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.

전국 단위 감시체계의 현황과 전망

강성규,안연순,지영구,김형옥,하미나,권호장,백남종,김성아,홍윤철,김재용,강대희,정혜선,하은희 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

우리나라 지역 직업성질환 감시체계의 현황과 전망

임종한,장성실,김성아,문재동,채창호,홍윤철,김수영,김진석,김영욱,한상환,이혜숙,원종욱,송동빈,하은희,강성규 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

기존의 특수건강진단과 작업환경측정을 통한 직업병 관리가 진폐증, 소음성난청 등의 소수 특정질환에 국한되고 실제 직업병 발생 규모 파악이나 신종 직업병의 발견에 한계를 보인다는 사실은 산업의학전문가들 사이에서도 공감을 이루고 있다. 미국과 영국 등에서의 직업성질환 감시체계에 대한 경험은 우리 나라의 직업성질환 감시체계 구축에도 새로운 자극제가 되면서, 1998년이후 인천, 대전, 여천, 구미, 부울경 지역에서 지역 직업성질환감시체계를 산업보건관리의 중요한 시스템으로 구축하려는 노력이 확산되고 있다. 새로이 구축되어지는 이들 지역 직업성질환 감시체계는 감시하고자 하는 대상질환, 활용 가능한 인적자원 및 자료원, 지역 의료체계의 특수성 등에 따라서 목적과 방법을 달리하면서 독특한 형태로 발전을 하고 있다. 각 지역단위 감시체계들이 그 상황에 맞게 독특한 목적과 전략들을 발전 시키면서도, 향후 발전할 국가적인 차원의 직업성질환 감시체계 구축을 위하여 직업성질환 감시의 기본 전략 등을 공유하는 등의 노력이 필요하다. 환례 정의 및 기본적인 등록 서식의 공유, 직업성질환 감시 자료원의 발굴, 공동의 정보 네트워크 및 직업성질환 감시 데이터베이스 구축 등 직업성질환 감시활동을 지원하기 위한 여러 기초 인프라 구축에 힘을 모아야 할 것이다. 우리 나라에서 직업성질환 감시체계를 성공적으로 구축하기 위해서는 수집된 자료의 질 관리를 위한 직업성질환 감시의 원칙 제정과 감시 전략의 공유 등이 필요하며, 전국적인 직업성질환 감시체계의 하부구조라고 할 수 있는 지역감시체계의 기초 토대 마련과 강화작업이 절실하게 필요하다.

팔라디움 촉매하에서 산염화물과 유기주석의 커플링 반응

김두화,박정환,한도수,허선아,김성현,조성동 조선대학교 기초과학연구소 1992 自然科學硏究 Vol.15 No.1

The reaction of Asymmetrical organotins with acid chlorides in the presence of Benzylbis (triphenylphosphine) palladium(Ⅱ) chloride gave good yields of ketones in chloroform.

소음부서 근로자 특수건강진단 실태 및 문제점

김현욱,정치경,김형아,노영만,장성실 大韓産業醫學會 1994 대한직업환경의학회지 Vol.6 No.2

Occupational hearing loss became the leading occupational disease by constituting 56% of all work-related diseases in Korea. However, the prevalence rates showed wide variations among the specific medical examination providers (SMEPs) and were very low(0.8-1.4%) compared with those of 8.4% in Japan. This study was designed to identify of those variations by investigating current audimetric testing methods and the diagnostic criteria utilized by the SMEPs. A questionnaire was distributed to each of 27 SMEPs selected from total 70 SMEPs. Among them, 20 SMEPs were interviewed and the rest of them were given the questionnaire form by mail. Included in the survey form were questions concerning audiometric testing methods and procedures, equipment, facility, personnel and criteria utilized. The results were as follows: 1. Employee audiometric testings were primarily conducted by nurses and nurse-aids who had no formal training for audiometry because no training program had been established. No requirement about the Quality of audiometric testing personnel was specified in the regulation. 2. Although audiometric testing equipment used by the SMEPs should be periodically calibrated, a significant number of them were not properly calibrated. Most of the calibration services were provided by the outside contractors and were done with no uniformly established periods. No SMEPs conducted the daily functional calibration. Most of the SMEPs did not keep their calibration records. 3. Initial audiometric testings were conducted at any available spaces in the workplace or at the testing room without considering noise level in that place. Follow-up audiometric testings were also provided without considering the worker's noise exposure. Although audiometric booths were used during the follow-up testings, most of them did not meet the ANSI noise requirement for audiometric booths. 4. Although a standard diagnostic criterion was promulgated in the law, the criterion was not used uniformly by the SMEPs. In addition, some SMEPs were applying age corrections which were not incorporated into the regulation yet. Therefore wide range of prevalence in NIHL among SMEPs could have possibly been caused by variable audiometric testing procedures and methods. In conclusion, it was recommended that systematical and general measures, such as formal and establishment of standard diagnostic criteria, be established for solving current problems and assuring equity among SMEPs in diagnosing occupational hearing losses.

개 비장 질환의 미세세침흡입술을 통한 세포병리학 검사 4례

김현아,윤기영,최호정,정성목,이영원,조성환,박성준 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2011 動物醫科學硏究誌 Vol.18 No.1

To evaluate the accuracy and diagnostic significance of cytopathological diagnosis of canine splenic disorders, cytopathological examination throgh fine-needle aspiration(FNA) referred to Veterinary Medical Teaching Hospital of Chungnam National University were retrospectived. Splenic neoplasm, hemolymphatic neoplasm, hyperplasia, extramedullary hematopoiesis and splenitis were diagnosed canine splenic disorders through cytopathological examination. The patient should be identified what coagulation profile are normal before aspiration, because complication such as hemorrhage could happen. The 4 cases were identified symmetric, asymmetric splenomegaly on abdominal ultrasonography and then were performed ultrasound-guided FNA. The 4 cases were diagnosed hemangiosarcoma(2), hyperplasia(1) and extramedullary hematopoiesis(1) by clinical signs, hematological examination, and cytopathological examination. Cytopathological examination through FNA was cost-effective, no gneral anesthesia, no complication, and non-invasive method of diagnosis for canine splenic disorders.

고양이의 만성 췌장염 치료 증례

김현아,윤기영,박정호,이왕희,송근호,박성준 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2011 動物醫科學硏究誌 Vol.18 No.1

A 5-year-old Russian blue cat was referred to the Veterinary Medical Teaching Hospital of Chungnam National University with the history of anorexia, lethargy, weight loss(6.5 to 4.8 kg) 2 weeks ago. Abdominal ultrasonography showed the following : increase of echogenicity of liver, irregular shape of gall bladder, hyperechoic region around duodenum. Pancreatitis, cholangitis, hepatic lipidosis was diagnosed by the ultrasonography. Anti- inflammatory therapy, antibiotic therapy was administered. Abdominal ultrasonography is a efficient available diagnostic tool but serum fPL test reveals the highest sensitivity and specifity result for feline pancreatitis. SNAP fPL test is newly released that can check pancreatitis within 10 minutes by same princple of Spec fPL test used in Gastrointestinal Laboratory of Texas A & M Univerrsity.

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.

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.

Kirschner wire를 사용한 과두하 골절의 구강내 접근법

김성일,김승룡,백진아,고승오,신효근 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.3

The treatment of mandibular subcondylar fractures is a matter of controversy. The majority of mandibular subcondylar fracture are treated by closed reduction, but the displaced or dislocated mandibular subcondylar fractures may be treated by open reduction. The characteristics of open reduction are the anatomical reduction, the functional restoration, the rapid function, the maintenance of vertical ramus dimension, the better appearance and the less resultant TMJ problem etc. When an open reduction is considered, the wire, miniplate, lag screw and Kirschner wire are available with internal fixation. Of these, Kirschner wire is a simple method relatively and correct positioning of the wire achieves rigid fixation. But many open reduction methods for mandibular subcondylar fractures require extraoral approach. The extraoral approach has some problems, the facial scar and the risk of facial nerve injury. On the other hand, the intraoral approach eliminates the potency of the facial scar and the facial nerve injury, but is difficult to access the operation site. Since the intraoral approach was first described by Silverman (1925), the intraoral approach to the mandibular condyle has been developed with modifications. The purpose of this article is to describe the intraoral technique with the Kirschner wire on mandibular subcondylar fractures. Conclusion : The intraoral reduction with Kirschner wire on mandubular subcondylar fractures avoids the facial scar and facial nerve injury and is simple method to the extraoral approach. And it has minimal morbidity and better esthetics.