• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.723-729
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• 2017

Objective : Acute subdural hematoma (ASDH) is generally considered a condition that should be managed surgically. However, some patients initially receive conservative treatment, a subset of whom require surgical intervention later. This study aimed to evaluate the predictors of delayed surgical intervention in ASDH patients who are initially managed conservatively. Methods : From January 2007 to December 2015, 842 patients diagnosed with ASDH were treated at our institution. Among them, 158 patients with convexity ASDH were initially treated conservatively. Patients were divided into a delayed surgery group and a conservative group. Demographic characteristics, past medication and medical histories, and radiological and laboratory data were collected by retrospective chart review. Independent risk factors were identified with univariate and multivariate analyses. Results : Twenty-eight patients (17.7%) underwent delayed surgical intervention. Their mean age was 69.0 years, and 82.1% were male. Hypertension, diabetes mellitus, and heart disease prevalence and use of anti-platelet agents did not significantly differ from the conservative group. However, age (p=0.024), previous cerebral infarction history (p=0.026), increased maximal hematoma thickness (p<0.001), midline shifting (p=0.001) and accompanying subarachnoid hemorrhage (p=0.022) on initial brain computed tomography (CT) scan, low hemoglobin level (p<0.001), high leukocyte count (p=0.004), and low glucose level (p=0.002) were significantly associated with delayed surgical intervention. In multivariate analysis, increased maximal hematoma thickness (odds ratio [OR]=1.279, 95% confidence interval [CI] 1.075-1.521; p=0.006), low hemoglobin level (OR=0.673, 95% CI 0.467-0.970; p=0.034), and high leukocyte count (OR=1.142, 95% CI 1.024-1.272; p=0.017) were independent risk factors for delayed surgical intervention. Conclusion : Due to the high likelihood of delayed surgical intervention among minimal ASDH patients with a thicker hematoma on initial brain CT, lower hemoglobin level, and higher leukocyte count, these patients should receive more careful observation.

• 대한지역사회영양학회지
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• 제7권6호
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• pp.762-768
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• 2002

This study was conducted to evaluate the health status of elderly women who attended in a Health Promotion Program of the Seo-gu Health Center in Daegu. The study subjects were 158 elderly women (over 65 years) in an urban community. The subjects were investigated by means of individual interviews using a questionnaire, Blood tests for analyzing their biochemical status were carried out. The average age of the study subjects was 70.9 $\pm$ 2.3 years. Of the subject group 79.1% ranged in age from 65 to 74 year and 20.9% were over 75 years. With respect to health related factors, 23.4% of subjects drank alcoholic beverages and 15.2% of subjects currently smoke.The prevalence with chronic diseases was 51.9%, and 26.6% of the subjects were healthy. The diseases most frequently reported as having been or being treated were arthritis (38.1%), hypertension (21.4%), and diabetes (17.9%). The average height of subjects was below the standard established in the Korean Recommended Dietary Allowances, while the average weight was close to the standard. The means of systolic and diastolic blood pressure were 130.2 mmHg and 71.9 mmHg, respectively. The mean serum albumin level was 4.5 mg/d$\ell$ and the value of hemoglobin and hematocrit was 12.5 mg/d$\ell$ and 0.7%, respectively. The mean serum cholesterol level was 207.1 mg/d$\ell$ and the mean triglyceride level was 187.7 mg/d$\ell$. The serum lipid levels were higher then in those reported in research. The serum cholesterol levels of 71.5% of subjects were within the normal range. The GOT and GTP levels were within the moderate range. In conclusion, the health status of the elderly who attended the Health Promotion Program in the Seo-gu Health Center were very average. However, it was necessary to prepare a health management program to deal with the serum lipids so as to establish and maintain good health. When we carry out the health promotion program in a community, individual program Of adequate to health status should be developed more.

• 한국산업보건학회지
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• 제26권1호
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• pp.64-74
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• 2016

Objectives: The purpose of this study was to investigate whether chemical exposure among workers has relevance to dyspnea using data from the $3^{rd}$ Korea Working Conditions Survey. Methods: The research subjects were 29,711 wage workers. Chemical exposures consist of four factors, (1) breathing in vapors, fumes, dust and dirt, (2) breathing in organic solvent vapors, (3) handling or touching chemicals, and (4) secondhand smoke. Multiple logistic regression analysis was performed to examine the association between chemical exposure and dyspnea in the last 12months using proc surveylogistic in SAS 9.3 statistical software excluding people who had received a diagnosis of hypertension or obesity that can affect the respiratory distress symptoms(n=27,842). Results: Chemical exposure among workers was associated with dyspnea after adjustment for demographics and job characteristics. Prevalence of dyspnea was 4.9 per 1,000 among men and 5.8 per 1,000. Compared to a total score of 0 points of chemical exposure among workers, a total score of 1, 2-3, and 4 points tended to have increased risk of dyspnea in a dose-response manner for both men (OR=1.43, 1.93, and 4.26; P-for trend=0.002) and women(OR=1.10, 2.81, and 7.70; P-for trend=0.002). Stratified analysis by duration of current job showed that the association between chemical exposure and dyspnea tended to get stronger until 15 years and then disappeared afterwards, which reflects healthy worker survivor effect. Conclusions: We observed significant association between chemical exposure and dyspnea using the data of the $3^{rd}$ Korea Working Conditions Survey. Our results warrants providing knowledge related to chemical exposure, performing prevention activities, and creating various health policies to protect workers.

• 대한간호학회지
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• 제24권3호
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• pp.484-498
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• 1994

The purpose of this study was to investigate the home care needs in a rural county as a basic study to develop a Korean home care model. A stratified cluster sampling method was used to select 1, 352 household which accounted for 8.8% of Youn Cheon County population. A Standard criterias for home care subject were delineated by five nursing professors representing five different areas of nursing specialty. The developed criteria for home care subjects were as below, 1) Patients who had been discharged from hospital during the previous week. 2) Patients with special medical devices 3) Newborns and the mothers. 4) The chronically ill with poor recovery or control of disease. 5) Subjects with poor health care behavior or ability 6) Subjects with poor social support and / or family resources. 7) Subjects with health related educational needs. Three types of questionnaires were developed to screen home care subjects, one for adults, one for infants and one for the elderly. Also different questionnaire items were developed to evaluate the control and self care ability of chronically ill subjects. After training in interview methods for 2 days, 39 interviewers visited individual households for interviews. As the results of the study showed that 14.1％ of adult subjects and 76.5% of infants and child were judged as having at least one criterion related to home care need, 15.69% of adults and 53% of elderly had at least one chronic illness. The most prevalent chronic illnesses were hypertension, skeletal-neurological disease and diabetes. The prevalence of subjects with home care needs were, those with poor health care behavior(8.89%), with health-re-lated educational needs(8.71%), with poor recovery or control of disease (3.52%), and with poor social support and inadequate family resources(3.19%). There were only 0.3%, 0.37%, 0.11% who were discharged patients, patients with medical devices, or newborns respectively. Thus, the largest home care client group were those who need direct health care and health education. Seventy five percent of the subjects responded that they were willing to use and pay for home care service if it is offered in the future. It is suggested that recently discharged patients and patients with special medical devices can be cared for by hospital based home care nurses, but other home care clients can be cared for by com-munity based home care nurses.

• 한국콘텐츠학회논문지
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• 제10권12호
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• pp.190-204
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• 2010

본 연구는 우리나라의 민간의료보험 가입자의 인구 사회 경제학적 특성과 가입자와 미가입자간의 질병 유형, 예방 및 건강행태, 의료이용 양상 등을 비교하였다. 그리고 민간보험 가입의 영향을 파악하여 향후 국민건강보험 및 민간의료보험 관련제도의 바람직한 발전방향을 제시하기 위한 기초자료 활용에 그 목적이 있다. 연구의 결과는 민간의료보험 가입 요인은 인구 사회 경제적 요인이 유의하게 나타났으며, 국민건강 영양조사에서 이루어진 인플루엔자 예방접종율과 건강보험 건강검진은 민간의료보험 가입자에게서 더 낮았고, 지난 2년간 본인부담 건강검진비율과 지난 2년간 암검진비율은 민간의료보험 가입자의 검진율이 더 높았다. 그리고 건강행위 평균을 민간의료보험 가입여부별로 보면, 격렬한 신체활동을 실천하는 비율은 민간의료보험 가입자가 더 높았고, 평균 수면시간, 1주일간 격렬한 신체활동을 하는 일수, 1주일간 중등도 신체활동을 하는 일수, 1주일간 유연성 운동일수 및 1주일간 근력운동일수에서도 민간의료보험 가입자가 미가입자 보다 많았다. 걷기를 실천하는 비율과 1주일간 걷기일수는 민간의료보험 가입자가 미가입자보다 적었다. 의료이용에 민간의료보험이 어떤 영향을 미치고 있는가를 살펴본 결과에서는 외래이용이 있는 경우와 입원이용횟수에서 민간의료보험가입자가 미가입자보다 외래를 이용할 확률이 높았고, 더 많은 횟수의 입원이 관련 요인으로 나타났다.

• 생명과학회지
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• 제17권12호
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• pp.1744-1753
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• 2007

비만 여중생을 대상으로 하여 12주간 행동수정 프로그램을 포함한 걷기운동을 실시한 결과 비만 여중생의 체조성, 체력, 대사증후군의 유병률 및 대사증후군 위험인자에서 긍정적인 변화를 가져오는 것을 확인하였다. 또한 다중선형회 귀분석 결과 체조성의 상완위팔근육둘레, 허리둘레, 신체발달지수, 체수분, 체지방량의 개선과 체력의 50m달리기 향상이 BMI, WHR, HDL-C, 공복혈당, 수축기혈압, HOMA지수를 개선시킬 수 있는 것으로 나타나 유산소성 걷기운동과 행동수정 프로그램에 의한 식사량조절과 식습관 변화가 비만청소년에 있어서 대사증후군에 의한 심혈관질환과 당뇨병, 심리적 우울증에 효과적인 프로그램이 될 수 있다고 생각된다. 그러나 피험자 수가 적고, 실험기간이 짧아 실험결과를 일반화하기에는 주의가 필요하며, 실험이후에 학생들의 지속적 운동 습관을 유지하기 위한 프로그램의 개발이 필요하다고 생각된다.

• 한국노년학
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• 제29권4호
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• pp.1313-1325
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• 2009

본 연구는 지역사회 거주 저소득계층 노인의 우울 수준을 파악하고 우울의 영향요인을 규명하기 위한 서술적 조사연구이다. 본 연구는 수도권 A 지역 65세 이상의 남녀 재가 저소득계층 노인 306명을 대상으로 2007년 1월부터 9월까지 시행되었다. 측정변수는 생활만족도, 일상생활수행능력, 인지기능, 지각된 건강상태, 건강행위, 건강문제와 우울이었다. 자료분석은 기술통계, t-test, ANOVA, Pearson's correlation coefficient와 다중회귀 분석을 이용하여 분석하였다. 연구결과는 다음과 같다. 첫째, 본 연구대상자의 우울점수는 6.37점으로 8점을 기준으로 우울군은 43.8%이었다. 둘째, 대상자의 학력수준, 건강보험 유형 및 경제수준에 따른 우울 점수 차이는 통계적으로 유의하였다. 셋째, 대상자의 건강행위 및 건강상태에 따른 우울 점수를 비교한 결과에서는 흡연 유무, 고혈압, 관절염 및 요실금 유무가 유의한 변수로 나타났다. 넷째, 생활만족도, 지각된 건강상태, 및 인지기능은 우울과 유의한 음의 상관관계를 보였다. 다섯째, 선형회귀분석을 실시한 결과, 생활만족도, 인지기능, 건강보험유형이 유의한 설명변수로 나타났으며, 모형의 설명력은 67.6%이었다. 이러한 영향요인에 대한 연구결과를 기반으로 노인 우울이 발생할 수 있는 고위험군을 파악하며, 체계적이고 효과적인 중재방안이 모색되어야 할 것이다.

• Clinical and Experimental Pediatrics
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• 제45권9호
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• pp.1083-1089
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• 2002

목 적 : 지속적으로 증가하는 소아 비만은 성인 비만으로 이행되기 쉽고 합병증으로 고혈압, 지방간, 동맥경화증이 동반될 수 있다. Carnitine은 장쇄 지방산이 미토콘드리아로 이동할 때 필요한 조효소로 지방산 대사에서 중요한 역할을 한다. 지방간을 가진 비만 소아에서 혈중 지방산과 carnitine 농도를 측정함으로써 L-carnitine을 임상적으로 비만 치료에 적용할 수 있는지를 알아보고자 본 연구를 실시하였다. 방 법 : 7-18세의 지방간으로 진단받은 비만아 9명과 정상 대조군 소아 10명을 대상으로 하였다. 혈장을 sodium borate를 섞어 원심분리 후 하층을 methylene chloride를 이용하여 계층 분리하였고, MSTFA와 acetonitrile을 넣고 유도체화 반응을 시켰다. GC-MS 자동 분석기로 혈청 지방산 fraction을 정량 분석하였고, carnitine(free, acyl, total)은 cycling technique을 이용하여 415 nm에서 정량 분석하였다. 결 과 : 혈중 총 지방산은 지방간이 동반된 비만아 군에서 대조군에 비해 유의하게 증가하였고 특히 장쇄 지방산(myristic acid, palmitoleic acid, palmitic acid, linoleic acid, oleic acid, stearic acid)이 의미 있게 증가되어 있었다. 총 carnitine과 유리 carnitine 농도가 비만아에서 정상아에 비해 유의하게 증가하였으나 acyl carnitine은 유의한 차이가 없었다. 결 론 : 지방간이 동반된 비만아에서 장쇄 지방산이 뚜렷이 증가되었으며, 비만아군에서 정상아에 비해 혈청 carnitine이 증가되어 있음을 알 수 있었다. 이것을 기초로 하여 비만아에서 L-carnitine 투여 후 지방산 대사의 변화에 대해 추후에 연구할 예정이다.

• 한국콘텐츠학회논문지
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• 제22권3호
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• pp.354-360
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• 2022

대사성 질환은 국내의 경우 유병률이 26%에 이르는 질환으로 복부비만, 고혈압, 공복혈당장애, 고중성지방, 낮은 HDL 콜레스테롤 5가지 상태 중 3가지를 동시에 가진 상태를 말한다. 본 논문은 농촌진흥청의 소비자패널 데이터와 건강보험공단의 진료 데이터를 연계하여 식품 소비 특성을 통해 대사성 질환자군과 대조군으로 나누는 분류 모델을 생성하고 차이를 비교하고자 한다. 기존의 국내외에서 연구된 많은 대사성 질환과 식품 소비 특성 관련 연구는 특정 식품군이나 특정 성분의 질환 상관성 연구이며, 본 논문은 일반 식사에서 포함하는 모든 식품군을 고려한 로지스틱 회귀를 이용한 분류 모델, 의사결정나무 기반 분류 모델, XGBoost를 활용한 분류 모델을 생성하였다. 세 가지 모델 중 정확도가 높은 모델은 XGBoost 분류 모델이지만, 정확도가 0.7 미만으로 높지 않았다. 향후 연구로 환자군의 식품 소비 관찰 기간을 5년 이상으로 확대하고 섭취한 식품을 영양적 특성으로 변환한 후 대사성 질환 분류 모델 연구가 필요하다.

• Journal of Nutrition and Health
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• 제39권7호
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• pp.624-640
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• 2006

Dialysis patients are at risk of malnutrition not only because of losses of nutrients during peritoneal dialysis but also because of anorexia that results in inadequate nutrient intakes. The aim of this study was to estimate the nutritional status of 154 patients receiving continuous ambulatory peritoneal dialysis (CAPD), especially focused on protein-energy malnutrition and vitamin and mineral status. The mean age of the subjects was $5.12\;{\pm}\;12.4\;y$ with educational years of $12.3\;{\pm}\;0.4\;y$ for male and $9.6\;{\pm}\;0.4\;y$ for female. The mean duration of dialysis was $22.7\;{\pm}\;21.7\;mo$. The causes of renal failure included diabetes (32.7), chronic glomerulonephritis (15.0%), and hypertension (8.5%). The main complications associated with chronic renal failure were hypertension (86.1%), diabetes (35.4%) and liver disease (9.0%). The mean daily energy intake was $1216.8\;{\pm}\;457.3\;kcal$ and increased to $1509.2\;{\pm}\;457.2\;kcal$ when added with the energy from dextrose in dialysate. The latter was still much lower than estimated energy requirement but energy intake per kg of body weight (28.1 kcal/1 g) was within the range of that recommended for CAPD patients' diet therapy (25 - 30 kcal/kg). The average daily intake of protein was $49.2\;{\pm}\;25.1\;g$ with 37.6% of the patients showing their intakes less than Estimated Average Requirement. The average protein intake per kg of weight was 0.9 g/kg, which is less than that recommended for CAPD patients (1.2-1.5g/kg) with mean serum albumin level $3.2\;{\pm}\;0.5\;g/dl$. The proportion of the patients with dietary calcium intake less than EAR was 90.9%, but when added with supplementary calcium (phosphorus binder), most patients showed their total calcium intake between EAR and UL. Fifty percent of the patients were observed with dietary iron intake less than EAR, however most patients revealed their total iron intake with supplementation above UL. The addition of folic acid with supplementation increased mean total folic intake to $1126.0\;{\pm}\;152.4\;{\mu}g$ and ninety eight percent of the subjects showed their total folic acid intake above UL. The prevalence of anemia was 83.1 % assessed with hemoglobin level, even with high intakes of iron with supplementation. Thirty four percent of the patients showed their fasting blood glucose was not under control $(\geq\;126\;mg/dl)$ even with medication or insulin probably due to dextrose from dialysate. The mean blood lipid levels were within the reference levels of hyperlipidemia, but with 72.1 % of the patients showing lower HDL-C. In conclusion, Fairly large proportion of the patients were observed with protein malnutrition with low intake of protein and serum albumin level. Few patients showed their vitamins and minerals intake less than EAR with supplementation. For iron and folic acid, their intakes were increased to above UL for large proportion of he patients. However, more than eighty percent of the patients were still anemic associated with decreased renal function. The serum blood glucose and lipid level were not under control for some patients with medication. It seems that supplementation and medications that patients are taking should be considered for dietary consulting of CAPD patients.