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Long-term Follow-up of Cutaneous Hypersensitivity in Rats with a Spinal Cord Contusion
정지인,김준선,홍승길,윤영욱 대한약리학회 2008 The Korean Journal of Physiology & Pharmacology Vol.12 No.6
Sometimes, spinal cord injury (SCI) results in various chronic neuropathic pain syndromes that occur diffusely below the level of the injury. It has been reported that behavioral signs of neuropathic pain are expressed in the animal models of contusive SCI. However, the observation period is relatively short considering the natural course of pain in human SCI patients. Therefore, this study was undertaken to examine the time course of mechanical and cold allodynia in the hindpaw after a spinal cord contusion in rats for a long period of time (30 weeks). The hindpaw withdrawal threshold to mechanical stimulation was applied to the plantar surface of the hindpaw, and the withdrawal frequency to the application of acetone was measured before and after a spinal contusion. The spinal cord contusion was produced by dropping a 10 g weight from a 6.25 and 12.5 mm height using a NYU impactor. After the injury, rats showed a decreased withdrawal threshold to von Frey stimulation, indicating the development of mechanical allodynia which persisted for 30 weeks. The withdrawal threshold between the two experimental groups was similar. The response frequencies to acetone increased after the SCI, but they were developed slowly. Cold allodynia persisted for 30 weeks in 12.5 mm group. The sham animals did not show any significant behavioral changes. These results provide behavioral evidence to indicate that the below-level pain was well developed and maintained in the contusion model for a long time, suggesting a model suitable for pain research, especially in the late stage of SCI or for long term effects of analgesic intervention.
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정지인 한국보건행정학회 2022 보건행정학회지 Vol.32 No.3
With the outbreak of coronavirus disease 2019 (COVID-19) pandemic, health policymakers are adopting new policies regarding theissue of immunization disparities, especially for children in low-income communities of color who lack awareness and thereby accessto vaccines. The purpose of this paper is to propose an evaluation framework using program theory-based evaluation approach andlogic model to analyze and evaluate the immunization disparities in children aged 19–35 months. Data is collected from New York Citydepartment of Health and the U.S. Census Bureau for Northern Manhattan Start Right Coalition program which consists of 19,800children, and the community-provider partnership includes 26 practices and 20 groups. Program theory is used to evaluate thiscommunity-based initiative with the logic model which is a visual depiction that illustrations the program theory to all stakeholders. The logic model highlights the resources, activities, outputs, outcomes, and impacts of the program to guide to planners andevaluators and to call attention to the inadequacies or flaws in the operational, implementation and service delivery process of theprogram in offering a new perspective on the program. This framework adds to the literature on evaluations of immunizationdisparities in determining whether evaluators can definitively attribute positive immunization outcomes in the community to theprogram and conclude whether it has potential in expanding or duplicating it to other similar settings, especially in other rural areasof the United States, and abroad, where routine immunization equity gaps are wide due to income, racial and ethnic diversity, andlanguage barrier.
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Trends in Avoidable Death over 20 Years in Korea
정지인,송윤미,최지숙,김보미 대한의학회 2008 Journal of Korean medical science Vol.23 No.6
To evaluate the achievement of health care services in Korea independent of other socioeconomic factors, we observed the time trend of avoidable death between 1983 and 2004. A list of avoidable causes of death was constructed based on the European Community Atlas of ‘‘Avoidable Death’’. We calculated sex- and agestandardized mortality rates of Korean aged 1-64 yr using data of the Korea National Statistical Office. The avoidable mortality rate (per 100,000 persons) decreased from 225 to 84 in men and from 122 to 41 in women. Accordingly, the proportion of avoidable deaths among all classifiable deaths was reduced by 8.1% in men and 6.4% in women. However, mortality rates from some preventable causes such as ischemic heart disease and malignant neoplasms of lung, breast, cervix, and colorectum have been on the rise. Mortality preventable by appropriate medical care showed the greatest reduction (by 77.8%), while the mortality preventable by primary prevention showed the least reduction (by 50.0%). These findings suggest that health care service has significantly contributed to the improvement of health in Korea. However, more effective intervention programs would be needed given the less reduction in mortality avoidable by primary or secondary prevention than expected and unexpectedly increasing mortality from several preventable causes.
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