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안수미,윤기영,신연명,최경현,임근승,장문경,송윤미,공은희 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2
Background : About 30% of patients in the hospital are under nourishment. A large portion of people are undernourished when they are admitted to the hospital and in the majority of these, undernutrition develops further while in hospital. Patient-Generated subjective global assessment(PG-SGA), a method of nutritional assessment based on clinical judgment, has been widely used to assess the nutritional status of adults for both clinical and research purposes. Modified PG-SGA can be used as a nutrition screening tool, and a comprehensive nutrition assessment is desirable for those who are malnourished. The purpose of this study is to develop a simple, reliable and valid nutrition screening program(NSP). Methods : We applied the nutrition screening program(NSP) to adult inpatients who are at risk of malnutrition using the Modified Patient-Generated subjective global assessment(PG-SGA) and objective assessment(electrical medical record data). Results : Therefore simple and beneficial NSP is developed for patients with severe malnutrition. Using NSP. nutritional information of the severe malnutrition patient should be shared with the physicians and they should be taken care of by clinical dietitians to improve their nutritional status. Conclusion : The Modified PG-SGA and nutrition screening tool are simple, reliable and valid nutrition screening program(NSP).
한국인 쯔쯔가무시병 환자에서 사이토카인 유전자의 다양성 조사
장우임,김수연,위성헌,김태규 대한감염학회 2010 감염과 화학요법 Vol.42 No.1
Background: Scrub typhus is caused by Orientia tsutsugamushi and can become severe and potentially life-threatening. It is suggested that specific host factors can modify the host response during O. tsutsugamushi infection. It is known that susceptibility and outcome of infectious disease are associated with genetic polymorphisms of some cytokines. Materials and Methods: Peripheral blood of 144 patients who were diagnosed with scrub typhus and of 311 unrelated healthy subjects were collected. A diagnosis of scrub typhus was made upon demonstration of a fourfold rise in antibody titer to O. tsutsugamushi in paired serum specimens in an indirect immunofluorescent (IFA) test. Genomic DNAs were extracted from peripheral mononuclear cells and genotypings for IL-1 (-511C/T), IL-1β (+3953T/C), IL-2 (-330T/G), IL-4 (-590C/T), IL-4R(-1902G/A), IL-10 (-1082G/A), IL-10 (-819C/T), TNF-α (-238G/A) and TNF-α (-308G/A) were performed simultaneously using PCR-SSP (sequence specific polymorphisms) assay. Results: The frequency of IL-1 (-511T/T) (OR=0.53, P<0.01) and IL-2 (-330T/T) (OR=0.56, P<0.01) were significantly decreased, but that of IL-2(-330G/G) (OR=4.49, P<0.01) was increased, in the scrub typhus patients compared to the healthy controls. And, there were no statistically significant differences in the genetic polymorphisms of IL-4 (-590C/T), IL-4Rα (-1902G/A), IL-10 (-1082G/A), IL-10 (-819C/T), TNF-α (-238G/A), TNF-α (-308G/A) genes, in the scrub typhus patients compared to the unrelated healthy controls. Conclusions: Cytokine polymorphisms in the IL-1 (-511T/T) and the IL-2 genes may influence the host response to O. tsutsugamushi.
건강보험에서 5인 미만 사업장의 직장보험 편입 효과 평가와 정책 방향
송명섭,김창보,고수경,임정수,박지연 한국사회보장학회 2002 사회보장연구 Vol.18 No.2
본 논문은 건강보험공단이 2001년 「월 이후 추진하고 있는 5인 미만 사려장의 직장보험 편입을 평가하고 향후 정책방향을 제시하는데 목적을 두고 있다. 5인 미만 사업장의 직장보험 편입은 보험 가입자의 보험료 부과의 형평성을 제고하고, 영세사업장 노동자들의 보험료 부담을 경감시키며 건강보험재정 안정 효과를 위한 것이다. 2001년 7월 이후 12월 31일까지 직장보험으로 신규편입한 대상자는 모두 약 64만명이었으나 편입이전지역보험 대상자는 약 53만명, 직장보험 대상자는 약 10만명이었다. 또한 동일 기간동안 직장보험으로 편입된 사업장은 모두 88,751개였다. 편입 전후 개인별 보험료 수준 변화를 살펴보면 보험료 부과대상 중 77.6%는 본인이 부담해야 할 보험료가 감소하였다. 대신 사업주의 보험료 부담은 상대적으로 늘어났다. 한편 2001년 7월 이후 12월까지 직장보험 편입으로 건강보험의 재정은 약 19,530백만원의 재정절감효과가 있었다. 직장보험은 7,331백만원의 보험료 수입 증가가 발생하였으며, 지역보험은 12,199백만원의 재정절감 효과가 있었다. 향후 5인 미만 사업장의 직장보험 편입이 원만히 추진되기 위해서는 피부양자 인정기준의 개선과 영세사업장 사업주의 보험료 부담을 경감시켜주기 위한 방안을 강구해야 하며, 사회적으로는 비정규직 노동자에 대한 사회보장 적용 확대를 위한 노력이 동시에 추구되어야 할 것이다. This study was conducted for the purpose of evaluating coverage of small companies with less than 5 persons by Corporate Insurance since July 2001 and of suggesting policy implication. This coverage expansion by Corporate Insurance was intended for improving equity level of contribution imposition, alleviating financial burden of employees and achieving financial stability of health insurance. While, from July 2001 to December, the number of newly covered beneficiaries was about 642 thousand persons, the number of Regional beneficiaries before the new coverage expansion by Corporate Insurance was 533 thousand persons. And the number of Corporate Insurance beneficiaries before the coverage expansion was 101 thousand persons. For the same period, the number of companies by the new coverage expansion of Corporate Insurance was 88,751. Before and after the expansion, taking into account changes of individual contribution levels, payment share levels of contribution were reduced to the 77.6% of the beneficiaries newly covered by Corporate Insurance. Instead, payment share level of contribution of employers was increased more than before. And 19,530 million won was increased in National Health Insurance Expenditure. 7,331million won was increased in Corporate Insurance revenue. Expenditure reduction effect of 12,199 million won was able to be obtained in Regional Insurance. In order to implement successfully the coverage expansion by Corporate Insurance in times ahead, employers' contribution share should be reduced, when considering low profitability levels of small companies.
Im, Su-Yeon,Cho, Seon-Hye,Hwang, Jeong-Hyo,Lee, Seung-Jin The Pharmaceutical Society of Korea 2003 Archives of Pharmacal Research Vol.26 No.1
Drug releasing porous poly($\varepsilon$-caprolactone) (PCL)-chitosan matrices were fabricated for bone regenerative therapy. Porous matrices made of biodegradable polymers have been playing a crucial role as bone substitutes and as tissue-engineered scaffolds in bone regenerative therapy. The matrices provided mechanical support for the developing tissue and enhanced tissue formation by releasing active agent in controlled manner. Chitosan was employed to enhance hydrophilicity and biocompatibility of the PCL matrices. PDGF-BB was incorporated into PCL-chitosan matrices to induce enhanced bone regeneration efficacy. PCL-chitosan matrices retained a porous structure with a 100-200 $\mu$m pore diameter that was suitable for cellular migration and osteoid ingrowth. $NaHCO_3$ as a porogen was incorporated 5% ratio to polymer weight to form highly porous scaffolds. PDGF-BB was released from PCL-chitosan matrices maintaining therapeutic concentration for 4 week. High osteoblasts attachment level and proliferation was observed from PCL-chitosan matrices. Scanning electron microscopic examination indicated that cultured osteoblasts showed round form and spread pseudopods after 1 day and showed broad cytoplasmic extension after 14 days. PCL-chitosan matrices promoted bone regeneration and PDGF-BB loaded matrices obtained enhanced bone formation in rat calvarial defect. These results suggested that the PDGF-BB releasing PCL-chitosan porous matrices may be potentially used as tissue engineering scaffolds or bone substitutes with high bone regenerative efficacy.
조수연(Su Yeon Jo),최수현(Su Hyeon Choi),임지영(Ji Young Im),홍성철(Sung Chul Hong),이종대(Jong Dae Lee),양원호(Won Ho Yang),손부순(Bu Soon Son) 한국실내환경학회 2011 한국실내환경학회지 Vol.8 No.3
We measured indoor, outdoor, and personal exposure concentrations of ozone (O₃) at 54 households in Gwangyang from June to September, 2009. The results are as follows. The concentration of ozone in outdoor, 16.53±5.72 ppb, was observed two times higher than the concentration of ozone in indoor, 8.22±4.60 ppb. The similar arithmetic average ozone were obtained in exposed and controlled areas, 15.16±1.45 ppb and 15.25±1.94 ppb, respectively. The ozone concentration of an individual smoker was 24.89±7.11 ppb, which was higher than that of a non-smoker, 21.01±11.79 ppb. The indoor occupant density elevated ozone concentrations. The relatively low concentration of ozone was observed in a house with air conditioner (8.59±4.04 ppb) than a house without the unit(10.07±6.43 ppb).