전공의들의 직업적 유해인자 및 직업만족도

송혜란,김진하,변주현,이광영,이덕희,김호찬 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.3

목적: 전공의는 여러 유해인자에 노출되어지고 있으며 과중한 업무로 인한 수면 부족에 시달리고 있다. 본 연구는 전공의의 건강상태의 기초 자료를 제공하고 향후개선 방안을 도출하기 위하여 시행하였다. 방법: 연구대상은 2000년 3사관학교와 국군군의학교에 입소한 전체 1,316명 중 전공의 수련과정 없이 입대한 의사와 치과의사, 한의사를 제외한 881명을 대상으로 설문지를 배포하여 784부(회수율: 89.0%)를 회수하고 이중 분석이 가능한 704(79.9%)명의 자료를 최종 분석하였다. 결과: 월평균 당진횟수는 레지던트 1년차에서 19회 정도이었다. 당직 시 평균 수면시간은 레지던트 1년차에서 4시간미만 이었다. 수련기간 동안 전공의의 20%이상에서 방사선, 레이저, 살균소독제, 마취가스, 항암제에 노출되었으며 예방대책은 방사선과 레이저의 노출의 경우 35%정도를 제외하고는 10%내외로 조사되었다. 연구대상자중 91.1%에서 수련기간 동안 주사침이나 시술에 의해 손상을 입었으며 그 중 본인이 감염된 경우는 HBV 2.3%(4명), HCV 0.6%(1명)으로 조사되었다. 응답자의 28.4%에서 자신의 직업에 불만족 하였으며 96.5%가 과중한 업무부담을 느꼈고 69.5%가 동일한 임금수준에서 직업을 바꾸고자 한다고 응답하였다. 결론: 전공의는 수련기간 동안 물리적, 화학적, 생물학적 유해인자에 노출되고 있었으나 이에 대한 보호나 예방대책은 거의이루어지지 않고 있었으며 과중한 업무부담으로 수면부족을 초래하여 가장 중요한 환자 진료에 지장을 받고 있었다. 수련기간 동안 대다수가 의사로서 직업에 대한 흥미를 가지고 있었으나 업무부담과 진료이외의 업무 등으로 소득과 조건이 비슷하다면 다른 직업을 선택하고자 하였다. 이상의 결과를 토대로 전공의들을 위한 유해인자의 보호대책 및 예방대책을 마련하며 과중예방대책이 마련되어야 하고 업무환경개선 및 업무로 인한 건강장해에 대한 정당한 보상이 향후에 마련되어야 할 것이다. Objects: Residents are exposed to various hazards and harassed by sleep dificiency due to overwork. This study was performed to outline the health condition of residents and develop the ways of improving it. Mehtods: A questionnaire was distributed to 881 army doctors who enrolled at the Korea Third Military Academy and The Armed force Health Service School in 2000 with the exception of medical doctors who joined the armed service without going through intern and resident periods, dental and oriental medical doctors. 784(89.0%) of the 881 questionnaires were resident of which 704 cases (79.9%). This should actually be 89.0% were regarded for analyses as being reliable data. Results: More than 20% of residents were exposed to radiation, laser, disinfectants, anesthetic gas, and anticancer drugs during their training periods with preventive neasures for each of these hazards taken in about 10% of the cases of the lesser hazards but in about 35% for the hazards from radiation and laser. 91.1% of residents had experience of needlestick injuries during theirtraining periods with over 36.3% being exposed to patients with infection during that time. The cases contracting HBV and HCV diseases due to pricking are 2.3% and 0.6% respectively. The average number of night duties per month during a one-year resident's period was about 10. The average sleeping time on duty during a one-year residents was less than 4 hours. 28.4% of respondents were not satisfied with their occupation, 96.5% delt tired from overwork and 69.5% wanted to change their occupation to another that would pay the same salary. Conclusion: Residents are exposed to harmful physical, chemical and biological factors, but the preventive care seldom undertaken. In addition, their overwork brings about lack of sleep which causes them problems when giving medical treatment to patients during their training periods. Despite the resident's interest in an occupation as a doctor, many intend to select other occupations if they can receive the same salary. According to the above results, preventative systems and measures should be prepared with environmental improvements for residents, and proper rewards for their overwork should be accomplished

행동억제 기질과 사회불안 및 긍정적 정서의 관계에 대한 연구 고찰

이혜미,송현주 서울여자대학교 2010 심리치료: 다학제적 접근 Vol.10 No.2

본 연구는 청소년기에 일반적으로 가장 흔하게 발생하는 불안장애의 하나인 사회불안의 특성에 대하여 알아보고, 사회불안의 발생요인 및 사회불안을 유지하게 하는 심리적 기제로 알려진 행동억제 기질과 사회불안의 관계에 대한 선행 연구들을 살펴보고자 하였다. 최근 들어 행동억제 기질과 사회불안과의 관계에 영향을 미치는 여러 변인들의 매개효과, 중재효과에 대한 연구가 많이 진행되고 있는데, 이에 대한 연구들에 대해서도 전반적으로 고찰해보고자 한다. 또한 대부분의 심리학이 정신 병리와 관련된 부정적 정서에만 초점이 되었던 과거의 시각에서 벗어나 긍정적 정서에까지 넓혀진 시각에 맞춰 사회불안과 긍정적 정서와의 관련성에 대해서도 살펴볼 것이다. 그렇게 함으로써 청소년기에 발생해 장기적 손상을 지속적으로 초래하는 사회불안 발생 및 치료적 중재, 조기 예방적 접근을 위한 기초 자료로 활용할 수 있는 방안들에 대해 탐색해 보고자 한다. This study wants to find out characteristics of a social anxiety which is a type of anxiety disorders that adolescents generally often have. In addition, it was intended to examine previous studies on causes of the social anxiety and its correlation with an behavioral inhibition, known as a psychological mechanism for maintaining the social anxiety. Recently, there have been many researches on mediated effects of variables which have influence on correlations between behavioral inhibition and the social anxiety, so it was considered to study the researches. While psychology focused on the negative emotions of psychological disorders in the past, but to get out of the narrow point of view, the correlations between the social anxiety and positive emotions would be considered here. The purpose of this study is to find out ways to build basic data for causes of the social anxiety which continuously imposes a long-term trauma on adolescents, and psychological intervention and early prevention of it.

아동기 실행기능 발달에서 부모양육 태도의 중요성에 대한 연구 및 고찰

황혜련,송현주 서울여자대학교 특수치료전문대학원 2011 심리치료: 다학제적 접근 Vol.11 No.1

The executive function are a collection of processes that are responsible for guiding, directing, and managing cognitive, emotional, and behavioral function, particularly during active, novel problem solving (Gioia, Isquith, Guy, & Kenworthy, 2000). It is proposed that favorable environmental experiences, especially those embedded within early caregiving relationships, may have a positive impact on brain development (Glaser, 2000; Nelson & Bloom, 1997; Schore, 1996, 2001). Parenting quality mediated the effects of family resources on children's performance at all age (Julieta Lugo-Gil & Caterine S, 2008). Parent-child relationships may play an important role in children's developing self-regulatory capacities (Narasha Whipple, 2010). However, until now there have been few studies on parent-child executive function. Therefore, this researcher studied executive function in the childhood and parents' fostering attitude in order to prove the existing studies. Key words:executive functions, parenting.

고등급 이형성을 보인 편평톱니샘종

권경주,정성애,심기남,정정화,강석형,송도경,전승정,김혜인 이화여자대학교 의과학연구소 2012 EMJ (Ewha medical journal) Vol.35 No.1

Until recently, colorectal polyps were classified predominantly as hyperplastic or adenomatous. While adenomatous polyps are well-characterized precursor lesions of adenocarcinomas, hyperplastic polyps have been considered as benign lesion. However, some hyperplastic polyps with serrated morphology of the crypts have been recognized to have distinctive features and these polyps were termed ‘serrated adenomas’. Recent data show that sessile serrated adenomas (SSA) might be the precursors of serrated colonic cancers, underlining the necessity of identifying them. SSA is approximately 3% of all polyps, commonly appears as flat or sessile and yellowish due to mucus production. In the pathogenesis of SSA, progression to high grade dysplasia or early invasive carcinoma may be associated with serrated neoplasia pathway different from adenoma-carcinoma sequence. We report a case with a colon polyp diagnosed as sessile serrated adenoma with high grade dysplasia after endoscopic submucosal dissection.

프리셉터 경험이 간호업무수행과 직무만족에 미치는 영향 연구

류언나,송혜숙,장은희,서효신,추연화,김인선,나명주,지성애,박경숙 중앙대학교 간호과학연구소 2001 중앙간호논문집 Vol.5 No.2

The purpose of this study was to investigate how preceptor experience has an effect upon preceptor nurses. This study was so designed that it could compare the difference between clinical performance and Job satisfaction of preceptor nurses and those of nonpreceptor nurses. Study subjects were sampled out from those nurses who worked with two university hospitals where preceptor programs were implemented. The number of subjects totaled to 134, including 69 preceptor nurses and 70 nonpreceptor nurses. The score of preceptor nurses' clinical performance and job satisfaction revealed a higher value than that of nonpreceptor nurses. A similar result was also shown in the subdomains. However these difference were not statistically significant. Among all of the preceptor nurses, the highest number of preceptor experience was just one time. Except for five times in preceptor experience, the more the number of times of preceptor experience, the higher score in clinical performance. It was manifested that the number of preceptor experience was not related to job satisfaction. The score of preceptor nurses' clinica1 performance and job satisfaction revealed a higher value than that of nonpreceptor nurses. A similar result was also shown in the subdomains. However these difference were not statistically significant. The reward that preceptor nurses wished most was a reduction of the work load assigned to them. Currently preceptor nurses are only receiving a small quantity of financial reward related with their preceptor role. Most of preceptor nurses (96.8%) were not satisfied with their existing reward. Almost half of the preceptor nurses(43.5%) did not want to play a role as preceptor again. The reason why the scores of clinical performance and job satisfaction were low might be attributed to the inadequate preceptor training program and reward system. Appropriate knowledge and clinical skill are expected to enhance the level of preceptor nurses' clinical performance and appropriate internal and external reward to elevate the level of preceptor nurses' Job satisfaction. Therefore, it is needed for us to develop more effective preceptor education program, financial reward, support of colleague nurses and nursing managers, and adjust workload for the purpose of more effective preceptor programs.

식품 기준·규격의 합리적 관리 ·운영에 관한 연구(Ⅰ) : 두부,식용유지, 전분의 분말상 원료에 관하여 Powdered marerials of Tofu, Edible oil, Starch

김희연,홍진환,박혜경,한상배,박종석,이은주,이정성,송경희,최은희,최영준,소경아,성영제,이주엽 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-

본 연구는 분말상 원료(전분, 대두분)의 저장유통시 품질변화를 건전성과 안전성 측면에서 검토하여 식품의 기준 ·규격 설정f.」 합지적으로 반영하고자 하였다. 전분과 패두분의 이물을 검사하고, 2종 대두분(중국산, 미국산)을 ?0일간 IS'c와 30t에 저장하면서 성상, 수분, 산가, 과산화물가, 지방산 조성,아플라톡신 BB의 생성여부를 분석하였다. 중국산 대두분 30'』 저장군에서 50일 이후 곰팡이가 발생한 것 이외에 모든 시료에서 양호한 성상을 나타내었고, 전분과 대두닥 모든 시료에서 이물은 검출되지 않았다. 산가는 중국산과 미국산 시료간에 편차를 보여 증국산 30"C, 50일 저장시료에서 약 10배끙도 증가하였고, 과산화물가는 저장 90일후 15'E 저장군은 약 2.3배, 30'c 저장군은 3배정도 증가하였다. 대두분의 주요 지방산은 linoleic acidf18. 2), oleic acid(18 : 1), palmitic acid(16 : 0)이었으며, 3개월 저장에 따른 지방산 함량의 변화는 미미하였다. 아플라톡신 B₁은 모든 시료에서 검출되지 않았다. The objective of this study was to investigate auality changes of type raw materials(starch, soy flour) during various storage conditions. Starchflour(source of China, U.S.A) were slfred under two temperature(15'C, 30'c) forSensory evaluation, (o.reign material test, moisture content, acid value, peroxide ualue,composition, aflatorin Bi were analyzed. China soy flour(stor·ed 30'f) was contaminated by fungj on 50 days. Except for soy flour contardnated by fungi, sensory characteristics were not changed and foreign mater;als were notdetected. Acid value of China soy flour(stored at 30'C, 90 days) was about 10 times higherlevel before storage and acid value was more influenced by source(China, USA). Peroxide valuewas in proportion with the storage period slightly. The major fatty acid of soy flour waslinoleic acid(18 . 2), an(3 the change of fatty acid composition was not observed. Aflatoxlrl Blwas not detected.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

Tissue-specific Regulation of Calbindin-D<SUB>9κ</SUB> Gene in Transgenic Mouse

Hye Kyoung Song,Joo-Hyoung Kang,Kun Yeong Lee,Jae-Hoon Choi,Sun Ja Cho,Young-Han Ryu,Eun-Young Kim,Seung Phil Park,Hye Jin Kim,Eun-Kyoung Kim,Yun Jeoung Seo,Sung Kyu Park,Goo Taeg Oh(오구택) 한국실험동물학회 2004 한국실험동물학회 학술발표대회 논문집 Vol.2004 No.-

The etiology of potential small-bowel bleeding depending on patient’s age and gender

Song, Joo Hye,Hong, Sung Noh,Kyung Chang, Dong,Ran Jeon, Seong,Kim, Jin-Oh,Kim, Jinsu,Lee, Bo-In,Choi, Myung-Gyu,Kim, Kyeong Ok,Yang, Dong-Hoon,Song, Hyun Joo,Hyuk Do, Jae,Jeong Lim, Yun,Shim, Ki-Nam SAGE Publications 2018 United European gastroenterology journal Vol.6 No.8

<B>Background</B><P> Whether the etiology of potential small-bowel bleeding depends on the age and gender of the patient is not yet fully understood. </P><B>Methods</B><P> A total of 1953 patients who underwent video capsule endoscopy (VCE) to evaluate potential small-bowel bleeding and were registered in the Capsule Endoscopy Nationwide Database Registry from 2003 to 2014 were eligible for this study. VCE findings and the etiology of small-bowel bleeding were analyzed by age and gender. </P><B>Results</B><P> The diagnostic yield of VCE was 48.4% (95% CI: 46.2%-50.6%) and the diagnosis rate of etiology of potential small-bowel bleeding was 61.4% (95% CI: 59.2%-63.6%). The etiology of potential small-bowel bleeding depends on the age and gender of the patient. Crohn's disease and small-bowel diverticular diseases were more prevalent etiology of potential small-bowel bleeding in the young adults group (@@<@@ 40 years) whereas angiodysplasia was revealed to be a most common etiology in elderly group (≥ 60 years), reaching statistical significance ( p@@<@@0.00152) by Bonferroni correction. </P><B>Conclusions</B><P> The etiology of potential small-bowel bleeding depends on the age of the patient. Thus, an individualized lesion-specific diagnostic approach based on age might be needed for patients with potential small-bowel bleeding. </P>

Long-term Outcomes after the Discontinuation of Anti-Tumor Necrosis Factor-α Therapy in Patients with Inflammatory Bowel Disease under Clinical Remission: A Korean Association for the Study of Intestinal Disease Multicenter Study

( Joo Hye Song ),( Eun Ae Kang ),( Soo-kyung Park ),( Sung Noh Hong ),( You Sun Kim ),( Ki Bae Bang ),( Kyeong Ok Kim ),( Hong Sub Lee ),( Sang-bum Kang ),( Seung Yong Shin ),( Eun Mi Song ),( Jong Pi 대한소화기기능성질환·운동학회 2021 Gut and Liver Vol.15 No.5

Background/Aims: Our study aimed to evaluate the long-term outcomes and risk factors for relapse after anti-tumor necrosis factor (TNF)-α cessation in inflammatory bowel disease (IBD) patients because they are not well established. Methods: A retrospective multicenter cohort study was conducted involving patients with Crohn’s disease (CD) or ulcerative colitis (UC) from 10 referral hospitals in Korea who discontinued firstline anti-TNF therapy after achieving clinical remission. Results: A total of 109 IBD patients (71 CD and 38 UC) with a median follow-up duration of 56 months were analyzed. The cumulative relapse rates at 1, 3, and 5 years were 11.3%, 46.7%, and 62.5% for CD patients and 28.9%, 45.3%, and 60.9% for UC patients. Multivariable Cox analysis revealed that discontinuation owing to the clinician’s decision was associated with lower risk of relapse (vs patient’s preference: hazard ratio [HR], 0.13; 95% confidence interval [CI], 0.04 to 0.48; p=0.002) and adalimumab use was associated with higher risk of relapse (vs infliximab: HR, 4.42; 95% CI, 1.24 to 17.74; p=0.022) in CD patients. Mucosal healing was associated with lower risk of relapse (vs nonmucosal healing: HR, 0.12; 95% CI, 0.02 to 0.83; p=0.031) in UC patients. Anti-TNF re-induction was provided to 52 patients, and a response was obtained in 50 patients. However, 25 of them discontinued retreatment owing to a loss of response (n=15), the patient’s preference (n=6), and other factors (n=4). Conclusions: More than 60% of IBD patients in remission under anti-TNF therapy relapsed within 5 years of treatment cessation. Anti-TNF re-induction was effective. However, half of the patients discontinued anti-TNF therapy, and 50% of these patients discontinued treatment owing to loss of response. (Gut Liver 2021;15:752-762)