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.

급성 중독 환자에 대한 역학적 고찰 : 서울과 지방의 비교

김성중,김인병,최성욱,김경수,이영수,Choi, Jong Moo 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Study objective: To compare patients with acute poisoning between urban and rural areas Design: Retrospective chart review of 217 patients with acute poisoning Setting: Two University Hospital EDs Methods: patients were divided into two groups according to hospital. The group A was 109 patients who came to ED of Asan Medical Center and the group B was patients who came to ED of Ajou University Hospital from June 1994 to February 1995. We analysed the age and sex distributions, poisoning substances. causes of poisoning and the past history of psychiatric problems in patients of the two groups. Results: Total number of patients with acute poisoning were 109 in the group A and 108 in the group B. Female was more prevalent than male in the group A and male was more than female in the group B. There was a significant difference in sex distribution between two groups. The mean age of the group A was 27.7 years which was significantly different from the mean age of the group B, 33.7 years. The age incidences in both group were highest in 2nd decade. The accidental poisoning cases were 37% in the group A and 31% in the group B. The rates of committed suicide were 7% in the group A and 22% in the group B. The most common agent of poisoning was therapeutic drug in the group A and agricultural or industrial chemical in the group B. The overall mortality was 5% in the group A and 15% in the group B. Conclusion: There were significant differences in age and sex distributions. poisoning substances, causes of poisoning and the past history of psychiatric problems between two groups.

혈관모세포종의 임상 분석

김은성,강삼석,이정길,김태선,정신,김재휴,김수한,이제혁 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.1

관상동맥 스텐트 시술 후의 재협착에 관한 연구

김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.

관상동맥질환을 동반한 모야모야병 1례

김동기,이영태,김기향,김성만,김대경,김두일,김동수 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Moyamoya disease is an occlusive intracranial arteriopathy with an abnormal cerebral vascular collateral networks. Although this disease is known to be associated with stenosis of extracranial arteries, such as the renal artery, a case associated with stenosis of the coronary artery is extremely rare. We report a case of coronary artery occlusive disease affected by Moyamoya disease. The patient was a 38-year-old female experiencing intermittent headache and exer tional chest pain. Cerebral MRI showed complete obstruction of both internal carotid arteries and abnormal cerebrovascular systems which confirmed Moyamoya disease. Coronary angiography showed a significant stenosis of left anterior descending coronary artery ostium with TIMI grade I collateral blood flow from the normal right coronary artery. After coronary artery stenting and medical treatment for headache, her subjective symptoms were relieved. In Moyamoya patient, an evaluation of the extracranial (especially coronary artery) vascular system should be considered if there are some evidences of coronary artery disease.

정형물리치료의 적정 의료보험수가에 관한 연구

김명준,황성수,김호봉,김수형 대한정형물리치료학회 2000 대한정형도수물리치료학회지 Vol.6 No.2

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

Fibrous Dysplasia Associated with Primary Hyperparathyroidism Absent of McCune-Albright Syndrome : Tc-99m MIBI and Tc-99m MDP Findings

김승장,석주원,김인주,김영기,김동수 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.2

섬유성 골이형성증은 비정상적인 섬유성 골조직으로 대체되며 느리게 진행하는 골병변이다. 섬유성 골이형성증과 부갑상선기능항진증은 흔하게 관찰되는 질환이나 McCune-Albright 증후군 없이 일차성 부갑상선기능항진증에 동반된 섬유성 골 이형성증은 거의 보고된바가 없다. Tc-99m MDP 골스캔이 섬유성 골이형성증의 진단에 유용하다고 알려져 있으나, Tc-99m MIBI 영상은 아직 보고된 바가 없다. 저자들은 McCune-Albright 증후군이 없이 부갑상선기능항진증에 동반된 섬유성 골 이행성증의 Tc-99m MIBI 스캔과 Tc-99m MDP 골스캔의 영상을 비교하였다. Tc-99m MDP 골스캔상 병변 부위에서 증가된 섭취 소견을 보였으며, Tc-99m MIBI 조기영상에서도 동일한 위치에서 섭취증가가 관찰되었다. 2시간 지연 Tc-99m MIBI 영상에서는 Tc-99m MIBI의 섭취가 배출되는 소견을 보였다. 섬유성 골이형성증 병변에서 Tc-99m MIBI 스캔이 유용할 것이라고 생각하며, 섬유성 골이형성증 병변에서 Tc-99m MIBI의 섭취를 증가시키는 인자에 대한 더 많은 연구가 필요할 것으로 생각한다.

Kim,Seong-soo : Possiblity of Low Salting Process in Gae-Woo Jeot(Salted and Fermented Gastrophoda) and Changes in Fatty Acid Composition during Fermntation 低鹽化 可能性 檢討 및 熱成중 脂肪酸 組成의 變化

姜永周,河璡桓,金永東,宋大鎭,金洙賢,金成洙 제주대학교 1990 논문집 Vol.30 No.-

To establish the way of processing of Gae-Woo jeot which used abalone intestine that has not been systematically used compare to its characteristic taste and fame as main ingredient and to develop as a local tourist good, the change of constituents the quality of salted fish products suring Gae-Woo jeot fermentation were examined. The results are as follows. 1. In the organoleptic test, Gae-Woo jeot which fermented through 65 days were dominant and the group of 105 salkt concentration were better than that of 20%. It was the best of 10% salted products to add small abalone. Both law salted(10%) and high salted (20%) Gae-Woo jeot were similar in general constityents, nutrients and texture. 2. Compositions of highly unsaturated acid were farely high to 45.6% and 46.1% in small abalone added froup and top sheel added group respectively. during 3 months fermentation low decreasing rate of 3~4% was shown. EPA(eicosapentaenoic acid) was approximately 7~8% and DHA(docosahexaenoic acid) was extremely low to be less than 0.3%. 3. In the changes General composition and pH, pH was within range of 4~5.5, 9~12% in protein, 3~5% in total sugar, 0.5~1% in lipid and approximately 1% in ash. 4. Gae-Woo jeot can be made with 10% low salting method, and 10% group gets all the better for taste, small abalone adding is recommended. 5. When low salt fermented fish of 10% is processed, it is highly recommended to put sorbitol, ethyl alcohol, lactic acid or other humectant for better taste and longer storage and good quality food additives must be developed for tourist and presently applied mil ordering transportation must be sought.

Yamaguchi index에 의한 파라쿼트 중독 환자의 예후 결정

김인병,최성욱,김성중,김경수,이영수 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Study objective: To evaluate the significance of Yamaguchi index as a predictor of outcome in patients with acute paraquat poisoning Design: Retrospective chart review Setting: Two university Hospital EDs Methods: We reviewed the medical records of 47 patients with acute paraquat poisoning(18 survived and 29 died). The Eq1 was defined as : Eq1=[K+] x [HCO₃] / 0.088[Cre] mEq L¹ The patient's data were plotted as calculated Eq1 values(y-axis) against interval of time from ingestion to admission (T) (x-axis). The study patients were divided into three groups. Group A consisted of patients with Eq1> 1500-399LogT; Group B consisted of patients with Eq1: 930-399LogT < Eq1 ≤ 1500-399LogT; Group C consisted of patients with Eq1 ≤ 930-399LogT. Results: There was a significant difference among three groups (A, B and C) as far as prognosis was concerned(P<0.01). In group A, all patients survived(survival rate 100%). In group B, six of 13 patients survived(survival rate 46%). In group C, none of patients survived Isurvival rate 0%). Conclusion: Yamaguchi index is a significant predictor of outcome in patients with acute paraquat poisoning