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.

담낭 방선균증 1예

김형수,정진원,김양수,우준희,송현순,류지소,김명환,김남중 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

저자들은 우상복부 통증과 소화불량을 주소로 내원한 83세 여자 환자에서 국내 최초로 담낭 방선균증을 진단하고 치료 관찰 중으로 이에 문헌고찰과 함께 보고하는 바이다. Actinomycosis is a chronic suppurative and granulomatous disease, characterized by abscess formation, tissue fibrosis, and draining sinuses. Actinomycosis of the gallbladder is very rare and has not yet been reported in Korea. We report a case of actinomycosis of the gallbladder in an 80-year-old women with history of cholelithiasis for 3 years, preoperatively misidentified as gallbladder cancer. Histologic section of the gallbladder showed Gram-positive branching bacilli compatible with actinomyces. After cholecystectomy, the patient received intravenous ampicillin for 4 days, followed by amoxicillin for 4 months thereafter.

Health Behaviors Before and After the Implementation of a Health Community Organization: Gangwon’s Health-Plus Community Program

Hyeong,Kim Nam-Jun,Kim Soo-Hyeong,박웅섭 대한예방의학회 2023 예방의학회지 Vol.56 No.6

Objectives: Community organization is a resident-led movement aimed at creating fundamental social changes in the community by resolving its problems through the organized power of its residents. This study evaluated the effectiveness of health community organization (HCO), Gangwon’s Health-Plus community program, implemented from 2013 to 2019 on residents’ health behaviors.Methods: This study had a before-and-after design using 2011-2019 Korea Community Health Survey data. To compare the 3-year periods before and after HCO implementation, the study targeted areas where the HCO had been implemented for 4 years or longer. Therefore, a total of 4512 individuals from 11 areas with HCO start years from 2013 to 2016 were included. Complex sample multi-logistic regression analysis adjusting for demographic characteristics (sex, age, residential area, income level, education level, and HCO start year) was conducted.Results: HCO implementation was associated with decreased current smoking (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.57 to 0.95) and subjective stress recognition (aOR, 0.79; 95% CI, 0.64 to 0.97). Additionally, the HCO was associated with increased walking exercise practice (aOR, 1.39; 95% CI, 1.13 to 1.71), and attempts to control weight (aOR, 1.36; 95% CI, 1.12 to 1.64). No significant negative changes were observed in other health behavior variables.Conclusions: The HCO seems to have contributed to improving community health indicators. In the future, a follow-up study that analyzes only the effectiveness of the HCO through structured quasi-experimental studies will be needed.

서남해안 지방에서 발생한 Vibrio vulnificus 감염의 임상적 고찰

조남수,김춘호,김성중,김용배,조수형,안태훈 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: V. vulnificus infection in found between May and October when the man who has hepatic disorder or immunity disorder eats raw shellfish and it causes the systemic symptoms such as sudden fever, chilling, shock and stupor and local skin lesions like bleb and necrosis. This disease has 46∼61% of fatality rate in spite of intensive treatment. This study conducts the examination of history, epidemic study, ingesting raw fish and bacteriologic investigation in the patients with similar clinical symptoms to the above and examines the diagnostic dorrelations. Method: It is conducted with 31 cases who admitted at emergency medical center of Chosun University Hospital from May of 1995 to September of 1998 and are suspected to have V.vulnificus infection. It analyze bacteriologic examination, the survey of residence, eating raw shellfish, hepatic disorder, alcohol drinking habits and skin lesion. Results: 1) The rate of male and female is 15.5:1 and in the age, 18 cases are in fifties, seven are in forties and six are over sixties. 2) Clinically, V.vulnificus is detected in 20 of 31 cases which is suspected to have V.vulnificus infection and it is not detected in 5 cases. Other bacteria are detected in 6 cases and they include staphylococcus aureus, pseudomonas species, β-hemolytic streptococcus and E-coil. 3) In local distribution, Kohung has 10 cases, Shinan and Mokpo have six, Haenam and Kangjin have five, Yongkwang and Muan have five, Naju and Yongam have five and Kwangju has one. 4) Eating fishes and raw shellfishes is found in 31 cases. In the kind of shellfishes, eating raw clam is 10 cases, raw thin-shelled surf calm is 8 cases, raw oyster is 5 cases and sliced raw fish is 4 cases and pickled sea foods are 4 cases. 5) The cases with hepatic disorder are 23 and 15 cases with heavy alcohol drinking Carrier are included. The cases with Diabetic Mellitus are four and those with pulmonary tuberculosis are two. Two cases have not basal diseases. 6) On the opinion of skin lesion, 20 cases show vesicular necrosis, 7 cases have dendriform erythema, 3 cases have papule and one case doesn't show clear skin lesion. Conclusion: When V.vulnificus infection is detected, it is fatal and those who have hepatic disorder or heavy alcohol drinking habit must avoid eating fishes and shellfishes raw in summer. It is important to have emergency treatment for the patient whose V.vulnificus infection is suspected. It is considered that the administration of initial antibiotics is effective by generalizing the clinical symptom, epidemic opinion and patient history even before the results of bacteriologic confirmed.

흡착제로써 폐자원을 이용한 염색폐수의 색도제거

김은호,성낙창,김수생,김국태,이영형 동아대학교 환경문제연구소 1998 硏究報告 Vol.21 No.1

Dyeing has always had a pressing need for techniques that allow economical pretreatment for color removal in wastewater. The effectiveness of adsorption for color removal from dyeing wastwater has made it an ideal alternative to other expensive treatment options. This study deals with an investigation on four waste resources locally available in dyeing wastewater treatment for color removal. Peat, bentonite, slag and fly ash were utilized for this study and their performance evaluated against that of granular activated carbon. Color of dyeing wastewater was high removed in peat, bentonite and slag except for fly ash. In point of recycling, if waste resources substituted for a valuable adsorbent such as granular activated carbon, peat, bentonite and slag could look forward to an expected economical effect.

모균증(Mucormycosis)의 임상적 고찰

김준명,박형천,김 응,홍천수 대한감염학회 1994 감염 Vol.26 No.4

목적: 모균증은 치명적인 진균감염증으로 생체의 면역학적 방어력이 감소되었을때 잘 합병되는 기회감염이다. 모균은 자연계 도처에 존재하나 정상인에서는 잘 감염되지 않으며, 당뇨병, 백혈병, 임파종, 장기이식등과 같은 면역저하 상태에서 잘 발생한다. 국내에는 지금까지 약 13예가 산발적으로 보고되었으며 최근 각종 항생제의 사용증가, 스테로이드제제의 과용, 항암제의 사용 등으로 감염에 대한 환자의 저항력이 약화됨에 따라 모균증이 증가하는 추세를 보이고 있다. 방법: 저자들은 1986년 3월부터 1993년 6월까지 연세대학교 의과대학 세브란스병원에서 모균증으로 진단받은 15명의 환자의 임상적 특성을 관찰하여 다음과 같은 결과를 얻었다. 결과: 1) 모균증의 남녀의 비는 1:1.1로 남녀 성별 차이는 없었고, 연령분포상 50대에서 가장 많이 발생하였다. 2) 임상형태에 따른 분류상 총 15예 중 비대뇌형 모균증이 13예였고, 위장관형모균증이 2예 있었다. 3) 대부분 선행질환을 동반하였고, 비대뇌형모균증의 경우 당뇨병이 5예로 가장 많았고 위장관형모균증은 모두 급성백혈병에서 발생하였다. 4) 초기증상은 비대뇌형모균증의 경우 두통과 안와부동통이 가장 많았고 위장관형모균증의 경우 복부동통이 초기에 나타났다. 5) 치료는 근치적 절제술과 항진균제의 병합요법이 총 15예 중 10예에서 사용되었고, 4예에서는 외과적 수술만 시행하였고 1예에서는 스테로이드제제만 사용하였다. 6) 예후는 일반적으로 불량하여 전체 생존률이 64%였고, 비교적 전형적인 모균증의 증상과 증후를 나타낸 경우 모두 사망하였다. 결론: 모균증은 생체의 면역학적 방어력이 감소되었을때 호발하는 치명적인 진균감염증으로 조기진단과 초기치료가 중요하다. 치료는 대개 외과적 절제술과 항진균제의 병합요법이 사용되며 적극적인 치료에도 불구하고 상당히 불량한 예후를 보인다. Background: Mucormycosis is a highly virulent and rapidly progressive disease with a grave prognosis. It encompasses a distinctive group of infections caused by fungi belonging to order Mucorales. These fungi are widespread in nature, subsisting on decaying vegetation and diverse organic materials. The infection occurs almost exclusively in immunocompromised hosts and poses difficult diagnostic challenge to physicians. The aim of the study was to investigate the clinical characteristics of patients with mucormycosis. Methods: Clinical characteristics of mucormycosis was examined by retrospective review of 15 patients diagnosed as mucormycosis at Severance hospital from March 1986 to June 1993. Results: 1) Mucormycosis occured most frequently in the 6th decade. 2) Underlying diseases, frequently diabetes mellitus, were usually present. 3) Headache and ocular pain were the most common initial symptoms in rhinocerebral mucormycosis. 4) Ethmoid and maxillary sinuses were the most frequently involved sites. 5) Radical surgery combined with Amphotericin B was the treatment of choice. 6) Mortality rate was 36%(5/14) among those who were followed. Most patients with high mortality rate had underlying disease, especially diabetes and liver cirrhosis. Conclusion: Mucormycosis is a fatal fungal infection usually arising in immunocompromised patients. Early diagnosis and timely institution of aggressive treatment is sine qua non for patients with mucormycosis.

간혈관종: 초음파 검사상 종양 에코와 삼중시기 나선식 전산화단층촬영상 조영증강양상과의 관계

김일영,한건수,신형철 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Purpose: To evaluate the relation of internal echo and enhancement patterns on three phase spiral CT in hepatic hemangioma. Methods: This retrospective study included 41 cases in 34 patients who were diagnosed as hepatic hemangioma who had ultrasonography and three phase spiral CT scan. We classified hepatic hemangioma as two different groups according to the findings of internal echo on ultrasonography. Three phase spiral CT images were obtained at 30 seconds(arterial phase), 60 seconds( portal phase), and 3-5minutes(delayed phase) after the initiation of injection of contrast materials(120ml, 2.7ml/sec). Enhancement patterns of hemangiomas during three phases were classified as total high attenuation, peripheral high attenuation, low attenuation, or iso attenuation. Results : The most common enhancement pattern of hemangioma on three phase spiral CT was peripheral high attenuation in whole three phases in both high and low echoic groups. There was no statistical significance(P>0.1). Total high attenuation in whole three phases on three phase spiral CT is 3 cases(3/13, 23%) in low echoic group and 1 case(1/28, 4%) in high echoic group. It is statistically significant(P<0.1). Conclusion: The enhancement patterns on three phase spiral CT is different between low and high echoic group. Total high attenuation in whole three phases on three phase spiral CT is more in low echoic group than in high echoic group.

割賦賣買

金炯秀 朝鮮大學校 法學硏究所 1999 法學論叢 Vol.5 No.-

쯔쯔가무시병 환자들의 합병증 발생과 관련 있는 임상 소견

김경진,조남수,조수형 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: Tsutsugamushi disease is an acute, rashed febrile disease that shows widely varying prognoses from unsymptomatic infection to death. Early diagnosis and treatment lead to speedy recovery. Otherwise, many complications develop. This research was carried out to analyze the factors that affect the development of complications by comparing Tsutsugamushi patients with complicaions with those without complications. Methods: Among the acute febrile disease patients who visited the emergency center of Chosun University Hospital from January to December 2000, 41 patients were clinically and serologically confirmed as having Tsutsugamushi disease. They were divided into two groups; 14 patients with complications and 27 patients without complications. We analyzed the two groups for correlations between complications and sex, age, period of occurrence, transfer or not, vital signs, laboratory findings, period before treatment, and checks for the existence of underlying disease, eschar, eruption, chest X-rays, and early diagnosis. Results: 1) The aged have a high incidence of the disease, but there was no correlation between age and complications. Also, there was no correlation based on sex. 2) Although fall has a high incidence of the disease, the other seasons have higher complication rates. 3) The complication incidence rate has no correlation with either blood pressure or heart rate, also it does no correlate with eschar and skin rashes. 4) In the laboratory findings, hemoglobin and platelet, and Bun/Cr correlate with the complicaton incidence rate, but the white blood cell count and AST/ALT do not. 5) The complication incidence rate was high when treatment was started 10 days after the onset of Tsutsugamushi disease and no early diagnosis had been given. Conclusion: Early diagnosis and treatment are most important in preventing complications of Tsutsugamushi disease because the factors that affect the developement of complications of Tsutsugamushi disase are found during early diagnosis. Patients with doubtful clinical symptoms and abnormal lab findings should be started on a program of antibiotic treatment.

PGA에 의한 교량의 손상도 곡선

김종인,이수철,김태형 대구대학교 산업기술연구소 2003 産業技術硏究 Vol.15 No.1

In performing a risk analysis of structure for earthquake, it is imperative to identify the vulnerability of structures associated with various stages of damage. And the earthquake resisting capability is needed for structures like bridge. So the damage analysis of bridges with or without isolator for earthquake effects is necessary. In this paper, the method for construction of fragility curve is presented. In doing that. general purpose structural analysis program and generally used probability density function are used. The results of structural analysis are represented by Bernoulli distribution which says damage or no damage. By the use of Maximum Likelihood Method. two parameters of lognormal distribution -median and standard deviation - are found. With them, the fragility curves are constructed. In this paper, the fragility curves of bridge are constructed with respect to PGA(Peak Ground Acceleration). The results of this study are as follows: (1) As the result according to research, we got the Fragility Curve to have median and standard deviation as 0.242 0.262 respectively. (2) For PGA, the fragility curve is distributed on relatively wide range of PGA. So it can be a good measure for evaluation of damage effect with respect to PGA.