• 한국융합학회논문지
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• 제13권3호
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• pp.113-124
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• 2022

본 연구는 한국 성인 여성의 체내 납 (Pb) 노출 수준과 심혈관질환 (CVD) 사이의 관계를 분석하기 위해 수행되었다. 2017년 국민건강영양조사 (KNHANES)에 참여한 만 19세 이상 성인 1,821명을 대상으로 혈중 납과 허혈성 심장 질환 (IHD), 뇌졸중 및 고혈압의 자가 보고한 의사 진단에 대한 단면 자료를 이용하였다. CVD 및 혈중 납 농도는 로지스틱 회귀분석을 통해 분석하였고, pearson 상관계수를 이용하여 요인 간의 상관관계를 확인하였다. 혈중 납 수치 증가는 여성에서만 허혈성 심장 질환 (OR 5.68, 95% CI 1.01-17.51) 및 고혈압 (OR 3.37, 95% CI 2.24-5.07) 위험 증가와 연관이 있었다. 또한, 혈중 납과 영양소 섭취 사이에는 상관관계가 있었다. 이는 혈중 납 수치가 CVD 발병의 주요 예측 인자로 사용될 수 있으며 여성이 납 노출과 관련된 IHD 및 고혈압에 더 취약하다는 것을 시사한다.

• Korean Journal of Radiology
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• 제23권9호
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• pp.921-930
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• 2022

Objective: To identify epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma based on ¹⁸F-fluorodeoxyglucose (FDG) PET/CT radiomics and clinical features and to distinguish EGFR exon 19 deletion (19 del) and exon 21 L858R missense (21 L858R) mutations using FDG PET/CT radiomics. Materials and Methods: We retrospectively analyzed 179 patients with lung adenocarcinoma. They were randomly assigned to training (n = 125) and testing (n = 54) cohorts in a 7:3 ratio. A total of 2632 radiomics features were extracted from the tumor region of interest from the PET (1316) and CT (1316) images. Six PET/CT radiomics features that remained after the feature selection step were used to calculate the radiomics model score (rad-score). Subsequently, a combined clinical and radiomics model was constructed based on sex, smoking history, tumor diameter, and rad-score. The performance of the combined model in identifying EGFR mutations was assessed using a receiver operating characteristic (ROC) curve. Furthermore, in a subsample of 99 patients, a PET/CT radiomics model for distinguishing 19 del and 21 L858R EGFR mutational subtypes was established, and its performance was evaluated. Results: The area under the ROC curve (AUROC) and accuracy of the combined clinical and PET/CT radiomics models were 0.882 and 81.6%, respectively, in the training cohort and 0.837 and 74.1%, respectively, in the testing cohort. The AUROC and accuracy of the radiomics model for distinguishing between 19 del and 21 L858R EGFR mutational subtypes were 0.708 and 66.7%, respectively, in the training cohort and 0.652 and 56.7%, respectively, in the testing cohort. Conclusion: The combined clinical and PET/CT radiomics model could identify the EGFR mutational status in lung adenocarcinoma with moderate accuracy. However, distinguishing between EGFR 19 del and 21 L858R mutational subtypes was more challenging using PET/CT radiomics.

• Clinical and Experimental Reproductive Medicine
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• 제2권2호
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• pp.13-26
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• 1975

Seven aspects of attitude toward marriage in Korea are examined to better understand present and future marriage patterns. Also, various facets of current marriage practice are compared with attitudes. The study comprises three groups of roughly 600 women each, selected by random sampling from a rural, an urban, and a semi-urban area. A carefully designed and pretested questionnaire was checked for reliability by a reinterview in a 15% subsample. The great majority of Korean women support traditional attitudes that one must or should marry. The small group who recommend that one should not marry are mostly the very young or the never married, whose attitudes still may change. However, there are important and probably predictive shifts in favor of more individual decision, especially among the better educated, the young, and the more urban. Traditional reasons for marriage such as "custom" and procreation are ranked first by a majority, but there is a large shift to more contemporary or liberal desire for companionship and love, also primarily among the better educated, the urban, the young, and the never married. The traditional attitude that parents should have the sole or major role in mate selection is still held by a bare majority; the educated, urban, young, and never married are more liberal. Only 6% opt for each of the two extremes: That the parent alone or the respondent alone should decide. The remainder prefer one of the two middle-of-the-road positions where parent and child together decide. The proportions of respondents who classed specified criteria as moat important for selecting a husband, arranging the criteria in order from traditional to contemporary were: Lineage, etc., 23%; personal attributes, 40%; health and education, 27%; and love, 10%. The changing attitudes are suggested by the fact that love was ranked first by only 3% of the poorly educated rural poulation versus 23% of urban college level and 31% of the urban never married. There has been a substantial rise in the ideal age of marriage over the past twelve or more years, but there also is evidence that the ideal age is at or near a ceiling. Knowledge about legal age of marriage is minimal; the implications of this for proposed legislation are discussed. Three-fifthes to four-fifths of all respondents married husbands of the same religious, residential, and economic backgrounds as themselves. Almost all of them married men of the same or higher educational level. These evidences of traditional influences in mate selection are contrasted with the low priority given some of those items in earlier questions on reasons for marriage and criterion for selecting husband. Contrary to the expressed attitudes as to who should select the husband, we find that marriages of the study sample were stated to be arranged by parents alone in 62%; and in another 23%, the parents made the decision but asked the respondent's views. Such arrangements were most frequent among the rural, the less educated, and the older respondents and less common in the urban and more educated. The implications of these and related findings are discussed.

• Journal of Preventive Medicine and Public Health
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• 제34권1호
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• pp.9-20
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• 2001

Objectives : To explore the relationship between Percutaneous Transluminal Coronary Angioplasty(PTCA) volume and the associated immediate outcome. Methods : A total of 1,379 PTCAs were peformed in 25 hospitals in Korea between October 8 and December 31 in 1997. Data from 1,317 PTCAs (95.5%) were collected through medical record abstraction. Inter-observer reliability of the data was examined using the Kappa statistic on a subsample of 110 PTCA procedures from five hospitals. Intra-observer reliability of the data was also examined. PTCA success and immediate adverse outcomes were selected as the outcome variables. A successful PTCA was defined as a case that shows less than 50% diameter stenosis and more than 20% reduction of diameter stenosis. Immediate adverse outcomes included deaths during the same hospitalization, emergency coronary artery bypass graft (CABG) within 24 hours after PTCA, and acute myocardial infarction within 24 hours after PTCA. The numbers of PTCAs performed in 1997 per hospital were used as the volume variables. Results : Without adjusting for patient risk factors that may affect outcomes, procedures at high volume hospitals ($\geq200$ cases per year) had a greater success rate (P=0.001) than low volume hospitals. There was a marginally significant difference (P=0.070) in major adverse outcome rates between high and low volume hospitals. After adjusting for risk factors, there were significant differences in procedural failure and major adverse outcome rates between high and low volume hospitals. Conclusions : After adjusting for patient clinical risk factors, the hospital volume of PTCA was associated with immediate outcomes. It is recommended that a PTCA volume per year be established in order to improve the immediate outcome of this procedure in Korea.

• Asian Pacific Journal of Cancer Prevention
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• 제17권12호
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• pp.5295-5302
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• 2016

Objectives: A physically active lifestyle is important for cancer survivors. Therefore, this study was conducted to 1) provide population-based estimates of the prevalence of physical activity and sitting time, and 2) their correlates in Korean cancer survivors. Materials and Methods: This study analyzed a cancer survivor subsample (N=1,482) from 2008-2013 Korea National Health and Nutrition Examination Survey (KNHANES), data selected with a complex sampling design. Overall and subgroup-specific prevalences of physical activity and sitting time were estimated. Correlates of moderate- to vigorous-intensity physical activity ( MVPA) and sitting time were tested using age-group-specific hierarchical multiple regression models. Results: Overall adherence rate to physical activity guidelines was 34.9% (95% CI=31.5-38.4). Age-group-specific adherence rates were 41.1% (95% CI=36.3-45.9) in adults (30-64 years old), and 25.3% (95% CI=21.0-25.3) in older adults (65 years or older). Adults spent 213.33 minutes (95% CI=172.4-254.3) per week on MVPA and 55.3 minutes (95% CI=36.4-64.6) on sitting time per day. In adults, sitting time was significantly associated with employed status (B=28.0, p=0.046), smoking (B=-47.4, p=0.020), and number of comorbidity conditions (B=-13, p=.037). MVPA was significantly associated with marital status (B=134.9, p<0.001), employment status (B=98.12, p=.046), and years since cancer diagnosis (B=104.7, p=0.015). Older adults spent 162.2 minutes (95% CI=119.5-204.8) per week on MVPA and 63.0 minutes (95% CI=45.0-89.5) on sitting time per day. Their significant correlates were sex (B= -45.2, p=0.014), smoking (B=-70.14, p<0.001), and years since cancer diagnosis (B=37.0, p=0.024). Age (B=5.8, p=0.042) and marital status (B=83.8, p=0.033) were also significantly associated with MVPA in older adults. Conclusion: A majority of Korean cancer survivors do not sufficiently participate in physical activity. In general, older, unhealthier, non-working, and being unmarried were risk factors for physical inactivity. While this study informs public health policy makers and practitioners about physical activity intervention demand for cancer survivors, future investigations should address psychosocial mediators to better inform intervention programs.

• 한국아동복지학
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• 제36호
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• pp.133-163
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• 2011

본 연구는 미국 저소득 미혼모가구의 사회적 지지가 아동의 문제행동과 인지능력에 미치는 영향을 분석하였다. 스트레스-대응모델과 가족과정모델, 사회적 지지에 관한 이론적 관점을 기초로 사회적 지지가 아동발달에 영향을 제공하는 직접효과와 미혼모의 양육스트레스를 매개로 한 간접효과를 분석하였다. 본 연구를 위해 미국 취약가족아동복지연구의 종단패널자료를 사용하였으며, 전체 1,315명의 저소득 미혼모가구와 빈곤아동이 분석에 사용되었다. 분석결과, 사회적 지지는 아동문제행동에 직접적인 영향을 제공하는 것으로 분석되었으며, 양육스트레스를 매개로 한 간접효과도 발견되었다. 반면에 사회적 지지는 아동인지능력에 직접적으로 유의미한 영향을 제공하지는 않으나 양육스트레스와 아동문제행동을 매개로 한 간접효과를 제공하는 것으로 나타났다. 본 연구결과를 토대로 저소득 미혼모가구의 경제적 환경을 개선하고 양육스트레스를 완화하기 위한 정책적 함의와 서비스방안에 대해 논의하였다.

• 한국아동복지학
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• 제53호
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• pp.1-23
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• 2016

본 연구는 빈곤 미혼모의 경제적, 정신적, 양육특성과 아동학대 및 방임과의 관계를 분석하고, 미혼모의 아동학대 및 방임이 아동의 사회행동발달에 미치는 영향을 분석하였다. 분석을 위해 미국 취약가구 및 아동복지연구자료(Fragile Families and Child Wellbeing Study)를 사용하였으며, 총 1,373명의 빈곤 미혼모의 경제적 어려움과 우울증상, 양육스트레스, 아동학대 및 방임, 아동의 문제행동과 비행행동, 사회성기술을 측정하였다. 분석과정에서 아동의 출생시점과 3세, 5세, 9세 시점에서의 미혼모와 아동의 특성을 고려하였다. 연구결과, 미혼모가 경험하는 경제적 어려움과 양육스트레스는 아동에 대한 학대 및 방임을 야기하는 위험요인인 것으로 분석되었으며, 높은 수준의 우울증상은 미혼모의 양육스트레스를 가중시킴으로써, 간접적으로 아동 학대 및 방임위험성을 높이는 것으로 분석되었다. 또한 미혼모의 학대 또는 방임적 양육행동은 아동의 문제행동과 비행행동을 유발하고, 사회성 발달을 저해하는 요인으로 작용하는 것으로 나타났다. 연구결과를 기초로 아동의 건강한 사회행동발달과 미혼모의 학대 혹은 방임적 양육행동을 예방하기 위한 정책적 실천적 전략에 대해 논의하였으며, 동시에 빈곤과 재정궁핍, 우울증상, 양육스트레스를 효과적으로 완화하기 위한 지원방안을 제시하였다.

• 국제지역연구
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• 제22권4호
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• pp.3-18
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• 2018

본 연구에서는 변동성반응가설에 입각한 T-GARCH 모형을 사용하여 최근 24년간의 일별 주식시장 수익률 자료를 바탕으로 OECD 29개 회원국들의 자본시장 충격반응도를 분석하였다. 연구모형에 사용한 독립변수로는 글로벌 금융위기의 진원지이며 세계시장 점유율도 가장 큰 미국시장 수익률을 사용하였다. 그 결과 OECD 회원국 중 미국으로부터의 수익률 전이효과가 가장 큰 나라는 프랑스, 핀란드, 멕시코의 순으로 나타났고 모형의 설명력은 캐나다, 멕시코, 프랑스 순으로 나타났다. 변동성반응가설에 입각한 충격반응의 크기로는 독일, 칠레, 스위스, 덴마크의 순으로 크게 나타났고 하락시장 충격에 대한 반응은 그리스, 영국, 호주, 일본의 순으로 크게 나타났다. NAFTA에 속한 캐나다와 멕시코는 예상대로 미국시장으로부터의 수익률 전이와 설명력이 크게 나타났으나 충격반응의 정도는 OECD 회원국들 중 하위권에 속하는 것으로 나타나 인근 지역의 국가들간의 더 큰 영향력이 존재한다는 중력이론을 지지하지 않았다. 한편, 2008년 미국발 글로벌 금융위기기간만을 고려한 소표본 분석을 통해서는 전체 기간과는 달리 북미 3국의 충격반응도가 서로 일관성이 없는 대신 유럽 각국의 충격반응도는 더욱 강하게 나타남으로써 미국발 충격이 주로 유럽지역에 미쳤음을 입증해 주었다.

• Korean Journal of Radiology
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• 제23권10호
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• pp.1009-1018
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• 2022

Objective: This study aimed to investigate the feasibility of using artificial intelligence (AI) to identify normal chest radiography (CXR) from the worklist of radiologists in a health-screening environment. Materials and Methods: This retrospective simulation study was conducted using the CXRs of 5887 adults (mean age ± standard deviation, 55.4 ± 11.8 years; male, 4329) from three health screening centers in South Korea using a commercial AI (Lunit INSIGHT CXR3, version 3.5.8.8). Three board-certified thoracic radiologists reviewed CXR images for referable thoracic abnormalities and grouped the images into those with visible referable abnormalities (identified as abnormal by at least one reader) and those with clearly visible referable abnormalities (identified as abnormal by at least two readers). With AI-based simulated exclusion of normal CXR images, the percentages of normal images sorted and abnormal images erroneously removed were analyzed. Additionally, in a random subsample of 480 patients, the ability to identify visible referable abnormalities was compared among AI-unassisted reading (i.e., all images read by human readers without AI), AI-assisted reading (i.e., all images read by human readers with AI assistance as concurrent readers), and reading with AI triage (i.e., human reading of only those rendered abnormal by AI). Results: Of 5887 CXR images, 405 (6.9%) and 227 (3.9%) contained visible and clearly visible abnormalities, respectively. With AI-based triage, 42.9% (2354/5482) of normal CXR images were removed at the cost of erroneous removal of 3.5% (14/405) and 1.8% (4/227) of CXR images with visible and clearly visible abnormalities, respectively. In the diagnostic performance study, AI triage removed 41.6% (188/452) of normal images from the worklist without missing visible abnormalities and increased the specificity for some readers without decreasing sensitivity. Conclusion: This study suggests the feasibility of sorting and removing normal CXRs using AI with a tailored cut-off to increase efficiency and reduce the workload of radiologists.

• 대한간호학회지
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• 제3권3호
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• pp.1-14
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• 1973

This study is designed to meet the following objectives: (1) To study attitude and behavior regarding marriage and age at marriage, (2) To learn correlates of age at marriage and to examine their relations, (3) To measure relative importance of the correlates of age at marriage, and (4) To study relations of age at marriage and family planning practice to fertility and their relative importance as correlates of fertility. The data are obtained by an independent cross-sectional survey in three study areas purposively selected to represent metropolitan. semihuman. rural population. The study population is confined to women age 17-50 as of survey. The overall response rate is 90%. Reliability of data is measured by . individual and aggregate inconsistency based upon a 15% subsample of the original interviews. The individual inconsistency (31%) is found to be high compared to the aggregate inconsistency (6%) for all 85 variables. However, the magnitude of differences between means is small, and the mean absolute shifts and proportional shifts are also small on the whole. In a word respondents did not change their answers too extremely or radically. The study populations of each study area are compared on some basic characteristics. It is found that the three study populations have more dissimilarities than similarities. The findings on seven different attitudinal positions of women toward marriage indicate that there have been tremendous changes in all study areas Iron "traditional" attitudes which have been prevalent for a long time in Korean society to "liberalized" or "modernized" attitudes. An apparent tendency is that women generally take a position of a "golden mean" attitude by not preferring either extreme of marriage attitudes. Nevertheless, the young, single, educated, and urbanite appears more "liberalized. " There has been some increase in ideal age at marriage from 1958 to 1970 for both sexes. No age group, marital status, or study area differentials in ideal age at marriage are found, the average ideal age at marriage in every sub-group being 24-25. Awareness of existing legal marriageable ages is low; only 4.4% are aware that "with parental permission: minimum age for males is 18 years and for females 16 years,"and only 3.7% are aware that "without parental permission: 27 years for males and 23 years for females." People in Korra tend to marry spouses who are in various social ways like themselves: the similarities include (a) education, occupational status of father, (c) economic status, (d) usual residence before marriage, and (e) religion. Both singulars and actual mean ages at marriage in this study confirm the trend of rising age at marriage previously established by other independent studies. The urban-rural differential in age at marriage is observed, but the differential narrows down gradually from 1935 to 1970. All socio-economic, demographic, and other variables pertaining to wife before and at first marriage, excluding (a) religion, (b) father′s of occupation, and (c) as: of menarche, are correlated with respondent's age at first marriage, whereas only three variables out of all socio-economic variables relating to husband before and at wife′s first marriage, viz., (a) education, (b) usual residence, and (c) economic level of his old home, are correlated with respondent′s age at marriage. Among socio-economic and modernity variables related to either husband or wife at the time of survey, only education and duration of residence are correlated with wife′s age at first marriage. Among the correlates of respondent′age at first marriage, education is in general the most important variable. However, it is found that wife′s education is more important than husband′s. The combined effects or the correlates studied explain no more than about 40% of variance for any of the selected groups of variables. Points which might counteract the effects of late marriage on fertility are not serious in Korea. For each of the correlates of the three fertility indices chosen for this study. namely, (a) number of living children, (b) number of live births, and (c) number of pregnancies, age at marriage is the major contributor to the variance in all age groups except the age group of 20-29 in which the index of family planning practice is the major contributor. The proportion of variability in fertility indices accounted for by the correlates is never more than 40% of the total variance in any age group. Based upon the findings from this study, it could be concluded that in the foreseeable future (a) celibate group will no! be increased to a point that would slow down population growth rate in Korea, (b) age at marriage will not increase continually, (c) although education stands out as the major contributing variable which independently explains the variation in age at marriage, it seems probable that education may not be the major variable in the near future, and (d) despite the fact found by this study that age at marriages has been the major contributor to the variance of each of the fertility indices used, family planning practice will play a more important role in the reduction of fertility in the Korean society. Therefore, factors interrupting practice of family planning must be eliminated and family planning program should be strengthened if further fertility reduction is needed.