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.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

스위칭 함수를 이용한 3상 전압원 인버터의 모델링 및 특성해석

백수현,김용,박철현 동국대학교 산업기술연구원 1996 산업기술논문집 Vol.8 No.-

Static power converters can be analyzed by means of available simulation software packages such as PSPICE. This paper proposes the macro models developing technique for three-phase power converters using the transfer function approach. Also, These models were based on converter switching functions rater than actual circuit configuration. In this approach, SPWM VSI(Voltage Source Inverter) was simulated as multiport networks avoiding nonlinear macromodels of the power switches. Also, Output phase voltage and line-to-line voltage of VSI have been verified experimentally.

대전자골을 이용한 골이식증례

이백수,김여갑,이상철,김은철,류동목 大韓顎顔面成形再建外科學會 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.1

Autogenous bone graft is the useful technique for management of various bone defect in oral and maxillofacial surgery. The most common site for bone graft harvest is the anterior iliac crest. There is usually considerable cancellous bone graft available and it can be obtained with minimal morbidity. However, complications noted in iliac crest grafts include prolonged postoperative pain, hematoma and fracture, gluteal muscle weakness. Occasionally, when large amounts of bone graft are needed and previous harvest procedure had used, iliac bone harvest may be not adequate. Like the iliac crest, the greater trochanter has abundant cancellous bone and is readily accessible with acceptable morbidity. The purpose of this study was to assess the availability of cancellous bone graft from the greater trochanter, compare the quantity with that available from the anterior iliac crest, investigate anatomical hazards, and make recommendations for consistent harvest.

흰쥐의 중추성 Serotonin 고갈이 강제수영 중 부동자세 시간, 불안 및 수동적 회피 학습에 미치는 효과

박제민,김종백,강철중 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.3

흰쥐에서 p-chlorphenylalanine(PCPA)로 인한 강제수영 중 부동자세 시간의 단축이 불안이나 수동적 회피 학습 능력의 변화와 관련된 것인가를 검증하고자 하였다. 흰쥐에게 PCPA 300mg/kg 혹은 생리식염수를 하루 한 번 연속 3회 복강내 주사하였다. 마지막 주사 24시간 후에 공간에서의 활동성(ACT0), 높은 십자 통로 실험에서 개방 통로에 머무는 시간(ANX0), 왕복 회피상자에서 통과 지연 시간(STL0) 등을 측정하고 0.5mA 전기자극을 3초간 주어 회피 반응을 학습시켰다. 그리고 15분간 강제수영시켰다. 다음 날 같은 방법으로 활동성(ACT1), 불안(ANX1), 수동적 회피 반응 학습 정도(STL1), 5분간의 강제수영 중 총 부동 자세 시간 등을 측정하였다. 마지막 약물 혹은 대조액 투여 7일 후 수동적 회피 학습 유지 정도(STL7)를 다시 측정하였다. 결과는 아래와 같다. 1) 전체 대상군에서 ACT1은 ACT0보다 감소하였다. PCPA는 개방공간에서의 활동성에 영향을 주지 않았다. 2) PCPA 군은 높은 십자 통로 실험에서 ANX0와 ANX1 둘 다 대조군 보다 유의하게 길었다. 3) STL1은 PCPA군과 대조군 모두 STL0 보다 유의하게 지연되었다. PCPA는 STL0 이나 STL1에 영향을 주지 않았다. 그러나 대조군은 수동적 회피 학습 7일 후에도 통과 지연 시간이 유의하게 연장되어 있는데 반하여 PCPA군은 STL7이 STL0과 유의한 차이가 없었다. 4) 강제수영 중 부동자세 시간은 PCPA군이 대조군보다 유의하게 짧았다. 이상의 결과에서 PCPA 투여로 인한 강제수영 중 부동자세 시간의 단축은 PCPA가 비특이적 신체 활동을 증가시키거나 수동적 회피 반응 습득을 방해함으로써 일어나는 현상이 아니며, 진정 작용없이 탐색 행동을 증가시키거나, 스트레스 하에서의 행동 억제 현상을 차단함으로써 강제수영 중 부동자세 시간을 단축시킨다고 추론한다. 아울러 PCPA가 기억 고정 과정을 방해할 가능성이 있음을 제안한다. Purpose : The test if p-chlorophenylalanine(PCPA) induced decrease of immobility time during forced swimming test in rats is an epiphenomenon related with PCPA-induced changes in anxiety level or learning ability. Methods : 22 male rats(Sprague Dawley, weighting 180-280gm) were randomly assigned to PCPA or control group and treated with 300mg/kg of PCPA or saline i.p. at -72, -48, and -24 hrs. Number of segment(ACT0) entered with 4 limbs on the open field(L100×W100×H40cm, 25 segments), time(ANX0, sec) spent on the open arm(L110×W10cm, 50cm from the ground) in the elevated plus maze, and step-through latency(STL0, cut-off time : 300sec) in the shuttle box(L76.2×W34.3×H50.8cm, 7.5w electric bulb in the light chamber, 0.5mA for 3 sec in the dark chamber) were measured consequently at 24hrs after the last injection of PCPA or saline. After 20min of rest, animals were forced to swim for 15 min(cylinder : φ18×H40cm ; water : H15cm, 25℃). On the next day, the second trial of open field test(ACT1), elevated plus maze test(ANX1), passive avoidance learning test(STL1), and measurement of total immobility time(IT, sec) during the 5min of forced swim were done in the same manner as the first trial except that electrical shock was not given to the animals in the passive avoidance learning test and duration of forced swimming was shortened from 15min to 5min. To evaluate longterm effect of PCPA on maintenance of memory, measurement of step-through latency was repeated 7 days after the first trial(STL7). Result: 1) ACT1 was significantly decreased in the pooled sample, but the effect of PCPA on the general motor activity was not significant. 2) PCPA significantly prolonged the time spent on the open arms in the elevated plus maze test. 3) Comparing to STL0, STL1 was significantly prolonged in both groups. PCPA did not affect STL0 or STL1. STL7 was significantly prolonged in the control group, but not in the PCPA group. 4) PCPA shortened IT significantly. Conclusion : PCPA-induced decrease of immobility time during the forced swimming test in rats seems to be related with disinhibition of stress-related behavioral suppression. PCPA does not affect acquisition and short-term maintenance of passive avoidance learning, but necessity of further studies about its effect on long-term maintenance on memory is raised.

응급의료 헬리콥터를 이용한 환자이송에 대한 고찰

송형곤,김병철,송근정,정연권,신백효 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background: The first EMS helicopter was introduced to Korea in 1996 and from Dec. 1. 1997, it was used for transporting emergent patients. Authors, here upon, report the transporting experiences. Methods: From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data prospectively analyzed. Result: A total of 65 patients were transported. Male to female ratio was 1.95:1. The mean transport time was 64.1 min(10 - 160 min). Majority of the evacuated patients was surgical patients (General Surgery : 16, Orthopedic surgery : 10, Neurosurgery : 6, Internal medicine : 13, Pediatrics : 3, and others : 3). Twenty-one of the 65 patients transported were admitted to ICU and 31 did not require ICU care. During the air evacuation, one physician and one nurse trained for air evacuation attended the patients. No medical problems or deaths developed during the air evacuation period. Conclusion: The first EMS helicopter was introduced to Korea in 1996. From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data reported.

부산, 울산, 경남지역 직업병감시체계에서 나타난 수지진동증후근의 역학적 특성

최영희,유철인,이지호,이충렬,이헌,김영욱,채창호,고상백,김은아,이유진,김양호 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.3

목적: 국내에서도 국소진동에 의한 수지진동증후군이 다수 있을 것으로 추정하나 최근에 이에 대한 보고가 적어 부·울·경 직업병감시체계를 통하여 수지진동증후군에 대한 환례를 수집하여 이의 역학적 특성을 밝히고자 본 연구를 실시하였다. 방법: 2001년 44월부터 2002년 12월까지 부산, 울산, 경남지역에 있는 종합병원 9곳을 통하여 특수 건강진단과 산업의학과 외래를 방문한 근로자를 대상으로 진동폭로에 대한 설문조사를 실시하고 이들중에서 수지진동으로 인한 증상을 호소하는 근로자는 이학적 검사와 Stockholm workshop scale을 이용하여 수지진동증후군이 있는지 평가하였다. 결과: 남자 188명, 여자 4명 등 총 192례의 수진진동증후군이 의심되는 환례를 수집하였으며, 업종별로는 조선업에 종사하는 근로자들이 가장 많았다. 국소진동의 주된 폭로원은 그라인더가 가장 많았으며, 혈관장해로 인한 증상보다 감각신경성 장해로 인한 증상을 많이 호소하였다. 결론: 전국적으로 조선업종의 그라인더 사용자를 중심으로 많은 수의 수지진동증후군의 환자가 있을 것으로 추정되며, 이들에 대한 예방대책을 마련하기 위하여 전국규모의 정확한 유병률 조사 및 실태파악이 필요한 것으로 판단된다. Objects: The objectives of this study were to estimate the epidemiologic characteristics of hand-arm vibration syndrome (HAVS) due to occupational exposure of hand transmitted vibration and to identify the occupations and industries where such exposures arises, and the main sources of exposure. Methods: In April 2001 the Busan, Ulsan, and Kyung-Nam Province occupational disease surveillance system was established to measure the incidence and prevalence of work-relatd HAVS and other occipational diseases in these Korean provinces. Occupational physicians of nine hospitals in Busan, Ulsan, and Kyung-nam Province were involved in this project between April 2001 and November 2002. Physicians collected information through questionnaires and interviews. Information gathered included age, occupation, types of vibration tools used and presence of subkective symptoms such as vibration-induced white finger (VWF), numbness and tingling. Results: A total 192 cases were reported with 188 males and 4 females. The shipbuilding industry was the most common type of industry and grinders were the most common source of exposire. Symptoms of neurological disorder were more common than those of vascular disprder. Conclusions: The authors concluded that exposure to hand transmitted vibration is common and that HAVS is one of the most common occupational diseases in Korea. However, the range and extent of hand transmitted vibration and the overall prevalence of HAVS in Korea is still unknown. More extensive research on this syndrome in order to priorite necessary preventive measures is required.

상악골에 발생한 악성섬유성조직구종의 치험례

이상철,김여갑,류동목,이백수,윤옥병,신민철 大韓顎顔面成形再建外科學會 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.1

師範系 體育敎育科 志望生의 一般運動能力檢査 基準値 設定에 關한 硏究

梁點紅,高基俊,黃喆文,金泰運,金重雄,白永鎬,表內淑,黃太相,徐國雄 釜山大學校 附設 體育科學硏究所 1989 體育科學硏究所 論文集 Vol.5 No.-

This study was analyzed the validity and the reliability of evaluation norm. which was used in choosing and grading events of the General Motor Ability Test. The General Motor Ability Test has been done for applicants for entrance to the department of physical education, college of education, Pusan National University. The subjects of this study were 433 applicants(men :387, women :46) for three years. They were tested in seven events : 1) 100m Dash, 2) 1500m Run(man), 800m Run (woman), 3) Throwing Hand-Ball, 4) Broad Jump, 5) Chinning(man), Flexed-Arm Hang(woman), 6) Zig-Zag Run, 7) Trunk Flexion. The results could be summerized as follows ; 1. In 100m Dash, 1500m Run, and Throwing Hand-Ball, man's average records were shown normal distribution which was inclined toward low ll grade. Therefore, the interval size of those three events must be regulated to lower. 2. Average records of Broad Jump in man were distributed into high (1) grade. So, the interval size must be adjusted to higher. 3. In Chinning, Zig-Zag Run, ad Trunk Flexion, man's average records were shawn normal distribution, and the interval size was similar to present records. 4. For woman, it was impossible to analyze correctly in all seven events because of the small number of subjects. So, it was for the sake of the reference. 5. The record of applicants for three years were operated to the variable quantity analysis. And the restults were these ; 100m Dash was F=3.0865(p<0.05), Chinning F=3.9309(p<0.05), Broad Jump F=14.7338(p<0.001), Throwing Hand-Ball F=4.9716(p<0.01), and Zig-Zag Run F=6.8297(p<0.001). Then, it was shown statistical meaningful difference in three groups. 6. In investigating the validity in choosing seven events, it was concluded that the events have been chosen reasonably. Because all events except for 100m Dash, and Zig-Zag Run in man were independent. From the analysis of the General Motor Ability Test, we could realized the necessity of regulating the standard and the interval size in several events. Then, we proposed the new evaluation norm which was suitable to present situation.

An Economic Evaluation of Thread Embedding Acupuncture for the Treatment of Lumbar Herniated Intervertebral Disc in a Randomized Controlled Clinical Trial

Kim, Ha-Na,Kim, Jun-Yeon,Park, Kyeong-Ju,Hwang, Ji-Min,Jang, Jun-Yeong,Jo, Min-Gi,Ko, Min-Jung,Chae, Sang-Yeup,Kim, Jung-Hyun,Goo, Bonhyuk,Park, Yeon-Cheol,Seo, Byung-Kwan,Baek, Yong-Hyeon,Nam, Sang-S Korean AcupunctureMoxibustion Medicine Society 2021 대한침구의학회지 Vol.38 No.4

Background: Lumbar herniated intervertebral disc (LHIVD) is a frequently presented condition/disease in Korean medical institutions. In this study, the economics of thread embedding acupuncture (TEA) was evaluated in a randomized controlled trial comparing TEA with sham TEA (STEA). Methods: This economic evaluation was analyzed from a limited social perspective, and the per-protocol set was from a basic analysis perspective. The cost-effectiveness analysis was based on the change in visual analog scale score, and the cost-utility analysis was based on the quality-adjusted life years. The final results were expressed as the average cost-effectiveness ratio and incremental cost-effectiveness ratio, and furthermore sensitivity analysis was performed to confirm the robustness of the results observed. Results: The cost-effectiveness analysis showed that TEA was 9,908 won lower than STEA, while the decrease in 100 mm visual analog scale score was 8.5 mm greater in the TEA group compared with the STEA group (p > 0.05). The cost-utility analysis showed that TEA was 9,908 won lower than STEA, while the quality-adjusted life years of TEA was 0.0026 years higher than STEA (p > 0.05). These results were robust in the sensitivity analysis, but were not statistically significant. Conclusion: In treating LHIVD, TEA appeared to have cost-effectiveness and cost-utility compared with STEA. However, there were no significant differences between the groups in terms of cost, effectiveness, and utility indicators. Therefore, results must be interpreted prudently; this study was the 1^st to conduct an economic evaluation of TEA for LHIVD.