• Title/Summary/Keyword: 후향연구

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The Construction of Job Exposure Matrix (직무 - 노출매트릭스의 설계)

  • Yim, Hyeon Woo;Roh, Youngman;Lee, Won Chul
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.11 no.2
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    • pp.161-168
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    • 2001
  • The types of exposure data needed in an industry-based study depend on the diseases of interest and the study design to be used. The best situation occurs when we have quantified personal exposure estimates for the agents of interest, the least informative case occurs when we have only knowledge of the fact of employment in a plant, industry, or trade where exposure probability is high. Exposure information for most industry-based studies falls somewhere between these tow extremes. Job exposure matrices(JEM) are designed to link information on occupation with information on exposure to specific workplace hazards. Some forms of systematic error of bias may be less likely to occur in studies that utilize job-exposure matrices to indirectly infer exposures from job titles than in studies that assess exposures by asking subjects about their past exposure. JEM can be used effectively in industry-based studies for historic cohort studies, case-control study to assist with the retrospective assessment of occupational exposures among workers whose individual exposure histories are unavailable. JEM generally consist of a computerized database that links information about job categories and likely exposures. These two major axes may be stratified by calendar time. This article reviews the design of JEM in support of industry-based studies. Specific matrices may find broader applicability along with the increasing availability of detailed hygienic data.

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Development of prediction model identifying high-risk older persons in need of long-term care (장기요양 필요 발생의 고위험 대상자 발굴을 위한 예측모형 개발)

  • Song, Mi Kyung;Park, Yeongwoo;Han, Eun-Jeong
    • The Korean Journal of Applied Statistics
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    • v.35 no.4
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    • pp.457-468
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    • 2022
  • In aged society, it is important to prevent older people from being disability needing long-term care. The purpose of this study is to develop a prediction model to discover high-risk groups who are likely to be beneficiaries of Long-Term Care Insurance. This study is a retrospective study using database of National Health Insurance Service (NHIS) collected in the past of the study subjects. The study subjects are 7,724,101, the population over 65 years of age registered for medical insurance. To develop the prediction model, we used logistic regression, decision tree, random forest, and multi-layer perceptron neural network. Finally, random forest was selected as the prediction model based on the performances of models obtained through internal and external validation. Random forest could predict about 90% of the older people in need of long-term care using DB without any information from the assessment of eligibility for long-term care. The findings might be useful in evidencebased health management for prevention services and can contribute to preemptively discovering those who need preventive services in older people.

Optimal Glycemic Control to Reduce Mortality in Surgical Intensive Care Unit (외과계 중환자실에서 사망률 감소를 위한 적정혈당지표에 관한 연구)

  • Yoon, So-Jung;Song, Young-Chun;Kim, Jae-Yeon;Lee, Byung-Koo;Gwak, Hye-Sun
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.2
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    • pp.107-113
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    • 2010
  • 서 론: 중환자실에서 집중적 인슐린 요법에 의한 평균혈당강하는 사망률을 감소시키는 것으로 나타났으나 이로 인한 저혈당 및 혈당변동은 새로운 문제로 대두되고 있다. 본 연구에서는 혈당과 관련한 여러 요인들이 사망에 미치는 영향을 규명하고 적정 혈당치를 확인하고자 하였다. 연구방법: 2008년 2월부터 7월 사이인 6개월 동안 서울아산병원 외과계 중환자실에서 4일 이상 재실한 18세 이상의 성인 환자를 대상으로 전자 의무기록 조사를 통해 후향적으로 연구가 진행되었다. 연구를 위해 환자의 인구학적 특성, 수술의 종류, 중환자실에서의 재실기간, 사망여부, 스테로이드 사용 유무, 기계적 인공호흡기의 사용유무, 신대체요법의 사용유무, 혈당치, 재실기간 중 스테로이드 사용유무와 인슐린 양, 입원 후 첫 24시간 동안의 포도당 주입속도, 입원 후 2일 이내와 그 이후에 발생한 균혈증 감염, APACH II와 SOFA 점수를 조사하였다. 혈당수치는 각각의 환자에서 중환자실 입실 후 가장 처음 측정된 혈당, 재실기간 중 가장 높은 혈당과 가장 낮은 혈당수치를 조사하였고 중환자실 전체 재실기간 동안 혈당수치의 평균과 변동계수를 계산하였다. 이상의 혈당관련지표를 포함한 인자들이 일차 종속변수인 사망에 어떠한 영향을 주는지를 환자를 생존군과 사망군으로 나누어 분석하였고 ROC (receiver operator characteristic) 곡선을 사용하여 혈당지표와 APACH 및 SOFA 점수의 cut-off치를 구하여 이로부터 단변량 및 다변량 분석을 시행하였다. 결 과: 연구에 포함된 환자는 170명 이었고 그 중 23명이 연구 기간 중 중환자실에서 사망하였다. 생존자에 비해 사망자의 최대혈당은 유의적으로 높았고 최소혈당치는 유의적으로 낮아 높은 변동계수를 보였다. ROC곡선으로부터 산출된 혈당치들의 cut-off 수치는 최소혈당치 70 mg/dL, 변동계수 25%, 최대혈당치 250 mg/dL, 평균혈당치 150 mg/dL이었다. 다변량분석에서 최소혈당이 70 mg/dL 보다 큰 경우가 낮은 경우에 비해 오즈비가 0.922(95% 신뢰구간 0.881-0.965)로 유의성 있게 낮았으며 변동계수가 25% 보다 높은 집단의 경우 그보다 낮은 집단에 비해 오즈비가 1.121(95% 신뢰구간 1.017-1.236)로 유의성 있게 높았다. Kaplan-Meier 생존분석 결과 최소혈당치 70 mg/dL와 변동계수 25%에 따라 생존기간에 유의성 있는 차이가 나타났다.(각각 P < 0.001, P < 0.05) 결 론: 고혈당 발생의 감소뿐 아니라 최소혈당치를 70 mg/dL 이상으로 유지하면서 변동을 최소화하는 것이 외과계 중환자실에서의 사망률감소를 위한 중요한 요인임을 알 수 있었다.

The Production, Distribution, and Utilization of Rice in Japan (일본의 쌀 생산, 유통 및 이용 현용)

  • Inouchi, Naoyoshi
    • Food preservation and processing industry
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    • v.1 no.1
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    • pp.17-26
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    • 2002
  • 일본은 기후적으로도 쌀의 생산에 적합하며 쌀은 일본의 주곡이다. 1893년 국립농업연구소가 설치된 이래로 쌀은 품질과 단보당 생산량이 꾸준히 개선되어와 116의 노동시간으로 생산량은 2.5배의 증가를 가져왔다. 이러한 진전은 재배방법의 개선, 비료, 농약, 재배기술, 기계화, 관개배수, 농지개량 등의 요인들로 볼 수 있다. 현재 일본에서 생산되고 있는 주요 쌀 품종으로는 코시히카리($35.5\%$), 히토메보레($9.7\%$), 히노히카리($9.0\%$), 아키다코마치($8.5\%$), 키라라($4.8\%$) 등 10여 품종이며 최근에는 형질전환 품종의 연구와 함께 생물공학적 연구 ,생리, 품질, 곤충과 잡초, 토양, 식품가공 등 기본적인 연구에 심혈을 기울이고 있다. 새로운 형태의 쌀 품종으로는 냉동조리쌀밥, 초밥, 레토르트룡 쌀 등 가공용으로 적합하도록 하기 위하여 아밀로오즈의 함량을 $5-15\%$로 낮춘 쌀이나 카레, 필라프, 튀김 쌀 등의 용도에 적합하도록 아밀로오스의 함량을 $30\%$이상으로 높인 쌀뿐만 아니라 곡립의 크기와 길이 등을 변형시킨 쌀, 유색미, 향미, 단백질 함량 조절 쌀, 거대 배아미, lipoxygenase 활성을 없앤 쌀, 단맛나는 쌀 등이 연구, 생산되고 있다. 일본에서의 쌀이용은 먼저 가공용 쌀을 들 수 있다. 밥, 청주, 스낵, 쌀가루, 미소발효 등 다양하게 이용이 되고 있으며 parboiled rice와 이의 색과 향을 개선한 converted rice, 현미를 이용한 가공쌀, 쌀빵, 현미가루, 세척미, 쌀국수, 쌀스낵, 당과, 죽, 쌀은 채소아 함께하는 타키코미고한, 초밥, 냉동쌀밥, 무균포장밥, 건조밥, 즉석밥 등 매우 다양하다.는 일, 쌀 재배구조 조정과 함께 높은 미질을 가지는 품종육종, 기계화를 비롯한 경작기술의 발달, 쌀과 부산물 가공기술의 개발연구, 특정기능을 함유하는 유전공학적 기술의 적용, 토지와 도시화 그리고 식량순환에 시스템의 개혁 등 과학기술을 고양하는 일 등을 들 수 있다.하는데 도움이 되리라 생각된다.=0.002)가 통계적으로 유의한 인자였다. 결론 : 본 기관에서 시행되어진 근침윤성 방광암에 대한 방광보존치료법은 기존의 근치적 방광절제술에 비하여 대등한 치료성적을 내는 동시에 $63\%$에서 장기보존이 가능하였다. 따라서 본 치료법이 방광암의 치료에 적극적으로 적용되어야 할 것으로 생각하며 향후 여러 기관이 참여하는 활발한 연구를 통해 한국인에게 가장 적절한 치료법을 개발해야 될 것으로 생각한다. B2+3, C1, C2+3군에서 수술달독군과 방사선치료 추가군의 골반종양제어율은 각각 $79\%$$75\%$ (p=0.88), $100\%$$100\%,\;44\%$$68\%$ (p=0.01)이었다. 전체 환자를 대상으로 다요인 분석을 시행한 결과 생존율과 무병생존율에 병기만이 유의하였고 두 치료 군에서도 역시 병기가 유의한 인자로 나타났다. 전체환자에서 골반종양제어율에 유의한 예후인자로 다요인분석을 시행한 결과 병기와 수술방법이 유의하였다. 수술단독군에서는 병기만이 유의하였고 방사선치료 추가군에서는 수술방법만이 유의하여 복부회음절제술군의 골반종양재발률이 높았다. 결론 : 본 후향적 연구에서 수술 후 보조적 방사선치료를 시행하여 수술단독군에 비해 병기 C2+3군에서 골반종양제어율이 향상되었음을 알 수 있었다. 그러나 병기 B2이상의 모든 환자에서 골반종양제어율 뿐만 아니라 생존율의 향상을 가져오기

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Development of Image Quality Measurement Method of Coronary Angiography Using Image Analysis Program (영상 분석 프로그램을 이용한 관상동맥 혈관 조영상의 화질 측정 방법 고안)

  • Seo, Young-Hyun;Song, Jong-Nam
    • Journal of the Korean Society of Radiology
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    • v.14 no.2
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    • pp.111-120
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    • 2020
  • Research should be actively conducted for the ability of X-ray equipment and Retrospective image analysis of X-ray equipment used in hospitals. Retrospective image analysis of X-ray machines, CT and MRI of radiology and medical equipment has been actively conducted. However, image quality measurement using angiography equipment of angiography room is mostly measured with phantom, and image quality measurement on image after being taken by actual patient is insufficient and researches on accurate image quality measurement method are remarkable. It is in short supply. Therefore, through this study, the researcher devised a method to measure the image quality of the acquired image after coronary angiography, and to provide a high quality image to the operator. The equipment and programs used were angiographic examination equipment (Axiom Artis Zee Ceiling) and Image J program. Subjects were images automatically saved in PACS program after coronary angiography.For image quality measurement, selected the AP Caudal 30° image that show the LCA vessel well and the LAO 30° image that show the RCA vessel well during the coronary angiography. In order to measure the background and ROI of the selected image by selecting an image, a criterion on how to find and measure a section where the overlap of the shadow, such as blood vessel, liver and lung is minimized, is presented. In conclusion, there is no exact standard for analyzing an image quality measurement method of angiography image. Therefore, in order to provide quality images to the practistioners, not only the technicians of the equipment but also the users who actually use them should become researchers and conduct research on image quality measurement in various ways. Thus, it is expected to provide excellent images to patients.

Epidemiologic Study on the Patients Visited to Dept of Oral Medicine -In the Area of Choongnam- (구강내과 내원환자에 관한 역학조사 -충남지역에 대한-)

  • Lee, Dong-Ju;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.31 no.1
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    • pp.101-111
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    • 2006
  • Temporomandibular disorders (TMD) is a collective term embrassing a number of clinical problems that involve the masticatory musculature, the Temporomandibular joint and associated structures, or both. The prevalence of signs and symptoms associated with TMD can be best appreciated by examining epidemiologic studies. But domestic epidemiologic studies about sex, history, chief complaint, diagnosis were not sufficient comparing with foreign countries. The results obtained as follow. 1. The number of visiting patients were 6500 and mean age was 34.06 year (Male's mean age was 33.15, Female's 34.62). In the age of patients, there was no significant difference between sex. 2. There are most patients who were referred by dentist (80.07%). Most diagnostic group was arthrogenous TMD group and followed by myogenous TMD, soft tissue disease. 3. There was strong interaction between diagnostic groups and chief complaint. 4. There was little pain difference between right and left sides. Male mainly had pain onset under 6 month, but female had pain onset more than 6 month. 5. The number of patients who had joint sound history were 3445 (53.15%). There was no significant difference of pain onset between sex. Clicking sound was most among joint sounds which happened to patients. 6. In analyzing the parafunctional habit, male mainly had bruxism, but female had clenching habit.

Overweight & Obesity in Children & Adolescents with Autism Spectrum Disorders - Retrospective Chart Review - (자폐스펙트럼장애(Autism Spectrum Disorder) 소아청소년에서의 과체중 및 비만 연구 - 후향적 의무기록 조사 -)

  • Im, Woo Young
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.2
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    • pp.129-135
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    • 2015
  • Objectives : In children and adolescents, the prevalence of overweight has increased in the last 20 years. little research is available on the prevalence of obesity in children with autism spectrum disorders(ASD). The purpose of our study was to determine the prevalence of overweight among a clinical population of children diagnosed with autism spectrum disorders(ASD). Methods : Retrospective chart review of children ages 3-18 years seen between 2012 and 2015 at a Konyang University hospital psychiatric clinic. Diagnostic, medical, and demographic information was extracted from the charts. Body mass index(BMI) was calculated from measures of height and weight recorded in the child's chart. The Center for Disease Control's BMI growth reference was used to determine an age and gender-specific BMI z-score for the children. Results : In our study, children with ASD compared to non ASD group had significantly higher BMI percentiles (p=0.032). The prevalence of overweight($BMI{\geq}85th$ to 95th percentiles) and obesity($BMI{\geq}95th$ percentiles) was 35% and 19% respectively in children with ASD and without ASD. Conclusions : Despite noted limitations, our data suggest that overweight and obesity in children with ASD are more prevalent than without ASD. Longitudinal and further study is needed to examine the factors associated with obesity in this population.

MULTICENTER RETROSPECTIVE STUDY OF IMMEDIATE TWO DIFFERENT RBM SURFACED IMPLANT SYSTEMS AFTER EXTRACTION (발치 후 즉시 매식된 서로 다른 두종의 RBM표면 처리된 임플란트에 대한 다기관 후향적 임상연구)

  • Park, Hong-Ju;Kook, Min-Suk;Kim, Su-Gwan;Kim, Young-Kyun;Cho, Yong-Seok;Choi, Gab-Lim;Oh, Young-Hak;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.3
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    • pp.258-265
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    • 2008
  • Purpose. This multicenter retrospective study was performed to evaluate the survival and success rates of immediate placement of USII and SSII Osstem implant (Osstem implant Co, Korea) on the maxillary and mandibular anterior and premolar areas. Materials and methods. Dental records were obtained in 37 patients who were treated with immediate implantation on the maxillary and mandibular anterior and premolar areas in 6 different clinics. The 98 implants were evaluated both clinically and radiographically using predefined success criteria. Results. There was no failed implant in all patients. The mean follow up period was 24.7 months (ranged from 12 to 58 months), and 25.1 months (ranged from 16 to 35 months) in USII and SSII implants, respectively. The crestal bone loss was 3 mm in 3 USII implants during 41 months, and in 1 SSII implant during 22 months. The overall success rate was 94.2% and 97.7% in USII and SSII implants, respectively. The age, gender, diameter, or length of implants, and type of surgery were not influenced to the success rate of immediate implantation. Conclusion. These results suggest that USII and SSII Osstem implant can be used successfully in immediate implantation on the maxillary and mandibular anterior and premolar areas.

Surgical Management of Primary Cardiac Tumor: Early and Late Results (원발성 심종양의 외과적 치료: 조기 및 후기의 결과)

  • 강준규;윤유상;김형태;이철주;박인덕
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.228-234
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    • 2004
  • Primary cardiac tumors are rare disease and they present nonspecific symptom. They are divided in benign and malignant tumors and require surgical therapy and/or additional therapy. From March 1995 to March 2003, twenty one patients were diagnosed as having primary cardiac tumors. We analysed them retrospectively in terms of various perioperative factors and early and late results. 6 men and 15 women and their average age was 45.44$\pm$18.76. Pathology revealed eighteen benign (fourteen myxoma, two fibroelastoma, one hemangioma and one paraganglioma) disease and three malignant (one angiosarcoma, one mesothelioma and one myxofibrosarcoma) disease. There was one (myxoma) operative mortality and three late death (hemangioma, angiosarcoma and mesothelioma) during additional therapy and follow up. Surgical treatment of primary cardiac tumor is important and sometimes additional therapy is required but the prognosis of malignant cardiac tumor is still very poor.

Taegeuk Acupuncture for Patients with Chronic Musculoskeletal Pain: A Retrospective Analysis of Medical Records (만성 근골격계 통증환자에 대한 태극침법의 임상적 유효성: 후향적 의무기록 분석 연구)

  • Kim, Jae Kyu;Kim, Kun Hyung;Noh, Seung Hee;Kim, Yu Ri
    • Journal of Acupuncture Research
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    • v.31 no.2
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    • pp.145-152
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    • 2014
  • Objectives : This study aimed to assess the effectiveness and safety of Taegeuk acupuncture for patients with chronic musculoskeletal pain. Methods : A retrospective analysis of the electronic medical records of Pusan National University Korean Medicine Hospital from March 2012 to March 2013 was performed. Eligible cases were outpatients who had received at least six sessions of Taegeuk acupuncture for their pain and had agreed to the use of their medical records for research purposes. Pain levels, heart rate variability, and patients' perceptions of the safety of acupuncture were investigated through the medical records and follow-up telephone interviews. Results : Fifteen cases were selected for analysis. All had suffered from musculoskeletal pain for at least one year. After six sessions of Taegeuk acupuncture, the average score on the pain numeric rating scale decreased from $6.7{\pm}2.0$ to $2.9{\pm}2.2$(a 43 % reduction). Follow-up telephone interviews revealed that patients experienced no adverse event after Taegeuk acupuncture. Conclusions : Patients with chronic musculoskeletal pain showed a reduction of more than half of the baseline pain after six sessions of Taegeuk acupuncture. However, the beneficial effects observed in this retrospective analysis should be interpreted with caution due to selection and recall bias. Further randomized controlled trials of Taegeuk acupuncture for chronic musculoskeletal pain are warranted.