• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.427-436
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• 2001

Objective : To estimate the prevalence of congenital heart disease from the 1990 student heart disease screening program. Methods : The heart disease screening program for elementary students was conducted in Kyonggi-do, in 1998. The subjects of the present study comprised the 40,402 students who attended the schools in the catchment area of a collaborative university hospital and who participated in the primary examination. The congenital heart disease (CHD) patients were initially identified through a questionnaire about prior medical history, and further through diagnostic tests & medical examinations in the secondary & the tertiary examinations. Certain assumptions were used in the estimation of the number of CHD cases among non-participants of the secondary & tertiary examinations. The overall prevalence of CHD was estimated by adding the CHD detection rates of the participants and the estimated prevalence of the non-participants. Results : Among the 40,402 primary participants, 1,655 were referred further, of whom 79.1% (1,309) participated in the secondary examination. Of these, 121 were referred to the tertiary examination, with a participation rate at this last stage of 80.2%. The positive predictive value (PPV) of the screening tools was the highest when the results of both EKG and the questionnaire were positive. Because 85.9% of the detected cases had a past history of CHD, PPV was higher when the selection criteria in the questionnaire included past CHD history than when it didnt. The CHD defection rate among the participants was 1.76 cases/1,000 and the presumed number of cases among the non-participants was 31; giving an estimated final CHD prevalence of 2.52 cases/1,000 (95% CI : 2.06-3.06). Among the identified cases of CHD, VSD (52.8%) was the most common, followed by PDA (9.7%), TOF (9.7%) & PS (9.7%). Conclusion : Because the characteristics of the non-participants differed from those of the participants, the estimation of prevalence was influenced by the participation rate. Of the detected cases, 85.9% had a past history of diagnosis or operation for CMD. These findings suggested that the prevalence estimated in this study may be an underestimation of the actual condition. Therefore, a birth cohort study is required in order to more accurately estimate the prevalence and the effects of the program.

• 대한핵의학회지
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• 제5권2호
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• pp.7-18
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• 1971

The liver function test was performed by means of two radioisotope tracer techniques in 20 normal subjects and in 63 patients with hepatobiliary diseases. The blood disappearance rates of $^{131}I$-rose bengal and of $^{198}Au$ colloid were determined by external counting method. The hepatocellular function and the hepatic blood flow were estimated from the observed data and the results were compared with those of the conventional liver function tests. The results obtained were as follows: 1. The mean blood disappearance half time of $^{131}I$-rose bengal was $6.6{\pm}0.63$ minutes in normal control, $17.7{\pm}6.93$ in cirrhosis of the liver, $16.6{\pm}4.80$ in acute hepatitis, and $14.7{\pm}3.46$ in obstructive jaundice. It was markedly prolonged in the hepatobiliary diseases as compared with the normal control, but there was no significant difference among the hepatobiliary diseases. 2. The mean blood disappearance half time of $^{198}Au$ colloid was $4.0{\pm}0.66$ minutes in normal control, $9.8{\pm}3.42$ in cirrhosis of the liver, $4.4{\pm}0.82$ in acute hepatitis, and $5.0{\pm}1.42$ in obstructive jaundice. The difference between cirrhosis of the liver and normal control Was statistically significant. However, there was no definite difference among acute hepatitis, obstructive jaundice, and normal control. The mean blood disappearance rate constant (K value) was $0.177{\pm}0.028/minute$ in normal control. In cirrhosis of the liver, it was markedly decreased which was suggestive of the reduced hepatic blood flow. 3. The ratio of $^{131}I$-rose bengal blood disappearance half time to $^{198}Au$ colloid disappearance half time was $1.68{\pm}0.20$ in normal control, $1.82{\pm}0.31$ in cirrhosis of the liver, $3.80{\pm}0.82$ in acute hepatitis, and $3.01{\pm}0.54$ in obstructive jaundice. The ratios in acute hepatitis and obstructive jaundice were remarkably higher than those in normal control and cirrhosis of the liver. 4. There was a significant correlation between the blood disappearance half time of $^{131}I$-rose bengal and that of $^{198}Au$ colloid in cirrhosis of the liver. 5. In cirrhosis of the liver, the blood disappearance half times of $^{131}I$-rose bengal and of $^{198}Au$ colloid were inversely correlated to the serum albumin level. In acute hepatitis, there was a good positive correlation between the blood disappearance half time of $^{131}I$-rose bengal and the serum transaminase activities. In obstructive jaundice, the blood disappearance half time of $^{131}I$-rose bengal was correlated to the serum bilirubin level.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2965-2972
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• 2016

Background: China carries a heavy burden of cervical cancer (CC) and substantial disparities exist across regions within the country. In order to reduce regional disparities in CC, the government of China launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Critical to the success of the program are the health care workers who play a pivotal role in preventing and managing CC by encouraging and motivating women to use screening services and by providing identification and treatment services. This study aimed to assess cervical cancer knowledge among these health care workers at the county level in maternal and child health (MCH) hospitals across different socio-economic regions of China. Materials and Methods: A cross-sectional survey was conducted and self-administered questionnaires were sent to all health care workers (a total of 66) providing cervical cancer screening services in 6 county level MCH hospitals in Liaoning, Hubei and Shaanxi provinces, representing eastern, central and western regions of China; 64 (97.0%, 64/66) of the workers responded. ANOVA and Chi-square test were used to compare the knowledge rate and scores in subgroups. Results: The knowledge level of the respondents was generally low. The overall combined knowledge rate was 46.9%. The knowledge rates for risk factors, prevention, clinical symptoms, screening and diagnostic tests and understanding of positive results were 31.3%, 37.5%, 18.1%, 56.3% and 84.4%, respectively. Statistically significant differences in scores or rates of CC knowledge were seen across the different regions. The total and sectional scores in the less developed regions were statistically significantly lower than in the other regions. Conclusions: The majority of the health care workers who provide CC screening service in NCCSPRA at county level MCH hospitals do not have adequately equipped with knowledge about CC. Given the importance of knowledge to the program's success in reducing CC burden in rural women in China, efforts are needed to improve the knowledge of health care workers, especially in less developed regions.

• 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.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1976년도 제10차 학술대회연제 순서 및 초록
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• pp.85.3-86
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• 1976

돌발성난청은 만약청력이 구조될 가망이 있으면 즉각적인 검사와 치료가 필요하다. 이것은 이과적 비상사태이며 또 진단의 도전자이다. 감각신경성돌발성난청은 광범위한 종류의 병인으로 생길 수 있다. 종합적인 정밀검사를 곧 시행하여 치료를 지체없이 시작해야만 될 것이다. 감각신경성난청환자에 대해서 아무것도 할 것 없다는 관념은 버려야 되겠다. 돌발성난청을 일으키는 어떤 병인은 치료에 순응 않거나 또는 다만 일부만 정상회복이 가능하다. 그러나 그냥 두면 조금은 회복되거나 또는 스스로는 전연 회복되지 않고, 적절한 치료에는 반응하는 병인들도 있다. 이 병인들을 확인하여 그 처치에 대하며 전심 연구하는 것은 긴요하다. 연령 성별의 비율 및 병변의 편측 또는 양측성은 그 원인에 관련되며, 모은 환자군의 형에 의해서 다르다. 돌발성난청은 개별적으로는 드므나, 모이면 흔한데 외래신이과환자의 약 2.5%에 이르렀으며, 약 70%는 편측성이였다. virus, 세균 및 treponema 감염성은 약 30%였고, 약 16%는 cochlea의 혈관성병변에 의해서였다. 거의 22%는 원인불명(idiopathic)으로 이것은 청년층에서 주로 발생하였으며, 감각성이거나 신경성이였다. 12%는 외상성이고, 9%는 이중독성이였다. 기타가 11%였다. 이대중요요소는 병변의 부위와 청력장해의 기간인데 일찍 진단하여 치료하면 그만큼 치료반응이 좋다. 동시에 원인, 병리 및 치료에 대한 고찰을 더 하였다.

• 대한임상독성학회지
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• 제17권1호
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• pp.38-41
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• 2019

Procalcitonin (PCT) is commonly employed in medical practice as a diagnostic biomarker of bacterial infection and also as a monitoring biomarker for antimicrobial therapy. There have been a few published reports concerning elevated PCT levels in people with acute liver injury caused by an overdose of acetaminophen. We report here on a case of PCT elevation in an adolescent with acute acetaminophen poisoning without any bacterial infection or liver injury. A 15-year-old girl had deliberately ingested 20 tablets of 650 mg acetaminophen (13 g) and she presented to our emergency department. The PCT level on admission was elevated to 65.64 ng/mL (reference range: 0-0.5 ng/mL). Her PCT level on the second day peaked up to 100 ng/mL and then it gradually decreased. There was no evidence of liver injury or infection on the computed tomography examination and other lab tests. The patient regained her good health and was discharged on the sixth day of hospitalization.

• 재활복지
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• 제18권4호
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• pp.257-277
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• 2014

본 연구의 목적은 국외에서 중추청각처리장애의 선별도구로 널리 사용되고 있는 Fisher's 청각행동문제 체크리스트(Fisher's auditory problems checklist, FAPC)와 청각행동특성척도(Scale of Auditory Behaviors, SAB)를 한국어로 번역하여 학령기 아동을 대상으로 실시하므로 국내의 학령기 아동의 청각행동특성을 파악하고, 두 검사 간의 특성을 비교하므로 국내에서 중추청각처리장애 선별을 위한 기초 자료를 제공하는데 있다. 한국어로 번역된 FAPC와 SAB 검사도구를 1~6학년 223명의 학생의 부모나 양육자에게 실시한 결과, FAPC와 SAB 검사 도구는 모두 학년별로 유의미한 점수 차이를 보이지 않았고, 학년 증감에 따른 수행 점수 간에 특정 유형이 관찰되지 않았으므로 본 설문지들은 학년에 상관없이 사용하여도 무방하다고 여겨진다. 그러나 두 검사의 유의미한 상관관계에도 불구하고 공통위험군 범위의 아동 수가 적어 서로 다른 특성을 포함하고 있으므로 선별검사 및 청각행동특성을 기초로 한 진단검사의 선정 및 재활 계획 수립시 서로 보완적으로 사용하는 것이 바람직하다고 여겨진다. 더하여 두 검사의 중추청각처리장애와의 관련성 검증과 표본 집단을 확대한 규준 제시를 통한 후속 표준화 연구가 요구된다.

• 대한임상검사과학회지
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• 제51권1호
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• pp.26-33
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• 2019

최근 반려동물 시장의 급격한 성장으로 인해 동물용 질병 진단키트의 개발이 이루어지고 있다. 이에 동물 분자진단 개발을 위한 바이오마커의 도입으로 효용성을 재평가하고 있다. 좋은 바이오 마커는 정확하고 신뢰할 수 있어야 하고, 정상 상태와 질병 상태를 구별하고, 다른 질병을 구별해야 한다. 최근 보고된 유전마커나 세포유리 DNA, 순환종양세포, granzyme, 피부종양에 관한 종양마커의 개발이 활발히 이루어지고 있으며, 기타로는 브루셀라증, programmed death receptor-1, symmetric dimethylarginine, periostin, cysteinyl leukotrien이 활발히 도입되고 있다. 따라서 바이오마커는 위험 예측에 사용되거나 질병 진행의 스크리닝, 진단 및 모니터링에 사용된다. 관련 바이오 마커에 대한 가장 중요한 기준은 질병 특이성이며 많은 잠재적 바이오 마커가 실험실 및 시험 연구에서 출현했지만, 독립적인 실험이나 대규모 임상 연구에서 검증이 부족하다. 후보 바이오 마커는 질병과 연관성을 평가하고, 조기 발견, 질병 진행에 대한 바이오 마커의 유효성을 검증하여서 인간 및 동물에게 접목하게 된다. 향후 잘 구조화 된 바이오마커 기반 연구의 효용성을 재평가하고 동물 질병 진단에 도입되는 추세에 맞춰 현장검사에서 활용될 수 있는 키트의 개발에 대한 연구가 요구돼야 할 것으로 사료된다.

• 중환자간호학회지
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• 제12권3호
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• pp.35-49
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• 2019

Purpose : This study aimed to propose a common scope of practice (SOP) for 13 specialties of Advanced Practice Nurses (APNs) in Korea. Methods : The first draft of a common SOP was extracted from domestic and international laws with a literature review by 17 experts from the Korean Association of Advanced Practice Nurses (KAAPN). Then, the common SOP was finalized after comparing the activities of APNs in clinical settings. Results : A total of 70 duties were identified and six categories were suggested for the common SOP. The SOP proposed by the KAAPN featured the following: 1) identification of and discrimination between health problems; 2) prescription and implementation of diagnostic tests; 3) treatment of injuries and diseases while implementing measures to prevent exacerbation; 4) prescription of medicinal products in line with 1) to 3); 5) referral and consultation; and 6) education and counseling. It was then confirmed that the proposed six categories in the common SOP reflected all the duties performed by APNs in clinical practice, including all 40 activities. Conclusion : The results of this study can be used as evidence for the legalization of a common SOP for APNs. Given the increasing multidisciplinary team approach adopted in Korean hospitals, it may be desirable to establish a broader SOP to reflect the diverse duties of APNs.

• 한국의료질향상학회지
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• 제27권2호
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• pp.73-82
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• 2021

Purpose: This study aims to examine the quality of tuberculosis (TB) care after the 1st to 3rd national quality assessment (QA) program for TB healthcare service in Korea was conducted. Methods: We analyzed Health Insurance Review & Assessment Service (HIRA) claims data of new TB patients during the period of January to June from 2018-2020. The new TB patients were defined as TB patients reported to Korea Centers for Disease Control and Prevention Agency (KCDA). The unit of analysis was the patient. Chi-square tests were used to analyze the differences in indicator value according to the types of medical facilities. The QA indicators of TB care were divided into 3 areas consisting of the following 7 quality indicators: 4 indicators of diagnosis test (the rate of acid-fast bacilli smear, the rate of acid-fast bacilli culture, the rate of Mycobacterium tuberculosis-polymerase chain reaction, drug susceptibility test), 1 compliance of treatment guideline, and 2 indicators of care management of TB patients (encounter rate, day of therapy). Results: The QA program for TB care was conducted among 8,246 patients from 534 facilities in 2020. The value of the 7 quality indicators was shown to increase as a result of the QA program. The indicators of the diagnostic test were all higher than 95%, with the exception of the drug susceptibility test which was 84.8%. Both indicators for care management of TB patients were 88.5%. Conclusion: The quality of TB care has been improving with the implementation of the QA program. In order to continue to improve the quality of TB care, it will be necessary to disclose the results of the QA program in medical facilities in the future.