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An Analysis of the Effectiveness of Stroke between East-West Integrative Medicine Hospital and Western Medicine Hospital by the Data of Brain Rehabilitation Registry (뇌질환 재활 통합 등록체계 자료(Brain Rehabilitation Registry)를 통한 한양방 협진병원과 양방병원의 뇌졸중 환자 치료효과 분석)

  • Heo, Kwang-Ho;Hwang, Eui-Hyoung;Cho, Hyun-Woo;Lee, In;Hong, Jin-Woo;Shin, Yong-Il;Kim, Soo Yeon;Shin, Byung-Cheul
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.3
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    • pp.117-124
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    • 2013
  • Objectives The aims of this study was to observe the effectiveness of East-West Integrative Medicine (EWIM) by analysing between EWIM estimated group and Non-EWIM eastimated group with Brain Rehabilitation Registry. Methods We divided hospitals into two groups, one is EWIM estimated group hospital (Kyeonghee university, Wonkwang university, Dongguk university) and the other is non-EWIM estimated group (Jeonnam university, Gyeongbuk university, Catholic university). Then we analysed the effectiveness of treatments retrospectively using the database of Brain Rehabilitation Registry (http://www.kbrr.or.kr/, version 1.0). Totally 293 patients were included, EWIM estimated group was 175 and non-EWIM estimated group was 118. The main outcome measurements were National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI) and Mini Mental State Examination-Korea (MMSE-K). Results Changes of NIHSS was not significant in both total patient and patient who treated over 3 weeks. MMSE-K showed positively significant difference (p=0.044) in EWIM estimated group patients who treated over 3 weeks. In case of MBI, EWIM estimated group showed more effective result and also statistically significant in both total patients and patients who treated over 3 weeks. Conclusions We patially argued that EWIM estimated group was more effective than non-EWIM estimated group in stroke patients' functional recovery. We suggested base data of EWIM in stroke patiens through this study and this could be applied future researches of developing modified EWIM system.

Development and Validation of a Novel Generic Health-related Quality of Life Instrument With 20 Items (HINT-20)

  • Jo, Min-Woo;Lee, Hyeon-Jeong;Kim, Soo Young;Kim, Seon-Ha;Chang, Hyejung;Ahn, Jeonghoon;Ock, Minsu
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.1
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    • pp.38-59
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    • 2017
  • Objectives: Few attempts have been made to develop a generic health-related quality of life (HRQoL) instrument and to examine its validity and reliability in Korea. We aimed to do this in our present study. Methods: After a literature review of existing generic HRQoL instruments, a focus group discussion, in-depth interviews, and expert consultations, we selected 30 tentative items for a new HRQoL measure. These items were evaluated by assessing their ceiling effects, difficulty, and redundancy in the first survey. To validate the HRQoL instrument that was developed, known-groups validity and convergent/discriminant validity were evaluated and its test-retest reliability was examined in the second survey. Results: Of the 30 items originally assessed for the HRQoL instrument, four were excluded due to high ceiling effects and six were removed due to redundancy. We ultimately developed a HRQoL instrument with a reduced number of 20 items, known as the Health-related Quality of Life Instrument with 20 items (HINT-20), incorporating physical, mental, social, and positive health dimensions. The results of the HINT-20 for known-groups validity were poorer in women, the elderly, and those with a low income. For convergent/discriminant validity, the correlation coefficients of items (except vitality) in the physical health dimension with the physical component summary of the Short Form 36 version 2 (SF-36v2) were generally higher than the correlations of those items with the mental component summary of the SF-36v2, and vice versa. Regarding test-retest reliability, the intraclass correlation coefficient of the total HINT-20 score was 0.813 (p<0.001). Conclusions: A novel generic HRQoL instrument, the HINT-20, was developed for the Korean general population and showed acceptable validity and reliability.

Study of the safety education condition and injury occurrence in dental technicians- in Seoul and Gyeonggi (치과기공사의 안전교육 실태 및 상해발생 조사연구 -서울·경기 지역을 중심으로)

  • Kim, Jin;Choi, Se-Woong;Shin, Su-Jeong;Cho, Yoon-Sang;Lim, Su-Min;Shim, Jeong-Seok;Lee, Jung-Soo;Bae, Eun-Jeong
    • Journal of Technologic Dentistry
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    • v.39 no.3
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    • pp.179-185
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    • 2017
  • Purpose: It is intended to raise awareness of importance of protective equipment and necessity of safety education by examining the actual condition of measures to deal with accident, occurrence of injury, whether safety education is received or not, the actual condition of wearing protective equipment, and working environment of dental lab and dental technician. Methods: A self-administered survey was conducted for a total of 150 dental technologists. A chi-squared test and independent-samples t-test was carried out by using SPSS WIN Program (version 12.0) in order to analyze the actual condition of safety education according to work experience and position and whether injury occurred according to whether to wear protective equipment. Significance level was 0.05. Results: With regard to whether injury occurred according to whether safety education was received, there was 'receiving the safety education-injured (71.8%)', 'not receiving the safety education-injured (79.7%)', 'receiving the safety education-not injured (28.2%)', and 'not receiving the safety education-not injured (20.3%)'. The statistical results of injury occurrence according to safety education were not significant. With regard to whether to be injured according work experience, there was 'less than 10 years-injured (68.4%)', 'less than 10 years- not injured (31.6%)', '10 years or above-injured (89.1%)', and '10 years or above-not injured (10.9%)'. The statistical results of injury occurrence according to work experience were significant (p<0.001). Conclusion: Dental lab and specialized agencies should continue to be interested in periodic safety training, recommending wearing protective equipment and personal protective equipment support and so on.

The Effects of Dynamic Functional Electrical Stimulation With Treadmill Gait Training on Functional Ability, Balance Confidence and Gait in Chronic Stroke Patients

  • Cho, Young-Ki;Ahn, Jun-Su;Park, Yong-Wan;Do, Jung-Wha;Lee, Nam-Hyun;Kwon, Oh-Yun
    • Physical Therapy Korea
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    • v.21 no.4
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    • pp.23-33
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    • 2014
  • The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

Measuring Quality of Life in Cerebral Palsy Children According to the Severity Using the Visual Analogue Scale, Time Trade-Off, and EQ-5D-Y Proxy (뇌성마비 환아 중증도별 시각화척도, 시간교환법, EQ-5D-Y Proxy를 이용한 삶의 질 측정)

  • Lee, Go-Eun;Kim, Nam Kwen;Yun, Young Ju;Wang, Hye Min;Kim, Jeong Hun;Lee, Dong Hyo
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.2
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    • pp.49-59
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    • 2017
  • Objectives: To measure the quality of life in patients according to virtual cerebral palsy severity by using the Korean version of EQ-5D-Y proxy, Visual Analogue Scale (VAS), and Time Trade-Off method (TTO). Methods: The study was conducted in parents of children and adolescents aged 4 to 15 years in Seoul. We analyzed the difference in the utility value according to five levels of cerebral palsy severity in the Gross Motor Function Classification System (GMFCS) and test-retest reliability. Results: 1. There were significant differences in VAS, TTO, and EQ-5D-Y proxy according to the cerebral palsy severity (p<.001). 2. VAS was significantly different according to the respondent's visit to the medical institution, the presence of disease in the respondent, a visit to the child's medical institution, the age of the child, and the sex of the child. The value of TTO was significantly different according to the respondent's visit to the medical institution, respondent's sex, and the age of the child. Also, EQ-5D-Y proxy was significantly different according to the age of the child. 3. Intraclass correlation coefficient values were more than 0.6 for both VAS and TTO at all stages. But for the EQ-5D-Y proxy, the value was less than 0.6 at all stages. Conclusions: The quality of life assessment using EQ-5D-Y proxy showed significant differences in the severity of cerebral palsy. However, large-scale studies using EQ-5D-Y proxy are needed because of low test-retest reliability.

IRS-2 Partially Compensates for the Insulin Signal Defects in IRS-1-/- Mice Mediated by miR-33

  • Tang, Chen-Yi;Man, Xiao-Fei;Guo, Yue;Tang, Hao-Neng;Tang, Jun;Zhou, Ci-La;Tan, Shu-Wen;Wang, Min;Zhou, Hou-De
    • Molecules and Cells
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    • v.40 no.2
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    • pp.123-132
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    • 2017
  • Insulin signaling is coordinated by insulin receptor substrates (IRSs). Many insulin responses, especially for blood glucose metabolism, are mediated primarily through Irs-1 and Irs-2. Irs-1 knockout mice show growth retardation and insulin signaling defects, which can be compensated by other IRSs in vivo; however, the underlying mechanism is not clear. Here, we presented an Irs-1 truncated mutated mouse ($Irs-1^{-/-}$) with growth retardation and subcutaneous adipocyte atrophy. $Irs-1^{-/-}$ mice exhibited mild insulin resistance, as demonstrated by the insulin tolerance test. Phosphatidylinositol 3-kinase (PI3K) activity and phosphorylated Protein Kinase B (PKB/AKT) expression were elevated in liver, skeletal muscle, and subcutaneous adipocytes in Irs-1 deficiency. In addition, the expression of IRS-2 and its phosphorylated version were clearly elevated in liver and skeletal muscle. With miRNA microarray analysis, we found miR-33 was down-regulated in bone marrow stromal cells (BMSCs) of $Irs-1^{-/-}$ mice, while its target gene Irs-2 was up-regulated in vitro studies. In addition, miR-33 was down-regulated in the presence of Irs-1 and which was up-regulated in fasting status. What's more, miR-33 restored its expression in re-feeding status. Meanwhile, miR-33 levels decreased and Irs-2 levels increased in liver, skeletal muscle, and subcutaneous adipocytes of $Irs-1^{-/-}$ mice. In primary cultured liver cells transfected with an miR-33 inhibitor, the expression of IRS-2, PI3K, and phosphorylated-AKT (p-AKT) increased while the opposite results were observed in the presence of an miR-33 mimic. Therefore, decreased miR-33 levels can up-regulate IRS-2 expression, which appears to compensate for the defects of the insulin signaling pathway in Irs-1 deficient mice.

Effects of an Abdominal Obesity Management Program on Physiological Bio-markers of Middle-aged Women in Korea: A Meta-analysis (국내 중년기 비만 여성의 생리적 지표에 대한 복부비만관리프로그램의 효과: 메타분석)

  • Kim, KyengJin;Hong, HaeSook;Park, WanJu;Ko, SangJin;Na, YeonKyung
    • Journal of Obesity & Metabolic Syndrome
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    • v.25 no.3
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    • pp.138-148
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    • 2016
  • Background: The purpose of this study is to analyze the effects of an abdominal obesity management program in middle-aged women in Korea. Methods: Examination of databases, including the Research Information Sharing Service, Database Periodical Information Academic, and Korean Studies Information, resulted in identification of 772 studies performed up to 2014, of which 43 satisfied the inclusion data. Data analysis was performed using R version 3.2 to calculate the effect sizes, explore possible causes of heterogeneity, and check for publication bias, using a funnel plot and its trim-and-fill analysis. Results: The mean effect size of the management program was small (g=0.22), along with the anthropometric index (g=0.18), metabolism index (g=0.21), fat-distribution (g=0.36), and inflammatory index (g=0.36). Moderator analysis was performed to determine heterogeneity, but no significant differences were found between the randomized controlled trial (RCT) group and non-RCT group. In addition, the length of the session was found to be statistically significant after performing a meta-regression. Finally, a funnel plot with a trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected. Conclusion: Based on these findings, the abdominal obesity management program affects middle-aged women in Korea. Further research is needed to target other age groups with abdominal obesity.

Analysis of the Necessity of Medical Records Related to Radiological Examination (방사선검사의 의무기록에 관한 요구도 분석)

  • Hong, Dong-Hee;Lim, Cheong-Hwan;Lim, Woo-Taek;Joo, Young-Cheol;Jung, Hong-Ryang;Kim, Eun-Hye;Yoon, Yong-Su;Jung, Young-Jin;Choi, Ji-Won;Jeong, Sung-Hun;Park, Myeong-Hwan;Yang, Oh-Nam;Jeong, Bong-Jae
    • Journal of radiological science and technology
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    • v.44 no.5
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    • pp.513-523
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    • 2021
  • The purpose of this study was to discuss the required items and feasibility of medical records of radiological examinations performed by radiological technologists at medical institutions. An online survey was conducted to a total of 10,000 radiation-related workers, of which 1,026 (10.3%) responded. As a research method, self-made questionnaires were used. The online survey was conducted from September 10 to September 20, 2021 for the survey period. For response data, a Chi-square test was performed according to demographic characteristics using SPSS 27.0 version (IBM Inc., Chicago, Ill, USA), and it was judged to be significant when the P value was less than 0.05. The reliability of the questionnaire response was found to be Chronbach α=0.933. More than 90% of the medical records related to radiological examinations are necessary, and they answered that a curriculum, remuneration curriculum, and legal system for medical records should be prepared. More than 90% of the respondents agreed with the proposal of the Radiological Technologist Independent Act for legal preparation, and most of the information required for medical records is currently recorded in DICOM images. According to the demographic characteristics, the medical record requirement for radiological examination, curriculum, continuing education, and legislation were found to be higher with higher education and higher with longer working experience. In addition, most of the radiology departments showed a high demand for medical records, so most of them responded positively to the medical records requirements for radiological examinations. This study analyzed the medical record requirements for radiological examinations, and as shown in the results, medical record requirements for radiological examinations was found that most radiological technologists felt need for the new law and supported it. In addition, if the information recorded in the DICOM image is used, it is considered that medical records could be easily prepared without additional work by the radiological technologists.

Evaluating the Effectiveness of Chuna Manual Therapy for low back pain in the Pilot Insuring Project of the National Health Insurance (건강보험 시범사업 기관에 내원한 요통환자에 대한 추나요법 유효성 평가 연구)

  • Ryu, Jiseon;Kim, Dongsu;Shin, Byung-Cheul;Lim, Byungmook
    • Journal of Society of Preventive Korean Medicine
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    • v.22 no.3
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    • pp.1-10
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    • 2018
  • Backgrounds : In 2017, National Health Insurance implemented the pilot insuring project for Chuna manual therapy(CMT). 65 Korean Medicine(KM) hospitals and clinics were selected in the project to monitor the provision of insured CMT. Objectives : This study aimed to evaluate the effectiveness of CMT for low back pain provided in the real world setting. Methods : Patients with low back pain who agreed to participated in the study were enrolled and requested to complete questionnaires. Patients who received CMT regardless of receiving other KM therapies were classified to Chuna group, and patient who received KM therapies without CMT to KM group. Pain(pain-VAS) and back function(KODI, Oswestry disability index-Korean version), quality of life were assessed at baseline, 4 weeks, and 8 weeks. Additionally, patients who received CMT twice and more, and who's pain-VAS 20 and over were included, and patients who used pain injection were excluded in the analysis. Results : Of 371 patients who completed all questionnaire (mean age=42.6years, SD=12.45; 61% female), 96 were excluded, 170 were in Chuna group, and 105 were in KM group. Proportions of patients who had low back pain for more than twelve weeks in the Chuna group and KM group were 57.7% and 24.8%, respectively. Pain and back function were significantly improved on 4weeks and 8weeks in both groups, but there was no difference between two groups. For the patients in the sub-acute and chronic stage(>=12 weeks), change of total KODI scores in the Chuna group was higher than KM group(p=0.013) at 4weeks. Conclusions : CMT with other KM therapies can improve back function in the sub-acute and chronic patients. For insurance policy decision, economic evaluation of CMT is needed.

Survey on the Relationship between the Number of Medical Technologists and the Medical Test Count (검사건수에 따른 임상병리사의 인원편성에 관한 설문조사 분석)

  • Kim, Junghyun;Kim, Dae-Eun;Yoon, Joong-Soo;Lee, Jeong Soo;Park, Tae-Wha
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.93-104
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    • 2019
  • This study examined the relationship between the number of medical technologists and the medical test count. Data was obtained from 441 medical technologists in a hospital through a self-reported questionnaire. The Pearson correlation test, student's t-test, ANOVA or descriptive statistics were performed for data analysis. The distribution of medical technologist according to the size of hospitals was small 5.8, medium 14.9, large 25.8, and super 45.4. The analysis demonstrated a relationship between the number of medical technologists and the number of medical tests in the field, number of clinical tests per MT, and number of optimal medical test per MT according to the hospital size (P<0.001). The average time for quality control by the department at a higher hospital was less than two hours. In terms of the satisfaction of salary, work environment, test accomplishment, and welfare service, the dissatisfaction of medical technologists in small and medium hospitals was higher than those in large and super hospitals. Overall, a focus on intensifying systemic supplementation and improving the condition of medical technologists is needed to provide reliable data for medical examinations in medical areas.