• 지역사회간호학회지
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• 제33권3호
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• pp.299-311
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• 2022

Purpose: Untreated depression in adolescents affects their entire life. It is important to detect and intervene early depression in adolescence considering the characteristics of adolescent's depressive symptoms accompanied by internalization and externalization. The aim of this study was to identify latent classes of depressive symptom trajectories of adolescents and determinants of classes in Korea. Methods: The three time-point (2018~2020) data derived from the Korean Children and Youth Panel Survey 2018 were used (N=2,325). Latent Growth Curve Modeling (LGCM) was conducted to explore the depressive symptom trajectories in all adolescents, and Latent Class Growth Modeling (LCGM) was conducted to identify each latent class. Multinomial logistic regression analysis was performed to confirm the determinants of each latent class. Results: The LGCM results showed that there was no statistically significant change in all adolescents' depressive symptoms for 3 years. However, the LCGM results showed that four latent classes showing different trajectories were distinguished: 1) Low-stable (intercept=14.39, non-significant slope), 2) moderate-increasing (intercept=19.62, significantly increasing slope), 3) high-stable (intercept=26.30, non-significant slope), and 4) high-rapidly decreasing (intercept=26.34, significantly rapidly decreasing slope). The multinomial logistic regression analysis showed that the significant determinants (i.e., gender, self-esteem, aggression, somatization, peer relationship) of each latent class were different. Conclusion: When screening adolescent's depression, it is necessary to monitor not only direct depression symptoms but also self-esteem, aggression, somatization symptoms, and peer relationships. The findings of this study may be valuable for nurses and policy makers to develop mental health programs for adolescents.

• 지역사회간호학회지
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• 제33권4호
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• pp.396-407
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• 2022

Purpose: The purpose of this study was to assess insomnia and the quality of sleep, investigate the concordance between objective and self-report sleep patterns, and identify physiological, psychological, and situational factors influencing insomnia and sleep quality among firefighters. Methods: A descriptive, cross-sectional study was conducted with 103 firefighters in Korea. The collected data were analyzed using SPSS 23.0. Descriptive statistics, the independent t-test, and hierarchical logistic regression analysis were performed. Results: Insomnia was found in 66 (64.1 %) of the total subjects, and the average quality of sleep (PSQI) was 5.65 (SD=2.57). Total sleep time (401.00 minutes) and sleep latency (21.60 minutes) measured using self-reported scales were longer than the ones measured using objective measurements by approximately 48.70 and 17.10 minutes, respectively. Factors related to insomnia included the role as a paramedic (OR=4.28, 95% CI: 1.02~17.92), anxiety (OR=1.12, 95% CI: 1.01~1.24), and sedentary lifestyle (OR=0.85, 95% CI: 0.78~0.94), and factors related to sleep quality were physical illness status (OR=5.17, 95% CI: 1.53~17.51) and social support (OR=0.86, 95% CI: 0.78~0.95). Conclusion: The results show a high prevalence of insomnia, poor quality of sleep and the discrepancy between objective and subjective sleep patterns among firefighters. To promote sleep quality and health, early screening and treatment of anxiety and physical illness are required. It is necessary to conduct further studies examining the relationship between physical activity level and sleep.

• 대한치과교정학회지
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• 제53권2호
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• pp.106-115
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• 2023

Objective: To evaluate the null hypothesis that there is no difference in a set of clinical predictors of potentially impacted canines between low-risk patients with and without displaced canines. Methods: The normal canine position group consisted of 30 patients with 60 normally erupting canines ranked in sector I (age, 9.30 ± 0.94 years). The displaced canine group comprised 30 patients with 41 potentially impacted canines ranked in sectors II to IV (age, 9.46 ± 0.78 years). Maxillary lateral incisor crown angulation, inclination, rotation, width, height, and shape, as well as palatal depth, arch length, width, and perimeter composed a set of clinical predictors, which were evaluated on digital dental casts. Statistical analyses consisted of group comparisons and variable correlations (p < 0.05). Results: There was a significant association between sex and mesially displaced canines. Unilateral canine displacement was more prevalent than bilateral displacement. The crown of the maxillary lateral incisors was significantly angulated more mesially and rotated mesiolabially in low-risk patients with displaced canines, who also had a shallower palate and shorter anterior dental arch length. Lateral incisor crown angulation and rotation, as well as palatal depth and arch length, were significantly correlated with the canine displacement severity. Conclusions: The null hypothesis was rejected. Maxillary lateral incisor angulation inconsistent with the "ugly duckling" stage as well as a shallow palate and short arch length are clinical predictors that can significantly contribute to the early screening of ectopic canines in low-risk patients.

• 대한치과교정학회지
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• 제53권2호
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• pp.116-124
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• 2023

Objective: The absence of a guideline to refer to developing malocclusions appropriately, may be a contributing factor to the inadequacy of timely interceptive orthodontics provision. This study aimed to develop and validate a new orthodontic grading and referral index to be used by dental frontliners to prioritize the orthodontic referral of developing malocclusion in children based on its severity. Methods: A cross-sectional study involving clinical assessment with 413 schoolchildren aged between 8.1 and 11.9 years was conducted in 2018. All the presenting malocclusion was listed and graded based on a few dental guidelines to produce the draft index. The validity and reliability of the draft index were tested using twenty study models. Face and content validation was carried out using the content validation index and Modified Kappa Statistics. Results: Fourteen dental and occlusal anomalies were identified as components of malocclusion and three grades of referral (monitor, standard, urgent) were included in the final index. The scale-level content validity index average value of 0.86 and 0.87 was obtained for content and face validation, respectively. There was moderate to excellent agreement in the Modified Kappa Statistics for both validations. Excellent inter- and intra-assessor agreement was obtained. The new index displayed valid and reliable scores. Conclusions: The Index for Interceptive Orthodontics Referral was developed and validated for the dental frontliners to identify and prioritize the developing malocclusion in children based on its severity and refer for orthodontic consultation to increase the possibility for interceptive orthodontics.

• 대한치과기공학회지
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• 제44권1호
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• pp.15-23
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• 2022

Purpose: The purpose of this study was to identify the experiences of depression, suicidal thoughts, and habitual drug use in middle and high school students and examine their relationship with the oral symptoms experiences. Methods: The participants of this study were 54,948 middle and high school students who took the screening and health survey at the 16th "Youth Health Behavior Survey" (2020). The SPSS statistical software (IBM SPSS 23.0 for Windows; IBM) was used for data analysis. The significance level was set to 0.05. Results: Complex-sample logistic regression analysis was performed to confirm the relationship between the experiences of depression, suicidal thoughts, and habitual drug use and oral symptom experienced. The results indicated that the absence of depression, suicidal thoughts, or habitual drugs had a significant effect on oral symptom experience. Conclusion: A systematic counseling program for early detection of oral symptoms and oral health promotion as well as strategies for practicing correct oral hygiene are required. Additionally, it is necessary to develop a customized education program to promote health education in middle and high school students. It can be used as the basis for an integrated support system that students can use to grow healthy. A differentiated program on the topic of mental health promotion for each grade can be planned and its effects can be monitored.

• Investigative Magnetic Resonance Imaging
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• 제26권1호
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• pp.32-42
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• 2022

Purpose: To evaluate the clinical benefit of 2D contrast-enhanced T2 fluid-attenuated inversion recovery (CE-T2 FLAIR) image for detecting leptomeningeal metastasis (LM) in the brain metastasis work-up for lung cancer. Materials and Methods: From June 2017 to July 2019, we collected all consecutive patients with lung cancer who underwent brain magnetic resonance image (MRI), including contrast-enhanced 3D fast spin echo T1 black-blood image (CE-T1WI) and CE-T2 FLAIR; we recruited clinico-radiologically suspected LM cases. Two independent readers analyzed the images for LM in three sessions: CE-T1WI, CE-T2 FLAIR, and their combination. Results: We recruited 526 patients with suspected lung cancer who underwent brain MRI; of these, we excluded 77 (insufficient image protocol, unclear pathology, different contrast media, poor image quality). Of the 449 patients, 34 were clinico-radiologically suspected to have LM; among them, 23 were diagnosed with true LM. The calculated detection performance of CE-T1WI, CE-T2 FLAIR, and combined analysis obtained from the 34 suspected LM were highest in the combined analysis (AUC: 0.80, 0.82, and 0.89, respectively). The inter-observer agreement was also the highest in the combined analysis (0.68, 0.72, and 0.86, respectively). In quantitative analyses, CNR of CE-T2 FLAIR was significantly higher than that of CE-T1WI (Wilcoxon signed rank test, P < 0.05). Conclusion: Adding CE-T2 FLAIR might provide better detection for LM in the brain-metastasis screening for lung cancer.

• 디자인융복합연구
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• 제17권2호
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• pp.235-244
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• 2018

국민건강관리공단에서 행하고 있는 건강검진은 질병의 초기발견과 예방에 목적을 둔다. 검진 이후에는 결과지를 받게 되는데 이는 의료진과 환자의 원활한 의사소통을 위한 수단이 된다. 지금까지 몇 차례 결과지에 대한 디자인 개선이 이루어졌다. 그러나 여전히 환자들의 낮은 이해도와 인지의 문제점이 지적되고 있다. 따라서 본 연구에서는 실제 사용자인 수검자와 의료진, 디자이너들의 의견을 조사하여 디자인을 개선하고 사용성도 편리한 검진결과표를 제안하고자 한다. 연구방법은 건강검진 결과서와 관련한 각종 정보디자인 연구에 대한 문헌고찰과 현재 건강검진 결과지에 대한 사용자 인터뷰로 사전 조사하여 문제점을 파악하고 기존의 결과지를 1차로 디자인을 개선하였다. 또한 기존의 건강검진결과지와 본 연구자가 개선한 검진결과지를 수검자와 의료진에게 검증을 실시하여 그 결과를 참조하여 최종적으로 디자인 하였다. 그 결과 기존의 결과지에서 지적되었던 문제점이 상당수 해소 되었다는 긍정적인 답변을 얻었다.

• 현장농수산연구지
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• 제19권1호
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• pp.153-163
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• 2017

This study is aimed at researching on psychopathological characteristics of agriculture-specialized college students, in a specific educational environment, consulting some students who show maladjusted characteristics, verifying its effects and providing basic data for college life instructions. The complete survey MMPI was conducted for 676 freshmen and juniors attending K agriculture-specialized college located in Jeollabuk-do. To analyze the results, basic statistics, bivariate correlation analysis, and multiple regression analysis were implemented. The results of this study are as follows; First, the level of overall clinical scale was lower than 50 points, standard point, and freshmen showed higher depression (D), hysteria (Hy) and psychasthenia (Pt) in general. Such results are different from the other study results. It is considered an anxiety in early stage, resulted from a living in a dormitory. For the juniors who came back from one-year practice, anxiety about employment seems little because they are already employed. Second, The effects of personal consultation for maladjusted students were proved (p<.01). The students who got consultation showed improvement effect from 'very bad condition' to 'considerable depression', which is low score. This study has a meaning in preventing from any accident, by screening maladjusted students who are supposed to learn in a specific situation, by relieving their symptoms through consultation and letting them concentrate on learning.

• Clinical and Experimental Pediatrics
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• 제45권9호
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• pp.1097-1105
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• 2002

목 적 : 평소 건강한 학동전 아동에서 심전도 집단 검진을 이용한 WPW 증후군의 유병률을 조사하였고 심전도 이상 소견에 따른 WPW 증후군 유형을 분류하고 각 유형에 따른 심실 및 심중격 운동 이상 소견을 심초음파 검사로 관찰하였다. 방 법: 1999년 4월부터 2001년 8월까지 전북지역 4-7세 사이의 유치원생 77,824명을 대상으로 실시한 심전도 집단 검사에서 WPW 증후군으로 진단된 아동을 대상으로 심전도상 이상 소견에 따른 세부 분류와 심초음파 검사상 심벽 운동의 이상 여부를 조사하였다. 결 과: 총 77,824명 중 WPW 증후군으로 진단된 환아는 23명으로 유병률은 2.9/10,000명이었다. 대상 환아의 평균 연령은 5.4세이었고, 남아는 13명 여아는 10명으로 남녀비의 의의있는 차이는 보이지 않았다. 빈맥의 기왕력을 가진 환아는 2명이었으며, 2명의 환아는 남매간으로 가족력 소견을 보였다. Rosenbaum 등에 의한 부전도로 추정 위치에 따른 분류로 A형은 5명(21.8%), B형은 18명(78.2%)이었다. Boineau 등의 분류에 의한 I군 18명(78.2%), IV군은 3명(13.0%), III, V군은 각각 1명(4.3%)이었고, II군은 관찰되지 않았다. Gallagher 등의 분류에 의한 유형 중 1형 4명(17.3%), 2형 12명(52.1%), 3형, 5형, 6형, 10형은 각각 1명(4.3%), 9형은 3명(13.0%), 4형, 7형, 8형은 관찰되지 않았다. 19명의 환아에게 실시한 심초음파 검사에서 5명의 A형 환아 중 4명의 환아에서 좌심실 후벽의 초기 수축기 전방운동 소견을 보였으며, B형 환아 14명 중 12명의 환아에서 심중격의 초기 수축기 후방운동 소견이 관찰되었다. 결 론 : 학동전기 아동에서 WPW 증후군의 유병율은 10,000당 2.9명이었다. 심전도상 부전도로의 위치는 우심실이 우세하여 이전의 보고와 다른 소견을 보였고, 심초음파 검사 소견상 대부분의 무증상 WPW 증후군 환아에서 이상 심실운동 소견이 관찰되었다. WPW 증후군에서 부전도로의 위치를 추정할 수 있는 비침습적 검사 방법으로 심전도 소견 및 심초음파 검사가 이용될 수 있다.

• Clinical and Experimental Pediatrics
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• 제51권9호
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• pp.964-970
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• 2008

목 적 : 메틸말로닌산뇨증과 프로피오닌산뇨증은 상염색체 열성으로 유전되는 아미노산 대사 이상 질환으로, methylmalonyl-CoA mutase와 propionyl-CoA carboxylse의 결함에 의해 발생하며 최근 유전자형에 대한 연구가 활발히 이루어지고 있다. 저자들은 단일기관에서 경험한 이 질환군의 임상 양상과 유전자형에 대해 조사하고자 하였다. 방 법 : 1993년부터 2007년까지 서울아산병원 소아과에서 유기산뇨증으로 진단된 20례를 대상으로 질병의 종류, 진단시 연령과 임상 양상, 유전자형, 검사 소견, 치료와 예후 등을 후향적으로 분석하였다. 혈장 암모니아, 소변 유기산 분석과 혈장 아미노산을 조사하였고, 유전자분석은 메틸말로닌산뇨증에서는 MUT, MMAA, MMAB 와 MMACHC 유전자를, 프로피오닌산뇨증에서는 PCCA와 PCCB 유전자를 분석하였다. 결 과 : 유기산뇨증으로 진단된 환아는 모두 20명이었으며, 그 중 메틸말로닌산뇨증이 12명(남아 8명, 여아 4명), 프로피오닌산뇨증이 8명(남아 6명, 여아 2명)이었다. 신생아 대사이상 검사로 진단된 환아가 5명이었으며, 6명은 신생아기에 급성 증상으로 발현하였고, 9명은 1개월 이후 발현한 지발형이었다. 신생아기 발현형에서는 6명 중 5명이 구토와 기면을 주증상으로 내원하였으며, 지발형에서는 구토와 기면 이외에도 발달 지연, 보행 장애, 혈소판 감소증 등 다양한 임상 양상을 보였다. 예후로는 메틸말로닌산뇨증 환아 중 2명(17%)이 2세경에 고암모니아혈증과 대사성 산증으로 사망하였으며, 7명(58%)이 정상발달을 보였다. 프로피오닌산뇨증 환아는 1명이 사망하였고, 4명(50%)이 정상 발달을 보이고 있다. 증상의 발현시기에 따라서는 신생아기 발현형에서 6명중에서 2명은 사망, 2명은 정상 발달, 2명은 발달지연을 보이고 있는 것에 비해, 증상 없이 신생아 대사이상 검사로 진단된 환아 중에는 2명(40%)이 정상발달을 보이고 있고, 지발형에서는 7명(63%)이 정상 발달을 보이고 있다. 유전자형은 메틸말로닌산뇨증 전례에서 규명되었으며 10명은 MUT 유전자에서 11종의 서로 다른 돌연변이가 발견되었는데 대부분 nonsense 돌연변이였다. 비타민 B12 반응형 환아 2명에서는 MMACHC 유전자에서 3종의 서로 다른 돌연변이가 발견되었으며 프로피오닌산뇨증에서는 16개 대립유전자 중 14개에서 PCCA와 PCCB 유전자의 돌연변이가 규명되었다. 결 론 : 유기산뇨증은 진단이 지연되면 매우 치명적이나, 조기에 의심하여 진단하고 적절히 치료하면 좋은 예후를 기대할 수 있는 질환이다. 유기산뇨증의 유전자형의 분석은 정확한 진단을 가능하게 할 뿐 아니라 유전상담, 산전 진단 및 표현형의 예측에도 도움이 된다.