경남 일부 지역 간흡충 감염 주민에 대한 혈청 생화학검사 소견 분석

손운목,조영표,김기진,김미영,이종욱,박도흠 한국건강관리협회 1999 건협 Report Vol.2 No.-

잉어류 바이러스성전신괴사증바이러스 (VSNCV) 백신 투여에 대한 잉어의 면역반응

조미영,손상규,김이청,김진우,오명주,정성주,박수일 한국어병학회 2003 한국어병학회지 Vol.16 No.3

양식 잉어류에서 심각한 피해를 야기하고 있는 VSNCV에 대한 백신을 제작하며 잉어에 투여한 후 특이적 및 비특이적 면역반응을 조사하였다. 백신은 포르마린처리백신 (FKV)과 가온처리백신 (HKV)를 제작하여 건강한 잉어에 0.2㎖씩 복강주사 하였으며, 2주 후 동일한 방법으로 boost처리하였다. 백신 투여 후 비특이적 면역반응 중 혈청 라이소자인 활성과 대식세포의 chemiluminescent (CL) reponses은 1차 주사 후 및 boost 처리 후 2일째부터 7일째까지 유의적인 증가를 나타내었으며, 이후 대조구 수준으로 감소하였다. ELISA법으로 항체가를 조사한 결과 대조구를 제외한 FKV와 HKV 투여구에서 주사 후 2주 째부터 boost처리 후 6주 째까지 유의적으로 증가하였으며, 그 중에서도 boost 처리 후 2주 째에 VSNCV로 공격 실험한 결과 FKV 투여구에서는 20%의 누적폐사율을 나타내어 방어력이 인정 되었으나, HKV투여구에서는 70%의 누적폐사율이 나타나 방어효과가 거의 없는 것으로 나타났다. VSNC is a viral disease causing significant economic losses in cultured carp Ciprinus carpio L. in Korea. Carps were immunized with prepared vaccines against VSNCV and examined specific and nonspecific immune responses. Carps were injected by 0.2㎖ of formalin-killed vaccine(FKV), heat-killed vaccine(HKV) or E-MEM, respectively and dealt with boost with same way two weeks later. The lysozyme activity of serum and chemiluminescent reponses of head-kidney leucocytes showed increased responses during 2-7 days post-first injection(pfi) and post-boost(pb) in the vaccinated fish, and then decreased to the level of control. As measured by ELISA, vaccinated groups showed a significant increase in VSNCV-specific serum antibodies between 2 weeks pfi and 6 weeks pb with a peak at 2 weeks pb. Results of the virus challenge showed that the fish vaccinated with FKV have induced protective immunity, white HKV injection hardly provided protection.

6 시그마 기법을 이용한 임상약동학 자문 업무의 효율성 개선 : 신속성과 정확성을 중심으로 Focusing on Speed and Accuracy of CPS

김민영,박효정,박향미,손기호,최경업,박영하 한국병원약사회 2001 병원약사회지 Vol.18 No.2

연구 배경 : 적정한 약물요법을 순발력 있게 시행하기 위해서는 CPS 업무가 신속, 정확하게 수행되는 것이 필수적임에도 불구하고 지금까지 CPS 업무의 신속성, 정확성을 향상시키기 위한 객관적인 업무 표준은 물론 그의 측정까지도 전무한 실정이었다. 이에 수요자인 의사의 측면에서, CPS 자문결과의 신임도에 영향을 미치는 업무의 순발력과 정확성을 향상시키기 위해 CPS 업무의 신속성, 정확성에 영향을 미치는 요인을 파악, 분석하고 이를 향상시킬 수 있는 업무 표준을 개발하는 것을 목표로 6-Sigma 기법을 사용하여 본 연구를 진행하였다. 방 법 : CPS 업무의 신속성 평가를 위해 전체 업무 과정과 부분별 업무 과정에 대한 소요 시간을 측정하였고, 정확한 평가를 위해 예측되는 Cpeak와 실제 측정된 Cpeak를 비교하였다. CPS 업무에 대해 6-Sigma 기법을 사용하여 개선이 필요한 사항을 파악하고 이에 대한 개선활동을 한 후, 개선 활동 전과 후의 CPS 업무의 신속성과 정확성의 σ 수준을 각각 측정하여 이의 향상 정도를 잠재적인 경제적 이익으로 환산하였다. 결 과 : 신속성은 제 1차 자료수집 기간(대조군, 현황 파악 기간) 중 총 소요시간은 평균 930.6±583.2이었으며, 채혈-검체 접수 : 140.4±8705분, 검체접수-약물농도 결과보고: 48.4±23.1분, 결과보고-CPS 보고서 작성 : 741.8±510.6분으로 측정되었다. σ 수준은 총 소요시간의 경우는 0.56σ, 단계별로는 각각 0.45σ, 5.70σ, 0.30σ이었다. 제 2차 자료수집 기간(개선군, 개선활동 평가 기간) 중 총 소요시간은 평균 659.1±344.1분이었고 단계별로는 각각 92±66.2분, 48±28.0분, 518.9±340.7분이 소요되었다. σ 수준은 총 소요시간은 1.75σ이고, 단계별로는 1.32σ, 4.70 σ, 1.10σ로서 총 소요시간과 단계별 소요시간이 1차 자료수집기간에 비해 향상되었다. 정확성 측면에서는, 대조군의 경우, 예측 Cpeak와 실측 Cpeak의 차이는 평균은 0%, 분산 ±27.10%, σ 수준은 -0.56σ이었고 개선군의 평균과 분산 그리고 σ 수준은 각각 0%, ±15.10%, 0.14σ로 향상되었다. CPS 신속성, 정확성 향상으로 인한 경제적 이익은 정확성 측면에서 380만원/년, 신속성 측면에서 1350만원/년으로 총 1730만원/년의 비용절감 효과가 있었다. 결 론 : CPS 업무 흐름에 따라 CPS 효율성에 영향을 미치는 요인을 분석한 결과 CPS 효율성 향상을 위해서는 투약관련 의무 기록의 정확성, 임상병리 검사의 정도관리 향상, 그리고 관련 부서와의 원활한 업무 협조가 가장 중요하였다. The effectiveness of CPS (Clinical Pharmacokinetics Service), one of pharmacist's clinical services, was emphasized by many studies since 1985 it was introduced Korea about. But in the view of clinicians (medical doctors), customers, it's convenience or reliability was not properly evaluated for applying it to patient's care. To improve quality of Clinical Pharmacokinetics Service (CPS), the speed and the accuracy of CPS, the key points of efficiency in CPS, were evaluated by using 6-Sigma method. The speed of CPS was evaluated using total hours it took from blood sampling by a nurse to sending a CPS report to the patient's chart by a clinical pharmacist. Total hours were divided into blood sampling-to-sampling registering, sampling registering-to-C_(peak) result reporting, and C_(peak) result reporting-to-pharmacist's CPS report. The accuracy of CPS was evaluated by the difference between expected C_(peak) and measured C_(peak). Then the speed and the accuracy of CPS were expressed as σ level. After the campaign for improvement by Six Sigma method, the speed was improved by 1.19σ (before and after the campaign; 0.56σand 1.75σ, respectively) and the accuracy was improved by 0.7σ (before and after the campaign, -0.56σand 0.14σ, respectively). Exact recordings of dosing time, drug infusion hours and blood sampling time were shown to have profound effect on the accuracy of CPS. The improvement in the speed and the accuracy of CPS could produce potential financial benefit of U.S.$ 15,300 a year. There have not been studies on evaluating and objectifying as numerical value for the speed and the accuracy of CPS; thus, 6-Sigma method for improving efficiency in manufacturing process was applied to CPS process by expressing as σlevel. The speed and the accuracy of CPS could be improved by tightly controlling many factors related to CPS efficiency.

일부 한국인에서 환자-대조군 연구에 의한 위암 관련 요인

이영희,이충원,이희자,이미영,전종찬,손수상 대한보건협회 2000 대한보건연구 Vol.26 No.4

A hospital case-control study was initiated to investigate stomach cancer-related variables in some Koreans November 1996 to December 1998. The cases were selected from inpatients admitted to department of general surgery of Dongsan Hospital, Keimyung University to have gastrectomy for the first time and to whom controls were individually matched from the same hospital. The face-to-face interview was administered by one trained interviewer before patients underwent surgery. One hundred sixty seven cases and 324 controls were analyzed in the final analysis. After univariatc conditional logistic regression, multiple conditional logistic regression with backward elimination started with variables having P less than 0.20. The variables increasing the risk were number of siblings, onion, excessive salt or soybean sauce use, and past history of gastritis or peptic ulcer. However, consumption of fresh fruits, green onion and garlic, and all kinds of stew, and years since last gastric endoscopy appeared to decrease the risk. Drinking, all kinds of vegetables, tofu, duration of refrigerator use and frequency of UGI were marginally statistically significant. These results suggested that stomach cancer-related variables in Korea are consistent with other studies, however onion, all kinds of stew, and variables related with screening behaviors merit further studies.

노년여성의 브래지어 착용실태 조사연구

박은미,김영숙,손희순 服飾文化學會 1996 服飾文化硏究 Vol.4 No.2

The purpose of this study is to suggest fundamental information about wearing method and production of brassiere, which is suitable for physiological hygiene and efficient action for elderly women. The subject is 418 elderly women aged 50~69 years old. Data is processed by a computer(SAS) and is analyzed by using frequency, percentage, χ²-test. The main results of this study are as follows: 1. Elderly women' weight and breast size are higher than their younger counterparts' in their 20's. but the older and poorer women with more children have smaller weight and breast. Most of the elderly women feel that their breasts are drooped or falling apart. In fact, those elderly women who gave birth to more children have more drooped and wider breasts. the major type of elderly women' breasts is the drooped breast' featured by those elderly women who have more children. 2. Most of the elderly women began to wear the brassiere for the first time in their 20's. the older women with more children began to were the brassiere earlier, while those less educated and poorer began to protect their breasts with brassiere later. Many elderly women were the brassiere to be protected from dirt, noise or look more neat, but day tend to wear the brassiere not all day around but at certain times, older, less educated and poorer women with more children tend to use the brassiere for etiquette and less often. This group of elderly women feel tedious, strange or uncomfortable for the brassiere. 3. Most of the elderly women know about their brassiere size. Such variables as age, education and income are correlated positively with the interest in and conscious ness of the brassiere size. All in all, the statistical distribution of elderly women's brassiere size is very wide, while most of them use 90A, 85A and 95A sizes. On the other hand, the most popular size for the under bust circumference is 85~90cm, while their primary cup size is A.

호주의 유전자변형생물체(Genetically Modified Organisms) 안정성 심사절차 및 유전자변형식품의 표시제도

김태산,김영미,손성한,김용환,박용환 한국국제농업개발학회 2002 韓國國際農業開發學會誌 Vol.14 No.1

1. 호주는 GMO의 실험 및 상업화를 규제하는 신법 "유전자기술에 관한 법(Gene Technology Act 2000)을 제정 운영중임 2. GMO를 관리 감독하기 위하여 보건후생성산하에 유전자기술 감독국(Office of the Gene Technology Regulator)이 신설됨 3. GMO를 취급(dealings)형태에 따라서 면제(exemption), 위험이 매우적은 취급(notifiable low risk dealing), 면허(licensing), 등록(register)의 4가지로 분류하여 감독함 4. GM식품의 안전성 심사는 호ㆍ뉴식품청(Australia New Zealand Food Authority, ANZFA)에서 관장하며 호주식품 강령 기준 18(Standard A18 of the Australian Food Standards Code)이 근거 법임 5. ANZFA에서는 제초제 저항성 콩, 옥수수, 면화, 감자, 카놀라 등 6작물 12종의 GM작물에 대하여 식품안정성 확인을 완료함 6. 호주에서는 2001년 12월 7일부터 유전자변형식품의 의무 표시제를 시행하고 있으며 비의도적 혼입 허용치는 1%로 설정함 As Australia's new national gene technology regulatory system began on 21 June 2001, the Office of the Gene Technology Regulator (OGTR) was newly established to regulate GMO related research and GM products throughout the nation. "Gene Technology Act 2000" is the statutory basis the new regulatory system. The OGTR is within the Commonwealth Department of Health and Aged Care, responsible for overseeing the gene technology research and development including the GMO field trials across Australia. For the regulation of genetically modified food, the Australia New Zealand Food Authority(ANZFA) is responsible for developing and reviewing national food standards. All foods available for sale in Australia and New Zealand must comply with the relevant national food standards. ANZFA also responsible for carrying out safety assessments of GM foods on behalf of the Commonwealth, State and Territory Governments of Australia and the Government of New Zealand. The ANZFA's safety assessment process for GM foods is based on concepts and principles that have been developed through international organizations such as the World Health Organization(WHO) and the Food and Agriculture Organization(FAO) and the Organization for Economic Co-operation and Development(OECD). Mandatory labelling of GM foods containing either introduced DNA or protein in the final food came into effect on 7 December, 2001.

통합적 림프부종 간호중재 개발 연구

조명옥,정향미,전점이,손수경,우영자,노미영,박순옥 성인간호학회 2003 성인간호학회지 Vol.15 No.2

The purpose of this study was the development of a comprehensive nursing intervention program for the client with acute lymph stasis and stage I lymphedema. Method: The Quasi-experimental design using a non-equivalent control group was used. The subjects were 22 stroke patients with lymph stasis in the control group and 23 patients in the experimental group. The complex physical therapy of Casley-Smith was carried out to the control group for 0 hours, and comprehensive nursing intervention for the experimental group was carried out for 60 minutes. The data for this study was gathered from Feb. 2002 until June 2002 and pertains knowledge about lymphedema, self-care for managing lymphedema, and circumferences of affected limbs. Data was analyzed by mean, standard deviation, x^2-test. And t-test. Result: The changes in knowledge about lymphedema, self-care practices, and circumference of affected limbs after nursing intervention did not show significant differences between control group and experiment group. Conclusion : It can be concluded that comprehensive nursing intervention had more efficiency than complex physical therapy in the treatment of edema for stroke patients because of it’s simplicity and time saving. Thereby, the comprehensive nursing intervention program developed in this study would be a useful therapy for the clients with lymph stasis and early stage lymphedema.

Provisional implant의 임상적 적용례

안선희,안경미,이경원,장보영,안미라,손동석 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.1

It has been reported that for implatns to become osseointegrated, they must heal in the absence of functional loads for 4 to 6 months. The provisional implants were designed to support provisional restorations and to allow for load-free osseointegration of definitive implants, while the was provided with immediate esthetic and function. In addition, the provisional implant protects graft site. Also the provisional implant provides anchorage for orthodontic treatment and reconstructs vertical dimension in edentulous condyle fracture to practice functional therapy. The provisional implant system is a sound and economical method to achieve patient's immediate masticatory and esthetic function. Three cases are presented to document and illustrate the clinical application.

림프부종 환자의 자가관리에 관한 실태 조사

조명옥,정향미,전점이,손수경,우영자,노미영,박순옥 성인간호학회 2003 성인간호학회지 Vol.15 No.3

Purpose : The purpose of this descriptive study was to gain basic data to develop a self-care protocol for the lymphedema patients. Method : The subjects of this study consisted of 115 patients with lymphedema from 8 hospitals and two community health and welfare centers in Busan and Seoul. The data was collected with questionnaire by self reporting of patients between March 2001 and December 2001. Data was analyzed by mean and percentage. Result : For self-care activities in daily life, compliance of 'use skin care preparations', 'use heat and cold', 'protect from local compression on affected limbs', 'protect from insect biting', 'use aids to protect affected limbs', 'take diuretics and take protein diet' did not reach to 50%. For self-care activities related to complex physical therapy, 28.7% of subjects complied with compression garment, 14.8% with manual lymph drainage and 13.0% with exercise, 20.0% of subjects tried to treat with acupuncture and 13.9% with heat therapy. Conclusion : From this study, it is suggested that patients need to get a self-care education with correct information about self care activities and health care professionals need to develop more convenience self-care techniques of massage and exercise.

방사선조사가 악하선 미세혈관과 내피세포에 미치는 영향에 관한 실험적 연구

최갑식,최미,손정익,유영아,배용철 大韓口腔顎顔面 放射線學會 1994 Imaging Science in Dentistry Vol.24 No.1

The purpose of this study was to investigate the irradiation effects on the capillary and endothelial cell in the submandibular gland. Sprague-Dawley strain male rats were singly irradiated to their neck region with the dose of 5Gy and 10Gy by 6MV X-irradiation and sacrificed on the 6 hours, 12 hours, 1,3,7, and 14 days after irradiation. The authors observed the histological changes of the capillary at H & E and PAS staining under a light microscope, and also observed the ultrastructural changes of the endothelial cell using a transmission electron microscope. The obtaining results were as follows: 1. In the light microscopic examination, the capillary density was slightly increased on the 1 day after irradiation, and increased until the 7 days after irradiation. After then, capillary density was apparently decreased. 2. The reaction to PAS staining at acinar cells was decreased on the 6 hours after irradiation, and recovered on the 7 days after irradiation. But reaction was decreased on the 14 days after irradiation again, after then, gradually recovered with days. 3. In the transmission electron microscopic examination, mild proliferation of cytoplasmic process of the endothelial cell and reduction in luminal size were observed just after irradiation. After then, nuclear degeneration, marked proliferation of cytoplasmic process, thickened basal lamina, and numerous cytoplasmic vesicles were observed on the 1 day after irradiation. These changes were recovered to normal on the 14 days after 5GY group, but not with 10GY irradiation group. And destruction of endothelial cell and loss of basal lamina were not observed in both groups. 4. From the above results, reduction in luminal size, proliferation of cytoplasmic process and thickening of basal lamina were observed as the irradiation effects on the capillary and endothelial cell of the submandibular gland. And also, these changes may induce increase in capillary number and endothelial permeability by means of increase of cytoplasmic vesicle formation. The changes appeared earlier and more prominent in 10Gy irradiated group than in 5Gy irradiated group.