• 제목/요약/키워드: Prospective approach

검색결과 170건 처리시간 0.031초

결시적 자료에서 관측 중단을 모형화하기 위해 사용되는 경쟁 위험의 적용과 결합 모형 (Joint model of longitudinal data with informative observation time and competing risk)

  • 김양진
    • 응용통계연구
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    • 제29권1호
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    • pp.113-122
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    • 2016
  • 경시적 자료는 반복적으로 측정된 다변량 자료의 한 형태로 임상학, 보건학, 경제학에서 자주 발생된다. 시계열자료와 구분되는 가장 큰 특징은 표본수와 공변량 효과의 추정에 있다. 경시적 자료는 일반적으로 시계열 자료보다 더 큰 표본 개체로 이루어져 있으며 연구의 주 관심은 특정 공변량의 효과를 추정하는 데 있다. 또한 시계열 자료보다 반복 측정 횟수가 짧으며 개체마다 다른 관측 횟수와 다른 관측 중단 시점을 가질 수 있다. 본 연구에서는 관측 시점과 관측 종료 원인이 경시자료와 서로 연관된 경우에 결합 모형을 적용함으로써 이들간의 연관성을 분석하고자한다. 따라서 이들 변량간의 연관성을 모형화하기 위해 이변량 랜덤효과가 적용된다. 실제 자료 분석에서는 간경변증 환자의 핼액 응고 수치 시간을 관심 있는 경시적 자료로 환자가 병원 방문시점과 관측 중단원인들간의 상호 연관관계를 규명하고자 하였다. 특히, 중도 절단원인은 사망이나 간이식을 받는 사건일 때 발생하는데 본 연구에서는 사망 사건과의 연관성이 고려되었다. 결과를 통해 혈액 응고 시간이 길고 병원 방문 시점이 빈번할수록 사망할 가능성이 높음을 알수 있었다. 또한 혈액응고 시간이 길수록 병원 방문 횟수가 빈번하였다.

Buccal infiltration injection without a 4% articaine palatal injection for maxillary impacted third molar surgery

  • Sochenda, Som;Vorakulpipat, Chakorn;Kumar, K C;Saengsirinavin, Chavengkiat;Rojvanakarn, Manus;Wongsirichat, Natthamet
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권4호
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    • pp.250-257
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    • 2020
  • Objectives: Palatal infiltration is the most painful and uncomfortable anesthesia technique for maxillary impacted third molar surgery (MITMS). This approach could cause patients distress and aversion to dental treatment. The aim of this study was to evaluate the anesthetic efficacy of a buccal infiltration injection without a palatal injection in MITMS. Materials and Methods: This prospective research study was a crossover split mouth-randomized controlled trial. Twenty-eight healthy symmetrical bilateral MITMS patients (mean age, 23 years) were randomly assigned to two groups. Buccal infiltration injections without palatal injections were designated as the study group and the buccal with palatal infiltration cases were the control group, using 4% articaine and 1:100,000 epinephrine. The operation started after 10 minutes of infiltration. Pain assessment was done using a visual analogue scale and a numeric rating scale after each injection and extraction procedure. Similarly, the success rate, hemodynamic parameters, and additional requested local anesthetic were assessed. Results: The results showed that the pain associated with local anesthetic injections between both groups were significantly different. However, the success rates between the groups were not significantly different. Postoperative pain was not significant between both groups and a few patients requested an additional local anesthetic, but the results were not statistically significant. For hemodynamic parameters, there was a significant difference in systolic pressure during incision, bone removal, and tooth elevation. In comparison, during the incision stage there was a significant difference in diastolic pressure; however, other steps in the intervention were not significantly different between groups. Conclusion: We concluded that buccal infiltration injection without palatal injection can be an alternative technique instead of the conventional injection for MITMS.

현행 주민번호제도의 문제점에 관한 연구: 정보 제공 자유도를 기반으로 (A Study on The Problem in Policy of Korean Resident Registration Number: On Basis of Freedom of Data Provision)

  • 이혜경
    • 디지털융복합연구
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    • 제14권11호
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    • pp.45-51
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    • 2016
  • 개인정보 유출 사고를 불러일으키는 근거를 과학적으로 발굴해 보려는 연구는 아직까지 전무한 실정이다. 본 논문은 해킹을 통한 주민 정보 유출의 정도를 결정짓는 근거 요인을 찾아내기 위해 시도됐다. 연구의 중요도에 비추어 이를 위한 연구가 문헌상에 나타나지 않았던 점은 과학적인 연구방법론을 찾아내고 적용하기 곤란한 연구주제인 점에서 본 논문에서는 과학적 분석 모형을 제안하였고 그에 기반 한 분석 방법론을 개발하였다. 연구결과, 개인 식별에 동원되는 데이터의 경직성 요인이 유출 수위에 가장 결정적 역할을 하는 것으로 드러났다. 강도가 강할수록 해킹건수와 비례하는 것이 증명됐다. '주민 데이터 자유도' 개념을 정립함으로써 국가별 주민식별관련 주민 자유도 허용 순위를 결정할 수 있었다. 영국과 한국이 순위 열 양단에 위치하는 것으로 드러났으며 자유도 면에서 영국이 국민에게 가장 많은 자유를 허용하는 국가로, 또한 한국이 가장 좁은 의미의 자유를 허용하는 국가로 매겨졌다.

Analysis of Influencing Factors to Depth of Epidural Space for Lumbar Transforaminal Epidural Block in Korean

  • Kim, Lee-Kyoung;Kim, Jung-Ryul;Shin, Sung-Sick;Kim, In-Ji;Kim, Bac-Ne;Hwang, Gan-Tac
    • The Korean Journal of Pain
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    • 제24권4호
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    • pp.216-220
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    • 2011
  • Background: Transforaminal epidural steroid injection is one of the effective treatments in managing radicular pain. There have been some prospective studies on the depth to the epidural space with the transforaminal approach. However, there have been no studies about the depth in Asians, especially Koreans. This study was carried out in order to evaluate the depth to the epidural space and the oblique angle and factors that influence the depth to the epidural space during lumbar transforaminal epidural injection. Methods: A total of 248 patients undergoing fluoroscopically guided transforaminal epidural steroid injections were evaluated. At the L3-4, L4-5, L5-S1, and S1 levels, we measured the oblique angle and depth to the epidural space. Results: Needle depth was positively associated with body mass index (correlation coefficient 0.52, P = 0.004). The median depths (in centimeters) to the epidural space were 6.13 cm, 6.42 cm, and 7.13 cm for 50-60 kg, 60-70 kg, and 70-80 kg groups, respectively, at L5-S1. Age and height were not significantly associated with the needle depth. Conclusions: There is a positive association between the BMI (and weight) and transforaminal epidural depth but not with age, sex, and height.

A Study on SNP of IL10 in Cerebral Infarction Patients

  • Jung, Tae-Young;Choi, Sung-Hun;Kim, Kyung-Woon;Lee, Yoon-Kyung;Lim, Seong-Chul;Lee, Kyung-Min;Seo, Jung-Chul
    • Journal of Acupuncture Research
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    • 제23권2호
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    • pp.173-179
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    • 2006
  • Objectives : In this study, we investigated the SNP (single-nucleotide polymorphism) of IL10 in patients with stroke. The present study was undertaken to see if specific genotypic and allelic variations are associated with stroke in the Korean population. Methods : Blood samples from all subjects were obtained for DNA extraction and collected in EDTA tube. Genomic DNA was extracted using DNA isolation kit for Mammalian Blood (Boehringer Mannheim, IN, USA). The extracted DNA was amplified by polymerase chain reaction (PCR). Pyrosequencing was performed according to manufacturer's standard protocol. Results : There was no statistically significant genotypic distribution difference between control and stroke group. The frequencies of A/A homozygotes and A/C heterozygotes among control subjects were 91 (87.5%) and 13 (12.5%). The frequencies of A/A and A/C among the stroke patients were 85 (89.5%) and 10 (10.5%). There was not statistically significant allelic frequency difference between control and stroke group. The allelic frequency of A and C was 195 (93.8%) and 13 (6.2%) among the control subjects and 180 (94.7%) and 10 (5.3%) in stroke patients, respectively. Conclusion : The cytokine IL10 may not be pathogenetic factors in stroke. But further studies including different cytokine gene can be a useful for predicting stroke. Establishment of more systemic approach and high quality of prospective cohorts will be necessary for the good prediction of genetic markers.

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일 지역 재활병원의 낙상 정보에 근거한 낙상예방 간호중재 프로그램 개발을 위한 문헌분석 연구 (A Literature Review for Fall-Prevention Nursing Program Development based on the Fall Information of a Rehabilitation Hospital)

  • 박희옥;강희경
    • 융합정보논문지
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    • 제10권8호
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    • pp.99-107
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    • 2020
  • 본 연구목적은 일지역 중소 재활병원 입원환자의 낙상실태 및 위험요인을 규명하고, 낙상예방 간호중재 연구 트랜드를 문헌고찰하여 실제적인 낙상예방 간호중재프로그램을 구상하기 위함이다. 연구방법으로는 낙상실태 및 위험요인을 규명하기 위한 서술적 연구와 실제적 낙상예방 간호중재프로그램 구상을 위한 통합적 문헌고찰을 병행하였다. 연구결과 해당병원의 임상현장 특징이 반영된 낙상실태와 낙상위험요인을 확인하였으며, 문헌고찰을 통해 노년 인구에 민감도가 높은 낙상위험사정도구의 활용과 보다 효과적인 방식의 낙상예방 간호중재를 제안하였다. 결론적으로, 본 연구는 낙상예방 간호중재의 실무근거를 마련하기 위해 통합적 문헌고찰 결과를 기반으로 실제에 맞는 낙상사정도구와 낙상예방 중재프로그램의 선택을 제안하고 이들의 활용 전망을 비춰주었다. 이는 병원낙상 간호에서 비판적사고를 통한 근거기반 간호실무 향상에 기여할 것이다.

유산소 운동이 소아 및 청소년의 인지기능에 미치는 영향 : 문헌고찰 (Effect of Aerobic Exercise on Cognitive Functions in Childen and Adolescents : A Review)

  • 강경두;조정환;한덕현
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제26권3호
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    • pp.143-148
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    • 2015
  • The purpose of this review was to investigate the relationship between aerobic exercise and cognitive function as well as synthesize the effect of aerobic exercise intervention studies centered on psychiatric symptoms associated with general cognitive deficit. Prospective studies on aerobic exercise and improvement of cognitive function were reviewed and synthesized. In addition, this literature review provides significant positive results on the relationship between aerobic exercise and general cognitive deficit associated with psychiatric symptoms. Review of this literature suggests that there is a positive relationship between participation in aerobic exercise and cognitive function. In this text, there are at least three general pathways by which aerobic exercise may facilitate executive function in children : 1) cognitive demands inherent in engaging in physical activity, 2) cognitive demands inherent in cooperation of complex motor tasks, and 3) physiological changes resulting from aerobic exercise. Another main finding of this review is that physical activity has a stronger influence on cognitive deficit, including attention-deficit hyperactivity disorder, depression, and anxiety. Development of cognitive function is the most important factor for children and youth. Therefore, future research should prove relationship between physical activity and cognitive function using a more scientific and quantitative approach design.

관절내 종골 골절의 전산화 단층 촬영에 따른 분류 및 치료 (CT Classification and Treatment of Intraarticular Calcaneal Fractures - Conservative vs. Surgical Treatment by Prospective Study -)

  • 강재도;김형천;김진형
    • 대한족부족관절학회지
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    • 제5권1호
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    • pp.35-42
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    • 2001
  • Purpose: To analyze the results of conservative or surgical treatment after computed tomograhy(CT) classification in intraarticular calcaneal fractures. Materials and methods: From January 1996 to May 1999, we prospectively analyze 23 cases of intraarticular calcaneal fractures who were treated conservatively or operated by open reduction and internal fixation by extensive L-shaped lateral approach after CT classification. Results: A functional scoring system of 0-100 points which was based upon the responses to AOFAS Ankle-Hindfoot Scale for the operative group was at 82.8, compared with 73.2 for the non-operative group, and these were meaningful statistically(P<0.05). Of type I fracture, in the operative group there were 2 excellent results and in the non-operative group there were 2 excellent results, 1 good result. or type II fractures, in the operative group there were 2 excellent results, 3 good results, 1 fair result and in the non-operative group there were 1 good result, 1 fair result, 2 poor results. Of type III fractures, in the operative group there were 2 fair results, 2 poor results and in the non-operative group there were 1 fair result, 3 poor results. Bohler angles of subtalar joint were changed from initial average $13.3^{\circ}$ to postoperative average $20.9^{\circ}$ for the operative group compared with from initial average $15.5^{\circ}$ to follow-up average $14.8^{\circ}$ of the non-operative group(P<0.01). Conclusions: Computed tomography in the evaluation of intraarticular calcaneal fractures is effective tool. We believed that open reduction and internal fixation in all Crosby & Fitzgibbons type II and according to degrees of comminution reducible type III for the intraarticular calcaneal fractures is more effective method than conservative treatment.

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태양폭풍 영향 우주 및 육상시스템 피해에 관한 재난안전정보시스템 구현 (An Implementation of the Disaster Management Systems on the Space and Terrestrial System Damages by Solar Maximum)

  • 오종우
    • 한국재난정보학회 논문집
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    • 제8권4호
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    • pp.419-431
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    • 2012
  • 우주기상 극대기인 2003년은 지구상에 크나큰 재앙을 초래할 것으로 예견되고 있다. 특히 근년에 들어 지자기 폭풍에 의한 손상과 가시화 될 수 있는 대 폭풍피해 사례를 보이고 있다. 본 연구에서는 이상에서 제시된 문제점에 대한 피해분석에 따른 궁극적인 우주기상정보시스템 모델 구축으로 피해 저감하고 대비방안을 설정하는 것이다. 구현방법으로는 uIT기반과 GIS기반의 우주기상 정보시스템 구축으로 우주폭풍에서 방사되는 우주복사폭풍(flare), 우주입자폭풍(solar proton event), 우주자기폭풍(geomagnetic storm) 등에 의한 분야별 폭풍피해를 분석하여 유형별 피해 대응에 대비할 수 있도록 하였다. 이로써 공간정보기반의 우주폭풍 전기전자 피해대비 운영관리시스템 구현은 GIS기법에 의한 의사결정지원 시스템으로 피해예측 및 방재환경을 스마트 IT환경과 융합한 첨단 정보시스템으로 구현하여 인명과 재산을 보전할 수 있는 방안으로 활용될 수 있을 것이다.

승모판 협착증 환자에 대한 한방치험 1례 (A Case Report of a Mitral Stenosis Patient Treated with Korean Medicine)

  • 신혜령;김철현;추홍민;이영웅;김광호;원진희;송봉근
    • 대한한방내과학회지
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    • 제41권3호
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    • pp.457-466
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    • 2020
  • Introduction: This study aimed to report on the effectiveness of using Korean medicine to improve symptoms of mitral stenosis. While some patients that do not require surgery due to mild mitral stenosis are treated with medication, the medication does not always alleviate the symptoms. Thus, we administered Korean medicine treatments to those patients because there are not many case reports on using this approach to treat symptoms of mitral stenosis. Case Presentation: A 48-year-old male patient with mitral stenosis complained of symptoms, such as palpitation, dyspnea, chest pain, fatigue, and swelling in both legs. To reduce the patient's symptoms, we administered Korean medical treatments, including herbal medicine (Samulanshin-tang-gamibang) and acupuncture. To evaluate the results, we used the numeric rating scale (NRS) and the New York Heart Association (NYHA) functional classification. After 17 days of treatment, the NRS score decreased for palpitation (8→2), dyspnea (8→1), chest pain (5→0), fatigue (96→2), and swelling in both legs (6→2). The NYHA class also changed from Class II to Class I. No adverse reaction was noted. Conclusion: According to the results, Korean medicine treatments can be considered to be effective for mitral stenosis patients. To confirm this finding, a prospective study is needed in the future.