근로자 건강증진전략을 위한 행동변화에 대한 요구도 평가

이강숙,임현우,구정완,홍현숙,이정민,이원철,박정일,맹광호,M, O'Donnel 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : In order to evaluate the stage of behavior change for health promotion strategy in workplace Methods : Questionnaire survey was carried out for 309 workers who employed in H Electronics company in Kyong-in area from September to October 1998. Results : According to need assessment of four step such as precontemplation stage, contemplation stage, action stage, maintenance stage which were to change of behavior for health promotion, the percent for quitting smoking were observed 48.8%, 43.1%, 8.1%, 0%, and for the restriction of drinking were 29.8%, 10.6%, 9.3%, 5.3%; for fitness 11.1%, 31.0%, 37.3%, 20.6% in male 26.6%, 27.8%, 26.6%, 19.0% in female, for regular diet 26.1%, 19.8%, 38.7%, 15.3% in male, 27.8%, 22.2%, 40.0%, 10.0% in female and for stress management 5.8%, 10.6%, 8.7%, 75.0% in male, 13.6%, 22.7%, 19.7%, 44.0% in female. In heavy smoker(p=0.017) and heavy drinker,(p=0.021) the percent of precontemplation stage was significantly higher than in lower drinker and light smoker. Conclusions : This study suggested that company support for health promotion in workplace was and workers of high risk group for smoking and drinking were in precontemplation stage. So before conducting the health promotion program, health risk appraisal and need assessment for stage of behavior change should be taken for the efficient health promotion strategy.

일부 사업장 건강증진사업 실태조사 및 요인분석

이경화,이원철,이강숙,홍현숙,송연이 가톨릭대학교 산업의학센터 2000 韓國의 産業醫學 Vol.39 No.2

For the purpose of access the health promotion activities in 138 worksite which had more than 50 workers, we surveyed the questionnaire on May and September 1998. The results of survey were as follows: 1.59 companies(45.1%) were conducting the health promotion activities. Most of them were manufacturing and located Kyung-sang province and had nurses as a health manager. 2.Companies operating the health promotion activities had significant higher degree of satisfaction and usage of welfare facilities than non-operating companies. 3.The level of knowledge for regulations, professional skills, and performance related health promotion was low in all companies. Top manager's interest and will for investment to health promotion was significant lower in non-operating companies. 4.The reasons why the health promotion program was not operated, were low budget, top manager's indifference, lack of information, work overloading, no human resource, an insufficient governmental support in order. 5.The most necessary items for program were education and promotion, budget, and governmental support. Needed personnel were nurses, fitness trainner, and necessary program were health management, exercise, nutrition, and stress counselling. For comparing before and after IMF, amount of budget was decreased. In conclusion, this study suggested that major barriers to conduct health promotion activities were lack of budget, lower interest of top managers, and insufficient professional information, therefore detail health promotion program would be developed and supported by government.

일개 대학 병원 종사자의 직종별 직무스트레스 수준

심미선,이강숙,홍현숙,이경숙 가톨릭대학교 산업의학센터 2000 韓國의 産業醫學 Vol.39 No.4

This study was carried out to find out the job stress factors, coping skill, stress symptom, stress results at a university hospital workers and to develop the goal of health promotion including stress management program. The data for job stress were collected from 61 doctors, 141 nurses, and 84 assistant-nurses in a university from March, 2000 to April, 2000. The results of the study were summarized as follows; 1.The stress scores from job internal factors were highest in doctor group for variety, in nurse group for significance, and assistant-nurse group for identity. 2.The hospital workers felt high stress from promotion and salary but there was no difference from professional groups. There were significant differences in interpersonal relation and organizational norm between nurse and assistant-nurse group and in job-home conflict between doctor and assistant-nurse group. 3.The stress symptoms such as anxiety, depression, and physical symptom were highest in assistant-nurse group. 4.The coping skill was highest in nurse group. 5.The result of stress such as work performance, job involvement and organization commitment was highest in nurse group. The intention to change the job was highest in doctor group. 6.The stress scores had positive correlations with various symptoms. In conclusion, the hospital workers felt high stress from job, interpersonal relation, and organizational norm. In order to relive the stress, the stress management program including to improve coping skill and strategy would be necessary.

톨루엔 노출 근로자에서 유전자적 요인, 생활습관 및 식이가 요중 마뇨산 배설에 미치는 영향

임현우,박정일,노영만,이강숙,이정민,이원철,이세훈,정치경 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.3

목 적 : 본 연구는 생물학적 지표 특성 연구를 위한 단면조사 연구로서 톨루엔 노출과 톨루엔의 생물학적 모니터링으로 이용되는 요중 마뇨산 농도간의 양-반응 관계에서 효과 변경인자로서 작용하는 유전자 ALDH2, CYPIAI, CYP2El의 다양성 분포를 조사하고, 이들 유전자가 요중 마뇨산 배설 농도에 미치는 영향을 알아보고자 하였다. 방 법 : 연구대상자는 경인지역에 위치한 22개의 사업체에서 페인트 제조 72명, 제조업에서 도장작업 50명, 인쇄업 12명, 접착작업 12명, 벽지의 코팅작업 14명등 160명의 근로자이었다. 성, 연령, 유기용제 작업장 근무경력, 흡연습관, 음주습관, 검사일 이전 밤에 음주 여부, 시료 채취전 6시간 이내에 섭취한 식품조사, 측정일 개인보호구의 착용 여부에 대하여 설문조사를 시행하였다. 톨루엔에 대한 개인노출량은 passive air sampler로 측정하였고, 요중 마뇨산은 요중 크레아틴으로 보정하여 측정하였다. 또한 aldehyde dehydrogenase 2 (ALDH2) , cytochrome P45O IAI(CYPIAI), 그리고 cytochrome P45O 2El(CYPfEl)의 유전적 다양성은 혈액으로부터 백혈구의 DNA를 추출하여 제한 효소 절단 길이 다양성 (restiction fragment length polymorphism, RFLP)법으로 검사하여 다음의 결과를 얻었다. 결 과 : 연구대상자의 요중 마뇨산 농도의 기하평균은 0.44g/g creatinine, 기하표준편차 2.80이었다. 톨루엔 노출 농도, 개인 보호구 착용여부, 안식향산이 함유된 식품의 섭취여부중 요중 마뇨산 배설농도에 영향을 미치는 인자는 톨루엔 노출 농도뿐이었다. ALDH2, CYPIAI, CYPfEl, 연령, 흡연, 근무기간에서 회귀계수간에 차이를 보이는 경향이 있었다. 요중 마뇨산 농도에 대한 다중회귀분석에서 톨루엔, ALDH2, CYPIAI, CYP2El유전자형의 회귀계수가 통계적으로 유의하였다. 결 론 : 톨루엔 노출로 인한 요중 마뇨산 배설 농도는 ALDH2, CYPIAI, CYP2El유전자 다양성에 의해 영향을 받기 때문에, 유전자형의 대사능의 차이를 고려하여 마뇨산 기준 농도를 찾는 연구가 이루어져야 하겠다. Objectives The purpose was to investigate the distributions and the effects of genetic polymorphism of aldehyde dehydrogenase 2(ALDH2), cytochrome P45O IAI (CYPIAI), and cytochrome P45O 2El (CYPfEl) on the toluene metabolism. Methods : The subacts consisted of 160 workers who were exposed to toluene in different industries such as paint manufacturing, painting on steel and wood products, printing, bonding, and coating. The exposed toluene level was monitored by passive air sam paler, and the questionnaire variables were age, sex, smoking, drinking, previous night's drinking, use of personal protectlve equipment, work duration, and taking benzoic acid containing food. The urinary hippurric acid collected in the end of shift was corrected by urinary creatinine concentration. The genotypes of ALDH2, CYPIAI, and CYP2El were investigated using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods with DNA extracted from venous blood. Results'The geometric mean and the geometric standard deviation of urinary hippuric acid concentration were 0.44 g/g creatinine and 2.80. The urinary hippuric acid concentration was significantly related to personal exposed toluene level among personal exposed toluene level, use of personal protective equipment, and benzoic acid containing food diet. The slope differences of the regression for ALDH2, CYPIAI, and CYP2E1 genetic polymorphism, age, smoking, and work duration tended to be significant. In multiple regression analysis, the regression coefficient of toluene, ALDH2, 7YPIAl, CYP2E1 genetic polymorphism were significant. Conclusions : From the above results, urinary hippuric acid level after toluene exposure was significantly affected by the genetic polymorphism of ALDH2, CYPIAI, CYPfEl. It is needed further investigation of the urinary hippuric acid level considering the effect of genetic polymorphism.

음악양식의 다원성

李康淑 이화여자대학교 철학과 1978 마음 : 哲學論集 Vol.- No.1

복수과 진료 환자의 중복 처방에 대한 분석 및 평가

이지은,장혜경,오지영,유윤경,김현지,임숙인,연숙희,강진숙,최귀령 한국병원약사회 2003 병원약사회지 Vol.20 No.1

In an aging society, there is an increasing possibility of the duplication of the drugs given to patients because they take many kinds of drugs. Among the prescriptions given to the patients who was treated at multiple ambulatory clinics in St. Mary's hospital for one month of September, 2002, in which drugs that has identical or similar effects are prescribed, we analysed and evaluated them by patients' characteristics, kinds of medication, severity of side effects on a case by case basis. More, we assessed the potential additional costs. As a result of this study, the duplication rate turned out to be 6.69% and it was shown that the proportion of the elderly patients over 60 was high. The gastro-intestinal medications took up a large part and most of the cases showed that the danger caused by double taking of medicine was slight, but there were some examples in which the serious side effects were predicted. Expected additional costs were the average 11.349 won and it ranges from the minimum of 56 won to the maximum of 135,720 won. In conclusion, the management of drug histories of the patients who need the plural treatments is very important and the necessity of the individual and professional guidance of taking medicines for the elderly patients is emerged, too.

함치성 낭의 임상 방사선학적 연구

이강숙 慶北大學校 齒科大學 1995 慶北齒大論文集 Vol.12 No.2

악골의 매복치아와 관련된 단방성의 치관부 방사선투과상을 나타내는 병소들 중에서 임상적, 방사선학적, 조직병리학적 검사를 통해 함치성 낭으로 진단된 200중례들의 임상, 방사선학적 소견을 분석하여 다음과 같은 결론을 얻었다. .함치성 낭은 10대(34.5%)에서 가장 호발되었으며, 남성(66.5%)에서 더 많았다 .주소는 무통성의 종창(31.0%)이 가장 많았고, 대부분 외과적으로 치료되었으며 적출술(80.2%) 또는 조대술(19.8%)이 사용되었다. .병소는 중심형(84.5%)이 대부분이었으며, 병소의 크기는 2-2.9cm인 경우(32.5%)가 가장 많았다. .병소는 상악에서는 전치부(38.0%), 하악에서는 구치부(26.5%)에서 호발되었으며, 원인 치아는 상악 과잉치(40.0%)에서 가장 많았다. .주변 정상 골조직과의 경계는 과골성의 분명한 골경화로 나타난 경우(50.5%)가 가장 많았으며, 병소의 변연형태가 평활항 경우(73.5%)와 병소 내부의 방사선투과상이 균일한 경우(83.0%)가 대부분이었다. .병소와 관련된 피질골의 비박과 팽융이 대부분의 경우(78.6%)에서 나타났으며, 그 방향은 협측인 경우(58.6%)가 가장 많았다. .병소가 발생된 치아의 전위(37.5%)와 치근 발육의 지연(20.0%)이 나타났으며, 원인치아의 백악법랑 경계부와 치아부착부 사이의 거리는 2mm미만인 경우(79.6%)가 가장 많았다. .병소와 관련된 치아의 치조백선 소실(63.5%), 치아 전위(29.5%), 치근 흡수(26.0%)가 관찰되었으며, 하악관의 전위(50.0%)와 상악동 또는 비강의 전위(72.2%)가 관찰되었다. The purpose of this study was to obtain information on the clinical and radiographic features of the dentigerous cysts in the jaws. For this study, the author examined and analysed the clinical record and radiographs of 200 patients who had lesion of dentigerous cysts diagnosed by clinical and radiographic or histopathological examinations.. The obtained results were as follows: Dentigerous cysts occurred the most frequently in the 2nd decade(34.5%) and occurred more frequently in males(66.5%) than in females(33.5%). The most common clinical symptom was swelling of the jaw(31.0%), and the lesions were treated by the method of surgical removal The type of lesions was mainly observed as central type(84.5%), and size of the lesion was most frequently observed 2 ∼ 2.9cm in the widest length. The lesions were most frequently observed well-defined outline with hyperostotic border(50.5%), and smooth margin(73.5%), and homogeneous lesional radiolucency(83.0%). Cortical thinning and expansion of the lesions were observed at 78.6%, and their direction were most frequently observed toward buccal side(58.6%). The effect on the causative tooth were observed tooth displacement(37.5%) and delayed root development(20.0%), and distance between cemento-enamel junction and lesional wall attachment of the causative tooth were mainly observed as below 2mm(79.6%). The effect on the adjacent tooth were observed loss of lamina dura(63.5%), tooth displacement(29.5%), and root resorption(26.0%). And the effects on the adjacent anatomic structures were observed displacement of the mandibular canal(50.0%) and maxillary sinus or nasal cavity(72.2%).

방사선조사에 따른 구개점막상피의 형태학적 변화에 관한 실험적 연구

이강숙,손정익,최갑식,안상희 大韓口腔顎顔面 放射線學會 1994 Imaging Science in Dentistry Vol.24 No.2

The purpose of this study was to investigate the irradiation effects on the palatal mucosa. For this study, Sprague-Dawley strain rats were irradiated to their head and neck region with the dose of 5Gy and 10Gy by 6MV X-radiation and sacrificed on the experimental periods after irradiation. The authors observed the histological changes of the hard and soft palatal mucosae. The results were as follows: In the light microscopic examination, hydropic change on the basal cells, increased cell size of the epithelium, and decreased epithelial cell layers were observed on the 3hours, 6hours, and 12hours groups after irradiation. But, basal cell hyperplasia, increased epithelial cell layers, and elongated rete pegs were observed on the 3days group after irradiation. After then, these changes were recovered in the mucosa of the hard palate on the 7days and 14days groups, and in the mucosa of the soft palate on the 14days and 28days groups after irradiation. And such changes were greater in the mucosa of the soft palate than in that of the hard palate, and more prominent in 10Gy irradiated groups than in 5Gy irradiated groups.

일부 한국인 여성에 있어 교육수준과 순환기질환 위험요인과의 관련성

이강숙,박정일,김정아 가톨릭대학산업의학센타 산업의학연구소 1997 韓國의 産業醫學 Vol.36 No.3

This study was conducted to evaluate the cardiovascular risk factors associated with educational attainment in a group of 698 female who had regular health examination and had never taken medicine for hypertension, diabetes and hypercholesterolemia. By the questionnaire, the informations of education level, monthly income, physical activity, alchohol consumption and smoking habit were obtained. Height, weight, body mass index(BMI), blood pressure were measured by trained nurse, the level of fasting blood sugar, total cholesterol, high and low density lipoprotein (HDl and LDL) cholesterol, triglyceride were tested by enzyme method. Statistical analyses were done by SAS package program. We used the analysis of variation to examine differences of cardiovasclar risk factors among educational status. By using logistic regression adjusted for age and BMI, odds ratio of various cardiovascular risk factors were calculated in women less than high school graduate against and or more high school graduate. The results obtained were as follows : 1. There were significant differences among age groups in BMI, blood pressure, fasting blood sugar, and triglyceride. 2. Height, HDL cholesterol were positively associated with level of education and BMI, triglyceride, diastolic and systolic blood pressure, fasting blood sugar were negatively associated with level of education. As increasing income level, HDL cholesterol was significantly increased, but triglyceride was decreased. 3. Educational level was divided into three classes : less than high school, high school graduate, more than high school. The life style such as alcohol intake and smoking as a cardiovascular risk fator was not significant difference among education levels, but physical activity was increasing trend in over high school graduate. 4. The odds ratio of lower LDL, hypertriglyceridemia and hypertension were 1.57, 2.43 and 1.75 respectively, but after adjustment for age and BMI, hypercholesterolemia and high LDL were 0.54 and 0.49 in women less than high school graduate against and or more high school graduate. In conclusion, it was suggested that BMI, blood pressure, HDL cholesterol, triglyceride which were known for cardiovascular risk factors were associated with educational attainment, but they were not cleary influenced by educational attainment after adjusted for age and BMI. It may be that educated women are better informed about proper health behaviors and adopt them. However further study were need for evaluation comprehensive socioecomic status and cardiovascular disease risk factors.

정신과적 질환에 대한 업무상 인정기준

이강숙 가톨릭대학교 산업의학센터 2001 韓國의 産業醫學 Vol.40 No.2

With increasing the mental and behavioral disorders due to job-stress, it is necessary to establish the guideline for deciding the relevance to work. This paper reviews various causes and their mechanism of mental disorders due to job-stress, and the series of assessment for strength of stress in workplace or life-event, individual susceptibility, and alcohol dependency. The occurring time of disorder is very important in relation with work. Finnaly it suggested that the categories of mental disorder due to job-stress were F2(schizophrenia, schizotypal and delusional disorders), F3(mood or affective disorders), F4(neurotic. stress-related and somatoform disorders) by ICD-10