수입각증후군에 의한 급성 복증 1례

정은욱,지삼룡,이영태,박지훈,김동기,제인수,채두근,박성재,박은택,이연재,이상혁,설상영,정정명 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Afferent loop syndrome is an uncommon complication of a gastrectomy and Billroth Ⅱ reconstruction. It may cause symtoms at any time from the first postoperative day to many years after the gastrectomy. Afferent loop syndrome is characterized by abdominal pain, vomiting and elevation of serum amylase. Thus, it is difficult to differentiate afferent loop syndrome from other cause of acute pancreatitis. However, the history of gastrectomy can be an important clue for diagnosing afferent loop syndrome. We experienced one case of chronic afferent loop syndrome with acute pancreatitis. After appropriate management, the abdominal pain disappeared and serum amylase level decreased. We report this case with a review of relevant literatures.

혈중 및 호기 일산화탄소를 이용한 일산화탄소 헤모글로빈 농도간의 관련성 연구

김형수,박태혁,손지언,정갑열,김정만,김준연 동아대학교 2001 大學院論文集 Vol.26 No.-

This study was conducted to find a correlation between blood COHb and calculated COHb with expiratory air and related variables such as occupational and smoking factors. Author selected 69 healthy workers in 8 workplaces suspected CO exposure. Basic informations were collected by self-reported questionnaire and medical history taking. Author measured Indirect COHb concentration with expiratory air using Micro II-Smokerlyzer and blood COHb concentration using Oxymeter. The results of the study were summarized as follows : 1. In the smoker, mean blood COHb and calculated COHb with expiratory air were 2.21±0.98% and 2.27±0.97 %, and there was not a statistically significant difference. In the non-smoker, mean blood COHb and calculated COHb with expiratory air were 0.42±0.43 % and 0,65±0.30 %, and there was also not a statistically significant difference. 2. There were positive correlations between blood COHb and calculated COHb with expiratory air in both the smoker (r=0.91, p=0.0001) and non-smoker (r=0.73, p=0.0001). 3. In the smoker, the factors affected COHb were total smoking index (Pack × years) and passed time after the last smoking. 4. In the nonsmoker, the parking and driving groups had higher COHb concentration than others (p<0.05). In conclusion, there was no significant difference between indirect COHb concentration with expiratory air using Smokerlyzer and blood COHb concentration and there was a highly significant correlation between indirect and blood COHb concentrations. Therefore indirect COHb concentration with expiratory air is a useful screening method for CO exposure. Author suggest the resection of smoking during at least 90 minutes before measuring COHb concentration in order to exclude smoking effects.

치매방지 작업기구 사용이 항산화효소 활성에 미치는 영향

조경혜,박정은,윤지윤,문세보,박효영,정인옥,이정원 서울여자대학교 자연과학연구소 2001 자연과학연구논문집 Vol.13 No.-

We developed an occupational therapy tool to maintain and improve the cognitive function for the elderly who have senile dementia. 86 elderly people took a mininal mental state examination (MMSE) for the therapy to perform the occupational therapy, and divided into three groups based on avarage ages and MMSE values. The occupational therapy was treated three times per week for 10 weeks. The results showed that there were significant differences in the performing scores before and after the treatment ; the scores for the occupational therapy were increased significantly (p<0.001) and the performing time was shortened from 6-week throughout 10-week regimen. This study was to examine the effect on the activity of antioxidant enzymes by occupational therapy. The activities of antioxidant enzymes such as catalase, Glutathion-6-phosphate dehydrogenase (G6PDH), and superoxide dismutase (SOD) were increased to the normal standard by the occupational therapy for the elderly having dementia. The recovery of activities of antioxidant enzymes was obvious in severe demented elderly compared to those in normal or mild demented elderly. These results suggest that the occupational therapy had an beneficial effect on the protection against the oxidative stress especially for severe demented elderly, and the occupational tool need to be modified so as to improve the protection against the oxidative stress for normal and/or mild demented elderly.

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.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

흥미로운 구조를 가진 Dipyrrolylbenzene들의 합성에 관한 연구

정대일,김인식,정두희,박철우,김윤영 東亞大學校 大學院 1996 大學院論文集 Vol.21 No.-

1-(2-Aminophenyl)pyrrole 20a and 1,2-dipyrrolylbenzene 17a were synthesized by using 1,2-phenylenediamine 16a with 2,5-dimethoxytetrahydrofuran 12 in glacial acid. 1-(3-Aminophenyl)pyrrole 20b and 1,3-dipyrrolylbenzene 17b were obtained by using 1,3-phenylenediamine 16b with 2,5-dimethoxytetrahydrofuran 12 in glacial acetic acid. 1,4-Dipyrrolybenzene 17c was synthesized by using 1,4-phenylenediamine 16c with 2,5-dimethoxytetrahydrofuran 12 in glacial acetic acid. Aminophenylpyrroles 20 and dipyrrolylbenzenes 17 were respectively synthesized by the treatment of 1,2-phenylenediamine 16a, 13-phenylenediamine 16b, 1,4-phenylenediamine 16c and 2,5-dimethoxytetrahydrofuran 12 in no solvent, acrylic acid, silica-gel, acrylic acid + silica-gel + acetic acid instead of glacial acetic acid. In case of silica-gel + acetic acid among various methods reactivity about synthesis of dipyrrolylbenzene 17 was best. 9-Phenylcarbazole 15 was synthesized by treatment of 1-phenylpyrrole 13 with 2,5-dimethoxytetrahydrofuran 12 in glacial acetic acid.

농산물 소독과정에서 브롬화메틸에 노출된 근로자에게 발생한 신경병 2례

박태혁,김정일,손지언,김종국,김형수,정갑열,김준연 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목적 : 농산물 소독과정에서 브롬화메틸에 노출된 근로자에게 발생한 신경병 2례 보고. 방법 : 피로감, 전신무력감, 어지럼증, 보행장애 등의 증상을 주소로 내원한 브롬화메틸을 사용하여 방역작업에 종사하는 건강한 20세와 18세의 근로자를 대상으로 혈액검사, 신경정도 및 근전도검사, 뇌자기공명영상 등의 임상검사와 작업력조사를 시행하였다. 결과 : 1례에서 뇌자기공명영상에서 연수와 소뇌의 양측 측충부의 고신호강도가 관찰되었고 11일 후의 추적조사에서 동일 부위의 고신호강토가 감소된 소견이 관찰되었으며 뇌병증으로 최종 진단되었다. 다른 1례는 신경전도검사에서 다발성 신경병 소견과 뇌유발전위검사에서 우측 하부 뇌간부위 병소가 관찰되었고 뇌병증 및 말초신경 병으로 최종 진단되었다. 결론 : 근로자들의 증상은 소독과정에서 브롬화메틸 노출로 인한 신경 병으로 판단되며 훈증소독과방역작업에 종사하는 근로자들의 실태조사와 안전에 대한 대책이 시급하다고 하겠다. Objectives : To report two cases of neuropathy due to methyl bromide intoxication. Methods : Workers, engaged in the fumigating process, complained fatigue, general weakness, ataxia, and hypersomnia. We evaluated them with blood tests, neurophysiologic studies and MRI and investigated their occupational history. Results : Increased signal intensities were found in the medulla oblongata and paraver mian of cerebellum in MRI and after 11 days, high signal intensities were reduced in the following MRI. In the other case, polyneuropathy and rlght lower brainstem lesion were observed In the NCV and BAEP studies. Conclusions : We confirmed that worker's symptoms were related to methyl bromide exposure in the fumigation. It is necessary that we should evaluate present condition of fumigating process and prepare appropriate methods to protect workers engaged in the fumigation.

Zr 신합금 핵연료피복관 제조단계의 미세조직, 집합조직 및 부식특성

朴政容,鄭龍煥,鄭然浩 대한금속재료학회 2002 대한금속·재료학회지 Vol.40 No.12

Microstructure characterization, texture measurement and evaluation of corrosion properties were performed at various manufacturing steps from TREX to final tube for advanced Zr fuel cladding tubes. From the result of corrosion test in steam at 400℃, it was found that the corrosion behavior at the early stage was highly affected by crystallographic texture and the corrosion resistance increased when (0002) texture normal to the corrosion surface was well developed. However, the effect of texture on the corrosion behavior decreased when oxide thickness increased. It is suggested that the texture of Zr alloy plays an important role in corrosion behavior at the early stage though the corrosion behavior is dominated by oxide characteristics when thick oxide was formed.

건강한 성인에서 발병한 칸디다와 연관된 위궤양 1례

박지훈,이상혁,김희,이재호,박성재,지삼룡,양성연,박은택,이연재,설상영,정정명,강미선 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Fungus such as Candida albicans is a normal flora that is frequently found in the oral cavity, gastrointestinal tract, genitourinary tract, vaginal mucosa in a normal person. However, candida can cause opportunistic infection in an immune compromised host. Candidiasis has broad spectrum of disease from mucocutaneous infection to invasive or disseminated infection. But, it is rarely reported that candida is associaed with gastrointestinal tract disease in a healthy adult. The case of gastric ulcer associated with candida particularly in a health adult is reported with relevant literature.

지르코늄 핵연료피복관의 부식에 미치는 내부압력의 영향

박정용,김선기,정용환,정연호 대한금속재료학회 2004 대한금속·재료학회지 Vol.42 No.1

Effect of the internal pressure on the corrosion behavior was investigated for the Zr nuclear fuel cladding tubes which were pressurized up to 2500 psi using Ar gas and corroded in steam of 1500 psi at 400℃. It was found that corrosion resistance of Zr fuel cladding tube was decreased with increasing the internal pressure although corrosion behavior at the early stage was similar irrespective of internal pressure. X-ray diffraction result on the oxide showed that crystal structure was not affected by the applied pressure of 2500 psi. SEM observation on the oxide surface revealed that a number of cracks elongated in axial direction were propagated from surface to interior in the case of 2500 psi. The degradation of corrosion resistance with internal pressure was attributable to the extensive cracking at the oxide surface, which is thought to be originated from the difference of ductility between Zr alloy and oxide when Zr fuel cladding tube was deformed due to the applied internal pressure. However, the increase of corrosion rate with internal pressure was shown to be relatively small. It was therefore suggested that the crack induced at the surface did not propagate to oxide layer in the vicinity of oxide/metal interface which is known to be protective to oxygen diffusion and to control the corrosion behavior.