• Korean Circulation Journal
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• 제48권11호
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• pp.1002-1011
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• 2018

Background and Objectives: The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods: Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <-30 degree. The primary outcome was all-cause mortality. Results: The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, -3.25; 95% confidence interval, -5.82, -0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).

• 한방재활의학과학회지
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• 제34권2호
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• pp.101-134
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• 2024

Objectives The purpose of this study is to observe the effectiveness of acupotomy treatment for lateral epicondylitis by comparing it with various control groups. Methods We searched 11 domestic and international databases for systematic reviews and meta-analysis. The subjects were studies published from January 1, 2017 to September 1, 2023, and only randomised controlled trials were included. Results 208 studies were searched, of which 21 studies were finally selected. Among the studies published after 2017, the largest number of studies was published in 2019. The average number of participants per study was 72.28±20.26 and the average age was in the 40s. The most frequent intervention in the study was acupotomy alone, and the treatment most often mentioned as a control group was local nerve block. The most used evaluation tool is efficiency. Acupotomy+manipulation had statistically better effect than that of local nerve block in terms of pain (standard mean difference -1.87, 95% confidence interval, -2.18 to -1.57, p<0.00001) and elbow joint function (standard mean difference 2.25, 95% confidence interval, 1.65 to 2.86, p<0.00001). Conclusions As a result of the meta-analysis, the effect of acupotomy added manual therapy treatment was statistically significant compared to the local nerve block frequently used for lateral epicondylitis. Based on these results, it appears that more research on combination treatments other than acupotomy treatment will be needed. Also, it appears that more large-scale randomized controlled studies that strictly adhere to the standards for reporting interventions in controlled trials of acupuncture, risk of bias 2 criteria will be needed.

• 보건행정학회지
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• 제34권2호
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• pp.156-162
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• 2024

연구배경: 본 연구는 지역박탈지수(Area Deprivation Index, ADI)와 우리나라 노인의 노쇠와의 관련성을 분석하는 것을 목적으로 하였다. 방법: 2014년부터 2019년까지 국민건강영양조사 자료 중 65세 이상 노인을 대상으로하였다. 노쇠는 Fried phenotype을 기준으로 평가하였다. ADI와 노쇠의 관련성을 검증하기 위하여 다중 로지스틱 회귀분석을 실시하였다. 결과: 연구대상자 9,825명 중 ADI가 낮은 지역의 노인보다 높은 지역의 노인이 1.23배 더 (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.09-1.37). 기혼자의 경우 ADI가 낮은 지역에 거주하는 노인보다 높은 지역에 거주하는 노인이 1.35배(OR, 1.35; 95% CI, 1.16-1.57) 더 노쇠한 것으로 나타났다. 결론: 본 연구는 65세 이상의 노인을 대상으로 ADI와 노쇠의 관련성을 파악하였다. 특히 기혼자의 경우 ADI가 높은 지역에 거주할 수록 더 노쇠한 것으로 나타났다. 따라서 건강불평등 해소를 위해 박탈지수가 높은 지역과 낮은 지역 간 격차를 감소시키기 위한 정책적 개입의 필요성을 제언한다.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.306-316
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• 1999

Objectives: In Korea, as in most countries, there will be a sharp increase in the number of dementia patients in the near future. However basic data on dementia prevalence, which is important in defining epidemiologic characteristics and in implementing preventive strategy, are limited. This study was conducted to estimate the prevalence rate of dementia in the urban elderly aged 65 or older in Kwangmyung, Korea. Methods: A two phase design was used for case finding and case identification. In phase I, a representative sample aged 65 or older was selected and interviewed by door-to-door survey with a Korean version of the Mini-Mental State Examination (K-MMSE). In phase II, Of the 946 subjects interviewed in phase 1,356 elderly were randomly selected disproportionately according to K-MMSE score. Of these elderly, 223 (61.5%) underwent standardized clinical evaluations, including psychiatric interview, neurological examination, and neuropsychological assessment. Dementia was diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The diagnosis of Alzheimer's disease (AD) was made by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and feinted Disorders Association(NINCDS-ADRDA) criteria and vascular dementia (VD) by DSM-IV. Results: The overall weighted prevalence rate of all dementia among Kwangmyung residents aged 65 or older was 12,8%(age-adjusted rate: 13,0%, 95% Confidence Interval[CI]: 10.6-15.3%). Women had much higher prevalence rate than men even when age was controlled(15.9%[95% CI 12.6-19.2%] vs 7.5%[95% CI 4.0-10.4%]), The rates of dementia were 5.2%, 12.2%, 17.0%, and 34.3% for the age groups of 65-69, 70-74, 75-79 and 80 and over, respectively. The rate of AD appeared to be slightly higher than that of VD(5.2% vs 4.8%), though not statistically significant. Most of the cases(69%) were mild dementia according to CDR(<1) in these subjects. Conclusions : These results showed that the prevalence rate of dementia among urban elderly in Korea appears to be higher than those of other Asian countries.

• 대한임상검사과학회지
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• 제48권4호
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• pp.304-311
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• 2016

이 연구는 노인여성을 대상으로 비만, 복부비만 기준에 따른 대사증후군 위험요인의 차이를 알아보고, 비만 유형과 대사증후군 위험요인과의 관련성을 규명하고자 하였다. 비만 기준은 세계보건기구 아시아 태평양 기준에서 제시한 비만 기준을 따랐으며, 대사증후군은 The National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III)의 진단기준에 따라 분류하였다. 연구 대상자 591명 중 정상군 272명, 단순비만군 124명, 복부비만군 19명, 비만-복부비만군 176명 이었다. 비만, 복부비만 기준에 따른 대사증후군 위험요인의 유병률 차이를 비교한 결과 낮은 HDL-콜레스테롤혈증(p=0.009), 고중성지방혈증(p=0.025), 복부비만(p<0.001), 대사증후군 진단 유병률(p<0.001)은 집단간 차이를 보였으며, 비만-복부비만군에서의 유병률이 높게 나타났다. 로지스틱 회귀분석을 통해 복부비만 기준에 따른 비만유형과 대사증후군 각각의 위험요인 및 대사증후군 진단간의 관련성을 분석한 결과, 정상군에 비해 단순비만군에서 낮은 HDL-콜레스테롤혈증의 발생이 1.6배 높았으며(odds ratio, OR: 1.576, 95% confidence interval, 95% CI: 1.006~2.469), 비만-복부비만군에서는 1.9배 높은 양상을 보였다(OR: 1.882, 95% CI: 1.266~2.799). 고중성 지방혈증은 정상군보다 비만-복부비만군에서 1.9배 높았다(OR: 1.904, 95% CI: 1.246~2.910). 또한 정상군보다 복부비만군에서 대사증후군 발생이 6.6배 높았으며(OR: 6.579, 95% CI: 2.233~19.385), 비만-복부비만군의 경우 10.6배 높은 양상을 보였다(OR: 10.638, 95% CI: 6.053~18.697).

• 한국환경농학회지
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• 제34권4호
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• pp.355-358
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• 2015

BACKGROUND: Changes in Korea's agricultural soil properties were analyzed at a four-year interval from 1999 to 2002 on a national scale and used as basis for the determination of the appropriate agricultural policy on maintaining food safety and soil quality. The scope of this study ideally requires sampling thousands of paddy, greenhouse, upland and orchard land across the country, however, due to limitations in economic and manpower resources, it was deemed necessary to reduce sampling site to greenhouse soil. In this study, we try to investigate the applicability of cultivated crops as criteria for selecting representing fields in greenhouse soils.METHODS AND RESULTS: Soil samples were collected from red pepper, oriental melon, watermelon and strawberry cultivated soil. Principal components analysis (PCA) was performed on soil chemical properties of the selected fields: pH, electron conductivity (EC), available phosphate (Av-P₂O₅), organic matter (OM), and exchangeable cation (Ex.-K, Ca, and Mg). Soil chemical properties of oriental melon cultivated soil was separated from red pepper, watermelon, and strawberry cultivated soil on PC1 and red pepper cultivated soil was separated from watermelon cultivated soil on PC2. Position on PC1 was strongly correlated with pH, Ex.-Ca and Ex.-Mg and position on PC2 was strongly correlated with OM and Av-P₂O₅.CONCLUSION: The soil chemical properties of greenhouse soil was assorted amongst the different crops. Therefore, the cultivated crops as a criteria for the selection of representative field in greenhouse soil would be used in the future.

• Journal of Oral Medicine and Pain
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• 제33권4호
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• pp.323-338
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• 2008

한국어판 측두하악장애 연구진단기준(RDC/TMD) 설문지의 신뢰도를 분석하기 위하여 서울대학교 치과병원 구강내과에 내원한 154명의 턱관절장애 환자들(남자 31명, 여자 123명)에게 한국어판 RDC/TMD 설문지를 작성하게 하였다. 검사-재검사 신뢰도는 동일한 피검자에게 1주 내지 2주 간격으로 같은 설문지를 작성토록 하였다. 설문지의 검사-재검사가 완료되기 전까지는 환자에게 어떠한 치료도 제공되지 않았다. 첫번째 검사로 본 통증강도(pain intensity), 장애점수(disability score), 악기능장애(jaw disability) 및 심리사회적 상태(psychosocial status)의 내적 일관성(internal consistency)의 신뢰도는 크론바흐-알파(Cronbach’s alpha) 계수로 각각 0.92, 0.94, 0.68, 0.94 였다. 검사-재검사 신뢰도의 각 설문항목별 상관계수는 0.40에서 0.94까지의 범위로 나타났으며, 각각의 세부 항목별 등급내 상관계수(intra-class correlation coefficient; ICC)는 0.81에서 0.93의 범위로 나타났다. 만성통증척도(Graded Chronic Pain)의 검사-재검사 신뢰도계수는 0.63이었다. 한국어판 RDC/TMD 설문지는 좋은 신뢰도를 보였으며, 한국인의 측두하악장애 환자들에서 심리사회적측면을 분석하는데 유용하게 사용될 수 있다.

• 한국수자원학회논문집
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• 제48권10호
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• pp.807-816
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• 2015

일반적으로 수위-유량관계 곡선식은 선형성과 등분산성 가정을 기반으로 구축되지만, 측정단면의 형태, 단면 상 하류의 지형요인 등으로 인하여 영향을 받기 때문에 실질적인 수위 및 유량의 관계는 관계식 구축에 이용되는 가정에 위배된다. 이로 인한 오차를 줄이기 위하여 곡선식을 분할하여 이용하고 있으나, 측정단면의 변화를 고려한 관계자의 주관적인 판단이 구간분할의 주요 근거로 이용되고 있다. 따라서 본 연구에서는 이러한 주관성을 배제하고 관측데이터를 기반으로 객관화된 분할근거를 제시하고자 한다. 곡선식의 구간 분할을 위하여 변동계수를 이용한 기존의 연구를 바탕으로 변동계수가 정규분포를 따르는 것으로 가정하여, 계산된 변동계수가 전 단계에서 계산된 95% 신뢰구간 이내에 존재하지 않는 경우 구간을 분할하였다. 즉, 변동계수를 이용하여 집단 간의 특성을 비교하였으며, 변동계수의 분포를 이용하여 분할을 위한 기준 값을 제시하였다. 방법론의 추정능력 검토를 위하여 가상의 곡선으로부터 생성된 데이터에 제안된 방법론을 적용하였고, 실제유역에 적용성 검토를 위하여 금강에 위치한 무주 및 산계교 수위관측소 지점에 적용하였다. 결과적으로 자동으로 분할된 관계곡선식을 사용하여 추정의 정확도를 높일 수 있을 뿐만 아니라 외삽을 하는 경우 역시 그 정확도를 향상할 수 있음을 확인하였다. 마지막으로 실측값을 활용한 수위-유량관계 곡선식의 구축 시 구간 분할 전 후의 잔차 데이터에 대하여 Shapiro-wilk 정규성 검정을 수행하였으며, 구간분할 후 잔차가 정규성을 갖게 되는 것으로 나타났다.

• Korean Journal of Radiology
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• 제21권4호
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• pp.402-412
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• 2020

Objective: To evaluate the performance of predicting early recurrence using preoperative factors only in comparison with using both pre-/postoperative factors. Materials and Methods: We retrospectively reviewed 549 patients who had undergone curative resection for single hepatcellular carcinoma (HCC) within Milan criteria. Multivariable analysis was performed to identify pre-/postoperative high-risk factors of early recurrence after hepatic resection for HCC. Two prediction models for early HCC recurrence determined by stepwise variable selection methods based on Akaike information criterion were built, either based on preoperative factors alone or both pre-/postoperative factors. Area under the curve (AUC) for each receiver operating characteristic curve of the two models was calculated, and the two curves were compared for non-inferiority testing. The predictive models of early HCC recurrence were internally validated by bootstrap resampling method. Results: Multivariable analysis on preoperative factors alone identified aspartate aminotransferase/platelet ratio index (OR, 1.632; 95% CI, 1.056-2.522; p = 0.027), tumor size (OR, 1.025; 95% CI, 0.002-1.049; p = 0.031), arterial rim enhancement of the tumor (OR, 2.350; 95% CI, 1.297-4.260; p = 0.005), and presence of nonhypervascular hepatobiliary hypointense nodules (OR, 1.983; 95% CI, 1.049-3.750; p = 0.035) on gadoxetic acid-enhanced magnetic resonance imaging as significant factors. After adding postoperative histopathologic factors, presence of microvascular invasion (OR, 1.868; 95% CI, 1.155-3.022; p = 0.011) became an additional significant factor, while tumor size became insignificant (p = 0.119). Comparison of the AUCs of the two models showed that the prediction model built on preoperative factors alone was not inferior to that including both pre-/postoperative factors {AUC for preoperative factors only, 0.673 (95% confidence interval [CI], 0.623-0.723) vs. AUC after adding postoperative factors, 0.691 (95% CI, 0.639-0.744); p = 0.0013}. Bootstrap resampling method showed that both the models were valid. Conclusion: Risk stratification solely based on preoperative imaging and laboratory factors was not inferior to that based on postoperative histopathologic risk factors in predicting early recurrence after curative resection in within Milan criteria single HCC patients.

• 대한임상검사과학회지
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• 제37권2호
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• pp.65-70
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• 2005

Those specifications of the CLIA analytical tolerance limits are consistent with the performance goals in Six Sigma Quality Management. Six sigma analysis determines performance quality from bias and precision statistics. It also shows if the method meets the criteria for the six sigma performance. Performance standards calculates allowable total error from several different criteria. Six sigma means six standard deviations from the target value or mean value and about 3.4 failures per million opportunities for failure. Sigma Quality Level is an indicator of process centering and process variation total error allowable. Tolerance specification is replaced by a Total Error specification, which is a common form of a quality specification for a laboratory test. The CLIA criteria for acceptable performance in proficiency testing events are given in the form of an allowable total error, TEa. Thus there is a published list of TEa specifications for regulated analytes. In terms of TEa, Six Sigma Quality Management sets a precision goal of TEa/6 and an accuracy goal of 1.5 (TEa/6). This concept is based on the proficiency testing specification of target value +/-3s, TEa from reference intervals, biological variation, and peer group median mean surveys. We have found rules to calculate as a fraction of a reference interval and peer group median mean surveys. We studied to develop total error allowable from peer group survey results and CLIA 88 rules in US on 19 items TP, ALB, T.B, ALP, AST, ALT, CL, LD, K, Na, CRE, BUN, T.C, GLU, GGT, CA, phosphorus, UA, TG tests in chematology were follows. Sigma level versus TEa from peer group median mean CV of each item by group mean were assessed by process performance, fitting within six sigma tolerance limits were TP ($6.1{\delta}$/9.3%), ALB ($6.9{\delta}$/11.3%), T.B ($3.4{\delta}$/25.6%), ALP ($6.8{\delta}$/31.5%), AST ($4.5{\delta}$/16.8%), ALT ($1.6{\delta}$/19.3%), CL ($4.6{\delta}$/8.4%), LD ($11.5{\delta}$/20.07%), K ($2.5{\delta}$/0.39mmol/L), Na ($3.6{\delta}$/6.87mmol/L), CRE ($9.9{\delta}$/21.8%), BUN ($4.3{\delta}$/13.3%), UA ($5.9{\delta}$/11.5%), T.C ($2.2{\delta}$/10.7%), GLU ($4.8{\delta}$/10.2%), GGT ($7.5{\delta}$/27.3%), CA ($5.5{\delta}$/0.87mmol/L), IP ($8.5{\delta}$/13.17%), TG ($9.6{\delta}$/17.7%). Peer group survey median CV in Korean External Assessment greater than CLIA criteria were CL (8.45%/5%), BUN (13.3%/9%), CRE (21.8%/15%), T.B (25.6%/20%), and Na (6.87mmol/L/4mmol/L). Peer group survey median CV less than it were as TP (9.3%/10%), AST (16.8%/20%), ALT (19.3%/20%), K (0.39mmol/L/0.5mmol/L), UA (11.5%/17%), Ca (0.87mg/dL1mg/L), TG (17.7%/25%). TEa in 17 items were same one in 14 items with 82.35%. We found out the truth on increasing sigma level due to increased total error allowable, and were sure that the goal of setting total error allowable would affect the evaluation of sigma metrics in the process, if sustaining the same process.