부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim`s technique and comparison to laparotomy

( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2

Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.

수면량과 집중력의 상관관계

김병우,류지근,박우진,박계원,김미정,임지은,백대현,최재덕,최윤호,이가현,이관,김덕수 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

수면, 기억 그리고 학습의 연관성은 실제 매우 복잡하다. 많은 연구에도 불구하고 명확한 연구결과는 아직 없다. 우리는 이 연구에서 평소와는 달리 시험 전날 수면 변화 양상이 집중력에 어느 정도 영향력을 미치는지 알아보고자 하였고, 이를 이용해 효율적인 수면 관리를 할 수 있는 기초자료로 삼고자 하였다. 동국대 의대 본과 1학년생 중 지원자 30명과 본과 2학년생 10명을 대상으로 평상시 상태와 시험 직후 수면이 부족한 상태에서 각각 K-PES TEST를 실시하여 총 8항목에 걸쳐 암기력, 판단력, 단순반응의 변화정도를 검사하였다. 또 설문조사를 병행하여 결과에 영향을 미칠 수 있는 다른 인자들도 파악하였다. 수면량에 대한 부호 숫자 짝짓기(순간 판단력)을 검사한 결과, 인간의 최대 생리학적 기능은 꼭 수면부족에 의해 좌우되는 것은 아니다. 그러나, 수면감소는 피로를 증가시키고, 동기부여를 감소시키나 단, 새로운 사실을 학습하는 데에는 큰 영향을 끼치지 않는다. 즉, 수면부족으로 장시간 깨어있는 것은 정확성과 반응성을 떨어뜨린다. 흡연에 대한 부호 숫자 짝짓기(순간 판단력)을 검사한 결과, 니코틴의 수면에 대한 상호관계는 알려지지 않았고, 인간의 감정이나 의식, 인식에 영향을 주는 것으로 알고있지만, 장기적은 측면에서 흡연이나 알코올은 인식능력과 무관한 것 같다. 카페인에 대한 숫자 외우기(암기력)검사 결과, 카페인은 spacial selective attention에는 특별한 영향을 주지 않지만 지각과정이나 주의 집중에 큰 효과를 주며, 인간의 의식 수행에 긍정적인 효과를 준다. 즉 카페인은 활력, 혼란, 피로상태를 변화시키고 visual analog scales에서 휴식상태에 가까운 양상을 나타낸다. 또 48시간 동안 수면을 취하지 않은 사람에게 카페인은 집중력과 장시간의 좋은 기분을 유지하게 하였다. 그러나 규칙적, 비규칙적으로 먹는 사람간에는 인지수행력의 차이를 보이지 않으며 상용자에서는 상당한 내성이 보인다. 수면패턴에 대한 숫자 더하기(순간 판단력)검사 결과, 집중력은 수면패턴에 의해서도 영향을 받고, 수면패턴이 바뀌게 되면 순간판단력을 저하시킨다. This study was performed to evaluate relationship of sleep and attention, and to control sleep effectively. We conducted a K-PES test of 40 medical students. K-PES contains eight elements, for example, simple response, selective response, color pairing, OddEven discrimination, number addition, number-symbol matching, memory, right-tapping, left tapping. Through these, we tested changes of memory, judgement, simple response. And we conducted a questionnaire survey to exclude bias. Results are as follows. As a results of number-symbol matching test, we know that sleeplessness is not complete responsible for physiologic function for humans. But, decreased sleep increases fatigue and decreases motivation, but no influence on learning new materials. So, long term sleeplessness decreases precision and responsibility. As a results of number-symbol matching test on smoking, a relationship of nicotine and sleep is not certain. A point of view in long term period, smoking and drinking is not related cognition, even if we know that those influence mood, consciousness and cognition. As a results of memory work test on caffeine, caffeine does not influence spacial selective attention, but mainly does perception, attention and consiousness process. Namely caffeine changes energetic activities, chaos, fatigue states and shows resting state in visual analog scales In sleeplessness for 48 hours, caffeine produced attention and good mood for a long time. But, in case of cognitive process no significance shows in regular or irregular diet. Regular diet shows high resistance. As a results of number addition test on sleep patterns, seep patterns influence attention, changes of sleep patterns decrease a moment judgement.

조혈모세포이식 후 발생한 주폐포자층 폐렴에 대한 고찰

주지현,최정현,이동건,백지연,고윤호,이혜정,김세희,신호진,박윤희,박지영,김유진,신완식,김춘추 대한감염학회 2001 감염 Vol.33 No.4

Background : Pneumocytitis cainii pneumonia (PCP) can occur in immunocompromised hosts especially such as AIDS or cancer patients. Although recent research had focused on PCP in AIDS patients, few studies have described the clinical presentations of PCP in recipients of stem cell transplantation (SCT). We evaluated the clinical manifestations of PCP in SCT patients admitted at St. Mary's hospital, Seoul, Korea. Methods : The medical records of 17 PCP patients undergoing SCT between Feb. 1998 and Feb. 2000 were reviewed. The diagnosis of PCP was confirmed through the demonstration of Pneumocytitis cainii via either cytology of brochoalveolar lavage (BAL) or histological technique of lung biopsy. CMV disease and CMV infection were confirmed by BAL culture and antigenemia respectively . Results : Seventeen patients were all recipients of allogeneic SCT and 7 of 17 patients were performed non-sibling SCT. Patients presented with symptoms including brief period (4 ∼23 days) of fever (76%), dyspnea (70%), cough (64%), and signs such as rare(58.8%), Sixteen patients (94%) had been receiving immunosuppressive agent such as cyclosporine A (64%) or Fk506 (35%) without PCP prophylaxis. Eleven patients (64%) were treated with corticosteroid with mean dose of 16 mg/day prednisolone and mean duration of 4.6 months after post-SCT period. Twelve patients were co-infected with CMV. Another co-infected miCroorganisms were Pseudomonas aeruginosa, Mycobacterium tuberculosis, herpes simplex virus, parainfluenza virus, Average duration of treatment with trimethoprim-sulfamethoxazole (TMP/SMX) was 21 ±9 days. Four patients died, and three of them were related with PCP. Conclusion : PCP developed frequently in patients who were taking immunosuppressive drug due to graft versus host disease or were not taking TMP/SMX prophylaxis. High risk patients showing fever, cough, or dyspnea should be considered to take early bronchoscopic intervention for detection of PCP. When treat for PCP, it also be considered to the possibility of coinfection such as CMV. (Korean J Infect Dis 33:273∼279, 2001)

항갑상선제로 치료한 그레이브스병 환자의 관해예측인자

남일송,윤여일,김선규,김용현,이주영,목지오,윤석기,김철희,김영선,변동원,서교일,유명희 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background: Most cases of Graves' disease have been treated by antithyroid drugs in Korea. The major drawbacks of antithyroid drugs are the relative high rate of relapse and the inconvinience of long term therapy. Measurement of TBII and TRH stimulation test have been considered as the most reliable tests predicting relapse, but the predictive power is not high enough to use in clinical situation. This study was performed to find good prognostic indicators in Graves' disease patients after the discontinuation of antithyroid drug therapy. Subjects and methods : We restrospectively evaluated 96 patients with Graves' disease who showed normal TRH test at the end of antithyroid drug therapy and were followed for more than one year. Serum T3, T4, T3/T4 ratio, TBII, Anti-TPO Ab and TGAb levels were measured at the time of diagnosis and at the end of therapy. Two to three months after withdrawal of antithyroid medication, serum TSH and free T3 responses to TRH were examined. These parameters were compared between the relapse group and the remission group. Results : Among the 96 patients, 22 patients(22.9%) relapsed(Group Ⅱ) and 74 patients(77.1%) remained in remmision(Group Ⅰ). No significant difference was observed between the relapse and the remission group in clinical parameters, serum T3, T4, TSH, T3/T4 ratio, TBⅡ and Anti-TPO Ab determined before and after treatment. Serum TSH and free T3 levels measured after TRH stimulation were also similar in both groups. Serum TGAb levels determined at the end of treatment were significantly higher in the remission group(p<0.05). Relapse following the discontinuation of therapy occured within 24 months in 72.7% of the relapsed cases. After 24 months, relapse rate was reduced significantly. Conclusion : These results suggest that high serum TGAb levels could be a favorable prognostic indicator for the long term remission of Graves' disease treated with antithyroid drugs, and may suggest that Hashimoto's thyroiditis is combined with Graves' disease in those patients.

항암화학요법 관련 오심과 구토 완화를 위한 비약물요법에 관한 연구동향

소향숙,최자윤,조인숙,김영재,김지영,김애숙,김옥미,김춘심,김현오,설영애,안정옥,이애리,이영자 성인간호학회 2003 성인간호학회지 Vol.15 No.3

Purpose: Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction. Method: Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods. Result: Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group: 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting. Conclusion: Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.

기계적합화법으로 제조된 TiNi 분말의 방전플라즈마 소결에 관한 연구

김윤호,강지훈,김지순,안인섭,권영순 울산대학교 1999 공학연구논문집 Vol.30 No.2

기계적합금화법(MA)에 의해 제조된 TiNi 분말을 사용하여 방전플라즈마 소결법(SPS)으로 소결체를 제조하고 치밀화 거동을 조사하기 위하여 미세조직의 관찰 및 상분석을 행하였다. SPS법으로 소결체를 제조한 결과, 통상적인 소결법으로 소결체를 제조하였을 때 보다, 낮은 온도와 짧은 시간의 유지시간에서 이론 밀도의 99% 가까운 소결체 밀도를 얻을 수 있었고, 소결체의 상은 B2구조의 cubic과 2차상으로 Ti₂Ni가 존재함을 확인하였다. Mechanically-alloyed TiNi powders were densified by Spark-Plasma Sintering(SPS) method. The densififcation behavior was investigated throgh the microstructural observation, the phase analysis and the measurement of change in devsity, linear shrinkage and densification rate as a function of temperature. Sintered body with close to 99% relative density was obtained at lower sintering temperature for shorter holding time in comparison to the conventional sintering methods. TiNi with B2 structure was confirmed as the major phase and Ti₂Ni as the second phase.

가상현실을 이용한 뇌졸중 환자의 균형장애 평가와 임상평가 지수와의 상관성 연구

김연희,박지원,정준용,우영근,최종덕,김남균 최신의학사 2003 最新醫學 Vol.46 No.11-12

사회적 상호작용을 강조한 과학 탐구실험의 효과

김지영,성숙경,박종윤,최병순 한국과학교육학회 2002 한국과학교육학회지 Vol.22 No.4

사회적 상호작용을 강조한 과학탐구실험이 학생들의 학업성취와 과학탐구능력 및 학습동기에 미치는 효과에 대해 연구하였으며, 탐구실험 수업이 소집단의 구성방식에 따라 어떠한 차이를 나타내는지 알아보기 위해 인지수준이 동질인 집단과 이질인 집단의 효과를 비교하였다. 이를 위해 중학교 2학년 255명을 통제집단과 실험집단으로 나누어, 실험집단에는 사회적 상호작용을 강조한 과학탐구실험 수업을, 통제집단에는 전통적인 실험 수업을 1년간 적용한 후 과학학업성취도, 과학탐구능력, 학습동기 검사를 실시하였다. 사회적 상호작용을 강조한 탐구실험은 이끌어내기, 친숙해지기, 구성하기, 확장하기의 4단계로 구성되어 있으며, 관찰 현상을 학습과 연관시키고 실험을 설계하며 결론을 이끌어내는 과정을 통해 동료 및 교사와 상호작용을 할 수 있도록 구성되어 있다. 연구 결과 사회적 상호작용을 강조한 과학탐구실험은 학생들의 학업성취와 과학탐구능력 및 학습동기에서 유의미한 효과가 있었다. 모든 인지수준의 학생들에게 효과가 나타난 것은 아니었으나 대분분의 인지 수준에서 학업성취의 효과가 크게 나타났으며, 학업성취에 비해 과학탐구능력의 향상정도가 낮았다. 소집단 구성에 따른 효과에서는 동질집단이 이질집단에 비해 성취도와 학습동기에서 유의미한 향상이 있었다. 이러한 결과는 과학탐구실험에서 상호작용이 중요하며, 상호작용이 학생들의 성취도와 탐구능력 향상에 긍정적 영향이 있음을 시사한다. This study investigated the effects of scientific inquiry experiments emphasizing social interaction on the academic achievement, the ability for science inquiry and the learning motivation of the students. To examine the differences among the classes of scientific inquiry experiments according to the way of organizing small groups, the effects of the group in homogeneous cognitive level and the group in heterogeneous cognitive level were compared. 255 7th-graders were grouped into the treatment group and the control group. After the treatment group received the scientific inquiry experimental lessons emphasizing social interaction and the control group received traditional lessons for one year, academic achievement, ability for scientific inquiry, and learning motivation were examined. These inquiry experiments were composed of four steps which are eliciting, familiarizing, constructing and bridging. And students can interact with peers and teachers through the process of relating observed phenomena to concept, constructing experiment procedure, and eliciting results. The ANCOVA results revealed that there were significant effects of science inquiry experiments emphasizing social interaction on the academic achievement, the ability for scientific inquiry and the learning motivation of the students. The significant academic achievement of the students in most of the cognitive levels, if not all, was found and degree of improvement in the ability for scientific inquiry was lower than that in the academic achieve3ment. Concerning the effects according to the way of organizing small groups, there were significant improvement in academic achievement and learning motivation of the group in homogeneous cognitive level compared to the group in heterogeneous cognitive level. These results indicate that social interaction in learning is important and it has positive influences on the improvement in academic achievement and ability for scientific inquiry of students.

림프절 종창의 임상적 관찰

김삼용,김현수,김종숙,박상준,최지영,윤환중,조덕연 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Objectives : Clinical management of patient with lymphadenopathy requires judicious judgement of clinicians. Careful evaluation of lymph node enlargement by various clinical parameters will help to disclose the etiology of lymph node enlargement. This study was conducted to identify the clinical manifestations and etiology of lymphadenopathy in korean patients. Methods : A total 192 patients with lymph node enlargement were studied retrospectively. All patients who underwent excisional lymph node biopsy during the period from January 1992 to July 1994 were included. The lymph node biopsy and clinical records were reviewed and patient characteristics were analyzed by various clinical parameters. Results : A female predominance was noted in lymphadenopathy of tuberculosis (58.5%), Kikuchi's syndrome (70%). In lymphadenopathy of nonspecific, tuberculosis, kikuchi syndrome, per centage of patients younger than 40 years of age were 84.5%, 75.6%, 100%, respectively. In lymphadenopathy of tuberculosis and metastatic cancer, the duration of lymphadenopathy below 30days were 51.2%, 73.9%, respectively. The two most common etiology of cervical lymphadenopathy were nonspecific lymphadenitis (47.7%) and tuberculous (26.8%). The two most frequent etiology of supraclavicular lymphadenopathy were nonspecific lymphadenitis (46.3%) and metastatic lymphadenopathy (26.8%) and the most common etiology of axillary lymphadenopathy was nonspecific lymphadenopathy (34.5%). The most common frequent of lymph node enlargement with size below 1㎠ was nonspecific lymphadenitis, while above 2.25㎠ it was metastatic lymphadenopathy. Conclusion : Careful evaluation regarding patient age, sex, size of lymph node, consistency, location of lymph node, presence or absence of systemic symptoms should be pursued before performing a biopsy and management.