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육군 장병의 비타민 C 섭취와 상기도 감염 예방과의 관계
석웅 ( Seog Woong ),김태경 ( Kim Taekyung ),변준수 ( Byun Junsu ),임형렬 ( Lim Hyungryul ) 국군의무사령부 2018 대한군진의학학술지 Vol.49 No.1
Objectives : This study was conducted to investigate whether vitamin c intake can prevent common colds in the Republic of Korea Army soldiers. Methods : To determine if vitamin c intake can prevent common colds, we selected soldiers who enlisted the Korea Army Training Center for 30 days from February 12, to March 13, 2018. In the randomized, placebo-controlled, and double-blind trial, study participants were divided into groups(vitamin c vs. placebo). Also, whether or not the participants had a common cold was detected by searching the military medical records. Based on the synthesized data, multiple logistic regression analysis was performed to identify association between intake of vitamin c and diagnosis of common colds. Results : A total of 1,444 participants were included in the our study. Of the participants, 695 participants took vitamin c(6,000 mg/day) and 749 participants took placebo(0 mg/day). Also, 895 never smokers, 450 smokers(temporary non-smokers) and 99 former smokers were included in the study. The group took vitamin c had a 0.80-fold lower risk of getting a common cold than the placebo-treated group. In addition, the relationship between intake of vitamin c and common cold diagnosis was analyzed after categorizing the participants as smoking status(non-smoker vs. smoker). Conclusions : Through this study, we confirmed that vitamin c ingestion is effective in preventing common colds. Our results may serve as a basis for introducing military health-care policies that can provide vitamin c with military personnel in basic military training.
정신 ( Jeong Shin ),석웅 ( Bg Seok Ung ) 국군의무사령부 2018 대한군진의학학술지 Vol.49 No.1
Objectives: Understand feature of High Reliability Organization (HRO) and suggest a method to build system capable of maintaining maximum output while maintaining preventable death, patient injury and even accidents occurrence ZERO during mission performance related with patient and organization such as evacuation, ICU and ER. Methods: Subjects of study are safety management case of trusted civil organization, high reliability organization of US military medicine and various HRO materials. Results: It is important for all members to have a mindfulness to pursue highly trusted organization. To do that, trace small failure first. Second, deny oversimplifying mission performance. Third pay attention to management state. Fourth maintain resilience. Fifth empower leadership and experts. Conclusions: All members have to maintain the mindfulness to evaluate flexible and reparative mission capability periodically to become HRO to restore trust in military hospital. To do so, leadership is necessary first. All leaders in the fields of medical·nurse·administration should share and put concept of high reliability and common understanding about patient safety into practice. Second, they have to keep safety culture which is pushing ahead mutual trust, identification of unstable state and autonomous report and improvement compatibly. Third, systematic approach using performance improvement method and process improvement are necessary to change operation principle quickly and eradicate complex safety problems and design very effective plan.
이버들 ( Buddle Lee ),석웅 ( Woong Seok ),임형렬 ( Hyungryul Lim ),전철구 ( Cheolgu Jeon ),서남주 ( Namjoo Seo ) 국군의무사령부 2019 대한군진의학학술지 Vol.50 No.1
Objectives; The purpose of this study is to install an air purifier at the army training center dormitory and to check the pneumonia prevention effect according to the air quality Methods; We selected unit with frequent pneumonia and studied between 568 people who used air purifiers and 1,710 people who did not use them from November 30, 2017 to April 27, 2018. PM2.5, PM10, carbon dioxide and VOC were measured at 9points in both the air cleaner and non-use groups, and were performed every 2hours from 22:00 to 06:00 the next day. The number of pneumonia diagnoses and upper respiratory tract infections between the air pufier and no-use group were checked and statistically verified. Results; Mean±SD of PM2.5, PM10 was 29.7±48.0㎍/㎥, 55.9±135.1㎍/㎥ for air purifier use group, 115.0±346㎍/㎥, 259.0±371.7㎍/㎥ for nonuse group, and significantly lower for air purifier use group.(p<0.05) Mean±SD of carbon dioxide, VOC was 2,439±1,042ppm, 429.9±146.3㎍/㎥ for air purifier use group, 3,147±1388ppm, 589±264㎍/㎥ for nonuse group, and significantly lower for air purifier use group.(p< 0.05) RR(Relative Risk) of pneumonia patients in the air purifier and non-use group was 4.65, but the P-value was 0.08.(p >0.05). Conclusions; Air purifiers improve the air quality of the training dormitory, but have not proved sufficient to prevent pneumonia.
장기간 스테로이드 및 Sulfasalazine 투여를 받아 온 아메바성 대장염 의 임상경과
이준규(Jun Kyu Lee),석웅(Woong Seok),천재희(Jae Hee Chun),김유선(You Sun Kim),최일주(Il Ju Choi),김주성(Joo Sung Kim),정현채(Hyun Chae Jung),송인성(In Sung Song),김정룡(Chung Yong Kim) 대한소화기학회 2000 대한소화기학회지 Vol.36 No.3
Many of water-borne infectious diseases are under control nowadays because of the improvement of hygiene and sewage system, but some of them (e.g. amebic colitis) are still endemic in developing countries. Since there is no definite method of diagnosis, amebic colitis is often diagnosed too late or misdiagnosed as idiopathic inflammatory bowel disease. There have been some reports that treatment with glucocorticoids or immuno-suppressive agents may lead to catastrophic result in amebic colitis. We experienced a 65-year-old man who showed somewhat different clinical consequences. He had longstanding hematochezia with lower abdominal pain, and was misdiagnosed as ulcerative colitis. Because his symptom continued over a year despite treatment with glucocorticoids and sulfasalazine, total colectomy was considered. However, the diagnosis of amebic colitis was made with repeated stool parasite examinations, colonoscopic biopsy and serologic tests. He showed dramatic improvement after the antiamebic therapy with metronidazole. (Kor J Gastroenterol 2000;35:398 - 403)
말초혈액 도말검사로 우연히 진단된 말레이 사상충증 2예
조영욱,성흥섭,이호종,김지훈,석웅,박호선,정태은,이영하 대한진단검사의학회 2005 Annals of Laboratory Medicine Vol.25 No.1
The Brugian filariasis in Korea was once endemic in several areas including Jeju-do and small remote islands located in the southwestern part of the Korean peninsula. But recently it has almost been controlled. The first patient was a 42-year-old man, who visited the hospital with the chief complaints of fatigue, jaundice and edema on the right low extremity. Examination of a peripheral blood smear revealed non-megaloblastic macrocytic anemia, thrombocytopenia and eosinophilia, and a parasite, which was identified as microfilaria of Brugia malayi on the glass slide of blood obtained from the patient at midnight. The second patient was a 23-year-old man, who visited the hospital with the chief complaints of cough, sputum and fever. A parasite resembling that of the first patient was found in a peripheral blood smear accompaning neutrophilia. No more parasites, however, were found in the peripheral blood obtained from the patient at midnight. These two clinical cases of Brugian filariasis indicate that the clinical laboratory in Korea should be able to detect microfilariae for the diagnosis of filariasis. 우리나라에서 말레이 사상충증은 과거 제주도와 한반도 남서부의 낙도지역에서 유행한 적이 있었으나, 현재 대부분 지역에서현저히 감소하였다. 첫째 예는 42세된 남자로 피곤함, 황달 그리고 우측 발등의 부종을 주소로 내원하였다. 말초혈액 도말검사에서 비거대적혈모구 대적혈구성 빈혈, 혈소판감소증, 호산구증다증과 함께 기생충이 관찰되었다. 자정에 채취한 말초혈액에서 말레이 사상충의 미세사상충으로 동정하였다. 둘째 예는 2세 남자로 기침, 가래 그리고 발열을 주소로 내원하였다. 말초혈액 도말검사에서 호중구증가증과 함께 첫째 예와 유사한 기생충이 관찰되었다. 그러나 자정에 채취한 말초혈액에서는 기생충이 발견되지 않았다. 두 증례를 통해 앞으로 국내 검사실에서도 사상충증의 진단에 대한 지식이 필요할 것으로 사료된다.