• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.225-232
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• 2008

The mission of National Health Screening Program for Infant and Children is to promote and improve the health, education, and well-being of infants, children, families, and communities. Although the term 'diagnosis' usually relates to pathology, a similar diagnostic approach applies to the child seen primarily for health supervision. In the case of health, diagnosis determines the selection of appropriate health promoting and preventive interventions, whether medical, dental, nutritional, educational, or psychosocial. Components of the diagnostic process in health supervision include the health 'interview'; assessment of physiological, emotional, cognitive, and social development (including critical developmental milestones); physical examination; screening procedures; and evaluation of strengths and issues. Open and informed communication between the health professional and the family remains the most significant component of both health diagnosis and health promotion. Families complete medical history forms at their health supervision visit. Family-friendly questionnaires, checklists, and surveys that are appropriate for the child's age are additional tools to improve and update data gathering. This type of information helps initiate and inform discussions between the family and the health professional. This article provides a comprehensive review of current National Health Screening Program for Infant and Children in Korea.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.113-120
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• 2018

혈관 질환 검사는 일반적으로 혈관 조영술(angiography)과 CT 혈관 조영술(CT angiography) 등을 통해 이루어지며, 대부분 검사자의 육안을 통한 주관적 판단에 의존하여 진단이 이루어진다. 본 논문에서는 의료영상으로부터 재구성된 3차원 혈관 내벽 모델로부터 대표적 혈관질환에 해당하는 협착과 팽창 질환 의심 영역을 탐색하는 방안을 제안한다. 먼저, 의료영상에서 재구성된 3차원 혈관 내벽 모델로부터 혈관에 대한 골격 곡선(curve skeletons)과 외곽선(contours)을 생성하고, 생성된 골격 곡선을 가지 단위로 분할한 후, 가지에 속하는 각 노드에 대한 외곽선의 면적을 계산한다. 그런 다음, 계산된 외곽선들의 면적에 대해 평균 면적 및 최대/최소 면적, 그리고 인접 노드들 간의 외곽선 면적 차이를 고려하여 협착 및 팽창 질환의심 영역에 해당하는 노드들을 탐색한다. 다음으로 탐색된 의심 영역들을 적절하게 시각화함으로써 혈관질환의 진단을 지원한다. 제안된 방안을 구현하여 몇 가지 3D 인체 혈관모델에 적용한 결과 질환 의심 영역이 잘 찾아짐을 확인하였다. 이를 통해 제안된 방안의 유용성을 보인다.

• 한국산학기술학회논문지
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• 제15권6호
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• pp.3751-3758
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• 2014

본 연구는 제3기 국민건강영양조사 자료를 이용하여 우리나라 65세 이상 노인의 관절염과 동반 만성질환에 따른 건강관련 삶의 질(이하 HRQoL) 감소 양상을 파악하고자 하였다. 연구대상자는 7개 단일질환군(관절염, 추간판탈출증, 골다공증, 천식, 위십이지장궤양, 뇌졸중, 백내장) 1,357명, 관절염에 더하여 상기 만성질환중 하나를 추가 보유한 복합만성질환군 886명, 무질환군 465명 등 총 2,708명이었다. HRQoL 지표인 EQ-5D index를 집단 간에 비교하기 위해 공분산 분석을 실시하였고 관절염과 동반 만성질환의 교호작용을 관찰하기 위해 다중 회귀분석을 실시하였다. 남녀로 나누어 분석한 연구결과는 다음과 같다. 남성에서 연령보정 EQ-5D index 평균치가 관절염군과 유의한 차이를 보인 질환군은 단일질환군 중에는 뇌졸중군이 유일하였으며, 복합만성질환군 중에는 뇌졸중을 동반한 관절염군과 백내장 동반 관절염군이었다. 여성에서 연령보정 EQ-5D index 평균치가 관절염군과 유의한 차이를 보인 질환군은 단일질환군 중에는 천식, 뇌졸중, 백내장 등이었으며, 복합 만성질환군 중에는 골다공증 동반 관절염군, 위십이지장궤양 동반 관절염군, 뇌졸중 동반 관절염군, 백내장 동반 관절염군 등이었다. 다중 회귀분석을 실시한 결과 남성에서는 교호작용이 관찰되지 않았고, 여성에서는 관절염환자가 뇌졸중을 동반한 경우만 교호작용이 관찰되었는데 감산관계 양상을 보였다. 관절염환자에서 건강관련 삶의 질을 평가하는 경우에는 동반 만성질환의 이러한 효과를 고려하여할 것이다.

• Journal of Chest Surgery
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• 제43권4호
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• pp.387-393
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• 2010

배경: 이번 연구의 목적은 정맥내 레이저 응고술(EVLT)과 발거술의 재발을 포함한 중기 임상 결과를 비교 평가하는 것이다. 대상 및 방법: 2007년 1월부터 2010년 2월까지 237명의 환자에서 대복재 및 소복재 정맥류 318개를 대상으로 980-nm 다이오드 레이저 또는 전통적인 발거술을 시행하였다. 첫 방문과 수술 후 1, 2, 6, 12, 18, 24, 36개월째 외래를 방문한 모든 환자를 대상으로 듀플렉스 초음파 검사와 Venous Clinical Severity Score (VCSS) 기록을 위한 임상검사 및 설문조사를 시행하였다. EVLT 및 정맥류 발거술의 두 치료군 간의 임상 결과를 비교하기 위해 수집된 모든 데이터를 이에 맞게 가공하여 분석하였다. 결과: 두 치료군 간에 관통정맥 부전의 수나 정맥 역류의 정도는 차이가 없었다. EVLT나 발거술로 대복재 및 소복재 정맥의 역류가 제거된 후 이 역류 제거 상태의 성공적인 유지율은 양 군간에 차이가 없었으며 12개월째 성공적인 유지율은 EVLT군이 $90.3{\pm}4.5%$, 발거술군이 $93.9{\pm}4.2%$였다. 전체적인 재발율은 EVLT군이 4.4%, 발거술군이 1.5%로 두 군간의 통계적인 차이는 없었다. VCSS 점수는 두 군 모두에서 수술 후 1주와 1개월, 2개월에 유의한 감소를 보였다. 결론: 대복재 및 소복재 정맥 부전의 제거에 대한 효율성이나 정맥 부전으로 인한 임상 경과의 수술 후 개선 능력 등에 있어 EVLT와 발거술은 비슷한 결과를 나타냈다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.783-786
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• 2015

Background: Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. Materials and Methods: In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. Results: The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). Conclusions: In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.

• 대한한방소아과학회지
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• 제23권3호
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• pp.109-119
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• 2009

Objectives The purpose of this study is to collect the statistics of pediatric problems and to develop more effective oriental medical treatments for pediatric diseases, their clinical applicability, and chief complaints on pediatric inpatients in oriental hospitals. Methods The study was composed of seventy inpatients that were age from 0 to 20, had received hospital treatment at the pediatrics in Dongguk Bun-Dang Oriental Medicine Hospital for seven years from 1 January 2002 to 31 December 2008. The chief complaints were mainly categorized by oral examination on their patients. Results 1. In this study, male children were thirty one and female children were 39. Thus, sex ration of male to female was 0.79:1. 2. In age distribution, one month to one year were three (4.3%), 1 to six years were forty two (60%), six to ten years were fifteen (21.4%), and ten to twenty years were ten (14.3%). 3. In November, the number of inpatients was the highest (15.7%) in a year. However, there were no significant seasonal differences. 4. In the systemic division, the respiratory diseases : 44(62.9%), the digestive diseases : 11(15.7%), the infectious diseases : 5(7.1%), the musculoskeletal diseases : 3(4.3%), the diseases of nervous system : 3(4.3%), the gynecologic diseases : 1(1.4%), the liver and biliary disorders : 1(1.4%), and etc. : 3(4.3%). 5. The chief complaint of the inpatients is pneumonia, a common cold, respiratory complex symptoms, rhinitis, sinusitis, bronchitis, tonsillitis, diarrhea and etc. Conclusions The two main causes of inpatients were respiratory diseases and digestive disease. More data of inpatients are required for further study. Thus, the new diseases and treatment methods should be studied as a field of oriental medical treatment.

• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5171-5174
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• 2014

Background: The increase in breast cancer awareness and widespread use of mammographic screening has led to an increased detection of (non-palpable) breast cancers that cannot be discovered through physical examination. One of the methods used in the diagnosis of these cancers is vacuum-assisted core biopsy, which prevents a considerable number of patients from undergoing surgical procedures. The aim of this study was to present the results of stereotactic vacuum-assisted core biopsy for suspicious breast lesions. Materials and Methods: Files were retrospectively scanned and data on demographic, radiological and pathological findings were recorded for patients who underwent stereotactic vacuum-assisted core biopsy due to suspicious mammographic findings at the Interventional Radiology Centre of the Florence Nightingale Hospital between January 2010, and April 2013. Statistical analysis was carried out using Pearson's Chi-square, continuity correction, and Fisher's exact tests. Results: The mean age of the patients was 47 years (range: 36-70). Biopsies were performed due to BIRADS 3 lesions in 8 patients, BIRADS 4 lesions in 77 patients, and BIRADS 5 lesions in 3 patients. Mammography elucidated clusters of microcalcifications in 73 patients (83%) and focal lesions (asymmetrical density, distortion) in 15 patients (17%). In terms of complications, 1 patient had a hematoma, and 2 patients had ecchymoses (3/88; 3.3%). The histopathologic results revealed benign lesions in 63 patients (71.6%) and malignant lesions in 25 patients (28.4%). The mean duration of the procedure was 37 minutes (range: 18-55). Although all of the BIRADS 3 lesions were benign, 22 (28.6%) of the BIRADS 4 lesions and all of the BIRADS 5 lesions were malignant. Among the malignant cases, 80% were in situ, and 20% were invasive carcinomas. These patients underwent surgery. Conclusions: In cases where non-palpable breast lesions are considered to be suspicious in mammography scans, the vacuum-assisted core biopsy method provides an accurate histopathologic diagnosis thus preventing a significant number of patients undergoing unnecessary surgical procedures.

• 한국산학기술학회논문지
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• 제17권2호
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• pp.649-656
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• 2016

본 연구의 목적은 대퇴부골절로 수술 후 섬망 발생군과 섬망이 발생하지 않은 군을 비교하여 수술 후 섬망 발생이 임상 예후에 미치는 영향을 파악하고 섬망의 위험요인을 규명하기 위한 후향적 조사연구이다. 자료수집은 2010년 7월 1일부터 2014년 1월 31일까지 대퇴부골절로 일 대학병원에서 수술한 65세이상 노인환자 68명의 의무기록지를 3년간 추적조사하였다. 연구결과 섬망발생군은 31명(45.6%), 섬망이 발생하지 않은 군이 37명(54.4%)이었으며, 섬망이 발생한 환자의 평균나이는 80.8세, 섬망이 발생하지 않은 군은 81.8세로 대부분 여성이었으며, 통계학적 유의성은 없었다. 섬망유무에 따른 특성은 5종류 이상의 약물복용, 혈중 크레아티닌 수치, 총 의료비용이 섬망 발생군과 섬망이 발생하지 않은 군에 따른 유의한 차이를 보였다. 또한 대퇴부 수술 후 주요 임상경과 발생에 예측요인을 확인하기 위해 Cox의 비례위험 모형(Cox's proportional hazard regression model)을 이용한 결과, 섬망, 5가지이상의 다중약물복용, 수혈경험이 유의한 예측요인으로 나타났다. 따라서, 대퇴부 수술 후 노인의 섬망발생은 환자와 보호자에게 부정적인 결과를 초래할 수 있으므로, 수술 전 섬망과 관련된 위험인자에 대한 평가 및 처치를 시행해야 한다.

• Journal of Preventive Medicine and Public Health
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• 제40권5호
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• pp.388-396
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• 2007

Objectives: The purpose of this study was to examine the relationship between the differences in employment status and self assessed health in Korea. Methods: We analyzed 4 year follow-up data generated by the Korean Labor and Income Panel Study(KLIPS), which was conducted on 1,207 men and 582 women who had undergone a change in employment status. The study subjects were placed into 1 of the following 4 groups based on their employment history; Non-precarious workers, Precarious to non-precarious workers, Non-precarious to precarious workers and Precarious workers. Logistic regression was then used to examine the relationship between the changes in employment status and self assessed health. Results: When males were considered, self assessed health was better among the precarious to non-precarious workers (OR 1.58, 95% CI=1.57-1.60) and the precarious workers (OR 1.29, 95% CI=1.28-1.30) than in the non-precarious workers, after adjusting for age, socioeconomic status (education level, occupational class, marital status, average equivalent household income and average number of hours worked per week), health behavior (smoking, drinking and exercise) and medical service access (regular medical examination, have chronic disease or hospitalized within 1 year). When female workers were considered, the precarious to non-precarious workers (OR 1.89, 95% CI=1.86-1.92), non-precarious to precarious workers(OR 1.24, 95% CI=1.23-1.26) and precarious workers (OR 1.27, 95% CI=1.25-1.28) all reported poorer health than the non-precarious workers after adjusting for the aforementioned factors. Conclusions: This study showed that changes in employment status were associated with differences in self assessed health among men and women. Specifically, the results of this study showed that a corresponding positive outcome based on self assessed health was greater for employees that changed from precarious to non-precarious jobs and for male employees with precarious jobs., whereas female employees with non-precarious jobs had higher self assessed health. However, additional longitudinal studies on the health effects of employment status should be conducted.

• 한국임상수의학회지
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• 제33권1호
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• pp.51-57
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• 2016

In this study, the features of canine lymphoma on fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were evaluated in three small breed dogs. In case 1, ultrasonography and CT indicated neoplastic involvement of the sternal, right axillary, submandibular, lower cervical, tracheobronchial, mesenteric, and sublumbar lymph nodes; spleen; and liver. However, intense FDG uptake on PET/CT images was detected only for the lymph nodes and spleen. No FDG uptake by the liver was detected for case 1 despite the confirmation of lymphoma by cytology. In case 2, ultrasonography and CT indicated neoplastic involvement of the axillary, mesenteric, and sublumbar lymph nodes and the spleen, while intense FDG uptake on PET/CT images was detected for the axillary and a few mesenteric lymph nodes, and the spleen. FDG uptake was additionally observed from popliteal lymph nodes, however there was no uptake by the sublumbar lymph nodes and some mesenteric lymph nodes. In case 3, neoplastic changes in the splenic, mesenteric, and sublumbar lymph nodes and spleen were suspected on ultrasonography, and lower cervical and popliteal lymph node involvements were additionally detected on PET/CT. Compared to ultrasonography, repeated PET/CT showed increased FDG uptake by the lymph nodes at an earlier stage after chemotherapy in case 3. This study illustrated the features of PET/CT in canine lymphomas and compared those to ultrasonography and CT findings. FDG uptakes were not detected from some lesions which were suspected to be neoplastic involvement in case 1 and 2. We could not clearly explain the reason of this result in the present study because cytological or histological examination was not performed for lesions that showed different results on ultrasonography, CT, and PET/CT. Further studies on the subclassification of canine lymphoma and the sensitivity and specificity of PET/CT for the detection of canine lymphoma are required. PET/CT data can provide useful information for predicting the therapeutic response at an early stage after treatment.