제 4세대 시멘트 기법을 이용한 Hybrid 인공 고관절 전치환술의 초기결과

김신윤,백승훈,박일형,김풍택,인주철,김창윤,김영모 대한고관절학회 2003 Hip and Pelvis Vol.15 No.3

인천지역 TDI 노출 작업자에서 직업성천식 유병율

김형렬,김철우,홍윤철,전형준,김치년,김현수,이지나,신주연,고동희,노재훈 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : TDI는 직업성천식을 일으키는 대표적인 물질로 알려져 있다. 과거 TDI에 노출된 작업자들의 천식 발생률을 5~6%가량 보고하였고, 국내에서도 2-20%에 이르는 유병율을 보고한바 있다. 작업환경이 많이 개선되고, 노출량이 감소된 최근에도 TDI에 의한 직업성천식에 대한 보고가 많이 이루어지고 있어, 이에 대한 적극적인 조사와 진단과정을 통해 유병율을 구하고 질병발생의 변화양상을 파악해 보고자 하였다. 방법 : 인천지역에서 특수건강진단을 수행하는 2개 기관의 TDI 노출 근로자 400여명 중, 사업장의 규모가 50인 이상이며 사업주가 연구진행을 허락한 사업장에서 근무하는 근로자 중 직접적으로 TDI에 노출되는 작업에 종사하는 근로자 170명을 연구대상으로 하였다. 이들에 대해 설문지와 산업의학의사의 면담을 통한 작업관련성 평가를 근거로 정밀대상자를 선정하고 이들에 대해 메타콜린 유발시험, TDI 유발시험 등을 수행하여 직업성천식을 확인하였다. 결과 : 설문조사 결과 11명이 직업과 관련하여 천식증상을 보이는 것으로 나타났고(6.9%), 이중 7명에서 메타콜린 유발검사 양성소견을 보였다. TDI에 의한 특이유발시험 결과 1명에서 양성반응이 나타나, 이 집단에서 TDI에 의한 직업성천식의 유병율은 0.58%였다. 결론 : 과거 국내연구에서 TDI에 의한 직업성천식의 유병율이 2~20%에 이르렀던 데 비해, 본 연구에서는 0.58%로 나타났다. 이는 국외 논문에서도 나타나는 경향으로 작업장 노출량 감소로 점차 발생률이 감소하는 양상을 보이고 있다. 그러나 이미 증상이 나타난 근로자들이 부서를 옮기거나, 직장을 그만둠으로 인해 그 유병율이 과소평가되었을 가능성도 있다고 판단된다. Objecdives: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. Methods: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. Results: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma. and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1 %). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. Conclusions: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

급성 심근경색 초기에 도플러 심초음파를 이용한 좌심실 이완기 기능의 평가

신원용,김주성,김철현,이광희,최태명,현민수,김성구,권영주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background : Congestive heart failure after acute myocardial infarction relate to left ventricular systolic sysfunction. Also, left ventricular diastolic function contribute to heart failure. The aims of this study were, firstly to characterize left ventricular diastolic function by transmitral flow velocity, and secondly to study the significance of Doppler measurements in relation to the development of heart failure in the early phase of myocardial infarction. Method : Pulsed Doppler echocardiography of transmitral flow was assessed in 34 patients with acute myocardial infarction. According to the Doppler transmitral flwo velocity profile, the study patients were assigned to the three groups: normal filling pattern (DT > 140ms, IVRT < 100ms), relaxation abnormality (DT > 140ms, IVRT ≥ 100ms), pseudonormal or restrictive pattern (DT ≤ 140ms). Also, on the basis of the presence of heart failure during first week of hospitalization, the patients were divided into two groups: patients with no sign of heart failure (Killip class Ⅰ) and heart failure (Killip class Ⅱ-Ⅳ). Results : Of the 34 patients studied, 10(29%) were normal filling pattern, 17(50%) abnormal relaxation and 7(21%) were restrictive patterns. The left ventricular ejection fraction(EF, 40 ±6%) of restrictive pattern was significantly lower than that of normal filling pattern of abnormal relaxation(p < 0.01). And, the IVRT, DT, E/A and left ventricular EF were reduced in patients with heart failure(14 patients) compared to no sign of heart failure(20 patients)(p<0.05). Of the patients with heart failure, IVRT and left ventricular EF were reduced in patients with DT≤140 ms compared to DT> 140ms(p=0.001). Conclusion : Left ventricular diastolic dysfunction is present early after onset of symptoms of acute myocardial infarction. Assessment of left ventricular diastolic function complements measurements of systolic function in the evaluation of cardiac function. DT, IVRT, E/A and left ventricular EF are useful predictors for development of congestive heart failure following acute myocardial infarction.

강유전 박막에서의 분극역전과정 예측

김상주(Sang-Joo Kim),신준호(Joonho Shin),김윤재(Yun-Jae Kim) 대한기계학회 2002 대한기계학회 춘추학술대회 Vol.2002 No.3

A two-dimensional finite element model for polarization switching in ferroelectric materials developed by Kim and Jiang<SUP>(1)</SUP> and Sang-Joo Kim<SUP>(2)</SUP> is used to predict the formation of domains in a ferroelectric thin film. Initially the ferroelectric film is poled upward and the bottom electrode is grounded. A strong downward de field is imposed on a point of the top surface of the film. A region of switched domains with downward polarization is nucleated and is grown with time. It is found that initially the shape of the nucleated domains is that of a bulgy dagger, but later it turns into the shape of a reversed cup with the lower part wider than the upper part. It can also be concluded that the size of nucleated domains increases with the period of applied electric potential. The present results are qualitatively consistent with experimental observations.

분편 인플루엔자백신(split influenza vaccine)의 임상효과 및 면역원성에 관한 연구

우흥정,김동림,정희진,천병철,이주연,안정배,김지희,박찬,신영규,김우주,김민자,박승철 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.1

목적 : 아단위 인플루엔자 백신 접종 후 백신의 인플루엔자 예방효과, 인플루엔자 방어 항체형성, 인플루엔자 백신의 안전성을 조사하고자 하였다. 방법 : 총 571명을 대상으로 인플루엔자 백신 접종을 하였고, 이들 접종자에서 인플루엔자 양질환의 이환을 조사하여 인플루엔자 백신의 인플루엔자예방효과를 알아보았고, 백신의 접종 전 및 접종 4주 후 혈청에서 혈구응집억제물(Hemagglutination Inhibition : HAI) 항체 검사를 실시하여 백신의 방어항체생성을 조사하였고, 백신의 안전성을 알아보기 위해 백신접종 후 1주일 이내의 부작용을 조사하였다. 결과 :백신 접종군과 백신 비접종군에서 인플루엔자 양 질환의 이환을 조사한 결과 접종군 28.35%, 비접종군 35.88%으로 나왔으며, p 값이 0.001로 통계적으로 접종군에서 유의하게 낮았고, 인플루엔자 양 질환의 예방 효과는 20.97%를 보였다. 백신의 방어항체 형성의 평가를 위해 유럽의 인플루엔자 백신 허가 기준을 조사하였는데 B/Guangdong/5/94균주의 백신접종 후 항체가 40이상의 비율을 제외한 다른 기준은 모두 만족 시켰다. 부작용은 전체 조사자 521명중 149명(29%)으로 주로 접종 부위의 국소 부작용을 호소했고, 전신 부작용은 2% 내외였으며 특별히 심각한 부작용은 발견되지 않았다. 결론 : 분편 인플루엔자 백신은 인플루엔자양질환의 예방과 방어항체생성에 효과 있으며 안전한 것으로 사료된다. Background : The safety and effectiveness of influenza vaccine are well known in developed country. The influenza vaccination has been recommended as one of the tentative immunization schedule for indicated persons since 1997 in Korea. But there are still no available data about them, even though nearly 5 million doses of influenza vaccine were used in 1997-1998 season. So it is immediately needed to investigate the safety. efficacy and immunogenicity of influenza vaccine among Korean. Methods : We studied the clinical efficacy of influenza vaccine by monitoring Occurrence of influenza-like illness in influenza risk group(vaccination ; 300, non-vaccination; 215) from December in 1997 to March in 1998. We used the split quadrivalent influenza vaccine containing 15 microgram of hemagglutinin of A/Beijing/262/95(HlNl), A/Wuhan/359/95(H3N2), B/Mie/1/93 and B/Guangdong/5/94. Hemagglutination inhibition(HA1) antibody titers were determined before immunization and 1 months after vaccination And we evaluated adverse effect of influenza vaccination at 7 days after vaccination. Results : Influenza vaccination was associated with si@icant reductions in influenza-like spptoms(vaccination group; 28.35%, non-vaccination group, 35.88%, p=0.001). The preventive effect of influenza-like i3lne.s among influenza risk goup was 20.97%. And immunogenicity of influenza A and B exceeded all of the European licensure criteria for immunogenicity except postvaccination proportion of titers 240 of B/Guangdong/5/94 strain. And the adverse effects were mainly local injection site problem and no serious adverse effect was noted. Conclusion : Split influenza vaccine is safe, inmunogenic and eff'tive in influenza risk group in Korea.

산업훈련 프로그램 개발에 관한 연구 : 가구 판매사원 훈련 프로그램

김신자,주영주,이광희 이화여자대학교 한국문화연구원 1995 韓國文化硏究院 論叢 Vol.66 No.1-3

Rapid development of modern society demands incessant cultivation of new knowledge, function and skills. Even if a firm succeeds in securing qualified manpower, continuous training is imperative for the company to adapt to rapidly changing consumer tastes and business environment. Many of large size firms in Korea began to realize the importance of training programs of their employees. Therefore, they are developing their own programs and willing to spend a large portion of their budget to human resource development. Most of small and medium size firms, however, have not understood the necessity of training program of their won employees. Even if some of them want to make an investment on training their own employees. They could not find the right model suitable to small and medium size firms. Therefore, without analyzing the relevance for the model to their situation, they are forced to use the model mainly designed for large scale firms. After brief introduction, in chapter 2, we analyze the needs for new training programs and introduce well-known training models. We cannot, however, apply the models to the furniture industry without major modification to reflect the main features of furniture industry. Therefore, in chapter 3, we develop new graining programs which consist of four steps of need assessment, design, development, formative evaluation and which are more suitable to furniture industry. We do need assessments in four areas-business needs analysis, job analysis, task analysis, and content analyses. In the second step of design, we prepare program specification and road map. In the third step of development, we produce manuals, transparencies, slides and audio pates for the trainee. In the final step, we perform formative evaluation. In the last chapter, after summarizing our research, we make some suggestion on effective training programs for small and medium size firms on the basis of our study.

고관절 치환술후 무균성 해리와 골용해 조직에서 세포사멸

김신윤,인주철,손윤경,김정완,신홍인,구경회 경북대학교 병원 2003 경북대학교병원의학연구소논문집 Vol.7 No.1

목적 : 인공 고관절 치환술 후 실패의 가장 중요한 원인이 되는 무균성 해리및 골용해와 nitric oxide(NO)에 의한 염증세포 사멸의 연관성을 규명하기 위해 본 연구를 시행하였다. 대상 및 방법 : 무균성 해리와 골용해로 인해 재치환술을 받은 18명의 환자의 조직에서 세포들의 사멸을 Terminal Deoxyribonucleotidyl Transferase-Mediated dUTP Nick End Labeing (TUNEL) 방법을 이용하여 검사하였으며, inducible nitric oxide synthase(iNOS)와 미토콘드리아 관련 세포사멸 경로를 p53, Bax, Bcl2, Ki67 항체를 이용해서 면역 염색하였다. 대조군으로 대퇴 경부 골절 환자 6명의 관절낭을 이용하였다. 결과 : 16명(89%)에서 iNOS, p53, Bax 항체에 양성 반응을 보였으며, 12명(67%)에서 Bcl2, Ki-67 항체에 양성반응을, 전례에서 TUNEL에 양성반응을 보였다. 대조군에서는 1명(17%)에서 iNOS와 Bax에, 3명(50%)에서 TUNEL에 양성반응을 보였다. 무균성 해리와 골용해 조직의 세포사멸에 대한 양성반응의 발현빈도가 대조 조직에서 보다 유의하게 높았다. 결론 : Nitric oxide에 의한 염증세포의 사멸이 인공고관절 치환술 후 생기는 무균성 해리와 골용해에 작용함을 알수 있었다. 이 결과는 해리 및 골용해의 예방과 치료방법을 개발하는데 도움을 줄 수 있다. Purpose : To evaluate the relationships between the apoptosis induced by nitric oxide(NO), aseptic loosening and osteolysis, which are the most serious causes of failure after total hip arthroplasty. Materials and Methods : Apoptosis of the inflammatory cells of interface tissues from 18 patients who underwent revision hip arthroplasty was identified by Teminal Deoxyribonucleotidyl Transferase-Mediated dUTP Nick End Labeling(TUNEL). The reaction to immunostaining of inducible nitric oxide synthase(iNOS), p59, Bax, Bcl2, and Ki-67 were evaluated. Six joint capsules obtained from six patients of femoral neck fracture were studied as controls. Results : Sixteen(89%) of 18 interface tissues were positive for iNOS, p53, and Bax monoclonal antibody and twelve(67%) for Bcl2 and Ki-67 monoclonal antibody. All tissues were positive for TUNEL. In the control group of six joint capsules, only one(17%) was positive for iNOS and Bax, and three(50%) were positive for TUNEL. The incidences of apoptiotic signals at the interfacial tissue of aseptic loosening and osteolysis were significantly greater than those of the control. Conclusion : The current study suggested that the apoptosis of inflammatory cells, due to oxidative stress by NO, might be involved in the development of implant loosening and osteolysis after total hip arthroplasty. This information might be crucial for the treatment and prevention of periprosthetic osteolysis and subsequent loosening.

1998學年度 新入生 實態調査

金光會,朴州信,元俊載 인하대학교 학생생활연구소 1999 學生生活硏究 Vol.19 No.-

GT rotary file을 이용한 만곡 근관형성시 작업 효율 및 file 변형 발생에 관한 연구

신주희,백승호,배광식,임성삼,윤수한,김병현 대한치과보존학회 2001 Restorative Dentistry & Endodontics Vol.26 No.5

Root canal preparation process is of utmost importance in successful treatment of root canal. Also, one of the most important purpose of the root canal preparation is to enlarge the root canal three dimensionally without changing the curvature of the root canal. However, as the curvature of the root canal increases, there are many difficulties involved in formation of optimum root canal. Therefore, in order to solve the above mentioned problems, new developments in methods of root canal preparation and equipments for such purposes were made. Recently, vigorous studies about newly introduced engine-driven nitckel-ti-tanium rotary file are conducted. As shown in research results to dates, it is well established that the use of nickel-titanium file is better suited for curved root canal than stainless steel file in maintaining the curvature of root canal and reducing the deformation of root canal. However, it is also acknowledged that there are a few discrepancies in research results according to protocol, due to failure to remove variables in experiments. In addition, although it is recommended by the manufacturer that the GT rotary file should maintain a low rotational speed of 150∼350rpm and 'light pressure' as light as not to break the lead of a pencil, academic studies about the vertical force which is not yet standardized are not sufficiently explored. Therefore, this research devised and utilized a special research equipment to standardize the appropriate range of vertical force for GT rotary file through experiments by breaking of the lead of a pencil as expressed by the manufacturer and to accurately measure factors involved through repeating and recreating the environment of root canal preparation. Forming nine experimental groups by varying the vertical forces (150g, 220g, 300g) and rpm (150rpm, 250rpm, 350rpm), the effects of changing vertical forces and rpm on working efficiency were measured in terms of time expended in root canal preparation by crown-down method using a transparent resin block with 35 degree curvature and GT rotary file (z-test). The following research using this special research equipment that involved nine experimental groups and varying the vertical force for root canal preparation from 300g which is within the normal vertical force range to 700g and 1000g which fall outside the normal rpm range. The results were as follows : 1.Analysis of the experiment results revealed that the tome spent in root canal preparation decreased as the vertical forces and rpm increased (p<0.05). Also, the effects of rpm were greater than those of the vertical forces within the normal vertical force range (β-weight test) . 2.Observation of the deformation of GT rotary file revealed that deformation increases in a direct correlation with the vertical force increase and in a reverse correlation with the rpm decrease, In the case of the vertical forces close to the normal range, the probability of GT rotary file deformation were quite different depending on the rpm changes. In the case of◎eater tier◎cal forces, the occurrences of deformation of the file were more frequent regardless of the rpm changes. 3.Deformation and breakage of file were also commonly observed in the expended time measurement experiments and GT rotary file deformation experiments in which low speed rpm (150rpm) was used and at the curved portion of the resin block. Key words : GT rotary file, Crown-down method, Working efficiency, Vertical force, Rpm, Deformation and breakage of file

반복작업으로 유발된 수근관내의 굴곡근 건초염과 수근관 증후군 : 증례 보고 Case Report

김돈규,서경묵,신주연,강시현,송인섭 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.1

A 46 year-old woman who had worked repetitive manual job for 3 years visited our hospital because of aggravated right hand sensory symptom and newly developed limitation of 3, 4, 5th finger extension. In physical examination, moderate swelling of volar aspect of wrist and limitation of finger extension was noticed as well as positive tinnel sign. We confirmed carpal tunnel syndrome after electrodiagnostic studies and associated flexor tenosynovitis of 4th flexor tendon in the carpal tunnel through MRI (magnetic resonance imaging) study. She was successfully treated with conservative program including wrist splint and steroid injection. We also tracked the result of treatment using MRI and electrodiagnositic studies. Analyzing her work procedure, we concluded that repetitive and forceful exertional nature of job impose a high burden on hand and wrist region and it caused her carpal tunnel syndrome.