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.

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.

삭제기구의 종류에 따른 자가부식 프라이머 접착제의 법랑질에 대한 미세전단 결합강도

정진호,조영곤,이명선 大韓齒科保存學會 2011 Restorative Dentistry & Endodontics Vol.36 No.6

연구목적: 이 연구는 서로 다른 버로 형성한 법랑질 표면에 대한 자가부식 프라이머 접착제의 결합강도를 상호 비교함으로써 법랑질에 우수한 접착 표면을 제공하는 적절한 버를 알아보기 위해 시행하였다. 연구 재료 및 방법: 42개의 발거된 대구치 치관의 법랑질을 이용하였고, 법랑질을 삭제하는 기구의 종류에 따라 6개군, 즉 1군은 Coarse (125 - 150 μm) diamond bur; 2군은 standard (106 - 125 μm) diamond bur; 3군은 fine (53 - 63 μm) diamond bur; 4군은 extrafine (20 - 30 μm) diamond bur; 5군은 plain-cut carbide bur (no. 245); 6군은 cross-cut carbide bur (no. 557)으로 분류하였다. 각 군의 법랑질 표면에 Clearfil SE Bond를 적용한 후 Tygon tube를 이용하여 Clearfil AP-X를 접착하였다. 각 군의 미세전단 결합강도를 측정하였다. 결과: 4군의 결합강도는 모든 군중 가장 높게 나타나 1군, 2군, 3군 및 6군보다 통계학적으로 높게 나타났으며(p < 0.05), 5군과는 통계학적으로 유의한 차이를 나타내지 않았다(p > 0.05). 결론: 버의 종류와 다이아몬드 버의 입자크기는 약한 자가 산부식 프라이머 접착제의 법랑질에 대한 결합강도에 영향을 주었 다. Clearfil SE Bond의 법랑질에 대한 우수한 접착을 위해서는 초미세입자 다이아몬드 버나 plain-cut 카바이드 버의 사용 이 추천된다. Objectives: The purpose of this study was to compare the microshear bond strength (uSBS) to enamel prepared with different burs and to determine what type of bur were chosen when a self-etching primer adhesive was used. Materials and Methods: Enamel of forty-two human molars were used. They were divided into one of six groups (n = 7), Group 1, coarse (125 - 150 μm) diamond bur; Group 2, standard (106 - 125 μm) diamond bur; Group 3, fine (53 - 63 μm) diamond bur; Group 4, extrafine (20 - 30 μm) diamond bur; Group 5, plaincut carbide bur (no. 245); Group 6, cross-cut carbide bur (no. 557). Clearfil SE Bond and Clearfil AP-X (Kuraray Medical Inc.) was bonded to enamel surface. The bonded specimens were subjected to uSBS testing. Results: The uSBS of Group 4 was the highest among groups and it was significantly higher than that of Groups 1, 2, 3, and 6 (p < 0.05), but it was not significantly different from that of Group 5. Conclusions: Different burs used on enamel surface affected the microshear bond strengths of a self-etching primer adhesive to the enamel surface. In the case of Clearfil SE Bond, extrafine diamond and plain-cut carbide bur are recommended for bonding to enamel. [J Kor Acad Cons Dent 2011;36(6):477-482.]

해양미생물로부터 카로테노이드 색소의 생산을 위한 최적조건

정영기,박정욱,주우홍,류병호,정명주,김태수 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The optimal medium composition for the production of carotenoid pigment from Haloarcular sp. EH-1 as a dietary for fishes were 1.0% sucrose, 1.0% yeast extract, 25% sodium chloride, 0.3% sodium citrate, 0.2% potassium chloride, 2.0% magnesium sulphate, 0.002% ferric sulphate(pH7.0). The incubation temperate, aeration rate and agitation speed were 40℃, 100ml medium/500ml vol. shaking flask, and 180 rpm/min. The carotenoid pigment production was highest after 5 days of incubation with the light.

플라즈마 표면복합처리한 구상흑연주철의 열피로 특성

정봉용,주대헌,박주승,김명호 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.9

This paper reports an investigation of the characteristics of plasma duplex treated ductile cast irons during thermal fatigue tests on a thermal cycling rig. The thermal fatigue cracking behaviors and microstructure of untreated and plasma surface treated ductile cast irons have been investigated. Both ferrite and pearlite matrix ductile cast irons were evaluated. During the tests, 60 mm long cylinders with 20 mm diameter were subjected to 1,000 high frequency induction heating and water cooling cycles, lasting 7 and 5 sec, respectively. The thermal fatigue damage was evaluated by analyzing different crack dimensions and distribution by light microscopy. The results showed that the plasma surface treatment increased thermal fatigue cracking resistance. When thermal fatigue cracking occurs, the cracks always initiate at the surface of the specimen. The major path of crack propagation is generally along the ferrite grain boundaries. The hardened layer had an effect on the thermal fatigue property. In addition, the ductile cast iron with an pearlite matrix has a better resistance to thermal fatigue than that of ferrite matrix.

허혈성 심질환에서 염증지표에 관한 연구

번정득,권영주,박상호,한대희,이상철,강진환,김명구,심규혁,최병조,온영근,현민수,김성구 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background : Atherosclerosis is the chief underlying cause of ischemic heart disease and there is increasing evidence that inflammation is an important determinant of the development of atherosclerosis. We assessed the levels of inflammatory markers in patients with ischemic heart disease and normal group who has normal coronary angiograms. Materials and Methods : Coronary angiography was performed in 142 patients. 107 patients of ischemic heart disease(stable angina pectoris 58, unstable angina pectoris 30, Acute myocardial infarction 19) and 38 normal control subjects. We assessed the level of inflammatory markers, such as CRP, ESR, fibrinogen and leukocyte. Results : CRP, ESR and fibrinogen values of the patients with stable angina pectoris and unstable angina pectoris were higher than that of normal control group, but there were no statistical significance. Leukocyte value of the patients with unstable angina pectoris(9003.3±701.5/mm^(3)) was significantly higher than that of the patients with stable angina pectoris(6685.5±245.8/mm^(3)) and normal control subjects(6394.3±235.1/mm^(3)). CRP, ESR and fibrinogen values of the patients with acute myocardial infarction were also higher than that of normal control subjects. CRP was 3.88±2.05 mg/dL in acute mocardial infarction group, and 0.29±0.15 mg/dL in normal control subject group(p<0.05). Fibrinogen was 541.6±45.1 mg/dL in acute myocardial infarction group, 321.4±25.6 mg/dL in normal control subject group(p<0.05). Leukocyte was 10942.1±737.6/mm^(3) in acute myocardial infarction group, 6394.3±235.1/mm^(3) in normal control subject group(p<0.05). Conclusions : This study demonstrate that CRP, fibrinogen and leukocyte values of acute myocardial infarction group were significantly higher than that of control group and stable, unstable argina pectoris group. Leucokyte values were significantly elevated in unstable angina group, but CRP values were not in unstable angina group.

지방척수수막류 14례의 임상 분석 : Clinical Analysis of 14 Cases

이정호,신규만,김명현,송준혁,박향권,김성학,박동빈 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.6

Lipomyelomeningocele is the most common malformation leading to spinal cord tethering. Nonetheless, these lesion continues to pose a challenge in patient management. The purpose of this study was to identify the clinical feature, candidate for surgical repair, and outcome of lipomyelomeningocele in young children and adults. We studied the magnetic resonance images and/or lumbar myelo-CT of lipomyelomeningocele performed between January 1987 and September 1995 at our institutions and reviewed the pertinent medical records and radiologic studies to determine clinical feature, surgical candidate, and outcomes of these patients. Of the 14 cases(11 female and 3 males) studied, the most common factor that caused these patients to seek help was the cosmetic effect of the mass on their back, followed by urinary incontinence, and weakness of lower extremities. The patients' age ranged from 2 months to 21 years(mean, 5.0 years). All the patients underwent immediate surgical management that consisted of removal of lipoma, untethering of the cord, and complete dural sac repair. Follow up for these patients ranged from 6 to 82 months(median, 54 mo). None of the patients that underwent surgical correction before the emergence of neurological deficit had ever developed neurological deficits at the end of the follow up. However a few of the patients, despite presented with neurological deficits or urinary incontinence at the time of surgery, improved significantly. In conclusion, early detection and prophylactic surgery is imperative to prevent permanent neurological deficits and urinary dysfunction.

만성 심부전환자의 혈액에서 측정한 Tumor necrosis factor-α 및 Interleukin-6의 임상적 의의

김명구,김성구,박상호,한대희,강진환,변정득,심규혁,최병조,방덕원,온영근,현민수,권영주 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background and objectives: Many conditions are responsible for the pathophysiology and progressive mechanisms of congestive heart failure. More recently, it has also become evidence that another class of biologycally activated molecules generically reffered to as cytokine these are also over expressed in congestive heart failure. Therefore, the purpose of this study was to measure concentrations of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) in mild to severe symptoms of heart failure and compare their values with those found in normal control and analysed correlation relationship between cytokine level, clinical findings and hemodynamic indicies. Subjects and Methodology: Levels of TNF-α and IL-6 were measured on pulmonary artery during cardiac catheterization in heart failure patients(n=32) and normal subjects(n=8) as well as physical examination and echocardiogram. Cytokines assay were performed on plasma using commercially available ELISA(Enazyme-Linked Immunosorbent Assay) kits. Results: Although the levels of TNF-α and IL-6 tend to increase in congestive heart failure group, the cytokines level was not made significantly statistical difference between congestive heart failure group and controls. When analyzing the correlation between the levels of PCWP(pulmonary capillary wedge pressure) and cytokines(TNF-α, IL-6), respectively, there were statistically significant correlation coefficient 0.32,(p<0.05), 0.39(p<0.01). The cytokine IL-6 and pressure of pulmonary artery were significant correlation.(correlation coefficient 0.36, p<0.02) More significantly, there was correlated with TNF-α and IL-6.(correlation coefficient 0.57, p<0.001) Conclusions: There was tended toward high concentration of TNF-α & IL-6 in congestive heart failure and significant difference for PCWP between TNF-α & IL-6, thus may be correlated with development and progression in congestive heart failure.

척추관 협착증의 수술적 치료

김명호,이성철,박진영,김정완 단국대학교 1997 論文集 Vol.31 No.-

Surgical treatment of spinal stenosis is a common procedure especially for the elderly people. Spinal stenosis may be local, segmental or generalized and may be caused by the encroachment of bone or soft tissue. The objectives of the present study were to evaluate clinically and radiologically two groups of spinal stenosis who were surgically treated with pedicular screw fixation system and posterior lumbar interbody or posterolateral bone graft following complete posterior decompression. One group was multilevel type and other group was one or two level type spinal stenosis. We have compared the results of autogenous bone fusion and mixed bone fusion(autogenous and heterogenous). From July 1994 to October 1996, 101 cases of lumbar spinal stenosis were surgically treated and were followed up for more than three months. The indication for operative treatment was pain, continuous or intermittent, which caused significant functional disability, and which had not been relieved by conservative treatment. The results of the study were as follows 1. There were 79 cases of degenerative type, 14 cases of spondylolis-thetic type, 3 cases of iatrogenic type, 3 cases of any possible combination type and 2 cases of congenital type lumbar stenosis. 2. The involved levels were as follow : 1 level 18(17.8%), 2 level 47(46.5%), 3 level 26(25.7%) and 4 level 10(9.9%). And among involved levels, the most frequent level was L4-L5 intervertebral space(97%). 3. According to Kirkaldy-Willis criteria, the postoperative results were excellent in 26 patients(25.7%), good in 58(57.4%), fair in 17(16.8%), and showed satisfatory results in 18 cases(100%) of 1 level, 46 cases(97.9%) of 2 level, 13 cases(50%) of 3 level, 7 cases(70%) of 4 level 4. There were 32 cases of sutogenous bone fusion and 69 cases of mixed bone fusion(sutogenous and heterogenous) 5. The non-union rate was 10.9%(11 cases) and 13%(9 cases) in mixed bone fusion(autogenous and heterogenous) and 6.2%(2 cases) in autogenous bone fusion. 6. Postoperatively, the complications were as follows : 11 cases(10.9%) non-union, 6 cases(5.9%) implant failure, 2 cases(1.98%) wound infection, 2 cases(1.98%) cauda equina syndrome.

비복신경이식을 이용한 긴 거리의 말초신경 결손부 수복

이종호,이세영,김명진,이은진,안강민,김성민,최원재,명훈,황순정,서병무,최진영,정필훈 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.2

The surgery of oral and maxillofacial area poses the risk of cranial nerve damage such as trigeminal nerve or facial nerve. Inferior alveolar nerve is prone to damage in the third molar extraction, implant installation, orthognathic surgery, open reduction and rigid fixation, and tumor ablation surgery. On the other hands,facial nerve is likely to be damaged or sacrificed with trauma or parotidectomy. In case of inferior alveolar nerve injury, the incidence is reported to be about 1.3%. The nerve function will almost recover in minimal damage, but it won't recover at last in total damage of a part of nerve unit. In latter cases, nerve regeneration in intended by allograft as nerve substitute or various route of merve condit. But the recovery with autograft is believed to be most relialbe mrthod in the rapair of long-span(longer than 15㎜)nerve defect. We have performed autologous sural nerve graft in the repair of nerve defect, which is caused by resection of benign or malignant tumor. Hereby we report the method of nerve harvesting, recovery of defected peripheral nerve and the complications of donor site with the discussion of sural nerve anatomy.