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

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

Genetic associations of body composition, flexibility and injury risk with ACE, ACTN3and COL5A1polymorphisms in Korean ballerinas

( Jun Ho Kim ),( Eun Sun Jung ),( Chul Hyun Kim ),( Hyeon Youn ),( Hwa Rye Kim ) 한국운동영양학회 2014 Physical Activity and Nutrition (Phys Act Nutr) Vol.18 No.2

Jun Ho Kim, Eun Sun Jung, Chul-Hyun Kim, Hyeon Youn and Hwa Rye Kim. Genetic associations of body composition, flexibilityand injury risk with ACE, ACTN3and COL5A1polymorphisms in Korean ballerinas. JENB., Vol. 18, No. 2, pp.205-214, 2014[Purpose] The purpose of this study was to exam the association of body composition, flexibility, and injury risk to genetic polymorphismsincluding ACEID, ACTN3RX, and COL5A1polymorphisms in ballet dancers in Korea. [Methods]For the purpose of this study,elite ballerinas (n = 97) and normal female adults (n = 203) aged 18 to 39 were recruited and these participants were tested forbody weight, height, body fat, fat free mass, flexibility, injury risks on the joints and gene polymorphisms (ACE, ACTN3, COL5A1polymorphism). [Results]As results, the ACEDD genotype in ballerinas was associated with higher body fat and percentageof body fat than the ACEII and ID genotypes (p< 0.05). In the study on the ACTN3polymorphism and ballerinas, the XXgenotype in ballerinas had lower body weight and lower fat-free mass than the RR and RX genotype (p < 0.005). Also, the meansof sit and reach test for flexibility was lower in the ACTN3XX genotype of ballerinas than the RR and RX genotype of ballerinas(p< 0.05). Among the sports injuries, the ankle injury of the XX-genotyped ballerinas was in significantly more prevalence thanthe RR and XX-genotyped ballerinas (p< 0.05). According to the odd ratio analysis, XX-genotyped ballerinas have the injuryrisk on the ankle about 4.7 (95% CI: 1.6~13.4, p< 0.05) times more than the RR and RX-genotyped ballerinas. Meanwhile, theCOL5A1polymorphism in ballerinas has no association with any factors including flexibility and injury risks. [Conclusion]Inconclusion, ACEpolymorphism and ACTN3polymorphism were associated with ballerinas` performance capacity; COL5A1wasnot associated with any factors of performance of Ballerinas. The results suggested that the ACEDD genotype is associated withhigh body fat, the ACTN3XX genotype is associated with low fat-free mass, low flexibility, and higher risk of ankle-joint injury. [Keyword]ballet, flexibility, body composition, injury risk, ACE, ACTN3, COL5A1

외음부의 기저세포암

김보영 ( Bo Young Kim ),황선정 ( Sun Jung Hwang ),박병준 ( Byung Joon Park ),이은실 ( Eun Sil Lee ),한호섭 ( Ho Suap Han ),김용욱 ( Yong Wook Kim ),김태응 ( Tae Eung Kim ),노덕영 ( Duck Yeong Ro ),이안희 ( An Hi Lee ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.9

Basal cell carcinoma (BCC) is the most common human malignant neoplasm, accounting for 75% of all non-melanoma skin cancer. The incidence of BCC is strongly correlated with sun exposure as well as older age. Therefore, the vast majority of BCCs is observed in elderly patients on the sun-exposed skin of the head and neck with a frequency of more than 80%. BCC is very rare on sun-protected skin such as the perianal and genital regions and other etiologic factors must be considered in these cases. Although the pathogenesis of vulvar BCC is unclear, early diagnosis is very important. Because BCC in these areas sometimes seems innocuous, it is recommended that a biopsy of all suspect lesions be performed. We report a woman with BCC of the vulva treated with wide local resection and reviews the literatures on this subject.

혈관모세포종의 임상 분석

김은성,강삼석,이정길,김태선,정신,김재휴,김수한,이제혁 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.5

Effects of Phenytoin and Diazepam on the Seizure Activity in the Cortical Dysplasia Animal Models

Kim, Si-Hyung,Choi, In-Sun,Cho, Jin-Hwa,Park, Eun-Ju,Jang, Il-Sung,Choi, Byung-Ju,Kim, Hyun-Jung,Kim, Young-Jin,Nam, Soon-Hyeun The Korean Academy of Oral Biology 2006 International Journal of Oral Biology Vol.31 No.2

Dysplasia-associated seizure disorders are markedly resistant to pharmacological intervention. Relatively little research has been conducted studying the effects of antiepileptic drugs(AEDs) on seizure activity in a rat model of dysplasia. We have used rats exposed to methylazoxymethanol acetate(MAM) in utero, an animal model featuring nodular heterotopia, to investigate the effects of AEDs in the dysplastic brain. Pilocarpine was used to induce acute seizure in MAM-exposed and age-matched vehicle-injucted control animals. Field potential recordings were used to monitor amplitude and numbers population spikes, and paired pulse inhibition in response to stimulation of commissural pathway. Two commonly used AEDs were tested: diazepam 5, 2.5mg/kg;phenytoin 40, 60mg/kg. Diazepam(DZP) and phenytoin(PHT) reduced the amplitude of population spike in control and MAM-exposed rats. However, the amplitude of population spike was nearly eliminated in control rats as compared to the MAM-exposed rats. Pharmaco-resistance was tested by measuring seizure latencies in awake rats after pilocarpine administration(320mg/kg, i.p.) with and without pretreatment with AEDs. Pre-treatment with PHT 60 mg prolonged seizure latency in control rats, but not in MAM-exposed animals. The main findings of this study are that acute seizures initiated in MAM-exposed rats are relatively resistant to standard AEDs assessed in vivo. These data suggest that animal model with cortical dysplasia can be used to screen the effects of potential AEDs.

FORREST II 궤양 출혈의 적절한 치료 유용성 : 전향적 무작위 연구

김성은,이선영,신정은,주미순,전정현,이경은 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

Objectives : This study is to compare the clinical and cost effectiveness of various pharmacologic therapies with of without endoscopic procedure in the Forrest II ulcer. Methods : Between May 2001 and June 2002, total of 58 Forrest II bleeding activity patients (37 cases of NBVV, 6 adherent blood clots, 9 flat red spot, and 6 flat black spot) with gastric ulcer(32 cases) and duodenal ulcer(26 cases) were analyzed. UGI endoscopy was performed within 12 hours of the first bleeding episodes, and underwent repetitive endoscopy after 48h. All the patients were randomly assigned to receive somatostatin(group I), PPI(omeparzole : group II), only H2 blocker (famotidine, group III), or endoscopic injection therapy followed by famotidine (group IV). We compared with rebleeding rates, changes of ulcer size, and modified estimated costs for 3 day-hospital in four groups respectively. Results : 1) Twelve patients experienced rebleeding(20.7%). 2) The rates of rebleeding were 16.6% (2/12) in group I, 28.6%(4/14) in group II, 5.9%(1/17) in group III, 26.7% in group IV. There was no significant difference in rebleeding rate among the groups, but there was low rebleeding tendency in group III, compared with group II(p=0.087).3)Type of stigmata including non-bleeding visible vessels and adherent clots were associated with an increased rate of recurrent bleeding(p=0.01).4) When modified estimated costs were calculated, group III could be treated at the lowest cost(p<0.05). Conclusion : In Forrest II bleeding ulcer, medical therapy, especially famotidine could be suggested prudently as a proper treatment modality for this lesion, considering the cost-effecti-veness. 목적: 위십이지장의 궤양성 출혈은 대부분 특별한 치료없이 보존적인 치료만으로 지혈된다. 그러나 활동성 출혈이 있는 Forrest II 궤양의 경우는 흔히 내시경적인 치료를 하게 되는데 최근 여러 연구에서 약물치료와 비교 연구가 있었으나 다양한 약물들과 내시경 치료의 효과 및 비용-효용성의 비교는 이루어지지 않았다. 방법: 2001년 5월부터 2002년 6월가지 Forrest II 궤양출혈 환자 68명을 전향적으로 포함시켰고 이중 위암으로 진단된 경우와 내시경의 추적 검사를 거부한 경우 또는 다른 중증의 내과적 질환이 동반된 경우를 제외시켜 58명의 환자를 대상으로 하였다. 대상 환자 58명은 위궤양이 32명이고 십이지장 궤양이 26명으로 비출혈성노출 혈관 37명, 신선 부착 혈괴 6명, 적색반 9명, 그리고 흑색반 6명이었다. 초기 상부 위장관 내시경은 내원 후 12시간 이내에 이루어졌고 추적 검사는 48시간 이후에 시행되었다. 치료는 네 개의 군으로 나누어 무작위로 소마토스타틴 투여군(1군), 프로톤펌프 억제제 투여군 (2군), H₂수용체 차단제 투여군(3군), 그리고 내시경적 지혈제 주사군(4군)으로 치료하였고 각 군의 재출혈 여부, 혈압, 수혈, 궤양의 크기, 급성 출혈 흔적 등을 비교 관찰하였고 입원 3일간의 입원치료비용을 계산하였다. 결과: 1) 재출혈은 12명(20.7%) 에서 발생하였다. 2) 각군에서의 재출혈은 제1군이 16.6%(2/12), 제2군에서 28.6%(4/14), 제3군이 5.9%(1/17), 제4군이 26.7%(4/15)로 각 군의 재출혈 빈도는 차이가 없었으나 제3군에서 제2군에 비해 재출혈이 낮은 경향을 보였다.(p=0.087).3) 재출혈에 영향을 미치는 인자는 노출 현환과 신선 혈괴였다(p=0.01). 4)평균 입원치료 비용은 제3군이 가장 적어 높은 치료 비용-효과를 보였다.(p<0.05).

Duplication or deletion of chromosome 17p11.2-p12 in CMT1 and HNPP peripheral neuropathy patients

Kim, Hyo-Sun,Jang, Young-Eun,Chung, Ki-Wha 公州大學校 基礎科學硏究所 2003 自然科學硏究 Vol.10 No.-

CMT와 HNPP 말초신경증은 가장 흔하게 발병하는 운동 및 감각 말초신경계의 선천성 질환이다. CMT1과 HNPP의 유전적 원인으로는 염색체 17p11.2-p12의 1.5 Mb 지역의 중복과 결실이 각각 50%이상과 70% 이상을 차지하는 것으로 알려졌다. 본 연구에서 한국인 CMT1 및 HNPP 환자를 대상으로 중복 및 결실을 조사하였는데, 31 CMT1 가족 중 13 가족에서 중복을 보였으며 (42%), 24 HNPP 가족 중 19 가족에서 결실을 보였다 (79%). 17p11.2-p12 중복을 보이는 CMT1A 환자가 HNPP 결실환자보다 발병 연령, 발병 기간, 근육 이양성 및 족 기형성에서 훨씬 심한 증상을 보였다. Charcot-Marie-Tooth disease (CMT) and hereditary neuropathy with liability to pressure palsies (HNPP) are most common inherited motor and sensory peripheral neuropathies. The majority of CMT1 patients have a 1.5 Mb duplication in chromosome 17p11.2 while most HNPP patients have a deletion of the same region. In the analysis of Korean CMT1 and HNPP patients, each HNPP deletion and CMT1A duplication was observed from 79% (19 families) among 24 HNPP families and 42% (13 families) among 31 CMT1 families. CMT1A duplication patients showed more severe clinical symptoms than HNPP deletion patients, when we examined oneset age, disease duration, muscular atrophy, foot deformity and scoliosis.

기억력 저하를 호소하는 노인들을 대상으로 INM176를 3개월간 임상시험한 후의 치료성적 및 부작용 평가 보고

김지혜,고선규,고효정,권영아,김성환,김재경,김태은,박재우,서민영,송영란,이인수,김도관 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2

Objectives : We examined the effects of INM 176 (K-l107) compared with placebo on the cognitive functions of 92 old aged subjects with cognitive impairment. Methods : This was a prospective, 12 week, double-blind, Placebo-controlled clinical trial. The elderly who achieved a score of less than 25 points on the K-MMSE or showed a high risk of Alzheimer's disease from the 7-Minute Neurocognitive Screening Battery were considered to have objective impairment and were selected as subjects for this study. The subjects were randomized to placebo or INM 176 group. The outcome measures were from the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog), the Instrumental Activities ofDaily Living (IADL) and the Korean Geriatric Depression Scale (KGDS) and two kinds of computerized priming tests. After setting the total error score in the Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog) as the repeated measurement factor, an analysis of variance of the combined factor design was done between the placebo and INM 176 group. Results : The interaction effect of time (pre- and post-trial) and group (placebo and INM 176 group) was significant in the analysis of the ADAS-cog's total error score. The INM 176 group's total error score in the ADAS-cog decreased significantly (p<0.01), whereas the placebo group showed a slight increase. The mean changes in IADL and GDS from baseline scores favored in the INM 176 group than in the placebo group. Outcome changes ofADAS-cog, IADL, KGDS scores during the 12 week clinical trail ofINM 176 and placebo demonstrated favorable responses in the INM176 administered group. Conclusions : This is a preliminary clinical trial result of INM176 as a memory pill. Based on these results, INM176 may be a candidate molecule for the improvement of cognitive functions, including memory, Further clinical trial should demonstrate its efficacy.

Proteomic Approach to Analyzing Flooding Stress in Soybean (Glycine max(L.) Merr.)

Kim,Tae-Seon,Cho,Seong-Woo,Lee,Jae-Eun,Kim,Yook-Han,Cho,Kun,Choi,Jong-Soon,Chung,Keun-Yook,Song,Beom-Heon,Jong,Seung-Keun,Kim,Hong-Sig,Woo,Sun-Hee 한국작물학회 2005 한국작물학회 학술발표대회 논문집 Vol.2005 No.-