• Clinical and Experimental Reproductive Medicine
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• 제24권2호
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• pp.153-165
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• 1997

In male reproducible health, fertility and IVF (in-vitro fertilization), semen analysis has been most important. Semen analysis can be divided into concentration, motional and morphological analysis of sperm. The existing method which was developed earlier to analyze semen concentrated on the sperm motility analysis. To provide more useful and precise solutions for clinical problems such as infertility, semen analysis must include sperm morphological analysis. But the traditional tools for semen analysis are subjective, imprecise, inaccurate, difficult to standardize, and difficult to reproduce. Therefore, with the help of development of microcomputers and image processing techniques, we developed a new sperm morphology analyzer to overcome these problems. In this study the agreement on percent normal morphology was studied between different observers and a computerized sperm morphology analyzer on a slide-by-slide basis using strict criteria. Slides from 30 different patients from the SNUH andrology laboratory were selected randomly. Microscopic fields and sperm cells were chosen randomly and percent normal morphology was recorded. The ability of sperm morphology analyzer to repeat the same reading for normal and abnormal cells was studied. The results showed that there was no significant bias between two experienced observers. The limits of agreement were 4.1%${\sim}$-3.8%. The Pearson correlation coefficient between readers was 0.79. Between the manual and sperm morphology analyzer, the same findings were reported. In this experiments the slides were stained by two different methods, PAP and Diff-Quik staining methods. The limits of agreement were 7.2%${\sim}$-5.7% and 6.0%${\sim}$-6.3%, respectively. The Pearson correlation coefficients ware 0.76 and 0.91, respectively. The limits of agreement was tighter below 20% normal forms. In the experiments of repeatability, 52 cells stained by PAP and Diff-Quik staining methods were analyzed three times in succession. Estimating pairwise agreement, the kappa statistic for the pairs were 0.76, 0.81, 0.86, and 0.75, 0.88, 0.88 respectively. In this study it was shown that there was good agreement between manual and computerized assessment of normal and abnormal cells. The repeatability and agreement per slide of computerized sperm morphology analyzer was excellent. The computer's ability to classify normal morphology per slide is promising. Based on results obtained, this system can be of clinical value both in andrology laboratories and IVF units.

• 대한지역사회영양학회지
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• 제26권4호
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• pp.280-295
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• 2021

Objectives: This study aimed to examine the characteristics of patients according to their nutritional status as assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 at the Samsung Medical Center were included. We categorized patients into malnourished and normal according to the five nutritional screening tools 1 month after surgery and compared their characteristics. We also calculated the Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each pair of screening tools. Results: We observed 86.24% malnutrition based on the PG-SGA and 85.82% based on the NUTRISCORE among gastric cancer patients in our study. When we applied NRI or CONUT, however, the malnutrition levels were less than 30%. Patients with malnutrition as assessed by the PG-SGA, NUTRISCORE, or NRI had lower intakes of energy and protein compared to normal patients. When NRI, PNI, or CONUT were used to identify malnutrition, lower levels of albumin, hemoglobin, total lymphocyte count, total cholesterol, and longer postoperative hospital stays were observed among patients with malnutrition compared to those without malnutrition. We found relatively high agreement between PG-SGA and NUTRISCORE; sensitivity was 90.86% and AUC was 0.78. When we compared NRI and PNI, sensitivity was 99.64% and AUC was 0.97. AUC ranged from 0.50 to 0.67 for comparisons between CONUT and each of the other nutritional screening tools. Conclusions: Our study suggests that PG-SGA and NRI have a relatively high agreement with the NUTRISCORE and PNI, respectively. Further cohort studies are needed to examine whether the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• 대한원격탐사학회지
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• 제37권3호
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• pp.503-514
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• 2021

쌀 수급 조절 정책의 합리적 수립을 지원하기 위해서는 벼 재배면적의 조기 추정이 필요하다. 본 연구는 국내 벼 주산지인 김제시를 대상으로 Sentinel-1 위성영상을 활용하여 이앙이 마무리되는 7월 초순 벼 재배면적을 조기에 추정하기 위해 최적의 훈련자료 수집을 위한 무인기(UAV) 영상 활용 방안을 제시하고자 수행하였다. 5월부터 7월 초까지 수집한 Sentinel-1 위성영상은 ESA에서 제공하는 SNAP(SeNtinel application platform, Version 8.0)프로그램으로 전처리하고 팜맵을 활용하여 농경지만을 추출하였다. 벼 재배지 중심 지역과 벼·콩 혼재지 무인기 영상 촬영 영역을 혼합하여 훈련자료로 선정하여 김제시 전체 벼 재배지를 추정한 결과, 정확도와 카파 계수는 각각 89.9%, 0.774로 가장 좋은 결과를 보였는데, 이는 김제시 전역을 대상으로 무작위 표본조사를 수행하여 분류한 결과와 비교 시 전체 정확도 1% 내외, 카파 계수 0.02~0.04 범위에서 차이를 보여 벼 재배지 조기 추정을 위한 무인기 영상 활용 가능성을 확인할 수 있었다.

• 대한지역사회영양학회지
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• 제27권3호
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• pp.205-222
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• 2022

Objectives: This study examined the characteristics of patients according to nutritional status assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 were included. The patients were categorized into malnutrition and normal status according to five nutritional screening tools one month after surgery. The Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each two screening tools were calculated. Results: Malnutrition was observed in 86.24% of patients based on the PG-SGA and 85.82% based on the NUTRISCORE. When NRI or CONUT were applied, the proportions of malnutrition were < 30%. Patients with malnutrition had lower intakes of energy and protein than normal patients when assessed using the PG-SGA, NUTRISCORE, or NRI. Lower levels of albumin, hemoglobin, total lymphocyte count, and total cholesterol and longer postoperative hospital stays were observed among patients with malnutrition compared to normal patients when NRI, PNI, or CONUT were applied. Relatively high agreement for NUTRISCORE relative to PG-SGA was found; the sensitivity was 90.86%, and the AUC was 0.78. When NRI, PNI, and CONUT were compared, the sensitivities were 23.72% for PNI relative to NRI, 44.53% for CONUT relative to NRI, and 90.91% for CONUT relative to PNI. The AUCs were 0.95 for NRI relative to PNI and 0.91 for CONUT relative to PNI. Conclusions: NUTRISCORE had a high sensitivity compared to PG-SGA, and CONUT had a high sensitivity compared to PNI. NRI had a high specificity compared to PNI. This relatively high sensitivity and specificity resulted in 77.00% agreement between PNI and CONUT and 77.94% agreement between NRI and PNI. Further cohort studies will be needed to determine if the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• 한국산림과학회지
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• 제112권3호
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• pp.267-279
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• 2023

본 연구는 IPCC에서 제시하고 있는 Approach 3 수준의 토지이용 및 토지피복 면적 추정을 위해 고해상도 항공사진에 딥러닝 알고리즘과 Sampling method를 적용하였으며, 표본강도에 따라 토지피복 면적을 산출하고 최적의 표본강도를 도출하는 것을 목적으로 하였다. 원격탐사자료로는 51 cm급의 고해상도 칼라 항공 이미지를 사용하였으며, 딥러닝 알고리즘은 전이 학습이 적용된 VGG16 아키텍처를 활용하였다. 딥러닝 기반 토지피복 분류모델의 학습과 검증은 육안판독을 통해 선별된 데이터를 이용하였다. 최적의 표본강도를 도출하기 위한 평가는 7개의 표본강도(4 × 4 km, 2 × 4 km, 2 × 2 km, 1 × 2 km, 1 × 1 km, 500 × 500 m, 250 × 250 m)에 따른 토지이용 및 토지피복 면적을 추정하고 환경부에서 제시한 토지피복지도와 비교하였다. 본 연구 결과, 딥러닝 기반의 토지피복 분류 모델의 전체정확도와 카파계수는 각각 91.1% 와 88.8%였다. F-Score는 초지를 제외한 모든 범주가 90% 이상으로 구축되어 모델의 정확도가 우수하였다. 표본강도별 적합도 검정은 유의수준 0.1에서 4 × 4 km를 제외한 모든 표본강도에서 환경부에서 제시한 토지피복지도의 면적 비율과 유의한 차이를 보이지 않았다. 또한, 표본강도가 증가할수록 상대표준오차와 상대효율은 감소하였으며, 상대표준오차는 1 × 1 km 표본강도에서 모든 토지피복범주가 15% 이하로 감소하였다. 따라서, 지역 단위의 토지피복 면적 산정을 위해서는 표본강도를 1 × 1 km보다 상세하게 설정하는 것이 적합하다고 판단된다.

• 심성연구
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• 제33권1호
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• pp.61-80
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• 2018

본 연구는 그레이-휠라이트 검사의 문항들이 융의 유형론의 개념을 잘 반영하는지 알아보고 그 결과를 바탕으로 개선된 단축형 그레이-휠라이트 검사를 만든 것이다. 총 431명의 사람들이 연구에 참여하여 그레이-휠라이트 검사를 실시하였고 최우도법(Maximum likelihood)과 Varimax 회전법을 이용한 요인분석을 통해 그 결과를 분석하였다. 그레이-휠라이트의 81개 문항들을 요인분석에서 추출한 요인으로 분류하고 분류된 요인들이 융의 유형 척도와 일치하는지를 살펴보았다. 요인들과 일치하지 않거나 주요 요인에 포함되지 않은 문항들을 제외하고 남은 45개의 문항들로 단축형 그레이-휠라이트 검사를 제작하였다. 급내상관계수로 평가한 단축형 그레이-휠라이트 검사의 검사-재검사 신뢰도와 Cronbach's α 계수로 평가한 단축형 그레이-휠라이트 검사의 내적일치도는 원 그레이-휠라이트 검사의 결과와 대등한 수준이었다. 급내상관계수와 Cohen's weighted kappa로 각각 평가한 단축형 검사와 원 검사의 일치도 역시 매우 높았다. 단축형 그레이-휠라이트 검사는 적은 수의 문항으로 검사에 소요되는 시간과 노력을 줄이면서도 융의 유형론에 기반한 성격 유형을 잘 측정하고 있어 향후 임상에서 단축형 그레이-휠라이트 검사의 활용도를 높일 수 있을 것으로 기대한다.

• Korean Journal of Radiology
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• 제25권3호
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• pp.267-276
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• 2024

Objective: To evaluate the diagnostic performance of susceptibility map-weighted imaging (SMwI) taken in different acquisition planes for discriminating patients with neurodegenerative parkinsonism from those without. Materials and Methods: This retrospective, observational, single-institution study enrolled consecutive patients who visited movement disorder clinics and underwent brain MRI and ¹⁸F-FP-CIT PET between September 2021 and December 2021. SMwI images were acquired in both the oblique (perpendicular to the midbrain) and the anterior commissure-posterior commissure (AC-PC) planes. Hyperintensity in the substantia nigra was determined by two neuroradiologists. ¹⁸F-FP-CIT PET was used as the reference standard. Inter-rater agreement was assessed using Cohen;s kappa coefficient. The diagnostic performance of SMwI in the two planes was analyzed separately for the right and left substantia nigra. Multivariable logistic regression analysis with generalized estimating equations was applied to compare the diagnostic performance of the two planes. Results: In total, 194 patients were included, of whom 105 and 103 had positive results on ¹⁸F-FP-CIT PET in the left and right substantia nigra, respectively. Good inter-rater agreement in the oblique (κ = 0.772/0.658 for left/right) and AC-PC planes (0.730/0.741 for left/right) was confirmed. The pooled sensitivities for two readers were 86.4% (178/206, left) and 83.3% (175/210, right) in the oblique plane and 87.4% (180/206, left) and 87.6% (184/210, right) in the AC-PC plane. The pooled specificities for two readers were 83.5% (152/182, left) and 82.0% (146/178, right) in the oblique plane, and 83.5% (152/182, left) and 86.0% (153/178, right) in the AC-PC plane. There were no significant differences in the diagnostic performance between the two planes (P > 0.05). Conclusion: There are no significant difference in the diagnostic performance of SMwI performed in the oblique and AC-PC plane in discriminating patients with parkinsonism from those without. This finding affirms that each institution may choose the imaging plane for SMwI according to their clinical settings.

• Korean Journal of Radiology
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• 제20권4호
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• pp.641-648
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• 2019

Objective: The purpose of this study was to investigate whether three-dimensional (3D) magnetic resonance imaging could improve diagnostic accuracy for suspected posterior ligamentous complex (PLC) disruption. Materials and Methods: We used 20 freshly harvested goat spine samples with 60 segments and intact surrounding soft tissue. The animals were aged 1-1.5 years and consisted of 8 males and 12 females, which were sexually mature but had not reached adult weights. We created a paraspinal contusion model by percutaneously injecting 10 mL saline into each side of the interspinous ligament (ISL). All segments underwent T2-weighted sagittal and coronal short inversion time inversion recovery (STIR) scans as well as coronal and sagittal 3D proton density-weighted spectrally selective inversion recovery (3D-PDW-SPIR) scans acquired at 1.5T. Following scanning, some ISLs were cut and then the segments were rescanned using the same magnetic resonance (MR) techniques. Two radiologists independently assessed the MR images, and the reliability of ISL tear interpretation was assessed using the kappa coefficient. The chi-square test was used to compare the diagnostic accuracy of images obtained using the different MR techniques. Results: The interobserver reliability for detecting ISL disruption was high for all imaging techniques (0.776-0.949). The sensitivity, specificity, and diagnostic accuracy of the coronal 3D-PDW-SPIR technique for detecting ISL tears were 100, 96.9, and 97.9%, respectively, which were significantly higher than those of the sagittal STIR (p = 0.000), coronal STIR (p = 0.000), and sagittal 3D-PDW-SPIR (p = 0.001) techniques. Conclusion: Compared to other MR methods, coronal 3D-PDW-SPIR provides a more accurate diagnosis of ISL disruption. Adding coronal 3D-PDW-SPIR to a routine MR protocol may help to identify PLC disruptions in cases with nearby contusion.

• The Journal of Advanced Prosthodontics
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• 제16권4호
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• pp.244-254
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• 2024

PURPOSE. This study aimed to evaluate the reliability and validity of a four-item questionnaire using a face rating scale to measure dental trait anxiety (DTA), dental trait fear (DTF), dental state anxiety (DSA), and dental state fear (DSF). MATERIALS AND METHODS. Participants were consecutively selected from patients undergoing scaling (S-group; n = 47) and implant placement (I-group; n = 25). The S-group completed the questionnaire both before initial and second scaling, whereas the I-group responded on the pre-surgery day (Pre-day), the day of implant placement (Imp-day), and the day of suture removal (Post-day). RESULTS. The reliability in the S-group was evaluated using the test-retest method, showing a weighted kappa value of DTA, 0.61; DTF, 0.46; DSA, 0.67; DSF, 0.52. Criterion-related validity, assessed using the State-Trait Anxiety Inventory's trait anxiety and state anxiety, revealed positive correlations between trait anxiety and DTA/DTF (DTA, ρ = 0.30; DTF, ρ = 0.27, ρ: correlation coefficient) and between state anxiety and all four items (DTA, ρ = 0.41; DTF, ρ = 0.32; DSA, ρ = 0.25; DSF, ρ = 0.25). Known-group validity was assessed using the initial data and Imp-day data from the S-group and I-group, respectively, revealing significantly higher DSA and DSF scores in the I-group than in the S-group. Responsiveness was gauged using I-group data, showing significantly lower DSA and DSF scores on post-day compared to other days. CONCLUSION. The newly developed questionnaire has acceptable reliability and validity for clinical use, suggesting its usefulness for research on dental anxiety and fear and for providing patient-specific dental care.

• Journal of Preventive Medicine and Public Health
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• 제31권1호
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• pp.49-58
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• 1998

부산지역의 공무원 및 사립학교 교직원 의료보험관리공단의 피부양자중 65세 이상인 16,524명에 대하여 생활습관에 대한 설문서를 발송하여 이중 9,139명으로부터 설문서를 회수하였다. 본 연구는 여기에 사용된 설문서의 신뢰도를 평가하기 위하여 이중 200명을 단순 무작위 표본추출하여 다시 설문서를 발송하였으며 회수된 설문서 110건에 대하여 항목별, 응답자별 신뢰도를 평가하였다. 1) 본인이 두 번 모두 응답한 경우에 있어서 대부분의 항목이 0.6이상의 신뢰도 계수를 가졌으나, '산보', '정원일', '맨손체조', '활동상태'와 같은 육체적 활동과 관계 있는 항목의 일부에 있어서는 낮은 신뢰도를 보였다. 반면 현재의 '현재까지의 흡연여부', '현재까지의 흡연량', '3년전의 흡연여부', '지난 1년간의 음주량', '3년전의 음주량' 등의 흡연 및 음주와 관련있는 항목과 '키', '몸무게', '체격그림'과 같은 체격과 관련 있는 항목, '폐경나이', '낳은 아이의 수'와 같은 산부인과력의 일부항목 등에서는 높은 신뢰도를 보였다. 2) 한번은 본인이 다른 한번은 대리응답자가 응답을 한 32건에 대하여 신뢰도 계수를 계산하였다. 두 번 다 본인이 응답한 경우에 비하여 신뢰도 계수가 크게 하락한 항목은 '청소', '주관적 건강상태', '첫아이를 낳은 나이', '폐경나이', '맵게 먹는 정도', '육식선호정도', '야간수면시간' 등이었으며 본인이 두 번 응답한 경우에 비하여 본인-대리응답에서 신뢰도계수가 더 높게 나타난 항목은 '3년전의 음주여부', '3년전의 홉연량', '산보', '정원일', '활동상태' 등이었다. 3) 응답자의 성별 타당도 분석결과 식생활과 관련된 항목에서는 여자보다 남자에서 타당도가 높았고, '약수터 가기', '정원일', '산보' 등의 일일 활동과 관련된 항목과 음주, 흡연 등의 항목에서는 여자에서 타당도가 높았다. 4) 대리응답자가 가질 수 있는 비뚤림을 파악하기 위하여 쌍체분석을 실시하였다. 분석대상은 본인과 자녀가 번갈아 응답한 19건에 제한하였다. '청소'와 '부엌일'에서 본인의 응답이 자녀의 응답보다 빈도가 더 높은 것으로 나타났다. '키'항목에서는 자녀보다 본인의 응답이 키가 더 작은 것으로 나타났다.