• 한국사회복지학
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• 제67권4호
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• pp.79-101
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• 2015

담론의 역할은 무엇일까? 미셸 푸코(Michel Foucault)는 특정 사회와 시기의 권력(power)은 담론을 통해 인식과 규범 체계 형성에 영향을 미치는 지식(knowledge)을 생성하여 사회와 구성원을 통제한다는 권력지식관계(power and knowledge relations)를 제시한다. 본 연구는 권력지식관계론의 근간을 이루는 배제의 형성(인식의 통제), 그리고 물질성 및 실천성(규범체계)을 분석 틀로 삼아, 4명의 전임 한국대통령의 복지관련 연설문에 대한 담론해석을 시도하였다. 분석결과로 복지와 성장의 균형 그리고 최고의 복지는 일자리(복지-성장-고용의 연계), 개인의 경제적 자립과 자활, 선별적 복지의 지향, 의존적이고 시혜적인 복지를 배제하는 지배적인 인식체계를 형성하고 있음을 발견하였다. 하지만 권력이 항상 체계적이고 정립된 지식을 형성하는 것은 아니며 인식과 규범의 괴리 문제가 동시에 관찰되었다. 푸코의 담론해석은 한국의 낮은 복지지출에 대한 인과적 추론을 제시하는 반면, 지식의 생산자와 주입자로서의 권력의 역할에 대한 과도한 초점은 어떻게 현대적 변화들을 지식체계에 수용할 것인가에 대한 질문을 남긴다.

• 한국임상약학회지
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• 제27권2호
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• pp.83-91
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• 2017

Background: Piperacillin/tazobactam (TZP) is an antibiotic against a broad spectrum of gram-positive, gram-negative, and aerobic and anaerobic strains of bacteria. Due to changes in its pharmacokinetic and pharmacodynamic parameters by TZP-treated patients' renal functions and obesity, it is important to administrate and monitor TZP based on their renal functions and Body Mass Index (BMI) levels. The purpose of this study was to determine the appropriateness of administration doses of TZP based on renal functions of obese cancer patients in a tertiary hospital. Methods: This study was retrospectively conducted with obese cancer patients with $BMI{\geq}30kg/m^2$ in a tertiary hospital, Korea from September 2004 to August 2014. Data were collected through Electronic Medical Record (EMR) which contained laboratory data and TZP dosing of each patient. Results: Among 7,058 patients during the study period, 102 prescriptions were selected based on inclusion and exclusion criteria and classified by their renal functions. Although TZP should be used based on patients' renal functions to adjust its dose, its initial dose and dosing interval were consistently used without considering patients' renal functions on a regular basis. Especially, in the comparison with FDA dosing standard of TZP, approximately twice patients with $20mL/min{\leq}CrCl{\leq}40mL/min$ received domestically 4.5 g instead of 2.25 g as the TZP starting dose. Conclusion: The appropriate doses of TZP were administered to almost all of obese cancer patients; however, the recommended TZP dose was different between Korea and other countries by twice the amount. Further related studies are necessary to clearly determine the results, to optimize TZP treatment for obese patients with cancer in clinical practice, and to design and develop new TZP formulations for them in pharmaceutical industry.

• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.179-194
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• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.317-333
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• 1996

The main goal of periodontal regeneration is to be achieved by epithelial exclusion, periodontal ligament cell activation or alveolar bone regeneration. The purpose of this study was to investigate on the physico- chemical and biological characteristics of biodegradable chitosan beads. Chitosan beads were fabricated by ionic gelation with sodium tripolyphosphate and they had the size in 300um diameter. As therapeutic agent, flurbiprofen was incorporated into the beads by 10, 20% loading contents. The release of drugs from the chitosan beads was measured in vitro. Also, biological activity tests of flurbiprofen loaded chitosan beads including cytotoxicity test, ihhibition of $IL-1{\beta}$ production, suppression to $PGE_2$ production, collagenase inhibition test, the ability of total protein synthesis, and tissue response were evaluated. The amount of flurbiprofen released from chitosan was 33-50% during 7 days. Minimal cytotoxicity was observed in chitosan beads. Flurbiprofen released from chitosan beads significantly suppressed the $IL-1{\beta}$ production of monocyte, $PGE_2$ production and markedly inhibited collagenase activity. Meanwhile, flurbiprofen released from this system showed increased ability for protein synthesis. Throughout 4 -week implantation period, no significant inflammatory cell infiltrated around chitosan bead and also fibroblast like cell types at the beads - tissue interface were revealed with gradual degradation of implanted chitosan beads. From these results, it was suggested that flurbiprofen loaded chitosan beads can be effectively useful for biocompatible local delivery system in periodontal regeneration.

• Journal of Preventive Medicine and Public Health
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• 제35권1호
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• pp.72-75
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• 2002

Objectives : To evaluate the health hazards in the underground storage facilities of ginger roots. Methods : The authors reviewed the emergency rescue records from the Seosan fire department over the period Jan 1, 1996 to Aug 31, 1999. The atmospheres in 3 different underground storage locations were analyzed for $O_2,\;CO_2,\;CO,\;H_2S\;and\;NH_4$. Results : From the emergency records, we were able to identify 20 individuals that had been exposed to occupational hazards in the underground storage facilities. Among these 20 cases, 13 were due to asphyxiation (resulting in f deaths) and 7 were due to falls. In the first atmospheric tests, peformed on Feb 25, 1998, the O2 level inside the underground storage facility, located about $5{\sim}6$ meters below the surface, was 20.6% and the $CO_2$ level was about 1,000 ppm. CO, $H_2S\;and\;NH_4$ were not detected. In the second tests on Jul 6, 1999, measurements of the $O_2$ level at 3 meters below the surface in two different storage locations were 15.3 and 15.1%. And the $O_2$ levels inside the storage facilities were 12.2 and 12.1%. The $CO_2$ level was above 5,000 ppm (beyond upper limits of measurement). CO, $H_2S\;and\;NH_4$ were not detected. Conclusions : We conclude that asphyxiation in the underground storage facilities for ginger roots was not due to the presence of toxic gases such as CO, $H_2S\;and\;NH_4$, but rather the exclusion of oxygen by carbon dioxide was responsible for causing casualties. For the development of a hazard free working environment, safety education as well as improvements in storage methods are needed.

• Journal of Periodontal and Implant Science
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• 제40권2호
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• pp.56-60
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• 2010

Purpose: The sinus lift procedure requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the location and prevalence of maxillary sinus septa using computed tomography (CT). Methods: This study was based on the analysis of CT images for posterior maxilla which were obtained from patients who visited Chonbuk National University Dental Hospital during the period of June 2007 to December 2008. With the exclusion of cases presenting any pathological changes, 236 maxillary sinuses in 204 patients were retrospectively analyzed. The average age of the patients was 50.9. The cases were divided into two groups, an atrophy/edentulous segment and a non-atrophy/dentate segment, and maxillary sinus septa of less than 2.5 mm were not taken in-to consideration. The location of septa was also divided for analysis into 3 regions: the anterior (1st and 2nd premolar), middle (1st and 2nd molar) and posterior (behind 2ndmolar) regions. Results: In 54 (20.9%) of the 204 patients there were pathologic findings, and those patients were excluded from the analysis. Sinus septa were present in 58 (24.6%) of the 236 maxillary sinuses and in 55 (27%) of the 204 total patients. In the atrophy/ edentulous ridge group (148 maxillary sinuses), 41 cases (27.7%) were found, and 17 cases (19.3%) were found in the non-atrophy/ dentulous ridge group (88 maxillary sinuses). In terms of location, septa were found in 18 cases (27.3%) in the anterior, in 33 cases (50%) in the middle and in 15 cases (22.7%) in the posterior regions. Conclusions: In the posterior maxilla, regardless of type of ridge (atrophy/edentulous or non-atrophy/dentate), the anatomical variation of sinus septa is diverse in its prevalence and location. Thus, accurate information on the maxillary sinus of thepatient is essential and should be clearly understood by the surgeon to prevent possible complications during sinus lifting.

• 한국태양에너지학회 논문집
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• 제35권2호
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• pp.1-10
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• 2015

Promising onshore wind farm sites in Gangwon province of Korea were investigated in this study. Gangwon province was divided into twenty five simulation regions and a commercial program based on Reynolds averaged Navier-Stokes equation was used to find out wind resource maps of the regions. The national wind atlas with a period 2007-2009 developed by Korea institute of energy research was used as climatologies. The wind resource maps were combined to construct a wind resource map of Gangwon province with a horizontal spatial resolution of 100m. In addition to the wind resource, national environmental zoning map, distance from substation, residence and automobile road, Beakdudaegan mountain range, terrain slope, airport and military reservation district were considered to find out promising wind farm sites. A commercial wind farm design program was used to find out developable wind farm capacities in promising wind farm site with and without excluding environmental protection regions. The total wind farm capacities with and without excluding the protection regions were estimated to be 46MW and 598MW, respectively, when a 2MW commercial wind turbine was employed.

• Clinics in Shoulder and Elbow
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• 제19권1호
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• pp.20-24
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• 2016

Background: Extracorporeal shock wave therapy (ESWT) is one of the treatment options used for patients with myofascial pain syndrome (MPS), although its effectiveness is controversial. The purpose of this study was to evaluate the effectiveness of ESWT in the treatment of MPS in terms of pain relief and functional improvements. Methods: We assessed 93 patients with MPS who underwent ESWT from March 2009 to July 2014. After exclusion of 25 patients with shoulder diseases, 68 patients were enrolled in the study. The mean follow-up period was 7.5 months (${\pm}4.2weeks$), and the average duration of symptoms was 5 months (range, 2-16 months). ESWT was applied to intramuscular taut bands and referred pain areas once a week for 3 weeks. Visual analog scale (VAS) pain scores and American Shoulder and Elbow Surgeons (ASES) scores were obtained at an initial assessment and at the 6-week, 3-month, and 6-month follow-up assessments. Results: VAS pain scores and ASES scores improved significantly after 3 sessions of ESWT (p<0.05). Both scores were improved, although not significantly, after 6 weeks (p>0.05). Conclusions: ESWT is an effective treatment option for patients with MPS.

• Korean Journal of Acupuncture
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• 제26권4호
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• pp.53-66
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• 2009

Objective : Acupuncture has been widely used throughout the world for the treatment of knee osteoarthritis (knee OA). This study investigated whether acupuncture, particularly Sa-am acupuncture, could be effective in relieving pain and improving the symptoms of knee OA. Method : This study was conducted as a prospective, randomized, controlled, and patient- and investigator-blinded clinical trial. Forty volunteers with knee OA participated in the study. All participants were screened through an inclusion and exclusion criteria. Thirty four participants completed the clinical trial. In total, forty subjects were randomly selected to receive Sa-am acupuncture. Eight sessions of acupuncture were given at the contralateral side of the problematic knee for 4 weeks. Korean translation of Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC) scores were measured twice: at the beginning and end of the clinical trial period. Both the Patient Global Assessment and physical health scores based on the 36-Item Short-Form Health Survey were also used to measure the results. Results : Compared to the pre-trial scores, the Sa-am acupuncture group (n=34) showed a significant decrease in KWOMAC total scores according to a paired t-test. The Sa-am acupuncture group also showed significant improvement in the Patient Global Assessment when compared to the pre-trial. Conclusions : Sa-am acupuncture for knee OA resulted in an improved KWOMAC total score. This was mostly driven by the function component score that was greatly affected by acupuncture. However, further studies with expanded designs are needed to solidify this finding with scientific rigor.

• 대한한방내과학회지
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• 제40권3호
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• pp.443-457
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• 2019

Objectives: This study aimed to review the clinical research trends in respiratory diseases related to particulate matter (PM) to help design clinical studies on herbal medicine that protects against PM. Methods: We searched three international databases (Pubmed, EMBASE, and CENTRAL) to investigate clinical studies on respiratory diseases related to PM and to analyze their study design, respiratory-related disease, inclusion/exclusion criteria, study period, outcome measure, study results, measurement method of PM and range of PM. Results: A total of 18 studies were finally selected, including 13 observational studies and 5 randomized controlled trials. The selected studies showed an increasing trend from 1985 to 2018 and were conducted mostly in North America, followed by Europe and Asia. Subject disease and age were decided in variety by each study objective, although asthma accounted for the majority. For the outcome assessment, pulmonary function test was mostly used for lung function. Quality of life questionnaires and biomarkers in blood and sputum were also used. Conclusion: A well-designed clinical study on herbal medicine that protects against PM is needed, and this study is expected to be used as base data.