• Title/Summary/Keyword: 의료비

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Public Attitudes toward Development of National Program for Cancer Survivorship (암 생존자를 위한 국가 프로그램 개발에 대한 일반 국민들의 태도)

  • Bae, Yeon-Min;Kim, Young-Ae;Hong, Sung-Hoo;Koo, Ja-Hyun;Yun, Young-Ho
    • Journal of Hospice and Palliative Care
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    • v.14 no.4
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    • pp.218-226
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    • 2011
  • Purpose: This study aimed to explore the public attitude toward the development of national health program for cancer survivorship. Based on the results of this survey suggest the necessity of national health program for cancer survivorship. Methods: We surveyed 1,015 adults who were over 20 years of age from the sixteen cities and local districts of Korea. We conducted a telephone survey with a structured questionnaire on the post-treatment care at the nation and on the permission as the handicapped for cancer. Results: Fifty-six percent of respondents answered that post-treatment program at the national level is very necessary and twenty-seven percent replied that it is necessary. Respondents emphasized 'Expanding insurance coverage for post-treatment care' (29.8%) and 'Systematic education and rehabilitation programs after treatment' (25.6%). This study found that a lower educational level [adjusted odds ratio (aOR)=1.36; 95% confidence interval (CI)=1.04~1.77], earning under 300 per month [aOR=1.36; 95% CI=1.04~1.77], being married (60.2%) [aOR=1.79; 95% CI=1.34~2.37] and thought higher level of cancer treatment in Korea than the advanced (64.4%) [aOR=1.56; 95% CI=1.15~2.12] influenced the positive attitude toward a national health program. Sixty-eight percent of respondents answered 'Strongly agree' or 'agree' to permission for cancer survivors as the handicapped. People who have been married (72.4%) [aOR=1.89; 95% CI=1.41~2.53] and who have had a lower educational level [aOR=1.35; 95% CI=1.03~1.78] responded that they agree more to permission for cancer survivors as the handicapped. Conclusion: This study shows the positive public attitude of the public toward the national health program for the cancer survivors.

Evaluation of Image Quality for 2D TSE(RT) and 3D GRASE in MRCP Study: Fast MRCP Method (췌담관자기공명영상에서 2D TSE(RT)와 3D GRASE(BH) 기법에 대한 영상의 질 평가 : Fast MRCP 기법)

  • Goo, Eun-Hoe
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.983-989
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    • 2021
  • In this study, we intend to evaluate image quality and provide to clinical basic data by applying to 2D TSE (RT) and 3D GRASE (BH) techniques using Fast MRCP testing methods for application to patients in poor patient condition. Data were analyzed for 30 patients (15 males, 15 females, and 64±4.26 average age) who underwent MRCP tests. The equipment used was Ingenia CX 3.0 T equipment and Ds anterior coil was used for data acquisition. SNR and CNR of each image were measured through quantitative analysis, and the quality of the image was evaluated by dividing it into 5 grades for qualitative evaluation. The image evaluation was performed on the paired t-test and the Wilcoxon test, and when the p value was 0.05 or less, it was considered to be significant. As a result of quantitative analysis of SNR and CNR, 3D GRASE (BH) was measured high when comparing the two techniques, 2D TSE (RT) MRCP and 3D GRASE (BH) (p<0.05). The qualitative analysis result is a sharpness of the bile duct: 3D GRASE(BH): 4.12±0.03, Overall image quality: 3D GRASE(BH): 4.21±0.91 was high (p=0.001). The motion artifact of the bile duct showed no significant difference with two techniques(2D TSE(RT): 4.41±0.04, 3D GRASE(BH): 4.53±0.14(p=0.067). However, the background suppression obtained significant results with 2D TSE(RT) of 4.14±0.55(p=0.001). In conclusion, as a result of using the Fast MRCP testing method, MRCP images obtained by 3D GRASE (BH) had an advantage over MRCP images using 2D TSE (RT). However, there will be useful results of 2D TSE(RT) MRCP technique in patients who have difficulty holding their breath.

A Study on the Optimal Angle as Modified Tangential Projection of Knee Bones (무릎뼈의 변형된 접선방향 검사 시 최적의 입사각에 관한 연구)

  • Oh, Wang-Kyun;Kim, Sang-Hyun
    • Journal of the Korean Society of Radiology
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    • v.15 no.6
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    • pp.919-926
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    • 2021
  • In this study, we wanted to find out the optimal angle as a modified tangential projection of the patella. In the experiment, we used Kyoto Kagaku's PBU-50 phantom. In the supine position, the F-T angle was set to 95°, 105°, 115°, 125°, 135°, 145°, and Patella tangential projection images were obtained by varying the X-ray tube angle by 5° so that the angle between the X-ray centerline and tibia at each angle was 5~20°. Image J was used for image analysis and the congruence angle, lateral patellofemoral angle, patellofemoral index and contrast to noise ratio(CNR) were also measured. SPSS 22 was used for statistical analysis, and the mean values of congruence angle, patellofemoral angle, patellofemoral index, and CNR were compared with Merchant method through one-way batch analysis and corresponding sample t-test. As a result of the study, in the case of congruence angle, the angle of incidence of the knee-angle X-ray centerline was 105°-72.5° (20° tangential irradiation), 115°-72.5°, 77.5° (15, 20° tangential irradiation), 125°-82.5° (20° tangential irradiation), lateral patellofemoral angle is 115°-72.5°, 77.5° (15, 20° tangential irradiation), 125°-72.5° (10° tangential irradiation), patellofemoral index is 115°-72.5° (15° tangential irradiation) and 125°-72.5° (10° tangential irradiation) were not significantly different from Merchant method (p> .05). In case of CNR, it is not different from Merchant method at 105°-67.5°, 72.5° (15, 20° tangential irradiation), 115°-67.5°, 72.5°, 77.5° (10, 15, 20° tangential irradiation). (P> .05). Based on the results of this study, high diagnostic value images can be obtained by setting the knee angle and the angle of incidence of the X-ray tube to 115°-72.5° (15° tangential irradiation) during the modified tangential examination of the knee bone. It was confirmed.

Connection of Dongmu Lee Je-ma's Sa-Sang Theory & Ken Wilber's all-quadrant approach (동무 이제마의 사상설(四象說)과 캔 윌버의 사상한(四象限) 일고(一考))

  • Heo, Hoon
    • Journal of Korean Philosophical Society
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    • v.116
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    • pp.411-435
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    • 2010
  • Ken Wilber(1949~) tries to approach integration of philosophy, emphasising the advent of the perennial philosophy in the exchange of scholarships at the present day. He suggests All Quadrant(四象限) for the first step to reach his integrated approach. In addition, his approach concretizes for AQAL(All Quadrant, All Level). His AQAL approach which can be divide into inside/outside, singular/plural, or interobjectivity/intersubjectivity is applied to a lot of fileds such as ecology, management, criminology, medical treatment and its boundary is getting bigger. The merits of Quadrant is that it can solve the problem of the plain(平原), which resolves the strength of subjective interior(cultural contexts) into the external existence(social system). From view of Dongmu Lee Je-ma(1837~1900), a former philosopher, Sa-Sang theory['Affairs-Mind-body-Objects(事心身物)', 'Heaven-Human-nature-Order(天人性命)] is in accord with Wilber in content. In Dongmu's writing, Quadrant(Affairs-Mind-body-Objects') called Sa-Sang theory(四象學) or Sasang Constitional Medicine(四象醫學) is basic component in order to explain the structure of all nature. 'Heaven-Human-nature-Order'; That is, 'Affairs-Mind-body-Objects' results in 'Heaven-Human-nature-Order' focused on human being(human body) in the universe. In other words, Sa-Sang theory is the same as the Wilver's inclusive perspectives from the universe and human being. Dongmu's Sa-Sang theory is compared with C. G. Jung(1875~1961)'s psychology and it helps both fields confirm the foundation and extend the province of application. Comparision of Dongmu's Quadrant with Wilber's is not just analogical reasoning. In comparison, Dongmu's Sa-Sang theory is more delicated and crystallized than Wilber's in medical prospective. Dongmu regards Quadrant not as diseases, but as origin of Physiology and Pathology. And he explains all of their courses as Quadrant.

A Study on the Current State of the Integrated Human Rights of the Elderly in Rural Areas of South Korea (농촌지역 거주 노인의 통합적 인권보장 실태에 관한 연구)

  • Ahn, Joonhee;Kim, MeeHye;Chung, SoonDool;Kim, SooJin
    • 한국노년학
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    • v.38 no.3
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    • pp.569-592
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    • 2018
  • This study purported to investigate the current state of human rights of older adults residing in rural areas of Korea. The study utilized, as an analytic framework, 4 priority directions (1. "older persons and development", 2. "rural area development", 3. "advancing health and well-being into old age", and 4. "ensuring enabling and supportive environments") with 13 task actions recommended by Madrid International Plan of Action on Ageing (MIPAA). Furthermore, the study examined gender differences in all items included in the analytic framework. Data was collected by the face-to-face survey on 800 subjects aged 65 and over. Statistical analyses were conducted using STATA 13.0 program. The main results were summarized in order of 4 priority directions as follows. First, average working hours per day were 6.2, and men reportedly participated in economic activities and needed job training more than women, while women participated in lifelong education programs more than men. Awareness of fire and disaster prevention facilities was low in both genders. Second, accessibility to the support center for the elderly living alone as well as protective services for the vulnerable elderly was found to be low. IT-based services and networking were used more by men than women, and specifically, IT-based financial transactions and welfare services were least used. Third, medical check-ups and vaccinations were well received, while consistent treatments for chronic illnesses and long-term care services were relatively less given. In addition, accessibility to mental health service centers was considerably low. Fourth, although old house structures and the lack of convenience facilities were found to be circumstantial risk factors for these elders, experiences of receiving housing support services were scarce. The elderly were found to rely more on informal care, and concerns for their care were higher in women than men. Plus, accessibility to elderly abuse services was markedly low. Based on these results, discussed were implications for implementing policies and practical interventions to raise the levels of the human rights for this population.

Effectiveness Evalution of 18F-FDG Auto Dispenser (RIID: Radiopharmaceutical Intelligent Dispenser) (18F-FDG 자동분주기 사용에 따른 유용성 평가)

  • Yoo, Moon-Gon;Moon, Jae-Seung;Kim, Su-Geun;Shin, Min-Yong;Kim, Seung-Chul;Lee, Tea-hun;An, Sung-Hyeun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.2
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    • pp.79-83
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    • 2018
  • Purpose $^{18}F-FDG$, which is commonly used in PET-CT examinations, is low in capacity and it is difficult to keep the amount of radioactivity busy when the specific activity is high, increasing the amount of space dose and radioactive contamination in the distribution room. Therefore, while evaluating the actual dose administered to patients during the manual dispense process, the medical institution intends to assess the usefulness of the auto dispenser by comparing the differences from the actual dose administered to the patient using the new automatic dispense. Materials and Methods From July 2016 to December 2016, 846 patients were manually administered by workers using $^{18}F-FDG$ and $^{18}F-FDG$ 906 patients were using auto dispenser from July 2017 to December 2017. Results Capacity administered to patients during the manual dispense averaged $35.41{\pm}27.79%$ compared to the recommended dose, and the auto dispenser process showed a small difference of $-2.15{\pm}3.99%$ compared to the recommended dose(p<0.05). Conclusion Working people did not have to touch radioactive medicines directly while they were busy in the auto dispenser, and because of the availability of other tasks far away, the time and distance to receive the exposure were also advantageous. It is believed that future use by many medical institutions will not only reduce the dose to patients but also help reduce the exposure dose to workers.

The effects of out of hospital ACLS simulation training on the paramedic's duty ability (구급대원의 전문심장소생술 시뮬레이션훈련이 직무수행융합능력에 미치는 영향)

  • Park, Yoo-Na;Cho, Byung-Jun;Kim, Gyoung-Young
    • Journal of the Korea Convergence Society
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    • v.10 no.4
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    • pp.99-106
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    • 2019
  • The purpose of this study is to analyze the effects of the simulation-based professional cardiac resuscitation training on the performance of professional cardiac resuscitation performed by paramedics in the pre-hospital stage and to provide basic data for effective cardiac resuscitation. This study is an experimental study of the design before and after the control of non-equality. The subjects of this study were 16 newly recruited paramedics from K firefighting school. The simulation training program and evaluation papers used as the evaluation tool were reviewed and commented by 6 ACLS simulation experts (2 emergency medical doctor, 2 emergency medical professors, 2 KALS instructors)Respectively. The training consisted of 30 minutes of theory and 150 minutes of practical training. The lecturer first demonstrated for 5 minutes, and after training by individual debriefing after individual training, individual and team education was conducted The evaluation scale was given a 5 - point Likert scale. The SPSS 22.0 program for Windows was used. The general characteristics of the subjects were analyzed for frequency, the examination of homogeneity between the experimental group and the control group wasfulfilled by t test, and the difference test between the groups of the two groups was performed using the paired t-test. The homogeneity test was able to confirm the homogeneity between experimental group and control group. In the evaluation of six ACLS techniques, it was proven that the experimental group that received the simulation training had better performance in all aspects than the non - training control group. The following are the technical items to be performed. 1. Electrocardiogram 2. Specialized instrument 3. Treatment of fluid 4. Leadership and teamwork 5. Medical guidance 6. Evaluation during transfer. It was proved that paramedics who received simulation training were improved on their job performance ability than general lecture and training group. Therefore, if simulation training and education are applied to a student in the synthetic course or an emergency resident who is engaged in clinical practice, he / she will be able to perform his / her duties more proficiently. It is expected that emergency services provided to patients with cardiac arrest will be improved.

Needs and Related Factors for Return-to-Work Support in Cancer Survivors (암 경험자의 직장복귀지원에 대한 요구도 및 관련 요인)

  • Lee, Sungwon;Lee, Kwang-Min;Oh, Gyu-Han;Yeom, Chan-Woo;Jung, Sanghyup;Hahm, Bong-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.126-134
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    • 2020
  • Objectives : The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods : 182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-to-work support between the patient group and caregiver group (patient's needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results : 34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is "very necessary". The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-to-work support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p=0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions : The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

2020 Dietary Reference Intakes for Koreans: riboflavin (2020 한국인 영양소 섭취기준: 리보플라빈)

  • Lee, Jung Eun;Cho, Jin Ah;Kim, Ki Nam
    • Journal of Nutrition and Health
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    • v.55 no.3
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    • pp.321-329
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    • 2022
  • Riboflavin and its derivatives, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD), are key components of mitochondrial energy metabolism and oxidation-reduction reactions. Proposed dietary reference intakes for Koreans (KDRIs), that is, estimated average requirements (EARs), for riboflavin, based on current knowledge of riboflavin and riboflavin derivative levels, and glutathione reductase activity, are 1.3 mg/d for men aged 19-64 years and 1.0 mg/d for women aged 19-64 years. By applying a coefficient of variance of 10%, reference nutrient intakes (RNIs) were set at 1.5 mg/d for men aged 19-64 years and 1.2 mg/d for women aged 19-64 years. Likewise, EARs and RNIs of riboflavin intake were proposed for all age groups and women in specific life stages such as pregnancy. Mean adult riboflavin intake for adults aged ≥ 19 years was 1.69 mg/d in Korea National Health and Nutrition Examination Survey (KNHANES) 2020, which was 124.9% of EAR according to the 2020 KDRIs. In the 2015-2017 KNHANES study, the mean riboflavin intake from foods and supplements was 2.79 mg/d for all age groups, and 32.7% of individuals consumed less riboflavin than EAR according to the 2020 KDRIs. For those that used supplements, mean intakes were 1.50 mg/d for riboflavin from foods, 10.26 mg/d from supplements, and 11.76 mg/d from food and supplements, and 5.5% of individuals consumed less riboflavin than EAR. Although the upper limit of riboflavin has not been established, the merits of increasing supplement use warrant further consideration. Also, additional epidemiologic and intervention studies are required to explore the role of riboflavin in the etiology of chronic diseases.

Musculoskeletal Injuries by Weapons in Korean Soldiers: Four-Year Follow-Up (총기 및 폭발물에 의한 군인의 근골격계 손상: 최근 4년간 분석)

  • Yang, Hanbual;Hwang, Il-Ung;Song, Daeguen;Moon, Gi Ho;Lee, Na Rae;Kim, Kyoung-Nam
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.234-244
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    • 2021
  • Purpose: To date, studies of firearm and explosive injuries in the Korean military have been limited compared to its importance. To overcome this, this study examined the characteristics of musculoskeletal damages in soldiers who have suffered firearm and explosive injuries over the past four years. Materials and Methods: From January 2015 to July 2019, military forces who had suffered musculoskeletal injuries from firearms or explosive substances were included. The medical records and radiographs were reviewed retrospectively, and telephone surveys about Short Musculoskeletal Functional Assessment (SMFA) for this group were conducted. To compare the functional outcomes, statistical analysis was performed using a t-test for the types of weapons, and ANOVA for others. Results: Of the 61 patients treated for firearms and explosives injuries, 30 patients (49.2%) were included after undergoing orthopedic treatment due to musculoskeletal injury. The average age at injury was 26.4 years old (21-52 years old). The number of officers and soldiers was similar. Eleven were injured by gunshot and 19 by an explosive device. Sixteen were treated in the Armed Forces Capital Hospital and 10 at private hospitals. More than half of the 16 patients (53.3%) with a fracture had multiple fractures. The most common injury site was the hand (33.3%), followed by the lower leg (30.0%). There were 14 patients (46.7%) with Gustilo-Anderson classification 3B or higher who required a soft tissue reconstruction. Fifteen patients agreed to join the SMFA survey for the functional outcomes. Between officers and soldiers, officers had better scores in the Bother Index compared to soldiers (p=0.0045). Patients treated in the Armed Forces Capital Hospital had better scores in both the Dysfunction and Bother Index compared to private hospitals (p=0.0008, p=0.0149). Conclusion: This is the first study to analyze of weapons injuries in the Korean military. As a result of the study, the orthopedic burden was high in the treating patients with military weapon injuries. In addition, it is necessary to build a military trauma registry, including firearm and explosive injuries, for trauma treatment evaluation and development of military trauma system.