• 제목/요약/키워드: Public health systems research

검색결과 332건 처리시간 0.029초

Angiogenesis Markers in Breast Cancer - Potentially Useful Tools for Priority Setting of Anti-Angiogenic Agents

  • Keyhani, Elahe;Muhammadnejad, Ahad;Behjati, Farkhondeh;Sirati, Fereidoon;Khodadadi, Faranak;Karimlou, Masoud;Moghaddam, Fatemeh A.;Pazhoomand, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7651-7656
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    • 2013
  • Background: Breast cancer is the most common malignancy among women in both developed and developing countries. The burden is increasing in low-income and middle-income countries (LMCs) and threatens the public health of such societies. Introduction of expensive monoclonal antibodies to cancer treatment regimens poses a real challenge in the health systems of LMCs. Despite controversy of cost-effectiveness of bevacizumab in breast cancer, some studies indicate gain of patients from this drug. The present study aimed to propose a priority setting model for administration of anti-angiogenic agents in breast cancer via assessment of tumor angiogenesis by the microvessel density (MVD) method and associations with clinicopathological characteristics (including simultaneous mutations of TP53 and HER-2 genes). Materials and Methods: Age, axillary lymph nodes status, tumor size, stage and grade, estrogen and progesterone receptors status, HER-2/neu status (by immunohistochemistry and FISH test), TP53 mutation, Ki-67 (for proliferation assay) and CD34 (for angiogenesis assay) were assessed in 111 breast cancer patients. The molecular subtype of each tumor was also determined and correlations of simultaneous mutations of HER-2 and p53 genes with angiogenesis and other clinicopathological characteristics were evaluated. Results: There were significant associations between simultaneous mutations of HER-2 and p53 genes and all other parameters except tumor size. The degree of angiogenesis in the ERBB2 subtype was greater than the others. Younger patients showed a higher angiogenesis rate rather those older than 50 years. Conclusions: Our results demonstrated that patients with simultaneous mutations of HER-2 and p53 genes, those with ERBB2 molecular subtype and also younger women (often triple negative) seem more eligible for obtaining anti-angiogenic agents. These results suggest a model for priority setting of patients with breast cancer for treatment with anti-angiogenic drugs in LMCs.

Cancer Research Advances Regarding the CKLF-like MARVEL Transmembrane Domain Containing Family

  • Lu, Jia;Wu, Qian-Qian;Zhou, Ya-Bo;Zhang, Kai-Hua;Pang, Bing-Xin;Li, Liang;Sun, Nan;Wang, Heng-Shu;Zhang, Song;Li, Wen-Jian;Zheng, Wei;Liu, Wei
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2741-2744
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    • 2016
  • The CKLF-like MARVEL transmembrane domain-containing family (CMTM) is a novel family of genes first reported at international level by Peking University Human Disease Gene Research Center. The gene products act between chemokines and the transmembrane-4 superfamily. Located in several human chromosomes, the CMTMs CKLF and CMTM1 to CMTM8 may be unregulated in tumors and act as potential tumor suppressor genes with important roles in the immune, male reproductive and hematopoietic systems. In-depth studies in recent years established a close relation between CMTMs and tumorigenesis and metastasis. The CMTM family has a significant clinical value in diagnosis and treatment of diseases linked to tumors and the immune system.

실태조사를 통한 장기요양시설과 요양병원의 효율적 연계방안 (Study on the Efficient Integration of Long-term Care Facilities and Geriatric Hospitals by Using NHIC Survey Data)

  • 최인덕;이은미
    • 한국노년학
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    • 제30권3호
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    • pp.855-869
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    • 2010
  • 본 연구는 노인장기요양보험 도입이후 장기요양시설과 요양병원의 효율적 연계방안을 모색하기 위한 기초조사 연구이다. 본 연구는 문헌고찰을 기반으로 국민건강보험공단 노인장기요양운영센터를 이용 장기요양시설 192곳과 요양병원 168곳 시설관계자(시설장, 병원장 및 이용자 등)에게 운영현황과 효율적 연계방안에 대해 면접조사를 실시 분석하였다. 자료분석은 기술통계, χ2검증 등을 SPSS 13.0으로 분석하였다. 연구결과 운영현황에서는 요양시설과 요양병원 모두 본인부담의 차이가 미미하나 식대에 대한 편차가 크게 나타났다. 경영수지적자에 대해서는 양 기관 모두 수가보전에 문제점을 지적하고 있으며, 교통과 환경요인이 입지조건을 좌우하는 것으로 파악되었다. 둘째 이용행태면에서는 양 기관 모두 비용할인 경험이 높은 것으로 나타났고, 면회를 오지 않는 경우가 많은 것으로 파악되었다. 반면, 요양시설이 사망 시까지 있는 경우가 요양병원에 비해 더 높게 나타나고 있다. 셋째, 기관의 서비스제공문제점으로는 일률적인 서비스제공, 가족의 지지나 방문 부족 등을 들 수 있다. 끝으로 양 기관의 효율적 연계방안으로는 수가현실화, 간병비 지급, 복합시설 허용, 판정기준 강화, 주치의, 요양병원의 장기요양보험 관리 방안 등을 제시하였다.

서울시 공공자전거 공유시스템(PBSS)의 시공간적 이용 패턴 분석 - 서울시 여의도동을 중심으로 - (Spatio-Temporal Patterns of a Public Bike Sharing System in Seoul - Focusing on Yeouido District -)

  • 윤승용;민경훈;고하정
    • 한국조경학회지
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    • 제48권1호
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    • pp.1-14
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    • 2020
  • 세계적으로 공공자전거 공유시스템(PBSS) 및 프로그램(PBSP)이 증가하면서 다양한 정책과 연구들이 진행되었다. 오늘날 PBSS가 일상생활에서 밀접하게 이용되면서 다양한 현상과 수요가 발생하고 있으나, 아직 국내에서는 통근통학에 초점을 맞춘 정책과 연구들이 주로 이루어지고 있다. 이에 본 연구는 다양한 PBSS 수요를 파악하기 위해서 서울시 여의도를 대상으로 2018년도 한 해 동안 발생한 PBSS 이용 데이터를 분석하여 이용 패턴을 유형화하고 특징을 분석하였다. 서울시에서 제공하는 PBSS 자료를 기반으로 주중/주말 이용률에 따라 대여소를 3개 유형으로 구분하여 각각의 특징을 분석하였다. 여의도의 PBSS는 이용량의 경우에는 서울시 전체에서 4.3%, 대여소 개소수의 경우에는 2%에 해당하는 것으로 나타났다. 주중 이용률이 높은 대여소는 다른 유형에 비하여 사계절 모두 높은 이용률을 보였으며, 업무 및 주거지역에 주로 분포하였다. 주말 이용률이 높은 대여소의 경우에는 봄(4~5월)과 가을(9~10월)에 집중된 이용 패턴이 나타났으며, 대여소에서 공원입구까지의 거리가 가까운 것으로 나타났다. 또한, 주중 이용률이 높은 패턴에 비해서 동일한 대여소를 통해 대여 및 반납이 이루어진 경우가 많고, 특정 대여소에 PBSS 이용이 집중된 쏠림현상이 나타나고 있는 것을 확인할 수 있었다. 따라서, 획일적인 PBSS 운영보다는 대여소별로 다양한 이용수요와 현상을 반영한 PBSS의 관리와 프로그램이 운영되어야 할 것이다. 본 연구결과는 PBSS 이용에 대한 수요를 유형에 따라 시공간적으로 파악함으로써 효과적인 PBSS 운영이 이루어질 수 있도록 기초자료를 제공하는 것에 의의가 있다.

염화벤지코늄과 구연산을 주성분으로 하는 살균 소독제 라미아-킬에 대한 급성경구독성 및 피부자극성 시험에 관한 연구 (Acute Oral Toxicity and Skin Irritation Studies on Lamia-Kill$^{(R)}$ Composed of Benzalkonium Chloride and Citric Acid)

  • 차춘남;이여은;손송이;유창열;박은기;최현주;김석;이후장
    • 한국식품위생안전성학회지
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    • 제26권4호
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    • pp.377-382
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    • 2011
  • 살균소독제, 라미아-킬(benzalkonium chloride(20%), citric acid(20%))에 대하여 랫드와 토끼를 이용하여 급성경구독 성과 피부 자극성 평가를 각각 수행하였다. 랫드에 라미아-킬 2,000 mg/kg 농도를 최고농도로 하여 단회 투여 후, 14일간 관찰한 결과, 사망, 이상증상 및 체 중변화 등은 관찰되지 않아, 라미아-킬의 $LD_{50}$은 2,000 mg/kg 이상으로 추정되었다. 토끼의 등 부위의 털을 제거하고 찰과부위와 비찰과 부위에 여러 농도로 라미아-킬을 도포 한 후, 피부 자극성을 확인한 결과, 라미아-킬의 l차 자극 지수가 0.50으로 비자극성 물질로 분류되었다. 따라서, 본 연구를 통하여, 라미아-킬은 급성경구독성 시 안전한 물질이며, 피부 자극성을 야기하지 않는 물질로 평가되었다.

Diclazuril을 주성분으로 하는 콕시멸-에스의 육계에 대한 실험실 및 야외적용 실험에서의 항콕시듐 효과 (Anticoccidial Efficacy of Coccimuel-S composed with Diclazuril on Experimental and Field Coccidiosis in Broiler Chickens)

  • 차춘남;손송이;김석;이여은;유창열;박은기;이후장
    • 한국임상수의학회지
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    • 제29권2호
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    • pp.154-159
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    • 2012
  • 디클라쥬릴의 음수형 제제인 콕시멸-에스의 항콕시듐 효과를 Eimeria spp. 감염 육계를 이용하여 수행하였다. 본 실험은 실험실 및 야외적용시험으로 나누어 진행하였으며, 실험실 실험에서는 Eimeria spp.를 인공 감염시킨 육계를 대상으로 콕시멸-에스 0.5 ml/L을 음수로 투여한 군에서 대조군과 비교하여 콕시듐 치료, 콕시듐 충란수의 감소, 그리고 장상해도 및 분변 설사지수 등에 있어서 유의성 있는 효과를 나타내었다($p$ < 0.001). 또한, 야외적용실험에서는, 콕시듐증에 걸린 육계를 대상으로 콕시멸-에스를 0.25와 0.5 ml/L로 각각 음수로 투여한 결과, 대조군과 비교하여 모두 유의한 콕시듐 치료효과를 나타내었다($p$ < 0.001). 이상의 결과로부터, 콕시멸-에스 0.25와 0.5 ml/L를 음수로 콕시듐증에 걸린 육계에 투여할 경우, 콕시듐증 치료에 매우 효과적일 것으로 판단된다.

응급의료기금, 무엇이 문제인가? (EMS fund, is it functioning or fumbling?)

  • 백홍석;이준호;김익성;박현숙;박상섭
    • 한국임상보건과학회지
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    • 제1권1호
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    • pp.35-45
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    • 2013
  • Purpose. Based on the comparison and analysis with those of United States, the aim of this research is to find the problems in current management, operation and future directions of emergency medical service (EMS) fund in S. Korea and to provide basic resources and appropriate measures to make a right decision in policies for EMS fund. Methods. Data from Ministry of Health and Welfare and other various sources during 1995 to 2012 were collected and analyzed. Results. From our analyses, several problems are identified in EMS fund operation. In brief, problems discerned are as follows. First, whereas the purpose and direction of EMS fund operations in United States are highlighted and focused on pre-hospital EMS system and associated infrastructures which need to be constructed, those of S. Korea are emphasized mainly on the in-hospital EMS system so far. Second, on the contrary to the fact that the EMS funds in United States are tuned to pre-hospital EMS system to provide prompt and efficient emergency care at the emergency scene of pre-hospital stage and to achieve the development, design, planning and demonstration projects for pre-hospital EMS systems, up to date, our investment of EMS funds demonstrated an excess biased inclination toward the construction of in-hospital EMS system, which is far from the realization of constructive and vital pre-hospital infrastructures. Third, while emergency medical technician is important and principal body in the management of emergency medical funds in United States, so far, no EMS funds in S. Korea existed for EMTs including the job condition, improved treatment and working environment for them. Conclusion. In conclusion, we strongly suggest that the problems pointed out must be revised and corrected. Current usage of EMS fund needs to be redirected predominatly to pre-hospital EMS system. Otherwise, unless current management and investment of emergency medical funds in S. Korea are applied and used for the vital necessities and demands of EMTs, public EMS units and private EMS units as well as related units in pre-hospital EMS system as in the cases of United States, in our consideration, they must be suspended or abolished.

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잔류물질분석의 국제공인시험기관 인정 관련 고찰 (Study on international accreditation for residue analysis laboratory)

  • 김미경;조병훈;김동규;윤선종;임채미;박수정;김희진;김연희;김수연;윤소미;권진욱;손성완;정갑수;이주호;강문일
    • 대한수의학회지
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    • 제46권4호
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    • pp.295-304
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    • 2006
  • Residual materials such as veterinary drugs, environmental contaminants, and pesticides are affecting food safety. High resolution techniques and quality controls are needed to analyze these materials from part per million to part per trillion quantities in food. In order to achieve quality results, standardized methods and techniques are required. Our laboratories were prepared to obtain a certificate of accreditation for ISO/IEC 17025 in the analytical criteria of animal drugs, dioxins, pesticides, and heavy metals. ISO together with IEC has built a strategic partnership with the World Trade Organization with the common goal of promoting a free and fair global trading system. ISO collaborates with the United Nations Organization and its specialized agencies and commissions, particularly those involved in the harmonization of regulations and public policies including the World Health Organization and CODEX Alimentarius for food safety measurement, management and traceability. Our goal was to have high quality analysts, proper analytical methods, good laboratory facilities, and safety systems within guidelines of ISO/IEC 17025. All staff members took requirement exams. We applied proficiency tests in the analysis of veterinary drugs (nitrofuran metabolites, sulfonamide and tetracyclines), dioxins, organophosphorus pesticides, and heavy metals (Cd, Pb, As) to the Food Analysis Performance Assessment Scheme (FAPAS) at Central Science Laboratory, Department for Environment Food and Rural Affairs (DEFRA), England. The results were very satisfactory. All documents were prepared, including system management, laboratory management, standard operational procedures for testing, reporting, and more. The criteria encompassed the requirements of ISO/IEC 17025:1999. Finally, the Korea Laboratory Accreditation Scheme (KOLAS) accredited our testing laboratories in accordance with the provisions of Article 23 of the National Standards Act. The accreditation will give us the benefit of becoming a regional reference laboratory in Asia.

미국 및 유럽 의료기기 품목분류 체계 분석을 통한 국내 의료기기 품목분류 개선 연구 (A Study on the Improvement of Domestic Medical Device Product Classification through Analysis of Medical Device Classification System in the U.S. and Europe)

  • 유강현;손지민;권경민;김유림;이희성;장원석
    • 대한의용생체공학회:의공학회지
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    • 제44권1호
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    • pp.73-79
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    • 2023
  • The purpose of this study is to derive medical devices with different management systems through comparison of domestic and overseas medical device product classification systems and to propose management conversion measures for the products. The definitions of medical devices were compared and the scope of medical devices defined by each country was confirmed through surveys of the Medical Device Act, Federal Food, Drug & Cosmetics Act (FD&C) in the U.S., and Medical Device Regulations (MDR) in Europe. Using the Ministry of Food and Drug Safety's regulations on medical device products and grades, 21 CFR part 860-892 and product code classification files in U.S., and EMDN in Europe as basic data to compare medical device products and derive medical devices with different management systems. As a result of comparing the definition and product classification systems of medical devices in Korea, the U.S. and Europe, medical device accessories, prosthetic limbs and aids among assistive devices for persons with disabilities, drugs, quasi-drugs and industrial products that are not managed by medical devices in Korea are managed as medical devices in the U.S. and Europe. This study aims to improve public health by securing systematic product safety management and essential performance under medical device regulations. Management within a single medical device system will increase the efficiency of licensing work of domestic medical device manufacturers and related organizations. It is also expected to help advance the system according to the international harmony of the item classification system and enhance smooth import and export competitiveness.

여성의 출산 후 체중변화와 생활양식 (Body Weight Changes and Lifestyle in Women within 1 year after Childbirth)

  • 정재원;김혜원;김효정
    • Perspectives in Nursing Science
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    • 제13권2호
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    • pp.88-95
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    • 2016
  • Purpose: Gestational weight gain and prepregnancy body weight are important factors of childbirth outcomes, which further cause obesity, metabolic diseases, or psychological problems later in women's lives. Changes in diet, westernized lifestyle, traditional postpartum care, and childbirth at older age are thought to be threats to proper weight management in Korean women of reproductive age. Public health and antenatal care need to focus on the proper body weight management of women by carefully planning pregnancy to postpartum periods. Purpose: This study explored the body weight changes from pregnancy to postpartum and the related characteristics in women within 12 months after childbirth. Methods: A cross-sectional, retrospective study was conducted with 102 Korean women within 12 months after childbirth. Data were collected using an online survey system, and a structured questionnaire available for electronic self-administration was modified to include demographics, obstetrical history, and body weight at 6 time points. The International Physical Activity Questionnaire and Eating Habit Measurement instruments were also used in data collection. A professional survey agency recruited the participants, and data were automatically saved and then analyzed. Results: The average age of the participants was 33.8 years, 48% were housewives and were well-educated. Seventy-two percent of the participants were primiparas and 82% had breastfed their babies. The body mass index (BMI) ranged from 17.3 to 27.8, indicating that 21.5% of the participants were overweight or obese. The mean gestational weight gain was 11.8 kg, and weight loss was apparent during the first 3 months postpartum. The mean decline in weight was 3.4 kg at one year after childbirth. Women wanted to lose 5.6 kg (range: 3~20 kg), however 44% of them reported that they had not engaged in any weight control efforts. Further, 72% of them reported having engaged in a low level of physical activity. Body weight was not associated with women's characteristics, physical activity score, and diet. Conclusion: Women's awareness of gestational weight gain, lifestyle modification, and the risk of prolonged weight retention should be promoted through the antenatal and women's healthcare systems. As pregnancy and childbirth are critical events that affect women's health, integrative education to ensure healthy transition to life after delivery is required.