• Title/Summary/Keyword: 임상적 성과지표

Search Result 56, Processing Time 0.025 seconds

Network Analysis of Depressive and Anxiety Symptom in Young Adult of an Urban City (일 도시 청년 인구의 불안 우울 공존 증상 네트워크 분석)

  • Jong wan Park;Hyochul Lee;Jae Eun Hong;Seok Bum Lee;Jung Jae Lee;Kyoung Min Kim;Hyu Seok Jeong;Dohyun Kim
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.31 no.2
    • /
    • pp.118-124
    • /
    • 2023
  • Objectives : Depressive disorder and anxiety disorder frequently co-occur, even at sub-threshold level. This study aims to identify network structure of co-morbid depression and anxiety at symptom level in nonclinical population and to reveal the central symptoms and bridge symptoms of the co-morbidity. Methods : This study was based on 2022 Asan Youth Mental Health Screening. Patient health questionnaire (PHQ-9) and Generalized anxiety disorder scale (GAD-7) were used to assess depressive and anxiety symptoms of 810 young adult participants from community sample. Network structure of co-morbid depressive and anxiety symptoms was estimated by Isingfit model. Results : Depressed mood, Restlessness and Nervousness were the most central symptoms in the network. Bridge symptoms between anxiety and depression were Restlessness and Irritability. Conclusions : This study revealed key central symptoms and bridge symptoms of co-morbid depression and anxiety in nonclinical population and provided potential insight for treatment targets to reduce co-morbidity.

Early Clinical Experience in Valve Replacement Using On-X Prosthetic Heart Valve (On-X 기계판막을 이용한 판막치환술의 단기성적분석)

  • 김인섭;김우식;신용철;유환국;김병열;정성철
    • Journal of Chest Surgery
    • /
    • v.37 no.9
    • /
    • pp.742-748
    • /
    • 2004
  • The On-X valve was recently introduced. It was the aim of this study to assess the safety and feasibility from the data derived from 28 patients who underwent aortic and/or mitral valve replacement with this prosthesis in National Medical Center. Material and Method: From May 1999 and May 2003, a series of 28 consecutive patients who had been implanted with 32 On-X prosthesis were reviewed, The operative procedure comprised of 12 MVR, 10 AVR and 6 DVR. The study followed the guidelines of AATS/STS. Mean follow-up was 27 months (total 04 patient-years). Result: Early ($\leq$30 days) mortality was 7.44% (2/28) and no late mortality occurred in the study. Total actuarial freedom from mortality at 2 years was 92.86$\pm$4.87% for all cases, 100% for MVR, 90$\pm$9.49% for AVR, and 83.3$\pm$1.52% for DVR. Thromboembolic event occurred in 2 MVR patients and that was the only complication; therefore, the linearized incidence of valve related complications was 3.17%/ patient-years for all cases and 6.5%/patient-years for MVR and the actuarial freedom from valve related complications at 2 years was 84.85$\pm$10.75%. Preoperatively, 24 (85.71%) patients were in NYHA functional class III or IV but postoperatively, 25 (89,29%) patients were in NYHA functional class I or II. The levels of hemoglobin, hematocrit, serum LDH, reticulocyte rate and indirect bilirubin were all within normal range at postoperative 3 month. In mitral position, the peak gradient was 6.1$\pm$1.8 mmHg and the mean gradient was 3.0$\pm$0.6 mmHg and EOA were 2.54$\pm$0.56 $m^2$, 2.39$\pm$0.73 $m^2$, 2.34$\pm$0.55 $m^2$, 2.40$\pm$0.63 $m^2$ at 27 mm, 29 mm, 31 mm, 33 mm respectively. In aortic postion, the peak gradient was 21.1 $\pm$14.12 mmHg and the mean gradient was 12.3$\pm$6.52 mmHg. Conclusion: Since there was no significant difference in the postoperative mortality, valve related complications and echocardiographic hemodynamic data compared to standard bileaflet design and since there was an improvement in the NYHA functional class and normal values of hemolytic indicators, it can be assumed that On-X valve is safe and feasible. However, accumulation of cases and long-term follow-up of this patient group is needed to establish this result.

Development of Evaluation Method of Regional Contractility of Left Ventricle Using Gated Myocardial SPECT and Assessment of Reproducibility (게이트 심근 SPECT를 이용한 좌심실의 국소탄성률 평가방법 개발 및 재현성 평가)

  • Lee, Byeong-Il;Lee, Dong-Soo;Lee, Jae-Sung;Kang, Won-Jun;Chung, June-Key;Lee, Myung-Chul;Choi, Heung-Kook
    • The Korean Journal of Nuclear Medicine
    • /
    • v.37 no.6
    • /
    • pp.355-363
    • /
    • 2003
  • Purpose: Regional contractility can be calculated using the regional volume change of left ventricle measured by gated myocardial SPECT image and curve of central artery pressure obtained from radial artery pressure data. In this study, a program to obtain the regional contractility was developed, and reproducibility of regional contractility measurement was assessed. Materials and Methods: Seven patients(male:female=5:2, $58{\pm}11.9$ years) with coronary artery diseases underwent gated Tc-99m MIBI myocardial SPECT twice without delay between two scans. Regional volume change of left ventricle was estimated using CSA (Cardiac SPECT Analyzer) software developed in this study. Regional contractility was iteratively estimated from the time-elastance curve obtained using the time-pressure curve and regional time-volume curve. Reproducibility of regional contractility measurement assessed by comparing the contractility values measured twice from the same SPECT data and by comparing those measured from the pair of SPECT data obtained from a same patient. Results: Measured regional contractility was $3.36{\pm}3.38{mm}Hg/mL$ using 15-segment model, $3.16{\pm}2.25{mm}Hg/mL$ using 7-segment model, and $3.11{\pm}2.57{mm}Hg/mL$ using 5-segment model. The harmonic average of regional contractility value was almost identical to the global contractility. Correlation coefficient of regional contractility values measured twice from the same data was greater than 0.97 for all models, and two standard deviations of contractility difference on Bland Altman plot were 1.5%, 1.0%, and 0.9% for 15-, 7-, and 5-segment models, respectively. Correlation coefficient of regional contractility values measured from the pair of SPECT data obtained from a same patient was greater than 0.95 for all models, and two standard deviations on Bland Altman plot were 2.2%, 1.0%, and 1.2%. Conclusion: Regional contractility of left ventricle measured using developed software in this study was reproducible. Regional contractility of left ventricle will be a new useful index for myocardial function after analysis of the clinical data.

A Study on a Quantitative Method in Estimating Forest Effects for Streamflow Regulation (II) - Mainly Dealing with Application of Coefficient for Slope Roughness - (삼림이수기능(森林理水機能)의 정량적(定量的) 평가방법(平價方法)에 관한 연구(硏究)(II) - 조도계수(粗度係數)의 응용(應用)을 중심(中心)으로 -)

  • Lee, Heon Ho
    • Journal of Korean Society of Forest Science
    • /
    • v.81 no.4
    • /
    • pp.337-345
    • /
    • 1992
  • In this research, a kinematic wave model was applied for the runoff analysis, Regulation of streamflow was estimated by the calibration of roughness coefficient as a parameter. The data analyzed were obtained from Ananomiya and Shirasaka experimental basins at Tokyo University Forest in Aichi. Estimation methods and characteristics of roughness coefficient as a evaluation method of hydrological function of forest are summarized as follows ; 1. Roughness coefficient($N_s$) indicates the resistance of hillslope to the flowing water of surface runoff. There exists an hypothesis that resistance of hillslope to flowing water increase with the growth forest and development of the $A_o$ layer. 2. Roughness coefficient($N_s$) was estimated by the parameter when the stream direct runoff was calculated by using the kinematic wave. 3. Secular change of '$N_s$' in ananomiya has a curve which has an upper limit and increases exponentially near the limit. The curve quickly increased from 1935 to 1945 when results of afforestation for erosion control were thought to be effective. On the other hand, slight increase of '$N_s$' in Shirasaka indicates that there was not such a big change in the surface of soil layer. 4. The increase of '$N_s$' was related with decrease of direct runoff and increase of base flow. It was recognized that the rate of direct runoff decreased with the improvement of forest physiognomy and the rate of base flow was increased. But absolute value of water runoff per one storm decreased in chronological order.

  • PDF

A Study on the Improvement of Sub-divided Land Cover Map Classification System - Based on the Land Cover Map by Ministry of Environment - (세분류 토지피복지도 분류체계 개선방안 연구 - 환경부 토지피복지도를 중심으로 -)

  • Oh, Kwan-Young;Lee, Moung-Jin;No, Woo-Young
    • Korean Journal of Remote Sensing
    • /
    • v.32 no.2
    • /
    • pp.105-118
    • /
    • 2016
  • The purpose of this study is to improve the classification system of sub-divided land cover map among the land cover maps provided by the Ministry of Environment. To accomplish the purpose, first, the overseas country land cover map classification items were examined in priority. Second, the area ratio of each item established by applying the previous sub-divided classification system was analyzed. Third, the survey on the improvement of classification system targeting the users (experts and general public) who actually used the sub-divided land cover map was carried out. Fourth, a new classification system which improved the previous system by reclassifying 41 classification items into 33 items was finally established. Fifth, the established land cover classification items were applied on study area, and the land cover classification result according to the improvement method was compared with the previous classification system. Ilsan area in Goyang city where there are diverse geographic features with various land surface characteristics such as the urbanization area and agricultural land were distributed evenly were selected as the study area. The basic images used in this study were 0.25 m aerial ortho-photographs captured by the National Geographic Information Institute (NGII), and digital topographic map, detailed stock map plan, land registration map and administrative area map were used as the relevant reference data. As a result of applying the improved classification system into the study area, the area of culture-sports, leisure facilities was $1.84km^2$ which was approximately more than twice larger in comparison to the previous classification system. Other areas such as transportation and communication system and educational administration facilities were not classified. The result of this study has meaningful significance that it reflects the efficiency for the establishment and renewal of sub-divided land cover map in the future and actual users' needs.

Acupuncture for Prehypertension and Stage 1 Hypertension in Postmenopausal Women: Protocol for a Randomized Controlled Pilot Trial (폐경 후 여성의 전단계 및 1기 고혈압에 대한 침 치료: 다기관 무작위 대조 예비연구)

  • Kim, Jung-Eun;Choi, Jin-Bong;Kim, Hyeong-Jun;Kang, Kyung-Won;Liu, Yan;Jung, Hee-Jung;Lee, Min-Hee;Shin, Mi-Suk;Kim, Jae-Hong;Choi, Sun-Mi
    • Korean Journal of Acupuncture
    • /
    • v.31 no.1
    • /
    • pp.5-13
    • /
    • 2014
  • Objectives : This study aims to evaluate the effectiveness and safety of acupuncture and explore the appropriate number of treatment for postmenopausal women diagnosed with prehypertension and stage 1 hypertension. Methods : A 4-arm randomized open label pilot trial will be performed at 2 centers. Sixty participants will be divided into 2 treatment groups and 2 control groups. Treatment groups will receive acupuncture at 8 points(bilateral GB20, LI11, ST36, SP6) for 4 weeks(treatment group A, 10 total sessions) or 8 weeks(treatment group B, 20 total sessions), while maintaining usual care. Control groups will not receive acupuncture but will be under usual care for 16 weeks(control group C) or 20 weeks(control group D). Each patient's living habits will be corrected and drugs that may affect blood pressure(BP) will be prohibited. Treatment group A and control group C will be evaluated at 4, 8, 12, and 16 weeks after randomization, while treatment group B and control group D will be evaluated at 4, 8, 12, 16, and 20 weeks after randomization. The major outcome variable is the magnitude of change in diastolic BP levels at 4 weeks after randomization; auxiliary outcome variables are (1) diastolic BP change at 8, 16, and 20 weeks, (2) systolic BP change, (3) BP control rate, (4) lipid profiles, and (5) high-sensitivity C-reactive protein. Patient safety will be assessed at every visit. Results and Conclusions : The study findings may help develop evidence for the effectiveness and safety of acupuncture for BP control.