임부(姙婦)의 산전위험요인평가연구(産前危險要因評價硏究): 일선(一線) 보건요원(保健要員)을 위한 산전관리용(産前管理用) 위험요인적용모형(危險要因適用模型) 개발(開發)

박인화 ( In-hwa Park ),주신일 ( Shyn Ii Joo ) 한국보건사회연구원 1985 保健社會硏究 Vol.5 No.1

1. Background and Purpose of Study The purpose of this study is to develop a risk factor assessment chart that is simple to use by health workers at grass-root level and predictive enough to screen and allocate limited resources to high-risk pregnancy. A risk scoring chart, currently in use by the government sector in the field of maternal and child health in Korea, is based on arbitrary criteria for selection and scoring of risk factors. Therefore this chart has considerable limitations in the statistical sense including the validity of scoring system. Against this backstop, development of a risk factor assessment chart that is valid on statistical consideration is critically indicated for manpower situation as unique in Korea where nurse-aids account for the predominant work-force engaged in the maternal and child health care service at the grass-root level in the public sector. 2. Design of Study Materials: The current study, which is the second phase one, relates to the 3,838 pregnant women reviewed and edited out of the original 4,012 women observed in the first phase of the study (Joo et al., 1982) and is intended to attempt further in-depth analysis of the information on pregnancy and labour of the population. Information on the medical charts of pregnant women who were consecutively delivered at the Busan II Shin Hospital during the first six months in 1981 are the main data source. Relevant information on these medical charts were collected in standardized questionaire that was developed by a Korea Institute for Population and Health research team. Analysis of Data: In principle, four main analyses were undertaken. First, the significance of association between maternal variables and a defined outcome variable which relates to unwanted pregnancy complications and labor/delivery outcomes, was assessed by means of the adjusted chi-square test. A list of variables that were shown statistically significant on chi-square test were selected as risk factors. Therefore, pregnancies with risk factors were categorized as high-risk pregnancy, and those without any were grouped as non-risk pregnancy which, however, were subject to further analysis of next stage. In short, all those non-risk pregnancies found without risk factors under· went analysis of each succeeding stage up 10 final one, fourth stage. Second, odds ratio as an approximation to the relative risk, was calculated to assess the potency of different risk factors associated with the defined outcome variable. Third, validity of each stage of screening scheme was tested. interms 01 sensitivity, specificity and predictability. Finally, a revised risk assessment chart to screen high-risk pregnancy was developed for the use of health workers at grass-root level. 3, Findings First stage of analysis: Six maternal variables including obstetric danger signals identified over chief complaints of the pregnant were examined in relation to the unwanted pregnancy complications and labour/delivery outcomes. The first stage analysis showed that there were significant associat ion between four danger signals of edema, blurred visionf headache, convulsion and bleeding, and the adverse outcome. Risk factors with the highest association are convulsion and edema that are highly correlated with hypertensive disorder 01 pregnancy. The prevalence of the pregnancy with single or more of the four risk factors is found to be 16.3 percent and corresponding odds ralio is 4.59, as shown in Table 8. Second stage of analysis: Non-risk pregnancies that were not exposed to anyone of the statistically Significant danger signals of the first stage of analysis were further divided into two groups, ie., primiparas and multiparas. Six independent variables including age for the group of primiparas and 15 variables for multiparas including the former six for the primiparas were examined in relation to the adverse outcomes. For primipara, age and height are found to be risk factors and for multipara, age, height and seven va riables related to previous obstet ric history are proved to be risk factors. Each prevalence of primiparas and multipa ras who are exposed to single or more of risk factors in each defined group are 4.5 percent and 50.0 percent respectively. Corresponding odds ratios for primipara and multipara thus exposed to risk factors are 4.41 and 3.45 respectively, as shown in Table 11. Third stage of analysis: Those non-risk pregnancies that were continuously left out over the process of first and second stage of analysis underwent further examination. Seven maternal variables that can be easily identified over simple clinical check-up were examined of their effect on the defined outcome variable. Statistically significant are two factors of blood pressure (140/90 mmHg or higher) and presence of pre-eclampsia/eclampsia. The prevalence of pregnancies with single or both of the two risk factors is 5.5 percent with corresponding odds ratio of 1.57, as shown in Table 13. It is comparatively weaker association in contrast with those found in the preceding stages of analysis. Fourth stage or analysis: Those non-risk pregnancies continuously left out over the three stages of analysis were further examined to find out what statistically significant risk factors were out of the 14 selected maternal variables during pregnancy of third trimester. These variables are divided into two groups. ie., one group of nine variables that are easily identifiable during clinical check-up and another group of five variables that would require examination of more skilled health personnel. Significant among the former group are found to be five risk factors including excessive weight gain and among the latter, three risk factors including abnormal size on abdominal examination. The prevalence of pregnancies with one or more of five risk factors in the former group accounts for 11.9 percent with corresponding odds ratio of 2.44, whereas the prevalence of pregnancies with single or more of the lauer`s three risk factors is 20.2 percent with corresponding odds ratio of 3.73. Thus, risk factors that would require expert examination seem to have higher degree of association, as shown in Table 15. Consequently the prevalance of pregnancies with single or more of the above eight risk factors combined. is 29.4 percent with corresponding odds ratio of 3. 19. 4. Conclusion and Recommendation Among the total of 48 maternal variables initially employed for analysis, 26 variables were selected as risk factors. Accordingly study pregnancies were screened at each stage of analysis, depending on the occurrence of the relevant risk factors. In this study, all those classified as high-risk pregnancy account for 41.5 percent-47.6 percent according to the type of screening scheme applied at fourth stage. The predictability of this screening scheme has, at all stages of screening, positive predictive power between 41.7 percent and 69.3 percent, and negative predictive power between 67.0 percent and 89.3 percent. Total correct classification which accounts for the percentage of true positive and negative cases combined among the cases observed, ranges from 67.3 percent to 73.8 percent, as shown in Table 19. High predictability is found of the fourth stage scheme with more complicated risk factors, and lower one, of the second stage scheme with risk factors of age, height, and previous obstetric histories. Positive predictive power of this screening scheme, by and large, is lower than negative predictive power. In conclusion, a risk factor assessment chart proposed in this study for the use of health workers at grass-root level is illustrated in Table 20. This revised scheme is modified out of study results in terms of statistical consideration between risk factors and the outcome variable, logical validation, and practical utility. In the future efforts, selection of risk factors and their cut-off points will be defined in view of balance between the seriousness of the false negative mistakes and the damage done to individuals by the needless use of resources on the false positives. This in turn raises a critical issue in the public health activities; how many and what kind of "mistakes" can be accomodated when resources are limited?

만성 실질환 환자에서 허혈성 심질환에 대한 좌심실 이완기능 장애의 영향

최보경 ( Bo Kyung Choi ),이경남 ( Kyung Nam Lee ),황인혜 ( In Hye Hwang ),김일영 ( Ii Young Kim ),이하린 ( Ha Rin Rhee ),성은영 ( Eun Young Seoung ),송상헌 ( Sang Heon Song ),이동원 ( Dong Won Lee ),이수봉 ( Soo Bong Lee ),곽임수 대한내과학회 2012 대한내과학회지 Vol.83 No.3

목적: 만성 실질환 환자에서 허혈성 심질환은 주된 사망 원인으로, 이와 연관된 위험인자를 파악하고 관리하는 것은 중요하다. 허혈성 심질환과 관련된 심장의 구조적인 변화 중특히 좌심실 이완기능 장애는 최근 발생률이 증가하고 있으며, 예후 또한 불량한 것으로 보고되고 있다. 따라서 본 연구는 만성 실질환 환자를 대상으로 심초음파를 이용하여 좌심실 이완기능 장애를 진단하고, 좌심실 이완기능 장애가 사망률 및 허혈성 심질환의 발생률에 미치는 영향에 대하여 알아보고자 하였다. 방법: 2005년 1월부터 2010년 5월까지 본원에서 심초음파를 시행한 만성 실질환 환자 중, 좌심실 구혈률이 55% 미만, 중등도 이상의 판막질환이 있는 환자와 관찰기간이 6개월 미만인 환자를 제외한 71명의 환자를 대상으로 하였다. 임상적 지표들은 의무기록 조사를 통해 수집하였고, 심초음파 검사, 혈액검사를 후향적으로 분석하였다. 결과: ROC curve를 이용한 허혈성 심질환과 연관된 좌심실 이완기능 장애의 진단 기준값은 E/E` = 15.55 (sensitivity: 100%, specificity: 64.7%, p = 0.005), E/A = 0.79 (sensitivity: 84.6%, specificity: 55.9%, p = 0.006)였다. 이 값을 기준으로 E/E` > 15.55, E/A > 0.79인 19명을 좌심실 이완기능 장애가 있는 환자군, Group I으로 지정하였고, 그 외 나머지 환자 52명을 Group II로 나누었다. 심초음파에서 Group I의 E/A, DT, E/E`값은 각각 1.27, 184.21, 19.08이었고 Group II에서는 0.73, 225.19, 13.58이었다(E/A, p < 0.001; DT, p = 0.017; E/E`, p <0.001). 좌심실 이완기능 장애에 영향을 미치는 인자를 분석하였고 연령, 허혈성 심질환의 병력, 낮은 혈색소 수치, 높은 저밀도 지단백 수치가 관련이 되었다. 또한 허혈성 심질환을 야기시키는 위험인자를 분석하였을 때는 좌심실 이완기능 장애, 흡연, 높은 저밀도 지단백 수치, 높은 부갑상선 호르몬수치가 상관관계가 있었다. 좌심실 이완기능 장애와 사망률 사이의 연관성을 살펴보면, 전체 사망률은 Group I, II에서 유의한 차이를 보이지 않았지만(p = 0.177), 허혈성 심질환을 나타내는 disease free survival로 비교하면 Group I이 Group II보다 의미있게 생존율이 감소하였다(p = 0.001). 결론: 만성 신질환 환자에서 좌심실 수축기능이 정상이라도 E/E` > 15.55, E/A > 0.79인 중등도 좌심실 이완기능 장애를 가진 환자는 허혈성 심질환의 발생률이 높았다. Background/Aims: Cardiovascular complications are commonly seen in patients with chronic kidney disease (CKD). Recently, the prevalence of left ventricular diastolic dysfunction (LVDD) has increased, and the importance of LVDD has emerged in patients with CKD. The objectives of this study were to identify diagnostic criteria for LVDD related to ischemic heart disease (IHD) and evaluate the prognostic impact of diastolic dysfunction in patients with CKD. Methods: A total of 71 patients with CKD who were evaluated between January 2005 and May 2010 were included in this study. These patients were evaluated by conventional echocardiography and tissue Doppler imaging (TDI) for diastolic dysfunction. Results: Diagnostic cutoff values for LVDD related to IHD were E/E` = 15.55 (sensitivity: 100%, specificity: 64.7%, p = 0.005) and E/A = 0.79 (sensitivity: 84.6%, specificity: 55.9%, p = 0.006), Group I consisted of 19 patients with an E/E` > 15.55 and E/A > 0.79. Group II consisted of the remaining patients. Factors contributing to LVDD were age, history of ischemic heart disease, anemia, and high low-density lipoprotein (LDL) level. Factors contributing to IHD were LVDD, smoking, high LDL level, and high parathyroid hormone (PTH) level. The disease-free survival for IHD was significantly lower in group I compared to group II (p= 0.001). However, there was no significant difference in overall survival between groups I and II (p = 0.177). Conclusions: Our study showed that moderate LVDD (E/E` > 15.55 and E/A > 0.79) in patients with CKD is positively associated with IHD.

한국인에서 혈소판 당단백 Ⅲa 유전자 다형성과 급성 관동맥 증후군의 관계

김광일,채인호,김효수,손대원,오병희,이명묵,박영배,최윤식,이영우 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

Resazurin(alarmar Blue™)을 이용한 효과적인 in vitro 항비듬력 즉정법

박병덕 ( Byeang Deog Park ),흥선영 ( Seon Young Hong ),정세규 ( Sekyoojeong ),조인식 ( In Sik Jo ),구형서 ( Hyeong Seo Gu ),한일민 ( Ii Min Han ),이상명 ( Sang Myeong Lee ),이완규 ( Wan Kyu Lee ) 대한화장품학회 1999 대한화장품학회지 Vol.25 No.3

Resazurin(alarmar Blue™)을 이용하여 in vitro 적으로 P. ovale의 최소 발육저지농도 (Minimum Inhibitory Concentration ; MIC)률 측정함으로써 여러 가지 조성의 항비듬제의 항비듬 효과를 측정하고자 하였다. 최적의 실험 조건을 결정하기 위한 기초 실험 결과, 약 2.6 X 105cfu/Mℓ 이상의 농도로 P. ovale가 주입되는 경우 alarmar Blue™ 흡광도의 변화률 정확하게 관찰할 수 있었고, alarmar Blue™ 자체의 희석 배율이 1:1 ~ 1:4 이며,16시간과 24 시간 배양을 하여야 비교적 정량적인 결과를 얻을 수 있었다. alarmar Blue™가 균체의 증식에 미치는 영향을 고찰하여 본 결과 1:1 의 희석 용액에서도 alarmar Blue™가 균체의 증식에 영향을 미치지 못함을 알 수 있었다. Zinc pyrithione과 Climbazole의 혼합계에서 항비듬 효과를 관찰하여 본 결과 일정 혼합비에서 효과적인 항비듬 효과를 관찰할 수 있었고, 현미경 관찰에 의한 MIC 측정 법과, SDDM(Skin-Disk Diffusion Method) 법에 의한 항비듬 효과와 비교하여 본 결과 유사한 경향성을 관찰할 수 있었다. 이상의 결과를 종합해 볼 때 alarmar Blue™를 사용한 in vitro 항비듬 효과 측정법은 시료나 배지의 탁도에 크게 영향을 받지 않으며, Micro-plate reader를 사용함으로써 많은 종류의 시료에 대한 결과를 빠르고 정확하게 얻을 수 있다는 장점을 가지고 있으므로, 향후 효율적인 in-vitro 항비듬 평가 방법으로 활용이 기대된다. We have tried to measure the anti-dandruff effect of the several kinds of formulations by determining the MIC values of the P. ovale which was determined by resazurin(alarmar Blue™). To get high reproducibility, it was suggested that about 2.6 X 105cfu/mℓ of P. ovale should be incubated with alarmar Blue™, optimum dilution ratio between alarmar Blue™ and PBS buffer should be 1:1 - 1:4, and oplimam incubation time should be 16 ~24 hours. Even though 1:1 diluted alarmar Blue™ was incubated with P. ovale,the metabolic activity of P. ovale was not inhibited by alarmar Blue™. The Minimum Inhibitory Concentration(MIC) values of several kinds of anti-dandruff formulation which were the mixture system between Zinc pyrithione and Climbazole make it possible to determine the optimal anti-dandruff formulation, which show similar results with that of microscopic MIC determination and that of SDDM(Skin-Disk Diffusion Method). It is expected that the anti-dandruff test method which uses alarmar Blue™ could be used as an effective in vitro test method because it was not so much affected by the turbidity of the broth and samples, and it can afford the MIC values of many samples within relatively short time by using microplate reader.

Study on colour characteristics depending on orientation of liquid crystal in the in-plane switching mode

Jung, Byoung Sun,Baik, In Su,Song, Ii Sub,Lee, Gi-Dong,Lee, Seung Hee Taylor Francis 2006 Liquid crystals Vol.33 No.9

<P> The degree of colour shift depending on viewing direction in the in-plane switching (IPS) mode has been investigated. The IPS cell with pure twist deformation exhibits a stronger colour shift than that of the IPS cell with tilt as well as twist deformation, although the former has better luminance uniformity in the bright state than the latter. Furthermore, the IPS cell with multi-directional LC orientation, with tilt as well as twist deformation, shows the least colour shift.</P>

코눈물관막힘 환자에서 폴리우레탄 스텐트 삽입술의 장기적 경과

노인호,최미영,차상훈,배일헌 충북대학교 의과대학 충북대학교 의학연구소 2005 忠北醫大學術誌 Vol.15 No.1

Purpose: To assess the long-term results of the nasolacrimal polyurethane stent placement in nasolacrimal obstruction. Subject and Methods: Fluoroscopically guided placement of a polyurethane nasolacrimal stent in Song nasolacrimal stent set was performed in nasolacrimal obstruction. Follow-up was at least 6 months. The success was defined that there was no lacrimal symptoms with lacrimal passage to irrigation at the final visit. Additionally, the symptoms of between the initial and the recurred obstruction were compared. Results: Of the 42 cases in 38 patients, stent placement was technically successful in 38 cases of 34 patients. The analysis was performed in 22 cases of 19 patients because 15 patients had to be excluded due to short follow-up duration. At the final examination, the stent placement was successful in 6 of 22 cases. The mean follow-up duration was significantly longer in the failed group than in the succeeded group (13 months: 50 months, p = 0.000). There was pustile discharge in one of 22 case at initial, while there was discharge in all cases at recurred symptoms, especially pustile or bloody in 6 of 16 cases. Conclusion: The long-term results achieved using polyurethane nasolacrimal stent were not encouraging. The careful follow-up and proper management are necessary to prevent complicated dacryocystitis. 연구목적: 코눈물관막힘 환자에서 폴리우레탄 스텐트 삽입술의 장기적 효과에 대하여 알아보고자 하였다. 대상 및 방법: 코눈물관막힘 환자에서 투시기의 안내 하에 Song 코눈물관 스텐트 세트를 이용하여 폴리우레탄 스텐트를 삽입한 후, 최소한 6개월 이상 관찰한 경우를 대상으로 하였다. 최종 내원 시 증상 및 코눈물관세척의 결과에 따라 성공여부를 결정하였으며, 초진 시와 재발 시의 증상을 비교하였다. 결과: 38명 42예 중 34명 38예에서 폴리우레탄 스텐트의 삽입에 성공하였다. 이 중 관찰기간이 6개월 미만인 경우를 제외하고, 19명 22예에 대하여 분석하였다. 최종 내원 시 성공군은 22예 중 6예이었으며, 성공군에 비하여 실패군의 시술 후 관찰기간이 통계학적으로 유의하게 길었다(13개월: 50개월, p=0.000). 초진 시 고름이 섞인 눈곱이 있었던 경우가 1예이었던 것에 비하여, 재발 시에는 16예 모두에서 눈곱이 있었으며, 이 중 6예에서는 고름이나 피가 섞여 있었다. 결론: 코눈물관막힘 환자에서 폴리우레탄 스텐트 삽입술의 장기적 예후는 부량하였으며, 이차적으로 눈물주머니염이 발생하는 것을 예방하기 위하여 주의 깊은 관찰과 적절한 치료가 필요할 것으로 생각한다.

백서에서 PGE₁이 임의형 배부 피부판의 생존율에 미치는 영향에 대한 실험적 연구

윤경준,김종환,이세일,장효죽,홍인표 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.4

An important aspect of plastic surgery is the survival of skin flap where the maintenance of blood flow is very important. Among the PGs, PGE₁ is used clinically to improve peripheral circulatory disturbances due to its actions of augmenting blood flow by vascular smooth muscle relaxation & its strong inhibitory actions of platelet aggregation. In order to figure out the effects of PGE₁ in increasing the survival rate of vascular insufficiency in cases of local flaps, free flaps & microreplantations of finger amputations & to apply the results of our clinical cases, we are presenting here the experimental results of PGE₁ on the survival of skin flap in rats. 40 male white rats were divided into 4 groups & caudally based 2x8cm sized flap elevation was done including panniculus carnosus on dorsal surface of the rats. In group 1, normal saline (0.25ml/kg) was injected intraperitoneally as control, in group 2, flurbiprofen(30mg/kg) was given intraorally & normal saline injection was done, in group 3, PGE₁ injection was done. In group 3, the skin flap survival area was the largest of all. From our experimental data, we could conclude that PGE₁ is effective for the survival of skin flaps in rats.

폐암의 해부학적 부위와 정량적 폐관류 주사와의 관계

이민수,박상선,고영일,장안수,임성철,양주열,김영철,최인석,박경옥 全南大醫大 1993 전남의대학술지 Vol.30 No.1

공개키를 이용한 SNMPv3 보안 모듈 설계 및 구현

한지훈(Han Ji Hoon),박경배(Park Gyong Bae),곽승욱(Kwak Seung Uk),김정일(Kim Jeong II),정근원(Jeong Keun Won),송인근(Song In Keun),이광배(Lee Kwang Bae),김현욱(Kim Hyen Uk) 한국정보처리학회 1999 정보처리학회논문지 Vol.6 No.1

Uses can share information and use resources effectively by using TCP/IP-based networks. So, a protocol to manage complex networks effectively is needed. For the management of the distributed networks, the SNMP(Simple Network Management Protocol) has been adopted as an international standard in 1989, and the SNMPv2 in which a security function was added was published in 1993. There are two encryption schemes in SNMPv2, the one is a DES using symmetric encryption scheme and the other is a MD5(Message Digest5) hash function for authentication. But the DES has demerits that a key length is a few short and the encryption and the authentication is executed respectively. In order to solve these problems, we use a RSA cryptography in this paper. In this paper, we examine the items related with SNMP. In addition to DES and MD5 proposed in SNMPv3, we enhance security functionality be adopting RSA, a public key algorithm executing the encryption and the authentication simultaneously. The proposed SNMPv3 security module is written in JAVA under Windows NT environment.

Effective Microorganism Substance (EM-S) Reduces Development and Aggravation of Atopic Dermatitis-Like Skin Lesions in NC/Nga Mice

( Kwang Hyun Park ),( Seung Ii Jeong ),( Ji Ye Mok ),( Jung Keun Cho ),( Ji Min Park ),( In Hwa Jeon ),( Hyeon Soo Kim ),( Seon Il Jang ) 한국응용생명화학회 2011 Applied Biological Chemistry (Appl Biol Chem) Vol.54 No.2

In a previous study, our group showed that the effective microorganism substance (EM-S) produced by fermentation of medicinal plants with effective microorganisms has an anti-inflammatory effect on atopic dermatitis-like lesions in NC/Nga mice. However, the possible anti-inflammatory effect and skin barrier function of EM-S for inflammatory cell infiltration, Interleukin-4 (IL-4) production, C-C chemokine receptor 10 (CCR10), and filaggrin (FLG) expression were not reported. Therefore, effects of EM-S on the development of atopic dermatitislike skin lesions in NC/Nga mice were evaluated. Efficacy of EM-S was judged by measurement of scratching behavior, T-cell subset infiltration, cytokine production, and FLG expression. Topical application of EM-S significantly reduced scratching behavior in NC/Nga mice caused by house dust mite antigen (Dermatophagoides farinse extract, DfE) sensitization. IL-4 production and CD4+ and CD45+ cell infiltrations were significantly reduced by EM-S. CCR10 expression was also significantly inhibited by EM-S. EM-S treatment also increased the level of FLG reduced by DfE sensitization. These results demonstrate EM-S, when applied topically, may be an effective substance for management of atopic dermatitis patients.