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관상동맥우회술의 중증도 측정과 병원 사망률 비교에 관한 연구
안형식,신영수,권영대,Ahn, Hyung-Sik,Shin, Young-Soo,Kwon, Young-Dae 대한예방의학회 2001 Journal of Preventive Medicine and Public Health Vol.34 No.3
Objective : Health insurers and policy makers are increasingly examining the hospital mortality rate as an indicator of hospital quality and performance. To be meaningful, a risk-adjustment of the death rates must be implemented. This study reviewed 5 severity measurement methods and applied them to the same data set to determine whether judgments regarding the severity-adjusted hospital mortality rates were sensitive to the specific severity measure. Methods : The medical records of 584 patients who underwent coronary artery bypass graft surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups, Disease Staging, Computerized Severity Index, APACHE III and KDRG were used to quantify severity of the patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex to evaluate the hospitals' performance, the ratio of the observed number of deaths to the expected number for each hospital was calculated. Results : The overall in-hospital mortality rate was 7.0%, ranging from 2.7% to 15.7% depending on the particular hospital. After the severity adjustment, the mortality rates for each hospital showed little difference according to the severity measure. The 5 severity measurement methods varied in their statistical performance. All had a higher c statistic and $R^2$ than the model containing only age and sex. There was a little difference in the relative hospital performance evaluation by the severity measure. Conclusion : These results suggest that judgments regarding a hospital's performance based on severity adjusted mortality can be sensitive to the severity measurement method. Although the 5 severity measures regarding hospital performance concurred, more often than would be expected by chance, the assessment of an individual hospital mortality rates varied by the different severity measurement method used.
윤석준,안형식,하미나,고경심,전경자,이희영,Yoon, Seok-Jun,Ahn, Hyung-Sik,Ha, Mi-Na,Koh, Kyung-Sim,June, Kyung-Ja,Lee, Hee-Young 대한예방의학회 2004 예방의학회지 Vol.37 No.1
Objective : In this study, we aimed to produce basic data on the prenatal environmental risk factors of low birth weight infants at a community level. Methods : In 2000, we conducted the direct interview using questionnaire about prenatal environmental risk factors with low birth weight infant-delivered mothers and normal weight infant-delivered mothers in Asan-city, Chungcheongnamdo Province, Korea. The questionsgiven to the mothers included past pregnancy history, menstrual status, disease history before and during the pregnancy, family history, environmental risk factors and exposure history. The responses of the twogroups were compared to calculate the prenatal environmental risk factors of each group. Results : Mothers' smoking was significantly associated with low birth weight infants (adjusted odds ratio(AOR) 3.27; 95% confidence interval (CI) 1.25-8.56) and preterm baby (AOR 4.20; 95% CI, 1.21-14.61). Other environmental risk factors were not significantly different between the two groups. Conclusion: Smoking of mothers can be a risk factor for the delivery of low birth weight infants. These results could provide the basic data on prenatal environmental risk factors of mothers of low birth weight infants and suggest research topics for further community-based evaluation.
경혈 조사를 중심으로 본 고출력 Yttrium Aluminum Garnet (YAG) 레이저의 활용
이마음 ( Maeum Lee ),최유민 ( Yoomin Choi ),안수빈 ( Subin Ahn ),이기향 ( Gihyang Lee ),이은희 ( Eunhee Lee ),임명진 ( Myungjin Yim ),서형식 ( Hyung-sik Seo ),황의형 ( Eui-hyoung Hwang ),장인수 ( Insoo Jang ) 경락경혈학회 2023 Korean Journal of Acupuncture Vol.40 No.4
Objectives : The purpose of this study is to investigate on the application of the yttrium aluminum garnet (YAG) lasers for acupoints irradiation. Methods : We conducted a systematic search for peer-reviewed studies published from inception to November 2023, in the following electronic databases: PubMed, Scopus, and Web of Science in English, Science ON, Oriental Medicine Advanced Searching Integrated System (OASIS) and Research Information Sharing Service (RISS) in Korean, and China National Knowledge Infrastructure (CNKI) and Wanfang in Chinese, and Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii) in Japanese. Inclusion criteria were original articles including clinical and experimental studies related with YAG lasers for acupoints including Ashi or meridian sinews. Results : Among the 8 selected studies, there were 7 studies on human subjects and 1 study on animals, 7 studies on Nd:YAG (1,064 nm) laser, and 1 study on Er:YAG (2,940 nm) laser. A total of 16 acupoints were used, 15 of which were in the face and 1 of which was located in the foot. In addition, there were two studies using Ashi. 4 studies looked at the effect of pain relief, 2 studies looked at safety, 1 study looked at changes in blood flow, and 1 study looked at the effect of skin care. There were no reported adverse events, and the YAG laser was confirmed to be safe and effective in pain relief, beautifying the skin, and increasing blood flow. Conclusions : We suggest that high intensity YAG lasers can be applied to laser acupuncture or laser moxibustion. YAG lasers are considered to be worth using for various clinical indications of Korean medicine because of photobiomodulation effects, analgesic action, and deep penetration depth. Further scientific research and clinical evidences should be warranted.
김동현,박병주,유근영,안윤옥,이효석,김정룡,이상일,이무송,안형식,김헌,박태수,Kim, Dong-Hyun,Park, Byung-Joo,Yoo, Keun-Young,Ahn, Yoon-Ok,Lee, Hyo-Suk,Kim, Chung-Yong,Lee, Sang-Il,Lee, Moo-Song,Ahn, Hyung-Sik,Kim, Heon,Park, Tae-Soo 대한예방의학회 1994 Journal of Preventive Medicine and Public Health Vol.27 No.2
The relationship between past liver disease history and the risk of primary liver cancer was analyzed in a hospital-based case-control study conducted in Seoul on 165 patients with histologically or serologically confirmed hepatocellular carcinoma and individually age- and sex-matched 165 controls in hospital for ophthalmologic, otologic, or nasopharyngeal problems. Significant association were observed for liver deseases occurring 5 or more years before liver cancer diagnosis [OR,4.9;95% confidence interval (CI), $1.6{\sim}14.0$) and family history of liver disease(OR, 9.0;95% CI, $2.1{\sim}38.8$). These associations were not appreciably modified by allowance for major identified potential confounding factors. From these results, it is possible to speculate that liver cell injuries caused by various factors might be a common pathway to developing primary liver carcinoma. Considering the significant effect of family history of liver diseases on PLCA risk after adjusting past liver disease history, there might be genetic susceptibility in the carcinogenic mechanism of liver cancer. Further investigations are needed to clarify the effect of family history of liver disease on PLCA risk.
요실금 환자의 경폐쇄공 질테이프수술 후 반복되는 질 미란의 피부판 이식을 이용한 치료
홍정희 ( Jung Hee Hong ),최승도 ( Seung Do Choi ),김윤숙 ( Yun Sook Kim ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ),안형식 ( Hyung Sik Ahn ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.3
Transobturator tape (TOT) as one of midurethral slings is increasingly popular for the surgical treatment of stress urinary incontinence because of low complication rate and short operating time. Vaginal erosion after TOT is generally observed in 0.7%-1.3% of all cases. For preventing complications like vaginal erosion or infection after TOT, subtotal or total excision of mesh materials and use of broad-spectrum antibiotics are recommended. We report our experience with a case of treatment using skin fl ap and foreign body removal of recurrent mesh erosion in TOT.
역행성 제1 배부 중수지동맥 섬피판을 이용한 수무지 첨부손상재건의 치험례
안형식 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
Reconstruction after traumatic loss of thumb tip portion is of utmost important for the function of the hand but distal thumb injury is a difficult problem for hand surgeons. More recently various microsurgical free flaps from the first and second toe and web space of the foot were described as favorable solution for this problem. Without underestimating the usefulness of these flaps, I introduce another possibility for thumb tip converage using reversed first dorsal metacarpal artery island flap. Reversed first dorsal metacarpal artery island flap can easily reach the distal areas of the thumb and rich vascular supply, relatively simple surgical procedure, no major scarring. So that we will have an alternative method of thumb tip reconstruction because of using reversed first dorsal metacarpal artery island flap.
유리 피판술을 이용한 하퇴재건 47례에 대한 임상적 고찰
김용배,안형식,정현교,양순재,탁민성,김재훈 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.5
Traumatic injury to the lower legs has been increasing in Korea and often leads to skin and soft tissue loss, exposing blood vessels, nerves, tendons or bones. Salvaging these legs often requires free flaps. Over the past two decades, the use of free tissue transfer has produced an increasing salvage rate for severely injured lower leg. Between April. 1988 to July, 1997, 47 cases of lower soft tissue defects were reconstructed with free flaps, and retrospective analysis was performed to determine more about the factors associated with free flap failure or immediate vascular complications. We evaluated wound status before operation, operation time after injury, vascular status of recipient site, use of vein graft, use of reverse flow, salvage protocol in compromised anastomosis, survival rate and complications. There were 9 cases of venous thrombosis and 2 cases of arterial insufficiency while 7 out of 9 cases of venous thrombosis were reexplorated. However, 2 cases of partial flap necrosis and 1 case of total necrosis. Two cases of arterial insufficiency were necrotized, so the overall free flap failure rate was 9.6%. The results were analyzed to determine the factors promoting either failure or vascular complication, Many factors which are often blamed for failure (trauma cause, preoperative general condition, preoperative infection status, intraoperative ischemic time) were not significant in this study, but prolonged time after injury correlated with free flap failure, We concluded the adequate debridement and infection control, adequate selection of recipient vessel, accurate vascular anastomosis and most of all, early free flap transfer after injury, will improve the success rate.