• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5219-5223
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• 2013

The number of axillary lymph nodes involved and retrieved are important prognostic factors in breast cancer. The purpose of our study was to investigate whether the lymph node ratio (LNR) is a better prognostic factor in predicting disease-free survival (DFS) for breast cancer patients as compared with pN staging. The analysis was based on 804 breast cancer patients who had underwent axillary lymph node dissection between 1999 and 2008 in Sun Yat-Sen University Cancer Center. Optimal cutoff points of LNR were calculated using X-tile software and validated by bootstrapping. Patients were then divided into three groups (low-, intermediate-, and high-risk) according to the cutoff points. Predicting risk factors for relapse were performed according to Cox proportional hazards analysis. DFS was estimated using the Kaplan-Meier method and compared by the log-rank test. The 5-year DFS rate decreased significantly with increasing LNRs and pN. Univariate analysis found that the pT, pN, LNR, molecule type, HER2, pTNM stage and radiotherapy well classified patients with significantly different prognosis. By multivariate analysis, only LNR classification was retained as an independent prognostic factor. Furthermore, there was a significant prognostic difference among different LNR categories for pN2 category, but no apparent prognostic difference was seen between different pN categories in any LNR category. Therefore, LNR rather than pN staging is preferable in predicting DFS in node positive breast cancer patients, and routine clinical decision-making should take the LNR into consideration.

• 대한임상검사과학회지
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• 제50권2호
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• pp.136-143
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• 2018

심근부담률은 심근산소소비량을 간접적으로 측정하는 지표로 심박수와 수축기 혈압의 곱으로 나타내며, 심근이 받는 부담을 나타낸다. 본 연구는 한국성인을 대상으로 트레드밀 운동부하 검사시 대사증후군에 따른 심근부담률의 적정 수준을 제시함으로써 대사증후군 유병률을 낮추기 위한 심근부담률의 목표치를 설정하여 그 기준을 제시하고자 하였다. 대사증후군 진단은 National Cholesterol Education Program (NCEP)의 Adult Treatment Panel (ATP) III에서 제시한 5가지 진단기준 중 3개 이상 충족하는 경우 대사증후군 진단군(MetS, N=25), 1~2개의 기준에 해당하는 경우를 대사증후군 전단계군(Pre-MetS, N=106), 5개의 진단기준에 해당하지 않는 경우는 대사증후군 위험요인이 없는군(Non-MetS, N=65)으로 분류하였다. 운동부하검사는 Bruce 프로토콜에 따라 시행하였다. 심근부담률은(심박수${\times}$수축기 혈압)${\div}1,000$으로 구하였다. 본 연구결과 대사증후군 진단군에서 도달한 일량이 낮음에도 불구하고 최대 수축기 혈압이 높은 것으로 나타났다. 또한 대사증후군에 따른 운동부하 검사시 심근부담률의 최적 임계점은 운동부하검사 1단계에서는 $12.56mmHg{\times}beats/min{\times}10^{-3}$, 운동부하검사 2단계는 $16.94mmHg{\times}beats/min{\times}10^{-3}$, 운동부하검사 3단계에서는 $21.11mmHg{\times}beats/min{\times}10^{-3}$로 나타났다.

• 콘크리트학회지
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• 제5권4호
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• pp.167-178
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• 1993

본 논문의 목적은 R.C.보 최적설계에 이산수학계획법을 적용하여 상세설계를 포함하는 실제설계의 가능성을 연구하기 위한 것이다. 이산최적문제에서 설계변수로는 단면의 총높이, 폭, 유효높이 및 길이방향철근의 단면적 그리고 전단철근의 단면적과 길이 방향철근의 절단점과 같은 상세변수 등이 고려되었다. 목적함수는 경비함수로 취했으며, 제약조건으로는 강도설계법에 의한 설계휨강도, 전단강도, 연성, 사용성, 콘크리트 덮개 및 철근간격, 복부보강 그리고 정착길이와 길이방향철근의 절단점 등에 관한 시방서 요구사항을 고려하여 문제를 형성하였다. 이산변수를 갖는 최적설계를 효율적으로 실행하기 위해 첫째단계에서 Feasible Direction Methed를 이용하여 연속최적해를 구했으며, 둘째단계에서 분기한계법(Branch and bound method)을 이용하여 이산최적해를 얻는 최적화 알고리즘을 제안하였다. 제안된 알고리즘의 신뢰도를 검증하기 위해 2개의 이산설계변수를 갖는 수치예에 적용하여 도해법 및 rounde-up method와 그 결과를 비교하였고, 단순지지된 R.C.보 및 2경간연속 R.C.보에 적용하여 제안된 알고리즘의 신뢰도, 효율성 및 적용성을 입증하였다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권2호
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• pp.95-103
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• 2013

Purpose: Iron deficiency remains a very common nutritional problem despite the improvement in nutrition and increased understanding of methods for its prevention. Thus, we try to create a new method for screening iron nutrition through infant nutrition history. Methods: Among the children who visited Inha University Hospital from March 2006 to July 2012, 181 children with iron deficiency anemia (IDA) and 52 children without IDA ranging from 6 to 36 months of age were reviewed in this study. We used the age when they began to wean food, the type of sort weaning foods, the time required for successful weaning, iron content in weaning foods, and the duration of breastfeeding for scoring infant nutrition history based on a questionnaire. Results: The mean score of the IDA group was $7.8{\pm}2.6$ points, which was significantly higher than that of the control group ($5.6{\pm}2.1$) (p=0.000). If we set up the cutoff value at 6 points, this screening has 86.8% sensitivity and 36% specificity. In addition, as the IDA score increased, there was a falling trend of hemoglobin. Conclusion: The IDA score does not have high specificity or high sensitivity. However, this study conveys that those patients who record a high score have low hemoglobin. Therefore, we suggest this score system for screening more IDA patients via nonpainful techniques.

• Nutritional Sciences
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• 제2권2호
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• pp.107-112
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• 1999

Diet quality index DQI) offers a new way of comparing eating habits across populations and across countries. Nutrients and food consumption data from 100 elderly Korean women aged 65 and older were collected in Seoul or Kyunggi-do, Korea by the 24 hour recall method. Diet quality index (DQI) was computed for 1049 elderly women (65 and older) from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) in the US according to US dietary guidelines, and applied to the diet of elderly Korean women for purposes of comparison. A modified 16-point DQI awarded 2 points each for moderate consumption of fat ($\leq$ 30% energy), saturated fat ($\leq$ 10%), cholesterol ($\leq$ 300 mg/day), sodium ($\leq$ 2400 mg/day), and protein ($\leq$ 100% RDA), adequate intakes of carbohydrate ($\qeq$50% energy) and calcium ($\qeq$ 100% RDA), and plenty of fruits and vegetables ($\qeq$ 5 servings). Criteria were based on US dietary guidelines. Partial scores were given if subjects were close to meeting these cutoff points. Diets with $\leq$ 300 mg cholesterol/day were reported by 97% or the Korean sample and 82% of the American sample, while 90% of the Koreans and 42% of the Americans met the goal of $\leq$ 30% of energy from fat, and 98% of the Koreans and 47% of American met the recommendation of $\leq$ 10% of energy from saturated fat. In contrast, only 8% of the Korean sample met the sodium recommendation of $\leq$ 2400 mg sodium per day, whereas 54% of the American subjects met this goal. The mean DQI scores were 10.1 for the elderly American women and 11.3 for the elderly Korean women. Overall, the elderly Korean diet was more consistent with the US dietary guidelines than the elderly American diet.

• 지역사회간호학회지
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• 제24권2호
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• pp.225-235
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• 2013

Purpose: The purpose of this study is to identify the prevalence of the metabolic syndrome (MS) and factors associated with it among elders in a rural community. Methods: Data were collected from 683 subjects with a questionnaire, physical measurement, and blood test. The prevalence of the MS was determined by AHA/NHLBI and waist circumference cutoff points for Koreans. Results: The prevalence of the MS was 50.5% in total (41.6% in men, 56.3% in women) while the prevalence of 5 metabolic risk factors was 67.7% for elevated blood pressure, 51.0% for low HDL-cholesterol, and 50.2% for abdominal obesity. Risk factors associated with the prevalence of the MS included family history, BMI, and physical activity; significant factors associated with that of metabolic components included family history, BMI, smoking, drinking, and physical activity. Especially, a higher BMI was a strong risk factor of the prevalence of abdominal obesity as well as the MS and its components. Conclusion: The findings indicate that nurses should care for elders based on each metabolic component regarding its prevalence level and concentrate primarily on reducing elevated blood pressure, low HDL-cholesterol by controlling the main risk factor, abdominal obesity through lifestyle modification.

• 한국재난관리표준학회지
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• 제4권1호
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• pp.49-55
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• 2011

본 연구는 철근 콘크리트 구조물의 새로운 자동화 최적설계 알고리즘을 제시하였다. 기존의 주철근과 콘크리트 단면사이즈 등의 국한된 최적설계 범위를 벗어나 철근의 부착길이, 매입길이, 콘크리트 커버두께 등 세부설계사항까지 모두 고려한 실무에 적합한 효용성 높은 설계알고리즘을 제시함으로써 앞으로 실무분야에 많은 기여를 할 수 있다고 보여 진다.

• Clinical and Experimental Pediatrics
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• 제62권12호
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• pp.450-455
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• 2019

Background: Lipid accumulation product (LAP) is associated with the presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults. Purpose: Here we evaluated the ability of LAP to predict NAFLD in obese children. Methods: Eighty obese children (38 girls; age 6-18 years) were included. Anthropometric measurements and biochemical values were obtained from the patients' medical records. LAP was calculated as [waist circumference (WC) (cm) - 58]×triglycerides (mmol/L) in girls; [WC (cm) - 65]×triglycerides (mmol/L) in boys. The minLAP and adjLAP were described (3% and 50% of WC values, respectively) and the total/high-density lipoprotein cholesterol index (TC/HDL-C) was calculated. NAFLD was observed on ultrasound, and patients were divided into 3 groups by steatosis grade (normal, grade 0; mild, grade 1; moderate-severe, grade 2-3). The area under the curve (AUC) and appropriate index cutoff points were calculated by receiver operator characteristic analysis. Results: LAP was positively correlated with puberty stage (rho=0.409; P<0.001), fasting insulin (rho= 0.507; P<0.001), homeostasis model assessment of insulin resistance (rho=0.470; P<0.001), uric acid (rho=0.522; P<0.001), and TC/HDL-C (rho=0.494; P<0.001) and negatively correlated with HDL-C (rho=-3.833; P<0.001). LAP values could be used to diagnose hepatosteatosis (AUC=0.698; P=0.002). The LAP, adjLAP, and minLAP cutoff values were 42.7 (P=0.002), 40.05 (P=0.003), and 53.47 (P= 0.08), respectively. For LAP, the differences between the normal and mild groups (P=0.035) and the normal and moderate-severe groups were statistically significant (P=0.037), whereas the difference between the mild and moderate-severe groups was not (P>0.005). There was a statistically significant difference between the normal and mild groups for adjLAP (P=0.043) but not between the other groups (P>0.005). There was no significant intergroup difference in minLAP (P>0.005). Conclusion: LAP is a powerful and easy tool to predict NAFLD in childhood. If LAP is ≥42.7, NAFLD should be suspected. This is the first study to assess LAP diagnostic accuracy for childhood obesity.

• 한국콘텐츠학회논문지
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• 제13권1호
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• pp.333-341
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• 2013

본 연구는 청소년의 자아분화, 자아존중감, 학교생활 적응과의 관계와, 학교생활 적응에 미치는 영향요인을 파악하는 서술적 조사 연구이다. 연구 대상은 2011년 5월 9일부터 27일까지 K시에 소재한 2개 중학교 재학생508명이었으며, 수집된 자료는 n (%), t-test, ANOVA 및 Scheffe test, Pearson's Correlation Coefficient 및 multiple regression analysis를 실시하여 분석하였다. 연구결과는 다음과 같다. 첫째, 대상자 학교생활 적응은 학년, 성별, 성적, 모 교육수준, 가정경제수준에서 유의한 차이가 있는 것으로 나타났다. 둘째, 대상자의 자아분화 총점 평균은 102점, 자아존중감 평균은 27.3점, 학교생활 적응 총점 평균은 63.6점으로 나타났다. 셋째, 대상자 학교생활 적응은 자아분화(r=.54, p<.001) 및 자아존중감(r=.52, p=.001)과 정적으로 유의한 상관관계가 있는 것으로 나타났다. 넷째, 대상자 학교생활 적응을 설명해주는 변인으로 자아분화 수준의 하위영역에서 가족퇴행, 정서적 단절, 인지 정서적 기능, 가족투사와 자아존중감, 그리고 일반적 특성에서 성별(여), 모 교육수준(대학교이상), 성적(상)이 확인되었으며, 46.5%의 설명력을 나타냈다. 본 연구 결과를 통해 청소년의 학교생활 적응을 이해하기 위해서는 인간의 기본적 발달이 이루어지고 초기 소속집단인 가족적 맥락을 고려하는 것이 필요한 것으로 나타났다. 이에 청소년기 학교생활 적응 관리를 위한 간호중재 개발 시 가정환경을 고려한 프로그램 개발이 필요하다.

• 한국건강관리협회지
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• 제4권1호
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• pp.1-11
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• 2006

"본 논문은 대한외과학회지 2006년 제70권제1호에 실렸던 논문으로 대한외과학회 편집위원회 승인을 득하고 본 협회지에 게재함. Purpose: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no' gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. Methods Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion fey malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid-arm muscle circumference, serum albumin)in and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic(ROC) curve was drawn to choose a cutoff valve that maximizes sensitivity and specificity. Results' The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified7 patients(13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. Conclusion The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.