산업보건관리자를 위한 소음성 난청 예방지침서의 개발

이원철,유경혜,장성실,이세훈,구정완,김현욱,노영만,이경재,김형아 가톨릭 대학 산업의학 쎈타 산업의학연구소 1996 韓國의 産業醫學 Vol.35 No.1

Occupational hearing loss became the leading occupational disease by constioution 56% of all work-related diseases in Korea. However, the prevalance rates showed wide variations among the specific medical examination providers and were very low(0.8-1.4%) compared with those 8.4% in Japan. The sources of these variations was regarded in the preview study as 1) Employee audometric estings were primarily conducted by nurses and nurse-aids who had no formal training for audiometry; 2) althought audiometric testing equipment used by the spedific medical examination providers, it should be periodically calibrated, a significant number of them were not properly calibrated : 3) Initial audiometric testings were conducted at any available spaces in workplace or at the testing room without considering bachground noise level. One of solutions that can be done for sloving surrent noise related problems is to provide a noise related manual for the occupational health managers including doctors, nurses and hyginests. This study was done to provide such a manual. The main core of the manual was hearing conservation program. And the contents of the manual was the same as the main frame of hearing conservation program such as noise survey, provided of the diagram showing the core contents of each factor of the hearing conservation program. Hopefully, this manual will be the references of the standardized performances of the specific medical examination providers.

우리나라 화상 환자의 발생 및 치료현황

이원재,배남석,이혜경,나동균 대한화상학회 2003 대한화상학회지 Vol.6 No.2

췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

정신분열병환자의 뇌량에 대한 신경병리적 고찰 : 확산텐서영상(Diffusion Tensor Image)기법의 적용

이경진,신용욱,하태현,이종민,김인영,김선일,문원진,정은철,박해정,오정은,박지영,강경훈,권기원,권준수 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.4

Objectives : Diffusion tensor imaging (DTI) is a new technique that can be used to visualize and measure the diffusion of water in brain tissue. It is particularly useful for evaluating white matter abnormalities. In this paper, we investigated the neuropathology of the corpus callosum in patients with schizophrenia through the new methods, diffusion tensor imaging. Methods : Diffuse tensor imaging was performed in 19 schizophrenic patients and 26 healthy controls. One complementary measure, fractional anisotropy (FA), which is considered to be sensitive indices of axonal integrity, was obtained from regions of interest in the five areas of the corpus callosum. Neuropsychological measurement also underwent for measurement of frontal lobe function in two groups. Results : There were no significant differences of FA in the DTI measures for either the schizophrenic patients compared with controls. FA was significantly decreased in women compared with men. Neuropsychological measurements such as Wisconsin card sorting test were correlated with FA of patients with schizophrenia. Conclusion : FA measures revealed no differences between schizophrenia and controls. The findings suggest that the structural integrity of white matter in patient with schizophrenia was not disrupted. The results are discussed in relation to previous studies reporting positive and negative findings. It is concluded that further studies using DTI in larger samples, improved and standardized methods of data acquisition and analysis are needed.

일부 사업장 건강증진사업 실태조사 및 요인분석

이경화,이원철,이강숙,홍현숙,송연이 가톨릭대학교 산업의학센터 2000 韓國의 産業醫學 Vol.39 No.2

For the purpose of access the health promotion activities in 138 worksite which had more than 50 workers, we surveyed the questionnaire on May and September 1998. The results of survey were as follows: 1.59 companies(45.1%) were conducting the health promotion activities. Most of them were manufacturing and located Kyung-sang province and had nurses as a health manager. 2.Companies operating the health promotion activities had significant higher degree of satisfaction and usage of welfare facilities than non-operating companies. 3.The level of knowledge for regulations, professional skills, and performance related health promotion was low in all companies. Top manager's interest and will for investment to health promotion was significant lower in non-operating companies. 4.The reasons why the health promotion program was not operated, were low budget, top manager's indifference, lack of information, work overloading, no human resource, an insufficient governmental support in order. 5.The most necessary items for program were education and promotion, budget, and governmental support. Needed personnel were nurses, fitness trainner, and necessary program were health management, exercise, nutrition, and stress counselling. For comparing before and after IMF, amount of budget was decreased. In conclusion, this study suggested that major barriers to conduct health promotion activities were lack of budget, lower interest of top managers, and insufficient professional information, therefore detail health promotion program would be developed and supported by government.

東醫壽世保元 臟腑論에 대한 考察

李敬愛,朴性植,李源哲 동국대학교 한의학연구소 1995 東國韓醫學硏究所論文集 Vol.4 No.-

The purpose of this study is to understand a term of 'Jangbu theory 臟腑論' in 'Dong-Eui-Su-Se-Bo-Won 東醫壽世保元' . The conclusion would be summerized as follows. 1.'Jangbu theory 臟腑論' of 'Sa-Sang medicine 四象醫學' is based on 'Sa-Sang structure 四象構造' . 2.'Mind 心' of 'Sa-Sang medicine 四象醫學' is recognised as the Lord of body. 3.'four-Jang 四臟' and 'four-Bu 四腑' constitute 'Sa-Sang structure 四象構造' which is based on the deviation of 'vital energy 氣', and 'four-Jang 四贓' plays a loading role. 4.'Sacho 四焦' explaine the whole function of human body including one's heart's desire, physical constitution and the visceral physiology. 5.'ear-eye-nose-mouth 耳 目 鼻 口' is connected with 'the profound secrets of nature 天機' and also has a close relation with creation of 'spirit-vital energy-blood-essence 神氣血精' and spiritual function. 6.'SaHae theory 四海論' of 'Dong Mu 東武' is philosophical concept set on the basis of 'nature 天性' and 'life 入命'. 7.'spirit-vital energy-blood-essence 神氣血精' doesn't have the relation of mutual transformation. It's creation and consumption lies on 'the power of ear-eye-nose-mouth 耳目鼻口之力'. 8.'Sa-Sang medicine 四象醫學' expands its theory centering on the deviation of 'vital energry 氣'and the transversaa circulation of 'SaHae 四海'. According to the above result, 'Jangbu theory 臟腑論' in 'Dong-Hui-Su-Se-Bo-Won 東醫壽世保元' should be understood on the basis of' Sacho 四焦' and 'SaHae 四海' according to 'Sa-Sang structure 四象構造' , accompanying philosophical thinking focused on human and society, the centural concept of 'Jangbu theory 臟腑論' could be said as' Mind 心' to be the Lord of body.

신경독성 물질에 폭로되지 않은 건강한 남자의 신경행동학적 검사 수행능력

이세훈,김형아,이원철,장성실,이경재,박정일,정치경 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.1

Five items among neurobehavioral core test battery of World Health Organization, including Santa Ana dexterity, pursuit aiming, digit symbol, simple reaction time, and Benton visual retention, were administered to the workers occupationally non-exposed to neurotoxic agents by operational guide for the WHO neurobehavioral core test battery. Subjects were volunteers from the industrial workers(117) and clerks(40). Detailed occupational history such as exposed agents including noise or vibration, educational level, residence, smoking and drinking habit were recorded. Most of the neurobehavioral tests were correlated with age and educational level. Smoking was correlated with pursuit aiming and digit symbol. Vibration affected pursuit aiming. Job type(industrial workers vs. clerks) and noise exposure did not affected among tested items. Multiple regression analysis was done for establishing predict equation to estimate normal ranges of the tests for male workers. Age was shown to be main independent variable affected for all tests except wrong dot of pursuit aiming. Educational level was also shown to affected most of the tests except Santa ana dexterity and wrong dot of pursuit aiming. Alcohol consumption affected Santa Ana dexterity, non-preferred hand, and smoking affected only wrong dot of pursuit aiming after multiple regression analysis.

P247 : A study on use of complementary and alternative medicine for acne

( Sook Kyung Lee ),( Taek Geun Lee ),( Hyun Hwang Bo ),( Tae Gwang Kwon ),( Se Won Jung ),( Young Seok Lee ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Background: Complementary and alternative medicine (CAM) is any practice that has healing effects, but is not based on evidence demonstrated by scientific method. Recently, CAM has been used in various diseases including acne. However, there have been no studies on CAM for acne in Korea. Objectives: The purpose of this study was to analyze the use of CAM in acne patients. Methods: A total of 159 patients with acne were enrolled on the study, and filled out a questionnaire about use of CAM. Results: Overall 87.4% (139/159) of the patients reported the previous or current use of at least one more type of CAM. Cosmetics for acne (100, 22.9%) was most frequently used, followed by diet therapy (81, 18.5%), spa and bath therapies (77, 17.6%), health food supplement (67, 15.3%), skin care shop (64, 14.6%), oriental medicine (38, 8.7%), and aromatherapy (9, 2.1%). The most common reason for using CAM was ``wish to try everything`` (28.6%), and the most common source of information was internet (40.5%). The therapeutic effect of CAM was best with diet therapy (32.1%). The most common side effect of CAM was aggravation of symptoms. The most common monthly cost for CAM was between 50,000 and 100,000 won/person. Conclusion: As our results, we can predict that the use of various types of CAM for acne will become more common. Therefore, dermatologists need to study about benefits and adverse effects of CAM for acne.

청소년 일탈행동 예방을 위한 사회정서학습의 특징과 교육적 함의

손경원 ( Kyung Won Son ),이인재 ( In Jae Lee ) 한국윤리교육학회 2009 윤리교육연구 Vol.0 No.19

청소년 문제가 날로 심각한 사회문제가 되고 있다. 본 연구는 청소년 문제의 효과적인 해결 방안을 모색하기 위해 사회정서학습(SEL)의 이론적 배경 및 실제 사례를 분석하여, 한국의 예방교육의 개선방향을 모색하였다. 사회정서학습은 사회 정서적 유능성을 길러, 단기적으로는 청소년이 당면하는 문제들을 발달적으로 적합하게 해결하도록, 장기적으로 책임있고 건전한 시민으로 성장하도록 기여하는 데 있다. 따라서 자신과 타인의 감정 인식과 조절, 친사회적 문제해결 기술을 기르는 데 중점을 둔다. 이러한 기술들은 문제 행동을 유발할 수 있는 개인의 기질적 위험요인이나 환경의 위험요인이 미치는 부정적 효과를 줄이거나 상쇄하는 보호하는 요인으로서 작용한다. 기술의 학습에서는 기술에 대한 이해와 지식만큼이나 반복적 실천이 중요하기 때문에, 교육에 적합한 환경조성이 중요하다. 그러므로 사회정서학습은 문제행동을 보이는 학생을 선별한 프로그램 교육보다 모든 학생들을 대상으로 한 예방 교육을 강조한다. 최근 청소년 문제를 해결하기 위해, 문제 행동을 보이는 청소년에게 문제해결기술 함양을 목표하는 사후적 상담 프로그램이 실시되고 있다. 이러한 조치가 보다 효과적이려면, 모든 학생들을 대상으로 한 예방교육이 동시에 이루어져야 하며, 보다 장기적으로 실시되어야 하며, 정서적 유능성과 관련된 정서 인식 및 조절에 대한 기술의 교육이 보완되어야 한다. 이를 위해 본 연구에서는 사회정서학습을 도덕과 교육의 내용요소로 통합하는 일이 하나의 대안이며, 이는 도덕과 교육의 효과성뿐 아니라 청소년 문제 해법의 효과성을 높일 것이라고 주장하였다. It has been more and more increasing worry about how to solve youth problems like violence, bullying drug abuse, drop out. This study is investigate to Social and Emotional Learning and suggest it`s implication on the korean education in order to effectiveness of the treatment and prevention of adolescents problems. SEL helps young people to be grown up with healthy and as responsible citizen. This is the reason why SEL tries to give importance to "understanding and control self and other`s emotion" as well as responsible decision making skill. Social and emotion skills works resilience elements in spite of risk element adolescents might meet. SEL tries to build good circumstance which students exercise their learned skills in the class whole day, and then SEL had better every student targeted program than indicated prevention program. In other hand, it has been implementing indicated prevention program in the Korea. That is enough efficient to help youth prevention because these program is too short, not for every student and doesn`t include emotion intelligence. This study suggests that SEL has to integrate in the moral education. That policy will be made win-win situation in prevention education as well as moral education on the side of education efficiency