이스라엘잉어 장관 수축에 관여하는 약물수용체에 관한 연구

윤효인,한경호,박승춘,조준형,오태광,Yun, Hyo-in,Han, Kyong-oh,Park, Seung-chun,Cho, Joon-hyoung,Oh, Tae-kwang 대한수의학회 1994 大韓獸醫學會誌 Vol.34 No.3

In order to elucidate the characterization of receptors involved in inestinal motility of Israeli carp, spontaneously contracting Israeli carp intestinal preperations were prepared and mounted in the organ chambers for contraction traicings using a polygraph. Various contractile agonists were treated and their dose-response curves were constructed. $EC_{50}$ values$(pD_2)$ of each agonist on specific receptors, $pA_2$ values of competitive antagonists against some agonists, and $K_1$, values of noncompetitive antagonists against some agonists were analyzed for characterization of receptors related with the intestinal contraction. Results obtained through the experiments were summarized as follows: 1. Acetylcholine(ACh) exhibited biphasic dose-response curves: initial ACh-induced dose dependent contractions were observed in pM levels but followed by decreased response in in-between concentration levels. Dose dependent contractions reappeared in ${\mu}M$ level. The peaks in pM and ${\mu}M$ levels appeared in $10^{-13}M$ and $3{\times}10^{-5}M$, respectvely. 2. Carbachol(CaCh) exhibited dose dependent contractions from $10^{-9}M$ to $10^{-5}M$, and its $pD_2$ values were higher than those of ACh($5.60{\pm}0.11$). ACh and CaCh exhibited equiactive contractions. Nicotine had no effects on contractile responses of Israeli carp intestine. 3. ACh-induced responses were inhibited by atropine($K_1:7{\times}10^{-8}M$), a muscarinic antagonist, in a non-competitive manner. But CaCh-induced responses were inhibited by both antimuscarinic atropine($pA_2:9.52{\pm}0.14$) and selective $M_2$ antagonistic 4-DAMP($pA_2:8.16{\pm}0.09$), in competitive manners. Nicotine receptor antagonistic decamethonium and hexamethonium had no effects on ACh-and CaCh-induced contractions. Therefore, the cholinergic receptor related to intestinal motility of Israeli carp was assumed as $M_2$ type. 4. In Israeli carp intestine, 5-HT (serotonin) exhibited dose dependent contractions in concentration range from $10^{-8}M$ to $10^{-5}M$. The maximal responses, however, were corresponded to about 50% of those of ACh or CaCh. 5-HT induced contractions were inhibited by $5-HT_2$ antagonistic ketanserin ($K_1: 7.8{\times}10^{-4}M$) in a non-competitive manner, but not by both of anti $5-HT_1$, spiperone and anti $5-HT_3$, MDL-72222. Hence, $5-HT_2$ receptors are suggested to be existed in Isreli carp intestine.

Celay/In-Ceram, Conventional In-Ceram, Empress 2 전부도재관의 변연적합도에 관한 비교 연구

양재호,여인성,이선형,한중석,이재봉,Yang, Jae-Ho,Yeo, In-Sung,Lee, Sun-Hyung,Han, Jung-Suk,Lee, Jai-Bong 대한치과보철학회 2002 대한치과보철학회지 Vol.40 No.2

There have been many studies about marginal discrepancy of single restorations made by various systems and materials. But many of statistical inferences are not definite because of sample size, measurement number, measuring instruments. etc. The purpose of this study was to compare the marginal adaptations of the anterior single restorations made by different systems and to consider more desirable statistical methods in analysing the marginal fit. The in vitro marginal discrepancies of three different all-ceramic crown systems (Celay In-Ceram. Conventional In-Ceram. IPS Empress 2 layering technique) and one control group (PFM) were evaluated and compared. The crowns were made from one extracted maxillary central incisor prepared with a 1mm shoulder margin and $6^{\circ}$ taper walls by milling machine. 10 crowns per each system were fabricated. Measurements or a crown were recorded at 50 points that were randomly selected for marginal gap evaluation. Non-parametric statistical analysis was performed for the results. Within the limits of this study, the following conclusions were drawn: 1 Mean gap dimensions and standard deviations at the marginal opening for the maxillary incisor crowns were $98.2{\pm}40.6{\mu}m$ for PFM, $83.5{\pm}18.7{\mu}m$ for Celay In-Ceram, $104.9{\pm}44.1{\mu}m$ for conventional In-Ceram, and $45.5{\pm}11.5{\mu}m$ for IPS Empress 2 layering technique. The IPS Empress 2 system showed the smallest marginal gap (P<0.05). The marginal openings of the other three groups were not significantly different (P<0.05). 2 The marginal discrepancies found in this study were all within clinically acceptable standards ($100\sim150{\mu}m$). 3. When the variable is so controlled that the system may be the only one, mean value is interpreted to be the marginal discrepancy of a restoration which is made by each system and standard deviation is to be technique-sensitivity of each one. 4. From the standard deviations. the copy-milling technique (Celay/In-Ceram) was not considered to be technique-sensitive in comparison with other methods. 5. Parametric analysis is more reliable than non-parametric one in interpretation of the mean and standard deviation. The sample size of each group has to be more than 30 to use parametric statistics. The level of clinically acceptable marginal fit has not been established. Further studies are needed.

<i>In vitro</i> and <i>in vivo</i> evaluation of a novel polymer-free everolimus-eluting stent by nitrogen-doped titanium dioxide film deposition

Park, Dae Sung,Bae, In-Ho,Jeong, Myung Ho,Lim, Kyung Seob,Sim, Doo Sun,Hong, Young Joon,Lee, So-Youn,Jang, Eun Jae,Shim, Jae-Won,Park, Jun-Kyu,Lim, Han Chul,Kim, Han Byul Elsevier 2018 Materials Science and Engineering C Vol.91 No.-

<P><B>Abstract</B></P> <P>Inflammation and thrombosis are linked to the use of polymer-based drug-eluting stents (DES). The aim of this study was to develop a polymer-free everolimus (EVL)-eluting stent using nitrogen-doped titanium dioxide (N-TiO<SUB>2</SUB>) and verify its efficacy by <I>in vitro</I> and <I>in vivo</I> assessment in a porcine coronary model. Various analytical approaches such as scanning electron microscopy and atomic force microscopy, electron spectroscopy, Fourier transform infrared spectrometry and contact angle measurement were employed for the characterization. As a part of biocompatibility assessment, platelet adhesion and smooth muscle cell (SMC) proliferation were examined. Bare metal stent (BMS), N-TiO<SUB>2</SUB> stent, everolimus-eluting N-TiO<SUB>2</SUB> (N-TiO<SUB>2</SUB>-EVL) stent, and commercialized EVL-eluting stent (EES) were randomly placed in forty coronary arteries in twenty pigs. After four weeks of implantation, the stents were subjected to histological and quantitative analysis. The N-TiO<SUB>2</SUB> film used in this study was well coated without any cracks or peeling. Surface hydrophilicity (88.8% of angle decrement) could be associated with the decrease in surface roughness post N-TiO<SUB>2</SUB> deposition (37.0%). The platelet adhesion on the N-TiO<SUB>2</SUB> surfaces was less than that on the BMS surface. The proliferation of SMC was suppressed in the N-TiO<SUB>2</SUB>-EVL group (30.2%) but not in the BMS group. In the animal study, the percent area restenosis was significantly decreased in the N-TiO<SUB>2</SUB>-EVL group compared to that in the BMS group. The results (BMS; 47.0 ± 11.00%, N-TiO<SUB>2</SUB>-EVL; 31.7 ± 10.50%, and EES; 29.1 ± 11.21%, <I>n</I> = 10, <I>p</I> < 0.05) were almost at par with those of the commercialized EVL-eluting stent. The introduction of N-TiO<SUB>2</SUB> deposition during fabrication of polymer-free DES may be an efficient accessorial process for preventing in-stent restenosis and thrombosis.</P> <P><B>Highlights</B></P> <P> <UL> <LI> N-TiO<SUB>2</SUB> surfaces can help to reduce the platelet adhesion. </LI> <LI> In porcine model, N-TiO<SUB>2</SUB> everolimus decreased in-stent restenosis and fibrin deposition. </LI> </UL> </P>

Uncoupling Protein 3의 골격근 세포내 과발현이 OLETF 백서 및 배양된 골격근 세포에서 포도당대사에 미치는 영향

한정희,박혜선,고정민,김하영,강호경,이인규,박중열,홍성관,이재담,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:Uncoupling protein(UCP)는 미토콘드리아의 내막에 위치하는 단백질로 세포내의 과다한 에너지를 열로 발산시키는 기능을 가진다. 최근 동물의 갈색지방조직에만 존재하는 UCP와 유사성을 가진 아형들(UCP2,3)이 사람에게도 존재함이 알려져 큰 관심을 끌도 있는데 이중 UCP3는 그 발현이 골격근세포와 갈색지방조직에만 국한된다. 본 연구에서는 UCP3가 체내 인슐린 감수성을 결정하는데 가장 중요한 조직인 골격근에 국한되어 발현되는 점에 착안하여 UCP3를 골격근세포에 과발현시켰을 때 포도당 대사에 어떠한 영향이 나타나는 지를 조사하였다. 방법:25주령의 8마리의 OLETF 백서를 대상으로 하여 4마리는 골격근에 adenovirus 2mL(1×10¹²pfu/mL)를 주사하여 대조군으로 하였고 4마리는 골격근에 재조합법으로 제작된 adenovirus­UCP3 2mL(1×10¹²pfu/mL)를 주사하였다(UCP3 과발현군). UCP3를 투여한 백서에서 먹이섭취가 증가하는 경향이 있어 그 전날 대조군이 먹은 야의 먹이만큼 투여하였다. 골격근에 adenovirus를 주사한 10일 후에 euglycemic hyperinsulinemic clamp를 시행하였다. Adenovirus­UCP를 C2C12 골격근 세포에 transfection시켜 UCP3를 C2C12 골격근 세포에 transfection시켜 UPS3­C2C12를 만들고 C2C12 골격근 세포와 UPS3­C2C12 골격근 세포에서 포도당 수송 및 당원합성을 측정하였다. 결과:UCP3 과발현 OLETF에서 체중이 감소하는 경향을 보였고 인슐린 감수성이 증가하였다. C2C12세포에서 기저상태 포도당 수송은 1.28±0.17μmol/L/min였고 100nM 인슐린으로 2시간 처리한 후 2.67±0.20 μmol/L/min로 증가하였다. UCP3­C2C12 세포에서는 기저상태 포도당 수송이 3.98±0.13μmol/L/min로 증가되었고 인슐린 처리 후 5.74±0.44μmol/L/min로 증가하였다. 인슐린을 처리한 UCP3­C2C12 세포에 P13K 억제제인 wortmannin을 첨가하였을 때 포도당 수송활성이 3.81±0.20μmol/L/min로 감소하였다. 기저상태 당원합성은 C2C12 세포에서 0.25±0.01μmol/L/min였고 인슐린 처리 후 0.45±0.01μmol/L/min로 증가하였다. UCP3­C2C12 세포에서는 기저상태 당원합성이 0.62±0.01μmol/L/min였고 인슐린 처리 후 1.26±454μmol/L/min로 증가하였다. UCP3­C2C12세포에 wortmannin을 첨가하였을 때 당원합성율이 0.80±0.04μmol/L/min로 감소하였다. 결론:UCP3 과발현이 OLETF 백서에서 인슐린 감수성을 증가시켰고 골격근세포에서 포도당 수송 및 당원합성을 증가시켰다. wortmannin을 첨가하였을 때 포도당 수송 및 당원합성이 감소함으로 보아 이 과정이 인슐린 신호전달체계인 P13K에 일부 의존함을 알 수 있었다. Background : UC P3 is a mitochondrial membrane protein expressed selectively in the skeletal muscle and brown adipose tissue. Since the skeletal muscle is the main organ determining insulin sensitivity in the body, it was hypothesized that UCP3 overexpression in skeletal muscle cells would improve glucose metabolism. Methods : An adenovirus-UCP3 was produced by a recombinant DNA method. OLETF rats were divided into 2 groups. Four rats were injected with the adenovirus-UCP3 (UCP3 group) and others were injected with the adenovirus(control group) in the skeletal muscle. The UCP3 group was provided with the same quantity of food as that consumed by the control group on the previous day. Insulin sensitivity was evaluated by the euglycemic hyperinsulinemic clamp method. In a separate experiment, glucose transport and glycogen synthesis we evaluated in C2C212 cells transfected with ether an adenovirus or the adenovirus-UCP3. Results : The insulin sensitivity improved significantly and the body weight decreased in the UCP3 group. The glucose transport and glycogen synthesis were higher in the UCP3-C2C12 skeletal muscle cells at the basal state. After insulin treatment, glucose transport and glycogen synthesis were also higher in the UCP3-C2C12 cells but the increments were reduced after treatment with wortmannin, a PI3K inhibitor. Conclusion : Insulin sensitivity was higher in the UCP3-overexpressed OLETF rats in the in vivo study. UCP3 transfection also increased glucose transport and glycogen synthesis in the cultured skeletal muscle cells by a PI3K dependent mechanism(J Kor Diabetes Asso 25 :460~468, 2001).

韓國에 있어서 肝吸蟲症 分布에 관한 疫學的 硏究

宋寅喆,李駿商,林漢鐘 고려대학교 의과대학 1983 고려대 의대 잡지 Vol.20 No.1

Korea, a total number of 19,758 stool specimens were collected from the inhabitants who lived in the basins of main 6 rivers, i.e. the Han River, the Gum River, the Nakdong River, the Mangyong River, the Yongsan River and the Seomjin River. The specimens were examined both by cellophane thick smear method and Stoll's egg counting technique during the period from March 1973 to October 1982. The distribution and infection rates were compared in those of river and non-river sides, and the epidemiological statrs was analysed statistically by the regression equations and catalytic curves with the results obtained from two endemic areas. The results are as follows: 1. High egg positive rates were revealed among the inhabitants in the areas of all above river basins, whereas low egg positive rates were obtained among the inhabitants in the areas apart from the riversides. However, in some areas which are not directly connected with the rivers, relatively high rates of Clonorchis infection were also observed. 2. The infection rates of Clonorchis sinensis by sex age were shown significantly different among the population in the most of these studied areas. The rates for males were significantly higher than that for females, and the rates were increased by the higher age groups up to 40 to 59 years old. However in the high endemic areas such as Kimhae the infection rates of both sexes were almost parallel and practically similar high rates revealed in all age groups for 20 to 60 years old. 3. The mean E.P.G. count of Clonorchis infection in the surveyed areas was found higher in the areas which shown as higher infection rates. The degree of the intensity of Clonorchis infection by E,P.G. counts was evenly distributed to heavy and very heavy infections as well light and moderate infections in the areas showed high infection rates. 4. The intensity of endemicity in all surveyed areas was compared with the regression equations calculated with the cumulative percentages of E.P.G. counts. 5. For the quantitative analysis of epidemiology of clonorchiasis in Kimhae and Pyongtrek areas, special type of simple catalytic model was applied to the age prevalence rates revealed through stool examination for Clonorchis eggs and intradermal test for the detection of positive reactors. 6. It was suggested that the two-stage catalytic was well fitted to the prevalince rates by sex and age in the egg positive cases in Kimhae and Pyongtaek areas, and the calculation lead to the equation y=1.042(e-^(0.003t)-e^(-0.074t), a=0.074〉b=0.003 in Kimhae area, and y=1.412(e^(-0.024t)-e^(-0.041t), a=0.024〈b=0.041 in Pyongtaed area. 7. In the high endemic area such as Kimhae, the tendency of familial aggregation was not recognized by statistical analysis. In this area, the mean E.P.C. obtained from same persons in 1973 were compared and descussed statistically.

Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer

김인아(In Ah Kim),최일봉(Ihl Bhong Choi),강기문(Ki Mun Kang),장지영(Jie Young Jang),문한림(Han Lim Mun),송정섭(Jung Sub Song),이선희(Sun Hee Lee),곽문섭(Mun Sub Kuak),신경섭(Kyung Sub Shinn) 대한방사선종양학회 1997 Radiation Oncology Journal Vol.15 No.1

목 적 : 국소진행된 III기 비소세포성 폐암에서 방사선감작제로서의 저용량 Cisplatin과 방사선 동시병합요법의 효과를 알아보고자하여, 관해율, 전체생존율, 무병생존율 및 치료에 따른 부작용을 방사선 단독치료군과 후향적으로 비교분석하였다. 대상 및 방법 : 1992년 4월부터 1994년 3월까지 32명의 III기 비소세포성 폐암환자(IIIa 12명, IIIb 20명)가 항암제 및 방사선동시병합요법을 받았다. 방사선치료는 3000cGy/ 10회를 2주간에 걸쳐 시행한 뒤 3주후에 2500cGy/ 10회를 추가하였으며, 방사선감작제로 cis platin 6mg/m2를 매일 방사선치료 전에 정맥주사하였다. 추적관찰기간은 13개월에서 48개월로 중간값은 24개월이었다. 방사선단독치료군 32명(IIIa 13명, IIIb 19명)은 매일 170- 200cGy씩 총 5580- 7000cGy (중간값 5960cGy) 치료받았으며, 추적관찰기간은 36개월에서 105개월로 중간값은 62개월이었다. 결 과 : cis platin- 방사선동시요법군이 방사선 단독치료군에 비해 유의하게 높은완전반응률(18.8% vs . 5.6%)및 낮은 조사야내 재발율(25% vs . 47%)을 나타내었다. 2년 전체생존율은 Cisplatin- 방사선동시요법군이 17%, 방사선단독치료군이 9.4%로 유의한 차이는 보이지 않았다.국소재발 없는 2년 무병생존율(16.5% vs. 5.3%) 및 원격전이 없는 2년 무병생존율(17% vs. 4.6%)도 두군간에 유의한 차이를 보이지 않았다. 그러나 Karnofsky performance scale 80 이상인 환자군만을 대상으로 분석한 결과, cisplatin- 방사선동시요법군이 방사선단독치료군에 비해 유의하게 높은 2년 전체생존율을 보였다(62.5% vs. 15.6%). 전체생존율에 영향을 미치는 예후인자로 cisplatin- 방사선동시요법군에 있어서는 performance status 및 조직학적 진단유형(상피세포암 vs. 비상피세포암)으로 나타났고, 방사선단독치료군에 있어서는 performance status 및 병기(IIIa vs. IIIb)로 나타났다. 치료에 따른 급성부작용으로 RTOG/ECOG grade 2 이상의 오심, 구토는 cisplatin- 방사선동시요법군이 방사선단독치료군 (22% vs. 6%)에 비해 유의하게 높은 빈도를 나타내었다. Gra de 2 이상의 혈액학적 독성은 Cis platin- 방사선동시요법군에서 방사선단독치료군에 비해 높은 빈도를 나타내었다(25% vs. 15.6%). 방사선단독치료군에 비해 cis platin- 방사선동시요법군에서, RTOG/ECOG Grade 2 이상의 폐독성의 빈도(31% vs. 19%)나 WHO Grade 3 이상의 폐섬유화의 빈도(38% vs. 25%)의 유의한 증가는 관찰되지 않았다. 방사선치료부위의 면적이 200cm2 이상이었던 경우, 두군 모두에서 폐독성 빈도의 유의한 증가를 보였다. 결 론 : cisplatin- 방사선동시병합요법이 방사선단독치료군에 비해 높은 국소제어율을 나타내었으나, 전체생존율이나 무병생존율의 유의한 증가는 보이지 않았다. KPS 80이상인 환자군에 있어서는 cisplatin- 방사선동시요법군이 방사선단독군에 비해 높은 전체생존율을 보였다. cisplatin- 방사선동시병합요법군에서 급성부작용이 증가되는 경향을 보였으나, 방사선에 의한 폐독성의 유의한 증가는 관찰되지 않았다. cisplatin- 방사선동시병합요법군이 방사선단독치료군에 비해 1년 이내에 조기사망율이 높은 반면, 2년이상 장기생존율이 높은 경향을 보여, 이러한 환자군에 대한 장기적인 추적조사를 통해 생존율에 대한 본 치료의 영향을 좀더 명확하게 평가할 수 있을것으로 기대되며, 향후 치료효과를 증가시키기위해 large fraction size의 split course RT 대신 continuous course의 conventional RT 혹은 hyperfractionated RT와 Cisplatin의 동시병합요법 등이 고려되어야할 것으로 사료된다. Purpose : This study was tried to evaluate the potential be nefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation thera py alone in stage III non- small cell lung cancer. The end points of analyses were responserate , overalls urvival, survival without locoregional failure , survival without distant metastasis , prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300cGy given 10 times up to 3000cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250cGy given 10 times up to 2500cGy) was combined with 6mg/M2 of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months . Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170- 200cGy) radiation therapy a lone. Total radiation dose ranged from 5580cGy to 7000cGy with median of 5940cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months . Results : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%). CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%). The overall survival rate had no significant differences in between CRT group and RT group(17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastas is (17% vs. 4.6% at 2 years) also had no significant differences . In subgroup analyses for patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a prognostic factors . RTOG/EORTC grade 2-3 nausea and vomiting(22% vs. 6%) and bone marrow toxicities (25% vs. 15.6%) were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmona ry toxicity had no significant differences in between CRT group and RT group (16% vs. 6%). The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group(38% vs . 25%). In analyses for relationship of field size and pulmonary toxicity, the patients who treated with field size beyond 200cm2 had s ignificantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performa nce status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good pe rformance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. The refore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

인간안보와 한국 외교

현인택,김성한 고려대학교 일민국제관계연구원 2001 국제관계연구 Vol.5 No.1

Many countries have derived enormous economic benefits from the end of the Cold War. Yet, the income gap between the industrialized and developing worlds has continued to widen. This trend has been compounded in some countries by internal conflict and state failure. At the same time, new security threats have emerged, including an increase in transnational crime and the proliferation of weapons of mass destruction. Armed conflict has taken on a different shape and is often rooted in religious or ethnic discord. Growing international recognition of human cost of conflict, in addition to other post-Cold War developments, has led the international community to reexamine the whole concept of security. This evolution in the perception of international security has resulted in a new concept of "human security." Human security recognizes that democratic development, human rights and fundamental freedoms, the rule of law, good governance, sustainable development and social equity are as important to global peace as are arms control and disarmament. Various issue areas in human security emerged as paramount as the economic crisis in Asia came to dominate Asia during the last years of the twentieth century. They include political and socio-economic insecurity; intra-state ethnic conflict and involuntary migration; drug-trafficking and transnational crime; environmental degradation; and the transfer of small arms and light weapons. Human security encompasses a wide array of complex issues that are interconnected with each other and thus demand knowledge and information for policy-makers to identify their state interests and recognize the latitude of actions deemed appropriate in specific issue-areas of human security. Thus, an international epistemic community needs to be formed with Korea's initiative to deal with newly emerging human security issues in the Asia-Pacific. If epistemic communities on human security help define the self-interests of a state, then, a coalition among the like-minded countries can be built. At this stage, government officials will try to make issue-based coalitions with other countries to establish allies in many fields of human security. Here, Korea can find some rooms for international cooperation depending on issues. Rapid information exchange could be used to strengthen such activities as addressing human rights abuses or international crime, areas where the rapid exchange of information across borders is essential. The strategy could also play a role in helping to establish free media and counter hate propaganda, and so bolster democracy and reduce likelihood of conflict in bolster democracy and reduce the troubled regions. Tackling the problem of food security is another area which could benefit from enhanced information networks as experts and information sources could be assessed quickly, facilitating the delivery of advice and knowledge. One of the stated aims of the first meeting of the ARF in 1994 was "the enhancement of political and security cooperation within the region as a means of ensuring a lasting peace, stability and prosperity for the region and its peoples." However, the financial crisis in Asia has proven that regional security arrangements are not well organised to handle a prolonged socio-economic shock. The imminent task the ARF faces is to prevent the socioeconomic effects of the financial crisis of Asia from developing into threats to human security. The ARF should identify the risks to security arising from economic, social and environmental problems and discuss their causes and potential consequences. Human security, most of all, is rooted upon protection of human rights, Human rights and regional security issues are inextricably linked. The security of nation states begins with the security of civil society of which they are composed. The security problems that beset the region-notably in Cambodia, North Korea, East Timor, and Myanmar-are the projected shadow of human rights violations. Conflicts cannot be resolved, confidence cannot be built and multilateral cooperation cannot be strengthened unless regional security issues are addressed at their root cause - violations of human rights. Thus, the violation of human rights needs to be prevented. The concepts of "human security" and "global governance" can raise perplexing questions. Whereas human security is concerned primarily with individual welfare conditions, global governance focuses on generalized rules of international regimes. To juxtapose these two concepts into a single thematic sweep may be considered too ambitious at best, or foolhardy at worst. But we are at a critical juncture in human history in which the forces of globalization can tip us toward either more human forms of governance or growing global gaps that will turn the world into islands of riches in oceans of structural poverty, resentment, and violence. Globalization of the world economy and society is increasingly calling for a broader consideration of security to include such humans rights as political, socio-economic, cultural, and environmental security. The opening of a new century has always served as a symbolic turning point in the history of human civilization. When cooperation is accumulated at the regional level, this will contribute to getting closer to global governance. The Asia-Pacific region is at a historical juncture between the roads to self-destruction and self-renewal. Even if the region has been hit by the financial crisis, it will have renewed opportunity of another take-off when it deals effectively with the root causes and effects of the financial crisis. This is the mission of the epistemic community on human security, which will determine the guiding principles of human security and promote regional cooperation through multilateral organizations in a future-oriented manner.

腦腫瘍의 神經精神科的인 側面

兪漢益,尹大炫,柳仁鈞 서울醫大 1997 精神醫學 Vol.22 No.1

Streptozotocin으로 당뇨병이 유도되는 흰쥐에서 Polyenoylphosphatidylcholine (PPC)의 췌장 β세포 보호작용

Che, yongzhe,한유미,박인선 한국노화학회 1998 한국노화학회지 Vol.8 No.3

입원진료비 상승요인 분석

한혜경 ( Hye-kyung Han ),이필도 ( Pil-do Lee ),노인철 ( In-chul Noh ) 한국보건사회연구원 1990 保健社會硏究 Vol.10 No.2

입원진료비의 상승은 높은 약제비 비중, 병원의 높은 수술률, 종합병원 이상의 검사비 등의 영향을 받는 것으로 나타났으며, 횡단면 다중회귀분석에 의한 입원진료비 결정요인은 입원일수, 전문의수, 의료장비수, 연령, 수술여부 등인 것으로 나타났다. 앞으로 45세이상 연령층의 만성질환으로 인한 입원진료비가 더욱 증가할 것이라는 전망에 따라 약제비 및 검사비에 대한 대책, 의료자원의 효율적인 사용을 위한 병원기능의 전문화 등 입원진료비의 경제성을 도모하기 위한 다양한 대책이 요구된다. The rapid increase in medical care costs have become a growing problems since health insurance was introduced. In particular, medical care costs for in-patients have tended to rise at a faster pace than those for out-patients. For example, while the out-patient costs in 1989 increased 3.32 times over those in 1983, the hospital care costs increased 3.75 times during the same period. Furthermore, the scale of hospital care costs continued to rise from about 33 percent in 1983 to 36 percent of the total expenditure in 1989. The principal cause of these increase was related to a considerable rise in medical care costs for out-patients less than 14 years old. Recently, however, the ratio of in-patient costs has risen markedly due to a sharp increase in the costs related to cancer and to chronic diseases of the circulatory system for those over 45. Since this age group continues to increase, it is expected that this pattern will continue as a leading factor in the increase in medical care costs. The concern over rising costs and a search for ways to control these costs are now stimulating interest in the development of public policies. The purpose of this study is, therefore, to examine factors giving rise to the cost escalation of hospital medical care and also to provide insight into the policy implications for containment of these costs. The data used here was obtained from a survey of the monthly insurance bills (13,532 cases) presented to the National Federation of Medical Insurance in February 1990. This group represented the employees and dependents of private companies as well as self-employed people. The main results and their implications are as follows : 1. The important factors which have influenced the increase in the medical care costs for in-patients was revealed as a high medication ratio, more examinations, a longer stay, and a high frequency of surgical procedures in the hospitals. 2. The portion of medication and injection costs was found to be extremely high. Medications constituted 37 % of total hospital care costs in excess of 500,000 Won per case. These extraordinarily high expenditures are due to excessive consumption and high prices. One alternative to limit expenditures on drugs is to establish a list of essential drugs as chosen for cost-effectiveness (low price with equal efficacy). Thus drugs not on this list would not be cove-red by insurance. Also important is the control of pharmacists` mark-ups, drug prices, and advertising expenditures by pharmaceutical firms for sales promotion. 3. The ratio of examination costs was about 30% of the total medical care costs per in-patient case, which was observed to be correlated mainly with the length of stay and the number of examinations, and the quantity of medical equipment in hospitals, so that in recent years the problem of excessive examinations has emerged particularly in both tertiary and general hospitals. The tertiary hospitals are prohibited from offering out-patient care. A committal order written by a physician in a clinic is required for a patient to receive hospital medical care. Both because of the poor flow of information between primary physicians and hospital physicians, and because outside physicians do not have access to superior hospital equipment, hospitals repeat many diagnostic examinations already performed by physicians prior to hospitalization. In fact, such duplication adds to the length of stay and ultimately to medical care costs. In addition, excess investments in such high- tech equipment as CT Scanner, MRI, and heart transplant equipment tend to result in new cost increases, so specialized central examination facilities with high-tech equipment should be established at the district level, both to share inforamtion and their use and to avoid duplication or excessive use of medical procedures and diagnostic tests. 4. The portion of medical procedure and operation costs in hospitals was relatively higher than those in both general hospitals and tertiary hospitals, which appeared to be associated with the high frequency of surgical produres in hospitals. The costs of medications and examinations were, however, shown to be highest in general and tertiary hospitals. One interesting result indicates that there is a negative correlation between surgical procedure costs and examination costs, suggesting that more examinations might reduce the frequency of surgery. 5. To cope with the soaring medical care costs, less expensive service facilities as are used in the developed countries ought to be developed or introduced into the health care sector. For example, there are day care centers, geriatric day hospitals, hospice systems, ambulatory surgical centers, nursing home care and home health care, which can be substituted for expensive hospital services. In addition, surgery and hospital admission and discharge can be managed in a rational manner to curb long-term hospital stays. For example, admission and discharge adjudication committees, composed of doctors including physicians in charge, and nurses and other medical care personnel should be set up in each hospital to check the condition of in-patients periodically to decide on whether they can be discharged.