노인 외상 환자의 중증도 분류 시 Triage-revised Trauma Score의 의의

양영모,하영록,정성필,김승환,유인술 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Backgrouds: The mortality of geriatric trauma patients is higher than that of other age groups. However, little research has been done the methods or criteria of triage for geriatric trauma patients. This study evaluated a clinical significance of the triage-revised trauma score(t-RTS) for triage of geriatric trauma patients. Methods: We retrospectively analyzed clinical data on 528 trauma patients over 65 years of age who were treated from Jan 1999 to Dec 2000. The t-RTS was calculated utilizing the RR(respiratory rate), SBP(systolic BP), and GCS scores and the ISS was abstracted from the final diagnosis. The obtained t-RTS and ISS were evaluated using the measures of sensitivity, specificity, accuracy, and AUC curve. Results: The overall mortality rate was 9%, and there was no significant differences between the survival group and the mortality group according to age and sex. The mean scores of SBP, RR and GCS of the survival group were significantly higher than those of mortality group(p=0.001). The mean of t-RTS and RTS of the survival group were also significantly higher(p=0.001), but the ISS was significantly higher in the mortality group(p=0.001). The t-RTS, RTS, and ISS showed good prediction rates on the ROC curve(p=0.001), and the AUC value was higher in the ISS than in the t-RTS and the RTS. The sensitivity and the accuracy were high in the t-RTS and the RTS, and the specificity was high in the ISS. The t-RTS is less than 10 for a survival probability of 50% or less Conclusions: Implementation of the t-RTS in the triage of geriatric trauma patients in the field and in emergency room would be very useful. The probability of death in geriatric trauma patients is high when the t-RTS is less than 10.

울산 석유화학공단 인근 어린이들의 혈액상변화 및 면역기능

이충렬,유철인,이지호,이헌,김양호 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

목적 : 지역 특성상 휘발성 유기화합물, 분진, 악취 등 환경오염의 영향을 많이 받는 것으로 추정되는 울산석유화학공단 인근 어린이들의 혈액상 변화, 계절 차이에 의한 혈액상 변화와 면역기능에 미치는 영향을 평가하기 위하여 본 연구를 실시하였다. 방법 : 2000년 4월, 7월, 10월 3회에 걸쳐 석유화학공단 인근 A 초등학생 46명(남자 32명, 여자 14명), B 초등학생 97명(남자 49명, 여자 48명)과 교외지역의 A 초등학생 95명(남자 47명, 여자 48명)을 대상으로 일반혈액검사, 백혈구 백분율 검사를 실시하였으며 7월 조사 때는 B 및 C 초등학생 11세 남자 각각 25명을 대상으로 면역학적 기능검사를 실시하였다. 결과 : 3차례에 걸쳐 진행된 검사결과는 계절별로 다른 양상을 보여 주었다. 즉, 총백혈구수, 호중구수, 림프구수는 A와 C 초등학생은 7월 조사에서는 감소되었다 다시 10월 조사 때는 다시 증가하는 경향을 보여주며, B초등학생은 계절별 변화가 거의 없는 것으로 나타났다. 적혈구수는 B와 C 초등학생은 7월 조사시 감소되었다가 10월 조사 때는 다시 증가하는 양상을 보여주나 A 초등학생은 갈수록 감소하는 경향을 보여주었다. 혈색소량의 변화는 적혈구수의 변화와 유사하였다 혈소판수는 모두 7월 조사 때는 감 소되었다가 10월 조사 때는 다시 증가하는 양상을 보여주었다. 조사시기에 따라 각 학교 어린이들간에 혈구세포수의 차이가 있음을 구명하기 위하여 generalized linear model의 repeated measures ANOVA를 시도한 결과 연령과 성을 공변인으로 보정한 후의 P 값에서 조사시기의 차이와 학교간 차이의 교호작용변수(interaction variable)는 모든 혈구세포에서 유의한 것으로 나타났다(P<0.05). 이는 조사시기에 따라 각 학교어린이들간에 혈구세포수의 차이가 유의하게 다르다는 것을 의미한다. 면역기능 평가를 위하여 혈중 immunoglobulin 측정 및 림프구 아형 분포분석을 B 및 C 초등학생 6학년 남학생 각 25명, 총 50명을 대상으로 실시하였으나 모두 정상범위이었고 학교간 차이도 없었다. 결론 : 휘발성 유기화합물 같은 물질에 쉽게 영향을 받을 수 있는 백혈구와 적혈구 등의 혈구세포는 조사시기에 따라 각 학교어린이들간에 혈구세포수의 차이가 유의하게 나타남은 각 학교 어린이들간에 조사시기에 따라 혈구세포수에 영향을 주는 휘발성 유기화합물의 노출량의 차이가 중요한 원인 중 하나일 것으로 추정된다. 향후 혈구세포의 변화의 원인이라 추정되는 휘발성 유기화합물의 기중 농도측정이나 체내 생체지표검사를 통한 노출원 조사를 병행하는 추가적 조사가 필요한 것으로 사료된다. Objectives : To evaluate the hematological changes and the immunological function of children living near the petrochemical estate in Ulsan. Methods : The study subjects comprised of 238 children who consisted of 143 children living near the petrochemical estate and 95 children living in a suburban area. We conducted the hematological examination 3 times, in April, July and October. Also we evaluated the immunological function of some children in July. To confirm differences between schools repeated measures ANOVA of generalized linear model was done controlling age and sex as covariates. Results : The blood cell counts of children showed differences between schools in accordance with the survey month. The total WBC, neutrophil, and lymphocyte counts of children living in a suburban area decreased in July and increased in October again, but those of some children living near the petrochemical estate did not changed distinctly. The RBC counts of children living in a suburban area decreased in July and increased in October again, but those of some children living near the petrochemical estate decreased as time passed. The changes of the amount of hemoglobin of all study subjects were similar with those of RBC. The platelet counts of all study subjects decreased in July and increased in October again. In the generalized linear model, school was a significant independent variable for the total WBC, RBC, and platelet counts, and sex was a significant independent variable for the RBC counts. Age was a significant independent variable for the iymphocyte and platelet counts. P values of all blood cell were statistically significant in interaction variable between the survey month and school, and those of the total WBC, neutrophil, and iymphocyte counts were statistically significant in interaction variable between the survey month and age. The immunological function showed no significant difference between study groups. Conclusions : The total WBC and RBC counts which would be easily affected by volatile organic compounds (VOCs) in the atmosphere showed differences between schools in accordance with the survey month. This suggests that the amounts of exposure to VOCs are different among each school children in different months. To ascertain the hematological changes by VOCs, an additional study evaluating the concentrations of atmosphere of VOCs and biological monitoring of some VOCs is needed.

정사각 덕트의 출구 영역에서 속도분포에 대한 실험적 연구

유영태,모양우,나기대,임인호 朝鮮大學校 機械技術硏究所 2002 機械技術硏究 Vol.5 No.2

A numerical simulation has been performed with the non-linear turbulence model proposed by Speziale(1987) coupled with the k-ε equations coming from the renormalization group theory(RNG) derived by Yakhot et al(1992). The fully developed turbulent flow through a straight square duct, involing secondary motion is simulated. This paper represent computations of the interaction between measurement and numerical computation of turbulent flow on velocity distribution of outlet region in a square duct. RNG turbulent model was adapted and compared with the experimental data and the result of Standard k-ε turbulent model. The predictions obtained with the RNG k-ε model show improvements when compared with the Standard k-ε model. Mean velocity, turbulence kinetic energy and Reynolds shear stresses are in quantitiative agreement with the experimental data. We feel that the RNG k-ε model suggested in this paper can be a useful turbulence model for practical engineering

Monocrotaline투여 백서 폐동맥고혈압에서 폐혈관내피세포와 폐신경내분비세포의 변화에 대한 형태학적 연구

양우익,조상호,최인준,이유복 대한병리학회 1992 Journal of Pathology and Translational Medicine Vol.26 No.6

보조공학기기 이용실태 및 서비스 희망에 대한 심층면접

정민예,김정란,양노열,유인규,박혜연 대한보조공학기술학회 2009 대한보조공학기술학회지 Vol.1 No.1

목적 : 구직장애인, 장애인공무원과 지원을 많이 받아보지 않은 사업주를 대상으로 심층면접을 통해 보조공학기기 이용실태 및 서비스 희망을 조사하고, 이를 통하여 앞으로 보조공학서비스 서비스 방향을 제안하고자 조사하였다 연구방법 : 심층면접의 대상자는 장애인공무원, 구직장애인, 사업주로 분류하여 반구조화된 가이드라인 설문을 구성하였다. 면접 대상은 설문조사를 위한 모집단 중 무작위로 추출하여 면담 조사에 협조를 약속한 대상자 사업주 7명, 구직장애인 7명, 장애인공무원 5명을 대상으로 총 19명이 응답에 참여하였다. 결과 : 수집된 자료는 질적 분석 절차를 통해 보조공학기기의 사용경험, 보조공학기기 신청경험 또는 개인적 구입경험, 장애유형에 관련된 보조공학기기의 사용경험여부 및 인식조사, 보조공학서비스에 대한 인식정도 및 이용경험과 보조공학서비스 방향과 추가로 제공을 희망하는 서비스 내용 5가지의 주제가 도출되었다. 결론 : 보조공학서비스의 보다 효율적인 운영방식을 고려해야 할 것이며, 보조공학서비스를 할 때 구입이나 사후 관리도 보다 사용자 중심에서 서비스 제공이 필요할 것이다. Objective : The purpose of this study was to provide the information about the actual demand and use of assistive technology among people with disabilities who not received assistive technology service. Methods : In-depth interview subjects were government officials with disable, disabled job seekers, and employers hiring workers with disabilities. We made up the semi-structure guidelines question with group into three classes. We asked for an interview with subjects that choose samples at random. Results : These results show five themes related to use and application experience in assistive technology, the awareness of assistive technology service, and the demand to make of assistive technology service. Conclusion : In conclusion, we suggests that they want to be included assistive technology services target and replied use of those assistive devices will help them to get a job or to improve work efficiency and capacity.

PC12를 이용한 신경세포 허혈모델에서 irp94 유전자의 발현

김승환,양영모,하영록,정성필,유인술,김인병 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: The ischemia responsive protein 94 kDa(irp94) gene belongs to the heat shock protein 110 family and was isolated in 1999 from rat brain by transiently induced forebrain ischemia. The PC12 cell is the pheochromocytoma cell line of rat, which is differentiated to a sympathetic neuron-like cell by the stimulation of a nerve growth factor. This study is to determine whether irp94 is expressed when an ischemia-like condition is induced by ATP depletion in cultured PC12 cells in vitro. Methods: PC12 cells were maintained as monolayer cultures in RPMI-1640 medium(Sigma) supplemented with 10% horse serum, 5% fetal bovine serum, 5 mg/ml transferrin, and 1 mg/ml insulin in a humidified 5% CO2 incubator at 37℃. The ATP depleting agent antimycin A was added at concentrations of 1, 2.5, and 5 μM to simulate ischemia, and 10 μg/ml of tunicamycin, which is expected to express heat shock protein maximally, was used as a positive control. The cells were harvested after a 60-minute incubation, and the total RNA was extracted. The reverse transcription polymerase chain reaction(RT-PCR) was performed to use 501 bp irp94 cDNA as a molecular probe, and the expression of irp94 mRNA was analyzed by northern blotting. Results: The irp94 mRNA expression was enhanced, compared to the negative control group, as the concentration of antimycin A was increased. Conclusion: This study suggests that irp94 mRNA expression is enhanced as the severity of ischemia is increased. Thus, it is possible to investigate the mechanism of ischemic neuronal injury indirectly by using this in-vitro model of neuronal ischemia.

일 지역 농업인의 근력강화운동이 정신사회 및 신체적 건강수준에 미치는 영향

정민예,양노열,유인규,고상백,이경숙,김경란,김효철 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.4

목적 농업인을 대상으로 근골격계질환의 예방과 관리를 위한 근력강화운동을 실시하여 심리상태와 신체능력에 미치는 효과를 밝힘으로써 농작업과 관련된 향후 치료프로그램의 기초자료를 제공하고자 하였다 방법 규칙적인 운동프로그램의 참여 경험이 없는 농작업 종사자 28명을 대상으로 8주간 주 3회 근력강화운동을 실시하여 4주 이상 규칙적으로 참여한 대상자의 정신사회적 수준(자아존중감 사회심리적 스트레스) 신체적 수준(장악력 민첩성 동 정적 균형능력 근지구력) 요통 수준의 변화를 측정하였다 결과 근력강화운동에 참여한 대상자들의 자아존중감은 운동전에 비하여 유의하게 향상되었고 사회 심리적 스트레스는 유의하게 감소하였다 장악력 민첩성 동 정적균형능력은 운동 후 모두 유의하게 향상되었으며 요통 수준 또한 유의하게 감소하였다 결론 농업인에게 근력강화운동의 적용은 심리적인 안정을 주고 신체능력을 향상시켜 근골격계질환을 예방하고 관리하는데 적합한 치료프로그램으로 사용될 수 있으며 요통 수준을 감소시키는데 유용한 프로그램이었다. Objectives To evaluate both the psychosocial and physical effects of muscle strengthening exercise on farmers and in so doing evaluate their effect on musculoskeletal disorders in farmers. Methods 28 subjects participated in our muscle strengthening exercise program. Mean age of subjects was 63±13 years. The exercise program was performed 3 times a week during the 8 week studys period Before and after training various measurements were made self esteem scale (SES), psychosocial well being index short form (PWI SF), static and dynamic balance ability grip strength arm curl, time up and go (TUG), functional reach, and oswestry disability index. Results The muscle strengthening exercise program increased the self esteem grip strength and static and dynamic balance of subjects, while psychosocial stress and low back pain levels were decreased significantly (P<0.05) Conclusions The muscle strengthening exercise improved psychosocial and physical status of test subjects. Thus exercise may be an effective strategy for enhancing the psychosocial and physical health of farmers.

9축 모션센서와 힘-감지저항센서 동기화를 이용한 비정상 보행 패턴 분석

유용규(Yong Kyu Yoo),원인식(In Sik Won),문상찬(Sang Chan Moon),양효실(Hyo Sill Yang),이순걸(Soon-Geul Lee),이원구(Won Gu Lee) 대한기계학회 2015 대한기계학회 춘추학술대회 Vol.2015 No.11

Abnormal gaits such as in-toeing gait and out-toeing gait have been known to cause various types of physiological disorders in human body. Therefore, many researches up to date have been dedicated to solve this issue. However, many of the previous researches have been limited in that they hardly considered a minimal use of sensors to analyze abnormal gaits, leading to a low efficiency due to unwanted power consumption. Here, we aimed to examine what parameters or axes of the sensors can be minimized to tell a minute difference between normal and abnormal gait patterns. For this purpose, we synchronized a 9-axes motion sensor (accelerator, gyroscope, and compass) with force sensing resistor (FSR) sensors to compartmentalize the valid measurement range between heel strike(initial contact of the foot) and toe off (final contact of the foot). Through this synchronization, we found out how the number of axes in sensors could be optimized for minimal power consumption which is necessary for manufacturing wearable healthcare devices at an affordable cost.

응급실에서의 확산강조 자기공명 영상

정성필,이석우,양영모,하영록,김승환,유인술 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: This study was designed to review the cases of patients who had undergone diffusion-weighted magnetic resonance imaging(DWI) in the emergency department(ED), and to investigate its clinical usefulness and current indications. Methods: We analyzed the cases of 152 consecutive patients who underwent DWI in the ED from Jan to Mar 2001. DWI was obtained with the use of a multislice, single-shot, spin-echo plana imaging technique(GE SignaR). Imaging time was less than one minute. The medical records, the DWI films and the computed topography results were reviewed. We investigated the chief complaint, initial findings of physical examination, final diagnosis, decision-making department, interval from admission to imaging, and DWI findings. Results: DWI showed positive findings of high signal intensity in 84 patients(55.3%). Among the 68 patients who yielded a negative result, false negative occurred with 12 patients(17.6%): 10 lacunar infarctions, a pons infarction, and a brainstem infarction. Eleven patients were determined as having a cerebral hemorrhage, all of whom showed the abnormal finding of a mixed signal in DWI. The sensitivity and the specificity of DWI to rule out stroke were 85.5% and 98%, respectively. Current indications for DWI in our ED are age older than 60, alert mental status, and one of the symptoms or signs among lateralyzing sign, language disturbance, and dizziness/vertigo. Conclusion: DWI was highly specific to rule out stroke, so emergency care professionals should be familiar with this new technology. Further prospective study is required to determine the proper indications and clinical usefulness of DWI in the ED.

유기용제노출이 직업적 청력손실에 미치는 영향

이지호,고영주,이헌,강정학,유철인,이충렬,김양호 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목적 : 산업 장에서 노출되는 유기용제가 청력역치에 어떠한 영향을 미치는가를 5년 동안의 추적조사를 통하여 파악하고자 하였다. 방 법 : 유기용제와 소음에 동시에 노출된 근로자 43명과 소음노출수준, 연령, 근무경력을 짝짓기 한소음노출군을 대상으로 문진과 이경검사, 소음노출 수준, 유기용제노출수준을 조사하였다. 결과 : 1. 전체 근로자의 각 주파수별 청력역치 변화양상에서 500Hz∼2000Hz에서는 추적기간 동 소음동안 현저한 변화가 없었고, 4000Hz 및 8000Hz에서는 역치가 증가하는 경향을 나타내었다. 2.유기용제와 소음에 동시에 노출된군에서 소음 노출군에 비해 4000Hz 이상에서 청력역치가 높게 나타났으나, 통계적인 유의성은 없었다(p(0.05). 3.반복측정 분산분석 법으로 각 주파수별 평균청력 역치의 연차적 변화에 미치는 영향을 분석한 결과 유기용제 노출은 통계적으로 유의한 영향이 없었으나(p)0.05), 소음노출수준은 250Hz, 2000Hz 및 4000Hz에서, 연령은 250Hz와 500Hz에서 통계학적으로 유의한 영향을 미치는 것으로 나타났다(p(0.05). 4.소음노출군파 동시노출군 각각에서의 청력역치 변화량을 paired t-test로 비교한 결과 250Hz∼4000Hz에서는 통계학적 유의성이 없었으며(p(0.1), 8000Hz에서만 경계치 (p=0.0884)의 유의성을 나타내었다. 5.요인들의 영향을 보정한 상태에서 관찰하기 위해 관찰기간동안의 청력역치변화량을 종속변수로 두고 일반선형모형을 이용하여 주파수별로 관찰한 결과 8000Hz에서만 모델에 통계학적 유의성이 있었으며 (p(0.05), 여기서 소음노출수준이 통계학적으로 유의한 영향을 미치는 것으로 나타났고(p(0.05), 유기용제노출은 경 계수준이 었다(p=0.087). 결론 : 청력에 대한 유기용제의 영향이 소음과 연령에 비해 상대적으로 미미하여 명확한 결론에 이르지는 못하였으나, 다소 영향이 있는 것으로 생각되어 유기용제의 영향에 대한 추가연구가 필요할 것으로 판단된다. 또한 보다 효과적인 근로자들의 청력관리를 위해서는 소음 외 산업 장에서 동시에 노출되는 여러 유해물질들을 고려하여야 할 것이다. Objectives : This study was to evaluate the impacts of simultaneous exposure to noise and mixed solvents on workers'hearing threshold level (HTL) over five-year period. Methods : The study was conducted by interview and annual audiometric test on workers in ship building industry from 1994 to 1998. The cases(workers who exposed to noise and mixed solvent simultaneously) were 43 male workers and controls (workers who exposed to nolle) were selected by matching method with regard to age, sex, carrier, and noise exposure level. To assess the impacts of solvent exposure on hearing threshold level, with considering other factors, general liner model was used. Results : 1. The audiogram of all subjects showed typical sensorineural hearing loss pattern. The mean HTLe were increased at high frequency (4000HB and 8000Hz) for study period. 2. The HTLs of cases were more increased than those of controls at high frequencies (4000Hz and 8000Hz), but there was not statlstical significance. 3. The impact of age on the HTL was statistically significant at 250Hz and 500Hz (p(0.05), and the impact of noise on the HTL was statistically significant at 250Hz, 2000Hz and 4000Hz (p(0.05), but the impact solvent exposure on the HTL was not significant. 4. The changes in HTLs of cases were higher than those of controls at high frequency, there were not statistical significance at 4000Hz, but only at 8000Hz (p=0.087). 5. Statistical analysis of the general linear model implicated that the changes in HTL was impacted by noise exposure bevel significantly (p=0.031) and Impacted by solvent exposure weakly (p=0.087) at 8000Hz. Conclusions : The results of this study suggest that workers who simultaneously exposed to noise and mixed solvent were at risk for more affected HTL than those exposed to noise exposure only, but we could not find definitive evidence. Further detailed studies must be made in large number of workers.