재제조와 중소기업형 환경보고서 가이드라인에 관한 연구

임익성,장무경 남서울대학교 2010 남서울대학교 논문집 Vol.16 No.1-1

환경에 대한 관심이 점점 높아지면서 국제표준화기구에서 제정한 환경경영에 관한 국제규격인 ISO14001을 인증을 받는 기업들이 증가하고 있다. 본 연구에서는 우리나라 환경경영보고서의 현 주소를 파악한 후 대기업과 중소기업의 환경경영보고서 가이드라인의 차이점을 살펴보았다. 우리나라 중소기업의 환경경영보고서는 기업의 실정을 감안하여 대기업과 달리 약화되어 차별화되어 있다. 환경경영에 기여할 수 있는 커다란 축의 하나는 재제조 및 재활용 이기 때문에 이것들에 대한 개념 및 현 주소를 살펴보았다. 본 연구의 목적은 환경경영가이드라인의 현 상태를 정리해서 현재 전세계적으로 추진되고 있는 그린혁명과 연계하여 환경경영에 기여할 수 있는 방향을 찾는것이며, 또한 향 후 우리나라 기업의 환경경영을 정량적으로 평가 및 기여할 수 있는 그린비율의 새로운 측도 방향을 제시하였다. Key Words : Envrionmental Report Guideline, Green Ratio, ISO14001, Remanufacturing

BRS 생체정보 분석방법(分析方法)의 정확도(正確度) 확인 연구

유상구,임무열,오상문,유경배,신연호,박병운,이완희 한국정신과학학회 1998 韓國精神科學學會誌 Vol.2 No.2

BRS는 인간의 잠재능력을 적극적으로 계발 · 활용하여 임의의 시료에 대한 미지 (未知)의 생체정보 (Bio-Information)를 편리하게 분석할 수 있는 효과적이고 경제적인 분석장비이다. 그러나 BRS와 관련된 분석방법 자체의 정확도에 대한 연구는 충분하게 이루어지지 않고 있다. 그래서 BRS 분석방법의 정확도를 과학적으로 확인해보기 위해서 본 연구를 진행했다 실험결과, BRS에 의한 생체정보 분석방법 의 정확도는 측정자의 숙련정도에 따라 다르지만 고급 측정자의 경우에는 95% 이상의 높은 확률로 표준시료의 생체정보를 정확하게 분석할 수 있으며, 측정자의 분석능력이 떨어지는 경우에는 여러 명의 측 정자를 대상으로 비교검토(Cross-Check) 방식으로 실험을 보완하면 90% 이상의 정확도를 확보할 수 있었다. BRS is a sort of analysis-instrument which help to estimate some Bio-Information for a sample conveniently and effectively But, for lack of the study to verify the confidence-degree of the Bio-Information analysis method related to BRS, the availability of the method is not known clearly yet, It was the reason that made authors perform this study And It was possible to arrive at the following two conclusions I though the confidence-degree of the Bio-Information analysis method ny BRS was different according to the degree of the expertness of a person using the instrument in the case of the very skillful expert, the confidence-degree for the standard sample used in this study was reached to 95% up 2 In the general case, to improve of the confidence-degree of the Bio-Information analysis method by BRS, the cross-check method by the several measuring person can be introduced.

췌장암 환자에서 알코올 내장신경 신경파괴블럭 후 발생한 간염

이상은,최석환,김영환,임세훈,이정한,이근무,정순호,최영균,김영재,신치만 인제대학교 2008 仁濟醫學 Vol.29 No.-

Splanchnic neurolytic block(SNB) with alcohol improves the management of pancreatic cancer pain. Adverse effects of alcohol SNB which include regional pain, hypotension, diarrhea, and acute alcohol intoxication are common, but acute hepatitis caused by alcohol neurolytic block is rare. A 63-year-old patient with pancreatic head cancer and liver metastasis had complete pain relief after both retrocrural tansdiscal SNB with 100% alcohol 10 ml. But, 1 day later, liver function test showed a high elevation in the aspartate aminotransferase (AST, 2182 IU/L) and alanine aminotransferase (ALT, 1807 IU/L). The patient had slight jaundice, general weakness, chilling, nausea and vomiting after SNB. Both AST and ALT decreased to 46 and 119 IU/L within 10 days with only supportive therapy. But, 19 days later, the patient died due to pneumonia. Our case illustrates the importance of clinical surveillance especially in patient with hepatic disease after alcohol SNB.

Dispatcher(전화 상담원)의 보조에 의한 심폐소생술

안무업,김영식,이부수,황성오,임경수 大韓應急醫學會 1992 대한응급의학회지 Vol.3 No.1

Background: Dispatcher-assisted telephone instruction in cardiopulmonary resuscitation(CPR) has been proposed to increase rates of bystander CPR in cases of out-of-hospital cardiac arrest. In Korea, bystanders do not know how they resuscitate the victims and EMS(Emergency Medical System) is incomplete. Study Objectives: This study was undertaken to tested the efficacy of dispatcher assisted telephone CPR using a recording mannikin(Anne Resusci) in a highstress, simulated cardiac arrest scenario. Study Subjects: We assesed in a group of volunteers, without prior CPR lectured and training(GroupⅠ, n=20), without prior CPR training but received lecture previously(Group Ⅱ, n=20) who received telephone instruction were compared with that of previously recevied lecture and tranined(Group Ⅲ, n=20) who received same massage. Performances of above groups were also compared with a group(Group Ⅳ, n=20) composed of previously received lecture and trained volunteers who did not receive the massage. Results: Members of groups Ⅰ,Ⅱ, and Ⅲ delivered similar average ventilation volumes, approximately 1L/cycle. In contrast, group Ⅳ delivered somewhat less, about 700ml/cycle(p<0.05). Group Ⅰ performed ventilation better than group Ⅳ but there was no significant intergroup differences in the performing effective chest compressions. The global performance of group Ⅲ, the group with prior CPR lecture, trained and telephone instruction, was superior to that achieved by other groups(p<0.05). We conclude that dispatcher-assisted telephone CPR can offer a safe and cost-effective means to increase the rate of bystander CPR and also improves the quality of CPR performed by persons with prior CPR training.

세 건의 재해사고를 통한 우리 나라의 재해대책 분석

안무업,황성오,임경수,강성준 대한응급의학회 1993 대한응급의학회지 Vol.4 No.2

Disaster is a any community or regional events that disrupts community functions and activities and cause concern for the lives, health, and property of the citizens of that community. Successful management of disaster requires adequate planning and practice drills. Emergency medical service must play an important role in disaster management because any disaster produces various types of patients who need emergent care. We tried to analyse korean disaster planning in review of three recent disasters including aircraft crash, ship submergence, and road traffic accident. The result of disaster survey shows that there are many defects in Korean disaster plan at the stage of notification, propagation, rescue, stabilization and withdrwal and emergency medical service system is not being involved in disaster management because korean disaster plan is a civil-defence model. We conclude that current korean disaster plan is inadequate for management of disaster and it should be reinforced.

환자가 작성한 어지럼설문지의 임상 적용시 주의할 점

임지숙,박정호,박지윤,박선아,이태경,이종대,성기범,안무영 순천향대학교 의학연구소 2009 Journal of Soonchunhyang Medical Science Vol.14 No.3

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Paraquat 중독환자의 초기검사로서 sodium dithionite를 이용한 소변내 paraquat검출의 임상적 의의

윤갑준,임경수,이진웅,김영식,이부수,박덕우,김선만,이강현,황성오,안무업 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

Background : Mortality from paraquat intoxication depends upon plasma paraquat concentration. To know the severity of paraquat intoxication is important for directing therapeutic modality and predicting prognosis. Sodium dithionite test for urinary paraquat provides an easy and simple method to determine the severity of paraquat intoxication in emergency department. purpose : To determine whether the result urinary paraquat test by sodium dithionite can predict outcome in patients with paraquat intoxication in emergency department. Subjects : 48 patients(male 31, female 17, mean age 37 years) who had exposure to paraquat and presented within 24 hours after exposure. Result : Thirty five patients were positive in paraquat urine test and thirteen patients were negative. Clinical manifestations were more severe in positive patients than in negatives. Complication was much more in positives than in negatives. 28 of 35 patients(80%) in positives and 2 of 13 patients(15%) in negatives died. Conclusion : Positive test for urinary paraquat is associated with high mortality and morbidity from paraquat intoxication, and qualitative test for urinary paraquat by sodium dithionite is an useful method to determine the severity of paraquat intoxication in emergency department.

농양진단을 위한 IgG-188Re 표지화합물 제조

오옥두,임상무,최태현 THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 1997 Journal of biomedical laboratory sciences Vol.3 No.2

농양진단을 위한 방사성표지화합물의 제조에 관한 기초실험을 수행하였다. IgG를 2-mercaptoethanol로 환원하여 분자당 1.5개의 -SH가 유도된 IgG를 얻을 수 있었다. 이것을 188Re과 표지 반응시켜 99%의 높은 표지반응수율로 IgG-188Re을 얻었으며, 여기에 인 혈청을 안정제로 가해줌으로써 1시간까지 약 90%의 방사화학적 순도를 유지할 수 있었다. 포도상구균으로 유발한 농양이식 백서에서 IgG-188Re의 생체분포실험을 통해 농양의 진단이 가능한 것으로 확인하였다. 이상의 결과를 적용하면 여러 가지 단클론 항체의 188Re표지화합물 제조에 적용할 수 있을 것으로 기대되었다. IgG-188Re conjugate was prepared for the diagnosis of abscess. The IgG molecules reduced by 2-mercaptoethanol contained 1.5 free sulfhydryl groups per IgG molecule. The reduced IgG molecule was labelled with 188Re through chelate to 99% of labelling yield. The radiochemical purity of IgG-188 Re conjugate was maintained at 90% in the presence of human serum for 1 hour. The IgG-188Re was intravenously administered into staphylococcal abscess-bearing rats and their biodistribution was monitored at 4 and 24 hours post injection. The IgG-188Re conjugate was moderately localized in the abscess tissue. This result implies that the IgG-188Re conjugate can be a tool for abscess diagnosis. This technique can be applied for the preparation of various monoclonal antibody labelled with 188Re.

응급센터내에서의 Do-Not-Resuscitate Order

김영식,황성오,이부수,안무업,임경수,강성준 대한응급의학회 1993 대한응급의학회지 Vol.4 No.2

Do-not-resuscitate(DNR) decision in certain patients is a important part of patient management. The use of DNR order has been widely recognized in hospitalized patients, but there has been little discussion of the use of DNR order in emergency department. DNR decision in emergency department is difficult because there is no previous contact between physician and patient. To identify the medical reasons of the DNR decision and the process of the DNR in the emergency department, 293 DNR patients in emergency department during 1 year and 36 physicians having experienced DNR decision were studied. Reasons for DNR are irreversible states from brain damage or acute illness(63%), chronic irreversible illness(15%), prolonged cardiac arrest over 30 minutes(16%), physical injuries including decapitation(1%) and family's hope(5%). Almost DNR(72%) were decided by physicians. 72% of DNR decision were not documented. Cardiopulmonary resuscitation was attempted before DNR decision in 38% of the patients and 17% of CPR attempts were unnecessary. Almost physician(88%) replied that physician should discuss resuscitation with family and process of DNR decision should be documented.

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.