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.

Pollen Viability of Common Buckwheat (Fagopyrum esculentum Moench.) in in vitro Germination and its Application to Male Gametophyte Isolation

Woo, Sun-HeeㆍKeun-Yook ChungㆍHeung-Tae, KimㆍYong-Gu, ChoㆍHong-Sig, KimㆍBeom-Heon, Songㆍ Chul-Won, Lee and Seung-Keun Jong 忠北大學校 農業科學硏究所 2004 農業科學硏究 Vol.21 No.-

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분절호선법으로 상하악 절치부 압하 시 순측경사도가 미치는 영향에 관한 3차원 유한요소법적 연구

김동우,양훈철,김기태,김성식,손우성 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.4

본 연구는 상하악 절치부의 압하를 도모하기 위한 장치의 하나인 분절호선장치를 사용하여 절치부의 순측경사에 따른 저항중심의 위치와 변화양상, 그리고 치축경사 개선과 압하를 동시에 이루기 위해 필요한 최소 후방 견인력의 크기 및 변화양상을 알아보기 위하여 3차원 유한요소법을 이용하여 시행되었으며 다음과 같은 결론을 얻었다. 1. 치축 경사도의 변화에 따른 상악 절치부 저항중심은 1) 정상 치축경사를 가진 경우에서 측절치 브라켓 원심면 후방 6mm에 위치하였다. 2) 순측경사가 10˚ 증가된 경우에서 측절치 브라켓의 원심면 후방 9mm에 위치하였다. 3) 순측경사가 20˚ 증가된 경우에서 측절치 브라켓 원심면 후방 12mm에 위치하였다. 4) 순측경사가 30˚ 증가된 경우에서 측절치 브라켓 원심면 후방 16mm에 위치하였다. 2. 치축 경사도의 변화에 따른 하악 절치부 저항중심은 1) 정상 치축경사를 가진 경우에서 측절치 브라켓 원심면 후방 10mm에 위치하였다. 2) 순측경사가 10˚ 증가된 경우에서 측절치 브라켓 원심면 후방 13mm에 위치하였다. 3) 순측경사가 20˚ 증가된 경우에서 측절치 브라켓 원심면 후방 15mm에 위치하였다. 4) 순측경사가 30˚ 증가된 경우에서 측절치 브라켓 원심면 후방 18mm에 위치하였다. 3. 응력 분포 양상은 1) 각 저항중심에서 압하력을 가한 경우에 치주인대에 균일한 압축응력을 나타내었다. 2) 후방 견인력을 동시에 적용한 경우에 순측경사가 증가할수록 응력분포 양상이 복잡해지는 양상을 보였다. 4. 상하악 절치부가 20˚까지 순측경사된 경우에서 pure intrusion을 위하여 필요한 후방 견인력의 크기도 증가하였다. This study was designed to investigate the position of anteroposterior center of resistance for genuine intrusion and the mode of change of the minimum distal force for simultanous intrusion and retraction of the upper and lower incisors according to the increase of labial inclination. For this purpose, we used the three-piece intrusion arch appliance and three-dimensional finite element models of upper and lower incisors. 1. Positions of the center of resistance in upper incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 6mm behind the distal surface of the lateral incisor bracket. 2) In 10˚ increase of the labial inclination situation, the center of resistance was located in 9mm behind the distal surface of the lateral incisor bracket. 3) In 20˚ increase of the labial inclination situation, the center of resistance was located in 12m behind the distal surface of the lateral incisor bracket. 4) In 30˚ increase of the labial inclination situation, the center of resistance was located in 16m behind the distal surface of the lateral incisor bracket. 2. Positions of the center of resistance in lower incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 10mm behind the distal surface of the lateral incisor bracket. 2) In 10˚ increase of the labial inclination situation, the center of resistance was located in 13mm behind the distal surface of the lateral incisor bracket. 3) In 20˚ increase of the labial inclination situation, the center of resistance was located in 15m behind the distal surface of the lateral incisor bracket. 4) In 30˚ increase of the labial inclination situation, the center of resistance was located in 18m behind the distal surface of the lateral incisor bracket. 3. The patterns of stress distribution were as follows; 1) There were even compressive stresses in and periodontal ligament when intrusion force was applied through determined center of resistance. 2) There were gradual increase of complexity in compressive stress distribution pattern with increase of the labial inclination when intrusion and retraction force were applied simultaneously. 4. With increase of the labial inclination of the upper and lower incisors, the position of the center of resistance moved posteriorly. And the distal force for pure intrusion was increased until 20˚ increase of the labial inclination.

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).

간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

Transcriptome profiling of olive flounder responses under acute and chronic heat stress

Woo‑Jin Kim,이규빈,Dain Lee,Hyun‑Chul Kim,Bo‑Hye Nam,Hyungtaek Jung,이선주,Kyunghwan Kim 한국유전학회 2021 Genes & Genomics Vol.43 No.2

Background The olive founder (Paralichthys olivaceus) is a saltwater fsh, which is valuable to the economy. The olive founder strives to adapt to environmental stressors through physiological, biochemical, and transcriptional responses. The rise in water temperature threatens the growth, development, reproduction, and survival of olive founder. Each organ in the olive founder can diferentially respond to heat stress. Objectives The purpose of this study is to investigate organ-specifc transcriptional changes in olive founder tissues during heat stress. Methods In this study, transcriptome dynamics of the gill, liver, and muscle of olive founder to acute or chronic heat stress were investigated. Results Principal component analysis plotting revealed that the transcriptome of each organ is quite separated. K-means clustering, gene ontology, and Kyoto Encyclopedia of Genes and Genomes pathway analysis showed the diferential transcriptome responses of each organ to heat stress. Heat stress commonly afects the pathways involved in the correct protein folding, DNA repair, and cell cycle. Conclusion Our results may provide a valuable molecular basis of heat acclimation in fshes.

분편 인플루엔자백신(split influenza vaccine)의 임상효과 및 면역원성에 관한 연구

우흥정,김동림,정희진,천병철,이주연,안정배,김지희,박찬,신영규,김우주,김민자,박승철 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.1

목적 : 아단위 인플루엔자 백신 접종 후 백신의 인플루엔자 예방효과, 인플루엔자 방어 항체형성, 인플루엔자 백신의 안전성을 조사하고자 하였다. 방법 : 총 571명을 대상으로 인플루엔자 백신 접종을 하였고, 이들 접종자에서 인플루엔자 양질환의 이환을 조사하여 인플루엔자 백신의 인플루엔자예방효과를 알아보았고, 백신의 접종 전 및 접종 4주 후 혈청에서 혈구응집억제물(Hemagglutination Inhibition : HAI) 항체 검사를 실시하여 백신의 방어항체생성을 조사하였고, 백신의 안전성을 알아보기 위해 백신접종 후 1주일 이내의 부작용을 조사하였다. 결과 :백신 접종군과 백신 비접종군에서 인플루엔자 양 질환의 이환을 조사한 결과 접종군 28.35%, 비접종군 35.88%으로 나왔으며, p 값이 0.001로 통계적으로 접종군에서 유의하게 낮았고, 인플루엔자 양 질환의 예방 효과는 20.97%를 보였다. 백신의 방어항체 형성의 평가를 위해 유럽의 인플루엔자 백신 허가 기준을 조사하였는데 B/Guangdong/5/94균주의 백신접종 후 항체가 40이상의 비율을 제외한 다른 기준은 모두 만족 시켰다. 부작용은 전체 조사자 521명중 149명(29%)으로 주로 접종 부위의 국소 부작용을 호소했고, 전신 부작용은 2% 내외였으며 특별히 심각한 부작용은 발견되지 않았다. 결론 : 분편 인플루엔자 백신은 인플루엔자양질환의 예방과 방어항체생성에 효과 있으며 안전한 것으로 사료된다. Background : The safety and effectiveness of influenza vaccine are well known in developed country. The influenza vaccination has been recommended as one of the tentative immunization schedule for indicated persons since 1997 in Korea. But there are still no available data about them, even though nearly 5 million doses of influenza vaccine were used in 1997-1998 season. So it is immediately needed to investigate the safety. efficacy and immunogenicity of influenza vaccine among Korean. Methods : We studied the clinical efficacy of influenza vaccine by monitoring Occurrence of influenza-like illness in influenza risk group(vaccination ; 300, non-vaccination; 215) from December in 1997 to March in 1998. We used the split quadrivalent influenza vaccine containing 15 microgram of hemagglutinin of A/Beijing/262/95(HlNl), A/Wuhan/359/95(H3N2), B/Mie/1/93 and B/Guangdong/5/94. Hemagglutination inhibition(HA1) antibody titers were determined before immunization and 1 months after vaccination And we evaluated adverse effect of influenza vaccination at 7 days after vaccination. Results : Influenza vaccination was associated with si@icant reductions in influenza-like spptoms(vaccination group; 28.35%, non-vaccination group, 35.88%, p=0.001). The preventive effect of influenza-like i3lne.s among influenza risk goup was 20.97%. And immunogenicity of influenza A and B exceeded all of the European licensure criteria for immunogenicity except postvaccination proportion of titers 240 of B/Guangdong/5/94 strain. And the adverse effects were mainly local injection site problem and no serious adverse effect was noted. Conclusion : Split influenza vaccine is safe, inmunogenic and eff'tive in influenza risk group in Korea.

사망진단서(사체검안서) 상의 선행사인으로부터 사망통계의 원사인이 선정되는 비율 : 3개 대학병원에서 교부된 사망진단서를 중심으로

박우성,박석건,정철원,김우철,탁우택,김부연,서순원,김광환,서진숙,부유경 한국의료QA학회 2004 한국의료질향상학회지 Vol.11 No.1

Background : To exatnine the problems intolved in writing practice of death certificates, we cotnpated the determination of underlying cause of death for wital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 rnortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record wpecialists. And causes of death determined at ministry of statistics for national vita statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificaties sere analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. Ane the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions tha caused death too. Conclusion : When we examined the correctness of death certificate writing practice using abpve methods, cortectness of writing could not be told as satisfactory. There was difference in correctness of writing between hospotals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

폐비닐여재를 적용한 부착성장식 공법의 유기물 및 영양염 제거 특성

서종환,김진우,안철우,이철승,박진식,김수생 동아대학교 환경문제연구소 2003 硏究報告 Vol.25 No.2

This study was carried out to demonstrate the removal characteristics of organic materials & nutrients in attached growth process applied Synthetic Wasted Polyethylene Media which is reused from wasted vinyl in rural. The results are as follows: 1. Removal efficiencies were indicated COD_(cr), 91.4, 92.4, 93.9%, T-N 56.9, 61.4, 65.1% and all T-P 45% or more with HRT 10, 12, 14 respectively. 2. It is indicated BOD volume load 0.18~0.40kg/ ㎥ ·d, COD volume load 0.28~0.53kg/ ㎥ ·d and NH₄-N volume load 0.12kg/ ㎥ ·d respectively. In conclusion, It is showed activated sludge process is replaced with this process applied Synthetic Wasted Polyethylene Media and this process is considered the methods that solve wasted vinyl troubling in a rural.

백혈병환자에서 Liposomal Amphotericin B로 치료된 파종성 Fusarium 감염 1예

이지연,김성범,박대원,신성희,김용현,윤소영,엄중식,최철원,정희진,김우주,김준석,김장수,이갑노 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

Fusarium spp.는 사람에서 드물게 각막염, 조갑진균증, 상처나 화상부위감염 등을 유발하는 것으로 알려져 있으나 최근에는 면역저하자에서 기회감염의 원인균으로 증가하고 있는 추세이다. 면역저하자에서 파종성 감염이 있는 경우에 예후는 치명적이나, 증례가 많지 않고 진단방법이 제한되어 있어 조기 진단과 신속한 치료가 쉽지 않다. 그러나 특징적으로 피부병변의 동반이 흔하여 면역저하자에서는 피부 병변의 면밀한 관찰과 함께 Fusarium 감염을 조기에 의심하여 피부생검이나 배양을 하는 것이 진단에 도움이 되리라 생각된다. 파종성 Fusarium 감염의 치료로는 감염 부위의 국소적 외과적 절제와 전신적 항진균제의 사용이 필요하고 현재까지는 amphotericin B가 비교적 효율적인 항진균제로 알려져 있으나 면역저하자에서 이에 반응을 하지 않는 경우가 많다. 저자들은 급성골수성백혈병 환자에서 관해유도화학요법 시행 후 호중구감소상태에서 피부병변과 폐침윤이 발견되었고 피부의 중심부 궤양을 동반한 구진성 병변에서 배양검사를 통해 파종성 Fusarium 감염을 진단하였으며 liposomal amphotericin B (AmBisome )를 사용하여 성공적으로 치료한 예를 경험하여 보고하는 바이다. Fusarium spp., basically a superficial pathogen, is a newly emerging fungal pathogen of opportunistic infections in immunocompromised patients. At present, although Fusarium spp. are relatively resistant to amphotericin B, the combination of amphotericin B and surgical debridement appear to be optimal treatment for disseminated infection. Recently we experienced a 32-year-old neutropenic patient after induction chemotherapy for acute myelocytic leukemia presented with skin lesions and infiltrations in both lungs. We diagnosed with disseminated fusariosis by skin culture and successfully treated the patient with liposomal amphotericin B. We emphasize a high index of suspicion for skin lesions especially in immunocopromised patients.