노령의 대퇴 전자간 골절 치료에서 압박고 나사못의 안정성 및 유용성

김종오,노권재,윤여헌,고영도,유재두,정준모,방한천,정재학 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 노령의 대퇴 전자간 골절에서 압박고 나사못의 안정성에 영향을 주는 인자들간의 상관 관계와 골절 양상에 따른 술후 고관절 기능을 평가 및 분석하였다. 대상 및 방법: 압박고 나사를 이용하여 수술적 치료를 시행한 231명의 환자 중 6개월 이상 추시가 가능하였던 60세 이상 84명의 환자들을 대상으로 했다. 방사선적 계측은 압박고 나사못의 활강 길이 및 내반각, 가압 나사 위치, 정복 상태, 원위 골편의 내측 전위를 측정하였으며 술후 기능은 Clawson의 기능 평가표로 하였고 골절 양상에 따라 방사선 계측과 기능 회복과의 상관 관계를 평가하였다. 결 과: 임상 결과는 불안정 골절에서 양호가 10례, 불량이 23례, 안정 골절에서는 양호 40례, 불량이 11례로 안정 골절에서 임상 결과가 좋았고(p<0.001), 압박고 나사 활강은 10 ㎜ 이상일 때 양호가 4례, 불량이 21례, 10 ㎜ 이하에서 양호가 46례, 불량이 13례로 10 ㎜ 이상 활강시에 술후 결과가 불량했다(p<0.001). 다르 방사선적 계측 요인은 결과에 의미있는 차이를 보이지 않았다. 또한, 불안정 골절 중에서 전위 양상 골절의 경우 10㎜ 이상 활강이 12례, 10㎜ 이하 활강이 8례, 분쇄 양상 골절의 경우는 10㎜ 이상이 11례, 10㎜ 이하가 2례로 분쇄 양상의 불안정 골절에서 10㎜ 이상 활강이 의미있게 많았다 (p<0.001). 결 론: 10㎜ 이상의 지연 나사 활강은 고관절 기능 회복 약화를 유발시킬 수 있으며 불안정 골절 분쇄 양상 골절은 이런 지연 나사의 활강이 과도하게 유발될 수 있으므로 불안정 분쇄 양상 골절에서 압박고 나사의 단독 사용은 재고해 보아야 할 것이다. Purpose: To evaluate the relationship between fracture stability and functional results, and analyze the correlation between stability factors and the outcome in intertrochanteric fracture of the elderly. Materials and Methods: Of the 231 patients, 84 patients with age above 60 were able to follow up for minimum 6 months. We measured the sliding length of the lag screw, varus degree, position of lag screw, reduction status and medialization of distal fragment radiologically. The functional outcome of the treatment was evaluated with the Clawson's result classification and we evaluated the correlation between the radiological results of measurement and the functional recovery depending on the Evans fracture classification. Results: There were good results in 40 cases out of 51 stable fractures, and in 10 cases out of 33 unstable fractures (p<0.001). In case of sliding of lag screw more than 10㎜, good results were obtained in 4 cases, and poor in 21. And in case of sliding less than 10㎜, good results were obtained in 46, and poor in 13. (p<0.001).But there was no relationship between other radiologic factors and clinical results. In unstable type, there were 12 cases with lag screw sliding more than 10㎜ and 10 cases with less than 10㎜. In comminuted type, there were 11 cases with lag screw sliding more than 10㎜ and 2 cases with less than 10㎜(p<0.001). Conclusion: The sliding of lag screw more than 10㎜ may result in poor outcome. As in comminuted unstable pattern, sliding of lag screw might be excessive, the use of compression hip screw alone is not good treatment option.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

全南 南部와 西部海域의 海洋物理, 化學的 特性

田承寬,金相根,朴榮齋,李貞愛 木浦大學校沿岸生物硏究所 1984 沿岸生物硏究 Vol.1 No.1

Seasonal variations of physico-chemical factors were studied in both southern and western coastal waters of Chon Nam Province during a decade from 1971 to 1980. The variation of water temperature in the investigated areas was within the range of 3.6-27℃ throughout the research period. The temperature of western coastal water was lower than that of southern coastal water by 2∼4℃ in February. In spring and summer, water temperature of Jindo-Jodo area was characteristically lower than any other area by 1.0∼1.5℃. The aslinity varied within the range of 25.97∼34.32%0 throughout the research period, and showed its maximum value in February and its minimum in September. Western coastal water was always less saline than southern coastal water. Dissolved oxygen varied widely within the range of 4.25∼58.75㎖/ℓ,and showed the lowest value in September and the highest in February. Concentrations of nitrite, Phosphate, and silicate varied within the range of 0.01∼2.96 ㎍-at/ℓ, 0.06∼2.07㎍-at/ℓ, and 2.13∼29.-01 ㎍-at/ℓ, respectively. Nitrite and silicate reached their maximum concentrations in summer but phosphate reached its maximum concentration in winter. These nutrients appeared abundantly in Sinan-Mokpo area and Waned-Kangjin area, under influence of the Yongsan liver and the Tamijin liver, respectively. Transparency of waters in the investigated areas varied within the range of 0.1∼5.0m with the tendency of being lower in southern coastal area than in southern coastal area than in western coastal area. Maximum value of transparency appeared in summer, and minimum value in winter.

국내 5개 3차 병원의 β-lactam계 항생제 사용 실태 및 Klebsiella pneumoniae의 항생제 내성과의 상관 관계

정숙인,박경화,권기태,고관수,오원섭,정두련,백경란,염준섭,장현하,김신우,손준성,송재훈 대한감염학회 2007 감염과 화학요법 Vol.39 No.4

Background : This study was performed to evaluate the prescribing pattern of β-lactam antibiotics and the relationship between antimicrobial resistance and antimicrobial use in 5 tertiary care hospitals in Korea. Materials and Methods : Data on annual patient-days and annual consumption (defined daily dose (DDD) per 100 patient-days) of β-lactam antibiotics from 2003 to 2005 in 5 tertiary hospitals were analyzed. To determine the antimicrobial resistance in K. pneumoniae, broth microdilution test and double disk synergy were performed according to the CLSI performance standards. Spearman's correlation coeffient was used to determine the relationship between antibiotic consumption and resistance. Results : The prescription of β-lactam antibiotics in 5 tertiary hospitals markedly varied. In two hospitals, increase in consumption of β-lactam antibiotics was more than 30% during recent 3 years. The higher consumption of β-lactam antibiotics significantly correlated with the higher rate of antibiotic-resistant K. pneumoniae in 5 tertiary care hospitals. Conclusion : Continuous surveillance of antibiotic use is needed to encourage appropriate prescribing of antibiotics and to reduce antibiotic resistance. 목적 : 항생제의 오남용으로 인한 내성균의 발현 및 급속한 확산이 전세계적으로 문제시 되고 있다. 특히 병원은 항생제 내성의 중심점에 있는 것으로 여겨진다. 본 연구에서는 최근 3년간 국내 5개 3차 병원의 β-lactam계 항생제의 사용량을 조사하고, 각 병원별 항생제 사용량과 K. pneumoniae의 항생제 내성률과의 상관관계를 알아보고자 하였다. 재료 및 방법 : 국내 5개 3차 병원에서 2003년 1월부터 2005년 12월까지 병원 입원 환자를 대상으로 연도별 재원연인원수와 각 β-lactam계 항생제의 총사용량을 수집하여 DDD (defined daily dose) per 100 patient-days로 환산하여 비교하였다. 2005년 6월부터 8월까지 각 병원의 임상검체에서 동정된 K. pneumoniae를 수집하여 액체배지미량희석법으로 항생제 감수성 검사를 시행하였고 ESBL(extended-spectrum β-lactamase) 생성 여부는 double disk synergy test를 시행하였다. 항생제 사용량과 내성의 상관관계는 Spearman 상관관계 분석을 시행하였다. 결과 : 5개 병원 중 3개 병원에서는 연도별 β-lactam계 항생제 사용량이 비슷하게 유지되었으나, 2개 병원에서는 2003년에 비해 2005년에 항생제 사용량이 30% 이상 증가하였다. β-lactam계 항생제 중 제제별 비율은 각 병원마다 차이가 있었으나, 3세대 cephaosporin의 사용이 가장 많았고 2세대 ceaphlosporin, β-lactam/β-lactamase inhibitor, 1세대 cephalosporin 순이었다. 경구용 β-1actam계 항생제의 사용량(r=0.900, P<0.037)과 2세대 cephalosporin의 사용량(r=0.900, P<0.037)은 각각 K. pneumoniae의 ESBL 생성과 양의 상관관계가 있었다. Ceftazidime의 사용량은 K. pneumoniae의 ceftazidime 내성률과 양의 상관관계가 있었다(r=0.900, P<0.037). 반면 imipenem의 사용량은 piperacillin/tazobactam 내성과 음의 상관관계가 있었다(r=-0.900, P<0.037). 결론 : 최근 3개년간 항생제 사용량은 병원별로 차이가 있으나 일부 병원에서는 증가하였다. β-lactam계 항생제의 사용량은 K. pneumoniae의 항생제 내성과 상관관계가 있었다. 항생제 사용을 줄임으로써 항생제 내성을 감소시킬 수 있을 것으로 기대되며, 병원별로 항생제 사용에 대한 지속적인 감시가 필요할 것이다.

계승치의 결손을 동반한 상, 하악 유구치의 다발성 유착에 대한 증례보고

정회훈,최형준,김성오,최병재,이제호 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.3

치아유착은 치근의 상아질 또는 백악질이 치조골과 융합된 것으로 치아의 맹출이상을 야기하여 치조골 성장의 장애를 일으킨다. 본 6세 여아는 유구치의 유착과 영구 소구치의 결손을 주소로 본과에 의뢰되었으며 특이할 만한 의과적, 치과적 병력은 없었다. 구강검진 소견상 상, 하악의 좌, 우측 유구치에서 저위교합이 관찰되었으며, 다수의 치아우식증이 존재하였다. 방사선 사진 검사 소견상 상악의 좌, 우측 영구 견치와 계승 소구치의 결손, 상악 유구치의 치근흡수와 하악 유구치의 치주인대공간의 소실 및 미약한 치근흡수가 관찰되었다. 계승 영구치의 결손을 동반한 유구치 유착시 치료목표는 적절한 치조골 성장과 유치의 유지이며, 유착의 발현 시기와 치근의 흡수 정도에 따라 관찰, 수복 또는 발치 등의 치료를 고려할 수 있다. 유착치아의 발치는 인접 치조골 성장에 문제가 없고 인접치의 경사가 일어나지 않도록 최대성장점(growth spurt)을 고려하여 그 시기를 결정해야 한다. Ankylosis is defined as a fusion of cementum or dentine with alveolar bone. Due to the loss of the periodontal ligament on the ankylotic area, the tooth is incapable of continued eruption and hence is unable to follow the normal vertical development of the neighboring teeth and alveolar process. A 6-year-old female was referred to the Dept. of Pediatric Dentistry for ankylosis of primary molars and congenital missing of permanent premolars on both jaws. She had neither specific past medical history nor trauma and infection history in oral and maxillofacial region. Radiographic finding is that the maxillary primary molars were the early onset of ankylosis and had fast root resorption rate. However the mandibular primary molars were ankylosed later and being resorbed slower than maxillary primary molars. The object of treating this case is to maintain the proper alveolar bone growth and retention of deciduous molars. The point of managing this case is as follows: Proper treatment (observation, restoration, of extraction) should be established after thorough consideration of the time of onset, the root resorption rate, progression of infraocclusion and the development of alveolar bone support. We should consider the timing of extraction of the ankylosed teeth without problem of neighbouring alveolar bone growth and tilting of adjacent teeth in the view of growth spurt. Early diagnosis is important to avoid many of the complications with infraoccluded primary molars.

한국수출기업의 고객지향전략이 해외바이어만족과 관계에 미치는 영향 : 영남지역의 주요 수출국가간 비교를 중심으로

정준식,공재형 한국관세학회 2009 관세학회지 Vol.10 No.1

The main aim of this paper is to investigate the effects of Korea exporting firms' customer orientation strategies on satisfaction and correlation, by comparing Chinese, American and Japanese buyers. For this purpose, this study classified the customer orientation strategies into three types of strategies (i.e. product, transaction, trust orientation) on the basis of previous studies. A email survey was conducted to collect to data for testing eleven hypotheses. Data were analyzed using multi-structural equation modeling by means of AMOS 7.0. The key findings of this study are as follows. Degree of customer orientation (i.e. product & service orientation) of the export firms was found to be related to degree of buyer's satisfaction. It was also identified that the degree of market orientation is a determinant of relationship quality (i.e. trust and commitment).

시설참외 연작재배지 토양의 객토 및 심토반전이 토양 화학성 변화와 토양선층 억제효과에 미치는 영향

전한식,박우철,정재식 한국환경농학회 2002 한국환경농학회지 Vol.21 No.1

우리나라의 시설참외 수산지인 성주지역의 시설참외 연작 대책으로 객토와 심경에 의한 토양 화학성분의 변화와 뿌리혹선충 억제 효과를 조사한 결과는 다음과 같다. 시설참외 연작대책으로 많은 양의 객토를 함으로 EC는 4.30 dS/m에서 1.80 dS/m로 58%, 유효인산은 406mg/kg으로 55% 감축되고 유기물 함량이 16g/kg에서 11g/kg으로 31% 줄어 퇴비 등 각종 거름 시용량을 증가해야 하면 뿌리혹선충 밀도 억제효과는 1년 차 89%, 3년 차 84%, 5년 차 69%로 되어 근본 대책이 되지 못하면서 영농비 가중 및 환경 파괴의 문제가 수반되었다. 심토반전 효과도 객토와 비슷하여 EC 4.30 dS/m에서 1.98 dS/m로 54% 줄고 유효인산 406 mg/kg에서 329 mg/kg 으로 19% 줄었으며 뿌리혹선충 밀도 억제 효과는 처리 후 1년 차 71%, 3년 차 67%, 5년 차 42%가 되므로 처리 3년 이후에는 다른 대책이 필요하였다. To elucidate the effect of soil addition and subsoil plowing on the change of soil chemical properties and the reduction of root-knot nematode, this experiment carried out in continuous cropping field of protected oriental melon (Cucumis melo L). Soil addition reduced electric conductivity (E. C.) from 4.3 to 1.8 dS/m (58%), available P_2O_5 from 406 to 182 mg/kg (55%) and organic matter content from 16 to 11 g/kg (31%). Population densities of root-knot nematode in soil reduced as much as 89%, 84%, and 69% at first year, third years, and of five years later, respectively. The effects of subsoil plowing were similar to that of soil addition. E. C. and phosphate were reduced from 4.30 to 1.98 dS/m (54%) and phosphate from 406 to 329 mg/kg (19%), respectively. Population densities of root-knot nematode reduced as much as 71%, 67%, and 42% after 1, 3, and 5 years, respectively. Subsoil plowing reduced nematode densities only for three years.

Trigger point를 利用한 口眼괘斜 患者 10例에 대한 臨床的 考察

鄭榮敦,李浚龜,金永一,朴泰均,辛泳一,黃載然,李賢,李秉烈 대전대학교 한의학연구소 2002 한의학연구소 논문집 Vol.10 No.2

From July 1th 2001 to October 31th 2001, the Clinical investigation studies were carried out 10 cases of patient with Bell's palsy using Trigger point treatment group, who had been treated in Han-seung Oriental Medical Clinic. The results were like below : 1. The distribution of sex : Male were 4cases, female were 6case and the female to male ratio was 1.5 : 1. 2. The distribution of contributing factor : Unknown reason was most predominant 4 cases, and then were revealed to labor too hard, menttal stress(3 cases), trauma·common cold(1 case) in turn. 3. The distribution of perid to fall ill : Under a week was the most number 6cases, and then were revealed a week under two weeks(3 cases), over two weeks(1 case) in turn. 4. About period of treatment : The Trigger point treatment group is shorter than the Acupuncture treatment group. 5. The distribution of grade on admission in descending order : GrⅠ was the most number and then GrⅡ, GrⅢ in turn. 6. The distribution of clinical symptoms on adimission : Mastoid pain was the most number 9 cases and then lacrimal gland disorder 8 cases, dysgeusia 4 cases, hyperacusis 2 cases, the others 2 cases in turn. 7. About effect of treatment : The Trigger point treatment group is more excellent than the Acupuncture treatment group. 8. The more patient age is young, the more effect of treatment was excellent, had nothing to do with both groups. 9. The more perid to fall ill is short, the more effect of treatment was excellent, had nothing to do with both groups. 10. About period of improved frontal belly : The Trigger point treatment group is more excellent than the Acupuncture treatment group.

FDM에서 경사면의 표면과 면적오차법의 관계에 대한 연구

전재억,정진서,황영모,김수광,김준안,계중읍,하만경 한국공작기계학회 2002 한국공작기계학회 추계학술대회논문집 Vol.2002 No.-

In any rapid prototyping process, the layer by layer building process introduces an area error between the staircase and the surface line specified by the computer-aided design model. This affects the dimensional accuracy as well as the surface finish for different part build orientations. This paper describes a methodology for computing the area error for any orientation of the part built by the fused deposition modelling system. This technique can be applied to determine the best build orientation of the part, based on the minimum area error. This technique is verified by comparing the results with the experimental measurements of the area error of the parts built at different orientations.

안내염과 대장암이 동반된 재발성 간농양

전승정,김태헌,류민선,오다연,송명은,이신아,류재인,김혜인,문일환,유권 이화여자대학교 의과학연구소 2011 EMJ (Ewha medical journal) Vol.34 No.2

The causes of pyogenic liver abscess has been known as biliary tract disease or intrabadominal infection but the large proportions of the patients has no apparent underlying disorders. Recently colonic mucosal lesions were reported in patients with cryptogenic liver abscess and it has been suggested that colonic mucosal break may play a role in developing liver abscess in otherwise healthy patients. We experienced a patient of severe recurrent liver abscess complicated with endophthalmitis only 3 months after successful treatment of initial cryptogenic liver abscess and a polypoid colon cancer was discovered by chance. It seems prudent to proceed colonoscopic examination in patients with cryptogenic liver abscess especially when it is recurrent.