• 제목/요약/키워드: health care system

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반복 유산환자의 말초혈액 단핵구와 태반항원을 체외 공동 배양시 세포 매개 면역반응에 프로게스테론이 미치는 영향 (The Effects of Progesterone on Cell Mediated Immunity to Trophoblast in Woman with Recurrent Pregnancy Loss)

  • 최범채
    • Clinical and Experimental Reproductive Medicine
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    • 제24권3호
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    • pp.399-405
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    • 1997
  • Progesterone is necessary for successful pregnancy and had immunosuppressive properties. Peripheral blood mononuclear cells (PBMC) from many women with unexplained recurrent spontaneous abortion responded to trophoblast extract in vitro by prolifertion and releasing soluble, heat-labile factors that are toxic to mouse embryos (embryotoxic factors). Accumulating evidence suggests that T Helper (Th)-1 type immunity to trophoblast is correlated with embryotoxic factor production and is associated with pregnancy loss, while Th2-type immunity is associated with successful gestation. The objective of this study was to determine whether progesterone can inhibit Th1-type cytokine secretion (IFN-${\gamma}$, TNF-${\alpha}$) by trophoblast-activated peripheral blood mononuclear cells from 23 nonpregnant women (age 25-35) with unexplained recurrent abortion (median 5, range 3 to 15)who otherwise produce embryotoxic factors in response to trophoblast. We also determined whether progesterone affected Th2-type cytokines (IL-4, IL-10) in this system in vitro and if IL-10 (1,500 pg/mL) could inhibit Th1-type immunity to trophoblast. IFN-${\gamma}$ was detected in 17 of 23 (74%) trophoblast stimulated PBMC culture supernatants ($77.94{\pm}23.79$ pg/mL) containing embryotoxic activity. TNF-${\alpha}$ was detected in 19 (83%) of these same supernatants ($703.15{\pm}131.36$ pg/mL). In contrast, none of the supernatants contained detectable levels of IL-4 or IL-10. Progesterone ($10^{-5}$, $10^{-7}$, $10^{-9}$M) inhibited Th1-type immunity in a dose dependent manner, but had no effect on Th2-type cytokine secretion. The inhibitory effects of progesterone were abrogated with RU486, but did not affect Th2-type cytokine secretion in trophoblast-activated cell cultures. IL-10, like progesterone also inhibited Th1-type cytokine secretion but had no effect on Th2-type cytokines. These data suggest that therapies designed to suppress Th1-type cytokine secretion in women with recurrent abortion who have evidence of Th1-type immunity to trophoblast may be efficacious in preventing pregnancy loss and should be tested in appropriately designed clinical trials.

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스마트올인원 심폐순환보조장치의 안전성 및 성능평가에 관한 연구 (A Study on Safety and Performance Evaluation of Smart All-in-one Cardiopulmonary Assist Device)

  • 박준현;호예지;이예림;이덕희;최재순
    • 대한의용생체공학회:의공학회지
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    • 제40권5호
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    • pp.197-205
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    • 2019
  • The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

The PNPLA3 rs738409 Variant but not MBOAT7 rs641738 is a Risk Factor for Nonalcoholic Fatty Liver Disease in Obese U.S. Children of Hispanic Ethnicity

  • Mansoor, Sana;Maheshwari, Anshu;Guglielmo, Matthew Di;Furuya, Katryn;Wang, Makala;Crowgey, Erin;Molle-Rios, Zarela;He, Zhaoping
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권5호
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    • pp.455-469
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    • 2021
  • Purpose: The rs641738 C>T in membrane-bound O-acyltransferase domain-containing protein 7 (MBOAT7) is implicated, along with the rs738409 C>G polymorphism in patatin-like phospholipase domain-containing protein 3 (PNPLA3), in nonalcoholic fatty liver disease (NAFLD). The association of these polymorphisms and NAFLD are investigated in Hispanic children with obesity. Methods: Obese children with and without NAFLD were enrolled at a pediatric tertiary care health system and genotyped for MBOAT7 rs641738 C>T and PNPLA3 rs738409 C>G. NAFLD was characterized by the ultrasonographic presence of hepatic steatosis along with persistently elevated liver enzymes. Genetic variants and demographic and biochemical data were analyzed for the effects on NAFLD. Results: Among 126 enrolled subjects, 84 in the case group had NAFLD and 42 in the control group did not. The two groups had similar demographic distribution. NAFLD was associated with abnormal liver enzymes and elevated triglycerides and cholesterol (p<0.05). Children with NAFLD had higher percentage of PNPLA3 GG genotype at 70.2% versus 31.0% in non-NAFLD, and lower MBOAT7 TT genotype at 4.8% versus 16.7% in non-NAFLD (p<0.05). PNPLA3 rs738409 C>G had an additive effect in NAFLD; however, MBOAT7 rs641738 C>T had no effects alone or synergistically with PNPLA3 polymorphism. NAFLD risk increased 3.7-fold in subjects carrying PNPLA3 GG genotype and decreased in MBOAT7 TT genotype. Conclusion: In Hispanic children with obesity, PNPLA3 rs738409 C>G polymorphism increased the risk for NAFLD. The role of MBOAT7 rs641738 variant in NAFLD is less evident.

Appraisal of Guidelines for Research & Evaluation (AGREE) II를 이용한 교통사고 상해증후군의 국내·외 기개발 임상진료지침의 평가 (Appraisal of Guidelines for Research & Evaluation II Appraisal of Clinical Practice Guidelines for Traffic Injuries)

  • 박경원;이준석;김현태;박선영;허인;신병철
    • 한방재활의학과학회지
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    • 제31권4호
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    • pp.129-143
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    • 2021
  • Objectives This study was aimed to evaluate clinical practice guidelines (CPGs) of traffic injuries, which has already been developed at domestic or outside of country, and to explore the Korean medical treatments included in the CPGs. Methods Twelve electronic databases (PubMed, Cochrane library, China National Knowledge Infrastructure [CNKI {Chinese Academic Journals, CAJ}], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS], KoreaMed, Korean Medical Guideline Information [KoMGI), National Guideline Clearinghouse [AHRQ], Core Outcome Measures in Effectiveness Trials Initiative Website [COMET], Turning Research into Practice [TRIP], The National Institute for Health and Care Excellence [NICE], and Medical Research Information Center [MedRIC]) up to July 2021 were searched. Only systematically developed CPGs for traffic injuries were selected and appraised. The appraisal was conducted by using Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results Six CPGs were included and evaluated. All CPGs were appraised as highly recommended because they exceeded 60% in more than 4 among 6 domains of AGREE II, including domain of 'rigor of development', and 30% in the rest. Recommendations related to Korean medicine treatments such as on manual therapy related to Chuna were given in 6 CPGs, 4 for acupuncture, 1 for Qigong and 1 for Taping. Conclusions The 6 CPGs were developed up to now through a systematic development methodology and there were many recommendations for Korean medical treatments related to manual (Chuna) treatment, acupuncture and Qigong. However, the evidence for the side effects and risk factors of Korean medical treatments was scantly reflected in CPGs. Therefore, it is considered that balanced CPG with benefits and risks should be developed, covering Korean medical diagnosis, treatment and prognosis.

손실과 이득 메시지 프레이밍 광고상황에서 COVID-19에 대한 관여와 사회적 거리두기 실천의도와의 관계에 영향을 미치는 광고태도의 매개효과 (Mediating Effect of Attitude toward Advertisement on the Relationship between COVID-19 Involvement and Behavioral Intention of Social Distancing in Loss versus Gain Advertising Context)

  • 최자인;최자윤
    • 한국융합학회논문지
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    • 제12권12호
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    • pp.467-477
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    • 2021
  • COVID-19 감염예방을 위한 손실과 이득 메시지 프레이밍 광고상황에서 COVID-19에 대한 관여와 사회적 거리두기 실천의도와의 관계를 확인하고 이들 간 관계에서 광고태도의 매개효과를 확인하였다. 대한민국에 거주하는 19세 이상 성인 379명을 대상으로 하였다. 2개 유형의 메시지 프레이밍 중 1개 광고를 무작위 할당하여 보도록 한 후 COVID-19에 대한 관여, 광고태도 및 사회적 거리두기 실천의도를 측정하였다. COVID-19에 대한 관여가 사회적 거리두기 실천의도에 영향을 미쳤는데 COVID-19에 관여함으로써 COVID-19에 대한 위험이나 심각성을 인식하여 위험감소행위를 시도하기 때문으로 생각되어 COVID-19에 대한 관여를 높이는 전략이 매우 필요하다. 또한 광고태도가 COVID-19에 대한 관여와 사회적 거리두기 실천의도와의 관계에서 매개작용을 하였다. 따라서 병원이나 지역사회 종사 간호사가 현장에서 대중과 소통하고 정책을 보급할 때 긍정적 광고태도를 유도할 수 있는 효과적인 메시지를 제시함으로써 건강관리 리더로서 역할을 충실히 해 나가야 할 것이다.

Korean physicians' attitudes toward the prenatal screening for fetal aneuploidy and implementation of non-invasive prenatal testing with cell-free fetal DNA

  • Kim, Soo Hyun;Kim, Kun Woo;Han, You Jung;Lee, Seung Mi;Lee, Mi-Young;Shim, Jae-Yoon;Cho, Geum Joon;Lee, Joon Ho;Oh, Soo-young;Kwon, Han-Sung;Cha, Dong Hyun;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • 제15권2호
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    • pp.72-78
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    • 2018
  • Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

스마트시티사업을 위한 설문결과 분석과 추진 방향 -도농복합도시 금산군의 사례- (The Analysis and Preparation Guideline of Survey for Smart-City -Focused on the Case Study of Geumsan-gun-)

  • 남윤철;박은영
    • 한국산학기술학회논문지
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    • 제22권3호
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    • pp.422-428
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    • 2021
  • 본 논문은 지방 중소도시로 도농복합도시 금산군을 대상으로 진행한 스마트시티 사업에서 주민과 공무원을 대상으로 지역내 문제와 스마트서비스 선호도에 대한 설문조사를 실시한 결과를 분석하고 그 경험을 토대로 설문조사 추진 방향을 제시하였다. 본 연구를 진행하는데 금산군의 자연 인문적 환경과 스마트시티와 관련한 지역현황도 함께 조사하였다. 중요한 설문조사 결과는 다음과 같다. 주거환경에 대한 만족도는 응답자의 절반이상이 살기 좋다고 평가하고 있었으며 지역내 문제는 복지부족, 주차부족, 산업인프라(일자리)부족 등의 순서로 꼽았다. 그런데 지역내 문제와는 별도로 스마트서비스를 우선해서 확충해야하는 분야로는 관광레저인프라, 건강의료, 산업인프라(일자리) 순서로 나타났다. 이것은 지역문제를 해결하는 것과 스마트서비스 선호와는 다르게 나타나는 특징이 있다. 설문조사를 진행하는데 있어 방향 제시는 다음과 같다. 설문조사의 실시도구는 군청내 그룹웨어 설문서비스를 사용하고 주민들에게는 1대1설문, 온라인설문조사플랫폼(구글설문지, 서베이몽키 등)을 활용한다. 특히 주민설문은 지역모임을 대상으로 핵심질문으로 압축하고 쉬운 용어를 사용한다. 예비조사에서 관련공무원과 면담을 통해 관련사업, 지역밀착형 설문으로 선별하는 것이 중요하다. 무엇보다 스마트시티사업은 지역문제와 여건을 고려하고 이를 설문조사를 통해 파악한 후 지역문제를 해결하면서 주민의 니즈를 반영해야 한다.

간호정보역량 국내 연구동향 분석: 주제범위 문헌고찰 (The Analysis of Research Trends in Korea on Nursing Informatics Competencies: A Scoping Review)

  • 노민;강현선;권용은
    • 디지털융복합연구
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    • 제20권4호
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    • pp.779-790
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    • 2022
  • 본 연구의 목적은 간호정보역량에 대한 국내 연구의 동향을 파악하고 간호정보역량과 관련된 후속 연구 방향을 제시하기 위해 시행되었다. 본 연구는 주제범위 문헌고찰 연구로 Arskey와 O'Malley의 방법론적 기틀을 사용하였다. 전자 데이터베이스를 이용하여 2000년부터 2021년까지 출판된 연구를 대상으로 하였다. 최종 분석에 포함된 연구는 총 18편으로, 분석틀은 연구의 일반적 특성과 주제분석으로 구성하여 분석하였다. 간호정보역량에 대한 연구는 2010년 이후 증가하였으며, 간호사 대상의 양적연구가 대부분을 차지하였다. 간호정보역량에 영향을 미치는 일반적 특성은 교육 정도와 직위였으며, 관련 핵심 변수는 업무수행능력, 셀프리더십, 직무만족, 간호업무성과, 간호조직문화, 간호근무환경이었다. 본 연구는 주제범위 문헌고찰 방법을 적용하여 국내 간호정보역량 연구를 체계적으로 고찰하고 후속 연구방향을 제시했다는 의의가 있다. 간호사, 간호대학생의 간호정보역량 향상을 위해서 보건의료시스템과 간호업무환경의 변화를 반영하고, 간호정보역량 향상 교육프로그램을 지속적으로 개발하여 적용하는 후속연구를 제언한다.

저 전력 블루투스 기반으로 의료데이터 전송 시 통신 거리와 연동 장치의 수가 데이터 손실률에 미치는 영향 (The Effect of Communication Distance and Number of Peripheral on Data Error Rate When Transmitting Medical Data Based on Bluetooth Low Energy)

  • 박영상;손병진;손재범;이호열;정유수;송찬호;정의성
    • 대한의용생체공학회:의공학회지
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    • 제42권6호
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    • pp.259-267
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    • 2021
  • Recently, the market for personal health care and medical devices based on Bluetooth Low Energy(BLE) has grown rapidly. BLE is being used in various medical data communication devices based on low power consumption and universal compatibility. However, since data errors occurring in the transmission of medical data can lead to medical accidents, it is necessary to analyze the causes of errors and study methods to reduce data error. In this paper, the minimum communication speed to be used in medical devices was set to at least 800 byte/sec based on the wireless electrocardiography regulations of the Ministry of Food and Drug Safety. And the data loss rate was tested when data was transmitted at a speed higher than 800 byte/sec. The factors that cause communication data error were classified, and the relationship between each factor and the data error rate was analyzed through experiments. When there were two or more activated peripherals connected to the central, data error occurred due to channel hopping and bottleneck, and the data error rate increased in proportion to the communication distance and the number of activated peripherals. Through this experiment, when the BLE is used in a medical device that intermittently transmits biosignal data, the risk of a medical accident is predicted to be low if the number of peripherals is 3 or less. But, it was determined that BLE would not be suitable for the development of a biosignal measuring device that must be continuously transmitted in real time, such as an electrocardiogram.

스킨헬스케어를 위한 에코코스메틱 효과성의 주·객관적인 평가 (Subjective and Objective Evaluation of Acne Skin Through Natural Cosmetics with Distilled Bamboo Vinegar Contents for Skin Health Care)

  • 박가희;박정연
    • 한국엔터테인먼트산업학회논문지
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    • 제15권7호
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    • pp.271-280
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    • 2021
  • 본 연구는 죽초액을 함유한 폼클렌징과 토너, 팩 사용에 따른 여드름 피부상태 개선을 주·객관적 평가를 통해 검증하고자 하였다. 연구 대상은 한국형 여드름 중등도 시스템에 의한 2등급 이상의 여드름 피부 해당자로 광주·전라 지역 고등학교 남·여학생 20명을 선정하였다. 실험 진행을 위해 대상자를 죽초액 함유 폼클렌징, 토너, 팩 사용군(실험군) 10명, 죽초액 비함유 폼클렌징, 토너, 팩 사용군(대조군) 10명으로 나누어 12주 동안 각각 폼클렌징과 토너, 팩사용하도록 하였으며, 그 결과는 다음과 같다. 객관적 측정값에 의한 피부개선 효과에서 실험군이 대조군에 비해 이마, 콧등, 왼쪽볼의 모공 감소와 피지 개선 정도가 크게 나타났으며(p<.001), 주관적 평가도구에 의한 피부개선 효과에도 실험군이 대조군에 전반적인 만족도가 높게 나타났다(p<.05, p<.001). 화장품 사용 만족도는 전체 값에서 폼클렌저, 토너, 팩 모두 실험군이 대조군에 비해 높게 나타났으며(p<.01, p<.001), 세부적으로 유용성에서 통계적으로 유의한 차이를 보였다(p<.01, p<.001). 이상의 결과 죽초액은 여드름 피부상태 개선에 효과적인 천연화장품 소재임이 확인되었다.