• 제목/요약/키워드: medical direction methods

검색결과 414건 처리시간 0.029초

일본 구강 재활 분야에서의 치과위생사의 역할 및 시사점 (The role and implications of dental hygienists in oral rehabilitation in Japan)

  • 강주현;최성미
    • 한국치위생학회지
    • /
    • 제22권6호
    • /
    • pp.477-483
    • /
    • 2022
  • Objectives: The purpose of this study was to provide basic data that would inform the direction of oral rehabilitation and how to expand of the role of dental hygienists in Japan. Methods: A systematic literature review was conducted on the role of dental hygienists in the field of oral rehabilitation in Japan. Results: Japan has been making academic and practical developments in the field of oral rehabilitation for over 30 years, and has been gradually implementing a fee support policy since the 1990s. In addition, Japan has been operating a dental hygienist system specializing in oral rehabilitation since 2006. The related work was being carried out with the dental hygienist's expertise in the field of rehabilitation medical treatment secured. Dental hygienists work full-time at long-term care facilities for the elderly in addition to conducting oral care activities under the local comprehensive care system, in the areas of convalescence and acute rehabilitation, as well as in the field of visiting rehabilitation. It can be seen that, in the field of nursing care, they are specialized in oral care tasks for the elderly. Conclusions: In the future, a policy and related fee system should be gradually prepared to expand the role of dental hygienists in the field of oral rehabilitation that can contribute to improving oral health linked to systemic diseases.

Impact of COVID-19 Pandemic on Psychological Well-Being of Firefighters

  • Elisabetta Riccardi;Luca Fontana ;Daniela Pacella;Fabio Fusco;Ilaria Marinaro;Giovanna Costanzo;Francesco Vassallo ;Maria Triassi ;Ivo Iavicoli
    • Safety and Health at Work
    • /
    • 제14권3호
    • /
    • pp.317-324
    • /
    • 2023
  • Background: COVID-19 pandemic represented a unique stressful event that affected the physical health and psychological well-being (PWB) of individuals and communities. Monitoring PWB is essential not only to clarify the burden on mental health effects but also to define targeted psychological-supporting measures. This cross-sectional study evaluated the PWB of Italian firefighters during the pandemic. Methods: Firefighters recruited during the pandemic period filled out a self-administered questionnaire, the Psychological General Well-Being Index, during the health surveillance medical examination. This tool is usually used to assess the global PWB and explores six subdomains: anxiety, depressed mood, positive well-being, self-control, general health, and vitality. The influencing roles of age, gender, working activities, COVID-19, and pandemic restrictive measures were also explored. Results: A total of 742 firefighters completed the survey. The aggregate median PWB global score was in the 'no distress"" range (94.3 ± 10.3), which was higher than that observed in studies conducted using the same tool in the Italian general population during the same pandemic period. Similar findings were observed in the specific subdomains, thus suggesting that the investigated population was in good PWB condition. Interestingly, significantly better outcomes were detected in the younger firefighters. Conclusion: Our data showed a satisfactory PWB situation in firefighters that could be related to different professional factors such as work organization and mental and physical training. In particular, our results would suggest the hypothesis that in firefighters, maintaining a minimum/moderate level of physical activity (consisting of even just going to work) might have a profoundly positive impact on psychological health and well-being.

최근 10년간(2010~2019) 의료기관 종사자의 업무상질병 및 역학조사 사례 특성 분석 (Analysis of Case Characteristics of Occupational Diseases and Epidemiological Investigation of Healthcare Workers)

  • 최지형;이지혜;이복임
    • 한국직업건강간호학회지
    • /
    • 제32권4호
    • /
    • pp.131-140
    • /
    • 2023
  • Purpose: We reviewed the cases of occupational diseases that occurred in healthcare workers from 2010 to 2019 and the cases of epidemiological investigations conducted by the Occupational Safety and Health Research Institute for them. Methods: In this study, gender, age, working period, occupational characteristics, and disease characteristics by occupation, which are general characteristics of healthcare workers approved for occupational diseases. In addition, 32 cases of epidemiological investigation of healthcare workers conducted by the Institute for Occupational Safety and Health for the past 10 years (2010~2019) were analyzed. Results: The gender, age, working period, occupational characteristics, and disease characteristics by occupation of medical workers recognized as occupational diseases were all statistically significant (p<.001). In the epidemiological investigation, ionizing radiation( 50.0%) and stress (33.3%) were recognized as disease-related factors, and even in cases of disapproval, ionizing radiation (60.0%) and shift work (25.5%) were designated as related factors. And it was statistically significant (p=.008). Conclusion: The current study identified the types of diseases, various causes, and general characteristics and occupational characteristics that occur frequently in healthcare workers. Therefore, if this study is used as basic information to set the priority and direction of disease prevention project for healthcare workers, it is judged that it will be helpful in preventing industrial accidents.

건강보험 급여 한약제제 56종 처방의 계량적 문헌 근거 현황 분석 (Analysis of the current status of quantitative literature evidence for the prescription of 56 herbal medicines covered by health insurance)

  • 김철;신현규
    • 대한한의학회지
    • /
    • 제44권3호
    • /
    • pp.189-200
    • /
    • 2023
  • Objectives: The purpose of this study is to analyze the current state of quantitative literature evidence for the prescription of 56 herbal medicines covered by health insurance that have been studied in Korea for the past 30 years, to evaluate the reliability of the evidence, and to find out the research direction of herbal medicine prescription in the future. Methods: 56 kinds of herbal medicine prescriptions were searched in domestic literature search databases OASIS, DBpia, and overseas PubMed, classified into chemistry, toxicity, cells, animals, clinical cases, and clinical trial studies, and built into an EBM pyramid structure. Results: When classified according to research contents, there were 61 cases (7.5%) of physicochemical analysis to identify constituent substances, 80 cases (9.8%) of toxicity evaluation, and 672 cases (82.7%) of efficacy evaluation. The efficacy evidence was classified according to the evidence-based medical pyramid structure: 196 cell trials (29.1%), 372 animal trials (55.4%), 89 case and case reporting series (13.3%), 7 comparative case studies (1.1%), and 8 randomized control clinical trials (1.2%). In the pyramid composition, the basis for the validity of 56 kinds of herbal medicines prescribed was 568 cases (84.5%) in cell and animal units, which could not be said to be highly reliable. There was no relationship between the ranking of quantitative literature evidence for herbal medicine prescriptions and the ranking of salary administration. Conclusions: In an era that continues to require scientific evidence for herbal medicine, traditional herbal medicine should secure the basis for safety validity even for the 10th most frequent prescription among 56 herbal medicine prescriptions for consumers. In particular, traditional herbal medicine should increase the quantitative and qualitative level of case reports on related herbal medicine prescriptions, focusing on each clinical society, and move toward comparative case studies and randomized clinical trial so that traditional herbal medicine is positioned as Evidence-based medicine.

Current strategies using 3D organoids to establish in vitro maternal-embryonic interaction

  • Islam Mohamed Saadeldin;Seif Ehab;Ahmed Elsayed Noreldin;Ayman Abdel-Aziz Swelum;Seonggyu Bang;Hyejin Kim;Ki Young Yoon;Sanghoon Lee;Jongki Cho
    • Journal of Veterinary Science
    • /
    • 제25권3호
    • /
    • pp.40.1-40.19
    • /
    • 2024
  • Importance: The creation of robust maternal-embryonic interactions and implantation models is important for comprehending the early stages of embryonic development and reproductive disorders. Traditional two-dimensional (2D) cell culture systems often fail to accurately mimic the highly complex in vivo conditions. The employment of three-dimensional (3D) organoids has emerged as a promising strategy to overcome these limitations in recent years. The advancements in the field of organoid technology have opened new avenues for studying the physiology and diseases affecting female reproductive tract. Observations: This review summarizes the current strategies and advancements in the field of 3D organoids to establish maternal-embryonic interaction and implantation models for use in research and personalized medicine in assisted reproductive technology. The concepts of endometrial organoids, menstrual blood flow organoids, placental trophoblast organoids, stem cell-derived blastoids, and in vitro-generated embryo models are discussed in detail. We show the incorportaion of organoid systems and microfluidic technology to enhance tissue performance and precise management of the cellular surroundings. Conclusions and Relevance: This review provides insights into the future direction of modeling maternal-embryonic interaction research and its combination with other powerful technologies to interfere with this dialogue either by promoting or hindering it for improving fertility or methods for contraception, respectively. The merging of organoid systems with microfluidics facilitates the creation of sophisticated and functional organoid models, enhancing insights into organ development, disease mechanisms, and personalized medical investigations.

방사선치료 시 전자포털 영상장치를 이용한 잡음전력스펙트럼 수평 및 수직 측정비교 (Comparison of Horizontal and Vertical Noise Power Spectrum in Measurements by Using Various Electronic Portal Imaging Devices in Radiation Therapy)

  • 김기원;최관우;정회원;장서구;권경태;손순룡;손진현;민정환
    • 대한방사선기술학회지:방사선기술과학
    • /
    • 제39권2호
    • /
    • pp.171-176
    • /
    • 2016
  • 영상화 품질향상은 방사선 치료영역과 진단영역의 영상화 검사와 같이 quality assurance (QA) 장비들의 특성평가에 매우 중요한 요소이다. 본 연구의 목적은 치료장비의 megavoltage X-ray 에너지를 사용하여 측정방법에 있어서 NPS에 대한 수평, 수직적인 방법에 대한 측정결과를 비교 평가하는 것이다. 잡음전력스펙트럼 평가 방법들은 국제 전기 규격 international electro-technical commission (IEC 62220-1) 기준을 사용하여 치료 영역에 적용되었다. 사용한 전자포털 영상장치(electronic portal imaging device, EPID)는 Siemens BEAMVIEW$^{PLUS}$, Elekta iViewGT 그리고 Varian Clinac$^R$ iX aS1000이었다. 데이터들로부터 각각의 주파수 값에 대응하는 노이즈 값들의 평균에 대해서, 각각의 주파수 별로 대응해서 표현하였으며, 수평 수직되어있는 주파수별 평균값의 노이즈값을 합산해서 정량적으로 장비마다 비교 평가하였다. 결과값은 Elekta iView에서 4가지 방법론에 의한 가로방향에서의 horizontal측정된 NPS값과 vertical 세로방향에서의 측정치는 비슷한 경향성에 따라서 horizontal과 vertical값은 3~5%정도의 차이가 있었으며, Siemens BEAMVIEW$^{PLUS}$, Varian Clinac$^R$ iX aS1000에서 horizontal측정된 NPS값과 vertical 측정된 NPS값은 편차의 차이가 전체값의 평균으로 했을 시 horizontal과 vertical값은 15%정도의 차이가 나타남을 보였다. 본 연구에서는 수평 수직되어있는 주파수별 평균값의 노이즈값을 합산해서 정량적으로 장비마다 비교 평가하였으며, 정량적인 평가방안을 제시하였다는 점을 둘 수 있다.

족저근막염의 중의학 치료에 대한 최신 임상 연구 동향: China National Knowledge Infrastructure 검색을 중심으로 - 2018년 이후 발표된 연구를 중심으로 (The Latest Research Trend on Chinese Medicine Treatment for Plantar Fasciitis Using China National Knowledge Infrastructure Database - Focused on Clinical Studies after 2018)

  • 신나영;고아라;이영진;안진우;조혜정;채고은;김현우;남혜진
    • 한방재활의학과학회지
    • /
    • 제33권2호
    • /
    • pp.33-48
    • /
    • 2023
  • Objectives The purpose of this study is to investigate the latest research trends regarding the traditional Chinese medicine treatment of plantar fasciitis and suggest the direction for future research. Methods We investigated recent clinical studies about traditional Chines medicine treatment for Plantar fasciitis through searching the electronic database of China National Knowledge Infrastructure. We analyzed the characteristics of selected studies according to study design, criteria for diagnosis and evaluation, periods, treatment methods. Results Twenty-six clinical studies published from 2018 to 2022 were analyzed. Acupuncture, herbal medication, herbal fumigation and washing, herbal integration, herbal external application, and manual therapy were performed for the treatment of plantar fasciitis in China. In particular, studies on acupuncture, herbal fumigation and washing, and manual therapy were actively conducted and all of these treatment methods were effective. Conclusions Various Chinese medical interventions are being studied in China for the treatment of plantar fasciitis. However, in order to reinforce evidence for effectiveness of treatment, additional high-level clinical studies are required. It is considered that additional research related to the Korean medicine treatment for plantar fasciitis is needed in the future in Korea.

소동물 영상을 위한 MicroPET R4스캐너의 특성평가 (Performance Characteristics of MicroPET R4 Scanner for Small Animal Imaging)

  • 이병일;이재성;김진수;이동수;최창운;임상무
    • 대한핵의학회지
    • /
    • 제39권1호
    • /
    • pp.49-56
    • /
    • 2005
  • 목적: 새로운 PET 추적자와 약물 개발, 유전자 및 줄기세포치료 연구 등에 소동물 전용 PET이 유용하게 쓰이고 있으며, 국내에도 최근에 microPET R4 소동물 전용 PET이 설치되어 각종 기초연구에 활발히 이용될 전망이다. 이 연구에서는 국내에 최초로 설치된 microPET R4 스캐너의 물리적 특성(공간분해능, 균일도, 민감도, 산란분획, NECR)을 측정하였다. 대상 및 방법: 내경 0.5 mm의 가는 모세관을 F-18으로 채워 만든 선선원을 이용하여 공간분해능 및 민감도를 측정하였다. 반경방향(radial) 및 접선방향(tangential) 분해능을 측정하기 위하여 60 mm의 선선원(65 ${\mu}Ci$)을 축방향과 나란하게 놓은 후 횡단면상 중앙에서부터 1 mm 간격으로 중심에서 4 cm 벗어난 지점까지 옮겨가며 각 2분간 PET 영상을 얻었다. 축방향(axial) 공간분해능 측정을 위하여서는 선선원을 축방향과 수직으로 놓고 동일한 실험을 반복하였다. PET 영상은 FBP 방법과 OSEM 방법으로 각각 재구성하였으며 가우시안 함수로 곡선정합하여 반치폭값을 구하였다. 축방향 위치에 따른 민감도 측정을 위하여 축방향 시야 길이와 동일한(78 mm) 선선원(16.5 ${\mu}Ci$)을 횡단면 중심에 축방향과 나란하게 위치시키고 불응시간이 1%이하가 됨을 확인한 후 축방향 중심에서 바깥방향으로 39 mm까지 (0.5 mm간격) 이동시키면서 각 4분간 PET 영상을 얻었다. 총동시계수에서 지연계수를 빼고 방사선 붕괴를 보정한 후 민감도를 계산하였다. 지름 60 mm, 길이 150 mm의 원통형 팬텀을 제작하여 NECR과 산란분획을 7반감기 동안 각 20분씩 얻은 데이터로부터 계산하였다. 결과: FBP로 재구성한 영상의 공간분해능은 횡단면 중심에서 각각 1.86 mm(반경 방향), 1.95 mm(접선방향), 1.95 mm(축방향)이었으며 중심에서 2 cm 벗어난 지점에서 각각 2.54 mm, 2.8 mm, 1.61 mm이었다. OSEM 영상의 공간분해능은 중심에서 각각 1.44 mm, 1.36 mm, 1.61 mm이었으며 중심에서 2 cm 벗어난 지점에서 각각 1.86 mm, 2.29 mm, 2.88 mm이었다. 민감도는 축방향 중심에서 2.36%, 축방향 시야길이의 1/4인 18.5 mm 지점에서 2.09%이었다. 산란분획은 20%이었으며, 최대 NECR은 242 kBq/mL에서 66.4 kcps이었다. 생쥐와 백서, 그리고 고양이의 뇌영상을 획득하여 영상의 품질을 확인하였다. 결론: 국내에 설치된 microPET R4의 공간분해능 및 민감도는 기존에 알려진 값들과 거의 유사하였으며, 소동물 PET 영상을 위하여 적합한 것으로 보인다.

폐암 환자의 정위적 방사선 수술 시 Respiratory Gating System의 유용성에 대한 연구 (Effectiveness of the Respiratory Gating System for Stereotectic Radiosurgery of Lung Cancer)

  • 송흥권;권경태;박철수;양오남;김민수;김정만
    • 대한방사선치료학회지
    • /
    • 제17권2호
    • /
    • pp.125-131
    • /
    • 2005
  • 목 적 : 폐암 환자 중 호흡에 의한 종양의 움직임이 큰 폐 하엽에서 정위적 방사선수술 시 호흡에 의한 종양의 움직임을 감소시키는 방법으로 종양의 움직임이 적은 호흡 주기에서만 방사선을 조사할 수 있는 respiratory gating system을 사용함으로써 그 유용성에 대하여 알아보고자 한다. 대상 및 방법 : 폐 하엽의 정위적 방사선 수술 환자 2명을 대상으로 하였으며, 환자의 복부에 maker block (sensor)을 부착하고 tracking camera와 Real Time Position Management (RPM)를 이용하여 호흡 주기를 측정하면서 1회 호흡주기에서 10 phases로 4D-CT를 촬영하였다. 종양의 위치 변화가 급격하지 않은 호흡주기 (%)의 phases를 치료 phases로 결정하였고, 치료 phases의 CT image를 Maximum Intensity Projection (MIP) 기법으로 재구성 후 volume contouring을 하였다. Set up의 재현성 및 GTV의 위치 변화를 확인하기 위해 치료 전과 치료 중 2회의 4D-CT 촬영을 하였다. 결 과 : GTV의 움직임이 가장 큰 Y(longitudinal)축에서 A환자는 전체 호흡주기($0{\sim}90%$)에서 9.4 mm가 치료 호흡 주기 범위 ($30{\sim}60%$)에서는 2.6 mm로, B환자는 전체 호흡주기 ($0{\sim}90%$)에서 11.7 mm가 치료 호흡주기의 범위($30{\sim}70%$)에서는 2.3 mm로 감소하였다. 2회의 4D-CT 비교 결과 set up의 X, Y, Z축 오차는 모두 3 mm이내였다. 결 론 : 호흡에 의한 종양의 움직임이 큰 폐 하엽에서 정위적 방사선수술 시행 시 respiratory gating system의 사용은 종양의 움직임을 5 mm이내로 감소시킬 수 있어 유용하였다.

  • PDF

안와 주변 방사선 치료 시 수정체 피폭선량 감소를 위한 2차 차폐의 유용성 평가 (Usefulness assessment of secondary shield for the lens exposure dose reduction during radiation treatment of peripheral orbit)

  • 곽용국;홍순기;하민용;박장필;유숙현;조웅
    • 대한방사선치료학회지
    • /
    • 제27권1호
    • /
    • pp.87-95
    • /
    • 2015
  • 목 적 : 안와 주변 방사선 치료 시 수정체 피폭선량감소를 위하여 사용된 2차 차폐 block의 유용성을 알아보고자 한다. 대상 및 방법 : Human phantom(Alderson Rando Phantom, The Phantom Laboratory, USA)을 사용하여 CT(Somatom Definition AS, Siemens, Germany) 모의촬영 후 전산화치료계획시스템(Pinnacle, PHILIPS, USA)을 통해 실제 치료와 유사한 IMRT치료계획을 실시하였다. 2차 차폐를 위하여 두께 3mm 지름 25 mm의 납판과 3 mm tungsten eye-shield block(Extra small size, Radiation Products Design, Inc, USA)를 사용하였으며, TPS(Treatment Planning System) 상의 lens dose와 모의치료 상의 lens dose를 OSLD로 측정 비교하였다. 또한, 5 cm 두께의 acrylic phantom에 동일한 조건의 2차 차폐물인 3 mm 납판과 tungsten eye-shield block을 사용하여 200 MU(6 MV, SPD(Source to Phantom Distance)=100 cm, $F{\cdot}S\;5{\times}5cm$)를 조사 및 측정하였으며, 조사야 밖의 누설선 및 투과방사선 영향을 제한시키고자 8 cm 납블럭(O.S.B: Outside Scatter Block)을 적용하여 위와 동일한 실험을 시행하였다. 조사야로부터 1 cm 이격하여 phantom 끝 옆면에 OSLD(Optically Stimulated Luminescence Dosimeter)를 부착하였고, eyelid의 두께에 해당하는 bolus 3 mm를 적용하였다. 결 과 : human phantom을 이용하여 IMRT 치료계획 상의 Lens dose와 실 측정치는 각각 315.9, 216.7 cGy가 측정되었고, 3 mm 납판과 tungsten eye-shield block으로 2차 차폐 후 각각 234.3, 224.1 cGy가 측정되었다. acrylic phantom을 이용한 실험 결과는 no block, 3 mm 납판, tungsten eye-shield block을 사용했을 때 5.24, 5.42, 5.39 cGy가 측정되었으며, 조사야 밖에 O.S.B를 적용하여 no block, 3 mm 납판, tungsten eye-shield block을 실험한 결과 각각 1.79, 2.00, 2.02 cGy가 측정되었다. 결 론 : 광자선 조사 시 critical organ을 보호하기 위하여 2차 차폐를 적용할 시에는 field 외부일지라도 헤드 누설방사선 및 collimator & MLC 투과방사선이 존재하므로 치료부위와 beam 방향에 따라 금속과 같은 높은 원자번호의 차폐물질이 critical organ근처에 있다면 선량 증가의 원인이 될 수 있다는 사실을 알 수 있었다. 따라서 피폭선량 감소를 위한 2차 차폐의 시도는 분명 의미가 있었으나 미 검증된 시도는 오히려 역효과를 가져올 수 있다는 사실을 인지하여 QA를 통해 목적에 부합하는 결과가 나오는지를 사전에 알아보아야 할 것이다.

  • PDF