내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

여우 빙의(憑依) 1례

이병욱,김무진,이수일 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.5

The authors experienced a 50 year-old female patient who manifested so-called fox possession syndrome of 3 days duration, showing fox-like behavior, idea of being possessed and auditory hallucination. She had a recent episode of transient hysteroid dream state with automatic behavior. She was a highly suggestible shamanistic believer, and recently suffering from emotieonal crisis accompanied by frustration, helplessness, loneliness and hostility. Her symptoms were spontaneously subsided without any specific therapeutic intervention.

톨루엔 디이소시아네이트 폭로 근로자들의 작업방법에 따른 대사물질의 비교 및 면역능에 관한 연구

이수일,조병만,황인경,이철호,박정래 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.3

Following recent advanced industrialization, the amount of polyurethane to use as thermal insulating materials, upholstery, mattresses and packing materials in automotive and furniture industry is increasing world-widely, and the number of polyurethane-producing worker will be increased. Because the numerous organic solvents are used in polyurethane-producing factory, the workers in this work site is exposed to many organic solvents. Of the organic solvents, Toluene Diisocyanate(TDI) has many hazardous effects to human. The effects of TDI on human are the irritation to respiratory mucosa and gastrointestinal symptoms. Conjunctival irritation, dermal inflammation (redness, pain, vesicular formation) and gastrointestinal symptom(nausea, vomiting. abdominal pain) are reported just after short-term exposure of TDI. TDI is known to give rise to bronchial asthma, as the immune disorder. And because of strongly volatile characteristics of TDI, it is suggested as a more injurious material to human health, especially human immune system, than other organic solvents. Bronchial asthma inducing mechanism of TDI is not clearly known, but on the analogy of TDI induced symptoms and recent studies, early-onset asthma is type I hypersensitivity reaction mediated by immunoglobulin E(IgE), and late-onset asthma is maybe type III hypersensitivity reaction by circulating IgG. And we know that the complicated human immune function is likely to move in such that mechanisms, there are not studies on immune indices evaluating the bronchial asthma-related immune function. The evaluation of change patterns of humoral immunity including IgE and IgG and cellular immunity including T-helper cell. T-suppressor cell and T-cytotoxic cell will be helpful to evaluate exposure degrees and prognosis in TDI exposed workers. Because TDA(toluene diamine) as a biological exposure index of TDI becomes the focus of interest, we know that a study on the correlation between urinary TDA and air TDI and immunological indices will make a contribution to biological effect monitoring indicies. We examined human immunity indicators such as WBC, %Lymph (percentile of Lymphocyte in WBC), %T-cell(percentile of T-lymphocyte in total lymphocyte). CD4, CD8, C3, C4, IgA, IgG, IgM, IgE in peripheral blood to evaluate the health hazard of the TDI-exposed workers. And we examined TDA to evaluate correlation between exposure and effect. Total 90 subjects was selected, 45 workers who worked in the polyurethane-producing factories as an exposed group, and 45 cases who were office workers(10 cases), other blue collors(27 cases), and medical college students(8 cases) as a control group. And the results were as follows; 1. The logarithm of IgE-Log10(IgE)±SD-in peripheral blood of a exposed group was significantly higher than a control group, 2.22 ±0.62 in case group compared with 1.98±0.53 in control group. (p<0.05) 2. IgA and IgM in the polyurethane-producing workers were 261.02±83.12㎎/㎗, 151.97 ±59.64 ㎎/㎗, respectively, and 292.77±100.45, 179.17±100.78 in control group. IgA and IgM was slightly lower in polyurethane-producing group than control.(p>0.05) 3. WBC, %Lymph. %T-cell, C3, C4, CD4, CD8, CD4/CD8 ratio and IgG in case group were 6.391.1 ea/㎖, 37.53 %, 59.54 %, 76.68 ㎎/㎗, 0.76×10(9) ea/L, 0.63×10(9) ea/L, 1.39, and 1606.29 ㎎/㎗, respectively, and 6,974.7 ea/㎖, 35.12 %, 59.64 %, 71.95 ㎎/㎗, 33.94 ㎎/㎗, 0.80×10(9) ea/L, 0.61×10(9) ea/L, 1.39, and 1581.51 ㎎/㎗ in control group. There was no statistical significance between two groups.(p>0.05) 4. In the comparison of each other companies, average of individual urinary TDA in polyurethane paint manufacturing companies is higher than that of polyurethane sponge foaming companies. And, the concentration of 2.6-TDA which is a metabolite of well-vaporized 2.6-TDI is higher than that of 2.4-TDA in the polyurethane sponge foaming companies. But, the concentration of 2.4-TDA which is a metabolite of illvaporized but well skin-absorbed 2.4-TDI is higher in polyurethane paint manufactures. 5. There were no statistical significance in the correlations between individual urinary TDA and immunologic indices.

核然料에 關한 硏究 : α-UO_3의 構造的 特性 Structural Characteristics of α-UO_3

李秀一,曺秉旭,洪光俊 조선대학교 기초과학연구소 1984 自然科學硏究 Vol.7 No.1

α-UO_3 have been prepared from uranyl acetate solution by the thermal decomposition method. The materials structure were examined by surface morpholgy, X-ray diffraction and optical density spectrum. The results showed that α-UO_3 exists two different crystalline forms depending on the temperature of precipitation ; hexagonl α-UO_3 at 350℃ and orthorhombic α-UO_3 at 600℃.

열사병에 관한 임상적 고찰

이춘일,김정완,길현교,장연복,박정식,박성우,김병태,최문기,고영박,선덕재 대한내과학회 1990 대한내과학회지 Vol.38 No.3

Heat stroke is a medical emergency and the most important environmental heat illness. It is a disease of high fever, dry warm skin without sweating, and mental disturbances. It commonly involves several organs including the liver, kidney, heart, brain, and the coagulation system. Recently, we experienced 10 cases of heat stroke. The clinical findings of those were as follows: 1) At the time of admission, body temperature in all patients were higher than 39.4℃, and especially in 4 cases, higher than 41.4℃ : pulse rates in all patients were more than 140/min: and systolic blood pressure were less than 100 ㎜Hg except in one case. 2) The clinical manifestations were CNS symptoms including 6 cases of coma, variable skin lesions, G-I hemorrhage, muscle swelling with tenderness and oliguria. 3) On blood chemistry, there were markedly decreased levels of protein, albumin and calcium: markedly inceased level of SGOT, SGPT, CPK, LDH, BUN, and creatinine: one case of hypokalemia and two cases of hyperkalemia: and 4 cases of hyperbilirubinemia greater than 2㎎/㎗. 4) Two cases of myoglobinuria, 3 cases of proteinuria nd 1 cases of hematuria were observed. 5) Complications, such as uremia, ventricular tachycardia, D.I.C., pulmonary edema, pleural effusion, jaundice and acute pancreatitis were observed. 6) Four cases out of 10 were died. The causes of death were pulmonary edema, cerebral edema, D.I.C., hepatic failure and cardiac failure.

현행 중학교 과학 실험·실습교육에 대한 교사들의 견해와 개선방안

이윤종,기우항,김영호,정원우,양승영,강용희,안병호,임성규,윤일희,김중욱,강동진 경북대학교 과학교육연구소 1996 科學敎育硏究誌 Vol.20 No.-

The status of facilities, management of the experiment, practices, and Science education teaching method in middle school have been investigated. The present status and reasonable management of middle school science education have been grasped from the questionaires. The results are as follows : The reasonable management for expeiments and practices of science education were scanty in the middle school around the urban and rural schools owing to the shortage of facilities and equipments, crowded class, excessive classes, work for teachers, excessive contents of present textbook and insufficience of administrative support etc. The current teaching method of middle school science has emphasized knowledge. This fact does not satisfy the objective of learning due to lack of teaching method. Desirable directions for the improvement of present status of middle school science education were proposed in this paper.

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.

견갑하 고립성 골연골종에 의한 가성 익상견갑 : 증례보고 A Case Report

이병일,민경대,추성옥,김진일 대한견.주관절학회 2000 大韓肩.주關節學會誌 Vol.3 No.1

학교체육 활성화 방안에 대한 연구(Ⅰ) : 강원대학교 교양체육 운영방법의 개선을 중심으로

이광재,문병용,노성규,박기동,홍관이,한상준,유옥재,엄기진,정청자,오수일,김윤래,박장평,부기원 江原大學校附設 體育科學硏究所 1986 江原大學校附設體育科學硏究所論文集 Vol.- No.11

Try to find a scheme for activation to College Physical Education, this Report informs the various kinds of Survey and process those were projected for improvement of management methods on Cultural Physical Education in Kang Weon National University. From experimentally carried out "Sports events Choosing System" not as usual be inforced "Total practical Skill System", Following Positive effects and sujestions were Presented; 1. "Sports events choosing system" gave birth to more students' interesting and more voluntary participation to the sports events they chose, and sports skill and instruction level was elevated due to charge of expert according to each sports events. This system would be managed continuously hereafter for it related to life sports. 2. This System needs to closed cooperations between College and Community, for the facilities of community are utilized by college. 3. To complete the plan for activation of college Physical Education, additionally, the successional study ; namely "autonomous extracurricular sports activity" should be excuted hereafter.

병원근무자에 대한 특수건강진단 적용 가능성에 관한 연구

이수일,조병만,조봉수,김영욱,고광욱,문남출,김주원 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

병원근무자들에 대한 특수건강진단 적용 여부를 판단하기 위한 기초자료를 제공하기 위해 1995년 3월 10일부터 4주간에 걸쳐 부산시내에 위치하는 2개 종합병원 근무자 830명을 대상으로 설문조사를 시행해 얻은 결과를 요약하면 다음과 같다. 1. 조사된 43개 항목 중 10% 이상의 대상자가 유해요인에 폭로되고 있다고 응답한 항목은 소음, 분진 등 16개 항목이었다. 이 중 분진, 소음 및 스트레스는 연구대상자의 50%이상에서 폭로되고 있다고 응답했으며 그 외 알콜류 소독제(41.3%), 방사선(34.6%), 일반약제(33.3%)의 순으로 폭로되고 있었고 VDT의 경우 25.2%, aldehyde류는 18.7%에서 폭로되고 있는 것으로 나타났다. 2. 대상자의 63.1%에서 병원근무 환경 중에 유해인자가 존재한다고 응답했고 병원의 환경측정이 필요하다고 대답한 사람은 80%에 달했다. 35.7%가 유해인자에 대한 교육을 받은 적이 없다고 응답했다. 전체 응답자의 35.7%가 유해인자에 폭로시 보호 장비를 착용하지 않는다고 응답했고 주기적인(격년) 건강진단은 48.6%에서 받는 것으로 조사되었다. 근무부서의 환기상태는 7.2%만이 좋은 편이라고 응답했다. 이상에서 살펴본 바와 같이 병원근무자들이 여러 가지 유해환경에 노출되고 있고 또, 이로 인해 발생할 수 있는 건강장해에 대한 예방대책이 소홀한 것으로 나타나 병원의 작업환경측정의 시행이 필요하고 이 결과를 바탕으로 병원근무자들에 대한 특수건강진단 적용여부를 결정해야 할 것이다. This study was performed to decide the possibility of special health examination to the hospital employees. We carried out questionnaire survey for 830 subjects at 2 general hospitals located in Pusan city. The summary of this study are as follows. 1. Above 10% of total hospital employees were replied that they exposed to 16 hazard items, such as dust, noise, stress and etc. Among them, over 50% of hospital employees exposed to dust(69.8%), noise(52.3%), stress(60.1%). And hospital employees exposed to alcoholic disinfectant(41.3%), radiation(34.6%), drug(33.3%), VDT(25.2%), and aldehyde(18.7%) also. 2. 63% of the hospital employees replied that there were hazardous factors in hospital environments, and 80% insisted the necessity for hospital environment measuring. 35.7% of respondents replied that they had never taken the education about hazardous factors. 35.7% of the total respondents answered that they didn't use protective equipment when exposed to hazardous factors. And 48.6% answered they took periodic health examination. Only 7.2% replied that ventilation condition of office room was proper. As shown in above results, hospital employees are exposed to various hazards, and turn out neglecting to health problems caused these hazardous factors. So at first, it is necessary to measuring hospital working environment, and then will be decided the possibility of special health examination to the hospital employees.