• 대한영양사협회학술지
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• 제25권2호
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• pp.142-155
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• 2019

The aim of this study was to construct and test a structural equation model for the risk factors of metabolic syndrome in Korean adults. The structural equation model hypothesizes that eating alone and feeling depressed is a risk factor for metabolic syndrome. The data of this study were obtained from the Sixth Korea National Health and Nutrition Examination Survey which was cross-sectional data from the representative national survey. A total of 4,013 subjects replied to the survey item of lifestyle and completed the physical examinations among adults aged 19 years or older in South Korea was in 2015. The structural model in this study was composed of four latent variables: eating alone, depression, negative health behavior, and metabolic syndrome. Two variables, the rate of eating alone and depression, were exogenous variables. Negative health behavior was both a mediating variable and endogenous variable, and metabolic syndrome was the final endogenous variable. The data were analyzed using the Maximum Likelihood method and bootstrapping. The structural model was appropriate for the data based on the model fit indices. The results of this study can be summarized as follows: Eating alone is a direct risk factor of metabolic syndrome in Korean women. Depression can mediate metabolic syndrome through negative health behaviors. Negative health behavior had a direct impact on metabolic syndrome in both men and women. This study may be a guideline for interventions and strategies to reduce the incidence of metabolic syndrome in Korean adults.

• 한국터널지하공간학회 논문집
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• 제20권6호
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• pp.931-946
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• 2018

도심지에서의 공동구의 활용성 증가에 따라 쉴드 TBM 공법이 적용된 터널식 공동구의 시공 및 연구개발이 활발히 진행되고 있다. 터널식 공동구는 지하굴착 공사로써 건설안전에 상대적으로 취약하지만, 건설업 재해율 감소를 위한 설계안전성 검토 제도 도입에도 불구하고 터널식 공동구 건설에 적합한 위험요소가 제대로 알려져 있지 않다. 따라서 본 연구에서는 터널식 공동구에 적합한 안전 위험요소를 발굴하고 이중에서 중점으로 관리되어야 할 핵심 안전 위험요소를 도출하였다. 도출된 핵심 안전 위험요소는 매트릭스 기법을 적용하여 위험성 평가를 실시함으로써 공동구 계획, 설계 및 시공 단계의 위험성 평가 및 주요 참고 자료로 사용될 수 있도록 하였다.

• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.97.1-97.12
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• 2018

Objective: Women with cervical cancer (CC) found to have positive surgical margins, positive lymph nodes, and/or parametrial invasion receive a survival benefit from postoperative chemoradiotherapy (CRT) vs. radiation therapy (RT) alone. However, older women may not benefit to the same extent, as they are at increased risk of death from non-oncologic causes as well as toxicities from oncologic treatments. This study sought to evaluate whether there was a survival benefit of CRT over RT in elderly patients with cervical cancer. Methods: The National Cancer Database was queried for patients ${\geq}70$ years old with newly diagnosed IA2, IB, or IIA CC and positive margins, parametrial invasion, and/or positive nodes on surgical resection. Statistics included logistic regression, Kaplan-Meier overall survival (OS), and Cox proportional hazards modeling analyses. Results: Altogether, 166 patients met inclusion criteria; 62 (37%) underwent postoperative RT and 104 (63%) underwent postoperative CRT. Younger patients and those living in areas of higher income were less likely to receive CRT, while parametrial invasion and nodal involvement were associated with an increased likelihood (p<0.05 for all). There were no OS differences by treatment type. Subgroup analysis by number of risk factors, as well as each of the 3 risk factors separately, also did not reveal any OS differences between cohorts. Conclusion: In the largest such study to date, older women with postoperative risk factor(s) receiving RT alone experienced similar survival as those undergoing CRT. Although causation is not implied, careful patient selection is paramount to balance treatment-related toxicity risks with theoretical outcome benefits.

• 대한간호학회지
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• 제52권1호
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• pp.24-35
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• 2022

Purpose: This study investigated the incidence and risk factors of cataract in people with diabetes mellitus (DM) using data from Ansan cohort of the Korean Genome and Epidemiology Study (KoGES). Methods: Data from a total of 329 patients with type 2 DM without cataract who participated in Ansan cohort of the KoGES from baseline survey (2001-2002) to fifth follow-up visit (2011-2012) were examined. The characteristics of the subjects were analyzed with frequency and percentage, and mean and standard deviation. Cataract incidence was measured as incidence proportion (%). For risk factors of cataract, hazard ratio (HR) and 95% confidence interval (CI) were obtained using the Cox proportional hazard model. Results: The cataract incidence over a 10-year follow-up period was 19.1% (15.1 in males and 25.8 in females), and mean age at the incidence of cataract was 63.48 years (61.58 years in males and 65.31 years in females). Age (HR=1.09, 95% CI=1.05-1.13) and HbA1c (HR=1.21, 95% CI=1.07-1.37) or the duration of DM (HR=1.05, 95% CI=1.00-1.09) were found to be independently associated with cataract development. Conclusion: Cataract development in people with DM is common, and its likelihood increases with age, HbA1c, and the duration of DM. Considering negative effect of cataract on their quality of life and economic burden, nurses should identify people with DM at a higher risk of cataract development, and plan individual eye examination programs to detect cataract development as early as possible.

• 응용통계연구
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• 제26권3호
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• pp.483-494
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• 2013

국제적인 금융위기가 연달아 발생하면서, 금융리스크관리의 중요성이 어느 때보다 더 커지고 있다. 금융리스크관리의 주요 현안 가운데 하나는 리스크를 어떻게 측정할 것인가이며, 가장 널리 사용되고 있는 방법이 Value at Risk(VaR)이다. 금융자료가 최근 시장에서처럼 두꺼운 꼬리를 갖는 분포를 보일 때, 우리는 극단치 이론을 이용하여 VaR를 측정하는 방법을 고려할 수 있다. 이 논문에서는 꼬리가 매우 두꺼운 분포를 갖는 자료를 적합시킬 때 많이 사용되는 Peaks over Threshold(POT)를 이용하여 VaR를 측정하는 방법을 연구하였다. POT를 이용하기 위해서는 우선 일반화 파레토 분포(GPD)의 모수를 추정해야 하는데, 여기서 우리는 KOSPI 5분 자료를 이용하여 추정된 VaR의 성능을 살펴봄으로써 세 가지 다른 모수추정 방법을 비교하였다. 또한, Normal Inverse Gaussian(NIG) 분포에서 자료를 생성하여 두 가지 다른 모수추정 방법을 비교하기도 하였다. 이러한 비교를 통하여 KOSPI 수익률 자료의 첨도가 매우 큰 경우에는 최근 제안된 모수추정 방법들이 최대가능도 추정법에 비해 월등히 나은 성능을 보임을 알 수 있었고, 모의실험 자료에서도 같은 결과를 확인하였다.

• Journal of Chest Surgery
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• 제53권5호
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• pp.258-262
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• 2020

Background: The aim of this study was to evaluate risk factors associated with difficult heparin reversal by protamine after cardiopulmonary bypass. Methods: Data from 120 consecutive patients who underwent open heart surgery from 2009 to 2017 were retrospectively reviewed. Patients were divided into 2 groups: (1) those in whom complete heparin reversal was achieved after a single infusion of protamine (group A, n=89); and (2) those who required more protamine for heparin reversal (group B, n=31). Results: Female sex, prolonged bypass time (>200 min), long aortic cross-clamping time (>120 min), and a lowest rectal temperature <26℃ were significant predictors of difficult heparin reversal. Larger amounts of fresh frozen plasma and platelet concentrate were transfused in group B than in group A. Conclusion: Surgeons' efforts to reduce operative time and avoid deep hypothermia may be helpful for increasing the likelihood of easy heparin reversal, especially in female patients.

• Childhood Kidney Diseases
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• 제19권1호
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• pp.8-13
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• 2015

Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.

• 한국작물학회지
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• 제46권2호
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• pp.157-163
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• 2001

Introgression from genetically modified plants (GMPs) may be dependent on the genetic similarity to wild relative plants. In Korea, many wild plant species are botanically related to the cultivated plants that have a potential to be genetically transformed. The controversy for hazards of GMPs is continuing because the studies on gene flow or introgression are little. Based on the systematic criteria, we have surveyed Korean wild plant species that showed the similarity to cultivating crops. The consideration for feasibility of genetic pollution (introgression of transgene) is necessary for the successful accomplishment in the practical use of GMPs. Although the detrimental effects of GMPs on wild relatives have not been clearly verified, Korean wild plant species related to crop plant (potential GMP) have to be investigated with respect to the introgression. Korean flora consists of ca. 5,500 species. Among them, 1,448 species are classified as weed species (966 native, 325 naturalized, and 167 escaped ones), which is vulnerable to GMPs in term of introgression. We suggested the principal Korean wild plants related to major crops that might be affected by GMPs via introgression. The investigated species herein are selected based on the morphological and phenological relationship. It is necessary to verify the genetic relationship between cultivated plants and wild relatives sing more precise molecular techniques, which provide the information of likelihood for the introgression of transgene.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권1호
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• pp.39-44
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• 2020

Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

• Journal of Preventive Medicine and Public Health
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• 제41권3호
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• pp.200-207
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• 2008

Objectives : This study examined whether serious psychological distress (SPD) is associated with occupational injury among US employees. Methods : The employed population aged 18-64 years was examined (n=101,855) using data from the National Health Interview Survey (NHIS) 2000-2003. SPD was measured using the Kessler 6-item Psychological Distress Scale (K-6), a screening scale designed to identify persons with serious mental illness. The predicted marginal prevalence of psychological distress and occupational injury with the adjusted odds ratio were estimated using multiple logistic regression analyses. Results : The age-adjusted 3-month prevalence of occupational injury was $0.80{\pm}0.12%$ in workers with SPD, which was 37% greater than in workers without SPD ($0.58{\pm}0.03%$). The odds of occupational injury in workers with SPD were higher compared to workers without SPD (OR=1.34, 95% CI=0.93-1.92), after controlling for sex, age, race, education, occupation, and activity limitation by at least one medical condition. Male, service and blue collar occupation, and activity limiation by co-morbidity showed significantly higher odds of occupational injury for workers with SPD. Conclusions : The findings suggest that SPD accounts for an increased likelihood of occupational injury among US employees. A further longitudinal study is needed to differentiate the mechanism or causal pathways linking individual injury risk at the workplace, SPD, and socioeconomic factors.