주요우울증이 근로자의 생산성에 미치는 영향 : WHO-HPQ(Health and Work Performance Questionnaire)를 이용한 예비연구

김원,황태연,함병주,이준석,최병휘,김세주,서용진,강은호,우종민 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Major depressive disorder (MDD) causes patients' distress and makes socioeconomic burden, both directly and indirectly. We used the concept of lost productive time (LPT) to estimate the indirect costs and calculated both absenteeism and presenteeism among workers with MDD. Mcthods : Depression group was recruited from workers visiting psychiatric outpatient clinic who had MDD without major physical or mental disorders (N= 106). Age and sex matched healthy control group was also recruited through advertisement (M=100). All participants completed a interview using WHO Health and Work Performance Questionnaire (HPQ), Job Stress Measurement Scale for Korean Employees, and Hamilton Rating Scale for Depression. Statistical analysis was performed with independent t-test or χ² test as characteristics of values (p=0.05). Results : The number of absence (0.94-day/month vs. 0.10-day/month, P=0.015) andthe numberofearly leaving (2.56-day/month vs. 0.24-day/month, P<0.001) were significantly higher in the depression group. Depression group evaluated their Perfor-mance level much lower than controls with significant value (5.16 vs. 7.62, P<0.001). In addition, depression group estimated their performance level during the last 4 weeks lower compared to the level of past 1-year (5.16 vs 6.63, P<0.001). The estimated costs of absenteeism in depression group were higher than controls by 2,520,000 Korean Won per year, and those of presenteeism were also higher by 4,880,000 Korean Won per year. The total costs of LPT in depression group were higher than controls by 7,400,000 Korean Won, which corresponds to 26% ofmean annual salary. In addition, the level of occupational stress, such as high demand and interpersonal conflict, was higher in the depression group. Conclusion : Major depressive disorder costs substantial productivity loss to workers and their company. Presenteeism imposes more time cost than absenteeism. Effectiveness trials are needed to devise cost-effective programs for the early detection and treatment of depression at the workplace.

일부 지역 주민에서 초기 신기능 저하의 지표로서 혈청 Cystatin C 농도의 유용성

원기범,김준섭,박준형,강혁주,이정호 동국대학교 의학연구소 2009 東國醫學 Vol.15 No.2

혈청 cystatin C농도는 혈청 creatinine농도에 비해 신기능을 정확히 반영한다고 알려져 있지만, 대규모 연구 자료가 제한적이었다. 따라서 저자는 다수의 일부 지역 주민을 대상으로 cystatin C를 creatinine과 비교하여 신기능의 지표로서 cystatin C의 유용성을 알아보고자 하였다. 2008년 7월부터 9월까지 포항지역의 건강 검진자 999명 (남자: 324명, 여자: 657명)을 대상으로 혈청 cystatin C, 혈청 creatmine, 나이, 체중을 측정하고, Cockcroft-Gault식으로 사구체 여과율을 계산하였다. 계산된 사구체 여과율을 National Kidney Foundation의 Kidney Disease Outcomes Quality Initiative (KDOQI)에서 제시한 만성 신장병 분류 기준에 따라 5단계로 분류하였지만 4단계 (중증의 사구체 여과율 저하) 및 5단계 (신부전 또는 투석) 에 포함되는 대상자들의 숫자가 적어 (4단계: 4명, 5단계: 1명) 연구 대상에서 제외하였다. 대상자들의 평균 나이는 52.1 ± 17.1 세, 평균 체중은 59.7 ± 11.3 Kg,평균 혈청 cystatin C농도는 0.9 ± 0.2 mg, 평균 creatinine 농도는 1.0 ± 0.2 mg/dL이었다. 사구체 여과율을 각 단계별로 비교해 본 결과는 다음과 같이 혈청 cystatin C농도는 1 단계 (정상 신기능)는 0.8 ± 0.1 mg, 2단계 (경도의 신기능 저하)는 0.9 U 0.1 mg, 3단계 (중등도의 신기능 저하)는 1.0 d=0.1mg로 각각 유의한 차이를 보였다 (p<0.05).혈청 creatinine농도는 1단계는 0.9 ± 0.2 mg/dL, 2단계는 0.9 ± 0.1 mg/dL, 3단계는 1.0 ± 0.1 mg/dL로 l단계와 2단계 간에 차이가 없었으나 (p>0.05), 2단계와 3단계 간에는 유의한 차이를 보였다 (p<0.05).혈청 cystatin C농도와 혈청 creatinine농도는 나이 (cystatin C: r=0.275, p<0.05; creatinine: r=0.300, p<0.05) 및 체중 (cystatin C: r=0.075, P<0.05; creatinine: r=0.162, p<0.05) 과 양의 상관 관계를 보였다. 혈청 cystatin C 농도는 성별 간의 차이가 없었고, 혈청 creatinine농도는 남성에서 유의하게 높았다. 혈청 cystatin C농도는 혈청 creatinine농도에 비해 초기 신기능 저하를 반영하는 유용한 지표라고 생각된다. Although serum cystatin C has been suggested to be a better alternative marker than serum creatinine for estimating renal function, there have been limited data about its superiority over creatinine in a large number of populations. The aim of this study was to evaluate cystatin C as a renal marker compared to creatinine in a large population of the local community. We measured serum cystatin C, creatinine, age, body weight from 999 volunteers (Male; 324, Female; 657) of a single local cohort, Phohang, from July to September, 2008, and then calculated the GFR according to Cockcroft Gault(CG) formula. The population was divided into five stages followed by the chronic renal disease classification presented by KDOQI. The numbers in stage 4 (severe renal impairment), and 5 (renal failure) were too small (4 in stage 4, 1 in stage 5) to perform statistical analysis, so we excluded them. The mean age was 52.1 ± 17.1, and body weight 59.7 ± 11.3 Kg; serum cystatin C 0.9 ± 0.2 mg/L; serum creatmine 1.0 ± 0.2 mg/dL; CG GFR 70.6 ± 19.1 ml/min/1.73 m^(2). The tests completed for the comparison among each stage suggested the following results; serum cystatin C levels in stage 1 (normal renal function), stage 2 (mild deterioration of renal function), and stage 3 (moderate deterioration of renal function) showed the significant differences (stage 1 vs 2: 0.8 ± 0.1 vs 0.9 ± 0.1, p<0.05; stage 2 vs 3: 0.9 ± 0.1 vs 1.0 ± 0.1, p<0.05). Serum creatinine levels showed no significant differences between stage 1 and stage 2 (stage 1 vs 2: 0.9 ± 0.2 vs 0.9 ± 0.1, p>0.05), but showed significant differences between stage 2 and stage 3 (stage 2 vs 3: 0.9 ± 0.1 vs 1.0 ± 0.1, p<0.05). Serum cystatin C and creatinine presented positive correlation between age (cystatin C: r=0.275, p<0.05; creatinine: r=0.300, p<0.05) and body weight (cystatin C: r=0.075, p<0.05; creatinine: r=0.162, P<0.05). Serum cystatin C levels showed no significant difference in sex, but serum creatinine levels were significantly higher in men than women. Serum cystatin C level is suggested to be more useful parameter than serum creatinine level to evaluate early renal impairment.

대장-직장암에서 Cyclooxygenase-2의 발현

강원경,천준성,장세진,조현민,천성원,안창혁,오승택 대한대장항문학회 2004 Annals of Coloproctolgy Vol.20 No.2

독성물질의 세포사 기전 및 세포사 유발물질의 검색법 개발에 관한 연구(Ⅰ) : 독성물질로 인한 파킨슨병 모델에서의 세포사 기전 연구 Study on the cell-death mechanisms of toxin-induced parkinsonism

강태석,김종민,서경원,김영옥,김준규,오재호,이윤동,김규봉,오정자,송연정,임종준,전범석,문전옥,최광식 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-

MPTP 독성물질이 도파민성 신경세포에 선택적으로 작용하여 산화성 손상에 의한 신경세포사를 일으키는 것을 이용하여 파킨슨병의 동물모델을 만들고, 이를 통해서 아폼토시스를 비롯한 포사의 기전에 대한 연구 및 너코틴의 신경세포 보호효과 여부를 판정하는 실험을 병행하고자 하였다. 파킨슨꾐의 동물모델을 MPTf 독성 물질을 이용하여 확립하였으며, MPTP(30mgag, i.p.)를 투여한 후 1, 2,3, 4, 5일째 흑질 조직을 채춰하여 tarm로 박걸하여 tyrosine hydroxylase 면역조직화학염색을 수행하여 cell countif우한 결과, control은 57.635ce11s, 1일째 친.OfDells,2일째 57.9±6cells,3일릴 없.3±죠ells, 4일째 49.0츠3cells, 5일째 39.4±Scells료 4, 3일째 뚜렷한 신경세포 수의 감소를 보였다. 신경세포사 기전 규명을 위한 아폼토시스 분걱에서는 벼PTP 투여 후 1, 2, 3, 4, 5일째 조직을 채취하여 Hoechst staining, TUNEL staining을 수곡하였는데 양성 반응을 보인 신경세포는 관찰되지 않아. 아폼토시스로 인한 세포사가 관찰되지 않았다. bIPTP 파킨슨병 동물모델에서 nicotine 보호효과 탐색에 관한 실험은 nicat푸e 0.2mgAg을 5일 퐁안 투여 후 리『fP(30mgag)를 CS7Bt/6 마은스에 복강 내주사로 nicotine과 병용 투여한 후 1, 2, 3, 4, 5일째 뇌를 적출하땄다. 신경세포사가 뚜렷이 관찰되기 시작하는 4, 5일째의 신경세포 수의 감소 정도를 20. 30% 정도 약화시키는 경향을 보였으나, nicotine 보호효과에 대한 추가 실헝이 현재 수행 중에 있다. The cause of Parkinson's disease (PD) is largely unknown. However, free radical toxicit? may plaf a role ip. the degeneration of substantia nigra, which is the Hajorfocus of pathological damages in PD. Recently, a neuroprotective effect of nicotine in PD has been suggested. Therefore, the mechanism of neurodegenerafion and protective potential o( nicotine in PD were investigated in the experimental modeB of Pll using a neurotoxin, C57BL/6mice were administered with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 30 mg/kg,j.p.). The degree of neurodegenerafion was determined by immunohistochemical stainiHB oftyrosine hydroxylase (TH). TH-positive cells on nigral sections were found 56.0 ±4, 57.9 ±6,52.315ce11s, 49.0±3cells, and 39,4±Scells at days 1, 2, 3, 4, 5, respectively (controls : 57.6±Scells). Hoechst and TUNEL staining showed no evidence of apoptosis. The exandnation on themice co-adrunistered with nicotine(0.2mgAg) and MPTP(30mgag) revealed a tendency ofnicotine protective effects. At days 4 and 5, the degree of TH-positive cells was decreased by20-30%, In corclusiffn, the role of apoptosis was not evidenced in this MPTP modeB of PB.The possible proteccon by nicotine should be elucidated with further studies.

표준 원자력발전소 확률론적 안전성 평가의 인간 신뢰도 분석 평가

강대일,정원대,양준언 한국안전학회 2003 한국안전학회지 Vol.18 No.2

Based on ASME probabilistic risk assessment (PRA) and NEI PRA peer review guidance, we evaluate a human reliability analysis (HRA) in probabilistic safety assessment (PSA) for Korea standard nuclear power plants, Ulchin Unit 3&4, to improve it performed at under design. The HRA for Ulchin Unit 3&4 is assessed as higher than Grade I based on ASME PRA standard and as higher than Grade 2 based on NEI PRA peer review guidance. The major items to be improved identified through the evaluation process are the documentation, the systematic human reliability analysis, the participitation of operators in the works and review of HRA. We suggest the guidance on the identification and qualitative screening analysis for pre-accident human errors and solve some items to be improved using the suggested guidance.

비정형 항산균의 한국산 다람쥐(Eutamias sibiricus asiaticus)에 대한 병원성에 관한 연구

姜媛淑,柳駿 大韓癩學會 1976 癩學 會誌 Vol.10 No.1

Efficacy of Intracytoplasmic Sperm Injection for Leukocytospermia

강희규,--,--,--,--,--,--,--,-- THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 2004 Journal of biomedical laboratory sciences Vol.10 No.1

White blood cells (WBCs) are present in most human ejaculates, but abnormally high concentration of seminal leukocytes map reflect an underlying pathological condition. The World Health Organization (WHO) has defined leukocytospermia as status of more than 10^(6) WBC/mL of semen. The purpose of this study was firstly, to compare the outcomes between conventional IVF and ICSl in leukocytospermia, and secondly, to investigate whether ICSI may be an alternation treatment for patients with leukocytospermia. Total 346 cycles of conventional IVF and ICSI candidates underwent IVF cycles at Eulji Hospital Infertility Clinic. Semen Parameters including concentration, motility, morphology of spermatozoa and concentration of leukocytes were assessed from the raw ejaculates. There was no difference in sperm concentration, motility and morphology. The rates of fertilization and good embryo development from ICSI were significantly higher than those from conventional IVF in leukocytospermia (60.4% & 32.5% respectively for ICSI group and 44.4% & 28.5%, respectively for IVF group, P<0.001). The pregnancy rate after ICSI was also higher than that from conventional IVF (34.0% vs 29.1%. P<0.05). These results indicate that the presence of seminal leukocyes (>1×10^(6) WBC/mL of semen) is adversely related with fertilization, embryo development and pregnancy rate. Therfore the measurement of seminal leukocytes in routine semen analysis appears to be of prognostic value with regard to male fertilizing potential. In conclusion. it is suggested that ICSI is an alternative choice of treatment for patients with leukocytospermia.

미세 골절 진달을 위한 초음파 C-scan의 활용 가능성

박원근,최민주,이원흠,이윤준,이헌주,강창익,박전홍 제주대학교 공과대학 첨단기술연구소 2001 尖端技術硏究所論文集 Vol.12 No.2

The study examines the medical potential of an ultrasonic C-scanning technique and for diagnosis of the fatigue induced micro-fractures of the bone. In general, it is not easy to detect the micro­fracture by a simple radiological technique. In the study, the micro­fractures were made on the tibia taken from pigs using a three point bending. Comparison was made between the ultrasonic C-scan images (25 MHz) and X-ray images of the bones with the micro-fractures, It was found that the micro-fractures invisible on the X-ray images were observed on the ultrasonic images. It is proposed further in-vitro and in-vivo studies making the ultrasonic C-scan technique clinically useful for the diagnosis of the fatigued induced micro-fractures of the bone which are not possible to detect by the conventional radiological method.

Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

편측안면경련의 미세혈관 감압술시 안면근전도의 수술중 감시 : 임상연구 Clinical Research

이강운,고원일,최영근,박주현,백민우,강준기 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.9