• Title/Summary/Keyword: 의료인지지

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Up-to-date or Complete Immunization Coverage and Their Related Factors (영유아의 예방접종 및 그 관련요인)

  • Lee, Moo-Sik;Kim, Eun-Young;Kim, Keon-Yeop;Lee, Jin-Yong;Jang, Min-Young;Hong, Jee-Young
    • Journal of agricultural medicine and community health
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    • v.37 no.4
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    • pp.233-245
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    • 2012
  • Objectives: Understanding the predictor of immunization status in childhood is critical issue to improve National Immunization Program (NIP). The aims of this study were to verify the status of up-to-date or complete immunization coverage and to investigate its related factors. Methods: As of 2005, according to local residence registry data, there were 2,188 children who aged 12 to 35 months in Nonsan city, Korea. We conducted household survey for aged 12 to 35 months children, using questionnaires to obtain data on the status of immunization such as BCG, DTaP (diphtheria, tetanus, and pertussis), Polio, and MMR (mump, measles, rubella). Finally 1,472 participated in the survey. The operating definitions used in this study were following; "Complete immunization rate" refers to the rate of children who received all immunization within recommended age intervals fully "on-time"; "The 4:3:1 series" means status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), the third Polio (3 Polio), and the first measles-mumps-rubella (1 MMR) doses. Multivariate logistic regression analyses were used to determine factors affecting complete vaccination coverage of children. Results: Immunization rates of vaccine based on the vaccination card were from 92.7% to 96.4% except 4th DTaP (79.3%). Complete immunization rate of Korea NIP was 74.0% and that of the 4:3:1 series was 77.1%. A parent as primary caregiver (OR 0.59, 95% CI 0.39-0.87 at 19-35 months of children's age) and first-born children (OR 1.79, 95% CI 1.05-3.03 at 24-35 months of children's age) were significantly related to complete immunization coverage of Korea NIP. And a parent as primary care giver (OR 0.58, 95% CI 0.38-0.88 at 19-35 months of children's age) and first-born children (OR 1.94, 95% CI 1.21-3.14 at 19-35 months, OR 2.23, 95% CI 1.27-3.91 at 24-35 months of children's age) were significantly related to complete immunization rate of 4:3:1 series. Conclusions: Government should take actions to increase complete immunization rate. In particular, intervention on the secondary caregiver and non-first-born children should be needed.

The Epidemiologic and Clinical Study of Pulmonary Tuberculosis - Among Students at One Women's University for Recent 10 Years - (일개 여자대학교 학생의 최근 10년간 폐결핵 동태 및 임상경과에 관한 고찰)

  • Choi, Hee-Jung;Hong, Young-Sun;Oh, Ji-Yong;Cheon, Seon-Hee;Kim, Kyung-Ja;Kim, Man-Ae;Min, Hong-Ki;Choi, Sam-Sub;Lee, Kee-Young
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.465-473
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    • 1995
  • Background: The prevalence of pulmonary tuberculosis has decreased progressively after the control of the tuberculosis began as national control. But as diabetes, malignancy, immunodeficiency disease recently tend to be increased, the tuberculosis become to the important national health problem. So, this study was designed to observe the state and the change of the prevalence and the clinical status of pulmonary tuberculosis for recent 10 years at one women's university. Method: We retrospectively investigated the epidemiology and the clinical status of 612 patients who were registered at the Ewha Womans University Health Center by analyzing records from 1983 to 1992. Results: 1) The prevalence rate had been steadily decreased from 0.63% in 1983 to 0.11 % in 1992. The prevalence of freshman and the incidence rate according to the entrance year while in the university significantly decreased since 1989. 2) In classifying by registered source, 45.6% of students were detected by annual periodical health examination, 34.5% by entrance physical examination, 12.0% by hospital, 5.4% by health center clinic, 2.5% by reentrance physical examination, sequentially. 3) The students with past history of tuberculosis were 70(11.4%) and 61(10%) suffered from pulmonary tuberculosis. The patients with family history of tuberculosis were 142(23.3%). 4) There were 530(86.6%) with minimal disease, 79(12.9%) with moderate and only 3(0.5%) with far advanced, when classified by the severity of disease. 5) The initial symptoms were mild breathing difficulty in 30.1%, sweating in 14.9%, fatigue in 14.3%, febrile sense in 11.7%, hemoptysis in 8.2%, sequentially. 6) The duration of treatment was $10.6{\pm}3.6$ months in mild group, $14.9{\pm}5.2$ months in the moderate group(P<0.05). 7) The side reactions of the drug were GI trouble in 7.2%, hepatitis in 1.8%, skin rash in 0.8% and streptomycin side in used patients in 9.1%. Conclusion: The prevalence of pulmonary tuberculosis among the students in one women's university was significantly lower than that of university students and 20-24 year-old age group announced in tuberculosis survey on a national scale, and significantly decreased since 1989. The treatment effect was desirable in student's group managed by university health center.

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Monitoring of Pulmonary Tuberculosis by Polymerase Chain Reaction After Antituberculous Treatment (항결핵제 투여후 중합효소연쇄반응으로 추적한 폐결핵 환자들의 치료반응 관찰)

  • Jeon, Chang-Ho;Suh, Hun-Suk;Lee, Sang-Chae;Hyun, Dae-Sung;Ahn, Wook-Su
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.935-941
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    • 1998
  • Background: As living and dead Mycobacteria could be amplified by polymerase chain reaction(PCR), it was considered that PCR was inappropriate for the monitoring of pulmonary tuberculosis after treatment. But we found negative conversion of PCR after successful treatment. We would like to know about the negative conversion rate of PCR and its conversion time after antituberculous treatment. Methods: We collected 113 sputums from the 16 patients of pulmonary tuberculsosis visiting Catholic University Hospital of Taegu Hyosung. We consecutively tested AFB smear, AFB culture and PCR by 2 to 4 weeks after antituberculous therapy. The patients were classified according to the chest X ray findings. Results: We detected negative conversion of PCR from all 16 patients of the pulmonary tuberculosis within 30 weeks after treatment. The average negative conversion time was $16{\pm}8$ weeks. The conversion time according to the chest X -ray findings were as follows : For the 8 cases of minimum were $9{\pm}5$ weeks, 4 cases of modreate advanced were $20{\pm}8$ weeks, and 4 cases of far advanced were $23{\pm}2$ weeks. The product of PCR was gradually decreased according to the duration of treatment. Conclusions: From the results of our study, we could utilize M. tubercuosis PCR for the prediction of therapy response and monitoring of the patient with pulmonary tuberculosis after treatment.

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The Clinical Study of Hemoptysis in Lung Disease (객혈을 주소로 입원한 환자의 임상적 고찰)

  • Lee, Hyang-Ju;Um, Hye-Suk;Kim, Jung-Tae;Cho, Dong-Ill;Rhu, Nam-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.760-773
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    • 2000
  • Background : Hemoptysis is a common clinical symptom responsible for 11% of admission to the hospital chest service. In KOREA pulmonary tuberculosis is still the most common cause of hemoptysis and the incidence of hemoptysis due to neoplasia has increased. Bronchoscopy and high resonance CT are essential for diagnosis of the cause of hemoptysis. We studied the causes, diagnostic tools and treament treatment of hemoptysis Methods : We conducted a retrospective analysis of clinical profiles, radiologic and bronchoscopy findings and treatments of hemoptysis for 220 patients who were admitted to our hospital with hemoptysis between 1994 and 1998. Results : The mean age at diagnosis was 49.3 years and male to female ratio was 2.1 : 1. The main causes were active pulmonary pulmonary tuberculosis in 72 cases(32.7%), inactive pulmonary tuberculosis with sequlae in 69 cases(31.4%) lung cancer in 43 cases(19.5%), bronchiectasis in 10 cases(4.5%), and chronic bronchitis in 10 cases(4.5%). The mean amount of hemoptysis for 24hrs was 120cc. The mean duration of bleeding was 25 days. The number of cases with a past history of pulmonary tuberculosis were 128 cases, in which 24 were relapsed tuberculosis cases, 25 chronic tuberculosis cases, 69 inactive tuberculosis cases, and 10 lung cancer cases. High resonance CT was the most useful method for structural etiologic evaluation of hemoptysis developed in patients with inactive tuberculosis, bronchiectasis and aspergilloma. Sputum study and bronchofiberscopy were the confirmative diagnostic tools for active pulmonary tuberculosis and lung cancer. The treatments of hemoptysis medical in 152 cases(71.7%), bronchial arteη embolization in 39 cases(17.8%), and operation in 9 cases(4.0%). The mean following up duration was 22.4 months. The overall outcomes of hemoptysis were controlled in 77 cases(43.5%), rebleeding in 100 cases (56.5%) and expired in 9 cases (4.0%). The outcomes of hemoptysis in pulmonary tuberculosis were controlled in 21.6%, rebleeding in 78.4%, and expire in 14.7%. Conculsion : The most common cause of hemoptysis was related with pulmonary tuberculosis. HRCT was an important diagnostic tool in AFB smear negative active pulmonary tuberculosis and inactive tuberculosis with sequelae. Early, proper management of pulmonary tuberculosis is important for prevention of hemoptysis in Korea.

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Development of Questionnaire Measuring Quality of Life in Pneumoconioses (진폐증 환자의 삶의 질 설문지 개발)

  • Baak, Young-Mann;Ahn, Byoung-Yong;Mun, Je-Hyeok;Jeong, Jin-Sook;Kim, Ji-Hong;Kim, Kyoung-Ah;Lim, Young
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.1
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    • pp.54-66
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    • 2000
  • Background: Pneumoconiosis, like other chronic respiratory diseases, is essentially incurable and, for many, progressive. While improved survival time is an important aim of treatment, there is growing recognition that for some people, improving the quality of life is more important than extending the length of life. Currently the measurement of the quality of life is used to assess the efficacy of therapeutic agents. Methods: Sixty-three pnemoconiotics who were admitted to St. Mary's Hospital between April and August 1999 were interviewed using COOP charts, Chronic Respiratory Questionnaire(CRQ) and Pneumoconiotic Respiratory Questionnaire(PRQ), a newly developed questionnaire concerning clinical and socioeconomic features of pneumoconiotics. Also, ILO classification of the chest film, pulmonary function test, and arterial blood gas analysis of the patients were evaluated. The scores between Industrial Accident Compensation Insurance(IACI) covered and uncovered patients and between clinically stable and unstable patients were compared. Results: Domains of CRQ and PRQ showed a high internal consistency reliability($\alpha$=0.86-0.89, 0.77-0.81) except the dyspnea domain($\alpha$=0.63) of CRQ. The scores on the CRQ and PRQ showed statistically significant correlations with the results of COOP charts, pulmonary function test and arterial blood gas analysis. The dyspnea domain and social activity domain of the PRQ showed significant difference between IACI covered and uncovered patients and between clinically stable and unstable patients. Conclusion : Korean translation of the Chronic Respiratory Questionnaire and the newly developed Pneumoconiotic Respiratory Questionnaire are reliable and valid methods and are likely to be useful in measuring the quality of life in patients with the chronic respiratory disease including pneumoconiosis.

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Recovery Rate and Characteristics of Nontuberculous Mycobacterial Isolates in a University Hospital in Korea (한 대학병원에서 비결핵항산균의 분리 및 동정 실태)

  • Lee, Jung Yeon;Choi, Hee Jin;Lee, Hyeyoung;Joung, Eun Young;Huh, Jin Won;Oh, Yeon-Mok;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.385-391
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    • 2005
  • Background : The incidence of nontuberculous mycobacterium (NTM) infections in Korea is increasing. This retrospective study was performed to examine the recovery rate of NTM from respiratory specimens as well as the isolated NTM colony characteristics, and to assess the clinical significance of a NTM isolation. Methods : The results of the respiratory specimens requested for an acid-fast bacilli (AFB) examination during 2002 at Asan Medical Center, along with the patients clinical characteristics were analyzed. Results : A total 26,820 respiratory specimens were requested for the acid-fast bacilli (AFB) smear and culture during the study period. The proportion of M. tuberculosis and NTM isolation was 5.7% and 2.2%, respectively. Among the AFB smear and culture positive specimens, 12.2% were found to be NTM. The scotochromogen showing a low colony count < 20, which appeared to be contaminants, were isolated in 31.8% of the 584 NTM isolates. Excluding the low-colony scotochromogens, the M. avium-intracellulare complex was the most common NTM isolates (42.1%), and was also the most common causative organism for NTM pulmonary diseases. 8.4% (23/275) and 17.8% (49/275) of patients with NTM isolates met the American and British Thoracic Society diagnostic criteria for NTM pulmonary disease, respectively. Conclusion : In case of a positive AFB-smear or culture result, the possibility of NTM being a causative organism should always be considered, even in Korea, which has an intermediate incidence of tuberculosis.

THE CHANGES IN PRACTICE PATTERNS FOR THE LAST 8 YEARS (2001-2008) IN THE DEPARTMENT OF PEDIATRIC DENTISTRY, SEOUL NATIONAL UNIVERSITY DENTAL HOSPITAL (최근 8년간(2001-2008) 서울대학교치과병원 소아치과의 진료현황 및 수익분포 변화에 대한 조사)

  • Son, Yu-Jin;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.97-101
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    • 2010
  • The practice pattern of pediatric dentistry in the university dental hospital has been changing for the last several decades, due to socioeconomic changes, developments in dental materials and increasing number of private pediatric dental clinics. The purpose of this study is to survey the changing patterns of pediatric dental treatment in the university dental hospital and to present the future direction for pediatric dentistry. Patient distribution and practice trends were reviewed based on the OCS (order communication system) records of the department of pediatric dentistry, Seoul National University Dental Hospital from 2001 to 2008. Results were as follows; 1. The number of patients increased up to 2005 and decreased in 2006, and has remained constant up to 2008. 2. The proportion of preventive and orthodontic treatment increased and the proportion of restorative and pulpal treatment decreased. 3. In restorative treatment, amalgam restoration decreased and resin restoration increased. 4. Frequency of sedation decreased in 2006, 2007 and increased in 2008. 5. Frequency of general anesthesia increased up to 2008.

A Prediction Model for the Radiation Safety Management Behavior of Medical Cyclotrons (의료용 Cyclotron의 방사선안전관리 행위 예측모형)

  • Jung, Ji-Hye;Han, Eun-Ok;Kim, Ssang-Tae
    • Journal of Radiation Protection and Research
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    • v.33 no.2
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    • pp.77-86
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    • 2008
  • This study attempted to provide reference materials for improving the behavior level in radiation safety managements by drawing a prediction model that affects the radiation safety management behavior because the radiation safety management of medical Cyclotrons, which can be used to produce radioisotopes, is an important factor that protects radiation caused diseases not only for radiological operators but average users. In addition, this study obtained follows results through the investigation applied from January 2 to January 30, 2008 for the radiation safety managers employed in 24 authorized organizations, which have already installed Cyclotrons, through applying a specific form of questionnaire in which the validity was guaranteed by reference study, site investigation, and focus discussion by related experts. The radiation safety management were configured as seven steps: Step 1 is a production preparation step, Step 2 is an RI production step, Step 3 is a synthesis step, Step 4 is a distribution step, Step 5 is a quality control step, Step 6 is a carriage container packing step, and Step 7 is a transportation step. it was recognized that the distribution step was the most exposed as 15 subjects (62.5%), the items of 'the sanction and permission related works' and 'the guarantee of installation facilities and production equipments' were the most difficult as 9 subjects (37.5%), and In the trouble steps in such exposure, the item of 'the synthesis and distribution' steps were 4 times, respectively (30.8%). In the score of the behavior level in radiation safety managements, the minimum and maximum scores were 2.42 and 4.00, respectively, and the average score was $3.46{\pm}0.47$ out of 4. Prosperity and well-being programs in the behavior and job in radiation safety managements (r=0.529) represented a significant correlation statistically. In the drawing of a prediction model based on the factors that affected the behavior in radiation safety managements, general characteristics, organization characteristics, and selfefficacy didn't show a significant path statistically in which the prosperity and well-being programs in job characteristics affected the behavior in radiation safety managements. Therefore, it is necessary to establish a strategy that improves the level of prosperity and well-being levels in job characteristics in order to increase the behavior in radiation safety managements. Thus, this study provides basic materials for the radiation safety management of Cyclotron through the full-scale investigation that is first applied in Korea.

A Study on The Records of [The Book of Supernumerary Embryo Preservation] and [The Book of Supernumerary Embryo Donation] Enacted by "The Law on Bioethics and Safety" ("생명윤리 및 안전에 관한 법률"이 정해준 [잔여배아보관실적대장]과 [잔여배아제공실적대장]의 작성에 관한 연구)

  • Yoon, San-Hyun;Ko, Yong;Lim, Jin-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.4
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    • pp.253-273
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    • 2007
  • Objective: This study was to find ways to let a manager or superintendent rationally and consistently inspect as well as let a embryologist precisely record [The Book of Supernumerary Embryo Preservation] and [The Book of Supernumerary Embryo Donation]. Methods: Based on the data collected between 1994 and 2004 in Clinic 44 (Maria Fertility Hospital), [The Present State about Production and Use of Embryos], [The Preservation of Supernumerary Embryos and Their Thaw State], [The Present State about Thaw and Use of Frozen Embryos], [The Present State about Donation and Charge of Frozen Embryos], [The Book about Frozen Embryo Discard], and [The Summarization Book about Management and Use of Frozen Embryos] were designed and recorded. Results: The production, use, preservation, discard and donation quantity of human embryos, the use and discard quantity of thawed embryos, and the cumulative embryo preservation quantity could be totalized in [The Present State about Production and Use of Embryos in Clinic 44]. Also, [The Preservation of Supernumerary Embryos and Their Thaw State in Clinic 44] supported "the supernumerary embryo preservation quantity" etc. In addition, [The Present State about Thaw and Use of Frozen Embryos in Clinic 44] or [The Book about Frozen Embryo Discard in Clinic 44] supported "the use and discard quantity of thawed embryos" etc. Moreover, "The embryo donation quantity" could be totalized in [The Present State about Donation and Charge of Frozen Embryos in Clinic 44]. Finally, [The Summarization Book about Management and Use of Frozen Embryos in Clinic 44] could be used for rational and consistent management or inspection. Conclusion: The present results suggest that the documents not only be standard data to record [The Book about Supernumerary Embryo Preservation in Clinic] and [The Book about Supernumerary Embryo Donation in Clinic] but can also be preserved as treatment references.

Thyroglossal Duct Cyst and Fistula (갑상설관 낭포 및 루)

  • 최종욱;김한상;안문성;김춘길;주양자
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.10-10
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    • 1981
  • The thyroglossal duct cyst is relatively rare disease that derived congenitally from the remnant of thyroglossal duct and that was found anywhere from the foramen cecum to pyramidal lobe of thyroid. We studied the 62 cases of above disease who admitted and operated at E.N.T. dept. of N.M.C. for 20 years since 1961 to 1980 on the clinical and histopathological aspect, and we concluded following results. 1. In the age distribution, 45 cases(72.6%) were under 20 years, and in the age distribution of the known on-set of symptoms, 26 cases(58.0%) were under 10 years. In the duration, 23 cases(37.0%) were under 1 year. The sex ratio of male to female revealed 1.2:1. 2. The palpable mass were complained at 48 cases(77.4%) and 14 cases(22.6%) complained of the discharge from sinus tracts and the other complaints were dysphagia and odynophagia, etc. 3. In location 55 cases (88.7%) were at midline, 1 case(1.6%) was at right and 6 cases(9.7%) were left sided. And 47 cases(75.8%) were situated at infrahyoid region, 11 cases(17.7%) at suprahyoid, 3 cases(4.8%) at suprasternal, only 1 case(1.6%) at intralingual region. 4. In 27 cases formed fistulae, spontaneous occurrance were 7 cases and artificial occurrance were 20 cases. 5. In histopathologically among 41 cases preserving available slides, 5 cases(12.2%) had single duct and 20 cases(48.8%) had multiple accessory ducts, but 16 cases were impossible to detect the ducts. The lining epithelium composed of chiefly respiratory and squamous epithelium. 15 cases had inflammatory reaction at periductal area and 7 cases had around the cysts. The ectopic thyroid tissue was found on 6 cases(14.6%) and 1 case had the follicular adenoma. 6. In the recurrance rate among 43 cases performed sistrunk type operation, 2 cases (4.6%) recurred, and among 19 cases performed simple removal of cysts, 4 cases (21.1%) recurred.

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