8년간(1992~1999) 산업안전보건연구원에 의뢰된 직업병 심의 사례 분석

강성규,김규상,김양호,최정근,안연순,진영우,최병순,양정선,김은아,채창호,최용휴,김대성,박정선,정호근 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Pneumoconisis and noise-induced hearing loss (NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardio-cerebrovascular accident (CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). Methods : The local office of the Korea Labor Welfare Corporation (KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. Results : Male was 80.7 % of the requested cases. Their mean age was 42 years old and 75.5 % of them were more than 35 years old. The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50.7 %. The majority of requested cases were respiratory diseases(22.4%), cancers(18.5%), Neuropsychiatric problems(14.5%), and musculoskeletal problems(13.5%). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73.6% of them were caused by chemical agents, especially 28.5 % were by organic solvents. 67% of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. Conclusions : A claim was common in workers whose age was over 35 years old and exposure history was over 10 years. The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.

변위 매복된 상악 중절치의 맹출유도

강근영,양규호,최남기,김선미 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.3

매복치아란 어떤 원인에 의하여 구강점막이나 약골내에서 치아의 맹출이 중지된 상태를 말하며, 악궁내의 어떠한 치아도 매복될 수 있으나 가장 흔하게 이환되는 치아는 상, 하악 제 3대구치, 상악 견치, 상, 하악 제 2소구치, 상악 중절치의 순으로 나타난다. 이 중 상악 영구 전치의 매복률은 0.1-0.5%정도이며 매복 원인으로는 여러 가지가 있으나 유전치의 외상, 과잉치, 치근단 병소로 인한 매복이 흔하며 조기에 적절히 치료되지 못하면 정중선의 변위, 인접치에 의한 맹출공간 감소, 치조골 높이의 차이 등의 결과를 유발한다. 치료로는 주기적 관찰방법, 매복치의 맹출로가 정상이며 치근이 미완성일 경우 상부 연조직과 경조직을 단순히 제거하여 맹출을 유도하거나 외과적 노출 후 매복치를 교정 하는 방법, 치아이식술, 발치 등을 시행할 수 있다. 본 증례들은 상악 중절치의 맹출 지연을 주소로 본원에 내원한 환아들로 상악 중절치의 변위 배복을 외과적 노출과 교정적 견인을 시행하여 양호한 결과를 얻어 보고하는 바이다. Tooth impaction is defined as a cessation of the eruption of a tooth at the level of the oral mucosa or alveolar bone by any causes. Any tooth in the dental arch can be impacted, but the teeth frequently involved in a descending order are the mandibular and maxillary third molars, the maxillary canines, the mandibular and maxillary second premolars, and the maxillary central incisors. In these teeth, impaction of maxillary incisor occurs in about 0.1-0.5% and major causes are trauma, supernumerary teeth and periapical inflammation of primary maxillary incisor. Delayed eruption of a maxillary central incisor results in midline shift, the space's being occupied by an adjacent tooth and different levels of alveolar height. Treatment options are observation, surgical intervention, surgical exposure and orthodontic traction, trans-plantation and extraction. These cases were about the patients with delayed eruption of maxillary central incisor. We surgically exposed impacted tooth and guided it into normal position by the orthodontic traction. At the completion of traction, the maxillary central incisor was positoned fairly within the arch and complications such as root resorption were not observed.

1990년대 한국의 직업성암

강성규,안연순,정호근 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

The proportion of cancer as a cause of dearth in Korean has been continuously increas-ing. In 2000, 24 % (59,020 of 247,346) of deaths were caused by cancer. Occupational exposure would have contributed to the deevelopment of some cancers. It would have accounted for more than 2,000 cancers in a year if 4% of all cancer or 10% of lung cancer was regarded as arising from the work environment. However, occupational cancer has not been reported as much as expected. The first case of occupational cancer reported officially was mesothelioma caused by asbestos exposure at an asbestos textile industry in 1992. Following the report, many cases of occupational cancers have been reported such as lung cancer due to exposure to asbestos, chromium, exhaust gases, coke oven emissions, and silica, as well as leukemia due to exposure to benzene or other solvent and bladder cancer arising from exposure to benzidine salts. The Health Examination for retirees has been conducted since 1992 in order to detect occupational cancer early in workers who have been exposed to 11 carcinogenic sub-stances. However, to date no occupational cancer has been detected through the Retirees' Health Examination. The Korea Labor Welfare Corporation (KLWC) has referred 108 claims for occupational cancer to the Korea Occupational Safety and Health Agency (KOSHA) between 1992 and 2000. Thirty-three cases were accepted, including 14 cases of lung cancer, eight cases of hematopoietic cancer and six cases of mesothelioma. KLWC has accepted the claim for primary lung cancer developed with pneumoconiosis as an occupational cancer, of which there were 31 cases in 1999 and 61 cases in 2000. In conclusion, special attention is required to detect occupational cancer due to their long latency period and the fact they are usually found after retirement.

III급 부정교합 어린이의 수완부 골성숙과 하악 3대구치 발육에 대한 연구

강근영,양규호,최남기,김선미 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

본 연구는 I급 부정교합과 III급 부정교합 어린이의 수완부 골성숙 단계와 하악 제3대구치 발육을 비교 · 평가하고자 하였다. 이를 위해 전남대학교병원 소아치과에 내원한 환자들로 8세부터 15세 사이의 Angle I급 부정교합을 지난 남자 149명,여자 155명 그리고 Angle III급 부정교합을 지닌 남자 153명,여자 155명,총 612명을 대상으로 하였으며 골성숙 단계 평가를 위해 수완부 사진을 이용한 Fishman의 방법을 사용하였고 하악 제3대구치의 발육 단계를 평가하기 위해 Orthopantomogram을 이용한 Gat 등의 New Six-Developmental-Stage 방법으로 판독하여 다음과 같은 결과를 얻었다. 1. 골성숙 단계는 I급 부정교합과 III급 부정교합군 모두 전반적으로 여자가 남자보다 빠르나(p<O.05) 하악 제3대구치의 석회화 단계는 성별 차이가 없었다. 2. 남녀별 골성숙 단계와 하악 제3대구치의 석회화 단계는 I급과 III급 부정교합군 간에서 유의한 차이가 없었다. 3. I급 부정교합과 III급 부정교합군의 수완부 골성숙 단계와 하악 제3대구치 석회화 단계 사이의 상관관계는 두 군 모두 높은 상관성을 보였다(p<O.O1). 4. I급 부정교합과 III급 부정교합군의 하악 제3대구치 석회화 단계와 연령사이의 상관관계는 두 군 모두 높은 상관성을 보였다(p<O.O1). 이상의 결과로 수완부 골성숙도와 하악 제3대구치 발육은 I급 부정교합과 III급 부정교합군 간에 차이가 없었다. The purpose of this study was to investigate the relationship of the skeletal maturity of hand-wrist and the development of mandibular third molar in subjects with class I and class III malocclusion. The subjects used in this study were 304 children(149 boys, 155 girls) with class I malocclusions and 308 children(153 boys, 155 girls) with class III malocclusions, ranged from 8 to 15 years of age. Hand-wrist radiographs and panoramic radiographs were used to evaluate the stage of skeletal maturity and teeth development. Fishman s method for the skeletal maturity stages of the hand-wrist and new six-developmental-stage method for the calcification stages of mandibular third molars were analyzed. The results were as follows: 1. In subjects with class I and class III malocclusion, skeletal maturity of the hand-wrist occured earlier in females than in ma1es(p<0.05), while the calcification stages of mandibular third molars were no significant gender differences. 2. There were no significant differences between the groups, when comparing the skeletal maturity stages of the hand-wrist and the calcification stages of mandibular third molars between subjects with the class I and the class III malocclusion. 3. The correlation coefficients between the calcification stages of mandibular third molars and the skeletal maturity stages of the hand-wrist in subjects with class I and class III malocclusion showed a high interrelationship(p<0.01). 4. The correlation coefficients between the calcification stages of mandibular third molars and chronological age in subjects with class I and class III malocclusion showed a high interrelationship (p<0.01). As a result, there were no significant differences between class I and class III malocclusion group for skeletal maturity of the hand-wrist and third molar development.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

불규칙 반복하중을 받는 무근콘크리트의 누가손상

강호영,김영진,변근주,이기성 연세대학교 산업기술연구소 1988 논문집 Vol.20 No.1

An assessment of cumulative damage of plain concrete subjected to random loading is studied in this paper. Random loading of Beta distribution, which is governed by the mean and standard deviation of peak stresses working on concrete, is applied and the influence of the random loading on the fatigue of plain concrete is analyzed. The relationship among mean of peak stresses, its standard deviaton and fatigue life, the relation between fatigue life and changes in strain, and the one between fatigue life and modified Palmgren-Miner hypothesis are investigated for the random compressive loading on concrete cylinder specimens. From these relationships, a model which may be used to estimate the cumulative damage of concrete structure subjected to random loading of Beta distribution is proposed.

상악 협측 치은에 발생한 모세혈관종 치험례 : A CASE REPORT

강근영,양규호,최남기,김선미 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.4

혈관종은 혈관의 증식에 의해 발생하는 양성 종양으로 유아와 어린이에서 호발한다. 대부분 진성종양으로 보다는 과오종(hamartoma)으로 보며 구강내 호발부위는 입술, 혀, 협점막 구개부 등이다. 임상소견은 편평하거나 융기된 적청색 병소로 보통 단발성이다. 조직학적 소견을 통해 모세혈관성(capillary), 해면상(cavernous), 혼합성(mixed), 경화성(sclerosing)등으로 분류되며 확진된다. 본 증례는 6세 남자 환아가 치은에 뭐가 났다는 것을 주소로 전남대학교 병원 소아치과에 내원하였다. 임상검사 결과 #62, 63 부위의 부착치은에 딸기모양 종물(mass)이 관찰되었다. 조직검사 시행 결과 모세혈관종으로 확진되었으며 외과적 절제로 양호한 결과를 얻었기에 보고하는 바이다. 혈관종은 재발이 드물며 악성전환이 없지만 출혈 경향이 높으므로 임상적 시술시 주의가 요구된다. The hemangioma, a benign proliferation of blood vessel, is the most common tumor of infancy and childhood. In many instances, the lesion probably represents a hamartoma or malformation rather than a true neoplasm. In the oral cavity, common sites are lips, followed by tongue, buccal mucosa and palate. Clinical characteristics appear as a flat or raised reddish-blue lesion and are generally solitary. They are classified on the basis of their histological appearance into capillary, mixed, cavernous or a sclerosing variety. A 6-year-old male of this case was referred to the Department of Pediatric Dentistry, Chonnam National University with a chief complaint of swelling lesion on gingiva. The strawberry appearance mass was detected by clinical examination on attached gingiva at the upper left primary lateral incisor and canine. Surgical excision and biopsy were carried out for histological examination and the lesion was diagnosed with a capillary hemangioma. The risk of recurrence after this therapy is rare, and there is no malignant transformation. Despite their benign origins and behaviour, hemangiomas in the region of oral cavity are always clinically important to the dental profession because of bleeding tendency.

5년간 특수건강진단기관 분석정도관리 결과 분석

강성규,양정선,이미영,박인정,정호근 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목 적 : 1980년대 후반부터 산업보건에서 혈중 및 요중 중금속농도 분석의 정확성 문제가 크게 부각되었다. 같은 시료를 가지고 분석기관마다 보이는 커다란 오차로 인해 직업병 진단 결과에 대한 신뢰성을 크게 감소시켰다. 이에, 노동부에서는 1992년부터 특수건강진단 기관에 대한 생체시료 분석정도관리 프로그램을 시작하였다. 본 연구는 1995년부터 시작된 생체시료 분석정도관리 5년간의 결과를 보고하고, 현재 생물학적모니터링으로 사용되는 항목과 빈도를 조사하고 이 항목의 정도관리 참여율을 비교하여 산업보건 관계 연구나 직업병 관리에 참고할 수 있도록 하기 위해 실시하였다. 방 법 : 생체시료 분석정도관리는 무기와 유기분석분야로 나누어 일년에 전후반기 2회 실시하고 있으며, 지정항목과 자율항목으로 구분하고 있다. 지정항목인 혈중 납과 요중 마뇨산은 분야별로 한 번에 3개 농도수준을 주어 2개 이상이 기준값의 ±15%내외의 범위에 들면 적합한 것으로 판정하고 있으며, 자율항목은 2개의 시료를 주어 2개 모두 기준실험실 평균값의 ±3SD 내외의 범위에 들면 적합한 것으로 판정하고 있다. 결 과 : 지정항목인 혈중 납과 요중 마뇨산 분석은 평균 적합률이 각각 89%, 90% 이었고, 대학기관, 비영리법인, 종합병원, 사업장 자체기관별로 차이는 없었으나 신규 기판의 적합률 70% 수준으로 상대적으로 낮았다. 자율항목의 적합률은 평균 50% 수준이었고, 저농도보다는 고농도의 적합률이 떨어졌다. 국내에서 가장 많이 분석되고 있는 항목은 요중 마뇨산과 혈중 납이었고, 혈중 및 요중 망간도 많이 분석되고 있었다. 요중 삼염화물, 페놀, 만델산, 카드윰, 메칠마뇨산, 크롬 등도 많이 분석되고 있는 항목이었다. 혈중 망간, 요중 수은, 요중 NMF는 정도관리에서 적합판정을 받은 기관의 숫자보다 실제 분석을 하고 있는 기관의 숫자가 많았다. 결 론 : 지난 5년간의 생체시료 분석정도관리 결과 우리나라 분석실험실의 분석능력은 향상되고 있으나, 자율항목에 대한 분석능력은 아직 미흡한 것으로 나타났다. 그리고, 아직 일부 일부 항목에 대해서는 외부 정도관리 없이 분석되고 있는 경우도 있었다. Objective : The accuracy of analytical results of blood and urine heavy metals came out to the main issue on occupational health from late eighties. The discrepancy of the results for same samples from different laboratories made the diagnosis for occupational diseases be unreliable. Therefore, a quality control program for analysis of samples taken from workplace had been introduced in Korea since 1992. This study aims to show the quality control program for analysis of blood and urine samples and its proficient rates from 1992 to 1999 and to know how they have been being used in occupational health. Methods The quality control program runs twice a year with mandatory items of blood lead and urine hippuric acid and voluntary items of blood cadmium and manganese and urine mandellic acid and methyl hippuric acid. Participant laboratories are receiving three levels for each items and two out of three samples have to be qualified for being a profi-cient laboratory for the item. The acceptable range of blood lead and urine hippuric acid is ± 15% and that of the others is within 3 SD (standard deviation) from the reference values. Results : The proficient rates of blood lead and urine hippuric acid was 89%, 90%, repectively, however those of the other voluntary items have been from 51% to 62%. The proficient rates of urine mercury and urine N-methylformamide (NMF), which are introduced since 1999, were very poor. Urine hippuric acid and blood lead were analyzed frequently for the purpose of biological monitoring conducting by special health examination organizations. Urine and blood manganese and urine metabolites of trichloroethylene, urine phenol, methylhippuric acid and cadmium were followed. Conclusions : In conclusion, the quality control program for biological monitoring has dramatically improve the ability of analysing blood and urine samples and eventually con-tributes to diagnose occupational diseases and to prevent occupational poisoning. However, some biological monitoring data, such as urine manganese, mercury and NMF, have been still reported from laboratories that were not accepted as a proficient laboratory.

디메칠포름아미드에 의한 간기능 장해에 관한 연구

강성규,장재연,이경용,정호근 大韓産業醫學會 1991 대한직업환경의학회지 Vol.3 No.1

To investigate the liver dysfunction among workers exposed to dimethylformamide, 24 workers were examined on the liver transaminases and the urine metabolite. The results were as follows: 1. Nine of 24 workers examined had abnormal values in serum aspartate aminotransferase(AST), 5 in serum alanine aminotransferase (ALT), 1 in Υ-glutamyl transferase(Υ-GT). The possibilties of hepatitis due to other causes were excluded by the viral serologic tests and other results. 2. The urinary excretion values of N-methylformamide(NMF), metabolite of dimethylformamide(DMF) were over biological exposure index(BEI) in 4 of 24 workers. 3. The air concentration of dimethylformamide was over threshold limit values(TLV-TWA) in 1 of 5 workers sampled by personal air sampler. 4. The correlation coefficients between age, working part and the values of liver transaminases were not statistically significant.

구조물의 정적보강에 따른 동적 응답 예측에 관한 연구

김강부,전종균,엄호성 선문대학교 2000 공학계열 논총 Vol.3 No.-

본 논문에서는 기존 반도체 공장의 세품 정밀도를 개선하기 위한 방안으로 정적보강올 실시하는 구조물에 대하여 동적 응답 을 실험적인 방법과 해석적 방법을 병행하여 예측하였다. 또한, 실험적인 방법과 해석적 방법의 상호적용을 위하여 진동제어 절차서를 제시하였다. 동특성 실험을 통하여 구조물의 지배 모드를 확인 하고, 모델해석과 비교하였다. 해석결과에서는 구조보강 前/後에 대하여 동일한 모드형상을 갖는 고유진동수를 4차까지 선정하여 강성 증가에 따른 변화를 비교하였다. 또한, 정적보강 前/後 구조물의 동적 특성을 비교하기 위하여 격자보 구조물에서 가장 취약할 것으로 판단되는 지점을 가진점으로 선정하여 주파수별 단위 하중에 대한 응답특성을 계산하였다. 실험/해석결과를 바탕으로 구조물의 정적보강을 통한 동적 응답의 기여도를 확인하였다. In this paper, dynamic response about the static stiffening reinforcement of structure by the experimental method and theoretical analysis has been predicted for the improvement of accuracy in the manufacturing process of semiconductor factory. Also, vibration control procedure is presented by the mutual working of the experimental method and theoretical analysis. Dominant vibration mode of the structure has been investigated by the experiments for the dynamic characteristics and compared with the model analysis of the structure. The change due to the increase of stiffening about the same mode shape for the four natural frequencies is investigated after(and before) the reinforcement of structure stiffness. Response characteristic about the weight at each band of frequency has been calculated at the exciting points in which the lattice-type structure has weakness mostly. The effect of dynamic response of the structure with reinforced static stiffness through the experimental and theoretical results is verified.