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박혜윤,권오정,김호중,정만표,서지영,고원중,엄상원,전경만,이경종,정병호,엄중섭,유홍석,송원준,신범수,정호중,임성용 대한결핵 및 호흡기학회 2013 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.116 No.-
Objectives: The apparent effect of emphysema on left heart structure and function was reported, which is as important as that of traditional risk factors such as smoking and diabetes. However, the relationship between emphysema, another component of chronic obstructive pulmonary disease, and metabolic syndrome (MetS) are unclear. Methods: We identified 2815 adult male patients of the Health Promotion Center in Samsung Medical Center between January 2009 and June 2009 and retrospectively reviewed clinical data. Emphysema index were measured by using commercially available software with a -950-HU threshold. MetS was defined according to the AHA/NHLBI and IDF criteria. Results: We found that emphysema index was not associated with the prevalence of MetS, while prevalence of MetS significantly increase as the FEV1 (% pred) decreased. Among components of metabolic syndrome, independent factors leading inverse relation between obstructive type (FEV1% ≤80%) and MetS were large waist circumference (OR 1.57, p<0.001), impaired glucose metabolism (OR 1.330, p<0.001) and low HDL cholesterol (OR 1.164, p=0.006). Despite lack of relationship between emphysema type (emphysema index ≥12%) and MetS, elevated blood pressure was positively related (OR 1.461, p <0.001) with emphysema type, while the presence of high triglycerides had an inverse relationship (OR 0.814, p=0012). High LDL cholesterol (≥160 mg/dL) was also inversely correlated with emphysema type. Conclusions: Metabolic syndrome is associated reduced FEV1 and dyslipidemia attenuate CT quantified emphysema severity.Objectives: The apparent effect of emphysema on left heart structure and function was reported, which is as important as that of traditional risk factors such as smoking and diabetes. However, the relationship between emphysema, another component of chronic obstructive pulmonary disease, and metabolic syndrome (MetS) are unclear. Methods: We identified 2815 adult male patients of the Health Promotion Center in Samsung Medical Center between January 2009 and June 2009 and retrospectively reviewed clinical data. Emphysema index were measured by using commercially available software with a -950-HU threshold. MetS was defined according to the AHA/NHLBI and IDF criteria. Results: We found that emphysema index was not associated with the prevalence of MetS, while prevalence of MetS significantly increase as the FEV1 (% pred) decreased. Among components of metabolic syndrome, independent factors leading inverse relation between obstructive type (FEV1% ≤80%) and MetS were large waist circumference (OR 1.57, p<0.001), impaired glucose metabolism (OR 1.330, p<0.001) and low HDL cholesterol (OR 1.164, p=0.006). Despite lack of relationship between emphysema type (emphysema index ≥12%) and MetS, elevated blood pressure was positively related (OR 1.461, p <0.001) with emphysema type, while the presence of high triglycerides had an inverse relationship (OR 0.814, p=0012). High LDL cholesterol (≥160 mg/dL) was also inversely correlated with emphysema type. Conclusions: Metabolic syndrome is associated reduced FEV1 and dyslipidemia attenuate CT quantified emphysema severity.
박혜윤 서울대학교 국제학연구소 2013 국제지역연구 Vol.22 No.1
The Paris Declaration on Aid Effectiveness of 2005 and the Accra Agenda for Action of 2008, which called for better institutions in both donor and recipient countries, were two important developments that marked the shift of the agenda of the international aid community towards aid effectiveness. While aid community began to adopt changes in institutions and policies, there is yet much to be improved. For those who are working on the reform, it is indeed quite important to understand what aspects of institutions place particular constraints upon the incentives of the actors within them. To solve this question, new institutionalism ― in particular rational-choice institutionalism ― may provide an insightful analysis. It argues that aid institutions tend to have “collective-action problems” in which rational actors’ optimal decisions end up with collectively sub-optimal outcomes. Development aid also involves “multiple-principals” and “broken feedback loops of information” (Martens et al., 2002), both of which may formulate perverse incentives for actors. New institutionalists have suggested a number of alternative paths for solving institutional dilemmas of development aid: a competition among donors, and a participatory process of decision making regarding aid. For aid agencies, it is particularly important to make all information transparent so that relevant aid officials can learn from past practices and manage and sustain the outcomes of aid after projects are completed. For this to take place, organizational incentives within these agencies are critical. The present paper is expected to be a first step towards institutional understanding of development aid in Korea and to contribute to the future progress in Korean development aid. 2005년 경제협력개발기구(OECD) 회의에서 채택된 ‘원조효과성에 대한 파리선언(Paris Declaration on Aid Effectiveness)’과 2008년 ‘아크라행동계획(Accra Agenda for Action)’은 좀 더 효과적인 원조를 위해 적합한 원조체제를 갖출 것을 원조커뮤니티에 요구하고 있다. 지난 십여 년간 연구자들과 각 국의 원조정책기관들은 원조의 제도 문제에 주목해왔으며 그 이론적 근간에는 신제도주의(new institutionalism)가 있다. 신제도주의에서도 특히 합리적 선택 제도주의(rational-choice institutionalism)는 개발원조의 문제를 합리적 개인의 선택이 다수의 불이익을 초래하게 된다는 이른바 ‘집단행동의 문제(collective-action problems)’라 규정하고, 이의 해결을 위해서는 개인들의 인센티브에 영향을 미치는 제도적 조건을 바꾸는 것이 중요하다고 주장한다. 다수의 행위자들이 각자의 이익을 위해 공동생산에 참여하는 과정에서 책임과 권한의 오너십이 불분명해지고, 공여국과 수원국 사이의 물리적, 정치적 거리로 인해 정책 피드백이 불가능해지는 원조의 특수한 상황으로 인해, ‘주인-대리인 문제(principal-agent problems)’와 같은 왜곡된 인센티브의 문제가 심화된다는 것이다. 신제도주의 학자들은 공여국 간의 경쟁체제 도입, 주민의 적극적인 참여를 통한 원조결정과 실행 등을 대안으로 제시하고 있다. 공여국의 원조기관에 대해서는 원조와 관련된 정보를 모든 원조업무 담당자들이 투명하게 공유하고, 원조의 결과물을 지속적으로 관리할 수 있도록 조직 차원의 인센티브를 제공할 것을 제안한다. 현재 국제 원조커뮤니티는 결과중심주의와 수원국 오너십과 같은 제도개혁을 통해 원조효과성을 제고시키고자 하고 있다. 앞으로 한국이 선진적인 원조제도를 구비해 나아가는 데에는 신제도주의적 접근과 진단이 유용할 것으로 보이며, 본 논문이 이에 기여할 수 있기를 바란다.
박혜윤,황인량,서정범,김수원,서현애,이인규,김정국 대한내분비학회 2015 Endocrinology and metabolism Vol.30 No.3
Background: This study investigated the association between the frequency of growth hormone receptor (GHR) exon 3 polymorphism (exon 3 deletion; d3-GHR) and metabolic factors in patients with acromegaly in Korea. Methods: DNA was extracted from the peripheral blood of 30 unrelated patients with acromegaly. GHR genotypes were evaluated by polymerase chain reaction and correlated with demographic data and laboratory parameters. Results: No patient had the d3/d3 genotype, while four (13.3%) had the d3/fl genotype, and 26 (86.7%) had the fl/fl genotype. Body mass index (BMI) in patients with the d3/fl genotype was significantly higher than in those with the fl/fl genotype (P=0.001). Age, gender, blood pressure, insulin-like growth factor-1, growth hormone, fasting plasma glucose, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol levels showed no significant differences between the two genotypes. Conclusion: The d3-GHR polymorphism may be associated with high BMI but not with other demographic characteristics or laboratory parameters.