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      • KCI등재

        Head to Head Comparison of Stress Echocardiography with Exercise Electrocardiography for the Detection of Coronary Artery Stenosis in Women

        김미나,김수아,김용현,홍순준,박성미,신미승,김명아,홍경순,신길자,심완주 한국심초음파학회 2016 Journal of Cardiovascular Ultrasound Vol.24 No.2

        Background: Exercise-stress electrocardiography (ECG) is initially recommended for the diagnosis of coronary artery disease. But its value has been questioned in women because of suboptimal diagnostic accuracy. Stress echocardiography had been reported to have comparable test accuracy in women. But the data comparing the diagnostic accuracy of exercise-stress ECG and stress echocardiography directly are few. The aim of the study was to compare the diagnostic accuracy of exercise-stress ECG and dobutamine stress echocardiography (DSE) in Korean women. Methods: 202 consecutive female patients who presented with chest pain in outpatient clinic, and who underwent treadmill exercise test (TET), DSE and coronary angiography were included for the study. The diagnostic accuracy TET and DSE were calculated by the definition of > 50% or > 75% coronary artery stenosis (CAS). Results: The sensitivity and specificity were higher with DSE (70.4, 94.6%) than TET (53.7, 73.6%) for detection of > 50% CAS. The higher accuracy of DSE was maintained after exclusion of the patients who could not achieve over 85% age predicted heart rate before ischemia induction. DSE also showed greater diagnostic accuracy than TET by > 75% CAS criteria, and in subsets of patient with intermediate pretest probability. Conclusion: In the diagnosis of CAS, DSE showed higher accuracy than TET in female patients who presented with chest pain. As well as the test accuracy, adequate stress was more feasible with DSE than TET. These finding suggests DSE may be used as the first-line diagnostic tool in the detection of CAS in women with chest pain.

      • KCI등재

        지배구조와 노사관계가 수출기업의 성과에 미치는 영향

        김미나,김성환 한국무역연구원 2014 貿易 硏究 Vol.10 No.6

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        In this study, we investigate the effects of various types of corporate governance and labor unions, relations between the management and the labor unions on the performance of 2,218 exporting firms in Korea. The study was performed empirically using panel data analysis techniques like fixed effects panel models with biennial HCCP or Human Capital Corporate Panel developed by KRIVET for years of 2005, 2007, 2009, and 2011 and Korea Research Institute for Vocational Education and Training. Moreover, the database of Korea Information Service(KIS-Value) from 2005 till 2013 was used in this study. The major findings are summarized as follows. First, there is a positive relationship between the export ratio, measured by export to sales, and the profitability of firms, measured by ROA or return on assets. Second, there is a negative relationship between the extent of professional management and the profitability of firms. Third, there is a negative relationship between the extent of foreign management and the profitability of firms. Fourth, there is a negative relationship between the existence of labor unions in the firm and the profitability of the firm. Fifth, there is a positive effect of a good relationship between the management and the labor on the profitability of firms. However, we could not find any statistically significant evidence between the types of corporations like an independent firm, affiliated firm, or holding firm on their profitability. The results indicate that firms in Korea are depending on their profitability, regardless of their types of management. However, labor unions and bad management labor relationships hurt their profitability.

      • KCI등재

        Liver Cirrhosis, Not Antiviral Therapy, Predicts Clinical Outcome in Cohorts with Heterogeneous Hepatitis B Viral Status

        김미나,Seong Gyu Hwang,Beom Kyung Kim,Jun Yong Park,Do Young Kim,Kwang-Hyub Han,Seung Up Kim,Sang Hoon Ahn 거트앤리버 소화기연관학회협의회 2019 Gut and Liver Vol.13 No.2

        Background/Aims: Antiviral therapy (AVT) reduces the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB). This multicenter retrospective study investigated the effects of AVT and hepatitis B virus (HBV)-related factors on the risk of HCC development in a cohort with heterogeneous HBV status. Methods: A total of 1,843 patients with CHB from two institutions were included in this study. Ultrasound and laboratory tests, including the α-fetoprotein test, were conducted regularly to detect HCC development. Results: The mean age of our study population (1,063 men and 780 women) was 49.4 years. Cirrhosis was identified in 617 patients (33.5%). During follow-up (median, 42.5 months), 81 patients developed HCC (1.39% per person-year). A total of 645 patients (35.0%) received ongoing AVT at enrollment. Ongoing AVT was not significantly associated with the risk of HCC development (all p>0.05). HBV-related variables (HBV DNA level, hepatitis B e antigen status, and alanine aminotransferase level) were also not significantly associated with the risk of HCC development (all p>0.05). In contrast, cirrhosis was significantly associated with the risk of HCC development, regardless of adjustment (adjusted hazard ratio=4.098 to 7.020; all p<0.05). Cirrhosis significantly predicted the risk of HCC development in subgroups with and without ongoing AVT at enrollment, regardless of adjustment. Conclusions: Our study showed that cirrhosis, not AVT and HBV-related variables, was associated with HCC development in a cohort of patients with heterogeneous HBV status. Our results may help clinicians apply individualized surveillance strategies according to fibrotic status in patients with CHB.

      • KCI등재후보

        이문구 작품 속 한강의 공간성 연구 - 1960년대 배경 작품을 중심으로

        김미나 단국대학교(천안캠퍼스) 한국문화기술연구소 2016 한국문화기술 Vol.20 No.-

        The period of 1960s is the era when dense population of city due to industrialization occurred and when political and economical willingness to restore the base of life which is destroyed by the Korean War strongly revealed. At that time, industrialization and capitalism created in city have people's life and consciousness changed. Migration to city on the purpose of earning money continued incessantly from this period, and a new type of urban refugees was also shown in the 1960s. Diverse symbolisms implicit in Han River is remarkably various to emblematize whole country of Korea such as rapid growth after war is called 'Miracle on the Han River', but Han River is served as main place in which displaced people selected a site and started new life owing to its spatial characteristic that it cannot function as privately- owned part and its locational attribute that it flows through Seoul. This research reveals the awareness of space focused on Han River, in these situations of past, through the early works of Lee Mun Ku, Not Accompanied, Monggeumpo Taryeong, and Gold Dust Color, and ascertains the phases of the times based on reality depicted by perspectives of displaced people and the working people who are the main characters of those works. Furthermore, the study demonstrates the meaning of connected researches on the works which have the same time and place. In the works of Lee Mun Ku, Han River is the living foundation of displaced people and working people and the space in which that cold reality of discrimination and oppression is held and endured at the same time. In these works, however, it doesn't cease as the spatial sign just reflecting the reality, involving general signs of water and river, and further it is manifested as the significant space where people can overcome grim actualities and expect better future. The phases of the 1960s identified by the works of Lee Mun Ku are as follows; first, those who left inevitably their native place for particular reasons as well as displaced people by the aftermath of the war gathered to Seoul, increasing population, settling down around Han River, second, displaced people congregating near Han River had to bear discrimination and persecution committed by the central people who had already resided in Seoul only to degenerate into marginal figures or the lower class, third, capitalism and materialism overflowed in the times which underwent a sudden change facing modernization and industrialization, and negative aspect in which people judged others by money can be found in reality. Through Lee Mun Ku's works, this study finds that numerous transitions during 1960s under the name of development, industrialization, and capitalism represent a stepping stone and side effect in order to achieve current Han River, industrialization, and capitalism, and that to investigate some works set in the same space and time together can be utilized as a method to establish the character of specific period.

      • 만성B형간염 : 면역 관용기 환자, 치료할 것인가?

        김미나,안상훈 대한간학회 2014 간학회 싱글토픽 심포지움 Vol.2014 No.1

        Substantial progress in the treatment of chronic hepatitis B (CHB) and new knowledge on the natural history of hepatitis B virus (HBV) infection have expanded the indications for antiviral therapy in CHB. In regions where HBV infection is endemic, perinatal transmission typically results in a prolonged immune-tolerant phase characterized by extensive HBV replication without evidence of active liver inflammation or fibrosis. Currently, treatment is not recommended for HBeAg-positive patients in the immune-tolerant phase because these patients rarely have significant liver disease and have a low likelihood of treatment-related HBeAg seroconversion. A high level of serum HBV DNA is a strong risk predictor of hepatocellular carcinoma (HCC) and cirrhosis, independent of HBeAg status, serum alanine aminotransferase (ALT) level. These findings may have important implications for immune tolerant patients with high HBV DNA levels. In addition, ALT level is the predominant factor in the decision to initiate antiviral therapy in CHB patients. However, the serum ALT levels may not accurately reflect the presence or degree of liver inflammation and fibrosis, so surrogate use of serum ALT levels may underestimate the proportion of patients with significant fibrosis who may benefit from antiviral therapy. Thus, some patients in the immune tolerant phase may not have a benign natural course of disease. For older patients over 40 years who may have been infected for a longer period of time, and patients with a family history of HCC, additional liver biopsy or non invasive tests for liver fibrosis can be considered for immune-tolerant phase CHB patients.

      • KCI등재

        Real-time Vessel Navigation Using Indocyanine Green Fluorescence during Robotic or Laparoscopic Gastrectomy for Gastric Cancer

        김미나,손상용,Long-Hai Cui,신호정,허훈,한상욱 대한위암학회 2017 Journal of gastric cancer Vol.17 No.2

        Our preliminary results indicate that intraoperative vascular imaging using the ICG fluorescence technique may be helpful for robotic or laparoscopic pylorus-preserving gastrectomy.

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