• 한국방사선학회논문지
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• 제15권7호
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• pp.1021-1030
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• 2021

국내 결핵 환자 관리의 방안을 모색하고 결핵 정책의 기초자료를 제공하고자 2010년부터 2018년까지 통계청과 질병관리본부의 결핵 환자 통계 연보와 세계보건기구(WHO; World Health Organization)의 GLOBAL Tuberculosis Report 등의 자료를 수집하여, 국내 결핵 환자 현황을 분석하였다. 결과는 다음과 같다. 첫째, 국내 결핵 환자 발생 현황 결과는, 2018년 33,796명(65.9%), 신환자는 2018년 26,433명(51.5%)으로 약 21.3% 감소한 것으로 나타났다. 둘째, 국내 결핵 환자치료 현황은 과거 치료결과 불명확은 2018년 655명으로 2014년 대비 약 160% 증가한 것으로 나타났다. 셋째, 청소년 결핵환자 발생률은 10에서 14세는 2018년 1.8%, 15세에서 19세는 15.0%로 고등학생의 결핵 발생률이 높았다. 넷째, 나이별 결핵 환자 발생률을 보면 60대 이상의 대상자가 60% 이상의 결핵 유병률을 보였으며 특히 80세 이상의 노인결핵 환자가 증가하였다. 다섯째, 성별 결핵 환자발생률 현황은 2010년 대비 2018년에 남성이 여성보다 1.4배가 많은 것으로 나타났다. 여섯째, 전국적으로 결핵 유병률은 전남 1,419명(75.6%)이 가장 높았고, 세종 99명(33.4%)이 가장 낮았다. 일곱째, 국내 외국인 환자 수는 2012년 1,510명으로 지속적으로 늘어나 2016년에는 2,569명으로 증가한 것으로 나타났다. 이상의 결과에 따라 결핵 재발자, 고등학생, 60세 이상의 연령층, 80세 이상의 노인, 군대 등의 남성 집단, 외국인 대상의 신속하고 정확한 결핵 조기 검진정책과 관리가 필요하다.

• 융합정보논문지
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• 제11권12호
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• pp.148-157
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• 2021

본 연구는 한국어판 전문직 간 교육에 대한 인식 측정도구(K-IEPS)의 타당도와 신뢰도를 검증하기 위하여 시행되었다. 연구 방법은 전문직 간 교육에 대한 인식 측정 원도구를 세계보건기구의 가이드라인에 따라 한국어로 번안하였고, 번안된 도구를 활용하여 2020년 12월부터 2021년 1월까지 4개의 대학 보건의료전공 대학생 302명을 대상으로 자료를 수집하였다. 자료 분석은 탐색적 요인분석(EFA), 확인적 요인분석(CFA), 수렴타당도, Cronbach's alpha, 급내 상관계수(ICC)를 사용하여 분석을 실시하였다. 분석 결과, K-IEPS는 2개의 하위요인(역량과 자발성에 대한 인식, 실제적인 협력에 대한 인식)과 10개 문항이 적합하였다. 또한 K-IEPS의 전체문항 신뢰도 Cronbach's alpha는 .87이었고, 검사-재검사 신뢰도는 .83이었다. 본 연구에서 검증된 K-IEPS는 전문직 간 교육에 대한 인식을 측정하는데 타당도와 신뢰도가 있는 도구임이 확인되었다. 따라서 향후에 K-IEPS는 전문직 간 교육에 대한 인식 및 프로그램의 효과를 측정하기 위한 도구로 활용될 수 있을 것으로 기대된다.

• Clinical and Experimental Pediatrics
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• 제62권5호
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• pp.179-186
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• 2019

Purpose: Information about overweight and obesity among students in rural areas of Thailand is limited. Therefore, we aimed to determine overweight and obesity prevalences and associated factors among school-aged children in a rural community of Thailand. Methods: We selected 9 public schools through cluster sampling in 2 provinces located in central Thailand in 2016. Anthropometric measurements were measured using standard techniques, classified as overweight (>1 standard deviation [SD]) and obese (>2 SD) with respect to their age and sex using 2007 World Health Organization reference charts. Standardized questionnaires on risk factors were sent to parents to be completed together with their child. Results: Among 1,749 students, 8.98% had overweight and 7.26% had obesity. Mean age (range) was 11.5 years (5-18 years). Independent factors associated with overweight and obesity included primary school student (reference as secondary school) (adjusted odds ratio [aOR], 2.25; 95% confidence interval [CI], 1.24-4.08; P=0.07), mother's body mass index (aOR, 1.07; 95% CI, 1.02-1.12; P=0.001), self-employed father (aOR, 1.99; 95% CI, 1.12-3.55; P=0.018), number of siblings (aOR, 0.61; 95% CI, 0.47-0.81; P=0.001), having sibling(s) with obesity (aOR, 1.82; 95% CI, 1.20-2.77; P=0.005), more than one (aOR, 7.16; 95% CI, 2.40-21.32; P<0.001), consuming 2-3 ladles of rice/meal (aOR, 2.14; 95% CI, 1.38-3.32; P=0.001), consuming >3 ladles of rice/meal (aOR, 2.69; 95% CI, 1.11-6.46; P=0.27), watching <2 hours of television/day (aOR, 2.18; 95% CI, 1.19-4.01; P=0.012), and watching >2 hours of television/day (aOR, 2.60; 95% CI, 1.36-4.96; P=0.004). Conclusion: Many sociodemographic, dietary, and behavioral factors were related to overweight and obesity among school-aged children not only in urban but also rural communities of Thailand.

• Brain Tumor Research and Treatment
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• 제6권2호
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• pp.60-67
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• 2018

Background Recently, modern technology such as diffusion tensor imaging (DTI), neuro-navigation and intraoperative neurophysiological monitoring (IOM) have been actively adopted for the treatment of thalamic tumors. We evaluated surgical outcomes and efficacy of the aforementioned technologies for the treatment of pediatric thalamic tumors. Methods We retrospectively reviewed clinical data from 37 children with thalamic tumors between 2004 and 2017. There were 44 operations (27 tumor resections, 17 biopsies). DTI was employed in 17 cases, neuro-navigation in 23 cases and IOM in 14 cases. All diagnoses were revised according to the 2016 World Health Organization Classification of Tumors of the Central Nervous System. Progression-free survival (PFS) and overall survival (OS) rates were calculated, and relevant prognostic factors were analyzed. The median follow-up duration was 19 months. Results Fifteen cases were gross total resections (GTR), 6 subtotal resections (STR), and 6 partial resections (PR). Neurological status did not worsen after 22 tumor resections. There were statistically significant differences in terms of the extent of resection between the groups with DTI, neuro-navigation and IOM (n=12, GTR or STR=12) and the group without at least one of the three techniques (n= 15, GTR or STR=9, p=0.020). The mean PFS was $87.2{\pm}38.0$ months, and the mean OS $90.7{\pm}36.1$ months. The 5-year PFS was 37%, and the 5-year OS 47%. The histological grade ($p{\leq}0.001$) and adjuvant therapy (done vs. not done, p=0.016) were significantly related to longer PFS. The histological grade (p=0.002) and the extent of removal (GTR/STR vs. PR/biopsy, p=0.047) were significantly related to longer OS. Conclusion Maximal surgical resection was achieved with acceptable morbidity in children with thalamic tumors by employing DTI, neuro-navigation and IOM. Maximal tumor resection was a relevant clinical factor affecting OS; therefore, it should be considered the initial therapeutic option for pediatric thalamic tumors.

• The Korean Journal of Pain
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• 제34권3호
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• pp.288-303
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• 2021

Background: Complex regional pain syndrome (CRPS) is an intractable pain disease with various symptoms. Here, we investigated the disease status, work life, sleep problems, medical insurance, economic status, psychological problems, and quality of life (QOL) of CRPS patients. Methods: CRPS patients from 37 university hospitals in South Korea were surveyed. The survey questionnaire consisted of 24 questions on the following aspects of CRPS patients: sex, age, occupation, cause of injury, activities of daily living (ADL), pain severity, sleep disturbance, level of education, economic status, therapeutic effect, and suicidal ideation. Additionally, the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions, was used to identify the status of QOL. Results: A total of 251 patients completed the questionnaire. According to the survey, 54.2% patients could not perform ADL on their own. Over the previous week, the mean pain score was 7.15 ± 1.78 (out of a total of 10 points); 92.1% of patients had sleep disorders and 80.5% had suicidal ideation, with most patients suffering from psychological problems. The average for each domain of WHOQOL-BREF was as follows: 21.74 ± 14.77 for physical, 25.22 ± 17.66 for psychological, 32.02 ± 22.36 for social relationship, and 30.69 ± 15.83 for environmental (out of a total of 100 points each). Occupation, ADL, sleep time, therapeutic effect, and suicidal ideation were statistically correlated with multiple domains. Conclusions: Most patients had moderate to severe pain, economic problems, limitations of their ADL, sleep problems, psychological problems, and a low QOL score.

• 토지주택연구
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• 제13권1호
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• pp.1-9
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• 2022

유엔세계관광기구(UNWTO)는 1991년 관광약자를 위한 '모두를 위해 접근 가능한 관광'을 선언하며 관광향유권의 실천을 권고하였다. 보건복지부(2019)에 따르면 관광약자인 등록장애인은 전체 인구 대비 5.1%이며, 2025년 65세 이상 노인 인구는 20.3%까지 증가할 것으로 전망된다. 특히 65세 이상 노년층 장애인의 비율이 지속적으로 증가하면서 맞춤형 정책의 필요성이 제기되고 있다. 본 연구는 이러한 필요성을 바탕으로 관광 취약계층을 고려한 유니버설 디자인 관광지의 공간적 특성을 파악하였다. 이를 위해 서울시 행정동(425개)을 공간적 범위로 설정하였으며, 시간적 범위는 2020년으로 설정하였다. 연구방법으로는 먼저, LM 검증을 통해 적합한 공간 모형을 추정한 후, 적합한 모형을 적용한 공간회귀분석을 실시하였다. 분석 결과, 유니버설 디자인 관광지의 공간적 특성은 관광약자가 이용 가능한 시설로 인증된 유니버설 인증업소 수, 외식업소 수, 버스정류장 수와 정(+)의 영향관계를 갖는 것으로 나타나 유니버설 디자인 관광지가 밀집된 행정동에 유니버설 인증업소와 외식업소, 버스정류장이 다수 분포하는 것을 확인하였다. 이러한 분석 결과는 향후 관광향유권의 도모를 위한 정책과 국내의 유니버설 디자인 정책 개선에 시사점을 제공할 수 있을 것으로 판단된다.

• 한국식품위생안전성학회지
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• 제38권6호
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• pp.409-419
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• 2023

Okadaic acid (OA) 군 독소는 설사성 패류중독(diarrhetic shellfish poison, DSP)을 유발하는 해양생물독소이다. 설사성패독은 오카다익산(OA)과 그 유사체인 디노피시스톡신(DTX)으로 구성되어 있으며, 주로 와편모조류에서 생성되어 이매패류의 체내에 축적되어 독화된다. 이에 EFSA, WHO에서는 안전관리를 위하여 수산물 내 OA군 독소 함량 기준을 설정하였다. 최근 우리나라 연안에서도 원인조류인 Dinophysis sp.의 출현이 보고된 바 있으며, 국내 수산물 생산과 소비에도 영향을 미치고 있다. 또한 국제적인 움직임에 발맞추어 국내에서도 2022년 설사성 패독 기준 관리 대상 물질에 DTX2를 추가하여 관리하고 있다. 본 연구는 OA군 독소의 이화학적 특성, 분석법, 인체 노출 사례와 국내외 관리 현황 등의 자료를 검토하여 OA군 독소의 체계적인 모니터링과 안전관리의 기반을 마련하고자 수행되었다.

• Korean Journal of Radiology
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• 제24권4호
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• pp.349-361
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• 2023

Objective: To quantitatively assess the pulmonary vasculature using non-contrast computed tomography (CT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) pre- and post-treatment and correlate CT-based parameters with right heart catheterization (RHC) hemodynamic and clinical parameters. Materials and Methods: A total of 30 patients with CTEPH (mean age, 57.9 years; 53% female) who received multimodal treatment, including riociguat for ≥ 16 weeks with or without balloon pulmonary angioplasty and underwent both non-contrast CT for pulmonary vasculature analysis and RHC pre- and post-treatment were included. The radiographic analysis included subpleural perfusion parameters, including blood volume in small vessels with a cross-sectional area ≤ 5 mm² (BV5) and total blood vessel volume (TBV) in the lungs. The RHC parameters included mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI). Clinical parameters included the World Health Organization (WHO) functional class and 6-minute walking distance (6MWD). Results: The number, area, and density of the subpleural small vessels increased after treatment by 35.7% (P < 0.001), 13.3% (P = 0.028), and 39.3% (P < 0.001), respectively. The blood volume shifted from larger to smaller vessels, as indicated by an 11.3% increase in the BV5/TBV ratio (P = 0.042). The BV5/TBV ratio was negatively correlated with PVR (r = -0.26; P = 0.035) and positively correlated with CI (r = 0.33; P = 0.009). The percent change across treatment in the BV5/TBV ratio correlated with the percent change in mPAP (r = -0.56; P = 0.001), PVR (r = -0.64; P < 0.001), and CI (r = 0.28; P = 0.049). Furthermore, the BV5/TBV ratio was inversely associated with the WHO functional classes I-IV (P = 0.004) and positively associated with 6MWD (P = 0.013). Conclusion: Non-contrast CT measures could quantitatively assess changes in the pulmonary vasculature in response to treatment and were correlated with hemodynamic and clinical parameters.

• Korean Journal of Radiology
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• 제25권1호
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• pp.103-112
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• 2024

Objective: To investigate the association of ultrasound (US) features of follicular thyroid carcinoma (FTC) with tumor invasiveness and prognosis based on the World Health Organization (WHO) classification and telomerase reverse transcriptase (TERT) promoter mutations. Materials and Methods: This retrospective study included 54 surgically confirmed FTC patients with US images and TERT promoter mutations (41 females and 13 males; median age [interquartile range], 40 years [30-51 years]). The WHO classification consisted of minimally invasive (MI), encapsulated angioinvasive (EA), and widely invasive (WI) FTCs. Alternative classifications included Group 1 (MI-FTC and EA-FTC with wild type TERT), Group 2 (WI-FTC with wild type TERT), and Group 3 (EA-FTC and WI-FTC with mutant TERT). Each nodule was categorized according to the US patterns of the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and American College of Radiology-TIRADS (ACR-TIRADS). The Jonckheere-Terpstra and Cochran-Armitage tests were used for statistical analysis. Results: Among 54 patients, 29 (53.7%) had MI-FTC, 16 (29.6%) had EA-FTC, and nine (16.7%) had WI-FTC. In both the classifications, lobulation, irregular margins, and final assessment categories showed significant differences (all Ps ≤ 0.04). Furthermore, the incidences of lobulation, irregular margin, and high suspicion category tended to increase with increasing tumor invasiveness and worse prognosis (all Ps for trend ≤ 0.006). In the WHO groups, hypoechogenicity differed significantly among the groups (P = 0.01) and tended to increase in proportion as tumor invasiveness increased (P for trend = 0.02). In the alternative group, punctate echogenic foci were associated with prognosis (P = 0.03, P for trend = 0.03). Conclusion: Increasing tumor invasiveness and worsening prognosis in FTC based on the WHO classification and TERT promoter mutation results were positively correlated with US features that indicate malignant probability according to both K-TIRADS and ACR-TIRADS.

• Korean Journal of Radiology
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• 제24권2호
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• pp.133-144
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• 2023

Objective: Cyclin-dependent kinase inhibitor (CDKN)2A/B homozygous deletion is a key molecular marker of isocitrate dehydrogenase (IDH)-mutant astrocytomas in the 2021 World Health Organization. We aimed to investigate whether qualitative and quantitative MRI parameters can predict CDKN2A/B homozygous deletion status in IDH-mutant astrocytomas. Materials and Methods: Preoperative MRI data of 88 patients (mean age ± standard deviation, 42.0 ± 11.9 years; 40 females and 48 males) with IDH-mutant astrocytomas (76 without and 12 with CDKN2A/B homozygous deletion) from two institutions were included. A qualitative imaging assessment was performed. Mean apparent diffusion coefficient (ADC), 5th percentile of ADC, mean normalized cerebral blood volume (nCBV), and 95th percentile of nCBV were assessed via automatic tumor segmentation. Logistic regression was performed to determine the factors associated with CDKN2A/B homozygous deletion in all 88 patients and a subgroup of 47 patients with histological grades 3 and 4. The discrimination performance of the logistic regression models was evaluated using the area under the receiver operating characteristic curve (AUC). Results: In multivariable analysis of all patients, infiltrative pattern (odds ratio [OR] = 4.25, p = 0.034), maximal diameter (OR = 1.07, p = 0.013), and 95th percentile of nCBV (OR = 1.34, p = 0.049) were independent predictors of CDKN2A/B homozygous deletion. The AUC, accuracy, sensitivity, and specificity of the corresponding model were 0.83 (95% confidence interval [CI], 0.72-0.91), 90.4%, 83.3%, and 75.0%, respectively. On multivariable analysis of the subgroup with histological grades 3 and 4, infiltrative pattern (OR = 10.39, p = 0.012) and 95th percentile of nCBV (OR = 1.24, p = 0.047) were independent predictors of CDKN2A/B homozygous deletion, with an AUC accuracy, sensitivity, and specificity of the corresponding model of 0.76 (95% CI, 0.60-0.88), 87.8%, 80.0%, and 58.1%, respectively. Conclusion: The presence of an infiltrative pattern, larger maximal diameter, and higher 95th percentile of the nCBV may be useful MRI biomarkers for CDKN2A/B homozygous deletion in IDH-mutant astrocytomas.