독립인 두 모집단 설계에서의 표본수 비교

고해원,김동재,Ko, Hae-Won,Kim, Dong-Jae 한국데이터정보과학회 2010 한국데이터정보과학회지 Vol.21 No.6

임상시험을 시행하는 경우 위약을 신약과 비교하는 경우가 대다수이다. 기존에 독립인 두 모 집단의 표본수를 계산하는 방법으로 모수적 방법에서는 t검정을 이용하였고, 비모수적 방법에서는 Wilcoxon 순위합검정 (Wilcoxon, 1945)을 이용하였다. 본 논문에서는 Orban과 Wolfe (1982)가 제안한 선형위치통계량의 검정법과, Kim (1994)이 선형위치통계량에 기초하여 계산한 검정력의 결과를 이용하여 표본수 구하는 방법을 제안한다. 또한 앞서 제안한 방법의 표본수를 기존의 Wilcoxon 순위합검정을 이용하여 Wang 등 (2003)이 제안한 공식을 이용한 표본수, 그리고 모수적 방법을 이용한 t검정의 표본수와 비교하였다. For clinical trials, it is common to compare the placebo and new drug. The method of calculating a sample size for two independent populations are the t-test that is used for parametric methods, and the Wilcoxon rank-sum test that is used in the non-parametric methods. In this paper, we propose a method that is using Kim's (1994) statistic power based on the linear placement statistic, which was proposed by Orban and Wolfe (1982). We also compare the sample size for the proposed method with that for using Wang et al. (2003)'s sample size formula which is based on Wilcoxon rank-sum test, and with that of t-test for parametric methods.

소아 알레르기비염의 경제적 부담 평가를 위한 다기관 조사

공도연 ( Do Youn Kong ),김경원 ( Kyung Won Kim ),김우경 ( Woo Kyung Kim ),민택기 ( Taek Ki Min ),박용민 ( Yong Mean Park ),안재억 ( Jae Ouk Ahn ),양현종 ( Hyeon Jong Yang ),염혜영 ( Hye Yung Yum ),윤혜선 ( Hae Sun Yoon ),전유훈 ( 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2012 소아알레르기 및 호흡기학회지 Vol.22 No.2

목적: 알레르기비염의 유병률은 전 세계적으로 급격히 증가하고 있으며, 그에 따른 경제적 부담도 증가하고 있다. 그러나, 소아 알레르기 질환이 미치는 경제적 부담에 관한 국내 연구는 제한적이어서 소아 알레르기비염이 환자와 그 가족에게 미치는 경제적 부담을 산출하고자 본 연구를 진행하였다. 방법: 2008년 7월 1일부터 9월 31일까지 서울시 6개 2-3차 의료기관을 방문한 18세 이하 소아 알레르기비염 환자 및 보호자를 대상으로 설문 조사를 진행하였다. 설문을 통해 직접 의료비 (병·의원 진료비, 및 약제비 한방 진료비 및 약제비, 보완/대체요법비), 직접비의료비 (교통비, 환경개선비), 그리고 간접비용 (월 평균 노동 손실)을 조사하였고 그 결과를 질환의 중증도 및 유병 기간에 따라 분석하여 그 차이를 비교하였다. 결과: 모집된 262명의 대상 중 174명(66.4%)이 남자였고, 평균 연령은 6.54세였다. 대상군의 연간 평균 직접 의료비는 177만 원이었고 직접비 의료비는 57만 원이었다. 비록 통계학적 유의성은 없었지만, 알레르기비염의 중증도가 증가할수록 직접 의료비가 증가하는 경향을 보였고, (P=0.053) 유병 기간 또한 직접 의료비의 증가와 유의한 양의 상관 관계를 보였다. (R=0.195, P=0.002) 대상 환자 보호자의 약 17%가 아이의 알레르기비염으로 인해 직장에 결근 또는 조퇴를 경험한 것으로 조사되어 사회적 간접비용을 미루어 생각할 수 있었다. 결론: 알레르기비염이 미치는 경제적 부담은 질환의 중증도가 심할수록, 그리고 유병 기간이 길수록 증가하며, 이는 특히 한방 진료 및 치료비와 보완/대체요법비의 증가에 기인한 것으로 조사되었다. 따라서 알레르기비염으로 인한 경제적 부담을 줄이기 위해서는 환자와 보호자를 대상으로 근거 중심의 치료를 할 수 있도록 지속적이고 체계적인 교육이 필요할 것으로 사료된다. Purpose: The prevalence of allergic rhinitis is rapidly increasing and results in relatively high socio-economic burden on their family and community. However, studies on the economic burden of pediatric allergic rhinitis in Korea are limited. Therefore, we conducted this study to investigate the impact of pediatric allergic rhinitis on economic burden. Methods: Two hundred sixty two children with allergic rhinitis were enrolled in 6 secondary or tertiary medical centers in Seoul from July to September, 2008. We collected data of the economic burden of allergic rhinitis (direct medical costs, direct nonmedical costs, and indirect costs) by face to face questionnaire survey. We compared the economic burden according to the severity and the duration of allergic rhinitis. Results: The mean age of subjects was 6.54 years, and male were 174 (66.4%). Direct medical costs (10,000 Korean Won/yr) were 177.75, and direct nonmedical costs were 57.92. Although, there was no statistical significance, direct medical costs showed increasing trends in severe allergic rhinitis. (P=0.053) In addition, direct medical costs were positively correlated with duration of allergic rhinitis.( R=0.195, P=0.002). About 17% of the parents who care the allergic rhinitis children experienced the work absence due to their child s illness. Conclusion: The economic burdens of allergic rhinitis were positively correlated with the severity and duration of illness. Particularly costs for alternative medicine including oriental medicine` were related with severity and duration allergic rhinitis. Therefore, special efforts for education with evidence based treatment strategy are necessary to decrease the economic burden of allergic rhinitis.

알레르기 환자에서 한방 이외의 대체 요법의 사용 현황에 대한 다기관 조사

이현정 ( Hyun Jung Lee ),이재현 ( Jae Hyun Lee ),이용원 ( Yong Won Lee ),김철우 ( Cheol Woo Kim ),동헌종 ( Hun Jong Dhong ),박해심 ( Hae Sim Park ),조영주 ( Young Joo Cho ),조진희 ( Jin Hee Cho ),조상헌 ( Sang Heon Cho ),편복양 ( 대한내과학회 2011 대한내과학회지 Vol.80 No.1

Background/Aims: The use of unproven complementary/alternative medicine (CAM) to treat allergies is popular in Korea. We conducted a multicenter survey of the current use of CAM other than herbal medication in Korean allergy patients. Methods: This study enrolled 510 adults with allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, and chronic urticaria, from ten hospitals. They underwent a structured questionnaire interview and clinical assessment of the prevalence, motivation, costs, and subjective assessment of CAM. Results: Of the patients, 16.7% used at least one type of CAM to treat their allergic diseases. Common types of CAM were diet (48.6%), aroma therapy (23.8%), massage (14.3%), breathing exercises (7.6%), baths (5.7%), and mind control (5.7%). The therapeutic effects of CAM included improved in patients using mind control (50%), diet (50%), breathing exercises (75%), and baths (33.3%), but worse in patients using aroma therapy (28%), and massage (26.7%). About 36.4% of the patients used CAM more than four times per year, and the average cost per CAM user was 370,000 won/year. The main reason for trying CAM was `hope to improve my constitution`. Conclusions: CAM is used widely for treating allergic diseases in Korea. Detailed knowledge of CAM and patient education are important. Further studies of the clinical efficacy of CAM are needed. (Korean J Med 2011;80:68-77)

수술환자에 있어 수술실내에서 수술대기 시간이 불안에 미치는 영향에 관한 연구

이혜원,이규정,김해옥,이해옥,김혜숙,이미경,송말순,Lee, Hea-Won,Lee, Kyu-Chung,Kim, Hae-Ock,Lee, Haik-Ock,Kim, Hea-Suk,Lee, Mi-Kyung,Song, Mal-Soon 대한간호협회 1990 대한간호 Vol.29 No.3

This study was attempted to provide us with basic information on how to improve understanding with patients for operation, and to offer then better nursing and treatment. This kind of study will help scientific application to nursing practice and operating room. The data was collected by interviewing 29 patients who underwent the elective surgery under the general anesthesia at Y hospital in Seoul. The interview ran from October 15 to December 15, 1989. The research instrument was a anxiety measurement device (SAAI) originally developed by Spielberger, et al and modified by Jung-Tack Kim. 1. Hypothesis Testing Hypothesis one was that there would be a difference in state anxiety level according to a time difference in watiting for operation. This hypothesis was rejected(state.anxiety level one hour before operation P>.05, r-.747, State anxiety level half an hour before operation P>.05, r-.1550, state anxiety level just before operation, P>.05, r=.1099). However, state anxiety, evel appeared to be associated with a longer watiting period, like one day before operation (P<.05, r-.4628). Hypothesis two was that there would be a difference according to state anxiety level of patients for operation. This was rejected. (Change of blood perssure in systolie P>.05 r=.1082, Change of blood pressure in diastolic P>.05, r=.088, Change of pulse rate, P>.05, r-1.909) 2. Examining trait anxiety and state anxiety levels, the average level of trait anxiety was 42.034, and the average level of state anxiety one day before operation was 43,000. The average level of state anxiety was averaged 42.356 in a waiting room for operation. 3. Examining the state anxiety level by time period, the one hour before was 42.379 the level half an hour before 42.276, and the level just before operation 42.414. The low level of state anxiety was due to the fact that premedication was not eliminated. 4. Age and time period like one day before operation was related to state anxiety level (F=5.271, P<.0.01) and blood pressure in waiting room for operation. That is, state anxiety level and blood pressure of patients one day before operation appeared high. Sex was relation to changes of blood pressure ; the blood pressure of male patients appeard higer than of female patients. A marital status was also related anxiety level one hour before operation the married patient for operation showed a higher state anxiety level than that of the unmarried patient for operation. Education was similarily related to trait anxiety level in which highly educated patients show lower levels of trait anxiety than poorly educated ones. Motive for hospitalization was related to state anxiety level for patient one hour before operation (F=6.464, P<.05) likewise, patients who are supposed to undergo operation hastily showed higher levels of anxiety than patients who expect elective surgeries.

HCV, Alcoholic : PE-096 ; Clinical and histopathological features of acute onset autoimmune hepatitis

( Min Young Rim ),( Soo Yong Park ),( In Ku Yo ),( Min Su Ha ),( Ju Seung Kim ),( Ju Won Lee ),( Young Kul Jung ),( Dong Hae Chung ),( Oh Sang Kwon ),( Yun Soo Kim ),( Duck Joo Choi ),( Ju Hyun Kim1 ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Autoimmune hepatitis (AIH) is a progressive inflammatory liver disease of unknown etiology that is reported to be a consequence of aberrant autoreactivity. Several studies which reported the acute presentation of AIH have different clinical course and histologic features. In this study, we compared acute presentation of AIH and chronic presentation of AIH. Methods: We retrospectively reviewed the medical records of patients with autoimmune hepatitis from January 2003 to June 2011 at Gachon University, Gil Hospital. A total of 29 patients were enrolled, 7 patients were diagnosed with acute presentation of AIH. Results: There was no difference between two group in age, gender, and score system of AIH. Patients with acute presentation had higher serum levels of total bilirubin, lower serum levels of albumin in clinical feature (p<0.05), and higher frequency of zone 3 necrosis in histologic feature. The cumulative incidental rate of the normalization of serum AST and ALT levels with prednisolone treatment was similar between patients with acute presentation and chronic presentation in clinical course. Conclusions: Higher AST, ALT and, bilirubin were clinical specific feature, and zone 3 necrosis is a histological characteristic of autoimmune hepatitis with acute presentation.

Practice guidelines for managing extrahepatic biliary tract cancers

Hyung Sun Kim,Mee Joo Kang,Jingu Kang,Kyubo Kim,Bohyun Kim,Seong-Hun Kim,Soo Jin Kim,Yong-Il Kim,Joo Young Kim,Jin Sil Kim,Haeryoung Kim,Hyo Jung Kim,Ji Hae Nahm,Won Suk Park,Eunkyu Park,Joo Kyung Par The Korean Association of Hepato-Biliary-Pancreati 2024 Annals of hepato-biliary-pancreatic surgery Vol.28 No.2

Backgrounds/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions: The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Characterization of the asp Mutations in Asparaginase Ⅱ-deficient Yeast Strains

Kim, Kyu-Won,Hong, Young-Soo,Lee, Su-Jae,Chung, Hae-Young 부산대학교 유전공학연구소 1992 분자생물학 연구보 Vol.8 No.-

We have studied the genomic structure of the ASP3 gene in the wild type and asp mutant Saccharomyces cerevisiae strains. The asp2. asp3 and asp6 mutant strains did not synthesize asparaginase Ⅱ under both nitrogen-starved and nitrogen-rich conditions. Southern blot analysis showed that the ASP3 gene was completely deleted in the asp3 mutant strain. In contrast, the ASP3 gene structure was essentially intact in the asp2 and asp6 mutant strains. Northern blot analysis indicated that the asp2 and asp6 mutants did not synthesize ASP3 mRNA in spite of the presence of an intact ASP3 gene. These results implied that the loss of asparaginase Ⅱ was related to the extensive deletion of the structural gene in the asp3 mutant strain or probably some defects in the regulatory genes in the asp2 and asp6 mutant strains.

Changes in Plasma Cortisol in Patients with Bronchial Asthma

Kim, Kwan Hyoung,Han, Ki Don,Song, Jeong Sup,Moon, Hwa Sik,Park, Sung Hak,Byun, Hae Won CATHOLIC MEDICAL CENTER 1987 Bulletin of the Clinical Research Institute Vol.15 No.1

To examine the possible contribution of the circardian rhythm of plasma cortisol level to pathogenesis of bronchial asthma, the levels of plasma cortisol were measured at 8 A.M., 11 P.M., before and after ACTH infusion for 8 hours. The observed results were as follows : 1. In patients with bronchial asthma without nocturnal dyspnea, the value of plasma cortisol at 8 A.M. was 15.1 ± 7.0 ug/dl and at 11 p.M.8.8 ± 5,7 ug/dl. 2. In 17 patients with nocturnal or morning dipper asthma, the value of plasma cortisol at 11 P.M. was 3.2 ± 1.1 ug/dl and was lower than that of bronchial asthmatics without noctural dyspnea (p < 0.01). 3. In 20 bronchial asthmatics without nocturnal dyspnea. The value of plasma cortisol before ACTH infusion was 12.6 ± 5.9 ug/dl and after ACTH infusion 35.1 ±3.2 ug/dl. The results of present study show that the patients with bronchial asthma have normal circardian rhythm of cortisol level, but the bronchial asthamtics with nocturnal dyspnea have lower level of plasma cortisol at 11 P.M. than that of bronchial asthmatics without nocturnal dyspnea. The function of adrenal cortisol secretion after stimulation with ACTH infusion was normal. The circardian rhythm of coirticosteroid secretion seems to be a possible factor of nocturnal asthma.

Structure and in silico substrate-binding mode of ADP-L-glycero-D-manno-heptose 6-epimerase from Burkholderia thailandensis.

Kim, Mi-Sun,Lim, Areum,Yang, Seung Won,Park, Jimin,Lee, Daeun,Shin, Dong Hae Wiley-Blackwell 2013 Acta crystallographica. Section D, Biological crys Vol.69 No.4

<P>ADP-L-glycero-D-manno-heptose 6-epimerase (AGME), the product of the rfaD gene, is the last enzyme in the heptose-biosynthesis pathway; it converts ADP-D-glycero-D-manno-heptose (ADP-D,D-Hep) to ADP-L-glycero-D-manno-heptose (ADP-L,D-Hep). AGME contains a catalytic triad involved in catalyzing hydride transfer with the aid of NADP(+). Defective lipopolysaccharide is found in bacterial mutants lacking this gene. Therefore, it is an interesting target enzyme for a novel epimerase inhibitor for use as a co-therapy with antibiotics. The crystal structure of AGME from Burkholderia thailandensis (BtAGME), a surrogate organism for studying the pathogenicity of melioidosis caused by B. pseudomallei, has been determined. The crystal structure determined with co-purified NADP(+) revealed common as well as unique structural properties of the AGME family when compared with UDP-galactose 4-epimerase homologues. They form a similar architecture with conserved catalytic residues. Nevertheless, there are differences in the substrate- and cofactor-binding cavities and the oligomerization domains. Structural comparison of BtAGME with AGME from Escherichia coli indicates that they may recognize their substrate in a `lock-and-key' fashion. Unique structural features of BtAGME are found in two regions. The first region is the loop between β8 and β9, affecting the binding affinity of BtAGME for the ADP moiety of ADP-D,D-Hep. The second region is helix α8, which induces decamerization at low pH that is not found in other AGMEs. With the E210G mutant, it was observed that the resistance of the wild type to acid-induced denaturation is related to the decameric state. An in silico study was performed using the Surflex-Dock GeomX module of the SYBYL-X 1.3 software to predict the catalytic mechanism of BtAGME with its substrate, ADP-D,D-Hep. In the in silico study, the C7'' hydroxymethyl group of ADP-D,D-Hep is predicted to form hydrogen bonds to Ser116 and Gln293. With the aid of these interactions, the hydroxyl of Tyr139 forms a hydrogen bond to O6 of ADP-D,D-Hep and the proton at C6 orients closely to C4 of NADP(+). Therefore, the in silico study supports a one-base mechanism as a major catalytic pathway, in which Tyr139 solely functions as a catalytic acid/base residue. These results provide a new insight into the development of an epimerase inhibitor as an antibiotic adjuvant against melioidosis.</P>

The Effect of Moisture Absorption and Gel-coating Process on the Mechanical Properties of the Basalt Fiber Reinforced Composite

Kim, Yun-Hae,Park, Jun-Mu,Yoon, Sung-Won,Lee, Jin-Woo,Jung, Min-Kyo,Murakami, Ri-Ichi Korean Society of Ocean Engineers 2011 International journal of ocean system engineering Vol.1 No.3

Generally, strength degradation is caused by the absorption of moisture in composites. For this reason, a fracture is generated in the composites and traces of glass fiber degrade human health and physical damage is generated. Therefore, in this research, we studied the mechanical properties change of composites by moistureabsorption. The composites were manufactured with and without the Gel-coating process and were immersed in a moisture absorption device at $80^{\circ}C$ for more than 100 days. The mechanical properties of the moistureabsorption composites and the composites which dry after moisture-absorption were compared. The mechanical properties degradation of basalt fiber composites according to the result of the measurement of moistureabsorption was smaller than that of glass fiber composites by about 20%. In addition, the coefficient of moisture absorption was lower for the case of Gel-coating processing than the composites without the Gel-coating process by about 2% and it was deduced that Gel-coating did not have a significant effect on the mechanical properties.