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Inter-Rater Reliability of Carotid Intima-Media Thickness Measurements in a Multicenter Cohort Study (다기관 코호트 연구에서 경동맥 내막-중막 두께 측정의 측정자간 신뢰도 평가)

  • Lee, Jung Hyun;Choi, Dong Phil;Shim, Jee-Seon;Kim, Dae Jung;Park, Sung-Ha;Kim, Hyeon Chang
    • Journal of health informatics and statistics
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    • v.41 no.1
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    • pp.49-56
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    • 2016
  • Objectives: Carotid intima-media thickness (CIMT) and the presence of carotid artery plaque are widely used as preclinical markers of atherosclerosis. Due to operator dependency in measuring CIMT, it is important to evaluate the reliability of measuring CIMT and plaque between centers in a multicenter study. The purpose of this study is to evaluate the inter-rater reliability of CIMT and plaque presence among three clinical centers of the Cardiovascular and Metabolic Disease Etiology Research Center (CMERC). Methods: Twenty people without known cardiovascular disease (age 37-64) were enrolled during 2014-2015, and their left and right carotid arteries were examined repeatedly with ultrasonography for CIMT measurements at three clinical centers according to a predetermined protocol. Maximum and mean values of CIMT at distal common carotid artery were recorded. Plaque presence at a carotid artery was checked by an operator. The reliability of CIMT and carotid plaque presence was assessed using an intraclass correlation coefficient (ICC) and kappa statistics, respectively. Results: Calculated ICC was 0.647 (95% CI: 0.487-0.779) for maximum CIMT, and 0.758 (95% CI: 0.632- 0.854) for mean CIMT. In Bland Altman plot, most observed values were distributed within mean difference ${\pm}1.96$ SD ranges. Kappa statistics of plaque presence between two centers were 0.304 (center 1 and 2), 0.507 (center 1 and 3), and 0.606 (center 2 and 3), respectively, while Fleiss kappa for overall agreement was 0.445. Conclusions: The inter-rater reliability of CIMT measurements among three clinical centers turned out to be high, and the agreement of measuring carotid plaque presence was fair.

A Study on Dongbu Hamchunwon in Hanyang during the Joseon Dynasty (조선시대 한양 동부(東部) 함춘원(含春苑)에 관한 연구)

  • Oh, Jun-Young;Kim, Young-Mo
    • Korean Journal of Heritage: History & Science
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    • v.50 no.3
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    • pp.110-125
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    • 2017
  • The purpose of this study is to investigate the constructional facts and the operational features of Hamchunwon(含春苑), a wonyu(苑?, a royal garden) constructed in Dongbu(Eastern District) of the capital city of Hanyang. As the living quarters of the queen dowagers were scheduled for relocation after the construction of Changgyeonggung Palace(昌慶宮) during the reign of King Seongjong(成宗), it is presumed that the screening tree planting project discussed around tongmangcheo(通望處, a place allowing open view) was the original form of Dongbu Hamchunwon. Dongbu Hamchunwon was a longitudinal royal garden built in the area across the section from Wolgeunmun Gate(月覲門) to Seoninmun Gate(宣仁門), which were both attached to the east side walls of Changgyeonggung Palace. The area corresponds to the west side area of the newly built main building of Seoul National University Hospital today. During the Joseon Dynasty, only royal gardens built within a palace were referred to as geumwon(禁苑, a palace garden). But Dongbu Hamchunwon which was built outside a palace was recognized as a symbolic and hierarchical space comparable to geumwon. The site location of Donbu Hamchunwon was an important place that corresponded to Naecheongnyong(內靑龍) according to Hanyang's geomancy, and large-scale public works were prohibited in order to protect the vein of Naecheongnyong. During the reign of King Injo(仁祖), part of Dongbu Hamchunwon was partitioned as a ranch. The area around the ranch was called Madongsan(馬東山) and Bangmawon(放馬苑) and was an open space used for rest and pleasure (amusement). In the early days of Hamchunwon's construction, fast growing trees were planted to screen the view to Changgyeonggung Palace. However, after the construction of Gyeongmogung Shrine(景慕宮), a broad scale tree planting project was undertaken to complement Naecheongnyong's vapor of the earth. In particular, after the construction of Yugeunmum Gate(?覲門) and Yucheommun Gate(?瞻門) during the reign of King Jeongjo(正祖), Dongbu Hamchunwon functioned as a key point on the King's progress for paying respects to the ancestors, which followed the route of Palace(Changgyeonggung)-Wonyu(Hamchunwon)-Ancestral Shrine(Gyeongmogung).

Impact of Awareness and Educational Experiences on Cardiopulmonary Resuscitation in the Ability to Execute of Cardiopulmonary Resuscitation among Korean Adults (한국 성인에서 심폐소생술에 대한 인지, 교육경험이 그 시행능력에 미치는 영향)

  • Lee, Jae-Kwang;Kim, Jeongwoo;Kim, Kunil;Kim, Keunhyung;Kim, Dongphil;Kim, Yuri;Moon, Seonggeun;Min, Byungju;Yu, Hwayoung;Lee, Chealim;Jeong, Wonyoung;Han, Changhun;Huh, Inho;Park, Jung Hee;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.43 no.4
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    • pp.234-249
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    • 2018
  • This study was performed to identify the impact of awareness and educational experiences on cardiopulmonary resuscitation in the ability to execute of cardiopulmonary resuscitation among Korean adults. This study used original data of 2014 Community Health Data Survey. 228,712 participants in this survey were resident in South Korea who is aged 19 or older on July 2014. Participants in this survey were sampled an average of 900 residents(target error ${\pm}3percent$) per community health center of Korea. Data were analyzed by using R 3.1.3 employing chi-squared test, fisher's exact analysis, and logistic regression analysis. Ability to execute CPR was significantly higher in males(3.34 time), higher the education level (1.61 times), the white color occupation (1.14 times), the higher the income level (1.07 times), the higher the education level (0.91 times), non-hypertensive patients (1.12 times), non-diabetic patients (1.16 times), non-dyslipidemic patients (0.86 times), non-stroke patients (0.30 times), CPR education experience group (3.25 times), CPR experience group with manikin-based training (4.30 times), higher subjective health status (1.08 times, 1.16 times) respectively. This study identified that awareness, educational experience, and mannequin-based learning experience of CPR impacted on the ability to execute CPR. Responding to education-related factors could contribute to reducing the rate of out-of-hospital acute cardiac arrest by improving the ability to execute CPR of the general public.

Factors Influencing Sexuality Knowledge and Gender Sensitivity During Adolescents and Early Adulthoods (청소년기 및 초기 성인기의 성지식과 성인지 감수성에 영향을 미치는 요인)

  • Hae Su Na;Sun Goo Lee;Kang Min Baek;Woo Young Im;Seung-Gul Kang;Seong-Jin Cho;Kyoung-Sae Na;Jae Myeong Kang;Seo-Eun Cho;Seung Min Bae
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.25-32
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    • 2023
  • Objectives : This study investigated the level of sexuality knowledge and gender sensitivity and factors influencing on them among Korean high school and college students. Methods : 129 questionnaires from high school and college students with consent forms, collected from July to December of 2022, were analyzed. After identification of participants' gender, age, major, their report of the practicality of sex education, and their experience of violence or sexual assaults, participants' level of sexuality knowledge and gender sensitivity were compared. Results : Females showed higher gender sensitivity, regardless of age and group (p=0.004). The early adulthood group (≥19 years old) showed higher sexuality knowledge and gender sensitivity, compared to those adolescents (<19 years old). Among college students, those who majored in health science were identified with higher sexuality knowledge and gender sensitivity, compared to non-health science major students(p<0.001; p=0.005). Conclusions : This study revealed the significant differences in sexuality knowledge and gender sensitivity according to sex, age, and majors in adolescents and early adults. Therefore, it seems to be necessary to consider the differences in sexuality knowledge and gender sensitivity among age, sex, and majors when establishing public policy or legislation for sex crimes, including digital sex crimes.

Effects of Visiting Prehabilitation Program against Functional Decline in the Frail Elderly: A Prospective Randomized Community Trial (허약노인을 위한 방문재활 프로그램의 장애발생예방 효과에 대한 연구)

  • Kim, Chang-O;Lee, Heeyeon;Ho, Seung Hee;Park, Hyunsuk;Park, Chulwoo
    • 한국노년학
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    • v.30 no.4
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    • pp.1293-1309
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    • 2010
  • This study is aimed to evaluate the effects of community-based prehabilitation program developed to prevent functional decline in the frail elderly and to provide a basis to practically operate this program in the public health care service. From March to August 2009, 110 frail elderly people were recruited among the registered participants of the home visit program in Korea to perform a prospective randomized community trial. We randomly assigned these people into two groups. One group (n=50) participated in the visiting prehabilitation program for 3 months focusing on improving their muscle strength of upper and lower limbs, walking ability, and balancing. The other group (n=60) underwent our visiting fall prevention program for control. To assess the effectiveness of prehabilitation program, physical functioning (PF) and short physical performance battery (SPPB) were measured for the primary outcomes and also some other indicators: exercise performance, nutritional status, emotional functioning, experience of admission, and events of fall. As a result, significant improvements of geriatric functional status were noticed among the participants. After 3 months, PF increased by 1.3 ± 3.8 points in prehabilitation group and decreased by 1.1 ± 5.4 points in controls (p=.020). SPPB improved by 2.4 ± 2.0 points in prehabilitation group and increased only 0.3 ± 1.5 points in controls (p<.001). Significant effects were also shown in their exercise performance tests and emotional status, the number of multiple falls, and the experience of functional decline after the fall (p .002-.038). Visiting prehabilitation program is safe and effective program for frail older adults. Thus, it is strongly recommended to universally adopt this program to prevent functional decline in the frail elderly.

Analysis of Intervention in Activities of Daily Living for Stroke Patients in Korea: Focusing on Single-Subject Research Design (국내 뇌졸중 환자를 대상으로 한 일상생활활동 중재 연구 분석: 단일대상연구 설계를 중심으로)

  • Sung, Ji-Young;Choi, Yoo-Im
    • Therapeutic Science for Rehabilitation
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    • v.13 no.1
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    • pp.9-21
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    • 2024
  • Objective : The purpose of this study was to confirm the characteristics and quality of a single-subject research that conducted interventions to improve activities of daily living (ADL) in stroke patients. Methods : 'Stroke,' 'activities of daily living,' and 'single-subject studies' were searched as keywords among papers published in the last 15 years between 2009 and 2023 among Research Information Sharing Service, DBpia, and e-articles. A total of nine papers were examined for the characteristics and quality before analysis. Results : The independent variables applied to improve ADL included constraint-induced therapy, mental practice for performing functional activities, virtual reality-based task training, subjective postural vertical training without visual feedback, bilateral upper limb movement, core stability training program, traditional occupational therapy and neurocognitive rehabilitation, smooth pursuit eye movement, neck muscle vibration, and occupation-based community rehabilitation. Assessment of Motor and Process Skills was the most common evaluation tool for measuring dependent variables, with four articles, and Modified Barthel Index and Canadian Occupational Performance Measure were two articles each. As a result of confirming the qualitative level of the analyzed papers, out of a total of nine studies, seven studies were at a high level, two at a moderate level, and none were at a low level. Conclusion : Various types of rehabilitation treatments have been actively applied as intervention methods to improve the daily life activities of stroke patients; the quality level of single-subject studies applying ADL interventions was reliable.

A Study of Decrease Exposure Dose for the Radiotechnologist in PET/CT (PET-CT 검사에서 방사선 종사자 피폭선량 저감에 대한 방안 연구)

  • Kim, Bit-Na;Cho, Suk Won;Lee, Juyoung;Lyu, Kwang Yeul;Park, Hoon-Hee
    • Journal of radiological science and technology
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    • v.38 no.1
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    • pp.23-30
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    • 2015
  • Positron emission tomography scan has been growing diagnostic equipment in the development of medical imaging system. Compare to 99mTc emitting 140 keV, Positron emission radionuclide emits 511 keV gamma rays. Because of this high energy, it needs to reduce radioactive emitting from patients for radio technologist. We searched the external dose rates by changing distance from patients and measure the external dose rates when we used shielder investigate change external dose rates. In this study, the external dose distribution were analyzed in order to help managing radiation protection of radio technologists. Ten patients were searched (mean age: $47.7{\pm}6.6$, mean height: $165.5{\pm}3.8cm$, mean weight: $65.9{\pm}1.4kg$). Radiation was measured on the location of head, chest, abdomen, knees and toes at the distance of 10, 50, 100, 150, and 200 cm, respectively. Then, all the procedure was given with a portable radiation shielding on the location of head, chest, and abdomen at the distance of 100, 150, and 200 cm and transmittance was calculated. In 10 cm, head ($105.40{\mu}Sv/h$) was the highest and foot($15.85{\mu}Sv/h$) was the lowest. In 200 cm, head, chest, and abdomen showed similar. On head, the measured dose rates were $9.56{\mu}Sv/h$, $5.23{\mu}Sv/h$, and $3.40{\mu}Sv/h$ in 100, 150, and 200 cm, respectively. When using shielder, it shows $2.24{\mu}Sv/h$, $1.67{\mu}Sv/h$, and $1.27{\mu}Sv/h$ in 100, 150, and 200 cm on head. On chest, the measured dose rates were $8.54{\mu}Sv/h$, $4.90{\mu}Sv/h$, $3.44{\mu}Sv/h$ in 100, 150, and 200 cm, respectively. When using shielder, it shows $2.27{\mu}Sv/h$, $1.34{\mu}Sv/h$, and $1.13{\mu}Sv/h$ in 100, 150, and 200 cm on chest. On abdomen, the measured dose rates were $9.83{\mu}Sv/h$, $5.15{\mu}Sv/h$, and $3.18{\mu}Sv/h$ in 100, 150, and 200 cm, respectively. When using shielder, it shows $2.60{\mu}Sv/h$, $1.75{\mu}Sv/h$, and $1.23{\mu}Sv/h$ in 100, 150, and 200 cm on abdomen. Transmittance was increased as the distance was expanded. As the distance was further, the radiation dose were reduced. When using shielder, the dose were reduced as one-forth of without shielder. The Radio technologists are exposed of radioactivity and there were limitations on reducing the distance with Therefore, the proper shielding will be able to decrease radiation dose to the technologists.

Relationship of Hair Copper and Mercury Contents to Personality in Chronic Schizophrenia (정신분열증 환자의 두발 중 구리 및 수은 함량과 그 인성과의 관련성)

  • Kim, Doo-Hie;Kang, Young-Woo;Park, Soon-Woo;Lee, Kuen-Hoo;Lee, Young-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3 s.31
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    • pp.296-308
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    • 1990
  • The relationship between copper and mercury contents in the scalp hair and chronic schizophrenia was investigated. The samples of scalp hair were collected from 80 male chronic schizophrenic patients at the age from 20 to 29, who were hospitalized in the National Psychiatric Hospital in Seoul. As the control group, 69 males were collected from general population. Hair samples were taken from the napes and the Minnesota Multiple Personality Inventory (MMPI) was performed also. The copper and mercury contents were determined by an atomic absorption spectrophotometer. Significantly higher T-score of MMPI was seen in patients group for Hypochondriasis Scale (Hs), Depression Scale (D), Psychopathic Deviate Scale (Pd), Paranoia Scale (Pa), Psychasthenia Scale (Pt), Schizophrenia Scale (Sc) subscales than control group, and the frequency distribution by T-score was also significantly different between the patient and the control group for above scales. The content of copper in the hair of patient group was significantly lower than the control group. In the case of mercury, the mean value of patient group was significantly higher than control group. Between the value of copper and mercury, statistically significant negative correlation (r=-0.25) was found. When grouped by the T-score of MMPI, there was no difference of copper contents between T-score subgroup at all MMPI scale. But the mercury contents showed significant difference between T-score subgroup at Pt, Sc scale. When compared between the group of above 70 T-score and the group of less than 70, the mercury contents of Pa, Pt, Sc scale of above 70 T-score group were significantly higher than the group of less than 70. In other scales, the mercury content of the above 70 group were higher than the group of less than 70 except Mf scale, although there were no statistscally significances. In D, Pa, Sc scales, as the T-score of MMPI increased, the contents of mercury also increased. When divided into the patient group and the control group, the copper contents of the patient groups were significantly lower than the control group at each T-score scale in most MMPI scales. In the case of mercury, the value of patient group were significantly higher than the control group in the less than 44 scale of D, in the $60{\sim}69$ scale of Pd, in the $45{\sim}59$ scale of Mf, in the $60{\sim}69$ scale of Ma, in the less than 44 of Si. These results suggest that the effects of the deficiency of copper or high intake of mecury on schizophrenia and personality may be of possible value. Thus further studies are necessary to determine whether schizophrenia and personality formation would be attributed to copper deficiency or mercury intake.

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A Study of Educational System for Medical Technologists in Korea (한국(韓國)의 의료기사(醫療技士) 교육제도(敎育制度)에 관(關)한 조사(調査) 연구(硏究))

  • Song, Jae-Kwan;Lee, Gun-Sub;Kim, Byong-Lak;Kim, Chung-Rak;Cho, Jun-Suk;Huh, Joon;Lee, Joon-Il
    • Journal of radiological science and technology
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    • v.6 no.1
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    • pp.131-181
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    • 1983
  • After the investigation on, and the analysis of, the educational system for medical technicians and the present educational situation for medical technologies in this country, the following conclusions were drawn. 1. As of March 1983 the current academic system for education in medical technologies included the regular 4-year college courses and those of the 2-year professional junior college courses. But except in the cases on clinical pathology and physical therapy, there were no college-level departments. Particularly, no educational institutions, at whatever level, had a department for working therapies. 2. The total number of credits needed for graduation from a department of medical technologies was 150 points at a regular 4-year college and 85 to 96 points at a 2-year professional college. The obligatory minimum number of credits for a student at a professional college was set at 80 points and above. 3. As for the number of the educational institutions for medical technologies in this country, there were one regular college and 14 professional colleges, a total of 15 institutions. As many as 14 colleges had departments of clinical pathology, 12 had departments of Radiotechnology, 11 had departments of physical therapy, 12 had departments of dental technology, and eight had departments of dental hygiene. 4. The total capacity of the professional colleges in admitting new enrollment each year were 1,920 for clinical pathology, 1,552 for radiology, 1,012 for physical therapy, 1,334 for dental technologies, 828 for dental hygiene, an aggregate of 6,646 for all of the professional college departments. 5. The total number of graduates from the 12 professional colleges by department during the period of 1965-83 were 7,595 for clindical pathology, 4,768 for radiology, 2,821 for physical therapy, 3,000 for dental technologies, and 1,787 for dental hygiene, totalling 19,971 for all departments in the professional colleges. 6. In the state examination for licensed medical technicians, 12,446 have passed from among the total of 26,609 participants, representing a 45% passing ratio. By departments the ratios showed 44% for clinical pathology, 39.7% for radiology, 51.2% for physical therapy, 42.5% for dental technology, 72.5% for dental hygiene and 73.1% for working therapy. 7. As for the degree of satisfaction shown by the people in this field, 52.2 percent of the teaching staffs who responed to the questionaires said they were satisfied with their present profession, while the great majority of medical technicians(66%) replied that they were indifferent to the problem. 8. The degree of satisfaction shown by the students on their enrollment in this particular academic field was generally in the framework of indifference(43.7%), but mere students(36.5%) were satisfied with their choice than those were not satisfied(14.4%) 9. As for the student's opinions on the lectures and practicing hours, a good many students replied that, among such courses as general science and humanities courses the basic medical course, the major course and practicing hours, the hours provided for the general courses(47.1%) and practicing(47.6%) were insufficient. 10. When asked about the contents of their major courses, comparatively few students (23.6%) replied that the courses were too difficult, while a convincing majority(58.5%) said they were neither difficult nor easy. As for the appropriateness of the number of the present teaching staffs, a great majority(71.0%) of the students replied that the level of the teaching personnel in each particular field was insufficient. 11. Among the students who responded to the poll, good part of them(49.5%) wanted mandatory clinical practicing hours, and the the majority of them(64.6%) held the view that the experimental and practicing facilities of their schools were insufficient. 12. On the necessity of the attached hospitals, 71.1% of the teaching staffs and 58.0% of the medical technicians had the opinion that this kind of facility was indispensable. 13. As for the qualifications for applicants to the state examination in the licensing system for medical technicians, 52.2% of the teacher's and 36% of the medical technicians replied that the present system granting the qualifications according to the apprenticeship period should be abolished. 14. On the necessity of improving the present system for education in medical technologies, an overwhelming majority(94.4% of the :caching staffs, 92.0% of the medical technicians and 91.9% of students) of these polled replied that the present system should be changed for the better. 15. On the method of changes for the present educational system, a great majority(89.4% of the teaching staffs, 80.4% of the medical technicians and 90.1% of the students) said that the system must be changed so that it fits into the reality of the present day. 16. As for the present 2-year program for the professional colleges, 61.6% of the teachers, 72.0% of the medical technicians and 38.8% of the students expressed the hope that the academic period would be extended to four regular years, hemming a full-fledged collegelevels program. 17. On the life-long eductional system for medical technicians, there was a considerable number of people who expressed the hope that an open university system(38.9% of the teaching staffs, 36.0% of the medical technicians) and a graduate school system would be set up. 18. As for the future prospects for medical technicians as professionals, the optimists ana pessimists were almost equally divided, and 41.1% of the teaching staffs 36.0% of. the technicians and 50.5% of the students expressed an intermediate position on this issue.

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A Case-Control Study on Effects of Genetic Polymorphisms of GSTM1, GSTT1, CYP1A1 and CYP2E1 on Risk of Lung Cancer (GSTM1과 GSTT1, 그리고 CYP1A1, CYP2E1 다형성이 폐암발생에 미치는 영향에 대한 환자-대조군연구)

  • Nan, Hong-Mei;Kang, Jong-Won;Bae, Jang-Whan;Choe, Kang-Hyeon;Lee, Ki-Hyeong;Kim, Seung-Taik;Won, Choong-Hee;Kim, Yong-Min;Kim, Heon
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.2
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    • pp.123-129
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    • 1999
  • Objectives: This study was performed to investigate sweets of genetic polymorphisms of glutathione S-transferase M1 (GSTM1), glutathione S-transferase M1 (GSTT1), cytochrome P450 1A1 (CYP1A1) and cytoehrome P450 2E1 (CYP2E1) on lung cancer development. Methods: Ninety-eight lung cancer patients and 98 age-sex matched non-cancer patients hospitalized in Chungbuk National University Hospital form March 1997 to August 1998, were the subjects of this case-control study. Direct interview was done and genotypes of GSTM1, GSTT1, CYP1A1 and CYP2E1 were investigated using multiplex PCR or PCR-RFLP methods with DNA extracted from venous blood. Effects of the polymorphisms of GSTM1, GSTT1, CYP1A1 and CYP2E1, lifestyle factors including smoking, and their interactions on lung rancor were statistically analyzed. Results: GSTM1 was deleted in 67.01% of the cases and 58.16% of the controls, and the odds ratio(95% CI) was 1.46(0.82-2.62). GSTT1 deletion was 58.76% for the lung cancer patients and 50.00% for the controls[OR:1.43(0.81-2.51)]. The frequencies of lle/lle, lle/Val and Val/Val of the CYP1A1 polymorphisms were 59.18-18%, 35.71%, and 5.10% for the cases, and 52.04%, 45.92%, 2.04% for the controls, respectively. Risk of lung cancer was not associated with polymorphism of CYP1A1 ($x^2trend=0.253$, p-value>0.05). The respective frequency of c1/c1 c1/c2, c2/c2 genotypes for CYP2E1 were 50.00%, 42.86%, 7.14% for the lung cancer patients, and 66.33%, 30.61%, 3.06% for the controls $(x^2trend=5.783,\;p<0.05)$. c2 allele was a significant risk factor for lung cancer. We also observed a significant association of cigarette smoking history with lung cancer risk. The odds ratio(95% Cl) of cigarette smoking was 3.03(1.58-5.81). In multiple logistic analysis including genotypes of GSTM1, GSTT1, CYP1A1 and CYP2E1, and smoking habit, only snaking habit came out to be a significant risk factor for lung cancer. Conclusion: Genetic polymorphisms of GSTM1, GSTT1, CYP1A1 and CYP2E1 are not so strongly associated with lung cancer as lifestyle factors including cigarette smoking.

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