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.

2,5-헥산디온에 의한 피부착색 3례

김성아,정상재,이채용,이상만,김상우 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.2

Objectives : To report on the skin discoloration experienced by three workers handling 2,5-hexanedione Methods : Three workers, who showed orange-brown discoloration of the palms during observation under the Kumi occupational disease surveillance system, had their history evaluated and underwent physical examination. A workplace survey was performed by an occupational physician and an industrial hygienist. Results : The three workers were determined to have been experiencing skin discoloration since the introduction to a new cleaning solvent. The new solvent contained 2,5 hexanedione, which is reported in the literature to be possibly capable of causing orange-brown discoloration of the skin. After discontinuation of solvent use, the workers recovered within a week. Conclusions : These cases demonstrate that 2,5-hexanedione can produce skin pigmentation.

골다공증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이남수,이상건,이상범,이상우,이선정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : As the average lifespan of human increases, osteoporosis and osteoporosis-related fractures have become major health care problems. Despite recent advances in medical treatment, few studies have assessed the recognition of osteoporosis in general adults. This study examined the recognition of osteoporosis and analyzed the relating factors. Method : A population-based sample of 1086 adults in Asan-city, Korea was investigated with questionnaires and height, weight, Information regarding the general characteristics(gender, age, economic state), lifestylef exercise, smoking, alcohol),medical history(progestin, GH, steroid, calcitonin, PTH), demographic parameter, obesity, stress, and family history was collected through an interview using a structural questionnaire. The level of obesity was measured by the body mass index(BMI). BMD(Bone mineral density) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry. Osteoporosis was considered to be T-score below -2.5. Results : The prevalence of osteoporosis increased progressively with age, decreased with BMI and predominant in women by the result of x^(2) -test, T-test. Age, weight, BMI were significantly correlated with osteoporosis by the result of Pearson correlation ana1ysis(P<0.05). And age, gender, BMI, family history of osteoporosis were proved to be significant risk factors of osteoporosis by the result of multiple logistic regression(P<0.05). Conclusion : These results suggest that age, gender, BMI might be the most important risk factors of osteoporosis. And the history taking about family history of osteoporosis is helpful for diagnosing osteoporosis.

스웨징(swagging) 작업자에서 수지진동증후군 및 신경전도장애

김성아,김상우,정상재,이채용,김규상,정보우,박상규 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.2

목 적 : 스웨징작업자들에서 발생한 수지진동증후군 사례를 실제 진동수준 평가와 함께 보고하고, 진단시 신경전도검사의 소견에 대한 해석을 검토하고자 하였다. 방 법 : 2001년 4월과 5월에 구미소재 스웨징작업 종사자 8인을 대상으로 병력문진, 자각증상평가, 이학적 검사를 실시하고 수지진동증후군의심자 4인에대해 냉각부하검사와 신경전도검사를 실시하였다. 작업장조사는 진동측정장비들을 이용하여 실제 작업환경에서 측정후 국제표준화기구에 따라 평가하였으며, 수근관증후군의 동시 가능성을 알아보고자 인간 공학적 요인에 대해 조사평가 하였다. 6개월후인 12월에는 이들 4인에 대해 진동각검사와 싱경전도검사를 추적검사하였다. 결 과 : 진동수준은 주파수가중가속도값이 단일작업은 0.99∼10.79 m/sec^2, 2개의 복합작업은 3.03 ∼12.98 m/sec^2로서 ISO의 권고치를 초과하고 있었다. 1차 대상근로자 8인의 근무기간은 평균 8.7년(범위 0.8∼15)이었고, 1인은 당뇨병자이었다. 스톡홀름 분류에 의한 증상평가, 손톱압박검사, 진동각검사에서 비교적 진동노출수준과 비려하여 임상소견을 나타내었고, 2차 평가대상자 4인의 경우 신경전도검사에서 1인은 정상, 2인은 수근관증후군, 1인은 말초신경병증으로 해석되었다. 그러나, 문헌 고찰을 통해 수근관증후군으로 나온 신경전도검사결과는 오히려 진동으로 인한 다병소 신경장해로 판단하였다. 6개월후 추적 신경전도검사에서 4인 모두 진동으로 인한 다병소 신경자해를 확인하였다. 그러나, 1인에서는 수근관증후군의 동시존재 가능성을 고려하였다. 결 론 : 고정된 진동공구인 스웨징사용자들에서 수지진동증후군발생을 확인하고, 진동노출수준을 실제로 측정하여 그 양-반응관계를 동시에 평가하였다. 신경전도검사의 해석과 관련하여 수지진동증후군에서 종종 동시 존재하는 수근관증후군과의 연관성 및 감별점을 실례로써 제시함으로써 향후 진동장해를 평가하는데 도움을 주고자 하였다. Objectives : To investigate the hand-arm vibration syndrome (HAVS) among symptomatic swagging workers exposed to hand-arm vibration, using medical evaluation and measurement of workplace vibration. Furthermore, to evaluate the neurophysiological findings. Methods : Four workers showing symptoms relevant to HAVS were evaluated. Medical evaluation consisted of medical interview, questionnaire, nail-bed compression test, and sensory perception tests for vibration and pain. Some other diseases were excluded by a medical interview, hematological assessment, and urinalysis. Cold provocation test was used to assess the peripheral vascular changes, and a nerve conduction velocity (NCV) test was implemented to ascertain the peripheral neural changes. Pegboard, hole plate, and tapping board tests were performed to assess motor nerve function. The hand-arm vibration acceleration levels of the swagging machines were measured. Six months later, follow-up NCV tests were performed. Results : The actual exposure time to vibration was not longer than 15 minutes per day. The hand-arm vibration acceleration levels of the swagging machines, according to actual exposure time, were from 3.63 to 12.98 m/sec^2, by ISO 5349. The vibratory perception thresholds and the recovery time of a nail color following finger cooling were significantly increased in all four workers. The perception of pain was mildly increased. The nerve conduction studies at first diagnosis and follow-up showed multifocal neural impairment caused by vibration. However, we could not rule out the concomitant presence of the carpal tunnel syndrome in one worker. Conclusions : These results show that HAVS can be caused by hand-arm vibration in swagging workers. Interestingly, the NCV results suggested that vibration-induced neural conduction impairments could vary, and need to be interpreted cautiously.

한국 천식아동의 기질특성

김승태,최성구,김상엽,정유숙,홍성도,김선우,이상일,이흥재 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

이 연구의 목적은 기관지 천식아동의 기질특성을 알아보기 위한 것이다. 저자중 일인의 예비연구에 의하면 천식아동집단은 습진이나 알러지성 비염 등의 만성질환을 가진 아동집단이나 정상아동과는 다른 기질특성을 갖는다. 세 살에서 일곱 살 사이의 정상아동과 기관지 천식을 앓는 아동 85명의 어머니들에게 한국판"부모기질설문(Parental Temperamental Questionnaire)"을 완성하도록 하여 기질을 측정하였다. 기질의 9가지 범주 및 요인 A점수를 비교하기 위하여 비모수적 통계법을 사용하였으며, 아동들의 기질진단을 비교하기 위하여 Chi-square통계법을 사용하였다. 그 결과 천식을 앓는 여아집단은 정상 여아집단에 비해 적응성과 반응의 역치 범주에서 통계적으로 유의하게 낮았다. 또 정상아동집단의 11%가 기질진단적으로 양육곤란형인 반면 천식아동집단은 22%를 차지했다. 두 집단은 기질진단면에서도 통계적으로 유의한 차이를 보였다. 이와 같은 결과는 천식아동에 특징적인 기질양상이 있음을 시사한다. 기질양상의 조기발견은 부모들에게 천식아동의 건강한 발달을 이해하고 행동장애 고위험집단인 만성질환을 앓는 소아들에게 적절한 양육을 제공하는데 도움을 줄 것이다. The objective of this study was to determine temperamental characteristics of children with bronchial asthma. An earlier preliminary study(Kim SP, Ferrara A, Chess 5, 1980) results show that the asthmatic children, as a group, are significantly different from two other control groups(1. children with eczema, allergic rhinitis, or both without asthma : Ⅱ. normal healthy children in their temperamental profile). The parents of 85 Korean children with bronchial asthma, ages 3 to 7 years, completed the Korean version of Parental Temperamental Questionnaire developed by Thomas and Chess. The data collected were of ordinal type, ranked from 1 to 7 and the non-parametric Mann-whitney U Test was utilized. Any child with a suspected history or diagnosis of premature birth, organic brain syndrome, mental retardation, childhood psychosis, congenital physical anomaly, hereditary disease or any other medical or surgical conditions, other than asthma, requiring continuous physicians care was excluded from the study population. The results showed that asthmatic female children were characterized by lower adaptability and lower threshold of responsiveness. And 22% of asthmatic children were of the difficult type, compared to 11% of normal children. Both groups were statistically different in terms of temperamental constellation. The findings strongly suggest the existence of a distinct temperamental profile of asthmatic children. Early detection of the profile may be of great value for parents and child health care providers in understanding the asthmatic children's correct developmental needs and in determining appropriate parenting approaches for the chronically ill children at the risk of behavioral disorder.

구내 골신장술 후 식립된 전치부 임플란트보철 치험보고

김한석,김명래,이성근,강상원,김기환,김형섭 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.1

Objective : This is to report the effectiveness of intraoral distraction osteogenesis for alveolar augmentation in the extremely atrophied alveolar defects and to review the clinical results of the 2 cases. Subjects and Methods : Anterior segmental osteotomy was performed and the trans-oral alveolar distractors(Martin, Germany) were applied in 2 patients with the severe acquired anterior maxillary and mandibular defect. After latent period for 1 week, the osteomized alveolar segments were distracted by 1 ㎜ a day (0.5 ㎜/l turn) for 8 days in case Ⅰ and 0.6 ㎜ a day(0.3 ㎜/l turn) for 10 days in case Ⅱ. The consolidation period was about 8 weeks in each case. Thereafter, 6 titanium threaded implants(Branemark, Restore) were simultaneously installed with removal of distractor. The implants were tested clinically and radiographically. Results : Amounts of acquired alveolar bone were 8 ㎜ in case Ⅰ and 6 ㎜ in case Ⅱ respectively, with the increased width of the ridge crests and soft tissue expansion. Dental implants installated on the augmented alveolar ridges in 8 weeks after distrction were confirmed as in good osseointegration and in good function without any complications. Conclusion : Intraoral distraction osteogenesis can be a good option for alveolar ridge augmentation of the severely atrophied ridges and soft-tissue defects. However, for the better vector control of distracting segments and for anterior esthetics, customized distraction devices could be considered later.

혈우병 환자에 동반된 자발성 후복막강 출혈

김광일,김동호,우상민,이석주,김홍성,조인성,윤환중,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

Spontaneous retroperitoneal hemorrhage due to hemophilia A with impaired coagulopathy is very rare. Spontaneous retroperitoneal hemorrhage has been recorded as having originated from many retroperitoneal organs and blood vessels, and it may be due to local and/or systemic factors. In the majority of the patients, kidney and adrenal gland were the major site of hemorrhage. The systemic causes of spontaneous retroperitoneal hemorrhage are anticoagulation therapy and chronic hemodialysis. During the course of these treatments, hemorrhagic complications may occur at many site, including the retroperitoneal space. Blood dyscrasias including leukemia, polycythemia, sickle cell trait and hemophilia have been reported associated with spontaneous retroperitoneal hemorrhage. We report a case of spontaneous retroperitoneal hemorrhage occurred in a gemophilia A patient with brief review of literature

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

국가 대표급과 제주도 고교 대표급 수영선수들의 그랩 스타트의 운동학적 분석

김철원,김승곤,오만원,임상용,김성찬,이창준,남사웅,이세형,류재청,신석종,김세민 濟州大學敎 體育科學硏究所 1998 체육과학연구 Vol.4 No.-

The purpose of the study was to undertaken to analysis the Grab starting technique between national representive team(3) and Cheju's representive team(3) with 3D cinematography. The conclusions obtained were as follows: Cheju's showed more elapsed time than national representive team on starting block. and more vertical than horizontal direction of COG position, more concentrated vertical velocity & acceleration than forward direction. Therefore It is necessory for cheju's to train balanced trust force in horizontal and vertical direction in grab starting technique.