부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

尙州地域 5世紀 古墳의 樣相과 地域政治體의 動向

洪志潤 嶺南考古學會 2003 嶺南考古學 Vol.- No.32

5세기대는 신라와 백제, 고구려가 백두대간을 경계로 치열한 각축을 전개하던 시기이다. 신라가 상주를 비롯한 영남서북부지역의 요충지를 점령하게 됨으로써 육상교통로를 확보하고 삼국통일의 전기를 마련하게 되었다. 이 글은 상주지역 5세기 고분의 전개 양상을 통해 영남 서북부지역 정치체의 동향을 확인하고자 하는 목적으로 작성하였다. 신라세력이 상주지역에 진출한 것은 4세기 중엽경이며, 5세기대에 들어오면서 상주분지를 확보하고 금강수계권으로 진출을 모색하였다. 상주지역의 고분은 소지역 단위로 그 문화상에서 뚜렷한 차이를 나타내고 있다. 즉 함창분지의 신흥리고분에서는 장방형의 석곽묘와 고배를 배제한 토광묘 이래의 유물부장이 지속되지만, 상주분지 고분군에서는 세장방형의 횡구식석곽묘와 고배를 중심으로 하는 영남 북부지역 양식토기가 부장된다. 이는 상주지역 고분이 토광묘 이후 서로 다르게 전개된 결과이며, 신라 중앙으로부터 지배방식의 차이에서 기인한 결과로 파악하였다. 한편, 상주분지의 고분과 청원 미천리지역 고분의 유사성에 근거하여 신라의 진출에 따른 문화의 확산으로 이해하였고, 5세기 후반에는 신라세력이 금강수계권으로 진출하였음을 살펴보았다. 5th century is the period when Shinla. Paekje and Goguryo were harshly competing and fighting around the border of Paekdoo. As taking essential territories from Sang-ju to western and northern regions in Youngnam, Shinla took charge of the land traffic route, laying stepping shtones for unification of the three countries. It was in the middle of the 4th century when Shinla forces made their way to Sang-ju, and as the 5th century came., it took possession of Sang-ju Basin as well as finding a way to the Kumkang water system. Sang-gu region shows a distinct line on cultures of tombs between Hamchang and Sang-ju Basin. That is, in Shinheungri tomb in Hamchang Basin artifacts since Pit-tomb have been found except for rectangular rectangular stone lined tombs and Gobe, while tombs in Sang-ju Basin have modes earthenware of northern Youngnam region centered on Gobe and horizontal entrance stone lined tomb of longer rectangular. It is believed that the difference between tomb-building-method and artifacts excavated from them resulted from the governing discrepancies of Shinla's government. Sungdongri, Byungsungdong, and O'daedong tombs in Sang-ju Basin empoly horizontal entrance stone lined tomb of longer rectangular as a primary tomb, develops the modes earthenware in northem Youngnam, and produces the same line of culture as Ahndongr·Yaecheon·Uisung·and Sunsan, However, the 5th century's earthenware in the Shingheungri tombs in Hamchang Basin shows a strong characteristic of small regions in west and north of Youngnam. It demonstrates that political system in Hamchang Basin maintained long-lasting power of its own. Into the late 5th century that began to construct big scale tombs along the ridgeline of Shinheungri tombs, earthenware of the regional pattern and the sorts based on Gobe, pivoted on big scale tombs, began to be buried, and each of these shows very much of Gyungjoo. From this time on. It seems like that Hangchang Basin was taken under the indirect control of Shinla, setting out into the center of west and north of Youngnam. In the meantime, it has been understood as the distribution of culture resulted from Shinla's advancement, based on similarities of tombs in Sang-ju and the tombs in Meechunri, Chungwon. In the late 5th century. How Shinla went all the way to Kumkang water system was examined.

장중첩증을 동반한 맹장 지방종 1예

홍의실,나병규,김민옥,유일영,채지영,채희복,윤세진,이상전,송형근,박길선,정현용 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

대장 지방종은 주로 우측 결장에 호발하고 특히 회맹판 부위와 맹장 부위에 호발한다. 또한 50~60대에 빈도가 높고 증상이 있는 환자에서 장중첩증이 높게는 40~50%에서 보고되고 있어 성인 장중첩증의 원인으로 중요한 비중을 차지한다. 특히 성인 장중첩증 및 장폐쇄의 중요 원인인 악성 종양과 임상 양상이 유사하여 감별진단이 중요하다. 저자들은 반복적인 복통을 주소로 내원한 환자에서 맹장의 4×5㎝의 점막하 지방종이 말단 회장부위와 반복적인 장중첩중이 발생했던 1례를 부분 절제술로 치료하여 양호한 임상 경과를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Lipomas are one of the most common benign nonepithelial tumors of the colon which are often detected incidentally by radiologic investigation or on operation. These tumors are usually without specific symptoms. Colonic lipomas occur most often in the right colon, particularly in the ileocecal valve and the cecum. Most patients are asymptomatic. but tumors larger than 2 cm tend to produce a change in bowel habit. abdominal pain. rectorrhagia and complications including luminal obstruction or intestinal intussusception. Diagnosis can be made by colonoscopy abdominal CT. MRI, or barium enema. We report a case of lipoma of the cecum that originated in the submucosa and presented as a intussusception in a 50-year-old woman with a brief review of the literature.

상지 단순반복작업 근로자의 수근관 증후군 유병률에 관한 조사

손지언,장태원,김윤규,홍영습,정갑열,김동일,이강진,하남진,김상범,김준연 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 본 연구는 수근관 증후군의 발생위험이 높은 작업형태에 종사하는 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장과 목재소 근로자에서 근전도검사를 이용하여 수근관 증후군의 유병률을 조사하고자 하였다. 방법 : 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장 근로자 69명과 목재소 근로자 17명을 실험군으로, 관리직, 경리, 경비등 상지의 단순반복작업이 없는 근로자 28명을 대조군으로 선정하여, 작업적 및 병력조사, 이학적 검사와 근전도검사를 통해 수근관 증후군의 유병률을 조사하였다. 결과 : 수근관 증후군의 유병률은 육류 및 어류 가공 사업장과 목재소에서 각각 26.09 % (18명)와 29.41 %(5명)로 조사되었으며, 육류 및 어류가공사업장과 목재소 근로자를 '7년 이상과 미만의 작업기간'으로 층화하여 비교한 결과 '상지부위의 통증 호소 유무', 'Visual Analogue Scale(VAS: 총 10점) 4점 이상 여부', 'Tinel teat 양성 유무', 'Phalen test 양성 유무'는 모두 단기 작업근로자군에서 양성의 빈도가 증가되었고 '수근관 증후군 유무'는 장기작업근로자군에서 양성의 빈도가 증가되었다. 결론 : 육류 및 어류 가공 사업장과 목재소의 수근관 증후군 유병률은 각각 26.09 %와 29.41 %로 육류 및 어류 가공 사업장과 목재소는 1996년 OSHA가 지정한 바와 같이 위험한 작업요인이 있는 작업장으로 분류하여 관리되어야 할 것으로 생각된다. Objectives : This study was carried out to survey on the prevalence of Carpal Tunnel Syndrome(CTS) in high risk jobs(meat and fish processing plant and wood plant), by application of Nerve Conduction Study(NCS), a confirmatory diagnostic method. Methods : Experimental group was 69 workers sampled from meat and fish processing plants and 17 workers sampled from wood plants, who were simple, repetitive workers using upper extremities and control group was 28 workers sampled from managers, secretaries and keepers. All employees were examined through work history, physical examination and NCS. Results : 18 workers(26.09%) in meat and fish processing plants, and 5 workers(29.41%) in wood plants had compatible findings to NIOSH diagnostic criteria for CTS. The experimental group had more symptoms (complaint of upper extremities, Visual Analogue Scale ≥4(VAS: total 10 point)), signs(Tinel and Phalen test) and prevalence of CTS than control group(p<0.05). The prevalence of symptoms and signs were higher in short term workers(<7 years), but the prevalence of CTS was higher in long term workers(≥7 years). Conclusions : The prevalence of CTS in meat and fish processing plant and wood plant were 26.09% and 29.41% respectively. Authors propose that meat and fish processing and wood plants should be managed as a risk job category which were designated by OSHA in 1996

골수염으로 발현된 재발성 콕시디오이데스 진균증 1예

백지현,박은영,정윤숙,홍재원,채윤태,진성준,최희경,신소연,한상훈,진범식,김창오,최준용,송영구,조남훈,김준명 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Coccidioidomycosis is a fungal infection that results from inhaling the airborne arthroconidia of the Coccidioides species. It is an endemic disease in the southwest part of North America and rarely diagnosed in Korea. As tourism to endemic areas and the number of immunocompromised patients have been increasing, the incidence of this infection has increased in non-endemic areas. Treatment is usually successful with antifungal agents; however, recurrence is common. It is difficult to decide when to discontinue the antifungal treatment especially in non-endemic areas where doctors are not familiar with the disease. We report a case of recurrent coccidioidomycosis manifesting as osteomyelitis after the treatment of the patient for disseminated coccidioidal infection. The complement fixation test was a useful tool for the assessment of patient response and to evaluate suspected recurrence.

심인성 색전 요인이 없는 뇌경색 환자에서 경식도 심초음파와 Acoustic Quantification을 이용한 대동맥 탄성의 평가

이종민,윤호중,임효영,박지원,김휘열,전희경,문건웅,정욱성,채장성,김재형,최규보,홍순조 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

석면관련 폐질환의 진단에 있어서 흉부고해상도전산화단층촬영검사(HRCT)의 유용성

이현재,손지언,,홍영습,,이영일,예병진,유창훈,정갑열,김상훈,임형준,장은철,김정만,김준연 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 석면에 노출된 근로자에서 석면관련 폐질환의 양상을 분석하고 진단에 있어 HRCT의 유용성을 연구하여 석면에 대한 의학적 감시프로그램의 개발에 기여하고자 하였다. 방법: 석면에 직접 노출되는 작업자 68명과 간접 노출되는 작업자 94명 등 총 162명에 대해 OSHA 석면 표준, 의학적 감시 프로그램에 따라 단순 흉부방사선검사, 폐활량검사 및 우리나라 실정에 맞게 일부 수정한 의학적 설문지를 통해 면접조사의 방식으로 환자에 관한 정보를 수집하였으며, 자료의 신뢰성을 확보하기 위하여 면접조사는 1달 이상의 기간을 두고 2차례에 걸쳐 실시된 후 확인, 수정하였다. 또한, 석면관련 폐질환을 확진하기 위하여 HRCT를 추가적으로 실시하였다. 결과: HRCT결과 석면관련 폐질환의 유병율은 162명의 근로자중 17명으로 10.5%였는데, 직접 노출군에서 10명 (14.7%), 간접 노출군에서 7명 (7.4%)이었다. HRCT와 비교할 때 단순 흉부방사선검사의 민감도와 특이도는 각각 70.6%와 98.6%이었고, 양성 예측도와 음성 예측도는 각각 85.7%와 96.6%으로, HRCT는 단순흉부방사선검사에 비해 민감도가 높아 초기 석면관련 폐질환을 진단하는데 효과적이었다. 석면관련 폐질환의 진단에 있어 HRCT와 폐활량검사 사이에 유의한 관련성이 관찰되었다. HRCT 결과 석면관련 폐질환의 유무와 의학적 설문조사 결과의 빈도분석을 실시한 결과, 유의한 변수는 작업기간, 흡연량, 호흡기질환의 과거력, 기침, 호흡곤란이었다. 결론: HRCT는 석면관련 폐질환의 진단에 있어 단순 흉부방사선검사와 비교하여 민감도가 높아 초기 진단에 유용하므로 단순 흉부방사선선검사 결과 석면관련 폐질환소견을 보일 때뿐만 아니라, 정상소견을 보이더라도 폐활량 검사결과와 근무력, 흡연력, 호흡기질환의 과거력, 기침, 호흡곤란 등의 호흡기 증상을 참고하여 HRCT검사를 고려해야 한다. 또한, 본 연구에서 관련성이 없었던 요인들에 대해서도 향후 연관성을 규명하는 광범위한 전향적 연구가 필요하다. Objectives: This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease. Methods: The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveilance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveilance program consists of simple chest x-ray, spirometry and medical questionnarie. Results: Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT, HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea. Conclusions: In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.

2.9% 과산화수소를 함유한 부착형 미백제의 임상적 효능과 안정성에 관한 연구

박은숙,성소래,홍성태,김지은,이소영,황수연,이신재,진보형,손호현,조병훈 大韓齒科保存學會 2006 Restorative Dentistry & Endodontics Vol.31 No.4

2.9%의 과산화수소를 함유한 시험용 부착형 미백제(Medison dental whitening strip, Samsung medical Co.,Anyang,Korea)를 실험군 피험자 23명, 시험용 미백제에서 과산화수소를 제외한 동일한 제재를 대조약으로 대조군 피험자 24명에게 매일 1시간 30분씩, 2주간 적용하여 임상적 효능과 안전성을 평가하였다. 미백 효과는 Shade Vision, Chroma Mete 및 Vitapan classical shade guide를 이용하여 색변화를 측정하여 다음과 같은 결론을 얻었다. 1. 실험군에서의 전체 치아의 색변화량(ΔE^(*))은 세 가지 측정법에서 모두 대조군에 비해 통계적으로 유의한 차이를 보였고 (p < 0.05). 쉽게 인지할 수 있는 정도였다. 2. 색변화는 색좌표 상에서 명도의 증가와 녹색조 및 청색조로의 변화에 의해 얻어졌다. 3. 치아별로는 어두운 견치의 색변화량이 가장 컸고, 측절치, 중절치 순으로 감소하였다. 4. 47명의 피험자 중 5명이 경도의 과민증을 경험하였으나 곧 완화되었다, 치은염증지수와 전기치수검사 결과 시험 전후에 차이가 없어 안전성을 확인하였다. This study evaluated the effectiveness and safety of an experimental bleaching strip (Medison dental whitening strip, Samsung medical Co., Anyang, Korea) containing 2.9% hydrogen peroxide. Twenty-three volunteers used the bleaching strips for one and a half hour daily for 2 weeks. As control group, the same strips in which hydrogen peroxide was not included were used by 24 volunteers with the same protocol. The shade chang (ΔE^(*), color differnce) of twelve anterior teeth was measured using Shade Vision (X-Rite Inc., S. W. Grandville, MI, USA), Chroma Meter (Minota Co., Ltd. Osaka, Japan) and Vitapan classical shade guide (Vita Zahnfabrik, Germany). The shade change of overall teeth in the experimental group was significantly greater than that in the control group (p < 0.05) and was easily perceivable. The change resulted from the increase of lightness (CIE L^(*) value) and the decrease of redness (CIE a^(*) value) and yellowness (CIE b^(*) value). The shade change of individual tooth was greatest in canine, can smallest in central incisor. The safety of the bleaching strip was also confirmed. 〔J Kor Acad Cons Dent 31(4):269-281, 2006〕

경식도 심초음파도의 Direct Planimetry를 이용하여 측정한 대동맥판 면적의 심박출량 및 좌심실 구출율의 변화에 따른 정확도

진승원,김종진,김희열,박지원,전두수,윤호중,박준철,노태호,채장성,김재형,홍순조,최규보 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

Effects of a mouthwash containing potassium nitrate, sodium fluoride, and cetylpyridinium chloride on dentin hypersensitivity: a randomized, double-blind, placebo-controlled study

Hong, Ji-Youn,Lim, Hyun-Chang,Herr, Yeek Korean Academy of Periodontology 2016 Journal of Periodontal & Implant Science Vol.46 No.1

Purpose: We evaluated the efficacy of a mouthwash containing potassium nitrate ($KNO_3$) as its main component, along with sodium fluoride (NaF) and cetylpyridinium chloride (CPC). The primary endpoint was the relief of dentin hypersensitivity (DH) against the cold stimuli. The effects on other DH tests and periodontal inflammation were also evaluated. Methods: We used a single-center, double-blind, placebo-controlled, randomized design. A total of 82 patients with DH (40 in the test group, 42 placebo controls) were analyzed using visual analog scales (VASs) for a cold test, a tactile test, a compressive air test, and self-reported pain during daily activities, as well as clinical parameters including plaque index, gingival index, modified sulcular bleeding index (mSBI), gingival recession, and probing depth, which were collected at baseline and after four and six weeks of mouthwash use. Results: VAS scores for cold sensations, tactile sensations, the compressive air test, and self-reported pain significantly decreased from baseline during the six weeks in both groups (P<0.01), and no significant differences between the groups were found. In male patients (10 in the test group and 7 in the control group), both groups showed significant reductions in VAS scores for the cold test over the six weeks, and greater reductions were found in the test group than in the control group between four and six weeks (P=0.01) and between baseline and six weeks (P<0.01). In addition, the mSBI in the test group significantly decreased from baseline during the six weeks (P<0.01), and the changes at four and six weeks from baseline were significantly greater in the test group compared to the control group (P=0.03 and P=0.02, respectively). Conclusions: A mouthwash containing a mixture of $KNO_3$, NaF, and CPC reduced DH and gingival inflammation, however, the efficacy was comparable to the control group.