• 한국화재소방학회논문지
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• 제18권1호
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• pp.54-66
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• 2004

본 논문은 도시 가스 지하배관의 위험관리체계를 유지하는데 필요한 요소들 중 배관의 위험성평가에 적절한 기법을 제안하고, 그 평가결과에 근거하여 가장 비용-효과가 큰 배관 유지관리방안을 찾아내는데 그 목적이 있다. 본 연구에서 제안된 지하배관의 위험성서열화의 접근방법은 세 가지 측면에서 행하여졌는데, 첫째는 RBI(Risk Based Inspection)으로서 배관의 위험도에 영향을 주는 주변인구조건, 관의 크기 및 두께. 사용시간 등을 기준으로 일차적 평가를 함으로서 노출위험도의 높고 낮음을 정성적으로 평가하였고, 둘째는 Scoring System으로서 매설된 배관의 환경적인 요소에 기초하여 점수화하여 구체적으로 위험도를 서열화 하였다. 셋째로는 THOMAS 이론으로부터 대상배관의 누출빈도를 정량화 하였다. 그 결과 도시 가스 대상배관의 노출위험도는 대략 중간이상의 값을 갖는 것으로 나타났으며, 제안된 SPC기법을 적용하여 위험성을 평가한 결과, 대상배관의 부식위험성 점수 값이 허용범위(30-70)에 골고루 분포하는 것으로 보아 설정된 평가기준이 실제배관에 대해 상대적인 부식위험성을 잘 서열화 됨을 알 수 있었다. 또한 THOMAS모델을 적용한 평가결과로서의 Score값은 배관의 길이를 포함한 여러 치수들에 무관한 환경요인에 관련된 값인 반면, 기본누출빈도는 배관의 길이를 포함해서 다른 치수들에 비례함을 보여주고 있다. 그 결과 점수 값이 상대적으로 적은 배관구간(상대적으로 위험성이 낮은 구간)도 배관길이가 훨씬 더 크다면 누출발생빈도가 더 높은 값을 갖는다는 것을 알 수 있었다. 또한 대상 파이프라인의 허용위험수용범위는 전체 누출 빈도 값인 최대 1.00E-01/yr로부터 최소 2.50E-02의 영역을 나타내고 있어 이에 상응되는 높은 Consequence를 수용 가능한 영역으로 낮추는 조치가 필요함을 보여주고 있고, 종합파손확률에 대해 사용시간을 회기 분석법(Regression Analysis)으로 예측한 결과, 이에 대한 방정식을 유추할 수 있었고, 그에 대한 결과가 대상 파이프라인의 사용 년 수인 11년에서 13년으로 나타나 실제 대상배관들의 연령과 거의 일치함을 알 수 있었다. 따라서 본 연구에서 제안된 위험성 서열화 접근방법은 실제적으로 지하배관의 유지관리를 하는데 있어서 매우 효율적으로 적용될 수 있을 것으로 사료된다.

• 대한의생명과학회지
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• 제29권4호
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• pp.355-362
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• 2023

This study aimed to determine whether smoking affects the metabolic syndrome and its components through long-term follow-up. Of the 10,030 cohort subjects in the community-based Korean Genome and Epidemiology Study (KoGES) from 2001 to 2018, 2,848 people with metabolic syndrome and 4,854 people with insufficient data for analysis were excluded for this study. The study population comprised 2,328 individuals (1,123 men, 1,205 women) who were eligible for inclusion. The mean age of the participants was 49.2±7.5 years, and 21.9% were current smoker. In log rank test, current smoker had a significantly higher cumulative incidence of metabolic syndrome compared with non smoker (P<0.001). In the Cox proportional hazards model adjusted for key variables, metabolic syndrome (hazard ratio [HR] 1.57, P<0.001), high fasting glucose (HR 1.40, P<0.01), hypertriglyceridemia (HR 1.60, P<0.001), low HDL-cholesterol (HR, 1.30, P<0.01), and abdominal obesity (HR 1.32, P<0.01) in current smoker compared with non smoker were statistically significant, respectively, but not hypertension (HR 1.00, P>0.05). After adjustment for confounders, the time (P-time<0.001) and group (P-group<0.001) effects on metabolic syndrome score change were statistically significant. Furthermore, the interaction analysis of time and smoking group on the change in metabolic syndrome score was statistically significant (P-interaction<0.001). In long-term follow-up, smoking worsens metabolic syndrome.

• Tuberculosis and Respiratory Diseases
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• 제49권5호
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• pp.601-613
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• 2000

연구배경 : 통상성 간질성 폐섬유증(usual interstitial pneumonia : UIP)은 특발성 간질성 폐렴(Idiopathic interstitial pneumonia : I.I.P)의 한 형태로서 생존기간 중앙값이 약 3-5 년 정도로 보고되는 치명적인 질환으로 알려져 있으나, 최근 분류된 BOOP이나 NSIP등을 제외한 순수한 UIP환자들만을 대상으로 임상경과나 예후에 대한 연구는 외국에서도 극소수아고, 국내에서는 보고된 바가 없다. 이에 연구자들은 수술적 폐생검 검사로 확진된 UIP 환자들의 임상경과와 예후의 예측 지표를 찾고자 본 연구를 시행하였다. 방법 : 1989년 3월부터 1999년 8월까지 서울중앙병원에서 개흉 또는 흉강경을 통한 폐생검검사로 UIP로 진단된 72명(연령 $58.2{\pm}11.6$세, 남 : 여=45:27, 관찰기간 중앙값 : 18.1개월 (0.7-103.6개월))을 대상으로 하였다. 진단시의 임상증상과 흉부고해상도단층촬영, 폐기능검사, 동맥혈 가스검사 등을 증상점수(C) (1-20점), 방사선학점수(R)(봉와양 소견 : 0-5점, 젖빛유리야 소견 : 0-5점) 및 생리적검사점수(P) (FVC 1-12점, $FEV_1$ 0-3점, TLC 1-10점, $D_{LCO)$ 0-5점, $AaDO_2$ 0-10점)로 수치화하여 CRP 접수를 계산하였다. 임상경과와 진단시의 CRP점수, 기관지 폐포세척액검사 등을 비교 분석하여 예후의 예측지표를 검색하였다. 결과 : 1) 대상 UIP환자들의 1년 누적생존률은 78.3%, 3년 누적생존률은 58.1% 였고, 생존기간 중앙값은 42.5개월이었다. 2) 단기(1년)예후 : 단기 사망군(14명)은 생존군(46명)에 비하여 전체CRP점수($28.6{\pm}8.3$ vs. $16.6{\pm}9.7$)가 높았으며, 이는 주로 증상점수($8.4{\pm}2.1$ vs. $5.7{\pm}3.9$)와 FVC, $D_{LCO)$, $AaDO_2$를 포함하는 생리적검사점수 $v{\pm}7.5$ vs. $8.1{\pm}7.3$)의 차이에 기인하였다. 또한 호전 혹은 안정군(61.7%)과 악화군 및 사망군(38.3%) 사이에는 연령과 흡연률, 진단당시의 CRP점수(증상점수, FVC, $AaDO_2$, $D_{LCO)$)가 유의한 차이가 있었다. 그러나 방사선학점수, TLC 및 기관지폐포세척액소견 등은 유의한 차이가 없었다. 2) 장기(3년) 예후 : 장기생존군(14명)은 사망군(22명)에 비하여 역시 진단시 총CRP점수($12.2{\pm}6.7$ vs. $28.7{\pm}7.9$)와 증상점수, FVC, $D_{LCO)$, $AaDO_2$)가 차이가 있었다. 3) 생존기간분석에서도 총 CRP 점수와 증상점수, $AaDO_2$ FVC, $D_{LCO)$가생존기간과 유의한 상관관계를 보였다. 4) Cox 회기분석을 이용한 다변수 분석에서는 $D_{LCO)$ (${\geq}$60% : Hazard ratio : 4.56, 95% CI : 2.30-16.04)만이 UIP환자 사망의 독립적인 예측인자로 나타났다. 결론 : 이상의 결과는 UIP 진단시의 $D_{LCO)$는 UIP환자의 예후를 예측할 수 있는 임상적 지표임을 시사하였다.

• 대한암한의학회지
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• 제24권2호
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• pp.1-11
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• 2019

Objectives : We investigated whether a single center nutrition screening tool (Kyunghee Neo Nutrition Risk Screening, KNNRS) can predict survival in patients with metastatic cancer. Methods : We retrospectively reviewed data of inpatients with metastatic cancer from April 2016 to August 2019. Data on demographic and clinical parameters were collected from electronic medical records, and overall survival was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine factors associated with survival. Patients with a KNNRS score of 0 to 3 were classified as "no-risk", 4 to 10 as "low-risk", and 11 to 20 as "high-risk". Results : Total 105 patients were included in the study. According to nutritional screening at baseline, 25 patients (23.8%, median age 57.0) were classified as ""no risk"" group; 80 patients (76.2%, median age 68.5) as "low risk" group; No patients as "high risk" group. Predictors of survival were Eastern Cooperative Oncology Group Performance Status score of 3 or 4 (hazard ratio [HR] = 1.93; 95% confidence interval [CI] = 1.21-3.10), hemoglobin less than 10 g/dL (HR = 1.97; 95% CI = 1.25-3.10) and C-reactive protein more than 1.0 mg/dL (HR = 1.95; 95% CI = 1.21-3.13). Kaplan-Meier survival analysis showed significant differences in the survival between KNNRS groups: ""no risk"" group: 6.1 ± 1.4 months (95% CI = 3.37-8.83); ""low risk"" group: 3.4 ± 0.9 months (95% CI = 1.5-5.37). Conclusions : Nutritional status according to KNNRS wasn't significant predictor of survival for patients with metastatic cancer. Improvement of KNNRS score thresholds is needed.

• 한국식품조리과학회지
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• 제15권6호
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• pp.579-585
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• 1999

This study was conducted to evaluate the recognition of HACCP(Hazard Analysis Critical Control Point) concept by the industry foodservice managers in Pusan and the Kyung Nam areas and to suggest a guideline for an effective HACCP education program. A survey was conducted from 133 foodservice managers by using a questionnaire. The results were as follows; 68.0% industry foodservice managers were educated about HACCP concept, 33.8% didn't understand the concept, and only 13.4% understood the concept fully. On the application of HACCP program to the foodservice operation, 15.0% of managers always applied HACCP program, 35.4% often, and 49.6% did not. The reasons for not applying HACCP were the ignorance HACCP implementation method(36.7%), poor facilities of foodservice operations(34.7%), shortage of time(l4.3%), and difficult of HACCP principles(6.1%). The mean score of HACCP knowledge for all manager was 64.1, in which the educated manager showed significantly higher score than noneducated CP(0.01). The ratio of correct answers concerning HACCP was 80.5% for the pre-preparation stage, 60.3% for the receiving and storage stage, 57.0% for the hot and cold holding stage, 54.5% for the facilities sanitation stage, and 46.0% for the preparation stage. The mean score of HACCP knowledge was positively correlated with understanding of HACCP program as well as the application. Also, the implementation of HACCP program was positively correlated with the understanding of HACCP.

• Journal of Gastric Cancer
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• 제19권2호
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• pp.183-192
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• 2019

Purpose: Due to adverse events, dose reduction or withdrawal of adjuvant chemotherapy is required for some patients. To identify the predictive factors for tolerability to postoperative adjuvant S-1 monotherapy in gastric cancer (GC) patients, we evaluated the predictive values of blood indicators. Materials and Methods: We analyzed 98 patients with pStage II/III GC who underwent postoperative adjuvant S-1 monotherapy. We retrospectively analyzed correlations between 14 parameters obtained from perioperative routine blood tests to assess their influence on the withdrawal of postoperative adjuvant S-1 monotherapy, within 6 months after discontinuation. Results: Postoperative adjuvant chemotherapy was discontinued in 21 patients (21.4%) within 6 months. Univariable analysis revealed that high preoperative albumin-bilirubin (ALBI) scores had the highest odds ratio (OR) for predicting the failure of adjuvant S-1 chemotherapy (OR, 6.47; 95% confidence interval [CI], 2.08-20.1; cutoff value, -2.696). The high ALBI group had a significantly shorter time to failure of postoperative adjuvant S-1monotherapy (hazard ratio, 3.48; 95% CI, 1.69-7.25; P=0.001). Multivariable analysis identified high preoperative ALBI score as an independent prognostic factor for tolerability (OR, 10.3; 95% CI, 2.33-45.8; P=0.002). Conclusions: Preoperative ALBI shows promise as an indicator associated with the tolerability of adjuvant S-1 monotherapy in patients with pStage II/III GC.

• 한방안이비인후피부과학회지
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• 제34권2호
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• pp.53-69
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• 2021

Objectives : The purpose of this study is to analyze the effects of treatment between Western medicine and Korean medicine on Allergic rhinitis patients using national population-based claim data from the Health Insurance Review and Assessment Service. Methods : The subjects of the study were 30,024 patients in the Korean medicine group and 30,024 in the Western medicine group who were diagnosed with Allergic rhinitis from September 1, 2018 to December 31, 2018. Propensity score analysis was used for matching age, sex, etc. at a ratio of 1:1. Cox regression and subgroup analysis were used to estimate the adjusted hazard ratio of recurrence, Asthma, and Atopic dermatitis in Korean medicine group and Western medicine group. In addition, the total treatment period, total treatment cost, and average cost per day of visit were compared and analyzed. Results : Compared to Korean medicine, Western medicine had a significantly higher risk of recurrence at 1.701 times, Asthma occurrence risk at 1.609 times and Atopic dermatitis occurrence risk at 1.098 times. Compared to Western medicine, the total treatment period of Korean medicine was 14.27 days longer, the total treatment cost was 53,591 won more, and the average cost per day was 7,539 won more. Conclusions : This study is a retrospective cohort study using the propensity score matching in Korea to compare the outcomes of Allergic rhinitis between Western medicine and Korean medicine. Further research is needed by considering patients characteristics, and linking with additional data.

• Journal of Gastric Cancer
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• 제22권1호
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• pp.56-66
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• 2022

Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19-12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90-19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26-8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.

• Safety and Health at Work
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• 제11권4호
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• pp.543-549
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• 2020

Background: The working conditions of bus drivers are difficult; they lead to occupational diseases and require careful study, particularly in Ukraine. The objective of the article is the description of occupational health risks of passenger bus drivers that lead to deteriorating health. Methods: The risk assessment was performed using a modified Risk Score method, which allowed determining the generalized level of danger to the driver's health. The hygienic hazards level was assessed as based on Stevenson's law, which was generalized later. Results: Based on the modification of the Risk Score method, it was possible to depart from expert assessments method of the risk level and calculate the general indicator based on the degree of dependence of the impact on the human body on its intensity, proposed by V. Minko. This allows objective determining of the impact of hygiene hazards on the health of the driver and to predict the occurrence of occupational diseases associated with the cardiovascular system, musculoskeletal system, and partial or complete disability due to the accumulation of emotional fatigue. The hazard assessment was carried out for three brands of passenger buses common in Ukraine, in which the driver is exposed to the dangers of fever, vibration, noise, harmful impurities in the bus cabin, and emotional load. Conclusion: The health of drivers in the cabins of passenger buses is most affected by hygiene hazards: fever, vibration, and emotional stress. The generalized level of risk is calculated by the modified method of Risk Score is 0.83; -0.99, -0.92 respectively.

• 한국산림과학회지
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• 제103권2호
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• pp.233-239
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• 2014

본 연구는 지역산림지역을 중심으로 수량화이론을 이용하여 산사태 발생면적에 영향을 미치는 인자를 도출하여 각 인자의 기여도 분석을 통해 산사태 발생 위험성에 대한 예측기준을 마련하고, 그 기준을 평가하였다. 산사태 발생지 붕괴면적에 영향을 미치는 인자는 모암(화성암), 횡단사면(복합), 침엽수림(임상), 사면경사($21{\sim}30^{\circ}$ 이상)이었다. 각 인자의 Range를 추정한 결과, 횡단사면 (0.2922)이 가장 높게 나타났고, 다음으로는 모암(0.2691), 임상(0.2631), 사면경사(0.2312)순으로 나타났다. 산사태 발생 위험도 판정표를 기준으로 4개 인자의 category별 점수를 계산한 추정치 범위는 0 점에서 1.0556 점 사이에 분포하고 있으며, 중앙값은 0.5278 점이었다. I 등급의 점수는 0.7818 이상, II 등급은 0.5279~7917, III 등급은 0.2694~0.5278, IV 등급은 0.2693 이하로 나타났다. 1 등급 및 2 등급에서 산사태 발생 비율이 72%로서 비교적 높은 적중률을 보였다. 따라서 본 판정표는 산사태 위험도 판정에 활용 가능한 것으로 판단된다.