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.

선택적 후근절제술의 수술중 근전도 감시방법과 치료효과

김형일,김연희,김완호,김근수,김동찬 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.10

Selective posterior rhizotomy(SPR) has been known to reduce the spasticity as well as to improve the quality of life in patients with intractable spasticity. Twenty patients underwent SPR under intraoperative electrophysiological monitoring(IOM). Fifty-two percent of sacrolumbar rootlet were cut after electrical stimulation. Eighteen patients(90%) with spastic type of cerebral palsy showed marked reduction of spasticity and functional improvement without any complication. The patients who did not respond to SRP had mixed types of spasticity. IOM facilitate the selection of pathological rootlets regardless of anaesthetic level. intensity of electrical stimulation, and individual variability of responses. It is concluded that careful selection of surgical candidates and of pathological rootlets under IOM are important to reduce the spasticity. thereby to obtain a better outcome.

일부 의료서비스업 VDT작업자의 상지 근골격계 증상의 정도와 관련된 요인

김형렬,원종욱,송재석,김현수,김치년,노재훈 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.2

목적: 본 연구는 상지 근골격계 질환의 유병율이 높은 집단으로 알려진 VDT작업자를 대상으로 이들의 근골격계 통증을 정량화하고, 정량화된 통증점수를 종속변수로 하여, 이와 관련성을 갖는 작업요인, 사회심리적 요인을 파악하고자 하였다. 방법: 서울지역에 위치한 1500병상 규모의 대학병원에 근무하고 단말기 작업을 주로 수행한다고 알려진 부서에 대해 병원내 안전관리과와 협의를 거쳐 163명을 연구대상으로 선정하였다. 이중 138명이 설문에 참가하였고, 이들을 최종 연구대상으로 하였다. 설문지를 가지고 연구변수를 측정하여, 나이, 근무연수, 가사노동의 정도 등의 인구학적 변수와 직무스트레스 및 사회적지지, 근골격계 증상, 통증의 양상 등을 조사하였다. 분석방법은 일반적 특성 및 작업특성, 통증의 양상을 성별에 따라 파악하였고, 통증점수의 타당성을 검정하기 위해, 통증점수의 구성요소와 통증점수를 시각적 상사척도와 상관성 검정을 시행하였다. 통증점수를 종속변수로 하고 직무요구도, 직무재량도, 동료의지지, 상사의지지, 여러작업환경특성, 인구학적 특징 등을 독립변수로 하여 다중회귀분석을 시행하였다. 결과: 첫째 통증의 정량화를 위해 사용한 통증평정지수는 시각적 상사척도와의 상관관계가 높은 것으로 나타나, 어느 정도의 타당성을 지닌 방법으로 해석할 수 있었다. 둘째, 이 통증 점수를 종속변수로 하여, 관련요인 분석한 다중회귀분석에서 직무요구도가 높을수록 통증의 정도가 높고(p<0.01), 여성일수록 남성에 비해 높은 통증점수를 보였다(p<0.01). 결론: 근골격계 질환의 높은 유병율을 보이는 집단의 경우, 이들의 증상 유무만을 가지고 관련요인을 분석하는 방법을 사용하기 어렵다. 따라서 이런 경우, 통증을 정량화하여, 다양한 관련요인을 찾으려는 노력이 필요하며, 본 연구에서 사용한 통증평정지수는 타당성을 지닌 정량화 방법이라고 여겨진다. 또한 본 연구에서는 직무요구도가 높을수록, 여성일수록 높은 통증점수를 보였다. Objectives: This study was designed to quantify symptoms in the upper extremities and to identify the pain related factors among hospital workers using video display terminals. Methods: The subject-group consisted of 138 employees working at a hospital using video display terminals. A structured questionnaire was used to estimate the participants' general characteristics, and job contents. Job stress was measured using Karaseks JCQ(Job Content Questionnaire). Pain in the upper extremities was identified according to the NIOSH symptoms survey criteria. Quantification was measured using Kim Chul's method. Pearson's Correlation analysis was used to identify validity in quantification. VAS(visual analog scale) was used to compare with this method. Multiple regression analyses elucidated the relationship between quantified pain and various work factors, such as job stress. Data were analysed with SAS 6.12 program. Results: First, in quantification using Kim Chul's method, the correlation between modified PRS(pain rating score) and VAS was extremely high by 0.60(P<0.01), indicating the high validity of PRS. Second, the groups of high job demand, high job control, and females were related to an increased pain level. Conclusions: These results suggest that the self pain assessment method, PRS, is valuable and useful in analyzing occupational musculoskeletal symptoms. High demand, job control and gender may influence the levels of pain. Prospective studies about musculoskeletal disorder are required.

장관골에 발생한 거대세포 종양의 국소 재발에 관한 연구

김인,김정만,이승구,장한,김용식,김성수,한창환,김형관 가톨릭 중앙의료원 가톨릭 암센터 1991 가톨릭 암센터 論集 Vol.5 No.1

인천지역 TDI 노출 작업자에서 직업성천식 유병율

김형렬,김철우,홍윤철,전형준,김치년,김현수,이지나,신주연,고동희,노재훈 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : TDI는 직업성천식을 일으키는 대표적인 물질로 알려져 있다. 과거 TDI에 노출된 작업자들의 천식 발생률을 5~6%가량 보고하였고, 국내에서도 2-20%에 이르는 유병율을 보고한바 있다. 작업환경이 많이 개선되고, 노출량이 감소된 최근에도 TDI에 의한 직업성천식에 대한 보고가 많이 이루어지고 있어, 이에 대한 적극적인 조사와 진단과정을 통해 유병율을 구하고 질병발생의 변화양상을 파악해 보고자 하였다. 방법 : 인천지역에서 특수건강진단을 수행하는 2개 기관의 TDI 노출 근로자 400여명 중, 사업장의 규모가 50인 이상이며 사업주가 연구진행을 허락한 사업장에서 근무하는 근로자 중 직접적으로 TDI에 노출되는 작업에 종사하는 근로자 170명을 연구대상으로 하였다. 이들에 대해 설문지와 산업의학의사의 면담을 통한 작업관련성 평가를 근거로 정밀대상자를 선정하고 이들에 대해 메타콜린 유발시험, TDI 유발시험 등을 수행하여 직업성천식을 확인하였다. 결과 : 설문조사 결과 11명이 직업과 관련하여 천식증상을 보이는 것으로 나타났고(6.9%), 이중 7명에서 메타콜린 유발검사 양성소견을 보였다. TDI에 의한 특이유발시험 결과 1명에서 양성반응이 나타나, 이 집단에서 TDI에 의한 직업성천식의 유병율은 0.58%였다. 결론 : 과거 국내연구에서 TDI에 의한 직업성천식의 유병율이 2~20%에 이르렀던 데 비해, 본 연구에서는 0.58%로 나타났다. 이는 국외 논문에서도 나타나는 경향으로 작업장 노출량 감소로 점차 발생률이 감소하는 양상을 보이고 있다. 그러나 이미 증상이 나타난 근로자들이 부서를 옮기거나, 직장을 그만둠으로 인해 그 유병율이 과소평가되었을 가능성도 있다고 판단된다. Objecdives: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. Methods: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. Results: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma. and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1 %). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. Conclusions: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

익수환아의 예후에 영향을 미치는 인자에 관한 연구

김용배,정대봉,조수형,조남수,박영봉,박상기,김춘호,양은석,문경래 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.3

Drowning is the second most common cause of accidental death of children in Korea. But the study of near-drowning is very rare in Korea. The purpose of our study is to determine the factors that may influence survival on the basis of submersion time, consciousness state upon admission to hospital, the kinds of water, laboratory findings and neurological outcomes. The survey was performed by a retrospective cohort study on 28 near-drowning victims of less than 15 years of age who were admitted to the emergency room in the Chosun University Hospital between May 1988 & May 1997. The results were as follows :1)Sex distribution was 22 males and 6 females. 2) Submersion time was <5 minutes in 9 cases, 5-9 minutes in 6 cases, 10-14 minutes in 5cases, 15-19 minutes in 3 cases, ≥20 minutes in 5cases. 3) Comatose patients upon arrival were 6/7 cases in the death group(86%) and 2/21 cases in the improved group(10%). They had unfavorable outcomes(P<0.05). 4) The first PH value was mean 7.02±0.12 in the death group and mean 7.31±0.13 in the improved group. There was a statistically significant difference between the death and the improved group(P<0.05) 5) The patients who gad increased blood glucose concentration were all 7 cases in the death group and 12/22 cases in the improved group(54%). The mean blood glucose concentration was mean 424.7235.6㎎/㎗ in the death group and mean 140.182.7㎎/㎗ in the improved group. There was a statistically significant difference between the death and the improved group(P<0.05). 6) The patients who had pulmonary edema upon arrival were all 7 cases in the death group and 1/21 cases in the improved group(46%). They had unfavorable outcomes(P<0.05). 7) The patients who had been submerged more than 15 minutes were all 7 cases in the death group and 6/21 cases in the improved group(5%). They had unfavorable outcomes(P<0.05). We conclude that pediatric victims of near-drowning can be assigned to high or low likelihoods of unfavorable our outcomes with the use of five variables ; comatose mentation upon arrival decreased initial blood pH, increased initial blood glucose concentration, pulmonary edema, and maximum submersion time estimated longer than fiften minutes. This prediction rule may be useful if it can be validated in another cohort.

오디첨가 요구르트의 발효특성

김혜경,배형철,남명수 충남대학교 농업과학연구소 2003 농업과학연구 Vol.30 No.1

오디의 건강 효과와 유산균 배양시 발효촉진 효과를 기대한 새로운 요구르트 개발의 일환으로, 환원 탈지유에 건조방법에 따른 오디의 첨가와 오디 첨가수준을 달리 한 요구르트 제조시 pH, 산도, 유산균수의 변화, 오디요구르트의 저장성 및 관능검사를 수행한 결과는 다음과 같다. 1. 생오디, 동결건조오디, 열풍건조오디는 보통 요구르트에 비하여 pH 저하와 산 생성의 증가가 빨라 발효촉진 효과를 보였으며, 처리구 간에는 동결건조오디나 열풍건조 오디에 비하여 생오디에서 그 효과가 두드러짐을 알 수 있었다. 2. 생오디의 첨가수준이 높을수록 pH 저하와 산생성의 증가가 빨라 발효촉진의 효과를 보였으며, 유산균수도 첨가수준이 높을수록 증가하였다. 3. 생오디 요구르트는 대조군에 비하여 유리당중의 fructose가 증가되었다. 4. 생오디 요구르트에서 lactic acid 함량은 대조군에 비하여 오디의 첨가량이 많을수록 더욱 증가되었다. 5. 생오디 요구르트의 관능검사 결과 외관(color), 맛(taste) 및 전체적인 기호도(overall acceptability)에서 유의적 차이를 보였으며, 향기(oder)와 조직감(texture)에서도 0.3%, 0.6% 처리구에 비하여 0.9%처리구가 좋은 결과를 보여 오디첨가요구르트의 제조 가능성을 보여주었다. 6. 생오디 요구르트의 저장실험 결과, 5℃에서 15일간 저장시 0.9% 오디첨가요구르트는 pH 4.04, 산도 1.082로 나타났고, 유산균수는 1.9×10^9cfu/ml로 우리나라의 호상 요구르트 총 유산균수 기준치 1.0×10^8cfu/ml를 초과하여 제품으로서의 우수성을 확인 할 수 있었다. This experiment was carried out to examine the fermentation properties of yogurt added fresh mulberry, freeze dried-mulberry and heated air dried-mulberry at concentrations of 0%, 0.3%, 0.6% and 0.9%. Lactic acid bacteria was used mixed starter culture(Str.salivarius ssp. thermophilus and Lac. delbrueckii ssp. bulgaricus). We obtained excellent results from the yogurt added fresh mulberry. In yogurt added 0.9% fresh-mulberry, lactic acid contents and titratable acidity were higher than those of 0%, 0.3%, 0.6% fresh-mulberry added. Also, sensory scores of color, taste and overall acceptability of the yogurt with 0.9% fresh mulberry was higher than those of any other groups.

노후 건강 및 복지증진을 위한 평생교육 프로그램개발에 관한 연구 : 대학 내 노년학센터(가칭)의 설치운영을 중심으로 Centering around the Establishment and Management of Aging Center in University

김형수,이원재 韓國保健敎育.健康增進學會 2003 보건교육건강증진학회지 Vol.20 No.1

In aging Korean society, many elderly people have difficulty in the areas of health, economic insecurity, role-loss(both work &pouse), loneliness, and family conflicts. Above all, retirement from work is one of the most important stressful life events having influences an elderly's persons economic &ocial activities, mental state, health status, and Lifelong educational programs could help the aged cope with these situations in later life. Health and social welfare are commonly recognized as an important value of life. They also have an effect on each other. Most people agree that the promotion of health and social welfare is to take a short-cut toward achieving human well-being. Thus we need to develop a substantially integrated program of lifelong education, before and after retirement, for the promotion of health and welfare. Universities have the advantage of practicing lifelong educational programs because they have more material, intellectual, and human resources than any other educational facilities. As a result, the purpose of this study is to suggest life-long educational programs for promoting both health conditions and the level of social welfare by utilizing an aging center affiliated with a university. Specifically, the developmental courses of pre-retirement, learning in retirement, elder-hostels, and the connection between pre and post-retirement educational programs are proposed in this study.

요통환자에 대한 임상적 고찰 : 한·양방 협진병원 내원 환자를 중심으로

김형태,류규수 慶山大學校 保健福祉硏究所 1997 保健福祉硏究 Vol.1 No.-

With 160 lumbago patients (85 inpatients and 75 outpatients) who received both Oriental and Western medical treatment from December, 1994 to April, 1995 at the acupuncture section and rehabilitation section of the H Hurb Hospital which is located in Seoul, a clinical study on the realities of lumbago was carried out. Findings from such a study are as follows: 1. It appeared that regarding the distribution of sex, 80 lumbago patients(50%) were male while the same number of lumbago patients were female, thereby presenting a distributional rate of male and female, 1:1 ; regarding the distribution of age groups, from the age group which consists a large number of lumbago patients, they were the age group of 30s 44 lumbago patients(which is 27.5% of total lumbago patients), age group of 60s or more than that, age group of 50s, and age group of 20s ; regarding the distribution of job, from the group which consists a large number of lumbago patients, they were the group of housewives, group of the unemployed(or the aged), group of clerical workers, group of professional job, etc. 2. It appeared that the causes of the attack of lumbago are unknown etiology 56 lumbago patients(35.0%), heavy lifting 39 patients(24.4%), longtime standing 24 patients(15%), sprain 20 patients(12.5%), and accidents and contusion 11 patients(6.9%) in the order from the most case. 3. Regarding the relapse rate among the subjects, it appeared that 106 lumbago patients(66.2%) had more than relapse, and 54 patients(33.8%) were newpatients; and among the patients having more than relapse, the case of 3rd recurrence outnumbered the case of 2nd recurrence. Regarding the distribution other relapse rate according to age groups, it appeared that the most case was in the group of 60s and more than that with 28 patients(26.2%), then the next case in the group of 30s, then the case in the group of 20s, and then the case in the group of 50s. Regarding the distribution of the relapse rate according to job, it appeared that from the most case, there were 28 lumbago patients of housewives(28.0%), 27 patients(24.7%) of theunemployed(an aged population), and 19 patients(17.8%) of clerical workers. 4. Regarding the distribution of the causes of relapse, it appeared that the most case was due to unknown etiology with 43 patients(40.2%), then the next case due to heavy lifting, then due to longtime standing, then due to sprain, and then due to accidents and contusion. Regarding the distribution of the causes of relapse accoriding to age groups, it appeared that the most case was due to unknown etiology which was seen in all the age groups ; in the age group of 30s, due to heavy lifting, then due to longtime standing, and then due to sprain; and in the age group of 60s and more than that, due to heavy lifting, then due to longtime standing, and then due to contusion. Regarding the causes of relapse according to job, it appeared that the most case was due to unknown etiology or no special cause of attack ; in the group of the unemployed(an aged population), due to heavy lifting, and then due to longtime standing in the order from the most case ; in the group of service workers, due to heavy lifting, and then due to contusion ; and in the group of clerical workers, due to heavy lifting, then due to sprain, and then due to longtime standing in the order from the most case. 5. Regarding the results of the combined treatment of Oriental medicine and Western medicine, it appeared that 86 patients(53.8%) were in a superior state, 45 patients(28.1%) in a good, satisfactory state, 15 patients(9.4%) in the evenly improved state, 8 patients(5.1%) in a lightly improved state, and 6 patients(3.8%) in a poorly improved or inferior state, showing a valid rate of 96.2%. 6. Regarding the required period of medical treatment according to the case history of lumbago, it appeared that the acutest patients(82 patients : 51.3%) required 17.5days, the semi-acute(29 patients ; 18.1%) 20.9 days, the acute(10 patients ; 12.5%) 28.1 days, and the chronic(29 patients; 18.1%) 30.5 days(p=0.0874). Regarding the required period medical treatment according to the degree of the pain, 40 patients(25.2%) having an pain in a degree of an even ache required 18.2 days, 87 patients(54.6%) having a severe pain 22.6 days, 26 patients(16.4%) having a very severe pain 27.9 days, and 7 patients(4.6%) having a light pain 29.4 days(p=0.5857). 7. Regarding the period of medical treatment according to the diagnosed names of lumbago, it appeared that in Western medicine, 57 patients(35.7%) of Accute back pain required 10.1 days, 20 patients(12.4%) of Chronic back pain 24.3% days, 57 patients(37.0%) of HNP 26 days, 19 patients(11.9%) of degenerative spondylosis 26.5 days, 4 patients(2.5%) of Spondyolisthesis 33.3 days, 1 patients(0.6%) of Spinal stenosis 25.5 days(p=0.0108) ; in Oriental medicine, 29 patients(18.2%) of Shensu-zwasum lumbago 31.7% days, 46 patients(28.8%) of Shensu lumbago 25.7 days, 27 patients(16.9%) of Zwasum-yihyul lumbago 20.6 days, 55 patients(34.4%) of Zwasum lumbago 15.5 days, 2 patients(1.3%) of Yihyul lumbago 21 days, and 1 patients(0.6%) of Shi lumbago 2 days(p=0.2762). 8. Regarding the period of medical treatment according to the diagnosed names of lumbago in case of new patients and old patients(or relapsed patients), it appeared that new patients required a period of medical treatment of 18.4 days in general or average for curing lumbago while old patients required a period of 24.1 days in general or average ; this indicates that new patients were cured earlier than old patients. Regarding the period of medical treatment according to the diagnosed names of lumbago, it appeared in Oriental lumbago, when the diagnosed names was Zwasum lumbago and Yihyul lumbago, the required period of medical treatment was short ; in Western medicine, when the diagnosed name was Acute back pain, the required period of medical treatment was short ; in Western medicine, when Shensu lumbago and Shensu lumbago develop into Chronic back pain and HNP, medical treatment of them required more days ; regarding the period of medical treatment in case of new patients and old patients, new patients required a shorter period than old patients ; in particular, in case of Shensu lumbago in Oriental medicine and Chronic back pain in Western medicine, it was understandable that the required period of medical treatment necessitates more days.

Characterization of Antihypertensive Angiotensin I-Converting Enzyme Inhibitor from Recombinant E. coli

Kim, Jae-Ho,Jeong, Seung-Chan,Lee, Dae-Hyoung,Lee, Jong-Soo 배재대학교 자연과학연구소 2005 自然科學論文集 Vol.16 No.1

안지오텐신(ACE) 저해제는 항고혈 효과를 갖고 있으므로 오랫동안 고혈압의 예방이나 치료에 이용되어 왔다. 본 연구는 재조합 대장균으로부터 새로운 ACE 저해제를 생산하고 정제하며 나아가 이들이 구조-기능 관P를 규명하기 위해 수행되었다. Saccharomyces cerevisiase의 ACE 저해 펩타이드 유전자를 함유하고 있는 재조합 pGEX-4T-3을 대장균 BL21(DE3)로 형질전환 시켰다. 재조합 pGEX-4T-3을 갖고 있는 대장균 BL21(DE3)로부터 생산된 Glutathione-s 전이효소 (GST) 융합 단백질을 얻어서 그중 ACE저해 펩타이드를 Sephadex G-25 컬럼 크로마토그래피로 정제하였다. 정제된 ACE 저해 펩타이드는 타이로신-아스파틱엑시드-그리신-글리신-발린-패닐알라린-아르기닌-발린-타이로신-트레오닌의 서열을 가진 새로운 decapeptide이었고 ACE에 대하여 경쟁적으로 저해하였다. The angiotensin I-converting enzyme (ACE) inhibitor has anti-hypertensive effects and has long been used as prevention or remedy of hypertension. This study were carried out to produce and purify a new ACE inhibitor from recombinant E. coli and further elucidate its structure-function relationship. Recombinant pGEX-4T-3 containing ACE inhibitory peptide gene of Saccharomyces cerevisiae was transformed into E. coli BL21(DE3). Glutathione-S transferase (GST) fusion protein from E. coli BL21(DE3) harboring the recombinant pGEX-4T-3 was obtained and the ACE inhibitory peptide was purified with Sephadex G-25 column chromatography. The purified ACE inhibitory peptide was a novel decapeptide with sequence Tyr-Asp-Gly-Gly-Val-Phe -Arg-Val-Tyr-Thr which shows very low similarity to the other ACE inhibitory peptide sequence. The purified ACE inhibitor competitively inhibited ACE.