Cleidocranial dysostosis 1例 報告

朴辰河,文命相 최신의학사 1971 最新醫學 Vol.14 No.9

A Case of cleidocranial dysostosis in a 3 months old infant was presented with review of the literature.

Association of Pre- and Post-Donation Renal Function with Midterm Estimated Glomerular Filtration Rate in Living Kidney Donors: A Retrospective Study

박진하,김소연,조진선,신동관,함성연,김혜수,곽영란 연세대학교의과대학 2023 Yonsei medical journal Vol.64 No.3

Purpose: The estimated glomerular filtration rate (eGFR) at 6 months after donation (eGFR6m) is strongly associated with the risk of end-stage renal disease in living kidney donors. This study aimed to investigate the incidence of eGFR6m <60 mL/min/1.73 m2(eGFR6m <60) and identify the risk factors that can predict the occurrence of eGFR6m <60 in living kidney donors. Materials and Methods: Living kidney donors who underwent nephrectomy at Severance Hospital between January 2009 and December 2019 were identified. We excluded 94 of 1233 donors whose creatinine values at 6 months after donation were missing. The risk factors for eGFR6m <60 were assessed using multivariate regression analysis. The optimal cutoff points for candidate risk factors for predicting eGFR6m <60 occurrence were determined using the Youden index. Results: The eGFR6m <60 occurred in 17.3% of the participants. Older age (≥44 years), history of hypertension, lower preoperative eGFR (<101 mL/min/1.73 m2), and degree of increase in creatinine levels on postoperative day 2 compared to those before sur gery (ΔCr2_pre) (≥0.39 mg/dL) increased the risk of eGFR6m <60. The addition of ΔCr2_pre to preoperative eGFR yielded a higher predictive accuracy for predicting eGFR6m <60 than that with preoperative eGFR alone {area under the receiver operating charac teristic curve=0.886 [95% confidence interval (CI), 0.863–0.908] vs. 0.862 (95% CI, 0.838–0.887), p<0.001}. Conclusion: The incidence of eGFR6m <60 was 17.3%. Older age, lower preoperative eGFR, history of hypertension, and greater ΔCr2_pre were associated with the occurrence of eGFR6m <60 after living donor nephrectomy. The combination of preoperative eGFR and ΔCr2_pre showed the highest predictive power for eGFR6m <60.

아세토니트릴-물 혼합용매중에서 브롬화파라즈로모펜아실과 아닐린과의 반응속도론적 연구

박진하,신철호 全北大學校 基礎科學硏究所 1985 基礎科學 Vol.8 No.1

The rate constants, thermodynamic parameters and isokinetic temperature for the reaction of p-bromophenacyl bromide with aniline in acetonitrile-water was studied by conductometry. The pseudo-first-order rate constants were calculated by Guggenheim equation, and then the second-order rate constants were determined. In result, it was found that rate constants, the values of enthalpies of activation and those of entropies of activation increased in proportion as the dielectric constants increased. The values of ehthalpies of activation were comparatively low and those of entropies of activation were quite negative, and both increased in proportion as water content increased. It, therefore, may be concluded that the reaction was to be S_N2 mechanism. The isokinetic temperature was 227K(-46℃) and this temperature was lower than experimental one, so this reaction was entropy controlled.

아세토니트릴 물 혼합용매중의 브롬화 페나실과 파라톨루이딘과의 반응속도 연구

朴鎭夏,韓光來 全北大學校 基礎科學硏究所 1979 基礎科學 Vol.2 No.1

The reactions of phenacyl bromide with p-toluidine have been studied in acetonitrilewater by conductometrically. The rate constants were calculated by Guggenheim equation and the activation thermodynamic parameters were also evaluated. In results, the rate constants were increased with water content and the reaction was the second-order. The values of the enthalpy of activation were comparatively low and those of the entropy of activation were quite negative. It, therefore, may be concluded that the reaction was to be S_N2 mechanism. It is also found that the change of activation entropy was important in the rate of reaction. Some effects of protic-dipolar aprotic solvent were considered and discussed.

아세톤 및 아세토니트릴 용매중에서 브롬화페나실과 나프틸아민과의 반응속도

박진하 全北大學校 1982 論文集 Vol.24 No.-

The observed pseudo-first order rate constants k_obs for the reactions of phenacyl bromide with 1-and 2-naphthylamine in acetone and acetonitrile were determined by conductometry using the Guggenheim method, and then the second order rate constants k_2 and the third order catalytic rate constants k_3 were calculated from k_obs. The order of magnitude of k_2 was 2-naphthylamine-acetonitrile>2-naphthylamine-acetone>1-naphthylamine-acetonitrile>1-naphthylamine-acetone. k_3 obtained were negative and they are largely due to the formations of charge transfer complexes. Peri-hydrogen effect was observed for 1-naphthylamine. Taking the k_2, the values of entropy of activation were quite negative and those of enthalpy of activation were comparatively low. It, therefore, is concluded that the reaction were to be S_N2 mechanism.

아세톤중 브롬화페나실과 메타 및 파라니트로 아닐린과의 친핵반응속도

朴鎭夏 全北大學校 文理科大學 1976 論文集 Vol.4 No.-

The rate constants for nucleophilic substitution ractions of phenacyl bromide with m- and p-nitroaniline in anhydrous acetone were determined, and the activation parameters were also evaluated. In the result, the reactions were first-order with respect to each reactant and the rate constant of the reaction with m-nitroaniline was larger by about eight times than that of the reaction with p-nitroaniline at 35℃. This is interpreted as meaning that the electron-withdrawing effect of p-nitro group is larger than that of m-nitro group, and that the softness on nitrogen atom of p-nitroaniline is smaller than that of m-nitroaniline. The values of the enthalpy of activation were comperatively low and those of the entropy of activation were quite negative. It is, therefore, concluded that the reactions were to be S_N2 mechanism.

아세톤-물 混合溶媒中의 브롬化페나실과 파라클로아닐린과의 反應速度硏究

朴鎭夏,洪性完 全北大學校 基礎科學硏究所 1982 基礎科學 Vol.5 No.1

The rate constants of the reactions of phenacyl bromide with p-chloroaniline in acetone-water at 30, 35 and 40℃ were determined by means of electric conductivity method and some activation parameters were also calculated. In the results, the rate constants were first order with respect to each reactant and increased with water content and the values of entropy of activation were quite negative and those of enthalpy of activation were comparatively low. Therefore, it is concluded that the reactions were to be S_N2 mechanism.

아세톤-물 혼합용매중에서 브롬화파라브로모펜아실과 아닐린과의 반응속도

박진하,오병용 全北大學校 基礎科學硏究所 1984 基礎科學 Vol.7 No.1

The reaction of p-bromophenacyl bromide with aniline in acetone-water have been studied by conductometric method. The observed pseudo-order rate constants were determined by Guggenheim method, and then the second-order rate constants were determined and the activation themodynamic parameters were evaluated. In result, the reaction was second-order and the rate constants were increased as water content and temperature had been increased. The values of enthalpies of activation were comparatively low and those of entropies of activation were quite negative. It, therefore, may be concluded that the reaction was S_N2 mechanism. It was also found that the reaction is entropy controlled.

개원 가정의를 상용 치료원으로 이용하는 고혈압 환자의 건강행태와 일차의료 서비스 질

박진하,김경우,성낙진,최윤구,이재호,일차의료연구회 대한가정의학회 2011 Korean Journal of Family Medicine Vol.32 No.2

Background: Management of hypertension has been performed mainly in primary care institutions, but hypertension control in population is still unsatisfactory. This study was aimed at finding a strategy to improve health promotion activities in patients with hypertension by exploring the association between health behaviors and quality of primary care. Methods: April to June in 2007, a questionnaire survey of the patients who has a family physician as a usual source of care was conducted for the development of the Korean Primary Care Assessment Tool (KPCAT). In this study, a usual source of care was defined as a physician of the persons who had visited their primary care clinic on six or more occasions over a period of more than 6 months. Of the data collected from 9 private clinics (3 in Seoul and 6 at small cities), cases of the patients who marked on having hypertension were selected. The associations between levels of quality of primary care and socio-demographic characteristics or health behaviors were analysed by Student t-test and chi-square test. Controlling socio-demographic variables, the association between quality of primary care and health behaviors was examined by multiple logistic regression analysis. Results: Among the patients (n = 602) of 9 private clinics who has a family physician as a usual source of care, those who marked on having hypertension were 134. Among 5 domains of the KPCAT, the highest domain in score was personalized care (71.7/100), and the lowest domain in score was coordination function (49.7/100). In patients who gave total average (69.2/100) or more in total primary care score, after adjustment with age, sex, income, education, and duration, odds ratio to have a normal BMI (<25 kg/m2) was 2.53 (P = 0.02), and odds ratio to have a habit drinking an adequate amount of alcohol was 4.32 (P = 0.02). Conclusion: The fact that high-quality primary care was associated with good health behaviors in this study suggests that improving quality of primary care by health care reform can make health behaviors more desirable in patients with essential hypertension. 연구배경: 일차의료에서 고혈압 환자의 관리가 많이 이루어지나 그 관리 수준은 만족스럽지 못하다. 개원 가정의를 상용치료원으로 이용하는 고혈압 환자들의 건강 행태와 일차의료서비스 질을 살펴봄으로써 건강증진 활동의 향상 방안을 찾아보고자 하였다. 방법: 한국 일차의료 평가도구(Korean Primary Care Assessment Tool, KPCAT) 개발과 타당도검증을 위한 조사(2007년4-6월) 기간 동안, 가정의학과 의원(총 9곳: 서울 3곳, 경기 3곳, 경주-포항 3곳)에서 수집된 602명의 자료 중, 고혈압 환자(134명) 자료를 분석하였다. 참가 자격은 해당 의료기관을 상용 치료원(처음 방문하고 6개월이 경과하고 6회 이상 방문 경험이 있는 의료 제공자)으로 이용하는 환자 또는 그 보호자에한정되었다. 환자의 연령, 성, 소득, 교육연한, 첫 방문 후 경과기간 등 인구사회학적 정보와, 흡연력, 음주력, 운동습관, 비만도, 그리고 KPCAT 5영역 평가점수를 분석하였다. 통계처리는SAS ver. 8.11 프로그램을 이용하여 T검정, 카이제곱 검정, 다중로지스틱 회귀분석을 이용하였다. 결과: 개원 가정의를 상용 치료원으로 이용하는 고혈압환자들은 KPCAT 5영역 중에서, 전인적 돌봄을 가장 높게(71.7/100), 그리고 조정기능을 가장 낮게(49.7/100) 평가하였다. 일차의료 서비스 질을 평균(69.2/100) 이상으로 높게 평가한 환자들은 환자-의사 관계의 지속기간이 유의하게 길었다(P=0.035). 인구사회학적 변수들을 통제한 상태에서 일차의료 서비스 질을 높게 평가한 환자들은 낮게 평가한 환자들에비하여 체질량 지수가 정상(BMI<25 kg/m2)일 경우의 교차비가 2.53배(P=0.02), 건강한 음주 습관을 가질 경우의 교차비는4.32배(P=0.02)로 나타나 건강행태가 양호한 것으로 나타났다. 결론: 고혈압 환자의 일차의료 서비스 질이 건강행태와 연관성이 있다는 사실은, 제도 개혁을 통한 일차의료 서비스 질 향상이 고혈압 환자의 혈압관리에 기여할 수 있음을 시사한다.

신용등급하락이 판관비 비율과 자산 효율성에 미치는 영향

박진하,심호식 한국공인회계사회 2017 회계·세무와 감사 연구 Vol.59 No.4

This study investigates the impact of credit rating downgrades on SG&A ratio and the asset efficiency of a company. Corporate bond issues are subject to have at least two ratings by the credit rating agencies. For the financial market participants, credit ratings appear to have substantial importance (Boot et al. 2006). First, the credit rating agencies may perform an implicit monitoring role. Typically, a credit rating agencies issue credit outlook or credit watch reviews before an immediate credit rating change when there is an event that may affect the credit rating of the company. Boot et al.(2006) argue that this monitoring process makes the company to exert an effort to improve the situation. Second, credit rating agencies influence investors' investment decisions since a credit rating reflects a firm’s credit risks. This condition strengthens the implicit contract between the credit rating agencies and the firm. However, the literature also casts doubt on the importance of credit ratings. The disagreements arise from the question whether credit rating have a real informational content, since credit rating agencies do not directly invest a capital, but they just disclose ratings. This study extends the prior studies on this issue by examining the impact of credit rating downgrades on SG&A ratio and asset turnover ratio. We focus on these measures because, first, the financial ratios are the main determinants of the credit rating. Second, among the financial ratios, SG&A ratio and asset turnover ratio are factors which reflect management decision-making in relation to resource adjustment and investment. Thus, if credit downgrade encourages managers to improve the company’s financial condition, then the recovery effort will be reflected in those financial ratios. Based on this argument, this paper tests the following hypotheses: (1) Companies that experience a credit rating downgrades reduce their SG&A ratio, (2) Companies experiencing a credit rating downgrades increase asset turnover ratio. This study analyzes the sample of listed companies in KRX from 2000 to 2014. Credit rating data are obtained from Korea Investors Service (KIS), a nation’s first licensed credit rating agency. KIS became an affiliate of Moody’s Investors Service in December 2001. Financial data, ownership data, and analyst data are obtained from FnGuide’s DataGuide5. Through the sample selection process, 1,309 firm-year observations are finally left. The results of the empirical analysis are as follows. First, the decline in the credit ratings shows a significant negative correlation with the SG&A ratio and a positive correlation with the change in the asset turnover ratio. These results can be interpreted as the fact that companies with a credit rating downgrade attempt to recover their credit ratings, by reducing discretionary costs, and operating their assets efficiently to increase sales. Second, this relationship is strongest in companies with the BBB group, which is the boundary between the investment grade and the speculative grade, suggesting that companies which face the largest cost burden in a period of falling credit rating may put more efforts to recover from downgrades. In addition, as a result of analyzing the sample by the ratio of SG&A expenses in prior period, this study finds that the improvement in the SG&A ratio due to the downgrade of the credit rating is more pronounced in higher SG&A sample, which seems to be related to larger agency costs. The results in this study implicate that there is an implicit monitoring role of the credit rating company, and that it is actually affecting the strategy of the company. This finding provides useful implications for various stakeholder groups such as academics, practitioners, investors and supervisory agencies. 본 연구는 신용등급하락이 기업의 판관비 비율과 자산 효율성에 미치는 영향을 분석하였다. 2000년부터 2014년까지의 유가증권시장 상장기업 자료를 이용한 실증분석 결과는 다음과 같다. 첫째, 전기의 신용등급하락은 당기의 판관비 비율 변화와 유의한 음(-)의 상관관계를 보였고, 당기 총자산회전율의 변화와는 유의하게 양(+)의 상관관계를 나타냈다. 이러한 결과는 신용등급이 하락한 회사의 경우 신용등급을 회복하기 하여 재량적 비용은 감소시키고, 자산을 효율적으로 운영하여 매출을 증대하려는 노력을 기울인다는 것으로 해석할 수 있다. 둘째, 이러한 관계는 투자등급과 투기등급의 경계인 신용등급 BBB그룹에서 가장 강하게 나타나, 신용등급이 하락할 경우 부담해야 할 원가(cost)가 가장 큰 기업이 특히 더 신용회복을 위해 노력하고 있음을 시사한다. 한편 판관비의 경우 절감하는 것이 효율성 증진 측면에서 기업에 유리한 반면, 미래의 기업가치 증진을 위해 요구되는 부분도 있다. 따라서 맥락에 따라 신용등급하락에 대한 판관비 조정 행태에 차이가 있을 수 있다. 이를 고려하여 표본을 전기의 판관비 비율로 구분하여 분석한 결과, 신용등급하락에 따른 판관비 비율 개선효과는 전기의 판관비 비율이 높은 그룹에서만 유의하게 나타났다. 본 연구를 통해 신용평가회사의 암묵적인 모니터링 역할이 존재하고, 실제로 기업의 전략에 영향을 미치고 있음을 살펴볼 수 있었으며, 이러한 발견은 학계뿐만 아니라 실무계, 투자자 및 감독기관 등 여러 이해관계자 집단에도 유용한 시사점을 제공할 수 있을 것으로 기대한다.