• Journal of Periodontal and Implant Science
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• 제51권2호
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• pp.114-123
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• 2021

Purpose: This retrospective cohort study aimed to assess the effect of nonsurgical periodontal therapy on glycated hemoglobin (HbA1c) levels in patients with both type 2 diabetes and chronic periodontitis. Methods: The intervention cohort (IC) comprised 133 patients with type 2 diabetes who received nonsurgical periodontal treatment, while the matching cohort (MC) included 4787 patients with type 2 diabetes who visited the Department of Endocrinology and Metabolism of Asan Medical Center. The patients in each cohort were divided into 3 groups according to their baseline HbA1c level: subgroup 1, HbA1c <7%; subgroup 2, 7%≤ HbA1c <9%; and subgroup 3, HbA1c ≥9%. Changes in HbA1c levels from baseline to 6 and 12 months were analyzed. In addition, the association between changes in HbA1c levels and the number of periodontal maintenance visits was investigated. Results: There were no statistically significant changes in HbA1c levels in the IC and MC or their subgroups when evaluated with repeated-measures analysis of variance. However, the IC showed maintenance of baseline HbA1c levels, while the MC had a trend for HbA1c levels to steadily increase as shown by pairwise comparisons (baseline to 6 months and baseline to 12 months). IC subgroup 1 also maintained steady HbA1c levels from 6 months to 12 months, whereas MC subgroup 1 presented a steady increase during the same period. The number of periodontal maintenance visits had no association with changes in HbA1c levels during the 1-year study duration. Conclusions: For patients with both type 2 diabetes and periodontitis, nonsurgical periodontal treatment and periodontal maintenance may help to control HbA1c levels.

• Journal of Gastric Cancer
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• 제21권1호
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• pp.49-62
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• 2021

Purpose: This study aimed to investigate the prognostic value of lymph node ratio (LNR) in patients with locally advanced gastric cancer who received neoadjuvant chemotherapy. Materials and Methods: We retrospectively enrolled gastric cancer patients treated with neoadjuvant chemotherapy and curative surgery at the First Affiliated Hospital of Zhejiang University from 2004 to 2015 as the study cohort. Patients with the same inclusion criteria treated in 2016-2017 were enrolled as the validation cohort. Kaplan-Meier curves were assessed using the log-rank test to analyze the differences in overall survival (OS). Multivariate survival analysis was performed using the Cox proportional hazards model. The areas under the receiver operating characteristic curve of ypN and LNR categories for predicting the actual 3-year OS were compared. Results: A total of 265 patients were included in the proposal cohort. The median number of retrieved lymph nodes (rLNs) was 32. The number of positive lymph nodes (pLNs) increased as rLN increased (P=0.037), but the LNR remained relatively constant (P=0.462). The LNR was categorized into 4 groups according to the prognosis: ypNr0, node-negative with rLN>25; ypNr1, node-negative with rLN≤25 or 00.3. In the validation cohort of 43 enrolled patients, there was a clear distinction in OS that significantly (P<0.001) varied depending on the LNR values and LNR was the only independent prognostic factor in multivariate analysis (P<0.001). Conclusions: LNR was an independent prognostic factor for survival of patients with gastric cancer after preoperative chemotherapy and might be an alternative predictor for ypN stage.

• Safety and Health at Work
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• 제13권1호
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• pp.112-116
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• 2022

Background/Aims: The Gachon Regional Occupational Cohort Study (GROCS) is a large-scale longitudinal study of occupational safety and health data (covering Work Environment Monitoring, Workers' Health Surveillance, and Occupational Health Service) conducted by the Gachon University Gil Medical Center (GUGMC) in Incheon, Republic of Korea. We conducted GROCS to identify the health effects of workers' occupational risks, behavior, socioeconomic status, and life style. Methods: The GROCS includes data from Work Environment Monitoring, Workers' Health Surveillance, and Occupational Health Service. The baseline year for all data collection was 2018. Work Environment Monitoring was conducted in 240 companies located in Incheon. General Health Examination and Special Health Examination were performed on 32,725 and 9,504 workers, respectively. Occupational Health Services were provided to 16,883 workers in 171 companies. These data have been collected and operated at an external data management institution and were provided as a retrospective cohort after removing personal identification information. Results: In 2018, the total number of companies was 2,854, among which which 488 special Health Examination, 171 Work Environment Monitoring, and 240 Occupational Health Service. The proportion of companies undergoing Special Health Examination was 17.1%, the proportion of companies undergoing Work Environment Monitoring was 8.4%, and the proportion of Companies undergoing Occupational Health Service was 6.0%. Conclusion: GROCS expects researchers to utilize its useful and reliable resource for occupational health and surveillance with for academic or political purposes to lead to improved workers' health and working environment.

• 한국노년학
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• 제41권3호
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• pp.397-420
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• 2021

본 논문은 전향적 설계를 통하여 중장년 및 노년기 성인 자원봉사와 고혈압 발생, 고혈압증세 호전, 일상생활활동 어려움발생, 약복용 및 치료 등과의 관계를 규명하고자 한다. 이를 위해 2008년~2018년까지 10년에 걸쳐 수집된 종단 패널데이터를 사용했으며 분석 코호트 약 5,867명을 표본 추출하여 멀티레벨 혼합효과일반화선형 모델로 통계분석을 수행했다. 분석결과 자원봉사를 적어도 연 200시간 이상 한 사람은 안했을 때 보다 고혈압발생위험이 3.4배 낮았고, 연 50~99시간 한 사람은 안했을 때 보다 고혈압 증세호전이 더 크게 증가하였으며, 연 200시간 이상 자원봉사를 한 사람은 안했을 때 보다 활동어려움 발생확률이 7.7배 낮았으며, 그리고 연 50~99시간 자원봉사를 한 사람은 안했을 때 보다 약 복용 및 치료 발생 확률이 2.5배 낮은 것으로 나타났다. 이 결과는 중장년 및 노년기 성인의 자원봉사는 고혈압 및 관련 현상에 유익한 개선 효과가 있다는 것을 함의한다. 그리고 연구 한계점, 추후 연구방향, 실천함의를 논의했다.

• 국제지역연구
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• 제14권1호
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• pp.309-330
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• 2010

이 논문은 동아시아정체성에 영향을 미치는 연령 및 세대코호트(cohort)효과에 대해 분석한다. 또한 이 논문은 동아시아 지역정체성이 한국인이라는 국가정체성(national identity)의 정도와 어떠한 방식으로 연관되는가를 분석한다. 2008년 시카고국제문제협의회-동아시아연구원에서 실시한 한국인 여론조사 데이터에 대한 분석은 다음과 같은 흥미로운 경험적 발견을 제시한다. 연령이 높을수록 동아시아정체성의 정도가 더 강하게 나타나며, 국가정체성이 강할수록 강한 동아시아정체성을 지니는 경향이 있다. 이러한 경험적 발견은 서구를 대상으로 한 기존연구들의 발견과는 다른 패턴을 보이는 것이다. 첫째, 한국의 경우 젊은 층이 아니라 경제적 자원이 어느 정도 있는 연령층이 더 초국가정체성을 지닌다. 둘째, 일반적인 동북아공동체에 관한 연구의 논의와 다르게, 이 연구는 강한 국가정체성이 동아시아 지역정체성과 상보적(complementary)이라는 점을 제시한다. 이 연구는 동아시아지역통합의 이론적, 정책적 모색과 동아시아 지역 내 강한 민족주의의 관계에 대한 새로운 미시적 기초를 밝혀준다.

• 경제분석
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• 제26권3호
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• pp.48-70
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• 2020

본 연구는 1994~2016년 '가계동향조사'의 미시자료 변수를 표본평균으로 전환하는 방식의 코호트 접근법을 사용하여 소비 불확실성이 존재하는 상황에서 예비적 저축 동기를 추정하였다. 이를 위해 오일러 방정식을 이용하여 도출된 상대적 신중도와 유동성 제약 관련 최초 소득을 통제한 회귀모형을 추정함으로써 예비적 저축 동기 여부를 살펴보았다. 추정 결과, 2SLS 집단 간 추정량(BE2SLS)의 경우 선행연구의 결과와 유사하게 상대적 신중도가 작게 추정되어 예비적 저축 동기가 존재한다고 보기 어려웠다. 반면, 2SLS 확률효과 추정량(RE2SLS)을 사용한 경우에는 예비적 저축 동기가 존재하는 것으로 나타났다. 또한, 유동성 제약 여부를 기준으로 나눈 그룹별 추정에서 유동성 제약 그룹이 미래의 불확실성에 더 민감하게 반응하는 것으로 나타났다.

• Nutrition Research and Practice
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• 제16권sup1호
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• pp.21-36
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• 2022

BACKGROUND/OBJECTIVES: The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. SUBJECTS/METHODS: The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. RESULTS: The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. CONCLUSIONS: A 'U' or 'J' shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.

• 한국노년학
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• 제30권4호
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• pp.1225-1237
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• 2010

본 연구는 한국노동연구원의 『한국노동패널』 1-11차년도 자료를 이용하여 인구구조의 변화가 소비격차에 미친 영향에 대해 코호트 분해 방법을 활용하여 분석하였다. 이에 따르면 우리나라 소비격차는 외환위기 직후 급격히 악화된 이후 점차 개선되고 있으나 2005년 이후 다시 악화되고 있는 모습을 보이고 있다. 이러한 소비 격차의 변화를 연령-세대-연도효과로 분해할 경우 40대 중반을 기점으로 소비격차는 큰 변화가 있으며 노인 세대보다 젊은 세대에서 소비격차를 개선시키는 효과는 적은 것으로 나타났다. 이는 앞으로 현재 젊은 세대가 자연스럽게 나이가 들어감에 따라 소비격차의 문제는 지금보다 심각해질 가능성이 있음을 시사한다. 그리고 1998년을 기준으로 인구-세대-연령 효과 요인을 분해하여 그 변화를 살펴본 결과에 의하면 소비격차의 변화에 대한 연령효과는 낮아지고 인구구조의 변화에 따른 인구고령화 효과에 의한 설명력은 더욱 높아지고 있다. 이는 향후 인구고령화가 급격히 진행되는 우리사회에 소비격차의 문제가 더욱 심각하게 다가올 수 있음을 시사하고 있다.

• Korean Journal of Radiology
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• 제23권9호
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• pp.921-930
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• 2022

Objective: To identify epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma based on ¹⁸F-fluorodeoxyglucose (FDG) PET/CT radiomics and clinical features and to distinguish EGFR exon 19 deletion (19 del) and exon 21 L858R missense (21 L858R) mutations using FDG PET/CT radiomics. Materials and Methods: We retrospectively analyzed 179 patients with lung adenocarcinoma. They were randomly assigned to training (n = 125) and testing (n = 54) cohorts in a 7:3 ratio. A total of 2632 radiomics features were extracted from the tumor region of interest from the PET (1316) and CT (1316) images. Six PET/CT radiomics features that remained after the feature selection step were used to calculate the radiomics model score (rad-score). Subsequently, a combined clinical and radiomics model was constructed based on sex, smoking history, tumor diameter, and rad-score. The performance of the combined model in identifying EGFR mutations was assessed using a receiver operating characteristic (ROC) curve. Furthermore, in a subsample of 99 patients, a PET/CT radiomics model for distinguishing 19 del and 21 L858R EGFR mutational subtypes was established, and its performance was evaluated. Results: The area under the ROC curve (AUROC) and accuracy of the combined clinical and PET/CT radiomics models were 0.882 and 81.6%, respectively, in the training cohort and 0.837 and 74.1%, respectively, in the testing cohort. The AUROC and accuracy of the radiomics model for distinguishing between 19 del and 21 L858R EGFR mutational subtypes were 0.708 and 66.7%, respectively, in the training cohort and 0.652 and 56.7%, respectively, in the testing cohort. Conclusion: The combined clinical and PET/CT radiomics model could identify the EGFR mutational status in lung adenocarcinoma with moderate accuracy. However, distinguishing between EGFR 19 del and 21 L858R mutational subtypes was more challenging using PET/CT radiomics.

• Journal of Yeungnam Medical Science
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• 제41권1호
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• pp.39-44
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• 2024

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a significant concern, particularly among patients taking bisphosphonates (BPs), denosumab, and selective estrogen receptor modulators (SERMs) for osteoporosis. Despite the known risks, large-scale cohort studies examining the incidence and severity of MRONJ are lacking. We aimed to ascertain the incidence and risk of MRONJ among these patients, whom we stratified by age groups, medication types, and duration of use. Methods: We utilized data from the National Health Insurance Service's sample cohort database, focusing on patients aged 40 years and above diagnosed with osteoporosis. The patients were divided into three groups: those prescribed BPs only, those prescribed SERMs only, and those prescribed both. Results: The overall incidence rate of MRONJ was 0.17%. A significantly higher incidence rate was observed among those taking osteoporosis medications, particularly among females with a relative risk of 4.99 (95% confidence interval, 3.21-7.74). The SERM group also had an incidence rate comparable to that of the BP group. Severity was assessed based on the invasiveness of the treatment methods, with 71.3% undergoing invasive treatment in the medication group. Conclusion: This study provides valuable insights into the incidence and severity of MRONJ among a large cohort of patients with osteoporosis. It underscores the need for comprehensive guidance on MRONJ risks across different medication groups and sets the stage for future research focusing on specific populations and treatment outcomes.