• 농촌의학ㆍ지역보건
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• 제47권3호
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• pp.143-153
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• 2022

목적: 병원에서 재가 및 시설로 퇴원한 환자가 지역사회에서 건강을 유지하기 위해서는 전환기 돌봄서비스(Transitional care services)가 필요하다. 이를 위해 지역사회 내 의료서비스와 자원을 연계하는 주치의의 역할이 중요시된다. 본 연구에서는 선행연구를 바탕으로 일차진료 의사들의 환자중심성에 대한 인식을 파악하여 환자중심 기반의 서비스 제공을 위해 필요한 정책을 제시하였다. 또한 Transitional Care Service에 대한 일차진료 의사들의 인식을 확인하고 인구사회학적 요인과의 관계를 확인함으로써 서비스 우선순위를 도출하고자 하였다. 방법: 본 연구는 전국의 가정의학과, 내과, 신경과 등 노인 질환과 관련 있는 과의 전문의 자격증이 있으며 자발적으로 온라인 설문조사에 참여할 의사를 표현한 일차진료 의사 259명을 대상으로 수행되었다. 환자중심성 및 전환기 돌봄서비스에 대한 인식을 살펴보기 위해 구조화된 설문지를 개발하였으며, 조사전문업체를 통해 2019년 10월 28일부터 2019년 11월 22일까지 온라인으로 설문조사를 수행하였다. 결과: 본 연구에 대한 주요 결과는 다음과 같다. 첫째, 일차진료 의사들을 대상으로 9가지 전환기 돌봄서비스 인식에 대해 살펴본 결과 "입원 시 진단, 건강상태, 치료계획 및 결과 에 대한 설명(4.4)"과 "퇴원 후 자가 건강관리를 위한 정보 및 훈련 (4.2)"에 대한 필요성이 높게 나타났다. 둘째, 35세 이상 일차진료 의사가 34세 이하 일차진료 의사보다 전환기 돌봄서비스에 대한 인식이 높게 나타났다(F=7.3, p<0.01). 또한, 환자중심성에 대한 인식이 높을수록, 연령이 높을수록, 서울 외 지역에서 근무할수록 전환기 돌봄서비스에 대한 인식이 높게 나타났다. 결론: 본 연구에서는 일차의료를 제공하는 의료진들을 위한 교육프로그램과 지역사회에서 일차의료 의사들을 중심으로 하는 지역 연계 방안을 제시하였다는 점에서 의의가 있다.

• 대한통합의학회지
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• 제10권4호
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• pp.165-173
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• 2022

Purpose : This study was conducted to apply a 12-week resistance exercise program to obese elderly people with sarcopenia and verify the risk factors of sarcopenia and metabolic syndrome as well as the effects of this program on improving muscle function, and thus to serve as basic data for preventing and improving sarcopenia. Methods : Forty elderly people aged 65 or older were recruited and underwent dual energy x-ray absorptiometry. Based on the criteria of appendicular skeletal muscle mass (ASM/Height²: less than 5.4 kg/m²) and body fat percentage (at least 30 % for women and 25 % for men), 18 obese elderly people with sarcopenia were finally selected after excluding 22 elderly people who did not meet the criteria. Variables related to sarcopenia, metabolic syndrome, and muscle function were measured before the 12-week resistance exercise program. Results : The 12-week resistance exercise program significantly increased the bone density and muscle mass and decreased the fat mass and fat percentage in obese elderly with sarcopenia. The 12-week resistance exercise program significantly increased the HDL-C and decreased the LDL-C and waist circumference in obese elderly people with sarcopenia (p<.05). The 12-week resistance exercise program significantly increase grip strength, static balance, and 6-minute walking in obese elderly people with sarcopenia (p<.05). Conclusion : Accordingly, resistance exercise is considered a way to reduce the exorbitant medical expenses of patients who are bedridden for long and improve the lowered quality of individuals in a super-aged society.

• Journal of Hospice and Palliative Care
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• 제25권4호
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• pp.198-203
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• 2022

Purpose: To grasp public opinion accurately, we conducted an opinion poll on beliefs and attitudes toward physician-assisted suicide (PAS). Methods: A randomized telephone survey ensuring a representative sample was conducted, 1,007 participants aged 18 years or older (response rate, 9.5%). Results: The main results are as follows: i) 61.1% of participants thought that the current social support system for terminally ill patients and their families is insufficient; ii) 60% of participants did not recognize the term "hospice and palliative care"; iii) 81.7% of participants would not like to receive life-sustaining treatment if there is no possibility of recovery; iv) 58.4% of participants would like to receive hospice and palliative care if they are diagnosed with a terminal illness; v) the priorities for dignified dying were preparing a support system to reduce the burden of care (28.6%), economic support including reduction of medical expenses (26.7%), expansion of hospice and palliative care services (25.4%), and legalization of PAS (13.6%); and vi) 58.3% of participants agreed that the expansion of hospice and palliative care should precede the legalization of PAS. Conclusion: Koreans currently want other efforts, including expansion of hospice and palliative care services, instead of the legalization of PAS.

• PNF and Movement
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• 제21권2호
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• pp.223-229
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• 2023

Purpose: Assessing physical strength and muscle mass is crucial, but many methods rely on specialized equipment, which can be challenging. In situations where a quick and straightforward test is needed, the sit-to-stand test (STST) proves useful. Although several studies have investigated STST and muscle mass separately, the actual correlation between these two factors has not been extensively researched. Hence, the objective was to comprehensively investigate the correlations between the different tests. Methods: The study participants consisted of 20 healthy young men in their 20s. In this study, measurements were taken for muscle mass, the five-times sit-to-stand test, the 30-second sit-to-stand test, and the 1-minute sit-to-stand test. The results of each test were analyzed using Pearson's correlation analysis. Results: Although no significant correlation was found between muscle mass and STST, interestingly, significant correlations were observed among the different types of STST. Conclusion: The STST is a rapid and straightforward test used to assess lower limb strength and balance ability in individuals. However, there is a dearth of research on STST conducted in domestic settings. Based on the findings of this study, further research is necessary to establish age- and gender-specific reference values for STST. This will allow its broader application, encompassing not only older adults and patients but also healthy individuals.

• 대한이식학회지
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• 제31권4호
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• pp.170-176
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• 2017

We need to establish an informative guideline to increase inter-institutional and inter-observer reproducibility of renal transplant diagnosis, and to improve the diagnostic ability of pathologists in Korea. A first nation-wide survey for renal transplant pathology was conducted by Renal Pathology Study Group of the Korean Society of Pathologists in 2016, to provide the continued excellence in the transplantation pathology laboratory, and to improve the diagnostic ability for the best treatment of transplant patients. This survey revealed the significant variations in scale, work load and biopsy indications for the renal transplant pathology in various institutions in Korea. The Banff classification were used by all institutions for the diagnosis of renal transplant pathology, but different formats were used: most institutions (70%) used the "2013 Banff classification" while the others were using "2007 Banff classification" (20%) or even older formats. In daily diagnostic practice of the renal allografts, difficulties that pathologists encounter were quite diverse due to different environments they work in. Most respondents agreed that standardized diagnostic practice guidelines, regular education on renal transplant pathology and convenient ways of consultation are further needed. We are currently working toward the enhancement of the expertise of renal pathologists and to increase inter-institutional and inter-observer reproducibility by 1) development of a set of virtual slides of renal allograft biopsies for the training, 2) validation and gathering expert's consensus on the core variables of rejection diagnosis by using virtual slides, and 3) continued education by the developed virtual slide atlas.

• 대한한의학회지
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• 제44권2호
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• pp.1-9
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• 2023

Objectives: To study symptom differentiation for yang deficiency and blood heat based on 117 psoriasis patients. Methods: Obtained frequency analysis (%), mean (%), and OR, CL(P-value) with prospective pre-post intervention design and multiple regression analysis. Results: There were no statistically significant differences as to sex, BMI, smoking and marital status, but there were statistically significant differences in variables of average age, family history, and alcohol consumption (P<0.05). There were no statistically significant differences in psoriasis symptoms as to initial age of onset, morbidity span, area of the initial onset, and the progression of psoriasis during the last three months of each patient. However, the type of psoriasis showed a statistically significant difference (p=0.011). While there were no statistically significant differences as to common cold, condition of psoriasis after recovering from the cold, skin condition, exercise, and seasonality, irregular perspiration showed significant difference (p<0.00). When confounding factors have been controlled the blood heat patient group as the comparison group, multiple regression analysis showed OR, CI(95%) of 1.06(0.31-3.63) for men, 0.28(0.08-1.06) for aged 30 to 49,0 and 0.18(0.04-0.80) for aged 50 and older. it was 0.06(0.01-0.7) for family history, 1.06(0.29-3.88) for drink alcohol, 19.90(2.53-156.7) for seasonality, and 10.28 (3.19-33.11) for perspiration problems. In these variables, Sex, age, smoking, and alcohol consumption showed no statistically significant results, but family history(p=0.049), seasonality(p=0.005), and irregular perspiration (p=0.017) were statistically significant. Conclusion: Family history, seasonality and irregular perspiration are the determining factors for yang deficiency and blood heat in psoriasis.

• 대한물리의학회지
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• 제18권2호
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• pp.41-48
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• 2023

PURPOSE: Falls are caused by a decline in physical and cognitive function. A quantitative evaluation tool that can comprehensively evaluate motor and cognitive functions for elderly people with an impaired physical function. This study assessed the clinical application potential by confirming the correlation between the physical function tests, cognitive and the stepping trail-making test (S-TMT). METHODS: Fourteen community-dwelling older patients (65-75 years) were recruited. The study conducted cognitive function tests with the trail-making test (TMT-A, B), and physical function tests (6-minute walking test (6MWT), short physical performance battery (SPPB), and timed up and go (TUG)). The results of were analyzed using SPSS version 21.0. Descriptive statistics were used for the general characteristics of the study subjects, and the correlations between S-TMT, other functional tests were examined through Pearson's correlation analysis. The statistical significance was set to .05. RESULTS: S-TMT had a significant positive correlation with the TUG (r = .588^*) and trail-making test-B (TMT-B) (r = .689^*, p < .05). Furthermore, S-TMT showed a negative correlation between SPPB (r = -.397) and 6MWT (r = -.422), but it was not statistically significant. CONCLUSION: S-TMT is a cognitive-gait dual-task performance evaluation tool that can be performed safely. A significant correlation was confirmed between the TUG test and the TMT-B. S-TMT is a dual-task screening tool that can evaluate both physical and cognitive functions simultaneously.

• 치위생과학회지
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• 제23권3호
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• pp.225-235
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• 2023

Background: This study aimed to analyze the effects of periodontal treatment and individual- and tooth-related factors on tooth extraction in people with disabilities. Methods: The Korea National Health Insurance claims data of individuals with disabilities aged 40~64 years with chronic periodontitis in 2008 were obtained. Of these, data on the disabled who underwent scaling/root plaining, subgingival curettage/periodontal surgery, or non-periodontal treatments, and data on their teeth were selected. The extraction of 716,688 teeth from 39,097 patients was tracked until 2018, and the patient- and tooth-level factors related to tooth loss were identified using a mixed-effect logistic regression analysis. Results: Data from approximately 17% of the teeth were extracted during a follow-up period of approximately 11 years. Among the tooth-level variables, scaling/root planing treatment at baseline and periodontal treatment during the follow-up period were associated with a lower risk of tooth loss (odds ratio=0.692 and 0.769, respectively, p<0.001). Non-vital teeth increased the risk of tooth loss by 3.159 times (p<0.001). Among the patient-level variables, females were less likely to have lost their teeth than males, and those with orthopedic impairment or brain lesions/mental disabilities, a higher age group, lower income level, or residents in medium/small cities or rural areas were more likely to have lost their teeth (p<0.001). Conclusion: Through approximately 11 years of follow-up, scaling or root planing, experience with periodontal treatment at least once, female sex, older age, lower income, smaller residential areas, type of disability, and pulp vitality were found to be associated with tooth loss in individuals with disabilities aged 40~64 years with chronic periodontitis. To prevent tooth loss in individuals with disabilities, it is necessary to establish a dental treatment plan that considers the timing of periodontal treatment and the characteristics of the patient and teeth.

• 한국전자통신학회논문지
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• 제18권5호
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• pp.989-998
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• 2023

급격한 인구 고령화 및 식습관의 변화로 만성질환과 디지털 헬스케어에 대한 관심이 증가하고 있다. 2020년 노인실태조사에 따르면 우리나라 65세 이상 인구 중 84%가 한 가지 이상의 만성질환을 앓고 있으며, 고령층이 복용하는 약물의 종류 및 복용 기간도 증가하고 있다. 만성질환자의 순응을 높이는 관리는 합병증의 발병을 예방하여 심각한 질환으로 이어지는 것을 방지할 수 있기 때문에 약 복용에 대한 습관이 매우 중요하다. 본 논문에서는 OCR 기술을 활용한 복약 정보 검색 시스템을 제안한다. Google Cloud Vision API를 활용하여 의약품명을 검출 및 인식하고, 인식된 의약품명을 DB에서 검색하여 사용자에게 복약 정보 및 복약 일정 관리서비스를 제공한다. 복약 정보 검색을 통해 올바른 의약품 정보를 제공함으로써 복약 방법과 습관에 변화를 줄 수 있다. 또한, OCR 기술을 통해 직접 입력에 따른 불편을 제거하여 사용자에게 정보를 신속하게 전달함으로써 편의가 증진될 것으로 기대된다.

• 한국치위생학회지
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• 제24권1호
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• pp.9-16
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• 2024

Objectives: The demand for dental care is expected to increase as the population ages. This study aimed to predict the utilization of dental implant care following the expansion of national health insurance benefits for dental implants. Methods: Multiple linear regression analysis was performed on HIRA big data open portal data and DNN-based artificial intelligence models to forecast the utilization of dental care in relation to the national health insurance coverage for dental implants. Results: National health insurance coverage of dental implants was found to be associated with the number of patients using dental implant services and demonstrated a statistical significance. The dental implant services utilization increased with the increased dental implant health insurance benefits for the elderly population, increased mean by region, increased number of dental institutions by region, and increased health insurance coverage rate for dental implants. However, the dental implant services utilization decreased with the increased number of older people living alone and increased size of dental institutions. Conclusions: With the expansion of the national health insurance coverage for dental implants, it is predicted that the utilization of dental implant medical services will increase in the future.