• Clinical and Experimental Pediatrics
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• 제58권8호
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• pp.294-300
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• 2015

Purpose: It is difficult to differentiate between central precocious puberty (CPP) and premature thelarche (PT) in girls. The aim of this study was to investigate the diagnostic usefulness of pelvic ultrasonography to distinguish between CPP and PT in girls with early breast development. Methods: This study included girls with early breast development who visited the clinic between January 2012 and December 2013. Clinical, laboratory, and pelvic ultrasonographic data were evaluated. CPP and PT were confirmed using the gonadotropin-releasing hormone stimulation test. Results: A total of 248 girls aged 7-8 years were included, among whom 186 (75.0%) had CPP and 62 (25.0%) had PT. The uterine length, transverse diameter, fundus, volume, and cross-sectional area were significantly larger in the CPP group (uterine length, $2.45{\pm}0.50cm$ vs. $2.63{\pm}0.49cm$, P=0.015; uterine volume, $0.95{\pm}0.62cm^3$ vs. $1.35{\pm}0.76cm^3$, P<0.001). However, there were no differences in the fundus/cervix ratio and ovarian measurements. In receiver operating characteristic analysis, a uterine volume of at least $1.07cm^3$ was the most predictive parameter for CPP with an area under the curve of 0.670 (95% confidence interval, 0.593-0.747). Conclusion: Uterine measurements by pelvic ultrasonography in girls with early pubertal development were significantly larger in the CPP group. However, the diagnostic value of ultrasonographic parameters was not high because of a considerable overlap of values between the two groups. Therefore, pelvic ultrasonography in combination with clinical and laboratory tests may be useful to distinguish between CPP and PT in girls.

• Journal of Korean Neurosurgical Society
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• 제39권2호
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• pp.102-108
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• 2006

Objective : The management of diffuse astrocytomas is one of the most controversial areas in clinical neurooncology. There are numerous reviews and editorials outlining the difficulties in the management of these lesions. In this study, we assess the role of Gamma Knife radiosurgery[GKS] for diffuse astrocytomas. Methods : Twenty-three patients with a diffuse astrocytoma were treated with GKS as a primary or adjuvant method from February 1995 to October 2003. The mean marginal dose was $13.6\;[8.5{\sim}17.5]Gy$ and the mean maximal dose was $27.3\;[17.0{\sim}35.0]Gy$. Local control and the pattern of radiologic response were evaluated. The probable factors affecting local control, such as tumor volume, margin dose, previous history of craniotomy or stereotactic biopsy, and the presence or absence of previous radiotherapy were statistically analyzed. The average duration of follow-up was 39.7 [$11.3{\sim}101.5$] months after GKS. Results : Of the 23 lesions treated, 16 lesions [69.6%] were controlled during the follow-up period. The mean progression-free interval was 57.4 months and the 5-year progression-free rate was 68%. Only tumor volume was found to be a statistically significant factor for local control. Smaller tumors were better controlled by GKS; it was significantly effective in tumors with less than $10cm^3$ volume. Conclusion : GKS could be a valuable therapeutic modality both as a primary treatment and as a postoperative adjuvant therapy in some selected cases.

• 보건행정학회지
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• 제27권3호
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• pp.241-246
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• 2017

Background: The purpose of this study is to investigate the trends on the induced abortion in Korea using social big-data and confirm whether there was time series trends and seasonal characteristics in induced abortion. Methods: From October 1, 2007 to October 24, 2016, we used Naver's data lab query, and the search word was 'induced abortion' in Korean. The average trend of each year was analyzed and the seasonality was analyzed using the cosinor model. Results: There was no significant changes in search volume of abortion during that period. Monthly search volume was the highest in May followed by the order of June and April. On the other hand, the lowest month was December followed by the order of January, and September. The cosinor analysis showed statistically significant seasonal variations (amplitude, 4.46; confidence interval, 1.46-7.47; p< 0.0036). The search volume for induced abortion gradually increased to the lowest point at the end of November and was the highest at the end of May and declined again from June. Conclusion: There has been no significant changes in induced abortion for the past nine years, and seasonal changes in induced abortion have been identified. Therefore, considering the seasonality of the intervention program for the prevention of induced abortion, it will be effective to concentrate on the induced abortion from March to May.

• 대한한의진단학회지
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• 제10권2호
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• pp.132-150
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• 2006

Objectives : The objective is that we measure and analyze Pulse-Respiration Ratio and Body Composition Analysis to study the correlation between both. Methods : First, after subjects take a rest over 10 minutes, we measure their electrocardiogram and respiration pattern through which we take average peak interval to calculate an average pulse cycle and a respiration cycle. An average respiration cycle divided by an average Pulse Rate gives Pulse-Respiration Ratio. Next, we draw out 22 Body Composition Analysis indicators by using In-Body 720 model. Last, we analyze and take statistics on them by using SPSS 13.0 program. Results : Negative is the correlation between P/R Ratio and Body Composition Analysis indicator like fatness degree, body fat volume, body fat rate, abdominal fatness, BMI. Conclusions : 1. The higher P/R Ratio the more likely to be thin, the lower P/R Ratio the more likely to be fat. 2. We separately analyze P/R Ratio depending on each breathing frequency and pulse frequency to find out that breathing frequency has great influence and that breathing frequency decides the fatness degree. 3. In study on the correlation between P/R Ratio and Body Composition Analysis, fatness degree, in-body fat volume, in-body fat rate, BMI are the related indicators, which shows the connection with the fatness indicators. 4. In study on the correlation between Han-Yeol [寒熱] grade and Body Composition Analysis indicators, the result is that Han[寒] has no connection and that only Yeol[熱] grade has something to do with it, which means the higher heat symptom subjects have, the more basic metabolism volume and muscular build they have.

• 한국측량학회지
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• 제20권3호
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• pp.265-272
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• 2002

지금까지 토공량계산을 위한 많은 방법들이 단순식에서부터 복잡한 방법으로 개발되어 왔다. 일찍이 토공량계산을 위한 기본적인 방법은 상부면적을 x, y방향으로 뻗은 경계선의 사각격자로 나누어 계산한다. 그러나 이들 방법은 많은 측량현장에서 요구되는 토공량견적을 정확하게 계산할 수 없다. 1998년 Easa는 x, y 각 방향으로 같은 선상을 따라 사각격자를 나누었다. 이 방법은 격자 양방향으로 3차의 Hermite 다항식을 이용하였다. 이것은 반드시 동일한 x, y방향의 경계를 따라 표고데이터가 존재해야 하므로 지형의 최대, 최소점 같은 점의 선택을 불가능하게 한다. 이 연구에서 제시된 토공량 계산법은 Easa(1998)방법의 단점을 피하고 장점을 결합시켰다. 제안된 방법은 가로x, 세로y 방향의 각 경계를 따라 3차의 Hermite 다항식을 이용하지만 각각의 부등간격의 격자는 양방향으로 일정하지 않고 부분적으로 비격자형태로 이루어져 있다. 새롭게 제시된 방법은 다른 재래식 방법보다 더 나은 정확도를 제공한다.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.359-364
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• 2019

Background Few scales are currently available to evaluate changes in hand volume. We aimed to develop a hand grading scale for quantitative assessments of dorsal hand volume with additional consideration of changes in skin texture; to validate and prove the precision and reproducibility of the new scale; and to demonstrate the presence of clinically significant differences between grades on the scale. Methods Five experienced plastic surgeons developed the Hand Volume Rating Scale (HVRS) and rated 91 images. Another five plastic surgeons validated the scale using 50 randomly selected images. Intra- and inter-rater agreement was calculated using the weighted kappa statistic and intraclass correlation coefficients (ICCs). Paired images were also evaluated to verify whether the scale reflected clinical differences. Results The intra-rater agreement was 0.95 (95% confidence interval, 0.922-0.974). The interrater ICCs were excellent (first rating, 0.94; second rating, 0.94). Image pairs that differed by 1, 2, and 3 grades were considered to contain clinically relevant differences in 80%, 100%, and 100% of cases, respectively, while 84% of image pairs of the same grade were found not to show clinically relevant differences. This confirmed that the scale of the HVRS corresponded to clinically relevant distinctions. Conclusions The scale was proven to be precise, reproducible, and reflective of clinical differences.

• 한국ITS학회 논문지
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• 제18권5호
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• pp.79-90
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• 2019

본 연구에서는 국내의 연속류 자전거도로에 대한 차두시간 분포 모형을 개발하고자 하였다. 현장조사를 통해 수집된 데이터를 교통량으로 구분하여 분석하였으며, 교통량의 기준은 전체 교통량을 분포를 고려하여 1분당 8대 미만은 낮은 수준의 교통량으로 하고 8대 이상은 높은 수준의 교통량으로 구분하였다. 차두시간의 집계간격은 기존의 자동차교통류에서 일반적으로 적용해오던 0.5초를 적용하였다. 적용된 분포는 기본적인 정규분포와 함께 음지수분포, 전이된 음지수분포, 피어슨 III분포이며, 카이스퀘어 검정 분석결과 음지수분포와 전이된 음지수분포에서 방향과 교통량 구분 모두에서 이론치와 관측치간에 적합한 것으로 나타났다. 제시된 자전거 차두시간 분포모형의 적정성을 판단하기 위한 분석결과, 역시 동일하게 음지수분포와 전이된 음지수분포가 적합한 것으로 나타났다.

• The Korean Journal of Physiology and Pharmacology
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• 제26권3호
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• pp.195-205
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• 2022

Determining blood loss [100% - RBV (%)] is challenging in the management of haemorrhagic shock. We derived an equation estimating RBV (%) via serial haematocrits (Hct₁, Hct₂) by fixing infused crystalloid fluid volume (N) as [0.015 × body weight (g)]. Then, we validated it in vivo. Mathematically, the following estimation equation was derived: RBV (%) = 24k / [(Hct₁ / Hct₂) -1]. For validation, non-ongoing haemorrhagic shock was induced in Sprague-Dawley rats by withdrawing 20.0%-60.0% of their total blood volume (TBV) in 5.0% intervals (n = 9). Hct₁ was checked after 10 min and normal saline N cc was infused over 10 min. Hct₂ was checked five minutes later. We applied a linear equation to explain RBV (%) with 1 / [(Hct₁ / Hct₂) -1]. Seven rats losing 30.0%-60.0% of their TBV suffered shock persistently. For them, RBV (%) was updated as 5.67 / [(Hct₁ / Hct₂) -1] + 32.8 (95% confidence interval [CI] of the slope: 3.14-8.21, p = 0.002, R² = 0.87). On a Bland-Altman plot, the difference between the estimated and actual RBV was 0.00 ± 4.03%; the 95% CIs of the limits of agreements were included within the pre-determined criterion of validation (< 20%). For rats suffering from persistent, non-ongoing haemorrhagic shock, we derived and validated a simple equation estimating RBV (%). This enables the calculation of blood loss via information on serial haematocrits under a fixed N. Clinical validation is required before utilisation for emergency care of haemorrhagic shock.

• Journal of Preventive Medicine and Public Health
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• 제56권2호
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• pp.145-153
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• 2023

Objectives: Although it is difficult to define the quality of stroke care, acute ischemic stroke (AIS) patients with moderate-to-severe neurological deficits may benefit from thrombectomy-capable hospitals (TCHs) that have a stroke unit, stroke specialists, and a substantial endovascular thrombectomy (EVT) case volume. Methods: From national audit data collected between 2013 and 2016, potential EVT candidates arriving within 24 hours with a baseline National Institutes of Health Stroke Scale score ≥6 were identified. Hospitals were classified as TCHs (≥15 EVT case/y, stroke unit, and stroke specialists), primary stroke hospitals (PSHs) without EVT (PSHs-without-EVT, 0 case/y), and PSHs-with-EVT. Thirty-day and 1-year case-fatality rates (CFRs) were analyzed using random intercept multilevel logistic regression. Results: Out of 35 004 AIS patients, 7954 (22.7%) EVT candidates were included in this study. The average 30-day CFR was 16.3% in PSHs-without-EVT, 14.8% in PSHs-with-EVT, and 11.0% in TCHs. The average 1-year CFR was 37.5% in PSHs-without-EVT, 31.3% in PSHs-with-EVT, and 26.2% in TCHs. In TCHs, a significant reduction was not found in the 30-day CFR (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.76 to 1.12), but was found in the 1-year CFR (OR, 0.84; 95% CI, 0.73 to 0.96). Conclusions: The 1-year CFR was significantly reduced when EVT candidates were treated at TCHs. TCHs are not defined based solely on the number of EVTs, but also based on the presence of a stroke unit and stroke specialists. This supports the need for TCH certification in Korea and suggests that annual EVT case volume could be used to qualify TCHs.

• 한국전문물리치료학회지
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• 제30권4호
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• pp.288-305
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• 2023

Background: The compression therapy, which is the standard treatment for lymphedema patients, may be difficult to implement and contraindicated to some patients depending on their health condition. Objects: The purpose of this study is to investigate whether kinesiology taping (KT) can be used effectively and safely in the management of lymphedema as an alternative treatment through systematic review and meta-analysis. Methods: In February 2023, the literature was systematically collected through eight search engines with a combination of terms, 'lymphedema' and 'kinesiology taping.' We qualitatively analyzed the differences and safety of KT methods, and quantitatively meta-analyzed the effects of volume reduction in edema, range of motion (ROM), and pain improvement using Review Manager ver. 5. 4. To assess the risk of bias in the randomized controlled trial (RCT) studies, Risk of Bias was used. Results: A total of 616 articles searched and 20 studies were selected, including 12 RCTs and eight case studies. KT intervention could not replace multilayer compression bandage (MLB), but it demonstrated similar or better results compared to compression garment (CG), with reduced pain and improved intervention comfort. Studies reported skin adverse events ranging from 2.5% to 20.68%, with a total adverse event incidence of 7.7%. There was no significant difference in the application method of KT. As a result of the meta-analysis from the 8 RCTs, the KT intervention showed a mean difference (MD) of -7.18 with a 95% confidence interval (CI) [-12.64 to -1.72] in the volume change of lymphedema, while the pain difference was MD 0.82 with CI 95% [0.50 to 1.15], in comparison to the MLB and CG intervention. Conclusion: KT therapy led to a reduction in edema size, volume, pain, and improved ROM and quality of life. KT may be a viable option for lymphedema patients who have trouble applying traditional compression therapies.