피로와 의료이용, 업무상 사고 및 질병결근

장세진,고상백,강동묵,김성아,정진주,이철갑,강명근,현숙정,조정진,차봉석,박종구 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: This study examined the relationship of fatigue to medical utilization, occupational accident and sickness absence. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project, 2002~2004). A total of 30,146 employees categorized within the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were recruited. A structured-questionnaire was used to assess the participants' sociodemo-graphics, job-related factors, health-related behaviors, personality trait, self=perceived fatigue (MFS) and the frequency of medical utilization, occupational accident and sickness absence. Data on medical utilization and occupational accident were confirmed from company health records. Chi-square test and logistic regression analysis were used to elucidate the relationship of self-perceived fatigue to medical utilization, occupational accident and sickness absence. Results: In logistic regression analyses, self-perceived fatigue was associated with medical utilization (outpatient), occupational accident and sickness absence although the strength of the associations was higher in the blue collar workers except for medical utilization. For medical utilization, the white collar worker's adjusted odds ratios of outpatient utilization for workers scoring in the third quartile and the highest quartile, compared to workers scoring in the lowest quartile were 1.50 (95% CI: 1.20-1.87) and 2.16 (95% CI: 1.69-2.75), respectively. The blue collar workers' adjusted odds ratios of outpatient utilization for workers scoring in the second (OR: 1.23, 95% CI: 1.06-1.43), third (OR: 1.42, 95% CI: 1.22-1.66) and highest quartile (OR:1.83, 95% CI: 1.55-2.17), respectively, compared to workers scoring in the lowest quartile were statistically significant. However, no associations were found between fatigue and inpatient utilization for either the white or blue collar workers. The blue collar workers' adjusted odds ratios of being injured for workers scoring in the second, third and highest quartile were 1.41 (95% CI: 1.00-2.00), 1.57 (95% CI: 1.10-2.22) and 2.41 (95% CI: 1.69-3.44), respectively, compared to those scoring in the lowest quartile, but, those of the white collar workers were not significant. There was more likely to an increased risk of sickness absence in workers scoring in the second, third and highest quartile compared to those scoring in the lowest quartile in both white and blue collar workers, but the magnitudes of risk were higher in the blue collar workers than the white collars workers. Conclusion: This result suggests that fatigue is a determinant predictor of medical utilization, occupational accident and sickness absence, and that the pattern of risks for the three outcomes differs according to the occupational type. Some limitations of this study and considerations for future study were also discussed.

관상동맥질환 환자에서 스텐트 시술 후 재협착에 관한 연구

강진환,권영주,박상호,한대희,이상철,김명구,변정득,최병조,심규혁,온영근,현민수,김성구 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background and aims : In the coronary artery disease, a rate of restenosis was much decreased by placement of coronary stent than when percutaneous transluminal coronary angioplasty has been applied, but there are still important clinical problems of restenosis. There has been many progressive studies about various factors contributed to this restenosis. So, we studied a relation between restenosis after placement of coronary stent in the coronary artery disease and many clinical factors, characteristics of stenotic lesion and procedural factors, and also assessed the restenosis rate of various coronary stents. Methods : Total 58 lesions(46 cases of patients ; man 30, woman 16) were evaluated, which has been performed a follow-up coronary angiography after 6 months (mean 188 days) since coronary stent had been placed. Various stents were implanted and assessed a relation between restenosis and many factors. Results : Of 58 lesions were target stenotic studies, there were 22 of restenotic lesions(37.9%), and the restenosis rate wes statistically significant difference in the relation with diabetes mellitus(p<0.05), group of acute myocardial infarction(p<0.05) among clinical diagnosis of ischemic heart disease(stable angina, unstable angina and acute myocardial infarction) in clinical factors and with high dilation pressure of stent(p<0.05) in procedural factors. When the rate of restenosis was evaluated among implanted stents, it was lowest in the Multilink^(®) stent and highest in the Nir Royal^(®) stent(60%). Conclusion : In this study of restenosis and various factors after placement of stents in the coronary artety disease, factors such as diabetes mellitus, group of acute myocardial infarction and a dilation pressure of stent were significant related with restenosis and the restenosis rate of Multilink^(®) stent was lowest and the highest restenosis rate was of Nir Royal^(®) stent.

무궁화 根群 分布에 관한 연구 : 2. 土壤 種類別 實生苗의 根群 分布 2. Root system of seedlings on the soil conditions.

심경구,하유미,김진춘,서병기,강호철 성균관대학교 생명과학자원연구소 1995 生命資源科學硏究 Vol.2 No.1

This study was carried out to examine the characteristics of root system for seedlings of Hibiscus syriacus L. on the different soil conditions as a basic study for the stock of top-root cultivars. The obtained results are summarized as follows; It was significantly different on soil hardness between upland soil with 13 kg f/cm2 until 60 cm depth and waste landfill soil with 5 kg f/cm2 until 5 cm depth. But it was not measured soil hardness under 30 cm of waste landfill soil because of waste base. But soil pH was not different between soil conditions. The root depth of 'SKK 91-3' growing on upland soil was 81.0 cm and it was significantly different as compared with that of 'SKK 91-3' on the waste landfill. In addition, 'SKK 91-3' growing on upland soil had more root weight, root width, root number, main root diameter, and shoot growth than that on the waste landfill. Therefore it was suggested that soil condition affect root growth of seedlings in Hibiscus syriacus L. and then induce top-root system.

만성 심부전환자의 혈액에서 측정한 Tumor necrosis factor-α 및 Interleukin-6의 임상적 의의

김명구,김성구,박상호,한대희,강진환,변정득,심규혁,최병조,방덕원,온영근,현민수,권영주 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background and objectives: Many conditions are responsible for the pathophysiology and progressive mechanisms of congestive heart failure. More recently, it has also become evidence that another class of biologycally activated molecules generically reffered to as cytokine these are also over expressed in congestive heart failure. Therefore, the purpose of this study was to measure concentrations of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) in mild to severe symptoms of heart failure and compare their values with those found in normal control and analysed correlation relationship between cytokine level, clinical findings and hemodynamic indicies. Subjects and Methodology: Levels of TNF-α and IL-6 were measured on pulmonary artery during cardiac catheterization in heart failure patients(n=32) and normal subjects(n=8) as well as physical examination and echocardiogram. Cytokines assay were performed on plasma using commercially available ELISA(Enazyme-Linked Immunosorbent Assay) kits. Results: Although the levels of TNF-α and IL-6 tend to increase in congestive heart failure group, the cytokines level was not made significantly statistical difference between congestive heart failure group and controls. When analyzing the correlation between the levels of PCWP(pulmonary capillary wedge pressure) and cytokines(TNF-α, IL-6), respectively, there were statistically significant correlation coefficient 0.32,(p<0.05), 0.39(p<0.01). The cytokine IL-6 and pressure of pulmonary artery were significant correlation.(correlation coefficient 0.36, p<0.02) More significantly, there was correlated with TNF-α and IL-6.(correlation coefficient 0.57, p<0.001) Conclusions: There was tended toward high concentration of TNF-α & IL-6 in congestive heart failure and significant difference for PCWP between TNF-α & IL-6, thus may be correlated with development and progression in congestive heart failure.

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.

정신분열병 환자에서 가상현실을 이용한 추론과제 수행 중 활성화된 뇌영역과 현존감과의 관계 : 기능자기공명영상 연구

최수희,김재진,박일호,김소영,구정훈,이형래,윤강준,김인영,김선일 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.3

Objectives : Virtual reality has been increasingly used in the psychiatric field. Presence, the sense of “being there,” is an essential concept in terms of the effectiveness of the virtual reality. The present study aimed to investigate the characteristics of the presence-related brain regions in patients with schizophrenia. Methods : Using fMRI, brain activities were measured while performing the virtual reality tasks m fifteen healthy normal subjects and fifteen patients with schizophrenia. The tasks consisted of listening to some stories and inferring the content of the previous events. Ambiguous information was given for the experimental task, whereas clear information was given for the control task. Correlations between the image contrast values and the presence scores were analyzed. Result : The presence-related brain regions in healthy controls were identified in the two discrete region groups that could be referred to as the cognitive neural correlates and the perceptual neural correlates. The former included the anterior cingulate, the left inferior temporal gyrus, the right lingual gyrus, and the right cuneus, whereas the latter consisted of the right posterior cingulate, the left lingual gyrus and the right fusiform gyrus. Compared with healthy controls, regional correlation patterns were different in patients with schizophrenia, including that the posterior cingulate had significant correlations. Conclusion : These results suggest that patients with schizophrenia utilize perceptual apparatus for the presence more than the cognitive aspect. A peculiar pattern of the presence in schizophrenia may be related to increased correlations between the posterior cingulate and other brain regions.

허혈성 심질환에서 염증지표에 관한 연구

번정득,권영주,박상호,한대희,이상철,강진환,김명구,심규혁,최병조,온영근,현민수,김성구 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background : Atherosclerosis is the chief underlying cause of ischemic heart disease and there is increasing evidence that inflammation is an important determinant of the development of atherosclerosis. We assessed the levels of inflammatory markers in patients with ischemic heart disease and normal group who has normal coronary angiograms. Materials and Methods : Coronary angiography was performed in 142 patients. 107 patients of ischemic heart disease(stable angina pectoris 58, unstable angina pectoris 30, Acute myocardial infarction 19) and 38 normal control subjects. We assessed the level of inflammatory markers, such as CRP, ESR, fibrinogen and leukocyte. Results : CRP, ESR and fibrinogen values of the patients with stable angina pectoris and unstable angina pectoris were higher than that of normal control group, but there were no statistical significance. Leukocyte value of the patients with unstable angina pectoris(9003.3±701.5/mm^(3)) was significantly higher than that of the patients with stable angina pectoris(6685.5±245.8/mm^(3)) and normal control subjects(6394.3±235.1/mm^(3)). CRP, ESR and fibrinogen values of the patients with acute myocardial infarction were also higher than that of normal control subjects. CRP was 3.88±2.05 mg/dL in acute mocardial infarction group, and 0.29±0.15 mg/dL in normal control subject group(p<0.05). Fibrinogen was 541.6±45.1 mg/dL in acute myocardial infarction group, 321.4±25.6 mg/dL in normal control subject group(p<0.05). Leukocyte was 10942.1±737.6/mm^(3) in acute myocardial infarction group, 6394.3±235.1/mm^(3) in normal control subject group(p<0.05). Conclusions : This study demonstrate that CRP, fibrinogen and leukocyte values of acute myocardial infarction group were significantly higher than that of control group and stable, unstable argina pectoris group. Leucokyte values were significantly elevated in unstable angina group, but CRP values were not in unstable angina group.

Analysis of a Data Recovery Circuit with Digital Oversampling Technique

Jin-Ku Kang 한국정보과학회 1998 Journal of Electrical Engineering and Information Vol.3 No.5

In this paper we analyzed a data recovery system using the oversampling technique. The input waveform is assumed to be non-return-zero (NRZ) binary signals. A finite Markov chain model is used to evaluate the steady-state phase jitter performance of the data recovery system in the presence of input noise. Theoretical results are able to predict the input signal-ta-noise ratio (SNR) versus bit error rate (BER) of the data recovery system for various oversampling ratios. The more number of samples per single bit results in the better performance on BER at the same input SNR. To achieve 10^(-11) BER, 8 times oversampling has about 2dB input signal penalty compared to 16 times oversampling. In an architectural choice of the oversampling data recovery circuit, the recovered clock can be updated in each data bit or in every multiple bits. Two different clock update schemes were analyzed and compared. The scheme updating clock in every data bit has about 1.5dB penalty against the multiple bits (4 bits) clock updating scheme with 16 times oversampling.

Dosing study of esmolol for reducing hemodynamic changes during lightwand intubation

Kang Jin Ku,Yoo Sie Hyeon,정진헌,Kim Nan Seol,정호순,서용한,전혜림,공형윤,Son Hee Dong,Kim A Joo 대한마취통증의학회 2020 Anesthesia and pain medicine Vol.15 No.4

Background: Lightwand is a convenient tool that can be used instead of a laryngoscope for intubation. Tracheal intubation causes direct stimulation of the larynx, drastically increasing hemodynamic values including blood pressure and heart rate. This study aims to identify the effect of different doses of esmolol on hemodynamic changes during lightwand intubation.Methods: The study subjects included 140 patients who underwent general anesthesia for elective surgery. The patients were randomly divided into four groups (35 patients in each group). The ‘C’ group only received 20 ml of normal saline, while the ‘E0.5’, ‘E1’, and ‘E2’ groups received 20 ml of normal saline containing esmolol—0.5 mg/kg, 1 mg/kg, and 2 mg/kg, respectively, injected 2 min prior to intubation. The patients’ blood pressure, heart rate, and rate-pressure product were measured six times, before and after the intubation.Results: The degree of heart rate elevation was suppressed in the E1 and E2 groups compared to the C group, and RPP after intubation significantly decreased in the E2 group compared to the C group.Conclusions: 1–2 mg/kg of a single esmolol injection prior to lightwand intubation effectively blunts heart rate elevation, and 2 mg/kg of esmolol injection blunts rate-pressure product elevation.

A DLL Circuit Design with Precise Delay Coordination Method

Jin Ku Kang 대한전자공학회 1998 ICEIC:International Conference on Electronics, Inf Vol.1 No.1