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.

전자 빔 조사 민감 물질의 전자회절분석을 위한 Imaging Plate 기술

김영민,김양수,김진규,이정용,김윤중 韓國電子顯微鏡學會 2008 Applied microscopy Vol.38 No.3

전자 빔 조사 민감 물질인 gibbsite (γ-Al(OH)₃)의 전자 빔 조사 상전이 연구에서 전자회절 자료의 기록에 대한 imaging plate 와 필름의 기록 특성을 실험적으로 비교하였다. Imaging plate는 극단적으로 낮은 전자 강도와 높은 전자 강도를 동시 기록하기에 충분한 선형 dynamic range를 갖기 때문에, 매우 낮은 전자조사 조건 (≤0.1 e-/μm²)에서 전자 회절 자료를 기록할 때 필름에 비해 회절 자료의 spatial frequency 범위가 두 배 이상 확장되었다. 심지어 이미 기록 포화된 투과 빔 주위의 신호 정보 레벨을 세분화하는 데에도 훨씬 우수한 분해 성능을 나타내었다. 따라서 본 연구 결과는 imaging plate가 극단적으로 낮은 전자강도 기록이 필요한 전자 빔 조사 민감 물질이나 cryo-biological 시편들의 구조 연구 관점에서 가장 적절한 기록 매체임을 나타낸다. An experimental comparison of the detection properties between imaging plate and film for recording the electron diffraction pattern was carried out on a radiation-sensitive material, an aluminum trihydroxide (gibbsite, γ-Al(OH)₃), through the electron beam irradiation. Because the imaging plate has a wide dynamic range sufficient for recording extremely low- and high-electron intensities, the range of spatial frequency for the diffraction pattern acquired by the imaging plate was extended to two times larger than the range by the film, especially at a low electron dose condition (≤0.1 e-/μm²). It is also demonstrated that the imaging plate showed better resolving power for discriminating fine intensity levels even in saturated transmitted beam. Hence, in the respect of investigating the structures of radiation-sensitive materials and cryobiological specimens, our experimental demonstrations suggest that the imaging plate technique may be a good choice for those studies, which have to use an extremely low electron intensity for recording.

Original Article : Geographic difference of epidemiological features of HCV infection in Korea

( Kyung Ah Kim ),( Sook Hyang Jeong ),( Eun Sun Jang ),( Young Seok Kim3 ),( Youn Jae Lee ),( Eun Uk Jung ),( In Hee Kim ),( Sung Bum Cho ),( Mee Kyung Kee ),( Chun Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4

Background/Aims: The prevalence of hepatitis C virus (HCV) infection in Korea exhibits significant geographic variation, with it being higher in Busan and Jeonam than in other areas. The reason for this intranational geographic difference was investigated in this study by conducting a comparative analysis of the risk factors related to HCV infection among three geographic areas: the capital (Seoul), Busan, and the province of Jeolla. Methods: In total, 990 patients with chronic HCV infection were prospectively enrolled at 5 university hospitals located in Seoul (n=374), Busan (n=264), and Jeolla (n=352). A standardized questionnaire survey on the risk factors for HCV infection was administered to these three groups of patients, and a comparative analysis of the findings was performed. Results: The analysis revealed significant regional differences in exposure to the risk factors of HCV infection. By comparison with patients in Seoul as a control group in the multivariate analysis, patients in Busan had significantly more experience of invasive medical procedures, acupuncture, cosmetic procedures, and multiple sex partners. In contrast, patients in Jeolla were significantly older, and they had a higher prevalence of hepatocellular carcinoma, a lower prevalence of multiple sex partners, and had experienced fewer invasive procedures. Conclusions: There was a significant geographic difference in the exposure to potential risk factors of HCV infection between patients from the three studied regions. This may explain the regional variation of the prevalence of HCV infection in Korea, and should be taken into account when planning strategies for the prevention and management of HCV infection. (Clin Mol Hepatol 2014;20:361-367)

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.

세라믹 재료의 연삭 특성

정을섭,김성청,강연식 충북대학교 건설기술연구소 2003 建設技術論文集 Vol.22 No.2

In this study, experiments were carried out to investigate the characteristics of ceramic material s for grinding and wear process by diamond wheel. Normal component of grinding resistance of A1₂0₃was less than that of Si₃N₄ and Zr0₂. This seems to be the characteristics of ceramic material generating between toots and work pieces both of high hardness. For the case of Si₃N₄ and ZrO₂ as the grain mesh number of wheel increases, the surface roughness decreases. For the case of Al₂O₃, the surface roughness does not decreases, Specific grinding energy decreases as the chip removal rate increases. Si₃N₄ and ZrO₂ materials is grinded by abrasive wear processes but Al₂O₃ material is grinded by grain shedding process, i.e, brittleness destruction

전자토모그래피의 정량적 분석에서 대물렌즈 조리개의 영향

김진규,이상희,권희석,정종만,정원구,이수정,주형태,김윤중 韓國電子顯微鏡學會 2008 Applied microscopy Vol.38 No.4

Electron tomography의 정량적 분석을 위해서 대물렌즈 조리개가 투과빔의 강도에 미치는 영향을 평가하였다. Electron tomography에 도입되는 Beer’s law의 올바른 적용을 위해서는 투과빔은 시료의 기울기에 따른 mass thickness의 변화에 의한 효과만을 반영해야 한다. 그러므로 빔 경로상의 대물렌즈 조리개, 홀더 등에 의한 다른 효과는 제거되어야 한다. 본 연구에서는 대물렌즈 조리개의 cut-off 효과를 120 kV TEM과 Quantifoil holey 카본 시료를 이용하여 상세히 평가하였다. 대물렌즈 조리개를 사용하지 않은 경우와 비교할 때, 30 μm 크기의 대물렌즈 조리개를 통과한 투과전자빔의 강도는 약 16.7%의 감소가 일어난다. 또한 55˚이상의 고경사각 기울기에서는 대물렌즈 조리개의 cut-off 효과에 의해 14.2%의 강도 감소가 추가적으로 발생함을 알 수 있었다. Electron tomography에서 정량적 분석을 위해서는 이러한 대물렌즈 조리개의 영향을 고려해야만 한다. 또한 Beer’s law의 올바른 적용을 위해서는 일련의 기울기에 따른 2차원적 영상은 가능하면 대물렌즈 조리개를 사용하지 않은 상태에서 획득하는 것이 바람직하다. We have evaluated the effects of experimental factors on transmitted electron beam intensities for quantitative analysis in electron tomography. For the correct application of Beer’s law in electron tomography, the transmitted beam intensity should reflect the net effect of mass properties on beam path. So, the any other effects of the objective aperture and the specimen holder on beam path should be removed. The cut-off effects of objective aperture were examined using Quantifoil holey carbon film and a transmission electron microscope operated at 120 kV. The transmitted beam intensities with 30 μm objective aperture dropped about 16.7% compared to electron beam intensities without the objective aperture. Also, the additional losses of about 14.2% at high tilt angles were occurred by cut-off effects of the objective apertures. For the precise quantitative analysis in electron tomography, the effect of the objective aperture on transmitted electron beam intensities should be considered. It is desirable that 2-D tilt series images are obtained without the objective aperture for correct application of Bee’s law.

Risperidone 조기 중단군 및 장기 유지군의 임상적 특성 비교

김광수,박원명,전태연,배치운,김대진,백인호,이철,김정수,한상익,최보문,장계호,고효진 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : Risperidone 투여후 조기 중단한 환자들과 장기적으로 계속 risperidone을 복용하고 있는 환자의 임상적 특성을 평가하고 나아가 risperidone장기 유지와 조기 중단의 요인을 분석하고 정신병리가 약물 투여에 미치는 영향을 조사하고자 하였다. 방 법 : 연구 대상자는 1996년 1월부터 1996년 12월까지 가톨릭대학교 의과대학 부속 8개 병원 정신과에서 risperidone을 투여 시작한 환자 580명중 DSM-IV기준에 의해 정신분열병으로 진단받고 투여 기간이 6개월 미만(조기 중단군)이거나 2년 이상(장기 유지군)을 경과하였으며 의무기록의 누락이 없는 210명을 선정하였다. 두 군간 임상적 특성을 조사하기 위하여 인구학적 변인, 정신병리학적 변인, 약물 투여기록 및 부작용 등을 과거 의무기록을 근거로 평가하였다. 결 과 : 대상환자 210명 중 조기 중단군이 67명(31.9%)이었고 장기 유지군은 143명(68.1%)이었으며 두 군간 인구학적 변인과 정신병리학적 변인에 따른 특징에는 두 군간 차이가 없었다. 두 군간 risperidone의 시작 용량과 변인과 정신병리학적 변인에 따른 특징에는 두 군간 차이가 없었다. 두 군간 risperidone의 시작 용량과 최대 용량은 유의한 차이가 없었으나 유지용량은 조기 중단군에서 4.49(±1.44)mg,장기 유지군에서 3.67(±1.50)mg으로 유의한 차이가 있었다(t=3.698, p<0.05). 또한, 이전 항정신병약물의 사용 기왕력 변인에서 조기 중단군은 기왕력이 없는 환자가 39명(58.2%), 고역가 항정신병약물을 사용한 기왕력이 있는 환자는 27명(40.3%), 저역가 항정신병약물을 사용한 기왕력이 있는 환자는 1명(1.5%)이었고, 장기 유지군은 기왕력이 없는 환자가 58명(40.6%), 고역가 항정신병약물을 사용한 기왕력이 있는 환자는 77명(53.8%), 저역가 항정신병약물을 사용한 기왕력이 있는 환자는 8명(5.6%)으로 유의한 차이가 있었다.(x²=6.559, df-=2, p<0.05). 결 론 : 본 연구결과에 의하면 가급적 환자 상태에 따라 낮은 최적 치료 용량을 투여하는 것이 장기잔의 투여를 바람직한 것으로 생각된다. 본 연구와 같은 대규모의 후향적 자연적 연구는 일반 실제 진료에서 risperidone의 효과 및 기타 다른 측면에서의 유용한 정보를 얻을 것으로 기대된다. Objective : This retrospective naturalistic study was designed to compare the clinical characteristics including psychopathology of two groups of patients, long-term maintenance group and short-term drop-out group, who were taking risperidone. Method : Datas were collected for 210 schizophrenic patients with complete medical records among 580 patients who were enrolled with risperidone administration from January 1996 to December 1996 in 8 affiliated hospital of the Catholic University. The short-term drop-out patients group were assigned to whom treatment period was less than 6 month, and the long-term maintained patients group, treatment period was more than 2 years. We assessed demographics, psychopathology, and other variables related with medication based on past medical records. Results : Among subjects of 210, short-term drop-out patients group were 67(31.9%) and long-term maintained patients group were 143(68.1%). Demographics and psychopathology were not significantly different between two groups. The stating and maximal dosage of risperidone was not significantly different between two groups but the maintenance dosage of risperidone was lower in long-term medicated patients group than short-term drop-out patients group(t=3.698, p<0.05). Additionally, the result of this study showed differences in experiences of past antipsychotic use as following. The number of no previous use of antipsychotic was 39(58.2%), the number of high potency amtipsychotic use was 27(40.3%), and the number of no previous use of antipsychotic was 58(40.6%), the number of high potency ntipsychotic use was 77(53.8%), the number of low potency antipsychotic use was8(5.6%) in long-term maintained group.(x²=6.559, df-=2, p<0.05). Conclusions : According to these results, administration of low therapeutic dosage should be recommended for long-term maintenance as if possible. Multi-center based retrospective naturalistic study like this would be useful for getting informations about efficacy and some other aspects of antipsychotic administration in practial field.

뇌 농양의 임상적 분석

김정수,성연상,강재규,도종웅,정현태 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.3

The authors reviewed 24 Patients with brain abscess from January 1986 to December 1990. The male to female ratio was 16:8 and most frequently developed at second decades. The commonest cause was chronic ear infection with abscess in the temporal lobe, and common organism was proteus species. All patients received a total of 6 weeks of antiobiotic therapy. Surgery was performed in 24 patients. Drainage of drainage and later capsulectomy may offer a simple, safe and easy removal of capsule. There was no postoperative death or empyema. The most important predictor of outcome was the patients condition when first seen. Early specialist care, computerized tomography, correct choice and dosage of antibiotics, and the surgical methods in present use should make this a benign disease.

결절성 황색종과 동반된 제 Ⅲ 형 과지질단백혈증 1예

김지현,김연진,김현주,조소연,황규광,함정희 梨花女子大學校 醫科大學 醫科學硏究所 2000 EMJ (Ewha medical journal) Vol.23 No.1

We report a case of type Ⅲ hyperlipoproteinemia associated with tuberous xanthoma, which is improved by treatment with lovastatin and bezafibrate. A 34-year-old female patient visited our clinic for evaluation of multiple yellowish-brown papulonodules on the kness, elbows and palms. Serum lipid examination showed an abnormal elevation of serum cholesterol and triglyceride. Lipoprotein electrophoresis showed a single peak at pre-β and β portion without separation. The biopsh specimen from a nodule on the knee and a papule on the palm revealed characteristic findings of xanthoma. We diagnosed the case as type Ⅲ hyperlipoprotei-nemia. After 3 months of treatment with diet restriction, lovastatin and bezafibrate, the serum levels of cholesterol and triglyceride were reduced to normal level. The skin lesion of the palm showed complete regression and ones on both knees and elbows were moderate improvement.

보이타 접근법을 이용한 운동이 뇌성마비 아동의 대근육 운동 기능에 미치는 영향

김정연,김시원 이화여자대학교 특수교육연구소 2012 특수교육 Vol.11 No.2

본 연구는 특수학교에 재학하고 있는 뇌성마비 아동을 대상으로 보이타 접근법을 이용한 운동이 이들의 대근육 운동 발달에 미치는 영향을 살펴보는데 연구의 목적이 있다. 본 연구의 참여자는 5.0-8.0세의 뇌성마비 아동이며, 대상자간 중다간헐 기초선 연구설계 방법을 적용하여 대근육 운동 기능에 미치는 효과를 관찰하였다. 보이타 치료원리를 이용한 운동 중재를 학교 내 물리치료실에서 주 2회 40분씩 실시하였으며, 유지는 3주 후에 3회기에 걸쳐 측정하였다. 참여 아동의 변화 수준을 분석한 결과 다음과 같은 결론을 얻었다. 첫째, 보이타 접근법을 이용한 운동 중재는 정도의 차이는 있으나 3명의 참여아동 모두의 대근육 운동 능력에 긍정적인 영향을 미친 것으로 나타났다. 둘째, 보이타 접근법을 이용한 운동은 중재 종료 후 대근육 운동 능력이 기초선 기간에 비해 상향된 수준을 유지하는 것으로 나타났다. 이상의 연구 결과를 토대로 본 연구에서 적용한 보이타 접근법을 이용한 운동은 뇌성마비 아동의 대 근육 운동 능력에 효과적임을 알 수 있었다. 그러나 뇌성마비 아동의 유형이나 운동특성이 다양하므로 대근육 운동 능력에 대한 접근법 연구 등은 향후 반복연구를 통해 효과성이 입증되어야 할 것이다. The purpose of this study was to examine the effects of exercise training for using Vojta approach on gross motor function. The research subjects are 3 children with cerebral palsy with an age range from 5 to 8 years. This study conducted research baseline, intervention, and maintenance test by multiple probe baseline design across the participants. The program was applied to the children from march 2010 to july 2010. Treatment was implemented 40 minutes per time and per session and 2 sessions. The gross motor function was analyzed to determine with GMFM(Gross Motor Function Measure). The gross motor function was measured at 3-week follow-up. The results were as follows; 1) the intervention of the exercise training using Vojta approach increased the gross motor function of children with cerebral palsy, and 2) after termination of intervention, the condition remained in higher quality than the beginning. The study indicates that the exercise training for using Vojta approach is effective in improving the gross motor function of children with cerebral palsy.