사례연구 : 가업승계와 가족기업의 경쟁력: 에스엘 사례

이장우 ( Jang Woo Lee ),마윤주 ( Yoon Joo Ma ),정수철 ( Su Chul Jung ) 한국중소기업학회 2010 中小企業硏究 Vol.32 No.4

본 연구의 목적은 가족기업의 핵심역량 축적과정을 살펴보고 성공적인 가업승계의 중요성을 논의하는 것이다. 이를 위해 가족기업의 경쟁우위를 설명한 Miller and Le Breton-Miller (2005)의 4C(Continuity, Community, Connection, Command)모델을 기반으로 3대에 걸친 성공적인 가업승계를 기반으로 한 에스엘의 핵심역량 축적과정을 조사했다. 국내 자동차부품회사인 에스엘의 성장과정에 관한 2차 자료를 분석하고, 대표이사와의 심층인터뷰를 통해 그 연관성을 구체적으로 살펴보았다. 분석결과 창업자 가족이 공유한 가치관과 비전, 노하우, 경험 등은 장기적인 지향성을 가지고 지속적으로 핵심역량을 개발하는데 큰 역할을 하였다. 또한 신뢰의 가치관이라는 사회적 자본을 효과적으로 전달받은, 다음 세대의 후계자는 가족 가치관을 토대로 대외 네트워크를 더욱 견고히 하고 지속적으로 발전시켰다. 에스엘은 성공적인 가업승계로 소유와 지배구조를 집중화 할 수 있었고, 이에 따라 외부 이해관계자들의 압력 없이, 가족 내부 조화를 통해 독립적이고 과감한 의사결정이 가능하였다. 이는 가족기업의 경우 고유한 공동체적 문화와 신뢰에 기반 한 외부 네트워크 형성을 통해 경쟁력 구축에 힘쓸 필요가 있으며, 일반기업의 경우에도 공동체 적 조직문화와 중장기적 관점의 외부 협력관계가 기업의 영속성 유지에 중요하다는 시사점을 제공한다. 또한 가엽승계가 기업경쟁력의 유지와 세대 간 이전에 중요한 기능을 함에 따라 이에 대한 적절한 정책적 배려가 필요하다. The purpose of this study is to examine the process of accumulating com-petences and competitiveness by family companies, and discuss the importance of successful succession of a family business. The core competence accumulation process and competitiveness sources of SL, which is based on successful succession of the family business for three generations, was examined based on the 4C (Continuity, Community, Connection, Command) model of Miller and Le Breton-Miller (2005), which explains the competitive superiority of family companies. Secondary data on the growth process of SL, a domestic auto-mobile parts company, was analyzed and their strategic implications were examined in detail through an in-depth interview with the CEO. The 4C factors, which are antecedent variables of a successful family business, played an important role on the growth process of SL. The continuity factor existed through continuous research and development that focuses on and invests in improving technology quality such as mold pro-duction, lamp production, sash production, and design automation. 2 to 3 percent of the sales amount each year was spent on research and development, regardless of the condition of the economy. As a result, the intellectual property of the company reached 1,108 items (583 applications, 440 registered properties, 47 in review, 38 trademarks) by 2006. From a long-term perspective, the company is improving their technical power to an international standard through technical investments. The continuity of investments in research and development is apparent through three generations, and it can be said that this reflects the characteristics of family business management that shares a goal, and confirms and develops the core capacities of the company. The factor of community started with the "people first" business, management philosophy of the late presi-dent, Hae-joon Lee. Then, it expanded to "human respect" during the president Choong-kon Lee`s generation, and to "ethical management" for the CEO Sung-yup Lee`s generation. The sense of community was revealed to be in the form of a community corporate culture based on a good welfare system for employees and com-munity awareness. Diverse benefits including a housing support system, housing fund support system, child-ren`s education fee support system, scholarship system, and company clubs support system were used to make people feel like "the company and I are one" and work with a sense of ownership. The fact that there has not been one conflict between labor and management since 1968, when the labor union was first established, is especially a noteworthy point. The business management based on "people first" stresses the responsibility and roles of employees and reflects the belief that a workplace should not simply be a place to make a living, but a part of life where you can cultivate character and fulfill your role as a member of society. The connection factor appears as continuous partnerships and networks with domestic and international parts suppliers and technologically advanced companies. The late honorary chairman Hae-joon Lee maintained partnerships and networks with Hyundai Motor Company and Daewoo Motors. Then, chairman Choong-kon Lee expanded the network to include KIA and Ssangyong Motors and maintained long-term relationships with domestic automobile makers. In addition, the company is maintaining cooperative relations with the Japanese company Stanley and German company Hella, and has started dealing with the U.S. company GM, too. CEO Sung-yup Lee`s generation improved the company`s relationship with GM and made the achievement of re-ceiving the QSTP Award (an award GM gives to selected skilled companies out of all the parts companies in the world) from GM for 14 consecutive years (1997-2010), solidifying its position as a skilled partner of GM. SL is also advancing into China through collaborations with the local branch to extract new cooperative relations. The value of "trust" is the motivation that helped SL maintain and strengthen relationships and networks. This value started with the founder of the company and was handed down to chairman Choon-kon Lee and CEO Sung-yup Lee, and worked as a core factor to strengthen external cooperative relationships. The factor of command is apparent from the decisions of business managers who take on a challenge, structural management that includes an endless will for innovation, and leadership. When the late honorary chairman Hae-joon Lee could not cultivate a road for the automobile parts industry because of smuggled goods, he recognized the importance of the automobile parts industry and folded his bicycle parts business, which was number one in the market at the time, without hesitation thanks to his owner-focused independent and bold decision-making skills. In the mid-1990s, when most automobile production companies experienced difficulties because of the economic crisis where Korea was dependent on the IMF, and the aftershocks of restructuring affected automobile parts manufacturing companies, chairman Choong-kon Lee considered the crisis an opportunity and acquired and merged with Seogu Industry (currently known as SL Litech), Oriental Construction and Poongi Building (currently known as SL Seo Bong Co., Ltd. Shiheung factory), creating a turning point to develop further after the crisis. CEO Sung-yup Lee pursues continuous innovation including a corporate culture that places importance on learning and admitting mistakes, change of the structural system to a project based system, and a human resources system that focuses on human resources management, and is emphasizing corporate changes according to the situation of the times. An examination of the SL core competence accumulation process based on the 4C model shows that it is establishing positive relationships and continuity based on connection and trust, leading to a cooperation sys-tem based on the value of trust. It also establishes a positive relationship with command focusing on a com-munity structure culture, which leads to structure capacity based on community culture. The factors of con-nection and community were found to be especially strong at SL. The factor of connection was a core growth motivation, influenced by the key values of family. SL reveals its growth motivation to be "unification of all employees," shares the goals and visions of family with its employees, and offers a variety of different benefits. The active will of employees to participate in this community is seen to be the background behind big accomplishments such as innovations in the field, which are still being pursued. Successful succession of the family company and family business management are strengths that lie in the center of the motivation that allowed SL to continue to grow for three generations, starting with the founder, the late honorary chairman Hae-joon Lee, who provided a foundation of growth with values of trust and peo-ple first, moving on to the second generation chairman Choong-kon Lee, who accomplished a rapid development of the company based on technological developments and respect for people, and finally through to the third generation CEO Sung-yup Lee, who is making efforts for globalization and innovation based on ethical management and change. This shows that the values of trust set by the founder have continued on for a long time, through his son, chairman Choong-kon Lee, and grandson, CEO Sung-yup Lee. Chairman Lee, CEO Lee and executive director Lee Seung-hoon are learning corporate culture and management know-how through a great will to participate and actual participation in management. SL was able to gain competitiveness and continuously reach excellent management performance through cooperation based on the value of trust and structural management that focuses on community culture. As a result of analyzing the company through the 4C model and conducting in-depth interviews with man-agement, it can be said that the values, vision, know-how and experience the founder shared with his family largely contributed to continuous development of core competence with a long-term goal. This in turn had a positive effect on establishment of a corporate community based on trust. By inducing loyalty, participation, and focus on employees in the organizational structure with something more than just financial incentives, the core values of the company are relayed through generations and play an important role in maintaining the community, and also emotionally motivating members of the community. Another point is that the successor who effectively received the social capital of trust as a value, strengthened and continued to develop the ex-ternal network based on the family values. The value of "trust" started by the founder played a key role in strengthening external cooperative relations as it was succeeded through generations. This had a positive ef-fect on connection based on the value of trust, and especially decisively contributed to maintaining close rela-tions of cooperation in the external network and long-term cooperative relationships. SL was able to focus the possession and domination structure through successful succession of the family business, and make in-dependent bold decisions through internal harmony of the family, without pressure from people involved externally. The results above lead to the following points of discussion regarding corporate management. From a busi-ness management perspective, first, a family company needs to establish an external network based on a unique community culture and trust to work on establishing competitiveness. Second, there is a need to reflect the fact that a community-like structural culture and external cooperative relations from a mid- to 0long-term perspective have an important effect on maintenance of corporate continuity, even for companies that are not family businesses, on business management. Third, there is a need to focus on the fact that a structural man-agement method that uses values such as community help secure continuity of a company. From a policy per-spective, since succession of a family business can be not succession of wealth but succession of accumulated technological core competence and good management philosophy and know-how, it is important for improve-ing national competitiveness, to maintain corporate competitiveness, and transfer the competitiveness between generations. Therefore, there is a need for appropriate policies that support the successful transgenerational succession of family businesses.

정안침요법(整顔鍼療法)을 응용하여 호전된 후천성 사경환자 치험 2례

박서영,김재수,홍의재,이윤경,이봉효,임성철,정태영,이경민,Park, Seo-Young,Kim, Jae-Su,Hong, Eui-Jae,Lee, Yoon-Kyoung,Lee, Bong-Hyo,Lim, Seong-Chul,Jung, Tae-Young,Lee, Kyung-Min 대한침구의학회 2008 대한침구의학회지 Vol.25 No.4

Objectives : This report intended to estimate effects of Jung-an acupuncture on the acquired torticollis caused by muscle contraction. Methods : The patients were treated by Jung-an acupuncture, herb medication and Physical treatment daily. The improvement of the patients was judged by Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS), Tsui's score and Visual Analogue Scale(VAS). Results : After 7 days of treatment, the 2 patients' neck pain and cervical movement were improved. Also, TWSTRS score, Tsui's score and VAS were all reduced. Conclusions : As the Jung-an acupuncture's theological base is organized with meridian theory and myofacial release therapy, We considered the Jung-an acupuncture is effective not only for the skin disease but also for the muscle problem such as torticollis.

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.

GO-62 : Lower extremity edema in patients with endometrial cancer

( Myong Cheol Lim ),( Jeong Seon Lee ),( Jung Nam Joo ),( Sang Soo Seo ),( Sok Bom Kang ),( Sang Yoon Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

The objective of this study was to investigate clinical manifestations of lower extremity edema (LEE) in endometrial cancer Medical records for LEE and/or responses to the Gynecologic Cancer Lymphedema Questionnaire (GCLQ) were evaluated in 177 patients with endometrial cancer Patients had a median age of 53 years. Sixty-seven patients (37.9%) had past (9 patients, 13.4%) and/or current patient-reported LEE (58 patients, 86.6%). Symptoms reported on the GCLQ in over 20% of respondents were swelling, numbness, aching , and heaviness. GCLQ total symptoms score was significantly higher in patients with current LEE. Most of the LEE (43/67, 64.2%) developed within 12 months after surgery and LEE lasted more than 6 months in most patients (56/59, 94.9%) Prospective clinical trials are needed to know the clinical significance, impact on quality of life, and preventive strategy of LEE in patients with endometrial cancer

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.

한국인에게서 그레이브스병 약물치료의 적정기간

이형숙,이동훈,정희선,이종우,김정은,신승수,정윤석,이관우,김현만 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.1

연구배경: 그레이브스병의 치료에는 항갑상선제, 수술 및 방사성 요오드법이 선택되어 사용되고 있다. 이중 항갑상선제는 가장 많이 선호되고 있으나 낮은 관해율과 높은 재발율로 장기간 치료기간이 요구된다. 저자들은 그레이브스병 환자에게서, 선택되는 치료법의 선호도와 각 치료법의 관해율을 조사하고자 본 연구를 시행하였다. 또한 본 연구에서는 항갑선제 치료의 적정기간을 평가하고자 하였다. 방법: 아주대학교병원에 내원한 환자 중 1년 이상 추적관찰이 가능한 205명의 그레이브스병 환자를 대상으로 조사하였다. 항갑상제군, 수술군 및 방사성 요오드군은 각각 170명, 29명 그리고 6명이었다. ROC curve를 이용하여 약물치료의 예후예측인자를 분석하였다. 결과: 1) 그레이브스병 환자의 치료 방법의 선택은 항갑상선제군, 수술군 및 방사성 요오드군 각각 170명(83.0%), 29명(14.1%) 그리고 6명(2.9%)으로 항갑상선제 치료가 가장 선호되었다. 2) 그레이브스병의 관해율은 항갑상선제군, 수술군 및 방사성 요오드군에서 각각 60.0%(102/170명), 96.5%(28/29명) 그리고 83.0%(5/6명)으로 수술군이 가장 높았다. 3) ROC curve의 AUC는 치료기간과 진단시 TBII가 각각 0.709 및 0.648이었고 적절한 약물투여 추적 관찰기간은 26개월이었다. 결론: 그레이브스병의 일차 치료법으로는 항갑상선제가 선호되고 있으나 수술 및 방사성 요오드 치료군에 비해 상대적으로 낮은 관해율을 보였다. 따라서 항갑상선제 치료로 26개월 이상 관해가 되지 않을 경우에는 치료 방법의 변경을 고려하는 것이 관해율을 높이는데 도움이 될 것으로 생각된다. Background: Graves' disease in an organ specific autoimmune disease. Three kinds of therapeutic modalities (antithyroid drugs, ablation with radioactive iodine and subtotal thyroidectomy) are frequently performed for the management of this disease. The most popular therapeutic policy for the disease in Korea is antithyroid treatment. We analysed and compared the remission rates of all three modalities for Graves' disease, and evaluated the antithyroid modality to determine the correct duration of treatment. Subjects & Methods : The medical records of 205 patients with Graves' disease were reviewed. For the evaluation of the antithyroid modality medical treatment, antithyroid drugs were administered for more than 1 year. The prognostic factors associated with remission were analysed by means of an ROC curve. Results: 1) Of the 205 patients, proportions that received medical therapy, subtotal thyroidectomy and radioiodine therapy were 83.0, 14.1 and 2.9%, respectively. 2) The remission rates of the medical therapy, surgery and radioiodine therapy were 60.0, 96.5 and 83.0%, respectively. 3) The remission rate of the medical therapy was associated with the duration of medication and TBII activity. The determined proper duration for the antithyroid treatment was 26 months from the ROC curve analysis. Conclusion: The above results suggest that the proper duration of antithyroid treatment for Graves' disease is 26 months, after which time the subtotal thyroidectomy or radioiodine therapy should be considered if the disease has not remitted (J Kor Soc Endocrinol 18:24∼31, 2003).

제2형 당뇨병 환자에서 적극적 환자 교육이 혈당조절에 미치는 효과

이윤욱,황원선,최선정,이동훈,김도현,이은희,홍은경,노혜림,정윤석,이관우,김현만 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.1

연구배경: 현재까지의 당뇨병 교육에 대한 노력은 제한되었으며, 연구 결과를 보면 식사 조절 교육과 체중 조절 프로그램을 수행한 환자들 중 적극적이고 기간이 긴 교육을 받은 경우, 성공적 결과가 나타남을 알 수 있었다. 자가관리나 체중감량 등의 당뇨병 치료의 중요한 목표는 적극적이고 긴 기간의 교육 없이는 시행되기 어렵다. 본 연구에서는 외래에서 당뇨병 환자를 대상으로 시행할 수 있는 행동 및 식사 교육 등의 적극적 교육 프로그램을 개발하여 제2형 당뇨병 환자들을 대상으로 이들에게 식사 조절 방법에 대한 목표설정과 문제에 직면하였을 때의 해결 방법 등을 교육해서 궁극적으로는 적극적 자아관리에 연결될 수 있도록 도와주는 것을 목적으로 기존의 통상적 교육과 보다 적극적인 교육이 당뇨병 환자의 혈당 조절에 어떠한 영향을 미치는지에 대해 알아보기 위해 다음과 같은 연구를 시행하였다. 방법: 본 연구는 아주대학교 병원 내분비 대사 내과를 처음으로 방문하여 치료받았던 58명의 제2형 당뇨병 환자를 대상으로 하였다. 내원 환자들을 무작위하게 추출하여 진찰권 번호 끝자리에 따라 홀수는 통상적 교육군(conventional education group, CE)과 짝수는 적극적 교육군(intensive education group, IE)으로 나누어 교육하고, 3개월후에 교육의 효과를 평가하였다. 결과: 1) 연구 대상자들의 교육 전과 후의 공복혈당, 식후2시간 혈당 및 HbA_lc 치는 IE군과 CE군 모두 각 그룹 내에서, 유의적으로 감소하였다(p<0.05). IE군에서는 공복혈당이 12.4nmol/L에서 7.7nmol/L로, 식후2시간 혈당이 20.3nmol/L에서 10.9nmol/L으로, HbA_lc치가 9.4%에서 7.0%로 모두 교육 전에 비하여, 교육 후에 감소(p<0.05)하였고, CE군도 공복혈당은 10.9nmol/L에서 9.4nmol/L로, 식후2시간 혈당은 17.1nmol/L에서 14.6nmol/L으로 HbA_lc가 8.5%에서 7.3%으로 모두 교육 후에 감소하였다(p<0.05). 또한, 교육 전에 비하여 교육 후에 공복 혈당 및 HbA_lc치가 감소하는 정도는 IE군에서의 감소가 CE군에 비해 더 현저하였다Op<0.05). 2) 식사에 대한 태도는 3부분으로 나누어 식사에 대한 규칙성, 식사 내용의 균형성, 식사에 대한 태도 등으로 나누어 각각의 점수 및 총점을 비교하였으며 교육 전에 비해 교육 후에 연구 대상자들의 식태도가 향상되었음을 알 수 있었다. 두 그룹간의 차이를 분석한 결과 식사의 균형성 항목에서와 총점에서 유의적으로 두 그룹의 차이를 보여서 IE군에 CE군에 비해 식사의 균형성 측면이 향상되었고, 전체적인 식태도가 좋아졌음을 알 수 있었다(p<0.05). 결론: 비교적 긴 기간은 아니지만 적극적 교육을 받은 당뇨병 환자들이 통상적 교육을 받은 군보다 혈당 및 HbA_lc, 식태도 점수등의 수치의 호전뿐만 아니라 당뇨병 환자의 삶에서 중요한 부분을 차지하는 식사요법 관리 부분에 있어 향상됨을 알 수 있었다. Background: To this date, efforts to develop effective methods for the education of diabetic patients have been limited. The important goal of self-management and weight control for diabetic treatment can not be attained without long and intensive period of education. This study was undertaken to assess the effectiveness of an intensive educational program, of behavior and diet control, which was carried out on subjects with type 2 diabetes, on and out-patient basis. we compared the effectiveness of an intensive education programme with that of a conventional education programme for the self-management of type 2 diabetic patients. Methods: Subjects with type 2 diabetes were randomly selected, and allocated to one of two groups. One group received a conventional education programme of self-management(the CE group), and the second group received an intensive education progammes for three months, after which the effectiveness of the programmes were evaluate. Results: 1) The levels of fasting blood sugar(FBS), postprandial 2 hour blood sugar(PP2h) and HbA1c were significantly lowered in both groups following the intervention(p<0.05). In the IE group, the FBS declined from 12.4nmol/L to 7.7nmol/L, PP2h declined from 20.3nmol/L to 10.9nmol/L, and the HbA_lc showed a similar decline from 9.4 to 7.0% after intervention(p<0.05). In the Ce group, the FBS declined from 10.9 to 9.4nmol/l, the PP2h decreased from 17.1 to 14.6nmol/l, and the HbA_lc also decreased from 8.5 to 7.3% after intervention(p<0.05). The decrease in the FBS and HbA_lc following the educational intervention was more pronounced in the IE group than the CE group(p<0.05). 2) The effectiveness of the education programmes in promoting appropriate dietary behavior in the diabetic subjects was assessed by a scoring system in three parts: a regularity score, a balance score and an attitude score. From a comparative study of the three scores, the patients attitudes were observed to be much improved in both the groups following the intervention compared to before the programmes, but the balance and total scores were significantly higher in the IE group than the CE group(p<0.05). Conclusion: We can conclude that the intensive diabetic education programme is more effective than a conventional programme, not only in improving the patients' levels of glucose, HbA_lc, and dietary score, but also the diabetic patients self-control abilities, promoting behavioral change, and prompting problem solving capabilities in respect to the everyday problems that they have to face throughout their lives(J Kor Soc Endocrinol 18:63∼72, 2003).

금속가공유 사용 근로자에서 발생한 과민성폐장염 1예

이선웅,고동희,진구원,박동욱,이정탁,송윤희,이상윤 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.1

서론: 과민성폐장염의 원인물질로 금속가공유는 외국의 경우 작업장의 집단발병 사례들을 중심으로 많은 보고가 되어 왔으나 우리나라에서는 아직 보고되지 않았으며,저 자들은 금속가공유에 1년간 노출된 근로자에서 발생한 과민성폐장염 1예를 발견하였기에 작업환경측정을 시행한 후 작업관련성을 평가하여 보고하는 바이다. 증례: 64세 남자 환자가 1년간 강관을 절단하는 작업을 한 후 호흡곤란을 주소로 내원하였다 노출력,임상적 소견 및 방사선학적 소견을 토대로 과민성폐장염으로 진단되었다. 작업환경 측정결과 공기 중 금속가공유,엔도 톡신,총 세균 및 곰팡이는 각각 0.531 mg/m³, 6.33 EU/m³ 100 CFU/m³ 및 75 CFU/m³이었고,금속가 공유 내 엔도톡신,총세균 및 곰팡이는 각각 1.5x10⁴EU/mL,4.6x10^(5) CFU/mL 및 1.8×10^(5) CFU/mL이었다. 고찰: 금속가공유 내의 원인항원에 대한 침강항체를 검사하지 못했으나,작업환경 측정결과 금속가공유가 일반적인 허용가능 수준 이상으로 오염되었으며,기존의 과민성폐장염 발생 사례들과 비슷한 수준 또는 그 이상으로 오염되어 있었다. 공기 중 금속가공유 농도 역사 NIOSH의 REL과 ACGIH의 NIC를 초과하고,기존의 사례들에 비해서도 대체적으로 높은 수준 이었다. 금속가공유 이외의 다른 원인에 대한 감별과 기존의 발생사례들과의 노출수준 비교를 통하여,저자들은 환자가 금속가공유에 의한 미생물 항원에 노출되어 과민성폐장염이 발생한 것으로 판단하였다. Introduction: There have been no reports of hypersensitivity pneumonitis caused by metal working fluids in Korea, despite their existence in other countries. Here, we report the first such case, along with an assessment of work-relatedness through exposure assessment. Case report: A 64-year old male patient visited the hospital with dyspnea after metal pipe cutting for about a year. He was diagnosed with hypersensitivity pneumonitis from the evidence of specific exposure history, clinical symptoms, and radiologic findings. The air exposure levels of the oil mist, endotoxin, total bacteria and fungus in the work environment was TWA(8-hr) 0.531 mg/m³, 6.33 EU/m³, 100 CFU/m₃ and 75 CFU/m³, respectively. The concentrations of the endotoxin, total bacteria and fungus within the metal working fluid was 1.5 X 10⁴EU/mL, 4.6 X 10^(5) CFU/mL and 1.8 X 10^(5) CFU/mL, respectively. Discussion: Although the patient did not receive a specific precipitating antibody test, the microbial concentration within the metal working fluid was higher than normal and similar to previous case reports, The oil mist level in the air exceeded the NIOSH REL and ACGIH NIC, and were similar or higher than previous cases. By excluding other causes of hypersensitivity pneumonitis, we concluded that the disease developed from exposure to microbial antigens in the metal working fluid.

폐내 기관지 낭종

이석열,이숭진,박형주,이철세,이길노,김윤정,나주옥 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A 33-year-old female was admitted to our hospital due to removal of lung mass which indicentally detected Chest radiography. Chest computerized tomography revealed lung parenchymal cystic lesion. Open thoracotomy was done for diagnosis and therapy. Cystic lesion was communicated to bronchus and wedge resection including cystic lesion was done. Bronchogenic cyst is congenital disease and mainly locate in mediastinum. It is rare in lung parenchyme. Herein we report a case of intrapulmonary bronchogenic cyst.

한국인에서 혈소판 당단백 Ⅱb/Ⅲa 유전자 다형성과 관동맥 성형술 후 재 협착과의 관계

이민수,이정우,김보영,임대승,강정아,김정희,김윤철,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Platelet aggregation is the final pathway of acute coronary syndrome such as acute myocardial infarction and unstable angina. Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and yon Willebrand factor and it plays an important role in platelet aggregation and in the pathogenesis of acute coronary syndrome. It is known that polymorphism of the gene that encoding platelet glycoprotein IIb/IIIa(PI^A1/A2) is strongly related to acute coronary syndrome in Caucasian, but not in Koreans. We investigated relationship between platelet glycoprotein llb/Illa gene polymorphism and restenosis of coronary artery after angioplasty in Koreans. Total 371 patients(M=251. F=120) were enrolled. Angioplasty group comprised 143 patients who underwent coronary angioplasty, and in the angioplasty group, restenosis group comprised with the 65 patients who had restenotic lesion over 50% of luminal diameter in follow-up coronary angiography. Normal group comprised 153 patients who had no significant angiographic lesion and variant angina group comprised 75 patients who were positive in ergonovine test. Genomic DNA was extracted from peripheral arterial blood. To determine the frequency of P1^A1/A2 genotype, polymerase chain reaction(PCR) was done and the product was restricted with Mspl. 3%. agarrose gel electrophoresis showed restriction fragment length polymorphism. Clinical profile and risk factor were also reviewed. Among all 371 patients of study group, genotype of only one patients in restenosis group if is proven to be PI^A1/A2 heterozygote. All patients of normal study group, no restenosis group, and the other patients in restenosis group have an PI^A1 homozygote genotype. In our study, platelet glycoprotein IIb/Illa polymorphism has no relationship with restenosis of the coronary artery after angioplasty in Koreans. But the genotypic frequency of platelet glycoprotein IIb/IIIa gene polymorphism in Koreans is concordant with that of previous studies.