화농성 슬관절염이 동반된 수막구균성 수막염 1예

김태연,유진홍,박성환,김연식,임상현,신완식,강문원,정창훈,최문구,강지민 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.2

저자들은 최근 화농성 슬관절염과 병발한 수막구균성 수막염 1예를 체험하였고, 이는 국내에서 아직 보고되지 않은 드문 예로 사료되어 문헌고찰과 함께 보고하는 바이다. We recently experienced a case of meningococcal meningitis associated with pyogenic arthritis in a 37-year old male patient. Pyogenic arthritis developed in right knee joint during treatment for meningococcal meningitis. He was treated successfully by appropriate antibiotics and arthroscopic irrigation. To our knowledge, such a rare case has not ever been reported in Korea, Hence we report this case with a review of related literatures.

Short term effects by acupuncture to SP3 on the autonomic blood flow control.

Lee, Seungmin,Chae, Younbyoung,Kim, Seung-Nam,Kim, Song-Yi,Park, Ji-Yeun,Kwark, Young-Rong,Kang, O-Seok,Lee, Hyejung,Yin, Chang Shik,Park, Hi-Joon Butterworths [etc.] 2010 Neurological research Vol.32 No.suppl1

<P>OBJECTIVES: In this study, we investigated the short term effects of acupuncture on autonomic control of blood flow in healthy subjects. We also studied whether deqi (obtaining qi) sensations are correlated with these autonomic hemodynamic changes. METHODS: The experiment had a randomized, crossover design. Five healthy volunteers (age: 18-26 years) participated in this study. Acupuncture (2 Hz rotations for 10 seconds to 20 mm deep) was applied either to the acupuncture point SP3 or KI2 for 5 minutes. Non-invasively obtained continuous hemodynamic measurements of ultrasound Dopplerography were recorded at the radial artery before, during and after acupuncture stimulation. Cardiovascular autonomic tone was also recorded using power spectral analysis of heart rate variability. After acupuncture stimulation, the participants completed the acupuncture perception scales to measure the degree of deqi or pain they had experienced. RESULTS: Acupuncture stimulation to the acupuncture point SP3, when compared to the acupuncture point KI2, decreased the maximum systolic velocity. It also decreased low frequency component and increased high frequency component of heart rate variability, indicating that the decrease in systolic blood flow velocity was due to the increased parasympathetic response. Interestingly, warm, radiating and energetic feeling, which are related to deqi, had close correlations with the decrease in blood flow velocity. DISCUSSION: Acupuncture stimulation to the acupuncture point SP3 modulates the autonomic cardiovascular responses by enhancing parasympathetic function, and this may help to understand the therapeutic effects of acupuncture.</P>

The successful clinical outcomes of pregnant women with advanced chronic kidney disease

( Ji Yeun Chang ),( Hanbeol Jang ),( Byung Ha Chung ),( Young Ah Youn ),( In Kyung Sung ),( Yong Soo Kim ),( Chul Woo Yang ) 대한신장학회 2016 Kidney Research and Clinical Practice Vol.35 No.2

Background: Successful pregnancy outcomes in patients with advanced chronic kidney disease (CKD) are increasingly common in Western countries. However, in Korea, the available literature addressing this clinical issue is scarce. Methods: We reviewed 5 successful parturitions [1 patient with Stage 5 CKD and 4 with maintenance hemodialysis (HD)] at Seoul St. Mary``s Hospital over 3 years and investigated changes in dialysis prescription, anemia management, and the incidence of maternal and neonatal complications. Results: There were no maternal or neonatal deaths in this cohort. The mean age at the time of conception and delivery was 35.8 ± 3.7 and 36.2 ± 3.5 years, respectively. Dialysis patients received more frequent and intensified HD during pregnancy, 20.0 ± 5.7 h/wk of HD over 5 visits with the ultrafiltration dose maintained between 1 and 2 kg per session. All patients received erythropoietin-stimulating agents and iron replacement therapy during pregnancy. The mean hematocrit was 33.1 ± 1.9% before pregnancy and was well maintained during gestation (33.9 ± 3.8% at the first trimester, 29.2 ± 4.2% at the second trimester, and 33.6 ± 8.7% at delivery). The mean gestation period was 32.7 ± 4.7 weeks, with 60% of patients experiencing premature delivery. The primary maternal complication was pre-eclampsia; 3 women developed pre-eclampsia and underwent emergency cesarean sections. Most neonatal complications were related to preterm birth. Conclusion: Dialysis-related care and general clinical management improved the clinical outcome of pregnancy for patients with advanced CKD.

LETTER TO THE EDITOR : Recurrent neutropenia induced by rifabutin in a renal transplant recipient

( Ji Yeun Chang ),( Eun Gyo Jeong ),( Ji Hyun Yu ),( Byung Ha Chung ),( Chul Woo Yang ) 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.4

돌봄노동의 사회화 유형과 여성노동권

장지연(Chang, Ji-Yeun) 한국여성연구소 2011 페미니즘 연구 Vol.11 No.2

돌봄노동의 사회화는 다섯 가지 유형으로 구분할 수 있다. 어떤 방식의 사회화는 돌봄서비스의 생산을 주로 민간시장에 의존하게 만듦으로서, 돌봄노동의 상품화(또는 시장화)를 촉진할 가능성이 매우 높다. 또 다른 특정한 방식의 사회화는 돌봄의 역할을 결국 다시 가족, 그 중에서도 여성에게 부여하여 돌봄노동의 재가족화를 낳는다. 한 사회가 가지고 있는 돌봄노동의 성격은 여성의 임금노동 접근권과 일자리의 질에 영향을 미친다. 돌봄노동의 재가족화는 돌봄에 대한 국가개입이 주로 현금지급 중심으로 이루어지는지, 현물급여(서비스)의 제공에 초점이 두어지는지에 따라 결정된다. 돌봄 관련 수당제도는 여성의 노동공급에 부정적인 영향을 미치는 것으로 분석되었고, 특히나 이러한 영향은 소득계층별로 달리 나타날 수 있음에 주목하였다. 즉, 돌봄 관련 수당제도는 저소득층 여성의 노동공급을 줄일 가능성이 더 클 것으로 예측할 수 있다. 돌봄노동의 상품화는 돌봄서비스 일자리의 질을 악화시킨다. 돌봄서비스 제공에 있어서는 전달체계의 기본적인 틀이 공공화 되어 있는 국가들은 시장화되어 있는 국가들에 비하여 돌봄서비스 일자리의 임금수준이 높은 것으로 나타났다. 이것은 전반적인 여성노동자의 근로조건 향상에도 영향을 미칠 것으로 예상된다. The public interventions to care work affect women’s labor participation as well as quality of care jobs in the market. We identify five different patterns of ways in which care work has been socialized. Some ways of intervention tend to reinforce the commodification of care work through producing it in the market area. Other ways of intervention has a lot of hazard to return care work to women in the families, after all. We can call it re-familization. Whether care work is re-familized or not largely depends on the ways of public supports for care: cash benefit vs. in-kind benefit. Cash benefits for women’s care work negatively affect on their labor market participation. The effects vary across family income levels. In other words, you may expect that cash benefits for care work may reduce female labor supply in lower income classes. The marketization of care service provision may worsen the quality of care jobs while the public provision tends to increase the wage level of care jobs.

특집 : 소득불평등 심화의 메커니즘과 정책 선택

장지연 ( Ji Yeun Chang ),이병희 ( Byung Hee Lee ) 민주사회정책연구원 2013 민주사회와 정책연구 Vol.23 No.-

소득불평등의 심화 현상을 노동시장 임금불평등, 인구 고령화, 가구의 노동공급, 그리고 재분배 정책의 효과성 측면에서 검토하였다. 소득불평등도를 시계열적으로 살펴보면, 1980년대 말에 불평등도가 크게 완화되었다가 1990년대 중반 이후에 다시 악화되는 추세가 발견된다. 이 시기는 1987년 노동운동이 활성화된 시점과 1997년 외환위기 시점과 각각 일치한다. 최근 15년간 소득불평등의 악화를 초래한 요인으로 가장 주목해야 할 것은 노동시장 임금불평등의 확대이다. 임금불평등의 추이는 가구소득 변화와 추세적으로 일치한다. 그럼에도 임금불평등이 가구소득불평등으로 온전히 전이되지는 않았는데, 이것은 저소득층의 적극적인 소득활동 참여에 힘입은 것이었다. 그러나 이러한 효과를 향후에도 지속적으로 기대하기는 어려울 것으로 예상된다. 저소득층 여성의 노동시장 진입이 가구주의 임금불평등을 상쇄하는 역할을 하였다는 이전 연구결과가 있으나, 최근까지 관찰기간을 연장해서 살펴본 바에 따르면 그런 효과는 나타나지 않았다. 또한 선진국 여성과 커다란 격차를 보이는 부분이 고소득 가구주배우자의 노동시장 참여인 것을 감안하면 향후 가구소득 불평등이 심화될 가능성은 더 커진다. 저소득층의 적극적인 노동시장 참여가 포화상태에 이르고 나면, 노동시장의 임금불평등이 고스란히 가구소득 불평등으로 이어지게 되므로 재분배 정책을 통해 소득불평등을 완화해야 할 부담은 지금보다 훨씬 더 커지게 된다.부족한 공적 소득이전을 지속적으로 확대해나가야 하는 것은 분명하지만, 계속 확대되는 임금격차를 방치한 채 소득이전을 통해 불평등을 줄여나가는 정책은 한계가 있다. The intensification of income inequality was studied based on the wage inequality of the labor market, aging of the population and household labor supply and the effectiveness of wealth redistribution policies. From a times series approach, income inequality dropped significantly in the late 80s and began to intensify after the mid 90s. The changes coincide with the activation of labor movements in 1987 and the financial crisis in 1997. During the last 15 years, the most noteworthy factor driving income equality is the increase of wage inequality in the labor market. The rise and fall of wage inequality coincides with the changes and trends of household income. Even so, wage inequality did not fully translate to household income inequality thanks to the active labor force participation of the low income classes. However, it is unlikely that such effects will continue. Labor market participation from low-income class females offset the wage inequality of household heads, but analyses of recent years show that such effects have disappeared. Considering that spouses` labor market participation of high-income household heads in Korea shows a large difference with females in developed countries, it is unlikely that household labor supply patterns will continue to mitigate inequality. Once labor market participation from low-income classes saturates, the wage inequality in the labor market will directly translate to household income inequality. Hence, redistribution policies will have to play a larger role in easing income inequality. Public income transfer must be gradually increased, but there are limits to reducing inequality through income transfer without tending to the wage gap.

소득 양극화와 자살

장지연 ( Ji Yeun Chang ),신동균 ( Dong Gyun Shin ) 한국사회보장학회 2010 사회보장연구 Vol.26 No.2

이 글의 목적은 소득 분배의 양극화가 어떤 경로를 통하여 자살률을 증가시키는가에 대한 논거를 제시하며 나아가 이 가설을 실증적으로 뒷받침하는 데에 있다. 소득 자료의 국가 간 비교를 용이하게 할 목적으로 구축된 CNEF(the Cross-National Equivalent File)자료에 근거하여 한국을 포함한 6개 국가에 대한 패널 데이터를 이용하여 분석한 결과, 자살률을 설명함에 있어서 소득분포와 관련된 주요 요인은 소득이 얼마나 불평등하게 분포되어 있는가가 아니라 얼마나 양극화되어 있는가, 즉 소득 집단 간 이동성이 얼마나 단절되어 있는가인 것으로 판명되었다. This paper explains how bi-polarization of an income distribution increases the suicide rate of a society. Following Lee and Shin (2009), it is hypothesized that upward mobility from the low to the high income group is reduced, as the income distribution is more bipolarized, which lowers both the expected future income of the poor and their incentive to supply labor in the legal labor market. Consequently, with other things being constant including income inequality, suicide rates are expected to increase as the income distribution is more bipolarized. Our analysis based on the CNEF(Cross-National Equivalent File) data reveals that suicides rates as well as labor force participation rates are better explained by bi-polarization rather than inequality of an income distribution.

중,고령자 노동시장의 구조와 노동이동

장지연 ( Ji Yeun Chang ) 민주사회정책연구원 2007 민주사회와 정책연구 Vol.11 No.-

비만을 동반한 폐경이 Group 구심성 신경의 대사적 수용기에 미치는 영향

김지연(Ji-Yeun, Kim),김종경(Hosung Nho),노호성(Jong-Kyung Kim),장명재(Myoung Jei Chang) 한국생활환경학회 2012 한국생활환경학회지 Vol.19 No.6

Both obesity and menopause cause the dysfunction of autonomic nervous system. Recent human studies have reported that exercise pressor reflex (EPR)-mediated increases in blood pressure are exaggerated in obese or postmenopausal women. Whether these findings can be extended to both obese and postmenopausal women remains unclear. Mean arterial pressure (MAP), cardiac output (CO), and total vascular conductances (TVC) were measured in normal premenopausal women (NPW; n = 11; 36 ± 2 yr), normal postmenopausal women (NPOW; n = 14; 57 ± 1 yr), and overweight postmenopausal women (OPOW; n = 14; 56 ± 1 yr) at baseline, and during static handgrip at 50% maximal voluntary contraction (MVC) followed by a period of postexercise muscular ischemia (PEMI) to isolate the metabolic component of the EPR. Changes in MAP from baseline were augmented in OPOW subjects during both 50% MVC handgrip (P < 0.05), and these group differences were maintained during PEI (P < 0.05). There were no differences in heart rate (HR), stroke volume (SV), and CO during hand grip exercise and PEMI among groups. Even though there was no group difference in TVC during exercise and PEMI, the TVC tended to be abolished in OPOW group. In summary, compared with NPW subjects, OPOW group exhibit exaggerated pressor responses to handgrip exercise that are maintained during PEMI, indicating that activation of the metabolic component of the EPR is augmented in OPOW group. The exaggerated pressor response mediated by the muscle metaboreflex activation in OPOW group mainly occurs via preperial vasoconstriction with little change in CO.

여성인구변동과 노동시장

장지연(Ji-Yeun Chang) 한국인구학회 1998 한국인구학 Vol.21 No.2

본 논문은 지난 3001년간 여성노동시장의 변화의 추이를 출산력 감소 등 인구학적 요인의 변화의 영향을 중심으로 살펴 보았다. 여성의 경제활동참가율에 영항을 미칠 것으로 여겨지는 인구학적 요인들로는 교육, 혼인상태, 출산 등이 중요하다. 여성의 학력 수준이 평균적으로 높아지고, 결혼을 늦게 하는 추세이며, 자녀 수는 줄어드는 추세이다. 이러한 경향이 인구의 구성에 미치는 영향은 경제활동가능인구 중 고학력 여성의 비율이 증가하고 어린 자녀를 둔 여성의 비율은 줄었으며, 기혼 여성의 비율은 큰 변화가 없는 상황이다. 이러한 인구 구성의 변화가 여성의 경제활동참가율을 증가 시킨 것은 사실이다. 이에 더하여, 같은 인구학적 특성을 갖는 여성 집단의 노동력공급행태도 변화하였다. 고학력으로 분류할 수 있는 고졸, 대졸 여성의 경제활동참여율이 초졸, 중졸 여성의 참여율보다 빠르게 증가하였고, 혼인하여 배우자가 있는 여성의 경제활동참가율이 미혼여성의 그것보다 빨랐다. 출산이 경제활동참여를 억제하는 정도도 줄어든 것 같다. 즉, 지난 30년간 여성인구구성의 변화나 행위양식의 변화는 여성의 경제활동의 증가를 지원하는 방향으로 변하였다. 그러나 경기가 하강국면에 접어들 때, 여성은 더 먼저 노동시장 밖으로 밀려나는 경향이 있으며, 이 때 저연령, 저학력 등 인적자본이 열세인 여성, 그리고 여성노동자의 비율이 높은 산업, 직업에 속해 있는 여성이 더욱 취약한 것으로 보인다. This study examines the change of female labor market structure during the last several decades, focusing the effects of demographic factors such as declining fertility and increasing educational attainment of women. Women of the recent cohort tend to postpone their first marriages, to attain higher levels of education, and to have smaller number of children than women of the old cohort. This demographic trend results in the change of the population compositions in a way that population subgroups with hisgh labor force participation have been increased. In addition, women of each population subgroup supply their labor in the market with higher rate than their old cohort counterparts. The labor force participation rate of highly educated women, and of married women has been increased faster than that of women with low education and of unmarried women. Although childbirth is still one of the most critical barrier for the women's participation, more and more women with young children tend to work for pay than ever before. In spite of the demographic change which is supportive to the increasing labor force participation, the Korean labor market have lost its female participants for the last year of the economic restructuring, reflecting demand-side factors as well as demographic factors are essential to determine the labor force participation of women.