• Journal of Hospice and Palliative Care
• /
• 제24권4호
• /
• pp.254-260
• /
• 2021

Continuous deep sedation (CDS) is an extreme form of palliative sedation to relieve refractory symptoms at the end of life. In this study, we shared our experiences with CDS and examined the clinical characteristics associated with survival in patients with terminal cancer who received CDS. We conducted a chart audit of 106 consecutive patients with terminal cancer who received CDS at a single hospice care unit between January 2014 and December 2016. Survival was defined as the first day of admission to the date of death. The associations between clinical characteristics and survival were presented as hazard ratios and 95% confidence intervals using a Cox proportional hazard model. The mean age of participants was 65.2 years, and 33.0% (n=35) were women. Diazepam was the most commonly administered drug, and haloperidol or lorazepam were also used if needed. One sedative was enough for a majority of the patients. Stepwise multivariate analysis identified poor functioning, a high Palliative Prognostic Index score, hyperbilirubinemia, high serum ferritin levels, and a low number of sedatives as independent poor prognostic factors. Our experiences and findings are expected to be helpful for shared decision-making and further research on palliative sedation.

• 한국치위생학회지
• /
• 제21권2호
• /
• pp.119-128
• /
• 2021

Objectives: The aim of this study was to investigate the effect of breastfeeding on the occurrence of early childhood caries in Korean infants and toddlers. Methods: Data on oral examinations of infants and toddlers of the National Health Insurance Service were analyzed. The study subjects were children who participated in both the first, second, and third oral examinations and the first general health examination in 2008-2017 (n=142,185). Based on the responses to the questionnaire, the subjects were classified into breastfeeding, formula feeding, and mixed feeding groups. The participants were monitored for the development of early childhood caries in three sequential oral examinations. Results: Based on the oral examination results conducted at 54-65 months old, the decayed-filled teeth index of the breastfeeding group was the highest (2.03±3.08), followed by the mixed (1.96±3.03) and the formula feeding groups (1.82±2.91). The Cox proportional hazard regression model including all the variables showed that the risk of developing dental caries was significantly lower in the formula (hazard ratio [HR], 0.85) and mixed feeding groups (HR, 0.91) than in the breastfeeding group. Conclusions: Breastfeeding children have a higher risk of early childhood caries; therefore, oral hygiene education and regular dental check-ups are necessary.

• 한국식품영양과학회지
• /
• 제42권11호
• /
• pp.1753-1758
• /
• 2013

본 연구에서는 식이패턴의 차이가 BMI 25 이상의 비만 발병에 영향을 미치는지 구명하였다. 한국인유전체역학조사사업으로 일환으로 수행된 안성-안산 코호트 연구의 식품섭취빈도 자료에 대해 군집분석을 수행하여 3개의 식이패턴 군집을 도출하였다. 3개의 식이패턴은 '다양성', '잡곡', 그리고 '쌀밥' 식이패턴이다. 식이패턴, 나이, 열량섭취량, 소득, 교육수준, 흡연여부, 음주량, 고강도 활동 시간, 직업 변수들을 비만 발병률에 대한 Cox Hazard Model을 회귀분석 실시한 결과 식이패턴변수는 비만 발병에 영향을 미치지 않는 것으로 나타났다. 오히려 식이패턴보다는 나이, 섭취 열량, 소득, 고강도 활동시간, 직업 요인들이 비만 발병에 유의성 있는 영향을 미치는 것으로 나타났다.

• 한국환경보건학회지
• /
• 제33권4호
• /
• pp.242-249
• /
• 2007

Indoor air quality has become a topic of interest and concern. Especially changes in construction design and the increased use of synthetic products may result in an increasing of complaints and health effects about the quality of indoor air at home. In this study, nitrogen dioxide($NO_2$) and volatile organic compounds(VOCs) within new and established apartments on the basis of 4 years of building year were measured every 3 days consecutively during 60 days. We selected each 10 house in Seoul, Asan and Daegu, respectively, and produced risk numbers for hazard quotients, and predicted increases in incidence of cancer. The calculations were made for the adult with default exposure values and also made for a worst case scenario using Monte-Carlo simulation as describing the reasonable exposure(RME). Mean of Monte carlo analysis by benzene, in the construction under 4 years (male: $9.2{\times}10^{-5}$, female: $1.0{\times}10^{-4}$) and over 4 years (male: $6.8{\times}10^{-5}$, female: $8.3{\times}10^{-5}$) exceeded $10^{-6}$ of permitted standards in US EPA, RME of Monte carlo analysis. In construction under 4 yews (male: $9.9{\times}10^{-3}$, female: $9.6{\times}10^{-3}$) and over 4 years (male: $9.8{\times}10^{-3}$, female: $7.8{\times}10^{-3}$) exceeded $10^{-4}$ of maximum permitted standards in US EPA. The hazard index of non-carcinogenic pollutants by nitrogen dioxide, toluene, m,p-xylene and o-xylene, both male and female in apartment constructed under 4 yews and over 4 years was found less than the permitted standards of hazardous health effects in CTE. Significant cancer risks and non-cancer hazard quotients were predicted in under 4 yews of building year.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권22호
• /
• pp.10027-10031
• /
• 2014

Background: We investigated the risk of cancer mortality according to obesity status and metabolic health status using sampled cohort data from the National Health Insurance system. Materials and Methods: Data on body mass index and fasting blood glucose in the sampled cohort database (n=363,881) were used to estimate risk of cancer mortality. Data were analyzed using a Cox proportional hazard model (Model 1 was adjusted for age, sex, systolic blood pressure, diastolic blood pressure, total cholesterol level and urinary protein; Model 2 was adjusted for Model 1 plus smoking status, alcohol intake and physical activity). Results: According to the obesity status, the mean hazard ratios were 0.82 [95% confidence interval (CI), 0.75-0.89] and 0.79 (95% CI, 0.72-0.85) for the overweight and obese groups, respectively, compared with the normal weight group. According to the metabolic health status, the mean hazard ratio was 1.26 (95% CI, 1.14-1.40) for the metabolically unhealthy group compared with the metabolically healthy group. The interaction between obesity status and metabolic health status on the risk of cancer mortality was not statistically significant (p=0.31). Conclusions: We found that the risk of cancer mortality decreased according to the obesity status and increased according to the metabolic health status. Given the rise in the rate of metabolic dysfunction, the mortality from cancer is also likely to rise. Treatment strategies targeting metabolic dysfunction may lead to reductions in the risk of death from cancer.

• 한국지반공학회논문집
• /
• 제30권6호
• /
• pp.61-68
• /
• 2014

본 연구는 실제 지형의 특성을 파악, 이를 초기 산사태 위험도 평가에 활용하는데 그 목적이 있다. 지형특성 분석을 위해 SINMAP과 통계적 기법인 평면도(Planarity)를 활용하였으며 이를 실제 산사태 발생지역에 적용, 지형 특성과 산사태 위험도와의 관계를 규명하고자 하였다. 분석결과는 제안한 두 가지 기법 모두 위험도가 높다고 평가한 지역에서는 초기 산사태 위험도가 상대적으로 높게 산정되었다. 이는 본 연구에서 제시한 방법이 지형특성과 산사태 위험도와의 관계성 규명에 있어 합리적임을 보여준다고 할 수 있다. 또한, 실제 현장조사 결과와 비교한 초기 산사태 위험도는 SINMAP 기법이 토석류와 같은 연속성 산사태에 있어 보다 정확하게 판단되었으나, 특정요소의 위험성을 구체적으로 고려할 수 있는 기법을 추가적으로 고려한다면 보다 정확한 초기 산사태 위험도를 평가할 수 있을 것으로 사료된다.

• 한국환경보건학회지
• /
• 제36권4호
• /
• pp.294-305
• /
• 2010

This study estimated the health risk of heavy metals in particulate matter $(PM)_{2.5}$ in a Gwangyang industrial complex. The $PM_{2.5}$ containing heavy metal was collected from January to November, 2008 using a denuder air sampler and by IC (Ion Chromatograph). The risk assessment was performed in a four-step process; hazard identification, exposure assessment, dose-response assessment and risk characterization. In the hazard identification process, $Cr^{6+}$, Ni, As, and Pb were categorized as human carcinogens and probable human carcinogens, while Ti, Mn, Se, P, $Cr^{3+}$, Cu, and Zn were not classified as human carcinogens. It was found that the excess cancer risk by Central Tendency Exposure (CTE) of $Cr^{6+}$ and As in $PM_{2.5}$ was > $10^{-6}$, and the total excess cancer risk posed by carcinogen heavy metals in $PM_{2.5}$ was > $10^{-6}$. It was also determined that the total hazard index by CTE of non-carcinogen heavy metals in $PM_{2.5}$ was <1. Taken together, these results indicate a high cancer risk associated whit inhalation of heavy metal-containing$PM_{2.5}$ in industrial areas.

• 한국식품영양학회지
• /
• 제26권1호
• /
• pp.44-50
• /
• 2013

Quantitative analyses of naturally occurring methanol were performed for the alcoholic beverages commonly consumed in Jecheon, Chungbuk province, South Korea. The headspace analysis method was optimized for the low and high alcoholic beverages. The external standard method was applied due to the overlapping of 2-propanol and 2-butanol (the internal standard candidates) with target sample matrix peaks. The target samples were selected based on the retail sales amounts of alcoholic beverages in the largest retailer food-mart chain, Jecheon, Chungbuk province, South Korea. There was no sample containing methanol over 0.5 $mg/m{\ell}$, the Korean maximum level of methanol in alcoholic beverages (1.0 $mg/m{\ell}$ for fruit originated liquor etc). The total exposure amount of methanol via alcoholic beverages was estimated based on the daily alcohol consumption of 40 g. The hazard indices calculated by methanol RfD 0.5 mg/kg bw day (US EPA) and ADI 20 mg/kg bw day (proposed by Lachenmeier etc.) were 0.301 and 0.008, respectively. As with the hazard index, aggregate exposures below a HI of 1.0 will likely not result in adverse noncancer health effects over a lifetime of exposure. Then the methanol exposure via the alcoholic liquours might not hazard to Jecheon citizen.

• 한국방재학회 논문집
• /
• 제5권4호
• /
• pp.79-84
• /
• 2005

건축물, 운송수단에 많이 사용되는 고분자재료는 화재에 노출되면 다량의 열 및 연소가스를 발생시켜 피해를 야기시키는데 특히 유독성 연소가스는 인명피해의 주된 원인이 된다. 본 연구에서는 화재시 발생되는 다양한 종류의 연소가스를 동시에 연속적으로 분석할 수 있는 새로운 분석방법인 FTIR(Fourier Transform Infrared) 분석방법을 이용하여 ASTM E 1678 실험장치에서 발생시킨 PVC, FRP, SMC 및 Ureathane foam 4종의 고분자재료 연소가스를 분석하였고, 분석된 연소가스 데이터를 NIST에서 개발한 FED 독성 모델에 적용하여 연소가스 유해성을 정량적으로 제시하였다. 또한 현재 우리나라에서 사용되고 있는 마우스를 사용한 KS F 2271 가스유해성 실험결과와 비교분석을 하였으며, FTIR 연소가스 분석방법을 이용하면 동물을 사용하지 않고서도 연소가스 유해성을 정량적이고 정확하게 평가할 수 있음을 알 수 있었다.

• 한국수자원학회논문집
• /
• 제39권1호
• /
• pp.23-33
• /
• 2006

본 연구에서는 국내에서 발생했던 산사태에 대한 사례연구를 통하여 GIS 기반의 산사태 예측모형 SINMAP의 적용성을 검토하였다. 사례연구의 대상지역은 서울에서 남쪽으로 78km 정도 떨어진 곳에 위치한 용인시 이동면 덕성리 소재 달봉산으로 1991년 집중호우기간 동안에 많은 산사태가 발생하였다. 이 지역에 대하여 SINMAP을 적용하여 당시 산사태지도와 비교 분석한 결과 대부분의 산사태를 성공적으로 예측하였다. 또한 본 연구에서는 SINMAP 모형의 적용에 필요한 3가지 매개변수인 흙의 내부마찰각, 점착력, T/R 산사태 예측에 미치는 영향과 적정범위에 대하여 검토하였다 본 연구를 통하여 SINMAP은 사면 경사가 급하고 토층의 두께가 얕은 국내산지의 산사태 위험도를 예비적으로 평가하는 유용한 도구가 될 수 있는 것으로 보인다.