응급의학과 전공의 교육을 위한 제언

백광제,박승희,선경,장연희,엄병선,홍윤식 대한응급의학회 1993 대한응급의학회지 Vol.4 No.2

Although the medical science in Korea has experienced remarkable development, both qualitatively and quantitatively, since its introduction at the beginning of the 20th century, its main focus has been on the expansion of spcialized treatment and medical care in general. However, the fast-paced economic development that started in the 1960's has caused substantial increases in cerbrovascular disease and coronary artery disease while the industrial development and in creased use of means of transportation have resulted in the rapid rise of incidents in external injuries. Consequently, the public has become acutelyh aware of the need for fast and effective emergency transportation and treatemnt. Such awareness also stems from the wide avalilability of medica care which is now established as a basic citizen's right as a result of the national medical insturance system that started in 1977 and was fully implemented in 1989. In response to the public demand for effetive emergency treatments, kthe health care sector has been making serious efforts to deliver better emergency treatments by expanding the emergency facilities and newly offering emergency training programs. Several hospitals have already commenced training programs in order to provide personnel specially trained in that area. The emergency medicine requires not only specialized training in the emergency treatment program in emergency should be designed in order to adapt to the specific needs of the Koreans, as based on epidemiological studies of the nature of emergency cases, its distribution in the population by ages and nature of injury, admission ratio, death rates, etc. currently prevailing in Korea. The present research has been carried out by the Korea university Hospital in preparation of the commencement of the emergency training program in 1994. The research consists of analysis of the emergency cases admitted in the Emergency center of Korea University Hospiatl from January 1992 to December 1992, its distribution, nature, and statistics regarding admission. Based on our research and our review of other available literature on the subject, we make the following suggestions regarding the specialized training program for emergency treatment. 1. The trainees must be required to be also t4rained in the areas of internal medicine surgery, obstetrics and pediatrics. 2. The training in internal medicine should include gastrointestinal, espiratory, cardiovascular medicine and nephrology which the training in surgery should include general surgery, neurosurgery and cardiac surgery. 3. The program should provide training for effective and accurate reading of the radiology. 4. The trainees should be required to participate in actural emergency treatment activities in order to have opportunities to acquire practical skills as well as theoretical knowledge. 5. The program should include course in medical management which would be necessary for effective management and administration of emergency centers and facilities. 6. The continued development of the program would require extensive studies and researches supported by the academic associations of medicine.

미용사의 요통 경험에 영향을 미치는 요인

백승룡,남철현,배성욱,김성우,권현숙,이정옥,전연숙 慶山大學校 保健福祉硏究所 2002 保健福祉硏究 Vol.7 No.-

The purpose of this study is to analyze and grasp the actual lumbaginous condition and relevant factors of 1,182 beauty artists of beauty shops in 5 metropolitan cities, small-to-medium cities, and fishing or agrarian villages for 3 months from June 20 to September 25, 2000 through questionnaires. 1) They showed 61.0 percents in her twenties, 66.4 percents of unmarried women from all the female objects, 70 percents in high school graduates as educational background, 52.4 percents in metropolitan city as service place, 25.4 percents in smoking rate, 71.6 percents in drinking rate, 48.1 percents in general bed as condition of bedroom, 17.9 percents in exercising rate, 53.6 percents in 'little eating', 39.6 percents in two or three centimeters of heel, and 89.5 percents in hair as beauty-related professional field. 2) The rate of lumgaginous experience of beauty artists was 83.5 percents. They showed higher rate of 91 percents in the thirties and forties, 92 percents of the married, 93.9 percents in junior college graduates, 97.2 percents in higher economic classes, 88.7 percents in smokers, 85 percents in general bed, 89.3 percents in sleeping on one's face, 85 percents in swimming, 92 percents in stretch, 86.7 percents in 56 to 60 kilograms of weight, 89.7 percents in group O blood, 90.5 percents in experienced women of abortion, 97 percents in heel over 8 centimeters, 58.3 percents in 'feel much fatigue', 93.6 percents in inconvenient chair of beauty shop, and 89.4 percents in a lack of recess than other group. 3) The more women who have been experienced in lumbago, the higher their social treatment(p<0.01), income(p<0.001), working time(p<0.05), job potentiality(p<0.05), inner affinity(p<0.05), and job satisfaction of environment(p<0.001) were. Women who suffered much stress related to job environment(p<0.001), client(p<0.01), and their duty(p<0.01) showed high rate of lumbaginous experience. 4) In degree of lumbago by characteristic, there was the significant difference in age over 50-years-old, unmarried women, college graduates, service of small-medium cities, higher economic classes, smokers or drinkers, hot-floored room, sleeping with ransack, stretch or swimming, group A blood, fat body, experience of abortion, 6 to 7 centimeters of heel, convenient chair of beauty shop, insufficient recess, lumbago continued for one to the three months in comparison of other group. 5) There were variables of posture such as to place materials under one foot(p<0.001), to lay arm on armrest and desk(p<0.001), to pull materials near body while lifting them (p<0.05), to sometimes use anodyne(p<0.01), not to lift also light materials(p<0.001), to be inconvenient in sleeping(p<0.001), to be absent at job for two or three days(p<0.01). The degree of depression(p<0.001), had the significant effect on the degree of lumbago(32.7%). The results are as follows : Beauty artists have faced upon dangerous job environment to cause lumbago. The more the industrial society will be developed, the more their burden of service will be increased. In addition, the occupational stress and posture of beauty artists who showed high job satisfaction and high economical level became major factors which have had an effect on their lumbago. In conclusion, it is desirable for beauty-related organizations and professionals to positively develop program of health education with much concern as well as to lessen stress of beauty artists through education of job posture and rightful life in order to prevent lumbago of those beaut.

치수/치근단 질환에 이환된 영구치의 치수 조직 재생과 치근 형성

유연지,백승호,손호현 大韓齒科保存學會 2010 Restorative Dentistry & Endodontics Vol.35 No.4

최근 치수 질환 또는 치근단 질환을 가진 미성숙 영구치에 대한 보존적 치료의 방법으로 여러가지 근관 내 소독 약제를 이용하에 증상 개선은 물론 치근의 성장 및 치수의 재생이 이루어진 증례들이 보고되고 있다. 그 기전에 대해서는 아직 명확하게 밝혀지지는 않았지만 여러가지 줄기 세포 또는 미분화 간엽 세포들이 관여하는 것으로 생각되며, 실제로 재생된 조직에서는 대부분백악질양또는골양물질의 침착이 관찰되고 있다. 이 새롭고보존적인 치료접근 방법은 다능성 줄기 세포와 다양한조직 공학 기술에 대한 연구와 더불어, 재생적 근관 치료에 더 밝은 비전을 제시하고 있다. Numerous cases about additional growth of roots or pulp tissue regeneration by using various intracanal medicaments in immature permanent teeth with periapical or pulpal disease have been reported. The underlying mechanism has not been clearly delineated. but it has been widely accepted that undifferentiated mesenchymal cells and stem cells are involved. Moreover, the growth and deposition of osteoid or cementoid tissues have been observed in regenerated pulp and roots. This new and non-invasive treatment has brightened the future of endodontics. and enlarged the vision of regenerative root canal treatment with multi-potent stem cells and various tissue engineering techniques.

Rat의 복강에 삽입한 Fluorouracil-Polyglycolic acid 제형의 Fluorouracil 용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitoneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adcnocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

Rat의 복강에 삽입한 Filorouracil-Polyglycolic acid제형의 Fluorouracil용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitioneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adenocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구

노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.

위암 환자에서 위절제술후 나타나는 담도확장의 임상적 의의: 추적 CT 소견을 중심으로

윤구섭,백승연,이문규,김영환,오용호 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.1

A retrospective review of consecutive 35 patients'pre and post operative abdominal computed tomography was performed to determine frequency and degree of bile duct dilatation following Billroth Ⅱ operation for stomach cancer and it's clinical significance. Degree of intrahepatic biliary dilatation was classified as mild, moderate, marked according to the extension into central, middle and peripheral zone of liver, respectively. Three specialists on the abdominal image participated in analysis of those findings without prior information of the patients. Intrahepatic biliary dilatation was seen in 22 patients(63%) analysed by at least one radiologist, in 13 patients(37%) by at least two radiologists. Bile duct dilatation on CT was common finding and not necessarily meant tumor recurrence. Vagotomy and afferent loop resulted form Billroth Ⅱ were one of possible causes of bile duct dilatation. This study showed in the cases of bile duct dilatation without clinical and other radiological evidence of recurrence, no further study are needed and only enough to follow up study.

직장암 환자의 술 전 병기 결정에 있어서 전산화 단층 촬영의 의의

신용덕,백승언,신연명,오경승 대한대장항문학회 1995 Annals of Coloproctolgy Vol.11 No.3

뼈에 발생한 악성 림프종 환자의 치료 효과 판정에서 ^(18)F-FDG Positron Emission Tomography의 유용성

김남돈,박연희,기승석,박용진,김형준,류백렬,김흥태,김성은,천기정,최창운,임상무 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.5

원발성골림프종은 매우 드문 질환이기는 하나, 복합항암요법이나 방사선 치료등에 높은 반응율을 보이며, 좋은 예후를 가지는 림프절의 비호지킨 림프종의 일종이다. 그러나, 치료 효과 판정에 있어 골병변의 특이성에 의한 모호한 방사선학적 특징으로 어려움이 있어 왔다. 본 증례는 위와 같은 원발성골림프종 환자에서 PET 스캔을 사용하여 민감하게 완전 반응을 평가할 수 있었던 예로, 앞으로 다른 고식적인 방법과 함께 이 질환의 진단과 치료 평가 있어 유용하게 사용 될 수 있을 것으로 전망할 수 있었다. Purpose: Accurate assessment of the lesion after treatment of patients with bone lymphoma is difficult. In this patient who demonstrated complete remission after chemotherapy, the regions of fluorine-18 fluorodeoxyglucose (^(18)FFDG)PET uptake diminished more rapidly following therapy, indicating a complete response at much earlier stage than did Magnetic Resonance Imaging (MRI) or CT based findings. With the conventional methods, such as MRI and CT. It was difficult to assess whether the residual tumor tissue was viable or not. Decision to complete response is very important in patients with ymphoma to plan the further treatment. We experienced a patient with primary lymphoma of bone who revealed complete response to chemotherapy on ^(18)FFDGPET while CT showed persistent destructive bone lesion. Thus, ^(18)FFDGPET study after therapy may be superior to CT in the evaluation of response to treatment in primary lymphoma of bone.

하악 대구치에서 근관세척방법에 따른 잔사제거효과에 대한 평가

이소영,손원준,이우철,금기연,배광식,백승호 대한치과보존학회 2009 Restorative Dentistry & Endodontics Vol.34 No.3

본 연구의 목적은 isthmus가 존재하는 하악 대구치의 근심 근관에서 근관세척방법에 따른 잔사제거효과를 평가하는 것이다. 45개의 하악 대구치의 근심근관을 #30 Profile .06까지 확대하였다. 각 근관을 3개의 군으로 나누고 conventional irrigation syringe와 초음파, RinsEndo를 사용하여 1분간 최종 세척하였다. 조직표본을 제작한 후, 광학현미경으로 치근단 1, 3, 5 mm 부위의 단면을 관찰하였다. 근관과 isthmus의 잔사 양으로 청결도를 계산하고 Mann-Whitney U test로 검정하였다. 1. 초음파 군과 syringe 군은 5 mm 부위의 isthmus를 제외한 나머지 부위에서 청결도의 유의한 차이가 없었다. 2. RinsEndo군은 syringe 군에 비해 1 mm, 3 mm 부위의 근관과, 모든 부위의 isthmus에서 유의하게 높은 청결도를 나타내었다(p<0.05). 3. 초음파 군과 RinsEndo 군은 3 mm 부위의 근관을 제외한 나머지 부위에서 청결도의 유의한 차이가 없었다. 임상적으로 RinsEndo를 이용한 근관세척방법의 부가적인 적용이 하악 대구치의 근심근관의 잔사제거에 효과가 있을 것으로 사료된다. The aim of this in vitro study was to evaluate the cleaning efficacy of various irrigation methods in the mandibular mesial roots. The forty five mesial root canals were shaped by Profile .06 instruments to apical size #30 and irrigated with 5 ml of 3.5% NaOCl. The teeth were divided into 3 groups and irrigated finally for 1 minute; Group 1: syringe irrigation, Group 2: ultrasonic irrigation, Group 3: RinsEndo irrigation. After histological processing, the cross sections of apical 1, 3, and 5 mm level were examined with an optical microscope. The cleanliness values of canals and isthmuses were calculated and analyzed by Mann-Whitney U test. 1. There were no significant differences in both canal and isthmus cleanliness between syringe irrigation and ultrasonic irrigation except 5 mm level of isthmus. 2. RinsEndo irrigation had significantly higher canal cleanliness values than syringe irrigation at 1 mm and 3 mm levels (p<0.05). Also, RinsEndo irrigation had significantly higher isthmus cleanliness VaIues than syringe irrigation at all levels evaluated (p<0.05). 3. There were no statistical differences in both canal and isthmus cleanliness between ultrasonic irrigation and RinsEndo irrigation except 3 mm level of canal. From this study, RinsEndo irrigation can be useful as an additional irrigation procedure.