• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제61권11호
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• pp.580-587
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• 2018

Background and Objectives We evaluated the clinical characteristics and vestibular function of patients with direction changing vibration induced nystagmus (DC VIN) and unilateral vestibular hypofunction and suggest clinical implication and a proposed mechanism of DC VIN. Subjects and Method The records of 315 patients who underwent the VIN test were reviewed retrospectively. Among these, 18 patients (5.7%) showed DC VIN, and out of whom, 15 patients (4.8%) were diagnosed as unilateral vestibular hypofunction by caloric, rotation chair (RCT), and video head impulse test (vHIT). We analyzed the relationship between DC VIN and the dizziness characteristics, duration of disease, and the outcome of the vestibular function test. Results The mean age of 15 patients was $67.4{\pm}10.7years$ and the mean duration of dizziness was $13.6{\pm}29.7months$. The caloric test revealed 25% of the patients to have significant canal paresis [Caloric vestibular neuritis (VN)], while 75% showed normal caloric response. However, unilateral vestibular hypofunction was observed by abnormal results in RCT or vHIT (Non-caloric VN). Seven patients showed ipsilateral DC VIN (nystagmus to vibrated side) and eight patients contralateral DC VIN (nystagmus to opposite side of vibration). Patients with ipsilateral DC VIN were shown to have a significant longer duration of dizziness than those with contralateral DC VIN. Conclusion Although rare, DC VIN can also be found in patients with unilateral vestibular hypofunction. Patients with DC VIN had a mild vestibular asymmetry with Non-caloric VN or Caloric VN in the process of compensation. The mechanism of ipsilateral DC VIN seems to be due to the small amount of vestibular asymmetry, which is smaller than the interaural attenuation of vibration.

• 보건행정학회지
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• 제31권1호
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• pp.74-90
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• 2021

Background: It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex. Methods: Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016-2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex. Results: The proportion of people having 'not good' self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having 'not good' self-rated health was high in people having 'poor' (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34-12.03) self-rated oral health status and in those having 'fair' (OR, 4.03; 95% CI, 1.68-9.70) in comparison with those having 'good' self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having 'no discomfort' speaking difficulty, the risk of having 'not good' self-rated health was high in people having 'not bad' (OR, 1.60; 95% CI, 1.14-2.24) and 'discomfort' (OR, 1.79; 95% CI, 1.30-2.47) speaking difficulty. The covariates significantly associated with the risk of having 'not good' self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women. Conclusion: Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way.

• 보건행정학회지
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• 제33권3호
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• pp.243-252
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• 2023

This paper aims to introduce Korea's total current health expenditure (CHE) and National Health Accounts of the year 2021 and their 2022 preliminary figures constructed on the basis of the System of Health Accounts 2011. As CHE includes expenditures for prevention, tracking, and treatment of coronavirus disease 2019 (COVID-19) and compensation for losses to medical institutions from 2020, the details are also introduced. Korea's total CHE in 2021 is 193.3 trillion won, which is 9.3% of gross domestic product (GDP). The preliminary figure in 2022, 209.0 trillion won, exceeded the 200 trillion won line for the first time, and its "ratio to GDP" of 9.7% is expected to exceed the average of Organisation for Economic Co-Operation and Development member countries for the first time. Korea's health expenditures, which were well controlled until the end of the 20th century, have increased at an alarming rate since the beginning of the 21st century, threatening the sustainability of national health insurance. The increase in health expenditure after 2020 is partly due to a temporary increase in response to COVID-19. However, when considering the structure of Korea's health insurance price hike, where the ratchet effect of increased medical expenses works particularly strongly, it is unlikely that the accelerating growth trend that has lasted for more than 20 years will stop easily. More aggressive policies to control medical expenses are required in the national health insurance which not only constitutes the main financing sources of the Korean health system but also has the most powerful policy means in effect for changes in the health care provision.

• Journal of Preventive Medicine and Public Health
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• 제29권3호
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• pp.617-637
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• 1996

Occupational dermatosis is one of the most prevalent occupational disorders. However, the extent of the occupational dermatoses including incidences and prevalencies of each disease entity, and etiologic materials are not yet welt stated in Korea. Authors reviewed the literatures on the statistic data and reports on the occupational dermatoses, and surveyed on the occupational dermatoses in two factories, and surveyed the physicians responsible to the occupational dermatoses with formed questionnaire. The results are as follows; 1. Among medical journals published since 1964, there were 31 articles on the occupational dermatoses. Of 31 articles, 18 were case reports and all others were review articles. Of 18 case reports, 9 were epidemiologic survey. The Workers' Periodic Health Examinations revealed that prevalence of the occupational dermatoses was highest(4.36 per 10,000 workers) in 1974, but number of the cases reported were decreased sharply since 1978 with some tendency to increase since 1981. There were 2,240 reported cases of occupational dermatoses between 1966 and 1992, which is 1.90% of all the reported occupational diseases. Skin infection and injuries due to chemicals were most frequent and there were 6 cases of skin cancer. 2. In an epidemiological survey on the dermatoses among 995 workers in a metal product manufacturing factory and 225 workers in a coal chemical factory, there were 794 with dermatomycosis, 296 workers with acne, 130 workers with scar, 123 workers with deformity of toe nails. Scars, photosensitivity dermatitis, deformity of finger and toe nails, and acne were more prevalent in the metal product manufacturing factory(p<0.05). In the metal prouct manufacturing factory, workers treating organic solvents and oils had more dermatoses than those without treating the materials(p<0.05). On the skin patch performed on 16 workers in the metal product manufacturing factory, there were 8 cases of irritation dermatitis and 5 cases of contact dermatitis. Prevalence of contact dermatitis in the metal product manufacturing factory was 1.3%. 3. On the questionnaire survey, 34 dermatologists, 29 doctors of preventive medicine, and 22 family physician replied. The proportion of occupational etiology among all dermatoses assumed by the physicians were below 9%, and the most important occupational dermatosis in Korea was contact dermatitis. Main etiologic materials related to the occupational dermatosis were organic solvent, acid and alkali, and metals. The reason for the scarcity of report of occupational dermatoses were difficulty in diagnosis and physician's ignorance of the occupational etiology. They replied that to prevent the occupational dermatoses in the workplace, the use of protective devices was most important, and development of diagnostic criteria on the occupational dermatoses is urgent. Above results shows us that there is many workers with occupational dermatoses, but they are mostly unreported. Measures to prevent and manage the occupational dermatoses are not satisfactory at present. Hence, authors suggest measures for the precise diagnosis, report and prevention of the occupational dermatoses. a. Dermatologist, preventive physician, and industrial hygienist should work as a team to examine the high risk group and establish the preventive measures. b. Disease entities, diagnostic criteria of occupational dermatoses should be listed, criteria for the compensation and job fitting at recruitment should be established, and manual for the proper treatment and effective prevention of each occupational dermatosis should be developed. c. Patch test antigens against each occupational category should be developed and it should be available to any physicians responsible. d. To facilitate the diagnosis of occupational dermatoses by the doctors responsible for the Workersr Periodic Health Examination, development of standardized questionnaire, education on the techniques of the patch test, and cooperation with the dermatologist in diagnosis of occupational dermatoses is essential.

• 종양간호연구
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• 제1권2호
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• pp.191-203
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• 2001

The health of a nurse is very important because her mental and physical health can influence toward nursing patients directly, Especially, Cancer patients are growing annually. Also, terminal cancer patients' nursing and dead place are increasingly using hospital and the period of nursing for cancer patients are increasing. Nursing for cancer patients are different with acute disease. Therefore, I analysed comparing nurses' health working in cancer and general ward so that nurses working at cancer ward could be developed as a professional nurse, and I wanted to establish the foundation of nursing administration and reasonable manpower management to supply good quality of nursing to patients. In my research, I selected 117 nurses working in cancer ward and 134 nurses working in general word to analyse the stress rate and nurse's health comparing nurses working in general ward and cancer ward. The survey was conducted of nurses working in cancer ward nurses in 2 university hospitals, nurses working in a cancer hospital, and general ward nurses working in 3 public hospital. Also, the data was collected from Sep. 13, 2001 to Sep. 28, 2001. As health measuring tool, I used Cornell Medical Index(CMI) which are developed to fit Koreans by Ko Ungrin and Park Hang-bas (1980) using Cornell Medical Services which were designed by Weiser, Brosman, Mittelman, Wechler, Wolff in Cornell University(1945). As working stress measuring tool, I used Questionaries which were designed by Kim Mae-ja and Ku Mi-ok(1984) and then developed by Bae In-sook(1996). For managing the data, I used frequency, percentage, ${\chi}^2$ verification, t-test, and F-test (ANOVA). And in the case of significant data(p<.05). I did Duncan's test for post verification. The mutual relation between health condition and working stress rate have been conducted using Pearson's Correlation Coefficient. Followings are the results of my research. 1. Two groups showed significant differency at age after testing homogeneous character between two groups (${\chi}^2$ =9.919, p=.007). 2. Comparing two group's health condition, cancer ward(average 19.35${\pm}$18.34) were higher than general ward(14.42${\pm}$10.59) and showed statistical significant differency(p=.009). And, comparing two group's mental condition, cancer ward(9.00${\pm}$9.79) were higher than general ward(7.13${\pm}$6.35) and statistically no differency. 3. After comparing two group's working stress rate, the rate of cancer ward nurse's working stress(3.36${\pm}$.50) is higher than general ward nurse (3.32${\pm}$.48). There are no significant differency. However, in the detailed verification test, there were significant differency at inappropriate compensation (t=3.254, p=.001) and medication issue (t=2.170, p=.031). 4. After comparing health condition at general points, physical health condition showed significant differency at age(p=.020), the number of children (p=.015), religion (p=.015), position(p=.005), career(p=.008), working satisfaction(p=.003), activity after office hour(p=.045); and mental health condition showed significant differency at position(p=.010), career (p=.017), working satisfaction (p=.003). 5. After comparing the working stress rate according to general points, there were significant differency at working satisfaction (F=5.285, p=.006), predicted nursing(F=3.822, p=.023). 6. At the relation of health condition and working stress rate between two groups. physical and mental condition showed significant relation with working stress rate. i.e, if a nurse's health condition is not good, she are feeling much more stress than others. After considering all the factors in my research, I found that the health condition and stress rate of cancer ward nurses is much higher than general ward nurses. Considering that cancer ward nurses is necessary to care for increasing cancer patients with mental and physical nursing, the less stress for cancer ward nurses is very important to develop nursing quality and working efficiency by keeping good health condition, specializing cancer ward nurses. Therefore, we need following studies to find the factors which are effecting to cancer ward nurses' health and specialization. Also, we need to improve managing working condition to decrease working stress by improving working condition.

• Tuberculosis and Respiratory Diseases
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• 제48권1호
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• pp.54-66
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• 2000

연구배경: 설문지를 이용한 삶의 질 평가를 통해 진폐증 및 만성 호흡기 환자의 삶의 질 및 생활 만족도를 향상시키기 위한 효과적인 치료 및 관리 방법을 찾는데 기초 자료로 쓰고자 삶의 질 설문지의 신뢰도와 타당도를 검증 하였다. 방 법: 3차 의료기관에 요양되어 입원중인 진폐증 환자 25명과 진폐 정밀검사를 받기 위해 1주일간 입원한 진폐증 유병자 38명등 총 63명을 대상으로 1999년 4월에서 8월 사이에 COOP charts, CRQ, PRQ 등 3종의 설문지를 이용해 조사하였고 그 결과를 다른 임상 지표와 비교하였다. 결 과: 설문지 문항의 내적 일치도를 보는 크론바하 계수는 CRQ에서 각 영역별로 0.63-0.89였고 PRQ는 0.77-0.81로 외국의 설문지를 번역해서 사용한 CRQ와 독자 개발한 PRQ 모두 내적 일치도에서 만족할 만한 신뢰도를 나타내었으며 기존에 사용되어 온 COOP charts의 점수와 CRQ. PRQ 간에는 유의한 상관관계를 보였다. CRQ의 호흡곤란 및 정서 항목과 PRQ의 호흡증상 및 정서상태는 같은 개념을 서로 다른 두 가지 방법으로 측정한 것인데 이들간의 상관 관계가 다른 개념들과의 상관 관계보다 높지는 않았다. CRQ의 호흡곤란 항목의 접수는 폐기능검사 성적과 유의한 상관관계를 나타냈으며 CRQ의 정서 항목은 동맥혈 가스분석의 산소분압 및 산소포화도와 유의한 연관성을 보였다. 한편 PRQ에서는 호흡증상과 사회활동 향목이 폐기능 검사 성적과 유의한 연관을 보여주었다. 산업재해보상보험법상 요양 유무에 따라 비교한 결과 요양군이 비요양군에 비해 임상적 지표가 더 불량했으며, CRQ의 호흡곤란 항목과 PRQ의 호흡 증상 및 사회활동 항목에서 각각 요양군이 비요양군에 비해 유의하게 낮은 접수를 보였다. 임상적으로 불안정한 환자와 안정한 환자군으로 구분하여 비교한 결과 폐기능검사 소견상 노력성 폐활량(FVC)과 최고기류속도(PEF)만이 임상적으로 불안정한 군에서 유의하게 낮았으며, 설문 결과에서 CRQ는 양군간에 유의한 차이를 찾을 수 없었으나, PRQ의 호흡증상 및 사회활동 영역 그리고 COOP charts에서 불안정군의 점수가 안정군에 비해 유의하게 낮았다. 결 론: 번역한 CRQ와 새로 개발한 PRQ가 모두 진폐증 환자의 삶의 질 측정에 사용될 수 있음을 보여주며 특히 PRQ는 임상지표만 가지고 구분할 수 없는 환자의 기능적 상태 및 주관적인 생활 만족도를 알아보는데 활용될 수 있음을 알 수 있었다. 진폐증 환자를 비롯한 만성 호흡기 환자에게 CRQ와 PRQ를 활용할 수 있도록 향후 지속적인 연구를 통해 설문지 검사의 신뢰도와 타당도를 검정하는 것이 필요하다.

• 한국산림과학회지
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• 제111권3호
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• pp.405-417
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• 2022

본 연구는 건조 스트레스에 따른 Prunus maximowiczii(산개벚나무) 및 Prunus serrulate Lindl. var. pubescens(Makino)Nakai(잔털벚나무)의 광합성 특성 및 광계II 활성에 미치는 영향을 알아보고자 수행하였으며, 건조 스트레스(drought stress, DS)는 30일간의 단수처리를 통해 유도하였다. 건조 스트레스가 진행됨에 따라 토양 수분함량은 감소하였으며, DS 10~12일 사이에 두 수종모두 10% 이하로 건조한 상태가 되고, DS 15일 이후부터는 5% 이하로 나타나 위조가 시작되는 조건에 해당되었다. DS 10일부터 최대광합성 속도, 광보상점의 감소가 두드러졌고, 암호흡 및 순양자수율은 DS 15일에 크게 감소하다가 DS 20일 이후부터 증가하는 경향을 보였다. 또한 산개벚나무의 기공증산속도는 DS 15일에 크게 감소한 뒤 DS 20일 이후부터 증가하였으며, 수분이용효율은 DS 15일에 증가한 뒤 DS 20일 이후부터 감소하였다. 잔털벚나무의 경우 기공증산속도는 DS 20일에 크게 감소한 뒤 이후부터 증가하였으며, 수분이용효율은 DS 20일에 증가한 뒤 이후부터 감소하는 경향을 보였다. 이는 수분 손실을 막기 위해 기공을 닫게 되어 수분이용효율이 일시적으로 증가한 것을 의미한다. 엽록소 형광분석을 통해 산개벚나무는 DS 15일, 잔털벚나무는 DS 20일 이후에 기능지수(PI_ABS) 및 에너지전달 효율의 감소가 두드려졌으며, 광계II의 활성이 감소되었다. 특히, Ts-Ta, PI_ABS, DI_O/RC, ET_O/RC는 토양수분함량의 감소와 광합성 특성과도 유사하게 나타나, 수목의 건조 스트레스를 평가하는데 있어서 유용한 변수로 활용될 수 있을 것으로 보인다.

• Journal of Preventive Medicine and Public Health
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• 제32권1호
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• pp.30-39
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• 1999

이 연구는 특수건강진단기관의 소음성 난청 진단결과의 유소견자$(D_1)$와 요관찰자(C)를 하나의 평가 지표로 설정하여, 첫째 소음 특수건강진단 결과 소음성 난청의 실태 파악, 둘째 소음성 난청 요관찰 자의 청력장애 평가, 셋째 정력장애 정도 에 따른 각 주파수 영역별 기도순음청력 검사 결과를 통해 청력손실의 정도를 파악하고 이의 판정기준에 따른 진단의 적정성을 검토하고자 하였다. 1. 1994년 l월부터 12월까지의 73개 특수건강진단기관의 특수건강진단 실시 사업장은 27,347개이며 이중 소음 특수 건강진단 설시 사업장은 16,388개(59.9%)이었으며, 전체 특수건강진단 수진 근로자는 731,029명이며 이중 소음 특수 건강진단 수진 근로자는 343,457명 (47.0%)이었다. 소음성 난청 요관찰자는 38,058명, 소음성 난청 유소견자는 1,358 명으로 소음성 난청 요관찰률은 11.1%, 유소견율은 0.44%이었다. 지역에 따라 소음성 난청 요관찰률의 차이를 보여주며 판정기준의 적용에 따른 기도순음 청력평균손실치가 일부 적정하게 판단되지 못하였음을 보여 주었다. 2. ISO 기준의 3분법에 의한 청력 평가시 97%가 경도난청 이하였으며, 회화음 역에서의 4분법에 비해 거의 비슷하였으나 약간 정상역이 많았고, 고음역을 포함하여 평가하는 4분법과 6분법의 적용시 정상자의 경도난청으로의 가능성이 높다고 볼 수 있어 청력평가시 평가방법의 적용에 따라 내재적인 판별능의 차이를 보여준다고 볼 수 있다. 3. 우측귀의 청력역치를 ISO 기준에 의해 평가한 후 양귀의 청력역치의 분포 및 차이를 보면, 우측귀의 평균역치(표준편차)가 20.54(9.56) dB, 좌측귀의 평균역치가 20.54(9.57) dB로 좌측귀의 평균역치가 우측보다 높았다. 양귀의 청력이 75.4%에서 정상역이었으며, 21,562명 (90.6%)의 양귀 청력역치 차이의 범위가 10dB이내였다. 4. 소음성 난청 요관찰자의 회화음역에 속하는 500, 1,000 및 2,000 Hz에서의 기도청력역치를 산술평균으로 하여 구하는 3분법의 청력손실도(표준편차)를 주파수 별로 보면, 우측귀에서 500 Hz 21.08(10.23), 1,000 Hz 18.44(10.01), 2,000 Hz 22.09(13.46), 4,000 Hz 52.36(16.38) dB이었다. 평균청력손실도를 10 dB 간격으로 구분한 후 각각의 주파수별 청력역치를 살펴보면, 정상역인 20 dB미만에서 고음역인 4,000 Hz에서 회화음역인 500, 1,000 및 2,000 Hz에서 보다 평균 30-40 dB 이상의 역치를 보이는 $C_5-dip$ 현상을 특징적으로 보였다. 평균정력손질이 증가함에 따라 4,000 Hz에서의 역치 증가 현상이 점차적으로 감소하다 평균청력손실이 50 dB 이상에서는 10dB 내외의 차이만을 나타내었다. 이상과 같이 소음성 난청 요관찰자에 대한 분석에서 소음성 난청의 평가방법 에 따른 실태와 의미, 소음에 의한 조기청력손실의 특정과 소음성 난청의 판정기준에 따른 진단의 적정성을 확인할 수 있었으며, 소음성 난청 요관찰자에 대한 관리의 필요성을 제언할 수 있겠다.