누두흉 환자에서 Nuss 금속막대 제거 전 · 후 폐 역학 변화

강규식,백남순,김천숙,안기량,권진형,김지은,유시현 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Nuss operation is one of the surgical procedure for pectus excavatum and it's method is the insertion of convex steel bar under the sternum through small bilateral thoracic incision. As the patients is growing, the thorax can be compressed gradually by steel bar. So Nuss bar needs to be removed two years after Nuss operation. This study was undertaken to assess the effect on the repiratory mechanics before and after the removal of the Nuss bar. Twenty patients with previous Nuss operation were allocated for the removal of Nuss bar. Lung mechanics (dynamic lung compliance, static lung compliance, and airway resistance), hemodynamic change (heart rate, systolic pressure, and diastolic pressure), and pulmonary gas exchange (arterial oxygen tension, arterial carbon dioxide tension, pulse oximeter saturation, and end tidal carbon dioxide tension) were measured before and after removal of Nuss bar. Respiratory mechanics (dynamic and static lung compliance, inspiratory airway resistance), pulmonary gas exchange and hemodynamic parameter were unchanged before and after the removal of Nuss bar. We concluded that lung mechanics were not changed before and after the removal of Nuss bar in the patients with pectus excavatum and the 95% patients were satisfied with operation.

이대생의 체력 및 건강도에 관한 조사 연구

강지용,김종선,윤남식,이희순,한성일 梨花女子大學校 韓國生活科學硏究院 1975 韓國生活科學硏究院 論叢 Vol.15 No.-

The following results were obtained from the survey of health status and the measurements of physical fitness of 914 students of Ewha Womans University by means of CMI, which were conducted from October 7 to October 27 for three weeks. The purpose of the research mainly consists in the improvement of university health adiministration and of physical education. A. Survey of Health Status 1. The average Number of Complaints are 26.8 for items A-L, 15.3 for items M-R, and 42.1 for items A-R. In terms of classes, the Numbers of Complaints are revealed on a decreasing scale as follows: sophomores, 44.0, the highest; seniors, 42.6; freshmen, 42.1; and juniors, 40.5. 2. Among all the items, the following figures of average Numbers of complaints per person are conspicuous: the seniors have shown 5.3 for item D, which is the highest; and the sophomores, 0,7, which is the lowest. Among the physiological item, D, which corresponds to the ailments of digestion system, shows the highest rate; and among the items for mental diseases, item M, which corresponds to non­adjustment, is 5.2, the highest. 3. The percentiles on the lower echelons of the Number of Complaints are the following: 26.1% for freshmen is the highest; 22.2% for sophomores, the lowest. The sophomores have shown 27.1%, the highest figure, of students who have Number of Complaints of four or above. 4. The percentile figures of 10 or above of Number of Complaints are displayed by seniors with 2.4% and by sophomores with 1.5%. On the other hand, the percentile figures of 80 or above are revealed by seniors with 5.4% and by sophomores with 5.3%. B. Physical Fitness Measurements The figures for the physical fitness measurements are found as given below: 1. Pull­up Freshmen 18.4 seconds Juniors 9.3 seconds Sophomores 7.5 seconds Seniors 7.0 seconds 2. 100 Meters Dash An approximation of 19 seconds is recorded by freshmen, and the tendency is to be slower as the years go up. 3. Sit­ups The freshmen recorded 13 sit­ups, and the tendency is to be fewer as the years go up. 4. Throwing An approximation of 19 meters is marked by freshmen, and the tendency is to be shorter as the years go up. 5. Long Jump The freshmen marked 249.5 centimeters, and the tendency decreases as the years go up. 6. 800 Meters Run 4'1"8"'(4 minutes 1 seconds 8 points) is obtained for freshmen, and the tendency is to be slower as the years go up. 7. Shuttle Run 12.5 seconds is recorded for freshmen, and the tendency is to be slower as the years go up. 8. Trunk Flexion 18 centimeters is marked by freshmen, and the tendency is to be decreasing as the years go up.

의료이용통계 일치도에 관한 연구

강성홍,남문희,임지혜 인제대학교 2009 仁濟論叢 Vol.24 No.1

This study was aimed to investigate medical utilization statistics of type and it’s reliability. Second objective is to suggest methods to improγe reliability of patient survey statistics. We collected patient survey data, health insurance data, discharge summary data in 2005 and reliability of medical utilization statistics analyzed using rate of diagnosis. We found correspondence rate of diagnosis among health insurance statistics, patient survey statistics, discharge injury survey statistics was not high. The rate of Mental and behavioral disorders was 5.0% in health insurance statistics, was 2.4% in patient survey statistics, was 1.3% in discharge injury survey statistics. The rate of diseases of the respiratory system was 10.3% in health insurance statistics, was 8.5% in patient survey statistics, was 12.1% in discharge injury survey statistics. Based on these results, to improvement reliability of medical utilization statistics, this study suggest public health statistics system building, performance of patient survey four times yearly, securing expert.

국내 의료기관의 항생제 사용 실태와 규제 시스템 조사

방지환,송경호,박완범,김성한,조재현,김홍빈,김남중,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 이전 연구들에 따르면 아직까지 국내에서 불필요한 항생제 사용은 무시할 수 없는 수준이며, 특히, 수술환자들에 대한 예방적 항생제 투여가 문제로 지적되고 있다. 많은 병원에서 불필요한 항생제 처방을 제한하려는 노력을 하고 있지만 구체적인 현황에 대한 자료는 적은 실정이다. 이에 본 연구자 등은 국내 의료기관의 항생제 규제 시스템의 현황과 수술시 예방적 항생제 사용의 적정성을 알아보고자 한다. 재료 및 방법 : 전임 감염내과 전문의가 근무하는 의료기관 55곳에 대해 설문조사를 시행하였다. 설문의 내용은 적정한 항생제 사용을 유도하기 위한 정책 및 규제 프로그램, 실제 각 의료기관의 예방적 항생제 사용 현황 등으로 이루어져 있다. 결과 : 55개의 의료기관에 보낸 설문 중 44개가 회수되었다. 회신한 의료기관에서 항생제 처방 관리는 제한항생제 시스템을 가장 많이 이용하고 있었고(95.5%), 항생제에 대한 교육(79.5%), 전산시스템에서 관리(59.1%), 감염내과에 의뢰(54.5%), 항생제 사용 실적 검토(52.3%) 등의 순이었다. 대개의 병원에서 glycopeptides (100.0%), carbapenems (93.0%), quinupristin/dalfopristin 또는 linezolid(93.0%), 4세대 cephalosporin (74.4%), caspofungin 또는 voriconazole (62.8%), liposomal amphotericin B (60.5%) 등을 제한항생제로 분류하여 관리하고 있었다. 모든 의료기관에서 위절제술 및 유방절제술시에 불필요하게 예방적 항생제를 사용하고 있었다. 슬관절치환술의 경우 2세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았으며(30.2%), 관상동맥우회술의 경우 3세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았다(47.2%). 예방적 항생제의 투여 기간을 살펴보면 위절제술시 70.5%에서 4일을 초과하여 사용하고 있었고, 유방절제술시에는 63.6%에서, 슬관절치환술시에는 81.8%에서, 관동맥우회술시에는 81.1%에서 4일을 초과하여 장기간 예방적 항생제를 투여하고 있었다. 한편, 예방적 항생제 투여시 aminoglycoside계 항생제를 병용하는 경우도 많았다. 결론 : 아직까지 국내 의료기관에서 항생제 오남용을 막기 위한 노력이 더 필요할 것으로 생각되며, 특히 수술시 예방적 항생제의 올바른 투여에 많은 관심이 필요하다. Background : Previous studies in Korea showed that unnecessary antibiotic use could not be neglected, especially in prophylactic use. Currently many hospitals employ diverse antibiotic stewardship programs, but there are few studies on surveillance of such programs. So, we planned this study to evaluate current status of antimicrobial stewardship and adequacy of antimicrobial prophylaxis in surgery. Materials and Methods : We sent questionnaires about policy on antibiotic usage, control program for adequate antibiotic prescription, and actual status of prophylactic antibiotic usage to 55 infectious disease physicians in each hospital. Results : Of 55 contacted infectious diseases clinicians, 44 answered the questionnaire. Majority of hospitals employed restricted antimicrobial system (95.5%), education (79.5%), control by order communicating system (59.1%), consult to infectious disease physicians (59.1%), and review of cumulative antimicrobial usage (52.3%) to prevent inadequate antibiotic use. Glycopeptides were designated as a restricted antimicrobial agent in 100.0% of hospitals; carbapenems, 93.0%; quinupristin/ dalfopristin or linezolid, 93.0%; the 4th generation cephalosporins, 74.4%; caspofungin or voriconazole, 62.8%; liposomal amphotericin B, 60.5%, and so on. Unnecessary perioperative prophylactic antimicrobial agents were prescribed in gastrectomy and mastectomy in all the hospitals. The second generation cephalosporins and the third generation cephalosporins were the most commonly prescribed prophylactic antimicrobial agents in total knee replacement arthroplasty (TKRA) and coronary artery bypass graft surgery (CABG) respectively. In 70.5% of institutes they use prophylactic antimicrobial agents more than four days in gastrectomy; 63.6% in mastectomy; 81.8% in TKRA; 81.1% in CABG. Unnecessary combination of aminoglycosides with other antimicrobial agents for prophylactic use was another common problem. Conclusion : This study shows that more effort is required to diminish antimicrobial misuse or overuse, especially in prophylactic use for surgical patients.

초등학생 태권체조 참여도가 학교생활적응에 미치는 영향

백남섭,지동철,강은정 龍仁大學校 武道硏究所 2011 武道硏究所誌 Vol.22 No.1

이 연구의 목적은 초등학생 태권체조 참여도가 학교생활적응에 미치는 영향을 규명하는데 그 목적이 있다. 이는 상관관계 분석과 다중회기분석을 실시하여 개인적 특성에 따른 태권체조 참여도, 학교생활적응의 차이와 태권체조 참여도와 학교생활적응의 관계에 대하여 결과를 얻었다. 검사자료의 분석 결과는 다음과 같다. 첫째, 개인적 특성인 성별, 학년, 수련기간, 주 수련횟수, 주 수련기간에 따른 태권체조 참여도의 차이분석에서는 주 수련시간이 진지형에 유의한 영향을 미쳤으며, 성별, 학년, 주 수련횟수가 기피하는 유형에 영향을 주었지만 성별, 학년, 수련기간, 주 수련횟수, 주 수련기간이 태권체조참여의 하위요인 진지형에는 영향을 주지 않았다. 둘째, 개인적 특성인 성별 학년, 수련기간, 주 수련횟수, 주 수련기간에 따른 학교생활적응의 차이분석에서는 학년, 수련기간, 주 수련횟수가 교사관계에서 좋은 영향을 미쳤으며, 또한 학년 수련기간이 교우관계에서도 좋은 영향을 미쳤으며, 성별, 학년, 수련기간이 학교수업에 긍정적인 성향을 띄었으며, 수련기간에 따른 학교규칙을 잘지킨다는 연구 결과가 나타났다. 셋째, 초등학생 태권체조 참여도가 학교생활적응에 어떠한 영향을 미치는 지를 알아보기 위한 결과로 진지형은 교사관계, 교우관계, 학교수업, 학교규칙에서 긍정적인 영향을 준다는 연구결과가 나타났지만, 의무형에서는 교사관계, 교우관계, 학교수업, 학교규칙 모두 영향을 미치지 않는 것으로 나타났다. 또한 기피형에서는 교사관계, 교우관계, 학교수업, 학교규칙 모두 영향을 미치지 않는 것으로 나타났다.

링 앞 휘돌아 물구나무서기 동작의 운동학적 분석

류지선,정남주,강병의 韓國體育大學校附屬 體育科學硏究所 1997 韓國體育大學校附屬 體育科學硏究所論文集 Vol.16 No.1

The purpose of this study is to examine the kinematical factors of Felge upward with straight arms to handstand motion, and to grope for the better Felge motion or dismount motion using the Felge motion on the Rings. As the subjects, six gymnasts(KOR 2, JPN 2, CHN 2) who participated in the 1997 Pusan East Asian Games(men's team competition Ⅰ). Two S-VHS video cameras were used for the data collection. The Direct Linear Transformation(DLT) technique was employed to obtain 3-D position coordinates of 30 control object points and 18 landmarks. A cubic spline function was used for smoothing and differentiation. And the following conclusions were drawn; 1. Down swing phase : It indicated that the longer vertical and horizontal displacement of CM were the smaller in vertical position of CM after the first handstand. Also it showed that the large extension of shoulder and hip joint resulted in the fast downward velocity at the Beating. 2. Beating swing phase : It indicated that the factors influencing the angular velocity of shoulder and hip joints and the horizontal velocity of the CM were the large downward vertical velocity during downswing phase, and the hip angle and position at the Beating. 3. Felge swing phase : It indicated that the large upward velocity and the small angular velocity of the shoulder and hip joints and the small horizontal velocity of the CM have the advantage of performing the last handstand motion.

치과기공사의 스트레스 증상 관련 요인분석

김지환,이원철,이강숙,이철,진기남 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목 적 : 치과기공사에서의 직무 스트레스 증상과 관련된 요인을 알아보기 위하여 본 연구를 수행하였다. 방 법 : 전국에 등록되어 있는 치과기공사 4861명중 786명을 대상으로 생활습관, 직무에서 오는 스트레스, 사회적 지원, 자아 존중감, 성격 및 스트레스증상 평가를 위한 설문조사를 시행하였다. 결 과 : 스트레스 증상지수는 80 percentile을 기준으로 하위척도들의 절단점을 선정하였으며, Receiver Operating Chacteristic Curve를 그려 민감도 81.5 %, 특이도 86.1 % 되는 55점을 절단점으로 선정하였다. 생활습관 및 상태 항목으로는 흡연자에서 OR=1.49(1.11-2.00), 주관적 건강상태가 좋지 않은 군에서 OR=1,53(1.06-2.21)로 유의하게 스트레스 증상이 높았다. 직업관련 스트레서(stressor)로는 역할 과부하 (OR=6.69, 4.74-9.44), 작업 요구(OR=8.34, 5.82-11.97), 작업과정(OR=9.89, 6.76-14.94), 작업환경(OR=8.27, 5.80-11.79), 대인관계(OR=5.82, 4.04-8.39), 직업갈등(OR=8.34, 5.82-11.97), 봉급(OR=5.70, 4.04-8.04), 역할갈등(OR=7.58, 5.37-10.71) 등이 높은군에서 스트레스 증상이 높았으며, 사회적 지원이 높은 군에서 OR꼰.39(0.27-0.57), 자아 존중감이 높은 군에서 OR=0.41(0.290.60)로 스트레스 증상이 유의하게 낮았다. 결 론 : 직업관련 스트레스 경험을 많이 한 사람일수록 직업성 스트레스 증상의 정도도 높았으며, 사회적 지원을 많이 받고 자아존중감이 높은 사람일수록 스트레스 증상을 느끼는 정도가 낮았다. 직장 내에서는 스트레스를 감소시킬 수 있는 다양한 대처 전략 프로그램의 개발과 개인을 위한 스트레스 관리교육이 필요하며, 전문화된 직장 내에서 근로자가 도움을 받을 수 있는 정보체계와 직장내의 지원이 필요함을 제시하고 있다. Objectives To investigate the factors associated with symptoms from job stress among Korean dental laboratory technicians. Methods : We collected the data of 786 technicians for life-style, job stressor, social support, self-esteem, personality, and various dimension of stress symptoms included roomatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and hostility by self-administerd questionnaire. Global severity index of dental technician (GSID) was calculated by total sum of sub-dimension. Results We used 80 percentile as a cut-off point, and got the 81.5 % of sensitivity, 86.1 % of specificity by receiver operating characteristic curve. The odds ratios of various factors in high group of GSID compared with low group were 1,49(95 % Cl 1.00-2.00) for smoker, 1,53 (1.06-2.21) for unhealthy group, 6,69 (4.74-9.44) for work overload, 8.34(5.82-11.97) for work demand, 9.89 (6.76-74.94) for work process, 8.27 (5.80-11,79) for work environment, 5.82 (4.04-8.39) for interpersonal relationship, 8.34 (5.82-11.97) for occupational conflict, 5.70 (4.04-8.04) for labor remuneration, 7.58 (5.37-10.71) for role conflict, but 0.39 (0.27-0.57) for social support, 0.41 (0.29-0.60) for self-esteem. By multiple logistic regression, factors were significantly associated with GSID were age, working area, role overload, work demand, work procedure, physical environment, occupational conflict, role conflict, social support, personality traits. Conclusions : Factors associated with symptoms from stress were role overload, work demand, work procedure, occupational conflict, interpersonal relationship, labor remuneration and role conflict in Korean dental laboratory technicians. It is suggested that health promotion program to reduce job stress and to enforce social support and self-esteem should be developed.

상지 단순반복작업 근로자의 수근관 증후군 유병률에 관한 조사

손지언,장태원,김윤규,홍영습,정갑열,김동일,이강진,하남진,김상범,김준연 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 본 연구는 수근관 증후군의 발생위험이 높은 작업형태에 종사하는 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장과 목재소 근로자에서 근전도검사를 이용하여 수근관 증후군의 유병률을 조사하고자 하였다. 방법 : 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장 근로자 69명과 목재소 근로자 17명을 실험군으로, 관리직, 경리, 경비등 상지의 단순반복작업이 없는 근로자 28명을 대조군으로 선정하여, 작업적 및 병력조사, 이학적 검사와 근전도검사를 통해 수근관 증후군의 유병률을 조사하였다. 결과 : 수근관 증후군의 유병률은 육류 및 어류 가공 사업장과 목재소에서 각각 26.09 % (18명)와 29.41 %(5명)로 조사되었으며, 육류 및 어류가공사업장과 목재소 근로자를 '7년 이상과 미만의 작업기간'으로 층화하여 비교한 결과 '상지부위의 통증 호소 유무', 'Visual Analogue Scale(VAS: 총 10점) 4점 이상 여부', 'Tinel teat 양성 유무', 'Phalen test 양성 유무'는 모두 단기 작업근로자군에서 양성의 빈도가 증가되었고 '수근관 증후군 유무'는 장기작업근로자군에서 양성의 빈도가 증가되었다. 결론 : 육류 및 어류 가공 사업장과 목재소의 수근관 증후군 유병률은 각각 26.09 %와 29.41 %로 육류 및 어류 가공 사업장과 목재소는 1996년 OSHA가 지정한 바와 같이 위험한 작업요인이 있는 작업장으로 분류하여 관리되어야 할 것으로 생각된다. Objectives : This study was carried out to survey on the prevalence of Carpal Tunnel Syndrome(CTS) in high risk jobs(meat and fish processing plant and wood plant), by application of Nerve Conduction Study(NCS), a confirmatory diagnostic method. Methods : Experimental group was 69 workers sampled from meat and fish processing plants and 17 workers sampled from wood plants, who were simple, repetitive workers using upper extremities and control group was 28 workers sampled from managers, secretaries and keepers. All employees were examined through work history, physical examination and NCS. Results : 18 workers(26.09%) in meat and fish processing plants, and 5 workers(29.41%) in wood plants had compatible findings to NIOSH diagnostic criteria for CTS. The experimental group had more symptoms (complaint of upper extremities, Visual Analogue Scale ≥4(VAS: total 10 point)), signs(Tinel and Phalen test) and prevalence of CTS than control group(p<0.05). The prevalence of symptoms and signs were higher in short term workers(<7 years), but the prevalence of CTS was higher in long term workers(≥7 years). Conclusions : The prevalence of CTS in meat and fish processing plant and wood plant were 26.09% and 29.41% respectively. Authors propose that meat and fish processing and wood plants should be managed as a risk job category which were designated by OSHA in 1996

봄철 익산지역 환경대기 중 수용성 이온성분의 일별 침적량

김남송,강공언,김정숙,김현아,신지혜,김병수,최석진 원광대학교 대학원 2008 論文集 Vol.40 No.-

Deposition samples were collected in wet gauge and dry gauge containers at downtown of Iksan city, located southwest of the Korean peninsula, from April 20 to May 1, 2004. The volume of 30-50㎖ deionized water was added for wet gauge before sampling, but dry gauge was installed in the dry state with no deionized water adding. These samples were collected twice a day during daytime and nighttime and were analyzed for anions(Cl^(-), NO^(3-), SO₄^(2-)) and cations (NH₄^(+), Na^(+), K^(+), Mg^(2+), Ca^(2+)) using ion chromatography. Data quality was checked by the data obtained from re-injection of standard solution, Dionex cross check standard solutions, and random several deposition samples, and measured data was estimated to be reliable. Considering the deposition sample volume, the sampling time, the surface area of sampling container, and the ion concentration measured, the deposition amounts were calculated in mg/㎡/day. The sum of ion dry deposition amounts for dry gauge and wet gauge was 9.1±6.7 mg/㎡/day and 26.5±9.1 mg/㎡/day, respectively. A significant increase in deposition amount during rainfall days and Asian yellow dust period was observed for both wet gauge and dry gauge, especially during rainfall days having no difference of deposition amount between in wet gauge and in dry gauge. The mean deposition of all ions measured in this study were higher in wet gauge than in dry gauge because of the surface difference of the sampling container. The mean deposition amount of NH₄^(+), SO₄^(2-), and NO^(3-) in wet gauge were found to be about 27.6 times, 5.5 times, and 3.4 times higher. than that in dry gauge, while the rest of the chemical species were equal or a little higher in wet gauge than in dry gauge. Dominant species in dry gauge were SO₄^(2-) and Ca^(2+), accounting for 14.7% and 47.3% of the total ion dry deposition, whereas those in wet gauge were SO₄^(2-) and NH₄^(+), accounting for 27.7% and 27.1% of the total ion dry deposition, respectively.

계지의 항염 효과에 관한 연구

박히준,이지숙,이재동,김남재,표지희,강전모,최일환,김수영,심범상,이제헌,임사비나 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : Cinnamomi Ramulus (CR), the young twing of Cinnamomi loureirii nees, has been used for treating symptoms related to pain. rheumatic arthritis and inflammation in Korean herb medicine. This study was carried out to investigate the anti-inflammatory effect of CR in vivo and in vitro. Methods : Extracts of CR were prepared and the chemical components of the extracts were examined by gas chromatography-mass spectrometry (GC-MS). The extracts were administrated to the rat paw edema model induced by carrageenan to evaluate the anti-inflammatory effect of CR. The expressions of nitric oxide (NO). prostaglandin E2(PGE2), inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 were also quantified in lipopolysaccharide (LPS)-induced RAW 264.7 macrophages to survey the effect of CR in vitro. The main components were cinnamaldechyde and coumarin. Results : We examined the anti-inflammatory activity of the 80% ethanol extract of Cinnamomi Ramulus in vivo by using carrageenan-induced rat paw edema model. Maximum inhibition of 54.9% was noted at the dose of 1000㎎/㎏ after 2 hours of drug administration in carrageenan-induced rat paw edema and this showed a potent anti-inflammatory effect. Conclusions : The results showed that Cinnamomi Ramulus suppressed dose-dependently LPS-induced NO production in RAW 264.7 macrophages and also decreased iNOS protein expression. Cinnamomi Ramulus also showed a significant inhibitory effect in LPS-induced PGE2 production and COX-2 expression.