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장애인 고용유지를 위한 근로지원인 및 작업지도원 정책의 효과성 검증 : 공단 서비스를 중심으로
박혜원,김원호 한국장애인고용공단 고용개발원 2016 장애와 고용 Vol.26 No.4
The purpose of this study to examine the effectiveness of the workplace personal assistance service and job coaching service systems in terms of promoting “employment retention” of severe people with disabilities in the rapidly changing employment environment. The study is to examine the actual conditions and effects of the assistance services to retain employment of severe people with disabilities, and based on the findings, to provide future directions for improvement, thereby contributing to create a stable employment conditions. We have found the results below by analyzing administrative record data from the Korea Employment Agency for the Disabled (KEAD) constructed from the projects including support of workplace personal assistance service and the employment management costs for disabilities. First, in terms of the workplace personal assistance service, among people with disabilities, those who are in relatively disadvantaged groups in terms of employment such as females, individuals with mental disabilities, and individuals with higher degree of disabilities are more likely to experience using the service. People who participated in the personal assistance service in workplace were also shown higher probability to retain employment was 0.08~0.11 point higher and statistically significant. This result shows that the policy result of the personal assistance service in workplace met its ultimate porposes. Second, chances of using the job coaching service was higher for females and for individual with mental related disabilities just as the case of the workplace personal assistance service, yet the difference was that the lower the degree of disability, the higher the chance of using the job coaching service. The probability of those who participated in the job coaching service to retain employment was 0.07~0.09 point higher than those who did not participate in the service, and the result was statistically significant. 본 연구는 급변하는 고용환경에서 중증 장애인의‘고용 유지’증진이라는 차원에서 근로지원인 서비스와 작업지도원 서비스 제도의 효과성을 알아보는 데 목적이 있다. 중증 장애인 고용 유지를 위한 지원 실태 및 그 효과를 파악하고 이를 기초로 향후 개선 방향을 제시하여 안정된 고용 환경을 조성하는 데 기여하기 위함이다. 공단이 구축하고 있는 근로지원인 서비스 지원 사업과 고용관리비용 지원 사업 등의 관련 자료를 분석해서 얻은 결과는 다음과 같다. 첫째, 근로지원인 서비스의 경우 장애인 중에서도 상대적으로 고용에 취약 계층인 여성 장애인일수록 정신적 장애인일수록 그리고 장애등급이 높을수록 서비스를 경험할 확률이 높은 것으로 나타났다. 근로지원인 서비스에 참여한 사람이 고용상태를 유지할 확률도 그렇지 않은 경우보다 0.08~0.11 높고 통계적으로도 유의하였다. 이러한 결과는 근로지원인 서비스가 본 목적에 부합하는 정책결과를 도출하였다고 할 수 있다. 둘째, 작업지도원 서비스를 경험할 확률은 여성일수록, 정신적 장애인일수록 높은 것으로 나타나 근로지원인의 경우와 비슷하였으나, 근로지원인 서비스와는 달리 장애등급이 낮을수록 서비스를 경험할 확률이 높은 것으로 나타났다. 작업지도원 서비스에 참여한 사람이 그렇지 않은 사람보다 고용을 유지할 확률은 0.07~0.09 정도 높은 것으로 분석되었고 이는 통계적으로도 유의하였다.
박혜원,현정원,박성섭,박명희,송은영 대한진단검사의학회 2011 Annals of Laboratory Medicine Vol.31 No.4
Loss of heterozygosity (LOH) in chromosome 6p has been reported in a number of tumors and some hematologic malignancies, including ALL. LOH in chromosome 6p, on which the HLA genes are located, can give rise to false homozygosity results in HLA genotyping of patients with hematologic malignancies. Here we report false homozygosity results in HLA genotyping due to the loss of whole chromosome 6 in the neoplastic cells of a patient with ALL. A 33-yr-old Korean female patient was admitted for the evaluation of leukocytosis detected during a workup for headache. Her initial white blood cell count was 336.9×10^9/L with 84% of blasts in the differential count. Precursor-B lymphoblastic leukemia was diagnosed from a subsequent bone marrow study. HLA high-resolution genotyping of the patient was requested at the time of diagnosis for possible hematopoietic stem cell transplantation. Homozygosity results (A*02:01, B*54:01, C*08:01, DQB1*04:01) were obtained, except for the DRB1 locus (DRB1*04:05, DRB1*11:01), in sequence-based typing. Conventional karyotyping of bone marrow metaphase cells revealed chromosomal abnormalities, with loss of multiple chromosomes including chromosome 6, and reduplication of the remaining chromosomes: 29,X,+X,+8,inv(9)(p11q13),+10,+14,+18,+21[15]/58,idemX2[3]/46,XX,inv(9)[2]. LOH at the HLA region was suspected and HLA genotyping was repeated with the peripheral blood in remission state after induction chemotherapy. All 5 HLA loci were typed as heterozygous (A*02:01, A*02:06, B*40:01, B*54:01, C*03:04, C*08:01, DRB1*04:05, DRB1*11:01, DQB1*03:01, DQB1*04:01). To avoid false HLA typing results in patients with hematologic malignancies, clinicians, as well as laboratory personnel, need to be aware of such problems and take appropriate precautions.
박혜원,유하영,김철현,김혜진,곽병옥,김교순,정소정 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.1
Purpose: An increase in the prevalence of obesity has been observed in children and adolescents. As remarkable changes in body composition occur with growth during the adolescent period, it is important that changes in body composition be monitored. The purpose of this study was to propose reference percentile values for body composition indices including body mass index (BMI) in children and adolescents in Korea. Materials and Methods: This study was performed using data from the Fourth and Fifth Korea National Health and Nutrition Examination Surveys. Body composition data were obtained using dual-energy X-ray absorptiometry. The percentile curves of body composition indices were constructed by the LMS method. Results: A total of 2123 children and adolescents between the ages of 10 and 19 years were included in this study. We obtained the percentile curves for BMI and body composition indices. Conclusion: The reference values for body composition from this study could help with assessing body composition in Korean adolescents.
p.R182C mutation in Korean twin with congenital lipoid adrenal hyperplasia
박혜원,곽병옥,김구환,유한욱,정소정 대한소아내분비학회 2013 Annals of Pediatirc Endocrinology & Metabolism Vol.18 No.1
Congenital lipoid adrenal hyperplasia (CLAH) is the most severe form of congenital adrenal hyperplasia which is caused by mutations in the steroidogenic acute regulatory protein (StAR). The mutations in StAR gene resulted in failure of the transport cholesterol into mitochondria for steroidogenesis in the adrenal gland. Twin sisters (A,B) with normal 46, XX were born at 36+2 gestational week, premature to nonrelated parents. They had symptoms as hyperpigmentation, slightly elevated potassium level and low level of sodium. Laboratory finding revealed normal 17-hydroxyprogesterone level, elevated adrenocorticotropin hormone (A, 4,379.2 pg/mL; B, 11,616.1 pg/mL), and high plasma renin activity (A, 49.02 ng/mL/hr; B, 52.7 ng mL/hr). However, the level of plasma cortisol before treatment was low (1.5 μg/dL) in patient B but normal (8.71 μg/dL) in patient A. Among them, only patient A was presented with adrenal insufficiency symptoms which was suggestive of CLAH and prompted us to order a gene analysis in both twin. The results of gene analysis of StAR in twin revealed same heterozygous conditions for c.544C>T (Arg182Cys) in exon 5 and c.722C>T (Gln258*) in exon 7. We report the first case on the mutation of p.R182C in exon 5 of the StAR gene in Korea.