사망진단서(사체검안서) 상의 선행사인으로부터 사망통계의 원사인이 선정되는 비율 : 3개 대학병원에서 교부된 사망진단서를 중심으로

박우성,박석건,정철원,김우철,탁우택,김부연,서순원,김광환,서진숙,부유경 한국의료QA학회 2004 한국의료질향상학회지 Vol.11 No.1

Background : To exatnine the problems intolved in writing practice of death certificates, we cotnpated the determination of underlying cause of death for wital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 rnortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record wpecialists. And causes of death determined at ministry of statistics for national vita statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificaties sere analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. Ane the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions tha caused death too. Conclusion : When we examined the correctness of death certificate writing practice using abpve methods, cortectness of writing could not be told as satisfactory. There was difference in correctness of writing between hospotals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

연구논문 : 제주지역 미세먼지의 장기변동 및 농도변화에 관한 국지기상 분석

박연희 ( Yeon Hee Park ),송상근 ( Sang Keun Song ),이수정 ( Soo Jeong Lee ),김석우 ( Suk Woo Kim ),한승범 ( Seung Bum Han ) 한국환경과학회 2016 한국환경과학회지 Vol.25 No.1

Long-term variations of PM_{10} and the characteristics of local meteorology related to its concentration changes were analyzed at 4 air quality sites (Ido-dong, Yeon-dong, Donghong-dong, and Gosan) in Jeju during two different periods, such as PI (2001-2006) and PII (2007-2013), over a 13-year period. Overall, the long-term trend of PM_{10} was very slightly downward during the whole study period, while the high PM_{10} concentrations in PII were observed more frequently than those in PI. The concentration variations of PM_{10} during the study period was clarified in correlation between PM_{10} and meteorological variables, e.g. the low (high) PM_{10} concentration with large (small) precipitation or high (low) radiation and in part high PM_{10} concentrations (especially, Donghong-dong and Gosan) with strong wind speed and the westerly/northwesterly winds. This was likely to be caused by the transport effect (from the polluted regions of China) rather than the contribution of local emission sources. The PM_{10} concentrations in “Asian dust” and “Haze” weather types were higher, whereas those in “Precipitation”, “Fog”, and “Thunder and Lighting” weather types were lower. The contribution of long-range transport to the observed PM_{10} levels in the urban center (Ido-dong, Yeon-dong, and Donghong-dong), if estimated by comparison to the data of the background site (Gosan), was found to explain about 80% (on average) of its input.

환경의식의 종합적 측정을 위한 설문지 개발

우형택,문연화 대구효성가톨릭대학교 1998 연구논문집 Vol.58 No.2

With respect to the increasing importance of understanding our environmental concerns, this study was conducted to develop the questionnaire for the comprehensive and objective measurement of environmental concerns and test its reliability. The major research methods taken include the design of environmental questionnaire based on literature review and related theories, and the process of increasing the reliability of developed questionnaire through the repetition of reliability analysis. The total of 3 surveys were conducted and the total of 510 persons including diverse sample groups were questionnaired. The SAS PC+ package program was used in the reliability analysis of surveyed data. The first designed questionnaire consisted of 50 items including 25 items related to environmental pollution and 25 items related to nature conservation, reflecting various factors of environmental concerns. The result of the first reliability analysis showed that Cronbach-αfor the total was 0.75. To increase the reliability, items having low correlation with the total were eliminated, corrected, or revised. The reliability of redesigned questionnaire consisting of 46 items was significantly improved to the level of Cronbach-α0.88, the high reliability of measurement. In the second reliability analysis, 11 items were further revised and corrected to develop the questionnaire having the very high reliability. The reliability of the finalized questionnaire was further increased to the level of Cronbach-α0.92.

분편 인플루엔자백신(split influenza vaccine)의 임상효과 및 면역원성에 관한 연구

우흥정,김동림,정희진,천병철,이주연,안정배,김지희,박찬,신영규,김우주,김민자,박승철 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.1

목적 : 아단위 인플루엔자 백신 접종 후 백신의 인플루엔자 예방효과, 인플루엔자 방어 항체형성, 인플루엔자 백신의 안전성을 조사하고자 하였다. 방법 : 총 571명을 대상으로 인플루엔자 백신 접종을 하였고, 이들 접종자에서 인플루엔자 양질환의 이환을 조사하여 인플루엔자 백신의 인플루엔자예방효과를 알아보았고, 백신의 접종 전 및 접종 4주 후 혈청에서 혈구응집억제물(Hemagglutination Inhibition : HAI) 항체 검사를 실시하여 백신의 방어항체생성을 조사하였고, 백신의 안전성을 알아보기 위해 백신접종 후 1주일 이내의 부작용을 조사하였다. 결과 :백신 접종군과 백신 비접종군에서 인플루엔자 양 질환의 이환을 조사한 결과 접종군 28.35%, 비접종군 35.88%으로 나왔으며, p 값이 0.001로 통계적으로 접종군에서 유의하게 낮았고, 인플루엔자 양 질환의 예방 효과는 20.97%를 보였다. 백신의 방어항체 형성의 평가를 위해 유럽의 인플루엔자 백신 허가 기준을 조사하였는데 B/Guangdong/5/94균주의 백신접종 후 항체가 40이상의 비율을 제외한 다른 기준은 모두 만족 시켰다. 부작용은 전체 조사자 521명중 149명(29%)으로 주로 접종 부위의 국소 부작용을 호소했고, 전신 부작용은 2% 내외였으며 특별히 심각한 부작용은 발견되지 않았다. 결론 : 분편 인플루엔자 백신은 인플루엔자양질환의 예방과 방어항체생성에 효과 있으며 안전한 것으로 사료된다. Background : The safety and effectiveness of influenza vaccine are well known in developed country. The influenza vaccination has been recommended as one of the tentative immunization schedule for indicated persons since 1997 in Korea. But there are still no available data about them, even though nearly 5 million doses of influenza vaccine were used in 1997-1998 season. So it is immediately needed to investigate the safety. efficacy and immunogenicity of influenza vaccine among Korean. Methods : We studied the clinical efficacy of influenza vaccine by monitoring Occurrence of influenza-like illness in influenza risk group(vaccination ; 300, non-vaccination; 215) from December in 1997 to March in 1998. We used the split quadrivalent influenza vaccine containing 15 microgram of hemagglutinin of A/Beijing/262/95(HlNl), A/Wuhan/359/95(H3N2), B/Mie/1/93 and B/Guangdong/5/94. Hemagglutination inhibition(HA1) antibody titers were determined before immunization and 1 months after vaccination And we evaluated adverse effect of influenza vaccination at 7 days after vaccination. Results : Influenza vaccination was associated with si@icant reductions in influenza-like spptoms(vaccination group; 28.35%, non-vaccination group, 35.88%, p=0.001). The preventive effect of influenza-like i3lne.s among influenza risk goup was 20.97%. And immunogenicity of influenza A and B exceeded all of the European licensure criteria for immunogenicity except postvaccination proportion of titers 240 of B/Guangdong/5/94 strain. And the adverse effects were mainly local injection site problem and no serious adverse effect was noted. Conclusion : Split influenza vaccine is safe, inmunogenic and eff'tive in influenza risk group in Korea.

MPEG 비디오 데이터를 이용한 움직이는 물체 추출 방법

김선우,최연성,박한엽 군산대학교 정보통신기술연구소 2000 情報通信技術硏究論文集 Vol.4 No.-

In this paper, we describe a method of moving object extraction directly using MPEG video data. Since motion information in MPEG coded data is determined in terms of coding efficiency point of view, it does not always provide real motion information of objects. We use a wide variety of coding information including motion vectors and DCT coefficients to estimate real object motion. Since such information can be directly obtained from coded bitstream, very fast operation can be expected. But, this bitstream have don't need noise because of illumination and H/W feature. In this paper, we proposed that the method is using median operator to exclude noise. Moving object are detected basically analyzing motion vectors and spatio-temporal correlation of motion in P- and B-Pictures. The simulation results show that successful moving object detection has been performed on MB level using several test sequences. Since proposed method is very simple and requires much less computational power than the conventional object detection methods, it has a significant advantage as motion analysis tool.

토끼 수막염 모델을 이용한 다제내성 폐렴구균에 대한 Meropenem의 치료 효과

김신우,진정화,강수정,정숙인,김연숙,기현균,김춘관,이혁,김성민,백경란,송재훈 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1

목적 : 다제내성 폐렴구균에 의한 수막염은 기존과 단일 항생제로는 근치가 어려워 ceftriaxone과 vancomycin 혹은 rifampin의 병용요법이 권유되고 있다. 다제내성 폐렴구균에 사용할 수 있는 다른 약제 중 meropenem은 시험관내 폐렴구균에 대한 항균력이 좋고 경련 등의 중추신경계 부작용이 거의 없어 다제내성 폐렴구균에 의한 수막염의 치료에 이용할 수 있을 것으로 기대되나 이에 대한 자료가 매우 부족한 상태이다. 이에 연자 등은 meropenem과 meropenem+vancomycin의 병용요법이 다제내성 폐렴구균 수막염의 치료에 효과가 있는지를 토끼 수막염 동물 모델을 이용하여 검증하고자 하였다. 방법 : 인체에서 수막염을 일으킨 다제내성 폐렴구균 균주(penicillin MIC 2, ceftriaxone MIC 4, meropenem MIC 0.5㎍/㎖)를 토끼 척수강 내에 직접 주입하여 수막염을 유발한 후 ceftriaxone, vancomycin, rifampin, meropenem의 단일 항균요법, ceftriaxone+vancomycin, ceftriaxone+rifampin, meropenem+vancomycin의 병용요법 간에 치료 효과의 차이를 비교 하였다. 각 치료군은 6 마리의 토끼를 대상으로 하였다. 각각의 항생제는 5 시간 간격으로 2번 정주하였으며, ceftriaxone은 1회 투여하였다. 균주 주입 후 각 치료군이 토끼에서 치료 후 0, 5, 10, 24 시간에 척수액을 채취하여 균주의 수를 측정하여 24시간째의 살균 여부를 최종 치료 효과로 판정하였다. 결과 : meropenem 단독 요법은 10시간째에 모든 균주를 살균하였으나 24시간 째에 다시 균의 성장이 관찰되었으며, meropenem+vancomycin의 병용요법은 단독 약제보다 우수한 살균효과를 보였으나 상승작용은 없었다. 결론 : meropenem+vancomycin의 병용요법은 기존의 ceftriaxone+vancomycin보다 24시간째에 더 큰 균의 감소 경향을 보여(P=0.054) 임상에서 사용이 가능할 것으로 기대되며 향후 실제 수막염 환자에서의 임상효과를 증명하는 연구가 필요할 것으로 생각된다. Background : Because antimicrobial monotherapy for pneumococcal meningitis caused by penicillin-resistant strains is not satisfactory, ceftriaxone+vancomycin [C+V] or ceftriaxone+rifampin [C+R] regimens are recommended. Meropenern [M] is one of the monotherapy options for penicillin-resistant pneumococcal meningitis due to good in-vitro activity against pneumococci and rare adverse reactions in CNS. But there have been few reports in the efficacy of meropenern against pneumococcal meningitis. We evaluated therapeutic efficacy of the meropenern and meropenem+vancomycin in a rabbit model of meningitis caused by penicillin-resistant S. pneumoniae (PRSP). Methods : Meningitis was induced by intracistemal inoculation of a pneumococcal strain isolated from a patient with meningitis (MIC; penicillin 2, ceftriaxone 4, meropenem 0.5 g/㎖). Bacterial concentrations in the CSF were measured at 0, 5, 10, and 24 h after therapy was started. Therapeutic efficacy was evaluated by the final bacterial concentration in the CSF at 24 h. Results : C+V cleared the CSF at 10 h, but regrowth of bacteria was noted at 24 h. Meropenem monotherapy resulted in sterilization at 10 h but regrowth at 24 h. M+V was superior to M or V monotherapy but did not show synergism. Therapeutic efficacy of M+V was at least equal or superior to that of C+V (P = 0.054). Conclusion : Meropenem+vancomycin regimen could be one of the useful options in the treatment of PRSP meningitis. Clinical trials to evaluate the M or M +V are warranted in the future.

족관절에 대한 임상적 고찰

김연일,한성우,정호원,서유성 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

The ankle joint is a modified complex hinge joint which plats an important vital role in normal gait, walking and weight bearing. The goal in the treatment of ankle fracture is the restoration of full function to the injured extremity such restoration can be accomplished only with full appreciation of the fracture, the concomitant soft tissue injuries and mechanical demands of the joint involved. The authors have reviewed a series of 131 cases of ankle fractures which were admitted and treated in orthopaedic department of Sunchunghyang university from Feb. 1994 to Oct. 2000. Among the 131 cases ,69 patients (52.7%) were male, and 62 patients (47.4%) were female. Peak incidence of age was 20-30 years old (55 cases, 42.5%). The main causes of injuries were slip down (84 cases, 64.1%) and the other causes were traffic accident (24 cases, 18.3%), rolling down (7 cases, 6.3), fall down (6 cases, 4.6%), direct blow (5 cases, 3.8%), sports injury (4 cases, 3.1%), human trouble (1 cases, 0.7%) in order. Accompanying injuries were noted on 32 case (23.4%) and fractures in lower extremities were most common (15 cases, 46.9%). Supination-external rotation injuries were most common by the Lauge-Hansen classification (53 cases, 40.5%) and type B ankle injuries were most common by the Danis-Weber classification (67 cases, 51.2%) type B2 ankle injuries were most common by the AO classification (44 cases, 33.6%). Open reduction was performed in 95 cases (72.5%) and closed reduction was performed in 36 cases (27.5%). The result was better in those cases which were treated by open reduction and internal fixation than those by closed reduction. SO anatomical reduction and firm internal fixation of the fibula and repair of the distal tibiofibular ligament or transfixation of the distal tibiofibular joint with screw were thought to be very important in the management of the ankle injuries.

위암환자에서 근치적 위절제술후 시행한 보조적 PMF 항암 화학요법에 대한 무작위 전향적 연구

최우식,신연명,최경현 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

연구 목적: 위암 수술 후 보조 항암 치료의 효과에 대하여서는 아직 논란이 있다. 전향적으로 무작위표본 추출법으로근치 절제 수술한 위암 환자에서 수술 후 cisplatin, mitomycin C 그리고 5-FU(PMF)의 주사가 5년 생존율이나 무병생존율을 증가할 수 있는지를 연구하였다. 연구 방법: 1995년 5월부터 2002년 5월까지 147명의 근치 수술된 위암 환자들 중에 병기 IB, II, IIIA, IIIB 및 IV를 대상으로 하였으나 65세 미만을 대상으로 하여 무작위적으로 2군으로 나누어, 경구 5-FU제를 투여하는 군(대조군)과, PMF 항암 주사 치료군(치료군)으로 나누어 치료하였다. 경구 5-FU항암제는 수술 후 퇴원할 시기부터 투여하였다. PMF 주사치료는 수술 후 8주 이내에 시작하며 2코스 이상 완료한 사람들을 치료군에 포함하였다. 항암 주사는 다음과 같이 진행하였다; cisplatin 30mg 정맥 주사를 제 1-5일에, mitomycin C 4mg과 5-FU 250mg정맥 주사를 주 2회 4 주간 주사하였다. 이런 주사치료를 매 4주마다 시행하였다. 이 후 5년 생존율과 무병 생존율을 Kaplan-Meier 분석과 log-rank 검정으로 구하였다. 결과: 중앙 추적기간은 36개월이었다. 전체 5년 생존율은 치료군과 대조군에서 각각 68.8%와 65.2%(p=0.26), 무병 생존율은 각각 72%와 64%(p=0.24)로 치료군에서 다소 나았으나 유의성은 없었다. 치료에 동의한 환자의 수가 적어 각 병기별 생존율보다 비교적 조기인 병기 IB와 병기 II를 A군으로, 병기 IIIA을 B군, 그리고 진행된 병기인 병기 IIIB 와 병기 IV를 C군으로 나누어 생존율 비교하여 보았다. A군과 C군은 5년 생존률이나 무병생존율의 차이가 없었으나, B군에서는 5년 생존율이 치료군에서 100%, 대조군은 40.8%(P=0.0019)로 유의한 차이가 있었고, 무병 생존율도 치료군 100%, 대조군 52.94%(p=0.005)으로 의미 있게 차이가 있었다. 항암 주사치료에 의한 부작용은 심하지 않았으며, 사망자는 없었다. 결론: 위암 수술 후 PMF에 의한 항암 보조치료는 경구 5-FU에 비하여 병기 IB, II, IIIB와 IV에서는 5년 생존율이나 무병 생존율에 차이가 없었으나 병기 IIIA에서는 5년 및 무병 생존율에 의미있게 좋았다. 앞으로 C군에 대한 수술 후 보조 항암치료법의 연구가 요망된다.

대두β-Conglycinin유전자의 발현인자

김우연 中央大學校 食糧資源硏究所 1991 食糧資源硏究所 論文集 Vol.3 No.1

췌장염에 의한 가성낭종내에 생긴 가성동맥류 : 1례 보고

오연희,이채경,김승현,이성우,양창현,이정호,이영현 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

만성 췌장염의 합병증으로 생긴 가성동맥류는 드문질환으로, 반복적으로 다량의 출혈을 일으킬 수 있으며, 치료를 하지 않을 경우 사망율이 높기 때문에, 조기 진단과 치료가 필수적이다. 저자들은 38세 남자 환자에서 췌장염의 합병증으로 생긴 가성낭종내에서 발생한 가성동맥류 1예를 경험하였기에 보고하는 바이다. 가성 동맥류의 색혈류도플러상 낭종내에 양방향 흐름의 와류를 볼 수 있었다. Pancreatic Pseudoaneurysm within Pseudocyst from Pancreatitis: 1 Case Department of Diagnostic Radiology and Internal Medicine, College of Medicine,DongGuk University Yeon Hee OH M.D., Chae Kyeong Lee M.D., Seoung Hyeon Kim M.D., Sung Woo Lee M.D., Chang Heon Yang M.D., Jung Ho Lee M.D., Young Hyun Lee M.D. Pseudoaneurysm from pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality, early detection and treatment of the pseudoaneurysm is needed. We report a case of pseudoaneurysm within pseudocyst from pancreatitis. Color-flow Doppler sonography shows bidirectional flow and turbulent arterial flow, within anechoic mass.