우리나라 환자의 대체의학 이용현황

李健世 대한의사협회 1998 대한의사협회지 Vol.41 No.12

소규모 제조업에서 재해발생과 사업장 특성간의 관련성 분석

이건세,김형수,,장성훈,정최경희,오원기,최재욱,이관형,오지영 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 소규모 제조업 사업장의 재해 발생 유무에 따른 사업장 조직 특성을 비교하여 재해 발생과 관련된 요인을 사업장 수준에서 파악하고자 하였다. 방법: 한국산업안전공단이 실시한 2004년도 산업안전 보건 동향조사 자료 중 5인 이상 50인 미만 제조업 1,886개 사업장(가중치를 부여하여 추정한 모집단 사업장은 65,921개)의 재해(산재 및 공상, 경상 포함) 발생 여부와 사업장의 조직 특성(일반적 특성, 고용특성 및 산업안전보건 특성)간 다변량 분석을, 사업장의 일반적 특성은 지역, 산업형태, 업종 등이며, 고용특성은 전체 근로자중에서 생산직 근로자의 분포, 여성근로자의 분포, 1주일 평균 근로시간, 교대근무 등이며, 산업안전보건 특성은 안전관리자/보건관리자의 선임형태, 산업안전보건위원회, 노동조합, 매월 정기안전보건교육시간, 안전보건관리 규정, 안전보건활동 점수, 안전문화 점수 등이다. 결과: 다변량 분석결과 재해가 발생한 사업장이 갖는 특성은 다음과 같았다. 첫째, 사업장의 일반적 특성에서 지역별로는 경인권에 비해 전라권, 산업형태 면에서 원청에 비해 사외협력업체, 업종별로는 전자부품/통신에 비해 코크스/석유정제업, 목재/나무제품업, 음식료품, 조립 금속제품에서 위험도가 높았다. 둘째, 사업장의 고용 특성에서는 전체 구성원 중에서 생산직 근로자가 증가할수록 재해발생 사업장이 유의하게 증가하였으며, 여성근로자의 증가할수록 재해발생 사업장이 유의하게 감소하였다. 주당 근무시간이 증가할수록 재해 발생 사업장이 유의하게 증가하였으며, 교대 근무와 사업장의 재해발생과는 유의한 관련성이 없었다. 셋째, 사업장의 산업안전보건 특성에서는 안전관리자가 전임으로 근무할수록, 산안전보건위원회가 활발히 활동할수록, 노동조합이 설립될수록, 안전보건규정이 갖추어지지 않을수록, 정기보건교육시간이 많을수록, 안전문화수준이 낮을수록 재해발생 사업장이 유의하게 증가하였다. 결론: 소규모제조업에서 사업장의 조직 특성에 따라 사업장 재해율이 다름을 확인할 수 있었으며, 이는 산업재해의 예방을 위해서는 근로자 요인이외에도 사업장 수준에서의 관련요인에 대한 접근이 필요함을 의미한다. Objective: This study evaluated the relationship between injury occurrence and workplace organization in small-sized, manufacturing factories in Korea. Methods: Using data from the 2004 Occupational Safety and Health Survey in Korea, this study compared workplace organizational factors (general characteristics, employee characteristics and health and safety characteristics) with injury occurrence of 1,866 small-sized, manufacturing factories (65,921 population factories after weighting). General characteristics of factories comprised location, type and classification of industry. Employee characteristics comprised proportion of manual workers and female workers, average working hours per week and shiftwork. Health and safety characteristics comprised type of safety and health manager, committee for occupational safety and health, labor union, health and safety regulation, monthly health and safety training time, score of health and safety activity and score of safety culture. Results: The following characteristics of injury-occurrence in small-sized, manufacturing factories were determined by multivariate analysis. In terms of general characteristics, the risk of injury-occurrence was higher in Jeolla area than Gyeongin area in outside associate than other enterprises and in coke, refined petroleum products and nuclear fuel, wood and products of wood, food products and beverages and fabricated metal products, except machinery and furniture industries than television and communication equipment and apparatus industries. In terms of employee characteristics, injury-occurrence significantly increased in factories with greater proportion of manual worker and with a higher rate of working hours per week. But significantly decreased in factories with a higher proportion of female workers. In terms of health and safety characteristics, injury-occurrence significantly increased in factories with a self-appointed safety manager, with unorganized union, with a more active committee for occupational safety and health, with unimplemented health and safety regulation, with longer monthly safety and health training time, and with a lower score of safety culture. Conclusions: This study demonstrated that several factors of workplace organization were significantly related with injury-occurrence in factories. These findings are supposed to raise the need for making effort in workplace organization to improve injury prevention.

십이지장의 평활근육종 1례

윤세진,김영건 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

We reported a case of 51-year old female who was diagnosed primary leiomyosarcoma in duodenum confirmed by post-operation pathologic diagnosis. She complained of melena and general weakness. The endoscopy revealed mass with central necrosis in third portion of duodenum. The endoscopic biopsy showed nonspecific inflammation and ulcer. The case was performed segmental resection and end-to-side duodeno-jejunostmy. Final postoperative diagnosis is low grade leiomyosarcoma in duodenum second and third portion.

수산화알루미늄 인산염의 난연 특성

변상근,윤세훈,김송호,이의수 동국대학교 산업기술연구원 2007 산업기술논문집 Vol.16 No.2

수산화알루미늄과 인산을 반응시켜 수산화알루미늄 인산염을 합성하고 이의 난연 특성을 측정하였다. 수산화알루미늄 인산염은 수산화알루미늄과 인산의 반응에서 다양한 반응 몰 비로 염이 형성될 수 있으며, 염의 구성비에 따라 열분해 현상에 차이가 발생하였다. 수산화알루미늄은 난연 소재의 하나로 이용되고 있고, 인산은 유기물 인산을 형성하여 다양한 유기 인산계 난연 소재로 적용되고 있다. 본 연구 결과에서 수산화알루미늄과 인산의 반응으로 형성된 수산화알루미늄 인산염은 무기물 난연 소재가 가지는 장점뿐만 아니라, 수산화알루미늄 자체의 난연 특성과 인산이 가지는 난연 특성을 공유하는 상승효과를 나타냄을 알 수 있었다. Aluminum hydroxide phosphate was synthesized by means of a salt reaction of aluminum hydroxide and phosphoric acid, thereafter the characteristics of the salt, as a flame retardant, was measured. Various salt compositions were produced in accordance with the mole combinations of two reactants. Aluminum hydroxide is used for a common inorganic flame retardant and phosphoric acid is also used for a part of organic phosphoric compound as an organic flame retardant, respectively. From the result of this study, the aluminum hydroxide phosphate salt has not only the merit of its property of the inorganic compound, but also the synergistic effect of each characters, i.e. flame retardants, in terms of aluminum hydroxide and phosphoric acid.

정보제공자와의 면담에 의해 진단된 뇌졸중후치매의 유병률과 상관인자에 관한 연구

배희준,이건세,김형수,김병건,구자성,권오현,박종무 대한치매학회 2004 Dementia and Neurocognitive Disorders Vol.3 No.2

Background and Objectives: With increasing age of population, stroke and dementia become greater health problems in Korea. However, there have been no studies on poststroke dementia in Korea. We intended to elucidate the frequency and clinical correlates of poststroke dementia in a hospital-based cohort. Methods: From July 2001 to July 2002, 372 patients were hospitalized to Eulji General Hospital within 7 days from onset with acute stroke or transient ischemic attack. Two hundred-eight patients (55.9%) were followed up and interviewed more than 1 year later (451 ±83.3 days). Dementia was diagnosed by Korean Dementia Screening Questionnaire (KDSQ) obtained by a direct interview. Based on Eulji Stroke Registry, demographic factors, risk factors for stroke, stroke characteristics, and stroke outcomes were gathered and examined. Results: Of 208 patients, poststroke dementia was detected in 36 patients (17.3%, 20 males, age=64.5±9.4 years). Poststroke dementia was associated with history of stroke, aphasia, modified Rankin Disability Scale (MRDS) at 3 month after stroke and when interviewed, and Barthel index at 6 months after stroke (p;0.05). Its correlation with diabetes mellitus and National Institute of Health Stroke Scale at discharge were marginally significant (0.05;p;0.1). Conclusions: Post-stroke dementia is common in Korean stroke patients. Its frequency is comparable to that in other countries. The correlates of poststroke dementia and their clinical meanings are demonstrated.

충주시 고등학생의 최근 4년간(1988-2001) B형간염 표면항원 및 항체 양성률 조사

김형수,이건세,장성훈,박수경,김청식,이창희,권혁중,정순섭 한국역학회 2002 Epidemiology and Health Vol.24 No.2

Objective : Since Korea has been known to be of the endemic area for hepatitis B virus(HBV) infection, vaccination for HBV has been recommended for all neonates in Korea. After starting vaccination in 1983, the change of sero-positivity of HBsAg and HBsAb is expected. This study was carried out to investigate the seropositive rate of hepatitis B virus surface antigen and antibody in high school freshmen students in Chungju-city. Methods and Materials : From 1998 to 2001, a total of 11,735 who were born in 1982 to 1986, were enrolled in this study. HBsAg and anti-HBs were tested by reversed passive hemagglutination and passive hemagglutination, respectively. Results : The study population was 11,735 students who were composed of 5,813 males (49.6%) and 5,914 females (50.4%). The HBsAg sero-positivity of male and female students was 3.25% (n=381) and 2.59% (n=153) respectively. The anti-HBs sero-positivity of male and female students was 62.2% (n=3,154) and 64.1% (n=2,969) respectively. There are significant difference observed in comparison of HBsAg and anti-HBs seropositivity according to sex (p<0.05). From 1982 to 1986 on birth year, anti-HBs sero-positivity has been increased significantly from 63.3% to 73.3%. But the change of HBsAg sero-positivity has not been changed significantly. Conclusions : As compared with previous studies of HBsAg and anti-HBs, the sero-positive rate of HBsAg has not been changed but that of HBsAb has been increased significantly. This result revealed that the effect of HBV vaccination program was successful.

충주시 농촌지역 주민의 건강행태 및 의료이용

장성훈,이건세,이원진,박종태 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.6 No.-

To evaluate the health behavior and medical utilization patterns of residents in Choongju rural area is useful for district health authority and health facilities in identifying the problems and setting the priorities. The reason is that rural area in Choongju city has a relatively few health resources except public health subcenters and public health posts. We evaluated the health behavior, health status, and medical utilization pattern of people in Choongju rural area using the household survey in summer, 1995. From 12 Myuns, randomly selected 6 Myuns first, and then applied convenient sample method. The residents had many health problems. 98(32%) out of the 307 respondents had some health problems, most of which were musculoskeletal and gastro-intestinal problems. A total of 218 persons(72%) thought that it was individual responsibility. Because the Lay referral system was poor and many of residents had to make the decisions about their health problems and medical seeking by themselves. When they were ill, 34% of respondents answered that they would visit hospitals first, and 24% would visit health-subcenter. But, when illness was severe, 72% of respondents answered that they would use hospitals at first. We suggest that public health facilities in rural area should be activated since they play the major role in promoting the health of rural residents. Health programmes such as health education, counseling, and disease prevention program, are also necessary especially for most of elderly persons.

위암조직에서 Carcinoembryonic Antigen 측정의 의의

정현용,윤세진,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

To estimate tumor CEA expression of stomach cancers in relation to normal mucosa CEA, degree of cellular differentiation, pathologic stage and other clinicopathologic findings, we measured CEA concentrations in tissue extracts by radioimmunoassay for 24 cases of stomach cancer. The results were as follows: 1. Ranges of tissue CEA concentrations in normal stomach mucosa was from 6.Ong/gm to 15.4 ng/gm(mean 10.2ng/gm). 2. Mean conceatrations of cancer tissue CEA was 42.1ng/gm(from 2.9 ng/gm to 414.Ong/gm), 4 times higher than normal mucosa. In 46% of stomach cancers, tissue CEA concentrations was above normal cut off value(18.7ng/gm). 3. Tiuse CEA concentrations of stomach cancer was significantly high as high CEA levels of normal mucosa(r=0.6954), not related to serum CEA concentrations. 4. Tissue CEA concentrations of stomach cancer was high as high TNM stage, but was not related to wall invasion depth, lymph node metastasis, cellular differentiation and other clinicopathologic findings. In conclusion, the production of CEA in stomach cancers was significantly increased in half cases, CEA expression of tumor was related to pathologic stage rather than cellular differentiation. The factors determined CEA production was considered more higher levels such as DNA profile. To estimate prognostic values of tissue CEA concentrations, follow up of included patients and further study should be pursued.

충주시 농촌지역 주민들에 대한 보건교육 평가

권복규,양준호,송진범,이건세,이원진,장성훈 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-

The aim of this study was to evaluate the effect of health education program in Choongju rural area which had conducted by Public Health Doctor during winter in 1994 and 1995. We used two step sampling method for a household survey. First, six were selected from 12 Myuns, which were stratified by the level of health education activity. Second, we applied convenient sample method. Of the 307 respondents, most of them knew Health-subcenter's existence in their region. However, only 149 persons(45%) visited it during last year. They visited Health-subcenter because it was easy to travel and convenient. Some of them thought that Health-subcenter had very poorly equipped and supplied. About 32∼34% of respondents participated the health education program for hypertension and diabetes mellitus which was done last winter, and 59∼70% of participants of the program answered that it was very, moderately helpful. 82∼83% of participants recognized complications of hypertension and diabetes mellitus, and 18∼20% of them did not know that medications of hypertension and diabetes mellitus should be continued one's whole life. The respondents want to receive health educations for cancer, arthritis, viral hepatitis and AIDS in orders. Many of rural residents utilize Health-subcenters because health clinics in Choongju rural area are very few.

병원표준화심사의 질 향상 관련 항목에 대한 평가와 개산방안

김창엽,이상일,이건세,신영수 한국의료QA학회 1995 한국의료질향상학회지 Vol.2 No.1

Background: Korean Hospital Standardization Program(KHSP), as a hospital accreditation program initiated and promoted by Korean Hospital Association since 1981, has played a key role in the hospital quality improvement in structural aspect particularly. Recently, however, KHSP has been critisized by hospitals and health personnels in that it is unpractical to be utilized as an initiative to improve hospital quality. In particular, the section of quality assurance in KHSP, strongly influenced by old version of Hospital accreditation of Joint Commission in U.S.A., has been required to be fundamentally sevised. For design of new criteria in quality assurance section, a survey for evaluation of existing program and collection of opinions for ideal one was conducted. Methods: For a month in 1994, structured questionnaires were administered by mailing to 470 hospital staffs from 200 hospitals, participated in the survey for the 1994 KHSP in each hospital. The total number of respondents was 116. Results: Less than half of the respondents(34.5%) value positively on the impact of current KHSP in general on the quality improvement of their hospitals. Moreover, most responses indicated that KHSP should be reorganized towards more practical and applicable one. Current KHSP criteria for quality activities in hospitals were regarded as a unpractical one which should be basically renewed. For new criteria and standards, most respondents emphasized the importance of applicability of those in real siuations. Conclusion: For the KHSP to be effective, new evaluation criteria for quality activities should be more practical and fully accommodated to hospital situations in reality.