병원급식소의 HACCP 제도 적용을 위한 미생물학적 위해도 분석

이병두(Byung?Doo Lee),김장호(Jang?Ho Kim),김정목(Jeongmok Kim),김두운(Du?Woon Kim),이종욱(Chong?Ouk Rhee),은종방(Jong?Bang Eun) 한국식품영양과학회 2006 한국식품영양과학회지 Vol.35 No.3

호남지역 병원 6곳의 급식시설 및 부식류 등에 대한 미생물학적 안정성이 평가되어졌다. 조사된 병원급식시설의 공중낙하균 평가에서는 식탁, 조리장 및 냉동고에서 미생물균수가 비교적 높게 측정되어 이러한 시설에 대한 미생물학적 오염에 대한 철저한 관리가 요구됨을 보여주었다. 또한 조리기구 및 용기 표면의 미생물학적 안정성 측정에서는 도마, 칼, 식판 등의 일반세균수는 비교적 높았으나 유의적인 수준은 아니었으며 대장균군, 황색포도상구균, 대장균 등의 수준도 일반적인 미생물 오염기준 미만으로 나타나 미생물학적 안정성은 양호하였다. 하지만 이들 급식시설에서 제공되는 부식류에 대한 미생물학적 안정성 평가에서는 대체적으로 가열조리식품의 미생물학적 오염은 기준 미만으로 나타났으나 기준을 초과한 부식에 대해서는 철저한 미생물학적 안전 관리가 이루어져야 할 것으로 판단되었다. Microbiological hazard analysis of foodservice facilities and utensils of 6 hospitals in the Honam region was evaluated. In the microaerosol evaluation, the microbial counts of dinning table, kitchen, and freezer were comparatively high, and it indicated the microbial contamination of these facilities should be effectively managed. In the microbiological hazard analysis evaluation of cooking utensils and appliances, the total plate counts of cutting boards, knife, and meal plates were comparatively high but did not reveal significance. The counts of coliforms, Staphylococcus aureus and Escherichia coli, were lower than the general limit of microbial contamination, and the microbiological safety of the cooking utensils and appliances were satisfactory. In the microbial safety evaluation of side dishes, microbial counts of heat?cooked foods were generally low and microbiological hazards of these side dishes were comparatively low.

젊은 연령층의 정상 성인남자에서 체지방분포가 당대사에 미치는 영향

최문기(Moon Gi Choi),박성우(Sung Woo Park),박충기(Choong Ki Park),이병두(Byung Doo Rhee),이홍규(Hong Kyu Lee),고창순(Chang Soon Koh),민헌기(Hun Ki Min) 대한내과학회 1988 대한내과학회지 Vol.35 No.2

N/A The Subgrouping of human obesity might be of importance for the elucidation of the pathogenesis of type II diabetes mellitus, To evaluate the effects of the degree of fatness and regional distribution of fat on hyperinsulinemia (insulin area; IA) and insulin sensitivity (KJTT), standard oGTT during a 3-hour period and insulin tolerance tests were performed on 16 noniabetic young men. Body mass index (BMI), waist to hip circumference ratio (WHR), and the intraabdominal visceral fat to subcutaneous fat ratio (VSR) were measured using an abdominal CT scan. There were significant positive correlations between IA and BMI (r=0.58, p<0.05) and WHR (r=0.76, p<0.001). There were significant negative correlations between KITT and BMI (r=0. 64, p<0.05) and WHR (r=0.64, p<0.05), However, VSR had no significatn correlation with IA (r=0.07) and KlTT (r=0.39). These results suggest that in non- diabetic young men, the intraabdaminal distribution of fat has no influence on hyperinsulinemia and insulin sensitivity, and that upper body obesity and the degree of overall fatness have major roles in the genesis of hyperinsulinemia and insulin insensitivity.

도시림이 직장인의 직무만족과 스트레스에 미치는 영향

신원섭 ( Won Sop Shin ),김재준 ( Jae Jun Kim ),김외정 ( Wae Jung Kim ),유려화 ( Rhee Hwa Yoo ),이병두 ( Byung Doo Lee ) 한국산림과학회 2003 한국산림과학회지 Vol.92 No.1

The overall purpose of this study was to investigate the influence of nearby forests on office workers` job satisfaction and stress. During August-September of 2002, 10 experimental areas (i.e., nearby urban forests existed) and 10 control areas (i.e., no nearby urban forests existed) were selected. In the 20 study areas, 935 office workers were sampled to collect data. The results of this study indicated that there were significant differences in job satisfaction and stress between office workers in experimental and control areas. In lower level of income status, the differences shown much stronger than workers level who have higher income.

제2형 당뇨병 환자에서 스타틴 치료 시 HDL 콜레스테롤의 변화

박종률 ( Jong Ryul Park ),장혜정 ( Hye Jung Jang ),문정윤 ( Jung Youn Moon ),석지혜 ( Ji Hye Suk ),김미경 ( Mi Kyung Kim ),박정현 ( Jeong Hyun Park ),이병두 ( Byung Doo Rhee ) 대한내과학회 2008 대한내과학회지 Vol.74 No.4

목적: 스타틴은 심혈관계 질환의 일차 및 이차 예방에 효과적인 것으로 받아들이고 있지만 HDL 콜레스테롤을 올리는데 있어서는 개인간에 편차가 큰 것으로 알려져 있다. 본 연구는 제 2형 당뇨 환자에서 스타틴 치료 시 HDL 콜레스테롤의 변화를 살펴보기 위해 시행하였다. 방법: 217명의 제 2형 당뇨와 이상지혈증을 가진 환자를 대상으로 스타틴의 반응을 살펴보았다. 진료기록부를 근거로 한 후향적 연구로 본 연구를 시행하였다. 피브린산 유도체나 니코틴산을 병합하여 사용하고 있는 환자나 이전에 스타틴을 사용한 환자, 크레아티닌이 1.5 mg/dL 이상, 공복 중성지방이 300 mg/dL 이상인 경우, 그리고 만성 간질환이 있는 경우는 연구 대상에서 제외시켰다. 결과: HDL 콜레스테롤은 평균 2.3% 감소하였다. HDL 콜레스테롤의 퍼센트 변화에 영향을 준 인자는 기저 HDL 콜레스테롤, LDL 콜레스테롤의 퍼센트 변화, 총 콜레스테롤, 기저 총 콜레스테롤이었다. 그 중 기저 HDL 콜레스테롤이 퍼센트 변화에 가장 강력한 인자였다. 기저 HDL 콜레스테롤으로 대상을 5분획으로 나누어 보면 기저 HDL 콜레스테롤 값이 높을수록 HDL 콜레스테롤 값은 많이 감소하였다. 결론: 제2형 당뇨병 환자에서 스타틴 치료 시 HDL 콜레스테롤 변화는 기대했던 효과와 달리 오히려 그 수치가 감소하는 환자들도 있었다는 것이 관찰되었고, 향후 이에 대한 전향적인 연구가 더 필요할 것으로 생각된다. Background/Aims: Statins have been a mainstay of treatment for primary and secondary prevention of coronary heart disease through their beneficial effect on lipid profile. However, their effect on the HDL cholesterol level has been determined to be equivocal or unclear. This study sought to investigate HDL cholesterol response to statin treatment in type 2 diabetic patients. Methods: We retrospectively assessed the effect of statins in 217 patients with type 2 diabetes and dyslipidemia through chart review. Patients who were using medications such as fibrates, niacin, or thiazolidinediones, or had a plasma creatinine concentration greater than 1.5 mg/dL, a fasting triglyceride level greater than 300 mg/dL, or chronic liver disease, were excluded from the study. Result: The mean level of LDL cholesterol was significantly decreased, and the percentage of patients who achieved the normal LDL cholesterol level was increased in this study. The mean HDL cholesterol level after statin treatment was decreased by 2.3%. The percent change of HDL cholesterol was affected by baseline HDL cholesterol level, percent change of total cholesterol, percent change of LDL cholesterol, and baseline total cholesterol level. When subjects were divided into quintiles according to baseline HDL cholesterol, HDL cholesterol level was found to be increased in the lowest two quintiles while it was decreased in the highest two quintiles. Conclusions: There were some patients whose HDL cholesterol level was decreased after statin treatment, depending on their baseline HDL cholesterol level. We think further study on the effect of statins on HDL level will be needed in the future.(Korean J Med 74:411-417, 2008)

전신성 홍반성 루푸스에 동반된 중추성 요붕증

김지현 ( Ji Hyun Kim ),남영진 ( Young Jin Nam ),권미란 ( Mi Ran Kwon ),이찬희 ( Chan Hee Lee ),한성훈 ( Seong Hoon Han ),박원도 ( Won Do Park ),이병두 ( Byung Doo Rhee ),이윤우 ( Yun Woo Lee ) 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.3

Central diabetes insipidus is caused by the insufficient secretion of vasopressin and has been reported in great variety of disorder of brain tumor, systemic infiltrative disease such as histiocytosis, amyoidosis and vasculitis, leukemia, and other autoimmune diseases. But there has been reported only 3 cases of systemic lupus erythematosus (SLE) associated with central diabetes insipidus. The exact pathophysiologic process of pituitary gland involvement in SLE has been unknown, although there are some evidence that vascular impairment and autoantibodies to pituitary gland may be contributory factors. Here, we report a case of central diabetes insipidus complicated by neuropsychiatric systemic lupus erythematosus.

당뇨병의 고혈압 치료 전략

이병두 대한가정의학회 2001 Korean Journal of Family Medicine Vol.22 No.5

비 낭종성 양성 갑상선 결절의 Tetracycline 경화 요법

김종순,김옥,김종호,김윤자,이병두,문병천,김광회,문재환 대한내분비학회 1991 Endocrinology and metabolism Vol.6 No.1

Percutaneous tetracycline injection (PTI) is a sclerosing method for the treatment of the pure thyroid cyst. PTI of 23 cases of benign thyroid nodules (solid echopattern-six, mixed echopattern-nine, cystic echopattern-six, resected nodules-two cases) were done with 23-G needle under the guidance of ultrasonography. After then, we followed up ultrasonographical size and volume of nodules, thyroid function test, cytology, histopathological examination and complications of treatment. The results were as follows: 1) with 0.5-2ml tetracycline injection, the mean volume of thyroid nodules were reduced after PTI at 6 months.In the solid nodules, (4.70 1.20 4.44 2.67)(ml)(p$gt;0.05) In the mixed nodules, (13.59 7.85 4.34 6.73)(ml)(p$lt;0.05) In the cystic nodules, (20.33 21.66 6.79 8.32)(ml)(p$lt;0.05) 2) The echogenicity was decreased of unchanged in the most solid and mixed nodules but increased in the cystic nodules. 3) There were no significant changes at 6 months follow-up of TFT after PTI in all cases as compared with the base line studies. 4) Aspiration cytologic finding shows the decreased number of thyroid follicular cells, the increased number of macrophages, a few foam cells and the cytoplasm containing the pale brown foreign body. (Tetracycline phagocytosis).Histopathologic finding shows the destruction and sclerotic changes of the cystic degenerated follicles with infiltration of the lymphocytes and macrophages. 5) The complication such as burning sensation, pain and tenderness developed in the two cases but disappeared within several days. In conclusion, sclerotherapy using tetracycline is a safe and effective adjunctive treatment of the benign mixed of cystic thyroid nodules and Percutaneous Alcohol Injection (PAI) is recommendable for solid nodules. (J Kor Soc Endocrinol 6:58 67, 1991)

한국인 당뇨병 환자들에서의 항도세포 항체 출현에 관한 연구

김창진,이홍규,고창순,박영진,민헌기,이기업,이병두,김성연,윤지원 대한당뇨병학회 1985 Diabetes and Metabolism Journal Vol.9 No.2

의식 변화를 주소로 응급실에 내원한 당뇨병 환자의 임상적 특성

최대식,박연희,이승훈,윤범,임충현,조문숙,이병두,류석용,김홍용 인제대학교 2000 仁濟醫學 Vol.21 No.2

Objectives: The purpose of this study was to analyze the clinical characteristics of the diabetic patients with altered mentality in the emergency room. Methdos and Materials: Retrospective study was performed from April 1994 to August 1999. We included the diabetic patients with altered mentality on the base of the daily reports of the emergency room and patient's admission database, then review the medical records of the patients. Results: The number of diabetic patients with altered mentality entering emergency room was 432 for about 4.5 years. The mean age was 62.2 years. The causes of altered mentality consisted of hypoglycemia(31.9%), neurologic problems(25.5%), hepatic encephalopathy(13.4%), hyperglycemic crises(7.6%) , and others. Patients with diabetic acute metabolic complications showed better prognosis than others. Conclusion: The diabetic patients visiting emergency room with altered mentality had carious causes. The most common cause was hypoglycemia followd by neurologic problems, especially stroke. The hyperglycemic crises relatively less common causes of the altered mentality. The rapid determination of the patients blood glucose bevel using the glucose reagents strip and acid-base status helps the physician to evaluate and manage the diabetic patients with altered mentality in a large majority.

부산시 기장지역 주민에서 혈청 요산치와 인슐린저항성 증후군

임경호,김성목,조문숙,박정현,김동준,이병두,강창일,윤보영,채두근 대한당뇨병학회 2001 Diabetes and Metabolism Journal Vol.25 No.4

Background: Insulin resistance syndrome is defined as the constellation of central obesity, hypertension, glucose abnormality and dyslipidemia. Other constituents of insulin resistance syndrome have recently been reported including serum uric acid. Causative correlation between serum uric acid and insulin resistance syndrome is still not clear. We pertormed epidemiologic study to clarify its correlation with insulin resistance syndrome in the people living at Kijang district of Busan City. Methods: We pertormed volunteer study of the people living at Kijang district of Busan City from 16th to 19th day of November in 1998 (n=232). Height, body weight, abdominal and hip circumference, and blood pressure were measured. We also measured fasting blood glucose, fasting serum insulin (Linco^(R) RIA), HDL-cholesterol, triglyceride, total cholesterol and serum uric acid. Insulin resistance was calculated by HOMA (homeostasis model assessment) method. Results: Total number of subjects were 232 (male 61, female 171), and their mean age was 5.1±13.4 (years), BMI (body mass index) 23.4±3.2 kg/㎡, and WHR (waist to hip ratio) 0.82±0.07. Mean HOMA-IR value derived from fasting blood glucose and insulin was 2.5±2.4, mean serum uric acid was 270±72 μmol/L. The serum uric acid level showed positive correlation with BMI (r=.324), WHR (r=.403), log transformed triglyceride value (r=.135), systolic blood pressure(r=.181), diastolic blood pressure (r=.185) and negative correlation with HDL-cholesterol (r=-.185,p$lt;0.01). Stepwise linear regression revealed that only serum creatinine, WHR and natural logarithmic value of triglyceride showed statistically independent correlation with serum uric acid level. Conclusion: Serum uric acid level in the people living at Kijang district of Busan City showed statistically significant correlation with other well-known constituents of insulin resistance syndrome. Thus, we may conclude that the level of serum uric acid can be regarded as the component of insulin resistance syndrome in the people living at Kijang district. However, its relationship with insulin resistance syndrome may be indirect.