3개 대학병원의 주 진단 코딩사례 평가

서순원,김광환,부유경,서진숙,서정돈,윤석준,이영성,이무식,정희웅 한국의료QA학회 2002 한국의료질향상학회지 Vol.9 No.1

Background : Coding of principal diagnosis is essential component for producing reliable health statistics. We performed this study to evaluate the current practice of principal diagnoses determination and coding, and to give some basic data to improve coding of principal diagnosis. Method : Nineteen medical record administrators(MRAs) of 3 university hospitals participated in coding principal Dx. From August 1, 2001 to August 31, 2001. From each hospital, 10 medical records of patients with high frequency disease were selected randomly. Each 10 medical records were grouped into three(A,B,C). Then, these 30 medical records were given to each MRAs for coding. At the same time questionnaire was given to each of them. Questions were to prove how they decide and code the principal diagnosis among many current diagnoses ; how they decide and code the principal diagnosis when day see irrelevant diagnosis recorded as the principal diagnosis in medical record, when only tentative diagnoses were recorded without final diagnosis, and when different diagnoses were recorded in different sheets of same record. Agreement of coding among 3 hospitals were compared and survey results were analysed with SAS 6.12. Results : Agreement of coding was found in medical records 5-6 of each 10 medical records. Causes of disagreement were as follows. Difference of clinician’s opinion from each hospital; mixed use of guideline from KCD-3 and guideline from DRG; difference in 4th digit classification according to the absence of pathology report in the medical record; difference of abbreviations among hospitals. 57.9% of decided principal diagnosis after consulting to KCD-3 guideline. When there were difficulties in determining the principal diagnosis, 42.1% of MRAs decided principal diagnosis after discussion with the physician, 26.3% after discussion with fellow MRAs. Conclusion : There were differences in coding among hospitals. To minimize the difference, we suggest the development of disease-specific guidelines for coding in addition to the current general guideline such as KCD-3. To do this, Coding Clinic which can produce guidelines is needed.

철도차량 미분무수 소화설비 성능 평가

박원희(Won-Hee Park),음푸른별(Pu-Reun-Byul Eum),윤경범(Kyung-Beom Yoon),이덕희(Duck-Hee Lee) 한국유체기계학회 2014 한국유체기계학회 논문집 Vol.17 No.1

A New Hybrid Cymbidium ‘Beauty Smile’ with Orange Colored Flower and Medium Type

Mi-Seon Kim,Pu-Hee Park,Byeong-Woo Yae,Young-Ran Lee,Pil-Man Park,Dong-Su Lee,Hye-Ryun An 한국육종학회 2014 한국육종학회 심포지엄 Vol.2014 No.07

A new hybrid, Cymbidium(C.) ‘Beauty smile’ was developed as new hybrid by National Institute of Horticultural & Herbal Science, Rural Development Administration, Suwon, Korea in 2013. This hybrid came from the progenies crossed between C. ‘2113’(Accession No.) and C. Lucky Rainbow ‘Randevous’ in 2000. Finally, eighty seven seedlings were obtained after planting and acclimatization in green house. In 2007, one line was selected by their performance such as flower color, leaf shape, flower stalk, and vigorous growth and named ‘Wongyuo F1-43. The line code 000550-78 had uniformity and excellent characteristics. The selected line after second characteristics test was named as ‘Beauty smile’. This hybrid had bright pink colored petal and lip (RP63D)and large sized flower(diameter 8.3cm). A ‘Beauty smile’ had about 13.3 flowers per flower stalk and medium sized flower and plant. General impression of petals and sepals showed some incurved shape. The attitude of peduncle was half-erect. Bloom was started from middle of November under optimal culture condition.

A New Hybrid Cymbidium ‘Sunny Bell’ with Fragrant of Small Type

Mi-Seon Kim,Pu-Hee Park,,Byeong-Woo Yae,Young-Ran Lee,Pil-Man Park,Dong-Su Lee,Hye-Ryun An 한국육종학회 2014 한국육종학회 심포지엄 Vol.2014 No.07

A new hybrid, Cymbidium(C.) ‘Sunny Bell’ was developed as new hybrid by National Institute of Horticultural & Herbal Science, Rural Development Administration, Suwon, Korea in 2013. This hybrid came from the progenies crossed between C. karan and ebruenum in 2000. Finally, one hundred-one seedlings were obtained after planting and acclimatization in green house. In 2007, one line was selected by their performance such as flower color, leaf shape, flower stalk, and vigorous growth and named ‘Wongyuo F1-47. The line code 000390-46 had uniformity and excellent characteristics. The selected line after second characteristics test was named as ‘Sunny Bell’. This hybrid had light purple colored petal and lip (RP59B)and large sized flower(diameter 7.9cm). A ‘Sunny Bell’ had about 7.8 flowers per flower stalk and small sized flower and plant. General impression of petals and sepals showed some incurved shape. The attitude of peduncle was erect. Bloom was started from February under optimal culture condition

MicroRNA-10b Plays a Role in Bone Formation by Suppressing Interleukin-22 in Ankylosing Spondylitis

( Pu-reum Park ),( Sungsin Jo ),( So-hee Jin ),( Tae-jong Kim ) 대한류마티스학회 2020 대한류마티스학회지 Vol.27 No.1

Objective. The microRNA (miR)-10b is the T helper (Th) 17 cell specific in patients with ankylosing spondylitis (AS). The interleukin (IL)-22, which is closely related to Th17 cells, has been implicated in the regulation of new bone formation in experimental models. Therefore, the aim of this study was to evaluate whether miR-10b affects bone formation via the IL-22 pathway in AS. Methods. Primary CD4+ T cells from AS were purified and transfected with miR-10b, anti-miR-10b, or scramble. Cell-surface markers and cytokine expression were analyzed by flow cytometry and enzyme-linked immunosorbent assay. Primary bone-derived cells (BdCs) from the facet joints of the spine were isolated, then osteogenic differentiation of primary BdCs was performed. We assessed alkaline phosphatase (ALP) activity and staining of BdCs at early time points. Alizarin red S staining of BdCs was performed at late time points. Results. Overexpression of miR-10b reduced both IL-22 producing cell frequencies and cytokine production in T cells from the patients with AS. The IL-22 significantly increased ALP staining and bone mineralization. The ALP promotor activity of AS-BdCs was notably higher for the IL-22 concentration. The supernatants of the miR-10b overexpression group suppressed ALP activity on osteogenic progenitor cells from the facet joints of the spine in patients with AS. Conclusion. Our data suggest that miR-10b suppresses IL-22 production, which was involved in osteogenic proliferation in AS. Therefore, miR-10b might be a potential therapeutic candidate for regulation of new bone formation in patients with AS. (J Rheum Dis 2020;27:61-67)

Synthesis and Importance of Bulky Aromatic Cap of Novel SAHA Analogs for HDAC Inhibition and Anticancer Activity

Chun, Pu-Soon,Kim, Won-Hee,Kim, Jung-Su,Kang, Jin-Ah,Lee, Hye-Jin,Park, Ji-Young,Ahn, Mee-Young,Kim, Hyung-Sik,Moon, Hyung-Ryong Korean Chemical Society 2011 Bulletin of the Korean Chemical Society Vol.32 No.6

On the basis of potent HDAC-inhibitory activity and anticancer activity of SAHA, novel SAHA derivatives 3a-d and 7 with a bulky cap such as p-dimethylaminophenyl, 4-phenylaminophenyl, 4-phenyloxyphenyl, 9H-fluorenyl or naphthalenyl ring were synthesized starting from the corresponding aryl amines or naphthalenyl acetic acid using an EDC-mediated amide coupling reaction in the presence of HOBt followed by a nucleophilic addition-elimination reaction with hydroxylamine. Compounds 3b, 3c and 3d showed more potent inhibitory activity on total HDACs (14~27-fold), HDAC1 (8~15-fold), HDAC2 (1.3~25-fold) and HDAC7 (1~3-fold) and more potent anticancer activity (2~22-fold) against MCF-7, MDA-MB-231, MCF-7/Dox, MCF-7/Tam, SK-OV-3, LNCaP and PC3 human cancer cell lines than SAHA.

간질 환아에서 Handedness와 임상양상과의 관계

김부진(Pu Jin Kim),남상욱(Sang Ook Nam),박희주(Hee Ju Park) 대한소아신경학회 2001 대한소아신경학회지 Vol.9 No.1

목적: 오랜 기간동안 간질 환자에서 왼손잡이가 많다고 인식되어져 왔으나 이에 대한 연구는 흔하지 않다. 저자들은 간질 환아의 handedness를 조사하고 간질의 원인 및 뇌병변의 위치에 따른 왼손잡이의 빈도 및 handedness에 따른 여러 임상양상과의 관계를 분석하여 간질 환아에서 왼손잡이의 빈도와 왼손잡이의 주 기전이 간질 자체에 의한 것인지 간질과 동반된 뇌병변에 의한 것인지에 대한 연구로 간질의 원인, 치료 및 예후를 예측하는데 도움을 주고자 한다. 방법: 1996년 1월부터 1999년 8월까지 부산대학교병원 소아과에 경련으로 내원하여 간질로 진단받은 환아 158명을 대상으로 하였다. 대조군은 신경학적 결함이 없는 환아 158명이었다. 의무기록지에 의한 후향적 조사를 실시하여 두 군간의 handedness, 성별, 연령, 성별에 따른 handedness와 대조군에서 handedness에 다른 첫 경련 발생시의 연령, 연령분포, 간질의 가족력, 경련의 형태, 간질 원인의 유무, 증후성 간질의 원인, 해부학적 병변의 위치, 뇌파 결과에 의한 병변의 위치, 그리고 대상군을 특발성 간질 환아군과 증후성 간질 환아군으로 나누어 handedness를 조사하였다. 결과: 대상군과 대조군에서의 handedness, 성별, 연령, 성별에 따른 handedness의 차이는 없었다. 첫 경련시의 연령, 연령 분포, 경련의 형태, 가족력 유무와 handedness는 관계가 없었다. 증후성 간질 환아군은 오른손잡이에서 25명(17.9%)이었고 왼손잡이에서는 8명(44.0%)으로 왼손잡이에서 증후성 간질의 빈도가 높았고 증후성 간질 환아군에서 대조군에 비해 왼손잡이가 의미있게 많았으나 특발성 간질 환아군에서는 handedness의 차이가 없었다. 증후성 간질 환아군에서 좌뇌반구에 병변이 있는 경우, 뇌파검사상 왼손잡이에서 국소성 이상 소견있는 경우에 왼손잡이가 많았다. 결론: 대상군에서 대조군에 비해 왼손잡이의 빈도가 높지 않았으나 증후성 간질, 증후성 간질의 병변이 좌뇌반구에 있는 경우, 뇌파검사상 국소성 이상소견을 보인 경우에서 왼손잡이의 빈도가 높았다. 본 연구에서는 간질 환아에서의 왼손잡이의 높은 빈도는 증후성 간질의 원인으로 선행된 뇌병변에 주로 의한 것으로 생각된다. Purpose: Some reports left handedness is more common in epileptic patients compared with normal populations, but the study on this topics are rare. This can be due to epilepsy itself or brain lesion in epileptic patients. The study about the handedness in epileptic patients may help identifying the relationship of handedness and epilepsy, symptomatic epilepsy, sites of brain lesion, age at first seizure attack, family history of epilepsy. Methods: Subjects were 158 children with epilepsy who were admitted and able to describe the handedness at the Department of Pusan national university hospital between January 1996 and August 1999. We reviewed their sex, age, handedness. At patient group, age at first seizure, age distribution, family history of epilepsy, seizure type, etiology of epilepsy, causes of symptomatic epilepsy, site of brain lesion, localization by EEG were analyzed. Control group is 158 children without neurologic problem. We analysed handedness according to its variables. Results: There was no statistical significance in handedness between epileptic group and control group. There was no significant difference in handedness according to age at first seizure attack, seizure type, family history of epilepsy and age distribution. The left handedness is more common significantly in the group of symptomatic epilepsy, left side brain lesion and focal abnormality by EEG recording. Conclusion: We can find significant difference between symptomatic epileptic patient group, especially in the case of the left brain lesion and focal abnormality by EEG recording. In the case of bilateral or diffuse brain lesion, most of patients showed right handedness(87.5%). Accordingly, we concluded that high prevalence of left-handedness in children with epilepsy is more related with left side brain lesion than epilepsy itself. We assumed the social factors strongly affect the handedness of epileptic patients when we see that most of patients show the right handedness in the bilateral or diffuse brain lesions.

TOXICOLOGICAL STUDIES ON RAW AND PROCESSED (PREBREWED) ACONITI TUBERS

Han-Soo Park(박한수),Seung-Hee Kim  (김승희),Pu-Young Kim(김부영),Il-Moo Chang  (장일무) 한국독성학회 1990 Toxicological Research Vol.6 No.1

모듈간 슬라이싱 알고리즘

우종부(Jong-Pu Woo),류희열(Hee-Yeol Ryu),박재흥(Jae-Heung Park) 한국정보과학회 1994 한국정보과학회 학술발표논문집 Vol.21 No.2B

프로그램 슬라이싱(slicing)은 자료흐름과 제어 흐름을 분석함으로써 프로그램 행위(behavior)를 관심있는 특정 부분으로 제한하는 기법이다. 본 논문에서는 Gallagher 의 모듈내 슬라이싱 알고리즘의 문제점을 제시하고 이를 수정, 보완하고 Weiser 의 UP, DOWN 을 이용하여 모듈간 슬라이싱 알고리즘을 제시한다. 제시된 알고리즘의 타당성을 예를 들어 보인다.

Melatonin in the colon modulates intestinal microbiota in response to stress and sleep deprivation

( Young Sook Park ),( Soo Hyung Kim ),( Jong Won Park ),( Younglim Kho ),( Pu Rum Seok ),( Jae-ho Shin ),( Yoon Ji Choi ),( Jin-hyun Jun ),( Hee Chan Jung ),( Eun Kyung Kim ) 대한장연구학회 2020 Intestinal Research Vol.18 No.3

Background/Aims: Stress is closely related to the deterioration of digestive disease. Melatonin has potent anti-inflammatory properties. The objective of this study was to determine the effect of water stress (WS) and sleep deprivation (SD) on intestinal microbiota and roles of melatonin in stressful condition. Methods: We used C57BL/6 mice and specially designed water bath for stress and SD for 10 days. We measured melatonin concentrations in serum, feces, and colon tissues by high-performance liquid chromatography. Genomic DNA was extracted from feces and amplified using primers targeting V3 to V4 regions of bacterial 16S ribosomal RNA genes. Results: Compared to the control, melatonin concentration was lower in the WS and SD. Fecal concentration was 0.132 pg/mL in control, 0.062 pg/mL in WS, and 0.068 pg/mL in SD. In colon tissue, it was 0.45 pg/mL in control, 0.007 pg/mL in WS, and 0.03 pg/mL in SD. After melatonin treatment, melatonin concentrations in feces and colon tissue were recovered to the level of control. Metagenomic analysis of microbiota showed abundance in colitogenic microbiota in WS and SD. Melatonin injection attenuated this harmful effect. WS and SD showed decreased Lactobacillales and increased Erysipelotrichales and Enterobacteriales. Melatonin treatment increased Akkermansia muciniphila and Lactobacillus and decreased Bacteroides massiliensis and Erysipelotrichaceae. Conclusions: This study showed that stress and SD could affect intestinal dysbiosis and increase colitogenic microbiota, which could contribute to the aggravating digestive disease. Melatonin concentrations in feces and colon tissue decreased under WS and SD. Melatonin treatment brought recovery of melatonin concentration in colon tissue and modulating dysbiosis of intestinal microbiota. (Intest Res 2020;18:325-336)