족관절 내과골절에서 피질골 나사못을 이용한 변형된 긴장대 고정술

최호림,도현우,김병흠,김규현,박종석,송준민 대한골절학회 2004 대한골절학회지 Vol.17 No.4

목적 : 전위된 족관절 내과골절에 대해 피질골 나사못을 이용한 변형된 긴장대 고정술을 이용한 치료결과를 분석해 보고자 하였다. 대상 및 방법 : 2001년 1월부터 2003년 1월까지 전위된 내과골절에 대해 변형된 긴장대 고정술을 시행 받고 최소 1년 이상 추시관찰 가능 하였던 24례를 대상으로 하였다. 남자 13례, 여자 11례로 평균 연령은 46세였다. 골절은 Lauge-Hansen 분류법을 사용하였으며, 결과는 Meyer와 Kumler의 평가 방법을 이용하였다. 결과 : 13례 (54%)에서 우수의 결과를 얻었고, 9례 (38%)에서 양호의 결과를 얻었으며, 운동범위의 제한이 발생한 1례에서 보통, 후외상성 관절염이 발생한 1례에서 불량의 결과를 얻었다. 결론 : 전위된 족관절 내과골절에서 피질골 나사못을 이용한 변형된 긴장대 고정술은 견고한 내고정과 조기 관절 운동이 가능한 효과적인 수술 방법이 될 수 있을 것으로 사료된다. Purpose : To evaluate the clinical results of modified tension band wire technique using cortical screw for treatment of displaced medial malleolar fractures of the ankle. Materials and Methods : From January 2001 to January 2003, 24 patients were treated by modified tension band wiring using cortical screw for medial malleolar fracture. The follow-up period was 12~35 months (average 18 months). There were 13 males and 11 females, and the mean age was 46 years. Fractures were classified by Lauge-Hansen's classification. The results were analyzed by Meyer and Kumler's criteria. Results : There were 13 cases (54%) of excellent, 9 cases (38%) of good, and one case of fair because of limitation of motion of the ankle joint and one case of poor which showed post-traumatic arthritis of the ankle. Conclusion : Modified tension band wire technique using cortical screw can be an effective operative method for the treatment of displaced medial malleolar fractures of the ankle.

다발성 모기질종 1예

신봉석,정병수,최규철 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Pilomatricoma, often called calcifying epithelioma of Malherbe, is a tumor with differentiation toward hair cells, particularly hair matrix cells. It presents as a firm, deep-seated nodule that is covered by normal or pink skin. It is occuring usually as a single lesion which is most commonly found on the face, neck, or proximal upper extremity. Multiple lesions are quite unusual, comprising only 2-3.5% of cases. A 32-year old man had 3 subcutaneous nodules on the both upper extremities. Histological findings of the lesion showed the typical pattern of pilomatricoma. We presented herein one case of multiple pilomatricoma with the review of literatures.

아래턱뼈 계측을 통한 한국인의 체질인류학적 특징 및 남녀판별함수 분석

허경석,고기석,정한성,강민규,최병영,김희진 대한췌담도연구회 2000 대한췌담도연구회지 Vol.5 No.4

소음성 난청 선별검사용 문진표의 유용성

송재석,최병수,원종욱,노재훈 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목적 : 소음 특수건강진단시 문진표의 유용성을 알기 위하여 실시되었다. 방법 : 자료로는 전국을 5대 권역으로 나눈 후 연구에 협조적인 산업보건기관을 대상으로 하여, 소음성 난청이 발생한 사업장과 그 부서에 대하여 정상인 근로자의 검진기록과 작업환경측정 기록 및 문진표를 수집하여 분석하였다. 결 과 : 각각의 문진 항목과 청력이상 여부에 대한 분석결과, 귀에서 소리가 난다고 하는 항목과 최근 작은 소리가 잘 안들린다고 하는 만성 특이적 항목만 청력이상 여부와 관계가 있었고, 급성 항목들은 청력 이상 여부와 통계적 연관성이 없었다. 또한 7개의 설문 항목과 연령 및 근무경력만을 이용하여 청력이상을 판정한다고 하였을 때, 실제 건강진단 결과와 비교하게 되면 민감도, 59 %, 특이도, 88 %로 계산 되었으며, 평균 23 %정도가 잘못 분류되었다. 결 론 : 만성적이고 특이적인 항목을 위주로 한 단순하고도 판별력있는 항목의 개발이 필요하며, 이러한 항목들을 전산화하였을 때, 효과적인 소음성 난청의 선별검사 체계를 구축할 수 있을 것이다. Objectives : This study was performed to investigate the effectiveness of the questionnaire. Methods : Workers'health examination records, work environment record, and questionnaires of selected industries as samples were analysed using logistic regression analysis and discrimination analysis Results'Cases of bearing impairment (Dl+C) as dependent variables, and age, work duration and level of environmental noise as independent variables were selected for multiple unconditional logistic regression analysis. Odds ratio was 4.04 in hearing difficulty, 2.78 in tlnnitus and 1.08 in age. In the second analysis Noise induced hearing loss is selected as dependent variable. The OR in hearing difficulty was 3.67(95 % C.1. : 1.61 8.61), and was 1.09(95 % C.1. : 1.05-1.14) in age. Conditionnal multlple logistic regression analysis was performed. In hearing impairment as dependent variable, the OR of age was 1.02(95 % C.1. : 1.00-1.04) and other variables were not significant. However, NIHL as dependent, the OR of hearing difficulty was 4.57(95 % C.1. : 1.43-14.67). According to multiple logistic regression adopting each items of questionnaire as dependent variable, the only item of hearing difficulty showed significant difference with hearing ability. The discrimination analysis was performed with the class variable of hearing impairment, and discrimination variables of age, work duration, and environment noise level. The sensitivity of 59 %, and specificity of 88 %, and average error count of 23 % were obtained. When the numbers of items answered in questionnaire were assumed as the parameter of judgement for noise induced hearing loss (NIHL), the highest sensitivity and specificity were 33.5% and 49.0% in cases of more than two items answered. Conclusions : The development of items that is simple and discriminative mainly consisted of chronic and specific diseases related items is needed. Computerization for newly developed items might be needed to establish effective surveillance system for NIHL in the future.

모반을 실로 묶어 발생된 화농성 육아종양 병변 1예

신봉석,정병수,최규철 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Pyogenic granuloma is a benign vascular, inflammatory proliferation that appears following minor trauma in children and young adults. The exact pathogenesis of pyogenic granuloma is unknown, but its formation is closely related to minor trauma, chronic irritation, and hormonal influences. A 52-year old woman visited us with a protruding nodule on the right zygoma area. The nodule was pedunculatedby trauma of tied up nevus. Based on the histological finding, we diagnosed post-traumatic pyogenic granuloma like lesion developed within melanocytic nevus.

알쯔하이머형 치매 환자에서 우울증의 유무에 따른 인지기능과 일상생활 수행능력의 차이

김승민,최태규,안석균,손석한,유계준,오병훈,오희철 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구목적 : 알쯔하이머형 치매 환자에게 있어서 중요한 행동증상중의 한가지인 우울증의 다양한 범위로 보고되고 있으며 우울증과 인지능력 및 기능적 능력과의 관계에 대한 연구가 매우 중요하게 부각되고 있다. 본 연구의 목적은 지역사회에 거주하는 경도 및 중등도의 알쯔하이머형 치매 환자를 대상으로 우울증이 일상생활 수행능력과 인지기능의 특정 영역과 연관이 있는지의 여부를 알아보기 위함이다. 방 법 : 본 연구대상은 경기도 광주군에 거주하는 65세 이상의 알쯔하이머형 치매 노인 48명이며, 한국판 Mini-Mental State Examination(이하 MMSE-K), 한국어판 신경행동학적 인지상태 검사(이하 한국어판 NCSE), 한국형 노인우울검사(이하 KGDS), 기본적인 일상생활 수행정도(이하 ADL), 그리고 도구적인 일상생활 수행정도(이하 IADL)를 연구도구로 하여 이들로부터 자료를 수집 조사하였다. 연구대상은 KGDS에 의해 우울 치매군과 비우울치매군으로 분류하였으며 두 군간의 상기 척도에 의해서 얻어진 결과를 χ²test 및 independent t-test를 이용하여 분석하였다. 결 과 : 우울 치매군과 비우울 치매군은 성별, 연령, 교육수준 및 MMSE-K 점수의 유의한 차이가 없었다. 우울 치매군은 비우울 치매군보다 ADL의 한 항목인 목욕하기에서 유의한 저하를 보였다. 우울 치매군은 비우울 치매군보다 IADL의 총점 및 식품점에 가서 장보기, 집안일(청소나 정리정돈), 금전 관리의 3개 항목에서 유의한 저하를 보였다. 그러나 우울 치매군은 비우울 치매군은 한국어판 NCSE를 이용한 인지기능의 영역별 비교에서는 유의한 차이를 보이지 않았다. 결 론 : 이상의 결과로 미루어 볼 때 알쯔하이머형 치매 환자에서의 우울증은 기본적인 일상생활 기능의 일부와 도구적인 일상생활 기능의 저하와 상당한 관련 있고, 이러한 우울증에 동반된 일상생활 기능의 저하는 인지기능의 영향에 기인하지 않는 것임을 시사된다. Objectives : Coexistence of depression is one of the important behavioral symptoms in patients with dementia of Alzheimer type. The study on the relationship between depression and cognitive abilities and /or functional abilities emerges as very important one. The aim of this study was to investigate whether depression is related to the impairment of daily activities and to certain areas of cognitive function in mild to moderate dementia of Alzheimer type. Methods : In this study, 48 patients with dementia of Alzheimer type among elderly community-residents in Kwangju, Kyunggi province, age 65 and older, were finally included. We examined their demographics and administered Korean Version of the Mini-Mental State Examination(MMSE-K). Korean Version of the Neurobehavioral Cognitive Status Examination (Korean version of NCSE), Korean Form of Geriatric Depression Scale(KGDS), Activities of Daily Living(ADL), and Instrumental Activities of Daily Living(IADL) to the subjects. We classified the subjects into two groups, dementia with and without depression on the basis of KGDS scores. The two groups were compared using χ²test and independent t-test. Results : The results show that the two groups did not differ in sex, age, education, and scores of MMSE-K. The depressed dementia group showed significantly poorer performance in bathing, one item of ADL, than the non-depressed dementia group. The depressed dementia group showed significantly more impairment in total scores of IADL and each score of three item(shopping, housework, handling finances) than the non-depressed dementia group. However, the two groups showed no significant difference in five major cognitive ability areas of Korean version of NCSE. Conclusion : These results suggest that depression in patients with dementia of Alzheimer type is highly related to the functional impairments, instrumental activities of daily living and part of activities of daily living, beyond the effects of cognitive impairments.

문수산(봉화군) 일대의 식물상

한종원, 양선규, 최슬기, 장창석, 김규식, 오병운 忠北大學校部設基礎科學硏究所 2007 自然科學硏究 Vol.21 No.-

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관상동맥색전증에 의한 급성심근경색증 4예

김민근,주혜원,강경필,최병돈,박민석,변영섭,고충원,이건주,김병옥 인제대학교 2006 仁濟醫學 Vol.27 No.-

Acute myocardial infarction(AMI) due to coronary embolism can occur in patients with normal coronary artery. Coronary embolism is believed to be a cause of acute myocardial infarction when emergent coronary angiography shows perfectly normal coronary trees, except for the finding of coronary artery occlusion. In this report, we describe four patients with AMI due to coronary embolism who were successfully treated using a thrombus aspiration device and anticoagulation, and those patients had intracardial thrombus arising from the left atrium due to chronic atrial fibrillation and valvular heart disease. Patients with chronic or paroxysmal atrial fibrillation can present with AMI due to coronary embolism, and thrombus aspiration with percutaneous aspiration device is a feasible treatment option for these patients along with anticoagulation the rapy.

주요우울증이 근로자의 생산성에 미치는 영향 : WHO-HPQ(Health and Work Performance Questionnaire)를 이용한 예비연구

김원,황태연,함병주,이준석,최병휘,김세주,서용진,강은호,우종민 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Major depressive disorder (MDD) causes patients' distress and makes socioeconomic burden, both directly and indirectly. We used the concept of lost productive time (LPT) to estimate the indirect costs and calculated both absenteeism and presenteeism among workers with MDD. Mcthods : Depression group was recruited from workers visiting psychiatric outpatient clinic who had MDD without major physical or mental disorders (N= 106). Age and sex matched healthy control group was also recruited through advertisement (M=100). All participants completed a interview using WHO Health and Work Performance Questionnaire (HPQ), Job Stress Measurement Scale for Korean Employees, and Hamilton Rating Scale for Depression. Statistical analysis was performed with independent t-test or χ² test as characteristics of values (p=0.05). Results : The number of absence (0.94-day/month vs. 0.10-day/month, P=0.015) andthe numberofearly leaving (2.56-day/month vs. 0.24-day/month, P<0.001) were significantly higher in the depression group. Depression group evaluated their Perfor-mance level much lower than controls with significant value (5.16 vs. 7.62, P<0.001). In addition, depression group estimated their performance level during the last 4 weeks lower compared to the level of past 1-year (5.16 vs 6.63, P<0.001). The estimated costs of absenteeism in depression group were higher than controls by 2,520,000 Korean Won per year, and those of presenteeism were also higher by 4,880,000 Korean Won per year. The total costs of LPT in depression group were higher than controls by 7,400,000 Korean Won, which corresponds to 26% ofmean annual salary. In addition, the level of occupational stress, such as high demand and interpersonal conflict, was higher in the depression group. Conclusion : Major depressive disorder costs substantial productivity loss to workers and their company. Presenteeism imposes more time cost than absenteeism. Effectiveness trials are needed to devise cost-effective programs for the early detection and treatment of depression at the workplace.

장군봉(봉화군) 일대의 식물상

한종원, 양선규, 최슬기, 장창석, 김규식, 오병운 忠北大學校部設基礎科學硏究所 2007 自然科學硏究 Vol.21 No.-

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