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.

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.

주요우울증에 대한 벤라팍신의 효과 및 안전성

이민수,남종원,강성민,연병길,오병훈,이철,정인과,채정민,백인호 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 주요우울증 환자에서 벤라팍신의 치료 효과와 안정성을 조사하기 위해 다기관 개방연구를 시행하였다. 방 법 : DSM-IV 진단 기준에 의거하여 주요우울증으로 진단된 환자중 벤라팍신 투여에 동의한 환자를 대상으로 하였다. 선택된 환자에서 다른 항우울제를 복용하고 있는 경우 14일 이상의 약물 배설기간을 가진후 벤라팍신을 6주간 투여하였으며, 기준점, 1주, 2주, 4주, 6주 후에 HAM-D, MADRS, 그리고 CGI등을 사용하여 평가하였다. 본 연구기간중 발생된 모든 부작용은 부작용의 발생 및 소설 시기, 심한 정도, 발생 빈도, 벤라팍신과의 관련성, 관련 조치 및 결과에 대하여 증례기록서에 기록하도록 하였다. 결 과 : 총 141명을 대상으로 하였으며, 이중 94명(66.7%)이 6주간의 연구를 완결하였고, 47명(33.3%)이 중도탈락하였다. HAM-D총점수는 벤라팍신 투여 1주후부터 유의한 감소를 나타내었으며, 2주,4주, 6주후에도 지속적인 감소를 보였다. MADRS의 총점수도벤라팍신 투여 1주 후부터 유의한 호전을 나타내었으며, 2주, 4주, 6주 후에도 지속적인 감소를 보였다. CGI에서도 기준점, 1주, 2주, 4주, 6주 후 각각의 시점 사이에 유의한 호전이 보였다. 활력징후, 일반 혈액학, 생화학, 심전도 검사 등에서 유의한 변화는 없었다. 벤라팍신과 관련된 부작용으로 흔히 보고한 증상은 오심(10.6%), 소화불량(9.5%), 변비(8.5%), 현기증(8.5%)등 이었다. 결 론 : 다기관 개방연구를 통해 주요우울증 환자에 대한 벤라팍신의 투여는 우울증상의 호전에 효과적이었으며 안전하였다. Objective : A Multicenter open-label study was conducted to evaluate the clinical efficacy and safety of venlafaxine for the tretment in patients with major depression. Method : The study was done in patients with major depression diagnosed by DSM-IV who accepted venlafaxine medication. In cases of the patients taking other antidepressants, 6 weeks of venlafaxine medication was carried out after 14 days of drug excretion period and evaluation using HAM-D, MADRS, and CGI was done at baseline, and after 1, 2, 4, and 6 weeks. Regarding all side effects that had occurred during the period of our study such as their developed/disappeared time, severities, incidences, relationship with venlafaxine, managements and results have been putted into the records. Results : A total of 141 patients were enrolled. Among 94 of them finished the 6 weeks of research and 41 of them did not make it through the research. Total HAM-D scores showed significant decrease after 1 week of venlafzxine medication and continous decrease through the study period. Total scores of MADRS also showed significant improvement after 1 week and continuous decrease through the study period. Similarly, CGI showed significant improvement between baseline, 1, 2, 4, and 6 weeks. There were no significant changes in vital sign, CBC, chemistry, and EKG. The commonly reported side effects of venlafaxine were nausea(10.6%), indigestion(9.5%), constipation(8.5%), and dizziness(8.5%). Conclusion : According to the results, venlafaxine was effective and safe in the treatment of patients with major depression.

캔음료중 epichlorohydrin 의분석법에 관한 연구

이광호,곽인신,최재천,전대훈,김형일,강경모,최병희,김귀정,이철원 식품의약품안전청 2001 식품의약품안전청 연보 Vol.5 No.-

캔식품중에 잔류하는 epichlorohydrin을 분석하기 위한 pu링e & trap-Cc/uf통D 분석법을 확립하여 캔의 lacauer 코팅제에서 식품으로 이행되어 잔류하는 epichtorohydfn을 측정하고, 식품유사용매에 의한 용출시험을 통해 일일추정섭취량을 산출하였다. epichlorohydrin의 검량선은 y=0.0006x+0.OO6?(R큰0.9983)의 직선성·라 0.05#ga의 검출한계를 나타내었다. 각종 음료 및 식품유사용매에 일정량의 epichlorohydrin을 첨가한 후 분석하였을 때 회수을은 72~91%였으며, 실제 시판되는 f5건의 캔음료 중 잔류하는 epichlorohydrin을 측정한 결과 모든 캔음료에서 검출한계(0.1#94) 이하였다. 제관업체에서 구입한 modifed epoxy, epoxy phenolic, vinyl organosol, epoxy phenol ester 등의 BADGE(bisphenol A diglycidyt ether)형 에폭시수지로 lacquer 코팅된 식품용 캔에 식품윤사용매인 10% 또는 95% 에탄올을 층L진한 후 90~121'c의 드라이오븐에서 30분~2시간동안 용출시켰을 패 캔의 lacquer 코팅재에서 식품유사용매로 이행되는 epichBorollydirn은 코팅재질, 그리고 가열온도 및 시간에 문관하게 모든 캔에서 검출한계(0.4#ga)이하 였다. 위의 용출결과를 FD.f_의 "Recommendation for Chemistry Data for Indirect Food Additive Petition" 윽 일일추정섭취량 산출법에 적용하여 얻은 epichtorohydrin의 일딜추정 섭 취 량은 0.2r조persorday이하였다. A sensitive ana1?~7tical method based on gas cl)romatogFapy~mass spectrometry with a selected ion monitoring (GE/hfS-Slhf) and the purge-and-trap concentrator ))·asdeveloped for determining ot'epicillorohydrin in canr;ed be)#erages coated with eporl· resin. Thecalibration rurve in the ranre of 0.j ~50nr had'correlation coefficient of 0.9983 and detection limit of 0.Osrga. Recoveries of epichlorohydrin spiked to beverages were in the range of 72 ~91% with detection limits of 0.1 #ga. fn survey of epichlorohydff in twenty commercialcanned beverage samples, epichlorohydrin was not found in all the samples with the detectionlimit of 0.1 r9a. In migration test of various cans coated with BADGE-based coating cans;modifed epoxy, epoxy phenolic, vinyl organosol, epox?· phenol ester were exposed to the foodsimulants of 10% ethanol and 95% ethanol. flfo delectable epichlorohydrin migrated to foodsiHulants was found in aTl the cars with detection Jimit of 0.4 #9/L. Using the miEration data,along uTith the applicstion of food and beverage cans complied with FDA's "Recommendationfor Chemlstry Data f,3r Indirect Food Additive Petition" , the potential dietary exposure toepichlorohydrin was estlmated to be under 0.2rf/person/day.

Rhinocerebral Mucormycosis 2예

오명돈,최강원,김병국,김재중,이홍규,김상윤 대한감염학회 1986 감염 Vol.18 No.2

Mucormycosis is an acute suppurative opportunistic mycosis that produce predominantly rhinocerebral disease in patient with diabetic ketoacidosis and immunosuppressed patient. We experienced two cases of rhinocerebral mucormycosis recently. The one occurred in patient with diabetic ketoacidosis and the other in acute leukemia. They showed nasal discharge, orbital cellulitis and proptosis. Their condition rapidly deteriorated. Biopsy from palate and sinus revealed broad, nonseptate, right-angled branching hyphae, a finding compatible with mucormycosis.

半夏의 修治方法에 따른 細胞毒性硏究

李秀培,金德宗,金康柱,田炳勳,禹元洪 圓光大學校 韓醫學硏究所 1993 원광한의학 Vol.3 No.1

The purpose of this study is to know the effects of Pinelliae Tuber on the cytotoxicity of human gingival fibroblasts according to brewing methods. Pinelliae Tuber was extracted by water in the state of being raw materials, prebrewing with Zingiberis Tuber and alumen. The extracted Pinelliae Tuber was applied to the cultured human gingival fibroblasts. The cytotoxic effct of Pinelliae Tuber was meaeured by MTTassay and microscopic findings. The results were as follows : 1. The cell viability of the fibroblasts by Pinelliae Tuber water extracts significantly decreased compared to control group. 2. The cell viability by the Pinelliae Tuber extracts prebrewed with Zingiberis Tuber was similiar to those of control group. 3. The cell viability by the Pinelliae Tuber extracts prebrewed with alumen slightly decreased, but was higher than those of PT group. 4. According to the microscopec findings, the number of cell count were smaller than normal in all experimental group, specially in the PT group, and showed the shrinkage of cytoplasmic process in the PT group and PA group.

多樣한 黃芩藥鍼製劑의 安全性 및 效能에 關한 硏究

김호경,마진열,전원경,윤수영,강은정,주혜정,고병섭 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

In order to detect the safety and effect of various aqua-acupunctures from Scutellariae Radix, the modifications of boiling, filtration and dilution were employed for the manufacture of aqua-acupunctures. We injected 0.2cc of aqua-acupunctures into Joksamri(足三里) of rat, repeatedly. we compared subacute toxicity of them with saline group, distilled water(D.W.) group, acupuncture group and control group. The results were summarized as follows: 1. The groups were all healthy and alive, and there was no special abnormality in physical condition and autopsy. And there were not any toxic symptoms in repeating application of aqua-acupunctures to the rat, including changes of body weight, organ weight, haematological examination and serum biochemical test. 2. There was slight change of body weight in acupuncture group : We could see significance after 3 days (p<0.05) and after 7 days (p<0.001) in body weight loss. After 9 days, all tested groups were suppressed in body weight increment. 3. Result of organ weight: In Palking aqua-acupuncture(D-2 group), saline group and acupuncture group there were some statistical significance. Especially, acupuncture group revealed significant result in liver and spleen than aqua-acupunctures. From this result, we could suggest that the efficacy of acupuncture was preceded herbal medicine. 4. In serum biochemical test, we examined glucose(GLU), triglyceride(TG) and cholesterol(CHOL). In comparison with control group, the diluted 10 times of hwanggum aqua-acupuncture (× 10 group) was recognized significant decrease of glucose, but the diluted 100 times of Hwanggum aqua-acupuncture (× 100 group), D-2 group, saline group were confirmed significant increment. There was not any meaningful change of CHOL in all of tested group, excepting the acupuncture group was exhibited statistically significant decrease(p<0.05). In TG level all tested group except complex injection of standard compound (CPA group) and HG, there were significant value in statistically. The diluted solution was more significant decrease than Hwanggaum aqua-acupuncture(HG). The mutual relationship of components of aqua-acupuncture tended to decrease level of TG, regardless of its concentration. In acupuncture group, we gained some interesting result in meaningful decrease in TG. 5. Haematological examination showed significant increment of gramulocytes(GR) in all tested groups except Hwanggum aqua-acupuncture. And the diluted solutions of HG expressed very high increment of them(p<0.001). The GR and Mean Corpuscular Volume(MCV) of acupuncture group showed statistical significance.

동종골수이식 환자에서 발생한 지역사회발생 Parainfluenza virus 3형 폐렴 1예

신종욱,조요한,강철인,김성한,이상윤,김의석,오명돈,이환종,박선양,김병국,최강원 대한감염학회 2002 감염 Vol.34 No.5

백서 척수후근절로부터 슈반세포의 효과적인 체외 배양법

김성민,이종호,김남열,안강민,최원재,최시호,차미주,이주영,황순정,장정원,명훈,최진영,서병무,정필훈,김명진 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

Schwann cells(SCs), an important component of the peripheral nervous system, intract with nerous to mutually support growth and replication for the peripheral nerve regentation. Recently, ading SCs to the lumen of guidance channel is widely tried to improve regeneration or to make regeneration possible over otherwise irreparable gaps. however, it is not easy to isolate and multiplicate SCs as much as enough to help the axonal regeneration. For the allogeneic SCs source for tubular nerve guidance, we developed a little bit improved technique of harvesting and multiplicating SCs. by culturing dispersed dorsal root ganglia in specially designed medium with growth factors and serial processing, we repeatedlly generate relatively homogenous SC cultures. Our technique was compared with other methods of literature using immunostaining methods such as GFAP, S100, BDNF and the total SC count assessment at different time interval after primary culture.

베체트씨병에 동반된 복부 대동맥 동맥류의 스텐트 삽입술 1 예 : Treatment with Endovascular Stent Graft

허웅,안정수,황지영,김현지,강보리,나현희,이건주,변영섭,고충원,이병권 인제대학교 백병원 2003 仁濟醫學 Vol.24 No.1

Behcet's disease is an inflammatory disorder of unknown cause, characterized by recurrent oral aphthous ulcer, genital ulcers, ocular manifestations, and skin lesions. Large-vessel involvement of both arterial and venous system appears in 7-29% of patients, and it is major cause of morbidity and mortality. Venous involvement, including superficial thrombophlebitis and deep vein thrombosis, is more frequent. Arterial manifestations occurs infrequently and presents with aortitis or arterial aneurysm and arterial thrombosis. Arterial aneurysms or occlusions which occur in the systemic or the pulmonary arterial bed are present in approximately 2 to 3% of patients with Behcet's disease and accounts for only 12% of vascular complication. Aneurysms are more frequent than occlusions and are mostly present in the pulmonary arteries and abdominal aorta. They have poor prognosis because of rupture with fatal outcome and surgical treatment is necessary. But, Surgical treatment often difficult and may lead to formation of further false aneurysms at the site of vascular anastomosis. Endovascular stent graft placement emerged as an alternative treatment that is less invasive with a lower risk. We experienced a case of abdominal aortic aneurysm in 36-year-old man with Behcet's disease. The patient was diagnosed by CT scan and treated with percutaneous endovascular stent graft.