• Journal of Gastric Cancer
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• 제24권2호
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• pp.145-158
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• 2024

Purpose: Although smoking and alcohol consumption are known risk factors for gastric cancer (GC), studies assessing their effects on early-onset GC are limited. In this nationwide, population-based, prospective cohort study, we assessed the effects of smoking and alcohol consumption on early-onset GC in patients aged <50 years. Materials and Methods: We analyzed data of patients aged 20-39 years who underwent cancer and general health screening in the Korean National Health Screening Program between 2009 and 2012. We calculated the adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for GC incidence until December 2020. Results: We enrolled 6,793,699 individuals (men:women=4,077,292:2,716,407) in this cohort. The mean duration of follow-up was 9.4 years. During follow-up, 9,893 cases of GC (men:women=6,304:3,589) were reported. Compared with the aHRs (95% CI) of never-smokers, those of former and current-smokers were 1.121 (1.044-1.205) and 1.282 (1.212-1.355), respectively. Compared with the aHRs (95% CI) of non-consumers, those of low-moderate- and high-risk alcohol consumers were 1.095 (1.046-1.146) and 1.212 (1.113-1.321), respectively. GC risk was the highest in current-smokers and high-risk alcohol consumers (1.447 [1.297-1.615]). Interestingly, alcohol consumption and smoking additively increased the GC risk in men but not in women (P_interaction=0.002). Conclusion: Smoking and alcohol consumption are significant risk factors for early-onset GC in young Koreans. Further studies are needed to investigate sex-based impact of alcohol consumption and smoking on GC incidence in young individuals.

• 한국산학기술학회논문지
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• 제19권3호
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• pp.499-508
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• 2018

본 연구는 남자 간호 대학생을 대상으로 군복무를 위한 의무병 역할 과정에서 무엇을 경험하였고 이러한 경험이 복학 후 간호대학 교과과정에서 어떠한 영향을 미치게 되었는지 경험한 내용을 파악하고자 함이며 이를 토대로 간호대학에서 남학생들을 대상으로 하는 간호 교육에 기초적 자료를 제공하고자 하는데 목적이 있다. 본 연구는 질적 연구 중 포커스그룹 인터뷰를 실시하여 심층적 내용 중 공통적으로 존재하는 자료를 수집하였다. 연구 참여자는 의무병을 경험한 남자 간호대학생 15명을 선정하여 3개의 포커스그룹으로 심층적 인터뷰를 통해 실시하였다. 본 연구결과에서는 5개의 주제가 도출되었으며, '다양한 의무병 역할에 대한 인식', '특수한 질병관리 및 처리능력 습득'. '계급별 업무 특성에 대한 적응'. '의료계 네트워크의 인식'. '학교 교과목의 선행학습'등으로 나타났다. 본 연구결과를 바탕으로 남자 간호 대학생의 의무병 경험은 다양한 역량을 계발하도록 하며 이러한 역량은 다시 학교 교육현장으로 복귀하거나 추후 간호사로써의 역할에서 수월한 인간관계 및 주어진 업무수행에 대해 자신감을 가지고 능력을 발휘 할 수 있도록 돕는 것으로 나타났다. 본 연구결과를 통해 남자 간호대학생의 의무병 경험은 개인적 능력 및 학업능력 강화 뿐만 아니라 간호사의 역할에서도 다양한 능력을 발휘 할 수 있도록 돕는다는 이론적 근거를 제시하고자 한다.

• 한국산학기술학회논문지
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• 제20권11호
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• pp.157-163
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• 2019

본 연구는 노인 인구에서 대조군과 만성폐쇄성폐질환 환자의 빈혈 유병률과 헤모글로빈 농도의 차이를 살펴보고자 시행되었다. 또한, 본 연구는 노인 인구에서 만성폐쇄성폐질환의 중증도에 따른 빈혈 유병률과 헤모글로빈 농도를 조사하였다. 제 7기 국민건강영양조사 1차 년도(2016) 조사에 참여한 8150명의 의무기록을 분석하여 총 694명이 연구에 포함되었다. 대상자를 만성폐쇄성폐질환군과 비질환 대조군으로 분류하였고, 헤모글로빈, 헤마토크리트, 적혈구 농도 및 빈혈 유병 유무를 조사하였다. 만성폐쇄성폐질환군은 중증도에 따라 하위그룹으로 나누어 동일한 분석을 시행하였다. 비질환 대조군과 만성폐쇄성폐질환군의 빈혈 유병률은 그룹 간에 차이가 없었다. 비질환 대조군에 비해 만성폐쇄성폐질환군의 헤모글로빈, 헤마토크리트 및 적혈구 농도가 통계적으로 유의하게 높았다. 통계적으로 유의하진 않았으나, 만성폐쇄성폐질환의 중증도가 심해짐에 따라 빈혈 유병률은 감소하고 헤모글로빈, 헤마토크리트 및 적혈구 농도는 증가하는 경향성을 보였다. 본 연구를 통해 노인 만성폐쇄성폐질환 환자의 빈혈 유병률 및 헤모글로빈 농도에 대한 구체적인 자료를 제시할 수 있었다. 노인 만성폐쇄성폐질환 환자에서 빈혈이 발생한다면 원인에 대한 추가적인 평가를 고려해 봐야 한다.

• 지역사회간호학회지
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• 제6권2호
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• pp.319-334
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• 1995

To investigate the risk factors of low back pain, an epidemiological study was carried out among male workers aged 20-55 employed in an automobile industry in Korea during the time period from February 1993 to October 1995. Workers participated to this study were divided into low back pain group(LBP) and control group, according to the self-reports by written questionnaires. General characteristics, medical history, work related factors, fatigue, and MMPI were compared between two groups. To clarify the relationship between job related low back pain and radiologic features of lumbar spine, radiographic study was carried out. The resultant data were processed for $x^2-test$, t-test, and stepwise logistic regression to confirm the adjusted odds ratios. The results were as follows: 1. History of back disease, lifting and carrying work, excessive physical fatigue, and weakend back strength of individual workers were directly associated with low back pain. Odd ratios of these 4 risk factors of low back pain were 5.07, 3.34, 1.49, and 1.22 respectively. 2. The frequency of low back pain history was significantly higher in LBP group. 3. Back muscle strength of lumbar spine of LBP group were significantly lower than control group. 4. The workers in LBP group revealed high fatigue symptoms. 5. In MMPI test LBP group showed higher scales in hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizophrenia, and hypomania. 6. LBP group were more frequently involved in lifting and carrying, working in awkward position, bending, twisting and using lower extremities. 7. LBP group were exposed more to vibration during working. 8. In the Analysis of radiographs of lumbar spine, Jacob's line not crossing fourth lumhar disc space, transitional vertebrae and lumbar displacement more than 4.4mm in standing lateral view were more frequently observed in LBP group than control group. Through these results, it is concluded that identification of previous history of back problem, change of work or working environment for workers with previous back problem and measures to relieve both physical and psychological fatigue of the workers are required for optimal management of work-related back problems among workers. In the present study, several results were different from the previous reports: Jacob's line not corssing fourth lumbar disc space, lumbarization, and vertebral slipping (spondylolisthesis) more than 4.4mm are related to backache. Meticulous studies are required to elucidate the difference.

• Journal of Radiation Protection and Research
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• 제47권4호
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• pp.195-203
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• 2022

Background: The aim of the present study was to determine radioactive concentrations in fertilizers known to contain essential nutrients. Results of this study could be used as basic data to monitor the impact of chemical fertilizers on the environment and public health. Nitrogen fertilizers, calcium fertilizers, sulfur fertilizers, phosphate acid fertilizers, and potassium chloride fertilizers were used in this study. Materials and Methods: Five chemical fertilizers were pulverized, placed in polyethylene containers, and weighed. The time to measure each specimen was set to be 3,600 seconds for a scintillator-based gamma-ray spectroscopy system. Concentration of gamma radionuclide was analyzed based on obtained spectra. At the end of the measurement, the spectrum file was stored and used to calculate radioactive concentrations using a gamma-ray spectrometer software. Results and Discussion: In the nitrogen fertilizer, 3.49 ± 5.71 Bq/kg of ¹³⁷Cs, 34.43 ± 7.61 Bq/kg of ¹³⁴Cs, and 569.16 ± 91.15 of ⁴⁰K were detected whereas ¹³¹I was not detected. In the calcium fertilizer, 5.74 ± 4.40 Bq/kg of ¹³⁷Cs (the highest concentration among all fertilizers), 22.37 ± 5.39 Bq/kg of ¹³⁴Cs, and 433.67 ± 64.24 Bq/kg of ⁴⁰K were detected whereas ¹³¹I was not detected. In the sulfur fertilizer, 347.31 ± 55.73 Bq/kg of ⁴⁰K, 19.42 ± 4.53 Bq/kg of ¹³⁴Cs, 2.21 ± 3.49 of ¹³⁷Cs, and 0.04 ± 0.22 Bq/Kg of ¹³¹I were detected. In the phosphoric acid fertilizer, 70,007.34 ± 844.18 Bq/kg of ⁴⁰K (the highest concentration among all fertilizers) and 46.07 ± 70.40 Bq/kg of ¹³⁴Cs were detected whereas neither ¹³⁷Cs nor ¹³¹I was detected. In the potassium chloride fertilizer, 12,827.92 ± 1542.19 Bq/kg of ⁴⁰K was and 94.76 ± 128.79 Bq/kg of ¹³⁴Cs were detected whereas neither ¹³⁷Cs nor ¹³¹I was detected. The present study examined inorganic fertilizers produced by a single manufacturer. There might be different results according to the country and area from which fertilizers are imported. Further studies about inorganic fertilizers in more detail are needed to create measures to reduce ⁴⁰K. Conclusion: Measures are needed to reduce radiation exposure to ⁴⁰K contained in fertilizers including phosphoric acid and potassium chloride fertilizers.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.245-248
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• 1997

Operative interventions for the management of osteonecrosis of the femoral head (ONFH) include core drilling, with or without vascularized fibular bone grafting. Nevertheless, their clinical results have not been consistently satisfactory. Recently, a new surgical procedure that incorporates cementation with polymethylmethacrylate (PMMA) after core drilling has been tried clinically. In this study, a biomechanical analysis using a finite element method(FEM) was undertaken to evaluate surgical methods and their underlying surgical parameter. Our finite element models included five types. They were (1) normal model (Type I), (2) necrotic model (Type II), (3) core decompressed model (Type III). (4) fibular bone grafted model (Type IV), and (5) cemented with PMMA model (Type V). The geometric dimensions of the femur were based on digitized CT-scan data of a normal person. Various physiological loading conditions and surgical penetration depths by the core were used as mechanical variables to study their biomechanical contributions in stress transfer within the femoral head region. In addition. the peak von Mises stress(PVMS) within the necrotic cancellous bone of the femoral head was obtained. The fibular bone grafted method and cementation method provided optimal stress transfer behaviors. Here. substantial increase in the low stress level was observed when the penetration depth was extended to 0mm and 5mm from the subchondral region. Moreover, significant decrease in PVMS due to surgery was observed in the fibular bone grafted method and the cementation method when the penetration depths were extended up to 0 and 5mm from the subchondral region. The drop in PVMS was greater during toe-off than during heel-strike (57% vs. 28% in Type IV and 49% vs. 22% in Type V). Both the vascularized fibular bone grafting method (Type IV) and the new PMMA technique (Type V) appear to be very effective in providing good stress transfer and reducing the peak Von-Mises stress within the necrotic region. Overall results show that fibular bone grafting and cementation methods are quite similar. In light of above results, the new cementation method appears to be a promising surgical alternative or the treatment of ONFH. The use of PMMA for the core can be less prone to surgical complication as opposed to preparation of fibular bone graft and can achieve more immediate fixation between the core and the surrounding region.

• Annals of Pediatric Endocrinology and Metabolism
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• 제23권4호
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• pp.196-203
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• 2018

Purpose: The hemoglobin glycation index (HGI) represents the degree of nonenzymatic glycation and has been positively associated with cardiometabolic risk factors (CMRFs) and cardiovascular disease in adults. This study aimed to investigate the association between HGI, components of metabolic syndrome (MS), and alanine aminotransferase (ALT) in a pediatric nondiabetic population. Methods: Data from 3,885 subjects aged 10-18 years from the Korea National Health and Nutrition Examination Survey (2011-2016) were included. HGI was defined as subtraction of predicted glycated hemoglobin ($HbA1_c$) from measured $HbA1_c$. Participants were divided into 3 groups according to HGI tertile. Components of MS (abdominal obesity, fasting glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure), and proportion of MS, CMRF clustering (${\geq}2$ of MS components), and elevated ALT were compared among the groups. Results: Body mass index (BMI) z-score, obesity, total cholesterol, ALT, abdominal obesity, elevated triglycerides, and CMRF clustering showed increasing HGI trends from lower-to-higher tertiles. Multiple logistic regression analysis showed the upper HGI tertile was associated with elevated triglycerides (odds ratio, 1.65; 95% confidence interval, 1.18-2.30). Multiple linear regression analysis showed HGI level was significantly associated with BMI z-score, $HbA1_c$, triglycerides, and ALT. When stratified by sex, age group, and BMI category, overweight/obese subjects showed linear HGI trends for presence of CMRF clustering and ALT elevation. Conclusion: HGI was associated with CMRFs in a Korean pediatric population. High HGI might be an independent risk factor for CMRF clustering and ALT elevation in overweight/obese youth. Further studies are required to establish the clinical relevance of HGI for cardiometabolic health in youth.

• 한국전문물리치료학회지
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• 제15권1호
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• pp.86-95
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• 2008

The Pediatric Balance Scale (PBS) is a modified Berg's Balance Scale developed as a balance measure for school-aged children with mild to moderate motor impairments. The purpose of this study was to determine the inter-examiner reliability of the Korean version of PBS when applied to children with developmental delays. In this study, PBS was administrated to a total of 79 children with developmental delays (17 with global developmental delay, 31 with cerebral palsy, and 31 with mental retardation) in the Seoul Community Rehabilitation Center. Two pediatric trained physical therapists with longer than 13 year of clinical experience scored the children's performance blind, while replaying videotaped data. The inter-examiner reliability was statistically determined by intraclass correlation coefficients (ICCs). The results of this study revealed that the Korean version of PBS seems to have high inter-examiner reliability when applied to children with movement disorders such as global developmental delay (ICC=.96) and cerebral palsy (ICC=.97); however, it has relatively lower inter-examiner reliability (ICC=.78) for children with developmental delay secondary to mental retardation. therefore, the results support that the Korean version of the PBS could be a useful clinical measurement to assess the balance skills for children with developmental delay who have an adequate level of cognition to enable them to fol1ow the verbal instructions to complete the test.

• The Korean Journal of Pain
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• 제30권4호
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• pp.272-280
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• 2017

Background: The high cost of intrathecal morphine pump (ITMP) implantation may be the main obstacle to its use. Since July 2014, the Korean national health insurance (NHI) program began paying 50% of the ITMP implantation cost in select refractory chronic pain patients. The aims of this study were to investigate the financial break-even point and patients' satisfaction in patients with ITMP treatment after the initiation of the NHI reimbursement. Methods: We collected data retrospectively or via direct phone calls to patients who underwent ITMP implantation at a single university-based tertiary hospital between July 2014 and May 2016. Pain severity, changes in the morphine equivalent daily dosage (MEDD), any adverse events, and patients' satisfaction were determined. We calculated the financial break-even point of ITMP implantation via investigating the patient's actual medical costs and insurance information. Results: During the studied period, 23 patients received ITMP implantation, and 20 patients were included in our study. Scores on an 11-point numeric rating scale (NRS) for pain were significantly reduced compared to the baseline value (P < 0.001). The MEDD before ITMP implantation was 0.59 [IQR: 0.55-0.82]. The total MEDD increased steadily to 0.77 [IQR: 0.53-1.08] at 1 year, which was 126% of the baseline (P < 0.001). More than a half (60%) responded that the ITMP therapy was somewhat satisfying. The financial break-even point was 28 months for ITMP treatment after the NHI reimbursement policy. Conclusions: ITMP provided effective chronic pain management with improved satisfaction and reasonable financial break-even point of 28 months with 50% financial coverage by NHI program.

• 융합정보논문지
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• 제10권6호
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• pp.183-192
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• 2020

본 연구의 목적은 치위생(학)과 학생들의 감성지능, 대인관계 유능성과 전공만족도와의 관련성을 파악하여 효과적인 치위생전공 대학생활과 높은 질적 수준의 치과의료서비스를 제공할 수 있는 예비 전문 치과위생사로써 증진방안을 모색하고자 시도되었다. 자료 수집은 2019년 4월 8일부터 2019년 4월 26일까지 대전·청주·군산지역의 치위생(학)과 학생들을 대상으로 편의표본추출법을 활용하여 자기기입식 설문법을 작성하였다. 감성지능과 대인관계 유능성은 양의 상관관계가 있는 것으로 나타났고, 전공만족도와도 양의 상관관계가 있는 것으로 나타났으며, 대인관계 유능성과 전공만족도는 양의 상관관계를 나타내었다. 전공만족도의 영향 요인은 감성지능, 대인관계 유능성, 임상실습 만족도로 나타났다. 이에 각 개별화된 맞춤 상담 및 교육적 접근이 요구되며, 감성지능과 대인관계능력 훈련프로그램을 접목시킨 다차원적인 향상 전략을 활용할 필요성이 있을 것으로 사료된다.