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.

우리 나라의 명절과 음식에 관한 주부들의 인지도 연구 : 서울과 충청지역을 중심으로 In the Region of Seoul and Choongchung Province

조후종,조진아,최성은 동아시아식생활학회 1998 동아시아식생활학회지 Vol.8 No.3

The purpose of this research was to determine the dishes most commonly served during various festive days. This research studied the habits of housewives in Seoul and in the Choongchung province who have children in high school. 1. Most of the housewives in Seoul graduated from high school. On the other hand, those in the Choongchung province graduated from elementary school in their education backgrounds. The monthly income ranged from 1,550,000won to 1,190,000won for the housewives of Seoul, and from 1,000,000won to 1,490,000 for those of Choongchung. The nuclear family system was dominated in both areas and 63.8% of the housewives had a full-time job. 2. "Sulnal(The New Year's Day), Chusuk(Thanksgiving Day), Jungwol-daeborum(The 1st Full-Moon Day)" are among the festive days celebrated in 85% of the both areas, and "Yuwol-Yudu(6th, June), Chungyangjul(9th, September), Naphyang(8th, December)" were celebration in 0.5%. 3. Traditional festive dishes with respect to the festive days were as follows, Tuckuk(rice cake soup) was a favorite food in Sulnal(The New Year's Day), Burum(peanut, pine-nut, walnut, etc) in Jungwol-daeborum(The 1st Full-Moon Day), Samgyetang(chicken soup) in Sambok, Songpyen(rice cake) in Chusuk(Thanksgiving day) and Patiuk(small red beans soup) in Dongji (22th, December). No significance was found in the number of dishes. 4. The Regional differences the festive days such as Sulnal(The New Year's Day), Ipchun(4th, February), Jungwol-daeborum(The 1st Full-Moon Day), Samwol-samjit(3th, March) Sawol-chopail(Budda's birthday), Tano(5th, May), Yuwol-yudu(6th, June), Chilwol-chilsok(7th, July), Suddal-gumum(The year's last day) were very significant. 5. The festive days should continue. On the other hand, the menu(dishes) of the festive days should be simplified.

전라도 김치에 대한 고찰

조후종,조진아 명지대학교 자연과학연구소 1998 자연과학논문집 Vol.17 No.-

최근에 국가산업으로 이루어지고 있는 김치의 세계화 산업에 기초자료로 제공하고자 본 연구를 실시하였으며, 그 결과 아래와 같이 요약한다. 1. 고대로부터 술빗기, 장담그기와 함께 김치담그기는 우리 식생활에서 기본음식으로 발달해 왔으며, 고추 등 향신료와 양념을 많이 넣어 만드는 것은우리만이 가지는 특징이다.2. 전라도는 위도상 ??~??사이에 있는 서남부지방으로 다양한 농산물과 해산물이 산출된다. 따라서 향토음식이 잘 발달되었고, 특히 동북부 지방에 비해 음식의 간이 센 편이다. 3. 전라도는 계절에 따라 산출되는 채소와 젓갈을 이용하여 봄김치, 여름김치,가을.겨울김치 등연구된 종류가 40여 종으로 조리법이 매우 다양하다. This research is performed in order to provide the foundation reference of the globalization of Kimch'i as the national industry lately. The results are follow. 1. From the ancient age, making Kimch'i have been developed by the basic dish with making alcohol and Jang. And it is our own characteristics that Kimch'i is made with spice like red pepper and much seasoning. 2. Chuira-Do is located in 35。∼36。 latitudinally. As a result it has various agricultural products and seafood, so there have developed tyles of cooking peculiar to locality. Especially its taste stronger than the other locality. 3. There are various Kimch'i of four seasons using uegetables producted as each season and Salt-fermented. Also there ae very various 40 researched cooking method in Chulra-Dl.

피로와 의료이용, 업무상 사고 및 질병결근

장세진,고상백,강동묵,김성아,정진주,이철갑,강명근,현숙정,조정진,차봉석,박종구 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: This study examined the relationship of fatigue to medical utilization, occupational accident and sickness absence. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project, 2002~2004). A total of 30,146 employees categorized within the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were recruited. A structured-questionnaire was used to assess the participants' sociodemo-graphics, job-related factors, health-related behaviors, personality trait, self=perceived fatigue (MFS) and the frequency of medical utilization, occupational accident and sickness absence. Data on medical utilization and occupational accident were confirmed from company health records. Chi-square test and logistic regression analysis were used to elucidate the relationship of self-perceived fatigue to medical utilization, occupational accident and sickness absence. Results: In logistic regression analyses, self-perceived fatigue was associated with medical utilization (outpatient), occupational accident and sickness absence although the strength of the associations was higher in the blue collar workers except for medical utilization. For medical utilization, the white collar worker's adjusted odds ratios of outpatient utilization for workers scoring in the third quartile and the highest quartile, compared to workers scoring in the lowest quartile were 1.50 (95% CI: 1.20-1.87) and 2.16 (95% CI: 1.69-2.75), respectively. The blue collar workers' adjusted odds ratios of outpatient utilization for workers scoring in the second (OR: 1.23, 95% CI: 1.06-1.43), third (OR: 1.42, 95% CI: 1.22-1.66) and highest quartile (OR:1.83, 95% CI: 1.55-2.17), respectively, compared to workers scoring in the lowest quartile were statistically significant. However, no associations were found between fatigue and inpatient utilization for either the white or blue collar workers. The blue collar workers' adjusted odds ratios of being injured for workers scoring in the second, third and highest quartile were 1.41 (95% CI: 1.00-2.00), 1.57 (95% CI: 1.10-2.22) and 2.41 (95% CI: 1.69-3.44), respectively, compared to those scoring in the lowest quartile, but, those of the white collar workers were not significant. There was more likely to an increased risk of sickness absence in workers scoring in the second, third and highest quartile compared to those scoring in the lowest quartile in both white and blue collar workers, but the magnitudes of risk were higher in the blue collar workers than the white collars workers. Conclusion: This result suggests that fatigue is a determinant predictor of medical utilization, occupational accident and sickness absence, and that the pattern of risks for the three outcomes differs according to the occupational type. Some limitations of this study and considerations for future study were also discussed.

구미지역 직업성질환 감시체계

김성아,김진석,전혜리,정상재,김상우,이채용,함정오,유재영,최태성,하봉구,조민환,우극현 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.1

목적: 구미지역 내 대학병원이자 특수건강진단·보건관리대행기관의 산업의학전문의, 보건관리대행 간호사, 사업장 간호사를 중심으로 직업성질환감시체계를 구축하여 주요 직업성질환들의 발생현황과 규모를 파악하고자 하였다. 또한 연차적으로 산업, 직업, 업무내용 등에 따른 분포나 원인을 기존 자료원(특수건강진단의 직업병 유소견자와 산재요양승인 되는 직업병자)과 비교하여 분석·기술하고 예방 및 관리를 포함한 보건의료기술개발까지을 포함하는 종합적인 감시체계를 구축하고 운용하고자 하였다. 방법: 구미지역의 산업적 특성에 맞는 직업성질환감시체계를 구축하고 지역 감시체계의 모델을 제시하였다. 6대 감시대상 직업성질환(독성 간염, 직업성천식, 직업성 근골격계질환, 직업성 피부질환, 직업성 암, 수지진동증후군)의 실행적 환례정의, 보고양식 및 보고체계 개발, 분석양식 및 결과 배포 형식을 개발하였으며, 그 유병규모를 파악하고, 감시질환의 분포 및 특성, 관련인자 등을 분석·기술하고자 하였다. 이때, 1년간의 환례분석시 직업병 유소견자 및 직업병 요양자에 대한 자료와 함께 비교 분석하였으며, 노동통계자료를 이용하여 년간 발생률을 추정하였다. 결과: 2001. 1. 1일부터 2002.4.30일까지 총 287건이 보고되었으며, 직업성 근골격계질환 132건(46.0%), 직업성 피부질환 100건(34.8%), 독성간염 34건 (11.8%), 직업성천식 16건 (5.6%), 수지진동증후군 5건 (1.7%) 이었으며 직업성 암은 한건도 보고되지 않았다. 보고경로별로는 보건관리대행에서 33건 (11.5%), 해당 유해인자별로 실시되는 특수검진 외의 각종 건강진단업무 수행 중 발견된 환례에 대한 보고가 206건(71.7%)이었다. 직종별 분류의 결과는 섬유업종사자, 단순노무종사자, 음식업종사자 등이 다수를 차지하였다. 근골격계질환의 경우, 수근관증후군이 42건(33%), 외상과염/내상과염이 39건(30%)로 가장 많았다. 직업성 피부질환은 97건이 접촉성 피부염으로 유기용제류가 59건(59%)으로 가장 많고, 니켈 및 에폭시수지에 의한 알레르기성 접촉성 피부염이 각각 6건과 5건이었다. 독성 간염은 모두 DMF 나 DMAc에 의한 것으로, 근무시작 후부터 간기능이상이 발견되기까지의 근무기간은 대부분이 3개월 이하이며, 1개월 이하인 경우도 10건이나 되었다. 동 기간 중 감시환례에 대해 산재요양 자료와 중복여부를 확인한 결과, 중복되는 것은 하나도 없었다. 특수건강진단에서 직업병유소견자로 판정된 경우는 독성간염에서 3건이 있었으며, 나머지 질환은 중복되는 것은 없었다. 2001도 구미지역의 근로자수와 보고환례건수를 이용하여 연간 발생률을 추정하였다. 근로자 10만 명당 연간 발생률은 상지 근골격계질환은 63.6명, 피부질환 48.2명, 독성 간염 17.9명, 천식 7.7명, 수진진동증후군 2.4명이었다. 참여예상인원은 총 46명이었으며, 실제 참여자수는 21명, 평균참여율은 46%, 실제 참여 1이당 평균 보고건수는 산업의학전문의가 28건으로 가장 많았고, 대행간호사는 45,건, 사업장 간호사는 3.3건이었다. 결론: 지역 감시체계는 기존 통계자료들에서 발견되지 않았던 직업성질환의 발견에 유용한 통계원이며, 특히 지역의 특성과 여건을 고려하여 체계화된 시스템을 구축하여 운용한다면 더 성과가 클 것이다. Objectives: Area-based occupational disease surveillance in Kumi (KODS) was used to collect data on occupational diseases. The data was used to estimate the magnitude of the diseases, to analyze for their characteristics and to find links for their intervention and prevention. Methods: Since January 2001, occupational physicians and nurses in Occupational Health Service (OHS) have reported six major occupational diseases; occuaptional musculoskeletal disorders of the upper extremities (MSDUE), occupational dermatoses, toxic hepatitis, occupational asthma (OA), hand-arm vibration syndrome (HAVS), and occupational cancer. For the respective diseases, a reporting sheet and operational diagnostic criteria were developed by the KODS. An analysis of the KODS data, collected over a certain period, was compared with data from the Korea Labor Workers Corporation (KLWC) and the Specific Health Examination (SHE), and the incidence rates of the diseases estimated. Results: Between Jan 2001 and Apr 2002, 287 cases of the six major occupational disease were reported. Of these, there were 132 (46.0%), 100 (34.8%), 34 (11.8%), 16 (5.6%), and 5 (1.7%), cases of MSDUE, occupational dermatoses, toxic hepatitis, OA, and HAVS, repectively. But, there were no cases of occupational cancer. 33 (11.5%) of the incidence were reported via the OHS, 206 (71.7%) from health checkups, and the other 48(16.8%) from other routes. The synthetic fibers and electronic components manufacturing industries accounted for the greatest number of reported cases. With resport to occupation, the greatest numbers of incidence were reported from the elementary occupations, textile workers, assemblers, and cooks and food services worker, in that order. Of the MSDUE cases, carpal tunnel syndrome and epicondylitis were the two most common diseases. Most of the occupational dermatoses were due to contact dermatitis, with organic solvents (59%), nickel (6%), and epoxy resin (5%) accounting for the majority of these cases. All cases of toxic hepatitis were induced by dimethylformamide or dimethylacetamide, which were reported by a unique monitoring system. During same period, there were no cases claimed by workers to the KLWC, and only three cases from SHE, were identified. Using data from workers' number and surveillance, the annual incidence of MSDUE, dermatoses, hepatitis, OA, and HAVS, per 100,000 workers were 63.6, 48.2, 17.9, 7.7, and 2.4, respectively. Conclusions: These results show that an area-based surveillance system can be very effective for the collection of data on work-related diseases, at least in Kumi.

브라켓 부착 시 실런트 레진이 법랑질 탈회에 미치는 영향

윤영아,조진형,이기헌 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.1

본 연구는 교정용 브라켓 부착 시 사용되는 접착제 중 two paste type 의 실런트 레진 적용이 법랑질 탈회에 미치는 영향을 알아보고자 시행되었다. 건전한 표면을 가진 발치된 소의 상악절치 48개를 실험재료로 하여 법랑질 처리 방법에 따라 4개 군으로 분류하고 각 군을 Phase Ⅱ^(?) (Reliance, Itasca, Ⅲ) 를 이용하여 치면처리 하였다. 대조군으로서 아무런 처리를 하지 않은 Group 1, 37% 인산으로 39초간 산부식을 시행한 Group 2, 산부식 후 실런트 A와 B를 동량으로 혼합하여 도포한 Group 3과 산부식 후 실런트를 도포하고 레진 페이스트 A와 B를 동량으로 혼합하여 도포한 Group 4로 분류하여 각 군을 인공탈회용액에서 탈회시킨 다음 공초점 레이저 주사현미경을 이용하여 각각의 탈회된 깊이를 측정한 후 비교한 결과, 탈회된 법랑질의 평균 깊이는 47.4 ㎛ (Group 1), 61.8 ㎛ (Group 2), 13.9 ㎛ (Group 3), 8.2 ㎛ (Group 4) 로 나타났다. 산부식 후 인공탈회용액에 노출되는 군(Group 2)은 산부식 없이 노출되는 군 (Group 1) 에 비해 탈회된 깊이가 더 깊은 것으로 나타났으며 (p <0.55), 실런트 레진을 도포한 군 (Group 3) 은 산부식 없이 노출되는 군 (Group 1) 이나 산부식 후 노출되는 군 (Group 2) 에 비해 탈회된 법랑질 깊이가 유의성 있게 감소하였다 (p <0.55). 접착레진으로 부착된 군 (Group 4) 은 법랑질 탈회가 거의 나타나지 않았다. 이상의 연구결과는 교정지료 시 법랑질 탈회 가능성을 줄이기 위해서 브라켓 부착 시 실런트 레진의 도포가 유용함을 시사하였다. The purpose of this study was to evaluate the effects of a sealant resin on enamel demineralization in orthodontic bracket bonding. The forty eight extracted sound bovine teeth were subdivided into four groups and treated with Phase Ⅱ^(?) (Reliance, Itasca, Ⅲ) on the surface. Group 1 was not treated. Group 2 was acid etched with 37% phosphoric acid for 30 seconds. Group 3 was applied with sealant after acid etching. Group 4 was applied with resin paste after acid etching and sealant application. Each group was demineralized in artificial caries solution. Demineralized enamel depth was measured by confocal laser scanning microscopy. The results were as follows: the mean demineralized enamel depth was 47.4 ㎛ (Group 1), 61.8 ㎛ (Group 2), 13.9 ㎛ (Group 3), 8.2 ㎛ (Group 4) the demineralized enamel depth was increased in Group 2 than in Group 1 (p < 0.05) the demineralized enamel depth was reduced in Group 3 than in Group1 and Group 2 with statistically significant differences (p < 0.05) and demineralization in Group 4 was very little. The results of the present study indicate that sealant application is useful for reducing enamel demineralization in orthodontic bracket bonding.

민간건강보험에서 정신과 질환에 대한 보험비 지급 관련 약관 현황과 문제

반건호,김종우,조아랑,박진경,김영종,박준헌 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.4

Objectives : Recently, Korean psychiatrists have noticed the complaints from probands and family members that private health insurance companies do not pay for most psychiatric disorders. Furthermore, Probands cannot even apply for insurance because of their medical record of psychiatric disorders. Authors investigated and reviewed contracts of Korean private insurance companies to find reasons for banning psychiatric disorders from insurance policies. Methods : Authors reviewed more than 800 contracts from 48 insurance companies. Results : Among all the psychiatric diagnoses, few of them-dementia and some other organic mental disorders-are guaranteed to be paid from insurance companies. Less then 10 contracts say they pay for psychiatric illnesses. Most insurance companies have contracts prohibiting F codes ; however, there are not enough reasons in these contracts. Conclusions : In the private health insurance system, Psychiatric illnesses have almost no rooms. It is very urgent to add space for patients with psychiatric illnesses and psychiatrists in the insurance policies.

주의력결핍-과잉운동장애의 비중추신경흥분제 치료의 최신지견

반건호,손소정,이서경,강원섭,조아랑,박진경 경희대학교 2006 慶熙醫學 Vol.22 No.1

Methylphenidate (MPH), amphetamine, and pemoline are cerebrostimulants that have been commonly prescribed for more than half century in the treatment of attention-deficit/hyperactivity disorder (ADHD). The use of such drugs, however, is often followed by untoward effects such as loss of appetite, insomnia, nausea, abdominal pain, vomiting, irritability, and etc. There are also debates about decrements in height and weight percentiles and drug dependency. Thus, in this study, we discussed new therapeutic drugs, non cerebro-stimulants, with possibly less adverse effects and more efficacies. Atomoxetine, highly selective inhibitor of the presynaptic noradrenaline transporter with little or no affinity for other neurotransmitter transporters and receptors, is a non-excitatory drug with a strong possibility to replace CNS excitatory drugs. It is also safer in relation to drug dependency since it does not affect nucleus accumbens or the striatum. Atomoxetine, therefore, can be used in patients who do not respond to the CNS excitatory drugs. Tricyclic antidepressants, imipramine and desipramine are also most extensively studied drugs as ADHD treatment modalities. They also exert inhibitory effect on the reuptake of norepinephrine. The use of these drugs in children, however, is limited because of cardiovascular effects. Bupropion is one of promising drugs in treating prepubertal children with ADHD. It is also useful for comorbid depression and conduct problems. Increasing attention is being given to a narcolepsy drug, modafinil. Modafinil acts on histamine pathway resulting in wakefulness. This effect is similar to that of neuropeptide orexin. Since the effect of modafinil is independent of catecholamine, drug dependency adverse effect is not expected. Recently, some new drugs, such as reboxetine, are reported as safe and efficacious for children with ADHD, but they need long-term safety and controlled studies.

EGFR 돌연변이와 ROS1 전위를 동시에 가진 폐선암 환자의 Erlotinib 치료 1예

김민환,박예현,박혜정,지아영,송창호,진무년,김영주,김선욱,이중희,김인수,김혜련,김주항,조병철 Ewha Womans University School of Medicine 2014 EMJ (Ewha medical journal) Vol.37 No.1

The rearrangement of c-ros oncogene 1 (ROS1) has been recently identified as an important molecular target in non small cell lung cancer (NSCLC). ROS1 rearrangement and epidermal growth factor receptor (EGFR) mutation were mutually exclusive each other in previous studies, and the clinical implication of co-existence of the two genetic alterations has not been determined. We report a case of 46-year-old female never-smoker NSCLC patient whose tumor harbored ROS1 rearrangement and EGFR mutation concomitantly. She had undergone curative surgery for stage IIIA NSCLC, and the recurrence in left pleura and brain occurred at 2 years after the surgery. She received several lines of chemotherapy including docetaxel plus carboplatin, erlotinib, pemetrexed, and gemcitabine. Erlotinib therapy showed a favorable treatment response with progression-free survival of 9.5 months and partial response of tumor on radiologic evaluations. This case represents a successful erlotinib treatment in a NSCLC patient with concurrent ROS1 rearrangement and EGFR mutation.

인천 인현동 호프집 화재 피해자 분석

최정태,안무업,안희철,최영미,정재봉,서정열,유기철,이삼우,박석현,조준휘,김성환,김아진,송근정 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Purpose : This study was conducted to develop field triage, transportation, distribution, and prehospital care at a fire disaster by analyzing the victims of the fore that broke out at a bar in Incheon. Method : We analyzed the cases of the victims of a fire in Incheon in Oct. 1999. We determined the primary care hospital, the arrival time, the burn size, the outcome, and the injury type from the medical records, the concerned organ records, and interviews with concerned persons. Result : The total number of victims was 137: 56 prehospital deaths, 1 hospital death, and 80 survivals. The Pearson correlation coefficient between the burn size and the severity was -0.175. There were 121(89.6%) cases of inhalation injury, 59 (43.7%) cases of flame burns, 66 (48.9%) cases of hypoxic brain damage, and 16 (11.9%) cases involving other types of injury. Conclusion : The causes of death of the fire victims were inhalation injury and hypoxic brain damage due to CO poisoning and other toxic inhalants. We propose the use of a simple triage and rapid treatment(START) system and a reassessment the delayed category in fire disasters.