• 한국환경보건학회지
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• 제49권4호
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• pp.218-227
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• 2023

Background: Since 2019, the Ministry of Environment has implemented a seasonal fine dust management system from December to March, targeting high PM_2.5 levels with the aim of reducing PM_2.5 concentrations and protecting public health. The focus of improving the seasonal management system lies in the atmospheric PM_2.5 levels. Considering the primary goal of protecting public health, it is necessary to analyze the policy effects from an exposure perspective rather than a concentration-based approach. Objectives: This study aims to quantitatively assess the improvement of indoor PM_2.5 levels and the health impacts of the seasonal management system by comparing the periods before and during its implementation in residential environments. Methods: PM_2.5 concentrations within residential environments in a metropolitan area were measured using an optical particle counter (IAQ-C7, K-weather, Ltd, Korea) at one-minute intervals during the pre-implementation period (November 21~25, 2022) and during the implementation period (December 19~23, 2022). Based on the measured PM_2.5 concentrations, a quantitative evaluation of cancer and mortality risks was conducted according to age and gender. Results: The results of comparing indoor and outdoor PM_2.5 concentrations before and during the implementation of the seasonal management system showed a decrease of approximately 56.6% and 47.9%, respectively. Health risk assessments revealed that both the safety-limit-based and safety-target-based Hazard Quotients (HQ) exceeded the threshold of 0.1 for children under 19 years of age, both before and after the implementation. The mortality risk decreased by approximately 47.9% after the implementation, with children aged 0-9 showing the highest mortality risk at 0.9%. Conclusions: The findings of this study confirmed the positive health impacts of the seasonal management system across all age groups, particularly children under 19 who are more vulnerable to fine dust exposure.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2523-2526
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• 2012

Introduction: Febrile neutropenia is a relatively frequent event in cancer patients treated with chemotherapy and improvement in absolute neutrophil count (ANC) has been linked directly to improved outcome. Evaluation of granulocyte colony stimulating factors (GCSFs) for treatment has shown reduced incidences of episodes of prolonged neutropenia and protracted hospitalization. To determine absolute neutrophil counts with GCSF in febrile neutropenic cancer patients admitted to a tertiary care centre and to co-relate the improvement in ANC with mortality and hospital discharge. Methods: A prospective cross sectional study was carried at an oncology ward at Aga Khan University hospital from January 2010 to June 2011. All adult patients who were admitted and treated with GCSF for chemotherapy induced febrile neutropenia were included. Multivariable regression was conducted to identify the factors related with poor outcomes. Results: A total of 131 patients with febrile neutropenia were identified with mean age of 43.2 (18-85) years, 79 (60%) being ${\leq}50$. Seventy-five (57%) had solid tumors and 56 (43%) hematological malignancies, including lymphoma. Fifty seven (43.5%) had an ANC less 100 cells/$mm^3$, 34 (26%) one between 100-300 cells/$mm^3$ and 40 (31%) an ANC greater than 300 cells/$mm^3$. Thirty (23%) patients showed ANC recovery in 1-3 days, and 74(56%) within 4-7 days. Thirteen (10%) patients showed no recovery. The overall mortality was 18 (13.7%) patients. The mean time for ANC recovery seen in hematological malignancies was 6.34 days whereas for solid tumors it was 4.88 days. Patients with ANC <100 cells/$mm^3$ were more likely to die than patients with ANC >300 cells/$mm^3$ by a factor of 4.3. Similarly patients >50 years of age were 2.7 times more likely to die than younger patients. Conclusion: Our study demonstrated that use of GCSF, in addition to intravenous antibiotics, in treatment of patients with chemotherapy induced febrile neutropenia accelerates neutrophil recovery, and shortens antibiotic therapy and hospitalization. We propose to risk classify the patients at the time of admission to evaluate the cost effectiveness of this approach in a resource constrained setup.

• Asian Pacific Journal of Cancer Prevention
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• 제17권11호
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• pp.4999-5003
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• 2016

The testicular cancer (TCa) incidence is increasing in many countries, with age-standardized incidence rates up to 7.8/100,000 men in the Western world, although reductions in mortality and increasingly high cure rates are being witnessed at the same time. In Africa, where rates are lower, presentation is often late and morbidity and mortality high. Given this scenario, awareness of testicular cancer and practice of testicular self-examination among future first response doctors is very important. This study was conducted to determine knowledge and attitude to testicular cancer, and practice of testicular self-examination (TSE) among final (6th) year medical students. In addition, the effect of an intervention in the form of a single PowerPoint(R) lecture, lasting 40 minutes with image content on testicular cancer and testicular self examination was assessed. Pre and post intervention administration of a self-administered structured pre tested questionnaire was performed on 151 medical students, 101 of whom returned answers (response rate of 66.8%). In the TC domain, there was a high level of awareness of testicular cancer, but poor knowledge of the age group most affected, with significant improvement post intervention (p<0.001). Notable also was the poor awareness of the potential curability of TC, this also being improved following the intervention (p<0.001). A poor level of awareness and practice of testicular self-examination pre-intervention was found considering the nature of the study group..Respondents had surprisingly weak/poor responses to the question "How important to men's health is regular testicular self-examination?" Answers to the questions "Do you think it is worthwhile to examine your testis regularly?" and "Would you be interested in more information on testicular cancer and testicular self-examination?" were also suboptimal, but improved post intervention p<0.001, p<0.001 and p=0.037. Age, gender and marital status were without specific influence. In conclusion, this study showed poor levels of knowledge regarding epidemiology of TCa and its potential curability when detected early. There was also a poor awareness of, practice of, and poor attitudes to TSE. The significant improvement in these parameters post intervention indicates value in educational intervention. We recommend inclusion of TCa coverage and TSE teaching in the secondary school curriculum (targeting adolescents). Greater emphasis should also be given to testicular cancer in the curricula of medical schools and other training institutions for health care personnel.

• Clinical and Experimental Pediatrics
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• 제52권2호
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• pp.194-198
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• 2009

목 적 : 총폐정맥 환류이상은 드문 선천성 심장질환이나, 진단 즉시 완전 교정 수술이 필요한 질환이며 폐정맥 협착 동반 유무에 따라 수술 사망률과 예후가 다르게 보고되고 있다. 이번 연구는 총폐정맥 환류이상 환아를 조사하여 이들의 임상적 특성과 수술 후 경과를 살펴보고자 시행하였다. 방 법 : 1994년 1월부터 2008년 2월까지 14년간 경북대학교병원에서 총폐정맥 환류이상으로 진단된 환아 27명의 의무 기록 정보를 후향적으로 분석 하였다. 결 과 : 총폐정맥 환류이상 환아 27명은 남아 17명, 여아 10명이었고, 진단 시 나이는 평균 $28.1{\pm}33.4$일(1-126일), 평균 체중은 $3.6{\pm}0.9$ kg (1.9-6.3 kg)였다. 병원을 방문한 주 증상으로 빈호흡, 저산소증 등의 호흡기 증상이 7명, 수유 시 청색증이나 전신 청색증이 13명, 심잡음이 7명이었다. 13명(48.1%)에서 심부전 소견을 보였다. 심초음파 검사로 진단된 해부학적 형태로 심상부형이 15명(55.6%), 심형이 6명(22.2%), 심하부형이 5명(18.5%)이고 혼합형은 1명(3.7%)있었다. 수술 전 폐정맥 협착이 동반된 경우는 7명으로 심상부형에서 5명, 심형과 심하부형에서 각각 1명이었다. 본원에서 수술 받은 환아는 총 24명으로 수술 중 경식도 초음파 검사는 14명(58.3%)에서 시행하였다. 수술 중 경식도 초음파 검사를 사용한 경우의 사망률은 0%이고 사용하지 않은 경우의 사망률 40%로 유의한 차이(P<0.05)를 보였다. 수술 사망은 4명(16.7%)으로, 수술하지 않고 사망한 환아 2명을 포함하여 전체 사망률은 22.2%였다. 그러나 수술 시기를 2000년을 기준으로 구분하여 살펴보면, 사망한 4명 모두 2000년 이전이었으며(사망률 50%, 4/8명), 2000년 이후에는 수술 후 사망이 한 명도 없었다(사망률 0%, 0/18명). 수술 후 폐정맥의 협착은 심초음파 검사로 진단하여 5명에서 발생하였다. 5명중 3명은 수술 부위의 협착이고 나머지 2명은 폐정맥 자체의 협착이었다. 수술 부위의 협착을 보인 3명은 재수술을 시행하였고(평균 기간 : 24일) 재수술 후 사망률은 0%이며, 현재 모두 약물치료는 시행하지 않으며 특별한 증상도 보이지 않으나 3명 모두 정기적으로 시행한 심초음파에서 후기 재 협착 소견을 보였다. 이들이 수술 부위의 후기 재 협착이 진단되기까지의 평균 기간은 31.3개월(17-54개월)이었다. 폐정맥 자체의 협착을 보인 환아는 2명으로, 교정 수술 후 심초음파 검사로 진단되기까지의 기간은 각각 3개월과 84개월이었다. 추적 관찰되었던 환아 20명에서 평균 관찰 기간은 $24.2{\pm}24.9$개월(2-80개월)이었다. 결 론 : 수술 후 폐정맥 협착 및 수술 부위의 재 협착이 발생할 수 있으므로 수술 중 경식도 초음파 검사의 적극적 이용과 수술 후 정기적이고 지속적인 관리가 필요할 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제45권6호
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• pp.1252-1264
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• 1998

연구배경 : 급성호흡곤란층후군은 기계호흡을 포함한 집중 치료에도 불구하고 일반적으로 사망율이 50%에 이르는 중증 급성폐손상으로 사망률 개선을 위해 지난 10여년간 여러 'sepsis trial'들이 시도되어 왔으며, 기계 호흡관리 전략의 변화로 의미 있는 사망율의 개선을 보이고 있다. 사망에 관련한 인자들로는 패혈증, 장기 손상, 고령, APACHE II 점수등이 있다. 내과계 중환자실에서 기계호흡 치료로 관리된 급성호흡곤란증후군 환자를 대상으로 이러한 인자들이 예후에 미치는 영향을 보고자 하였다. 방 법 : 급성호흡곤란증후군의 진단은 1994 년 ATS-ESICM에서 발표된 진단범주에 근거하였다. 천안 순천향병원에서 1995년 3월부터 1998년 10월까지 호흡기계 중환자실에서 기계호흡 치료로 관리된 급성호흡곤란증후군 환자 40예를 대상으로 후향적 조사하여 다음과 같은 결과를 보았다. 결 과 : 급성호흡곤란증후군 발생원인으로는 각각 패혈증 50%(20/40), 폐렴 30%(12/40), 흡인성 폐렴은 20%(8/40) 이였다. 원인에 따른 사망률은 각각 패혈증이 50%(20/40), 폐렴 67%(8/12), 흡인성폐렴38%(3/8)이였다. 전체 사망율은 60%(24/40)였으며, 28일-사망군에서 사망원인으로 각각 패혈중이 43%(9/21), 다발성장기부전이 29%(6/21), 호흡부전이 19%(4/21)이였다. 28일-생존군(19)과 28일-사망군(21)간에 연령, 성별차이는 없었으며, 급성호흡곤란증후군 발생당시 APACHE II 점수는 각각 $22.82{\pm}3.25$ 및 $24.94{\pm}4.67$, 저산소 점수는 각각 $124.11{\pm}49.10$ 및 $110.33{\pm}55.74$, 장기손상수는 각각 $2.00{\pm}0.94$ 및 $2.12{\pm}0.93$개로 양군간에 차이는 없었다. 발생당시 70세 이상, APACHE II 점수가 26 이상, 저산소점수가 150 미만이였던 예는 양군간에 유의한 차이가 있었다 (p<0.05). 생존군에서 발생 당시 및 3일째에 비해 7일째에 APACHE II 점수, 장기손상수, 저산소점수가 유의하게 호전되었고 (p<0.05), 사망군과 유의한 차이를 보였다 (p<0.05). 사망군에서는 7 일간의 관찰기간동안 장기손상수 및 저산소정수의 변화는 없었으며, 특히 APACHE II 점수는 발생당시에 비해 유의하게 증가하였다(P<0.05). 1995년부터 1998년까지 사망율을 비교한 결과 68%에서 40% 이하로 감소하였으며, 연도별로 연령, APACHE II 점수, 저산소 점수 및 장기손상수는 차이가 없었다. 전년도 및 후년도군 각각에서 첫주에 적용된 평균 호기말양압은 2.8mmHg 및 9.2mmHg였으며(p=0.0001), 일환량은 475.8ml 및 371.8ml로 차이가 있었다(p=0.0013). 결 론 : 급성호흡곤란증후군에서 발생당시 APACHE II 점수 및 저산소점수 정도와 함께 치료경과에 따른 APACHE II 점수, 저산소점수 및 장기손상수 등의 호전여부가 예후에 중요한 것으로 사료되며, 근년에 관찰된 급성호흡곤란증후군의 유의한 사망률 개선에 적어도 호기말양압의 유의한 증가가 영향을 준 것으로 사료되었다.

• 한국건설관리학회논문집
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• 제17권5호
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• pp.108-119
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• 2016

국내 건설재해율은 1992년 도입된 이후 현재까지 PQ에 '환산재해율' 반영 등을 통하여 건설재해 감소 및 건설업 안전관리 체제 구축에 기여하고 있다. 또한, 최근 정부가 도입 추진 중인 종합심사낙찰제에도 '재해율' 및 '사망만인율'이 평가항목으로 구성되어 입 낙찰제도의 그 영향력이 확대되고 있다. 그러나 현행 건설재해율은 입 낙찰제도에 따라 이원화된 기준으로 산정 및 운영되고 있는 실정이므로 현 시점에서 건설재해율 평가지표에 대한 현황 검토와 효율적 운영을 위한 방안이 모색될 필요성이 대두되고 있다. 이에 본 연구에서는 건설업체의 재해관리 실무자를 대상으로 설문조사를 실시하여, 현행 건설재해율의 평가 운영에 대한 현황 검토를 통하여 문제점을 분석하고 그에 따른 개선방안을 제시하였다. 연구 결과, 건설재해율 평가지표의 일원화를 위한 산정기준, 평가대상업체 범위 설정, 건설업 공상처리 개선 측면에서의 개선방안을 제시하였다. 제시된 개선방안을 통해서 보다 효율적이고 합리적인 건설재해율 평가지표의 산정 및 운영이 가능할 것이며, 나아가 건설업체의 자율적인 안전보건 활성화 등을 통한 건설 재해 감소 효과를 기대할 수 있을 것이다.

• 대한토목학회논문집
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• 제35권4호
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• pp.969-975
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• 2015

본 논문에서는 철도안전과 관련된 규정들을 검토하고 역 근무자 인터뷰, 8개의 도시철도 운영기관(서울도시시철도공사, 서울메트로, 인천교통고사 등)의 현재 실시하고 있는 예방대책 현황조사를 통하여 사고감소를 위한 적극적인 예방대책 수행에 어려움을 미치는 근본원인을 관련 규정의 미흡, 조직문화와 근무환경, 소극적인 운영기관의 예방대책으로 도출하고 이를 통하여 3가지 개선방향을 도출하였다. 우선 도시철도 철도안전사상사고 행동 규정 제작을 제안하였으며, 대학생 안전도우미 활용 및 운영기관 고위 관리자의 안전 교육 등 조직문화와 근무환경 개선을 위한 방향을 제시하였다. 마지막으로 적극적인 사고예방캠페인, 이용객의 교육 참여를 높일 수 있는 방향을 제시하였다. 이러한 사고감소를 위한 개선방향은 향후 운영기관의 예방대책 수립시 가이드라인의 역할을 담당할 것이라 사료된다.

• 대한수의학회지
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• 제37권4호
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• pp.755-763
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• 1997

Recently new technologies for the establishment of high health herds are becoming efficient tools in the control of PRRS virus and secondary infections. Medicated early weaning(MEW) and nursery depopulation(ND) have shown to be one of the most successful procedures in the eradication and control of pathogens. Indirect evidence of the role of PRRSV in precipitating secondary infection comes from successful improvement in growth and in decreasing mortality on farms that have eliminated PRRSV through ND. Hence the present experiments were conducted in an effort to compare ND with MEW procedures as a means of eliminating PRRSV controlling secondary pathogens and improving performance of pigs in endemically infected swine herds. Following MEW and ND procedures practiced in the farms, some benefits obtained were as follows: 1. A decrease in PRRSV circulation in the nursery, but no entire elimination. 2. Decrease in the frequency of secondary bacteria and in the use of antibiotics. 3. Mycoplasma hyopneumoniae infection was prevented during the nursery stage. 4. ND protocol had a lower cost and management changes than MEW techniques. 5. Nursery performance was improved after the depopulation, cleaning and disinfection procedures, even though PRRSV still being cycled in the old nursery rooms. These studies revealed that the MEW and ND protocols are not always successful for PRRS virus elimination but it's great effect on control of secondary pathogens and improvement of performance make MEW and ND an efficient tools for the establishment of healthier and more efficient herds.

• The Korean Journal of Pain
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• 제18권2호
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• pp.187-191
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• 2005

Background: Discogenic leg pain is a major cause of health problems, often due to herniation of the intervertebral disc, and has traditionally been treated conservatively or with an open surgical discectomy. Conventional open surgery has many complications, such as nerve root injury, discitis and a relatively high mortality rate; failure of conservative treatments is also common. Recently, the $Dekompressor^{(R)}$ Percutaneous Lumbar Discectomy probe was developed. Herein, we present the early results for a percutaneous lumbar discectomy in herniated lumbar disc disease. Methods: Eleven patients, including 8 men and 3 women, with ages ranging from 22 to 78 years, were enrolled in this study. Those patients with a previous history of back surgery were not excluded from the study. All patients were postoperatively evaluated for their clinical outcomes, such as visual analogue scale (VAS) for pain after 1 and 3 months, reduction in analgesics, functional improvement and overall satisfaction. Results: The percutaneous lumbar discectomy was completed in 11 patients (17 levels), with average reductions in pre-VAS of 61.3 and 60.2% at 1 and 3 months, respectively. Also, 72.7% of patients reported functional improvement, with 81.1% expressing overall satisfaction. There were no procedural related complications. Conclusions: We concluded that a percutaneous lumbar discectomy is a safe and effective treatment modality for a herniated lumbar disc.

• 부모자녀건강학회지
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• 제16권1호
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• pp.11-16
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• 2013

Purpose: Ethiopia is one of the sub-Saharan countries most affected by high maternal and infant mortality. The government has trained health extension workers (HEWs), the community health workers, to deliver preventive and basic curative health services to community residents in Ethiopia. Very few studies have investigated on-the-job educational effects for HEWs on improvement of their knowledge and performance confidence in maternal and child health care (MCH). This study aimed at identifying the educational effects for HEWs in one health center in Tigray, Ethiopia on improvement of their knowledge in MCH. Methods: Twelve HEWs from 6 health posts participated in this study. A health center officer provided a total of 5 educational sessions on antenatal and postnatal care, family planning, and newborn care from August, 2012 to April, 2013. Ten to 12 items regarding the topics were tested before and after each education. Wilcoxon signed rank test was used to analyze the data. Results: All the HEWs were female with average 4-year working experience. Their knowledge significantly increased after education, except the first session. Their satisfaction on education was greater than 45 points out of 50. Conclusion: This study suggests a focused education for HEWs should continue to improve their capacity on MCH.