• 수면정신생리
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• 제4권2호
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• pp.164-171
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• 1997

Introduction : Periodic limb movement disorder (PLMD) is shown to common in patients with OSA and may become evident or worsened when treated with nasal continuous positive airway pressure (CPAP). Whether this is due to im proved sleep continuity. adverse nocturnal body positioning, uncovered by CPAP, or due to the CPAP stimulus is still debat-ed. We hypothesized that the increase in PLM activity following CPAP is associated with more supine-sleeping tendencies when being treated with CPAP. In the present work, we compared differences in the PLMD index (PLMI) and sleeping position of patients with sleep disordered breathing before and after CPAP treatment. Method : We studied 16 patients (mean age 46 yr, 9M, 7F) with OSA (11 patients) or UARS (5 patients) who either had PLMD on initial polysomnogram (baseline PSG) or on nasal CPAP trial (CPAP PSG). All periodic leg movements were scored on anterior tibialis EMG during sleep according to standard criteria (net duration; 0.5-5.0 seconds, intervals; 4-90 seconds. 4 consecutive movements). Paired t-tests compared PLMD index (PLMI), PLMD-related arousal index (PLMD-ArI), respiratory disturbance index (RDI), and supine sleeping position spent with baseline PSG and CPAP PSG. Results : Ten patients (63%) on baseline PSG and fifteen patients (94%) on CPAP PSG had documented PLMD ($PLMI{\ge}5$) respectively with significant increase on CPAP PSG(p<0.05). Ten patients showed the emergence (6/10 patients) or substantial worsening (4/10 patients) of PLMD during CPAP trial. Mean CPAP pressure was $7.6{\pm}1.8\;cmH_2O$. PLMI tended to increase from baseline PSG to CPAP PSG, and significantly increase when excluding 2 outlier (baseline PSG, $19.0{\pm}25.8/hr$ vs CPAP PSG, $29.9{\pm}12.5/hr$, p<0.1). PLMD-ArI showed no significant change, but a significant decrease was detected when excluding 2 outlier (p<0.1). There was no significant sleeping positional difference (supine vs non-supine) on baseline PSG, but significantly more supine position (supine vs non-supine, p<0.05) on CPAP PSG. There was no significant difference in PLMI during supine-sleeping and nonsupine-sleeping position on both of baseline PSG and CPAP PSG. There was also no significant difference in PLMI during supine-sleeping position between baseline PSG and CPAP PSG. With nasal CPAP, there was a highly significant reduction in the RDI (baseline PSG, $14.1{\pm}21.3/hr$ vs CPAP PSG, $2.7{\pm}3.9/hr$, p<0.05). Conclusion : This preliminary data confirms previous findings that CPAP is a very effective treatment for OSA, and that PLMD is developed or worsened with treatment by CPAP. This data also indicates that supine-sleeping position is more common when being treated with CPAP. However, there was no clear evidence that supine position is the causal factor of increased PLMD with CPAP. It is, however, suggested that the relative movement limitation induced by CPAP treatment could be a contributory factor of PLMD.

• 대한간호학회지
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• 제47권6호
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• pp.794-805
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• 2017

Purpose: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. Methods: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. Results: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (${\pm}14.90$), 41.15 (${\pm}16.04$), 53.44(${\pm}24.67$), and 54.33 (${\pm}22.80$) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ${\geq}70$ years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ${\geq}36.5^{\circ}C$ (OR 3.12, 95% CI: 1.17~8.17); age ${\geq}70$ years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ${\geq}36.5^{\circ}C$ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. Conclusion: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.

• 보존과학연구
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• 통권28호
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• pp.121-147
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• 2007

A large variety of mineral pigments has been used for Korean paintings and it has known that organic pigments have been used together on the Buddhist painting and the portrait. Haehakbando-do, which is from Honolulu Academy Museum in the United States, 12-fold screen was commissioned by Court of the late Joseon Dynasty in order to pray for the King's longevity. Therefore, it seems that all material used including pigments were selected very carefully and a great deal of technical effort was gone into its process. The purposes of this research were to estimate the pigments and the contributory elements of each color used on Haehakbando-do, in accordance with the conservation treatment carried out by Gochang Conservation Institute throughout last year. Without extracting sample, property of pigment was measured by nondestructive method, X-ray spectral analysis, and by comparing with the data about ancient pigments. In spite of the limited range of pigment analysis by nondestructive method, it should be noted that this method would not cause damage to the cultural properites. White pigment was found in all colored parts except the background, so it can be suggested that white color was used as a grounding of other color pigments. This would be flake white[$2PbCO_3{\cdot}Pb(OH)_2$] as Pb was found. Pb was the only element could be found in yellow, however, it can be organic pigment like Gamboge as same as background. Red would be Cinnabar (HgS) as hydrargyrum (Hg) was detected. For the light purple in cloud, organic pigments were probably used since any element is not detected except for Pb, which is used for background. It is possible that green color is the mixture of Malachite[$CuCO_3{\cdot}Cu(OH)_2$] and Azurite [$2CuCO_3{\cdot}Cu(OH)_2$], which share Cu as their main element. Azurite[$2CuCO_3{\cdot}Cu(OH)_2$] was used for bluish pigments. Black is carbon compound. For gold, solid gold (Au) was detected. It shows that gold was gilded on the flake white background. Red painted on the frame of screen was identified as Cinnabar (HgS) and the gold pattern was solid gold (Au). The supporting leg of folding screen was made of brass because both copper and zinc were detected. In conclusion, white pigment was used as grounding of all colors of Haehakbando-do, and specific pigments were used for each color. Additionally, result from the analysis of several pigments shows that mineral pigment and organic pigment, or different mineral pigments were mixed to make various colors.

• 대한약리학회지
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• 제20권2호
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• pp.59-71
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• 1984

신장기능에 대한 중추신경계의 역할을 구명코자. presynaptic ${\alpha}-adrenoceptor$의 선택적 작동약인 clonidine을 urethane마취 가토의 측뇌실내로 (icv)투여하여 신장기능의 변동을 관찰하였다. $5{\mu}g/kg$ icv이하의 양으로는 신장기능의 유의한 변동을 볼 수 없었으나, $15{\mu}g/kg$ icv 으로는 20분간에 걸쳐 현저한 Na 및 K배설 증가를 볼 수 있었다 이 때 신혈류 및 사구체 여과율은 유의한 변동을 나타내지 아니하였다. 또 이때 Na 재흡수율은 유의하게 감소하였으며, Na배설증가 작용이 세뇨관에서의 Na재흡수 억제에 기인함을 알 수 있었다. 전신혈압 변동은 이 작용에 기여하지 아니하였다. Presynaptic ${\alpha}-adrenoceptor$에 대한 선택적 길항약인 yohimbine $100\;{\mu}g/kg$을 clonidine투여 20분전에 측뇌실내로 투여하면 clonidine의 신장작용이 완전히 차단되었다. 이 량의 yohimbine은 측뇌실내 투여시 신장기능에 아무런 변동도 초래하지 아니하였다. $15\;{\mu}g/kg$ clonidine을 정맥내로 투여하면 투여 직후에 뇨량 감소와 신장기능 감퇴를 초래한 뒤 후기에 약간의 Na배설증가의 경향을 보였으나, clonidine을 icv로 투여하였을 때 볼 수 있던 만큼의 Na배설증가는 볼 수 없었다. 따라서 icv clonicine의 신장작용에는 신장에 대한 clonidine의 직접작용이 관여하지 않음을 알 수 있었다. 이 연구결과는 가토의 신장기능 조절에 있어서 중추의 교감신경 긴장도가 중요한 역할을 하고 있음을 시사하였다.

• 보건행정학회지
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• 제29권2호
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• pp.206-219
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• 2019

This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. 'Transfers from government domestic revenue' share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to 'compulsory contributory health financing schemes,' 'transfers from government domestic revenue' share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.

• Journal of Nutrition and Health
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• 제53권6호
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• pp.648-662
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• 2020

국내 나트륨 평균 섭취량은 2017년 3,477 mg으로 2010년 4,876 mg 대비 71.3% 수준으로 감소하였다. 나트륨 섭취량 감소 추이에서 생산 및 조리 주체별 구분에 따른 기여도에서는 산업체에서 생산된 식품과 가정에서 조리한 식품으로부터의 나트륨 섭취량 감소 비율이 단체급식과 외식업체에서 조리하여 제공하는 식품으로부터의 나트륨 섭취량 감소 비율보다 컸다. 식품군과 음식군으로부터 나트륨에 가장 많이 기여하는 요인은 생산 및 조리 주체별로 다르게 나타났는데, 산업체 생산에서는 김치류에서, 가정과 단체급식에서는 조리한 국/탕/찌개/전골류에서, 외식업체에서는 조리한 면/만두류였고, 나트륨 기여도가 가장 높았던 이들 식품 및 음식들은 연도에 따른 나트륨 섭취량 감소 폭도 가장 큰 것으로 나타났다. 특히 가정에서 조리한 국/탕/찌개/전골류와 면/만두류의 나트륨 함량 감소 폭은 외식업체 및 단체급식에서 조리한 음식보다 더 큰 것으로 나타났다. 나트륨 섭취량에 주로 기여하는 주요 식품군과 음식군의 종류는 연도가 증가함에 따라 나트륨 급원 식품이 특정 식품 위주에서 다양한 식품으로 확대되는 경향을 보여, 향후 나트륨 저감 대상 품목에 대한 다양한 접근이 요구됨을 시시하였다. 국내 나트륨 섭취에 기여하는 식품은 가공식품을 완제품 형태로 섭취하는 것 외에도 조리 단계에서 식재료로 다양하게 사용하는 비율이 높으므로 본 연구에서 제안한 생산 및 조리 주체별로 식품군 또는 음식군을 분류하여 나트륨 섭취 주요 급원 및 감소 요인을 파악한 결과는 저염 식품의 개발 및 생산, 저염 섭취와 관련된 식생활 교육 등과 같은 분야의 기초 자료로 활용될 것으로 기대된다. 향후 식문화를 고려한 다양한 식품 분류체계 방법을 마련하여 나트륨 섭취량 분석 및 저감 전략 수립에 활용하는 것이 필요할 것으로 생각된다.

• 자원환경지질
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• 제56권3호
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• pp.331-341
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• 2023

지구통계 기법을 기반으로 토양오염지도를 작성하는 경우 예측 오차가 발생하며 이에 영향을 미치는 다양한 원인이 존재한다. 본 연구에서는 정규 크리깅을 활용하여 폐광산지역의 토양 내 중금속 농도 샘플링 데이터로부터 격자형 기반의 토양오염지도를 작성하였다. 해당 지도의 예측 오차에 영향을 미친다고 판단된 5개 인자를 선정하고, Leave-one-out 기법을 기반으로 인자의 옵션과 설정값의 변화에 따른 예측값과 실측값 간의 평균제곱근오차(root mean square error, RMSE) 변화를 분석하였다. 이후 머신러닝 알고리즘을 이용하여 RMSE에 영향을 미치는 상위 3개 인자를 도출하였다. 그 결과, Standard interpolation에서는 Variogram Model, Minimum Neighbors, Anisotropy 인자가 RMSE에 가장 큰 영향을 미치는 것으로 분석되었다. 베리오그램 모델에서는 Spherical 모델이 가장 낮은 RMSE를 보였으며, Minimum Neighbors는 3에서 최젓값을 보인 후 값이 증가함에 따라 증가하였다. Anisotropy의 경우 이방성을 고려하지 않는 것이 더 적합한 것으로 나타났다. 본 연구에서는 지구통계와 머신러닝의 복합 활용을 통해 지역 규모에서 높은 신뢰성을 갖는 토양오염지도를 작성할 수 있었고, 적은 수의 토양 샘플링 데이터의 보간 작업 시 어떠한 요인들이 큰 영향을 미치는지 파악할 수 있었다.

• 한국노년학
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• 제31권3호
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• pp.573-590
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• 2011

본 연구에서는 제1~2차 고령화연구패널조사 자료를 사용하여 첫째, 가구소득 및 가구동원가능자산에 대한 결정요인을 분석을 통해 국내 중·고령가구의 소비여력에 영향을 미치는 주요 요인들에 대해 논의하였다. 둘째, 가구소비 결정요인을 추정하여, 국내 중·고령가구의 소비에 있어서 가구특성들 중 어떠한 요인들이 중요한 영향을 미치는지 여부를 분석하였다. 먼저 가구 소비여력인 가구소득 및 가구동원가능자산에 대한 분석 결과, 여러 설명변수들 중에서도 특히, 교육수준이 높고 가구원수가 많을수록, 자가 거주와 근로상태인 경우, 그리고 특수직역연금을 수급하는 중·고령자가구의 경우 상대적으로 가구소득과 가구동원가능자산과 같은 소비 여력이 높은 것으로 나타났다. 다음으로 2차 자료를 대상으로 가구소비 결정요인을 추정한 결과, 연간가구 가처분소득과 가구동원가능자산이 많을수록, 가구원수가 많고 교육수준이 높을수록, 광역시에 거주하고 자가 거주주택을 보유하고 있을수록, 근로행위를 하거나 특수직역연금을 수급하는 가구일수록 가구 소비를 증가시킬 유인이 상대적으로 큰 것으로 나타났다. 그에 반해 연령이 높을수록, 국민연금을 수급하거나 남성일 경우 가구 소비는 상대적으로 감소하는 것으로 나타났다.

• 대한두개안면성형외과학회지
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• 제25권1호
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• pp.11-16
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• 2024

Background: The pathogenesis of orofacial cleft (OFC) is multifactorial, involving both genetic and non-genetic factors, the latter of which play a key role in the development of these anomalies. This paper addresses the incidence of OFC in Indonesia, with a focus on identifying and examining the distribution of contributory factors, including parental medical history, pregnancy history, and environmental influences. Methods: The study was conducted through the collection of primary data. An interdisciplinary research team from Indonesia administered a standardized questionnaire to parents who had children with OFC and who had provided informed consent. The case group comprised 133 children born with cleft lip and/or palate, and the control was 133 noncleft children born full-term. The risk factors associated with OFC anomalies were analyzed using the chi-square test and logistic regression. All statistical analyses were performed using SPSS version 25. A p-value of 0.05 or less was considered to indicate statistical significance. Results: The study comprised 138 children, of whom 82 were boys (59.4%) and 56 were girls (40.6%). Among them, 45 patients (32.6%) presented with both cleft lip and cleft palate, 25 individuals (18.1%) had a cleft palate only, and 28 patients (20.3%) had a cleft lip only. OFC was found to be significantly associated with a maternal family history of congenital birth defects (p<0.05), complications during the first trimester (p<0.05), consumption of local fish (p<0.05), caffeine intake (p<0.05), prolonged medication use (p<0.05), immunization history (p<0.05), passive smoking (p<0.05), and X-ray exposure during pregnancy (p<0.05). Conclusion: The findings indicate close relationships between the incidence of OFC and maternal medical history, prenatal factors, and environmental influences.

• Korean Journal of Radiology
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• 제20권4호
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• pp.631-640
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• 2019

Objective: To evaluate the value of airway computed tomography (CT) in patients with obstructive sleep apnea (OSA) as a predictor of cerebrocardiovascular disease (CCVD) clinically, by quantitatively analyzing carotid arterial calcification (CarAC). Materials and Methods: This study included 287 patients aged 40-80 years, who had undergone both polysomnography (PSG) and airway CT between March 2011 and October 2015. The carotid arterial calcium score (CarACS) was quantified using the modified Agatston method on each upper airway CT. The OSA severity was categorized as normal, mild, moderate, and severe using the PSG results. Clinical characteristics, comorbid diseases, and lipid profiles of all patients were analyzed, and the prevalence of CCVDs was investigated during the follow up period (52.2 ± 16.0 months). Results: CCVD occurred in 27 patients (9.3%) at the end of follow-up, and the CCVD-present groups showed a significantly older mean age (57.5 years vs. 54.2 years), higher prevalence of hypertension (59% vs. 34%) and CarAC (51.9% vs. 20.8%), whereas sex, other comorbid diseases, and severity of OSA were not significantly different from the CCVD-absent group. A univariate analysis showed that age, hypertension, incidence of CarAC, and CarACS were risk factors for the occurrence of CCVD events. In a multivariate analysis, the incidence of CarAC was the only independent risk factor for CCVD. Conclusion: CarAC is an independent risk factor for CCVD, whereas the severity of OSA is not a contributory risk factor in patients with OSA. Therefore, additional analysis of CarACS based on airway CT scans may be useful for predicting CCVD.