• 한국직업건강간호학회지
• /
• 제9권1호
• /
• pp.5-17
• /
• 2000

The occupational health nursing guideline for primary care was developed by the Korean Academic Society of occupational health nursing and the organization for occupational health nurses (currently known as the Korean Association of Occupational Health Nurses) in 1993. Since then, there have been many changes in the health care environment and job performance of occupational health nurses. Appropriate revisions are necessary of the guidelinea based on this background. The purpose of this study was to describe the use of the occupational health nursing guideline for primary care and to analyze the characteristics of primary care activities by occupational health nurses. The questionnaire was mailed to 150 occupational health nurses(OHNs) with the response rate of 64%. The results can be summarized as follows; 1. 65.6% of OHNs have been using the guideline for primary care and 75.9% of them agreed that the guideline was be helpful for their job. 2. Common symptom care, emergency care and chronic illness care were more frequently implemented than occupational disease care by OHNs. In manufacturing industries, emergency care was more frequently implemented than chronic illness care in contrast to the service industries. 3. Most frequent common symptoms treated by OHNs were indigestion, diarrhea, abdominal pain, headache, and coughing. In the case of chronic illness, OHNs more frequently treated diseases of the gastro-intestinal system, skin and sensory organs, and the respiratory system. Emergency care for bruises, burn, and abrasions was more frequently provided. VDT syndrome was the most common occupational disease cared by OHNs in manufacturing and service industries. 4. OHNs prescribed the medicine for external application more frequently than internal medicine. Remedy for colds, analgesics, vitamins, and digestives were more frequently used. From these results, we suggest that the guideline should be revised to emphasize the activities consisting problem finding such as health assessment, physical examinations, monitoring and screening, and to renew the drug list in the range of over- the counter medication (OTC). In the future, the guideline will include the strategies for the role as the case manager.

• Clinical and Experimental Pediatrics
• /
• 제58권6호
• /
• pp.211-217
• /
• 2015

Purpose: Mycoplasma pneumoniae (MP) infection is a major cause of respiratory infection in school-aged children. Extrapulmonary manifestations of MP infection are common, but liver involvement has been rarely reported. The aim of this study was to determine the clinical characteristics of MP-associated hepatitis. Methods: This prospective study included 1,044 pediatric patients with MP infection diagnosed serologically with MP IgM at one medical center from January 2006 to December 2012. Eighty of these patients had elevated levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT), each greater than 50 IU/L, without any other specific liver disorder and were compared with the 964 children without liver disorders. Results: In total, 7.7% of patients with MP infection had a diagnosis of hepatitis, especially in fall and winter. The ratio of male to female patients was 1.7:1, and the mean age of the patients was 5 years and 5 months. The most common symptoms were cough, fever, and sputum. Anorexia was the most common gastrointestinal symptom, followed by nausea/vomiting, diarrhea, and abdominal pain. Mean levels of AST and ALT were 100.65 IU/L and 118.73 IU/L, respectively. Serum AST/ALT level was normalized within 7.5 days on average without complications. The mean duration of hospitalization (11.3 days) was longer for children with hepatitis than for those without hepatitis (P=0.034). Conclusion: MP-associated hepatitis is not uncommon and has a relatively good prognosis. Therefore, clinicians should be concerned about liver involvement in MP infection but avoid further unnecessary evaluation of hepatitis associated with MP.

• 한국가금학회지
• /
• 제11권1호
• /
• pp.49-64
• /
• 1984

1978년부터 1919년까지의 ND 대류행기간중계 군관리 기록이 확실하고 ND발생전후 ND 항체주사가 가능했던 5개 농장을 대상으로 ND에 대한 역학사항, 면역정도 및 피해상황을 조사한 바 다음과 같은 결론을 얻을 수 있었다. 1. 생독 또는 사독 ND백신을 4회이상 접종한 20주령 이상된 계군에서는 비록 ND HI 역가가 3 log$_2$이하일지라도 ND로 인한 폐사율은 대체로 주간 1%미만으로 피해가 크지 않았다. 2. 이러한 계군에서의 산란율의 감소는 최종백신접종일로 부터 DN발생시까지 경과한 기간에 따라서 4주이내에 발병되었을 때는 뚜렷한 변동이 없었으나 6주이상 경과한 경우에는 산란율의 감소를 보였으며 그 정도는 경과한 기간에 비례하는 양상을 보여 주었다. 3. 사독백신만을 접종한 계군에서는 ND가 발생되었을 때 비록 산란감소가 없을지라도 호흡기증상은 심하게 나타났다. 4. 6i주령 이하의 어린 계군에서 ND로 인한 폐사를 방지할 수 있는 HI 역가는 3.0 log$_2$이상인 것으로 추정되었으며 비록 생독백신을 3회나 접종하였을지라도 이러한 정도의 면역이 형성되지 못한 계군에서는 약40%의 폐사율을 보일 정도로 피해가 컸다. 5. ND에 걸린후 내과회복한 계군의 HI 역가는 발병당시 임상증상 및 산란율의 멸소 또는 폐사율이 높은 계군일수록 높았으며 대부분 8 log$_2$ 이상이었다. 6. ND가 발생된 농장일지라도 계사조건(무창계사)과 관리상황(교통통제)에 따라서는 ND 무감염으로 경과하는 계군도 있었으며 유창계사조건일지라도 계군간의 전파기간이 1주 이상인 경우도 허다하였다.

• Journal of Preventive Medicine and Public Health
• /
• 제19권1호
• /
• pp.137-145
• /
• 1986

A Nationwide health care utilization survey was conducted from March 11 to September 19, 1985 to assess the level of illness and the magnitude of medical care utilization. A probability sample of 15,427 persons was taken from 180 Enumerated Districts designated by the Economic Planning Board. Of those 4,500 housewives were proxy respondents. A interview was conducted with pre-tested questionnaire schedule which was recorded by well trained interviewers. Age and sex compositions of the study population were similar to those of general population structure in 1985. The major findings of this survey are as follows : 1) A total of 64.5% of the study population lived in city area and 35.5% lived in county area. 2) While no difference was observed in interview rate between city and county area, it showed statistically significant difference in the medical security program coverage rate between the two areas(44.7% and 37.1%, respectively) 3) Morbidity rate was 79 per 1,000 persons during the two week periods. There was difference in age and sex adjusted morbidity rates between city and county area. Furthermore morbidity rates by the status of the program were significantly difference between the two areas. 4) Average ambulatory care utilization rate was 7.2 visits per person per year and average admission rate was 1.8 per 100 persons per year. There was significant difference in average ambulatory care utilization rate by the program. but no significant difference in medical utilization rate between city and country area. 5) The major symptoms of the perceived illness was the respiratory system(44.1%). 6) A total of 50.4% of the perceived illness among the covered group by the program were treated at the hospital and clinics, but those who are not covered used primarily drug stores(61.3%).

• Journal of Chest Surgery
• /
• 제25권11호
• /
• pp.1318-1326
• /
• 1992

Backgroud. To determine the influence of age at operation upon surgical outcome in patients with isolated secundum atrial septal defect, retrospective clinical analysis was done. Material and method. From June, 1976 to December, 1991, 146 patients, 63 male and 83 female patients ranging in age from 13 months to 56 years, were operated on for isolated secundum atrial septal defect. The patients were divided into 3 groups according to their age at operation: Group I [<20 years old], 91 patients[62.3%]; Group II [21 to 40 years old], 44 patients[30.1%]; GroupIII[>41 years old], 11 patients[7.6%]. Significant differences in clinical features, hemodynamic function, early and late results between age groups were speculated. Results. One hundred thirty-one patients[89.6%] were symptomatic at the time of operation, the most common symptoms being dyspnea on exertion, recurrent respiratory infection, palpitation and chest pain. Patients in NYHA class III or IV were 3.3% in group I, 25% in groupIII, and 54.5% in group Ill. Hemodynamic data was available for 138 patients [94.5%]. Significant pulmonary hypertension [MPA systolic pressure $^3$ 40mmHg] was noted in 22 patients [15.9%]. Patients with pulmonary vascular disease [Rp/Rs>1.25] were 2% in group I, 7.3% in group Il, and 9.1% in groupIII. But there were no significant differences between the age groups in the size of the shunt or the ratio of pulmonary to systemic flow. Atrial septal defects were closed with direct suture in 144 patients and patch repair was performed in 2 patients with high defect. Atrial arrhythmia [8.2%] was the most common postoperative complication. The mean [LSD] duration of follow-up in all patients was 16$\pm$22 months [range, 1~96 months]. Functional result was excellent regardless of the age groups. During follow-up period, late cardiovascular events were arrhythmia [7 cases], reoperation for recurrent ASD [2 cases], and premature late death due to bacterial endocarditis [1 case]. Incidence of preoperative and late atrial fibrillation was significantly higher in older age group. Conclusion. Age at operation is one of the most important predictor of early and late surgical outcome with its impact on the following factors : 1] hemodynamic alterations and ventricular dysfunction due to longstanding volume and pressure overload, 2] pulmonary vascular disease, and 3] atrial arrhythmia including atrial fibrillation as a result of atrial dilatation. Therefore, among patients with surgically repaired atrial septal defects, those operated on over the age of 20 require careful supervision on the long-term basis.

• Journal of Chest Surgery
• /
• 제48권4호
• /
• pp.258-264
• /
• 2015

Background: This study aimed to evaluate the therapeutic results and safety of pectoralis major muscle turnover flaps in the treatment of mediastinitis after coronary artery bypass grafting (CABG) procedures. Methods: Data regarding 33 patients with post-CABG deep sternal wound infections (DSWIs) who underwent pectoralis major muscle turnover flap procedures in the Emam Reza and Ghaem Hospitals of Mashhad, Iran were reviewed in this study. For each patient, age, sex, hospital stay duration, remission, recurrence, and associated morbidity and mortality were evaluated. Results: Of the 2,447 CABG procedures that were carried out during the time period encompassed by our study, DSWIs occurred in 61 patients (2.5%). Of these 61 patients, 33 patients (nine females [27.3%] and 24 males [72.7%]) with an average age of $63{\pm}4.54$ years underwent pectoralis major muscle turnover flap placement. Symptoms of infection mainly occurred within the first 10 days after surgery (mean, $10.24{\pm}13.62days$). The most common risk factor for DSWIs was obesity (n=16, 48.4%) followed by diabetes mellitus (n=13, 39.4%). Bilateral and unilateral pectoralis major muscle turnover flaps were performed in 20 patients (60.6%) and 13 patients (39.4%), respectively. Complete remission was achieved in 25 patients (75.7%), with no recurrence in the follow-up period. Four patients (12.1%) needed reoperation. The mean hospitalization time was $11.69{\pm}6.516days$. Four patients (12.1%) died during the course of the study: three due to the postoperative complication of respiratory failure and one due to pulmonary thromboembolism. Conclusion: Pectoralis major muscle turnover flaps are an optimal technique in the treatment of post-CABG mediastinitis. In addition to leading to favorable therapeutic results, this flap is associated with minimal morbidity and mortality, as well as a short hospitalization time.

• 한국임상약학회지
• /
• 제28권3호
• /
• pp.230-237
• /
• 2018

Objective: To compare adverse event reporting patterns between ethical-the-counter and over-the-counter drugs from community pharmacies and outpatient settings. Methods: We conducted a descriptive study using the adverse event reporting database, wherein data were collected from the regional pharmacovigilance centers of the Korean Pharmaceutical Association between January 1, 2016 and December 31, 2016. The reported drugs were classified into either ethical-the-counter or over-the-counter drugs, and we compared the distribution of patient age and gender, frequent adverse events and medications, serious adverse events, and causality assessment results, where causality assessments were performed according to the World Health Organization-The Uppsala Monitoring Centre's system. Results: We included 17,570 reports (75,451 drug-adverse event pairs). Ethical-the-counter and over-the-counter drugs accounted for 81.4% and 18.6% of the total adverse event reports, respectively. The use of over-the-counter drugs was higher in females and patients aged <18 years, whereas the use of ethical-the-counter drugs was higher in those aged >65 years. Alimentary tract and metabolism drugs, and respiratory system drugs were the most frequent ethical-the-counter and over-the-counter drugs, respectively. From causality assessment results, "possible" (75.4%) was the most commonly assigned category for ethical-the-counter drugs, while "possible" (44.0%) and "unlikely" (47.7%) were the most common categories for over-the-counter drugs. The distribution of serious adverse events were similar for both ethical-the-counter and over-the-counter drugs. Conclusion: Differences were observed in age, gender, reported medications, and symptoms for both ethical-the-counter and over-the-counter drugs. Further pharmacovigilance activities considering the adverse event characteristics of over-the-counter drugs, which are comparable to ethical-the-counter drugs, should be performed.

• 여성건강간호학회지
• /
• 제7권4호
• /
• pp.447-460
• /
• 2001

The purpose of this study were to identify a relationship between symptom of health and fatigue-regulation behavior in middle-aged women. The subjects were 241 women living in Seoul and near the city, ranging in ages of 30-59(mean= 42.1 years) being interviewed during the month of Oct. to Dec., 2000. The following questionnaires were utilized in this study: a self reported symptom of health and a fatigue-regulation behavior scale originated from Kwon(1997). The analysis for the data was done by SAS program, t-test, ANOVA, and Pearson correlation. The results of this study were as follows 1. Total mean scores of health status were shown 29.1, physical symptom 17.9 and psychological symptom 11.2. According to symptom of body system were higher in muscular-skeletal sympom 5.5, neurologic symptom 3.5, and digestive symptom 2.7. 2. The mean scores of symptom of health were significantly different in duraion of marriage, status of menstruation, perceived fatigue, perceived cause of fatigue, perceived help of family, hours of sleep. Physical symptom was significantly different in years of educational, status of menstruation, perceived fatigue, perceived cause of fatigue, perceived help of family, hours of sleep. Psychological symptom was significantly different in parity, whether or not having past illness, perceived fatigue. 3. The neurologic symptom was significantly different in years of education, status of menstruation, perceived fatigue, time to rest The respiratory symptom was significantly different in years of education, status of menstruation and hours of physical exercise. The muscular-skeletal symptom was significantly different duration of marriage, status of menstruation, BMI. perceived fatigue, perceived cause of fatigue, perceived help of family. The cardiovascular symptom was significantly different in whether or not having religion, number of children, duration of marriage, number of pregnancy & abortion, parity, status of menstruation, BMI. The digestive symptom was significantly different in whether or not having religion and the number of children. The urologic symptom was significantly different in whether or not having job, type of family, status of menstruation, BMI, perceived fatigue, perceived cause of fatigue, perceived help of family. The score of fatigue was significantly different in number of pregnancy. 4. There were significantly positive relationships in the area of symptom on health, especially fatigue was significantly positive relationships in score of symptom of health, physical symptom and psychological symptom. 5. They choose fatigue-regulation behavior physical rest, method of diversion, management of stress, enough sleep, and psychological rest in order. In the near future, it is required that further studies investigate socio-environmental factors related to symptoms of health and develop programs motivating fatigue-regulation behaviors actively.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권1호
• /
• pp.275-280
• /
• 2016

Background: A tobacco-free workplace policy is identified as an effective means to reduce tobacco use and protect people from second-hand smoke; however, the number of tobacco-free policies (TFP) remains very low in workplaces in Malaysia. This study explored the factors affecting support for a tobacco-free policy on two healthcare campuses in Malaysia, prior to the implementation of TFP. Materials and Methods: This cross-sectional study was conducted among 286 non-smokers from two healthcare training centres and two nearby colleges in Malaysia from January 2015 to April 2015. A standardized questionnaire was administered via staff and student emails. The questionnaire collected information on sociodemographic characteristics, support for a tobacco-free policy and perceived respiratory and sensory symptoms due to tobacco exposure. Bivariate and multivariate logistic regression analyses were performed to estimate the independent effects of supporting a tobacco-free campus. Results: The percentage of individuals supporting completely tobacco-free facilities was 83.2% (N=238), as opposed to 16.7% (N=48) in support of partially tobacco-free facilities. Compared to the supporters of partially tobacco-free facilities, non-smokers who supported completely tobacco-free health facilities were more likely to be female, have higher education levels, to be very concerned about the effects of other people smoking on their health and to perceive a tobacco-free policy as very important. In addition, they perceived that tobacco smoke bothered them at work by causing headaches and coughs and, in the past 4 weeks, had experienced difficulty breathing. In the multivariate model, after adjusting for sociodemographic characteristics and other factors, only experiencing coughs and headaches increased the odds of supporting a completely tobacco-free campus, up to 2.5- and 1.9-fold, respectively. Conclusions: Coughs and headaches due to other people smoking at work enhances support for a completely tobacco-free campus among non-smokers.

• Neonatal Medicine
• /
• 제18권1호
• /
• pp.124-129
• /
• 2011

목적: 최근 PPHN의 치료를 위해 iNO와 함께 많은 약물적 치료가 사용되고 있다. Sildenafil은 PDE5의 억제제로 선택적인 폐혈관 확장제로 알려져 있으며 iNO에 비하여 접근성이 뛰어나 iNO에 대안적인 약제로 연구되어 왔다. 저자들은 본원에서 sildenafil로 PPHN을 치료한 경험을 분석하였다. 방법: 심초음파를 통해 PPHN으로 진단된 재태 기간 35주 이상, FiO2 1.0을 필요로 하는 32명의 환아를 대상으로 하였으며 의무기록을 후향적으로 조사하였다. sildenafil은 0.5 mg/kg로 시작하여 6시간마다 1 mg/kg로 투약하였으며, 투약 전과 후 6, 12, 24, 48시간의 MAP, $FiO_2$, OI, MBP를 비교하였다. 부작용을 확인하기 위하여 환아들의 위장관 증상, 뇌초음파, 안저검사와 청성뇌간유발반응 검사의 결과를 조사하였다. 결과: 대상 환아 32명 중 태변 흡인 증후군 9명, 호흡곤란증후군 8명, 폐렴 3명이었으며, 12명은 특발성이었다. 이 중 31명이 생존하였으며 28명의 환아는 본원에서 sildenafil만으로 치료되었고 3명의 환아는 전원되어 iNO 치료 후 회복하였다. Sildenafil 단독으로 치료된 28명의 환아에서 $FiO_2$와 OI는 치료 6시간째부터 MAP는 48시간째부터 유의하게 감소하였다. 모든 환아에서 특별한 부작용은 관찰되지 않았다. 결론: Sildenafil은 35주 이상의 PPHN 환아에서 비교적 효과적이고 안전하게 시도해 볼 수 있는 대안 약제로서, 특히 iNO가 가능하지 않은 병원에서 유용할 것으로 생각된다.