• The Korean journal of internal medicine
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• 제39권3호
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• pp.477-487
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• 2024

Background/Aims: Risk factors for progression to critical illness in hospital-acquired coronavirus disease 2019 (COVID-19) remain unknown. Here, we assessed the incidence and risk factors for progression to critical illness and determined their effects on clinical outcomes in patients with hospital-acquired COVID-19. Methods: This retrospective cohort study analyzed patients admitted to the tertiary hospital between January 2020 and June 2022 with confirmed hospital-acquired COVID-19. The primary outcome was the progression to critical illness of hospital-acquired COVID-19. Patients were stratified into high-, intermediate-, or low-risk groups by the number of risk factors for progression to critical illness. Results: In total, 204 patients were included and 37 (18.1%) progressed to critical illness. In the multivariable logistic analysis, patients with preexisting respiratory disease (OR, 3.90; 95% CI, 1.04-15.18), preexisting cardiovascular disease (OR, 3.49; 95% CI, 1.11-11.27), immunocompromised status (OR, 3.18; 95% CI, 1.11-9.16), higher sequential organ failure assessment (SOFA) score (OR, 1.56; 95% CI, 1.28-1.96), and higher clinical frailty scale (OR, 2.49; 95% CI, 1.62-4.13) showed significantly increased risk of progression to critical illness. As the risk of the groups increased, patients were significantly more likely to progress to critical illness and had higher 28-day mortality. Conclusions: Among patients with hospital-acquired COVID-19, preexisting respiratory disease, preexisting cardiovascular disease, immunocompromised status, and higher clinical frailty scale and SOFA scores at baseline were risk factors for progression to critical illness. Patients with these risk factors must be prioritized and appropriately isolated or treated in a timely manner, especially in pandemic settings.

• 대한한방내과학회지
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• 제28권4호
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• pp.830-837
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• 2007

Background and purpose : Stroke is one of the most deadly diseases and a leading cause of disability. Lipids confer an increased risk for cardiovascular morbidity and mortality. In spite of many studies on the relationship between stroke and lipids, their relationship is not clear. This study was undertaken to determine whether lipids were associated with stroke. Method : We compared the components of blood lipids between stroke patients group (n=217,Cases), non-stroke control group (n=160, Controls) and healthy control group without hypertension, diabetes mellitus, ischemic heart disease, or hyperlipidemia (n=140, Normals). These data were statically analyzed by general linear models and binary logistic regression analysis to get each adjusted odds ratio. Result : The results were as follows. The blood levels of total cholesterol (T-Chol), triglyceride (TG) and low density lipoprotein cholesterol (LDL-Chol) were significantly higher in patients of ischemic stroke, while the blood levels of T-Chol and LDL-Chol were significantly lower, and the blood levels of TG significantly higher in patients of hemorrhagic stroke. The blood level of high density lipoprotein cholesterol (HDL-Chol) was significantly lower in all cases. Conclusion : These results suggest that high TG and low HDL-Chol may be risk factors of hemorrhagic stroke and ischemic stroke, high T-Chol and LDL-Chol may be risk factors of ischemic stroke, and low T-Chol and LDL-Chol may be risk factors of hemorrhagic stroke in Koreans.

• Nutrition Research and Practice
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• 제9권2호
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• pp.165-173
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• 2015

BACKGROUND/OBJECTIVES: This study addressed the question whether the composition of supposedly 'healthy' or 'unhealthy' dietary regimes has a calorie-independent short-term effect on biomarkers of metabolic stress and vascular risk in healthy individuals. SUBJECTS/METHODS: Healthy male volunteers (age $29.5{\pm}5.9years$, n = 39) were given a standardized baseline diet for two weeks before randomization into three groups of different dietary regimes: fast food, Mediterranean and German cooking style. Importantly, the amount of calories consumed per day was identical in all three groups. Blood samples were analyzed for biomarkers of cardiovascular risk and metabolic stress after two weeks of the baseline diet and after two weeks of the assigned dietary regime. RESULTS: No dietary intervention affected the metabolic or cardiovascular risk profile when compared in-between groups or compared to baseline. Subjects applied to the Mediterranean diet showed a statistically significant increase of uric acid compared to baseline and compared to the German diet group. Plasma concentrations of urea were significantly higher in both the fast food group and the Mediterranean group, when compared to baseline and compared to the German diet group. No significant differences were detected for the levels of vitamins, trace elements or metabolic stress markers (8-hydroxy-2-deoxyguanosine, malondialdehyde and methylglyoxal, a potent glycating agent). Established parameters of vascular risk (e.g. LDL-cholesterol, lipoprotein(a), homocysteine) were not significantly changed in-between groups or compared to baseline during the intervention period. CONCLUSIONS: The calorie-controlled dietary intervention caused neither protective nor harmful short-term effects regarding established biomarkers of vascular or metabolic risk. When avoiding the noxious effects of overfeeding, healthy individuals can possess the metabolic capacity to compensate for a potentially disadvantageous composition of a certain diet.

• 한국건축시공학회지
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• 제16권6호
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• pp.519-527
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• 2016

최근 건설 기업들이 질적 성장을 필요로 하면서 리스크 분석 요구가 증가하고 있다. 하지만 건설 현장의 정량적인 데이터를 활용하여 손해 범위로 리스크 분류를 진행하는 연구는 미비한 실정이다. 따라서 본 연구에서는 건설 현장의 사고원인에 따른 내 외부 리스크 핵심 요인을 분석하는 것을 목표로 한다. 이를 위해 본 연구에서는 A보험사에서 실제 12년간 발생된 사고 데이터를 329개 수집하였다. 우선 수집한 데이터를 토대로 내 외부 발생 위험도에 따른 사고 원인별 중요도 차이를 분석하기 위해 RPN 기법을 수행하였다. 또한, 이러한 차이가 유의미한지를 분석하기 위해 T-test분석을 활용하여 내 외부 발생 위험도 간의 피해율 차이를 검증하였다. 그 결과, 내 외부 발생 위험도 간의 차이는 유의미한 것으로 나타났으며, 특히 480억 미만의 건설 현장의 사고에서는 시공결함과 진동 소음 먼지가, 480억 이상의 대규모 건설 프로젝트의 현장에서는 호우, 태풍이 주요사고 원인으로 이에 대한 대처 방안이 필요한 것으로 나타났다. 본 연구의 결과는 향후 건설 공사 현장에서 리스크 관리를 수행할 때, 내 외부에 따른 체계적인 리스크 식별 데이터로 활용이 가능할 것으로 기대된다.

• 한국방재학회 논문집
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• 제10권4호
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• pp.105-117
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• 2010

도시지역의 지형적인 저지대, 배수능력 부족, 하수역류 노면배수 등은 내수침수의 주요원인이며 최근 기후변화에 따른 강우증가, 경제발전과 인구증가에 따른 급격한 도시화, 도시지역 불투수 면적의 증가는 도시지역 내수침수의 위험성을 가중시키고 있다. 이에 본 연구는 도시지역의 내수침수 위험도 분석을 위하여 부산시 대표 도시하천인 온천천을 대상유역으로 하여 SWMM 모형을 구축하고 각 소유역의 대표 우수관을 선정하여 강우에 의한 도시하천 내수침수 위험 취약성 분석을 실시하였다. 침수위험 취약성 분석을 위하여 SWMM모형 내 관거의 용량을 나타내는 지표인 Capacity를 이용하였으며 Capacity에 따라 내수침수 위험도를 1단계에서 4단계로 구분하였다. 내수침수 위험도 분석은 2009년 7월 7일 부산시 집중호우에 의한 실제침수 구역과 SWMM 모형의 모의에 의한 결과를 비교 분석하여 모형의 타당성을 입증하고 부산지점 빈도별(10, 20, 50, 100년) 지속시간별(6, 12, 18, 24hr) 확률강우량을 입력하여 내수침수 위험 취약성 분석을 실시하였다. 본 연구의 결과는 도시지역의 내수침수 예경보 및 내수침수 취약지구 선정에 활용가능할 것이다.

• Korean Circulation Journal
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• 제54권6호
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• pp.354-356
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• 2024

• Industrial Engineering and Management Systems
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• 제9권2호
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• pp.121-130
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• 2010

In today's uncertain economic environment, economic risk is inherent in making large investments on manufacturing facilities. It is, therefore, practically meaningful to divide investment over multiple periods, reducing the risk of investment. Then, the cash-flow over the entire planning horizon would comprise positive inflow and negative outflow. In this case, in general, evaluation by internal rate of return (IRR) is not feasible, because multiple IRRs are involved. This paper deals with a problem of evaluating profitability, as well as risk, of investment alternatives made in multiple times of investment over the entire horizon. Typically, an additional investment is required after the initial one, for expanding manufacturing capacity or other reasons. The paper pays attention to a unit cash-flow over two periods, decomposing the total cash-flow into a series of unit cash-flow patterns. It is easy to evaluate profitability of a unit cash-flow by using IRR. The total cash-flow can be decomposed into the series of two types of unit cash-flows: an investment type one (negative-positive) and the borrowing type one (positive-negative). This paper, therefore, proposes a method in which only the borrowing type unit cash-flow is eliminated in the series by converting total cash-flow using capital interest rate. Then, a unique IRR can be obtained and the profitability is evaluated. Thus, the paper extends the method of IRR so that it may help decision making in complicated cash-flow pattern observed in practice.

• Genomics & Informatics
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• 제8권4호
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• pp.194-200
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• 2010

The PIK3CA gene, oncogenic gene located on human chromosome 3q26.3, is an important regulator of cell proliferation, death, motility and invasion. To evaluate the role of PIK3CA gene in the risk of Korean lung cancer, genotypes of the PIK3CA polymorphisms (rs11709323, rs2699895, rs3729679, rs17849074 and rs1356413) were determined in 423 lung cancer patients and 443 normal controls. Statistical analyses revealed that the genotypes and haplotypes in the PIK3CA gene were not significantly associated with the risk of lung cancer in the Korean population, suggesting that these PIK3CA polymorphisms do not contribute to the genetic susceptibility to lung cancer in the Korean population.

• Tuberculosis and Respiratory Diseases
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• 제74권3호
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• pp.111-119
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• 2013

Background: Hemoptysis due to pulmonary tuberculosis (TB) frequently develops in Korea where the prevalence of TB is intermediate. The effect of bronchial artery embolization (BAE) on the control of massive hemoptysis has been well known. This study is designed to identify the risk factors contributing to rebleeding after BAE in patients with TB. Methods: We retrospectively evaluated risk factors and the time for rebleeding after BAE in 72 patients presenting with hemoptysis. Results: The overall immediate success rate of BAE was 93.1% (67 of 72 patients). Of the 29 patients (40.3%) who showed rebleeding after BAE, 13 patients experienced rebleeding within 1 month, and 14 patients between 1 month to 1 year. The existence of a shunt in angiographic finding, aspergilloma, and diabetes mellitus were risk factors of rebleeding after BAE in multivariate analysis. Conclusion: BAE was very effective for obtaining immediate bleeding control in hemoptysis associated with active TB or post-TB sequelae. It is important to observe whether or not rebleeding occurs up to 1 year of BAE especially in TB patients with aspergilloma, DM, or a shunt. Even rebleeding can be managed well by second BAE.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10209-10215
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• 2015

To assess the contribution of tumor necrosis factor $(TNF){\beta}$ +252 polymorphisms to risk and prognosis of hepatocellular carcinoma (HCC), we enrolled 150 pairs of sex- and age-matched patients with HCC, patients with cirrhosis alone, and unrelated healthy controls. $TNF{\beta}$ +252 genotypes were determined by polymerase chain reaction with restriction fragment length polymorphism. Multivariate analysis indicated that $TNF{\beta}$ G/G genotype [odds ratio (OR), 3.64; 95%CI, 1.49-8.91], hepatitis B surface antigen (OR, 16.38; 95%CI, 8.30-32.33), and antibodies to hepatitis C virus (HCV) (OR, 39.11; 95%CI, 14.83-103.14) were independent risk factors for HCC. There was an additive interaction between $TNF{\beta}$ G/G genotype and chronic hepatitis B virus (HBV)/HCV infection (synergy index=1.15). Multivariate analysis indicated that factors associated with $TNF{\beta}$ G/G genotype included cirrhosis with Child-Pugh C (OR, 4.06; 95%CI, 1.34-12.29), thrombocytopenia (OR, 6.55; 95%CI, 1.46-29.43), and higher serum ${\alpha}$-fetoprotein concentration (OR, 2.53; 95%CI, 1.14-5.62). Patients with $TNF{\beta}$ G/G genotype had poor cumulative survival (p=0.005). Cox proportional hazard model indicated that $TNF{\beta}$ G/G genotype was a biomarker for poor HCC survival (hazard ratio, 1.70; 95%CI, 1.07-2.69). In conclusion, there are independent and additive effects between $TNF{\beta}$ G/G genotype and chronic HBV/HCV infection on risk for HCC. It is a biomarker for poor HCC survival. Carriage of this genotype correlates with disease severity and advanced hepatic fibrosis, which may contribute to a higher risk and poor survival of HCC. Chronic HBV/HCV infected subjects with this genotype should receive more intensive surveillance for early detection of HCC.