• Gut and Liver
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• 제12권6호
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• pp.714-721
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• 2018

Background/Aims: Recently reported prognostic models for primary biliary cholangitis (PBC) have been shown to be effective in Western populations but have not been well-validated in Asian patients. This study aimed to compare the performance of prognostic models in Korean patients and to investigate whether inflammation-based scores can further help in prognosis prediction. Methods: This study included 271 consecutive patients diagnosed with PBC in Korea. The following prognostic models were evaluated: the Barcelona model, the Paris-I/II model, the Rotterdam criteria, the GLOBE score and the UK-PBC score. The neutrophil-to-lymphocyte ratio (NLR) was analyzed with reference to its association with prognosis. Results: For predicting liver transplant or death at the 5-year and 10-year follow-up examinations, the UK-PBC score (areas under the receiver operating characteristic curve [AUCs], 0.88 and 0.82) and GLOBE score (AUCs, 0.85 and 0.83) were significantly more accurate in predicting prognosis than the other scoring systems (all p<0.05). There was no significant difference between the performance of the UK-PBC and GLOBE scores. In addition to the prognostic models, a high NLR (>2.46) at baseline was an independent predictor of reduced transplant-free survival in the multivariate analysis (adjusted hazard ratio, 3.74; p<0.01). When the NLR was applied to the prognostic models, it significantly differentiated the prognosis of patients. Conclusions: The UK-PBC and GLOBE scores showed good prognostic performance in Korean patients with PBC. In addition, a high NLR was associated with a poorer prognosis. Including the NLR in prognostic models may further help to stratify patients with PBC.

• 한국산학기술학회논문지
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• 제20권7호
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• pp.158-165
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• 2019

선수능력의 발달 미흡과 신경학적 손상으로 인해 나타나는 쓰기 장애는 의미전달의 혼동을 줄 수 있고 가독성이 떨어지며 학습, 사회정서 문제 유발 가능성이 높다. 이에 문제 파악과 적시 개입을 위한 평가가 요구되고 있지만 임상에서는 수기에 의한 채점 방식을 채택하며 주관적인 평가에 따른 오류 가능성이 발생한다. 본 연구는 성인의 오프라인 필기체 문자를 영상처리를 통해 글자의 크기비율, 위치를 데이터화 하고 정량화 하며 수기 채점방식과의 비교, 분석을 통해 보다 객관적이고 정확하게 쓰기 수행을 평가하고자 하였다. 2018년 11월 12일부터 16일까지 신경학적 손상이 없는 성인 20명을 채택하여 10단어, 2 문장 자극을 평소 쓰기 습관을 유지한 후 연필을 사용해 따라 쓰며 쓰기 검사 데이터를 수집하였다. 본 연구에서 개발한 글씨 측정 알고리즘 결과 단어의 높이가 폭에 비해 1.2배 정도 크고 왼쪽 아래로 치우치는 경향을 보였으며 평균 9mm의 간격을 두고 띄어 썼다. Paired T test를 통한 수기와 본 시스템의 분석결과, 단어 검사와 문장 2의 검사는 고도의 상관관계를 보여 추후 검사 도구로써의 가능성을 보였다. 본 연구는 성인의 오프라인 필기체 문자를 영상처리를 통해 보다 객관적이고 정확하게 쓰기 수행을 평가하였으며 수행 규준을 위한 예비자료를 제공하였다. 향후 다양한 연령대의 쓰기 진단의 기초 자료로 제시될 수 있으며 아동의 경우 쓰기 장애 개입에 깊이 있게 활용될 수 있을 것이다.

• 대한간호학회지
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• 제25권4호
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• pp.653-667
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• 1995

Post - operative wound infections have been a serious problem in nursing care in the operating room and appear to be strongly related to the infection occurring during the performance of operation. The purpose of this study is to identify patterns in duration of surgical hand scrub (SHS), to evaluate the method of SHS and to examine the rate of glove perforation. Subjects for this study include 244 doctors and 169 nurses working in the operative theatre of a hospital in Seoul area. Test samples and related data were collected from this medical facility between April 1, through 15, and July 1, through 5, 1995 by the author and a staff member working in the operating room. For the study, data on the SHS of doctors and nurses were obtained at the time of operation and multiple batches of surgical gloves worn by the operating doctors were collected after each operation. The duration of SHS was measured with a stop watch and the method of SHS was evaluated according to Scoring Hand Scrub Criteria (SHS Criteria) and expressed as SHS scores. For the analysis of the data, t-test was used to compare the differences in the duration and the SHS scores of doctors and nurses, and Pearson's correlation coefficient was used to examine the relationship between the SHS duration and the SHS scores. The results of the study are summarized as follows. 1) The mean time spent in each SHS was 167 seconds in nurses, and 127 seconds in doctors. The data comparing nurses and doctors indicated that there were significant differences in Our ation of SH S between these two groups (t=5.58, p=.000). 2) The mean time spent in the first SHS was 145 seconds and that in the End SHS, 135 seconds, and there was not a significant difference in the duration of the SHS between doctors and nurses (t=1.44, P=.156). 3) The mean time spent in the SHS by OS (Orthopaedic surgery) doctors was 162 seconds, 150 seconds by NS(Neurologic surgery), 121 seconds by GS(General surgery), 94 seconds by OPH(Opthalmology) and DS(Dental surgery), 82 seconds by URO(Urology), 78 seconds by PS(Plastic surgery) and 40 seconds by ENT(Ear, Nose & Throat) These also showed a significant difference in the duration of the SHS among the medical specialities (t=4.8, P=.0001). 4) The average SHS score of the nurses was 15.2, while that of doctors was 13.1. The statistical analysis showed that t-value was 3.66, p was. 000. This indicates that the nurses actually clean their hands more thoroughly than the doctors do. 5) The average SHS score of NS doctors was 15.5, 15.3 for doctors for OPH,14.3 for OS,12.7 for GS, 12.0 for DS, 11.7 for URO, 10.1 for PS, 7.5 for ENT. Comparison of the average SHS scores from 8 specialties showed that there was a significant differences in the patterns of the SHS (F=5.08, P=.000) among medical specialties. 6) It appears that the operating personnel scrub the palms and dorsum of their hand relatively well, however, less thorough the nails and fingers. 7) The more the operating personnel spend their time in hand scrubbing, the more correctly they clean their hands(r=.6427, P<.001). 8) The overall frequencies of perforation in all post-operative gloves tested was 38 out of 389 gloves (10.3%). The perforation rate for PS was 13%, 12.1% for GS,8.8% for 05, and 3.3% for NS.

• 대한영상의학회지
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• 제83권5호
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• pp.1090-1103
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• 2022

목적 본 연구는 미세석회화가 의심되는 유방에서 정위적 조직검사에 앞서서 시행하는 디지털 유방단층영상합성법(digital breast tomosynthesis with the two-dimensional synthesized mammogram; 이하 DBT with 2DSM)과 전면디지털유방촬영술(full-field digital mammography; 이하 FFDM)의 진단능을 비교 평가하고 영상의 진단적 명확도를 평가하기 위해서 시행하였다 대상과 방법 2015년 1월에서 2020년 1월까지 후향적 연구로서 189명의 환자 중 정위적 조직검사를 통한 조직병리검사상 미세석회화 병변이 확인된 환자를 중 DBT with 2DSM나 FFDM을 시행한 환자군에서 시행되었다. 두 명의 영상의학과 의사가 눈가림 상태로, Breast Imaging Reporting and Data System (BI-RADS) 분류에 따른 미세석회화의 평가 및 본 연구에서 별도로 1-5점 척도를 통해 정의한 진단적 명확도에 대한 평가를 시행하였다. 결과 전반적인 검사자간 일치도는 우수한 것으로 확인되었다. 맥네머 검정에서 악성가능성이 높은 미세석회화(4B, 4C, or 5)의 검출에 있어서는 두 진단방법 간에 통계적 유의성은 보이지 않았으나, 양성가능성이 높은 미세석회화(4A)의 진단에 있어서는 통계적 유의성을 보였다. DBT with 2DSM는 FFDM보다 더 높은 가시성을 보임이 확인되었고, 치밀유방에서도 FFDM보다 진단에 있어서 더 우수하였다. 결론 DBT with 2DSM는 FFDM과 비교하여 미세석회화 병변에 대해서 더 높은 전반적 진단적 정확도와 진단적 명확성을 제공하였다. DBT with 2DSM는 FFDM보다 양성 미세석회화 병변에서와 치밀유방에서 우수성을 보였다. 본 연구에서는 치밀 유방에서 미세석회화 병변에 대해서 정위적 생검을 시행할 때 유용한 진단 기구로서의 DBT with 2DSM의 역할을 확인할 수 있었다.