• Pediatric Infection and Vaccine
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• 제17권1호
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• pp.49-55
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• 2010

목 적 : 서울 지역의 급성 호흡기 감염의 원인이 되는 바이러스를 분석하고 임상적 특징과 비교, 분석하였다. 방 법: 2008년 9월부터 2009년 3월까지 3개 대학병원에 입원한 5세 미만의 소아의 급성하기도감염환자에서 418개의 비인두흡입검체를 채취하여, 14종 바이러스를 multiplex PCR을 통한 진단하였다. 바이러스 양성환자의 임상정보를 병원별, 시기별로 분석하였다. 결 과: 418명이 분석되었고, 연령은 평균 16.4개월, 성별비는 1.36대 1이었다. 환자들 중 56.2%에서 바이러스 양성을 보였고, RSV (35%)가 가장 많이 검출된 바이러스였으며, 다음은 hRV (22%)였으며, HBoV, ADV, hMPV, PIV1, IFV, hCoV, PIV2, PIV3가 검출되었다. 양성검체 중 21.9%에서 동시감염이 있었다. 결 론:바이러스의 지역별, 시기별 지속적인 감시가 필요하며, 급성호흡기질환을 보이는 소아의 진료에, 유행하는 바이러스의 특징을 고려해야 할 것이다.

• 한국산학기술학회논문지
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• 제19권9호
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• pp.174-185
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• 2018

본 연구는 2015년 국내 메르스(중동호흡기증후군) 유행시 상급종합병원에 임상실습을 경험하는 학생의 메르스에 대한 지식, 태도 및 예방행위 수행 정도를 파악하고 메르스 예방행위 수행 예측요인을 확인하기 위해서 시도되었다. 본 연구 대상자는 3, 4학년 간호학과와 의과대학 학생 480명이었으며, 자료수집은 2015년 6월 9일부터 6월 30일까지 구조화된 설문지를 이용하였다. 자료분석은 SPSS/WIN 24.0을 이용하여 분석하였고, 메르스 예방행위 수행에 영향을 미치는 예측요인들은 위계적 회귀분석(hierachial regression)을 이용하였다. 임상실습 학생의 메르스에 대한 지식 수준은 9.56점(13점 기준)으로 보통 이상으로 높았으며, 메르스의 심각성 인지와 예방가능성에 대한 신념인 메르스에 대한 태도는 4.15점(5점 기준)으로 긍정적이었다. 메르스 예방행위 수행정도는 3.02점(5점 기준)으로 보통 수준이었다. 메르스 예방행위는 여학생인 경우, 메르스에 관한 교육 경험이 있는 경우, 지난 해 인플루엔자 접종을 한 경우, 올해 인플루엔자 접종 의도가 있는 경우, 메르스 감염에 대한 두려움이 높은 경우, 메르스에 대한 지식 수준이 높고, 태도가 긍정적일수록 수행 정도가 높게 나타났다. 이에 감염환자들을 치료하고 돌보게 될 간호학과와 의과대학 임상실습 학생의 메르스 예방행위 수행률을 높이기 위해서는 메르스 예방행위 수행에 영향을 미칠 수 있는 임상실습 학생의 특성을 고려해야 한다. 더 나아가 임상실습 학생들이 메르스를 예방하기 위하여 필수적으로 습득해야 하는 내용이 포함된 효과적인 감염예방 교육프로그램을 개발하고 실시하여 미래 보건의료인들의 메르스 관련 지식 수준을 높이고, 질환 전파를 막으려는 태도를 강화함으로써 전염성 감염질환 예방에 기여해야 한다.

• 보건행정학회지
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• 제29권2호
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• pp.105-111
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• 2019

On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.

• 대한치과의사협회지
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• 제53권10호
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• pp.732-742
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• 2015

The objective of this study was to identify bisphosphonate-related osteonecrosis of the jaw (BRONJ) awareness and experience level of patients by medical doctors who prescribes bisphosphonate being used, analyze dental examination referral reality and to utilize its result as basic education data for early diagnosis of BRONJ and its prevention. The study was carried out through a self-administered questionnaire distributed among a sample 192 residents and specialists. They belonged to family medicine, internal medicine and orthopedics of 6 tertiary medical centers located in Seoul. The survey consisted of 22 questions; general characteristics, bisphosphonate therapy, awareness of BRONJ, implementation level of dental examination referral. Among 192 medical doctorss, 78.1% (n=150) showed awareness of BRONJ. Only 8.9% (n=17) had correct response in all 5 BRONJ knowledge questions. Dental examination referral by medical doctors was implemented in below 30% of the total patients. At the time of bisphosphonate administration, specialist of oncology most highly recognized necessity of dental examination referral and it was represented in the order of endocrinology, rheumatology, family medicine, orthopedics specialists. As recognition of medical doctors for BRONJ and implementation level of dental referral were represented to be low, it is considered that enhancement of BRONJ recognition for medical doctors and development of high accessible education program for increasing implementation rate of dental examination referral would be required.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권2호
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• pp.163-173
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• 2020

Purpose: This study aimed to investigate the clinical and metabolic determinants of circulating soluble leptin receptor (CSLR) and free leptin index (FLI) in pre-pubertal obese male children. Methods: We conducted a preliminary cross-sectional study at three tertiary hospitals and one public primary school. Eighty obese male children without growth and developmental abnormalities aged 5-9 years were recruited. In these children, obesity was solely caused by excessive food intake, and not by acute illness, medications, endocrine abnormalities, or any syndrome. Body mass index (BMI), body fat mass, carbohydrate intake, fat intake, high density lipoprotein cholesterol level, low density lipoprotein cholesterol level, triglyceride level, and Homeostatic Model Assessment for Insulin Resistance are the potential determinants for leptin regulation, which is represented by CSLR level and FLI. Results: Carbohydrate was the main source of energy. BMI and body fat mass had negative weak correlation with CSLR and positive weak correlation with FLI. Furthermore, carbohydrate intake was found to be independently associated with CSLR based on the results of the multiple linear regression analysis. Following an increase in carbohydrate intake, CSLR level decreased progressively without any negative peak. Conclusion: Leptin regulation in prepubertal obese male children is associated with body composition and dietary intake. Carbohydrate intake is useful for predicting CSLR. Lipid profiles and insulin resistance are not related to both CSLR and FLI. Treatment and prevention of leptin resistance in obese children should focus on reducing BMI, fat mass, and carbohydrate intake.

• 대한간호학회지
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• 제41권6호
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• pp.814-820
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• 2011

Purpose: This study was performed to compare the effects of standardized peristomal skin care (SPSC) and crusting technique (CT) on the peristomal skin of ostomates. SPSC was developed by a consensus among the expert group based on a comprehensive review of the relevant literature and hospital protocols. Methods: A randomized controlled pilot trial with 2 parallel arms was used. A total of 81 ostomates, who were recruited from a tertiary hospital, completed the baseline, 1-month, 2-month, and 3-month follow-up (SPSC group, n=45; CT group, n=36). SPSC consisted of water cleansing and direct application of ostomy appliances. CT involved crusting hydrocolloid powder and patting with water sponge or protective barrier liquid film. The outcomes of the study were assessed by skin problems, such as discoloration, erosion and tissue overgrowth; the domains of the evaluation tool used in examining the peristomal skin. A generalized estimating equation model was used to examine the effects according to time and group. Results: In both SPSC and CT groups, the likelihood of occurrence of discoloration (OR, 1.99; 95% CI, 1.61-2.46), erosion (OR, 1.87; 95% CI, 1.55-2.25) and tissue enlargement (OR, 1.94; 95% CI, 1.36-2.77) increased with time. There was no significant difference in discoloration between the groups, whereas the probability of erosion (OR, 0.38; 95% CI, 0.16-0.89) and tissue overgrowth (OR, 0.09; 95% CI, 0.02-0.55) was lower in the SPSC group than in CT group. Conclusion: SPSC was sufficient in preventing peristomal skin problems of ostomates compared to the CT.

• Journal of Preventive Medicine and Public Health
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• 제51권5호
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• pp.227-233
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• 2018

Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

• Safety and Health at Work
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• 제3권3호
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• pp.209-215
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• 2012

Objectives: Knowledge, attitudes, and practices of healthcare providers related to occupational exposure to bloodborne pathogens were assessed in a tertiary-care hospital in Middle East. Methods: A cross-sectional study was undertaken using a self-administered questionnaire based on 3 paired (infectivity known vs. not known-suspected) case studies. Only 17 out of 230 respondents had an exposure in the 12 months prior to the survey and of these, only 2 had complied fully with the hospital's exposure reporting policy. Results: In the paired case studies, the theoretical responses of participating health professionals showed a greater preference for initiating self-directed treatment with antivirals or immunisation rather than complying with the hospital protocol, when the patient was known to be infected. The differences in practice when exposed to a patient with suspected blood pathogens compared to patient known to be infected was statistically significant (p < 0.001) in all 3 paired cases. Failure to test an infected patient's blood meant that an adequate risk assessment and appropriate secondary prevention could not be performed, and reflected the unwillingness to report the occupational exposure. Conclusion: Therefore, the study demonstrated that healthcare providers opted to treat themselves when exposed to patient with infectious disease, rather than comply with the hospital reporting and assessment protocol.

• 한국작물학회지
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• 제49권5호
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• pp.363-367
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• 2004

The deep irrigation of rice plants brings about some beneficial effects such as reduced tiller production which results in the formation of bigger panicles, prevention of chilling injury, reduced weed growth, etc. The present study was carried out to examine the involvement of ethylene in the suppression of tiller production due to deep water irrigation in rice (cv. Dongjinbyeo). The ethylene production was induced in leaf sheath within 24 hours after the deep water irrigation and has increased even until 30 days after the treatment, recording 4.5-fold increase as compared to the shallow-irrigated rice plants. In the deep water irrigated rice plants, ethylene was accumulated to a high concentration in the air space of submerged leaf sheath as the irrigated water deterred the diffusion of ethylene out of the leaf sheath and ethylene biosynthesis was accelerated by the deep irrigation as well. The ethylene concentration recorded 35-fold increase in the deep-irrigated rice plants for 35 days. The tiller production was reduced significantly by the deep irrigation with water, the tiller bud, especially tertiary tiller bud differentiation being suppressed by the deepwater irrigation treatment, whereas the rice plants deep-irrigated with solutions containing $10^{-5}$ M or $10^{-6}$ M silver thiosulfate (STS), an action inhibitor of ethylene, showed the same or even higher production of tillers than those irrigated shallowly with water. This implies that the ethylene is closely linked with the suppression of tiller production due to deep water irrigation. In conclusion, ethylene, which was induced by hypoxic stress and accumulated in the leaf sheath due to submergence, played a key role in suppressing the tiller production of the deepwater irrigated rice.

• 한국콘텐츠학회논문지
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• 제11권8호
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• pp.231-238
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• 2011

본 연구는 20대 성인 남성에서 건강행태와 비만지표가 혈압에 미치는 영향을 알아보기 위하여 시도되었다. 연구대상자는 서울시내 일개 상급종합병원에서 2006년 10월부터 2011년 4월까지 임상시험 참여를 위해 스크리닝을 시행한 20~29세의 남성 수진자 총 214명이며 탐색적 후향 연구로 시행하였다. 연구결과 수축기 및 이완기 혈압이 정상인 비율은 28.5%와 50.0%였으며, 총콜레스테롤과 중성지방이 정상치인 집단보다 정상치 이상인 집단에서 수축기 및 이완기 혈압은 더 높았으며 두 집단 간에 유의한 차이가 있었다. 24세 이하보다 25~29세 집단이, 비흡연자에 비해 흡연자가 이완기혈압이 더 높았으며, 두 집단 간에 유의한 차이가 있었다. 수축기 혈압 상승에는 체질량지수와 중성지방이, 이완기혈압 상승에는 총콜레스테롤, 중성지방, 연령, 흡연량이 유의한 요인이었다. 결론적으로 20대 성인 남성에게 고혈압 발생을 예방하기 위해 중성지방 및 총콜레스테롤 감소를 위한 식습관 개선과 정상 BMI 유지 및 금연의 건강행태 개선 활동이 필요하다.