부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

정상 한국인에서 연령증가에 따른 혈장 Dehydroepiandrosteronesulfate ( DHEA-S ) 농도 및 DHEA - S / cortisol 비의 변화

박성우,유형준,임성희,최문기,유재명,박민숙,이권엽,박철수,김철홍,김현규,김두만,박규용 대한내분비학회 1997 Endocrinology and metabolism Vol.12 No.2

Backgroud: DHEA-S is the most abundant steroid hormone in circulation, and primarily secreted from the adrenal cortex, but its physiological role is little known. One of the characteristic features of DHEA-S is progressive decrement of plasma DHEA-S level with advancing age, in contrast, plasma levels of other adrenal hormones are not chaging or littie decreasing. To grasp the trends of plasma DHEA-S level and DHEA-S/cortisol ratio by age in healthy Korean, we measured the plasma DHEA-S levels and DHEA-S/cortisol ratios in healthy Korean. Methods: Healthy Korean(men: 99, women: 102, age range: 15-97 year old)were studied. Subjects were not taking drugs(such as glucocorticoid or androgenic medication) or cigarettes known to modify the plasma level of DHEA-S and cortisol, and had no evidence of hepatic, renal disease or hyperlipidemia as determined by serum lipid, bilirubin, SGOT, SGPT, BUN, creatinine. Data were analyzed by 10-year age group for men and women: i.e, 10-19, 20-29, 30-39, 40- 49, 50-59, 60-69, 70-79, 80-89 and 90 year or more. Plasma DHEA-S levels were measured by using a commercially available RIA kit with 125I labeled-DHEA-SO4(Coat-A Count DHEA-SO4), and for the measurement of plasma cortisol levels, commercial Gamma Coat TM[125I] Cortisol Radioimmunassay Kit was used. Results:. 1) In both men and women, plasma DHEA-S level showed high interindividual variation within the same age group. 2) There were individual sex differences in plasma levels of DHEA-S, in all age groups, plasma DHEA-S levels were significantly higher values for men than for women. 3) Maximum plasma DHEA-S levels(men; 237+-3.35 ug/dL, women; 108+-17.5 ug/dL) were at third decade in both men and women. 4) Both men and women showed the continuous decline in plasma DHEA-S level with age. These age-related decline was more prominent in men than in women(men; y= -3.152 * +292.6, r2= 0.8459, P$lt;0.05, women; y= -1.417 * +143.3, r2 = 0.7278, P$lt; 0.05). 5) As an index of aging, there was no stastical difference between DHEA-S and DHEA- S/cortisol ratio. Conclusion: In healthy Korean, there were high interindividual variation of plasrna DHEA-S levels. In both men and women plasma DHEA-S level was peak at third decade, and from when it declined progressively with age. These results suggest that although the reliability of single plasma DHEA-S measurement are limited, the decline of DHEA-S with advancing age might be a specific marker of endocrinologic hormonal milieu(aging index). Also, concerning to individual adrenal secreting capacity, we measured DHEA-S/cortisol ratio. But we did not found that plasma DHEA-S/cortisol ratio is superior to the plasma DHEA-S level as an aging index. (J Kor Soc Endocrinol 12:245-254, 1997)

단무지 공장에서 발생한 질식 사고의 원인과 방사선학적 소견: 중례보고 및 가스분석 결과

박충기,김만구,김흥철,안범규,박만수,황우철,최철순,강익원 江原大學校 附設 環境硏究所 1994 環境硏究 Vol.11 No.-

목 적:단무지 공장에서 질식사고를 일으켰던 가스의 종류를 알아내고, 이러한 가스중독의 방서선학적 소견을 소개하기 위하여 본 연구를 하였다. 대상 및 방법:단무지 공장에서 발생한 질식 사고자 3예중 생존자 1예를 대상으로 단순흥부X-선검사와 CT 소견을 분석하였으며, 가스의 종류를 알아내기 위하여 단무지를 유리병에 넣어 발생된 가스를 가스크로마토그래픽을 이용하여 분석하였다. 결 과:단무지 공장에서 발생한 질식사고자중 생존한 1명의 방사선학적 검사에서 신속히 호전되는 폐경결(consolidation)을 볼 수 있었으며 이는 폐부종의 소견임을 알 수 있었다. 협기성 상태에서 단무지를 담은 유리병의 상층부 가스를 실험 분석한 결과 이산화탄소, 에칠알코올이 다량으로 검출되었으나 독성가스는 주로 황화수소이였다. 결 론:단무지 공장의 질식 사고자에서 폐방사선학적 소견은 폐경결을 보이는 폐부증으로서 이는 실험을 통해 단무지에서 발생되는 유독가스인 황화수소 때문임을 입증하였다. Purpose: To identify the main toxic gas released from salted radish in rice bran(Dan-M-Ji) and to introduce the radiological findings of the patient who was exposed to the gas. Materials and Methods: Chest radiographs and CT scans of one survivor among three men who were exposed to the gas from Dan-Mu-Ji were reviewed. Gas obtained from the closed bottle containing Dan-Mu-Ji was analized by using the gas chromatography. Results: The radiographlc examinations of the survivor were suggestive of pulmonary edema with it's rapidly improving consolidations in both lung. The headapace gas within the bottle containing Dan-Mu-Ji was mainly composed with carbon dioxide, ethyl alcohol and hydrogen sulfide, of which hydrogen sulfide was considered the main toxic gas released. Conclusion: Under the anaerobic condition, Dan-Mu-Ji released toxic hydrogen sulfide. Inhalation of hydrogen sulfide might produce non-cardiogenic pulmonary edema.

부신피질 호산성 과립세포종 1예

이성진,이호권,박철영,정인경,홍은경,오기원,김현규,김두만,유재명,임성희,최문기,유형준,박성우 대한내분비학회 2004 Endocrinology and metabolism Vol.19 No.1

저자들은 건강검진에서 시행한 복부 초음파검사상 우연히 좌측 부신 종괴가 발견되어 복부 전산화 단층 촬영검사와 호르몬검사를 시행한 후 부신피질 악성종양과의 감별 진단을 위해 부신절제술과 전자현미경검사를 포함한 병리조직학적 검사를 시행하여 부신피질호산성 과립세포종으로 진단한 증례를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. Oncocytomas are neoplasms, histologically are composed of epithelial cells, with abundant, acidophilic and granular cytoplasm. Electron microscopic studies of oncocytomas have shown that the cytoplasm of oncocytes is packed with mitochondria. The adrenal gland is a very rare anatomical site for oncocytomas, and to the best of our knowledge, only thirty-six cases of adrenal oncocytomas have been described. Herein, a case of a large adrenal mass in a forty-year-old man, which was incidentally detected by abdominal ultrasonography, is presented. This patient demonstrated no clinical manifestation associated with adrenal hyperfunction. Hormonal studies showed no abnormal findings, except for a mild elevation of the 24-hour urinary VMA level. Abdominal computed tomography with enhancement revealed a large, well-defined left adrenal mass, measuring 5.0×4.2 ×3.0 cm. The patient underwent a left adrenalectomy, and a light microscopic examination confirmed an adrenocortical oncocytoma, with characteristic oncocytes and polygonal, abundant, eosinophilic and granular cytoplasm. The tumor cells were positive for cytokeratin and vimentin as well as S-100, but negative for chromogranin on immunohistochemical staining. An electron microscopic examination demonstrated closely packed mitochondria, containing intramitochondrial inclusions. After surgery, there was no evidence of a recurrent or distant metastatic disease at the 5 month follow-up. In summary, an extremely rare case of a man with an adrenocortical oncocytoma is reported, which was confirmed by histological examinations, including electron microscopy (J Kor Soc Endocrinol 19:82∼89, 2004).

백제 무령왕릉 및 송산리 5.6호분의 현황과 보존대책

김광훈,최석원,정상만,서만철,이금배,이남석 公州大學校 基礎科學硏究所 1998 自然科學硏究 Vol.7 No.-

무령왕릉을 비롯한 송산리 고분군의 5호분 및 6호분의 발굴이후의 변화상황, 고분구조의 벽체거동 상황 및 구조안전, 누수현상, 고분 내에 서식하는 조류문제, 고분내 습기 및 결로현상 제거를 위한 공기조화시설 등을 포함하는 종합정밀조사를 1996년 5월 1일 부터 1997년 4월 30일 까지 1년간 수행하였다. 무령왕릉 및 6호분 벽돌깨김 상황 조사결과 1972년과 l996년을 비교하여 보면 벽돌파손율이 각각 2.5배와 2.9배로 증가하고 있다. 1972년 상황은 약 1450년간 진행된 것이고 l996년의 상황은 불과 24년간 진행된 것임을 감안할 때 고분이 발굴된 이후 벽돌의 균열은 상당한 가속도로 진행되어 온 것이 사실이며 이대로 진행된다면 더욱 더 가속화될 것으로 판단된다. 고분벽체의 거동상태를 계측한 결과 우기에 지하수 유입에 의한 지반의 약화로 인하여 건기보다 2배 정도 거동하는 양상을 보인다. 한편, 무령왕릉 연도 입구의 호벽은 전실쪽으로의 거동이 0.43 mm/myr, 연도쪽으로 2.05 mm/myr의 거동을 보여 무령왕릉에서는 가장 심한 거동을 보이고 있다. 봉분내부의 토양층구조에 대한 지오레이다 영상단면을 분석한 결과 지중의 누수방지층이 심하게 균열되어 있는 것으로 판단된다. 직접누수와 지하수 형태로 유입된 침투수는 고분군 주위의 지반의 함수비를 증가시켜 지반의 지지력을 악화시키고 또한 고문내로 서서히 유입되어 고분내부의 습도를 100% 로 유지시키는 주된 원인이다. 이러한 높은 습도는 고분내의 남조류의 번식을 초래하였다. 이와 같이 고분군의 발굴후 인위적인 환경변화와 지속적인 강우침투 및 배수 불량의 영향은 고분군의 안정성에 상당한 위험을 초래하였으며, 현 상태는 각 고분에 대한 보강이 불가피한 것으로 판단된다. 고분 벽돌의 깨짐, 고분 벽체의 거동, 조류의 서식 등올 포함하여 송산리 고분군에서 발생되고 있는 보존상의 제반 문제점들은 일차적으로 누수 및 침투수에 의한 결과이다. 그러므로 무엇보다도 고분군 내부 및 고분 주변으로의 강우 및 지하수 침투를 막는 차수 대책이 시급한 것으로 판단된다. 또한 이미 발생한 변위가 더 이상, 진행되지 않도록 봉분하중 경감 빛 토압균형을 이루는 보강대책이 시급한 실정이다. The detail survey on the Songsanri tomb site including the Muryong royal tomb was carried out during the period from May 1, 1996 to April 30, 1997. A quantitative analysis was tried to find changes of tomb itself since the excavation. Main subjects of the survey are to find out the cause of infiltration of rain water and groundwater into the tomb and the tomb site, monitoring of the movement of tomb structure and safety, removal method of the algae inside the tomb, and air controlling system to solve high humidity condition and dew inside the tomb. We found that break rate of bricks inside the Murong royal tomb and the 6th tomb had been increased about 250 % and 290 % for just last 24 years from 1972 to 1996, respectively. The situation in 1996 is the result for just 24 years while the situation in 1972 was the result for about 1450 years. Status of breaking of bricks represents that a severe problem is undergoing. The wall movement of tombs is detecting in disadvantageous directions, especially in rainy season. The front wall of the Muryong royal tomb shows the biggest movement having a rate of 2.05 mm/myr toward the passage way. Georadar section of the shallow soil layer represents several faults in the artificial water-protection layer within soil layer. Rainwater flew through faults into the tomb and nearby ground and high water content in nearby ground resulted in low resistance and high humidity inside tombs. High humidity inside tomb made good living condition for algae with high temperature and moderate light source. Artificial change of the tomb environment since the excavation, infiltration of rain water and groundwater into the tombsite and bad drainage system had resulted in dangerous status for the tomb structure. Main cause for many problems including breaking of bricks, movement of tomb walls and algae living is infiltration of rainwater and groundwater into the tomb site. Therefore, protection of the tomb site from high water content should be carried out at fust. Waterproofing method includes a cover system over the tomsite using geotextile, clay layer and geomembrane. Decrease and balancing of soil weight above the tomb are also needed for the safety of tomb structures. Above mentioned preservation methods are suggested to give least changes to tomb site and to solve the most fundmental problems. Repairing should be planned in order and some special cares are needed for the safety of tombs in repairing work. Finally, a monitoring system measuring tilting of tomb walls, water content, groundwater level, temperature and humidity is required to monitor and to evaluate the repairing work.

Mo¨nckeberg 중막 석회화로 인해 초기자궁내막암이 진행성 자궁내막암으로 판독되었던 1례

김승만,배철성,김동훈,김정란,이현경,윤혜원 동국대학교 경주대학 1997 東國論集 Vol.16 No.1

Mo¨nckeberg 중막 석회화는 크거나 중간크기의 근육성 동맥(large and medium-sized muscular arteries)의 중막(media)에 노화와 관련되어 퇴행성 과정인 윤상석회화가 특징적으로 나타나는 동맥경화증의 일종으로, 근본적으로 폐쇄성 죽상경화증(occlusive atherosclerosis)과는 다른 과정으로 동맥의 관강(lumen)을 막는 경우는 드물어 상대적으로 임상적 의의는 적거나 거의 없다. 저자들은 Mo¨nckeberg 중막 석회화때문에 초음파 및 컴퓨터 단층촬영에 의한 병기결정에 혼란을 초래하였던 초기 자궁내막암 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The Mo¨nckeberg medial calcification is aging change rather than disease entity. The Mo¨nckeberg medial calcification involve muscular arteries of limb, head, and genital track and cause fibrosis change associated with hyalinization and fine basophilic staining, suggesting early calcification with little or no clinical significance but is demonstrable on roentgenograms as regular and diffuse radiopaque shadow under intima. We experienced one case of mis-staging of early endometrial cancer due to the Mo¨nckeberg medial calcification therefore, we report this case with a brief review of the literature of the Mo¨nckeberg medial calcification.

解放後 濟州硏究槪觀(Ⅲ) : 社會科學分野

金榮敦,高南旭,夫萬根,申幸澈,金泰保,許鐵洙 제주대학교 탐라문화연구소 1985 탐라문화 Vol.0 No.4

TRISS Method와 ASCOT Method를 이용한 외상환자의 생존율 분석

김형수,배성만,양혁준,박철완,이근,고영관 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Despite traumatic injuries cause serious problems in our society, there are few adequate and objective scoring system that assess the severtiy of trauma patients. The Major Trauma Outcome Study(MTOS)in United States deisgned the TRISS(Trauma Score & Injury Severity Score)method by means of Revised Trauma Score(RTS),Injury Severity Score(ISS0,and age,while Champion et al deviced ASCOT(A Severtriy Characterizaiton Of Trauma)method to overcome the limitation of TRISS. This study attempted to make a comparison between TRISS and ASCOT by using date for 422 injured patients which were collected form September,1993 to February,1994. Ascot and TRISS were compared in their sensutivity,Specificity,disparity and Z-statistics. 1)Sex ratio of male to female was 2.8:1 and the commonest age of trauma patients was thirties (23.8%). 2)The average probability of survival(Ps)for 442 patient by TRISS method was 0.9228 and that of ASCOT method 0.9356. 3)Disparity of Ps between survival and non-survival using TRISS and ASCOT was relatively low for both indexes as 0.3507 and 0.3296, respectively. 4)The sensitivity rates(number of patients predicted to die who actually died/total who actually died)for the non-survival of both TRISS and ASCOT method were low (35.0%),but the specificity rates(number of patients predicted to live who actually lived/total who actually lived)for the survival of TRISS and ASCOT were 99.1%and 99.6%respectively. 5)Z-statistics(difference between predicted and actual number of death)of both TRISS(1.3224)and ASCOT(1.2234)resulted in positive value which meant that actual number of death exeeded predicted number of death. 6)The ASCOT that have presumed to be more accurate method for patients with head trauma and with multiple injuries to one portion of body,had its intricacy and difficult points in practical application. And the difference between the result of ASCOT and TRISS was not so significant. 7)It is thought that a new, more comprehensive index would like to be developed and thoroughly tested on a variety of data sets in order for it to be used in trauma system quality assurance evaluation.

과잉양수에 의한 지하수고갈 영향에 대한 연구

김종태,배두원,김만일,정교철 7개 국립대학교 환경연구논문집 공동발행 위원회 2005 공업기술연구 Vol.5 No.-

To study the relations of underground/surface-water exhaustion and excessive pumping, we have analyzed river, geological characteristics, recharge rate of rainfall and underground-water level. The ground water recharge rate from the SCS-CN analysis is 8.4%, and the recharge is computed in 6.4111 x 10^(5)㎥/y. This results mean that a big drawdown in observation holes may be occurred by excessive pumping. From in-situ hydraulic conductivity test, hydraulic conductivity in basement of the study area is calculated in 7.996 x 10^(-6)-2.067 x 10^(-6)m/sec. The underground/surface-water in the study area with small underground-water recharge rate will be exhausted by long time pumping.

와편의 연대결정에서 SAAD방법과 SAR방법으로 측정한 연대측정 결과 비교

김현식,홍사용,서만철 공주대학교 문화재보존과학연구소 2003 문화재과학기술 Vol.2 No.1

경기도 하남시 천왕사지에서 채취한 와편으로부터 석영을 분리하여 SAAD방법과 SAR방법을 적용 연대를 측정하였다. SAAD 방법에 의한 자연축적선량 값은 5.37±0.32Gy, SAR 방법에 의한 값은 5.40±0.22Gy이었다. 이것은 오차범위 내에서 일치하는 값이다. 연간선량은 4.31±0.17Gy/ka로, 측정연대는 SAAD방법의 경우 AD 756±53년, SAR방법의 경우 AD 750±45년이다. The roof tiles excavated from Cheonwangsaji at Hanam-shi in Gyeonggi province were dated by using SAAD and SAR protocols. The paleodoses by SAAD and SRR protocols were 5.37±0.32 Gy and 5.40±0.22 Gy, which were agreed with in the range of the measurement error. The evaluated dose rate from the soil around the excavated roof tiles and the tile themselves was 4.31±0.17Gy/ka and the ages of the roof tiles were determined to be (756±53)AD by SAAD and (750±45)AD by SAR.