기종성 방광염을 동반한 기종성 신우신염 1예

김선두,김순제,이길도,김정수,김지훈,윤호상,송종오,문언수 대한노인병학회 2000 Annals of geriatric medicine and research Vol.4 No.3

우리나라 시 · 군 · 구 지역보건의료계획의 비전(Vision) 문구 분석

안치영(Chi-Young Ahn),김현수(Hyun-Soo Kim),김원빈(Won-bin Kim),오창훈(Chang-hoon Oh),홍지영(Jee-Young Hong),김은영(Eun-Young Kim),이무식(Moo-Sik Lee) 한국농촌의학 지역보건학회 2017 농촌의학·지역보건 Vol.42 No.1

지역보건의료계획서에서 비전은 각 지역의 보건의료계획을 나타내는 핵심요소임에도 불구하고 작성방법에 대한 구체적인 지침이 부재하여 각 지역의 비전은 매우 다양하게 표현되어 있다. 이에 이 연구에서는 제6기 지역보건의료계획에서 제시한 비전 문구를 보건소 유형별, 권역별로 분석하였다. 전국 229개 지역의 제6기 지역보건의료계획서의 비전 문구와 이와 관련된 미션, 전략체계도, 중장기 추진과제 등을 대상으로 하였다. 지역을 권역별 4개, 읍·면·동 구성에 따른 보건소 유형을 4개로 분류하였고, 각 지역 비전의 글자 수, 문장 평가, 단어 빈도, 문구 평가를 빈도분석과 카이제곱검정, 일원배치분산분석을 이용하여 분석하였다. 비전의 글자 수가 17자 이하인 보건소가 172개소(75.1%)였고, 보건소 유형별로 유의한 차이가 있었다(p<0.05). 문구에 대한 수사표현에서 비유법(37.1%)이, 한글 외에 표현 언어 사용에서는 특수문자(43.2%)가 많았으며, 보건소 유형별로 유의한 차이가 있었다(p<0.01). 비전에 사용된 단어들은 ‘건강’, ‘행복’, ‘함께’, ‘군민’ 또는 ‘시민’, ‘도시’, ‘100세’ 등이었다. 문구평가 점수에서는 특·광역시 및 수도권에서 가장 높았으며, 보건소 유형 및 권역별로 유의한 차이를 보였다(p<0.05). 보건소 유형별로 과정 및 평가 영역, 공유가능성 등에서 유의한 차이가 있었다(p<0.01). 방향성은 충청권, 수도권 순으로 권역별로 유의한 차이가 있었으며(p<0.01), 미래지향성 및 공유가능성은 영남권이 가장 높아 권역별로 유의한 차이가 있었다(p<0.01). 비전은 지역보건의료계획에 가장 중요 요소 중 하나이다. 이 연구는 지역사회 특성별로 비전의 설정이 다름을 확인하였으며, 이러한 결과를 통하여 지역보건의료계획 등 보건소 비전 수립시 참고가 될 수 있는 기초적인 자료가 될 것으로 판단된다. Objectives: In this study, we analyzed vision statements of the 6th community health plan of local government in Korea. Methods: We examined vision statements letters, missions and strategy plans, and long-term missions of 6th community health plans of 229 local government in Korea. We also analyzed the numbers of vision letters, sentence examination, word frequency, each vision statement with frequency analysis, chi-square test, and one-way ANOVA. Results: Among 229 local government, 172(75.1%) of local government had the number of letters (Korean) less than 17 of vision statements, and there were a significant differences according to type of community health centers (p<0.05). Figuration (37.1%) were the most used in an expression of vision statement sentence, and special characters (43.2%) were the most used language except Korean. The most commonly used words of vision statement in order of frequency were ‘health’, ‘happiness’, ‘with’, ‘citizen’, ‘city’, ‘100 years old’ etc. Chungcheong provinces and Daejeon metropolitan city had a highest score in directionality on phrase evaluation, and there were a significant differences according to regional classes of local government (p<0.01). Gyeongsang provinces, Ulsan, Daegu, and Busan metropolitan cities had a highest score in future orientation and sharing possibilities on phrase evaluation, and there were a significant differences according to regional classes of local government (p<0.01). Conclusions: Vision is one of the most important component of community health plan. We need more detailed ‘vision statement guideline’ and the community health care centers of local government should effort to make more clear and complete their vision.

복망-척수 이전술을 이용한 비외상성 경추 및 흉추 협착성 척수병증의 치료 경험

김영수,조용은,지훈상 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.2

Stenotic myelopathy due to ossification of posterior longitudinal ligament or degenerative spondylosis compresses the spinal cord and produces pain, motor weakness, sensory change. spasticity by several factors such as direct compression, vascular factor, mechanical factors. Chronic compression of spinal cord causes a ischemic change of spinal cord and cord atrophy. In this condition, only decompression of cord with wide decompressive laminectomy or expansive laminoplasty initially can expect mild improvement of clinical conditions of cord compression, but it cannot improve the irreversible ischemic change or atrophy of cord Omentum in peritoneal cavity has good blood supply and has lipid angiogenic factors proven by experimental study. Using these characteristics omentum transposition to spinal cord in chronic spinal cord injured patients have been tried. Authors tried the omentum-spinal transposition after wide decompressive laminectomy in three cases of severe nontraumatic spinal stenotic myelopathy and experienced the marked clinical improvement in one case of them. Operative thechniques were introduced and literatures were reviewed.

진공 Cavity상 멤브레인 구조를 가진 마이크로 유량센서의 단열특성

김석군,전치훈,김윤태,이종현 경북대학교 센서기술연구소 1998 센서技術學術大會論文集 Vol.9 No.1

We have proposed a surface-micromachined new microflow sensor to resolve the problems of poor thermal isolation and low sensitivity inherently in typical thermal flow sensors. A membrane of insulating films on a vacuum cavity supports a n'-poly heating resistor and two bidoped poly-Si thermophiles. We have investigated on heat-transfer characteristics of the sensor microstructure with the Sum-depth cavity of 100x100 μm^(2) by a two-dimensional numerical simulation as a function of the inside pressure of the cavity. As a result, the microstructure with the vacuum cavity shows better themal isolation effects than that of the air cavity.

흰쥐를 대상으로 벤지딘 노출에 의해 형성된 혈장 단백질 부가체의 생물학적모니터링 적용과 에탄올과 phenobarbital이 미치는 영향

김치년,이세훈,노재훈 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.4

목 적 : 에탄올 또는 phenobarbital를 섭취한 근로자들이 벤지딘 및 벤지딘계 염료에 노출되는 경우 혈장 단백질 부가체를 이용한 생물학적 노출평가가 정확하게 이루어지도록 흰쥐를 대상으로 대사에 영향을 주는 물질로 알려진 에탄올과 phenobarbital이 벤지딘 투여시 혈장 단백질 부가체 형성에 미치는 영향을 파악하고 N-acetulation에 미치는 영향도 함께 평가하였다. 방 법 : 실험 대상인 흰쥐를 대조군, 에탄올 전처치군, phenobarbital 전처치군으로 분류하여 벤지딘을 투여하기 24시간 전에 에탄올과 phenobarbital을 전처치하였다. 혈액시료 채취는 투여전과 투여후 30분, 3, 6, 9, 12, 24, 48, 72, 96, 144시간에서 각 군을 대상으로 5마리를 대상으로 실시하였다. 채취한 혈액은 즉시 혈장을 분리하고 부가체를 염기 가수분해하여 방향족 아민의 형태로 전환시켰다. 가수분해한 벤지딘, 모노아세틸벤지딘 그리고 4-아미노비페닐을 유도체화 과정 없이 역상 액체크로마토그래프를 이용하여 분리하였으며, 그 물질들은 선택성과 감도가 높은 전기화학검출기로 정량분석하였다. 분석한 대사산물은 혈장 단백질 결합지수와 N-acetylation 비로 표현하였다. 결 과 : 에탄올 또는 phenobarbital 전처치군의 벤지딘-혈장 단백질 결합지수. 모노아세틸벤지딘-혈장 단백질 결합지수, 4아미노비페닐-혈장 단백질 결합지수가 대조군보다 높아 에탄올 또는 phenobarbital이 혈장 단백질의 부가체 형성을 증가시키는 역할을 하였다. 혈장 단백질 부가체에서 일어나는 N-acetylation은 전처치에 상관없이 모든 군에서 유사하게 나타났으며 헤모글로빈 부가체의 경우와난 다르게 N-acetylation이 적게 이루어졌다. 헤모글로빈 부가체에서는 4-nitroso-4'-N-acetylbiphenyl이 가장 많이 형성되었지만 혈장 단백질에는 다른 양상이었으며 에탄올이 방향족 아민류와 함께 노출이 되면 N-acetylation이 증가한다는 효과도 적었다. 또한 1회 경구 투여 후에 형성된 혈장 단백질 부가체는 전처치헤모글로빈 부가체보다 빠르게 증가하고 감소하는 경향이 있었다. 결 론 : 에탄올과 phenobarbital은 벤지딘 투여에 의해 형성되는 혈장 단백질 부가체를 증가시켰다. 그러나 헤모글로빈 부가체와는 다르게 N-acetylation을 증가하는 경향은 없었다. 혈장단백질 부가체는 벤지딘 노출에 대한 누적효과가 헤모글로빈 구가체보다 상대적으로 적었다. 따라서 벤지딘 노출근로자들은 대상으로 혈장 단백질 부가체를 생물학적 모니터링으로 이용할 때는 에탄올이나 phenobatbital에 대한 영향을 고려하는 것이 필요하면 최근에 대한 노출평가에만 활용되는 것이 바람직하다. Objectives : The effects of ethanol and phenobarbital, which are known to affect metabolism of xenobiotics, on the formation of benzidine- and its metabolites-plasma protein adducts in rats administered benzidine were evaluated. Methods : The experimental rats were divided into the control, ethanol and phenobarbital groups. The experimental groups (ethanol and phenobarbital group) were pretreated with ethanol (1g/㎏) or phenobarbital (80㎎/㎏) 24 hours prior to the oral administration of benzidine (0.5mmol/㎏). Blood samples were obtained from the vena cava from 5 rats in each group; and at 30 min, 3 h, 6 h, 9 h, 12 h, 24 h, 48 h, 72 h, 96 h, and 144 after the administration of benzidine using heparin treated syringes. The plasma protein levels were separated immediately atfer taking blood samples. The adducts were underwent basic hydrolysis to convert them into aromatic amines. The hydroluzed benzidine, monoacetulbenzidine, and 4-aminobiphenyl were analyzed by reverse-phased liquid chromatography with an electrochemical detector. The quantitative amount of the matabolites waw expressed by the plasma protein binding index(PBI). Results : similar to the hemoglobin adducts, the levels of the plasma protein adducts of the ethanol and phenobarbital groups (benzidine-, monoacetylbenzidine-, and 4-amino-biphenyl-PBI) were higher than those of the control group. These results are attributable to the fact that ethanol and phenobarbital induced to the plasma protein adduct formation. The N-acetylation ratio in the control group was highest at 72 h with 2.34. In the ethanol group, it was highest at 72 h with a ratio of 2.46 and was highest in the phenobabital group at 72 h with a ratio of 2.43. The N-acetulation ratio of the plasma protein adducts was relatively lower than that of the hemoglobin adducts. The level of the plasma protein adduct increased more rapidluy than the hemoglobin adducts in all experimental gruops regadless of the pretreatment, and decreased rapidluy after reaching the maxi-mum level. Conclusion : The above results indicate that ethanol and phenobarbital increased the level of plasma protein adduct formation. The plasma protein adducts tended to decrease more rapidly than the hemoglobin adducts in the body after benzidine exposure. This results in this study result suggests that the effects of ethanol or phenobarbital need to be considered in the biochemical monitoring, and that the level of the plasma protein adducts be a more proper biomaker than the hemoglobin adducts for assessing the short term exposure to a benzidine and benxidine based dye.

염화비닐 노출 근로자의 시료채취시기에 따른 요중 thiodiglycolic acid의 농도 변화

김현수,김치년,원종욱,차봉석,이경종,노재훈 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 본 연구는 염화비닐 및 폴리염화비닐수지 제조공장의 VCM 노출 근로자들을 대상으로 소변 시료채취 시기에 따른 요중 TDGA 농도의 변화를 알아보고자 하였다. 방법: VCM 및 PVC 제조공장 남성 근로자 31명을 대상으로 공기중 VCM 개인노출평가를 실시하였으며 소변내 TDGA 배설 양상을 알아보기 위해 3일 휴식 후 척 작업 시작 전(TDGA1), 1일 작업종료 후(TDGA2), 1일 작업 한 다음날 작업 전(TDGA3) 소변을 채취하였다. VCM에 노출되지 않은 대조군 30명에 대해 작업종료 후 소변을 채취하였다. 공기 중 VCM의 측정 및 본석은 NIOSH 공정시험법 No. 1007에 따라 실시하였다. 요중 TDGA 분석을 위하여 소변을 trimethylsilyldiazomethane(2.0 M in diethyl ether)으로 메틸화 반응하여 가스크로마트그래피/펄스불꽃광도검출기로 분석하였다. 결과: VCM 노출 후 요중 TDGA가 배설되어 감소하는 시기를 조사하기위해 대조군과 VCM 노출 근로자들의 3일 휴식 후 작업 시작 전 요중 TDGA 농도 (TDGA1)를 비교한 결과 각각 0.179±0.271 mg/g creatinine, 0.218±0.443 mg/g creatinine으로 통계학적으로 유의한 차이가 없었다. 1일 작업 종료 후 요중 TDGA 농도(TDGA2)는 0.434±0.623 mg/g creatinine, 1일 작업 한 다음날 작업전 요중 TDGA 농도(TDGA3)는 0.767±1.056 mg/g creatinine으로 순차적으로 증가하였다. 하루 노출량을 평가하기 위해 공기 중 VCM 농도와 요중 TDGA와의 단순회귀분석 결과 1일 작업한 다음날 작업 전 요중 TDGA 농도(TDGA3)와 공기 중 VCM 농도와의 관련성은 R^(2)=0.4215로 1일 작업종료 후 요중 TDGA 농도(TDGA2)보다 높았다. 결론: VCM 노출 후 3일이 경과하면 대조군의 요중 TDGA 농도 수준으로 감소하여 요중 TDGA의 배설 반감기가 3일 이내인 것으로 판단된다. 또한, 하루 근무하고 그 다음날 작업 전에 채취한 요중 TDGA 농도(TDGA3)가 전날 근무시의 VCM노출량과 상관성이 가장 높아 하루 동안의 VCM노출을 평가하기 위한 유용한 생물학적 지표로 사용할 수 있을 것으로 판단된다. Objectives: The study was performed to investigate the changes of urinary thiodiglycolic acid (TDGA) concentration in workers exposed to vinyl chloride monomer (VCM) according to the time of sampling urine. Methods: The personal exposure to airborne VCM was assessed and urinary TDGA concentration was sampled in 31 workers employed in a VCM and polyvinyl chloride (PVC) manufacturing factory. Urinary TDGA was sampled three times: before the start of the shift after 3 days off (TDGA 1), after the end of the first-day shift (TDGA2) and before starting the following day shift after completing the one- day shift (TDGA3). Urinary TDGA in 30 workers who had not been exposed to airborne VCM was sam- pled after the end of the shift. A gas chromatography/pulsed flame photometric detector (GC/PFPD) was utilized to analyze TDGA concentration in urine after the urine was methylated with trimethylsilyldia- zomethane (2.0M in diethyl ether). Results: The creatinine level was 0.179±0.271 mg/g in the control workers and 0.218±0.443 mg/g in the workers before the start of the shift after 3 days off (TDGA1), showing no significant difference (p=0.7035). Urine samples were compared according to sampling time in order to investigate the change of urinary TDGA concentration in the case of continuous exposure to airborne VCM. In VCM-exposed workers, urinary creatinine concentration was 0.434±0.623 mg/g in TDGA2 and 0.767±1.056 mg/g in TDGA3, which indicated a gradual but significant increase (p=0.024). In terms of the statistical correlation between airborne VCM and urinary TDGA to evaluate exposure dose per day, of the three urinary TDGA concentrations, TDGA3, showed the highest degree of regression (R^(2)=0.4215) with 8h-TWA airborne VCM concentration. Conclusion: Based on this result, the excretion half-life of urinary TDGA was assumed to be less than 3 days, because the concentration of urinary TDGA at 3 days after exposure to airborne VCM was decreased to the level of urinary TDGA concentration in the control workers. The concentration of urinary TDGA increased in the case of continuous shift, due to the accumulation of residual metabolites of TDGA. It was considered that TDGA3 can be applied as a useful biological index to evaluate the exposure dose of airborne VCM during one day because TDGA3 showed the highest correlation with the exposure dose of airborne VCM in the previous shift day.

수혈이 혈액응고 변화 및 예후에 미치는 영향

김용정,지훈상,이경포 대한외상학회 1996 大韓外傷學會誌 Vol.9 No.2

Background: The administration of large volume of stored blood has been shown to have a close association with coagulopathy. This change reflects a washout phenomenon and volume restoration with large stored blood, the effects of shock on organ function, and post resuscitation fluid shift. The purpose of this study was to examine the effect of the transfusion with large stored blood on prognosis and coagulation changes. Materials and methods: Platelet count, prothrombin time(PT) and partial thromboplastin time(PTT) et al were daily studied for 7 days in 71 patients who received transfusions exceeding 5pints of packed red cell(PRC). Result: The platelet count was the lowest in the immediate post transfusion and continued to fall after transfusion for 3 to 4 days, then began to rise by the third and fourth days, and was above normal at convalescence. The significant prolongation in PT and PTT consistently occurred immediately follnwing the transfusion of more than 20pints of PRC, but patients rapidly recovered. The incidences of bleeding tendency and mortality were greater in patients with 60min of shock than in those with 35min of shock. No difference in the severity of shock was noted. Conclusion: There were decreases in platelet count, prolongation of PT and PTT immediate after the administration of large volume of stored blood but rapid recovery followed. The empirical, prophylactic administration of platelet concentration and fresh frozen plasma was not necessary in this study. Because the duration of shock is an important prognostic factor, we must resuscitate aggressively to shorten the duration of shock.

고립성 폐결절의 조직학적 진단에 있어서 경기관지폐생검의 진단적 가치

김치훈,김정주,왕준호,연규민,김형수,리원연,용석중,신계철 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

Transbronchial lung biopsy(TBLB) is a relatively simple and convenient diagnostic tool in solitary pulmonary nodule(SPN) on chest radiograph, which is cannot be diagnosed through routine tests. To investigate the diagnostic value and diagnostic rate of TBLB according to the variable factor, we analyzed 69 patients with radiologically SPN lesion on chest radiograph which was confirmed histologically. A histologic diagnosis of TBLB was made in 47 of 69 patients(68.1%), in which 26 of 37(70.3%) with malignancy and 21 of 32(65.6%) with benign lesion. There were no significant differences in diagnostic yield according to age, sex and location of the lesion. The diagnostic rate tended to increase with the more than 5 pieces to acquired by TBLB. When the size of SPN was less than 3 ㎝, it cannot be diagnosed. In conclusion, TBLB is a diagnostic procedure with good yield and safety, but percutaneous needle aspiration, transbronchial needle aspiration, and bronchial washing fluid cytology may be a complementary procedure to overcome the limitation of TBLB and get higher diagnostic yield for SPN.

컨테이너 터미널의 효율적 운영을 위한 의사결정지원시스템

김갑환,김홍배,윤원영,김종훈,권봉재,조지운 釜山大學校生産技術硏究所 1998 生産技術硏究所論文集 Vol.55 No.-

A decision support system is introduced for the efficient operation of port container terminals. It consists of ship planning subsystem, yard planning subsystem, resource management subsystem, real-time control subsystem, and simulation subsystem. The system is intended to support the planning process of the planners and the operation process of the administrators in the container terminals. It is assumed that the transfer crances and the yard tractor/trailers are used to handle containers in the marshaling yard. The system is explained in terms of the functions of each subsystem and the data flows among various subsystems.

절수에 의한 Mongolian Gerbil 장기중량변화에 관한 분석연구

김무강,이기훈,이강이,송치원,이경열,권효정,박미선,정승혁,이행연,김명철 충남대학교 수의과대학 동물의과학연구소 2000 動物醫科學硏究誌 Vol.8 No.-

In this study, authors measured the each organ weight of the long term water deprived Mongolian gerbil, after then we calculated the mean, standard deviation, variance coefficient of the real measured organ weight and induced the organ weight change quantity, rate of quantity, deviation between measured and theological organ weight, deviation rate, sum of deviation rate, organ weight change rate, rate of organ weight by the mathematical formula. The results obtained as follow 1. The weight of the brains, lung, and testis were abruptly decreased after water deprived until the 5th day, after then slowly decreased until the 20th day. 2. The weight of the heart was decreased gradually from the first day until the 20th day. 3. The weight of the liver was abruptly decreased until the 10th day, after then the more slowly decreased until the 20th day. 4. The weight of the thymus, spleen, kidney, and pancreas were abruptly decreased until the 15th day, after then increased slowly until 20th day but the weight of the kidney was abruptly increased from the 10th day. 5. The organ weight change rate and the rate of the each day organ weight were very diversified.