자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

Original Article : Geographic difference of epidemiological features of HCV infection in Korea

( Kyung Ah Kim ),( Sook Hyang Jeong ),( Eun Sun Jang ),( Young Seok Kim3 ),( Youn Jae Lee ),( Eun Uk Jung ),( In Hee Kim ),( Sung Bum Cho ),( Mee Kyung Kee ),( Chun Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4

Background/Aims: The prevalence of hepatitis C virus (HCV) infection in Korea exhibits significant geographic variation, with it being higher in Busan and Jeonam than in other areas. The reason for this intranational geographic difference was investigated in this study by conducting a comparative analysis of the risk factors related to HCV infection among three geographic areas: the capital (Seoul), Busan, and the province of Jeolla. Methods: In total, 990 patients with chronic HCV infection were prospectively enrolled at 5 university hospitals located in Seoul (n=374), Busan (n=264), and Jeolla (n=352). A standardized questionnaire survey on the risk factors for HCV infection was administered to these three groups of patients, and a comparative analysis of the findings was performed. Results: The analysis revealed significant regional differences in exposure to the risk factors of HCV infection. By comparison with patients in Seoul as a control group in the multivariate analysis, patients in Busan had significantly more experience of invasive medical procedures, acupuncture, cosmetic procedures, and multiple sex partners. In contrast, patients in Jeolla were significantly older, and they had a higher prevalence of hepatocellular carcinoma, a lower prevalence of multiple sex partners, and had experienced fewer invasive procedures. Conclusions: There was a significant geographic difference in the exposure to potential risk factors of HCV infection between patients from the three studied regions. This may explain the regional variation of the prevalence of HCV infection in Korea, and should be taken into account when planning strategies for the prevention and management of HCV infection. (Clin Mol Hepatol 2014;20:361-367)

배자와 태아에서 하악골의 형태발생 및 교원질 발현에 관한 면역조직화학적 연구

국윤아,김상철,김은철,김오환,김정기 대한치과교정학회 1996 대한치과교정학회지 Vol.26 No.2

치아 위치에 영향을 미치는 악안면의 성장 발육에서 Meckel 연골발생전 후의 하악골 형성과정과 교원 단백질 분포 및 발현정도를 알아보고자 좌고를 측정하여 태령을 결정한 후 4주부터 38주까지 50례의 배자와 태아를 대상으로 통법에 따른 조직절편을 제작하였으며 Hematoxylin과 Eosin, Alcian blue-pas와 Goldner의 Masson Trichrome 염색, 그리고 제1형과 제2형 교원 단백질에 대한 면역조직화학 염색을 시행하였다. 좌고 20.5 MM 배자에서 Meckel 연골이 출현하였으며, 좌고 22mm에서 38mm까지 하악골 외방에 신생골을 형성하고, 좌고 60mm태아에서 Meckel 연골이 점유하던 공간이 신생골로 채워져 연골내골화가 뚜렸하게 관찰되었으나, 좌고 240mm에서 Meckel 연골이 거의 소실되었다. 교원질에 대한 면역 염색결과에서 Mackel 연골 출현전 제1형 교원질 발현은 주로 상, 하악돌기의 구강상피에 국한되어 관찰되었고 제2형교원질 발현은 상대적으로 약간 적었다. Meckel 연골 출현 및 신생골 형성시기는 제1형교원질이 주로 치제상피와 신생골에서 약양성의 발현을 보였으며, Meckel 연골 및 신생골에서는 제1형보다 제2형의 교원질이 많이 발현되었다. 막내골화시기에는 제1형 교원질이 골아세포 및 골기질에서 중등도로 발현되었으나, 제2형에서는 경미하게 나타나 Meckel 연골형성전 후 제2형에서 제1형으로 발현전환이 있었다. Underlying malocclusions and dentofacial deformities are often related to variations in the craniofacial development. Type I and type Ⅱcollagens are considered the major collagens of bone and cartilage respectively. Monitoring the patterns of those protein expressions during development will provide a basis for the understanding of normal and abnormal growths. This study was undertaken to investigate the morphogenetic changes and the expression patterns of type I and Ⅱcollagen proteins involved in the developing mandible of human embryos and fetuses. 50 embryos and fetuses were studied with Hematoxylin and Eosin, Alcian blue-PAS, Masson Trichrome, and Immunohistochemical stains. The results were as follows: 1. A 13.5mm embryo showed the stomatodeum with dental lamina, maxillary and mandibular processes. Meckel's cartilage appeared in the mandibular arch of a 20.5mm embryo. New bone formation was bilaterally initiated at the outer side of middle portion of Meckel's cartilage of 22-38 mm embryos. 2. Meckel' cartilage was resorbed at the 15th week fetus. The endochondral ossification was observed where there was direct replacement of cartilage by bone. Meckel' cartilage disappeared and membraneous ossification were observed at the 25th week. 3. Before the appearance of Meckel's cartilage, the expression of type I collagen was moderate at the odontogenic epithelium of maxillary & mandibular process, but mild for the expression of type Ⅱ collagen. 4. During the appearance of Meckel's cartilage and new bone formation, the immunoactivity of type Ⅱ collagen was more expressed than type I collagen at the Meckel's cartilage and new bone. 5. During intramembranous bone formation, the expression of type Ⅱcollagen was rare in the bony trabeculae. There was a switch for the expression of collagens from type Ⅱto type I during the appearance of Meckel's cartilage.

In vivo study for the hemostatic efficacy and foreign body reaction of a new powder-type polysaccharide hemostatic agent

Yoonhyeong Byun,Eun Jin Kim,Areum Lee,Young-Ah Suh,Hee Ju Sohn,Jung Min Lee,Jae Seung Kang,Yoo Jin Choi,Youngmin Han,Hongbeom Kim,Wooil Kwon,Jin-Young Jang 대한외과학회 2022 Annals of Surgical Treatment and Research(ASRT) Vol.102 No.2

Purpose: Various hemostatic agents have been introduced in therapy as postoperative bleeding is a poor prognostic factor for postoperative outcomes. These products can be divided into those that directly promote the hemostatic cascade and those that physically form a barrier by absorbing blood. The latter, powder-type hemostatic agents have the advantages of being inexpensive and more absorbable with less foreign body reactions (FBRs) and are applicable to a relatively wide area. This study was conducted to verify the safety and efficacy of a newly invented polysaccharide product (OOZFIX, Theracion Biomedical), which improves blood absorption and hemostatic effects. Methods: Two separate animal experiments were performed. The first evaluated FBRs histologically at 3 days, 2 weeks, and 4 weeks, after implantation of OOZFIX in rats, and the second compared hemostatic performance of OOZFIX and Arista AH (Bard) in the porcine liver punch biopsy model. Results: We found minimal FBRs in the 3-day group and no reactions in both the 2-week and 4-week groups after implantation of hemostatic agents. The time to hemostasis of OOZFIX was not significantly different from that of Arista AH (median [interquartile range]: 9 [6–10] minutes vs. 8 [6–10] minutes, respectively; P = 0.522). When comparing the serial bleeding grade tendency, there was no statistical difference between OOZFIX and Arista AH (P = 0.656). Conclusion: OOZFIX caused a minimal FBR that disappeared within 2 weeks in vivo, and its hemostatic performance was comparable with that of an existing agent, Arista AH. Further clinical studies are required in the future.

우리나라 지역 직업성질환 감시체계의 현황과 전망

임종한,장성실,김성아,문재동,채창호,홍윤철,김수영,김진석,김영욱,한상환,이혜숙,원종욱,송동빈,하은희,강성규 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

기존의 특수건강진단과 작업환경측정을 통한 직업병 관리가 진폐증, 소음성난청 등의 소수 특정질환에 국한되고 실제 직업병 발생 규모 파악이나 신종 직업병의 발견에 한계를 보인다는 사실은 산업의학전문가들 사이에서도 공감을 이루고 있다. 미국과 영국 등에서의 직업성질환 감시체계에 대한 경험은 우리 나라의 직업성질환 감시체계 구축에도 새로운 자극제가 되면서, 1998년이후 인천, 대전, 여천, 구미, 부울경 지역에서 지역 직업성질환감시체계를 산업보건관리의 중요한 시스템으로 구축하려는 노력이 확산되고 있다. 새로이 구축되어지는 이들 지역 직업성질환 감시체계는 감시하고자 하는 대상질환, 활용 가능한 인적자원 및 자료원, 지역 의료체계의 특수성 등에 따라서 목적과 방법을 달리하면서 독특한 형태로 발전을 하고 있다. 각 지역단위 감시체계들이 그 상황에 맞게 독특한 목적과 전략들을 발전 시키면서도, 향후 발전할 국가적인 차원의 직업성질환 감시체계 구축을 위하여 직업성질환 감시의 기본 전략 등을 공유하는 등의 노력이 필요하다. 환례 정의 및 기본적인 등록 서식의 공유, 직업성질환 감시 자료원의 발굴, 공동의 정보 네트워크 및 직업성질환 감시 데이터베이스 구축 등 직업성질환 감시활동을 지원하기 위한 여러 기초 인프라 구축에 힘을 모아야 할 것이다. 우리 나라에서 직업성질환 감시체계를 성공적으로 구축하기 위해서는 수집된 자료의 질 관리를 위한 직업성질환 감시의 원칙 제정과 감시 전략의 공유 등이 필요하며, 전국적인 직업성질환 감시체계의 하부구조라고 할 수 있는 지역감시체계의 기초 토대 마련과 강화작업이 절실하게 필요하다.

RAW 264.7 세포에 대한 중국산 천연 광물성 섬유 TAFMAG의 독성효과

임영,한진구,김지홍,김현욱,김은경,김경아,장황신 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.3

Objectives : This study was designed to evaluate cytotoxicity of TAFMAG, which is a trade name of natural mineral fiber mined and produced in China. Methods : The cytotoxicity of TAFMAG was evaluated by measuring iron content, lipid peroxidation, erythrocyte hemolysis, and cytotoxicity in vitro. These results were compared with the data of chrystotile and wollastonite as a positive and negative control, respectively. Results : There was significant increase of Fenton activity in TAFMAG and chrysotile with dose-response pattern. The iron chelating agent, desferrioxamine, significantly decreased Fenton activity of the particulates except wollastonite. TAFMAG and chrysotile fibers significantly increased malondialdehyde concentration from lipid peroxidation of the red blood cell membrane. In erythrocyte hemolysis test, TAFMAG & chrysotile had stronger effect on erythrocyte hemolysis than wollastonite with the concentration of 1,000g/ml. Furthermore, TAFMAG was more hemolytic than chrysotile with the concentration of 5,000g/ml. There was a significant cytotoxic effect in TAFMAG and chrysotile on RAW cell compared with wollastonite. Conclusions : In vitro study suggested that TAFMAG may have a similar health hazard as usual asbestos.

대황황련해독탕의 항고지혈증 작용

김영석,정은아,장종철,양형길,김남재,조기호,배형섭,이경섭,김동현 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2001 No.-

Whangryunhaedok-Tang (WT) is formulated with Coptidis Rhizoma, Phellodendri Cortex, Scutellariae Radix and Gardeniae Fructus, and Daewhang-whangryunhaedok-Tang (DWT) is made by the combination of Rhei Rhizoma, a wellknown anticostipation drug in WT. Therefore, DWT has been evaluated for antihyperlipidemic effects on experimental hyperlipidemic rats and mice induced by corn oil and high cholesterol-diet. Oral administration of DWT significantly inhibited the increase of serum triglyceride and LDL-cholesterol levels, and the decrease of serum HDL-cholesterol levels in hyperlipidemic rats induced by corn oil. Also, oral administration of DWT significantly prevented the increase of serum total cholesterol, triglyceride and LDL-cholesterol, and liver total cholesterol and triglyceride in 1% cholesterol-diet fed mice. These results suggest that DWT is effective for the treatment of hyperlipidemia.

대황황련해독탕의 사염화탄소 유발 간장해 보호효과 미치 급성독성

김영석,정은아,장종철,양형길,김남재,조기호,배형섭,이경섭,김동현 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2002 東西醫學硏究所 論文集 Vol.2002 No.-

ABSTRACT - This study was performed to evaluate hepatoprotective effect of daewhang-whangryunhaedok-Tang(DWT) on liver injured rats induced by CCI_4 and the acute oral toxicity of it in mice. The activities of serum transaminase(ALT/AST), alkaline phosphatase(ALP) and lactic dehydrogenase(LDH), the levels of serum total cholesterol(TC) and triglyceride(TG), change of liver enlargement, and inhibitory activities of lipid perotidation, catalase and glutathione-S-transfrease(GST) in liver microsome were determined in hepatotoxic rats induced by CCI_4. DWT was significantly reduced the serum ALT, AST, ALP, LDH. TC and TG lecels. And, the increase of lipid peroxidation, decrease of catalase and GST activities in the liver microsome of CCI_4-intoxicated rat were significantly improved by the treatment of DWT. Male and female mice were administered maximum dosages of 5.000 mg/kg b.w. of DWT. After single oral administration of DWT to mice, we observed them daily for 2 weeks.DWT did not induce any toxic signs in the mortalitie, clinical signs, body weight changes, and gross necropsy finfings of mice. Based in these results. It is concluded that DWT may have the hepatoprotective effect on CCI_4 induced hepatotoxicity in rats. Also. DWT may have no side effect and its LD_50 value may be over 5.000mg/kg b.w. in mice.

초산모의 분만유형과 모성관련지식에 관한 연구

김혜란,노진아,손은정,이명아,김증임 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

Purpose: This study was to know primipara's general characteristics, delivery type, delivery characteristics, maternity related knowledge level, and relation of delivery type and maternity related knowledge level. Method: This is a survey. Subjects were sixty primiparas who had admitted to a pediatric outpatient clinic at general hospital in Seoul. Subject's age was ranged from 15 to 44 and it was lapsed 10 weeks after delivery of their first baby. Maternity related knowledge level was measured by "primipara's maternity related knowledge level". Data was nalyzed using frequency. percentage, mean, standard deviation, ANOVA, t-test by SPSS 11.0. Result: Relation of delivery type and maternity related knowledge in primipary did not show a statistically significant. But the relation of natural delivery and maternity related knowledge in primipara was a littlehig than that of caesarean section. Conclusion: There is no significant diference of maternity related knowledge between natural delivery and caesarean section. We suggest for randomized clinical trials with a larger sample size.

결정형 규산분진에 의한 A549 세포의 독성 및 섬유모세포 증식에 Desferrioxamine이 미치는 영향

김경아,김은경,김지홍,임영 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.2

The inhalation of crystalline silica results in the production of reactive oxygen species (ROS). Among these ROS, hydroxyl radical (˙OH) is believed to be the most reactive one. ˙OH is generated in reaction between superoxide and hydrogen peroxide catalyzed by transition metal, especially iron. Therefore iron should be important in the bioactivity of crystalline silica. Desferrioxamine, a iron chelator, may be protective in silica-induced pulmonary reaction. To test this assumption we investigated the protective effect of desferrioxamine on lipid peroxidation of cell membrane, cytotoxicity, production of proinflammatory and chemotactic cytokine and fibroblast proliferation by crystalline silica in vitro model. The results were as follows; 1. Fenton activity of silica and asbestos was significantly higher than that of control. Fenton activity in crocidolite was higher than silica at the same dose. This result correlated with iron content of dust. Fenton activity of silica and crocidolite was decreased by preincubation of silica with desferrioxamine. 2. Silica induced a dose-dependent increase of MDA concentration in lung epithelial cell lysate dose dependently. Marked decrease of MDA was observed in desferrioxamine treated silica group compared with untreated group. 3. As concentration of stimulated silica, silica-induced cytotoxicity was increased. There was significant decrease of cytotoxicity in desferrioxamine-treated silica group compared with untreated group. 4. α-quartz augmented the production of TNF-α and IL-8 from A-549 cell. While desferrioxa-mine suppressed the release of cytokines. 5. Supernatant of silica-cocultured A549 cell induced a significant proliferation of fibroblast, which desferrioxaime blocked this proliferation. From these result, we concluded that desferrioxamine has a protective effect on silica induced pulmonary reaction.