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.

TNF-α 유전자형과 방광암과의 관계

정필두,김은정,엄민식,서정원,윤석중,김종석,이상철,김원재 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

연구목적: TNF-α는 일부 종양의 종양화 과정과 관련이 있는 것으로 알려져 있다. 본 연구는 TNF-α 발현에 영향을 미치는 TNF-α 촉진자 -308 부위의 유전적 다형성이 방광암과 관련이 있는지 유무를 알고자 시행하였다. 대상 및 방법: 유전자 분석을 위하여 환자 113명 및 대조군 109명으로부터 혈액을 채취하여 genomic DNA를 분리한 후 PCR-RFLP 및 direct DNA sequencing을 통하여 TNF-α유전자의 다형성을 조사하여 방광암의 발생, 병기 및 분화도와 비교 검토하였다. 결과: TNF-α 촉진자 -308 부위의 유전형은 대조군에서는 GG형이 83.5%(90례 및 GA형이 16.5%(19례)로 관찰되었으며 AA형은 없었다. 환자군에서는 GG 형이 85.4%(97례), GA형 및 AA형은 각각 13.1%(15례)및 0.8%(1례)에서 관찰되었다. 두 군 모두에서 GG형이 가장 많이 나타났으며 다음으로 GA형을 보이고 AA형은 1례의 방광암 환자에서만 관찰되었다. -308부위의 경우도 두 군 사이에 유전자형의 차이는 없었다(p=0.259) 분화도별 분포를 보면 grade I이 20례, grade II가 49례, grade Ⅲ은 34례였고 병기별로 표재성인 경우가 90례였으며 침윤성은 14례였다. 분화도가 나빠질수록 GA형이 증가하였다(p=0.04). 그러나 병기와 TNF-α promoter -308부위의 유전자형 사이에는 유의한 상관 관계가 없었다(p=0.123). 결론: 방광암 환자의 혈액에서 GA genotype이 관찰되는 경우, 분화도가 나쁠 가능성이 매우 높기 때문에 좀 더 적극적인 치료와 세밀한 추적관찰을 함으로써 방광암으로 인한 사망과 암의 진행을 예방할 수 있을 것으로 기대한다. Purpose : Tumor necrosis factor-alpha (TNF-α) is involved in tumorigenesis of several cancers as an endogenous tumor promoter. The purpose of this study was to investigate whether genetic polymorphism of TNF-α promoter region (-308) was associated with human bladder tumor. Materials and Methods: The DNA from 113 and 109 respective blood samples of bladder tumor Patients and control group was analyzed by PCR-based restriction fragment length polymorphism (RFLP) and direct DNA sequencing methods to characterize the genetic polymorphism of -308 promoter region of the TNF-α gene in bladder tumor patients. We compared the association of bladder tumor with genetic Polymorphism of TNF-α promoter region(-308) in relation to the stage, grade, recurrence and progressio. Results : Eighty-six percents(97/113) of bladder tumor patients and 83.5% (90/109) of control group showed genotype GG at -308 region of TNF-α. Difference in genetic variations of TNF-α promoter (-308) did not exist between bladder tumor patients and control group(p=0.259). Tumor grade was significantly related to the GA genotype (p=0.04). The higher is the grade in bladder tumor, the more frequent was the GA genotype. Tumor stage, recurrence and progression were not significantly associated with genetic polymorphism of TNF-α promoter region (-308). Conclusion: The GA genotype of TNF-a promoter region (-308) had a significant impact on TNF-α production and was related to higher grade tumor compared to GG genotype. TNF-α serum levels in bladder tumor patients were significantly higher than controls. These data suggested that TNF-α might involve the tumorigenesis of the bladder rather than treatment or prevention of bladder tumor.

초음파 전파 및 산란 문제의 유한요소 해석

정현조,박문철,박윤원 한국비파괴검사학회 2002 한국비파괴검사학회지 Vol.22 No.4

초음파의 전파와 결합에 의한 산란장의 정확한 해석은 초음파 비파괴평가에서 중요한 역할을 한다. 수치해석법은 매개변수에 대한 연구를 간단하고 값싸게 할 수 있으므로 결함 탐지 확률을 높이고 결과적으로 검사의 신뢰도를 개선시키는데 도움이 된다. 본 연구에서는 초음파 전파와 산란장의 계산을 위하여 유한요소법(finite element method)을 사용하였으며, 대표적인 몇 가지 문제에 대하여 시뮬레이션을 실시하여 해석의 타당성을 검증하였다. 상용 FEM 프로그램을 이용하여 안정적인 수치해를 얻기 위한 유한요소 격자 크기와 시간 근사 스텝을 먼저 결정하였다. 2-D등방성 및 이방성 재료에서의 전파와 산란 문제를 다루었으며, 이론적 정해 또는 실험 결과가 알려진 문제를 선정하여 FEM 해석 결과와 비교, 분석하였다. The accuate analysis of ultrasonic wave propagation and scatttering plays an important role in many aspects of nondestructive evaluation. A numeracal analysis makes it possible to perform parametic studies, and in this way the probability of detection and reliability of test results can be improved. In this study, a finite element method was developed for the analysis fo ultrasonic fields, and the accuracy of results was checked by solving several representative preblems. The size of element and the integral time step, which are the critical components for the convergence of numerical results, were determineed in a commercial finite element code. Several propagation and scattering problems in 2-D isotropic and anisotropic materials were solved and their results were compared with known analytical or experimental results.

정신분열증 환자와 우울증 환자의 MMPI-2 프로파일

고윤화,손용훈,윤정흠,오상우,이귀행,박민철 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

Background: Minnesota multiphasic personality inventory-2(MMPI-2) is superior to its predecessor in differential diagnosis. this study was to investigate MMPI-2 profiles of the patients with schizophrenia and depression and to discriminate among two groups. Methods: The sample consisted of 35 patients with schizophrenia(male 24, female 11), 35 patients with depression(male 18, female 17) diagnosed by the diagnostic and statistical manual of mental disorders(DSM-IV) for schizophrenia & depression at department of neuropsychiatry in WonKwang University from January 2005 to December 2007. The data from the results were analyzed statistically by t-test and discriminant analysis. Results: The results were as follows. First, according to t-test results the comparison of schizophrenia patients and depression patients in MMPI-2 among two groups showed significant differences; the validity scales: F, F(P); The clinical scales: D, Pa; The restructured clinical scales: Rcd(dem), RC4, RC6, RC8; The content scales: ANX, DEP, BIZ; The supplementary scales: AGGR, PSYC, Mt, GF, O-H. Second, as a results discriminant analysis, BIZ, D were significant predictors in distinguishing patients with schizophrenia from patients with depression. Third, probability to be discriminated schizophrenia in schizophrenia was 91.4%, probability to be discriminated depression in depression was 85.7%. Conclusion: Finally, we remind readers that although the MMPI-2 may prove to be useful in the task of differential diagnosis, it should be used only in combination with other patient information. 배경: MMPI-2는 감별진단에서 기존의 MMPI 보다 더 우수하다. 본 연구는 정신분열증 환자와 우울증 환자의 MMPI-2 프로파일과 두 집단을 판별하는 연구를 하였다. 방법: 2005년 1월부터 2007년 12월까지 원광대학교 병원 신경정신과에서 정신분열증과 우울증으로 진단된 정신분열증 환자 35명(남성 24명, 여성 11명), 우울증 환자 35명(남성 18명, 여성 17명)이 본 연구에 참여하였다. 자료는 t-검증과 판별분석으로 분석하였다. 결과: 결과는 다음과 같다. 1. t-검증 결과, 두 집단간 유의미한 차이를 보인 척도들로는 타당도 척도에서 F, F(P) 척도, 임상척도에서 D, Pa, 척도, 재구성 임상척도에서 Rcd(dem), RC4, RC6, RC8척도 였다. 내용척도에서는 ANX, DEP, BIZ척도 였으며 보충척도에서는 AGGR, PSYC, MT, GF O-H척도 였다. 2. 판별 분석 결과로서, 정신분열증과 우울증을 구별하는데 가장 유의한 예언요소는 BIZ, D척도로 나타났다. 3. 판별함수를 통한 진단율은 정신분열증을 정신분열증으로 판별해주는 정확도는 91.4%였고, 우울증을 우울증으로 판별해주는 정확도는 85.7%였다. 결론: 본 연구 결과를 통해서 MMPI-2가 두 집단을 감별하는데 유용하다고 증명되었을지 모르지만 더욱 정확하게 감별하기 위해서 환자의 기타 정보를 사용해야 할 것이다.

회맹장 및 대장을 침범한 장 결핵에 있어서 바륨을 이용한 방사선 이중조영촬영 소견에 대한 연구

진용현,전혜정,이용근,강철호,조성범,김윤환,박철민,차상훈,김일영,이혜경 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

To determine the characteristic double contrast barium enema findings of ileo-cecal and colonic tuberculosis and to make differential diagnosis from other bowel inflammatory disease. Sixty-seven patients confirmed as ileo-cecal and/or colonic-tuberculosis in six hospitals were evaluated retrospectively. The diagnosis was proven by endoscopic biopsy, surgery, and clinical follow up. Nine of 67 patients were excluded because radiologic findings were normal though endocopic biopsy examinations resulted in tuberculosis. Histopathological diagnosis were madein 58 cases as follows: endoscopic biopsy(n=29), operation(n=12), follow up examination(n=14), tissue culture(n=1), laparoscopic biopsy(n=2). There were 30 men and 28 females. The mean age were 36 yrs(range:16-67), 34 patients were in the second and third decade. The distribution of lesions, morphological characteristics, mucosal changes, ulcer shape and depth, associated with other tuberculous lesion, multiplicity were retrospectively analyzed in the findngs of double contrast barim enema. The commonest clinical symptoms were abdominal pain(n=35, 60%) and diarrhea(n=18, 31%). The chest radiography revealed association of pulmonary tuberculosis in 39 cases. Tuberculous lesions of other organs except chest were present in five cases. Double contrast barium enema findings showed a thickening and irregularity of intestinal mucosal fold(n=29, 50%), bowel contraction and/or shortening(n=26, 45%). There were small, nodular, superficial ulcers in the case of ulcer depth less than 2 mm in the depth. As many as 39 cases(67%) in this series had two or more lesions in the intestinal tuberculosis. The involved segment revealed symmetrical feature(n=21, 36%). Inflammatory pseudopolypoid lesions were noted in 30 cases(52%). The ileo-cecal region was involved in 38 cases(66%). The ascending colon(n=25, 43%) was the second commonest site with or without contiguous cecal involvement. Lesions in terminal ileum, ileo-cecal valve, transverse colon, descending colon and appendix were seen in 19, 18, 18, 12 and seven cases, respectively. Among 18 cases of ileo-cecal valve lesions, there were incompetency in nine cases(16%) and wide gapping in four cases(7%). In 14 cases, tuberculous enterocolitis was diagnosed by clinical follow-up and double contrast barium enema study. 12 out of 14 cases, the findings of double contrast barium enema of tuberculous enterocolitis were normalized after anti-tuberculous medication. However, two cases showed more aggravated state than before due to inappropriate treatment. Double contrast barium enema plays an important role in the diagnosis of tuberculous enterocolitis, determines the type, site and extent of the involvement and helps in treatment guide by using sequential studies.

요석 환자에서 대사 이상의 평가

이석영,서정원,윤석중,이상철,김용태,김원재 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

연구목적: 요석은 대사적 질환의 일종이라 할 수 있으며 이는 소변의 유체 역학의 장애나 혹은 배설되는 대사 산물의 생화학적 불균형으로 초래하게 된다. 따라서 본 연구에서는 24시간 요검사를 통하여 요석 환자들에서 요중 대사적 이상에 대해 알아보고자 하였다. 대상 및 방법: 연속적으로 내원한 재발성 요석 환자 151명(남자 114명, 여자 37명)을 대상으로 하였으며, 요석이 완전 치유된 후 최소 3개월이 지나고 24시간 소변을 채취하여 요량, 나트륨, 인, 요산, 칼슘, 마그네슘, 수산 및 구연산에 대하여 분석하였으며 대사 이상의 종류 및 빈도를 조사하였다. 결과: 요석 환자들에서 가장 호발하는 대사적 이상은 저구연산뇨증(47.1%)이었으며 다음으로 고나트륨뇨증(43.2%), 저소변량(30.5%), 고칼슘뇨증(23.5%), 고요산뇨증(22.1%), 고수산뇨증(10.7%), 그리고 저마그네슘뇨증(9.4%) 순이었다. 151명의 환자 중 적어도 한가지 이상의 대사 이상이 136명에서 관찰되었다. 결론: 요석 환자들에서 요중 대사 이상은 90.1%에서 관찰되었으며 저구연산뇨증과 고나트륨뇨증이 요석의 생성과 재발에 중요한 역할을 하는 것으로 조사되었다. 이러한 요중대사적 평가는 요석 환자의 진단 및 예방에 유용하게 이용될 수 있을 것으로 사료된다. Purpose: Urolithiasis is a metabolic disease which arises from disturbances of the physico-chemical balance or the hydrodynamic system of the urine. This study was to determine the metabolic abnormalities through the 24-hour urine examination in patients with urolithiasis. Materials and Methods: The 24-hour urine specimens of 151 RSF (114 men, 37 women) were analyzed for volume, sodium, phosphorus, uric acid, calcium, magnesium, oxalate, and citrate. The incidence and frequency of metabolic abnomalities in RSF were determined. Results : The most frequent metabolic abnormality in RSF was hypocitraturia (47.1% ), followed by hypernatriuria (43.2%), low urine volume (30.5% ), hypercalciuria (23.5%), hperuricosuria (22.1%), hyperoxaluria (10.7%), and hypomagnesiuria (9.4%). At least one metabolic abnormality was found in 136 out of 151 RSF. Conclusion : Our results showed that RSF had metabolic abnormalities were found up to 90.1% of them. Hypocitraturla and hypernatriuria could play an important role in the development and recurrence of urolithiasis. This data suggested that metabolic evaluation might be the useful tools for urolithiasis detection and prevention.

난포기 및 황체기에 있어서 돼지 난관 협부 평활근의 neurotransmitter들의 수축효과에 대한 estradiol-17β및 progesterone의 영향

이민기,노규진,심철수,남윤정,김주현,최상용 慶尙大學校 1991 論文集 Vol.30 No.2

The effects of estradiol-17β or progesterone on the contractility of neurotransmitters on pig oviductal isthmic smooth muscle were investigated. The motility of the isolated smooth muscle was recorded by using physiological recording system. The results were summarized as follows : 1. The contractility induced by histamine or prostaglandin F2α was depressed by the pretreatment of estradiol-17β but was not by the preteatment of progesterone in follicular or luteal stage. 2. The contractility induced by acetylcholine was depressed un follicular stage but excited in luteal stage by the pretreatment of estradiol-17β or progesterone. 3. The contractility induced by norepinephrine was depressed by the pretreatment of progesterone in follicular stage but was excited by the pretreatment estradiol-17β in luteal stage.

구강악안면 외상환자의 조직손상의 양상 및 정도에 관한 임상적 연구

신효근,소병수,안태섭,진우성,윤철희 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.3

This is a clinical and retropective study on th patients with oral and maxillofacial trauma. This study was based on a series of 917 patients were treated as in-patients, at Chon-buk National University Hospital, during the period of Jan., 1989 through Dec., 1993. The results obtained were as follows : 1. The ratio of men to women were 3.59 : 1 in oral and maxillofacial injuries, 3.92 : 1 in facial bone fractures, and 3.18 : 1 in soft tissue injuries. 2. The oral and maxillofacial injuries occurred most frequently in the third decade(32.2%), and fourth, second, fifth decade in orders. 3. The major etiologic factors were traffic accident(57.4%) and fall-down(17.1%), interpersonal accident(16.6%), and industrial accident were next in order of frequency. 4. The incidence of facial bone fracture was 72.1%, soft tissue injury 58.8%, and dental injury 40.5%. 5. The most common site of fracture were mandible(62.9%) and maxilla(19.9%), zygoma and zygomatic arch(18.7%), and nasal bone(4.7%) were next in order of frequency. 6. The most common type of soft tissue injury was laceration(51.0%). The lesion of soft tissue injuries were mostly 1 or 2 lesions and deep.

진성 복압성 요실금 환자에서 복강경하 방광경부현수술의 유용성: 타술식과의 비교 연구

김용태,엄민식,이석영,신관희,서정원,윤석중,이상철,김원재 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

연구목적: 진성 복압성 요실금의 치료법으로서 복강경을 이용한 Burch 수술을 타수술법과 비교하여 그 유용성을 알아보고자 하였다. 대상 및 방법: 진성 복압성 요실금을 주소로 본원 비뇨기과에서 수술을 시행받은 44명의 환자를 수술법별로 분류하여 수술법에 따른 성공률, 수술 시간, 입원 기간 및 합병증의 빈도를 비교 분석 하였다. 결과: 전체 환자에서 수술 성공률은 86.4% 였으며 이들 중 복강경을 이용한 Burch 수술군에서는 성공률이 100% 이었다. 복강경을 이용한 Burch 수술군은 타수술군에 비하여 입원 기간이 짧았다. 복강경을 이용한 Burch 수술군은 합병증이 매우 경미하였으며 전체 환자의 31.8%에서 단기간의 배뇨곤란을 호소하였으나 장기간의 배뇨곤란은 없었으며 슬링 수술군에서는 3례(16.7%)에서 심한 절박성 요실금을 호소하였다. 결론: 복강경을 이용한 Burch 수술은 높은 치료 성공률과 낮은 합병증의 빈도를 나타내어 진성 복압성 요실금의 치료에서 매우 우수한 수술법으로 사료된다. Purpose: We performed this study to investigate the usefulness of laparoscopic Burch colposuspension as a treatment of genuine stress incontinence compare to other anti-incontinence operation. Materials and Methods : We analyzed success rate, operation time, admission day, and complication rate of various anti-incontinence operations in 44 genuine stress incontinence patients who have been received operation in our hospital. Results : Overall success rate was 86.4%, but laparoscopic Burch coposuspension showed 100% success rate. Laparoscopic Burch colposuspension required shorter admission day compared to other anti-incontinence oparations. Complication rate was lower in laparoscopic Burch colposuspension group. Short-term voiding problems were identified in 31.8% of total patients but 3 patients(16.7%) who have received sling operation complained severe urge incontinence. Conclusion : Laparoscopic Burch colposuspension is considered as an effective surgical method for genuine stress incontinence due to high success rate and low complication rate.

OB-13 : Congenital varicella syndrome (CVS) ; Systematic review

( Yun Jeong Park ),( Ki Jin Ryu ),( Ji Sung Lee ),( Min Jung Kang ),( Geum Joon Cho ),( Min Jeong Oh ),( Hai Joong Kim ),( Soon Cheol Hong ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

The object of this systematic review for congenital varicella syndrome (CVS) is to review the vertical infection rate according to the each trimester, infection type (chickenpox or H. zoster) and management. Literatures from MEDLINE and EMBASE published from 1947 to 2013 are reviewed for searching data of congenital varicella syndrome (fetal varicella syndrome) or fetal malformation in pregnancy by VZV infection; chickenpox, or herpes zoster. As congenital varicella syndrome is rare, case reports are also included in addition to large scale studies like prospective cohort studies. In 1947, the first case of CVS was reported. Over 130 cases are reported up to date. From thirteen cohort studies, the incidence of CVS in cases infected with VZV in pregnancy was estimated to be 0.59% (16/2705). From ten cohort studies, the incidence of CVS in cases infected with VZV in first 20 weeks of pregnancy was estimated to be 0.84% (14/1675). Nine case reports of CVS by VZV infection in 21~28 weeks of pregnancy are published. One case report of CVS by VZV infection in 36 weeks of pregnancy is reported. Two cases of CVS seem to be caused by herpes zoster, whereas most cases are due to primary infection from chickenpox. Vaccination, VZIG, and antiviral drugs such as acyclovir are used for management VZV infection. Vaccination has been used for primary prevention, and contraindicated during pregnancy or three months within pregnancy. VZIG with or without acyclovir could be used for post-exposure prophylaxis within 96 hours. Congenital varicella syndrome can be caused by any trimester infection and by both chickenpox and herpes zoster. VIZG within 96 hours should be considered for the management of pregnant women who exposed to or infected with chickenpox or herpes zoster.