• 농촌의학ㆍ지역보건
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• 제2권1호
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• pp.65-72
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• 1977

This study was made with 1394 clinical records obtained by a mobile charity health team in a rural Korea for 10 days from July 23 to Aug. 1, 1977 to see the disease pattern of the rural population in Korea. The health team consisted of 7 physicians in different clinical departments of the St. Mary's Hospital tried to cover as many as patients in that area by giving full informations and instructions before starting health services. which supposed to minimize the omissions of patients visits in that area. The proportion of each disease as well as its order in terms of the number of patients was reviewed by matching with age and sex distribution of patients, and with the duration of illness (complaints). Major findings obtained in this analysis were as follows; 1. Among 1394 patients, 536 (38.5%) was male and 858(61.5%) was female. As to the age distribution of the patients. those who are in the age group of 10-19 showed the highest proportion of 15.6% and those who are in the age group of 5-9 and 40-49 was the next with the proportion of 15.4% and 15.2% respectively. 2. The most prevalent cause of general morbidity were diseases of digestive system, diseases of nervous system and sensory organs, diseases of respiratory system, and diseases of skin and subcutaneous tissue in order. And their proportions among all patients were 21.8%, 20.7%, 14.5%, and 12.4% in respectively. The order of the diseases ranked by the number of patiens was slightly different in female population from that of total population, i. e. diseases of nervous system and sensory organs was the first. diseases of digestive system was the second, and the diseases of circulatory system was the third. 3. 23.2% of all patients were found to have had symptoms relating to their illness for more or less 5 years, and 18.3%, for more or less 6 months. Looking at the duration of illness by diseases, 28.6% of digestive tract disease patients and had the relating symptoms for about 1 week while 24.3% had had the symptoms for about 5 years, and in diseases of nervous system and and sensory organs, many(33.7%) had had symptoms for relatively long period (more than one year). On the other hand, in diseases of respiratory system, those who had had the relating symptoms for about 1 month was 24.3 % among all patients in this category and those who had had the symptoms for less than 1 week was 32.2%. 4. The duration of illness (complaints) was longer in females than in males and shorter in younger age groups than in older age groups.

• 대한지리학회지
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• 제51권1호
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• pp.143-166
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• 2016

본 연구는 치유의 경관 중 영적 치유의 경관을 한국 천주교 순례지의 사례를 통해 고찰하는 것에 목적을 두고 있다. 박해의 역사로 점철된 한국 천주교 순례지는 약 300여개가 전국적으로 퍼져있으며, 이는 조성형, 선택형, 체험형 등으로 유형을 나눌 수 있다. 조성형 순례지에는 천주교를 상징하는 조형물이 곳곳에 배치되어 있지만, 황량하거나 혹은 도심 속에 숨어있는 듯 조성되어 있어 종교의 치유적 요소가 주는 정서적인 안정감 혹은 절대적 신이 돌보고 있다는 점을 느끼기에는 다소 한계가 있다고 판단된다. 선택형 순례지에는 순례자들이 직접 신성한 경험을 체험할 수 있도록 종교적 요소들을 순례지의 구석구석에 배치했으며, 종교적 요소의 예는 박물관, 청원기도, 십자가의 길, 묵주기도의 길, 성모마리아상, 천주교 관련 조형물 등을 들 수 있다. 그렇지만 순례자들이 얼마만큼 적극적으로 그 종교적 요소를 체험하느냐에 따라 치유의 정도와 강도는 천차만별이 될 수 있다. 마지막으로 체험형 순례지는 일정한 프로그램 안에서 다양한 종교적 요소를 경험하게 되는 것을 의미한다. 이러한 체험은 개인이 아니라 순례자 집단을 위한 것이며, 여기에서 형성된 대인관계는 참여자들에 대한 관심의 네트워크로 승화되고, 승화된 타인을 향한 열린 마음은 정서적 안정과 감정의 해소, 진정성 충만한 심도 있는 치유에 닿을 수 있도록 하는 힘이 된다. 종교적 요소를 통한 영적 치유는 궁극적으로 인간의 한계와 세상의 유한성을 깨닫고, 절대적 신에게 자신을 스스로 내어놓는 것을 말하며, 이러한 영혼의 의식을 자유롭게 펼칠 수 있는 장이 바로 영적 치유의 경관이라 할 수 있다.

• 한국병원경영학회지
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• 제23권3호
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• pp.28-38
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• 2018

Purposes: 본 연구는 전립선암 환자의 의료비 지출을 평가하기 위해 남성호르몬 박탈 치료와 근치적 전립선적출술의 비용을 비교하였다. Methods: 본 연구는 스마트 전립선암 데이터베이스(Smart Prostate Cancer Database)의 전립선암 환자 357명의 데이터와 청구데이터베이스에서 의료비 관련 데이터를 도출하였다. 근치적 전립선적출술과 남성호르몬 박탈 치료간 비교를 위해 독립표본 t검정을 실시하였다. 또한 남성호르몬 박탈 치료와 근치적 전립선적출술에 영향을 미치는 요인을 검증하기 위해 다중회귀 분석을 실시하였다. Findings: 치료 후 1년까지 남성호르몬 박탈치료가 근치적 전립선적출술 보다 비용이 낮은 것으로 나타났으며, 치료 후 4년까지 낮게 유지되었다. 그러나 4년이 지나면 남성호르몬 박탈 치료의 누적의료비가 근치적 전립선적출술보다 더 유의미하게 높게 나타났다. 환자의 병기가 높거나 나이가 많은 경우 근치적 전립선적출술보다 남성호르몬 박탈 치료를 할 확률이 더 높았다. Practical Implications: 본 연구는 조기 암 발견이 환자 뿐 아니라 국민건강보험공단의 의료비를 줄일 수 있다는 것을 보여 준다. 또한 의료비를 정확히 평가하기 위해서는 오랜 기간의 정보를 평가해야 하며, 이를 기반으로 평가 및 예측이 필요함을 증명하였다.

• 전자공학회논문지
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• 제51권10호
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• pp.213-220
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• 2014

시공간 분해능이 우수하고 비침습적으로 대뇌 신경활동의 측정이 가능한 뇌자도는 뇌기능 연구 및 뇌질환 진단에 유용한 진단용 의료기기이다. 순수 국내기술로 개발한 한국형 뇌자도 시스템을 임상시설(병원)에 설치하고 뇌질환 환자를 대상으로 유발자계를 측정, 분석하여 한국형 뇌자도 시스템의 임상 응용 가능성을 검토하였다. 1) 반측성 안면 경련 환자를 대상으로 소리자극에 대한 청각유발자계를 측정, 분석하여 안면신경과 청신경의 상호작용 여부 및 이명과의 연관성 검토, 2)뇌종양 환자의 정중신경 자극에 대한 체성감각 유발자계를 측정하여 뇌전증 유무에 따른 연관성 검토. 뇌자도 데이터의 분석 결과로부터 한국형 뇌자도 시스템이 뇌기능 연구 및 뇌질환 진단에 유용한 시공간적인 분석 정보를 제공할 수 있음을 시사하고 있다.

• 구강회복응용과학지
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• 제26권3호
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• pp.273-283
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• 2010

이 연구는 다수의 임플란트에 의해 지지되는 보철물과 단일 임플란트 보철물에서 호환 가능한 세 가지 종류의 나사의 풀림토크값을 측정하여 나사 결합부 안정성에 차이가 있는지를 알아보고자 하였다. 이를 위해, 네 개의 외부 육각 임플란트에 직접 연결되는 임플란트 상부구조물을, 아크릴릭 레진을 이용한 연결인상법으로 얻은 총 6개의 실험모형에 20 Ncm의 힘으로 조인 후, 각 나사의 풀림토크값을 총 2회 측정하였다. 사용한 지대주 나사는 토크타이트(TorqTite), 골드타이트(Gold-Tite), 그리고, 티타늄(Titanium) 나사였다. 또한, 단일 임플란트 수복의 경우 를 가정하여 총 5개의 실험모형 상의 2개의 임플란트에, 한 개의 지대주(GoldAdapt Engaging)를 다시 세 종류의 나사로 연결한 후, 각 나사의 풀림토크값을 총 2회 측정하였다. 나사의 풀림토크값의 비교를 위한 통계적 분석을 혼합모형(mixed model)을 이용하여 유의수준 .05에서 실시한 결과, 다수 임플란트 지지 상부구조물의 경우, 나사의 종류에 따른 풀림토크값은 통계적으로 유의성 있는 차이를 보이지 않았다(p>0.05). 그러나 단일 임플란트 지대주의 경우에는 통계적으로 유의성 있는 차이를 보였으며(p=0.0175), 토크타이트 나사(p=0.0462)와 티타늄 나사(p=0.0348)는 각각, 골드타이트 나사보다 유의성 있게 큰 풀림토크값을 보였으나, 두 나사 간에는 유의성 있는 차이가 없었다(p>0.05). 이상의 연구 결과로 보아, 서로 다른 종류의 나사가 나사 결합부의 초기 안정성에 미치는 영향은, 단일 임플란트 보철물의 경우에서와는 달리, 다수의 임플란트에 의해 지지되는 보철물의 경우에는 미미하다고 할 수 있다.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.111-120
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• 2016

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

• Tuberculosis and Respiratory Diseases
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• 제75권1호
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• pp.18-24
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• 2013

Background: We investigated the prevalence of latent tuberculosis infection (LTBI) among the health care workers (HCWs) and analyzed its risk factors in South Korea. Methods: A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant and tuberculin skin test (TST), QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay, and chest radiography were performed. Results: A total of 493 participants, 152 (30.8%) doctors and 341 (69.2%) nurses were enrolled in eight tertiary referral hospitals. The mean age of the subjects was 30.6 years old, and 383 (77.7%) were female. Of the 152 doctors, 63 (41.4%) and 36 (23.7%) were positive by TST and by QTF-GIT, respectively, and among the 341 nurses, 119 (34.9%) and 49 (14.4%) had positive TST and QFT-GIT results, respectively. Overall, the agreement between the two tests was 0.22 by the chance corrected proportional agreement rate (kappa coefficient) in 493 subjects. Experience of working in tuberculosis (TB)-related departments was significantly associated with positive LTBI test results by QFT-GIT assay, not by TST. In multivariate analysis, only age was independently associated with increased risk of a positive TST result, while age and experience of working in TB-related departments (odds ratio, 2.29; 95% confidence interval, 1.01-5.12) were independently associated with increased risk of a positive QFT-GIT result. Conclusion: A high prevalence of LTBI was found among South Korean HCWs. Considering the association between the experience of working in TB-related departments and high risk of LTBI, QFT-GIT may be a better diagnostic test for LTBI than TST in HCWs.

• 한국전문물리치료학회지
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• 제10권2호
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• pp.45-59
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• 2003

The purpose of this study was to assess the effects of ultrasound on adjuvant-induced arthritis in rats. Adjuvant arthritis was induced in 26 female Sprauge-Dawley rats by the subcutaneous injection of a single dose of .1 mL of Complete Freund's Adjuvant (CFA) (1 mg of Mycobacterium Butyricum suspended in .1 $m{\ell}$ paraffin oil) into the right hind paw. After confirming inflammatory edema and arthritis in the paw 2 weeks later, the arthritic rats were divided into 3 groups, i.e., a control group, a pulsed ultrasound group (Group A), and a continuous ultrasound group (Group B) with 8 rats placed in each group. The rats in Group A were treated with pulsed ultrasound at 1 MHz frequency with .5 $W/cm^2$ intensity in 1 : 4 mode for 3 minutes. The rats in Group B were treated with continuous ultrasound at 1 MHz frequency with 2 $W/cm^2$ intensity in the continuous mode for 3 minutes. The ultrasound treatment was done in the left and right ankles for 2 weeks. Clinical, radiographic and histopathologic findings were then evaluated before and after treatment and yielded the following results. 1. No significant difference was present in body weight between the control group and the treated groups. 2. A statistically significant decrease in the edema of the paw was seen in the rats in Group A that was treated with pulsed ultrasound by 26~29 days after the treatment started (p<.05). 3. According to radiological examination, Group A showed the lowest score in arthritis scale which means it showed a tendency to suppress arthritic inflammation of the left and right hind paws. However, no statistically significant difference was present in the score between the control group, Group A and Group B. 4. According to histopathologic findings, the degree of infiltration by inflammatory cells and hypertrophy of the synovium were less in Group A compared with the control group and Group B. The results of the study show that rats that were treated with the pulsed ultrasound effectively suppressed adjuvant arthritis. However, more effort is needed to objectively prove the effectiveness of ultrasound by developing more sensitive testing methods that could quantitatively evaluate the treatment effects of acute rheumatoid arthritis and by trying out different ultrasound treatment methods.

• 생물정신의학
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• 제23권1호
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• pp.29-36
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• 2016

Objectives Firefighters and rescue workers are likely to be exposed to a variety of traumatic events; as such, they are vulnerable to the risk of post-traumatic stress disorder (PTSD). The psychometric properties of the Korean version of the PTSD Checklist (PCL), a widely used self-report screening tool for PTSD, were assessed in South Korean firefighters and rescue workers. Methods Data were collected via self-report questionnaires and semi-structured clinical interviews administered to 221 firefighters. Internal consistency, item-total correlation, one-week test-retest reliability, convergent validity, and divergent validity were examined. Content validity of the PCL was evaluated using factor analysis and receiver operating characteristic (ROC) analyses were used to estimate the optimal cutoff point and area under the curve. Results The PCL demonstrated excellent internal consistency (${\alpha}=0.97$), item-total correlation (r = 0.72-0.88), test-retest reliability (r = 0.95), and convergent and divergent validity. The total score of PCL was positively correlated with the number of traumatic events experienced (p < 0.001). Factor analysis revealed two theoretically congruent factors: re-experience/avoidance and numbing/hyperarousal. The optimal cutoff was 45 and the area under the ROC curve was 0.97. Conclusions The Korean version of the PCL may be a useful PTSD screening instrument for firefighters and rescue workers, further maximizing opportunities for accurate PTSD diagnosis and treatment.

• 한국의학물리학회지:의학물리
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• 제26권4호
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• pp.223-228
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• 2015

이중으로 집중된 미세 다엽콜리메이터(Double-focused micro Multileaf Collimator: ${\mu}MLC$)는 보통의 다엽콜리메이터(Multileaf Collimator: MLC)에 비하여 조사면 가장자리 부분의 선량을 급격하게 줄여준다. 이러한 특성 때문에, 미세 다엽 콜리메이터는 정위적 방사선 수술과 치료(Stereotactic Radio-Surgery/RadioTtherapy, SRS/SRT)에 사용되어 왔다. 우리는 Elekta Synergy 선형가속기에 이중으로 집중된 동적 미세 다엽콜리메이터(Double-focused Dynamic micro-Multileaf Collimator: DMLC)를 부착하여 선량학적 특성을 평가하였다. 본 연구에서는, 필름(GafChromic EBT2 film), EDGE 다이오드 검출기, 3차원 물 팬텀을 이용하였다. 깊이선량백분율(Percent Depth Dose, PDD), 엽 투과도(leaf leakage), 반그림자(Penumbra)를 측정하였고, 모든 데이터들은 6MV 광자선으로 측정하였다. 그 결과, DMLC가 1% 이내의 투과도를 갖는것을 확인할 수 있었다. DMLC는 이중으로 집중 되는 구조를 가졌기 때문에 반 그림자가 조사야 크기에 대하여 독립적인 것을 확인하였다. 본 연구에서는 DMLC의 선량학적 특성을 바탕으로, Elekta Synergy에 부착된 DMLC의 적용 가능성을 증명하였다.