• 디지털융복합연구
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• 제13권1호
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• pp.353-366
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• 2015

본 연구의 목적은 심정지 발생의 지역별 변이요인을 규명하는 것이다. 분석을 위하여 244개 행정구역별로 건강상태 및 심정지발생에 관한 지표를 수집하여 분석용 데이터 셋을 구축하였다. 지표 선정을 위해 질병관리본부의 2010년 심정지 조사자료와 지역사회 건강조사자료를 이용하였다. 자료 분석은 다중회귀분석, 지리적 가중회귀분석, 의사결정나무분석 기법을 이용하였다. 의사결정나무를 이용하여 심정지 발생의 지역별 변이를 설명하는 최종 모형을 설정하였다. 최종 모형인 의사결정나무에 근거한 지역별 변이요인은 인구밀도, 고혈압 평생의사 경험진단율, 스트레스 인지율, 고지혈증 평생의사 경험진단율, 우울증 경험률, 건강검진 수검율, 고위험음주율, 현재 흡연율로 나타났다. 심정지 발생을 감소시키기 위한 지역별 보건정책의 수립은 지역의 건강상태, 건강행위 및 사회경제적 요인 등에 근거하여 이루어질 필요가 있다.

• Tuberculosis and Respiratory Diseases
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• 제58권6호
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• pp.600-606
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• 2005

Background : The development of bronchoscopic equipment along with the precision of radiographic techniques had reduced the mortality rate of patients with tracheobronchial foreign bodies but has been no change in the incidence of tracheobronchial foreign bodies since their introduction. The aim of this study was to assess the clinical characteristics of a tracheobronchial foreign body aspiration and to evaluate the efficacy of the treatment modality in children and adults. Methods : This is a retrospective review of 64 patients who underwent bronchoscopic procedures for the treatment of aspirated foreign bodies from December 1994 through March 2004 at the Chonnam national university hospital. Results : There were 47 males and 17 females, aged from 1 month to 78 years. Most of the patients had no underlying illness except for one patient with a cerebrovascular accident that contributed to the foreign body aspiration. The most common symptom was cough, which was noted in 54 patients (84.3%). The other presenting symptoms were dyspnea (48.8%), fever (20.3%), sputum (14%), vomiting (7.8%), and chest pain (4.6%). Those whose tracheobronchial foreign bodies were diagnosed more than 2 days after the aspiration (21 patients) were more likely to have pneumonia than those whose foreign bodies were diagnosed within 2 days (p = 0.009). Foreign bodies were visualized in the plain chest radiographs in 12 cases (18.8%), while others showed air trapping (21, 32.8%), pneumonia (15, 23.4%), atelectasis (7, 10.9%), and normal findings (9, 14.1%). The foreign bodies were more frequently found in the right bronchial tree (36) compared with the left bronchial tree (22, p = 0.04). In order to remove the foreign bodies, twenty (31.2%) cases were removed using flexible bronchoscopy, while 42 (65.6%) and 2 (3.2%) cases required rigid bronchoscopy and surgery, respectively. Conclusions : Tracheobronchial Foreign body aspiration had a bimodal age distribution in the infancy and old age around 60 years. They were found more frequently in the right bronchial tree. In addition, patients whose foreign bodies were diagnosed more than 2 days after the aspiration were more likely have a infection. Rigid bronchoscopy is the procedure of choice for uncooperative children and for those with foreign bodies lodged deeply in the small bronchial tree.

• Korean Journal of Radiology
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• 제24권1호
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• pp.51-61
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• 2023

Objective: To develop and test a machine learning model for classifying human papillomavirus (HPV) status of patients with oropharyngeal squamous cell carcinoma (OPSCC) using ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET-derived parameters in derived parameters and an appropriate combination of machine learning methods in patients with OPSCC. Materials and Methods: This retrospective study enrolled 126 patients (118 male; mean age, 60 years) with newly diagnosed, pathologically confirmed OPSCC, that underwent ¹⁸F-FDG PET-computed tomography (CT) between January 2012 and February 2020. Patients were randomly assigned to training and internal validation sets in a 7:3 ratio. An external test set of 19 patients (16 male; mean age, 65.3 years) was recruited sequentially from two other tertiary hospitals. Model 1 used only PET parameters, Model 2 used only clinical features, and Model 3 used both PET and clinical parameters. Multiple feature transforms, feature selection, oversampling, and training models are all investigated. The external test set was used to test the three models that performed best in the internal validation set. The values for area under the receiver operating characteristic curve (AUC) were compared between models. Results: In the external test set, ExtraTrees-based Model 3, which uses two PET-derived parameters and three clinical features, with a combination of MinMaxScaler, mutual information selection, and adaptive synthetic sampling approach, showed the best performance (AUC = 0.78; 95% confidence interval, 0.46-1). Model 3 outperformed Model 1 using PET parameters alone (AUC = 0.48, p = 0.047) and Model 2 using clinical parameters alone (AUC = 0.52, p = 0.142) in predicting HPV status. Conclusion: Using oversampling and mutual information selection, an ExtraTree-based HPV status classifier was developed by combining metabolic parameters derived from ¹⁸F-FDG PET/CT and clinical parameters in OPSCC, which exhibited higher performance than the models using either PET or clinical parameters alone.

• 대한영상의학회지
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• 제84권5호
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• pp.1066-1079
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• 2023

목적 경막내척수외 뇌실막세포종의 임상 및 영상 특성에 대한 보고는 드물다. 하지만, 발생 위치와 병리학적 특성을 고려하였을 때 점액유두상 뇌실막세포종과 구별하기 어렵다. 본 연구는 경막내척수외 뇌실막세포종과 척수 점액유두상 뇌실막세포종을 구별하기 위한 임상적 특징 및 MRI 영상 특징을 조사하였다. 대상과 방법 종양 크기, 종양의 종축/횡축 위치, 조영 정도/패턴, 동공, 종양 변연, T2 강조 영상(T2-weighted image), T1 강조 영상(T1-weighted image; 이하 T1WI), 종양 아래의 cerebrospinal fluid (이하 CSF) T1 신호강도 증가 및 CSF space로의 종양 전파에 대하여 12개의 병리학적으로 확인된 경막내척수외 뇌실막세포종과 10개의 병리학적으로 확인된 척수 점액유두 뇌실막세포종을 대상으로 분석을 하였다. 또한, 분류 및 트리 분석(classification and tree analysis; 이하 CART) 을 수행하여 경막내척수외 척수 뇌실막세포종을 점액유두 뇌실막세포종과 구별하는 데 중요한 임상적 특징 및 MRI 영상 특징을 조사하였다. 결과 경막내척수외 뇌실막세포종 환자는 척수 점액유두 뇌실막세포종 환자보다 유의하게 나이가 많았으며(48세 vs. 29.5세, p < 0.05), T1W1에서 높은 신호 강도는 점액유두상 뇌실막세포종보다 경막내척수외 척수 뇌실막세포종에서 더 자주 관찰되었다(p = 0.02). 반대로 점액유두상 뇌실막세포종은 지주막하강으로의 종양의 파급을 보였다. CSF 신호 강도는 경막내 척수외 척수 뇌실막세포종보다 점액유두 뇌실막세포종에서 더 자주 관찰되었다(p < 0.05). 종양 아래로의 CSF T1 신호 증가 및 CSF space로의 종양 전파는 경막내척수외 척수 뇌실막세포종과 점액유두 뇌실막세포종을 구별하기 위한 CART 분석에서 가장 중요한 변수였다. 결론 경막내척수외 뇌실막세포종과 척추 점액유두 뇌실막세포종을 구별하는 데 있어 임상 및 MRI 영상의 특징이 도움이 될 수 있다.

• 한국조경학회지
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• 제49권6호
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• pp.1-15
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• 2021

본 연구는 산림청 소관 법령분석을 통해 법제도에 의해 양성되는 산림전문가를 고찰했다. 특히, 산림관련 법률의 변천과정과 산림전문가를 양성하는 법률을 파악하고, 산림정책 분야에 따른 산림전문 인재 양성에 관한 변화 및 특성을 규명했다. 그 결과, 산림산업 정책에 관한 산림전문가는 임야를 가지고 임업진흥을 위한 임업후계자와 산림산업 발전을 위한 기술능력을 갖춘 산림기술자가 있으며, 목재의 지속가능한 이용을 위한 법률 개정에 따라 목구조기술자, 목재등급평가사, 목재교육전문가를 별도로 양성하는 것으로 나타났다. 산림복지 정책에 관한 산림전문가는 산림에 설치하는 산림문화 휴양시설, 치유의 숲, 산림레포츠시설의 다양한 서비스를 제공하기 위해 전문 교육과정을 이수하는 산림전문가를 양성하는 것으로 밝혀졌으며, 산림복지전문가와 산림레포츠지도사가 있다. 산림복지전문가는 산림교육전문가와 산림치유지도사로 구분되며, 산림교육전문가는 숲해설가, 유아숲지도사, 숲길등산지도사로 구분하고 있다. 산림보호 정책에 관한 산림전문가는 수목원과 정원의 효율적 관리 및 전시를 위한 수목원·정원 전문가와 수목진료를 위한 나무의사와 수목치료기술자를 양성하는 것으로 나타났다. 나무의사와 수목치료기술자는 수목피해 진단 및 치료를 위한 나무병원업을 운영하기 위해 필요한 자격조건으로 밝혀졌다. 따라서 산림청은 임업 진흥 및 산림산업 발전과 수목진료를 위한 기술능력을 갖춘 산림전문가와 산림 내 문화·휴양·치료·보전 등의 시설에서 교육 및 복지 서비스를 제공하는 산림전문가를 양성하는 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.6857-6862
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• 2015

Background: To identify the optimal cost effective strategy for the management of women having ASC-US who attended at King Chulalongkorn Memorial Hospital (KMCH). Design: An Economical Analysis based on a retrospective study. Subject: The women who were referred to the gynecological department due to screening result of ASC-US at King Chulalongkorn Memorial Hospital, a general and tertiary referral center in Bangkok Thailand, from Jan 2008 - Dec 2012. Materials and Methods: A decision tree-based was constructed to evaluate the cost effectiveness of three follow up strategies in the management of ASC-US results: repeat cytology, triage with HPV testing and immediate colposcopy. Each ASC-US woman made the decision of each strategy after receiving all details about this algorithm, advantages and disadvantages of each strategy from a doctor. The model compared the incremental costs per case of high-grade cervical intraepithelial neoplasia (CIN2+) detected as measured by incremental cost-effectiveness ratio (ICER). Results: From the provider's perspective, immediate colposcopy is the least costly strategy and also the most effective option among the three follow up strategies. Compared with HPV triage, repeat cytology triage is less costly than HPV triage, whereas the latter provides a more effective option at an incremental cost-effectiveness ratio (ICER) of 56,048 Baht per additional case of CIN 2+ detected. From the patient's perspective, the least costly and least effective is repeat cytology triage. Repeat colposcopy has an incremental cost-effectiveness (ICER) of 2,500 Baht per additional case of CIN2+ detected when compared to colposcopy. From the sensitivity analysis, immediate colposcopy triage is no longer cost effective when the cost exceeds 2,250 Baht or the cost of cytology is less than 50 Baht (1USD = 31.58 THB). Conclusions: In women with ASC-US cytology, colposcopy is more cost-effective than repeat cytology or triage with HPV testing for both provider and patient perspectives.

• International Journal of Internet, Broadcasting and Communication
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• 제12권3호
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• pp.102-107
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• 2020

Recently, the number of people visiting the hospital is increasing due to diabetes. According to the Korean Diabetes Association, statistically, 1 in 7 adults over the age of 30 are suffering from diabetes. As such, diabetes is one of the most common diseases among modern people. In this paper, in addition to blood sugar, which is widely used for diabetes awareness, BMI, which is known to be related to diabetes, triglycerides and cholesterol that cause various complications in diabetics it was studied using random forest techniques and decision trees known to be effective for classification. The importance of each element was confirmed using the results and characteristic importance derived using two techniques. Through this, we studied the diabetes-related relationship between BMI, triglyceride, and cholesterol as well as blood sugar, a factor that diabetic patients should pay much attention to.

• Mass Spectrometry Letters
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• 제8권4호
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• pp.105-108
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• 2017

Recently, deciduous teeth have been proposed as a promising biomatrix for estimating internal and external chemical exposures of an individual from prenatal periods to early childhood. Therefore, detection of organic chemicals in teeth has received increasing attention. Organic materials in tooth matrix are mostly collagen type proteins, but lipids and other small organic chemicals are also present in the tooth matrix. In this study, matrix-assisted laser desorption/ionization (MALDI) mass spectrometry (MS) was employed to obtain lipid fingerprints from deciduous teeth. Phospholipids and triacylglcerols (TAGs) from deciduous teeth were successfully detected by MALDI MS with 2,5-dihydroxybenzoic acid (DHB) or gold nanoparticle (AuNP) as a matrix.

• Journal of Chest Surgery
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• 제19권2호
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• pp.259-264
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• 1986

Broncholithiasis is defined as a cor9ition in which a concretion is present within a bronchus or a cavity in the lung communicating with a bronchus. The usual causes of broncholithiasis are known as tuberculosis, histoplasmosis, silicosis, aspirated calculi, and a few fungal infections. It is generally accepted that the constant motion created by respiration and beating of the heart may cause the peribronchial calcified lymph node to erode into the tracheobronchial tree and to form broncholith. After the analysis of our 6 cases of broncholithiasis which were treated surgically in the Department of Thoracic Surgery, Seoul National University Hospital from 1960 to December, 1985, we could suggest that intrinsic formation of calculi should be regarded as the pathogenesis of broncholithiasis in addition to the extrinsic formation of calculi.

• Journal of Chest Surgery
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• 제18권2호
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• pp.320-326
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• 1985

Pulmonary sequestration occurs when some disturbance produces a cystic mass of nonfunctioning lung tissue which lacks normal communication with the tracheobronchial tree. Between 1971 and 1985, pulmonary sequestration was diagnosed in 11 patients, ranging age from 3 to 29 years. All sequestration were intralobar type. Definitive diagnosis can only be obtained by aortography and/or surgical exploration in 10 cases. The other one was confirmed by pathologic examination postoperatively. The presenting complaints were mostly recurrent local pulmonary infection, but in 2 cases mediastinal mass with respiratory symptoms was presented, and cardiac murmur was only finding in one case. Preoperative diagnostic procedure revealed 3 associated anomalies which were funnel chest, right aortic arch, and pulmonic stenosis with vascular ring. Operative treatment for sequestration was lobectomy in 10 cases, and a segmentectomy in one. There was no operative mortality, but 3 complications [empyema, B-P fistula, post-op bleeding] which were controlled by subsequent operations or conservative measure. Aortography is strongly advocated not only for its diagnostic value, but for its preoperative localization of the aberrant vessels that are the major concern to the surgeon.