영아교사의 직무환경에 대한 인식이 자기개발 욕구에 미치는 영향 : 셀프리더십과 이직의도의 매개효과를 중심으로

임성안,김정희 다문화아동청소년연구원 2022 다문화아동청소년연구 Vol.7 No.1

본 연구는 영아교사의 직무환경 인식이 자기개발 욕구에 미치는 영향을 셀프리 더십과 이직의도가 매개하는지를 분석하기 위해 실시되었다. 서울시와 수도권에 소재한 어린이집에 재직 중인 영아교사 240명을 대상으로 온라인을 통해 설문 조사를 진행하였는데, 직무환경 인식 질문지, 자기개발 욕구 질문지, 셀프리더십 질문지, 이직의도 질문지를 사용하였다. 수집한 자료는 SPSS 25.0과 AMOS 26.0 통계프로그램을 사용하여 분석하였으며, 빈도와 백분율 산출, 경로분석, Sobel test를 실시하였다. 연구결과 첫째, 직무환경 인식의 하위요인 중 동료교사의 지 지와 의사결정 참여정도는 자기개발 욕구에 셀프리더십의 매개를 통해 자기개 발 욕구에 영향을 미치는 완전매개효과가 있고, 전문적인 성장기회는 자기개발 욕구에 직접적으로 긍정적인 영향을 미치고 있었다. 둘째, 직무환경 인식의 하 위요인 중 영아교사의 보상정도와 원장의 지지, 의사결정 참여정도는 자기개발 욕구에 직접적으로 영향을 미치기보다는 이직의도의 매개를 통해 자기개발 욕 구에 영향을 미치는 완전매개효과가 있고, 전문적인 성장기회는 자기개발 욕구 에 직접적으로 긍정적인 영향을 미치고 있었다. 본 연구는 어린이집 영아교사의 자기개발 욕구를 높이는 방안을 모색하는 기초자료를 제시하였다는 데 의의가 있다. This study was conducted to analyze whether self-leadership and turnover intention mediate the effect of perception of the job environment of infant teachers on self-development needs. Two hundred forty teachers working with infants at day care center in Seoul and the metropolitan area participated in this study. To collect the data, participants were given survey questionnaires on perception of the job environment, self-development needs, self-leadership, and turnover intention through the Internet. The collected data were analyzed by SPSS 25.0 and AMOS 26.0 statistical program, conducting frequency, percentage calculation, path analysis, and Sobel test. As a result of the study, first, among the sub-factors of perception of the job environment, peer teacher support and decision-making participation had a complete mediating effect on self-development needs through self-leadership, and professional growth opportunities had a direct positive effect on self-development needs. Second, among the sub-factors of perception of the job environment, infant teachers' compensation, support, and decision-making participation had a complete mediating effect on self-development needs through the mediation of turnover intention, and professional growth opportunities had a direct positive effect on self-development needs. Through the results of the study is meaningful in that it presented basic data seeking ways to increase the desire for self-development of infant teachers at daycare centers.

영상증폭장치를 이용한 경추 신경근 차단술 중 약물투입 전 발생한 뇌경색증 - 증례 보고 -

임성안,백성년,최용수 대한척추외과학회 2021 대한척추외과학회지 Vol.28 No.3

Study Design: Case report. Objective: To report a case in which cerebral infarction occurred before drug administration during cervical nerve root block using an image amplifier. Summary of Literature Review: Complications of cervical nerve root block associated with intravascular injections have been reported. Materials and Methods: A 74-year-old woman with cervical radiculopathy complained of nausea and drowsy mental state after contrast injection was performed without an intravascular injection during sixth cervical nerve root block. After the procedure was stopped, general treatment was performed in the recovery room, but visual disturbances occurred. Results: Brain magnetic resonance imaging revealed cerebral infarction in the left posterior cerebral artery territory. The visual disturbances improved slightly, but a visual field defect remained at a 1-year follow-up. Conclusions: Even if an intravascular injection during cervical nerve root block is not performed, cerebral infarction could occur. It is necessary to monitor the patient carefully and prepare for emergency treatment. 연구 계획: 증례 보고목적: 영상증폭장치를 이용한 경추 신경근 차단술 중 약물투입 전 발생한 뇌경색증을 증례 보고 하고자 한다. 선행 연구문헌의 요약: 경추 신경근 차단술의 합병증은 혈관 내 주사와 관련이 많다. 대상 및 방법: 74세 여자 환자가 경추부 신경근병증으로 좌측 제 6경추 신경근 차단술기 중에 조영제를 주입하자마자, 구토와 의식 저하를 호소하였다. 술기를 중단한 후 회복실에서 일반적인 치료를 시행하였으나 시력 이상이 있었다. 결과: 대뇌자기공명검사상 좌측 후대뇌동맥 영역 및 왼쪽 시상에서 뇌경색이 발견되었다. 1년 추적 관찰에서 우측 시야 결손이 경도 호전되었으나 후유증으로 잔존하였다. 결론: 경추부 신경근 차단술 중 객관적인 혈관 내 주사가 확인되지 않더라도 뇌경색증이 발생할 수 있다. 따라서 시술을 위해서는 적절한 환자 감시와 응급처치를 위한 준비가 필요하다.

퇴행성 척추증의 흉-요추부 시상 지표에서 제1요추 경사도의 특성

임성안(Sung-An Lim),심승우(Seung-Woo Shim),백성년(Sung-Nyun Baek),박태규(Tae-Gyu Park),최용수(Yong-Soo Choi) 대한정형외과학회 2022 대한정형외과학회지 Vol.57 No.6

목적: 퇴행성 척추증 환자에서 흉-요추부 시상 지표와 제1요추 경사도의 관계를 분석하고, 젊고 건강한 연구 지원자와의 차이를 알아보고자 하였다. 대상 및 방법: 만성 요통 또는 배부통을 호소하는 평균 연령 72.00±10.00세의 36명을 1군으로, 요통을 호소하지 않는 평균 연령 29.3±4.97세의 지원자 20명을 2군으로 하였다. 두 군에서 제7경추 시상수직축(C7 sagittal vertical axis), 흉추후만각(thoracic kyphosis), 요추전막각(lumbar lordosis), 제1흉추 경사도(T1 slope), 천추 경사도(sacral slope), 골반 경사각(pelvic tilt), 골반 지수(pelvic incidence), 제1요추 경사도(L1 slope)를 기립 측면 전신 방사선 검사를 통해 측정하여, 제1요추 경사도와 흉-요추부 시상 지표와의 관계를 분석하였다. 결과: 제1요추 경사도는 1군에서 2.70±12.66°, 2군에서 12.24±4.08°였고, 두 군 간에 유의한 차이가 있었다(p<0.001). 제1요추 경사도는 2군에서 제1흉추 경사도, 흉추후만각과 양의 상관관계(R<SUP>T1 slope</SUP>=0.448, R<SUP>TK</SUP>=0.537)를 가졌고, 1군에서는 흉추후만각, 요추 전만각 및 천추 경사도와 양의 상관관계(R<SUP>TK</SUP>=0.480, R<SUP>LL</SUP>=0.774, R<SUP>SS</SUP>=0.385)를 가졌으며, 제7경추 시상수직축과 음의 상관관계(R<SUP>C7-SVA</SUP>=-0.529)를 보였다. 전체 연구대상자 분석에서 제1요추 경사도는 흉추후만각, 요추 전만각, 천추 경사도와 양의 상관관계로 확인되었고(R<SUP>TK</SUP>=0.466, R<SUP>LL</SUP>=0.790, R<SUP>SS</SUP>=0.409), 제7경추 시상수직축, 골반 경사도와 음의 상관관계로 확인되었다(R<SUP>C7-SVA</SUP>= -0.608, R<SUP>PT</SUP>=-0.364). 결론: 퇴행성 척추증의 경우 요추 전만각이 감소하고 이로 인해 흉추후만각이 감소, 제7경추시상수직축이 증가하고, 제1요추 경사도는 감소하는 양상을 보여 제1요추 경사도가 퇴행성 척추증 환자들의 흉-요추부 시상 정렬을 이해하는데 도움이 될 수 있을 것으로 생각된다. Purpose: To identify the characteristics of the L1 slope in the thoracolumbar sagittal parameters of degenerative spondylosis through comparison with healthy young people. Materials and Methods: Thirty-six patients who had chronic back and lower back pain were classified as Group I and twenty healthy people were as Group II. The average age of subjects in the Group I was 72.00±10.00 years and that of, Group II was 29.3±4.97 years. Radiographic parameters such as the C7 sagittal vertical axis (SVA), thoracic kyphosis (TK), lumbar lordosis (LL), T1 slope, sacral slope (SS), pelvic tilt (PT), pelvic incidence, and L1 slope were measured on whole-spine lateral radiographs taken with the patient standing. We analyzed the relationships between the L1 slope and other parameters. Results: There were significant differences between the two groups. the mean L1 slope was 2.70±12.66° in Group I and 12.24±4.08° in Group II (p<0.001). In the healthy young group, the T1 slope and TK had a positive correlation with the L1 slope (R<SUP>T1 slope</SUP>=0.448, R<SUP>TK</SUP>=0.537). In the degenerative spondylosis group, the L1 slope had a positive correlation with TK, LL and SS (R<SUP>TK</SUP>=0.480, R<SUP>LL</SUP>=0.774, R<SUP>SS</SUP>=0.385) and a negative correlation with C7-SVA (R<SUP>C7-SVA</SUP>=-0.529). Taking both groups together, the L1 slope had a positive correlation with TK, LL and SS (R<SUP>TK</SUP>=0.466, R<SUP>LL</SUP>=0.790, R<SUP>SS</SUP>=0.409) and a negative correlation with C7-SVA and PT (R<SUP>C7-SVA</SUP>=-0.608, R<SUP>PT</SUP>=-0.364). Conclusion: In degenerative spondylosis, LL may decrease, which leads to a decrease in the TK, an increase in the C7-SVA, and a decrease in the L1 slope. These results suggest that the L1 slope could be helpful in understanding the thoracolumbar sagittal alignment.

감염성 당뇨 족부 궤양 치료에서 Texas 기준 체계에 따른 음압치료 적용

장영재,임성안,최용수,백성년,배안나 대한족부족관절학회 2022 대한족부족관절학회지 Vol.26 No.2

Purpose: A group of patients who were hospitalized for diabetic foot ulcers was classified according to the University of Texas Staging System for Diabetic Foot Ulcers, and we attempted to evaluate whether this staging system could be a criterion for treatment success using vacuum-assisted closure (VAC) technique. Materials and Methods: A total of 32 patients were diagnosed with diabetic foot ulcers according to the University of Texas Staging System for Diabetic Foot Ulcers. Of these, 24 patients who were evaluated as stage B according to the staging system were classified as Group 1, and 8 patients in stage D were classified as Group 2. After applying VAC, the treatment success rate was compared by evaluating the size and severity of ulcers between the two groups. Results: The grade of granulation after VAC was on average 3.75±0.53 in Group 1 and 2.25±0.71 in Group 2. There was better granulation after VAC application in Group 1 (p<0.01). The success rate of the treatment was 22 cases (91.67%) in Group 1 and one case (12.5%) in Group 2. Thus there were statistically significant differences in the success rate of treatment between groups 1 and 2 (Pearson’s chisquare test, p=0.01; odd ratio 77.00, 95% confidence interval [CI] 1.26~14.66; relative risk 4.30, 95% CI 1.26~14.66). Conclusion: These results suggest that there was a higher success rate of treatment with VAC in stage B patients. The University of Texas Staging System for Diabetic Foot Ulcers can thus be an index for applying VAC to patients with infective diabetic foot ulcers.

Feasibility of Serum Pentosidine Level as a Potential Risk Factor for Osteoporotic Vertebral Compression Fracture

최동혁,이상민,임성안,최용수 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.6

Study Design: Feasibility study. Purpose: To evaluate the feasibility of using serum pentosidine level as a potential marker for osteoporotic vertebral compression fracture (OVCF). Overview of Literature: A review of previous studies suggests a negative correlation between serum pentosidine concentration and bone strength. However, it is unclear whether serum pentosidine level might be a potential marker of OVCF in Koreans. Methods: Forty patients who underwent bone mineral density examination were included in this study, and their serum pentosidine levels were prospectively analyzed. Serum pentosidine level was evaluated using enzyme-linked immunosorbent assay. Among all the patients, 11 with OVCF were assigned to the vertebral fracture group and 29 who did not have vertebral fracture were included in the non-fracture group. In addition, we used the Fracture Risk Assessment (FRAX) tool Korean version for assessing the 10-year probability of fracture. Results: There was a statistically significant difference in the mean serum pentosidine level (p =0.04) of the vertebral fracture group (110.8 ng/mL) and the non-fracture group (64.3 ng/mL). Logistic regression analyses showed that serum pentosidine was significantly associated with OVCF. The vertebral fracture group had significantly higher 10-year probability of major osteoporotic fracture as per FRAX than the non-fracture group. There was a positive correlation between pentosidine level and FRAX results (r =0.35, p =0.02). Conclusions: These results suggest that increased serum pentosidine level could be a potential marker for OVCF.

Impact of Fat Infiltration in Cervical Extensor Muscles on Cervical Lordosis and Neck Pain: A Cross-Sectional Study

김충영,이상민,임성안,최용수 대한정형외과학회 2018 Clinics in Orthopedic Surgery Vol.10 No.2

Background: Weakness of cervical extensor muscles causes loss of cervical lordosis, which could also cause neck pain. The aim of this study was to investigate the impact of fat infiltration in cervical extensor muscles on cervical lordosis and neck pain. Methods: Fifty-six patients who suffered from neck pain were included in this study. Fat infiltration in cervical extensor muscles was measured at each level of C2–3 and C6–7 using axial magnetic resonance imaging. The visual analogue scale (VAS), 12-Item Short Form Health Survey (SF-12), and Neck Disability Index (NDI) were used for clinical assessment. Results: The mean fat infiltration was 206.3 mm2 (20.3%) at C2–3 and 240.6 mm2 (19.5%) at C6–7. Fat infiltration in cervical extensor muscles was associated with high VAS scores at both levels (p = 0.047 at C2–3; p = 0.009 at C6–7). At C2–3, there was a negative correlation between fat infiltration of the cervical extensor muscles and cervical lordosis (r = –0.216; p = 0.020). At C6–7, fat infiltration in the cervical extensor muscles was closely related to NDI (p = 0.003) and SF-12 (p > 0.05). However, there was no significant correlation between cervical lordosis and clinical outcomes (VAS, p = 0.112; NDI, p = 0.087; and SF-12, p > 0.05). Conclusions: These results suggest that fat infiltration in the upper cervical extensor muscles has relevance to the loss of cervical lordosis, whereas fat infiltration in the lower cervical extensor muscles is associated with cervical functional disability.

요추 신전근의 지방 변성 분류 점수와 골다공증성 척추 압박 골절의 관계

허주영,박지훈,김민욱,이상민,임성안,최홍석,최용수 대한척추외과학회 2018 대한척추외과학회지 Vol.25 No.3

Study Design: Retrospective study. Objectives: To investigate the reliability of the lumbar extensor muscle degeneration classification as an indicator of potential risk for osteoporotic vertebral compression fractures (OVCF). Summary of Literature Review: Fatty degeneration of lumbar extensor muscles has attracted increased interest in the literature as a risk factor for OVCF. Materials and Methods: Ninety-one patients with OVCF (group 1) and 60 patients without OVCF (group 2) were investigated. Magnetic resonance imaging was used to measure and to analyze the muscle mass and fatty degeneration of the lumbar extensor muscle. The degree of fatty degeneration of the lumbar extensor muscle was classified into 4 stages: less than 10%, 10%-25%, 25%-50%, and more than 50%. Results: Fatty degeneration of the lumbar extensor muscle and the bone mineral density T-score were 29.66%±12.28% and −3.56±1.13 in group 1 and 24.04%±13.29% and −2.27±1.46 in group 2, which were statistically significant differences (p<0.05). Logistic regression analysis revealed that as the fatty degeneration of the lumbar extensor muscle increased, the risk of OVCF increased (odds ratio [OR]=1.21; p=0.01). The risk of OVCF increased as the lumbar extensor muscle degeneration classification scores increased (OR=13.53; p=0.02). Furthermore, as the muscle mass of the multifidus decreased, lumbar lordosis and sacral inclination decreased (β=0.33; p=0.01 and β =0.25; p=0.04, respectively). However, no factor affected thoracic kyphosis. Conclusions: Fatty degeneration of the lumbar extensor muscle was correlated with OVCF. A lumbar extensor muscle degeneration classification higher than stage 3 should be considered a risk factor of OVCF. 연구 계획: 후향적 연구목적: 요추 신전근의 지방 변성을 변성 분류 점수로 분류하고 골다공증성 척추 압박 골절 위험도와 관계를 분석하고자 하였다. 선행 연구문헌의 요약: 골다공증성 척추 압박 골절의 위험 요소로서 척추 주위 근육의 지방 변성에 대한 관심이 증가하고 있으나 위험 지표가 불분명하여논란이 있다. 대상 및 방법: 골다공증성 척추 압박 골절이 발생한 환자군(91예)과 골다공증성 척추 압박 골절의 기왕력이 없는 대조군(60예)을 비교 분석하였다. 요추부 자기공명영상에서 요추 신전근의 근육량과 지방 변성도를 측정하여 분석하였다. 또한, 요추 신전근의 지방 변성도를 10% 미만, 10~25%, 25~50%, 50% 이상의 4 단계로 분류하여 분석하였다. 결과: 요추 신전근의 지방 변성도 및 골밀도 T 점수는 골절군 평균29.66±12.28%, -3.56±1.13이었고, 비골절군 평균은 24.04±13.29%, -2.27±1.46 의 결과로 각각 차이를 보였으나(p<0.05), 양 군 간 연령, 성별 및 체질량 지수에는 차이가 없었다. 로지스틱 회귀 분석 결과 요추 신전근의 지방 변성도가증가할수록 골다공증성 척추 압박 골절의 발생 가능성이 증가하였으며(p=0.01, OR=1.21), 요추 신전근의 지방 변성 분류 점수가 증가할수록 골다공증성척추 압박 골절 위험도의 증가를 보였다(p=0.02, OR=13.53). 척추의 시상정렬에 대한 다중 회귀 분석 결과에서 요추 신전근 중 다열근의 근육량이 감소할수록 요추 전만 및 천추 경사가 감소하였다(p=0.01, β=0.33; p=0.04, β=0.25). 결론: 요추 신전근의 지방 변성도가 증가할 수록 골다공증성 척추 압박 골절의 위험성이 증가하였으며, 요추 신전근 지방 변성 분류 점수 3단계 이상은골다공증성 척추 압박 골절의 위험도 평가에 적용될 수 있으리라 사료된다. 약칭 제목: 요추 신전근의 지방 변성 분류 점수