체력관리 전문가 집단 만들기: 건강운동관리사의 전문성과 사회적 경계

진현주 ( Jin¸ Hyunju ),김효민 ( Hyomin Kim ) 한국체육학회 2021 한국체육학회지 Vol.60 No.2

이 연구의 목적은 대중의 체력을 관리해온 전문 지식인 집단인 건강운동관리사 집단의 전문성을 둘러싸고 만들어지고 있는 사회적 경계를 드러내는 것이다. 지난 70여년의 세월 동안 한국 사회에서 체력의 사회적 개념은 공공 보건 구호의 캐치프레이즈인 ‘체력은 국력’에서, 개인의 삶의 역량과 기술을 반영하는 ‘생존 체력’의 구호로 변모해왔다. 이 연구는 변화해온 체력의 개념과 체력 관리라는 영역에서 전문화의 시도가 어떻게 이루어졌으며, 해당 직역의 전문성이 어떠한 사회적 도전에 직면해 있는지 드러낼 것이다. 이를 위해 본 연구에서는 대중의 신체를 관리하는 유일한 정부 공인 집단인 운동처방사(현, 건강운동관리사)가 어떠한 사회적 환경에서 등장하여 어떠한 제도를 통해 자신을 형성했는지 추적하는 것을 통해, 운동처방사가 기반해 왔던 학문적 지식장의 변화, 제도적 변화, 그러한 변화 안에서 겪어야 했던 갈등이 어떻게 건강운동관리사의 변화를 견인했는지 탐색한다. 이어서 그 갈등을 과학기술학(STS: science and technology studies)의 전문성에 관한 논의를 통해 고찰함으로써, 기존의 체육학 학술장에서 추구해 온 ‘자기 완성’으로서의 전문성 반성만으로는 현재의 건강운동관리사가 처한 사회적 갈등을 돌파할 수 없으며, 의학과 체육학의 경계에 존재하고 있는 건강운동관리사의 전문성은 체력관리 관련 제도를 둘러싼 내·외부의 동원을 모두 포함해 동시적으로 산출되는 것임을 지적할 것이다. This study aims to reveal and unfold the social boundary made around the expertise of sports/exercise specialist, a group of experts who have managed the physical fitness of the public. Over the past 70 years, the social concept of physical fitness in Korean society has been transformed. The catchphrase of ‘physical strength is national power’ has changed to the slogan of ‘physical stamina for survival’, reflecting increased the social interests in individual capabilities and skills. This study investigates how the attempts of expertification have been made and un-made around physical fitness as an ever-changing notion. Firstly, the study follows the pathways through which exercise prescriptors(currently, sports/exercise specialists) have formed as an institutionalized group. Secondly, the study examines how sports/exercise specialists as a group have been transformed in response to the conflicts stemming from changes in academic fields and regulatory frameworks. Lastly, the study discusses the aforementioned conflicts through insights obtained from science and technology studies (STS) literature on expertise. The study concludes that expertise of sports/exercise specialists, who currently occupy the boundary between medicine and sports medicine, is to be produced both inside and outside of the institutionalized system of managing physical fitness. In order to settle the conflicts emerging around the expertise of sports/exercise specialists, the issue of expert-making needs to be seen as a social problem, which cannot be sufficiently resolved if conceptualized as individual self-completion.

AOPWIN을 이용한 Acetanilide의 광분해 특성 평가

권민정,최윤호,송상환,박혜연,구현주,정성환,나진균,박광식 한국환경독성학회 2001 환경독성보건학회지 Vol.16 No.3

Acetanilide is a High Production Volume Chemical, which is produced about 2,300 tons/year in Korea as of 1998 survey. Most is used as an intermediate for synthesis of pharmaceuticals and dyes, and the chemical is one of seven chemicals of which human and environmental risk are being assessed by National Institute of Environmental Research under the frame of OECD SIDS program. The Atmospheric Oxidation Program for Microsoft Windows (AOPWIN) is used to estimates the rate constant for the atmospheric, gas-phase reaction between photochemically produced hydroxyl radicals and organic chemicals. It is also used to estimates the rate constant for the gas-phase reaction between ozone and olefinic/acetylenic compounds. The rate constants estimated by the program are then used to calculate atmospheric half-lives for organic compounds based upon average atmospheric concentrations of hydroxyl radicals and ozone. AOPWIN requires only a chemical structure to make these predictions. Structures are entered into AOPWIN by SMILES (Simplified Molecular Input Line Entry System) notations. In this study, one of environmental fate/distribution of the chemical elements, photodegradation of acetanilide was estimated using AOPWIN model based on SMILES notation and chemical name data.

Benzoyl peroxide의 환경에서의 초기 위해성 평가

김미경,배희경,김수현,송상환,구현주,박광식,이문순,전성환,나진균 한국환경독성학회 2004 환경독성보건학회지 Vol.19 No.1

Benzoyl peroxide is a High Production Volume Chemical, which is produced about 1,375 tons/year in Korea as of 2001 survey. The substance is mainly used as initiators in polymerization, catalysts in hte plastics industry, bleaching agents for flour nad medication for acne vulgaris. In this study, quantitative Structure-Activity Relationships(QSAR) are used for getting adequate information on the physical-chemical properties of this chemical. And hydrolysis in water, acute toxicity to aquatic and terrestrial organisms for benzoyl peroxide were studied. The physical-chemical properties of benzoyl peroxide were estimated as followed; vapor pressure=0.00929 pa, Log K_(ow)=3.43, Henry's Law constant=3.54×10^(-6) atm-m³/mole at 25℃, the half-life of photodegradation=3days and bioconcentration factor(BCF)=92. Hydrolysis half-life of benzoyl peroxide in water was 5.2hr at pH 7 at 25℃ and according to the structure of this substance hydrolysis product was expected to benzoic acid. Benzoyl peroxide has toxic effects on the aquatic organisms. 72 hr-ErC_(50)(growth rate) for algae was 0.44mg/L, 48hr-EC_(50) for daphnia was 0.07mg/L and the 96hr-LC_(50) of acute toxicity to fish was 0.24mg/L. Acute toxicity to terrestrial organisms(earth worm) of benzoyl peroxide was low(14 day-LC_(50)=>1,000mg/kg). Although benzoyl peroxide is high toxic to aquatic organisms, the substance is not bioaccumulated because of the rapid removal by hydrolysis (half life=5.2hr at pH 7 at 25℃) and biodegradation(8.% by BOD after 21days). The toxicity observed is assumed to be due to benzoyl peroxide rather than benzoic acid, which shows much lower toxicity to aquatic organisms. One can assume that effects occur before hydrolysis takes place. From the acute toxicity value of algae, daphnia and fish, an assessment factor of 100 was used to determine the predicted no effect concentration(PNEC). The PNEC was calculated to be 0.7㎍/L based on the 48hr-EC_(50) daphnia(0.07mg/L). The substance shows high acute toxicity to aquatic organisms and some information indicates wide-dispersive use of this substance. So this substance is a candidate for further work, even if it hydrolysis rapidly and has a low bioaccumulation potential. This could lead to local concern for the aquatic environment and therefore environmental exposure assessment is recommended.

P286 : Melanonychia: single centre experience in Korea

( Hyunju Jin ),( Gun Wook Kim ),( Hyun Ho Cho ),( Won Jeong Kim ),( Je Ho Mun ),( Margaret Song ),( Hoon Soo Kim ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Background: Melanonychia is well-known predisposing condition of acral lentiginous melanoma. Furthermore, many patients with melanochia is visiting dermatologic department due to publicity activities for this risk by mass media. But, the basic clinical data for Korean melanonychia is lacking. Objectives: To identify basic clinical data for Korean melanonychia Methods: From January 2002 to August 2014, total 282 patients with melanonchia in PNUH and PNUYH were included in this study. We reviewed the medical records, clinical photos, dermoscopic photos, and histopathologic results. In clinical findings, duration of disease, the number and the location of affected nail, and possible causing factors were identified. Results: Average duration of melanonychia from onset to visiting was 34.0 months. Eighty five (29.6%) patients have melanonychia on a single nail and thumb is the most frequently affected nail. Thirty of them were underwent skin biopsy. Nine (3.2%) patients were diagnosed with malignant melanoma, and the rest of them were diagnosed with benign conditions. Among them, 80 (28.4%) patients had subungual hemorrhage, 42 (14.9%) patients had ethnic type pigmentation, and 25 (8.9%) patients were related to extrinsic causes such as minor trauma or occupation. Conclusion: This study could be used as basic data of Korean melanonychia for dermatologists and public information and additionally for the further large-scale studies.

Chronic pruritus in the elderly ; its prevalence, clinical characteristics and associated life habits

( Hyunju Jin ),( Min-young Park ),( Kyungnam Bae ),( Sung-min Park ),( Hyun-joo Lee ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Moon-bum Kim ),( Byung- 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2

Background: Pruritus is one of the most common skin complaint in the elderly. Its prevalence is increasing with the rapid growth of their population. Its prevalence and clinical characteristics were not yet fully elucidated in Korean elderly population. Objectives: To analyze the prevalence, clinical characteristics and their associated life habits for chronic pruritus in Korean elderly. Methods: A face-to-face questionnaire was given to 648 subjects over age of sixty from October to February in 2013 to 2017. All subjects were divided into two groups based on whether they were suffered from chronic pruritus or not. Results: The prevalence of chronic pruritus in the elderly was 72.2% (n=468). In 63.2 percent of the itchy group, itch appeared on a daily basis. During winter (56.1%) and at night (87.4%), itch became worse. Itch was perceived as pricking (30.3%), stinging (18.8%) and burning (11.1%) rather than stabbing (9.8%) and pinching (6.2%). Among daily life habits, proportion in using emollients in itchy group was lower than in non-itchy group with statistical significance (p<0.001). Also, more subjects in itchy group scrubbed and did not use soap (p<0.001) during bath or shower. Conclusion: Pruritus in elderly is not rare. This study highlights the detailed characteristics of itch in Korean elderly. In order to reduce the prevalence of pruritus in elderly, it is better to use soap and emollients and not scrub during bath or shower.

Quadrivalent human papilloma virus vaccine for the treatment of multiple warts: a retrospective analysis of 30 patients

( Jin-hwa Son ),( Min-young Yang ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Moon-bu 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2

Background: Various therapeutic modalities have been implemented for wart treatment. Recently, resistant warts treated using quadrivalent human papilloma virus (HPV) vaccine have been reported, although original articles on the efficacy of quadrivalent HPV vaccine on viral warts are rare. Objectives: To evaluate the efficacy of quadrivalent HPV vaccine in the treatment of multiple warts Methods: We retrospectively reviewed 30 patients with multiple warts who had been treated with quadrivalent HPV vaccine in Pusan National University Hospital from January 2014 to November 2016. All patients received 3 doses of quadrivalent HPV vaccine at baseline, 2 and 6 months. Patient demographics and clinical features were reviewed. Therapeutic response and adverse reactions following vaccination were assessed. Results: Regarding therapeutic response, 14 patients (46.67%) showed “Complete response”, 5 (16.67%) showed “Partial response”, and 11 (36.67%) showed “No response”. There were no statistically significant differences in sex, age, disease duration, and lesion number and location between the three groups divided by treatment response. No severe adverse events were noted. Conclusion: The advantage of quadrivalent HPV vaccine in the treatment of multiple warts is that it is more convenient and less painful. HPV vaccine might be a good alternative to conventional destructive methods for certain cases such as those including multiple warts, dangerous lesion locations, and uncooperative patients.

Chronic acquired macrocheilia: a clinical and pathologic characteristics of Korean patients

( Hyunju Jin ),( Dongyoung Roh ),( Hyang-suk You ),( Woo-haing Sim ),( Joeng-min Kim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

Background: Macrocheilia is acute or chronic enlargement of one or both lips. The causes of this peculiar condition are well known. Though, its chronic acquired form can be challenging condition to dermatologists, but the clinical data for chronic acquired macrocheilia has been very limited especially in Korean patients. Objectives: To identify clinical and pathologic characteristics of chronic acquired macrocheilia in Korean patients Methods: We have performed a clinico-pathological analysis of the patients with chronic acquired macrocheilia who visited to our clinics (Pusan National University Hospital [Busan and Yansan]) from September 2002 to August 2016. Results: Total 25 patients were enrolled. There were various caused; granulomatous cheilitis (n=8), secondary swelling due to other type of cheilitis (n=7), exfoliative cheilitis (n=3), chronic idiopathic macrocheilia (n=3), pseudolymphoma (n=2), neuroma which was associated with multiple endocrine neoplasia type IIb (n=1), and foreignbody granuloma (n=1). Conclusion: By this study, we wish Korean dermatologists could be more familiar with chronic acquired macrocheilia, which had a variety of cause and could be a challenging condition to dermatologists.

Idiopathic eruptive macular hyperpigmentation: additional three cases for rare disease

( Hyunju Jin ),( Jeong Min Kim ),( Gun Wook Kim ),( Je Ho Mun ),( Hoon Soo Kim ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ),( Margaret Song ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Idiopathic eruptive macular pigmentation (IEMP) is a rare hyperpigmentary disorder characterized by asymptomatic non-confluent dark-brown or grayish colored macules. It usually affects children and young adults. Commonly involved sites are the trunk, proximal extremities, neck and face. Etiology of IEMP is not established yet. It was reported as self-limiting disease and no treatment is required. Though diagnostic criteria for IEMP were suggested, this entity is not familiar to dermatologist. Three patients presented with brown to grayish macules on their faces and necks without any symptom. The macules were varied in size from several millimeters to less than two centimeters. The patient``s ages were between tens and twenties. The macules developed on face without preceding erythema and slowly spread to contralateral side and neck. Histopathologic study showed basal hyperpigmentation, dermal melanophages and perivascular infiltration of lymphocytes. With the clinical and histopathologic characteristics, the patients were diagnosed with IEMP. Without any treatment, individual lesions slowly faded out, but new lesions emerged for several months. Unawareness of IEMP may results in underestimation of prevalence. Suspicion of this entity and correct diagnosis may prevent waste of resource for treatment.

Biopsy-proven malignant skin tumors referred to a tertiary medical center: are they all true malignant?

( Jin-hwa Son ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hoon-soo 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2

Background: When patients were diagnosed as a malignancy by skin biopsy, most of them were consulted to tertiary medical center. However, there were some cases that were finally changed to benign result from malignant through the reassessment of histologic specimen. Objectives: To analyze characteristics of cases confirmed of benign tumors through reassessment of histologic specimen among cases consulted as cutaneous malignancies from other clinics. Methods: A retrospective study was conducted by reviewing the records of patients changed to benign result in our hospital after referral for biopsy-proven malignancy.. Results: Fourteen patients were enrolled in this study. Most patients got the procedure by non-dermatologist. Pathologic diagnoses reported from other clinics included sarcoma such as dermatofibrosarcoma protuberans, squamous cell carcinoma and so on. The expertise of dermatopathologist was necessary for the final diagnoses of dermatofibroma, myopericytoma, ancient schwannoma and so on. Moreover, most patients had been referred without immunohistochemical evaluation for diagnosis. Conclusion: Although referred patients were proven as malignancy by biopsy in other clinics, reassessment of pathologic slides was mandatory to confirm the diagnostic accuracy. If the final result is changed to benign from malignant, this process will relieve patient’s anxiety and prevent the over-evaluation and inappropriate management.

[P441] Recurrent cellulitis related to lymphedema : it may be the result of regional invasion of the internal malignancy

( Jin-hwa Son ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hoon-soo Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Cellulitis is the common infectious disease occurred on the skin and soft tissue, and is associated with frequent recurrence. Lymphedema is one of risk factors of recurrent cellulitis, and common causes of it are malignancy and malignancy-associated treatment. Bulky lymphadenopathy by cancer invasion and direct tumor compression of regional lymphatic vessels can play a role in lymphedema. A 57-year-old woman presented with erythematous indurated patches on right lower quadrant of abdomen, right thigh and lower leg. Histopathologic examinations revealed perivascular inflammation with neutrophil infiltration. In addition, total WBC count was 14,460/ul, ESR and CRP were 14mm/hr and 17.56mg/dl respectively. She was diagnosed as cellulitis and improved with antibiotics treatment. But, for 9 months these clinical findings were repeated and imaging studies were performed. On imaging test of lower extremity, no specific findings were found except for lymphedema. After 1 year, subcutaneous mass on left supraclavicular region was found incidentally, and a biopsy revealed a metastatic carcinoma. Finally, cervical cancer was identified as the origin of metastatic carcinoma and its regional lymphatic invasion was considered as the cause of recurrent cellulitis with lymphedema. Herein, we report a rare case in which recurrent cellulitis related to lymphedema was significant cutaneous sign of regional lymphatic invasion of occult internal malignancy.