스웨징(swagging) 작업자에서 수지진동증후군 및 신경전도장애

김성아,김상우,정상재,이채용,김규상,정보우,박상규 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.2

목 적 : 스웨징작업자들에서 발생한 수지진동증후군 사례를 실제 진동수준 평가와 함께 보고하고, 진단시 신경전도검사의 소견에 대한 해석을 검토하고자 하였다. 방 법 : 2001년 4월과 5월에 구미소재 스웨징작업 종사자 8인을 대상으로 병력문진, 자각증상평가, 이학적 검사를 실시하고 수지진동증후군의심자 4인에대해 냉각부하검사와 신경전도검사를 실시하였다. 작업장조사는 진동측정장비들을 이용하여 실제 작업환경에서 측정후 국제표준화기구에 따라 평가하였으며, 수근관증후군의 동시 가능성을 알아보고자 인간 공학적 요인에 대해 조사평가 하였다. 6개월후인 12월에는 이들 4인에 대해 진동각검사와 싱경전도검사를 추적검사하였다. 결 과 : 진동수준은 주파수가중가속도값이 단일작업은 0.99∼10.79 m/sec^2, 2개의 복합작업은 3.03 ∼12.98 m/sec^2로서 ISO의 권고치를 초과하고 있었다. 1차 대상근로자 8인의 근무기간은 평균 8.7년(범위 0.8∼15)이었고, 1인은 당뇨병자이었다. 스톡홀름 분류에 의한 증상평가, 손톱압박검사, 진동각검사에서 비교적 진동노출수준과 비려하여 임상소견을 나타내었고, 2차 평가대상자 4인의 경우 신경전도검사에서 1인은 정상, 2인은 수근관증후군, 1인은 말초신경병증으로 해석되었다. 그러나, 문헌 고찰을 통해 수근관증후군으로 나온 신경전도검사결과는 오히려 진동으로 인한 다병소 신경장해로 판단하였다. 6개월후 추적 신경전도검사에서 4인 모두 진동으로 인한 다병소 신경자해를 확인하였다. 그러나, 1인에서는 수근관증후군의 동시존재 가능성을 고려하였다. 결 론 : 고정된 진동공구인 스웨징사용자들에서 수지진동증후군발생을 확인하고, 진동노출수준을 실제로 측정하여 그 양-반응관계를 동시에 평가하였다. 신경전도검사의 해석과 관련하여 수지진동증후군에서 종종 동시 존재하는 수근관증후군과의 연관성 및 감별점을 실례로써 제시함으로써 향후 진동장해를 평가하는데 도움을 주고자 하였다. Objectives : To investigate the hand-arm vibration syndrome (HAVS) among symptomatic swagging workers exposed to hand-arm vibration, using medical evaluation and measurement of workplace vibration. Furthermore, to evaluate the neurophysiological findings. Methods : Four workers showing symptoms relevant to HAVS were evaluated. Medical evaluation consisted of medical interview, questionnaire, nail-bed compression test, and sensory perception tests for vibration and pain. Some other diseases were excluded by a medical interview, hematological assessment, and urinalysis. Cold provocation test was used to assess the peripheral vascular changes, and a nerve conduction velocity (NCV) test was implemented to ascertain the peripheral neural changes. Pegboard, hole plate, and tapping board tests were performed to assess motor nerve function. The hand-arm vibration acceleration levels of the swagging machines were measured. Six months later, follow-up NCV tests were performed. Results : The actual exposure time to vibration was not longer than 15 minutes per day. The hand-arm vibration acceleration levels of the swagging machines, according to actual exposure time, were from 3.63 to 12.98 m/sec^2, by ISO 5349. The vibratory perception thresholds and the recovery time of a nail color following finger cooling were significantly increased in all four workers. The perception of pain was mildly increased. The nerve conduction studies at first diagnosis and follow-up showed multifocal neural impairment caused by vibration. However, we could not rule out the concomitant presence of the carpal tunnel syndrome in one worker. Conclusions : These results show that HAVS can be caused by hand-arm vibration in swagging workers. Interestingly, the NCV results suggested that vibration-induced neural conduction impairments could vary, and need to be interpreted cautiously.

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.

췌장염에 의한 가성낭종내에 생긴 가성동맥류 : 1례 보고

오연희,이채경,김승현,이성우,양창현,이정호,이영현 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

만성 췌장염의 합병증으로 생긴 가성동맥류는 드문질환으로, 반복적으로 다량의 출혈을 일으킬 수 있으며, 치료를 하지 않을 경우 사망율이 높기 때문에, 조기 진단과 치료가 필수적이다. 저자들은 38세 남자 환자에서 췌장염의 합병증으로 생긴 가성낭종내에서 발생한 가성동맥류 1예를 경험하였기에 보고하는 바이다. 가성 동맥류의 색혈류도플러상 낭종내에 양방향 흐름의 와류를 볼 수 있었다. Pancreatic Pseudoaneurysm within Pseudocyst from Pancreatitis: 1 Case Department of Diagnostic Radiology and Internal Medicine, College of Medicine,DongGuk University Yeon Hee OH M.D., Chae Kyeong Lee M.D., Seoung Hyeon Kim M.D., Sung Woo Lee M.D., Chang Heon Yang M.D., Jung Ho Lee M.D., Young Hyun Lee M.D. Pseudoaneurysm from pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality, early detection and treatment of the pseudoaneurysm is needed. We report a case of pseudoaneurysm within pseudocyst from pancreatitis. Color-flow Doppler sonography shows bidirectional flow and turbulent arterial flow, within anechoic mass.

2형 당뇨 환자에 있어서 C형 간염의 유병률에 관한 연구

김구영,서광섭,유광렬,임병욱,채선애,강남훈,김창훈,권영우,김희수,류성태,이정환,박성우,오웅식,김정한 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.1

Background: We have doubt about the truth that Type 2 DM is associated with chronic hepatitis C infection. The aim of our study was to prove a close relationship between chronic HCV infection and type 2 DM in korean patients. Methods: We reviewed the out-patient's medical records of 466 patients with type 2 DM who visit the Sung-ae hospital from March 2000 to August 2001. Diabetic patients were analyzed for the following variables: age, sex, waist circumference, weight, waist/hip ratio, using of self monitoring of blood glucose, method of therapy, duration of disease, experience of previous transfusion, major surgical procedure, accompanied disease, liver function tests (LFT), HbA1 c. We ruled out patients with liver cirrhosis. Results: Hepatitis C virus infection was observed more frequently in patient with Type 2 DM. Of 466 Type 2 DM patients, 13 patients were infected with Hepatitis C virus (2.79%). Compared with mean prevalence of Korean population (1.3~1.6%), it's value is very high. the other hand, 21 patients were infected with Hepatitis B virus (4.5%). Such results are similar to mean prevalence of the general public (4~5%). Conclusions: Prevalence of hepatitis C was closely associated in korean patients with type 2 DM. And an increased prevalence is independent of cirrhosis.

Determinants of Korean Seniors' Travel Destination Choice Attitudes

Jung,Sung-Chae 세계문화관광학회 2009 International Journal of Culture and tourism Resea Vol.2 No.1

This study determines Korean seniors' travel destination choice attitudes. Using iterated principal factor analysis with varimax rotation analysis technique, this study identified five preference factors in travel destination choice: tourism environment, events, feeling, differentiation and culture. Duncan's multiple range test was then applied to examine the relative preference level of each of these factors in determining destination choice intention. The results indicate that the Korean senior's travel destination choice attitudes were varied between different sets of socio-demographic and travel characteristics. The gained information can serve the tourist industry as a tool for decision-making regarding tourism policy and marketing activities, and measures for determining priority of assignments aimed at improving elements of the tourist supply.

Cultural Tourism

Jung,Sung-chae 세계문화관광학회 2008 Conference Proceedings Vol.9 No.0

This study suggests and predicts the implications for managing and designing on cultural tourism in the aspect of business and management according as theoretical and practical backgrounds. It could be reached by better targeting of tourism managing or planning along with a better understanding of nature of culture and cultural tourism. Those will be reached to the main objective of cultural tourism business and management implementation. This study shows the critical level of management and development implications of culture towards managing as cultural tourism. The implementation of a better defined, better targeted market driven strategy for realizing the managerial goals will be needed. The success of cultural tourism rely heavily on the supports from and partnership with local community, and technical assistance from various levels.

노인복지와 관광:스페인 노령자관광 촉진제도

鄭聖彩 湖南大學校 1996 호남대학교 학술논문집 Vol.17 No.1

The UN predictions show that world's population over 70 years of age will increase to 590 million by the year 2000 and to 1,100 million, 25% of the total world population, by the year 2025. This social trend forecasts a change in the world tourism market structure. Under such circumstances, more ways should be developed for the elderly to spend their large amount of leisure time effectively. Tourism is treated as a human right in our modern society, and the law, in maintaining a standard for quality of life, declares that everyone has a right to enjoy his or her tourism activities. However, due to the fact that tourism acitivities are generally dependent on the economic power in practice, the elderly who have no fixed remunerations and income might find it impossible to participate in the tourism activities in today's modern capitalist societies, which tend to emphasize profitable business rather than public business. In Spain, the public organizations organized by the central government, local governments, parliaments, religious and public welfare clubs, and others try to support welfare tourism for the elderly. These organizations contribute towards the achievement of welfare tourism for the elderly. This study examines the welfare tourism system for the elderly in Spain. In Korea, which does not have such a system and tries to promote the welfare for the elderly, the information presented in this study may be helpful as a benchmark to central and local government and other parties interested in formulating policy programs aimed at elderly travelers. If Korea put such a system in operation, the system can help: 1) to promote welfare for the elderly who can become depressed and aimless in their last stage of life. and 2) to accelerate tourism industry which is influenced by seasonality and create the labor power. Lastly, it can help 3) to resolve the serious tourism deficit due to the drawing the elderly tourists going abroad.

동종 말초혈액 조혈모세포를 이용한 다양한 임상적용에 관한 단일병원 경험보고

채의수,손상균,성우진,서광운,박성원,김종광,정진태,이난영,서장수,이규보 경북대학교 병원 2002 경북대학교병원의학연구소논문집 Vol.6 No.1

배경:동종 말초혈액 조혈모세포 이식은 골수이식에 비해 많은 양의 조혈모세포 및 T―림프구 이식으로 인해 빠른 회복이 가능하며 강력한 이식편대종양반응이 유도될 수 있는 장점이 있어 이를 잘 응용한다면 악성 혈액질환에서 치료율을 높일 수 있을 것으로 사료된다.본 연구에서는 동종 말초혈액 조혈모세포 이식의 장점을 이용한 다양한 임상적용을 소개하고자 한다. 방법:경북대학교병원 조혈모세포 이식센터에서 동종 말초혈액 조혈모세포 이식을 시행한 증례 중에서 동종 골수이식수술에 비해 말초혈액 조혈모세포 이식이 유리할 것으로 생각디는 재발의 가능서이 높은 악성질환에서의 더욱 강력한 이식편대종양반응 유도를 위한 동종 말초혈액 조혈모세포를 이용한 예방적 공여자 림프구주입 등의 임상적용을 시도한 증례 및 결과를 분석하였다. 결과:17례의 재발의 가능성이 높은 고위험군의 악성 혈액질환을 대상으로 한 동종 말초혈액 조혈모세포 이식에서 90일 이내의 치료와 관련된 사망률은 23.5%이었고 중앙 추적기간 563일(범위 120∼926일)간의 무병생존율은 35.3%이었다.CSF로 가동화한 말초혈액 조혈모세포를 추가적으로 수혈받은 환자 7명 중 4명(57.1%)이 중앙 추적기간 538일(범위120∼926일)째에 완전관해 상태로 생존 중에 있다.그 외 말초혈액 조혈모세포를 아용한 미니 이식,동종 말초혈액 조혈모세포를 이용한 예방적 stepwise dose-increment 공여자 림프구주입술 등을 시행한 증례에서 장기 생존의 결과를 보여주고 있다. 결론:동종 말초혈액 조혈모세포 이식은 많은 양의 조혈모세포 및 T-림프구의함유로 인해 높은 생착률과 빠른 회복,강력한 이식편대종양반응 등이 유도되는 장점이 있으므로 기존의 골수이식술에 비해 보다 광범위한 임상적용이 가능하리라 사료된다. Background: It is apparent that more stem cells can be harvested by mobilization treatment with recombinant human G-CSF and/or GM-CSF from normal healthy donors in allogeneic peripheral biood stem celltransplantation(allo-PBSCT) compared to allogeneic bone marrow transplantation(allo-BMT).It is also known to be more effective in inducing the graft-vs-tumor affects than allogeneic BMT because of higher T cell content. Methods: A variety of clinical applications with allo-PBSCT was done for patients with hematoligical malignancies with a high risk of relapse in sigle transplantation center. We reported the preliminary results on trial of allo-PBSCT followed by planned prophyactic G-and/or GM-CSF primed donor lymphyocyte infusion additionally reserved at harvest in hematological malignancies with a high risk of relapse and also presented the successful trial of non-myeloablative transplantation for old aged AML paient in 4th complete remission and cases with 2nd transplantation with allo-PBSCs. Results: Seventeen patients with hematological malignancies with a high risk of relapse were enrolled in trial of allo-PBSCT followed by prophylactic donor lymphocyte infysion.All patients received allogeneic PBSCT from HLA- matched sibling donor.Aeven out of 17 patients recived additional PBSCs with a median number of CD3+ CELLS OF 5.0×10^7/kg(range,3.0 to 9.9×10^7/kg), between day 41 and day 120.Four surving patients(4/7) were free of disease when last assessed(median follow-up duration, 538 days), but were suffering from chronic GVHD(1 limited and 3 extensive). A 56 year old acute myeloid leukemia patient in the 4th complete remission was successfully treated with allo-PBSCT with non-myeloablative conditioning regimen.One of 2 patients who received second transplantation with allo-PBSCT has shown a long term disease free survival. Conclusion: A merit of allo-PBSCT would allow us to design a variety of clinical applications. Allo-PBSCT might be preferable in special clinical setting such as non-myeloablative transplantation, second transplantation,or the situation in need of the strong GVL effect. And also CSF-primed PBSCs can be used for the purpose of donor lymphocyte infusion.(korean J Hematol 2001;36:214~222)

기분장애를 주소로 내원한 Binswanger씨 병 1례

채정호,전태연,윤수정,최성빈,김대진,김광수 대한생물치료정신의학회 2000 생물치료정신의학 Vol.6 No.1

We report a 70 year-old man with Binswanger's disease associated with mood symptoms. He was apparently well until 15 years ago when the treatment-resistant atypical mood symptoms had been appeared. He showed a fluctuating course in mental disturbance, such as irritable and labile affect, emotional incontinence, and irritable behavior. Two years ago, he was diagnose as hypertension, renal failure, and heart failure. He was admitted to psychiatric ward due to irritable mood, dysarthria, lack of bladder control, gait disturbance, and impulsive behaviors, which had been aggravated during the last 2 months. In physical examination, he had hypertension and both pretibial pitting edema was revealed, and also in neurological examination, exaggeration of deep tendon reflexes and weakness of extremities were found. On mental status examination, he showed irritable and labile mood with mild cognitive disturbances. Brain MRI demonstrated multifocal high signal intensity in periventricular white matter, both basal ganglia, and thalami on the T2 imaging. These findings were compatible with Binswanger's disease with mood symptoms.

Interleukin-1β와 tumor necrosis factor-α가 마우스 조골세포의 nitric oxide 생성에 미치는 영향

채종성,고선일,김정근 단국대학교 치의학연구소 1996 논문집 Vol.8 No.1

Bone remodeling is characterized by the coupling of osteoclast-mediated bone resorption and osteoblast-mediated bone formation. The process is tightly regulated at the local level by an incompletely known complex network of humoral factors produced in the bone microenvironment, including peptide as well as non-peptide molecules. Nitric oxide(NO) is recently identified messenger molecule regulating a wide range of functions throughout the body but little is known about its possible role in skeletal metabolism. Many other cells, including macrophages, hepatocytes, chondrocytes and bone marrow cells, also produce NO. Recently, NO was reported to inhibit osteoclastic bone resorption in vitro, and there are indications of an arginine-dependent NO pathway in osteoblasts and osteoclasts. In this study we present evidence that mouse osteoblasts can be induced to produce NO by cytokines (interleukin-1β (IL-1β), tumor necrosis factor-α (TNT-α) known to modulate bone cell activity. The observed results were as follows. 1. In case of 24 hr incubation with IL-1β, NO production of MC3T3/E1 cells was not stimulated. But significant amounts of NO were measured after 48 hr incubation. In case of TNT-α, significant amounts of NO were measured after 24 hr, and increased further during the next 48 hr followed by a much slower increase up to 96 hrs. 2. IL-1β stimulated NO production into cultured medium in cultures of MC3T3/E1 cells dose dependently (0.4, 0.2, 1 ng/ml). 3. TNT-α stimulated NO production into cultured medium in cultures of MC3T3/E1 cells dose dependently (0.2, 1, 5 ng/ml). 4. Cytokine combination increased NO production dose dependently. And synergistic effects of the two cytokines were observed at all dose combinations.