• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.125-133
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• 2021

Purpose: The clinical outcomes were investigated to determine if arthroscopic management is a useful method for 19 hips with iliopsoas tendon impingement (IPI) after total hip arthroplasty (THA). Materials and Methods: Eighteen patients (19 hips), who complained of groin pain and flexion pain that persisted after THA from September 2013 to December 2019, were the subjects of this investigation. The mean time to manifestation after THA was four months (range, 1-9 months) in patients of an average age of 60 years (range, 50-69 years). Thirteen out of 18 patients underwent THA using the direct anterior approach and five by the lateral approach. IPI was diagnosed by the medical history, physical examination, blood test, radiographic examination using X-ray and computed tomography, and topical injection therapy. All patients underwent arthroscopic treatment and a dynamic arthroscopic physical examination after exposure to the iliopsoas tendon revealed impingement. Tenotomy was then performed on the muscle portion through the total tendon portion. Symptoms and pain levels of preoperative, postoperative and follow-up period were investigated and compared. Results: The Western Ontario and McMaster Universities Osteoarthritis Index score decreased from an average of 58.4 (range, 40-88) before surgery to an average of 35.0 (range, 15-76) after surgery. Similarly, the visual analogue scale decreased from an average of 4.0 (range, 2-6) before surgery to an average of 1.4 (range, 0-4) after surgery. Sixteen patients (88.9%) showed pain relief and improvement in the straight leg raise test, and two patients showed postoperative muscle weakness and sustained pain. In the follow-up period, muscle weakness improved. One patient underwent arthroscopic iliopsoas tenotomy at the lesser trochanteric level but the symptoms persisted. The clinical symptoms were improved after one more tenotomy at the joint level. Conclusion: Arthroscopic iliopsoas tenotomy performed in patients with IPI after THA showed good clinical results.

• 한국체육학회지인문사회과학편
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• v.57 no.3
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• pp.345-356
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• 2018

Objective: The purpose of this study was to investigate the local stability of the lower extremity joints and muscle activation patterns of the lower extremity during walking between falling and non-falling group in the elderly women. Method: Forty women, heel strikers, were recruited for this study. Twenty subjects (age:72.55±5.42yrs; height:154.40±4.26cm; mass:57.40±6.21kg; preference walking speed:0.52±0.17m/s; fall frequency=1.70±1.26 times) had a history falls(fall group) within two years and Twenty subjects (71.90±2..90yrs; height:155.28±4.73cm; mass:56.70±5.241kg; preference walking speed: 0.56±0.13m/s) had no history falls(non-fall group). While they were walking on a instrumented treadmill at their preference speed for a long while, kinematic and EMG signals were obtained using 3-D motion capture and wireless EMG electrodes, respectively. Local stability of the ankle and knee joint were calculated using Lyapunov Exponent (LyE) and muscles activation and their co-contraction index were also quantified. Hypotheses were tested using one-way ANOVA and Mann-Whitey. Spearman rank was also used to determine the correlation coefficients between variables. Level of significance was set at p<.05. Results: Local stability in the knee joint adduction-abduction was significantly greater in fall group than non-fall group(p<.05). Activation of anterior tibials that acts on the foot segment dorsal flexion was greater in non-fall group than fall group(p<.05). CI between gastrocnemius and anterior tibials was found to be significantly different between two groups(p<.05). In addition, there was significant correlation between CI of the leg and LyE of the ankle joint flexion-extention in the fall group(p<.05). Conclusion: In conclusion, muscles that act on the knee joint abduction-adduction as well as gastrocnemius and anterior tibials that act on the ankle joint flexion-extention need to be strengthened to prevent from potential fall during walking.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• Journal of agricultural medicine and community health
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• v.30 no.2
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• pp.213-225
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• 2005

Objectives: This study was carried out to evaluate the socio-demographic, style of living, and health related behaviors of community residents between urban and rural areas in Jeonbuk province. Methods: The data was obtained from 2,086 residents who lived in Jeonbuk province from July to September 2001 which included 1,238 residents in urban area and 848 residents in rural area. Results: The results were as follows; There were significant differences socio-demographic characteristics including occupation and educational level of the populations between urban and rural areas. In the urban populations, housewives, professional classes, and people who received collage graduate education were significantly higher, people who were engaged in the primary industries and lower educational classes(below middle school), in contrast, were significantly lower than in the rural populations. In the practice of health behavior, consumption of health foods and amount of exercise in urban populations were significantly higher than in the rural, whereas the state of health, prevalence of chronic disease, Body Mass Index(BMI), consumption of ethanol and cigarette, and hours of sleep were not significantly different between the urban and rural populations. In the eating habits, rate of surfeit, vaccination of hepatitis B, and screening of cancer in the urban populations were significantly higher than in the rural, rate of regular meal, taste of salted food, consumption of vegetables, in contrast. were significantly lower than in the rural. But, consumption of coffee, intake of meat, and periodic medical checkup were not significantly different between urban and rural communities. Logistic regression analysis revealed that the factors associated with subjective thought on health state were sex, age, occupation, educational level, exercise, and consumption of coffee. Logistic regression analysis to find related factor with prevalence of chronic disease was conducted. As a results, age, educational level, BMI, intake of meat, screening of cancer, and consumption of health foods were related to prevalence of chronic disease. Conclusions: The study showed that special attention to device the health plan are necessary and it suggested that consideration of regional differences are required to provide the community health projects.

• Clinical and Experimental Pediatrics
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• v.51 no.2
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• pp.134-144
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• 2008

Purpose : This study aimed to investigate body shape perception, weight control behaviors and eating habits of adolescent girls in urban, suburban and rural areas of Korea to obtain basis for establishing adequate weight control program for adolescent. Methods : From May 2002 to November 2002, a cross-sectional questionnaire survey and physical examination were conducted to examine body shape perception, weight control behaviors, eating habits and health status of 2,891 adolescent girls and 891 boys in Seoul, Ansan and Paju. Results : The proportion of underweight adolescent girl was decreased in rural area than in urban area. 46.3% of girls considered themselves to be somehow or very obese. Notably 3.2% of underweight girls considered themselves obese. 57.9% were unsatisfied with their own body shape. The proportion of dissatisfaction increased with age and body mass index (BMI), but there were no differences among area. The experiences of weight control increased by age, BMI and dissatisfaction of own body shape. The eating attitudes test-26 (EAT-26) score of girls was significantly higher than that of boys. The girls with high risk of eating disorder were 10.9%. And risk factors of eating disorder were living in urban area, severe stress for weight control excessive expenditure for appearance and think themselves unhealthy. Conclusion : The findings of this study demonstrate that there were serious impairment of body shape perception of adolescent girls and unhealthy, inadequate weight control behaviors were widely done. Therefore adequate weight control program for adolescent girl should be established promptly.

• Journal of Korean society of Dental Hygiene
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• v.11 no.2
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• pp.197-211
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• 2011

Objectives : OHIP-14 and EQ-5D were used, targeting the residents of farming communities to identify the elements that influence oral cavity's health and quality of life due to health and to identify the importance of oral cavity's health in order to increase health of adults' oral cavity and quality of life via improved health. Methods : This research was conducted from July 17th, 2010 to August 16th, 2010 targeting 600 residents in Goryeong-gun, Gyeongsangbuk-do, aging over 40. The data has been analyzed using Mann-Whitney U test, Kruskal-Wallis test and hierarchical multiple regression through SPSS Win Program 18.0 version. Results : 1. OHIP-14 and EQ-5D based on general characteristics showed lower oral health-related quality of life and health-related quality of life on the following cases: women (p=0.004, p<0.001), older (p<0.001, p<0.001), lower scholastic ability (p<0.001, p<0.001), lower average of average spending money (p<0.001, p<0.001), higher number of chronic disease (p<0.001, p<0.001), less drinking (p=0.012, p=0.008), lower perceived oral health and health status (p<0.001, p<0.001) and non smoking showed only EQ-5D (p<0.001). 2. OHIP-14 and EQ-5D based on oral health behavior showed lower oral health-related quality of life and health-related quality of life on the following cases: no periodic oral check-up (p<0.001, p<0.001), less experience of oral health education (p<0.001, p<0.001), horizontal tooth-brushing method(p<0.001, p<0.001) and lower frequency of tooth-brushing showed only OHIP-14 (p=0.042). OHIP-14 and EQ-5D based on oral health status and subjective oral symptom showed lower oral health-related quality of life and health-related quality of life on following cases: number of existing tooth less than 20 (p<0.001, p<0.001), the number of missing teeth more than 9 (p<0.001, p=0.044), DMFT (Decay, Missing, Filling Teeth) index more than 18 (p<0.001, p<0.001), wears denture (p<0.001, p<0.001), edentulous (p<0.001, p=0.002), have xerostomia (p<0.001, p<0.001) and have chewing discomfort (p<0.001, p<0.001). 3. Factors affecting OHIP-14 were gender, age, perceived oral health status, perceived health status, number of existing teeth, dental status, xerostomia and chewing discomfort, and the of reliability (how well it explains) the final model was 48.7%. EQ-5D showed relevance on gender, age, presence of chronic disease, perceived health status, xerostomia, chewing discomfort and oral health-related quality of life, and the reliability of the final model was 42.9%. Conclusions : In order to improve the quality of life of ruralists, oral health needs to be improved or remained by increasing the rate of possession of the existing teeth and preventing the loss of teeth. In order to do so, improvement of accessibility of dental clinic, change of direction from treatment-centered to prevention-centered health care system, development of oral health education program and various oral health care policies which would vitalize continuous oral health care system are considered to be necessary.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.614-618
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• 2010

Background: The aim of our study was to assess the extent of regression of left ventricular mass after aortic valve replacement in isolated aortic regurgitation. Material and Method: Retrospective analysis of echocardiographic data was collected preoperative and postoperative 1 year. There were 20 patients (12 males, 8 females, mean age $55.8{\pm}11.8$ years, mean body surface area $1.64{\pm}0.19m^2$) with aortic regurgitation from 2002 through 2007. We studied the change of left ventricular ejection fraction, ventricular septum and left ventricular posterior wall thickness, and left vemtricular muscle index (LVMI). The control group was age matched with normal echocardiographic study results. Patients with combined surgery or infective endocarditis were excluded. Result: Seven cases of tissue valves and thirteen cases of mechanical valve were used. The valve sizes were 21 mm (3 cases), 23 mm (13 cases) and 25 mm (4 cases). The postoperative ($125.5{\pm}42g/m^2$) LVMI has decreased than preoperative LVMI ($212.3{\pm}80g/m^2$, p=0.000) but higher than that of control group ($80.5{\pm}15.9g/m^2$, p=0.000). Postoperative septal wall (systolic/diastolic: $13.5{\pm}3.4mm/17.1{\pm}4.1mm$) and left ventricular posterior wall (systolic/diastolic: $12.9{\pm}3.4mm/16.7{\pm}3.4mm$) thickness were slightly decreased after the valve replacement but was not significantly different than preoperative levels. And postoperative interventricular septal wall and left ventricular posterior wall thickness (systolic/diastolic: $8.6{\pm}1.4mm/12.1{\pm}1.7mm$, systolic/diastolic: $8.4{\pm}1.4mm/13.2{\pm}1.9mm$) were higher than that of the control group (p<0.001). Conclusion: The significant regression of LVMI after aortic valve replacement developed at postoperative one year but the level was higher than control group. The main cause of decreased LVMI is decreased in left ventricular dimension.

• Sleep Medicine and Psychophysiology
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• v.21 no.2
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• pp.74-79
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• 2014

Objectives: Shift work is a stressful situation. It is important to know the factors associated with the ability to adapt to a shift work schedule. The aim of the present study was to investigate the association between sleep, as well as personality variables, and the resilience of shift work nurses. Method: Self-report questionnaires were administered to 95 nurses who worked in one national university hospital. Connor-Davidson resilience scale, hospital anxiety and depression scale, morningness-eveningness scale, Pittsburgh sleep quality index, other sleep-related questionnaires, and Korean defense style questionnaires were used. Results: Age, shift work duration, off-day oversleep, depression, anxiety, adaptive defense style, and self-suppressive defense style were significantly associated with resilience (p < 0.05). Multiple regression analysis showed that age (${\beta}=0.34$, p < 0.05), depression (${\beta}=-0.25$, p < 0.05), adaptive defense style (${\beta}=0.45$, p < 0.001), and self-suppressive defense style (${\beta}=-0.19$, p < 0.05) significantly predicted the resilience of shift work nurses. Concerning individual defense mechanisms, resignation (${\beta}=-0.20$, p < 0.05), sublimation (${\beta}=0.19$, p < 0.05), omnipotence (${\beta}=0.19$, p < 0.05), and humor (${\beta}=0.20$, p < 0.05) significantly predicted the resiliency. Conclusion: The findings indicate that a specific defense style and other mechanisms were associated with the resilience of shift work nurses. A future prospective study with more participants could further clarify the relationship between sleep-related variables, as well as personality factors, and resilience of shift work nurses.

• Analytical Science and Technology
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• v.28 no.6
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• pp.417-424
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• 2015

In this study, the relationship between selenoprotein concentrations in blood and stomach cancer have been searched for Korean. The concentration of each selenoprotein in blood serum was analyzed and the correlation between the concentration and stomach cancer was studied to find a potential for using Selenium as a biomarker. In concentration determination, a simple calibration curve method was used with the monitoring of m/z 78 without the use of solid phase extraction. This is a lot more simple than the method using SPE with post column isotope dilution. The result obtained from the analysis of CRM BCR-637, 72.20±3.35 ng·g⁻¹, showed similar value of reference value (81±7 ng·g⁻¹). The total concentration of Se for the controlled group, cardiovascular patients group, was 105.70±21.20 ng·g⁻¹. This value was the same as normal healthy person reported earlier. Each selenoprotein concentration of GPx, SelP and SeAlb was 26.12±7.84, 65.15±14.50, 14.43±6.99 ng·g⁻¹, respectively. The distribution of each selenoprotein was 24.7%, 61.6%, and 13.7%, which was similar to the normal person. The result of stomach cancer patients, the total concentration of Se was 76.11±28.12 ng·g⁻¹ and each concentration of GPx, SelP and SeAlb was 15.41±9.01, 50.83±17.91, and 9.87±5.21 ng·g⁻¹, respectively. The total and each selenoprotein concentration level showed significant decrease for the stomach cancer patients. The level of decrease was 41.0% for GPx, 22.0% for SelP, and 31.6% for SeAlb. However, the distribution of each selenoprotein was not much different. Either total Selenium or each selenoprotein could be used as a possible index for the diagnosis of cancer. However, in age group study, it is shown that young age group (30's-40's) did not show much difference.

• Sleep Medicine and Psychophysiology
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• v.15 no.2
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• pp.87-93
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• 2008

Introduction: Although it is well known that medical students are not getting an adequate amount of sleep, there have been only few studies on the sleep patterns of medical students in Korea. Therefore, the present study aimed to investigate the life style and sleep patterns of Korean medical students and the impact they have on the students' academic performance. Methods: A questionnaire package was administered to the $3^{rd}$ year medical students at the Seoul National University to examine their sleep patterns on weekdays and weekends. It consisted of questions asking about their lifestyles as well as Pittsburgh sleep quality index (PSQI) and GPA (Grade Point Average) that are considered relevant to their sleep patterns. A total of 110 students (85 males and 25 females, mean age $24.4{\pm}20.6$) responded to the survey and the result was analyzed using the independent t-test, the chi-square test, the paired t-test, Pearson's rank correlation and ANOVA. P-values of less than 0.05 were considered statistically significant in all analyses. Results: The weekend bedtime was significantly delayed (01：24 on weekday；03：12 on weekend; t=-5.23, p<0.01), the weekend rise time was delayed (07：36 on weekday；10：30 on weekend ; t=-24.48, p<0.01) and the total sleep time was increased on weekends (5：57 on weekday；8：17 on weekend ; t=15.94, p<0.01). They wished to sleep for 7 hours 6 minutes which was different from their actual weekday total sleep time (t=-11.41, p<0.01). The poor sleeper group had lower GPAs than the good sleeper group (t=2.05, p<0.05). The GPA of medical students were negatively correlated with age (r=-0.23, p<0.05), daily amount of smoking (r=-0.78, p<0.01), total amount of smoking (r=-0.75, p<0.01), weekday sleep latency (r=-0.23, p<0.05), weekend sleep latency (r=-0.23, p<0.05) and PSQI score (r=-0.30, p<0.01). Conclusion: Medical students were experiencing a lack of sleep during weekdays as they have a later bedtime and earlier rise time, and consequently had more hours of sleep on weekends. Overall, the responded students were experiencing poor sleep quality, and the GPAs of the poor sleeper group were lower than those of the good sleeper group.