진료비 상담의 효율적인 업무개선을 통한 고객만족도 향상

서지연,채은경,고영준외 39인 한국의료QA학회 2006 한국의료질향상학회지 Vol.13 No.2

문제: 최근 몇 년간, 환자 및 보호자들이 의료와 관련된 전문기관을 대상으로, 민원발생이 급, 상승되고 있음이 통계상 확인되고 있다. 목적: 최근 몇 년간, 환자 및 보호자들이 의료와 관련된 전문기관을 대상으로, 민원발생이 급, 상승되고 있음이 통계상 확인되고 있다. 의료기관: 서울에 소재한 2,200병상의 전문종합요양기관 소속 보험 심사 팀 질 향상 활동: 상담 Data base 구축을 위한 전산개발 및 핵심 문제 부분에 대한 직무프로세스 변경, 보완 및 수정 활동결과: 진료비 사례 환자 상담건수는 2003년 기준 75.4%의 증가율을 보였으며, 본원의 민원검수는 전년대비 9%의 감소효과가 확인되었다.

고추 탄저병 저항성 중간모본 ‘원예 100005호 ’,‘원예 100006호’ 육성

양은영,김수,채영,채수영,조명철,문지혜,박태성,이우문,곽정호 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2

Owing to frequent heavy rain due to abnormal weather, the occurrence of pepper anthracnose has recently increased, which affects the supply and demand of pepper. As a result, the price of red pepper powder in 2011, for example, increased three times compared to the average year. Although anthracnose of pepper plants has been controlled by fungicides until now, it is important to develop new resistant cultivars because of the reduction of the labor force in rural area and occurrence of new anthracnose strains resistant to fungicides. National Institute of Horticultural and Herbal Science developed two pepper lines, ‘Wonye 100005’ and ‘Wonye 100006’ that are resistant to pepper anthracnose. These lines were developed by continuous selection of progenies from a cross between ‘Wonye AR1’, which were developed from interspecific hybridization and ‘TF68’. The anthracnose resistance level of the two lines was higher than that of commercial cultivars and similar to check varieties showing highest level of anthracnose resistance.

혈관내피세포-U937세포의 부착에 미치는 Eicosapentaenoic Acid의 효과

김은지,전재은,임현주,차성철,정의룡,조용근,조용근 경북대학교 병원 1998 경북대학교병원의학연구소논문집 Vol.2 No.1

연구배경: 역학적연구에서 어류의 섭취가 많은 집단에서 관상동맥질환의 빈도가 낮은 것이 보고되었고, 이것은 어류에 많이 함유된 불포화지방산(polyunsaturated fatty acid) 특히 eicosapentaenoic acid 때문으로 생각되어지고 있다. 본 연구에서는 동맥경화증 발생의 초기단계로 여겨지는 단핵구와 혈관내피세포 사이의 adhesion에 미치는 다불포화지방산의 영향을 in vitro system에서 관찰하고자 하였다. 방 법: 제대정맥에서 얻은 혈관내피세포를 배양하여 96 well에 옮기고 25, 50, 100, 200 ㎛ 농도의 eicosapentaenoic acid(EPA)를 6시간 동안 처리한 U937세포를 부착시켜 adhesion assay를 시행하였다. 혈관내피세포를 자극하기 위해서는 lipopolysaccharide(LPS)를 well당 100 ng씩을 투여하였다. 음성대조군으로는 LPS로 자극하지 않은 혈관내피세포에 EPA처리를 하지 않은 U937세포로 adhesion assay한 성적을 사용했고, 양성대조군으로는 LPS로 자극한 혈관내피세포에 EPA처리를 하지 않은 U937세포로 adhesion assay한 성적을 사용했다. 그리고 EPA(3.3 mM)을 5㎛ CuSO4 및 300 ㎛ asscorbic acid와 혼합하여 섭씨 37도에서 16시간 두어 산화-EPA를 만들어 같은 실험을 반복하였다. 결 과: U937세포에 25, 50, 100, 200 ㎛의 EPA로 6시간 처리하였을 때 U937세포의 생존율은 99% 이상이었다. 혈관내피세포를 LPS로 자극했을 때 adhesion assay에서 혈관내피세포에 붙는 U937세포의 수는 현저히 증가하였다. 그러나 EPA를 U937세포에 25, 50, 100, 200 ㎛의 농도로 6시간 처리 후에 lipopolysac-charide를 처리한 제대정맥 내피세포에 부착(adhesion)시켰을 때 처리한 EPA의 각 농도에 따른 부착된 U937세포의 수는 통계적으로 유의한 차이를 나타내지 못했다. EPA처리가 부착된 U937세포의 수에 영향을 미치지 못하였다. 결 론: EPA는 U937세포에 영향을 미쳐 혈관내피세포-U937 세포부착을 감소시키지는 못하였다. 따라서 EPA에 의한 혈관내피세포-단핵구 부착 억제 효과는 EPA의 단핵구에 미치는 영향에 의하지는 않는 것으로 생각되나 추후 더 많은 연구가 필요하리라 생각된다. Background : Epidemiological studies have shown correlation between low incidence of coronary heart disease and high consumption of fish products. It has been suggested that this may be due to the high content of polyunsaturated fatty acids of the n-3 fatty acid group in fish oil. In animal studies eicosapentaenoic and (EPA) inhibited attachment of monocytes to the arterial endothlium. Method : Adhesion assay was performed on the endothelial cells of the human umbilical vein with 25, 50, 100, 200 ㎛ EPA-treated U937 cells. The endothelial cells were activated with lipopoysaccharide (LPS). The adhesion assay was repeated with oxidized EPA. EPA was oxidized with CuSO4 and ascorbic acid. Result : Viability of U937 cells were not afected by concentrations up to 200 ㎛ of EPAand oxidized EPA. LPS treatment of endothelium notably increased the number of U937 cells attached to endothelial cells on the adhesion assay. However, treatment of EPA, native or oxidized, to U937 cells did not afect the number of U937 cells attached to LPS activated endothelial cells. Conclusion : EPA treatment, native or oxidized, of U937 cells did not affect U937 cell-endothlial cell adhesion. This suggests that inhibition of monocyte-endothlial cells ◎attachment by EPA is not due to the effects of EPS on monocytes.(Korean Circulatin J 1998;28(4):606-610)

골수염으로 발현된 재발성 콕시디오이데스 진균증 1예

백지현,박은영,정윤숙,홍재원,채윤태,진성준,최희경,신소연,한상훈,진범식,김창오,최준용,송영구,조남훈,김준명 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Coccidioidomycosis is a fungal infection that results from inhaling the airborne arthroconidia of the Coccidioides species. It is an endemic disease in the southwest part of North America and rarely diagnosed in Korea. As tourism to endemic areas and the number of immunocompromised patients have been increasing, the incidence of this infection has increased in non-endemic areas. Treatment is usually successful with antifungal agents; however, recurrence is common. It is difficult to decide when to discontinue the antifungal treatment especially in non-endemic areas where doctors are not familiar with the disease. We report a case of recurrent coccidioidomycosis manifesting as osteomyelitis after the treatment of the patient for disseminated coccidioidal infection. The complement fixation test was a useful tool for the assessment of patient response and to evaluate suspected recurrence.

초산 중독에 의한 범발성 혈관내 응고증: 1증례 보고

곽은경,김동자,박지영,배한익,채종민,곽정식,박태인 大韓法醫學會 1998 대한법의학회지 Vol.22 No.2

Strong corrosive acid is accidentally ingested by children or by psychiatric patients for the purpose of suicidal attempt. Late complications include chemical burn to pharyunx, perforation and stricture of upper gastrointestinal tract, respiratory insufficiencyand renal failure caused by hemoglobinuria following hemolysis. Acetic acid is difficult to ingestion large volume in a time because it is a strong irritant, provocating painful pharynx, and its autopsy case is rare. We report an autopsy case of acetic acid intoxication with acute disseminated intravascular coagulation (DIC) in several hours. We present pathogenesis of acetic acid intoxication and the associated forensic problems. A comatous 39-year-old female was admitted to emergency room 6 hours after she swallowed 90 gm of acetic acid. She was treated with gastric lavage but she was expired 9 hours after swallowing acetic acid. She was consulted to Department of Forensic Medicine of Kyungpook National University School of Medicine. She was grossly icteric and livor mortis was generally dark red. External wounds were 10 hemorrhagic lesions with 5 x 3.7cm and 3 x 2.8cm on the left arm and hand dorsum and facial abrasions. Internal gross examination revealed several purpural lesions in the gastric serosal surface and greater omentum. Microscopically, the stomach showed diffuse mucosal coagulation necrosis and intravascular hyalinized or fibrinoid thrombi in submucosal blood vessels. Liver showed necrosis of periportal area (zone I) and intracellular cholestasis around the central vein. Sections from renal tissue frequently show hemoglobin casts in the tubules and RBCs in the Bowman's capsules. Acetic acid of a remnant bottle, sampled blood and bloody necrotic tissues in the stomach were toxicologically examined in National Science Laboratory. The purity of ingested acetic acid is 98%, the concentration of acetic acid ion in blood is 734ppm and the content in gastric juice is 0.09%. In patients after acetic acid ingestion, DIC is most probably caused by procoagulants, produced by extensive acid-induced necrosis of the upper gastrointestinal tract. In this case, several purpural lesions were revealed on the arm, around facial abrasion and intravenous injection sites of the wrists. These are important to differentiate with contusion because she was battered before acetic acid ingestion. Purpurae in DIC are poorly demarcated, dark purple elevations with spreading margin but subcutaneous hemorrhage in contusion is grayish black or dark red with well demarcation (Table 2). But careful examination should be considered because traumatic hemorrhage is also exaggerated and mixed in DIC. (The Korean Journal of Legal Medicine)

축구선수의 Detraining과 Retraining이 혈청지질 및 호르몬농도에 미치는 영향

정정화,박재현,채종훈,성혜련,황지인,윤미숙,노금선,윤종관,윤영학,노순덕,정경숙,박일규,김은희,박현태,박상갑 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

The purpose of this study was to investigate the effects of detraining and retraining on serum lipid and hormones in soccer players. Subjects were seven male high-school soccer players. V˙O_2max was determined for each subjects by administering a treadmill test(initial speed: 90m/min, grade: 5%, increasing speed per 3 min: 30m/min). Serum lipid(T-C, TG, HDL-C LDL-C) and hormones(epinephrine, norepinephrine, growth hormones, cortisol) were assayed pre and post detraining in 10, 20, 30 days after retraining. The repeated ANOVA was used to determine significant differences. The 0.05 level of significance was as critical level for the study. The results of the study were as follows: 1. V˙O_2max(ml/min) were 3576.3±204.2ml/min pre detraining, 3234.1±198.9 ml/min post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/min) were 3601.4±170.9 ml/min. There were significantly(p<.05) increased in retraining periods. 2. V˙O_2max(ml/kg/min) were significantly(p<.05) decreased from 62.3±2.9 ml/kg/min to 55.9±4.7 ml/kg/min in detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/kg/min) were 62.4±3.4ml/kg/min, 62.7±2.3ml.kg/min, 67.3±7.2ml/kg/min respectively. There were significantly(p<.05) increased in retraining periods. 3. T-C were significantly (p<.05) increased from 166.6±8.5mg/dl to 175.3±10.3 mg/dl in detraining. In 10, 20, 30 days after retraining, T-C were 160.1± 3.2mg/dl, 156.7±3.7mg/dl, 140.3±9.0mg/dl. There were significantly(p<.05) decreased in retraining periods. 4. HDL-C were 61.4±6.6mg/di pre detraining, 5.3±6.6mg/dl post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, HDL-C were 56.9±7.1mg/dl, 56.4±9.2mg/dl, 57.7±9.1mg/dl respectively. There were no significant difference in retraining periods. 5. The hormones(epinephrine. norepinephrine, growth hormone, cortisol) were changed as same patterns. Epinephrine were 26.0±7.0[g/ml pre detraining, 24.6±3.2pg/ml post detraining. In 10, 20, 30 days after retraining, epinephrine were 26.9±5.6pg/ml, 30.6±6.2pg/ml, 29.4±5.6pg/ml respectively. There were no significant difference in retraining periods. In conclusion, HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were decreased, T-C, LDL-C and TG were increased in detraining. But HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were increased, T-C, LDL-C and TG were decreased in retraining.

순환기 내과로 자문의뢰된 환자의 임상상

황진용,최지용,손상균,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.4

목적 : 순환기내과 영역은 많은 과로부터 자문의뢰를 받는 영역으로 알려져 있다. 특히 최근 우리나라의 순환기질환의 유형이 변화되고 입원환자가 고령화되면서 동반된 심질환의 유병율도 증가하고있다. 이에 저자들은 타과로 입원하여 순환기내과로 자문의뢰되는 환자의 임상상과 3차병원인 경북대학교병원에서의 순환기내과자문의 유용성 등을 평가하여 향후 순환기질병에 대한 협의진료에 도움을 주고자 본 연구를 시행하였다. 방법 : 1995년 3월부터 순환기내과로 공식자문의뢰된 첫 100명을 대상으로 전향적으로 연령, 의뢰이유, 최종진단명, 수술과의 관련성 여부, 순환기내과의 최종조치, 타과의 순응도 등을 조사하였다. 결과 : 1) 자문을 의뢰한 환자는 평균 58±16(15-89, 중앙치 61)세였고 60세이상의 환자가 57%로 고령의 환자가 많았다. 2) 내과계열 25%, 외과계열 75%로 외과계열의 자문이 많았고 일반외과가 26%로 가장 많았고 내과의 다른 분과가 12%, 신경외과 12%, 정형외과 11%, 흉부외과 11%, 신경과 11% 등의 순이었다. 외과계열중 수술을 시행한 경우는 58례로 이중 응급수술이 13례였다. 술전 위험도 평가를 위한 자문이 38례에서 있었는데 순환기적인 문제로 수술을 받지 못한 경우는 2례(1례는 허혈성 심질환, 1례는 심낭질환)이었다. 이때 응급수술을 제외한 입원일과 술전 자문일파의 간격은 평균 3±7일(입원일-42일)이고 술전 자문일과 수술일과의 간격은 평균 6±4일(1-16일)이었다. 3) 타과의 의뢰이유는 심전도 이상이 36례, 높게 측정된 혈압이 20례, 순환기질환의 과거력 17례, 환자의 증상 때문인 경우가 10례였고 심전도의 이상중에는 부정맥이 18례, 이상 Q파 6례, ST절 이상이 5례, 각차단이 3례의 순이었다. 순환기과거력 중에는 허혈성 심질환이 6례, 현재 혈압은 정상이나 고혈압의 과거력이 있는 경우가 4례 순이었고 환자의 증상은 흉통 6례, 호흡곤란이 3례, 기절이 1례였다. 4) 자문후 최종진단이 가능했던 91례를 진단별(총 97 진단명)로 나누어 보면 고혈압이 28례, 부정맥이 16례, 허혈성 심질환이 14례, 판막질환이 11례, 순환기질환이 아닌경우가 19래였다. 이들중 추적진료가 필요하다고 응답한 경우가 57례였으나 순환기내과 외래에 1번이상 추적진료한 경우는 32례(56%)로 환자의 순응도는 낮았다. 결론 : 순환기내과의 자문의뢰는 고령자에게 많았고 수술과 관련된 경우가 많았으며 심전도의 이상이 의뢰이유로 가장 많았으며 진단별로는 고혈압과 부정맥이 가장 많았다. 그리고 순환기적인문제로 수술을 받지 못한 경우는 드물었고 자문후 지속적인 추적진료를 위해 환자의 교육이 필요하겠다. Objective : Clinical characteristics of the patients with cardiovascular diseases in the general hospital have been changed and prevalance of co-existing cardiovascular disease in the patients who were admitted for non-cardiac diseases has been increased remarkably as the proportion of elderly patients increased rapidly in Korea. We evaluated clinical features of the patients consulted for cardiological evaluation and effectiveness of the consultation in the setting of tertiary general hospital, Kyungpook University Hospital. Method : One hundred patients were studied between January 1995 and January 1996. They were evaluated for the reason of consultation, final diagnosis, final recommendation from cardiologists and its impact on the management of the patients, and compliance of the consulting departments. Results : 1) The ages ranged between 15 and 89 (mean 58±16, median 61) years, 57 patients were male and 43 female. Fifty seven patients were older than 60 years. 2) Consultations from surgical parts were 75 patients. Consultation from general surgery was most frequent (26%), followed by other divisions of internal medicine (12%), neurosurgery (12%) and orthopedic surgery (11%), chest surgery (11%), neurology (11%), obstetrics and gynecology (8%), urology (4%), ophthalmology (2%), dermatology (2%), ENT (1%). Among 75 patients from surgical parts, operation was done on 58 patients, including 13 emergency cases. Preoperative cardiac risk evaluation was the reason of consultation in thirty eight patients, of which operation could not be done in only 2 patients (one had severe ischemic heart disease, the other large pericardial disease). Interval between consultation day and operation day was 6±4 days (1-6 days). 3) Reasons for cardiac consultation were electrocardiographic (ECG) abnormalities in 36 patients, high blood pressure in 20 patients, previous cardiovascular diseases in 17 patients, symptoms of the patients in 10 patients. Among EGG abnormalities, arrhythmias was the reason in 18 patients, abnormal Q waves in 6 patients, ST-T segment abnormalities in 5 patients, bundle branch block in 3 patients. Among previous cardiovascular disease, presence of ischemic heart disease was the reason in 6 patients, previous hypertension in 4 patients. Chest pain was the reason of the consultation in 6 patients, dyspnea in 3 patients, syncope in 1 patient. 4) Definite diagnoses could be made in 91 patients with 96 diagnoses which were hypertension and its complications in 28, arrhythmia with underlying disease in 16, ischemic heart disease in 14. valvular heart disease in 11, non-cardiovascular disease in 19. Cardiological follow up was recommended in 57 patients. However, 25 patients (44%) were lost to follow-up. Conclusion : Cardiological consultation was frequent in the elderly patients. Most frequent reason for consultation was EGG abnormalities. Hypertension or arrhythmia was most common final diagnosis. Inoperability due to cardiovascular problems were rare.

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

Analysis of properties of lactic acid bacteria isolated from traditional salted-fermented Alaska pollack roe, Myungran-jeot

Chae-Eun Kim,Se-Young Oh,Myeong-Jin Lee,Seung-Hyun Lee,Bo-La Choi,Eun-Ji Jo,Kyung-Bon Lee,Tae Hoon Kim,Eun-Seo Lim,Eun-Woo Lee 한국수산과학회 양식분과 2016 한국수산과학회 양식분과 학술대회 Vol.2016 No.10

Evaluation of probiotics characteristics and synbiotics activity of strains isolated from Korean traditional marine fermented foods

Chae-Eun Kim,Se-Young Oh,Yang-Ho Kim,Jin-Su Kim,Eun-Ji Lee,Jung-Kil Seo,Eun-Seo Lim,Kyung-Bon Lee,Tae-Hoon Kim,Eun-Woo Lee 한국수산해양기술학회(구 한국어업기술학회) 2017 한국수산해양기술학회 학술발표대회 Vol.2017 No.11