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.

Rolandic Cortical Dysplasia : 증례보고 Case Report

김형일,정채경,최하영,Palmini, Andre,이민철,이정청 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.6

The advent of MRI enables us to make an in-vivo diagnosis of cortical dysplastic lesions which are highly epiletogenic and show the variety of seizure patterns. Authors report a case of rolandic cortical dysplasia who had highly intractable focal motor clonic seizures. Invasive recording with subdural grid was very helpful in delinating the epileptogenic area as well as in functional mapping of eloquent areas. Total removal of dysplastic lesion could treat this highly intractable epilepsy successfully.

골반부 방사선 치료 환자에서 in vivo 선량측정시스템의 임상적용

김보경,지의규,허순녕,이형구,하성환 대한방사선 방어학회 2002 방사선방어학회지 Vol.27 No.1

방사선치료 시 종양에 정확한 양의 방사선을 조사하는 것은 국소 재발을 방지하고 합병증의 빈도를 낮춰 효과적인 치료를 가능하게 하는 중요한 요소이다. 종양에 조사되는 방사선량의 측정을 통해 치료의 정확성을 확인하기 위한 여러 방법들이 시도되고 있으며, 투과선량을 이용한 측정법도 그 중 한 예로 비침습적이며 매 치료 시 측정이 가능한 장점을 가지고 있다. 본 교실에서는 투과선량을 이용한 in vivo 선량측정시스템과 임의의 치료 조건에서 투과선량을 계산하기 위한 알고리즘을 개발하였다. 본 교실에서 개발한 in vivo 선량측정시스템의 단기간 및 장기간의 재현성을 확인하고, 환자의 방사선치료에서의 이용 시 발생할 수 있는 문제점을 파악하고 알고리즘의 정확성을 확인하기 위하여 본 연구를 시행하였다. 2000년 7월 25일부터 8월 14일 사이에 방사선치료를 시행 받은 환자 66명을 대상으로 투과선량의 측정을 시행하였으며, 이 중 골반부위의 방사선 치료를 3회 이상 시행 받은 11명의 환자를 대상으로 측정선량과 예측선량의 비교 분석을 시행하였다. 측정시스템의 재현성의 확인을 위하여 환자의 치료 전 및 치료 중 매시간 기준 조사조건에서 측정치를 확인하였다. 일별 몇 일 중 변동은 ±2% 이내로 재현성을 확인할 수 있었다. 본 시스템의 사용 시 별다른 문제점은 없었으나, 2명의 흉부 치료환자에서 투과선이 치료용테이블의 측면 금속을 관통하는 문제가 발생하였다. 골반부위 환자에서는 골반부위의 불균질조직에 의한 영향의 확인을 위하여, CT 및 simulation film을 이용하여 골 조직의 두께를 확인하여 보정 전 및 후의 값을 비교하였다. 전후방 및 후방조사야의 경우 골 조직의 보정을 시행하지 않은 경우 평균 오차가 -5.20%내지 +2.20%이었으며, 보정을 시행한 경우 -0.62%내지 +3.32%로 환자에 따라 정도의 차이는 있으나 골 보정이 필요함을 확인할 수 있었다. 측정치와 예측치 간 오차의 표준편차는 1.19%내지 2.46%로서 재현성이 높음을 확인할 수 있었다. 좌우 측방조사야에서 골 보정을 시행하지 않은 경우 평균오차는 -10.80%내지 +3.46%로서 골 조직의 보정이 필요하지 않은 1인의 환자를 제외하면 모두 음수 값을 지녔고, 보정을 시행한 경우 -0.55%내지 +3.50%의 평균오차를 지녀 골 보정의 필요성을 확인할 수 있었다. 측정치와 예측치 간 오차의 표준편차는 1.09%내지 6.98%로 전후방조사야의 경우보다 재현성이 낮음을 알 수 있었다. 복와위로 방사선치료를 시행 받은 환자의 경우를 제외하면, 표준편차는 1.09%내지 3.12%로 1례 외에는 2.57% 이내로 재현성이 높음을 확인할 수 있었다. 본 실험을 통하여 in vivo 선량측정시스템의 안전성과 재현성을 확인할 수 있었다. 정확한 예측치를 얻기 위하여 불균질 조직이 조사야에 포함되는 경우 보정이 요구되며, 골반의 경우 골 조직의 보정이 중요한 요인임을 알 수 있었다. 이를 위하여 불균질 조직에 대한 정확한 정보가 요구되며, 이는 CT 영상을 이용하는 것이 크게 도움이 되리라 생각된다. The accuracy of radiation dose delivery to target volume is one of the most important factors for good local control and less treatment complication. In vivo dosimetry is an essential QA procedure to confirm the radiation dose delivered to the patients. Transmission dose measurement is a useful method of in vivo dosimetry and it's advantages are non-invasiveness, simplicity and no additional efforts needed for dosimetry. In our department, in vivo dosimetry system using measurement of transmission dose was manufactured and algorithms for estimation of transmission dose were developed and tested with phantom in various conditions successfully. This system was applied in clinic to test stability, reproducibility and applicability to daily treatment and the accuracy of the algorithm. Transmission dose measurement was performed over three weeks. To test the reproducibility of this system, X-ray output was measured before daily treatment and then every hour during treatment time in reference condition (field size; 10 cm x 10 cm, 100 MU). Data of 11 patients whose pelvis were treated more than three times were analyzed. The reproducibility of the dosimetry system was acceptable with variations of measurement during each day and over 3 week period within ±2.0%. On anterior- posterior and posterior fields, mean errors were between -5.20% and +2.20% without bone correction and between -0.62% and +3.32% with bone correction. On right and left lateral fields, mean errors were between -10.80% and +3.46% without bone correction and between -0.55% and +3.50% with bone correction. As the results, we could confirm the reproducibility and stability of our dosimetry system and its applicability in daily radiation treatment. We could also find that inhomogeneity correction for bone is essential and the estimated transmission doses are relatively accurate.

레미콘업계의 심비오틱 마케팅 도입에 관한 연구

김형길,하재은 제주대학교 관광과경영경제연구소 2003 産經論集 Vol.19 No.-

뇌동맥류성 지주막하 출혈 후 지연허혈신경결함에 대한 평가에 있어서의 Acetazolamide단일광자방출전산화 단층촬영술의 역할

김형중,김은영,하윤,윤승환,박형천,박현선 The Korean Neurosurgical Society 2004 Journal of Korean neurosurgical society Vol.35 No.2

피질이형성증과 동반된 난치성 간질의 외과적 치료

김형일,김연희,이민철,정애자,권지현,최하영,Andre Palmini 啓明大學校 醫科大學 1995 계명의대학술지 Vol.14 No.2

The advent of neuroimaging technique has enabled the accurate diagnosis of structural abnormalities associated with intractable epilepsy. Among these, neuronal migration disorders(NMDs) or cortical dysplasias(CDs) involving cerebral cortex are increasingly recognized as a major cause of intractable epilepsy. CDs are expressed as variety of forms depending upon the time of injury to the developing nervous system. CDs are highly and intrinsically epileptogenic. It is crucial to completely resect the epileptogenic zone in focal CDs for better seizure outcome. Hemispherectomy or multilobar resection is preferred for hemimegalencephaly. Callosotomy can be chosen in the diffuse CDs who have intractable drop attacks. However, resective surgery can benefit the selected patients with diffuse CDs if localizing information persists.

주의력 결핍 과잉행동장애 아동의 운동 수행이 사회기능변화에 미치는 영향

김은정,하형주 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.20 No.1

The ADHD (Attention Deficit Hyperactivity Disorder) children (full age : 7~9) attending elementary school had golf putting exercise : 3 times a week, 10 putting each time. Measurement was made for 9 months on the standard artificial grass mat at the distances of 2.5m, 4m, and 5.5m. This experiment was accompanied with the questionnaire concerning ACTers (Attention Deficit with or without Hyperactivity Comprehensive Teacher's Rating Scale) to know the effects of the exercise on behavior adjustment in the periods of 3, 6, and 9 months. The following sums up the results from this study : 1. Attention concentration was improved to get better learning attitude and classwork. 2. The exercise learning had an insufficient effects on the decrease hyperactivity. 3. The skills of sociality were developed through the physical exercise activities. Therefore, the subjects could form sympathy with peer students and affirmative social acceptance. 4. The exercise learning brought about a little decrease in offensive tendency and animosity. 5. The exercise learning hardly affected their behavior toward the teacher and peer students. In sum, the golf putting exercise in this research had a positive effect on the behavioral change of the ADHD kids. Henceforth, it is thought to be an effective proposal for preventing, healing, and guiding ADHD, one of the important problem behavior disorders to be solved on the spot of child education.

METRx™ 기구를 이용한 후방 경추부 추궁추간공 제거술의 예비 결과

박형천,윤승환,박종운,하윤,현동근,김은영,박현선,임대철 대한척추신경외과학회 2004 Neurospine Vol.1 No.1

Objectives: Posterior cervical microscopic laminoforaminotomy has been a preferred procedure for a posterolateral cervical disc or foraminal stenosis. However, neckpain from wide skin incision and muscle injury are some of disadvantages. The authors performed cervical microscopic laminoforaminotomy with METRx™ tubular dilator system and were compared the results with classical cervical microscopic foraminotomy. Methods: Six patients underwent posterior cervical microscopic laminoforaminotomy using the METRx™ during 6 months. We have selected 10 patients from our institution as a comparison group. Preoperative and postoperative pain score composed of the radicular and neck component was examined and disability score also recorded. Diameters and lengths of laminoforaminotomy on the postoperative CT also were compared with two methods Results: Postoperative pain scores to the radiculopathies were not different but postoperative pain scores to the neckpain on the follow up periods were significantly different. The average vertical and transverse diameters of the laminoforaminotomy defect on the postoperative CT scans were not different between two groups. Average hospital stay of the classical methods was 8.8±7.5 days comparison with 4.5±0.54days of new procedure. Conclusions: Posterior cervical microscopic laminoforaminotomy with METRx™ systems seems to provide similar decompression and clinical results as classical methods compared to classical methods and shows superior results for postoperative neckpain and hospital stays.

탄화물 입자 강화 7075 Al 합금 기지 복합재료의 미끄럼마멸 특성 연구

강석하,박형철,강신철,김용석 국민대학교 생산기술연구소 2002 공학기술논문집 Vol.25 No.-

Effects of the type and volume fraction of carbide-particle-reinforcements on dry sliding wear behavior of 7075 Al alloy matrix composites were investigated. SiC, TiC and B₄C reinforced 7075 Al alloy matrix composites were manufactured by a pressureless infiltration technique and wear tested. Wear tests were carried out using a pin-on-disk wear tester with varying loads of 3N-160N at a constant sliding velocity of 0.2m/s. AISI 52100 bearing steel ball was a counterpart of the composites. Wear resistance of the composites was always higher than that of the monolithic alloy except the TiC reinforced 7075 Al matrix composite. The resistance increased with the increase of volume fraction of the reinforcing particles. Among the composites, the TiC reinforced composite had the lowest wear resistance and the B4C reinforced composite showed the highest wear resistance.

하지방사통을 동반한 성인 협부결손성 요추전방전위증의 후방요추간유합술 및 추경나사고정술후 추적결과

최철,김근수,최하영,김철진,김형일,이정청 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.4