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김정수,김인아,이수진,김용규,박시복,고재우,송재철 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4
Objective: This study was carried out to investigate if the measurement of range of motion(ROM) could be applied in the diagnosis of Myofascial Pain Syndrome(MPS) and to determine the severity by analyzing ROM in MPS patients. Methods: The study subjects were 476 female telephone number information service workers. Southampton Protocol and Pittsburgh Protocol were used to diagnose MPS and to measure ROM. ROMs were measured by 2 inclinometers exercising each shoulder passively and actively in 5 directions ; abduction, forward flexion, extension, external rotation, and internal rotation. Results: Compared to the normal group (n=147), the mean of right side ROM in the subjects (n=270) with same side MPS was 2.1˚ (SD=11.5) lesser in active extension and 1.7˚ (SD=10.4) lesser in passive extension. Compared to the mild group (n=210), the mean of right side ROM in the patients with same side severe MPS (N=58) was lesser in all directions. Especially in active forward flexion, passive forward flexion, active extension, passive extension and active external rotation, ROM in the subjects with severe MPS was lesser by 6.5˚ (SD=13.1), 5.1˚ (SD=12.8), 5.9˚ (SD=11.8), 5.0˚ (SD=10.6) and 3.9˚ (SD=9.8), respectively, than those of the subjects with mild MPS. Compared to the subjects with left side mild MPS(n=172), ROM in the subjects with left side severe MPS (n=59) was 5.3˚ (SD=13.3) lesser in active forward flexion. Conclusions: In this study, ROMs in the subjects with severe MPS tended to be lesser than those in mild patients. This tendency was more prominent in the right side than the left, active range of motion than passive and forward flexion and extension than others. The results of this study are expected to help diagnose shoulder MPS and determine severity.
서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)
김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2
Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.
흰쥐에서 에스트로젠 결핍이 하악골 골밀도에 미치는 영향
김기현,신상훈,김욱규,박봉수,정인교 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.2
The relationship between systemic bone loss(osteopenia) and loss of oral bone has been of considerable recent interest. In dentistry, some investigators have studied using human subjects, but no firm conclusion due to many obstacles have yet been obtained. From these obstacles in the assessment of human subjects, the significance of investigations with overiectomized rats has been proposed recently. Also, in ovariectomized rats, quantitative data on changes in the alveolar bone of mandible and basal bone of mandible using dual-energy x-ray absorptiometry(DEXA) were far fewer. The purposes of this study were to certify systemic estrogen deficiency-induced osteopenia by biochemical markers(serum osteocalcin(OC) & urinary deoxypyridinoline(DPD)) and bone mimeral density(BMD) of femur by DEXA and examine changes in BMD of the rat mandible by DEXA with 24-week-old female Sprague-Dawley rats. Forty eight rats were used in this study and twenty four rats were ovariectomized bilaterally(OVX) to induce systemic osteopenia and remainders were subjected to sham surgery(Sham). The experimental rats were killed at different time interval(1st, 2nd, 3rd, 4th, 6th, 8th, 12th and 16th week) for histologic examination, biochemistry analysis and BMD measurement. The results obtained from this study were as follows: On histological examination, in mandible, early degeneration of periodontal ligament, early bone resorption in alveolar bone and late bone resorption in basal bone were observed. On biochemical analysis, OC and DPD were observed statistically no significancy to predict systemic osteopenia. On DEXA measurement, in OVX group, we observed statistically significant decrease from 3rd week in distal metaphysis, statistically non-significant decrease from 2nd week in alveolar bone of mandible, and statistically significant decrease at 16th week in total mandible. From these results, it could be stated that systemic osteopenia by ovariectomy was early affected in the trabecular bone of femur and alveolar bone of the mandible whereas the total mandible was affected later.
Kim, Eun Jung,Jeong, Myung Ho,Kim, Ju Han,Ahn, Tae Hoon,Seung, Ki Bae,Oh, Dong Joo,Kim, Hyo-Soo,Gwon, Hyeon Cheol,Seong, In Whan,Hwang, Kyung Kuk,Chae, Shung Chull,Kim, Kwon-Bae,Kim, Young Jo,Cha, Kwa Elsevier 2017 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.236 No.-
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Acute hyperglycemia on admission is common in acute myocardial infarction (AMI) patients regardless of diabetic status, and is known as one of prognostic factors. However, the effect of hyperglycemia on non-diabetic patients is still on debate.</P> <P><B>Methods</B></P> <P>A total of 12,625 AMI patients (64.0±12.6years, 26.1% female) who were enrolled in Korea Acute Myocardial Infarction Registry-National Institute of Health between November 2011 and December 2015, were classified into 4367 diabetes (65.4±11.6years, 30.4% female) and 8228 non-diabetes (63.3±13years, 23.9% female). Patients were analyzed for in-hospital clinical outcome according to admission hyperglycemic status.</P> <P><B>Results</B></P> <P>In diabetic patients, independent predictors of in-hospital mortality were old age, high HbA<SUB>1</SUB>C, pre-Thrombolysis In Myocardial Infarction (TIMI) flow 0, left ventricle ejection fraction<40%, cardiogenic shock and ventricular tachycardia. In non-diabetic patients, independent predictors of in-hospital mortality were old age, high admission glucose (≥200mg/dL), pre TIMI flow 0, failed percutaneous coronary intervention, low left ventricle ejection fraction<40%, cardiogenic shock, stent thrombosis and decreased Hb≥5g/dL. In hospital mortality was significantly higher in diabetic patients compared to non-diabetic patients (5.0% vs. 3.4%, <I>p</I> <0.001). However, non-diabetic patients with hyperglycemia have significantly higher mortality compared to diabetic patients (17.4% vs. 7.2%, <I>p</I> <0.001). Comorbidity including cardiogenic shock (<I>p</I> <0.001), cerebral hemorrhage (<I>p</I> =0.012), decreased Hb≥5g/dL (<I>p</I> =0.013), atrioventricular block (<I>p</I> <0.001) and ventricular tachycardia (<I>p</I> =0.007) was higher in non-diabetic with hyperglycemia than in diabetic patients.</P> <P><B>Conclusions</B></P> <P>These findings underscore clinical significance of admission hyperglycemia on in-hospital mortality in non-diabetic AMI patients.</P>
급성 중독 환자에 대한 역학적 고찰 : 서울과 지방의 비교
김성중,김인병,최성욱,김경수,이영수,Choi, Jong Moo 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2
Study objective: To compare patients with acute poisoning between urban and rural areas Design: Retrospective chart review of 217 patients with acute poisoning Setting: Two University Hospital EDs Methods: patients were divided into two groups according to hospital. The group A was 109 patients who came to ED of Asan Medical Center and the group B was patients who came to ED of Ajou University Hospital from June 1994 to February 1995. We analysed the age and sex distributions, poisoning substances. causes of poisoning and the past history of psychiatric problems in patients of the two groups. Results: Total number of patients with acute poisoning were 109 in the group A and 108 in the group B. Female was more prevalent than male in the group A and male was more than female in the group B. There was a significant difference in sex distribution between two groups. The mean age of the group A was 27.7 years which was significantly different from the mean age of the group B, 33.7 years. The age incidences in both group were highest in 2nd decade. The accidental poisoning cases were 37% in the group A and 31% in the group B. The rates of committed suicide were 7% in the group A and 22% in the group B. The most common agent of poisoning was therapeutic drug in the group A and agricultural or industrial chemical in the group B. The overall mortality was 5% in the group A and 15% in the group B. Conclusion: There were significant differences in age and sex distributions. poisoning substances, causes of poisoning and the past history of psychiatric problems between two groups.
체간미주신경절단술 및 유문성형술, 선택적미주신경절단술 및 유문성형술과 벽세포 미주신경절단술후 Histamine 자극이 위산분비에 미치는 영향에 관한 실험적 연구
김인수,김세민 고려대학교 의과대학 1984 고려대 의대 잡지 Vol.21 No.1
The goal of the therapy for peptic disease is to reduce the acid-pepsin secretion in ther stomach and the recurrence rate, and the parietal cell vagotomy is believed to be a suitable operation for this purpose. The purpose of this study is to report on the response of the gastric secretion after variable vagotomy procedures and to compare the response rate with the administration of histamine in each vagotomy procedures. The author carried out an experimental study on the gastric secretory response to histamine in total 23 mongrel dogs, 8 control group (gastrostomy), 5 truncal vagotomy with pyloroplasty group; 5 selective vagotomy with pyloroplasty group and 5 parietal cell vagotomy group. Gastric juice analysis was carried out 3 times on a monthly with the administration of histamine. The result are as follows: 1. In group of truncal vagotomy with pyloroplasty, the mean value of free acidity after 1 month, 2 month and 3 month of operation decreased by 70.4% 47.1% and 83.1% respectively in comparison with control group, and mean value of total acidity decreased by 32.1%, 24% and 53.1% respectively. The mean value of histamine-responded free acidity after 1 month, 2 month and 3 month of operation decreased by 24%, 43.7% and 48.3% respectively in comparison with control group and mean value of total acidity decreased by 9.4%, 21.2% and 38.8% respectively. 2. In group of selective vagotomy with pyloroplasty, the mean value of free acidity after 1 month, 2 month and 3 month of operation decreased by 18.5%, 41.3% and 25.9% respectively, in comparison with control group. The mean value of histamine-responded free acidity after 1 month, 2 month and 3 month of operation decreased by 27.1%, 45.4% and 46.5% respectively, in comparison with control group and mean value of total acidity decreased by 24.0%, 18.7% and 8.4% respectively. 3. In group of parietal cell vagotomy, the mean value of free acidity after 1 month, 2 month and 3 month of operation decreased by 40.7%, 70.4% and 57.7% respectively, in comparison with control group and mean value of total acidity decreased by 24.0%, 18.7% and 8.4% respectively. Then mean value of histamine-responded free acidity after 1 month, 2 month and 3 month of operation decreased by 33.7%, 25.1% and 63.8% respectively, in comparison with control group and mean value of total acidity decreased by 24.9%, 21.8% and 28.8% respectively. 4. In summary, average reduction rates of free acidity in truncal vagotomy with pyloroplasty, selective vagotomy with pyloroplasty and parietal cell vagotomy were 66.7%, 29.2% and 56.3% respectively, and average reduction rates of total acidity, 36.4%, +10.1% and 28.4% respectively. Average reduction rates of histamine-responded free acidity were 28.7%, 39.5% and 40.9% respectively, and histamine-responded total acidity, 23.1%, 17% and 25.2% respectively.
Kim, Sung-Soo,Cho, Young-Seok,Kim, Hyung-Keun,Shin, Ok-Ran,Chae, Hiun-Suk,Choi, Myung-Gyu,Chung, In-Sik The Korean Society of Gastroenterology 2010 대한소화기학회지 Vol.55 No.4
<P>Background/Aims: Ligands for peroxisome proliferator-activated receptorgamma (PPARgamma), a member of the ligand-activated nuclear receptor superfamily, exhibit anti-tumoral effects and are associated with de novo synthesis of proteins involved in regulating the cell cycle and cell survival/death. Helicobacter pylori (H. pylori) is an etiologic agent for gastric adenocarcinoma, and raises the cell turnover of gastric epithelium. The aim of this study was to investigate the effect of PPARgamma ligand rosiglitazone on the cell proliferation and the expressions of p27 and Skp2 protein in H. pylori infected gastric epithelial cells. Methods: We examined the expression of PPARgamma by Western blot in H. pylori infected AGS human gastric epithelial cells. The effect of rosiglitazone on the survival of H. pylori infected AGS cells was assessed by cell viability assay. After the treatment of rosiglitazone in H. pylori infected AGS cells, the expressions of p27 and Skp2 were assessed by Western blot. Results: The expression of PPARgamma protein was increased in H. pylori infected AGS cells. Cell growth was inhibited and decreased in dose- and time- dependent manner in H. pylori infected AGS cells treated with rosiglitazone. A decrease in Skp2 expression and a reciprocal increase in p27 expression were found in dose- and time-dependent manner in H. pylori infected AGS cells treated with rosiglitazone. Conclusions: Rosiglitazone inhibited the growth of H. pylori infected AGS cells. Rosiglitazone attenuated Skp2 expression, thereby promoting p27 accumulation in H. pylori infected human gastric epithelial cells. Further studies will be needed to find the effects of accumulation on cell turnover in H. pylori infection and the role in the H. pylori-associated gastric carcinogenesis.</P>
김준연,손지언,김형수,김두희,원미숙,김인식,이혜령 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5
This study investigated mean airborne CO concention of 15 workplaces, suspected of CO exposure and conducted self-reported questionnaire completion and indirect COHb concentration measure using Micro II Smokerlyzer to healthy 702 adult subjects from 1999 May to 1999 September in order to find a relation of CO exposure and occupational factors, socioeconomic factors, and health related behaviors and confirm the related conditions in the screening test for CO exposure. The results of this study were summarized as follows : 1. In the CO exposed and non exposed group, COHb concentrations of the smokers were 2.55±0.96% and 2.21±0.97% and that got a statistically significant difference, There were not statistically significant differences in the age and total smoking index. Passed times after the last smoking, Working time/day, and working duration were statistically significant difference (p〈0.05). 2. In the CO exposed and non exposed group, COHb concentrations of non-smoking group were 0.94±0.35% and 0.68±0.47% and that got a statistically significant difference. There were not statistically significant differences in the age and working duration but Working time/day was a statistically significant difference(p〈0.05). 3. In the CO exposed group, r-square of multiple regression of the smokers was 38.5 % and passed time after the last smoking, working time/day, and job category were statistically significant differences (p〈0.05). And r-square in the CO non-exposed group was 38.3 % and age, passed time after the last smoking, and total smoking index were statistically significant difference. 4. In the CO exposed group, r-square of multiple repression of the non-smokers was 66.3% and job category and airborne CO concentration were statistically significant differences(p〈0.05). But r-square of non-smokers in the CO non-exposed group was 1.0% and there was not a statistically significant difference(p〈0.05). 5. In the smokers of CO exposed and non exposed groups, relation of COHb concentration and passed time after the last smoking was expressed as exponential function, Y = 2.9182e-0.0083x and r-square of this function was 37.4%. Therefore it was more than 150 minutes that passed time after the last smoking was when COHb concentrations were measured as less than 1%. In conclusion, variable, that was statistically significant to COHb concentraion in the both CO exposed and non-exposed smokers, was a passed time after the last smoking. We suggest that you have to restrict the smoking of smokers at least 150 minutes in the exposed and non exposed group before COHb concentration measure in order to exclude smoking effects
김수인,연규월,하은희,우행원,김영철 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3
연구목적 : 최근 산업재해(이하 산재) 및 교통사고 발생이 증가하면서 사고 후유증으로 치료받는 환자들이 늘어나고 있다. 산재를 포함한 각종 사고들은 환자의 신체적 상태를 변화시킬 뿐 아니라 이로 인한 사회적, 직업적, 경제적 문제들을 초래하게 되고 환자의 삶 전체를 변화시킬수 있다. 본 연구에서는 산재가 환자들에게 미치는 정신적 영향을 알아보기 위해 산재 환자들과 대조군에서 삶의 질, 자살사고 및 우울증상을 비교하였다. 방 법 : 연구대상은 1999년 12월 21일부터 12월 30일 사이에 경상남도 울산 마산·창원지역의 입원한 산재환자 169명이었고 정상 대조군은 울산의 공업단지 내 일반근로자 166명이었다. 평가군과 대조군 모두 남성이었고, 19세에서 60세였다. 모든 대상에서 일반 인구학적 특성, 삶의 질, 자살사고, 우울 증상을 평가하였고, 산재 환자군의 경우 사고일시, 사고원인, 치료기간, 손상부위를 추가로 조사하였다. 주관적 삶의 질은 한국판 스미스클라인 비챰 삶의 질척도로 평가하였고, 자살사고는 Beck의 자살사고(思考)척도로 평가하였으며, 우울증상은 PRIME-MD를 개선한 Patient Problem Questionaire의 우울증 척도로 평가하였다. 결 과 : 산재환자군과 대조군간 일반 인구학적 요인에서 통계적으로 유의한 차이 없었다. 산재환자군이 대조군에 비해 유의하게 낮은 삶의 질 척도 점수를 나타냈고, 유의하게 높은 자살사고와 우울증상을 나타냈다(p<.05). 산재환자군에서 연령, 결혼상태, 치료기간과 삶의 질 점수는 관련이 있었다. 30대 이상의 연령에서 유의하게 낮았고 10∼20대 연령에서 유의하게 높았으며, 미혼이거나 이혼, 별거중인 경우 유의하게 삶의 질 점수가 낮았고, 치료기간이 길수록 낮았다. 치료기간과 자살사고가 관련있었으며, 치료기간이 길수록 자살사고가 많았다. 산재환자군에서 손상부위에 따라 삶의 질 점수, 자살사고 점수와 우울증상이 유의한 관련이 있었다. 삶의 질 점수는 요추부 손상군에서 높았고, 경추부 손상군과 다발성 좌상환자군에서 낮았다(p<0.01). 자살사고 점수는 경추부손상군과 다발성 좌상 환자군에서 높았고, 요추부 손상군에서 낮았다(p<0.01). 연구 대상군에서 삶의 질 점수, 자살사고 점수, 우울증상간 유의한 상관관계가 있었다. 결 론 : 본 연구 결과 산재환자들은 일반 근로자들과 비교하였을 때 삶의 질이 낮다고 느끼고 있었으며, 주관적으로 우울감과 자살사고를 많이 나타냈다. 따라서 산재로 인한 우울 및 자살등의 증상을 예방하기 위해서는 조기 정신과적 치료 중재가 반드시 필요하다고 생각된다. Objective : As the occupational and traffic accidents are increased, patients who are treated for complications of accidents have been increased in recent years. Accidents including industrial injury affect the physical state of the patients and make social, vocational, and economic problems, so that they can affect the whole life of the patients. We performed this study to compare subjective evaluation of quality of life, depressive symptoms, and suicide ideation in both industrial injury patients and control subjects in order to know how industrial injury affect patients in psychiatric aspect. Method : The subjects were 169 inpatients who met the inclusion criteria of industrial injury patients and 166 healthy control subjects. All subjects were male and their age is from 19 to 60 years old. Demographic variables, quality of life, depressive symptom, suicide ideation were assessed in subjects. The types of injury and duration of treatment were assessed in patients. The quality of life was measured using the Korean version of SmithKline Beecham 'Quality of Life' Scale(KvSBQOL), and the suicide ideation was measured using the Scale for Suicide Ideation(SSI), and the depressive symptom was measured using the Dpression scale of Patient Problem Questionaire(PPQ) which were devised from Primary Care Evaluation of Mental Disorder(PRIME-MD). Results : 1) There were no significant differences in the general demographic variables between industrial injury patients and control subjects. 2)Scores of KvSBQOL were significantly lower, and SSI and Depression scale of PPQ were significantly higher in the industrial injury patients than control subjects(p<0.05). 3) In industrial injury patients, there was a correlation between the age and the scores of KvSBQOL(p<0.01). The scores of KvSQOL were lowest in older than 30's, highest in 10's-20's. No significant correlation was recognized between the age and the suicide ideation, the depressive symptoms. Threre was a correlation between the marital status and the scores of KvSBQOL(p<0.01). In unmarried, divorced or separated state, the scores of KvSBQOL were significantly lower than married state. There was a correlation between the the duration of treatment and the scores of KvSBQOL, the suicide ideation. As the duration of treatment was longer, the scores of KvSBQOL were significantly lower(p<0.01), and the scores of SSI were significantly higher(p<0.01). 4) In industrial injury patients, there was a significant correlation between the type of injury nd the scores of KvSBQOL, the suicide ideation, and the depressive symptoms. The scores of KvSBQOL were highest in the L-spine injury patients, lowest in the C-spine injury and multiple contusion patients(p<0.01). The scores of SSI were higher in the C-spine injury and multiple contusion patients, lowest in the L-spine injury patients(p<0.01). 5) In subjects, there was significant correlation between the scores of KvSBQOL, the scores of SSI, and the Depression scale of PPQ. Conclusion : Industrial injury patients feel bad about the quality of life and have more depression and suicide ideation. As a results, psychiatric intervention is needed for prevention of depression and suicide due to industrial injury.
김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1
Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.