• 한국산학기술학회논문지
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• 제13권8호
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• pp.3597-3609
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• 2012

본 연구는 청소년이 접근할 수 있는 중독행동을 포괄적으로 측정할 수 있는 다차원적 중독행동 측정도구를 개발하고 신뢰도와 타당도를 검정함으로써, 청소년 중독행동에 대한 포괄적인 사정과 다차원적 접근을 위한 기초자료를 제시하고자 시행되었다. 본 연구는 개념적 기틀형성, 초기문항 작성, 내용타당도 검정, 2차 문항 작성 및 최종문항 확정의 과정으로 진행되었다. 대상자는 636명의 중고등학생인 청소년이었고, 자료는 자가보고 질문지로 수집되었다. 자료분석은 SPSS 19.0 프로그램을 이용하였다. 청소년의 중독행동은 총 70문항이 최종문항으로 선정되었으며, 게임 중독행동, 쇼핑 중독행동, 휴대폰 중독행동, 니코틴 중독행동, 텔레비전 중독행동, 도박 중독행동, 인터넷 중독행동, 알코올 중독행동의 8개의 하부요인이 분류되었고, 이에 대한 설명변량은 56.6%이었다. 청소년 중독행동은 중독성과 자기통제와 유의한 순상관이 있었으며, 신뢰도인 Cronbach's alpha가 .94이었다. 또한 중동행동의 선별기준이 일반군, 중독행동 위험군, 중독행동군으로 분류되었다. 청소년의 중독행동을 정확하게 파악하여 효과적인 교육 및 지도를 위한 방안을 마련하고, 청소년의 중독을 조기에 발견하여 적절한 관리를 시작하게 함으로써 청소년의 신체적 정신적 건강증진을 위한 교육과 연구 및 실무에 기여할 것이다.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.294-299
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• 2001

Objectives : CT-guided stereotactic evacuation for spontaneous intracerebral hemorrhage can minimize the brain damage and can be performed safely and simply under local anesthesia. But that procedure is time consuming and has a risk of rebleeding because of the stress during head pin fixation. So authors describe easy and precise guidelines for FHA of putaminal hemorrhage without stereotactic instrument. Methods and Materials : We analyzed the data of 298 patients who underwent CT-guided stereotactic aspiration of putaminal hematoma in our hospital between January 1990 and December 2000. We divided the patients into three groups according to the location of hematoma : anterior portion, middle portion and posterior portion of putamen. Total number of catheters inserted into the hematoma were 345 and there were with regard to the direction and depth of catheters. Results : Proposed guidelines of catheter insertion to putaminal hemorrhage in our institution. 1) hematoma at the anterior portion of putamen ; Direction of catheter was the midpupillary line of the eye and the point intersecting a line drawn from the burr hole to a point between external auditory meatus(EOM) and 1cm posterior to EOM. Depth of catheter was 6-6.5cm. 2) hematoma at the middle portion of putamen ; Direction of catheter was the midpupillary line of the the eye and the point intersecting a line drawn from the burr hole to a point between 1cm and 2cm posterior to EOM. Depth of catheter was 6.5-7cm. 3) hematoma at the posterior portion of putamen ; Direction of catheter was 15 degree laterally from the midpupillary line of the eye and the point intersecting a line drawn from the burr hole to a point between 2cm and 3cm posterior to EOM. Depth of catheter was 7-7.5cm. We have performed FHA of putaminal hemorrhage in 48 cases according to this guideline. All catheter were inserted exactly at the center of hematoma and average operation time was about 30 minutes. Conclusion : Our proposed guidelines for putaminal hemorrhage are considered to be safe and simple method with similar accuracy and rapid decompression compared with traditional stereotactic method. Main advantages of this technique were unnecessity of stereotactic frame application and less time requirement for hematoma removal.

• Nutrition Research and Practice
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• 제10권1호
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• pp.56-66
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• 2016

BACKGROUND/OBJECTIVES: Despite successes recorded in combating iodine deficiency, more than 2 billion people are still at risk of iodine deficiency disorders. Rural landlocked and mountainous areas of developing countries are the hardest hit, hence the need to explore and advance novel strategies such as biofortification. SUBJECTS/METHODS: We evaluated adoption, purchase, and consumption of iodine biofortified vegetable legumes (IBVL) using the theory of protection motivations (PMT) integrated with an economic valuation technique. A total of 1,200 participants from three land-locked locations in East Africa were recruited via multi-stage cluster sampling, and data were collected using two, slightly distinct, questionnaires incorporating PMT constructs. The survey also elicited preferences for iodine biofortified foods when offered at a premium or discount. Determinants of protection motivations and preferences for iodine biofortified foods were assessed using path analysis modelling and two-limit Tobit regression, respectively. RESULTS: Knowledge of iodine, iodine-health link, salt iodization, and biofortification was very low, albeit lower at the household level. Iodine and biofortification were not recognized as nutrient and novel approaches, respectively. On the other hand, severity, fear, occupation, knowledge, iodine status, household composition, and self-efficacy predicted the intention to consume biofortified foods at the household level; only vulnerability, self-efficacy, and location were the most crucial elements at the school level. In addition, results demonstrated a positive willingness-to-pay a premium or acceptance of a lesser discount for biofortification. Furthermore, preference towards iodine biofortified foods was a function of protection motivations, severity, vulnerability, fear, response efficacy, response cost, knowledge, iodine status, gender, age. and household head. CONCLUSIONS: Results lend support for prevention of iodine deficiency in unprotected populations through biofortification; however 'threat' appraisal and socio-economic predictors are decisive in designing nutrition interventions and stimulating uptake of biofortification. In principle, the contribution is threefold: 1) Successful application of the integrated model to guide policy formulation; 2) Offer guidance to stakeholders to identify and tap niche markets; 3) stimulation of rural economic growth around school feeding programmes.

• Journal of Yeungnam Medical Science
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• 제7권1호
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• pp.95-103
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• 1990

1989년 8월 1일부터 1990년 4월 30일까지 영남대학교 의과대학 산부인과에서 대량출혈이 예상되는 18명의 환자에서 21례의 자가수혈을 시행하여 관찰한 결과 자가수혈의 가장 많은 적응증으로는 전치태반이었으며(10/21) 수술후 자가수혈 및 homologous transfusion의 빈도도 제일 많았다. 출혈위험이 있는 산모 20례중 6례에서 자가수혈로 인해 homologous transfusion을 피할 수 있었다. 혈액 채취전후의 혈압 및 맥박, 호흡 및 reticulocyte등은 통계학적으로 별차이점이 없었고, 채혈전후에 시행하였던 태아감시장치상 약 8례에서 약간의 이상이 나타났으나 대부분 자세변화 및 산소공급으로 20분 이내에 정상으로 돌아왔다. 태어난 신생아중 거대아 1명, 저체중아 3명이었으며 14명이 정상체중아였고, 분만전의 채혈로 인한 이상소견을 발견할 수가 없었다. 채취전후의 혈액학적 변화로소 채취전 Hct는 $34.1{\pm}2.9%$였고, 채취 후는 $31.8{\pm}2.4%$로 유의성이 있었다(P<0.01). 대부분의 혈액 채취시간은 4-8분 정도였으며 채혈시 산모에서 특별한 합병증을 발견하지 못하였다. 3명을 제외하고 15명이 채혈후 3주 이내에 분만하였다. 상기한 여러가지 결과 대량출혈이 예상되는 산모에 있어서 수술전에 혈액을 채취하여 필요할 때 사용할 수 있는 자가수혈은 산모 및 태아에 있어 특별한 이상을 발견할 수 없었다. 그러므로, 산모에 있어서 자가수혈은 homologous transfusion을 피할 수 있는 매우 유용한 한 방법일 수 있다는 결론을 얻었고, 채혈시 나타났던 태아감시상의 여러가지 이상소견에 대해서는 더 많은 연구가 필요할 것으로 사료된다.

• Journal of Yeungnam Medical Science
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• 제22권2호
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• pp.199-210
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• 2005

전 세계적으로 비만 인구의 급격한 증가와 이로 인한 다양한 만성질환의 증가가 중요한 건강 문제로 대두되고 있으며, 최근 여러 종류의 암들도 비만과 연관성이 있을 것이라는 연구들이 많이 이루어지고 있다. 비만과 암과의 연관성에 대한 정확한 기전은 아직 밝혀지지 않았으나 다양한 스테로이드와 펩타이드 호르몬 그리고 성장인자가 중요한 역할을 할 것으로 생각되어지며, 전립선암 역시 호르몬 의존성의 종양이므로 남성 비만 환자에서의 증가된 혈청 에스트로겐 농도와 교감 신경계의 활성화 등 비만과 관련된 호르몬의 변화는 전립선암과도 상당한 연관이 있을 것으로 추정된다. 그러나, 지금까지의 비만과 전립선암과의 연관성에 대한 임상연구들은 대부분 서구인을 대상으로 시행되었으며 그 결과 또한 서로 상반되게 발표되고 있어 명확한 연관성을 밝히지 못하고 있는 실정이다. 이에 본 저자들은 한국인을 대상으로 비만과 전립선암과의 연관성을 알아보고자 2000년 1월부터 2005년 6월까지 영남대학교 의과대학 부속병원 비뇨기과에서 임상적으로 전립선암이 의심되어 경직장초음파유도하 전립선생검(transrectal ultrasound guided prostate biopsy)을 시행한 286명을 대상으로 환자들의 의무기록을 후향적으로 분석하여, 환자의 나이, 키, 몸무게, BMI, PSA, DRE, TRUS, 경직장초음파유도하 전립선생검, Gleason 점수, 임상적 병기 등을 비교, 분석하였다. 본 연구 결과에서는 BMI와 전립선암 발병률과는 연관성을 확인 할 수 없었으며, BMI와 임상적 병기와는 다소 연관성이 있는 것으로 나타났으나 통계적 유의성은 없었다. 이러한 비만 환자를 대상으로 한 연구에서는 비만의 기준에 따라서 큰 차이가 유발될 수 있으며, 비만 환자의 경우 전립선암 진단 및 치료 방법 등에 있어서 다양한 편견 및 오류가 작용할 수 있을 것으로 생각된다. 따라서, 비만과 전립선암과의 명확한 연관성을 확인하기 위해서는 향후 비만에 영향을 미칠 수 있는 다양한 인자와 호르몬 측정 및 BMI 이외의 여러 가지 비만 지수 등의 측정을 포함한 대규모 임상연구가 필요하리라 생각된다.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.356-365
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• 2018

Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.

• Journal of Korean Medical Science
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• 제33권49호
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• pp.308.1-308.10
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• 2018

Background: The aim of this study was to describe the structure, organization, management, and staffing of pediatric critical care (PCC) in Korea. Methods: We directed a questionnaire survey for all Upper Grade General Hospitals (n = 43) in Korea in 2015. The first questionnaire was mainly about structure, organization, and staffing and responses were obtained from 32 hospitals. The second questionnaire was mainly about patients and management. Responses to second questionnaire were obtained from 18 hospitals. Results: Twelve from 32 Upper Grade General Hospitals had pediatric intensive care units (PICUs) and 11 of them had the PICU which was exclusive for children. Total number of PICU beds in Korea was 113. The ratio of the number of PICU beds to the number of children was 1:77,460 in Korea and this ratio is lower than that of other developed countries. The mean number of beds in the PICUs was $9.4{\pm}9.3$ (range, 2-30). There were 16 medical doctors who were assigned for PCC and only 5 of them were full time pediatric intensivists. In the 18 Upper Grade General Hospitals that responded to the second questionnaire survey, there were 97 patients in the PICUs with an average number of $5.7{\pm}7.2$ (range, 0-22) on the survey day. The mean age of the patients was $3.4{\pm}5.6$ years. The mean length of hospital stay was $82{\pm}271days$. The mean Pediatric Risk of Mortality score III was $9.4{\pm}7.8$ at the time of admission to the PICUs. Conclusion: There is a considerable shortage of PICU beds compared to those in developed countries. In addition, the proportion of PICUs with PCC specialists is much lower than those in the US and European countries.

• Journal of Korean Medical Science
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• 제33권47호
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• pp.296.1-296.7
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• 2018

Background: Antepartum, intrapartum, and postpartum preventive measures with antiretroviral drugs, appropriate delivery methods, and discouraging breastfeeding significantly decrease the risk of mother-to-child transmission of human immunodeficiency virus (HIV) infection. Herein, we investigated the pregnancy outcomes in HIV-infected Korean women. Methods: We retrospectively reviewed medical records of childbearing-age HIV-infected women between January 2005 and June 2017 at four tertiary care hospitals in Korea. Results: Among a total of 95 HIV infected women of child-bearing age with 587.61 years of follow-up duration, 15 HIV-infected women experienced 21 pregnancies and delivered 16 infants. The pregnancy rate was 3.57 per 100 patient-years. Among the 21 pregnancies, five ended with an induced abortion, and 16 with childbirth including two preterm deliveries at 24 and 35 weeks of gestation, respectively. The two preterm infants had low birth weight and one of them died 10 days after delivery due to respiratory failure. Among the 14 full-term infants, one infant was small for gestational age. There were no HIV-infected infants. Conclusion: The pregnancy rate of HIV-infected women in Korea is lower than that of the general population. Although several adverse pregnancy outcomes were observed, mother-to-child transmission of HIV infection was successfully prevented with effective preventive measures.

• Journal of Korean Medical Science
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• 제33권47호
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• pp.292.1-292.10
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• 2018

Background: We investigated the incidence of active tuberculosis among patients with inflammatory bowel disease (IBD) treated with tumor necrosis factor (TNF) inhibitors, with or without latent tuberculosis infection (LTBI). Methods: The study was performed at a Korean tertiary referral center between January 2011 and June 2017. In total, 740 patients with IBD who underwent LTBI screening tests and were followed-up for ${\geq}1$ year after TNF inhibitor treatment initiation were enrolled. LTBI was detected on the basis of tuberculin skin test results, interferon-gamma release assay results, chest X-ray findings, and previous tuberculosis treatment history. The patients were classified into LTBI (n = 84) or non-LTBI (n = 656) group. The risk of developing tuberculosis in each group was assessed on the basis of standardized incidence ratio (SIR) and 95% confidence interval (CI) for active tuberculosis. Results: Mean patient age was 33.1 years, and patients with Crohn's disease were predominant (80.7%). Within 1 year after the initiation of TNF inhibitor treatment, 1 patient in the LTBI group (1/84; 1.2%) and 7 patients in the non-LTBI group (7/656; 1.1%) developed active tuberculosis. The overall 1-year incidence of tuberculosis among the patients was significantly higher than that among the general population (SIR, 14.0; 95% CI, 7.0-28.0), and SIR was not affected by LTBI status (LTBI group: 14.5, 95% CI, 2.0-102.6; non-LTBI group: 14.0, 95% CI, 6.7-29.4). Conclusion: Patients with IBD undergoing TNF inhibitor treatment showed a higher 1-year incidence of tuberculosis than the general population irrespective of LTBI status.

• 대한안과학회지
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• 제59권11호
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• pp.1091-1096
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• 2018

목적: 양안 급성 폐쇄각녹내장 후 발생한 양안 비동맥염 앞허혈시신경병증 1예를 보고하고자 한다. 증례요약: 76세 여자 환자가 하루 전 시작된 양안 통증 및 시력저하로 방문하였다. 양안 시력 0.02, 안압은 우안 52 mmHg, 좌안 50 mmHg, 양안 각막부종과 얕은 전방이 관찰되었으며, 동공은 4 mm로 고정되어 있었다. 만니톨 주사로 안압하강 시킨 후 양안 레이저홍채절개술을 시행하였다. 그러나 2일 후 시력은 우안 안전수지 10 cm, 좌안 안전수지 50 cm로 더 감소되었고 양안 시신경 유두부종이 관찰되었다. 양안 급성 폐쇄각녹내장 후 발생한 비동맥염 앞허혈시신경병증으로 진단하고 경과관찰하였다. 한 달 뒤, 시력은 우안 0.02, 좌안 0.04로 약간 호전되었고, 양안 시신경 유두부종은 사라졌다. 매우 작은 유두함몰비와 시신경 창백과 위축이 관찰되었으며, 표준자동시야검사상 우안은 완전시야결손, 좌안에 상하 수평시야결손이 관찰되었다. 결론: 급성 폐쇄각녹내장이 비동맥염 앞허혈시신경병증의 선행 위험인자가 될 수 있으며, 구심동공운동장애와 유두부종, 다른 위험인자의 동반이 있는 경우 비동맥염 앞허혈시신경병증의 동반 가능성을 고려해야 한다.