일자리 참여 프로그램이 노인의 자아존중감과 생활만족도에 미치는 영향

민순 ( Soon Min ),주리애 ( Ree Aie Ju ),정현필 ( Hyon Pil Jung ),정영주 ( Young Ju Jung ),김미란 ( Mi Ran Kim ),김윤경 ( Yun Gyung Kim ) 경희대학교 동서의학연구소 2008 동서간호학연구지 Vol.14 No.2

본 연구는 G시 D복지관에 있는 60세 이상 된 노인 70명을 대상으로 일자리 참여 프로그램이 노인들의 자아존중감과 생활만족도에 미치는 영향을 파악하고자 한다. 단일군 전후 원시실험설계로 노인들의 대조군이 없는 현실적인 문제를 갖고 있어 비교할 수 없는 제한점을 갖고 있지만 노인들에게 일자리를 참여시키므로 그들을 돕는데 의미를 두고 있으며, 본 프로그램에서 얻어진 결과를 토대로 논의하고자 한다. 일자리 프로그램에 참여하기 전 자아인식의 평균이 참여 전3.31에서 참여 후 3.50으로, 자아가치는 참여 전 평균이 3.04에서 참여 후 3.46으로, 자아존중 정도도 참여 전 평균 3.31에 참여 후 3.48로 모두 유의하게 향상되었다. 이는 저소득 노인의 자아존중감이 낮다는 Shim (2005)의 연구결과와 일치했고, 월 사용 지출액에 따라 자아존중감이 차이가 있다는 Kim2003)의 연구 결과와 월수입이 많은 사람 즉 경제적으로 나은사람이 자아존중감이 높다는 Kim (2002)의 연구 결과 및 일자프로그램 참여를 여가활동으로 여겨 이에 참여하는 사람이참여하지 않는 경우보다 자아존중감이 높다고 한 Kim (2007)연구 결과와도 유사한 결과를 보였다. 노인에게 자아존중감은 정신건강을 결정짓는데 중요한 요소로, 자아존중감은 노인의 우울과 역상관관계가 있는데(Park,1993), 본 연구에서 노인들이 일자리에 참여하므로 자존감 향상에 긍정적인 영향을 미치는 것으로 나타난 바, 이는 노후에노인 대상자들에게 여가활동과 소정의 수익을 통해 용돈이나기초생활에 필요한 경비를 조달받게 된 것이 자아존중감을 높인 것으로 사료된다.그러므로, 본 연구에서도 일자리 참여 프로그램이 노인들의 자아존중감을 향상시키는 점을 볼 때, 노인의 일자리 참여는 자신들의 소득을 확보하려는 경제적인 측면뿐 아니라 사회참여의 욕구도 포함하고 있어 노인에게 일자리 참여는 매우 중요한 의미를 지니고 있고, 소일거리와 여가선용 차원에서도 노인에게 일자리 참여의 기회를 제공해주는 것은 노후의 경제적인 자립생활은 물론 사회적으로도 바람직한 방안이라 할 수 있어 일을 통해 보람도 얻고, 단체 활동을 통한 소속감을 가지고 경제활동도 할 수 있는 방안도 모색해야 할 것이다.일자리 참여 프로그램 전과 후의 생활만족도의 변화에서, 일자리 프로그램에 참여하기 전 평균 3.04점이었고, 일자리 프로그램에 참여한 후 평균 3.24점으로 유의하게 향상하였는데, 이는 일자리 참여자와 비참여자들을 비교 연구한 Kim (2007)과Seo (2007)의 연구 결과와 일치하였고, 시니어클럽에 참여하고 있는 노인이 참여하지 않고 있는 노인보다 생활만족도가 유의하게 높게 나타난 Bang (2005)의 연구 결과와도 일치하였다.노인들의 생활만족도에 관한 선행연구를 고찰한 결과 노인의 생활만족도는 배우자가 있는 경우, 주관적 건강상태가 좋을수록, 경제수준이 높을수록, 교육정도가 높을수록 생활만족도가 높다고 보고되고 있으며, 노인의 사회적 지지나 자아존중감이 높을수록 생활만족도가 높다고 하였다(Jang, 2006; Kim,2005; Park & Lee, 2006).노인들이 일자리 프로그램에 참여하므로 생활만족도에 긍정적인 영향을 미치는 것으로 나타난 바, 이는 노인대상자들에게일자리를 통해 심리적, 경제적 여건에 도움이 된 것으로 여겨지며, 이로 인해 생활만족 정도를 높인 것으로 사료된다. 노후의시간활용 방법에 대한 2004 전국 노인생활실태 및 복지욕구조사 결과에서 가장 선호되는 것이 소득창출 27.8%, 취미활동16.3%, 소일거리 14.5%, 자원봉상활동 3.1%, 자아계발 활동2.4%로 나타났다(Jung et al, 2005). 그러나 노인의 일자리 참여는 여러 가지 문제에 봉착하게 된다. 우선 노인시장에 유입되는 신규 노동력의 과잉과 기업의 인사정체, 그리고 노인취업에 대한 잘못된 인식으로서 기능주의적 사회격리이론은 인간의 노화를 기능주의적으로 이해하려는 사회적 편견인데 노인이 반드시 체계적, 생물학적으로 또는 정신적으로 결함이 있다는 편견으로 인해 노인인력 활용가능성을 근본적으로 저해하는 요인이 된다(Jung, 2007). 또한 본 연구 대상자들에게 연구일자리 프로그램 유형에 따른 생활만족도와 자아존중감 정도를 분석한 결과에서는 유의하지 않았는데 노인들에게 일자리 참여 자체가 생활만족과 자아존중감 정도에 영향을 주는 것이지 유형별로는 큰 의미가 있는 것은 아닌 것으로 보인다. 본 연구 결과를 종합하여 볼 때 어떤 형태이든 간의 노인의 일자리 참여는 고령화 사회에서 나타나는 심각한 노인문제를 해결하고 노후 생활에 대한 적응력을 높이며, 노년기의 역할변화에 따른 적절한 대응을 통해 역할상실에 대한 대비를 할 수 있을 뿐만 아니라 노인 스스로의 자아존중감과 생활만족도 향상을 위해 필요하다. Purpose: The effects of job participation on self-esteem and life satisfaction were investigated. Methods: Seventy residents of D welfare center located in G city who were >60 yr-of-age were selected for the study. The SERS research tool (Nugent and Thomas,1993; modified by Koh, 2002) was used to assess self-esteem before and after a job participation program. The Cronbach`s αvalue-based reliability of this tool was 0.923 and 0.920 before and after the job participation program, respectively. Cronbach`s αvalue-based life satisfaction as measured according to Choi (1986) was 0.932 and 0.933 before and after the job participation program, respectively. Results: The hypothesis that job participation program increases self esteem was supported by the results. The mean self esteem of subjects before and after the job program, 3.31 and 3.48, respectively, represented a significant increase. The hypothesis that the job participation program increases life satisfaction was supported by the results, The mean life satisfaction index of subjects before and after the program, 3.04 and 3.24, respectively, represents a significant increase. Conclusions: Increased job opportunities and income guarantee for adults, particularly the elderly, can increase self-esteem, life satisfaction, and emotional stability.

해안서식 어패류 중 유해중금속 함량에 관한 연구 (Ⅰ)

유영찬,정진일,박유신,이종숙,인상환,최동기,김동우 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-

한국인 정신분열병 환자의 HLA-DQA1,HLA-DQB1 HLA-DRB1 대립유전자 빈도

신규성,이민수,김영리,김영태,조윤정 대한신경정신의학회 2000 신경정신의학 Vol.39 No.4

연구목적: 저자들은 PCR-SSOP 방법으로 한국인 정신분열병 환자에서 HLA-DQA1, HLA-DQB1 및 HLA- DRB1과 정신분열병의 감수성과의 상관성을 밝히고자 하였다. 방법: DSM-IV 에 의거하여 정신분열병으로 진단된 환자군 128명과 정상대조군 160명에 대해 polymerase chain reaction-sequence specifc oligonucleotide probes(PCR-SSOP) 방법을 이용하여 HLA-DQA1, HLA-DQB1, HLA-DRB1 대립유전자의 빈도를 분석하였다. 결과: HLA-DQB1□04는 환자군에서 14.6%로 정상대조군의 8.2%보다 높은 빈도를 보였고 (p=0.028), HLA-DRB1□14는 환자군에서 11.8%로 정상대조군으 5.5%보다 높았으며 (p=0.01), HLA-DRB□15는 환자군에서 2.0%로 정상대조군의 7.1%보다 낮은 빈도를 보였고(p=0.007), HLA-DRB□16은 환자군에서 1.6%로 정상대조군의 4.8%에 비해 유의하게 낮았다(p=0.043). 결론: 한국인 정신분열병 환자에서 HLA-DQB1□04와 HLA-DRB1□14S는 질병 발생의 감수성 인자로 작용을 하고, HLA-DRB1□15와 HLA-DRB1□16은 방어적인 역할을 할 수 있다고 할 수 있으나, 다른 인종에 관한 외국의 연구자들의 결과와는 상이한 양상을 보였다. Objectives: The aim of this study was to investigate the correlation between HLA-DQA1,HLA-DQB1 and HLA-DRB! alleles and disease susceptibility in Korean schizophrenic patients. Methods: HLA-DQA1, HLA-DQB1, and HLA-DRB! allele typing were performed using polymerase chain reaction-sequence specific oligonucleotide probes(PCR-SSOP) method in 128 Korean schizophrenic patients diagnosed by DSM-IV criteria, who were not blood-related, and 160 normal blood bank donors. Results: The HLA-DQB1□04 allele frequency was 14.6% in schizophrenic patients, which was significantly higher than that of normal controls which was 8.2%(p=0.028). HLA-DRB1□14 allele frequency was 11.8% in patients, which was also more frequent than that of normal controls which was 5.5%(p=0.01). HLA-DRB1□15 allele frequency was 2.0% in patients, which was significantly lower than that of normal controls which was 7.1%(p=0.007) and HLA-DRB1□16 allele frequency was 1.6% in patients, which was also lower than that of normal controls which was 4.8%(p=0.043). Conclusion: Schizophrenia in Korea had positive correlation with HLA-DQB1□04 and HLA-DRB1□14, and negative correlation with HLA-DRB1□15 and HLA-DRB1□16. These findings support the association of the HLA-DQB1 and HLA-DRB1 with schizophrenia in Korean population, which was different from other study results in other different ethnic groups.

제주도에서 브루셀라에 의해 발생한 특발성 세균성 복막염

허상택,조유경,김영리,이근화,윤지완,고관수,박미연,최영실 대한감염학회 2007 감염과 화학요법 Vol.39 No.1

Spontaneous bacterial peritonitis is the common infectious disease in liver cirrhosis patients with a fever. Brucellosis is a rare cause of bacterial peritonitis. A case indigenous to a citizen of Jeju, he ate a raw veal of cow four times in last 2 months prior to admission. The gram-negative bacilli were isolated from blood and peritoneal fluid cultures. He was confirmed brucellosis by serologic work- ups. This isolate was confirmed as Brucella abortus by using PCR amplification of 16S ribosomal RNA (rRNA) and omp2. This is the first case of bruellosis that was diagnosed spontaneous bacterial peritonitis in liver cirrhosis patient among native korean citizens. Successful treatment was obtained by using a regimen of doxycycline and gentamicin. Brucella should be suspected as a cause of spontaneous bacterial peritonitis in cirrhotic patients with no response to standard spontaneous bacterial peritonitis treatments. 브루셀라증은 전 세계적으로 발생하는 인수공통 전염병중의 하나로, 국내에서도 해마다 환자가 증가하고 있는 상황이다. 본 증례는 간경화 환자에서 환자의 잘못된 지식을 바탕으로 소 태아 육회를 섭취한 이후 복수와 발열을 주소로 내원한 환자이다. 상기 과거력이 환자의 질환과의 직접적인 연관성을 밝히기는 어려우나 환자의 진단을 추정하는데 도움이 되었으며, 이러한 가능성을 배제하기 위해서라도 국내 유통에 있어서 좀더 적극적인 대체가 필요하다 하겠다. 상기 환자는 브루셀라에 의해 발생한 특발성 세균성 복막염 환자로 제주도에서 발생한 내국인의 첫 증례이기에 문헌 고찰과 함께 보고하는 바이다.

Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae Causing Invasive Pneumococcal Disease in Korea Between 2017 and 2019 After Introduction of the 13-Valent Pneumococcal Conjugate Vaccine

Kim Gyu Ri,Kim Eun-Young,Kim Si Hyun,Lee Hae Kyung,Lee Jaehyeon,Shin Jong Hee,Kim Young Ree,Song Sae Am,Jeong Joseph,Uh Young,Kim Yu Kyung,Yong Dongeun,Kim Hyun Soo,Kim Sunjoo,Kim Young Ah,Shin Kyeong 대한진단검사의학회 2023 Annals of Laboratory Medicine Vol.43 No.1

Background: Streptococcus pneumoniae is a serious pathogen causing various infections in humans. We evaluated the serotype distribution and antimicrobial resistance of S. pneumoniae causing invasive pneumococcal disease (IPD) after introduction of pneumococcal conjugate vaccine (PCV)13 in Korea and investigated the epidemiological characteristics of multidrug-resistant (MDR) isolates. Methods: S. pneumoniae isolates causing IPD were collected from 16 hospitals in Korea between 2017 and 2019. Serotyping was performed using modified sequential multiplex PCR and the Quellung reaction. Antimicrobial susceptibility tests were performed using the broth microdilution method. Multilocus sequence typing was performed on MDR isolates for epidemiological investigations. Results: Among the 411 S. pneumoniae isolates analyzed, the most prevalent serotype was 3 (12.2%), followed by 10A (9.5%), 34 (7.3%), 19A (6.8%), 23A (6.3%), 22F (6.1%), 35B (5.8%), 11A (5.1%), and others (40.9%). The coverage rates of PCV7, PCV10, PCV13, and pneumococcal polysaccharide vaccine (PPSV)23 were 7.8%, 7.8%, 28.7%, and 59.4%, respectively. Resistance rates to penicillin, ceftriaxone, erythromycin, and levofloxacin were 13.1%, 9.2%, 80.3%, and 4.1%, respectively. MDR isolates accounted for 23.4% of all isolates. Serotypes 23A, 11A, 19A, and 15B accounted for the highest proportions of total isolates at 18.8%, 16.7%, 14.6%, and 8.3%, respectively. Sequence type (ST)166 (43.8%) and ST320 (12.5%) were common among MDR isolates. Conclusions: Non-PCV13 serotypes are increasing among invasive S. pneumoniae strains causing IPD. Differences in antimicrobial resistance were found according to the specific serotype. Continuous monitoring of serotypes and antimicrobial resistance is necessary for the appropriate management of S. pneumoniae infections.

당뇨병성 신증의 조기예측지표로서 저항계수 및 박동계수의 의의

김상훈,김시영,이화영,이영래,김향,이상종,김병익,최윤상,이규백,조윤경,김유리,조용욱 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.5

Background: Diabetic nephropathy has long been known as most common culprit of ESRD. In NIDDM. histopathologically intrarenal hemodynamic changes are nonspecific, frequently with global glomerulosclerosis, interstitial fibrosis, tubular atrophy and severe arterosderosis. Duplex renal Doppler sonography is useful in the noninvasive assessment of intrarenal hemodynamic change and Doppler indices reflect increased renal vascular resistance. So we compared the values of R.I. and P.I., in NIDDM patients, with several clinical parameters to identify that R.I. and P.I. values can reflect increased renal vascular resistance and predict diabetic nephropathy as early markers. Methods: Renal Doppler US scan was performed on 40 patients with NIDDM to obtain Doppler signals from arcuate artery or interlobar artery and thereby calculate the R.I. and P.I. From every each individual, clinical and laboratory data including age, sex, morbidity period, BMW, mean blood pressure, total cholesterol, serum creatinine, BUN, HbA1c, 24 hr urine protein and creatinine clearance were analyzed. We analyzed the correlation between values of R.I. and P.I. with clinical parameters by using univariate and multiple linear regression analysis. The patients were classified as three groups on the basis of the amount of 24 hour urirne protein and value of serum creatinine: Group l(n=15) was defined as patients with 24 hr urine protein lees than 150mg/day and serum creatinine less than 1.5mg/dL, group 2(n=12) as between 150mg/day and 500mg/day and serum creatinine less than 1.5mg/dL and group 3(n=13) as more than 500mg/day or serum creatinine above 1.5mg/dL. Results: 1) R.I. values showed correlation with age, morbidity period, mean blood pressure, HbA1c, serum creatinine, BUN, creatinine clearance and 24 hour urine total protein. P.I. values showed correlation with age, morbidity period, mean blood pressure, serum creatinine, BUN, creatinine clearance and 24 hour urine total protein. 2) R.I. and P.I. values were significantly affected by creatinine clearance and age in multiple regression analysis. 3) There were statistically positive correlation between 24 hour urine protein and R.I. and P.I.. But when we divided into three groups based on their amount of 24 hour urine protein. R.I. didn't show statistical correlation but P.I, showed significant correlation in the group of patients with proteinuria over 500mg/day(p$lt;0.05). Conclusion: Renal doppler indices reflect increased renal vascular resistance in NIDDM patients and correlate with clinical parameters of diabetic nephropathy. We suggest that the R.I. and P.I. are useful marker for indicating diabetic vascular complication in NIDDM patients. However, further conative studies should be carried out to elucidate the usefulness of R.I. and P.I. as early markers or advantaging parameters in predicting diabetic nephropathy.

서울의 PPNG 발생빈도(1988)

김재홍,이정욱,소순남,김영태,김중환,한영수,이성열,김동석,이봉구,이상수,윤종성,임이석,이종성,김호준,최성관,이성배,강성범,조규종,안철현,차영수,전환표,이주흥 대한화학요법학회 1989 대한화학요법학회지 Vol.7 No.2

The prevalence of PPNG among pretreatment isolates at a STD clinic in Seoul has been studied and reported annually since 1981. In 1988, 461 strains of N. gonorrhoeae were isolated, among which 258 (56.0%) were PPNGs. The prevalence of PPNG in Seoul is still increasing.

Serotype Distribution and Antimicrobial Resistance of Salmonella Isolates in Korea between 2016 and 2017

Kim Si Hyun,Sung Gyung-Hye,Park Eun Hee,Hwang In Yeong,Kim Gyu Ri,송새암,Lee Hae Kyung,Uh Young,Kim Young Ah,Jeong Seok Hoon,Shin Jong Hee,Shin Kyeong Seob,Lee Jaehyeon,Jeong Joseph,Kim Young Ree,Yong Do 대한진단검사의학회 2022 Annals of Laboratory Medicine Vol.42 No.2

Salmonella is one of the major causes of food-borne infections. We investigated the serotype distribution and antimicrobial resistance of Salmonella isolates collected in Korea between January 2016 and December 2017. In total, 669 Salmonella isolates were collected from clinical specimens at 19 university hospitals. Serotyping was performed according to the Kauffmann–White scheme, and antimicrobial susceptibility was tested using Sensititre EUVSEC plates or disk diffusion. Among the strains, C (39.8%) and B (36.6%) were the most prevalent serogroups. In total, 51 serotypes were identified, and common serotypes were S. enterica serovar I 4,[5],12:i:- (16.7%), S. Enteritidis (16.1%), S. Bareilly (14.6%), S. Typhimurium (9.9%), and S. Infantis (6.9%). The resistance rates to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole were 32.6%, 12.1%, and 8.4%, respectively. The resistance rates to cefotaxime and ciprofloxacin were 8.1% and 3.0%, respectively, while 5.4% were multidrug-resistant. S. enterica serovar I 4,[5],12:i:- and S. Enteritidis were highly prevalent, and there was an increase in rare serotypes. Multidrug resistance and ciprofloxacin resistance were highly prevalent. Periodic investigations of Salmonella serotypes and antimicrobial resistance are needed.

Clinical Significance of CLDN18.2 Expression in Metastatic Diffuse-Type Gastric Cancer

Kim, Seo Ree,Shin, Kabsoo,Park, Jae Myung,Lee, Han Hong,Song, Kyo Yong,Lee, Sung Hak,Kim, Bohyun,Kim, Sang-Yeob,Seo, Junyoung,Kim, Jeong-Oh,Roh, Sang-Young,Kim, In-Ho The Korean Gastric Cancer Association 2020 Journal of gastric cancer Vol.20 No.4

Purpose: Isoform 2 of tight junction protein claudin-18 (CLDN18.2) is a potential target for gastric cancer treatment. A treatment targeting CLDN18.2 has shown promising results in gastric cancer. We investigated the clinical significance of CLDN18.2 and other cell-adherens junction molecules (Rho GTPase-activating protein [RhoGAP] and E-cadherin) in metastatic diffuse-type gastric cancer (mDGC). Materials and Methods: We evaluated CLDN18.2, RhoGAP, and E-cadherin expression using two-plex immunofluorescence and quantitative data analysis of H-scores of 77 consecutive mDGC patients who received first-line platinum-based chemotherapy between March 2015 and February 2017. Results: CLDN18.2 and E-cadherin expression was significantly lower in patients with peritoneal metastasis (PM) than those without PM at the time of diagnosis (P=0.010 and 0.013, respectively), whereas it was significantly higher in patients who never developed PM from diagnosis to death than in those who did (P=0.001 and 0.003, respectively). Meanwhile, CLDN18.2 and E-cadherin expression levels were significantly higher in patients with bone metastasis than in those without bone metastasis (P=0.010 and 0.001, respectively). Moreover, we identified a positive correlation between the expression of CLDN18.2 and E-cadherin (P<0.001), RhoGAP and CLDN18.2 (P=0.004), and RhoGAP and E-cadherin (P=0.001). Conversely, CLDN18.2, RhoGAP, and E-cadherin expression was not associated with chemotherapy response and survival. Conclusions: CLDN18.2 expression was reduced in patients with PM but significantly intact in those with bone metastasis. Furthermore, CLDN18.2 expression was positively correlated with other adherens junction molecules, which is clinically associated with mDGC and PM pathogenesis.

Slowly Progressing Thrombotic Microangiopathy during Two Years of Treatment with Sunitinib

( Min Young Kim ),( Hee Jung Choi ),( Yoon Jung Kim ),( Na Ree Kang ),( Hye Ryoun Jang ),( Ghee Young Kwon ),( Woo Seong Huh ),( Young Suk Park ),( Yoon Goo Kim ),( Dae Joong Kim ),( Ha Young Oh ),( J 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.5

A 75-year-old man with mild renal impairment was started on sunitinib for a metastatic gastrointestinal stromal tumor. After 7 months of this therapy, proteinuria became aggravated. Serum creatinine concentration was increased from 1.34 to 2.57 mg/dL 24 months after sunitinib administration. Hematologic features of thrombotic microangiopathy (TMA) were absent. Renal histology revealed endothelial swelling and plasmatic insudation of the glomeruli. Proteinuria and renal function improved after discontinuation of sunitinib. Our experience suggests that TMA associated with sunitinib can be diverse in onset and severity, and that the hematologic features of TMA may be absent.