고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

부산시 가로수 현황과 토양환경개선에 관한 연구

김석규,박승범,남정칠,김승환,강영조 동아대학교 건설기술연구소 1999 硏究報告 Vol.23 No.2

The purpose of this study is to analyze the correlation between soil hardness, soil acidity, and the vitality of street trees. This data was investigatived in 40 areas on 10 main street routes of Pusan; Chungang-ro, Naktong-ro, Suyeong-ro, Taejong-ro, Konghang-ro, Kudeok-ro, Kumjeong-ro, Mandeok-ro, Kaya-ro, Chungjang-ro. The findings are as follows : 1. The average soil hardness where tree grates have been built was shown to be 22.23㎜. In the absence of tree grates, the average soil hardness was 24.60㎜. These figures do not exceed the accepted parameters for acceptable soil hardness when rearing trees (22∼25㎜). However, soil hardness was measured higher in areas where tree grates were absent. Consequently, tree grates are necessary. 2. Soil acidity was measured as satisfactory(pH 5.5), mediocre(pH 5.5∼5.0), inferior(pH 5.0∼4.5), very inferior(pH 4.5). No areas were measured as satisfactory soil acidity. Four areas were measured as mediocre(10%), 19 areas as inferior(47.5%), and 17 areas as very inferior (42.5%). This indicates a requirement to improve soil acidity as about 90% of the investigatived areas were measured as either inferior or very inferior. 3. The following is an analysis of correlation between soil hardness, soil acidity and the vitality of the Ginkgo biloba ; The Ginkgo biloba was found to have a positive correlation was measured with the diagram (R²). In conclusion, the results of the analysis show a strong influence of soil hardness and soil acidity upon the vitality of Street Tree.

개인의의 개방병원 참여에 대한 의견

김석범,권굉보,강복수,김기홍 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.1

A mailed survey with structured questionnaire was conducted to study the demand of private physicians who were operating their own clinics in the community to be a attending physician at the general hospital. The responding proportion was 21.6 percent of the 960 private physicians. A total of 207 responders : 65.2 percent wanted to be a attending physician. In particular, the physicians who were male, young, surgeon and teaching hospital careered after specialist were more highly motivated. The major activities what they wanted as a attending physician were medical care for the admission patients. They responded that the hospital charges for the medical services and the responsibility of malpractice issues should be fairly shared by attending physician and hospital according to their contributions. There is growing consensus that the need of attending physician at the general hospital will become wide spread, but little organizational preparation to assure the quality of medical care of attending physicians including training of resident physicians and students. In addition, the effective reimbursement system should be develop to compensate appropriately according to the medical achievement of the attending physicians.

고혈압 환자들의 건강행태

김석범,강복수,윤성호,황정희,이경수 韓國保健敎育.健康增進學會 2000 보건교육건강증진학회지 Vol.17 No.1

This study was conducted to examine health behaviors in hypertensive patients and the factors that would affect these healthy life-styles, and to provide basic data for effective and continuous hypertension control in private medical facilities. Among those patients diagnosed as hypertension who had visited the Department of Internal Medicine of Yeungnam University Hospital during the two month period from August 2 to September 30, 1999, the present study included 222 patients who were in more than one month after the initial diagnosis of hypertension and those who had hypertension for less than 10 years. Using a structured questionnaire, the present study was conducted by a self-administered survey method, and the obtained data were analyzed with t-test, χ2-test and one-way analysis of variance using the SPSS statistical program. The scores on knowledge related to hypertension were higher as the education level of a patient was higher(p〈0.05). As for occupation, those who performed office or management jobs showed higher scores than those who were into manufacturing jobs, and as for economic status, although those patients who were in middle class showed highest scores, however, no statistical significance was observed. The scores of knowledge on hypertension was higher when the family history hypertension was present(p〈0.05). The scores of health-related behaviors were higher with higher education level and higher economic status, higher in those with family history of hypertension, and higher in those with office or management jobs than those who had manufacturing jobs(p〈0.05). Blood pressure measurement on regular basis was performed most frequently in those who were between 50∼59 years old with 83.3% and was least frequent in those who were older than 70 years old with 50%(p〈0.05). The frequency of regular blood pressure measurement was higher with higher education level, higher economic status, higher in those with family history of hypertension, and the highest in those with management position with 93.5%, however, on statistical significance was observed. Changes in health-relaxed behaviors after hypertension diagnosis were higher with higher education level, higher economic status, and in those patients performed office or management work. In particular, diet change was observed in female and higher economic status and smoking cessation was observed in 60∼69 years old. Housewives and office workers or managers have taken exercise more regularly and those who had management jobs and had high scores on knowledge related to hypertension would participate health education program more actively. Thus, for improving health-related behaviors for continuous management of hypertension, changes in health-related behaviors can be followed through conduction health education to improve understanding of knowledge related to hypertension as the method of helping to improve changes in health life-styles in those with little education and those in low economic status.

성인 여성의 골밀도와 관련된 요인

도준형,강복수,주리,김석범,김상규 한국모자보건학회 2000 한국모자보건학회지 Vol.4 No.2

수술실 간호사의 스트레스와 관련된 요인 분석

홍복화,강복수,김석범 韓國保健敎育學會 1996 보건교육건강증진학회지 Vol.13 No.1

To measure the degree of work stress and identify factors influencing the stress among OR nurses, a study was implemented for 131 OR nurses working at four university hospitals in Taegu city through self administered questionnaires. Mean score of total work stress of nurses was 3.71, when maximum score was 5. Relatively high degrees of work stress was evident among OR nurses. When the related factors of the stress specified in the questionnaire were grouped into 11 categories, the repondents turned out to feel the highest stress when they were faced with the categories of non-peculiar duty and personal conflict with doctors. The most stressful events were nursing malpractice during surgical operations and damage to OR equipments. The nurses more susceptible to workstress were married with one child, less educated and worked at OR for 3 to 6 years.

극미세 입자 Aluminosilicate 계 졸의 합성 및 응용 : (Ⅰ) SiO₂및 γ-AIOOH졸의 제조 및 케릭터라이제이션

현상훈,송재권,강범석 연세대학교 산업기술연구소 1993 논문집 Vol.25 No.1

Nanoparticulate silica sols could be synthesized by an interfacial hydrolysis reaction between TEOS and high alkaline water. The silica sols were extremely stable at pH of 8 and their average particle sizes were less than 3 nm, while very unstable between 4 and 5 of pH. The sol particles grew up to about 10 nm within 1 day in the region of pH less than 7. It was found that the silica sol with pH less than 2 was stabilized without further growing after 1 day-aging. The particle size of γ-AlOOH sols synthesized via the modified Yoldas-method could be controlled according to the mole ratio of nitric acid/aluminium tri-sec-butoxide(0.07∼1.0). The stable γ-AlOOH sol with the average particle size of 45 nm, which was prepared using the mole ratio of 0.07, was estimated to be suitable for coating reproducible γ-AlOOH membrane layers with the high specific surface area.

산업장 근로자들의 건강증진 프로그램에 대한 수요

유중선,김석범,강복수 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

산업장 근로자들의 건강과 관련된 변수 및 행태를 조사하고, 그들이 원하는 건강증진 내용을 각 근로자의 특성별로 조사하여 비용-효과적인 근로자 건강 증진 프로그램을 개발하기 위해 1995년 12월부터 1996년 1월 사이에 실시된 40개의 근로자 일반 건강검진 및 특수검진 사업장에 근무하는 근로자 500명을 무작위로 추출하여 검진 실시와 병행하여 이 연구를 위해 개발된 설문지를 이용하여 자기기입식 방법에 의해 자료를 수집하였다. 현재 직장에서 실시하고 있는 건강증진 활동으로는 야외운동이 14.8%로 가장 많았으며, 정기적 건강검진, 실내운동 및 맨손체조 순이었다. 남자에서는 야외운동이 가장 많이 수행하는 건강증진 활동이었으며, 여자에서는 정기적 건강검진이 가장 많았다. 전체적으로 여자에 비해 남자의 건강증진 활동률이 더 높았다. 앞으로 현재근무하는 직장에서 실시되기를 희망하는 건강증진 활동은 정기적 건강검진이 26.2%로 가장 많았으며, 건강상담, 실내운동 및 야외운동 순이었다. 남자에서는 정기적 건강검진이 33.7%로 가장 많았으며, 그 외에도 건강상담, 실내운동, 야외운동 순으로 희망하였다. 여자에서는 체중관리 프로그램이 21.4%로 가장 많았고, 정기적 건강검진, 건강상담 등의 순이었다. 근무부서별 희망 건강증진 활동은 생산직의 경우 남녀근로자 모두 정기적 건강검진을 가장 선호하였고, 사무직의 경우 남자는 정기적 건강검진을, 여자는 체중관리 프로그램을 가장 많이 희망하였다. BMI 지수별 희망 건강증진 활동은 저체중 근로자 중 남자는 영양교육을, 여자는 체중관리 프로그램을 가장 선호하였다. 정상체중에 속하는 여자 근로자들도 체중관리 프로그램을 가장 선호하였다. 규칙적인 운동 및 식사를 하는 근로자는 남녀 모두 정기적 건강검진을 가장 선호하였으며, 규칙적인 운동 및 식사를 하지 않는 근로자 중 여자는 체중관리 프로그램을 가장 선호하였다. 남자 근로자는 음주 및 흡연 여부에 관계없이 정기적 건강검진, 건강상담 및 실내운동 순으로 선호하였다. 이상의 결과로 앞으로 가장 우선적으로 실시해야 할 건강증진프로그램은 정기적 건강검진이며 현대 실시중인 근로자 정기신체검사에 대한 만족도가 낮아 검진의 내용과 방법에 대한 개선이 요구되며 여성근로자들에 대한 체중 및 영양에 대한 올바른 지식 및 태도를 갖도록 하는 교육프로그램과 흡연근로자들을 대상으로 하는 금연프로그램의 필요성을 고취시켜야 하겠다. This study was conducted to identify the demand of work-site health promotion program of employees. A self-administered questionnaire method was used to collect data from 492 employees from 40 work-sites in Taegu City and Kyungpook Provincial area. The work-site health screening programs conducted for several years were placed low value by employees. The out-door exercise was the most popular health promotion activity implemented at work-site as a whole. The employees expressed that periodic health check-up, the health counseling, indoor exercise would be implemented as a health promotion program in the future. The male employees regarded that the periodic health check-up program should be established preferentially at work-site. However, the female employees gave priority to fitness program. The health related behavioral patterns slightly influenced the preference of health promotion program. The health screening program for employees should be improved and the health education of nutrition and diet for female employees should be implemented.

외래 의료서비스 질적 수준의 결정요소

박숙희,김석범,강복수 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.2

This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived. "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.