Comparative Analysis of T-Score Discordance between a Registry-Based Korean Population and Atypical Femoral Fracture Patients of a Single Institution

Yun Seong Choi,Tae Woo Kim,Jin Hwa Jeong,Seung-Beom Han,Moon Jong Chang,Chong Bum Chang,Seung-Baik Kang 대한정형외과학회 2022 Clinics in Orthopedic Surgery Vol.14 No.3

Background: The purpose of this study was to analyze the epidemiology of T-score discordance between the spine and femur in the South Korean population and compare the prevalence of T-score discordance between the Korean osteoporosis population and atypical femoral fracture (AFF) patients. Methods: A total of 12,422 subjects from the Korea National Health and Nutrition Examination Survey were reviewed retrospectively. T-score discordance was defined as a difference of ≥ 1 standard deviation between the lumbar spine (LS) and femoral neck (FN) bone mineral density (BMD). The prevalence of T-score discordance (low LS [LS BMD < FN BMD], low FN [LS BMD > FN BMD], and total [low LS + low FN]) was investigated in the osteoporosis and non-osteoporosis groups and stratified by sex and age. Tscore discordance of 63 patients with AFFs diagnosed at a single institution was compared with that of the Korean osteoporosis population using propensity score matching. Results: T-score discordance was prevalent in the Korean osteoporosis population (44.8%), and low LS discordance (37.5%) was more frequently seen than low FN discordance (7.2%) (p < 0.001). The prevalence of total and low LS discordance was significantly higher in AFF patients than in the Korean osteoporosis population (total discordance: 69.8% and 42.5%, respectively; low LS discordance: 63.5% and 31.7%, respectively; p < 0.001). Conclusions: T-score discordance was highly prevalent in the Korean osteoporosis population, and low LS discordance was more common than low FN discordance. Nevertheless, the prevalence of low LS discordance was significantly higher in AFF patients than in the Korean osteoporosis population.

우리나라 쌍태아의 출생체중 불일치 수준과 조기분만에 관한 연구; 2009-2013

박상화 ( Sang Hwa Park ),한정호 ( Jung Ho Han ),임달오 ( Dar Oh Lim ) 한국보건정보통계학회(구 한국보건통계학회) 2015 한국보건정보통계학회지 Vol.40 No.2

Objectives: To compare the relationship between intra-twin birth weight discordance and preterm birth (PTB; ≤36 weeks) by analyzing the birth certificated data of Koera Statistics. Methods: The 2009-2013 birth certificated data of Korea Statistics was used for this analysis. There were 31,998 completely matched twin pairs from 67,557 twin birth data. The data of unmatched twin cases, teenage birth, extra-marital birth, non-hospital birth cases, and gestational age and birth weight information missing cases were excluded. Odds ratio and 95 percent confidence intervals were calculated from logistic regression analyses to describe the risk of PTB by the degree of intra twin birth weight discordance (birth weight difference/ birth weight of heavier twin x 100) adjusted for infantile sex, birth order, maternal age, year of birth, and maternal education & occupation. Results: The incidence of intra-twin birth weight discordance was 55.3 percent in discordance level of ≤9 percent, and 4.4 percent in discordance level of ≥30 percent. The mean gestational age was getting shorter from 35.9 weeks in discordance level of ≤9 percent to 34.8 weeks in discordance level of ≥30 percent. The rate of PTB in twins was increased with increasing degree of birth weight discordance. The PTB rates were 52.1 percent and 70.8 percent, respectively, in subjects with a birth weight discordance of ≤9 percent and in those ≥30 percent. Compared with birth weight discordance of ≤9 percent, odds ratio of PTB was 1.15 (95% confidence interval: 1.07-1.24) in birth weight discordance (20%), and 2.28 (2.02-2.57) in birth weight discordance of ≥30 percent. Conclusions: The risk of PTB was significantly increased with higher degree of intra-twin birth weight discordance of ≥20 percent.

Randomized control trial to compare effects of ultra-low dose (Ethinyl Estradiol 20 µg or 15 µg) with low dose (Ethinyl Estradiol 30 µg) hormonal pills on lipid discordance in non-obese PCOS women

Subhankar Dasgupta,Joyeeta Mondal,Barnali Goswami,Jija Dasgupta 대한산부인과학회 2023 Obstetrics & Gynecology Science Vol.66 No.6

Objective Regular users of hormonal contraceptive pills show marked heterogeneity in metabolic effects with variations in compositions. This might be due to choice of outcome variables for comparison. Total cholesterol-high-density lipoprotein ratio (TC/HDL) discordance with low-density lipoprotein (LDL-C) has now become an established marker of future risk for atherosclerotic cardiovascular disease and stable to variations in user. Methods The present study was a randomized controlled trial to compare prevalence of TC/HDL and LDL discordance among non-obese women with polycystic ovarian syndrome (PCOS) treated with hormonal pills. Women were randomized into three arms, two arms received ultra-low dose pills (Ethinylestradiol [EE] 20 μg with drosperinone 3 mg or EE 15 μg with gestodene 60 μg) and one arm received low dose pill (EE 30 μg with desogestrel 150 μg). The role of baseline participant features and pill composition on discordance was determined. Results Discordance was observed in more than a quarter of the participants before intervention. After 1 year of treatment, less than a fifth of the participants were discordant. Ultralow-dose pill users had lower discordance, LDL, and TC than low-dose pill users after 1 year of treatment. The random forest, a non-linear classifier, showed the highest accuracy in predicting discordance. The baseline Parameters with the maximal impact on the occurrence of discordance were triglyceride, homeostatic model assessment for insulin resistance, body mass index, and high density lipoprotein. Conclusion Non-obese PCOS women on ultra-low dose pill have a lower risk of acquiring future atherosclerotic cardiovascular disease.

전 임신 기간 동안 임산부 체중 변화와 쌍태아가 체중 불일치 변화의 양상의 관찰

백민정 ( Min Jung Baek ),이경주 ( Kyung Ju Lee ),강석호 ( Suk Ho Kang ),이경진 ( Kyoung Jin Lee ),박상원 ( Sang Won Park ),한원보 ( Won Bo Hahn ) 대한주산의학회 2006 Perinatology Vol.17 No.2

목적 : 체중 불일치가 있는 쌍태임신에서 연속적인 임신 기간 동안 산모의 체중변화와 쌍태간 체중 불일치의 변화 양상을 관찰하고자 한다. 방법 : 148명의 쌍태임신를 대상으로 2002년 2월부터 2004년 5월까지 의무 기록에 의한 후향적 연구를 하였다. 이들은 분만 시 25% 미만의 쌍태간 체중 불일치를 가진 A군과 25% 이상의 쌍태간 체중 불일치를 가진 B군으로 나누어 세 임신 기간(1기 : 임신 18주까지; 2기 : 임신 18주에서 28주까지; 3기 : 28주에서 분만까지)에 산모의 체중과 초음파로 태아의 체중을 측정하였다. 결과 : 109쌍의 A군과 39쌍의 B군 산모의 분만시 연령, 임신력, 분만력, 신장, 분만 재태 연령, 임신 전 체중, 임신전 체질량 지수(BMI) , 쌍태임신의 방법은 두 군에서 평균값의 통계적인 차이는 없었다. 평균 산모의 BMI 증가는 임신 시기별 A군과 B군이 각각 0.53±0.10% and 2.01±1.28%, 2.97±0.11% and 4.84±1.23%, and 3.29±0.16% and 2.15±0.63% 이었다. 쌍태간 체중 불일치의 경우 각각 임신 시기별 평균값이 8.29±0.67% and 11.26±1.25%, 7.79±0.05% and 13.03±1.36%, 9.07±0.55% and 32.7±91.13%이었다. 결론 : 쌍태아의 체중 불일치에 영향을 주는 요인을 고려하더라도 산모의 임신기간별 적절한 체중 증가는 임신 1기의 쌍태 체중 불일치 변화량을 임신이 진행하더라도 일정하게 유지함을 보여준다. Objectives: To evaluate the patterns of changes in maternal weight and fetal weight discordance in twin pregnancies during consecutive gestational periods. Methods: A retrospective chart review was done for a total of 148 twin pregnancies taken care of throughout pregnancies between February 2002 and May 2004. They were divided into two groups; group A consisting of 109 cases without postnatal complications and with no more than 25% twin weight discordance at birth, and group B consisting of 39 cases with more than 25% twin weight discordance. Both ultrasound examination and maternal weight measurement were conducted in the three gestational intervals; between prepregnant times to gestational age 18 weeks, between gestational ages 18 to 28 weeks, and from gestational age 28 weeks to delivery. Results: Except for maternal weights, none of the pregnancy factors such as maternal age, parity, gravity, height, prepregnant weight, duration of pregnancy, natural or artificial pregnant status, gender and chorionicity showed any significant difference by means between the two groups. The maternal BMI of the group A vs. the group B at the first, the second, and the third period were 0.53±0.10% and 2.01±1.28%, 2.97±0.11% and 4.84±1.23%, and 3.29±0.16% and 2.15±0.63% respectively. Inter-twin weight discordances between the two groups were 8.29±0.67% vs. 11.26±1.25%, 7.79±0.05% vs. 11.03±1.36%, and 9.07±0.55% vs. 32.79±1.13%, respectively. Conclusions : Although several factors that affect twin weight discordance may be considered, we showed that the pattern of maternal weight gain during the gestational period is associated with the estimated values of twin weight discordances in the first gestational period.

학습부진의 대안 개념으로서의 학습부조

신재영 한국교육학회 2013 敎育學硏究 Vol.51 No.1

학습부진 개념은 부정적 함의 때문에 대안 용어 개발의 필요성이 제기되어 왔다. 다문화 국가들에서 주류와 소수민족 집단 간 학력격차를 설명하는 이론들의 발달과정을 참조준거로 삼아 ‘학습부조’(學習不調)라는 대안 개념을 도출하였고, 그 타당성을 통찰의 과정을 소개하는 방식으로 제시하였다. 통찰의 원천이 된 연구자의 개인적 체험과 배경 지식을 부연함으로써 두 개념 간의 비교를 통한 정교화를 도모하였다. 두 개념의 차이는 교육체제의 문제와도 관련되어 이에 대한 논의도 부연하였다. 그 과정에서 학습부조 개념에 부합하는 ‘양치기식 교육’이라는 개념모형을 제시하였다. 논의의 마무리로서, 학습부진 개념 아래서는 결핍모형의 한계 때문에 악순환의 고리 속에 갇힐 우려가 큰 점을 지적하고, 학습부조 개념과 더불어 선순환적인 성장모형을 지향할 수 있음을 주장하였다. Due to the negative implications of the word underacheivement there has been raised the need for developing an alternative concept. The researcher captured by himself the concept of ‘learning discordance’ through the process of insight and suggested its relevance by introducing the process of the insight. The resources of the insight, i.e. researcher’s first hand experiences and academic knowledge background, were extrapolated for conceptual elaboration. The discourse on the two concepts extended to the matter of educational systems, while developing a concept model of ‘shepherd mode of teaching.’ Under the concept of underachievement, efforts for improvement might get trapped in a vicious circle due to its deficit model directedness, while the concept of learning discordance relates to the growth model that might produce a virtuous circle.

The Usefulness of a 180° Rotatable Monitor for an Assistant to Overcome the Hand-Eye Discordance in Laparoscopic Colorectal Surgery

김성진,강성일,김소현,김재황 대한내시경복강경외과학회 2020 Journal of Minimally Invasive Surgery Vol.23 No.3

Purpose: Hand-eye discordance during laparoscopic colon surgery is an obstacle to the assistant. We evaluated the usefulness of a 180 degrees rotatable laparoscopic monitor for the colorectal surgery assistant to overcome hand-eye discordance. Methods: Twenty-six residents of the department of surgery (novice group, n = 13; experienced group, n = 13) participated in this study. They performed grasping a ring and transferring it to standing bars on a laparoscopic training kit under the conventional view and a 180 degrees rotated monitor view. We defined successful performance when this procedure was completed in 3 minutes. Results: The number of successful performance was higher under the 180 degrees rotated monitor view than under the conventional view monitor (6.88 ± 2.79 vs. 0.92 ± 0.80, P < 0.01). Under the 180 degree rotated monitor view, the experienced group had a higher number of successful performances than the novice group (8.31 ± 2.59 vs. 5.46 ± 2.26, P = 0.009). However, no statistically significant difference was found between the two groups under the conventional view (1.23 ± 0.93 vs. 0.62 ± 0.51, P = 0.091). Conclusion: This study shows the usefulness of a 180 degrees rotated monitor view to overcome hand-eye discordance, which adversely affects the laparoscopic performance of the colorectal surgery assistant.

Percutaneous Ultrasound-Guided Vacuum-Assisted Removal versus Surgery for Breast Lesions Showing Imaging-Histology Discordance after Ultrasound-Guided Core-Needle Biopsy

손유미,윤정현,김은경,문희정,김민정 대한영상의학회 2014 Korean Journal of Radiology Vol.15 No.6

Objective: To evaluate the upgrade rate and delayed false-negative results of percutaneous vacuum-assisted removal (VAR) and surgical excision in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy (CNB) of the breast and to validate the role of VAR as a rebiopsy method for these discordant lesions. Materials and Methods: Percutaneous US-guided 14-gauge CNB was performed on 7470 patients between August 2005 and December 2010. Our study population included 161 lesions in 152 patients who underwent subsequent rebiopsy due to imaging-histologic discordance. Rebiopsy was performed using VAR (n = 88) or surgical excision (n = 73). We investigated the upgrade rate immediately after rebiopsy and delayed false-negative results during at least 24 months of follow-up after rebiopsy. We also evaluated the clinicoradiological differences between VAR and surgical excision. Results: Total upgrade to malignancy occurred in 13.7% (22/161) of lesions at rebiopsy including both VAR and surgical excision: 4.6% (4/88) of VAR cases (4/88) and 24.7% (18/73) of surgical excision cases (p < 0.001). Surgical excision was performed significantly more frequently in older patients and for larger-sized lesions than that of VAR, and a significant difference was detected between VAR and surgical excision in the Breast Imaging and Reporting and Data System category (p < 0.007). No delayed false-negative results were observed after VAR or surgical excision during the follow-up period. Conclusion: Long-term follow-up data showed no delayed cancer diagnoses after US-guided VAR in imaging-histologic discordant lesions of the breast, suggesting that VAR might be a rebiopsy method for these lesions.

Factors Influencing the Diagnostic Accuracy of Acoustic Radiation Force Impulse Elastography in Patients with Chronic Hepatitis B

( Mi Sung Park ),( Sun Wook Kim ),( Ki Tae Yoon ),( Seung Up Kim ),( Soo Young Park ),( Won Young Tak ),( Young Oh Kweon ),( Mong Cho ),( Beom Kyung Kim ),( Jun Yong Park ),( Do Young Kim ),( Sang Hoo 대한소화기학회 2016 Gut and Liver Vol.10 No.2

Background/Aims: To determine factors predictive of discordance in staging liver fibrosis using liver biopsy (LB) and acoustic radiation force impulse (ARFI) elastography in patients with chronic hepatitis B (CHB). Methods: Consecutive patients with CHB who underwent LB and ARFI elastography on the same day from November 2010 to March 2013 were prospectively recruited from three tertiary hospitals. Results: We analyzed 105 patients (median age of 47 years). The F0.1, F2, F3, and F4 fibrosis stages were identified in 27 (25.7%), 27 (25.7%), 21 (20.0%), and 30 (28.6%) patients, respectively. The areas under the receiver operating characteristics curves for ARFI elastography in assessing ≥F2, ≥F3, and F4 was 0.814, 0.848, and 0.752, respectively. The discordance of at least one stage between LB and ARFI was observed in 68 patients (64.8%) and of at least two stages in 16 patients (15.2%). In a multivariate analysis, advanced fibrosis stage (F3.4) was the only factor that was negatively correlated with one-stage discordance (p=0.042). Moreover, advanced fibrosis stage was negatively (p=0.016) correlated and body mass index (BMI) was positively (p=0.006) correlated with two-stage discordance. Conclusions: Advanced fibrosis stage (F3.4) was a predictor of nondiscordance between LB and ARFI elastography; BMI also influenced the accuracy of ARFI elastography. (Gut Liver 2016;10:275-282)

세계측지계 좌표변환계수를 이용한 지적불부합지 추정에 관한 연구

전영길(Jeon, Yeong Gil),조지현(Cho, Jee Hyun) 한국지적정보학회 2013 한국지적정보학회지 Vol.15 No.2

현재 한국의 지적정보와 지형정보는 서로 다른 좌표체계를 기반으로 하고 있다. 지적정보는 구좌표계(동경측지계), 지형정보는 세계측지계로 제작되고 있다. 따라서 양 정보체계는 서로 호환되지 못하며, 상호간에 상당량의 수치적 오차를 발현시키고 있다. 심지어 동일한 한 지역에서도, 서로 다른 측정결과를 보인다. 이러한 상황에서 우리는 구좌표계 자체가 어느 정도 훼손되어 지적불부합을 양산시키는 것으로 추정할 수도 있고, 다른 한편으로는 지적과 지형정보간의 좌표간 불일치 때문에 어느 동일한 지역에서도 서로 다른 측정치가 다량으로 불부합되는 것으로 예측할 수도 있다. 구좌표계의 기준점 중 하나인 지적도근점과 세계측지좌표계를 비교·분석한 결과로 보면 사례지역은 대량의 지적불부합이 있음을 추정할 수 있다. 그러므로 본 논문의 분석결과로 보면 양 좌표계의 수치 차이는, 곧 어느 일정지역의 불부합 상황을 예측할 수 있는 지표가 될 수 있다고 판단된다. Now, Korean Cadastral Survey System and Geographical Survey System are base on each different ‘Geodetic Coordinates System’. The former has been made by old Geodetic System(So Called ‘Tokyo Geodetic System’), but later by another ‘World Geodetic Coordinates System. So both Information System can not interface each other and expose a lot of numerical errors mutually. Even in one same area, there can be much different estimating results. As this situation, we can presume that the old Geodetic frame itself may be somewhat corrupted, and then caused much cadastral discordance. In other words, we can predict the amount of cadastral & geographical discordance, if in any same region or area there can be found much estimating value between two geodetic system. After compared with those two geodetic coordinates based on ‘supplementary control point’ & as an ‘control point’ of old Geodetic System, world geodetic coordinates we can presume that any region has much cadastral discordance. So, The difference, as a result of this study, of both coordinates may be the indicator of cadastral discordance in any region or area.

정보체계 생애주기이론에 기반한 우리나라 지적정보체계 발전과정 분석

전영길(Jeon, Yeong Gil) 한국지적정보학회 2012 한국지적정보학회지 Vol.14 No.2

지적학계 및 실무계의 오랜 숙원이던 지적재조사가 2012년부터 시행되게 된다. 지적재조사의 목적은 단지 새로운 정보체계를 구축하는 데 만 있지는 않으며, 핵심사업으로 다양한 토지정보간의 불일치를 해소하는 데에도 동시적으로 중점이 두어져 있다. 장기적 목표로는 ‘통합된 디지털지적시스템’으로의 구조변환을, 단기적으로는 유관 토지정보간의 불일치(즉, 지적불부합)를 해소하여 정확하고 완전한 지적정보를 재정비, 확정하고자 하는 것이다. 본 연구는, 위와 같은 지적재조사의 의미를, 정보이론 중 ‘Nolan의 수명주기이론’에 비교검토시켜 분석함으로써, 그 논리적 근거와 사업의 타당성을 확보하려는 목적에서 구상되었다. Nolan의 수명주기이론은 모든 정보체계를 ‘살아있는 시스템’으로 가정하고, 각 정보체계가 수명주기의 어느 단계에 와 있는가를 탐색하는 모형이다. 본 연구에서의 분석결과, 현 한국의 지적정보체계는 Nolan 모형의 소위 ‘전환점’단계에 와 있는 것으로 판명되며, 이는 기술적, 제도적 혁신을 통하여 시급히 새로운 정보체계로의 변환을 필요로 하는 단계로 인식되어야 한다. Cadastral renovation, which is long-cherished plan for us, is going to start this year. The purpose of this cadastral renovation is not simply converse into new land information system, but also it is emphasized on the removal of discordance among various land informations. As a long-term goal of this policy, old LIS structure of korea should be transferred into new ‘integrated digital system’. Otherwise, as a short-term goal, several forms of discordance among each related land informations (so called ‘cadastral discordance’) must be removed and then arranged to the accurate and sound cadastral information. The aim of this study is to find some theoretical references on cadastral renovation, examined by and compared with the ‘Nolan’s Life Cycle (of IS) Theory’. Nolan’s Life Cycle Theory, in which all information systems are regarded as the ‘living system’, is useful in analyzing the present stage that any information system copes with. AS a result of this comparative analysis, we can find that current korean cadastral information system may be confronted with the ‘innovative turning point stage’, which ought finally to prepare a new information system urgently.