• Journal of Nutrition and Health
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• 제46권1호
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• pp.61-71
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• 2013

The aim of this study was to examine the relationship between dietary variables and the prevalence of insulin resistance (IR) in middle-aged Korean adults using data from the 2007-2009 Korea National Health and Nutrition Examination Survey. Because IR is closely linked with metabolic syndrome, subjects were divided into three groups according to symptoms of metabolic syndrome: the 'Normal group' without any symptoms, the 'Risk group' with one or two symptoms, and the Metabolic syndrome (MetS) group' with three or more symptoms. Subjects between the ages of 30 and 65 years with no prior diagnosis or treatment for diabetes, hypertension, or dyslipidemia were selected. The number of subjects per group was as follows: 2,085 adults in the Normal group, 3,699 adults in the Risk group, and 1,160 adults in the MetS group. Metabolic syndrome was defined according to Adult Treatment Panel III criteria with modified waist circumference cutoff values (men ${\geq}$ 90 cm, women ${\geq}$ 85 cm). Subjects with HOMA-IR > 2.0 were classified as IR. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was calculated using the following formula: (fasting plasma glucose ${\times}$ fasting plasma insulin)/22.5. Nutrients and food groups intake were obtained from a single 24-hour recall. Subjects with IR in the Normal group were more obese and less physically active than non-IR subjects. In the MetS group, subjects with IR were more obese and had a lower prevalence of smoking and drinking, compared with non-IR subjects. Men with IR in the Normal group had a tendency to consume more oils and sugars than non-IR men, while women with IR in the same group had higher intake of carbohydrate, dietary glycemic index, and dietary glycemic load than non-IR women. Women with IR in the Risk group had lower energy intake but higher intake of oils and sugars than non-IR women. In the MetS group, consumption of fruits was higher in subjects with IR than in non-IR subjects. In conclusion, findings of this study suggest that dietary carbohydrate intake, including glycemic index, may be associated with IR in healthy women. Further research in prospective cohort studies in order to examine the effects of dietary carbohydrate on IR incidence will be necessary.

• Journal of Chest Surgery
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• 제53권3호
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• pp.104-113
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• 2020

Background: Accurate intraoperative assessment of mediastinal lymph nodes is a critical aspect of lung cancer surgery. The efficacy and potential for upstaging implicit in these dissections must therefore be revisited in the current era of uniportal video-assisted thoracoscopic surgery (VATS). Methods: A retrospective study was conducted in which 544 patients with stage I (T1abc-T2a, N0, M0) primary lung cancer were analyzed. To assess risk factors for nodal upstaging and to limit any imbalance imposed by surgical choices, we constructed an inverse probability of treatment-weighted (IPTW) logistic regression model (in addition to non-weighted logistic models). We also evaluated risk factors for early locoregional recurrence using IPTW logistic regression analysis. Results: In the comparison of uniportal and multiportal VATS, the resected lymph node count (14.03±8.02 vs. 14.41±7.41, respectively; p=0.48) and rate of nodal upstaging (6.5% vs. 8.7%, respectively; p=0.51) appeared similar. Predictors of nodal upstaging included tumor size (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.12-2.70), carcinoembryonic antigen level (OR, 1.11; 95% CI, 1.04-1.18), and histologically confirmed pleural invasion (OR, 3.97; 95% CI, 1.89-8.34). The risk factors for locoregional recurrence within 1 year were found to be number of resected N2 nodes, age, and nodal upstaging. Conclusion: Uniportal and multiportal VATS appear similar with regard to accuracy and thoroughness, showing no significant difference in the extent of nodal dissection.

• Clinical and Experimental Pediatrics
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• 제52권3호
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• pp.370-375
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• 2009

목 적 : 터너증후군 환자에서 대사증후군과 심혈관 질환의 위험성이 높다. 성인 연령의 터너증후군 환자들에서 대사증후군 관련요인을 분석하고, 인슐린 저항성의 대사위험성을 알아보기 위한 연구를 시행하였다. 방 법 : 43명의 성인 터너증후군 환자에서 대사증후군의 빈도와 관련 요인 값들을 분석하였다. HOMA-IR을 이용하여 인슐린 저항성군과 비저항성군으로 분류한 후 각 집단을 분석하고, HOMA- IR과 대사 증후군 관련요인의 상관관계를 알아보았다. 결 과 : 대사증후군은 터너증후군 환자의 7%에서 보였고 각 항목에 대해서 인슐린 저항성은 16.3%, 복부 비만이 15.4%, 고중성지방이 2.3%, 저HDL 콜레스테롤이 9.3%였고, 고혈압이 36.8 %였다. 체질량지수, 허리둘레, 공복 혈당, HOMA-IR, 수축기 혈압은 인슐린 저항성군에서 의미 있게 높게 나왔으며, HOMA-IR은 체질량지수, 허리둘레, 공복 혈당, 수축기 혈압과 양의 상관관계를 보였다(P<0.05). 결 론 : 터너증후군 성인 환자들에서 대사증후군의 위험성이 있으며, 인슐린 저항성과 대사증후군 관련요인 간에 상관관계를 보인다. 터너증후군 환자들에게서 대사관련 요인을 일정기간 마다 검사하여 대사증후군 또는 인슐린 저항성으로의 진행여부를 감시하고 심혈관 합병증을 예방하는 것이 필요하다.

• 한국식품영양학회지
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• 제31권3호
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• pp.425-434
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• 2018

Metabolic syndrome is a risk factor for cardiovascular and type 2 diabetes. This study was conducted to examine the relevance between nutrition intake, meal quality, and high-sensitivity C-reactive protein in Koreans with metabolic syndrome. The 2,536 subjects, aged 19~64, who participated in 2015 National Nutrition Survey were included in this study. The 24-hour recall method was employed to analyze nutrition intake and dietary quality. Subjects were grouped into either the non-metabolic syndrome group (n=1,938) or the metabolic syndrome group (n=598). Total males and females were divided into 3 groups according to the high-sensitivity C-reactive protein (hs-CRP) level to study its relationship to metabolic syndrome and its components, including odds ratio (OR) and confidence interval (CI). Results showed the homeostasis model assessment of insulin resistance (HOMA-IR) value was higher in the metabolic syndrome group (3.37) than non-metabolic syndrome group (1.57) (p<0.001). In the Index of Nutrition Quality, males in the non-metabolic syndrome group showed higher niacin (p<0.05) than males in metabolic syndrome group. Females in the non-metabolic syndrome group had higher vitamin $B_1$ (p<0.01), vitamin $B_2$ (p<0.001), niacin (p<0.05), calcium (p<0.001), and phosphate (p<0.01). Female in the high hs-CRP group showed high OR in blood glucose component (OR 2.488, 95% CI: 1.269~4.879) and metabolic syndrome risk (OR 2.856, 95% CI: 1.292~6.314). Females in the middle hs-CRP group had high triglycerides component (OR 2.956, 95% CI: 1.920~4.551), compared to the low hs-CRP group. The study showed females with higher hs-CRP had a higher risk of metabolic syndrome.

• 생명과학회지
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• 제22권9호
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• pp.1261-1267
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• 2012

본 연구에서는 12주간 비알코올성 지방간을 가진 비만아동을 대상으로 유산소 운동군과 짐볼 운동군으로 나누어 운동을 실시한 결과 체중, BMI, 체지방율이 유의하게 감소하였다. 또한 Adiponectin의 증가와 Leptin의 감소로 인해 인슐린저항성과 혈당, 인슐린 농도도 유의하게 감소하는 것으로 나타났다. 또한 이러한 Adipokine들의 긍정적인 기능들로 인하여 비알콜성 지방간을 평가하는 간 기능 평가지수인 AST와 ALT도 감소하는 것으로 나타났다. 결론적으로 비알코올성 지방간을 가진 비만아동뿐만 아니라 비알코올성 지방간 환자에 있어 유산소운동 뿐만 아니라 짐볼 운동에서도 운동효과가 유사하게 나타났으므로 규칙적인 운동은 심폐체력 증진 및 혈중지질의 감소와 함께 혈중 Adiponectin 발현을 증가시킴으로서 인슐린저항성 개선을 통하여 비알코올성 지방간 기능 개선 뿐만 아니라 비만으로 인한 당뇨병, 심혈관 질환 발병의 예방에도 도움이 될 수 있을 것으로 기대된다.

• 한국건축시공학회지
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• 제18권2호
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• pp.151-159
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• 2018

한국 건설업의 재해율은 매년 증가하고 있는 추세이며 다른 산업에 비해 월등히 높다. 이는 국가차원에서 재해예방을 위해 수행하는 안전활동들이 건설산업의 재해율 감소에는 효과를 보이지 못한다는 것을 의미한다. 이러한 문제점을 해결하기 위해서는, 인명사고 예측모델에 대한 프레임이 구축되어야 하며, 인명사고 발생형태에 대한 정량화 연구가 필요하다. 이에, 본 연구는 인명사고 발생형태의 불확실성을 정량화하고 몬테카를로 시뮬레이션을 통해 다양한 환경에서 어떻게 변화하는지 예측하고자 한다. 이를 위하여 첫째, 선행연구 고찰을 통해 인명사고 발생형태를 정의한다. 둘째, 14년 간 국내 건설현장에서 발생한 인명사고 및 보상지급액 데이터를 수집한다. 셋째, 발생형태별 특성을 파악하기 위해 수집된 데이터를 토대로 기술통계분석을 실시한다. 넷째, 인명사고 발생형태를 정량적으로 분석하기 위하여 발생형태별 사고 발생 확률과 보상지급액의 모수를 추정한다. 마지막으로 추정된 모집단을 토대로 몬테카를로 시뮬레이션을 실시하여 인명사고 발생형태별 분포 특징을 분석한다. 본 연구의 결과는 향후 건설현장 안전관리 체크리스트 개발 및 인명사고 예측 모델 개발의 참고 자료로 활용될 것으로 기대된다.

• 농촌의학ㆍ지역보건
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• 제44권4호
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• pp.209-219
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• 2019

이 연구는 치과위생사의 직무스트레스와 상지의 근골격계 기능 장애의 관련성을 알아보고자 수행하였다. 연구 대상자는 부산·경남 지역의 병원급 이상, 치과의원에 근무하는 치과위생사를 220명을 편의 표집하여 설문지를 배포한 후 최종 수거된 200부에서 응답이 부실한 2부를 제외하고 최종적으로 198명의 자료를 분석하였다. 설문문항으로는 일반적 특성, 직무스트레스, 작업관련 상지 근골격계 통증, 동작수행능력에 따른 기능평가 문항으로 구성하였다. 치과위생사의 대한 상지근골격계질환 통증은 목 39.4%, 어깨 54.6%, 팔/팔꿈치 14.7%, 손/손목/손가락 50.0% 였다. 그리고, 상지의 기능 장애는 치과위생사에서 호발하는 건강관련 문제로 불편한 작업자세와 상지 부위별 근골격계 통증을 보정하더라도 직무스트레스와 유의한 관련이 있었다. 즉, 팔꿈치를 굽혔다 펴는 반복 작업, 팔꿈치 부위에 통증이 있는 경우외에도 직무스트레스 역시 상지의 기능 장애와 관련이 있었다. 치과위생사의 직무스트레스는 이들의 상지 기능 장애로 이어져 결과적으로 의료서비스의 저하로 이어지므로, 장단기 계획하에 근무환경개선 등을 통하여 직무 스트레스를 감소시킬 수 있는 방안을 모색하여야 할 것이다.

• 산업경영시스템학회지
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• 제38권3호
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• pp.64-77
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• 2015

An effective method for produce munitions effectiveness data is to calculate weapon effectiveness indices in the US military's Joint Munitions Effectiveness Manuals (JMEM) and take advantage of the damage evaluation model (GFSM) and weapon Effectiveness Evaluation Model (Matrix Evaluator). However, a study about the Range Safety that can be applied in the live firing exercises is very insufficient in the case of ROK military. The Range Safety program is an element of the US Army Safety Program, and is the program responsible for developing policies and guidance to ensure the safe operation of live-fire ranges. The methodology of Weapon Danger Zone (WDZ) program is based on a combination of weapon modeling/simulation data and actual impact data. Also, each WDZ incorporates a probability distribution function which provides the information necessary to perform a quantitative risk assessment to evaluate the relative risk of an identified profile. A study of method to establish for K-Range Safety data is to develop manuals (pamphlet) will be a standard to ensure the effective and safe fire training at the ROK military education and training and environmental conditions. For example, WDZs are generated with the WDZ tool as part of the RMTK (Range Managers Tool Kit) package. The WDZ tool is a Geographic Information System-based application that is available to operational planners and range safety manager of Army and Marine Corps in both desktop and web-based versions. K-Range Safety Program based on US data is reflected in the Korean terrain by operating environments and training doctrine etc, and the range safety data are made. Thus, verification process on modified variables data is required. K-Range Safety rather than being produced by a single program, is an package safety activities and measures through weapon danger zone tool, SRP (The Sustainable Range Program), manuals, doctrine, terrain, climate, military defence M&S, weapon system development/operational test evaluation and analysis to continuously improving range safety zone. Distribution of this K-range safety pamphlet is available to Army users in electronic media only and is intended for the standing army and army reserve. Also publication and distribution to authorized users for marine corps commands are indicated in the table of allowances for publications. Therefore, this study proposes an efficient K-Range Safety Manual producing to calculate the danger zones that can be applied to the ROK military's live fire training by introducing of US Army weapons danger zone program and Range Safety Manual

• 한국지반공학회:학술대회논문집
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• 한국지반공학회 2010년도 추계 학술발표회 3차
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• pp.72-77
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• 2010

The Incheon Bridge, which was opened to the traffic in October 2009, is an 18.4 km long sea-crossing bridge connecting the Incheon International Airport with the expressway networks around the Seoul metropolitan area by way of Songdo District of Incheon City. This bridge is an integration of several special featured bridges and the major part of the bridge consists of cable-stayed spans. This marine cable-stayed bridge has a main span of 800 m wide to cross the vessel navigation channel in and out of the Incheon Port. In waterways where ship collision is anticipated, bridges shall be designed to resist ship impact forces, and/or, adequately protected by ship impact protection (SIP) systems. For the Incheon Bridge, large diameter circular dolphins as SIP were made at 44 locations of the both side of the main span around the piers of the cable-stayed bridge span. This world's largest dolphin-type SIP system protects the bridge against the collision with 100,000 DWT tanker navigating the channel with speed of 10 knots. Diameter of the dolphin is up to 25 m. Vessel collision risk was assessed by probability based analysis with AASHTO Method-II. The annual frequency of bridge collapse through the risk analysis for 71,370 cases of the impact scenario was less than $0.5{\times}10^{-4}$ and satisfies design requirements. The dolphin is the circular sheet pile structure filled with crushed rock and closed at the top with a robust concrete cap. The structural design was performed with numerical analyses of which constitutional model was verified by the physical model experiment using the geo-centrifugal testing equipment. 3D non-linear finite element models were used to analyze the structural response and energy-dissipating capability of dolphins which were deeply embedded in the seabed. The dolphin structure secures external stability and internal stability for ordinary loads such as wave and current pressure. Considering failure mechanism, stability assessment was performed for the strength limit state and service limit state of the dolphins. The friction angle of the crushed stone as a filling material was reduced to $38^{\circ}$ considering the possibility of contracting behavior as the impact.

• 한국조경학회지
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• 제43권3호
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• pp.92-100
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• 2015

대부분의 일반적인 계획 과정과 달리, 브라운필드 계획은 잠재된 오염문제로 인한 기술적, 법률적 전문지식을 필요로 한다. 성공적으로 통합적인 의사결정에 관여하기 위해서는 조정된 협력적 계획 모델이 중요하다. 본 연구는 기존의 협력적 계획 접근방식이 브라운 필드 재생에 있어 상반된 분야의 전문가들 및 지역 주민들이 함께 일하며 적절하게 균형 잡힌 협력을 이루어 내기 위한 어려움들을 극복하는 데에 어떻게 효과적으로 적용될 수 있는지 알아보는 것을 목표로 한다. 의사소통적 계획이론 관련 문헌분석을 통해 적절한 지표들을 찾아내어, 네 단계의 브라운 필드 계획과정(대상지 선별, 평가, 정화, 디자인)에 적용시켜 본 후, 중요한 부분들을 짚어내었다. 본 연구의 결과, 크게 세 가지 점에 초점을 맞춘, 브라운 필드 재생에 적합한 협력적 계획 모델의 필요성이 인식되었다(1. 사회, 문화, 디자인 분야와 과학, 기술 분야의 전문가 간의 균형 잡힌 대화의 촉진, 2. 일반주민들과의 잠재적 오염 위험과 관련한 커뮤니케이션을 위한 적절한 방법개발, 3. 전문가 주도의 객관적 데이터와 주민 의견 중심의 주관적 데이터의 통합을 위한 의사결정지원 시스템의 마련).