• Tuberculosis and Respiratory Diseases
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• 제42권2호
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• pp.149-155
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• 1995

연구목적: Cytokeratin 19는 기관지의 상피세포와 같은 단순 또는 가중층상피세포에 국한된 40KD의 산성 분자로 면역조직학적 검사를 통해 cytokeratin 19가 폐암 조직에서 많이 발현되는 것으로 알려져 있다. Cytokeratin 19에 특징적인 단일 클론 항체 BM 19-21과 KS 19-1을 이용한 면역방사계수법, CYFRA 21-1을 이용하여 cytokeratin 19분절이 폐암 특히 편평상피세포암의 진단에 유용한 표지자가 될 수 있다는 보고가 있어 폐암 표지자로서 CYFRA 21-1의 유용성을 조사해 보기 위하여 본 연구를 하였다. 방법: 저자 등은 영남대학교 의과대학 부속병원 내과에 1993년 4월부터 1994년 8월까지 입원한 원발성 폐암 환자 39명(편평상피 세포암 19명, 선암 11명, 소세포암 9명)을 폐암군으로, 비악성 호흡기질환자 15명(폐결핵 8명, 만성 폐색성 폐질환 3명, 폐렴 2명, 만성 폐색성 폐질환과 폐결핵이 동반된 환자 2명)을 대조군으로 하여 새로운 폐암 표지자의 가능성이 있는 CYFRA 21-1의 유용성을 조사하였다. CYFRA 21-1의 측정은 면역방사계수측정 kit인 ELSA-CYFRA 21-1을 사용하였다. 결과: 폐암의 조직학적 분류에 따른 CYFRA 21-1의 혈중 측정치는 편평상피세포암이 $20.2{\pm}4.7ng/ml$, 선암이 $7.2{\pm}1.6ng/ml$, 비소세포암이 $15.5{\pm}4.7ng/ml$로 모두 대조군의 $1.7{\pm}0.5ng/ml$보다 유의하게 증가되어 있었다(p<0.01). 또한 비소세포암중 편평상피세포암에서 선암보다 유의하게 증가되어 있었다(p<0.05). 그러나 소세포암에서는 $2.9{\pm}0.9ng/ml$로 대조군과 유의한 차이가 없었다. CYFRA 21-1의 정상 범위를 3.3ng/ml 이내로 하였을때 소세포암에서는 민감도 11.1%, 특이도 65.2% 였으나, 비소세포암에서는 민감도 70.0%, 특이도 62.5%였고 이 중 편평상피 세포암인 경우 민감도 73.7%, 특이도 75%였으며 선암인 경우 63.6%, 78.9%로 산출되었다. 결론: CYFRA 21-1은 비소세포암의 종양 표지자로 유용성이 있을 것으로 생각되며, 특히 편평상피 세포암의 진단에 도움이 될 것으로 생각되었다.

• Tuberculosis and Respiratory Diseases
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• 제58권5호
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• pp.490-497
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• 2005

연구배경 : Paraoxonase는 산소유리기 제거효소의 하나로서, 유기인제 화합물의 독소제거에 있어서 중요한 역할을 한다. 본 연구에서는 한국인 남성에서 PON1 Q192R 유전자 다형성이 흡연과 관련하여 폐암발생에 미치는 영향을 조사하였다. 대상 및 방법 : 연구대상자는 조직 병리학적으로 폐암으로 새롭게 진단받은 남성 환자 335명과, 이들과 3세 이내에서 연령을 짝지은 동수의 대조군으로 하였다. 직접면접조사를 통하여 인적사항과 직업력 그리고 흡연력, 음주력 등을 조사하였다. TaqMan 실시간 중합 효소 연쇄반응을 이용하여 PON1 유전자 다형성을 확인하고, 폐암과 흡연 그리고 PON1 유전자 다형성 유형 사이의 상호 관련성을 통계적으로 분석하였다. 결 과 : 흡연과 PON1 유전자 Q/Q형이 폐암 발생 위험도를 유의하게 증가시켰다. 흡연자에서 PON1 Q/Q형인 사람이 Q/R 혹은 R/R형인 사람에 비하여 폐암에 대한 교차비(95% 신뢰구간)가 2.56(1.52 - 4.31)으로 폐암발생 위험도가 통계적으로 유의하게 증가하였다. 비흡연자이며 PON1 Q/R 혹은 R/R형인 사람을 비교군으로 하였을 때, 비흡연자이며 PON1 Q/Q형인 군, 흡연자이며 Q/R 혹은 R/R형인 군, 흡연자이며 Q/Q형군으로 이행할수록 대응비는 모든 세포유형에서 유의하게 증가하였다. 특히 흡연자이며 Q/Q형인 사람은 비흡연자이며 PON1 Q/R 혹은 R/R형인 사람에 비하여, 편평세포암종은 53.77(6.55 - 441.14)배, 선암종은 6.25(1.38 - 28.32)배, 소세포암종은 59.94(4.66 - 770.39) 배 더 잘 생기는 것으로 나타났다. 결 론 : 흡연과 PON1 Q/Q형은 폐암의 위험인자이며, 흡연과 PON1 Q/Q형은 조직학적 유형에 관계없이 폐암발생 위험도를 서로 상승적으로 증가시키는 것으로 판단된다.

• 생물정신의학
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• 제22권4호
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• pp.187-194
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• 2015

Objectives To examine direct causes of attempted suicides, methods adopted to commit suicide, and psychiatric diagnoses among suicide attempters in South Korea. Methods A total of 1359 suicide attempters who had visited emergency department of 17 medical centers due to suicide attempt from May 2013 to Nov 2013 were interviewed using semi-structured questionnaires. Results Psychiatric symptoms were the most common cause of suicide attempts (62.2%), followed by interpersonal relationships (24.4%). Women attempted suicide more often for interpersonal reasons, whereas men were more likely to do so for financial and job-related reasons. Half of participants (55.8%) attempted suicide by drug intoxication, which was more prevalent among females and those who had previous history of psychiatric disease or previous suicide attempt. Men were more likely to use more lethal methods such as pesticide poisoning and gas inhalation than women. Pesticide poisoning was also prevalent among the elderly group and the rural population. Near ninety-five percent (94.5%) of participants received a psychiatric diagnosis : the most frequent diagnosis was depressive disorder. Conclusions This is the first nationwide study of cases of attempted suicide. When stratified by age groups, gender, urbanicity, living alone or not, presence of physical illness, previous psychiatric history, and previous suicide attempt, there were significant differences with respect to causes, methods of attempted suicides and psychiatric diagnoses of suicide attempters.

• Ocean and Polar Research
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• 제26권3호
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• pp.385-400
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• 2004

The Lago Sofia Conglomerate encased in the 2km thick hemipelagic mudstones and thinbedded turbidites of the Cretaceous Cerro Toro Formation, southern Chile, is a deposit of a gigantic submarine channel developed along a foredeep trough. It is hundreds of meters thick kilometers wide, and extends for more than 120km from north to south, representing one of the largest ancient submarine channels in the world. The channel deposits consist of four major facies, including stratified conglomerates (Facies A), massive or graded conglomerates (Facies B), normally graded conglomerates with intraformational megaclasts (Facies C), and thick-bedded massive sandstones (Facies D). Conglomerates of Facies A and B show laterally inclined stratification, foreset stratification, and hollow-fill structures, reminiscent of terrestrial fluvial deposits and are suggestive of highly competent gravelly turbidity currents. Facies C conglomerates are interpreted as deposits of composite or multiphase debris flows associated with preceding hyperconcentrated flows. Facies D sandstones indicate rapidly dissipating, sand-rich turbidity currents. The Lago Sofia Conglomerate occurs as isolated channel-fill bodies in the northern part of the study area, generally less than 100m thick, composed mainly of Facies C conglomerates and intercalated between much thicker fine-grained deposits. Paleocurrent data indicate sediment transport to the east and southeast. They are interpreted to represent tributaries of a larger submarine channel system, which joined to form a trunk channel to the south. The conglomerate in the southern part is more than 300 m thick, composed of subequal proportions of Facies A, B, and C conglomerates, and overlain by hundreds of m-thick turbidite sandstones (Facies D) with scarce intervening fine-grained deposits. It is interpreted as vertically stacked and interconnected channel bodies formed by a trunk channel confined along the axis of the foredeep trough. The channel bodies in the southern part are classified into 5 architectural elements on the basis of large-scale bed geometry and sedimentary facies: (1) stacked sheets, indicative of bedload deposition by turbidity currents and typical of broad gravel bars in terrestrial gravelly braided rivers, (2) laterally-inclined strata, suggestive of lateral accretion with respect to paleocurrent direction and related to spiral flows in curved channel segments around bars, (3) foreset strata, interpreted as the deposits of targe gravel dunes that have migrated downstream under quasi-steady turbidity currents, (4) hollow fills, which are filling thalwegs, minor channels, and local scours, and (5) mass-flow deposits of Facies C. The stacked sheets, laterally inclined strata, and hollow fills are laterally transitional to one another, reflecting juxtaposed geomorphic units of deep-sea channel systems. It is noticeable that the channel bodies in the southern part are of feet stacked toward the east, indicating eastward migration of the channel thalwegs. The laterally inclined strata also dip dominantly to the east. These features suggest that the trunk channel of the Lago Sofia submarine channel system gradually migrated eastward. The eastward channel migration is Interpreted to be due to tectonic forcing imposed by the subduction of an oceanic plate beneath the Andean Cordillera just to the west of the Lago Sofia submarine channel.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6227-6232
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• 2012

Interleukin-4 receptor (IL-4R) gene single nucleotide polymorphisms (SNPs) are implicated in cancer development. However, results from the published reports have remained inconclusive. The objective of this study was to conduct a meta-analysis investigating the association between polymorphisms in IL-4R gene and cancer risk. Pubmed, EMBASE and China National Knowledge Infrastructure (CNKI) were searched for case-control studies published up to October 30, 2012 that investigated IL-4R polymorphisms and cancer risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the strength of any associations. Three IL-4R polymorphisms (Q576R, rs1801275; I75V, rs1805010; S503P, rs1805015) in 21 case-control studies were analyzed. Our meta-analysis indicated that these three polymorphisms are not associated with cancer risk when all studies were pooled together. In the subgroup analysis by tumor site, the results showed that Q576R G allele carriers were associated with a significantly decreased cervical cancer risk (recessive model: OR = 0.77, 95%CI = 0.60-0.98; homozygote comparison: OR = 0.76, 95%CI = 0.58-0.98). I75V G allele carriers were associated with a decreased risk of renal cancer (dominant model = 0.71, 95%CI = 0.57-0.89, heterozygote comparison: OR = 0.69, 95%CI = 0.55-0.87). When stratified by ethnicity, Q576R G allele carriers were associated with a decreased cancer risk in Caucasians (dominant model: OR = 0.90, 95%CI = 0.83-0.98; heterozygote comparison: OR = 0.89, 95%CI = 0.82-0.98). I75V G allele carriers were associated with a decreased cancer risk in Asians (heterozygote comparison: OR = 0.76, 95%CI = 0.62-0.94). S503P C allele carriers were also associated with a decreased cancer risk in Asians (CC VS TT: OR = 0.29, 95%CI = 0.08-0.99). Our results suggest that Q576R, I75V and S503P may be associated with a decreased cancer risk for certain types of cancers and in some specific ethnic groups. Future case-control studies with large sample size are needed to evaluate these associations in detail.

• 농촌의학ㆍ지역보건
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• 제15권2호
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• pp.97-106
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• 1990

1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

• 생태와환경
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• 제35권1호통권97호
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• pp.10-20
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• 2002

소양호와 팔당호에 대한 한강수질검사소(1996${\sim}$1998)와 환경부(1990${\sim}$1997), 그리고 건설교통부(1996${\sim}$1998)자료를 인용하여 수문학적 특성에 따른 소양호와 팔당호의 수질특성 및 계절적 변화양상을 비교${\cdot}$분석하였다. 소양호에서는 수온차에 의한 뚜렷한 성층현상이 관찰되었다. 춘계와 하계에 관찰된 좁은 폭의 표층은 추계로 갈수록 점차 넓어진 반면 중층의 폭은 좁아지는 경향을 보였으며 심층은 연중 수온이 $5^{\circ}C$내외로 거의 변동을　보이지 않았다. 춘계와 하계에는 표층에서 용존산소의과포화가 관찰되었고, 추계로 들어가면서 표층과 중층의　용존산소 포화도는 약 75%까지,　심층은 45${\sim}$55%까지　감소하였으며 빈산소　수괴가 시간의 흐름에 따라 심층으로 이동하는 현상이 관찰되었다. 우기동안에는 중층에서 약 $50\;{\mu}S/cm$의 가장 낮은 전기전도도를 갖는 수괴가　분포하고 있음이 관찰되었다. 팔당호에서 수심별 수은의 분포는 연도별,　계절별 구분 없이 비교적 잘 혼합된 수괴의 특성이 관찰되었으나$5{\sim}9$월에는 상${\cdot}$하층이 약 $5^{\circ}C$내외의 수온차이를 나타냈다. 용존산소포화도는 연중 90% 이상으로 소양호에 비해 높은 산소포화도가 관찰되었다. 초여름부터 초가을까지 표층에서는 과포화가, 심층에서는 60%정도까지 낮은 포화도가 관찰되었다. 늦은 봄부터 초가을 (우기)의전기전도도는 수심 $4{\sim}5\;m$ 이하의 수층에서 $90\;{\mu}S/cm$정도까지 감소하여 표층보다 낮은 값을 보였다. 그러나,늦은 가을부터 초봄까지의 전기전도도는 약 $10^{\circ}Cm$깊이까지 표층이 심층보다 낮게 관찰되었다. 소양호의 체류시간은 평균 245일로, 팔당호의 평균 5.1일과 큰 차이를 보였으나, 팔당호는 소양호보다 클로로필 3농도는 약 2.7배, 총 질소 농도는 약 1.2배 그리고 총 인 농도는 약 2.6배 높았다. 따라서 영양염류 농도가 체류시간보다 조류증식에 더 기여한 것으로 판단된다.

• Pediatric Infection and Vaccine
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• 제20권1호
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• pp.17-27
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• 2013

목 적 : 잠복결핵감염(LTBI)을 진단하는 방법은 결핵 피부반응검사(TST)와 interferon-${\gamma}$ releasing assay(IGRA)이다. 그런데 TST의 위양성 문제 때문에 TST 대신 IGRA로 대치하려는 경향이 있다. 이에 결핵 접촉자 조사를 시행함에 있어 TST와 QuantiFERON$^{(R)}$-TB Gold In-Tube (QFT-GIT) 검사를 동시에 시행하여 결과를 비교하였다. 방 법 : 2007년 2월부터 2008년 5월까지 가톨릭대학교 성빈센트병원 소아청소년과 외래에 LTBI 여부의 확인을 위해 방문한 소아를 대상으로 TST와 QFT-GIT 검사를 동시에 시행하였다. 연구대상은 감염원이 같은 집에 거주하는 경우를 동거 접촉, 아닌 경우를 비동거 접촉으로 구분하였다. 결 과 : 연구대상은 총 35명으로 폐결핵 노출 후 접촉자 조사 대상이 29명, 폐결핵으로 진단된 경우가 6명이었다. 접촉자 조사 대상에서 동거 접촉군은 18명(62.1%), 비동거 접촉군이 11명(37.9%)이었다. 최종 접촉자 조사 결과로 TST 양성은 동거 접촉군 38.9% (7/18), 비동거 접촉군 45.5% (5/11)이었고, QFT-GIT 검사 양성은 각각 5.6% (1/18), 9.1%(1/11)로 TST의 양성률이 더 높았다. 접촉자 조사에서 두 검사를 모두 시행한 경우는 1차 검사의 26건과 2차 추적검사의 15건을 합하여 총 41건으로 두 검사의 일치율(kappa값)은 0.063으로 매우 낮았다. 6명의 폐결핵 환자에서 TST는 모두 양성, QFT-GIT 검사는 5명이 양성으로, 이들까지를 포함했을 때의 일치율은 0.334이었다. 결 론 : 본 연구에서 TST와 QFT-GIT 검사 결과의 일치율은 낮았는데, 대부분이 TST 양성인 경우이었다. 두 검사 결과 중 어떤 것이 정확한 것인지 판단할 수 있는 표준 검사법이 없고, 소아청소년에 대한 자료가 충분치 않은 상황에서 민감도가 낮은 IGRA에 의한 결과만을 신뢰하여 LTBI 진단에 IGRA만 사용하는 것은 적절치 않다고 사료된다.

• 한국사회복지학
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• 제57권3호
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• pp.305-335
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• 2005

이 논문은 2003년에 개발된 SPDA(A Screening Scale For Potential Drug-use Adolescents)의 타당성검증을 위한 2차년도 연구결과이다. SPDA는 청소년들의 약물사용에 대한 조기 예방적 개입을 위한 선별도구로서 활동을 그 목적으로 한다. 연구를 위한 조사대상자는 전국에 재학중인 중 고등학생(n=4,307)으로서 층화표집과 할당표집으로 선발되어 SPDA와 관련척도에 대하여 응답하였으며, 비교집단으로 전국 보호관찰청소년(n=305)들도 동일한 조사에 참여케 하였다. 타당화의 주요한 내용은 신뢰도, 내용타당도, 구성타당도, 기준관련타당도, 동시타당도 등을 검증하는 것이었다. 연구 결과, 척도의 신뢰도는 Cronbach 알파계수 0.914를 나타냈다. 구성타당성을 위한 탐색적 요인분석 결과 SPDA는 개인특성, 문제행동, 부모의 문제와 약물경험, 부모와의 관계, 음주환경과 태도, 약물사용환경과 태도 등 7가지 요인으로 나뉘었고, 확인적 요인분석결과는 모형적합도 지수, 요인부하량을 검토할 때 SPDA의 각 요인구조가 적합도가 높은 측정모델로 입증되었다. 그리고 기준관련 타당도를 검증하기 위한 판별분석에서는 본 척도의 분류 적중률이 86.6%(중학생 78.8%, 고등학생 87.4%)로 나타나 적절한 예측타당도를 가지고 있음을 확인할 수 있었다. 동시타당도에서는 "Hare Home Self-Esteem Scale", "Hare School Self-Esteem", "Zuckerman-Kuhlman Sensation-seeking scale" 세 척도와 모든 영역의 상관계수가 유의미한 값을 보여주었다. 또한 SPDA 총 약물사용에 대한 잠재군과 비잠재군(일반중고생)에 대해 유의미한 변별력을 가지고 있었다. 실제적 활용을 위해 잠재군을 분류할 수 있는 절단점으로 T-점수(+0.5SD)를 이용하였으며 잠재 약물사용군으로 분류될 수 있는 대상은 총 점수 77점 이상일 경우였다.

• Tuberculosis and Respiratory Diseases
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• 제71권5호
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• pp.328-334
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world and is the only major disease that is continuing to increase in both prevalence and mortality. The second Korean National Health and Nutrition Survey revealed that the prevalence of COPD in Korean subjects aged ${\geq}45$ years was 17.2% in 2001. Further surveys on the prevalence of COPD were not available until 2007. Here, we report the prevalence of spirometrically detected COPD in Korea, using data from the fourth Korean National Health and Nutrition Survey (KNHANES IV) which was conducted in 2007~2009. Methods: Based on the Korean Statistical Office census that used nationwide stratified random sampling, 10,523 subjects aged ${\geq}40$ years underwent spirometry. Place of residence, levels of education, income, and smoking status, as well as other results from a COPD survey questionnaire were also assessed. Results: The prevalence of COPD (defined as forced expiratory volume in 1 sec/forced vital capacity <0.7 in subjects aged ${\geq}40$ years) was 12.9% (men, 18.7%; women, 7.5%). In total, 96.5% of patients with COPD had mild-to-moderate disease; only 2.5% had been diagnosed by physicians, and only 1.7% had been treated. The independent risk factors for COPD were smoking, advanced age, and male gender. Conclusion: The prevalence of COPD was 12.9% in the KNHANES IV data. Most patients with COPD were undiagnosed and untreated. Based on these results, a strategy for early COPD intervention is warranted in high risk subjects.