• 보건행정학회지
• /
• 제19권4호
• /
• pp.18-32
• /
• 2009

The goal of this study was to predict the health outcomes of lung cancer surgery based on the Charlson comorbidity index (CCI). An attempt was likewise made to assess the prognostic value of such data for predicting mortality, survival rate, and length of hospital stay. A medical-record review of 389 patients with non-small-cell lung cancer was performed. To evaluate the agreement, the kappa coefficient was tested. Logistic-regression analysis was also conducted within two years after the surgery to determine the association of CCI with death. Survival and multiple-regression analyses were used to evaluate the relationship between CCI and the hospital care outcomes within two-year survival after lung cancer surgery and the length of hospital stay. The results of the study showed that CCI is a valid prognostic indicator of two-year mortality and length of hospital stay, and that it shows the health outcomes, such as death, survival rate, and length of hospital stay, after the surgery, thus enabling the development and application of the methodology using a systematic and objective scale for the results.

• 한국임상약학회지
• /
• 제24권3호
• /
• pp.183-192
• /
• 2014

Purpose: This study was aimed to identify the status of utilization of healthcare services and self-care behaviors, knowledge level and influencing choice factors of non-prescription drugs (OTCs) on consumers since sales of OTCs at the outside of pharmacy in Korea, and to confirm the changes in perception of consumers for OTCs policy through check of perception level for current OTCs policy. Methods: Data was collected from April 2014 to May 2014 from questionnaires by 418 adults who are in university located in Seoul or live in Seoul Metropolitan area but not health science major and healthcare providers. Results: The female gender was 56.6% and University students were 73.9%. The ratio by age was as follows: below 25 (60.9%), 26-30 (18.2%), 30-40s (14.9%) and 50-60s (6.0%). The knowledge level of OTCs for use of medicine, dose and side effects was generally low and especially they knew little how to deal with side effects after taking OTCs on sale at the outside of pharmacy, even though over one year has passed since the policy. The proportion of those who thought the current OTCs policy has problems regarding safety issues since the policy was very high and it was also high that the study group thought there are problems with the current way to sale OTCs and educate employees. Conclusion: After selling OTCs at the outside of pharmacy, the consumers still lacked knowledge of OTCs and did not get correct information properly. Especially, they had little information about the way to deal with side effects after taking OTCs. Public policy should be based on the health of the people and the public health is a national health priority. When all these things are taken into consideration, the government has to strengthen the OTCs policy and provide a safer environment with the accurate drug information for people than developing OTCs policy in the future.

• 한국임상약학회지
• /
• 제24권1호
• /
• pp.1-8
• /
• 2014

Objective: Currently, rivaroxaban is widely used clinically for thromboprophylaxis after surgery. However, there are concerns on effectiveness and safety of rivaroxaban for its proper use. We aimed to evaluate the effectiveness and safety of rivaroxaban in orthopaedic patients after total hip replacement surgery in a large medical centre after the preferred formulary was switched from enoxaparin to rivaroxaban. Methods: The study was conducted on the patients who underwent hip arthroplasty surgery at the department of Orthopaedic Surgery at Seoul St. Mary's Hospital, South Korea. Electronic medical records were retrospectively reviewed to identify patients treated with rivaroxaban following total hip replacement between February 2011 and March 2012. Evaluation criteria included indications for use, dose, initiation and duration of therapy, drug interactions, adverse reactions, and status of health care reimbursement. The patients who were on enoxaparin were also reviewed as a reference. Results: We identified 57 patients who received rivaroxaban and 50 who received enoxaparin. All patients were prescribed the drugs for Korean Food and Drug Administration-approved indications. No thromboembolic or bleeding events were observed in either group. However, only 5.3% of rivaroxaban- treated patients had an appropriate length of prophylaxis and only 3.5% began rivaroxaban treatment at the recommended time. Surprisingly, 47.4% of rivaroxaban-treated patients received rivaroxaban despite being ineligible for reimbursement benefits. Conclusion: Rivaroxaban was generally well tolerated clinically. However, the duration of treatment, the time of initiation and patient eligibility for reimbursement require improvements, emphasising the need for education which indicates the area of pharmacists' involvement.

• 대한치과의사협회지
• /
• 제54권12호
• /
• pp.1035-1044
• /
• 2016

Purpose : The purpose of this study was to compare the plaque removal effects of vacuum oral cleaner developed for the patients with limited mobility with those of manual toothbrushes and high pressure injection oral cleaner (dental water jet). Meterials and methods : Thirty human subjects were measured with Patient Hygiene Performance index (PHP index) and O'Leary index before and after the use of toothbrush, high pressure injection oral cleaner and vacuum oral cleaner. These three different oral hygiene methods were conducted with seven-day intermittence. Then the statistical analysis was carried out to define plaque removal rate of three different oral hygiene methods (${\alpha}=.05$). Results : According to the efficacy analysis of plaque removal before and after the oral cleaning using each of three methods, significant reduction in plaque after the treatment compared to the previous state when using toothbrush, high pressure injection oral cleaner, and vacuum oral cleaner was observed (P < 0.001). PHP index of tooth brushing was higher than that of the high pressure injection oral cleaner, while PHP index of vacuum oral cleaner did not show significant difference from either of the other two methods. There was no significance difference in O'Leary index among the three methods. Conclusion : Effect of plaque removal using the vacuum oral cleaner is comparable to that of manual tooth brush or high pressure injection oral cleaner, so it will be helpful for self-oral hygiene care of the patients with limited mobility.

• Clinical and Experimental Pediatrics
• /
• 제62권11호
• /
• pp.416-421
• /
• 2019

Background: The seropositivity rate of hepatitis B surface antigen (anti-HBs) antibodies is known to be ≥95% after hepatitis B virus vaccination during infancy. However, a low level or absence of anti-HBs in healthy children is discovered in many cases. Recent studies in adults reported that a reduced anti-HBs production rate is related to obesity. Purpose: To investigate whether body mass index (BMI) affects anti-HBs levels in healthy children following 3 serial dose vaccinations in infancy. Methods: We recruited 1,200 healthy volunteers aged 3, 5, 7, or 10 years from 4-day care centers and 4 elementary schools. All subjects completed a questionnaire including body weight, height, and vaccine type received. Levels of serum hepatitis B surface antigen (HBsAg) and anti-HBs in all subjects were analyzed using electrochemiluminescence immunoassay. The standardized scores (z score) for each sex and age were obtained using the lambda-mu-sigma method in the 2017 Korean National Growth Charts for children and adolescents. Results: Our subjects (n=1,200) comprised 750 males (62.5%) and 450 females (37.5%). The overall anti-HBs seropositivity rate was 57.9% (695 of 1,200). We identified significant differences in mean BMI values between seronegative and seropositive groups (17.45 vs. 16.62, respectively; P<0.001). The anti-HBs titer was significantly decreased as the BMI z score increased adjusting for age and sex (B=-15.725; standard error=5.494; P=0.004). The probability of anti-HBs seropositivity based on BMI z score was decreased to an OR of 0.820 after the control for confounding variables (95% confidence interval, 0.728-0.923; P=0.001). Conclusion: There was a significant association between anti-HBs titer and BMI z score after adjustment for age and sex. Our results indicate that BMI is a potential factor affecting anti-HBs titer in healthy children.

• 대한예방한의학회지
• /
• 제12권3호
• /
• pp.129-139
• /
• 2008

The purpose of this study was to investigate the effect of aqua exercise on women 50 years of age or older with knee degenerative arthritis, and then examining the therapeutic value of aqua exercise in degenerative arthritis of the knee. The subjects of the study were 115 residents 50 years of age or older who had been diagnosed as degenerative arthritis of the knee by doctors from medical institutions and applied for the aqua exercise program in the Public Health Care Center in Suseong-gu in 2006 and 2007. Experiments were conducted to all the subjects with the application of the 8-week aqua exercise program (2 times a week, 50 minutes a time), designed in the study, and the differences before and after the aqua exercise were compared through questionnaires for measuring the state of the body such as the knee extension angles, weight, body fat, and abdominal obesity. The data was analyzed by t-test and the Wilcoxon method through SPSS 14.0 and the statistical significance level ${\alpha}$ was set at 0.05 and 0.01. The results of the study are as the following. First, In comparison of before and after the aqua exercise, there was improvement in the extension angle of the right knee(p<0.01), while there was some improvement in the extension angle of the left knee, it was not significant. Second, In comparison of before and after the aqua exercise there were statistically significant differences in weight(p<0.05), body fat ratio, and abdominal obesity(p<0.01). The results of this study showed that the aqua exercise program to female patients with knee degenerative arthritis significantly increased the extension angle of the knee. Therefore it is thought that aqua exercise is an effective meditating method to improve their symptoms of female patients 50 years of age or older

• 한국멀티미디어학회논문지
• /
• 제25권5호
• /
• pp.757-768
• /
• 2022

In this paper, we proposed a system that visualizes a hologram device in 3D by utilizing the CT image segmentation function based on artificial intelligence deep learning. The input axial CT medical image is converted into Sagittal and Coronal, and the input image and the converted image are divided into 3D volumes using ResUNet, a deep learning model. In addition, the volume is created by segmenting the tumor region in the segmented liver image. Each result is integrated into one 3D volume, displayed in a medical image viewer, and converted into a video. When the converted video is transmitted to the hologram device and output from the device, a 3D image with a sense of space can be checked. As for the performance of the deep learning model, in Axial, the basic input image, DSC showed 95.0% performance in liver region segmentation and 67.5% in liver tumor region segmentation. If the system is applied to a real-world care environment, additional physical contact is not required, making it safer for patients to explain changes before and after surgery more easily. In addition, it will provide medical staff with information on liver and liver tumors necessary for treatment or surgery in a three-dimensional manner, and help patients manage them after surgery by comparing and observing the liver before and after liver resection.

• 한국직업건강간호학회지
• /
• 제6권2호
• /
• pp.144-155
• /
• 1997

In December 1990, Occupational Safety and Health Law was amended to reinforce employer's responsibilities on employees' health and safety. Among the amended law it was important to expand the role of an occupational health nurse to the role of an occupational health manager. An occupational health manager should take charge of coordinating periodic health examination and environmental hazard evaluation, providing primary care, monitoring employees' health status, giving the workplace walk-through, selecting safe protection equipment, providing health information, counseling and health education, independently. This position of occupational health nurse is equivalent to the role of doctors or occupational hygienists. In 1991, government made a master plan to prevent occupational disease and injury. Under the plan, Korea Industrial Nursing Association (KINA) was established in 1994 with the purpose of improving health services and upgrading career opportunities for members. Therefore, this study was designed to analyze the transition of occupational health nursing education with the changes of law and policy in Korea between 1991 and 1996. In details, it was to analyze the rate of school providing occupational health nursing practice based lecture, lecture hours, lecture contents in undergraduate curriculum, program contents of graduate school, kinds of continuing education, etc. For this purpose, we conducted survey two times. In February 1991, baseline study was conducted with all nursing programs in Korea (19 BSN programs and 43 nursing departments of junior college). From April to May in 1996, the second survey was conducted with all nursing programs (38 BSN programs and 69 junior colleges). The first response rate was 66.1% and the second was 40.6%. Structured questionnaires were mailed to the deans or the community health nursing faculties. In the case of graduate school, telephone survey was conducted with 10 school of public health or environmental health area. Data from the yearbook of Industrial Safety Training Institute (ISTI), the history of Korea Industrial Health Association, and the journals of KINA were also included in the analysis. As the results, we found that there were remarkable improvement in undergraduate and graduate programs, obligatory as well as voluntary continuing education in terms of occupational health nursing expertise between 1991 and 1996. 1) The number of school providing occupational health nursing practice-based lecture was increased with the rate from 7.3% to 25.6%. The rate of school giving over 15 class-hours was increased from 33.3% to 46.6%. 2) Content areas were composed of introduction of occupational health, occupational epidemiology, industrial hygiene, occupational disease and injury, law and policy, health education, concept of occupational health nursing, role of occupational health nurse, occupational health nursing process, etc. Of content areas, occupational health nursing process was more emphasized with the increased rate from 43.9% to 88.4%. 3) In the case of graduate school, occupational health programs were increased from 4 to 10. One of them has developed occupational health nursing program as an independent course since 1991. 4) The law increased educational hours from 28 hours to 36 hours for introductory course at the time of appointment, and from 14 hours to 24 hours every 2 years for continuing education. Course contents were Occupational safety and health law, introduction of occupational health, health education methodology, planning and evaluation, periodic health exam, occupational disease care, primary care, emergency care, management, industrial environment evaluation, etc. In 1996, Korea Industrial Nursing Association has begun to provide continuing education after Industrial Safety Training Institute. 5) Various educational programs in voluntary base were developed such as monthly seminar, CE articles, annual academic symposium, etc. It was shown that changes of law and policy led rapid growth of occupational health nursing education in various levels. From this trend, it is expected that occupational health nurse expertise be continuously to be enhanced in Korea. Legal and political supports should proceed for the development of occupational health nursing in early stage.

• 대한예방한의학회지
• /
• 제20권1호
• /
• pp.55-64
• /
• 2016

Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.

• 대한신경집중치료학회지
• /
• 제11권2호
• /
• pp.93-101
• /
• 2018

Background: At most centers, general anesthesia (GA) has been preferred for endovascular treatment (EVT) of ruptured intracranial aneurysms (RIAs). In this study, we analyzed procedural results, clinical outcomes, and follow-up angiographic findings for patients undergoing EVT for RIA under local anesthesia (LA) with conscious sedation (CS). Methods: We retrospectively evaluated 308 consecutive patients who underwent EVT for RIAs at a single institution between June 2009 and February 2017. EVT under LA with CS was considered for all patients with aneurysmal subarachnoid hemorrhage, regardless of Hunt and Hess (HH) scale score. Results: EVT was performed for 320 aneurysms in 308 patients with subarachnoid hemorrhages. The mean patient age was $55.5{\pm}12.6$ years. Moderate (III) and poor (IV, V) HH grades were observed in 75 (24.4%) and 77 patients (25%), respectively. Complete occlusion immediately after EVT was achieved for 270 (84.4%) of 320 aneurysms. Thromboembolic complications and intraprocedural ruptures occurred in 25 (7.8%) and 14 cases (4.3%), respectively. The morbidity rate at discharge (as defined by a modified Rankin scale score of 3 or greater) was 27.3% (84/308), while the mortality rate was 11.7% (36/308). Follow-up angiographic results were available for 210 (68.1%) of 308 patients. Recanalization was observed in 64 (29.3%) of 218 aneurysms in 210 patients. Conclusion: Based on our experience, EVT for RIAs under LA with CS was feasible, regardless of the clinical grade of the subarachnoid hemorrhage. Complication rates and follow-up angiographic results were also comparable to those observed when GA was used to perform the procedure.