부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

자가부식 프라이머의 적용시간이 법랑질 접착에 미치는 영향

진철희,조영곤,김수미,이명선 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.3

이 연구의 목적은 6종의 자가부식 프라이머 접착시스템에서 제조사에서 추천한 프라이머 적용시간과 2배의 프라이머 적용시간에 따른 법랑질에 대한 미세전단 결합강도와 전자현미경적 소견을 비교하기 위하여 시행하였다. 이 연구의 결과 법랑질에 대한 자가부식 프라이머 접착제의 결합강도는 제조사에서 추천한 프라이머의 적용시간보다 프라이머의 적용시간을 2배 증가시킨 경우 높게 나타났으며, 특히 pH가 높은 프라이머를 사용하였을 때 통계학적으로 높은 결합강도를 나타내었다. 이는 법랑질에서 pH가 높은 프라이머를 사용할 경우, 제조사에서 추천한 시간보다 더 긴 시간동안 적용하는 것이 결합강도를 증가시킬 수 있을 것으로 생각된다. The purpose of this study was to compare the normal and two times of application time of six self-etching primers applied to enamel using microshear bond strength (uSBS) test and the finding of scanning electronic microscope (SEM). Crown of sixty human molars were bisected mesiodistally and buccal and lingual enamel of crowns were partially exposed and polished with 600 grit SiC papers. They were divided into one of two equal groups subdivided into one of six equal groups (n = 10) by self-etching primer adhesives. After the same manufacture' s adhesive resin and composites were bonded on the enamel surface of each group, the bonded specimens were subjected to uSBS testing and also observed under SEM. In conclusion, generally two times of primer application time increased the enamel uSBS, especially with the statistical increase of bond strength in adhesives involving high-pH primers.

폐결핵의 조기진단에 있어서 이중중합효소연쇄반응법의 유용성

조성란,최영진,김용훈,이철세,김영창,김휘준 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

Background: Pulmonary tuberculosis is a great public health problem in Korea. Early detection of Mycobacterium tuberculosis (M. tuberculosis) in clinical samples becomes more and more important in the control of tuberculosis. Recently, molecular methods have been applied to early detection of M. tuberculosis. Methods: To elucidate the effectiveness of nested polymerase chain reaction (PCR) in early diagnosis of pulmonary tuberculosis, we peformed Acid-fast bacilli (AFB) stain, AFB culture, and nested PCR on 84 sputa. Results: 8 (9.5%) specimens were positive by AFB stain, 17 (20.2%) by AFB culture, and 15 (17.9%) by nested PCR. Using AFB culture as standard method, the sensitivity of AFB stain and nested PCR was 47.1% and 82.4%, respectively. The specificity of AFB stain and nested PCR was 100% and 98.5%, respectively. Conclusions: Nested PCR was more sensitive than AFB stain and had shorter processing time(24-48hrs) than AFB culture. So it may be effective to use nested PCR in order to detect M. tuberculosis when AFB smear Is negative.

회맹장 및 대장을 침범한 장 결핵에 있어서 바륨을 이용한 방사선 이중조영촬영 소견에 대한 연구

진용현,전혜정,이용근,강철호,조성범,김윤환,박철민,차상훈,김일영,이혜경 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

To determine the characteristic double contrast barium enema findings of ileo-cecal and colonic tuberculosis and to make differential diagnosis from other bowel inflammatory disease. Sixty-seven patients confirmed as ileo-cecal and/or colonic-tuberculosis in six hospitals were evaluated retrospectively. The diagnosis was proven by endoscopic biopsy, surgery, and clinical follow up. Nine of 67 patients were excluded because radiologic findings were normal though endocopic biopsy examinations resulted in tuberculosis. Histopathological diagnosis were madein 58 cases as follows: endoscopic biopsy(n=29), operation(n=12), follow up examination(n=14), tissue culture(n=1), laparoscopic biopsy(n=2). There were 30 men and 28 females. The mean age were 36 yrs(range:16-67), 34 patients were in the second and third decade. The distribution of lesions, morphological characteristics, mucosal changes, ulcer shape and depth, associated with other tuberculous lesion, multiplicity were retrospectively analyzed in the findngs of double contrast barim enema. The commonest clinical symptoms were abdominal pain(n=35, 60%) and diarrhea(n=18, 31%). The chest radiography revealed association of pulmonary tuberculosis in 39 cases. Tuberculous lesions of other organs except chest were present in five cases. Double contrast barium enema findings showed a thickening and irregularity of intestinal mucosal fold(n=29, 50%), bowel contraction and/or shortening(n=26, 45%). There were small, nodular, superficial ulcers in the case of ulcer depth less than 2 mm in the depth. As many as 39 cases(67%) in this series had two or more lesions in the intestinal tuberculosis. The involved segment revealed symmetrical feature(n=21, 36%). Inflammatory pseudopolypoid lesions were noted in 30 cases(52%). The ileo-cecal region was involved in 38 cases(66%). The ascending colon(n=25, 43%) was the second commonest site with or without contiguous cecal involvement. Lesions in terminal ileum, ileo-cecal valve, transverse colon, descending colon and appendix were seen in 19, 18, 18, 12 and seven cases, respectively. Among 18 cases of ileo-cecal valve lesions, there were incompetency in nine cases(16%) and wide gapping in four cases(7%). In 14 cases, tuberculous enterocolitis was diagnosed by clinical follow-up and double contrast barium enema study. 12 out of 14 cases, the findings of double contrast barium enema of tuberculous enterocolitis were normalized after anti-tuberculous medication. However, two cases showed more aggravated state than before due to inappropriate treatment. Double contrast barium enema plays an important role in the diagnosis of tuberculous enterocolitis, determines the type, site and extent of the involvement and helps in treatment guide by using sequential studies.

複合非破壞試驗法을 利用한 現場콘크리트 强度推定에 關한 硏究

조철희,김하진,이승엽,김정섭 朝鮮大學校 建設技術硏究所 1999 建設技術硏究 Vol.19 No.1

This study is to improve the reliability of compressive strength estimation using combined non-destructive testing method in estimating the compressive strength of in-situ concrete after 730 days of age, measures the values of compressive strength and non-destructive test of in-situ concrete with the combined strength of 240kg/㎠, conducts the experiment for estimating the compressive strength, makes the estimation expression of the results through simple and duplicate regressive analysis and then the results of comparing and analyzing to existing expressions to secure the range of application of estimation expression and its reliability are as follows. It is found that the positive curing is very important in the early curing of the strength revelation in long-term age and especially in hydrate and it is considered that the formation and application of estimation expression of comprressive strength according to placement and curing method are needed to enhance the degree of strength estimation of in-situ concrete. After 365 days of age, the compressive strength of concrete tends to be decreased. While the single method has not a great change of non-destructive test value according to the change of concrete strength, the combined method shows a high reliability and then it is appropriate to use it for the exact strength estimation. Existing estimation expression used for estimating the compressive strength indicates a high estimation error in comparison with the expression suggested by this research in the difference of materials used, combined strength of concrete and the difference of placement and curing methods. Accordingly, it will be desirable to use an estimation expression suitable to the in-situ conditions for the exact strength estimation. The estimation expression of compressive strength using combined non-destructive test method of in-situ concrete on 730 days of age (2 years) suggested by this research is as follows. Air Curing fc' = 7.33R+219Vp-846 [R-sq(adj) = 0.839, N=81] Water Curing fc' = 12.6R+176Vp-805 [R-sq(adj) = 0.839, N=81]

疲勞荷重을 받는 鐵筋콘크리트 보의 炭素纖維시트 補强에 따른 構造特性에 관한 硏究

조철희,김하진,김광섭,김정섭 朝鮮大學校 建設技術硏究所 1999 建設技術硏究 Vol.19 No.1

This study is an experimental study of reinforced-concrete beam with carbon fiber sheet under fatigue load and aims at utilizing it as the basic material of strengthening design of reinforced-concrete structure under the fatigue load by examining the structural characteristics according to the fatigue load. Non-strengthening and strengthening, kind of strengthening materials(non-resin carbon fiber sheet, resin carbon fiber sheet) and the loading size (80%, 100%, 120% of static destruction load) in static and fatigue experiment are designed as the variables of experiment. The experimental results are as follows. 1. The strengthening test specimen shows the increase of yield strength of 208% in comparison with non-strengthening test specimen in the static experiment which is the standard of fatigue experiment. 2. The strengthening test specimen of non-resin CFS of K company and of resin CFS of M company indicate the increase of yield strength of 228% and 183% respectively in static experiment. 3. It is found that the strengthening test specimen in fatigue experiment has the increase of fatigue strength according to that of static yield strength. The strengthening test specimen with the loading of 120% of static load secures the fatigue yield strength of greater cycle than non-strengthening test specimen with 80% of static destruction load. Accordingly, it is judged that it is suitable to use CFS for the strengthening of reinforced-concrete due to the lack of fatigue load and structural yield strength. 4. It is shown that non-resin CFS strengthening test specimen of K company tested under the same condition secures the fatigue yield strength of greater cycle than resin CFS strengthening test specimen of M company. Initial deflection and elastic behavior have a similar form. Therefore it is thought that non-resin CFS produced at home is the strengthening material with the quality of international standard. 5. The test specimen reinforced with CFS has greater effects at static and fatigue yield strength, prevention of initial deflection and elastic deflection. So, it is considered that the reinforcement of CFS structure in actual structure may have the similar reinforcement effect to this experiment

Ⅱ급 부정교합에서 혀, 설골의 위치 및 기도 크기에 관한 연구

조진형,김상철 원광대학교 생체재료·매식연구소 1999 원광생체재료·매식 Vol.8 No.1

The purpose of this study was to evaluate the position of tongue and hyoid bone and the dimension of airway in class Ⅱ malocclusion. Lateral cephalogram(63 patients : 33 in male, 30 in female, average age 23.2 years) taken in natural head position(NHP), were traced and measured about the head posture, the position of the tongue and the hyoid bone and the dimension of airway, using the horizontal and vertical reference lines The angle of mandibular plane to SN plane was employed to classify samples into groups of hypodivergent and hyperdivergent. Craniofacial measurements were compard between hypodivergent group and hyperdivergent group The results were as follows; 1. The craniocervical angle was smaller in the hypodivergent group than in the hyperdivergent group. 2. The dimension of nasopharyngeal airway was smaller in the hyperdivergent group than the hypodivergent group. But the dimension of oropharyngeal airway was of no significant difference. 3. Tongue position was lower in the hyperdivergent group than in the hypodivergent group. 4. The vertical or horizontal position of hyoid bone was not distinctly different between the hypodivergent group and the hyperdivergent group.

급성충수돌기염으로 발현된 방선균증 2예

조진원,송진영,김창억,민영훈,최창순,우흥정,현인규,김종현,유기철,채승완,손진희 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1

The Actinomyces species are normal flora of oral cavity and upper intestine characterized as gram-positive, non-spore-forming anaerobic or mjcroaerophilic rods. Actinomycosis is a chronic suppurative and granulomatous disease characterized by abscess, sinus, abundant granulation and mass. The appendix is the commonly involved site among abdominal actinomycosis. Abdominal actinomycosis is often difficult to diagnose before operation because of no reliable clinical features and infrequency of the disease. We report two cases of abdominal actinomycosis which were manifested as acute appendicitis. Those were detected Incidentally tv the pathologist after routine appendectomy. Both patients were successfully treated with appendectomy followed by proper antibiotics use.

상아질의 깊이에 따른 단일 단계 접착제의 결합강도 비교

조영곤,진철희,민정범 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.4

본 연구는 단일 단계 접착제의 표충과 심층 상아질에 대한 미세인장 결합강도의 차이를 평가하기 위해서 시행되었다. 발거된 상·하악 대구치의 교합떤측에 있는 표층 상아질과 심층 상아질을 각각 15개씩 노출시킨 후, 사용된 접착제에따라 AQ 군, L-Pop 군, Xeno 군으로 분류하여 복합레진을 축조하였다. 각 시편은 상아질과 복합레진 계면의 단면적이 1.0 ㎣이 되도록 절단하였고, 각 군 당 20개의 시편을 사용하였다. 각 군의 미세인장 결합강도의 측정하여 다음과 같은 결과를 얻었다. 표층과 심층 상아질 모두에서 Xeno Ⅲ는 다른 접착제보다 가장 높은 결합강도를 나타내었다 (p<0.05). 또한 모든 접착제는 심층 상아질에서 보다 표층 상아질에서 더높은 결합강도를 나타내었으나 이들 간에 통계학적인 유의성은 접착제의 종류에 따라 다르게 나타났다. This study compared the microtensile bond strength (μTBS) of single step adhesives to different dentin depths. Superficial or deep dentin was exposed in 30 molar teeth by sectioning immediately under the DEJ or 1.5 mm area from central pit, respectively. After polishing with 600-grit SiC paper, the dentin surfaces were assigned to three groups: AQ group-AQ Bond, L-Pop group-Adper Prompt L-Pop, Xeno group-Xeno Ⅲ. The bonded specimens were sectioned into sticks and subjected to μTBS testing with a crosshead speed of 1 mm/minute. The results of this study were as follows; The μTBS to superficial dentin was higher than that to deep dentin in all group. The μTBS of Xeno group was significantly higher than that of L-Pop group and AQ group in both superficial and deep dentin (p<0.05).[J Kor Acad Cons Dent 30(4):319-326,2005]

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.