일부 남성 금속제품 조립작업자들의 피로에 영향을 미치는 작업관련요인

장준호,강동묵,고상백,김정원,조병만,이수일 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : 남성 금속제품 조립 작업자들의 피로에 영향을 미치는 작업관련요인을 파악하고자 한다. 방법 : 작업자의 일반적 특성 및 작업관련 특성, 육체적 부하, 직무 스트레스 등을 조사 항목으로 하여 자동차 부품 조립업 1개소(476명), 자동차 엔진 조립업 1개소(610명), 대형 선박 엔진 조립업 1개소(454명)의 작업자(1,540명)를 대상으로 수거된 설문지 중 부실하게 응답한 38부를 제외한 1,136부(총연구대상의 73.8%)를 분석하였고, 피로도와의 연관성을 다중선형회귀분석으로 살펴보았다. 조사는 자기 기입식 설문지를 사용하였다. 육체적 부하를 측정하기 위해서는 Borg의 scale이 사용되었다. 격무 스트레스를 측정하기 위해서는 Karasek의 Job content questionnaire가 사용되었다. 피로의 측정은 전반적 피로도(sum of fatigue), 일상생활 기능장애(daily dysfunctioning), 상황적 피로(situational fatigue), 피로점수의 총합(sum of fatigue)으로 구성되어 있는 다면적 피로척도를 사용하였다. 피로점수의 분포는 본 연구에 응답한 피로점수의 총합을 사분위수로 나누어서 4등급으로 나누었다. 결과 : 피로점수의 분포는 피로점수의 총합을 사분위수로 나누었을 때, 0≤1등급≤73, 74≤2등급≤82, 83≤3등급≤93, 94≤4등급≤133이었다. 다중선형회귀분석에서 피로점수의 총합과 유의한 관계를 보인 경우는 주간근무, 긴 주당 노동시간, 높은 육체적 부하, 높은 직무요구도, 낮은 직무자율성, 낮은 상사의 지지 등이었고, 전반적 피로도와 유의한 관계를 보인 경우는 주간근무, 높은 육체적 부하, 높은 직무요구도, 낮은 직무자율성, 낮은 상사의 지지 등이었다. 일상생활 기능장애와 유의한 관계를 보인 경우는 주간근무, 긴 주당 노동시간, 높은 육체적 부하, 낮은 직무자율성 등이었다. 상황적 피로와 유의한 관계를 보인 경우는 높은 연령, 주간근무, 긴 주당 노동시간, 낮은 직무자율성 등이었다. 결론 : 피로관련 요인은 긴 주당노동시간, 높은 직무요구도, 높은 육체적 부하, 낮은 직무자율성, 낮은 상사의 지지로 생각된다. Objectives: To find work related factors affecting perceived fatigue among male metal product assemblers. Methods: The study subjects were metal product assemblers from three metal product companies (476 car parts assemblers, 610 car engine assemblers, 454 ship engine assemblers). From the total of 1,540 subjects, 1,136 (73.8%) were included and 38 respondents with insufficient replies were excluded. Associations between fatigue score and other variables (general characteristics, job related factors, workload, job stresses) were investigated in terms of the concept of multidimensional fatigue construct by self administered questionnaire. Using MFS (Multidimensional Fatigue Scale), JCQ (Job Content Questionnaire), and Borg's scale, we estimated the fatigue, job stress, and workload, respectively. Fatigue score was estimated by 'sum of fatigue' in MFS. Associations were tested by linear regression analysis using SAS v.8.0. Results: In this study, the fatigue related factors were older age, longer working hours per week, higher workload, higher job demand, lower decision latitude, and lower supervisor support. Conclusions: Prolonged working hours, higher workload, higher job demand, poor supervisor support and lower decision latitude were fatigue related factors among the male metal product assemblers of this study.

상지 단순반복작업 근로자의 수근관 증후군 유병률에 관한 조사

손지언,장태원,김윤규,홍영습,정갑열,김동일,이강진,하남진,김상범,김준연 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 본 연구는 수근관 증후군의 발생위험이 높은 작업형태에 종사하는 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장과 목재소 근로자에서 근전도검사를 이용하여 수근관 증후군의 유병률을 조사하고자 하였다. 방법 : 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장 근로자 69명과 목재소 근로자 17명을 실험군으로, 관리직, 경리, 경비등 상지의 단순반복작업이 없는 근로자 28명을 대조군으로 선정하여, 작업적 및 병력조사, 이학적 검사와 근전도검사를 통해 수근관 증후군의 유병률을 조사하였다. 결과 : 수근관 증후군의 유병률은 육류 및 어류 가공 사업장과 목재소에서 각각 26.09 % (18명)와 29.41 %(5명)로 조사되었으며, 육류 및 어류가공사업장과 목재소 근로자를 '7년 이상과 미만의 작업기간'으로 층화하여 비교한 결과 '상지부위의 통증 호소 유무', 'Visual Analogue Scale(VAS: 총 10점) 4점 이상 여부', 'Tinel teat 양성 유무', 'Phalen test 양성 유무'는 모두 단기 작업근로자군에서 양성의 빈도가 증가되었고 '수근관 증후군 유무'는 장기작업근로자군에서 양성의 빈도가 증가되었다. 결론 : 육류 및 어류 가공 사업장과 목재소의 수근관 증후군 유병률은 각각 26.09 %와 29.41 %로 육류 및 어류 가공 사업장과 목재소는 1996년 OSHA가 지정한 바와 같이 위험한 작업요인이 있는 작업장으로 분류하여 관리되어야 할 것으로 생각된다. Objectives : This study was carried out to survey on the prevalence of Carpal Tunnel Syndrome(CTS) in high risk jobs(meat and fish processing plant and wood plant), by application of Nerve Conduction Study(NCS), a confirmatory diagnostic method. Methods : Experimental group was 69 workers sampled from meat and fish processing plants and 17 workers sampled from wood plants, who were simple, repetitive workers using upper extremities and control group was 28 workers sampled from managers, secretaries and keepers. All employees were examined through work history, physical examination and NCS. Results : 18 workers(26.09%) in meat and fish processing plants, and 5 workers(29.41%) in wood plants had compatible findings to NIOSH diagnostic criteria for CTS. The experimental group had more symptoms (complaint of upper extremities, Visual Analogue Scale ≥4(VAS: total 10 point)), signs(Tinel and Phalen test) and prevalence of CTS than control group(p<0.05). The prevalence of symptoms and signs were higher in short term workers(<7 years), but the prevalence of CTS was higher in long term workers(≥7 years). Conclusions : The prevalence of CTS in meat and fish processing plant and wood plant were 26.09% and 29.41% respectively. Authors propose that meat and fish processing and wood plants should be managed as a risk job category which were designated by OSHA in 1996

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

석면관련 폐질환의 진단에 있어서 흉부고해상도전산화단층촬영검사(HRCT)의 유용성

이현재,손지언,,홍영습,,이영일,예병진,유창훈,정갑열,김상훈,임형준,장은철,김정만,김준연 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 석면에 노출된 근로자에서 석면관련 폐질환의 양상을 분석하고 진단에 있어 HRCT의 유용성을 연구하여 석면에 대한 의학적 감시프로그램의 개발에 기여하고자 하였다. 방법: 석면에 직접 노출되는 작업자 68명과 간접 노출되는 작업자 94명 등 총 162명에 대해 OSHA 석면 표준, 의학적 감시 프로그램에 따라 단순 흉부방사선검사, 폐활량검사 및 우리나라 실정에 맞게 일부 수정한 의학적 설문지를 통해 면접조사의 방식으로 환자에 관한 정보를 수집하였으며, 자료의 신뢰성을 확보하기 위하여 면접조사는 1달 이상의 기간을 두고 2차례에 걸쳐 실시된 후 확인, 수정하였다. 또한, 석면관련 폐질환을 확진하기 위하여 HRCT를 추가적으로 실시하였다. 결과: HRCT결과 석면관련 폐질환의 유병율은 162명의 근로자중 17명으로 10.5%였는데, 직접 노출군에서 10명 (14.7%), 간접 노출군에서 7명 (7.4%)이었다. HRCT와 비교할 때 단순 흉부방사선검사의 민감도와 특이도는 각각 70.6%와 98.6%이었고, 양성 예측도와 음성 예측도는 각각 85.7%와 96.6%으로, HRCT는 단순흉부방사선검사에 비해 민감도가 높아 초기 석면관련 폐질환을 진단하는데 효과적이었다. 석면관련 폐질환의 진단에 있어 HRCT와 폐활량검사 사이에 유의한 관련성이 관찰되었다. HRCT 결과 석면관련 폐질환의 유무와 의학적 설문조사 결과의 빈도분석을 실시한 결과, 유의한 변수는 작업기간, 흡연량, 호흡기질환의 과거력, 기침, 호흡곤란이었다. 결론: HRCT는 석면관련 폐질환의 진단에 있어 단순 흉부방사선검사와 비교하여 민감도가 높아 초기 진단에 유용하므로 단순 흉부방사선선검사 결과 석면관련 폐질환소견을 보일 때뿐만 아니라, 정상소견을 보이더라도 폐활량 검사결과와 근무력, 흡연력, 호흡기질환의 과거력, 기침, 호흡곤란 등의 호흡기 증상을 참고하여 HRCT검사를 고려해야 한다. 또한, 본 연구에서 관련성이 없었던 요인들에 대해서도 향후 연관성을 규명하는 광범위한 전향적 연구가 필요하다. Objectives: This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease. Methods: The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveilance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveilance program consists of simple chest x-ray, spirometry and medical questionnarie. Results: Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT, HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea. Conclusions: In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.

학교체육 활성화 방안에 대한 연구(Ⅰ) : 강원대학교 교양체육 운영방법의 개선을 중심으로

이광재,문병용,노성규,박기동,홍관이,한상준,유옥재,엄기진,정청자,오수일,김윤래,박장평,부기원 江原大學校附設 體育科學硏究所 1986 江原大學校附設體育科學硏究所論文集 Vol.- No.11

Try to find a scheme for activation to College Physical Education, this Report informs the various kinds of Survey and process those were projected for improvement of management methods on Cultural Physical Education in Kang Weon National University. From experimentally carried out "Sports events Choosing System" not as usual be inforced "Total practical Skill System", Following Positive effects and sujestions were Presented; 1. "Sports events choosing system" gave birth to more students' interesting and more voluntary participation to the sports events they chose, and sports skill and instruction level was elevated due to charge of expert according to each sports events. This system would be managed continuously hereafter for it related to life sports. 2. This System needs to closed cooperations between College and Community, for the facilities of community are utilized by college. 3. To complete the plan for activation of college Physical Education, additionally, the successional study ; namely "autonomous extracurricular sports activity" should be excuted hereafter.

The Korean Society of Gastroenterology& SLDDS 2021 : Slide Session ; K-BP-11 : Pancreatobiliary ; Eicosapentaenoic Acid Dissolves Cholesterol Gallstones by Attenuating Cholesterol Saturation and Suppressing Mucin Production in Mice

( Sung Ill Jang ),( Lee Yong Paik ),( Su Yeon Lee ),( Joon Mee Kim ),( Dong Ki Lee ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: The increasing prevalence of cholesterol gallstone (CG) disease has become an economic burden to the healthcare system. Ursodeoxycholic acid (UDCA) is the only established medical agent used to dissolve gallstones. In investigating novel therapeutics for CG, we assessed the therapeutic effects of eicosapentaenoic acid (EPA), which is one of most bioactive omega-3 polyunsaturated fatty acids, on CG induced by feeding a lithogenic diet (LD) containing high cholesterol levels to mice. Methods: Mice were divided into the following four groups: (A) LD; (B) LD+EPA; (C) LD+UDCA; (D) LD+EPA+UDCA. After LD feeding for 10 weeks, EPA or UDCA was administered orally and the diet maintained for 16 weeks. The levels of phospholipids and cholesterol in bile, CG dissolution, gallbladder wall thickness, MUC gene expression ingallbladder were analyzed. Results: Mice in the EPA treatment (Groups B, D) showed signifi cantly higher stone dissolution than the control LD group (Groups A). The combination treatment of EPA and UDCA accelerate stone dissolution more than mono-therapy with EPA or UDCA. Bile phospholipid levels were signifi cantly elevated and cholesterol saturation index was decreased in the Group B. Although hypertrophy of the gallbladder wall was evident in mice fed LD, the wall thickness of gallbladder in mice treated with EPA (Group B, D) was signifi cantly thinner than in mice fed LD. MUC 2, 5ac, 5b and 6 mRNA expression levels were signifi cantly elevated in the LD-fed group, and this was suppressed by EPA with or without UDCA. Conclusions: EPA dissolves cholesterol gallstone in mouse through increasing the levels of bile phospholipids, decreasing cholesterol saturation and suppressing bile mucin formation. Further human study is required to investigate the therapeutic effects of EPA in patients with CG.

Safety Evaluation of Paclitaxel-Eluting Biliary Metal Stent with Sodium Caprate in Porcine Biliary Tract

Sung Ill Jang,Seok Jeong,Don Haeng Lee,Kun Na,Sugeun Yang,Dong Ki Lee 거트앤리버 소화기연관학회협의회 2019 Gut and Liver Vol.13 No.4

Background/Aims: Metallic stents designed to relieve malignant biliary obstruction are susceptible to occlusive tumor ingrowth or overgrowth. In a previous report, we described metallic stents covered with paclitaxel-incorporated membrane (MSCPM-I, II) to prevent occlusion from tumor ingrowth via antitumor effect. This new generation paclitaxeleluting biliary stent is further endowed with sodium caprate (MSCPM-III) for enhanced drug delivery. The purpose of this study is to examine the safety of its drug delivery system in the porcine biliary tract. Methods: MSCPM-III (10% [wt/vol] paclitaxel) and covered metal stents (CMSs) were endoscopically inserted in porcine bile ducts in vivo. Histologic biliary changes, levels of paclitaxel released, and various serum analytes (albumin, alkaline phosphate, aspartate transaminase, alanine transaminase, total protein, total bilirubin, and direct bilirubin) were assessed. Results: Based on the intensity of reactive inflammation and fibrosis, changes in porcine biliary epithelium secondary to implanted MSCPMIII were deemed acceptable (i.e., safe). Histologic features in the MSCPM-III and CMS groups did not differ significantly. In a related serum analysis, paclitaxel release from MSCPMIII stents was below the limit of detection for 28 days. Biochemical analyses were also similar for the two groups, and no evidence of hepatic or renal toxicity was found in animals receiving MSCPM-III stents. Conclusions: In a prototypic porcine trial, this newly devised metal biliary stent incorporating both paclitaxel and sodium caprate appears to be safe in the porcine bile duct.

Biliary Complications after Living Donor Liver Transplantation Differ from Those after Deceased Donor Liver Transplantation

Jang Sung Ill,Lee Dong Ki 거트앤리버 소화기연관학회협의회 2022 Gut and Liver Vol.16 No.2

The Korean Society of Gastroenterology& SLDDS 2014 : Slide Session ; K-BP-04 : Pancreatobiliary ; Effi cacy of A Multiplex Paclitaxel Emission Stent Using Pluronic® Mixture Membrane Versus a Covered Metal Stent in Malignant Biliary Obstruction : A Prosp

( Sung Ill Jang ),( Hae Won Kim ),( Yong Hoon Kim ),( Jieun Yun ),( Seok Jeong ),( Don Haeng Lee ),( Myung Hwan Kim ),( Dong Ki Lee ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: The placement of a self-expandable metallic stent (SEMS) is widely used nonsurgical treatment method in patients with unresectable malignant biliary obstructions but SEMS is susceptible to occlusion by tumor ingrowth or overgrowth. The effi cacyand safety of a new generation paclitaxel-eluting biliary metallic stent using a Pluronic® mixture membrane (MSCPM-II) was compared prospectively with those of a covered metal stent (CMS) in patients with malignant biliary obstructions. Methods: Patients with unresectable distal malignant biliary obstructions (n = 72) were prospectively enrolled in this study at multiple treatment centers. A MSCPM-II was insertedendoscopically in 40 patients, and a CMS was inserted in 32 patients. Patients underwent systemic chemotherapy regimens alternatively according to disease characteristics. Results: The two groups did not differ signifi cantly in mean age, male to female ratio, ormean follow-up period. Stent occlusion occurred in 14 patients who received MSCPMII and in seven patients who received CMS. Stent patency and survival time did not differ signifi cantly between the two groups (p = 0.355, 0.570). Chemotherapy and type of tumors had no infi uence on stent patency and survival time. Complications, including cholangitis and pancreatitis, were found to be acceptable in both groups. Conclusions: Although the use of MSCPM-II produced no signifi cant differences in stent patency or patient survival in patients with malignant biliary obstructions compared with the use of a CMS, this study demonstrated that metallic stents covered with a paclitaxel-incorporated membrane can be used safely in humans.

Is the Intestinal Gas Associated With the Development of Right Colonic Diverticula?: Author`s Reply

( Sung Ill Jang ),( Hyo Jin Park ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.2