56 research outputs found
๊ฑด์กฐํ๊ฒฝ๊ณผ ๋์๊ฑฐ์ฃผ์์ ๊ฑด๊ฐ
ํ์๋
ผ๋ฌธ (๋ฐ์ฌ)-- ์์ธ๋ํ๊ต ๋ํ์ : ๋ณด๊ฑด๋ํ์ ๋ณด๊ฑดํ๊ณผ, 2018. 2. ์กฐ์ฑ์ผ.and the odds of atopic dermatitis increased by 1.08 (1.01 โ 1.15) times if the road density increased by 13,120m2 within 300m of place of residence. For the children living on the tenth floor and higher, the prevalence of asthma and allergic rhinitis was higher for those living closer to major roads, but its effect was not consistent.
Discussions
In this study, the effect of urban BE measure regarding accessibility, density, and distance on walking practice and health results such as obesity and atopic eczema were analyzed by applying spatial analysis on public health monitoring data. Based on the results of analyses, the following implications were drawn: (1) the recently diminishing amount of physical activities exercised by urban residents could be significantly improved through increased neighborhood walkability, and one of the methods for improvement may increase adjusting accessibility to public transport from the place of residence(2) because obesity of urban residents is affected by neighborhood diet environment, additional intervention from the public health discipline must be considered simultaneouslyand (3) higher proximity to roads indicate higher air pollution in the neighborhood and it may trigger other health issues such as allergic reaction and atopic eczema especially for those with restricted activity perimeter, e.g., children. To sum up, adjusting access in BE will increase physical activity level, and thereby, effectively reduce noninfectious disorders such as obesity, but it may also increase the prevalence of noninfectious disorders in a certain population with vulnerability. Therefore, to improve the health issues in our cities, we must first adequately test various urban planning concepts formulated in Western urban environments and need better awareness and proactive intervention from the public health perspective.Background
A neighborhood environment is comprised of a physical environment and a socioeconomic environment and influences human health in a range of ways. Within a physical environment, all the human-made surroundings are referred to as built environment (BE), and it substantially influences the health of people living in an urban setting, more so in cities with higher population density. Interests and intervention from the public health perspective on health and wellness in the BE as a remedy against communicable diseases diminished after the 19th century but began to resurface in recent years to get to the bottom of noninfectious disorders relating to physical activities. Unfortunately, most studies conducted in this area focused on increasing quantity of physical activities of the general population and the scope of dialogue needs to be much expanded to deal with various health issues and effect on a vulnerable population. In South Korea, the demographic convergence in the Seoul Metropolitan Area is on the extremely high side, making it one of the most densely populated regions in the world. Accordingly, a multilateral evaluation in public health on its BE is very important. Especially, to overcome the numerous problems materialized due to the rapid expansion of cities in the past few decades, it is imperative to deliberate urban renewal programs regarding public health. However, the previous studies verified individual environmental factors, that was evaluated in Western cities, in connection with physical activities, and most of them were in the field of urban planning. A continuous health surveillance system is indispensable to determine and evaluate health effects of BE, and it is important to first determine whether the regional data from public health surveillance system are compatible with this study. Furthermore, applying spatial analysis and geographic information system will facilitate determining the relationship between urban planning components and its public health impact in a more extensive geographical region.
Objectives
The purpose of this study is to explore the urban built environmental factors that affect public health through spatial analysis using regional public health surveillance data, determine correlation among those factors and present basis stemming from the public health perspective for healthy urban renewal. This study aimed to evaluate the effect of urban BE on healthy activities and health results. Applying three aspects, density, distance, and accessibility, for measuring BE out of the available 5, the following analyses were performed:
Analysis 1: Correlation between accessibility to public transport and walking practices in adults
Analysis 2: Correlation between fast food outlet density and prevalence of obesity in adults
Analysis 3: Correlation between distance to a major roads and allergic diseases in children
Methods
Information on individual health behaviors and diseases prevalence was collected from public health surveillance data, more specifically, the Community Health Survey data (2011-2014, 92,357 subjects) for adults of 19 years of age or higher and the Seoul Atopy-Friendly School Survey data (2010, 24,040 subjects) for children. The built environmental factors influencing them were analyzed using a geographic information system, which required very precise location information. To achieve this, the participants of the Seoul Atopy-Friendly School Survey were geocoded on their home addresses. Those of the Community Health Survey were geocoded on regional representative location based on their type of residence (detached house, apartment) and geographically censored information of their home address at the community level (424 dongs in 2014). Of the many elements to the BE, accessibility to public transport by a community, density of top 5 fast food outlets (McDonald's, Lotteria, Burger King, KFC, Popeyes) by county, distance to major roads from residential address were used in analyses 1, 2 and 3. As for the impact of BE, walking duration (minutes) per week, obesity as defined by BMI of 25kg/m2, and prevalence of allergic and atopic diseases (atopic eczema, asthma, allergic rhinitis) were determined in each analysis.
Results
Accessibility to public transport and weekly walking duration had a nonlinear relationship, where the walking duration for those who lived between 1.0 to 1.5km from a subway station increased by 28.5 minutes (95% CI=16.7 - 40.2) but for those who lived 1.5km or farther away from a subway station decreased by 1.9 minutes (-19.9 โ 16.1). The density of fast food outlets, when adjusted with personal and regional factors, had an insignificant correlation with obesity in a county-level (male: Odds ratio=1.01, 95% CI=0.97 โ 1.05female: 1.04, 0.99 โ 1.09). Because the density of fast food restaurants closely correlated with regional socioeconomic level, when the effect was determined after adjusting the financial independence of the region, there was some discrepancy between the regional socioeconomic level and gender, but overall it had an insignificant correlation with obesity. The odds of atopic eczema were higher for children living on less than 4 floors and 150m, 150-300m, and 300-500m away from a major street than those living over 500m away, respectively by 1.15 (1.01 โ 1.32), 1.17 (1.03 โ 1.34) and 1.16 (1.01 โ 1.34) timesChapter 1. Introduction 1
Chapter 2. Built Environment and Walking Behavior 19
2-1. Introduction 20
2-2. Methods 23
2-3. Results 33
2-4. Discussion 44
References 49
Chapter 3. Built Environment and Obesity 53
3-1. Introduction 54
3-2. Methods 57
3-3. Results 62
3-4. Discussion 70
3-5. References 74
Chapter 4. Built Environment and Allergic Diseases 83
4-1. Introduction 84
4-2. Methods 87
4-3. Results 96
4-4. Discussion 105
References 112
Chapter 5. Discussions 123
Appendices 129
Abstract in Korean 133Docto
์ ์ฌ์ฑ์ ๋ฌธํ์ ์ฌํ: ใ์ฌ์ธ์ ์ด์ใ, ใ๊ฐ์ฑใ, ใ๋์ ์ํ ๋์ใ๋ฅผ ์ค์ฌ์ผ๋ก
ํ์๋
ผ๋ฌธ (๋ฐ์ฌ)-- ์์ธ๋ํ๊ต ๋ํ์ : ์ฌ๋ฒ๋ํ ์ธ๊ตญ์ด๊ต์ก๊ณผ, 2018. 2. ์ ๋ฌธ์.๋ณธ ๋
ผ๋ฌธ์ 19์ธ๊ธฐ ๋ง์์ 20์ธ๊ธฐ ์ด๋ผ๋ ๋ฏธ๊ตญ์ฌํ์ ๊ฒฉ๋ณ๊ธฐ์ ์๋ก์ด ๋ฑ์ฅํ ์ด๋ฅธ๋ฐ ์ ์ฌ์ฑ์ด ๋น๋์ ๋ฏธ๊ตญ์์ค ์์ ์ด๋ป๊ฒ ์ฌํ๋๊ณ ์๋์ง๋ฅผ ์์์คํ์ ์ถ๊ตฌํ๋ ์ ์ฌ์ฑ๋ค์ ๋๋๋ฌ์ง ๋ ๊ฐ์ง ์์ง, ์ฆ ์๊ธฐ์ ์ ๋ฐํ์ ๋ ์๋ฆฝ์ ์ฃผ์ฒด์ฑ๊ณผ ๋จ๋ค๋ฅธ ์ฑ
์์์์ ์ด์ ์ ๋๊ณ ์ดํด๋ณด๊ณ ์ ํ๋ ์๋์ด๋ค. ์ฐ์ , ๊ธ๊ฒฉํ ๋ณํ์ ์๊ธฐ์ ๋
๋ฆฝ์ ์ธ ์์๋ฅผ ์ถ๊ตฌํ๋ฉฐ ๊ณ ๋ฑ๊ต์ก์ ๋ฐ๊ณ ์คํฌ์ธ ๋ฅผ ์ฆ๊ธฐ๊ณ ์ ๋ฌธ์ง์ ์ง์ถํด์ ๊ฒฝ์ ์ ์๋ฆฝ์ ์ถ๊ตฌํ๋ฉฐ ๊ถ๊ทน์ ์ผ๋ก ์ฌํ๊ฐํ์ ๋๋ชจํ๋ ์ฌ์ฑ๋ค์ ํํ ์ ์ฌ์ฑ์ด๋ผ ์ง์นญํ ๋, ใ์ฌ์ธ์ ์ด์ใ์ ์ด์ฌ๋ฒจ ์์ฒ, ใ๊ฐ์ฑใ์ ์๋๋ ํฐํ
๋ฆฌ์, ใ๋์ ์ํ ๋์ใ์ ์ํ ๋์์ ๋ ๋ ๋ฑ๊ณผ ๊ฐ์ ์ฌ์ฑ์ธ๋ฌผ๋ค์ด ๊ณผ์ฐ ์๋ฐํ ์๋ฏธ์์ ์ ์ฌ์ฑ์ด๋ผ ๊ท์ ๋ ์ ์๋์ง ๋ช
ํ์น ์์ ์ ์๋ค. ์ฌ์ค ์ด๋ฌํ ๋ฌธ์ ์ ๊ธฐ๊ฐ ๋ฐ๋ก ์ด ๋
ผ๋ฌธ์ ํ๊ณ์ ์์๋ฅผ ์ญ์ค์ ์ผ๋ก ๋์์ ๋
ธ์ ํ ๊ฒ์ด๋ผ ๋ณผ ์ ์๋ค. ์ด๋ฅธ๋ฐ ์ ์ฌ์ฑ์ด๋ ์์ง์ ์ธ ์ ํ์ผ๋ก ํฌ๊ด์ ์ธ ์๋ฏธ์์ ์ค์ค๋ก๋ฅผ ๊ฐ์กฐํด๋๊ฐ๋ ์์ง๋ฅผ ๋ณด์ด๋ ํ๋์ ์ธ ์ด์ํ์ ํต์นญํ๋ค๋ ๋ง์ฌ ํจํฐ์จ์ ์ด์ผ๊ธฐ์ฒ๋ผ, ๋ณธ ๋
ผ๋ฌธ์ด ๋น์์ ์ ์ฌ์ฑ๋ค์๊ฒ์ ๊ฐ์ฅ ์ฃผ๋ชฉํ๊ณ ์ฒ์ฐฉํ๊ณ ์๋ ๊ฒ์ ํ์์ ์ธ ์ฌํํ๋๋ณด๋ค๋ ๊ทธ๊ฒ์ ๊ฐ๋ ฅํ ์ ์ธ์ด ๋์๋ ์ ์ฌ์ฑ์ผ๋ก์์ ๋ณธ๋ น, ์ฆ ๋ฐ๋ก ์ด์ ์ธ๋์ ์ฌ์ฑ๋ค๊ณผ๋ ํ์ฐํ ๊ตฌ๋ถ๋๋ ์์๋ฐ์ ์ ์ํ ์ฑ์ฐฐ, ์ฃผ์ฒด๋ก์์ ์์กด๊ฐ๊ณผ ์๋ฆฝ์์ง ๊ทธ๋ฆฌ๊ณ ์ฑ
์์์์ด๋ผ๊ณ ํ ์ ์๋ค. ๋ฐ๋ก ์ด๋ฌํ ์ด์ ๋ก ์ด์ฌ๋ฒจ, ์๋๋ ๊ทธ๋ฆฌ๊ณ ์ํ ๋์๋ ๋ฌธํ์ ์ผ๋ก ์ฌํ๋ ์ ์ฌ์ฑ๋ค๋ก ๊ฐ์ฃผ๋ ์ ์๊ณ ์ดํ ํ๋ฐํ ์ฌํ๊ฐํ์ ๊ฐ์ ธ์ค๋ ํ๋ฐฐ๋ค์ ๊ด๋ชฉํ ๋งํ ์ ์๋ผ ํ ์ ์๋ค. ๋ํ ์ด์ฌ๋ฒจ๊ณผ ์๋๋๋ ์ธ์์ด๋ ๋ฒ ๋ธ๋ฐ์ด ์ด์ผ๊ธฐํ๋ ๊ณผ์์ ์๋น๋ผ๋ ์ถ์ ๋ฐฉ์์์ ๋น์ ์๋กญ๊ฒ ๋ฑ์ฅํ ๊น์จ๊ฑธ๊ณผ ์๋นํ ์ ์ ์ ๋ณด์ด๊ธฐ๋ ํ๋ค. ๊น์จ๊ฑธ์ด ๋ณด๋ค ๋ ์ ๊ทน์ ์ด๊ณ ํ๊ฒฉ์ ์ธ ์๋ก์ด ์ ํ์ ์ฌ์ฑ๋ค์ ๋ฑ์ฅ์ ์ํ ๊ธธ์ ๋ฆ์๋์ ๊ฒ์ฒ๋ผ, ์์์ฑ์ฐฐ์ ๋ํ ์ด์ฌ๋ฒจ๊ณผ ์๋๋์ ๋
ธ๋ ฅ์ ๋
ธ๋์ ํตํด ๋ณด๋ค ์ ๊ทน์ ์ผ๋ก ์ฌํํ๋์ ์ฐธ์ฌํ๋ ์ฌ์ฑ์ธ๋ฌผ ์ํ ๋์์๊ฒ๋ก ์ด์ด์ง๋ค๊ณ ํ ์ ์๋ค.
๋จผ์ ใ์ฌ์ธ์ ์ด์ใ์ ์ดํด๋ณด๋ฉด, ์ด์ฌ๋ฒจ ์์ฒ๋ ๋๋ฅด์์คํธ์ ์ธ ํ์๊ณผ ์ง๋์น ์์ ๊ฐ์ ๊ฐ์ง ์ ์ฌ์ฑ์ ํ ์ ํ์ด๋ผ ํ ์ ์๋ค. ์ ๋ฝ๋๋ฅ์ ์์ํ์ฑ์ ์ํ ์ผ์ข
์ ์คํ์ค๋ก ์ ํํ๋ ์ด์ฌ๋ฒจ์ ๋ง๋ํ ์ ์ฐ์ด ๊ฐํ๋ ์๋ฐ๊ณผ ๋ณธ์ฐ์ ์์๋ฅผ ์งํจ๋ค๋ ๋ช
๋ถ์ผ๋ก ์ธํด, ์ธ์์ ์ง์ ์ฒดํํด๋ณด๊ณ ์ ํ๋ ํ๊ธฐ๋ฅผ ์ฝ๊ฒ ํฌ๊ธฐํ๊ณ ์ค์ฆ๋จผ๋๋ฅผ ๊ฒฐํผ์๋๋ก ์ ํํ๋ ์น๋ช
์ ์คํ์ ๋ฒํ๋ค. ์ฐ๋ฏผ์ผ๋ก ์๊ณก๋ ๋ชจ์ฑ์ , ๋งน๋ชฉ์ ์ธ ์๊ธฐ์ค์ฌ์ฃผ์ ๊ทธ๋ฆฌ๊ณ ๋์ด๋ธํ ์์๋ ฅ์ ์ค์ค๋ก๋ฅผ ๊ฐ๋ถ์ฅ์ ์ธ ๊ฒฐํผ์ด๋ผ๋ ๋ซ์ ๋น ์ง๊ฒ ๋ง๋ ๊ทธ๋
์ ๋ ๋ค๋ฅธ ํ๊ณ์ด๋ค. ๋ค๋ง ์คํจํ ๊ฒฐํผ์ด๋ผ๋ ์์ ์์, ๋ง๊ฐ๋ ํ๋ฌ์ ๋ง์ฐฌ๊ฐ์ง๋ก ๋ฏธ๊ตญ์ ์ฝ๋ฆฐ๊ณผ ๊ฐ์ ์ ํ์ ์ฌ์ฑ์ด๋ผ ํ ์ ์๋ ์ด์ฌ๋ฒจ์ ์ ์ด๋ฆฌ์์ ๊ฒฐํผ์ ์ ํํ๋๊ฐ?๋ผ๋ ๋ฌธ์ ๊ฐ ์๋๋ผ ๊ณผ์ฐ ๋ฌด์์ ํ ๊ฒ์ธ๊ฐ?๋ผ๋ ๋ฌธ์ ๋ก ๋ค์ ์์ ์ ๋๋ฆฌ๊ณ ์์ ์ ์ถ์ ์กฐ์ข
ํ๋ ค๋ ์ฃผ์์ธ๋ฌผ๋ค์ ์ด์ํด ์์๋ฅผ ์ฌ์ ๋ฆฝํ๋ ๋จ๋ค๋ฅธ ์ฑ
์์์๊ณผ ์์กด๊ฐ์ ๋ค์ ํ๋ฒ ๋ณต์ํ๊ฒ ๋๋ค. ์๋ก์ด ์์๋ฅผ ํ์ฑํ๋ ํ๋์ ์คํ์ค๋ก์ ์ ๋ฝ์ ์ ํํ๋ ๋ฏธ๊ตญ ์ฌ์ฑ์ผ๋ก์ ๋ง์น ์ ๋๋ฅ์ ๊ฐ์ฒํ ์ฒญ๊ต๋๋ค์ด ๊ทธ๋ฌํ๋ฏ์ด ๊ทธ ๊ณณ์์ ์์ ์ด ๊ฒช๋ ๋ชจ๋ ๊ฒฝํ๋ค์ ๊ด์ฐฐํ๊ณ ์ค์ค๋ก๋ฅผ ์ฑ์ฐฐํ๋ ๊ณผ์ ์ ํตํด ๋ง์นจ๋ด ๋ฏธ์ํ๋ ๋ชจ์ต์ ์กฐ๊ธ์ฉ ํํผํ๊ณ ์ ๋ณด๋ค ๋ ์ฑ์ฅํ ์ ์๊ฒ ๋ ๊ฒ์ด๋ค. ์ด ๋ ํฌ์ง๋ ๋ ํ์ ๋งบ๊ฒ ๋๋ ๋จ๋งค์ ์ ๊ฐ๊น์ด ๋ชจ์ฑ๋ ๊ฐ๋ถ์ฅ์ ์ ์ข
์๋ ๋ชจ์ฑ์ด ์๋๋ผ ๊ทธ๊ฒ์ ๋์ฒดํ๋ ์ฑ๊ฒฉ์ ๋ชจ์ฑ์ด๋ผ ๊ฐ์ฃผ๋ ์ ์๋ค.
ใ์ฌ์ธ์ ์ด์ใ์ด 1870๋
๋ ๋ฏธ๊ตญ์์ ์ ๋ฝ์ผ๋ก ๊ฑด๋์ ์์ ์ ์ด๋ช
์ ๋๋ณํ๊ณ ์ ํ ์ด์ฌ๋ฒจ์ ์ด์ผ๊ธฐ๋ผ๋ฉด ใ๊ฐ์ฑใ์ ๊ทธ๋ณด๋ค 20๋
์ฏค ํ์ธ 1890๋
๋ ๋ฏธ๊ตญ ๋ด ์ฌ๋ฆฌ์ธ์ฆ ํฌ๋ ์ฌ ์ฌํ์์ ํ ๋จ์์ ์๋ด์ด์ ๋ ์์ด์ ์ด๋จธ๋๋ก ์ด์์ผ๋ง ํ๋ ์ ์ฌ์ฑ์ธ ์๋๋์ ์ด์ผ๊ธฐ์ด๋ค. ์ด์ฌ๋ฒจ์ด ๊ต์์ด ํ๋ถํ๊ณ ๋ญ๋ง์ ์์๋ ฅ์ผ๋ก ๊ฐ๋ํ ๋ฏธํผ์ฌ์ฑ์ด๋ผ๋ ์ ์ฌ์ฑ์ ์ธํ์ ์กฐ๊ฑด์ ๊ฐ์ถ๋ฐ ๋นํด์ ์๋๋๋ ๋ชจ์ฑ์ ์ ๋ํ ์ธ์์ ์ฐฌ์์ ๋ฏธ๋ผ๋ก ์ฌ์ฑ์ ์์ํ ๊ฐ์ ์ด๋ผ๋ ์์ญ์ ํ์ ํด ๊ฐ๋๋ ค ํ๋ ํจ์ ์ ๋ํด ๋๊ตฌ๋ณด๋ค ์ฒ์ ํ๊ฒ ๋ฐ์ํด์ผ ํ๋ ๊ธฐํผ์ฌ์ฑ์ ์
์ฅ์ ์์๋ค๊ณ ๋ณผ ์ ์๋ค. ๊ฒฐ๊ตญ ๊ทธ๋
๋ ๊ฒฐํผ๊ณผ ๋ชจ์ฑ์ผ๋ก ํ์๋๋ ์์ ์ ์ ์ฒด์ฑ์ ๊ฐํด์ง ์๋ฐ์ ๋ฒ์ด๋๊ธฐ ์ํด ๊ทธ ์ ๋ง์ ์ธ ๋ถ๋
ธ๋ฅผ ์์ด์ด๋ผ๋ ๊ทน๋จ์ ์ ํ์ผ๋ก ํด์ํ๊ณ ์ ํ๋ค. ์ด๋จธ๋๊ฐ ๋๊ธฐ ์ด์ ์ด๋ผ๋ฉด ์ด์ฉ๋ฉด ์ด์ฌ๋ฒจ์ฒ๋ผ ์์ ๋ง์ ๋ญ๋ง์ ์ถ์ ๋ฐฉ์์ ์ก์ฒด์ ์๋ช
๊ณผ ๊ณต์กด์ํค๋ฉฐ ํ์ํด ๋๊ฐ ์ ์์๊ฒ ์ง๋ง ์๋๋์๊ฒ๋ ์ด๋ฏธ ๋๋ฌด ๋ฆ์ด๋ฒ๋ ธ๊ณ ์ฃฝ์๋ง์ด ์ ์ผํ ํด๊ฒฐ์ฑ
์ด์๋ค๊ณ ํ ์ ์๋ค. ๋ณธ์ง์ ์ธ ์์๋ฅผ ์งํค๊ณ ์ ํ๋ ๊ฐํ ์๊ธฐ์ ๋ก ์ธํด ๋น๋ก ์ก์ฒด์ ์ฃฝ์์ ์ ํํ์์ง์ธ์ ๋ง์ง๋ง ์์กด์ฌ๋ง์ ๊ฟ๊ฟ์ด ์ง์ผ๋ด ์ ์ ์ ์ธ ์ฃฝ์๋ง์ ๋ชจ๋ฉดํ ์ ์์๋ ๊ฒ์ด๋ค. ์๋๋๋ ์์ ์ด ๋๊ปด์จ ๋ง์ฐํ ๋ถ๋
ธ๊ฐ ๊ฐ์ฑ์ ๊ณ๊ธฐ๋ก ์ค์ค๋ก์ ๋ด๋ฉด์ ํ๊ณ ๋ค๋๋ก ํ๋ฝํจ์ผ๋ก์จ ์๊ธฐ ํ๊ดด์ ํํ์ธ ์ฃฝ์์ ์ถ๊ตฌํ๊ฒ ๋๋ค. ๊ฒฐ๊ตญ ์๋๋์ ํ๋ํ ์ค์ ์ธ ์๋ง์ ์ฐํ์ ์ธ ๋ถ๋
ธ์ ํํ์ด์ ์ ์ฌ์ฑ๋ค์ ์ฃผ์ฒด์ ์ถ์ ๋ํ ์ ์ ํ ๊ฐ๋ง์ ๋น๊ปด ๋งํ ๊ฒ์ด๋ผ๋ ๋ช
์ ๊ฐ ์ ํจํด์ง ์ ์๋ค.
ใ๋์ ์ํ ๋์ใ๋ ์ด์ ์ธ๋์ ์ ์ฌ์ฑ๋ค์ธ ์ด์ฌ๋ฒจ์ด๋ ์๋๋์๋ ๋ ๋ค๋ฅธ ์ ํ์ ์ ์ฌ์ฑ์ ๋ชจ์ต์ ์ ๋ณด์ด๊ณ ์๋ค. 1910๋
๋ ๋ฏธ๊ตญ ์ค์๋ถ์ ๋ค๋ธ๋ผ์ค์นด์์ ๊ฐํ ๊ฐ์ฒ์ง์ฌ์ธ์ผ๋ก ์ด์๊ฐ๊ฒ ๋๋ ์ํ ๋์๋ ํ ์ฐฉ๋ฏผ๊ณผ ๋๋น๋๋ ๋ฏ์ ์ด๋ฏผ์ ์ฌํ์ ์ผ์์ด๋ฉฐ ๋์์ ๊ฐ๋ถ์ฅ์ ๊ถ์ ํ์ ์ฌ์ฑ์ด๋ผ๋ ์ด์ค์ ํจ์ ์ผ๋ก ๊ณ ๋์ ๊ฒช๊ฒ ๋๋ ์ธ๋ฌผ์ด๋ค. ์ด์ฌ๋ฒจ์ด๋ ์๋๋๊ฐ ์ค์ฐ์ธต์ ์ถ์ ํฅ์ ํ๋ฉฐ ๊ฒฝ์ ์ ์ด๋ ค์์ ๊ทธ ๊ณ ๋ ค์ ๋์์ด ๋์ง ์์๋ ๋ฐ๋ฉด์ ์ํ ๋์๋ ๋น์ฅ ํ ๊ตด ์์์ ๊ฒจ์ธ์ ๋์ผ ํ๋ ์์กด์ด๋ผ๋ ์ ์ฒด์ ๋ช
์ ๊ณผ์ ์ ์ง๋ฉดํด ์๋ ๊ฒ์ผ๋ก ๋น์ถ์ด์ง๋ค. ๋ฐ๋ผ์ ์ด๋ฆฐ ์์ ๋ถํฐ ์ธ์ด๋ฅผ ๋น๋กฏํ ๊ต์ก์ ๋ํ ์ด๋ง์ด ์ง๋ํ์์๋ ๋ถ๊ตฌํ๊ณ ์ฌํ์ด๋ ํ ๋ก , ๋
์, ์์ ํ๋๊ณผ ๊ฐ์ ์ ์ฌ์ฑ๋ค์ ํน๊ถ์ผ๋ก๋ถํฐ๋ ์์ ๋ฐฐ์ ๋์ด์ง ์ฌ์ฑ์ธ๋ฌผ์ด๋ผ๊ณ ํ ์ ์๋ค. ์ด์ ๊ฐ์ด ์ํ ๋์๊ฐ ์ด์ ์ธ๋์ ์ ๋ฐฐ๋ค๊ณผ๋ ๋ค๋ฅธ ์์์ ๋ ๋ ์ฌ์ฑ์ธ๋ฌผ์์๋ ๋ถ๊ตฌํ๊ณ ์ ์ฌ์ฑ์ ๋ฒ์ฃผ์ ํฌํจ๋ ์ ์๋ ์ด์ ๋ ๋๊ตฌ๋ณด๋ค๋ ๊ฐํ ์๋ฆฝ์์ง์ ์์ ์ ์ถ์ ๋ํ ์ด์ , ์ฑ
์์์์ ๊ตฌํํด๋๊ธฐ ๋๋ฌธ์ด๋ค. ํนํ ๋
ธ๋์ ๋ํ ์ํ ๋์์ ์๊ฐ์ ์ด์ฌ๋ฒจ์ด๋ ์๋๋์ ๋ค์ ์๊ทน์ ์ธ ์
์ฅ๊ณผ๋ ๋น๊ตํ๊ธฐ๊ฐ ์ด๋ ค์ธ ์ ๋๋ก ๊ฐ๋ ฌํ ์ธ์์ ์ฃผ๊ณ ์๋ค. ๊ฐ์ฒ์ง์ ์ฃผ์ธ๊ณต์ ๋จ์ฑ์ด ๋์ด์ผ ํ๋ค๋ ํต๋
์ ์ ๋ณต์ํค๊ณ ์ ๊ทน์ ์ธ ๋
ธ๋์ ํตํด ๊ฐ์กฑ๊ณผ ๋์ง์ ์ด๋ช
์ ๊ฐ์ฒํด ๋๊ฐ๋ ์ํ ๋์๋ ์ธ ์ฌ์ฑ์ธ๋ฌผ ์ค ๋๊ตฌ๋ณด๋ค๋ ์ฑ
์๊ฐ ์๋ ๋ชจ์ต์ ๊ตฌํํ๋ฉฐ ๋์ง๋ชจ๋ก์ ์ฒดํํ๋ ์์์ ๋ณด์ด๊ฒ ๋๋ค. ๊ฐํ ์๋ช
๋ ฅ์ผ๋ก๋ถํฐ ๋์ค๋ ์๋ฆฝ์์ง๋ ์ํ ๋์์ ๊ฐ์ ๊ฐ์ฒ์ง์ ์ด๋ฏผ ์ฌ์ฑ๋ค์๊ฒ ์ถ์ ๋ณต์์ํค๋ ๊ธฐ์ ๋ก ์์ฉํ๊ณ ๋ง์น ์๋ฌ๋ ๋ณผ๊ณผ ๊ฐ์, ์ํ ๋์๊ฐ ๋ง๋๋ ๋ณดํค๋ฏธ์์ ์ฝ๋ผ์ฌ์ ๊ฐ์ ๋ค์์ ์ธ ๋ฏธ๊ตญ์ฌํ์ ์ ์ฒด์ฑ์ ์ฑ๊ณต์ ์ผ๋ก ๊ตฌ์ถํด๋๋ค๊ณ ํ ์ ์๋ค. ์ด์ฌ๋ฒจ์ด ๋ญ๋ง์ ์์๋ ฅ๊ณผ ์์งํจ, ์์ ์ ๋
๋ฆฝ์ ๋ํ ๋๋์ ์ด์๊ณผ ์์ ๊ฐ์ผ๋ก ์ฃผ์ฒด์ ์ ์ฌ์ฑ์ผ๋ก์์ ์์ ์ ์ด์์ ์์ฑํ๊ณ ์๋๋๊ฐ ์์ด์ด๋ผ๋ ๊ทน๋จ์ ์ธ ๋ฐฉ๋ฒ์ผ๋ก ๋ณธ์ฐ์ ์์๋ฅผ ์งํค๋ ์ ํ์ ํ ์๋ฐ์ ์์๋ค๋ฉด ์ํ ๋์๋ ๋ถ๋ชจ์ง๋ฅผ ๊ฐ์ฒํ๊ณ ๊ฐ์กฑ์ ์ถ์ ์ฑ
์์ง๊ณ ์ ํ๋ ์๋ฆฝ์์ง๋ก ๋ณด๋ค ๊ฐ์ธํ ์ ์ฌ์ฑ์ ๋ชจ์ต์ ๊ตฌํํด๋๋ค๊ณ ํ ์ ์๋ค.
์ด์๊ณผ ๊ฐ์ ์ฌ์ฑ์ธ๋ฌผ๋ค์ ๋ชจ๋ ์ฌํ์ ํต๋
์ ์ ํญํ๊ณ ๋๊ตฌ๋ณด๋ค๋ ์๊ธฐ ์์ ์ ์ฌ๋ํ ์์์๊ณผ ์ฑ
์๊ฐ์ ์ง๋ ์๋ก์ด ์ ํ์ ์ฌ์ฑ ์ฆ ์ ์ฌ์ฑ๋ค์ด๋ผ ํ ์ ์๋ค. ์ด๋ค์ด ๊ณตํต์ ์ผ๋ก ์ด์ผ๊ธฐํ๋ ์ฐธ๋ค์ด ์ถ์ ๊ฐ์น๋ ๋ฌด์๋ณด๋ค๋, ์๊ธฐ ์์ ์ ๋ด๋ฉด์์ ์ธ๋ ค๋์ค๋ ๋ณธ์ฐ์ ๋ชฉ์๋ฆฌ์ ๋ฐ๋ฅด๋ ์ถฉ์คํ ์ถ์ด๋ค. ๋ณธ ๋
ผ๋ฌธ์ ๊ฐ์ฅ ํฐ ์์๋ ์ฐ์
ํ์ ์๋ณธ์ฃผ์๋ก์ ๊ธ๊ฒฉํ ์ ํ ์์ ์ ์ฒด์ฑ์ ํผ๋์ ๊ฒช์ด์ผ๋ง ํ๋ ์ด๋ฌํ ์ ์ฌ์ฑ๋ค์ ์ด์ผ๊ธฐ๋ฅผ ๊ณ ์ฐฐํด ๋ด์ผ๋ก์จ ์ค๋๋ ์ ์ฌ์ฑ๋ค ์ญ์ ๊ฐ์ ์ ์ธ ์์ฌ์ ์ ๋ฐ๊ฒฌํ ์ ์๋ค๋ ์ ์ผ ๊ฒ์ด๋ค. ์ด๋ค์ ์ด์ผ๊ธฐ๋ฅผ ํตํด ๊ฒฐํผ๊ณผ ๋ชจ์ฑ์ด ์ฌ์ฑ์๊ฒ ์ด๋ค ๋ณํ๋ฅผ ๊ฐ์ ธ์ค๋์ง ๋ฐ์ถํด ๋ณด๊ณ ์ฌํ๋ฅผ ๋ฐ๋ผ๋ณด๋ ์ฑ์ํ ์์ ์ ํค์ฐ๋ฉฐ ์์์ฑ์ฅ์ ์ํด ๊ฐ์ฅ ๊ธด์ํ ์กฐ๊ฑด๋ค์ ์ฑ์ฐฐํ๋ ๊ณผ์ ์ ์ฐธ์ฌํ ์ ์์ ๊ฒ์ด๋ฉฐ ์ถ์ ์งํ๋ฅผ ์ค์ค๋ก ํ์ธํด๋ณด๊ฒ ๋ ๊ฒ์ด๋ค.์ 1์ฅ ์๋ก 1
1. ์ฐ๊ตฌ์ ๋ชฉ์ 1
2. ์ ์ฌ์ฑ์ ๋ฑ์ฅ๊ณผ ์์ 5
์ 2์ฅ ์ฌ์ธ์ ์ด์: ์ด์ฌ๋ฒจ ์์ฒ์ ๋ง์ง๋ง ์ ํ 26
1. ์ด์ฌ๋ฒจ์ ์๊ธฐ์ ์ ์์์ฑ์ฐฐ 28
2. ์๊ณก๋๊ณ ๋ณ์ฃผ๋ ๊ฒฐํผ๊ณผ ๋ชจ์ฑ 49
3. ์ด์ฌ๋ฒจ์ ๋ง์ง๋ง ์ ํ 69
์ 3์ฅ ๊ฐ์ฑ: ํด๋ฐฉ๋ ์ฌ์ฑ์ฑ์ ๊ณต๊ฐ, ๋ฐ๋ค 74
1. 19์ธ๊ธฐ ํฌ๋ ์ฌ ์ฌํ์ฒด์ ์์์ ์๋๋์ ์๋ก์ค์ ํ๋ํ ์ค 77
2. ํ์ตํฐ์ฝ ์์ ๊ฐํ ์๋๋์ ๋๋ ๋ง 92
3. ์๋๋์ ์ฃฝ์์ ๋ํ ์๊ฐ 104
์ 4์ฅ ๋์ ์ํ ๋์: ๋ค๋ธ๋ผ์ค์นด ํ์์ผ๋ก์ ๊ทํฅ 110
1. ์ ์ฌ์ฑ์ผ๋ก์์ ์ํ ๋์์ ์๋ฆฝ์์ง 113
2. ์๋ถ ์ด๋ฏผ์ ์ฌํ์ ๊ฐ์ฒ์ง ์ฌ์ฑ 129
3. ๋ค๋ธ๋ผ์ค์นด ํ์์ผ๋ก์ ๊ทํฅ 148
์ 5์ฅ ๊ฒฐ๋ก 160
์ฐธ๊ณ ๋ฌธํ 167
Abstract 179Docto
Bilirubin and risk of ischemic heart disease in Korea: a two-sample Mendelian randomization study
OBJECTIVES:
Bilirubin is an endogenous antioxidant that protects cells against oxidative stress. Increased plasma levels of bilirubin have been associated with a reduced risk of ischemic heart disease (IHD) in previous studies. Nonetheless, whether those associations reflect a true protective effect of bilirubin on IHD, rather than confounding or reverse causation, remains unknown. Therefore, we applied two-sample Mendelian randomization to evaluate the causal association between bilirubin levels and IHD risk in a Korean population.
METHODS:
A total of 5 genetic variants-TRPM8 (rs10490012), USP40 (rs12993249), ATG16L1 (rs2119503), SLCO1B1 (rs4149014), and SLCO1B3 (rs73233620)-were selected as genetic instruments for serum bilirubin levels using a communitybased cohort, the Korean Genome and Epidemiology Study, comprising 33,598 subjects. We then evaluated their impact on IHD using the Korean Cancer Prevention Study-II cohort.
RESULTS:
Among the 5 instrumental variables that showed significant associations with serum bilirubin levels, rs12993249 (USP40) showed the most significant association (p<2.36ร10-105). However, we found no significant association between serum bilirubin levels and IHD. Sensitivity analyses demonstrated a consistent association, suggesting that our observations were robust.
CONCLUSIONS:
Using two-sample Mendelian randomization, we found no association between serum bilirubin levels and IHD. Further studies that confirm the observed interactions among other ethnicities are warranted.ope
The Associations between Alcohol Intake and HDL Cholesterol Subclasses in Korean Population
Objective: Alcohol intake has been found to be associated with high-density lipoprotein (HDL) cholesterol. However, the
association of alcohol intake with HDL cholesterol subclasses is unclear. Therefore, this study was conducted to determine
the association between alcohol intake and HDL cholesterol subclasses among Koreans.
Methods: This study included in 1,101 healthy Koreans (men: 765, women: 336) who underwent health check-up at
two hospitals in the Korean Cancer Prevention Study 2 (KCPS2). The amounts of alcohol intake were classified into 4
groups: non-, light, moderate, and heavy drinkers (0, <12.5, 12.5-49.9, and โฅ50.0 g/day, respectively). The proportions
of HDL cholesterol subclasses were measured after subclasses were identified by 4โ30% gradient gel electrophoresis. Multiple
regression models were used to estimate regression coefficients after multivariate adjustments.
Results: The concentration of HDL, HDL2 and HDL3 significantly increased with increasing amount of alcohol intake.
After adjusted for age, body mass index (BMI), waist and smoking status, alcohol consumers of <12.5 g/day, 12.5-49.9 g/day
and more than 50.0g/day showed significant positive associations with HDL, HDL2 and HDL3 concentration when compared
to non-alcohol drinkers in men. In particular, The strongest positive associations were obtained with HDL2b and HDL3c.
Conclusion: HDL2 and HDL3 were significantly associated with increasing amount of alcohol intake in Koreans. In particular,
HDL2b among HDL2 and HDL3c among HDL3 showed the strongest positive association with increasing amount of alcohol
intake.ope
In vitro Expansion of Mesenchymal Stem Cells using 3D Matrix Derived from Cardiac Fibroblast
Mesenchymal stem cells (MSC), nonhematopoietic progenitor cells are capable of differentiating into multiple lineage of the mesenchyme such as bone, cartilage, tendon, fat, heart, muscle, and brain, in vitro and in vivo. Although autologous MSC have some advantageous factors, MSC have very poor replicative capacity. Previous studies indicated that growth factors but also cell seeding density made an effect on expansion of MSCs. In this study, we examined the growth rate and adhesion of MSC in tissue culture coated with a basement membrane-like extracellular matrix. When self-renewal of MSC were compared between 2-D and 3-D, the growth rate of MSCs on 3-D matrix was highest among plastic, Fibronectin- and 3-D matrix plate but also attachment of MSCs on 3-D matrix was 6-fold greater than that on plastic. MSCs plated into 3-D matrix showed colocalization of ฮฑ5 integrin and ฮฑV integrin. This study may reflect that the extracellular matrix had greater effect on the expansion of MSCs because this distinctive in 3-D matrix adhesion differ in localization and function from classically described in vitro adhesion.ope
Enhanced calreticulin expression promotes calcium-dependent apoptosis in postnatal cardiomyocytes
Calreticulin (CRT) is one of the major Ca2+ binding chaperone proteins of the endoplasmic reticulum (ER) and an unusual luminal ER protein. Postnatally elevated expression of CRT leads to impaired development of the cardiac conductive system and may be responsible for the pathology of complete heart block. In this study, the molecular mechanisms that affect Ca2+-dependent signal cascades were investigated using CRT-overexpressing cardiomyocytes. In particular, we asked whether calreticulin plays a critical role in the activation of Ca2+-dependent apoptosis. In the cells overexpressing CRT, the intracellular calcium concentration was significantly increased and the activity of PKC and level of SECAR2a mRNA were reduced. Phosphorylation of Akt and ERKs decreased compared to control. In addition the activity of the anti-apoptotic factor, Bcl-2, was decreased and the activities of pro-apoptotic factor, Bax, p53 and caspase 8 were increased, leading to a dramatic augmentation of caspase 3 activity. Our results suggest that enhanced CRT expression in mature cardiomyocytes disrupts intracellular calcium regulation, leading to calcium-dependent apoptosis.ope
Hydrophilicity of non-fatty acid moiety: significant determinant affecting antibacterial activity of lauric acid esters
ํ์๋
ผ๋ฌธ (์์ฌ)-- ์์ธ๋ํ๊ต ๋ํ์ : ๋์๋ช
๊ณตํ๋ถ ์ํ์๋ช
๊ณตํ์ ๊ณต, 2016. 2. ์ฅํ์.What affects to the antibacterial activities of lauric acid esters was investigated. Based on the results of antibacterial activity test evaluating minimum inhibitory concentration and minimum bactericidal concentration, sesamol laurate was found to have no effect on either Gram positive bacteria or Gram negative bacteria. On the other hand, erythorbyl laurate had antibacterial activity to Gram positive bacteria. To investigate why the antibacterial activities are shown differently between sesamol laurate and erythorbyl laurate, monolaurin, sucrose monolaurate, isoamyl laurate, and methyl laurate, erythorbyl laurate, and sesamol laurate were chosen based on hydrophilicity of non-fatty acid moiety.
Minimum inhibitory concentration was assessed by broth micro-dilution method against Staphylococcus aureus, Listeria monocytogenes, Escherichia coli, and Salmonella Typhimurium. Monolaurin, erythorbyl laurate, and sucrose monolaurate showed antibacterial activities against Gram positive bacteria. On the other hand, isoamyl laurate, methyl laurate, and sesamol laurate had no inhibitory effect on both Gram positive and Gram negative bacteria even treated up to 1.0 mM.
The mechanism of monolaurin, erythorbyl laurate, and sucrose monolaurate was investigated by measuring the released cell constituents at 260 nm using spectrophotometer and the lipid compositional changes using gas chromatography (GC). 260 nm absorbing materials of Staphylococcus aureus treated with monolaurin, erythorbyl laurate, and sucrose monolaurate were increased for 2 h, and membrane lipid composition was also changed.
Octanol/water partition coefficient was calculated by atom/fragment contribution method. The partition coefficients indicating lipophilicity were 7.175, 5.284, and 5.717 for isoamyl laurate, methyl laurate, and sesamol laurate, respectively, whereas monolaurin, erythorbyl laurate, and sucrose monolaurate showed 3.670, -0.6858, and -4.122, respectively. The hydrophilic-lipophilic balance values of isoamyl laurate, methyl laurate, and sesamol laurate were 1.800, 3.700, and 4.835, respectively, while monolaurin, erythorbyl laurate, and sucrose monolaurate had the higher HLB value of 7.025, 15.25, and 16.09, respectively.
These results suggested that lauric acid esters should retain proper hydrophilicity based on the log P value of lower than 4, and the HLB value of higher than 7 to incorporate into bacterial cell membrane as antibacterial agents.1. Introduction 1
2. Materials and methods 3
2.1. Materials 3
2.1.1. Sample preparation 3
2.1.2. Chemicals 3
2.2. Procedure for lipase-catalyzed esterification between sesamol and lauric acid 4
2.2.1. Quantitative analysis of esterification product 4
2.2.2. Purification and identification of sesamol laurate 5
2.3. Cell culture 6
2.4. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) 6
2.5. Release of cellular constituents 7
2.6. Fluorescence microscopy 9
2.7. Membrane lipid composition 10
2.8. Octanol-water partition coefficient (log P) 11
2.9. Hydrophilic-lipophilic balance (HLB) 16
2.10. Statistical analysis 18
3. Results and discussion 19
3.1. Progression of enzymatic synthesis of sesamol laurate in acetonitrile 19
3.2. Structural analysis of sesamol laurate produced 21
3.3. Susceptibility screening of sesamol laurate 22
3.4. Selection of lauric acid esters 23
3.5. Antibacterial activities of lauric acid esters 26
3.5.1. Minimum inhibitory concentration (MIC) 26
3.5.2. Minimum bactericidal concentration (MBC) 32
3.6. Release of cellular constituents 37
3.7. Fluorescence microscopy 39
3.8. Membrane lipid composition 41
3.9. Octanol-water partition coefficient (log P) 44
3.10. Hydrophilic-lipophilic balance (HLB) value 45
4. Conclusion 47
5. References 48
๊ตญ๋ฌธ์ด๋ก 55Maste
Prevalence of a metabolic syndrome and analysis on its' related factors in Korea : Seoul City metabolic syndrome research initiatives
๊ฑด๊ฐ์ฆ์ง๊ต์กํ๊ณผ/์์ฌ[ํ๊ธ]
์ฐ๊ตฌ ๋ฐฐ๊ฒฝ ๋ฐ ๋ชฉ์ ์ฌํ๊ด์งํ์ ์ ์ธ๊ณ์ ์ผ๋ก 15์ธ ์ด์ ์ฑ์ธ ์ง๋ณ๋ถ๋ด์ 13%๋ฅผ ์ฐจ์งํ๊ณ ์๋ค. ์ฐ๋ฆฌ๋๋ผ 2005๋
์ฌ๋ง๋ฅ ํต๊ณ๋ฅผ ๋ณด๋ฉด, ์ฌํ๊ด์งํ ์ฌ๋ง๋ฅ ์ ์ด ์ฌ๋ง์์ธ์ 20.6%๋ฅผ ์ฐจ์งํ ์ ๋๋ก ์ฃผ์ํ ์ฌ๋ง์์ธ ์ค ํ๋์ด๋ค. ๋์ฌ์ฆํ๊ตฐ(Metabolic Syndrome)์ ๋น๋ง, ๊ณ ํ์, ์ด์ ์งํ์ฆ, ๋น๋จ ๋ฑ์ด ํผํฉํ์ฌ ๋ํ๋๋ ๊ฒ์ ๋งํ๋ฉฐ, ์ด๋ ์ฌํ๊ด์งํ์ ์ํ์์ธ์ผ๋ก ์๋ ค์ ธ ์๋ค. ๋ณธ ์ฐ๊ตฌ๋ ์ฐธ์ฌ๋์์์ ๋์ฌ์ฆํ๊ตฐ ์ ๋ณ๋ฅ ์ ๊ตฌํ๊ณ ๊ด๋ จ์์ธ์ ๋ถ์ํ์ฌ ๋์ฌ์ฆํ๊ตฐ๊ณผ ์ฌํ๊ด์งํ ๋ฐ์์ ์๋ฐฉํ๊ณ ์ ํ๋ค.์ฐ๊ตฌ ๋ฐฉ๋ฒ2006๋
4์๋ถํฐ 2006๋
12์๊น์ง ์ ์ด์ธ๋ธ๋์ค๋ณ์, ์๋์ธ๋ธ๋์ค๋ณ์, ์ด๋๋ชฉ๋๋ณ์, ๋ถ๋น์์ธ๋๋ณ์, ๊ณ ๋๊ตฌ๋ก๋ณ์์ 5๊ฐ ๊ฒ์ง์ผํฐ๋ฅผ ๋ฐฉ๋ฌธํ ์์ง์ 13,756๋ช
์ค ์ ์ฒด๊ณ์ธก(์ ์ฅ, ์ฒด์ค, ๋น๋ง๋, ํ๋ฆฌ๋๋ , ํ์)๊ณผ ํ์ก๊ฒ์ฌ(์ค์ฑ์ง๋ฐฉ, HDL-์ฝ๋ ์คํ
๋กค, ๊ณต๋ณตํ๋น), ๋ฌธ์ง(ํก์ฐ๋ ฅ)์ด ๋๋ฝ๋ ์์ง์์ 30์ธ ๋ฏธ๋ง ์ฑ์ธ 1,011๋ช
์ ์ ์ธํ 12,745๋ช
(๋จ์ 7,466๋ช
, ์ฌ์ 5,279๋ช
)์ ์ฐ๊ตฌ๋์์ผ๋ก ํ์๋ค.์ฐ๊ตฌ๋์์์ ์ผ๋ฐ์ ์ธ ํน์ฑ๊ณผ ์ฐ๋ น๊ตฐ/๋ณ์๋ณ ํน์ฑ์ ๋ํ๋ด๊ณ 30์ธ ์ด์์์ NCEP-ATPโ
ข(National Cholesterol Education Program Adult Treatment Panel โ
ข)์ APC(Asia Pacific Criteria: ์์์-ํํ์๋น๋ง์ง์นจ) ๊ธฐ์ค์ ๋์ฌ์ฆํ๊ตฐ ์ฐ๋ น ๊ต์ ์ ๋ณ๋ฅ (2005๋
์์ธ์ ํ์ค์ธ๊ตฌ)์ ๊ตฌํ์๋ค. ์ด ๋ ๋น๋ง๊ธฐ์ค์ ์ฒด์ง๋์ง์(Body Mass Index)์ ํ๋ฆฌ๋๋ ๋ก ๊ตฌ๋ถํ์ฌ ๋์ฌ์ฆํ๊ตฐ ์ ๋ณ๋ฅ ์ ๋น๊ตํ์๋ค.๋์ฌ์ฆํ๊ตฐ๊ณผ ๊ด๋ จ์์ธ๋ถ์(๋จ๋ณ๋ ๋ก์ง์คํฑ)์ ํ์์ผ๋ฉฐ ์ด ๋ ๊ฐ ํญ๋ชฉ์ ์ฐ๋ นํต์ ํ ํ ๋น์ฐจ๋น(odds ratio)๋ฅผ ๊ตฌํ์๋ค. ๊ด๋ จ์์ธ์ผ๋ก AST(Aspartate aminotransferase), ALT(Alanine aminotransferase), GGT(Gamma Glutamyl Transferase), WBC(White Blood Cells)์ ๊ฒฝ์ฐ ๊ฒฐ๊ณผ์์น๋ฅผ ์ฌ๋ถ์์(Q1-Q4)๋ก ๋๋์์ผ๋ฉฐ CRP(C-reactive protein)๋ ๋ฏธ๊ตญ์ฌ์ฅํํ์ ์ง๋ณํต์ ์ผํฐ์์ ๋ง๋ จํ ๊ฒ์ฌ์ง์นจ์ ๋ฐ๋ผ 0.1mg/dL ์ดํ(์ ์ํ), 0.1๏ฝ0.3mg/dL(ํ๊ท ์ํ), 0.3mg/dL ์ด์(๊ณ ์ํ)์ผ๋ก ๊ตฌ๋ถํ์๋ค. ๊ฐ ๊ด๋ จ์์ธ๋ณ๋ก ๊ฐ์ฅ ๋ฎ์ ์ง๋จ์ ๋น๊ต๊ตฐ์ผ๋ก ํ์ฌ ๋์ฌ์ฆํ๊ตฐ๊ณผ์ ๋น์ฐจ๋น(odds ratio)๋ฅผ ๊ตฌํ์ฌ ๊ด๋ จ์ฑ์ ๋ณด์๋ค.์ฐ๊ตฌ ๊ฒฐ๊ณผ์ฐ๊ตฌ๋์์์ ํ๊ท ์ฐ๋ น์ ๋จ์ 45.9์ธ, ์ฌ์ 46.2์ธ์ด๋ฉฐ ๋จ๋
๊ตฌ์ฑ์ ๋จ์ 58.6%, ์ฌ์ 41.4%๋ก ๋จ์๊ฐ ๋ง์๋ค. ๋น๋ง๊ธฐ์ค์ ํ๋ฆฌ๋๋ ๋ก ํ ๊ฒฝ์ฐ ๋์ฌ์ฆํ๊ตฐ ์ฐ๋ น ๊ต์ ์ ๋ณ๋ฅ ์ ์ ์ฒด 17.2%์ด๋ฉฐ ๋จ์ 19.1%, ์ฌ์ 14.9%๋ก ๋ํ๋ฌ๋ค. ์ด์ ๋น๊ตํ์ฌ ๋น๋ง๊ธฐ์ค์ ์ฒด์ง๋์ง์๋ก ํ ์ฐ๋ น ๊ต์ ์ ๋ณ๋ฅ ์ ์ ์ฒด 18.5%์ด๋ฉฐ ๋จ์ 22.8%, ์ฌ์ 13.2%๋ก ๋ํ๋ฌ๋ค.๋์ฌ์ฆํ๊ตฐ ๊ด๋ จ์์ธ๋ถ์์์๋ ์ฐ๋ น์ด ์ฆ๊ฐํ ์๋ก ๋์ฌ์ฆํ๊ตฐ ๋น์ฐจ๋น(odds ratio)๋ ์ฆ๊ฐํ์์ผ๋ฉฐ ํนํ ์ฌ์์ ๊ฒฝ์ฐ 30~39์ธ์ ๋นํ์ฌ 60์ธ ์ด์์์ ๋์ฌ์ฆํ๊ตฐ ์ํ์ด 17.7๋ฐฐ ๋์๋ค. ์ฐ๋ น์ ํต์ ํ ํ WBC๋ ๊ฐ์ฅ ๋ฎ์ ์ง๋จ(Q1)์ ๋นํด ๋์ ์ง๋จ(Q2๏ฝQ4)์ผ์๋ก ๋์ฌ์ฆํ๊ตฐ์ ์ํ์ด ๋จ์์ ๊ฒฝ์ฐ 1.6๋ฐฐ(Q2), 2.2๋ฐฐ(Q3), 3.7๋ฐฐ(Q4)๋ก ์ฌ์์ ๊ฒฝ์ฐ 1.6๋ฐฐ(Q1), 2.6๋ฐฐ(Q2), 4.8๋ฐฐ(Q3)๋ก ํต๊ณ์ ์ผ๋ก ์ ์ํ๊ฒ ์ฆ๊ฐํ์๋ค. ๋ํ AST, ALT, GGT๋ ๊ฐ์ฅ ๋ฎ์ ์ง๋จ(Q1)์ ๋นํด ๋์ ์ง๋จ (Q2๏ฝQ4)์ผ์๋ก ๋น์ฐจ๋น(odds ratio)๊ฐ ํต๊ณ์ ์ผ๋ก ์ ์ํ๊ฒ ์ฆ๊ฐํ์๋ค. ๊ทธ ์ค GGT์ ๊ฒฝ์ฐ ๊ฐ์ฅ ๋ฎ์ ์ง๋จ(Q1)์ ๋นํ์ฌ ๋์ฌ์ฆํ๊ตฐ ์ํ์ด ๋จ์์ ๊ฒฝ์ฐ 2.8๋ฐฐ(Q2), 5.9๋ฐฐ(Q3), 15.0๋ฐฐ(Q4)๋ก ์ฆ๊ฐํ์์ผ๋ฉฐ ์ฌ์์ ๊ฒฝ์ฐ 2.4๋ฐฐ(Q2), 4.5๋ฐฐ(Q3), 6.5๋ฐฐ(Q4)๋ก ์ฆ๊ฐํ์๋ค. CRP๋ ์ ์ํ์ง๋จ๋ณด๋ค ํ๊ท ์ํ, ๊ณ ์ํ์ง๋จ์ผ์๋ก ๋์ฌ์ฆํ๊ตฐ์ ๋น์ฐจ๋น(odds ratio)๊ฐ ๋จ๋
๋ชจ๋ ์ฆ๊ฐํ์๋ค.WBC์ GGT๋ ์ฆ๊ฐํ ์๋ก ๊ณ ์ค์ฑ์ง๋ฐฉํ์ฆ์ ์ํ์ ๊ฐ์ฅ ๋์์ผ๋ฉฐ AST, ALT, CRP๋ ์์น๊ฐ ์ฆ๊ฐํ ์๋ก ๋น๋ง์ ์ํ์ ๊ฐ์ฅ ๋์๋ค.๊ฑด๊ฐ๊ฒ์ง์ผํฐ ์ค์ฌ์ ๋์ฌ์ฆํ๊ตฐ ์ฐ๊ตฌ๋ ์ ๋์น์ ์ถ์ ๋ณด๋ค๋ ์๋์ ์ธ ๊ด๋ จ์ฑ์ ๋ณด๋ ์ฐ๊ตฌ์ ์ง์คํ๋ ๊ฒ์ด ๋ฐ๋์งํ ๊ฒ์ผ๋ก ๋ณด์ด๋ฉฐ ๋ณ์๋ณ๋ก ๊ฒ์ฌ์์น์ ์ฐจ์ด์ ์ ๋ณด์์ผ๋ฉฐ ์ด๋ ํฅํ ๋ง์ ์ฐ๊ตฌ๋ฅผ ์ํ์ฌ ๋ฌธ์ง๊ณผ ๊ฒ์ฌ๋ฐฉ๋ฒ์ ํต์ผ ๋๋ ์ ๋๊ด๋ฆฌ๋ฅผ ํตํ ๊ฒ์ง์์น์ ๋ณด์ ์ด ํ์ํ ๊ฒ์ผ๋ก ๋ณด์ธ๋ค.
[์๋ฌธ]Purposes: The purposes of this study were to examine prevalence of a metabolic syndrome in healthy subjects aged 30 years old and more, and to analyze influencing factors. The present study might contribute to prevent metabolic syndrome and cardiovascular disease incidence.Methods: The data for the study were collected from a sample of 13,756 subjects who had a routine examination at 5 health centers from April, 2006 till December, 2006. We excluded 1,011 subjects who were under 30 years old and did not submit questionnaires, physical exam data and blood test results. The final sample used for the study was 12,745 (7,466 men, 5,279 women). To estimate the prevalence of the metabolic syndrome among the subjects, the reference values applied to the data were based on the Asia-Pacific waist-circumference (WC), and body mass index (BMI). The age-adjusted prevalence of the metabolic syndrome was estimated by using the direct standardized method. Factors related with metabolic syndrome were analyzed through logistic regression analysis.Results: The mean age for the study subjects was 45.9 years old for men and 46.2 years old for women. Forty one point four percent among subjects were women. The prevalence of the metabolic syndrome was increased with increasing age group. The age-adjusted prevalence of the metabolic syndrome was 17.2% (19.1% for men, 14.9% for women) based on the Asia-Pacific criteria for WC. The age-adjusted prevalence was 18.5% (22.8% for men, 13.2% for women) based on BMI.Associated factors for metabolic syndrome were age, ex-smoker, WBC, AST, ALT, GGT and CRP. Among these factors, women aged 60 years old or higher and/or men with highest quartile of GGT were significantly associated with metabolic syndrome. Also, WBC and GGT were highly associated with high level of triglycerides. In addition, AST, ALT and CRP were significantly associated with obesity.Conclusions: Based on multi-center approach in urban area, the prevalence of metabolic syndrome was relatively lower than that from nationwide survey. However, metabolic syndrome related factors were similar including: age, WBC, AST, ALT, GGT and CRP.ope
Thomas Hardy ์์ค์ ๋ํ๋ ํ์๋ก์์ ์ฌ์ฑ
ํ์๋
ผ๋ฌธ(์์ฌ)--์์ธ๋ํ๊ต ๋ํ์ :์ธ๊ตญ์ด๊ต์ก๊ณผ ์์ด์ ๊ณต,2002.Maste
Eros and Thanatos in Chopin's The Awakening
This paper is to investigate how the dynamics of Eros (sexual instinct, the instinct of self-preservation) and Thanatos (death instinct) work with each other in Chopins The Awakening. In truth, Eros is not incompatible with Thanatos. Instead the highest self-love inevitably goes with the self-destruction (physical death) as we can see in Tristan and Isolde. At the end of the 19th century, American society witnessed a very intense conflict between the traditional Victorian moral values and the new awakening for women that mainly stemmed from both the philosophy of enlightenment and American transcendentalism. As for Edna, the heroine of The Awakening, everything which surrounds her, especially the 19th century Creole society in Louisiana rigorously prohibits her from realizing her real identity, her so-called essentials. The role assigned for her by society is nothing but that of a wife or a mother. At first, Edna repeatedly tries to overcome these social barriers through the salvation of the surrogate mothers (Adele Ratignolle, Mlle. Reisz) or the perfect lover (Robert Lebrun) which is destined to fail. Gradually the home, the counterpart of Foucaults prison, is suffocating her to the extent that she cannot sustain herself as an integrated individual any more. Motherhood is one of the most unwilling duties imposed on her by society. She neither wants to be a woman-angel nor a woman-monster. Like the great thunderstorm that hit all of Louisiana in 1893, the Thanatos in Edna finally induces her to take her own life. Her suicide should be regarded as not a defeat to her fate but a victory to achieve her true self which is the only worthwhile object of her highest Eros
- โฆ