절사층 총합추정을 위한 복합추정량

황종민,신기일,Hwang, Jong-Min,Shin, Key-Il 한국통계학회 2012 Communications for statistical applications and me Vol.19 No.1

절사표본 추출법은 절사층, 표본층, 전수층으로 모집단을 분리한 후 표본층과 전수층의 조사결과를 이용하여 전체 모집단의 총합을 추정하는 방법이다. 이 방법은 왜도가 심한 사업체조사에서 흔히 사용하는 방법이다. 절사층의 총합 추정은 전체 모집단 총합 추정에 영향을 미치므로 절사층 총합의 정확한 추정은 매우 중요하다. 최근 김지학과 신기일 (2011)은 절사층에서 소수의 표본을 추출하여 얻은 결과와 기존의 추정량에서 얻은 결과를 선형결합하는 복합추정법을 제안하였다. 본 논문에서는 최량선형불편예측(best linear unbias predictor; BLUP)을 이용한 새로운 복합추정량을 제안하였으며 모의실험을 통하여 기존의 방법과 새로운 복합 추정량의 우수성을 비교하였다. Cut-off sampling that discards a part of the population from the sampling frame, is a widely used method for a business survey. Usually, to the estimate of population total, an accurate estimate of the total of the take-nothing stratum is required. Many estimators have been developed to estimate the total of the take-nothing stratum. Recently Kim and Shin (2011) suggested a composite estimator and showed the superiority of that estimator. In this paper, we suggest an alternative composite estimator obtained by combining BLUP estimator and a ratio estimator obtained by the small samples from the take-nothing stratum. Small simulation studies are performed for a comparison of the estimators and we confirm that the new suggested estimator is superior.

내시경 검사에서 점액교를 보인 Menetrier 병

황종민 ( Jong Min Hwang ),김광하 ( Gwang Ha Kim ),김원진 ( Won Jin Kim ),이희선 ( Hee Sun Lee ),이혜원 ( Hye Won Lee ),류동엽 ( Dong Yup Ryu ),송근암 ( Geun Am Song ),박도윤 ( Do Yun Park ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.3

Menetrier`s disease is a rare entity characterized by large, tortuous gastric mucosal folds. The mucosal folds in Menetrier`s disease are often most prominent in the body and fundus. Histologically, massive foveolar hyperplasia (hyperplasia of surface and glandular mucous cells) is noted, which replaces most of the chief and parietal cells. Profuse mucus is usually observed during the endoscopy but there have been few cases that show interesting endoscopic findings such as mucus bridge or water pearl. Herein, we report a case of Menetrier`s disease showing mucus bridge by excessive mucus observed during the endoscopy. (Korean J Gastroenterol 2011;57:184-188)

신장 ; 신기능에 따른 폐외결핵의 임상적 특징과 예후

최보경 ( Bo Kyung Choi ),이희선 ( Hee Sun Lee ),황인혜 ( In Hye Hwang ),신경화 ( Kyung Hwa Shin ),최문기 ( Mun Ki Choi ),최보광 ( Bo Gwang Choi ),안강희 ( Kang Hee Ahn ),남형석 ( Hyung Seok Nam ),황종민 ( Jong Min Hwang ),성은영 ( 대한내과학회 2010 대한내과학회지 Vol.79 No.4

목적: 만성 신질환 환자에서 세포성 면역기능이 감소되어 결핵에 이환될 위험성이 높으며, 특히 폐외결핵의 발생 빈도가 높은 것으로 알려져 있다. 이에 신기능에 따른 폐외결핵의 임상양상, 치료 반응, 질환과 연관된 사망률의 차이점을 비교하였다. 방법: 2003년 1월부터 2007년 12월까지 폐외결핵으로 진단된 18세 이상의 환자를 대상으로 하였고, 진단 당시의 크레아티닌 값을 이용하여 MDRD 공식으로 계산한 추정 사구체 여과율(eGFR)이 60 mL/min/1.73 m2을 기준으로 신기능 장애군(Group I)과 정상 신기능군(Group II)으로 분류하여 폐외결핵의 임상상, 치료성공률, 사망률 및 치료기간의 차이를 후향적 비교 분석하였다. 결과: 총 342명의 환자 중 Group I은 30명으로 이중 투석을 시행하고 있는 환자는 6명이었고, Group II는 312명으로, 각각의 평균 사구체 여과율은 34±19 mL/min/1.73 m2, 102±26 mL/min/1.73 m2이었다. Group I에서 고연령, 빈혈, 저알부민증이 많았으며, 고혈압, 당뇨병 및 심혈관계 질환을 동반한 경우가 많았다. 폐외결핵의 발생 부위는 두 환자군 모두 (Group I vs. Group II)에서 흉막(30.0% vs. 28.2%)이 가장 빈도가 높았고, 신경계통(23.3% vs. 16.3%)과 림프절(16.7% vs. 17.6%)의 감염이 흔하였으나, 통계학적 유의성은 없었다 (p=0.379). 모든 환자들은 표준 결핵화학요법인 HERZ, HER 및 HRZ 등을 용량 조절하여 치료하였으며, 두 환자군 모두에서 치료 실패 및 재발은 없었다. 결핵과 연관된 사망률은 Group I에서 높았으며(Group I, 22.2% vs. Group II, 2.8%, p<0.001), 연령, 혈색소 및 알부민, 당뇨병, 고혈압 및 심혈관계 질환의 유무를 보정하였을 경우에도 Group I이 사망의 위험률이 높았다(HR=11.51, 95%CI 2.512~52.741; p=0.002). 치료 중 이탈된 환자 및 사망환자를 제외하였을 경우, Group I이 치료 기간이 짧았다(278±110일 vs. 367±170일, p=0.009). 결론: 신기능 장애 환자에서 폐외결핵에 대한 치료기간이 연장되지 않았고 사망을 제외한 치료실패와 재발이 없었으나 폐외결핵으로 인한 사망률은 높았고, 신기능 저하 자체가 사망의 독립적인 위험 요소였다. 그러므로 신기능 장애 환자에서 폐외결핵에 대한 적극적인 진단 및 치료가 더 요구된다고 판단한다. Background/Aims: There is an increased risk of tuberculosis (TB) with impaired cellular immunity and extrapulmonary TB is more common in patients with chronic kidney disease. We explored the clinical features and treatment outcomes of extrapulmonary TB according to renal function. Methods: This retrospective study reviewed the medical records of patients diagnosed with extrapulmonary TB between January 2003 and December 2007. We classified the patients into two groups using the glomerular filtration rate (eGFR), estimated using the Modification of Diet in Renal Disease (MDRD) formula cut-off of 60 mL/min/1.73 m2 and evaluated their clinical features, treatment outcome and mortality (Group I vs. Group II, ≥ 60 mL/min/1.73 m2). Results: The mean eGFR of Groups I (n=30) and II (n=312) was 34±19 and 102±26 mL/min/1.73 m2, respectively. The pleura was the most frequent site of TB in both groups (Group I, 30.0% vs. Group II, 28.2%; p=0.379). There was no treatment failure or recurrence in either group. The mortality was higher in Group I (22.2% vs. 2.8%; p<0.01). In a multivariate analysis, eGFR<60 mL/min/1.73 m2 was an independent risk factor for mortality (HR=11.51, CI 2.512-52.741; p=0.002). Conclusions: Mortality related to extrapulmonary TB was higher in patients with impaired kidney function and kidney function was an independent predictor. However, there was no difference in treatment failure and recurrence according to renal function. (Korean J Med 79:387-393, 2010)

증례 : 신장 ; Nutcracker Syndrome과 함께 진단된 특발성 막증식성 사구체 신염 제1형 1예

신민지 ( Min Ji Shin ),이희선 ( Hee Sun Lee ),안강희 ( Kang Hee An ),황종민 ( Jong Min Hwang ),남형석 ( Hyung Suk Nam ),김정섭 ( Jung Sup Kim ),곽임수 ( Ihm Soo Kwak ) 대한내과학회 2011 대한내과학회지 Vol.81 No.1

Nutcracker 증후군이란 좌측 신정맥이 대동맥과 상장간막동맥 사이에서 압박을 받아 발생하는 임상적인 증후군으로 무증상의 혈뇨, 좌측 요통이나 복통의 형태로 나타나고 심한 단백뇨는 드물다고 알려져 있다. 저자들은 신증후군과 현미경적 혈뇨로 내원하여 Nutcracker syndrome과 함께 특발성 막증식성 사구체신염 제1형으로 확진된 1예를 경험하였다.Nutcracker 증후군으로 진단되더라도 심한 단백뇨를 보일 때는 사구체신염의 동반 가능성도 배제해야 하므로 신생검을 고려해야 하겠다. The Nutcracker syndrome refers to compression of the left renal vein between the aorta and superior mesenteric artery, which results in renal vein and left gonadal vein varices, hematuria, and left flank pain. Here, we report a case of biopsy-proven membranoproliferative glomerulonephritis with radiologically documented Nutcracker syndrome. The patient presented with generalized edema for several months. In order to evaluate isomorphic hematuria, we performed computed tomography (CT), which showed Nutcracker syndrome. A renal biopsy revealedmembranoproliferative glomerulonephritis, Type I. In conclusion, inadults with Nutcracker syndrome that involves severe proteinuria, the possibility of combined glomerulonephritis must be considered. (Korean J Med 2011;81:111-115)

종 slit 유공 caisson에 대한 파압분포

박상길(Sang-Kil Park),박오영(O-Young Park),이지훈(Ji-Hun Lee),황종민(Jong-Min Hwang) 대한조선학회 2012 대한조선학회 학술대회자료집 Vol.2012 No.5

This study calculate distribution of wave pressure on the external wall when same characteristic wave go to the front of the perforated caisson and the inner wall of the perforated caisson due to the hydraulic state in limited internal space when wave go to the inside of the wall after the passage between the slit by two dimensional hydraulic experiment. Therefore, this study analyze the stability of perforated caisson and provide the fundamental data to determine the structurally stable and economical optimum cross section by measurement of wave pressure act on the each section.

종 slit 이중 유공 caisson 상판에 작용하는 양압력

박상길(Sang-Kil Park),박오영(O-Young Park),이지훈(Ji-Hun Lee),황종민(Jong-Min Hwang) 한국해양환경·에너지학회 2012 한국해양환경·에너지학회 학술대회논문집 Vol.2012 No.5

To Mode the high wave come from the open sea by breakwater structure is the basic condition for harbor construction. Part of the high wave attacking the inside of a harbor adversely affect to the harbor tranquility. The plan of the reducing the reflectance by the change of the shape of the caisson structure is cm the rise to minimize this adverse effect Therefore, the substance of the hydraulic model test carried out from this study is to arrange and analyze the wave pressure data by the measurement of the reflection factor and the wave pressure. This study investigate the chanacteristics of wave pressure distribution in the perforated caisson structure by the numerical calculation according to the existing theory.

두경부 감염증에 나타난 내경정맥혈전증의 장기적 추적 결과:

진임건(Im-Geon Jin),강문호(Moon-Ho Kang),황종민(Jong-Min Hwang),정해석(Hae-Seok Jeong),이의룡(Ui-Lyoung Lee),명훈(Hoon Myung),황순정(Soon-Jung Hwang),최진영(Jin-Young Choi),이종호(Jong-Ho Lee),정필훈(Pill-Hoon Choung),김명진(Myung-J 대한구강악안면외과학회 2007 대한구강악안면외과학회지 Vol.33 No.3

Abscesses are common in the oral and maxillofacial area. However, secondary thrombosis of the internal jugular vein accompanying the primary abscess is rare. In 1936, Andre Lemeierre studied 20 patients who showed an initial oropharyngeal infection, septicemia, internal jugular vein thrombosis, and secondary spread of the infection, and after then this condition Lemierre syndrome. Clinically, these patients present with tonsilitis lasting several days, continuous fever, and cervical pain. In the past, ligation and excision of the internal jugular vein was often performed. Current therapeutic modality for this condition is appropriate antibiotic prescription and surgical drainage of abscess. This case report presents a patient who showed symptoms of Lemierre syndrome, initiated as an oropharyngeal infection then developed thrombosis of the internal jugular vein. This patient was admitted into Seoul National University Dental Hospital. In addition to routine antibiotic therapy, surgical incision and drainage of the infection site was performed. Without ligation or excision, the thrombosed IJV disappeared eventually. As the Lemierre syndrome is not a common disease, this case report and review of the literature would be useful regarding a treatment of patients with Lemierre syndrome.

구강악안면외과 의료행위 상대가치 개발에 대한 조사연구

송진아(Gin-Ah Song),백경원(Kyung-Won Baek),황종민(Jong-Min Hwang),유순용(Soon-Yong Yu),최진영(Jin-Young Choi) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.4

The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon’s opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.

천식 환자에서 우울과 천식의 중증도 및 조절과의 관련성

김원진 ( Won Jin Kim ),배현숙 ( Hyun Sook Bae ),최보경 ( Bo Kyung Choi ),황종민 ( Jong Min Hwang ),신경화 ( Kyung Hwa Shin ),김미현 ( Mi Hyun Kim ),이광하 ( Kwang Ha Lee ),김기욱 ( Ki Uk Kim ),전두수 ( Doo Soo Jeon ),박혜경 ( Hye 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.69 No.4

Background: Psychological factors are increasingly recognized for their influence on the course of asthma, on a worldwide basis. The aim of this study was to assess the presence of depression, anxiety, and asthma-related quality of life in patients with asthma and to evaluate their impact on severity and control of asthma. Methods: We assessed the severity of asthma by comparing patients` current medications to GINA guideline. The patients were classified into the controlled group (asthma patients with controlled disease) or into the uncontrolled group (asthma patients with uncontrolled disease), which included partly controlled and uncontrolled patients, again based on GINA guideline 2004. Patient-reported depressive symptoms, anxiety, and asthma-related quality of life were evaluated using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and Korean asthma quality of life (KAQLQ). Results: One hundred and twenty patients were enrolled (mean age, 55±1 years; 65% women). Among the 120 patients, 14 (12%) patients were classified as having mild asthma, 88 (73%) as having moderate asthma, and 18 (15%) as having severe asthma. Eighty-one (67%) of the 120 patients were controlled. The asthma-related quality of life showed the difference according to severity of asthma (p=0.002). The prevalence of depression was lower (10% vs 26%, p=0.024) and the asthma-related quality of life was higher (59.951 (29∼75) vs 35.103 (18∼72), p≤0.001) in the controlled group. Higher trait anxiety score and lower asthma-related quality of life were associated with depression (p<0.001, p=0.002, respectively). Conclusion: Psychological factors, such as anxiety and depression, are strongly associated with asthma control. Therefore, screening and management of depression is needed in patients with asthma.

종 slit 유공 caisson에 대한 파압분포

박상길(Sang-Kil Park),박오영(O-Young Park),이지훈(Ji-Hun Lee),황종민(Jong-Min Hwang) 한국해양환경·에너지학회 2012 한국해양환경공학회 학술대회논문집 Vol.2012 No.5

This study calculate distribution of wave pressure on the external wall when same characteristic wave go to the front of the perforated caisson and the inner wall of the perforated caisson due to the hydraulic state in limited internal space when wave go to the inside of the wall after the passage between the slit by two dimensioned hydraulic experiment. Therefore, this study analyze the stability of perforated caisson and provide the fundamental data to determine the structurally stable and economical optimum cross section by measurement of wave pressure act on the each, section.