성인학습원리 기반 웍샵에 의한 사회의학 교육평가의 시도

고광욱,김정민,김윤지,이용환,유병철,전만중 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Background: For effective education of social medicine, new and more efficient means of education are needed because social medicine consist of diverse background academics . Metohods: Workshop based lecture was carried out twice in social medicine class for medical students and was assessed with questionnaires survey. Results: Half of the students were satisfied with workshop-based learning and required more discussion time and pre-information. Conclusions: With some improvements, workshop-based adult learning method is expected to bring effectiveness in social medicine education.

胃神經症患者의 Mecholyl 試驗에 關한 臨床的 硏究

金喆洙,高侊道 고려대학교 의과대학 1976 고려대 의대 잡지 Vol.13 No.1

Clinical application of a test of autonomic nerve tonicity was introduced by Eppinger and Hess in 1910. There are many reports about the relationship between autonomic nerve tonicity and many diseases. But there are very few reports about clinical investigation of gastric neurosis and autonomic nerve tonicity with mecholyl test. Seventy eight cases of gastric neurosis who admitted to Hanil hospital during 2 years from May 1973 to May 1975, were selected for the study. As a control, 21 healthy Koreans were selected. Mecholyl test is the autonomic nerve tonicity. Mecholyl was injected intramuscularly as 0.1 ㎎/㎏. body weight and the measurement of autonomic nerve tonicity was done by Gellhorn's method. The results are summarized as follows: 1) Type Ⅲ (sympathetic hyporeactor) was the most frequent in gastric neurosis and type Ⅱ (intermediate group) was mostly observed in control group. 2) The peak age incidence was 4 th decade and male to female ratio was 1 : 2.5. 3) In type Ⅲ patient of gastric neurosis, the chief complaint was continued for more than 10 years, in type Ⅰ for 5-7 years. But in type Ⅱ, less than 3 years was most frequent. 4) The most frequent complains were epigastric pain and epigastric fullness. 5) The untoward effect was on its peak 2 minutes after mecholyl injection in gastric neurosis and 3 minutes after mecholyl injection in control group. 6) The most frequent side effects of all cases were flushing and palpitation after the mecholyl injection.

경상남도 일부지역 농업인의 농약관련 인지도 및 실행도 결정요인

김정민,전만중,고광욱,유병철,이용환 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Background : The amount of pesticide to be produced and consumed have rapidly growed in Korea and the evidences for pesticide intoxication to human body, natural environment and consumers have evoked. But the studies concerned to pesticide intoxication are inactive. So, we conducted this study about the determinants of awareness and performance for prevention of pesticide intoxication. Methods : The study conduced during the period from July to August 2007 with population consisted of 111 farmers. The toolkit was produced through referencing previous studies. Data analysis was performed with t-test, ANOVA and multiple linear regression analysis using SPSS 14.0K program. Results : The mean awareness score was 3.07 ± 0.75, the mean of total performance score was 2.72 ± 0.69, mean of subtotal performance score for keeping safety guideline was 2.72 ± 0.69 and mean of subtotal performance score for wearing protective equipments was 2.43 ± 0.83. Awareness score was associated with sex, age and family income. Female, older people and people with high income were tend to show low awareness score. Performance score was associated with sex, family income and educational level. Female, people with low education and high income were tend to show low performance score. Conclusion : We concluded that educational effort for noticing the harmful affects of pesticide, the importance of keeping safety guideline and wearing protective equipments to farmers especially female, older people, people with low education and high income were significant factors for prevention of pesticide intoxication.

Thiocarbamyl Enoxacin 유도체의 합성 및 항균작용

신화우,고무수,정동훈,최광식,임철부 원광대학교 식품약품안전성연구소 1991 食品藥品安全性硏究 Vol.4 No.-

Treatment of 1-ethyl-6-fluoro-1, 4-dihydro-4-oxo-7-(1-piperazinyl)-1, 8-naphthyridine-3-carboxylic acid (Enoxacin) with alkyl(or aryl) isothiocyanates which obtained from alkyl(or aryl) amines afforded six 1-ethyl-6-fluoro-1, 4-dihydro-4-oxo-7-(1-alkylthiocarbamylpiperazinyl)-1, 8-naphthyridine-3-carboxylic acids and five 1-ethyl-6-fluoro-1, 4-dihydro-4-oxo-7-(1-arylthiocarbamyl piperazinyl)-1, 8-naphthyridine-3-carboxylic acids. The compounds synthesized were evaluated for their antimicrobial activities, in vitro, against Escherichia coli 6-PE-4, Bacillus subtilis 74-51, Proteus vulgaris 78645, Klebsiella pneumoniae JYA-78314, Staphylococcus aureus 79110 and Pseudomonas aeruginosa 8765-1 p_2.

부산지역 일부 종합병원의 컴퓨터 단말기 작업을 하는 여성 원무업무종사자들에 있어서 누적외상성장애에 대한 조사

전만중,유병철,고광욱,이용환 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

registration system were organized, computerized, and simplified. Especially the workers for the hospital registration desk were almost used computer all the working time. Therefore we assessed cumulative trauma disorder of registration desk workers related to computer use of general hospital. Methods: 62 women computer users who worked for registration desk of general hospitals in Busan were assessed from March to August, 2007. The workers were checked general characteristics(age, educational level, and marital status), work related characteristics, and symptoms by self-administered questionnaires. Results: Significantly decreased prevalences for cumulative trauma disorder were observed for subjects who had more educational level, the prevalence of cumulative trauma disorder was 69.2% among high school graduates, 38.2% among junior college graduates, and 20.0% among college graduates. Significantly increased prevalences for cumulative trauma disorder were observed for subjects who had more duration of computer use, the prevalence of cumulative trauma disorder was 56.5% for those who had used computer for more than 8 hours, 32.1% for those who had used computer for 4-7 hours, and 27.3% for those who had used computer for less than 3 hours. And Significantly increased prevalences for cumulative trauma disorder were observed for subjects who had more maximun daily computer use time without break, the prevalence of cumulative trauma disorder was 66.7% for those who had used computer for more than 7 hours, 38.1% for those who had used computer for 3-6 hours, and 21.7% for those who had used computer for less than 2 hours. Multiple logistic regression showed that subjects who had more maximum daily computer use time without break was more likely to report patient. Conclusion: Therefore these findings suggest that preventive interventions on hospital registration desk worker related to computer use were needed

간세포암종에서 간절제술 후 이환율과 사망률에 영향을 미치는 위험 인자

김완욱,이광웅,최성호,허진석,김용일,김성주,이대성,이환효,백승운,고광철,이준혁,최문석,유병철,조재원 대한간학회 2004 Clinical and Molecular Hepatology(대한간학회지) Vol.10 No.1

목적: 간세포암종은 우리나라에서 간절제의 가장 흔한 적응증이다. 그러나 간경변을 동반한 경우가 많아 수술 후 이환율과 사망률이 높아 수술 전후 처치에 주의를 요한다. 최근에는 외과적 술기의 발전과 수술 전 및 수술 후 처치의 향상으로 이환율과 사망률이 감소하고 있으나 다른 수술에 비해 여전히 높다. 이에 본 연구에서는 간세포암종의 수술 중 위험 인자를 알아보고 수술 후 이환율과 사망률을 줄일 수 있는 방법을 찾아보고자 하였다. 대상과 방법: 1994년 11월부터 2001년 12월까지 간세포암종으로 진단받고, 간절제술을 시행받은 환자 510명을 대상으로 하였다. 대상 환자의 평균 연령은 51.6세였고, 남녀 비는 4.01 : 1이었다. 수술 전 HBsAg (+)는 76.0%, 수술 전, anti-HCV (+)는 8.2%였으며 종양의 크기는 평균 5.19 ㎝이었다. 환자 중 26.2%에서 수술 전 경도자 동맥색전술의 병력이 있었으며 8.7%에서 수술 전 경피적 간문맥색전술을 시행받았다. 시행받은 수술은 종양절제술 55예, 분절절제술 127예, 구역절제술 77예, 반간절제술 214예, 동반 혹은 확대 반간절제술 37예였다. 위험 인자로 나이, 성별과 각종 임상 지표(간기능 수치, 프로트롬빈시간, 혈청 알부민, 혈당, 알파태아단백, ICG 검사, 수술 전 경도자 동맥색전술, 경피적 간문맥색전술 시행 여부) 등의 수술 전 인자, 수술의 종류, 수술 시간, 수혈량 등의 수술 인자, 그리고 종양의 크기, 종양의 수, 간경변 여부 등의 병리조직학적 인자 등을 분석하였다. 분석자료는 대상 환자들의 의무기록을 통해 후향적 방법으로 조사하였다. 수술 사망은 수술 후 30일 이내에 사망한 경우로 정의하였고, 입원 사망은 수술 후 합병증으로 퇴원하지 못하고 사망한 경우로 정의하였다. 단변량 분석은 student t test와 x² test를 이용하였으며, 다변량 분석은 logistic regression을 이용하였다. 결과: 수술 후 합병증은 총 56예(10.5%)에서 나타났으며, 조절되지 않는 복수 19예, 호흡기 합병증 10예, 상처 합병증 8예, 간기능 이상으로 인한 고빌리루빈혈증 6예, 출혈 5예, 고질소혈증 4예 등이었다. 수술 사망은 5예(0.98%), 입원 사망은 수술 사망을 포함하여 6예(1.1%)였다. 이중 간부전과 연관된 사망이 5예였고, 간부전과 동반된 흡인성 폐렴으로 사망한 예가 1예 있었다. 이환율에 영향을 미치는 인자를 다변량 분석을 통해 알아본 결과, 수술 중 수혈량(P=0.002), 프로트롬빈시간(P=0.038), 혈당 수치(P=0.002)가 통계학적으로 의미가 있었고, 다변량 분석 상 수술 후 사망률과 관련된 인자로는 나이(P=0.028), 혈당 수치(P=0.011), 수술 전 경도자 동맥색전술 시행 여부(P=0.046) 등이 의미 있는 것으로 나타났다. 결론: 위의 위험 인자 분석을 통해 간세포암종에서 간절제시에 수술 후 이환율을 중이기 위해 가능한한 수술 중 출혈을 최소화하면서 불필요한 수혈을 피하고, 당뇨 환자에서는 수술 후 이환율과 사망률이 상대적으로 높고, 고령 환자에서는 사망률이 상대적으로 높으므로 수술 전후 처치에 세심한 주의가 필요함을 알 수 있었다. 수술전 경도자 동맥색전술 시행 여부가 수술 후 사망률과 유의한 상관성이 있었고 이에 대한 지속적인 연구가 필요하리라 생각된다. Background/Aims: Recently, mortality following surgical resection for hepatocelluar carcinoma has been reduced significantly. Morbidity, however, is still significant. This study evaluated the risk factors leading to morbidity and mortality. Methods: 510 patients who had a hepatic resection form Nov. 1994 to Dec. 2001 were included. The patient demographics showed a mean age of 51.6 years with a male to female ratio of 4:1. The HBsAg was positive in 76.0% and the anti-HCV was positive in 8.2%. The mean tumor size was 5.2 cm, 26.2% of patients had preoperative transcatheter arterial embolization (TAE), and 8.7% had preoperative percutaneous transhepatic portal embolization (PTPE). Limited resection was performed in 259 cases (50.7%), and major resection was conducted in 251 cases (49.1%). Risk factors included age, sex, laboratory findings (liver function test, prothrombin time, albumin, glucose, α-fetoprotein, ICG test), preoperative TAE, PTPE, operation type, operation time, intraoperative transfusion, tumor size, and cirrhosis. Results: The morbidity was 10.5% (54 cases). Operative death occurred in 5 cases (1.0%). Hospital death, including operative death, occurred in 6 cases (1.2%). Five cases were associated with hepatic failure and 1 case was associated with aspiration pneumonia accompanying hepatic failure. Transfusion (P=0.002), glucose (P=0.002), and prothrombin time (P=0.038) were significantly related to morbidity. Age (P=0.028), glucose (P=0.011), and TAE (P=0.046) were significantly related to mortality. Conclusions: Intraoperative transfusion, which is mainly related to intraoperative bleeding, should be reduced if possible to decrease morbidity. Diabetes mellitus patients and the elderly need careful perioperative management.(Korean J Hepatol 2004;10:51-61)

수술로 절제된 간의 국소 결절성 증식의 임상적 특징

황남철,최문석,이준혁,고광철,백승운,유병철,이종철,이광웅,조재원,박철근 대한간학회 2004 Clinical and Molecular Hepatology(대한간학회지) Vol.10 No.2

목적: 간의 국소 결정성 과형성은 일반적으로 특별한 치료가 필요 없는 양성 종양이다. 그러나 드물지만 합병증이 발생한 경우와 진단이 불확실한 경우에는 수술을 시행하게 된다. 이에 저자들은 간절제술을 시행한 국소 결절성 과형성의 임상적, 영상학적 특징들을 알아보고자 하였다. 대상과 방법: 1995년부터 2003년까지 수술을 시행하여 조직을 확인한 국소 결절성 과형성 환자 10명을 대상으로 연령, 성별, 실험실 검사 및 영상 소견과 조직 소견을 분석하였다. 결과: 연령의 중앙값은 37.5세, 남녀 비는 1.5:1이었다. 5예에서는 간세포선종이나 간세포암종을 감별할 수 없어서 수술을 시행하였으며, 수술 후 우연히 진단된 예는 4예이었다. 간세포암종의 위험 인자를 가지고 있었던 예는 4예(B형 간염 바이러스 보유자 3예, 간경변 2예)이었다. CT검사가 시행되었던 6예 중 5예는 동맥기에서 조영 증강을 보였고 문맥기 및 지연기로 감에 따라 주변과 동일(4예)한 또는 감소(2예)되는 양상을 보여 간세포암종과의 감별이 어려웠다. 크기는 3.2±2.2㎝이었으며 위치는 간우엽의 후하구역(S6)에 가장 많았다(30.0%). 4예에서 수술 전 침생검을 시행하였으나 고분화 간세포암종이나 간세포선종과의 감별이 어려웠다. 결론: 임상상, 영상검사 및 간침생검으로도 간세포암종이나 간세포선종과의 감별이 어려운 경우 수술을 시행하였으며 수술 전에는 발견하지 못하였지만 다른 질환으로 인한 수술시 우연히 발견된 경우도 있어 국소 결절성 과형성의 수술 전 진단이 어려운 경우가 적지 않음을 알 수 있었다. Background/Aims: Focal nodular hyperplasia (FNH) is a benign hepatic tumor with few serious complications and no malignant transformation. However, differential diagnosis between FNH and other liver tumors, especially hepatocellular carcinoma, is often difficult. Methods: Clinical features of surgically resected FNH were reviewed. From January, 1995 to February, 2003, 10 patients with surgically resected FNH were enrolled. Their age, sex, results of laboratory examination, imaging studies and pathologic findings were evaluated. Results: Median age was 37.5 years and sex ratio (male:female) was 1.5:1. In 5 cases, resection to exclude hepatic adenoma or HCC was performed. Four cases were diagnosed incidentally after surgery. Four patients had risk factors for HCC, such as hepatitis B virus infection, liver cirrhosis or both. The size of FNH was 3.2 2.2 cm. The most common site of the tumor was segment 6 (30.0%). Differential diagnosis with HCC was difficult in 5 of six cases in whom CT was performed. Although needle biopsies were performed preoperatively in 4 cases, it was difficult to distinguish FNH from hepatic adenoma or HCC. Conclusions: FNH was resected due to uncertainty of diagnosis, or incidentally during hepatectomy in patients with other liver disease. In the former, differential diagnosis with hepatic adenoma or HCC was a major problem despite extensive work-up including dynamic CT or biopsy. (Korean J Hepatol 2004;10:135-141)

불명열 환자에서 진단된 중증 만성 활동성 Epstein-Barr virus 감염증

전경만,김응호,손준성,장현하,정숙인,오원섭,백경란,송재훈,고광철,정철원,고영혜 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

최근 장기적이고 심각한 임상 증상을 유발하는 만성 활동성 EBV 감염증의 개념이 정립되면서 그 증례들이 보고되고 있다. 만성 활동성 EBV 감염증은 소아나 젊은 성인들에게서 주로 발생되며, EBV-VCA IgG, EBV-EA IgG의 수치가 높게 관찰되고, 지속적인 발열, 전신쇠약감, 광범위한 임파선비대증, 간비장비대, 범혈구감소증, 다크론성감마병증을 나타낸다. 이 질환은 환자의 임상소견, 혈액학적 소견, EBV 항체 역가 및 침범 장기의 EBV genome 검출로 확진 되며 치료로 항 바이러스 체제, 항암 치료, 골수이식술 등이 시도되고 있으나 아직 검증되어 있지 않다. 저자들은 불명열을 주소로 내원하여 중증 만성 활동성 EBV 감염증으로 진단된 증례 4례를 경험하였다. 한 례에서는 항 바이러스 제제를 추여 후 임상적, 혈액학적 호전을 보였으나 치료 20일째 발생한 세균성 복막염과 패혈증으로 사망하였고, 두 례에서 총 6회의 CHOP 항암치료와 자가조혈모세포이식을 시행 받은 후 현재까지 증상 없이 추적관찰 중이다. 지속되는 발열을 주소로 내원한 불명열 환자들에게서 EBV에 대한 검사를 시행할 경우 불명열의 원인을 규명하는데 하나의 단서를 제공할 수 있을 것으로 사료된다. Epstein-Barr virus (EBV) is one of eight human herpesvirus. Primary infection with EBV in childhood is generally asymptomatic or mild, however, often causes overt diseases such as infectious mononucleosis (IM) and lymphoproliferative disorder (LPD), the latter occursing in immunologically compromised individuals. Historically, EBV has been considered to be etiologically linked to human malignancies such as EBV genome positive Burkitt's lymphoma and nasopharyngeal carcinoma. Recently, however, another category of EBV-related disease, "chronic active EBV infection", has been made to describe persons without a clearly defined underlying disease. We report 4 cases of patients, presented with episodic fever of unknown origin (FUO), who were diagnosed as severe chronic active EBV infection. A combined application of serology for EBV and in-situ hybridization established the diagnosis of the EBV infection.

도시정보체계의 공간정보 관련성 분석 연구

고광철(Kwang-Chul Koh),민경옥(Kyung-Ouk Min),김은형(Eun-Hyung Kim) 대한공간정보학회 2003 한국지형공간정보학회 학술대회 Vol.2003 No.4

GIS 사업유형을 고려한 GIS 감리의 기반 모델 연구

고광철(Kwang Chul Koh),김은형(Eun Hyung Kim) 대한공간정보학회 2000 한국공간정보시스템학회 논문지 Vol.2 No.2

Since 1995, national and local governments have competitively initiated many and large GIS projects and audit for the projects becomes an important issue. So far, the audit in the Information Technology (IT) area has tried to deal with the issue but ineffectiveness has been found for the successful GIS project management. Effective auditing is a critical element for the project management. In order to establish a proper audit model for the GIS projects and to promote auditing activities in the projects, this study constructs two hypotheses and tries to prove them. The hypotheses are as follows : 1) For a good audits model for GIS, unique characteristics of a GIS project audit ,items and the scope of the audit need to be identified. 2) The scope of audit needs to be classified according to the requests from tasks, in the projects. To prove the hypotheses, this study analyzes positive aspects of audit in IT and construction projects. clarifies the audit items in GIS projects by comparing with them, and classifies the scope of the GIS audit based on various types of GIS projects. As a results, 5 types of the GIS audit are identified: (1) audit for project management. (2) audit focused on IT. (3) audit characterized by GIS technologies, (4) GIS database audit and (5) consulting services for critical problems in the projects. In addition, 4 criteria in classifying the GIS projects are suggested for the GIS audit. The 4 criteria are domain. Scope, duration, and GIS applications technologies, Especially, GIS technology considered in this study includes GIS software, methodologies for GIS development. GIS database and Quality control of GIS data, which are not usually reflected in the existing studies about in GIS audit. Because the GIS audit depends on a type of GIS projects, scopes of the audit can be flexibly reconstructed in accordance with the types of GIS projects. This is a key to effective and realistic audit for the future G1S projects. Strategies for effective GIS audit are also proposed in terms of the following: GIS project management. goal establishment in each audit stage, documentation from GIS audit, timing strategies for intensive GIS audit, and designing team structure.