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요양급여적정성 평가자료를 이용한 예방적 항생제 사용과 수술부위 감염 발생의 관련성 연구
김경훈,박춘선,장진희,김남순,이진서,최보람,이병란,이규덕,김선민,염선아,Kim, Kyoung-Hoon,Park, Choon-Seon,Chang, Jin-Hee,Kim, Nam-Soon,Lee, Jin-Seo,Choi, Bo-Ram,Lee, Byung-Ran,Lee, Kyoo-Duck,Kim, Sun-Min,Yeom, Seon-A 대한예방의학회 2010 예방의학회지 Vol.43 No.3
Objectives: To examine the prophylactic antibiotic use in reducing surgical site infection. Methods: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. Results: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies, 3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. Conclusions: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.
Charlson 동반질환의 ICD-10 알고리즘 예측력 비교연구
김경훈,Kim, Kyoung-Hoon 대한예방의학회 2010 예방의학회지 Vol.43 No.1
Objectives: To compare the performance of three International Statistical Classification of Diseases, 10th Revision translations of the Charlson comorbidities when predicting in-hospital among patients with myocardial infarction (MI). Methods: MI patients ${\geq}20$ years of age with the first admission during 2006 were identified(n=20,280). Charlson comorbidities were drawn from Heath Insurance Claims Data managed by Health Insurance Review and Assessment Service in Korea. Comparisions for various conditions included (a) three algorithms (Halfon, Sundararajan, and Quan algorithms), (b) lookback periods (1-, 3- and 5-years), (c) data range (admission data, admission and ambulatory data), and (d) diagnosis range (primary diagnosis and first secondary diagnoses, all diagnoses). The performance of each procedure was measured with the c-statistic derived from multiple logistic regression adjusted for age, sex, admission type and Charlson comorbidity index. A bootstrapping procedure was done to determine the approximate 95% confidence interval. Results: Among the 20,280 patients, the mean age was 63.3 years, 67.8% were men and 7.1% died while hospitalized. The Quan and Sundararajan algorithms produced higher prevalences than the Halfon algorithm. The c-statistic of the Quan algorithm was slightly higher, but not significantly different, than that of other two algorithms under all conditions. There was no evidence that on longer lookback periods, additional data, and diagnoses improved the predictive ability. Conclusions: In health services study of MI patients using Health Insurance Claims Data, the present results suggest that the Quan Algorithm using a 1-year lookback involving primary diagnosis and the first secondary diagnosis is adequate in predicting in-hospital mortality.
건강보험 청구자료에서 동반질환 보정방법과 관찰기관 비교 연구: 경피적 관상동맥 중재술을 받은 환자를 대상으로
김경훈,안이수,Kim, Kyoung-Hoon,Ahn, Lee-Su 대한예방의학회 2009 예방의학회지 Vol.42 No.4
Objectives : To compare the performance of three comorbidity measurements (Charlson comorbidity index, Elixhauser s comorbidity and comorbidity selection) with the effect of different comorbidity lookback periods when predicting in-hospital mortality for patients who underwent percutaneous coronary intervention. Methods : This was a retrospective study on patients aged 40 years and older who underwent percutaneous coronary intervention. To distinguish comorbidity from complications, the records of diagnosis were drawn from the National Health Insurance Database excluding diagnosis that admitted to the hospital. C-statistic values were used as measures for in comparing the predictability of comorbidity measures with lookback period, and a bootstrapping procedure with 1,000 replications was done to determine approximate 95% confidence interval. Results : Of the 61,815 patients included in this study, the mean age was 63.3 years (standard deviation: ${\pm}$10.2) and 64.8% of the population was male. Among them, 1,598 2.6%) had died in hospital. While the predictive ability of the Elixhauser's comorbidity and comorbidity selection was better than that of the Charlson comorbidity index, there was no significant difference among the three comorbidity measurements. Although the prevalence of comorbidity increased in 3 years of lookback periods, there was no significant improvement compared to 1 year of a lookback period. Conclusions : In a health outcome study for patients who underwent percutaneous coronary intervention using National Health Insurance Database, the Charlson comorbidity index was easy to apply without significant difference in predictability compared to the other methods. The one year of observation period was adequate to adjust the comorbidity. Further work to select adequate comorbidity measurements and lookback periods on other diseases and procedures are needed.
저온 열원 활용을 위한 암모니아-물 재생 랭킨 사이클의 성능 해석
김경훈(Kim Kyoung-Hoon),한철호(Han Chul-Ho) 한국태양에너지학회 2011 한국태양에너지학회 논문집 Vol.31 No.1
It is a great interest to convert more energy in the heat source into the power and to improve the efficiency of power generating processes. Since the efficiency of power generating processes becomes poorer as the temperature of the source decreases, to use an ammonia-water mixture instead of water as working fluid is a possible way to improve the efficiency of the system. In this work performance of ammonia-water regenerative Rankine cycle is investigated for the purpose of extracting maximum power from low-temperature waste heat in the form of sensible energy. Special attention is paid to the effect of system parameters such as mass fraction of ammonia and turbine inlet pressure on the characteristics of system. Results show that the power output increases with the mass fraction of ammonia in the mixture, however workable range of the mass fraction becomes narrower as turbine inlet pressure increases and is able to reach 16.5㎾per unit mass flow rate of source air at 180℃.
연구논문 : 오배자(Rhus javanica) 추출물의 어병세균 Vibrio ichthyoenteri 와 Streptococcus iniae 에 대한 항균활성
김경훈 ( Kyoung Hoon Kim ),김아라 ( Ah Ra Kim ),조은지 ( Eun Ji Cho ),주성제 ( Seong Je Joo ),박종훈 ( Jong Hoom Park ),문지영 ( Ji Young Moon ),염종화 ( Jong Hwa Yum ),김태훈 ( Tae Hoon Kim ),권현주 ( Hyun Ju Kwon ),이은우 ( Hyun 한국수산과학회(구 한국수산학회) 2014 한국수산과학회지 Vol.47 No.1
The antibacterial activities of methanol extracts of 19 commercial herbal medicines were measured against the fish pathogens Vibrio ichthyoenteri and Streptococcus iniae, which cause several fish diseases. Rhus javanica showed the strongest antibacterial activity against V. ichthyoenteri and S. iniae. The methanol extract of R. javanica was extracted further using several organic solvents with different polarities. The extract from the ethyl acetate fraction showed strong activity against both fish pathogens. The minimum inhibitory concentration (MIC) of the R. javanica extract was 32μg/mL for V. ichthyoenteri and 128μg/mL for S. iniae. Further purification and isolation of the active com- pound (s) responsible for these activities and further study of the synergistic effect using combinations of antibiotics against pathogenic bacteria are needed.
캐쉬 효과를 고려한 확장된 이진 탐색 트리 알고리즘에 관한 연구
김경훈(Kyoung-Hoon Kim),정균락(Kyun-Rak Chong) 한국정보과학회 2000 한국정보과학회 학술발표논문집 Vol.27 No.2Ⅰ
VLSI 기술의 발전에 따라 프로세서의 속도는 빠르게 증가하고 있는 반면 메모리의 속도는 이를 뒷받침하지 못하여 속도의 차이를 줄이기 위해 캐쉬(cache) 메모리를 사용하고 있다. 캐쉬가 알고리즘의 실행시간에 미치는 영향이 점점 더 커지고 있으나 이제까지 개발된 대부분의 알고리즘들은 이러한 캐쉬의 중요성을 고려하지 않고 개발되었다. 본 논문에서는 캐쉬 효과를 고려한 확장된 이진 탐색 트리 알고리즘에 관해 연구하였고, 실험을 통하여 기존의 이진 탐색 트리와 제안된 알고리즘의 성능을 비교하였다.
ICR 마우스를 이용한 Bacillus subtilis JNS 균주의 단회경구투여 독성시험
김경훈(Kyoung-Hoon Kim),정창화(Chang Hwa Jeong),주성제(Seong-Je Joo),박종훈(Jong-Hoon Park),문지영(Ji-Young Moon),조은지(Eun-Ji Cho),이현태(Hyun-Tai Lee),권현주(Hyun-Ju Kwon),김병우(Byung-Woo Kim),엄성환(Sung-Hwan Eom),이은우(Eun-Woo 한국식품영양과학회 2015 한국식품영양과학회지 Vol.44 No.1
청국장에서 분리한 항균활성이 우수한 Bacillus subtilis JNS의 probiotics로서의 활용성을 검증하기 위해 단기투여에 의한 안전성을 확인하고자 실험을 실시하였다. 경구투여용 존데를 이용하여 임상적용 경로인 경구로 투여하였으며, 최고투여용량은 2,000 mg/kg으로 설정하였다. ICR계 암수마우스에서 14일간 관찰한 결과 일반증상, 사망률, 체중, 임상증상 및 육안적 소견 등에서 무처리 대조군과 비교해서 유의성 있는 차이를 보이지 않았다. 부검 후의 주요 장기에 대한 육안적 검사에서 또한 대조군과 비교하여 이상소견이나 병변이 관찰되지 않았다. 이상의 결과로부터 시험물질인 B. subtilis JNS는 경구투여 시 ICR계 암수 마우스에서 독성학적인 변화가 관찰되지 않았으며, 경구투여가 2,000 mg/kg 이상인 저독성의 안전한 물질로 사료된다. The present study was carried out to investigate the in vivo single-dose acute toxicity of Bacillus subtilis JNS isolated from Cheonggukjang, which is a probiotic candidate showing strong and broad antibacterial activity. The test sample was orally administrated to male and female ICR mice at a highest dose of 2,000 mg/kg for 14 days. No significant change in general conditions, mortalities, body weight changes, clinical signs, autopsy findings, or presence of gross lesions was observed in either sex of mice. The results indicate that up to 2,000 mg/kg of B. subtilis JNS had no adverse effect on ICR mice.