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.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

흰쥐의 방사선 피폭후 생물학적 지표로서의 혈액효소

김진규,김상복,김국찬,천기정,김인규,박효국,이강석 대한방사선 방어학회 1993 방사선방어학회지 Vol.18 No.2

생물학적 선량평가를 위한 생화학적 지표 연구로서 흰쥐 혈액내 효소활성도의 변화를 조사한 결과는 다음과 같다. 1) Alkaline phosphatase 활성도는 0.1, 0.25, 0.5, 2, 4 Gy의 방사선 조사후 24시간까지 혈액내 활성도가 증가하였고 72시간 경과시에는 대조군과 비슷한 활성도를 보였다. Creatine kinase는 2, 4 Gy 방사선 조사후 혈액내에서 활성도에서 활성도가 72시간까지 증가하였으나 0.1, 0.25Gy, 0.5 Gy 방사선 조사시에는 커다란 변화를 보이지 않았다. 2) Malate dehydrogenase 활성도는 0.1, 0.25, 0.5 Gy 방사선 조사시에는 커다란 변화가 없었으며 lactate dehydrogenase는 방사선 조사후 활성도가 감소하였다. 3) GOT의 활성도는 선량률 0.1Gy/min.로 0.1, 0.25, 0.5, 2, 4 Gy 조사후에는 어떠한 변화도 없었으며 선량률 0.5 Gy/sec.로 0.5, 1, 1.5, 2, 3, 5, 7 Gy로 조사후에는 증가현상을 보이고 있다. Acid phosphatase 활성도는 상기의 어떠한 선량에서도 나타나지 않고 있다. 잠재적으로 이러한 효소들은 방사선 피폭의 지표물질로 사용될 수 있으며 생화학적 지식과 기술을 이용한 좀더 나은 지표물질을 찾기 위하여 계속적인 조사가 필요하다. Enzyme activity changes in rat blood as biochemical indicator useful for evaluating exposure dose were experimentally studied. The experimental results obtained are as follows: 1) Alkaline phosphatase activities increased in the blood serum until 24 hours after 0.1, 0.25, 0.5, 2 and 4 Gy irradiation and its activities returned mormal condition after 72 hours of post-irradiation. Creatine kinase activities increased in the blood serum until 72 hours after 2 and 4 Gy irradiation but any significant activity changes were not detected after 0.1, 0.25 Gy irradiation. 2) Malate dehydrogenase activities did not reveal available changes changes after 0.1, 0.25, 0.5 Gy irradiation and lactate dehydrogenase activities decreased in the blood serum after 0.1, 0.25, 0.5 Gy irradiation. 3) Glutamate oxaloacetate transaminase activity changes were detected in the blood serum after 0.1, 0.25, 0.5, 2, 4 Gy(0.1 Gy/min.) and GOT activities increased after 0.5, 1, 1.5, 2, 3, 5, 7 Gy(0.5 Gy/sec.). Any acid phosphatase activities were detected in the blood serum after 0.1, 0.25, 0.5, 2, 4 Gy(0.1 Gy/min.) and 0.5, 1, 1.5, 2, 3, 5, 7 Gy(0.5 Gy/sec.) irradiation. Potentially some of these enzymes can be used as indicator protein for radiation injury. Futher investigation is needed to find better biochemical indicatiors utilizing recent knowledge and techniques of biochemistry.

사구체 수의 증감을 비교할 수 있는 기준 개발

김용진,이지은,이국주,최영호,홍정석 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.1

Background: The number of glomerulus has been considered one of the etiologic factors especially for focal segmental glomerulosclerosis. However, glomeruli are too many to calculate them correctly. Although the fractionator method has became convinced, in which they used selected sections, not whole kidney sections, with same intervals, it is also very hard to get good results. Because it is still very time-consuming and laborous work which leads to make big observers' biases. Methods and Materials: We designed the index for glomerular number to estimate the tendency of increase or decrease of the number of it in different kidneys and which was evaluated by other conventional methods including fractionator method. Index was based upon the theory by Nyengaard; "the number of glomerulus correlates with the weight of kidney, which is positively correlated with body weight". Calculating formula is the number of glomeruli/surface areas of cortices, which contain calculacted glomeruli multiplies by kidney weight/body weight. Results: We applied this index to kidneys of FGSKist mouse and those of RFM/Nga mouse. The former is spontaneous glomerulosclerosis model with heavy protein uria and renal faille and the latter is the mother side of FGS/Kist mouse but has no glomerular disease or protein aria. The number of glomerulus of FGS/Kist mouse was decreased by 30% to those of RFM/Nga mouse. Conclusion: This index was useful and reliable for estimating the relative glomerular number between two groups.

병풀(Centella asiatica) 엑스-베타시클로텍스트린 고체 분산체를 함유한 폴록사머 407 히드로겔 제조 및 피부투과

김경국,곽은선,이계원,박진규,박목순,지웅길 충남대학교 약학대학 의약품개발연구소 1998 藥學論文集 Vol.14 No.-

Extract of Centella asiatica(ECA), which is poorly water-soluble extract from the Centella asiatica is known to express excellent wound healing properties. ECA-β-cyclodextrin (asiaticoside-β-cyclodextrin and genin-β-cyclodextrin) solid dispersion system, which was prepared by freeze-drying method, was formulated as gels containing poloxamer 407 and propylene glycol, and evaluated with respect to their viscosity. stability, skin permeation and drug amount in the skin of hairless mouse. The average molar ratio asiaticoside-β-CD and genin-β-CD was 1:1,7 and 1:22, respectively. When the molar ratio of genin and β-CD was 1:5, madecassic acid made 100% solid dispersion system and asiatic and about 65%. In dissolution study, >99% of asiaticoside from asiaticoside-β-CD was dissolved in 5 minutes, and >99% madecassic acid and >64% asiatic acid from genin-β-CD. The apparent viscosity of poloxamer 407 gels with ECA-β-CD solid dispersion system increased in proportion to poloxamer 407 and gels showed that asiaticoside was most stable and madecassic acid stable and asiatic acid similar to stability of gel with free ECA. The permeation amount of asiaticoside in poloxamer gels through-hairless mouse skin decreased as the concentration of poloxamer 407 increased. When propylene glycol was added at the level of 10%, the permeation amount of asiaticoside at poloxamer gels through hairless mouse skin increased but from 15% it decreased. The permeation of asiaticoside into the skin of hairless mouse was estimated to be about 0.10 ㎍/㎠.

알콜리즘의 진단과 치료

김진국 서울대학교 의과대학 정신과학교실 1983 精神醫學報 Vol.7 No.10

경구개법 또는 내시경하 비내 접근법으로 치료한 비인강 혈관 섬유종 3예

김진국,이민우,강성호,남태욱,김재영 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

Nasopharyngeal angiofibroma is uncommon, histologically benign vascular tumor that occurs almost exclusively in adolescent males. It is clinically malignant because it has propensity for locally destructive growth and fatal hemorrhage. Treatment of angiofibroma is controversial. The two major treatment modality are surgery and radiation. Adjuvant treatment with chemotherapy or embolization can be used as well. We experienced three cases of nasopharyngeal angiofibroma that was resected by transpalatine and endoscopic endonasal approach with good result. So, we report these with review of literature.

대구지역 일부 중학생의 건강증진행위와 관련요인

김경희,한창현,권진희,이성국 韓國保健敎育.健康增進學會 2001 보건교육건강증진학회지 Vol.18 No.2

The propose of this study is to find out how well the middle school students are practicing the health Promotion behaviors and the factors relating their health promotion bahavior. Questionnaire survey on 922 middle school students attending 6 middle schools (three middle schools for each sex) located in Taegu City from the 7th through 19th of Feb. 2000 were conducted. The following were as follows; 1.The perceived health status is higher in male students than in female students(p<0.01). And the ratio of the students' feeling that they are healthy becomes also high in proportion to their economic status, and their mothers' educational level, and their parents' interest in health(p<0.01). The perceived importance of health is high in proportion to the student's economic status, and their parent's interest in health. 2.In case of the Health Locus of Control in Personality, the students with both parents have higher trend of inner control than the students with single mother or single father. The perceived self efficacy is significantly higher in male students than in female students(p<0.01). And it becomes significantly high in proportion to the students' economic status and their parents' educational level and interest in health(p<0.01). It is also higher in the students who had no diseases. 3.In case of the perceived benefit of the health promotion behavior, the ratio of the students responding that it is high is higher in male students than in female students(p<0.01). It also becomes high in proportion to the students' economic status, and their parent's educational level and interest in health(p<0.01). The barriers of the health promotion behavior was found to have no variables that are related to itself. 4.According to the data from Multiple Regression of Analysis which has the health promotion behavior practice as a subordinate variable, in male students' case the degree of health promotion behavior practice becomes high in promotion to their parents' interest in health, and the perceived health status. Their degree of health promotion behavior practice is also in proportion to their perceived self efficacy and the perceived benefit of the health promotion behavior practice. But in case of the barriers of the health promotion behavior practice, the result is the opposite. As to the female students, their health behavior practice becomes high in proportion to their parents' interest in health. It also becomes high in proportion to the perceived health status, the understanding of the importance of the health, the perceived self efficacy and the perceived benefit of the health promotion behavior. But in case of the barriers of the health promotion behavior, it was the same as the male students' case.

비내시경을 이용한 안와 내벽 골절 정복 2예

김진국,남태욱,임채형,김재영,김정석 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

Traditional surgical approaches to orbital medial wall fractures are either extraocular skin incision or indirect bicoronal flap. However these methods can leave remarkable orbital scar or scalp alopecia with possible complications. Endoscopic intranasal visualization of the medial orbital wall and lamina papyracea is a technique familar to otolaryngologists. This endoscopic view allows confirmation of fracture of medial orbital wall and herniation of orbital contents. Good visualization of the fracture can facilitate the anatomic reduction of orbital contents and the proper placement of orbital implant. Two cases of medial orbital wall fracture repaired by intranasal endoscopy using silastic sheet are reported.

道의 詩學의 定立을 위한 試論

金鎭國 圓光大學校 1982 論文集 Vol.16 No.1

Ⅰ. We need to establish poetics of Tao in order to reveal truely the traditional quality of Korean literature of poetry. Contemporary literary criterary criticism or studies on Korea there are two Kinds of the limit situation. One is the narrowness of positivism, another the abusement of western theories of literature. Now we need to establish the traditional and independent thery of poetry of Korea within the world-literatu. This poetics of Tao synthesizes the oriental traditional poetics and phenomenological pcetics of the west. Poetics of Tao is a kind of the ontological poetics. Therough this poetics we could observe the liner nature of Korean poetry. Ⅱ. Tao is the most essential concept of the oriental religious thoughts confucianism, Zen Buddhism and Taoism. The ultimate goal of life in the orient is to attain the Tao. The religious life is not different from the ordinary life in the oriental thought. Most orient poets would try to experience the Tao and presense it through poetry. Poems raised from that kind of experience is evaluated as the best poem. Moon shim cho rayng ( 文心雕龍) of Yu Hyup(劉(??)) ond Chang rang shi wah (滄浪詩話) of Hwum uh(嚴羽) are the representative works of that kind of literary theory Ⅲ. Poetics of Tao, Which contents the identity between Tao and Poetry, and Zen and poetry, could be more Iogically theorized and extended through Poetics of Hermeutics and ontological criticism of Heidegger, Kayser and Sraiger. Poetics of Tao and phenomenological poetics are identified in the conceptions of lyrical experience. The conception of lyrical experience in poetics of Tao is characterized by returning deeply to the ultimate Being. Tao, and in ontologicd poetics by Erinnerung. These returning and Erinnerung could be recognized as the same meaning. Ⅳ. The poetic Creativity in this poetics of Tao is related the conception of creativity of Taoism, which relates mentally The world and Tao. The relationship between Tao and phenomena is that of inner reflection Tao presents the real world throuth the creation of self by the sponta neous relflection. The sense of reflective creativity conld be identified with the poet's creativity. poets represent the inner experience of the intuitive reflection between self and world. This reflection means the experience of the interjection between the subject and the reality of the object. Ⅴ. In this poetics of Tao the concepts of language of poetry is deeply related with the ideas of language of Romanticism. Though within the thoughts of Taoism and Zenism there are radical rejection of languaage, we could find the negative idea of language, there is, too, the ultimate language Which begins to being with Tao in illo tempore. This ultimate language is the poetic language in poetics of Tao. Assimiately, idea of language of poetry as Energia in Romanticism is related essentially with Logos, Language of God. Ccnclusively remark, we content that language of poetry is related ultimately language of Tao and Logos of God. Ⅵ. Now we could analysis the werk-Immanenz of Kkorean poetry's lyrical aspects through poetics of Tao. The thought of poetics of Tao continueously has flowed from Hayngas and Korean Ballads through shizo to moderm poetry. we could certify the possibility and usefulness through the analysis of Changiparanga and Winter Sky. The interjective mind of Taoism and Zen Buddhism has been the essential aspect of lyricality in Korean Poetr's tradition.