• Journal of Korean Medical Science
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• 제33권53호
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• pp.342.1-342.6
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• 2018

We validated the diagnostic performance of a previously developed blood-based 7-protein biomarker panel, $AptoDetect^{TM}$-Lung (Aptamer Sciences Inc., Pohang, Korea) using modified aptamer-based proteomic technology for lung cancer detection. Non-small cell lung cancer (NSCLC), 200 patients and benign nodule controls, 200 participants were enrolled. In a high-risk population corresponding to ${\geq}55years$ of age and ${\geq}30pack-years$, the diagnostic performance was improved, showing 73.3% sensitivity and 90.5% specificity with an area under the curve of 0.88. $AptoDetect^{TM}$-Lung (Aptamer Sciences Inc.) offers the best validated performance to discriminate NSCLC from benign nodule controls in a high-risk population and could play a complementary role in lung cancer screening.

• 한국엔터테인먼트산업학회논문지
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• 제14권2호
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• pp.225-235
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• 2020

본 연구는 골다공증 환자의 라이프 케어 증진을 위한 미충족 의료실태와 위험요인 분석하기 위하여 패널 자료를 활용한 횡단적 2차 분석 조사연구이다. 연구대상자는 한국의료패널 2015년 자료(β-version 1.0)를 활용하여 골다공증 진단을 받은 941명을 대상으로 하였다. SPSS/win 22.0 Program을 이용하여 χ² test, logistic regression을 이용하여 자료를 분석하였다. 연구결과 골다공증 환자의 미충족 의료 발생률은 22.6%이었으며, 인구학적 특성 요인의 Model I에서는 나이, 교육수준으로 나타났으며, 신체적 요인을 추가한 Model II에서는 섭식문제, 기억력 장애, 활동제한, 장애 판정으로 나타났다. 심리·사회적 요인을 추가한 Model III에서는 섭식문제, 기억력 장애, 총 가구 소득, 통증/불편감으로 확인되었다. 본 연구 결과를 바탕으로 골다공증 환자의 라이프 케어를 증진시키기 위해 지속적으로 의료정책 기획 시 고려되어져야 하겠으며, 미충족 의료를 감소시키기 위한 의료서비스 접근성 개선과 현실적인 예방 및 중재가 필요하겠다.

• 핵의학기술
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• 제17권2호
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• pp.15-24
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• 2013

SPECT/CT의 수요가 늘면서 CT에 따른 복합적 진단정보에 대한 관심이 대두되고 있으며, 그 잠재적 성능가치에 대한 연구가 다양하게 진행 중이다. 하지만 그에 따른 CT 피폭 저감에 대한 연구는 미비한 실정이다. 그러므로 본 연구에서는 상 하지(extremity) 뼈 SPECT/CT 검사 시 평판형(flat-panel) CT에서의 피폭저감 영향에 대해 고찰하는데 목적을 두었다. 상 하지 뼈 SPECT/CT 검사 시 평판형과 나선형(helical) CT 간의 선량 조건에 따른 영상의 질, 피폭선량 비교를 위해 BrightView XCT (Philips Healthcare, Cleveland, USA)와 Briliance 16 CT (Philips, Healthcare, Cleveland, USA)를 적용하였다. AAPM CT phantom을 대상으로 노이즈(noise), 공간 분해능(spatial resolution)을 평가하였으며, 촬영 조건은 관전압 120 kVp로 고정하고, 관전류량(mAs)는 평판형 CT의 상 하지용 촬영 조건인 20, 30, 40, 50, 60, 70, 80 mA를 기준으로 산출된 mAs를 두 장비에 동일 적용하였다. 각 조건별 동일 촬영거리 내에서 DLP (dose-length product)값을 산출하였다. 또한 CT의 조건변화에 따라 SPECT 영상에 미치는 영향을 확인하기 위해 NEMA IEC body phantom으로 영상을 획득하고 %contrast를 확인하였다. 산출된 정보는 SPSS ver.18로 기술통계 분석 하였다. AAPM phantom에서는 mAs의 증가에 따라 노이즈는 감소하였고, 평판형 CT가 나선형 CT보다 노이즈가 낮았으며, 그 차이는 저선량의 조건일수록 증가하였다. 분해능 평가에서 두 장비 모두 0.75 mm까지 육안으로 식별 가능하였고, 평판형 CT의 경우 선량조건(mA)의 증가에 따라 DLP값이 54-216 mGy cm까지 증가하였으며, 나선형 CT의 경우 177-709 mGy cm로 증가하였다. NEMA IEC body phantom에서는 CT 촬영 조건 변화에 따른 동일한 크기의 구(sphere)에서 측정한 결과 %contrast는 일정한 값을 유지하였다. 동일한 조건을 적용한 평판형과 나선형 CT 간의 선량 조건 변화에 따른 영상의 질은 큰 차이를 보이지 않았으며, 충분한 피폭저감의 효과를 얻을 수 있었다. 또한 SPECT 영상의 %contrast 분석을 통해 영상의 질이 유지되는 것을 확인하였다. 그러므로 촬영범위가 넓지 않고 고분해능을 요구하는 상 하지 뼈 SPECT/CT 검사에서 평판형 CT를 적용하는 것이, 나선형 CT에 비해 낮은 선량조건을 적용함에도 불구하고 유사한 영상의 질을 기대할 수 있다. 또한 이를 통해 실제 임상에서 불필요한 피폭선량 저감에 도움이 되리라 사료된다.

• 의학교육논단
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• 제25권2호
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• pp.139-158
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• 2023

Defining a competent doctor is important for educating and training doctors. However, competency frameworks have rarely been validated during the process of their development in Korea. The purpose of this study was to validate the patient-centered doctor's competency framework, which had been developed by our expert working group (EWG). Two rounds of Delphi questionnaire surveys were conducted among a panel of experts on medicine and medical education. The panel members were provided with six core competencies, 17 sub-competencies, and 53 enabling competencies, and were asked to rate the importance of these competencies on a 5-point Likert scale. Between April and July 2021, a total of 28 experts completed both rounds. The data of the Delphi study were analyzed for the mean, standard deviation, median, inter-rater agreement (IRA), and content validity ratio (CVR). A CVR >0.36 and IRA ≥0.75 were deemed to indicate validity and agreement. This study found that five enabling competencies were not valid, and agreement was not reached for three sub-competencies and two enabling competencies. In consideration of CVR and the individual opinions of panel members at each session, the final competencies were extracted through consensus meetings of the EWG. The competencies were modified into six core competencies, 16 sub-competencies, and 47 enabling competencies. This study is meaningful in that it proposes patient-centered doctor's competencies enabling the development of residents' milestone competencies, an assessment system, and educational programs.

• 보건행정학회지
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• 제25권4호
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• pp.295-306
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• 2015

This study aims to examine the performance of public municipal hospitals through the analysis of data envelopment analysis, efficiency, profitability, and publicness by using panel data during period from 2006 to 2010. The main findings of the study are as follows. First, as a result of efficiency analysis during the period from 2006 to 2010, it was revealed that the number of staff by each job category, labor cost ratio, the number of operating beds need to be decreased. Second, the performance data represented by the indicators of efficiency, profitability and publicness were complementary and showed a tendency of being increased or decreased in same direction. Third, from the result of panel analysis, the efficiency was mainly influenced by the structural factors, while the profitability was influenced by managerial factors, and the publicness by medical environment. In conclusion, in order to enhance the performance of public municipal hospitals in Korea, it is important to harmonize the effort for efficiency, financial and policy support by central and local government, and the continuous participation of community residents.

• 대한의용생체공학회:의공학회지
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• 제30권6호
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• pp.476-481
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• 2009

The most troublesome artifacts in micro computed tomography (micro-CT) are ring artifacts. The ring artifacts are caused by non-uniform sensitivity and defective pixels of the x-ray detector. These ring artifacts seriously degrade the quality of CT images. In flat-panel detector based micro-CT systems, the ring artifacts are hardly removed by conventional correction methods of digital radiography, because very small difference of detector pixel signals may make severe ring artifacts. This paper presents a novel method to remove ring artifacts in flat-panel detector based micro-CT systems. First, the bad lines of a sinogram which are caused by defective pixels of the detector are identified, and then, they are corrected using a cubic spline interpolation technique. Finally, a ring artifacts free image is reconstructed from the corrected projections. We applied the method to various kinds of objects and found that the image qualities were much improved.

• 보건의료산업학회지
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• 제14권2호
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• pp.55-65
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• 2020

Objectives: This study intends to analyze the relationship between medical service experience and subjective health awareness by using data from Panel Study of Worker's Compensation Insurance(PSWCI). Methods: Tte χ2-test was performed to investigate subjective health awareness and medical service experience relevance. Logistic analysis was performed to analyze the influencinge factors. Results: The subjective health awareness scored "bad" in"'lack treatment period" compared to "adequate treatment period" in medical service experience (OR = 2.603 [95% CI = 1.666-2.555]). Conclusions: To improve the subjective health awareness of patients with industrial accidents, the industrial accident compensation and medical care approval system should be improved, and long-term industrial accident insurance policies should be developed to accommodate direct and indirect medical services.

• Parasites, Hosts and Diseases
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• 제55권5호
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• pp.513-521
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• 2017

Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses, 2.8% bacteria, and 9.8% mixed). Rotavirus (19.6%), Giardia duodenalis (16.5%), and Cryptosporidium spp. (8.5%) were the mostly detected pathogens. Adenovirus 40/41 (4.2%), Salmonella (3%), Shiga toxin-producing Escherichia coli (3%), and Entamoeba histolytica (2.4%) were also detected. Norovirus GI/II, Vibrio cholerae, Yersinia enterocolitica, and Clostridium difficile toxin A/B were not detected in any patients. All pathogens were involved in coinfections except E. histolytica. Giardia (5.5%) and rotavirus (3%) were the most commonly detected in co-infections. Enterotoxigenic E. coli (2.4%), Campylobacter spp. (2.4%), E. coli 0157 (1.8%), and Shigella spp. (1.2%) were detected in patients only as co-infections. Infections were more in children 0-4 years, less in adults <40 years, and least >40 years, with statistically significant differences in risk across age groups observed with rotavirus (P<0.001), Giardia (P=0.006), and Cryptosporidium (P=0.036) infections. Lastly, infections were not significantly more in the spring. This report demonstrates the high burden of various enteropathogens in the setting. Further studies are needed to define the impact of these findings on the clinical course of the disease.

• 대한의용생체공학회:의공학회지
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• 제25권2호
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• pp.97-102
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• 2004

소 동물 촬영에 이용될 수 있는 고해상도의 x-선 cone-beam micro computed tomography (micro-CT) 시스템을 개발하였다 Micro-CT 시스템은 120${\times}$120 mm2 의 2차원 평판 x-선 감지기, micro-focus x-선 발생장치, 주사 기구부, 병렬처리 영상 재구성 시스템으로 이루어져 있다. 개발된 시스템의 성능을 평가하기 위해 대조도와 공간해상도를 측정하였다. 대조도 실험에서는 95 mGy 에서 36 CT-번호를 구별할 수 있음을 확인하였고, 공간 해상도 실험에서는 14 lp/mm 의 성능을 확인하였다. 소 동물 촬영 결과로 실험용 쥐의 대퇴부, 심장 그리고 복부 동맥 혈관을 촬영한 경상을 제시하였다. 개발된 micro-CT 시스템은 소 동물을 이용한 생명공학 분야 연구에 널리 이용될 수 있을 것으로 기대된다.

• 치위생과학회지
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• 제19권1호
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• pp.23-30
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• 2019

Background: The health of the economically active population contributes to increased corporate productivity by reducing the productivity loss caused by disease and increasing job efficiency, which in turn is a national benefit. Since the economically active population is a concept encompassing workers and a source of economic development for a country, that population's health should be treated with importance not only from a personal standpoint but also at a national level. Methods: In this study, data of 11,007 adults aged 20 years and older who participate in economic activities were analyzed in the five-year Korea Health Panel Study from 2010 to 2014 including the number of dental visits and dental medical expenses. Results: Factors related to "gender," "education level," "age," "duty category," "income level," "employment type," "national health insurance," and "chronic disease status" of the economically active population are affected in relation to the number of visits and dental medical expenses. The number of dental visits increased with higher education levels (p<0.001), and the number of visits to the dentist increased with older age (p <0.001). Dental medical expenses were 91,806 Korean won (KRW) more for "white-collar workers" than for "blue-collar workers" (p<0.03), and 127,674 KRW more for "regular workers" than for "atypical workers" (p<0.02). Conclusion: When it is necessary to improve policies to enhance the efficiency of the distribution of health and medical resources in the overall balance of the dental health sector, we should try to identify various factors of oral health disorder due to income inequality among the classes according to the country's employment type in order to find ways to reduce the health gap among the social classes.