• Journal of Radiation Protection and Research
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• 제20권3호
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• pp.181-186
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• 1995

자외선이 피부에 조사되면 다양한 피부반응을 초래한다. 이러한 반응은 크게 1) 급성 반응과 2) 만성반응으로 나눌 수 있다. 급성반응으로서는 피부가 붉어지는 홍반반응, 피부색이 검어지는 색소반응, 그리고 피부두께의 변화 등을 들 수 있다. 홍반반응은 피부의 주된 세포인 각질형 세포를 비롯하여 진피세포들이 광여하여 진피혈관을 확장시키는 반응을 말한다. 홍반반응은 자외선의 파장, 광량, 피부의 조건, 환경조건 등에 따라 달라지며 피부에는 각질형성세포가 변형된 일광화상세포가 출형한다. 홍반반응은 가장 흔한 주된 반응이나 그 기전에는 명확하지 않은 점이 아직도 많이 있다. 색소반응은 멜라닌세포가 관여하는 반응으로서 자외선 조사 후 즉시 피부가 검어지는 즉시세포침착과 수일 후 검어지는 지연색소침착으로 나눌 수 있다. 색소반응과 피부두께의 변화 등은 자외선 조사로부터 몸을 보호하기 위한 방어작용의 일종이다. 자외선 조사에 의한 만성반응으로는 광노화현상과 광 발암현상을 들 수 있다. 광노화란 장기간에 걸친 광노출로 인한 피부의 노화를 말하며 생리적인 노화와는 임상적, 조직학적으로 다른 점이 많다. 자외선의 장기노출은 피부암을 발생시키는 중요한 원인의 하나로서 우리나라도 피부암 발생이 점차 증가하고 있다. 서울대학교병원 피부과에서의 피부암 발생빈도는 70년대에는 외래환자의 0.2% 정도였으나 80년대에는 0.4-0.8%를 차지하고 있다. 앞으로 우리나라의 경제성장과 함께 수명의 증가, 레져나 스포츠의 증가, 피부노출의 증가와 함께 오존층 파괴로 인하여 피부에 조사되는 자외선의 절대량의 증가는 자외선에 의한 피부의 급 만성반응을 더욱 증가시킬 것으로 예상되며 이에 대한 적절한 대책이 요구된다.

• 한국사회복지학
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• 제68권2호
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• pp.131-160
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• 2016

본 연구는 2001~2015년까지 아동학대 사망사례 55건의 판결문(피고인 81명, 판결문 95건)에 제시된 가해자에 대한 양형 실태를 분석하였다. 주가해행위자에 대한 양형분석 결과, 집행유예 및 3년 미만의 비교적 경미한 처벌을 받은 경우가 약 40%였으며 선고형량이 법정형 하한 미만이거나 양형기준의 권고형량을 하한이탈한 판결의 비중이 높은 것으로 나타나 그동안 아동학대 사망사건 가해자에 대한 처벌수위가 매우 관대했던 것으로 분석되었다. 양형요소에 대한 분석 결과, '아동을 성실하게 양육해 온 점', '아동의 사망으로 인한 심적 고통, 죄책감', '훈육 목적 등 참작할만한 동기'와 같이 판사의 아동학대에 대한 인식이나 주관적 성향에 따라 달리 판단될 수 있는 양형요소가 형을 감경하는데 영향력이 큰 것으로 분석되었다. 방조자의 경우 피해아동의 사망을 방지할 수 있는 지위에 있었음에도 대부분 집행유예 또는 벌금형으로 매우 경미한 처벌을 받고 있음이 드러났다. 판결문에 대한 내용분석을 통해 초범, 우발적 범행, 친권자 및 양육자, 유족과의 합의, 훈육 등 그동안 아동학대 사망사건에서 관행적으로 언급되어 온 양형요소에 대한 재고찰이 필요함을 논의하고, 앞으로 판사들의 아동학대에 대한 교육 및 인식 개선, 아동학대 고유의 양형기준의 재정비가 필요함을 제언하였다.

• Journal of Preventive Medicine and Public Health
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• 제21권2호
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• pp.357-364
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• 1988

충청북도 단양지역 착암 근로자 79명과 착암기를 사용하지 않는 광산 근로자 39명을 대상으로 1987년 6월 10일부터 1987년 6월 19일까지 면접 조사 및 집단 검사를 시행하여 다음과 같은 결과를 얻었다. 1. 창백지(white finger)는 오른쪽 손에 더 많이 나타났다. 2. 창백지 발현에 진동 노출량, 연령, 음주 및 흡연 여부가 통계학적으로 유의한 변수로 선정되었다. 3. 진동 증후군 증상자의 수지부 통각역치가 대조군에 비해 증가되었다. 4. 냉수 침적후 진동 증후군의 피부온도가 대조군에 비해 낮았으며 회복은 대조군에 비해 지연되는 경향을 보였다.

• 대한치과마취과학회지
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• 제14권4호
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• pp.213-219
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• 2014

Background: Clinical use of propofol along with remifentanil for intravenous sedation is increasing in these days, but there are not enough researches to evaluate proper target concentration when these drugs are infused by using target controlled infusion (TCI) pump in dental treatment cases. In this study, we compared efficacy of TCI conscious sedation and target concentration of propofol when it used with or without remifentanil during conscious sedation with the help of a TCI for the surgical extraction of impacted teeth. Methods: After IRB approval, all the charts of patients who had undergone surgical extraction of impacted teeth under propofol TCI sedation for 6 months were selected and reviewed for this study. After reviewal of charts, we could divide patients in two groups. In one group (group 1), only propofol was selected for sedation and initial effect site concentration of propofol was $1{\mu}g/ml$ (n = 33), and in another group (group 2), both propofol and remifentanil was infused and initial effect site concentration of each drug was $0.6{\mu}g/ml$ and 1 ng/ml respectively (n = 25). For each group, average propofol target concentration was measured. In addition, we compared heart rate, respiratory rate, and systolic and diastolic blood pressure as well as oxygen saturation. Besides, BIS, sedation scores (OAAS/S), and subjective satisfaction scores were compared. Results: Between group 1 and 2, there were no significant differences in demographics (age, weight and height), and total sedation time. However, total infused dose and the effect site target concentration of propofol was $163.8{\pm}74.5mg$ and $1.13{\pm}0.21{\mu}g/ml$ in group 1, and $104.3{\pm}46.5mg$ and $0.72{\pm}0.26{\mu}g/ml$ in the group 2 with $1.02{\pm}0.21ng/l$ of the effect site target concentration of remifentanil, respectively. During sedation, there were no differences between overall vital sign, BIS and OAAS/S in 2 groups (P > 0.05). However, we figured out patients in group 2 had decreased pain sensation during sedation. Conclusions: Co-administration of propofol along with remifentanil via a TCI for the surgical extraction of impacted teeth may be safe and effective compared to propofol only administration.

• 한국콘텐츠학회논문지
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• 제11권10호
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• pp.370-379
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• 2011

산업장 근로자의 구강보건교육 프로그램개발과 향후 근로자의 구강건강을 증진 유지할 수 있는 구강 보건사업 및 제도 개선에 필요한 기초자료를 제공하고자 2009년 6월 1일부터 12월 31일까지 경북 구미시에 소재하는 49개 산업장에 근무하는 근로자 7,185명을 대상으로 치과의사 4인이 산업장을 직접 방문하여 인공조명하에서 치경과 핀셋, 탐침, 설압자를 이용하여 구강검사를 실시한 후 결손치 유무를 조사하였다. 또한 결손치에 영향을 미치는 문항은 구강검진문진표를 이용하여 조사하였고, 회수된 구강검사결과통보서 7,185개 중 응답내용이 부실한 209개를 제외한 6,976개의 자료를 SPSS 12.0으로 분석하였다. 연령층이 높은 경우, 치석제거를 받지 않은 경우, 치아우식증과 치주질환이 있는 경우, 과거에 흡연을 했거나 현재 흡연을 하고 있는 경우, 양치횟수가 적은 경우, 치아가 욱신한 경우, 잇몸에 통증 및 출혈과 혀 및 뺨이 욱신한 경우에 결손치율은 높았다. 근로자들의 구강건강을 증진 유지시켜 주기 위해서는 결손치의 원인인 치면세균막과 치석을 제거할 수 있는 스켈링의 유효성을 인지시켜, 스켈링의 경험률을 높여주고, 금연을 위한 보건교육프로그램을 개발해야 할 것이다. 또한 검진을 통한 충분한 상담과 교육을 통해 근로자들의 구강건강에 대한 의식을 고취시켜, 근로자의 구강건강을 유지하는데 실질적 도움이 되는 방향으로 개선 보완되어져야 할 것이다.

• 대한간호
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• 제29권3호
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• pp.25-35
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• 1990

It is a fact that there are recent increasing trends or incidence of the colorectal carcinoma among other colorectal diseases. In such trend, the early detection remain to be most important by the air contrast barium enema and total colonofiberscopy. There are several ways to prepare the colon for barium enema and colonofiberscopy which include several agents. The mechanical cleansing have been used most frequently since Brown's method was adapted to be most perfect for colon deansing. The ideal laxatives and enema solutions were limited to adequate dose, it's effectiveness, patient's diet and bowel habit, minimal side effect, low cost and simple to perform. In order to compare the effectiveness of various cleansing solutions, six experimental methods were formed as shown; 1. normal saline enema, 2. castor oil with normal saline enema, 3. castor oil with soap suds enema, 4. magnesium citrate with normal saline, 5. magnesium citrate with soap suds enema and 6. ingestion of Golyetly solution. The authors have compared and determined the degree of cleanness by an experienced endoscopist. The total number of patients was 247, age distribution was $43{\pm}15$ years old, and sex distribution was 133 males and 114 females. The grade I and II represented no difficulties at performing the colonofiberscopy, but grade ill and N had some difficulties, even unable to perform the colonofiberscopy. The effectiveness the cleansing agents, represented with grade I and II was 95.9% (47/49) in method 6, 93.2%(54/58) in method 2, 83.3%(30/33) in method 3, 70.0%(28/10) in method 5, 66.7%(16/24) in method i, and 45.7%(18/40) in method 4. Method 2 and 6 were the most effective in normal bowel habit patients. In constipated patients, method 6 was the most effective and all method except method 11 were effective in diarrhea patients. The degrees of less mucosal irritation by various bowel cleansing method were in the order of method 6(100%), 1(100%), 5(74%), 2(69%). In subjective symptoms and cleansing groups, abdominal distension, pain, nausea and vomiting were complained, and that's subject symptoms were in the order of method 3(88.9%), 6 (79.6%), 1(75%), 5(72.5%), 2(72.4%), 4(67.5%). In conclusion, we believe that the Golytely of the mechanical cleansing solution for colonofiberscopy was the most effective, but others depended on the patient's condition und bowel habit.

• Asian-Australasian Journal of Animal Sciences
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• 제15권6호
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• pp.905-911
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• 2002

A study was carried out to assess the therapeutic effect of ascorbic acid in mastitis of dairy cows. The herd with a population of 250-275 lactating cows was screened for clinical and subclinical mastitis for a period of 5 months. Based on inclusion and exclusion criteria, eighteen animals each with clinical and subclinical mastitis in one quarter only were selected as study population. Twelve cows (group A) with normal udder and health were also selected as a healthy control. Clinical mastitis cows were grouped as B (n=12) and C (n=6). Cows of group B were treated with ascorbic acid at 25 mg/kg, subcutaneously for 5 consecutive days and intramammary infusion (Ampicillin sodium 75 mg and Cloxacillin sodium 200 mg/infusion) based on antibiotic sensitivity test, till complete recovery. Group C cows received only intramammary infusion till the complete recovery. Eighteen subclinical mastitis cows were divided in group D (n=12) and E (n=6). Cows of group D were treated with ascorbic acid at 25 mg/kg subcutaneously for 5 consecutive days while group E did not receive any treatment. California mastitis test (CMT), somatic cell count (SCC), physical changes of udder and milk were used to diagnose and classify the mastitis. Evaluation of the therapy was based on CMT score and physical changes of udder and milk. Sample size calculation was also performed but was not followed for control groups due to scarcity of cases. Adequate blinding was done when and where required to avoid the biases. Confounding variables like herd, age of the cow, stage of the lactation, season and geographical region were duly considered and adequate blocking was followed. Ascorbic acid was administered in clinical and subclinical cases even after cure considering its immunostimulatory and healing inducing effects. The recovery rate was faster in cases of clinical mastitis treated with ascorbic acid along with an intramammary infusion (group B) than the quarters of group C cows. Quarter wise the average duration/number (3.16${\pm}$0.11 days) of antimicrobial intramammary infusion was significantly (p<0.01) less in group B than that of average duration/number (5.33${\pm}$0.20 days) of group C. Subclinical mastitis cows treated with ascorbic acid showed 83.33% recovery while 16.77% did not respond to treatment till last day of study. Cows of group E (untreated) did not recovered from the mastitis. Subjective parameters viz. swelling, pain reflex of udder and physical changes in milk from quarter of ascorbic acid treated cows (group B) disappeared earlier than that of group C cows. It is concluded from this study that the ascorbic acid might be useful as an adjunct in case of clinical mastitis to get quick recovery with less number of intramammary infusions. High recovery rate in subclinical mastitis quarters of group D cows is appreciable and opens a new avenue to conduct further trials in a larger population in various field conditions. However, the pharmacology of ascorbic acid with particular reference to health of mammary gland needs to be investigated.

• 대한족부족관절학회지
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• 제20권3호
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• pp.126-130
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• 2016

Purpose: The aim of this study was to evaluate the result of extraarticular dorsal closing wedge osteotomy in Freiberg's disease. Materials and Methods: Between February 2012 and July 2014, total 10 patients who underwent dorsal closing wedge osteotomy and followed up more than 1 year were selected for inclusion. Average age was 16.3 years, and average follow-up period was 15.5 months. The diagnosis was made using magnetic resonance imaging of those with a limitation in walking or usual activity due to pain in the metatarsal head. During operation, we removed loose body, and synovectomy was done. Osteotomy at the metatarsal neck and fixation with Kirschner wire were performed. X-ray was taken to check shortening of 2nd metatarsal and bone union. Moreover, we checked the active range of motion of 2nd metatarsophalangeal joint before and after surgery. At the last follow-up, the shortening of metatarsal, American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), and patient's subjective satisfaction were evaluated. Results: According to the Smillie's stage, there were 3 cases of stage II, 4 cases of stage III, and 3 cases of stage IV. Average bone union time on the osteotomy site was 8 weeks. Average shortening of metatarsal was 2.53 mm. Average AOFAS score improved significantly from 56.9 to 82.8 points at final follow-up (p<0.05), and average VAS score also improved significantly from 6.4 to 1.4 points at final follow-up (p<0.05). Average active range of motion at metatarsophalangeal joint improved from $28.0^{\circ}$ preoperatively to $46.5^{\circ}$ at the final follow-up. Other complications, such as metatarsalgia and arthritis, were not found; however, there was 1 case of delayed union with no symptom. Conclusion: In Freiberg's disease, dorsal closing wedge osteotomy is recommended for the improvement of clinical symptoms and range of motion.

• 대한족부족관절학회지
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• 제20권1호
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• pp.23-26
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• 2016

Purpose: Nerve conduction study (NCS) test is a standard diagnostic study of the tarsal tunnel syndrome. The purpose of this study was to determine the relation between the results of the NCS and postoperative clinical results. Materials and Methods: From June 2004 to July 2015, 104 patients were diagnosed with tarsal tunnel syndrome and treated surgically. Of 104 patients diagnosed through NCS preoperatively and postoperatively, 41 patients were included in this study. There were 23 male and 18 female patients with mean age of 49.2 years old and the average follow-up period was 15.5 months. NCS, pain visual analogue scale (VAS) score, and subjective satisfaction were examined preoperatively and postoperatively. Results: On the preoperative NCS, 32 patients (78.0%) were positive and 9 patients (22.0%) were negative, and 32 positive NCS patients consisted of 9 positive (28.1%), 16 improved (50.0%), and 7 negative (21.9%) postoperatively. VAS score was 7.4 preoperatively and 4.4 postoperatively. According to satisfaction, there were 8 excellent (19.5%), 21 good (51.2%), 6 fair (14.6%), and 6 poor (14.6%) patients. For 32 patients who were positive on the preoperative NCS, the postoperative VAS score was 4.87 and there were 7 excellent (21.9%), 16 good (50.0%), 4 fair (12.5%), and 5 poor (15.6%) patients. Sixteen patients were negative on the postoperative NCS, with a VAS score of 3.75, 1 excellent (6.3%), 11 good (68.8%), 2 fair (12.5%), and 2 poor (12.5%). There was no statistical correlation between the preoperative NCS and postoperative VAS score (p=0.10), between preoperative NCS and postoperative satisfaction (p=0.799), between preoperative NCS and postoperative VAS score (p=0.487), and between postoperative NCS and postoperative satisfaction (p=0.251). Conclusion: For patients diagnosed with tarsal tunnel syndrome and treated surgically, NCS showed little correlation with postoperative result.

• Journal of Preventive Medicine and Public Health
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• 제22권1호
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• pp.153-161
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• 1989

Authors studied on the prevalence of 94 cases of pneumoconiosis who were found out through the screening test on 1,062 workers engaged in welding process at 36 shipyard in Pusan area from March 1st, 1986 to November 30th, 1986. The result were as follows; 1. Dust concentration was measured $4.49{\pm}0.54mg/m^3$ in the small scale shipyard while it was $6.25{\pm}1.08mg/m^3$ in the large one. 2. The prevalence of welder's lung was 8.9% (male:8.5%, female:12.0%) and this is consist of 4.9% suspected pneumoconiosis and 4.0% pneumoconiosis more than category 1/0. 3. The prevalence was significantly increased according to the duration of dust exposure(p<0.05), and it showed the increasing tendency by the age group. 4. The prevalence was significantly higher in the large scale shipyard than is the small scale one(p<0.01). 5. The type and shape of opacities were 71.4% of p type and 28.6% of q type, however no pneumoconiosis with r type observed in this study. 6. The main subjective symptoms were the sputum(29.8%), coughing(25.5%), shortness of breath(20.2%), fatique(6.4%), and chest pain(5.3%). In other hand, 57.4% of pneumoconiosis were asymptomatic. 7. The prevalence of pulmonary tuberculosis was radiologically 1.7% in all subjects including 5.3% in pneumoconiosis and 1.3% in no pneumoconiosis(p<0.01).