우리나라 지역 직업성질환 감시체계의 현황과 전망

임종한,장성실,김성아,문재동,채창호,홍윤철,김수영,김진석,김영욱,한상환,이혜숙,원종욱,송동빈,하은희,강성규 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

기존의 특수건강진단과 작업환경측정을 통한 직업병 관리가 진폐증, 소음성난청 등의 소수 특정질환에 국한되고 실제 직업병 발생 규모 파악이나 신종 직업병의 발견에 한계를 보인다는 사실은 산업의학전문가들 사이에서도 공감을 이루고 있다. 미국과 영국 등에서의 직업성질환 감시체계에 대한 경험은 우리 나라의 직업성질환 감시체계 구축에도 새로운 자극제가 되면서, 1998년이후 인천, 대전, 여천, 구미, 부울경 지역에서 지역 직업성질환감시체계를 산업보건관리의 중요한 시스템으로 구축하려는 노력이 확산되고 있다. 새로이 구축되어지는 이들 지역 직업성질환 감시체계는 감시하고자 하는 대상질환, 활용 가능한 인적자원 및 자료원, 지역 의료체계의 특수성 등에 따라서 목적과 방법을 달리하면서 독특한 형태로 발전을 하고 있다. 각 지역단위 감시체계들이 그 상황에 맞게 독특한 목적과 전략들을 발전 시키면서도, 향후 발전할 국가적인 차원의 직업성질환 감시체계 구축을 위하여 직업성질환 감시의 기본 전략 등을 공유하는 등의 노력이 필요하다. 환례 정의 및 기본적인 등록 서식의 공유, 직업성질환 감시 자료원의 발굴, 공동의 정보 네트워크 및 직업성질환 감시 데이터베이스 구축 등 직업성질환 감시활동을 지원하기 위한 여러 기초 인프라 구축에 힘을 모아야 할 것이다. 우리 나라에서 직업성질환 감시체계를 성공적으로 구축하기 위해서는 수집된 자료의 질 관리를 위한 직업성질환 감시의 원칙 제정과 감시 전략의 공유 등이 필요하며, 전국적인 직업성질환 감시체계의 하부구조라고 할 수 있는 지역감시체계의 기초 토대 마련과 강화작업이 절실하게 필요하다.

골격성 Ⅲ급 부정교합자의 두개안면형태에 대한 하악이부의 형태 및 하악절치의 위치에 대한 연구

김성식,박재억,손우성 대한치과교정학회 1998 대한치과교정학회지 Vol.28 No.5

골격성 Ⅲ급 부정교합자의 두개안면골격형태가 하악이부형태와 하악전치의 위치에 미치는 영향을 알아보고자 연구를 시행하였다. 전후방적인 악골부조화가 나타나지 않고 교정치료의 경험이 없는 만 20세 이상의 성인남녀(정상군)와, 하악전돌의 악골부조화를 보이며 교정치료의 경험이 없는 만 20세 이상의 성인남녀(하악전돌군)를 비교하여, 두개안면골격형태에 따른 하악이부형태와 하악전치의 위치에 관하여 다음과 같은 결론을 얻었다. 1. 두개안면골격형태의 비교에서 하악에 관련된 ∠SN-Mn, ∠FMA, ∠Pal-Mn, ∠LFH은 하악전돌군이 정상군에 비하여 크게 나타났지만, (p<0.05) 상악에 관련된 항목은 차이를 나타내지 아니하였다(p>0.05). 2. 하악전치를 둘러 싸고 있는 치조돌기는 하악전돌군이 정상군에 비해서 수평적으로 좁고, 수직적으로 긴 형태를 나타내었다(p<0.05). 하악이부의 형태에서도 수평적으로는 하악전돌군이 정상군에 비해서 좁게 나타났으나, 수직적으로는 차이를 나타내지 아니하였다(p>0.05). 3. 하악전돌군의 두개안면골격형태와 이부계측항목과의 상관관계에서 두개저와 하악하연에 기인하는 수직적인 악골부조화가 증가할수록 LaABH, LiACBW, LaACBW, LiABBW, SW, ∠LISA가 감소하는 역상관계를 나타냈지만(p<0.05), 전후반적인 악골부조화와는 별다른 상관관계가 나타나지 않았다(p>0.05). 4. 하악전돌군에서 수직적인 두개안면골격형태를 나타내는 ∠SN-Mn, ∠FMA, ∠Pal_Mn, ∠LFH와 하악이부의 계측항목인 ∠LiACBW. LiaBBW, SW, ∠LISA사이에 높은 상관관계가 존재하여, 수직적인 악골부조화로 하악이부의 형태와 하악전치의 경사도를 예측할 수 있었다(p<0.001). The purpose of this study was to evaluate the morphology of mandibular symphysis and location of lower incisor under the influence of the craniofacial skeleton in skeletal Class III malocclusion. The sample consisted of 132 adults who have severe Class III malocclusion (prognathism group, 33 males and 33 females), and who have normal occlusion (normal group, 33 males and 33 females). They had not received any orthodontic treatment or orthognathic surgery. The lateral cephalograms were evaluated. The results were as follows: 1. Prognathism group were larger than normal group in comparison of facial skeleton (p<0.05) with the exception of ∠FH-Pal, ∠SNA. 2. In the morphology of symphysis, measurements of anteroposterior width(LaABBW, LiABBW, SW) of prognathism group were significantly less than that of normal group(p<0.001). 3. In the correlative analysis between the craniofacial skeleton and symphysis measurements of prognathism group, vertical measurements in relation with cranial base and mandibular plane showed reverse correlationship with anteroposterior with of symphysis(LiACBW, LaACBW, LiABBW, SW)(p<0.05). But, there was not distinct difference between horizontal skeletal measurements and symphysis measurements(p>0.05). 4. The probability by regression test between vertical measurements(∠SN-Mn, ∠FMA, ∠Pal-Mn, ∠LFH) and symphysis measurements(LiACBW, LiABBW, SW, ∠LISA)were very high(p<0.001).

MR Spectroscopy로 진단한 Leigh 병 1례

황성욱,황태규,김용우 인제대학교 2006 仁濟醫學 Vol.27 No.-

Leigh syndrome is a progressive and degenerating central nerve system disease with symmetrically localized necrotic changes on the both gray and white matter, called subacute necrotizing encephalopathy. The causes of this disease have been revealed that defect of various enzymes (pyruvate dehydrogenase, repiratory complex Ⅰ, Ⅳ, Ⅴ, etc.)related to mitrochondrial carbonate metabolism and energy generating mechanisms. The clinical course is variable, and symptoms such as non-specific- seizure, respiratory failure, nystagmus, decreased muscle tone, developmental delay, vomiting and lethargy etc. appeared. And the diagnostic tool is not clear, so the diagnosis is difficult. Brain MRI and MR spectroscopy have been used to diagnose Leigh syndrome. We experienced 1 case of Leigh syndrome with typical MR, MR spectroscopic findings. MRI shows the lesions on midbrain, both basal ganglia, caudate nucleus, putamen, periaqueductal area, and periventricular white matter. MR spectroscopic findings showing high lactate peak were appropriate to Leigh disease. The patient is a 16-month-old girl with generalized weakness, and died within 1 month after first admission on our hospital. We report this case with typical MR spectroscopic findings.

가와사끼병에서 면역글로불린 사용 후 ASO 수치의 변동에 관한 고찰

황성욱,이지웅,송민섭,김철호 인제대학교 2006 仁濟醫學 Vol.27 No.-

Objective : Since Kawasaki disease was first described in 1967, the cause and prognostic factors have not been known despite many researches and efforts. The introduction of high-dose intravenous gamma-globulin (IVGG) was an epoch and IVGG is now a standard therapy. But the mode of action of IVGG in reducing inflammatory response is not clearly understood. Understanding of the mechanism should supply the clues that indicate the cause, prognosis, the better treatment of this disease. At present, the correlation of CRP, ESR and change of leukocyte numbers to Kawasaki diseases were known, but the correlation studies of ASO titers are rare. To discover this, we evaluated the interrelationship between the ASO titer and IVGG therapy. Methods and Materials : The subjects included 35 patients with Kawasaki disease who were treated by IVGG at department of pediatrics, Inje university, Busan Paik hospital from June, 2004 to December, 2005. Before and after IVGG administration, ASO titers were evaluated. Results: In the 32 among 35 patients, ASO titers checked before IVGG administration were increased prominently after IVGG therapy. Conclusion : Remarkably increased ASO titers after IVGG administration for the treatment of Kawasaki diseases were found. And changes of ASO titers seem to be due to immunoglobulin instead of streptococcal infection. Further studies will be necessary to clarify the pathogenic mechanisms of increased ASO titers.

腦硬塞患者의 血壓·脈搏 및 腦血流에 대하여 水溝-承漿穴 電鍼刺戟이 미치는 影響

박성욱,문상관,고창남,조기호,김영석,배형섭,이경섭 경희대학교 1997 慶熙醫學 Vol.13 No.4

한국 일 도시지역 청소년의 우울 증상 유병률과 관련요인에 대한 연구

조성진,전홍진,김무진,김장규,김선욱,류인균,조맹제 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구 목적 : 한국의 일 도시지역에 거주하는 청소년의 우울 증상의 유병률과 관련요인을 밝힘으로써 청소년 정신건강 증진을 위한 기초 자료를 수집하기 위하여 실시되었다. 방 법 : 연구 대상은 부천시에 거주하는 중학교나 고등학교에 재학중인 청소년 71,102명 가운데에서 무작위 집락 표본 추출법에 의해 선정된 2,203명이었으며, 이들에 대해서 CES-D(the Center for Epidemiologic Studies Depression Scale)와 사회인구학적 정보에 대한 문항이 들어 있는 설문을 실시하였다. 설문은 직접 학교를 방문하여 수행하였다. 선정된 2,203명의 청소년 가운데에 CES-D문항을 완성한 학생은 1,972명으로 반응률은 89.5%였다. 결 과 : 1) CES-D의 절단점을 16점으로 하여 계산한 '가능한' 우울 증상의 유병률은 중학생의 경우에 남학생 34.6%, 여학생 44.7%였으며, 고등학생의 경우에는 남학생 43.8%, 여학생 49.6%였다. 2) CES-D의 절단점을 25점으로 하여 계산한 '명확한' 우울증 증상의 유별률은 중학생의 경우에 남학생 18.4%, 여학생 20.7%였으며, 고등학생의 경우에는 남학생 21.4%, 여학생 23.9%였다. 3)종교, 인문계와 실업계의 여부에 따라서 우울 증상의 유병률에는 유의한 차이가 없었다. 4) 성,학년, 생활수준에 대한 자신의 평가, 가족의 구조, 성적에 대한 만족도의 다섯 가지 변수에 대해 CES-D점수가 16점 이상인 우울 증상의 유무에 따라서 로지스틱 회귀 분석을 시행하였을 때 성적에 대해 불만적 하는 군에서 매우 만족하는 군에 비해서 8.850배의 상대 위험도를 보였다. 생활 수준을 중하정도라고 대답한 군은 상이라고 대답한 군에 비해서 2.007배의 상대 위험도를 보였다. 여학생은 남학생에 비해서 1.307배의 상대 위험도를 보였다. 5) 우울 증상에 있어서 남학생과 여학생의 비율은 전체 군에서 1:1.38이며 중학생의 경우에는 1:1.88, 고등학생의 경우에는 1:1.13으로 나타났다. 고등학생에 있어 남학생의 우울 증상이 증가하는 것은 학업과 입시에 대한 부담과 관련된 것으로 생각되었다. 결 론 : 한국 일 도시거주 중고등학생에서 CES-D로 측정한 우울 증상은 남학생의 34.3%, 여학생의 47.5%에서 나타날 정도로 흔하다. 특히 학업 성적에 대해 불만족 하는 군에서 높은 우울 증상의 상대 위험률을 보이며, 고등학생에서 남학생의 우울증의 유병률이 높아지는 것은 이 지역 학생들이 학업에 대한 높은 부담을 가지고 있다는 것을 알 수 있었다. 따라서 이들에 대한 특별한 관심이 요구된다. Objective : We tried to see the prevalence and correlates of symptoms of depression in an adolescent population in Korea, and collected the basal data for mental health promotion of adolescents. Method : We sampled 2,203 adolescents among 71,102 adolescents living in Puchon City in Korea by the randomized clustered sampling method. The Center for Epidemiologic Studies Depression scale(CES-D) was used to measure depressive symptoms. The measurements were conducted through visiting schools. Of the 2,203 adolescents(aged 13 to 18) who were sampled, 1,972 persons completed CES-D and sociodemographic questions. The response rate was 89.5%. Result : 1) The prevalence rate of 'probable' depressive symptoms with cutoff point 16 was 34.3% in the boys and 47.5% in the girls. 2) The prevalence rate of 'definite' depression symptoms with cutoff point 25 was 17.4% in the boys and 20.6% in the girls. 3) We could not find any meaningful difference in the average of CES-D from the districts where they live, the course of their education, and their religions. 4) We used the logistic regression analysis to find the risk factor for adolescent depression in these samples. Among the variables degree, it was most important risk factor in adolescent depression to dissatisfy with their school degrees. Compared it with fully satisfied group, the odds ratio was 8.850. The group of mid to low socioeconomic status had the odds ratio 2.007 compared with high socioeconomic status. The girls had the odds ratio 1.307 compared with the boys. 5) The male versus female ratio was 1: 1.38 in the total students and 1 : 1.88 in the middle school students, and 1 : 1.13 in the high school students. The male versus female ratio was relatively low in the high school students. It was the result of the high prevalence of depressive symptoms in the high school boys, and it was due to the large burden to their school degrees. Conclusion : The depressive symptoms checked by CES-D were very common among adolescents in Korean urban area. The prevalence of depressive symptoms was 34.3% in the boys and 47.5% in the girls. The result that male versus female ratio was relatively low in the high school adolescents, and the group that were dissatisfied with the school degrees had high risk of depressive symptoms, revealed that the students had large burden to their school degrees and so they needed special concerns.

南冥과 一齋의 學問 方法과 處世 態度

洪性旭 慶尙大學校 南冥學硏究所 2002 남명학연구 Vol.13 No.-

Due to a series of massacres of Confucian scholars including 'Muosahwa(戊年土禍)' until the early part of the 16th century. many scholars gave up entering on an official career and secluded themselves from the world. Nammyeong(南冥) and Iljae(一齋) also led humble lives in a remote village. They devoted themselves to studying and practicing sacred books including Daehak(大學) The Great Learning-, which is the basic book for the realization of politics based on the rule of right, to cultivate their mind in the way of 'Geogyeonggibui(居敬集義)' and 'Geogyeonggungkyeong(居敬窮義)'. They were recommended as Yuil-those who don't enter into government service, but they were not positive. It is not because they didn't have any intention of government position, but because they thought that their sovereign was not worth working with. Nammyeong(南冥) didn't enter on an official career all life, but Iljae(一齋) did that a while. Nammyeong(南冥) is more complete than Iljae(南冥). However both Nammyeong(南冥) and Iljae(一齋) taught junior scholars through reading and lecture, and they practiced 'Kyeongui'. They always worried about the life of the people and the matters of the nation. Such things are their common points. Especially all of them suggested and practiced 'Kyeon(敬)' as a key point of cultivation and a learning method. When they met the king and advised him on the main point of statecraft. they emphasized that he had to deat with everything through 'Kyeong(經)'-oriented method We can know how positively they practiced 'Neo Confucianism(性理學)' through this. Though Nammyeong(南冥) and Iljae(一齋) won great popularity due to their studies and reputation in the right of Kyeongsang province(慶尙石道) and the north of Honam area(湖南北部), they didn't seem to associate with each other except the fact that they studied together in Seoul, went Seoul through recommendation and exchanged their thought about studies and official career. However it seems that they knew each other well, worried about their future, and had lots of interest and affection. At that time, the dispute on 'Liqi theory(理氣論)' was in full swing, and Nammyeong(南冥), who was positive in practice, didn't state particular opinion. He reconfirmed Zhuzi's viewpoint and expressed his opinion. He had a tendency of 'Liqi monism(理氣一元論)'. This is similar to Iljae(一齋)'s 'Liqi's Unity(理氣體論)' based on Na, HeumSun(羅欽順)'s theory. Many scholars, who secluded themselves from the world, tried to be learned and have interest in 'The Doctrines of Wang Yangming(陽明學)'. 'Liqi's Unity(理氣一元論)' was inclined to 'Neo Confucianism(性理學)'. If we consider the social background, which attached greater importance to theoretical studies than to practice, their theory deserves our attention.

Shaphylococcus enterotoxin B와 lipopolysaccharide를 작용시킨 사람 섬유아 세포에서 생성된 Transforming Growth Factor-β₁의 정량적 분석

이성근,김광혁,김욱규,김종렬,정인교,양동규 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2

TGF-β1 is a potent chemotactic factor for inflammatory cells and fibroblasts. It also stimulates the celluar source and components of extracellular matrix and the production of proteinase inhibitors. Collectively, these biologic activities lead to the accumulation and stabilization of the nascent matrix, which is vital to infection control. The objective of this study is to investigate production of TGF-β in vitro fibroblast culture in the presence of Staphylococcus enterotoxin B(SEB) and/or lipopolysaccharide(LPS) and to elucidate the role of TGF-β1 which may be responsible for infection control. The fibroblasts were originated from gingiva and facial dermis in 26 year-old male patient. In the presence of LPS(0.01㎍, 0.1㎍, 1.0㎍), SEB(0.01㎍, 0.l㎍, 1.0㎍) respectively, cells(5×103ml) were cultivated in vitro. At 1, 3, and 5 days after incubation, cells were counted. Also, cells(2.5×105ml) were cultivated in EMEM with LPS(0.01, 0.1 and 1.0㎍), SEB(0.01, 0.1 and 1.0㎍) respectively and LPS(0.1㎍) and SEB (0.1㎍) in combination for 24,48, and 72 hours respectively. Culture supernatants were harvested at 1, 2, and 3 days after incubation period and triplicate culture supernatants were pooled and TGF-β1 was assayed in duplicate. The results were as follows. 1.In gingival fibroblast induced with SEB and LPS respectively or in combination, the suppression of cell Proliferation occurred very significantly since 3 days after incubation, compared with the control and the production of TGF-β1 occurred very significantly at 1 day after incubation, compared with the control. 2.In facial dermal fibroblast induced with SEB and LPS respectively or in combination. the suppression of cell proliferation occurred very significantly at 1 day after incubation, compared with the control. In SEB exposure, the production of TGF-β1 was decreased very significantly at 1 day after incubation, compared with the control. However, in LPS, SEB and LPS exposure, the production of TGF-β1 was increased very significantly at 1 day after incubation, compared with the control. In conclusion, the concentration of bacterial toxins and the incubation period correlated with cell proliferation and production of TGF-β1 very significantly. The gingival and facial dermal fibroblasts have different phenotype each other The orchestrated understanding of fibroblast proliferation and TGF-β1 production play an important part in host defense against the bacterial Infection and may prevent tissue necrosis such as necrotizing fasciitis and life-threatening syndrome such as multiple organ failure.

남성 동성애자와 남성 이성애자의 삶의 질과 정신 건강 비교

공성욱,오강섭,노경선 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.5

연구목적: 본 연구는 동성애자와 이성애자의 삶의 질과 정신 건강-우울, 자살 등-에 대해서 비교하였으며, 동성애자의 삶의 질이 여러 정신 건강과 어떤 관련성이 있는가를 연구하였다. 방법: 20∼30대의 남성 동성애자 129명과 남성 이성애자 114명을 대상으로 횡단적 연구를 실시하였다. 동성애자와 이성애자 모두 삶의 질(소외감), 우울감, 자살 생각, 무망감, 자아 존중감, 대처 방식, 사회적 지지와 갈등, 가족의 적응력과 결손력에 대해서 자기 보고식 척도를 사용하여 비교하였다. 결과: 동서애자군과 이성애자군 간에 연령, 학력, 월수입, 음주, 흡연, 종교에서는 유의미한 차이가 없었다. 동성애자군이 이성애자군에 비해서 과거 여성스러움으로 놀림의 경험, 과거 정신과 병력, AIDS 검사면에서 유의미하게 높게 나타났다. 자아 존중감, 무망감, 대처방식, 가족의 적응력, 사회적 지지와 갈등에서는 두 군 사이에 별다른 차이가 나타나지 않았다. 동성애자군이 이성애자군에 비해서 삶의 질과 가족 결속력이 저하되어 있었으며, 우울감과 자살 사고가 높게 나타났다. 삶의 질의 하위 변인인 가정으로부터의 소외, 사회로부터의 소외, 대인 관계로부터의 소외가 동성애자군에서 높게 나타났다. 따라서 높은 우울감과 낮은 가족의 결손력이 동성애자의 삶의 질에 중대한 영향을 미치고 있는 것으로 나왔다. 결론: 동성애가 DSM 진단 기준에서 제외 되었지만, 많은 정신 건강 문제들이 이성애자군에 비해서 동성애자군에서 높게 나타나고 있다. 동성애자로서 가지게 되는 여러 가지 우울, 가족 관계에 대한 더 많은 연구와 도움이 필요할 것이다. Objectives: The study was performed to compare the quality of life and mental health-depression, suicide etc-in homosexual men with those in heterosexual men and to identify how the quality of life is related with mental health. Methods: 129 homosexual men and 114 heterosexual men in twenties and thirties were enrolled by crosssectional method. Quality of life, depression, suicidal idea, hopelessness, self esteem, coping strategy, social support, social conflict, familiar adaptability and familiar cohesion were measured by self-report scale to compare the homosexual and the heterosexual groups. Results: The results showed that age, educational level, income, alcohol intake, smoking and religion were not significantly different between homosexual group and heterosexual group. Teased experience about feminity, post psychiatric history. HIV test experience in homosexual group were higher than those in heterosexual group. The self-esteem, hopelessness, coping strategy, familiar adaptability and social support-conflict were not significantly different between two groups. Homosexual group had poorer quality of life, lower familiar cohesion, higher depression and higher suicidal idea than heterosexual group. Being alienated from home, social system and interpersonal relationship, which are subscales of the quality of life, scored lower by homosexual group as compared with heterosexual group. Therefore, high depression and low familiar cohesion had significant effect on the quality of life in homosexual group. Conclusion: Although homosexuality is excluded from DSM, the prevalences of many mental health problems are higher in homosexual group than heterosexual group. It is suggested that the more studies on depression and familiar function related to homosexuality are needed.

건설업 규모별 안전관리 활성화 방안

고성석,이종빈,김종욱 한국안전학회 2004 한국안전학회지 Vol.19 No.1

After the IMF financial crisis, a lot of risks in construction industry have been increased gradually with the expansion of construction industry widely, higher stories of building, and the expansion of the underground space and excavation work. These risks are bringing out constriction accidents such as the death, the injury of worker and so on, not so much as it would be effected the corporation's image. In spite of these situations, many constriction industries still maintain the wrong methods and riot try to decrease construction accidents. Decently, we should focus on the fact that larger construction industries have been endeavoring to decrease the accidents in construction site and the safety management system of the larger constriction also is being good, on the other hand, the condition of the work in the case of smaller construction industries is very poor, construction company have a particular safety management system but it has a difference according to the construction magnitude, construction companies have a particular safety management system but it has a difference depending on the construction magnitude. Thus, we need to study the smaller construction safety management to decrease the construction accident according to the construction magnitude. Therefore, this study will suggest the developed way of construction safety management by the comparison and analysis from the difference between the higher and the smaller construction industries.