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The Impact of President Kim Dae-jung’s Beliefs on North Korea Policy
Jeong-yong Kim 한국학술연구원 2003 Korea Observer Vol.34 No.2
This article inquires into the source of the Kim Dae-jung administration’s unwavering commitment to Kim’s Sunshine Policy vis-à-vis North Korea. Although such international variables as U.S. policy towards the North helped shape South Korea’s policy, this study argues that former President Kim Dae-jung’s beliefs regarding Korean unification and strategies for North Korea policy -- developed through diverse experiences over many long years -- were pivotal. Changes in the international environment and within North Korea in the 1990s impelled Kim to more precisely articulate his thoughts on North Korea, which found expression as a Three-stage Unification Plan. During his presidency, Kim’s abiding belief in his Sunshine Policy served as a causal belief, information screen, and decision-making rule for the South Korean government as it formulated and implemented North Korea policy.
장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4
Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.
김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2
Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.
서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)
김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1
In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.
Yong‑Min Kim,Ha‑Seung Seong,Jung‑Jae Lee,Da‑Hye Son,Jin‑Su Kim,Soo‑Jin Sa,Young‑Sin Kim,Tae‑Jeong Choi,Kyu‑Ho Cho,Joon‑Ki Hong,Jung‑Woo Choi,Eun‑Seok Cho 한국유전학회 2020 Genes & Genomics Vol.42 No.12
Background: Woori-Heukdon (KWH) is a Korean synthetic pig breed generated using Chookjin-Duroc (KCD), Chookjin-Chamdon (KCC), and their crossbreds. Currently, there is a severe lack of studies investigating the Korean breed populations including wild boars (KWB) throughout the genome. Objective: This study was performed to investigate the genetic characteristics of Korean pig populations at the genome-wide level. Methods: Using the SNP dataset derived from genotyped and downloaded datasets using the Illumina PorcineSNP60K BeadChip, we compared the genomes of 532 individuals derived from 23 pig breeds to assess the genetic diversity, inbreeding coefficient, genetic differentiation, and population structure. Results: KWB showed the lowest average expected heterozygosity (HE = 0.1904), while KWH showed the highest genetic diversity (HE = 0.02859) among Korean populations. We verified that the genetic composition of KWH, showing USD of 74.8% and KCC of 25.2% in ADMIXTURE analysis. In population structure analyses, KCC was consistently shown to be separated from other pig populations. In addition, we observed gene flow from Western pigs to a part of Chinese populations. Conclusion: This study showed that Korean native pigs, KCC have genetic differences in comparison with Chinese and Western pigs; despite some historical records and recent genetic studies, we could not find any clear evidence that KCC was significantly influenced by Chinese or Western breeds in this study. We also verified the theoretical genomic composition of KWH at the molecular level in structure analyses. To our knowledge, this is the first genomic study to investigate the genomic characteristics of KWH and KCC.
Yong‑Ho Kim,Hyo‑Sang Yoo,Jeong‑Han Lee,Ik‑Hyun Oh,Hyun‑Kuk Park,Hyeon‑Taek Son 대한금속·재료학회 2021 METALS AND MATERIALS International Vol.27 No.7
In order to investigate the microstructure and mechanical properties on Al–25Cr–5Si (at%) alloy, a mixed powder with pureelements and an alloy powder using a gas atomization process were used. Fine and high purity Al–25Cr–5Si (at%) alloypowder was successfully prepared by gas atomization and densified using a spark plasma sintering (SPS) process. The overallpowder size distribution of the mixed Al, Cr, and Si elemental powders was in the range of 10–15 μm. The atomized Al–Cr–Sialloy powder was fine and spherical in morphology and difficult to be formed by intermetallic formation. Densification wasclearly confirmed at 1000 °C, with almost isolated pores formed, by clear removal of pores between particles, deformationof particles, an increase in the number of contacts, and a change in size between particles. As a result of XRD analysis ofthe sintered compacts, single phase was observed using the mixed powder, but the compact using gas atomization remainedthe alloy phase even at the process temperature. The Vickers hardness of the compacts by mixed powder was observed at59.70 Hv and the compact using gas atomized powders on the temperature 1000 °C of the Vickers hardness increased to702.6 Hv. The compressive yield strength of the compact with mixed powder was 195.24 MPa and the compressive strengthof the compact with gas atomized powder increased to 802.07 MPa. It is considered not to be decomposed by the AlCrSi,Al13Cr4Si4and Al8Cr5phases sintering process, resulting from the improvement of mechanical properties.
조혈모세포이식 환자의 삶의 질에 대한 연구 : 화학요법 환자 및 정상인과의 비교
김병수,서재홍,최철원,김열홍,김준석,김정아,손상균,김재석,이경희,이제중,정익주,곽재용,안진석,이정애,박영석 대한조혈모세포이식학회 1999 대한조혈모세포이식학회지 Vol.4 No.1
연구배경: 조혈모세포이식후 신체 및 정신적 장애의 정도가 얼마나 환자의 '삶의 질(QOL)'에 영향을 미치는지에 대하여 외국에서는 연구들이 활발히 진행되고 있다. 그러나 우리나라에서는 조혈모세포이식이 비교적 활발히 시술되고 있음에도 불구하고 이에 대한 연구가 미미한 실정이었다. 연구자 등은 우리 나라에서 조혈모세포이식을 받은 환자들의 QOL은 어떤지를 알아보고자 하는 목적으로 본 연구를 시행하였다. 방법: 본 연구에 참여한 각 기관에서 조혈모세포이식을 받고 주된 치료가 끝난 후 1999년 2월 시점에서 최소 3개월이 지나고 관해상태에서 일상생활을 영위하고 있는 재생불량성 빈혈과 급성 및 만성 백혈병 환자들을 각각 자가 및 동종 조혈모세포이식을 시행받은 조혈모세포이식군(1군)과 항림프구 글로불린, 공고요법 등으로 치료를 끝낸 화학요법군(2군)으로 분류하고 연구자 병원에 내원한 건강한 환자 보호자들로 이루어진 정상대조군(3군)을 선정하여 각각의 QOL을 비교, 분석하였다. QOL의 측정은 EORTC QLQ-C30 문항을 우리나라의 실정에 맞게 번역하여 사용하였다. 결과: 조혈모세포이식군(1군)은 53명, 화학요법군(2군)은 57명, 정상대조군(3군)은 55명 이었고, 성별, 나이, 질환별 분포, 검사시점 등에서의 유의한 차이는 없었다. 각 군간의 QLQ-C30 평균 점수를 비교한 결과, 전반적인 삶의 질에서는 1군이 73.5, 2군이 51.7, 3군이 79.3으로 2군이 1.3군보다 낮았고 역할 및 사회기능은 각각 1군이 64.3/68.9, 2군이 57.6/70.3, 3군이 85.2/85.5로 1,2군이 3군에 비하여 낮았다.(P<0.01). 또한, 오심/구토가 1군은 8.7, 2군은 4.5, 3군은 3.2로 1군이 2, 3군보다 높았으며 통증은 1군은 17.0, 2군은 19.2, 3군은 9.6으로 1,2군이 3군에 비하여 높았다(p〈0.01). 기타 신체, 감정, 인식기능 및 피로에서는 각군간에 유의한 차이를 발견할 수 없었다. 결론: 본 연구에 참여한 조혈모세포이식환자들의 전반적인 삶의 질은 화학요법을 받은 환자들보다 우월하면서 정상인들과 유사하였으나 역할기능 및 사회기증, 통증에서는 화학요법 환자들처럼 정상인들에 비하여 열악하였고 오심/구토는 화학요법 환자들 및 정상인에 비하여 심한 양상을 보였다. 그러므로 본 연구를 바탕으로 하여 국내 실정에 맞는 QOL 측정 방법을 개발하고 조혈모세포이식을 시행받는 환자들의 삶의 질에 관한 연구들이 향후 계속 진행되어야 하리라고 생각된다. Background: It is very important to endow patient with satisactory quality of life (QOL). However, little is known about QOL after hematopoietic stem cell transplantation (HSCT) in Korea. In this study we tried to measure QOL in the patients treated with HSCT and compare QOL scores with those of patients treated with usual chemotherapy and normal populations. Methods: The QOL evaluation was performed with EORTC QLQ-C30 questionnaires interpreted to Korean language. The study populations were consisted with 53 patients treated with HSCT (Group 1), 55 patients treated with usual chemotherapy (Group 2), and 55 normal populations (Group 3). The QLQ-30 scores of each group were evaluated and compaired with x² test. Results: Global quality of in group 1, 3 (score: 73.5, 79.3, respectively) were higher than that (score: 51.7) of group 2. Role and social function were lower in group 1, 2 (score: 64.3/68.9, 57.6/70.3, respectively) than those (score: 85.2/85.5) of group 3. The degree of nausea and vomiting was more severe in group 1 (score: 8.7) than those of group 2, 3 (score: 4.5, 3.2 respectively). Pain scores of group 1, 2 (score: 17.0, 19.2, respectively) were more higher than that of group 3 (score: 9.6) In other parameters of QLQ-C30, there was no significant difference between each groups. Conclusion: Our perliminary result may suggest that HSCT is not necessarily associated with deterioration of QOL. This underlines the necessity of undertaking perospective studies using reliable and well-validate methods for measuring QOL
쿠싱증후군 환자에서 당 대사 이상 정도에 따른 인슐린 감수성과 인슐린 저항성의 변화
정인경,김성훈,정재훈,민용기,이명식,이문규,유형준,안규정,노정현,김동준,김광원 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4
연구배경 당질 코르티코이드는 당 대사에 매우 중요한 호르몬으로 내인성 당질 코르티코이드 과다상태인 쿠싱증후군에서는 말초조직에서 인슐린 저항이 증가하고 이를 보상하고자 인슐린 분비의 증가로 고인슐린혈증이 동반된다고 보고되고 있다. 하지만 생체 내에서와 달리 시험관내에서는 췌도세포에 당질 코르티코이드를 장시간 처리하면, 인슐린 분비 및 생합성이직접적으로 억제됨이 확인된 바 있어 쿠싱증후군 환자에서 당뇨병의 원인으로는 아마도 말초조직에서 증가된 인슐린 저항성 뿐 아니라 이를 충분히 보상하지 못하는 췌장에서의 인슐린 분비 저하가 같이 동반되어있지 않을까 하는 가설을 세우게 되었고, 아직까지 당질코르티코이드가 당대사 이상을 일으키는 기전에 대해 쿠싱증후군을 당대사 정도에 따라 인슐린 감수성과 분비능을 분석한 연구는 없었기에 이를 알아보고자 하였다. 방법: 삼성서울병원에서 쿠싱증후군으로 진단 받은 환자 15명을 대상으로 하였다. 이에 대한 대조군으로는 쿠싱증후군 환자와 같은 성별 그리고 체질량지수를 갖은 15명의 건강한 성인을 대상으로 비교 하였다 쿠싱증후군 환자를 대상으로 경구당부하 검사를 통해 당대사 정도를 정상군, 내당능장애군, 그리고 당뇨병군으로 나눈 후 정맥 당부하 검사를 시행하여 각군의 인슐린 저항성과 인슐린 분비능의 지표를 비교하고, 수술 후 쿠싱증후군이 완치된 상태에서 수술 전후의 당대사 지표의 변화를 조사하였다. 결과: 1) 쿠싱증후군 환자 중 정상인은 20%, 내당능 장애는 27%, 그리고 당뇨병은 53%였다. 체질량지수, 나이, 그리고 발병 기간은 세 군간에 의미 있는 차이가 없었으나, 24시간 소변검사의 코르티솔 농도는 당뇨병군에서 의미있게 높았다. 2) 정맥당부하 검사 결과, 인슐린 감수성 지표인 Sl는쿠싱증추린」서 1.58±0.10[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 대조군의 3.37±0.49[×10^(-4)(min^(-1)(μU/mL)^(-1)]에 비해 의미있게 낮았으나(P=0.024), 쿠싱증후군 환자 중 NGT, IGT, DM 군간에 서로 통계적인 차이는 없었다. 3) SG는 정상 대조군과 쿠싱증후군 환자간에는 의미있는 차이가 없었고, 쿠싱 증후군에 있어서 당대사가 악화될수록 감소하는 경향을 보였으나 의미있는 차이는 없었다. 4) 인슐린 분비능의 지표인 AIRg는 정상인에 비해 전체 쿠싱증후군 환자의 경우 증가하는 경향을 보였으나 의미있는 차이는 없었다. 하지만 쿠싱증후군 환자중에서 당대사 상태에 따라 NGT군은 1299 (1297∼1310)(mu/g/min ×10^(-2))로 정상 대조군(368.9±98.6[mu/g/min ×10^(-2)]) 보다도 의미있게 높았고, DM군{202.2 (91.1~371.4) [mu/g/min ×10^(-2)}은 NGT군에 비해 의미있게 낮았다(P=0.0031). 5) 15명중 현재 완치 상태에 있는 6명에 대해 수술전과 후로 비교하였다. 수술 전 당대사 상태가 1명은정상, 1명은 내당능 장애, 그리고 4명은 당뇨병이었으나 수술 후 시행한 경구 당부하 검사상 모두 정상 당대사 상태를 보였다. 6) 수술 후 완치된 환자 6명에 있어 인슐린 감수성지표인 Sl는 수술전에 중앙값이 1.22[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 대조군에 비해 의미있게 감고』어 있었으나(p.0.05), 수술후 10.95 [×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 수준으로 회복되었고(P=0.0022), 인슐린 분비능을 나타내는 AIRg [mu/g/min ×10^(-2)] 값도 정상수준으로 회복되었다. 특히 인슐린 분비능의 회복양상은 혈당농도에 따라 판이하게 나타나서, 정상과 내당능장애 상태에 있던 2명은 수술전에 1201 [mu/g/min ×10^(-2)]로 증가되어 있던 AIRg 값이 수술 후 정상 수준으로 감소하였고, 수술 전에 당뇨병 상태에 있던 4명의 경우 245.9 [mu/g/min ×10^(-2)]로 인슐린 분비능이 감고il어 있었는데 이들은 수술 후 모두 정상 수준으로 증가되었다 (P=0.0286). 결론: 쿠싱증후군 환자에서 당대사 이상은 80%로 높은 유병률을 보였다. 모든 쿠싱증후군환자에서 인슐린 감수성은 정상인에 비해 저하되어 있어 말초조직의 인슐린 저항이 선행됨을 시사하며, 인슐린 분비능은 당대사의 정도에 따라 다르게 나타났는데, 정상 당대사군에서는 인슐린의 저항성을 극복할 만큼 정상 대조군보다 더 많은 양의 인슐린 분비를 하다가 고코르티솔혈증이 심할수록 인슐린 분비능의 감소로 당뇨병으로 진행됨을 확인할 수 있었고, 이런 인슐린 저항성과 인슐린 분비장애는 수술 후 다시 회복되는 가역적인변화를 보였다. Background: Glucocorticoid plays an important role in the control of carbohydrate metabolism. Patients with Cushing's syndrome have been reported to have an increased incidence of carbohydrate intolerance due to peripheral insulin resistance and hyperinsulinemia, although the exact incidence and nature of this disorder have remained unclear. Few results have been published about insulin resistance and insulin secretion according to the level of glucose concentration, or about the reversibility of such defects in patients with Cushing's syndrome. Methods: To assess the effect of glucocorticoid on the insulin sensitivity and insulin secretion in Cushing's syndrome, 15 patients with Cushing's syndrome were classified into 3 groups (normal glucose tolerance: NGT, impaired glucose tolerance: IGT, diabetes: DM) according to the degree of glucose tolerance based on the oral glucose tolerance test (OGTT). Insulin modified, frequently sampled, intravenous glucose tolerance test (FSIGT) was performed before and after curative surgery on these patients and on 15 healthy control subjects. Data were evaluated by non-parametric statistical analysis. Results: 1) Among the 15 patients with Cushing's syndrome, 3 (20%) were NGT, 4 (27%) IGT, and 8 (53%) DM, based on OGTT. Twenty-four hour urinary free cortisol (UFC) was significantly higher in the DM group. 2) Insulin sensitivity index (SI) of Cushing's syndrome was significantly lower than that of the control group p=0.0024), but was not significantly different among the three Cushing's syndrome groups of NGT, IGT and DM. 3) Glucose mediated glucose disposal (SG) (Ed- confirm this abbreviation; it does not seem to match the definition) of Cushing's syndrome was not significantly different from that of the control group. 4) Insulin secretion (AIRg) of Cushing's syndrome tended to be high, but it was not significantly different from that of control. However, according to the level of glucose concentration there was significant difference in AlRg among the three Cushing's syndrome groups p=0.0031); AIRg of DM was significantly lower than that of NGT. 5) After surgical treatment, parameters of insulin sensitivity and insulin secretion were normalized in 6 cured patients; 1 with NGT, 1 with IGT, and 4 with DM, preoperatively. Median SI of all 6 patients was significantly improved up to the normal range postoperatively p=0.0022). Median AIRg of these 6 patients was balanced around that of normal control postoperatively p=0.0286). Conclusion: Eighty percent of patients with Cushing's syndrome had abnormality of carbohydrate metabolism. Insulin sensitivity was significantly decreased in Cushing's syndrome. Insulin secretion was significantly higher only in the NGT and IGT groups of Cushing's syndrome. As the hypercortisolemia is exacerbated, insulin secretion is significantly decreased and causes DM, suggesting that glucocorticoid has a direct or indirect toxic effect on the pancreatic beta cell (J Kor SOC Endocrinol 18:392-403, 2003).
데빅병 치료에 사용한 Interferon β-1b의 부작용 1예
김정미,조은경,조정선,최용석,한영수,한정호,김두응,최진영 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-
A 63 year-old woman who had diagnosis of multiple sclerosis complaining left hemiparesis and fluctuating decreased visual acuity in her right eye and abnormal findings in pattern shift visual evoked potentials(PSVEPs) and on T2 weighted MR scanning. We treated her subcutaneously with 250μg interferon (3-lb(ITFß -lb) every other day. There were detected pancytopenia, skin rash, and abnormal liver function test seven days after the therapy. In spite of reducing the dose of interferon injection, abnormal laboratory findings were not returned to normal. Dose adjustment of interferon-I3 for body weight or race, may be helpful to reduce the side effects.