• 대한치매학회지
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• 제17권4호
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• pp.156-162
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• 2018

Background and Purpose: Previous studies have reported conflicting results about the prevalence of seizures in Alzheimer's disease (AD). There are few epidemiological studies on this topic in Asia. Thus, the objective of this study was to examine demographic and clinical characteristics as well as incidence for seizures in AD patients compared to non-AD patients in a prospective, longitudinal, community-based cohort with a long follow-up. Methods: Data were collected from National Health Insurance Service-National Elderly Cohort (NHIS-elderly) Database to define patients with AD from 2004-2006 using Korean Classification Diseases codes G30 and F00. We performed a 1:5 case-control propensity score matching based on age, sex, and household income. We conducted Cox proportional hazards regression analysis to estimate the risk of epilepsy in AD patients. Results: In the cohort study, patients with AD had higher risk for epilepsy than those without AD, with hazard ratio of 2.773 (95% confidence interval [CI], 2.515-3.057). This study also showed that male gender and comorbidities such as hypertension, hyperlipidemia, diabetes, and chronic kidney disease increased the risk of developing epilepsy. Patients with AD had 1.527 (95% CI, 1.375-1.695) times higher mortality rate than those in the control group. Conclusions: AD patients have significantly higher risk of developing epilepsy than non-AD patients.

• Journal of Chest Surgery
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• 제55권1호
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• pp.30-36
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• 2022

Background: No consensus exists regarding whether volatile anesthetics are superior to intravenous anesthetics for reducing postoperative pulmonary complications (PPCs) in patients undergoing general anesthesia for surgery. Studies of this issue focused on anatomic pulmonary resection are lacking. This study compared the effects of total intravenous anesthesia (TIVA) versus volatile anesthesia on PPCs after anatomic pulmonary resection in patients with lung cancer. Methods: This retrospective study examined the medical records of patients with lung cancer who underwent lung resection at our center between January 2018 and October 2020. The primary outcome was the incidence of PPCs, which included prolonged air leak, pneumonia, acute respiratory distress syndrome, empyema, atelectasis requiring bronchofiberscopy (BFS), acute lung injury (ALI), bronchopleural fistula (BPF), pulmonary embolism, and pulmonary edema. Propensity score matching (PSM) was used to balance the 2 groups. In total, 579 anatomic pulmonary resection cases were included in the final analysis. Results: The analysis showed no statistically significant difference between the volatile anesthesia and TIVA groups in terms of PPCs, except for prolonged air leak. Neither of the groups showed atelectasis requiring BFS, ALI, BPF, pulmonary embolism, or pulmonary edema after PSM. However, the length of hospitalization, intensive care unit stay, and duration of chest tube indwelling were shorter in the TIVA group. Conclusion: Volatile anesthetics showed no superiority compared to TIVA in terms of PPCs after anatomical pulmonary resection in patients with lung cancer. Considering the advantages of each anesthetic modality, appropriate anesthetic modalities should be used in patients with different risk factors and situations.

• Journal of Gastric Cancer
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• 제24권2호
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• pp.199-209
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• 2024

Purpose: Long-term outcomes of patients with positive lateral margins (pLMs) after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). This study aimed to evaluate the remnant cancer and survival rates of patients with pLMs compared with those who underwent curative resection. Materials and Methods: A retrospective analysis was performed on consecutive patients with pLMs as the only non-curative factor of expanded indication who underwent ESD for EGC with a follow-up duration of 5 years or more. The rates of remnant cancer, recurrence, and survival were analyzed and compared to those of control patients who underwent curative resection by propensity score matching. Results: Among 3,515 patients treated with ESD between 2005 and 2018, 123 non-curative EGCs were retrospectively analyzed. A total of 108 patients were followed up without endoscopic or surgical resection for 8.2 years. The control group was matched in a 1:1 ratio with patients with EGC who underwent curative resection after ESD. The observation group with pLMs had a higher incidence of remnant cancer (25.9%; 28/108) compared to that in the curative resection group (0/108; P=0.000). The remaining tumors were treated with surgical or endoscopic resection, and no additional recurrences were observed. The overall survival analysis demonstrated no significant difference between the observation and curative resection groups (P=0.577). Conclusions: No difference was observed in the overall survival rate between observation and curative resection groups. Therefore, observation may be a possible option for incomplete ESD with pLMs if continuous follow-up is performed.

• 보건행정학회지
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• 제34권1호
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• pp.87-93
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• 2024

연구배경: 최근 건강기능식품 섭취에 따른 의료비 절감효과에 대해 상이한 연구결과들이 제시되면서 논쟁이 불거졌다. 이에 따라 본 연구는 건강기능식품 섭취 여부가 의료비 지출에 미친 영향을 분석하고자 한다. 방법: 2019-2020년의 제2기 한국의료패널 자료에서 2년간 건강기능식품을 섭취한 군과 섭취하지 않은 군을 확인하고 이들의 일반적 특성 차이를 배제하고자 성향점수매칭기법을 통해 1:1 매칭 데이터를 추출하였으며 두 군의 연간 총 의료비를 비교하였다. 더불어 의료비 지출에 대한 건강기능식품 섭취 여부의 영향을 확인하기 위해 다변량 회귀분석(Proc Surveyreg)을 실시하였다. 결과: 건강기능식품 섭취군은 약 172만 원을, 미섭취군은 약 143만 원을 의료비로 지출하였다(p=0.0186). 다변량 회귀분석 결과, 섭취군이 미섭취군에 비해 약 26.15% 더 많은 의료비를 지출하는 것으로 확인되었다(p=0.0004). 결론: 건강기능식품 섭취가 의료비를 절감시킨다는 이전 연구들과 달리, 본 연구에서는 건강기능식품을 지속적으로 섭취하는 사람들이 의료서비스 지출이 더 큰 것으로 나타났다. 이는 건강기능식품 섭취가 질병 예방이나 의료비 절감의 관점보다는 건강에 관심 있는 사람들이 건강관리를 위해 취하는 행동임을 제시한 이전 연구들과 같은 맥락으로 해석될 수 있다. 그러나 의료패널 자료의 다양한 한계점으로 인해 주의 깊은 해석이 필요하다. 향후 개인수준의 코호트 자료를 활용한 인과성 규명이 필요하다.

• 정보보호학회논문지
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• 제26권2호
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• pp.523-531
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• 2016

본 연구에서는 갈수록 심각해지는 개인정보 유 노출 문제에 대해 기업 및 개인의 개인정보와 관련한 행동 및 그 결과를 기존의 연구에 비해 보다 충실하고 풍부하며 이질적인 데이터를 이용하여 실증적으로 살펴봄으로써 개인정보 문제를 좀 더 미시적인 차원에서 이해하고 이를 기초로 해결책을 논의하는 시도를 하였다. 선택편이(selection bias)의 문제를 해결할 수 있는 성향점수 매칭(PSM) 방법을 통한 실증분석의 결과, 우리의 직관과는 달리 기업이 기술적 대책을 적극적으로 수립하고 정보보호를 위한 투자를 많이 할수록 오히려 개인정보 침해사고를 경험할 가능성이 높아지며, 개인들 역시 바이러스 검사를 더 자주할수록 침해사고를 경험할 가능성이 높아지는 것으로 나타났다. 또한 개인정보 침해를 경험한 기업이 개인정보보호 투자를 늘리는 경향이 있으며, 개인정보 침해를 경험한 사람들이 바이러스 검사를 더 적극적으로 할 가능성이 높아지는 역의 인과관계(reverse causality)의 결과가 도출되었다. 이러한 결과를 바탕으로 개인정보보호 대책에 대한 시사점을 논의하였다.

• 치위생과학회지
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• 제20권2호
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• pp.89-96
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• 2020

Background: Multicultural families are constantly on the rise as marriage migrants and foreign workers increase. Multicultural families appear to record poor health levels compared to native families. As health is a social issue, children of surviving generations of multicultural families are also a growing interest. This study was conducted to confirm the effect of multicultural families and parents' educational level on the scaling experience of children. Methods: For this study, the 2016~2018 Korea Youth Risk Behavior Web-based Survey data were used. In order to make the two groups of adolescents belonging to multicultural and native families similar, a total of 5,362 people were included in the survey, consisting of 2,681 individuals each from multicultural and native families using the propensity score matching method. Logistic analysis was performed to identify factors influencing the scaling experience of adolescent children. Results: The results confirm that, even after controlling for factors such as parents' educational level, household income, and children's oral health behavior, parents' nationality appeared to have a statistically significant effect on their children's scaling experience. In addition, it was confirmed that the experience of oral health education had a significant effect. Conclusion: Cultural heterogeneity and the lack of adequate language ability of immigrants affects health behavior and medical accessibility. Therefore, children from multicultural families are more likely to be exposed to unhealthy environments compared to the children of native Korean families. Based on an understanding of the socioeconomic multicultural background of individuals, education and public policy should be prepared to improve the awareness for the need for preventive oral health and provide unhindered accessibility to dental services.

• 기술혁신학회지
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• 제21권2호
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• pp.738-766
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• 2018

본 논문의 목적은 정부에서 지원하는 자동화, 스마트 공장 구축 지원사업이 기업의 경영성과에 미치는 효과를 분석하는 것이다. 이를 위해서 t-test 및 ANOVA 등의 방법을 이용하였다 지원기업과 비지원 기업간 비교시 발생하는 실험집단과 통제집단간의 선택편의 문제를 해결하기 위해 PSM 방법을 활용하였다. 분석결과, 자동화 지원사업의 효과는 미미한 것으로 나타났으나 스마트 지원사업의 경우 일정 시차가 지난 후 매출액과 연구개발비가 증가하는 것을 확인할 수 있었다. 정부지원 효과가 나타나는데 어느 정도 시차가 발생하는 것으로 확인되었고 자동화 지원사업의 경우는 직접적인 영향을 주기 보다는 연구개발 비율 등과 같은 매개변수의 증대를 통해 장기적 매출 증대로 이어지는 것을 확인할 수 있었다. 본 연구는 정부 지원사업의 신규예산 확보와 개선방안을 모색하는데 유용한 기초자료로 활용될 것이다.

• Journal of Chest Surgery
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• 제49권5호
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• pp.366-373
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• 2016

Background: The aim of the study was to test the hypothesis that in patients with chronic complex sternum dehiscence, the use of muscle flap repair minimizes the occurrence of paradoxical motion of the chest wall (CWPM) when compared to sternal rewiring, eventually leading to better respiratory function and clinical outcomes during follow-up. Methods: In a propensity score matching analysis, out of 94 patients who underwent sternal reconstruction, 20 patients were selected: 10 patients underwent sternal reconstruction with bilateral pectoralis muscle flaps (group 1) and 10 underwent sternal rewiring (group 2). Eligibility criteria included the presence of hemisternum diastases associated with multiple (${\geq}$3) bone fractures and radiologic evidence of synchronous chest wall motion (CWSM). We compared radiologically assessed (volumetric computed tomography) ventilatory mechanic indices such as single lung and global vital capacity (VC), diaphragm excursion, synchronous and paradoxical chest wall motion. Results: Follow-up was 100% complete (mean $85{\pm}24months$). CWPM was inversely correlated with single lung VC (Spearman R=-0.72, p=0.0003), global VC (R=-0.51, p=0.02) and diaphragm excursion (R=-0.80, p=0.0003), whereas it proved directly correlated with dyspnea grade (Spearman R=0.51, p=0.02) and pain (R=0.59, p=0.005). Mean CWPM and single lung VC were both better in group 1, whereas there was no difference in CWSM, diaphragm excursion and global VC. Conclusion: Our study suggests that in patients with complex chronic sternal dehiscence, pectoralis muscle flap reconstruction guarantees lower CWPM and greater single-lung VC when compared with sternal rewiring and it is associated with better clinical outcomes with less pain and dyspnea.

• Journal of Korean Medical Science
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• 제33권43호
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• pp.268.1-268.11
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• 2018

Background: We aimed to compare the therapeutic efficacy of prolonged macrolide (PMC), corticosteroids (CST), doxycycline (DXC), and levofloxacin (LFX) against macrolide-unresponsive Mycoplasma pneumoniae (MP) pneumonia in children and to evaluate the safety of the secondary treatment agents. Methods: We retrospectively analyzed the data of patients with MP pneumonia hospitalized between January 2015 and April 2017. Macrolide-unresponsiveness was clinically defined with a persistent fever of ${\geq}38.0^{\circ}C$ at ${\geq}72$ hours after macrolide treatment. The cases were divided into four groups: PMC, CST, DXC, and LFX. We compared the time to defervescence (TTD) after secondary treatment and the TTD after initial macrolide treatment in each group with adjustment using propensity score-matching analysis. Results: Among 1,165 cases of MP pneumonia, 190 (16.3%) were unresponsive to macrolides. The proportion of patients who achieved defervescence within 48 hours in CST, DXC, and LFX groups were 96.9% (31/33), 85.7% (12/14), and 83.3% (5/6), respectively. The TTD after initial macrolide treatment did not differ between PMC and CST groups (5.1 vs. 4.2 days, P = 0.085), PMC and DXC groups (4.9 vs. 5.7 days, P = 0.453), and PMC and LFX groups (4.4 vs. 5.0 days, P = 0.283). No side effects were observed in the CST, DXC, and LFX groups. Conclusion: The change to secondary treatment did not show better efficacy compared to PMC in children with macrolide-unresponsive MP pneumonia. Further studies are needed to guide appropriate treatment in children with MP pneumonia.

• 한국융합학회논문지
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• 제12권12호
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• pp.331-338
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• 2021

본 연구는 에너지바우처제도가 서비스 이용자 가구의 소비·지출에 미친 영향을 파악하고자 하였다. 자료는 한국복지패널 10차년도(2015년)와 15차년도(2020년)을 이용하였다. 연구대상은 서비스를 이용한 실험군과 이용하지 않은 통제군으로 구성하였다. 집단간의 특성차이는 카이제곱검정 및 t-test를 이용하였으며, 다중이중차이회귀분석을 통해 소비·지출에 대한 영향을 파악하였다. 연구결과 에너지바우처제도 이용자 가구의 총생활비(𝛽=-5.37)와 보건의료비(𝛽=-2.37)는 감소하였으며, 기본비(𝛽=2.51)와 교육비(𝛽=0.54)는 증가하였다. 보건의료비와 기본비는 제도 효과에 통계적으로 유의한 차이가 있었다. 따라서 제도 효과를 증대시키기 위해서는 급여수준을 확대하고 급여대상자의 자격기준을 완화하는 제도개선이 요구된다.