• 대한예방한의학회지
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• 제22권3호
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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.

• 대한임상검사과학회지
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• 제51권1호
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• pp.93-104
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• 2019

본 연구는 국내의 진단검사의학과의 검사현황 및 인력배치현황과 검사 건수를 파악하기 위함이다. 지역별, 규모별 임상병리사를 대상으로 설문조사를 실시하여 최종 441부를 분석 자료로 사용하였다. 자료의 분석은 STATA (version 12.0)를 이용하여 Descriptive statistics analysis, Chi-square test, ANOVA test를 실시하였다. 병원 규모별 임상병리사 분포는 의원급 5.8명, 병원급 14.9명, 종합병원 25.8명, 대학병원 45.4명으로 나타났다. 부서별검사건수, 1인 1일 검사건수는 의원, 병원, 종합병원, 대학병원간의 유의한 차이가 있었다. 임상병리사의 1일 검사건수와 1일 적정 검사건수의 차이는 상급병원으로 갈수록 감소하는 것으로 나타났다. 정도관리는 상급병원의 부서별 정도관리 평균 시간은 2시간 이내로 나타났다. 급여만족도, 근무환경만족도, 검사성취도, 복지제도측면에서 의원, 병원급에서 불만족도 다수 차지하는 것으로 나타났다. 이는 선진국형 의료 수준에 맞는 신뢰성 있는 검사의 데이터를 제공하기 위해 임상 병리사의 근무환경에 따른 근무의 만족도와 임상검사의 정확도를 높이기 위해서라도 임상병리사의 처우개선에 초점을 맞추어야 할 것으로 사료된다.

• Asian Journal for Public Opinion Research
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• 제7권2호
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• pp.94-112
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• 2019

Objective: The objective of this study was to compare the quality of life (QOL) of patients with end-stage renal disease (ESRD) between patients receiving hemodialysis (HD) and patients receiving continuous ambulatory peritoneal dialysis (CAPD) and to compare personal characteristic factors relating to the quality of life in patients with ESRD. Method: This study used a descriptive research design. The sample was recruited using purposive sampling that included 76 ESRD patients receiving either HD or CAPD at a dialysis clinic in Phraphutthabat Hospital, Saraburi Province, Thailand. Data was collected using the Quality of Life Questionnaire for Chronic Kidney Disease ($KDQOL-SF^{TM}$) version 1.3. Independent t-test and ANOVA procedures were used to analyze study data. Results: The results revealed that the HD patients had a moderate level of QOL. The highest scoring dimension of QOL was the encouragement of staff at the dialysis unit and patient satisfaction with the treatment (${\bar{X}}=100$, SD=.00), followed by social support (${\bar{X}}=89.29$, SD =16.88) and cognitive function (${\bar{X}}=88.57$, SD=11.82). On the other hand, the lowest scoring QOL dimension was physical problems (${\bar{X}}=50$, SD=51.89), and pain (${\bar{X}}=50$, SD=39.03), followed by work status (${\bar{X}}=53.57$, SD=45.84) and burden from kidney disease (${\bar{X}}=58.48$, SD=31.07). The CAPD patients also had a moderate QOL. The highest scoring QOL dimension was the encouragement of staff in the renal unit and patient satisfaction with the treatment (${\bar{X}}=100$, SD=.00), followed by social support (${\bar{X}}=95.61$, SD=14.20) and cognitive function (${\bar{X}}=88.83$, SD=13.52). The worst scoring QOL dimensions were work status (${\bar{X}}=44.44$, SD=42.72), general health (${\bar{X}}=53.61$, SD=39.05), and pain (${\bar{X}}=62.70$, SD=41.14). The difference overall and in each dimension of QOL in ESRD patients who were treated with HD and CAPD was not statistically significantly different. The QOL was not significantly different among patients with different personal characteristics except for income and duration of treatment; in those cases, the difference in QOL was statistically significant (p=.05). Conclusion: The overall QOL and life expectancy of patients with ESRD treated with HD and CAPD are not affected by gender, age, marital status, education, occupation, or type of health coverage. QOL was not significantly different, except for patients with different incomes and duration of renal replacement therapy, whose QOL was significantly different. The QOL of patients receiving dialysis should be studied to develop a QOL program for patients with chronic kidney disease who receive dialysis.

• 대한신경과학회지
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• 제36권4호
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• pp.294-301
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• 2018

Background: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. Methods: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. Results: Among 1,080 patients (mean age: $47.7{\pm}14.3$, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p<0.001). Conclusions: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.

• 한국융합학회논문지
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• 제12권4호
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• pp.275-284
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• 2021

본 연구는 만성 뇌졸중 환자에게 고유수용성신경근촉진법을 시행한 연구를 체계적이고 종합적으로 분석하고자 하였다. 연구의 선정기준을 연구대상 (뇌졸중 환자), 중재 방법 (고유수용성신경근촉진법), 비교집단 (중재 또는 비 중재방법), 연구 결과 (동적 균형) 및 연구 설계 (무작위 배정 임상실험) 유형에 맞춰 정리하였다. 총 7개의 데이터베이스에서 문헌을 검색하여 본 연구의 선정기준에 적합한 문헌 17편을 선정하였다. 메타분석을 위해 R 4.0.3 프로그램을 이용하여 개별연구의 효과크기를 산출하였다. 연구의 질 평가는 코크란 그룹이 개발한 무작위배정 임상실험 연구를 평가하는 척도를 사용하였다. 고유수용성신경근촉진법의 동적 균형에 대한 전체 효과크기는 0.59 (95% 신뢰구간 : 0.41-0.77)로 중간 이상의 효과크기로 유의한 차이가 있었다. 동적 균형에 대한 하위항목들을 분석하였고, 버그 균형척도 (0.50), 일어나 걷기 검사 (0.78), 기능적 뻗기 검사 (0.51)의 효과크기로 나타났다. 이처럼 고유수용성신경근촉진법은 만성 뇌졸중 환자의 동적 균형 능력의 향상에 긍정적인 영향을 제공한다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권6호
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• pp.557-564
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• 2021

Background: Conscious sedation is a useful adjunct in the treatment of patients in dentistry; however, a lack of knowledge among the dental profession regarding sedation is a restricting factor in the practice of dental sedation. Therefore, this study was conducted to assess the knowledge and practice of sedation in dentistry among dental professionals in Tanzania. Methods: This was a cross-sectional study conducted for five months targeting all practicing dental professionals in Tanzania. A modified questionnaire contained 14 questions regarding knowledge about sedative agents and a section on the practice of sedation. The data obtained from this study were coded and entered into a computer program and analyzed using SPSS software version 23.0. The data are presented as frequencies and percentages in tables and charts. Statistical significance was set at P < 0.05. Results: The age range of participants was between 24 and 63 years (mean 36.6 ± 7.7 years). There were 107 men (78.1%), and the male-to-female ratio was 3.6:1. The majority (76.6%) of participants only had an undergraduate dental degree. Thirty-one percent of participants only worked in publicly owned health facilities. Slightly more than half (59.9%) of participants had satisfactory knowledge regarding sedation in dentistry. There was no statistically significant association between the level of sedation-related knowledge and the demographic characteristics of the participants. Only 21.9% reported using sedation in their practice, and the most commonly used sedative drug was diazepam. The reasons for not using dental sedation in clinical practice included a perceived lack of knowledge on sedation, lack of equipment, and cost. Conclusion: Most dental professionals in Tanzania have basic knowledge of sedation in dentistry, although knowledge regarding sedative agents is generally low. The practice of sedation in dentistry in Tanzania is very low compared to that in middle- and high-income countries. Inadequate knowledge, lack of equipment, and the cost of practicing sedation are the main reasons for not practicing sedation.

• Journal of Nutrition and Health
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• 제56권4호
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• pp.391-403
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• 2023

그동안 국내 연구에서 PAL을 산출하기 위해 사용해온 18단계 신체활동분류표로 신체활동을 평가하는 데 한계가 있었기에 새롭게 한국인을 위한 신체활동분류표가 보고되었다. 이에 본 연구에서 총에너지소비량을 측정하는 gold standard인 이중표식수법을 이용하여 새로 보고된 신체활동분류표의 타당도를 평가한 결과, TEE_DLW와 TEE_PACT 간의 유의한 차이가 없었으며 TEE_DLW와 TEE_PACT 간의 스피어만 상관관계 (r = 0.769)는 유의한 높은 양의 상관성을 보였다. 즉, 본 연구에서 TEE 및 PAL 산출을 위해 새로운 신체활동분류표의 사용이 타당한 것으로 평가되었으며, 앞으로 이와 관련된 연구 결과는 2025 한국인 영양소 섭취기준에서 에너지필요추정량 산출식에 필요한 신체활동단계별 계수 (PA)를 결정하는데 유용한 자료가 될 것으로 기대된다. 또한 개인별 및 연구 목적으로도 쉽게 사용하기 위해서, 신체활동분류표를 이용한 웹 버전의 소프트웨어 프로그램 및 스마트폰 어플리케이션의 개발이 필요하다.

• 농업과학연구
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• 제50권4호
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• pp.809-815
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• 2023

This study was conducted to find out the correlation between meat quality and muscle fat ratio in pork part meat (pork belly and shoulder butt) using CT (computed tomography) imaging technique. After 24 hours from slaughter, pork loin and belly were individually prepared from the left semiconductors of 26 pigs for CT measurement. The image obtained from CT scans was checked through the picture archiving and communications system (PACS). The volume of muscle and fat in the pork belly and shoulder butt of cross-sectional images taken by CT was estimated using Vitrea workstation version 7. This assemblage was further processed through Vitrea post-processing software to automatically calculate the volumes (Fig. 1). The volumes were measured in milliliters (mL). In addition to volume calculation, a three-dimensional reconstruction of the organ under consideration was generated. Pearson's correlation coefficient was analyzed to evaluate the relationship by region (pork belly, pork shoulder butt), and statistical processing was performed using GraphPad Prism 8. The muscle-fat ratios of pork belly taken by CT was 1 : 0.86, while that of pork shoulder butt was 1 : 0.37. As a result of CT analysis of the correlation coefficient between pork belly and shoulder butt compared to the muscle-fat ratio, the correlation coefficient was 0.5679 (R² = 0.3295, p < 0.01). CT imaging provided very good estimates of muscle contents in cuts and in the whole carcass.

• Korean Journal of Radiology
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• 제22권9호
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• pp.1579-1586
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• 2021

Objective: To evaluate the diagnostic performance of the modified Korean Thyroid Imaging Reporting and Data System (K-TIRADS), and compare it with the 2016 version of K-TIRADS using the Thyroid Imaging Network of Korea. Materials and Methods: Between June and September 2015, 5708 thyroid nodules (≥ 1.0 cm) from 5081 consecutive patients who had undergone thyroid ultrasonography at 26 institutions were retrospectively evaluated. We used a biopsy size threshold of 2 cm for K-TIRADS 3 and 1 cm for K-TIRADS 4 (modified K-TIRADS 1) or 1.5 cm for K-TIRADS 4 (modified K-TIRADS 3). The modified K-TIRADS 2 subcategorized the K-TIRADS 4 into 4A and 4B, and the cutoff sizes for the biopsies were defined as 1 cm for K-TIRADS 4B and 1.5 cm for K-TIRADS 4A. The diagnostic performance and the rate of unnecessary biopsies of the modified K-TIRADS for detecting malignancy were compared with those of the 2016 K-TIRAD, which were stratified by nodule size (with a threshold of 2 cm). Results: A total of 1111 malignant nodules and 4597 benign nodules were included. The sensitivity, specificity, and unnecessary biopsy rate of the benign nodules were 94.9%, 24.4%, and 60.9% for the 2016 K-TIRADS; 91.0%, 39.7%, and 48.6% for the modified K-TIRADS 1; 84.9%, 45.9%, and 43.5% for the modified K-TIRADS 2; and 76.1%, 50.2%, and 40.1% for the modified K-TIRADS 3. For small nodules (1-2 cm), the diagnostic sensitivity of the modified K-TIRADS decreased by 5.2-25.6% and the rate of unnecessary biopsies reduced by 19.2-32.8% compared with those of the 2016 K-TIRADS (p < 0.001). For large nodules (> 2 cm), the modified K-TIRADSs maintained a very high sensitivity for detecting malignancy (98%). Conclusion: The modified K-TIRADSs significantly reduced the rate of unnecessary biopsies for small (1-2 cm) nodules while maintaining a very high sensitivity for malignancy for large (> 2 cm) nodules.

• Korean Journal of Radiology
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• 제22권4호
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• pp.559-567
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• 2021

Objective: To evaluate the impact of multiparametric magnetic resonance imaging (mpMRI) before confirmatory prostate biopsy in patients under active surveillance (AS). Materials and Methods: This retrospective study included 170 patients with Gleason grade 6 prostate cancer initially enrolled in an AS program between 2011 and 2019. Prostate mpMRI was performed using a 1.5 tesla (T) magnetic resonance imaging system with a 16-channel phased-array body coil. The protocol included T1-weighted, T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging sequences. Uroradiology reports generated by a specialist were based on prostate imaging-reporting and data system (PI-RADS) version 2. Univariate and multivariate analyses were performed based on regression models. Results: The reclassification rate at confirmatory biopsy was higher in patients with suspicious lesions on mpMRI (PI-RADS score ≥ 3) (n = 47) than in patients with non-suspicious mpMRIs (n = 61) and who did not undergo mpMRIs (n = 62) (66%, 26.2%, and 24.2%, respectively; p < 0.001). On multivariate analysis, presence of a suspicious mpMRI finding (PI-RADS score ≥ 3) was associated (adjusted odds ratio: 4.72) with the risk of reclassification at confirmatory biopsy after adjusting for the main variables (age, prostate-specific antigen density, number of positive cores, number of previous biopsies, and clinical stage). Presence of a suspicious mpMRI finding (adjusted hazard ratio: 2.62) was also associated with the risk of progression to active treatment during the follow-up. Conclusion: Inclusion of mpMRI before the confirmatory biopsy is useful to stratify the risk of reclassification during the biopsy as well as to evaluate the risk of progression to active treatment during follow-up.