• 제목/요약/키워드: screening assessment

검색결과 617건 처리시간 0.024초

다낭난소증후군 진단시 복식 초음파의 유용성에 관한 연구 (Transabdominal Ultrasound Assessment of the Polycystic Ovary Syndrome)

  • 정경아;이운정;정혜원
    • Clinical and Experimental Reproductive Medicine
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    • 제36권4호
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    • pp.255-263
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    • 2009
  • 목 적: 한국 가임기 여성의 다낭난소증후군 진단시에 복식 초음파를 이용하는 방법의 유용성과 정확도를 분석하여 국내 다낭난소증후군의 진단 기준 마련에 도움이 되고자 하였다. 연구방법: 이화여자대학교 목동병원에서 선별설문조사를 받은 15~44세 여성 8,793명에서 복식 초음파를 시행한 총 701명 중, 정상 월경을 하면서 안드로겐 과다 및 초음파의 다낭난소 소견이 없는 정상 대조군에서 복식 초음파를 시행한 185명과 초음파 검사 소견을 제외하고 NIH 진단 기준으로 다낭난소증후군을 진단 받은 248명의 환자에서 복식 초음파를 시행한 소견을 ROC (receiver operating characteristic) 곡선 분석하였다. 결 과: 정상 대조군의 평균 연령은 $23.64{\pm}4.26$세로 복식 초음파로 측정된 평균 난소 부피는 $6.03{\pm}1.89\;cm^3$, 평균 난포 개수는 $6.49{\pm}1.93$개였다. 복식 초음파를 진단에 사용할 경우 난소 부피를 이용하면 AURC (area under the ROC curve)가 0.761로 난소 부피>$9\;cm^3$ 기준일 때, 민감도 51.0%, 특이도 91.4%였다. 난포 개수에 대한 AURC는 0.733으로 ${\geq}9$개 기준일 때, 민감도 54.9%, 특이도 87.0%였으며, 난포 개수 ${\geq}10$개 기준일 때, 민감도 53.2%, 특이도 90.4%였다. 복식 초음파로 난소 부피와 난포 개수를 검사하여 다낭난소증후군의 선별 진단에 이용하기에는 부적합하였다. 결 론: 복식 초음파를 이용하여 다낭난소증후군을 진단하는 방법은 유용성과 정확도에서 신뢰할만하지 못하다.

구제역 가축 매몰지 침출수 독성영향평가 (Ecotoxicity Assessment of Leachate from Disposal Site for Foot-and-Mouth Disease Carcasses)

  • 김동우;유승호;장순웅;이정아
    • 한국지반환경공학회 논문집
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    • 제15권8호
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    • pp.5-11
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    • 2014
  • 구제역 가축 매몰지 침출수(이하 구제역침출수)의 생태계 위해성 평가 기법을 개발하기 위한 기초자료를 도출하고자 구제역 가축 매몰지의 유공관 또는 관측정에서 채취한 시료에 대하여 이화학적 분석과 생태독성시험을 수행하였다. 이화학적 분석은 환경부 기준 구제역침출수 유출판별지표 항목 중 염소이온($Cl^-$)과 암모니아성질소($NH{_4}{^+}-N$)농도, 그리고 한국원자력연구원에서 제안한 구제역침출수 유출판별지표인 NRN(Ninhydrin-Reactive Nitrogen)농도를 분석하였고, 생태독성시험은 발광박테리아(V. fischeri), 담수미세녹조류(P. subcapitata), 그리고 물벼룩(D. magna)을 생물종으로 이용하여 수행하였다. 이화학적 분석 결과와 V. fischeri에 대한 독성영향과의 상관관계를 분석하여 상관도가 높은 구제역침출수 유출판별기준 인자를 도출하였고 회귀분석식을 이용하여 반수독성을 유발하는 지표항목의 농도를 산출하였으며 생태독성영향과 구제역침출수의 수계유출관리법과의 연계성을 평가하였다. 본 연구의 결과는 구제역 가축 매몰지에 의한 생태계 위해성을 평가하고 향후 관리 기준을 설정하는데 활용될 수 있을 것으로 예측한다.

골(骨)스캔을 이용(利用)한 천장관절(薦腸關節)/천골섭취비(薦骨攝取比)의 정량적(定量的) 측정(測定) (Sacroiliac Joint/Sacrum Uptake Ratio Measured by Quantitative Sacroiliac Joint Scintigraphy)

  • 이영열;박선양;이명철;최성재;조보연;최강원;고창순
    • 대한핵의학회지
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    • 제16권2호
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    • pp.63-70
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    • 1982
  • To evaluate the diagnostic usefulness and significance of quantitative sacroiliac joint scintigraphy in the assessment of sacroiliitis, we measured Sacroiliac Joint/Sacrum Uptake Ratio(SIS Ratio) by region of interest(ROI) method using $^{99m}Tc-methylene$ diphosphonate. The observed results were as follows: 1. Using ROI method, the SIS ratios for the control group of 65 persons were $1.05{\pm}0.08$(left) and $1.06{\pm}0.07$(right) which were narrower in range than those of slice method $(mean{\pm}S.D.)$. 2. The effects of age, gender and laterality on SIS ratio were not significant. 3. In left side, one of 6 patients with rheumatoid arthritis had SIS ratio in excess of 2 standard deviation of normal control group, and remainder had SIS ratios within normal limit. In right side, 3 patients had SIS ratios in excess of 2 standard deviation of normal control group, and remainder, within normal limit. 4. In both sacroiliac joint, 2 of 3 patients having sacroiliitis clinically with Reiter's syndrome whose pelvis A-P X-ray findings showed normal had high SIS ratios (left/right; 1.31/1.69, 1.90/1.80), but SIS ratio of one patient who had no evidence of sacroiliitis clinically was within normal limit. 5. In 6 patients with ankylosing spondylitis in both sacroiliac joints, 4 whose pelvis A-P Xray findings showed severe sclerotic change of sacroiliac joints had SIS ratio within normal limit or below that of normal control group, and SIS ratios of 2 patients whose pelvis A-P X-ray findings showed were increased. 6. 4 of 5 patients with low back pain of which cause could not be evaluated clinically and radiologically had SIS ratios in excess of that of normal control group. It would be concluded that quantitative sacroiliac joint scintigraphy is useful and sensitive screening method in the diagnosis as well as in the assessment clinical activity of sacroiliitis.

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유방암 환자에서의 디스트레스의 유병률 및 디스트레스가 삶의 질에 미치는 영향 (Prevalence of Distress and Its Influence on Quality of Life in Breast Cancer Patients)

  • 전수연;심은정;황준원;함봉진
    • 정신신체의학
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    • 제18권2호
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    • pp.72-81
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    • 2010
  • 연구목적 디스트레스를 조기에 발견하여 치료하는 것이 효율적인 암 환자의 관리에 필수적이라는 인식이 확대되고 있다. 본 연구에서는 유방암 환자들의 디스트레스의 유병률을 조사하고, 그 디스트레스가 삶의 질에 미치는 영향을 알아보았다. 방 법 서울의 한 대학병원 유방암 환우회 환자 95명을 대상으로 병원우울불안척도, 불면증심각도척도, 사건충격척도 개정판, Functional assessment of cancer therapy-Breast(FACT-B)를 시행하였다. 결 과 디스트레스의 유병률은 우울 26.3%, 불안 26.3%, 불면 13.7%, 외상후스트레스장애 증상 24.3%였다. 한가지 이상의 디스트레스를 겪고 있는 환자는 전체의 47.4%였으며, 이들은 정상군에 비해 FACT-B 총점으로 측정한 삶의 질 평균점수가 유의하게 낮았다(82.91 vs. 107.20, p<0.001). 정상범위의 환자들에서도 디스트레스와 삶의 질은 유의한 관계를 보였다. 결 론 유방암 환자의 디스트레스를 조기에 발견하기 위한 주기적인 선별검사와 적절한 치료가 필요하다.

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화학물질 우선순위 선정 기법(CRS-Korea)의 개발과 적용 (Development of Korean Chemical Ranking and Scoring System (CRS-Korea) and its Application to Prioritizing National Toxic Chemicals)

  • 박화성;김예신;이동수;신용승;최승필;박성은;김명현;양지연;신동천
    • Environmental Analysis Health and Toxicology
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    • 제20권2호
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    • pp.109-121
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    • 2005
  • A chemical ranking and scoring (CRS-Korea) system was developed and proposed to use as the first step to prioritize the toxic chemicals for the purpose of monitoring and detailed risk assessment that might follow as necessary. The CRS-Korea system takes a basic concept of risk assessment (both human health risk and ecological risk) in that risk score is determined by the product of toxicity score and exposure score. Included in the toxicity category are acute toxicity, chronic/sub -chronic toxicity, carcinogenicity, and other toxicity. The exposure category consists of quantity released to the environment, bioconcentration, and persistence. A consistent scheme and a comprehensive chemical data base are offered in the CRS-Korea system to calculate a score for the each component in the two categories by using specific physicochemical, fate, and toxic properties and the quantity of the chemical used. The toxicity score is obtained by adding up all the individual scores for the components in the toxicity category. The exposure score is determined by multiplication of the score of the quantity released with the sum of persistent score and bioconcentration score. Equal weight is given to the toxicity score and the exposure score. As the CRS-Korea system was applied to identify 50 national priority chemicals, it was found that significant data gap exists on toxicity and fate properties and that the uncertainty associated with estimating the quantify released to the environment is notably high. The proposed CRS system is only a screening tool in the first step toward the priority setting and should be used with expert judgement and other considerations necessary.

치매 환자의 인지 기능과 작업 참여와의 상관관계 (Correlations between Cognitive Function and Occupational Participation in Dementia Patients)

  • 이현진;권혁철;김환
    • 한국산학기술학회논문지
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    • 제19권4호
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    • pp.472-480
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    • 2018
  • 본 연구는 경도와 중등도 치매 환자의 인지 기능과 작업 참여 능력을 알아보고, 인지 기능과 작업 참여의 상관관계를 알아보고자 시행하였다. 2017년 9월부터 2017년 11월까지 대구광역시 지역의 주간보호센터를 방문하는 95명의 치매 환자를 대상으로 하였다. 인지 기능을 측정하기 위하여 한국판 간이정신상태 판별검사(MMSE-K)와 한국판 로웬스타인 작업치료 인지 평가-노인용(Loewenstein Occupational Therapy Cognitive Assessment Geriatric population: (LOTCA-G)을 사용, 작업 참여를 측정하기 위하여 인간작업모델 선별 평가도구(MOHOST)를 사용하였다. 본 연구 결과는 SPSS 20.0 통계처리 프로그램의 기술 통계를 이용하여 연구 대상자의 인지 기능과 작업 참여 정도를 분석하였고, 인지 기능과 작업 참여 간 상관관계 분석을 위해 피어슨 상관분석을 실시하였다. 연구 결과 치매 환자의 인지 기능과 작업 참여 간 상관관계를 확인할 수 있었다. 본 연구의 결과를 바탕으로 치매 환자의 평가 및 치료적 목표 수립 시 인지 기능과 관련한 작업 참여도 고려해야 할 것으로 사료된다.

Bioimpedence to Assess Breast Density as a Risk Factor for Breast Cancer in Adult Women and Adolescent Girls

  • Maskarinec, Gertraud;Morimoto, Yukiko;Laguana, Michelle B;Novotny, Rachel;Guerrero, Rachael T Leon
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.65-71
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    • 2016
  • Although high mammographic density is one of the strongest predictors of breast cancer risk, X-ray based mammography cannot be performed before the recommended screening age, especially not in adolescents and young women. Therefore, new techniques for breast density measurement are of interest. In this pilot study in Guam and Hawaii, we evaluated a radiation-free, bioimpedance device called Electrical Breast Densitometer$^{TM}$ (EBD; senoSENSE Medical Systems, Inc., Ontario, Canada) for measuring breast density in 95 women aged 31-82 years and 41 girls aged 8-18 years. Percent density (PD) was estimated in the women's most recent mammogram using a computer-assisted method. Correlation coefficients and linear regression were applied for statistical analysis. In adult women, mean EBD and PD values of the left and right breasts were $230{\pm}52$ and $226{\pm}50{\Omega}$ and $23.7{\pm}15.1$ and $24.2{\pm}15.2%$, respectively. The EBD measurements were inversely correlated with PD ($r_{Spearman}=-0.52$, p<0.0001); the correlation was stronger in Caucasians ($r_{Spearman}=-0.70$, p<0.0001) than Asians ($r_{Spearman}=-0.54$, p<0.01) and Native Hawaiian/Chamorro/Pacific Islanders ($r_{Spearman}=-0.34$, p=0.06). Using 4 categories of PD (<10, 10-25, 26-50, 51-75%), the respective mean EBD values were $256{\pm}32$, $249{\pm}41$, $202{\pm}46$, and $178{\pm}43{\Omega}$ (p<0.0001). In girls, the mean EBD values in the left and right breast were $148{\pm}40$ and $155{\pm}54{\Omega}$; EBD values decreased from Tanner stages 1 to 4 ($204{\pm}14$, $154{\pm}79$, $136{\pm}43$, and $119{\pm}16{\Omega}$ for stages 1-4, respectively) but were higher at Tanner stage 5 ($165{\pm}30{\Omega}$). With further development, this bioimpedance method may allow for investigations of breast development among adolescent, as well as assessment of breast cancer risk early in life and in populations without access to mammography.

The Prevalence Rate of Tuberculin Skin Test Positive by Contacts Group to Predict the Development of Active Tuberculosis After School Outbreaks

  • Kim, Hee Jin;Chun, Byung Chul;Kwon, AmyM;Lee, Gyeong-Ho;Ryu, Sungweon;Oh, Soo Yeon;Lee, Jin Beom;Yoo, Se Hwa;Kim, Eui Sook;Kim, Je Hyeong;Shin, Chol;Lee, Seung Heon
    • Tuberculosis and Respiratory Diseases
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    • 제78권4호
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    • pp.349-355
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    • 2015
  • Background: The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. Methods: The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. Results: The mean duration of follow-up was $3.9{\pm}0.9years$. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ ${\geq}$ 16% (OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). Conclusion: Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.

산업장 근로자의 건강증진 프로그램 요구도 (Need Assessment for Worksite Health Promotion Program)

  • 송연이;장정희
    • 한국직업건강간호학회지
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    • 제8권2호
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    • pp.115-129
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    • 1999
  • This study was conducted to investigate the kinds of health promotion program which workers want, worker's intention for participation, proper method, time, duration and manager. A self-administered questionnaire method was used to collect data from 412 employees of 3 worksites in Chungpook and Kyungkee. This survey was carried out from Aug. 10 to Aug. 20, 1998. The results of this study are as follows: 1. In male, among health promotion programs, favorite ones were physical fitness(32.2%), periodic health check-up(24.6%), and stress management(18.0%). In female, among health promotion programs, favorite ones were periodic health check-up(26.0%), physical fitness(22.0%), and body weight control(19.5%). 2. The more young subjects are, the more they like physical fitness program, and the female like body weight control program regardless of BMI. Manufacturing worker preferred back pain prevention program to clerical worker did. In female, drinker preferred stress management program to non-drinker did. 3. The more old subjects are, the more they like back pain prevention program, and non-smoker preferred body weight control program to smoker did. 4. In health promotion program format which the subjects wanted, learning of self-examination techniques was 41.1%, worksite screening was 3l.0%, availability of pamphlets and audiovisual materials was 20.0%, presentation of worksite educational sessions was 7.9%, and the most wanted manager for the program was medical doctor and then nurse, physical trainer, psychological counselor. The favorite health promotion program duration was less than 30 minutes(49.6%), and the favorite time was before work(49.6%). 5. Among respondents, 48.5% was smokers, 81.8% was drinkers, 39.9% engaged in the regular exercise, 68.2% engaged in regular diet habit. In vaccination, 50.2%, if possible, wanted to be vaccinated and 37.6% never wanted to be vaccinated. 6. Ex-smoker, ex-drinker, the subjects in the regular exercise, and in the regular diet habit responded they were in good health. There was a significant difference between exercise and health status. Need and intention for participation of health promotion program were high in ex-smoker, ex-drinker, the subjects in the regular exercise, and in the regular diet habit. According to results for this study, if the favorite programs, exercise, periodic health check-up, stress management program, are operated at a proper time and with managers they want, this programs can really raise the participation of employees. And as employees want to learn self-examination techniques if worksite educational sessions are performed, health promotion program can effectively be operated.

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한국판 삼킴 곤란 척도(K-SDQ)의 번안본 검증 (The Verification of Korean Version Swallowing Disturbance Questionnaire (K-SDQ))

  • 정소운;김정완
    • 재활복지
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    • 제22권4호
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    • pp.43-58
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    • 2018
  • 영양 섭취와 일상생활 삶의 질에 영향을 미치는 삼킴장애는 신경장애 환자뿐만 아니라 정상 노년층에게서도 적지 않게 나타난다. 본 연구에서는 노인의 삼킴 문제를 조기 선별하여 진단 검사로 연결될 수 있도록 도움을 주기 위한 기초연구로서, 주관적 삼킴장애 평가도구인 삼킴곤란척도(Swallowing Disturbance Questionnaire, SDQ)를 한국인의 정서와 문화에 맞게 번안하여 신뢰도와 타당도를 검증하고, 뇌졸중 환자 105명을 대상으로 하여 그 유용성을 검증하였다. 연구 결과, 한국판 SDQ의 문항내적 일관성 신뢰도는 .601, 검사-재검사 신뢰도는 .97, 공인타당도는 .956이었고, 절단점 8점을 기준으로 민감도가 46.8%, 특이도가 81.6%인 것으로 나타났다. 객관적 삼킴장애 검사인 비디오투시조영검사와 한국판 SDQ 검사 상 관찰된 삼킴곤란 유무와의 비교 결과, 음성예측도(negative predictive value, NPV)는 81%, 양성예측도(positive predictive value, PPV)는 53%로 나타났다. 한국판 SDQ는 뇌졸중 환자들의 삼킴장애 유무를 변별하는데 유용한 검사도구로 활용될 수 있을 것으로 기대되며, 재활전문가에 의한 임상평가가 이루어지기 전에 대상자가 보이는 삼킴곤란을 미리 선별하여 진단검사를 의뢰하거나, 삼킴문제가 없는 뇌졸중 환자를 정확하게 선별하여 잉여적인 추가 검사 노출을 배제하는 차원에서 그 임상적 의의가 크다고 볼 수 있다.