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가상적 편의를 제거한 조건부가치평가모형- 동강 보존을 위한 지불용의비용 추정-
박주헌 한국계량경제학회 2002 계량경제학보 Vol.13 No.3
가상적 편의는 조건부가치평가모형에서 공통적으로 발견되는 문제이다. 가상적 편의를 제거하지 않으면, 조건부가치평가모형에서 추정된 지불용의비용은 필연적으로 과대추정된다. 그러나 기존의 조건부가치평가모형은 가상적 편의의 발생원인을 모형내에서 설명하지 못하고 있을 뿐만 아니라, 이를 제거하는데도 한계가 있다. 본 논문에서는 조건부가치평가모형이 가정하고 있는 전통적 응답메커니즘 대신 확률적 응답메커니즘을 제시함으로써 모형내에서 가상적 편의의 발생 원인을 설명하고 이를 제거할 수 있는 새로운 분석방법을 제시한다. 새롭게 제시된 분석방법을 동강 환경보존을 위한 지불용의비용 추정에 적용함으로써 실증분석의 활용 가능성을 보인다.
Anemia in COPD patients of Korean Obstructive Lung Disease (KOLD) cohort.
박주헌,신승수,이규성,이재승,김은경,이지현,유광하,김태형,윤호일,임성용,오연목,이상도 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-
Background : Anemia can be manifested as one of the co-morbidities developing due to chronic inflammation in COPD. Thus, anemia is considered as an important prognostic factor in COPD. Therefore, this study was performed to evaluate the effect of anemia on the prognosis of COPD and investigate factors linked with anemia in COPD. Methods : We analyzed 442 COPD patients of Korean Obstructive Lung Disease (KOLD) cohort enrolled from 16 hospitals in Korea. Anemia was determined by the reference values of hemoglobin: < 12 g/dL for women and < 13 g/dL for men. Results : Compared to non-anemic COPD, anemic COPD had older age, lower BMI, lower cholesterol level, lower albumin level, and shorter walk distance in six minute walk test (p<0.05). However, there was no difference in pulmonary function tests and emphysema index between two groups. By multivariate analysis, older age (OR = 1.101, 95%CI = 1.020 - 1.188, p=0.015) and lower serum albumin level (OR = 0.074, 95%CI = 0.017 - 0.318, p<0.001) were independent factors associated with anemia in COPD. The survival period of non-anemic COPD (mean survival = 8.59 ± 0.14 years) was longer than anemic COPD (6.31 ± 0.78 years, p = 0.004). Conclusions : Older age and lower serum albumin level were independent factors associated with anema in COPD. The survival period of anemic COPD was shorter.
KOCOSS 만성폐쇄성폐질환(COPD)코호트에서 폐기능 감소군의 임상양상
박주헌,이진국,김덕겸,박용범,이지현,유광하,정기석,( Kocoss Study Group ) 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.0
배경: COPD는 폐기능이 지속적으로 감소되고 손상된 폐기능은 정상으로 회복되지 않는 병태생리적 특징을 가진다. 국내 COPD 환자에서 폐기능 손상의 원인 인자에 대한 보고는 드물어 KOCOSS 코호트에서 폐기능 감소의 원인 인자를 규명하고자 본 연구를 시행하였다. 방법: 전국 대학병원에서 COPD로 진단된 40세 이상 환자가 등록된 KOCOSS 코호트에서 1년간 폐기능검사를 추적하였던 42명의 환자를 대상으로 하였다. FEV1의 1년간 변화치를 기준으로 감소가 가장 심한 25%를 감소군(13명, 남:여=12:1, 연령 69.5 ± 8.8세)으로 나머지를 유지군(28명, 남:여=28:1, 연령 67.5±7.6세)으로 정의하고 두 군 간의 차이를 비교 분석하였다. 결과: 등록시점에서 감소군과 유지군 사이에 FVC (103.0±19.9 vs. 92.3±16.2%, p=0.105), FEV1 (67.6±16.4 vs. 60.9±16.1%, p=0.222), 및 FEV1/FVC (48.2±12.8 vs. 47.1±9.5%, p=0.752)는 차이를 보이지 않았으나 DLCO (72.2±21.9 vs. 91.0±25.7%, p=0.034)는 감소군이 유지군에 비하여 유의하게 낮았다. 등록시점의 6분도보검사는 감소군의 6분도보거리(411.2±70.8 vs. 449.5±60.9, p=0.083)가 유지군에 비하여 짧은 경향을 보였고 산소포화도(2.2±4.8 vs. 1.8±4.5 p=0.815)는 두 군 간 차이가 없었다. 혈중 콜레스테롤 농도는 감소군(202.9±29.4 mg/dl)이 유지군(179.4±39.7 mg/dl)에 비하여 유의하게 높았다(p=0.014). 결론: KOCOSS COPD 코호트의 폐기능 감소군은 유지군에 비하여 DLCO가 낮고 혈중 콜레스테롤 농도가 높은 특징을 보였다.
박주헌,이혜림,김영선,정윤정,정우영,이규성,신승수,황성철,( Stephen I Rennard ) 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.-
Purpose: Prostaglandin E2 (PGE2) is increased in the lower respiratory tract of patients with COPD. Hepatocyte growth factor (HGF) plays a role in modulating epithelial cell proliferation. In some mesenchymal cells, PGE2 modulates HGF production. This study was to see if PGE2 modulates HGF production and to determine the specific receptors involved. Methods: Human fetal lung fibroblasts (HFL-1) were cultured in Dulbecco`s Modified Eagle`s Medium DMEM) with 10% fetal calf serum. For stimulation, media were changed to DMEM without serum and supplemented with PGE2 or specific agonists and antagonists for each of the four E-prostanoid (EP) receptors. Media were harvested and assayed for HGF by ELISA.Forskolin, KT-5720 (PKA antagonist), and wortmannin were treated to investigate the downstream pathway. Results: Release of HGF was stimulated by PGE2 (p<0.05). The effect was greater as cells became confluent in culture over 10 days. Both PGE2 and EP2 agonist stimulated HGF release in a concentration dependent manner. EP2 antagonist inhibited the stimulatory effect of PGE2 and EP2 agonist. The other EP agonists and EP antagonists did not alter HGF release.Forskolin treatment also enhanced HGF release (p<0.05). KT-5720 inhibited HGF release (p<0.05) but wortmannin did not. Conclusion: HGF production in HFL-1 is stimulated by PGE2 acting on EP2 receptor. Forskolin has a similar effect suggesting that the effect is mediated by modulation of cAMP. The pathway of HGF release through the stimulation by PGE2 is a potential target to modulate lung tissue repair.
박주헌,조현우,박한빈,유동휘,김상균,권오훈,최강의,최성훈,Hong-Min Chu,장종원 대한침구의학회 2020 대한침구의학회지 Vol.37 No.1
Background: This study aimed to investigate the clinical effectiveness of treatment of Korean medicine on superior labrum anterior to posterior (SLAP) lesions. Methods: A total of 55 inpatients diagnosed with SLAP lesions by magnetic resonance imaging, were investigated from May 1 st , 2014 to May 31 st , 2019 at Haeundae Jaseng Hospital of Korean Medicine. The patients were sorted by gender, age, causing factor, illness duration, period of hospitalization, SLAP lesion type, complications, and treatments. Treatments included acupuncture, pharmacopuncture, Chuna therapy, herbal treatment, and physiotherapy. After treatment, the Numeric Rating Scale, Shoulder Pain and Disability Index, and European Quality of Life 5-Dimension questionnaire were used to evaluate treatment effect. Results: There were more males than females in this study (1:0.83). Patients were more likely to be in their 50s (38.18%), have an unknown etiology (70.91%), and be in the subacute disease stage (41.82%). According to the SLAP lesion type, most of the inpatients had Type 2 lesions (69.09%). For inpatients diagnosed with SLAP lesions, the mean shoulder numeric rating scale score decreased from 5.55 ± 0.90, to 4.07 ± 1.18 (p < 0.001), the mean Shoulder Pain and Disability Index score decreased from 50.35 ± 18.36, to 39.90 ± 19.34 (p < 0.001), and the mean European quality of life 5-dimension index increased from 0.70 ± 0.16, to 0.75 ± 0.13 (p < 0.01) after treatment. Conclusion: Treatment of Korean medicine effectively decreased pain and increased the quality of life of the patients with SLAP lesions in this study.