• Title/Summary/Keyword: primary prevention

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영유아기 아토피 환아에서 말초혈액 T 림프구에서 Interleukin-4 유전자의 DNA 메틸화 변화 (DNA Methylation Change of IL-4 Gene from T Cell in Allergic Children)

  • 오재원;염명걸;김창렬;설인준;신수아;이하백;장세진
    • Clinical and Experimental Pediatrics
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    • 제48권6호
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    • pp.634-639
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    • 2005
  • 목 적 : 2세 미만의 소아에서는 임상적으로 확실한 증상이 있거나 알레르기 가족력이 있는 것을 제외하고는 실제적으로 아토피 유무를 판별하는 것은 성인에 비해 제한점이 많다. 본 연구에서는 영유아기에 알레르기 질환과 관련된 사이토카인이 유전자 배열에서 발현하는 지를 말초혈액의 Th2 림프구에서 interleukin-4 유전자의 DNA 탈메틸화를 통하여 알아보고자 하였다. 방 법 : 대상은 한양대학교 구리병원 소아알레르기클리닉을 내원한 3세 미만 소아에 대해 소아의 병력과 가족력을 조사하여 family allergy score와 개인력을 기준으로 알레르기질환에 대한 고위험군 7명, 저위험군 8명, 정상 대조군 7명이었다. 이들 모두에서 총 IgE치와 Der f II 특이 IgE를 측정하였고 이들의 말초혈액에서 T세포를 Der f II로 자극하여 배양한 후 DNA 추출을 하여 IL-4 유전자 두 번째 인트론의 CpG 섬에 대한 메틸화 분석을 실시하였다. 결 과 : 정상군에 비해 알레르기 환아군에서 IL4 유전자의 두번째 인트론에 위치한 CpG 섬의 두 부위 모두에서 메틸화 특이 PCR 신호강도가 약하게 나타나는 반면 정상아에서는 118 bp PCR 산물과 205 bp PCR 산물이 모두 강하게 나타나서 메틸화된 것으로 보이며, 저위험군 알레르기 환아에서 최소한 한 부위에서 탈메틸화가 일어났으며 고위험군 알레르기 환아에서는 두 부위 모두에서 탈메틸화가 일어났다. 결 론 : 정상 대조군의 T 세포에서는 IL-4 유전자의 메틸화가 일어나고 알레르기 환아에서 고위험군과 저위험군 모두 정도의 차이는 있으나 메틸화의 소실이 관찰되었다. 이를 이용하여 향후 영유아기에서 아토피 유무를 판별할 수 있는 가능성을 제시하였으나 더 많은 연구가 필요할 것으로 사료된다.

중년여성의 강인성, 폐경지식과 폐경관리에 관한 연구 (A Study on Hardiness, Knowledge of Menopause, Menopausal Management among Middle Aged Women)

  • 신혜숙;권숙희
    • 여성건강간호학회지
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    • 제5권2호
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    • pp.247-261
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    • 1999
  • The purpose of this study was to figure out related factors to the self-reported climacteric symptoms and the relationship among the health promoting behaviors, climacteric symptoms and degree of Sanhujori, the Korean traditional postpartal care. A cross-sectional survey design was employed in this study. The subjects were 108 middle-aged women who were non-hystrectomized and ranged in age from 40 to 60 years. They were selected in seoul and Kyoung-ki province, Korea, Data were collected from Oct.25 Nov. 10, 1997 by a structured questionnaire. The instruments used for this study were the revised health Promotion Lifestyle(HPLP) developed by Walker, Sechrist & Pender, and revised Climacteric Symptoms Scale developed by Chi, Sung Ai. the data were analyzed by the SPSS/$PC^+$ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; 1. The mean score of health promoting behaviors was low($2.42{\pm}0.35$). There were statistically significant differences in the score of health promoting behaviors according to the educational background, family income, marital satisfaction, whether or not taking a restorative food and degree of Sanhujori, especially the period (t=-2.07, F=2.60~7.57, p<0.05). 2. The mean score of score self-reported climacteric symptoms was 1.69%;99% of middle-aged women had symptoms. There were statically significant differences in the score of middle -aged women's self-reported climacteric symptoms according to the age, number of children, educational background, occupation, family income, marital satisfaction, whether or not receiving hormon replacement therapy (HRT) or consultation by a professional, perceived health status and self evaluation of Sanhujori(t=-2.04~3.69, F=2.87~11.63, p<0.05). 3. women's degree of Sanhujori was a positive correlation with health promoting behaviors(r=0.34, p=0.00) and negative correlation with the degree of self-reported climacteric symptoms(r=-0.19,p=0.03). 4. The influencing factors to the climacteric symptoms were self actualization, interpersonal support, and perceived health status among the health promoting behaviors with 57% of variance($R^2$=0.57). 5. The middle-aged women's type of coping pattern for the climacteric symptoms was classified as active behavioral coping, spiritual & psychological coping, and negative coping. In conclusion, to intervene the middle aged women's climacteric symptoms and develop nursing strategies for their health, health promoting behavior, especially ; self actualization, interpersonal support, and perceived health status should be considered. And, as the primary prevention strategy for women's health during the period of childbearing and also middle age, especially for the climacteric symptoms, Sanhujori should be reconsidered.

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퇴원손상심층조사 자료를 이용한 의료기관 중증도 보정 사망비 비교 (Comparison of Hospital Standardized Mortality Ratio Using National Hospital Discharge Injury Data)

  • 박종호;김유미;김성수;김원중;강성홍
    • 한국산학기술학회논문지
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    • 제13권4호
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    • pp.1739-1750
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    • 2012
  • 본 연구는 의료서비스의 결과지표인 의료기관 중증도 보정 사망비(HSMR)를 산출하고, 비교하여 행정자료를 이용한 의료서비스 결과를 평가할 수 있는 방안을 마련하고자 수행되었다. 이를 위해서 질병관리본부의 2007-2008년의 퇴원손상환자 63,664건의 자료를 분석하였다. 중증도 보정모형 개발을 위해 데이터마이닝을 이용한 의사결정나무와 로지스틱 회귀분석을 실시하였으며, 최종 모형으로 선정된 로지스틱 회귀분석에는 성별, 재원일수, Elixhauser 상병지수, 입원경로, 주상병 변수가 포함되었다. 퇴원시 사망에 영향을 끼치는 이러한 변수를 보정 후 병원간의 중증도 보정 사망비(HSMR)를 비교한 결과 병원간의 중증도 보정 사망비(HSMR)는 차이가 있는 것으로 나타남에 따라 병원의 의료서비스 수준 차이가 있는 것이 확인되었다(HSMR 범위: 55.6-201.6). 본 연구를 통하여 병원간의 퇴원시 사망률을 비교할 수 있는 방법이 개발되었으므로 향후에 이를 이용하여 다양한 의료의 질 향상 활동을 할 수 있는 방안을 마련하여야 할 것이다.

여성의 자살시도 고위험군 선별을 위한 관련요인 분석 (A Study on the Analysis of the Related Factors to Distinguish High Risk Group of Female Suicidal Attempts)

  • 최향숙;허명륜;김은미
    • 한국산학기술학회논문지
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    • 제18권5호
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    • pp.308-317
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    • 2017
  • 본 연구는 한국 여성의 자살시도 경험 현황을 확인하고, 관련요인을 확인하여 고위험군 선별을 위한 기초자료를 제공하고자 시도하였다. 2013년부터 2015년까지 질병관리본부에서 전국적으로 조사한 국민건강영양조사 자료 중 제 6기 3차 자료를 이용하였고. 전체 대상자중 여성만을 선별하여 일반적 특성, 정신건강 관련 특성, 일상생활 활동 특성 등의 자료를 수집하였다. 수집된 자료는 가중치를 적용하여 SPSS 20.0 프로그램의 복합표본 분석방법을 이용하여 빈도분석, 교차분석, 다변량 로지스틱 회귀분석으로 분석하였다. 그 결과 전체 여성의 1%에서 자살 시도 경험이 있는 것으로 파악 되었으며, 1년 이내의 정신 상담 경험이 있는 대상자가 없는 대상자보다 5.25배, 스트레스가 적은 대상자에 비해 많은 대상자가 14.92배, 일의 강도가 높은 대상자가 그렇지 않은 대상자에 비해 4.85배, 하루 중 앉아 있는 시간이 많은 대상자가 적은 대상자에 비해 3.76배 더 자살 시도를 한 것으로 나타났다. 따라서 이와 같은 대상자들을 자살시도의 고위험군으로 고려하여야 하며, 여성의 자살시도 예방을 위하여 일차적으로 정신 건강 상태와 일상생활의 활동 특성 변수를 고려한 선별 지침이 필요하겠다. 또한 사회적, 정책적으로 제공되는 자살 예방 프로그램의 개별적 접근이 필요할 것으로 사료 된다.

소아서혜부탈장의 선택적 편대측 시험절개 (Selective Contralateral Exploration in Pediatric Inguinal Hernia)

  • 이명덕
    • Advances in pediatric surgery
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    • 제1권1호
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    • pp.18-26
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    • 1995
  • For the prevention of later contralateral hernia as well as unnecessary contralateral exploration in pediatric patients with unilateral inguinal hernias, a reasonable indication of contralateral exploration is required. To examine the contralateral positivity, a prospective selective contralateral exploration has been performed by the author from Sept. 1985 to Dec. 1993, at Pediatric Surgical Section of the Department of Surgery, Kangnam St. Mary's Hospital, Catholic University Medical College. Among the total 1200 cases of pediatric inguinal hernias, 580 cases of contralateral side were explored at hernia operations, by the indications as; male with infant onset, 2)female of all age, 3)prematurity, 4)profuse ascites due to cirrhosis, nephrotic syndrome, and ventriculoperitoneal shunt, and 5)remarkable silk sign. Overall positive rate was 71.4%, and positive rates of each indication were 80.7%, 70.4%, 73.1%, 66.7%, and 72.0%, respectively. Right side hernia showed 67.0%, left s ide 75.7%, and positive familial history 71.8% of contralateral positivities. In male, getting older revealed lower positive rates and the rate suddenly dropped after 12 years of age. Birth order, mother's age at delivery, postmaturity did not show any significant differences between the rates. Recurrence was seen in 3(0.5%) ipsilateral and 2(0.3%) contralateral, both of which were negative esplorations on previons operations. Overall complication rate was 3.8%, including 1 infection, 14 fluid or blood accumulation, 5 edemas, 3 temporary testicular edemas, 2 persisting fevers, 2 enures is and one delayed recovery from anesthesia. Among 38 cases with contralateral hernias developed after unilateral surgery by authors(6 cases) or surgeons in other institutions, 14 were males with infant onset, 4 were prematurities and 9 were females. Therefore, 27(71.7%) cases were originally under the contralateral exploration indications. The primary site of the hermia was right in 25 and left in 13. With above results, the following indications for contralateral exploration could be suggested ; 1)under one year of age, both sex, 2)prematurity, 3) remarkable silk sign, 4)in the double checked suspicions among males with infant onset, all age females, ascites, left hernia and familial history. After 12 years of age, exploration is not required. Considering complications, contralateral explorations could be considered only in the following situations; 1)expert, experienced pediatric surgeon, 2)experienced pediatric anesthesiologist, 3)operations could be done smoothly in an hour, 4)good general condition of the patient.

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Pleural Fluid Pentraxin-3 for the Differential Diagnosis of Pleural Effusions

  • Yeo, Chang Dong;Kim, Jin Woo;Cho, Mi Ran;Kang, Ji Young;Kim, Seung Joon;Kim, Young Kyoon;Lee, Sang Haak;Park, Chan Kwon;Kim, Sang Ho;Park, Mi Sun;Yim, Hyeon Woo;Park, Jong Y.
    • Tuberculosis and Respiratory Diseases
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    • 제75권6호
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    • pp.244-249
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    • 2013
  • Background: Conventional biomarkers cannot always establish the cause of pleural effusions; thus, alternative tests permitting rapid and accurate diagnosis are required. The primary aim of this study is to assess the ability of pentraxin-3 (PTX3) in order to diagnose the cause of pleural effusion and compare its efficacy to that of other previously identified biomarkers. Methods: We studied 118 patients with pleural effusion, classified as transudates and exudates including malignant, tuberculous, and parapneumonic effusions (MPE, TPE, and PPE). The levels of PTX3, C-reactive protein (CRP), procalcitonin (PCT) and lactate in the pleural fluid were assessed. Results: The levels of pleural fluid PTX3 were significantly higher in patients with PPE than in those with MPE or TPE. PTX3 yielded the most favorable discriminating ability to predict PPE from MPE or TPE by providing the following: area under the curve, 0.74 (95% confidence interval, 0.63-0.84), sensitivity, 62.07%; and specificity, 81.08% with a cut-off point of 25.00 ng/mL. Conclusion: Our data suggests that PTX3 may allow improved differentiation of PPE from MPE or TPE compared to the previously identified biomarkers CRP and PCT.

일부 도시주부들의 스트레스 생활사건 및 신체증상에 관한 연구 (Stressful Life Events and Somatic Symptoms of Urban Women)

  • 김영희;박형숙
    • 대한간호학회지
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    • 제22권4호
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    • pp.569-588
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    • 1992
  • This study examined the relationship between the experience of stressful life events and somatic symptoms of urban women. Data were collected by interviewing 200 women from June to July 1, 1991. Vsable data work obtained from 162 of the women. Modified version of a stressful life events measurement tool developed p.5. Lee (1984) and the Somatic Discomfort Inventory by Wittenborn were used to measure the variables. Data were processed by an 5.p.5.5. program and analyzed. statistically for percentage, T-test, ANOYA and Pearson Correlation coefficient. Result of the Study are as follows : 1) The group total mean score of stressful life events was 92.66 $\pm$ 10.41. The higher scores in the $\boxDr$Test and school$\boxUl$ of the Extrapersonal factor, in the $\boxDr$Health problems$\boxUl$ of the Intrapersonal factor and $\boxDr$Conflict and differences within the family$\boxUl$ of the Interpersonal factor, factors. which a suggested by Neuman's model. 2) The group total mean score for somatic symptoms was 100.41$\pm$9.74. The higher scores were for the factors of $\boxDr$Fatigue (1.94)$\boxUl$, $\boxDr$Menopause (1.74)$\boxUl$, $\boxDr$Muscular system(1.67)$\boxUl$ and $\boxDr$Sleeping (1.67)$\boxUl$ 3) The mean scores of stressful life events were higher in the 40~60 age group, for middle school graduates(P<.05), career women and those in nuclear families (P>.05). 4) The mean scores of somatic symptoms were higher in the 45~60 age group, for middle school graduates, non career women and women with 5 or more children(P<.05). 5) There was a positive correlation between the scores of stressful life events and somatic symptoms (r=.585 P<.05). The higher the level of stressful life events the higher the score of somatic symptoms, the results were consistent with the Extrapersonal, Intrapersonal and Interpersonal stress factors of Neuman's Health Care Systems. This research assessed the stressful life events of women, who play the most important role in the family for illness prevention and health promotion and suggested the importance of programs in the Primary Health Services to build basic coping resources.

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Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw

  • Kang, Mong-Hun;Lee, Dong-Keon;Kim, Chang-Woo;Song, In-Seok;Jun, Sang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제44권5호
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    • pp.225-231
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    • 2018
  • Objectives: The purpose of this study was to investigate the demographic and clinical characteristics of patients with medication-related osteonecrosis of the jaw (MRONJ) and to elucidate factors affecting recurrence in surgical treatment. Materials and Methods: A total of 51 patients who were diagnosed with MRONJ were analyzed according to demographic and clinical features and treatment results through a retrospective chart review from 2013 to 2017 in the Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul in Korea. Results: Alendronate composed the majority of medication doses (55.6%), followed by ibandronate (20.0%), risedronate (15.6%), and zoledronate (6.7%). Forty patients (88.9%) were given oral medication, and five patients (11.1%) were intravenously treated, and the mean duration of medication use was $61.1{\pm}42.9$ months. A total of 10 patients (22.2%) had a drug holiday before MRONJ-induced dental treatment lasting an average of $6.8{\pm}7.0$ months. MRONJ occurred 2.7 times more in the mandible, with 41 cases (73.2%) occurring in the mandible and 15 cases (26.8%) occurring in the maxilla, and the prevalence of affected posterior parts (premolar-molar) was six times greater than that of the anterior parts (incisor-canine) (48 cases vs 8 cases, 85.7% vs 14.3%). The most common dental cause of MRONJ was tooth extraction (69.6%). Regarding recurrence, there was no statistical difference in recurrence rate according to either site or stage. However, recurrence occurred in 4 out of 34 cases (11.8%) in the primary closure group and 9 out of 20 cases (45.0%) in the secondary healing group, and there was a statistical difference with respect to closure technique. Conclusion: The identified risk factors in patients taking bone resorption inhibitors can aid dental clinicians in ensuring prevention and proper treatment of MRONJ.

Effects of Antiretroviral Therapy on the Survival of Human Immunodeficiency Virus-positive Adult Patients in Andhra Pradesh, India: A Retrospective Cohort Study, 2007-2013

  • Bajpai, Ram;Chaturvedi, Himanshu;Jayaseelan, Lakshmanan;Harvey, Pauline;Seguy, Nicole;Chavan, Laxmikant;Raj, Pinnamaneni;Pandey, Arvind
    • Journal of Preventive Medicine and Public Health
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    • 제49권6호
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    • pp.394-405
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    • 2016
  • Objectives: The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India. Methods: The present study used data from 139 679 HIV patients aged ${\geq}15$ years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival. Results: The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for < $100cells/mm^3$ vs. > $350cells/mm^3$), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients. Conclusions: The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.

청소년 알레르기성 질환의 복합성과 중증도가 자살 생각에 미치는 영향 (Effect of Allergy Related Disease on Suicide Ideation among Adolescents in Korea)

  • 왕진우;김은영;박수진;이준협;임국환
    • 한국학교ㆍ지역보건교육학회지
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    • 제17권3호
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    • pp.11-25
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    • 2016
  • Background & Objectives: There were increasing evidence about the relationship between allergy related disease such as asthma, atopic dermatitis and allergic rhinitis and suicide ideation. However little was known about the concrete relatedness between severity and comorbidity of allergy related disease with suicide ideation. The objective of this study was to investigate the cases of the prevalence of suicide ideation among adolescents with allergy related disease such as asthma, atopic dermatitis and allergic rhinitis, and examine the association between allergy related disease and suicidal ideation among adolescents in South Korea. Methods: Data was based on Korean Youth Risk Behavior Web-based Survey(2014) which was a cross-sectional study containing 34,874 Korean middle and high school students who diagnosed with allergy related disease. We used the weights, strata and primary sampling unit information provided by the public use dataset to compute descriptive statistics and logistic regressions. Computations were done with SPSS version 20.0. Results: 19.9%, 15.6%, 13.8% of adolescents who suffered from one, two and three of allergy related diseases respectively reported having been thought of suicide ideation. Socio-demographic factors were adjusted as control variables. Students with greater severity of disease were more likely to have suicide ideation. Odds ratio for students who were absent one to three days from school because of allergies was 1.96(95% CI 1.51-2.46), and odds ratio for those who were absent more than four days from school was 3.60(95% CI 2.46-5.28). Conclusions: Given that adolescents' severity and comorbidity of allergy related disease were clearly associated with suicide ideation, suicide prevention programs for adolescents with allergy related disease should be improved by strategic approaches towards the severity and comorbidity of disease.