• 한국환경보건학회지
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• 제43권6호
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• pp.478-490
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• 2017

Objectives: The association of air pollution levels and land-use types with changes in the prevalence of allergic diseases (allergic conjunctivitis, allergic rhinitis, asthma, and atopic dermatitis) was investigated for seven metropolitan cities in Korea Methods: Data on daily hospital visits and admissions (of those under 19 years old) for 2003-2012 were obtained from the National Health Insurance Cooperation. Meteorological data on daily mean temperature, humidity, and air pressure were obtained from the Korea Meteorological Administration. Daily mean or maximum concentration data for five pollutants ($PM_{10}$, $O_3$, $NO_2$, $SO_2$, and CO) as measured at air quality monitoring sites operated by the Ministry of Environment were used. We estimated excess risk and 95% confidence intervals for the increasing interquatile range (IQR) of each air pollutant using Generalized Additive Models (GAM) appropriate for time series analysis. Results: In this study, we observed a significant association between the IQR increases of air pollutants and the prevalence risk of allergic diseases (allergic conjunctivitis, allergic rhinitis, asthma, and atopic dermatitis) in all metropolitan cities after adjusting for temperature, humidity, and air pressure at sea level. Among the air pollutants, $NO_2$ and $PM_{10}$ were associated with the prevalence of asthma, and $O_3$ was associated with only allergic conjunctivitis in regression analysis. However, in GAM analysis considering land-use, $O_3$ and $SO_2$ were associated with allergic conjunctivitis, PM10, O3, NO2, and CO were associated with allergic rhinitis, and $PM_{10}$, $O_3$ and $NO_2$ were associated with asthma in industrial area. Conclusion: This study found a significant association between air pollution and the prevalence of allergic related diseases in industrial areas. More detailed research considering mixed traffic-related air pollution (TRAP) and conducting meta-analyses combining data of the all cities is required.

• Pediatric Infection and Vaccine
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• 제26권1호
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• pp.22-31
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• 2019

목적: 캄필로박터 장염은 박테리아 장염의 흔한 원인 중 하나로 알려져 있다. 그러나 국내에서 소아에서의 캄필로박터 장염의 빈도와 임상 양상에 대한 연구는 드물다. 본 연구는 단일 병원 소아청소년과 환자에서 경험한 캄필로박터 장염의 빈도와 임상적 특징을 파악하고자 시행하였다. 방법: 2012년 1월부터 2017년 12월까지 을지대학교 을지병원 소아청소년과에 급성 위장관염으로 방문한 18세 이하 소아환자로부터 대변 검체를 확보하였다. 그 중에서 배양 혹은 polymerase chain reaction을 통해 캄필로박터 장염으로 진단된 환자들의 의무기록을 후향적으로 검토하였다. 결과: 총 123명의 환자가 캄필로박터 장염을 진단받았으며 환자의 나이 중앙값은 12 세(사분위수, 8-16세)이었다. 캄필로박터 장염은 일년 내내 발생했지만 주로 6월과 9월 사이에 86명(69.9%)으로 집중적으로 발생하였다. 증상은 설사(97.6%), 발열(96.7%), 복통(94.3%), 구토(37.4%)와두통(34.1%) 순으로발생하였다. 복부컴퓨터단층촬영은 25.2%의사례에서시행되었다. 다른 치료군과 비교했을 때, azithromycin 3일 요법으로 치료하는 것이 더 짧은 입원 기간과 관련이 있었다 (P<0.05). 결론: 캄필로박터 장염은 청소년기와 여름철에 흔하다. 설사 증상을 보이기 전에 심한 복통과 열이 발생하여 병원에 내원하게 된다. 캄필로박터 장염에 대한 올바른 이해를 수반한다면 적절한 진단과 항생제 사용을 통해 장염의 이환시간을 줄일 수 있을 것으로 보인다.

• 한국환경과학회지
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• 제11권10호
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• pp.1061-1068
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• 2002

To identify possible associations with concentrations of ambient air pollutants and daily mortality in Busan, this study assessed the effects of air pollution for the time period 1999-2000. Poisson regression analysis by Generalized Additive Model were conducted considering trend, season, meteorology, and day-of-the-week as confounders in a nonparametric approach. Busan had a 10% increase in mortality in persons aged 65 and older(95% Cl : 1.01-1.10) in association with IQR in $NO_2$(lagged 2 days). An increase of $NO_2$(lagged 2days) was associated with a 4% increase in respiratory mortality(Cl : 1.02-1.11) and CO(lagged 1 day) showed a 3% increase(Cl : 1.00-1.07).

• 한국환경보건학회:학술대회논문집
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• 한국환경보건학회 2005년도 국제학술대회
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• pp.311-314
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• 2005

To evaluate the acute effects of fine particles on pulmonary function, a longitudinal study was conducted. This study was carried out for the schoolchildren(3rd and 4th grades) living in Inner-Mongolia, China. 113 Chinese children were asked to record their daily levels of peak expiratory flow rate(PEPR) using portable peak flow meter(mini-Wright) for 40 days and 3 time everyday(12 April 2004 to 21 May 2004). The atmospheric concentration of fine particles in study area was also determined everyday during same period. The relationship between dailypeak expiratory flow rate(PEFR) and fine particle levels was analyzed using a mixed linear regression models including gender, age, height, the presence of respiratory symptoms, and daily average relative humidity as extraneous variables. The analysis showed that the increase of fine particle concentrations was negatively associated with the variability in PEPR. The IQR(inter-quartile range) increments of $PM_{10}$ or $PM_{2.5}(66.0{\mu}g/m^3$ and $118.9{\mu}g/m^3$, respectively) were also shown to be related with 1.422L/min(95% Confidence intervals: 0.270 ${\sim}$ 2.574) and 1.214L1min(95% Cl: 0.010 ${\sim}$ 2.418) decline in PEFR.

• 한국수자원학회논문집
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• 제45권3호
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• pp.275-290
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• 2012

본 연구에서는 극치강우의 시간분포 연구를 위하여 서울지점 우량관측소의 자기기록지를 1분단위로 독취한 MMR(minutely data using the magnetic recording)자료와 최근 들어 관측을 시작한 AWS (automatic weather system) 분단위기상관측 자료를 이용하여 연최대치 계열의 중앙값을 기준으로 한 POT(peaks over threshold) 계열 추출을 통하여 강우의 최적 시간분포 모형을 개발하였다. 기존 Huff 방법에서의 최대 단점인 지속기간별 시간분포 변화 특성을 고려하지 못하는 점과 강우사상별 강우총량에 대한 기준강우량의 일괄적용 등의 문제를 개선하였으며, 분단위 관측자료의 가중치 적용을 통한 순위결정으로 최빈분위를 선택하고 IQR (interquartile range) matrix의 적용을 통한 Quartile별 호우사상을 추출하는 방법을 제안하였다. 마지막으로 추출된 분단위 무차원 단위우량주상도에 핵밀도함수를 적용하여 자료의 크기와 분포 특성을 고려한 지속기간별 최적 시간분포형을 유도하였다.

• 한국의료질향상학회지
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• 제21권2호
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• pp.12-24
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• 2015

Purpose: The need for the rapid evaluation and treatment of emergency department patients with major trauma is essential. A computerized physician order entry (CPOE) system can improve communication and provide immediate access to information with the goal of reducing ED time delays. The aim of this study was to report on the operation of a trauma CPOE program and demonstrate its usefulness by comparing time intervals from ED arrival to various evaluation steps before and after implementation of the program. Methods: This was a before-and-after observational study from a single emergency department at an academic center. The CPOE program was implemented for 6 months and compared with the data collected from the pre-CPOE implementation period. The efficacy of the program was assessed by comparing the time difference before and after CPOE implementation based on the following factors: total boarding time in ED, door-to-disposition decision time, door-to-blood-test report time, door-to-X-ray time, door-to-CT time, and door-to-transfusion time. Results: Over a period of 6 months, the CPOE was activated for a total of 17 patients. Total boarding time was reduced significantly after implementation [median, 641.5 minutes (IQR, 367.3-859.3) versus289.0 minutes (IQR, 140.0-508.0) for pre-CPOE vs. post-CPOE, respectively, p< 0.05). Time intervals for all evaluation steps were reduced after implementation of the program. The improvements in the door-to-blood-test and door-to-CT times were both statistically significant. Conclusion: This study demonstrated that a standard CPOE system can be successfully implemented and can reduce ED time delays in managing trauma patients.

• Journal of Korean Medical Science
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• 제33권45호
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• pp.285.1-285.10
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• 2018

Background: Robot-assisted radical prostatectomy (RARP) is a feasible treatment option for high-risk prostate cancer (PCa). While patients may achieve undetectable prostate-specific antigen (PSA) levels after RARP, the risk of disease progression is relatively high. We investigated metastasis-free survival, cancer-specific survival (CSS), and overall survival (OS) outcomes and prognosticators in such patients. Methods: In a single-center cohort of 342 patients with high-risk PCa (clinical stage ${\geq}T3$, biopsy Gleason score ${\geq}8$, and/or PSA levels ${\geq}20ng/mL$) treated with RARP and pelvic lymph node dissection between August 2005 and June 2011, we identified 251 (73.4%) patients (median age, 66.5 years; interquartile range [IQR], 63.0-71.0 years) who achieved undetectable PSA levels (< 0.01 ng/mL) postoperatively. Survival outcomes were evaluated for the entire study sample and in groups stratified according to the time to biochemical recurrence dichotomized at 60 months. Results: During the median follow-up of 75.9 months (IQR, 59.4-85.8 months), metastasis occurred in 38 (15.1%) patients, most often to the bones, followed by the lymph nodes, lungs, and liver. The 5-year metastasis-free, cancer-specific, and OS rates were 87.1%, 94.8%, and 94.3%, respectively. Multivariate Cox-regression analysis revealed time to recurrence as an independent predictor of metastasis (P < 0.001). Time to metastasis was an independent predictor of OS (P = 0.003). Metastasis-free and CSS rates were significantly lower among patients with recurrence within 60 months of RARP (log-rank P < 0.001). Conclusion: RARP confers acceptable oncological outcomes for high-risk PCa. Close monitoring beyond 5 years is warranted for early detection of disease progression and for timely adjuvant therapy.

• 한국환경보건학회지
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• 제30권2호
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• pp.140-148
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• 2004

To evaluate the acute effects of fine particles on pulmonary function, a longitudinal study was conducted. This study was carried out for the schoolchildren (3rd and 6th grades) living in Beijing, China. Each child was provided with a mini-Wright peak flow meter and a preformatted health symptom diary for 40 days, and was trained on their proper use. Participants were instructed to perform the peak flow test three times in standing position, three times a day (9 am, 12 pm, and 8 pm), and to record all the readings along with the symptoms (cold, cough, and asthmatic symptoms) experienced on that day. Daily measurement of fine particles (PM$_{10}$ and PM$_{2.5}$) was obtained in the comer of the playground of the participating elementary school for the same period of this longitudinal study. The relationship between daily peak expiratory flow rate (PEFR) and fine particle levels was analyzed using a mixed linear regression models including gender, height, the presence of respiratory symptoms, and daily average temperature and relative humidity as extraneous variables. The total number of students participating in this longitudinal study was 87. The range of daily measured PEFR was 253-501$\ell$/min. In general, the PEFR measured in the morning was lower than the PEFR measured in the evening (or afternoon) on the same day. The daily mean concentrations of PM$_{10}$ and PM$_{2.5}$ over the study period were 180.2$\mu\textrm{g}$/㎥ and 103.2$\mu\textrm{g}$/㎥, respectively. The IQR (inter-quartile range) of PM$_{10}$ and PM$_{2.5}$ were 91.8$\mu\textrm{g}$/㎥ and 58.0$\mu\textrm{g}$/㎥. During the study period, the national ambient air quality standard of 150$\mu\textrm{g}$/㎥ (for PM$_{10}$) was exceeded in 23 days (57.5%). The analysis showed that an increase of 1$\mu\textrm{g}$/㎥ of PM$_{10}$ corresponded to 0.59$\mu\textrm{g}$/㎥ increment of PM$_{2.5}$. Daily mean PEFR was regressed with the 24-hour average PM$_{10}$ (or PM$_{2.5}$) levels, weather information such as air temperature and relative humidity, and individual characteristics including gender, height, and respiratory symptoms. The analysis showed that the increase of fine particle concentrations was negatively associated with the variability in PEFR. The IQR increments of PM$_{10}$ or PM$_{2.5}$ (at 1-day time lag) were also shown to be related with 1.54 $\ell$/min (95% Confidence intervals: 0.94-2.14) and 1.56$\ell$/min (95% CI: 0.95-2.16) decline in PEFR.R.ine in PEFR.ine in PEFR.

• Tuberculosis and Respiratory Diseases
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• 제68권2호
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• pp.87-92
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• 2010

Background: D-dimer testing is widely applied as a first step in the diagnostic work-up of pulmonary embolism (PE). Although this is the most sensitive assay for ruling out PE, the prognostic implications of D-dimer testing in patients with normotensive PE are not well known. The aim of this study was to determine if D-dimer testing on admission predicts major adverse cardiac events (MACE) in patients with normotensive PE. Methods: A total of 180 consecutive patients with normotensive PE admitted between January 2003 and June 2009 were included. The group was divided into quartiles on the basis of their D-dimer levels. We compared the frequency of MACE by quartile of D-dimer level and estimated sensitivity, specificity, and predictive values for MACE in the first and fourth quartile. Results: In the 37 (20.6%) patients with MACEs, the median D-dimer level (7.94[IQR:4.03~18.17]${\mu}g/mL$) was higher than in patients with a benign course (5.29[IQR:2.60~11.52]${\mu}g/mL$, p<0.01). The occurrence of MACEs was increased with increasing D-dimer level (p=0.017). In the first quartile (D-Dimer <$2.76{\mu}g/mL$) sensitivity, specificity, and positive and negative predictive values for predicting MACEs were, respectively, 91.9%, 29.4%, 25.2%, and 93.3%. Conclusion: Patients with D-dimer levels below $2.76{\mu}g/mL$ have a low risk of MACEs. Our study suggest that D-dimer level may be used to identify low risk patients with normotensive PE.

• 대한응급의학회지
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• 제29권6호
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• pp.649-655
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• 2018

Objective: This paper reports the possibility of using of a locking horizontal mattress suture technique in repairing lacerations that are difficult to suture with staples. Methods: Data were collected retrospectively over a 6-month period regarding the routine repair of scalp lacerations: those in areas injured by a high energy blunt mechanism, continued to bleed after pressure, nonlinear or damaged skin repaired with a locking horizontal mattress technique, and simple interrupted technique. The effects of the two techniques used to repair scalp lacerations on wound healing, complication rate, and patient satisfaction were examined. The categorical variables are expressed as the number and percent. A Mann-Whitney-Wilcoxon test was used for statistical analysis. A P-value less than 0.05 was considered significant. Results: Thirty-seven consecutive patients with scalp lacerations presented for care. Wound closure was accomplished with the locking horizontal mattress sutures in 40.5% (n=15) (median length, 5.0 cm; interquartile range [IQR], 4.0-7.0 cm). Simple interrupted sutures (median length, 4 cm; IQR, 3.0-5.0 cm) were used in 59.5% (n=22) (P=0.015). The frequency of additional bandage compression (P=0.008), frequency of exudative hemorrhage (P=0.018), and suture mark frequency at suture removal (P=0.047) were significantly lower in the locking horizontal mattress group. Conclusion: The locking horizontal mattress suture, which has the advantage of a horizontal mattress suture, may be one of the ways that can be used alternatively to treat scalp lacerations that difficult to suture with staples.