Association between sleep duration and bone mineral density density in Korean adults over 18years old: Based on the Korea National Health and Nutrition Examination Survey, 2010

Background: Sleep duration is associated with many diseases, yet few studies have been performed on the association between sleep duration and bone mineral density(BMD) in Korea. In this study we investigated the association between sleep duration and bone mineral density in adults over 18 years of age. Methods: Subjects of this study were adults over 18 years of age who responded to a questionnaire on sleep duration and underwent BMD measurement by dual X-ray absorptiometry. Comprehensive data on the study sample was obtained from the Korean National Health and Nutrition Examination Survey(KHANES) conducted in 2010. Age- and sex-stratified multiple regression analyses were conducted with adjustment for possible confounding factors. Results: There was an inverse, dose-dependent association between sleep duration and BMD measured in the total femur, femur neck, lumbar spine and total bone in both women over 50 years of age and men between 30 and 49 years of age. Sex-stratified multiple regression analysis adjusted for age and body mass index revealed a negative correlation between sleep duration and BMD in the total femur and femur neck in both genders over 50 years of age, as well as in women between ages 30 and 49. Initial significance disappeared after adjustment for additional covariates including smoking, alcohol, and exercise. Conclusion: Significant variations in regional BMD with sleep duration were observed among women and men between ages 30 and 49. Prolonged sleep duration appears to be a risk factor for low bone mineral density. Thus, adequate sleep duration is important for preventing osteoporosisope

Association between daily protein intake and cardiometabolic risk factors and metablic syndrome in Korean elderly women: Based on the Korea National Health and Nutrition Examination Survey, 2009~2013

Background: The Rrecommended daily aAllowances (RDA) of for protein is increasing in recent studieshas increased in recent studies. However, virtual protein intake is lower than the RDA in the majority of Korean elderly Korean women. ObjectPurpose: This study was performed to evalauate the relationship between protein intake, and cardiometabolic risk factors, and metabolic syndrome in Korean elderly Korean women group. Methods: This study used the data from Korea National Health and Nutrition Survey administered from for 5years in 2009~2013. We performed multivariate analysis for on the association of between protein intake with and cardiometabolic risk factors including body weight, weight circumference, blood pressure, glucose, triglycerides, and HDL. We controlled for age, physical activity, energy intake, carbohydrate intake, total fat intake, smoking, and alcohol consumption. Then weWe then performed logistic regression analysis to study of the associateion with metabolic syndrometo assess association with metabolic syndrome. Results: Protein intake was inversely associated with BMI and, weight circumference, ,whereas a positive association was observed between protein intake and HDL cholesterol, especially in the normal weight group. Protein intake also haswas also association associated with metabolic syndrome. Conclusion: In this study, protein intake is was related associated with cardiometabolic risk factors and metabolic syndrome. We recommend sufficient protain protein intake in elderly women to decrease cardiometabolic risk factors and metabolic syndrome.ope

Association between Body Mass Index, Waist Circumference and Prevalence of Microalbuminuria in Korean Adults of Age 30 Years and Older without Diabetes, Hypertension, Renal Failure, or Overt Proteinuria: The 2013 Korean National Health and Nutrition Examination Survey

BACKGROUND: Microalbuminuria and obesity markers are known risk factors for cardiovascular or renal disease. This study aimed to evaluate the prevalence of microalbuminuria according to body mass index (BMI) and abdominal obesity criteria. METHODS: The study subjects included 3,979 individuals aged 30 years or older who did not have diabetes, hypertension, renal failure, or overt proteinuria, from among those who participated in The Korean National Health and Nutrition Examination Survey in 2013, a cross-sectional, nationally representative, stratified survey. Microalbuminuria was defined as a urinary albumin to creatinine ratio of 30 to 300 mg/g. BMI and waist circumference were classified according to the Asia-Pacific criteria. RESULTS: The prevalence of microalbuminuria was found to be 5.1%. In the normoalbuminuria group, 3.4%, 41.7%, 24%, 27.6%, and 3.2% of participants were included in the underweight, normal, overweight, obesity 1, and obesity 2 groups, respectively. These percentages in the microalbuminuria group were 7.1%, 34.5%, 19.2%, 28.6%, and 10.6%, respectively (P<0.001). The waist circumference in men was 21.4% in the normoalbuminuria group and 36.5% in the microalbuminuria group (P=0.004). Logistic regression analyses were performed to evaluate the relationship between the presence of microalbuminuria and BMI or waist circumference groups. The risk of microalbuminuria was significant only in the underweight group (odds ratio, 13.22; 95% confidence interval, 2.55-68.63; P=0.002) after adjusting for confounding factors, abdominal obesity was not significantly associated with microalbuminuria. CONCLUSION: The prevalence of microalbuminuria in a general population in Korea was associated with underweight in men and was not associated with waist circumference in either men or women.ope

Spectroscopy of molecular ions and their state-selective reaction dynamics

Thesis(doctor`s)--서울대학교 대학원 :화학부,2007.Docto

The relavance between death within 30 days and stroke quality assessment of patients and stroke quality assessment of patients

Objective With the rapid aging process in Korea, cerebrovascular diseases such as stroke generates additional social cost burden through high incidence of related mortality and disabilities. Therefore, the purpose of this study was to identify the death relevance within 30 days of hospitalization according to the assessment of stroke quality of medical institutions and analyze the factors affecting the death of stroke patients. Methods The study analyzed 45,741 patients who were diagnosed with stroke and underwent surgery and 374 hospitals that were based on data from Health Insurance Review and Assessment Service(HIRA) dataset from January 1, 2013 to December 31, 2016. The diagnosis of stroke was made by ICD-10 CODE I60-I63. The groups were divided into those that were assessed for stroke quality and those that were not evaluated. The distribution and percentages of the demographic characteristics were measured in groups by Chi-square test and survival analyzes were performed using a Cox proportional hazards model. A majority of logistic quasi-analysis was performed using the Glimix Procedure of SAS, which is a generalized linear mixed models (GLMM), to measure the relationship between death and the variables related to medical institutions and stroke patients. All statistical analyzes were performed using SAS software, version 9.4(SAS Institute, Cary, North Carolina, USA), and all statistical significance levels were set below 0.05. Results Of the total 45,741 patients, at a medical institution that was evaluated for stroke quality 90.5% (40,041 patients) survived, 9.5% (4,181 patients) died and at a medical institution that was not evaluated for stroke quality 84.0% (1,276 people) survived and 16.0%(243 people) died. Stroke mortality were higher in not evaluated stroke group. In the analysis of the relationship between volume performance and mortality, in the lower volume group(Tertile 1, Low) 1,884 (12.5%) died and 13,240 (87.5%) survived, in the middle volume group(Tertile 2) 1,281 (8.6%) died and 13,652 (91.4%) survived, in the upper volume group (Tertile 3, High) 1,259 (8.0%) died and 14,425 (92%) survived. Stroke mortality rate was the lowest in the upper volume group while the lower volume group had a lower survival rate than the middle volume group. Compared to the group that was evaluated for quality, men in the unassessed group had a 1.57 times higher risk of death, and women 1.61 times higher. The risk of stroke patients in unassessed groups dying was 1.31 times higher if the medical institutions location was located in the city, and 1.61 times higher if they were located in non-urban areas, so the risk of death was high if they were located in non-urban areas. In the analysis of the relationship between stroke mortality and mortality in the age group under 40's was 1.52 times higher, 1.82 times in 50's, 1.72 times in 60's, 1.55 times in 70's and above compared to the group receiving stroke quality evaluation, all of which were statistically significant. In the analysis of relevance according to the type of health insurance, compared to the group evaluated, the risk of unassessed group health insurance holders dying from stroke was 1.40 times higher, while those eligible for medical aid were 2.32 times higher. In the analysis of the relationship between mortality and admission route, groups that are not evaluated compared to groups that are evaluated was higher 1.67 times hospitalized in the emergency room, and outpatient was 1.57 times high and all were statistically significant. Conclusion The risk of mortality was higher when hemorrhagic stroke patients were operated in an medical institution that was not evaluated for stroke quality and the lower the volume performance, the higher the mortality rate. The risk of stroke mortality was higher that as the age increases, women than men, non-urban medical institutions, admission route is an emergency room rather than an outpatient, the lower the cost of health care, medical aids are higher than health insurance. In order to reduce stroke mortality and improve overall quality of stroke care, it is necessary to manage unassessed medical institutions(small and medium sized hospitals). Developing and managing indicators of stroke risk factors for medical institutions that are not assessed for quality will lead to reduced mortality and disability rates for stroke patients and ultimately contribute to lower health care finances. 연구목적 우리나라는 노인인구의 증가와 더불어 뇌졸중 등 뇌혈관 질환으로 높은 발생률 과 사망률로 사회적 부담을 가중시키고 있다. 이에 출혈성 뇌졸중 수술 환자를 대상 으로 요양기관의 뇌졸중 적정성 평가여부에 따른 입원 30일내 사망 관련성을 파악 하고, 뇌졸중 환자의 사망에 영향을 미치는 요인을 분석하는 것을 목적으로 한다. 연구대상 및 방법 이 연구는 2013년 1월 1일부터 2016년 12월 31일까지 건강보험심사평가원 요양 급여비용 청구데이터 중 출혈성 뇌졸중으로 진단받고 수술 치료한 45,741명의 환자와 374개 요양기관을 대상으로 분석하였다. 뇌졸중의 진단은 ICD-10 CODE I60-I63으로 정하였고, 뇌졸중 적정성 평가를 받는 그룹과 평가받지 않는 그룹으로 구분하였다. 연구대상의 일반적인 특성을 알아보기 위해 Chi-square test를 사용 하였으며, 의료기관 및 뇌졸중 환자 관련 변수들과 사망과의 관계를 측정하기 위해 generalized linear mixed models (GLMM)인 SAS의 Glimmix Procedure 를 이용하여 로지스틱 다수준분석을 실시하였다. 모든 statistical analysis는 SAS software, version 9.4(SAS Institute, Cary, North California, USA) 를 사용하였다. 모든 통계 유의 수준은 0.05 이하로 정하였다. 연구결과 전체 45,741명 대상 환자 중 뇌졸중 적정성 평가를 받는 요양기관에서 뇌졸 중 수술을 받은 환자는 90.5%(40,041명)가 생존, 9.5%(4,181명)이 사망하였고, 뇌졸중 적정성 평가를 받지 않는 요양기관에서는 84.0%(1,276명)가 생존, 16.0% (243명)이 사망하여 뇌졸중 적정성 평가를 받지 않는 요양기관에서 환자의 사망률 이 더 높았다. 진료량과 사망률과의 관련성 분석에서, 진료량 하위그룹은 1,884명 (12.5%)이 사망, 13,240명(87.5%)이 생존하였고, 중위그룹은 1,281명(8.6%)이 사망, 13,652명(91.4%)이 생존하였으며, 상위그룹은 1,259명(8.0%)이 사망, 14,425명(92%) 이 생존하여 진료량이 높은 상위그룹에서 사망률이 가장 낮았고, 하위그룹은 중위그 룹보다 더 생존율이 낮았다. 적정성 평가 받는 그룹 대비 평가 받지 않는 그룹의 남성이 사망할 위험이 1.57배 높았고, 여성은 1.61배 높았다. 요양기관 소재지가 도시에 위치한 경우 평가를 받지 않는 그룹의 뇌졸중 환자가 사망할 위험이 1.31배 높았고, 비도시에 위치한 경우 사망위험이 1.61배 높아 비도시에 위치한 경우 사망할 위험이 높았다. 연령과의 관련성 분석에서 평가 받는 그룹 대비 40대 이하 뇌졸중 사망위험이 1.52배, 50대 연령은 1.82배, 60대는 1.72배, 70대 이상은 1.55배 높았고 모두 통계적으로 유의하였다. 의료보장 유형에 따른 관련성 분석에서 평가 받는 그룹 대비 평가 받지 않는 그룹의 건강보험 자격자가 뇌졸중으로 사망할 위험이 1.40배 높았고, 의료급여 자격자는 2.32배 높았다. 입원 경로와의 관련성 분석결과 평가 받는 그룹 대비 평가 받지 않는 그룹이 응급실로 입원한 경우 사망 위험이 1.67배 높았고, 외래로 입원한 경우 1.57배 높았고 모두 통계적으로 유의 하였다. 결론 출혈성 뇌졸중 환자가 뇌졸중 적정성 평가를 받지 않은 기관에서 수술한 경우 사망할 위험이 더 높았고, 진료량이 적을수록 사망위험이 증가하였다. 연령이 증가할수록, 여성보다 남성이, 요양기관 소재지가 비도시인 경우, 외래보다는 응급실로 경유하여 입원하는 경우, 건당진료비가 낮은 경우, 건강보험 자격자 보다 의료급여 자격자가 뇌졸중으로 사망할 위험이 높았다. 뇌졸중 사망률을 감소시키고 전반적인 질적 수준을 향상시키기 위해서는 평가받지 않는 요양기관의 관리도 필요하다. 적정성 평가를 받지 않는 기관의 뇌졸중 위험요인 에 대한 지표를 개발하여 평가 영역을 확대시키고 관리하는 등의 노력을 기울이면, 뇌졸중 환자의 사망률과 장애율 감소로 이어지게 될 것이고, 궁극적으로는 보건의료 재정 절감에도 기여할 것이다.open석

시판되는 각종 음료수내 불소 함량과 소아의 불소섭취에 관한 연구

학위논문(석사)--서울대학교 대학원 :치의학과 소아치과학전공,1997.Maste

Quantitative analysis of glucosyltransferase gene expression in xylitol-resistant Streptococcus mutans and Streptococcus sobrinus

학위논문(박사)--서울대학교 대학원 :치의학과,2007.Docto

Restructuring School Education for an IT Society

Currently, we are experiencing a rapid societal change due to information technology (IT). The perceived rapidity of this change presents major challenges to societal adaptation. Schools, like any other aspect of society, need to adapt to this societal change, originating from the IT revolution. We need to figure out what kinds of educational change need to take place. Therefore, this study explores how schools should build an information-oriented education system in an IT society. This issue is examined through the following three questions: 1. How can an information-oriented learning system play a role in helping students use and produce knowledge on their own? 2. How should education be changed to prepare students to survive in this knowledge-based labor market? 3. How should teachers interact with students in digital code? Moreover, this study surveys people's perceptions about the gap between the present state of education and an IT society. Separate questionnaires on the suject were given to teachers (n = 206), students (n=474), and parents (n=429) in Seoul. The data were analyzed with x2 tests. The findings and conclusions are summarized as following. This study found that presently education does not playa good role in offering information-knowlege appropriate to an IT society. School graduates are not able to meet the needs of companies or labor markets in this IT society. In other words, schools neither educate students with high-tech knowledges, nor sufficiently nurture their creativity. Students in digital code seem to have difficulty in interacting with schools who have stayed in analogue code. Based upon these findings, this study suggests how an information-oriented learning system should be built. This study analyzes three aspects of schooling regarding these issues: teachers, curriculum, and educational interaction. Regarding the issue of teachers, this study examines what the teachers' role as facilitators should be to help students produce their own knowledge with raw information. In addition, it redefines the concept of the teachers' authority and explores a labor cooperation system of teachers to increase the performance of their own teaching using the internet. This study will also suggest various types of curricula which will complement the labour markets in an IT society. For example, the study suggests curricula which allow students diversified tracks: individualized curriculum ordered by each student, who is an educated prosumer and knows what they need; curriculum in fusion style where no borders exists between academic disciplines; curriculum to enhance the students' practical intelligence as well as critical intelligence Lastly, the study investigates how digitalized interaction could be used in an educational setting at school. Proposed in the study are two-way-e(lectric)-conversations between students within and beyond classrooms, between students and teachers, or between students and e-textbooks. This study promotes these kinds of educational reforms as a result of the IT revolution, which could reduce the students' panic and anxiety due to radical changes in the nature of work and of production organization in this IT society. School is not an exception; it should also be flexible in a changing and evolving society

아르곤 레이저의 소아치과에서의 임상적 적용

Argon laser used in this case report, is special in having two wavelength of 488, 514nm blue-green visible light spectrum. Blue light is used for composite resin polymerization and caries detection. Green light is used for soft tissue surgery and coagulation. Maximum absorption of this laser light occurs in red pigmentation such as hemoglobin. The argon laser may be well-suited for selective destruction of blood clots and hemangioma with minimal damage to adjacent tissues. Argon laser light penetrates tissue to the 1 mm depth, so its thermal intensity is lower than laser light. Also, due to its short wavelength it can be focused in a small spot and even single gene can be excised by this laser and microscopy. After applicating argon laser to 4 patient for surgical procedure and to 1 patient for curing the composite resin, following results were obtained. 1. Improved visibility were gained due to hemostasis and no specific technique were needed according to easy recontouring of the tissue. 2. Ability to use by contact mode, tactile sense was superior but tissue dragability and accumulation of tissue on the tip needed sweeping motion. 3. Additive local anesthetic procedure was needed. 4. No suture and less curing time reduced chair time, this made argon laser available in pediatric dentistry