入院醫療의 他中診療圈 利用에 관한 硏究

黃聖喆,李允鉉 한국인구보건연구원 1993 保健社會論集 Vol.13 No.1

제주도 고등학교 학생들의 비만 유병률과 심혈과 위험인자

황승욱,김현주,홍성철,이상이 제주대학교 생명과학연구소 2002 제주생명과학연구 Vol.5 No.6

연구배경 : 최근 청소년 연령층의 비만이 급격히 증가하고 있으며, 비만 청소년들에 있어서 고혈압, 당뇨, 고지혈증이 조기에 발현될 뿐 아니라 성인비만과 성인병 발생의 주 원인이 되고 있다. 본 연구는 제주도내 고등학생들의 비만 유병률과 청소년 비만과 심혈간 위험인자인 혈압, 총콜레스테롤, 공복시혈당의 관련성을 알아보고 소아비만과 청소년 비만의 관련성을 조사하였다. 방법 : 연구대상은 제주도내 22개 고등학생 1학년 6,064명을 대상으로 하였고. 체격조사는1999년도 학교 신체검사 자료와 병원 건강검진 자료를 이용하였다. 비만에 대한 평가는 대한소아과학회에서 발행한 1998년도 한국소아표준치와 체질량 지수 두가지를 이용하였다 심혈관 위험인자로는 총콜레스테롤 수축기 혈압, 이완기혈압 공복시 혈당으로 하였으며, 배상자중 646명에 대해 과거 건강기록부를 열람하여 초등학생 때의 비만실태를 조사하였다. 결과 : 제주도 고등학생의 비만 유병률은 표준체중에 의한 비만 산출법으로는 남, 여학생 각각 12.6%, 13.3%이었고 체질량 지수에 의한 비만 위험군 및 비만 학생이 남, 녀 각각 12.7%, 13.4%로 나타났다. 지역에 따른 비만 유병률은 남학생의 경우 시 지역 12.9%, 군 지역 10.3%로 시 시역에서 비만 유병률이 유의하게 높았으며, 여학생의 경우 시·군지역 각각 12.9%, 14.2%이었으나 통계적 유의성은 없었다. 고등하교 계열에 따른 비만 유병률은 남학생의 경우 인문계 13.9%, 실업계 10.1%로 인문계가 유의하게 높았으나, 여학생의 경우는 통계적 유의성은 없었다. 비만 정도에 따른 심혈관 위험인자와의 관련성에서 남학생의 경우 수축기와 이완기혈압, 공복시혈당, 총콜레스테롤 수치가 비만 정도에 따라 유의한 차이를 보였으며(P<0.05), 여학생의 경우 공복시혈당을 제외한 나머지 변수에서 유의한 차이를 보였다. 체질량지수와 심혈간 위험인자간의 상관관계에서 남학생은 혈압, 공복시혈당 총콜레스테롤이 유의한 양의 상관관계를 보였으며, 여학생의 경우 공복시혈당 외에 다른 수치에서 유의한 양의 상관관계를 보였다. 연구대상자 중 646명에 대해 초등학교 1학넌 때의 비만실태를 추적한 결과 초등학생 비만이 고등학생 비만에 미치는 비교위험도가 남녀 각각 3.77, 2.16으로 유의하게 나타났다(P<0.05). 결론 : 제주도지역 고등학생들의 비만 유병률이 상당히 높게 나타났고, 청소년 비만과 심혈관 위험인자간의 관련성을 알 수 있었다. 또한 소아비만이 청소년 비만으로 상당수 이행되었으므로 소아 및 청소년기에 적절한 비만관리 프로그램이 요구된다. Background: Recently, adolescent obesity was increased and tended to become obese adults, facing increased risk for diabetes, cardiovascular disease. Even vefore reaching adulthood, adolescent, obesity already was experiencing hypertension, dyslipidemia, and diabetes mellitus. The purpose of this study was to find prevalence of obesity of high school students in Jeju island and association between obesity and cardiovascular risk factors and association between childhood obesity and adolescent obesity. Method: The study subjects were 6,064 students of twenty-two high school in Jeju island and health survey data was gathered from high school health examination data and hospital health examination data from Aug. 1999 to Dec. 1999. Adolescent obesity was evaluated by ideal body weight method in 1998 and body mass index. Cardiovascular risk factors were checked total cholesterol, systolic and diastolic blood pressure, fasting blood sugar. In 646 students, obesity at primary school is checked by primary school health record. Results: Prevalence of obesity in Jeju island high school students was 12.6% in male students, 13.3% in female students by ideal body weight method and Prevalence of obesity risk and obesity was 12.7% in male students, 13.4% in female student by body mass index. Prevalence of obesity of male students in city area and district area of Jeju island were each 12.9%, 10.3% and that of male students in city area was significantly higher. Prevalence of obesity of female students in city area and district area of Jeju island were each 12.9%, 10.3% and that of male students in city area was significantly higher. Prevalence of obesity of female students in city area and district area of Jeju island were each 12.9%, 14.2% and not significantly different. Prevalence of obesity of male students in general and commercial school group were each 13.9%, 10.1% and that of general school group was significantly higher. In female students, Prevalence of obesity general and commercial school group was not significantly different. Total cholesterol, systolic and diastolic blood pressure were significantly associated with degree of obesity in male and female students(P<0.05) and fasting blood sugar was only significantly associated with degree of obesity in male students (P<0.05). In 646students, Relative risk of obesity at primary school and that at high school in male and female students were 3.77, 2.66 and was significantly associated. Conclusion: Prevalence of obesity of high school students in Jeju island is very high and adolescent obesity was significantly associated with cardiovascular risk factors. Mostly childhood obesity tended to become adolescent obesity and program of control of obesity at childhood and adolescence is required.

노인 입원 환자의 질병 양상과 의료이용 실태

김현주,홍성철,이상이,김명주,황승욱 대한노인병학회 2003 대한노인병학회지 Vol.7 No.4

AVPU scale과 Glasgow Coma Scale의 상관관계 : 외상환자의 의식상태 평가법 THE EVALUATION METHODS OF MENTAL STATUS IN TRAUMA

김 현,임경수,이강현,김영식,김선만,황성오 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Background: The emergency treatment of multiple trauma patient includes rapid evaluation of mental status, triage and resuscitation. The principles of Advanced Trauma Life Support consist of primary survey & resuscitation, secondary surveys and definitive cares. In primary survey, the mental status is evaluated by AVUP scale, and GCS(Glasgow coma scale) is used in secondary survey because the calculation of GCS needs more times than AVPU scale. Purposes: Is there a correlation between AVPU scale and GCS as an evaluation method of mental status in trauma? Subjects: 434 injured patients(male 321, female 113, mean age 35.9 years) who had visited the emergency center of Wonju Christian Hospital was evaluated prospectively. The mental status was evaluated by AVPU scale and GCS by emergency physician as soon as the patients was admitted to emergency center. Results: Alert patients as AVPU scale were ranged from 14 to of GCS, patients who responded to verbal command were from 9 to 14 of GCS, patients who responded to pain stimuli were from 4 to 10 of GCS, and patients who did not respond to pain stimuli were from 3 to 5 of GCS. The linear correlation of AVPU scale and GCS was seen(r2=0.90). Conclusion: This study suggest that AVPU scale was vey closely correlated with GCS.

디지탈영상의 치근이개부 골손실 판독효과에 관한 실험적 연구

이상래,황의환,오봉현 大韓口腔顎顔面 放射線學會 1995 Imaging Science in Dentistry Vol.25 No.2

The aim of this study was to evaluate and compare observer performance between conventional radiographs and their digitized images for the detection of bone loss in the bifurcation of mandiblar first molar. One dried human mandible with minimal periodontal bone loss around the first molar was selected and serially enlarged 17 step defects were prepared in the bifurcation area. The mandible was radiographed with exposure time of 0.12, 0.20, 0.25, 0.32, 0.40, 0.64 seconds, after each successive step in the preperation and all radiographs were digitized with IBM-PC/32 bit-Dx compatible, video camera(VM-S8200, Hitachi Co., Japan), and color monitor(Multisync 3D, NEC, Japan). Sylvia Image Capture Board for the ADC(analog to digital converter) was used. The obtained results were as follows: 1. In the conventional radiographs, the mean score of the readability was higher at the condition of exposure time with 0.32 second. Also, as the size of artificial lesion was increased, the readability of radiographs was elevated(P<0.05). 2. In the digital images, the mean score of the readability was higher at the condition of exposure time with 0.40 second. Also, as the size of artificial lesion was increased, the readability of digital images was elevated(P<0.05). 3. At the same exposure time, the mean scores of the readability were mostly higher in the digitized images. As the exposure time was increased, the digital images were superior to radiographs in readability. 4. As the size of lesion was changed, the digital images were superior to radiographs in detecting small lesion. 5. The coefficient of variation of mean score has no significant difference between digital images and radiographs.

발치 후 교정력 적용 시기에 따른 치아 이동 양상

한성호,황현식 전남대학교 치과대학 1999 전남치대논문집 Vol.11 No.1

This study was performed to compare and analyze the mode of tooth movement according to the timing of orthodontic force application after extraction. The upper right and left third incisors were carefully extracted at three-week interval in four adult dogs. Both canines were used as an anchorage for the bodily movement of the upper second incisors. Orthodontic force of 100 gm was simultaneously applied at one week after extraction on one side and four weeks after extraction on the other side using NiTi closed coil spring. While orthodontic force was applied for twelve weeks, the amount of tooth movement was measured at every second week with digital calipers. The animals were sacrificed at twelve weeks and histologic examination was executed to reveal any difference between both sides. The results were obtained as follows; 1. The tooth movement was faster in four-week side than one week side for the first two weeks while faster in one-week side during next two weeks 2. The rate of tooth mevement was fastest during four to six weeks period, then decreased gradually. 3. The total amount of tooth movement tended to be larger in one-week side compared to four-week side. 4. Any damage to tooth and periodontal tissue could not be seen in the histologic section of one-week side. These results suggest that earlier application of orthodontic force is better than later after extraction in terms of the rate of tooth movement.

크롬(Ⅵ)의 체내 흡수와 소실속도에 관한 연구

김현영,이성배,임철홍,이권섭,정용현,이종성,한정희,전윤석,황호순,이용묵 한국산업위생학회 2003 한국산업보건학회지 Vol.13 No.1

The CrO3 mostly used in plating. metal surface disposal, leather, cosmetic manufacturing, as an experiment material by repeatedly inhaling and exposure the male S.D. rats at a 0.00, 0.2., 0.50, 1.25 mg/㎡ concentration(particle size: 0.5-0.5 aerosol)6hours a day, 5day a week in 13weeks comparing with 2weeks, 8weeks of recovery group about the noxiousness of the experiment animal and the reduce scale of the CrO3 in the internal organ especially in blook and respiratory organ with the period of convalescent and clearance. The experiment results which we received are as follows. 1. In blood the RBC, HGB and HCT experiment, rats with 0.20, 0.50 mg/㎡ concentration showed that there were some decreases but not dependent. The kidneys absolute weight compared with control group was reduced intentionally(p〈0.05) and the lungs absolute weight compared with control group showed intentional increase(p〉0.05). 2. After the exposure of the experiment material, the whole blook, l\blood plasma and red blood cell in blood by (x): the period of convalescent, per (y); the decreasing of Cr concentration, was y=66.51 e -0.057x, y=67.2 e-0.101x, y=70.01 e-0.030 in 0.50 mg/㎡ exposure concentration by calculating the clearance coefficient of correlation, and the half life (day)was estimated 12.0, 6086, 23.0 each. 3, After the exposure of the experiment material, the experiment animals lung, liver and kidneys by(x); the period of convalescent, per (y); the decreasing of Cr conentration, was y=1808 e-0.00493x, y=12.02e-0.0297x, y=67.61 e-0.0292x in 0.50mg/㎡ exposure concentration by calculating the clearance coefficient of correlation, and the half life(day)was estimated 140.6, 23.3, 23.7, each, and including lung, liver with all of the experiment internal organs, the Cr clearance decreased as the exposure concentration increased.

발치 후 교정력 적용 시기에 따른 치아 이동 양상

한성호,황현식 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.1

본 연구는 발치 후 인접치 이동을 위한 교정력 적용 시 적용 시기에 따른 치아이동 양상을 비교·분석하기 위하여 시행되었다. 성견을 실험대상으로 상악 좌우 제 3절치를 3주 간격으로 각각 발거하고, 양 견치를 고정 원으로 제 2절치의 치체이동을 위한 장치를 장착하였다. 100 gm의 지속적인 힘을 내는 견인 스프링을 사용하여 발치 후 4주와 1주부터 좌우 제 2절치를 각각 12주간 동시에 견인하였다. 2주 간격으로 디지털 캘리퍼스를 이용하여 이동거리를 측정·비교하고 실험에 사용된 좌우 제 2절치의 조직소견을 관찰하여 다음과 같은 결론을 얻었다. 1.교정력 적용 후 처음 2주간에는 발치 후 4주에 견인한 치아가, 그 다음 2주간에는 발치 후 1주에 견인한 치아가 빠르게 이동하는 양상을 보였다. 2.12주간의 실험기간 동안 견인 4주와 6주 사이에 가장 빠르게 이동하는 경향을, 이 후에는 이동 속도가 감소하는 양상을 보였다. 3.실험기간 동안 이동한 전체 거리는 발치 후 4주에 비해 1주에 견인한 경우에서 크게 나타나는 경향을 보였다. 4.발치 후 4주에 견인한 경우에 비하여 1주에 견인한 경우에서 유해한 조직소견이 나타나지 않았다. 이상의 결과는 발치 후 교정력 부여 시 조기 적용이 유리함을 시사하였다. This study was performed to compare and analyze the mode of tooth movement according to the timing of orthodontic force application after extraction. The upper right and left third incisors were carefully extracted at three-week interval in four adult dogs. Both canines were used as an anchorage for the bodily movement of the upper second incisors. Orthodontic force of 100 gm was simultaneously applied at one week after extraction on one side and four weeks after extraction on the other side using NiTi closed coil spring. While orthodontic force was applied for twelve weeks, the amount of tooth movement was measured at every second week with digital calipers. The animals were sacrificed at twelve weeks and histologic examination was executed to reveal any difference between both sides. The results were obtained as follows : 1.The tooth movement was likely to be faster in four-week side than one-week side for the first two weeks while faster in one-week side during next two weeks 2.The rate of tooth movement was fastest during four to six weeks period, then decreased gradually. 3.The total amount of tooth movement was likely to be larger in one-week side compared to four-week side. 4.Any damage to tooth and periodontal tissue could not be seen in the histologic section of one-week side. These results suggest that earlier application of orthodontic force is better than later after extraction in terms of the rate of tooth movement.

성견에서 수직적 골결손부에 골이식후 교정력 적용시기에 따른 치주조직의 반응

이상열,이기헌,황현식 대한치과교정학회 2001 대한치과교정학회지 Vol.31 No.3

본 연구는 수직적 골결손부에 골이식을 시행한 후 교정력 적용시기에 따른 치주조직의 반응을 알아보고자 시행하였다. 체중 15 kg 내외의 성견 9마리에서 상악 좌우측 제3절치의 원심 치근면에 수직적 골결손을 형성하고 치주질환을 유발시킨2주 후 치주판막술을 시행하고 골결손 기저부 수준의 치근면에 기준 흠을 형성하였다. 골이식 후 치유기간에 따라 2주군, 4주군, 6주군으로 각각 3마리씩 분류하고 우측 제3절치는 치주판막술만 하는 비이식측으로, 좌측 제3절치는 치주판막술과 골이식을 병용한 이식측으로 설정하여 양측 모두 술후 2주, 4주, 또는 6주부터 120 gm의 교정력을 적용하여8주 동안 치체이동 시킨 후2주간 보정하였다. 이후 동물을 희생시키고 조직표본을 만든 후 치주조직의 반응을 비교 관찰하여 다음과 같은 결과를 얻었다. 1. 모든 실험동물에서 비이식측에 비해 이식측의 골재생양이 많이 나타났다. 2. 6주군에서는 홈에서 백악-법랑 경계부까지 거리의 1/2이상 치조골과 백악질이 재생되었고 상피의 하방증식없이 결합조직대가 치근면과 부착을 이루었다. 3. 4주군에서는6주군과 유사한 치주조직 재생소견을 보였으나 그 양은 더 적게 나타났다. 4. 2주군의 경우 골재생이 양측 모두 홈에 한정되어 나타났으며 상피의 하방증식이 홈의 기저부까지 연장되고 백악질과 결합조직의 재생은 관찰되지 않았다. 이상의 결과는 치주질환에 의한 수직적 골결손 환자에서 치주판막술과 골이식을 시행하고 교정적 치아이동을 할 경우 교정력 적용시기에 따른 치주조직의 반응이 차이가 있음을 시사하였다. (주요 단어 : 수직적 골결손, 골이식, 교정력 적용시기, 치주반응) The aim of this study was to investigate the periodontal response according to the timing of orthodntic force application after bone graft into the angular bony defect. Nine dogs were divided into three groups, 2, 4, and 6 weeks, according to the timing of orthodontic force application after bone graft. Periodontal angular bony defects were created surgically at the distal aspect of both maxillary third incisors. Two weeks later, flap operation was performed to eliminate inflammation and reference notch was made on the root surface at the level of the bottom of each defect. Demineralized freeze-dried bone was implanted on the left side whereas only debridement was done on the other side. Experimental tooth movement was executed during 8 weeks on both graft and non-graft sides. After 2 weeks of retention period, animals were sacrificed for histologic specimens. The results were obtained as follows : 1.New bone formation was more pronounced in the graft side than in the non-graft side in all experimental animals. 2.In the 6-week group, new bone and cementum formation was observed in more than half from the notch to the cemento-enamel junction, and the zone of connective tissue attachment was found without apical migration of junctional epithelium. 3.In the 4-week group, the amount of new bone formation was smaller than in the 6-week group whereas the overall remodeling pattern was similar. 4.New bone formation was confined to around the notch and the junctional epithelium migrated apically to the level of the notch with no connective tissue attachment and cementum formation in the 2-week group. The results of the present study suggest that periodontal response may be influenced by the timing of orthodontic force application after bone graft into angular bony defect. Key words : Angular bony defect, Bone graft, Timing, Periodontal response

성견에서 수직적 골결손부에 골이식후 교정력 적용시기에 따른 치주조직의 반응

이상열,황현식,김경근 전남대학교 치과대학 2000 전남치대논문집 Vol.12 No.1

The aim of this study was to investigate the periodontal response according to the timing of orthodontic force application after bone graft into the angular bony defect. Nine dogs were divided into three groups, 2, 4, and 6 weeks, according to the timing of orthodontic force application after bone graft. Periodontal angular bony defects were created surgically at the distal aspect of both maxillary third incisors. Two weeks later, flap operation was performed to eliminate inflammation and reference notch was made on the root surface at the level of the bottom of each defect. Demineralized freeze-dried bone was implanted on the left side whereas only debridement was done on the other side. Experimental tooth movement was executed during 8 weeks on both graft and non-graft sides. After 2 weeks of retention period, animals were sacrificed for histologic specimens. The results were obtained as follows: 1. New bone formation was more pronounced in the graft side than in the non-graft side in all experimental animals. 2. In the 6-week group, new bone and cementum formation was observed in more than half from the notch to the cemento-enamel junction, and the zone of connective tissue attachment was found without apical migration of junctional epithelium. 3. In the 4-week group, the amount of new bone formation was smaller than in the 6-week group whereas the overall remodeling pattern was similar. 4. New bone formation was confined to around the notch and the junctional epithelium migrated apically to the level of the notch with no connective tissue attachment and cementum formation in the 2-week group. The results of the present study suggest that periodontal response may be influenced by the timing of orthodontic force application after bone graft into angular bony defect.