• Journal of Preventive Medicine and Public Health
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• 제49권4호
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• pp.230-239
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• 2016

Objectives: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. Methods: To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Results: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Conclusions: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

• 대한추나의학회지
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• 제5권1호
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• pp.213-222
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• 2004

Objectives : To investigate contributing degree of other factors except pelvic tilting to F.L.L.D by analizing with Gonstead technique on the correlation between femur head height discrepancy on the standing pelvic AP view and F.L.L.D caused by pelvic tilting. Method : We analysed standing pelvis AP X-ray of 70 patients who had visited at the department acupunture and moxibustion in Conmaul oriental medical hospital, during May, 1st, 2004 - July, 30th, 2004, with low back pain or lower extremity pain. We excluded the person with any past history of polio, genetic defect, malunited fracture, growth plate injury, infection and overgrowth attributable to hemangioma, or arteriovenous fistula. Results & Conclusion : The functional leg length discrepancy caused by pelvic tilting and femur head height difference had no statistical difference(p=0.132) but poorly correlated(Pearson ${\nu}=0.05$). In the 94.28% of subjects, the femur head height difference wasn't in accord with F.L.L.D. caused by pelvic tilting. In 47.14% of subjects were expected to have over $3^{mm}$ of leg length discrepancy after pelvic adjustment. The mean of measurement difference between two methods was $3.76{\pm}3.12^{mm}$ and the range was $0{\sim}11.4^{mm}$. Consequently, we must consider not only functional leg length discrepancy caused by pelvic tilting but also anatomical leg length discrepancy, misalignment of ankle, knee or hip joint etc.

• 한국방사선학회논문지
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• 제12권3호
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• pp.397-402
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• 2018

본 연구는 엉치엉덩관절의 골절, 탈구, 엉치엉덩 퇴행성관절염 진단을 위한 가장 좋은 영상을 얻기 위해 골반 팬톰과 엑스선관을 각도 변화를 주어 엉치엉덩관절의 Joint space 가장 잘 나타내는 영상을 얻어 방사선사에게 주관적 평가를 받아 보았다. 평가 결과 결론으로 엉치엉덩관절염과 퇴행성 관절염 발견을 위한 단순촬영에서는 엎드린상태에서 촬영은 검사반대쪽 엉덩이를 $25^{\circ}{\sim}30^{\circ}$ 들어올리고 엑스선관을 앞엉덩뼈가 시에서 2.5 cm 안쪽을 지나는 시상면에 대해 수직촬영 하고 누운자세에서는 검사쪽 엉덩이를 $25^{\circ}{\sim}30^{\circ}$ 들어 올리고 위앞엉덩뼈가시가 중앙에서 위앞엉덩뼈가시가 중앙에 대해 엑스선관 각도를 발쪽으로 $5^{\circ}$ 촬영 하며 반드시 양쪽 엉치엉덩관절후전사방향(RAO,LAO) 및 전후사방향(RPO, LPO) 모두 촬영을 하게 되면 관절염 진단을 내리는데 있어 많은 도움이 되리라 본다.

• Journal of Preventive Medicine and Public Health
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• 제50권1호
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• pp.29-37
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• 2017

Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

• 대한정형외과스포츠의학회지
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• 제1권1호
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• pp.75-78
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• 2002

슬근의좌골결절부착부 견열손상은스포츠인구의증가와군대훈련을받고있는 젊은 남자에게 간혹볼수있는손상이며 대부분은젊은성인 특히 운동선수에게주로발생한다. 이는 슬관절이신전된상태에서고관절이 과도히굴곡되면슬근에강력한 긴장을 일으켜야기된다. 조기에진단하여 견열된 근육을 좌골에 부착시키는 수술적 치료로 기능을 회복시키고 기형을 교정할수있으나진단과치료가지연되면기능적으로나임상적으로양호한결과를얻기어렵다. 좌골결절에서슬근견열골절의수술적치료후생길수있는합병증은이소성골형성과고정실패외에크게알려진것이없으며, 특히좌골신경손상은보고된적이없다. 저자들은수상후3개월된슬근의좌골결절부착부파열을수술적치료한후좌골신경손상을경험하여보고하는바이다.

• 한국임상수의학회지
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• 제24권3호
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• pp.422-425
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• 2007

6개월령 수컷 진도종 개가 교통사고에 의한 골반 골절 교정술을 위하여 내원하였다. 일반적인 수술 전 검사에서 마취와 관련해 위험성 있는 이상은 발견되지 않았다. 이 개는 아트로핀으로 전처치하고, 유도마취로 thiopental을 주사하였으며 유지 마취 약물로 isoflurane을 사용하였다. 수술 시작 40분 후 갑자기 서맥이 발생하여 아트로핀(18ug/kg)을 천천히 정맥주사 하였으나 즉시 맥박이 증가하지 않고 오히려 heart rate가 감소하며 방실 전도 차단($2^{nd}$ degree type I)이 발생하였다. 따라서 ephedrin을 즉각적으로 주사하였으며, 투여 7분 후 정상 심박으로 회복되었다. 본 증례는 개에서 고용량 atropine 투여로 드물게 발생하는 역설적 방실전도 차단 임상예이다.

• Nutrition Research and Practice
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• 제14권1호
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• pp.55-61
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• 2020

BACKGROUND/OBJECTIVES: Osteoporosis is characterized by low bone mass and results in vulnerability to fracture. Calcium and vitamin D are known to play an important role in bone health. Recently, potassium has been identified as another important factor in skeletal health. We examined the link between potassium intake and bone health among the Korean older adult population. SUBJECTS/METHODS: This retrospective, cross-sectional study included 8,732 men and postmenopausal women over 50 years old who completed the Korean National Health and Nutrition Survey (KNHANES) between 2008 and 2011. Potassium consumption was evaluated using a 24-hour recall method. Bone mineral density (BMD) was measured at three sites (total hip, femur neck, and lumbar spine) by dual-energy X-ray absorptiometry (DEXA). Multinomial logistic regression was used to examine the link between potassium intake and prevalence of osteoporosis and osteopenia, after controlling for potential confounding variables. RESULTS: The BMD of the total femur and Ward's triangle were significantly different according to the potassium intake among men (P = 0.031 and P = 0.010, respectively). Women in the top tertile for potassium intake showed higher BMD than those in the bottom tertile at all measurement sites (all P < 0.05). Daily potassium intake was significantly related to a decreased risk of osteoporosis at the lumbar spine in postmenopausal women (odds ratios: 0.68, 95% confidence interval: 0.48-0.96, P trend = 0.031). However, the dietary potassium level was not related to the risk of osteoporosis in men. CONCLUSION: Current findings indicate that higher dietary potassium levels have a favorable effect on bone health and preventing osteoporosis in older Korean women.

• Journal of Trauma and Injury
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• 제35권3호
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• pp.215-218
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• 2022

The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.

• 한국재료학회지
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• 제33권8호
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• pp.337-343
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• 2023

3Y-TZP (3 mol% yttria-stabilized tetragonal zirconia polycrystals) ceramics have excellent mechanical properties including high fracture toughness, good abrasion resistance as well as chemical and biological stability. As a result, they are widely used in mechanical and medical components such as bearings, grinding balls, and hip implants. In addition, they provide excellent light transmittance, biocompatibility, and can match tooth color when used as a dental implant. Recently, given the materials' resemblance to human teeth, these ceramics have emerged as an alternative to titanium implants. Since the introduction of CAD/CAM in the manufacture of ceramic implants, they've been increasingly used for prosthetic restoration where aesthetics and strength are required. In this study, to improve the surface roughness of zirconia implants, we modified the 3Y-TZP surface with a biocomposite of hydroxyapatite and forsterite using room temperature spray coating methods, and investigated the mixed effect of the two powders on the evolution of surface microstructure, i.e., coating thickness and roughness, and biological interaction during the in vitro test in SBF solution. We compared improvement in bioactivity by observing dissolution and re-precipitation on the specimen surface. From the results of in vitro testing in SBF solution, we confirmed improvement in the bioactivity of the 3Y-TZP substrate after surface modification with a biocomposite of hydroxyapatite and forsterite. Surface dissolution of the coating layer and the precipitation of new hydroxyapatite particles was observed on the modified surface, indicating the improvement in bioactivity of the zirconia substrate.

• 대한정형외과학회지
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• 제52권1호
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• pp.25-32
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• 2017

목적: 고령 환자에서 발생한 불안정성 대퇴골 전자간부 골절의 치료 시 골수강내 금속정의 길이에 따른 방사선적, 임상적 치료 결과를 비교 분석하고자 한다. 대상 및 방법: 2009년 8월부터 2014년 12월까지 방사선 영상상 AO/OTA 분류 31-A2 대퇴골 전자간부 골절로 진단되어 골수강 내 금속정을 이용한 내고정을 시행한 뒤 최소 1년 이상 추시가 가능하였던 65세 이상의 환자 139예를 대상으로 후향적 대조군 연구를 시행하였다. 대상군을 짧은 골수정(I군)과 긴 골수정(II군)을 사용한 군으로 분류하였으며 각각 106예, 33예로 조사되었다. 방사선적인 평가로 골절의 정복 정도, 골유합까지의 기간, 합병증 발생을 조사하였으며 수술 전 혈색소, 수술 시간, 수술 중 출혈량, 수혈 유무, 입원 기간 및 최종 추시 시 Charnley 고관절 점수를 통한 임상적 평가를 시행하였다. 결과: 수술 후 단순 방사선 검사상 전 예에서 good 또는 acceptable한 정복 상태를 얻었다. 골유합까지 평균 4.8개월이 걸렸으며 두 군 간의 차이는 없었다. II군(57.87분)이 I군(45.65분)보다 수술 시간이 길었던 것으로 확인되었다(p=0.003). 수술 중 출혈량의 경우 II군(288.78 ml)이 I군(209.90 ml)보다 많은 것으로 확인되었다(p=0.046). 최종 추시 시 임상적 결과는 두 군 모두 만족스러웠다. 결론: 고령의 환자에서 발생한 후내측 골편을 동반한 불안정성 대퇴골 전자간부 골절의 치료 시 골절 부위의 정복을 잘 시행한 경우 긴 골수정과 짧은 골수정 모두 만족스러운 방사선적, 임상적 결과를 보였다.