새로 진단받은 제2형 당뇨병에서 미세알부민뇨와 관련 인자

김동진 ( Dong Jin Kim ),유성진 ( Seong Jin Ryu ),서영진 ( Young Jin Seo ),김남훈 ( Nam Hoon Kim ),정혜수 ( Hye Soo Chung ),은채령 ( Chai Ryoung Eun ),최혜정 ( Hye Jung Choi ),김혜숙 ( Hye sook Kim ),양세정 ( Sae Jeong Yang ),박주 대한내과학회 2007 대한내과학회지 Vol.73 No.5

Background: To determine the prevalence and the associated factors of microalbuminuria in Korean subjects with newly diagnosed type 2 diabetes mellitus. Methods: A total of 304 patients with newly diagnosed type 2 diabetes mellitus that visited Anam Hospital, Korea University Medical Center, were studied cross-sectionally for the presence of microalbuminuria and other micro- and macrovascular complications. Microalbuminuria was calculated by the amount of albumin excretion in the urine for 24 hrs (30-299 mg/24hr) or by the albumin creatinine ratio in a spot urine sample (30-299 mg/g creatinine). Subjects were divided into two groups: the normoalbuminuria group and the microalbuminuria group. Results: The prevalence of microalbuminuria, normoalbuminuria and overt proteinuria in patients with newly diagnosed type 2 diabetes mellitus was 17.1%, 80.3% and 2.6%. respectively. Microalbuminuria was significantly correlated with the body mass index (BMI), fasting insulin level, fasting C-peptide level and triglyceride level. The number of metabolic syndrome components was significantly correlated with the amount of microalbuminuria. In patients with microalbuminuria and without retinopathy, the correlation of microalbuminuria and the presence of metabolic syndrome was also significant. Conclusions: The prevalence of microalbuminuria in 304 Korean patients with newly diagnosed type 2 diabetes mellitus was 17.1%, and microalbuminuria had a correlation with the BMI, fasting insulin level, fasting C-peptide level, HOMA level, triglyceride level and the presence of metabolic syndrome.(Korean J Med 73:503-511, 2007)

디지털다중서명을 이용한 이동에이전트 보안시스템의 설계

유성진,정일용,김영철 조선대학교 전자정보통신연구소 2002 電子情報通信硏究所論文誌 Vol.5 No.1

Mobile agent system comes into the spotlight since it contributes largely to mobile computing on distributed network environment. However, this system has a number of significant security problems. In this paper, we analyze security attacks to mobile agent system presented by NIST[3]. In order to protect this system from them, we suggest a security protocol for mobile agent system by employing ID based key distribution and digital multi-signature scheme. To solve these problems described on NIST, securities of mobile agent and agent platform should be accomplished. Comparing with other protocols, our protocol performs both of these securities, while other protocols mentioned only one of them. Furthermore, it is designed to guarantee the liveness of agent, and to detect message modification immediately by verifying each step of agent execution at a corresponding server.

직무스트레스와 감정표현불능 성향과의 상관성

유성진,김자현,장순우,전형준,김병권,박종태 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.4

목적 근로자를 대상으로 직무스트레스와 감정표현불능성향과의 상관성에 대하여 연구하였다 방법 서울과 경기도 안산지역의 2개 대학병원에 건강검진을 위해 내원한 근로자중 생산직 근로자521명을 대상으로 하였다 한글판 Karasek 직무스트레스 설문(Korean version of the Karasek's Job Content Questionnaire JCQ)을 통해 직무스트레스를 평가하고 한글판 토론토 감정표현불능증 적도 설문(Korean Version of Toronto Alexithymia Scale TAS-20K)으로 감정표현불능 성향을 조사하였다 개별 JCQ 척도의 중앙값을 기준으로 이분하였고 직무긴장도 (Karasek 직무 긴장모델에 의해 정신적 직무요구와 직무재량도로 직무긴장도 평가 높음/중간/낮음) 직업불안정성 (높음/낮음) 직무불만족도(높음/낮음) 3가지 척도로 직무스트레스를 평가하였다 JCQ 척도와 감정표현불능 성향(total TAS score ≥52)과의 상관성을 알아보기 위해 보정하지 않은 비차비(crude odds ratios)와 보정비차비(adjusted odds ratios)를 계산하였다 결과 보정하지 않은 비차비 계산시 직무긴장도가 낮은 집단보다 높은 집단(crude OR 3.05 95% CI 1.35-6.87)에서 직업불안정성이 높은 집단(2.98 1.69-5.27)에서 직무불만족도가 높은 집단(2.93 1.69-5.09)에서 감정표현불능 성향이 유의하게 높게 나타났다 다중로지스틱회귀모형에 의한 보정비차비 계산시 직무긴장도가 낮은 집단보다 높은 집단(adjusted OR 2.26 95% CI 0.93-5.44)에서 감정표현불능 성향이 크게 나타났으나 유의하지는 않았고 직업불안정성이 높은 집단(2.26 1.21-4.22)에서 직무불만족도가 높은 집단(1.99 1.06-3.74)에서 감정표현불능 성향이 유의하게 높게 나타났다 결론 직무스트레스와 감정표현불능 성향 사이에 유의한 상관성이 있는 것으로 나타났다 Objectives We evaluated the association between job stress and alexithymic traits in Korean workers Methods Workers(n=521) who visited two university hospitals for medical check-ups were recruited for this study Job stress was evaluated using the Korean version of Karasek's Job Content Questionnaire(JCQ) and alexithymic traits were assessed using the Korean version of the Toronto Alexithymia Scale(TAS-20K) Crude and adjusted odds ratios(ORs) of job stress scales (job strain, job insecurity and job dissatisfaction) with alexithymic traits(total TAS score ≥ 52) were calculated Results High job strain compared with low strain had a high but insignificant association with alexithymic traits(adjusted OR, 2.26 95% CI, 0.93-5.44) High job insecurity(adjusted OR 2.26, 95% CI 1.21-4.22) and high job dissatisfaction (adjusted OR 1.99 95% CI 1.06-3.74) had significant associations with alexithymic traits Conclusions This study suggests that job stress is associated with alexithymic traits in workers.

신경정신증상을 동반한 트리클로로에틸렌 중독 1예

김자현,유성진,김병권,전형준,박종태,김해준 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.1

배경: 트리클로로에틸렌은 중추신경계에 주로 작용하는 유해 발암물질로서 사용 및 관리 에 주의가 필요하다. 최근까지도 영세사업장을 중심으로 트리클로로에틸렌을 사용함으로 인해 지속적으로 트리클로로에틸렌 중독에 의한 산업재해가 발생하고 있음에도 불구하고 트리클로로에틸렌 중독에 관한 연구 및 보고가 많지 않다. 사례: 환자는 장기간 금속부품 세척 공장에서 트리클로로에틸렌에 노출되었으며,건망증 및 말더듬 증상과 함께 식욕감소와 성욕감소를 동반한 전반적 의욕부진과 우울감정이 양손의 이상감각 및 저림, 통증과 함께 나타났다. 신경전도검사에서 자율신경계의 이상소견을 보였으나,자기공명영상 검사 결과 소뇌의 위축 등의 기질적 이상 소견 및 중추신경계의 감염이나 종양 등은 없었으며 대사 장애나 전해질 이상도 보이지 않았다. 저자들은 환자가 전자부품 세척 공정에서 트리클로로에틸렌을 사용하였다는 점을 중시하여 요중 총삼염화물의 농도를 검사한 결과 과량의 요중 총삼염화물이 검출되어 임상적으로 트리클로로에틸렌 중독을 진단할 수 있었다. 노출은 입원과 동시에 중단되었다. 요중 총삼염화물의 농도는 입원직후 3,331.1 mg/g creatinine, 입원 후 3일째 347.9 mg/g creatinine,입원 후 5일째 64.6 mg/g creatinne으로 감소하였다. 주요 증상이었던 손발 저림과 통증의 급격한 호전을 보였고,우울감 등의 기분장애와 술 취한 느낌,발기부전,말더듬 등의 증상이 입원 후 시행 한 요중 총삼염화물의 농도 감소에 따라 단계적인 회복을 보였다. 결과: 트리클로로에틸렌의 저농도 만성 노출에서 신경 정신증상을 동반한 중독 증상이 나타날 수 있으며,이로 인해 발생한 신경정신증상이 정신과적 절환으로 판단되어 적절한 진단,치료 및 노출 평가가 어려울 수 있다. 트리클로로에틸렌 취급 근로자에서 신경정신증상이 나타나는지를 검토하여 이것이 트리클로로에틸렌 노출로 인한 것인지를 조기에 파악하려는 노력이 필요하다. Background: Trichloroethylene (TCE) has been widely used as a typewriter correction fluid, Paint remover, adhesive, spot removers and, particularly, as a degreasing agent in metal-fabricating operation. However, few studies have reported on the effects of TCE intoxication, in spite of numerous occupation al accidents arising from TCE intoxication, even until quite recently used in small companies. TCE affects mainly the central nervous system (CNS) and is carcinogenic, even when carefully used and managed. Case report: A 48-year-o1d male worker visited our hospital complaining of decreased motivation and general weakness, In history taking, the patient had suffered insomnia, memory disturbance, stuttering, loss of interest and sexual desire, depressive mood for 4 years, dysesthesia with tingling sensation and pain in both extremities, and a nauseas feeling similar to a hangover which had been aggravated for 4 months before admission. The patient had been engaged in metal degreasing with TCE for 8 years. Electromyography indicated disturbance of autonomic function, but there was neither peripheral neuropa-thy nor cervical radiculopathy. Organic abnormalities including cerebellar atrophy and CNS infection were ruled out, while there was no indication of malignancy in magnetic resonance imaging (MRI) and metabolic disorders and electrolyte imbalances in laboratory test. The authors performed biological monitoring for the possible exposed chemicals. Urinary 2,5-hexanedione, a metabolite of n-hexane, was undetected but 3,331.1 mg/g creatinine of urinary trichloro-compounds, a metabolite of TCE, was detected. The patient was diagnosed as TCE intoxication due to a level of urinary trichloro-compounds in excess of the normal range (300 mg/g creatinine), in addition to an occupational history and clinical symptoms. TCE exposure was stopped in admission and the neuropsychiathc symptoms of the patient were improved as the urinary thchloro-compounds were decreased from 3,331.1 mg/g creatinine to 64.6 mg/g creatinine in 5 days. Conclusion: Low-dose, chronic TCE intoxication shows neuropsychiatric symptoms, which are often misrecognized merely as a psychiatric disorder; its appropriate diagnosis, early treatment and exposure assessment are therefore difficult. The neuropsychiatric symptoms in workers who have been exposed to TCE should be monitored, detailed job history should be taken and biological monitoring should be conducted to gain early insight of chronic TCE exposure.