농촌지역주민의 암 조기검진과 관련 요인에 관한 연구

장성훈,이원진,이건세,Chang, Soung-Hoon,Lee, Won-Jin,Lee, Kun-Sei 대한예방의학회 2000 Journal of Preventive Medicine and Public Health Vol.33 No.3

Objectives : Cancer is the second most frequent cause of death in Korea. Cancer screening tests can save lives through early detection. Enhancing the cancer screening rate is an important strategy for reducing cancer mortality. The purpose of our study was to evaluate the screening rate and related factors in a rural area. The study investigated relationships between sociodemographic characteristics, several preventive behaviors, and the experience of several cancer screening behaviors. Materials and Methods : The study population was recruited voluntarily from the three rural areas(Myen) in Chungju city. The participants completed structured questionnaire from July 21, 1990 to July 26, 1998. Results : The proportions of the study population who had previously received stomach, liver, breast, or cervix cancer screening tests were 24.5%, 18.5%, 27.0%, 59.2% respectively. The 1-year screening rates of stomach, liver, breast, and cervix cancer were 7.4%, 6.8%, 8.6%, 15.6% respectively. In multivariate logistic analysis, some sociodemographic variables, preventive behaviors, or psychological variables were significantly associated with several cancer screening tests. Those who had previously received a stomach cancer screening test were significantly associated with the presence of chronic disease, physician's recommendation, use of alcohol family history of cancer, or previous liver cancer screening test. Those who had previously received a liver cancer screening test were associated with education level, physician's recommendation and previous stomach cancer screening test. Those who had received a cervix cancer screening test were significantly associated with education level, presence of a transportation vehicle, physician's recommendation use of alcohol and previous breast cancer screening test. And those who had received a previous breast cancer screening test were significantly associated with age, marital status, and earlier cervix cancer screening test. Conclusion : Based on the results of this study a strategy to promote cancer screening and health objectives at the district level can be made.

모 수은취급사업장의 작업환경 개선 및 근로자 작업전환 효과에 관한 연구

장성훈,김광종,Chang, Soung-Hoon,Kim, Kwang-Jong 대한예방의학회 1989 예방의학회지 Vol.22 No.4

This research was conducted to evaluate the effect of improvement in work environment and of segregation in a fluorescent lamp manufacturing factory. Among the total of 80 workers, 8 workers whose mercury concentration in urine reached a hazardous level ($200-299{\mu}g/l$) were moved to mercury free workplace. The follow-up examination for their mercury concentration in urine was done three times ; on May 3, 1988, September 1, 1988 and April 3, 1989. The results were as follows : 1. Mercury concentration in the air was reduced from 0.140 to 0.107 $mg/m^3$ in 4 months, and to $0.087mg/m^3$ in one year after environmental improvement in workplace. However the level still exceeded the Threshold Limit Value. 2. The geometric mean of urinary mercury concentration among 80 workers was $173.0{\mu}g/l\;(5.1{\sim}458.6{\mu}g/l$). The distribution of workers according to urinary mercury concentration showed that 9 workers (11.2%) were above the mercury poisoning level ($300{\mu}g/l$), 24 workers (30.0%) were $200-299{\mu}g/l$, 35 workers (43.8%) were $50-199{\mu}g/l$, and 12 workers (15.0%) were below 50 ${\mu}g/l$. 3. Among the 24 workers whose urinary mercury concentration was 200-299 $50-199{\mu}g/l$, 8 were able to be followed up. Their mean urinary mercury concentration before segregation was $244.9{\mu}g/l$, but decreased to $151.4{\mu}g/l$ in four months, $128.8{\mu}g/l$ in six months, and $46.8{\mu}g/l$ in one year after segregation.

건국의대 제 1회 기초의학 종합시험의 결과 분석

장성훈(Soung Hoon Chang),이원진(Won Jin Lee),이건세(Kun Sei Lee),이법이(Beob Yi Lee),고기석(Ki Seok Koh) 한국의학교육학회 1998 Korean journal of medical education Vol.10 No.1

To provide the information about overall test reliability and test improvement, we analyzed the first fundamental medical sciences examination at the Kon-Kuk University College of Medicine on August 23, 1997. The results are as follows: 1. The number of the items in the test is 230. The range of the scores is from 32.5 to 61.3(average percentage score: 50.0+/-6.1). Among the 39 students, three(7.7%) passed the examination with percentage scores of higher than 60. 2. The correlation coefficients between the fundamental medical sciences examination and academic records are 0.4682(the first semester in 1st grade), 0.5933(the second semester in 1st grade), and 0.6538(the first semester of 2nd grade), respectively. 3. Among the 230 items, 47(20.4%) are too difficult or too easy. Therefore these items are recommended to be discarded. 4. Among the 230 items, 115(50%) have lower discriminative indices(lower than 0.14) and 55(23.9%) have higher discriminative indices(higher than 0.23). 5. Among the 230 items, overall acceptable items are 101; the range of difficulty is 0.15~0.84 and discriminative indices are higher than 0.15. Good acceptance is shows in pharmacology and microbiology. 1997년 8월 23일에 건국대학교 의과대학 의학과 2학년 학생 39명 전원이 참석한 가운데 제1회 기초 의학 종합시험을 시행하였다. 본 연구의 목적은 처음 시행하는 기초의학 종합시험 결과에 대한 철저한 분석을 통해 문제점을 도출하여 보다 개선된 문제 출제를 유도하기 위함이다. 1.기초의학 종합시험은 총 230문제를 치렀으며, 100점 만점으로 환산한 성적은 최고 61.3점, 최저 35.2점이었으며, 평균은50.0+/-6.1이었다. 정답을 60%이상 맞추어 합격한 자는 39면 중 3명(7.7%)뿐이었다. 2. 이 시험성적과 의학과 1학년 1학기 평점과의 상관계수는 0.4682, 1학년 2학기 평점과는 0.5935, 1학년 전체 평점과는 0.5528, 2학년 1학기 평점과는 0.6538로 의학과 1,2학년 평점과 이 시험과는 일관되게 비교적 좋은 상관관계를 보였으며 특히 2학년 1학기 평점과 가장 좋은 상관을 보였다. 3. 총 230개 문항 중 난이도에서는 18개(7.8%)문항은 너무 쉬웠으며, 29개(12.6%)문항이 너무 어려웠다. 따라서 총 47개(20.4%)문항이 너무 쉽거나 어려워서 폐기해야 할 문항이었다. 4. 음성 변별도를 나타낸 문항이 35개(15.2%)이었으며 변별계수가 0.14이하의 불량한 문항은 115개(50%)이었다. 변별계수가 0.23이상의 양호한 문항은 55개(23.9%)이었다. 5. 난이도(0.15~0.84)와 변별도(0.15이상)모두가 수용할 만한 문항은 총 101개(43.9%)이었다. 10개 교과목 중 문제 수용률이 가장 높은 과목은 약리학(72%), 미생물학(68%)의 순서이었으며, 면역학과 행동과학의 수용률은 각각 0%이었다.

건국의대생의 의사국가시험 결과와 학업 및 졸업시험 성적과의 일치도 분석

장성훈(Soung Hoon Chang),이원진(Won Jin Lee),이건세(Kun Sei Lee),김상윤(Sang Yoon Kim),이예철(Ye Chul Lee) 한국의학교육학회 1998 Korean journal of medical education Vol.10 No.2

본 연구는 의사국시의 변화에 따른 본교 졸업생의 의사국시 합격/불합격과 학업성취도와의 관련성을 분석하고자 하였다. 즉, 1995년부터 1998년까지 4년간의 건국의대 졸업생 중 의사국시에 합격한 자와 불합격한 자간에 학업성적과 졸업시험성적의 차이가 있는가를 밝히고 이 둘 중 어느 것이 의사국시의 합격/불합격을 보다 잘 예측할 수 있는 자료이며 그 일치도가 어떠한지를 분석하여 학생들의 학습지도를 위한 자료로 활용하기 위함이다. 연구결과는 다음과 같다. 1.의사국시 합격/불합격한 자의 학업성적, 졸업시험성적 비교 의학과 4학년 평균 평점은 의사국시 합격자가 불합격자보다 평균0.49에서 0.71점까지 높았으며 통계적으로 유의하였다. 졸업시험 성적은 의사국시 합격자가 불합격자보다 평균4.9에서 9.9점까지 높았으며 통계적으로 유의하였다. 2.의사국시 합격/불합격과 학업 성적, 졸업시험성적과의 일치도 연도별 의사국시 합격/불합격 여부와 4학년 평점, 졸업시험 성적과의 일치도를 분석한 결과 가장 일치도가 높았던 점수는 의학과 4학년 평점의 경우 2.2점일 때였으며, 이 때의 kappa값은 평균 0.49이었고, 졸업시험의 경우 71점일 ??였으며, 이 때의 kappa지수는 평균0.64이었다. 따라서 의학과 4학년 성적과 졸업시험 성적 중 졸업시험 성적에서 더 좋은 일치도를 보였다. 결론적으로 건국의대의 경우 의학과 4학년 평점이 2.2점 이하이거나, 졸업시험 평균성적이 71점 이하인 학생은 의사국시에 불합격할 가능성이 크기 때문에 이들에 대한 집중적인 지도가 필요하다고 사료된다. In order to identify students who needs more intensive guide, we analysed the association between the results of Korean medical licensing examination(KMLE) and two different types of scholastic achievement; 4th grade score and graduation examination score. The scholastic achievement between passed and failed the KMLE at Konkuk University College of Medicine from 1995 to 1998 was investigated. First, we grouped the students into four groups according to the year they graduated. Second, we regrouped the group into two subgroups according to whether passed or failed in the KMLE. In the 4th grade score, the passed KMLE is higher than the failed from 0.49 to 0.71 and which is statistically significant. In the graduation examination score, the passed KMLE is higher than the failed from 4.9 to 9.9 and which is also statistically significant. We analyzed the degree of agreements between the results of the KMLE and the two different types of scholastic achievement. In 4th grade score, the highest degree of agreement shows 2.2 and its kappa index is 0.49. In graduation examination score, the highest degree of agreement shows 71 and its kappa index is 0.64. In conclusion, students who have lower than 2.2 in 4th grade score or lower than 71 in graduation examination score are tend to be failed the KMLE. So they need more intensive guide for the KMLE.

1996년도 의학과 평가에 사용된 정량적 평가항목들의 타당도 분석

장성훈(Soung-Hoon Chang),이원진(Won-Jin Lee),이건세(Kun-Sei Lee),김청식(Cheong-Sik Kim),김상윤(Sang-Yoon Kim) 한국의학교육학회 1999 Korean journal of medical education Vol.11 No.2

1996년에 시행한 의학과 평가에서 사용한 평가지표 중에서 정량적인 평가지표들을 대상으로 각 지표의 자료와 평가 결과를 비교 분석하였다. 조사에 사용된 자료는 한국의과대학장협의회에서 발간하고 있는 의과대학교육현황의 자료를 사용하였다. 평가 결과에서 우수 대학으로 판정된 군의 자료가 다른 군의 자료와 통계적으로 가장 의미 있는 차이를 보인 정량적 평가 지표는 기초의학 교수 및 조교의 숫자이었으며, 연구실적, 대학원 학생수, 도서관 장서 및 교육 공간도 우수대학 군이 잘 확보하고 있는 것으로 분석되어 타당성 있는 평가지표로 판단되었다. 의학과 학생수는 평가 결과와 잘 연계되었지만 국내 의학과의 평가 지표로서는 부적절하며 다른 평가지표들은 평가 결과에 영향을 줄 정도의 차이는 없었다고 판단되었다. The purpose of this study is to review the validity of quantitative indices on the Evaluation of Korean Medical Schools in 1996. The data required for the indices were obtained from the 1996 s edition of the Directory of Korea Medical Education and compared to the results of the evaluation. Among the quantitative indices of the evaluation the number of professors and assistants of basic medical science was the most valuable index to differentiate the better group from lesser groups of medical schools in Korea.

충주지역 전업농민의 농부증에 관한 연구

장성훈(Soung-Hoon Chang),이건세(Kun-Sei Lee),이원진(Won-Jin Lee) 한국농촌의학 지역보건학회 1998 농촌의학·지역보건 Vol.23 No.1

일부 농촌 지역 여성의 자궁경부암 조기검진에 영향을 미치는 요인

구혜원,이원진,장성훈,유근영,이건세,Koo, Hye-Won,Lee, Won-Jin,Chang, Soung-Hoon,Yoo, Keun-Young,Lee, Kun-Sei 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.2

Objectives: To construct basic data to develop strategies for achieving higher Pap test coverage rate by evaluating factors associated with the use of Pap test through population-based survey. Methods: 16.4%(671) of the 4,090 women, who were eligible population for this study, in 3 Myens of Chung-ju City participated in this study voluntarily from July 21 to 26, 1997. After basic physical examination by trained doctors, they were interviewed with structured questionnaire by well-educated interviewers. Results: It shows that only 54.3% of study participants experienced Pap test. The strongest factor which is related with the use of Pap test was the history of having breast screening tests(aOR=8.71, 95% CI=4.25-17.84). Probability of ever having Pap test was also higher in married women(aOR of single=0.46, 95% CI=0.29-0.72), younger(Ptrend<0,051, more educated (Ptrend<0.001), non-smoker (aOR of smoker=0.25, 95% CI=0.12-0.55), women of ever having Hepatitis test(aOR=2.60, 95% CI=1.73-3.88) in multiple lineal logistic analysis. Conclusions : This study suggests that several factors significantly associated with the use of Pap test, and especially, high-risk population for cervical cancer such as women of older ages, less educated, living alone are less likely to have the Pap test. We should concentrate on encouraging high-risk women in the use of Pap test to improve Pap test coverage rate.

톨루엔 폭로근로자의 혈장중 마뇨산과 공기중 톨루엔과의 상관관계

황천현,이원진,장성훈,김형아,Hwang, Cheon-Hyun,Lee, Won-Jin,Chang, Soung-Hoon,Kim, Hyoung-Ah 대한예방의학회 2000 Journal of Preventive Medicine and Public Health Vol.33 No.1

Objectives : This study was undertaken to evaluate correlation between the levels of hippuric acid in blood plasma (HAP) and those of toluene concentration in the workplace air. Methods : Study subjects were composed of two groups; 21 workers who were occupationally exposed to toluene and 25 rural-area residents who were not exposed to any known occupational toluene source, as an exposed group and a reference group, respectively. Mean age and work duration of the exposed was 42 years and five years, respectively. Mean age of the reference was 42 years. To determine toluene concentrations in the workplace air, air sampling has been conducted for more than six hours using a personal sampler, and analyzed by a gas chromatography-flame ionization detector. Concentrations of hippuric acid in biological samples were determined by a high performance liquid chromatography-ultraviolet detector. Results : Geometric mean(geometric standard deviation) of HAP and hippuric acid in urine(HAU) for the exposed was 1.39(2.21) mg/L and 2.77(1.46) g/L, respectively, which were significantly different from those of the reference [HAP, 9.45(2.94); HAU, 0.37(0.45)]. Teluene concentration in the workplace air was 86.92(range: $45.18\sim151.23$)ppm. The level of HAP or HAU was significantly correlated (r=0.70 and r=0.63, respectively) with that of toluene in the workplace air. The estimated regression equation was logHAP(mg/L)=-3.60+1.93 log(toluene, ppm) or logHAU(g/L)=-0.85+0.67 log(toluene, ppm). The magnitude of correlation was further enhanced when analyzing relationship between toluene concentrations lower than 100 ppm and its corresponding HAP levels. Conclusion : Overall, plasma hippuric acid levels were well correlated with toluene concentrations in the workplace air, and a statistically significant correlation was observed for the samples with toluene concentration lower than 100 ppm.

농약 폭로 농민들의 면역독성에 관한 연구

임채승,이건세,장성훈,이원진,Lim, Chae-Sung,Lee, Kun-Sei,Chang, Soung-Hoon,Lee, Won-Jin 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.3

Objective: This paper examines the possible toxicity to immune system in farmers chronically exposed to pesticides. Methods : We compared 43 male farmers exposed to pesticides with 29 male residents who had neither past nor current pesticides exposure. The selected variables for studying immunotoxicity were WBC, CD3, CD4, CD8, CD19, CD56, IgG, IgA, IgM, and IL-2. As part of the baseline questionnaires for the immunotoxicity, subjects were asked about kinds of farming, posticides exposure and medical history. Results : None of the variables for studying immunotoxicity showed statistically significant difference between the two groups. Although the results were not statistically significant, CD4 and the CD4/CD8 ratio decreased and CD8 increased. These effects showed a dose response change with exposure level. In the exposed group, the values of CD3, CD4, CD4/CD8 and CD19 decreased and those of the CD8 and CD56 increased compared to the non-exposed group. Also there was higher prevalence of self-reported disease in the exposed group compared to the non-exposed group. Conclusions: Although statistically significant differences in indices of immunotoxicity in farmers exposed to pesticides were not shown, the results suggest that pesticides may decrease immune function. More advanced test methods for immunotoxicity need to be developed and tested in larger population to detect immunotoxic effects of pesticides.

일부 농촌주민에서 Alcohol Use Disorders Identification Test를 이용한 위험 및 유해 음주율 조사

김형수,이건세,김청식,김기옥,장성훈,Kim, Hyeong-Su,Lee, Kun-Sei,Kim, Cheong-Sik,Kim, Ki-Ock,Chang, Soung-Hoon 대한예방의학회 2001 예방의학회지 Vol.34 No.3

Objectives : To investigate the prevalence of hazardous and harmful alcohol use, which are a subthreshold of alcohol related disorders, Methods : Direct-interview questionnaires to 1,183 rural persons (489 male, 694 female) were conducted in Chungju-city from July 2 to 20, 1998. As a screening instrument, the alcohol use disorders identification test (AUDIT) was used. Results : The prevalence of alcohol use was 41.7%. In males, it was 66.3% and in females, it was 24.4%. The mean of the AUDIT score of males and females was 13.2 and 5.6, respectively. As WHO guideline, the prevalence of hazardous alcohol use in males and females was 80.3% and 20.7%, respectively. This suggests that the prevalence of 'hazardous drinking' and 'harmful drinking' was 45.4% and 29.3% for males and 1.2% and 2.4% for females, respectively. Conclusions : This study presented the prevalence of hazardous and harmful drinking of a rural population in Korea and reviewed those health problems. Further evaluation to detect and treat lower alcoholic drinkers is recommended.