• 한국식품영양과학회지
• /
• 제35권4호
• /
• pp.464-469
• /
• 2006

진주 채취 후 폐기되는 진주조개 육 및 패주를 기능성 식품의 추출소재 또는 가공품의 소재와 같이 효율적으로 이용하기 위한 기초 연구로서 진주조개 육 및 패주의 식품성분특성에 대하여 살펴보았다 진주조개 육의 중금속은 수은과 크롬의 경우 검출되지 않았고, 카드뮴의 경우 0.06 ppm, 납의 경우 0.11 prm이 검출되었다. 또한 패주의 경우 검토한 4종의 중금속이 모두 검출되지 않았다. 휘발성염기질소 함량과 pH는 진주조개 육의 경우 각각 11.6 mg/100 g 및 6.31이었고, 패주의 경우 각각 8.6 mg/100 g 및 6.33을 나타내었다. 이와 같은 결과로 미루어 보아 진주조개 패주 및 육은 식품가공 소재로서 식품위생적인 면에서 문제가 없었다. 패주의 조단백질 및 총 아미노산 함량은 각각 16.5%와 15.691 mg/100 g으로서, 진주조개 육(11.2% and 10,131 mg/100 g)과 대조구인 굴(12.1% and 11,213 mg/100 g)보다 높았으며, 칼슘과 인의 함량은 육이 각각 93.4mg/100g과 116.0mg/100g, 패주가 75.2 mg/100 g과 148.1 mg/100 g이었다. 유리아미노산과 taste value는 진주조개 육이 각각 635.5 mg/100 g과 40.2, 패주가 각각 734.9 mg/100 g과 24.1이었으나, 굴의 경우 각각 883.8 mg/100 g과 40.2로 진주 가공부산물보다 높은 수치를 나타내었다. 이상의 이화학적, 영양적 특성으로 살펴본 결과, 진주조개 패주는 육에 비하여 단백질 및 탄수화물, 총 아미노산 함량 및 무기질 함량이 높아 근육에 비하여 영양적인 면에서 식품 재자원으로서 우수하다고 판단되었다. 하지만 진주조개 패주 및 육은 굴이나 기타 패류에 비하여 맛 특성은 낮아 맛 추출 소재로는 부적절하다고 판단되었다.련이 필요한 것으로 사료된다. 세부속성별로는 "분위기가 조용하고 편안하다.", "불만이나 고충이 신속히 처리된다."라는 속성이 중점개선 영역에 포함되어 분위기와 고충처리 부분에 대한 개선을 위한 집중적인 노력이 필요한 것으로 분석되었고, "내부시설 및 기물이 쾌적하다.", "종업원이 친절하다." 항목은 유지관리 영역에 포함되기는 하였으나, 수행도 수준이 중요도에는 다소 못 미쳐 일부 개선이 필요한 것으로 사료된다. 전반적으로 기존의 일반 베이커리 연구들에서 나타난 선택속성 및 고객인지 중요도가 제품중심이었던 결과와는 달리 베이커리카페에 대해 고객이 인지하는 중요 선택속성은 제품, 서비스, 인테리어 등의 복합적인 요소가 포함되는 것으로 나타나 향후 베이커리카페 관련연구에서는 이러한 차이를 명확히 파악하고 연구를 전개해 나가야 할 것으로 사료된다. 또한 업체의 마케팅전략 수립에 있어서도 고씩의 욕구에 부응하기 위해 중요도와 수행도의 차이가 큰 선택속성 차원과 세부항목을 중점대상으로 하여 일반 베이커리와는 구분되는 방식으로 접근해야 할 것으로 판단된다. 이상의 결과를 종합해볼 때, 베이커리카페 이용고객은 특징적인 선택속성을 기준으로 베이커리카페를 선택하는 것으로 나타나 새로운 외식 산업 군인 베이커리카페의 조기정착과 발전을 위해서는 이러한 선택속성에 대한 이해를 바탕으로 활발한 연구가 진행되어야 할 것으로 사료된다. 또한 본 연구를 통해 도출된 선택속성 차원 중 많은 경우에 있어 고객이 인지하고 있는 중요도에 비해 수행도가 낮은 것으로 나타나 해당 차원의 개선을 위한 경영자들의 노력이 요구되어 진다. 체중군(0.82)에 비해 영양 질적 지수(INQ)가 높았으며(p<0.0335), 비타민 $B_1$은 정상 체중군이 유의적으로 가장 높은 영양 질적 지수를 보여주었다(p<0.0452). 이상의 결과로

• Clinical and Experimental Reproductive Medicine
• /
• 제35권2호
• /
• pp.99-110
• /
• 2008

목 적: 착상전 유전진단은 환아를 출산할 가능성이 높은 부부들에게 정상아의 출산 기회를 제공해주는 보조생식술의 하나로서 널리 시행되고 있다. 골형성부전증은 상염색체 우성 유전질환으로서 뼈와 피부를 구성하는 결합조직의 이상으로 뼈가 잘 부러지는 특징을 가지고 있으며, 질환의 95% 이상은 COL1A1 또는 COL1A2 유전자의 이상으로 발병한다고 알려져 있다. 본 논문에서는 골형성부전증 환자 2 가계를 대상으로 5 주기의 착상전 유전진단을 시행하여 임신에 성공한 사례에 대해 보고하고자 한다. 연구방법: 착상전 유전진단 수행 전에 환자의 단일 림프구에서 증폭성공률과 allele drop-out (ADO) rate을 확인하기 위하여 임상전 검사를 수행하였다. 각각 원인 돌연변이로 확인된 COL1A1 유전자 c.2452G>A와 c.3226G>A를 가지고 있는 골형성부전증 2 가계를 대상으로 5 주기의 착상전 유전진단을 시행하였다. 생검한 할구로부터 원인 돌연변이를 진단하기 위하여 nested PCR 후 HaeIII 제한효소를 이용한 restriction fragment length polymorphism (RFLP) 분석방법과 direct sequencing 방법을 이용하여 진단을 실시하였다. 결 과: Genomic DNA를 이용하여 COL1A1 유전자 검사를 해 본 결과 각 가계의 원인 돌연변이는 c.2452G>A와 c.3226G>A임을 재확인하였으며, 단일세포를 이용한 임상전 검사 결과 첫 번째 사례의 경우 94.2%의 증폭성공률과 22.5%의 ADO rate을 나타내었고, 두 번째 사례의 경우 98.1%의 증폭성공률과 1.9%의 ADO rate를 나타내었다. 착상전 유전진단 결과 첫 번째 사례의 경우, 3 주기의 착상전 유전진단에서 총 34개의 배아 중 31개의 배아에서 진단에 성공하여 91.2% (31/34)의 진단성공률을 나타내었고, 총 19개의 정상 배아 중 8개의 배아 (2.7개/배아이식)를 이식하였다. 세 번째 주기에서 임신에 성공하였고 제왕절개로 건강한 아이를 분만하였다. 두 번째 사례의 경우 2 주기의 착상전 유전진단을 시행하였으며, 총 19개의 배아 모두 진단에 성공하여 100.0% (19/19)의 진단성공률을 나타내었고, 총 11개의 정상 배아 중 4개 (2개/배아이식)의 배아를 이식하였다. 두 번째 착상전 유전진단에서 임신에 성공하였고, 건강한 아이를 분만하였다. 결 론: 착상전 유전진단을 통한 골형성부전증 환자 2 가계에서의 성공적인 임신과 출산은 국내에서 처음으로 보고되는 임상 결과로, 본원의 착상전 유전진단방법은 효과적이고 확실한 방법으로써 앞으로도 더 많은 단일 유전자 이상의 유전질환을 가진 환자들에게 적용하게 될 것이며, 이는 이와 유사한 유전질환을 가지고 있거나 유전질환의 이환 가능성이 있는 부부들에게 정상아의 임신과 출산의 기회를 더욱 많이 제공할 수 있을 것이다.

• Journal of Preventive Medicine and Public Health
• /
• 제20권1호
• /
• pp.165-203
• /
• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.