• 한국콘텐츠학회논문지
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• 제13권8호
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• pp.250-257
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• 2013

본 연구는 삼척소재 유아의 보호자 사회경제적 지위와 구강보건행태에 따른 간식 섭취 실태를 조사하였다. 삼척소재 3개 유치원 148명의 유아 보호자에게 설문조사를 실시한 후 결과를 분석하였으며, 보호자 사회경제적 지위 및 구강보건행태와 유아의 간식섭취 실태의 관련성을 알아보기 위하여 카이제곱검정과 로지스틱회귀분석을 이용하여 분석하였다. 연구결과 당 포함 간식 섭취빈도와 보호자의 교육수준, 그리고 가정의 수입에서 의미 있는 관련성이 검토되었다(p<.05), 또한, 탄산(청량)음료 섭취와 보호자 연령, 가정 수입에 따른 차이가 검토되었다(p<.05). 유아의 간식섭취와 구강보건행태에서는 보호자가 칫솔질을 해주는지 여부와 과일섭취빈도에서 의미 있는 관련성이 발견되었다(p<.05). 유아 보호자 사회경제적 지위 및 구강보건행태와 유아의 간식섭취 실태의 관련성을 로지스틱회귀분석을 통해 살펴본 결과 과일섭취빈도는 보호자 교육수준이 낮을 때 더욱 높았다(2.98(CI:1.01-8.81)). 탄산음료 섭취빈도는 보호자의 연령이 20-29세 일 때(14.51(CI:1.20-176.08)) 가장 높은 것으로 조사되었다. 보상성 당 제공의 경우 보호자 교육수준이 낮을 때(0.18(CI:0.05-0.68) 적게 제공되는 것으로 검토되었다.

• 농촌계획
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• 제21권2호
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• pp.33-49
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• 2015

The objective of this study was to predict land use change based on the land use change scenarios for the Hwangguji river watershed, South Korea. The land use change scenario was derived from the representative concentration pathways (RCP) 4.5 and 8.5 scenarios. The CLUE (conversion of land use and its effects) model was used to simulate the land use change. The CLUE is the modeling framework to simulate land use change considering empirically quantified relations between land use types and socioeconomic and biophysical driving factors through dynamical modeling. The Hwangguji river watershed, South Korea was selected as study area. Future land use changes in 2040, 2070, and 2100 were analyzed relative to baseline (2010) under the RCP4.5 and 8.5 scenarios. Binary logistic regressions were carried out to identify the relation between land uses and its driving factors. CN (Curve number) and impervious area based on the RCP4.5 and 8.5 scenarios were calculated and analyzed using the results of future land use changes. The land use change simulation of the RCP4.5 scenario resulted that the area of urban was forecast to increase by 12% and the area of forest was estimated to decrease by 16% between 2010 and 2100. The land use change simulation of the RCP8.5 scenario resulted that the area of urban was forecast to increase by 16% and the area of forest was estimated to decrease by 18% between 2010 and 2100. The values of Kappa and multiple resolution procedure were calculated as 0.61 and 74.03%. CN (III) and impervious area were increased by 0-1 and 0-8% from 2010 to 2100, respectively. The study findings may provide a useful tool for estimating the future land use change, which is an important factor for the future extreme flood.

• 한국치위생학회지
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• 제12권3호
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• pp.521-531
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• 2012

Objectives : The aim of this study was to evaluate the relation between the state of dental health(number of natural teeth) and nutritional status of Korean elderly using Korean Dietary Reference Intakes, which was an objective standard for nutritional intake based on database of Korea National Health and Nutrition Examination Survey, large scale of sample obtained by the government. Methods : Complex sampling procedure was used to analyze the fourth data(2007-2009) of Korea National Health and Nutrition Examination Survey. When preparing planning file, the estimator of variance as a stratification variance (variance name : kstrata), population of survey unit as a cluster variance(variance name : PSU), and previous exam and nutritional related weighted as a weighted were analyzed by considering reproduced survey and nutritional related total weighted. Complex samples chi-square test was used to estimate the relation between number of natural teeth and inadequate intake and relation factors included in the model were analyzed by complex samples logistic regression analysis. Results : The group of edentulous had a higher risk to intake less nutrient, except calcium, riboflavin and vitamin C than recommended level comparing to reference group which had natural teeth more than 20(phosphate : OR=1.763; 95% CI=1.273-2.443, thiamine : OR=1.748; 95% CI=1.276-2.395, protein : OR=1.610; 95% CI=1.213-2.138). Conclusions : The number of teeth in Korean elderly over 65 years old had a relation with nutritional status in this investigation. Especially, intake level of nutrients was different between the edentulous group and the reference group. Therefore, dental health care is needed from young and middle age to keep health dental condition for through whole life as well as old age. Although the dental condition of the aged is not good, it is evitable to educate them about the relation between dental health and nutritional ingestion to take balanced nutrition, we think.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3223-3227
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• 2015

Objective: We evaluated the association of body mass index (BMI) with perioperative outcomes in patients who underwent laparoscopic or open radical nephroureterectomy. Materials and Methods: This retrospective single-center study included 113 patients who had been diagnosed with upper urinary tract cancer from January 1998 to June 2013 and were treated with laparoscopic nephroureterectomy (Lap group, n=60) or open nephroureterectomy (Open group, n=53). Laparoscopic nephroureterectomy was performed via a retroperitoneal approach following an open partial cystectomy. The two surgical groups were stratified into a normal-BMI group (<25) and a high-BMI group ($BMI{\geq}25$). The high-BMI group included 27 patients: 13 in the Lap group and 14 in the Open group. Results: Estimated blood loss (EBL) in the Lap group was much lower than that in the Open group irrespective of BMI (p<0.01). Operative time was significantly prolonged in normal-BMI patients in the Lap group compared to those in the Open group (p=0.03), but there was no difference in operative time between the Open and Lap groups among the high-BMI patients. Multivariate logistic regression analysis of the data for all the cohorts revealed that the open procedure was a significant risk factor for high EBL (p<0.0001, hazard ratio 8.02). Normal BMI was an independent predictor for low EBL (p=0.01, hazard ratio 0.25). There was no significant risk factor for operative time in multivariate analysis. There were no differences in blood transfusion rates or adverse event rates between the two surgical groups. Conclusions: Laparoscopic radical nephroureterectomy via a retroperitoneal approach can be safely performed with significantly reduced EBL even in obese patients with upper urinary tract cancer.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권4호
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• pp.229-238
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• 2017

Objectives: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. Materials and Methods: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study. The initial dose of MDZ was determined by body mass index (BMI) and weight. In the case of insufficient sedation at the beginning of surgery, additional doses were injected. During surgery, peripheral oxygen saturation, bispectral index score (BIS), heart rate, and blood pressure were monitored and recorded. The predictor variables were sex, age, BMI, sleeping time ratio, dental anxiety, Pederson scale, and initial dose of MDZ. The outcome variables were additional administration of MDZ, observer's assessment of alertness/sedation, intraoperative amnesia, and patient satisfaction. Descriptive statistics were computed, and the P-value was set at 0.05. Results: Most patients had an adequate level of sedation with only the initial dose of MDZ and were satisfied with the treatment under sedation; however, 19 patients needed additional administration, and 13 patients were unsatisfied. In multivariable logistic analysis, lower age (odds ratio [OR], 0.825; P=0.005) and higher dental anxiety (OR, 5.744; P=0.003) were related to additional administration; lower intraoperative amnesia (OR, 0.228; P=0.002) and higher BIS right before MDZ administration (OR, 1.379; P=0.029) had relevance to patient dissatisfaction. Conclusion: The preoperative consideration of age and dental anxiety is necessary for appropriate dose determination of MDZ in the minor oral surgery under IVS. The amnesia about the procedure affects patient satisfaction positively.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.152-158
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• 2012

Purpose: To understand the epidemiology of head trauma and the utilization of brain CT in Korea, we analyzed a national sampling data set, the National Patient Sample obtained from the Health Insurance Review and Assessment Service. Methods: We retrospectively collected and analyzed demographic and clinical data on enrolled patients from the National Patient Sample based on medical claims data for 2009. The data included patient's age, sex, treatment date, diagnosis codes, procedure codes related with CT, holiday or night consultation fee, and fee for emergency management services. Results: In 2009, the estimated population with head trauma was 819,059(1.8%), and the rate of brain CT utilization was 22.4%. Children ages 5 to 15 were the most commonly injured group(22.8%), but had the lowest brain CT utilization(16.5%). The mean age of the estimated population with head trauma was $34.9{\pm}0.5years$ old, and male patients accounted for 60.5% of that population. Intracranial injury was found in 8.6% of all head traumas, and the rate of intracranial injury in children was lower than it was in adults(4.1% vs. 10.9%, p<0.001). Twenty- three percent of patients with head trauma visited the emergency department (ED). More patients with head trauma visited medical facilities in the daytime on weekdays(66.5% vs. 33.5%, p<0.001), but head CT was performed more frequently at night or on weekends/holidays(16.1% vs. 34.7%, p<0.001) There is low incidence of head trauma in the winter in children (p<0.001). In the multivariate logistic regression analysis, patients who were adults, female, or ED visitors were more likely to undergo brain CT (odds ratio (OR): 1.65, 95% confidence interval (CI): 1.47-1.84; OR: 1.40, 95% CI: 1.27-1.54; OR: 7.80, 95% CI: 6.91-8.80, respectively). Conclusion: In this study, we analyzed the national epidemiologic trend for head trauma, and the pattern of utilization of brain CT.

• 대한두경부종양학회지
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• 제34권1호
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• pp.21-27
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• 2018

Background/Objectives: This study aimed to evaluate the changes of uptake around the sternoclavicular joint (SCJ) according to 18F-FDG PET images in patients with head and neck cancer who underwent neck dissection. Materials & Methods: Retrospectively, the medical records of patients who received selective or comprehensive neck dissection were reviewed. Preoperative and 1-year postoperative 18F-FDG PET images, if available, were analyzed by nuclear medicine physicians in both qualitative and quantitative manners. Correlation between the changes of uptake around SCJ and perioperative data were statistically analyzed. Results: Thirty-seven patients satisfying the inclusion criteria were enrolled. Seven patients with increased uptake around SCJ on 1-year postoperative 18F-FDG PET showed a correlation with radical or comprehensive neck dissection, accessory nerve sacrifice, and high postoperative SUVmax. When 20 patients with increased uptake around SCJ according to quantitative measurement were compared with other patients without increased uptake, no parameter was significantly different, except postoperative SUVmax. Bivariate logistic regression analysis revealed that the clinical symptom (shoulder or sternal pain) was significantly correlated with the extent of neck dissection (OR 0.227, CI 0.053-0.966, p=0.045) and spinal accessory nerve sacrifice (OR 13.500, CI 1.189-153.331, p=0.036). Conclusions: Increased uptake around SCJ on 1-year postoperative 18 F-FDG PET was correlated with either the radical or comprehensive procedure, as well as with accessory nerve sacrifice. This suggests that subjective analysis of 18F-FDG PET can be used to detect subclinical shoulder instability.

• 한국인구학
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• 제33권3호
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• pp.101-121
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• 2010

이 논문은 최근 사회서비스 영역에서 강조되고 있는 사회서비스 품질관리 접근과 관련하여 노인돌보미 바우처사업 종사자의 근무특성을 살펴보았다. 한국에서 그 동안 수행된 대부분의 사회서비스 품질관리 연구들이 이용자 측 요소에 집중되었던 반면, 본 연구는 2007년부터 시행된 4대 전자바우처 서비스의 하나로서 재가 환경에서 이루어지는 "노인돌보미 바우처 사업"에 종사하는 일선 돌봄노동자의 특성을 살펴봄으로써, 서비스 공급인력 측 요소의 중요성을 부각시켰다. 특히 재가서비스 환경에서 발생하는 서비스 이용자-종사자 간 관계적 특성을 조명하고자 하였다. 돌봄 제공자 요소를 서비스 품질요소의 하나로 주목하고 이용자의 주거지에서 서비스를 수행하는 돌보미의 근무특성을 살펴본 최초의 실증적 연구로서, 서비스 수행인력 그 중에서도 일선 돌봄노동자에게 적절한 근무여건과 분명한 업무영역을 설정해 주는 것이 서비스 품질향상에서 간과할 수 없는 매우 중요한 과제라는 것을 강조하였다. 사회서비스관리센터(2008)가 실시한 223개 서비스 제공기관 현황조사 데이터를 이용하여, 재가 돌봄서비스 품질 구성요인 중 과정과 구조 요소를 독립변수로 하고 돌보미의 인권침해 경험여부를 종속변수로 하여 로지스틱 회귀분석을 실시한 결과, 표준계약서를 비롯하여 각종 문서를 철저히 기록 및 관리하는 행정역량을 갖추고, 월 1회이상 수퍼비젼을 주는 기관에 소속한 도우미는 인권침해 경험 확율이 낮은 것으로 나타났다. 이러한 결과는 향후 서비스 품질관리에서 이용자권리와 더불어 종사자 안전과 권리보호가 균형있게 이루어져야 함을 시사한다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.129-135
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• 2020

Background: Postoperative fluid retention is a factor that causes delay in recovery and unexpected adverse events. It is important to prevent intraoperative fluid retention, which is putatively caused by intraoperative release of stress hormones, such as ADH (anti-diuretic hormone) or others. We hypothesized that intraoperative analgesia may prevent pathological fluid retention. We retrospectively explored the relationship between analgesics and in-out balance in surgical patients from anesthesia records. Methods: Anesthetic records of 80 patients who had undergone orthognathic surgery were checked in this study. Patients were anesthetized with either TIVA (propofol and remifentanil) or inhalational anesthesia (sevoflurane and remifentanil). During surgery, acetated Ringer's solution was infused for maintenance at a rate of 3-5 ml/kg/h at the discretion of the anesthetist. The perioperative parameters, including the amount of crystalloid and colloid infused, and the amount of urine and bleeding were checked. Furthermore, we checked the amount and administration rate of remifentanil during the surgical procedure. The correlation coefficient between the remifentanil dose and the in-out balance or the urinary output was analyzed using the Pearson correlation coefficient. The contributing factor to fluid retention, including urinary output, was statistically examined by means of multivariate logistic regression analysis. Results: A significant positive correlation was found between remifentanil dose and urinary output. Urinary output less than 0.04 ml/kg/min was suggested to cause positive fluid balance. Although in-out balance approaches zero balance with increase in remifentanil administration rate, no contributing factor for near-zero fluid balance was statistically picked up. The remifentanil administration rate was statistically picked up as the significant factor for higher urinary output (> 0.04 ml/kg/min) (OR, 2,644; 95% CI, 3.2-2.2 × 10⁶) among perioperative parameters. Conclusions: In conclusion, remifentanil contributes in maintaining the urinary output during general anesthesia. Although further prospective study is needed to confirm this hypothesis, it was suggested that fluid retention could be avoided through suppressing intraoperative stress response by means of appropriate maintenance of remifentanil infusion rate.

• 한국임상약학회지
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• 제29권2호
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• pp.125-132
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• 2019

Objective: To examine the perceptions and attitudes toward spontaneous adverse drug reaction (ADR) reporting system among community pharmacists and identify factors that influence reporting, by implementing a survey. Methods: A structured questionnaire was developed and distributed online. Request for the survey was posted on the website of pharmacy's billing program, and the survey was conducted for 8 days. We collected the participants' response on their work environment, experience of ADR reporting, and their perception and attitude on the reporting system. Multivariate logistic regression was used to evaluate factors influencing ADR reporting. Results: A total of 382 pharmacists participated in the survey. Significant contributing factors for reporting level were age (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.84-0.96), knowledge of reporting method (OR, 53.56; 95% CI, 9.10-315.41), installation of reporting program (OR, 31.92; 95% CI, 4.16-244.75), and encouragement from the Korean pharmaceutical association (OR, 4.13; 95% CI, 1.11-15.35). Regarding the attitude toward spontaneous ADR reporting system, 'lack of time for reporting' (OR, 0.29; 95% CI, 0.15-0.53) and 'complexity of reporting procedure' (OR, 0.51; 95% CI, 0.31-0.84), were associated with a low likelihood of reporting. Conclusion: Our results indicated that the knowledge of ADR reporting method, installation of the reporting program, and encouragement from the Korean Pharmaceutical Association contribute to active reporting. It is necessary to simplify the reporting method, make the ADR reporting program user-friendly, and provide educational interventions to increase participation in spontaneous reporting by the community pharmacists.