7.62, P<0.001). In addition, depression group estimated their performance level during the last 4 weeks lower compared to the level of past 1-year (5.16 vs 6.63, P<0.001). The estimated costs of absenteeism in depression group were higher than controls by 2,520,000 Korean Won per year, and those of presenteeism were also higher by 4,880,000 Korean Won per year. The total costs of LPT in depression group were higher than controls by 7,400,000 Korean Won, which corresponds to 26% ofmean annual salary. In addition, the level of occupational stress, such as high demand and interpersonal conflict, was higher in the depression group. Conclusion : Major depressive disorder costs substantial productivity loss to workers and their company. Presenteeism imposes more time cost than absenteeism. Effectiveness trials are needed to devise cost-effective programs for the early detection and treatment of depression at the workplace.

Growth Inhibition of Colon Cancer through Inactivation of STAT3 Pathway by IL-10 and IL-1ra Released from Murine Macrophage

Jin Tae Hong, Dohee Won1, Mi Hee Park, Sun Mi Kown, Miran Jo, Sang-Yoon Nam, Beom Jun Lee, Young Won Yun, Ki-Wan Oh, Sang Bae Han 충북대학교 동물의학연구소 2011 Journal of Biomedical and Translational Research Vol.12 No.4

The objective of this study was to determine the effect of macrophages on growth of human colon cancer cells. The results showed that co-culture of colon cancer cells with macrophages inhibited the growth of colon cancer cells (HCT116 and SW620) depending on the number of macrophages, RAW 264.7 cells, and activated THP-1 cells accompanied by down regulation of pSTAT3 in cancer cells. We also found that expression and release of cancer cell growth inhibitory cytokines, IL-1 receptor antagonist (IL-1ra) and IL-10, was increased in macrophages. Blocking of the STAT3 pathway with specific inhibitor and siRNA of STAT3 abolished the growth of colon cancer cells and expression of IL-1ra and IL-10. In addition, neutralization of IL-1ra and IL-10 with antibodies resulted in reversal of macrophage-induced inhibition of cancer cell growth. These data showed that IL-1ra and IL-10 released from macrophages inhibit growth of colon cancer cells through inhibition of the STAT3 pathway

위암발증 원인에 대한 생활습관 및 영양섭취에 있어서 농촌지역 주민 조사 : 강원도 화천군 주민의 Helicobacter pylori 감염률을 중심으로 Infection of Helicobacter pylori in Whachon Area, Kang-Won Do

권태봉,이정선,우영국,이명헌,정철원,주진순 한국식품영양학회 1999 韓國食品營養學會誌 Vol.12 No.1

위암발증의 원인을 밝히기 위하여 설문조사를 통하여 강원도 화천군에 거주하는 주민들의 일반사항, 생활습관 및 영양섭취실태와, ELISA법으로 Helicobacter pylori 감염률을 조사하였다. 조사 대상자는 40∼69세까지의 지역주민 169명으로 남자 79명, 여자 90명이었으며 그 결과는 다음과 같다. 조사 대상자의 학력은 65.7%가 초등학교 이하였으며, 월수입은 60%가 50만원 이하였다. 대상자의 62.7%가 농업에 종사하였고 자녀수는 64.3%가 3∼5명이었으며 대상자의 34.5%가 흡연을 하고 있었고 68.4%가 음주를 한다고 대답하였다. 대상자의 전체 평균신장은 156.7㎝로 여자는 150.1㎝, 남자는 164.4㎝ 이었다. 평균체중은 61.1㎏으로 여자의 체중은 57㎏, 남자는 65.7㎏이었으며 BMI는 전체 평균 25.5%로 여자는 24.8%, 남자는 20.1%이었다. Helicobacter pylori의 감염률은 전체 조사대상자의 66.3%이었으며, 여자의 67.7%, 남자의 64.6%가 감염되었고 연령별로는 40대의 70%, 50대의 62.2%, 60대의 69.4%가 각각 감염된 것으로 나타났다. 일상 생활 요인에 따른 Helicobacter pylori의 감염률은 흡연의 정도가 심하고 학력이 낮으며 월수입이 낮을수록 높은 경향을 보였다. Helicobacter pylori의 감염여부에 따라 감염자와 비감염자의 영양섭취량을 조사해 본 결과 비감염자는 감염자와 비교해서 에너지, 총단백질, 동물성 단백질, 칼슘, 비타민 C 섭취량이 높은 경향을 보였으며 철분과 niacin의 섭취량은 낮은 경향을 보였다. To examine the relationship between the casual infection of gastric cancer and lifestyle and nutritional status, we surveyed 169 persons, 90 females and 79 males, aged 40∼69 years from June 7 to June 14, 1997, in Whachon area, Kang-Won Do, Korea. For this purpose, we investigated Helicobacter pylori infection and identified the effect of sex, age, smoking, alcohol consumption, economic status, occupation, life-style and food intake on Helicobacter pylori infection. Helicobacter pylori status was evaluated using an enzyme-linked immunosorbant assay(ELISA) for anti-Helicobacter pylori immunoglobulin G(IgG). Helicobacter pylori infection was present in 66.3% of total subjects, namely, 67.7% of female and 64.6% of male and its prevalence increased with smoking, low education level and low monthly income. Energy, total protein, calcium and vitamin C intakes in the negative Helicobacter pylori infection group were higher than those in positive Helicobacter pylori infection group. However iron and niacin intakes were lower in the Helicobacter pylori negative group than in the positive group.

한국인 관상동맥의 변화양상에 대한 형태학적 연구

권태정,이상용,이한영,고영창,권기석,조재홍,김태공,김유훈,조갑래,서중석,이원태 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-

포괄수가지불제도 적용에 따른 산부인과 진료수입의 변화

황태연,유병철,정귀언,정수진,김성준,배기택,손혜숙,이종태,전진호,엄상화 인제대학교 2001 仁濟醫學 Vol.22 No.1

Objectives: Under the fee-for-service system, Korean hospitals have been suffering from the worsening profitability caused by law medical care fees. To overcome the difficulties, they have maximized the quantity of medical services and made relatively large investment in developing new medical services using high-priced medical equipment, medicines and medical supplies which were not covered by medical insurance system rather than reduced running costs. Materials and Methods: This study was made to analyze and forecast the revenue change of the department of Obstetrics and gynecology of an university hospital in Seoul, expecting the implementation of DRG system in 2000. Results: The results were as follows : 1.During the first two days of hospitalization. 41% of total medical service fee was occurred, which was thought that most of the check-ups and operations were made during this period. After two days of hospitalization, the new occurrence of medical service fee tended to reduce. 2.Out of total medical service fee, 67% of admission fee was occurred after 5 days of hospitalization. This was because medical service fees in obstetrics and gynecology department occurred during the first 5 days of hospitalization. 3.Out of fees for operation, treatment, medical supplies and blood transfusion. 71% was occurred during the first two days. 4. In case of fees for examination, 50% was occurred during the first two days. 5.A total of 53% of fees for medication and injection was occurred during the first 5 days. Conclusions: By the implementation of the DRG system, the income is forecast to increase by 800 won to 310,000 won by the disease group of obstetrics and gynecology department. To increase hospital income with the implementation of DRG system, the results of this study suggest that examinations should be done at out-patient departments before the hospitalization of patient, the discharge of patient should be noticed in advance to reduce the period of hospitalization, and admission appointment system should be implemented for the immediate operation and delivery.