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.

국내 의료종사자에서 HHV-8의 항체양성률에 대한 연구

주우철,최용준,박재은,이혜명,이진수,정문현,김수미,문지혜 대한감염학회 2008 감염과 화학요법 Vol.40 No.4

HHV-8 virus is known to be associated with Kaposi's sarcoma (KS) in HIV seropositive patients and its seroprevalence has geographic difference, In South Korea, incidence of KS is low not only in general population but also in HIV patients compared to other countries, It is speculated that low seroprevalence of HHV-8 has contributed to the low incidence of KS in South Korea. We examined the seroprevalence of anti HHV-8 IgG of HIV seronegative health care workers in one University hospital. Enzyme-linked immunosorbent assay(ELISA) was used for diagnosis. One person (0.6% 1/164) was seropositive, six were equivocal (3.7%,6/164) and 157 people were seronegative (95.73%, 157/164). This study revealed that seroprevalence of HHV-8 in general population was. low in South Korea. Further studies are needed to be carried out to evaluate the low HHV-8 seroprevalence in Korea.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

프레탈정 (실로스타졸 100mg)에 대한 실로스탄정 (한국유나이티드 제약)의 생물학적 동등성

용철순,이경희,최진석,박병주,정세현,김용일,박상만,유봉규,이종달,최한곤 한국병원약사회 2003 병원약사회지 Vol.20 No.2

Bioequivalence of one cilostazol tablets, the Pletaal^(R)(Korea Otsuka Pharmaceutical Co., Ltd.) and Cilostan^(R)(Korea united Pharmaceutical Co., Ltd.), was evaluated according to the guideline of KFDA. Sixteen normal male volunteers(age 20~30 years old)were divided into two groups and a randomized 2×2 cross-over study was employed. After one tablet containing 100㎎ of cilostazol were orally administered, blood was taken at predetermined time intervals and the concentration of cilostazol in plasma was determined with an HPLC method using UV detector. The pharmacokinetic parameters(C_(max), T_(max) and AUC_(t)) were calculated and ANOVA was utilized for the statistical analysis of parameter. The results showed that the differences in C_(max), T_(max) and AUC_(t) between one tablet were 16.08%, 18.88% and 17.57%, respectively. The powers (1-β) for C_(max), T_(max) and AUC_(t) were 85.03%, 83.92% and 80.12%, respectively. Detectable differences(Δ) and confidence intervals were all less than 20%, and confidence interval of all the parameters were also less than 20% at the significance level(α) of 0.05. All of these parameters met the criteria of KFDA for bioequivalence, indicating that Cilostan^(R) tablet is bioequivalent to Pletaal^(R) tablet.

알코올 의존 환자의 Tryptophan Hydroxylase 유전자 다형성

홍주봉,이상익,신철진,김헌,지경환,정인원 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : 알코올 의존 환자에서 세로토닌 합성 조절 효소인 tryptophan hydroxylase(TPH) 유전자 다형성 빈도를 정상 대조군과 비교함으로써 알코올 의존의 유전적 요인을 추적하고, 임상변인과 이 유전자 다형성과의 관련성을 알아보고자 하였다. 방 법 : DSM-IV진단기준에 부합되는 알코올 의존 환자 100명과 정상 대조군 100명을 대상으로 TPH유전자 다형성을 증합효소 연쇄반응과 제한효소 처리법을 이용하여 동정하였다. 여기서 분리된 대립 유전자와 유전자형에 따른 빈도의 차이를 서로 비교하였으며, 알코올 의존 환자군의 여러 임상 변인에 따른 차이를 비교하였다. 결 과 : 알코올 의존 환자군과 대조군 간에 TPH의 A216C 유전자형 및 대립유전자 빈도에서의 통계적으로 유의한 차이는 관찰되지 않았으나, 조기 발병한 환자의 경우는 유전자형의 빈도가 AA,AC,CC형이 0.57, 0.39, 0.04, 후기 발병한 환자의 경우 0.34, 0.45, -.21로, 조기 발병한 환자군에서 대조군과 비교하여 통계적으로 유의하게 A 대립 유전자의 빈도가 높은 것이 관찰되었다.(by chi-square test, p<0.05). 결 론 : 이는 조기 발병형 알코올 의존의 경우 TPH유전자 다형성과 관련이 있으며, 일부 알코올 의존 환자에서 유전적으로 세로토닌계의 이상이 있다는 사실을 시사한다. Objectives : This study was performed to explore the association of tryptophan hydroxylase (TPH) gene with diagnosis of alcohol dependence and/or clinical characteristics such as age of onset, family history, and severity of symptoms in Korean alcoholics. Methods : The genotype and allele frequencies of TPH in 100 male hospitalized patients who met DSM-IV criteria for alcohol dependence were investigated using polymerase chain reaction and restriction fragment length plymorphism and were compared with 100 age-matched healthy male control subjects. And the associations between gene polymorphisms and clinical characteristics in alcoholic patients were explored. Results : The distributions of TPH genotype and allele in alcohol dependent patients were not different from control subjects. However, the frequencies of TPH genotype in early-onset alcoholic patients, which were 0.57, 0.39, and 0.04(AA, AC and CC, respectively), were significantly different from those of late-onset alcoholics(0.34, 0.45, and 0.21, respectively). "A" allele was found more frequent in early-onset alcoholics. Conclusion : The result suggests that TPH gene polymorphism is associated with early-onset alcioholic patients possibly related with inherited abnormalities of serotonin system.

아세클로페낙 연질캡슬(클란자 에스 연질캡슬)의 개발

용철순,이경희,최진석,박병주,정세현,김용일,박상만,배명수,김귀자,김영식,유창훈,강성룡,유봉규,이종달,최한곤 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.1

To develop and aceclofenac soft capsule, four preparations with various solubilizers were prepared and their dissolution test was carried out. Among four preparations tested, a preparation with ethanolamine was selected a formula of aceclofenac soft capsule (Clanza S^(™), since it showed the fastest dissolution rate. Bioequivalence of aceclofenac tablet, Airtal^(™)(Dae-Woong Pharmaceutical Co., Ltd.) and aceclofenac soft capsule, Clanza S^(™)(Korea United Pharmaceutical Co., Ltd.) was evaluated according to the guideline of KFDA. Fourteen normal male volunteers (age 20-25 years old) were divided into two groups and a randomized 2×2 cross-over study was employed. After oral administration of one tablet or capsule containing 100 ㎎ of aceclofenac, blood ws taken at predetermined time intervals and the concentration of aceclofenac in plasma wa determined with an HPLC method under UV detector. The pharmacokinetic parameters (C_(max), T_(max) and AUC_(t)) were calculated and ANOVA was utilized for the statistical analysis of parameters using logarithmically transformed AUC_(t), C_(max) and T_(max) between Airtal tablet and Clanza soft capsule were 2.89%, 0.18% and 43.0%, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log(0.8) to log(1.250(e.g.log(0.81) - log(1.23) and log(0.89) - log(1.14)) for AUC_(t) and C_(max), respectively. Thus, the criteria of the KDFA guidelines for the equivalence was satisfied, indicating that Clanza S^(™) soft capsule is bioequivalent to Airtal^(™) tablet.

『무정』의 계보 : 『무정』의 정본 확정을 위한 판본의 비교 연구

김철,이경훈,서은주,임진영 민족문학사학회 2002 민족문학사연구 Vol.20 No.-

이광수의 장편소설『무정』은 단행본으로 출판되는 과정에서 편집자에 의해 심하게 훼손되고 변개(變改)되었다. 신뢰할 만한 정본(定本)이 부재한 상태에서 그동안의 연구자들은 변개의 양상이 가장 심한 1962년도 삼중당 전집의 『무정』을 텍스트로 사용하였다. 이러한 현실이 『무정』연구의 질적 발전을 가로막았다. 이 논문은 이러한 사정에 주목하여, 1917년『매일신보』에 연재된 최초의 『무정』으로부터 가장 최근에 출판된 『무정』에 이르기까지 모두 아홉개의 판본을 검토하였다. 이 검토를 통하여 식민지 시대에 출판된 『무정』의 간행 상황과 그 판본들의 차이, 1956년 광영사에서 간행된 『무정』에서 가장 심한 훼손이 이루어진 사실, 그 이후 아무런 의심 없이 이 판본이 연구용 텍스트로 사용되어 온 사실 등이 밝혀졌다. 1990년대 이후 『무정』이 정본을 출판하기 위한 몇몇 시도가 있었지만, 그것 역시 오류가 많은 것들이어서 정본이라고 할 수 없다. 이 논문에서는 보다 완벽한 『무정』정본의 간행을 위해 기왕의 주요 판본들을 비교 검토하였고, 이에 따라 『무정』정본의 출판을 위한 기본적인 조건들이 마련되었다. A lot of paragraphs of Yi Kwang-Soo’s novel MuJeong had been changed and even spoiled by editors while it was published Many researches have used MuJeong SamJungDang Co. 1962 as an original text, which was most severely spoiled by editors. Reflecting upon this situation, we have scrutinszed nine texts, that is, from the first serialized MuJeong in Maeil Shinbo 1917 to the last one which was published most recently. From this scrutiny, we came to know not only many differences among the texts but also the fact that MuJeong has been published eight rimes during colonial era. Allthough there have been several tries to publish the original text of MuJeong since 1990’s they also include a lot of errors. From the scrutiny of this paper, we would be provided with the fundamental materials for the more complete text MuJeong.

韓國近代技術敎育史 定立을 위한 基礎硏究

金振淳,宋周鎬,金東哲 충남대학교 공업교육연구소 1983 論文集 Vol.6 No.2(A)

This study investigated what and how were taught in the practical arts/industrial arts education and vocational education in the last Yi Dynasty (1876-1910) and Japan ruling (1911-1945) era in Korea. The findings of the study are summarized as follows; 1. The modern industrial vocational education in Korea has its roots in so called the Practical Science Thought (17th and 18th century) and the Civilized Thought (late of 19th century). 2. From the year of 1895, the modern school system of primary, secondary and vocational education was set up by the Korean Government. But after establishing of Resident General (1905), the school system was distorted and reformed by Japanese colonialism. 3. As for practical arts education of primary school, `Manual Arts', `Sewing' and `Vocation' subjects were taught from the year of 1906. At first these were optional, and later i.d. in 1922 (Sewing), in 1929 (Vocation) and in 1938 (Manual Arts) these became compulsory. 4. As for industrial arts education of secondary school for boys, `Industrial Arts' began to be taught as a compulsory subject from the year 1909, and `Manual Arts' was taught only in 1910's. 5. As for vocational education, the Commercial-Industrial School was established by the Korean Government as a first vocational school in 1899. In the Japan ruling era (1911-1945), the vocational education was emphasized to produce lower craftsmen in order to supply the needed labor in carrying out Japanese colonial policy.

관상동맥질환 환자에서 스텐트 시술 후 재협착에 관한 연구

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

Background and aims : In the coronary artery disease, a rate of restenosis was much decreased by placement of coronary stent than when percutaneous transluminal coronary angioplasty has been applied, but there are still important clinical problems of restenosis. There has been many progressive studies about various factors contributed to this restenosis. So, we studied a relation between restenosis after placement of coronary stent in the coronary artery disease and many clinical factors, characteristics of stenotic lesion and procedural factors, and also assessed the restenosis rate of various coronary stents. Methods : Total 58 lesions(46 cases of patients ; man 30, woman 16) were evaluated, which has been performed a follow-up coronary angiography after 6 months (mean 188 days) since coronary stent had been placed. Various stents were implanted and assessed a relation between restenosis and many factors. Results : Of 58 lesions were target stenotic studies, there were 22 of restenotic lesions(37.9%), and the restenosis rate wes statistically significant difference in the relation with diabetes mellitus(p<0.05), group of acute myocardial infarction(p<0.05) among clinical diagnosis of ischemic heart disease(stable angina, unstable angina and acute myocardial infarction) in clinical factors and with high dilation pressure of stent(p<0.05) in procedural factors. When the rate of restenosis was evaluated among implanted stents, it was lowest in the Multilink^(®) stent and highest in the Nir Royal^(®) stent(60%). Conclusion : In this study of restenosis and various factors after placement of stents in the coronary artety disease, factors such as diabetes mellitus, group of acute myocardial infarction and a dilation pressure of stent were significant related with restenosis and the restenosis rate of Multilink^(®) stent was lowest and the highest restenosis rate was of Nir Royal^(®) stent.

만성 정신분열병 환자에서 지연성 운동장애와 음성증상 및 인지기능 장애와의 연관성

심주철,반철식,성기수,이정구,정도운,정청,윤진상,김영훈 대한신경정신의학회 2000 신경정신의학 Vol.39 No.4

연구목적: 정신과 전문병원에 입원해 있는 만성정신분열병 환자들을 대상으로 첫째 지연성 운동장애의 유병율과 위험인자들을 조사하고, 둘째 지연성 운동장애와 정신분열병의 음성증상 및 인지기능 장애와의 상관성을 조사하고자 한다. 방법: 연구대상자는 마산동서병원에 입원 중인 환자 중 DSM-IV의 정신분열별 진단기준에 부합하며, 최근 3개월 이상 동일 용량의 항정신병약물 복용한 271명(남자 174명, 여자 97명)의 환자들이었다. 지연성 운동장애에 대한 평가는 Abnormal Involuntary Movement Scale(AIMS)을 이용하였고, DSM-IV와 Sc-hooler와 Kane(1982)의 진단기준 양자에 부합하는 환자들만을 지연성 운동장애군으로 분류하였다, 정신 분열병 정신병리에 대한 평가는 Brief Psychiatric Rating Scale(BPRS)와 Schedule for the Deficit Syndrome(SDS)을 이용하였고, 인지기능에 대한 평가는 Mini-Mental Status Examination(MMSE)을 이용하였다. 결과: 지연성 운동장애의 유병율은 50.9%이었고, 50세 이상, 남자에서 높았다. 그러나 입원기간과 항정신병 약물의 일일 사용량에 따른 차이는 없었다. 지연성 운동장애의 호발부위는 혀, 상지, 입술과 입 주위의 순이었다. BPRS 총점 및 소항목 척도점수와 SDS 척도점수는 지연성 운동장애의 유무에 따른 차이가 없었다. MMSE 총점 및 소항목 점수도 지연성 운동장애의 유무에 따른 차이가 없었다. 결론: 평균입원기간이 9년 이상인 만성정신분열병 환자들에게서의 지연성 운동장애의 유병율은 50.5%이었고, 연령이 가장 의미있는 위험인자임을 확인했다. 만성정신분열병 환자들이 주 대상인 본 연구에서는 지연성 운동장애와 정신분열병의 음성증상 및 인지기능 장애와의 상관성은 입증하지 못했다. Objectives: The purpose of present study was to determine the prevalence rate of tardive dyskinesia and to search for its risk factors in chronically institutionalized schizophrenic subjects. We also examined the relationship between tardive dyskinesia and both negative symptoms and cognitive impairments in the same subjects. Methods: Subjects were 271 in-patients(174 males, 97 females) at Masan Dongsuh Hospital. They met DSM-IV criteria for schizophrenia and had been taking fixed doses of antipsychotics for at least 3 months. Tardive dyskinesia was assessed by Abnormal Involuntary Movement Scale(AIMS). Cases of tardive dyskinesia were ascertained by the criteria of Schooler and Kane (1982) and DSM-IV. The rating of psychopathology was acquired using Brief Psychiatric Rating Scale(BPRS) and Schedule for the Deficit Syndrome(SDS) and the assessment of cognitive function using Mini-Mental State Examination(MMSE). Results: The prevalence of tardive dyskinesia is 50.9% and the frequency of tardive dyskinesia was high est in male above the age of fifty. But there was no statistically significant relationship between the frequency of tardive dyskinesia and both the length of hospitalization and the daily dose of antipsychotics. The frequency order of abnormal movement in the patients with tardive dyskinesia was as follows : tongue, upper extremities, lips and perioral area. We couldn't find any significant difference in the total and subscale scores of BPRS between the groups with and without tardive dyskinesia. There were no differences in MMSE scores between the groups with and without tardive dyskinesia. Conclusion: This study gave us that the prevalence of tardive dyskinesia was high in chronically institutionalized schizophrenic inpatients and that age was the most significant risk factor of tardive dyskinesia. The relationship between tardive dyskinesia and both negative symptoms and cognitive impairment, however, was not revealed.