우리나라 보건지표의 지역 격차: 지경학적 고찰과 대응방안

김춘배 ( Chun-bae Kim ),정무권 ( Moo-kwon Chung ),공인덕 ( In Deok Kong ) 한국보건행정학회 2018 보건행정학회지 Vol.28 No.3

By the end of 2017, in a world of 7.6 billion people, there were inequalities in healthcare indices both within and between nations, and this gap continues to increase. Therefore, this study aims to understand the current status of regional inequalities in healthcare indices and to find an action plan to tackle regional health inequality through a geo-economic review in Korea. Since 2008, there was great inequality in life expectancy and healthy life expectancy by region in not only metropolitan cities but also districts in Korea. While the community health statistics from 2008-2017 show a continuous increase of inequality during the last 10 years in most healthcare indices related to noncommunicable diseases (except for some, like smoking), the inequality has doubled in 254 districts. Furthermore, health inequality intensified as the gap between urban (metropolitan cities) and rural regions (counties) for rates of obesity (self-reported), sufficient walking practices, and healthy lifestyle practices increased from twofold to fivefold. However, regionalism and uneven development are natural consequences of the spatial perspective caused by state-lead developmentalism as Korea has fixed the accumulation strategy as its model for growth with the background of export-led industrialization in the 1960s and heavy and chemical industrialization in the 1970s, although the Constitution of the Republic of Korea recognizes the legal value of balanced development within the regions by specifying “the balanced development of the state” or “ensuring the balanced development of all regions.” In addition, the danger of a 30% decline or extinction of local government nationwide is expected by 2040 as we face not only a decline in general and ageing populations but also the era of the demographic cliff. Thus, the government should continuously operate the “Special Committee on Regional Balanced Development” with a government-wide effort until 2030 to prevent disparities in the health conditions of local residents, which is the responsibility of the nation in terms of strengthening governance. To address the regional inequalities of rural and urban regions, it is necessary to re-adjust the basic subsidy and cost-sharing rates with local governments of current national subsidies based mainly on population scale, financial independence of local government, or distribution of healthcare resources and healthcare indices (showing high inequalities) overall.

운동생리학의 새로운 미개척 분야

공인덕(IN DEOK KONG) 제어로봇시스템학회 2012 제어로봇시스템학회 합동학술대회 논문집 Vol.2012 No.7

사람 망막아세포종 세포에 발현된 니코틴성 수용체의 특성

김대란,차승규,공인덕,정세환,라상훈.Dae-Ran Kim. Ph.D.. Seung-Kyu Cha. Ph.D.. In-Deok Kong. M.D.. Se-Hwan Jung. M.D. Sang Hoon Rah. M.D. 대한안과학회 2005 대한안과학회지 Vol.46 No.6

Purpose: To identify the characteristics and physiological function of the nicotinic receptor expressed in human retinoblastoma cells. Methods: We measured possible nicotinic signaling in WERI-Rb-1 cells using the Ca2+ imaging technique and the patch clamp method. Results: 1) Nicotine-induced [Ca2+]i rise arose entirely through Ca2+ influx, which was completely abolished by hexamethonium (100 μM). 2) Nicotine also induced remarkable depolarization from -56.6±3.7 mV to -29.6±3.6 mV (n=4) under current clamp mode, but it failed to directly activate the T-type Ca2+ channel expressed in retinoblastoma cells. Conclusions: Nicotinic activation can increase the intracellular calcium level through calcium influx in the undifferentiated retinoblastoma cells, which may play important roles in cell proliferation, differentiation, and cell death.

광용적맥파 비맥동성분에 의한 혈관경직도 변화 분석

이충근,신항식,공인덕,이명호,Lee, Chung-Keun,Shin, Hang-Sik,Kong, In-Deok,Lee, Myoun-Ho 대한의용생체공학회 2011 의공학회지 Vol.32 No.2

Assuming that photons absorbed by a vessel do not have acute variations, DC component reflect the basal blood volume (or diameter) before blood pulsation. Vascular stiffness and reflection is influenced by changes in basal blood volume (or diameter). This paper describes analysis of the characteristic variations of vascular stiffness, according to relative variations in DC components of the PPG signal (25-75%). For quantitative analysis, we have used parameters that were proposed previously, reflection and stiffness index, and the second derivative of PPG waveform, b/a and d/a. Significantly, the vascular stiffness and reflections were increased according to increase in DC component of the PPG signal for more than about 3% of baseline values. The systolic blood pressure were increased from $113.1{\times}13.18$ to $116.2{\times}13.319$ mmHg, about 2.76% (r = 0.991, P < 0.001) and the AC component of the PPG signal were decreased from $2.073{\times}2.287$ to $1.973{\times}2.2038$ arbitrary unit, about 5.09% (r = -0.993, P < 0.001). It is separated by DC median and correlation analysis was performed for analyzing vascular characteristics according to instantaneous DC variations. There are significant differences between two correlation coefficients in separated data.

Mouse Leukemia 세포에서 Adenosine 5'-triphosphate에 의한 Apoptosis

주난영,박규상,정해숙,공인덕,이중우,Joo, Nan-Young,Park, Kyu-Sang,Chung, Hae-Sook,Kong, In-Deok,Lee, Joong-Woo 대한약리학회 1997 The Korean Journal of Physiology & Pharmacology Vol.1 No.6

Extracellular ATP elicits various biological responses and plays a significant role in physiological regulation. Recently, ATP-induced growth inhibitions were reported in some tumor cell lines, but these effects and mechanisms are not well hewn. This study was conducted to investigate ATP-induced growth inhibition in mouse $leukemic(P388D_1)$ cells. ATP inhibited cell growth in a dose-dependent manner as analyzed by MTS assay$(IC_{50}: 33.1\;{\mu}M)$. Nucleotides other than ATP, such as ADP$(37.5;{\mu}M)$ and AMP$(33.2;{\mu}M)$ had the same effects as ATP but adenosine$(57.8;{\mu}M)$ showed less effect than ATP. ATP attenuated the cells in $G_0/G_l\;and\;G_2/M$ phases but increased those in S phase in flow cytometric analysis. Hypodiploid cells$(A_0)$, the presumptive findings of apoptosis, were found among the ATP-treated cells. ATP induced DNA fragmentation into $180{\mu}200\;bps $as measured by electrophoresis. some apoptotic cells were stained by TUNEL method. ATP increased the intracellular free $Ca^{++}$concentration$([Ca^{++}]_i)$ and the increment of $([Ca^{++}]_i)$ was caused by influx from the extracellular space. These results suggest that extracellular ATP induces growth inhibition through apoptosis.

사람 망막아세포종 세포에 발현된 P2Y11 수용체의 확인

김윤희,김대란,전고이,이종혁,공인덕,Yoon Hee Kim,Dae Ran Kim,Ko I Chun,Jong Hyuck Lee,In Deok Kong 대한안과학회 2007 대한안과학회지 Vol.48 No.8

Purpose: The present study aimed to identify the characteristics and physiological function of the P2Y11 receptor, a receptor likely expressed in human retinoblastoma cells. Methods: We measured possible P2Y11 signaling in WERI-Rb-1 cells using a Ca2+ imaging technique and RT-PCR. Results: 1) 10 ?M ATP elicited a strong but transient increase in Ca2+ in the WERI-Rb-1 cells, and this Ca2+ rise was well maintained after external Ca2+-depletion. 2) ATP-induced Ca2+ response arose entirely through Ca2+ mobilization. 3) P2Y11 agonist (BzATP, 100 ?M) increased Ca2+ by 31.2±3.7 % of ATP effect. 4) mRNA for P2Y11 subtype was identified using RT-PCR. Conclusions: P2Y11 purinergic activation can increase the intracellular calcium level through calcium mobilization in undifferentiated retinoblastoma cells, which may play an important role in cell proliferation, differentiation, and even pathologic processes.

Mouse Leukemia 세포에서 Adenosine 5’-triphosphate에 의 한 Apoptosis

주난영(Nan Young Joo),박규상(Kyu Sang Park),정해숙(Hae Sook Chung),공인덕(In Deok Kong),이중우(Joong Woo Lee) 대한생리학회-대한약리학회 1997 The Korean Journal of Physiology & Pharmacology Vol.1 No.6

Extracellular ATP elicits various biological responses and plays a significant role in physiological regulation. Recent1y, ATP-induced growth inhibitions were reported in some tumor cell lines, but these effects and mechanisms are not well known. This study was conducted to investigate ATP-induced growth inhibition in mouse leukemic(P388DJ) cells. ATP inhibited cell growth in a dose-dependent manner as analyzed by MTS assay(IC5o: 33.1 μM). Nuc1eotides other than ATP, such as ADP(37.5 μM) and AMP(33.2 μM) had the same effects as ATP,but adenosine(57.8 μM) showed less effect than ATP. ATP attenuated the cells in Go/GJ and G2/M phases,but increased those in S phase in flow cytometric analysis. Hypodiploid cells(Ao), the presumptive findings of apoptosis, were found among the ATP-treated cells. ATP induced DNA fragmentation into 180-200 bps as measured by electrophoresis. Some apoptotic cells were stained by TUNEL method. ATP increased the intracellular++ ... , .... .--++ free Ca concentration([Ca]i) and the increment of [Ca]i was caused by influx from the extracellu1ar space. These results suggest that extracellular ATP induces growth inhibition through apoptosis.

βTC-6 세포에서 Floxetine과 Mirtazapine이 인슐린 분비에 미치는 영향

전성균(Sung-Kuyn Jun),박기창(Ki-Chang Park),장형민(Hyung-Min Chang),이건일(Keon-Il Lee),공인덕(In-Deok Kong) 대한생물치료정신의학회 2004 생물치료정신의학 Vol.10 No.2

Objective : It is well known that antidepressants improve glycemic control and prevent relapse of depression in diabetics. However, TCA antidepressants directly interfere with blood glucose levels in some recent reports, and the effects of SSRI antidepressants on blood glucose are controversial. This study aimed to explore the effects of fluoxetine and mirtazapine on insulin secretion. Methods : This study investigated the effect of fluoxetine and mirtazapine on insulin secretion in βTC-6 cells-mouse pancreatic β cell line. Fluoxetine is a prototype of SSRI, mirtazapine is a NaSSA, both of them are widely prescribed. After static incubation during 2 hours, insulin secretion was measured by radioimmunoassay. Results : 1) Glucose increased insulin secretion in a concentration-dependent manner with EC?? 2.7±0.3mM. 2) As the number of cell increased, the amount of insulin secretion was significantly increased. 3) Glibenclamide, K<SUB>ATP</SUB>-channel blocker, markedly increased insulin release. 4) Fluoxetine and mirtazapine inhibited insulin secretion at low(1μM) and high(10μM) concentration. 5) The inhibitory effects of fluoxetine(10μM) were significantly greater than those of mirtazapine(10μM). 6) These inhibitory effects of fluoxetine and mirtazapine on insulin secretion were significantly greater in high glucose level than in low glucose level. Conclusion : Taken together, fluoxetine and mirtazapine might inhibit insulin secretion directly in βTC-6 Cells. 목적 : 우울증이 동반된 당뇨병환자에게 항우울제를 투여하면 우울증상의 재발을 막는 것은 물론이고 혈장조절에도 도움이 된다고 알려져 있다. 그러나, 최근 연구들은 TCA계 항우울제가 혈장을 악화시킨다고 하고, SSPI계 약물들에 대해서는 연구자마다 다른 결과를 보고하고 있다. 본 연구는 SSPI계 대표적 약물인 fluoxetine과, 고혈당증을 유발한 것으로 최근 국내에서 보고된 mirtazapine이 췌장 β세포의 인슐린 분비에 어떠한 영향을 미치는 지를 알아보고자 하였다. 방법 : 마우스의 췌장 β 세포주인 βTC-6를 대상으로 fluoxetine과 mirtazapine을 투여하여 인슐린 분비에 미치는 영향을 관찰하였다. βTC-6 세포를 2시간의 정적 배양 후 방사면역법을 이용하여 인슐린 분비를 측정하였다. 결과 : 1) 인슐린 분비는 포도당에 농도의존적으로 증가하였고, EC??는 2.7±0.3mM이었다. 2) 인슐린 분비는 세포 수에도 의존적으로 증가하였다. 3) KATP-channel 억제적인 glibenclamide를 처치한 군과 대조군을 비교하였을 때, gibenclamide 군의 인슐린 분비가 유의하게 높았다. 4) fluoxetine은 저농도(1μM)와 고농도 (10μM)에서 인슐린 분비를 유의하게 억제하였으며 mirtazapine도 저농도와 고농도에서 인슐린 분비를 억제하였다. 5) 같은 농도의 포도당에서 고농도 fluoxetine의 인슐린 억제효과가 고농도 mirtazapine의 억제효과보다 유의하게 높았다. 6) 고농도의 fluoxetine에서, 그리고 고농도와 저농도의 mirtazapine 모두에서, 고포도당 농도(10mM)일 때가 저포도당 농도(2.5mM)일 때 보다 인슐린에 대한 억제효과가 유의하게 높았다. 결론 : 본 실험결과로 미루어, fluoxetine과 mirtazapine은 βTC-6 세포에 직접적으로 작용하여 인슐린 분비를 억제시키는 것으로 보인다.

성인간호연구에서의 생물표지자 ‘텔로미어 길이’의 이해와 활용: 종설연구

한설빈(Han, Seolbin),민지희(Min, Jihee),김대광(Kim, Dae-Kwang),공인덕(Kong, In Deok),김나현(Kim, Nahyun) 한국성인간호학회 2023 성인간호학회지 Vol.35 No.1

건강형평성의 지역 격차 해소를 위한 접근

손강주(Kang Ju Son),조훈(Hoon Jo),김춘배(Chun-Bae Kim),김수미(Su Mi Kim),민인기(In Gi Min),공인덕(In Deok Kong) 한국보건교육건강증진학회 2018 보건교육건강증진학회지 Vol.35 No.4