• 한국노년학
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• 제38권4호
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• pp.811-835
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• 2018

노년기의 사회적 관계와 인지기능은 상호 밀접한 관계가 존재한다. 사회적 관계(social relation)는 구조적 특성과 이에 대한 인지적 정서적 평가를 반영하는 질적 특성으로 구분되며, 최근 노년기의 사회적 관계와 관련하여 사회적 고립(social isolation) 개념이 부각되고 있다. 사회적 고립은 사회연결망, 가구형태, 사회참여 등 객관적 차원과 지각된 사회적 지지에 대한 결핍과 외로움 등 주관적 차원으로 구분되는 다차원적인 이론적 구조를 가진다. 노년기 대인관계갈등 역시 인지기능과 밀접한 관계가 존재한다. 본 연구에서는 사회적 관계의 구조적 특성을 나타내는 객관적 사회적 고립과, 질적 특성을 나타내는 주관적 사회적 고립, 대인관계갈등이 노년기 연령집단별 인지기능에 미치는 주효과와 상호작용효과를 검증하였다. 분석자료는 KSHAP 1차조사부터 3차조사까지 총 1,740명의 패널자료를 활용하여, 무선효과 패널로짓모형을 적용하여 분석하였다. 분석결과는 다음과 같다. 첫째, 노년기 연령증가에 따라 인지기능 저하는 급격하게 증가하는 경향성이 나타났다. 객관적 주관적 사회적 고립은 모두 80세를 변곡점으로 U자형의 분포가 나타났다. 아울러 배우자, 자녀 친척, 이웃 친구 노년기 연령증가에 따라 대체적으로 감소하는 분포가 나타났다. 둘째, 인지기능저하에 대한 주효과는 객관적 주관적 사회적 고립과 정적으로 유의미하게 나타난 반면, 대인관계갈등 유형은 유의미하게 나타나지 않았다. 셋째, 노년기 인지기능저하에 영향을 미치는 이원상호작용효과 분석결과, 주관적 사회적 고립과 인지기능저하와의 관계는 배우자와의 갈등수준별로 유의미하게 다른 것으로 나타났다. 또한 주관적 사회적 고립을 많이 느낄수록 연소노인(65~74세)에 비해 초고령노인(85세 이상)의 경우 인지기능저하가 급격하게 높아지는 것으로 나타났다. 본 연구결과에 기초하여 노년기 연령집단별 인지기능 저하를 감소시키기 위한 정책적 실천적 시사점을 제시하였으며, 연구의 한계점과 추후연구를 위한 제언에 대해 논의하였다.

• Composites Research
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• 제30권5호
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• pp.323-330
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• 2017

본 연구에서는 폴리프로필렌 내에 투입된 탄화규소 나노 입자들의 군집현상이 나노복합재의 역학적 거동에 미치는 영향을 고찰하기 위해 분자동역학 전산모사를 통해 얻은 정보를 연속체 역학 수준에 적용시키는 멀티스케일 해석을 수행하였다. 입자 간의 거리에 따른 계면 물성의 하락을 반영하는 모델을 이용하여, 다양한 군집 상황에 따른 고분자 나노복합재의 탄성거동 변화를 관찰하였다. 또한, 나노복합재의 기계적 거동에 영향을 미치는 주요 요인을 파악하여 군집밀도라는 새로운 지표를 정의하였다. 나노 입자의 군집밀도와 나노복합재의 탄성거동 간의 상관관계를 파악한 결과, 군집밀도의 값이 증가할수록 계면효과가 저하되어 최종적으로 나노복합재의 기계적 물성 상승이 억제되었다. 나노 입자의 랜덤분포를 고려한 해석을 통해, 동일한 군집밀도의 수치에 대해 나노복합재가 가질 수 있는 탄성계수의 범위를 파악할 수 있었다. 상관관계는 지수 함수형태로 표현될 수 있었으며, 이를 통해 나노 입자의 군집밀도를 이용하여 고분자 나노복합재의 기계적 거동을 효과적으로 예측 가능하다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1881-1895
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• 2015

Background: The vascular endothelial growth factor family has been implicated in tumorigenesis and metastasis. The prognostic value of each vascular endothelial growth factor family member, particular VEGF/VEGFR co-expression, in patients with non-small lung cancer remains controversial. Materials and Methods: Relevant literature was identified by searching PubMed, EMBASE and Web of Science. Studies evaluating expression of VEGFs and/or VEGFRs by immunohistochemistry or ELISA in lung cancer tissue were eligible for inclusion. Hazard ratios (HRs) and 95% confidence intervals (CIs) from individual study were pooled by using a fixed- or random-effect model, heterogeneity and publication bias analyses were also performed. Results: 74 studies covering 7,631 patients were included in the meta-analysis. Regarding pro-angiogenesis factors, the expression of VEGFA (HR=1.633, 95%CI: 1.490-1.791) and VEGFR1 (HR=1.924, 95%CI: 1.220-3.034) was associated separately with poor survival. Especially, VEGFA over-expression was an independent prognostic factor in adenocarcinoma (ADC) (HR=1.775, 95%CI: 1.384-2.275) and SCC (HR=2.919, 95%CI: 2.060-4.137). Co-expression of VEGFA/VEGFR2 (HR=2.011, 95%CI: 1.405-2.876) was also significantly associated with worse survival. For lymphangiogenesis factors, the expression of VEGFC (HR=1.611, 95%CI: 1.407-1.844) predicted a poor prognosis. Co-expression of VEGFC/VEGFR3 (HR=2.436, 95%CI: 1.468-4.043) emerged as a preferable prognostic marker. Conclusions: The expression of VEGFA (particularly in SCC and early stage NSCLC), VEGFC, VEGFR1 indicates separately an unfavorable prognosis in patients with NSCLC. Co-expression VEGFA/VEGFR2 is comparable with VEGFC/VEGFR3, both featuring sufficient discrimination value as preferable as prognostic biologic markers.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3687-3693
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• 2012

Objective: The current meta-analysis was performed to address a more accurate estimation of the association between glutathione S-transferase P1 (GSTP1) codon 105 polymorphism and risk of gastric cancer (GC), which has been widely reported with conflicting results. Methods: A comprehensive literature search was conducted to identify all the relevant studies. Fixed or random effect models were selected based on the heterogeneity test. Publication bias was estimated using Begg's funnel plots and Egger's regression test. Results: A total of 20 studies containing 2,821 GC cases and 6,240 controls were finally included in the analyses. Overall, no significant association between GSTP1 polymorphism and GC risk was observed in worldwide populations. However, subgroup analysis stratified by ethnicity showed that GSTP1 polymorphism was significantly associated with increased risk of GC in Asians (G vs. A, OR = 1.273, 95%CI=1.011-1.605; GG vs. AA, OR=2.103, 95%CI=1.197-3.387; GG vs. AA+AG, OR =2.103, 95%CI=1.186-3.414). In contrast, no significant association was found in Caucasians in any genetic models, except for with AG vs. AA (OR=0.791, 95%CI=0.669-0.936). Furthermore, the GSTP1 polymorphism was found to be significantly associated with GC in patients with H. pylori infection and in those with a cardiac GC. Subgroup analysis stratified by Lauren's classification and smoking status showed no significant association with any genetic model. No studies were found to significantly influence the pooled effects in each genetic mode, and no potential publication bias was detected. Conclusion: This meta-analysis suggested that the GSTP1 polymorphism might be associated with increased risk of GC in Asians, while GSTP1 heterozygote genotype seemed to be associated with reduced risk of GC. Since potential confounders could not be ruled out completely, further studies are needed to confirm these results.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5889-5897
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• 2015

Background: The performance of combined testing visual inspection with acetic acid (VIA) and cervical cytology tests might differ from one setting to another. The average estimate of the testing accuracy across studies is informative, but no meta-analysis has been carried out to assess this combined method. Objective: The objective of this study was to estimate the average sensitivity and specificity of the combined VIA and cervical cytology tests for the detection of cervical precancerous lesions. Materials and Methods: We conducted a systematic review and a meta-analysis, according to the Cochrane Handbook for Systematic Review of Diagnostic Test Accuracy. We considered two cases. In the either-positive result case, a positive result implies positivity in at least one of the tests. A negative result implies negativity in both tests. In the both-positive case, a positive result implies having both tests positive. Eligible studies were identified using Pubmed, Embase, Website of Science, CINHAL and COCRANE databases. True positive, false positive, false negative and true negative values were extracted. Estimates of sensitivity and specificity, positive and negative likelihood (LR) and diagnostic odds ratios (DOR) were pooled using a hierarchical random effect model. Hierarchical summary receiver operating characteristics (HSROC) were generated and heterogeneity was verified through covariates potentially influencing the diagnostic odds ratio. Findings: Nine studies fulfilled inclusion criteria and were included in the analysis. Pooled estimates of the sensitivities of the combined tests in either-positive and both-positive cases were 0.87 (95% CI: 0.83-0.90) and 0.38 (95% CI: 0.29-0.48), respectively. Corresponding specificities were 0.79 (95% CI: 0.63-0.89) and 0.98 (95% CI: 0.96-0.99) respectively. The DORs of the combined tests in either-positive or both-positive result cases were 27.7 (95% CI: 12.5-61.5) and 52 (95% CI: 22.1-122.2), respectively. When including only articles without partial verification bias and also a high-grade cervical intraepithelial neoplasia as a threshold of the disease, DOR of combined test in both-positive result cases remained the highest. However, DORs decreased to 12.1 (95% CI: 6.05-24.1) and 13.8 (95% CI: 7.92-23.9) in studies without partial verification bias for the combined tests in the either-positive and both-positive result cases, respectively. The screener, the place of study and the size of the population significantly influenced the DOR of combined tests in the both-positive result case in restriction analyses that considered only articles with CIN2+ as disease threshold. Conclusions: The combined test in the either-positive result case has a high sensitivity, but a low specificity. These results suggest that the combined test should be considered in developing countries as a primary screening test if facilities exist to confirm, through colposcopy and biopsy, a positive result.

• 유통과학연구
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• 제14권7호
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• pp.91-100
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• 2016

Purpose - Recently actively growing franchise systems distribution channel system in which franchise headquarter compared with franchise occupies an important place in distribution channel. Due to this, franchise and franchise headquarter are interdependent on task and in this situation the goal they go after, motivation and objective are probably inconsistent. If so, possibility to participate goal setting process or operating activity of opposite side is becoming bigger and in the end conflict may generate. The purpose of this study is to examine the role of the supervisor's attitude and expertise as moderating factors in the relationship between goal-incongruity/coercive power/role-incongruity and the conflict perceived by franchisee. Research design, data and methodology - This study was intended to verify how the supervisor's attitude and expertise as moderating factors in the relationship between goal-incongruity/coercive power/role-incongruity and the conflict perceived by franchisee. In order to achieve the purpose of this study, some study models and hypotheses have been established through theoretical examinations. Then, using these scales, the researcher completed the questionnaire survey. To test our hypotheses, the survey was conducted from March 9, 2016 for 20 days by random sampling, The study was implemented through a descriptive survey method using a self-administered questionnaire. A survey of 124 restaurant franchisee across Seoul and Gyeonggi Province was performed. A total of 124 completed responses were analyzed. In this study, I used SPSS 22.0 to analyze data and did frequency analysis to see demographic, and general features of the respondents; also did exploratory factor analysis to examine the validity of the items of measurement. Factor analysis was first calculated at a minimum, the number of factors, principal component analysis used when variables are committed to maximising the information with (principle component analysis) and the rotation of factors were angry about the great variable factors than 1.0 by applying Varimax rotation. In addition, I used the value of Cronbach's (Alpha) to examine the reliance of questionnaire items, final analysis the reliability factor can be found both high reliability hayeoteumeuro exceeds over 0.6 and did Multiple regression analysis to test hypothesis and also did hierarchical regression analysis to examine moderating effect. Results - To analyze the proposed model, according to the analysis result, it was found that the influence of goal-incongruity, coercive power, and role-incongruity on the perceived conflict of franchisee is moderated by the supervisor's attitude and expertise. That is, the more the supervisor's attitude and expertise were positive, the more the conflicts of the goal-incongruity, coercive power, and role-incongruity were decreased. It also confirmed previous research's finding that goal-incongruity, coercive power, and role-incongruity positively influence on the conflict. Conclusions - According to the results of this research which reduces the conflict of franchise from the in consistent goal; coercive power, and inconsistent role of superiors, it provides very important implications for franchise headquarter which has franchise system and also give them some suggestion about how to recruit superiors and what kind of training may be fit for the superiors.

• 한국산학기술학회논문지
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• 제18권10호
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• pp.209-214
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• 2017

본 연구에서는 한 칠 FTA 이후 시설포도 재배농가들이 가온시기를 늦추는 요인을 알아보기 위해 2004년부터 2016년까지 작형 변화 패널 데이터를 이용하여 분석하였다. 패널로지스틱모형에 대한 분석결과 시설포도 재배면적에 대한 추정계수는 0.0002로 10% 유의수준에서 통계적으로 유의한 것으로 나타났고, 포도 수입량에 대한 추정계수는 1.4258로 1% 유의수준에서 통계적으로 유의한 것으로 나타났으며, 지역더미에 대한 추정계수는 0.808로 5% 유의수준에서 통계적으로 유의한 것으로 나타났다. 이것은 재배면적이 많은 농가일수록, 포도 수입량이 증가할수록, 상대적으로 추운 중북부지역일수록 가온시기를 뒤로 미루게 될 확률이 증가하는 것으로 나타났다. 정부에서는 포도의 수입량 증가로 인한 시설포도농가의 피해를 줄이기 위해 FTA 피해보전직접지불 폐업지원을 하고 있어 시설포도농가의 피해를 다소나마 줄일 수 있지만, 이것은 궁극적인 대책이 되지는 않을 것이다. 포도 소비변화에 적절하게 대응하기 위해서는 품종 갱신, 가온비용 절감을 위한 농자재 지원, 비닐하우스 시설현대화를 통한 에너지 효율 증대 및 비용 절감 등의 다양한 지원책이 필요할 것이다.

• 한국임상약학회지
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• 제21권4호
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• pp.364-375
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• 2011

Given that single blockade with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) can achieve only partial and undurable suppression of the Renin Angiotensin System (RAS), it has been hypothesized that dual blockage would be more beneficial in the management of blood pressure (BP) reduction and prevention of progressive chronic kidney disease (CKD) than either agent alone. Thus, it has been suggested that the combination of an ACEI and an ARB might provide renal benefits to hypertensive patients over and above BP reduction. However, this might also expose patients to additive or synergistic side effects. We attempted to conduct a systematic review to evaluate the benefits and harms of combination therapy in hypertensive patients with or without kidney diseases. MEDLINE and KoreaMed were searched for relevant randomized clinical trials in adult hypertensive patients with or without diabetes (restricted to 1997, limited to trials published in English). Results were summarized using the random-effects model, and between-studies heterogeneity was estimated with $I^2$. A final analysis of ten trials (23,928 patients) revealed that the combination of an ACEI and an ARB reduced blood pressure (SBP/DBP) by 3.95/2.02 mmHg (95% confidence interval [CI], -4.38 to -3.53/-2.33 to -1.71) compared with ACEI monotherapy, and 2.83/2.64 mmHg (95% CI, -3.25 to -2.41/-4.95 to -0.33) compared with ARB monotherapy. Eight trials (391 patients) demonstrated a significant reduction in 24h-proteinuria (weighted mean difference, 0.16 g/day, 95% CI, -0.26-0.05), but they did not translate into an improvement in GFR. Tests for heterogeneity showed no difference in effect among the studies. The combination therapy reduced proteinuria by 30% (95% CI, 23% to 37%) and 39% (95% CI, 31% to 48%) compared with ACEI monotherapy and ARB monotherapy, respectively. However, in patients who had proteinuria more than 0.5 g/day, the combination therapy failed to show significant reduction in urinary protein excretion. The current cumulative evidence suggests that diabetic patients with proteinuria on dual RAS blockade have an increase risk of adverse events such as hyperkalemia, hypotension, and so on, compared with ACEI or ARB alone. It is, therefore, proposed that the combination therapy should not be routinely used for the treatment of hypertension with or without compelling indications.

• 한방비만학회지
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• 제20권1호
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• pp.52-68
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• 2020

Objectives: The purpose of this study is to investigate the weight loss effects of auricular acupuncture in obese patients. Methods: Six databases (Research Information Sharing Service [RISS], Korean studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], PubMed, The Cochrane Library, China National Knowledge Infrastructure [CNKI]) were searched up to May 20, 2020. Eight eligible randomized controlled trials were included the present study. The quality of included studies was assessed by the Cochrane risk of bias tool and a meta-analysis was performed by Review Manager software. A meta-analysis was conducted using a random-effects model and a subgroup analysis was performed to detect the sources of heterogeneity, identify the selection of acupuncture methods and explore its contributions to the weight loss effects. Results: Among 8 trials, 5 trials used auricular acupuncture and 2 trials used auricular acupressure, 1 trial used both types of intervention. Most commonly selected acupoints were Shenmen (TF4) and stomach (CO4). Treatment duration was six to twelve weeks, and total treatment session was six to twelve. Compared to the control groups, auricular acupuncture significantly decreased body weight, body mass index (BMI), high density lipoprotein-cholesterol (HDL) and ghrelin. For the selection of acupuncture methods, both methods performed similarly in most outcome except waist circumference (WC), body fat percentage (BFP), and triglycerides (TG). Conclusions: We found that auricular acupuncture can be effective for weight loss and controlling appetite. However, the findings should be interpreted with caution due to heterogeneity. So further vigorous and well-designed studies should be conducted to strengthen the evidence of the use of auricular acupuncture for obesity.

• 대한한방내과학회지
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• 제41권6호
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• pp.1100-1118
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• 2020

Objectives: The purpose of this study was to assess the effects of acupuncture as a treatment for allergic rhinitis (AR). We used a meta-analysis and systematic review to analyze the results of randomized controlled trials (RCTs) that applied acupuncture to AR patients. Methods: The key question assessed the effects of acupuncture on patients with AR, and we included only RCTs. We searched the KoreaMed, NDSL, KMBASE, Koreantk, OASIS, PubMed, EMBASE, and Cochrane databases, with no language restriction. We assessed risk of bias with the Cochrane Risk of Bias tool. The random effects model was used to adjust for the heterogeneity of the included studies, and the effect sizes between two groups were reported as mean differences (MD) and risk ratios (RR). Results: Twelve RCTs were analyzed, with a total of 1788 participants; 824 participants were in the treatment group (i.e., acupuncture) and 964 were in the control group (sham acupuncture, western medicine, or waitlist). The meta-analysis results of 7 RCTs comparing the therapeutic efficacy of acupuncture with that of sham acupuncture showed a statistically significant difference (p<0.05) in the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and the Change of Total Nasal Symptom Score (TNSS). The meta-analysis of 4 RCTs comparing the therapeutic efficacy of acupuncture with western medicine showed statistically significant differences (p<0.05) in the RQLQ but not in the changes in effective rate (p>0.05). Conclusions: Acupuncture can be an effective treatment for AR, but more studies are required to enhance the level of evidence and to confirm safety.