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韓國人에서 多重增幅 重合酵素反應으로 分析한 STRs 遺傳座位의 遺傳的 多樣性
권국환,이혜린,박종진,황적준,이희석,송은섭 大韓法醫學會 1996 대한법의학회지 Vol.20 No.1
The tetrameric STRs loci were studied in a population of Korean(n=223) for allele frequency distribution and applicability to identity and paternity testing, using multiplex PCR with electrophoresis of the PCR products in DNA sequencing gels and subsequent detection of allelic fragments by silver staining. The STRs loci analyzed were HUMCSF1PO, HUMTPOX, and HUMTHO1 ; in the Korean population, 9 alleles with their frequency range of 0.002-0.363 are detected in the HUMCSF1PO, 5 alleles with those of 0.020-1.480 in the HUMTPOX, and 6 alleles with those of 0.002-0.489 in the HUMTHO1. The highest observed heterozygosity is found at the locus HUMCSF1PO(0.709), those of the loci HUMTPOX and HUMTHO1 being 0.646 and 0.632, respectively. All loci meet Hardy-Weinberg expectations ; there are good agreement between the observed and expected values under Hardy-Weinberg equilibrium. Moreover, pairwise comparisons between loci show allelic independence for all the 3 loci comparisons. The power of discrimination (PD) determined for the locus HUMCSF1PO is 0.8896 (88.96%), that of the HUMTPOX is 0.8818(88.18%), and that for the HUMTHO1 is 0.8367(83.67%) ; the combined power of discrimination for the triplex is 0.9976(99.76%). The power of exclusion(PEX) calculated for the loci HUMCSF1PO, HUMTPOX, and HUMTHO1, being prior probability that a falsely accused father will be excluded, and 0.5173(51.73%), 0.4610(46.10%), and 0.5101(510.01%), respectively, and the cummulative power of exclusion(CPE) for all the three loci is 0.8726(87.26%). Thus, these allelic frequency data can be used to construct the database of the multiplex PCR-based DNA profile in the Korean population. The calculated parameter, "power of discrimination(PD)" and "power of exclusion(PEX)", show the informativeness of these loci for the determination of identity and relatedness of individuals.
영양불량환자의 중증도 적용 향상을 위한 영양지원팀 협의진료체계 개선활동의 중요성
권국환 ( Kuk Hwan Kwon ),이형순 ( Hyung Soon Lee ),유지형 ( Jee Hyoung Yoo ),지수나 ( Soo Na Chi ),박현희 ( Hyun Hee Park ),김소원 ( So Won Kim ),김경란 ( Kyung Ran Kim ),윤난희 ( Nan Hee Yun ),라경택 ( Kyoung Taek Ra ),송현정 ( H 한국정맥경장영양학회 2018 한국정맥경장영양학회지 Vol.10 No.1
Purpose: The grade of complexity in the diagnosis related group (DRG) payment system is influenced by the secondary diagnosis of specific complication and comorbidity level, in which moderate or severe malnutrition is included. This study examined an existing proportion of patients with malnutrition who were supposed to be qualified for the complexity level and devised quality improvement measures to increase the proportion of qualifying complexity payments. Methods: The goal of the activities was to increase the rate of complexity payment claims for patients with malnutrition (%). Cases ineligible for the DRG payment system and cases with no diagnosis of malnutrition were excluded. We established a collaborative system between the nutrition support team and departments related to each improvement factor (i.e., patient care, medical records, insurance review, and medical information). Results: Before implementing the activities, this study investigated the current level of complexity payment claims for malnutrition patients who were discharged within a specific period (June 1, 2015∼August 31, 2015). The results showed that complexity payment claims were filed in 10.00% (2 of the 20 malnutrition cases). After the activities, the rate of complexity payment claims for the patients with malnutrition within the study period (June 1, 2016∼August 31, 2016) was 46.43% (26 out of 56), showing an approximately 364% increase from the pre activity rate. This change was statistically significant according to the chi-square test on Microsoft Excel 2010 (P<0.01). Conclusion: Collaborative efforts by the related departments enabled the smooth implementation of each activity. In addition, moderate or severe malnutrition was revealed to be a variable in the complexity-specific payment system. In the future, hospital-wide awareness and effort are crucial to promot the steady practice of these activities and expand their implementation.