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        독립인 두 모집단 설계에서의 표본수 비교

        고해원,김동재,Ko, Hae-Won,Kim, Dong-Jae 한국데이터정보과학회 2010 한국데이터정보과학회지 Vol.21 No.6

        임상시험을 시행하는 경우 위약을 신약과 비교하는 경우가 대다수이다. 기존에 독립인 두 모 집단의 표본수를 계산하는 방법으로 모수적 방법에서는 t검정을 이용하였고, 비모수적 방법에서는 Wilcoxon 순위합검정 (Wilcoxon, 1945)을 이용하였다. 본 논문에서는 Orban과 Wolfe (1982)가 제안한 선형위치통계량의 검정법과, Kim (1994)이 선형위치통계량에 기초하여 계산한 검정력의 결과를 이용하여 표본수 구하는 방법을 제안한다. 또한 앞서 제안한 방법의 표본수를 기존의 Wilcoxon 순위합검정을 이용하여 Wang 등 (2003)이 제안한 공식을 이용한 표본수, 그리고 모수적 방법을 이용한 t검정의 표본수와 비교하였다. For clinical trials, it is common to compare the placebo and new drug. The method of calculating a sample size for two independent populations are the t-test that is used for parametric methods, and the Wilcoxon rank-sum test that is used in the non-parametric methods. In this paper, we propose a method that is using Kim's (1994) statistic power based on the linear placement statistic, which was proposed by Orban and Wolfe (1982). We also compare the sample size for the proposed method with that for using Wang et al. (2003)'s sample size formula which is based on Wilcoxon rank-sum test, and with that of t-test for parametric methods.

      • 소아 알레르기비염의 경제적 부담 평가를 위한 다기관 조사

        공도연 ( Do Youn Kong ),김경원 ( Kyung Won Kim ),김우경 ( Woo Kyung Kim ),민택기 ( Taek Ki Min ),박용민 ( Yong Mean Park ),안재억 ( Jae Ouk Ahn ),양현종 ( Hyeon Jong Yang ),염혜영 ( Hye Yung Yum ),윤혜선 ( Hae Sun Yoon ),전유훈 ( 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2012 소아알레르기 및 호흡기학회지 Vol.22 No.2

        목적: 알레르기비염의 유병률은 전 세계적으로 급격히 증가하고 있으며, 그에 따른 경제적 부담도 증가하고 있다. 그러나, 소아 알레르기 질환이 미치는 경제적 부담에 관한 국내 연구는 제한적이어서 소아 알레르기비염이 환자와 그 가족에게 미치는 경제적 부담을 산출하고자 본 연구를 진행하였다. 방법: 2008년 7월 1일부터 9월 31일까지 서울시 6개 2-3차 의료기관을 방문한 18세 이하 소아 알레르기비염 환자 및 보호자를 대상으로 설문 조사를 진행하였다. 설문을 통해 직접 의료비 (병·의원 진료비, 및 약제비 한방 진료비 및 약제비, 보완/대체요법비), 직접비의료비 (교통비, 환경개선비), 그리고 간접비용 (월 평균 노동 손실)을 조사하였고 그 결과를 질환의 중증도 및 유병 기간에 따라 분석하여 그 차이를 비교하였다. 결과: 모집된 262명의 대상 중 174명(66.4%)이 남자였고, 평균 연령은 6.54세였다. 대상군의 연간 평균 직접 의료비는 177만 원이었고 직접비 의료비는 57만 원이었다. 비록 통계학적 유의성은 없었지만, 알레르기비염의 중증도가 증가할수록 직접 의료비가 증가하는 경향을 보였고, (P=0.053) 유병 기간 또한 직접 의료비의 증가와 유의한 양의 상관 관계를 보였다. (R=0.195, P=0.002) 대상 환자 보호자의 약 17%가 아이의 알레르기비염으로 인해 직장에 결근 또는 조퇴를 경험한 것으로 조사되어 사회적 간접비용을 미루어 생각할 수 있었다. 결론: 알레르기비염이 미치는 경제적 부담은 질환의 중증도가 심할수록, 그리고 유병 기간이 길수록 증가하며, 이는 특히 한방 진료 및 치료비와 보완/대체요법비의 증가에 기인한 것으로 조사되었다. 따라서 알레르기비염으로 인한 경제적 부담을 줄이기 위해서는 환자와 보호자를 대상으로 근거 중심의 치료를 할 수 있도록 지속적이고 체계적인 교육이 필요할 것으로 사료된다. Purpose: The prevalence of allergic rhinitis is rapidly increasing and results in relatively high socio-economic burden on their family and community. However, studies on the economic burden of pediatric allergic rhinitis in Korea are limited. Therefore, we conducted this study to investigate the impact of pediatric allergic rhinitis on economic burden. Methods: Two hundred sixty two children with allergic rhinitis were enrolled in 6 secondary or tertiary medical centers in Seoul from July to September, 2008. We collected data of the economic burden of allergic rhinitis (direct medical costs, direct nonmedical costs, and indirect costs) by face to face questionnaire survey. We compared the economic burden according to the severity and the duration of allergic rhinitis. Results: The mean age of subjects was 6.54 years, and male were 174 (66.4%). Direct medical costs (10,000 Korean Won/yr) were 177.75, and direct nonmedical costs were 57.92. Although, there was no statistical significance, direct medical costs showed increasing trends in severe allergic rhinitis. (P=0.053) In addition, direct medical costs were positively correlated with duration of allergic rhinitis.( R=0.195, P=0.002). About 17% of the parents who care the allergic rhinitis children experienced the work absence due to their child s illness. Conclusion: The economic burdens of allergic rhinitis were positively correlated with the severity and duration of illness. Particularly costs for alternative medicine including oriental medicine` were related with severity and duration allergic rhinitis. Therefore, special efforts for education with evidence based treatment strategy are necessary to decrease the economic burden of allergic rhinitis.

      • 수술환자에 있어 수술실내에서 수술대기 시간이 불안에 미치는 영향에 관한 연구

        이혜원,이규정,김해옥,이해옥,김혜숙,이미경,송말순,Lee, Hea-Won,Lee, Kyu-Chung,Kim, Hae-Ock,Lee, Haik-Ock,Kim, Hea-Suk,Lee, Mi-Kyung,Song, Mal-Soon 대한간호협회 1990 대한간호 Vol.29 No.3

        This study was attempted to provide us with basic information on how to improve understanding with patients for operation, and to offer then better nursing and treatment. This kind of study will help scientific application to nursing practice and operating room. The data was collected by interviewing 29 patients who underwent the elective surgery under the general anesthesia at Y hospital in Seoul. The interview ran from October 15 to December 15, 1989. The research instrument was a anxiety measurement device (SAAI) originally developed by Spielberger, et al and modified by Jung-Tack Kim. 1. Hypothesis Testing Hypothesis one was that there would be a difference in state anxiety level according to a time difference in watiting for operation. This hypothesis was rejected(state.anxiety level one hour before operation P>.05, r-.747, State anxiety level half an hour before operation P>.05, r-.1550, state anxiety level just before operation, P>.05, r=.1099). However, state anxiety, evel appeared to be associated with a longer watiting period, like one day before operation (P<.05, r-.4628). Hypothesis two was that there would be a difference according to state anxiety level of patients for operation. This was rejected. (Change of blood perssure in systolie P>.05 r=.1082, Change of blood pressure in diastolic P>.05, r=.088, Change of pulse rate, P>.05, r-1.909) 2. Examining trait anxiety and state anxiety levels, the average level of trait anxiety was 42.034, and the average level of state anxiety one day before operation was 43,000. The average level of state anxiety was averaged 42.356 in a waiting room for operation. 3. Examining the state anxiety level by time period, the one hour before was 42.379 the level half an hour before 42.276, and the level just before operation 42.414. The low level of state anxiety was due to the fact that premedication was not eliminated. 4. Age and time period like one day before operation was related to state anxiety level (F=5.271, P<.0.01) and blood pressure in waiting room for operation. That is, state anxiety level and blood pressure of patients one day before operation appeared high. Sex was relation to changes of blood pressure ; the blood pressure of male patients appeard higer than of female patients. A marital status was also related anxiety level one hour before operation the married patient for operation showed a higher state anxiety level than that of the unmarried patient for operation. Education was similarily related to trait anxiety level in which highly educated patients show lower levels of trait anxiety than poorly educated ones. Motive for hospitalization was related to state anxiety level for patient one hour before operation (F=6.464, P<.05) likewise, patients who are supposed to undergo operation hastily showed higher levels of anxiety than patients who expect elective surgeries.

      • KCI등재후보

        알레르기 ; 알레르기 환자에서 한방 이외의 대체 요법의 사용 현황에 대한 다기관 조사

        이현정 ( Hyun Jung Lee ),이재현 ( Jae Hyun Lee ),이용원 ( Yong Won Lee ),김철우 ( Cheol Woo Kim ),동헌종 ( Hun Jong Dhong ),박해심 ( Hae Sim Park ),조영주 ( Young Joo Cho ),조진희 ( Jin Hee Cho ),조상헌 ( Sang Heon Cho ),편복양 ( 대한내과학회 2011 대한내과학회지 Vol.80 No.1

        목적: 한국에서 알레르기 질환 치료를 위한 한방 치료뿐만 아니라 대체 요법이 많이 이용되고 있으며, 그 현황에 대하여 다기관 조사를 시행하였다. 방법: 10개의 대학병원 외래로 내원한 647명의 알레르기 환자를 대상으로 설문조사를 시행하였으며, 이 중 510명이 한방 이외의 대체 요법에 응답하였다. 이환되어 있는 알레르기 질환은 천식(50.0%), 알레르기 비염(36.0%), 아토피 피부염(36.0%), 그리고 두드러기(9.3%)였다. 각각 환자들에게 12 문항의 설문조사를 시행하였으며, 한방 이외의 대체 요법의 사용 빈도 및 종류, 대체 요법에 의지하게 된 이유, 비용, 그리고 치료효과에 대한 의견을 물어 보았다. 결과: 16.7%의 알레르기 환자에서 한방 이외의 다른 대체 요법을 받았으며, 평균 1.6종의 한방 이외의 대체 요법을 받았다. 가장 많이 의지하는 대체 요법은 민간 식이요법 (48.6%)이었고, 그 다음이 아로마 요법(23.8%), 지압(14.3%), 건강 호흡법(7.6%), 마인드 컨트롤(5.7%), 목욕요법(5.7%) 순이었다. 대체 요법을 받은 환자 중 마인드 컨트롤(50%), 식이요법(50%), 그리고 건강 호흡법(75%)의 경우 치료 효과가 만족스럽다는 응답이 높았으며, 목욕요법, 아로마 요법, 그리고 지압은 만족도가 각각 33.3%, 28.0%, 26.7%로 저조하였다. 대체 요법 사용자의 63.6%가 5회 미만의 대체 요법을 받았고, 91.8%가 1년 이내로 치료받았으며, 1인당 평균 연 37 만원을 지출하였다. 대체 요법을 선택한 가장 큰 이유는 체질이 개선될 수 있을까 해서(44.2%)였으며, 대체 요법이 몸에 부담이 없어서(31.4%), 면역기능이 강화되어서(22.9%) 순으로 나타났고, 15.7%는 양약치료가 도움이 되지 않아서 대체 요법을 선택하였다고 응답하였다. 결론: 한국에서 알레르기 환자의 상당수가 한방뿐만 아니라 여러 가지의 대체 요법을 사용하고 있음을 알 수 있었다. 대체 요법의 사용 빈도가 증가하고 그 종류가 다양함을 고려할 때, 의료진은 대체 요법의 현황에 대하여 정확히 인지하고 이에 대해 관심을 가지고 환자를 대하여야 하며 올바른 알레르기 질환 치료법에 대해 환자뿐만 아니라 의료인에게 교육하는 것이 필요하다. Background/Aims: The use of unproven complementary/alternative medicine (CAM) to treat allergies is popular in Korea. We conducted a multicenter survey of the current use of CAM other than herbal medication in Korean allergy patients. Methods: This study enrolled 510 adults with allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, and chronic urticaria, from ten hospitals. They underwent a structured questionnaire interview and clinical assessment of the prevalence, motivation, costs, and subjective assessment of CAM. Results: Of the patients, 16.7% used at least one type of CAM to treat their allergic diseases. Common types of CAM were diet (48.6%), aroma therapy (23.8%), massage (14.3%), breathing exercises (7.6%), baths (5.7%), and mind control (5.7%). The therapeutic effects of CAM included improved in patients using mind control (50%), diet (50%), breathing exercises (75%), and baths (33.3%), but worse in patients using aroma therapy (28%), and massage (26.7%). About 36.4% of the patients used CAM more than four times per year, and the average cost per CAM user was 370,000 won/year. The main reason for trying CAM was `hope to improve my constitution`. Conclusions: CAM is used widely for treating allergic diseases in Korea. Detailed knowledge of CAM and patient education are important. Further studies of the clinical efficacy of CAM are needed. (Korean J Med 2011;80:68-77)

      • HCV, Alcoholic : PE-096 ; Clinical and histopathological features of acute onset autoimmune hepatitis

        ( Min Young Rim ),( Soo Yong Park ),( In Ku Yo ),( Min Su Ha ),( Ju Seung Kim ),( Ju Won Lee ),( Young Kul Jung ),( Dong Hae Chung ),( Oh Sang Kwon ),( Yun Soo Kim ),( Duck Joo Choi ),( Ju Hyun Kim1 ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

        Background: Autoimmune hepatitis (AIH) is a progressive inflammatory liver disease of unknown etiology that is reported to be a consequence of aberrant autoreactivity. Several studies which reported the acute presentation of AIH have different clinical course and histologic features. In this study, we compared acute presentation of AIH and chronic presentation of AIH. Methods: We retrospectively reviewed the medical records of patients with autoimmune hepatitis from January 2003 to June 2011 at Gachon University, Gil Hospital. A total of 29 patients were enrolled, 7 patients were diagnosed with acute presentation of AIH. Results: There was no difference between two group in age, gender, and score system of AIH. Patients with acute presentation had higher serum levels of total bilirubin, lower serum levels of albumin in clinical feature (p<0.05), and higher frequency of zone 3 necrosis in histologic feature. The cumulative incidental rate of the normalization of serum AST and ALT levels with prednisolone treatment was similar between patients with acute presentation and chronic presentation in clinical course. Conclusions: Higher AST, ALT and, bilirubin were clinical specific feature, and zone 3 necrosis is a histological characteristic of autoimmune hepatitis with acute presentation.

      • KCI등재
      • SCOPUSKCI등재

        The influence of adjuvant radiotherapy on patterns of failure and survivals in uterine carcinosarcoma

        Hae Jin Park,Hak Jae Kim,Hong-Gyun Wu,Hans Kim,Sung Whan Ha,Soon-Beom Kang,Yong-Sang Song,Noh-Hyun Park,Jae-Won Kim 대한방사선종양학회 2011 Radiation Oncology Journal Vol.29 No.4

        Purpose: To evaluate the impact of postoperative radiotherapy (PORT) on patterns of failure and survivals in uterine carcinosarcoma patients treated with radical surgery. Materials and Methods: Between October 1998 and August 2010, 19 patients with stage Ⅰ–Ⅲ uterine carcinosarcoma received curative hysterectomy and bilateral salpingo-oophorectomy with or without PORT at Seoul National University Hospital. Their hospital medical records were retrospectively reviewed. PORT and non-PORT groups included 11 and 8 patients, respectively. They were followed for a mean of 22.7 months (range, 7.8 to 126.6 months). Results: At 5 years, the overall survival rates were 51.9% for entire, 61.4% for PORT, and 41.7% for non-PORT groups, respectively. There was no statistical difference between PORT and non-PORT groups with regard to overall survival (p = 0.682). Seven out of 19 (36.8%) patients showed treatment failures, which all happened within 12 months. Although the predominant failures were distant metastasis in PORT group and loco-regional recurrence in non-PORT group, there was no statistically significant difference in loco-regional recurrence-free survival (LRRFS) (p = 0.362) or distant metastasis-free survival (DMFS) (p = 0.548). Lymph node metastasis was found to be a significant prognostic factor in predicting poor LRRFS (p = 0.013) and DMFS (p = 0.021), while the International Federation Gynecology and Obstetrics (FIGO) stage (p = 0.043) was associated with LRRFS. Conclusion: Considering that adjuvant radiotherapy after surgical resection was effective to decrease loco-regional recurrence and most treatment failures were distant metastasis, multimodal therapy including surgery, radiotherapy, and chemotherapy might be an optimal treatment for uterine carcinosarcoma patients.

      • SCISCIESCOPUS

        The incidence and predictors of postprocedural incomplete stent apposition after angiographically successful drug-eluting stent implantation

        Kim, Yong-Seok,Koo, Bon-Kwon,Seo, Jae-Bin,Park, Kyung Woo,Suh, Jung-Won,Lee, Hae-Young,Park, Jin-Shik,Kang, Hyun-Jae,Cho, Young-Seok,Chung, Woo-Young,Chae, In-Ho,Choi, Dong-Ju,Kim, Hyo-Soo,Oh, Byung-H Wiley Subscription Services, Inc., A Wiley Company 2009 CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS Vol.74 No.1

        <P>Objectives: The aim of this study was to evaluate the incidence and predictors of postprocedural incomplete stent apposition (ISA) after angiographically successful drug-eluting stent (DES) implantation. Background: The deployed stents are usually evaluated by angiography alone; however, there are possibilities of postprocedural ISA despite the angiographically successful implantation. Methods: A total of 339 lesions in which poststent intravascular ultrasound (IVUS) was performed after successful DES implantation was included. Paclitaxel-eluting stents were implanted in 237 lesions and sirolimus-eluting stents (SES) in 102 lesions. Clinical, angiographic and procedural characteristics and IVUS findings for all cases were analyzed. Results: The overall incidence of ISA was 13.9% (47/339). By multivariate analysis, male gender (OR: 2.36, 95% CI: 1.09–5.11), deployment of SES (OR: 2.90, 95% CI: 1.49–5.67), the presence of intracoronary thrombus (OR: 7.47, 95% CI: 1.67–33.47), and non-ST elevation myocardial infarction (OR: 2.73, 95% CI: 1.09–6.83) were independent predictors for postprocedural ISA after angiographically successful DES implantation. Conclusions: The incidence of postprocedural ISA after angiographically successful implantation of DES was not infrequent. A DES deployment strategy incorporating IVUS guidance might be helpful to reduce the incidence of postprocedural ISA. © 2009 Wiley-Liss, Inc.</P>

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