• 한국산학기술학회논문지
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• 제10권7호
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• pp.1760-1765
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• 2009

의료기관 핵의학과에서는 진단과 치료를 목적으로 방사성동위원소를 사용하므로 누구나 방사선피폭에 노출 될 위험이 있다. 일반적으로 방사선 작업종사자에 대한 피폭관리는 비교적 철저히 이루어지고 있으나 환자보호자 및 일반인에 대한 피폭관리는 소홀한 경향이 있다. 특히 방사성의약품을 투여한 환자들은 잠재적 선원이 되어 작업종사자외에 환자보호자 및 일반인에 대해 방사선피폭을 초래하므로 이로 인한 방사선피폭을 최소한으로 감소시킬 수 있도록 관리되어야 한다. 따라서 핵의학과 방사선피폭에 대한 관리실태를 파악하기 위하여 전국에 있는 대학병원 중 7개소에 대해 조사한 결과 환자이송요원, 환경미화원 등 수시출입자에 대해서 2 개소의 의료기관에서는 피폭선량평가 및 관리와 안전교육이 없었다. 또한 환자와 동행하는 보호자에 대한 통제와 관리는 7 개소 모두 허술하였는데 대기실에서 검사직전 환자로부터 흡수될 수 있는 평균 방사선량률은 25.60 ${\mu}$Sv/h로서 일반인에 대해 연간 선량한도를 초과하지 아니하는 범위 내에서 허용되는 20 ${\mu}$Sv/h를 초과하였다. 따라서 비록 아주 적은 피폭선량이 예상된다고 하더라도 수시출입자에 대한 철저한 피폭선량의 관리와 교육이 요구되며, 환자보호자 등을 보호하기 위해 환자와 가까이 하는 것을 통제하거나 환자를 격리할 필요가 있었다.

• 한국산학기술학회논문지
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• 제15권10호
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• pp.6223-6233
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• 2014

본 연구는 심뇌혈관질환자들을 대상으로 소득수준과 교육수준이 건강행태에 미치는 영향을 분석하여 질병관리와 예방에 도움을 주는 방안을 제시하는데 있다. 2010-2011 국민건강영양조사 원시자료를 이용하여 30세 이상의 심뇌혈관질환자 3,687명을 대상으로 건강행태, 일반적(사회인구학적) 특성, 신체계측 및 혈액검사를 소득수준별, 교육수준별로 상관관계를 분석하였다. 본 연구의 결과, 소득수준과 교육수준이 낮을수록 심뇌혈관질환의 유병율이 높고, 현재흡연에서의 OR(95% CI) 값은 고소득자 0.71(0.52-0.96), 고교육자 0.41(0.29-0.58)로 소득과 교육수준이 낮을수록 건강수준의 감소와 관계되는 현재흡연과의 상관성이 높았다. 한편 1개월음주와 고위험음주에서 고소득자의 OR(95% CI) 값은 각각 1.55(1.22-1.95), 1.42(1.11-1.82)로 음주율이 고소득자에서 높았으나 교육수준에서는 유의한 차이가 없었다. 걷기운동의 실천율은 소득과 교육수준 모두 유의한 차이가 없었다. 따라서 소득수준이 높은 환자군에서는 절주홍보를 강조하고, 소득과 교육수준이 낮은 환자군에서는 금연의 중요성을 강조하는 것 이외에도 서비스공급을 위한 제도적인 뒷받침이 필요할 것으로 보인다.

• 한국산업보건학회지
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• 제28권3호
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• pp.292-303
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• 2018

Objectives: This study aims to analyze manganese (Mn) concentrations in maternal and cord bloods at delivery and to estimate the Mn exposure risk for fetuses whose mothers were occupationally exposed to Mn. Materials and Methods: Forty-six pairs of maternal and cord blood samples were collected at delivery from mothers who were occupationally unexposed to Mn. Mn concentrations of blood were analyzed by graphite furnace atomic absorption spectrometer. Mn exposure levels for fetuses of female workers were estimated by simulating two working exposure scenarios. Results: The geometric mean concentration of Mn in maternal and cord blood were $27.0(1.34){\mu}g/L$, $46.6(1.25){\mu}g/L$, respectively. Transfer ratios of Mn from maternal to cord blood were $1.81{\pm}0.62$, which indicated that the Mn concentrations in cord blood were higher than those in maternal blood. Mn concentrations in cord blood for the worse or general scenarios were estimated to $22.3-1,881{\mu}g/L$ and $1.59-308{\mu}g/L$, respectively. The probabilities of exceeding $74{\mu}g/L$, which was adopted as a reference level reported in a previous study, were 95% and 44% for the two scenarios, respectively. Conclusions: Comparable levels of Mn exposure in maternal or cord blood to those in this study have shown various health effects in previous studies. This suggests that Mn exposure levels in mothers and fetuese in Korea need to be monitored and managed. In addition, female workers who are occupationally exposed to Mn should be protected from the exposure since their fetuses can be exposed to Mn at risky levels during their pregnancy.

• 동의생리병리학회지
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• 제20권6호
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• pp.1732-1741
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• 2006

Obesity is chronic disease which influenced on health severly. The causes of obesity have been known as life change, lack of excercise, genetic factor, mental and social economic factors. Especially the obesity of women increased the risk of the diseases such as DM, osteoarthritis, cardiovascular disease, breast cancer and infertility. The limitations of the widely used negative definition of health as the absence of disease and WHO's 1946 definition of health as total social, psychological and physical well-being have long been recognized (WHO 1958). The Quality of Life (QoL) includes functional ability, the degree and quality of social and community interaction, psychological well-being as somatic sensation and life satisfaction. I investigated to compare the differences between obese women (n=63), non-obese women (n=37) in clinic and general women (n=43, control) on baseline characteristics and WHO QoL-BREF. The purpose of this study is to assist the diagnosis and treatment of obesity. WHO QoL-BREF is self administered type which consisted of 26 questions. The prospective question is calculated with 5 scores by Likert's method. The results are as follows : The means of physical, psychological, social, overall and total scores of QoL were significant among BMI group (P<0.05). The score of control group (BMI < 25) was higher than other groups significantly (P<0.05). In multiple regression analysis, the variable of high school/below middle school was significant in environmental and overall domain of QoL scores (P<0.05). The variable of college/below middle school was significant in environmental, overall domain and total score of QoL scores (P<0.05). The variable of above university/below middle school was significant in physical health, environmental, overall domain and total score in QoL scores (P<0.05). The variable of Health perception (moderate/bad) was positively significant in physical health, environmental, overall domain and total score of QoL scores (P<0.05). The variable of Health perception (good/bed) was positively significant in physical health, environmental, social, overall domain and total score of QoL scores (P<0.05). The variable as BMI non-=obese women/control was negatively significant in social domain of QoL scores (P<0.05). Above the results, It suggests that the variable as BMI did't affect on the QoL in patients and control, but the variables as education and health perception affected on the QoL scores. Further study is required to conduct QoL differences between before and after treatment of obese patients.

• Journal of Preventive Medicine and Public Health
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• 제39권4호
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• pp.331-338
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• 2006

Objectives: The goal of this study is to measure women's willingness to pay for cancer screening and to identify those factors associated with this willingness to pay. Methods: A population-based telephone survey was performed on 1,562 women (aged 30 years or over) for 2 weeks (9-23th, July, 2004). Data about sociodemographic characteristics, health behaviors, the intention of the cancer screenings and willingness to pay for cancer screening were collected. 1,400 respondents were included in the analysis. The women's willingness to pay for cancer screening and the factors associated with this willingness to pay were evaluated. Results: The results show that 76% of all respondents have a willingness to pay for cancer screening. Among those who are willing to pay, the average and median amount of money for which the respondents are willing to pay are 126,636 (s.d.: 58,414) and 120,000 won, respectively. As the status of education & the income are higher, the average amount that women are willing to pay becomes much more. The amount of money women are willing to pay is the highest during the 'contemplation' stage. Being willing to payor not is associated with a change of behavior (transtheoretical model), the income, the concern about the cancer risk, the family cancer history, the marital status, the general health exam, age and the place of residence. Income is associated with a greater willingness to pay. Old age was associated with a lower willingness to pay. Conclusions: According to the two-part model, income and TTM are the most important variables associated with the willingness to pay for cancer screening. The cancer screening participation rate is low compared with the willingness to pay for cancer screening. It is thought that we have to consider the participants' behavior that's associated with cancer screening and their willingness to pay in order to organize and manage cancer screening program.

• 보건행정학회지
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• 제25권3호
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• pp.185-196
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• 2015

Background: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. Methods: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. Results: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. Conclusion: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.

• Asian Pacific Journal of Cancer Prevention
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• 제17권12호
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• pp.5295-5302
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• 2016

Objectives: A physically active lifestyle is important for cancer survivors. Therefore, this study was conducted to 1) provide population-based estimates of the prevalence of physical activity and sitting time, and 2) their correlates in Korean cancer survivors. Materials and Methods: This study analyzed a cancer survivor subsample (N=1,482) from 2008-2013 Korea National Health and Nutrition Examination Survey (KNHANES), data selected with a complex sampling design. Overall and subgroup-specific prevalences of physical activity and sitting time were estimated. Correlates of moderate- to vigorous-intensity physical activity ( MVPA) and sitting time were tested using age-group-specific hierarchical multiple regression models. Results: Overall adherence rate to physical activity guidelines was 34.9% (95% CI=31.5-38.4). Age-group-specific adherence rates were 41.1% (95% CI=36.3-45.9) in adults (30-64 years old), and 25.3% (95% CI=21.0-25.3) in older adults (65 years or older). Adults spent 213.33 minutes (95% CI=172.4-254.3) per week on MVPA and 55.3 minutes (95% CI=36.4-64.6) on sitting time per day. In adults, sitting time was significantly associated with employed status (B=28.0, p=0.046), smoking (B=-47.4, p=0.020), and number of comorbidity conditions (B=-13, p=.037). MVPA was significantly associated with marital status (B=134.9, p<0.001), employment status (B=98.12, p=.046), and years since cancer diagnosis (B=104.7, p=0.015). Older adults spent 162.2 minutes (95% CI=119.5-204.8) per week on MVPA and 63.0 minutes (95% CI=45.0-89.5) on sitting time per day. Their significant correlates were sex (B= -45.2, p=0.014), smoking (B=-70.14, p<0.001), and years since cancer diagnosis (B=37.0, p=0.024). Age (B=5.8, p=0.042) and marital status (B=83.8, p=0.033) were also significantly associated with MVPA in older adults. Conclusion: A majority of Korean cancer survivors do not sufficiently participate in physical activity. In general, older, unhealthier, non-working, and being unmarried were risk factors for physical inactivity. While this study informs public health policy makers and practitioners about physical activity intervention demand for cancer survivors, future investigations should address psychosocial mediators to better inform intervention programs.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.356-365
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• 2018

Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.

• Journal of Korean Medical Science
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• 제33권47호
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• pp.296.1-296.7
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• 2018

Background: Antepartum, intrapartum, and postpartum preventive measures with antiretroviral drugs, appropriate delivery methods, and discouraging breastfeeding significantly decrease the risk of mother-to-child transmission of human immunodeficiency virus (HIV) infection. Herein, we investigated the pregnancy outcomes in HIV-infected Korean women. Methods: We retrospectively reviewed medical records of childbearing-age HIV-infected women between January 2005 and June 2017 at four tertiary care hospitals in Korea. Results: Among a total of 95 HIV infected women of child-bearing age with 587.61 years of follow-up duration, 15 HIV-infected women experienced 21 pregnancies and delivered 16 infants. The pregnancy rate was 3.57 per 100 patient-years. Among the 21 pregnancies, five ended with an induced abortion, and 16 with childbirth including two preterm deliveries at 24 and 35 weeks of gestation, respectively. The two preterm infants had low birth weight and one of them died 10 days after delivery due to respiratory failure. Among the 14 full-term infants, one infant was small for gestational age. There were no HIV-infected infants. Conclusion: The pregnancy rate of HIV-infected women in Korea is lower than that of the general population. Although several adverse pregnancy outcomes were observed, mother-to-child transmission of HIV infection was successfully prevented with effective preventive measures.

• Journal of Korean Medical Science
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• 제33권52호
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• pp.347.1-347.11
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• 2018

Background: Smartphone addiction has recently been highlighted as a major health issue among adolescents. In this study, we assessed the degree of agreement between adolescents' and parents' ratings of adolescents' smartphone addiction. Additionally, we evaluated the psychosocial factors associated with adolescents' and parents' ratings of adolescents' smartphone addiction. Methods: In total, 158 adolescents aged 12-19 years and their parents participated in this study. The adolescents completed the Smartphone Addiction Scale (SAS) and the Isolated Peer Relationship Inventory (IPRI). Their parents also completed the SAS (about their adolescents), SAS-Short Version (SAS-SV; about themselves), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). We used the paired t-test, McNemar test, and Pearson's correlation analyses. Results: Percentage of risk users was higher in parents' ratings of adolescents' smartphone addiction than ratings of adolescents themselves. There was disagreement between the SAS and SAS-parent report total scores and subscale scores on positive anticipation, withdrawal, and cyberspace-oriented relationship. SAS scores were positively associated with average minutes of weekday/holiday smartphone use and scores on the IPRI and father's GAD-7 and PHQ-9 scores. Additionally, SAS-parent report scores showed positive associations with average minutes of weekday/holiday smartphone use and each parent's SAS-SV, GAD-7, and PHQ-9 scores. Conclusion: The results suggest that clinicians need to consider both adolescents' and parents' reports when assessing adolescents' smartphone addiction, and be aware of the possibility of under- or overestimation. Our results cannot only be a reference in assessing adolescents' smartphone addiction, but also provide inspiration for future studies.