• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.534-539
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• 2020

The management of severe scoliosis remains a challenge to spine surgeons. The rapid intraoperative correction of severe scoliosis may increase the risk of perioperative complications, such as neurological compromise and implant failure. To minimize these risks, various preoperative traction methods have been employed to achieve partial correction before performing definitive corrective surgery. On the other hand, some studies have shown that one of the complications associated with halo traction could lead to cranial nerve palsy, with the sixth nerve (abducens nerve) being most commonly affected. To reduce the complications, gradual increases in the traction weight and detailed neurological examinations are needed, particularly for patients who have previously undergone brain or cervical surgery. The authors report a case of sixth cranial nerve palsy by preoperative halo-pelvic traction in patients with severe scoliosis who underwent previous decompression surgery for a Chiari I malformation with a review of the relevant literature.

• 한국노년학
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• v.29 no.1
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• pp.37-50
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• 2009

The purpose of the present study was to develop a community-based intensive health care program for the community dwelling elderly to strength their functional status and to verify the effect on their geriatric syndrome. A one-group pretest-posttest design was used for the study. A total of 69 frail elderly, who lived in the area within 20 minutes by car, were committed themselves to the day care center(Sangikjae), and had the ability of verbal communication were selected from G city in Kyunggi province. The participants completed a set of questionnaires to measure the sub-score of frailty, fall, urinary incontinence, malnutrition, and mild cognitive disorder domain, using the Otasha-Kensin through the physical examinations and interviews. After 4 weeks of intervention, the outcome was measured to evaluate the effects of the program, and the data obtained were analyzed using descriptive statistics, paired t-test and McNemar test. The results showed that the sub-score of frailty, fall, urinary incontinence, and malnutrition domain were statistically significantly decreased after intervention except those of urinary incontinence and mild cognitive disorder domain, implying that the risk of frailty, fall, and malnutrition was decreased. These findings indicated that community-based the intensive health care program is effective for relieving geriatric syndrome of the community dwelling elderly.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1298-1311
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• 2022

Purpose To develop and validate a deep learning-based screening tool for the early diagnosis of scoliosis using chest radiographs with a semi-supervised generative adversarial network (GAN). Materials and Methods Using a semi-supervised learning framework with a GAN, a screening tool for diagnosing scoliosis was developed and validated through the chest PA radiographs of patients at two different tertiary hospitals. Our proposed method used training GAN with mild to severe scoliosis only in a semi-supervised manner, as an upstream task to learn scoliosis representations and a downstream task to perform simple classification for differentiating between normal and scoliosis states sensitively. Results The area under the receiver operating characteristic curve, negative predictive value (NPV), positive predictive value, sensitivity, and specificity were 0.856, 0.950, 0.579, 0.985, and 0.285, respectively. Conclusion Our deep learning-based artificial intelligence software in a semi-supervised manner achieved excellent performance in diagnosing scoliosis using the chest PA radiographs of young individuals; thus, it could be used as a screening tool with high NPV and sensitivity and reduce the burden on radiologists for diagnosing scoliosis through health screening chest radiographs.

• Journal of the Korean Society of Radiology
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• v.81 no.2
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• pp.324-336
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• 2020

Cardiovascular calcifications can occur in various cardiovascular diseases and can serve as a biomarker for cardiovascular event prediction. Advances in CT have enabled evaluation of calcifications in cardiovascular structures not only on ECG-gated CT but also on non-ECG-gated CT. Therefore, many studies have been conducted on the clinical relevance of cardiovascular calcifications in patients. In this study, we divided cardiovascular calcifications into three classes, i.e., coronary artery, thoracic aorta, and cardiac valve calcifications, which are closely associated with cardiovascular events. Further, we briefly described pericardial calcifications, which can be found incidentally. Since the start of lung cancer screening in Korea in the second half of 2019, the number of non-enhanced, non-ECG-gated, low-dose chest CT has been increasing, and the number of incidentally found cardiovascular calcifications has also been increasing. Therefore, understanding the relevance of cardiovascular calcifications on non-enhanced, non-ECG-gated, low-dose chest CT and their proper reporting are important for radiologists.

• Clinical and Experimental Pediatrics
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• v.50 no.1
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• pp.20-27
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• 2007

Purpose : Child sexual abuse is a significant and serious problem that affects public health and society. Pediatricians are responsible for preventing and detecting sexual abuse of children. The aim of this study was to examine clinical findings of child sexual abuse. Methods : The authors retrospectively studied 292 patients between the ages of 0 and 18 who were referred for evaluation of sexual abuse to the Emergency Department of the National Police Hospital from Oct 1, 2001 to May 5, 2005. Results : Sixty three (21.6 percent) of sexual abuse victims were younger than 6 years of age; 89 (30.5 percent) were 6-12 years of age; and 104 (47.9 percent) were 12-18 years of age. Attack time was the most common between noon and 6 pm. Victims were attacked in their home or nearby (51.4 percent). One hundred fifty six (53.6 percent) offenders were accquaitances, thirty nine (13.4 percent) of whom were family members. The disclosure of attack by parents with abnormal physical symptoms was more common in younger children than in adolescence. Eighty nine (30.5 percent) victims had no specific physical findings, 51 percent had injury to the hymen, 37.3% had injury to external genitalia, and 4 percent had anal injury. One case of gonorrhea and thirteen cases of chlamydia were found. Sperm was found in 19 cases and acid phosphatase was positive in 28 cases. The absence of physical findings and laboratory findings was more common in younger children than in those in adolescence. The time interval from attacks to hospital visits had a significant negative correlation with age. Conclusion : For younger victims, the time interval from attack to hospital visitis was more prolonged. Victims may have no physical evidence of sexual abuse. Therefore, a careful history should be obtained and a through physical examination should be performed. Pediatricians must play a leading role in evaluation and treatment of sexually abused children, considering children,s growth and development. Coordination with other professionals is necessary to provide consultation, medical treatment, and legal assistance for the sexually abused children and families.

• Journal of Preventive Medicine and Public Health
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• v.26 no.4 s.44
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• pp.628-649
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• 1993

This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile (poor performers) and 97 children whose school performance were within high 5 percentile (good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry (body weight, height, head circumference), intelligence (Kodae Stanford-Binet test), test anxiety (TAI-K), neurologic examination by a developmental pediatrician and heavy metal content (Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and prenatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic & language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder (ADHD), poor physical growth (weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order (odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD (odds ratio=9.67), I.Q. score (odds ratio=0.85) and height less than Korean standard mean-1S.D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(P<0.05) and zinc was positively correlated with grade (P<0.05). among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.149-158
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• 2003

Objectives: The authors studied the anxiety, depression and psychological characteristics of medical out-patients, which are diagnosed as peptic ulcer disorder and essential hypertension. We also examined the state of psychiatric consultation. Methods: The subjects were composed of 56 patients with peptic ulcer disorder, 44 patients with essential hypertension and 116 controls. STAI, BDI and SCL-90R was administered to all subjects. Chart review, telephone interview and Self report questionnaire of etiology and severity of illness, drug compliance and so forth were performed in disease groups. Results: Considerable depression was noticed in 39.3% among the patients with peptic ulcer disorder, 27.7% in hypertension and 12.1% in control group by BDI. State anxiety was noticed in 44.6% among the patients with peptic ulcer disorder, 54.5% in hypertension and 18.1% in control group by State anxiety. Trait anxiety was noticed in 42.9% among the patients with peptic ulcer disorder, 34.1% in hypertension and 25.8% in control group by Trait anxiety. The higher SOM, BDI, STAI, the lower drug compliance and rapport. Psychological problems are considered of the most important etiology in 48.2% of peptic ulcer group and 45.7% of hypertensive group. But psychiatric consultation is made only in 1.8% of peptic ulcer group and 2.3% of hypertensive group. Conclusions: Anxiety and depression are common phenomena in medical outpatients. In comparison with the normal control group, peptic ulcer group showed significantly higher trait anxiety and depression and hypertensive group higher state anxiety. These characteristics are related to the drug compliance and doctor-patient relationship. These results suggested the needs of active psychiatric consultation.

• Korean Journal of Occupational Health Nursing
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• v.2
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• pp.26-39
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• 1992

본 연구는 보건관리대행기관에 근무하는 산업간호사들의 보건관리업무실태 및 근무만족도와 이들간의 관계를 파악함으로써, 산업간호업무향상 및 효율적인 산업보건관리를 위한 기초자료로 제시하고자 시도되었다. 조사대상은 38개 보건관리대행기관중 24개 기관에 근무하는 산업간호사 118명중 97명을 대상으로 하였다. 연구기간은 '92년 5월부터 6월까지 설문조사를 실시하였으며 그중 89명이 설문에 응답하여 이를 분석 대상으로 하였다. 연구결과는 다음과 같다. 첫째, 보건관리대행기관의 간호사는 산업간호사의 일반적 특성과 비교해볼 때 기존 산업간호사와 유사하였다. 그러나 법정휴가를 받는다는 간호사가 59.1%로 더 낮았다. 둘째, 보건관리대행기관 산업간호사의 담당사업장수는 법적으로 30개 사업장, 2,000명의 근로자를 담당하도록 되어있는데 조사결과 법적기준인 보건관리사업장의 수를 담당하는 간호사는 57.1%를 차지하였고, 담당 근로자 수로 볼때는 2,000명이하가 29.8%를 차지하여 많은 산업간호사가 법적인 기준을 초과하여 산업보건관리를 대행하고 있는 것으로 나타났다. 셋째, 보건관리대행의 방문방법으로 교통편은 대행 기관차량을 이용하며, 간호사 혼자 산업장을 방문하는 것이 대부분으로 나타났고, 방문횟수는 100인미만이 월1회, 100인이상이 월2회로 규정된 것과 비교해보면 규정을 따르는 곳이 100인 미만의 경우 97.4%, 100인이상의 경우 86.4%였다. 또한 의사나 위생사는 방문을 안하거나 년1-5회 방문하는 것으로 나타나 보건관리대행의 주제공자는 간호사인 것으로 냐타났다. 또한 사업장 방문시 업무수행장소는 휴게실이나 사무실이 87.5%, 현장이나 수위실에서 하는 곳이 70.5%나 되어 뚜렷이 업무를 수행할 장소가 마련되지 않은 실정을 나타냈다. 네째, 보건관리대행에 근무하는 산업간호사의 애로사항은 사업장내에서는 조직과 체계상의 문제, 간호사 역할에 대한 인식부족, 권한과 자율성 부족 등을 들었고, 사업장 방문시에는 사업주와 근로자의 인식부족이 우선적으로 지적되었다. 또한 산업간호사는 보건관리 대행업무에서 사업장의 참여유도, 사업장 순회점검 및 개선지도, 보건교육, 건강상담이 우선적으로 실시되어야 한다고 하였다. 다섯째, 보건관리대행기관 산업간호사의 업무수행정도는 건강검진이나 직업병관리, 보건교육, 환경위생관리업무를 비교적 많이 실시하는 것으로 나타났다. 여섯째, 보건관리대행기관 산업간호사의 직무만족도는 전문적 위치나 상호작용, 업무요구등은 높게 나타났으나 보수와 산업보건관계자와의 관계등은 만족도가 낮게 나타났다. 또한 직무만족도에 대한 총화점수는 사업장근무자가 240점중 143.8인데 비해 보건관리대행기관 근무자는 230점중 129.61점으로 더 낮게 나타났다. 일곱째, 일반적 특성별 보건관리대행 산업간호사의 직무수행정도는 연령별 30세이상군이, 결혼상태별로 기혼군이, 경력은 1년이상인 군이, 근무시간 8시간인군이, 급여수준은 50만원이상인군이, 법정휴가가 있는 군이, 자질향상교육을 받은군이 담당사업장수가 30개이하인 군이, 더 높게 나타났다. 또한 연령군이 20-24군과 30세이상인군 (p<0.05), 결혼상태별로 기혼군과 미혼군(p<0.01), 급여수준별로 50만원미만군과 이상인 군(p<0.05), 법정휴가가 있는 군과 없는군(p<0.05), 자질향상 교육을 받은군과 받지못한 군(p<0.01), 담당사업장수가 30이하인 군과 31인이상인 군(p<0.05) 간에 유의한 차이를 보였다. 즉 산업간호사중 나이가 많고, 기혼이며 급여수준이 높고 법정휴가와 교육을 받고, 담당사업장수가 30이하인 군이 보건관리대행업무를 잘 수행하는 것으로 나타났다. 여덟째, 일반적 특성별 보건관리대행 산업간호사의 직무만족도는 연령별 30세이상군이, 결혼상태별로 기혼군이 경력은 1년이상인 군이, 근무시간 8시간인군이, 급여수준은 50만원이상군이, 법정휴가가있는군이, 자질향상교육을 받은군이, 담당사업장수가 30개이하인 군이 더 높게 나타났다. 또한 결혼상태별로 기혼군과 미혼군(p<0.01), 근무시간별로 8시간군과 9시간 이상인 군(p<0.01), 급여수준별 50만원 미만군과 이상군(p<0.05), 자질향상교육을 받은군과 받지 않은군(p<0.05) 사이에 유의한 차이를 보였다. 즉 산업간호사중 기혼이고 근무시간은 8시간이며 급여수준이 높고 자질향상교육을 받은 군이 만족도가 높은 것으로 나타났다. 아홉째, 보건관리대행기관 산업간호사의 업무수행정도와 직무만족도 사이의 상관관계를 보면 보수, 자율성, 업무요구가 높을수록 산업간호업무를 수행을 잘하는 것으로 나타났으며(상관관계 r>0.6, P>0.001), 전체적으로 총직무만족도와 업무수행정도와의 상관관계는 6346, P<0.001로서 만족도가 높을수록 업무수행정도가 높은 것으로 나타났다. 이상의 결과를 토대로하여 보면, 보건관리대행기관에 근무하는 산업간호사는 그 특성을 고려하여 업무도 사업장 근무자와 다르게 규정되어야 하며, 담당업무의 명확한 한계를 정해 중소규모사업장의 산업보건관리업무를 책임있게 수행할 수 있도록 뒷받침이 필요하다. 더불어, 직무만족도를 높일수 있도록, 산업간호사에 대한 다방면의 지원이 필요하다고 하겠다. 또한 보건관리대행기관 산업간호사는 나이가 많고 기혼이며 경력있는 간호사를 채용하고 근로조건을 잘 개선하면 직무수행정도가 더 높아질 것으로 보인다. 좋은 근로조건의 형성과 직무만족도 등을 높여 산업간호사의 직무를 효율적으로 수행할 수 있도록 하기 위하여는 보건관리대행기관에 관한 규정이 강화 보완되어야 하겠으며, 민간단체와 의료기관 뿐아니라 공공기관에서도 중소규모사업장의 보건관리업무를 담당하는 방향으로 전환하는 방안을 모색해 보아야 할 것이다.

• Journal of Preventive Medicine and Public Health
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• v.19 no.1 s.19
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• pp.85-90
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• 1986

This study was conducted in July-August, 1984, to define the causes of chronic gastrointestinal symptoms in rural population and to provide data for the management of such patients. A household survey was conducted to identify all the residents of Youngchun and Sungiu counties in Kyungpook province who were over 20 years of age, had chronic upper gastrointestinal symptoms for over the last 6 months, never had medical examination for the symptoms, and volunteered to participate in the gastroscopic examination. Gastroscopy was done for 106 males and 108 females. Gastric ulcer was found in 16.8% of all the examinees, duodenal ulcer in 15.4%, gastritis in 14.0%, and gastric cancer in 3.7%. No lesion was found by gastroscopy in 52.3%. Gastric ulcer more common in male(26.4%) than in female(7.4%) (p<0.01) and the same was true for duodenal ulcer(20.8% of male, 10.2% of female). Gastric cancer was found in 7.5% of the male while none of the female had gastric cancer. A higher proportion of the female (68.5%) showed normal finding in the gastroscopy than the male(35.9%) (p<0.01). No significant association was found between the upper gastrointestinal symptoms and the gastroscopic findings. The higher prevalence rate of gastric ulcer than that of duodenal ulcer in this study which is the reverse of the study findings of urban area in Korea and western countries may be related in part with the dietary habit and social environment of the rural population. Although early diagnosis is the most important for the treatment of gastric cancer, many of the people with chronic upper gastrointestinal complaints defer the diagnosis and treatment. It is may be due to lack of the knowledge of diseases and the health care attitude of the rural people. A national program for the health education and mass screening for the gastric cancer should be developed.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.345-354
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• 2001

The purpose of this study was to make public oral health plan more effective and the improvement of the hospital management system for better clinical dental practice. Distribution and trends were examined in all patients who had been examined and diagnosed at Department of Pedodontics, Dental Hospital, Chosun University over 10 year-period from 1990 to 1999 Results were as follows, 1. The number of patients per year was increasing trend after 1996 and higher visiting rate in male(55.9%) than in female(44.1%). 2. Age distribution had shown $3\sim4$ year-old cup being the largest (23.4%) and each percentage of $5\sim6,\;7\sim8,\;0\sim2,\;9\sim10,\;11\sim12,\;13\sim14,\;above\sim15$ year-old group was 19.9%, 17.7%, 14.6%, 12.6%, 8.0%, 3.3%. 0.5%. 3. Geographic distribution showed a majority of patients in Kwang-Ju (83.0%). Group in the suburbs of Kwang-Ju(Jang-Sung group) was 5.4%. 4. Dental caries showed the highest percentage(40.5%) in chief complaints and percentage of oral exam, orthodontic problem, oral pain, trauma, supernumerary teeth, swelling was 13.9% 12.6%, 8.8%, 7.4%, 5.5%, 4.9%. 5. In all patients with traumatic problem, crown fracture showed the highest percentage(41.4%) and percentage of subluxation was 19.4%. 6. Majority(78.7%) of patients were not refered, and percentage of patients refered from local clinic was 20.5%. 7. Patients who had periodic check-up comprised 19.6%, and percentage of after 3, 6, 9, 12, 18, 24month was 36.7%, 22.2%, 13.5%, 11.3%, 5.4%, 11.0%.