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.

유도 '되치기 본'의 개선 방안에 관한 연구

김의환,김도준,김규수,김관현,김종달,최종삼,조용철,박순진,윤익선,안병근,정 훈,김미정,한성철 龍仁大學校 武道硏究所 1999 武道硏究所誌 Vol.10 No.1

The purpose of this study was to reform practically a Korean Judo's Doechigi-Bon(Forms of Counterattack, judo's Gaeshi no Kata, Judo's Uradori no Kata, Judo's Gonosen no Kata) that was established in 1955 Korea, according to changing of techniques by Judo's modernization, in order to have Judo's carefulness and systematic diffusion. Reform procedure of Judo's Doechigi-Bon was 1st stage, Questionnaire survey 303 judokas, 2nd stage, Technical seminar by judo experts(12 judo professor) 4 times, 3rd stage, wording report for reform, 4rd stage, Discussion and judgement of Teaching and Judgement commission of Korean judo Association(KJA), 5th stage, Public hearing for reform in KJA, 6th stage, Report and decision of board of directors in KJA, 7th stage, public publication of Judo News(No.53) in KJA. Basic principle of reform of Judo's Doechigi-Bon were as table 1. Table 1. Basic principle of reform of Judo's Doechigi-Bon ------------------------------------------------------------------------------- Items Reformed Key Points of Judo's Doechigi-Bon ------------------------------------------------------------------------------- 1. Structure 1) Grand classification : Classified by 3 parts(1,2,3Gyo) 2)Medium classification : Te waza, Goshi waza, Ashi waza devided per each part(Gyo) 3)Sub-classification : Classified five techniques per each part(Gyo) 2. Contents 1) Selected established techniques as possible 2) Considered rationalty and overlapping of counterattack techniques 3. Decision of Conterattack techniques 1) Refered to results of Basic Questionnaire survey 2) Priority to decisions of Judo expert technical seminar -------------------------------------------------------------------------------- Reformed Korean Judo's Doechigi-Bon(Forms of Counterattack techniques-KJA, 1999) are as follows: 1. Gyo; ① Uki otoshi -> Uchi mata ② Harai goshi -> Harai goshi gaeshi ③ O soto gari -> O soto gake ④ Ko uchi gari -> Sasae tsurikomi ashi ⑤ O uchi gari -> Ko soto gari 2. Gyo; ① Ippon seoi nage -> Okuri eri jime ② Tsuri domi goshi -> Uki waza ③ Okuri ashi harai -> Okuri ashi harai ④ Ko soto gari -> Tai otoshi ⑤ Hiza guruma -> Hiza guruma 3. Gyo; ① Kata guruma -> Sumi gaeshi ② Tai otoshi -> Ko soto gari ③ Hane goshi -> Harai tsurikomi ashi ④ Uchi mata -> Tai otoshi ⑤ Tomoe nage -> O uchi gari

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.

Amitriptyline 과 Desipramine, Paroxetine 은 백서의 Schwann 세포 일차배양에서 산화질소의 생성을 억제한다

김용철,이상철,김선희,임영진,함병문,김현정,정일영,박학수 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.42 No.2

Background : Antidepressants are being used as supplemental therapy in neuropathic and inflammatroy pain. The mechanism of their inhibitory effect on experimental animal inflammation is not clear. Studies during the past few years clearly indicate an important role for nitric oxide (NO) in the inflammation and pain-processing system. We evaluated the effects of amitriptyline, desipramine and paroxetine on NO production in primary Schwann cell cultures. Methods : Primary cultures of the Schwann cell were prepared from dorsal root ganglia of 1-to 3-day old Spraque-Dawley rats. Schwann cells were cultured in the presence or absence of interferon-?? (500 ng/㎖) plus tumor necrosis factor-α (500 ng/㎖), amitriptyline, desipramine or paroxetine. Production of NO was determined in the supernatant of the culture media. Results : Amitriptyline (10 ㎍/㎖), desipramine (10 ㎍/㎖) and paroxetine (10 ㎍/㎖) inhibited NO release by 29.8%, 51.4%, and 66.8%, respectively. No drug had a toxic effect on cultured cells, which was determined by an LDH assay. Conclusions : Inhibition of NO production by Schwann cells may be a mechanism by which some antidepressant medications affect inflammatory and neuropathic pain. (Korean J Anesthesiol 2002; 42: 221~227)

박의 RAPD 분석을 위한 PCR 최적 조건 연구

김보경,김성만,김용철,이충열,박현철,최인수 밀양대학교 농업기술개발연구소 2000 農業技術開發硏究所報 Vol.4 No.1

This study was conducted to identify the best combinations of factors(template DNA concentration, MgCl2 concentration, and amount of taq polymerase) for the optimization of PCR in gourd. 3×3×3 factorial experiment for template DNA concentration, MgCl2 concentration, and amount of taq polymerase was conducted. Another factorial experiment for denature, annealing, extension temperature on the optimal PCR condition was also conducted. The most clear and reproducible bands were appeared in 40ng(1unit taq polymerase and 2.5mM MgCl2, and lunit taq polymerase and 4.5mM MgCl2, 1unit taq polymerase and 7.0mM MgCl2), 60ng(0.5unit taq polymerase and 2.5mM MgCl2, 0.5unit taq polymerase and 4.5mM MgCl2, 1unit taq polymerase and 2.5mM MgCl2, 1unit taq polymerase and 4.5mM MgCl2, and 1unit taq polymerase and 7.0mM MgCl2). The best MgCl2 concentration was 4.5mM(40ng template DNA and 1unit taq polymerase, 60ng template DNA and 0.5unit taq polymerase, and 60ng template DNA and lunit taq polymerase), and 7.0mM(40ng template DNA and 0.5unit taq polymerase DNA). The combinations which showed the best bands from the amount of taq polymerase were 0.5unit(60ng template DNA and 4.5mM MgCl2) and lunit(40ng template DNA and 2.5mM MgCl2, 40ng template DNA and 4.5mM MgCl2, 40ng template DNA and 7.0mM MgCl2, 60ng template DNA and 2.5mM MgCl2, 60ng template DNA and 4.5mM MgCl2, 60ng template DNA and 7.0mM MgCl2). When we consider results from template DNA concentration, MgCl2 concentration, and amount of taq polymerase, 1 condition(40ng of template DNA, 4.5mM MgCl2 and 1unit taq polymerase) was the best combination for the optimal PCR condition. Reaction temperatures for the optimal PCR condition were 84℃, 32℃, 62℃ and 86℃, 35℃, 64℃.

정신분열병 환자의 가족부담 척도 개발에 대한 예비연구

김철권,조진석,서지민,김용관,김호찬,김현수,김상수,제영묘 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적 : 정신분열병 환자의 가족이 느끼는 부담을 측정하기 위한 가족부담 척도를 개발하기 위함이다. 방 법 : 200명의 정신분열병 환자 가족과의 비구조적 면담과 외국 부담척도 고찰을 통하여 94문항을 수집하였고 그 다음에 전문가들과 가족들이 문항 및 영역을 분류하고 통합하여 최종적으로 36문항을 선정하였다. 그리고 정신분열병 환자의 가족 135명, 불안장애 환자의 가족 22명, 기분부전장애 및 신체화 장애 환자의 가족 26명, 치매 환자의 가족 49명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과 : 자료분석 결과 검사-재검사 신뢰도, 내적 일치도, 감별타당도 모두 높게 나타났으며, 요인분석을 통해 다섯 가지 구성요인이 추출되었다. 결 론 : 본 가족부담 척도는 정신분열병을 포함한 만성 정신질환을 앓고 있는 환자의 호전과 가족의 부담을 덜어주기 위한 다양한 프로그램의 효과를 검증하는데 유용하게 사용되어질 수 있을 것이다. Objectives : This preliminary study was carried out to develop the Family Burden Scale(FBS) of the schizophrenics. Methods : Ninety-four items were collected by interviewing in a free unstructured format with one relative of each 200 schizophrenic patients and reviewing foreign FBS's. Several professionals and relatives were asked to group and integrate them into several categories. Finally 36 burden items were chosen to constitute a FBS. The FBS was administered to the relatives of 135 schizophrenic, 22 anxiety disorder, 26 dysthymic disorder and somatization disorder, and 49 dementia patients for examining the reliability and validity. Results : The FBS showed high test-retest reliability, internal consistency, and discriminant validity. The results of the factor analysis revealed five-factor solution. Conclusion : The FBS can be used to evaluate the effectiveness of various programs intended not only to reduce decompensation among schizophrenics, but also to alleviate family burden.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

알데히드탈수소효소 2(ALDH2) 및 CYP2E1 유전자 다형성에 따른 요중 뮤콘산 농도와 요중 8-hydroxydeoxyguanosine과의 관련성

김용대,강종원,엄상용,장연위,김성훈,김은영,이철호,문재동,김헌 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.2

아세클로페낙 연질캡슬(클란자 에스 연질캡슬)의 개발

용철순,이경희,최진석,박병주,정세현,김용일,박상만,배명수,김귀자,김영식,유창훈,강성룡,유봉규,이종달,최한곤 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.1

To develop and aceclofenac soft capsule, four preparations with various solubilizers were prepared and their dissolution test was carried out. Among four preparations tested, a preparation with ethanolamine was selected a formula of aceclofenac soft capsule (Clanza S^(™), since it showed the fastest dissolution rate. Bioequivalence of aceclofenac tablet, Airtal^(™)(Dae-Woong Pharmaceutical Co., Ltd.) and aceclofenac soft capsule, Clanza S^(™)(Korea United Pharmaceutical Co., Ltd.) was evaluated according to the guideline of KFDA. Fourteen normal male volunteers (age 20-25 years old) were divided into two groups and a randomized 2×2 cross-over study was employed. After oral administration of one tablet or capsule containing 100 ㎎ of aceclofenac, blood ws taken at predetermined time intervals and the concentration of aceclofenac in plasma wa determined with an HPLC method under UV detector. The pharmacokinetic parameters (C_(max), T_(max) and AUC_(t)) were calculated and ANOVA was utilized for the statistical analysis of parameters using logarithmically transformed AUC_(t), C_(max) and T_(max) between Airtal tablet and Clanza soft capsule were 2.89%, 0.18% and 43.0%, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log(0.8) to log(1.250(e.g.log(0.81) - log(1.23) and log(0.89) - log(1.14)) for AUC_(t) and C_(max), respectively. Thus, the criteria of the KDFA guidelines for the equivalence was satisfied, indicating that Clanza S^(™) soft capsule is bioequivalent to Airtal^(™) tablet.

헬리코박터 파이로리 균 진단용 ^13C-요소 캅셀의 개발

용철순,김용일,김지만,강성훈,권기철,이종달,김종국,사홍기,최한곤 영남대학교 약품개발연구소 2002 영남대학교 약품개발연구소 연구업적집 Vol.11 No.-

The purpose of this study was to develop a new ^13C-urea-containing capsule for diagnosis of H.pylori. The urea-containing capsules were prepared with various diluents such as polyethylene glycol (PEG), microcrystaline cellulose, sodium lauryl sulfate and citric acid. The dissolution test, ^13C-urea breath test and stability test were then performed on the capsules. Microcrystalline cellulose and sodium lauryl sulfate retarded the initial dissolution rates of urea. However, PEG increased the initial dissolution rates of urea. Furthermore, two formulae composed of PEG,[^13C-urea/PEG (38/1.9 mg/cap)] and [^13C-urea/PEG (38/1.9/1.9 mg/cap)] had the maximum DOB value. about 16 at 20 min, while the formula composed of only 38 mg ^13C-urea had the maximum DOB value at 30 min. The results indicated that PEG improved the sensitivity of ^13C-urea in the human volunteers. The capsule [^13C-urea/PEG (38/1.9 mg/cap)] was stable for at least six months in 25 and 37℃. Thus, a PEG-containing capsule, [^13C-urea/PEG (38/1.9 mg/cap)] would be a more economical, sensitive and stable perparation for diagnosis of H. pylori.