효율적인 군 전직지원체제 정립 방안

정철영,고재관,황원채,윤희철,박가열,김재호,이성식,김동승,표성일,이건남,양안나,최수정,김은석 한국직업능력개발원 2008 직업능력개발연구 Vol.11 No.1

이 연구의 목적은 제대군인에 대한 효율적인 전직지원을 위해서 현행 전직지원 프로세스에 대한 개선 안과 이에 따른 국방부, 국가보훈처 등 제대군인 전직지원관련 기관 간의 역할분담 및 연계방안에 대해서 제안하는 것이다. 연구는 크게 세 가지 과정을 거쳤다. 첫째, 국내 군 전직지원 실태를 분석하여 문제점과 시사점을 도출하였다. 둘째, 이러한 문제점과 시사점, 군 전직지원 선행연구를 종합하여 효율적인 군 전직지원 프로세스 안을 제시하였다. 셋째, 구축한 군 전직지원 프로세스 안에 따라 주요 군 전직지원 관련 기관인 국방부, 국가보훈처의 역할 분담 안을 제안하였다. This study aims to suggest an improvement plan for the support process of effective occupation change for discharged soldiers and then role assignments among related institutions for supporting discharged soldiers such as Ministry of Defense, Ministry of Patriots and Veterans Affairs, Ministry of Labor and the cooperation plan among the institutions. The study was made in three steps. First, after analyzing currents support facts and status for discharged soldiers, it induced its problems and implications. Second, integrating the findings of previous studies related to support plan on occupation changes for the discharged soldiers, Problems and implications mentioned above, it constructed effective occupation change process for discharged soldiers. Then, according to the established process, it suggested role assignments such as Ministry of Defense, Ministry of Patriots and Veterans Affairs, Ministry of Labor.

Perspective on Diagnostic Criteria for Obesity and Abdominal Obesity in Korean Adults

Nam, Ga Eun,Park, Hye Soon Korean Society for the Study of Obesity 2018 Journal of obesity & metabolic syndrome Vol.27 No.3

<P>Excessive body weight is associated with increased health risks in humans. In general, the risk of mortality increases with greater obesity. The 2018 guideline for the management of obesity by the Korean Society for the Study of Obesity proposed the body mass index (BMI) cut-off levels of 25 kg/m<SUP>2</SUP> and 23 kg/m<SUP>2</SUP> as diagnostic criteria for obesity and overweight (pre-obese) in Korean adults, respectively. Abdominal obesity has been defined as waist circumference (WC) ≥90 cm in men and WC ≥85 cm in women. In this review, the validity of these criteria for Korean adults was examined based on the evidence regarding the associations of obesity index with mortality and morbidity. The American Association of Clinical Endocrinologists/American College of Endocrinology algorithm and American Diabetes Association guideline for the medical care of obese and overweight patients support a BMI of 25 kg/m<SUP>2</SUP> and 23 kg/m<SUP>2</SUP>, respectively, as the cut-off levels for Asians (and some ethnicities) corresponding to the BMI values of 30 kg/m<SUP>2</SUP> and 25 kg/m<SUP>2</SUP>, respectively, for Caucasians. In the future, the optimal cut-off levels for obesity and abdominal obesity may require adjustment as the demographic characteristics of the Korean population change. In addition, development of more valid indicators that better reflect health risks of obesity is needed.</P>

Implication of Nonalcoholic Fatty Liver Disease, Metabolic Syndrome, and Subclinical Inflammation on Mild Renal Insufficiency

Nam, Ga Eun,Hwang, Soon Young,Chung, Hye Soo,Choi, Ju Hee,Lee, Hyun Jung,Kim, Nam Hoon,Yoo, Hye Jin,Seo, Ji-A,Kim, Sin Gon,Kim, Nan Hee,Baik, Sei Hyun,Choi, Kyung Mook Hindawi 2018 International Journal of endocrinology Vol.2018 No.-

<P><B>Background</B></P><P> Limited information exists about the impact of nonalcoholic fatty liver disease (NAFLD) on mild renal insufficiency. We compared the relative influence of NAFLD, metabolic syndrome (MetS), and subclinical inflammation, alone or in combination, on mild renal insufficiency. </P><P><B>Methods</B></P><P> This study included 1174 Korean adults. NAFLD was diagnosed using ultrasonography. Mild renal insufficiency was defined as an estimated glomerular filtration rate (eGFR) ≥ 60 and <90 mL/min/1.73 m<SUP>2</SUP>. </P><P><B>Results</B></P><P> In partial correlation analysis, several components of MetS and liver aminotransferase levels, but not high-sensitivity C-reactive protein (hsCRP), were associated with eGFR. Multivariate logistic regression analysis demonstrated the independent association of NAFLD (<I>P</I> = 0.034) and MetS (<I>P</I> = 0.018) with mild renal insufficiency, but not elevated hsCRP (<I>P</I> = 0.885). Furthermore, NAFLD without the MetS group (odds ratio (95% confidence interval) = 1.56 (1.05–2.34)) or MetS without the NAFLD group (1.82 (1.11–3.00)) was associated with mild renal insufficiency after adjusting for confounding variables. However, individuals with high hsCRP showed no relationship with mild renal insufficiency, irrespective of the existence of NAFLD. </P><P><B>Conclusions</B></P><P> This study demonstrated that NAFLD and MetS are independently associated with mild renal insufficiency, whereas subclinical inflammation did not affect the risk for mild renal insufficiency in Korean adults.</P>

Weight change and microvascular outcomes in patients with new-onset diabetes: a nationwide cohort study

( Eun Sil Koh ),( Kyung Do Han ),( Mee Kyoung Kim ),( Eun Sook Kim ),( Min-kyung Lee ),( Ga Eun Nam ),( Hyuk-sang Kwon ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.4

Background/Aims: Because weight control is important in treatment of type 2 diabetes, it is essential to understand the associations between weight change and the risk of microvascular complications among patients with type 2 diabetes. We examined whether weight changes early after new-onset diabetes have an impact on the clinical outcomes of diabetic nephropathy and retinopathy. Methods: Using the Korean National Health Insurance Service-National Health Screening Cohort database, 181,872 patients newly diagnosed with type 2 diabetes who were free of end-stage renal disease (ESRD) and proliferative diabetic retinopathy (PDR) during 2007 to 2012 were followed to the end of 2016. Weight change was defined as the difference in body weight from the time of diabetes diagnosis to 2 years later. Results: We identified 180 cases of ESRD and 780 cases of PDR followed up for a median of 5.5 years from the index year at 2 years after diagnosis. Those with 5% to 10% weight gain showed a significantly higher hazard ratio (HR) for ESRD, compared with those with ≤ 5% weight change after adjusting for several confounding factors, including the baseline estimated glomerular filtration rate (HR, 1.75; 95% confidence interval [CI], 1.14 to 2.70). Those with ≥ 10% weight loss showed the lowest HR for PDR (HR, 0.52; 95% CI, 0.33 to 0.83), whereas those with ≥ 10% weight gain showed the highest HR for PDR (HR, 3.20; 95% CI, 2.51 to 4.08). Conclusions: Weight gain after new-onset diabetes was associated with increased risk of ESRD and PDR whereas weight loss with decreased risk of PDR, but not ESRD.

Outcome of repeat Loop electrosurgical excision procedure of the cervix: is repeat procedure necessary in margin positive cases?

( Ga Won Yim ),( Young Tae Kim ),( Sang Wun Kim ),( Sunghoon Kim ),( Jae Wook Kim ),( Eun Ji Nam ) 대한산부인과학회 2011 대한산부인과학회 학술대회 Vol.97 No.-

Comparison of Carboplatin- and Cisplatin-Based Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer Patients With Morbidity Risks

Nam, Eun Ji,Lee, Maria,Yim, Ga Won,Kim, Jae Hoon,Kim, Sunghoon,Kim, Sang Wun,Kim, Jae Wook,Kim, Young Tae AlphaMed Press 2013 The oncologist Vol.18 No.7

<P>This study assessed the activity and toxicity of primary carboplatin-based chemoradiotherapy (CarboRT) and compared CarboRT with cisplatin-based chemoradiotherapy (CisRT) in patients with locally advanced cervical cancer and poor general condition. CarboRT was better tolerated than CisRT without compromising tumor response and survival in these patients.</P>

Perioperative Complications of Robot-Assisted Laparoscopic Surgery Using Three Robotic Arms at a Single Institution

( Ga Won Yim ),( Sang Wun Kim ),( Sung Hoon Kim ),( Eun Ji Nam ),( Young Tae Kim ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: The aim of this study was to evaluate perioperative complications of robot-assisted laparoscopic surgery in gynecology. 방법: Patients who underwent elective robot-assisted laparoscopic surgery at the Department of Obstetrics and Gynecology, Severance Hospital between February 2006 and December 2013 were identified. Robotic procedures were performed using the da Vinci robotic system. Patient demographic data and operative outcomes were prospectively collected in a computerized database and extracted for this study. 결과: Two hundred and ninety eight patients were identified during the study period. One case was converted to conventional laparoscopy due to mechanical failure of the robot system and excluded from review. The median age and body mass index of patients were 48 years and 23.0 kg/m2, respectively. The majority (n=130, 43.6%) of operative procedures was radical hysterectomy, followed by endometrial cancer staging (n=112, 37.6%), total hysterectomy (n=39, 13.1%), and myomectomy (n=17, 5.7%). The median operative time, estimated blood loss, and postoperative hospital stays were 208.5 min, 184.8 mL, and 8.9 days, respectively. The overall complication rate was 18.8% and that for only the oncologic cases was 16.1%. Intraoperative complications (n=5, 1.7%) consisted of 3 vessel injury and 1 bowel content leakage during appendectomy during endometrial cancer staging and one case of bladder injury during radical hysterectomy. Early and late postoperative complications were 14.4% and 2.7%, respectively. Five patients (1.7%) experienced grade 3 complications according to Clavien-Dindo classification and therefore needed further intervention. 결론: Robot-assisted laparoscopic surgery is a feasible approach in gynecology with acceptable complications.

Diarylheptanoids from the Seeds of <i>Alpinia katsumadai</i> as Heat Shock Factor 1 Inducers

Nam, Joo-Won,Kang, Ga-Young,Han, Ah-Reum,Lee, Dongho,Lee, Yun-Sil,Seo, Eun-Kyoung American Chemical Society and American Society of 2011 Journal of natural products Vol.74 No.10

<P>Seven new diarylheptanoids, (−)-(<I>R</I>)-4″-hydroxyyashabushiketol (<B>1</B>), (3<I>S</I>,5<I>S</I>)-alpinikatin (<B>2</B>), katsumain C (<B>3</B>), 7-<I>epi</I>-katsumain C (<B>4</B>), <I>ent</I>-alpinnanin B (<B>5</B>), <I>ent</I>-alpinnanin A (<B>6</B>), and <I>ent</I>-calyxin H (<B>8</B>), were isolated from the EtOAc extract of the seeds of <I>Alpinia katsumadai</I> together with three known compounds, alpinnanin B (<B>7</B>), epicalyxin H (<B>9</B>), and calyxin H (<B>10</B>). Each isomer mixture of <B>3</B> and <B>4</B>, <B>5</B>–<B>7</B>, and <B>8</B>–<B>10</B> was separated successfully by preparative HPLC using a chiral column. The three isomer mixtures (<B>3</B> and <B>4</B>, <B>5</B>–<B>7</B>, <B>8</B>–<B>10</B>) at 1 μM increased expression of heat shock factor 1 (HSF1) with fold increases of 1.438, 1.190, and 1.316, respectively, which was accompanied with increased expression of heat shock protein (HSP) 27 (1.403-, 1.250-, and 1.270-fold, respectively) and HSP70 (1.373-, 1.313-, and 1.229-fold, respectively) without cellular cytotoxicity, suggesting a possible application of these compounds as HSP inducers. Celastrol was used as a positive control of HSP induction, producing fold increases of 1.066 (HSF1), 1.216 (HSP27), and 1.371 (HSP70) at 1 μM. Compounds <B>1</B> and <B>2</B> did not affect the induction of HSF1 protein.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/jnprdf/2011/jnprdf.2011.74.issue-10/np200355n/production/images/medium/np-2011-00355n_0002.gif'></P><P><A href='http://pubs.acs.org/doi/suppl/10.1021/np200355n'>ACS Electronic Supporting Info</A></P>

Long non-coding RNA HOXA11as is associated with survival in advanced epithelial ovarian cancer

( Ga Won Yim ),( Hee Jung Kim ),( Mi Ri Hyun ),( Sunghoon Kim ),( Sang Wun Kim ),( Eun Ji Nam ),( Young Tae Kim ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: The functions of many long non-coding RNAs (ncRNAs) in human cancers are not well understood. Homeobox A11 (HOXA11) genes, which normally regulate mullerian duct differentiation, are not expressed in normal ovarian epithelium. The aim of this study was to examine the expression of HOXA11 antisense (HOXA11as) in patients with ovarian cancer. 방법: HOXA11as expression was determined in ovarian cancer tissues (n=142) and normal tissues (n=40) and ovarian cancer cell line by using real-time polymerase chain reaction. Its correlation with clinical parameters and survival were analyzed. 결과: The expression level of HOXA11as in ovarian cancer tissue was significantly higher than in noncancerous tissues by more than 8 fold (p=0.001). High HOXA11as expression (HOXA11as/GAPDH > 400 fold) among cancer tissues was not correlated with stage and lymph node metastasis, however associated with cell type and reduced recurrence-free survival. Median recurrence-free survival was 24 vs. 18 months in low and high expression group, respectively (Log rank p= 0.044). Knockdown of HOXA11as (siHOXA11as) reduced cell proliferation and invasion by in vitro assays using the OVCAR429 cell line. Hoxa11as knockdown also demonstrated inhibition of migration by wound healing migration assay. 결론: The results suggest that HOXA11as may represent a novel biomarker for epithelial ovarian cancer progression and prognosis.

Nutritional Risk Index as a potential prognostic factor in advanced stage epithelial ovarian cancer patients

( Ga Won Yim ),( Eun Ji Nam ),( Sung Hoon Kim ),( Sang Wun Kim ),( Jae Wook Kim ),( Young Tae Kim ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

Ovarian cancer is a chronic and wasting disease. Nutritional Risk Index (NRI) has been reported as a simple and accurate tool to assess nutritional status of patients with chronic disease. This study is to explore the association between pre/post-chemotherapy nutritional risk and survival using NRI. Also, the impact of weight change and body mass index (BMI) on cancer outcomes was analyzed. A retrospective data review was conducted of 214 advanced ovarian cancer patients who received primary surgical staging with 6 cycles of paclitaxel plus platinum postoperative adjuvant chemotherapy. NRI was calculated with patient`s body weight, ideal body weight, and serum albumin level. BMI was categorized by WHO criteria for Asians; underweight (<18.5 kg/m2), normal (18.5-22.9 kg/m2), and overweight (≥23.0 kg/m2). Weight change was defined as the ratio of body weight at the last course of chemotherapy to pre-surgery body weight. Overall survival (OS) and recurrence-free survival (RFS), classified by NRI were estimated by Kaplan-Meier, and associations were assessed using a Cox proportional hazards analysis, adjusted for known prognostic variables (age, histology, tumor grade, residual tumor). Mean age of patients was 54 years. Mean BMI was 23.1 kg/m2 and 22.5 kg/m2 before and after chemotherapy, respectively. Most (48.0%) of patients experienced 1-9.9% of weight loss after chemotherapy. Twenty-eight percent of patients were moderate to severely malnourished before treatment according to Nutritional Risk Index. During 10 years of follow up, 117 patients recurred and 67 patients died. The median survival time was 80 months. The 5-yr OS and RFS was 58.9% and 37.8%, respectively. Nutritional risk index was significantly associated with both OS and RFS. Moderate to severely malnourished patients before treatment had lower OS (48 months) compared to normal to mild group (80 months), respectively(p=0.014). Adjusted for covariates, the relative risk of death was 3.6 times higher in moderate/severely malnourished group (HR=3.6, 95% CI=1.63-7.96, p=0.002) compared with normal/mildly malnourished patients. Similarly, post-treatment NRI less than 97.5 (moderate risk) was associated with shorter PFS (median survival 12 months) compared with normal to mild risk group (17 months, p=0.006). There was no association between weight change and OS. Nutritional risk index is a simplified nutritional screening index that may be used as a potential predictor for mortality. Since weight change may not necessarily reflect patient`s nutritional status, NRI would be a clinically useful marker for the assessment of nutritional status as well as survival in ovarian cancer patients.