쓰레기 매립장 주변 농촌 주민들의 삶의 질 연구

이명경,최준열,김인경,조영아,김영신,정혜진,김리나,이영규,조영태,Lee, Myung-Kyung,Choi, Jun-Yeol,Kim, In-Kyoung,Cho, Yeong-Ah,Kim, Young-Shin,Jung, Hye-Jin,Kim, Li-Na,Lee, Young-Kyu,Cho, Young-Tae 대한예방의학회 2006 예방의학회지 Vol.39 No.4

Objectives: This study aims to examine if a garbage dumping site has real and negative influence on the quality of life (QOL) for the nearby residents. The net effects of the residential distance from the garbage dumping site and from the garbage truck route were investigated for five domains of the QOL. Methods: Two hundred fifty seven Shin-dong Myeon residents, Chun-cheon Si, participated in a self-administrated survey. The Shin-dong Myeon garbage dumping site began operating in 1996. ANCOV A with generalized linear models and multiple regression analysis were performed. Results: Descriptive analyses show that a residence nearby a garbage dumping site is negatively associated with the physical and environmental domains of the QOL. The residential distance from the garbage truck route does not exert any significant effect on various domains of QOL, except for the environmental domain. On the multivariate analysis, the residents living near the garbage dumping site tended to have a significantly negative QOL in the physical and environmental domains. However, the distance from the garbage truck route did not show a significant nor substantial effect on the QOL. The demographic and socioeconomic control variables are associated with a number of the QOL domains, and their patterns are consistent with the general expectations. Conclusions: The results indicated that a garbage dumping site is considered to be an environmental hazard among the nearby residents according to the lower scores on the physical and environmental domains of the QOL. The findings from this study provide comprehensive understanding on the residents' QOL, and they may help politicians and policy makers make decisions for appropriate interventions.

한국판 IOWA 코너스 평정 척도의 개발

신민섭,류명은,김붕년,황준원,조수철 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.1

Objectives : This study was conducted to develop the Korean version of the I0WA Conners rating scale (K-IOWA), and to examine its reliability and validity. Methods : The subjects were 41 normal children and 40 ADHD children between the ages of 5 and 12. All of the teachers administered the K-IOWA and the abbreviated Conners' rating scale to calculate the internal consistency coefficient of the K-I0WA and to examine its validity. Results : The reliability coefficient of the K-IOWA (Cronbach's α) was .913. The range of correlation coefficients between K-IOWA scores and the Abbreviated Conners Rating Scale scores were from .81 to .93. The mean score of the ADHD group on the K-IOWA was significantly higher than that of the normal group. The result of factor analysis showed that the K-IOWA was composed of 2 factors (Inattention/Overactive and Oppositional/Defiant). Conclusion : These results suggest that the K-IOWA rating scale is a very reliable and valid test and it would be useful in diagnostic evaluation and the treatment effect for ADHD children.

뇌동맥류 파열 후 뇌지주막하 출혈로 인한 신경학적으로 불량한 환자에 대한 급성기 수술의 성적

신규만,김명현,송준혁,김성학 梨花女子大學校 醫科大學 醫科學硏究所 1999 EMJ (Ewha medical journal) Vol.22 No.2

Objective: Despite of recent advances in pharmacological treatment and improvement surgical and anesthetic techniques, subarachnoid hemorrhage(SHA) from ruptured intracranial aneurysms with poor clinical grades still carries unacceptably high morbidity and mortality rates. Recently surgery for aneurysmal SAH with poor clinical grade has increased interest. Method : The authors experienced 57 patients with poor clinical grade (Hunt and Hess grade Ⅳ-Ⅴ) after ancurysmal SAH. Among them 25 patients were treated with immediate CSF drainage via ventriculostomy, blood pressure control, early angiography(except 3 patients) and surgery within 12 hour of admission. The outcomes of patients were categorized using a four-tiered scale : 1) independent and working 2) impaired but independent 3) severly impaired and dependent 4) dead Results : The average age was 48(13-75) and the male to female ratio was 7:18 in surgical group. The average time to admission and surgery was 12 hours or less among the 25 patients. Among them 9 cases were dead, 2 cases were severly impaired and dependent, 3 cases were impaired but dependent, and 11 cases were independent and working. In this patient all cases, exception one could be ligated with a clip. Conclusion : The above results suggest that the acute aggressive surgery based on appropriate selection in poor aneurysmal SAH patients can reduce of the mortality.

전교통동맥 동맥류의 조기수술

신규만,송준혁,김명현,최혜영 梨花女子大學校 醫科大學 醫科學硏究所 1996 EMJ (Ewha medical journal) Vol.19 No.4

Objectives : The timing of aneurysm surgery has been a topic of major neurosurgical controversy. Aneurysmal rebleeding is the most cataclysmic and disabling event following initial subarachnoid hemorrhage. Thus, early surgical obliteration of aneurysm eliminates the potential for rebleeding during the highest risk period. Method : The results of operation for the twenty-three patients who had admitted to neurosurgical departments, Mokdong hospital and undergone surgery within the 24-72 hours after initial rupture of these aneurysms from October, 1993 to August, 1996, were reviewed. Results : Twenty-three patients underwent craniotomy for clipping and intracranial clot evacuation, and postoperative hypertensive, hypervolemic, and hemodilution therapy. The outcome was excellent in 10(43%), good in 3(13%), poor in 5(22%) and death in 5(22%). The mean age was 57.7 and the ratio of male to female was 13:10. The outcome according to Hunt-Hess(H-H) grade was followings. H-H grade 1 was 2(%) and all excellent outcome, H-H grade 2 24(61%) and the outcome were excellent in 8(35%), good in 1(4%), poor in 2(9%), death in 3(13%), H-H grade 3 was 6(26%) and good in 2(9%), poor in 2(9%), death in 2(9%), and H-H grade 4 was 1(4%) and the outcome was poor in 1(4%). The outcome according to grading system of Fisher was followings. Grade 2 was 6(26%), and the outcome was excellent in 5(22%) and death in 1(4%). The grade 3 was 14(61%) and excellent in 5(22%), good in 2(9%), poor in 3(13%), and death in 1(4%). The grade 4 was 3(31%) and good in (4%) and poor in 2(9%). The variations in anterior communicating complex were followings. The both A_1 equal in 6(26%), left A_1 dominancy was 1(4%), right A_1 atresia was 13(57%) and left atresia was 3(13%). Conclusions : The most favorable outcomes and lowest mortality rate were patients of H-H grade 1 group. The surgical results of alert patients with early surgery should even further improve as compared to delay surgery. However, patients who present in poor medical condition at the time of operation were still indicated delay surgery.

안와상 접근법

신규만,송준혁,김명현 梨花女子大學校 醫科大學 醫科學硏究所 1996 EMJ (Ewha medical journal) Vol.19 No.3

Objective : The approaches for skull base lesions should allow excellent visualization, minimized working distance and avoid brain retraction. We consider the supraorbital approachto be the approach of choice for orbital, anterior and middle cranial fossae lesions. Thetechnique of procedure is described and reviewed its advantages. Material & Methods : the authors reviewed the eleven cases which were operated bysupraorbital approach and one case which were operated by supraorbital bifrontal approach,from May 1992 to May 1996. Results : Eleven patients(four cases of tuberculum sellae meningiomas, one case of pituitarymacroadenoma, two case of suprasellar germinoma, one case of cavernous hemangioma in theorbit, two cases of huge size of craniopharyngiomas, one case of optie and oculomotor nervepalsy due to compound fiacture of orbit) were cured or improved with the supraorrbtal andsupraorbito-bifrontal approsch. But one case of suprasellar germinoma died. Conclusions : The supraorbital approach is preferred in lesions of orbital, anterior and middlecranial fossae, because it minimize brain retraction, shorten the distance of the target of lesionsand provide multiple pathways for dissection of the lesions. Also this approach may combinewith other skull base approaches.

흰쥐에서 염화비닐 폭로수준에 따른 소변내 thiodiglycolic acid 농도의 변화

왕승준,차봉석,노재훈,신동천,김명수,전근재 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : It is the objective of this research to identify the variation of thiodiglycolic acid(TdGA) in urine with vinyl chloride monamer(VCM) exposure levels through methylation. Methods : After rats were exposed to vinyl chloride monomer of 4 levels, 0㎎/㎥, 50㎎/㎥, 150㎎/㎥, 500㎎/㎥, respectively, of which urine was sampled in each sampling time of 0 hour, 2 hours, 4 hours, 8 hours, 16 hours, 36 hours, 48 hours. After urine had been methylated with diazomethane in the preliminary experiment and the peak of 146 m/z had been verified, the main experiment was done. Results : In the variation of TdGA with sampling times, concentration of TdGA increased rapidly in 4 hours and then decreased after 8 hours. When the variation of urinary TdGA concentration in urine according to exposure level of VGM was verified through Kruskal-Wallis statistical method at each sampling time, the significant increment with the exposure levels at 2 hours, 4 hours, 8 hours after exposure was clarified. Conclusion : TdGA concentration in urine with increment of VCM exposure level increased, especially significantly at 2 hours, 4 hours, 8 hours of sampling time.

성인원외폐렴의 원인미생물에대한 전향적 다기관 연구 : 성인원외폐렴의 원인으로 세균의 역할을 중심으로

우준희,강재명,김양수,신완식,류진홍,최정현,김양리,정희진,어수택,박춘식,정문현,정기석,이찬주,류지소 대한감염학회 2001 감염 Vol.33 No.1

Background : Communite-acquired peumonia (CAP) is one of the leading causes of mortality and morbidity. Despite progress in diagnostic techniques and treatments, management of pneumonia remains challenging, because the precise etiology remains uncertain in as many as 49% of cases. The limitaions of identifying etiologic agents make it necessary to use empiric antibiotics in almost all patients, and furthermore emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric antibiotic regimen. For the optimal choice of empirical antibiotics, we should know the frequency of etiologic agents and antimicrobial resistance rates in the community. Methods : A prospective multicenter study of community-acquired pneumonia in Korea was carried out between May 1997 and April 2000. The microbiologic diagnosis was based on the results of sputum culture, blood culture and pleural culture. Results : Five hundred eighty eight cases of community-acquired peumonia in 562 patients admitted to the hospitals. The mean age was 59.9 with male predominance (58.3%), and 370 (63%) had underlyin gillness. The etiologic agents were identified in 38.3%, and the list of individual agents, in decreasing order, was Streprococcus pneumoniae (21.7%), Klebsiella pneumoniae (14.8%) Pseudomonas aeruginosa (9.8%), Staphylococcus aureus (9.5%), viridans group streptococci (5.7%), Enterobacter cloacae (4.2%), Hemophillus Influenza (3.8%), The rates of admission to the intensive care unit was 10.4%. The motality was 7.1%. Susceptible rates of S. pneumoniae to penicillin was 36.6% and showed multidrug resistant. Forty percents of S. aureus were methicillin-resistant S. aureus. K. penumoniae were susceptible to cephalosporin and quinolone. Conclusion : In Korea, S.pneumoniae is the most important agent causing community-acquired pneumonia. Susceptible rates of S. pneumoniae to penicillin was 36.6% and showed multidrug resistant. Gram negative bacteria such as K. pneumoniae, P. aeruginosa showed high incidence when compared with that of other countries. Most of them had underlying diseases including bronchiectasis and chronic obstructive pulmonary diseases. (Korean J Infect Dis 33:1∼7, 2001)

뇌지주막하 출혈 환자에게서 경두개도플러와 SPECT를 사용하여 측정한 이산화탄소 반응성에 대한 연구

김명현,신규만,송준혁 梨花女子大學校 醫科大學 醫科學硏究所 1998 EMJ (Ewha medical journal) Vol.21 No.1

The assessment of the cerebral vasoreactivity provides information regarding to the reserve capacity of the cerebral circulation in patients with cerebrovascular disease, which has important therapeutic consequencies because it allows for the diagnosis of impending ischemia and for the control of the effect of initiated correcitive measures. The author performed transcranial doppler study to measure the CO2 reactivity to the entire basal cerebral arteries in 30 cases of control group and 10 cases of disease group between 3rd and 7th day after insult. The control persons involved 10 cases of 3rd decade, 10 cases of 5th, 10 cases of 7th, and the diasease persons involved 10 cases of spotanenous subarachnoid hemorrhages. All disease patients were examined by single photon emission computed tomography and their results were compared to Doppler CO2 reactivities. In control group, the mean blood flow velocity and pulsatility index increased with age, but the CO2 reactivity decreased. In patient group, MBFV, PI index, MI ratio were not correlated to the presence of disease, but only CO2 index was decreased than the same age group of normal control. The regions showing abnormal ROI by SPECT well corresponded with the regions showing decreased CO2 reactivity. There was no close correlation between ROI(Region of Interest) index and CO2 index, but the CO2 reactivity was remarkably decreased in the region which showed abnormal regional cerebral blood flow in SPECT findings(p=0.04). In the relationship between the various prognostic factors, ROI increased as the clinical status worse(r=-0.05, p=0.0008), the acute prognosis(3Mo) had positive correlation with CO2 omdex(r=0.32, p=0.04) or clinical status, and negative correlation with ROI index(r=0.40, p=0.0094). Transcranial doppler CO2 testing in patients with spotanenous subarachnoid hemorrhage provides useful information regarding hemodynamic state, prognosis and determination of beneficial effects specific therapy. In the various TCD parameters, CO2 index was correlated well with the acute prognosis.

소아에서 출혈을 동반한 단일 연소성 용종의 내시경적 절제술

김준기,조상욱,신성하,고영춘,최정영,서강석,강명원,임연근,여향순,김경수 全南大醫大 2001 전남의대학술지 Vol.37 No.3

가토의 뇌동맥류 모형에서 모동맥 및 동맥류 협자에 따른 동맥류 내압의 변화 :기초 연구

김은영,송준혁,김명현,박향권,김성학,신규만,박동빈 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.4