서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

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.

의무고용제도 재설계 방안

김종진,장창엽,유완식,김언아,이정주,류정진,강필수,최종철,남용현,김윤삼 한국장애인고용촉진공단 고용개발원 2008 연구개발 Vol.- No.2

현행 우리나라 의무고용제도는 장애인구의 급격한 증가, 장애인차별금지 및 권리구제 등에 관한 법률의 도입 등 외부환경변화에 신축적으로 대처하지 못하고, 경증장애인 중심으로 의무고용제도가 운영됨으로써 중증장애인의 고용배제가 우려되고 있다. 본 보고서는 이러한 문제점을 해결하기 위해 의무고용제도의 일자리 확대와 고용증가를 통해 중증장애인의 고용기회를 확대할 수 있는 정책방안을 제시하기 위한 것이다. 본 보고서는 (1)의무고용 사업체의 의무고용 산정인원에서 자립장애인 제외 (2)현행 2% 의무고용률을 3%로 상향 조정 (3)사업체가 고용하는 중증장애인에 대한 더블카운트(2배) 가산제도 도입 (4)의무고용률 미달 사업주에 대한 부담금 차등징수의 4가지 정책방안, 제도 합리화 차원에서 장려금 지급방식의 개선과 사업주의 장애인에 대한 인식개선 방안을 제시하였다. 정책방안에 대한 영향분석 결과 의무고용 적용대상자에서 비장애인과 고용상 차별되지 않는 자립장애인(6등급)을 의무고용 산정인원에서 제외하는 경우 의무고용 사업체의 고용인원은 23,296명이 감소해 고용률은 1.35%에서 0.88%로 감소하였고, 의무고용 사업체의 장애인 일자리 수는 미고용인원의 증가로 15,152개가 증가하였다. 그리고 기금은 부담금이 631억원 증가하고, 장려금이 352억원 감소해 983억원의 수지개선 효과가 발생하는 것으로 나타났다. 의무고용 사업주의 의무고용률 3% 인상 방안은 의무고용률 상향 조정에 따른 미고용인원의 증가로 장애인의 일자리 수는 43,101개가 증가하고, 기금은 부담금이 1,709억원 증가하는 반면, 장려금은 293억원이 감소해 2,002억원의 수지개선 효과가 발생하는 것으로 나타났다. 의무고용 사업주가 고용하는 중증장애인을 2인으로 더블카운트 하는 중증장애인 가산제도의 도입은 의무고용 사업체의 장애인근로자가 67,261명에서 79,685명(1,2등급만 포함시 75,685명)으로 증가하여 고용률은 1.35%에서 1.60%(1.2등급만 포함시 1.52%)로 증가하고, 의무고용률 미달 사업체의 미고용 인원이 감소하여 2,745개의 일자리가 감소하였다. 그리고 기금은 부담금이 118억원 감소하는 반면, 장려금은 418억원이 증가해 536억원의 수지악화가 발생하는 것으로 나타났다. 의무고용률 미달 사업체의 고용유인을 위해 고용률 1.0%미만, 1.0-1.5%, 1.6-2.0% 미만에 대해 각각 20%, 10%, 5%의 할증률을 순차적으로 가중하여 부과하는 부담금 차등징수 방안(3차년까지의 효과임)은 1.0% 미만 사업주는 86만원, 1.0-1.5% 사업주는 64만원, 1.6-2.0% 미만 사업주는 58만원의 부담기초액을 부과할 때 고용률은 1.35%에서 1.53%로 증가(1.6-2.0% 미만 사업주는 의무고용률 2%를 달성)하고, 미고용인원의 감소로 장애인의 일자리는 8,836개가 감소하는 것으로 나타났다. 그리고 기금은 부담금이 58억원 감소하여 수지는 악화되었다. 이상의 네 가지 방안은 모두 장애인의 고용증대를 가져온다는 측면에서는 유효하지만, 장애인의 일자리 확대를 통한 중증장애인의 고용을 증대한다는 정책목표를 달성하는 데에는 한계점을 안고 있기 때문에 어느 한 정책만을 선택하기보다는 정책효과를 극대화하기 위해 정책결합(policy mix)을 이용하는 것이 바람직함을 제시해주었다. 즉, 의무고용 적용대상자 조정방안/의무고용률 상향조정 방안과 중증장애인 가산제도/부담금 차등징수 방안을 조합 또는 모두 동시에 선택하는 경우 의무고용 사업체의 장애인 일자리 수의 확대와 중증장애인 고용을 동시에 달성하고, 기금의 수지균형도 달성 가능한 것으로 나타났다. The mandatory employment quota system of Korea does not reflect the changing external factors such as the growing population of people with disabilities(PWDs) and the enactment of the Anti-discrimination Law for People with Disabilities. The current employment quota system focuses on people with mild disabilities thus excluding people with severe disabilities from employment. The purpose of this report is to propose a plan in order to increase employment opportunity for the severely disabled through the reform of the employment quota system. This report analyzes the following : (1) exclude grade 6 disability from mandatory employment quota (2) raise the employment quota from 2% to 3% (3) implement the double counting for employers that employ the severely disabled (4) differentiate the amount of levy collected from corporations that are unable to meet the quota. The aforementioned plans are useful in that they increase employment for people with disabilities. However, there are limitation to reaching the policy objectives by increasing jobs for people with severe disabilities. Therefore, to maximize the effects we should consider policy mix of these four policies. In other words, by mixing the policies of adjusting the employment quota target/raising the quota ratio and implementing the double count/differentiating the amount of levy, we can achieve the goal of increasing jobs for the severely disabled and maintain equilibrium between incomings and outcomings.

관상동맥 스텐트 시술 후의 재협착에 관한 연구

김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.

사용종료매립지 환경현황 및 사후관리대책

김은호,박진식,김정권,안종수,성낙창,김수생,박출재 동아대학교 환경문제연구소 1996 硏究報告 Vol.19 No.1

In this study, we can be obtained the following conclusions about the present environmental conditons and the post management of the expired landfill. 1. The component ration in paper, vinyl·plastic and leather·rubber of combustible amounts to much more than others. In the future, decompositions will be delayed considerably, due to these. 2. Except heavy metals in leachate, each of analysis value change considerably, but are equal to the component of general leachate. 3. The soils of lower part in landfill do not differ greatly from surrouding soils. soil pollutions with heavy metals in general domestic waste proved to be concerned greatly. 4. All of landfill facilites are poor in enviromental, and the post management is rearly controlled, so the proper countmeasure preparation is urgent.

Palmes Tube를 이용한 지역별 NO₂농도와 직종별 NO₂개인 폭로량에 관한 연구

김준연,박순우,김동일,장봉기,정경동,김두희,홍대용,정갑열,김용규,이종섭,유일수,김정만 동아대학교 의과대학 부설 산업의학연구소 1992 산업의학연구소 논총 Vol.- No.1

Indoor air quality is important to human wellbeing because people their spend much of time indoors. Current efforts to reduce ventilation rates in building may conserve energy but may also passibly empair human health and welfare through increased levels of indoor contaminants. Nitrogn dioxide( NO₂)has been regarded as one of the important indoor air pollutants. This report updates the assessment of NO₂concentrations at indoor & vehicle road and personal NO₂exposure levels by job groups in four urban cities. NO₂concentrations were measured using the diffusion tube method on 671 subjects in four cities(Pusan, Taegu, Chinju. Iri) from Dec. 1988 to Feb, 1989 and from Dec. 1989 to Feb. 1990. The results of the study obtained were as follows. Ⅰ. Indoor & vehicle road NO₂levels 1. The mean NO₂level was 37.8±19.6(8∼189)ppb and the highest with 42.2±20.5ppb at Bus & Taxi. 2. The NO₂levels by area were as follows: Pusan city, 38.3±20.3ppb: Taegu city, 41.1±17.6ppb: Chinju city, 33.0±19.4ppb: Iri city, 35.8±20.6ppb. 3. The site of the highest NO₂level in Pusan, Taegu, Chinju and Iri city were as follows: Bus & Taxi, 45.4ppb: Vehicle road, 50.8ppb: Bus & Taxi, 37.5ppb: Bus & Taxi. 45.0ppb. Ⅱ. Personal NO₂exposure level 1. The mean level of personal NO₂exposure was 42.7 ±23.1(6∼145)ppb and the highest with 54.0±25.5ppb at office workers. 2. Personal NO₂exposure levels by area were as follows: Pusan city 44.8±20.2ppb: Taegu city, 50.6±24.3ppb: Chinju city, 47.1±23.2ppb: Iri city, 48.0±27.0ppb. 3. The job group of the highest personal NO₂exposure level in Pusan, Taegu, Chinju and Iri city were as follows: Office workers, 50.3ppb: Bus & Taxi drivers, 63.8ppb: Office workers, 59.8ppb: Office workers, 60.0ppb.

EGFR 돌연변이와 ROS1 전위를 동시에 가진 폐선암 환자의 Erlotinib 치료 1예

김민환,박예현,박혜정,지아영,송창호,진무년,김영주,김선욱,이중희,김인수,김혜련,김주항,조병철 Ewha Womans University School of Medicine 2014 EMJ (Ewha medical journal) Vol.37 No.1

The rearrangement of c-ros oncogene 1 (ROS1) has been recently identified as an important molecular target in non small cell lung cancer (NSCLC). ROS1 rearrangement and epidermal growth factor receptor (EGFR) mutation were mutually exclusive each other in previous studies, and the clinical implication of co-existence of the two genetic alterations has not been determined. We report a case of 46-year-old female never-smoker NSCLC patient whose tumor harbored ROS1 rearrangement and EGFR mutation concomitantly. She had undergone curative surgery for stage IIIA NSCLC, and the recurrence in left pleura and brain occurred at 2 years after the surgery. She received several lines of chemotherapy including docetaxel plus carboplatin, erlotinib, pemetrexed, and gemcitabine. Erlotinib therapy showed a favorable treatment response with progression-free survival of 9.5 months and partial response of tumor on radiologic evaluations. This case represents a successful erlotinib treatment in a NSCLC patient with concurrent ROS1 rearrangement and EGFR mutation.

하지 분절 각도에 따른 수의 등척성 수축(MVIC)시 근전도 비교

김정자,이민형,김연정,채원식,한윤수,권선옥 한국운동역학회 2005 한국운동역학회지 Vol.15 No.1

J. J. KIM, M. H. LEE, Y. J. KIM, W. S. CHAE, Y. S. HAN, O. KWON. Comparison of the maximum EMG levels recorded in maximum effort isometric contractions at five different knee flexion angles. Korean Journal of Sport Biomechanics, Vol. 15, No. 1, pp. 197-206, 2005. The purpose of this study was to quantify the maximum EMG levels and determine if there are differences in these EMG levels with respect to different knee flexion angles. Eight university students with no known musculoskeletal disorders were recruited as the participants. The maximum voluntary isometric knee extensions and flexions were taken from each participant sat on the isokinetic exercise machine (Cybex 340) at five different knee flexion angles (10?30?50?70? 90?. After surface electrodes were attached to rectus femoris, vastus medialis, vastus laterlis, biceps femoris, and semitendinosus, maximum EMG levels at five different knee flexion angles were measured. The results showed that there was no significant difference in maximum EMG levels among five different knee flexion angles. Although there was no significant difference in EMG levels and were some variations among different knee flexion angles, the EMG signals of quadriceps in extension and biceps femoris in flexion were the greatest at 30? It seems that different joint angles or relative locations of body segments might affect the magnitude of EMG levels. Because the maximum EMG levels could change with a different knee flexion angle, an attempt should be made to more accurately measure these values. If then, %MVIC measure provides more reliable data and is most appropriate for EMG normalization.