우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계

강혜영,강대룡,장영화,박성은,최원정,문성환,양규현,Kang, Hye-Young,Kang, Dae-Ryong,Jang, Young-Hwa,Park, Sung-Eun,Choi, Won-Jung,Moon, Seong-Hwan,Yang, Kyu-Hyun 대한예방의학회 2008 예방의학회지 Vol.41 No.5

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

다슬기(Semisulcospira libertina)의 생식세포 형성 및 생식시기에 관한 연구

강태완 춘천교육대학교 과학교육연구소 1998 과학교육연구 Vol.22 No.-

In this studies, histological changes of the Semisulcospira libertina which inhabited in the Gulgi-ch’on. Kang won-do, were observed during the period from March to Octover in 1997. The results of these investigations were summarized as follows: 1. Semisulcospira libertina was a gonochorism, and ovoviviparity. 2. Young melania snails of S. libertina were discharged from the mid June to the end of August.

조혈모세포이식술이 골수기질세포의 기원 및 조골세포로의 증식 및 분화에 미치는 효과

강무일,조성원,오은숙,백기현,이원영,오기원,김혜수,한제호,윤건호,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

A Study on the Energy Consumption of Energy Poverty Households

Kang-Guk Lee,Gyu-Yeob Jeon,Won-hwa Hong 한국생활환경학회 2017 한국생활환경학회지 Vol.24 No.4

This study was conducted to identify requirements and improvements for policies related to energy welfare by investigating and analyzing household characteristics, residential building information, elements of energy use, and energy welfare status among the energy poverty. In this study, the energy consumption of the energy poverty and support policies are investigated, and characteristics of each are analyzed. The average number of household members in the energy poverty group was 2.3, and the average monthly household income of the households was 93.3 million won. The average expenditure on energy use per year was 947,957 won, which was the highest in January, February, and December. The most desirable energy welfare policy was the reduction or reduction of electricity cost.

The Political and Administrative Culture of Modernizing Korea and Its Impact Upon Political Integration

Kang,Chi Won(姜致遠) 국민대학교 법학연구소 1979 法政論叢 Vol.1 No.1

광범위 베타 락탐계 항생제 분해 효소를 생성하는 폐렴간균에 의한 균혈증이 발생한 환자에서 감영의 위험 인자 및 치료 결과

강철인,김성한,방지환,김홍빈,박상원,최영주,오명돈,김의종,최강원 대한감염학회 2003 감염과 화학요법 Vol.35 No.2

목적 : 본 연구는 ESBL을 생성하는 K. pneumoniae에 의한 균혈증 환자에서 감염의 위험 인자 및 치료 결과를 알아보고자 시행하였다. 방법 : 1998년 1월부터 2002년 4월까지 혈액 배양 검사에서 동정된 K. pneumoniae를 대상으로 NCCLS guidelines과 이중 디스크 확산법(double-disk diffusion test)을 이용하여 ESBL 생성 여부를 확인하였다. ESBL 생성 균주에 의한 균혈증 환자 60명(환자군)에 대해 ESBL을 생성하지 않는 균주에 의한 균혈증 환자들(대조군)을 연령, 성별, 균혈증 발생 시점을 고려하여 1:2 또는 1:3으로 배정하였다. 총 159명의 대조군을 선정하였고 후향적인 환자-대조군 연구를 시행하였다. 결과 : 환자군과 대조군 사이에 연령, 성별, APACHE Ⅱ score, 주된 감염 부위의 유의한 차이는 없었다. ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 발생할 독립적인 위험 인자에는 요관 삽입, 균혈증 발생 이전 72시간 동안 침습적인 시술을 받은 경우, 균혈증 발생 이전 30일 동안 투여받은 항생제 개수가 있었다. 초기 항생제 치료 72시간 후의 반응을 평가하였을 때, 완전 반응(complete response)은 대조군에서 더 많았고(13.3% vs. 40.3%, P<0.001), 치료 실패(treatment failure)는 환자군에서 더 많았다(33.3% vs. 11.9%, P<0.001). 7일 사망률은 환자군에서 20% (12/60), 대조군에서 15.6% (25/159)이었고(P=0.451), 30일 사망률은 환자군에서 30% (18/60), 대조군에서 24.5% (39/159)이었다(P=0.410). ESBL 생성 균주에 의한 균혈증이 있는 환자들에서 최종 항생제 치료가 부적절했던 환자들을 제외하고 30일 사망률을 분석하였을 때 효과적인 항생제 치료의 지연은 사망률을 높이지 않았다(11.1% vs. 9.1%, P=1.000). 결론 : ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 있는 환자에서 초기 항균제 치료 72시간 후의 치료 반응률은 낮지만 사망률은 유의하게 증가하지 않았다. 원인균이 동정된 후 최종 치료 항생제의 선정이 적절하다면 초기에 효과적인 항생제 투여의 지연은 사망률을 유의하게 증가시키지는 않았다. Background : This study was conducted to evaluate risk factors for infection and treatment outcome of bloodstream infection due to extended spectrum β-lactamases(ESBL)-producing K. pneumoniae. Methods: ESBL production was evaluated by NCCLS guidelines and/or double-disk synergy test in K. pneumoniae blood isolates stored from January, 1998 to April, 2002. Sixty patients with bloodstream infection due to ESBL-producing K. pneumoniae (case patients) were compared with 159 matched control patients with bloodstream infection of non-ESBL-producing K. pneumoniae. Retrospective case-control study was performed. Results : There were no significant differences in age, sex, APACHE Ⅱ score, and the primary site of infection between the case and control groups. In multivariate analysis, significant independent risk factors associated with bloodstream infection due to ESBL-producing K. pneumoniae were urinary catheterization, invasive procedure within previous 72 hours, and the number of antibiotics administered within previous 30 days. In clinical response at 72 hours after initial antibiotic treatment, complete response rate was higher in the controls (13.3% vs. 40.3%, respectively, P<0.001), however, treatment failure rate was higher in the cases (33.3% vs. 11.9%, respectively, P<0.001). Overall 7-day mortality rates in the cases and the controls were was 20% (12/60) and 15.7% (25/159) (P=0.451), respectively, and overall 30-day mortality rates were 30% (18/60) and 24.5% (39/159), respectively (P=0.410). When the patients with bloodstream infection of ESBL-producing organism were evaluated and the patients who received inadequate definitive antibiotic treatment were excluded, delayed effective antibiotic treatment was found to be not associated with higher mortality. Conclusion : In patients infected with ESBL-producing K. pneumoniae bacteremia, clinical response rate at 72 hours after antimicrobial therapy was lower, but the increase of mortality rate was not significant. Delayed effective antibiotic treatment was not associated with higher mortality, when definitive appropriate antibiotic treatment was prescribed.

Investigation of the April 2000 forest fire damage in Kang-won Province, Korea, using RADARSAT data

Kang, Sung Chul,Seo, Jin Won,Lee, Tae Hee,Park, Sang Eun,Hong, Suk Young,Moon, Wooil M. 대한원격탐사학회 2000 International Symposium on Remote Sensing Vol.16 No.1

The series of forest Fires in Kangwon Province in April, 2000, were one of the mast serious ones in the Kang-won Province in recent years. The fire damaged areas are extensive and this paper investigates the utility of the satellite image data, particularly the RADARSAT SAR data. One of the main objectives of this study included evaluation of potential usefulness of the C-band RADARSAT data in the detection of forest fires in mountainous areas. Among several fire damaged sites, the area near Samchuk (city) was selected as the main study area and mufti-temporal RADARSAT(raw) data were acquired and the processed results were comparatively investigated with the IRS-1c data acquired shortly after the fire. To identify the burnt area from the undamaged background in the optical imagery, supervised classification and NDVI processing were carried out and tested with the IRS-1C data. For this experiment, several sets of raw RADARSAT standard and Fine mode (S4, F3, ascending orbit) data were processed and the final image was formed. In addition to the final image, sigma nought (σ°) was catnputed and compared for the burnt area against the undamaged areas. Because of the steep slopes in the study area and subsequent deviation from the flat surface scattering models, the fire scars in the sigma nought (σ°) image were not apparent. However, fire scars are slightly detected in the difference and ratio images obtained from the signal intensity data acquired at different dates (bath before and after fire). Texture analysis of the image data including the burnt areas were carried out using the Multiplicative Markov Random-Field (MMRF) algorithm. The detection of the fire damaged area from both standard mode and fine mode RADARSAT was not as straightforward as in optical data. However, Previous studies with ERS-1 S_AR and RADARSAT data in Indonesia and in the North American Plains indicate that C-band SAR data provide us with an effective tool for studying the forest fire damages. However, the application of C-band SAR data to the analysis of the forest fire areas requires careful processing of the data with realistic scattering models.

한국 프로야구 운영상의 문제점과 개선방안

강유원(Kang Yu-Won) 한국체육과학회 2000 한국체육과학회지 Vol.9 No.2

We could conclude that there would be a positive solution on managing Korean Baseball League in active. Currently, the management of a corporation owning a professional baseball team and the KBO regulations are so positive and owned by those corporations of professional baseball teams. In the beginning of Korean Baseball League, there was a great amount of promoting efficiency by team owners since the economic situation of KBL wasn't good enough. But, because of this unbalanced managed system, the team competition had been worse and those baseball fans had left their home teams. Finally, KBO and those team owners have made the lowest profit from the fans because of their wrong managements and faults. From now on, there should be the moment that this wrong system must be changed. They must realize that the game is shown by those athletes and those fans love the fair games of athletes. There won't be any profits if the system wouldn't be based on those athletes and fans. They have to improve the circumstances and environments of athletes' treatments and freedom from any bad regulations. In addition, there should be a great marketing of getting variety focuses from baseball fans who really want great service from team owners. The professional baseball is a great model of any professional sports. In amateur sports, there is only athletes' efforts needed, but in professional, it's not. Those owners should throwaway that their short term of profits only. If they are thinking of great amounts of profits, they have to improve and develop for athletes and fans continuously. We expect that there will be fine teams and fans from their professional system of team owners and KBO.

다기관 기능부전을 초래한 치명적인 삼일열 말라리아 증례

박상원,김동우,박주원,이순일,신영학,김의종,오명돈,최강원 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

삼일열 말라리아는 국내에서 재유행하고 있는 감염질환으로, 일반적으로 양성의 임상경과를 거친다. 저자들은 특이한 질병력이 없이 건강하였던 젊은 성인이 국내에서 삼일열 말라리아에 걸린 후 다기관기능부전과 폐출혈으로 사망한 증례를 경험하였다. 환자의 중증 임상경과를 설명할 만한 특이한 인자가 발견되지 않았다. Vivax malaria is a re-emerging infectious disease in Korea with cumulating 19,416 cases as of December 2003 since 1993. Vivax malaria is generally a benign disease with few severe complications. Even in the worldwide literature, there are only small number of case reports on severe complications. We experienced a fatal vivax malaria in a previously healthy young adult with severe multi-organ failure and fatal massive pulmonary hemorrhage. The patient presented with abdominal pain and shock. There were splenic hemorrhage, disseminated intravascular coagulation, oliguric acute renal failure requiring dialysis, and pulmonary hemorrhage leading the patient finally to death. The initial parasitemia was 2,046/μL. Thin smear and PCR revealed only Plasmodium Vivax. There was no explainable cause of death except for the only serological suggestion of Mycoplasma pneumoniae infection without correlating clinical evidence. This is a first case of fatal vivax malaria in Korea since its re-emergence in 1993. Further case monitoring is needed to define whether this is a index case or an isolated one.

관해유도 항암요법을 받는 백혈병 환자에서 진균 감염증의 예방 : 무작위 배정법과 이중 눈가림법에 의한 Fluconazole과 Nystain의 효과에 관한 다기관 공동연구 A Randomized, Double-blind, Multicenter Trial to Compare Fluconazole with Nystatin

최강원,오명돈,배현주,백경란,박선양,김병국,신완식,강문원,진종률,박종원,김춘추,김동집,한지숙,민유홍,이선주,고윤웅 대한화학요법학회 1993 대한화학요법학회지 Vol.11 No.2

Fluconazole의 진균 감염증 예방 효과와 안전성에 관하여 3개 대학병원에서 관해유도화학요법을 받는 급성 백혈병환자를 대상으로 무작위 배정법과 너도나도 누가림법에 의하여 연구하였다. 모두 62명의 환자에게 fluconazole(100㎎ bid) 또는 nystatin(1,000,000IU/day)을 무작위로 투여하였다. 투약은 관해유도화학요법과 같은 날짜에 시작하여 호중구수가 1,000㎣이상으로 회복되거나 진균 감염증이 확인되거나 의심되어 Amphotericin-B를 시작하거나, 약과 관련된 부작용이 나타날 때까지 계속하였다. 진균 colonization은 fluconazole군에서 감소하였으나 nystqatin군에서는 증가하였다, 표재성 진균감염증으로 nystatin군에서 C. albicans 진균혈증 1례와 C.parasilosis 진균혈중 1례가 발생하였다. 경험적 항진균요법으로 Amphotericin-B를 투여한 경우는 fluconazolerns 34명중 7례(21%), nystatinrns 28명중 10례(36%)였다(p<0.05). Fluconazole군과 nystatin군 사이에 부작용이나 사망률에 차이는 없었다. 결론적으로, fluconazole은 관해유도화학요법을 받는 급성 백혈병환자에서 진균의 colonization을 줄이는데 효과적이고 안전한 항진균제이다. We made a randomized, double-blind, multicenter trial to compare the efficacy and safety of fluconazole with nystatin for prevention of fungal infections in patients with acute leukemia. Sixty-two adult undergoing remission induction chemotherapy for cute leukemia were enrolled. Patients were randomly assigned to receive either fluconazole (100㎎ bid) or nystatin(1,000,000IU×6/day) with corresponding placebo. The study drug was started in initiation of chemotherapy and continued until recovery of neutrophil counts(>1,000/㎣), development of proven or suspected invasive fungal infection, or the occurrence of drug-related toxicity. Fungal colonization decreased in fluconazole(F) group, however increased in nystain(n) group. Superficial fungal infection occurred in 1 of 34 F group, whereas invasive fungal infection developed in 3 of 28 N group. Empirical amphotericin-B therapy was given in 7 of 34(21%) F group and 10 of 28(36%) N group(p>0.05). The incidence of drug-related side effects and overall moratlity were similar in both study groups.