현훈 환자 Neuron Specific Enolase의 임상적 의의

김원주,김선곤,유철형,김원찬,김용덕,최영철,이명식 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4

항정신병약물 사용 중인 정신분열병 환자에서 올란자판으로의 교체 방법에 관한 연구(II) : Comparison of Safety 안전성 비교

안용민,권용실,권준수,민성호,박두병,양문정,소형석,송종호,신윤식,우행원,유범희,이홍석,정한용,한창환,김용식 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.5

연구목적: 이 다기관 공동임상연구는 사용 중인 항정신병약물을 ’직접 교체 방법’또는 ’시작-감량 교체 방법’중 한 가지 방법으로 올란자핀으로 교체한 후, 안정성 측면에서 두 교체 방법 간의 비교와 교체후의 변화를 관찰하기 위한 것이다. 방법: 국내 13개 병원의 입원 및 외래에 내원한 환자들 중 ICD-10 지단기준으로 정신분열병에 해당되며, 임상적으로 항정신병약물 교체가 필요한 환자를 대상으로 하였다. 두 가지 교체 방법 중 한 가지를 무작위로 피험자에 적용하였으며, ’직접 교체 방법’에 배정된 경우에는 사용중인 항정신병약물을 일시에 중단하고 10㎎의 올란자핀을 바로 투여하였고, ’시작-감량 교체 방법’에 배정된 경우는 10㎎의 올란자핀 투여하고 2주에 걸쳐서 기존 약물을 감량하여 중단하였다. 올란자핀 사용기간은 총 6주이며, 용량은 5∼20㎎ 범위로 제한하였다. 한정성 평가를 위해서 체중, 생명징후, 자발적인 이상반응 복, 실험실 검사 그리고 Simpson-Angus Scale(SAS), Barnes akathisia rating scale(BARS), Abnormal involuntary movement scale(AIMS). Liverpool University neuroleptic side effect rating scale(LUNSERS)등을 이용하였다. 결과: 총 103명의 정신분열병 환자를 대상으로 하였다. 사용한 올란자핀의 용량, 벤조디아제핀의 병용률, 탈락률과 탈락 사유, 자발적인 이상반응 보고, 생명징후, 실험실 검사 그리고 대부분의 부작용 척도 상에서 임상적으로 의미 있는 차이를 두 교체 방법간에 발견하지 못하였다. 다만 AIMS의 감소는 ’직접 교체 방법’군에서 보다 적었고, 항콜린제의 병용률은 ’시작-감량 교체 방법’군에서 보다 많았다. 기저 상태에서 전체 피험자의 SAS와 BARS 점수는 각각 3.5점과 1.8점이었으며 70% 이상의 피험자가 고프로락틴 혈증을 보였다. 올란자핀으로 교체한 후, SAS, BARS, AIMS 점수의 유의한 감소가 있었으며 고프로락틴 혈증을 보인 피험자 분율도 약 30%이하로 감소하였다. 그러나 교체 방법과 상관없이 올란자핀 교체 후 유의한 체중 증가가 있었다. 결론: 이 연구를 통해 교체 방법에 관계없이 비교적 안전하고 용이하게 올란자핀으로 교체 할 수 있음을 알 수 있었다. 그리고 기존 항정신병약물을 올란자핀으로 교체함으로써 일부 부작용들을 줄일 수 있음을 간접적으로 관찰할 수 있었다. 하지만 이 연구는 여러 제한점과 문제점을 지니고 있기 때문에 보다 체계적인 연구를 통해 검정이 필요하리라 생각된다. Objectives: This multicenter clinical trial involving 13 hospital sites compared the safely of switching to olanzapine between ’direct switching method’ and ’start-tapering switching method’. Method: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For ’direct switching method’group, previous antipsychotics were abruptly discontinued and 10㎎ of olanzapine was administered, and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20㎎. The safety of switching to olanzapine was measured with vital sings including body weight, adverse events reported spontaneously, laboratory tests, and various scales such as Simpson-Angus Scale(SAS), Barnes Akathisia Rating Scale(BARS). Abnormal Involuntary Movement Scale(AIMS), and Liverpool University Neuroleptic Side Effect Rating Scale(LUNSERS). Results: 103 patients were switched to olanzapine in this study. The comparison between two switching methods did not show any significant difference in the dosage of olanzapine used, the concomitant use of benzodiazepine, the rate and reasons of drop-out, the adverse events, vital signs, laboratory tests, and most scales for measuring side-effects. However, the decrease in AIMS scores was significantly lower in ’direct switching method’ group, and the concomitant use of anticholinergics was comparatively greater in ’start-tapering switching method’ group. At baseline, SAS and BARS scores were 3.5 and 1.8 points respectively, and more than 70% of the subjects showed hyperprolactinemia. After switching to olanzapine, SAS, BARS, and AIMS scores were significantly decreased and the proportion of the patients with hyperprolactinemia was also decreased to less than 30%. However significant weight gain after the treatment of olanzapine was observed regardless of switching method. Conclusion: This study may suggest that switching to olanzapine can be done with relatively high safety regardless of switching methods and olanzapine can significantly decrease some side-effects induced by other antipsychotics.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

전상회계 전자교재(e-Textbook) 개발에 관한 연구

김소형,정용화 한국직업능력개발원 2003 직업능력개발연구 Vol.6 No.1

This study researched to apply a accounting education method of the future that to consider college environment. The research model was completed to be analysis a concept, strong-weakness of e-Book & e-Text Book, environment factor for development of accounting e-textbook. The contents development used to the effect of animation and made the simple design. It was to be purposed to study an important accounting knowledge fast. The accounting e-textbook was made to use the PC and internet explore for convenient the students. This method learn anywhere the computer accounting program.

톨루엔 노출 근로자에서 요중마뇨산 배설농도로 평가한 호흡보호구 착용효과에 관한 연구

김범석,박정일,임현우,김형아,오상용 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

목적 : 보호구 착용 효과에 대한 실제적, 구체적자료를 제시함으로서 예방목적의 보호구 사용에 대한 근로자들의 인식을 제고시키기 위함이다. 방법 : 서울시내에 소재한 일부 그라비아 인쇄소에서 톨루엔이 함유된 잉크 및 희석제를 취급하는근로자 26명을 대상으로 본 연구를 수행하였다. 유기가스용 방독마스크 미착용 상태와 유기가스용 방독마스크 착용후 작업환경 중 톨루엔 개인노출농도와 요중 마뇨산 시간별 농도를 측정, 비교하였다. 결과 : 그라비아 인쇄소의 공기중 톨루엔 개인노출농도는 유기가스용 방독마스크 미착용일과 착용일에서 각각 147.52+57.34 ppm 및 134.55+52.44ppm으로 통계학적으로 유의한 차이는 없었다. 방독마스크 미착용일파 착몽일의 작업종료 후 요중 마뇨산 농도의 기하평균값은 각각 1.5) 10.33:1 g/L 및0.49(0.14) 하였으며 두 일간에 유의한 차이를 보였단. 방독마스크 미착용일에서 요중 마뇨산 농도는 근무시작 4시간 후(오후 작업시작전, 13:00)부터 유의하게 증가하기 시작하였으며, 착용일에서는 근무종료시까지 유의한 증가를 보이지 않았다. 유기가스용 방독마스크 착용 효과를 톨루엔 대사산물인 요중마뇨산 농도로 평가하면 착용시 농도가 미착용시에비하여 89.3% 감소하였다. 보호구 미착용일에 있어서 공기중 톨루엔 개인노출농도와 요중 마뇨산 농도는 유의한 상관성을 나타났으며 회귀방정식은 Y(요중 마뇨산, g/L) =0. OO7x (공기중 톨루엔, ppm)+0.665로 계산되었다. 결론 : Fit Test등 올바른 보호구 착용 교육을 통한 전 작업시간에 걸친 유기가스용 방독마스크 보호구 착용은 직업적인 톨루엔 노출의 호흡기 흡수를거의 대부분 차단하였다. Objectives : This study was carried out in order to raise workers' recognition of the effects of respirator use by providing concrete and practical data. Methods : Twenty-six workers who dealt with toluene based ink and diluents at a gravure printing office in Seoul were investigated. The toluene exposure level and urinary hippuric acid level were monitored under respirator non-wearing (RNW) and under respiratory wearing (RW) conditions. Results : The mean concentrations of toluene exposed to each worker through the air of gravure printing office were 147.52±57.34 and 134.55±52.44 ppm on respirator non-wearing day and respirator wearing day, respectively. There was no significant difference in toluene exposure concentration for the two days. The mean concentration of urinary hippuric acid in RNW and RW groups were 1.51 (0.53) g/L and 0.49 (0.14) g/L, respectively, as measured at the end of the workday. There was a significant difference seen in urinary hippuric acid concentration between the two days. The urinary hippuric acid concentration began to increase at 4 hours after the start of the workday (13:00) in RNW. However, there was no significant increase until the end of the workday in the case of RW. The urinary hippuric acid concentration in RW reduced 89.3% as compared with the concentration seen in RNW. There was a significant correlation between the toluene concentration and the urinary hippuric acid concentration in RNW. The regression equation was Y (urinary hippuric acid concentration, g/L) = 0.007 ×χ(toluene concentration in the air, ppm) + 0.665. Conclusions : Our results indicate that the respirator intercepted most toluene that may have been absorbed Into the respiratory organs, and suggested that properly wearing a respiratory such as wearing the respirator during the entire workday and performing a proper fit test played an important role in the protection from toluene exposure

원발성 하지정맥류에 대한 임상적 고찰

김형태,조원현,박흥수,이상목,정기용,김유사 大韓脈管外科學會 1995 大韓脈管外科學會誌 Vol.11 No.2

익수환아의 예후에 영향을 미치는 인자에 관한 연구

김용배,정대봉,조수형,조남수,박영봉,박상기,김춘호,양은석,문경래 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.3

Drowning is the second most common cause of accidental death of children in Korea. But the study of near-drowning is very rare in Korea. The purpose of our study is to determine the factors that may influence survival on the basis of submersion time, consciousness state upon admission to hospital, the kinds of water, laboratory findings and neurological outcomes. The survey was performed by a retrospective cohort study on 28 near-drowning victims of less than 15 years of age who were admitted to the emergency room in the Chosun University Hospital between May 1988 & May 1997. The results were as follows :1)Sex distribution was 22 males and 6 females. 2) Submersion time was <5 minutes in 9 cases, 5-9 minutes in 6 cases, 10-14 minutes in 5cases, 15-19 minutes in 3 cases, ≥20 minutes in 5cases. 3) Comatose patients upon arrival were 6/7 cases in the death group(86%) and 2/21 cases in the improved group(10%). They had unfavorable outcomes(P<0.05). 4) The first PH value was mean 7.02±0.12 in the death group and mean 7.31±0.13 in the improved group. There was a statistically significant difference between the death and the improved group(P<0.05) 5) The patients who gad increased blood glucose concentration were all 7 cases in the death group and 12/22 cases in the improved group(54%). The mean blood glucose concentration was mean 424.7235.6㎎/㎗ in the death group and mean 140.182.7㎎/㎗ in the improved group. There was a statistically significant difference between the death and the improved group(P<0.05). 6) The patients who had pulmonary edema upon arrival were all 7 cases in the death group and 1/21 cases in the improved group(46%). They had unfavorable outcomes(P<0.05). 7) The patients who had been submerged more than 15 minutes were all 7 cases in the death group and 6/21 cases in the improved group(5%). They had unfavorable outcomes(P<0.05). We conclude that pediatric victims of near-drowning can be assigned to high or low likelihoods of unfavorable our outcomes with the use of five variables ; comatose mentation upon arrival decreased initial blood pH, increased initial blood glucose concentration, pulmonary edema, and maximum submersion time estimated longer than fiften minutes. This prediction rule may be useful if it can be validated in another cohort.

晋州市 南江水質의 變化와 그 影響

金炯甲,趙鏞雲 진주산업대학교 농업기술연구소 1989 農業技術硏究所報 Vol.2 No.-

1988年 6月부터 12月까지 7個月 동안에 걸쳐 晋州市內의 南江 5개 지점을 매월 4∼5 일씩 採水하여 水質을 分析한 結果는 다음과 같다. 調査期間中 南江의 位置別 水質平均値는 1. 下水가 流入되지 않는 上位쪽은 各各 DO 8.8ppm, BOD 2.6ppm, SS 22.1ppm, 蒸發殘溜物 57.4ppm, KM_nO_4 消費量 8.6ppm, 硬度 67.1ppm, Cl^- 10.8ppm이었다. 2. 下水가 流入되어 흐르는 下位쪽은 各各 DO 6.3ppm, BOD 3.8ppm, SS 23.6ppm, 蒸發殘溜物 102ppm, KM_nO_4消費量 12.1ppm, 硬度 73.0ppm, Cl^- 14.2ppm으로서 比較的 汚染이 적었다. 3. 강의 中間에 位置하며 下水가 放流되는 지점은 一部地域이지만 심한 汚染度를 나타냈다. During the seven months from June to December in 1988, Water quality analyzed at five site of the Nam river in Chinju city. Analytical water sampled for four or five days of every month. For investigated preiods, the averages of water quality of the Nam river were as followed. 1. The upstream in which sewage didn't flow into were DO 8.8ppm, BOD 2.6ppm, SS 22.1ppm, total residue 57.4ppm, total hardness 67.1ppm, consumption of KMnO_4 8.6ppm and Cl^- 10.8ppm. 2. The downstream were DO 6.3ppm, BOD 3.8ppm, SS 23.6ppm, total residue 102ppm, total hardness 73.0ppm, consumption of KMnO_4 12.1ppm and Cl 14.2ppm. These showed the low pollution relatively. 3. Though the middle sewage inflow site was a small part, it seemed to be very polluted.

제조업체 광물성분진의 총분진, 흡입성분진, 흉곽성분진과 호흡성분진의 농도

김용우,피영규,김현욱,김형아 가톨릭대학교 산업의학센터 2000 韓國의 産業醫學 Vol.39 No.2

This study was designed to estimate particle size distribution of airborne dust by an 8-stage cascade impactor, to compare concentrations of total dust by 37mm closed-face cassette with total dust, thoracic particle mass(TPM), inhalable particle mass(IPM) concentrations by an 8-stage cascade impactor and to estimate concentrations of respirable dust collected by cyclone in manufacturing factories. Total 85 sites in 44 factories were sampled from August 1, 1996 to December 31, 1997. The results were as follows: 1.The geometric mean concentration of total dust collected by 37mm closed-face cassette were 0.27-1.44 mg/㎥. The GM concentrations of total dust by impactor were 0.82-2.85 mg/㎥, of inhalable dust 0.63-2.24 mg/㎥, and of thoracic dust were 0.31-1.40 mg/㎥, respectively. 2.The analysis of particle size distribution showed bimodal patterns for almost all sampling sites studied. Geometric mean(GSD) diameters of the small mode were 0.515(1.577) ㎛ - 3.032(13.698) ㎛, while the large mode were 11.873(2.460) ㎛ - 19.774(2.606) ㎛, respectively. 3.The geometric mean(GSD) concentrations of respirable dust collected by cyclone were 0.08-0.46 mg/㎥. To evaluate health hazards from mineral dusts occurring in manufacturing industries, these results suggest the necessity of promulgating particle size-selective limit values and sampling methods such as IPM, TPM, and RPM.

MP-2에서 타원형 편미분 방정식 병렬계산

김형중,이용호 江原大學校 産業技術硏究所 1994 産業技術硏究 Vol.14 No.-

일반적으로 2차원 Poisson 방정식을 풀기 위해 유한 차분법을 이용하여 tridiagonal block Toeplitz 선형방정식을 얻는다. 이 선형방정식의 독특한 형태를 활용하기 위해 Lyapunov 방정식으로 변화시킨 다음 이산정형변환(DST)을 이용해서 대각선 행렬로 만들면 계산이 용이해진다. 또 DST는 FFT를 이용해 계산할 수 있으므로 고속 계산이 가능하다. FFT를 병렬로 처리하기 위해 프로세서가 4,096개인 SIMD 컴퓨터 MP-2에서 시뮬레이션했다. 본 논문에서는 알고리즘 유도, 매핑 및 시뮬레이션 결과를 제시했다. We can get a tridiagonal block Toeplitz linear system by the finite difference approximation of 2-D Poisson equation. To exploit the nice property of this linear equation, we transform the equation into'a Lyapunov equation and apply DST(discrete sine transform) to get diagonal matrix based Lyapunov equation. DST can be performed using FFT, which enables high-speed computaion. All the computations are performed on an SIMD parallel computer, the MasPar MP-2 with 4,096 processing elements. In this paper, parallel algorithm, mapping method of the algorithm onto the MP-2, and timing results are presented.