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Microbiology and Epidemiology of Infectious Spinal Disease

  • Jeong, Se-Jin;Choi, Seung-Won;Youm, Jin-Young;Kim, Hyun-Woo;Ha, Ho-Gyun;Yi, Jin-Seok
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.21-27
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    • 2014
  • Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

Assessment of Cognitive Disorders in Alcoholics Using the 7 Minute Screening Battery (주정의존 환자에서 7분선별검사를 이용한 인지장애의 평가)

  • Cheon, Jin-Sook;Yoon, Han-Cheol;Lee, Kwang-Young;Oh, Byoung-Hoon
    • Korean Journal of Biological Psychiatry
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    • v.8 no.2
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    • pp.258-265
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    • 2001
  • Objectives : Chronic alcohol consumption has been known to result in various neurocognitive deficits. Many neuropsychological studies revealed that the major disturbances occurred in the executive function, learning and short-term memory, visuospatial performance function, perceptuo-motor skills, and abstraction and problem solving abilities. This study was done to identify which cognitive areas might be mainly affected. Methods : The cognitive disturbance was evaluated using the Korean Version of the Mini Mental State Examination(MMSEK) and the 7 Minute Screen(7MS) in male inpatients with alcohol dependence(N=3 : as well as in age and education level matched healthy male controls(N=30). Four individual tests of the 7MS were consisted of the Benton Temporal Orientation Test, the Enhanced Cued Recall, the Clock Drawing and the Category Fluency. Results : 1) The average scores of four individual test of the 7MS for the alcoholics were $2.77{\pm}4.38$ for the Benton Temporal Orientation Test, $13.90{\pm}2.02$ for the Memory Test(the Cued Recall $6.77{\pm}1.94$, the Uncued Recall $7.10{\pm}2.45$), $5.84{\pm}1.86$ for the Clock Drawing, and $12.58{\pm}3.29$ for the Category Fluency. Except the Benton Temporal Orientation Test, there were statistically significant differences between test scores of alcoholics and those of controls(p<0.01). 2) The alcoholics who had MMSE-K score <24 were 9.68%. The average(${\pm}S.D.$) score of the MMSE-K for the patient group($27.23{\pm}2.62$) was significantly(p<0.001) lower than that of the healthy controls($29.20{\pm}1.24$). There were no statistically significant differences between four individual test scores of the 7MS of alcoholics with the MMSE-K score <24(N=3) and those of alcoholics with the MMSE-K score ${\geq}24$(N=28). 3) Four individual test scores of the 7MS seemed to have statistically significant association with such variables as MMSE-K, duration of alcohol drinking, blood magnesium concentration, liver function and thyroid function. Conclusion : Mild deficits of cognitive areas such as orientation, memory, visuospatial abilities and verbal fluency could be found in alcohol dependence.

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Structural Equation Model of Clinical Nurses' Willingness to Perform Basic Life Support (BLS) in South Korea (임상간호사의 기본소생술 수행의지에 관한 구조방정식 모형 분석)

  • Uhm, Dong-Choon;Hwang, Ji-Young;Jun, Myung-he;Kim, Dong-ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.290-298
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    • 2016
  • This study was conducted to develop a model that explains the factors influencing the clinical nurses' willingness to perform Basic Life Support and to verify the appropriateness of the model. The participants were 550 clinical nurses working at a university hospital in Korea. The data were collected from self-reported questionnaires from October 2012 to February 2013. A total of 520 questionnaires were analyzed using the SPSS/WIN 20.0 and Amos version 18.0 software packages. The results indicated that the clinical nurses' knowledge of basic life support had a direct impact and their clinical experience had an indirect impact on their willingness to perform basic life support at the scene. These variables together explained 19.5% of the variance in the nurses' willingness to perform Basic Life Support. The clinical experience was correlated significantly with knowledge (r=.61, p<.001). To increase the clinical nurses' performance of Basic Life Support, knowledge and clinical experience should be reinforced by continuous in-service education on Basic Life Support, considering the disease status of hospitalized patients.

DETERMINATIONS OF ITS ABSOLUTE DIMENSIONS AND DISTANCE BY THE ANALYSES OF LIGHT AND RADIAL-VELOCITY CURVES OF THE CONTACT BINARY - I. V417 Aquilae (접촉쌍성의 광도와 시선속도곡선의 분석에 의한 절대 물리량과 거리의 결정 -1. V417 Aquilae)

  • 이재우;김천휘;이충욱;오규동
    • Journal of Astronomy and Space Sciences
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    • v.21 no.2
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    • pp.73-82
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    • 2004
  • New photometric and spectroscopic solutions of W-type overcontact binary V 417 Aql were obtained by solving the UBV light curves of Samec et al. (1997) and radial-velocity ones of Lu & Rucinski (1999) with the 2003 version of the Wilson-Devinney binary code. In the light curve synthesis the light of a third-body, which Qian (2003) proposed, was considered and obtained about 2.7%, 2.2%, and 0.4% for U, B, and V bandpasses, respectively. The model with third-light is better fitted to eclipse parts than that with no third-light. Absolute dimensions of V417 Aql are determined from our solution as $M_1$= 0.53 $M_{*}$, $M_2$= 1.45 $M_{*}$, $R_1$= 0.84 $R_{*}$, and $R_2$= 1.31 $M_{*}$, and the distance to it is deduced as about 216pc. Our distance is well consistent with that (204pc) derived from Rucinski & Duerbeck's (1997) relation, $M_{v}$ = $M_{v}$(log P, B-V), but is more distant than that (131$\pm$40pc) determined by the Hipparcos trigonometric parallax. The difference may result from the relatively large error of Hipparcos parallax for V 417 Aql.l.

Assessment of VARK Learning Styles in Medical School and the Influence of Gender Status, Academic Achievement (의과대학생의 VARK 학습양식과 성별, 학년, 학업성취도간의 차이분석)

  • Yoo, Hyo Hyun;Kim, Young-Jon
    • The Journal of the Korea Contents Association
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    • v.19 no.11
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    • pp.144-152
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    • 2019
  • Learning styles are the methods of gathering, processing, interpreting, organizing the information. VARK learnig inventory is instructional preference classified according to their visual(V), aural(A), read-write(R), and/or kinesthetic(K) sensory modality preferences(SMP). Learner-centered learning is emphasized, but there are few studies on VARK learning styles in Korean medical school. The purposes of this study were to assess the student' SMPs and compare those with gender, status, and academic achievement. The subjects of study were 394 students at C Medical School and Graduate School of Medicine. For the study style test, 16 questions were used in Korean version of VARK test paper© 7.0 developed by Fleming provided on the VARK website. Academic achievement was converted into a standardized score(t score). Frequency analysis, cross analysis, and variance analysis(t-test, ANOVA) were conducted to identify learning style disposition and differences between groups. The uni-modal type was 87(22.1%) and the multimodal was 307(77.9%). Regardless of gender, quasi-modal VARK was the most preferred. There was no significant difference in learning styles by gender. The first grade in medicine was the lowest in uni-modal type(8.8%) and the highest in quasi-modal VARK type(47.8%), while the fourth grade was the highest in uni-modal type(30.7%) and the lowest in quasi-modal VARK type(19.8%) and tri-modal type(19.8%). There was no difference in academic achievement by all learning types(F=1.09, p=0.37). The knowledge about students' learning styles is helpful for instructors to apply more learner-centered teaching strategies in medical education.

fMRI evidence of compensatory mechanisms during a verbal working memory task in individuals with alcohol use disorders (알코올 사용 장애자의 언어 작업 기억과 관련된 뇌의 보상 기전: fMRI 연구)

  • Park, Mi-Suk;Son, Seon-Ju;Park, Ji-Eun;Eum, Yeong-Ji;Kim, Suk-Hui;Yu, In-Gyu;Son, Jin-Hun
    • Proceedings of the Korean Society for Emotion and Sensibility Conference
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    • 2009.05a
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    • pp.101-104
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    • 2009
  • This study investigated compensatory mechanisms in the brain during a verbal working memory task among people with Alcohol Use Disorders (AUD). A total of 21 college male students participated in the study: eleven AUD participants and 10 normal controls. Study participants were asked to complete the Korean version of the Wechsler Adult Intelligence Scale-III (K-WAIS-III) prior to the fMRI experiment. Verbal 0-back and 2-back tasks were used to assess brain activities of the participants' verbal working memory. Brain scanning was performed on Siemens SONATA 1.5T Scanner while participants were performing the 0-back and 2-back tasks. Within the AUD group, participants with greater dependency to alcohol (based on DSM-IV criteria) in the past 1 year showed lower mean score on the 'Similarities' of the K-WAIS-III (r=-0.63, p<0.05, N=11). The more participants experienced alcohol withdrawal symptoms in the past 1 year, the lower the score they received on the K-WAIS-III 'Picture Arrangement' (r=-0.69, p<0.05, n=11). The fMRI regression results showed that individuals who present greater degree of alcohol dependency symptoms are likely to show greater brain activation in the bilateral middle frontal gyri (BA 9) during the verbal working memory task. The degree of alcohol withdrawal symptoms were associated with increased brain activation in the left superior and middle frontal gyri (BA8), left precentral gyrus (BA 6), and left inferior parietal lobule (BA 40). The study findings showed that the degree of alcohol abuse/dependence and withdrawal symptoms were associated with decreased cognitive function and increased activations in brain regions particularly important for abstract reasoning (BA 9), central executive (BA 9), or spatial storage (BA 40) during a working memory task. Therefore, these results could support previous studies suggesting that the neural system of people with ADD may adopt a brain compensatory mechanism to maintain normal level of cognitive functions.

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Correlation Analysis with Modified Barthel Index and Motor Assessment Scale in Stroke Patients (뇌졸중환자의 기능평가척도로서의 MBI와 MAS의 상관성분석)

  • Ko, Seong-Gyu;Jun, Chan-Yong
    • The Journal of Korean Medicine
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    • v.20 no.1 s.37
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    • pp.52-59
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    • 1999
  • 연구목적 : 뇌졸중환자에 기능회복도의 측정을 위해 가장 신뢰도가 높은 MBI에 대해서 순수하게 뇌졸중환자의 운동기능평가만을 위해 고안된 MAS의 상관성을 각 기간별로 분석하여 MAS의 운동기능평가척도로서의 객관성에 대해 연구한다. 또 한편으로 경과시간에 따른 운동기능 회복도의 차이를 전체그룹과 사상그룹에서 평가한다. 연구방법 : 1998년 1월부터 1998년 6월까지 6개월에 걸쳐 상지대학교 한의과대학 부속한방병원 내과에 입원하여 뇌졸중으로 진단된 환자 중 의식과 언어상태가 명료한 32명을 대상으로 하였다. 입원직후 사상의학과에 의뢰하여 QSCCII 시스템에 의하여 체질진단을 받은 후 본원 운동기능평가실에서 입원직후, 입원 후 2주와 4주 등 3회에 걸쳐 Modified Barthel Index(MBI)와 Motor Assessment Scale(MAS)을 시행하였다. 각 환자에 대한 검사는 2명의 한방순환기내과 전문의와 전공의에 의해 환자에 대한 사전 정보 없이 이루어졌다. 연구결과 : 통계처리는 상관분석을 위해서는 Pearson correlation coefficient, 사상체질에 있어서 각 경과시간에 따른 점수변화는 Repeated ANOVA, 일반적특성 분석에는 Descriptive analysis가 사용되었고, 프로그램은 SPSS/PC+ 7.5 version을 사용하였다. 1. 뇌졸중 환자의 사상의학적인 분포는 태음인이 56.3%로 가장 많았고, 소양인이 28.1%, 소음인이 12.5%, 태양인이 3.1%이었으며, 연령별로는 50대가 32.6%로 가장 많았으며, 평균연령은 60.9세였다. 2. 경과시간에 따른 사상체질간의 MBI, MAS 평균점수변화는 MBI, MAS 모두 반복측정 분산분석 결과 입원당시와 2주 후, 입원당시와 4주 후에서 모두 P<0.001의 범위에서 통계학적으로 유의하게 증가하였고, 경과시간과 사상체질간의 교호작용은 없었다. 3. MBI, MAS 모두 각 항목과 기능별 분류군에서도 경과시간에 따른 평균점수의 변화는 P<0.001 범위에서 통계학적으로 유의하게 증가하여 한방치료의 효과가 있음을 보여주었다. 4. MBI와 MAS의 경과시간별 Pearson 상관성 분석결과 입원당시의 MBI와 입원당시의 MAS에서, 2주 후의 MBI와 입원당시, 2주 후, 4주 후의 MAS에서, 4주 후의 MBI와 입원당시, 2주, 4주 후의 MAS에서 모두 높은 상관성을 보여, 두 평가방법 간에는 상관성이 높다고 본다.

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Work Hours and Cognitive Function: The Multi-Ethnic Study of Atherosclerosis

  • Charles, Luenda E.;Fekedulegn, Desta;Burchfiel, Cecil M.;Fujishiro, Kaori;Hazzouri, Adina Zeki Al;Fitzpatrick, Annette L.;Rapp, Stephen R.
    • Safety and Health at Work
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    • v.11 no.2
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    • pp.178-186
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    • 2020
  • Background: Cognitive impairment is a public health burden. Our objective was to investigate associations between work hours and cognitive function. Methods: Multi-Ethnic Study of Atherosclerosis (MESA) participants (n = 2,497; 50.7% men; age range 44-84 years) reported hours per week worked in all jobs in Exams 1 (2000-2002), 2 (2002-2004), 3 (2004-2005), and 5 (2010-2011). Cognitive function was assessed (Exam 5) using the Cognitive Abilities Screening Instrument (version 2), a measure of global cognitive functioning; the Digit Symbol Coding, a measure of processing speed; and the Digit Span test, a measure of attention and working memory. We used a prospective approach and linear regression to assess associations for every 10 hours of work. Results: Among all participants, associations of hours worked with cognitive function of any type were not statistically significant. In occupation-stratified analyses (interaction p = 0.051), longer work hours were associated with poorer global cognitive function among Sales/Office and blue-collar workers, after adjustment for age, sex, physical activity, body mass index, race/ethnicity, educational level, annual income, history of heart attack, diabetes, apolipoprotein E-epsilon 4 allele (ApoE4) status, birth-place, number of years in the United States, language spoken at MESA Exam 1, and work hours at Exam 5 (β = -0.55, 95% CI = -0.99, -0.09) and (β = -0.80, -1.51, -0.09), respectively. In occupation-stratified analyses (interaction p = 0.040), we also observed an inverse association with processing speed among blue-collar workers (adjusted β = -0.80, -1.52, -0.07). Sex, race/ethnicity, and ApoE4 did not significantly modify associations between work hours and cognitive function. Conclusion: Weak inverse associations were observed between work hours and cognitive function among Sales/Office and blue-collar workers.

Biopsychological Validation of the Sasang Personality Questionnaire in Middle School Students (중학생에서 사상성격검사(SPQ)의 생리심리적 타당화 연구)

  • Lee, Soo Jin;Yun, Bo Mi;Choi, Young Jun;Choi, Yu Jin;Yoon, Yeo Jin;Hwang, Bo Kyung;Chae, Han
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.3
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    • pp.246-257
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    • 2016
  • Objectives The Sasang Personality Questionnaire (SPQ) measures the Yin-Yang temperament of Sasang typology with proven structural and clinical validity in adults, however it was not examined with teenagers. The purpose of this study was to validate the biopsychological structure of SPQ in middle school students.Methods 681 Korean high school students (356 boys and 325 girls) completed SPQ, Junior version of Temperament and Character Inventory (JTCI), and height and weight measures. The correlation between SPQ and JTCI subscales were examined, and the differences of SPQ and JTCI subscales, Body Mass Index (BMI) and Pondera Index (PI) among high (30%), middle (40%), and low (30%) SPQ total score groups were investigated with Analysis of Variance (ANOVA). The profile analysis was also performed to compare JTCI subscale profiles of three SPQ total score groups.Results The SPQ score was significantly (p<0.001) correlated positively with JTCI Novelty-Seeking and negatively with JTCI Harm-Avoidance. The JTCI Novelty-Seeking score of high SPQ group was significantly (p<0.001) higher than that of low SPQ group, and the JTCI Harm-Avoidance score of low SPQ group was significantly higher than that of high SPQ group. The JTCI subscale profiles for three SPQ groups were significantly different for boys and girls. Significant correlations or differences for the PI and BMI among SPQ groups were not found.Conclusions This study presented that the biopsychological structure of SPQ is robust as shown in adults. The SPQ would be a useful clinical measures of Sasang typology in pediatric patients.

Educational Effects of Traditional Classroom Instruction and Video Self-instruction (VSI) for Cardiopulmonary Resuscitation(CPR) in Boy's High School Students (고등학교 남학생에서 심폐소생술에 대한 전통적교실학습과 영상자가학습의 교육효과)

  • Park, Sang-Sub;Baek, Hong-Seok;An, Ju-Yeong
    • Journal of agricultural medicine and community health
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    • v.36 no.1
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    • pp.13-24
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    • 2011
  • Objectives: The purpose of this study is to compare educational effects between traditional classroom instruction and video self-instruction (VSI) for cardiopulmonary resuscitation (CPR) in boy's high school students. Methods: This study was carried out targeting totally 96 boy students(47 people for experimental group, 49 people for control group) in the second grade of high school where is located in G city of G province from July 9-10, 2009. The experimental group and control group were arbitrarily selected two classes in the second grade. One class was assigned to the experimental group. another class was assigned to the control group. The experimental group was educated with VSI for CPR. The control group was educated with traditional classroom instructions for CPR. The analysis was performed with SPSS WIN (version 12.0) program using frequency chi-square($x^2$) test, independent samples t-test, and paired t-test. Results: After instructions, the knowledge, attitude, self-confidence, and skill performance accuracy scores on CPR increased statistically in both group. The increases of self-confidence ($2.40{\pm}0.73$) and skill performance accuracy score ($2.67{\pm}0.29$) in the experiment group were significantly higher than those ($2.01{\pm}0.96$ and $2.54{\pm}0.31$) in the control group, respectively. Conclusion: This study suggested that VSI was more effective than traditional classroom education for self-confidence and skill-performance accuracy in CPR. To confirm it, more studies are warranted.