• Title/Summary/Keyword: 병원평가

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Changes in Occupational Therapy Students' Occupational Balance and Quality of Life in Epidemic of COVID-19 (COVID-19 유행으로 인한 작업치료(학)과 학생들의 작업균형과 삶의 질 변화)

  • Lee, Hyang-sook;Han, Gyeong-ju;Park, In-yeong;Hwang, Eun-bi;Chae, Hyun-ah;Noh, Chong-su;Cha, Jung-jin
    • The Journal of Korean society of community based occupational therapy
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    • v.11 no.1
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    • pp.11-22
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    • 2021
  • Objective : The purpose of this study was to investigate the changes in occupational balance and quality of life caused by COVID-19 in occupational therapy students. Methods : From May 27 to June 26, 2020, questionnaires were distributed to a total of 35 universities among 62 occupational therapy departments nationwide. General characteristics, COVID-19 related characteristics, OBQ and WHOQOL-BREF were used to evaluate and analyze occupational balance and quality of life. The SPSS/PC 24.0 program was used to analyze frequency analysis, crossover analysis, chi-square test, independent t-test, analysis of variance, and Pearson correlation analysis. Results : There were significant differences in school system(years), class, life pattern, quality of life, personal and public schedule depending on whether they are interested in occupational balance. There were significant differences in occupational balance(OBQ) and quality of life(WHOQOL-BREF), 'Hobby', 'new hobbies after COVID-19', 'life patterns', 'use of public transportation', 'maintenance of occupational balance', and 'quality of life'. There was a significant positive correlation occupational balance and quality of life. Conclusion : This study showed that the more people who have changed their lives due to COVID-19 are interested in work balance, and the better they maintain their work balance and emotional well-being, the higher the work balance and quality of life, and the positive correlation between work balance and quality of life was confirmed. This will be the basis for studies related to intervention strategies that can improve occupational balance and quality of life in a time when social isolation is easy due to the COVID-19 epidemic.

Non-invasive Brain Stimulation and its Legal Regulation - Devices using Techniques of TMS and tDCS - (비침습적 뇌자극기술과 법적 규제 - TMS와 tDCS기술을 이용한 기기를 중심으로 -)

  • Choi, Min-Young
    • The Korean Society of Law and Medicine
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    • v.21 no.2
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    • pp.209-244
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    • 2020
  • TMS and tDCS are non-invasive devices that treat the diseases of patients or individual users, and manage or improve their health by applying stimulation to a brain through magnetism and electricity. The effect and safety of these devices have proved to be valid in several diseases, but research in this area is still much going on. Despite increasing cases of their application, legislations directly regulating TMS and tDCS are hard to find. Legal regulation regarding TMS and tDCS in the United States, Germany and Japan reveals that while TMS has been approved as a medical device with a moderate risk, tDCS has not yet earned approval as a medical device. However, the recent FDA guidance, European MDR changes, recalls in the US, and relevant legal provisions of Germany and Japan, as well as recommendations from expert groups all show signs of tDCS growing closer to getting approved as a medical device. Of course, safety and efficacy of tDCS can still be regulated as a general product instead of as a medical device. Considering multiple potential impacts on a human brain, however, the need for independent regulation is urgent. South Korea also lacks legal provisions explicitly regulating TMS and tDCS, but they fall into the category of the grade 3 medical devices according to the notifications of the Korean Ministry of Food and Drug Safety. And safety and efficacy of TMS are to be evaluated in compliance with the US FDA guidance. But no specific guidelines exist for tDCS yet. Given that tDCS devices are used in some hospitals in reality, and also at home by individual buyers, such a regulatory gap must quickly be addressed. In a longer term, legal system needs to be in place capable of independently regulating non-invasive brain stimulating devices.

Analysis of Central Line-associated Bloodstream Infection among Infants in the Neonatal Intensive Care Unit: A Single Center Study

  • Kim, Minhye;Choi, Sujin;Jung, Young Hwa;Choi, Chang Won;Shin, Myoung-jin;Kim, Eu Suk;Lee, Hyunju
    • Pediatric Infection and Vaccine
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    • v.28 no.3
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    • pp.133-143
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    • 2021
  • Purpose: This study aimed to determine the incidence of central line-associated bloodstream infection (CLABSI) in the neonatal intensive care unit (NICU), evaluate the patients' clinical characteristics, and identify the etiologic agents for guidance in prevention and treatment. Methods: A retrospective chart review study of infants classified as having CLABSI was conducted at the NICU of Seoul National University Bundang Hospital from January 2016 to December 2020. Results: Of the 45 infants, 53 had CLABSIs within a follow-up period of 18,622 catheter days. The incidence of CLABSIs was 2.85 per 1,000 catheter days. The most common catheter type was a peripherally inserted central catheter (n=47, 81%). A total of 57 pathogens were isolated, of which 57.9% (n=33) were Gram-positive bacteria, 36.8% (n=21) were Gram-negative bacteria, and 5.3% (n=3) were Candida spp. The most common pathogens were Staphylococcus aureus (n=12, 21%) and coagulase-negative staphylococci (n=12, 21%), followed by Klebsiella aerogenes (n=8, 14%). The median duration of bacteremia was 2 days, and 19 episodes showed bacteremia for 3 days or more. The mortality rate of infants within 14 days of CLABSI was 13.3% (n=6). Conclusions: This study analyzed the incidence of CLABSI and the distribution of pathogens in the NICU. Continuous monitoring of CLABSI based on active surveillance serves as guidance for empiric antibiotic use and also serves as a tool to assess the necessity for implementation of prevention strategies and their impact.

Nutrition and Psychosocial Factors were associated with Possible Sarcopenia in the Rural Elderly (농촌지역 주민의 영양결핍 및 사회심리적 요인과 근감소증 가능군과의 관련성)

  • Kim, Bokyoung;Lee, Gyeong-Ye;Seo, Ae-Rim;Kim, Mi-Ji;Seo, Sung-Hyo;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.47 no.2
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    • pp.90-98
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    • 2022
  • Objective: This study aimed to provide basic data for preventing and managing sarcopenia by identifying the relationship between sarcopenia, malnutrition, and psychosocial factors among the elderly in the community. Methods: The study included 1,019 subjects aged 60 and over. "Possible sarcopenia" was defined by low handgrip strength with or without reduced physical performance. Nutrition was evaluated according to the mini nutrition assessment (MNA), and the psychosocial factors examined were self-efficacy, social isolation, fear of falling, and social capital (trust and participation). A logistic regression analysis was also performed on the relationship between risk of malnutrition, psychosocial factors, and sarcopenia. Results: MNA was significantly associated with social participation (OR = 1.747, p <0.001), fear of falling (OR = 2.905, p <0.001), and self-efficacy (high/low, OR = 0.654, p = 0.011). In model 3, which included both MNA and psychosocial factors, sarcopenia was significantly associated with MNA (OR = 2.529, p <0.001) and fear of falling (OR = 1.544, p = 0.045). Compared with the low self-efficacy group, the high group (OR = 0.589, p = 0.009) was significant. The factors related to possible sarcopenia include risk of malnutrition, fear of falls, and low self-efficacy. Conclusion: It will be necessary to improve self-efficacy so that individuals feel they can do activities of daily living themselves and to reduce their fear of falling through muscle strength and balance exercises. Finally, it is also necessary to increase regular participation in community social activities.

Retrospective study on survival and complication rates of posterior single implant according to the implant diameters, lengths and position (구치부 단일 임플란트의 직경과 길이, 식립 위치에 따른 생존율 및 합병증의 발생률에 대한 후향적 연구)

  • Soo-Young Hong;Seon-Ki Lee;Jin-Han Lee;Jae-In Lee
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.2
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    • pp.101-112
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    • 2023
  • Purpose. This retrospective study was to investigate the survival and complication rates of posterior single implant according to the implant diameters, lengths and position. Materials and methods. Patients who had been restored single implant prosthesis in the posterior area by the three prosthodontists in the department of prosthodontics, Daejeon dental hospital of Wonkwang university, in the period from February 2014 to May 2018 were selected for the study. A total of 505 patients with 697 implants were observed. The survival and complications of implants were investigated using electronic medical records and radiographs. Fixture diameters, lengths, position, patient's sex and age were assessed as possible factor affecting the survival and complications of implants. Results. 3-year cumulative survival rates of posterior single implants were 98.5% and 5-year cumulative survival rates were 94.4%. 5-year cumulative survival rates were higher in implants with diameter > 4.0 mm (97.0%) than implants with diameter ≤ 4.0 mm (89.5%), and in females (98.8%) than males (92.4%). There were statistically significant differences (P < .05). The mechanical complication rate was 20.1% and the biological complication rate was 4.7%. Complications occurred in order of abutment screw loosening (7.5%), decementation (6.3%), proximal contact loss (3.7%) and so on. Abutment screw loosening occurred more frequently in the lower molar region (10.5%), in males (9.5%) than females (5.1%), and in patients aged < 65 years (9.4%) than patients aged ≥ 65 years (5.1%). There were statistically significant differences (P < .05). Conclusion. The 5-year cumulative survival rates were higher in implants with diameter > 4.0 mm than implants with diameter ≤ 4.0 mm and in females than males. Abutment screw loosening which was the most commonly occurring complication occurred more frequently in the lower molar region, in males than females, and in patients aged < 65 years than patients aged ≥ 65 years. There were statistically significant differences.

Evaluation of the LG AdvansureTM Malaria P.f./P.v. real-time QPCR for the Diagnosis of Malaria (LG AdvansureTM Malaria P.f./P.v. real-time QPCR의 말라리아 진단 유용성)

  • Lee, Hye Jin;Kim, Ha Nui;Yoo, Byong Joon;Kim, Jang Su;Kim, Myong Han;Lim, Chae Seung;Lee, Kap No
    • Laboratory Medicine Online
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    • v.1 no.2
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    • pp.100-104
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    • 2011
  • Background: Malaria is a problematic disease in Korea, and microscopic examination of Giemsa-stained blood smear has been used as the gold standard for its diagnosis. However, this technique is time-consuming and has low sensitivity in samples with low numbers of malarial parasites (<20 parasites/μL). Here, we evaluated the performance characteristics of the LG AdvansureTM Malaria P.f./P.v. real-time QPCR (LG life sciences, Korea). Methods: Blood samples from 173 persons who visited Korea University Ansan Hospital were evaluated. QPCR was performed in 73 malaria patients and 100 healthy subjects by using the LG Advansure Malaria P.f./P.v. real-time QPCRR kit, and the results were compared with those of microscopy. The detection limit of this kit was determined by serial dilution of Plasmodium-infected blood with normal blood (blood not infected with Plasmodium). Results: Among the 73 patients that were microscopically confirmed to have malaria (Plasmodium vivax infection, N=70, P. falciparum infection, N=3), 69 patients were diagnosed with P. vivax infection and 3 were diagnosed with P. falciparum infection by LG AdvansureTM Malaria P.f./P.v. realtime QPCR. Both the tests indicated absence of infection in the 100 healthy subjects. The detection limit of LG AdvansureTM Malaria P.f./P.v. real-time QPCR was 0.1 parasite/μL. Conclusions: LG AdvansureTM Malaria P.f./P.v. real-time QPCRis a very sensitive and specific technique and can be used as a confirmatory test for malaria.

Randomized Controlled Clinical Trials of Warm Herbal Foot Bath Therapy for Insomnia: A Literature Review Based on the CNKI (불면증에 대한 한방 족욕요법의 무작위 대조군 임상연구 현황 : CNKI를 중심으로)

  • Chan-Young Kwon;Boram Lee;Kyoungeun Lee
    • The Journal of Internal Korean Medicine
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    • v.44 no.4
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    • pp.726-740
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    • 2023
  • Objectives: This review investigated the research on warm herbal foot bath therapy (WHFT) for insomnia. Methods: A search was conducted on the China National Knowledge Infrastructure (CNKI) database to collect relevant studies published up to August 29, 2023. Randomized controlled trials (RCTs) comparing WHFT and sleeping pills in patients with insomnia were included. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias assessment tool. The results of the meta-analysis were presented as risk ratios (RRs) or mean differences (MDs) and their 95% confidence intervals (CIs). Results: A total of 11 RCTs were included. WHFT as monotherapy resulted in a significantly higher total effective rate (TER) (RR, 1.25; 95% CI, 1.15 to 1.36; I2=25%) and an improved Pittsburgh Sleep Quality Index (PSQI) global sore (MD, -3.10; 95% CI, -4.24 to -1.95; I2=73%) compared to benzodiazepines. Additionally, WHFT as a combined therapy with benzodiazepines resulted in a significantly higher TER (RR, 1.15; 95% CI, 1.04 to 1.27; I2=0%) and an improved PSQI global score (MD, -2.23; 95% CI, -4.09 to -0.38; I2=80%) compared to benzodiazepines alone. In network analysis visualizing the components of HWFT, four clusters were discovered, and Polygoni Multiflori Ramuls and Ziziphi Spinosae Semen were the key herbs used in WHFT. Overall, the methodological quality of the included studies was poor. Conclusions: There was limited evidence that WHFT as a monotherapy or combined therapy was effective in improving insomnia. The findings can be used as basic data for future WHFT research in South Korea.

Colletotrichum Diversity within Different Species Complexes Associated with Fruit Anthracnose in South Korea and Their Fungicides In-Vitro Sensitivity (국내 과실 탄저병을 일으키는 종 복합체와 종 다양성 및 살균제 감수성)

  • Taehyun Chang;Oliul Hassan;Jong Yeob Jeon;Chi Hyun Kim;Dae Min Lee;Ju Sung Kim;Eun Chan Kang;Jaewon Kim
    • Research in Plant Disease
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    • v.29 no.4
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    • pp.345-362
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    • 2023
  • Anthracnose, caused by the Colletotrichum genus, comprises a significant number of plant pathogens and poses a major threat to fruit production worldwide, including South Korea. Colletotrichum species were identified associated with anthracnose in fruits such as apple, persimmon, plum, peach, jujube, walnut, and grape. A polyphasic approach, including morphology, multigene phylogenetics, and pathogenicity testing, was used. Additionally, the in-vitro sensitivity of identified Colletotrichum species to common fungicides was also evaluated. A total of nine Colletotrichum species within two complexes, namely gloeosporioides and acutatum, have been identified as the causal agents of anthracnose in common fruits in South Korea. In the gloeosporioides complex, we found Colletotrichumaenigma, C. fructicola, C. gloeosporioides, C. horii, C. siamense, and C. viniferum. Meanwhile, in the acutatum complex, C. fioriniae, C. nymphaeae, and C. orientalis were identified. Notably, C. fructicola, C. siamense, C. fioriniae, and C. nymphaeae were reported for the first time from apple, C. siamense, C. fioriniae and C. nymphaeae from plum, C. siamense, C. fructicola, and C. fioriniae frompeach, C. siamense and C. horii from persimmon, C. fioriniae from Omija (Schisandra), C. orientalis from walnut, C. nymphaeae from jujube, and C. aenigma, C. fructicola, and C. siamense fromgrape. Fungicide sensitivity tests revealed significant variation in the EC50 values among specific Colletotrichum species when exposed to different fungicides. Moreover, the same Colletotrichum species isolated from different host plants displayed varying sensitivity to the same fungicide.

The 1998, 1999 Patterns of Care Study for Breast Irradiation After Breast-Conserving Surgery in Korea (1998, 1999년도 우리나라에서 시행된 유방보존수술 후 방사선치료 현황 조사)

  • Suh Chang-Ok;Shin Hyun Soo;Cho Jae Ho;Park Won;Ahn Seung Do;Shin Kyung Hwan;Chung Eun Ji;Keum Ki Chang;Ha Sung Whan;Ahn Sung Ja;Kim Woo Cheol;Lee Myung Za;Ahn Ki Jung
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.192-199
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    • 2004
  • Purpose: To determine the patterns on evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was peformed. Materials and Methods: A web-based database system for korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998$\~$1999 from 15 hospitals were reviewed. Results: The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9$\%$) followed by medullary carcinoma (4.2$\%$) and infiltrating lobular carcinoma (1.5$\%$). Pathologic T stage by AJCC was T1 in 59.7$\%$ of the casses, T2 in 29.5$\%$ of the cases, Tis in 8.8$\%$ of the cases. Axillary lymph node dissection was peformed I\in 91.2$\%$ of the cases and 69.7$\%$ were node negative. AJCC stage was 0 in 8.8$\%$ of the cases, stage I in 44.9$\%$ of the cases, stage IIa in 33.3$\%$ of the cases, and stage IIb in 8.4$\%$ of the cases. Estrogen and progesteron receptors were evaluated in 71.6$\%$, and 70.9$\%$ of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2$\%$, wide excision in 11.5$\%$, quadrantectomy in 23$\%$ and partial mastectomy in 27.5$\%$ of the cases. A pathologically confirmed negative margin was obtained in 90.8$\%$ of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90$\%$ of the planned radiotherapy dose. Radiotherapy volume was breast only In 88$\%$ of the cases, breast+supraclavicular fossa (SCL) in 5$\%$ of the cases, and breast+ SCL+ posterior axillary boost in 4.2%$\%$of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45$\~$59.4 Gy (median 50.4) and boost dose was 8$\~$20 Gy (median 10 Gy). The total radiation dose delivered was 50.4$\~$70.4 Gy (median 60.4 Gy). Conclusion: There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.

Clinical Characteristics of precocious puberty girls and Comparison Analysis of GnRH Test results with Diagnosis type (성조숙증 여아들의 임상적 특징 및 진단별 성선자극호르몬 분비호르몬 GnRH (Gonado Tropin Releasing Hormone) 검사결과의 비교분석평가)

  • Kim, Jung-In;Kwon, Won-Hyun;Moon, Ki-Choon;Lee, In-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.54-61
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    • 2016
  • Purpose Precocious Puberty is defined as the development of secondary sexual characteristics in girls younger than 8 years, and boys 9 years. Cause premature closure of the epiphysis is a disease that eventually decreases the final adult height. In this study, we retrospectively analyzed to evaluate the diagnostic difference the GnRH (Gonado-tropin-releasing Hormone) stimulation test results with medical records of precocious puberty in girls. Materials and Methods From February 2015 to December 2015 it was enrolled in the girls 118 people who visited the Seoul National University Bundang Hospital, Pediatrics, Endocrinology Internal Medicine. True precocious puberty group (n=57), early puberty group (n=39), were divided into Premature thelarche (n=22) group. A Tanner stage, chronological age, bone age, height, body weight for each group was determined by examining the mean${\pm}$standard deviation. GnRH test result was compared LH (Basal, 30 min, 45 min, 60 min), FSH (Basal, 30 min, 60 min) for each group, Each group LH, FSH Peak value distribution, the mean${\pm}$standard deviation was calculated for the peak LH/LH basal ratio, peak LH/Peak FSH ratio. The significance probability (P-value) between the value of each third group was determined. Results The average height of the true precocious puberty group $131{\pm}14.85$, the mean weight was $28.80{\pm}4.93$, the average chronological age $7.1{\pm}0.81$, the mean bone age was $9.9{\pm}0.9$, The average height of early puberty group was $134{\pm}5.10$, the average weight $28.50{\pm}4.43$, the average chronological age $8.05{\pm}0.03$, the mean bone age was $10.0{\pm}0.62$, The average height of Premature thelarche $129{\pm}6,01$, the average weight was $28.65{\pm}5.98$, the average chronological age $7.02{\pm}0.58$, the mean bone age was $8.04{\pm}1.29$. There was no significant difference when compared to the height and weight. There was a significant difference between the groups in the chronologic age and bone age difference (P <0.0002) True precocious puberty group showed peak LH levels at 30'(82.5%), 45'(12.3%), 60'(5.3%), in Peak FSH 30'(8.8%), 60'(91.2%). Early Puberty group showed high values in Peak LH at 30'(79.5%), 45'(17.9%), 60'(2.6%), in peak FSH levels at 30'(7.7%), 60'(92.32%). In Premature thelarche Group it showed the Peak LH levels at 30'(30%), 45'(59%), 60'(9.09%), Peak FSH levels at 30'(0%) 60'(100%). When compared with the The Peak LH/basal LH ratio, True precocious puberty group was $19.09{\pm}17.15$, early puberty group was $15.23{\pm}10.88$, Premature thelarche group showed significant differences between the three groups as $4.93{\pm}4.36$.(P <0.0001) LH Peak/FSH Peak ratio, true precocious puberty group was $1.222{\pm}0.77$, early puberty group was $1.34{\pm}1.23$, Premature thelarche group showed significant differences between the three groups as $0.3{\pm}0.09$(P <0.0001) Conclusion In order to diagnose the true precocious puberty have a diagnostic value when the LH peak after GnRH stimulation is increased by more than two to three times compared to baseline or a predetermined level or more than 5~10 IU/L increases. GnRH Test is a test for a long time and the patient discomfort due to repeated blood sampling, but the hypothalamus-pituitary gland- gonad axis activity evaluate and is the most basic accurate test in the differential diagnosis of precocious puberty disorders.

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