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      • KCI등재후보

        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.

      • KCI등재

        한국인 직무 스트레스 측정도구의 개발 및 표준화

        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.

      • 1996-1997년 겨울철에 유행한 인플루엔자의 임상역학적 분석 및 원인 바이러스의 분리

        김수정,정규영,이용화,기창석,이남용,이상일,김지희 대한감염학회 1997 감염 Vol.29 No.4

        목적: 인플루엔자는 매년 겨울 전 세계적인 유행을 일으키는 급성 호흡기 질환으로 높은 이환률과 사망율을 보인다. 국내에서도 1996-1997년 겨울철에 다수의 보고가 있었으나 아직 체계적인 감시가 이루어지고 있지 못하다. 저자들은 이 기간 동안 인플루엔자 바이러스 감염의 역학적 특성과 임상상을 연구하여 인플루엔자 감시의 기초 자료를 제공하고자 하였다. 방법: 1996년 10월부터 1997년 4월까지 삼성서울병원 임상병리과에 인플루엔자 바이러스 배양 검사가 의뢰된 모든 검체를 대상으로 인플루엔자 바이러스의 분리율과 유행 양상, 그리고 환자들의 임상상을 후향적으로 조사, 분석하였다. 결과: 총 461명의 환자로부터 525례의 검체가 의뢰되어 총 98명의 환자로부터 인플루엔자 바이러스가 분리되었다. 인플루엔자 A형은 54명의 소아 환자와 4명의 소아 환자로부터 분리되었다. 아형과 항원 특성 검사를 시행한 31례의 인플루엔자 A형 중 한 예에서 A/Wuhan/359/95 유사주로 확인되었고 12례의 인플루엔자 B형 중 5례에서 B/Guangdong/8/97 유사주로 확인되었다. 인플루엔자의 유행 양상은 3월과 4월 중순, 두 번의 인플루엔자 최고 분리 시점이 관찰되었고, 가장 많은 불리 빈도를 보인 연령층은 인플루엔자 A형의 경우 1세 미만이었고 인플루엔자 B형의 경우 3-5세였으며 폐렴이 가장 흔한 호흡기 질환이었다. 결론: 저자들은 3차 의료기관에서 분리된 인플루엔자 바이러스에 대한 역학적, 임상적 특성을 연구하였다. 지역사회에 대한 광범위한 연구가 아니므로 국내의 전반적 상황과는 차이가 있을 것으로 생각되지만 우리나라에서도 인플루엔자 바이러스의 이환률이 낮지 않을 것으로 생각되며, 보다 조직적이고 전국적인 인플루엔자 감시가 이루어져야 할 것으로 사료된다. Background: Although influenza has been a leading cause of global morbidity and mortality, we have few data regarding the epidemioloical and clinical characteristics of influenza activity in korea. Since an outbreak of influenza was recognized during winter of 1996-1997, we analysed the epidemiological and clinical features of influenza activity in the hospital seeting. Methods: All clinical specimens requested for isolation of influenza virus at Samsung Medical Center from October 1996 to April 1997 were included. Mardin-Darby canine kidney (MDCK) cell line was used for virus culture. Isolated viruses were confirmed with immunostain followed by subtyping. The demograpic and clinical characteristics of the patients were reviewed retrospectively. Results: Ninety eight influenza viruses were isolatd from 461 patients (21.3%). Influenza A and B virus were isolated from 58 (54 children and 4 adults) and 40 pediatric patients, respectively. One of 31 influenza A viruses was confirmed as A/Wuhan/359/95-like strain and 5 of 12 influenza B viruses were confiremd as B/Guangdong/8/97-like strains. Two distinctive peaks of influenza activity were recognized and the most common age of patients was less than 1 year for influenza A, and 3 to 5 years for influenza B. Common lower respiratory infections were pneumonia followed by croup, bronchiolitis and laryngitis. Conclusion: We analyzed the epidemiological and clinical features of influenza activity during winter of 1996-1997. Although this study was performed not in the community but in the hospital setting, the morbidity caused by influenza may not be low in Korea. Therefore, nationwide surveillance for influenza activity is warranted.

      • 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.

      • 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

      • KCI등재후보

        위절제술 환자의 표준진료지침 개발 및 적용 효과

        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.

      • KCI등재

        대퇴동맥을 통한 경피적 관동맥 중재시술 환자의 천자부위 지혈을 위한 Angioseal^(�) 사용과 고식적 용수 압박법의 비교 : 전향적 연구

        김용훈,권현철,김필호,안석진,유철웅,최진호,이상철,김준수,김덕경,전은석,이상훈,홍경표,박정의,서정돈 대한내과학회 2004 대한내과학회지 Vol.66 No.5

        목적 : 경피적 관동맥 중재술은 최근 양적 및 질적으로 급격한 발전을 보였지만 시술 시 천자부위의 혈관 합병증은 아직 해결해야 할 문제점이다. 저자들은 대퇴동맥을 통한 경피적 관동맥 중재술을 환자에게 천자부위 지혈을 위한 혈관폐쇄기구인 안지오실의 안전성과 유용성을 고식적인 용수 압박법과 비교 연구하고자 하였다. 방법 : 2002년 4월부터 2003년 5월 사이에 삼성서울병원 심장혈관센터에서 대퇴동맥을 통한 경피적 관동맥 중재술을 성공적으로 시행한 200명의 환자(안지오실 사용군: A군, 100명, 고식적 용수압박법 사용군 B군, 100명)를 대상으로 시술 후 주요 합병증 및 경한 합병증, 지혈 후 환자가 자리에 앉기까지의 시간, 보행개시 가능시간, 총 재원 기간과 시술 1주 후의 합병증을 전향적으로 조사하여 비교 연구하였다. 결론 : 두 군에서 연령, 성별, 기저질환, 심혈관 질환의 위험요소, 시술의 종류, 시술 중 사용한 헤파린의 양, clopidogrel의 양, ticlopidine의 양, 지혈 시 수축기와 확장기혈압, ACT (activated clotting time)는 차이가 없었다. A군이 B군에 비해 시술 후 자리에 앉기까지의 시간 (A군: 4.3±0.3시간, B군: 13.7±0.8시간, p=0.004) 및 보행개시까지의 시간(A군: 6.8±0.5시간, B군: 18.8±2.1시간, p=0.013)이 유의하게 짧았다. 시술 후 주요 합병증은 두군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 A군에서 유의하게 적었다(A군: 28명, B군: 19명, p=0.003). 반상출혈의 경우는 A군에서 유의하게 낮았지만(A군: 3명, B군: 12명, p=0.01), 혈종, 출혈의 발생은 두군간에 차이가 없었다. 총 재원기간에는 두 군간에 차이가 없었다(p=0.239). 시술 1주 후 경과관찰에서 주요합병증은 역시 두 군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 두 군에서 차이가 없었다(A군: 15명, B군: 13명 p=0.418), 반상출혈의 빈도는 차이가 없었지만 혈종의 발생은 A군에서 더 낮았다(A군: 2명, B군:6명, p=0.004). 두 군 모두에서 출혈은 발생하지 않았다. 결론 : 대퇴동맥을 통한 경피적 관동맥 중재술을 시행한 환자에서 안지오실의 사용은 고식적 용수 압박법에 비해 환자의 침상 안정시간을 줄여 조기 활동개시가 가능하게 하였으며 국소합병증의 위험도를 일부 낮추어, 시술에 따른 환자의 불편을 현저하게 감소시킬 수 있다고 할 수 있을 것으로 기대된다. Background : Although the number and the quality of percutaneous coronary intervention have been recently increased dramatically, the vascular complication at puncture site is still the major cause of patients' morbidity. We evaluated the safety and efficacy of newly of newly-developed collagen-based arterial closure device, Angioseal after transfemoral percuatenous coronary intervention. Methods : This study was designed as a prospective single center non-randomized comparative study. A total 200 patients undergoing transfemoral percutaneous coronary intervention were enrolled between April 2002 and May 2003. They were divided into two groups; Angioseal group (group A, n=100) and manual compression group (group B, n=100). The baseline clinical and angiographic characteristics were reviewed. The time to sit up, the time to ambulation, the duration of hospital stay, major and minor vascular puncture site complications were monitored. The patients were followed-up for 1 week after procedure by telephone. Results : The baseline clinical characteriwtics, clinical diagnosis, cardiocascular risk factors, typesof procedure, doses and numbers of anticoagulants were similar between two groups. The blood pressure and activated clotting time were also similar. The time to sit up (group A: 4.3±0.3 hours, group B: 13.7±0.8 hours, p=0.004) and the time to ambulation (group A: 6.8±0.5 hours, group B: 18.8±2.1 hours, p=0.013) were shorter in group A. No major vascular complications were noted. The incidence of hematoma and bleeding were not significantly different between two groups. The incidence of ecchymosis, however, was significantly lower in group A (group A:12%, group B: 3%, p=0.001) The duration of gospital stay was similar between groups. During 7 days of follow-up period incidence of hematoma was significantly lower in group A (p=0.004). Although the incidence of ecchymosis was not significantly different between two groups. Conclusion : The angioseal may be associated with earlier ambulation and less patients' morbidity with low incidence of local complication rate compared to manual compression after transfemoral percutaneous coronary intervention.

      • KCI등재

        Genome-wide investigation of a Korean synthetic breed, Woori-Heukdon using the Illumina PorcineSNP60K BeadChip

        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.

      • 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.

      • SCOPUSKCI등재

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