지속적인 기립 작업에 의한 만성 하지 정맥 부전증 1예

정철,임현술,유선희 東國大學校醫學硏究所 2003 東國醫學 Vol.10 No.1

저자들은 10년 간 자동차 부품 조립공장에 근무하면서 지속적인 기립 작업에 의하여 하지 정맥류가 발생하였고 이후 하지 정맥 혈전증이 합병되어 통증과 부종을 수반하는 만성 하지 정맥 부전증으로 업무상 질병이 인정된 증례를 보고하는 바이다. 환례는 44세 여자로 1966년부터 우측 하지에 정맥류가 발생하였고 2001년 6월부터 시작된 하지 통증과 부종으로 2001년 7월 25일 정확한 진단을 위해 병원을 방문하였다. 과거력상 2001년 7월초 진단된 결핵 이외에는 혈관질환 등 기타질환을 앓거나 약물을 복용한 것이 없었고, 가족력과 사회력 조사에서도 정맥류와 관련된 특이한 점은 없었다. 환례는 현 직장에 1991년 입사하여 10년 간 동일한 조립공정 업무를 수행하였다. 작업은 계속 한 자세로 서서 일하는 형태였으며, 하루 총 작업식간은 8시간이었다. 진찰 소견상 우측 하지 후슬와부에 정맥류가 관찰되었고, 압박시 하지 통증과 부종이 관찰되었다. 입원시 실시한 우측 상행 하지정맥 조영술 검사상 호가장된 다수의 정맥이 장딴지에서 보이고 오금정맥이 하부 하지부에서는 불투명화 되지 않아 약 1개월간 병원에 입원하여 혈전증에 대한 항응고제 치료를 시행 받았다. 환례와 동일한 작업을 하는 동료근로자는 12명으로 작업 후 하지 통증은 모두 경험하였다고 하였으며, 이들 중 1례는 하지 정맥류가 관찰되었다. 프로트롬빈시간은 입원일 9.8초였다가 이후 정상으로 회복하여 퇴원시 11.5초를 보였으며, 활성 부분트롬보플라스틴시간도 입원 당시 퇴원시 33.4초로 회복되었다. 하지 통증 및 부종은 입원 중 점차 감소하였고 내원 당시 방사선 검사상 관찰되었던 하지 정맥 혈전도 소실되었다. 본 환례를 통하여 장시간 서서 일하는 근로자는 하지 정맥류에 대한 발생 가능성을 염두에 두고, 하지 통증이나 부종이 동반될 경우 혈전 여부 검사를 시행하여야 할 것이며, 그 원인추구에 있어서 반드시 직업관련성을 조사해 보아야 할 것이다. 작업장내 장시간 서서 하는 작업이 있을 경우에는 정기적인 검진을 통해 유소견자를 가려내고, 혈전증 예방을 위해 한 쪽 다리는 교대로 올려놓을 수 있는 발받침대를 설치하거나 작업 전 압력 스타킹을 신게 하는 등의 작업환경 개선에 대한 노력을 강조하여야 할 것이다. We report a case of chronic venous insufficiency with a history of 10 year standing work. The authors reviewed the clinical and hematologic features of the case. We also reviewed the job contents of her workplace. The worker was a 44-year old female who had worked in a mobile accessory factory for 10 years (1991-2001). She had been founded right leg varicous vein since 1996. The varicose veins induced severe pain and edema on June 2001. By venography, thrombus were detected and finally diagnosed as venous thrombosis on 25th July 2001. She regarded the occupational disease by longstanding work of standing position. She received anticoagulant treatment by one-month admission, and then improved the symptom and hematologic laboratory results. To prevent chronic venous insufficiency, we must modify working environments, begin comprehensive medical surveillance, educate workers on risk of lower leg venous problems, and increase workers awareness of safety regulations in the workplace.

모 대학병원 입원환자의 직업력 기록에 관한 조사

임현술,김지용,정철 동국대학교 경주대학 1998 東國論集 Vol.17 No.2

From January 9, to January 27, 1996, we surveyed medical records for the occupational history of 352 admitted patients in university hospital located in Pohang city. Also, we interviewed the study subjects about their occupational histories to search for occupational related cases. The results obtained are as follows. The number of males were 205 cases and the number of females were 147 cases. The age and sex distributions of study subjects were not significant (p>0.05). Internal medicine (50.3%), orthopaedics (19.6%), general surgery (8.8%), neurosurgery (5.7%) and obstetrics & gynecology (3.7%) were the major admitted departments of the study subjects. The records of occupational history by doctors were only 9 cases (2.6%) but by nurses were 197 cases (56.0%). And then, there were no detailed descriptions for occupations by doctors and nurses. We would suspect that 18 cases (5.1%) were related to the occupations, of which 13 cases (3.7%) were in occupational injuries and 5 cases (1.4%) were in occupational diseases. It should be emphasized in medical education that the occupational and environmental histories were thoroughly investigated to make a correct diagnosis and appropriate treatment and that the standard forms for occupational history taking should be developed.

관상동맥질환의 중증도와 혈중지질치 및 아포지단백과의 상관관계

임현주,황종현,류재근,정병천,조용근,채성철,전재은,박의현 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.1

목적 : 관상동맥질환의 위험인자로서 혈청지질 및 혈장 지단백에 대한 관심이 높아지고 있고 또 아포지단백이 관상동맥 질환을 일으키는데 다른 지질보다 더 중요하다는 연구가 많이 발표되고 있으나 우리나라에서는 아포지단백에 대한 연구가 그리 많지 않은 편이다. 이에 저자등은 혈중지질치와 새로운 위험인자로 알려지고 있는 아포지단백치를 측정하고 이들과 관상동맥질환 중증도와의 상관 관계를 알아보았다. 대상 및 방법 : 관상동맥질환이 의심되어 관상동맥조영술을 실시한 69명의 환자를 대상으로 하였으며 12시간 이상 공복후 혈청을 채취하여 총콜레스테롤, 중성지방, HDL-콜레스테롤, 아포지단백 AI (ape AI), 아포지단백 B (ape B)를 측정하였다. 관상동맥조영상 50%이상의 협착이 있는 혈관의 수 (lesion number), 최대협착을 합한 값 (lesion score), 각 분절의 최대협착을 합한 값 (total score), 가장 심한 협착 값 (peak stenosis) 등으로 관상동맥 중증도를 알아본 다음 이들과 혈청지질치, 아포지단백과의 상관 관계를 비교해 보았다. 상관 관계는 Spearman's correlation coefficient를 구하였다. 결과 : 관상동맥질환의 중증도와 각 지질치 간의 상관 관계를 비교해 보았을때 lesion number와 관계있는 것은 연령 (r=0.2789), 중성지방치 (r=0.2829)이며 lesion score와 관계있는 것은 연령(r=0.2911), 중성지방치0 (r=0.3316), 총콜레스테롤과 HDL-콜레스테롤의 비 (r=0.2361), apo B 치(r=0.2759), apo AI과 apo B의 비 (-0.3154)로 나타났다. Total score는 연령 (r=0.3100), 총콜레스테롤치 (r=0.2452), 중성지방치 (r=0.3022), 총콜레스테롤과 HDL-콜레스테롤의 비 (r=0.2770), apo B치 (r=0.2927), apo AI과 apo B의 비 (r=-0.3408)와 연관이 있었고 peak stenosis는 중성지방 치(r=0.3305), ape B 치 (r=0.2968), apo AI과 apo B의 비 (r=-0.3977)와 관계가 있었다. 연령으로 조정하여 partial correlation을 좌면, 관상동맥조영술상 중증도는 중성지방치 (r=0.3408), apo B 치(r=0.2877), apo AI과 apo B의 비 (r=-0.3460)와 유의한 상관 관계가 있었다. 이중 ape AI과 ape B의 비는 lesion score (r=-0.2640), total score (r=-0.3057), peak stenosis (r=-0.3460)와 유의한 상관관계를 보였다. 결론 : 이상의 결과로 보아 apo B치 그리고 apo AI과 apo B의 비가 관상동맥 중증도의 예견인자로 다른 혈중 지질 치보다 더 유용하다는 것을 알 수 있었다. Objectives : Recently, it was reported that the measurements of apolipoprotein levels may be valuable in the clinical assessment of coronary artery disease severity. However there are a few reports regarding to the relationship between coronary artery disease severity and apolipoprotein levels in Korea. Thus, we measured serum lipid and apolipoprotein levels and studied the relationship between coronary artery disease severity and serum lipids and apolipoproteins levels. Subjects and Methods : The 69 patients who underwent coronary angiography to evaluate chest pain were subjected to this study. We measured the levels of serum cholesterol, triglycerides, HDL cholesterol, apolipoprotein AI(apo AI) and apolipoprotein B(Apo B) and measured the severity of coronary artery disease by lesion number, lesion score, total score and peak stenosis. Then, we studied the relationship between coronary artery disease severity and apolipoproteins and calculated the correlation coefficient. Results : The results were as follows. There are significant correlation(r=0.3) between age, triglycerides, apo B levels, apo AI/B ratio and coronary artery disease severity. In controlling for age, tyiglycerides, apo B levels and apo AI/B ratio shows significant correlation(r=0.3) with coronary artery disease severity. Especially, apo AI/B ratio shows significant correlation(r=0.3) with lesion number, total score and peak stenosis. Conclusion : These results suggest that the apo B levels and the ratio of apo AI/B can be used as significant independent predictor for coronary artery disease severity rather than other serum lipid levels.

가축의 장내용물에서 Listeria 속균의 분포도 조사

정병열,임현숙,김봉환 한국수의공중보건학회 2003 예방수의학회지 Vol.27 No.1

We surveyed the prevalence of Listeria spp. in cecal contents of pig and chicken collected from abattoirs. only 4 L. lnnocua isolates were detected in a total of 100 pig samples. From the 100 chicken samples, 47 were confirmed positive for Listeria spp. Twenty eight of these 47 positive samples contained only L. lnnocua; 15 contained both L. monocytogenes and L. lnnocua; 4 contained only L. mnocytogenes. No other Listeria spp. were detected in this study. Listeria spp. were detected in 471115 (40.9%) blackened Fraser broth samples and in 4/85 (4.7%) samples in which Fraser broth did not blacken. Fourteen (73.7%) L. monocytogenes isolates were recovered after 48 h, not 24 h, Fraser broth secondary enrichment.

지속적인 기립 작업에 의한 만성 하지 정맥 부전증 1예

정철,임현술,유선희 약업신문사 1984 의약정보 Vol.10 No.1

갑상선암 예측에 있어 초음파적 변수 분석

임현정,최영식,박요한,오경승,이강대 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

Background: The introduction of high resolution sonography has made it possible to detect nodules in the thyroid gland. However, there has been no reliable sonographic sign for distinguishing between benign and malignant thyroid conditions. The aim of present study was to evaluate ultrasonographic (US) parameters in predicting thyroid cancer. Methods: One hundred fifty three patients who underwent thyroidectomy at Kosin Medical Center from January, 2000 to April, 2002 were included in the study. All patients were checked high resolutional US before surgery. Of the 153 patients 89 were malignant tumors and 64 benign. Malignant US parameters were defined as calcification, irregular margin, more taller than wide, and fat line obliteration. Calcification pattern was classified with single, punctated, and amorphous calcification. The US characteristics to predict malignancy were evaluated by means of multiple logistic regression analysis. Results: All of the malignant sonographic parameters such as calcification, 53 (89.8%) were thyroid carcinoma. The incidence rate of malignancy was 55.9% in solitary nodules and 65.7% in multiple nodules (p=0.303). Even though nodule size was less than 1.5㎝, the incidence of malignant tumor was 69.5% (p=0.04). Of 53 malignant nodules with calcification, the incidence of single, punctated, and amorphous calcification pattern was 6 (11.3%), 22 (41.5%), 25(47.2%), respectively. The sensitivity, specificity, positive and negative predictive value, and accuracy of sonographic parameters were 76.4%, 87.5%, 89.5%, 72.7% and 81.0%, respectively. Upon the correlation of US-guided FNA cytology with pathologic diagnosis, the sensitivity of ultrasound-guided FNA cytology in differentiating benign and malignant nodule was 85.9%, the specificity 100% and overall diagnostic accuracy was 91.2%. The sensitivity, specificity, and accuracy of US parameters associated to follicular neoplasm, all were 75.0%. Conclusion : All the malignant US parameters including calcification, irregular margin, and more tall than wide showed high level of sensitivity, specificity and accuracy. Of these parameter, calcification and irregular margin were more significants. The more presence of calcifications with punctated and amorphous pattern could suggest the higher possibility of malignancy. However, further study is needed for clinical application of malignant US parameters in the thyroid tumors.

국소성 분절성 사구체 경화증의 완전 관해 후 발병한 IgA 신병증 1예

임현민,김현정,박민석,주혜원,최원,김상현,박원도 인제대학교 2006 仁濟醫學 Vol.27 No.-

We report a rare case of primary glomerular disease with IgA nephropathy in a 43-year old man. 7-years ago, he was diagnosed with minimal change nephrotic syndrome. After treatment with steroid for 1-year, azotemia and proteinuria were improved. But, nephrotic range proteinuria was relapsed within 1 week after cessation of steroid. Renal biopsy revealed focal segmental glomerulosclerosis, and achived a complete remission with the use of steroids and cyclophosphamide. Then, he was followed up with normal renal function for 4-years. On admission, the patient showed generalized edema and marked proteinuria. In 3rd renal biopsy, mesangial proliferative glomerulonephritis with diffuse global sclerosis was observed. Electron microscopy showed electron-dense deposit on the mesangium with slight mesangial proliferation, and immunofluoroscence microscopy showed granular deposits of IgA and IgM. These features were consistent with IgA nephropathy, different from results of previous biopsies. The pathogenesis of IgA nephropathy occurred with primary FSGS is not clear, as well as treatment. Now, proteinuria is improving, steroid and cyclophosphamide are probably useful for the disease.

에탄 분자의 적외선 스펙트럼의 이론적 합성

鄭玹采,윤대현,임화준,김기선 慶熙大學校 1987 論文集 Vol.16 No.-

The ν_6 band of the ethane gas molecule was theoretically synthesized. The intensity and the frequency of each rotational line were computed with VAX-11 computer. The theoretically synthesized spectrum was compared with the experimentally obtained spectrum, which was taken through FT-IR spectrophotometer MX-3600. The R and P branches of the ν_6 band contour of the ethane gas molecule were different from the regular symmetrie top molecule and rather similar to the linear molecules as if there were no K dependence. The absorbance of the P-branch spectrum was overlapped by the unknown branches of the neighbour bands The intensities and frequencies of the unknown lines were not indentified. The overall band contour of the observed spectrum was quite well coincided with the theoretical spectrum except the P-branch.

TV유아프로그램의 음악적 활용에 대한 연구

임현정 이화여자대학교 교육대학원 2003 이화교육논총 Vol.13 No.-

This study analyzed the music applied to children's hours of main 3 TV broadcasting stations, by component, function, and genre. 10 programs of each TV broadcasting company, 30 TV programs in total, which were broadcasted from February to March in 2002 were selected at random for analysis research. The examination results tell about the frequency and the continuation period of Music/Non-music Segment, instrumental music/vocal music, analysis on music's functions, and so on. Then, the applied music that functions as structural prompt was analyzed in the sides of melody, lyric lines, and tempo. The analysis result tells that the music segment occurs 565 times in total, which means 18.83 times' frequency per program in average, and that the continuation period of time was 30.27 seconds in average, which indicates 92%'s confidence coefficient(reliability). Non-music segment occurred 289 times in total, 9.63 times per program in average, and the mean continuation period of non-music was 30.56 seconds, which signified 92%'s confidence coefficient(reliability). 335 pieces of instrumental music were used in 30 programs in total, the instrumental music pieces were used 11.17 times per program. The vocal music pieces were used 230 times in total, and the average frequency rate was 7.67 times per program. The music that adopted structural prompt occurred 187 times in total; the music pieces included into the learning area occurred 19 times in total, the mean frequency rate was 4.63 times per program. The music pieces belonging to the social area occurred 23 times in total, the mean frequency rate was 0.83 times per program. Finally, The music pieces belonging to the body area occurred 25 times in total, the mean frequency rate was 0.83 times per program. The music applied for the purpose of discriminative stimulation occurred 77 times in total, the mean frequency rate was 2.57 times per program. The number of music pieces used as background music was 301, the mean frequency rate was 10.03 times per program. The music pieces that applied structural prompt were analyzed by lower ranked factors such as melody, lyric lines, and tempo. The analysis results are as follows; the occurrence frequency of the music pieces that adopted the existing structural prompt was 64 times in total(2.13 times per program in average), and the occurrence frequency of the music pieces that adopted the newly created structural prompt was 123 times in total, which means 4.10 times' occurrence per program in average, and the rate of 66.78%. The number of vocal music pieces that deliver their lyric lines at the first time was 177 in total. So the number of vocal music pieces whose lyric lines ware clearly conveyed was 5.9 per program, which means 94.65% 's occupation rate out of the whole frequency rate of the music pieces that applied structural prompt On the contrary, the number of vocal music pieces whose lyric lines were not conveyed was 10 in total(the occupation rate of 5.35%). The music pieces that applied the same melody repeatedly occurred 187 times in total, which means an occupation rate of 84.49% out of the whole structural-prompt-music's percentage. Similarly, the number of music pieces that used the same lyric lines repeatedly was 168, which signifies 89.84%'s occurrence rate With respect to voice colors, the most frequently used one was children's voice, secondly used voice color was that of adult/children, and the next order was male adult solo, female adult solo, adult group, and male children solo. As for the range of Melody, the most frequently used range was 8 degree range(1Octarve), which was used 66 times in total. The next order was 7 degrees, 6 degrees, 9 degrees, and 5 degrees. The degrees of below 4 or over 10 occurred rarely. As for the tempo range, the tempos of 121∼140 was used most frequently, 75 times in total. The next frequency order was 141∼160 range (67 times in total), then 161∼180 range and 101∼120 (19 times in total). Next, a slower range of 80∼100 occurred 6 times, and a very fast one of 180∼200 occurred I time I total. This study analyzed the structural and functional sides of the music pieces applied for children's educational programs on TV. Based on the results obtained this thesis, the main characters of the applied music were examined. Furthermore, the additional aim of this study is to offer basic materials for music therapy that can be used for children in the desirable and useful directions.

성게 가시에 의해 유발된 수지의 육아종성 염증 2예

김정란,김동훈,장태정,이종임,임현술,이현경,배성한 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.1