한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

개 비장 질환의 미세세침흡입술을 통한 세포병리학 검사 4례

김현아,윤기영,최호정,정성목,이영원,조성환,박성준 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2011 動物醫科學硏究誌 Vol.18 No.1

To evaluate the accuracy and diagnostic significance of cytopathological diagnosis of canine splenic disorders, cytopathological examination throgh fine-needle aspiration(FNA) referred to Veterinary Medical Teaching Hospital of Chungnam National University were retrospectived. Splenic neoplasm, hemolymphatic neoplasm, hyperplasia, extramedullary hematopoiesis and splenitis were diagnosed canine splenic disorders through cytopathological examination. The patient should be identified what coagulation profile are normal before aspiration, because complication such as hemorrhage could happen. The 4 cases were identified symmetric, asymmetric splenomegaly on abdominal ultrasonography and then were performed ultrasound-guided FNA. The 4 cases were diagnosed hemangiosarcoma(2), hyperplasia(1) and extramedullary hematopoiesis(1) by clinical signs, hematological examination, and cytopathological examination. Cytopathological examination through FNA was cost-effective, no gneral anesthesia, no complication, and non-invasive method of diagnosis for canine splenic disorders.

요양급여 적정성 평가체계 혁신 중장기 계획

김상지,전숙경,이창원,정영애,안재영,안유미,권아영,임상희,최정남,윤미선,변의형,조미현 건강보험심사평가원 2021 HIRA RESEARCH Vol.1 No.2

국내산 중하(Metapenaeus joyneri) 내 주알레르겐 규명 : 가열 및 소화액에 의한 변화

윤성호,김현아,김현미,최정희,서창희,남동호,김윤근,민경업,박해심 대한알레르기학회 2004 천식 및 알레르기 Vol.24 No.2

감염된 가축과의 직접 접촉 없이 발생한 브루셀라증 환자1례와 축산 부산물 시장에서의 역학조사 : Sero-epidemiology Study on Market, by-product, Stock-raising

정성주,김성범,박대원,정혜원,기세윤,권정아,박만석,박미연,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

브루셀라증은 전 세계적으로 발생하는 인수공통 전염병중에 하나로서, 본 증례는 국내에서 감염된 가축에 대한 노출력이 없는 집단에서 현증 브루셀라증이 발생한 첫 증례이기에 문헌 고찰과 함께 보고한다. 또한 환자가 근무하였던 축산물 부산물 시장에서 역학 조사를 실시하여, 현증환자 및 기감염자를 발견하여 축산물 부산물 시장 근무자에서 현증 브루셀라증이 발생할 위험성을 평가하였다. 역학 조사 결과 축산물 부산물을 다루는 일을 하는 사람들에서 감염된 가축과의 직접 접촉이 없이도 브루셀라증이 발생할 수 있음을 알 수 있었다. Brucellosis is a world-wide zoonotic disease. We report the first case of brucellosis in South Korea that is not related to direct contract with intected cattles. The patient had been working in the market of by-product, stock raising for twenty years and complained of 1-month history of fever, chill, and intermittent epistaxis. We confirmed brucellosis by anti-brucella antibody test and PCR. After 6 weeks' treatment with rifampicin and doxycycline, fever and chilling subsided, and, generalized weakness and oral intake improved. We performed seroepidemiology study against workers who were working in the same market as the patient. However, we couldn't find out other cases with seropositivity. We concluded that although the workers of by-product market have a risk of getting brucellosis, the risk is low.

Streptozotocin 유도 당뇨쥐에서의 Phospholipase A₂, Cyclooxygenase 활성과 Thromboxane 및 Prostacyclin합성

양정아,김성옥,최정화,곽오계,이순재,장현욱 영남대학교 약품개발연구소 1998 영남대학교 약품개발연구소 연구업적집 Vol.8 No.-

당뇨병에서의 혈전생성 기전에 관련된 주된 요인을 관찰코져 흰쥐를 4주간 사육한 후 streptozotocin(STZ)으로 당뇨를 유발한 후 6일째에 희생하여 당뇨쥐에 있어서의 phospholipase A₂ 활성변화에 따른 조직의 과산화적 손상과 혈소판 응집능 등의 변화를 관찰한 결과는 다음과 같다. 체중증가는 STZ를 투여한 후에는 STZ 투여군에서 현저하게 감소하였다. 식이섭취에 있어 STZ injection 후, DM군은 16% 증가하였다. 식이효율은 STZ injection 후 DM군은 정상군에 비해 유의적으로 감소하였다. 혈청 중의 총 지질과산화물가는 정상군에 비해 DM군은 2.5배 높았다. HDL 중의 TBARS는 정상군에 비해 DM군은 약 1.6배 정도 높았고 LDL 중의 TBARS는 정상군에 비해 DM군에서 4.8배의 높은 증가를 보였다. 혈소판 phospholipase A₂ 활성은 DM군은 정상군에 비해 42% 증가하였다. 혈소판 cyclooxygenase 활성은 정상군에 비해 DM군이 2배 정도 높은 수준이었다. 혈소판 중의 TXA₂ 농도는 정상군과 비교하여 DM군에서 169%로 현저하게 높았고 대동백 PGI₂의 농도는 정상군에 비해 DM군은 낮은 수준을 보였으며 대동맥 PGI₂와 혈소판 TXA₂의 비는 DM군에서 정상군에 비해 55% 낮았다. 결론적으로 STZ 유발 당뇨쥐에 있어서는 혈청 지질과산화물 수준의 증가와 더불어 phospholipase A₂ 활성이 증가되었으며 따라서 cyclooxygenase가 유도하는 AA cascade 활성화에 의해 TXA₂ 생성증가 및 PGI₂/TXA₂ ratio의 감소가 관찰되었다. 이러한 결과는 당뇨병 질환에서 나타나는 동맥경화증, 심혈관계 질환 등의 여러 혈관계의 병리적 현상들이 당뇨 상태에서의 지질대사 이상으로 인한 지질과산화물의 증가와 그의 독성으로 인한 여러 혈소판 관련 인자들의 활성화와 밀접하게 연관되어 나타나는 것을 시사하는 것이라 하겠다. The relation between lipid peroxidation and thrombotic reaction were investigated in streptozotocin (STZ)-induced diabetic rats. Sprague-Dawley male rats weighing 100±10gm were randomly assigned to normal and STZ-induced diabetic group(DM). Diabetes was experimentally induced by intravenous injection of 55mg/kg of body weight of STZ in citrate buffer(pH 4.3) after 4 weeks feeding of basal diet. Animals were sacrificed at the 6th day of diabetic states. Body weight gains were lower in diabetic group after STZ injection. Serum levels of thiobarbituric acid reacting substances(TBARS) that were markedly increased in DM group compared with of normal group. TBARS levles of HDL and LDL were similar patterns to total TBARS of serum. Activities of platelet phospholipase A₂(PLA₂) were higher in diabetic group than those of normal group. Activities of platelet cyclooxygenase were 106% in DM group than normal group. Platelet thromboxane A₂(TXA₂) formation was increased in DM group than normal group. Production of aortic prostacyclin(PGI₂) was lower in diabetic group than that of normal group. PGI₂/TXA₂ ratios were decreased by 55% in DM groups than those of normal group. The present results indicate that STZ-induced diabetic rats are more sensitive to oxidative stess which leads to acceleration of lipid peroxidation and platelet aggregability. In conclusion, accelerating effect of lipid peroxidation and thrombogenesis in diabetic state is regarded to be resulted from enhancement of PLA₂ activity and arachidonic acid metabolism, inhibition of antiaggregating agent and aortic PGI₂ formation.

Chlorhexidine과 fluoride 성분의 varnish가 타액 내 mutans streptococci 수에 미치는 효과

서정아,김재곤,백병주,양연미,이용희,김상훈 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.4

본 연구의 목적은 chlorhexidine(Cervitec)과 fluoride(Fluor-protector) 성분을 각각 포함한 varnish를 치아에 적용하였을 때 타액내의 mutans streptococci의 수의 감소에 미치는 효과를 알아보기 위한 것이다. 전북대학교 치과대학생 40명을 대상으로 하여 mutans streptococci 균종 수를 평가하였으며, 이들을 무작위로 네 군으로 나누어 다음과 같이 varnish를 적용하였다; A) varnish를 적용하지 않은 군(n=10), B) chlorhexidine varnish 적용군(n=10), C) fluoride varnish 적용군(n=10), D) chlorhexidine과 fluoride varnish를 모두 적용한 군(n=10), Mutans streptococci 수 측정에는 Orion diagnostica 사의 Dentocult SM을 사용하였다. Varnish를 적용하지 않은 상태에서 1차로 Mutans streptococci 수를 측정한 후 각각의 varnish를 적용하였으며, varnish 적용 12주 후 다시 측정하여 기록하였다. 모든 실험군(group B, C, D)에서 12주 후에 측정한 Mutans streptococci 수가 감소한 개체가 증가한 개체보다 많았으나 통계적으로 유의한 차이는 보이지 않았다(p>0.05). 실험에 사용된 어떠한 varnish도 적용 12주 후에 타액 내 mutans streptococci 수에 통계적으로 유의할 만한 변화를 주지는 못하는 것으로 나타났다(p>0.05). The objective of the present prospective trial was to compare the efficacy of chlorhexidine(Cervitec), Fluoride(Fluorprotector) and combination of chlorhexdine and fluoride varnishes in decreasing the level of salivary mutans streptococci. Forty healthy students of school of dentistry, Chonbuk national university were investigated to evaluate mutans streptococci(MS) counts and randomized into four groups to treat with the experimental varnishes: A) untreated group(n=10), B) chlorhexidine group(n=10), C) fluoride group(n=10), D) chlorhexidine and fluoride group(n=10). Dentocult SM^(�)(Orion Diagnostica) strip method was used for measurement of the level of mutans streptococci in saliva. Stimulated saliva were collected at baseline for mutans streptococci counts evaluation(ms1), 12 weeks later the completion of each varnish treatment, mutans streptococci counts were re-evaluated. In varnish group with chlorhexidine, fluoride and combination of chlorhexidine and fluoride, the level of mutans streptococci was lower after 12 weeks than at baseline, but there were no significant differences in saliva(p>0.05), when compared with baseline. After 12 weeks, a remarkable reduction was still found in the subjects with high level of mutans streptococci at baseline, but not different in the low and moderate level of mutans streptococci(p>0.05).

상수 응집제 황산알루미늄과 PAC 응집처리 후 염소 및 오존산화처리에 따른 부식물 색도 및 중금속류의 제거

옥치상,김정아 高神大學校 保健科學硏究所 1993 보건과학연구소보 Vol.3 No.-

The removal of heavy metals by chlorination and ozonization after coagulations in drinking water treatment was investigated. Based on the results, the optimal coagulant concentrations to remove heavy metals were 10ppm for alum at pH 8, 10ppm for PAC at pH 7, respectively. The removal of Pb, Cu and Cd in heavy metal samples was high in alum and PAC coagulation. And in removal of Pb, Cu and Cd, PAC was more effective than alum. The removal of heavy metals by oxidation after coagulation were that ozonization was more effective than chlorination.

폐경 후 여성의 심혈관질환 예방을 위한 식사중재에 대한 준수도(adherence) 평가

정경아,김상연,우정익,장유경 漢陽大學校 韓國生活科學硏究所 2001 韓國 生活 科學 硏究 Vol.- No.19

The purpose of this study is to assess the adherence to dietary intervention for prevention of coronary heart disease (CHD) in postmenopausal women by observing changes of antioxidant vitamins and fatty acid composition in dietary intake and seam level. The subjects with hypercholesterolemia (TC≥240mg/dl) were treated with one of hormone replacement therapy (HRT group), dietary intervention (DIET group) or combination of hormone replacement therapy and dietary intervention (HRT+DIET group) for 12 weeks. The results were as followed. Mean daily nutrient intakes were not significantly changed in the HRT group, but were significantly changed in the DIET group and the HRT+DIET group. Especially, dietary vitamin A and E intakes were increased from less than 75% to more than 90% of RDA for Korean in the two groups. With changes of dietary intakes, serum vitamin A and E levels were also significantly increased in the DIET group and tended to increase in the HRT+DIET group. Dietary fatty acid composition was also not significantly changed in the HRT group, but was significantly chanced in the DIET group and the HRT+DIET group. With changes of dietary fatty acid composition, serum phospholipid fatty acid composition was significantly changed in the DIET group and the HRT+DIET group although there was tendency of returning to initial value after 12 weeks. Judging from changes in serum phospholipid fatty acid composition, subjects' adherence to dietary intervention tended to decrease after 12 weeks. However, the changes of antioxidant vitamins and fatty acid composition in dietary intake were compatible with the changes of those in serum level, and we can conclude that dietary intervention was adhered quite well by subjects.

제1형 당뇨병 환자에서 췌도세포 동종이식의 반복시행

양태영,정인경,서인아,오은영,조건영,오승훈,김성주,정재훈,민용기,이명식,이문규,김광원,도영수,주성욱 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경:췌도세포 이식은 시술이 간편하고 안전하기 때문에 반복이식이 가능하여 그 동안 여러 센터에서 반복이식의 성공을 보고한 바 있다. 국내에서도 본 병원을 비롯하여 몇몇 센터에서 췌도세포 이식이 활발히 시도되고 있으나 사람에서의 동종이식 및 동종 이식의 반복시행은 보고된 바 없는 실정이다. 저자 등은 국내 최초로 췌도세포 동종이식을 시행하여, 혈청 C­펩타이드가 증가하고 인슐린 요구량이 감소하였으며, 혈당농도와 당화혈색소의 안정을 보였다. 그러나 이식 70일 후 다시 인슐린 요구량이 증가하고 C­펩타이드가 감소하여 췌도세포 이식을 다시 시행한 바 있다. 2차 이식 후 70여일이 지난 현재 다시 혈청 C­펩타이드가 증가하고, 인슐린 요구량이 더 감소되어 췌도세포 이식에서 반복 시행의 유용성을 보고하는 바이다. 방법:환자는 32세 남자로 17년전 당뇨병 진단 후 인슐린 치료 중이었으며, 3년전 부터는 만성신부전증으로 혈액툭석을 하고있었다. 1999년 12월 25일 신장이식을 하였고 3일 후 췌도이식을 하였으며, 두번째 이식은 70일 후 시행하였다. 췌도분리는 변형된 Recordi방법과 비연속성 자당 농도차(discontinuous density gradient)를 이용하였으며 분리한 췌도는 배양 후 환자의 신장기능이 정상화되고 미생물학 검사에서 음성을 확인한 후 경피경간으로 간문맥을 접근하여 16G 폴리 에틸렌 카테터를 이용하여 간실질에 이식하였다. 결과:1차 췌도이식시 순수분리전 췌도수는 210,000개, 순수분리후 획득한 췌도수는 90,000개, 순도 95%, 세포양 1.0mL 이었고, 2차 췌도이식시 순수분리전 췌도수는 420,000개, 순수분리후 획득한 췌도수는 370,000개, 순도 95%, 세포양 1.5mL 이었다. 1,2차 모두 간문맥을 통해 약 20분에 걸쳐 간실질에 주입하였다. 췌도이식전 인슐린요구량은 75∼75U/일, HbA1e 8∼10%, C­펩타이드 0.6ng/mL 였으며, 1차 췌도이식수 7일째 인슐린 요구량은 40U/일, C­펩타이드 1.5ng/mL, FPS 109mg/mL 였고, 40일 추적관찰 후 인슐린 요구량이 36U/일, C­펩타이드 1.8ng/mL, HbA1e 6.5∼7.0%로 안정되었다. 그러나 이식 50일째부터 인슐린 요구량이 50∼56U/일, C­펩타이드 0.6ng/mL, FPS 130∼200mg/dL로 혈당 조절이 불안정하여 다시 췌도이식을 시행하였다. 2차 이식후 50일이 경과한 현재, 인슐린 요구량은 26U/일, C­펩타이드 1.8ng/mL, FPS 90∼120mg/dL로 다시 안정되었다. 결론:췌도이식은 반복이식이 가능하며, 본 환자의 경우 인슐린요구량 감소, 혈당의 안정화 및 C­펩타이드가 상승하여 이식한 췌도의 기능을 확인할 수 있었고, 향후 스테로이드 등 면역억제가 유지 용량으로 감량되면 인슐린 요구량은 더 감소될 것으로 기대된다. Over the past 20 years, significant advances have been made in human islet transplantation. However, cases of prolonged insulin independence after islet allotransplantation have rarely been reported and over time, a slight, gradual decrease in insulin secretion appears to occur, as suggested by the lower C-peptide. Although preliminary clinical success achieved over the past few years has been considerably higher with whole pancreatic transplant than with isolated islet grafts, both approaches remain experimental. Islet grafts might gain, over time, increasing credibility and might eventually provide an easier alternative in terms of grafting procedures and patient management, as compared with the more "traumatizing" whole-pancreas transplantation. Also, using islet, re-transplantation is possible. But it is not known whether re-transplantation of islet could be suitable for those patients who lost grafted islet function. The aim of the present study was to investigate the benefits of re-transplantation of islet in previously simultaneous islets-kidney transplant (SIK) patient who have lost graft function. Methods : The recipient was a 32 year old male. First islet transplantation was underwent at December 25, 1999. However, the grafted islets lost function after 70 days. So we performed re-transplantation of islets. The isolation of islet was conducted sterilely on a laminarflow hood and isolated by a modified Recordimethod. The islet was injected slowly into the liver via a cannular placed in the potalvein for 20 minutes. Results : Transplanted islets were 90,000 IEq at first islet transplantation, 370,000 IEq at second islet transplantation. The insulin requirement was reduced from 75-85 to 35-40 U/day, the basal C-peptide level was 1.5 ng/mL at 7 days posttransplant Unfortunately, the grafted islets lost function after 70 days. After second transplantation, the insulin requirement was reduced to 26 U/day. Conclusions : Despite the continuous need for exogenous insulin therapy, islet transplantation can prevent wide glucose fluctuations, thus resulting in normalization of glycemic control and improvement in HbAlc, and also, show that islets can be successfully and safely re-transplanted intraportally in patients who have lost previously grafted islet function (J Kor Diabetes Asso 457~466, 2000).