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.

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.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

남성화를 보이는 여성에서 발견된 난소의 Steroid Cell Tumor 1예

조인호,정대훈,박영미,서영진,손영실,정철회,강영미,정수전,김영남,이경복,성문수,김기태 인제대학교 2006 仁濟醫學 Vol.27 No.-

Steroid cell tumor is a rare ovarian sex cord-stromal tumor which accounts for 0.1% of all ovarian tumors. Until now, only 4 cases have been reported in domestic literatures. Steroid cell tumor often secrets testosterone and presents virilization in adult women or precocious puberty in children. Treatment is often performed by surgical removal, adjuvant chemotherapy and radiation, but completely accepted treatment was not existed. We experienced a case of steroid cell tumor, which was manifested by typical virilization in a 43-year old patient, who was previously performed hysterectomy and unilateral oophorectomy. So, we present with a brief review of the literatures.

오행화침법(五行和鍼法)의 이론적 고찰 및 운용

심성흠 ( Sung Heum Sim ),감철우 ( Cheol Woo Kam ),김진영 ( Jin Young Kim ),백상인 ( Sang In Baek ),이병권 ( Byung Gwon Lee ),손호영 ( Ho Young Son ) 대한경락경혈학회 2009 Korean Journal of Acupuncture Vol.26 No.4

Objectives: The object of this study is to report on the theory of Ohaeng-Hwa Acupuncture Therapy. Methods: The theory of Ohaeng-Hwa Acupuncture Therapy(OHAT; 五行和針法) is a part of the Five Elements Theory unique to Korea. This research Classic of Difficulty Issues-Nan Jing review Ohaeng-Hwa Acupuncture Therapy. Results: OHAT, created and developed by Jae-hoon Song, integrates the victor-vanquished as well as the son-mother relationship of the Five Elements of breakdown and restoration of balance between yin and yang. And also, it provides resources and data on The seventy fifth Nan(75難), The sixty ninth Nan(69難) of Classic of Difficulty Issues-Nan Jin 75, 69. OHAT establishes objectiveness and accuracy of diagnosis based upon the traditional method and procedure of pulse taking. In OHAT, a person`s state of illness is diagnosed by applying the comparative examination of the palpitation of the pulse. It is the fact that the pulse varies according to the state, and that OHAT treatment has proven the positive results by using the victor-vanquished relationship on The Nan Jin 75. On the basis of this, it is necessary to add the sixty ninth Nan(69難), to research the theory of the generation of the Five Element. Conclusions: Ohaeng-Hwa Acupuncture is very effective in treating the wide range of illness, and thus it has gained an increasing attention of many scholars and practitioners in the field of traditional Korean oriental medicine. However, it is the first theoretical attempt to the clinical research and scientific methodology of Ohaeng(Five) Ohaeng-Hwa Acupuncture, and more active Ohaeng-Hwa Acupuncture R&D is being conducted nationwide.

최근 8년간(2001-2008) 서울대학교치과병원 소아치과의 진료현황 및 수익분포 변화에 대한 조사

손유진,현홍근,김영재,김정욱,이상훈,김종철,한세현,장기택 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

The practice pattern of pediatric dentistry in the university dental hospital has been changing for the last several decades, due to socioeconomic changes, developments in dental materials and increasing number of private pediatric dental clinics. The purpose of this study is to survey the changing patterns of pediatric dental treatment in the university dental hospital and to present the future direction for pediatric dentistry. Patient distribution and practice trends were reviewed based on the OCS (order communication system) records of the department of pediatric dentistry, Seoul National University Dental Hospital from 2001 to 2008. Results were as follows; 1. The number of patients increased up to 2005 and decreased in 2006, and has remained constant up to 2008. 2. The proportion of preventive and orthodontic treatment increased and the proportion of restorative and pulpal treatment decreased. 3. In restorative treatment, amalgam restoration decreased and resin restoration increased. 4. Frequency of sedation decreased in 2006, 2007 and increased in 2008. 5. Frequency of general anesthesia increased up to 2008. 소아치과 전문 지역 의원의 증가, 소아치과에 대한 보호자의 인식 변화, 치의학의 발전, 소아치과 진료 범주의 확대 등에 의해 최근 소아치과의 진료 양상이 크게 변화하고 있다. 이러한 변화 양상을 파악하고 앞으로의 대학병원 소아치과 및 소아치과 전문 지역 의원의 진료분담에 대한 방향성을 제시하고자 본 연구를 시행하였다. 2001년 1월 1일부터 2008년 12월 31일까지 서울대학교치과병원 소아치과에 내원한 모든 초진 및 재진 환자를 대상으로, 서울대학교치과병원 종합의료정보시스템(OCS)을 통하여 1년간의 외래환자집계 및 수가코드별 진료 행위 건수 및 수익 분포를 조사하여 다음과 같은 결과를 얻었다. 1. 내원환자의 수는 2001년부터 2005년까지 대체로 증가하다 2006년에 감소하였으며 그 이후에는 2006년도와 별다른 변화가 없었다. 2. 2001년에는 예방치료가 6.84%, 수복치료가 49.96%, 치수치료가 9.64%, 외과치료가 10.78%, 교정치료가 22.78%를 차지하였으나, 2008년에는 예방치료가 15.40%, 수복치료가 28.97%, 치수치료가 3.28%, 외과치료가 14.83%, 교정치료가 37.52%를 차지하여 수복치료와 치수치료의 비율은 감소하고 예방치료와 교정치료는 증가하였다. 3. 수복치료의 비율에 있어서 아말감과 글라스 아이오노머 수복 및 기성금관수복의 비율은 감소하였고, 레진의 비율은 증가하였다. 4. 진정요법하 치과치료는 2005년까지 증가하다 2006년, 2007년에는 감소하였고, 2008년에 다시 증가하였다. 5. 전신마취하 치과치료는 2001년부터 2008년까지 꾸준히 증가하였다.

치과교정환자의 치면세균막 관리교육 효과

손우성,김진범,제영지 대한치과교정학회 1994 대한치과교정학회지 Vol.24 No.1

The short-term effects of plaque control instruction were studied in 42 adolescent orthodontic patients under active fixed treatment. At first visit, all the patients were received plaque control instruction using materials such as oral hygiene education slides, dentiform, disclosing agents, tooth brush and interdental brush. After that, Pateints were asked to perform the tooth brushing according to instruction. Such a procedure was repeated every week for 3 weeks. Plaque index and bleeding index were scored once a week for 4 weeks and were compared according to ages, sex and duration with fixed appliance. The results were as follows : 1. Plaque control instruction was effective in reducing plaque accumulation and gingival inflammation of the orthodontic patients. 2. The effect of plaque control instruction was continued during 3 weeks among all groups of subjects, and it was prominent at the first week. 3. There was no statistically significant difference in the effects of the plaque control instruction according to sex, ages, or duration with fixed appliances.

Human Chorionic Gonadotropin(HCG)에 의한 넙치, Paralichthys olivaceus의 배정효과

손진기,최희정,이영돈,김형배,박인석 濟州大學校海洋硏究所 1992 해양과환경연구소 연구논문집 Vol.16 No.-

넙치(Paralichthys olivaceus)에서 호르몬 처리에 의한 효과적인 인공산란 연구의 일환으로 human chorionic gonadotropin(HCG)에 의한 성숙 넙치에서의 spermatocrit법에 의한 배정(spermiation)효과를 연구하였다. 안정된 spermatocrit치를 위한 정액의 분획조건은 12,000rpm, 30분간의 원심분리가 적절하였으며 spermatocrit(Y)는 정자밀도(X)와는 Y=1.14X-10.04(r=0.91, P<0.0001, n=50)의 관계식을 나타내었다. 정자밀도는 21.5∼98.4×10??정자/㎕정액으로 12∼95%의 spermatocrit치에 해당하였다. 성숙넙치의 정액생산은 1,000IUHCG/㎏BW의 주사시 24시간후에 가장 높았고(7.46㎖/㎏BW), 낮은spermatocrit치(63%)와 낮은 정자밀도(67.4×10??정자/㎕정액)수준과 일치하여 정액점도는 매우 낮게 나타났다. 이와같은 낮은 정액점도는 HEG처리에 의한 정소의 수화(hydration)에 기인된 것으로 여타 lobular형 정소에서의 호르몬 처리시 결과와 일치하였다. 48시간후의 HCG처리군과 대조군간의 정액생산, spermatocrit치 및 정자밀도에서는 유의한 차이를 보이지 않았다. 본 연구결과 성숙넙치의 배정은 spermatocrit법에 의해 명확히 판별될 수 있으며 HCG는 본 종에서 배정을 효과적으로 촉진시킬 수 있음이 나타났다. For the evaluation of hormonal control of sperm in cultured fish a method to quantify the spermiation response of mature flatfish to hormonal therapy is described. Spermatocrit was determined after 30 min. in centrifuge condition of 12,000rpm. Sperm density was estimated by a standard hemacytometer method. However, sperm density can be predicted from spermatocrit since their relationship is linear as described by the regression equation, Y=1.14X-0.04(r=0.91, P<0.0001, n=50), where Y is spermatocrit and X is sperm density. Sperm density levels ranged from 21.5 to 98.4×10?? spermatozoa per ㎕ milt corresponding to spermatocrit values of 12 to 95%. Milt production by mature flatfish was highest(7.4ml per ㎏ body weight) at 24h after injection of 1,000IU of human chorionic gonadotropin(HCG) per ㎏ body weight and coincided with low spermatocrit(63%) and sperm density(67.4×10?? spermatozoa per ㎕ milt) levels. No significant differences was appeared in milt production, spermatocrit and sperm density between control and HCG-treated fish at 48h after HCG injection. These results demonstrate that spermiation in mature flatfish can be reliably evaluated by a spermatocrit method and that HCG is effctive in stimulating of spermiation in this species.

한국인의 건강관련 행동 및 체력 의학적 변인의 비교분석

손두옥,서재균,선우섭,방영진,김형돈 경희대학교 사회체육연구소 1996 體育科學論叢 Vol.- No.9

The purpose of this study was to provide health related informations to establish better cultural welfare policy of government. The data of korean on the physical physique(height, weight), physical fitness and health related variables(smoking, drinking, % body fat, blood pressure, cholesterol level, etc.) were compared with data of other countries. The coclusions of this study were as follow: 1. The ratios of smokers and drinkers of Koreans were higher than that of Japanes. 2. The height and weight of middle aged Koreans were higher than those of Japanes at the same age. 3. Japanes wemen showed higher phsical fitness level in 50m run than Korean women. 4. Disease rate of Korean men and women showed a increasing tendancy every year.

0.2% 불화나트륨 용액으로 5년간 양치한 초등학교 아동의 영구치 우식증 예방효과

손석환,이재화,김지영,김진범 대한구강보건학회 2003 大韓口腔保健學會誌 Vol.27 No.2

Supervised weekly fluoride mouthrinsing(FMR) program with 0.2 percent neutral sodium fluroide solution has been implemented at primary schools in Pusan, Korea since 1995 to prevent the prevalent dental caries. Children of sixth grade in 2000 who had joined the weekly FMR program at four primary school in Pusan with a 0.2 percent sodium fluoride solution for five years from first grade in 1995 to fifth grade in 1999 were selected as experimental group. Children of sixth grade in 2000 who had not joined the FMR program until sixth grade and had not drunk fluoridated pulic water at two primary schools in the Bukgu(Norhtern) District of Ulsan were selected as control group. Samples were 295 in FMR group and 312 in control group. To estimate caries preventive effect, epidemiologic dental survey was performed at the schools of FMR and control group in 2000 for 11-year-old children. The surveyed data were analyzed with SPSS statistical package. The obtained results were as follws. 1. Children who experienced caries on permanent teeth were 71.2% in FMR group and 83.3% in control group. 12.1% of DMF rate decreased in FMR group compared to control group. 2. The DMFT scores were 2.68 in FMR group and 3.29 in control group. The difference of DMFT scores was 0.61 between fluoride mouthrinsing group. The caries reduction rate from 5-year FMR program was calculated as 18.5% by the difference of DMFT scores between FMR group and control group. 3. The DMFS scores were 4.04 in FMR group and 5.05 in control group. The difference of DMFS scores was 1.01 between FMR group and control group. The caries reduction rate from 5-year FMR program was calculated as 20.0% by the difference of DMFS scores between FMR group and control group. 4. Significant Caries Index of permanent teeth was 5.46 in FMR group and 6.02 in control group. 5. We suggest that fluoride mouthrinsing program should be developed to all primary schools to prevent dental caries.