육군 장병의 비타민 C 섭취와 상기도 감염 예방과의 관계

석웅 ( Seog Woong ),김태경 ( Kim Taekyung ),변준수 ( Byun Junsu ),임형렬 ( Lim Hyungryul ) 국군의무사령부 2018 대한군진의학학술지 Vol.49 No.1

Objectives : This study was conducted to investigate whether vitamin c intake can prevent common colds in the Republic of Korea Army soldiers. Methods : To determine if vitamin c intake can prevent common colds, we selected soldiers who enlisted the Korea Army Training Center for 30 days from February 12, to March 13, 2018. In the randomized, placebo-controlled, and double-blind trial, study participants were divided into groups(vitamin c vs. placebo). Also, whether or not the participants had a common cold was detected by searching the military medical records. Based on the synthesized data, multiple logistic regression analysis was performed to identify association between intake of vitamin c and diagnosis of common colds. Results : A total of 1,444 participants were included in the our study. Of the participants, 695 participants took vitamin c(6,000 mg/day) and 749 participants took placebo(0 mg/day). Also, 895 never smokers, 450 smokers(temporary non-smokers) and 99 former smokers were included in the study. The group took vitamin c had a 0.80-fold lower risk of getting a common cold than the placebo-treated group. In addition, the relationship between intake of vitamin c and common cold diagnosis was analyzed after categorizing the participants as smoking status(non-smoker vs. smoker). Conclusions : Through this study, we confirmed that vitamin c ingestion is effective in preventing common colds. Our results may serve as a basis for introducing military health-care policies that can provide vitamin c with military personnel in basic military training.

군대 삼일열 말라리아 반복 입원 환자 분석

고동훈 ( Dong Hoon Ko ),김신수 ( Shin Soo Kim ),최병섭 ( Byung Seop Choi ),석웅 ( Woong Seog ),김창훈 ( Chang Hoon Kim ),조영기 ( Young Key Cho ),소병조 ( Byung Jo So ),김창수 ( Chang Soo Kim ) 대한내과학회 2005 대한내과학회지 Vol.68 No.6

의료종합상황센터의 향상된 임무, 역할 및 발전 방안에 대한 연구

박성범 ( Sung Bum Park ),우호열 ( Woo Ho Youl ),정주원 ( Jeong Juwon ),황일웅 ( Iloong Hwang ),석웅 ( Woong Seog ) 국군의무사령부 2017 대한군진의학학술지 Vol.48 No.1

Objectives ; In addition to known emergency control team, the tele-medical team, infection surveillance team, and public consultation control team were added to the Emergency Control Center, then it was reopened, called Medical Emergency Operation Center(MEOC) in August 13, 2015. The center begun to control air-evacuation using helicopter called MEDEON, thus it allowed the military to have a single chain of command system in air-evacuation duties. Since there was a few information about the public emergency control center, there was a limitation to discuss pros and cons or future direction about the function and mission of MEOC. So we planned to visit the public emergency control center, and study whether there was anything to emulate. Methods ; Since March 2016, we have toured the iconic and representative emergency support organization in public society. We visited Gyeongsangbuk-do Regional 119 center, Incheon 119 center, Gacheon Medical Study Gil Hospital Trauma center and Doctor-Hell center of Andong hospital. We conducted research by observing and analyzing the organization, infrastructure, hardware and software system or their own center. Results ; The 119 center we visited were very well equipped and organized as the days of emergency relief were long enough, thus there were many lessons to be considered for introduction to the MEOC. 24/7 resident of the facility maintenance team and the legal affairs team, touchpad system computers and phones, real time image transfer and location tracking system in both helicopter and ambulance, customized AMB navigation system, and LTE based disaster communication network(PS-LTE) were representative things good enough to consider to introduce to the MEOC. Gacheon Medical Study Hospital Trauma center was prominent in the care of trauma patients based on its strong medical staffs and powerful support system. Docter Heli was in many ways behind the MEDEON helicopter, so we could feel the strength and potential of the MEDEON helicopter. Conclusion; In order for the MEOC to develop further as a emergency response control tower in military, it is necessary to benchmark 119 civilian centers and newly introduce their advanced systems to the MEOC. After then, if the MEOC widen its dominance not only in air-evacuation but also in AMB transportation, MEOC would have level that civilian 119 centers could not beat.

군 스마트 헬스 케어 시스템을 이용한 원격 건강관리 효과

박성범 ( Sung Bum Park ),유리나 ( Ri Na Yu ),전채경 ( Chae Gyeong Jeon ),김수련 ( Soo Ryeon Kim ),이주환 ( Ju Hwan Lee ),황일웅 ( Iloong Hwang ),석웅 ( Woong Seog ) 국군의무사령부 2017 대한군진의학학술지 Vol.48 No.1

Objectives: Medical Emergency Operation Center(MEOC) of Armed Forces Medical Command started a remote healthcare service using tele-medical system in 2015 and a total of 2807 personnel have been taking advantage of the service. However, limited data is available on the efficacy of remote healthcare service. Thus, we recruited a small number of volunteer who are able to be managed intensively by 4 consultants of MEOC using tele-medical healthcare system and tried to find out the efficacy of remote healthcare using military tele-medical healthcare system. Methods: Out of the 2807 personnel, the applicants were asked again to seek the remote intensive healthcare, we recruited 109 volunteers from 7 different troops. We excluded 28 personnel who showed normal range of value in all four categories of obesity, blood pressure, blood sugar, and cholesterol, so we initially enrolled 81 personnel who had any abnormal values among those categories. We took care of 81 personnel intensively for 3 months from June 2016, but only 69 personnel finished the race since 13 applicants gave up halfway for private reasons. We developed new interventional operations of daily diet and exercise for prevention of metabolic syndrome, and made them check it weekly on health care diary after their doing it. We also provided a variety of information about health, metabolic synarome, and such a way of slimming down, diet, workout etc via daily group chat posting in online social media for the applicants to recognize our interventions were scientific evidence-based operations, and for not letting their daily attention to healthcare wander off. We estimated the efficacy of remote healthcare as improved” , “sustained” , or “deteriorated” by comparing the values between the initial estimation and the final one which measured at least a month later from initial records. The improved” result was a primary end-point in this study. We also carried out survey of satisfaction degree for both tele-medical hardware system itself and intensive remote healthcare service which provided by 4 consultants of MEOC. Results: For 3 months of intervention, the 69 personnel's performance rate of daily healthcare diary was 49%, and positive answer rate to the question that if lifestyle had been modified or not was overall 90%. We provided a total of 357 councils and interventions to the 57 obese people, and except 10 applicants who gave up halfway, 27 among 47 (57.4%) applicants showed improved results. 47 people of high blood pressure had gotten a total of 305 councils and interventions from MEOC, and except 3 people who quit the race, 21 out of 44 (47.7%) people reached the improved states. MEOC provided a total of 180 councils and interventions to the 28 people who had abnormal blood sugar level, and improved blood sugar level was shown in 9 (32.1%) personnel. 25 dyslipidemia people had received a total of 161 councils and intervention, and 4 (16%) applicants showed improved blood cholesterol level. 52 out of 69 applicants answered the question of the survey and it revealed 98% of respondent felt good about the overall intensive tele-medical healthcare service of MEOC. Conclusions: Intensive tele-medical healthcare service provided by special consultants of MEOC might be effective in military society. Personal healthcare using tele-medical healthcare system and self-care contents itself might not be good enough to reach the desired goal of individual. To experience improvement of healthcare indicators and satisfaction of attendants, special manager might intervene the personal healthcare intensively using tele-medical healthcare system.

췌장 낭성종양에서 세침흡인술로 얻은 검체에 대한 점소염색의 유용성

이우진,김용태,박인애,윤용범,김선희,류지곤,장유현,석웅,송인성,김정룡 대한소화기학회 2000 대한소화기학회지 Vol.35 No.4

Background/Aims: Serous cystadenoma (SCA) and mucinous cystic neoplasm (MCN) are common cystic tumors of the pancreas. Most of SCAs are benign but many of MCNs are malignant. Thus, it is very important to differentiate SCA from MCN of the pancreas. The purpose of this study was to examine whether mucin staining of fine needle aspirate (FNA) could differentiate MCN from other cystic lesions. Methods: Eighteen FNAs were obtained from 7 MCNs, 4 SCAs, 2 solid and papillary epithelial neoplasms (SPENs), 1 cystic adenocarcinoma and 4 pseudocysts. Cytologic analysis and mucicarmine staining were performed to find out whether mucin was contained in the cytoplasm of the cells or in the background fluid material aspirated from the cysts. Results: Epithelial cells were observed in 11 (79%) from 14 cystic tumors. However, the definite morphological characterization of cystic neoplasms was possible in only 4 MCNs. No mucicarmine positive cells were found in FNAs from cystic neoplasms. On the contrary, background fluid material was stained positively with mucicarmine in 6 (86%) of 7 MCNs and in 1 of 1 cystic adenocarcinoma, but not in cases of SCAs, SPENs, and pseudocysts. Conclusions: Mucin staining of FNA from cystic tumor of the pancreas, especially for background fluid material, is very useful in the differential diagnosis between MCN and other cystic tumors such as serous cystadenoma.

담관낭종절제술 후 발생한 간내 편평상피세포암

이효석,김정룡,이준성,우광훈,윤용범,송호준,석웅,윤정환 대한소화기학회 1999 대한소화기학회지 Vol.34 No.5

Since it was reported in 1944 that choledochal cyst could convert into cancer, there have been many studies and reports about the malignant conversion of choledochal cyst. The most common pathologic type of associated cancers is adenocarcinoma, and squamous cell carcinoma accounts for 4.8% of all associated cancers. Recently, we experienced an uncommon case of squamous cell carcinoma of the liver arising in a 16-year-old female, who had received choledochal cystectomy and choledochojejunostomy because of type Ⅳ choledochal cyst at 12 years of age. The abdominal computerized tomography scan showed a large (6 cm), ill-defined, low attenuated intrahepatic mass with peripheral bile duct dilatation. Ultrasonography-guided liver biopsy revealed squamous cell carcinoma with intercellular bridges. We report the first case of squamous cell carcinoma of the liver associated with choledochal cyst in Korea. At the time of diagnosis, it was centrally located and far advanced, invading portal vein. She died 3 months later.