• 보건행정학회지
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• 제33권3호
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• pp.243-252
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• 2023

This paper aims to introduce Korea's total current health expenditure (CHE) and National Health Accounts of the year 2021 and their 2022 preliminary figures constructed on the basis of the System of Health Accounts 2011. As CHE includes expenditures for prevention, tracking, and treatment of coronavirus disease 2019 (COVID-19) and compensation for losses to medical institutions from 2020, the details are also introduced. Korea's total CHE in 2021 is 193.3 trillion won, which is 9.3% of gross domestic product (GDP). The preliminary figure in 2022, 209.0 trillion won, exceeded the 200 trillion won line for the first time, and its "ratio to GDP" of 9.7% is expected to exceed the average of Organisation for Economic Co-Operation and Development member countries for the first time. Korea's health expenditures, which were well controlled until the end of the 20th century, have increased at an alarming rate since the beginning of the 21st century, threatening the sustainability of national health insurance. The increase in health expenditure after 2020 is partly due to a temporary increase in response to COVID-19. However, when considering the structure of Korea's health insurance price hike, where the ratchet effect of increased medical expenses works particularly strongly, it is unlikely that the accelerating growth trend that has lasted for more than 20 years will stop easily. More aggressive policies to control medical expenses are required in the national health insurance which not only constitutes the main financing sources of the Korean health system but also has the most powerful policy means in effect for changes in the health care provision.

• 대한본초학회지
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• 제24권4호
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• pp.205-213
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• 2009

Objectives : Cancer incidence is increasing in all countries and chemotherapy-induced peripheral neuropathy (CIPN) in patients undergoing chemotherapeutic agents have been a clinically serious problems. So far therapeutic options for CIPN patients are limited and no confirmed methods have yet been established for dealing with peripheral neuropathy. Therefore this review is to provide an evidence-based summary of oriental medicine and CAM (complementary and alternative medicine) neuroprotective and treatment therapies which have gone through clinical trials. Methods : An overview of the domestic and international papers of adult clinical trials relating management of only CIPN symptoms through 1990 to present were searched by electronic databases. Search key words were chemotherapy-induced neurotoxicity, chemotherapy-induced peripheral neuropathy, chemotherapy toxicity & herb, chemotherapy toxicity & acupuncture, chemotherapy toxicity & CAM. Only English and Korean written papers were reviewed. Total 25 papers were reviewed in this study, 18 papers were retrieved by electronic search. Results : Clinical studies of managing CIPN were rare, two acupuncture clinical studies and four herb medicinal studies were found. Rest of 19 papers were about other CAM clinical studies. Total 25 papers were analyzed, and all interventions were focused on their pain control efficacy. Other 24 trials of potential therapies except one proved to be effective for CIPN, however some described to be inadequate positive or sufficient negative. Conclusions : As most of the studies were pilot studies, interventions for the prevention and treatment of CIPN have to go through prospective confirmatory studies, such as larger scale randomized, double-blinded, placebo controlled clinical trials must be done for the safe and effective use of proposed therapies. Also standard measurement scales have to be developed for the better clinical study of CIPN.

• Journal of Veterinary Science
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• 제24권3호
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• pp.44.1-44.17
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• 2023

Background: Antibiotic resistance is a significant public health concern around the globe. Antimicrobial peptides exhibit broad-spectrum and efficient antibacterial activity with an added advantage of low drug resistance. The higher water content and 3D network structure of the hydrogels are beneficial for maintaining antimicrobial peptide activity and help to prevent degradation. The antimicrobial peptide released from hydrogels also hasten the local wound healing by promoting epithelial tissue regeneration and granulation tissue formation. Objective: This study aimed at developing sodium alginate based hydrogel loaded with a novel antimicrobial peptide Chol-37(F34-R) and to investigate the characteristics in vitro and in vivo as an alternative antibacterial wound dressing to treat infectious wounds. Methods: Hydrogels were developed and optimized by varying the concentrations of crosslinkers and subjected to various characterization tests like cross-sectional morphology, swelling index, percent water contents, water retention ratio, drug release and antibacterial activity in vitro, and Pseudomonas aeruginosa infected wound mice model in vivo. Results: The results indicated that the hydrogel C proved superior in terms of cross-sectional morphology having uniformly sized interconnected pores, a good swelling index, with the capacity to retain a higher quantity of water. Furthermore, the optimized hydrogel has been found to exert a significant antimicrobial activity against bacteria and was also found to prevent bacterial infiltration into the wound site due to forming an impermeable barrier between the wound bed and external environment. The optimized hydrogel was found to significantly hasten skin regeneration in animal models when compared to other treatments in addition to strong inhibitory effect on the release of pro-inflammatory cytokines (interleukin-1β and tumor necrosis factor-α). Conclusions: Our results suggest that sodium alginate -based hydrogels loaded with Chol-37(F34-R) hold the potential to be used as an alternative to conventional antibiotics in treating infectious skin wounds.

• 한국지반공학회논문집
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• 제23권5호
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• pp.77-88
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• 2007

6개의 도심지 굴착현장에서 계측된 현장계측자료를 토대로 다층지반에 설치된 앵커지지 지중연속벽에 작용하는 측방토압과 벽체의 변형을 분석하였다. 앵커지지 지중연속벽에 작용하는 측방토압의 분포는 사다리꼴 모양이며, 최대 측방토압의 크기는 $0.45{\gamma}H$임을 알 수 있다. 그리고 굴착면 상부에서도 $0.1{\gamma}H$의 토압이 작용하는 것으로 나타났다. 제안된 측방토압의 크기는 Terzaghi and Peck(1967), Tschebotarioff(1973) 및 홍원표와 윤중만(1995a)이 제안한 연성벽체의 경험토압보다 약 2배 정도 크다. 지중연속벽의 변형거동은 지지방식과 밀접한 관계가 있는 것으로 나타났다. 앵커지지 지중연속벽의 수평변위는 굴착깊이의 0.1%이내에서, 버팀보 지지방식의 경우에는 굴착깊이의 0.25% 이내에서 발생하고 있어, 벽체의 지지효과는 앵커지지방식이 버팀보 지지방식보다 양호함을 알수 있다. 그리고 지중연속벽의 수평변위는 엄지말뚝으로 시공된 앵커지지 흙막이벽의 시공관리기준인 $\delta=0.25%H$ 보다 작으므로 지중연속벽으로 시공된 굴착현장의 안정성은 상당히 양호함을 알 수 있다.

• 산업융합연구
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• 제21권3호
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• pp.139-148
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• 2023

본 연구는 강원도 일개 대학 4년제 치위생학과 276명을 대상으로 2021년 11월 24일부터 11월 26일까지 구글 온라인설문을 통하여 연구하였다. 본 연구의 목적은 유니폼의 감염인식과 세탁 규정 인식, 감염병 예방 의도를 개인주의 및 집단주의 자아존중감을 통해 알아보는 것으로, 향후 감염병 시기에 학생의 감염 교육 방법 모색을 위해 시행되었다. 통계는 SPSS Statistics 24.0, AMOS 21.0을 사용하여 빈도 분석, 탐색적 요인분석, 확인적 요인분석, 신뢰도 분석, 구조방정식, ANOVA 분석을 시행하였다. 연구결과 유니폼 감염인식, 유니폼 세탁 규정 인식, 자아존중감, 개인주의, 집단주의 감염병 예방 의도의 모형이 적합함을 확인하였고(p<.001), 구조방정식 결과 자아존중감은 개인주의, 집단주의 감염병 예방 의도에 영향을 미치는 것으로 나타났다(p<.001). 집단주의는 유니폼 감염인식, 유니폼 세탁 규정 인식, 감염병 예방 의도에 영향을 미치는 것으로 나타나 감염예방을 위한 인식 변화에 자아존중감과 집단주의가 영향을 미치는 것을 확인하였다. 향후 치위생학과의 감염관리 교육시 집단주의를 고려한 유니폼 세탁 방법에서 활용이 가능할 것이다.

• Journal of Veterinary Science
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• 제23권1호
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• pp.8.1-8.15
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• 2022

Background: Brucella infection induces brucellosis, a zoonotic disease. The intracellular circulation process and virulence of Brucella mainly depend on its type IV secretion system (T4SS) expressing secretory effectors. Secreted protein BspJ is a nucleomodulin of Brucella that invades the host cell nucleus. BspJ mediates host energy synthesis and apoptosis through interaction with proteins. However, the mechanism of BspJ as it affects the intracellular survival of Brucella remains to be clarified. Objectives: To verify the functions of nucleomodulin BspJ in Brucella's intracellular infection cycles. Methods: Constructed Brucella abortus BspJ gene deletion strain (B. abortus ∆BspJ) and complement strain (B. abortus pBspJ) and studied their roles in the proliferation of Brucella both in vivo and in vitro. Results: BspJ gene deletion reduced the survival and intracellular proliferation of Brucella at the replicating Brucella-containing vacuoles (rBCV) stage. Compared with the parent strain, the colonization ability of the bacteria in mice was significantly reduced, causing less inflammatory infiltration and pathological damage. We also found that the knockout of BspJ altered the secretion of cytokines (interleukin [IL]-6, IL-1β, IL-10, tumor necrosis factor-α, interferon-γ) in host cells and in mice to affect the intracellular survival of Brucella. Conclusions: BspJ is extremely important for the circulatory proliferation of Brucella in the host, and it may be involved in a previously unknown mechanism of Brucella's intracellular survival.

• Safety and Health at Work
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• 제14권2호
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• pp.141-152
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• 2023

Objective: We performed a meta-analysis of epidemiological results for the association between occupational exposure as a firefighter and cancer as part of the broader evidence synthesis work of the IARC Monographs program. Methods: A systematic literature search was conducted to identify cohort studies of firefighters followed for cancer incidence and mortality. Studies were evaluated for the influence of key biases on results. Random-effects meta-analysis models were used to estimate the association between ever-employment and duration of employment as a firefighter and risk of 12 selected cancers. The impact of bias was explored in sensitivity analyses. Results: Among the 16 included cancer incidence studies, the estimated meta-rate ratio, 95% confidence interval (CI), and heterogeneity statistic (I²) for ever-employment as a career firefighter compared mostly to general populations were 1.58 (1.14-2.20, 8%) for mesothelioma, 1.16 (1.08-1.26, 0%) for bladder cancer, 1.21 (1.12-1.32, 81%) for prostate cancer, 1.37 (1.03-1.82, 56%) for testicular cancer, 1.19 (1.07-1.32, 37%) for colon cancer, 1.36 (1.15-1.62, 83%) for melanoma, 1.12 (1.01-1.25, 0%) for non-Hodgkin lymphoma, 1.28 (1.02-1.61, 40%) for thyroid cancer, and 1.09 (0.92-1.29, 55%) for kidney cancer. Ever-employment as a firefighter was not positively associated with lung, nervous system, or stomach cancer. Results for mesothelioma and bladder cancer exhibited low heterogeneity and were largely robust across sensitivity analyses. Conclusions: There is epidemiological evidence to support a causal relationship between occupational exposure as a firefighter and certain cancers. Challenges persist in the body of evidence related to the quality of exposure assessment, confounding, and medical surveillance bias.

• 한국환경보건학회지
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• 제49권3호
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• pp.169-177
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• 2023

Background: The Korea Centers for Disease Control and Prevention (KCDC) has identified cases of people suspected of suffering lung disease potentially caused by chloromethylisothiazolinone/methylisothiazolinone (CMIT/MIT) used in humidifier disinfectants (HDs). The Korean Ministry of Environment (MoE) epidemiological investigation and toxicity test study found that HDs caused health damage such as asthma and lung disease. Objectives: The main purposes of this study were to classify the HD exposure rating and to analyze the exposure characteristics that affect exposure to CMIT/MIT HDs. Methods: The exposure characteristics and socio-demographic characteristics of victim participants using CMIT/MIT HDs were investigated through questionnaires. An inhalation no observed adverse effect level (NOAEL) for CMIT/MIT was produced based on inhalation toxicity values. Exposure ratings (class 1~class 2) were cross-tabulated with clinical ratings (acceptable~unacceptable). A correlation analysis was conducted with the main exposure characteristics that affect the exposure concentration of CMIT/MIT HDs. Results: The concentration in indoor air of CMIT/MIT was 8.75±25.40 ㎍/m³, and the exposure concentration was 2.30±6.29 ㎍/m³. The CMIT/MIT exposure rating of 67 participants with high exposures of not more than MOE 100 were evaluated as 14.5%, while the damage participants who matched the clinical rating made up 4.5%. The exposure concentration of CMIT/MIT showed a positive correlation with the daily usage amount and usage frequency, and a negative correlation with volume of the indoor environment. Conclusions: A new exposure rating could be suggested and calculated based on the MOE, and the factors affecting the exposure concentration could be identified.

• 해양환경안전학회지
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• 제29권4호
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• pp.332-337
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• 2023

우리나라는 3면이 바다로 둘러싸여 있을 뿐만 아니라 국가하천과 지방하천의 연장이 26,843km에 달하고 있어 풍부한 해수면과 내수면이 함께 공존하는 지리적 특징이 있다. 국민소득의 향상 등으로 내수면에서 운항하는 선박이 지속적으로 증가하고 있어 내수면에서 선박사고 및 인명사고의 위험성도 증가하고 있다. 본 연구에서는 내수면관련 법령조사 및 운영현황 분석을 통하여 거시적인 내수면 선박의 안전관리 대책 방안을 제시하였다. 그 개선방안으로 하드웨어적 인프라로서 사고 초기대응 및 인명구조의 골든타임 확보를 위한 충분한 내수면 소방정의 확보와 내수면 선박 사고예방 전문기관의 운영을 제언하며, 소프트웨어적 인프라로서 내수면 선박의 출항통제기준 마련과 현행 해수면 선박에만 적용하고 있는 안전진단제도를 기반으로 내수면 선박의 특성에 맞는 맞춤형 제도도입을 제언하였다. 이러한 내수면 안전관리 정책은 내수면 선박 사고발생 시 신속하고 체계적인 대처 방안 마련에 기여할 것으로 기대되며, 세월호 사건 이후 잠시 활성화 되었던 내수면 선박에 대한 안전관련 연구에 지속적인 관심을 갖는 기회가 되었으면 한다.

• 한국심리학회지ㆍ건강
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• 제16권3호
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• pp.557-575
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• 2011

본 연구에서는 폐쇄성 수면 무호흡증 환자(obstructive sleep Apnea, OSA)의 연령수준에 따른 주의력 결함 특성을 알아보고, 이들의 주의력 결함이 어떤 수면다원검사 지표들과 관련이 있는지 검토하고자 하였다. 두 하위 연령집단 및 정상군에 대해 전산화 주의력측정검사인 연속수행과제와 변화맹시과제를 실시하였다. 추가적으로 수면다원검사의 하위 지표들을 추출하고 주관적 주간 졸음을 측정하는 엡워스 주간 졸리움 척도도 실시하였다. 연구결과, OSA군은 정상군과 비교하여 연속수행과제에서 누락 오류와 오경보 오류의 수가 유의하게 많은 것으로 나타났고, 변화맹시 과제에서 정반응률이 유의하게 낮은 것으로 나타났다. 상관분석 결과, OSA군의 주의력 결함은 수면다원검사 지표들 중 저산소혈증과 유의한 상관을 보였다. 결론적으로, OSA군은 부주의하고, 반응 억제에 어려움을 보이며, 환경적 자극들 사이에서 일어나는 중요한 변화를 탐지하는데 결함이 있는 것으로 나타났다. 이러한 주의력 결함의 정도는 연령이 증가함에 따라 더욱 심화되었다. 특히 주의력 결함과 비가역적 대뇌 손상을 초래하는 저산소혈증과의 관련성은 OSA 환자의 인지기능의 손상을 예방하기 위해 조기치료가 필요함을 시사한다.