정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

임호박수검(林湖朴守儉)의 트라우머와 장자철학(莊子哲學) -치유담론으로서의 『장자』에 대한 역사적 사례-

김종수 ( Jong Soo Kim ) 영산대학교 동양문화연구원 2013 동양문화연구 Vol.15 No.-

17세기 중.후반을 주요 활동기로 삼았던 임호 박수검은 제천에 연고를 둔 노론계의 관인.유자였다. 수학기 적부터 자자한 문명을 떨쳤던 박수검은 20세 때에 진사초시에 합격하는 영예를 안았다. 그러나 이후 약20여 년간에 이르는 온갖 집안의 불행사들로 인하여 박수검의 과거 합격은 무한정 지연되어 가고만 있었다. 마침내 박수검은 뒤늦은 나이인 44세때에 과거에 급제하였으나, 이미 그의 영혼은 심각한 트라우머에 시달리고 있었다. 때문에 주로 한직과 외직을 전전했던 박수검의 관직생활은 단순한 생계유지의 수단 그 이상의 의미를 발휘하지 못했다. 대신에 박수검은 웅장한 경세에의 포부가 좌절된 데 따른 트라우머로 인하여 늘상 방황하는 모습을 연출하고 있었다. 박수검은 그런 자신을 ?『장자』? 속의 중증 장애인인 지리소로 비유하곤 하였다.그런 점에서 수학기 적에 만난 세 번째 스승인 무하옹 이준남은 박수검이 닮아야 할 동일시 모델로 다가섰고, 또한 텍스트 ?『장자』?를 매개.인도케해준 중요한 인물이었다. 박수검이 구축한 장자철학은 <장자소요유제물론이편주해서>로 대변되는 텍스트 ?『장자』?에 대한 해석과 시료로서 ?『장자』?를원용한 두 국면을 형성하고 있다. 전자가 정주학적 세계 구도인 음양.오행론과 역학적 사유가 묘하게 결부된 주해 방식을 선보여 주었다면, 후자의경우 자신의 트라우머를 드러내고 해소.치유하기 위한 의식적 노력과 결부되어 있다. 또한 두 국면 모두 『주역』의 복괘에 내함된 생의[陽]가 투사되어 있는바, 이는 트라우머의 치유를 위한 박수검 나름의 치열한 노력이반영된 결과였다. 그러나 박수검은 끝끝내 자신 안에 각인된 트라우머를 치유.승화시키는 단계로까지는 진입하지를 못했다. 박수검의 경우 ?『장자』?혹은 장자철학이란 자아 성찰과 세계 확장이라는 새로운 두 계기를 제공해주었으나, 궁극적인 치유담론으로 기능하지는 못한 것 같다. Imho(林湖) Park Soo-geom(朴守儉) could not pass an examination to become a government officer because of various misfortunes which continued for more than 20 years on him. He at last passed a government examination for government officer at the late age of 44 years old; however, his soul was already suffering serious trauma. Therefore, the government officer position of Park Soo-geom was just a way to make ends meet. Park Soo-geom always wandered because of the serious trauma caused by the frustration coming from the failure to realize the big aspiration he had held as a government officer. He frequently compared himself to Jiriso(支離疏), who is a seriously disabled person appearing in the book, Zhuangzi(莊子). The philosophy of Zhuangzi philosophy established by Park Soo-geom can be seen in his two writings quoting the book Zhuangzi as the material for his poetry and his preface on the two annotations on Soyoyoo (逍遙遊) and Jemullon(齊物論) in the book Zhuangzi(莊子逍遙遊齊物論二篇註解序). However, Park Soo-geom could not reach the stage of healing and sublimation of his internal trauma with deep source until the end. Consequently, the philosophy of Zhuangzi established by Park Soo-geom provided him with two opportunities of self-introspection and world-expansion; however, it seems it could not function as an ultimate discourse on healing

임호(林湖) 박수검(朴守儉)의 생애와 저술 양상

김종수 ( Kim Jong-soo ) 한국유교학회 2012 유교사상문화연구 Vol.50 No.-

향리인 제천의 만지곡에서 출생한 임호 박수검은 17세기 중후반을 전후로 한 관료이면서 사상가였다. 고려 왕족의 후손인 박수검은 효성과 학문을 중시한 전래의 가풍 속에서, 일찍부터 독서에 눈을 뜨기 시작했다. 이어지는 수학기 동안에 박수검은 순차적으로 조석윤ㆍ이영선ㆍ이준남ㆍ송시열 등의 문하에서 학업을 연마하는 행운을 누렸고, 자연히 임호는 원근을 막론하고 조기에 문명을 떨칠 정도의 실력을 배양하게 되었다. 그런데 박수검은 비교적 이른 시기에 과거 공부에 착수하였으나, 실제 그 가문과 급제한 나이는 뒤늦은 44세 때였다. 이후 박수검은 내직과 외직을 두루 거치는 사환기에 접어들게 되었으나, 남인과 뚜렷한 대립각을 곤두세웠던 그의 서인 노론적 당색으로 인해 잦은 환로의 부침을 경험하기에 이른다. 특히 박수검은 기사환국 직후에 고향 제천으로 낙향, 몇 년간에 걸쳐서 이른바 의림경영에 돌입하기도 했다. 그런 와중에서도 박수검은 경학과 역사학, 역학 과 장자철학 둥을 아우르는 일련의 저술을 추진해 나감으로써, 학자 본연의 자세를 망각하지 않았다. 박수검이 남긴 저서 목록인 『진사통고』ㆍ『중용석의』ㆍ『장자소요제물론이편주해』ㆍ『참동계교정』ㆍ『절위여편』과 문집인 『산일여편』등은 관직 생활을 하는 와중에서 저술된 결실로서, 임호의 치열한 학자적 탐구 노력을 반증해 준다. 특히 박수검은 一理 혹은 理原을 철학적 화두로 설정한 가운데, 자신의 전 저서들 속에 이 물음을 투영시켜 두었음이 주목된다. 이같은 정황은 박수검의 사상적 착지점이 근본 정주학자였다는 사실을 뚜렷이 확인시켜 주고 있다. Park Soo-geom was born in a country village, Jecheon (堤川). He was the posterity of Goryeo royal family and experienced the invasion of Ching (丙子胡亂) in person. Park Soo-geom studied until the age of 40 under the scnolars who succeed the tradition of Giho school neo-Confucianism (畿湖性理學) such as Jo Seok-yoon (趙錫尹), Yi Yeong-seon (李榮先) and Song Si-yeol (宋時烈). Accordingly, the academic school and political position of Park Soo-geom were defined as Seoin (西人) Norongye(老論系). Park Soo-geom passed examination for government officer (科擧) when he was 44 years old; however, his career as a government officer was not successful. He had frequent conflicts with Namin (南人) and he ended up resigning government position and returned to home village. Meanwhile, Park Soo-geom authored Jinsatonggo (震史通考), Jungyongseokeui (中庸釋義), Chamdonggyegyojeong (參同契矯正) and Jeolweeyeopyeon (絶韋餘編). He also published annotation (註解書) on Zhuangzi (莊子). Like this, the academic world of Park Soo-geom was quite extensive accommodating historical studies, jingxue (經學), yixue (易學) and Zhuangzi (莊子) philosophy. These books share the characteristic of exploring me topic or chengzhuxue (程朱學) represented by yili (一理).

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

遲延再植 時 齒根處理에 따른 齒周組織의 治癒에 關한 硏究

김종여,김종수,김용기,임성수 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.1

The purpose of this study was to analyze comparatively the effect of various root pretreatments prior to delayed replantation. Total 6 beagle dogs were used for the experiment and 8 teeth per each animal were treated by several prepared regimens before replantation. After 3 & 6 weeks of experimental periods, animals were sacrificed by perfusion method. The results obtained form the present study can be summarized as follows: 1. All root pretreatment regimen used in this experiment showed effectiveness in the periodontal repair of delayed replanted teeth. 2. The teeth treated by the regimen of stannous fluoride combined with tetracycline revealed more favorable tissue response and less frepuent root resorption or ankylosis than other groups. 3. The long term effect of Group Ⅳ-regimen seems to be worth further study since the result at 6-weeks showed the significant progress in periodontal healing when compared to 3-week result which was not indicated in any other group.

Callus distraction method를 이용한 하악골 신장술 : 계단골절단술식의 적용

김명진,윤필영,신동준,김수경,김종원,김규식 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regeneracted bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1974 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.

2000년 시드니 올림픽 유도경기 대비 세계 우수선수들의 개인별 기술 및 패턴에 관한 연구 : 남자선수를 중심으로

김종달,김규수,한성철,최종삼,윤익선,조용철,김의환 용인대학교 무도연구소 2000 武道硏究所誌 Vol.11 No.1

The purpose of this study was to analyze international contest levels and the competition techniques traits of each category, individual scoring - losing techniques of world elite judokas who were awarded in the international judo tournaments (I.J.T.) (part 1: ~O.G '96, part 2 :from O.G '96 to July, 2000), and who are expected to participate in the 27th Olympic Games(O.G.) Sydney 2000 to prepare the 27th O.G. which will be held from 16. to 22. September 2000 at Exhibition (Center, Darling Harbour, in Sydney, Australia The records of the results and contents of competition were obtained out of (115 for man,) I.J.T., world elite judokas. To decide individual contest levels, groups were derided into 3(A,B,C)groups and points were graded by 3 ways. The I.J.T. that were derided into 3 groups are shown in the table 1.

MCR에 의한 혐기성 소화에 대한 암모니아의 영향

김양지,김춘미,김성일,김종수 선문대학교 ·중소기업기술지원연구소 2002 선문공대 연구/기술 논문집 Vol.7 No.1

혐기성 소화에서 미생물에 저해/독성 물질로 알려진 암모니아의 농도와 식종원에 따른 영향을 MCR(Master Culture Reactor)을 이용하여 회분식으로 분석하였다. 식종원은 축간농가 축산폐수 집수조의 침전슬러지 그리고 하수종말처리장 혐기성 소화조 잉여슬러지를 사용하였다. 식종원에 상관없이 암모니아는 1,500㎎NH_4-N/L에서 COD 제거율과 가스생성율로 측정된 혐기성 미생물의 활성에 저해영향을 주기 시작하여 2,500㎎NH_4-N/L에서 더욱 심하였다. 암모니아 저해 농도 범위에서 휘발성 유기산의 농도는 50㎎/L 범위로 유지되므로 메탄생성균 뿐만아니라 산생성균도 저해영향을 받는 것으로 나타났다. 축산폐수 집수조 침전슬러지로 식종된 경우 암모니아 2,500㎎NH_4-N/L 농도 범위 이상으로 운전하여도 COD 제거율과 가스생성율은 일정하게 나타났지만 하수종말처리장 혐기성 소화조 잉여슬러지로 식종된 경우 암모니아 농도가 증가할수록 COD 제거율과 가스생성율은 감소하였다. 결과적으로 암모니아에 장기간 순응된 축산폐수 집수조의 침전슬러지로 식종한 경우 암모니아의 저해 농도에 대하여 적응도 빨랐으며 저해영향도 적음을 알 수 있었다. The influence of ammonia and the sources of seeding on anaerobic digestion were investigated by batch operation of MCR(master culture reactor). The sources of seeding on anaerobic digestion were from swine wastewater collection pit and anaerobic digestion sludge of a municipal sewage treatment plant. The inhibition effects of ammonia on anaerobic microorganisms were initiated at ammonia concentration of 1,500 ㎎NH_4-N/L and the effects were increased by increasing ammonia concentration upto 2,500 ㎎NH_4-N/L regardless the sources of seeding as evidenced by decreases in COD removal efficiencies and biogas yields. The inhibition occurred to not only methanogens but also acidogens since the concentration of volatile fatty acids was maintained at 50 ㎎/L during the batch operations of MCR. The COD removal efficiency and biogas yield were maintained constantly while increasing ammonia concentration upto 2,500 ㎎NH_4-N/L when swine wastewater collection pit was used as seeding; however, those were decreased while increasing ammonia concentration when anaerobic digestion sludge was used as seeding. The results indicate that the seeding acclimated to high concentrations of ammonia for long time was easy in adaptation to high ammonia concentration and less subjective to ammonia inhibitory effects.

항암제 처리한 백혈병 세포주에서의 Apoptosis 발현

김삼용,윤소현,김현수,김종숙,윤환중,김진경,조덕연 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The bcl-2 proto-oncogene encodes a 26 kD protein that promotes cell survival by blocking apoptosis. The bax protein is a member of the bcl-2 familly, now known to form heterodimers with the bcl-2 protein. The ratio of bax to bcl-2 is be critical in determining the fate of the cell in response to stimuli that can induce apoptosis. Extract of Pulsatilla Koreana (SB-31) showed promising antitumor activity in vitro with Topo I inhibitory action. In the present study, the relationship between apoptosis and the apoptosis related proteins, bcl-2 and bax were investigated in human leukemic cell lines HL-60, U-937 and CEM-CM3. All anticancer drugs(adriamycin, etoposide, camptothecin, SB-31) induced extensive apoptosis in HL-60, U-937 cells and CEM-CM3 cells. The expression of bcl-2 and bax protein were determined in cell lines by western blotting before and after incubation with anticancer drugs at different time points. 1) In HL-60 or U-937 cell lines, down regulation of bcl-2 and up-regulation of bax were found after incubation with ADR, VP-16 or camptothecin. 2) In HL-60 or U-937 cell lines, no significant change in bcl-2 or bax protein expression resulted after incubation with SB-31. 3) In CEM-CM3 cells, virtually no change was noted in bcl-2/bax expression after incubation with ADR, VP-16, camptothecin or SB-31. It is suggested that different leukemic cell lines use different pathways of apoptosis activation and a given cell may utilize different pathways of apoptosis activation in response to different cytotoxic agents.

의무고용제도 재설계 방안

김종진,장창엽,유완식,김언아,이정주,류정진,강필수,최종철,남용현,김윤삼 한국장애인고용촉진공단 고용개발원 2008 연구개발 Vol.- No.2

현행 우리나라 의무고용제도는 장애인구의 급격한 증가, 장애인차별금지 및 권리구제 등에 관한 법률의 도입 등 외부환경변화에 신축적으로 대처하지 못하고, 경증장애인 중심으로 의무고용제도가 운영됨으로써 중증장애인의 고용배제가 우려되고 있다. 본 보고서는 이러한 문제점을 해결하기 위해 의무고용제도의 일자리 확대와 고용증가를 통해 중증장애인의 고용기회를 확대할 수 있는 정책방안을 제시하기 위한 것이다. 본 보고서는 (1)의무고용 사업체의 의무고용 산정인원에서 자립장애인 제외 (2)현행 2% 의무고용률을 3%로 상향 조정 (3)사업체가 고용하는 중증장애인에 대한 더블카운트(2배) 가산제도 도입 (4)의무고용률 미달 사업주에 대한 부담금 차등징수의 4가지 정책방안, 제도 합리화 차원에서 장려금 지급방식의 개선과 사업주의 장애인에 대한 인식개선 방안을 제시하였다. 정책방안에 대한 영향분석 결과 의무고용 적용대상자에서 비장애인과 고용상 차별되지 않는 자립장애인(6등급)을 의무고용 산정인원에서 제외하는 경우 의무고용 사업체의 고용인원은 23,296명이 감소해 고용률은 1.35%에서 0.88%로 감소하였고, 의무고용 사업체의 장애인 일자리 수는 미고용인원의 증가로 15,152개가 증가하였다. 그리고 기금은 부담금이 631억원 증가하고, 장려금이 352억원 감소해 983억원의 수지개선 효과가 발생하는 것으로 나타났다. 의무고용 사업주의 의무고용률 3% 인상 방안은 의무고용률 상향 조정에 따른 미고용인원의 증가로 장애인의 일자리 수는 43,101개가 증가하고, 기금은 부담금이 1,709억원 증가하는 반면, 장려금은 293억원이 감소해 2,002억원의 수지개선 효과가 발생하는 것으로 나타났다. 의무고용 사업주가 고용하는 중증장애인을 2인으로 더블카운트 하는 중증장애인 가산제도의 도입은 의무고용 사업체의 장애인근로자가 67,261명에서 79,685명(1,2등급만 포함시 75,685명)으로 증가하여 고용률은 1.35%에서 1.60%(1.2등급만 포함시 1.52%)로 증가하고, 의무고용률 미달 사업체의 미고용 인원이 감소하여 2,745개의 일자리가 감소하였다. 그리고 기금은 부담금이 118억원 감소하는 반면, 장려금은 418억원이 증가해 536억원의 수지악화가 발생하는 것으로 나타났다. 의무고용률 미달 사업체의 고용유인을 위해 고용률 1.0%미만, 1.0-1.5%, 1.6-2.0% 미만에 대해 각각 20%, 10%, 5%의 할증률을 순차적으로 가중하여 부과하는 부담금 차등징수 방안(3차년까지의 효과임)은 1.0% 미만 사업주는 86만원, 1.0-1.5% 사업주는 64만원, 1.6-2.0% 미만 사업주는 58만원의 부담기초액을 부과할 때 고용률은 1.35%에서 1.53%로 증가(1.6-2.0% 미만 사업주는 의무고용률 2%를 달성)하고, 미고용인원의 감소로 장애인의 일자리는 8,836개가 감소하는 것으로 나타났다. 그리고 기금은 부담금이 58억원 감소하여 수지는 악화되었다. 이상의 네 가지 방안은 모두 장애인의 고용증대를 가져온다는 측면에서는 유효하지만, 장애인의 일자리 확대를 통한 중증장애인의 고용을 증대한다는 정책목표를 달성하는 데에는 한계점을 안고 있기 때문에 어느 한 정책만을 선택하기보다는 정책효과를 극대화하기 위해 정책결합(policy mix)을 이용하는 것이 바람직함을 제시해주었다. 즉, 의무고용 적용대상자 조정방안/의무고용률 상향조정 방안과 중증장애인 가산제도/부담금 차등징수 방안을 조합 또는 모두 동시에 선택하는 경우 의무고용 사업체의 장애인 일자리 수의 확대와 중증장애인 고용을 동시에 달성하고, 기금의 수지균형도 달성 가능한 것으로 나타났다. The mandatory employment quota system of Korea does not reflect the changing external factors such as the growing population of people with disabilities(PWDs) and the enactment of the Anti-discrimination Law for People with Disabilities. The current employment quota system focuses on people with mild disabilities thus excluding people with severe disabilities from employment. The purpose of this report is to propose a plan in order to increase employment opportunity for the severely disabled through the reform of the employment quota system. This report analyzes the following : (1) exclude grade 6 disability from mandatory employment quota (2) raise the employment quota from 2% to 3% (3) implement the double counting for employers that employ the severely disabled (4) differentiate the amount of levy collected from corporations that are unable to meet the quota. The aforementioned plans are useful in that they increase employment for people with disabilities. However, there are limitation to reaching the policy objectives by increasing jobs for people with severe disabilities. Therefore, to maximize the effects we should consider policy mix of these four policies. In other words, by mixing the policies of adjusting the employment quota target/raising the quota ratio and implementing the double count/differentiating the amount of levy, we can achieve the goal of increasing jobs for the severely disabled and maintain equilibrium between incomings and outcomings.