• Advances in pediatric surgery
• /
• v.5 no.1
• /
• pp.75-81
• /
• 1999

A survey on the intestinal atresias was made among 34 members of Korean Association of Pediatric Surgeons. The response rate was 82.4 %. Two hundred and fifteen patients from the January 1, 1994 to December 31, 1996 were analyzed. The lesions were 73 cases of duodenum(DA), 72 cases of jejunum(JA), 71 cases ileum(IA) and 2 cases cecum and sigmoid colon respectively. There were 2 cases of combined anomalies (DA + JA + IA and DA + JA). Male to female ratio was 1:1 in DA, and 1.8:1 in JA. Seventy four cases(34.3 %) were premature babies(DA 35.2 %, JA:48.6 %, IA:19.2 %), and 62 cases(28.7 %) had low birth weight (DA:39.4 %, JA 33.0 %, IA:13.7 %). Antenatal diagnosis was made in 92 cases(43.6 %). However 22 cases (23.9 %) of them were transferred to pediatric surgeon after delivery. Maternal polyhydramnios was observed in 63 cases(28.9 %). Seventy· five cases(34.4 %) were taken only simple abdominal film for diagnostic studies. The associated malformations were observed in 54 aresia and were observed more frequently in DA(35 cases, 47.9 %). Meconium peritonitis due to intrauterine bowel perforation was more frequently associated with IA compared to DA and JA. The overall mortality rate was 30 %. (Abbreuations: $P_{T}$;p-value in total, $P_{DJ,DI,JI}$;p value between two groups among duodenal, jejunal and ileal groups).

• Journal of Nutrition and Health
• /
• v.48 no.1
• /
• pp.46-57
• /
• 2015

Purpose: The aim of this study was to determine an appropriate energy level of breakfast with less risk of chronic disease for Korean adults. Methods: Using data from the 2007~2009 Korean National Health & Nutrition Examination Survey, from a total of 12,238 adults aged 19~64, the final 7,769 subjects were analyzed except subjects who were undergoing treatment for cancer or metabolic disorder. According to the percent of breakfast energy intake versus their estimated energy requirement (EER), the subjects were divided into four groups: < 10% (very low, VL), 10~20% (low, L), 20~30% (moderate, M), ${\geq}30%$ (sufficient, S). All data were analyzed on the metabolic risk and nutritional state after application of weighted value and adjustment of sex, age, residential area, income, education, job or jobless, and energy intake using a general linear model or logistic regression. Results: The subjects of group S were 16.9% of total subjects, group M 39.2%, group L 37.6%, and group VL 6.3%. The VL group included more male subjects, younger-aged (19 to 40 years), urban residents, higher income, higher education, and fewer breakfasts eaters together with family members. Among the 4 groups, the VL group showed the highest waist circumference, while the S group showed the lowest waist circumference, body mass index, and serum total cholesterol. The groups of VL and L with lower intake of breakfast energy showed high percent of energy from protein and fat, and low percent of energy from carbohydrate. With the increase of breakfast energy level, intake of energy, most nutrients and food groups increased, and the percentage of subjects consuming nutrients below EAR decreased. The VL group showed relatively higher intake of snacks, sugar, meat and eggs, oil, and seasonings, and the lowest intake of vegetable. Risk of obesity by waist circumference was highest in the VL group by 1.90 times of the S group and the same trend was shown in obesity by BMI. Risk of dyslipidemia by serum total cholesterol was 1.84 times higher in the VL group compared to the S group. Risk of diabetes by Glu-FBS (fasting blood sugar) was 1.57 times higher in the VL group compared to the S group. Conclusion: The results indicate that higher breakfast energy level is positively related to lower metabolic risk and more desirable nutritional state in Korean adults. Therefore, breakfast energy intake more than 30% of their own EER would be highly recommended for Korean adults.

• Clinical and Experimental Reproductive Medicine
• /
• v.37 no.2
• /
• pp.115-124
• /
• 2010

Objective: To testify whether the increased peripheral blood natural killer (pbNK) cells fraction and their cytolytic activity could coincide with patient's history of recurrent spontaneous abortion (RSA) and to evaluate these factors are can be valuable diagnostic markers in RSA. Methods: Women with a history of RSA comprised the patient group (n=35). Normal fertile women, who were experienced at least one healthy term birth without history of infertility or recurrent miscarriage, were included as the healthy control group (n=15). The pbNK cells of $CD3^-/CD56^+/CD16^+$ and their cytolytic activities against K562 cells were measured by flow cytometry and the values were compared between study and control groups. Results: Proportions of pbNK cells among peripheral blood monocytes (PBMC) ($14.2{\pm}5.2$ vs. $9.4{\pm}3.7%$, p=0.002, 95% confidence interval [CI], 1.8 to 7.8) was significantly higher in the patient group. The odds ratio of having RSA history was increased as 8.4 folds (59% of sensitivity, 80% of specificity, and 95% CI: 2.0 to 35.8) in patients who showed pbNK cells fraction above 12.1% which was determined as cut-off value by using ROC curve analysis. The cytolytic activities of pbNK cells which measured by three different ratio of effecter pbNK cells to target K562 cells and calculated by the percent of cytolytic K562 cells, were significantly higher in study group than that of control group (in 50:1 ratio, $48.3{\pm}19.0$ vs. $31.3{\pm}11.9%$, p=0.002; in 25:1 ratio, $37.0{\pm}18.1$ vs. $20.2{\pm}9.2%$, p<0.001; in 12.5:1 ratio, $23.5{\pm}12.7$ vs. $12.4{\pm}7.3%$, p=0.001). With the cut-off values of cytolytic activity of pbNK cells as 43.1% (50:1), 26.9% (25:1), and 17.4% (12.5:1) each, the risk of having RSA history was increased by 10.0, 11.4, and 15.0 folds in patients who had increased in each effector of pbNK to target of K562 cells ratio. Conclusion: The analysis of pbNK cells fraction and their cytolytic activity can be valuable diagnostic markers for RSA. We are going to planning the large scaled studies which include the data of obstetric outcomes in subsequent pregnancies to clarify our results of this study.

• Clinical and Experimental Reproductive Medicine
• /
• v.35 no.4
• /
• pp.309-317
• /
• 2008

Objectives: The aim of this study was to evaluate the usefulness of Anti-mullerian hormone (AMH) as a predictive marker for ovarian response and cycle outcome in IVF cycles. Methods: From Jan., to Aug., 2007, 111 patients undergoing IVF/ICSI stimulated by short or antagonist protocol were selected. On cycle day 3, basal serum AMH level and FSH level were measured. The correlation between basal serum AMH or FSH, and COH outcome was analyzed and IVF outcome was compared according to the AMH levels. To determine the threshold value of AMH for poor- and hyper-response, ROC curve was analyzed. Results: Serum AMH showed higher correlation coefficient (r=0.792, p<0.001) with the number of retrieved mature oocyte than serum FSH (r=-0.477, p<0.001). According to ovarian response, FSH and AMH leves showed significant differences among poor, normal, and hyperresponder. For predicting poor (${\leq}2$ oocytes) and hyperresponse (${\geq}17$ oocyets), AMH cut-off values were 0.5 ng/ml (the sensitivity 88.9% and the specificity 89.5%) and 2.5 ng/ml (sensitivity 85.7%, specificity 87.0%), respectively. According to the AMH level, patients were divided into 3 groups: low (${\leq}0.60\;ng/ml$), normal ($0.60{\sim}2.60\;ng/ml$), and high AMH (${\geq}2.60\;ng/ml$). The number of retrieved mature oocytes was significantly higher ($2.7{\pm}2.2$, $8.1{\pm}4.8$, $16.5{\pm}5.7$) and total gonadotropin dose was lower ($3530.5{\pm}1251.0$, $2957.1{\pm}1057.6$, and $2219.2{\pm}751.9\;IU$) in high AMH group (p<0.001). There was no significant difference in fertilization rates and pregnancy rates (23.8%, 34.0%, 37.5%) among the groups. Conclusions: Basal serum AMH level correlated better with the number of retrieved mature oocytes than FSH level, suggesting its usefulness for predicting ovarian response. However, IVF outcome was not significantly different according to the AMH levels. Serum AMH level presented good cut-off value for poor- or hyper-responders, therefore it could be useful in prediction of cycle cancellation, gonadotropin dose, and OHSS risk in IVF cycles.

• Journal of Gastric Cancer
• /
• v.5 no.1
• /
• pp.10-15
• /
• 2005

Purpose: Recently the role of vitamins, folate in particular, has been emphasized in the maintenance of health. Folate deficiency is known to give rise to developmental delay, immature vascular disease, neural tube defect, acute leukemia, atherosclerotic vascular disease, delivery defects, breast cancer, and particularly gastrointestinal neoplasia. Methylenetetrahydrofolate reductase (MTHFR) is an essential enzyme in folate metaboism, and influences DNA synthesis and DNA methylation. Generally, folate deficiency is associated with gastrointestinal neoplasms. The amino-acid- changing and enzyme-activity-reducing nucleotide polymorphism (766C$\rightarrow$T/ Ala222Val) has been described in the MTHFR polymorphism and leads to low enzyme activity that may reduce the capacity of DNA methylation and possibly uracil mis-incorporation into DNA. These processes may be critical in the oncogenic transformation of human cells, especially in colorectal carcinomas. We investigated the relationship between the MTHFR polymorphism in gastric cancer and the tumor site, the smoking history, and the alcoholic history. Materials and Methods: Ninety-six (96) individuals with gastric cancer and 287 healthy persons were analyzed. Blood sampling was performed, PCR-RFLP was analyzed, and MTHFR polymorphism genotypes of C/C, C/T, and T/T were obtained and analyzed statistically for their correlation. Results: In the gastric cancer group there were 69 ($72\%$) males and 27 ($28\%$) females. There were also 58 cases ($60\%$) involving the gastric lower body, 20 cases ($21\%$) the gastric mid-body, and 18 cases ($19\%$) the gastric upper body. In the control group there were 169 ($59\%$) males and 118 ($41\%$) females. Among the gastric cancer, 56 ($61\%$) smoking patients, 40 ($39\%$) non-smoking patients, 45($47\%$) alcoholic patients, 51 ($53\%$) non-alcoholic patients. In the gastric cancer group, MTHER polymorphisms were C/C in 18 ($19\%$) cases, C/T in 59 ($61\%$) cases, T/T in 19 ($20\%$) cases. In the control group polymorphisms were C/C 116 ($40\%$) cases, C/T 103 ($36\%$) cases, and T/T 68 ($24\%$) cases (P=0.045). In cases of lower gastric body cancer, polymorphisms were C/C in 16 ($24\%$) C/C in 16 ($24\%$) cases and C/T or T/T in 42 ($72\%$) cases. In cases of upper and mid-body cancer, polymorphisms were C/C in 2 ($5\%$) cases and C/T or T/T 36 ($95\%$) cases (P=0.006). In the non-smoking patient group, polymorphisms were C/C in 5 (12%) cases and C/T or T/T in 35 ($88\%$) cases. In the smoking patient group, C/C in 13 ($23\%$) cases and C/T or T/T in 43 ($77\%$) cases (P=0.189). In the non-alcoholic patient group, polymorphisms were C/C in 6 ($12\%$) cases and C/T or T/T in 45 ($88\%$) cases. In the alcoholic patient group, polymorphisms were C/C in 12 ($26\%$) cases and C/T or T/T in 33 ($74\%$) cases (P=0.063) Conclusion: MTHFR polymorphisms are associated with gastric cancer and tumor site, but not with smoking and alcohol drinking.

• Korea journal of population studies
• /
• v.19 no.2
• /
• pp.77-105
• /
• 1996

The rural problems which we are facing start from the extremely small sized population and the skewed population structure by age and sex. Thus we analyzed the change of the rural population. And we analyzed the recent return migration to the rural areas by comparing the recent in-migrants with out-migrants to rural areas. And by analyzing the rural village survey data which was to show the current characteristics of rural population, we found out the effects of the in-migrants to the rural areas and predicted the futures of rural villages by characteristics. The changes of rural population composition by age was very clear. As the out-migrants towards cities carried on, the population composition of young children aged 0~4 years was low and the aged became thick. The proportion of the population aged 0~4 years was 45.1% of the total population in 1970 and dropped down to 20.4% in 1995, which is predicted to become under 20% from now on. In the same period(1970~1995), the population aged 65 years and over rose from 4.2% to 11.9%. In 1960, before industrialization, the proportion of the population aged 0~4 years in rural areas was higher than that of cities. As the rural young population continuously moves to cities it became lower than that in urban areas from 1975 and the gap grew till 1990. But the proportion of rural population aged 0~4 years in 1995 became 6.2% and the gap reduced. We can say this is the change of the characteristics of in-migrants and out-migrants in the rural areas. Also considering the composition of the population by age group moving from urban to rural area in the late 1980s, 51.8% of the total migrants concentrates upon age group of 20~34 years and these people's educational level was higher than that of out-migrants to urban areas. This fact predicted the changes of the rural population, and the results will turn out as a change in the rural society. However, after comparing the population structure between the pure rural village of Boeun-gun and suburban village of Paju-gun which was agriculture centered village but recently changed rapidly, the recent change of the rural population structure which the in-migrants to rural areas becomes younger is just a phenomenon in the suburban rural areas, not the change of the total rural areas in general. From the characteristics of the population structure of rural village from the field survey on these villages, we can see that in the pure rural villages without any effects from cities the regidents are highly aged, while industrialization and urbanization are making a progress in suburban villages. Therefore, the recent partial change of the rural population structure and the change of characteristics of the in-migrants toward rural areas is effecting and being effected by the population change of areas like suburban rural villages. Although there are return migrants to rural areas to change their jobs into agriculture, this is too minor to appear as a statistic effect.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1981.05a
• /
• pp.6-7
• /
• 1981

With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study. 1. Sex incidence……male: female=1 : 1.7, Age incidence……21-30 years age group; 38 cases (39.6%). 2. Suicidal attempt……80 cases(83.3%), Accidental ingestion……16 cases (16.7%). Among those who ingested the substance accidentally, children below ten years were most numerous with nine patients. 3. Incidence acetic acid……41 cases(41.8%), lye…20 cases (20.4%), HCI……17 cases (17.3%). There was a trend of rapid rise in the incidence of acidic corrosive agents especially acetic acid. 4. Lavage……57 cases (81.1%). 5. Nasogastric tube insertion……80 cases (83.3%), No insertion……16 cases(16.7%), late admittance……10 cases, failure…4 cases, other……2 cases. 6. Tracheostomy……17 cases(17.7%), respiratory problems(75.0%), mental problems (25.0%). 7. Early endoscopy……11 cases(11.5%), within 48 hours……6 cases (54.4%). Endoscopic results; moderate mucosal ulceration…8 cases (72.7%), mild mucosal erythema……2 cases (18.2%), severe mucosal ulceration……1 cases (9.1%) and among those who took early endoscopic examination; 6 patients were confirmed mild lesion and so they were discharged after endoscopy. Average period of admittance in the cases of nasogastric tube insertion was 4 weeks. 8. Nasogastric tube indwelling period……average 11.6 days, recently our treatment trend in the corrosive esophagitis patients with nasogastric tube indwelling is determined according to the finding of early endoscopy. 9. The No. of patients who didn't given and delayed administration of steroid……7 cases(48.9%): causes; kind of drug(acid, unknown)……12 cases, late admittance……11 cases, mild case…9 cases, contraindication……7 cases, other …8 cases. 10. Management of stricture; bougienage……7 cases, feeding gastrostomy……6 cases, other surgical management……4 cases. 11. Complication……27 cases(28.1%); cardio-pulmonary……10 cases, visceral rupture……8 cases, massive bleeding……6 cases, renal failure……4 cases, other…2 cases, expire and moribund discharge…8 cases. 12. No. of follow-up case……23 cases; esophageal stricture……13 cases and site of stricture; hypopharynx……1 case, mid third of esophagus…5 cases, upper third of esophagus…3 cases, lower third of esophagus……3 cases pylorus……1 case, diffuse esophageal stenosis……1 case.

• The Journal of Korean Society for Radiation Therapy
• /
• v.33
• /
• pp.145-153
• /
• 2021

Purpose: The purpose of this study is to evaluate the ovarian dose during radiation therapy for breast cancer in women of childbearing age through an experiment. The ovarian dose is evaluated by comparing and analyzing between the calculated dose in the treatment planning system according to the treatment technique and the measured dose using a thermoluminescence dosimeter (TLD). The clinical usefulness of lead (Pb) apron is investigated through dose analysis according to whether or not it is used. Materials and Methods: Rando humanoid phantom was used for measurement, and wedge filter radiation therapy, 3D conformal radiation therapy, and intensity modulated radiation therapy were used as treatment techniques. A treatment plan was established so that 95% of the prescribed dose could be delivered to the right breast of the Rando humanoid phantom 3D image obtained using the CT simulator. TLD was inserted into the surface and depth of the virtual ovary of the Rando hunmanoid phantom and irradiated with radiation. The measurement location was the center of treatment and the point moved 2 cm to the opposite breast from the center of the Rando hunmanoid phantom, 5cm, 10cm, 12.5cm, 15cm, 17.5cm, 20cm from the boundary of the right breast to the center of treatment and downward, and the surface and depth of the right ovary. Measurements were made at a total of 9 central points. In the dose comparison of treatment planning systems, two wedge filter treatment techniques, three-dimensional conformal radiotherapy, and intensity-modulated radiation therapy were established and compared. Treatments were compared, and dose measurements according to the use of lead apron were compared and analyzed in intensity-modulated radiation therapy. The measured value was calculated by averaging three TLD values for each point and converting using the TLD calibration value, which was calculated as the point dose mean value. In order to compare the treatment plan value with the actual measured value, the absolute dose value was measured and compared at each point (%Diff). Results: At Point A, the center of treatment, a maximum of 201.7cGy was obtained in the treatment planning system, and a maximum of 200.6cGy was obtained in the TLD. In all treatment planning systems, 0cGy was calculated from Point G, which is a point 17.5cm downward from the breast interface. As a result of TLD, a maximum of 2.6cGy was obtained at Point G, and a maximum of 0.9cGy was obtained at Point J, which is the ovarian dose, and the absolute dose was 0.3%~1.3%. The difference in dose according to the use of lead aprons was from a maximum of 2.1cGy to a minimum of 0.1cGy, and the %Diff value was 0.1%~1.1%. Conclusion: In the treatment planning system, the difference in dose according to the three treatment plans did not show a significant difference from 0.85% to 2.45%. In the ovary, the difference between the Rando humanoid phantom's treatment planning system and the actual measured dose was within 0.9%, and the actual measured dose was slightly higher. This did not accurately reflect the effect of scattered radiation in the treatment planning system, and it is thought that the dose of scattered radiation and the dose taken by CBCT with TLD inserted were reflected in the actual measurement. In dosimetry according to the with or without a lead apron, when a lead apron was used, the closer the distance from the treatment range, the more effective the shielding was. Although it is not clinically appropriate for pregnancy or artificial insemination during radiotherapy, the dose irradiated to the ovaries during treatment is not expected to significantly affect the reproductive function of women of childbearing age after radiotherapy. However, since women of childbearing age have constant anxiety, it is thought that psychological stability can be promoted by presenting the data from this study.

• The Korean Society of Law and Medicine
• /
• v.23 no.4
• /
• pp.29-74
• /
• 2022

As social disasters occur under the Disaster Management Act, which can damage the people's "life, body, and property" due to the rapid spread and spread of unexpected COVID-19 infectious diseases in 2020, information collected through inspection and reporting of infectious disease pathogens (Article 11), epidemiological investigation (Article 18), epidemiological investigation for vaccination (Article 29), artificial technology, and prevention policy Decision), (3) It was used as an important basis for decision-making in the context of an infectious disease crisis, such as promoting vaccination and understanding the current status of damage. In addition, medical policy decisions using infectious disease data contribute to quarantine policy decisions, information provision, drug development, and research technology development, and interest in the legal scope and limitations of using infectious disease data has increased worldwide. The use of infectious disease data can be classified for the purpose of spreading and blocking infectious diseases, prevention, management, and treatment of infectious diseases, and the use of information will be more widely made in the context of an infectious disease crisis. In particular, as the serious stage of the Disaster Management Act continues, the processing of personal identification information and sensitive information becomes an important issue. Information on "medical records, vaccination drugs, vaccination, underlying diseases, health rankings, long-term care recognition grades, pregnancy, etc." needs to be interpreted. In the case of "prevention, management, and treatment of infectious diseases", it is difficult to clearly define the concept of medical practicesThe types of actions are judged based on "legislative purposes, academic principles, expertise, and social norms," but the balance of legal interests should be based on the need for data use in quarantine policies and urgent judgment in public health crises. Specifically, the speed and degree of transmission of infectious diseases in a crisis, whether the purpose can be achieved without processing sensitive information, whether it unfairly violates the interests of third parties or information subjects, and the effectiveness of introducing quarantine policies through processing sensitive information can be used as major evaluation factors. On the other hand, the collection, provision, and use of infectious disease data for research purposes will be used through pseudonym processing under the Personal Information Protection Act, consent under the Bioethics Act and deliberation by the Institutional Bioethics Committee, and data provision deliberation committee. Therefore, the use of research purposes is recognized as long as procedural validity is secured as it is reviewed by the pseudonym processing and data review committee, the consent of the information subject, and the institutional bioethics review committee. However, the burden on research managers should be reduced by clarifying the pseudonymization or anonymization procedures, the introduction or consent procedures of the comprehensive consent system and the opt-out system should be clearly prepared, and the procedure for re-identifying or securing security that may arise from technological development should be clearly defined.

• Proceedings of the Korean Society for Food Science of Animal Resources Conference
• /
• 1995.11a
• /
• pp.1-48
• /
• 1995

식생활은 인간 생활의 주체이고 먹는다는 것은 그 수단이다. 그중 중요한 하나의 명제는 인간이 놓여진 여러 환경에서 어떻게 건강을 유지하고 그 개체가 소유하고 있는 능력을 최대치까지 생리적으로 성장 발전시킴과 동시에 최대한 수명을 연장시키기 위한 식물 섭취방법을 마이크로 레벨까지 해명하는데 있다. 인간은 일생동안 엄청난 양의 음식물을 먹는다(70세 수명일 경우 200만 파운드 즉 체중의 1,400배). 그러나 먹기는 먹되 자신의 건강과 장수를 위하여 어떤 음식을 어떻게 선택하여 어떻게 먹어야 하는 문제가 매우 중요하다. 최근 우리나라도 국민 소득이 늘면서 식생활은 서구화 경향으로 기우는 듯하다. 공해를 비롯한 수입식품 등 여러 가지 문제점이 제기됨에 따라 자연식과 건강식을 주장하는 소리가 높이 일고 있다. 그중에는 축산 식품이 콜레스테롤 함량이 다른 식품에 비하여 높게 함유하고 있다는 것으로 심혈관질환의 주범인양 무차별 강조하는 나머지 육식공포 내지는 계란 등의 혐오감 마저 불러 일으키는 경향까지 있는 듯하다. 따라서 본논고에서는 축산식품중의 콜레스테롤 함량수준이 과연 성인병의 주범인지 아니면 다른 지방산과 관련해서 올바르게 평가하고 그 문제점과 대책을 개관해 보고 요약하면 다음과 같다. 1. 사람은 유사이래 본능적으로 주변의 식물이나 동물의 고기를 먹고 성장하여 자손을 증식시키고 어느 사이에 늙으면 죽음을 맞이 하는 싸이클을 반복하면서 기나긴 세월동안 진화를 하여 오늘날의 인간으로서의 자태를 이루었다. 유인원과 같은 인류의 선조들은 수렵을 통해 육식을 많이 하였을 것이므로 인간은 원래 육식동물이 아닐까? 구석기시대의 유물을 보면 많은 뼈가 출토되고 “얄타미라”나 “라스코” 동굴벽화가 선명하게 묘사되고 있다. 2. 우리나라 선조 승구족의 일파가 백두산을 비롯한 만주 송화강 유역에 유입되면서 수렵과 목축을 주요 식품획득의 수단으로 식품문화권을 형성하면서 남하하여 한반도 민족의 조상인 맥족(貊族)으로 맥적(貊炙)이라고 하는 요리(오늘날의 불고기)를 먹었다는 기록이 있다. 3. 인간의 수명을 1900년대로 거슬러 올라가서 뉴질랜드가 세계최장수국(호주는 2위)로서 평균수명은 남자 58세, 여자 69세인 반면 일본과 한국은 당시 남자 36세, 여자 37세이던 것이 일본은 1989년에 이르러 세계 최장수국으로 등장했으나 1990년 당시 뉴질랜드${\cdot}$호주 등은 목축 및 밀(小麥) 생산국가였기 때문이라는 것과 일본은 오늘날 합리적인 식생활 국가라는 것을 간과해서는 안된다. 4. 우리나라 10대 사망원인중 (1994년도) 뇌혈관질환이 1위, 교통사고 2위, 암이 3위 순위로서 연령별로는 10~30대의 불의의 사고(교통사고), 40~60대는 암, 70대 이상은 뇌혈관질환이 가장 많다. 구미${\cdot}$일 7개국 정상국가들은 심질환 사망이 가장 높다. 5. 식생활의 변화에 있어서 우리나라는 주식으로 섭취해 왔던 곡류는 70년 대비 94년에는 0.7배 감소된 반면 육류 5배, 계란 2.4배, 우유는 무려 29.3배 증가되었다. 식생활 패턴이 서구화 경향으로 바뀌는 것 같다. 6. 71년도 우리나라의 지질섭취량은 국민 1인당 1일 평균 13.1g에 섭취에너지의 5.7%수준이었으나 92년도에는 34.5g으로서 총에너지 섭취량의 16.6%에 달하고 총섭취 지방질중 동물성 섭취 비율은 47%를 차지 한다. 국민 평균 혈청콜레스테롤 농도는 80년에 비해 88년에는 11%가 증가되었고 80년에 210mg/dl 이상 되는 콜레스테롤 혈증인 사람의 비율이 5%에서 88년에는 23%로 크게 증가했다. 7. 세계 정상국가들의 단백질 즉 축산식품의 섭취는 우리나라보다 적게는 2배, 많게는 6~7배 더 섭취하고 90년도 우리나라의 지질섭취량은 일본의 1/3수준에 불과하다. 8. 콜레스테롤은 인체를 비롯한 모든 동물체에 필수적으로 분포하고 있는 것으로 체내 존재하고 있는 총량은 90~150g, 이중 혈청콜레스테롤은 4%(6g)를 차지하고 있음에도 불구하고 이 아주 적은 콜레스테롤에 일희일비(一喜一悲) 논쟁은 60~70년 끄러오고 있다. 9. 콜레스테롤의 생체내 기능으로서는 (1) 세포벽의 지지물질 (2) 신경세포 보호막물질 (3) 담즙산의 합성 (4) 비타민 D의 합성 (5) 임신시에 반듯이 필요한 분자 (6) 기타 여러 가지 기능을 수행하는 것으로 필수적인 물질이다. 10. 우리가 식이를 통해서 섭취 콜레스테롤을 550mg정도를 섭취한다고 하더라도 이 정도의 양은 배설 소모되는 양과 거의 맞먹는 양이다. 피부와 땀샘에서 소실되는 양만도 100~300mg에 달하기 때문에 미국농무성에서 섭취량을 300mg로 제한하는 것은 무의미하다. 11. 콜레스테롤 운반체로서의 지단백질은 그 밀도가 낮은 것으로부터 킬로미크론(chylomicron), 초저밀도 지단백질(VLDL), 저밀도 지단백질(LDL) 및 고밀도 지단백질(HDL)으로 나누는데 LDL은 혈청콜레스테롤 중 약 70%, HDL은 약20%를 함유한다. 12. 혈중 콜레스테롤 수준에 영향을 미치는 요인을 열거하여 보면 다음과 같다. 1) 음식을 통해서 섭취되는 콜레스테롤 중 단지 10~40%정도가 흡수되고, 체내에서 합성되는 콜레스테롤이 증가할수록 식이콜레스테롤은 실제 혈청콜레스테롤 수준에 거의 영향을 미치지 않으므로 식이중함량에 대하여 공포를 느끼고 기피할 필요가 없다. 2) 고도불포화지방산, 단가불포화지방산, 포화지방산의 비 즉 P/M/S의 비가 균형되도록 권장한다. 3) 동맥경화를 비롯한 성인병의 원인이 되는 혈전증에는 EPA의 양을 높여줌으로서 성인병을 예방할 수 있다. 4) 오메가6지방산 아라키도닉산과 오메가3지방산인 EPA로 유도되는 에이코사에노이드 또는 프로스타노이드는 오메가6와 3지방산을 전구체로 하여 생합성되는 중요한 생리활성 물질이다. 5) 사람은 일반적으로 20세에서 60세까지 나이를 먹어감에 따라 혈중 콜레스테롤 수준이 증가하고 60세 이후부터는 일정한 수준을 유지하며 심장보호성 HDL-콜레스테롤은 감소하는 반면에 죽상경화성 LDL콜레스테롤은 증가한다. 6) 높은 HDL콜레스테롤 수준이 심장병 발생 위험요인을 감소시키는 기능을 갖고 있기 때문에 좋은 HDL이라 부르고, LDL은 나쁜 콜레스테롤이라 부르기도 하는데, 이것은 유전적 요인보다도 환경적 요인이 보다 큰 영향을 미친다. 7) 이것은 생활 형태와 영양섭취상태를 포함해서 개인적 생활패턴에 영향을 받는다. 8) 많은 실험에서 혈중 콜레스테롤 상승은 노년의 가령(加齡)에 적응하기 위한 자연적 또는 생리적인 세포의 생화학적이고 대사적인 기능을 위해 필수적일 수 있다는 것을 간과해서는 안될 것이다. 이 점으로 미루어 노년의 여성들을 위한 콜레스테롤 농도를 200mg/dl이 가장 알맞은 양이 아닌 듯하다. 9) 스트레스는 두가지 모양으로 유발되는데 해로은 스트레스(negative), 이로운 스트레스(positive)로서 긴장완화는 혈중 콜레스테롤 농도를 10% 떨어진다. 10) 자주 운동을 하는 사람들은 혈중 HDL콜레스테롤치가 운동을 하지 않는 사람보다 높다. 육체적인 운동의 정도와 혈중 HDL콜레스테롤 농도와는 정비례한다. 11) 흡연은 지방을 흡착시키므로 혈전증의 원이이 되며 혈관속의 HDL농도를 감소시킨다. 12) 에너지의 과잉섭취에 의한 체중 증가느 일반적으로 지단백질대사에 영향을 미치고, 간에서는 콜레스테롤 과잉 생산과 더불어 VLDL콜레스테롤의 LDL콜레스테롤 혈증을 나타냄으로 운동과 더불어 비만이 되지 않도록 하여야 한다. 13. 콜레스테롤 함량에 대한 조절기술 1) 식품의 우열을 평가할 때 단순히 동물성 또는 식물성 식품으로 분류해서 총괄적으로 논한다는 것은 지양되어야 한다. 이것은 그 식품에 함유하고 있는 지방산의 종류에 따라서 다르기 때문이다. 2) 인체의 원할한 기능 유지를 위해서는 P /M /S비율 뿐만 아니라 섭취 지방질의 오메가6 /오메가3계 지방산의 비율이 모두 적절한 범위에 있어야 하며 한두가지 지방산만이 과량일 때는 또 다른 불균형을 일으킬 수 있다는 점을 알아야 한다. 3) 닭고기는 오메가6지방산 함량을 높이기 위하여 사료중에 등푸른 생선이나 어분이나 어유를 첨가하여 닭고기는 첨가수준에 따라 증가됨을 알 수 있다. 4) 오늘날 계란내의 지방산 조성을 변화시켜 난황내의 오메가 3계열 지방산 함량을 증가시킨 계란의 개발이 활발해졌다. 14. 계란 콜레스테롤에 대한 소비자들의 부정적 인식을 불식시키고자 계란의 클레스테롤 함량을 낮추는 과제가 등장하면서 그 기술개발이 여러모로 시도되고 있으나 아직 실용 단계에 이르지 못했다. 15. 계란의 콜레스테롤 문제에 대한 대책으로서 난황의 크기를 감소시키는 방법에 대한 연구도 필요하다. 16. 계란 중 콜레스테롤 함량 분석치는 표현 방식에 따라서 소비자들을 혼란시킬 가능성이 있다. 또한 과거에는 비색법으로 분석했으나 오늘날은 효소법으로 분석하면 분석치에 상당한 차이가 있다. 17. 소비자의 요구를 만족시키고 버터 소비를 촉진시키기 위해 콜레스테롤을 감소시키는 물리적${\cdot}$생물학적 방식이 제안되어 있으나 현장적용이 가능한 것은 아직 없다. 18. 우리나라에서 이미 시판되고 있는 DHA우유가 선보였고 무콜레스테롤 버터의 경우 트란스(trans)형 지방산에 관해서는 논란의 여지가 많을 것이다. 끝으로 국가 목표의 하나는 복지사회 건설에 있고 복지국가 실현에는 국민 기본 욕망의 하나인 식생활 합리화가 선행되어야 한다. 소득이 늘고 국가가 발전해감에 따라 영양식${\cdot}$건강식 및 기호식을 추구하게 됨을 매우 당연한 추세라 하겠다. 우리의 식생활이 날로 향상되어 지난날의 당질 위주에서 점차 축산물쪽으로 질적 개선이 이루어진다는 것은 고무적임에 틀림없다. 이 축산물을 통한 풍요로운 식의 문화를 창출하면서 건강과 장수 그리고 후손에 이르기까지 번영하고 국가 경쟁력 강화에 심혈을 기우려야 할 때이다.