• Asia pacific journal of information systems
• /
• 제21권1호
• /
• pp.1-27
• /
• 2011

In an attempt to cope with widespread, dynamic, and accelerating changes in both internal and external business environments, companies often utilize information technologies such as SCM(Supply Chain Management). To date, SCM research has mainly focused on the effects of dynamic factors on SCM success and emphasized adoption strategies and critical success factors. Consequently, the effects of more static factors such as interdependency between SCM partners have been largely ignored. The purpose of this study, therefore, is to examine the effects of both dynamic and static factors on SCM performance by controlling for information quality and partnership quality. The five factors examined in this study include innovative ness, mutual dependency, quality of information, partnership quality, and SCM performance. All factors were examined from the perspective of part suppliers, except the mutual dependency which was examined from two aspects: supplier's dependency on customer and customer's dependency on supplier. Data was collected through five hundred survey questionnaires distributed to the part supplier companies that have implemented SCM systems for at least one year. As a result, a total of 170 valid responses were obtained. A structural equation research model was fitted using SAS 9.1.3 and SMART-PLS 2.0. The results of this study can be summarized as follows. First, innovativeness positively affected SCM information quality. SCM partnership quality, and ultimately SCM performance. The path coefficient between innovativeness and information quality was 0.387, with a t-value of 3.528. Innovativeness also had a positively direct effect on partnership quality. The path coefficient was 0.351 with a t-value of 3.366. The total effect of innovativeness on partnership quality was significant, although its indirect effect on partnership quality by altering information quality was negligible. The total indirect effect of innovativeness on SCM performance by affecting information quality and partnership quality was significant with a p-value of 0.014. Innovativeness played an important role in determining SCM performance. Second, mutual dependency showed no significant effect on SCM information quality. This result contradicts the earlier assertion that the more dependent two companies are, the more accurate and timely the information they exchange ought to be. This study showed that this may not be the case; a partner may provide information of poor quality even when it is strongly dependent on the other. Mutual dependency showed significant effect on partnership quality. However, when the mutual dependency perceived by suppliers was divided into two parts, one being a supplier's dependency on its customer company and the other being a customer's dependency on the supplier, the latter showed a significant impact on the perceived SCM partnership quality. This result indicates that a customer company can hardly improve the partnership quality perceived by suppliers by making them more dependent. It improves only when the suppliers perceive that their partners, typically having more bargaining power, are more dependent on them. The overall effect of mutual dependency of any kind on SCM performance, however, was not significant. Although mutual dependency has been mentioned as an important static factor influencing almost every aspect of cooperation on a supply chain, its influences may not be as significant as it was initially perceived to be. Third, the correlation between information quality and partnership quality was 0.448 with a p-value of less than 0.001. Information quality had a path coefficient of 0.256 to partnership quality with a t-value of 2.940. The quality of information exchanged between partners may have an impact on their partnership quality. Fourth, information quality also had a significant impact on SCM performance with a path coefficient of 0.325 with a t-value of 3.611. In this study, SCM performance was divided into four categories: product quality, cost saving, service quality, and order fulfillment. Information quality has Significant impacts on product quality, cost saving and service quality, but not on order fulfillment. Fifth, partnership quality, as expected, had a significant impact on SCM performance. The path coefficient was 0.403 with a t-value of 3.539. Partnership quality, like information quality, had positive impacts on product quality, cost saving and service quality, but showed no impact on order fulfillment. It seemed that order fulfillment is the hardest category of performance that SCM can satisfy. One major limitation of this study is that it surveyed only the suppliers. To better understand the dual aspects of SCM, it is important to survey both suppliers and the assemblers, especially in pairs. This research, to our best knowledge, was the first attempt to study the level of dependency between the two groups by measuring the dual aspects of SCM and studying mutual dependency from the categories of suppliers and assemblers each.. In the future, a more comprehensive and precise measurement of SCM characteristics needs to be achieved by examining from both the supplier's and assembler's perspectives.

• 한국유통학회지:유통연구
• /
• 제16권1호
• /
• pp.65-93
• /
• 2011

본 연구에서는 관리형 유통경로의 구조적 요인들인 공급자 특유투자, 커뮤니케이션, 소매상 의존도가 신뢰에 미치는 효과를 검토하고자 하였다. 또한 이러한 변수들에 대한 관계수명주기의 조절효과를 밝히고자 하였다. 관계적 거래는 하루아침에 성사되는 것이 아니라 장기간에 걸친 반복적 거래 및 사회적 맥락(social context)이 누적된 결과로 발생하기 때문에 관계마케팅을 성공적으로 수행하기 위해서는 관계수명주기에 대한 단계별 검토가 우선되어야 한다. 작물보호제 소매상 296명으로부터 설문자료를 수집하여 분석한 결과, 공급자에 대한 소매상의 의존도가 신뢰를 가장 크게 증가시키는 것으로 나타났다. 특히 관계가 발전할수록 의존도의 영향력은 점점 더 커졌다. 따라서 공급자는 차별화된 제품과 서비스를 제공하여 시간의 흐름에 따라 소매상의 의존도가 더욱 높아질 수 있도록 노력해야 한다. 그리고 공급자 특유투자는 관계 초반에 신뢰를 증가시키는 역할을 하는 것으로 나타났다. 반면에 성숙기 이후에는 유의한 영향력을 보여주지 않았다. 이는 관계 초기에는 상대방을 평가하는 단서가 특유투자에 불과하기 때문에 특유투자의 효과가 크게 나타나지만 관계가 발전하면 상대방을 평가할 수 있는 여러 가지의 단서를 획득하게 되어 특유투자의 효과가 적은 것으로 볼 수 있다. 또한 양자간의 커뮤니케이션은 신뢰를 높여주는 것으로 나타났으며 신뢰는 장기지향성에 긍정적인 영향을 미치는 것으로 나타났다. 성숙기보다 강화기에서 커뮤니케이션의 영향력은 더 크게 나타났다. 본 연구는 관리형 시스템의 관계변수인 공급자 특유투자, 소매상 의존도, 양자 간 커뮤니케이션을 통합적으로 검토하였다는 점에서 의의를 찾을 수 있다. 그리고 관계수명주기의 조절효과를 검토함으로써 관계의 발전단계에 따른 차별적 전략을 제안할 수 있었다.

• Asia pacific journal of information systems
• /
• 제17권2호
• /
• pp.49-81
• /
• 2007

Research in the IS (Information Systems) outsourcing has focused on the importance of legal contracts and partnerships between vendors and clients. Without detailed legal contracts, there is no guarantee that an outsourcing vendor would not indulge in self-serving behavior. In addition, partnerships can supplement legal contracts in managing the relationship between clients and vendors legal contracts by itself cannot deal with all the complexity and ambiguity involved with IS outsourcing relationships. In this paper, we introduce a psychological contract (between client and vendor) as an important variable for IS outsourcing success. A psychological contract refers to individual's mental beliefs about his or her mutual obligations in a contractual relationship (Rousseau, 1995). A psychological contract emerges when one party believes that a promise of future returns has been made, a contribution has been given, and thus, an obligation has been created to provide future benefits (Rousseau, 1989). An employmentpsychological contract, which is a widespread concept in psychology, refers to employer and employee expectations of the employment relationship, i.e. mutual obligations, values, expectations and aspirations that operate over and above the formal contract of employment (Smithson and Lewis, 2003). Similar to the psychological contract between an employer and employee, IS outsourcing involves a contract and a set of mutual obligations between client and vendor (Ho et al., 2003). Given the lack of prior research on psychological contracts in the IS outsourcing context, we extend such studies and give insights through investigating the role of psychological contracts between client and vendor. Psychological contract theory offers highly relevant and sound theoretical lens for studying IS outsourcing management because of its six distinctive principles: (1) it focuses on mutual (rather than one-sided) obligations between contractual parties, (2) it's more comprehensive than the concept of legal contract, (3) it's an individual-level construct, (4) it changes over time, (5) it affects organizational behaviors, and (6) it's susceptible to organizational factors (Koh et al., 2004; Rousseau, 1996; Coyle-Shapiro, 2000). The aim of this paper is to put the concept, psychological contract commitment (PCC), under the spotlight, by finding out its mediating effects between legal contracts/partnerships and IS outsourcing success. Our interest is in the psychological contract commitment (PCC) or commitment to psychological contracts, which is the extent to which a partner consistently and deeply concerns with what the counter-party believes as obligations during the IS project. The basic premise for the hypothesized relationship between PCC and success is that for outsourcing success, client and vendor should continually commit to mutual obligations in which both parties believe, rather than to only explicit obligations. The psychological contract commitment playsa pivotal role in evaluating a counter-party because it reflects what one party really expects from the other. If one party consistently shows high commitment to psychological contracts, the other party would evaluate it positively. This will increase positive reciprocation efforts of the other party, thus leading to successful outsourcing outcomes (McNeeley and Meglino, 1994). We have used matched sample data for this research. We have collected three responses from each set of a client and a vendor firm: a project manager of the client firm, a project member from the vendor firm with whom the project manager cooperated, and an end-user of the client company who actually used the outsourced information systems. Special caution was given to the data collection process to avoid any bias in responses. We first sent three types of questionnaires (A, Band C) to each project manager of the client firm, asking him/her to answer the first type of questionnaires (A).

• Asia pacific journal of information systems
• /
• 제21권4호
• /
• pp.1-25
• /
• 2011

Internet-based commerce has undergone an explosive growth over the past decade as consumers today find it more economical as well as more convenient to shop online. Nevertheless, the shift in the common mode of shopping from offline to online commerce has caused consumers to have worries over such issues as private information leakage, online fraud, discrepancy in product quality and grade, unsuccessful delivery, and so forth, Numerous studies have been undertaken to examine the role of perceived risk as a chief barrier to online purchases and to understand the theoretical relationships among perceived risk, trust and purchase intentions, However, most studies focus on empirically investigating the effects of trust on perceived risk, with little attention devoted to the effects of perceived risk on trust, While the influence trust has on perceived risk is worth studying, the influence in the opposite direction is equally important, enabling insights into the potential of perceived risk as a prohibitor of trust, According to Pavlou (2003), the primary source of the perceived risk is either the technological uncertainty of the Internet environment or the behavioral uncertainty of the transaction partner. Due to such types of uncertainty, an increase in the worries over the perceived risk may negatively affect trust, For example, if a consumer who sends sensitive transaction data over Internet is concerned that his or her private information may leak out because of the lack of security, trust may decrease (Olivero and Lunt, 2004), By the same token, if the consumer feels that the online merchant has the potential to profit by behaving in an opportunistic manner taking advantage of the remote, impersonal nature of online commerce, then it is unlikely that the merchant will be trusted, That is, the more the probable danger is likely to occur, the less trust and the greater need to control the transaction (Olivero and Lunt, 2004), In summary, a review of the related studies indicates that while some researchers looked at the influence of overall perceived risk on trust level, not much attention has been given to the effects of different types of perceived risk, In this context the present research aims at addressing the need to study how trust is affected by different types of perceived risk, We classified perceived risk into six different types based on the literature, and empirically analyzed the impact of each type of perceived risk upon consumer trust in an online merchant and further its impact upon purchase intentions. To meet our research objectives, we developed a conceptual model depicting the nomological structure of the relationships among our research variables, and also formulated a total of seven hypotheses. The model and hypotheses were tested using an empirical analysis based on a questionnaire survey of 206 college students. The reliability was evaluated via Cronbach's alphas, the minimum of which was found to be 0.73, and therefore the questionnaire items are all deemed reliable. In addition, the results of confirmatory factor analysis (CFA) designed to check the validity of the measurement model indicate that the convergent, discriminate, and nomological validities of the model are all acceptable. The structural equation modeling analysis to test the hypotheses yielded the following results. Of the first six hypotheses (H1-1 through H1-6) designed to examine the relationships between each risk type and trust, three hypotheses including H1-1 (performance risk ${\rightarrow}$ trust), H1-2 (psychological risk ${\rightarrow}$ trust) and H1-5 (online payment risk ${\rightarrow}$ trust) were supported with path coefficients of -0.30, -0.27 and -0.16 respectively. Finally, H2 (trust ${\rightarrow}$ purchase intentions) was supported with relatively high path coefficients of 0.73. Results of the empirical study offer the following findings and implications. First. it was found that it was performance risk, psychological risk and online payment risk that have a statistically significant influence upon consumer trust in an online merchant. It implies that a consumer may find an online merchant untrustworthy if either the product quality or the product grade does not match his or her expectations. For that reason, online merchants including digital storefronts and e-marketplaces are suggested to pursue a strategy focusing on identifying the target customers and offering products that they feel best meet performance and psychological needs of those customers. Thus, they should do their best to make it widely known that their products are of as good quality and grade as those purchased from offline department stores. In addition, it may be inferred that today's online consumers remain concerned about the security of the online commerce environment due to the repeated occurrences of hacking or private information leakage. Online merchants should take steps to remove potential vulnerabilities and provide online notices to emphasize that their website is secure. Second, consumer's overall trust was found to have a statistically significant influence on purchase intentions. This finding, which is consistent with the results of numerous prior studies, suggests that increased sales will become a reality only with enhanced consumer trust.

• 생명과학회지
• /
• 제25권5호
• /
• pp.594-600
• /
• 2015

단백질-단백질 결합은 다양한 세포내 반응 조절에서 중요한 역할을 한다. Postsynaptic density-95/disks large/ zonula occludens-1 (PDZ) 도메인은 널리 알려진 단백질-단백질 결합 매개 도메인 중 하나이다. PDZ 도메인은 결합 단백질의 카르복실(C)-말단의 특정 motif와 결합한다. Multi-PDZ domain protein 1 (MUPP1)은 13개 PDZ 도메인을 가지는 단백질로서 다양한 구조단백질 및 신호단백질에 대한 scaffold로 작용한다고 알려져 있지만 MUPP1의 세포 내 기능은 아직 명확히 밝혀지지 않았다. 본 연구에서 MUPP1의 PDZ 도메인과 결합하는 단백질을 규명하기 위하여 효모 two-hybrid 방법을 이용하였고 muskelin이 MUPP1과 결합하는 것을 확인하였다. Muskelin은 GAB_AA 수용체(GABA_AR)의 α1 subunit와 결합하며 수용체의 endocytosis와 분해에 관여하는 것으로 알려져 있다. Muskelin은 MUPP1의 3번째 PDZ 도메인과 결합하지만, 다른 PDZ 도메인과는 결합하지 않았다. 또한 MUPP1과의 결합에 muskelin의 C-말단부위가 필수적임을 효모 two-hybrid 방법으로 확인하였다. HEK-293T 세포에 MUPP1과 muskelin을 동시에 발현하여 면역 침강한 결과 두 단백질은 같이 면역 침강하였다. 반면에 C-말단 결손 muskelin은 MUPP1과 같이 면역 침강하지 않았다. 또한 muskelin과 MUPP1은 세포내의 같은 위치에서 발현하였다. 이러한 결과들은, muskelin과의 결합을 통해, MUPP1 혹은 MUPP1과 결합하는 단백질이 GABA_AR의 세포내이동과 회전(turnover)을 조절할 가능성을 시사한다.

• Journal of Oral Medicine and Pain
• /
• 제33권4호
• /
• pp.305-316
• /
• 2008

본 연구의 목적은 하악전방이동장치요법으로 코골이와 수면무호흡증에 대한 치료를 시작한 후 1년이 경과한 한국인 환자들을 대상으로 하악전방이동장치의 지속적 사용 여부, 사용 빈도, 사용 중단 시까지의 사용 기간, 부작용 발생 여부, 그리고 장치사용의 중단 원인 등을 조사하여 하악전방이동장치의 장기적 사용에 영향을 주는 요인을 분석하는 것이다. 경북대학교병원 구강내과에서 코골이와 수면무호흡증을 주소로 내원한 환자들 중에 수면다원검사를 받고 하악전방이동장치요법을 시술받은 후 1년 이상 경과한 환자 103명 중에 전화를 통한 설문조사가 가능했던 49명의 환자를 대상으로 의무기록 조사 및 설문조사를 실하였다. 이들 중 현재까지 장치를 사용하고 있는 환자는 25명이었으며 사용을 중단한 환자는 24명이었다. 이들을 각각 계속사용군과 사용중단군으로 분류하여 두 군 사이에 초진 시의 연령, 성별분포, 체질량지수, 호흡장애지수, 구강장치요법을 시행하기 전의 코골이 빈도와 강도, 구강장치요법 시행 후의 코골이 감소 정도, 본인과 동침자의 구강장치요법에 대한 만족정도 등을 비교하였으며, 사용중단군에 대해서는 중단 사유를 물어봄으로서 다음과 같은 결론을 얻었다. 1. 계속사용군과 사용중단군 사이에 치료 시작 시점의 연령, 성별분포, 체질량지수, 호흡장애지수의 유의한 차이는 없었다. 2. 계속사용군과 사용중단군 사이에 치료 시작 전 코골이 빈도와 강도에서 유의한 차이가 없었다. 3. 계속사용군이 사용중단군에 비해 코골이의 개선정도가 높았다. 4. 계속사용군이 사용중단군에 비해 구강장치요법에 대한 만족도가 높았다. 5. 계속사용군이 사용중단군에 비해 동침자의 구강장치요법에 대한 만족도가 높은 경향을 보였다. 6. 구강장치 사용을 중단하게 된 사유 중에는 턱의 통증(25%), 치아 통증(20%), 장치 파손(20%) 등이 많았으나, 효과가 없어서 사용을 중단한 경우는 4.2%에 불과하였다. 7. 전체 조사대상자의 1년 사용자비율(1년 순응도)은 79.59%로 나타났다.

• Archives of Pharmacal Research
• /
• 제28권3호
• /
• pp.249-268
• /
• 2005

Drug metabolizing enzymes (DMEs) play central roles in the metabolism, elimination and detoxification of xenobiotics and drugs introduced into the human body. Most of the tissues and organs in our body are well equipped with diverse and various DMEs including phase I, phase II metabolizing enzymes and phase III transporters, which are present in abundance either at the basal unstimulated level, and/or are inducible at elevated level after exposure to xenobiotics. Recently, many important advances have been made in the mechanisms that regulate the expression of these drug metabolism genes. Various nuclear receptors including the aryl hydrocarbon receptor (AhR), orphan nuclear receptors, and nuclear factor-erythoroid 2 p45-related factor 2 (Nrf2) have been shown to be the key mediators of drug-induced changes in phase I, phase II metabolizing enzymes as well as phase III transporters involved in efflux mechanisms. For instance, the expression of CYP1 genes can be induced by AhR, which dimerizes with the AhR nuclear translocator (Arnt) , in response to many polycyclic aromatic hydrocarbon (PAHs). Similarly, the steroid family of orphan nuclear receptors, the constitutive androstane receptor (CAR) and pregnane X receptor (PXR), both heterodimerize with the ret-inoid X receptor (RXR), are shown to transcriptionally activate the promoters of CYP2B and CYP3A gene expression by xenobiotics such as phenobarbital-like compounds (CAR) and dexamethasone and rifampin-type of agents (PXR). The peroxisome proliferator activated receptor (PPAR), which is one of the first characterized members of the nuclear hormone receptor, also dimerizes with RXR and has been shown to be activated by lipid lowering agent fib rate-type of compounds leading to transcriptional activation of the promoters on CYP4A gene. CYP7A was recognized as the first target gene of the liver X receptor (LXR), in which the elimination of cholesterol depends on CYP7A. Farnesoid X receptor (FXR) was identified as a bile acid receptor, and its activation results in the inhibition of hepatic acid biosynthesis and increased transport of bile acids from intestinal lumen to the liver, and CYP7A is one of its target genes. The transcriptional activation by these receptors upon binding to the promoters located at the 5-flanking region of these GYP genes generally leads to the induction of their mRNA gene expression. The physiological and the pharmacological implications of common partner of RXR for CAR, PXR, PPAR, LXR and FXR receptors largely remain unknown and are under intense investigations. For the phase II DMEs, phase II gene inducers such as the phenolic compounds butylated hydroxyanisol (BHA), tert-butylhydroquinone (tBHQ), green tea polyphenol (GTP), (-)-epigallocatechin-3-gallate (EGCG) and the isothiocyanates (PEITC, sul­foraphane) generally appear to be electrophiles. They generally possess electrophilic-medi­ated stress response, resulting in the activation of bZIP transcription factors Nrf2 which dimerizes with Mafs and binds to the antioxidant/electrophile response element (ARE/EpRE) promoter, which is located in many phase II DMEs as well as many cellular defensive enzymes such as heme oxygenase-1 (HO-1), with the subsequent induction of the expression of these genes. Phase III transporters, for example, P-glycoprotein (P-gp), multidrug resistance-associated proteins (MRPs), and organic anion transporting polypeptide 2 (OATP2) are expressed in many tissues such as the liver, intestine, kidney, and brain, and play crucial roles in drug absorption, distribution, and excretion. The orphan nuclear receptors PXR and GAR have been shown to be involved in the regulation of these transporters. Along with phase I and phase II enzyme induction, pretreatment with several kinds of inducers has been shown to alter the expression of phase III transporters, and alter the excretion of xenobiotics, which implies that phase III transporters may also be similarly regulated in a coordinated fashion, and provides an important mean to protect the body from xenobiotics insults. It appears that in general, exposure to phase I, phase II and phase III gene inducers may trigger cellular 'stress' response leading to the increase in their gene expression, which ultimately enhance the elimination and clearance of these xenobiotics and/or other 'cellular stresses' including harmful reactive intermediates such as reactive oxygen species (ROS), so that the body will remove the 'stress' expeditiously. Consequently, this homeostatic response of the body plays a central role in the protection of the body against 'environmental' insults such as those elicited by exposure to xenobiotics.

• 통상정보연구
• /
• 제13권4호
• /
• pp.51-79
• /
• 2011

우리나라는 2003년부터 2008년까지 전자정부 과제로 인터넷기반의 국가전자무역망(uTradeHub)을 성공적으로 구축하여 무역의 전자화를 활성화하고 있으며, 전자무역의 마지막 단계라고 불리는 선하증권(B/L)을 전자화한 '한국형 전자선하증권 서비스(e-B/L Korea)'를 정부와 민간의 협력 하에 구축하여 시범사업을 거쳐 2009년에 공식적으로 전자선하증권 서비스에 들어갔다. 국가적 차원에서 상법을 개정하고 시행령을 만들어 선하증권을 제도화한 것은 세계 최초이며 세계 각국이 이의 성공여부에 지대한 관심을 가지고 주목하고 있다. 한국형 선하증권의 성공은 2011년 말을 기점으로 우리나라가 세계에서 9번째로 무역 1조불 클럽에 가입한 '무역강국'의 위상을 높이고 실질적으로 우리 수출입기업의 무역거래비용을 절감함으로써 향후 무역 2조불시대를 앞당길 전자무역 활성화의 시금석으로 인식되고 있다. 하지만 아직은 국가 간 연계구축망이 부재하고, 서류의 보안성과 안전성올 높이기 위한 전자인중이 국제적으로 통용되고 있는 사적인증을 배제하고 국내공인인증만을 취급하는 등 e-B/L 서비스를 활성화하기 위해서 해결해야할 문제점도 산적해 있어 실질적으로 e-Nego 서비스가 크게 확산되지 못하는 실정이다. 따라서 본 연구는 e-Nego 또는 서면전환 과정에서 발생할 수 있는 한국형 전자선하증권의 변형에 따른 문제점을 비롯하여 구조적, 제도적 문제점과 사용상 장애요인을 도출하여 이에 대한 해결방안을 제시하였으며, 한국형 전자선하증권의 특성을 검토하고 통 서비스 활용을 활성화하기 위한 전략을 제시하였다.

• Tuberculosis and Respiratory Diseases
• /
• 제42권4호
• /
• pp.474-480
• /
• 1995

연구배경: 우리나라의 결핵실태는 그동안 정부의 꾸준한 결핵퇴치사업의 추진과 경제성장에 따른 국민생활수준의 향상, 그리고 의료보험제도의 점진적확대 실시로 1965년 5.1%였던 결핵유병률이 지난 1985년에는 2.2%, 1990년에는 1.8%로 크게 감소하였으며, 가장 중요한 결핵역학지표의 하나인 도발양성 폐결핵유병율은 1980년도의 0.31%에서 1990년에는 0.14%로 감소하였다. 전체적인 치료효율을 반영하는 약제내성율은 1980년을 고비로 초회내성율 및 획득내성율 모두 점차 감소하는 추세에 있다. 그러나 외과적 치료를 요하는 환자에 있어서는 소위 MDRTB(Multi-Drug Resistant Tuberculosis)가 증가하는 추세이다. 아직도 보건행정의 무리와 환자의 무지, 그리고 결핵치료제의 남, 오용으로 초치료 및 재치료에 실패하는 환자들이 상당수 있음을 간과해서는 안된다. 장기간에 걸친 화학요법 혹은 단기간의 집중적 치료에도 불구하고 계속 잔존하는 결핵병소는 치료에 많은 문제점을 남기고 있다. 폐결핵의 외과적요법은 내과적 요법에 대한 유효한 보조수단이며 외과적요법의 목적은 내과적요법에 실패하기 쉽고 재발되기 쉬운 두꺼운 벽을 가진 공동성 병변 혹은 파괴된 잔여병소를 제거하거나 혹은 병소의 치유를 돕는 것이다.본 연구는 결핵요양소 정도로 알려져 있던 국립마산 결핵병원이 결핵치료에 있어 외과적 기능을 활발하게 수행하고 있음을 알리는 동시에 1994년 8월부터 1995년 4월까지 폐결핵으로 절제수술을 시행받은 30예를 분석, 검토함으로 향후 폐결핵 치료지침을 결정하는데 도움이 되고자 한다. 방법: 1994년 8월 부터 1995년 4월까지 국립마산결핵병원에 입원하여 폐절제수술을 시행받은 후 조직병리학적으로 폐결핵으로 진단받은 환자 30예를 대상으로 연령 및 성별분포, 폐결핵의 범위 (NTA classification), 수술적응증, 수술방법, 합병증 및 동반질환 그리고 술후 균음전화율 등에 대하여 분석, 검토하였다. 결과: 1) 남녀 성비는 24:6으로 남자에 많았다. 연령분포는 20대와 30대가 18예(60%)로 대부분을 차지하였다. 2) 수술적응으로는 공동성 병변이 19예(63.3%), 일측폐파괴가 8예(26.7%) 그리고 일엽파괴가 3예(10%)였다. 3) 폐결핵 병변의 정도는 증중이 21예(70%), 증등증이 9예(30%)였다. 4) 일측성 결핵에 대한 수술이 20예(66.7%)였으며 우측폐에 대한 수술이 18예(60%)였다. 5) 일측성 병변의 경우 수술전 균양성 16예중 술후 균음전화된 경우가 14예로 87.5%의 균음전화율을 보였으며 양측성 병변의 경우는 10예중 9예가 균음전화되어 90%의 균음전화율을 보였다. 일측 전폐절제술을 시행한 12예중 술전 균양성인 경우가 10예 였으며, 술수 모두 균음전화되었고, 폐엽절제술을 시행한 10명중 술전균양성인 경우가 14예 였으며 술후 12예에서 균음전화되었다. 6) 수술후 합병증으로는 사강형성이 2예(6.7%) 있었으며 경과관찰만으후 좋은 결과를 보였다. 7) 동반된 질환으로는 당뇨가 3예(10%) 있었다. 결론: 결핵치료에 있어서 화학요법단독으로는 한계가 있다. 단기간의 집중치료와 장기간에 걸친 항결핵제를 투여해도 계속해서 균양성인 환자중 두꺼운 벽을 가진 공동성 병변이나 파괴된 잔여병소를 가진 경우에는 외과적 치료가 화학요법의 효과적인 보조방법이 될 수 있다고 사료된다.

• KSBB Journal
• /
• 제21권3호
• /
• pp.204-211
• /
• 2006

IFN-${\gamma}$의 대량생산을 위한 기초연구로서 IFN-${\gamma}$의 아미노 말단에 glucagon과 ferritin을 융합파트너로 각각 결합시켜 재조합 IFN-${\gamma}$의 발현을 유도하였다. 대장균 내에서 발현되는 IFN-${\gamma}$는 그 자체로 매우 강한 소수성 결합의 양상을 나타내어 inclusion body 형태로 발현된다고 알려져 있으나 OrigamiTM(DE3) 균주로부터 50% 이상의 수용성 형태로 발현시켰다. IFN-${\gamma}$로부터 융합파트너를 제거할 수 있는 system을 개발하기 위해 융합파트너와 IFN-${\gamma}$ 사이에 enterokinase cleavage site를 도입하였으며, enterokinase에 의해 IFN-${\gamma}$에는 영향을 미치지 않고 효과적으로 융합파트너를 제거할 수 있었다. 재조합 IFN-${\gamma}$의 분리 및 정제를 위해 발현벡터상의 융합파트너와 IFN-${\gamma}$사이에 6X His-tag을 도입하였고 융합파트너의 N-말단에도 6X His-tag을 추가적으로 도입함으로써 융합파트너와 더불어 enterokinase에 의해 분해되지 않은 융합단백질을 Ni-NTA agarose column으로 제거함으로서 IFN-${\gamma}$를 완전 정제할 수 있었다. IFN-${\gamma}$의 발현을 유도하는 발현유도체로서 15 mM lactose를 이용하여 5 L 발효조에서 IFN-${\gamma}$의 발현을 검토한 결과, 재조합 균체의 단위 건조질량(dry cell weight, g)으로 약 11 g DCW/L 수준의 재조합 융합단백질을 얻을 수 있었다.