• 정신신체의학
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• 제23권1호
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• pp.26-35
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• 2015

연구목적 본 연구는 Lees-Haley가 1992년 개발한 Postconcussional Syndrome Questionnaire(PCSQ)의 한글판(K-PCSQ)을 개발하고 신뢰도와 타당도를 평가하여 임상적 유용성을 밝히고자 시행되었다. 방 법 2009년 4월 1일부터 2011년 12월 31일까지 고려대학교 안산병원 외래에 내원한 외상성 뇌 손상 환자들 중 International Classification of Disease-10(ICD-10)의 뇌진탕후증후군, 기질성 정신질환(기질성 기분장애, 기질성 불안장애, 기질성 인격장애, 기질성 감정이변성장애)의 진단기준을 만족하는 환자들을 대상으로 포함하였다. 환자들을 대상으로 자가 보고형 평가 척도인 K-PCSQ, State and Trait Anxiety inventory(STAI-I. II), Center for Epidemiologic Studies Depression Scale(CESD)를 시행하였다. 수집된 자료로 PCSQ의 신뢰도와 타당도를 평가하였으며 요인분석을 시행하였다. 결 과 K-PCSQ의 Cronbach's alpha 값은 0.956, 검사-재검사 신뢰도는 0.836이었으며 STAI-I. II, CESD와 유의한 상관관계를 보였다. 요인 분석 결과 K-PCSQ는 4개의 요인구조를 보였으며, 제 1 요인은 '기분 및 인지 증상' 요인, 제 2 요인은 '신체 증상' 요인, 제 3 요인은 '드물게 나타나는 증상' 요인, 제 4 요인은 '과장 또는 부주의한 응답' 요인으로 나타났다. 뇌진탕후 증후군 환자와 기질성 정신질환 환자 두 군에서 K-PCSQ의 총점과 4가지 하위 요인의 점수를 비교하였을 때 두 군 간에 통계적으로 유의한 차이를 보이지 않았다. '과장 또는 부주의한 응답' 항목에 답변한 대상자들은 그렇지 않은 대상자에 비해 K-PCSQ의 총점과 4가지 하위 요인의 점수가 유의하게 높았다. 결 론 본 연구는 K-PCSQ가 두부외상으로 인한 정신의학적 증상을 평가하는데 있어서 유용한 도구임을 확인하였으며, 추후 보다 많은 환자를 대상으로 하는 연구를 통해 임상적인 유용성의 평가 이루어져야 할 것으로 생각된다.

• 대한간호학회지
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• 제31권1호
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• pp.94-106
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• 2001

The purpose of this study was to verify the use of Seo's Elderly Stress Scale (SESS), which was developed in 1996. Through the modified tool, it is possible to examine the stress of Korean elders and to contribute to the welfare of them. The subjects were 350 elders over 65 years old who live in Seoul, Kwang-Ju, Yang-Ju Gun Kyung-ki Do, Ui-Jong Bu, and Young-Am Kun, Jeun-Ra Nam Do. the data of 331 elders (94%) were analyzed. Data were collected between January and March in 1996 and analyzed using the SPSS Win 8.0. The result are as follows: 1. Items with low correlation with the total items were removed. So 27 items were removed and 37 items remained. This 37 items were death in the family and/or close friends, family member's behavior not meeting expectations, marriage of daughter, marriage of son, friction with daughter- in-law, argument among children, children refuse to live with parent, children leaving home, sex injury or accident, in frequest visits from children and grandchildren, providing care for your daughter or daughter-in-law post-partum, decrease in decision making and authority in home, Lunar new year and the harvest featival, house sitting, working in the house, performing a sacrificial rite, missed birthday, not living with the eldest son, decreased eyesight, decreased strength, decreased memory, sleep pattern changes, thoughts about death, loneliness, decreased hearing, change of dental condition, change in your diet or eating style, difficulty in self care, moving because of disease or aging, argument with friend or neighbour, travel, dealing with the procedure of heritage, loss of money or property, not enough pocket money, hearing on elderly neglect in television or radio, hope of going home and ignorant from others. 2. Overlapped items were discussed by colleagues and were modified. 'marriage of daughter' and 'marriage of son' were modified in 'marriage of children'. 'self injury or accidents' and 'family accidents' were modified in to self or family accidents. 3. Factor analysis was done in order to identify validity and three factors were obtained from the result. The first factor familial relation area, included 17 items. The second factor, physical area, included 9 items. The third factor, psycho-socio-economic area, included 9 items. Cronbach coefficient alpha for the 35 items was .923. 4. Pearson's correlation was .704 between SESS and SOS (Symptoms of Stress) in order to confirm construct validity. Based on the result, the following is suggested; 1. The modified SESS needs to be reverified with elder. 2. Korean elder's health promotion can be made by development of stress intervention which was accurately measured with SESS.

• 한국환경생태학회지
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• 제12권2호
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• pp.131-137
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• 1998

공단지역과 일반지역의 대기오염 및 산성비가 수목피해에 미치는 영향을 파악하기 위하여 경남, 울산지역을 중심으로 산림내 유입되는 강우에 대한 오염물질의 이온특성을 분석하고, 대기중 S $O_2$농도와 수목의 쇠퇴도를 비교하였다. 강우의 pH는 공단지역이 일반지역보다 낮아 산성비가 내리고 있었고, EC는 pH와 강한 부의 상관(r=-.7861$^{**}$ )이었다. 용존성분중 양이온과 음이온 농도는 공단지역이 높았으며, 음이온에서는 S $O_{4}$$^{2-}$ 와 N $O_{3}$$^{-}$ 가 높았다. 대기중 S $O_2$농도는 공단지역이 높고, 계절별로는 겨울과 봄이 높았다. 수목쇠퇴와 변수들의 상관분석결과 편상관계수는 S $O_{4}$$^{2-}$ ＞ pH ＞ EC(Electrical conductivity) ＞ N $O_{3}$$^{-}$ ＞ S $O_2$＞ C $l^{-}$ 순이었으며, 추정회귀식은 Y = 5.1007-0.7811 $X_2$(pH) + 0.0253 $X_{5}$ (S $O_{4}$$^{2-}$ ) + 0.0275 $X_{6}$(NON $O_{3}$$^{-}$)로서, 대기오염과 산성비가 함께 영향을 미치는 것으로 나타나 산림생태계 쇠퇴 및 토양산성화는 계속될 것으로 생각된다.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.198-206
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• 2013

Purpose: This study was performed to calculate and analyze the effective radiation doses from computed tomography (CT) and radiologic intervention in patients in the emergency department (ED) with trauma critical pathway (CP) activation and further to estimate the lifetime attributable risks (LARs) for the incidence of and mortality from cancers induced by the radiation dose. Methods: Through a retrospective electrical chart review of 104 injured patients who trauma critical pathway were activated from November 2012 to March 2013, we calculated effective radiologic doses by taking the product of the dose-linear product of the scan and the conversion coefficient. After a determination of the image results, we divided the patients into two groups, negative or positive, and calculated the effective dose for each group. With these results, we estimated the LARs for the incidence of and the mortality from cancers by using the table in the Biologic Effects of Ionizing Radiation (BEIR)-VII report. Results: A total of 76 patients were enrolled. The mean age was $49.0{\pm}8.5$ years. The mean injury severity score (ISS) was $12.7{\pm}8.4$. The cumulative effective dose (CED) for individual patients varied from 2.8 mSv to 238.8 mSv, and the mean was $47.6{\pm}39.9$ mSv. The CED in patients with an $ISS{\geq}16$($63.2{\pm}26.6$ mSv) was higher than that of patients whose ISS<16($33.5{\pm}23.1$ mSv) (p<0.001). The CED in patients who were treated with surgery or intervention($69.0{\pm}45.2$ mSv) was higher than that of patients who were treated conservatively($33.6{\pm}22.4$ mSv) (p<0.001). The LARs for cancer incidence and mortality were $328.5{\pm}308.6$ and $189.0{\pm}159.3$ per 100,000 people, respectively. Conclusion: The CED and the LAR for trauma CP-activated patients in the ED were significant, so efforts should be made to decrease the effective dose received by severely injured patients.

• Journal of Korean Neurosurgical Society
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• 제67권4호
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• pp.442-450
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• 2024

Objective : Cerebral hyperperfusion syndrome (CHS) manifests as a collection of symptoms brought on by heightened focal cerebral blood flow (CBF), afflicting nearly 30% of patients who have undergone superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis. The aim of this study was to investigate whether the amalgamation of magnetic resonance imaging (MRI) fluid-attenuated inversion recovery (FLAIR) and apparent diffusion coefficient (ADC) imaging via MRI can discern cerebral hyperemia after STA-MCA anastomosis surgery. Methods : A retrospective study was performed of patients who underwent STA-MCA anastomosis due to Moyamoya disease or atherosclerotic steno-occlusive disease. A protocol aimed at preventing CHS was instituted, leveraging the use of MRI FLAIR. Patients underwent MRI diffusion with FLAIR imaging 24 hours after STA-MCA anastomosis. A high signal on FLAIR images signified the presence of hyperemia at the bypass site, triggering a protocol of hyperemia care. All patients underwent hemodynamic evaluations, including perfusion MRI, single-photon emission computed tomography (SPECT), and digital subtraction angiography, both before and after the surgery. If a high signal intensity is observed on MRI FLAIR within 24 hours of the surgery, a repeat MRI is performed to confirm the presence of hyperemia. Patients with confirmed hyperemia are managed according to a protocol aimed at preventing further progression. Results : Out of a total of 162 patients, 24 individuals (comprising 16 women and 8 men) exhibited hyperemia on their MRI FLAIR scans following the procedure. SPECT was conducted on 23 patients, and 11 of them yielded positive results. All 24 patients underwent perfusion MRI, but nine of them showed no significant findings. Among the patients, 10 displayed elevations in both CBF and cerebral blood volume (CBV), three only showed elevation in CBF, and two only showed elevation in CBV. Follow-up MRI FLAIR scans conducted 6 months later on these patients revealed complete normalization of the previously observed high signal intensity, with no evidence of ischemic injury. Conclusion : The study determined that the use of MRI FLAIR and ADC mapping is a competent means of early detection of hyperemia after STA-MCA anastomosis surgery. The protocol established can be adopted by other neurosurgical institutions to enhance patient outcomes and mitigate the hazard of permanent cerebral injury caused by cerebral hyperemia.

• 한국전문물리치료학회지
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• 제12권4호
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• pp.41-47
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• 2005

The purpose of this study was to determine the intra-rater and inter-rater reliability of various forward head posture measurements. Ten healthy adults (age, $20.4{\pm}2.2$ yrs; height, $164.0{\pm}5.5$ cm; weight, $58.7{\pm}7.3$ kg) participated in the study. They were free of injury and neurologic deficits in the upper extremities and neck at the time of testing. The subjects were asked to perform head forward posture by under the guidance of physical therapists. Markers were placed on the C7 spinous process, mastoid process, tragus of the ear, outer canthus, and forehead. Measurement 1 for forward head posture assessment was measured as the angle between the horizontal line through C7 and the line connecting the C7 spinous process with the tragus of the ear. Measurement 2 was measured as the angle between the C7 spinous process, the mastoid process and the outer canthus. Measurement 3 was measured as two kinds of angles the HT (head tilt) angle is between the line from the midpoint of forehead to the tragus line and Y-axis at the tragus point. The NF (neck flexion) angle is between the line from the tragus to the C7 line and the Y-axis at the C7. Intra-rater, inter-rater reliability and coefficient of variation was assessed by comparing the measured values from three kinds of measurements of forward head posture. The intra-rater reliability was indicated by intraclass correlation coefficients [ICC(1,1)] and inter-rater reliability was shown by intraclass correlation coefficients [ICC(3,k)]. The results of study were as follows: ICC(1,1) values for intra-rater reliability of three measurements were in the 'excellent' category. ICC(3,k) values for inter-rater reliability of three measurements were also in the 'excellent' category. The coefficient of variation of method 2 had a lower value than method 1 and method 3. This data means that the measured value of method 2 was less scattered. Further research is needed to determine whether the validity of all measurements is revealed in the 'excellent' category.

• 한국항해항만학회지
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• 제44권4호
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• pp.291-297
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• 2020

최근 항만하역근로자의 인명사고가 지속적으로 발생함에 따라 사고관리에 대한 필요성이 증대되고 있다. 이 연구는 GRA법과 Entropy법을 이용하여 우리나라 항만에 대해 하역근로자의 재해 위험성을 평가하고 위험성이 높은 항만을 결정하기 위한 것이다. 이러한 목적을 달성하기 위해 먼저 우리나라 항만을 11개의 대상항만으로 구분하고, 브레인스토밍법으로 항만하역근로자 재해 위험성 평가를 위한 평가항목을 추출한다. 두번째는 GRA법을 이용하여 대상항만의 회색관계계수를 산정한다. 마지막으로 엔트로피법을 이용하여 산출한 평가항목의 중요도와 GRA법의 회색관계계수를 결합하여 회색관계등급을 산정하여 재해 위험성의 우선순위를 결정한다. 따라서 제안된 모델에서는 항만하역근로자수, 50세 이상 항운노조원수, 총근로시간, 하역장비수, 철재화물량, 총화물량, 사상자수, 사망자수 등 8개의 평가 항목을 추출되었다. 그 결과 부산항의 재해 위험성이 가장 높게 나타났으며 이에 따라 우선적으로 재해위험성을 경감하는 방안이 검토되어야 할 것이다.

• 한국응용과학기술학회지
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• 제37권3호
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• pp.509-515
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• 2020

본 연구의 목적은 딥 스쿼트 동작 시 발목 관절 유연성이 무릎 관절의 운동역학적 요인들간의 관련성을 분석하는데 있었다. 본 연구는 최근 1년간 하지 근골격계 병력이 없는 성인 남성 19명과 여성 8명이 연구대상자로 참여하였다. 딥 스쿼드 시 발목 관절 유연성과 하지 관절의 운동역학적 요인들과 상관관계를 검증하기 위해 pearson의 적률상관계수(pearson's correlation coefficient)를 이용하였고(SPSS 24.0, Armonk, NY, USA), 통계적으로 유의미한 상관성을 나타낸 변인들은 단순회기분석(simple regression analysis)을 실시하였으며, 유의 수준은 .05로 설정하였다. 본 연구를 통해 발목 관절 유연성과 무릎 관절의 압력을 결정하는 최대 관절모멘트와 관절반발력 요인들 간의 관련성을 확인할 수 있었다. 그러므로 근력 트레이닝 시 딥 스쿼트와 같은 무릎 관절에 많은 부하를 발생시킬 수 있는 운동을 적용할 때 개인에 신체적 특성 중 발목 관절의 유연성의 정도를 확인하는 것은 신체의 안정성과 무릎 관절의 상해 위험성을 감소시킬 수 있는 운동 강도를 설정하는데 도움이 될 수 있을 것으로 기대한다.

• 대한임상검사과학회지
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• 제53권2호
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• pp.151-157
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• 2021

선천성 유전질환인 CMT와 후천성 면역 매개 질환인 CIDP는 임상적 증상이 유사하므로 두 질환의 감별진단을 위해서는 말초신경의 전기생리학적 특징을 비교하는 것이 도움이 될 수 있다. 본 연구는 CIDP와 CMT 1형으로 확진된 환자의 신경전도검사 결과 중 감각신경전도검사의 주요 지표별 결과를 후향적으로 정량분석하여 두 질환군의 전기생리학적 특징을 규명하고자 하였다. CIDP (N=35)와 CMT1 (N=30)로 확진된 환자의 dCNAP와 SNCV를 이용하여 두 질환군의 중증도 분석, 유의성 검정, 비정상 범위별 비율분석 및 상관분석을 실시하여 통계적 차이를 기반으로 특징을 비교하였다. 두 질환 모두 전신성 말초신경다발신경병증의 특징이 관찰되었고, 장딴지신경의 손상이 가장 심한 것으로 확인되었다. CMT1군은 탈수초성 및 축삭성 신경병증을 동반하는 전신성 신경병증이고, CIDP보다 더 중증의 신경병증임이 확인되었다. 또한, 상관계수 및 산점도 분석에서 CMT1은 신경 손상 범위가 전체 신경에서 균등한 전기생리학적 특징이 관찰되었다. 감각신경전도검사의 결과를 기반으로한 본 연구결과가 CIDP와 CMT 1형의 감별진단 및 연구에 도움이 될 것으로 사료된다.

• Korean Journal of Radiology
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• 제20권5호
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• pp.830-843
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• 2019

Objective: To examine the potential of intravoxel incoherent motion (IVIM) and blood oxygen level-dependent (BOLD) magnetic resonance imaging for detecting renal changes after iodinated contrast-induced acute kidney injury (CI-AKI) development in a diabetic rabbit model. Materials and Methods: Sixty-two rabbits were randomized into 2 groups: diabetic rabbits with the contrast agent (DCA) and healthy rabbits with the contrast agent (NCA). In each group, 6 rabbits underwent IVIM and BOLD imaging at 1 hour, 1 day, 2 days, 3 days, and 4 days after an iohexol injection while 5 rabbits were selected to undergo blood and histological examinations at these specific time points. Iohexol was administrated at a dose of 2.5 g I/kg of body weight. Further, the apparent transverse relaxation rate (R2^*), average pure molecular diffusion coefficient (D), pseudo-diffusion coefficient (D^*), perfusion fraction (f) were calculated. Results: The D and f values of the renal cortex (CO) and outer medulla (OM) were significantly decreased compared to baseline values in the 2 groups 1 day after the iohexol injection (p < 0.05). A marked reduction in the D^* values for both the CO and OM was also observed after 1 hour in each group (p < 0.05). In the OM, a persistent elevation of the R2^* was detected for 4 days in the DCA group (p < 0.05). Histopathological changes were prominent, and the pathological features of CI-AKI aggravated in the DCA group until day 4. The D, f, and R2^* values significantly correlated with the histological damage scores, hypoxia-inducible transcription factor-1α expression scores, and serum creatinine levels. Conclusion: A combination of IVIM and BOLD imaging may serve as a noninvasive method for detecting and monitoring CI-AKI in the early stages in the diabetic kidney.