사후분해 시체에 대한 법의학적 접근

최영식,이상용,김유훈,조갑래,이봉우,양경무,정낙은,서중석,이한영,이원태,강현욱 大韓法醫學會 2000 대한법의학회지 Vol.24 No.2

Disposal of a homicide victim by dismemberment is rare, but individual cases are on record in most major medicolegal departments. Recognition of postmortem mutilation may be of importance in the interpretation of certain murders committed by sexual perverts and other mentally deranged individuals and sometimes performed for the sole reason of easier disposal of the body. Postmortem dismemberment is usually readily recognizable as such; The edges of the injuries are dry and lack evidence of bleeding. The joints may be disarticulated without fracture, or the use of an axe or saw may be evident from examination of bones. Parallel horizontal or oblique furrows in the bone surface are caused by skipping of the saw prior to establishing depth. Such patterns on the bone may assist in identifying the particular saw involved. So we report 25 dismembered corpses that autopsied in National Institute of Scientific Investigation. This paper can help in attempting to establish not only the first criminal investigation steps but also the medicolegal approach methods in unidentified and dismembered deaths.

Predicting postoperative total calcium requirements after parathyroidectomy in secondary hyperparathyroidism

( Byung Heon Kang ),( Soon Young Hwang ),( Jeong Yeop Kim ),( Yu Ah Hong ),( Mi Yeon Jung ),( Eun Ah Lee ),( Ji Eun Lee3 ),( Jae Bok Lee ),( Gang Jee Ko ),( Heui Jung Pyo ),( Young Joo Kwon ) 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.6

Background/Aims: To prevent hypocalcemia after parathyroidectomy (PTX), parenteral calcium is required in addition to oral calcitriol and calcium. After switching to oral calcium, patients can be discharged from the hospital. The aim of this study was to analyze the clinical characteristics and outcomes of PTX performed at a single Korean center and to investigate the associated laboratory factors used to analyze the total amount of postoperative calcium required. Methods: We enrolled 91 hemodialysis patients undergoing PTX from November 2003 to December 2011. We collected clinical and laboratory data preoperatively, 12 and 48 hours postoperatively, at discharge, and 3 and 6 months postoperatively. Results: In total, 59 patients underwent PTX with autotransplantation (AT), 6 underwent total PTX without AT, 11 underwent subtotal PTX, and 15 underwent limited PTX. Total PTX without AT showed the lowest recurrence rate. At all postoperative time points, the mean levels of serum calcium, phosphorus, and intact parathyroid hormone (iPTH) decreased significantly, compared with preoperative levels; however, alkaline phosphatase (ALP) increased significantly from 48 hours postoperatively to discharge (p < 0.001). On multiple linear regression analysis, the total amount of injected calcium during hospitalization showed a significant correlation with preoperative ALP (p < 0.001), preoperative iPTH (p = 0.037), and Δphosphorus at 48 hours (p < 0.001). We developed an equation for estimating the total calcium requirement after PTX. Conclusions: Preoperative ALP, preoperative iPTH, and Δphosphorus at 48 hours may be significant factors in estimating the postoperative calcium requirement. The formula for postoperative calcium requirement after PTX may help to predict the duration of postoperative hospitalization.

피질하혈관성 치매와 알쯔하이머병에서 뇌량 용적의 변화 비교

이애영,손은희,유성동 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.2

Background : The clinical significance of callosal atrophy in demented patients has not been elucidated. We performed this study to compare the total and regional difference of corpus callosum according to demenua subtypes and analyzed the relationship with the white matter changes. Methods : Twenty-eight patients with Alzheimer's disease (NINCDS-ADRDA criteria), 17 patients with vascular dementia (NINDS-AIREN criteria), and 14 healthy controls were included. The total area of corpus callosum and three distinct subdivision were measured by manual tracing with Paintshop Pro 6.02 software. The degree of white matter changes were graded by the Scheltens' scale. The MMSE and Modified Mini-Mental Stats (3MS) Examination were used for cognitive function test Results : Total callosal area was much smaller in vascular dementia compared with those of Alzheimer's disease and control. The degree of white matter change correlated siginficantiy with the callosal atrophy in vascular dementia Callosal atrophy was proportional to the cognitive decline. Conclusion : We suggest that callosal atrophy in patients with subcortical vascular dementia may be a neuroradiological clue for the coginitive decline and reflects the cerebral white matter injury.

비병원성 야생효모, Apiotrichum sacrabaeorum WP49-1로부터 β-Glucosidase 생산

신유리, 장지은, 이종수 배재대학교 자연과학연구소 2016 自然科學論文集 Vol.32 No.1

콩에 함유되어 있는 식물성 여성 호르몬인 estrogen의 흡수를 증가시키기 위해 높은 활성의 β-glucosidase를 생산하는 비병원성 야생 효모의 선별과 β-glucosidase의 생산 조건을 조사하였다. 38종의 비병원성 야생효모 중 Apiotrichum scarabaeorum WP49-1의 무세포 추출물이 6.5 unit의 가장 높은 β-glucosidase 활성을 보였고 Zygosaccharomyces rouxii O-5-7도 5.9 Unit의 높은 활성을 보였다. 최종적으로 β-glucosidase 생성 효모 균주로 Apiotrichum scarabaeorum WP49-1 균주를 선별하였다. β-Glucosidase는 Apiotrichum scarabaeorum WP49-1을 yeast extract-peptone-dextrose 배지에 접종하여 30℃에서 72시간 배양했을 때 최대로 생성되었다. 선발 균주는 구형으로 출아에 의한 영양증식을 하였고 포자를 형성하지 않았다. 또한 비타민이 함유되어 있지 않은 배지에서도 생육하였고 5% 에탄올에 대하여 내성을 보였다

영·유아 언어, 인지, 사회·정서 발달 평가도구 문항 개발을 위한 예비연구

이종숙,신은수,박은혜,김영태,유영의,최일선,유흥옥 이화여자대학교 교육과학연구소 2009 교육과학연구 Vol.40 No.3

본 연구는 만 2~5세 영·유아의 발달 상태를 객관적으로 평가함과 동시에 발달이 지연된 영·유아를 선별할 수 있는 발달평가도구 문항을 개발하기 위한 예비연구이다. 이를 위해 문헌고찰 및 발달관련 평가도구들을 비교 분석하여 발달지표를 선정하고, 만 2세~5세까지의 영·유아의 언어, 인지, 사회·정서발달영역을 교사관찰에 기초하여 평가할 수 있는 문항을 개발하였다. 연구대상은 대도시, 중소도시, 읍면 소재지 별로 표집 된 만 2세부터 5세까지 총 13개 유아교육기관에 다니는 435명의 영·유아들이며, 본 연구에서 최종 개발된 평가도구의 문항은 총 141문항이다. 평가도구 문항은 언어, 인지, 사회·정서발달영역별로 영·유아의 행동과 언어를 중심으로 교사가 관찰하고, 관찰하기 어려운 문항에 대해서는 단서와 kit를 제시하여 평가할 수 있도록 구성하였다. 개발된 평가도구 문항의 적절성을 알아보기 위하여 내용 타당도와 내적 신뢰도를 살펴본 결과 비교적 양호한 것으로 나타났다. This was a preliminary study to construct a developmental rating scale for understanding children's objective developmental levels and screening developmental disabilities. For this purpose, a developmental indicator was selected by a literature review and comparative analysis of related developmental assessment tests. An assessment scale based on teacher's observations to measure language, recognition, and social-emotional developmental areas was developed. The subjects were 435 young children aged 2 to 5 who lived in both urban and rural areas. A trial test consisted of 141 assessment items in the language, recognition, and social-emotional developmental domains. The developmental scale was evaluated by teachers who observed children's behavior and language, and used clues and kits. Tests on validity and reliability for confirming the appropriateness of the developed assessment scale showed that content was relatively valid and internally consistent.

재발성 가와사끼병의 임상양상과 검사소견

유승택,최은정,이창우,오연균,박승택,윤향석 圓光大學校 醫科學硏究所 2003 圓光醫科學 Vol.18 No.2

무상의료 제도 도입에 대한 쟁점 분석

유은주,이근무 한국사회복지정책학회 2004 사회복지정책 Vol.19 No.-

본 연구의 목적은 무상의료제도에 대한 쟁점과 이슈들을 분석하고 실현가능한 대안은 제시하기 위함이다. 이를 위해 통합된 준거틀을 만들어 분석했는데 이 준거틀은 문제의 구조화, 예측, 영항평가로 구성되었다. 분석결과 첫째로, 경계분석기법을 사용하여 문제를 구조화한 결과 정책문제는 '전문가적 자율성의 침해', '의료자본주의', '의료공공성 강화', '의료제도의 합리화', '분배정의의 실현'으로 나타났다. 둘째, 델파이기법을 사용한 판단적 예측의 결과 이해당사자간 심한 갈등과 불일치를 보이는 것으로 나타났다. 마지막으로 사회 경제적 영향 평가모형을 사용하여 무상의료제도의 실시가 국민건강 환경과 경제에 미치는 영향은 분석한 결과 긍정적인 영향과 부정적인 영향이 공존할 것이라는 예측이 나왔다. 이상에서와 같이 무상의료제도는 규범적 가치와 당위성은 있으나 비용과 형평성에 문제가 있는 것으로 판단되었다. 이에 대한 대안으로 의료공개념을 제시했고 구체적인 방안으로는 공공병원의 확충과 진료비 지불제도를 총액예산제로 전환할 것을 제언했다. The purpose of this paper is to analyze the issues and disputes on National Health Service(NHS) and suggest the realizable alternatives. For this, this study makes united conformity frame and this consists of problem structuring, forecasting, and evaluation. Firstly, the result of problem structuring by boundary analysis that political problems appeared an invasion of professional autonomous rights, medical capitalism, reinforcement of medical public sector, rationalization of medical system, and accomplishment of distribution justice. Secondary, the result of forecasting for judgment by Delphi technique appeared terrible conflict and discord among the persons concerned. Finally, socio-economically, the effect of analysis which affected environment of peoples' health and economy by effective evaluation model was forecasted to coexist affirmative effect and negative effect. According to our analysis, NHS was turned out to have normative value and what might be but to have troubles in cost and equality. We suggested the public concept of medical treatment, an expansion of public hospital, and a shift of global budget system from the payment system of medical fee by this alternatives.

공황장애에서 Paroxetine 단기약물치료가 심리적 상태에 미치는 영향

이소영,김지혜,김율리,강은호,이동수,유범희 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.3

Objectives : This study was designed to evaluate clinical effect of paroxetine treatment and to explore psychological Pre-dictors of treatment response. Methods : Patients (n=26) who met DSM-IV criteria for panic disorder with or without agoraphobia were treated by Pa-roxetine for 12 weeks. We assessed symptom improvement using Clinical Global Impression (CGI), and clinical characteristics using Anxiety Sen&itivity Index (ASI), Anxious Thoughts and Tendencies (AT & T), Agoraphobic Cognition Questionnaire (ACQ), Body Sensation Questionnaire (BSQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). T-test, correlation analysis, and stepwise multiple regression analysis were performed. Results : Panic patients showed significant improvement in seventy of illness and each clinical characteristic after 12 weeks of paroxetine treatment. There were significant correlations among severity of illness, anxiety, and depression, and subjective seventy was related with catastrophic thoughts. The more catastrophic thoughts and the higher sensitivity of body sensation, Patients had the worse symptom improvement they shorved. Multiple regression analysis showed that catastrophic thought related to agoraphobia was the best predictor of symptom improvement (22%). Conclusion : This study suggests that short-term treatment of paroxetine is effective in panic disorder with or without ago-raphobia, and that catastrophic thought could be a predictor of poor treatment response. Thus cognitive intervention on Catastro-phic thoughts may play an important role in symptom improvement in panic disorder.

尿中 鉛 및 蛋白質 排泄量의 補正方法에 關한 實驗的 硏究

兪炳龍,廉容泰,李恩一 고려대학교 의과대학 1994 고려대 의대 잡지 Vol.31 No.1

One of the most important issue in occupational health is to estimate the exposure status or health effects of workers by hazardous chemicals through biological monitoring. The one of the most commonly used tests in biological monitoring to assess the internal doseof a chemical is the measurement of a metabolite or sometimes of the chemical itself in urine. Results from a 24-hour specimen is most representative of average body burden, but it is more difficult to obtain, so it is impractical and more likely to be contaminated. Therefore the analyses are commonly performed on "spot" specimens, and it is necessary to correct the results for the dilution of the urine in order to obtain a reliable estimation by adjustment methods. The most commonly used methods are the specific gravity method and the creatinine method. But these adjustment methods are not reliable satisfactorily, and some other adjustment methods have been suggested by some researchers. This study had been done to develop more reliable adjustment methods of protein and lead measurement in spot urine, and to seek the factors which affect the variability of spot urine. The subjects were 10 workers who had been exposed to lead above TLV. The results were as follows : 1. The coefficients of variation of lead in urine were greater than those of protein both in 21 hour urine specimen and in spot urine specimen. And in the results in spot urine specimens, the coefficients of variation of adjusted concentrations were less than that of unadjusted concentrations of both the protein and lead. 2. The correlation coefficients of urinary lead(adjusted concentration and unadjusted concentration) between in spot urine specimen and in 24-hour urine specimen were 0.6-0.8, and those of creatinine adjusted value between in spot urine specimen and in 24-hour urine specimen were lower in workers who had high level of blood lead(<40㎍/dl) than in workers who had low level of blood lead(>40㎍/dl). 3. The correlation coefficients of urinary protein(adjusted concentrations and unadjusted concentration) between in spot 'urine specimen and in 24-hour urine specimen were 0.6-0.8, and those of creatinine adjusted value between in spot urine specimen and in 24-hour urine specimen were lower in workers who had high level of blood lead(>40㎍/dl) than in workers who had low level of blood lead(<40㎍/dl). 4. The spot urine concentrations adjusted by log-creatinine both of protein and lead were correlated highest to 24 hour urine concentrations in all three adjustment methods such as creatinine adjustment, log-creatinine adjustment and specific gravity adjustment method. 5. The important factors which affect the variation of spot urine were specific gravity in urinary lead, and specific gravity and urinary volume or blood lead and specific gravity in urinary protein. 6. Urinary lead concentrations was not affected seriously by urinary creatinine and urinary volume, but urinary protein concentration was affected largely by urinary creatinine, specific gravity and urinary volume. The urinary protein adjusted by specific gravity was less affected than other adjustment methods. 7. The recommended adjustment method for urinary lead and protein in worker exposed to lead above TLV is log-creatinine method and specific gravity method.

대전광역 시민의 골다공증 검진에 관한 고찰

유은주,이관우,박현모,이수배,김광현,강희구,박성오 한국건강관리협회 1999 건협 Report Vol.2 No.-