지역보건의료계획 수립에 있어 지역의료보험자료의 활용가능성

이상이,김철웅,문옥륜,Lee, Sang-Yi,Kim, Chul-Woung,Moon, Ok-Ryun 대한예방의학회 1997 예방의학회지 Vol.30 No.4

The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.

Enhancement of Antigen-specific Antibody and CD8⁺ T Cell Responses by Codelivery of IL-12-encapsulated Microspheres in Protein and Peptide Vaccination

Sung, Young-Chul,Lee, Sung-Hee,Kim, Byong-Moon,Kwak, Hyun-Hee,Kim, Hye-Ju,Yang, Se-Hwan,Chang, Jun,Park, Su-Hyung 대한면역학회 2007 Immune Network Vol.7 No.4

Although IL-12 has been widely accepted to playa central role in the control of pathogen infection, the use of recombinant IL-12 (rIL-12) as a vaccine adjuvant has been known to be ineffective because of its rapid clearance in the body. Methods: To investigate the effect of sustained release of IL-12 in vivo in the peptide and protein vaccination models, rIL-12 was encapsulated into poly (A_DL-lactic-co-glycolic acid) (PLGA). Results: We found that codelivery of IL-12-encapsulated microspheres (IL-12EM) could dramatically increase not only antibody responses, but also antigen-specific CD4⁺ and CD8⁺ T cell responses. Enhanced immune responses were shown to be correlated with protective immunity against influenza and respiratory syncytial virus (RSV) virus challenge. Interestingly, the enhancement of CD8⁺ T cell response was not detectable when CD4⁺ T cell knockout mice were subjected to vaccination, indicating that the enhancement of the CD8⁺ T cell response by IL-12EM is dependent on CD4⁺ T cell help. Conclusion: Thus, IL-12EM could be applied as an adjuvant of protein and peptide vaccines to enhance protective immunity against virus infection.

Arabidopsis ubiquitin-specific protease 6 (AtUBP6) interacts with calmodulin

Moon, Byeong-Cheol,Choi, Man-Soo,Kang, Yun-Hwan,Kim, Min-Chul,Cheong, Mi-Sun,Park, Chan-Young,Yoo, Jae-Hyuk,Koo, Sung-Cheol,Lee, Sang-Min,Lim, Chae-Oh,Cho, Moo-Je,,Chung, Woo-Sik Plant molecular biology and biotechnology research 2005 Plant molecular biology and biotechnology research Vol.2005 No.

Calmodulin (CaM), a key Ca^(2+) sensor in eukaryotes, regulates diverse cellular processes by interacting with many proteins. To identify Ca^(2+)/CaM-mediated signaling components, we screened an Arabidopsis expression library with horseradish peroxidase-conjugated Arabidopsis calmodulin2 (AtCaM2) and isolated a homolog of the UBP6 deubiquitinating enzyme family (AtUBP6) containing a Ca^(2+)-dependent CaM-binding domain (CaMBD). The CaM-binding activity of the AtUBP6 CaMBD was confirmed by CaM mobility shift assay, phosphodiesterase competition assay and site-directed mutagenesis. Furthermore, expression of AtUBP6 restored canavanine resistance to the △ubp6 yeast mutant. This is the first demonstration that Ca^(2+) signaling via CaM is involved in ubiquitin-mediated protein degradation and/or stabilization in plants. ⓒ 2005 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

Predictors of Chronic Kidney Disease in Korean Patients with Lupus Nephritis

MOON, SU-JIN,KWOK, SEUNG-KI,JU, JI HYEON,PARK, KYUNG-SU,PARK, SUNG-HWAN,CHO, CHUL-SOO,KIM, HO-YOUN The Journal of Rheumatology 2011 The Journal of rheumatology Vol.38 No.12

<B>Objective.</B><P>Since chronic kidney disease (CKD) is closely associated with cardiovascular disease and mortality as well as endstage renal disease, prediction of progressive CKD is a clinically important issue. We investigated the independent risk factors for the development of CKD in patients with lupus nephritis (LN).</P><B>Methods.</B><P>The cohort included 322 Korean patients diagnosed with LN between 1985 and 2010. We retrospectively analyzed the clinical and laboratory indices, treatment response, the final renal function, and the biopsy findings. The timing and cumulative risk of developing CKD were identified by Kaplan-Meier methods. The independent risk factors for developing CKD were examined by univariate and multivariate Cox proportional hazards regression analyses.</P><B>Results.</B><P>The median followup time after the diagnosis of LN was 84 months. CKD occurs in 22% of the patients within 10 years after the diagnosis of LN. The probability of developing CKD was significantly associated with the onset time of LN (delayed-onset LN vs initial-onset LN; HR 2.904, p = 0.003), deteriorated renal function [an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m<SUP>2</SUP> body surface area] at the onset of LN (HR 7.458, p < 0.001), relapse of LN after achieving remission (HR 2.806, p = 0.029), and resistance to induction therapy (HR 8.120, p < 0.001).</P><B>Conclusion.</B><P>Our results demonstrate that delayed-onset LN, a decreased eGFR at the time of LN onset, and the failure to achieve a sustained remission are predictors for the development of CKD in Korean patients with LN.</P>

Role of Acid and Weakly Acidic Reflux in Gastroesophageal Reflux Disease Off Proton Pump Inhibitor Therapy

Sung, Hea Jung,Cho, Yu Kyung,Moon, Sung Jin,Kim, Jin Su,Lim, Chul Hyun,Park, Jae Myung,Lee, In Seok,Kim, Sang Woo,Choi, Myung-Gye Korean Society of Neurogastroenterology and Motili 2012 Journal of Neurogastroenterology and Motility (JNM Vol.18 No.3

<P><B>Background/Aims</B></P><P>Available data about reflux patterns and symptom determinants in the gastroesophageal reflux disease (GERD) subtypes off proton pump inhibitor (PPI) therapy are lacking. We aimed to evaluate reflux patterns and determinants of symptom perception in patients with GERD off PPI therapy by impedance-pH monitoring.</P><P><B>Methods</B></P><P>We retrospectively reviewed the impedance-pH data in patients diagnosed as GERD based on results of impedance-pH monitoring, endoscopy and/or typical symptoms. The characteristics of acid and weakly acidic reflux were evaluated. Symptomatic and asymptomatic reflux were compared according to GERD subtypes and individual symptoms.</P><P><B>Results</B></P><P>Forty-two patients (22 males, mean age 46 years) were diagnosed as GERD (17 erosive reflux disease, 9 pH(+) non-erosive reflux disease [NERD], 9 hypersensitive esophagus and 7 symptomatic NERD). A total of 1,725 reflux episodes were detected (855 acid [50%], 857 weakly acidic [50%] and 13 weakly alkaline reflux [< 1%]). Acid reflux was more frequently symptomatic and bolus clearance was longer compared with weakly acidic reflux. In terms of globus, weakly acidic reflux was more symptomatic. Symptomatic reflux was more frequently acid and mixed reflux; these associations were more pronounced in erosive reflux disease and symptomatic NERD. The perception of regurgitation was related to acid reflux, while that of globus was more related to weakly acidic reflux.</P><P><B>Conclusions</B></P><P>In patients not taking PPI, acid reflux was more frequently symptomatic and had longer bolus clearance. Symptomatic reflux was more frequently acid and mixed type; however, weakly acidic reflux was associated more with globus. These data suggest a role for impedance-pH data in the evaluation of globus.</P>

Applying Novel Nutrient Drink to Clinical Trial of Functional Dyspepsia

( Chul Hyun Lim ),( Myung Gyu Choi ),( Myong Ki Baeg ),( Sung Jin Moon ),( Jin Su Kim ),( Yu Kyung Cho ),( Jae Myung Park ),( In Seok Lee ),( Sang Woo Kim ),( Kyu Yong Choi ) 대한소화기기능성질환·운동학회 2014 Journal of Neurogastroenterology and Motility (JNM Vol.20 No.2

Background/AimsThe drink test has been regarded as a surrogate marker of gastric accommodation. The aims of this study were to develop anovel nutrient drink test (NDT) protocol and investigate its potential for application to a clinical trial of functional dyspepsia (FD). MethodsA novel NDT was designed, involving drinking 125 mL of nutrient 4 times at 5-minute intervals or until maximal tolerability. Healthy volunteers and patients with FD rated their symptoms every 5 minutes for 20 minutes in a developmental study. Patients with FD were enrolled in an open trial of itopride for 4 weeks. NDT was performed before and after treatment. Improvement of integrative symptoms score during NDT after treatment for more than 50% compared with baseline was definedas responder. ResultsTotal aggregate symptom scores, sum of symptom scores measured during NDT, were higher in FD patients (n = 40, 368.1± 245.3) than in controls (n = 19, 215.9 ± 171.2) (P = 0.018) in a developmental study. In an open trial of itopride, symptomscores measured during NDT decreased significantly at all time points after treatment in responders (n = 49), whereas didnot in non-responders (n = 25). Total aggregate symptom score for NDT correlated significantly with integrative dyspepticsymptom score, sum of 8 symptom scores of NDI questionnaire, at baseline (r = 0.374, P = 0.001) and after treatment (r= 0.480, P < 0.001). ConclusionsOur novel NDT can quantify dyspeptic symptoms and reflected therapeutic effects of itopride treatment in a clinical trial of FDpatients. This NDT can be used as an effective parameter in clinical trials or drug development programs for assessing effectsof novel therapies on postprandial symptoms.

Clinicopathological characteristics and prognostic factors in combined hepatocellular carcinoma and cholangiocarcinoma

Sang Eun Park,Sung Ha Lee,Jae Do Yang,Hong Pil Hwang,Si Eun Hwang,Hee Chul Yu,Woo Sung Moon,Baik Hwan Cho 한국간담췌외과학회 2013 한국간담췌외과학회지 Vol.17 No.4

Backgrounds/Aims: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an uncommon subtype of primary liver cancer that has rarely been reported in detail. This study was performed in order to evaluate the clinicopathological characteristics and prognostic factors of cHCC-CC in single center. Methods: The clinicopathological features of patients diagnosed and operated with cHCC-CC at Chonbuk National Hospital between July 1998 and July 2007 were retrospectively studied by comparing them with patients with only hepatocellular carcinoma (HCC) who had undergone a hepatic resection during the same period. Results: Ten out of 152 patients who had undergone a hepatic resection were diagnosed with cHCC-CC and thus included in this study (M : F=8 : 2, median age: 52±11.1 years). According to the parameters of the 7th American Joint Committee on Cancer T staging, there were 76 (50.0%), 44 (28.9%), 9 (5.9%), 18 (11.8%) and 5 (3.3%) patients with T stages 1, 2, 3a, 3b and 4, respectively. The overall survival period was longer in the HCC only group (68±40.4 months) than in the combined cHCC-CC group (23±40.1 months) (p<0.0001). The 5-year survival rate was 10% in the cHCC-CC group and 60% in the HCC group (p<0.0001). The disease free survival for patients with cHCC-HCC and HCC were 16±37.4 and 51±44.3 months, respectively (p<0.0001). Univariate analysis revealed that age, gender, transarterial chemoembolization (TACE), and T stage were statistically significant in terms of patient’s overall survival. However, there were no significant clinicopathological factors identified by the multivariate analysis. Conclusions: Even after the hepatic resection in the HCC, the prognosis is poorer if the patient has cholangiocellular components compared to the usual HCC.

Extent of resection for T2N0 gallbladder carcinoma regarding concurrent extrahepatic bile duct resection

Sung-Chan Gwark,Shin Hwang,Ki-Hun Kim,Yong-Joo Lee,Kwang-Min Park,Chul-Soo Ahn,Deok-Bog Moon,Tae-Yong Ha,Gi-Won Song,Dong-Hwan Jung,Gil-Chun Park,Sung-Gyu Lee 한국간담췌외과학회 2012 한국간담췌외과학회지 Vol.16 No.4

Backgrounds/Aims: Gallbladder carcinoma (GBCa) T2 lesions are considered to be advanced tumors showing diverse features in tumor extent. When this T2 lesion does not involve the cystic duct and there is no evidence of lymph node metastasis, we have to consider what is the most reasonable extent of resection - that is, whether to perform concurrent extra-hepatic bile duct resection (EHBD) resection or not. This study intends to evaluate the adequacy of EHBD resection in patients undergoing resection for T2N0 GBCa. Methods: From our institutional database of GBCa, 48 cases of T2N0 GBCa who underwent R0 resection during November 1995 and August 2008 were selected. Patients who underwent prior laparoscopic cholecystectomy were excluded. Their medical records were reviewed retrospectively. Results: Their mean age was 63.2±83.3 years and females were 25. The mean serum CA19-9 level was 37.3±89.3 ng/ml. The extents of liver resection were wedge resection (n=36) and segment 4a+5 resection (n=12). Concurrent EHBD resection was performed in 16 (33.3%) patients. No fatal surgical complication occurred. The majority of tumor pathology was adenocarcinoma (n=42), with additional unusual types as papillary (n=3), saromatoid (n=1), signet ring cell (n=1) and adenosquamous (n=1) cancers. The overall survival rate was 87.1% at 1 year, 69.5% at 3 years and 61.7% at 5 years. After exclusion of mortalities not related to cancer, the overall patient survival rate was 89.6% at 1 year, 72.9% at 3 years and 64.7% at 5 years, with 3-year survival rates of 72% in the EHBD resection group and 69.2% in the non-resection group (p=0.661). Conclusions: The results of this study indicate that concurrent EHBD resection did not improve patient survival when R0 resection was achieved in patients with T2N0 GBCa. Therefore, routine EHBD resection may not be indicated for T2N0 GBCa unless the tumor is close to the cystic duct. (Korean J Hepatobiliary Pancreat Surg 2012;16:142-146)

External Application of Fermented Olive Flounder (Paralichthys olivaceus) Oil Alleviates Inflammatory Responses in 2,4-Dinitrochlorobenzeneinduced Atopic Dermatitis Mouse Model

Sang-Chul Han,Gyeoung-Jin Kang,Yeong-Jong Ko,Hee-Kyoung Kang,Sang-Wook Moon,Yong-Seok Ann,Eun-Sook Yoo 한국독성학회 2012 Toxicological Research Vol.28 No.3

Allergic skin inflammation such as atopic dermatitis (AD) is characterized by edema and infiltration with various inflammatory cells such as mast cells, basophils, eosinophils and T cells. Thymic stromal lymphopoietin (TSLP) is produced mainly by epidermal keratinocytes, as well as dermal fibroblasts and mast cells in the skin lesions of AD. Omega-3 polyunsaturated fatty acids in fish oil can reduce inflammation in allergic patients. Fermentation has a tremendous capacity to transform chemical structures. The antiinflammatory effects of fish oil have been described in many diseases, but the beneficial effects by which fermented olive flounder oil (FOF) modulates the allergic response is poorly understood. In this study, we produced FOF and tested its ability to suppress the various allergic inflammatory responses. The ability of FOF to modulate the immune system was investigated using a mouse model of AD. The FOF-treated group showed significantly decreased immunoglobulin E (IgE) and histamine in serum. Also, the increased TSLP expression was significantly inhibited in the FOF group; the FOF-treated group was not appreciably different from the hydrocort cream treatment group. In addition, FOF treatment resulted in a smaller spleen size with reduced the thickness and length compared to the induction group. Splenocytes from mice treated with FOF produced significantly less IFN-γ, IL-4, T-box transcription factor (T-bet) and GATA binding protein 3 (GATA3) expression compared with the induction group. These results suggest that FOF may be effective in treating the allergic symptoms of AD. 5.

Podand-Mediated Transport of Ag^(+) in a Bulk Liquid Membrane System

Moon-Hwan, Cho,Sang-Chul, Lee,Seung-Chang, Yang,Song-Seok, Shin,Kyong-Tae, Kim 江原大學校 附設 環境硏究所 1997 環境硏究 Vol.14 No.-

The Podand I(Figure 1) has been studied as cation carrier in a bulk liquid membrane system. ag^(+) and some other transition metal ions(M^(2+)=Cu, Ni, Co, Zn, and Cd) have been transported using the podand as carrier in a bulk liquid membrane system. Studies in the transport of equimolar mixture of two or three competing components have also been carried out with the same system. Ag^(+) exhibited a higher transport rate than the other M^(2+) in the competitive experiments. Ligand structure and the equilibrium constant for complex formation are important parameters in the transport of the metal ions.