• 한국융합학회논문지
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• 제10권7호
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• pp.391-397
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• 2019

우리나라의 인구 10만명 당 자살자 수는 24.6명으로 OECD국가 중 가장 높은 수준이다. 연령이 증가함에 따라 자살사망은 증가하고 있어 노인인구는 자살사망의 위험이 다른 인구집단에 비하여 매우 높다. 본 연구는 한국노인의 자살을 예측하는 요인을 확인하기 위하여 시도되었다. 노인을 대상으로 한 자살예방교육의 기초자료로 활용하고자 한국 복지패널의 2016년도에 구축된 11차 년도 복지패널 자료 중 만 65세 이상 노인 가구원 자료를 추출하여 분석하였다. 연구 대상자의 평균연령은 75.55세(표준편차 6.34)이며, 남성은 37%, 여성은 63%였으며, 지난 일 년간 자살생각을 한 적이 있는 대상자는 165명으로 전체의 3.4%였다. 주관적 건강상태와 우울, 자아존중감, 기초생활수급, 의료급여, 노인장기요양급여 등 사회서비스 수급여부의 관련요인을 포함하여 단계적 로지스틱 회귀분석 결과 우울(Exp(B)=1.113), 주관적 건강상태(Exp(B)=.767)가 자살생각을 예측하는 것으로 나타났다(Nagelkerke $R^2=.248$). 따라서 노인을 대상으로 한 자살예방프로그램의 효과적 적용을 위하여 주관적 건강상태의 사정과 우울증 선별검사를 통한 고위험군의 파악이 요구된다.

• 대한지역사회영양학회지
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• 제24권3호
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• pp.197-207
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• 2019

Objectives: This study examined the characteristics and nutritional risk of the elderly who receive home delivery services. We then analyzed the effects of the characteristics of the elderly who receive the home-delivery meal service on their nutritional risk. Methods: A total of 220 respondents who receive home-delivery meal service in Seoul participated in the survey. The survey consisted of the characteristics of the elderly (health status, tooth condition, physical activity, social participation activity, depression and relationship with neighbors), nutritional risk assessment and other general matters. The data was analyzed by using the SPSS program. Cross-tabulation analysis, t-test, correlation analysis and regression analysis were all conducted. Results: 47.0% of the subjects were under 80 years old and 53.0% were over 80 years old, The nutritional risk score, as evaluated by a Nutrition Screening Initiative (NSI) checklist was 10.7 points, and the high nutrition risk group was 91.5% of the subjects. The subjective self-health status score was 2.24 points (out of a total of 5 points) and the tooth status score was 3.30 points. The physical activity level was 2.17 points for the under 80 years old group and 1.76 points for the over 80 years old, and there was a significant difference according to age (p<0.01), The higher the health status, tooth condition, physical activity and social participation activity level, the lower was the nutritional risk. Further, the higher the degree of depression, the higher was the nutritional risk. Conclusions: For the healthy life of the elderly in the community, various welfare policies should be planned to increase social participation as well as to promote physical health and reduce depression.

• 동의신경정신과학회지
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• 제30권3호
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• pp.185-198
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• 2019

Objectives: The purpose of this study was to identify the effectiveness of Korean medicine treatment in mild cognitive impairment (MCI) among a group of community dwelling elderly. Methods: Two-hundred and twenty-nine elderly living in a community and diagnosed with MCI were recruited. Participants were evaluated with various instruments such as the Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS) and the Korean version of Montreal Cognitive Assessment (MoCA-K). Korean medicine treatment consisted of herbal medicine, acupuncture, and pharmacoacupuncture. The change in cognitive ability was assessed by using the MMSE-DS and the MoCA-K. Data were analyzed by SPSS/WIN 22.0 using the paired t-test, and the ANOVA. Results: The MMSE-DS and the MoCA-K score generally increased after six months of Korean medicine treatment and the differences in both instruments were statistically significant. Additionally, some consecutive participants maintained long-term cognitive improvement. When analyzed specifically by herbal medicine group based on syndrome differentiation and pharmacoacupuncture group, most showed improvement in the MMSE-DS and the MoCA-K but not all data were statistically significant. The satisfaction score was mostly high and most participants were willing to re-participate in the program. Conclusions: Korean medicine treatment may contribute to the improvement and prevention of cognitive decline in the elderly. However, further systematic research based on large scale sample data and standardized protocols is needed to uplift the welfare and mental health of the elderly.

• Clinical and Experimental Pediatrics
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• 제62권2호
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• pp.48-54
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• 2019

Purpose: Liver metabolism plays a pivotal role in the development of metabolic disorders. We aimed to investigate the clinical and laboratory risk factors associated with alanine aminotransferase (ALT) levels in young adolescents from an urban population in Korea. Methods: A population of 120 apparently healthy adolescents aged 12-13 years was included in the cross-sectional design study; 58 were overweight or obese and 62 were of normal weight. We estimated anthropometric and laboratory measurements, including waist-to-height ratio, blood pressure, insulin sensitivity, aspartate aminotransferases (AST), ALT, and lipid profiles. Results: The mean ages of the overweight or obese and normal weight participants were $12.9{\pm}0.3$ and $13.0{\pm}0.3years$, respectively. Height, weight, body mass index, waist circumference, waist-to-height ratio, systolic and diastolic blood pressure, AST, ALT, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR) score were significantly higher and the high-density lipoprotein-cholesterol and quantitative insulin-sensitivity check index were significantly lower in the overweight/obese participants in comparison to the normal-weight participants (all P<0.05). In multivariate linear regression analysis, waist-to-height ratio, systolic blood pressure, and HOMA-IR score were independently and positively associated with serum ALT levels. Conclusion: Screening for ALT levels in adolescents may help to differentiate those at risk of metabolic abnormalities and thus prevent disease progression at an early age.

• Neonatal Medicine
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• 제25권4호
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• pp.137-143
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• 2018

Purpose: This study was performed to determine the clinical features of full-term infants with hypoxemia detected by pulse oximetry and to establish the diagnosis of critical congenital heart disease (CCHD). Methods: We retrospectively reviewed the medical records of neonates who had been admitted to the neonatal intensive care unit within 2 weeks of birth at Korea University Ansan Hospital between January 2013 and October 2017 (n=450). We classified these neonates based on the presence of hypoxemia at admission and investigated neonatal characteristics, initial symptoms, echocardiographic findings, and final diagnosis associated with hypoxemic diseases. Results: Of 450 term infants, 265 infants (58.9%) were identified hypoxemia by pulse oximetry at admission. The most common symptoms of them were cyanosis and tachypnea. Among them, 80.1% of infants (214/265) were diagnosed with respiratory tract disease and 8.3% of infants (22/265) had congenital heart disease. Thirteen infants (13/265, 4.9%) had CCHD and were treated with urgent surgery or transcatheter intervention within 28 days of birth. Majority of infants with respiratory tract disorder were transferred from hospital immediately after birth, but 46.1% of infants (6/13) with CCHD remained asymptomatic after birth and were admitted after 48 hours after birth. In addition, other hypoxemic illnesses were identified as neonatal infectious and neurological diseases. Conclusion: This study showed the importance of assessment in neonates with hypoxemia, including those diagnosed with CCHD. The possibility of CCHD should be considered in the differential diagnosis in neonates demonstrating hypoxemia after 48 hours of birth. A larger prospective study is needed to assess the effectiveness and outcomes of pulse oximetry for neonatal screening in Korea.

• 한국임상약학회지
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• 제31권2호
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• pp.153-159
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• 2021

Background: With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). Methods: We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service-National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC. Results: A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K). Conclusion: By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.

• 대한의용생체공학회:의공학회지
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• 제42권3호
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• pp.80-85
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• 2021

We developed a model to classify the absence of cervical cancer using deep learning from the cervical image to which the histogram equalization algorithm was applied, and to compare the performance of each model. A total of 4259 images were used for this study, of which 1852 images were normal and 2407 were abnormal. And this paper applied Image Sharpening(IS), Histogram Equalization(HE), and Contrast Limited Adaptive Histogram Equalization(CLAHE) to the original image. Peak Signal-to-Noise Ratio(PSNR) and Structural Similarity index for Measuring image quality(SSIM) were used to assess the quality of images objectively. As a result of assessment, IS showed 81.75dB of PSNR and 0.96 of SSIM, showing the best image quality. CLAHE and HE showed the PSNR of 62.67dB and 62.60dB respectively, while SSIM of CLAHE was shown as 0.86, which is closer to 1 than HE of 0.75. Using ResNet-50 model with transfer learning, digital image-processed images are classified into normal and abnormal each. In conclusion, the classification accuracy of each model is as follows. 90.77% for IS, which shows the highest, 90.26% for CLAHE and 87.60% for HE. As this study shows, applying proper digital image processing which is for cervical images to Computer Aided Diagnosis(CAD) can help both screening and diagnosing.

• 한국전문물리치료학회지
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• 제28권2호
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• pp.146-153
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• 2021

Background: Researchers have previously commenced examining the degree of concordance between parent proxy and child self-reports on health-related quality of life (HRQOL) of many disease and impairment populations. Objects: To explore the differences between parent proxy and child self-reports on the HRQOL using Korean version of KIDSCREEN-10 questionnaires for applying to elementary school children and their parents who participated for a school-based wellness program. Methods: The focus groups were recruited for a school-based wellness program by implementing the following wellness services: 1) referring to a screening session for detecting potential posture-related musculoskeletal problems and 2) recommending home exercise programs. Before a primary field testing for the program, two focus groups were formed with a group of 9 parents and their 9 elementary school children aged 8-10 years of age. The parent proxy and child self-report versions of KIDSCREEN-10 questionnaires were administered to both groups after completion of the wellness program. Item level Rasch rating scale analysis was applied to compute logit scales of KIDSCREEN-10 questionnaire. Intraclass correlation coefficients (ICCs) and scatterplot of item difficulty between two reports were analyzed. Results: For fit statistics of parent proxy report, all items except 4 items (i.e., psychological well-being, mood/emotions, self-perception, parent relation) were found to be acceptable. For fit statistics of child self-report, all items except 3 items (i.e., psychological well-being, autonomy and home life) were acceptable. The relationship between two reports using ICCs were ranging from weak to very strong at p = 0.05 (i.e, ICCs = 0.011 to 0.905). Scatterplot analysis between two reports showed a major disparity on self-perception item at 95% confidence intervals. Conclusion: Both item level analyses and ICC comparisons provided a disparity between parent proxy and child self-reports of the HRQOL on self-perception item after competing a school-based wellness program. Therapist should consider the item as part of the HRQOL assessment.

• The Plant Pathology Journal
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• 제37권2호
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• pp.200-203
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• 2021

Rice blast caused by the filamentous fungus Magnaporthe oryzae, is arguably the most devastating rice disease worldwide. Development of a high-throughput and reliable field blast resistance evaluation system is essential for resistant germplasm screening, resistance genes identification and resistant varieties breeding. However, the occurrence of rice blast in paddy field is easily affected by various factors, particularly lack of sufficient inoculum, which always leads to the non-uniform occurrence and reduced disease severity. Here, we described a procedure for adequately inducing the occurrence of rice seedling blast in paddy field, which involves pretreatment of diseased straw, initiation of seedling blast for the first batch of spreader population, inducing the occurrence of the second batch of spreader population and test materials. This procedure enables uniform and consistent infection, which facilitates efficient and accurate assessment of seedling blast resistance for diverse rice materials.

• Journal of Gastric Cancer
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• 제22권1호
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• pp.56-66
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• 2022

Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19-12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90-19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26-8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.