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Effects of Interfering Current Stimulation on Vastus Medialis Oblique and Vastus Lateralis Activity and Ratio during Squat Exercise (스쿼트 운동 시 적용된 중주파 전기자극이 안쪽빗넓은근과 가쪽넓은근의 근활성도 및 근활성비에 미치는 영향)

  • Kim, Chung-Yoo
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.4
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    • pp.283-289
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    • 2021
  • Purpose : The purpose of this study is to investigate the effect of mid frequency electrical stimulation during squat exercise on the muscle activity and muscle activity ratio of vastus medialis oblique and vastus lateralis, and to prepare scientific basic data for exercise intervention using mid frequency electrical stimulation. Methods : This study was conducted with students from University C located in Busan, and among a total of 123 subjects, 12 subjects who complained of knee joint dysfunction between 80 and 90 points using the Kujala patellofemoral score (KPS) were used. All subjects participated in the experiment for 3 days, and MVIC values were measured for normalization of muscle activity values on the first day. For the two days, participants participated in the experiment and performed squat exercise or squat exercise receiving mid-frequency electrical stimulation in random order. Measurements were taken in the squat position immediately after the squat exercise, and muscle activities of vastus medialis oblique and vastus lateralis were measured. The measured data were compared through the dependent t test, and the statistical significance level was set to .05. Results : According to the results of this study, in the case of applying mid-frequency electrical stimulation together in the ratio of vastus medialis oblique and vastus lateralis muscle activity during squat exercise, higher values were observed compared to the case of not applying mid-frequency electrical stimulation together, and statistically significant. Also, when mid-frequency electrical stimulation was applied to both vastus medialis oblique and vastus lateralis activities during the squat exercise, higher values were shown compared to the case where the mid-frequency electrical stimulation was not applied together, but there was no statistically significant difference. Conclusion : The results of this study reported that mid-frequency electrical stimulation provided to vastus medialis oblique increased the muscle activity ratio of vastus medialis oblique and vastus lateralis. Therefore, the improvement of coordination due to the enhancement of the activity of vastus medialis oblique through mid-frequency electrical stimulation will be more helpful in the treatment of patellofemoral pain syndrome patient. In addition, it is hoped that the electrical stimulation method applied to exercise will be widely used.

Laboratory analysis of acute acetaminophen overdose patients in Emergency Medical Centers: including analysis of one toxicological laboratory data (응급의료센터에서 아세트아미노펜 과다복용 환자의 검사실 분석 현황: 일개 중독분석실 농도 분석자료 포함)

  • Kim, In Chan;Won, Sinae;Lee, Arum;Jung, Haeun;Lee, Jeongsun;Oh, Bum Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.19 no.1
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    • pp.31-37
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    • 2021
  • Purpose: Acetaminophen (APAP) is a widely available drug responsible for a large part of drug-induced hepatotoxicity in developed countries. Although acetaminophen overdose cases in Korea are being continuously reported, there are no reports related to the level of this drug in the patient's blood or of laboratory analysis at emergency departments (ED). This study sought to analyze the acetaminophen overdose cases at a toxicological laboratory and to survey APAP analysis services offered at select EDs. Methods: We analyzed the demographic and analytic data at a toxicological laboratory run by the National Emergency Medical Center (NMC) in 2019-2020. We surveyed the APAP laboratory service in the 38 regional emergency medical centers (EMCs) and 68 local EMCs near the toxicological laboratory. Results: We studied 175 acute poisoning cases (112 women) with positive blood APAP results (mean age 47.0±24.1 years). Suicide attempts comprised 40.0% of the cases and 30.3% APAP overdose events. In the univariate analysis, we observed that patients were significantly younger, with fewer underlying medical diseases. There were a higher number of APAP overdose events, more favorable initial mental status, more toxic quantity intake in the above treatment line group (p<0.05), In multivariate analysis, the toxic amount intake was significantly more frequent in the above treatment line group (p<0.01). Hospital APAP analysis services were available in six EMCs (3/38 regional and 3/68 local). The hospital blood APAP level reporting intervals were shorter than outside-hospital laboratory services (p<0.01, regional 7.0±3.0 vs. 40.6±27.5, local 5.3±3.1 vs. 57.9±45.1 hours). The NMC toxicological laboratory reporting interval was shorter than the other outside-hospital laboratories (p<0.01, regional 5.7±0.6 vs. 50.2±22.7 local 7.5±3.0 vs. 70.5±41.5 hours). Conclusion: Over the treatment line group, toxic amount intake was significantly more frequent. Only six of 106 EMCs have their own APAP analysis service in their hospitals.

A Study on Work Intensity, Work-Life Balance, and Burnout among Korean Neurosurgeons after the Enactment of the Special Act on Korean Medical Residents

  • Kim, Tae Gon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.644-664
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    • 2021
  • Objective : Since the enactment of the Special Act on Korean Medical Residents, neurosurgeons working at training hospitals have been performing the duties of residents, in addition to their existing patient care responsibilities, which include surgery, education, and research. This study explores the relationships between work intensity, work-life balance, and burnout experienced by Korean neurosurgeons. Methods : The participants (n=451) were neurosurgeons working at training hospitals throughout Republic of Korea. Data on socio-demographic characteristics (including objective and subjective work environment), work intensity, work-life balance, and burnout were gathered using self-report questionnaires completed between March 1 and December 20, 2019. The data were analyzed using descriptive statistics, independent samples t-tests, one-way analysis of variance, Pearson's correlations, and multiple regression analysis. IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, NY, USA) was used for the analyses. Results : The work intensity, work-life balance, and burnout levels of neurosurgeons were 3.95, 3.57 (on a scale from 1 to 5) and 4.60 (on a scale from 1 to 7); and 280 (62.1%) of 451 neurosurgeons were found to be experiencing burnout. By controlling for the socio-demographic characteristics, the effects of work intensity and work-life balance on burnout were analyzed. Work intensity (B=0.314), work-life balance-family and leisure (B=0.216), work-life balance-growth (B=0.147), job stress (B=0.133), and satisfaction with human relationships (B=-0.069) were shown to be significant (all p<0.05), and they were found to affect burnout in the abovementioned order. The overall explanatory power was 58.3% (p<0.05), and the explanatory power with the addition of independent variables such as work intensity and work-life balance was 14.5% (p<0.05). Conclusion : This study showed that Korean neurosurgeons working at training hospitals experienced a high level of work intensity and job stress, and low work-life balance. Additionally, nearly half of the neurosurgeons were found to experience burnout related to factors such as work intensity, work-life balance, job stress, and satisfaction with human relationships. In particular, these factors seem to have deteriorated further after the implementation of the Special Act on Korean Medical Residents. These very high levels of burnout among Korean neurosurgeons who care for patients with both brain and spinal diseases may have a very important impact on patients' health. Therefore, it is recommended that the Korean Neurosurgical Society and the Korean government make efforts to improve the factors that affect burnout among Korean neurosurgeons.

The Effect of Dental Hygienist Prosthetic Medical Service on Dental Satisfaction and Dental Loyalty (치과위생사의 보철 의료서비스가 치과 만족 및 애호도에 미치는 영향)

  • Song, Kwui-Sook;Ryu, Da-Young;Lee, Su-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.1
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    • pp.713-718
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    • 2021
  • This study was conducted to clarify the role and importance of dental hygienists in improving patient satisfaction in dental medical institutions, and to improve the social position, working conditions, and environment of dental hygienists. This study evaluated the impact of dental hygienists on dental satisfaction, revisits, and doctor recommendations for patients who had received prosthodontic treatment at dentistry in the last 10 years. This study analyzed the data from 166 survey questionnaires from June 1, to July 2, 2020. For data analysis, the SPSS Ver 23.0 program was used to calculate frequency and percentage, mean and standard deviation of the variables, Pearson correlation analysis, and multiple regression analysis. As a result, the average quality of medical services provided by dental hygienists among prosthetics was 4.05, the average dental satisfaction was 4.27, the average revisit was 3.97, and the average recommendation was 4.01. As a result of Pearson's correlation analysis, there was a significant positive correlation between each variable (P<0.01). As a result of multiple regression analysis, the level of knowledge appeared as a factor affecting dental satisfaction (P<0.05). The factors influencing both the revisits and the intention to recommend were the level of knowledge and the level of education (P<0.05).

Appropriate Technology, Responding to the COVID-19 Pandemic - Redefined Roles in a Public Health Crisis (Part I) (COVID-19 대유행에 대응하는 적정기술 : 보건 위기에서 재정의된 역할 - 파트 1)

  • Lee, Sungwoo;Suh, Jungwoo;Kim, Jaeeun;Jang, Dongyoon;Pyun, Nayoon;Shin, Kwanwoo
    • Journal of Appropriate Technology
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    • v.6 no.2
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    • pp.238-255
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    • 2020
  • As COVID-19, which occurred at the end of 2019, has become a global pandemic, it has emerged as an unprecedented event that quickly destroys a nation's medical and healthcare system in both developed and developing countries. In the 21st century, most of the civil society that aimed for hyperconnected society is facing a new crisis that has not been experienced so far. Indeed, lack of personal protective equipment, isolation of clustered communities, disruption of medical systems necessary for diagnosis and treatment, and disruption of educational and economic activities due to social isolation are emerging. Since the COVID-19 has occurred, many of the difficulties that have occurred in the past six months indicate the basic infrastructure a society should have particularly in a pandemic. These include personal protective equipment (PPE), decontamination and quarantine tools essential for effective response, rapid and precise large-scale diagnosis, medical devices required for patient care, and identification and fast and wide on-line networks that can be used in social isolation. In this first part, we would like to introduce some representative examples of 1) personal protective equipment, 2) prevention of personal and community health, 3) social response through big data and networks within the framework of appropriate technology.

EVALUATION OF SERUM LEVELS OF SYSTEMIC STATUS IN ORAL AND MAXILLOFACIAL SURGERY PATIENTS (구강악안면 수술을 받은 환자들에서의 전신영양평가)

  • Kim, Uk-Kyu;Kim, Yong-Deok;Byun, June-Ho;Shin, Sang-Hun;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.5
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    • pp.301-314
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    • 2003
  • The purposes of this retrospective study were to assess the change of serum parameters in oral and maxillofacial surgery patients after operation and to determine what laboratory parameters on treatment periods were associated with the recovery of systemic condition. For purposes of assessing systemic nutritional status, several serum parameters were chosen. The sample patients were randomsubjects extracted from three category patient groups- oral cancer, odontogenic abscess, facial bone fracture based on treated patients at department of oral and maxillofacial surgery in Pusan National University Hospital from September 1, 1998, to September 1, 2002. Each groups were consisted with 10 patients. Each patient chart was examined and blood sample parameters were reviewed with clinical signs, symptoms and vital sign at preoperative day, postoperative 1 day, postoperative 1 week. Several parameters were analyzed statistically for extraction of mean values and differences between the periods groups. The findings of serum parameters of cancer, abscess and fracture groups were as follows: 1. In cancer patients, Hb, MCV, albumin, cholesterol, LDH, AST, ALT, neutrophil, platelet, leukocyte, Na, K, Cl, BUN, creatinine were analyzed. Values of Hb, albumin, AST, neutrophil, leukocyte, Cl showed significantly differences according to periods. 2. In abscess patients, CRP, ESR, leukocyte, body temperature, neutrophil were analyzed. Values of CRP, leukocyte, body temperature, neutrophil showed significanlty differences according to periods. 3. In fracture patients, same parameters with cancer patient's were chosen. Values of platelet, Cl only showed significantly differences according to periods. 4. In cancer patients, data regarding correlation was analyzed statistically as Pearson's value. A positive correlation was found between Hb and albumin, K, Na(P<0.05). A positive correlation was also found between neutrophil and leukocyte(P<0.05). Positive correlations were found between cholesterol and ALT, LDH and platelet, creatinine both, Platelet and BUN, Na and K(P<0.01). 5. In abscess patients, Peason's correlation values were analyzed on parameters. A positive correlation was found only between CRP and neutrophil(P<0.05). 6. In fracture patients, The correlations of parameters also were statistically analyzed. Positive correlations were found between MCV and K, albumin and LDH, AST and three parameters of creatinine, Na, Cl, K and neutrophil, neutrophil and three parameters of leukocyte, BUN, K(P<0.05). Positive correlations were found between LDH and AST, ALT and AST, creatinine both(P<0.01). This retrospective clinical study showed the CRP levels only on abscess patients may be useful in determination of clinical infected status, but the levels of other parameters on cancer, fracture patients did not showed significant values as diagnostic aids for clinical status.

From Patients and Caregivers 119 Rescue party's Experiences for Violence in the Pre-Hospital Emergency Medical Field (환자 및 보호자로부터 구급대원이 경험한 병원 전 응급의료현장 폭력실태)

  • Shin, Sang-Yol
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.12
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    • pp.3870-3878
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    • 2009
  • The purpose of this study was to investigate 119 rescue party's violence experiences and to analyze their responses of violence experiences based on the pre-hospital emergency medical field. Data were collected from the self-administered survey of 226 rescue party in Jeollabuk-do area in Korea from January 1 through March 2, 2009. The data were analyzed by descriptive statistics and logistic regression analysis using SPSS Win 12.0. The results were as follows: first, all of 119 rescue unit in the pre-hospital emergency medical field reported that they got violence experiences more than once a week, and 62% of rescue team were exposed to physical violence. Patient's factors that caused violence were drug abuse or alcohol(56.2%), on the other hand rescue party's factors were shortage of human resources. Second, 42% of the respondents replied that they did not have any educational experiences for prevention and coping methods about violence within 5 years. 77.4% of those surveyed indicated that they wanted to receive specific educations which can prevent and cope with violence. Third, the mean value of total violent response scores was 2.53, and emotional response score was 3.2, social response score was 2.22, and physical response score was 2.17. Fourth, violent response score related to general characteristics proposed that physical(t=-2.08, p=o.38), emotional(t=-7.13, p=.006), and total responses(t=-4.764, p=.000) were statistically significant. And emotional(t=4.257, p=.000) and total responses(t=8.1330, p=.000) related to age were also statistically significant. Finally, among current tenure qualification scores, social response(t=9.987, p=.012) and total score(t=8.130, p=.000) were statistically significant. Between fire departments, violent response score suggested that physical(t=9.987, p=.000), emotional(t=2.433, p=.012), social(t=6.738, p=.000), and total score(t=5.943, p=.000) were statistically significant.

The Evaluation of Clinical Usefulness on Application of Myocardial Extract in Quantitative Perfusion SPECT (QPS 프로그램에서 Myocardial extract 적용에 따른 임상적 유용성 평가)

  • Yun, Jong-Jun;Lim, Yeong-Hyeon;Lee, Mu-Seok;Song, Hyeon-Seok;Jeong, Ji-Uk;Park, Se-Yun;Kim, Jae-Hwan;Kim, Jeong-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.88-93
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    • 2011
  • Purpose: As to analytical method of data, the AutoQUANT software in which it is used quantitative rating of the myocardial perfusion SPECT are reported that there is a difference. Therefore the measured value error of the mutual program is expected to be generated even if the quantitative analysis is made data of the same patient. The purpose of this study is to offer the comparative analysis of myocardial extract method in Quantitative Perfusion SPECT. Materials and methods: We analyzed the 51 patients who were examined by Tc-99m MIBI gated myocardial SPECT in nuclear medicine department of Pusan National University Hospital from June to December 2010(34 men, 17 women, mean age $66.5{\pm}9.9$). We acquired the extracted image in myocardial extract protocol. QPS program that uses the AutoQUANT software measured TID(Transient Ischemic Dilation), ESD(Extent of Stress Defect), SSS(Summed Stress Score). Then analyzed the results. Results: The correlation of appyling myocardial extract is TID(r=0.98), ESD(r=0.99), SSS(r=0.99). In the 95% confidence limit, there was no satistically significant difference(TID p=0.78, ESD p=0.31, SSS p=0.19). After blinding test with a physician for making a qualitative analysis, there was no difference. Conclusion: Quantitative indices in QPS program showed good correlation and the results showed no statistically signigicant difference. The variance between method was small. therefore, the functional parameters by each method can be used interchangeably. Also, we expect patient's satisfaction.

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Independent Verification Program for High-Dose-Rate Brachytherapy Treatment Plans (고선량률 근접치료계획의 정도보증 프로그램)

  • Han Youngyih;Chu Sung Sil;Huh Seung Jae;Suh Chang-Ok
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.238-244
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    • 2003
  • Purpose: The Planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. Meterials and Methods: As primary input data, the program takes patients'planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were peformed in a $10\times12\times10\;Cm^3$ grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans peformed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients'plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. Results: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of $2.8\%$ in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip legion of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a $3.4\%$ deviation from the TPS plans. Conclusion: The accurate validation of complicate treatment plans is possible with the developed software and the qualify of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.

Analysis of the medication compliance of hypertensives and its influential factors (고혈압 환자의 투약순응도와 영향 요인 분석)

  • Son, Kyung-Ae;Kim, Yoon-Shin;Hong, Min-Hee;Jeong, Mi-Ae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.5
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    • pp.1897-1904
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    • 2010
  • The administration data of the national health insurance and health insurance bills were utilized in this study. The data of 432,915 patients who were at the age of 30 and up and used the out-patient departments of every medical institution located in some regions involving two southern and northern provinces once or more during a 184-day period from July to December. As a result of analyzing their prescription compliance and factors affecting it, the following findings were given: The average rate of the prescription compliance of the patients stood at 61.5 percent. It denoted that they were prescribed to take medicine for approximately 113 days during the six-month(184 days) period of time, and the rate of the patients who complied with the prescriptions just stood at 13.0 percent. They used out-patient department for 4.3 days on the average due to hypertension and they visited 1.1 medical institutions on the average. 94.9 percent just used a medical institution. The largest group (11.6%) suffered from diabetes as co-morbidity, and 23.3 percent of the hypertensives had co-morbidity. Concerning the relationship between their characteristics and prescription compliance, those who were male, who were beneficiaries of the national health insurance, who mainly used general hospitals and who suffered from co-morbidity complied better with the prescription they got. Their prescription compliance got better at the age of 65 to 74 and got worse afterwards. As for factors affecting their prescription compliance, the patients who were male, who were aged between 55 and 64 and who were beneficiaries of the national health insurance, who mainly used specialized general hospitals, general hospitals and public health centers and who had heart diseases and diabetes as co-morbidity complied better with the prescriptions. The above-mentioned findings of the study suggested that it's needed to make a factor analysis of the poor prescription compliance of patients from diverse angles, and that existing hypertension care plans should carefully be reviewed to improve the prescription compliance of patients and to find a feasible alternative. As hypertensives are easily likely to develop co-morbidity like diabetes, systematic health education should be provided for them to get into the right life habits such as taking low-salt meals or quitting smoking. In addition, the development of health care programs is required.