적절하게 조절되지 않는 중증 천식환자에서 급성 악화 유형과 사망 및 의료비 발생 현황

한솔아,서혜선 대한약학회 2019 약학회지 Vol.63 No.5

Patients with severe and uncontrolled asthma are at high risk for severe exacerbation and death, and are knownto have significantly more health care utilization than well-controlled patients. This study aims to report types ofexacerbation, case-fatality and medical costs in patients with severe and uncontrolled asthma. We used Health InsuranceReview and Assessment Service-National Patient Sample 2016~2017. Four types of exacerbation were defined:exacerbation requiring corticosteroid burst, exacerbation requiring emergency room visit, exacerbation requiring generalward admission, and exacerbation requiring intensive care unit (ICU) admission. The 28 day case-fatality was calculatedfor exacerbation requiring general ward and ICU admission, respectively. The medical cost by types of exacerbation werecalculated as total medical cost incurred during the exacerbation episodes. The 28 day case-fatalities for exacerbationrequiring general ward and ICU admission were 0.033 and 0.167, respectively. The medical cost per episode of the abovefour exacerbations were 78,818 Korean won (KRW), 561,832 KRW, 1,923,265 KRW and 11,215,063 KRW, respectively. We reported types of exacerbation, 28 day case-fatality and medical costs in patients with severe and uncontrolled asthma. This study was significant because it clearly defined and distinguished the patient group and each exacerbation episodes.

안구위축 또는 무안구에 동반된 안구함몰 교정을 위한 눈뒤 필러 주입술의 효과

한솔아,양민규,최영아,사호석 대한안과학회 2023 대한안과학회지 Vol.64 No.1

Purpose: To describe the clinical outcome of retrobulbar injection of synthetic fillers to correct enophthalmos associated with phthisis bulbi or anophthalmos. Methods: We retrospectively reviewed the medical records of patients who underwent enophthalmos correction using retrobulbar filler injections at Asan Medical Center between January 2015 and October 2019, and who were followed for at least 6 months. We evaluated the number of injections and amount of filler injected, improvement in enophthalmos, interval between injections, and adverse effects of filler injection. Results: The study enrolled five patients (four females and one male). Two patients had anophthalmos after evisceration and three had phthisis bulbi. Two patients received hyaluronic acid (HA) filler only, one had collagen-polymethylmethacrylate (PMMA) filler only, and two had both fillers. The HA and collagen-PMMA filler volumes per injection were 1.0–1.4 and 0.75–1.0 mL, respectively. The average degree of enophthalmos, compared to the contralateral eye, was 1.8 mm; the amount of enophthalmos correction per 1 mL of filler injection was 1.5 mm for HA filler and 1.4 mm for collagen-PMMA filler. The longest duration of enophthalmos correction was 15 months for HA filler and 25 months for collagen-PMMA filler. There were no significant adverse effects, but anterior migration of HA filler was observed in one case that resolved with hyaluronidase injection. Conclusions: Retrobulbar filler injection is a safe, effective, minimally invasive procedure for correcting enophthalmos in patients with anophthalmos or phthisis bulbi. If HA filler injection shows good outcomes without adverse effects, semi-permanent fillers can be used for long-term maintenance of enophthalmos correction. Further studies with more patients and long-term follow-up are needed to compare the effectiveness of various fillers. 목적: 안구위축 또는 무안구 환자에서 생긴 안구함몰을 비수술적으로 교정하기 위하여 시행한 눈뒤 필러 주입술의 임상적 결과에대해 알아보고자 한다. 대상과 방법: 안구위축 또는 무안구 환자에서 동반된 편측 안구함몰 교정을 위하여, 히알루론산 필러 또는 콜라겐-polymethylmethacrylate (PMMA) 혼합 필러의 눈뒤 주입술을 시행 받은 뒤 최소 6개월 이상 경과 관찰한 환자들을 후향적으로 분석하였다. 시술 전후 안구돌출계를 측정하고, 눈뒤 주입된 필러의 종류와 용량, 시술 횟수, 시술 사이 기간 및 합병증에 대해 살펴보았다. 결과: 총 5명의 환자가 연구에 포함되었고, 2명은 안구내용제거술 후 무안구 상태였으며, 3명은 안구위축 상태였다. 모든 환자에서안구함몰 개선 효과를 보였고, 시술과 관련된 특별한 합병증은 없었다. 히알루론산 필러의 일회당 주입량은 1.0-1.4 mL였고, 콜라겐-PMMA 필러는 0.75-1.0 mL였다. 필러 1 mL 당 안구함몰 교정 효과는 히알루론산 필러가 평균 1.5 mm였고 콜라겐-PMMA 필러의경우 1.4 mm였다. 시술 사이 기간은 히알루론산 필러가 최대 15개월, 콜라겐-PMMA 필러는 최대 25개월이었다. 결론: 실명한 환자에서 미용 목적으로 안구함몰을 교정할 때, 눈뒤 필러주입술은 눈뒤 주사가 익숙한 안과 의사가 비교적 쉽고 안전하게 시행할 수 있는 비수술적 치료 방법이다. 히알루론산 필러 시술에 좋은 결과를 보이는 환자에서는, 반영구 필러를 사용함으로써더 오랜 기간 교정 효과가 유지되는 것을 기대할 수 있다.

천식 환자의 응급실을 통한 입원: 연관성 규칙 마이닝

한솔아,서혜선 한국보건의료기술평가학회 2019 보건의료기술평가 Vol.7 No.2

Objectives: To explore the patients’ characteristics associated with hospitalization through emergency department (ED) visit with asthma exacerbation by using association rule mining (ARM) Methods: A retrospective cross-sectional study was performed using ED visit cases from National Emergency Department Information System database 2016. In 2016, 9127979 ED visit cases collected. We included ED visit cases with discharge diagnosis of asthma (ICD-10 code of J45/J46). ARM was performed with Apriori algorithm to explore association rules between patients’ characteristics and hospitalization through ED visit. Hospitalization includes admissions to general ward and intensive care unit. The association rules (A⇒B) meant that if a person has a feature A, a person also has a feature B (hospitalization). We used support, confidence, and lift to select interesting rules. Support was defined as the proportion of an itemset in the data. Confidence was used as a measure of reliability. Lift was used to estimate whether the occurrences of A and B were independent or not. The higher confidence, the more likely to have an interesting relation between A and B. The higher lift (lift >1), the more likely that there was a dependency between A and B. We eliminated redundant rules that have similar meanings. Results: We included 28179 ED visit cases for the analysis. We extracted association rules with a support ≥0.5%, a confidence ≥80% and a lift >1. After eliminating redundant rules, the rule with the highest confidence and lift was the rule ({over-80-year-old, female, comorbid with pneumonia}⇒hospitalization) with confidence: 80.87% and lift: 2.94. Conclusion: Among patients visited the ED with asthma exacerbation, combination of elderly, female, and comorbid with pneumonia was importantly associated with hospitalization.

노인 중증 천식에서 장기 경구스테로이드 사용으로 인한 감염 발생 위험 연구

한솔아,손진선,김형태,김시인,서혜선 한국보건의료기술평가학회 2018 보건의료기술평가 Vol.6 No.1

Objectives: To evaluate the risk of infections by long-term oral corticosteroid use in elderly patients with severe asthma. Methods: This is a retrospective cohort study using nationally representative data, namely Health Insurance Review and Assessment Service-Aged Patient Sample 2015, that included medical and pharmacy claims of approximately 1 million elderly patients aged 65 or older. We included severe asthma patients who were classified as step 5 of Global Initiative for Asthma (GINA) guideline. Multivariate logistic regression was performed to compare incidence of infection in severe asthma patients continuously exposed ≥3 months oral corticosteroids (OCS) with severe asthma patients who continuously exposed ≥3 months tiotropium. Results: A total of 45 patients in OCS group and 107 patients in tiotropium group were identified. The odds of developing associated any infections were slightly higher but not significant in OCS group compared to those in tiotropium group; odds ratio (OR)=1.50, 95% confidence interval (CI)=0.67−3.36. In sub-group analysis, the odds of developing pneumonia were slightly lower (OR=0.78, 95% CI=0.30−2.00) and developing fungal infection were higher (OR=2.30, 95% CI=0.89−6.00) in OCS group compared to tiotropium group but both were not significant. Conclusion: Infections are known as oral corticosteroid related complication. However, the results of relationship between OCS use and incidence of infection were not significant. Further studies are warranted to evaluate the incidence of oral corticosteroids related infection

편의점 PB(Private Brand)상품에 대한 인식이 대학생 소비자의 만족도에 미치는 영향

한솔,전민선 한국식생활문화학회 2018 한국식생활문화학회학술대회논문집 Vol.2018 No.06

[행복 일기] 내 동생 마쉴라

한솔 샘터사 2009 월간 샘터 Vol.467 No.-

남자 대학생들의 니트웨어에 대한 인식과 구매행동

한솔비(Sol-bi Han),이진경(Jin-kyoung Lee),권민정(Min-jung Kwon),김재환(Jae-hwan Kim),이지연(Ji-yeon Lee) 한국의상디자인학회 2010 한국의상디자인학회지 Vol.12 No.1

현대독일시감상(現代獨逸詩鑑賞)(1

한솔 한국독어독문학회 1966 獨逸文學 Vol.5 No.1

편의점 PB(Private Brand)상품에 대한 인식이 대학생 소비자의 만족도에 미치는 영향

한솔,전민선 동아시아식생활학회 2018 동아시아식생활학회 학술발표대회논문집 Vol.2018 No.6

다양한 기능성 물질의 황화수소 흡착 성능평가

한솔,김기현 한국분석과학회 2019 학술대회논문집 Vol.2019 No.5