Productivity Loss of Rheumatoid Arthritis Patients according to the Their Stages of the Disease Activity Score

( Sang-Cheol Bae ),( Jin-Hye Cha ),( Jung-Yoon Choe ),( Sung Jae Choi ),( Soo-Kyung Cho ),( Won-Tae Chung ),( Chung-Il Joung ),( Young-Ok Jung ),( Young Mo Kang ),( Dong-Wook Kim ),( Jinseok Kim ),( Y 대한류마티스학회 2018 대한류마티스학회지 Vol.25 No.2

Objective. Productivity loss was compared by 3-stage of disease activity and associations between higher disease activity and high productivity loss were identified. Methods. Data were extracted from Rheumatoid Arthritis (RA) Patient-reported Outcomes Research, which enrolled 2,000 RA patients (>20-year) on disease-modifying-antirheumatic-drugs (DMARDs) (≥ 6-month) from December 2012 to June 2013. This included 1,457 RA patients with the disease activity score (DAS-28-ESR) in their medical charts. Productivity loss in time and indirect cost was estimated using The World Health Organization Health and Work Performance Questionnaire (HPQ). Baseline characteristics and productivity loss outcomes were compared according to DAS-28-ESR groups. Results. 84.4% were females, 54.2% had low DAS-28-ESR (<3.2), and 38.2% and 7.6% had moderate (3.2∼5.1) and high DAS-28-ESR (>5.1). Patients with moderate to high DAS-28-ESR had higher lost productivity time (LPT) and monthly costs of LPT than those with low DAS-28-ESR (time in hours: 110.0±58.4 vs. 132.4±57.2 vs. 71.5±52.0, p<0.0001; monthly costs of LPT in 1,000 Korean won: 1,097±607 vs. 1,302±554 vs. 741±531, p<0.0001). Multiple regression analyses revealed significant associations with high LPT in high (adjusted odds ratio [OR]=3.87, 95% confidence interval [CI]: 2.18∼6.87) and moderate DAS-28-ESR (adjusted OR=1.88, 95% CI: 1.41∼2.52) compared to low DAS-28-ESR. In addition, positive associations with high monthly costs of LPT were observed in high (adjusted OR=3.45, 95% CI: 1.98∼5.99) and moderate DAS-28-ESR (adjusted OR=1.93, 95% CI: 1.43∼2.54) compared to low DAS-28-ESR. Conclusion. Timely therapeutic strategies should be taken into consideration given that the RA patients with moderate to high DAS-28-ESR showed strong associations with high productivity loss for effective management of RA. (J Rheum Dis 2018;25:122-130)

감염된 가축과의 직접 접촉 없이 발생한 브루셀라증 환자1례와 축산 부산물 시장에서의 역학조사 : Sero-epidemiology Study on Market, by-product, Stock-raising

정성주,김성범,박대원,정혜원,기세윤,권정아,박만석,박미연,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

브루셀라증은 전 세계적으로 발생하는 인수공통 전염병중에 하나로서, 본 증례는 국내에서 감염된 가축에 대한 노출력이 없는 집단에서 현증 브루셀라증이 발생한 첫 증례이기에 문헌 고찰과 함께 보고한다. 또한 환자가 근무하였던 축산물 부산물 시장에서 역학 조사를 실시하여, 현증환자 및 기감염자를 발견하여 축산물 부산물 시장 근무자에서 현증 브루셀라증이 발생할 위험성을 평가하였다. 역학 조사 결과 축산물 부산물을 다루는 일을 하는 사람들에서 감염된 가축과의 직접 접촉이 없이도 브루셀라증이 발생할 수 있음을 알 수 있었다. Brucellosis is a world-wide zoonotic disease. We report the first case of brucellosis in South Korea that is not related to direct contract with intected cattles. The patient had been working in the market of by-product, stock raising for twenty years and complained of 1-month history of fever, chill, and intermittent epistaxis. We confirmed brucellosis by anti-brucella antibody test and PCR. After 6 weeks' treatment with rifampicin and doxycycline, fever and chilling subsided, and, generalized weakness and oral intake improved. We performed seroepidemiology study against workers who were working in the same market as the patient. However, we couldn't find out other cases with seropositivity. We concluded that although the workers of by-product market have a risk of getting brucellosis, the risk is low.

Implementation of UPT Service in WIN-Based Mobile Communication Networks

Yun Won Chung(정윤원),Min Young Chung(정민영),Dan Keun Sung(성단근),In Jeong Kim(김인정),Jung Keun Shin(신정근),Sung Kim(김성) 한국통신학회 1999 한국통신학회 학술대회 및 강연회 Vol.1999 No.4

한국에서의 간질의 사회적 낙인

이상암,유희정,허경,박형국,신동진,송홍기,정원영,권오영,이성수,김요식,김성은,이병인 대한간질학회 2002 대한간질학회지 Vol.6 No.2

2010 해남, 평창, 원주지역 갈대 등 야초류의 이용실태와 사료가치 평가

서성(Sung Seo),한대덕(Dae Duk Han),장선식(Sun Sik Jang),김원호(Won Ho Kim),정민웅(Min Woong Jung),최진혁(Jin Hyuck Choi),김진숙(Jin Sook Kim),김하영(Ha Young Kim),이종경(Joung Kyong Lee) 한국초지조사료학회 2012 한국초지조사료학회지 Vol.32 No.1

본 연구는 부존 조사료자원 이용으로 수입사료를 줄이고 사료비를 절감하고자 2010년도에 전남 해남(간척지), 강원 평창(강변), 원주(섬강변), 전남 영광(와탄강변) 등 4개 지역에서 갈대와 억새 등 야초 자생지를 탐색하고, 수확·이용실태 조사와 함께 사료가치를 분석하였다. 전남 해남 해남목장 내 갈대(Phragmites communis) 위주의 야초 자생지는 300 ha로 예년에는 2회 곤포작업하여 연간 사일리지로 2,300~2,500톤(ha당 8톤)을 생산하였으나 2010년도는 1회 곤포조제로 사일리지 2,000톤(ha당 7톤)을 생산하였다. 유통가격은 롤 당 53천원으로 ㎏당 110원이었다. 곤포는 전량 자가소비하며, 외부 작업단에 롤 당 26천원의 작업비를 지불하였다. 연간 조수입은 2억 2,260만원이며, 소득은 1억원 수준(345천원/ha)이었다. 초장 150 ㎝의 갈대는 조단백질 8.4%, 상대사료가치 71.9 (건초 5등급), 건물 소화율 60.1%로 사료가치는 볏짚에 비해 약간 나은 것으로 평가되었다. 갈대 사일리지의 사료가치와 유기산 함량은 동일 지역에서 동일한 재료로 사일리지를 조제하더라도 수확시기에 따라 차이가 컸으며(CP 4.7~6.4%, RFV 62.2~78.9, 건물 소화율 41.9~53.9%), 갈대 사일리지의 품질은 수단그라스에 비해 불량하였다. 강원 평창 강변 자생갈대의 사료가치는 초장이 79, 117, 121, 142㎝로 생육이 진행됨에 따라 낮아져, 조단백질은 각각 13.9%에서 7.6%로, 상대사료가치는 90.7 (건초 3등급)에서 76.1 (건초 4등급)로, 건물 소화율은 72.9%에서 54.7%로 감소하였다. 원주 섬강 주변 야초류는 곤포수확 작업에 어려움이 있었으며, 초장 130 cm의 갈대는 조단백질 8.5%, 상대사료가치 82.3 (건초 4등급), 건물 소화율 70.2%로 사료가치는 높았으며, 220㎝의 성숙한 갈대는 조단백질 10.2%, 상대사료가치 65.1 (건초 5등급), 건물 소화율 48.9%로 볏짚 대비 조금 나은 것으로 평가되었다. 전남영광지역에서는 와탄천 주변에 자생하는 갈대를 수거 이용하고자 시도하였으나 경제성이 없어 중단하였다. 이상의 결과를 종합하여볼 때, 갈대, 억새 등 야초류는 현 상태에서 최대한 수거·이용하되, 사료가치를 유지하고 가축 기호성이 양호한 시기에 수확하는 것이 중요하며, 최소한 볏짚과 비슷하거나 그 이상의 사료가치를 기대하기 위해서는 7월 중순 이전(늦어도 7월까지)에 수확·이용하는 것이 권장된다. This study was carried out in 2010 to investigate the utilization and forage quality of native grasses, such as Phragmites communis which might reduce the cost of feeding domestic cattle. The regions surveyed were the Haenam ranch in Haenam, Pyeongchang, Wonju, and Yeonggwang. In Haenam, yearly silage production harvested from 300 ha was 2,000 MT (7 MT/ha). All of those round bale silages were self-consumed in that region, and marketing price was 50,000 55,000 won per roll (110 won/㎏). Phragmites communis of 150 ㎝ in length contained 8.4% crude protein (CP) with relative feed value (RFV) 71.9 and 60.1% in vitro dry matter digestibility (IVDMD), which was somewhat more favorable than forage quality of rice straw. The silage quality of Phragmites communis varied greatly by the time of harvest (CP 4.7 6.4%, RFV 62.2 78.9, and IVDMD 41.9 53.9%), even with the same district and of the same original forage materials. Generally, the quality of Phragmites communis silage of was poorer than that of sorghum * sudangrass hybrid. In Pyeongchang, forage quality of Phragmites communis was decreased from 13.9% to 7.6% in CP, 90.7 to 76.1 in RFV, and 72.9% to 54.7% in IVDMD, as plant was getting mature, from 79 ㎝ to 117 ㎝, 121 ㎝ or to 142 ㎝ in length. In Wonju, the quality values of Phragmites communis of 130 ㎝ in length were 8.5% CP, 82.3 RFV and 70.2% IVDMD, while those of matured grasses of 220 ㎝ in length were lower (10.2% CP, 65.1 RFV and 48.9% IVDMD), but this was a little more favorable than quality of rice straw. In Yeonggwang, feeding Phragmites communis was tried in a Hanwoo feed, but stopped due to low profitability. In conclusion, the overall quality of most native grasses including Phragmites communis in this survey was poor. Therefore, we recommend that Phragmites communis and native grasses should be harvested on June or July to obtain richer forage quality in forage values than rice straw.

2010 파주, 안산지역 갈대, 억새 등 야초류의 이용실태와 사료가치 평가

서성(Sung Seo),김원호(Won Ho Kim),정민웅(Min Woong Jung),박형수(Hyung Soo Park),심재진(Jae Jin Shim),박진길(Jin Gil Park),성하균(Ha Guyn Sung),김종덕(Jong Duk Kim),이종경(Joung Kyong Lee) 한국초지조사료학회 2011 한국초지조사료학회지 Vol.31 No.2

본 연구는 부존 조사료자원의 이용을 활성화하여 수입사료를 줄이고 가축 사료비를 절감하고자 2010년도에 경기 파주 (민통선 지역)와 경기 안산 (시화지구)에서 갈대와 억새 등 야초자생지를 탐색하고, 수확?이용실태 조사와 함께 사료가치를 분석하였다. 파주 민통선 내억새 (Miscanthus sinensis)와 갈대 (Phragmites communis) 혼합 자생지는 90~100 ㏊ 규모로, 1차 곤포작업으로 사일리지 520톤 (㏊당 6톤), 2차로 380톤 (㏊당 4톤)을 조제하여, 연 사일리지 900톤 (㏊당 10톤)을 생산하였다. 곤포의 유통가격은 롤당 52~55천 원으로 ㎏당 130~137.5원이었다. 곤포는 자가소비 50~70%, 판매유통 30~50%로, 수익성은 인건비 정도로 추정되었다. 초장 70 ㎝의 재생 억새는 조단백질 9.6%, 상대사료가치 82.4 (건초 4등급), 건물 소화율 67.7%, 초장 70 ㎝의 재생 갈대는 각각 13.8%, 84.3 (4등급), 67.9%로 사료가치는 높았으며, 수확이 늦어짐에 따라 사료가치는 크게 낮아졌다. 안산 시화지구 (3공구)의 갈대 등 야초류자생지는 100 ㏊ 정도로 2009년도에는 50 ㏊에서 사일리지 550톤 (㏊당 11톤)을 생산하여 롤당 50천 원에 유통하였으며, 2010년도는 잦은 강우와 장마로 부분 이용에 그쳤다. 고초기의 갈대는 건물률 89.8%, 조단백질 2.2%, NDF 80.6%, ADF 55.4%, 상대사료가치 52.9 (5등급), 건물 소화율 36.4%로 볏짚에 비해서도 사료가치는 크게 낮았다. 초장 80 ㎝의 재생 갈대는 조단백질 12.9%, 상대사료가치 99.8 (3등급), 건물 소화율 66.6%로 사료가치는 양호하였으며, 개화기의 초장 150 ㎝ 갈대는 조단백질 4.5%, 상대사료가치 59.9 (5등급), 건물 소화율 42.2%로 볏짚의 사료가치와 비슷하였다. 이상의 결과를 종합하여볼 때, 갈대, 억새 등 야초류는 현 상태에서 최대한 수거?이용하되, 사료가치를 유지하고 가축 기호성을 고려한 시기에 수확하는 것이 중요하며, 최소한 볏짚과 비슷하거나 그 이상의 사료가치를 기대하기 위해서는 7월 중순 이전 (늦어도 7월까지)에 수확?이용하는 것이 권장된다. 본 연구에서 조사된 대부분의 야초류는 상대사료가치가 75 이하인 건초 5등급으로 사료가치는 매우 낮았으며, 키가 작은 영양생장기에 수확한 경우에만 4등급으로 나타났다. 부존 조사료자원의 이용은 양질의 사료작물 생산과 병행하여 추진하는 것이 바람직하였다. This study was carried out in 2010 to investigate the utilization and nutritive value of native grasses, such as Phragmites communis and Miscanthus sinensis which might reduce the cost of feeding domestic cattle. The regions within the Civilian Control Line in Paju and Sihwa region in Ansan were surveyed. In Paju, the yearly silage production was 900 MT harvested from 90 ha (10 MT/㏊). About 30~50% of these were sold out at the marketing price of 52,000~55,000 Won per roll (130~137.5 Won/㎏). Regrown Miscanthus sinensis of 70 ㎝ in length contained 9.6% of crude protein (CP), 82.4 of relative feed value (RFV), and 67.7% of in vitro dry matter digestibility (IVDMD). Regrown Phragmites communis of 70 ㎝ in length contained 13.8% of CP, 84.3 of RFV, and 67.9% of IVDMD. As harvesting was delayed, the quality was decreased dramatically. In Ansan region, Phragmites communis plantation covers 100 ha. The silage production was 550 MT from the area of 50 ha (11 MT/㏊) in 2009. And the marketing price was 50,000 Won per roll. But in 2010 only a small amount of grasses could have been baled due to frequent and much rainfall from spring to summer season. However, the good forage quality was observed from regrown Phragmites communis of 80 ㎝ in length, 12.9% CP, 99.8 RFV and 66.6% IVDMD, while that of late matured grasses was very low, 2.2% CP, 52.9 RFV and 36.4% IVDMD, greatly lower than forage quality of rice straw. The quality of grasses at bloom stage of 150 ㎝ in length was similar to that of rice straw, showing 4.5% CP, 59.9 RFV and 42.2% IVDMD. In conclusion, the overall quality of most native grasses in this survey were very poor. Therefore, we recommend that Phragmites communis and Miscanthus sinensis should be harvested during June or July to obtain better forage quality which is richer in forage values than rice straw. Production of high quality forage crops was also desirable for self sufficiency of forage.

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.

동종 골수 이식한 백혈병에서 단반복 유전자로 살펴본 혼합 키메라 현상의 의의

장대영,이정신,서철원,이규형,이제환,지현숙,박찬정,한면수,최동원,김정균,최성준,김성배,김상위,김우건,김상희 대한조혈모세포이식학회 1998 대한조혈모세포이식학회지 Vol.3 No.1

연구배경 : 동종 골수 이식한 백혈병에서 키메라 현상의 분석은 착상, 질병 재발과 이식 거부를 이해하는데 도움을 줄 수 있다. 최근 STR을 PCR로 증폭한 검사법에 의해 매우 민감하고 유용하게 혼합 키메라 현상을 검출할 수 있다고 보고되고 있으나, 이 방법의 민감도와 임상적 의의는 아직 완전히 정립되지는 않았다. 따라서 PCR-STR검사법이 혼합 키메라 현상을 민감하게 검출하는지 보고, 동종 골수 이식 후 혼합 키메라 현상의 변화 양상을 관찰하고, 키메라 현상의 임상적 의의를 보고자 하였다. 방법 : 형제로부터 동종 골수 이식한 급성 백혈병 6명과 만성 백혈병 2명의 모두 8명을 대상으로 하였다. 44개 골수 검체에서 phenol/chloroform방법에 의하여 단핵세포 DNA를 추출하였다. DNA는 CTT 삼중체, vWA와 amelogenin시발체를 이용하여 증폭하였다. 증폭 산물은 5% 폴리아크랄아미드 젤에서 전기영동 뒤 은 염색으로 확인하였다. 2명의 DNA를 여러 비율로 혼합하여 상기 검사를 하여 검출 가능 최소 농도를 결정하였다. 결과 : 상기 검사법의 검출 가능 최소농도는 0.25%였다. 혼합 키메라 현상은 8명중 4명에서 관찰되었다. 혼합 키메라 현상은 보인 1명에서 급성 및 만성 이식편대 숙주 질환이 나타났고, 완전 공여자 키메라 현상을 보인 1명에서 만성 이식편 대 숙주 질환이 나타났다. 점진적으로 증가하는 혼합 키메라 현상을 보인 2명은 이식 후 12개월에 질병 재발을 보였으나, 완전 공여자 키메라 현상을 보인 경우엔 재발이 관찰되지 않았다. 결론 : PCR-STR검사법은 동종 골수 이식 후 남아 있는 환자 세포를 검출하고 키메라 현상을 관찰하는데 유용한 방법이다. 또한 이 검사법은 동종 골수 이식 후 재발의 조기 진단, 이식편 대 숙주 질환의 평가와 면역 관용에 임상적으로 응용할 수 있으리라 생각한다. Background : Chimerism analysis after allogeneic bone marrow transplantation (BMT) for leukemia could be helpful understanding of the early marrow engraftment, disease relapse, and graft rejection. Recently, a PCR technique which amplifies short tandem repeats(STR) has been reported to be highly sensitive and reliable in detecting mixed chimerism. But its sensitivity and clinical significance has not been established. The purpose of this study was firstly, to confirm whether a PCR-STR in highly sensitive enough ti assess mixed chimerism, secondly to monitor the changing patterns of mixed chimerism after allogeneic BMT, and lastly to determine correlation between the chimeric status and the clinical outcome. Methods : A study was made eight patients (six with acute leukemia and two with chronic leukemia) who underwent unmanipulated allogeneic BMT along with matched donors. DNA was extracted from mononuclear cells of 44 bone marrow samples using a phenol/chloroform method. Amplification of DNA was done using CSFIPO-TPOX-TH01(CTT) triplex with or without vWA or amelogenin primer. The amplified product was separated on 5% polyacrylamide gel and was confirmed by silver staining. The sensitivity of CTT triplex method was determined by mixing DNA from two person in serial proportion using the same method. Results : The sensitivity for CTT triplex method was 0.25% Mixed chimerism was documented in 4 of 8 patients. ONe of four patients with mixed chimerism developed acute and chronic graft versus host disease (GVHD) and one of four patients with complete donor chimerism also developed chronic GVHD. Two patient with progressive mixed chimerism relapsed at 12 months post-BMT, whereas no patient with complete donor chimerism has relapsed. Conclusion : The study has found that PCR-STR was an effective method for the detecting residual host cell and monitoring the chimeric status after allogenic BMT. PCR-STR can also be clinically applicable in early prediction of relapse, appropriate assessment of GVHD, as well as tolerance after allogeneic BMT.

난소 및 난소 종양 염전의 초음파 소견

오연희,이현경,이원재,이성우,박수성,윤혜원,임문환,심재철,김용탁,김성숙,김정란 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Acute torsion of the ovary and ovarian mass is a recognized surgical emergency, but rarely has the diagnosis been made preoperatively on the basis of imaging studies. The sonographic findings in 14 cases of surgically proven torsion of the ovary and ovarian mass are described. Mostly cystic ovarian mass, engorged vessel, dilated uterine tube, beak-like echo(torsion site), smooth mass wall thickening an free-fluid collection in cul-de-sac are described. More significant in terms of specificity were the demonstration in 6 cases(42.9%) of the smooth mass wall thickening and in 8 cases(57.1%) of a free fluid in the cul-de-sac. We report the sonographic findings of ovary and ovarian mass torsion that may suggest the preoperative diagnosis of this condition.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.