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      • KCI등재

        First Korean Case of Weaver Syndrome Along with Neuroblastoma and Genetic Confirmation of EZH2 Variant

        오인성,김보람,이지수,김만진,조성임,박성섭,성문우 대한진단검사의학회 2023 Laboratory Medicine Online Vol.13 No.1

        Weaver syndrome (WS) is a rare congenital disorder characterized by overgrowth and accelerated osseous maturation. This syndrome is caused by a variant in the enhancer of zeste homolog 2 (EZH2) gene. No genetically confirmed cases of WS have been reported in Korea. In this case report, we discuss a case in which a variant in EZH2 was detected and confirmed as WS in a patient showing overgrowth syndrome accompanied by neuroblastoma. A 7-month-old female presented to the out-patient pediatrics clinic of Seoul National University Hospital because of multiple palpable masses. Pathological examination confirmed that the mass was neuroblastoma. The patient’s height, head circumference, and weight were ≥97% of those expected for her age. The c.2050C>T (p.Arg684Cys) variant of EZH2 was confirmed through next-generation sequencing-based gene panel testing. Although overgrowth syndrome caused by variants in EZH2 is rare, screening for this condition should be included in the gene panel to evaluate overgrowth syndrome. The possibility of WS should be considered in cases of overgrowth syndrome accompanied by neuroblastoma.

      • KCI등재후보

        중소기업에서의 도급사업장에 대한 산업보건 관리 실태 및 관리 방안 개선에 관한 연구

        최재욱,염용태,오인성 大韓産業醫學會 1993 대한직업환경의학회지 Vol.5 No.2

        To examine occupational health management state of subcontract process, a total of 153 small scale companies(less than 300 workers) were surveyed about subcontract rate, kind of subcontract process, number of workers working in subcontract process, management system of occupational health in contractor company and general characteristics of subcontract company. The summary of results is as follows ; 1. Among 146 companies, 90 companies(61.6%)had subcontract process. And subcontract rate according to the industrial classification was 100% in furniture, 85.7% in fabricated metal products, 75.0% in electrical machinery and apparatus, and 70.0% in tanning and leather, etc. 2. The total number of workers in subcontract process was 2,591, and numer of workers that should get specific health examination for occupational disease was 2,127(82.1%) among them. Among 2,127 workers, kinds of specific health examination and number of workers were 539 workers(20.8%) in organic solvent, 482 workers(18.6%) in lead, 378 workers(14.5%) in noise, and 401 workers(15.4%) in noise and dust. 3. Among the 2,591 subcontract workers, number of workers working in personal subcontract(eq. cottage industry) was 275(10.7%), 1,772(68.4%) in partial process subcontract, 544(20.9%) in total process subcontract. 4. Number of companies that should appoint general safety and health manager by law was 31(34.4%), and appointment rate was 38.7% among them. Visit ever performed rate of general safety and health manager at subcontract company was 16.6%. 5. Among the above 31 companies, safety and health committee was organised in 3 companies(9.6%), and was held regularly in only 1 company. 6. The causes for subcontract were "for shortness of worker(72.0%)", "to keep the date of delivery(66.6%)", "for company own problems-eq. narrow working space(50.0%)", "for economic incentive(43.3%)", "for difficult labor management(25.5%)", "for strict government regulation(24.4%)", "for high and difficult technology(22.2%)". 7. Among the 356 subcontract companies except personal subcontract, average number of workers per company was 13.4, beneficiary rate of Industrial Accident Compensation Insurance was 28.3%, beneficiary rate of general health examination was 23.3%, beneficiary rate of specific health examination was 11.8%.

      • KCI등재

        국가별 산모·영유아 건강관리 서비스 비교 분석

        정유진 ( Jung Yujin ),이재경 ( Lee Jaekyung ),문다슬 ( Moon Daseul ),박인희 ( Park Inhee ),오인성 ( Oh Insung ),정혜주 ( Chung Haejoo ) 한국사회보장학회 2022 사회보장연구 Vol.38 No.4

        보건의료체계와 서비스는 산모와 영유아에 대한 조기개입을 통해 사회환경적 요인에 의한 영유아의 발달 격차를 완화시킬 수 있으므로 매우 중요하다. 그러나 국내 산모·영유아 건강관리 서비스는 시간적, 장소적, 연계적 차원에서 공백이 존재함에도 이와 관련된 국가별 비교 연구가 부족하다. 이에 본 연구는 미국, 일본, 독일, 스웨덴, 영국에서 제공하는 산모·영유아 건강관리 서비스를 생애주기와 서비스의 종류에 따라 세분화하고 각 차원을 비교 분석하여, 오늘날 우리나라의 해당 사업의 개선방안에 대하여 제언하고자 한다. 이를 위하여 2021년 2월부터 2021년 5월 23일까지 국내·외 산모·영유아 건강관리에 대한 문헌고찰을 실시하였으며, 2022년 6월부터 2022년 7월 13일에 재검색하여 내용을 보강하였다. 그 결과는 다음과 같다. 첫째, 대부분 국가에서 현금보다는 서비스 지원 방식을 통해 건강을 관리한다. 둘째, 미국, 일본, 독일은 주로 병·의원 서비스, 스웨덴과 영국은 가정방문 서비스를 통해 산모와 영유아의 건강을 관리하였다. 셋째, 미국, 일본, 독일은 모두 시간적, 장소적, 연계적 차원 중 최소 1개 차원 이상에서 공백이 존재하였으나, 스웨덴과 영국은 모든 차원에서 높은 연계성을 보였다. 넷째, 모든 국가가 가정방문인력에게 학사 이상의 학력을 요구하였으며, 스웨덴과 영국은 석사 학위 등 높은 전문성을 요구하여 그 역할을 강화하였다. 따라서 우리나라 역시 앞선 해외 사례와 마찬가지로 임산부와 영유아의 건강한 출발 및 성장을 도모하기 위해 초기아동발달기에 적절한 조기개입을 통해 다양한 차원의 건강 불평등을 감소시킬 필요가 있다. Environmental and health inequality experienced by mothers and infants during early child development has a continuous effect on health and development after childhood, and is further exacerbated if there is no appropriate early intervention. Therefore, most countries primarily use the (national) healthcare system and healthcare services to implement early intervention for mothers and infants during the early stages of child development. However, domestic healthcare services have gaps in terms of time, place, and connection between services, and studies comparing and analyzing foreign systems in terms of time, place, and connection are also insufficient. Therefore, this study aimed to suggest ways to improve maternal and child health care services in South Korea by subdividing healthcare services provided in the United States, Japan, Germany, Sweden, and the United Kingdom according to life cycle and type, and comparing and analyzing each dimension. The results of the comparative analysis between countries are as follows: First, all countries (used for comparative study) manage their health through the “in-service” type. Second, the United States, Japan, and Germany mainly managed maternal and child health through clinic and hospital clinic services, while Sweden and the United Kingdom managed maternal and child health through home visiting services. Third, the United States, Japan, and Germany all had gaps in at least one of the temporal (time), spatial (place), and linkage (connection) dimensions, but Sweden and the United Kingdom were excellent in all dimensions. Fourth, all countries demanded a bachelor's degree or higher from home visiting service personnel (providers), and Sweden and the UK demanded high expertise, such as master's degrees, as home visiting personnel played a large role. Therefore, as in the case of advanced countries, Korea needs to reduce various dimensions of inequality through early intervention for early childhood development in order to promote the healthy start and growth of pregnant women and infants.

      • KCI등재

        국내 산모·영유아 건강관리 지원제도 분석

        박인희 ( Park In-hee ),문다슬 ( Moon Daseul ),이재경 ( Lee Jae Kyung ),오인성 ( Oh Inseong ),정혜주 ( Chung Haejoo ) 한국사회보장학회 2020 사회보장연구 Vol.36 No.4

        초기아동발달기의 산모와 아동의 경험은 출생 이후 발달과 건강에 지속적으로 영향을 미칠 수 있어 적정한 개입이 필요하며, 이런 의미에서 산모·영유아 건강관리 지원제도는 모든 아동의 건강한 출발과 성장을 보호·증진하기 위해 개입하는 필수적인 제도이다. 이를 개별적으로 다룬 연구는 있었으나 이용자의 측면에서 종합적으로 다룬 연구는 부족한 실정이다. 따라서 본 연구는 국내 산모·영유아 건강관리 지원제도 전반을 분석하여 그 현황과 한계를 파악하고 정책 방향을 제시하고자 하였다. 본 연구는 전국 단위에서 시행되는 국내 24개 산모·영유아 건강관리 지원사업을 생애주기와 대상의 필요 정도(intensity)에 따라 분류하고, 각 사업의 지원대상, 급여방식, 지원시기, 담당기관 등을 분석하였다. 그 결과, 현행 산모·영유아 건강관리 지원제도는 첫째, 이용자의 신청에 기반하고, 둘째, 비용 지원이 대부분으로 서비스 지원이 부족하며, 셋째, 전문적인 필요에 대응하는 지원이 부족하며, 넷째, 지원기간이 출산 전후에 집중되어 있으며, 다섯째, 사업들이 분절적으로 시행되는 한계가 있음을 확인하였다. 따라서 산모·영유아 건강관리 지원제도는 생애주기에 따른 시간 차원의 연계성, 커뮤니티케어를 통한 장소 차원의 연계성, 필요 정도에 따른 사업 간 서비스 차원의 연계성을 구축하는 방향으로 발전해야 한다. 이러한 통합과 연계가 원활히 작동하기 위하여 ‘건강 우선 정책(HiAP)’ 관점의 다부문 협력 체계가 기반이 되어야 할 것이다. Proper interventions in the phase of early child development is necessary since the experience of mothers and children in the period can affect the development and health of children over time. The maternal and child healthcare services provided during early child development are essential to protect and promote a healthy start and growth of all children. There has been a lack of research that comprehensively analyzed maternal and child healthcare services in South Korea despite a few studies that examined individual programs. Therefore, this study aimed to analyze all of the maternal and child healthcare services in South Korea synthetically to identify their current status and limitations and to suggest policy directions. This study classified the 24 maternal and child healthcare services according to the life course and the intensity of needs. We analyzed the programs based on the intended subjects, benefit types, timing of support, and agencies in charge of each program, etc. Identified limitations of current maternal and child healthcare services are as follow: First, it is based on the application of users (opt-in). Second, the ‘in-cash’ benefit type constitutes most of the programs and the ‘in-services’ type is relatively scarce. Third, the ‘indicated support’ programs for families of children with additional needs are insufficient. Fourth, the life-course coverage range is restricted to only before and after the childbirth. Finally, there is a lack of connectivities and integrations. For the better maternal and child healthcare for the early childhood development, time- (life-course), place- (care in community), and services- (by intensity of needs) level integration should be considered. Furthermore, to ensure that these links work smoothly, the services should be based on the intersectoral cooperation system from the perspective of “Health in all policy (HiAP)”.

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