분편 인플루엔자백신(split influenza vaccine)의 임상효과 및 면역원성에 관한 연구

우흥정,김동림,정희진,천병철,이주연,안정배,김지희,박찬,신영규,김우주,김민자,박승철 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.1

목적 : 아단위 인플루엔자 백신 접종 후 백신의 인플루엔자 예방효과, 인플루엔자 방어 항체형성, 인플루엔자 백신의 안전성을 조사하고자 하였다. 방법 : 총 571명을 대상으로 인플루엔자 백신 접종을 하였고, 이들 접종자에서 인플루엔자 양질환의 이환을 조사하여 인플루엔자 백신의 인플루엔자예방효과를 알아보았고, 백신의 접종 전 및 접종 4주 후 혈청에서 혈구응집억제물(Hemagglutination Inhibition : HAI) 항체 검사를 실시하여 백신의 방어항체생성을 조사하였고, 백신의 안전성을 알아보기 위해 백신접종 후 1주일 이내의 부작용을 조사하였다. 결과 :백신 접종군과 백신 비접종군에서 인플루엔자 양 질환의 이환을 조사한 결과 접종군 28.35%, 비접종군 35.88%으로 나왔으며, p 값이 0.001로 통계적으로 접종군에서 유의하게 낮았고, 인플루엔자 양 질환의 예방 효과는 20.97%를 보였다. 백신의 방어항체 형성의 평가를 위해 유럽의 인플루엔자 백신 허가 기준을 조사하였는데 B/Guangdong/5/94균주의 백신접종 후 항체가 40이상의 비율을 제외한 다른 기준은 모두 만족 시켰다. 부작용은 전체 조사자 521명중 149명(29%)으로 주로 접종 부위의 국소 부작용을 호소했고, 전신 부작용은 2% 내외였으며 특별히 심각한 부작용은 발견되지 않았다. 결론 : 분편 인플루엔자 백신은 인플루엔자양질환의 예방과 방어항체생성에 효과 있으며 안전한 것으로 사료된다. Background : The safety and effectiveness of influenza vaccine are well known in developed country. The influenza vaccination has been recommended as one of the tentative immunization schedule for indicated persons since 1997 in Korea. But there are still no available data about them, even though nearly 5 million doses of influenza vaccine were used in 1997-1998 season. So it is immediately needed to investigate the safety. efficacy and immunogenicity of influenza vaccine among Korean. Methods : We studied the clinical efficacy of influenza vaccine by monitoring Occurrence of influenza-like illness in influenza risk group(vaccination ; 300, non-vaccination; 215) from December in 1997 to March in 1998. We used the split quadrivalent influenza vaccine containing 15 microgram of hemagglutinin of A/Beijing/262/95(HlNl), A/Wuhan/359/95(H3N2), B/Mie/1/93 and B/Guangdong/5/94. Hemagglutination inhibition(HA1) antibody titers were determined before immunization and 1 months after vaccination And we evaluated adverse effect of influenza vaccination at 7 days after vaccination. Results : Influenza vaccination was associated with si@icant reductions in influenza-like spptoms(vaccination group; 28.35%, non-vaccination group, 35.88%, p=0.001). The preventive effect of influenza-like i3lne.s among influenza risk goup was 20.97%. And immunogenicity of influenza A and B exceeded all of the European licensure criteria for immunogenicity except postvaccination proportion of titers 240 of B/Guangdong/5/94 strain. And the adverse effects were mainly local injection site problem and no serious adverse effect was noted. Conclusion : Split influenza vaccine is safe, inmunogenic and eff'tive in influenza risk group in Korea.

성인혈압의 집단검진에 있어서 자동혈압기의 유용성 평가

김주자,이용진 순천향대학교 산업의학연구소 1998 순천향산업의학 Vol.4 No.1

자동혈압계 (UDEXⅡ α - UEDA)의 유용성을 평가하기 위하여 1996년 6월 10일부터 7월 30일까지 모대학병원 건강관리과를 방문하여 건강진단을 받는 사람 852명 (남자 539명, 여자 313명)을 대상으로 혈압을 측정하였다. 혈압은 4회 측정되었는데 수은혈압계로 간호사, 의사가 각각 측정하였으며 자동혈압계로는 우측 전박을 위로 향한 방법과 좌측으로 돌려서 측정하는 두가지 방법을 차례로 이용하였다. 의사에 의한 수은혈압계 측정치를 표준치로 하여 자동혈압치의 신뢰도, 타당도, 상관성, 희귀성 등을 조사하였다. 자동혈압계에 의한 혈압치가 수은혈압계에 의한 혈압치보다 약간 낮은 수치를 보였으며 이것은 성, 연령군, 각 혈압군, 비체중군 별로 일정하게 나타나고 있었다. 그러나 약간 낮은 수치는 작은 차이로 상관성과 일치도에 있어서 고혈압군을 제외하고는 유의성을 보이고 있었다. 또 팔의 위치에 있어서 우측 상박을 위로 향한 방법이 좀 더 높은 특이도와 예측도를 보였다. 그러나 두가지 방법 모두 민감도는 낮게 나타났다. 그러므로 자동혈압계는 이미 기존 고혈압 환자에게 있어서 혈압의 자기측정으로 혈압을 조절하는데는 도움이 될 것으로 사료되며 새로운 고혈압 환자를 발견하고자 할 경우에는 다른 보조적인 방법이 함께 고려되어야 할 것이다.

20-30대 무증상 성인에 있어서 채용신검시 나타난 간기능 및 바이러스 간염검사 결과 분석

김주자,신연교,우극현 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

To determine the distribution of results of liver function test and viral markers for preemployment screening in asymptomatic young adults(twenties and thirties in age group), and also to evaluate the cutoff level of liver function test in deciding repeat follow-up examination. the data from which the first and second repeated examinations for preemployment screening performed during the period from Jan, 1, 1994 to Dec. 31 1994 were analized. The results were as follows: 1. Among 7,855 asymptomatic young adults who were examined, 814 (10.4%) had the abnormal liver function test (10.4% (814/7,855) in male, 0.8% (14/1,707) in female. 2. In 397 male who had repeated follow-up test, 27.2%(108/397) were turned out normal liver function test and 72.8%(289/397) remained abnormal. According to the interval of repeated follow-up test, the longer the interval the higher conversion rate to normal. This can be explained by the effect of treatment of health care, or was dropped from 87.5%(7/8) to 44.2%(23/52) at 401U/dl and that of SGOT was dropped from 80.7%(25/31) to 67.9%(19.28) at 451U/dl which suggest cutoff level to decide repeated follow-up test. This suggest that we can adjust the cutoff level in deciding follow-up examination. 3. Overall positive rates for HBsAg were 5.8%(80/1,561), and 5.9%(80/1,347) in age group 20-29, 4.7%(10/214) in age group 30-39, 6.0%(73/1,214) in male, 4.9%(17/347) in female. Positive rate for HBsAg according to the liver function test was significantly higer in abnormal liver function group than in normal liver function grup (12.7% vs 4.8%). 4. Positive rate for anti-HBs was 32.7% and there were no significant difference between age groups or between liver function groups. 5. Positive rate for anti-HCV was 1.3%(5 in 397 male), actually all 5 were in age group 20-29, among them, 3 had normal liver function test and 2 had abnormal liver function test.

동아리 활동을 통해 본 교육 대학 문화 연구

김재영,김지자,조주연,심성옥 서울敎育大學校 學生生活硏究所 1999 學生生活硏究 Vol.25 No.-

학생들의 동아리 활동은 정규 교육 과정에서 충족시키지 못하는 여러 가지 학생들의 요구를 충족시켜 주면서 그들의 사고 방식과 생활 양식 및 여가문화 형성에 크게 영향을 미치고 있다. 본 연구는 서울교육대학교 학생들의 동아리 활동에의 참여 양태를 분석함으로서 교육 대학생들의 문화의 일면을 밝혀 보기 위한 것으로 자료의 수집은 동아리 활동에 참여하고 있는 학생들(188명)을 대상으로 한 설문지 분석과 동아리 대표들(22명)을 대상으로 한 구조화된 면접에 의하여 이루어졌다. 자료의 수집 분석은 1998년 9월부터 10월에 걸쳐 이루어졌다. 주요 연구 결과는 다음과 같다. 동아리에 가입하여 활동하고 있는 서울교육대학 학생들은 동아리 활동이 대학 생활을 풍부하게 하고 여가 및 취미 생활에 도움이 된다고 지각하면서 동아리 활동에 높은 만족도를 표명하였다. 그러나 동아리 활동을 하는 과정에서 경비 부족-능력 부족-학과 수업에 지장 초래 등의 애로사항을 상당수 느끼고 있었고 동아리에의 가입은 흥미와 적성을 고려하여 스스로 선택하는 경우가 많았으나, 실제 동아리활동 참여는 여가활용이나 능력 개발을 목적으로 하는 동아리를 선호하고 학술 동아리의 선호도는 약세를 보이고 있다. 동아리 가입한 학생들의 56%정도가 거의 매일 동아리방을 찾는 실정이며 19%정도가 격일에 한번, 그리고 20%정도가 주 1-2회 동아리방을 찾고 있어, 전반적으로 동아리방의 방문이 상당히 높은 편이었다. 이들이 의미있게 느끼는 동아리 활동은 동아리의 기본 활동이었으나 (46.7%) 동아리 모임후의 뒷풀이(24%)와 친교모임(17.9%), 그리고 공강시간의 활용 (11.3%) 역시 의미가 크게 나타났다. 동아리 모임후 뒷풀이 유형으로는 식사 및 술마시기가 85.1%로 압도적인 활동으로 나타나고 있어 대학가 음주문화가 예외없이 뿌리를 내리고 있었다. 동아리 활동이 대학생활을 풍부하게 하고 교사의 자질함양에도 도움이 된다고 만족감을 보이고 있는데 동아리 활동의 만족도는 임원이나 고학년 학생들에게서 높게 나타나는 편이었다. 한편 동아리 대표들은 학생들의 동아리 가입을 높히기 위한 주요 유인책으로 깊이있는 인간관계를 들고 있으나 동아리 회원의 모집과 학교로부터의 지원 부족 등에 크게 어려움을 겪고 있는 실정이었다. The purpose of the present study was to investigate the university culture at the teacher training university in view of their Student Circle Activities. Since Student Circle Activities can help meet the students' needs which can not be met from their regular curricular activities, and can give influence to the formation of their way of thinking, mode of action, and their culture of leisure life etc.. The data was collected from 186 members of 22 Circles with Questionnaires and 22 leaders of these registered Circles at the Seoul National University through interview with structured Interview Schedules in September through October. 1998. The majority of the Circle members expressed higher degree of satisfaction with regard to their Circle Activities in terms of nurturing university life, and help good utilization of their leisure times, etc. However, most of them showed some difficulties in Circle Activity participation due to lack of expenditures, lack of competencies, and some hinderance for the classroom participations, etc. Though they tend to choose their circles by themselves in consideration of their interest and aptitudes, their actual participation appeared to be inclined more to the leisure oriented programs than academic orientation. The leaders and senior student members of the Circle showed more satisfaction than the non-leaders and freshmen or sophomores toward their experience of Circle Activities.

순천향의대에서 문제중심학습의 실행 및 평가

김주자,이경재,원종호,이동환,안의태 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Background and Objects : Problem based learning (PBL) was practiced the 2nd grade students of Soonchunhyand medical school for two weeks from Dec. 10th through 24th, 2001. This is to evaluate the effect of the PBL practice Materials and Methods : On study module was discussed each week for 17 small groups. Each group had 6-7 students and 1 tutor. Questionnaire was applied to both students and 20 tutors. The questions were grouped in 6 categories, that is, understanding and satisfaction about the PBL, the process of small group discussion and group activity in self-learning method, PBL module and tools for study, opinion about tutors evaluation method etc. And advantages, disadvantages and other opinions were described in self-administration. Results : Both students and tutors had satisfied the PBL practice positively. Practices of "self-learning and active discussion instead of spoon-feeding methods", "problem-solving ability and medical reasoning" were described as advantages, "inefficiency and loss of time because of poor process during the discussion", "time consuming and much loading problems in self-learning practice because lack of training" "time consuming and mush loading problems in self-learning practice because lack of training" "lack of study room" were described as disadvantages.

일 지역 농촌 노인들의 건강증진행위에 영향을 미치는 요인

김희자,김주현,박연환 성인간호학회 2000 성인간호학회지 Vol.12 No.4

The purpose of this study was to identify the factors influencing health promoting behavior of the elderly for develop health promoting intervention of old people. The subjects of this study were 167 elderly person over the age of 60, living in rural city in Korea. The data were collected by interview and self report questionnaire, during the period from Mar 1999 to August. 1999 The instruments for this study were the PRQ-II by Weinert(1988), the scale of Locus of Control by Wallstone et al(1978), the scale of self efficacy by Sherer & Maddux(1982). 10 points visual analogue scale for the perceived health status and the importance of health, the health promoting behavior scale by Walker et al(1987), and the scales developed by authors for the perceived benefits of health promoting behaviors, and the perceived barriers to health Promoting behaviors. The Cronbach's alpha of these scales were .84 ∼.97. The data were analyzed using descriptive statistics, Pearson's correlation coefficients, and stepwise multiple regression. The results of this study were as follows: 1.Among cognitive perceptual factors of the Health Promotion Model by Fonder(1987), the scores of the importance of health, the perceived internal control of health, the self efficacy, the perceived health status, and the perceived benefits were significantly positive correlation with the scores of the health promoting behavior of the eldelly. In addition, the scores of the perceived barriers were significantly negative collelation with the scores of the health promoting behavior of the elderly. 2.Among modifying factors of the Health Promotion Model by Pender(1987), the pocket money of the elderly, the scores of social support were significantly positive correlation with the scores of the health promotiong behavior of the elderly. In addition, aloes of old people were significantly negative correlations with the scores of the health promoting behavior of the elderly. 3.Stepwise multiple repression analysis revealed that the most powerful predictor of health promoting behavior was the self efficacy. A combination of the self efficacy, the Perceived barriers, the social support, the importance of health, and the perceived internal control of health accounted for 56.2% of the variance in health promoting behavior in the elderly. From the results of this study. we concluded that the Health Promotion Model by Fonder will be used to explain health promoting behavior of the elderly. We suggested that the results of this study will be considered in developing health promoting Programs of elderly.

톨루엔 폭로근로자의 요중 마뇨산과 자각증상에 관한 연구

김주자,함정오,안규동,이병국,남택승,백남원 大韓産業醫學會 1989 대한직업환경의학회지 Vol.1 No.2

To study the relationship between the urinary hippuric acid and subjective symptoms in toluene exposed workers, urinary hippuric acid was measured and subjective symptoms questionnarire was surveyed in 93 toluene exposed male workers and 96 non-exposed office male workers. The results are as follows: 1. Mean concentration of urinary hippuric acid, which is significantly higher in exposed group than in non-exposed group, was 1.3 g/1, 1.2(GM, GSD respectively) in exposed group and 0.6 g/1, 1.2(GM, GSD respectively) in non-exposed group. 2. Mean concentration of toluene in the air in the workplace, which is significantly higher in the department of coater than in the department of mexing, was 23.4 ppm, 6.2(GM, GSD respectively) in the department of mixing and 59.8 ppm, 3.4(GM, GSD respectively) in the department of coater. 3. Complained rates of subjective symptoms were significantly higher in exposed group than in non-exposed group in all items. 4. In exposed group, complained rate of CNS related symptoms was higher than that of irritation ralated symptoms in the first part but there was no significant difference and complained rate of irritation related symptoms in the second part was significantly higher than that of CNS related symptoms. 5. In exposed group, complained rates of subjective symptoms were not compatible with dose-response relationship by the concentration of urinary hippuric acid, duration of work, department of work, and age group retrospectively.

산모 및 제대 혈중 납농도에 관련된 행태학적 및 사회경제적 요인에 관한 조사

김주자,우극현,이임순 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.1

생활환경에 따라 산모 및 제대 혈중 납농도가 차이가 있을 것이며 그러한 납농도에 영향을 미칠수 있는 행태학적 및 사회경제적 수준의 영향이 어느정도일가 하는 문제를 알아보기 위하여, 연구대상 지역을 도시, 농촌, 공단 지역으로 구분하여 이들 각 지역에 거주하는 분만중의 산모를 대상으로 혈중 납농도 및 신생아의 제대 혈중 납농도를 조사하였으며 그에 관련된 여러 위험요인들에 대하여도 조사하였다. 도시지역으로는 서울에서 순천향 서울병원, 농촌지역으로는 음성에서 순천향 음성병원, 공단지역으로는 구미에서 순천향 구미병원을 선정하였다. 1993년 1월 부터 3월 사이의 기간동안 분만을 위하여 각 병원에 입원한 산모 306명에게서 일반 기초검사 및 혈중납 측정을 하였으며 분만시 신생아의 제대혈을 채취하였고 같은 기간동안 분만보조 간호사에 의하여 면접에 의한 설문작성을 하였으며 또한 의무기록도 조사하였다. 결과는 다음과 같다. 1. 조사대상자인 산모의 평균 연령은 27.5±5.3세, 임신기간은 39.4±3.1주로 모든 지역별 유의한 차이는 보이지 않았다. 산모 혈중 납농도는 4.73±1.49 ㎍/dl, 제대 혈중 납농도는 4.35±1.29 ㎍/dl이었으며 모두 지역별 유의한 차이는 보이지 않았다. 2. 산모의 생물학적 및 사회경제적 요인을 4분위로 나누어 각 등급정도에 따른 산모 및 제대 혈중 납농도의 변화경향을 조사한 결과 산모연령, 아기의 출생시 체중, 임신기간, 가정의 총 연수입등의 정도에 따라 일정한 변화경향을 보이지 않았다. 3. 산모 및 제대 혈중 납농도의 변화경향을 조사하기 위하여 산모 및 남편의 건강행태를 질문하여 전혀, 가끔, 자주, 매일의 4가지로 구분하여 그 정도에 따라 산모및 제대 혈중 납농도를 조사한 결과 임신중 산모의 철분복용, 비타민 복용, 화장품사용, 흡연, 음주, 커피음용에 있어서 일정한 경향을 보이지 않았으며 남편의 흡연, 음주, 커피음용의 정도에 있어서도 일정한 경향을 보이지 않았다. 4. 모든 조사대항 요인들과 산모 및 제대혈중 납농도와의 상관관계를 조사한 결과 산모 혈중 납농도와 제대 혈중 납농도와의 통계적으로 유의한 양의 상관관계를 보였으며 남편의 교육정도와는 산모 및 제대 혈중 납농도 모두에서 유의한 상관관계를 보였다. This study was performed to examine the effect of demographic and behavioral and socioeconomic factors on the maternal and cord blood lead level. Three Soon Chun Hyang University Hospitals (Seoul, Eumsung, Kumi) participated as of urban, rural, industrial areas, respectively. Blood sampling for lead and other routine tests and questionnaire were done on 306 pregnant women who were admitted to these hospitals to deliver the baby. Women who have history of disease, such as diabetes, hepatitis etc. were excluded from the analysis. The results were as follows; 1. Mean maternal age was 27.5±5.3, and mean gestational period was 39.4±3.1 weeks. Mean concentration was 4.73±1.49 ㎍/dl in maternal blood lead and 4.35±1.29 ㎍/dl in cord blood lead. there were no statistically significant differences between community areas. 2. Tendency of maternal and cord blood lead level by the degree of quartile of each demogrphic and socioeconomic variables showed no statistical significance in maternal age, baby birth weight, gestational period, family income. 3. Tendency of maternal and cord blood lead level by the degree (never, often, very often, everyday) of maternal and paternal health behavior showed no statistical significance in maternal iron supplement, vitamine intake, use of cosmetics, smoking, alcohol drinking, coffee drinking during pregnancy and paternal smoking, alcohol drinking, coffee drinking. 4. Correlation between demographic, health behavioral, socioeconomic variables and maternal and cord blood lead showed significant positive correlation between maternal and cord blood lead, and also correlation of paternal education to both maternal and cord blood lead.

건강진단 수진자의 당뇨위험요인 및 건강행태의 변화에 관한 5년 추적관찰 조사

김주자 순천향대학교 산업의학연구소 1998 순천향산업의학 Vol.4 No.1

This study was done to observe the change of risk factors and health behavior among health examines between baseline and 5 year follow-up examinations. For the study, 484 subjects who had regular health examinations on 1900 and on 1995 were selected. The subjects were divided into 3 subgroups, i.e., Normal, IGT-Ⅰ, IGT-Ⅱ groups depending on the criteria combined with fasting and 1 hour postprandial blood sugar. The results were as follows; 1. The subject was consisted of 383 male (79.1%) and 101 female (20.9%), 484 in total. Subgroups were consisted of 306 Normal group (63.2%), 159 IGT -Ⅰ group (32.9%) and 19 IGT-Ⅱ group (3.9%). The highest age distribution was in the 40-49 age group all three groups. Most of them were office workers for males and housewives for females. 2. The mean levels of risk factors at baseline were ccompared to the mean levels after follow-up. Age, fasting and 1 hour postprandial blood sugar levels, relaive body weight, triglyceride, total cholesterol were significantly increased after follow-ups, especially in the Normal group. And also the majority of risk factors were increasing according to the level of subgroups i.e., the IGT-Ⅱ, IGT-Ⅰ, Normal group in order, for both baseline and followup examinations. 3. The changes of various health behaviors were observed between baseline and follow-up examinations. Such habits as regular exercise, change of weight, smoking, liquor, coffee drinking significantly changed to more desirable health behavioral patterns during follow-ups, but consuming salty, greasy or regular meals, concept on one's body weight, and daily activity did not significantly changed. In conclusion, more intensive interventions such as screening, health education, etc., were needed for all subgroups.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions