Intravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review

한미아,Philipp Maisch,정재흥,황준을,Vikram Narayan,Anne Cleves,황의창,Philipp Dahm 대한비뇨의학회 2021 Investigative and Clinical Urology Vol.62 No.6

Purpose: To assess the comparative effectiveness and toxicity of intravesical gemcitabine instillation for non-muscle invasive bladder cancer (NMIBC). Materials and Methods: We performed a comprehensive literature search on 11 September 2020. We included RCTs in which participants received intravesical gemcitabine for primary or recurrent NMIBC. Two review authors independently assessed the included studies and extracted data for the primary outcomes (time to recurrence, time to progression, grade III to V adverse events) and the secondary outcomes (time to death from bladder cancer, time to death from any cause, grade I or II adverse events, and disease-specific quality of life). We performed statistical analyses using a random-effects model and rated the certainty of the evidence using GRADE. Results: We found seven studies with 1,222 participants. Gemcitabine may reduce the risk of recurrence over time, but may have a similar effect on progression and grade III to V adverse events compared to saline. Gemcitabine may reduce recurrence and progression compared to mitomycin. We are uncertain about the effect of gemcitabine on the grade III to V adverse events compared to mitomycin. Gemcitabine may reduce recurrence and progression compared to giving BCG again in recurrent high-risk NMIBC after BCG treatment. Conclusions: Based on the findings of this review, gemcitabine may have a favorable impact on recurrence and progression-free survival than saline and mitomycin but we are uncertain about how major adverse events compare. The same is true when comparing gemcitabine to BCG in individuals with high-risk diseases who have previously failed BCG.

일부 농촌지역 성인에서 EQ-5D를 이용한 건강관련 삶의 질

한미아,류소연,박종,강명근,박종구,김기순,Han, Mi-Ah,Ryu, So-Yeon,Park, Jong,Kang, Myung-Geun,Park, Jong-Ku,Kim, Ki-Soon 대한예방의학회 2008 예방의학회지 Vol.41 No.3

Objectives : The purposes of this study were to examine the health-related quality of life(HRQoL) and to identify its related factors for a group of rural adults. Methods : The study subjects were 1,901 adults who were aged 40-70 years and who were living in Naju City, Jeollanamdo. The sociodemographic characteristics, health-related behavior, health status and global self-rated health were collected for statistical analysis. The health-related quality of life was measured by the Euroqol EQ-5D instrument. The differences on the EQ-5D index between the groups were assessed with t-test, ANOVA and hierarchical multiple regression analysis. Results : Overall, the mean value of the EQ-5D index was $0.884{\pm}0.140$ and this score was significantly different according to the socioeconomic characteristics, the health-related behavior, the health status and the global self-rated health. According to the results from the hierarchical multiple regression analysis, the HRQoL was significantly reduced for females, older subjects, and other subjects with no spouse and the subjects with osteoporosis, obesity, mental distress or poorer global self-rated health. Conclusions : The HRQoL for rural adults was related to the socioeconomic characteristics, the health status and the global self-rated health, A better understanding of the factors related to the HRQoL would help to improve the rural adults' quality of life.

대사증후군과 알라닌 아미노전이효소와의 관련성 - 국민건강영양조사 제3기(2005년)

한미아(Mi Ah Han),류소연(So Yeon Ryu),박종(Jong Park),강명근(Myung Geun Kang),김기순(Ki Soon Kim) 한국역학회 2008 Epidemiology and Health Vol.30 No.1

  Purpose: The aim of this study was to investigate the association between the metabolic syndrome and alanine aminotransferase(SGPT) levels in Korean adults.   Methods: The study subjects were 4,325 adults aged ≥ 19 years without an apparent cause of liver disease from the Third Korea National Health and Nutrition Examination Survey(2005). The metabolic syndrome was defined using criteria established by the NCEP/ATP Ⅲ, while abdominal obesity was assessed based on the Asia-Pacific guidelines. Subjects with SGPT ≥ 40 IU/L were considered to have elevated SGPT levels. Demographic characteristics, waist circumference, blood pressure, triglyceride, HDL cholesterol, fasting blood sugar were recorded for statistical analysis.   Results: The prevalence of elevated SGPT levels was significantly increase with the presence of the metabolic syndrome and its components. In multiple logistic regression analyses, odds ratio for the elevated SGPT levels was significantly high in the subjects with the metabolic syndrome compared to the subjects without metabolic syndrome after adjusted for socio-demographic characteristics and health-related behavior.   Conclusions: The metabolic syndrome was independently associated with SGPT levels in Korean adults.

콩팥 손상 환자의 임상적 고찰

이창용,조원진,백승,임동훈,김철성,노준,한미아 조선대학교 의학연구원 2015 The Medical Journal of Chosun University Vol.40 No.4

Recently, renal traumas caused by traffic and industrial accidents have risen sharply due to rapid industrialization and an increase in automobiles. The evaluation of patients with suspected renal trauma relies mainly on clinical assessment, urinalysis and imaging studies. We retrospectively reviewed the medical records of 76 patients who presented to our hospital with renal trauma between January 2008 and December 2014. According to the review, A total of 76 patients presented to our hospital with suspected renal trauma. There were 61 male and 15 female between 2 and 83 years old. By cause, traffic accident was the most common cause of injury, accounting for 39 cases. The remaining injuries were caused by falls in 26 cases, assault in 8 cases and sports-related trauma in 3 cases. Surgical exploration was required in 18 patients for renal or associated injuries. We are of the opinion that close and prompt cooperation with other associated medical departments is mandatory in order to reduce morbidity and mortality caused by multiple injury. Accurate renal injury staging was essential to successful management of traumatized patients.

요부 안정화 운동이 어깨의 통증 및 관절 가동 범위에 미치는 영향

한소희,한미아,류소연,최성우 대한임상건강증진학회 2015 Korean Journal of Health Promotion Vol.15 No.1

Background: Lumbar stabilization exercise was used to improve spinal mobilization and stabilization. This research was conducted to investigate the effects of lumbar stabilization exercise programs on shoulder pain and range of motion among a group of elderly individuals. Methods: The study subjects were 28 elderly patients from C hospital, Gochang, Jeollabukdo. They were randomly divided into 3 groups: lumbar stability exercise group, passive upper arm exercise group, and conservative therapy group. The therapies were conducted for 4 weeks. Shoulder pain and range of motion were measured both before and after therapies. The homogeneity of study subjects was analyzed using the chi-square and Kruskal-Wallis tests. For the pre-/post-status comparison, the Wilcoxon’s signed-ranks tests and Kruskal-Wallis tests were conducted. Results: General characteristics including age, sex, and disease history of the 3 groups were comparable. After 4 weeks of exercise, shoulder pain was significantly reduced in the lumbar stability exercise group (6.4±2.9 vs. 3.6±3.1, P=.026) and range of motion was significantly increased in the same group. More specifically, right flexion (121.1±12.0° vs. 137.9±11.9°, P=.008), right abduction (96.6±21.8° vs. 129.7±50.7°, P=.008), and left abduction (92.0±21.8° vs. 110.3±21.2°, P=.038) increased significantly. Conclusions: Shoulder pain and range of motion improved significantly in the lumbar stability exercise group. Further study is needed to look into the longer effects of this exercise program using more subjects. 연구배경: 요부 안정화 운동은 요부근력, 하지 근력, 가동범위 등에 효과적이라고 알려져 있다. 본 연구에서는 노인들을 대상으로 요부 안정화 운동이 어깨 통증과 관절 가동 범위에 미치는 영향을 알아보고자 하였다. 방법: 전라북도 G군에 소재한 노인요양병원에 입원 중인 노인을 대상으로 실시하였다. 선정 기준에 적합한 28명의 노인들을 대상으로 보존적 치료를 병행한 요부 안정화 운동군(9명), 보존적 치료를 병행한 수동 상지 운동군(10명), 보존적 치료만 적용한 군(9명)에 무작위 배정하였다. 얼굴 통증 척도를 이용하여 안정 시와 움직임 시의 통증 정도를 측정하였으며, 측각기를 이용하여 상지의 굴곡과 외전의 관절 운동 범위를 측정하였다. 대상자의 동질성은 Chi-square test와 Kruskal-Wallis test로 분석하였고, 전후비교는 Wilcox signed rank test, 세 군 간 비교는 Kruskal-Wallis test로 분석하였다. 결과: 안정 시 통증점수는 요부 안정화 운동군에서 유의하게 감소하였고(6.4±2.9 vs. 3.6±3.1, P=.026), 관절 가동범위와 관련하여 우측 굴곡에서는 요부 안정화 운동군이유의하게 증가하였다(121.1±12.0° vs. 137.9±11.9°, P=.008). 우측 외전에서는 요부 안정화 운동군(96.6±21.8° vs. 129.7±50.7°, P=.008)과 수동 상지 운동군(77.5±18.5° vs. 95.1±19.1°,P=.028)이 유의하게 증가하였으며, 좌측 외전은 요부 안정화 운동군이 유의하게 증가하였다(92.0±21.8° vs. 110.3±21.2°,P=.038). 결론: 노인 환자의 통증과 관절 가동범위의 증가를 위해서 요부 안정화 운동이 효과적인 중재 방법으로 사료된다. 향후 연구에서는 더 많은 대상자를 대상으로 요부 안정화운동 프로그램의 장기적인 효과를 알아보는 연구와 노인들에게 요부 안정화 운동 프로그램을 다양하게 적용할 수있는 프로그램 개발이 필요할 것이라 판단된다.

간호사의 주사제 사용 시 감염관리 수행도 및 관련요인

노명주,한미아,박종,류소연 한국병원약사회 2017 병원약사회지 Vol.34 No.4

Background : When nurses do not perform injections properly, it can cause fatal complications for patients depending upon the nature of the drug. The aim of this study was to investigate nurses’ performances related to infection control during injection protocols and related procedures. Methods : The study subjects were 391 nurses working in one of 3 general hospitals in“ D”and“ G” metropolitan cities. The data were collected using a self-report questionnaire data which was composed of general characteristics, work-related characteristics, health-related characteristics, infection- related characteristics, and performance of infection control during injections. The collected data were analyzed using the Statistical Package for Social Sciences (SPSS) software. Statistical analyses included descriptive analysis, t-tests, and analyses of variance (ANOVAs). A multiple linear regression was used to investigate the factors associated with the performance of infection control during injections after controlling for several covariates. Results : The overall performance score of infection control during injections was 4.56±0.38. The performance score of hand hygiene and infection control during administration were 4.45±0.47 and 4.62±0.38, respectively. The performance of infection control during injection was related to age, working unit, perceived importance of infection control for injection use, and experience of infection control education in a multiple linear regression analysis. Conclusion : The performance of infection control for injection was significantly associated with the nurses’experiences with infection control education. Therefore, in order to improve the performance of infection control during injections, it is necessary to develop a training program and continuously evaluate and monitor the training according to the changes in the infection control instruction.

국립공원 안전관리전담자들의 외상 후 스트레스 실태 및 관련요인

김형욱,한미아 한국응급구조학회 2016 한국응급구조학회지 Vol.20 No.2

아로마를 이용한 발마사지가 대학생의 두뇌활용능력에 미치는 영향

전지원,한미아,권봉안 한국스포츠학회 2019 한국스포츠학회지 Vol.17 No.1

본 연구는 아로마 발마사지가 대학생의 두뇌활용능력에 미치는 영향을 규명하는데 그 목적을 두고 진행하였다. K대학에 재학중인 여대생 16명을 대상으로 아로마 발마사지 실험군 8명, 통제군 8명으로 분류하여 8주간 주 2회 회당 30분씩 실시하였다. SPSS 21.0을 사용하여 시기 간 집단 간 두뇌활용능력 차이 검정을 하였다. 연구결과 첫째, 실험군 에서는 시기 간 두뇌활용능력 세부 항목 중 인지강도와 집중력에서 통계적으로 유의한 차이가 나타났으나, 통제군에서 는 모든 세부 항목에서 통계적 유의한 차이는 나타나지 않았다. 둘째, 집단 간 두뇌활용능력 차이 비교는 모든 세부 항목 에서 실험군에서 통제군보다 높은 점수를 보였지만 통계적으로 유의한 차이는 나타나지 않았다. The purpose of this study was to investigate the effect of aroma foot massage on the brain utilization ability of college students. Sixteen college students at K university were divided into 8 groups of aroma foot massage and 8 control groups. This experiment was carried out for 30 minutes twice a week for 8 weeks. SPSS 21.0 was used to test the difference in brain power between groups. Results: First, in the experimental group, there was statistically significant difference in cognitive intensity and concentration among the detailed items of brainstorming ability, but there was no statistically significant difference in all the items in the control group. Second, there was no statistically significant difference between the groups in terms of the difference in brain capacity between groups.

일부 대학생에서 A형 간염 예방접종 실태 및 관련 요인

백재성,한미아,박종,윤나라 대한임상건강증진학회 2014 Korean Journal of Health Promotion Vol.14 No.3

Background: Hepatitis A is an acute infectious disease of the liver caused by the hepatitis A virus (HAV). The purpose of this study was to investigate the HAV vaccination status and related factors among college students. Methods: The study subjects were 503 students conveniently sampled from C university located in one district of Jeollanamdo. General characteristics and HAV vaccination related factors were collected by a self-reported questionnaire in October 2013. Chi-square tests and multiple logistic regression analyses were used to evaluate related factors with HAV vaccination. Results: Of the 503 subjects without a history of HAV infection, 65 subjects (12.9%) reported that they were vaccinated. In multiple analyses, subjects who have had health screening (adjusted odds ratio, aOR=2.44 and 95% confidence interval, 95% CI=1.26-4.73) and those who were aware of HAV infection (aOR=6.00, 95% CI=1.81-19.91) or who perceived the benefits of HAV vaccine (aOR=2.05, 95% CI=1.07-3.93) were more likely to be vaccinated than those not involved in these factors. With regard to intention for HAV vaccine, 314 subjects (71.9%) reported that they have the intention to be vaccinated against HAV. In multiple analyses, higher grade level, high monthly allowance, awareness of HAV vaccine, perceived susceptibility of HAV, perceived seriousness of HAV and perceived benefits of HAV vaccine were significantly associated with the intention for HAV vaccination. 연구배경: 위생수준 향상으로 A형 간염의 이환 후 항체형성률이 낮아짐에 따라 A형 간염의 예방접종이 권고되고있으나, A형 간염 예방접종 현황 및 관련요인에 대한 연구는 미비한 실정이다. 이에 본 연구에서는 A형 간염 예방접종 권고대상인 20대 대학생들을 대상으로 A형 간염 예방접종 현황과 관련요인을 파악하고자 하였다. 방법: 전라남도 한 개 대학에서 편의추출을 통해 대상자를 선정하였으며, 자기기입식 설문 조사를 통해 대상자 일반적 특성, A형 간염 예방접종 여부 및 의향을 수집하였다. 카이제곱과 다중로지스틱 회귀 분석을 통해 접종에 영향을 미치는 요인을 파악하였다. 결과: 총 503명 중 A형 예방접종 접종은 12.9%가 받았다고 응하였으며, 건강검진을 받은 경우(adjusted odds ratio,aOR=2.44; 95% confidence interval, 95% CI=1.26-4.73), A형 간염을 알고 있는 경우(aOR=6.00, 95% CI=1.81-19.91),A형 간염 예방접종이 효과가 있다고 생각하는 경우(aOR=2.05, 95% CI=1.07-3.93) 접종 받을 가능성이 높았다. A형 간염 예방접종을 받지 않았거나 모른다고 응답한대상자 437명 중 A형 간염 예방접종 의향이 있는 경우는71.9%로, 학년이 높은 경우, 용돈을 많이 받는 경우, 개인보험이 있는 경우, A형 간염 예방접종을 알고 있는 경우,A형 간염에 걸릴 수 있다고 생각하거나, 심각한 질병이라고 생각하는 경우, 예방접종이 효과가 있다고 생각하는 경우 예방접종 의향이 유의하게 높았다. 결론: 본 연구에 참여한 대학생들의 A형 간염 예방접종백신 접종률은 12.9%로 상당히 낮았다. 향후 A형 간염 예방접종률 향상을 위한 관리 시 본 연구결과를 활용할 필요가 있을 것으로 판단된다.

요양병원 요양보호사의 노인 구강건강관리 수행도 관련요인

최세은,한미아,박종,류소연,Choi, Se-Eun,Han, Mi-Ah,Park, Jong,Ryu, So-Yeon 한국치위생학회 2017 한국치위생학회지 Vol.17 No.5

Objectives: Oral health management is important to improve the quality of life among the elderly. This study investigated the performance of elderly oral health management among some care workers in long-term-care hospitals. Methods: The study subjects were 174 care workers in 10 long-term-care hospitals. Data on general characteristics of care workers, attitude, recognition and knowledge of elderly health, performance of elderly oral health management were collected by a self-administered questionnaire. Data were analyzed through descriptive analysis, t-test, ANOVA, correlation and multiple regression analysis by using a SPSS version 23.0 statistical program. Results: The performance score of oral health management was $4.34{\pm}0.64$ on the 5-point Likert scale. The subjects who exercised more than 2 times a month were significantly higher in their performance of elderly oral health management compared to subjects who did not exercise (${\beta}=0.232$, p=0.035). And, the subjects who cared 10-19 persons were significantly higher in performance of elderly oral health management compared to subjects who cared more than 20 elderly (${\beta}=0.246$, p=0.020). The oral health behavior of care worker (${\beta}=0.271$, p<0.001) and the knowledge of oral health care (${\beta}=0.055$, p=0.008) were positively related to the performance of elderly oral health management. Conclusions: The educational program designed to improve knowledge of care workers in accordance with the standard textbook for training care workers should be developed, and the long term education program should be reinforced to improve the performance for elderly oral health care. If care workers can care a proper number of old persons, they will give oral health care to them.