적절하게 조절되지 않는 중증 천식환자에서 급성 악화 유형과 사망 및 의료비 발생 현황

한솔아,서혜선 대한약학회 2019 약학회지 Vol.63 No.5

Patients with severe and uncontrolled asthma are at high risk for severe exacerbation and death, and are knownto have significantly more health care utilization than well-controlled patients. This study aims to report types ofexacerbation, case-fatality and medical costs in patients with severe and uncontrolled asthma. We used Health InsuranceReview and Assessment Service-National Patient Sample 2016~2017. Four types of exacerbation were defined:exacerbation requiring corticosteroid burst, exacerbation requiring emergency room visit, exacerbation requiring generalward admission, and exacerbation requiring intensive care unit (ICU) admission. The 28 day case-fatality was calculatedfor exacerbation requiring general ward and ICU admission, respectively. The medical cost by types of exacerbation werecalculated as total medical cost incurred during the exacerbation episodes. The 28 day case-fatalities for exacerbationrequiring general ward and ICU admission were 0.033 and 0.167, respectively. The medical cost per episode of the abovefour exacerbations were 78,818 Korean won (KRW), 561,832 KRW, 1,923,265 KRW and 11,215,063 KRW, respectively. We reported types of exacerbation, 28 day case-fatality and medical costs in patients with severe and uncontrolled asthma. This study was significant because it clearly defined and distinguished the patient group and each exacerbation episodes.

천식 환자의 응급실을 통한 입원: 연관성 규칙 마이닝

한솔아,서혜선 한국보건의료기술평가학회 2019 보건의료기술평가 Vol.7 No.2

Objectives: To explore the patients’ characteristics associated with hospitalization through emergency department (ED) visit with asthma exacerbation by using association rule mining (ARM) Methods: A retrospective cross-sectional study was performed using ED visit cases from National Emergency Department Information System database 2016. In 2016, 9127979 ED visit cases collected. We included ED visit cases with discharge diagnosis of asthma (ICD-10 code of J45/J46). ARM was performed with Apriori algorithm to explore association rules between patients’ characteristics and hospitalization through ED visit. Hospitalization includes admissions to general ward and intensive care unit. The association rules (A⇒B) meant that if a person has a feature A, a person also has a feature B (hospitalization). We used support, confidence, and lift to select interesting rules. Support was defined as the proportion of an itemset in the data. Confidence was used as a measure of reliability. Lift was used to estimate whether the occurrences of A and B were independent or not. The higher confidence, the more likely to have an interesting relation between A and B. The higher lift (lift >1), the more likely that there was a dependency between A and B. We eliminated redundant rules that have similar meanings. Results: We included 28179 ED visit cases for the analysis. We extracted association rules with a support ≥0.5%, a confidence ≥80% and a lift >1. After eliminating redundant rules, the rule with the highest confidence and lift was the rule ({over-80-year-old, female, comorbid with pneumonia}⇒hospitalization) with confidence: 80.87% and lift: 2.94. Conclusion: Among patients visited the ED with asthma exacerbation, combination of elderly, female, and comorbid with pneumonia was importantly associated with hospitalization.

안구위축 또는 무안구에 동반된 안구함몰 교정을 위한 눈뒤 필러 주입술의 효과

한솔아,양민규,최영아,사호석 대한안과학회 2023 대한안과학회지 Vol.64 No.1

Purpose: To describe the clinical outcome of retrobulbar injection of synthetic fillers to correct enophthalmos associated with phthisis bulbi or anophthalmos. Methods: We retrospectively reviewed the medical records of patients who underwent enophthalmos correction using retrobulbar filler injections at Asan Medical Center between January 2015 and October 2019, and who were followed for at least 6 months. We evaluated the number of injections and amount of filler injected, improvement in enophthalmos, interval between injections, and adverse effects of filler injection. Results: The study enrolled five patients (four females and one male). Two patients had anophthalmos after evisceration and three had phthisis bulbi. Two patients received hyaluronic acid (HA) filler only, one had collagen-polymethylmethacrylate (PMMA) filler only, and two had both fillers. The HA and collagen-PMMA filler volumes per injection were 1.0–1.4 and 0.75–1.0 mL, respectively. The average degree of enophthalmos, compared to the contralateral eye, was 1.8 mm; the amount of enophthalmos correction per 1 mL of filler injection was 1.5 mm for HA filler and 1.4 mm for collagen-PMMA filler. The longest duration of enophthalmos correction was 15 months for HA filler and 25 months for collagen-PMMA filler. There were no significant adverse effects, but anterior migration of HA filler was observed in one case that resolved with hyaluronidase injection. Conclusions: Retrobulbar filler injection is a safe, effective, minimally invasive procedure for correcting enophthalmos in patients with anophthalmos or phthisis bulbi. If HA filler injection shows good outcomes without adverse effects, semi-permanent fillers can be used for long-term maintenance of enophthalmos correction. Further studies with more patients and long-term follow-up are needed to compare the effectiveness of various fillers. 목적: 안구위축 또는 무안구 환자에서 생긴 안구함몰을 비수술적으로 교정하기 위하여 시행한 눈뒤 필러 주입술의 임상적 결과에대해 알아보고자 한다. 대상과 방법: 안구위축 또는 무안구 환자에서 동반된 편측 안구함몰 교정을 위하여, 히알루론산 필러 또는 콜라겐-polymethylmethacrylate (PMMA) 혼합 필러의 눈뒤 주입술을 시행 받은 뒤 최소 6개월 이상 경과 관찰한 환자들을 후향적으로 분석하였다. 시술 전후 안구돌출계를 측정하고, 눈뒤 주입된 필러의 종류와 용량, 시술 횟수, 시술 사이 기간 및 합병증에 대해 살펴보았다. 결과: 총 5명의 환자가 연구에 포함되었고, 2명은 안구내용제거술 후 무안구 상태였으며, 3명은 안구위축 상태였다. 모든 환자에서안구함몰 개선 효과를 보였고, 시술과 관련된 특별한 합병증은 없었다. 히알루론산 필러의 일회당 주입량은 1.0-1.4 mL였고, 콜라겐-PMMA 필러는 0.75-1.0 mL였다. 필러 1 mL 당 안구함몰 교정 효과는 히알루론산 필러가 평균 1.5 mm였고 콜라겐-PMMA 필러의경우 1.4 mm였다. 시술 사이 기간은 히알루론산 필러가 최대 15개월, 콜라겐-PMMA 필러는 최대 25개월이었다. 결론: 실명한 환자에서 미용 목적으로 안구함몰을 교정할 때, 눈뒤 필러주입술은 눈뒤 주사가 익숙한 안과 의사가 비교적 쉽고 안전하게 시행할 수 있는 비수술적 치료 방법이다. 히알루론산 필러 시술에 좋은 결과를 보이는 환자에서는, 반영구 필러를 사용함으로써더 오랜 기간 교정 효과가 유지되는 것을 기대할 수 있다.

노인 중증 천식에서 장기 경구스테로이드 사용으로 인한 감염 발생 위험 연구

한솔아,손진선,김형태,김시인,서혜선 한국보건의료기술평가학회 2018 보건의료기술평가 Vol.6 No.1

Objectives: To evaluate the risk of infections by long-term oral corticosteroid use in elderly patients with severe asthma. Methods: This is a retrospective cohort study using nationally representative data, namely Health Insurance Review and Assessment Service-Aged Patient Sample 2015, that included medical and pharmacy claims of approximately 1 million elderly patients aged 65 or older. We included severe asthma patients who were classified as step 5 of Global Initiative for Asthma (GINA) guideline. Multivariate logistic regression was performed to compare incidence of infection in severe asthma patients continuously exposed ≥3 months oral corticosteroids (OCS) with severe asthma patients who continuously exposed ≥3 months tiotropium. Results: A total of 45 patients in OCS group and 107 patients in tiotropium group were identified. The odds of developing associated any infections were slightly higher but not significant in OCS group compared to those in tiotropium group; odds ratio (OR)=1.50, 95% confidence interval (CI)=0.67−3.36. In sub-group analysis, the odds of developing pneumonia were slightly lower (OR=0.78, 95% CI=0.30−2.00) and developing fungal infection were higher (OR=2.30, 95% CI=0.89−6.00) in OCS group compared to tiotropium group but both were not significant. Conclusion: Infections are known as oral corticosteroid related complication. However, the results of relationship between OCS use and incidence of infection were not significant. Further studies are warranted to evaluate the incidence of oral corticosteroids related infection

CSR의 한국적 진화: SK의 사회적 기업 생태계 지원 전략을 중심으로

한솔 한국NGO학회 2022 NGO연구 Vol.17 No.3

Since the Asian Financial Crisis of 1997, CSR in Korea has undergone an ongoing expansion in both scale and discourse. However, there is a dearth of previous research that focus on how the chaebol, as an organizational variable, affected the long-term trajectory of institutionalization of CSRin Korea. This study aims to fill such gaps in understanding how how the chaebols’ CSR strategies facilitated acculturation process of CSR institutions in Korea. Recognizing the lack of currently available quantitative data, this study adopts the explorative single case study method. It intends to analyze in depth the patterns in a representative case so that it can serve asa cornerstone for systemic research in the future. The subject of this case study is SK’s CSR program, which has focused primarily on supporting social enterprise ecosystems and developing social value measurement systems from 2006 to 2018. SK’s social enterprise-related CSR initiatives can be summarized as follows: (1) direct and indirect founding of social enterprises (2) purchasing of social enterprises’products, (3) development and application of social value measurement systems, (4)grants to social enterprises, and (5) measurement and monitoring of the social value of its affiliates. This paper examines how each above-mentioned CSR initiative has been introduced and disseminated within the SK group, and how each strategy has been specifically routinized by SK as a typical chaebol group. First, the paper argues that the peculiar characteristics of SK as a chaebol played a significant role by demonstrating the institutionalization processes below: (1) SK began pursuing CSR as a response to the legitimacy crisis it faced after the severe governance crisis in the early 2000s. (2) During the initial period of institutional void, SK Telecom functioned as a forerunner through acquiring knowledge about social enterprises. The personnel from SK Telecom were then moved to the Happiness Foundation, the corporate foundation of the SK group. (3) The foundation, which functioned as a hub, led the mimetic isomorphism within SK. (4) In later phase, the group chairman played a large role as an institutional entrepreneur by adopting new long-term initiatives. In addition, SK’s CSR strategy has been structured by the following factors: (1) pooling and top-down management of its affiliates’ resources and capabilities, (2) provision of the social enterprise market through rapid re-organization of equity networks, (3) filling the institutional void by the development and application of the social value measurement systems within the chaebol group, (4) leadership of the group chairman as an institutional entrepreneur. Such examples reflect the coordination mechanism and the structural capability typical in chaebol groups.

다양한 기능성 물질의 황화수소 흡착 성능평가

한솔,김기현 한국분석과학회 2019 학술대회논문집 Vol.2019 No.5

Ionic liquid matrix in matrix-assisted laser desorption/ionization mass spectrometry of iso-maltooligosaccaride

한솔,김다희,김여선,박소영,원유광,이다빈,최혜민,김정권 한국분석과학회 2018 학술대회논문집 Vol.2018 No.11

유방암 환자의 항암 치료 부작용 및 한의학적 보완치료 경험에 관한 포커스 그룹 연구

한솔아 ( Sola Han ),장보형 ( Bo-hyoung Jang ),황덕상 ( Deok-sang Hwang ),서혜선 ( Hae Sun Suh ) 대한한방부인과학회 2017 大韓韓方婦人科學會誌 Vol.30 No.1

Objectives: To explore experiences of treatment-related side effects and supportive care among Korean breast cancer survivors (BCS). Methods: Focus group interview was conducted with six Korean women with breast cancer. Participants were recruited through snow-balling. Interview was audio-recorded and transcribed verbatim. NVivo-11 was used to code the data into themes. Results: Two major themes were identified: (1) experiences of Western medicine, including treatment, side effects, needs and costs; (2) experiences of supportive care with Korean medicine, including the same as above. All participants experienced Western medicine in treatment phase and reported impairment of physical, emotional, and social functioning during and after Western medicine treatment. Only three participants used Korean medicine after treatments end. The negative responses from Western medicine doctors were the most important factor keeping participants from accessing Korean medicine when treatment-related side effects occurred. For this reason, some participants used Korean medicine without disclosure. Participants usually acquired information about Korean medicine from online community or other BCS, which was another important factor because it raised concerns about side effects and credibility of Korean medicine. High cost was also reported as barrier in using Korean medicine. During the cancer treatment, participants tended to endure their treatment-related side effects. Conclusions: Korean BCS may be at high risk of physical or emotional distress during treatment period. Findings suggest that there is a high need for supportive care to relieve treatment-related side effects and improve patients` quality-of-life. Furthermore, developing a systematic guidance or credible information sources should be warranted to help patients find the best supportive care options including Korean medicine.

사회적 가치의 이론과 현실: CSES Round Table에 대한 소고

한솔,조희진 동의대학교 지방자치연구소 2022 공공정책연구 Vol.39 No.2

본 연구는 사회혁신, 사회책임투자, 임팩트 투자, 소셜 벤처 등사회적 가치의 실현을 둘러싼 제도적 장이 확대되는 현상에 주목하여 사회적 가치가 한국사회의 시대적 화두로 등장한 배경, 사회적 가치를 기치로 내걸고 있는 이들에게 해당 개념이 의미하는바, 그리고 사회적 가치 실현의 핵심 주체들에 대한 포괄적 검토를 시도한다. 이는 사회적 가치의 ‘조감도’를 그려보는 노력의 일환이라 볼 수 있다. 필자들은 SK 사회적가치연구원에서 주최한 라운드 테이블에 참여한 연구자/학자, 법률가/입법가, 실천가/기업가들의 논의들과 기존의 선행연구들을 포괄적이고 입체적으로 종합하여 위에서 언급한 목표를 달성하고자 하였다. 한국 사회에서 사회적 가치가 시대적 과제로 대두된 배경에는고도의 성장에도 불구하고 국민 행복도는 오히려 줄어드는 현상, 사회 각 영역의 제도 간 상호보완성의 해체, 개인들의 공동체와연대의 중요성 대두를 들 수 있다. 그럼에도, 사회적 가치에 대해명확히 정의된 바가 없으며, 사회적가치기본법에서조차 사회적 가치를 특정한 기준 없이, 매우 광범위하게 다루고 있는 실정이다. 이에, 본 연구는 UN의 SDGs, EU의 사회적 질 선언, 영국의 공공서비스 법, 그리고 한국의 사회적가치기본법안 등을 검토하여 ‘안전과 일자리’, ‘역능성과 혁신’, ‘공동체와 공공성’, ‘상생과 지속가능성’ 등 네 가지 가치로 사회적 가치를 압축적으로 정의하였다. 정부가 핵심 주체가 되어 사회적 가치 실현을 이끌어야 하지만, 그 정도가 너무 지나치면 창의성, 혁신성 등을 저해하는 부작용이 발생할 수 있다. 따라서 정부가 사회적 기업, 소셜 벤처 및 기업들에게 사회적 가치 실현을 강제하기 보다는 그들로 하여금 자신의역량을 제대로 발휘하여 사회적 가치를 구현해 나갈 수 있도록 협력하는 자세가 요구된다. 이를 위해서는 사회책임투자 및 ESG 평가, 사회책임 기업 인증 등이 활발해질 수 있도록 제도적인 보완도 필요하다. 본 연구는 이론적 논의와 현장의 시각을 결합하여각 제도적 장의 확산을 위한 논쟁 및 과제들을 도출함으로써 학계에서는 잘 드러나지 않는 현실의 문제를 반영하였다는 점에서 큰의의가 있다.

편의점 PB(Private Brand)상품에 대한 인식이 대학생 소비자의 만족도에 미치는 영향

한솔,전민선 동아시아식생활학회 2018 동아시아식생활학회 학술발표대회논문집 Vol.2018 No.6