십이지장의 평활근육종 1례

윤세진,김영건 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

We reported a case of 51-year old female who was diagnosed primary leiomyosarcoma in duodenum confirmed by post-operation pathologic diagnosis. She complained of melena and general weakness. The endoscopy revealed mass with central necrosis in third portion of duodenum. The endoscopic biopsy showed nonspecific inflammation and ulcer. The case was performed segmental resection and end-to-side duodeno-jejunostmy. Final postoperative diagnosis is low grade leiomyosarcoma in duodenum second and third portion.

완전대혈관 전위의 심방내 교정술 후 추적 관찰

김연우,노정일,허준,윤명자,김호성,최정연,윤용수,양세원,이정렬,김용진,노준량 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

서비스직 근로자의 감정 노동과 우울 수준

김수연,장세진,김형렬,노재훈 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.3

목적 : 본 연구는 조직의 규범화된 감정표현 규칙을 통해 감정 노동을 수행하는 서비스직 근로자들과 감정노동을 수행하지 않는 근로자들 대상으로 우울 수준의 정도를 비교하고, 감정 노동이 우울 수준과 어떠한 관련성을 보이는가를 파악하고자 하였다. 방법 : 서울의 백화점, 호텔, 외식업체에서 대면접객 서비스를 수행하는 331명의 감정 노동군과 서울의 한 공공기관의 사무직 근로자 90명, 인천의 한 전자제품 조립공장의 생산직 근로자 60명의 총 150명의 비감정 노동군을 대상으로 구조화된 설문지를 이용하여 직무 긴장도 및 직업불안정성, 직무만족도, 감정 노동, 우울 수준을 측정하기 위한 설문조사를 실시하였다. 결과 : 첫째, 감정 노동군이 비감정 노동군에 비해 직업불안정성과 우울 수준이 통계적으로 유의하게 높았으며, 직무만족도와 직무요구도, 직무자율성은 비감정 노동군에 비해 유의하게 낮았다. 둘째, 감정 노동군에서 우울 수준은 직무요구도, 직업불안정성과 양의 상관관계를 보였고 직무자율성, 직무만족도와는 음의 상관관계를 보였다. 감정노동정도는 직무요구도와 우울 수준간에는 양의 상관관계가, 직무자율성 및 직무만족도와는 음의 상관관계가 발견되었다. 셋째, 감정 노동군과 비감정 노동군을 전체 대상자로 하여 분석한 결과, 감정 노동을 하고 직업불안정성의 정도가 클수록, 그리고 직무 만족도가 낮을 수록 우울 수준이 높았다. 넷째, 감정 노동군에서는 직무에 대한 안정성이 낮을수록, 직무만족도가 낮을수록, 그리고 감정 노동 정도가 높을수록 우울 수준이 높았다. 결론 : 감정 노동군이 비감정 노동군과 달리 감정 노동을 수행함으로써 우울 수준이 더 높았으며, 이는 감정의 표현이 개인의 자발성으로부터 표출되는 것이 아닌 외부의 힘에 의해강요된 노동으로 나타나는 경우 그 것 자체가 개인의 우울 정도와 관련이 있다는 의미로 해석할 수 있다. 또한 낮은 직무만족도 역시 우울 수준의 증가와 관련이 있음을 알 수 있었다. 따라서 감정 노동수행 근로자들의 우울 수준을 감소시키기 위한 전략으로 기업 이윤의 균등 분배, 근로자들의 복지제도 향상, 직무 스트레스 감소 프로그램의 개발 등을 통해 근로자들의 높은 직무 만족도를 향상시킬 수 있는 제도적 보완장치가 절실히 요청되며, 그 동안 부수적(complementary) 형태의 노동, 혹은 인격과 같은 개인적 차원의 문제로 축소되거나 은폐되어왔던 감정 노동을 하나의 노동과정으로 새롭게 인식하는 문제에 대해 관심을 가져야 할 것이다. Objectives: This sudy was designed to identify the relationship between emotional labor and depressive symptoms among Korean indusrial service employees. Methods: The case group consisted of 331 employees who were performing emotional labor at department stores, hotels, and family restaurants in Seoul. The control group in this study consisted of 150 employees (90 officers in Seoul and 60 manufacturing workers in Incheon) who were not expected to perform emotional labor. A structured questionnaire was used to estimate each participants level of emotional labor, general characteristics, job content, job satisfaction, and any depressive symptoms. The measurements for emotional labor were performed only on the case group and not the control group. Results: While the mean values of job satisfaction, job insecurity, and the level of depressive symptoms of the employees who were working in the area of emotional labor were higher than the others, the mean values of job demand, and job control in the same group were lower than those who were not performing emotional labor. Overall, it was found that performing emotional labor and having high levels of job insecurity were related to increased depressive symptoms, and conversely, job satisfaction played a role in reducing depressive symptoms. Similarly, in the sub-sample of the emotional labor group, high levels of job insecurity, and preforming high degrees of emotional labor, and low job satisfaction were associated with depressive symptoms. Conclusions: These results suggest that performing emotional labor is related to an increase in depressive symptoms. In other words, involuntary emotional expression and low job satisfaction in the workplace may influence the level of depressive symptoms in workers. It is, therefore, imperative that further research be undertaken, which considers the importance of emotional labor, and its adverse effect on the mental health of service workers.

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.

위암조직에서 Carcinoembryonic Antigen 측정의 의의

정현용,윤세진,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

To estimate tumor CEA expression of stomach cancers in relation to normal mucosa CEA, degree of cellular differentiation, pathologic stage and other clinicopathologic findings, we measured CEA concentrations in tissue extracts by radioimmunoassay for 24 cases of stomach cancer. The results were as follows: 1. Ranges of tissue CEA concentrations in normal stomach mucosa was from 6.Ong/gm to 15.4 ng/gm(mean 10.2ng/gm). 2. Mean conceatrations of cancer tissue CEA was 42.1ng/gm(from 2.9 ng/gm to 414.Ong/gm), 4 times higher than normal mucosa. In 46% of stomach cancers, tissue CEA concentrations was above normal cut off value(18.7ng/gm). 3. Tiuse CEA concentrations of stomach cancer was significantly high as high CEA levels of normal mucosa(r=0.6954), not related to serum CEA concentrations. 4. Tissue CEA concentrations of stomach cancer was high as high TNM stage, but was not related to wall invasion depth, lymph node metastasis, cellular differentiation and other clinicopathologic findings. In conclusion, the production of CEA in stomach cancers was significantly increased in half cases, CEA expression of tumor was related to pathologic stage rather than cellular differentiation. The factors determined CEA production was considered more higher levels such as DNA profile. To estimate prognostic values of tissue CEA concentrations, follow up of included patients and further study should be pursued.

간경변증 환자에서의 위 배출 시간

기주영,채희복,박선미,윤세진,정현용 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

간경변증 환자에서 소화기 증상의 정도와 울혈성 위염, 복수의 유무가 위 배출 시간의 지연과 관련이 있는지 알아보고자 하였다. 대상 환자는 2001년 3월 1일부터 2002년 5월 31일까지 간경변증으로 진단 받은 33명의 환자를 대상(평균연령 54.3세)으로 하였고, 정상 대조군을 위 장관 질환의 과거력이 없고 소화 장애등의 자각증상이 전혀 없으며 위 배출등에 영향을 줄 수 있는 약물 복용이나 전신 질환이 없었던 15명을 대상(평균 연령 30세)으로 하였다. 위 배출 시간검사는 50gm의 달걀 1개에 Tc^(99m)-tincolloid lmCi를혼합하여 고형질화 시킨 TC^(99m)-tin-colloid-steamed egg를 섭취한 후부터 single-head-gamma camera(Picker Co,. USA)을 이용하여 위 배출 시간 반감기(T1/2)를 찾아냈으며 위배출 시간은 T1/2의 평균±표준편차로 표시하였다. 위 배출 시간의 지연은 정상 대조군 T1/2의 mean±1 SD(45.0+12.7분) 이상으로 하였다. 정상 대조군(n=15)의 위 배출 시간은 42.64±16.80분이었고, 간경변증 환자군(n=33)은 42.54±20.80분으로 두 군 사이에 유의한 차이가 없었고, 울형성 위염 및 복수의 유무, 증상점수 4점을 기준으로 하였을 때 위 배출 시간은 두 군 사이에 유의한 차이가 없었다. 식도 정맥류가 있는 군(n=26)과 없는 군(n=7)의 위 배출시간은 각각 49.27±16.80분, 31.71±10.61분이었고, 위 정맥류가 있는 군(n=7)과 없는 군(n=26)의 위 배출 시간은 각각 53.14±11.71분, 43.50±5.85분으로 정맥류가 있는 군에서 위 배출 시간의 지연을 보였으나 통계적으로 유의하지는 않았다(식도 정맥류 p=0.654, 위 정맥류 p=0.991). 혈청 알부민 수치와 위 배출 시간 반감기는 서로 유의한 상관관계가 없었다(p=0.177). 결론적으로, 간경변증 환자에서의 소화불량 증상의 정도와 울혈성 위염, 복수의 유무에 따라 위배출 시간에 차이가 없었다. The purpose of this study was to evaluate whether delayed gastric emptying time(GET) was associated with the degree of gastrointestinal discomfort, congestive gastropathy, and ascites in patients with liver cirrohsis. Thirty three patients, aged 54.3 years, with liver cirrhosis and fifteen control subjects, aged 30 years, without gastrointestinal symptoms and history of gastrointestinal disease were participated from the first of March in 2001 to the 31st of May in 2002. For GET, solid phase gastric emptying was done with radionuclide scintigraphy using single-head gamma camera after ingestion of Tc99m tin-colloid-steamed egg. Delayed GET was defined as the half time period in GET(T1/2) longer than the mean value plus 1SD of controls (45.0+12.7min). GET between Control group and patients with liver cirrhosis was 42.64±16.80min, 42.54+20.80, respectively. Therefore, there is no significant difference. On the base of congestive gastropathy, symptom score '4', and cirrhosis, there is no difference statistically between two groups. GET measured in the group with esophageal varix(n=26) or without esophageal varix(n=7), was 49.27±16.80min, 31.71±10.61min, respectively. GET measured in group with gastric varix or without varix, was 3.14±11.71min and 43.50±5.85min, respectively. But, there is no difference statically between two groups. There was no significant correlation between serum albumin level and T1/2 of GET(p=0.177). This study shows that there is with no apparent clinical difference between gastric emptying time and liver cirrohtic patients with gastrointestinal discomfort, congestive gastropathy, and ascites.

장상피화생과 Helicobactor pylori와의 상관 관계에 관한 연구

이복희,김대수,이현숙,진영주,윤세진,송형근,성노현,정현용,이동호 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

In 1965 Lauren divided advanced gastric carcinoma into two main types-namely, "intestinal" and "diffuse" type carcinoma, which differ not only morphologically but also in their clinical and epidemiological characteristics. Moreover, a different histogenetic process has been postulated by many authors that intestinal type gastric carcinoma might arise from areas with intestinal metaplasia. Since Warren and Marshall reported the presence of Helicobacter pylori in the stomach in 1983, strong evidence has been obtained that there is a close relationship between Helicobacter pylori and chronic gastritis, atrophic gastritis, intestinal metaplasia, and intestinal type gastric carcinoma. To study the relationship between intestinal metaplasia and Helicobacter pylori infection, we performed gastroscopic biopsies and CLO tests taken from patients with epigastric pain. Only 87 patients with macroscopically suspected antral gastritis were included. The prevalence of intestinal metaplasia in gastric antral biopsies increased from 33.3% in the age group<30 years to 63.6% in the age group 60 years. When all patients were divided into two age groups-namely, (i)<50 years(n=41) and (ii)≥ 50 years(n-=46), intestinal metaplasia was found significantly more often in patients ≥ 50 years. ((i) 39.2%, (ii) 54.3%, p<0.0001). The prevalence of Helicobacter pylori in gastric antral biopsies decreased from 66.7% in the age group<30 years to 62.5%, in the age group in the age group 50 to 59 years. When all patients were divided into the same two age groups-namely(i)<50 years and (ii)≥50 years, the prevalence of Helicobacter pylori did not differ between two groups in a statistically significant way. The mean age of intestinal metaplasia positive patients who were also Helicobacter pylori positive was 48±11.0(mean±S.D.)years, whereas the mean age of intestinal metaplasia positive patients who were Helicobacter pylori negative was 52±9.7(mean±S.D.)years. In conclusion. although our data do not prove a causal relationship between Helicobacter pylori infection and the histogenesis of intestinal metaplasia, we suggest that Helicobacter pylori plays an important role in the development of intestinal metaplasia in the gastric mucosa. Whether Helicobacter pylori has to be present at all times during this process or is only necessary as a 'trigger', needs further research.

소화성궤양 환자에 대한 Omeprazole(Losec^(�))의 임상 효과

이종선,이기천,허승식,안정기,윤세진,정현용,이헌영,김영건 최신의학사 1990 最新醫學 Vol.33 No.9

장중첩증을 동반한 맹장 지방종 1예

홍의실,나병규,김민옥,유일영,채지영,채희복,윤세진,이상전,송형근,박길선,정현용 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

대장 지방종은 주로 우측 결장에 호발하고 특히 회맹판 부위와 맹장 부위에 호발한다. 또한 50~60대에 빈도가 높고 증상이 있는 환자에서 장중첩증이 높게는 40~50%에서 보고되고 있어 성인 장중첩증의 원인으로 중요한 비중을 차지한다. 특히 성인 장중첩증 및 장폐쇄의 중요 원인인 악성 종양과 임상 양상이 유사하여 감별진단이 중요하다. 저자들은 반복적인 복통을 주소로 내원한 환자에서 맹장의 4×5㎝의 점막하 지방종이 말단 회장부위와 반복적인 장중첩중이 발생했던 1례를 부분 절제술로 치료하여 양호한 임상 경과를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Lipomas are one of the most common benign nonepithelial tumors of the colon which are often detected incidentally by radiologic investigation or on operation. These tumors are usually without specific symptoms. Colonic lipomas occur most often in the right colon, particularly in the ileocecal valve and the cecum. Most patients are asymptomatic. but tumors larger than 2 cm tend to produce a change in bowel habit. abdominal pain. rectorrhagia and complications including luminal obstruction or intestinal intussusception. Diagnosis can be made by colonoscopy abdominal CT. MRI, or barium enema. We report a case of lipoma of the cecum that originated in the submucosa and presented as a intussusception in a 50-year-old woman with a brief review of the literature.

Two Cases of Pneumatosis Cystoides Intestinalis

Sei Jin Youn , Young Shim Cho, Byung Chul Kim, Joung Ho Han, Soon Man Yoon, Hee Bok Chae, Seon Mee Park 충북대학교 동물의학연구소 2011 Journal of Biomedical and Translational Research Vol.12 No.4

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple intramural pockets of gas filled cysts in the intestinal wall. PCI is usually found incidentally on an imaging study. Many different causes of PCI have been suggested, including mechanical, pulmonary, and bacterial causes. Treatment is usually conservative, including oxygen and antibiotic therapy. We report on two cases of PCI, without symptoms, in a 62-year-old male and a 72-year-old male. Computed tomography showed numerous, small, round, and air densities on the sigmoid colon. Colonoscopy showed numerous, variable-sized, sessile polypoid, balloon-like distended, and protruding subepithelial masses covered with normal colonic mucosa on the sigmoid colon. We observed that when the cyst was stuck with a needle, the size of the cyst was reduced and showed a flat termination. Therefore, we made a diagnosis of PCI and report on the case with references.