• Journal of Periodontal and Implant Science
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• 제48권5호
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• pp.317-325
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• 2018

Purpose: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. Methods: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009-2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. Results: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. Conclusions: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.

• 대한방사선기술학회지:방사선기술과학
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• 제34권3호
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• pp.189-193
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• 2011

상지 검사(upper extremity X-ray examinations, UEX) 시 환자 위치 잡이로 가장 많이 활용되고 있는 앉은 자세 상지 X-ray 검사(sitting position upper extremity X-ray examinations, SUEX) 시 방사선에 민감한 생식샘과 목적장기 이외 부위에 대한 피폭이 크다고 판단되어 의료기관 별 SUEX 시 납 앞치마(Apron) 착용 유무와 생식샘 및 목적장기 이외 부위에 대한 방사선 피폭과 피폭선량 감소 방안에 대한 연구 결과 거리가 멀어 질수록, 조사야 조절장치를 가능한 목적장기 부위로 제한 조절할수록, 피사체의 두께가 얇을수록 방사선에 의한 피폭은 감소하였고, 생식샘 차폐 유무에 따른 피폭은 생식샘을 차폐했을 때 약 10~50%의 저감화효과를 얻을 수 있었다. 또한 검사 시 apron 착용 유무에 대한 조사에서는 대부분의 경우 apron을 착용하지 않은 것으로 조사되어 시급히 시정되어야 될 것으로 생각된다.

• 방사선산업학회지
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• 제12권4호
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• pp.365-372
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• 2018

The use of CT examinations is increasing rapidly and radiation dose from CT examinations is much higher than other diagnostic radiography examinations including general radiography and mammography. DRLs used to optimize the radiation dose of patients by diagnostic radiology in each country. The objective of this study was to investigate and to analyze the status of DRLs from CT examinations in domestic and other countries. In other countries, DRLs were set for each age group and each examination considering the medical situation of each country. In Korea, DRLs were set for adults and children in 2017. For adults, DRLs were set for 13 examinations. Reported DLP values were 1119, 297, $472mGy{\cdot}cm$ for head, chest and abdomen pelvis examination, respectively. For children, DRLs were set for head examinations. Reported DLP values were 298 (0~1 years), 404 (2~5 years), 494 (6~10 years), 1,088 (11~15 years) $mGy{\cdot}cm$. DRLs of Korea were similar to other countries for head examinations. For chest examinations and abdomen pelvis examinations were relatively lower than other countries. As a major reason for relatively low radiation dose, it is considered to contribute the activity and management of medical radiation safety at national level.

• 한국융합학회논문지
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• 제9권12호
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• pp.281-286
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• 2018

양안시 검사를 반복하면서 검사횟수 증가로 유발된 피로도에 따른 사위도의 변화 정도를 파악하고자 하였다. 사시 및 기타 안질환 또는 전신질환이 없는 20대 성인 남녀 21명을 대상으로 양안시 검사를 실시하였다. 검사가 진행될수록 정위와 사위 모두에서 사위 정도가 증가함을 볼 수 있었다. 원거리의 경우 검사가 5회 반복되었을 때, 정위는 $1.56{\Delta}$만큼 사위량이 증가하였고 사위의 경우에서는 $1.63{\Delta}$만큼 사위 량이 증가하였다. 근거리의 경우에는 검사가 5회 반복되었을 때, 정위는 $1.78{\Delta}$만큼 사위 량이 증가하였고 사위의 경우에서는 $2{\Delta}$만큼 사위 량이 증가하였다. 검사 횟수가 증가할수록 피로도가 증가함에 따라 결과 값이 정상범위에서 점진적으로 벗어나는 것으로 나타났으며, 변화의 정도가 실제 임상에서 잘못된 처방을 내릴 수 있을 정도라고 판단된다. 결론적으로 양안시 검사를 실시 할 때는 보다 정확하고, 신속하게 진행하여 검사를 하여야 한다는 것을 알 수 있었다.

• 한국방사선학회논문지
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• 제12권7호
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• pp.869-877
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• 2018

본 연구는 MRI 건강보험 급여기준 적용 연혁과 건강보험 청구 자료를 바탕으로 MRI 진료 현황(검사 수, 진료금액)을 분석하여 추후 MRI 급여기준 확대 시 참고할 수 있는 기초자료를 제공하기 위해 시행되었다. MRI 검사가 급여로 적용되기 시작한 것은 2005년으로 초기에는 일부 질환에 대해서만 적응증이 제한되었으나, 2010년, 2013년, 2016년, 2018년 급여 대상이 확대되었으며, 보건복지부는 2021년에는 모든 MRI 검사에 대해 건강보험을 적용키로 하였다. 2010년부터 2017년까지 MRI 검사수와 진료금액 변화는 검사수는 2010년 대비 2017년도에 86.7% 증가하였고, 진료금액은 53.5% 증가하였다. 일반적 특성에 따른 MRI 진료현황은 여성이 남성보다 검사수가 많았고, 연령별로는 70-79세 연령대가 검사수가 가장 많았다. 진료 형태는 외래 검사가 입원검사 보다 많았으며, 의료기관 형태에 따라서는 상급종합병원의 검사수가 가장 많았다. 검사 부위별로는 뇌 MRI 검사수가 가장 높은 비율을 차지하였다. 2013년 12월 심장질환과 크론병에 급여 확대에 따른 진료 현황 변화를 분석한 결과 심장 MRI와 복부 MRI 검사수가 2013년 대비 2014년에 증가하였다. 하지만 전체 대비 검사수가 차지하는 비율이 낮고 질병명과 연계하지 못한 제한점으로 전체 MRI 검사수 증가에 영향을 주었다고 보기는 어려울 것이다. 우리나라는 건강보험 보장성 강화를 위하여 MRI 급여기준을 지속적으로 확대하고 있다. 건강보험 지속가능성과 정책 효과 평가를 위해 추후 지속적인 모니터링이 필요할 것이다.

• 대한한방내과학회지
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• 제42권6호
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• pp.1211-1222
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• 2021

Objectives: The purpose of this study was to investigate the opinions of experts on abdominal examinations in Korean Medicine included in the curriculum of the College of Korean Medicine. Methods: Among Korean doctors, 14 experts on abdominal examinations were interviewed; the experts included 9 professors of Korean internal medicine, 1 expert in diagnostics of Korean Medicine, 1 primary care Korean medicine doctor, and 3 executives of a (former) Korean association of the abdomen. The interview consisted of questions regarding recognition of the clinical importance of abdominal examinations, how to perform abdominal examinations, the most frequent abdominal examination findings encountered in clinical practice, and the definition of some of the abdominal examination findings. Results: Most interviewees recognized abdominal examinations as important and used them in clinical practice. Opinions on additions and corrections were collected regarding observation items, posture, method, and order during abdominal examinations. Abdominal examination findings that were common clinically were abdominal fullness (腹滿), epigastric stuffness (心下痞鞕), abdominal tenderness, epigastric fullness (心下滿), and rib distention (胸脇苦滿). The answers to the question related to the definitions of abdominal examination findings included consent and supplementary opinions regarding definitions of deficiency-excess, cold-heat, abdominal tenderness, tension of abdominal muscles, succession sounds, and borborygmus; these were mainly selected based on abdominal symptoms that are highly quantifiable. Conclusions: In the future, based on the results of this study, additional research related to the drafting of a standard abdominal examination in Korean medicine should be conducted to provide an opportunity to increase the reliability of Korean medicine diagnosis.

• 한국병원경영학회지
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• 제6권2호
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• pp.70-85
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• 2001

This study has been conducted, on the reservation of specific examinations during seven months starting from June 1999 and ending December as the Group I for these of one stop service and as the Group II for those of existing direct reservation made by patients or patrons, to understand the differences between the two groups. The survey was extended to the patients visiting specific departments of K hospital with sample sizes of 154 for the Group I and 155 for the Group II. The findings of the survey are as follows: First, as the general characteristics of the sample, male patients account for 67% of the total and female patients 33%, with the former twice as large as the latter. The average age of the patients is 51, indicating relatively high level. By the geographical area of residence, metropolitan area is 80.7% and the other area 19.3%, showing most of the patients are from metropolitan area. The general characteristics do not have statistical significance between the Group I and the Group II(p>0.05). Second, regarding the ratio by the number of examinations, the Group I shows 37.0% for one examination and 63.0% for two examinations, while the Group IT indicates 30.3% for one examination and 69.7% for two examinations. The populations by the number of examinations do not have statistical difference between the two Groups(p>0.05). Third, regarding the time required for the reservation of examinations by the number of examinations, the Group I shows 9.8 minutes for one examination and 19.8 minutes for two examinations, with the average of 16.1 minutes. The Group IT indicates 19 minutes for one examinations and 25.7 minutes for two examinations, with the average of 23.7 minutes. Though the time required for the reservation by the number of examinations do not have statistical significance, the time required for the Group I was shortened. Fourth, regarding the time required for the reservation of examinations by the age range of patients, the Group I shows 21.7 minutes for 70-79 years of age, 17.5 minutes for 60-00 years of age, and 15.2 minutes for 30-39 years of age. The Group II indicates 27.2 minutes for 70-79 years of age, 26.3 minutes for 60-69 years of age, 24.4 minutes for 50-59 years of age, and 22.4 minutes for 30-39 years of age. The time required for the reservation gets longer as the age range moves up, and has statistical significance (p<0.05). Fifth, regarding the ratio by the range of time of required for reservation, the Group I shows 41.6% for 11-20 minutes, and 38.3% for 1-10 minutes, while the Group II indicates 43.9% for 11-20 minutes, 29% for 21-30 minutes, and 14.2% for 31-40 minutes. Statistical significance is revealed (p=0.001). Sixth, concerning the length of movement course by the number of examinations, the Group I shows 37 meters regardless of the number of examinations. The Group II indicates an average of 188 meters for one examination and 189 meters for two examinations, with the difference 151 meters between the Groups, and representing statistical significance (p=0.001). Based on the above findings. one-stop service contributes to the reduction of both the time and the movement course and therefore is considered to be beneficial to the patients, and the improve the efficiency of the hospitals in terms of the space and the time.

• Imaging Science in Dentistry
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• 제46권4호
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• pp.239-244
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• 2016

Purpose: The aim of this study was to investigate the use and acceptance of digital radiographic examinations by Brazilian dental practitioners in daily practice and to evaluate the advances that have occurred over the past 5 years. Materials and Methods: Dental practitioners enrolled in extension courses at the Piracicaba Dental School, University of Campinas, Brazil, responded to a self­administered questionnaire in the years 2011 and 2015. They were asked about sociodemographic factors and their knowledge and use of digital radiographic examinations. Descriptive analysis was performed, as well as the chi-square and Fisher exact tests, with a significance level of 5% (${\alpha}=0.05$). results: A total of 181 participants responded to the questionnaire in the years 2011 and 2015. Most of the respondents worked in private practice, had graduated within the last 5 years, and were between 20 and 30 years old. In 2011, 55.6% of respondents reported having ever used digital radiographic examinations, while in 2015 this number increased significantly to 85.4% (p<.0001), out of which 71.4% preferred it to conventional images. Moreover, 21.4% of respondents reported having used digital radiographic examinations for more than 3 years. A significant increase in use of intraoral digital radiography (p = 0.0316) was observed in 2015. In both years, image quality and high cost were indicated, respectively, as the main advantage and disadvantage of digital radiographic examinations. conclusion: This study showed that digital radiology has become more common in Brazil over the past 5 years. Most of the Brazilian dental practitioners evaluated in 2015 used digital radiographic examinations.

• Child Health Nursing Research
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• 제25권3호
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• pp.255-261
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• 2019

Purpose: This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity. Methods: Forty-five preterm infants were randomly assigned to receive a pacifier dipped in one of three solutions: human milk (n=14), 24% sucrose (n=15), or distilled water (n=16), 2 minutes before an eye examination. Their pain score, pulse rate, and oxygen saturation were measured at three time points: 5 minutes before the examination, 30 seconds after speculum introduction, and 2 minutes after the examination. Results: The infants' mean gestational age and weight at birth were $33.1{\pm}2.1$ weeks and $1,842{\pm}470g$, respectively. There were no between-group differences in pain relief during the eye examination. The pain score significantly increased both during (p<.001) and after the examinations (p=.003). Oxygen saturation decreased during the examinations (p<.001); however, the infants in the 24% sucrose group showed higher oxygen saturation (p=.047) during the examinations than the infants in the other groups. Conclusion: Sucking on a pacifier dipped in human milk or 24% sucrose did not reduce the pain associated with eye examinations in preterm infants. Pacifiers dipped in sucrose can be used to maintain better oxygen saturation during these examinations.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1225-1232
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• 1990

From March 1986 to June 1990, the percutaneous Fine Needle Aspiration Biopsy[FNAB] of 102 thoracic lesions were performed with Westcott needle [slotted 20G or 22G thin needle], for the purpose of identifying and diagnosing thoracic lesions. There were 94 lung lesions [67 malignant tumors, 27 benign lesions] and 8 mediastinal and chest wall lesions. The results of FNAB were compared with sputum cytology and bronchoscopic examinations. The sputum cytologic examinations were performed in 54 cases of malignant lung tumor and the malignant cell was found at the 18 cases [33%]. We bronchoscopic examinations were performed in 24 cases and the malignant cell was found at the 12 cases [55%]. The positive diagnostic rate of malignancy was 100% by FNAB. Among them, 55 cases [82%] were diagnosed by cytologic examinations and 43 cases[64%] by both. The specific diagnoses for benign lung lesions in 15 cases[55%] and for mediastinal and chest well lesions in 5 cases[62%]. The 7 patients[6.9%] developed the pneumothorax and 5 of them required the treatment. Therefore, the FNAB of thoracic lesions may be a preferred diagnostic method because of its safety, simplicity and accuracy.