공중보건의의 고혈압 진단 및 치료과정 평가

송윤미,김윤,조홍준,정희숙,김용익 한국의료QA학회 1996 한국의료질향상학회지 Vol.3 No.1

Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.8%). Level of training, duration of practice as a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the preestablished clinical guidelines, which leaves much to be desired in diagnosion and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

住居 暖房에 관한 環境學的 硏究(Ⅱ)

李璟會,노윤종 연세대학교 산업기술연구소 1977 논문집 Vol.7 No.1

It has been conceived that method of house-heating influences on the ways in which people make use of space, on behavioural consequences and react to their home environment. The study aims to clarify the influences as such through testing the differences in the evaluative criteria across the different house-heating groups. With a sample of 200 households in apartment houses with 4 different heating types (Type A; traditional Ondol, Type B; Panel heating, Type C; Panel heating and radiator, Type D; all radiator), measurements and descriptive evaluations have been made once in winter and once in summer of 1975/76. Part Ⅱ of this study includes the results of comparative analysis of the summer and winter survey.

1972년 8월 서울시내 침수지역하수에서 대한 장내병원균 분리상태

김성희,김우식,고광균,이연태,이종훈 中央醫學社 1974 中央醫學 Vol.26 No.5

Bacteriological survey was performed with the 81 seweage specimens taken from the flooded areas in Seoul City (Young; dungpo-Ku, Yongsan-Ku, Mapo-Ku, Seongdong-Ku and Seodaemoon-Ku) during August, 1972. Thirteen strains of enteric pathogens were isolated. from their specimens of the 13' strains of isolates, 5 strains of Salmonella species, 6 strains of Shigella and 2 strains of Vibrio parahaemolyticus were confirmed by means of biological, biochemial and serological test, respectively.

응급센터에 내원한 만성 폐쇄성 폐질환 환자에 대한 고찰

박승회,백광제,홍윤식 대한응급의학회 1993 대한응급의학회지 Vol.4 No.2

Chronic Obstrcitive Pulmonary Diseases(COPDs) produce significant morbvidity and mortality in human lives. COPD is a progressive disease that coexists with emphysema and chronic brochitis. The critical episodes depend on inciting or aggravating factors which can be classified into 3 ways. First, disease related aggravation. Second, Patient related aggravation. Third, Physician related(latrogenic). The authors reviewed 102 COPD patients who came to Korea University Hospital Emergency Medical center from March of 1992 to February of 1993. 1) Males were more frequently affected than females, and male to female ratio was 2.64 : 1 2) The average age of the patients were 62.8 years old. 3) The average number of hospital admission was 2.5 times and one patient was admitted 9 times for the same disease. 4) On an average, the patients had dyspneic symptoms for 15.6 years and the symptoms had developed since they were 47.8 years old. 5) The ratio between smokers and nonsmokers were3 2.1 : 1, the smokers had smoked for 36.3 years and the average amount of smoking was 1.5 pack per day. 6) After admission, sputum culture and sensitiveity test were done and the results were as follows : nonspceific organums 47 cases(46.0%), streptococcus 23 cases(22.5%), Pseudomonas 15 cases(14.7%), Hemophilus influenza 7 cases(6.8%), Klebsiella 5 cases(4.9%), Actinomycosis 3 cases (2.9%), Staphylococcus 2 cases(1.9%) 7) Aggravation factors for dyspnea were as follows : Upper Respiratory Tract Infection 40 cases(39.2%), Smoking 2.5 cases(24.5%), Pneumothorax 11 cases(10.8%), Pneumonia 7 cases(6.8%), Unknown origin 19 cases(18.6\%) 8) Prognosis after hospital admission were classified into 6 groups : 1. completely recovered 2. almost recovered 3. no improvement 4. hopeless discharge 5. expired within 48 hrs. 6. expired after 48hrs. The results were as follows : 87.3%(89 cases) discharged in almost recovered stated state, 1.9%(2 cases) discharged with no improvement, 4.9%(5 cases) were hoplessly discharged, 2.9%(3 cases) expired within 48 hrs, 2.9%(3 cases) expired after 48 hrs.

아침 식사시간의 다른 사람들에서 혈장 그렐린의 변화

이상엽,김윤진,김형회,손한철,전태용,심문섭 대한비만학회 2002 The Korean journal of obesity Vol.11 No.2

연구배경 : 최근 식욕조절인자로 관심이 집중되고 있는 그렐린(ghrelin)은 식사 전후로 독한 일중변동을 보인다. 하지만, 지금까지는 실험적으로 일정한 열량의 표준 음식을 일정한 식사시간에 공급한 이후 그렐린의 농도 변화를 관찰하였다. 저자 등은 평소 아침 식사시간이 각기 다른 사람들에서 아침 식사 전후의 혈장 그렐린 농도 변화를 관찰하여 향후 외래 환경에서도 그렐린 관련 연구가 가능하도록 기초 자료를 제공하고자 하였다. 방법 : 연구에 대한 설명을 듣고 동의한 23.4 ~ 35.5세 사이의 비교적 건강한 동양인 남자 4명을 대상으로 하였다. 신체 계측을 한 후 이중 에너지 방사선 측정법 (Lunar prodigy, GE medical systems, Waukesha, Wisconsis, USA, 이하 DEXA)으로 체지방을 측정하였다. 연구 대상자 모두 평소 아침 식사시간이 일정하였지만 연구 시작 2주전부터 아침 식사시간을 엄격히 고정하도록 하였다. 스트레스가 없는 상태에서 아침 식사를 하지 않는 지원자는 오전 6시 30분부터, 나머지는 아침식사 시간 1시간 전부터 1시간 간격으로 점심 식사 전인 오전 11시 30분까지 채혈하였다. 각각의 검체로 부터 혈장 그렐린은 상업적인 방사선면역측정법 (Phoenix Pharmaceuticals, Inc., Belmont, CA)으로 측정되었다. 랩틴은 Ⅰ-125 표지 랩틴을 이용한 이중항체 방사선면역측정법으로, 혈장 인슐린은 항체 부착관을 이용한 방사선면역측정법으로, 혈당은 포도당산화 효소법에 의해 Synchron LX 20 (Beckman Coulter, Inc, Fullerton, USA)으로 측정하였다. 결과 : 연구 대상자의 체질량지수는 22.9 ~ 27.1 kg/㎡이었고, 허리둘레는 80.3 ~ 93.3 cm이었다. DEXA로 측정한 결과 전체 체지방과 체부지방 비율은 각각 27.1 ~ 31.8%와 32.7 ~ 32.4%이었다. 아침 식사를 하지 않는 자를 제외한 나머지 연구 대상자의 아침 식사 직전의 식후 2시간의 혈장 그렐린 농도는 각각 113.0 ~ 800.0 pg/mL, 78.3 ~ 553.0 pg/mL이었고 랩틴 농도는 각각 4.9 ~ 5.1 ng/mL, 4.4 ~ 4.7 ng/mL 이었다. 혈장 그렐린 랩틴 농도는 아침 식사 직전에 비해 식사 2시간 후 각각 7.2 ~ 30.9%와 7.8 ~ 10.2%감소되었다. 아침식사를 하지 않는 대상자의 경우 인슐린과 혈당치가 변화가 없음에도 불구하고 혈장 그렐린 농도는 오전 7시 30분에 가장 낮았다. 그 외 연구 대상자에서는 각기 다른 시간이더라도 아침 식사 2시간 후의 혈장 그렐린 농도가 가장 낮았다. 결론 : 평소 아침 식사시간이 다른 사람들에게서 혈장 그렐린 농도는 각기 다른 아침 식사 2 시간 후에 가장 낮았다. 아침 식사를 하지 않는 경우에는 혈장 그렐린 농도가 오전 7시 30분에 가장 낮았다. Background : Recently, the particular interest is on ghrelin, the dietary control factor among many scientists and it a toxic diurnal variations has been demonstrated before and after meal. However, the experimental approach has been only to see the changes in the concentration of ghrelin after intake of meals standardized with fixed calories at scheduled meal hours. the authors of this particular experiment have tried to observe and record the changes in concentrations of plasma ghrelin of persons with different breakfast hours. This might help in providing a basis for further possible studies in outpatient setting. Method : A group of four relatively healthy males whose ages between 23.4 and 35.5 with prior agreements were selected for this study. After body measurements, body lipid status was measured based on Lunar prodigy (GE medical systems, Waukesha, Wisconsin, USA) which is also referred to as DEXA. All of the selected persons had somewhat fixed breakfast time; however, they were asked to strictly keep their breakfast time fixed and steady starting two weeks before the beginning of experiment. The bloods of those who skip their breakfast without any particular stress were sampled at 6:30 AM, whereas the rest had different schedule, whose bloods were sampled every hour starting 1 hour before the first meal of the day till just before lunch (11:30 Am). From each blood sample, the level of plasma ghrelin was measured using the commercial radioimmune assay (Phoenix Pharmaceuticals, Inc., Belmont, CA). Leptin was measured with double antibody radioimmune assay using Ⅰ-125 labelled leptin, plasma insulin with radioimmune assay using antibody attachment tube, and blood sugar with Synchron LX20 (Beckman Coulter, Inc, Fullerton, USA) using glucosylation enzyme method. Result : The body mass index of the volunteers was 22.9 ~ 27.1 kg/㎡, with 80.3 ~ 93.3 cm waist circumference. Based on measurements by DEXA, the rates of total body lipid and trunk lipid were each 27.1 ~ 31.8% and 32.7 ~ 32.4%, respectively. The concentrations of plasma ghrelin of those who consume their breakfast before and 2 hour after their breakfast are 113.0 ~ 800.0 pg/mL and 78.3 ~ 553.0 pg/mL. The concentrations of leptin are 4.9 ~ 5.1 ng/mL and 4.4 ~ 4.7 ng/mL. Compared to the concentration of plasma ghrelin and of leptin recorded just before breakfast, it showed 7.2 ~ 30.9% and 7.8 ~ 10.2% decrease, respectively, 2 hours after breakfast. For those who skip their breakfast, the plasma concentration of ghrelin was recorded the lowest at 7:30 AM, even though there was no change in insulin and blood sugar. The rest of the subjects had their lowest plasma ghrelin concentration at 2 hours after breakfast, despite their different meal schedule. Conclusion : The persons with different breakfast hours had their lowest plasma concentration of ghrelin at 2 hours after breakfast. In contrast, the persons who skip their breakfast had their lowest concentration at 7: 30 AM.

슬관절 골관절염 증상이 환자에게 미치는 우울 효과

박영규,이윤영,이계우,김정아,윤도경,박승회,조경환,홍명호,박용규 대한노인병학회 2001 대한노인병학회지 Vol.5 No.4

열 변화에 의한 구리전선의 미세조직 및 상 변화에 관한 연구(Ⅲ)

박성우,김윤회,김상현,박남규,김수철,김영만 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-

공구흔 동일성 여부 감정기법 개발

김상현,이경화,임세혁,김윤희 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-

발화기구의 정량적 해석을 위한 재현 실험 : 1차년도 전기화재 재현 Reconstruction for Electrical Fire

박남규,김상현,김진표,김윤희,문병선,조영진 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-

공구흔 동일성 감정기법의 실제 감정대상에 적용

임세혁,김상현,이경화,김윤회 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-