복부 결핵으로 발현된 후천성 면역 결핍증 1예

고병성,김상중,유경화,이경한,노기탁,허원석 이화여자대학교 의과학연구소 2015 EMJ (Ewha medical journal) Vol.38 No.3

The incidence of tuberculosis (TB) had gradually been declining all over the world, but in recent years, TB has been increasing due to the spread of the human immunodeficiency virus (HIV). When immune-suppression status deteriorates further, extrapulmonary TB generally appears more often. Abdominal TB is one type of extra-pulmonary TB, which may involve the gastrointestinal tract, peritoneum, lymph nodes or solid viscera. We encountered a case who had initially been diagnosed as having abdominal TB, had progressed to acute respiratory distress syndrome and was eventually confirmed as having developed acquired immune deficiency syndrome. In cases of coinfection of TB and HIV, it is reported that immunological responses become poor and complications with higher morbidity frequently occur. Therefore, the Korean guidelines for TB should be revised to ensure whether HIV infection exists in TB patients.

모래쥐의 양측 목동맥차단에 의한 전뇌허혈이 대뇌겉질 혈관의 미세순환에 미치는 영향

고운산,황성희,이병철 대한신경과학회 1998 대한신경과학회지 Vol.16 No.5

고정 스트레스 상태의 흰쥐에서 할로페리돌 전처치가 뇌생아민의 대사에 미치는 영향

이수복,양병환,김이영,이용성,고재경,김광일 漢陽大學校 精神健康硏究 1991 精神健康硏究 Vol.10 No.-

일부 남성 금속제품 조립작업자들의 피로에 영향을 미치는 작업관련요인

장준호,강동묵,고상백,김정원,조병만,이수일 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : 남성 금속제품 조립 작업자들의 피로에 영향을 미치는 작업관련요인을 파악하고자 한다. 방법 : 작업자의 일반적 특성 및 작업관련 특성, 육체적 부하, 직무 스트레스 등을 조사 항목으로 하여 자동차 부품 조립업 1개소(476명), 자동차 엔진 조립업 1개소(610명), 대형 선박 엔진 조립업 1개소(454명)의 작업자(1,540명)를 대상으로 수거된 설문지 중 부실하게 응답한 38부를 제외한 1,136부(총연구대상의 73.8%)를 분석하였고, 피로도와의 연관성을 다중선형회귀분석으로 살펴보았다. 조사는 자기 기입식 설문지를 사용하였다. 육체적 부하를 측정하기 위해서는 Borg의 scale이 사용되었다. 격무 스트레스를 측정하기 위해서는 Karasek의 Job content questionnaire가 사용되었다. 피로의 측정은 전반적 피로도(sum of fatigue), 일상생활 기능장애(daily dysfunctioning), 상황적 피로(situational fatigue), 피로점수의 총합(sum of fatigue)으로 구성되어 있는 다면적 피로척도를 사용하였다. 피로점수의 분포는 본 연구에 응답한 피로점수의 총합을 사분위수로 나누어서 4등급으로 나누었다. 결과 : 피로점수의 분포는 피로점수의 총합을 사분위수로 나누었을 때, 0≤1등급≤73, 74≤2등급≤82, 83≤3등급≤93, 94≤4등급≤133이었다. 다중선형회귀분석에서 피로점수의 총합과 유의한 관계를 보인 경우는 주간근무, 긴 주당 노동시간, 높은 육체적 부하, 높은 직무요구도, 낮은 직무자율성, 낮은 상사의 지지 등이었고, 전반적 피로도와 유의한 관계를 보인 경우는 주간근무, 높은 육체적 부하, 높은 직무요구도, 낮은 직무자율성, 낮은 상사의 지지 등이었다. 일상생활 기능장애와 유의한 관계를 보인 경우는 주간근무, 긴 주당 노동시간, 높은 육체적 부하, 낮은 직무자율성 등이었다. 상황적 피로와 유의한 관계를 보인 경우는 높은 연령, 주간근무, 긴 주당 노동시간, 낮은 직무자율성 등이었다. 결론 : 피로관련 요인은 긴 주당노동시간, 높은 직무요구도, 높은 육체적 부하, 낮은 직무자율성, 낮은 상사의 지지로 생각된다. Objectives: To find work related factors affecting perceived fatigue among male metal product assemblers. Methods: The study subjects were metal product assemblers from three metal product companies (476 car parts assemblers, 610 car engine assemblers, 454 ship engine assemblers). From the total of 1,540 subjects, 1,136 (73.8%) were included and 38 respondents with insufficient replies were excluded. Associations between fatigue score and other variables (general characteristics, job related factors, workload, job stresses) were investigated in terms of the concept of multidimensional fatigue construct by self administered questionnaire. Using MFS (Multidimensional Fatigue Scale), JCQ (Job Content Questionnaire), and Borg's scale, we estimated the fatigue, job stress, and workload, respectively. Fatigue score was estimated by 'sum of fatigue' in MFS. Associations were tested by linear regression analysis using SAS v.8.0. Results: In this study, the fatigue related factors were older age, longer working hours per week, higher workload, higher job demand, lower decision latitude, and lower supervisor support. Conclusions: Prolonged working hours, higher workload, higher job demand, poor supervisor support and lower decision latitude were fatigue related factors among the male metal product assemblers of this study.

호남지방에 적합한 우량조림 수종의 선발에 관한연구

위흡,朴炳益,高大植,姜聲然,金榮浩 全北大學校 1987 論文集 Vol.29 No.-

In order to select the superior race of red pine, some characteristics of individual trees of the three natural population selected from Byonsan area (lower inland parts of Byonsan, higher inland parts of Byonsan, seaside outland of Byonsan) were analyzed and compared with already reported superior population (Chuwang-san, An-Myeon-do, Odea-san). The study also investigated the variation of the wood quality of red pine in Byonsan area. The results obtained are summerized as follows; 1. The seed weight in the three natural populations selected from Byonsan area renged from 6.00g to 11.10g. The weight of seeds from the lower inland parts of Byonsan were the heaviest with an average value of 8.64g. 2. According to the classification based on the straightness of the stem, over 70% of all the natural red pine in Byonsan area were classified as A grade. The trees in the lower inland part showed the highest value in A-grade gopulation with a value over 80%. 3. There was no significant statistical differences among three natural red pine populations selected from Byonsan area, in the clear-length, seed length, seed width, seed weight and serration density. 4. As the above results, the natural red pine population of the lower inland parts of Byonsan, among three natural populations were defined by the superior individual trees. 5. The variation of the moisture content at D.B.H. was increased with an annual ring from the pith and the moisture content with height was increased as the measured point became higher. 6. The specific gravity with annual ring at D.B.H. ascended rapidly from pith to the 7th annual ring. From the 8th annual ring to the bark there was no variation. The specific gravity with its height decreased at the measured point became heighter and the average specific gravity based green wood in Bonsan area was 0.9±0.018. 7. The average shrindage of red pine in Byonsan area showed that the tangential direction was 5.62±0.794% the radial direction was 2.98±0.611% and the longitudinal direction was 0.30±0.96%. The ratio of the shirinkage compared with the tangential, radial and the longitudinal direction was 18.7:9.9:1. The tangential dirction shirinkage was shown 1.89 times more than the radial direction shirinkage. We knew it is comprehensible that in each section the shirinkage in the sap wood was larger than the shirinkage of the heart wood and variation of shirindage with height showed a decrease from the butt end to the top in the radial, tangential and longitudinal direction respectively. 8. We suppose that the tracheid length of the early wood at D.B.H. has no differences among the east, west, south and north directions and became longer while along with annual ring from the pith to the 20th annual ring, but there was no variation from the 20th annual ring to the bark. The variation of tracheid length with height showed sharp rising from the butt end to the point of 3.2m, but showed a decrease gradually from the point of 4.2m to the top of the tree. The average tracheid length of the early wood as 3.05±0.251mm.

전신성 홍반성 루푸스 환자에서 병발된 Coxsackievirus B3 심근염 1예

송봉근,임병관,김민형,신성철,정재홍,김동희,김정환,박건우,고은미,전은석 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.12

악성 임파종 임파절의 치료에 대한 전산화 단층 촬영상의 변화

함창곡,조온구,임현철,고병희,김성태,김선미 한양대학교 의과대학 1994 한양의대 학술지 Vol.14 No.1

Thrity one lymph njodes in thirty follow-up CT studies in 9 patients with a diagnosis of malignant lymphoma were reviewed to determine the efficacy of CT studies for determining response of the therapy. In these 9 patients, CT findings are subdivided to 5 groups by the gross appearances of lymph nodes; (a)complete disappear, (b)multiple strands, (c)decreasd size without changes in internal characteristics, (d)decreased size with central low density, (e)increased size. Clinical correlation preceding the follow-up CT examination was obtained and it's correlation was very excellent. The group (a) to (d)were matched with good clinical course and group (e)was matched with poor clinical course. The appearances of the lymph nodes were not correlated with the histologic cell types and methods of therapy. The CT examination is satisfactory in the post-therapy follow-up of lymphoma patients.

직업적 노출에 의한 스티븐스-존슨 증후군에서 트리클로로에틸렌의 노출수준 : 3예의 사례와 문헌고찰을 중심으로

이선웅,김은아,김대성,고동희,강성규,김병규,김민기 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.2

배경: TCE는 심각한 전산적 피부염과 관련 있는 것으로 몇몇 사례들을 통해서 보고되어 왔으나,기존의 사례 보고들에서 노출평가가 수행된 사례는 드물었고 추정되는 노출량 역시 매우 다양하였다. 본 연구에서는 TCE 노출에 의한 것으로 판단되는 스티븐스-존슨 증후군 3예를 확인하고 각 사례들에 대한 작업재연을 통해 노출수준을 추정하였으며,이를 통해 TCE의 직업적 노출수준과 스티븐스-존슨 증후군을 포함하는 전신적 박탈성 피부염 발생의 관계를 이해하고자 하였다. 증례: 사례 1은 24세 필리핀인 여자로 TCE를 이용한 탈지작업을 시작한 35일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스 존슨 증후군과 독성간염으로 진단되었고 증상발생 39일 간부전으로 사망하였다. 증상발생 전 약물 복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준 은 TWA 21.9 ppm과 32.3 ppm이었다. 사례 2는 47세 한국인 남자로 TCE를 이용한 탈지 작업을 시작한 20일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 중독성 표피괴사증 또는 스티븐스 -존슨 증후군, 전격성간염 및 동반된 패혈증으로 진단되었고 증상발생 42일 간부전 및 패혈증으로 사망하였다. 증상발생 전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 30.1 ppm이었으며 세척조 주위의 지역시료는 TWA 116.5 ppm∼229. 7 ppm 이었다. 사례 3은 22세 베트남인 여자로 TCE를 이용한 탐지작업을 시작한 30일 후 발전을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스-존슨 증후군 및 동반된 독성간염으로 진단되었고 증상발생 37일 증세 호전되어 퇴원하였다. 증상발생전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 107.2 ppm이었다. 고찰: TCE에 노출된 일부의 사람들에서 노출 후 2주에서 5주 사이에 심각한 급성 간염이 동반되는 스티븐스­존슨 증후군이 발생할 수 있음을 확인 하였고,이번의 연구결과와 기존의 연구를 종합 할 때 TCE에 대한 감수성이 있는 사람의 상당수는 노출기준 이상의 고 노출에 노 출 후 스티븐스- 존슨 증후군이 발생함을 확인할 수 있었다. 따라서. TCE에 대한 고 노출을 막기 위해 TCE 세척작업에 대한 작업환경 확인과 개선이 우선적으로 필요하며,동시에 노출 후 증상발생기간의 일관성과 노출기준 이하의 저 노출에서의 감작 가능성을 배제할 수 없음을 고려하여,작업시작 후 1개월경의 특수건강검진 역시 고려되어야 할 것으로 판단된다. Back ground: Trichloroethylene (TCE) has been reported to be related to severe generalized exfoliative dermatitis frequently accompanied by toxic hepatitis. The measurements of environmental exposure were limited in the previous case reports and the reported exposure values were also diverse. We reviewed three cases of Stevens-Johnson syndrome associated with TCE. The work environment was measured by the Korea Occupational Safety and Health Agency (KOSHA) after the cases occurred. From the study results, we intended to clarify the relationship between TCE exposure level and Stevens-Johnson syndrome. Case report: Case 1. A 24-year-o1d Filipino female worker developed a skin rash 35 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. She died of hepatic failure 39 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 22.0 to 32.3 ppm (Personal exposure level) with TWA. Case 2. A 47-year-o1d Korean male worker developed a skin rash, 20 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. He was diagnosed with Stevens-Johnson syndrome, toxic hepatitis and sepsis. He died of hepatic failure and sepsis 42 days after the onset ofthe first symptom. He had no previous history of taking medicine or viral infection. The work environment measured 30.1 ppm (Personal exposure level) and 116.5∼229.7 ppm (area exposure level close to the degreasing rnachine) with TWA. Case 3. A 22-year-old Vietnamese female worker developed a skin rash 30 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. Her symptoms improved and she was discharged 37 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 107.2 ppm (Personal exposure level) with TWA. Discussion: These three case reports and the previously reported cases indicated that the majority of people susceptible to TCE develops Stevens-Johnson syndrome after high-level TCE exposure (above the TWA occupational exposure limit of 50 ppm). Therefore, work environmental survey and improvements to the TCE degreasing process are essential to prevent high exposure. Furthermore, considering the consistency of the latency period in symptoms and the possibility of sensitization in low-level exposure, we recommend that the first specific health examination also should be conducted 1 month after workers have commenced working.

신이식 환자에서 EBV감염과 관련된 악성 임파종 2예

윤선애,진동찬,김용수,신완식,윤영석,방병기,최영진,심상인,고용복 大韓移植學會 1993 Korean Journal of Transplantation Vol.7 No.1

관상동맥내 스텐트 시술시 Aspirin과 Cilostazol 2개월 병합요법

윤명호,탁승제,염철훈,장혁재,최소연,유상용,안성균,고종훈,신준한,김한수,최병일 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8