• 제목/요약/키워드: The informed consent

검색결과 426건 처리시간 0.032초

고혈압노인의 식사시간 별 식후저혈압 발생실태 (Prevalence of Postprandial Hypotension in the Elderly People with Hypertension according to Mealtimes)

  • 손정태;이은주;김현미
    • 한국노년학
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    • 제31권4호
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    • pp.969-983
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    • 2011
  • 본 연구의 목적은 고혈압노인의 식사시간 별 혈압변화와 식후저혈압(PPH: Postprandial hypotension) 발생을 파악하기 위해 아침, 점심, 저녁 세 끼 식사 전후의 혈압을 측정하였다. 노인 복지시설에 거주하는 고혈압 노인 187명으로부터 서면동의를 받은 후 시행되었다. 혈압측정 도구는 휴대용 혈압모니터(ABPM)를 사용하여 아침, 점심, 저녁의 식전 30분부터 식후 2시간까지 15분 간격으로 측정하였다. 수집된 자료는 SPSS Win 14.0 program으로 빈도와 백분율, 평균과 표준편차, ANOVA와 Scheffé 사후검정을 이용하여 분석하였으며, 연구결과는 다음과 같다. • 수축기혈압과 이완기혈압의 하강 정도는 아침 식후가 점심이나 저녁 식후 보다 유의하게 더 많았다. • PPH 발생률은 아침 식후에는 73.4%, 점심 식후에는 54.2%, 저녁에는 50.2%이었다. • PPH가 가장 많이 발생한 시점은 아침과 점심 저녁 모두 식사 시작 후 90분이었다. • 식후 혈압을 8회 측정한 것을 기준했을 때, 평균 PPH 발생 횟수는 아침 식후가 평균 3.0±2.7회로 점심 평균 2.1±2.5회와 저녁 평균 1.9±2.4회 보다 더 많았다. 고혈압노인의 간호에서는 점심이나 저녁 식사에서보다는 아침식사 후에 PPH 발생이 더 많다는 점을 고려하여야 할 것이다. 또한 식사 시작 후 1시간에서 2시간 동안은 PPH로 인한 건강문제가 발생하지 않도록 주의 관찰과 간호관리가 이루어져야 한다. 아울러 고혈압노인의 PPH를 조절할 수 있는 간호중재를 개발하기 위한 추후연구가 활성화되어야 한다.

Association between High Diffusion-Weighted Imaging-Derived Functional Tumor Burden of Peritoneal Carcinomatosis and Overall Survival in Patients with Advanced Ovarian Carcinoma

  • He An;Jose AU Perucho;Keith WH Chiu;Edward S Hui;Mandy MY Chu;Siew Fei Ngu;Hextan YS Ngan;Elaine YP Lee
    • Korean Journal of Radiology
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    • 제23권5호
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    • pp.539-547
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    • 2022
  • Objective: To investigate the association between functional tumor burden of peritoneal carcinomatosis (PC) derived from diffusion-weighted imaging (DWI) and overall survival in patients with advanced ovarian carcinoma (OC). Materials and Methods: This prospective study was approved by the local research ethics committee, and informed consent was obtained. Fifty patients (mean age ± standard deviation, 57 ± 12 years) with stage III-IV OC scheduled for primary or interval debulking surgery (IDS) were recruited between June 2016 and December 2021. DWI (b values: 0, 400, and 800 s/mm2) was acquired with a 16-channel phased-array torso coil. The functional PC burden on DWI was derived based on K-means clustering to discard fat, air, and normal tissue. A score similar to the surgical peritoneal cancer index was assigned to each abdominopelvic region, with additional scores assigned to the involvement of critical sites, denoted as the functional peritoneal cancer index (fPCI). The apparent diffusion coefficient (ADC) of the largest lesion was calculated. Patients were dichotomized by immediate surgical outcome into high- and low-risk groups (with and without residual disease, respectively) with subsequent survival analysis using the Kaplan-Meier curve and log-rank test. Multivariable Cox proportional hazards regression was used to evaluate the association between DWI-derived results and overall survival. Results: Fifteen (30.0%) patients underwent primary debulking surgery, and 35 (70.0%) patients received neoadjuvant chemotherapy followed by IDS. Complete tumor debulking was achieved in 32 patients. Patients with residual disease after debulking surgery had reduced overall survival (p = 0.043). The fPCI/ADC was negatively associated with overall survival when accounted for clinicopathological information with a hazard ratio of 1.254 for high fPCI/ADC (95% confidence interval, 1.007-1.560; p = 0.043). Conclusion: A high DWI-derived functional tumor burden was associated with decreased overall survival in patients with advanced OC.

산모혈액 및 태아 제대혈액의 수은 농도에 따른 출생 시 체중에 관한 연구 (Birth Weight of Mercury Concentrations of Maternal and Umbilical Cord Blood in Pregnant Women)

  • 김병미;김대선;이종화;박혜숙;김영주;서주희;장문희;하은희
    • 한국환경보건학회지
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    • 제34권1호
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    • pp.12-19
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    • 2008
  • We evaluated the relationship between birth weight and mercury exposure levels in Seoul, Korea, by following a cohort of pregnant women and the outcomes of their pregnancies between 2001-2005. Eighty-five pregnant women were recruited into this study after obtaining informed consent. Samples were collected at delivery from normal pregnant women who were living in the city of Seoul, Korea. Mercury concentrations in 85 sets of maternal and cord blood samples were measured using a gold-amalgam collection method. We used multiple regression analysis to analyze the effect of mercury exposure on birth weight. The mean levels of total mercury concentrations were 5.41(ppb) in maternal blood of pregnant women and 3.58(ppb) in umbilical cord blood. The mean concentration of umbilical cord blood mercury exposures was higher than the level recommended by WHO. There was a significant correlation between maternal and cord blood mercury concentrations. Mercury concentrations of umbilical cord blood was associated with birth weight. In addition, after adjusting for potential confounding factors, we found that mercury exposure may reduce the birth weight. This study suggests that exposure to mercury concentration during pregnancy contributes to the risk of low birth weight. Therefore, prenatal and environmental education for various and possible sources of mercury exposure might be necessary for the good health of babies. The finding of this study supports the construction of national policy for environmental health management.

Evaluation of Chromosomal Alteration in Electrical Workers Occupationally Exposed to Low Frequency of Electro Magnetic Field (EMFs) in Coimbatore Population, India

  • Balamuralikrishnan, Balasubramanian;Balachandar, Vellingiri;Kumar, Shanmugam Suresh;Stalin, Nattan;Varsha, Prakash;Devi, Subramaniam Mohana;Arun, Meyyazhagan;Manikantan, Pappuswamy;Venkatesan, Chinnakulandhai;Sasikala, Keshavarao;Dharwadkar, Shahnaz N.
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권6호
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    • pp.2961-2966
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    • 2012
  • Extremely low frequency electro magnetic fields (EMFs) have been classified as possibly carcinogenic to humans by the International Agency for Research on Cancer. An increased number of chromosomal alterations in peripheral lymphocytes are correlated with elevated incidence of cancer. The aim of the present study was to assess occupationally induced chromosomal damage in EMF workers exposed to low levels of radiation. We used conventional metaphase chromosome aberration (CA) analysis and the micronucleus (MN) assay as biological indicators of non ionizing radiation exposure. In the present study totally 70 subjects were selected including 50 exposed and 20 controls. Informed written consent was obtained from all participants and the study was performed in accordance with the Declaration of Helsinki and the approval of the local ethical committee. A higher degree of CA and MN was observed in exposed subjects compared to controls, the frequency of CA being significantly enhanced with long years of exposure (P<0.05). Moreover increase in CA and MN with age was noted in both exposed subjects and controls, but was significantly greater in the former. The results of this study demonstrated that a significant induction of cytogenetic damage in peripheral lymphocytes of workers occupationally exposed to EMFs in electric transformer and distribution stations. In conclusion, our findings suggest that EMFs possess genotoxic capability, as measured by CA and MN assays; CA analysis appeared more sensitive than other cytogenetic end-points. It can be concluded that chronic occupational exposure to EMFs may lead to an increased risk of genetic damage among electrical workers.

Comparison of Automated Breast Volume Scanning and Hand-Held Ultrasound in the Detection of Breast Cancer: an Analysis of 5,566 Patient Evaluations

  • Choi, Woo Jung;Cha, Joo Hee;Kim, Hak Hee;Shin, Hee Jung;Kim, Hyunji;Chae, Eun Young;Hong, Min Ji
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9101-9105
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    • 2014
  • Background: The purpose of this study was to compare the accuracy and effectiveness of automated breast volume scanning (ABVS) and hand-held ultrasound (HHUS) in the detection of breast cancer in a large population group with a long-term follow-up, and to investigate whether different ultrasound systems may influence the estimation of cancer detection. Materials and Methods: Institutional review board approval was obtained for this retrospective study, and informed consent was waived. From September 2010 to August 2011, a total of 1,866 ABVS and 3,700 HHUS participants, who underwent these procedures at our institute, were included in this study. Cancers occurring during the study and subsequent follow-up were evaluated. The reference standard was a combination of histology and follow-up imaging (${\geq}12months$). The recall rate, cancer detection yield, diagnostic accuracy, sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were calculated with exact 95% confidence intervals. Results: The recall rate was 2.57 per 1,000 (48/1,866) for ABVS and 3.57 per 1,000 (132/3,700) for HHUS, with a significant difference (p=0.048). The cancer detection yield was 3.8 per 1,000 for ABVS and 2.7 per 1,000 for HHUS. The diagnostic accuracy was 97.7% for ABVS and 96.5% for HHUS with statistical significance (p=0.018). The specificity of ABVS and HHUS were 97.8%, 96.7%, respectively (p=0.022). Conclusions: ABVS shows a comparable diagnostic performance to HHUS. ABVS is an effective supplemental tool for mammography in breast cancer detection in a large population.

연작업자들에서 골중 연량이 신경행동학적 검사성적에 미치는 영향 (Association of Bone Lead with Neurobehavioral Test Scores in Lead Workers)

  • 이성수;김남수;김화성;안규동;이병국
    • 한국산업보건학회지
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    • 제15권2호
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    • pp.144-152
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    • 2005
  • To evaluate the effect of lead biomarkers including bone lead on neurobehavioral test in lead workers, 652 lead workers without any occupational exposure to organic solvent, mercury and arsenic were agreed to participate this study. For the control subjects 102 non-occupationally lead exposed blue collar workers in general manufacturing industries were also joined this study. All study subjects joined this study with written informed consent. The study variables of lead exposure were blood and patella lead. For the general characteristics of study subjects, standardized questionnaire regarding age, sex, past disease history, job duration, body mass index (BMI), drinking and smoking habit were provided. For the past history of neurotoxicity related diseases, all study subjects were interviewed by qualified occupational health physician. The results obtained were as follows: 1. Compared with controls without occupational lead exposure, lead exposed subjects had worse performance on all tests(p<0.05). 2. After adjustment for covariates (age, sex, job duration, education level, BMI, smoking and drinking status), the signs of the regression coefficients for blood lead were negative for 13 of the 14 tests. Blood lead was a significant predictor of poorer scores on 8 tests (simple reaction time(ms & root MSD), Trail-Making Test B, Digit Symbol Substitution, Purdue Pegboard assembly, Digit Span Test, Benton Visual Retention, and Purdue pegboard both hand). 3. After adjustment for covariates (age, sex, job duration, education level, BMI, smoking and drinking status), the signs of the regression coefficients for patella lead were negative for 12 of the 14 tests. Patella lead was a significant predictor of poorer scores on 8 tests (simple reaction time(ms). Purdue Pegboard assembly, Digit Span Test, Benton Visual Retention. Pursuit Aiming rest (no. of correct & no. of incorrect), Purdue pegboard non-dominant hand and both hand). With above results, blood lead and patella lead were associated with poorer performance of neurobehavioral tests. In addition, patella lead was confirmed to be better predictor of manual dexterity test in neurobehavioral test battery in lead workers

간호대학생의 스마트폰 중독, 수면상태, 학업성취가 정신건강에 미치는 영향 (Influence of Smartphone Addiction, Sleeping Condition, Scholastic Achievement on Mental Health in Nursing Students)

  • 임영순;노기옥
    • 사물인터넷융복합논문지
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    • 제6권2호
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    • pp.57-64
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    • 2020
  • 본 연구는 간호대학생의 스마트폰 중독, 수면상태, 학업성취가 정신건강에 미치는 영향을 파악하기 위해 시도되었다. 연구대상자는 간호대학에 재학 중인 2, 3학년 학생 185명으로, 자료수집기간은 2019년 5월 13일부터 2019년 6월 3일까지이다. 수집된 자료는 IBM SPSS/WIN 24.0프로그램을 이용하여 기술통계, Independent t-test, one-way ANOVA, Pearson correlation, 위계적 다중회귀분석으로 분석하였다. 간호대학생의 스마트폰 중독점수는 36.99점(60점 만점)이었으며, 스마트폰 중독이 심할수록 수면상태(r=.19, p=.009)와 정신건강(r=.34, p<.001)이 좋지 않은 것으로 나타났다. 간호대학생의 정신건강에 영향을 주는 변수로는 스마트폰 중독, 수면시간, 학년, 수면상태였으며, 스마트폰 중독(β=.27)이 가장 큰 영향력을 주는 것으로 나타났다. 영향요인에 의한 설명력은 20.4%였다. 따라서 간호대학생의 정신건강을 위하여 스마트폰 중독을 낮출 수 있는 다양한 프로그램의 적용과 수면에 대한 관리가 이루어져야 한다.

Tumor necrosis $factor-\;{\alpha}$, interleukin-6 and interleukin-10 polymorphisms in the Korean stroke patients

  • Kim, Kyung-Min;Lee, Sang-Hoon;Lee, Jae-Dong;Choi, Do-Young
    • Journal of Acupuncture Research
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    • 제22권2호
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    • pp.1-12
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    • 2005
  • Objective: With the onset of stroke, white blood cells release several proinflammatory cytokines, including interleukin (IL)-6, IL-10, and tumor necrosis factor $(TNF)-{\alpha}$. It has been proven in previous studies that the release of these cytokines is related to the extent of damage to the brain and to overall prognosis. However, no studies have yet been performed to determine the connection with IL-6 and IL-10. Thus, this study is performed to see whether polymorphisms of IL-6, IL-10, and $TNF-{\alpha}$ genes that show increased serum concentration with the onset of stroke are related to stroke attack in Koreans. Methods : Peripheral blood samples derived from patients with stroke (n=100) and healthy controls (n=100) were taken under informed consent. In subjects with stroke, blood samples were obtained within 24 hours of stroke onset. Genomic DNA was isolated using the Wizard DNA Purification Kit (Promega, Madison, WI). Results : 1. Subjects with Heterozygote (GA) and Homozygote (AA) $TNF-{\alpha}$ gene types showed 2.433 and 20.457 times higher risks of being attacked by stroke, respectively, compared to subjects with wild type (GG) $TNF-{\alpha}$ gene type. The data was still statistically significant after adjusting for age, sex, history of smoking, and history of alcohol drinking. 2. Subjects with Homozygote (CC) IL-6 gene type showed 182.033 times higher risk of being attacked by stroke, compared to subjects with wild type (GG) IL-6 genes. This data was statistically insignificant (p=0.700). The data was still statistically insignificant after adjusting for age, sex, history of smoking, and history of alcohol drinking. 3. Subjects with Heterozygote (GA) and Homozygote (GG) IL-10 gene types showed 8.785 and 3.303 times higher risks of being attacked by stroke, respectively, compared to subjects with wild type (AA) IL-10 genes. The data was still statistically insignificant after adjusting for age, sex, history of smoking, and history of alcohol drinking. Conclusion : Our results suggest that the investigated $TNF-{\alpha}$ and IL-10 gene polymorphisms play an important role in stroke attack, but IL-6 gene polymorphism has not been found to associated with stroke.

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소방공무원의 업무요인에 따른 구강건강관련 삶의 질 (Oral health related quality of life according to firefighters' job characteristics)

  • 황세현;김성애;이지영;고효진;박정현;엄상화;유병철
    • 한국치위생학회지
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    • 제15권2호
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    • pp.333-342
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    • 2015
  • Objectives: The $1.8{\pm}1.5$purpose of the study was to investigate the oral health related quality of life according to work factors of firefighters in Korea. Methods: A self-reported questionnaire was completed by 270 firefighters in Changwon, Gimhae, and Ulsan from June 27 to July 24, 2011 after receiving informed consent. The questionnaire consisted of 5 questions of general characteristics of the subjects, 6 questions of job-related characteristics, and 14 questions of oral health related quality of life(OHIP-14). Data analysis was performed with reliability test, descriptive analysis, t-test, analysis of variance(ANOVA) and multiple regression analysis using SAS(version 9.2) program. Results: The score of oral health related quality of life in firefighters was $10.1{\pm}8.0$. The scores of subscale of the oral health quality of life were $2.4{\pm}1.5$ in physical pain, $1.8{\pm}1.5$ in psychological discomfort, $1.5{\pm}1.5$ in physical disability, $1.4{\pm}1.5$ in functional limitation, $1.3{\pm}1.4$ psychological disability, $0.9{\pm}1.3$ in handicap, and $0.7{\pm}1.3$ in social disability. The related factors of oral health quality of life in firefighters were rank(p=0.016) and the frequency of daily mobilization(p=0.029). Conclusions: Oral health related quality of life in firefighters was relatively in good condition. For the better oral health related quality of life in firefighters, it is important to establish the continuing oral health promotion program for those who have irregular job characteristics and job intensity.

Korean physicians' attitudes toward the prenatal screening for fetal aneuploidy and implementation of non-invasive prenatal testing with cell-free fetal DNA

  • Kim, Soo Hyun;Kim, Kun Woo;Han, You Jung;Lee, Seung Mi;Lee, Mi-Young;Shim, Jae-Yoon;Cho, Geum Joon;Lee, Joon Ho;Oh, Soo-young;Kwon, Han-Sung;Cha, Dong Hyun;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • 제15권2호
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    • pp.72-78
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    • 2018
  • Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.