• 보건행정학회지
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• 제33권4호
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• pp.457-478
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• 2023

Background: This study aims to contribute to the adjustment of the appropriate doctor manpower by analyzing the distribution, supply and demand, and estimation of the doctor manpower. Methods: This study utilized the medical personnel data of the Ministry of Health and Welfare, population trend data of the National Statistical Office, and health insurance benefit performance data of the National Health Insurance Service. Based on 2021, we compared the number of doctors in actual supply and the number of doctors in demand according to the amount of medical use by gender and age for 250 regions. Logistic regression analysis and scenario analysis were performed to estimate the future medical workforce by considering the demand for doctors according to the future demographic structure, the size of the quota in medical schools, and the retirement rate. Results: There were 186 regions in which the supply of doctors was below average, and the average ratio of the number of doctors in supply to demand in the region was 62.1%. Conclusion: In order to increase the number of active doctors nationwide to at least 80%, 7,756 people must be allocated. The number of doctors in demand is estimated to decrease after increasing to 1.492 times in 2059. The future projected number of doctors is expected to increase to 1.349 times in 2050 and then decrease taking into account the doctor quota and the retirement rate.

• Korean Journal of Radiology
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• 제24권7호
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• pp.668-680
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• 2023

Objective: To compare multiparametric magnetic resonance imaging (MRI) features of intraductal carcinoma of the prostate (IDC-P) with those of prostatic acinar adenocarcinoma (PAC) and develop prediction models to distinguish IDC-P from PAC and IDC-P with a high proportion (IDC ≥ 10%, hpIDC-P) from IDC-P with a low proportion (IDC < 10%, lpIDC-P) and PAC. Materials and Methods: One hundred and six patients with hpIDC-P, 105 with lpIDC-P and 168 with PAC, who underwent pretreatment multiparametric MRI between January 2015 and December 2020 were included in this study. Imaging parameters, including invasiveness and metastasis, were evaluated and compared between the PAC and IDC-P groups as well as between the hpIDC-P and lpIDC-P subgroups. Nomograms for distinguishing IDC-P from PAC, and hpIDC-P from lpIDC-P and PAC, were made using multivariable logistic regression analysis. The discrimination performance of the models was assessed using the receiver operating characteristic area under the curve (ROC-AUC) in the sample, where the models were derived from without an independent validation sample. Results: The tumor diameter was larger and invasive and metastatic features were more common in the IDC-P than in the PAC group (P < 0.001). The distribution of extraprostatic extension (EPE) and pelvic lymphadenopathy was even greater, and the apparent diffusion coefficient (ADC) ratio was lower in the hpIDC-P than in the lpIDC-P group (P < 0.05). The ROC-AUCs of the stepwise models based solely on imaging features for distinguishing IDC-P from PAC and hpIDC-P from lpIDC-P and PAC were 0.797 (95% confidence interval, 0.750-0.843) and 0.777 (0.727-0.827), respectively. Conclusion: IDC-P was more likely to be larger, more invasive, and more metastatic, with obviously restricted diffusion. EPE, pelvic lymphadenopathy, and a lower ADC ratio were more likely to occur in hpIDC-P, and were also the most useful variables in both nomograms for predicting IDC-P and hpIDC-P.

• Annals of Occupational and Environmental Medicine
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• 제35권
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• pp.53.1-53.15
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• 2023

Background: Plastics are high-molecular-weight materials composed of long carbon chains. They are prevalent in daily life, present in various items such as food containers and microwavable packaging. Phthalates, an additive used to enhance their flexibility, are endocrine-disrupting chemicals. We utilized the data from the Korean National Environmental Health Survey (KoNEHS) cycle 3, representing the general South Korean population, to investigate the relationship between the use of plastics in refrigerator food storage and phthalate exposure. Methods: We assessed 3,333 adult participants (aged ≥ 19 years) including 1,526 men and 1,807 women, using data from KoNEHS cycle 3. Using the 75th percentile concentration, urine phthalate metabolites were categorized into high and low-concentration groups. χ² test was conducted to analyze variations in the distribution of each variable, considering sociodemographic factors, health-related factors, food intake, the use of plastics, and the concentration of urine phthalate metabolites as the variables. To calculate odds ratios (ORs) for the high-concentration group of urine phthalate metabolites based on the use of plastics in refrigerator food storage, logistic regression analysis was conducted. Results: In men, the use of plastics in refrigerator food storage had significantly higher adjusted ORs compared to those using the others. The adjusted ORs were calculated as follows: mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) had an OR of 1.35 (95% confidence interval [CI]: 1.05-1.72), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) had an OR of 1.48 (95% CI: 1.16-1.88), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) had an OR of 1.32 (95% CI: 1.04-1.66), ∑di(2-ethylhexyl) phthalate (∑DEHP) had an OR of 1.37 (95% CI: 1.08-1.74) and mono-n-butyl phthalate (MnBP) had an OR of 1.44 (95% CI: 1.13-1.84). Conclusion: The concentrations of urine phthalate metabolites (MEHHP, MEOHP, MECPP, ∑DEHP, and MnBP) were significantly higher in men who used plastics in refrigerator food storage compared to those using the others.

• Imaging Science in Dentistry
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• 제54권2호
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• pp.121-127
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• 2024

Purpose: Preoperative identification of the intraosseous posterior superior alveolar artery (PSAA) is critical when planning sinus surgery. This study was conducted to determine the distance between the cementoenamel junction and the PSAA, as well as to identify factors influencing the detection of the PSAA on cone-beam computed tomography (CBCT). Materials and Methods: In total, 254 CBCT scans of maxillary sinuses, acquired with 2 different scanners, were examined to identify the PSAA. The distance from the cementoenamel junction (CEJ) to the PSAA was recorded at each maxillary posterior tooth position. Binomial logistic regression and multiple linear regression were employed to evaluate the effects of scanner type, CBCT parameters, sex, and age on PSAA detection and CEJ-PSAA distance, respectively. P-values less than 0.05 were considered to indicate statistical significance. Results: The mean CEJ-PSAA distances at the second molar, first molar, second premolar, and first premolar positions were 17.0±4.0 mm, 21.8±4.1 mm, 19.5±4.7 mm, and 19.9±4.9 mm for scanner 1, respectively, and 17.3±3.5 mm, 16.9±4.3 mm, 18.5±4.1 mm, and 18.4±4.3 mm for scanner 2. No independent variable significantly influenced PSAA detection. However, tooth position (b=-0.67, P<0.05) and scanner type (b=-1.3, P<0.05) were significant predictors of CEJ-PSAA distance. Conclusion: CBCT-based estimates of CEJ-PSAA distance were comparable to those obtained in previous studies involving cadavers, CT, and CBCT. The type of CBCT scanner may slightly influence this measurement. No independent variable significantly impacted PSAA detection.

• Korean Journal of Radiology
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• 제21권8호
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• pp.946-954
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• 2020

Objective: To investigate preoperative magnetic resonance imaging (MRI) findings associated with resection margin status in patients with invasive lobular carcinoma (ILC) who underwent breast-conserving surgery. Materials and Methods: One hundred and one patients with ILC who underwent preoperative MRI were included. MRI (tumor size, multifocality, type of enhancing lesion, distribution of non-mass enhancement [NME], and degree of background parenchymal enhancement) and clinicopathological features (age, pathologic tumor size, presence of ductal carcinoma in situ [DCIS] or lobular carcinoma in situ, presence of lymph node metastases, and estrogen receptor/progesterone receptor/human epidermal growth factor receptor type 2 status) were analyzed. A positive resection margin was defined as the presence of invasive cancer or DCIS at the inked surface. Logistic regression analysis was performed to determine pre- and postoperative variables associated with positive resection margins. Results: Among the 101 patients, 21 (20.8%) showed positive resection margins. In the univariable analysis, NME, multifocality, axillary lymph node metastasis, and pathologic tumor size were associated with positive resection margins. With respect to preoperative MRI findings, multifocality (odds ratio [OR] = 3.977, p = 0.009) and NME (OR = 2.741, p = 0.063) were associated with positive resection margins in the multivariable analysis, although NME showed borderline significance. Conclusion: In patients with ILC, multifocality and the presence of NME on preoperative breast MRI were associated with positive resection margins.

• 한국간담췌외과학회지
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• 제28권1호
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• pp.14-24
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• 2024

This study aims to assess the quality and performance of predictive models for colorectal cancer liver metastasis (CRCLM). A systematic review was performed to identify relevant studies from various databases. Studies that described or validated predictive models for CRCLM were included. The methodological quality of the predictive models was assessed. Model performance was evaluated by the reported area under the receiver operating characteristic curve (AUC). Of the 117 articles screened, seven studies comprising 14 predictive models were included. The distribution of included predictive models was as follows: radiomics (n = 3), logistic regression (n = 3), Cox regression (n = 2), nomogram (n = 3), support vector machine (SVM, n = 2), random forest (n = 2), and convolutional neural network (CNN, n = 2). Age, sex, carcinoembryonic antigen, and tumor staging (T and N stage) were the most frequently used clinicopathological predictors for CRCLM. The mean AUCs ranged from 0.697 to 0.870, with 86% of the models demonstrating clear discriminative ability (AUC > 0.70). A hybrid approach combining clinical and radiomic features with SVM provided the best performance, achieving an AUC of 0.870. The overall risk of bias was identified as high in 71% of the included studies. This review highlights the potential of predictive modeling to accurately predict the occurrence of CRCLM. Integrating clinicopathological and radiomic features with machine learning algorithms demonstrates superior predictive capabilities.

• Tuberculosis and Respiratory Diseases
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• 제87권3호
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• pp.349-356
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• 2024

Background: Acute pulmonary embolism (APE) is a fatal disease with varying clinical characteristics and imaging. The aim of this study was to define the clinical characteristics, risk factors, and outcomes in patients with APE at a university hospital in Thailand. Methods: Patients diagnosed with APE and admitted to our institute between January 1, 2017 and December 31, 2022 were retrospectively enrolled. The clinical characteristics, investigations, and outcomes were recorded. Results: Over the 6-year study period, 369 patients were diagnosed with APE. The mean age was 65 years; 64.2% were female. The most common risk factor for APE was malignancy (46.1%). In-hospital mortality rate was 23.6%. The computed tomography pulmonary artery revealed the most proximal clots largely in segmental pulmonary artery (39.0%), followed by main pulmonary artery (36.3%). This distribution was consistent between survivors and non-survivors. Multivariate logistic regression analysis revealed that APE mortality was associated with active malignancy, higher serum creatinine, lower body mass index (BMI), and tachycardia with adjusted odds ratio (95% confidence interval [CI]) of 3.70 (1.59 to 8.58), 3.54 (1.35 to 9.25), 2.91 (1.26 to 6.75), and 2.54 (1.14 to 5.64), respectively. The prediction model was constructed with area under the curve of 0.77 (95% CI, 0.70 to 0.84). Conclusion: The overall mortality rate among APE patients was 23.6%, with APE-related death accounting for 5.1%. APE mortality was associated with active malignancy, higher serum creatinine, lower BMI, and tachycardia.

• 생물환경조절학회지
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• 제26권1호
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• pp.13-18
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• 2017

본 연구는 난지형 마늘 '남도'의 적정 생육 온도 구명과 일 평균온도를 이용한 구중 예측을 위하여 수행되었다. 온도처리는 주간 16시간 야간 8시간 처리로 $11/7^{\circ}C$, $14/10^{\circ}C$, $17/12^{\circ}C$, $20/15^{\circ}C$, $23/18^{\circ}C$, $28/23^{\circ}C$ 로 설정하였다. 구의 생체중과 건물중은 $20/15^{\circ}C$ 처리구에서 가장 높았으며 고온이나 저온으로 갈수록 감소하였다. 엽수와 총엽면적은 저온인 처리구가 고온처리구보다 생장이 느렸으나, 최종적으로는 최고온도인 $28/23^{\circ}C$을 제외하고 유사한 경향을 보였다. 구의 생체중으로 6종의 함수를 개발하였으며 이를 통해 '남도' 마늘의 적정 생육온도와 한계온도, 온도에 따른 구생장량을 확인할 수 있었다. 분석 결과 '남도' 마늘의 적정 생육온도는 $18{\sim}20^{\circ}C$이며 GDD 기본온도와 한계온도는 $7.1^{\circ}C$와 $31.7^{\circ}C$로 추정할 수 있었다. 일 평균온도를 이용한 수확기 기준 구생체중 모델을 검증하기 위하여 온도구배터널의 기상자료를 이용하여 예측하였다. 선형함수를 이용한 예측은 79.0~95.0%, 2차 함수를 이용한 예측은 77.2~92.3%, 로지스틱분포 함수를 이용한 예측은 80.0~95.8% 예측도를 보였다. 이중 가장 예측력이 좋은 함수는 로지스틱분포함수이며 생육적정온도와 한계온도도 잘 표현하였다.

• 한국건설관리학회논문집
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• 제15권5호
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• pp.31-39
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• 2014

현대사회에서 자동차는 통근 통학뿐만 아니라 여가 및 편의생활을 위한 매우 중요한 이동수단으로 자리매김한지 오래다. 특히 대표적인 개인 이동수단인 승용차는 개인소득 증대와 개인의 여가시간과 편의 중시하는 라이프 스타일 변화로 인해 1970년대 이후 꾸준히 증가하였다. 1970년 우리나라 인구 천명당 1.9대에 불과했던 승용차는 2012년 기준 291.5대로 42년만에 153배가 증가한 매우 가파른 증가속도로 보유대수를 늘려왔다. 이러한 승용차 보유대수의 예측은 향후 자동차 관련 산업이나 도로건설 및 시설물 설치 등을 위한 계획, 시공, 관리 등에서도 중요한 기초자료가 될 수 있다. 따라서 본 연구에서는 성장곡선모형을 이용한 승용차 보유대수 예측을 실시하였으며, 특히 인구 고령화 변수를 포함시켜 보유율에 어떤 영향을 미치는지 분석하였다. 분석결과, 2020년대 초에 1차 포화점을 지나 2045년에는 인구 천명당 486.8대를 보유할 것이며, 또한 인구 고령화의 영향으로 고령화 문제가 없을 때에 비해 2045년의 보유대수는 10%가까이 낮은 수치를 가질 것으로 예측되었다.

• 유통과학연구
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• 제12권4호
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• pp.31-39
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• 2014

Purpose - This study investigates the following two issues. First, we attempt to find the important determinants of housing investment and to identify their significance rank using survey panel data. Recently, the expansion of global uncertainty in the real estate market has directly and indirectly influenced the Korean housing market; households demonstrate a sensitive reaction to changes in that market. Therefore, this study aims to draw conclusions from understanding how the impact of financial strength of the household is related to house investment. Second, we attempt to verify the effectiveness of diverse indices of financial strength such as DTI, LTV, and PIR as measures to monitor the housing market. In the continuous housing market recession after the global crisis, the government places top priority on residence stability. However, the government still imposes forceful restraints on indices of financial strength. We believe this study verifies the utility of these regulations when used in the housing market. Research design, data, and methodology - The data source for this study is the "National Survey of Tax and Benefit" from 2007 (1st) to 2011 (5th) by the Korea Institute of Public Finance. Based on this survey data, we use panel data of 3,838 households that have been surveyed continuously for 5 years. We sort the base variables according to relevance of house investment criteria using the decision tree model (DTM), which is the standard decision-making model for data-mining techniques. The DTM method is known as a powerful methodology to identify contributory variables for predictive power. In addition, we analyze how important explanatory variables and the financial strength index of households affect housing investment with the binary logistic multi-regressive model. Based on the analyses, we conclude that the financial strength index has a significant role in house investment demand. Results - The results of this research are as follows: 1) The determinants of housing investment are age, consumption expenditures, income, total assets, rent deposit, housing price, habits satisfaction, housing scale, number of household members, and debt related to housing. 2) The impact power of these determinants has changed more or less annually due to economic situations and housing market conditions. The level of consumption expenditure and income are the main determinants before 2009; however, the determinants of housing investment changed to indices of the financial strength of households, i.e., DTI, LTV, and PIR, after 2009. 3) Most of all, since 2009, housing loans has been a more important variable than the level of consumption in making housing market decisions. Conclusions - The results of this research show that sound financing of households has a stronger effect on housing investment than reduced consumption expenditures. At the same time, the key indices that must be monitored by the government under economic emergency conditions differ from those requiring monitoring under normal market conditions; therefore, political indices to encourage and promote the housing market must be divided based on market conditions.