흰쥐 경골의 신연 골형성술에서 염증성 싸이토카인의 발현

황일웅(Il Ung Hwang),조태준(Tae-Joon Cho),최인호(In Ho Choi),정진엽(Chin Youb Chung),유원준(Won Joon Yoo),김은희(Eun Hee Kim) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.1

목적: 본 연구의 목적은 신연 골형성술에서의 염증성 싸이토카인의 발현 양상을 일반 골절 치유 과정과 비교하는 것이다. 대상 및 방법: 흰쥐 경골의 단순 골절 치유 모델과 신연 골형성술 모델을 대상으로 3주에 걸쳐서 단계적으로 골 조직을 채취하였다. 총 리보핵산을 추출하고 각종 염증성 싸이토카인 발현의 시간적 변화를 검사하였다. 수술 후 7일과 9일째에 조직에서 면역조직화학 검사를 통해서 IL-6의 공간적 발현 양상을 조사하였다. 결과: IL-1β, IL-6는 단순 골절 치유 과정에서 수술 후 1일째에 발현이 절정에 달하였다가 3일째부터 발현이 감소하여 수술 전 상태로 회복되었다. IL-1β는 신연 골형성술 중 신연 기간에도 발현의 변화가 없었으나 IL-6은 신연을 시작함에 따라 다시 발현이 증가하는 양상을 보였다. 면역조직화학 검사장 IL-6은 골수 세포 뿐 아니라 연골세포, 골모세포 그리고 신연 간격의 미성숙 간엽세포에서 발현이 확인되었다. 결론: 신연 변형력에 의한 IL-6의 발현이 유도되는 것을 확인하였으며, 이는 조절된 염증 반응이 신연 골형성술 과정에서 신생골 형성에 부분적으로 기여할 가능성을 시사하는 것으로 생각된다. Purpose: The purposes of this study were to investigate the expression pattern of pro-inflammatory cytokines during distraction osteogenesis and to compare these with expression during simple fracture healing. Materials and Methods: Regenerated bones from the rat tibia subjected distraction osteogenesis and simple fracture healing models were harvested over three-week periods. Temporal expressions of mRNA of pro-inflammatory cytokines were investigated by RNase protection assay. Immunohistochemical studies for IL-6 were performed in postoperative day 7 and 9 tissue section specimens. Results: IL-1β and IL-6 produced detectable signals, while IL-1α, TNF α and TNF β did not. The mRNA expressions of IL-1β and IL-6 were markedly upregulated on postoperative day 1 and then subsided to the preoperative level. IL-1β mRNA expression remained the same even when distraction began. However, IL-6 mRNA expression was reactivated during the distraction phase. Immunohistochemical study revealed the expressions of IL-6 not only at the transitional zone of the transchondroid ossification, in young osteoblasts lining newly formed trabeculae and in hematopoietic cells in the marrow but also in primitive mesenchymal cells at the distraction gap. Conclusion: Distraction strain re-induced IL-6 expression during distraction osteogenesis, which suggests that well-controlled inflammatory reaction might contribute to active new bone formation in distraction osteogenesis.

현역 부적합 심의에 회부된 병사들에 대한 원인인자 연구

황일웅 ( Hwang Il-ung ),서지원 ( Seo Ji Won ) 국군의무사령부 2012 대한군진의학학술지 Vol.43 No.1

When a soldiers shows malbehaviors or symptoms of maladjustment, the commander of the unit refer him to a special committee which consider the premature discharge. This study aimed to show the demographic features and personal background which affect the behavior of the soldiers. 477 soldiers who were referred to the committees held in army HQ, TROKA, and FROKA from January to October, 2010 were the subjects of this study. Family status could can be reviewd in 465 soldiers. 33% of soldiers were from broken families. Their parents were divorced, separated, or one of them was died. 3 soldiers(0.6%) had middle school graduation as their last education record. 140 soldiers(29%) had high school graduation, and 334 soldiers(70%) had the education record higher than highschool. 283 soldiers were students of colleges or universities. 86 colleges or universities were listed and 22 universities had multiple soldiers. a target for bullies, internet addiction, diseases, illegal behavior, suicidal attack, and homosexuality were reviewed. 331(69%) soldiers had one or more items of the list before army. 5 soldiers(1%) had 5 of 6. The most common diagnosis made in the army before the committee was maladjustment. The second one is personality disorder. The date of the first symptom could be reviewed in 170 soldiers. The earliest was 2nd day of army and the latest was the 387th day. In average This soldiers show their first symptom on 74.4th day. Statistic analysis was done between the date of first symptom and the period of service, the diagnosis and the period of service. No significance was found.

한국군 병사에서의 브루가다형 심전도의 유병율

황일웅 ( Hwang Il-ung ),이희경 ( Lee Hee Kyeong ),고재경 ( Ko Jae Kyung ),고현범 ( Ko Hyun Bum ),김경애 ( Kim Kyung Ae ),최훈정 ( Choi Hun Jung ) 국군의무사령부 2010 대한군진의학학술지 Vol.41 No.1

Objective: Brugada syndrome(BS), accounting for 40∼60% of indiopathic ventricular fibrillation(VF), is one of main causes of sudden cardiac deaths(SCD) in the young. It shows high incidence in Asean countries and extreme male predominance. Patients with BS are usually asymptomatic but become fatal when the VF is triggered. Typical Brugada-type ECG shows RBBB with the elevation of ST segment in V1∼3 without structural abnormalities. The prevalence of Brugada-type ECG has been reported 0.05%(Europe)∼ 0.4%(Japan). To find soldiers who have Brugada-type ECG but asymptomatic, a ECG screening was performed to 10,182 soldiers. Method: The authors used special ECGs mounted with CDMA wireless modem. After being checked the quality, every ECG was transmitted to a server computer located in 400km far from the base. BP were recorded. Every soldier was inquired about the history of the syncope and the SCD of family member. ECGs were interpreted by 13 cardiologists who specialized in ECG. The ECGs found out positive were reviewed by another 3 cardiologists. Results: Of 10,182 soldiers, 51(0.5%) showed Brugada-type ECG. 1 was type 1, 33 were type 2, 17 were type 3. 14 had histories of syncope. 3 experienced multiple episodes of syncope. 8 had family histories of sudden death. 1 of 51 confirmed as a brugada syndrome after EP study following flecainide provocation test. Conclusions: Prevalence of Brugada type ECG in korean young male is pretty high. The prevalence of general population may be higher than the result of this study.

신종 인플루엔자 A(HIN1) 환자에서 인후부 바이러스 배출 변화

황일웅 ( Hwang Il Ung ),이희경 ( Lee Hee Kyeong ),서미영 ( Seo Hi Young ),김재표 ( Kim Jae Pyo ),서유빈 ( Seo Yu Bin ) 국군의무사령부 2010 대한군진의학학술지 Vol.41 No.1

Objective: To assess the duration of Viral shedding in the patients infected with pandemic influenza A(H1N1) virus Method: 33 patients who was confirmed as Pandemic influeza A(H1N1) infection with RT-PCR were followed to find how long they could shed the virus from throats. Pharyngeal swabs were taken from each patient on the day 5, 7, 10 after onset of symptoms. and tested by PCR. Results: mean age of patients was 21.5 years. Fever and cough were the most common symptoms. Of 33, 9 were prescribed Olseltamivir, and 24 were not. The former group showed rapid drop of virus shedding after day 5 but no statistical significance was found d/t small number of cases. 21 cases(63.6%) were positive on day 5, 6 cases(18.2%) on day 7, and 0 case(0%) on day 10 Conclusions: In some cases, pandemic influenza A(H1N1) virus is shedding from the patients' throat and may have infectivity even on the 7th day after symptom . Further reseach including viral culture is needed to assess accurate shedding duration of live virus.

비전공상 판정자를 대상으로 한 전공상 기준에 대한 연구

황일웅 ( Hwang Il-ung ),서지원 ( Seo Ji Won ) 국군의무사령부 2012 대한군진의학학술지 Vol.43 No.1

When soldiers are injured or get diseases while they are in services. most of countrios have policies to compensate their physical losses. In Korea, by the law of Soldier's Pension, 1 year is critical to get a compensation for their losses. This study is to figure out the characteristics of the soldiers who discharged from army because of physical illness and see if one year time requirement is rational. In 2009, 1353 soldiers were referred to the central service-related disability committee for consideration of service-related disabilities. 667 were NCO and Officers and 686 were enlisted. For the NCO and officers, the rate of non service-related disabilities was 10% but the rate for the enlisted was 53%. For the soldiers who served less than 1 year, the rate was 8% for NCO and officers and 65% for enlisted. The rate of non-service related disabilities was very low in the soldiers with orthopaedic injuries but high in the soldiers with psychiatric diseases. In the enlisted who served less than 1 year and were decided as non-service related diabilities, 123 soldiers had no previous history, suicidal attack, and accidents during vacation. In this group, the most common disease was tumor(26), followed by depresion(11), bipolar disease(11), schizoprenia(11) seizure(8), blood disorder(7), etc. In tumogenesis, 1 year is not so long enough that it doesn't have significant meaning in determination of service-ralated disabilities. UK has 6 months criteria and US has no time criteria. It is time to change the law Soldier Pension Law to get rid of the provision with 1 year-criteria.

한국군 신병에서 수막알균의 보균율과 혈청형의 변화

황일웅 ( Hwang Il Ung ),이희경 ( Lee Hee Kyeong ),서미영 ( Seo Mi Young ),김재표 ( Kim Jae Pyo ),서유빈 ( Seo Yu Bin ),방연주 ( Bang Yeon Ju ) 국군의무사령부 2010 대한군진의학학술지 Vol.41 No.1

Objective: Carriage rate of Neisseria Meningitidis is known to be very high in the group of university students and army population although the general carriage rate is about 10%. 60∼ 80% of carriage rate was reported in the army population. To gain current information about the nasopharyngeal carriage of Neisseria meningitidis, this study was carried out. Method: 391 recruits of Korean army were swabbed two times. 1st swab was taken on the day of beginning of the army training and 2nd was done 5 weeks later. Results: Overall carriage rate was 17.6%(69) at first swabs and raised to 21.7%(85) at the second. Of 69 isolates from 1st swabs, 4 serogroups including B, C, W135, E29 were identified and 39.1%(278) were done as non-groupable. Results of serogrouping 85 isolates from the 2nd swabs were same with the 1st examination. B, C, W135, E29, non-groupable were identified. Serogroup B account for 31%(22) of 1st isolates and 60%(51) of 2nd isolates. 17 positive results converted into negative at 2nd swab. Conclusion: The carriage rate of the army recruits was higher than normal population but didn't go up so high as reported. Only 4 goups which are likely to causes disease were identified. Duration of carriage should be evaluated in the following study with longer follow up.

육군훈련소 훈련병 구강건강 실태 연구

홍진선 ( Hong Jinson ),황일웅 ( Hwang Il-ung ),최병섭 ( Choi Byungseop ),오대근 ( Oh Daekeun ),정신 ( Jung Shin ),박임희 ( Park Imhee ),이선주 ( Lee Sunjoo ),조근철 ( Jo Keunchul ) 국군의무사령부 2015 대한군진의학학술지 Vol.46 No.1

Objectives; The purpose of this study was to evaluate oral health status, dental treatment need and oral health awareness of army trainees in the Korea Army Training Center to develop the army policy on oral health and oral health providing. Methods; This study conducted by close oral examinations for 352 Army trainees based on the Korea National Oral Survey criteria with questionnaires. The questionnaires related to awareness and attitude on oral health. Results; DMFT index was 5.03, and DT was 0.65. DMFS index was 10.29 and DS was 1.49. Average of teeth needed dental treatment was 0.95 and 51.9% among teeth needed extractions was for the third molars. 48.3% of trainees needed periodontal treatment including scaling. Of the trainees, 15.4% considered their own oral status very good or good and 34.2% considered their dental status poor and very poor. Average frequency of toothbrushing was 2.6 times a day. 10.6% of trainees used tools for improving their oral health. Conclusions; Oral health status of army trainees affects the Army dental health care system. Close periodic oral examination on trainees and reevaluation is recommended.

총기 및 폭발물에 의한 군인의 근골격계 손상: 최근 4년간 분석

양한별(Hanbual Yang),황일웅(Il-Ung Hwang),송대근(Daeguen Song),문기호(Gi Ho Moon),이나래(Na Rae Lee),김경남(Kyoung-Nam Kim) 대한정형외과학회 2021 대한정형외과학회지 Vol.56 No.3

목적: 현재까지 군에서 발생하는 총기 및 폭발물 손상은 그 중요성에 비해 연구된 것이 제한적이었다. 이를 극복하기 위해 최근 4년간 총기 및 폭발물에 의해 수상한 군인 환자의 근골격계 손상에 대한 특징을 확인하고자 하였다. 대상 및 방법: 2015년 1월부터 2019년 7월까지 총기 및 폭발물에 의해 근골격계 손상을 당한 군인 환자를 대상으로 하였다. 의무기록과 의료영상저장전송시스템 영상자료를 분석하고, 전화 면담을 통해 short musculoskeletal function assessment (SMFS)를 이용한 기능평가를 후향적으로 시행하였다. 기능평가에 대한 통계 분석으로 무기종류에 따른 분석은 t-test를, 다른 요인에 따른 분석은 ANOVA 분석을 실시하였다. 결과: 총기 및 폭발물에 의한 손상으로 치료받은 총 61명의 환자 중 30명(49.2%)이 근골격계 손상으로 정형외과적 치료를 시행받았다. 평균 수상 나이는 26.4세(21-52세)였다. 간부와 병사의 수는 비슷하였다. 총기 손상이 11명, 폭발물 손상이 19명이었다. 30명 중 수도병원에서 16명(53.3%)이, 민간병원에서 10명(33.3%)이 치료받았다. 12명에게 복수부위 손상이 있었고, 골절이 동반된 16명(53.3%)의 환자 중 절반 이상인 7명의 환자가 다발성 골절이었다. 수부와 하퇴부가 가장 흔한 수상 부위였다. 2명을 제외하고는 모두 개방창이 있었으며, 연부조직 재건술이 필요한 환자는 14명(46.7%)이었다. SMFS 기능평가에는 15명이 응답하였다. 계급에 따른 분석 결과, Borther Index에서 간부의 결과가 통계적으로 유의하게 낮은 것으로 분석되었다(p=0.05). 치료 병원에 따른 분석 결과, Dysfunction Index와 Bother Index 모두 수도병원에서 치료 받은 인원의 점수가 통계적으로 유의하게 낮은 것으로 분석되었다. (p=0.0008, p=0.0149) 결론: 국내 무기에 의해 수상한 군인 환자에 대해 분석한 첫 연구이다. 무기 손상 환자의 치료에 있어 orthopedic burden이 높음을 확인하였으며, 장기적으로 이런 환자들에 대한 치료평가 및 군 외상 시스템 발전을 위해 총기 및 폭발물에 의한 손상 환자를 포함한 군 외상환자 레지스트리 구축이 필요하겠다. Purpose: To date, studies of firearm and explosive injuries in the Korean military have been limited compared to its importance. To overcome this, this study examined the characteristics of musculoskeletal damages in soldiers who have suffered firearm and explosive injuries over the past four years. Materials and Methods: From January 2015 to July 2019, military forces who had suffered musculoskeletal injuries from firearms or explosive substances were included. The medical records and radiographs were reviewed retrospectively, and telephone surveys about Short Musculoskeletal Functional Assessment (SMFA) for this group were conducted. To compare the functional outcomes, statistical analysis was performed using a t-test for the types of weapons, and ANOVA for others. Results: Of the 61 patients treated for firearms and explosives injuries, 30 patients (49.2%) were included after undergoing orthopedic treatment due to musculoskeletal injury. The average age at injury was 26.4 years old (21–52 years old). The number of officers and soldiers was similar. Eleven were injured by gunshot and 19 by an explosive device. Sixteen were treated in the Armed Forces Capital Hospital and 10 at private hospitals. More than half of the 16 patients (53.3%) with a fracture had multiple fractures. The most common injury site was the hand (33.3%), followed by the lower leg (30.0%). There were 14 patients (46.7%) with Gustilo-Anderson classification 3B or higher who required a soft tissue reconstruction. Fifteen patients agreed to join the SMFA survey for the functional outcomes. Between officers and soldiers, officers had better scores in the Bother Index compared to soldiers (p=0.0045). Patients treated in the Armed Forces Capital Hospital had better scores in both the Dysfunction and Bother Index compared to private hospitals (p=0.0008, p=0.0149). Conclusion: This is the first study to analyze of weapons injuries in the Korean military. As a result of the study, the orthopedic burden was high in the treating patients with military weapon injuries. In addition, it is necessary to build a military trauma registry, including firearm and explosive injuries, for trauma treatment evaluation and development of military trauma system.

제3기 키엔벡 병에서의 방형회내근 유경 골이식을 이용한 삽입관절 성형술

정문상(Moon Sang Chung),백구현(Goo Hyun Baek),황일웅(Il-ung Hwang),전득수(Deuk Soo Jun),김상림(Sang-Rim Kim) 대한정형외과학회 1998 대한정형외과학회지 Vol.33 No.5

軍 김염성 질환의 GIS 구축 - 한타바이러스를 중심으로 -

우경인 ( Koung-in Woo ),서지원 ( Ji-won Seo ),김미랑 ( Mirang-rang Kim ),김유진 ( Yu-jin Kim ),석웅 ( Ung Seok ),황일웅 ( Il-ung Hwang ) 국군의무사령부 2017 대한군진의학학술지 Vol.48 No.1

Objectives: To materialize Hantavirus GIS system at the Medical Emergency Operation Center after renting the server from exterior enterprise in June 2016 and receiving s/w for operating Hantavirus DB and GIS operation from the Agency for Defense Development. Method: We implemented the GIS system at the Medical Emergency Operation Center under the cooperation with AFMC’s Communication & Operation Planning Department after renting the equipments from exterior enterprise and receiving s/w technologies for operating the Hantavrisu DB and GIS operating. Results: We ran the system at the Medical Emergency Operation Center on 23^rd September 2016. Conclusion: The GIS system can visually and spatially materialize the geographical and personnel information or infectious diseases outbreak in military. By using the system, it is considered that patient outbreak status, density and trend can more easily or rapidly detected which will lead to an effective management or infectious diseases in military. Furthermore, the system is believed to capacitate an early prevention activities by predicting proliferation area or infectious diseases in times of nationwide emerging infectious diseases crisis. This will contribute to an early cease of epidemic crisis which will ultimately preserve combat power.