일부 농촌지역 사망신고자료에 기재된 사인에 관한 연구 -사망신고사인과 조사사인의 비교-

남해성,박경수,선병환,신준호,손석준,최진수,김병우,Nam, Hae-Sung,Park, Kyeong-Soo,Sun, Byeong-Hwan,Shin, Jun-Ho,Sohn, Seok-Joon,Choi, Jin-Su,Kim, Byong-Woo 대한예방의학회 1996 예방의학회지 Vol.29 No.2

This study was conducted to evaluate the accuracy of the official death registry in rural area. The base data used for the study was 379 deaths registered during the period of 1993 and 1994 in 4 rural townships of Chonnam province. The interview survey for cause-of-death was performed on the next of kin and/or neighbor. Additional medical informations were collected from hospitals and medical insurance associations for the purpose of verification. The underlying cause-of-death of 278 cases presumed by the survey was compared to the cause on official death registry. There was a prominent disagreement of cause-of-death between the survey data and the registry data(agreement rate: $38.9\sim44.6%$, according to disease classification method). These results may be caused by extremely low rates of physicians' certification, which were mostly confined to the poisoning and injury. Symptoms, signs, and ill defined conditions on death registry could be classified into circulatory disease(32.3%), neoplasm(21.2%), digestive disease(7.1%), injury and poisoning(7.1%) and so on. These results suggest that careful attention and verification be required on utilization of death registry data in rural area.

성인의 재발성 호흡기계 유두종증 환자에서 장기간 인터페론 치료의 유효성

남해성 ( Hae Seong Nam ),고원중 ( Won Jung Koh ),서지영 ( Gee Young Suh ),정만표 ( Man Pyo Chung ),권오정 ( O Jung Kwon ),김호중 ( Ho Joong Kim ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.5

연구배경: 재발성 호흡기계 유두종증은 기관을 따라 다발성 유두종이 반복적으로 재발하는 매우 드문 질환이다. 1980년대 이후, 소아의 재발성 유두종증에 보조적 치료로 인터페론이 사용되어 왔다. 그러나, 성인 환자에서의 유효성 등에 대하여는 많은 연구 등이 필요하다. 2002년 이후, 삼성서울병원에서는 성인의 재발성 호흡기계 유두종증 환자들에서 재발을 예방하기 위해, 인터페론을 사용하여 왔다. 이에 본 저자들은 재발성 호흡기계 유두종증 성인 환자에서 인터페론의 장기간 사용 효과를 알아보고자 하였다. 방법: 기관지내시경과 조직학적으로 확인된 5명의 재발성 호흡기계 유두종증 환자에서 타 병원에서 치료한 기록 등을 포함한 의무기록 등을 조사하였다. 레이저 소작술을 포함한 치료적 기관지내시경 시술 후, 모든 환자는 2개월 간격으로 인터페론-알파 600만 단위를 피하주사 하였다. 추가적인 치료적 기관지내시경 시술은 추적 검사 중 환자의 증상 등을 확인하여 필요 시 시행하였으며, 기관지 내시경 또는 컴퓨터 단층 촬영 등을 추적 조사하였다. 결과: 모든 환자들의 연령의 중앙값은 44세(범위 13∼68세), 남녀비는 3:2, 유두종증 기간의 중앙값은 31년(범위 1∼45년)이었다. 소아형과 성인형 유두종증은 각각 3명과 2명이었으며, 2명의 환자는 진단 당시 기관절개술을 시행 받았던 과거력이 있었다. 인터페론 치료기간의 중앙값은 56개월(범위 12∼66개월)이었다. 인터페론 치료 후 2명의 환자는 12개월과 36개월에 각각 완전완화를 보였으며, 나머지 3명의 환자는 부분완화를 보여 레이저치료의 횟수가 중요하게 감소하였다. 결론: 재발성 호흡기계 유두종증 환자에서 인터페론의 보조적 치료의 적정 용량과 기간 등은 향후 더 많은 연구 등을 필요로 하며, 오랜 기간 지속된 성인의 재발성 호흡기계 유두종증 환자에서 2개월 간격의 인터페론의 치료는 안정적이며 효과적이다. (Tuberc Respir Dis 2008;65:390-395) Background: Since the early 1980s, interferon-alpha (IFN-α) has been used as adjuvant therapy in pediatric patients with recurrent respiratory papillomatosis (RRP). However, its efficacy in adults needs to be validated. Since 2002, Samsung Medical Center`s guidelines have mandated regular injection of IFN-α in patients with RRP to prevent recurrence. To evaluate these guidelines, patient data were investigated. Methods: Five patients diagnosed as having RRP by bronchoscopy and histopathology were included. After initial bronchoscopic intervention, including laser cauterization, all patients received subcutaneous injection of 6 million units of IFN-α every 2 months. Further bronchoscopic intervention was carried out as needed. Patients were regularly evaluated using bronchoscopy or computed tomography. Results: The median age of the patients was 44 years (range 13∼68), and the median duration of papillomatosis was 31 years (range 1∼45). Three and two patients had juvenile-onset and adult-onset disease, respectively. Two patients had a history of tracheostomy at the time of diagnosis. The median duration of IFN-α therapy was 56 months (range 12∼66). Two patients showed complete remission at 12 and 36 months after IFN-α injection, respectively. The other three patients showed partial remission, and the number of laser therapy sessions was significantly reduced. Conclusion: Intermittent IFN-α injection is effective in patients with long-standing RRP and can reduce the number of laser therapy sessions required in their treatment.

서서히 자라는 폐암의 임상적 특성 6증례 평가

남해성 ( Hae Seong Nam ),양동혁 ( Dong Hyuk Yang ),김정수 ( Jeong Soo Kim ),김현정 ( Hyun Jung Kim ),이현규 ( Hyeon Gyu Yi ),이경희 ( Kyung Hee Lee ),조재화 ( Jae Hwa Cho ),윤용한 ( Yong Han Yoon ),곽승민 ( Seung Min Kwak ),이홍렬 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.3

Slowly growing lung cancers are quite rare and the leading cause of length time bias and over-diagnosis bias in lung cancer screening. We report 6 cases of slowly growing lung cancer in a tertiary hospital between January 1999 and December 2008. The clinical characteristics of these 6 cases with slowly growing lung cancer were examined. The median age at diagnosis was 68 years (range, 49∼72), and 5 patients (83%) were female. The most common histology type was adenocarcinoma (83%). After excluding two patients who showed no change in the tumor size, the median tumor doubling time was 189 months (range, 86∼387). The proportion of patients with slowly growing lung cancer appears to be particularly large in women, especially among patients with adenocarcinoma. Our experience shows that slowly growly lung cancers are more heterogeneous and diverse.

일부 농촌지역 시설노인의 건강상태

남해성(Hae-Sung Nam),박경수(Kyeong-Soo Park),이정애(Jung-Ae Rhee) 한국농촌의학 지역보건학회 1999 농촌의학·지역보건 Vol.24 No.2

악성흉수의 진단과 치료

남해성 ( Hae Seong Nam ),류정선 ( Jeong Seon Ryu ) 대한내과학회 2011 대한내과학회지 Vol.81 No.2

Malignant pleural effusions (MPEs) are an important clinical problem in patients with neoplastic disease. They can occur as the initial presentation of cancer, a delayed complication in patients with previously diagnosed malignancies, or the first manifestation of cancer recurrence after therapy. Common cancer types causing MPEs include lymphomas, mesotheliomas, and carcinomas of the breast, lung, and ovaries. However, almost all tumor types have been reported to cause MPEs. Regardless of the etiology, the median survival from clinical recognition is 4 months. New imaging modalities assist the evaluation of patients with a suspected MPE. However cytologic or tissue confirmation of malignant cells is necessary to establish a diagnosis. Management of an MPE remains palliative. Managements are directed toward removing pleural fluids and when appropriate, performing pleurodesis or initiating long-term drainage to prevent fluid reaccumulation. Talc pleurodesis is still the choice of treatment although concerns about its safety remain. Several factors such as performance status, expected survival, lung re-expansion following pleural fluid drainage and co-morbidities should be considered before the treatment. (Korean J Med 2011;81:167-173)

농촌지역과 어촌지역 주민들의 건강행태 비교

남해성(Hae-Sung Nam),이정애(Jung-Ae Rhee),신준호(Jun-Ho Shin),손명호(Myong-Ho Son),권순석(Sun-Seok Kweon),나백주(Baeg-Ju Na),김순영(Soon-Young Kim) 한국농촌의학 지역보건학회 2002 농촌의학·지역보건 Vol.27 No.1

히아루론산을 이용한 조직공학용 Scaffold 의 제조와 약물 방출 거동에 관한 연구

남해성(Hye Sung Nam),김지흥(Ji Heng Kim),안정호(Jeong Ho An),정동준(Dong June Chung) 한국고분자학회 2001 폴리머 Vol.25 No.4

일 도시 시설노인들과 지역노인들의 건강관련 삶의 질 비교

박경수,서용길,남해성,손석준,이정애,Park, Kyeong-Soo,Seo, Yong-Gil,Nam, Hae-Sung,Sohn, Seok-Joon,Rhee, Jung-Ae 대한예방의학회 1998 예방의학회지 Vol.31 No.2

The purpose of this study is to compare the level of health-related quality of life and relating factor between institutional elderly and community living elderly. The subjects were 390 from Sanatorium or Nursing home and 467 from the community in Kwangju. The results are followed : 1) A comparison of ADL between two groups, institutional elderly and community living elderly, resulted in that community elderly were more significantly independent in the areas of bathing and transfer than institutional elderly. 2) A comparison of IADL between two groups resulted in that : Community elderly were more independent in the areas of using telephone and transportation, food preparation, house keeping, and doing laundry. Institutional elderly were more independent in the area of handling finances. 3) In the case of poor health-related quality of life, institutional elderly showed 2.4 times in the dimension of physical fitness, 1.8 times in daily activity, 2 times in social activity, 2 times in pain, 26.7 times in social support, and 0.4 times in subjective quality of life higher than community elderly There was no significant differences in the rest of dimensions. 4) In institutional elderly, the analysis of variables related to the health-related quality of life resulted in that; The relating factors were sex, education, and chronic illness in the dimension of physical function. Direct contact with family or significant others in the dimension of social activity. Chronic illness in the dimension of pain and perceived health status. Direct or indirect contact with family or significant others over the phone or through letters in the dimension of social support. 5) The analysis of variables related to the health-related quality of life showed that community elderly has more relating variables in each area than institutional elderly. The relating factors were age, sex, and chronic illness in the dimension of physical function. Education and chronic illness in the dimension of emotional status. Age and chronic illness in the dimension of daily activity and social activity Education and chronic illness in the dimension of pain and perceived health status. Sex, education, family size in the dimension of social support. Education and chronic illness in the dimension of subjective quality-of-life. Throughout general daily activity, community elderly showed more satisfactory results than institutional elderly, but in the subjective area of health-related quality of life, such as subjective quality of life, institutional elderly group showed more positive results. And community elderly had more relating factors than institutional elderly. For the health care of the elderly that focused on quality of life, new approaches considering the characteristics of both group, institutional and community living elderly, are needed.

일개 군 사망신고자료에 기재된 사인의 정확성과 관련요인

신희영,신준호,남해성,류소연,임정수,이정애,정은경,Shin, Hee-Young,Shin, Jun-Ho,Nam, Hae-Sung,Ryu, So-Yeon,Im, Jeong-Soo,Rhee, Jung-Ae,Chung, Eun-Kyung 대한예방의학회 2002 Journal of Preventive Medicine and Public Health Vol.35 No.2

Objectives : To evaluate the accuracy of the registered cause of death in a county and its related factors. Methods : The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. Results : 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI=0.12-0.78). Conclusions : The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration. 전라남도의 일개 군에서 1998년 1월 1일부터 1998년 12월 31일까지 사망으로 신고된 건수는 총 504건이었으며, 이중 설문조사와 의무기록조사로 확인사인의 추정이 가능했던 388건을 연구대상으로 하였다. 확인사인을 신고사인과 비교하고 사망자와 사망관련 변수, 신고자의 특성 그리고 사망신고담당 공무원의 특성에 따른 양자간의 일치율을 통해 신고사인의 정확성과 관련된 인자를 파악하였다. 신고사인과 확인사인의 전체적 일치율은 19대 분류상 62.6%을 보였다. 19대 분류에 의한 사인별 일치율을 보면 손상, 중독 및 사망의 외인이 가장 높았고, 그 다음으로는 내분비, 영양 및 대사질환, 신생물, 순환기계질환 순이었다. 반면에 낮은 일치율을 보인 질환은 피부 및 피하조직의 질환, 근골격계 질환, 정신 및 행동장애 이었다. 사망자 및 사망관련변수에 따른 확인사인과 신고사인의 일치율은 사망자가 남자일 때, 사망 연령이 50대와 60대일 때, 그리고 사망원인 진단자가 의사일 때 높았다. 신고자의 특성별로는 신고자의 연령이 증가함에 따라 일치율이 감소하였으며, 신고자의 교육 정도와 직업과도 유의한 관련성이 있었다. 또한 사망신고 담당 공무원의 특성에 따라서는 공무원의 직급이 6급인 경우 7급 이상인 경우에 비해 일치율이 높았다. 확인사인과 신고사인의 일치여부를 종속변수로 하여 단변량분석을 실시한 후 통계적으로 의미 있는 변수에 대한 로지스틱 회귀분석의 결과를 보면, 사망원인 진단자가 의사인 경우 비차비 2.67(95% 신뢰구간: 1.21-5.89)로 높았으며, 사망신고담당 공무원의 직급이 7급 이상인 경우 비차비 0.30(95%신뢰구간: 0.12-0.78)로 낮았다. 사망신고자료에 기재된 신고사인의 정확성과 관련된 요인에 대한 결과를 종합하여 볼 때 무엇보다 중요한 일은 사망을 의사로 하여금 진단하게 하는 일이다. 또한 사망신고담당 공무원의 업무를 명확히 해야 하며 이들을 대상으로 하는 정기적이며 강화된 교육도 강조되어야 할 것이다.

2019년 충남지역에서 발생한 식중독 현황과 원인분석

이현아(Hyunah Lee),남해성(Hae-Sung Nam),최지혜(Jihye Choi),박성민(Seongmin Park),박종진(Jongjin Park),김현민(Hyeonmin Kim),천영희(Younghee Cheon),박준혁(Junhyuk Park) 한국환경보건학회 2020 한국환경보건학회지 Vol.46 No.2

Objectives: This study was performed to analyze cases of food poisoning outbreaks reported in Chungcheongnam-do Province in 2019 and report it as effective data for preventing food poisoning in the future. Methods: Food poisoning outbreaks were analyzed to detect virus, bacteria, and protozoa according to the Manual for Detection of Foodborne Pathogens in Outbreaks to clarify the causes of food poisoning that occurred in Chungcheongnam-do Province in 2019. Results: Among the 79 cases of food poisoning outbreaks, 59 cases (74.7%) were in general restaurants, 15 cases (19.0%) in food service institutions, three cases at banquets, and two cases in take-out food. The 42 cases at general seafood restaurants made up the majority of food poisoning in Chungcheongnam-do. Food poisoning pathogens were shown in 13 cases (86.7%) out of the 15 cases at food service institutions, and 10 cases were related to Norovirus. Among the 79 cases, food-borne pathogens were identified in 35 cases of outbreaks, accounting for 44.3%. The confirmed pathogens were as follows: bacteria (24 cases), Norovirus (12 cases) and Kudoa septempunctata. (five cases). The food-borne bacteria were pathogenic E. coli (12 cases), Staphylococcus aureus (six cases), Salmonella spp. (two cases), Campylobacter jejuni, Bacillus cereus, Clostridium perfringens, and Vibrio parahaemolyticus (one case). Conclusions: To prevent food poisoning, it is necessary to analyze regional characteristics and environments and to hold a campaign for the prevention of food poisoning based on that analysis. In addition, when food poisoning occurs, the results of analyzing its cause and spread based on accurate epidemiological survey need to be shared.