무상의료 제도 도입에 대한 쟁점 분석

유은주,이근무 한국사회복지정책학회 2004 사회복지정책 Vol.19 No.-

본 연구의 목적은 무상의료제도에 대한 쟁점과 이슈들을 분석하고 실현가능한 대안은 제시하기 위함이다. 이를 위해 통합된 준거틀을 만들어 분석했는데 이 준거틀은 문제의 구조화, 예측, 영항평가로 구성되었다. 분석결과 첫째로, 경계분석기법을 사용하여 문제를 구조화한 결과 정책문제는 '전문가적 자율성의 침해', '의료자본주의', '의료공공성 강화', '의료제도의 합리화', '분배정의의 실현'으로 나타났다. 둘째, 델파이기법을 사용한 판단적 예측의 결과 이해당사자간 심한 갈등과 불일치를 보이는 것으로 나타났다. 마지막으로 사회 경제적 영향 평가모형을 사용하여 무상의료제도의 실시가 국민건강 환경과 경제에 미치는 영향은 분석한 결과 긍정적인 영향과 부정적인 영향이 공존할 것이라는 예측이 나왔다. 이상에서와 같이 무상의료제도는 규범적 가치와 당위성은 있으나 비용과 형평성에 문제가 있는 것으로 판단되었다. 이에 대한 대안으로 의료공개념을 제시했고 구체적인 방안으로는 공공병원의 확충과 진료비 지불제도를 총액예산제로 전환할 것을 제언했다. The purpose of this paper is to analyze the issues and disputes on National Health Service(NHS) and suggest the realizable alternatives. For this, this study makes united conformity frame and this consists of problem structuring, forecasting, and evaluation. Firstly, the result of problem structuring by boundary analysis that political problems appeared an invasion of professional autonomous rights, medical capitalism, reinforcement of medical public sector, rationalization of medical system, and accomplishment of distribution justice. Secondary, the result of forecasting for judgment by Delphi technique appeared terrible conflict and discord among the persons concerned. Finally, socio-economically, the effect of analysis which affected environment of peoples' health and economy by effective evaluation model was forecasted to coexist affirmative effect and negative effect. According to our analysis, NHS was turned out to have normative value and what might be but to have troubles in cost and equality. We suggested the public concept of medical treatment, an expansion of public hospital, and a shift of global budget system from the payment system of medical fee by this alternatives.

최근 8년간(2001-2008) 서울대학교치과병원 소아치과의 진료현황 및 수익분포 변화에 대한 조사

손유진,현홍근,김영재,김정욱,이상훈,김종철,한세현,장기택 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

The practice pattern of pediatric dentistry in the university dental hospital has been changing for the last several decades, due to socioeconomic changes, developments in dental materials and increasing number of private pediatric dental clinics. The purpose of this study is to survey the changing patterns of pediatric dental treatment in the university dental hospital and to present the future direction for pediatric dentistry. Patient distribution and practice trends were reviewed based on the OCS (order communication system) records of the department of pediatric dentistry, Seoul National University Dental Hospital from 2001 to 2008. Results were as follows; 1. The number of patients increased up to 2005 and decreased in 2006, and has remained constant up to 2008. 2. The proportion of preventive and orthodontic treatment increased and the proportion of restorative and pulpal treatment decreased. 3. In restorative treatment, amalgam restoration decreased and resin restoration increased. 4. Frequency of sedation decreased in 2006, 2007 and increased in 2008. 5. Frequency of general anesthesia increased up to 2008. 소아치과 전문 지역 의원의 증가, 소아치과에 대한 보호자의 인식 변화, 치의학의 발전, 소아치과 진료 범주의 확대 등에 의해 최근 소아치과의 진료 양상이 크게 변화하고 있다. 이러한 변화 양상을 파악하고 앞으로의 대학병원 소아치과 및 소아치과 전문 지역 의원의 진료분담에 대한 방향성을 제시하고자 본 연구를 시행하였다. 2001년 1월 1일부터 2008년 12월 31일까지 서울대학교치과병원 소아치과에 내원한 모든 초진 및 재진 환자를 대상으로, 서울대학교치과병원 종합의료정보시스템(OCS)을 통하여 1년간의 외래환자집계 및 수가코드별 진료 행위 건수 및 수익 분포를 조사하여 다음과 같은 결과를 얻었다. 1. 내원환자의 수는 2001년부터 2005년까지 대체로 증가하다 2006년에 감소하였으며 그 이후에는 2006년도와 별다른 변화가 없었다. 2. 2001년에는 예방치료가 6.84%, 수복치료가 49.96%, 치수치료가 9.64%, 외과치료가 10.78%, 교정치료가 22.78%를 차지하였으나, 2008년에는 예방치료가 15.40%, 수복치료가 28.97%, 치수치료가 3.28%, 외과치료가 14.83%, 교정치료가 37.52%를 차지하여 수복치료와 치수치료의 비율은 감소하고 예방치료와 교정치료는 증가하였다. 3. 수복치료의 비율에 있어서 아말감과 글라스 아이오노머 수복 및 기성금관수복의 비율은 감소하였고, 레진의 비율은 증가하였다. 4. 진정요법하 치과치료는 2005년까지 증가하다 2006년, 2007년에는 감소하였고, 2008년에 다시 증가하였다. 5. 전신마취하 치과치료는 2001년부터 2008년까지 꾸준히 증가하였다.

纖維補强콘크리트의 特性에 관하여

李裕根 진주산업대학교 1980 論文集 Vol.18 No.-

The concept of using steel fibers as random reinforcement in concrete is of relatively recent origin. In this paper, the effect of steel fibers on the static compressive strengths, splitting tensile strengths, bending strengths, compressive toughness and impulse tests of concrete was studied. The results of this study are conduded as follows; 1) The workabilities of fiber reinforced concrete was decreased definitely with the addition of steel-­fiber. 2) Outherwise the tensile strengh and bending strength were in creased difinitely in the steel fiber added to the concrete. 3) The study was also concluded good condition of concrete toughness in order to prevent craek development by the addition of steel fiber in the concrete.

결핵성 육아종에서 Thioredoxin peroxidase-2 의 발현

박근호,유형륜,정영진,윤기중,한원철,유대열,문형배 圓光大學校 醫科學硏究所 1999 圓光醫科學 Vol.15 No.2

Background: Thioredoxin peroxidase(TPX) is a kind of recently discovered antioxidant enzyme which react as rapid hydrogen ion donor for the removal of hydroperoxide. The action and distribution of the TPX was poorly understood in the human diseases. This experiments were designed for the study about the distribution of the TPX in the chronic granulomatous inflammation and about the correlation between the expression of TPX and the site of inflammation, histological activities of tuberculous inflammation or existence of mycobacterium in the inflammatory foci. Methods: The immunohistochemical stains were performed for the localization of the TPX-2 in the epithelioid cells, giant cells and lymphocytes in the chronic granulomatous inflammation. The tissue sections were obtained from the paraffin blocks of the 54 cases of tuberculosis (lung 21 cases, lymph node 12 cases, bone and soft tissue 12 cases, kidney 9 cases; active 33 cases, inactive 21 cases by the histologic classification; presence of mycobacterium 15 cases, no mycobacterium 39 cases by PCR reaction). Results: The expression of TPX-2 was 16.7% in the giant cells, 27.8% in the epithelioid cells and 100% in the lymphocytes of tuberculous inflammations. The expression of TPX-2 in the giant cells and epithelioid cells of the tuberculosis were 28.6% and 57.1% of the pulmonary tuberculosis; 33.3% in each cells of the renal tuberculosis; 0% in each cells of the lymph node or bone and soft tissue tuberculosis. The expression of TPX-2 in the giant cells and epithelioid cells were 9.1% in each cells of the active tuberculosis and were 28.6% and 57.1% in each cells of the inactive tuberculosis by histologic classification. The expression of TPX-2 in the giant cells and epithelioid cells was 40% in each cells of tuberculosis which mycobacteria were detected and the expression of TPX-2 was 7.7% and 23.1% in each cells which mycobacteria were not detected by PCR reaction in the paraffin embedded tissue. Conclusions: The above results were summarized that the TPX-2 in the giant cells and epithelioid cells were more frequently expressed in the inactive tuberculosis than in the active tuberculosis. These results suggest that the TPX-2 is a kind of regulating or suppressing factors in the activity of the tuberculosis.

응급실에 내원한 약물중독환자의 지역별 비교분석

임근우,박일영,유승진,나병호,오동렬,전해명,황주일,김세경 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

We reviewed retrospectively 230 patients who came to emergency room of Kang Nam St. Mary's Hospital and Uijongbu St. Mary's Hospital between 1. January and 31. December 1994. We classified them according to their age, sex, a sort of drug, the cause of poisoning, prehospital care, time-lapse to arrive at hospital after poisoning, psychiatric problem the status of patients. *We conclude as follows; 1. The male to female ratio was totally 1 : 1.98, 1 : 1.24 in a urban area, 1 : 2.43 in a rural area. 2. On age of the patients in this study, the peake incidence was between 20 and 39(55.2%). 3. On seasonal prevalence, the poisoning was most common in summer and spring, in urban area(35.7%) and rural area(37.0%) respectively. 4. The common drug were as follow; Doxylamine, Organophosphate, Acetaminophen in urban area, Paraquat, Organophospate, Doxylamine in rural area 5. The percentage of suicidal attempt were 81.8% and 87.7% in urban area and rural area respectively. 6. The poisoning patients had psychatric problem in 19.4% and 24.6%, in urban area and rural area respectively. 7. Before arrival to emergency room, 27.7% of patient was done prehospital care in rural area. 8. On arrival to emergency room, 95.1% and 73.8% of patients show stable vital sign in urban area and rural area respectively.

短杭의 引拔低抗力과 SCALE EFFECT에 關한 實驗的 硏究

李裕根,尹龍喆,李炯來 진주산업대학교 1992 論文集 Vol.31 No.-

本 實驗은 杭의 직경을 변화시킨 경우 短杭의 引拔低抗力 實驗的으로 考察했다. 다음은 杭基礎의 引拔低抗力 實驗을 행한 결과를 요약한 것이다. 引拔低抗力과 變位量과의 關係에 있어서 地盤의 다짐정도에 따라 전체적 경향이 다르게 나타났다. 이는 전단대발생 Pattern의 차이가 원인인 것으로 생각할 수 있었지만 여기에 대한 상세한 것은 금후 발표할 예정이다. 그리고 地盤의 다짐정도가 클수록 限界 引拔低抗力은 根入深에 대해서 一次函數的으로 증가했지만 杭의 직경이 클수록 감소했다. 이는 杭의 Scale effect가 원인인 것으로 생각할 수 있지만 금후 상세한 검토를 행할 필요가 있다. 本 實驗에 있어서는 杭의 直徑 43㎜경우를 제외하면 Loose sand상태에 대해서만 實驗을 행하고 지금까지 연구발표된 결과를 토대로 고찰을 행했지만 금후 Dense sand 상태에서의 실험도 행할 필요가 있다. 또 실제 전단대발생에 의한 진행성파괴에 대해서 상세히 고찰할 필요가 있다. The uplift capacity and the scale effect of short piles are important to the rational design of pile foundation. Therefore, this paper discribes the results of an experimental consideration on the uplift capacity and scale effect of short pile. The Pile used in the pull-out test is the cylindrical concrete piles. Pile diameter is 43㎜, 66㎜ and 83㎜. The pile length of embedment is 20㎝~40㎝. Pull-out tests were carried out using sand have two densities : loose these results, the following conclusions were obtained : The rate of increase in ultimate uplift capacity become larger due to the increase in the pile length of the embedment and the unit weight of sand. The larger the pile diameter is, the larger ultimate uplift capacity increases. The larger the pile diameter is, the smaller ultimate uplift capacity per unit area decreases.

이차원전기영동법을 이용한 길항세균 Bacillus licheniformis DM3와 이의 항진균 활성 결여 돌연변이균주간 단백질 비교 분석

이영근,김재성,정혜영,장유신,장병일 한국환경농학회 2003 한국환경농학회지 Vol.22 No.3

항진균 활성균주를 선발하는 과정에서 DM3 균주를 대천 바닷가에서 수집된 진흙 시료로부터 분리하였으며 API 50CHB kit를 이용하여 동정한 결과 Bacillus licheniformis로 동정되었다. 이 균주는 12종의 식물병원성 진균에 대해 항균활성을 나타내었다. 감마선(^(60)Co)을 조사하여 항진균 활성 결핍 돌연변이체(mDM3)를 유도한 후, 이차원전기영동으로 단백질을 분석한 결과 DM3와 mDM3에만 존재하는 각각 4종과 3종의 단백질을 확인할 수 있었다. 2-DE 결과 B. licheniformis DM3에서 spot 1은 serine hydroxymethyltransferase(45.0 kDa), spot 2는 hypothetical protein(40.7 kDa), spot 3는 NifU protein homolog(15.4 kDa), 그리고 spot 4는 resolvase(12.5 kDa)와 상동성을 지닌 단백질로 동정되었고 B. licheniformis mDM3에서만 발현된 spot 5는 lysozyme(18.1 kDa)과 spot 6, 7은 alkyl hydroperoxide reductase(15.6 kDa)으로 동정되었다. B. licheniformis DM3에서 이들 단백질들의 항진균 활성 관련 여부를 규명하기 위해서 더 연구가 진행되어야 할 것으로 사료된다. In the course of screening for antifungal agents, a bacterial strain, DM3 was isolated from a mud sample collected at Daechon in Chungnam province and identified as Bacillus lichenifomris based on API 50CHB test. It has antifurgal activity against 12 plant pathogenic fungi in paper disc assay. At the 95% lethal dose of gamma radiation (^(60)Co, 10 kGy, D_(10)=2.32 kGy), the antifungal activity deficient mutant (mDM3) against Colletotrichum gloeosporioides was induced. From 2-D electrophoresis analysis, serine hydroxymethyltransferase(45.0 kDa), hypothetical protein(40.7 kDa), NifU protein homolog(l5.4 kDa), and resolvase(l2.5 kDa) horn ologous proteins were detected only in B. lichnifomris DM3. Lysozyme(l8.1 kDa) and dkyl hydroperoxide reductase(l5.6 kDa) homologous proteins were expressed uniquely in B. licheniformis mDM3. Further studies are needed to reveal that these proteins from B. lichenifomis DM3 could be closely related to the antifungal activity against plant pathogenic fungi.

구내 신연장치를 이용한 치조골 신연에 미치는 잠복기의 영향

오유근,유선열 전남대학교 치과대학 2000 전남치대논문집 Vol.12 No.1

The present study was aimed to investigate the effects of latency period on alveolar ridge distraction using the intraoral distraction device. Nine adult mongrel dogs of either sex, weighing about 15 kg, were used. They were divided into 3-day, 5-day, and 7-day groups according to the latency period. The left upper and lower premolars and first molars were extracted. Twelve weeks after the extraction, an osteotomy was performed and the distraction device was applied. After the latency period, the distraction was applied at a rate of 1.2mm for 8 days. The distraction device was left in place for 2 weeks to allow consolidation and was then removed. The animals were sacrified at 8 weeks after completion of distraction and were examined macroscopically, radiographically, and histologically. After completion of the distraction, the alveolar crest protruded prominently, showing the vertical augmentation of the alveolar bone. Soft tissues were broken down after the 6th day of distraction in 3-day latency group, and premature union occurred on the 7th day of distraction in the 7-day latency group. The average distance was 9.40±0.3mm in 3-day latency group, 9.35±0.1mm in 5-day latency group, and 8.85±0.1mm in 7-day latency group. In the radiograph taken at 8 weeks after distraction, there was slight bone resorption around the medial and distal edges of the alveolar bone segment, and a new bone deposition was observed in the neighboring alveolar crest area in all groups. Fibrous tissues were present in a part of the buccal cortical bone area of the distraction gap, and the woven and lamellar bones were observed in the distracted gap. There were bony bridges in the distraction gap in all animals examined. These results suggest that optimal time of latency period on alveolar ridge distraction using the intraoral distraction device is about 5 days in dogs, and about 7days in human beings.

안면부, 유방 및 상완부에 발생한 홍반성 루푸스 지방층염 1예

송유근,손두식,명형준,이현정,임중규,김순호,김윤아 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.2

Lupus erythematous panniculitis is a chronic inflammatory disease of subcutaneous fat that occurs in 2-3% of patients with systemic lupus erythematosus. Lupus erythematous panniculitis typically presents with firm, indurated subcutaneous nodules or plaques commonly developed in proximal extremities, trunks, head and neck. Face, breast and upper extremities involvement with lupus erythematous panniculitis has been infrequently reported. We report a case of lupus erythematous panniculitis developed in a 27-year-old female confirmed by histologic features and laboratory findings.

貯水池의 堆砂土에 關하여

李裕根 진주산업대학교 1983 論文集 Vol.21 No.-

The purpose of this paper is to investigated with regard to the character of Sedimented soil and the measurement of sediment in the reservoirs, and the results are as follows. 1) The measurement of sediment in the reservoir came out 186.7㎥/㎢ as yearly mean. 2) The reduction ratio of storage capacity came out 0.04% 3) CEC, Ca, Mg, SiO_2 content of sedimented soil is found out more big than the mean value in the Korea paddy field.