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지역주민의 한방의료 이용성향과 진료만족도 (Trends in the Use of Oriental Medical Care Service and Treatment Satisfaction)

  • 서호석;남철현;김재돈;김성진;류장근;전봉천;김미애
    • 대한예방한의학회지
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    • 제11권2호
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    • pp.41-70
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    • 2007
  • The purpose of this study was to identify a tendency in patients who seek oriental medical service and factors influencing patient satisfaction. The study was conducted with 1,520 residents of a community during the period from February 5, 2005 through June 30, 2005 using a questionnaire. This study results are summarized as follows : 1. Of subjects who sought oriental medical service, 66.2% had musculoskeletal disorder and connective tissue disease, 18.9% had digestive tract disease, 16.4% had respiratory disease, 8.2% had endocrinemetabolic disease, 7.5% had circulatory disease and the remaining subjects had other diseases(p<0.001). 2. Of subjects who sought oriental medical service for the treatment of musculoskeletal disorder, 84.9% preferred acupuncture. Of those who had digestive tract diseases, 47.0% preferred packaged herbal medicine. Of those who had respiratory disease, 63.0% preferred packaged herbal medicine. 3. Acupuncture was the most often sought by subjects with musculoskeletal disorder. Packaged herbal medicine was sought by subjects with respiratory disease, digestive tract disease, endocrine-metabolic disease or circulatory disease. Tablet-type herbal medicine was sought by subjects with musculoskeletal disorder or digestive tract disease. Combined therapy was sought by subjects with musculoskeletal disorder, digestive tract disease, hematopoietic disease or immune disorder. 4. The level of satisfaction with oriental medical service was higher in subjects with circulatory disease, subjects with digestive tract disease, subjects with neurological disorder and subjects with musculoskeletal disorder in descending order. Of total subjects, 39.4% experienced side effects of oriental medical care, 38.1% experienced side effects of herbal medicine. About 51.9% considered the price of herbal medicine costly while 23.2% considered it reasonable. 5. Subjects' knowledge of herbal medicine was measured as $29.2{\pm}3.83$ out of 42 scores or 69 out of 100 points, indicating a low knowledge level. Subjects' knowledge was influenced by occupation, religion, side effects, sex, age, residence area, the type of insurance. These variables explained 15.2% of the variance. 7. Of total subjects, 56.8% were satisfied with oriental medical service. Patient satisfaction varied with occupation, religion, the type of insurance, health state and treatment outcomes. These variables explained 37.3% of the variance. Conclusion : The majority of subjects were satisfied with oriental medical service. However, oriental medical care are not widely used to treat all kinds of diseases while its use skews to a small categories of diseases. It is therefore necessary for the government and oriental medical service providers to develop new therapy approaches for the treatment of a broader range of diseases.

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rDNA-ITS 분석에 의한 망태버섯속균(Dictyophora spp.)의 종간 구분 가능성 (Interspecific Distinguishability of Veiled Lady Mushrooms (Dictyophora spp.) Based on rDNA-ITS Analysis)

  • 정종천;이명철;김범기;박동석;홍승범;박정식
    • 한국균학회지
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    • 제32권1호
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    • pp.1-7
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    • 2004
  • 본 연구는 망태버섯속(Dictyophora species) 균의 종 구분을 위하여 국내수집 5균주와 국외도입 6균주에 대한 rDNA ITS 영역의 PCR-RFLP 및 염기서열을 분석하였다. 그 결과, ASI 32001, 32003, 32005, 32006, 32011이 D. indusiata, ASI 32002, 32007, 32008, 32010이 D. echinovolvata, 그리고 ASI 32004와 Phallus rugulosus ASI 25007은 같은 군으로 그룹화 되었다. 이 결과는 기존에 조사된 배양온도, 배지pH, 선택배지 등 배양적 특성과 재배적, 형태적 특성에 의한 구분과 일치하는 경향이었다. 따라서 rDNA ITS 영역의 PCR-RFLP 및 염기서열분석은 Dictyophora속 보존균주의 종 구분에 있어서 선행적, 보충적 수단으로 활용하기에 충분하다고 판단된다.

근력 종목선수들의 신체적 특성 및 식생활 패턴 (Physical Characteristics and Dietary Patterns of Strength Athletes; Bodybuilders, Weight Lifters)

  • 조성숙;이현근;김경원
    • 대한지역사회영양학회지
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    • 제12권6호
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    • pp.864-872
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    • 2007
  • The purpose of this study was to provide a descriptive assessment of the nutritional habits of resistance trained males in relation to protein and carbohydrate intakes in comparison with the recommended values. Thirty-four male bodybuilders ($27.0{\pm}2.1years,\;173.5{\pm}5.0cm,\;8.3{\pm}0.61%$ body fat), twenty-four male weight lifters ($20.9{\pm}2.1years,\;171.8{\pm}6.9cm,\;7.6{\pm}0.98%$ body fat) and twenty-five male non-athletes ($26.9{\pm}2.5years,\;175.3{\pm}5.7cm,\;8.5{\pm}0.95%$ body fat) participated in the study. Participants completed a comprehensive survey by twenty-four hour dietary recall methods. All diets were analyzed using the Computer Aided Nutritional (Pro) analyzer by a registered dietician. Body fat was measured using skin fold thickness. The average time spent in resistance training was $18.0{\pm}1.7$ hrs/week for body builders and $14.6{\pm}8.7$ hrs/week for weight lifters. Total daily calories were $2583.6{\pm}874.8kcal\;(31.9{\pm}11.9kcal/kg)$ for bodybuilders, $3565.9{\pm}1281.8kcal\;(42.7{\pm}15.0kcal/kg)$ for weight lifters and $2016.0{\pm}955.3kcal\;(28.1{\pm}13.9kcal/kg)$ for non-athletes (p=0.001). Percent of calories from carbohydrate, protein, and fat 64.2%, 27.1%, and 8.7% for bodybuilders, and 66.3%, 18.6%, and 15.1% for weight lifters. The mean protein intake was $1.9{\pm}1.2g/kg$ of BW for bodybuilders, $1.6{\pm}0.6g/kg$ of BW for male weight lifters and $1.1{\pm}0.69g/kg$ of BW for non-athletes. Although dietary calcium (78.7%) and riboflavin (86.3%) intakes for bodybuilders were below the RDA, dietary intakes of micronutrients were not deficient. More research needs to be conducted to determine the optimal amounts of protein, carbohydrates, fats, and micronutrients for the resistance trained athletes.

Cispatin 내성인 사람 위암 세포주 SNU-1의 복합약제내성 및 Verapamil의 효과 (Multidrug Resistance and Cytotoxicity of Anticancer Drug by Verapamil in Cisplatin Resistant Human Stomach Cancer Cell)

  • 손성권;김정희
    • Journal of Yeungnam Medical Science
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    • 제9권1호
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    • pp.75-89
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    • 1992
  • 복합약제내성암세포주의 출현은 암의 화학 요법에 있어서 중요한 문제점중의 하나이며 이 복합내성 암세포의 출현에 대한 정확한 기전은 아직 밝혀져 있지 않다. 본 실험에서는 약제내성 암세포의 다른 항암제에 대한 복합내성 형성정도와 calcium 길항제인 verapamil에 의한 내성극복 정도를 비교하고 내성 암세포의 세포막 단백질의 변화를 관찰하였다. 사람의 위암 세포주 SNU-1을 cisplatin 농도 $0.001{\mu}M$에서 시작하여 $10{\mu}M$까지 증가시켜 내성세포 SNU-1/$Cis_5$를 얻었으며, MTT assay로 세포성장을 관찰한 결과 doubling time은 SNU-1이 약 29 시간, SNU-1/$Cis_5$는 약 38시간으로 내성세포가 감수성세포보다 성장속도가 느린 것을 관찰하였다. 약제 감수성 검사를 위해서 4일간의 MTT assay로 대조군에 대한 50% 세포 생존시의 약제농도 $IC_{50}$를 비교하여 상대적 내성도 (Relative Resistance, RR)를 측정하였는데 cisplatin, 81.4; vinblastine, > 43.0; epirubicin, 22.9 ; dactinomycin, 16.0 ; etoposide, 15.0 ; vincristine, 9.2 ; adriamycin, 5.7 ; aclarubicin, 5.3으로 관찰되었고 그외의 약제인 cyclophosphamide, 5-fluorouracil, methotrexate, daunorubicin에서는 낮게 나타났다. $10{\mu}M$의 verapamil에 의한 내성 억제 효과는 vincristine, 13.1 ; epirubicin, 10.0 ; etoposide, 6.3 ; vinblastine, 4.4 ; dactinomycin, 3.6 ; daunorubicin, 2.4로 나타났다. Radioiodination을 이용한 SDS-PAGE로 SNU-1/$Cis_5$에서 항암제 내성과 관련된 것으로 여겨지는 51,400와 81,300 dalton의 막단백질의 발현을 관찰하였다.

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Prognostic Factors in Adult Patients with Solid Cancers and Bone Marrow Metastases

  • Hung, Yu-Shin;Chou, Wen-Chi;Chen, Tai-Di;Chen, Tse-Ching;Wang, Po-Nan;Chang, Hung;Hsu, Hung-Chih;Shen, Wen-Chi;Cheng, Wei-Hong;Chen, Jen-Shi
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권1호
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    • pp.61-67
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    • 2014
  • Background: Solid cancers with bone marrow metastases are rare but lethal. This study aimed to identify clinical factors predictive of survival in adult patients with solid cancers and bone marrow metastases. Methods: A total of 83 patients were enrolled consecutively between January 1, 2000 and December 31, 2012. Bone marrow metastases were confirmed by biopsies. Patient clinical features and laboratory data were analyzed for associations. Results: The median age of the patients was 54 years (range, 23-88 years), and 58% were male. The 3 most common primary tumor locations were the stomach (32 patients, 39%), prostate (16 patients, 19%), and lungs (12 patients, 15%). The median overall survival was 49 days (range, 3-1423 days). Patients with Eastern Cooperative Oncology Group performance status 1, cancers of prostate origin, platelet counts over 50,000/ml, and undergoing antitumor therapies had a significantly better prognosis in the multivariate analysis. The median survival times were 173 and 33 days for patients with 2-3 more favorable parameters (n=24) and those with 0-1 (n=69), respectively (hazard ratio 0.30; 95% CI 0.17-0.52, p<0.001). Conclusions: Solid cancers with bone marrow metastases are dismal and incurable diseases. Understanding prognostic factors to these diseases helps medical personnel to provide appropriate treatments and better inform patients about outcomes. Antitumor therapies may improve outcomes in selected patient cohorts.

치과위생사의 커뮤니케이션 기술 측정을 위한 평가 도구의 타당도와 신뢰도 (Validity and Reliability of the Assessment Tool for Measuring Communication Skills of Dental Hygienist)

  • 문학진;이수영;임순연
    • 치위생과학회지
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    • 제14권2호
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    • pp.198-206
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    • 2014
  • 1. 커뮤니케이션 기술 측정도구 38문항을 번역한 후 번역 정확도, 내용분석, 내용타당도 분석을 통하여 14문항을 수정하고, 10문항을 삭제하였으며, 팀 구성원 커뮤니케이션 4문항은 연구목적에 맞지 않아 제외하여 최종 커뮤니케이션 기술 측정도구는 총 24문항으로 구성되었다. 2. 수정 보완된 커뮤니케이션 기술 측정도구의 요인분석 결과 치과위생사의 커뮤니케이션 기술은 배려와 존중, 정보 제공, 불안과 통증 감소를 위한 커뮤니케이션 등 3개의 항목으로 구분되었다. 3. 확인적 요인분석을 통한 모형의 적합도는 대체로 기준을 충족하였으며 ($X^2=899.170$ [df=227, p<0.001], RMR=0.025, RMSEA=0.078, IFI=0.886, TLI=0.872, CFI= 0.886, GFI=0.848, AGFI=0.815, NFI=0.853) 모든 요인의 개념신뢰도, 분산추출지수가 일반적 기준을 충족시켜 집중타당성이 입증되었다. 모든 요인의 평균분산추출값은 각 요인간상관 관계 제곱값보다 크게 나타나 판별타당성도 입증되었다. 4. 내적일관성을 알아보기 위한 Cronbach's ${\alpha}$는 0.8 이상으로 높은 신뢰수준으로 나타났다. 이상의 결과를 종합해 보았을 때, 치과위생사의 커뮤니케이션 측정도구는 타당도와 신뢰도가 높고 적합하다고 검증되었다. 향후 우리나라 치과위생사의 커뮤니케이션 기술의 전문적인 발전과 연구에 활용되어 궁극적으로 환자 구강건강 증진 및 병원 경영에 도움을 줄 수 있을 것으로 생각된다.

다학제 팀의료에 의한 노인의료센터 입원환자의 항콜린약물부담 감소효과 분석 (Impacts of Pharmacist-involved Multidisciplinary Geriatric Team Services on Reducing Anticholinergic Burden)

  • 이주혜;박가영;서예원;이정화;이은숙;김은경;최정연;김광일;이주연
    • 한국임상약학회지
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    • 제30권2호
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    • pp.113-119
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    • 2020
  • Background: Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB. Methods: We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified. Results: The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26-3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines. Conclusions: This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.

외상환자의 전산화 단층촬영소견에서 나타난 달무리 소견의 임상적 유용성 (The Clinical Usefulness of Halo Sign on CT Image of Trauma Patients)

  • 이승용;손유동;안희철;강구현;최정태;안무업;서정열
    • Journal of Trauma and Injury
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    • 제20권2호
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    • pp.144-148
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    • 2007
  • Purpose: The management of hemorrhagic shock is critical for trauma patients. To assess hemorrhagic shock, the clinician commonly uses a change in positional blood pressure, the shock index, an estimate of the diameter of inferior vena cava based on sonography, and an evaluation of hypoperfusion complex shown on a CT scan. To add the finding for the hypoperfusion complex, the 'halo sign' was introduced recently. To our knowledge, this 'halo sign' has not been evaluated for its clinical usefulness, so we designed this study to evaluate its usefulness and to find the useful CT signs for hypoperfusion complex. Methods: The study was done from January 2007 to May 2007. All medical records and CT images of 124 patients with trauma were reviewed, of which 103 patients were included. Exclusion criteria was as follows: 1) age < 15 year old and 2) head trauma score of AIS ${\geq}$ 5. Results: The value of kappa, to assess the inter-observer agreement, was 0.51 (p < 0.001). The variables of the halo-sign-positive group were statistically different from those of the halo-sign-negative group. The rate of transfusion for the halo-sign-positive group was about 10 times higher than that of the halo-sign-negative group and the rate of mortality was about 6 times higher. Conclusion: In the setting of trauma, early abdominal CT can show diffuse abnormalities due to hypoperfusion complex. Recognition of these signs is important in order to prevent an unwanted outcome in hemorrhagic shock. We conclude that the halo sign is a useful one for hypoperfusion complex and that it is useful for assessing the degree of hemorrhagic shock.

Nutritional status of patients treated with radiotherapy as determined by subjective global assessment

  • Koom, Woong Sub;Ahn, Seung Do;Song, Si Yeol;Lee, Chang Geol;Moon, Sung Ho;Chie, Eui Kyu;Jang, Hong Seok;Oh, Young-Taek;Lee, Ho Sun;Keum, Ki Chang
    • Radiation Oncology Journal
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    • 제30권3호
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    • pp.132-139
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    • 2012
  • Purpose: The purpose of this prospective multi-institutional study was to evaluate the nutritional status of patients undergoing radiotherapy (RT) for treatment of head and neck, lung, or gastrointestinal cancer. Materials and Methods: A total of 1,000 patients were enrolled in this study at seven different hospitals in Seoul, Korea between October 2009 and May 2010. The nutritional status of patients after receiving 3 weeks of RT was evaluated using subjective global assessment (SGA). The nutritional status of each patient was rated as well nourished (A), moderately malnourished (B), or severely malnourished (C). Results: The mean age of patients in this study was $59.4{\pm}11.9$ years, and the male to female ratio was 7:3. According to the SGA results, 60.8%, 34.5%, and 4.7% of patients were classified as A, B, or C, respectively. The following criteria were significantly associated with malnutrition (SGA B or C; p < 0.001): loss of subcutaneous fat or muscle wasting (odds ratio [OR], 11.473); increased metabolic demand/stress (OR, 8.688); ankle, sacral edema, or ascites (OR, 3.234); and weight loss ${\geq}5%$ (OR, 2.299). Conclusion: SGA was applied successfully to assess the nutritional status of most patients. The prevalence of malnutrition in a radiation oncology department was 39.2%. The results of this study serve as a basis for implementation of nutrition intervention to patients being treated at radiation oncology departments.

Albumin-globulin Ratio for Prediction of Long-term Mortality in Lung Adenocarcinoma Patients

  • Duran, Ayse Ocak;Inanc, Mevlude;Karaca, Halit;Dogan, Imran;Berk, Veli;Bozkurt, Oktay;Ozaslan, Ersin;Ucar, Mahmut;Eroglu, Celalettin;Ozkan, Metin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권15호
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    • pp.6449-6453
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    • 2014
  • Background: Prior studies showed a relationship between serum albumin and the albumin to globulin ratio with different types of cancer. We aimed to evaluate the predictive value of the albumin-globulin ratio (AGR) for survival of patients with lung adenocarcinoma. Materials and Methods: This retrospective study included 240 lung adenocarcinoma patients. Biochemical parameters before chemotherapy were collected and survival status was obtained from the hospital registry. The AGR was calculated using the equation AGR=albumin/(total protein-albumin) and ranked from lowest to highest, the total number of patients being divided into three equal tertiles according to the AGR values. Furthermore, AGR was divided into two groups (low and high tertiles) for ROC curve analysis. Cox model analysis was used to evaluate the prognostic value of AGR and AGR tertiles. Results: The mean survival time for each tertile was: for the $1^{st}$ 9.8 months (95%CI:7.765-11.848), $2^{nd}$ 15.4 months (95%CI:12.685-18.186), and $3^{rd}$ 19.9 months (95%CI:16.495-23.455) (p<0.001). Kaplan-Meier curves showed significantly higher survival rates with the third and high tertiles of AGR in comparison with the first and low tertiles, respectively. At multivariate analysis low levels of albumin and AGR, low tertile of AGR and high performance status remained an independent predictors of mortality. Conclusions: Low AGR was a significant predictor of long-term mortality in patients with lung adenocarcinoma. Serum albumin measurement and calculation of AGR are easily accessible and cheap to use for predicting mortality in patients with lung adenocarcinoma.