한국인에서 일광 노출의 유해성에 대한 인지도와 일광 차단제의 이용 행태에 대한 연구

김상태,김기호,오선진,이승철,강세훈,윤재일,김진준,박석범,김홍용 대한피부과학회 1999 大韓皮膚科學會誌 Vol.37 No.6

Background: Although deleterious effects of sunlight have been increased recently, the surveillance of the attitudes toward sun-exposure and the behavioral aspect of using sunscreens in Koreans has hot been carried out. Objective: Our purpose was to evaluate the attitude toward the harmfulness of sun-exposure and behaviors of using sunscreens in Korea. Method: Five hundred and fifty-two subjects were surveyed to assess the attitude toward sun-exposure, as well as the subjects knowledge about, and the use of sunscreens. Underlying data including demographic data, skin colors, skin types, occupation, and sun-exposure, were obtained. Results: Fifty-four percent of subjects believed that sun-exposure is bad for their skins, but, on the contrary, 12.5% believed it to be beneficial. Fifty-two percent of subjects used sunscreens. Almost all subjects(93.8%) knew why to use sunscreens but 62.7% of subjects did not know the meaning of sun protective factors(SPF). Women, indoor workers, subjects less than 40 years old, with less sun-exposed, fair colored skin, or with skin type I, II, III tended to know the deleterious effects of sunlight and the meaning of SPF and used more sunscreen. Conclusion: High risk population-men, outdoor workers, subjects oider than 40 years old, with more sun-exposed, dark colored skin, or skin type VI, V could be targeted with campaigns that promote attitudinal and behavioral changes.

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.

반코마이신 내성 장내구균 분리 환자에서 황색포도알균의 내성

김동욱,신선혜,김혜진,류선,이선희,장철훈,김영대,곽임수 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : Vancomycin-resistant enterococci (VRE)로부터 S. aureus로의 vacomycin 내성 유전자의 전파는 오래전부터 예견되어져 왔으며 큰 걱정거리로 남아있다. 최근에 vanA 유전자를 가지고 있는 vancomycin-resistant S. aureus 2주가 미국에서 분리되었다. 이 연구의 목적은 VRE를 보균하고 있는 환자들에서 S. aureus 보균양상과 항균제 내성을 알아보는데 그 목적이 있다. 재료 및 방법 : 2001년 1월부터 2001년 12월까지 부산대학교병원에 입원하였던 환자들 중 임상검체에서 VRE가 분리된 환자 7명과 2001년 9월부터 12월까지 외과 중 환자실에 입원하였던 환자들 중 VRE 감시배양을 시행하였던 20명의 환자들을 대상으로 하였다. 환자들은 전비공, 액와부, 회음부, 직장에서 매주 면봉으로 검체를 채취하였다. 선별배지에서 검체를 배양하여 S. aureus를 분리하였고 원판 확산법을 이용하여 methicillin 감수성을 측정하였다. Broth microdilution 법으로 vancomycin MIC를 측정하였다. 결과 : 총 27명에서 73회의 방문과 292회의 배양이 시행되었으며 총 67주의 S. aureus가 분리되었다. 이중 64주(95.5%)가 methicillin 내성이었다. 전비공 MRSA 보균율은 VRE를 보균하고 있었던 환자는 19명 중 11명(58%)에서, VRE를 보균하지 않았던 환자는 8명 중 3명(37.5%)으로 VRE 보균자에서 보균율이 더 높았다. 총 64주의 MRSA의 vancomycin MIC의 분포는 0.5-2㎍/mL였으며 2㎍/mL를 초과하는 균주는 발견되지 않았다. 64주 중 vancomycin MIC가 1㎍/mL인 균주가 54주(84.4%)로 가장 많았으며 2㎍/mL 6주(9.4%), 0.5㎍/mL 4주(6.3%)의 순이었다. 결론 : VRE 환자에서 S. aureus의 보균율은 비보균자 보다 높았으며 분리된 균주들은 대부분 MRSA였다. VRSA 균주는 발견되지 않았다. Background : The transfer of vancomycin resistance from vancomycin-resistant enterococci (VRE) to Staphylococcus aureus has been predicted. The purpose of this study is to determine the prevalence and antibiotics resistance of S. aureus among patients colonized with VRE. Methods : Between January 2001 and December 2001, a prospective study was performed at Pusan National University Hospital on 27 patients. Surveillance swabs from nasal cavity, axilla, perineum, and rectum were obtained at weekly intervals. Methicillin susceptability of S. aureus was determined by oxacillin disk diffusion test and minimum inhibitory concentration (MIC) for vancomycin by microdilution broth test. Results : Total of 292 swab cultures were performed and 67 S. aureus isolates were collected. 64 isolates (95.5%) were resistant to methicillin. The prevalence of nasal MRSA carrier in 19 patients colonized with VRE was higher than that in 8 patients not colonized with VRE (58% vs. 37.5%). In 64 MRSA isolates, MIC (㎍/mL) for vancomycin ranged from 0.5 to 2. No isolates with MIC >2 ㎍/mL were observed. MIC of 1 ㎍/mL was shown (observed) in 54 isolates, 2 ㎍/mL in 6 isolates, and 0.5 ㎍/mL in 4 isolates. Conclusion : The prevalence of S. aureus with colonization of VRE is higher than that without colonization of VRE. Most of S. aureus isolates were resistant to methicillin. VRSA isolates were not observed.

정신과 입원환자의 서비스 만족척도의 개발

김철권,이지연,송영선,김규호,김경률,김제원,이동기,최병무 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.3

목적 본 연구의 목적은 국내 정신의료기관(정신병원, 종합병원 정신과)에서 간편하게 사용할 수 있는 신뢰도와 타당도가 검증된 입원환자의 서비스 만족척도를 개발하기 위한 것이다. 방법 여러 단계를 거쳐 국내 실정에 맞는 문항을 개발하였고,정신병원, 종합병원, 대학병원 정신과 병동에서 퇴원하는 348명의 환자들을 대상으로 신뢰도와 타당도를 조사하였다. 요인분석 결과 5개의 요인이 추출되었으며 전체 변량의 63.04%를 설명하였다. 내적 일관성에 대한 신뢰도 계수 (Crohnbach's α)는 0.95로 상당히 높은 수준이었고, 수정된 개별문항-총점 상관계수는 0.50부터 0.72까지의 범위에 속하였다. 요인분석을 통해 추출된 서비스 만족척도의 각 하위척도 점수와 서비스 만족척도에 첨부된 각 영역에 대해 전반적인 만족도를 묻는 세 개의 문항 점수 간의 상관성 역시 유의하게 높았다. 결과 진단명에 따른 서비스 만족척도의 전체 점수에서는 불안/신체형/강박장애 환자군과 기분장애 환자군이 각각 정신분열병 및 기타 정신병 환자군과 알코올중독 장애 환자군에 비하여 유의하게 높은 점수를 보였으며, 입원형태에 있어서는 자발적 입원군이 강제 입원군에 비하여 전체 만족점수가 유의하게 높았다. 그러나 성별, 월수입, 학력, 직업, 종교, 결혼상태 등의 변수에서는 서비스 만족척도의 전체 점수에서 유의한 차이가 발견되지 않았으며, 마찬가지로 연령, 입원일수, 입원횟수, 첫 발병나이, 유병기간 등의 임상적 변수에서도 서비스 만족척도의 전체 점수와 유의한 관계를 보이지 않았다. 서비스 만족척도의 전체점수에서 대학병원 환자군이 정신병원 환자군과 종합병원 환자군에 비하여 각각 유의하게 높았다. 결론 결론적으로 국내 정신의료기관에 입원한 환자들의 서비스 만족을 평가하기 위한 목적으로 개발된 본 척도는 높은 수준의 신뢰도와 타당도를 보였으며, 또 국내 정신의료 환경에 맞는 요인구조를 보였다. 따라서 정신의료 서비스에 대한 정신과 환자의 만족도에 대한 연구가 거의 없는 실정에서 본 척도의 개발은 향후 국내 정신의료의 질과 치료결과를 높이는 도구로 활용될 수 있을 것으로 기대된다. Objectives : To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale : SSS) for routinely assessing the quality of service in psychiatric ward inpatients. Methods : A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and University hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. Results : Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. Conclusion : SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring Satisfaction of psychiatric inpatients in Korea.

정상인에서 베타3-아드레날린 수용체 유전자의 변이가 복부 비만도 및 지질대사에 미치는 영향

김영선,윤석기,김철희,서교일,김학선,김극배,변동원,유명희 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

The β₃-adrenergic receptor is expressed in visceral adipose tissue in humans and is thought to contribute to the regulation of the resting metabolic rate and lipolysis. We studied the influence of a mutation in the β₃ -adrenergic receptor gene(Trp64Arg) on body fat distribution, central obesity, lipid metabolism in 65 healthy young male adults. One out of 65 subjects were homozygous (Arg/Arg) for the trp64Arg mutation, 17 subjects were heterozygous (Trp/Arg), and 47 lacked the mutation(Trp/Trp). The body weight, height, body mass index, waist-to-hip ratio were similar between the subjects with- and without the mutation. Total body fat, abdominal fat amount, body fat distribution, serum total- and HDL-cholesterol, triglyceride, glucose, and insulin concentrations were also not different according to the presence or absence of the mutation. These results suggested that Trp64Arg mutation in β₃-adrenergic receptor gene is not a major contributing factor for central obesity or change in lipid metabolism in Korean young adults.

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.

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)

Pollen Viability of Common Buckwheat (Fagopyrum esculentum Moench.) in in vitro Germination and its Application to Male Gametophyte Isolation

Woo, Sun-HeeㆍKeun-Yook ChungㆍHeung-Tae, KimㆍYong-Gu, ChoㆍHong-Sig, KimㆍBeom-Heon, Songㆍ Chul-Won, Lee and Seung-Keun Jong 忠北大學校 農業科學硏究所 2004 農業科學硏究 Vol.21 No.-

-본문참고-

골격성 3급 부정교합자의 임상적 특성에 따른 심리상태

김선옥 ( Sun Ok Kim ),진미영 ( Mi Young Jin ),유병철 ( Byeng Chul Yu ) 한국치위생학회 2015 한국치위생학회지 Vol.15 No.2

Objectives: The purpose of the study is to investigate the psychological state of the patients according to skeletal class Ⅲ malocclusion symptoms. Methods: The subjects were 200 skeletal class Ⅲ malocclusion patients. The questionnaire consisted of general characteristics, clinical manifestation, and T score of Korean version of self-rated Symptom Checklist-90-Revision modified by Jae-hwan Kim. The data were analyzed using SAS version 9.2 and t-test, ANOVA, and ANCOVA were used. Clinical manifestation included subjective recognition and radiological analysis. The subjective recognition of the patients consisted of self-satisfaction of the appearance, phonation, mastication, and temporomandibular joint pain. T score consisted of somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. Results: The most serious factor in 9 scales was the severe TMJ pain by ANCOVA. Male patients had a higher T score in phobic anxiety, psyochoticism, somatization and depression than female patients. Those having low appearance satisfaction had the problem in interpersonal sensitivity. Obsessive-compulsive symptoms were conspicuous in phonation difficulty and temporomandibular pain. Conclusions: The patients with skeletal class Ⅲ malocclusion have more satisfaction with appearance, pronunciation, and phonation than those with skeletal class Ⅲ malocclusion and overjet. Proper dental treatment will improve the communication and quality of life.

현훈 환자 Neuron Specific Enolase의 임상적 의의

김원주,김선곤,유철형,김원찬,김용덕,최영철,이명식 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4