도장작업시 유해인자들의 노출수준과 작업환경관리실태

이세기,문덕환,이채관,황용식,선병관,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objectives: For the purpose of preparing the fundamental data and assessing the status of exposure level of chemical substances in painting process. Methods and Materials: The author determined the concentration of organic solvents, lead(Pb), Chromium(Cr), and Toluene-2, 4-diisocyanate(TDI) in air of painting process to 90 industries classified by 15 types of manufacturing industry during a period from Jan. 1st 2001 to Dec. 31st 2001. Results: The results were as follows: 1. The geometric mean level of each chemical substance was 0.1706 ppm for exposure index in organic solvents, 0.0019㎎/㎥ for Pb, 0.0024 ㎎/㎥ for Cr, and 0.0004ppm for TDI, respectively. 2. The exposure level of each chemical substances by type of painting was the highest in dipping and brush painting for organic solvent, in spray-painting for TDI, and in spray gun-painting for Pb and Cr, respectively. 3. The exposure level of each chemical substances by type of local ventilation equipment was higher in enclosed and booth type for organic solvents. Cr, and TDI, and in exterior type for Pb, respectively than those of other types. 4. The exposure level of each chemical substances by type of hazardous material arresting media was higher in using water for organic substances, in using bag filter for Pb, TDI, respectively than those of other types. Conclusion: According to above results, this study suggests that the exposure level by type of industry exceeded the exposure level in wooden furniture and metal furniture manufacturing industry for organic solvents and Pb, respectively.

췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

제통단이 퇴행성 슬관절염 환자의 삶의 질에 미치는 영향

서병관,류성룡,강중원,우현수,이상훈,이재동,최도영,김건식,이두익,이윤호 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : to evaluate the effects of Jetongdan, the newly developed herbal medicine, on the quality of life in patients with osteoarthritis of knee Methods : Placebo-controlled, randomized clinical trial on the 80 patients with osteoarthritis of the knee was fulfilled. After enrollment, they took medication as they enrolled. And they were asked to answer the questionnaires (Korean Health Assessment Questionnaire (KHAQ), Lequesne's functional index (LF1), visual analogue scale (VAS)) and analysed with the erythrocyte sedimentation rate (ESR) at baseline, after 4 weeks and 8 weeks of medication. Results : Total KHAQ score, some categories of KHAQ like hygiene, activities were significantly improved after 8 weeks of medication. And the change of the KHAQ score was significantly correlated with the change of VAS. But LFI, VAS, ESR level was not significantly improved, and it was considered because of the short medication period and small size of study population. Conclusion : In conclusion, Jetongdan could improve the health-related quality of life in patients with osteoarthritis of knee. Further study in the large population, in long period were recommended.

퇴행성 슬관절염에 대한 제통단의 안정성과 효능 임상연구

서병관,류성룡,강중원,안경애,이상훈,최도영,김건식,이두익,이윤호,이재동 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : In order to investigate the efficacy and safety of the newly developed herbal medicine Jetongdan, a placebo-controlled randomized clinical trial of patients with osteoarthriotis of the knee was undertaken. Methods : Data were obtained from 80 patients with OA of the knee. After the enrollment, they were asked to answer a disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index) and analyzed with the erythrocyte sedimentation rate (ESR) in order to evaluate the efficacy of Jetongdan, and analyzed for aspartate transaminase (AST) level, alanine transminase (ALT) level, blood urea mitrogen (BUN) level, and creatinine (Cr) level in order to evaluate the safety of Jetongdan. Results : The liver function and renal function did not deteriorate after treatment with Jetongdan. Composite WOMAC score and physical function subscale was improved, but pain subscale, stiffness subscale, and ESR were not improved by Jetongdan. This was possibly because the baseline characteristics of the two groups were not homogenized after randomization. Conclusions : Jetongdan could be a promising treatment option for osteoarthritis of the knee. Further study in a larger population with appropriate severity grades is recommended.

퇴행성 슬관절염 환자의 증상 중증도 지표와 DITI의 상관성 연구

서병관,류성룡,강중원,안경애,이재동,최도영,김건식,이두익,이윤호,이상훈 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : To investigate the applicability of thermography as severity measurement in the patients with osteoarthritis (OA) of the knee. Methods : Data were obtained from 80 patiens with OA of the knee. They were asked to answer two disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index, Lequesne's Functional Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), VAS in order to assess the severity of disease, quality of life, degree of pain and taken thermography in standardized environment. Results : The thermal difference between ipsilateral side and contralaterla side of lateral aspect of knee was correlated with that of medial aspect of knee, and the thermal difference of anterior thigh was correlated with that of lateral, medial aspect of knee and patella region. Age, duration of disease, duration of morning stiffness, sex, crepitus, and painful side of knee were not correlated with the thermal differences of each region. LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ,, VAS were not correlated with the thermal differences of each region. Conclusion : Further study on the thermography on OA of the knee in population with appropriate severity grade and the standardization of analysis of thermographic data were recommended.

모 축전지 회사 근로자들의 연폭로 지표에 대한 경시적 관찰

강명식,김용배,이용진,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1998 순천향산업의학 Vol.4 No.1

Lead poisoning is still prevalent and one of important occupational disease in Korea. To prevent undue high lead burden and maintain good health condition of lead workers in lead using industries, periodic health examination and regular biological monitoring of lead workers are often required in addition to the fundamental improvement of their working condition. To evaluate the effect of comprehensive occupational health program with regular biological monitoring on the level of lead exposure of lead workers in lead using industries, 11 year database from 1983 to 1994 of one storage battery factory was reviewed. From 1983 to end of 1986 only periodic health examination was provided to the lead workers, but from 1987 comprehensive occupational health program with regular biological monitoring was provided to maintain better health condition of lead workers. Selected study variables for lead exposure were blood lead(PbB), zinc protoporphyrin in blood(ZPP), δ-aminolevulinic acid in urine(ALAU), hemoglobin(Hb), hematocrit(HCT). Information on sex, age and work duration was also reviewed. 5 years data from 1983 to 1987 and 3 years data from 1990, 1993 and 1994 were available for all lead exposure indices except ALAU which has only 5 years data from 1983 to 1997. The results of 11 years longitudinal observation of lead indices are all follows: 1. The mean value of ZPP of lead workers in 1983 was 148.7±73.1 ㎍/㎗(Male: 145.5±72.3, Female: 168.1±79.1), whereas that of ZPP of lead workers in 1994 was decreased to 64.3±32.7 ㎍/㎗(Male: 60.2±28.8, Female: 95.2±43.4). 2. The mean value of PbB of lead workers in 1983 was 56.4±18.8 ㎍/㎗(Male: 55.59±19.1, Female: 59.6±19.1), whereas that of PbB of lead workers in 1994 was dcreased to 35.4±11.9 ㎍/㎗(Male: 35.7±12.0, Female: 32.8±10.8). 3. The mean value of Hb of lead workers in 1983 was 14.1±1.4 g/㎗(Male: 14.4±1.1, Female: 11.7±0.8), whereas that of Hb of lead workers in 1994 was increased to 15.6±1.5 g/㎗(Male: 15.9±1.2, Female: 12.9±1.1). 4. Blood lead is most highly correlated with ZPP(r=0.522, male:0.54 and female:0.50) and also correlated with ALAU and work duration also. 5. The simple regression analysis of PbB and ZPP showed different coefficient of regression by the measurement year, but there was no difference of coefficient of regression between sex. The slope of equation of pooled data for 1983-1986 without comprehensive occupational health program was 2.16 and differed from that of pooled data for 1987-1994(1.25). This difference suggests that the unit effect of blood lead on ZPP was relatively smaller in later period of comprehensive occupational health program than carly period without comprehensive program. The slope change in the analysis of linear regression of PbB on ZPP in lead workers can be used to evaluate the possible effect of health intervention to prevent undue high lead absorption in lead using industries. 6. 11 years occupational health service in this storage battery factory brought out considerable improvement of health status of lead workers in terms of decrease of PbB and ZPP and increase of Hb and the improvement was more remarkable after the introduction of comprehensive occupational health program.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

광중합형 구치부 수복재료의 중합수축량과 중합수축력

박성호,이순영,조용식,김수선,이창재,김영주,이봉희,이광성,노병덕 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.4

The purpose of present study was to evaluate the polymerization shrinkage stress and amount of linear shrinkage of composites and compomers for posterior restoration. For this purpose, linear polymerization shrinkage and polymerization stress were measured. For linear polymerization shrinkage and polymerization stress measurement, custom made Linometer (R&B, Daejon, Korea) and Stress measuring machine was used (R&B, Daejon, Korea). Compositers and compomers were evaluated; Dyract AP (Dentsply Detrey, Gumbh, German) Z100 (3M Dental Products, St. Paul, USA) Pyramid (Bisco, Schaumburg, USA) Synergy Compact (Coltene, Altstatten, Switzerland), Heliomolar (Vivadent/Ivoclar, Liechtenstein), and Compoglass (Vivadent Ivoclar/Liechtenstein) were used. 15 measurements were made for each material. Linear polymerization shrinkage or polymerization stress for each material was compared with one way ANOVA with Tukey at 95% levels of confidence. For linear shrinkage ; Heliomolar, Surefil<Synergy Compact, Z100<Dyract AP<Pyramid, Compoglass F (p<0.05) For Shrinkage stress ; Heliomolar < Z100, Pyramid<Synergy Compact, Compoglass F<Dyract AP<Heliomolar HB, Surefil (p<0.05)

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

간세포암과 하대정맥 막성폐쇄의 치료 후 호전된 백혈구파괴혈관염 1예

이준엽 ( Jun Yeob Lee1 ),이주원 ( Ju Won Lee1 ),이진욱 ( Jin Wook Lee ),박현준 ( Hyun Joon Park ),장국환 ( Gook Hwan Jang ),김다정 ( Da Jung Kim ),김선민 ( Sun Min Kim ),한병훈 ( Byung Hoon Han ),정규식 ( Gyoo Sik Jung ),김근태 ( 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.5

저자들은 하지 자색반과 고환 통증으로 내원한 알코올성 간경화증 환자에서 LCV의 원인 감별하는 과정에서 HCC와 하대정맥 막성폐쇄를 진단하고 이에 대한 치료 후 LCV의 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Vasculitis is a heterogeneous group of diseases that destroy blood vessel walls by inflammation. Approximately half of vasculitis cases are idiopathic, but sometimes associated with genetic factors, medicines, chronic infection, autoimmune diseases, and malignancies. Although the mechanism remains unclear, vasculitis secondary to malignancy, also known as paraneoplastic vasculitis, has been reported. It is generally associated with hematologic malignancies rather than solid malignancies and commonly presents as leukocytoclastic vasculitis or polyarteritis nodosa. We experienced a case of leukocytoclastic vasculitis in a patient with hepatocellular carcinoma and membranous obstruction of the inferior vena cava. Here, we report this case with a brief review of literature. (J Rheum Dis 2015;22:322-326)