• Archives of Plastic Surgery
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• 제49권5호
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• pp.569-579
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• 2022

Open and closed rhinoplasty are two main approaches to perform nasal modifications. According to current literature, there is no current consensus among plastic surgeons and otolaryngologists on which technique is preferred in terms of aesthetic result, complications, and patient satisfaction. This study uses published research to determine whether open or closed rhinoplasty leads to superior patient outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed and a literature search was conducted in four databases based on our search strategy. Articles were then imported into COVIDENCE where they underwent primary screening and full-text review. Twenty articles were selected in this study after 243 articles were screened. There were 4 case series, 12 retrospective cohort studies, 1 prospective cohort study, 1 case-control, and 2 outcomes research. There were three cosmetic studies, eight functional studies, and nine studies that included both cosmetic and functional components. Sixteen studies utilized both open and closed rhinoplasty and four utilized open rhinoplasty. Both techniques demonstrated high patient and provider satisfaction and no advantage was found between techniques. Based on available studies, we cannot conclude if there is a preference between open or closed rhinoplasty in terms of which technique leads to better patient outcomes. Several studies determined that open rhinoplasty and closed rhinoplasty leads to comparative patient satisfaction. To make outcome reporting more reliable and uniform among studies, authors should look to utilize the Nasal Obstruction and Septoplasty Effectiveness scale and the Rhinoplasty Outcome Evaluation.

• 응용통계연구
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• 제29권7호
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• pp.1329-1346
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• 2016

한국 의료패널 데이터와 국민건강 영양조사는 추출된 표본의 자가 진단에 따른 건강상태(self-assessed health)와 그들의 의료기관 이용에 대한 자가응답식 자료(self-reported data)이다. 이러한 자료에 근거한 유병률 연구 및 그에 따른 건강기대수명 연구에 관하여 유병률의 신뢰도에 대한 검증이 선행되어야 한다는 주장은 이미 여러 연구에서 제기되었다. 반면 최근 공개된 건강보험공단의 표본코호트 DB는 전 국민을 대상으로 의료기관 이용에 관련된 모든 자료가 저장된 자료인 국민건강정보 DB로부터 추출된 객관적인 자료이다. 또한 추정된 질병별 유병률에 대하여 그 대표성 및 신뢰도가 확보되어 있음이 검증된 자료이다. 이에 본 논문에서는 우리나라 국민의 유병률에 대한 대표성 및 신뢰도가 확보되어 있는 표본코호트 DB와의 비교를 통하여 이들 응답식 데이터에서 도출된 유병률의 신뢰도에 대하여 논의하였다. 자가응답식 자료를 통한 유병률은 표본코호트 DB를 통한 유병률에 비교하여 보았을 때 과소추정되어 있고 이러한 과소추정은 건강기대수명의 과대추정 문제로 이어지고 있음을 확인할 수 있었다. 또한 표본코호트 DB를 제외한 우리나라 건강자료의 안정적이지 못한 표본의 문제는 추정된 건강기대수명의 트렌드를 왜곡하는 문제가 추가적으로 발생할 수 있음을 확인하였다.

• 한국유통학회지:유통연구
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• 제14권1호
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• pp.45-65
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• 2009

정보통신기기의 발달과 생활환경의 변화는 소비자의 구매유형을 다양화 시키는 역할을 하였다. 소비자의 구매유형에 따른 시장점유율의 변화는 관련 기업 뿐 아니라 정책 관계자들에 있어서도 매우 주요한 이슈로 떠오르고 있다. 본 연구는 2007년 설문조사 결과를 이용하여, 이중생잔모형을 고려한 다중로짓모형 분석과 구매형태별 시장점유율을 예측하였다. 시장규모 및 점유율에 대한 예측이 다양한 관련 주체의 경제적 효율성 및 형평성의 실현에 있어 중요한 사안임을 감안한다면, 본 연구의 결과 및 연구의의는 다음의 세 가지로 요약될 수 있다. 첫째, 소비자의 구매유형의 선택 형태는 생잔효과(Cohort Effect)를 고려하여야 한다. 연령대별 선호 구매형태 및 충성도가 다르며 또한 생잔효과를 감안한 시장점유율은 매우 유동적일 것으로 판단된다. 둘째, 기존의 온라인의 구매형태의 감소는 빠른 속도로 온라인 구매형태로 이전할 것이며, 동일 온라인 구매형태에 있어서도 온라인, 인터넷, TV 홈쇼핑 및 기타 간의 시장 분할도 2013년 경 안정된 비율을 유지할 것이다. 셋째, 시간의 경과에 따른 연령별 생잔효과의 분석에서 현재의 연령대가 차후 연령으로 진행하더라도 구매방법을 획기적으로 바꾸기보다는 현재의 소비행태를 비슷하게 유지하는 효과가 있는 것으로 판단되며, 이는 나이를 먹는 것(Aging)에도 일종의 사슬효과(Chain Effect)가 있는 것으로 해석할 수 있다. 본 연구는 구매형태를 고려한 시장점유율을 분석할 수 있는 방법론을 적용하였다는 측면과 생잔효과를 고려한 다양한 관련 주체들의 활동에 시사점을 줄 수 있다는 의의를 가진다.

• Journal of Ecology and Environment
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• 제31권3호
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• pp.207-211
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• 2008

We investigated the leaf demography of a temperate woody liana, Akebia trifoliata, in a temperate forest in Japan, Akebia is semi-evergreen: some leaves are shed before winter, while others remain through the winter. Previous studies of semi-evergreen species found that variation in leaf life span was caused by variation in the timing of leaf emergence, Leaves that appeared just before winter over-wintered, while leaves appearing earlier were shed, However, it is unclear whether leaves of the same cohort (i.e., leaves that appear at the same time within a single site) show variation in life span under the effect of strong seasonality. To separate variation in life span among the leaves in each cohort from variation among cohorts, we propose a new method - the single leaf diagram, which shows the emergence and death of each leaf. Using single leaf diagrams, our study revealed that Akebia leaves within a cohort showed substantial variation in life span, with some over-wintering and some not. In addition, leaves on small ramets in the understory showed great variation in life span, while leaves on large ramets, which typically reach higher positions in the forest canopy, have shorter lives, As a result, small ramets were semi-evergreen, whereas large ramets were deciduous, The longer lives of leaves on small ramets can be interpreted as a shade-adaptive strategy in understory plants.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1205-1210
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• 2014

Background: Previous studies on the association of oral contraceptives (OC) use and lung cancer generated inconsistent findings. The aim of this study was to confirm any definite correlation between OC use and lung cancer risk. Methods: Publications were reviewed and obtained through PubMed and EMBASE databases literature search up to November, 2013. Reference lists from retrieved articles were also reviewed. The language of publication was restricted to English. A meta-analysis was performed to evaluate the association by calculating pooled odds ratios (ORs) and 95% confidence intervals (CIs). Results: A total of 14 studies consisting of 9 case-control studies and 5 cohort studies were finally included in this meta-analysis. There was no significant association observed between OC use and lung cancer risk in the overall analysis (OR=0.91; 95% CI=0.81-1.03). There was a significant protective effect in Europe (OR=0.74; 95% CI=0.60-0.91) and a borderline significant protective effect with an adenocarcinoma histology (OR=0.90; 95% CI=0.80-1.01) in subgroup analyses. No association was observed for methodological quality of study, study design, smoking status and case number of study. Conclusion: This meta-analysis suggests that OC use is not likely to be associated with the risk of lung cancer at all. While a significant protective effect of OC use on lung cancer was observed in Europe, interpretation should be cautious because of the potential biases of low-quality studies. At the same time, more attention should be paid to the possible association of OC use with adenocarcinoma of lung. Our findings require further research, with well-conducted and large-scale epidemiological studies to confirm effects of OC use on lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.589-594
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• 2013

Background: Prospective cohort studies to determine cofactors with oncogenic HPV-infections for cervical cancer are very rare from developing countries and such data are limited to the few screening trials. Large screening trials provide such data as a by product. Some of the cases are prevented by screening and do not surface as invasive cancers at all. Also, pre-invasive lesions are detected almost entirely by screening. Screening causes selection bias if attendance in or effectiveness of screening is correlated with the risk factors. The aim of this study was to quantify the influence of screening on risk factors for cervical cancer. Materials and Methods: Our material stems from a rural cohort of 80,000 women subjected to a randomised screening trial. The effect of screening on the incidence of cervix cancer was estimated with reference to socio-demographic and reproductive risk factors of cervical cancer. We compared these risks with the incidence of cancer in the randomised control population by the same determinants of risk. Results: The results in the screening arm compared to the control arm showed that the women of low SES and young age were benefitting more than those of high SES and old age. The relative risk by age (30-39 vs 50-59) was 0.33 in the control arm and 0.24 in the screening arm. The relative risk by education (not educated vs educated) was 2.8 in the control arm and 1.8 in the screening arm. The previously married women did not benefit (incidence 113 and 115 per 100,000 women years in control vs screening arms) whereas the effect was substantial in those married (86 vs 54). Conclusions: The results in controls were consistent with the general evidence, but results in attenders and nonattenders of the screening arm showed that screening itself and self-selection in attendance and effectiveness can influence the effect estimates of risk factors. The effect of cervical cancer screening programmes on the estimates of incidence of cervical cancer causes bias in the studies on etiology and, therefore, they should be interpreted with caution.

• Journal of Preventive Medicine and Public Health
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• 제47권1호
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• pp.36-46
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• 2014

Objectives: To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history. Methods: We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ${\geq}65$ years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ${\leq}50{\mu}g/d$, 51 to $100{\mu}g/d$, 101 to $150{\mu}g/d$, and > $150{\mu}g/d$. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status. Results: Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to $100{\mu}g/d$ group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to 100 ${\mu}g/d$ group, was 1.93 (95% CI, 1.14 to 3.26). Conclusions: While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.

• Archives of Plastic Surgery
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• 제46권6호
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• pp.525-534
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• 2019

Background In microtia patients with bilateral hearing impairment, hearing improvement is crucial for language development and performance. External auditory canal reconstruction (EACR) has been performed to improve hearing, but often results in complications. We performed transcutaneous bone conduction implant (TBCI) surgery in these patients. This study aimed to evaluate the safety and efficacy of TBCI surgery. Methods A retrospective review was performed of five patients who underwent auricular reconstruction and TBCI surgery and 12 patients who underwent EACR between March 2007 and August 2018. Hearing improvement was measured based on the air-bone gap values using pure-tone audiometry over a 6-week postoperative period. We reviewed other studies on hearing improvement using EACR and compared the findings with our results. The surgical techniques for TBCI were reviewed through case analyses. Results Postoperative hearing outcomes showed a significant improvement, with a mean gain of 34.1 dB in the TBCI cohort and 14.1 dB in the EACR cohort. Both gains were statistically significant; however, the TBCI cohort showed much larger gains. Only three of the 12 patients who underwent EACR achieved hearing gains of more than 20 dB, which is consistent with previous studies. All patients who underwent TBCI surgery demonstrated hearing gains of more than 20 dB and experienced no device-related complications. Conclusions TBCI is a safe and effective method of promoting hearing gains in microtia patients with bilateral hearing impairment. TBCI surgery provided better hearing outcomes than EACR and could be performed along with various auricular reconstruction techniques using virgin mastoid skin.

• Environmental Analysis Health and Toxicology
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• 제30권
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• pp.10.1-10.14
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• 2015

Recent cohort studies have relied on exposure prediction models to estimate individual-level air pollution concentrations because individual air pollution measurements are not available for cohort locations. For such prediction models, geographic variables related to pollution sources are important inputs. We demonstrated the computation process of geographic variables mostly recorded in 2010 at regulatory air pollution monitoring sites in South Korea. On the basis of previous studies, we finalized a list of 313 geographic variables related to air pollution sources in eight categories including traffic, demographic characteristics, land use, transportation facilities, physical geography, emissions, vegetation, and altitude. We then obtained data from different sources such as the Statistics Geographic Information Service and Korean Transport Database. After integrating all available data to a single database by matching coordinate systems and converting non-spatial data to spatial data, we computed geographic variables at 294 regulatory monitoring sites in South Korea. The data integration and variable computation were performed by using ArcGIS version 10.2 (ESRI Inc., Redlands, CA, USA). For traffic, we computed the distances to the nearest roads and the sums of road lengths within different sizes of circular buffers. In addition, we calculated the numbers of residents, households, housing buildings, companies, and employees within the buffers. The percentages of areas for different types of land use compared to total areas were calculated within the buffers. For transportation facilities and physical geography, we computed the distances to the closest public transportation depots and the boundary lines. The vegetation index and altitude were estimated at a given location by using satellite data. The summary statistics of geographic variables in Seoul across monitoring sites showed different patterns between urban background and urban roadside sites. This study provided practical knowledge on the computation process of geographic variables in South Korea, which will improve air pollution prediction models and contribute to subsequent health analyses.

• 대한간호학회지
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• 제43권2호
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• pp.225-235
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• 2013

Purpose: This prospective cohort study was done to investigate recall bias to antepartum variables measured at postpartum periods and predictors of postpartum depression. Methods: Participants were 215 women who answered a self-administered questionnaire which included demographics, Postpartum Depression Predictors Inventory-Revised and Korean version of Edinburgh Postpartum Depression Scale at antepartum 36-40 weeks and postpartum 2 weeks and 6 weeks. Data were analyzed using kappa, and hierarchical multiple logistic regression. Results: Agreement between antepartum variables at both antepartum and two postpartum periods was relatively high (${\kappa}$=.55- .95). Postpartum depression rates were 36.3% and 36.7% at two follow-up points. In hierarchical multiple logistic regression analysis, prenatal depression (OR=4.32, 95% CI: 1.41-13.19; OR=5.19, 95% CI: 1.41-19.08), social support (OR=1.40, 95% CI: 1.18-1.66; OR=1.27, 95% CI: 1.06-1.53) and maternity blues (OR=4.75, 95% CI: 1.89-11.98; OR=4.22, 95% CI: 1.60-11.12) were commonly associated with postpartum depression at two follow-up points. Child care stress (OR=1.85, 95% CI: 1.01-3.37) was only associated with postpartum depression at 2 weeks postpartum and pregnancy intendedness (OR=1.57, 95% CI: 1.09-2.27) was only associated with postpartum depression at 6 weeks postpartum. Conclusions: The results indicate a need to apply nursing interventions such as prenatal education and counseling with families from antenatal period.