혈액성분제제 품질관리 자료의 통계학적인 비교

김종암 ( Chongahm Kim ),서동희 ( Dong Hee Seo ),권소영 ( So Yong Kwon ),오영철 ( Yuong Chul Oh ),임채승 ( Chae Seung Lim ),장충훈 ( Choong Hoon Jang ),김순덕 ( Soonduck Kim ) 대한임상검사과학회 2004 대한임상검사과학회지(KJCLS) Vol.36 No.1

According to increase of domestic blood components use, the quality control of blood components is necessary to support good products. The purpose of this study is used to provide the producing index of the good product as compared with the accuracy and validity for the distribution of the quality control data. The value of mean, standard deviation, 95% confidence interval and degree of normal distribution of data were calculated by univariate procedure, the value of monthly mean of each blood centers per items were compared by Analysis of Variance(ANOVA) test for the degree of distribution. When there was difference among the mean values, the Duncan``s multiple range test was done to confirm the difference. Finally, methods for accessing accuracy and validity of the quality data was done by the Contingency table test. The quality data of five blood centers was showed to the normal distribution and it was in a acceptable range. For each blood centers, the monthly means of Hematocrit(Hct), Platelet(PLT) and pH were not significantly different except Hct of C center, PLT of B, D center and pH of A center. The quality data per items was graded according to quality to six level. As a result of the comparative analysis, the monthly means of Hct of C and E center was significantly different higher than that of D, B and A center. The monthly means of PLT of A center and pH of C center was significantly different higher than that of the others. In the accuracy and validity of the quality control data, C center for Hct, A center for PLT and C center for pH were better than the other. The C blood center was most satisfiable and stable in the quality control for blood component. If the quality control method used in C blood center is adopted in other blood centers, the prepared level of the blood component of the center will be improved partly.

일개 종합병원 중환자실에서의 병원성 혈류감염에 관한 연구

김기숙(Ki Sook Kim),김순덕(Soonduck Kim),지선미(Sunmi Ji),이제숙(Jesuk Lee) 한국역학회 2007 Epidemiology and Health Vol.29 No.1

  Purpose: Despite of the development of recent medical technology, bloodstream infection (BSI) still has significant influences on mortality and morbidity of patients admitted to the ICU. The BSI has the second most frequent site. Especially BSI in ICU have higher infection rate than general ward. This study was investigated the incidence rate of the nosocomial BSI, risk factors and bacterial pathogens of BSI in ICU for a general hospital.<BR>  Methods: This study was carried out for those 443 patients in ICU of general hospital during the period from March 2002 to February 2003. The definition for BSI was based on that of CDC. Data was collected by questionnaire, medical record review. The statistical SPSS(ver. 10.0) was used to analyze data that included chi-square, t-test and logistic regression.<BR>  Results: In the incidence rates of the BSI were 76.7 in 1,000 per patients, 7.0 in per 1,000 patients days and 32.1 in per 1,000 patients with central lines, 3.2 in per 1,000 cental line days. In the incidence rates of the BSI by type of ICU showed MICU 10.1, SICU 2.9 in per 1,000 patients days. The significant risk factors were identified as type of ICU(OR=5.119, p=0.001), length of stay(OR=1.039, p=0.001). The causal microbes of the BSI were CNS 35.5%, MRSA 23.6%. The bacterial pathogens of central catheter-related BSI were CNS 50%, MRSA 50%.<BR>  Conclusion: The occurrence of ICU-acquired infection was significantly related to the increase in morbidity and mortality. Ongoing targeted surveillance and infection control strategies is necessary to control this problem.

소아청소년의 과체중과 비만의 유병률 및 관련요인

강신관(Shinkwan Kang),김순덕(Soonduck Kim),이제숙(Jesuk Lee) 한국역학회 2008 Epidemiology and Health Vol.30 No.2

Purpose: To investigate the prevalence rates of overweight and obesty, and their associations in children and adolescents(12-18years) who were defined as normal weight, overweight , and obese. Methods: Korean National Health and Nutrition Examination Survey 2005 raw data was utilized. The data on the 669 subjects aged 12-18 consisted of variables from the health interview survey, health examination and nutrition survey, and health consciousness behavior survey. Overweight and obesity was evaluated by established body mass index criteria. Chi-squire and Fisher exact test were performed to analyze differences among normal, overweight and obese groups according to basic characteristics and health consciousness behavior. Logistic regression was used to analyze risk factors for the overweight and obese groups. Results: Overweight and obesity prevalence rates were 11.7% and 8.1%, respectively. Of the subjects from urban regions, 20% were overweight and 12.2% were obese. Of those from semi-urban regions, 10.2% were overweight and 3.8% were obese. Of those from rural regions, 9.0% were overweight and 10.1% were obese. The obesity rate in semi-urban regions were 0.38% times lower than the rural rate. Conclusions: Geographical location constitutes a risk factor for overweight and obesity, which may influence preventative and education programs aimed at schools and the general community.

CS₂ 暴露 勤勞者의 進行性難廳 1例

李恩一(Eunil Lee),金順德(Soonduck Kim) 한국농촌의학 지역보건학회 1990 농촌의학·지역보건 Vol.15 No.2

스키어와 스노보더의 손상에 관한 연구

장우성(Woosung Chang),김순덕(Soonduck Kim),이제숙(Jesuk Lee) 한국역학회 2007 Epidemiology and Health Vol.29 No.1

  Purpose: To calculate the injury rate of skiers and snowboarders, to document the risk factors affecting injury, and to investigate the characteristics of the cause, kind and region of injury.   Methods: A questionnaire survey was conducted at 4 major Kangwon - province ski resorts during the 2004 - 2005 winter season with 373 skiers and snowboarders. The statistical SPSS was used to analyze data that included chi-square, fisher"s exact test, and multiple logistic regression. The mean mark of the safety rule by separating the skiers and snowboarders was compared between the two groups.   Results: The injury and wound experience rates of the snowboarders (46.5%, 34.2% respectively) were higher than those of the skiers (33.2%, 25.5% respectively). The proportion of injury and wound for the skiers was 76.7% and for the snowboarders was 73.6%. The occurrence of injuries was higher among those with ski career of 5 to 9 years (p=0.012), those with a higher level of ski skills (p=0.002), those who used the higher slope (p=0.002) and those who skied 15 to 19 times(p=0.004). Based on the results of logistic regression analysis, the significant risk factors for skiers were career, level, slope and visit number. Leg injuries accounted for 40.9% of total injuries among skiers, which was followed by arm injuries (35.9%) and head injuries (15.4%)(p=0.033).   Conclusions: The study therefore emphasizes safety training for individual skiers and overall conditions of ski resorts.

서울시 일부 보건소에 등록된 폐결핵 재발 환자의 특성에 관한 연구

한송이(Songyi Han),김순덕(Soonduck Kim),박종순(Jongsoon Park),지선미(Seonmi Ji),이제숙(Jesuk Lee) 한국역학회 2003 Epidemiology and Health Vol.25 No.2

Purpose: The purpose of this study is to survey general and clinical characteristics of a group of relapsed patients with pulmonary tuberculosis, who are registered at a public health center in order to provide basic data for treatment of a patient s relapse, follow-up examination after the flrst treatment and health education. Subject: Among 68 relapsed patients with pulmonary tuberculosis registered at two public health centers in Seoul from Jan, I, 2002 to Dec. 31, 2002, 50 patients were selected as research subjects because they were contactable by telephone and they agreed to be a research subject. Method: The research carried out the structured questionnaire survey by telephone and surveyed research subjects' general and clinical characteristics, diseases except tuberculosis, drinking and smoking habit and knowledge about pulmonary tuberculosis treatment. Furthermore, the results of x-ray, whether a cavity existed or not, bacteriologic test, culture examination and drug resistance examination were examined and interval to relapse and history of dose attitude were surveyed. Results: Among relapsed tuberculosis patients, male patients were 60% and they were more than women(40%). Patients over 60 were 42% most. ]n their occupation, 30% of them were unemployed and 50% of patients surveyed had monthly income below one million won. According to the findings in radiographic extent, most 50% of them were minimal, 44% were moderately advanced and 2% were far advanced. Patients who had cavity were 30%. According to the result in bacteriologic test, 54% showed positive smear pulmonary tuberculosis and 50.0% positive culture. According to the result in drug resistance, 24% showed drug resistance against one drug and 76% showed sensitive response. 46% had experienced medication side effects. According to interval to a relapse, 32% were relapsed less than 2 years, 14% less than 3-5 years and 54% more than 5 years. Average interval before a relapse were 11.6 years(11.6±11.15). There was a difference between their past regimen and their present regimen(P=0.001). The attitude towards taking a medication was assessed and they showed higher compliance with medication at present than in the past(P=0.001). In a case of smoking rate during treatment, the rate of non-smokers, who had been smokers, were higher(P=0.047). Conclusion: As a result, in order to prevent the disease from being relapsed and to increase the rate of treatment effectiveness, we need to make patients recognize the importance of regular follow-up examination and we should control thoroughly the patients. Furthermore, we need to provide them with more health education not to stop taking a medication earlier.

국내 의학 학술지의 대장암 관련 연구 분석 - 1967년부터 2004년까지

백은경(Eunkyoung Paik),김순덕(Soonduck Kim),이제숙(Jesuk Lee) 한국역학회 2007 Epidemiology and Health Vol.29 No.2

  Purpose: The study analyzed and categorized the colorectal cancers related medical journals published in Korea by the name of the journal, research materials, study method, statistical method and by content of study for the quality improvement of colorectal cancers related studies.   Methods: The authors reviewed a total of 567 colorectal cancer-related studies published in the Korean medical journals during the period 1967 and 2004 and kept in the National Assembly Library. The distribution of research materials, study method, statistical method and content of these studies were analyzed by the 5 year publication interval.   Results: By study period, the number of published studies steeply increase during the period between 2000 and 2004. As the research materials, hospital patients(64.6%) and In-vitro(16.6%) were the most prevalently used research materials, but health adults were the lowest research materials by only taking up 0.4% In study methods, patient follow up studies(28.7%) and human in vitro experimental(27.9%) were prevalent, and human in vitro experimental were relatively the most popular performed studies during the years of 1990-1994. As the statistical method, life table and survival analysis(27.0%) were the mostly performed methods, and the use of statistical method was applied in nearly all studies. The contents of the studies mainly focused on the patient prognostic estimations(27.6%) of therapeutic safety & efficacy(25.6%), but only the 4.1% of risk factors studies. Among the 109 studies which analyzed the survival term 78.9% of the studies mainly used the 5 year term in the analysis of survival rates.   Conclusion: The results of the study could be utilized as the basic data for the quality improvement of further colorectal cancers related studies.

공복혈당장애와 제 2형 당뇨병의 위험요인 - 데이터마이닝을 이용하여

류종선(Jongseon Ryu),김순덕(Soonduck Kim),박종순(Jongsoon Park),이제숙(Jesuk Lee) 한국역학회 2006 Epidemiology and Health Vol.28 No.2

  Purpose: This study aimed to contribute to overall public health by examining the prevalence rates of impaired fasting blood glucose and type 2 diabetes mellitus and developing a model to predict high risk factors for impaired fasting blood glucose and type 2 diabetes mellitus.   Methods: The 1998 Public Health Nutrition Survey data was used for this study. Subjects were 7,702 adult at the age of 20 or over. The frequency analysis, chisquared test was performed. A decision tree was utilized to define a model designed to predict high risk factors for impaired fasting glucose and type 2 diabetes mellitus.   Results: The prevalence rates of impaired fasting blood glucose was 10.8% and prevalence rates of type 2 diabetes mellitus was 9.4%. The decision tree analysis exhibited that age was strong factors for impaired fasting blood glucose. HDL cholesterol and kind of economic activities were high risk factors for impaired fasting blood glucose and type 2 diabetes mellitus on those in 20s. BMI, total cholesterol level, marriage status, sex for impaired fasting blood glucose and type 2 diabetes mellitus on those in 30s. The total cholesterol level, drinking and waist size were identified as risk factors on those in 40s. BMI, education level and hypertension seemed to have an impact on those in 50s. The waist size, sex and income had an impact on those in 60s.   Conclusions: This study underscores the need for the public health infrastructure to improve various health promotion programs for those who have risk factors for impaired fasting blood glucose and type 2 diabetes mellius. The implementation of effective nutrition, workout and anti-drinking programs will boost public health.

소아의 비강내 지역사회획득 Methicillin-resistant Staphylococcus aureus 감염실태 조사

박지영(Jiyoung Park),김순덕(Soonduck Kim),이제숙(Jesuk Lee) 한국역학회 2006 Epidemiology and Health Vol.28 No.2

  Purpose: Methcillin-resistant Staphylococcus aureus(MRSA) is known as a major cause of hospital acquired infection. The infection with MRSA bacteria is becoming frequent in the community because there are many people who have risk factors with low immunity. This study is intended to investigate the prevalence of MRSA in children and determine risk factors using genetic analysis.   Methods: Children aged between 3 and 7 years were recruited from six preschool institutions from Nov. 2004 to Feb. 2005 based in Seoul, Gyeonggi Province and Gyeongsang Province. A questionnaires was distributed to 1,000 parent of these children along with the letter of consent. A total of 242 questionnaires were collected and used for this study. Nasal secretion samples were collected using sterilized specimen containers and incubated in culture medium using mannitol salt agar to separate S. aureus. MRSA samples were identified through coagulase test and MICRO SCAN. PCR was performed on MRSA isolates to detect genetic sequence specific of MRSA.   Results: Of total 242 respondents, 16(6.6%) were found to be positive for MRSA. By residence area, 2(1.9%) out of 103 were positive in Seoul, 4(10.3%) out of 39 were positive in Gyeonggi Province and 10(10.0%) out of 100 were positive in Gyeongsang Province, showing a significant difference(p=0.037). A logistics regression was performed to evaluate the influences of variables that were significant. Gyeongsang Province had prevalence of MRSA(OR=5.520), and Gyeonggi Province(OR=5.710). Based on PCR, the distribution of genotypes of MRSA showed various patterns. But there was no difference between regions.   Conclusions: MRSA infection was high in children when one of their parents were working in hospital or when one of their family members have underlying disease. This study provided evidence that the prevalence of MRSA is largely influenced by individual element such as family and health condition.

일개 대학병원에서 손상의 특성에 관한 연구

신연수(Younsu Shin),김순덕(Soonduck Kim),이제숙(Jesuk Lee) 한국역학회 2007 Epidemiology and Health Vol.29 No.2

  Purpose: This study was performed to provide the basic data in the establishment of preventive countermeasures for injury by analyzing the characteristics of injury, and risk factors of injury.   Methods: From 2,059 injury patients among 19,947 patients admitted between January and December, 2004 at a university hospital located in Gyeonggi-do, 500 injury patients were sampled randomly by systematic sampling. A total of 500 questionnaires was collected and used for this study. The statistical SPSS was used to analyze data that included chi-square, fisher"s exact test.   Results: Injury patients among total admission patients was 10.3%. In both general characteristics of injury and non-injury patients, gender, age, length of stay was significant. As the cause of injury were compared with those of injury external causes, type, place, site, and time of injury were significant. As the cause of injury were compared with the characteristics of related-injury, surgery, multiple injuries, mental history, consciousness at the time emergency room visit, length stays were significant.   Conclusion: With regard to general characteristics, injury external causes, injury-related causes, and factors such as sex, age, occupation, and educational background were related to each other. Injury does not occur by accident or unexpectedly. Therefore, if preventive attention is focused on individuals with high risk factors of injury, the incidence rate will be diminished.