• 의료법학
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• 제19권1호
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• pp.81-111
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• 2018

최근 우리나라에서는 연속적으로 발생한 환자안전사건으로 인해 환자안전에 대한 사회적 관심이 높아졌다. 더불어 환자안전사건 발생 후 의료인 및 의료기관의 대응방식이 논란이 되면서, 사과법 및 디스클로져법 도입의 필요성이 제기되고 있다. 본 연구에서는 미국의 사과법과 디스클로져법 내용을 분석하고, 우리나라의 입법 움직임에 대하여 비판적으로 검토하고자 한다. 먼저 사과법은 의료인 등이 환자측에게 불편감, 통증, 손상, 사망 등에 대해 사과나 위로, 공감 등을 표하는 경우, 사과 등의 표현은 민사재판 및 행정절차에서 법적인 증거로 사용할 수 없도록 하는 것을 그 주요 내용으로 한다. 사과법은 실수, 오류, 잘못, 책임, 법적 책임의 표현과 같은 규범적 평가요소를 증거법의 보호 범위에 포함하는지 여부에 따라 '완전한 사과법'과 '부분적 사과법'으로 구분된다. 한편, 디스클로져법은 의료기관이 심각한 위해가 발생한 사건 등에 있어 사건의 공개, 발생원인, 보상계획, 재발방지대책 등에 관하여 환자 측과 소통하는 것을 법률상 강제하거나 자율적으로 유도하는 것을 그 주요 내용으로 한다. 한편, 최근 우리나라에서도 환자안전사고에 관한 관심이 증폭되고, 의료인 측과 환자측의 의사소통의 중요성이 인식되면서, 위와 같은 미국의 사과법 또는 디스클로져법을 수용한 "환자안전법" 개정법률안이 국회에 제출되기도 하였다. 본 연구에서는 미국의 사과법 및 디스클로져법의 분석을 토대로 위 개정법률안의 내용을 비판적으로 검토함으로써 향후의 입법방향에 시사점을 제시하고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3437-3445
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• 2016

Background: There is an increasing concern in the role of microRNA (miRNA) in the pathogenesis of bone metastasis (BM) secondary to prostate cancer (CaP). In this exploratory study, we hypothesized that the expression of vinculin (VCL) and chemokine X3C ligand 1 (CX3CL1) might be down-regulated in clinical samples, most likely due to the post-transcriptional modification by microRNAs. Targeted genes would be up-regulated upon transfection of the bone metastatic prostate cancer cell line, PC3, with specific microRNA inhibitors. Materials and Methods: MicroRNA software predicted that miR-21 targets VCL while miR-29a targets CX3CL1. Twenty benign prostatic hyperplasia (BPH) and 16 high grade CaP formalin-fixed paraffin embedded (FFPE) specimens were analysed. From the bone scan results, high grade CaP samples were further classified into CaP with no BM and CaP with BM. Transient transfection with respective microRNA inhibitors was done in both RWPE-1 (normal) and PC3 cell lines. QPCR was performed in all FFPE samples and transfected cell lines to measure VCL and CX3CL1 levels. Results: QPCR confirmed that VCL messenger RNA (mRNA) was significantly down-regulated while CX3CL1 was up-regulated in all FFPE specimens. Transient transfection with microRNA inhibitors in PC3 cells followed by qPCR of the targeted genes showed that VCL mRNA was significantly upregulated while CX3CL1 mRNA was significantly down-regulated compared to the RWPE-1 case. Conclusions: The down-regulation of VCL in FFPE specimens is most likely regulated by miR-21 based on the in vitro evidence but the exact mechanism of how miR-21 can regulate VCL is unclear. Up-regulated in CaP, CX3CL1 was found not regulated by miR-29a. More microRNA screening is required to understand the regulation of this chemokine in CaP with bone metastasis. Understanding miRNA-mRNA interactions may provide additional knowledge for individualized study of cancers.

• 디지털융복합연구
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• 제14권8호
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• pp.547-553
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• 2016

본 연구에서는 피부상재균을 대상으로 단일오일의 항균효과를 살펴보는 동시에 2가지 이상의 오일을 혼합한 블랜딩 오일이 실제로 상승효과를 일으키는지 탐색해보고자 하였다. 항균실험에 사용된 에센셜 오일은 100% 유칼립투스(EU), 레몬(LE), 라벤더(LA) 오일이었으며, 2가지 오일 블랜딩의 상승효과를 알아보기 위하여 EU+LE, LE+LA, EU+LA을 1:1의 비율로, 3가지 오일 블랜딩의 상승효과를 알아보기 위해 각 오일을 1:1:1 비율로 혼합하여 배지의 표피포도상구균에 적용한 후 항균 영역 값을 평균 비교하였다. 그 결과, 단일오일에서는 LE이 가장 높은 항균력을 보였으며, LA는 가장 낮은 항균력을 보였다. 2가지오일 블랜딩에서는 EU+LA의 항균력이 단일오일의 항균력의 합보다 커 상승효과를 나타내었다. 그러나 3가지 오일 블랜딩의 항균효과는 아주 낮게 나타나 상승효과를 나타내지 않았다. 이러한 결과는 블랜딩 한 오일의 수 보다 오일을 구성하는 화학 성분들 간의 상호작용이 상승효과에 더욱 중요한 영향을 미친다는 것을 보여주었다. 따라서, 본 연구를 토대로 에센셜 오일 블랜딩에 대한 과학적 증거 마련이 더욱 필요할 것이라 사료된다.

• Journal of Nutrition and Health
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• 제45권5호
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• pp.452-461
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• 2012

There is increasing evidence that dietary factors in plant-based diets are important for the prevention of chronic disease. Especially, phytonutrients in fruits and vegetables have been recognized as major contributors for the decreased level of oxidative stress. In this study, the effect of switching the dietary habit to high consumption of fruits and vegetables were evaluated on the parameters of serum antioxidant status in healthy high school students. Forty one students participated in a randomized controlled trial and were assigned to the control group (n = 18) or the intervention group (n = 23). The intervention group was provided for 8 weeks with the main food source being whole grain and vegetables. Anthropometric measurements, blood parameters and dietary intakes were measured, and compared before and after study. After 8 weeks, weight and BMI were significantly decreased in the intervention group (p = 0.000). The serum diacron reactive oxygen metabolites (d-ROMs) test resulted in a significantly decreased level only in the intervention group (p < 0.05) after 8 weeks, but serum biological antioxidant potential (BAP) was increased significantly in both groups (p < 0.001). Intake of energy, total fat, cholesterol and sodium in the intervention group were significantly decreased after 8 weeks (p < 0.05). Also, the intervention group had significantly increased vitamin and phytonutrient intakes of all-trans-${\beta}$-carotene, ${\alpha}$-carotene, ${\alpha}$-tocopherol, ascorbic acid, and total phenols (p < 0.05). Overall, the results of this study suggest that whole grain, fruits, and vegetables supplementation showed improvement of the adolescent health.

• Journal of Microbiology and Biotechnology
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• 제31권2호
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• pp.207-216
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• 2021

Supplement of high-protein food plays an important role in improving the symptoms of malnutrition and the immune capacity of the body, but the association of high-protein diet and gut microbiota remained unaddressed. Here, we systematically analyzed the internal organs and gut microbiota in C57(WT) or PD-1H-depleted (KO) mice (T cells were activated) fed with pupae or feed for six weeks. We observed that the body weight gain in the mice fed with pupae increased less significantly than that of the feed group, while the villi and small intestine lengths in the pupa group were reduced compared with that of mice given feed. However, the average body weight of the KO mice increased compared with that of the WT mice fed with pupae or feed. Pupae increased the concentration of blood glucose in WT, but not in KO mice. Moreover, in the feed group, there was no difference in the weight of the internal organs between the WT and KO mice, but in the pupae-fed group, liver weight was decreased and spleen weight was increased compared with that of KO mice. The amounts/plural/amounts of Melainabacteria, Chloroflexi, and Armatimonadetes were specifically upregulated by pupae, and this upregulation was weakened or eliminated by PD-1H depletion. Some bacteria with high abundance in the feed-fed KO mice, such as Deferribacteres, Melainabacteria, Acidobacteria, Bacteroidetes, Spirochaetes and Verrucomicrobia, were decreased in pupae-fed KO mice, and Proteobacteria and Deinococcus were specifically enriched in pupae-fed KO mice. Bacteroidetes, Firmicutes and Akkermansia were associated with weight loss in the pupae-fed group while Lachnospiraceae and Anaerobiospirillum were related glucose metabolism and energy consumption. Based on high-throughput sequencing, we discovered that some gut bacteria specifically regulated the metabolism of a high-protein diet, and PD-1H deficiency improved life quality and sustained blood glucose. Moreover, PD-1H responses to high-protein diet through modulating the type and quantity of gut bacteria. These findings provide evidence about the association among gut microbiota, T cell activation (for PD-1H depletion) and high-protein diet metabolism, have important theoretical significance for nutrition and health research.

• Asian-Australasian Journal of Animal Sciences
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• 제32권10호
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• pp.1501-1510
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• 2019

Objective: An experiment was conducted to evaluate genetic diversity of 26 Chinese indigenous goats by 30 microsatellite markers, and then to define conservation priorities to set up the protection programs according to the weight given to within- and between-breed genetic diversity. Methods: Twenty-six representative populations of Chinese indigenous goats, 1,351 total, were sampled from different geographic regions of China. Within-breed genetic diversity and marker polymorphism were estimated calculating the mean number of alleles, observed heterozygosities, expected heterozygosities, fixation index, effective number of alleles and allelic richness. Conservation priorities were analyzed by statistical methods. Results: A relatively high level of genetic diversity was found in twenty-four population; the exceptions were in the Daiyun and Fuqing goat populations. Within-breed kinship coefficient matrices identified seven highly inbred breeds which should be of concern. Of these, six breeds receive a negative contribution to heterozygosity when the method was based on proportional contribution to heterozygosity. Based on Weitzman or Piyasatian and Kinghorn methods, the breeds distant from others i.e. Inner Mongolia Cashmere goat, Chengdu Brown goat and Leizhou goat obtain a high ranking. Evidence from Caballero and Toro and Fabuel et al method prioritized Jining Gray goat, Liaoning Cashmere goat, and Inner Mongolia Cashmere goat, which agree with results from Kinship-based methods. Conclusion: Conservation priorities were determined according to multiple methods. Our results suggest Inner Mongolia Cashmere goat (most methods), Jining Gray goat and Liaoning Cashmere goat (high contribution to heterozygosity and total diversity) should be prioritized based on most methods. Furthermore, Daiyun goat and Shannan White goat also should be prioritized based on consideration of effective population size. However, if one breed can continually survive under changing conditions, the straightforward approach would be to increase its utilization and attraction for production via mining breed germplasm characteristics.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.300-306
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• 2010

목 적 : 최근 우리나라도 선진국형 저출산 고령사회로 변하고 있어 차세대의 건강한 국민 확보를 위하여 국민 개개인의 평생건강의 기초가 되는 영유아 및 소아청소년에 대한 건강증진사업의 필요성이 강조되고 있다. 이에 실효성 있고 표준적인 영유아 및 소아청소년(학교) 건강검진 지침(guideline)의 개발이 필요하다. 방 법 : 국내 검진 현황 파악 및 문제점 도출 후, 영유아 및 소아청소년 시기의 국내 질병부담 정보와 최근에 실시된 국가 역학조사자료를 검토하고, 선진국에서의 검진 체계를 비교 분석하였다. 이후 실효성 있는 영유아 및 청소년(학교) 건강검진 지침 개발을 위한 방안을 모색하였다. 결 과 : 1) 국내 영유아 관련 건강검진제도는 보건소를 중심으로 실시되고 있으나, 사업 대상이 경제적 취약계층으로 제한되어있을 뿐 아니라 빈혈검사, 소변검사, 청각검사, 혈압측정 등 검사중심으로 구성된 질병발견 위주의 검진체계이다. 2) 학교 건강검진제도 또한 성인에서의 검진제도와 유사하게 혈액검사, 소변검사, 방사선학검사 등 검체 검사 중심의 질병발견 위주 검진체계로 구성되어 있어 실효성 있는 건강검진 항목 개발과 검진빈도, 검진방법 등에 대한 근거중심의 체계가 부족한 실정이다. 3) 선진국의 영유아 검진체계에서는 검체 검사를 선별적으로만 실시하는 것을 원칙으로 하고 있다. 4) 선진국의 학교건강검진은 각국의 정책에 따른 차이는 있으나 기본적으로 검체검사나 방사선학검사 등의 질병에 대한 검사보다는 병력 청취와 질병 예방 및 건강한 생활습관과 환경 조성을 위한 상담과 교육에 중점을 두고 있다. 결 론 : 이상의 결과에서 대안으로 다음과 같은 검진 체계를 제시한다. 1) 급격히 성장 발달하는 영유아에서는 성인과는 달리 혈액검사, 소변검사로 유병률이 낮은 질병 발견에 초점을 맞추기보다는 이 시기에 가장 중요한 성장 및 발달을 주기적으로 평가하고, 연령별로 예측 가능한 예방차원의 육아 지침(anticipatory guidance)을 제공하는 질병예방 위주의 검진을 영유아 건강검진 사업의 목표로 설정하여야겠다. 2) 학생검진도 과거의 만성질환이나 성인병 조기 발견을 위한 검사보다는 급격한 신체적, 정신 사회적 성장과 발달 과정에서 흔한 건강 문제와 위해 요소를 파악하여 건강한 생활 습관 및 건강관리 능력을 배양할 수 있도록 지속적인 상담과 교육으로 발전시키는 것을 목표로 하여야겠다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제23권1호
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• pp.23-30
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• 2012

Objectives : This study was conducted to investigate the prevalence of victims of bullying and the demographic characteristics of victims, and their related psychopathology, in a Korean nationwide sample of youths in middle and high school over a one month period. Methods : During the autumn of 2009, students in the 7th to 12th grades at 23 secondary schools participated in a nationwide, cross-sectional study. The study subjects completed the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II (AMPQ-II) and Symptom Checklist-90-Revision (SCL-90-R). Based on the data acquired, descriptive statistics, correlation coefficients and multiple logistic regression analysis were performed. Results : Among the 3364 participants, 2272 (67.54%) completed the questionnaire. The prevalence of victimization was 28.9%. Male gender was positively associated with victimization, and grade level was negatively related to victimization. The AMPQ-II bullying score (Factor 4) was significantly (p<.001) and positively correlated to the AMPQ-II student total score (r= 0.50), Worry and thought (Factor 1 ; r=0.38), Mood and suicide (Factor 2 ; r=0.31), Academic and Internet-related problems (Factor 3 ; r=0.24), Rule violations (Factor 5 ; r=0.23), and AMPQ-II teacher total score (r=0.11). Somatization (r=0.23), Obsessive-compulsive behavior (r=0.24), Interpersonal sensitivity (r=0.30), Depression (r=0.33), Anxiety (r=0.26), Hostility (r=0.30), Phobic anxiety (r=0.22), Paranoid ideation (r=0.36), and Psychoticism (r=0.31) results from the SCL-90-R were also found to be positively related to the AMPQ-II bullying score, and remained significant after adjusting for age and gender. A total of 26% of the victims reported suicidal ideations as compared to 9% of non-victims over the month prior to the evaluation ($x^2$=119.595, df=1, p<.001). The multiple logistic regression analysis indicated that the AMPQ-II bullying score significantly increased the risk of suicidal ideation [Exp(b)=1.55, df=1, p<.001] after adjusting for age and gender. Conclusion : School bullying was highly prevalent among Korean middle and high school students. This study provided strong evidence that suicidal ideation and psychopathology were serious problems among the victims of bullying.

• Tuberculosis and Respiratory Diseases
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• 제61권5호
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• pp.463-472
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• 2006

연구배경: 농흉을 치료하는데 VATS가 도입된 후 VATS의 유용성에 대해 많은 연구의 결과들이 보고 되고 있으며 실제로 치료 프로토콜에도 변화를 가져왔으나 아직까지는 문헌상의 보고가 양적으로 충분하지 못하며 기존의 치료방법에 비해 VATS의 장점 역시 명확하게 검증되어 있지 못한 상태이다. 방 법: 의무기록과 흉부 방사선 사진을 검토하여 기존의 치료 환자 군과 VATS 환자 군을 비교하였다. 2001년 1월부터 2003년 12월까지 한림대학교 춘천성심병원에 농흉으로 입원하여 기존의 방법으로 치료받은 환자들을 A군으로 하고 2003년 12월부터 2006년 8월까지 농흉으로 흉강경 수술을 받은 환자들을 B군으로 나누어 입원기간, 흉관 유지 기간, 백혈구증가증이 있던 기간, 발열이 있던 기간, 항생제 사용기간을 비교하였다. 그리고 흉막비후, 갈비가로막각이 각각 치료 전후 어떻게 변하였는지 비교하여 보았다. 결 과: A군은 15명으로 남자가 11명, 여자가 4명이었고, 평균 나이는 $58.2{\pm}15.7$세 이었고, B군은 11명으로 남자가 9명, 여자가 2명이었으며 평균 나이는 $51.6{\pm}9.5$세 이었다. B군에서 입원 기간($16.6{\pm}7.4$일, A군은 $33.7{\pm}22.6$일; p=0.014)과 흉관 유지 기간($10.5{\pm}5.7$일, A군은 $19.5{\pm}14.4$일; p=0.039), 백혈구증가기간($6.7{\pm}6.5$일, A군은 $18.8{\pm}13.2$일; p=0.008), 발열 기간($0.8{\pm}1.8$일, A군은 $9.4{\pm}9.2$일; p=0.004), 항생제 사용기간(B군 $14.9{\pm}6.4$일, A군 $25.4{\pm}13.9$일; p=0.018)이 A군에서보다 통계적으로 유의하게 감소하였다. 그러나 흉막비후, 갈비가로막의 둔함의 정도는 통계적으로 유의한 변화는 없었다. 결 론: 농흉에서 흉강경을 이용한 치료를 하면 기존의 방법에 비해 입원 기간, 흉관 유지기간, 백혈구증가증 기간, 발열 기간, 항생제 사용기간을 단축시킬 수 있어 환자의 증상을 더 빨리 개선시키며, 흉관을 조기에 제거할 수 있고 입원기간을 단축시킨다.

• Archives of Pharmacal Research
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• 제25권6호
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• pp.923-931
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• 2002

Sopungsungi-won (SP) is a known for\mula for senile constipation and diabetes mellitus, based on traditional Korean medicine. The preventive effect of SP on the development of overt diabetes in Zucker diabetic fatty (ZDF) rats was evaluated. When administered orally through a diet for 8 weeks, diabetic conditions such as hyperglycemia, polydipsia and hypertriglyceridemia were all ameliorated in SP-treated rats. In parallel with the onset and progression of hyperglycemia in the ZDF control rats; there was a marked decline in plasma insulin concentrations from 26.1 $\mu$U/ml, at age 7 weeks, to 14.8 $\mu$U/ml at age 15 weeks. In the SP-treated rats, however, the plasma insulin concentrations did not decline, and SP at a dose of 5 g/kg significantly increased the insulin levels to 31.9 $\mu$U/ml. Early normalization of plasma insulin and a retained ability to subsequently increase plasma insulin were indicative of a pancreatic $\beta$ cell protective action by the SP for\mula. In addition, expressions of an insulin-responsive gene and corresponding protein, glucose transporter 4 (GLUT4), in skeletal \muscle, were also determined in SP- and rosiglitazone-treated ZDF rats. mRNA and protein levels of GLUT4 in SP-treated rats were upregulated in a dose dependent manner. Furthermore, when ZDF rats were treated with 2 g/kg of the SP for\mula, the activity of glucose-6-phosphatase was decreased by 49%, whereas the activity of glucokinase was increased by 196%, compared to the ZDF control rats. Taken together, these data provide evidence that the SP for\mula markedly lowered the plasma glucose levels, probably through an effect not only on improvement of insulin action, but through a combined sti\mulation of glycolysis and an inhibition of gluconeogenesis in the liver, and also suggest the validity of SP's clinical use in the treatment of type 2 diabetes mellitus following further toxicological investigation.