Anti-HBc 단독 양성자에서 B형 간염 백신 접종의 면역 반응과 B형 간염 DNA의 조사

김순덕,최지호,김성열,이진수,고희정,Kim, Soon-Duck,Choi, Ji-Ho,Kim, Sung-Ryul,Lee, Jin-Soo,Koh, Hee-Jeong 대한예방의학회 2005 예방의학회지 Vol.38 No.2

Objectives: The aim of this study was to evaluate the response to a hepatitis B vaccination, and investigate the HBV DNA in subjects with isolated anti-HBc. Methods: 34 subjects with persistent isolated anti-HBc were included in the study. 32 subjects negative for HBsAg, anti-HBs and anti-HBc were included as a control group. They were all vaccinated with Hepaccine at 0, 1 and 2 months, and anti-HBs titers were measured 1 month after the 1st and 3rd vaccinations (1 and 3 months). The HBV-DNA was tested by polymerase chain reaction in subjects with isolated anti-HBc. Results: After the 1st & 3rd vaccinations, the anti-HBs titers$\geq$10mIU/ml were 70.6 & 70.6% in isolated anti-HBc group, and 34.4 & 81.2% in the control group, respectively. There were statistically significant differences after the 1st vaccination, but none after the 3rd, between the two groups. In the isolated anti-HBc and control groups, the primary, amnestic and no responses were 0 vs. 46.9%, 55.9 vs. 6.3% and 29.4 vs. 18.8%, respectively. The HBV DNA was not detected in all subjects with isolated anti-HBc. Conclusion: None of the subjects with isolated anti-HBc had a false positive result (primary response); therefore, they should be excluded from vaccination programs in Korea. To differentiate between immunity and occult infections, a single dose of vaccine, with a follow-up anti-HBs test, is preferable for subjects with isolated anti-HBc. An amnestic response indicates late immunity, and no response a suspect occult infection.

손상의 역학과 대책

김순덕,Kim, Soon-Duck 대한예방의학회 2005 예방의학회지 Vol.38 No.2

Injury has recently become a major world-wide health problem. Injury related deaths occur in many actively working young people and produce major social and economical losses. However health related specialists do not recognize the importance of injury and there have not been many studies related to this problem. This research studied the trends of injury related research in Korea, mortality rate and prevalence rate, socio-economical losses and control in Korea and out of the country, based on literature from Korea and without such as statistical yearly reports on causes of deaths and OECD health reports, as well as WHO web sites. Studies in Korea about injury were very few, with 9 in the 1960's, 5 in the 1980's, 4 in the 1990's and 5 in 2000's. Mortality rate of injury was higher in Korea than in England, USA or Japan, especially in car accidents, suicide and falls. In Korea, the yearly trends in mortality rates were highest in car accidents but those rates are falling, suicide is steadily rising, with highest rate in 2003. Falls is in second rank with no change in rates. In 2003, the ten causes of death in Korea were suicide in 5th rank, transport accidents in 7th rank, and falls in 10th rank. Considering age groups, in the teens, transport accidents were 1st rank, in the 20's and 30's, suicide was 1st rank, and although there were some differences, falls, drowning, assault, fire were in the top 10. Prevalence rates of injury could not be known, but in 2001, according to the National Health and Nutrition Survey, lifelong injury was 10%, and yearly major injury was 1.3%, major injury for two weeks was 0.1%, and minor injury was 10%. In other foreign countries, injury has become to be recognized as a major health related problem, and much programs are being set up to reduce injury related deaths and injuries. WHO is putting much effort in prevention of violence and transport accidents, and in the USA, Canada and Europe, there are injury surveillance systems. Recently, as suicide is increasing rapidly and providing much problems, each country are managing suicide prevention programs. In Korea, Ministry of Construction and Transportation is managing and guiding the policies for prevention of transport accidents. In September of 2004, the Ministry of Health and Welfare has set up a 5 year plan of suicide prevention.

모 산업장에서 발생한 연중독자에 대한 D-Penicillamine의 치료효과

김순덕,Kim, Soon-Duck 대한예방의학회 1982 Journal of Preventive Medicine and Public Health Vol.15 No.1

For the purpose of the curative effects of oral D-penicillamine in lead poisoning, D-penicillamine was orally administered to 7 lead poisoned workers which were employed in glaze product industry dealing with the lead oxide ($Pb_3O_4$). The doses of D-penicillamine was 1,200mg per day which was administered by oral 7days schedules, taking for 5 days and stopping for the following 2days, repeatedly during 3 months period. (All the poisoned workers started working again in that industry after 1 month treatment, and were treated by oral D-penicillamine for 2 months still being exposed to contaminated environment.) In order to evaluate the curative effects of D-penicillamine, 10gm of whole blood and 24 hours urine were collected every 14 days during the curative period for laboratory analysis(hemoglobin, blood lead, urine $\sigma$-aminolevulinic acid, urine coproporphyrin, and urine lead levels) with the observation of the clinical symptoms. The results were as follows; 1. Oral D-penicillamine effected good curative results as that hemoglobin, blood lead, urine $\sigma$-aminolevulinic acid, and urine coproporphyrin levels were decreased below the critical level within 1 month treatment. 2. After re-exposure, oral D-penicillamine effected to some extent as that urine lead level was decreased below the critical level after 3 months treatment with disappearence of the clinical symptoms after 2 months treatment. However, the curative effects of oral D-penicillamine in the lead exposure state is questionable since increasement of blood lead level and remarkable decreasement of urine lead level after 3 months treatment can be observed.

의료전단체계 확립 후 3차진료기관의 환자추이

김순덕(Soon Duck Kim),조혜영(Hae Young Cho) 고려대학교 보건과학연구소 1993 보건과학논집 Vol.2 No.1

노인구강보철환자에게 미치는 치과 의료서비스 요인

김순덕 ( Soon Duck Kim ) 한국치위생학회 2007 한국치위생학회지 Vol.7 No.1

일부 농촌지역의 모자보건 및 가족계획실태에 관한 연구

김순덕(Soon-Duck Kim),김양수(Yang-Soo Kim),염용태(Yong-Tae Yum),손동빈(Dong-Bin Song) 한국농촌의학 지역보건학회 1987 농촌의학·지역보건 Vol.12 No.1

농촌 일차 보건사업에 있어서 마을건강원 업무량 및 업적에 관한 연구

김순덕(Soon-Duck Kim),허달영(Dal-Young Hur),이명숙(Myoung-Sook Lee),염용태(Yong-Tae Yum) 한국농촌의학 지역보건학회 1987 농촌의학·지역보건 Vol.12 No.1

Temporomandibular disorders and risk factors in office workers, service workers, and teachers

서의경,김순덕,이준영,임재석,Seo, Eui-Gyeong,Kim, Soon-Duck,Lee, June-Young,Rim, Jae-Suk Korean Society of Dental Hygiene 2012 한국치위생학회지 Vol.11 No.5

목적 : 본 연구는 업무형태에 따른 측두하악장애의 유병률과 업무 시 노출되는 직무스트레스 및 구강 내 악습관이 측두하악장애와 어떠한 연관성이 있는지 알아보아 보건학적 기초자료를 제공하고자 실시되었다. 방법 : 본 연구의 자료 수집을 위하여 서울과 경기 일부지역에 근무하고 있는 일반사무직, 서비스직, 교직원으로부터 편의 추출된 452명을 대상으로 2010년 1월부터 2010년 4월까지 설문조사를 실시하였고, 수거된 353명을 연구대상으로 하였다. 설문지는 측두하악장애의 증상, 하악사용에 관한 구강 내 악습관, 직무스트레스, 인구사회학적 특성으로 구성되었다. 측두하악장애의 증상의 정도를 구분하기 위해 설문지의 양성응답 수의 빈도에 따라 무증상인 1단계에서 양성응답 수가 가장 많은 4단계 까지 총 4그룹으로 나누었다. 측두하악장애의 유병률을 알아보기 위하여 빈도분석을 시행하였고, 측두하악장애의 증상의 정도에 따른 여러 요인들 간의 연관성 및 관련요인을 알아보기 위하여 교차분석 및 경향성 분석과 다항로지스틱회기 분석을 시행하였다. 결과 : 측두하악장애의 유병률은 75.4%였고, 측두하악장애에 대한 주관적 증상으로는 관절잡음이 56.4%로 가장 주된 증상 중 하나였으나 남녀 간의 차이는 통계적으로 유의하지 않았다. 다음으로는 두통이나 목의 통증이 36.5%이었고, 귀, 관자놀이, 볼 주위의 통증이 22.1%로 높았다. 측두하악장애의 주관적인 증상 수에 따른 인구사회학적 특성은 증상이 없는 경우 여성에서 19.1%, 남성에서 36.6%로 여성에서 더 높은 유병률을 보였다. 연령별로는 40세 이상의 그룹보다 20 - 30대그룹에서 측두하악장애 증상수가 높아지는 경향을 보였다. 하악 사용과 관련된 악습관 및 직무스트레스는 측두하악장애 증상수와 유의한 관련성이 있는 것으로 나타났는데, 하악 사용과 관련된 습관의 개수가 많아질수록 측두하악장애의 증상의 개수도 많아졌고, 습관이 한 가지씩 늘어날수록 측두하악장애 증상이 없는 1단계보다 3단계가 될 위험이 1.45배, 4단계가 될 위험이 1.57배 높아졌다. 스트레스 수준도 가장 하위단계에서 한 단계 높아지면 측두하악장애 1단계에서 4단계가 될 위험이 2.49배, 두 단계 높아지면 3.43배 높아졌다. 결론 : 본 연구의 결과 측두하악장애와 업무특성에 따른 연관성은 설명하지 못하였지만, 직무스트레스가 높은 경우 측두하악장애 증상의 개수 또한 높아짐을 확인할 수 있었다. 이는 측두하악장애의 주관적인 증상을 발생시키는데 있어서 업무형태 보다는 심인적인 부분이 더 중요한 인자임을 의미한다. 그러므로 측두하악장애 평가 시 신체적인 문제뿐 아니라 행동적, 심리 사회적 문제로 예측인자를 폭넓게 인식함으로써 다각적인 접근을 하는 것이 필요하며, 측두하악장애 증상이 발생된 경우 임상적 치료뿐 아니라 행동요법 및 심리 치료와 자가 관리 등이 함께 수반되어 기여요인 조절을 조절하는 것이 중요하다 하겠다.

일부 근로자들의 고혈압치료형태에 관한 연구

이은일,김순덕,차철환,Lee, Eun-Il,Kim, Soon-Duck,Cha, Chul-Whan 대한예방의학회 1986 Journal of Preventive Medicine and Public Health Vol.19 No.2

Hypertension is one of the most well known risk factors for cerebrovascular or coronary heart disease and is a major public health problem. Early detection and treatment of hypertension are essential, but the compliance of treatment on hypertension is not easy to achive. Hypertensive workers are being detected by the annual screening under the Labour Standard Law in Korea but the solidified control system for them is not existing. This study about workers 'Motive-Belief-Action in non-drug and drug treatment of their hypertension would be worthwhile to interpret how the workers actually behave in coping with hypertension, and also would be advisable to construct the follow-up program in Korea. In the field research process two criteria were used to select sample group. The first criterion included the workers who were screened to be hypertensive with their blood pressure above 160/95 in this survey. The second one was used to classify study-group respondents who had known their hypertension by successive annual screening. From such criteria a total of 156 male workers were sampled in 21 industries, the author interviewed them using the structured questionnaire which consisted of Belief-Motive-Action items about non-drug and drug treatment for hypertension with open-ended question on symptom of hypertension. The summary is as follows: 1) Sixty-one percent of respondents had ever checked their blood pressure somewhere besides the annual screening. 2) Most respondents(97.2%) complained no symptoms of hypertension at all. 3) Belief level of non-drug treatment was relatively high (82.1%-64.7%), but motive(55.1%-28.2%) and action(38.5%-16.7%) levels were low. 4) Belief level of drug treatment was relatively lower than that of non-drug treatment, blue collar workers showed higher artier level of drug treatment than white collar workers, and correlation coefficient between belief and motive on drug treatment was lower in group of not-recognizing their family history of hypertension than recognized group. Such findings indicated that belief on drug treatment of hypertensive workers would be problematic. 5) White collar workers showed significant lower correlation coefficients between Motive and Action of salt restriction, restriction of fatty diet and relaxation than blue collar workers. 6) Mild hypertension group showed low levels of Motive and Action of non-drug treatment(salt restriction, restriction of fatty diet and relaxation) and also showed low correlation coefficient between Belief and Motive of above non-drug treatment.

이황화탄소에 폭로된 근로자들의 말초신경병증에 관한 연구

김대성,김순덕,차철환,Kim, Dae-Seong,Kim, Soon-Duck,Cha, Chul-Whan 대한예방의학회 1993 예방의학회지 Vol.26 No.2

Neurotoxicity in the workplace may occur with exposure to scores of chemicals. Although large acute outbreaks of the occupational neurological disease are rare, the incidence of occupational neurotoxicity in its subtler aspects is unknown. A working knowledge of both the major occupational neurotoxic solvents and the tools used by cliniical neurologists and neurotoxicologists to evaluate neurotoxicity in working populations is a necessity fur the occupational physician. To investigate the effects of carbon disulfide($CS_2$) on the peripheral nerve system using the nervous conduction study, 105 male workers working in the spinning room of a viscose rayon factory were examined and compared with a sex and age matched, unexposed 105 male controls using t-test analysis. 72.4% of $CS_2$-exposed workers complained of neurological symptoms, and the abnormal cases in nerve conduction study were 48.6%. The abnormal cases of nerve conduction study increased in number according as the age and duration of exposure increased. In this study, asymptomatic workers were confirmed to have subclinical neuropathy by nerve conduction study. Also as there were abnormal cases even in its duration of exposure below 4 years, nerve conduction study turned out to be ways of discovering of early peripheral neuropathy. In nerve conduction study, the amplitude, velocity, F-wave latency and H-reflex of the motor and sensory nerves in both upper and lower extremities were significant different between $CS_2$-exposed workers and the controls. From the pathological viewpoint, both segmental and axonal degenerations were assumed in this study.