혈액투석시 Double Lumen Silicone Rubber Catheter ( = Permcath ) 사용의 임상적 경험

차대룡(Dae Ryong Cha),김선숙(Sun Sook Kim),이영호(Young Ho Lee),권영주(Young Joo Kwon),조원용(Won Yong Cho),김형규(Hyoung Kyu Kim),선경(Kung Sun),김정숙(Jung Sook Kim),함인귀(In Gui Ham),김미경(Mi Kyung Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.4

N/A Background: Repeated, long-term access of the vascular system is a prerequisite for successful extended care of the patients with end stage renal disease (=ESRD) treated with hemodialysis. Despite recent technical advances in percutaneous venous cannulation, vascular access remains a major problem in patients requiring acute Hemodialysis. Although the subclavian cannula has gained a large clinical acceptance in recent years, it carries specific risks such as hemothorax, pneumothorax, venus stenosis, thrombus formation and infection. Recently, a double-lumen, central venous catheter made of Silicone Rubber (=Perm cath) has developed for use as a vascular access device, This device is particularly useful in patients who have exhausted other vascular access sites or who have severe cardiovascular disease. Methods: A total of 23 dual-lumen silicone rubber catheters were placed through the internal jugular vein in 23 patients as a vascular access at our institution during the period of April, 1992 through November, 1992. The perm-cath (Hemocath, Quinton, Seattle) is 36 Cm long and each lumen has an internal diameter of 2 mm. Implantation of the catheters occurred in the operating room and under strict aseptic conditions through the right internal jugular vein. A 10 cm subcutaneous tunnel was then created, which extended from the in-cison to a point 2 cm above the ipsilateral clavicle. The catheter was passed out through the upper portion of the subcutaneous tunnel with the Dacron cuff placed 2 cm from the lower end of the tunnel, acting as both an anchor and a barrier to infection. The tip of the catheter was inserted through an internal jngular vein terminating in the right atrium under EKG monitoring. Each lumen of the catheter was filled with 1000 units of heparin sodium (1.5 ml in venous line, 1.5 ml in arterial line) and capped. Results : The mean duration of catheter use was 24±16 days (8 to 119 days), and the complication of perm-cath occurred in 3 cases such as venous thrombosis in 1 case, catheter exit site infection in 1 case, and exit site hematoma in 1 case. During hemodialysis, blood flow rate ranged from 190 to 313ml/min (mean:235±26ml/ min), and venous retrun pressure ranged from 20 to 150 mmHg(mean:65±16mmHg). Total 14 catheters were removed during treatment and the causes of catheter removal were patient death in 8 cases, venous thrombosis 1, recovery from acute rena1 failure 2, fistula maturation 2, infection 1. Conclusion: Internal jugular vein cannulation with silastic catheter which offers a new percutaneous method was provided safe and reliable as the temporary central vein access. The catheters are well tolerated by the patients and have the advantages of immediate use after placement, high blood flow rates, no repetitive venipuncture, and no cardiac dysfunction. Permcath is particulary useful in patients who have exhausted other vascular access site, severe cardiovascular disease, and terrified by repetitive venipuncture. Though our initial experience has been favorable, there will be needed to evaluate the outcome of permcath over longer period of time.

정기 건강진단 결과와 THI 증상군과의 관련성 연구

조인숙,안규동,이병국 순천향대학교 1992 논문집 Vol.15 No.2

For the purpose of obtaining basic information about health status of white collar workers, authors studied 11,266 subjects who were employed for government organization and private educational institute in Seoul, Kyungbuk and Chungnam areas. All the subjects visited hospitals to take biannual health examination provided by Medical Insurance Association to screen several importan adult diseases. Todai Health Index(THI)questionnaire which is modified questionnaire of Conell Medical Index by Todai was selected for the quwstionnaire form of this study. The results of this study were as follows : 1. The abnormal rate of screening test was 22.6% in male, and 8.3% in female. The rate was increased more significantly in female subjects by the increase of age. 2. While the prevalence of male subjects was 6.1% in cardiovascular disease, 4.2% in liver disease, 2.5% in diabetic disease and 2.3% in pulmonary disease, that of female subjects was 1.5% in cardiovascular and anemic disease respectively, 1.2% in liver disease and 0.5% in pulmonary disease. 3. The mean weight of male and female subjects were 65.3 ±6.6㎏ and 52.9 ±6.6㎏ and the mean Broka's index of those were 68.4 ±5.3㎏ and 57.6±4.7㎏ respectively. 4. The mean diastolic pressure of male and female subjects were 82.2±11.2 and 74.9±10.4mmHg, and the mean serum systolic pressure of those were 125.8±15.5 and 115.4±13.7mmHg respectively. The mean total cholesterol in male was 178.8±35.9 and that in female subject was 167.9±34.6. 5. The mean SGOT of male and female subjects were 23.9±18.0 & 17.9±8.2, the mean of SGPT of those were 22.4±21.1 & 15.1±13.2 respectively. 6. Concerning to the question of present health condition, while 57.7% of males with age of less than 29 years old answered their health in good condition, 47.7% of female with age of 30-39 answered their health in good condition which is the lowest rate among total subject group. On the other hand, only 4.9% of female with age under 29 answered their health as bad, and 14.0% of male with age over 40 answered that their health was in bad condition. 7. Concerning to the question of health management, 50.9% of male and 44.1% of female whose age were over 40 years old answered that they were doing sonthing for their health with food diet, taking nutrient medicine and proper exercise. 8. The diet habit of young age group was irregular compared to older age group. The older age group was fond of salty food. 9. While the smoking rate of male was 65.4% in age group under 29 years, 61.8% in age group of 30-39 years and 52.6% in age group of over 40 years, that of female subjects were 0%, 0.3% and 1.6% respectively. 10. The highest prevalence rate of symptoms and signs during current 3 moths was observed in the age group of 30-39 in males and in the age group over 40 years in female and there was no differences of prevalence between normal group and diseased group. 11. While the most frequent symptom category of THI in male was mental instability, and depression symptoms, nervousness and respiratory symptoms were next in order of frequency, that of THI in female was mental instability, and depression symptoms, nervousness and multiple subjectve symptoms were next in order of feequnecy.

약제 내성 폐렴구균의 비율이 높은 지역에서 발생한 하기도 감염 치료에 대한 Levofloxacin의 효능 및 안정성

조황래,오원섭,김춘관,김연숙,정숙인,김성민,백경란,송재훈 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.3

목적 : Levofloxacin은 지역성 호흡기 감염의 흔한 원인인 폐렴구균과 같은 그람 양성균뿐만 아니라, 그람 음성균, atypical organisms에 대해서도 넓은 항균 스펙트럼을 갖는 항균제로 알려져 있다. MDRSP의 빈도가 증가하고 있는 국내에서의 지역성 호흡기 감염에 대한 levofloxacin의 유효성과 안전성을 평가하기 위해 계획하였다. 방법 : 본 임상시험은 전향적 방법으로 2000년 1월부터 2001년 4월까지 삼성서울병원에 내원한 지역사회 획득 폐렴, 만성 기관지염에 병발된 급성 세균성 감염 환자 60명을 대상으로 하였다. 투여량 및 투여방법은 Levofloxacin 500㎎을 하루에 한번씩 12.6일(±3.3일)간 투여 하여 임상적으로 호전된 경우, 경구제로 전환하였으며(500㎎ q 24hrs), 신기능 장애시(Ccr 20-50㎖/min) 주사 및 경구제 500㎎을 48시간 간격을 두고 투여하였다. 임상효과, 미생물학적 평가, 및 부작용을 관찰하였다. 결과 : 총 60명의 환자가 시험을 완료 하였고, 결핵환자로 판명된 3명과 NK/T cell lymphoma로 확인된 1명, 투약 후 피부발진 발생으로 2일만에 중단된 환자 1명을 제외하고 55명을 평가하였다. 증상의 치료 및 개선을 임상적 유효성이 있는 경우로 하였을 때 55예 중 49예(89%)에서 만족할 만한 결과를 얻었다. 미생물학적 평가에서 10예중 10예(100%) 모두에서 미생물학적 소실을 보였다. 부작용으로는 간염 4예, 피부 발진 1예로 모두 5예(9%)가 발생 하였다. 결론 : 약제 내성 폐렴구균의 빈도가 증가하고 있는 국내에서의 지역성 호흡기 감염에 대하여 levofloxacin은 비교적 효과적이고 안전한 치료 방법이라 할 수 있다. Background: To evaluate the efficacy and safety of levofloxacin in the treatment of lower respiratory infections in the area with high prevalence of multidrug-resistant Streptococcus pneumoniae(MDBSP) Methods: Outpatients of over 18 years old with a confirmed diagnosis of a community acquired pneumonia and an acute bacterial exacerbation of chronic bronchitis were enrolled. Patients were treated with parenteral levofloxacin(500㎎ once a day) followed by oral levofloxacin(500㎎ once a day) for about 2weeks and evaluated. Results: Total number of 60 patients received levofloxacin for a mean of 12.6days. Successful clinical response(cured and improved) was 89.1%(49/55) of patients. Microbiologic eradication rate was achieved in 100% of patients whose pathogens were isolated. Hepatitis was developed in 4 cases and drug eruption occurred in I case. Conclusion: A once a day of 500㎎ of levofloxacin for lower respiratory infections developed in the region of high prevalence of MDRSP was effective and safe.

국내 기록관리학분야 석․박사학위논문의 계량서지학적 분석

조인숙,신준성 한성대학교 인문과학연구원 2012 소통과 인문학 Vol.15 No.-

This study inquired into and analyzed total 560 papers (558 master's theses and 2 doctoral dissertations) in the field of Archives & Records Management published in Korea from February 2001 through February 2010 in order to examine the trend of research and changes of the study through the topics and cited analyses of the papers for a degree published in graduate schools for the major of Archives & Records Management in Korea. First, for the analysis of the general situations of the theses for a degree, the status of publication per year, subject fields, the major fields of the academic advisors, research methods, data collection methods, and the target institutions of the research were surveyed. Next, 3 precedents studies that analyzed the trend of the research for domestic journals in the field of Archives & Records Management were compared and analyzed with this study. Second, for the analysis of the cited literatures of the theses for a degree, for 262 theses published in recent 2 years (Aug. 2008~Feb. 2010), the frequency and life span of the cited literatures, etc. were analyzed. In addition, the domestic/foreign journals at the high ranking of citation among the cited journals were listed.

정보원으로서의 학위논문 이용에 관한 연구

조인숙 한국문헌정보학회 1993 한국문헌정보학회지 Vol.24 No.-

The purpose of this study is to analyse theses and dissertations cited in research literature, particularly subjects, age, origin, and frequency of use of them, and kinds of papers that cite them. The theses and dissertations cited in the journal articles and theses dissertations in the fields of library science, information science and bibliography are analysed in this study. The major conclusions made in this study are summarised as follows. (1)Theses and dissertations form 5.6% of the total citations. (2)87.1% of the cited theses and dissertations are found in theses and dissertations and 12.9% in journal articles. (3)Most of research papers cite less than six theses and dissertations. The average number of theses and dissertations cited in a research paper in 2.7. (4)Most of the cited theses and dissertations are found in research papers from their own field and 24.5% in those from other fields. (5)Researchers prefer to cite recently produced theses and dissertations 63.5% of the total citations are those produced within three years in the past. (6)The theses and dissertations form most part(89.0%) of the total citations. 88.9% of the cited foreign theses and dissertations are found in theses and dissertations, and 11.1%in journal articles

우리나라 연 작업자들의 연폭로 수준에 관한 연구

조인숙,김용배,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

To assess lead exposure in Korean lead workers, 2047 male lead workers in 17 lead using industries were studied. Study population were divided into 4 occupation categories such as storage battery industry(type 1), secondary smelting and litharge making industries(type 2), PVC stabilizer making industries(type 3) and primary smelting and related industries (type 4). Blood lead and zinc protoporphyrin in whole blood (ZPP) were selected as an index of lead exposure. Hemoglobin and hematocrit were also checked. Fifteen questionnaires of lead related symptoms were provided to all lead workers and filled up by themselves and confirmed by medical doctors. Personal variables such as age, work duration, smoking and drinking habits were also collected. the results were as follows. 1) The mean blood lead, ZPP and hemoglobin of all lead workers were 29.7+12.6㎍/100㎖, 56.5+38.6㎍/100㎖ and 14.6+1.3 gm/100㎖ respectively. 2) While the mean blood lead of lead workers in type 1, 2, 3 and 4 were 28.6+11.6㎍/100㎖, 46.2+15.3 ㎍/100㎖, 46.8+12.1 ㎍/100㎖ and 26.2+10.2 ㎍/100㎖, the mean value of blood ZPP of those workers were 53.6+32.6 ㎍/100㎖, 108.1+87.1 ㎍/100㎖, 98.9 +54.9 ㎍/100㎖ and 45.8+19.5 ㎍/100㎖ respectively. 3) The percents of lead workers whose blood lead were 40-59.9 ㎍/100㎖ and over 60.0 ㎍/100㎖ were 17.6% and 2.1% respectively. Those whose blood lead were 40-59.9 ㎍/100㎖ and over 60.0 ㎍/100㎖ were 15.18% and 0.96% for type 1, 43.59% and 21.79% for type 2, 58.89% and 12.22% for type 3 and 11.82% and 0% for type 4 respectively. 4) The percents of lead workers whose blood ZPP were 100-149 ㎍/100㎖ and over 150 ㎍/100㎖ were 5.17% and 3.17% respectively. Those whose blood ZPP were 100-149 ㎍/100㎖ and over 150 ㎍/100㎖ were 4.66% and 2.04% for type 1, 10.26% and 25.64% for type 2, 23.33 and 13.33% for type 3 and 1.28% and 0.32% for type 4 respectively. 5) The prevalence rate of smoking and drinking of male lead workers in all lead industries were 70.8% and 71.0% respectively. While the mean blood lead of smoker, non-smoker, drinker and non-drinker were 30.24+12.58 ㎍/100㎖, 28.35+12.7 ㎍/100㎖, 30.24 ㎍/100㎖ and 28.74 ㎍/100㎖ respectively, the mean blood ZPP of those were 55.7+37.1 ㎍/100㎖, 58.4+41.9 ㎍/100㎖, 55.7+36.5 ㎍/100㎖ and 58.4+43.3 ㎍/100㎖ respectively. 6) While the correlation of hematocrit corrected blood lead with other lead exposure variables were higher than non-corrected blood lead, the correlation of log-transformed ZPP with other lead exposure variables were higher than non-corrected blood ZPP. 7) The most frequent symptom among 15 lead related symptom questionnaires was 'general fatigue' and the next one was 'feeling irritated with disturbance' and least one was 'acute abdominal pain around the umbilicus' in all lead workers. The overall prevalence of lead workers in storage battery industry and primary lead smelting industry were higher than secondary lead smelting and PVC stabilizer making industries. 8) The prevalence of lead related symptoms was a little higher in 13 symptoms in smokers than non-smokers and in 14 symptoms in drinker than non-drinkers, but they were not statistically significant. 9) Stepwise multiple regression analysis, using overall symptom prevalence as a dependent variable blood lead, blood ZPP, hemoglobin, age, work duration, drinking and smoking habits as independent variables, indicated that smoking habit, drinking habit and age were significantly contributed to the dependent variable. 10) The slopes of simple linear regression of blood lead (independent variable) with blood ZPP and log-transformed ZPP as dependent variable were different among 4 types of lead industries. The slope of lead industries with low mean blood lead were less steeper than those with high mean blood lead.

Factors Associated with Indeterminate and False Negative Results of QuantiFERON-TB Gold In-Tube Test in Active Tuberculosis

Cho, Ki-Won,Cho, Eun-Ha,Kwon, Soo-Hoon,Im, Sang-Hyuk,Sohn, In,Song, Sook-Hee,Kim, Hye-Ok,Kim, Su-Hyun The Korean Academy of Tuberculosis and Respiratory 2012 Tuberculosis and Respiratory Diseases Vol.72 No.5

Background: The sensitivities and specificities of interferon-gamma release assays (IGRAs) vary among different population studies, and the data on the routine use of IGRAs are limited. The aim of this study was to evaluate the role of QuantiFERON-TB Gold In-Tube (QFT-GIT) test in the diagnosis of active tuberculosis. Methods: We conducted a prospective study, enrolling 77 patients with suspected pulmonary tuberculosis (TB), at a secondary care teaching hospital in Seoul. Results: In total, 12 (15.6%) patients showed indeterminate results due to positive control failure on the QFT-GIT test. Indeterminate results were significantly associated with the elderly, history of the intensive care unit stay, lymphocytopenia, especially low CD4 count, increased C-reactive protein and decreased protein levels. Of the 77 patients, 44 (57.1%) were diagnosed with active pulmonary tuberculosis, and the percentage of false negative results of the QFT-GIT was 36.4% (vs. 31.8% with TST). In the TB group with >65 years old (n=12), the proportions of the indeterminate (33.3% vs. 3.1%) and the false negative results (58.3% vs. 25.0%) of the QFT-GIT were significantly higher than in the younger TB group (n=32). Conclusion: Indeterminate and false negative results of QFT-GIT test were not infrequent in tuberculosis, especially in the elderly. Care should be considered for the interpretation with the elderly, immunocompromised, chronic and severely diseased patients.

스티렌 폭로 근로자들의 기중 및 혈중 스티렌과 요중 만델산의 관계 분석

정호근,강성규,양정선,김기웅,이종성,조영숙,박인정 大韓産業醫學會 1994 대한직업환경의학회지 Vol.6 No.1

The concentration of styrene in air in blood and mandelic acid in urine were checked for the 60 workers with normal liver function, exposed to styrene. Styrene in air were sampled with personal air sampler at least 4 hours and analyzed by gas chromatography. Blood and spot urine were collected at the end of shift with a vacuum tube and a polythylene bottle and analyzed by gas chromatography and high performance liquid chromatography. Means of air and blood styrene and urine mandelic acid were 8.16 ppm(geometric mean), 0.199 mg/L, and 0.519 g/g creatinine, respectively. The concentration of styrene in air and mandelic acid in urine were high in the FRP factories and low in polymerization factory. Styrene in blood showed large difference by the working process. Styrene in air showed a good correlation with mandelic acid in urine(r=0.6369) and styrene in blood(r=0.6371). The mandelic acid in urine and styrene in blood corresponded to exposure of 50 ppm styrene were 0.890 g/g creatinine and 0.434 mg/L. However, hippuric acid in urine did not show any correlation with styrene in air. Urine mandelic acid excretion expected ratio showed a tendency to decrease according to obesity index and to increase with alcohol consumption.

공단지역과 청정지역에서 재배되는 농작물과 토양중 중금속함량 비교

이인숙,김동현,조영채 忠南大學校 環境問題硏究所 1995 環境硏究 Vol.13 No.-

This study was performed to investigate the degree of pollution and the relationship of heavy metal contents in crops and soils collected from unpolluted area of Cheong yang-gun and industrial complex areas of Taejon-city, Cheong ju-city, Cheon an-city, On yang-city from 1, August to 30,September, 1994. 4 industrial complex areas were divided into the area within industrial complex, the area of 1Km and 2Km distant from the industrial area. The author collected 6 kinds of crops(perilla leaf, chinese cabbage, radish, sweet potato, guinea pepper, and egg plant) and their soils from each areas and measured 7 items of heavy metals (Cd, Pb, Cr, Ni, Zn, Mn, Cu) by I.C.P. (Inductively Coupled Plasma Emission Spectroscopy). pH was also measured in soil samples. 1. In the crop samples, the average contents of Pb, Cr, Ni, Mn, and Cu were significantly increased in the industrial complex areas as compared with those in the unpolluted area. In the perilla leaf(Pb, Cr, Ni, Mn, Cu), chinese cabbage(Cr,Ni,Cu), radish(Pb, Cr, Ni, Cu), sweet potato(Pb, Cr, Ni, Zn, Cu), guinea pepper(Pb, Cr, Ni, Mn) and egg plant(Pb, Cr, Cu) the content of heavy metals of industrial complex areas were significantly increased as compared with those in unpolluted areas, Cheong yang-gun. 2. In the soil samples, the average contents of Cd, Pb, Cr, and Cu were also significantly increased in the industrial complex areas as compared with those in the unpolluted area, and Mn was significantly increased in the unpolluted area as compared with those in the industrial complex areas. 3. In the crop and soil samples, the average contents of Cd, Pb, Mn, and Cu were significantly increased in the soils as compared with those of the crops. However, the concentration of Cr in the crops was higher than that in the soils. 4. The contents of heavy metals in crops and soil showed decreasing tendency acording to the distance from the industrial complex area. There was a significant positive correlation beteen the contents of Zn, Mn and Cr in crops and soils. 5. The pH did not show a large difference by geographical location, and it maintained between pH 5.0 and pH 8.0.

韓·美·日 老人住宅硏究의 방향

신경주,조재순,곽인숙,최정신 漢陽大學校 韓國生活科學硏究所 1995 韓國 生活 科學 硏究 Vol.- No.13

The purpose of this research was to trace the trends in the research subjects related to housing for the elderly in Korea, U.S.A, and Japan. One hundred sixty eight researches were selected from six research journals besides Masters' and Ph. D theses published in Korea, 164 from five research journals and three research subject-lists in Japan, and 124 from three research journals in U.S.A. There were some common research areas of the elderly housing among the three countries such as facilities required for the elderly housing, general issues of the elderly housing, etc. There was some differences in the research areas. For instance, intergenerational coresidence was mainly studied in Korea. The results showed that housing policies as well as research methods related to the elderly housing are beginning areas and must be further developed to meet the rising needs of housing for the elderly in Korea.