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.

유도 '되치기 본'의 개선 방안에 관한 연구

김의환,김도준,김규수,김관현,김종달,최종삼,조용철,박순진,윤익선,안병근,정 훈,김미정,한성철 龍仁大學校 武道硏究所 1999 武道硏究所誌 Vol.10 No.1

The purpose of this study was to reform practically a Korean Judo's Doechigi-Bon(Forms of Counterattack, judo's Gaeshi no Kata, Judo's Uradori no Kata, Judo's Gonosen no Kata) that was established in 1955 Korea, according to changing of techniques by Judo's modernization, in order to have Judo's carefulness and systematic diffusion. Reform procedure of Judo's Doechigi-Bon was 1st stage, Questionnaire survey 303 judokas, 2nd stage, Technical seminar by judo experts(12 judo professor) 4 times, 3rd stage, wording report for reform, 4rd stage, Discussion and judgement of Teaching and Judgement commission of Korean judo Association(KJA), 5th stage, Public hearing for reform in KJA, 6th stage, Report and decision of board of directors in KJA, 7th stage, public publication of Judo News(No.53) in KJA. Basic principle of reform of Judo's Doechigi-Bon were as table 1. Table 1. Basic principle of reform of Judo's Doechigi-Bon ------------------------------------------------------------------------------- Items Reformed Key Points of Judo's Doechigi-Bon ------------------------------------------------------------------------------- 1. Structure 1) Grand classification : Classified by 3 parts(1,2,3Gyo) 2)Medium classification : Te waza, Goshi waza, Ashi waza devided per each part(Gyo) 3)Sub-classification : Classified five techniques per each part(Gyo) 2. Contents 1) Selected established techniques as possible 2) Considered rationalty and overlapping of counterattack techniques 3. Decision of Conterattack techniques 1) Refered to results of Basic Questionnaire survey 2) Priority to decisions of Judo expert technical seminar -------------------------------------------------------------------------------- Reformed Korean Judo's Doechigi-Bon(Forms of Counterattack techniques-KJA, 1999) are as follows: 1. Gyo; ① Uki otoshi -> Uchi mata ② Harai goshi -> Harai goshi gaeshi ③ O soto gari -> O soto gake ④ Ko uchi gari -> Sasae tsurikomi ashi ⑤ O uchi gari -> Ko soto gari 2. Gyo; ① Ippon seoi nage -> Okuri eri jime ② Tsuri domi goshi -> Uki waza ③ Okuri ashi harai -> Okuri ashi harai ④ Ko soto gari -> Tai otoshi ⑤ Hiza guruma -> Hiza guruma 3. Gyo; ① Kata guruma -> Sumi gaeshi ② Tai otoshi -> Ko soto gari ③ Hane goshi -> Harai tsurikomi ashi ④ Uchi mata -> Tai otoshi ⑤ Tomoe nage -> O uchi gari

발기부전증 환자의 MMPI 평가 분석

김헌수,김영돈,이재우,나철,이길홍,민병근,김세철 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.1

The present study was intended to examine the relationship of the MMPI mean scales in the Korean impotent and Beutler's decision rules to acertain the empirical utility of the MMPI in discriminating between organic and psychogenic erectile dysfunction. Subjects served for this study consisted of 451 patients visited to department of neuropsychiatry and urology, Chung-Ang University Medical Center from May 1, 1985 to July 31, 1987. Their age range was between 22 and 84. The actual number of cases put into the analyses was 97 including 53 psychogenic impotents and 43 organic impotents. Statistical methods employed were χ² and T score. Results of the study were presented as follows: 1) The mean overall 4-3/3-4 MMPI profile(17.7%) revealed somatic complaints, depression, conflict with spouse and emotionally unstable personality trait. However, there were no significant relationship of mean T score between psychogenic and organic impotents. 2) Applying the Beutler's rule decision, we found that our hit rate of rule I or rule Ⅱ were 12.3% and 47.2%, respectively. Applying the two rules to 97 cases, the hit rate was 60.4% with nonsignificant Chi square of 0.017. These results revealed no significant differences between psychogenic and organic subjects. Finally, we failed to examine the validity of Beutler's decision rules adapted to our 97 subjects.

당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

대학생의 노인복지에 대한 인식도

차병준,김무룡,김기열,차경미,김귀희,김현실,서인선,임상규,이순자,위광복,남철현 慶山大學校 保健福祉硏究所 1999 保健福祉硏究 Vol.2 No.-

The purpose of this study is to grasp the change of consciousness of young people in order to seek new approach of policy for aged era. 1,200 students attending collages and universities in three small or medium sized cities were inquired for 2 months, from October 1 to November 30, 1996. The result is as follows. 1. The characteristic of the respondents of this survey is that they include 72.1% of women, 40.4% of people aged between 20 to 21, and 49.1% of people who do not have any religion. Those who are from big cities and those who are form farming villages or fishing village occupy equally 40.2%, those who reside in that cities for a long period 49.0%, and those who live with their family 60.9%. 2. The family feature of the subject is that 31.5% of them are those whose father is the age of 55 and more than 55, 10% of them are those whose mothers age is so, 33.1% of them have 5 family members, 29.5% of them have the family income of 1,000,000 to 1,490,000 won, 83.9% of them are from middle class, 47.7% of them are the people whose grand parents have passed away, 70.4% of them live apart from their grand parents, and 60.9% of them are second child. 3. 64.0% of males, 70% of respondents who are aged over 24, 58.1% of respondents who are from rural communities, 62.4% of respondents who live in rural area, and 58.3% of respondents who live alone, prefer to live with grand parents, marked higher rate than other groups. The groups whose father and mother are the age of more than 55 marked higher rate of 55.9% and 58% each than any other groups(p<0.05). The groups whose family member is less than three, whose grand parents both have passed away in middle class, who live with their grand parents, and who are second children, give more positive answers than any other groups. 4. Those who are older, who are buddhists, who are from rural area or live in rural area, whose family is small, whose family income is small, who are from lower class and whose grand parents are still alive, shows preference to support their parents after marriage. 5. Females(89.4%), those who are from small or medium sized cities(89%), who live with their family(85.6%), whose father is the age of 55 and more than 55, whose mother is the age of 54 and less than 54, whose family member is 6, who are from middle class, whose grandparents are still alive and who are the eldest child in their family, give more response that they prefer to live apart from their children in their old age than any other groups. 6. What elderly people need most right now is past time(42.3%), and the respondents whose age is 20 to 21, who are buddhists, who are from middle sized cities and live alone, whose parents are the age of more than 55, who have small family income, who live with their grand parents and who are second children show higher level than any other groups. 7. 76.8% of respondents answer that they do not need their parent's fortune, marked still higher rate than the opposite answer. Those who are older, who are buddhists, who are from big cities, who reside in rural area, who live alone and have smaller family, who are in bad family economic conditions and who live with grand parents present higher rate of positive response. 8. 59.3% of respondents reply that they think about death from time to time, and those who are female, who are in the age of 20 to 21, who are christian, who live with their family, whose siblings or other family members offer their education expenses show higher rate than any other groups. 9. 92.3% of respondents answer that the budget for welfare facility for elderly people is very small. The younger the respondents are and the worse economic condition they have among those who live in big cities, the more answered that. 10. 50% of respondents think social security should provide for their old age, and 42.8% of them believe they themselves provide against it. The respondence that social security ought provide for it appeared more among those whose age are over 24, who are female, who reside in rural area, who are christian, who are in bad economic condition, and who ever used medical institutions in recent one month, marked higher level than other groups. 11. The adequate time of retirement is 59.97±5.60 for public officers, the highest and 59.28±6.35 for teachers, the next. 12. 35.2% of respondents reply that the adequate budget for the old age after their retirement at the age of 60 is 220 million won, showed the highest level of respondence. 13. The factors which affect on the old people in the charged welfare facilities are sex(p<0.01), the type of housing(p<0.05) and whole family income(p<0.05). 14. The factors which affect on remarriage are sex(p<0.05) and religion(p<0.05). For varying old population and expanded welfare service for them, government and relevant authority should give more attention to secure the budget, establish effective plans to expand various program and the facilities for elderly people in order that elderly people spend the rest of life time more happily and more fruitfully. To do that, each college and university should open Health courses, and educate and inform about health and welfare.

부산지역 소방공무원의 폐기능과 호흡기증상

김성훈,김정원,,김종은,손병철,김정호,이창희,장상환,이채관 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 본 연구에서는 소방관 집단의 호흡기 증상과 폐기능을 조사하여 호흡기 질환의 유병 정도를 비교 분석함으로써 소방관의 호흡기 질환과 화재 노출과의 관련성을 규명하고자 하였다. 방법: 2004년 11월 13일부터 동년 12월 15일까지 부산 소재 4개 소방서와 부속 파출소의 남성 소방공무원 699명을 대상으로 폐기능 검사와 호흡기 설문조사를 실시하였다. 호흡기 증상 설문은 BMRC에서 개발한 설문조사표를 이용하였다. FVC, FEV_(1), MMEF 예측치는 Morris의 폐기능 예측식을 사용하여 계산하였고, 폐기능 검사 이상을 판정하기 위하여 미국 NHNES 기준에 따라 정하였다. 폐기능 측정치와 호흡기 증상은 노출유무와 흡연여부로 집단을 나누어 각각 비교분석하였다. 유의수준은 p<0.05로 정하였다. 결과: 폐기능 비교에서 화재노출군이 FVC, FVC%, FEV_(1), FEV_(1)%, FEF_(25%)는 비노출군에 비해 통계학적으로 유의하게 저하되어 있었고, 이를 흡연여부에 따라 층화하였을 때, FVC 와 FEV_(1)은 흡연여부와 관계없이 노출 여부에 따른 차이를 보이나 FVC%, FEV_(1)%, PEFR은 흡연군에서만 차이를 보였다. 폐기능 검사 이상을 비교하면 전체적으로 화재노출군이 비노출군보다 폐기능 이상자의 수가 많았고 흡연군에서 FEV_(1) 이상자의 차이는 통계적으로 유의하였다. FVC, FEV_(1), MMEF를 종속변수로 하여 다중회귀분석을 시행하였을 때, FVC와 FEV_(1)은 부분적으로 화재노출유무와 관련성이 있었다. 호흡기 증상 조사에서 화재노출군은 비노출군에 비해 코막힘, 목아픔, 흉부압박감의 증상의 호소율이 통계학적으로 유의하게 높았으나, 이를 흡연여부에 따라 층화하면 이들 증상들은 경계역의 차이를 보였다. 결론: 이러한 결과들을 종합하면 소방관은 화재진압과정에서 노출되는 많은 호흡기 유독물질로 인해 급성 폐기능 저하와 높은 호흡기 증상 호소율을 보이며, 이는 화재노출 외에 흡연의 부가적 효과가 영향을 미친다고 생각된다. 따라서 폐기능이 저하된 경방군에서 주기적인 폐기능 검사가 실시되어야 하며, 금연과 호흡기 보호구의 철저한 착용이 권장되어야 하겠다. Objective: The purpose of this study was to evaluate the relationship between respiratory disorders and fire exposure by investigating and analyzing the lung function and respiratory symptoms of firefighters. Methods: The health effects of firefighting on respiratory function were investigated in 699 male fire officers in 4 fire departments in Busan by recording respiratory symptoms and measuring lung function. The data were analysed according to fire exposure and smoking habits. Results: Mean spirometric data showed significantly decreased levels in the fire-exposed group (FVC, -0.20 L; FVC%, -4.2%; FEV_(1) -0.21 L; FEV_(1)%, -5.1%; FEF25%, -0.13 L/SEE p<0.05). After stratification by smoking habits, FVC and FEV1 showed a significant difference between groups. The prevalence of spirometric abnormality was greater for the fire-exposed group than for the non-exposed group. Significantly higher prevalences of nasal stiffness (16.7% vs. 10.9%), sore throat (17.7% vs. 14.2%) and chest tightness (6.5% vs. 2.5%) were recorded in fire fighters compared to controls (p<0.05). However, after stratification by smoking habits, the 3 symptoms were showed only marginal differences in the smoking group. Conclusions: This study demonstrated that fire-exposed firefighters generally suffer a decline of lung function and a higher prevalence of respiratory symptoms. These results suggest that the exposure to routine firefighting activity is associated with adverse health effects to the respiratory system.

학생청소년의 불안성향과 문제행동 유형간의 상관분석

김헌수,이재우,나철,김영돈,김민호,김은희,권지란,박광식,이길홍,민병근 중앙대학교 의과대학 의과학연구소 1987 中央醫大誌 Vol.12 No.4

The purpose of the present study was to examine the relationship between their problem behavioral pattern and anxious trends among Korean student adolescent. Zung's measurement of anxiety level undergone through used of the self-rating anxiety scale. the data were collected through the questionaire survey which was conducted on Dec.1, 1983. Subjects served for this atudy consisted of 1,404 syudents in Korea, randomly sampled from Korean student population by means of census method. The data were analysed by CDC-174 computer of KAIST, using SPSS pogram. Statistical methods empoyed were χ^2 test and Eta measures. the results of this study were as follows. 1. It showed that students psychological anxious trends had greatest significant correlation with adolescent student's problem brhavioral pattern, but the cardiovascular, respiratory, gastrointestional and genitourinary anxious trends has not significantly related with student's problem behavioral pattern. 2. Students group with undersocialized aggressive, undersocialized nonaggressive,undersocialized school-norm avoidant, or socialized nonaggressive behavioral patterns were less anxious, whereas those with socialized latent aggressive, socialized sexual, or socialized modellong behavioral patterns were higher anxious.

경막내 척수외 종양의 수술적 치료

신병준,이재철,윤태경,정호원,한성우,김동원,김경제,김연일 대한척추외과학회 2002 대한척추외과학회지 Vol.9 No.3

질소산화물의 급성 노출로 인한 폐 손상 1례

김정호,김대환,손병철,이창희,김정원,문덕환,이채언,김주인 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Lung injuries due to exposure to nitrogen oxides can occur in various process in industry. We experienced a case of chemical pneumonitis induced by accidental inhalation of nitrogen oxides emitted from the bath in an acid dipping operation. Case : Dyspnea, cough and blood-tinged sputum production, cyanosis, and tachypnea occurred after exposure to oxides of nitrogen. There were bilateral diffuse ground glass opacities in simple chest radiography and high resolutional computed tomography, hypoxemia in arterial blood gas analysis, mixed ventilation defect and reduced diffusion capacity in spirometry. As an oxygen and supportive therapy, after hospitalization, was given, the patient recovered completely from the lung injury on the 8th day after admission. There was no evidence of delayed onset of bronchiolitis obliterance or pulmonary edema in a follow-up for about 6 months. Conclusions : Acid dip operation require more efficient hooding and exhausting system for the prevention of lung injuries caused by inhalation of nitrogen oxides. Also health education for worker need.

Amitriptyline 과 Desipramine, Paroxetine 은 백서의 Schwann 세포 일차배양에서 산화질소의 생성을 억제한다

김용철,이상철,김선희,임영진,함병문,김현정,정일영,박학수 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.42 No.2

Background : Antidepressants are being used as supplemental therapy in neuropathic and inflammatroy pain. The mechanism of their inhibitory effect on experimental animal inflammation is not clear. Studies during the past few years clearly indicate an important role for nitric oxide (NO) in the inflammation and pain-processing system. We evaluated the effects of amitriptyline, desipramine and paroxetine on NO production in primary Schwann cell cultures. Methods : Primary cultures of the Schwann cell were prepared from dorsal root ganglia of 1-to 3-day old Spraque-Dawley rats. Schwann cells were cultured in the presence or absence of interferon-?? (500 ng/㎖) plus tumor necrosis factor-α (500 ng/㎖), amitriptyline, desipramine or paroxetine. Production of NO was determined in the supernatant of the culture media. Results : Amitriptyline (10 ㎍/㎖), desipramine (10 ㎍/㎖) and paroxetine (10 ㎍/㎖) inhibited NO release by 29.8%, 51.4%, and 66.8%, respectively. No drug had a toxic effect on cultured cells, which was determined by an LDH assay. Conclusions : Inhibition of NO production by Schwann cells may be a mechanism by which some antidepressant medications affect inflammatory and neuropathic pain. (Korean J Anesthesiol 2002; 42: 221~227)