• 한국보육학회지
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• 제19권2호
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• pp.101-116
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• 2019

본 연구목적은 어린이집 1세와 2세반의 영아반 교사에 따라 나타난 신체활동 운영계획, 내용선정, 평가의 실행과 지원요구 차이를 분석하여 영아 발달수준에 적합한 신체활동 운영방안의 기초자료를 제공하는 것이다. 연구대상은 J도 어린이집 영아반 담임교사 221명이며, 51문항으로 구성된 설문지를 배포하여 수집된 자료는 ${\chi}^2$ 검증, 독립표본 t-검증 하였다. 연구결과 첫째, 신체활동 실행 변인 중에서 학급크기, 수업계획자, 적합한 지도자, 실외운동 주당수업 빈도와 수업시간, 연계교육 계획의 일부 변인, 신체활동 내용선정의 일부 변인, 신체활동 평가의 일부 변인에서 반별에 따라 유의한 차이가 나타났다. 둘째, 신체활동 실행 시 지원요구 변인 중에서 신체활동계획안 작성법, 교수학습방법, 평가방법, 신체표현활동프로그램, 보수교육운영 시 표준보육과정 신체운동영역의 일부 변인에서 반별에 따라 유의한 차이가 나타났다. 본 연구에서 논의된 1세반과 2세반에 적합한 신체활동 운영방안과 교사의 지원 요구를 개선시킬 수 있는 방안의 일환으로 효율적인 영아보수교육 운영에 대해서 제언도 하였다.

• Clinical and Experimental Pediatrics
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• 제62권5호
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• pp.179-186
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• 2019

Purpose: Information about overweight and obesity among students in rural areas of Thailand is limited. Therefore, we aimed to determine overweight and obesity prevalences and associated factors among school-aged children in a rural community of Thailand. Methods: We selected 9 public schools through cluster sampling in 2 provinces located in central Thailand in 2016. Anthropometric measurements were measured using standard techniques, classified as overweight (>1 standard deviation [SD]) and obese (>2 SD) with respect to their age and sex using 2007 World Health Organization reference charts. Standardized questionnaires on risk factors were sent to parents to be completed together with their child. Results: Among 1,749 students, 8.98% had overweight and 7.26% had obesity. Mean age (range) was 11.5 years (5-18 years). Independent factors associated with overweight and obesity included primary school student (reference as secondary school) (adjusted odds ratio [aOR], 2.25; 95% confidence interval [CI], 1.24-4.08; P=0.07), mother's body mass index (aOR, 1.07; 95% CI, 1.02-1.12; P=0.001), self-employed father (aOR, 1.99; 95% CI, 1.12-3.55; P=0.018), number of siblings (aOR, 0.61; 95% CI, 0.47-0.81; P=0.001), having sibling(s) with obesity (aOR, 1.82; 95% CI, 1.20-2.77; P=0.005), more than one (aOR, 7.16; 95% CI, 2.40-21.32; P<0.001), consuming 2-3 ladles of rice/meal (aOR, 2.14; 95% CI, 1.38-3.32; P=0.001), consuming >3 ladles of rice/meal (aOR, 2.69; 95% CI, 1.11-6.46; P=0.27), watching <2 hours of television/day (aOR, 2.18; 95% CI, 1.19-4.01; P=0.012), and watching >2 hours of television/day (aOR, 2.60; 95% CI, 1.36-4.96; P=0.004). Conclusion: Many sociodemographic, dietary, and behavioral factors were related to overweight and obesity among school-aged children not only in urban but also rural communities of Thailand.

• 환경영향평가
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• 제28권1호
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• pp.49-62
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• 2019

환경변화는 생물의 성장과 번식 등의 생활사에 영향을 주며, 생물은 살아가는 서식환경에서 생태적 적합도를 가장 극대화 시킬 수 있도록 적응되어 왔다. 본 연구에서는 동적상태의존모델을 이용하여 수온과 용존산소량의 변화가 어류의 초기 성장과 체내 스트레스 누적 과정에 미치는 영향을 분석하였다. 본 연구에서 제시한 어류의 생활사 모델은 취식 행동이 성장과 체내 스트레스 누적에 영향을 받는다고 가정하였다. 또한 수온과 용존산소량의 임계점은 가장 빠른 성장속도를 유도하는 수온과 용존산소량으로 가정하였다. 이에 모델은 수온과 용존산소량의 임계점에서 성장속도가 가장 빨랐으며 임계점보다 크거나 낮은 경우 성장속도는 느렸다. 용존산소량의 저산소 상태는 체내에 누적된 스트레스양의 증가로 성장속도는 느렸고, 고산소 상태는 성장속도를 향상 시켰으나 누적된 스트레스로 신체 크기를 감소시켰다. 본 연구를 통해 환경변화가 생물에 미치는 영향을 예측하는데 있어 단일 또는 독립적인 환경요인 보다 복합적 요인들의 영향이 높음을 보였다. 따라서 환경영향평가에서 환경변화에 대한 영향 예측을 향상시키기 위하여 생리생태학적 측면에서의 복합적 환경 요인을 평가에 도입이 필요하고 또한 관련된 기법 개발에 대한 연구가 후속 되어야 한다.

• Tuberculosis and Respiratory Diseases
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• 제82권2호
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• pp.118-125
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• 2019

Background: Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. Methods: Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015. Results: The median age was 69 years (interquartile range, 60-74 years); 65.4% were male and 62.1% were ever-smokers. Cough was the most common initial symptom (33.5%); 13.1% of patients were asymptomatic. While squamous cell carcinoma was the most common subtype in male patients (37.2%), adenocarcinoma was the most frequent histological type in all patients (48.7%) and females (76.3%). The majority of patients received treatment (76.5%), which included surgery, radiation therapy, and chemotherapy. Older age (hazard ratio [HR], 1.037), lower body mass index (HR, 0.904), ever-smoker (HR, 2.003), small cell lung cancer (HR, 1.627), and distant metastasis (HR, 3.990) were independent predictors of mortality. Patients without symptoms (HR, 0.387) and without treatment (HR, 0.364) were associated with a favorable outcome in multivariate Cox analysis. Conclusion: Lung cancer in Korea occurs predominantly in elderly patients, with adenocarcinoma being the most frequent subtype. The prognosis was poorer in ever-smokers and older, malnourished, and untreated patients with advanced lung cancer.

• Clinical and Experimental Otorhinolaryngology
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• 제11권4호
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• pp.293-300
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• 2018

Objectives. The current study aims to determine the correlation between nutritional status upon presentation and disease severity, as well as treatment and survival outcomes. Methods. Patients who were diagnosed with deep neck infection, underwent at least one surgical drainage/debridement, and had more than 1 week of hospitalization at a tertiary medical center from 2007 to 2015 were retrospectively included. Thereafter, initial serum albumin, C-reactive protein (CRP), and body mass index (BMI) were reviewed. Results. A total of 135 patients were included in the final analysis. Accordingly, the proportion of patients with simultaneous mediastinitis (21.0%), necrotizing fasciitis (12.9%), disease extent >1 cervical level (72.6%), mean CRP (22.4 mg/dL), mean length of hospitalization (25.0 days), and mean 1-week follow-up CRP (7.2 mg/dL) was significantly higher in the hypoalbuminemia group (initial serum albumin <3.0 g/dL) than in the normoalbuminemia group (all P<0.05). No significant correlations had been observed according to BMI status. After adjusting for age and Charlson comorbidity index, odds ratios for the following outcomes were calculated in patients initially presenting with hypoalbuminemia: simultaneous mediastinitis (3.07), necrotizing fasciitis (7.89), disease extent >1 cervical level (2.12), initial serum CRP over 20 mg/dL (3.79), hospitalization of more than 14 days (4.10), 1-week follow-up CRP over 5 mg/dL (3.78), and increased duration for an over 50% decrease in initial CRP (2.70) (all P<0.05). Although intravascular albumin replenishment decreased the proportion of patients with hypoalbuminemia after 2 weeks (P<0.05), it did not significantly predict better treatment outcomes. Conclusion. Among the markers reflecting an individual's nutritional state, an initial serum albumin of less than 3.0 g/dL was an independent serologic marker predicting increased disease severity and complications in patients with deep neck infection.

• 대한임상검사과학회지
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• 제53권3호
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• pp.241-248
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• 2021

본 연구는 고혈압이 있는 대한민국 성인에서 아스파르트산 아미노전이효소(aspartate aminotransferase, AST)/알라닌 아미노전이효소(alanine aminotransferase, ALT) 비율과 맥압(pulse pressure, PP) 사이의 관계를 평가하기 위해 수행되었다. 제6차 국민건강영양조사(KNHANES VI-3, 2015)에서 성인 1,515명의 데이터를 분석했다. 본 연구에서는 몇 가지 중요한 결과가 있다. 첫째, AST (odds ratio [OR], 1.018; 95% confidence interval [CI], 1.002~1.033), ALT (OR, 0.982; 95% CI, 0.969~0.996) 및 AST/ALT ratio (OR, 1.367; 95% CI, 1.027~1.819)는 고PP 결정하는 독립적인 요인이었다. 둘째, 관련변수(연령, 성별, 흡연, 음주, 규칙적인 운동, TC, TG, HDL-C, FBG, BMI, WC)를 조정한 후의 결과에서 AST/ALT ratio의 1 사분위에 대한 고PP의 OR을 기준으로, AST/ALT ratio의 2 사분위(OR, 1.188; 95% CI, 0.817~1.727) 및 AST/ALT ratio의 3 사분위(OR, 1.169; 95% CI, 0.800~1.710)는 유의하지 않았지만, AST/ALT ratio의 4 사분위(OR, 1.632, 95% CI, 1.113~2.393)에서 유의하게 높았다. 결론적으로, 고혈압이 있는 대한민국 성인에서 고PP은 AST/ALT ratio 및 AST와 양의 상관관계가 있었지만 ALT와 음의 상관계가 있었다.

• 융합정보논문지
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• 제11권5호
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• pp.242-250
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• 2021

본 연구는 서울·경기에 위치하고 있는 노인복지관과 노인정에서 자발적으로 참여의사를 밝힌 65세 이상노인 514명을 대상으로 노인의 근력, 인지기능, 일상생활수행능력 및 우울의 통합적 인과관계를 분석하였다. 자료수집은 근력은 상·하지근력, 악력(좌,우), 인지기능은 간이 정신상태검사, 선로잇기검사, 숫자외우기검사, 스트룹검사를 실시하였으며, 일상생활수행능력 및 우울은 설문지를 이용하여 측정하였다. 그 결과 첫째, 노인의 근력과 인지기능, 일상생활수행능력 및 우울간에는 통계적으로 유의한 상관관계가 나타났다. 둘째, 노인의 근력과 인지기능, 일상생활수행능력 및 우울의 통합적 관계성에 대한 분석에 모든 변인 간에 통계적 유의성이 나타났다. 본 연구는 노인의 근력, 인지기능, 일상생활수행능력 및 우울의 관계성을 확인하여 노인의 성공적인 노화와 자립적인 노후생활을 위한 기초자료를 제공할 수 있을 것이다.

• 대한방사선기술학회지:방사선기술과학
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• 제44권2호
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• pp.85-90
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• 2021

The purpose of this study is to consider usefulness of using AEC mode and importance of patient center location in L-spine lateral radiography by comparing dose and image quality according to the change of patient center location with using AEC mode or not. In this study, guide wire is attached to the human body phantom's lumbar spine and the lead ruler is attached to the bottom of the wall detector to find out center location in detector. ESD, mAs, and EI were selected as dose factors, and image quality was compared through SNR. With the lumbar spine located center of the detector, dose factors and image quality were compared according to using AEC mode or not. Afterwards, phantom moved 4 cm and 8 cm back and forth and compared dose factors and image quality. The exposure parameters were 85 kVp, 320 mA, x-ray field size 10×17 inch, and the distance between the center X-ray and the detector was fixed at 100 cm. The center X-ray was perpendicular to the fourth lumbar spine and the only bottom AEC chamber was used. All data were analyzed by independent t-test and ANOVA. As a result of this study, with AEC when the center is matched, ESD was 1.31±0.01 mGy, without AEC was 2.12±0.01 mGy. SNR was shown to be 22.81±1.83, and 23.44±1.87 respectively. When the phantom's center moves 4 cm, 8 cm forward, and 4 cm, 8 cm backward, ESD were 1.09±0.004 mGy, 0.32±0.003 mGy, 1.19±0.017 mGy, 1.11±0.006 mGy respectively, SNR were 18.29±0.60 dB, 11.11±0.22 dB, 18.98±0.80 dB, 17.71±0.82 dB. Using AEC in L-spine lateral radiography reduced ESD by 38%, EI by 35%, and mAs by 38%, without any difference in SNR(p<0.05). When the phantom's center moves 4 cm, 8 cm forward, and 4 cm, 8 cm backward, ESD was decreasing each 16%, 75%, 9%, 15%, EI was decreasing each 14%, 77%, 15%, 20%, mAs was decreasing each 15% 75% 9%, 15%. SNR was decreasing each 19%, 51%, 17%, 22%.

• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.78-87
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• 2021

Objective : Intraoperative neurophysiological monitoring (IONM) has been widely used during spine surgery to reduce or prevent neurologic deficits, however, its application to the surgical management for cervical myelopathy remains controversial. This study aimed to assess the success rate of IONM in patients with cervical myelopathy and to investigate the factors associated with successful baseline monitoring and the effect of increasing the stimulation intensity by focusing on motor evoked potentials (MEPs). Methods : The data of 88 patients who underwent surgery for cervical myelopathy with IONM between January 2016 and June 2018 were retrospectively reviewed. The success rate of baseline MEP monitoring at the initial stimulation of 400 V was investigated. In unmonitorable cases, the stimulation intensity was increased to 999 V, and the success rate final MEP monitoring was reinvestigated. In addition, factors related to the success rate of baseline MEP monitoring were investigated using independent t-test, Wilcoxon rank-sum test, chi-squared test, and Fisher's exact probability test for statistical analysis. The factors included age, sex, body mass index, diabetes mellitus, smoking history, symptom duration, Torg-Pavlov ratio, space available for the cord (SAC), cord compression ratio (CCR), intramedullary increased signal intensity (SI) on magnetic resonance imaging, SI length, SI ratio, the Medical Research Council (MRC) grade, the preoperative modified Nurick grade and Japanese Orthopedic Association (JOA) score. Results : The overall success rate for reliable MEP response was 52.3% after increasing the stimulation intensity. No complications were observed to be associated with increased intensity. The factors related to the success rate of final MEP monitoring were found to be SAC (p<0.001), CCR (p<0.001), MRC grade (p<0.001), preoperative modified Nurick grade (p<0.001), and JOA score (p<0.001). The cut-off score for successful MEP monitoring was 5.67 mm for SAC, 47.33% for the CCR, 3 points for MRC grade, 2 points for the modified Nurick grade, and 12 points for the JOA score. Conclusion : Increasing the stimulation intensity could significantly improve the success rate of baseline MEP monitoring for unmonitorable cases at the initial stimulation in cervical myelopathy. In particular, the SAC, CCR, MRC grade, preoperative Nurick grade and JOA score may be considered as the more important related factors associated with the success rate of MEP monitoring. Therefore, the degree of preoperative neurological functional deficits and the presence of spinal cord compression on imaging could be used as new detailed criteria for the application of IONM in patients with cervical myelopathy.

• 한국산학기술학회논문지
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• 제21권12호
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• pp.759-771
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• 2020

연구의 목적은 차상위 계층 우울 독거노인 삶의 경험을 통하여 삶의 의미를 파악하고 어떠한 삶을 살아가는지 본질적 구조를 알아보고자 함에 있다. 연구 대상은 인천광역시 A 정신건강복지센터에 등록된 65세 이상 노인으로, 한국형 노인우울척도(KGDS) 9점 이상, 현재 독거생활 1년 이상 된 의사소통의 어려움이 없는 차상위 계층 8명이다. 연구방법은 개인 심층 인터뷰를 통하여 2018년 5월부터 2019년 10월까지 Colaizzi 분석방법을 적용한 질적 연구이다. 연구결과 48개의 주제와 19개의 주제모음, 6개의 범주가 도출되었다. 참여자들이 차상위 계층 우울 독거노인으로 살아가는 경험은 '도움 없이 살수 없는 초라한 삶', '몸과 마음이 병든 삶', '자립하고 싶은 삶', '감사하는 삶', '내면의 평화가 있는 삶', '제도적 보완이 필요한 삶'으로 나타났다. 연구를 통해 차상위 계층 우울 독거노인을 위한 지역사회의 정서적 지지 프로그램 개발을 위한 정보를 제공하고 국가적인 차원의 다양한 복지 정책을 위한 근거 자료의 기초가 되고자 한다.