건강질단 질병 유소견자들의 순천향구미병원 외래이용에 영향을 미치는 요인

김진석,우극현,함정오,유재영,최태성,하봉구,윤성용 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Background ; The purpose of routine health screening of employee is not only to detect worker's disease at early stage but also to provide early appropriate health service. But, majority of patients who diagnosed by routine health screening haven't underwent health service utilization. Soonchunhyang Kumi Hospital had been provide total occupational health service in kumi industrial estate including health screening, worker interview at workplace by occupational nurses and doctors. Object ; We want to know how much proportion of patient who are diagnosed by routine health screening had visited Soonchunhyang Kumi hospital out-patient clinic and factors influencing such health care service utilization. Method ; Initial study subject were 189 workers who had proved to have hypertension, diabetes mellitus, hyperlipidemia in routine health screening which performed during year of 2000. Among those, 160 workers who had finished questionnaire were selected for final study subject. We investigate whether they had visited health services or not, if they had, what kind of health care facility they visited, and other factors which influencing their health service utilization. Result ; Among 160 workers, 59(36.9%) had visited Soonchunhyang Kumi hospital, 47(29.4%) had visited other health care facility, and 54(33.8%) had not went to any health care facility. Factors which influencing Soonchunhyang Kumi hospital utilization is sex, job, staff's support to hospital visit during worktime, history of medical consultation about health screening result.

20-30대 무증상 성인에 있어서 채용신검시 나타난 간기능 및 바이러스 간염검사 결과 분석

김주자,신연교,우극현 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

To determine the distribution of results of liver function test and viral markers for preemployment screening in asymptomatic young adults(twenties and thirties in age group), and also to evaluate the cutoff level of liver function test in deciding repeat follow-up examination. the data from which the first and second repeated examinations for preemployment screening performed during the period from Jan, 1, 1994 to Dec. 31 1994 were analized. The results were as follows: 1. Among 7,855 asymptomatic young adults who were examined, 814 (10.4%) had the abnormal liver function test (10.4% (814/7,855) in male, 0.8% (14/1,707) in female. 2. In 397 male who had repeated follow-up test, 27.2%(108/397) were turned out normal liver function test and 72.8%(289/397) remained abnormal. According to the interval of repeated follow-up test, the longer the interval the higher conversion rate to normal. This can be explained by the effect of treatment of health care, or was dropped from 87.5%(7/8) to 44.2%(23/52) at 401U/dl and that of SGOT was dropped from 80.7%(25/31) to 67.9%(19.28) at 451U/dl which suggest cutoff level to decide repeated follow-up test. This suggest that we can adjust the cutoff level in deciding follow-up examination. 3. Overall positive rates for HBsAg were 5.8%(80/1,561), and 5.9%(80/1,347) in age group 20-29, 4.7%(10/214) in age group 30-39, 6.0%(73/1,214) in male, 4.9%(17/347) in female. Positive rate for HBsAg according to the liver function test was significantly higer in abnormal liver function group than in normal liver function grup (12.7% vs 4.8%). 4. Positive rate for anti-HBs was 32.7% and there were no significant difference between age groups or between liver function groups. 5. Positive rate for anti-HCV was 1.3%(5 in 397 male), actually all 5 were in age group 20-29, among them, 3 had normal liver function test and 2 had abnormal liver function test.

2.5-헥산디온에 노출된 근로자에게서 발생한 말초 신경병증

조성용,장용석,최은경,김진석,유재영,우극현,최태성 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 영상음향장비 제조업체에서 2,5-헥산디온을 취급한 근로자에게서 발생한 다발성 말초 신경병증 환례를 보고하고, 동일 공정근로자들의 말초 신경기능을 조사하고 자 한다. 방법: 환례에 대해 방사선학적 검사, 소변 및 혈액 검사, 신경전달속도 검사, 작업환경 측정을 하였으며, 2,5-헥산디온의 노출을 중단시킨 후 5개월 후에 다시 신경전달속도 검사를 하였다. 동일공정 근로자들의 영향평가에서는 2,5-헥산디온에 노출된 13명의 남자 근로자를 노출 군으로, 해당 물질에 노출된 적이 없는 5명의 남자 근로자를 비노출군으로 선정하여 검사를 하였다. 결과: 환례의 신경전도 검사결과 양측 척골신경과 정중 신경에 이상소견을 보였으며, 호전여부를 관찰하기 위하여 5개월 후 추적검사를 실시한 결과 증상 및 신경전달속도 검사결과가 호전되었다. 동일공정 근로자들의 영향평가에서 노출군의 정중 신경과 척골신경이 비노출군에 비하여 유의하게 감소되어 있었다. 감각 신경의 진폭의 경우, 노출군의 정중 신경과 비복 신경이 감소되었으며, 운동 신경 전도속도에서는 노출군의 비골신경이 유의하게 감소되어 있었다. 말단 잠복기에서는 노출군의 정중신경, 척골신경, 비골신경, 경골신경이 비노출군에 비해서 유의하게 연장되어 있었다. 결론: 환례의 증상과 신경전달속도 검사의 이상소견은 2,5-헥산디온에 의한 말초신경병증에 부합되었다. 동일공정 근로자 건강영향평가에서 신경전달속도 검사결과 노출 군과 비노출군간의 유의한 차이가 있었는데, 이를 통해 2,5-헥산디온이 근로자들의 신경독성에 영향을 줄 수 있다는 것을 확인할 수가 있었다. Objectives: This study is a case report of 2,5-hexanedione induced occupational peripheral polyneuropathy. We also investigated the peripheral nerve function of all workers who had been exposed to 2,5-hexanedione in the same process. Methods: In June, 2006, a 2,5-hexanedione exposed worker complained of both hand numbness. He received neurologic, radiologic, laboratorial and electrophysiologic evaluation, including measurements of workplace environment. Five months after cessation of exposure to 2,5-hexanedione, a follow-up electrophysiologic examination was done. We evaluated the peripheral nerve function of 2,5-hexanedione exposed workers by comparing 13 male 2,5-hexanedione exposed workers who were in same company with the patient and 5 male workers who had not been exposed to 2,5-hexanedione. Results: Under electrophysiologic examination, there were abnormalities in sensory and motor nerve velocity, terminal latency, and F-latency of both median nerve and ulnar nerve. After 5 months, the patient symptoms and the results of follow-up electrophysiologic examinations were improved. Comparing the 2,5-hexanedione exposed group with the unexposed group, the sensory nerve velocity of the median and ulnar nerves in the exposed group was decreased. The motor nerve velocity of the peroneal nerve, and sensory nerve velocity of the median and sural nerves were decreased. Terminal latency of median, ulnar, peroneal, and tibial nerves in the exposed group were increased compared with the unexposed group(<0.05). Conclusions: 2.5-hexandione can induce peripheral polyneuropathy in male workers.

구미지역 직업성질환 감시체계

김성아,김진석,전혜리,정상재,김상우,이채용,함정오,유재영,최태성,하봉구,조민환,우극현 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.1

목적: 구미지역 내 대학병원이자 특수건강진단·보건관리대행기관의 산업의학전문의, 보건관리대행 간호사, 사업장 간호사를 중심으로 직업성질환감시체계를 구축하여 주요 직업성질환들의 발생현황과 규모를 파악하고자 하였다. 또한 연차적으로 산업, 직업, 업무내용 등에 따른 분포나 원인을 기존 자료원(특수건강진단의 직업병 유소견자와 산재요양승인 되는 직업병자)과 비교하여 분석·기술하고 예방 및 관리를 포함한 보건의료기술개발까지을 포함하는 종합적인 감시체계를 구축하고 운용하고자 하였다. 방법: 구미지역의 산업적 특성에 맞는 직업성질환감시체계를 구축하고 지역 감시체계의 모델을 제시하였다. 6대 감시대상 직업성질환(독성 간염, 직업성천식, 직업성 근골격계질환, 직업성 피부질환, 직업성 암, 수지진동증후군)의 실행적 환례정의, 보고양식 및 보고체계 개발, 분석양식 및 결과 배포 형식을 개발하였으며, 그 유병규모를 파악하고, 감시질환의 분포 및 특성, 관련인자 등을 분석·기술하고자 하였다. 이때, 1년간의 환례분석시 직업병 유소견자 및 직업병 요양자에 대한 자료와 함께 비교 분석하였으며, 노동통계자료를 이용하여 년간 발생률을 추정하였다. 결과: 2001. 1. 1일부터 2002.4.30일까지 총 287건이 보고되었으며, 직업성 근골격계질환 132건(46.0%), 직업성 피부질환 100건(34.8%), 독성간염 34건 (11.8%), 직업성천식 16건 (5.6%), 수지진동증후군 5건 (1.7%) 이었으며 직업성 암은 한건도 보고되지 않았다. 보고경로별로는 보건관리대행에서 33건 (11.5%), 해당 유해인자별로 실시되는 특수검진 외의 각종 건강진단업무 수행 중 발견된 환례에 대한 보고가 206건(71.7%)이었다. 직종별 분류의 결과는 섬유업종사자, 단순노무종사자, 음식업종사자 등이 다수를 차지하였다. 근골격계질환의 경우, 수근관증후군이 42건(33%), 외상과염/내상과염이 39건(30%)로 가장 많았다. 직업성 피부질환은 97건이 접촉성 피부염으로 유기용제류가 59건(59%)으로 가장 많고, 니켈 및 에폭시수지에 의한 알레르기성 접촉성 피부염이 각각 6건과 5건이었다. 독성 간염은 모두 DMF 나 DMAc에 의한 것으로, 근무시작 후부터 간기능이상이 발견되기까지의 근무기간은 대부분이 3개월 이하이며, 1개월 이하인 경우도 10건이나 되었다. 동 기간 중 감시환례에 대해 산재요양 자료와 중복여부를 확인한 결과, 중복되는 것은 하나도 없었다. 특수건강진단에서 직업병유소견자로 판정된 경우는 독성간염에서 3건이 있었으며, 나머지 질환은 중복되는 것은 없었다. 2001도 구미지역의 근로자수와 보고환례건수를 이용하여 연간 발생률을 추정하였다. 근로자 10만 명당 연간 발생률은 상지 근골격계질환은 63.6명, 피부질환 48.2명, 독성 간염 17.9명, 천식 7.7명, 수진진동증후군 2.4명이었다. 참여예상인원은 총 46명이었으며, 실제 참여자수는 21명, 평균참여율은 46%, 실제 참여 1이당 평균 보고건수는 산업의학전문의가 28건으로 가장 많았고, 대행간호사는 45,건, 사업장 간호사는 3.3건이었다. 결론: 지역 감시체계는 기존 통계자료들에서 발견되지 않았던 직업성질환의 발견에 유용한 통계원이며, 특히 지역의 특성과 여건을 고려하여 체계화된 시스템을 구축하여 운용한다면 더 성과가 클 것이다. Objectives: Area-based occupational disease surveillance in Kumi (KODS) was used to collect data on occupational diseases. The data was used to estimate the magnitude of the diseases, to analyze for their characteristics and to find links for their intervention and prevention. Methods: Since January 2001, occupational physicians and nurses in Occupational Health Service (OHS) have reported six major occupational diseases; occuaptional musculoskeletal disorders of the upper extremities (MSDUE), occupational dermatoses, toxic hepatitis, occupational asthma (OA), hand-arm vibration syndrome (HAVS), and occupational cancer. For the respective diseases, a reporting sheet and operational diagnostic criteria were developed by the KODS. An analysis of the KODS data, collected over a certain period, was compared with data from the Korea Labor Workers Corporation (KLWC) and the Specific Health Examination (SHE), and the incidence rates of the diseases estimated. Results: Between Jan 2001 and Apr 2002, 287 cases of the six major occupational disease were reported. Of these, there were 132 (46.0%), 100 (34.8%), 34 (11.8%), 16 (5.6%), and 5 (1.7%), cases of MSDUE, occupational dermatoses, toxic hepatitis, OA, and HAVS, repectively. But, there were no cases of occupational cancer. 33 (11.5%) of the incidence were reported via the OHS, 206 (71.7%) from health checkups, and the other 48(16.8%) from other routes. The synthetic fibers and electronic components manufacturing industries accounted for the greatest number of reported cases. With resport to occupation, the greatest numbers of incidence were reported from the elementary occupations, textile workers, assemblers, and cooks and food services worker, in that order. Of the MSDUE cases, carpal tunnel syndrome and epicondylitis were the two most common diseases. Most of the occupational dermatoses were due to contact dermatitis, with organic solvents (59%), nickel (6%), and epoxy resin (5%) accounting for the majority of these cases. All cases of toxic hepatitis were induced by dimethylformamide or dimethylacetamide, which were reported by a unique monitoring system. During same period, there were no cases claimed by workers to the KLWC, and only three cases from SHE, were identified. Using data from workers' number and surveillance, the annual incidence of MSDUE, dermatoses, hepatitis, OA, and HAVS, per 100,000 workers were 63.6, 48.2, 17.9, 7.7, and 2.4, respectively. Conclusions: These results show that an area-based surveillance system can be very effective for the collection of data on work-related diseases, at least in Kumi.

Psychological effects of a disastrous hydrogen fluoride spillage on the local community

Seung-Hyun Yoo,Seong-Yong Yoon,Kuck-Hyun Woo,Jin-Seok Kim,Seong-Yong Cho,Sung-Soo Lee,Hyun-Sul Lim,Yeon-Soon Ahn,Won-Ho Yang 대한직업환경의학회 2017 대한직업환경의학회지 Vol.29 No.-

Background: On September 27, 2012, at 3:43 pm, a hydrogen fluoride spill occurred in a manufacturing plant located at the 4th complex of the Gumi National Industrial Complex in Gumi City, South Korea. The present study aimed to evaluate the psychological effects of the hydrogen fluoride spill on the members of the community and to investigate their relationships with physical symptoms and changes in psychological effects occurring as time passed after the accident. Methods: The 1st phase involved a survey of 1359 individuals that was conducted 1 month after the spill, and the 2nd phase involved a survey of 711 individuals that was conducted 7 months after the accident. The questionnaires included items for assessing demographic characteristics, hydrogen fluoride exposure level, physical symptoms, and psychological status. Physical symptoms were assessed to determine the persistence of irritations. Psychological status was assessed to investigate the impact of event level using the Impact of Event Scale – Revised Korean version (IES-R-K), and the anxiety level was assessed using the Beck Anxiety Inventory (BAI). Results: As the hydrogen fluoride exposure level increased, the impact of event and anxiety levels increased significantly both 1 and 7 months after the accident (p < 0.05). The mean score of the impact of event levels decreased significantly from 33.33 ± 14.64 at 1 month after the accident to 28.68 ± 11.80 at 7 months after the accident (p < 0.05). The mean score of the anxiety levels increased significantly from 5.16 ± 6.59 at 1 month after the accident to 6.79 ± 8.41 at 7 months after the accident (p < 0.05). The risk of persistent physical symptoms at 7 months after the accident was significantly higher in females. The risk of persistent physical symptoms also increased significantly, with increasing age, hydrogen fluoride exposure, and impact of event levels (p < 0.05). Conclusions: The present study found that the impact of event level and anxiety level increased with increasing hydrogen fluoride exposure. Anxiety levels persisted even after time passed. The risk of persistent physical symptoms at 7 months after the accident was higher in females, and it increased with increasing age, hydrogen fluoride exposure level, and impact of event levels.

國家理論 再定立에 관한 硏究 : 國家自律性과 國家能力性의 關係를 中心으로

柳國鉉 단국대학교부설 중국연구소 1994 中國 Vol.- No.20

Novalis 의 Ofterdingen 연구(硏究)

최국현 한국독어독문학회 1962 獨逸文學 Vol.4 No.1

糖尿病의 心電圖學的 觀察

權國賢,孫敬植,具本天,尹榮佶 慶北大學校 醫科大學 1976 慶北醫大誌 Vol.17 No.1

慶北醫大附屬病院 內科에서 診療한 糖尿病 惠者 524例에서 初診時에 取한 心電圖를 分析하여 이들 所見을 健康人 200例에서 얻은 그것과 比較檢討하여 다음과 같은 成績을 얻었다. 1) 糖尿病 患者의 心電圖 所見은 健康人群의 그것보다 異常所見의 發生 頻度가 뚜렷이 높았으며 특히 各種 不整脈, 房室傳導障碍, 左側軸偏位, 左心室肥大, Q-T間隔延長 및 ST,T變化 所見은 더욱 뚜렷한 差異를 보였다. 2) 心電圖 異常 所見은 心血管疾患을 合倂한 例에서 뚜렷이 많았으며 心血管疾患이 없는 患者에서도 健康人에서 보다 높은 頻度의 異常所見을 볼 수 있었다. 3) 網膜症 有無에 따른 心電圖 異常 所見의 頻度는 網膜症이 있는 群에서 그 頻度가 뚜렷이 높았다. 4) 病歷 期間에 따른 心電 圖異常 所見의 頻度는 그 期間이 길수록 增加하는 傾向이 顯著하였으며 房室 block을 除外한 各種 不整脈, 心室內傳導障碍, 左側軸偏位, 左心室肥大, 心筋梗寒, Q-T間隔延長 및 ST,T變化등에서 뚜렷한 差異가 있었다. 5) 空腹血糖値와 心電圖 異常所見의 頻度 사이에는 一定한 相關性이 없었으나 血中 cholesterol値와의 사이에는 그 値가 높은 群에서 그 頻度가 높은 傾向을 보였다. Electrocardiograms obtained from 524 cases of diabetics on their first clinic visit at the department of medicine, Kyungpook National University Hospital were analyzed and a comparision of the results was made to those recorded on 200 apparently healthy persons. As expected, the incidence of abnormal electorcardiograms was considerably higher in the diabetics particularly in those with cardiovascular complications, arteriosclerotics, hypertensive and/or diabetic retinopathy, hypercholesterolemia, and longstanding illness. The major abnormal findings were prolongation of Q-T interval, left ventricular hypertrophy, ST, T change, left axis deviation, atrioventricular conduction defect and mechanism disorder, in the order of frequency. However, no relationship was noted between the levels of fasting blood sugar and the incidence of abnormal electrocardiograms.

Dynamic Relationship between Stock Prices and Exchange Rates: Evidence from Nepal

( Do-hyun Kim ),( Shyam Subedi ),( Sang-kuck Chung ) 국제지역학회 2016 국제지역연구 Vol.20 No.3

This paper investigates the linkages between returns both in foreign exchange and stock markets, and uncertainties in two markets using daily data for the period of 16 July 2004 to 30 June 2014 in Nepalese economy. Four hypotheses are tested about how uncertainty influences the stock index and exchange rates. From the empirical results, a bivariate EGARCH-M model is the best to explain the volatility in the two markets. There is a negative relationship from the exchange rates return to stock price return. Empirical results do provide strong empirical confirmation that negative effect of stock index uncertainty and positive effect of exchange rates uncertainty on average stock index. GARCH-in-mean variables in AR modeling are significant and shows that there is positive effect of exchange rates uncertainty and negative effect of stock index uncertainty on average exchange rates. Stock index shocks have longer lived effects on uncertainty in the stock market than exchange rates shock have on uncertainly in the foreign exchange market. The effect of the last period’s shock, volatility is more sensitive to its own lagged values.

Uncertainty Channel between Stock Prices and Foreign Exchange Rates in Nepal

Do Hyun Kim,Subedi Shyam,Sang Kuck Chung 한국무역연구원 2015 무역연구 Vol.11 No.4

In this paper, three different versions of bivariate GARCH in mean models were considered to explain the relationship between uncertainty and average outcomes of the stock index and exchange rate. From the empirical results, the bivariate EGARCH-M is the best model to explain the volatility in the two markets. This paper revealed four important conclusions. First, there is a negative relationship between the exchange rates return and stock prices return, but the current exchange rates return is positively affected by the lagged stock prices return at 5% significance level. Second, the results provide strong empirical confirmation of the first hypothesis (that uncertainty in foreign exchange market has an effect on average stock prices) and third hypothesis (that uncertainty in stock market has an effect on average stock prices), implying a negative effect of stock index uncertainty and a positive effect of exchange rates uncertainty on average stock index. On the other hand, for the exchange rates equation, the GARCH-in-mean variables in AR modeling are significant. This shows that there is a positive effect of exchange rates uncertainty and a negative effect of stock index uncertainty on average exchange rates. Third, the coefficient on the lagged residual variance is greater for stock index than for exchange rates, implying that stock index shocks have longer lived effects on uncertainty in the stock market than exchange rates shock have on uncertainty in the foreign exchange market. Finally, from the magnitude of coefficient that shows the effect of the last period’s shock, volatility is more sensitive to its own lagged values than it is to new surprises in the foreign exchange market.