Differential Prognostic Impacts of Diabetes over Time Course after Acute Myocardial Infarction

김학령,강시혁,윤창환,조영석,연태진,조구영,채인호,김효수,채성철,조명찬,김영조,김주한,안영근,정명호,최동주,김종 대한의학회 2013 Journal of Korean medical science Vol.28 No.12

This study was performed to evaluate the effects of diabetes on short- and mid-term clinical outcomes in patients with acute myocardial infarction (AMI). Between October 2005 and December 2009, a total of 22,347 patients with AMI from a nationwide registry was analyzed. At the time point of the day 30 after AMI onset, landmark analyses were performed for the development of major adverse cardiovascular events (MACEs), including death, re-infarction and revascularization. In this cohort, 6,131 patients (27.4%) had diabetes. Short-term MACEs, which occurred within 30 days of AMI onset, were observed in 1,364 patients (6.1%). Among the 30-day survivors (n=21,604), mid-term MACEs, which occurred between 31 and 365 days after AMI onset, were observed in 1,181 patients (5.4%). After adjustment for potential confounders, diabetes was an independent predictor of mid-term MACEs (HR, 1.25; 95% CI, 1.08-1.45; P=0.002), but not of short-term MACEs (HR: 1.16; 95% CI: 0.93-1.44; P=0.167). Diabetes is a poor prognostic factor for mid-term clinical outcomes but not for short-term outcomes in AMI patients. Careful monitoring and intensive care should be considered in diabetic patients, especially following the acute stage of AMI.

탈북 아동청소년의 실태 및 욕구조사설계를 위한 델파이조사 연구

김학령,김유연,이민영,장인숙 한국사회복지실천연구학회 2021 미래사회복지연구 Vol.12 No.3

이 연구의 목적은 그동안 탈북청소년 관련 조사에서 분절적이고 편의적으로 다루어졌던 탈북 아동청소년의 욕구를 포괄적이고 체계적으로 조사하기 위한 항목들을 추출하는 것이다. 이를 위해 4회의 전문가 면접조사(1차 델파이조사)와 전문가 100명 대상 설문조사(2차 델파이조사)를 실시하였다. 연구 결과, 0세부터 24세까지 전 발달단계에서 탈북 아동청소년의 부모-자녀관계, 부모의 정서적 지원, 가족유대감(보육 및 돌봄 영역), 건강상태와 치료받을 기회(건강 및 보건 영역), 한국어 소통정도, 지역사회 지지망(사회통합 영역)이 중요한 항목으로 나타났다. 영유아기와 학령기 집단에서는 양육자신감, 부재 시 돌봄, 규칙적 식사, 부모의 우울, 교사와 관계가 중요하였으며, 학령기와 후기청소년기 집단에서는 학업효능감, 친구관계, 자기이해, 진로계획(교육 및 진로 영역), 직업관, 진로관련경험과 도움 정도(노동 및 취업 영역), 소속감, 차별경험, 공동체의식, 도움 받을 사람 유무 등이 중요한 항목으로 나타났다. 이 연구는 기존 탈북청소년 조사에서 배제되었던 영유아기와 후기청소년기를 포괄하여 생애주기에 따른 성장단계별 발달과 욕구 변화를 파악할 수 있는 조사 설계를 발전시키는 데 기여할 것이며, 탈북 아동청소년을 위한 실태 및 욕구조사의 개선을 위한 과제들을 제시하였다. This study aimed to identify factors for a comprehensive investigation into the needs of North Korean refugee children and youth, who have until now been segmented in social surveys and need assessments. To this end, four expert group interviews (first Delphi survey) and a survey of a hundred experts (second Delphi survey) were conducted from infant to late adolescence groups. For the infant and school-age groups, parenting confidence, absenteeism, regular meals, parental depression, and relationships are key, while in the school-age to late adolescence groups, academic efficacy, friendship, self-understanding, career plans (education and career area), a sense of belonging, discrimination, and community are crucial. These findings can contribute to a survey design that studies changes in growth stages and needs according to life cycles, and suggests steps for improvement.

코크스 제조를 위한 원료탄 배합설계 최적화

김학령 한국화학공학회 1981 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.19 No.4

높은 강도의 코크스 제조를 위한 원료석탄배합계획에 대한 최적화를 원료탄배합이론과 선형계획법의 적용에 의하여 달성하였다. 최적화에 있어서 공장설비의 특성에 의하여 제약조건의 수를 제한해야 하였기 때문에 제약조건에 대한 적절한 선정이 필요하였다. 본연구에 의한 최적화방법은 공장실험결과에 의하여 매우 효과적인 것으로 판명되었다. The Coal Blending Plan for metallurgical cokemaking was optimized with the application of linear programming due to G.B. Dantzig. In this case, it was necessary to take discrimi nation in the selection of the number of the Constraints imposed upon the system, because the number of independent variables of the optimal solution should be restricted by the characteristies of the plant facility. It was found that the of optimization method was highly efficient after a series of in-plant experiments.

Helicobacter pylori Infection is Associated with Elevated Low Density Lipoprotein Cholesterol Levels in Elderly Koreans

김학령,전한호,박인영,강지선,민경완,최진만 대한의학회 2011 Journal of Korean medical science Vol.26 No.5

This study was conducted to investigate the association between Helicobacter pylori (H. pylori) infection and the lipid profile among elderly Koreans. A total of 462 subjects (mean age 66.2 ± 7.6 yr, 84% males) who underwent health check-up were investigated. Each subject underwent gastroduodenoscopy with gastric mucosal biopsy, and H. pylori infection was determined by histopathological examination using the updated Sydney System score. The presence of H. pylori infection was significantly associated with the elevated serum levels of total cholesterol and low density lipoprotein (LDL) cholesterol (P <0.05 for each) in univariate analysis. H. pylori infection was not associated with triglyceride and high density lipoprotein (HDL) cholesterol levels (P > 0.05 for each). After controlling confounders, multiple logistic regression analysis showed that the odds ratio of H. pylori infection for high LDL cholesterol level (> 140 mg/dL) was 3.113 (95% confidence interval,1.364-7.018; P = 0.007). There were no significant associations between the presence of H. pylori infection and elevated total cholesterol levels (> 200 mg/dL) in this model (P =0.586). The results of this study demonstrate that H. pylori infection is associated with the elevated serum LDL cholesterol levels in elderly Koreans, supporting the hypothesis that H. pylori plays a role in promoting atherosclerosis by modifying lipid metabolism.

Arterial stiffness and its associations with left ventricular diastolic function according to heart failure types

김학령,Jaehoon Chung,한석문,Hyun Sung Joh,Woo‑Hyun Lim,Jae‑Bin Seo,Sang‑Hyun Kim,Joo‑Hee Zo,Myung‑A Kim 대한고혈압학회 2023 Clinical Hypertension Vol.29 No.-

Background Little is known about the characteristics of arterial stifness in heart failure (HF). This study was per‑ formed to compare the degree of arterial stifness and its association with left ventricular (LV) diastolic function among three groups: control subjects, patients with HF with reduced ejection fraction (HFrEF), and patients with HF with preserved ejection fraction (HFpEF). Methods A total of 83 patients with HFrEF, 68 patients with HFpEF, and 84 control subjects were analyzed. All HF patients had a history of hospitalization for HF treatment. Brachial-ankle pulse wave velocity (baPWV) measurement and transthoracic echocardiography were performed at the same day in a stable condition. Results The baPWV was signifcantly higher in patients with both HFrEF and HFpEF compared to control subjects (1,661±390, 1,909±466, and 1,477±296 cm/sec, respectively; P<0.05 for each). After adjustment of age, baPWV val‑ ues were similar between patients with HFrEF and HFpEF (P=0.948). In the multiple linear regression analysis, baPWV was signifcantly associated with both septal e′ velocity (β=–0.360, P=0.001) and E/e′ (β=0.344, P=0.001). How‑ ever, baPWV was not associated with either of the diastolic indices in HFrEF group. The baPWV was associated only with septal e′ velocity (β=–0.429, P=0.002) but not with E/e′ in the HFpEF group in the same multivariable analysis. Conclusions Although arterial stifness was increased, its association with LV diastolic function was attenuated in HF patients compared to control subjects. The degree of arterial stifening was similar between HFrEF and HFpEF.

The Importance of Echocardiographic Screening for Pulmonary Arterial Hypertension in Korean Patients with Systemic Sclerosis

김학령 한국심초음파학회 2016 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.24 No.4

A Decline in Renal Function is Associated With Loss of Bone Mass in Korean Postmenopausal Women With Mild Renal Dysfunction

김학령,박인영,최진만,황세민,김효상,임재성,김민,손민정 대한의학회 2011 Journal of Korean medical science Vol.26 No.3

This study was conducted to assess the relationship between estimated glomerular filtration rate (eGFR) and bone mineral density (BMD) in Korean postmenopausal women with mild renal dysfunction. A total of 328 postmenopausal women who underwent BMD measurement during health check-up was investigated. BMD was measured in lumbar spine (L1-L4), femoral neck, total proximal femur and femoral trochanteric areas by dual energy radiography absorptiometry and renal function was estimated by eGFR using Cockcroft-Gault equation. Of the 328 subjects, 317 (96.6%) had an eGFR ≥60 mL/min/1.73 m2. By using simple linear regression analysis, age, height, weight and eGFR were significantly associated with BMD for the 4 aforementioned anatomic sites, while serum levels of creatinine and blood urea nitrogen did not influence BMD. When multiple regression analyses were applied, age and body weight still had significant associations with BMD at 4 different anatomic sites (P < 0.001). A significant association of eGFR with BMD remained in the lumbar spine, femoral neck and proximal total femur (P < 0.05) but not in the trochanteric area (P = 0.300). Our study suggests that a decline of renal function is associated with lower BMD in the lumbar spine, femoral neck and total proximal femur areas in Korean menopausal women with mild renal dysfunction.

1인 가구 노인을 위한 AI 안부 전화 서비스 이용 경험 연구

김학령,옥진 인문사회 21 2023 인문사회 21 Vol.14 No.2

This study explored the experiences of users and service providers regarding the AI care call service provided to the elderly in single households as part of community care. Qualitative content analysis was conducted on the overall experiences as a service user discussed in FGI. The service was effective in relieving the sense of isolation among elderly users. They accepted the AI as a being who regularly takes care of them, experienced positive emotions, and showed behavioral changes through interaction with the AI. This service was highly accessible to the elderly in a way that AI and phones were combined. We suggest that it can be used as a care system for single-person households as well as various classes with concerns about social isolation.

The 2022 focused update of the 2018 Korean Hypertension Society Guidelines for the management of hypertension

김학령,이은미,안신영,김광일,김현창,김주한,이해영,이장훈,박종무,조은주,박성하,신진호,김영권 대한고혈압학회 2023 Clinical Hypertension Vol.29 No.-

Hypertension is the leading cause of death in human being, which shows high prevalence and associated complications that increase the mortality and morbidity. Controlling blood pressure (BP) is very important because it is well known that lowering high BP effectively improves patients’ prognosis. This review aims to provide a focused update of the 2018 Korean Hypertension Society Guidelines for the management of hypertension. The importance of ambulatory BP and home BP monitoring was further emphasized not only for the diagnosis but also for treatment target. By adopting corresponding BPs, the updated guideline recommended out-of-office BP targets for both standard and intensive treatment. Based on the consensus on corresponding BPs and Systolic Blood Pressure Intervention Trial (SPRINT) revisit, the updated guidelines recommended target BP in high-risk patients below 130/80 mmHg and it applies to hypertensive patients with three or more additional cardiovascular risk factors, one or more risk factors with diabetes, or hypertensive patients with subclinical organ damages, coronary or vascular diseases, heart failure, chronic kidney disease with proteinuria, and cerebral lacunar infarction. Cerebral infarction and chronic kidney disease are also high-risk factors for cardiovascular disease. However, due to lack of evidence, the target BP was generally determined at < 140/90 mmHg in patients with those conditions as well as in the elderly. Updated contents regarding the management of hypertension in special situations are also discussed.

북한이탈주민의 남한 정착과정에서의 건강관리 경험에 관한 연구

김학령,김은지,최성수 중앙대학교 문화콘텐츠기술연구원 2022 다문화콘텐츠연구 Vol.- No.41

본 연구는 북한이탈주민 15명을 대상으로 초점집단면접 방법을 활용하여 북한이탈주민의 남한 정착과정에서의 건강관리와 관련된 경험을 파악하고 지역사회 현장에서 필요한 서비스 방안을 제시하는 것을 목적으로 하였다. 분석 결과 6개의 상위 범주와 12개의 하위 범주로 분석되었고, 이를 토대로 ‘건강에 신경 쓰지 못했던 남한 입국 이전의 생활’, ‘정착 과정에서 겪은 건 강관리의 시행착오’, ‘점차 자리를 잡아가는 나만의 건강관리 방식’ 총 3개 의 주제로 분류되었다. 끝으로, 북한이탈주민의 남한 정착과정에서 필요한 건강과 관련된 지원과 개입을 제언하였다. 본 연구는 지역사회 현장의 측면 에서 이들의 복지욕구를 파악했다는 점과 남한 정착기간의 시간적 추이에따라 건강관리 경험을 살펴보았다는 점에서 의의가 있다.