보건관리대행 기관의 사업장내 진료에 대한 근로자 요구 및 실시 의향

원종욱,송재석,정선아,박화미,노재훈 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.1

목적 : 본 연구에서는 보건관리대행 사업에 있어 사업장내 진료에 대한 수요와 보건관리대행기관의 방문진료 제공에 대한 의향을 조사하여 사업장내 진료에 대한 욕구를 파악하고, 이를 토대로 사업장내 진료에 대한 기초적인 자료를 제공하는데 목적이 있다. 방법 : 근로자들의 의료이용 행태와 방문진료에 대한 요구도를 파악하기 위해 167개 보건관리대행 사업장의 사업주와 보건담당자, 그리고 1,350명의 근로자에게 설문 조사를 실시하였고, 사업주 121명(72.5%), 보건담당자 145명(86.8%), 근로자 816명(60.5%)이 응답하였다. 일차진료의 제공 가능성을 파악하기 위해서 전국의 66개 보건관리대행기관의 의사와 간호사 및 행정책임자에게 우편 설문조사를 실시하여 의사 31명 (47.0%), 간호사 38명(57.6%) 및 행정책임자 34명(51.5%)이 응답하였다. 결과 : 보건관리대행 사업을 수행하고 있는 의사의 87%와 간호사의 94%가 보건관리대행 업무를 담당하면서 많은 근로자들로부터 투약 등 진료를 요구받고 있었고, 100 %의 간호사와 행정책임자 94%, 의사의 76 %가 보건관리대행 사업에서 진료를 수행하는 것이 필요하다고 생각하고 있었다. 한편사업주의 85 %, 보건관리 담당자 86 %와 근로자81 %가 보건관리대행기관에서 사업장내 진료를 시행 할 때 이를 수용하겠다고 응답하였다.결론 대다수의 근로자와 사업주가 보건관리대행기관의 진료를 요구하고 있었고, 보건관리대행 기관의 의사와 간호사가 사업장에서의 진료를 수용할 의향이 있고, 직업성 뇌심혈 관계질환의 예방 등 필요성이 인정된다면 보건관리대행 의사의 사업장내 진료를 인정해야 한다고 생각된다. Objectives : This study was performed to survey worker's demands for worksite medical care and agency's intention for offering worksite medical care in Group Health Service Agency. Methods : One study subjects were employers, workers and office personnels in 167 factories. They were asked for medical care utilization behavior and worksite medical care demand. 121 employers(72.5%), 145 office personnels(86.8%) and 816 workers(60.5%) answered the questionnaire. The other subjects were doctors, nurses and administrators in 66 Group Health Service Agencies nationwide. They were asked for intention of offering worksite medical care in Group Health Service Agency through the mail survey. 31 doctors (47.0%), 38 nurses (57.6%) and 34 administrators answered the questionnaire. Results : 87 percentage of doctors and 94 percentage of nurses had experiences of being requested to prescribe and laboratory examination. All nurses, 94 percentage of administrators and 76 percentage of doctors thought that it was necessary to give medical treatment at worksite. Also in worksite 85 percentage of employers, 86 percentage of office personnels and 81 percentage of workers answered that they accepted the worksite medical care when it would be given. Conclusions : Worksite medical care should be permitted because almost of all workers and employers requested worksite medical care, and doctors and nurses in Group Health Service Agency were willing to give worksite medical care and there was necessity to prevent occupational cerebrovascular disease.

산란계에 투여된 플루오로퀴놀론계 합성항균제의 계란내 이행 잔류 연구

서계원,이재일,이채용,김은선,이정치 한국수의공중보건학회 2002 예방수의학회지 Vol.26 No.4

In the past few years the use of four fluoroquinolones such as of ofloxacin(OF), norfloxacin(NORE), ciprofloxacin(CIP), enrofloxacin(ENR) in veterinary practice has increased. The aim of this study was to determine the elimination of fluoroquinolones into eggs, by intramuscular injection of laying hens(2.5mg of ENR/kg, 5mg of CIP/kg, 5mg of NOR/kg, 5mg of OF/kg). The treatment of fluoroquinolones was carried out in 3 stages with 9 laying hens (Isabrown), with mean weight 1.8kg, which were housed in individual cages. Four fluoroquinolones were administered to 9 laying hens through intramuscular injection at 1 day, 2 days, 5 days trial respectively. Sample (Albumen, Yolk, Whole egg) were analysed by high performance liquid chromatography (HPLC) with a fluorescence programmable detector and matrix solid phase despersion (MSPD) extraction. Residues of fluoroquinolones were much higher in the yolk than in the albumen. Detectable residues persisted for 12 days, 14 days, 16 days, respectively, in albumen and yolk after the injection was discontinued. The increase of the fluoroquinolones concentration in yolk was very rapid and reached a plateau after 3 days of dosing. In albumen, the fluoroquinolones concentration increased during intramuscular injection. As soon as the injection was discontinued, residues decreased in the albumen and the yolk.

비호지킨림프종 환자에서 발생한 폐 효모균증 1예

장재혁,송치원,심병용,이동건,변재호,정정임,이교영,홍영선,신완식,김춘추,이경식 대한감염학회 2003 감염과 화학요법 Vol.35 No.3

저자들은 비호지킨씨 림프종 환자에서 항암 치료 후 질환의 진행성 병변과 감별을 요했던 우폐 중엽의 단발성 종괴를 흉강경하 생검으로 폐 효모균증을 확진하고 amphotericin B와 fluconazole로 치료한 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Non-Hodgkin's lymphoma is monoclonal expansion of malignant B or T cells. The immunocompromised status in this disease is accompanied by many infections. The cryptococcosis, caused by Cryptococcus neoformans, frequently occurs in leukemia, Hodgkin's disease, sarcoidosis, diabetes mellitus, tuberculosis, and long-term steroid-using patients. Recent increasing incidence of fungal infection could be due to the spread of AIDS and transplantation. We experienced one patient with lung mass in Non-Hodgkin's lymphoma after three cycles of chemotherapy, which could not be discriminated from the newly developed lymphoma mass. Cryptococcus neoformans was isolated from the lung tissue obtained by thoracoscopic biopsy. Herein we report this case with brief review of pertinent literature.

엄지손가락 과다증을 동반한 수열에서 이엽피판을 이용한 제 1 갈퀴막 공간의 재건

문재원,천지선,양정열 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Cleft hand is a rare disease that is characterized by absence of one or more digits, It was introduced by Abroise Pare in 1575. The cause of this is not identified yet. Polydactyly is defined as normally pentadactylous hand with excess digits, It was reported that the possible cause of polydactyly is increased folding of AER(apical ectodermal ridge). There are so rare cases that cleft hand is accompanied with preaxial polydactyly. We experienced a case of cleft hand with preaxial polydactyly. That case had narrowing of first web space and thumb polydactyly. Untilil now, there have been so many methods of reconstruction of web such as skin graft, z-plasty, dorsal and volar flap, etc. We reconstruct the first web with bilobed flap elevated from polydactylized thumb. As it has good results of functional and cosmetic properties, It's very useful to use accessory tissue from polydactylized finger such as our case.

지역사회획득 폐렴의 치료지침 권고안

송재훈,정기석,강문원,김도진,배현주,서지영,심태선,안중현,안철민,우준희,이남용,이동건,이미숙,이상무,이영선,이혁민,정두련,지역사회획득 폐렴 치료지침 제정위원회 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

A successful therapy of community-acquired pneumonia requires appropriate empirical antimicrobial therapy. Etiology and antimicrobial susceptibility of major pathogens of pneumonia can differ by country. Therefore, an ideal treatment guideline of community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia in immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.

MSPD법과 HPLC를 이용한 계란내 플루오로퀴놀론계 항균물질의 동시 다성분 정량분석

서계원,이재일,이채용,김은선,이정치 한국수의공중보건학회 2002 예방수의학회지 Vol.26 No.4

A multi-residue matrix solid-phase dispersion extraction and the liquid chromatographic determination of enrofloxacin, ciprofloxacin, norfloxacin and ofloxacin in eggs is described. Blank and fluoroquinolones fortified egg samples (0.5 g) containing oxalic acid 0.05 g and sodium sulfate (anhydrose) 0.5 g were blended with octadecylsilyl (C_(18), 40 m, 18% load, endcapped, 2 g) derived from silica. After homogenization, C_(18)/egg matrix was transferred to column made of 10 ml plastic syringe and filter paper, and compressed 4.0 4.5 ml volume. A column was washed with 8 ml of hexane followed by 8 ml of ethylacetate and dried under N2 gas. Fluoroquinolones were eluated with 8 ml of methanol under gravity. The eluate contained fluoroquinolones, was free from interferences when analyzed by high performance liquid chromatography with fluorescence detection. Correlation coefficients for the fluoroquinolones standard curves (linear regression analysis, n = 5) ranged from 0.99918 (± 0.0035) to 0.99985 (± 0.0002). Aveage recoveries of fortified samples were between 89.4 and 103.5%. The method comparared favorably with the classical method in terms of the sample size, analysis time and overalls costs.

하악골 골절수술에서 흡수성 골고정장치의 유용성

문재원,천지선,양정열 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Introduction: The mandible is one of frequent facial bone fracture due to anatomic configuration like the nose and zygoma. When the mandible fractures occured, displacement of segments developed by pulling of strong muscles. And so for reduction of fractured mandible, rigid fixation needs for prevention of displacement. Metal plates and screws are most appropriate device to obtain for prevention of displacement in case of mandible fracture. But metal devices are hampered by temperature sensitivity and interference with radio-graphic imaging, leading corrosion, inflammatory response, the effect of atrophy of cortical bone, the need for a subsequent operation for removal. To overcome drawbacks of metal rigid fixation devices, there had been a continuous research on the development of a bioabsorbable skeletal fixation system using polymers of polylactic and polyglycolic acid. Material and Method: One hundred sixty eight fractures of the mandible in 110 patients (84 male patients and 26 female patients) were treated by open reduction and internal fixation using bioabsorbable plates and screws (BiosorbFX^(R), Bionix Implants, Inc., Finland). The average age is 36.5 years old. Total number used absorbable devices and 972 (182 plates and 790 screws). Patients were evaluated during the follow-up period, which ranged from 1 to 30 months. Common fracture sites are para symphysis (26%), body (19%) and angle (18%) which are experienced. Intermaxillary fixation placed before operation but removed after internal fixation of absorbable devices. After 5 days from operation, temporomandibular joint movement are started. We encountered no significant intraoperative difficulties obtaining placement of the devices. Result: None of patients has been experienced any implant-related complication including fracture instability or relapse, or radiographic evidence of osteolysis except one case of delayed osteomyelitis and four cases of intraoral infections. Conclusion: Absorbable devices have many advantage, that are lower infection rates, satisfactory strength, no metallic irritation, no restrictive growth of the neurocranium in pediatric patients, only one surginal procedure. Absorbable devices have some problems, such as slow and expense. But we experienced good results using absorbable devices to mandible fracture, and these results indicate that the use of bioabsorbable implants can be considered routinely for the fixation of mandible fractures.

활성화 수피를 이용한 중금속 흡착제 개발

박창진,양재의,유경열,장용선,김원일 한국환경농학회 2004 한국환경농학회지 Vol.23 No.4

The objective of this research was to develop the adsorbent for heavy metals by activating the bark sample. Barks from pine tree with diameters of 2~4 mm were activated in the muffle furnace under a high relative humidity condition at temperatures of 600~900℃. The removal efficiency of the activated bark (ACTBARK) for Cu and Cd was temperature dependent showing the order of 900℃ > 800℃ > 700℃ > 600℃. The critical temperature was considered to be 900℃ to become an efficient adsorbent for Cu and Cd. The bark samples activated at temperatures lower than 700℃ showed a less removal efficiency than the crude bark The ACTBARK activated at 900℃ removed more Cu and Cd from solution than the commercial activated carbon and charcoal. The ACTBARK (activated at 900℃) adsorbed all of the Cu and Cd in solution with concentrations less than 150 mg/L. The selectivity of the ACTBARK was in the order of Cu>Zn>Ni>Pb>Fe>Cd>Mn.

환기정도에 따른 수술실용 신발 종류가 수술실 오염에 미치는 영향 : How to Choose Suitable Shoes?

남경동,정혜선,박영신,원진희,주미자,성화신,이지혜,이병희,조경숙,배재춘 한국의료QA학회 2000 한국의료질향상학회지 Vol.7 No.1

Background : Various types of protective footwear have been used to minimize bacterial contamination in operating rooms. In recent years, debate has arisen concerning the need for use of such protective footwear. This study was designed to provide useful data about choosing shoes most suitable for the surgical environment. Methods : Between November, 1999 and January, 2000, we performed this experimental study by comparing effect of three types of shoes (i.e., disposable shoescover, operating room-restricted shoes, and ordinary shoes) on bacterial contamination of operating rooms equipped with two different ventilation systems (i.e., high air-change, low air-change) respectively. Data were collected during two-hour sham operations in which subjects and their activities were strictly standardized. Bacterial flora were sampled from the study area floor and air colony-counts were measured. Results : In experiments involving high air-change ventilation system, there was a significant difference of floor contamination between three types of shoes, but no difference of air contamination. Under low air-change system, there was a significant difference of both floor and air contamination between three types of shoes. Conclusion : The results show that protective footwear would be unnecessary in the operating room with high air-change ventilation system, but it is important to choose suitable shoes carefully under low air-change system. Therefore, the use of outdoor shoes can be considered under high air-change system, but it would seem sensible to apply their first use in less bloody operations at the day surgery center or out-patient department to prevent transfer of body fluid into the outside environment.

다시마 추출액의 점성과 향미 개선을 위한 볶음처리 조건

김나미,박명한,전병선,박채규,양재원 한국식품영양학회 1999 韓國食品營養學會誌 Vol.12 No.5

다시마 추출액의 향미와 물성을 개선하기 위하여 볶음처리에 의한 품질변화를 조사하고 최적 볶음조건을 선정하였다. 추출액의 상징액율과 고형분수율 및 조단백질 수율은 볶음온도와 시간이 증가할수록 높아졌다. Algin의 함량은 볶음온도 175℃에서 가장 높았고,회분의 함량은 볶음온도가 증가할수록 많아졌다. 추출액의 점도는 볶음온도와 시간이 증가함에 따라 낮아졌으며 175℃, 10분 볶음처리할 때 점도 감소가 뚜렷하였다. 추출액 의 pH는 볶음온도 150℃까지는 다소 낮아지는 경향이었으며 175℃ 이상의 볶음처리 시 볶음온도와 시간이 증가함에 따라 다소 높아졌다. 볶음온도와 시간이 증가함에 따라 명도(L값)은 감소하였고, 적색도(a값)과 황색도(b값)은 증가하다가 a값은 200℃ 15분처리, b값은 175℃, 30분 처리 이후에서 각각 감소되기 시작하였다. 다시마 추출액의 냄새는 175℃에서 볶음처리하였을 때 고소한 냄새가 크게 증가하고 메스꺼운 냄새가 뚜렷하게 감소되어 전체적인 기호도가 가장 높았다. 구수한 맛과 해조맛은 175℃에서 고소한 맛이 증가되면서 메스꺼운 맛이 뚜렷하게 감소되었고 200℃ 이상에서는 탄맛이 많아져 전체적인 맛의 기호도는 175℃에서 가장 좋은 것으로 평가되었다. 이상의 결과를 종 합하여 볼 때 다시마를 175℃에서 10분간 볶음처리하는 것이 다시마 추출액에서 좋지 않은 향미를 개선하고 점성을 감소시키기에 적합하였다. Roasting conditions for improvement of viscosity and sensory properties of sea tangle extracts were investigated. The supernatant %, solid yield and crude protein yield were increased by increasing of roasting temperature and times. The highest contents of algin was obtained in roasting temperature of 175℃, ash contents were increased by roasting temperature increasing. Viscosities of sea tangle extract were significantly decreased by increasing of roasting temperature and time upto 175℃ and 10 mins more than further roasting conditions. The pH of sea tangle extracts slightly decreased from 5.94 to 5.83 in the roasting of 150℃, however, at temperature more than 175℃, its pH was increased by increasing of temperature and time. According to increase of roasting temperature and time, Lightness (L value) were significantly decreased and redness (a value) and yellowness (b value) reached the highest value in the roasting of 200℃, 15 min. or 175℃, 30 min. and after that, its value were decreased. The odor characteristics showed that sea tangle extract prepared by roasting of 175℃, 10 min. was significantly low in intensity of nauseous odor and high in intensity of roasted odor and acceptability. The taste characteristics showed that sea tangle extract prepared by roasting of 175℃, 10mins was slightly reduced in intensity of savory and seaweed taste but significantly low in intensity of nauseous taste and high in intensity of roasted taste and acceptability. Overall data suggested 175℃, 10 min. was the most effective roasting conditions for improvement of viscosity and sensory properties of sea tangle extract.