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원내검사 및 원외검사 결정을 위한 손익분기점 분석 경험
김윤희 대한진단검사의학회 2006 Annals of Laboratory Medicine Vol.26 No.6
배경 : 심화된 경쟁구도 의료시장에서는 의료서비스의 지속적품질개선을 통한 원가절감이 요구된다. 검사실에서는 정기적으로원내 또는 원외검사(make-or-buy) 결정을 위한 자료들을 검토하는 것이 요구되는 데, 이때 유용한 도구가 손익분기점(break-even point, BEP) 분석이다. 본 연구에서는 최근 본원 검사실에서 의뢰건수의 증가추세를 보인 면역측정 외부위탁검사들을 검사실 내부에서 시행(make)할 경우의 원가계산을 하여, BEP 분석을 시행하였다. 대 상 및 방 법 : AFP, CEA, PSA, ferritin, fT4, T3, TSH,CA 125, CA 19-9 및 HBeAb 의 10가지 검사를 Abbott Ax-SYM 장비로 검사실 내부에서 자체 시행할 경우의 고정비 및 변동비를 계산하였다. 손익분기건수(break-even volume)는 연간고정비를 단위당 외부위탁구매가와 단위당 변동비의 차로 나누어서, BEP 비율은 손익분기건수에서의 총 구매가를 현재의 연 검사건수에서의 총 구매가로 나누어서 구하였다.\\Test volumeLoss\6,149,000 \18,447,000 \30,745,000ProfitTotal purchasing costsTotal purchasing costsContribution margin rateBreak-even pointTotal costsBreak-even pointBreak-evenvolume: 155930,000,00025,000,00020,000,00015,000,00010,000,0005,000,000012,000,00010,000,0008,000,0006,000,0004,000,0002,000,0000-2,000,000-4,000,000-6,000,000-8,000,000-10,000,0000 500 1,000 1,500 2,000 2,500 3,000A B464 김윤희결과 : AFP, CEA, PSA, ferritin, fT4, T3, TSH, CA125,CA19-9 및 HBeAb의 연 고정비는 평균 8,279,187원, 단위 당 변동비는 평균 3,786원이었다. 손익분기건수는 평균 1,599건, BEP비율은 평균 852%이었다. 고정비에 질 관리 비용을 포함하지 않은 경우의 BEP 비율은 평균 74%이었다.
가미강활산(加味羌活散)이 집먼지 진드기 추출물로 유도된 NC/Nga mouse의 아토피 피부염에 미치는 영향
김윤희,한재경,김윤희,Kim, Yun-Hee,Han, Jae-Kyung,Kim, Yun-Hee 대한한방소아과학회 2008 대한한방소아과학회지 Vol.22 No.1
Objectives The purpose of this study is to investigate the effect of KKHS on atopic dermatitis in an in-vivo experiment using an NC/Nga atopic dermatitis mouse, which has histological and clinical similarities to this condition in humans. Methods To investigate the effect of KKHS on atopic dermatitis (AD), we evaluated atopic dermatitis-like skin lesions by clinical skin index and analyzed immunological parameters in peripheral blood mononuclear cells(PBMCs), splenocytes, draining lymph node(DLN) and performed skin histology in ears and dorsal skin of atopic dermatitis of NC/Nga mouse in vivo. Results In vivo, clinical skin severity score was significantly lower in the KKHS group than in the control group. IgE, IL-6, TNF-${\alpha}$, IgM, IgG2a and IgG2b levels in serum decreased remarkably in the KKHS group than in the control group, and the level of IFN-${\gamma}$ production which is secreted from Th1 cell was increased by KKHS. After this experiment we analyzed immunological cells ($CD3^+$, $CD19^+$, $CD4^+$, $CD8^+$, $CD3^+CD69^+$, $CD4^+CD25^+$ and $CD49b^+$) by flow cytometry. It results that the total absolute number of $CD3^+$, $CD19^+$, $CD4^+$ and $CD8^+$ cells were recovered as much as normal state, and the level of $CD3^+CD69^+$ in isolated DLN and PBMCs were significantly decreased, and total absolute number of $Gr-1^+$, $CD11b^+$ and $CD3^+$ in dorsal skin of NC/Nga mouse were decreased by KKHS. We analyzed ear, DLN, and neck-back skin after biopsy and dyeing by hematoxyline/eosin(H&E), toluidine staining (mast cells marker). KKHS were very effective to the histological symptoms which are in dermal and epidermal thickening, hyperkeratosis and inflammatory cell infiltration. Ear thickness was significantly decreased compared with the control group and the size of inflammatory lymphocytes cells (ILC) and plasma cells (PC) in DLN were also decreased. Conclusions KKHS on atopic dermatitis in an in-vivo experiment using an NC/Nga atopic dermatitis mouse was very effectiveness to the atopy dermatitis treatment.
저온 저장 감수성 및 저항성 고구마 품종에서 저온 반응성 단백질체 연구
김윤희,지창윤,김호수,정정성,최성환,곽상수,이증주 한국식물생명공학회 2022 JOURNAL OF PLANT BIOTECHNOLOGY Vol.49 No.2
To obtain information on the molecular mechanism underlying the low temperature tolerance of sweet potato [Ipomoea batatas (L.) Lam], the proteome expressed in the sweet potato cultivar Xushu 15-1 with high cold storage tolerance and in the cultivar Xushu 15-4 with low cold storage tolerance was analyzed using 2-D and MALDITOF/TOF analyses. Compared with the control (without cold treatment), four protein spots were newly expressed in Xushu 15-1. The expression level of one protein spot was higher in Xushu 15-4 than in Xushu 15-1. Spot 2, which was newly expressed in Xushu 15-1, was identified as sporamin. Assessment of the change in protein expression levels over 8 weeks in the storage roots of the two cultivars treated at 4°C revealed no significant difference in the expression levels in Xushu 15-1 over time. However, in Xushu 15-4, the expression level of one protein spot increased, while those of four spots decreased. Of the proteins with reduced expression levels, spots 7 and 8 were identified as actin and spots 9 and 10 were identified as fructokinase-like proteins. The present results are expected to enhance the understanding of the complex mechanism underlying the low temperature tolerance of sweet potatoes during storage and can be used to identify candidate genes for the development of new varieties of sweet potatoes with improved low temperature tolerance during cold storage in the future.
Bone Marrow Toxicity Caused by Estrogen Toxicity in a Yorkshire Terrier with Leydig Cell Tumor
김윤희,고규련,노미영,김재훈,최을수 한국임상수의학회 2019 한국임상수의학회지 Vol.36 No.2
A 15-year-old intact Yorkshire terrier was presented with anorexia, lethargy, and a pale mucous membrane. A physical examination one year ago revealed right testis mass and subcutaneous petechia. Blood work revealed severe thrombocytopenia and mild anemia, and no abnormalities were found in serum chemistry or ultrasonography. The preoperative serum estrogen concentration was moderately elevated. The enlarged testis was surgically removed. A well-encapsulated mass composed of polyhedral or round with abundant eosinophilic cytoplasm containing fine granular or vacuolation were found in a histological examination of the removed tissue. The nuclei of tumor cells were round, and mitotic figures were low but neoplastic cells showed a mild invasive tendency to adjacent tissues with contained neoplastic cell emboli in one lymphatic lumen. A diagnosis of a malignant Leydig cell tumor was made. The patient recovered from surgery uneventfully, but his condition worsened despite repeated transfusions and supportive therapy, and he was euthanized according to the owner’s decision. Leydig cell tumor should be included in estrogen toxicity associated with testicular mass.
김윤희,조영태 한국인구학회 2008 한국인구학 Vol.31 No.1
This research examines the effect of area level characteristics on individual health, particularly focusing on the vulnerable populations in Seoul. We consider adult individuals whose family income is under 1.5 million won, who are aged 65 and over, or who have neither spouse nor job but aged 40 and over as vulnerable populations. Using the 2005 Seoul Citizens' Health Interview Survey, we conducted multilevel analyses to simultaneously investigate the effect of area and individual level characteristics on health. Between-area variance of self-rated health status was greater for the elderly population than for all populations. Area material deprivation index and happiness index were associated with the self-rated health of economically disadvantaged populations. Vulnerable populations showed greater between area variances in emotional health than the same for all populations. Area happiness index, material deprivation index, the proportion of households below poverty line and street safety showed statistically significant association with emotional health. The effect of area characteristics were particularly salient for the emotional health of elderly population and its between area variance was also notable. 본 연구는 주거지역 특성이 그 지역 구성원의 건강수준에 미치는 영향이 일반 집단보다는 취약집단에서 더 크게 나타날 것으로 보았다. 이를 규명하기 위해 서울시민을 대상으로 한 2005년 서울시 보건지표조사 자료를 이용하였으며, 행정구역상의 ‘구’를 지역효과를 나타내는 기본단위로 설정하였다. 개인의 건강수준은 주관적 건강인식(Self Rated Health)과 정신건강으로 측정하였으며 지역특성을 설명하는 변수로 서울시 25개 ‘구’ 각각의 사회 경제적 수준, 사회적 자본 및 문화 자본, 물리적 환경, 인구학적 특성 등을 활용하였다. 구성효과를 통제하기 위해 성, 연령, 결혼상태, 교육수준, 직업, 소득 등의 개인특성변수를 포함한 다수준 분석을 실시하였다. 취약집단으로 저소득층, 노인, 40세 이상으로 배우자가 없으면서 무직인 중 . 노년층 세 개의 집단을 선정하여 각각을 분석하였다. 분석결과 우울 경험을 이용하여 측정한 정신 건강의 경우 지역 간 차이가 세 취약집단 모두에서 일반 인구집단보다 더 크게 나타났다. 지역변수들과 개인변수들을 모두 고려한 다수준 모형에서 지역주민의 행복지수, 물질결핍지수, 빈곤선 이하 가구 비율, 행복 지수, 거리 안전에 대한 인식 수준 등의 지역변수들이 개인특성변수의 효과를 통제한 후에도 취약집단의 정신건강 차이를 설명하는 변수로 확인되었다. 이런 지역특성의 맥락효과는 주관적 건강에서보다 정신건강에서 더 크게 나타났다. 특히 취약집단 중 노인집단의 경우 지역 간 분산의 차이가 상대적으로 컸을 뿐 아니라 분석에 포함된 다양한 지역특성변수들이 통계적으로 의미있게 나타나 다른 취약집단에 비해 지역의 상황에 더 크게 영향을 받은 것으로 판단된다.