• Title/Summary/Keyword: School-public health

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Evaluate Utility of Thyroid Cancer Discrimination by 18F-FDG PET/CT Delay Scan Images (18F-FDG PET/CT검사에서 지연영상을 이용한 갑상선암 진단의 유용성 평가)

  • Lee, Hyeon-Guck;Han, Man-Seok;Kim, Yong-Kyun;Seo, Sun-Youl;Jeon, Min-Cheol;Kim, Tae-Hyung;Hong, Seong-Jong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.6
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    • pp.2958-2965
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    • 2013
  • Purpose : To evaluate the degree of malignancy of incident thyroid lesion found in 18F-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods : A retrograde study was conducted of 25 patients(1 exception) who were admitted in E hospital to receive 18F-FDG PET/CT examination until Janaary and April of 2008. 18F-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal 18F-FDG PET/CT image(1hr) and then 1hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid 18F-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1hr later, we took a 1 bed-delayed image and then made a comparative study between measured maxSUV of 1hr-abnormal uptake image and that of 2hr-delayed image. Results : In this 18F-FDG PET/CT study among the patients who showed incidental 18F-FDG thyroidal uptake the number of thyroid cancer was 5(20.8%), all of then showed benign findings. a comparison of results for 18F-FDG PET/CT. the benign patient measured maxSUV in the PET/CT. image(1hr) mean value 5.06maxSUV and delay image(2hr) mean value 5.23maxSUV differences of two value is 0.19maxSUV and the malignantIt patient measured maxSUV in the PET/CT. image(1hr) mean value 9.63maxSUV and delay image(2hr) mean value 10.65maxSUV differences of two value is 10.65maxSUV in Thyroid abnormal uptake patients. Conclusion : in the case of incidental 18F-FDG uptake in thyroid, max SUV of focal thyroid lesion is above 5.0 if 18F-FDG PET/CT examine the delayed images to add, You could see that reasonable diagnostic method useful. to differentiate whether lesions of malignant.

A study for the factors on choosing hospitals and patients satisfaction between Geriatric Hospitals and General Hospitals (노인병원과 종합병원의 선택요인 및 환자만족도 분석)

  • Yoon, Seo-Jung;Yu, Seung-Hum;Kim, Young-Hoon;Lee, Ji-Jeon
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.46-75
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    • 2004
  • This research anticipated on acknowledging the inpatients factors in choosing which hospital for the geriatric hospital and general hospital they would prefer to go to the analization of different factors in patients satisfaction, and the relation between satisfactory standards and the patients intentions on recommendation or re-visiting the hospital. The statistical data was based upon the 359 question and answer papers that were done by inpatients that were hospitalized in two geriatric hospitals and two general hospitals, and the methods used for analyzing were frequency, t-test, factor analysis, and hierarchical multiple regression. The results are as follows. 1. The factors on choosing hospitals between geriatric hospital and general hospitals were different. The priority for the geriatrics was kindness, and then considerate nursing, and the reliance of treatment. The patients of general hospitals looked first for reliance of treatment, reputation and history of the hospital, and the kindness of the staff. The kindness of the staff, good nursing, and easy procedures were the primary factors of choosing geriatric hospital. 2. The four primary factors in choosing which hospital patients would go to were the predominance of the facilities, kindness and convenience, the reliance and proximity of medical treatment, and recommendation. The patients in the geriatric hospital first looked for kindness and convenience, second the reliance and proximity of medical treatment, third predominance of facilities, and last recommendation. The general hospitals main priority was the reliance and proximity of medical care, second predominance of facilities, kindness and hospitality, and last recommendation. 3. The satisfaction rate was higher in the geriatric hospital compared to general hospitals, but the satisfactory of factors were very similar. Patients in the geriatric hospital were pleased with the hospital staffs kindness, quick nursing and the improvement of inconvenient matters, and clear diagnosis of the doctors. The general hospital patients were satisfied with the hospital staffs clear explanation and accurate diagnosis 4. The analysis in the satisfactory factors turned out to be the environment of the hospital, kindness of the staff, and convenience. Both the patients of the geriatric hospital and general hospitals were very pleased with the kindness of the hospital staff. Ranking second and third was convenience and service for the geriatric hospital, and environment of the hospital and convenience for the general hospital. 5. According to a rank of multiple recurrent analysis of the patients satisfaction and the intention of re-visiting in addition to intention of solicitation, in the case of a geriatric hospital, when the intention of re-visiting is the dependent variable, the first stage shows that the less insurance the patient has, the higher was the intention of re-visiting. In the second stage, the more satisfied the patient is of the staffs kindness, the higher was the intention of re-visiting. Further more, when the intention of solicitation is the dependent variable, the first stage shows that not all the independent variables were significant, but the second stage shows that the more satisfied the patient is of the staffs kindness and the hospital along with the medical treatment expenses, the higher was the intention of solicitation. 6. In the first stage of a rank of multiple recurrent analysis of the satisfaction of the general hospital and the intention of re-visiting, not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. Moreover, when the intention of solicitation was the dependent variable, the first stage shows not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. That is to say, in the case of a general hospital, the satisfaction of the hospital and the medical treatment expenses were high, and the more satisfied the patient is of the hospitals environment and the staffs kindness, the intention of re-visiting and the intention of solicitation was higher.

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Chromosome Aberration in Peripheral Lymphocyte of Radiation Workers in Hospital (병원내 방사선작업종사자들의 염색체이상빈도)

  • Yi, Chun-Ja;Ha, Sung-Whan;Jung, Hae-Won
    • Journal of Radiation Protection and Research
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    • v.22 no.4
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    • pp.227-235
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    • 1997
  • Cytogenetic studies were performed in peripheral blood lymphocytes from hospital workers occupationally exposed to low doses of radiation (0.30 - 40.07mSv). The workers were divided into three groups according to their job area : 18 diagnostic radiology, 17 therapeutic radiology, and 16 nuclear medicine. The control group consisted of 49 non-radiation workers with no history of exposure to radiation. A higher percentage of cells with aberration(1.275%) was observed in the workers compared to the controls(0.677%) and the difference was statistically significant(p<0.001). The frequency of chromosomal aberration was $0.706{\times}10^{-2}$/cell in the exposed and $0.344{\times}10^{-2}$/cell in the control(p<0.05). Chromosomal exchange frequency was $0.083{\times}10^{-2}$/cell in the control vs $0.245{\times}10^{-2}$/cell in the workers. There was no evidence of significant increase of chromosome aberration related to age or to the duration of employment. The frequency of chromosomal exchange in workers of nuclear medicine was $0.313{\times}10^{-2}$/cell, which was significantly higher than in the control($0.083{\times}10^{-2}$/cell) or other working groups: therapeutic radiology($0.265{\times}10^{-2}$/cell), and diagnostic radiology($0.167{\times}10^{-2}$/cell). No dose-effect relation was found between chromosome aberration and total cumulative doses, recent 5 yr, recent 2 yr cumulative dose. But in case of last 1 yr cumulative dose, dose-dependant increase was observed when controls were considered(p<0.05). The radiation dose which workers have received was much lower than the maximum permissible dose, but there was a significant difference in the frequency of chromosome aberration between occupationally exposed workers and control. So, it is clear that chromosome aberration is a quite sensitive indicator of radiation exposure and it can be detected at very low dose level of occupational exposure.

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Comparison of relative fitness between zirconia single coping and 3-unit fixed partial dentures (FPDs) manufactured by dental CAD/CAM system (치과 캐드/캠 시스템으로 제작된 지르코니아 single 코핑과 3-unit 구조물의 상대적 적합도 비교)

  • Lee, Wan-Sun;Park, Jong-Kyoung;Kim, Wook-Tae
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.1
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    • pp.16-22
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    • 2014
  • Purpose: The purpose of this study was to assess the marginal and mesial fitness of zirconia single copings and 3-unit fixed partial dentures (FPDs) manufactured with an identical model. Materials and Methods: An epoxy model in which the maxillary right 2nd premolar is lost and maxillary 1st premolar and 2nd molar are formed as abutments was manufactured and scanned by using a laser scanner. A ten units of zirconia single copings were manufactured for maxillary 1st premolar and 2nd molar, respectively and the same number of 3-unit FPDs were manufactured. For the measurements of fitness, the manufactured silicone replicas were divided into four parts and the fitness were measured by digital microscope at measurement points (P1, P2, P3, P4 and P5) of each plane. The measured gaps were classified into three categories: marginal gap (MG, P1), axial gap (AG, average of P2 and P3), occlusal gap (OG, average of P4 and P5). Results: The ranges of MG, AG and OG for single copings were 18.47 - 40.54 ${\mu}m$, 39.73 - 73.61 ${\mu}m$ and 116.90 - 134.69 ${\mu}m$, respectively. The ranges of MG, AG and OG for 3-unit FPDs were 45.95 - 87.44 ${\mu}m$, 23.78 - 57.00 ${\mu}m$ and 99.89 - 131.06 ${\mu}m$, respectively. Conclusion: The result of the study shows that the MGs for 3-unit FPDs were higher than those of single copings, though they are within the range of clinical acceptance, indicating that the use of more homogeneous zirconia block and modification of sintering processes are needed to ensure the prevention of increase of gap in 3-unit FPDs.

The Influence of Job Stress and Job Satisfaction on Turnover Intention for Male Dental Hygienists (남자 치과위생사의 직무 스트레스와 직무 만족도가 이직의도에 미치는 영향)

  • Kim, Young-ki;Kwon, Ho-Jang
    • Journal of dental hygiene science
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    • v.16 no.2
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    • pp.142-149
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    • 2016
  • The number of male dental hygienists has been continuously increasing in dental services. The purpose of this study aimed to identify the relationship between job stress, job satisfaction, and turnover intention in male dental hygienists and to provide basic data to improve their job satisfaction. The study population was 110 Korean male dental hygienists working for dental clinics or hospitals. The data were collected from November 10 to December 7, 2015. After an explanation about the objective of the study, 110 questionnaires were distributed via email, and 97 responses were analyzed using SPSS. Overall averages of job stress, job satisfaction and turnover intention in male dental hygienists were 3.05, 2.92, and 3.47 out of 5, respectively. Some sub-factors of job stress, including interpersonal relationships at the workplace and future prospects of dental clinics, were proven to have statistically significant negative influence on job satisfaction (p<0.001). Regression analysis was performed with job stress and job satisfaction as independent variables and turnover intention as a dependent variable. Results showed that job stress had a positive effect on turnover intention (p<0.01) while job satisfaction had a negative effect on turnover intention (p<0.001). Job satisfaction was revealed to have statistically significant negative influence on turnover intention (p<0.001). Some of sub-factors of job stress, including work environment and future prospects of dental clinics and professional position, had a positive effect on turnover intention (p<0.05). The study showed that higher job stress led to higher turnover intention, and higher job satisfaction led to lower turnover intention. Accordingly, job stress and job satisfaction are critical factors for turnover intention in male dental hygienists.

Practice guidelines for managing extrahepatic biliary tract cancers

  • Hyung Sun Kim;Mee Joo Kang;Jingu Kang;Kyubo Kim;Bohyun Kim;Seong-Hun Kim;Soo Jin Kim;Yong-Il Kim;Joo Young Kim;Jin Sil Kim;Haeryoung Kim;Hyo Jung Kim;Ji Hae Nahm;Won Suk Park;Eunkyu Park;Joo Kyung Park;Jin Myung Park;Byeong Jun Song;Yong Chan Shin;Keun Soo Ahn;Sang Myung Woo;Jeong Il Yu;Changhoon Yoo;Kyoungbun Lee;Dong Ho Lee;Myung Ah Lee;Seung Eun Lee;Ik Jae Lee;Huisong Lee;Jung Ho Im;Kee-Taek Jang;Hye Young Jang;Sun-Young Jun;Hong Jae Chon;Min Kyu Jung;Yong Eun Chung;Jae Uk Chong;Eunae Cho;Eui Kyu Chie;Sae Byeol Choi;Seo-Yeon Choi;Seong Ji Choi;Joon Young Choi;Hye-Jeong Choi;Seung-Mo Hong;Ji Hyung Hong;Tae Ho Hong;Shin Hye Hwang;In Gyu Hwang;Joon Seong Park
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.161-202
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    • 2024
  • Backgrounds/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions: The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

The Association of Central Obesity with Type 2 Diabetes among Koreans according to the Serum Gamma-Glutamyltransferase Level: Korean Genome and Epidemiology Study (혈청 Gamma-Glutamyltransferase에 따른 복부비만과 제2형 당뇨병간의 관련성: Korean Genome and Epidemiology Study)

  • Shin, Ji-Yeon;Hwang, Jun-Hyun;Jeong, Jin-Young;Kim, Sung-Hi;Moon, Jai-Dong;Roh, Sang-Chul;Kim, Young-Wook;Kim, Yang-Ho;Leem, Jong-Han;Ju, Young-Su;Hong, Young-Seoub;Ha, Eun-Hee;Lee, Yong-Hwan;Lee, Duk-Hee;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.386-391
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    • 2009
  • Objectives : This cross-sectional study was performed to examine if the serum gamma-glutamyltransferase (GGT) level that is within its normal range is associated with the risk of type 2 diabetes and if the association between the waist hip ratio (WHR) and type 2 diabetes is different depending on the serum GGT levels. Methods : The study subjects were 23,436 persons aged 40 years or older and who participated in regular health check-ups at 11 hospitals (males: 5,821, females: 17,615). The gender-specific quintiles of the serum GGT and WHR were used to examine the associations with type 2 diabetes. Results : The serum GGT levels within their normal range were positively associated with type 2 diabetes only in women. The adjusted odds ratios (ORs) were 1.0, 1.0, 1.4, 2.1, and 2.5 according to the quintiles of the serum GGT ($p_{trend}$<0.01). The WHR was more strongly associated with the prevalence of diabetes among the women with a high-normal serum GGT level as compared with those with a low-normal serum GGT level (p for interaction=0.02). For example, the adjusted ORs for women with a low normal serum GGT level were 1.0, 1.2, 1.5, 2.2, and 2.4 according to the quintiles of the WHR, while those figures were 1.0, 2.4, 3.6, 5.0, and 8.3 among the women with a high normal serum GGT level. However, in men, the serum GGT was very weakly associated with type 2 diabetes and the association between the WHR and type 2 diabetes was not different depending on the serum GGT level. Conclusions : Serum GGT within its normal range was positively associated with type 2 diabetes, and central obesity was more strongly associated with the prevalence of type 2 diabetes when the serum GGT level was highnormal. However, these associations were observed only in women, which is different from the previous findings. The stronger relation between central obesity and type 2 diabetes among women with a high-normal serum GGT level can be useful for selecting a group that is at high risk for type 2 diabetes irregardless of whatever the underlying mechanism is.

Relation of Self-Efficacy and Cognition of Irradiated Food among High School Students (고등학생의 방사선조사식품에 대한 인식과 자기효능감과의 관련성)

  • Han, Eun Ok;Choi, Yoon Seok
    • Journal of Radiation Protection and Research
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    • v.38 no.2
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    • pp.106-118
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    • 2013
  • In this paper, we analyzed the Cognition of irradiated food and its relation with self-efficacy. The most important variables described behaviors based on health choices compared with the choice to choose irradiated food items. According to the survey, 33.1% of respondents said that the reason why irradiated food is considered to be a health risk is because "radiation is dangerous". 27.9% of respondents answered that "eating irradiated food is like eating a radioactive substance", 21.1% said radiated food is comparable to a "genetic variation in food" while 10.1% said "food goes bad during the irradiation process". On this basis, it is reasonable to conclude that respondents have a misunderstanding of irradiated food without reference to the general theory of irradiated knowledge. In this respect, it would be helpful to provide education showing that irradiated food is not related to eating harmful or genetically modified food to help high school students create informed opinions of irradiated food. In terms of relevance with health-specific self-efficacy, experience of acquiring information about irradiated food was marked at r=0.148 (p<0.01), experience of purchasing irradiated food was marked at r=0.077 (p<0.05), experience of eating irradiated food was marked at r=0.113 (p<0.01) while knowledge of irradiated food, attitude towards irradiated food and behavior was marked at r=0.103 (p<0.01), r=0.076 (p<0.05) and r=0.105 (p<0.01) respectively. This shows that self-efficacy is high when one has experience of acquiring information about irradiated food, purchasing or eating irradiated food resulting in a high level of knowledge, attitude and behavior. Education which serves to improve the level of self-efficacy needs to be provided along with an educational program which will increase the public's understanding of irradiated food. It is expected that if this education which increases the level of self-efficacy is provided together with correct information of irradiated food, behavior to choose and eat irradiated food will also improve.

Proving Causation With Epidemiological Evidence in Tobacco Lawsuits (담배소송에서 역학적 증거에 의한 인과관계의 증명에 관한 소고)

  • Lee, Sun Goo
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.2
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    • pp.80-96
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    • 2016
  • Recently, a series of lawsuits were filed in Korea claiming tort liability against tobacco companies. The Supreme Court has already issued decisions in some cases, while others are still pending. The primary issue in these cases is whether the epidemiological evidence submitted by the plaintiffs clearly proves the causal relationship between smoking and disease as required by civil law. Proving causation is difficult in tobacco lawsuits because factors other than smoking are involved in the development of a disease, and also because of the lapse of time between smoking and the manifestation of the disease. The Supreme Court (Supreme Court Decision, 2011Da22092, April 10, 2014) has imposed some limitations on using epidemiological evidence to prove causation in tobacco lawsuits filed by smokers and their family members, but these limitations should be reconsidered. First, the Court stated that a disease can be categorized as specific or non-specific, and for each disease type, causation can be proven by different types of evidence. However, the concept of specific diseases is not compatible with multifactor theory, which is generally accepted in the field of public health. Second, when the epidemiological association between the disease and the risk factor is proven to be significant, imposing additional burdens of proof on the plaintiff may considerably limit the plaintiff's right to recovery, but the Court required the plaintiffs to provide additional information such as health condition and lifestyle. Third, the Supreme Court is not giving greater weight to the evidential value of epidemiological study results because the Court focuses on the fact that these studies were group-level, not individual-level. However, group-level studies could still offer valuable information about individual members of the group, e.g., probability of causation.

Bundled Discounting of Healthcare Services and Restraint of Competition (의료서비스의 결합판매와 경쟁제한성의 판단 - Cascade Health 사건을 중심으로 -)

  • Jeong, Jae Hun
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.175-209
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    • 2019
  • The bundled discounting which the dominant undertakings engage in is problematic in terms of competition restraint. Bundled discounts generally benefit not only buyers but also sellers. Specifically, bundled discounts usually costs a firm less to sell multiple products. In addition, Bundled discounts always provide some immediate consumer benefit in the form of lower prices. Therefore, competition authorities and courts should not be too quick to condemn bundled discounts and apply the neutral and objective standard in bundled discounting cases. Cascade Health v. Peacehealth decision starts ruling from this prerequisite. This decision pointed out that the dominant undertaking can exclude rivals through bundled discounting without pricing its products below its cost when rivals do not sell as great a number of product lines. So bundled discounting may have the anticompetitive impact by excluding less diversified but more efficient producers. This decision did not adopt Lepage case's standard which does not require the court to consider whether the competitor was at least as efficient of a producer as the bundled discounter. Instead of that, based on cost based approach, this decision said that the exclusionary element can not be satisfied unless the discounts result in prices that are below an appropriate measures of the defendant's costs. By adopting a discount attribution standard, this decision said that the full amount of the discounts should be allocated to the competitive products. As the seller can easily ascertain its own prices and costs of production and calculate whether its discounting practices exclude competitors, not the competitor's costs but the dominant undertaking's costs should be considered in applying discount attribution standard. This case deals with bundled discounting practice of multiple healthcare services by the dominant undertaking in healthcare market. Under the Korean healthcare system and public health insurance system, the price competition primarily exists in non-medical care benefits because public healthcare insurance in Korea is in combination with the compulsory medical care institution system. The cases that Monopoly Regulation and Fair Trade Law deals with, such as cartel and the abuse of monopoly power, also mainly exist in non-medical care benefits. The dominant undertaking's exclusionary bundled discounting in Korean healthcare markets may be practiced in the contracts between the dominant undertaking and private insurance companies with regards to non-medical care benefits.