• 농촌의학ㆍ지역보건
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• 제44권1호
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• pp.11-27
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• 2019

치매는 세계적으로 주요 유행 질환이 되었다. 한국의 2010년 치매 유병률은 8.7%에서 2050년 15.1%로 예측되고 있으며, 2017년 현재 725,000명의 치매환자가 추정되고 있다. 이 글은 한국의 국가치매 예방관리사업을 현황을 리뷰하고 그에 따른 정책과제 등을 살펴보고자 하였다. 한국은 치매에 대하여 2008년, 2012년, 2016년에 걸쳐 세 차례의 국가치매계획을 개발하였다. 제1차 치매계획은 치매에 대한 예방, 조기진단, 하부구조개발 및 조정, 관리, 인지도 개선 등에 초점을 맞추었으며, 제2차 치매계획은 치매환자 가족지원에 역점을 두었고, 치매관리법의 제정과 더불어 포괄적인 사업의 근거를 마련하였다. 제3차 치매계획은 치매 친화적 지역사회 구축에 목표를 두었으며, 가족부담을 줄이고, 연구, 통계, 기술개발 등에 지원을 마련하였다. 2017년 한국 정부는 국가치매책임제를 도입하였으며, 경증 치매에 대한 장기요양보험제도 혜택을 확대하고, 보건소 치매안심센터의 설치, 운영, 국가 및 공공치매관리시설의 확장 등을 추진하고 있으나 정책의 급속한 추진에 따르는 재정확보 등 많은 과제들이 남아 있다.

• Journal of Nutrition and Health
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• 제54권6호
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• pp.644-663
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• 2021

본 연구는 제6기 (2013-2015년) 국민건강영양조사 자료를 활용하여 만 15-45세의 가임기 여성 1,559명을 대상으로 요오드 섭취 및 소변 중 요오드 함량을 기준으로 요오드 섭취의 안전성을 평가하였다. 요오드 섭취량 분석을 위해 요오드 영양성분 DB를 구축한 후 24시간 식사조사자료와 매칭하여 식이를 통한 요오드 섭취량을 분석하였고, 소변 중 요오드 함량을 적용하여 하루 단위의 요오드 섭취량을 산출하였다. 또한 요오드 섭취의 안전성 평가를 위해 WHO의 평가기준을 적용하였고, 요오드의 영양소 섭취기준 중 상한섭취량을 기준으로 하여 BE를 산출한 후 소변 중 요오드 함량을 적용하여 HQ를 계산하였다. 그 결과 소변 중 요오드 함량이 100 ㎍/L 미만이어서 요오드 결핍으로 진단되는 비율은 15.22%이었고, 요오드 섭취 과잉으로 진단되는 300 ㎍/L 이상인 대상자는 48.16%이었다. 소변 중 요오드 함량은 평균 878.71 ㎍/L이었고, 요오드/크레아티닌은 589.00 ㎍/g이었으며, 요오드/크레아티닌은 30-45세 연령군이 15-18세, 19-29세 연령군에 비해 유의적으로 높았다. 식이를 통한 요오드 섭취량은 273.47 ㎍/day, 소변 중 요오드 함량을 통해 산출된 요오드 섭취량은 1,198.10 ㎍/day로, 두 조사방법에 의한 차이는 924.63 ㎍/day로 식이를 통한 요오드 섭취량보다 소변을 통해 산출된 요오드 섭취량이 더 높았다. 요오드 섭취량에 기여도가 높은 식품은 채소류, 어패류, 해조류 및 가공식품이었고, 요오드 섭취의 위험도를 평가하는 HQ는 한국인 영양소섭취기준 적용 시 0.228이었고, 소변 중 요오드 함량이 1,000 ㎍/L 이상 시 평균 1.665로 1 이상의 높은 수준이었다. 혈중 TSH는 2.14 mIU/L, free T4는 1.10 ng/L이었으며, 소변 중 요오드 수준과 HQ는 혈중 TSH 농도에 유의적인 차이를 보이지 않았으나, 혈중 free T4 농도는 연령과 소변 중 요오드 수준이 증가할수록 유의적으로 감소하였다. 본 연구결과 국내 가임기 여성의 과반수는 요오드를 과잉 섭취하였고, 특히 상위 10% 정도는 HQ 1 이상으로 건강에 위험할 정도의 극단적인 섭취량을 보였다, 또한, 식이와 소변을 통해 산출된 요오드 섭취량 사이에 차이가 상당히 큰 것으로 보아 충분한 요오드 DB가 구축되지 않은 현 상황에서 식이를 통한 요오드 영양상태를 평가하기보다는 소변으로 배출된 요오드 함량을 적용하여 요오드 영양상태를 평가하는 것이 더 적절할 것으로 사료되며, 과잉의 요오드 섭취가 갑상샘질환 뿐만이 아니라 관련 질환의 유병율에 미치는 다양한 연구가 수행될 필요가 있을 것으로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제63권1호
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• pp.119-135
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• 2020

Objective : To investigate the epidemiology of newly-diagnosed, histologically-confirmed (NDHC) central nervous system (CNS) tumours and its changes over a 21-year period in a regional hospital in Hong Kong. Methods : This is a single-institute retrospective descriptive study of patients undergoing surgery for CNS tumours in a regional hospital of Hong Kong in the period from January 1996 to December 2016. The histological definition of CNS tumours was according to the World Health Organization classification, while the site definition for case ascertainment of CNS tumours was as set out by the Central Brain Tumour Registry of the United States. Patients of any age, who had NDHC CNS tumours, either primary or secondary, were included. The following parameters of the patients were retrieved : age at diagnosis, gender, tumour location, and histological diagnosis. Population data were obtained from sources provided by the Government of Hong Kong. The incident rate, estimated by the annual number of cases per 100000 population, for each histology grouping was calculated. Statistical analyses, both including and excluding brain metastases, were performed. Statistical analysis was performed with Microsoft Excel, 2016 (Microsoft, Redmond, WA, USA). Results : Among the 2134 cases of NDHC CNS tumours, there were 1936 cases of intracranial tumours and 198 cases of spinal tumours. The annual number of cases per 100000 population of combined primary intracranial and spinal CNS tumours was 3.6 in 1996, and 11.1 in 2016. Comparing the 5-year average annual number of cases per 100000 population of primary CNS tumours from the period 1996-2000 to 2011-2015, there was an 88% increase, which represent an increase in the absolute number of cases by 4.52 cases/100000 population. This increase was mainly contributed by benign histologies. In the aforementioned periods, meningiomas increased by 1.45 cases/100000 population; schwannomas by 1.05 cases/100000 population, and pituitary adenomas by 0.91 cases/100000 population. While gliomas had a fluctuating 5-year average annual number of cases per 100000 population, it only had an absolute increase of 0.51 cases/100000 population between the 2 periods, which was mainly accounted for by the change in glioblastomas. Conclusion : This retrospective study of CNS tumour epidemiology revealed increasing trends in the incidences of several common CNS tumour histologies in Hong Kong, which agrees with the findings in large-scale studies in Korea and the United States. It is important for different geographic locations to establish their own CNS tumour registry with well-defined and structured data collection and analysis system to meet the international standards.

• 한국임상약학회지
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• 제30권1호
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• pp.19-30
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• 2020

Objective: To describe patterns of spontaneous reporting on adverse events following immunization (AEFIs) using the human papilloma virus (HPV) vaccine according to the Brighton Collaboration (BC) criteria. Methods: We used the Korea Adverse Event Reporting System (KAERS) database including vaccinations between 2008 and 2017. To apply BC criteria, we classified 58 BC AEFIs into World Health Organization Adverse Reaction Terminology (WHO-ART) codes. We applied MedDRA standard medical queries that were pre-defined as five BC AEFIs. Terminology mapping between MedDRA and WHO-ART terms was performed by three researchers. Descriptive statistics of individual case safety reports were analyzed according to BC applicability. Disproportionality analyses were performed on each BC AEFI and each preferred AEFI term according to the case-noncase approach; reporting odds ratio (ROR) and 95% confidence intervals (CI) were calculated. Results: Among the 30,266 reports of vaccinations between 2008 and 2017, 2,845 reports included the HPV vaccine. Of these reports, 1,511 (53.1%) included at least one BC AEFI. Reports from physicians or manufacturers included more BC AEFIs than from other reporters. Injection site reactions and fever were frequently reported in BC AEFIs; spontaneous abortion and ectopic pregnancy (ROR, 14.29 [95% CI, 4.30-47.49]) and vasculitic peripheral neuropathy (ROR, 8.57 [95% CI, 2.61-28.10]) showed the highest ROR. Among non-BC AEFIs, dizziness or myalgia were frequently reported; exposure during pregnancy (ROR, 23.95 [95% CI, 16.27-35.25]) and inappropriate schedule of administration (ROR, 22.89 [95% CI, 16.74-31.31]) showed the highest ROR. Conclusion: BC criteria would be applicable for labeled AEFIs, whereas analyzing non-BC AEFIs would be useful for detecting unlabeled AEFIs.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.430-436
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• 2001

Objective : The proliferative potential of intracranial glioma affects the histological malignancy and prognosis of patients with these tumors. In this study, we present the relationship between MIB-1 labeling index(LI) and clinical variables which might play the major role in determining the prognosis of patient with astrocytic tumors. Patients and Methods : Excised tumor specimens from a total of 52 patients were stained to detect monoclonal MIB-1-Ki-67 antibody by avidin-biotin complex immunohistochemistry. The MIB-1 LI was evaluated with histological grades, demograpghic data, and survival time. The statistical significance of their correlation was analyzed by Pearson correlation test. Results : The 52 patients included 30 male patients and 22 female patients. The tumors according to the criteria of the World Health Organization(WHO) classification were verified as pleomorphic xanthoastrocytoma in one, pilocytic astrocytomas 4, astrocytomas 1, anaplastic astrocytomas 3, and glioblastomas 31. MIB-1 LI in astrocytic ttumors showed no correlation with age and gender. However, the patients under 10 years had the longest survival time, whereas short survival time was observed in the older patients. The mean MIB-1 LI of different tumor grades were as follows : pleomorphic xanthoastrocytoma, $4.40{\pm}0.00$ ; pilocytic astrocytoma, $4.53{\pm}3.09$ ; astrocytoma, $5.50{\pm}6.03$ ; anaplastic astrocytoma, $12.68{\pm}12.50$ ; Glioblastoma, $21.31{\pm}19.63$. Although the levels of MIB-1 LI were varied in individual tumors, the MIB-1 LI was increased in parallel with the histological grades. Glioblstomas showed significantly higher MIB-1 LI compared with that of anaplastic astrocytomas and low grade astrocytomas (p = 0.001). The mean survival time of entire group of patients was also well correlated with MIB-1 LI in astrocytic tumors(p = 0.015). Moreover, the mean survival time of the entire group of patients with Lis < 10 was $125.33{\pm}113.57weeks$, and the mean survival of those with $Lis{\geq}10$ was $60.71{\pm}62.58weeks$. This difference was also statistically significant(p = 0.004). Conclusion : The results of this study suggest that MIB-1 LI correlates with histological grades and might play a significant role in predicting the survival of patients with astrocytic tumors.

• 한국산업보건학회지
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• 제24권2호
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• pp.122-129
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• 2014

Objectives: Because of its properties such as resistance to heat, chemicals and corrosion; tensile strength; sound absorption; and affordable price, asbestos has been widely used as a building material, fire resistant and retardant, thermal and heat insulator, soundproofing material, and electrical insulation. Since the prolonged inhalation of asbestos can cause serious illnesses such as lung cancer, mesothelioma, and asbestosis after an incubation period of 20 to 40 years, the mineral was classified as a Group 1 carcinogen by the International Agency for Research on Cancer, an intergovernmental agency forming part of the World Health Organization. Children and infants are more at risk than are adults if they are exposed to carcinogens, due to aweaker immunity that has not yet been fully developed. Most childcare centers are operated all day and children tend to spend a great amount of time in the centers. This is why it is important for them to be systematically isolated from environments that may expose them to asbestos. Materials: In order to understand both indoor and outdoor hazards to which children may have been exposed, the study focused on actual surveys of asbestos used in childcare centers, paying special attention to slate-roofed buildings in the vicinity of the centers. Results: A survey of a total of 211 childcare centers showed that the buildings of 18.1% of the centers contained asbestos, with 60.53% of the material being found in classroom ceilings. "Tex" was the most used material for ceilings, making up 89.47% of all ceilings. An outdoor survey showed that childcare centers in Daegu Metropolitan City had an average of 143 slate-roof buildings within a distance of 1km. Conclusions: Buildings housing mainly toddlers, children, teenagers and others more vulnerable to the toxicity of asbestos are not subject to asbestos investigation by law. A legal and practical basis for asbestos control is required for such buildings. In particular, housing materials which contain asbestos in day care centers require asbestos control. GIS should be used to identify the location of buildings with slate roofing materials in the vicinity of daycare centers in order to gauge toxicity of exposure to asbestos caused by potential asbestos friability possibility in outdoor conditions.

• Journal of Chest Surgery
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• 제25권3호
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• pp.258-270
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• 1992

Benign lung tumors have been considered as relatively rare disease, which comprise approximately 8 to 15% of all solitary pulmonary lesions that are detected radiographically. We clinically analized 30 cases of benign lung tumors underwent the operation from Jan. 1970 to Aug.1991 in the department of thoracic and cardiovascular surgery, Catholic University Medical College. We adopted the classification presented by the World Health Organization[WHO], modified from Liebow, and added benign mesothelioma. There were 11 males & 19 females ranging in age from 2 years to 68 years old % the mean age was 38 years old. Of all 30 benign lung tumors, hamartomas [14 cases, 49%] were the most common & followed by hemangiomas [9 cases, 30%], 3 cases of benign mesotheliomas % a case of teratoma, papilloma, arteriovenous malformation and inflammatory pseudotumor. 14 cases of tumors were asymptomatic & were incidentally detected by plane chest x-ray In other cases, chief complaints at admission were coughing, chest discomfort, dyspnea, hemoptysis, and fever. Diagnosis were made by pathological examination; exploratory thoracotomy in 23 patients[76.7%], bronchoscopy in 4 patients and percutaneous needle aspiration biopsy in 3 patients. Precisely, preoperative diagnosis for confirmation of benign lung tumor was made only in 7 cases[23.6%]. Tumors were located on Rt.side[24 cases], especially Rt. middle lobe, and Lt.side[6 cases]. Operation methods were as follows: 21 cases [70%] of lobectomy, 2 cases of segmentectomy, 2 cases of wedge resection, 1 case of pneumonectomy, 1 case of bronchotomy, 2 cases of wedge resection, 1 case of pneumonectomy, 1 case of bronchotomy removal of the endobronchial hamartoma which located at the rt. main stem bronchus and 3 cases of complete resection in benign mesotheliomas. There were no operative death. The post operative complications were developed in 3 cases; post pneumonectomy empyema, wound infection and atelectasis. In conclusion, benign lung tumors must be histologically diagnosed to confirm of benignity and to provide limited resection for preservation of the lung tissue, whenever possible.

• 한국미생물·생명공학회지
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• 제45권2호
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• pp.87-92
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• 2017

첫 번째 에볼라 출혈열 발발은 1976년 콩고 민주 공화국과 수단에서 발생했으며, 이후 2014년서 아프리카에서 27,741건, 11,284건의 사망자가 발생했다. 발열은 Filoviridae 계열에 속하며 ssRNA 게놈을 가진 에볼라 바이러스에 의해 발생했다. 바이러스의 알려진 아형은 Bundibugyo ebolavirus, Reston ebolavirus, Sudan ebolavirus, Tai Forest ebolavirus 및 Zaire ebolavirus이다. 역사적으로 에볼라의 주요 발생 지역은 동부 및 중부 아프리카 열대 지방에서 발생했다. 서아프리카에서의 발발로 인해 전세계 사회에서 수많은 사망과 공포가 확산되었다. 효과적인 치료와 백신이 없는 상황에서 전염병을 관리하고 통제하는 가장 중요한 방법은 정확한 진단을 통해서이다. WHO(세계 보건기구)는 체외진단(IVD) 검사에서 에볼라의 선택과 사용에 관한 긴급 지침을 발표했다. RealStar Ebolavirus Screen RT-PCR 키트 1.0 (Altona), Liferiver-Ebola Virus (EBOV) 실시간 RT-PCR 키트, Xpert 에볼라 검사 및 ReEBOV 항원 검사를 통해 수많은 회사 및 연구 기관에서 진단을 받고 4가지 WHO 조달 승인 진단을 확인했다. 또한, 신속한 검사 키트 Rapid Diagnosis Test (RDT)와 같은 새로운 진단법이 현재 연구 중이다.

• Radiation Oncology Journal
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• 제30권4호
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• pp.158-164
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• 2012

Purpose: To evaluated the patterns of failure, survival rate, treatment-related toxicity and prognostic factors in postoperative radiotherapy of patients with ependymoma. Materials and Methods: Thirty patients who underwent surgery and postoperative radiotherapy for ependymoma between the period of June 1994 and June 2008 were reviewed retrospectively. The age of patients ranged from 21 months to 66 years (median, 19 years). Seventeen patients had grade II ependymoma, and 13 had grade III anaplastic ependymoma according to the World Health Organization grading system. The postoperative irradiation was performed with 4 or 6 MV photon beam with median dose of 52.8 Gy (range, 45 to 63 Gy), and radiation field including 2 cm beyond the preoperative tumor volume. Median follow-up period was 51 months (range, 12 to 172 months). Results: Fourteen out of 30 (46.7%) patients experienced recurrence, and 12 of those died. Among those 14 patients who experienced recurrence, 11 were in-field and 3 were out-of-field recurrence. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 66.7% and 56.1%, respectively. On univariate analysis, tumor grade was a statistically significant prognostic factor for OS and PFS. There were two complications after surgery and postoperative radiotherapy, including short stature and facial palsy on the left side. Conclusion: We observed good survival rates, and histologic grade was a prognostic factor affecting the OS and PFS. Almost all recurrence occurred in primary tumor site, thus we suggest further evaluation on intensity-modulated radiotherapy or stereotatic radiosurgery for high-risk patients such as who have anaplastic ependymoma.

• Clinical and Experimental Reproductive Medicine
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• 제41권3호
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• pp.132-136
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• 2014

Objective: The presence of sperm-head vacuoles has been suspected to be deleterious to the outcomes of assisted reproductive technology (ART). It is difficult to accurately distinguish morphologically abnormal sperm with vacuoles under a light microscope. This study was performed to analyze the result of the observation of sperm-head vacuoles using Papanicolaou staining under a light microscope and whether the male partner's age affects these vacuoles. Methods: Sperm morphology with vacuoles was evaluated using Papanicolaou staining and observed under a light microscope ($400{\times)$) in 980 men. The normal morphology was divided into three categories (group A, <4% of normal morphology; group B, 4%-14% of normal morphology; and group C, >14% of normal morphology). The criteria for the sperm-head vacuoles were those given in the World Health Organization manual. For the analysis of the age factor, the participants were divided into the following groups: 26-30 years, 31-35 years, 36-40 years, 41-45 years, and 46-50 years. Results: The percentage of sperm-head vacuoles increased with normal sperm morphology (group A vs. groups B, C) (p<0.05). In the case of the age factor, a statistically significant difference was not observed across any of the age groups. Conclusion: A majority of the sperm-head vacuoles showed a statistically significant difference among normal morphology groups. Therefore, we should consider the probability of the percentage of sperm-head vacuoles not increasing with age but with abnormal sperm morphology. A further study is required to clarify the effect of the sperm-head vacuoles on ART outcomes.