• 한국콘텐츠학회논문지
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• 제11권10호
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• pp.333-341
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• 2011

분진에 노출 되었던 집단을 대상으로 폐질환 선별검사를 위해 시행한 저선량 CT영상의 관상동맥 석회화 소견과 석회화수치 CT검사 결과를 비교 분석하였다. 연구윤리심의위원회의 승인과 연구대상자로부터 동의서를 받은 후, 과거 분진에 노출된 직업력을 갖고 있는 61명의 남자를 대상으로 폐질환의 선별검사를 위해 저선량 CT촬영과 석회화수치 CT검사를 동시에 실시하였다. 저선량 CT영상(Axial image)은 영상의학과 전문의로부터 진폐 소견 및 폐질환과 관상동맥 석회화소견에 대해 판독하였고, 석회화수치 CT검사로부터 얻은 기초 영상(Row image)은 별도의 워크스테이션으로 보내져 상업적인 라피디아 소프트웨어(ver 2.8)를 이용하여 관상동맥 석회화수치를 구하였다. 저선량 CT영상에서 석회화소견을 보이지 않은 그룹(42명, 68.9%)과 보인 그룹(19명, 31.1%)사이에 총 석회화(13.68 vs. 582.93, p=.009), 좌전하행관상동맥 (3.15 vs. 248.95, p=.006)의 석회화수치가 통계학적으로 유의한 차이를 보였고, 좌주관상동맥, 좌회선관상동맥, 우관상동맥에서 석회화소견을 보인 그룹에서 높게 나타났다(p>0.05). 저선량 CT영상의 석회화소견은 석회화수치 CT검사의 석회화수치 100에서 가장 높은 일치도(K-value=0.80, 95% 신뢰구간=0.69-0.91)를 보였다. 폐질환을 조기 발견하기 위해 시행된 저선량 CT영상에서 보여진 석회화소견은 석회화수치 검사결과와 높은 관련성을 보임으로써 폐쇄성 관상동맥질환을 예측할 수 있는 것으로 사료된다.

• Journal of Gastric Cancer
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• 제21권4호
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• pp.368-378
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• 2021

Purpose: When patients with early gastric cancer (EGC) undergo non-curative endoscopic submucosal dissection requiring gastrectomy (NC-ESD-RG), additional medical resources and expenses are required for surgery. To reduce this burden, predictive model for NC-ESD-RG is required. Materials and Methods: Data from 2,997 patients undergoing ESD for 3,127 forceps biopsy-proven differentiated-type EGCs (2,345 and 782 in training and validation sets, respectively) were reviewed. Using the training set, the logistic stepwise regression analysis determined the independent predictors of NC-ESD-RG (NC-ESD other than cases with lateral resection margin involvement or piecemeal resection as the only non-curative factor). Using these predictors, a risk-scoring system for predicting NC-ESD-RG was developed. Performance of the predictive model was examined internally with the validation set. Results: Rate of NC-ESD-RG was 17.3%. Independent pre-ESD predictors for NC-ESD-RG included moderately differentiated or papillary EGC, large tumor size, proximal tumor location, lesion at greater curvature, elevated or depressed morphology, and presence of ulcers. A risk-score was assigned to each predictor of NC-ESD-RG. The area under the receiver operating characteristic curve for predicting NC-ESD-RG was 0.672 in both training and validation sets. A risk-score of 5 points was the optimal cut-off value for predicting NC-ESD-RG, and the overall accuracy was 72.7%. As the total risk score increased, the predicted risk for NC-ESD-RG increased from 3.8% to 72.6%. Conclusions: We developed and validated a risk-scoring system for predicting NC-ESD-RG based on pre-ESD variables. Our risk-scoring system can facilitate informed consent and decision-making for preoperative treatment selection between ESD and surgery in patients with EGC.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5483-5488
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• 2012

Background: Although nicotine dependence plays a role as a main barrier for smoking cessation, there is still a lack of solid evidence on the validity of biomarkers to determine nicotine dependence in clinical settings. This study aimed to investigate whether urinary cotinine levels could reflect the severity of nicotine dependence in active smokers. Materials and Methods: Data regarding general characteristics and smoking status was collected using a self-administered smoking questionnaire. The Fagerstr$\ddot{o}$m test for nicotine dependence (FTND) was used to determine nicotine dependence of the participants, and a total of 381 participants were classified into 3 groups of nicotine dependence: low (n=205, 53.8%), moderate (n=127, 33.3%), and high dependence groups (n=49, 12.9%). Stepwise multiple linear regression model and receiver operating characteristic (ROC) curves analyses were used to determine the validity of urinary cotinine for high nicotine dependence. Results: In correlation analysis, urinary cotinine levels increased with FTND score (r=0.567, P<0.001). ROC curves analysis showed that urinary cotinine levels predicted the high-dependence group with reasonable accuracy (optimal cut-off value=1,000 ng/mL; AUC=0.82; P<0.001; sensitivity=71.4%; specificity=74.4%). In stepwise multiple regression analysis, the total smoking period (${\beta}$=0.042, P=0.001) and urinary cotinine levels (${\beta}$=0.234, P<0.001) were positively associated with nicotine dependence, whereas an inverse association was observed between highest education levels (>16 years) and nicotine dependence (${\beta}$=-0.573, P=0.034). Conclusions: The results of this study support the validity of using urinary cotinine levels for assessment of nicotine dependence in active smokers.

• 한국산업보건학회지
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• 제25권4호
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• pp.566-572
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• 2015

Objectives: The major objective of this study was to analyze insomnia after the change to consecutive day shift from day and night shift in a motor assembly factory. Materials: Data were collected at before and after shift system change through a survey conducted by a labor union. We analyzed transition of PSQI(Pittsburgh Sleep Quality Index) among 222 workers by separating the day shift week and night shift week. The cut-off point of insomnia was 8.5 on the PSQI. Results: Mean PSQI in the day shift week significantly did not decrease, going from $6.36{\pm}3.23$ to $6.46{\pm}3.00$(p=0.612 by paired t-test), Mean PSQI for night shift week significantly decreased from $8.31{\pm}3.36$ to $6.19{\pm}3.18$(p<0.001 by paired t-test). However, mean PSQI in the day shift week increased from $6.33{\pm}3.83$ to $7.11{\pm}2.86$ in ${\geq}50$ years(p=0.085, by repeated measured ANOVA). Mean PSQI score in the night shift week improved more in the married group(from $8.38{\pm}3.27$ to $6.12{\pm}3.18$) than in the non-married group(from $7.82{\pm}3.27$ to $6.12{\pm}3.18$)(p=0.038, by repeated measured ANOVA). Conclusions: The change to consecutive day shift improved insomnia in night shift. However, insomnia in the day shift week was worsened among those more than 50 years old.

• 한국보건간호학회지
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• 제28권3호
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• pp.495-508
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• 2014

Purpose: This study was conducted in order to evaluate the reliability, validity, sensitivity, and specificity of the Short Form of Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS-SF). Methods: A validation study was conducted on 207 elderly patients aged over 65 who were admitted to Bobath Memorial Hospital. Fall risk scores of BMFRAS, composed of eight subscales (age, fall history, physical activity, consciousness level, communication, fall risk factors, underlying disease, and medications) were assessed from the electronic medical record. BMFRAS-SF was derived from eight subscales of the BMFRAS representing the significance between fallers and non-fallers (fall history, physical activity, fall risk factors, underlying disease, and medications). Internal consistency reliability and interrater reliability were assessed by Cronbach's alpha and kappa coefficient. Validity was assessed by Spearman correlation analysis, factor analysis. Sensitivity, specificity, positive predictive and negative predictive values, and a receiver-operating characteristic curve (ROC) were generated. Results: Fallers had significantly higher risk scores than non-fallers in fall history, physical activity, fall risk factors, underlying disease, and medication scales. The BMFRAS-SF demonstrated acceptable Cronbach's alpha (.706) and kappa coefficients of .95. The BMFRAS-SF subscales showed good convergent validity and construct validity. The BMFRAS-SF presented good sensitivity(86.7%), specificity(67.9%), positive predictive value(42.9%) and good negative predictive value(94.8%) at a cut-off score of 5. Areas under the ROC curves were .860 for the BMFRAS and .861 for the BMFRAS-SF. Conclusion: The BMFRAS-SF was proved to be reliable and valid. It could be used for time-saving assessment and evaluation of the high risks for falls in clinical practice settings.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.610-614
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• 2016

Objective : The purpose of this study was to present the outcome of the microsurgical foraminotomy via Wiltse paraspinal approach for foraminal or extraforaminal (FEF) stenosis at L5-S1 level. We investigated risk factors associated with poor outcome of microsurgical foraminotomy at L5-S1 level. Methods : We analyzed 21 patients who underwent the microsurgical foraminotomy for FEF stenosis at L5-S1 level. To investigate risk factors associated with poor outcome, patients were classified into two groups (success and failure in foraminotomy). Clinical outcomes were assessed by the visual analogue scale (VAS) scores of back and leg pain and Oswestry disability index (ODI). Radiographic parameters including existence of spondylolisthesis, existence and degree of coronal wedging, disc height, foramen height, segmental lordotic angle (SLA) on neutral and dynamic view, segmental range of motion, and global lumbar lordotic angle were investigated. Results : Postoperative VAS score and ODI improved after foraminotomy. However, there were 7 patients (33%) who had persistent or recurrent leg pain. SLA on neutral and extension radiographic films were significantly associated with the failure in foraminotomy (p<0.05). Receiver-operating characteristics curve analysis revealed the optimal cut-off values of SLA on neutral and extension radiographic films for predicting failure in foraminotomy were $17.3^{\circ}$ and $24^{\circ}s$, respectively. Conclusion : Microsurgical foraminotomy for FEF stenosis at L5-S1 level can provide good clinical outcomes in selected patients. Poor outcomes were associated with large SLA on preoperative neutral (>$17.3^{\circ}$) and extension radiographic films (>$24^{\circ}$).

• 대한예방한의학회지
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• 제20권2호
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• pp.17-26
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• 2016

Objectives : We presented the results of reliability study in advance, and analyzed agreement between Korean medicine doctors(KMDs)' diagnosis and cold-heat pattern identification questionnaire(CHPI)'s diagnosis. Methods : This survey was conducted from May 16 to 17, 2015. The subjects were 93 adults living in rural society. Diagnosis of CHPI was performed by 2 KMDs who have clinical experience more than 5 years. The KMDs' diagnosis was set as a reference index, and then we compare 23 items(cold pattern 11 items and heat pattern 12 items) of CHPI questionnaire and 15 items(cold pattern 8 items and heat pattern 7 items) that were brief form of it. We had cut-off value by standard of KMDs' diagnosis using receiver operating characteristic-curve(ROC-curve), with which we calculated agreement including kappa value. Correlation analysis between CHPI evaluation score by KMDs and by the questionnaire was fulfilled as well. Results : Agreement about 11 and 8 cold pattern items showed 87.1% together, and the value of kappa each recorded 0.742 and 0.741. Agreement about 12 and 7 heat pattern items suggested 81.7% and 78.5%, and the value of kappa showed 0.634 and 0.570. Correlation coefficients were 0.803 of 11 items and 0.761 of 8 items about cold pattern. In addition, correlation coefficients were 0.789 of 12 items and 0.767 of 7 items about heat pattern. The significant probability (p-value) was under 0.001. Conclusions : We have developed CHPI questionnaire involving reliability and agreement based on usual symptoms, and hope additional complements so that Korean medicine diagnostics and Korean preventive medicine would be improved.

• 대한지역사회영양학회지
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• 제14권3호
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• pp.340-353
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• 2009

It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hong-cheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR < 0.75:undernutrition, MAR < 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.

• 대한불안의학회지
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• 제13권2호
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• pp.123-131
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• 2017

Objective : The PTSD Checklist (PCL) is a self-report screen for posttraumatic stress disorder (PTSD) that can be scored for both diagnostic assessment and symptom severity measurement. The most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) contains a number of changes to the definition of PTSD, and the aim of this study was to assess the psychometric properties of the Korean version of the PCL for the DSM-5 (PCL-5-K). Methods : The participants were 204 Korean veterans of the Vietnam War who completed the PCL-5-K, the Mini Mental Status Examination (MMSE), PTSD module of Structured Clinical Interview for DSM-5, Research Version (SCID5-RV PTSD module), Korean version of Impact of Event Scale-Revised (IES-R-K) and Combat Exposure Scale (CES-K). Results : The PCL-5-K demonstrated good internal consistency (${\alpha}=0.972$) and test-retest reliability (r=0.96); the suggested cut-off score for PTSD diagnosis was ${\geq}37$ with 0.88 sensitivity and 0.96 specificity. The PCL-5-K scale correlated highly with the IES-R-K and CES-K. Factor analysis identified only one factor. Conclusion : Among elderly Korean veterans of the Vietnam War, the PCL-5-K demonstrated similar psychometric qualities to those of both the original PCL and subsequent versions. It is expected that the PCL-5-K will be a useful PTSD screening tool.

• Asian-Australasian Journal of Animal Sciences
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• 제28권7호
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• pp.926-935
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• 2015

The efficiency of genome-wide association analysis (GWAS) depends on power of detection for quantitative trait loci (QTL) and precision for QTL mapping. In this study, three different strategies for GWAS were applied to detect QTL for carcass quality traits in the Korean cattle, Hanwoo; a linkage disequilibrium single locus regression method (LDRM), a combined linkage and linkage disequilibrium analysis (LDLA) and a $BayesC{\pi}$ approach. The phenotypes of 486 steers were collected for weaning weight (WWT), yearling weight (YWT), carcass weight (CWT), backfat thickness (BFT), longissimus dorsi muscle area, and marbling score (Marb). Also the genotype data for the steers and their sires were scored with the Illumina bovine 50K single nucleotide polymorphism (SNP) chips. For the two former GWAS methods, threshold values were set at false discovery rate <0.01 on a chromosome-wide level, while a cut-off threshold value was set in the latter model, such that the top five windows, each of which comprised 10 adjacent SNPs, were chosen with significant variation for the phenotype. Four major additive QTL from these three methods had high concordance found in 64.1 to 64.9Mb for Bos taurus autosome (BTA) 7 for WWT, 24.3 to 25.4Mb for BTA14 for CWT, 0.5 to 1.5Mb for BTA6 for BFT and 26.3 to 33.4Mb for BTA29 for BFT. Several candidate genes (i.e. glutamate receptor, ionotropic, ampa 1 [GRIA1], family with sequence similarity 110, member B [FAM110B], and thymocyte selection-associated high mobility group box [TOX]) may be identified close to these QTL. Our result suggests that the use of different linkage disequilibrium mapping approaches can provide more reliable chromosome regions to further pinpoint DNA makers or causative genes in these regions.