최근 20년간 우리 나라 주요사인의 추이

김득조(Duk-Jo Kim),최봉근(Bong-Keun Choi),윤태영(Tai-Young Yoon),최중명(Joong-Myung Choi),박순영(Soon-Young Park),유동준(Dong-Joon Lew) 대한임상노인의학회 2000 대한임상노인의학회지 Vol.1 No.1

연구목적 : 최근에 이르러 우리 나라의 주요 사망원인은 전염성질환에서 비전염성의 만성퇴행성질환으로 현저히 변화되었다. 이제 저자들은 최근의 주요 사인의 변화양상과 그 추이를 검토하고저 본 연구를 수행하였다. 방법 : 그간 경제기획원, 통계정 및 기타 관련 정부 부서로부터 1977년이래 발표된 과거 20년간의 주요사인에 관한 통계자료를 수집, 연도별로 분석, 검토하여 최근 우리 나라에서 주요 사인의 변천양상과 그 추이를 고찰하였다. 결과 : 1970년대 후반 내지 1980년대 초반에서 주요사인이 전염성질환에서 비전염성의 만성퇴행성 질환으로 현저하게 역전되었는데, 특히 순환기계 질환과 악성 신생물이 수위권으로 괄목하게 부상하였다. 또한 1980년 중분이래 사망의 외인(불의의 사고)에 의한 사망이 점차 증가하여, 이제는 순환기계질환, 악성신생물(암) 그리고 사고(사망의 외인)은 三大주요사인이 되어 1996년도 현재 이 3대 사인이 전체사인의 약 61%를 차지하였다. 결론 : 주요사인의 추이를 보면, 과거에 위세를 떨치던 전염성질환(결핵포함)은 급격히 감소되었고, 비전염성의 만성퇴행성 질환인 소위 "성인병"인 순환기계질환과 암 그리고 만성폐쇄성 폐질환 등은 아직도 그 사망수준은 높은 실정이다. 또 각종 사고로 인한 사망률은 매년 꾸준히 증가하여 제 3위 사인으로 전체 사망의 약 15%를 차지하고 있다. Background : Recently the leading causes of death were remarkably changed from the communicable to the non-communicable chronic degenerative diseases. We tried to confirm the changing pattern and the transition of the recent leading causes of death in Korea. Methods : We have made an attempt to examine the changing pattern and the transition of the leading causes of death in our country recently since 1977 by analytically reviewing the annual statistical data on the causes of death for the latest two decades reported mainly from the Economic Planing Board, National Statistical Office and other informative materials. Results : After the inverting period of the late 1970s and 1980s changing remarkably from the communicable to the non-communicable disease, the leading causes of death were changed to the chronic degenerative diseases such as circulatory disease and malignant neoplasms recently. With the particularly increasing deaths due to the unintentional accidents since the mid-1980s, circulatory disease, malignant neoplasms and accidents became the three major causes of death, and accounted for about 61 percent of the total deaths in 1996. Conclusion : In reviewing the changing pattern, the transition of the leading causes of death, communicable diseases formidably prevailed for the past decades were rapidly decreased recently, and chronic degenerative disease, so-called, "Chronic Illness" such as circulatory diseases, malignant neoplasms, and chronic obstructive pulmonary disease are in tendency of continuous increase year by year.

Two Needle Slow Flow Method 를 이용한 재순환율 측정의 의의

박동균(Dong Kyun Park),김태석(Tae Seog Kim),오수용(Soo Yong Oh),김득조(Duk Jo Kim),최윤영(Yun Young Choi),이종호(Jong Ho Lee),김상일(Sang Il Kim) 대한내과학회 1997 대한내과학회지 Vol.53 No.2

N/A Objectives: Recirculation is one of the factors preventing effective hemodialysis(HD) and one of the methods which can detect vascular access stenosis. We analyzed the possible clinical risk factors and relationship between the recirculation rate(R) and adequacy of hemodialysis. Also, we attempted to find out whether vascular access stenosis actually exist in the high R group. Methods: We examined the period of hemodialysis, the presence of diabetes mellitus(DM), use of artificial grafts, the venous pressure(VP) during HD, the difference(ΔKt/V) between prescribed Kt/V(Kt/V') and delivered Kt/V(Kt/V) in 113 patients(22 DM, 39 artifical graft patients) receving maintenence HD. R was obtained by two needle slow flow method. Fistulogram was performed in the high R group(R>10%) and if significant stenosis was found, surgical correction was performed followed by repeated R, VP, Kt/V measurement. Results: As a whole R was 5.6%(±8.8), VP was 92mmHg(±44), the duration of hemodialysis was 36 months(±25) and Kt/V was 1.20 (±0.29). The VP of the group with artificial graft was higher than that of the group with native fistula, but there was no relationship between R and duration of HD, Kt/V, ΔKt/V as a whole. The VP and ΔKt/V of group with high R(>10%) were significantly higher than the group with low R(<10%). Positive correlation between R and ΔKt/V was demonstrated in the group with high R. In six patients with high R, fistulograms were taken and significant vascular stenosis were found. After surgical correction, R was significantly decreased from 25.5% to 5.2%. On the other hand, the R as well as the rate of diabetes or prosthetic grafts were higher in the group with high VP(≥100mmHg) than in the group with low VP(<100mmHg) as well as in patients with diabetes or prosthetic grafts, Conclusion: We believe recirculation should be measured during maintenance HD especially when the patient has diabetes, artificial graft or high venous pressure during HD. When the recirculation rate is high, reconstructive vascular surgery with proprer mediacl management may lead to better dialysis adequacy.

경구피임제를 복용한 여성에서 임신중 발생한 간세포암

박흠례(Heum Rea Park),최덕주(Duck Joo Choi),박현철(Hyun Chul Park),박종재(Jong Jae Park),이성광(Sung Kwang Lee),강동훈(Dong Hoon Kang),김주현(Ju Hyun Kim),김득조(Duk Jo Kim),오수용(Soo Yong Oh),강영숙(Young Sook Kang),이정남(Jong Nam 대한소화기학회 1997 대한소화기학회지 Vol.30 No.1

Hepatocellular carcinoma in pregnancy is very rare. Because it is associated with high maternal and fetal rnortality, the risk group of developing hepatocellular carcinoma in pregnant women must be closely monitored. The risk group includes pregnant women who are HBsAg carriers with cirrhosis, long term users of oral contraceptives, and who have a history of multiparity. An elevated a fetoprotein(AFP) level is useful for the diagnosis. The risk group should be closely monitered with a careful physical examination and AFP measurement. Then hepatocellular carcinoma can be detected at an early stage. We have experienced a case of hepatocellular carcinoma in a pregnant woman with an elevated AFP level who was an user of oral contraceptives and had a history of multiparity. It was confirmed by operation and histologic examination. (Korean J Gastroenterol 1997;30:126-130)

最近 十年間 우리나라 主要死因의 變化推移에 關한 硏究

金得祚,尹太永,崔重明,朴淳永,柳東俊 慶熙大學校 1995 論文集 Vol.24 No.-

The authors have made and attempt to examine the transition of the leading causes of death in Korea recently since 1984 by analytically reviewing the annual statistical data on the causes of death for the latest ten years reported mainly from the National Statistical Office and other informative materials. The results were summarized as follows: 1. After the inverting period of the 1970s and early 1980s changing remarkably from the communicable to the non-communicable disease, the leading causes of death were changed to the chronic degenerative diseases such as circulatory disease and malignant neoplasms recently. 2. With the particularly increasing deaths due to the unintentional accidents since the mid-1980s, circulatory disease, malignant neoplasms, and accidents became the three leading causes of death, and accounted for about 66.5 percent of the total deaths in 1993. 3. Concerning the sex-specific leading causes of death, currently they were malignant neoplasms, accidents, cerebrovascular disease, chronic liver disease, and heart disease in males, and cerebrovascuar disease, malignant neoplasms, heart disease, accidents, and hypertensive disease, malignant neoplasms, heart disease, accidents, and hypertensive disease in females in that order respectively. 4. As to the leading causes of death by the age-groups, they were congenital anomaly and infectious disease at infantile age; accidents and unintentional injury at ages 1-39year: malignant neoplasms, circulatory disease, and chronic degenerative disease at ages 40-69years; and circulatory disease, senility and other chronic degenerative disease at ages 70 and over respectively. 5. In reviewing the transition of the leading causes of death, communicable diseases formidably prevailed for the past decades were rapidly decreased recently, and chronic degenerative disease, So-called, "Chronic Illness" such as circulatory disease, malignant neoplasms, and chronic pulmonary disease are in tendency of continuous increase year by year. Although chronic liter disease seems to be stationary in incidence now-a-days, additionally, its level of death is still relatively high. And the death rates due to all kinds of accidents are remarkably increasing. Overall, accidents and unintentional injuries were the third leading cause of death and accounted for about 15 percent of the total deaths.

Glycyrrhizinic acid에 의해 유발된 Mineralocorticoid Excess Syndrome1례

김태석,양동경,오수용,박동균,김득조,장호열,이종호 대한신장학회 1996 대한신장학회잡지 Vol.15 No.4