• 대한영상의학회지
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• 제83권2호
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• pp.254-264
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• 2022

대한영상의학회 진료지침위원회는 기존의 2016년 진료지침을 개정하여 '주사용 요오드화 조영제 및 MRI용 가돌리늄 조영제 유해 반응에 대한 한국 임상진료지침: 개정된 임상적 합의 및 권고안(2022년 제3판)'을 제작하였다. 대한영상의학회와 대한천식알레르기학회, 대한신장학회에세 추천 및 승인된 전문가 위원들이 함께 참여하였고, 전문가 합의 또는 체계적 문헌 고찰을 기반으로, 조영제를 사용 시 감염관리를 위한 자동주입기 및 연결선에 대한 기술과 요요드화 조영제에 대한 급성 유해반응 및 신장 유해반응에 대한 내용들을 수정 및 추가하였다. 이에 개정된 내용을 소개하고자 한다.

• Journal of Chest Surgery
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• 제54권1호
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• pp.2-8
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• 2021

Since the first reported case of coronavirus disease 2019 (COVID-19) in December 2019, the numbers of confirmed cases and deaths have continued to increase exponentially despite multi-factorial efforts. Although various attempts have been made to improve the level of evidence for extracorporeal membrane oxygenation (ECMO) treatment over the past 10 years, most experts still hesitate to take an active position on whether to apply ECMO in COVID-19 patients. Several ECMO management guidelines have been published recently, but they reflect some important differences from the Korean medical system and aspects of real-world medical practice in Korea. We aimed to find evidence on the efficacy of ECMO for COVID-19 patients by reviewing the published literature and to propose expert recommendations by analyzing the Korean COVID-19 ECMO registry data.

• 유통과학연구
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• 제13권9호
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• pp.103-112
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• 2015

Purpose - This paper aims to provide a step-by-step approach to factor analytic procedures, such as principal component analysis (PCA) and exploratory factor analysis (EFA), and to offer a guideline for factor analysis. Authors have argued that the results of PCA and EFA are substantially similar. Additionally, they assert that PCA is a more appropriate technique for factor analysis because PCA produces easily interpreted results that are likely to be the basis of better decisions. For these reasons, many researchers have used PCA as a technique instead of EFA. However, these techniques are clearly different. PCA should be used for data reduction. On the other hand, EFA has been tailored to identify any underlying factor structure, a set of measured variables that cause the manifest variables to covary. Thus, it is needed for a guideline and for procedures to use in factor analysis. To date, however, these two techniques have been indiscriminately misused. Research design, data, and methodology - This research conducted a literature review. For this, we summarized the meaningful and consistent arguments and drew up guidelines and suggested procedures for rigorous EFA. Results - PCA can be used instead of common factor analysis when all measured variables have high communality. However, common factor analysis is recommended for EFA. First, researchers should evaluate the sample size and check for sampling adequacy before conducting factor analysis. If these conditions are not satisfied, then the next steps cannot be followed. Sample size must be at least 100 with communality above 0.5 and a minimum subject to item ratio of at least 5:1, with a minimum of five items in EFA. Next, Bartlett's sphericity test and the Kaiser-Mayer-Olkin (KMO) measure should be assessed for sampling adequacy. The chi-square value for Bartlett's test should be significant. In addition, a KMO of more than 0.8 is recommended. The next step is to conduct a factor analysis. The analysis is composed of three stages. The first stage determines a rotation technique. Generally, ML or PAF will suggest to researchers the best results. Selection of one of the two techniques heavily hinges on data normality. ML requires normally distributed data; on the other hand, PAF does not. The second step is associated with determining the number of factors to retain in the EFA. The best way to determine the number of factors to retain is to apply three methods including eigenvalues greater than 1.0, the scree plot test, and the variance extracted. The last step is to select one of two rotation methods: orthogonal or oblique. If the research suggests some variables that are correlated to each other, then the oblique method should be selected for factor rotation because the method assumes all factors are correlated in the research. If not, the orthogonal method is possible for factor rotation. Conclusions - Recommendations are offered for the best factor analytic practice for empirical research.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4591-4597
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• 2016

Purpose: Decisions as to whether to provide adjuvant treatment in older breast cancer patients remains challenging. Side effects of chemotherapy have to be weighed against life expectancy, comorbidities, functional status, and frailty. To aid decision-making, we retrospectively analyzed 110 women with breast cancer treated with a curative intention from 2006 to 2012. Survival data with clinical and pathological parameters were evaluated to address the role of adjuvant chemotherapy in this study population. Method: A total of 110 elderly (>70 years) patients that received mastectomy at two hospitals in Taiwan were observed retrospectively for a medium of 51 months. After mastectomy, patients received conservative treatment or adjuvant chemotherapy, or hormone therapy following clinical guidelines or physician's preference. Data were collected from the cancer registry system. Results: Median age at diagnosis was 75.7 years. Thirty-five percent of patients received adjuvant chemotherapy, these having a significantly younger age ($mean=74.0{\pm}5.3$ vs $77.5{\pm}5.3$, p<0.001) and higher tumor staging (p=0.003) compared with their non-chemotherapy counterparts.Five-year overall survival was non-significantly higher in patients who received adjuvant chemotherapy (with chemotherapy 64.2% vs without chemotherapy 62.6%, p=0.635), while five-year recurrence free survival was non-significantly lower (with chemotherapy 64.1% vs without chemotherapy 90.5%, p=0.80). Conclusions: In this analysis, adjuvant chemotherapy tended to be given to patients with a younger age and higher tumor staging at our institute. It was not associated with any statistically significant improvement in survival and recurrence rate. Until age specific recommendations are available, physicians must use their clinical judgment and assess the tumor biology with the patient's comorbidities to make the best choice. Clinical trials focusing on this critical issue are warranted.

• 한국임상약학회지
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• 제20권2호
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• pp.159-164
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• 2010

Radiofrequency ablation (RA) is being used to manage atrial fibrillation (AF) with patients failed at the $1^{st}$-line anti-arrhythmic medications. Patients undergoing this procedure are at increased risk of thromboembolism after ablation, and anticoagulation management surrounding the ablation remains controversial. Although no conclusive recommendations can be made, published guidelines and data support therapeutic anticoagulation with warfarin. The purpose of this study was to analyze effectiveness of current therapy and to find factors fluctuate International Normalized Ratio (INR) values in patients undergone RA followed by anticoagulation service (ACS). Retrospective review was conducted utilizing database in a hospital. Among 110 patients under warfarin around ablation between January 2006 to September 2007, 54 patients were selected and allocated into 2 groups: Group A included 47 who discontinued warfarin after ablation, while 7 in B continued the medication. Information on demographics, amount and length of warfarin dosing, INR values and measuring frequencies, and the causing factors on INR fluctuation were abstracted. Differences were analyzed using chi-squared test, Fisher's Exact test, and unpaired Student t-test. Mean amount of warfarin before and after surgery was 4.0 mg, 4.1 mg in Group A and was 5.1 mg, 4.6 mg in Group B, respectively. Average duration of warfarin doing before ablation was 73.7 days in Group A, 129.9 days in B with no significant difference (p = 0.312). The duration time of warfarin on groups after ablation lasted several months. The number of checking INRs was 4.1 and 7.6, respectively. Inter-individual variability of INR fluctuations were $2.1{\pm}0.6$ in Group A and $2.2{\pm}0.7$ in B which were not significantly different (p = 0.062). 164 cases of decreased INR were: 'omission in taking medication, stressfulness and headache, 'increased intake of high vitamin K foods', 'lifestyle change of increased physical activities', and 'increase of food-intakes'. To the contrary, 36 cases of increased INR were: 'reduce of food-intake', 'use of non-prescription drugs', 'reduction in physical activities', and 'excessive restriction on food-intake', consecutively. In conclusion, the study validated therapeutic outcomes of RA patients who we treated with standard guideline and demonstrated 9 factors of INR fluctuations in the patient. A well-trained, pharmacist-monitored anticoagulation service could reduce the risk of adverse effects and prevent complications in patients with AF around RA operation.

• Nutrition Research and Practice
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• 제10권5호
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• pp.516-523
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• 2016

BACKGROUND/OBJECTIVES: This study was conducted to examine relationships between dietary habits and intakes of antioxidants and B vitamins and the risk of ischemic stroke, and to compare dietary factors according to the presence of cerebral artery atherosclerosis and stroke subtypes. SUBJECTS/METHODS: A total of 147 patients and 144 control subjects were recruited consecutively in the metropolitan area of Seoul, Korea. Sixty participants each in the case and control groups were included in analyses after 1:1 frequency matching. In addition, 117 acute ischemic stroke patients were classified into subtypes according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) guidelines. Dietary intake was measured using a semi-quantitative food frequency questionnaire composed of 111 food items and plasma lipid and homocysteine levels were analyzed. RESULTS: When compared with control subjects, stroke patients had unfavorable dietary behaviors and lower intakes of fruits ($73.1{\pm}83.2g$ vs. $230.9{\pm}202.1g$, P < 0.001), vegetables ($221.1{\pm}209.0g$ vs. $561.7{\pm}306.6g$, P < 0.001), and antioxidants, including vitamins C, E, $B_6$, ${\beta}$-carotene, and folate. The intakes of fruits, vegetables, vitamin C, and folate were inversely associated with the risk of ischemic stroke after adjusting for confounding factors. Intakes of vegetables, vitamins C, $B_6$, $B_{12}$, and folate per 1,000 kcal were lower in ischemic stroke with cerebral atherosclerosis than in those without. Overall vitamin $B_{12}$ intake per 1,000 kcal differed according to the TOAST classification (P = 0.004), but no differences among groups existed based on the post-hoc test. CONCLUSIONS: When compared with control subjects, ischemic stroke patients, particularly those with cerebral atherosclerosis, had unfavorable dietary intake, which may have contributed to the development of ischemic stroke. These results indicate that proper dietary recommendations are important for the prevention of ischemic stroke.

• 기술혁신학회지
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• 제10권1호
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• pp.143-164
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• 2007

본 연구는 구가차원의 국가기술로드맵 활용도와 개선사항에 영항을 미치는 요인들에 대해 실증 분석함으로써 향후 국가기술로드맵의 활용도 제고와 발전방향을 제시하고자 한다. 국가수준 기술로드맵의 작성과 활용이 증가함에도 불구하고 실제 과학기술 전문가들의 활용도 현황이나 개선사항에 대한 체계적인 조사분석은 상대적으로 미흡하였다. 본 연구는 국내 320명의 과학기술 분야 전문가를 대상으로 수행한 설문조사를 바탕으로 국가수준 기술로드맵의 활용도와 개선방향에 대해 분석하였다. 분석결과, 국가기술로드맵 활용도에는 전반적인 기술수준이 높고 기술로드맵 참여 경험은 활용도에 유의한 영향을 미쳤다. 또한 중장기 기술전략의 세부목적에 따라 활용도에 차이가 있는 것으로 나타났다. 반면, 국가차원의 기술로드맵은 크게 기획과정, 작성과정, 결과활용에서 개선이 요구되며, 기술수준 참여경험 및 중장기 기술전략의 세부목적에 따라 서로 다른 측면에서의 향후 개선사항을 요구하고 있는 것으로 나타났다. 마지막으로 본 연구의 의의와 향후 국가차원의 국가기술로드맵의 활용도 제고와 발전방향을 위한 방안을 제시하였다.

• 한국식품영양과학회지
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• 제37권9호
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• pp.1214-1221
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• 2008

본 연구에서는 영 유아용 조제식의 안전성에 대한 소비자의 신뢰도를 회복하고 영 유아의 성장 및 발달에 도움이 되고자 우리나라, CODEX, EU, 호주 및 뉴질랜드의 영 유아용 조제식내 식품첨가물 및 오염물질 기준을 비교 분석하고 국내 영 유아용 조제식 기준의 문제점과 개선방안을 다음과 같이 제시하였다. 영 유아용 조제식내 식품첨가물 기준은 영양품질 개선을 목적으로 하는 영양 강화제와 식품에 첨가물 용도로 사용되는 식품첨가물로 분류하여 비교하였다. 영양 강화제의 경우 CODEX, EU, 호주 및 뉴질랜드에서는 영양소 유형에 따라 분류하여 제시한 반면, 우리나라에서는 영양 강화제의 명칭을 종합적으로 나열하여 제시하였다. 따라서 우리나라에서도 영양 강화제에 대하여 영양소별로 구분하여 제시할 필요성이 제기된다. 또한 첨가물 용도로 사용되는 식품첨가물의 경우 국내에서는 허용량이 규정되어 있지 않으므로 허용 식품첨가물의 명칭 및 최대 허용량을 제시하여 국제 기준과의 조화를 고려하도록 한다. 오염물질기준의 경우 국내에서는 일부 위해 미생물(E. sakazakii, B. cereus)과 방사선 조사처리 기준만 설정되어 있으나, CODEX 및 EU는 농약 기준을, 호주 및 뉴질랜드는 위해 미생물(Staphylococcus aureus, Salmonella sp.)과 중금속 중 납과 알루미늄의 최대 허용량에 대한 허용기준을 추가로 규정하고 있다. 따라서 우리나라 영 유아용 조제식의 안전성을 입증할 수 있는 과학적인 자료를 토대로 위해 미생물, 농약 및 기타 오염물질 기준을 정량적으로 추가 제시할 필요성이 제기된다.

• 터널과지하공간
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• 제27권1호
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• pp.12-25
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• 2017

국내 석회석광산은 주로 자연통기에 의존하고 있으나 자본 및 운전비용이 과다하게 소요되는 광산 전체통기방법보다 풍관과 선풍기를 이용한 국부통기방법이 바람직한 방법으로 평가된다. 국내 대단면 장대 광산갱도에 풍관이 접속된 국부선풍기를 직렬로 연결 설치하는 경우에 통기시스템의 경제성과 효율의 최적화가 반드시 요구된다. 최적화를 위한 가장 중요한 두가지의 설계변수는 벽면 이격거리와 풍관 간의 이격거리이다. 본 연구에서는 경제적 및 환경적으로 최적화된, 즉 풍관간의 이격 공간을 통한 압력손실, 누기 그리고 오염된 공기의 재유입을 최소화할 수 있는 두 설계변수 값을 도출하기 위하여 광범위한 CFD분석을 시행하였다. 기존 연구결과와 권고기준들을 고려하여 이들 변수의 연구대상 범위를 선정하였다. 본 연구의 궁극적 목표는 국내 장대 광산갱도내 설치되는 풍관 접속 선풍기의 직렬연결 국부통기시스템의 최적화를 통하여 깨끗하고 안전한 작업장 환경을 제공하기 위함이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3123-3129
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• 2016

Background: Cancer is the fourth leading cause of death in Sabah Malaysia with a reported age-standardized incidence rate was 104.9 per 100,000 in 2007. The incidence rate depends on non-mandatory notification in the registry. Under-reporting will provide the false picture of cancer control program effectiveness. The present study was to evaluate the performance of the cancer registry system in terms of representativeness, data quality, simplicity, acceptability and timeliness and provision of recommendations for improvement. Materials and Methods: The evaluation was conducted among key informants in the National Cancer Registry (NCR) and reporting facilities from Feb-May 2012 and was based on US CDC guidelines. Representativeness was assessed by matching cancer case in the Health Information System (HIS) and state pathology records with those in NCR. Data quality was measured through case finding and re-abstracting of medical records by independent auditors. The re-abstracting portion comprised 15 data items. Self-administered questionnaires were used to assess simplicity and acceptability. Timeliness was measured from date of diagnosis to date of notification received and data dissemination. Results: Of 4613 cancer cases reported in HIS, 83.3% were matched with cancer registry. In the state pathology centre, 99.8% was notified to registry. Duplication of notification was 3%. Data completeness calculated for 104 samples was 63.4%. Registrars perceived simplicity in coding diagnosis as moderate. Notification process was moderately acceptable. Median duration of interval 1 was 5.7 months. Conclusions: The performances of registry's attributes are fairly positive in terms of simplicity, case reporting sensitivity, and predictive value positive. It is moderately acceptable, data completeness and inflexible. The usefulness of registry is the area of concern to achieve registry objectives. Timeliness of reporting is within international standard, whereas timeliness to data dissemination was longer up to 4 years. Integration between existing HIS and national registration department will improve data quality.