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.

In vivo study for the hemostatic efficacy and foreign body reaction of a new powder-type polysaccharide hemostatic agent

Yoonhyeong Byun,Eun Jin Kim,Areum Lee,Young-Ah Suh,Hee Ju Sohn,Jung Min Lee,Jae Seung Kang,Yoo Jin Choi,Youngmin Han,Hongbeom Kim,Wooil Kwon,Jin-Young Jang 대한외과학회 2022 Annals of Surgical Treatment and Research(ASRT) Vol.102 No.2

Purpose: Various hemostatic agents have been introduced in therapy as postoperative bleeding is a poor prognostic factor for postoperative outcomes. These products can be divided into those that directly promote the hemostatic cascade and those that physically form a barrier by absorbing blood. The latter, powder-type hemostatic agents have the advantages of being inexpensive and more absorbable with less foreign body reactions (FBRs) and are applicable to a relatively wide area. This study was conducted to verify the safety and efficacy of a newly invented polysaccharide product (OOZFIX, Theracion Biomedical), which improves blood absorption and hemostatic effects. Methods: Two separate animal experiments were performed. The first evaluated FBRs histologically at 3 days, 2 weeks, and 4 weeks, after implantation of OOZFIX in rats, and the second compared hemostatic performance of OOZFIX and Arista AH (Bard) in the porcine liver punch biopsy model. Results: We found minimal FBRs in the 3-day group and no reactions in both the 2-week and 4-week groups after implantation of hemostatic agents. The time to hemostasis of OOZFIX was not significantly different from that of Arista AH (median [interquartile range]: 9 [6–10] minutes vs. 8 [6–10] minutes, respectively; P = 0.522). When comparing the serial bleeding grade tendency, there was no statistical difference between OOZFIX and Arista AH (P = 0.656). Conclusion: OOZFIX caused a minimal FBR that disappeared within 2 weeks in vivo, and its hemostatic performance was comparable with that of an existing agent, Arista AH. Further clinical studies are required in the future.

Helicobacter pyloir 양성 소화성 궤양에서 lansoprazole 포함 삼제요법의 제균율 및 제균판정에 있어서 요소호기검사의 유용성

정혜경,곽재진,유민아,배기선,권정미,이종수,김도영,문일환 대한감염학회 2003 감염과 화학요법 Vol.35 No.3

목적 : 본 연구는 Helicobacter pylori (이하 H. polyri) 양성인 소화성 궤양 환자에서 lansoprazole 포함 삼제요법의 제균율을 알아보고, 제균 치료 후 제균 판정에 있어서 요소 호기 검사(Urea breath test, 이하 UBT) 및 신속요소분해(rapid urease test, 이하 RUT test)와의 일치율에 대하여 알아보고자 하였다. 방법 : 상부위장관내시경 검사에서 H. polyri 양성인 소화성 궤양환자에서 lansoprazole 60㎎+amoxicillin 2g+clarithromycin 1g의 약제를 2회 분복하여 1주간 복용하는 삼제요법을 실시하였다. 최소 4주후 추적 상부위장관내시경을 실시하였고, 전정부와 체부에서 각각 RUT를 실시하였으며 UBT(5분, 20분)를 시행하였다. 결과 : 대상환자는 총 46명으로 남자 34명(48±13세), 여자 12명(53±14세)이었다. LAC 삼제요법의 제균율은 40/46명(87.0%)이었고, 궤양의 치유율도 42/46명(91.3%)이었다. RUT와 20분 UBT 결과가 모두 음성이었던 경우는 41예, 모두 양성이었던 경우는 4예로 RUT와 UBT는 97.8% (45/46)의 일치율을 보였고, 1예는 UBT는 음성이었으나 체부에서 시행한 RUT가 양성이었다. 5분 UBT 검사가 양성이었던 예는 14/34 (41.2%) 이었고, 이 14예 중 12예(85.7%)는 20분 UBT 검사 음성, RUT 음성이었다. 결론 : Lansoprazole과 amoxicillin, clarithromycin 1주일 병합요법은 H. polyri 양성인 소화성 궤양 환자에서 87.0%의 제균율을 나타내어 우수한 효과를 보였고, 요소호기검사는 제균 치료 후 제균 판정에 유용한 비침습적인 방법임을 확인할 수 있었다. Background : There are only a few studies on Helicobacter pylori (H. pylori) for its eradication rates of lansoprazole-based triple therapy in Korea, and the results are controversial. Therefore, we undertook to investigate the eradication rate of lansoprazole-based triple therapy, and compare the concordance rate of urea breath test (UBT) and rapid urease test (RUT) in evaluating H. pylori eradication. Methods : Patients with acute peptic ulcer who were H. pylori-positive were recruited by prospective, consecutive manner. They received lansoprazole 30 ㎎ b.d., amoxicillin 1 g b.d. and clarithromycin 500 ㎎ b.d. for 1 week. Upper endoscopy was performed after 4 weeks to check for ulcer healing, and UBT and RUT were performed to evaluate H. pylori eradication status. Results : A total of 46 patients were recruited, and they were all compliant. H. pylori eradication rate was 87.0% (40/46) and ulcer healing rate was 91.3% (42/46). Forty one patients showed negative in both UBT and RUT, and 4 patients revealed positive in both tests, therefore, the concordance rate of UBT and RUT was 97.8% (45/46). Conclusion : Our study showed that 1-week lansoprazole-based triple therapy was effective in H. pylori eradication and ulcer healing. UBT can be an effective, noninvasive method for evaluating H. pylori status after H. pylori eradication.

신장기증자들의 심리적 특성

정승아,김재환,강종명,이장한,김경욱 漢陽大學校 精神健康硏究 1998 精神健康硏究 Vol.17 No.-

적혈구 유무에 따른 벤젠, 스티렌, 트리클로로에틸렌에 의한 림프구 중 자매염색분체 교환 빈도

성재혁,김형아,신민정,최미정,이세훈 가톨릭대학교 산업의학센터 2001 韓國의 産業醫學 Vol.40 No.4

This study was performed to investigate the possible role of oxyhemoglobin in the metabolic activation of benzene, styrene and TCE by observing the difference of the SCE frequency between isolated lymphocyte and whole blood lymphocyte cultures exposed to these chemicals. Isolated lymphocyte and fresh heparinized peripheral whole blood samples from a healthy donor(male, smoker) were cultured in the phytohaemagglutinin stimulated culture media for 72 hours. The cells were treated with 100, 300, 1000, 3000 μM benzene, 250, 500, 100, 2000 μM styrene or TCE respectively. Slides were stained with Giemsa's solution for SCE. SCE was analyzed for each subject from coded slides by one researcher. The results were as follows : 1.The frequency of SCE increased dose-dependently with concentration of benzene in isolated lymphocyte and whole blood lymphocyte cultures, however there were no significance. There was no significant difference of SCE frequency between isolated lymphocyte and whole blood lymphocyte cultures. 2.The frequency of SCE in whole blood exposed to sytrene significantly increased in dose-dependant relationship, but not in isolated lymphocyte. The difference of SCE frequency between isolated lymphocyte and whole blood lymphocyte of 2000μM styrene exposure was marginally significant(P=0.0540). 3.In TCE, the frequency of SCE did not increase at any concentration used in this study of isolated lymphocyte and whole blood lymphocyte. Above results suggested that oxyhemoglobin in erythrocytes play an important role in the metabolic activation of styrene but not in benzene or TCE. Key Words : Benzene, Styrene, Trichloroethylene, Sister chromatid exchange, Metabolic activation, Oxyhemoglobin

STZ 유발 당뇨쥐에서 시간에 따른 생리적 항산화계의 변화

이순재,양정아,김성옥,최정화,신주영,채영미,차복경 대구효성가톨릭대학교 응용과학연구소 1997 응용과학연구논문집 Vol.5 No.-

The purpose of this study was to investigate change of physiological antioxidative system according to the time in streptozotocin-induced diabetic rats. Sprague-Dawley male rats weighing 150±10gm were randomly assigned to one normal and five STZ-induced diabetic groups. Diabetic groups were classified to experimental period. Diabetes was experimentally induced by intravenous injection of 55 mg/kg of body weight of STZ in citrate buffer(PH 4.3) after 6 weeks feeding of three experimental diets. Animals were sacrificed at 0, 3, 6, 12, 18th days of diabetic states. 1. Activity of superoxide dismutase(SOD) in liver was increased in that of diabetic mellitus(DM) groups at 3th day but that of DM groups was not significant from 6th day according to period. Glutathion peroxidase(GPX) was significantly decreased in DM groups from 6th day 2. Reduced glutathione(GSH) contents in liver significantly decreased in diabetic groups from 3rd day compared with those of DM groups according to the period. Oxidized glutathione(GSSG) was higher from 6th day. GSH/GSSG ratio was significantly lower than that of normal group from 3rd day to all experimental period 3. Contents of vitamin E in liver of DM groups were significantly decreased compared with that of normal group from 6th day. 4. Lipid peroxide(LPO) contents in liver of DM groups were significantly increased compared with that of normal group from 3rd day. The present results indicate that STZ-induced diabetic rats were reduced by antioxidative defense system and taken by peroxidate damage in tissue compared with normal group from 3rd day or 6rd day after injection STZ. It lended to acceleration all diabetic groups but no significance according to the experimental time.

인천 인현동 호프집 화재 피해자 분석

최정태,안무업,안희철,최영미,정재봉,서정열,유기철,이삼우,박석현,조준휘,김성환,김아진,송근정 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Purpose : This study was conducted to develop field triage, transportation, distribution, and prehospital care at a fire disaster by analyzing the victims of the fore that broke out at a bar in Incheon. Method : We analyzed the cases of the victims of a fire in Incheon in Oct. 1999. We determined the primary care hospital, the arrival time, the burn size, the outcome, and the injury type from the medical records, the concerned organ records, and interviews with concerned persons. Result : The total number of victims was 137: 56 prehospital deaths, 1 hospital death, and 80 survivals. The Pearson correlation coefficient between the burn size and the severity was -0.175. There were 121(89.6%) cases of inhalation injury, 59 (43.7%) cases of flame burns, 66 (48.9%) cases of hypoxic brain damage, and 16 (11.9%) cases involving other types of injury. Conclusion : The causes of death of the fire victims were inhalation injury and hypoxic brain damage due to CO poisoning and other toxic inhalants. We propose the use of a simple triage and rapid treatment(START) system and a reassessment the delayed category in fire disasters.

구미지역 직업성질환 감시체계

김성아,김진석,전혜리,정상재,김상우,이채용,함정오,유재영,최태성,하봉구,조민환,우극현 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.1

목적: 구미지역 내 대학병원이자 특수건강진단·보건관리대행기관의 산업의학전문의, 보건관리대행 간호사, 사업장 간호사를 중심으로 직업성질환감시체계를 구축하여 주요 직업성질환들의 발생현황과 규모를 파악하고자 하였다. 또한 연차적으로 산업, 직업, 업무내용 등에 따른 분포나 원인을 기존 자료원(특수건강진단의 직업병 유소견자와 산재요양승인 되는 직업병자)과 비교하여 분석·기술하고 예방 및 관리를 포함한 보건의료기술개발까지을 포함하는 종합적인 감시체계를 구축하고 운용하고자 하였다. 방법: 구미지역의 산업적 특성에 맞는 직업성질환감시체계를 구축하고 지역 감시체계의 모델을 제시하였다. 6대 감시대상 직업성질환(독성 간염, 직업성천식, 직업성 근골격계질환, 직업성 피부질환, 직업성 암, 수지진동증후군)의 실행적 환례정의, 보고양식 및 보고체계 개발, 분석양식 및 결과 배포 형식을 개발하였으며, 그 유병규모를 파악하고, 감시질환의 분포 및 특성, 관련인자 등을 분석·기술하고자 하였다. 이때, 1년간의 환례분석시 직업병 유소견자 및 직업병 요양자에 대한 자료와 함께 비교 분석하였으며, 노동통계자료를 이용하여 년간 발생률을 추정하였다. 결과: 2001. 1. 1일부터 2002.4.30일까지 총 287건이 보고되었으며, 직업성 근골격계질환 132건(46.0%), 직업성 피부질환 100건(34.8%), 독성간염 34건 (11.8%), 직업성천식 16건 (5.6%), 수지진동증후군 5건 (1.7%) 이었으며 직업성 암은 한건도 보고되지 않았다. 보고경로별로는 보건관리대행에서 33건 (11.5%), 해당 유해인자별로 실시되는 특수검진 외의 각종 건강진단업무 수행 중 발견된 환례에 대한 보고가 206건(71.7%)이었다. 직종별 분류의 결과는 섬유업종사자, 단순노무종사자, 음식업종사자 등이 다수를 차지하였다. 근골격계질환의 경우, 수근관증후군이 42건(33%), 외상과염/내상과염이 39건(30%)로 가장 많았다. 직업성 피부질환은 97건이 접촉성 피부염으로 유기용제류가 59건(59%)으로 가장 많고, 니켈 및 에폭시수지에 의한 알레르기성 접촉성 피부염이 각각 6건과 5건이었다. 독성 간염은 모두 DMF 나 DMAc에 의한 것으로, 근무시작 후부터 간기능이상이 발견되기까지의 근무기간은 대부분이 3개월 이하이며, 1개월 이하인 경우도 10건이나 되었다. 동 기간 중 감시환례에 대해 산재요양 자료와 중복여부를 확인한 결과, 중복되는 것은 하나도 없었다. 특수건강진단에서 직업병유소견자로 판정된 경우는 독성간염에서 3건이 있었으며, 나머지 질환은 중복되는 것은 없었다. 2001도 구미지역의 근로자수와 보고환례건수를 이용하여 연간 발생률을 추정하였다. 근로자 10만 명당 연간 발생률은 상지 근골격계질환은 63.6명, 피부질환 48.2명, 독성 간염 17.9명, 천식 7.7명, 수진진동증후군 2.4명이었다. 참여예상인원은 총 46명이었으며, 실제 참여자수는 21명, 평균참여율은 46%, 실제 참여 1이당 평균 보고건수는 산업의학전문의가 28건으로 가장 많았고, 대행간호사는 45,건, 사업장 간호사는 3.3건이었다. 결론: 지역 감시체계는 기존 통계자료들에서 발견되지 않았던 직업성질환의 발견에 유용한 통계원이며, 특히 지역의 특성과 여건을 고려하여 체계화된 시스템을 구축하여 운용한다면 더 성과가 클 것이다. Objectives: Area-based occupational disease surveillance in Kumi (KODS) was used to collect data on occupational diseases. The data was used to estimate the magnitude of the diseases, to analyze for their characteristics and to find links for their intervention and prevention. Methods: Since January 2001, occupational physicians and nurses in Occupational Health Service (OHS) have reported six major occupational diseases; occuaptional musculoskeletal disorders of the upper extremities (MSDUE), occupational dermatoses, toxic hepatitis, occupational asthma (OA), hand-arm vibration syndrome (HAVS), and occupational cancer. For the respective diseases, a reporting sheet and operational diagnostic criteria were developed by the KODS. An analysis of the KODS data, collected over a certain period, was compared with data from the Korea Labor Workers Corporation (KLWC) and the Specific Health Examination (SHE), and the incidence rates of the diseases estimated. Results: Between Jan 2001 and Apr 2002, 287 cases of the six major occupational disease were reported. Of these, there were 132 (46.0%), 100 (34.8%), 34 (11.8%), 16 (5.6%), and 5 (1.7%), cases of MSDUE, occupational dermatoses, toxic hepatitis, OA, and HAVS, repectively. But, there were no cases of occupational cancer. 33 (11.5%) of the incidence were reported via the OHS, 206 (71.7%) from health checkups, and the other 48(16.8%) from other routes. The synthetic fibers and electronic components manufacturing industries accounted for the greatest number of reported cases. With resport to occupation, the greatest numbers of incidence were reported from the elementary occupations, textile workers, assemblers, and cooks and food services worker, in that order. Of the MSDUE cases, carpal tunnel syndrome and epicondylitis were the two most common diseases. Most of the occupational dermatoses were due to contact dermatitis, with organic solvents (59%), nickel (6%), and epoxy resin (5%) accounting for the majority of these cases. All cases of toxic hepatitis were induced by dimethylformamide or dimethylacetamide, which were reported by a unique monitoring system. During same period, there were no cases claimed by workers to the KLWC, and only three cases from SHE, were identified. Using data from workers' number and surveillance, the annual incidence of MSDUE, dermatoses, hepatitis, OA, and HAVS, per 100,000 workers were 63.6, 48.2, 17.9, 7.7, and 2.4, respectively. Conclusions: These results show that an area-based surveillance system can be very effective for the collection of data on work-related diseases, at least in Kumi.

제대혈중 납농도와 신생아 신경행동평가

김정아,김성아,이채용,정상재,천병렬 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.1

목적: 제대혈중 납농도가 신생아 행동평가에 미치는 영향을 평가하고자 하였다. 방법: 구미지역 1개 종합병원 신생아실에서 정상 분만한 신생아 55명을 연구대상으로 선정하였다. 납농도는 신생아의 제대혈에서 채취하여 분석하였고, 행동평가는 생후 1일째와 생후 1개월째에 브레즐톤 신생아 행동평가(Neonatal Behavioral Assess-ment Scale, 이하 NBAS)를 이용하여 시해하였다. 산모의 교육정도, 산모의 흡연유무, 산모의 간접흡연 유무, 남편의 흡연유무, 직업에 대한 생후1개월째 외래방문 시 어머니들을 대상으로 면담설문조사를 실시하였다. 결과: 연구대상자들의 평균 제대혈중 납농도는 3.88±0.70 μg/dl으로 의학적으로 중독증상을 일으키거나 행동에 장애를 줄 수 있는 농도에 미치지 않는 낮은 농도였다. 중앙값(4 μg/dl)을 근거로 두 군으로 나누었다. 일반적 특성에 따른 두 군 간의 유의한 차이는 없었다. 생후 1일째의 NBAS는 영역군집별로 두 군 간에 유의한 차이는 없었으나, 생후 1개월째의 NBAS는 4 μg/dl미만인 군이 4 μg/dl 이상인 군에 비해 운동성 영역과 상태조직력 영역의 군집점수가 유의하게 높았다. 생후 1일째의 NBAS 중 항목별로 세분하여 비교한 결과, 4 μg/dl 미만인 군이 4 μg/dl 이상인 군보다 상태조직력 영역중 최고흥분도달상태점수만이 유의하게 높았다. 그러나 생후 1개월째의 NBAS는 사회성-상호작용 영역 중 생물성시각적 자극, 무생물성시각적 자극, 무생물성청각적 자극에서, 운동계 영역 중 활동수준에서, 상태조직력 영역중 최고흥분도달상태와 상태가변성에서 4 μg/dl 미만인 군의 점수가 4 μg/dl 이상인 군보다 유의하게 높았다. 검사시기에 따른 두 군간의 변화의 정도 차이를 생후 1일째의 신경행동평가 점수를 공변량으로 조정한 후 평가한 결과, 납농도에 따른 두 군간에 유의한 차이가 있는 항목들은 사회성-상호작용 영역에서는 생물성시각적 자극, 무생물성시각적 자극, 무생물성청각적 자극이었다. 운동계 영역 중에서는 활동수준이, 상태조직력 영역에서는 최고흥분도달상태와 상태가변성이었다(p<0.05). 결론: 신생아의 평균 제대혈중 납농도의 평균이 3.88 μg/dl으로 상당히 낮았다. 그러나 제대혈중 납농도가 4 μg/dl 미만인 군과 4 μg/dl 이상인 군의 생후 1일째와 생후 1개월 후의 신경행동학적 평가 결과를 비교하였더니 생물성시각적 자극, 무생물성시각적 자극, 무생물성청각적 자극, 활동수준, 최고흥분도달상태, 그리고 상태가변성의 항목에서 차이를 보였다. 이로써 납의 저농도 노출이 신생아의 신경행동학적 기능에 영향을 미칠 가능성이 있음을 알 수 있다. Objectives: To investigate the relation between umbilical cord blood lead level lower than 10 μg/dl and neonatal neurobehavioral performance. Methods: Umbilical cord blood lead level, as an indicator for prenatal exposure to lead, and Brazelton neonatal behavioral assessment scale (NBAS), as an indicator for effect, were determined in 86 neonates in Gumi, Kyungpook, Korea. The blood levels were measured by graphite furnace atomic absorption spectrophotometer. Development was assessed by NBAS at birth in 86 neonates and at I month in 55 neonates. Results: The mean cord blood lead levels of the 86 and 55 neonates were 3.90±0.7I μg/dI (range 2.24 - 5.39 μg/dl) and 3.88±0.70 μg/dl (range 2.24∼5.03 μg/dl), respectively. We used the median value of 4 μg/dl to divide into low- and high- lead level groups. There was a significant difference in the peak of excitement at birth, and in the animate visual, inanimate visual, inanimate auditory, activity level, peak of excitement, and liability of states at one month, between the two groups. For cluster scores, motor system and state organization scores showed significant differences between the two groups. For adjusting the potential confounding effect of intial difference, differences of the scores between the two groups at one month were analysed with ANCOVA. The results of ANCOVA showed the significant difference between the two groups. Conclusions: The findings suggest that prenatal low-level lead exposure, even lower than 10 μg/dl, might affect the neonatal neurobehavioral development.

한국인에서 구강상피세포를 이용한 발암물질 대사효소의 유전자 다형성에 관한 연구

최민아,박해준,정원윤,이재원,이정복,박광균 대한암예방학회 2002 Journal of cancer prevention Vol.7 No.3