• Title/Summary/Keyword: Medical Journal

Search Result 70,255, Processing Time 0.106 seconds

A Study of Effects of Psychosocial Factors and Quality of Life on Functional Dyspepsia in Firefighters (소방관에서 기능성 소화불량에 대한 심리사회적 요인의 영향 및 삶의 질에 관한 연구)

  • Jang, Seung-Ho;Ryu, Han-Seung;Choi, Suck-Chei;Lee, Hye-Jin;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.24 no.1
    • /
    • pp.66-73
    • /
    • 2016
  • Objectives : The purpose of this study was to investigate the characteristics of psychosocial factors related to functional dyspepsia(FD) and their effects on quality of life(QOL) in firefighters. Methods : This study examined data collected from 1,217 firefighters. We measured psychological symptoms by Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder questionnaire(GAD-7), Korean Occupational Stress Scale(KOSS), Ways of Coping checklist(WCCL), Rosenberg's Self-Esteem Scale(RSES) and World Health Organization Quality of Life Scale abbreviated version(WHOQOL-BREF). Chi-square test, independent t-test, Pearson's correlation test, logistic regression analysis, and hierarchical regression analysis were used as statistical analysis methods. Results : For the group with FD, the male participants showed significantly higher frequency(p=0.006) compared to the female participants. The group with FD had higher scores for depressive symptoms(p<.001), anxiety (p<.001), and occupational stress(p<.001), and did lower scores for self-esteem(p=.008), quality of life(p<.001) than those without FD. The FD risk was higher in the following KOSS subcategories: job demand(OR 1.94, 95% CI : 1.29-2.93), lack of reward(OR 2.47, 95% CI : 1.61-3.81), and occupational climate(OR 1.51, 95% CI : 1.01-2.24). In the hierarchical regression analysis, QOL was best predicted by depressive symptoms, self-esteem, and occupational stress. Three predictive variables above accounts for 42.0% variance explained of total variance. Conclusions : The psychosocial factors showed significant effects on FD, and predictive variables for QOL were identified based on regression analysis. The results suggest that the psychiatric approach should be accompanied with medical approach in future FD assessment.

Validation of the Korean version of Center for Epidemiologic Studies Depression Scale-Revised(K-CESD-R) (한국판 역학연구 우울척도 개정판(K-CESD-R)의 표준화 연구)

  • Lee, San;Oh, Seung-Taek;Ryu, So Yeon;Jun, Jin Yong;Lee, Kounseok;Lee, Eun;Park, Jin Young;Yi, Sang-Wook;Choi, Won-Jung
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.24 no.1
    • /
    • pp.83-93
    • /
    • 2016
  • Objectives : The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). Methods : Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. Results : The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. Conclusions : These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.

A Study on the Optimal Angle as Modified Tangential Projection of Knee Bones (무릎뼈의 변형된 접선방향 검사 시 최적의 입사각에 관한 연구)

  • Oh, Wang-Kyun;Kim, Sang-Hyun
    • Journal of the Korean Society of Radiology
    • /
    • v.15 no.6
    • /
    • pp.919-926
    • /
    • 2021
  • In this study, we wanted to find out the optimal angle as a modified tangential projection of the patella. In the experiment, we used Kyoto Kagaku's PBU-50 phantom. In the supine position, the F-T angle was set to 95°, 105°, 115°, 125°, 135°, 145°, and Patella tangential projection images were obtained by varying the X-ray tube angle by 5° so that the angle between the X-ray centerline and tibia at each angle was 5~20°. Image J was used for image analysis and the congruence angle, lateral patellofemoral angle, patellofemoral index and contrast to noise ratio(CNR) were also measured. SPSS 22 was used for statistical analysis, and the mean values of congruence angle, patellofemoral angle, patellofemoral index, and CNR were compared with Merchant method through one-way batch analysis and corresponding sample t-test. As a result of the study, in the case of congruence angle, the angle of incidence of the knee-angle X-ray centerline was 105°-72.5° (20° tangential irradiation), 115°-72.5°, 77.5° (15, 20° tangential irradiation), 125°-82.5° (20° tangential irradiation), lateral patellofemoral angle is 115°-72.5°, 77.5° (15, 20° tangential irradiation), 125°-72.5° (10° tangential irradiation), patellofemoral index is 115°-72.5° (15° tangential irradiation) and 125°-72.5° (10° tangential irradiation) were not significantly different from Merchant method (p> .05). In case of CNR, it is not different from Merchant method at 105°-67.5°, 72.5° (15, 20° tangential irradiation), 115°-67.5°, 72.5°, 77.5° (10, 15, 20° tangential irradiation). (P> .05). Based on the results of this study, high diagnostic value images can be obtained by setting the knee angle and the angle of incidence of the X-ray tube to 115°-72.5° (15° tangential irradiation) during the modified tangential examination of the knee bone. It was confirmed.

Fermented Jeju Soybean Extract Promotes Hair Growth in Human Hair Follicle Organ Culture and Clinical Trial (모낭기관배양과 임상에서 제주푸른콩발효추출물의 육모 효능에 미치는 영향)

  • Lee, Yonghee;Shin, Seung Hyun;Kim, Sehyun;Jeong, Gyusang;Hong, Min Jung;Park, Hyeokgon;Kim, Seung Hun;Kim, Eun Joo;Kang, Young-Gyu;Park, Byung Cheol;Park, Won Seok;Kim, Su Na;Kim, Hyoung-June
    • Journal of the Society of Cosmetic Scientists of Korea
    • /
    • v.47 no.3
    • /
    • pp.255-263
    • /
    • 2021
  • Soybean extract is known to play an important role in preventing and treating diseases associated with aging, cancer, obesity, and cardiovascular disease. A recent has revealed that soybean extract has a potent effect on hair growth in in vitro, in vivo, and clinical studies. Recently, it has been reported that their fermented extracts exhibit numerous and high efficacy, as compared to general extracts. However, the underlying mechanisms that induce hair growth after using fermented soybean extract are not well understood. The present study aimed to determine the effects of fermented Jeju soybean (FJS) extract on hair growth, with a focus on the underlying mechanisms similar to those of minoxidil. We conducted in vitro and ex vivo investigations and clinical studies. FJS extract enhanced dermal papilla cell proliferation, VEGF levels, and potassium channel opening. Moreover, it promoted human hair follicle elongation. These effects were comprehensively demonstrated in the clinical results, in which FJS extract-containing shampoo improved hair density after 24 weeks of utilization. Collectively, the results of this study demonstrate that FJS extract promotes hair growth and inhibits hair loss through a mechanism similar to that of minoxidil in hair follicles.

The Effect of Social Capital on Health-related Quality of Life - Using the Data of the 2019 Community Health Survey - (노인의 사회적 자본이 건강 관련 삶의 질에 미치는 영향 - 2019년 지역사회건강조사를 중심으로 -)

  • Kim, Ji-Hee;Park, Jong
    • Journal of agricultural medicine and community health
    • /
    • v.46 no.4
    • /
    • pp.280-294
    • /
    • 2021
  • Objectives: The purpose of this study is to investigate the effects of social capital characteristics, socio-demographic characteristics, physical condition, and health behavior characteristics on health-related quality of life of the elderly in Korea. Methods: T-test, one-way ANOVA, and regression analysis were performed by applying a complex sample design to 57.787 people aged 65 and over using the 2019 Community Health Survey. Results: First, as a result of complex-sample T-test and ANOVA analysis, it was found that there were differences in health-related quality of life according to social capital characteristics, physical condition & health behavior characteristics, and socio-demographic characteristics. Complex Sample Regression Analysis Results, the explanatory power of the model was 28%. When living in the metropolitan area, living in an apartment building, having a spouse, having a higher household income, economic activity, higher educational attainment, increase sleeping time, walking time, frequent binge drinking, health checkup, networking, trust, and social participation showed higher health-related quality of life. When people were older, their gender was female, higher BMI, number of chronic diseases, and severe stress that showed lower health-related quality of life. Conclusions: It was proved that the factors affecting the health-related quality of life of the elderly are not only physical condition and health behavior factors, but also social capital and socio-demographic characteristics. It was found that the role as a member was important.

The Factors Affecting the Population Outflow from Busan to the Seoul Metropolitan Area (지역별 수도권으로의 인구유출에 영향을 미치는 요인 연구: 부산시 사례를 중심으로)

  • LIM, Jaebin;Jeong, Kiseong
    • Land and Housing Review
    • /
    • v.12 no.2
    • /
    • pp.47-59
    • /
    • 2021
  • This study aims to review the trends of the population outflows in the metropolitan area of Busan and to investigate the factors that affect population out-migration to the Seoul metropolitan area. The following variables are considered for analysis: traditional population movement variables and quality of life variables, such as population, society, employment, housing, culture, safety, medical care, greenery, education, and childcare. The 'domestic population movement data', provided by the MDIS of the National Statistical Office, was used for this research. Out of the total of 57 million population movement data in the period 2012 - 2017, population outmigration from Busan to the Seoul metropolitan area was extracted. Independent variables were drawn from public data sources in accordance with the temporal and spatial settings of the study. The multiple linear regression model was specified based on the dataset, and the fit of the model was measured by the p-value, and the values of Adjusted R2, Durbin-Watson analysis, and F-statistics. The results of the analysis showed that the variables that have a significant effect on population movement from Busan to the Seoul metropolitan area were as follows: 'single-person households', 'the elderly population', 'the total birth rate', 'the number of companies', 'the number of employees', 'the housing sales price index', 'cultural facilities', and 'the number of students per teacher'. More positive (+) influences of the population out-movement were observed in areas with higher numbers of single-person households, lowers proportions of the elderly, lower numbers of businesses, higher numbers of employees, higher numbers of housing sales, lower numbers of cultural facilities, and lower numbers of students. The findings suggest that policies should enhance the environments such as quality jobs, culture, and welfare that can retain young people within Busan. Improvements in the quality of life and job creation are critical factors that can mitigate the outflows of the Busan residents to the Seoul metropolitan area.

Analysis of Application of Massive Transfusion Protocol for Trauma Patients at a Single Tertiary Referral Hospital (단일 3차 의료기관에서 외상환자에 대한 대량수혈 프로토콜 적용 분석)

  • Kim, Hyerin;Yoo, Dong-Won;Kim, Hyerim;Shin, Kyung-Hwa;Lee, Hyun-Ji;Chang, Chulhun L.;Kim, Hyung-Hoi
    • The Korean Journal of Blood Transfusion
    • /
    • v.29 no.3
    • /
    • pp.262-272
    • /
    • 2018
  • Background: Massive hemorrhage due to trauma is one of the major causes of death in trauma patients, and the quick supply of appropriate blood products is critical in order to reduce the mortality rate. We introduced a massive transfusion protocol (MTP) for safe and rapid transfusion of trauma patients. Using records collected since its adoption, we compared the characteristics of MTP applied group (MTP group) and MTP not applied group (non-MTP group) to determine whether there is an indicator for predicting patients to be treated with MTP. Methods: We retrospectively reviewed the electronic medical records and laboratory findings of patients who received massive transfusions in the trauma emergency room of a single tertiary hospital from February to August 2018. We analyzed various laboratory test results, the amount and ratio of the transfused blood products, and the time required for blood products to be released for the MTP group and the non-MTP group. Results: Of the 54 trauma patients who received massive transfusions, 31 were in the MTP group and 22 in the non-MTP group. There was no significant difference in initial vital signs (except blood pressure) and laboratory test results. Also there was no difference in the amount and ratio of blood products, but the time required for blood product release was shorter in the MTP group. Conclusion: There was no significant difference in clinical findings such as initial vital signs and laboratory test results between the MTP and non-MTP groups, but required blood products were prepared and released more quickly for the MTP group.

Therapeutic Endoscopy-related Gastrointestinal Bleeding and Thromboembolic Events in Patients Using Warfarin or Direct Oral Anticoagulant (와파린 및 새로운 경구용 항응고제를 복용하는 환자에서의 치료 내시경과 관련된 위장관 출혈 및 혈전색전증의 위험)

  • Na, Hee Kyong
    • The Korean Journal of Gastroenterology
    • /
    • v.72 no.5
    • /
    • pp.271-273
    • /
    • 2018
  • 내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

Impacts of Diastolic Function on Clinical Outcomes in Young Patients with Acute Myocardial Infarction (젊은 급성 심근경색증 환자에서 좌심실 이완 기능 및 충만압이 관상동맥중재술 후 임상 경과에 미치는 영향)

  • Cho, Eun Young;Jeong, Myung Ho;Yoon, Hyun Ju;Kim, Yong Cheol;Sohn, Seok-Joon;Kim, Min Chul;Sim, Doo Sun;Hong, Young Joon;Kim, Ju Han;Ahn, Youngkeun;Cho, Jae Young;Kim, Kye Hun;Park, Jong Chun
    • The Korean Journal of Medicine
    • /
    • v.93 no.6
    • /
    • pp.538-547
    • /
    • 2018
  • Background/Aims: The impact of left ventricular (LV) diastolic function and filling pressure on clinical outcomes in young patients with acute myocardial infarction (AMI) has been poorly studied. Therefore, the aim of this study was to investigate the impact of LV diastolic function and LV filling pressure on major adverse cardiac events (MACEs) in young patients with AMI. Methods: A total of 200 young patients (males < 45 year, females < 55 year) with AMI were divided into two groups according to the diastolic function; normal (n = 46, $39.5{\pm}5.3$ years) versus abnormal (n = 154, $43.5{\pm}5.1$ years). Results: Despite regional wall motion abnormalities, normal LV diastolic function was not uncommon in young AMI patients (23.0%). During the 40 months of clinical follow-up, MACEs developed in 26 patients (13.0%); 14 re-percutaneous coronary intervention (7.0%), 8 recurrent MI (4.0%), and 4 deaths (2.0%). MACEs did not differ between the normal and abnormal diastolic function group (13.6% vs. 10.9%, p = 0.810), but MACEs were significantly higher in the high LV filling pressure group than the normal LV filling pressure group (36.8% vs. 10.5%, p < 0.001). On multivariate analysis, high LV filling pressure was an independent predictor of MACEs (hazard ratio 3.022, 95% confidence interval 1.200-7.612, p = 0.019). Conclusions: This study suggested that measurement of the LV filling pressure (E/e' ratio) would be useful in the risk stratification of young patients with AMI. However, it would be necessary to monitor this category of patient more carefully.

The Present State and Curriculum Implementation Overview of the Nursing-Specialized Vocational High Schools (특성화고등학교 간호과 운영 현황 및 교육과정 운영실태 분석)

  • Yoon, In-Kyung;Jang, Myung-Hee;Lee, Hyun-Young
    • Journal of vocational education research
    • /
    • v.35 no.4
    • /
    • pp.19-46
    • /
    • 2016
  • The purpose of this study is to analyze the curriculum implementation of the Nursing-Specialized Vocational High School by researching on operation, organization and environment of the program of Nursing. This study aims to improve the curriculum of the Nursing-Specialized Vocational High School. This study has analyzed previous existing studies, Link of School info, Educational Statistics and data indicating establishment, operation and curriculum of the department of Nursing which have been collected from web sites of institutions and associations relevant to Nurse Education. The major results of this study are as follows: 1) As of the first semester of the year 2016, out of a total of thirty eight Specialized Vocational High Schools and Meister High Schools in the country, 6.4% of the schools have nursing educational programs. These schools have established the programs under various names, such as Health Nursing, Dental Health Nursing, Nursing, Nursing and Medical Tourism, Accounting in Nursing and Nursing Management, etc. Since 2012, enrollment rates have increased while post-graduation employment rates have decreased, with the average employment rate of Specialized Vocational High School graduates having reached up to 46% by 2015. 2) The Nursing-Specialized Vocational High School aims to create skilled Nurses Assistant such as Nurse Aide and Care giver. The program is successful in providing necessary courses to acquire required certification and proficient field experience but requires revisional changes in order to create a long-term program of sufficient qualification. The official requirement of 780 hours of field practice was completed during the three educational breaks from the first year of high school to the second year, while the curriculum was conducted separately in the field hospitals. 3) An average of two laboratory classrooms were available based on the facility requirement standard of Cities and Provinces Educational Policies. In order to secure proficient instructors of Nursing education, establishment of specific indicated subjects, regional placement, in-service education, research and supervision are essential for establishing excellence and continual improvement.