• 환경영향평가
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• 제25권6호
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• pp.514-524
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• 2016

생명기후분석시스템(BioCAS)을 이용하여 서울시 전역의 폭염사례일 기온, 인지온도(PT), 초과사망률($r_{EM}$) 분포를 분석하였다. 분석 해상도는 25m 였으며, 사례일은 2012년 8월 5일이었다. 분석 결과는 관측된 사망률 및 내원환자수 자료와의 비교를 통해 평가되었다. 2004년에서 2013년의 폭염 원인인 사망률 자료와 2006년에서 2011년의 국민건강보험공단의 폭염 내원환자수 자료를 이용하여 행정구별 폭염 건강위험 자료를 추출하였다. 자료 비교를 위한 공간 해상도는 사망률 및 내원환자수 자료의 해상도인 행정구 단위였다. BioCAS에서 분석된 사례일 최고 인지온도 및 초과사망률 분포 자료는 행정구별 공간 평균, 최대, 최소 및 누적값으로 변환된 후 건강피해자료와 상관분석이 수행되었다. 분석 결과 일 최고 인지온도 및 초과사망률의 공간 평균값은 건강피해를 설명하지 못하는 것으로 나타났다. 대신 일 최고 인지온도의 공간 최솟값은 사망률과, 공간 최댓값은 내원환자수와 상관관계가 있는 것으로 나타났다(각각 r=0.53, r=0.42). 즉, 밀집된 건물에 의해 생겨나는 공간 최댓값은 낮 동안의 일사병 발생과 내원환자수 증가에 영향을 주었고, 식생에 의해 나타나는 공간 최솟값은 밤 동안의 열 스트레스를 감소시켜 사망률에 영향을 주었던 것으로 판단된다. 한편 분석된 초과사망률($r_{EM}$)은 공간 최댓값과 내원환자수가 상관관계가 있었지만(r=0.52) 사망률과의 상관관계는 인정되지 않았는데, 이것은 연령별 인구구성 차이에 따른 기저 폭염위험도 차이 등 행정구별 불균일성을 고려하지 못한 한계가 나타난 것으로 판단된다. 개별 건물과 식생의 열적 효과는 공간 평균보다 최대, 최소 등 그 분포가 중요한 것으로 나타났다. 이러한 고해상도 분석기술은 도시의 건강영향평가를 통해 도시개발에 관한 경제성 분석에 활용이 가능할 것으로 기대된다.

• Journal of Preventive Medicine and Public Health
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• 제52권1호
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• pp.1-13
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• 2019

Objectives: In recent years, serious concerns have been raised regarding the impacts of rising temperatures on health. The present study was conducted to investigate the relationship between elevated temperatures and kidney disease through a systematic review and meta-analysis. Methods: In October 2017, 2 researchers independently searched related studies in PubMed and Embase. A meta-analysis was conducted using a random-effects model, including only studies that presented odds ratios, relative risks, or percentage changes, along with 95% confidence intervals (CIs). The characteristics of each study were summarized, and the Egger test and funnel plots were used to evaluate publication bias. Results: Eleven studies that met the criteria were included in the final analysis. The pooled results suggest an increase of 30% (95% CI, 20 to 40) in kidney disease morbidity with high temperatures. In a disease-specific subgroup analysis, statistically significant results were observed for both renal colic or kidney stones and other renal diseases. In a study design-specific subgroup analysis, statistically significant results were observed in both time-series analyses and studies with other designs. In a temperature measure-specific subgroup analysis, significant results were likewise found for both studies using mean temperature measurements and studies measuring heat waves or heat stress. Conclusions: Our results indicate that morbidity due to kidney disease increases at high temperatures. We also found significant results in subgroup analyses. However, further time-series analyses are needed to obtain more generalizable evidence.

• 환경영향평가
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• 제33권1호
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• pp.9-17
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• 2024

본 연구의 목적은 온열질환자를 설명, 예측하기 위한 최적의 폭염 관련 지표를 선정하고 예측하여 실효성을 확인하는 것이다. 2021년부터 2023년까지의 온열질환 응급실감시체계 데이터와 기상청 AWS 데이터를 기반으로 일 평균 기온, 일 최고 기온, 일 평균 WBGT, 일 최고 WBGT 값을 계산하여 회귀분석을 진행하였다. 분석 결과 네 가지 지표 중 일 최고 WBGT가 R² 값 0.81, RMSE 0.98로 가장 적합한 지표로 나타났으며 그 임계값은 29.94도로 나타났다. 전체 분석 기간 중 해당 임계값을 초과하는 날은 총 91일이었으며 이 때 발생한 환자수는 339명으로 나타났다. 일 최고 WBGT의 회귀식을 통해 2021년부터 2023년까지의 온열질환자 수를 예측한 결과 매년 10명 미만의 오차를 보여 정확성이 상당히 높은 것을 확인할 수 있었다. 지속적인 연구를 통해 데이터 및 분석 방법을 고도화한다면, 폭염 피해를 예측 및 저감하는데 도움이 될 수 있을 것이다.

• 임상간호연구
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• 제21권2호
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• pp.215-222
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• 2015

Purpose: For hemodialysis, a vascular access which can maintain a certain speed for a long time is required. The prevention of the vascular access dysfunction is very important to decrease morbidity and to improvethe quality of life of patients receiving hemodialysis It is reported that far infrared heat increases the blood flow by expanding capillaries and micro-arteriovenouses. This study aimed to evaluate the effect of far infrared heat therapy as a new nursing intervention for maintaining vascular access function and improving the blood flow of patients receiving hemodialysis. Methods: The quasi-experimental research of nonequivalent control group pre-post test design was carried out for 59 patients receiving hemodialysis 3 times per week at K medical center. A far infrared heat was applied to the experimental group for 3 months. Results: The arteriovenous fistula blood flow of the experimental group (far infrared heat therapy group) increased significantly when compared to the control group (p=.047). However, static intra-access pressure ratio(SIAPR)was not different statistically (p=.101). Conclusion: The far infrared therapy could be considered as nursing intervention of choice as it demonstrated increase in the arteriovenous fistula blood flow in the patients receiving hemodialysis.

• 대한한의학회지
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• 제44권2호
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• pp.1-9
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• 2023

Objectives: To study symptom differentiation for yang deficiency and blood heat based on 117 psoriasis patients. Methods: Obtained frequency analysis (%), mean (%), and OR, CL(P-value) with prospective pre-post intervention design and multiple regression analysis. Results: There were no statistically significant differences as to sex, BMI, smoking and marital status, but there were statistically significant differences in variables of average age, family history, and alcohol consumption (P<0.05). There were no statistically significant differences in psoriasis symptoms as to initial age of onset, morbidity span, area of the initial onset, and the progression of psoriasis during the last three months of each patient. However, the type of psoriasis showed a statistically significant difference (p=0.011). While there were no statistically significant differences as to common cold, condition of psoriasis after recovering from the cold, skin condition, exercise, and seasonality, irregular perspiration showed significant difference (p<0.00). When confounding factors have been controlled the blood heat patient group as the comparison group, multiple regression analysis showed OR, CI(95%) of 1.06(0.31-3.63) for men, 0.28(0.08-1.06) for aged 30 to 49,0 and 0.18(0.04-0.80) for aged 50 and older. it was 0.06(0.01-0.7) for family history, 1.06(0.29-3.88) for drink alcohol, 19.90(2.53-156.7) for seasonality, and 10.28 (3.19-33.11) for perspiration problems. In these variables, Sex, age, smoking, and alcohol consumption showed no statistically significant results, but family history(p=0.049), seasonality(p=0.005), and irregular perspiration (p=0.017) were statistically significant. Conclusion: Family history, seasonality and irregular perspiration are the determining factors for yang deficiency and blood heat in psoriasis.

• 동의생리병리학회지
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• 제35권2호
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• pp.47-55
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• 2021

In order to ensure the fact that eight principle pattern differentiation is used clinically as a basic guideline for Korean medicine practice, the definition, role and method of yin-yang pattern differentiation with its case report were explored at first. Yinyang Pattern Differentiation is a method of discriminating human tendencies or morbidity based on the yin and yang characteristics expressed in living bodies. And yin and yang are the two contrasting characteristics and aspects of the interaction when certain physical conditions that have a lasting effect on the human physiological metabolic function are correlated with the morbidity. Specific methods of yinyang pattern differentiation can be divided into several types of yin and yang indicators. First, time and space factors like day and night, hot and cold seasons, above and below, topographical districts. Second, colors and pulse and their/or relative clearness and muddiness, hardness and softness, moving and resting. Third, diagnose yin and yang patterns through distinguishing the true and false of a fever and cold in an emergency phase such as increase of brain pressure and shock state. Fourth, general characteristics of the propensity and constitution of a subject such as body type, speech, behavior, and physiological metabolism. And for clinical use, these were summarized again as a symptom indicators of physical signs and color, pulse, tongue and questionnaire indicators of propensity, body type, and space-time characteristics. Conclusively, it was confirmed that yinyang pattern differentiation has its own diagnostic significance which is distinct from exterior-interior, cold-heat and deficiency-excess pattern differentiation.

• Safety and Health at Work
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• 제6권3호
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• pp.256-262
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• 2015

Background: Heart attack is the most common cause of line-of-duty death in the fire service. Daily aspirin therapy is a preventative measure used to reduce the morbidity of heart attacks but may decrease the ability to dissipate heat by reducing skin blood flow. Methods: In this double-blind, placebo-controlled, crossover study, firefighters were randomized to receive 14 days of therapy (81-mg aspirin or placebo) before performing treadmill exercise in thermal-protective clothing in a hot room [$38.8{\pm}2.1^{\circ}C$, $24.9{\pm}9.1%$ relative humidity (RH)]. Three weeks without therapy was provided before crossing to the other arm. Firefighters completed a baseline skin blood-flow assessment via laser Doppler flowmetry; skin was heated to $44^{\circ}C$ to achieve maximal cutaneous vasodilation. Skin blood flow was measured before and after exercise in a hot room, and at 0 minutes, 10 minutes, 20 minutes, and 30 minutes of recovery under temperature conditions ($25.3{\pm}1.2^{\circ}C$, $40.3{\pm}13.7%\;RH$). Platelet clotting time was assessed before drug administration, and before and after exercise. Results: Fifteen firefighters completed the study. Aspirin increased clotting time before and after exercise compared with placebo (p = 0.003). There were no differences in absolute skin blood flow between groups (p = 0.35). Following exercise, cutaneous vascular conductance (CVC) was $85{\pm}42%$ of maximum in the aspirin and $76{\pm}37%$ in the placebo groups. The percentage of maximal CVC did not differ by treatment before or after recovery. Neither maximal core body temperature nor heart rate responses to exercise differed between trials. Conclusion: There were no differences in skin blood flow during uncompensable heat stress following exercise after aspirin or placebo therapy.

• 한국기후변화학회지
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• 제1권2호
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• pp.109-120
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• 2010

극단적 폭염은 온대지역의 여름철 사망률과 유병률을 증가시키는 기상재해이다. 기후모델의 예측결과에 따르면 미래 폭염의 강도와 빈도는 더욱 증가할 것으로 보고되고 있다. 이 연구는 국내 7개 대도시의 폭염유발기단과 일 사망률의 증가와의 연관성을 제시하며, 이를 기반으로 운영 중인 고온건강경보시스템을 소개한다. 1982년에서 2007년까지 관측된 기후자료로부터 종관기단분류기법이 적용되어 각 도시의 여름철의 각 날에 대한 기단분류가 수행되었다. 폭염유발기단과 일 사망률 증가와의 연관성 연구 결과, 고온건조(DT) 기단과 고온다습+(MT+) 기단의 두 기단에서 가장 높은 사망률 증가 연관성이 관찰되었다. 따라서 DT와 MT+ 기단 내의 기상요소들을 이용하여 초과사망자수를 종속변수로 하는 중회귀 분석을 통한 초과사망자수 예측알고리즘이 제작되었다. 또한, 각 대도시들마다 다르게 나타나는 지역적인 기후순응 특성에 입각하여 각 도시별 예측알고리즘에서 사용되는 독립변수가 선정되고, 고온건강경보시스템의 고온건강주의보 및 경보 기준인 초과사망자수 기준이 설정되었다. 지구온난화 추세 하의 고온건강경보시스템은 대규모 건강이상을 야기할 수 있는 폭염에 대한 효과적인 정보를 대도시 시민들에게 제공할 것으로 기대된다.

• 사상체질의학회지
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• 제23권4호
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• pp.445-457
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• 2011

1. Purpose Lee Je-Ma had continued to revise "Donguisusebowon" by adding the contents of the Symptomatic-pharmacology(病證藥理論) on Soeumin, Soyangin and Taeeumin to it from the first establishment of the old version in 1894 to 1900.(new version). This paper tries to find out the contents and meaning of the Discourse on the Constitutional Symptoms and Diseases(病證論) between the old version and new version and what the Discourse on the Constitutional Symptoms and Diseases affected the Theory of Eight Constitution created in subsequent years. 2. Methods I classified the Discourse on the Constitutional Symptoms and Diseases in "DongYiSuseBowon" into old version and new version and tried to find out the Theory of Eight morbidities(8病證論) which is the predecessor of the Theory of Eight Constitution, before reviewing their relation. 3. Conclusions 1) The Discourse on the Constitutional Symptoms and Diseases in the old version specify that the externally sensed diseases are caused by the deep sediment of nature(性) and that the internally touched diseases are caused by the violent activities of emotion(情). In addition, it said that all diseases are caused by the specific characteristics of patient's smaller internal organs(偏小之臟). But in new version, the diseases were understood through the concept Exterior, Interior, Heat and cold(表裏寒熱). The new version said that the diseases may be caused not only the specific characteristics of patient's smaller organs but also by bigger organs(偏大之臟). 2) The Theory of Eight Constitution was derived from the Theory of Eight morbidities, in which all kinds of human diseases are caused by 8 disease-orgin organ and that the diseases therefore can be classified into 8 morbidities. The Theory of Eight morbidities reorganized the Discourse on the Constitutional Symptoms and Diseases in "DongYiSuseBowon" by classifying them into first morbidity and second morbidity. 3) The Discourse on the Constitutional Symptoms and Diseases in "DongYiSuseBowon" has decisively affected the creation of the Theory of Eight morbidities which is the predecessor of the Theory of Eight Constitution. The Theory of Eight morbidities may be deemed another interpretation of the Discourse on the Constitutional Symptoms and Diseases in "DongYiSuseBowon". As the Theory of Eight morbidities put emphasis on the genetic characteristics, the Theory of Eight Constitution stating that Eight morbidities are caused by different specific constitution was derived.

• 적정기술학회지
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• 제5권2호
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• pp.118-125
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• 2019

제 5차 IPCC보고서(2014)에 의하면, 지구온난화의 원인은 온실가스(GHG)에 기인하며 가장 중요한 화석연료의 연소에서 발생하는 CO₂, NO₂, 메탄 등이다. IPCC는 2099년까지 지구 온도가 3.7℃ 상승하고 해수면은 0.63 m 상승할 것으로 예측하였다. 기후변화는 SDGs의 매우 중요한 한 부분이며, 그중 지구온난화는 잠재적으로 인류 건강에 가장 큰 위협이며 여러 다양한 질병의 원인이다. 만약 현재의 가스 배출과 토지이용의 추세가 계속된다면 미래의 세대는 질병, 부상, 자연재난으로 인한 사망, 감염, 영양부족, 대기오염으로 인한 사망율 등 매우 심각한 상황에 직면하게 될 것이다. 이 글에서는 홍수, 가뭄, 열 스트레스. 대기오염, 물부족, 영양실조, 전염성질환, 매개질환 등 지구기후변화와 이와 관련된 자연재난과 인류 건강의 관계를 조명하여 보았다.