골프장 경기보조원의 근골격계 자각증상과 관련 요인

허경화,한영선,정혜선,구정완 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

목적: 직업관련성 근골격계질환과 관련된 여러 가지 위험요인에 노출되어 있는 경기보조원의 작업내용과 관련하여 근골격계 증상 유발 양상을 파악하고, 근골격계 증상 관련 요인을 파악하고자 하였다. 방법: 경기도 지역에 있는 6개 정규 골프장을 대상으로 경기보조원 316명에 대하여 2003년 4월 9일부터 4월 30일까지 3주간 설문지를 배부한 후 자기 기입 식으로 작성하게 하여 수거함으로써 자각증상 조사를 실시하였으며, 설문지는 미국 산업안전보건연구원이 사용하는 표준화된 설문지(NIOSH, 1993)의 국내 번역판(노상철 등, 1997)을 이용하였다. 결과: 조사대상 경기보조원의 신체 부위별 근골격계 자각증상 호소율은 다리/무릎/발목/발이 41.8%로 가장 높은 증상 호소율을 보였으며 어깨 35.8%, 등/허리 35.8%, 목 28.8%, 팔/손목/손가락 28.5% 순 이었다. 성수기의 1일 근무시간이 팔/손목/손가락 부위를 제외한 나머지 부위에 영향을 주는 것으로 나타났다. 경기보조원의 업무특성과 관련하여 골프장의 경사와 굴곡의 정도, 내장객의 폭언 및 폭행, 업무의 속도를 조절할 수 없음, 일의 육체적 부담의 강도, 고용의 불안정성, 직장을 잃을 가능성 등이 근골격계 자각증상과 유의한 연관성을 보였다. 직무스트레스 특성에서는 정신적 직무요구도가 높은 반면, 낮은 직무 재량도를 보여 근무긴장도가 높은 것으로 조사되었다. 다변량 로지스틱 회귀분석을 실시한 결과 목 부위, 어깨 부위, 등/허리 부위 및 다리/무릎/발목/발 부위의 근골결계 증상에는 성수기 12시간 이상의 근무시간이, 팔/손목/손가락 부위의 증상에는 낮은 직무 재량도에서 유의한 영향을 미치는 요인으로 관찰되었다(P<0.05). 결론: 경기보조원의 근골격계 증상은 과중한 업무시간과 높은 직무요구도에 비해 낮은 직무재량도를 보이는 고긴장 직무 등에 의해 호소율이 높게 나타남을 알 수 있다. 근골격계 질환의 호소 요인에 대한 구체적인 대안의 마련과 더불어 정부기관에서 주도적으로 검토하여 경기보조원들이 속해있는 골프장 운영업체가 근골격계질환의 예방을 위한 조치와 경기보조원의 건강과 관련한 안전보건교육 등을 시행할 수 있도록 하는 방안이 마련되어야 할 것으로 본다. Objectives: This study evaluated the complaint rates of musculoskeletal symptoms and investigated the related factors of musculoskeletal symptoms in the caddies. Methods: For 316 caddies working at 6 regular golf courses, we used the self-recording questionnaires to examine general characteristics, job stress factors, subjective musculoskeletal symptoms designed by NIOSH, working environments, and working contents. Results: The complaint rates of musculoskeletal symptoms according to the musculoskeletal criteria of NIOSH were 41.8% in leg/knee/ankle/foot, 35/8% in the upper back/lower back, 28.8% in the neck, and 28.5% in the arm/wrist/fingers. Important factors affecting musculoskeletal symptoms were daily working hours during the high-demand seasons in all anatomical sites except the arm/wrist/fingers. Other related factors were degrees of winding and inclined in the golf courses, violent language and violence of customers, inability to regulate the velocity and work load control, heavy physical burden, instability of employment, and possibility of unemployment according to the specialty of caddies. As a results of multivariate logistic regression analysis, musculoskeletal symptoms of the neck, shoulders, back/lower back and leg/knee/ankle/foot were significantly influenced by working time over 12 hours in the high-demand season, and symptoms of the arm/wrist/fingers by low decision latitude (P<0.05). Conclusions: The complaint rates of musculoskeletal symptoms in the caddies were affected by working time over 12 hours and low decision latitude against excessively high psychological job demand.

디지털공제방사선촬영술을 이용한 치근단 흡수의 평가

허민석,이삼선,이경희,최항문,최순철,박태원 대한구강악안면방사선학회 2001 Imaging Science in Dentistry Vol.31 No.1

Purpose : This study was performed to compare the diagnostic ability of conventional intraoral radiographs with that of digital subtraction image and to assess the quantifying ability of digital subtraction image for simulated apical root resorption Materials and Methods : Conventional intraoral radiographs and digital images of ten sound maxillary central incisors and those with simulated apical root resorption were taken with varying horizontal and vertical angulations of the x-ray beam. The diagnostic accuracy to detect the lesion was evaluated on conventional intraoral radiographs and digital subtraction images by ROC analysis. The amount of simulated apical root resorption was also estimated on the reconstruction images by Emago□ and compared with actual amount of tooth loss using paired t-test. Results : The diagnostic accuracy of conventional intraoral radiographs to detect the apical root resorption was low(ROC area = 0.6446), and the sensitivity and the specificity of digital subtraction images were 100%, respectively. The calculated amounts of apical root resorption showed no statistically significant difference with the actual amounts of the lesion (p 〉 0.05). Conclusion : Digital subtraction radiography is powerful tool to detect the small apical root resorption, and quantitative analysis of small amounts of the lesion can be evaluated by digital subtraction radiography.(Korean J Oral Maxillofac Radiol 2001;31:51-5)

측두하와에 발생한 악성 섬유성 조직구종

허민석,이삼선,최순철,이경희 大韓口腔顎顔面 放射線學會 1999 Imaging Science in Dentistry Vol.29 No.2

Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life, but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area, the lateral wall of the maxillary sinus, and the ascending ramus of mandible. MRI demonstrated a well defined mass of intermediate signal intensity in T1 weighted images but T2 weighted images showed two distinctive regions of different characteristics. Upper portion of the lesion was of hyperintense signal but (at) lower protion, the signal intensity decreased clearly, which might mean that this lesion(mass) is composed of two different subtypes though it couldn't be confirmed by histopathological examination. Biopsy was taken the lesion as only in the soft tissue of the maxillary posterior alveolar region and confirmed the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.(J Korean Oral Maxillofac Radiol 1999;29:533-548)

포도나무가지 추출물의 프리라디칼 소거 작용 및 염증 발현 매개인자 생성 억제 효과

허선경,김선숙,허연희,안수미,이병곤,이상국 梨花女子大學校 藥學硏究所 2001 藥學硏究論文集 Vol.- No.10

Free radical scavengers or quenching agents for reactive oxygen species(ROS) present in consumable fruits, vegetables, and beverages have received considerable attention as potential antioxidants, and thus uses for treatment of several human diseases. In this study, grapevine shoot extract(GSE) containing high concentration of resveratrol and viniferine was evaluated for antioxidant potential and inhibition of pro-inflam-matory medicator production. Utilizing 1, 1-diphenyl-2-picrylhydrazyl(DPPH) scavenging activity and xanthine oxidase(XOD) inhibition assay the GSE showed inhibitory effects of DPPH radical scavenging and XOD activity with the IC_50 values of 34.5 ad 155㎍/ml, respectively. In addition, GSE also exhibited the inhibition of prostaglandin E_2(PGE_2) and nitric oxide(NO) production in lipopolysaccharide(LPS)-induced mouse macrophage RAW264.7 cells with the IC_50 value of 6.4 and 14.5 ㎍/ml, respectively. This suggests that grapevine shoot extract has the potential activity as a natural antioxidant or antiinflammatory agent.

돼지 하악골의 micro-CT 영상에서 추출한 3차원 골미세구조와 골강도 사이의 상관관계

허경회,박무순,이원진,허민석,이삼선,최순철 대한구강악안면방사선학회 2005 Imaging Science in Dentistry Vol.35 No.3

Purpose : To investigate the relationship between three-dimensional (3D) bone imaging parameters and trabecular strength in the mandible. Materials and Methods : Bone specimens were obtained from the mandibles of five male pigs weighing around 110 kg each. Of those, 43 samples were selected for 3D analysis and measured by micro-computed tomography. The five morphometric parameters were trabecular thickness (Tb.Th), bone specific surface (BS/BV), percent bone volume (BV/TV), structure model index (SMI) and degree of anisotropy (DA). Through destructive mechanical testing, strength parameters were obtained. Results : BV/TV, SMI, BS/BV, and Tb.Th showed significant correlations with strength parameters. DA did not show any correlation with the other parameters. In multiple linear regression analysis, BV/TV alone explained 43% of the variance in Young’s modulus. By stepwise inclusion of SMI, the variance in the Young’s modulus was better explained up to 52%. Conclusions : Predicting trabecular strength in the mandible through architectural analysis would be possible. Further study is needed to establish the tendency and variety of trabecular architecture and strength according to the locations within the mandible.

자가 면역성 간염에서 자가항체의 발현 양상과 스테로이드 치료의 효과

박기오,채경훈,허원석,강윤세,정재훈,김연수,문희석,이엄석,김선문,이병석,김남재,이헌영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 최근 8년간 본원에서 경험한 자기면역성 간염의 혈액학적 특징과 스테로이드의 치료효과를 알아보고자 본 연구를 시행하였다. 방법 : 1996년 이후부터 2002년까지 충남대학교 병원에서 1999년 International Autoimmune Hepatitis Group(LAHG)에서 제시한 수정 진단 기준안에 의거하여 총 진단점수가 probable 이상에 해당하는 환자들을 대상으로 임상적 특징, 검사실 및 조직 소견과 스테로이드와 azathioprine의 치료 효과를 후향적으로 조사하였다. 결과 : 9예의 환자들은 여성이 78%, 40대가 많았고, 급성 발병이 33.3%, 피로감, 식욕부진 및 황달 등이 나타났으며, 항핵항체가 55.6%에서 그리고 항평활근 항체가 77.8%에서 양성이었고, 동반 질환은 류마치스 관절염이 2예, 특발성 혈소판 감소증 1예, Henoch-Sch nlein 자반증 및 그레브스병이 각각 1예 씩이었다. 7예에 대해서 스테로이드와 azathioprine으로 치료하여 생화학적 임상적 완해가 이루어져서 유효한 치료 결과를 얻었다. 결론 : 자가면역성 간염은 우리 나라에서 원인을 찾을 수 없는 만성 간질환의 경우, 특히 중년여성에서 다른 자가면역성 질환이 동반되었을 때 자가면역성 간염을 의심하여 자가항체 선별검사를 시행해 보아야 할 것으로 생각된다. 향후 다기관 연구를 통하여 좀 더 많은 증례를 모으고 전향적인 연구를 시행하여야 할 필요가 있다. Although autoimmune hepatitis(AIH) is common in western contries, some studties have been reported in Korea. The aim of the study was to analyze the clinical and histological features and expression pattern of the autoantibody and to examine clinical course of AIH in Korea. For 9 patients diagnosed as having AIH in our hospital since 1996, we reviewed medical records and analyzed clinical and laboratory findings retrospectively. They had a probable or definite AIH according to the revised criteria of International AIH group. The mean age was 42.7(21∼68)years and 7(77.8%) were female. Three of them(33.3%) showed acute hepatitis and five of them showed cirrhosis. Fatigue and anorexia were the most frequently complained symptoms(55.6%). Four patients(44.4%) were accompanied with other autoimmune diseases. Antinuclear antibody was detected in 5(55.6%) and anti-smooth muscle antibody was detected in 7(77.8%). Three patients showed focal picemeal necrosis and four showed periportal fibrosis. Among 7 patients who received immunosuppressive therapy, six patients(85.7%) showed initial response. and biochemical and serologic remission were achived in 5(71.4%) and 3(42.8%) patients, AIH seems to be partly responsible for chronic liver disease of unknown etiology in Korea. AIH should be suspected in female patients with unknown chronic liver disease of unknown etiolgy, especially accompanied with other autoimmune disease. The clinical characteristics of AIH may not be quite different from those of Western countries.

단면 CT 영상을 이용한 무치악 하악 대구치부 잔존골의 형태 분석

이설미,허경회,이원진,허민석,이삼선,강태인,최순철 대한구강악안면방사선학회 2007 Imaging Science in Dentistry Vol.37 No.3

Purpose : The purpose of this study was to evaluate the morphologic features of posterior edentulous mandible for Korean patients using cross-sectional CT images. Materials and Methods : Computed tomographic cross-sectional views taken in 2004 and 2005 at Seoul National University Dental Hospital were analyzed by an oral and maxillofacial radiologist. Four indices were measured to meet the purpose of this study: 1) the horizontal distance between the alveolar crest and mandibular canal (Type), 2) the angle of the mandibular long axis (Angle), 3) the bucco-lingual location of mandibular canal, and 4) the depth of the submandibular fossa. The averages and standard deviations of the measurements were compared according to the location (the first and second molar area) and sex of the patients. Results : Statistically significant difference was found in Type, Angle, and submandibular fossa depth between the first and second molar area (P<0.05). However, there was no significant difference between men and women in any of the measured indices. Most of the mandibular canals were located in lingual side of posterior mandible. Conclusion : More care should be taken when an implant is installed on the mandibular second molar area.

다발성 연조직 종괴를 동반한 급성 림프구성 백혈병의 증례 보고

장정용,허경회,이원진,허민석,이삼선,최순철 대한구강악안면방사선학회 2005 Imaging Science in Dentistry Vol.35 No.2

A 15-year-old patient, who had been diagnosed and treated as Burkitt cell type acute lymphoblastic leukemia (ALLL3) already, visited our department. He complained of gingival enlargement and loosening teeth 1 month ago. The clinical examination revealed anterior open bite, gingival enlargement, and nontender swelling particularly in molar regions of both jaws. Deep periodontal pockets and severe mobility was shown on most of the teeth. The panoramic radiographs showed severe bone destruction and extrusion of the molars. The contrast enhanced CT showed multiple enhanced mass and bone marrow obliteration in both jaws. Chemotherapy was done and the swelling was subsided at 1 month later. In conclusion, radiologic findings of leukemia with soft tissue mass, known as chloroma or granulocytic sarcoma, mimic those of lymphoma, so blood test may be needed for the final diagnosis.

결합조직형성 법랑모세포종의 방사선학적 소견 : 증례보고 3례

최다혜,허경회,문제운,이원진,허민석,이삼선,최순철,박관수 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.37 No.1

Desmoplastic ameloblastoma is a rare histologic variant of ameloblastoma. It shows important differences in anatomic distribution, histologic appearance, and radiographic findings compared with the general type of ameloblastoma. It is histologically characterized by an abundance of densely collagenous stroma and radiographically a mixed radiolucent-radiopaque lesion. We present three cases of desmoplastic ameloblastoma. All the patients complained on buccal swelling with or without pain and the sites of occurrence were the anterior and the premolar region. Plain radiographs showed mixed radiopaque-radiolucent lesion with ill-defined or diffuse sclerotic margin and no external root resorption. Additionally, CT scans revealed buccal expansion and relatively well-defined margin of the lesions. The clinical and radiographic features of the presented cases were compared with those of the desmoplastic ameloblastoma in the previous literatures. (Korean J Oral Maxillofac Radiol 2006; 36 : 63-8)

CT사진을 이용한 한국인의 C형 치근관의 분포에 대한 연구

전록원,허경회,이원진,허민석,이삼선,최순철 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.2

Purpose : To investigate the incidence and prevalence of C-shaped root canal using computed tomographic images of head and neck in Korean population. Materials and Methods : Regardless of each examination purpose, randomly selected 268 examples which have serial axial computed tomographic images with 8 normal molars in maxilla and mandible were selected and investigated. Defined C-shaped root canal and we could get 82 proper image examples in view of this definition. These were detected and investigated of incidence and prevalence of C-shaped root canal. Results : C-shaped root canals were found in 82 examples among 268 (30.6%) and 147 teeth. They were only found on molar area, and the highest incidence was 37.41% of left mandibular second molars, and the lowest was 2.04%of right maxillary second molars. On prevalence of tooth position, mandibular second molar was the highest, 65% of C-shaped root canal teeth and maxillary second molar was 6% the lowest. Conclusion : 31% of randomly selected CT images no considering check-up reason have C-shaped root canals. The C-shaped root canals of mandibular second molar are found most frequently and they are also detectable on maxilla. On Korean population, C-shaped root canals are one of conditions that have to concern with dental treatment for it appears at a high prevalence relatively.