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장원만,이병철,안세영,두호경,안영민,Jang, Won-Man,Lee, Byung-Cheol,Ahn, Se-Young,Doo, Ho-Kyung,Ahn, Young-Min 대한한방내과학회 2007 大韓韓方內科學會誌 Vol.28 No.2
Objective : It has been reported that two-repeats ($IL1RN^{\ast}2$) of interleukin-1 receptor antagonist (IL-1Ra) gene is associated with ischemic stroke, and that Ala allele of the common Pro12Ala polymorphism in $PPAR-{\gamma}2$ isoform is associated with reduced risk for type 2 DM and its complications. The aim of the present study is to assess the association of IL-1Ra and $PPAR-{\gamma}2$ Pro12Ala polymorphism with the presence of ischemic stroke in the case of diabetic and non-diabetic patients. Methods : Genomic DNA was obtained from 373 healthy subjects, 157 DM subjects without ischemic stroke (known DM duration ${\ge}10$ years) and 302 ischemic stroke patients (including with DM). IL-1Ra polymorphism was analysed by polymerase chain reaction (PCR), and $PPAR-{\gamma}2$ polymorphism by restriction fragment length polymorphism after PCR. Results : $IL1RN^{\ast}1/IL1RN^{\ast}2$ genotype was associated with significantly increased risk for DM (OR=2.86, P = 0.0008) and ischemic stroke (OR=2.74, P = 0.0016). Pro/Ala genotype was associated with the reduced risk for DM (OR=0.53, P = 0.0491) and ischemic stroke (OR=0.38, P = 0.0039). They were also associated with the reduced risk for ischemic stroke in the DM patients compared with DM without ischemic stroke (OR=0.25, P = 0.0321). Conclusions : $IL1RN^{\ast}2$ allele could be an accelerating factor, not a predictive marker for ischemic stroke in type 2 DM. The Pro/Ala genotype of $PPAR-{\gamma}2$ Pro12Ala polymorphism may be associated with reduced risk for ischemic stroke with type 2 DM. Therefore it could be a useful predictive marker for ischemic stroke in Korean type 2 DM.
건강증진 프로그램 효과에 영향을 미치는 프로그램 관련 요소 분석 - 문헌고찰을 중심으로 -
장원기,정경래,김철웅 한국보건행정학회 2002 보건행정학회지 Vol.12 No.1
To find out more efficient ways of implementing health promotion programs and to determine the factors affecting the results of various interventions, we reviewed 73 articles on the effectiveness of health promotion programs. These include the papers on the smoking, alcohol, drug abuse, nutrition(obesity) and stress management etc. Specific interventions evaluated in this review are education based on the lecture or video shows, health-related event activities, modifications of policy or the environment, health risk appraisal etc. By using KIHASA Line of Korea Institute of Health and Social Affairs, National Congress Library Database and MEDLINE, we identified 201 articles published from 1980 to Jun. 1999 and finally selected 73 papers which contain the implementation process, and result of each program. The factors used in the analysis of the programs are (1) characteristics of participants (2) interventions evaluated (3) research design (4) length of programs and evaluation point (5) outcome indices (6) effect of program evaluated by each author. The study results did not prove positive effect of education based on lectures or video shows etc. Rather, it was suggested that lecture-based education has negative effect on the result. Event activity such as contest or health festivals has positive effect, and policy change or environmental change is closely related to the event activity. Also, the result shows that the overall effect of programs for the students is less than that of the programs for the others. The programs conducted over 1-year are more likely to have positive outcomes than shorter ones. And, the outcomes of the programs with controlled research design such as experimental or quasi-experimental study tend to be evaluated inferiorly to those with non-experimental design.
장원일,김미숙 한국항공우주학회 2015 한국항공우주학회 학술발표회 논문집 Vol.2015 No.4
고에너지 하전 입자의 형태의 전리 방사선으로 주로 구성되는 우주방사선은 우리가 지표면이나 저궤도에서 노출되는 방사선과는 다른 특징을 가지고 있다. 우주방사선에 의한 생물학적 영향의 정도와 형태 또한 기존 감마선이나 엑스선과는 다른 특징을 가질 것으로 생각된다. 하지만 우주비행사를 제외한 대부분의 인간은 이런 우주방사선 노출에 대한 경험이 없으며, 암발생 위험을 비롯한 인체에 미치는 영향 또한 제한적으로 연구되었을 뿐이다. 우주방사선의 암발생 위험도에 대한 연구를 진행하고 및 이에 대한 불확실성을 해소하는 것은 향후 도래할 우주시대의 필수적인 부분이라고 할 수 있다. 우리나라에서도 현재 개발 중인 중입자가속기를 이용하여 머지않은 미래에 우주방사선의 인체 영향에 대한 연구에 참여할 수 있을 것으로 기대해 본다. Space radiation, that is configured mainly with ionizing radiation in the form of high-energy radiation and charged particles, have different characteristics from radiation that are exposed at the surface and a low-earth orbit. It is considered that the extent and type of the biological effects caused by space radiation are also different from conventional X-ray and gamma-ray. However, the most of humans except for astronauts has no experience with space radiation exposure, the effects on human body including cancer risk has been based on only limited studies. It is the essential part of the Space Age to come in the future to study cancer risk induced by space radiation and resolve uncertainty. In the near future, we expect to be able to participate in studies on the health effects of space radiation, using heavy-ion accelerators under development in Korea.
고관절 부분 치환술 시술정보 공개에 따른 재입원율, 입원일수 및 진료비의 변화
장원모,은상준,사공필용,이채은,오무경,오주환,김윤,Jang, Won-Mo,Eun, Sang-Jun,SaGong, Pil-Young,Lee, Chae-Eun,Oh, Moo-Kyung,Oh, Ju-Hwan,Kim, Yoon 대한예방의학회 2010 Journal of Preventive Medicine and Public Health Vol.43 No.6
Objectives: We assessed impact of performance reporting information about the readmission rate, length of stay and cost of hip hemiarthroplasty. Methods: The data are from a nationwide claims database, National Quality Improvement Project database, of Health Insurance Review & Assessment Service in Korea. From January 2006 to April 2008, we received information of length of stay, readmission within 30 days, cost of 22 851 hip hemiarthroplasty episodes. Each episodes has retained the diagnoses of comorbidities and demographics. We used time-series analysis to assess the shifting of patients selections, between high volume (over 16 operations in a year) and low volume institutions, after performance reporting (December 2007). The changes of quality (readmission, length of stay) and cost were evaluated by multilevel analysis with adjustment of patient's factors and institutional factors after performance reporting. Results: As compared with the before performance reporting, the proportion of patients who choose the high volume institution, increased 3.45% and the trends continued 4 months at marginal significance (p = 0.059). After performance reporting, national average readmission rate, length of stay were decreased by 0.49 OR (95% CI=0.25 - 0.95) and 10% (${\beta}$=-0.102, p<0.01) and cost was not changed (${\beta}$=-0.01, p=0.27). The high volume institutions were more decreased than low volume in length of stay. Conclusions: After performance reporting, readmission rate, length of stay were decreased and the patient selections were marginally shifted from low volume institutions to high volume institutions.