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.

개 비장 질환의 미세세침흡입술을 통한 세포병리학 검사 4례

김현아,윤기영,최호정,정성목,이영원,조성환,박성준 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2011 動物醫科學硏究誌 Vol.18 No.1

To evaluate the accuracy and diagnostic significance of cytopathological diagnosis of canine splenic disorders, cytopathological examination throgh fine-needle aspiration(FNA) referred to Veterinary Medical Teaching Hospital of Chungnam National University were retrospectived. Splenic neoplasm, hemolymphatic neoplasm, hyperplasia, extramedullary hematopoiesis and splenitis were diagnosed canine splenic disorders through cytopathological examination. The patient should be identified what coagulation profile are normal before aspiration, because complication such as hemorrhage could happen. The 4 cases were identified symmetric, asymmetric splenomegaly on abdominal ultrasonography and then were performed ultrasound-guided FNA. The 4 cases were diagnosed hemangiosarcoma(2), hyperplasia(1) and extramedullary hematopoiesis(1) by clinical signs, hematological examination, and cytopathological examination. Cytopathological examination through FNA was cost-effective, no gneral anesthesia, no complication, and non-invasive method of diagnosis for canine splenic disorders.

성견에서 표면처리된 교정용 마이크로임플랜트의 골 접촉률 및 동요도

박승현,김성훈,류준하,강윤구,정규림,국윤아 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.6

The purpose of this study was to evaluate the mobility and ratio of the bone-implant contact (BIC) of a sandblasted, large grit and acid-etched (SLA) orthodontic micro-implant. Methods: Ninety-six micro-implants (48 SLA and 48 machined) were implanted in the upper and lower buccal alveolar bone, and palatal bone of four beagle dogs. Two weeks after surgery, orthodontic force (150 - 200 g) was applied. Two beagles were sacrificed at 4-weeks and the other two at 12-weeks. Histomorphometric comparisons were made between the SLA experimental group and the machined micro-implant as a control group to determine the ratio of contact between the bone and implant. Micro-implant mobility was also evaluated using Periotest. Results: Periotest values showed no statistically significant difference in the upper alveolar and palatal bone between groups except for the lower buccal area. BIC in the upper buccal area showed no significant difference between groups both at 4-weeks and 12-weeks. However, both the groups showed a significant difference in BIC ratio in the rest of the experimental areas between 4 weeks and 12 weeks. The experimental group showed active bone remodeling around the bone-implant interface compared to the control group. Conclusions: There were significant differences in the BIC and the Periotest values between the surface-treated and machined micro-implants according to bone quality in the early stage. 본 연구는 비글견에 식립된 sandblasted, large grit and acid-etched (SLA) 표면처리된 교정용 마이크로임플랜트와 평활면 마이크로임플랜트에 교정력을 가한 후 시간 경과에 따른 동요도와 골접촉률의 차이를 규명하기 위해 시행되었다. 비글 성견 네 마리를 이용하여 상, 하악 협측과 구개측 골에 대해 SLA 표면처리된 표면처리군 48개, 평활면의 비처리군 48개의 마이크로임플랜트 96개를 식립하고 2주의 치유기간 후 교정력(150 - 200 g)을 지속적으로 가했으며 식립 4주 후에 두 마리를 희생시키고, 12주 후에 나머지 2마리를 희생시켰다. 표면처리군과 비처리군 간의 마이크로 임플랜트의 동요도와 골과 임플랜트 간 접촉률을 조직학적인 측면에서 측정 비교하여 다음과 같은 결과를 얻었다. 상악 협측과 구개측에서는 표면처리군과 비처리군의 동요도에서 유의성 있는 차이가 없었으나 하악협측에서는 표면처리군이 유의하게 안정적인 동요도를 보였다. 마이크로임플랜트와 인접골 간 접촉률은 상악 협측에서는 4주와 12주 모두 표면처리군과 비처리군 간에 유의한 차이가 없었으나 하악 협측과 구개측의 경우 4주와 12주 모두 표면처리군이 비처리군에 비해 유의하게 높은 접촉률을 보였다. 표면처리군은 비처리군에 비해 임플랜트 주변에서 활발한 골개조가 관찰되었으며 모든 군에서 이물반응은 관찰되지 않았다. 본 연구를 통해 SLA 표면처리된 마이크로임플랜트는 평활면 마이크로임플랜트에 비하여 식립 초기에는 식립 부위에 따라 유의하게 높은 인접골 간 접촉률과 동요도의 안정성을 보임으로써 다양한 크기와 방향의 교정력의 적용이 가능할 것이라 생각한다.

고양이의 만성 췌장염 치료 증례

김현아,윤기영,박정호,이왕희,송근호,박성준 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2011 動物醫科學硏究誌 Vol.18 No.1

A 5-year-old Russian blue cat was referred to the Veterinary Medical Teaching Hospital of Chungnam National University with the history of anorexia, lethargy, weight loss(6.5 to 4.8 kg) 2 weeks ago. Abdominal ultrasonography showed the following : increase of echogenicity of liver, irregular shape of gall bladder, hyperechoic region around duodenum. Pancreatitis, cholangitis, hepatic lipidosis was diagnosed by the ultrasonography. Anti- inflammatory therapy, antibiotic therapy was administered. Abdominal ultrasonography is a efficient available diagnostic tool but serum fPL test reveals the highest sensitivity and specifity result for feline pancreatitis. SNAP fPL test is newly released that can check pancreatitis within 10 minutes by same princple of Spec fPL test used in Gastrointestinal Laboratory of Texas A & M Univerrsity.

전치부의 경미한 공간부조화 개선을 위한 가철성 장치의 적용 예

곽아람,최영철,박재홍,최성철,김광철 大韓小兒齒科學會 2007 大韓小兒齒科學會誌 Vol.34 No.4

골격성 부조화가 없는 I급 부정교합은 치아-악궁 간의 크기 차이에 의한 총생(crowding)이나 공극(spacing)이 주된 문제점이다. 이와 같은 경미한 공간 부조화를 개선시키고자 할 때,치열의 종류,치아-악궁크기 부조화의 양,환자의 협조도,또는 환자의 요구 등에 따라 치료 방법은 다양할 수 있다. 본 증례보고에서는 I급 구치부 관계를 지니면서 전치부의 치아-악궁크기 부조화의 양이 크지 않은 영구치열에서 상하 악 전치부의 경미한 총생이나 공극이 관찰되는 경우에 사용할 수 있는 clear aligner와 spring aligner 장치의 이용에 관하여 보고하고자 한다. 이와 같은 장치들의 임상 적용에는 몇 가지 제한적인 조건이 있기는 하지만,잘 선택된 증례에서는 매우 유용하며 편리하게 이용될 수 있다. 특히 총생이 존재하는 경우에는 이를 해소시킬 공간이 치열 내에서 확보되어야 하므로,확실한 분석과 진단으로 치아 인접면 삭제의 양을 정확히 결정하여 각 치아들의 근심면과 원심면에서의 삭제의 양이 균등히 이루어질 수 있도록 하는 것이 바람직하다. 또한 치간에 공극이 존재하는 경우에는 배열 후 치열궁 둘레의 감소와 함께 상하악 전치부 간의 over-jet 문제가 생길 수 있어 대합치열과의 교합관계에 신중을 기하여야 한다. Class I malocclusion without skeletal problem results from tooth size/arch-size discrepancies, either evidenced by crowding, or spacing problems. Treatment method can be chosen according to dentition, the amount of arch discrepancy, patient compliance, or patient demands. We report of clear aligner and spring aligner that can be applicated in cases of permanent dentition with minimal arch discrepancy in anterior segment. There are some limits of application, but these are very useful appliances in the selective case. When crowding exists, definitive analysis and diagnosis should be made before starting treatment because certain amount of space must be obtained somewhere in the dentition to resolve the crowding. Therefore, appliance should be applied when lacking space is small. Also, in cases with spacing arch circumference is reduced after alignment so no problem in intermaxilla occlusal relationship must be confirmed. In case with crowding, judicious removal of interproximal enamel is indicated.

SF-36에 의한 직장남성의 건강수준과 의료이용과의 관련성

김성아,박기수,장미경,감신 대한산업의학회 2006 대한직업환경의학회지 Vol.18 No.4

Objectives: This study was performed to examine the health status measured by SF-36 and medical facilities utilization according to the health status measured by SF-36 in male workers. Methods: A self-administered questionnaire survey was administered to 786 male workers. Results: In bivariate analysis, physical functioning score was significantly different among the workers according to age, educational level, economic level, and job type. The bodily pain score and general health score were significantly different according to the workers' economic level and job type. The vitality score was significantly different according to the workers' age, educational level, economic level, and job type. The social functioning score was significantly different according to the workers' age, marital status, economic level, and job type. The role limitation emotion score was significantly different according to the workers' age, marital status, and job type. The mental health score was significantly different according to the workers' marital status, economic level, and job type (p<0.05). The SF-36 scores increased with higher workers' self-rated health status (p<0.05). The self-rated current health status of the workers was good when their economic status was high, their previous year health status was good and their SF-36 score was high (p<0.05). The rates of morbidity incidence and medical facilities utilization for 1 year were lower when workers' SF-36 score was high (p<0.05). Conclusions: In consideration of the above findings, SF-36 is suitable to measure health status and predict the medical utilization.

스웨징(swagging) 작업자에서 수지진동증후군 및 신경전도장애

김성아,김상우,정상재,이채용,김규상,정보우,박상규 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.2

목 적 : 스웨징작업자들에서 발생한 수지진동증후군 사례를 실제 진동수준 평가와 함께 보고하고, 진단시 신경전도검사의 소견에 대한 해석을 검토하고자 하였다. 방 법 : 2001년 4월과 5월에 구미소재 스웨징작업 종사자 8인을 대상으로 병력문진, 자각증상평가, 이학적 검사를 실시하고 수지진동증후군의심자 4인에대해 냉각부하검사와 신경전도검사를 실시하였다. 작업장조사는 진동측정장비들을 이용하여 실제 작업환경에서 측정후 국제표준화기구에 따라 평가하였으며, 수근관증후군의 동시 가능성을 알아보고자 인간 공학적 요인에 대해 조사평가 하였다. 6개월후인 12월에는 이들 4인에 대해 진동각검사와 싱경전도검사를 추적검사하였다. 결 과 : 진동수준은 주파수가중가속도값이 단일작업은 0.99∼10.79 m/sec^2, 2개의 복합작업은 3.03 ∼12.98 m/sec^2로서 ISO의 권고치를 초과하고 있었다. 1차 대상근로자 8인의 근무기간은 평균 8.7년(범위 0.8∼15)이었고, 1인은 당뇨병자이었다. 스톡홀름 분류에 의한 증상평가, 손톱압박검사, 진동각검사에서 비교적 진동노출수준과 비려하여 임상소견을 나타내었고, 2차 평가대상자 4인의 경우 신경전도검사에서 1인은 정상, 2인은 수근관증후군, 1인은 말초신경병증으로 해석되었다. 그러나, 문헌 고찰을 통해 수근관증후군으로 나온 신경전도검사결과는 오히려 진동으로 인한 다병소 신경장해로 판단하였다. 6개월후 추적 신경전도검사에서 4인 모두 진동으로 인한 다병소 신경자해를 확인하였다. 그러나, 1인에서는 수근관증후군의 동시존재 가능성을 고려하였다. 결 론 : 고정된 진동공구인 스웨징사용자들에서 수지진동증후군발생을 확인하고, 진동노출수준을 실제로 측정하여 그 양-반응관계를 동시에 평가하였다. 신경전도검사의 해석과 관련하여 수지진동증후군에서 종종 동시 존재하는 수근관증후군과의 연관성 및 감별점을 실례로써 제시함으로써 향후 진동장해를 평가하는데 도움을 주고자 하였다. Objectives : To investigate the hand-arm vibration syndrome (HAVS) among symptomatic swagging workers exposed to hand-arm vibration, using medical evaluation and measurement of workplace vibration. Furthermore, to evaluate the neurophysiological findings. Methods : Four workers showing symptoms relevant to HAVS were evaluated. Medical evaluation consisted of medical interview, questionnaire, nail-bed compression test, and sensory perception tests for vibration and pain. Some other diseases were excluded by a medical interview, hematological assessment, and urinalysis. Cold provocation test was used to assess the peripheral vascular changes, and a nerve conduction velocity (NCV) test was implemented to ascertain the peripheral neural changes. Pegboard, hole plate, and tapping board tests were performed to assess motor nerve function. The hand-arm vibration acceleration levels of the swagging machines were measured. Six months later, follow-up NCV tests were performed. Results : The actual exposure time to vibration was not longer than 15 minutes per day. The hand-arm vibration acceleration levels of the swagging machines, according to actual exposure time, were from 3.63 to 12.98 m/sec^2, by ISO 5349. The vibratory perception thresholds and the recovery time of a nail color following finger cooling were significantly increased in all four workers. The perception of pain was mildly increased. The nerve conduction studies at first diagnosis and follow-up showed multifocal neural impairment caused by vibration. However, we could not rule out the concomitant presence of the carpal tunnel syndrome in one worker. Conclusions : These results show that HAVS can be caused by hand-arm vibration in swagging workers. Interestingly, the NCV results suggested that vibration-induced neural conduction impairments could vary, and need to be interpreted cautiously.

팔라디움 촉매하에서 산염화물과 유기주석의 커플링 반응

김두화,박정환,한도수,허선아,김성현,조성동 조선대학교 기초과학연구소 1992 自然科學硏究 Vol.15 No.1

The reaction of Asymmetrical organotins with acid chlorides in the presence of Benzylbis (triphenylphosphine) palladium(Ⅱ) chloride gave good yields of ketones in chloroform.

신경독성 물질에 폭로되지 않은 건강한 남자의 신경행동학적 검사 수행능력

이세훈,김형아,이원철,장성실,이경재,박정일,정치경 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.1

Five items among neurobehavioral core test battery of World Health Organization, including Santa Ana dexterity, pursuit aiming, digit symbol, simple reaction time, and Benton visual retention, were administered to the workers occupationally non-exposed to neurotoxic agents by operational guide for the WHO neurobehavioral core test battery. Subjects were volunteers from the industrial workers(117) and clerks(40). Detailed occupational history such as exposed agents including noise or vibration, educational level, residence, smoking and drinking habit were recorded. Most of the neurobehavioral tests were correlated with age and educational level. Smoking was correlated with pursuit aiming and digit symbol. Vibration affected pursuit aiming. Job type(industrial workers vs. clerks) and noise exposure did not affected among tested items. Multiple regression analysis was done for establishing predict equation to estimate normal ranges of the tests for male workers. Age was shown to be main independent variable affected for all tests except wrong dot of pursuit aiming. Educational level was also shown to affected most of the tests except Santa ana dexterity and wrong dot of pursuit aiming. Alcohol consumption affected Santa Ana dexterity, non-preferred hand, and smoking affected only wrong dot of pursuit aiming after multiple regression analysis.

피로와 의료이용, 업무상 사고 및 질병결근

장세진,고상백,강동묵,김성아,정진주,이철갑,강명근,현숙정,조정진,차봉석,박종구 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: This study examined the relationship of fatigue to medical utilization, occupational accident and sickness absence. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project, 2002~2004). A total of 30,146 employees categorized within the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were recruited. A structured-questionnaire was used to assess the participants' sociodemo-graphics, job-related factors, health-related behaviors, personality trait, self=perceived fatigue (MFS) and the frequency of medical utilization, occupational accident and sickness absence. Data on medical utilization and occupational accident were confirmed from company health records. Chi-square test and logistic regression analysis were used to elucidate the relationship of self-perceived fatigue to medical utilization, occupational accident and sickness absence. Results: In logistic regression analyses, self-perceived fatigue was associated with medical utilization (outpatient), occupational accident and sickness absence although the strength of the associations was higher in the blue collar workers except for medical utilization. For medical utilization, the white collar worker's adjusted odds ratios of outpatient utilization for workers scoring in the third quartile and the highest quartile, compared to workers scoring in the lowest quartile were 1.50 (95% CI: 1.20-1.87) and 2.16 (95% CI: 1.69-2.75), respectively. The blue collar workers' adjusted odds ratios of outpatient utilization for workers scoring in the second (OR: 1.23, 95% CI: 1.06-1.43), third (OR: 1.42, 95% CI: 1.22-1.66) and highest quartile (OR:1.83, 95% CI: 1.55-2.17), respectively, compared to workers scoring in the lowest quartile were statistically significant. However, no associations were found between fatigue and inpatient utilization for either the white or blue collar workers. The blue collar workers' adjusted odds ratios of being injured for workers scoring in the second, third and highest quartile were 1.41 (95% CI: 1.00-2.00), 1.57 (95% CI: 1.10-2.22) and 2.41 (95% CI: 1.69-3.44), respectively, compared to those scoring in the lowest quartile, but, those of the white collar workers were not significant. There was more likely to an increased risk of sickness absence in workers scoring in the second, third and highest quartile compared to those scoring in the lowest quartile in both white and blue collar workers, but the magnitudes of risk were higher in the blue collar workers than the white collars workers. Conclusion: This result suggests that fatigue is a determinant predictor of medical utilization, occupational accident and sickness absence, and that the pattern of risks for the three outcomes differs according to the occupational type. Some limitations of this study and considerations for future study were also discussed.