영아내사시의 술 전 원시값에 따른 수술결과 분석

김유정(Yu Jeong Kim),신광훈(Kwang Hoon Shin),백혜정(Hae Jung Paik) 대한안과학회 2016 대한안과학회지 Vol.57 No.11

목적: 영아내사시에서 원시 굴절값에 따른 장, 단기 수술결과 및 수술량에 따른 수술효과 차이를 알아보고자 하였다. 대상과 방법: 2007년부터 2011년까지 영아 내사시로 진단, 양안 내직근후전술을 받고 수술 후 36개월 이상 경과관찰이 가능했던 80명의 환자의 의무기록을 후향적으로 분석하였다. 조절마비검사 구면렌즈대응치에서 원시 굴절값이 +3.0D 미만(non-high hyperopia, NH)인 비고도원시군(59명)과 +3.0D 이상(high hyperopia, HH)인 고도원시군(21명)으로 분류하여, 수술 후 3개월째, 수술 후 3년째 수술성공률 및 수술 단위(mm)당 내편위교정량(PD)인 수술효과-수술량 관계를 분석하였다. 결과: 술 전 편위각은 비고도원시군 44.8 ± 10.2PD, 고도원시군 42.7 ± 11.6PD로 유사하였고(p=0.450), 양안 내직근후전술 후 수술 성공률은 비고도원시 69.5% (41/59), 고도원시 71.4% (15/21) (p=0.837), 부족교정률은 비고도원시 23.7% (14/59), 고도원시 9.5% (2/21) (p=0.191), 과교정률은 비고도원시 6.8% (4/59), 고도원시 19.1% (4/21) (p=0.138)로 통계적으로 차이를 보이지 않았다. 수술효과-수술량은 수술 후 3개월째 비고도원시 3.9PD/mm와 고도원시 4.3PD/mm로 차이를 보였으나 통계적으로 유의하지 않았으며 (p=0.105), 수술 후 3년째 고도원시군에서 외편위가 진행되어 비고도원시 3.9PD/mm와 고도원시 4.9PD/mm는 통계적으로 유의한 차이를 보였다(p=0.010). 약시의 비율은 비고도원시 8.5% (5/59), 고도원시 23.8% (5/21)로 차이는 있었으나 통계적으로 유의하지는 않았다(p=0.146). 결론: 영아내사시에서 수술 성공률은 술 전 원시값에 따른 유의한 상관관계가 없었다. 수술단위 길이당 내편위 교정효과는 수술 후 3개월째는 두 군 간 유의한 상관관계가 없었으나, 수술 후 3년째는 고도원시군에서 더 크게 나타났다. 따라서 술 전 +3.0D 이상의 고도원시값을 가진 영아 내사시 환자는 과교정에 유의하여 수술량의 조정이 필요하며, 특히 수술 후 장기간의 관찰이 필요할 것으로 사료된다. <대한안과학회지 2016;57(11):1752-1758> Purpose: In the present study, short-term and long-term surgical outcomes dependent on the amount of hyperopia in patients with infantile esotropia were analyzed. Methods: In this study, 80 patients with infantile esotropia who underwent both medial rectus recession from 2007 to 2011 and followed up for at least 36 months were retrospectively examined. The patients were divided into two groups according to the degree of hyperopia: ≥ +3.0 D (high hyperopia [HH], n = 59 patients) and < +3.0 D (non-high hyperopia [NH], n = 21 patients). Clinical characteristics analyzed included surgical success rate and dose-response relationship at the 3-month and 3-year postoperative follow-ups. Results: Initial preoperative alignment (NH: 44.8 ± 10.2 PD, HH: 42.7 ± 11.6 PD, p = 0.450), surgical success rates (NH: 69.5% (41/59), HH: 71.4% (15/21), p = 0.837), under-correction rates (NH: 23.7% (14/59), HH: 9.5% (2/21), p = 0.191) and over-correction rates (NH: 6.8% (4/59), HH: 19.1% (4/21), p = 0.138) were not statistically significantly different between the NH and HH groups. A tendency towards a larger dose-response relationship was observed with HH (NH: 3.9 PD/mm, HH: 4.3 PD/mm) at the 3-month postoperative follow-up, but was not significant (p = 0.105). At the 3-year postoperative follow-up, exodrift was in progress and the dose-response relationship was significantly higher in the HH group than NH group (NH: 3.9 PD/mm, HH: 4.9 PD/mm, p = 0.010). A difference between the groups with amblyopia was observed (NH: 8.5% (5/59), HH: 23.8% (5/21), p = 0.146), although without statistical significance. Conclusions: The surgical success rate of infantile esotropia was not statistically associated with the amount of hyperopia. There was no statistical association between the dose-response relationship and amount of hyperopia at the postoperative 3-month follow-up, but a statistical association was found in the high dose-response relationship in the HH group at the postoperative 3-year follow-up. Therefore, the conventional amount of recession or muscle resection should be modified in high hyperopic (≥ +3.0 D) infantile esotropia, and long-term postoperative follow-up is necessary. J Korean Ophthalmol Soc 2016;57(11):1752-1758

Dose-Response Relationship between Radiation Dose and Loco-regional Control in Patients with Stage II-III Esophageal Cancer Treated with Definitive Chemoradiotherapy

김현주,서양권,이용찬,이상길,신성관,조병철,이창걸 대한암학회 2017 Cancer Research and Treatment Vol.49 No.3

Purpose The correlation between radiation dose and loco-regional control (LRC) was evaluated in patients with stage II-III esophageal cancer treated with definitive concurrent chemoradiotherapy (CRT). Materials and Methods Medical records of 236 stage II-III esophageal cancer patients treated with definitive CRT at Yonsei Cancer Center between 1994 and 2013 were retrospectively reviewed. Among these, 120 received a radiation dose of < 60 Gy (standard-dose group), while 116 received ! 60 Gy (high-dose group). The median doses of radiation in the standard- and high-dose groups were 50.4 and 63 Gy, respectively. Concurrent 5-fluorouracil/cisplatin chemotherapy was administered to most patients. Results There were no differences in patient characteristics between the two groups except for high Karnofsky performance status and lower-thoracic lesions being more prevalent in the standard- dose group. The median progression-free survival (PFS) and overall survival (OS) times were 13.2 months and 26.2 months, respectively. Patients in the high-dose group had significantly better 2-year LRC (69.1% vs. 50.3%, p=0.002), median PFS (16.7 months vs. 11.7 months, p=0.029), and median OS (35.1 months vs. 22.3 months, p=0.043). Additionally, LRC exhibited a dose-response relationship and the complete response rate was significantly higher in the high-dose group (p=0.006). There were no significant differences in treatment-related toxicities between the groups. Conclusion A higher radiation dose (> 60 Gy) is associated with increased LRC, PFS, and OS in patients with stage II-III esophageal cancer treated with definitive CRT.

그레이스최우수논문상 (일반부인과학)

최주희 ( Joohee Choi ),( Dong Wook Shin ),( Seungmee Lee ),( Myung Jae Jeon ),( Sun Min Kim ),( Belong Cho ),( Seung Mi Lee ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

Objective: To evaluate whether smoking is a risk factor for female sexual dysfunction (FSD) and to determine the relationship between the cumulative smoking dose and FSD in premenopausal women. Methods: The study population consisted of sexually active premenopausal women. The frequency of FSD and female sexual function index (FSFI) total score were evaluated according to the smoking status (never/former and current smokers). Evaluation of sexual function was done using FSFI questionnaire, and women with FSFI score of ≤26.55 were considered to have FSD. In current smokers, sexual function was also evaluated according to the cumulative smoking dose and nicotine dependency. Results: A total of 900 women were included, and the frequency of current smokers and the frequency of FSD were 62 (6.9%) and 496 (55.1%), respectively. In current smokers, the frequency of FSD was significantly higher and the median total FSFI score was significantly lower than in never/former smokers, and this difference of FSD remained significant after adjustment for confounding variables. Among current smokers, the cumulative smoking dose (pack-years) and the total FSFI score showed negative correlation, in which increased cumulative smoking dose was associated with lower total FSFI score (r=-0.278, P<0.05). In terms of nicotine dependency, the total FSFI score of moderately to heavily nicotine dependent smokers was significantly lower than that of lightly dependent smokers. Conclusion: In premenopausal women, current smoking was an independent risk factor for FSD. And cumulative smoking dose and nicotine dependency were associated with higher risk of FSD.

Dose-response relationship between cigarette smoking and female sexual dysfunction

( Joohee Choi ),( Dong Wook Shin ),( Seungmee Lee ),( Myung Jae Jeon ),( Sun Min Kim ),( Belong Cho ),( Seung Mi Lee ) 대한산부인과학회 2015 Obstetrics & Gynecology Science Vol.58 No.4

Objective: To evaluate whether smoking is a risk factor for female sexual dysfunction (FSD) and to determine the relationship between the cumulative smoking dose and FSD in premenopausal women. Methods: The study population consisted of sexually active premenopausal women. The frequency of FSD and female sexual function index (FSFI) total score were evaluated according to the smoking status (never/former and current smokers). Evaluation of sexual function was done using FSFI questionnaire, and women with FSFI score of ≤26.55 were considered to have FSD. In current smokers, sexual function was also evaluated according to the cumulative smoking dose and nicotine dependency. Results: A total of 900 women were included, and the frequency of current smokers and the frequency of FSD were 62 (6.9%) and 496 (55.1%), respectively. In current smokers, the frequency of FSD was significantly higher and the median total FSFI score was significantly lower than in never/former smokers, and this difference of FSD remained significant after adjustment for confounding variables. Among current smokers, the cumulative smoking dose (pack-years) and the total FSFI score showed negative correlation, in which increased cumulative smoking dose was associated with lower total FSFI score (r=-0.278, P<0.05). In terms of nicotine dependency, the total FSFI score of moderately to heavily nicotine dependent smokers was significantly lower than that of lightly dependent smokers. Conclusion: In premenopausal women, current smoking was an independent risk factor for FSD. And cumulative smoking dose and nicotine dependency were associated with higher risk of FSD.

저선량 방사선 노출에 대한 생물학적 지표로서 Glycophorin A 변이발현율 측정의 유용성 평가

하미나,유근영,하성환,김동현,조수헌,Ha, Mi-Na,Yoo, Keun-Young,Ha, Sung-Whan,Kim, Dong-Hyun,Cho, Soo-Hun 대한예방의학회 2000 예방의학회지 Vol.33 No.2

Objectives : To assess the availability of the glycophorin A (GPA) assay to detect the biological effect of ionizing radiation in workers exposed to low-doses of radiation. Methods : Information on confounding factors, such as age and cigarette smoking was obtained on 144 nuclear power plant workers and 32 hospital workers, by a self-administered questionnaire. Information on physical exposure levels was obtained from the registries of radiation exposure monitoring and control at each facility. The GPA mutant assay was performed using the BR6 method with modification by using a FACScan flow cytometer. Results : As confounders, age and cigarette smoking habits showed increasing trends with GPA variants, but these were of no statistical significance. Hospital workers showed a higher frequency of the GPA variant than nuclear power plant workers in terms of the NO variant. Significant dose-response relationships were obtained from in simple and multiple linear regression models. The slope of the regression equation for nuclear power plant workers was much smaller than that of hospital workers. These findings suggest that there may be apparent dose-rate effects. Conclusion : In population exposed to chronic low-dose radiation, the GPA assay has a potential to be used as an effective biologic marker for assessing the bone marrow cumulative exposure dose.

A Dose-Response Relationship between Types of Physical Activity and Distress

김기랑,신영전,Joung Hyun Nam,최보율,김미경 대한의학회 2008 Journal of Korean medical science Vol.23 No.2

This study aimed to examine whether a dose-response relationship exists between psychological distress and types of physical activity (total, occupational, and leisuretime). The study subjects (233 men and 313 women) were recruited for a study on cardiovascular disease in the Yangpyeong community located in South Korea. The type and characteristics of physical activity were measured with a modified version of the Stanford 5 city project’s questionnaire by well-trained interviewers using a standard protocol. The Psychological Well-being Index-Short Form was used to assess psychological distress. Both the intensity and duration of time in either total physical activity or occupational physical activity (OPA) were not related to the distress score. However, a long duration of time (1 hr/day) in severely intensive (≥6 metabolic equivalent) OPA was related to a high distress score in men (14.1 for none vs. 19.7, pfor- trend=0.005), even after the adjustment for leisure-time physical activity (LTPA). A long duration in time (1 hr/day) in LTPA was related to a lower distress score in men independent of their OPA (16.7 for none vs. 13.1, p-for-trend=0.02). In conclusion, the dose-response relationship of physical activity on psychological distress appeared to differ among the different types of activities. The type of activity may be an important determinant of whether physical activity produces psychological benefits.

The effect of alcohol dose on the development of hypertension in Asian and Western men: systematic review and meta-analysis

( Mi-hyang Jung ),( Ein-soon Shin ),( Sang-hyun Ihm ),( Jin-gyu Jung ),( Hae-young Lee ),( Cheol-ho Kim ) 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.4

Background/Aims: There are inconsistencies in the effects of low to moderate dose alcohol consumption on the development of hypertension in adult men. We hypothesized that a region-specific effect might participate in this heterogeneity. Methods: We conducted a systematic review and meta-analysis to evaluate the effect of alcohol dose on hypertension incidence using contemporary data through December 2017. Subjects were categorized according to their level of alcohol consumption as non-drinkers (reference) and low- (0.01 to 20.0 g/day), moderate- (20.1 to 40.0 g/day), moderate- to high- (40.1 to 60.0 g/day), and high-dose (> 60.0 g/day) drinkers. We defined hypertension as a blood pressure ≥ 140/90 mmHg and/or the use of anti-hypertensive drugs. Results: In total, 11 articles (seven Asian and four Western) were selected for our analysis. Among Asian men, a significantly elevated risk was observed even in the low alcohol dose group in comparison with the group with no alcohol consumption, and the risk increased in a dose-dependent manner (pooled relative risks [95% confidence intervals (CI)]: 1.25 [1.13 to 1.38], 1.48 [1.27 to 1.72], 1.75 [1.43 to 2.15], and 1.78 [1.51 to 2.09]). Among Western men, a similar dose-response relationship was noted in general (p for subgroup difference > 0.1), but a significantly elevated risk was evident only in the high-dose group (pooled relative risks [95% CI]: 1.22 [0.85 to 1.74], 1.57 [0.90 to 2.75], 1.47 [0.44 to 4.91], and 1.49 [1.02 to 2.18]). Conclusions: Even low doses of alcohol can lead to the development of hypertension, particularly in Asian men. Our findings could serve as additional evidence for developing an appropriate preventive strategy in each region.

Alcohol Consumption Can Reduce the Risk of Gallstone Disease: A Systematic Review with a Dose-Response Meta-Analysis of Case-Control and Cohort Studies

( Byung Hyo Cha ),( Myoung-jin Jang ),( Sang Hyub Lee ) 대한간학회 2019 Gut and Liver Vol.13 No.1

Background/Aims: Gallstone disease (GSD) is a common gastrointestinal disorder. Clinical epidemiological studies revealed that alcohol consumption has a preventive effect on the development of GSD. This study aimed to evaluate the relative risks of drinking for GSD development and investigate the dose-response relationships. Methods: A systematic search of the MEDLINE, EMBASE, and Cochrane Library databases for studies published up to 2018 was performed. All studies that satisfied the following eligibility criteria were included: patients with GSD with or without cholecystitis; and cohort or case-control studies investigating the association between alcohol consumption and GSD development. Results: Sixteen case-control studies including 24,401 gallstone cases and 76,185 controls, and eight cohort studies with 14,693 GSD cases among 2,432,471 person-years were enrolled. Alcohol consumption presented a decreased overall risk of GSD (pooled relative ratio [RR], 0.84; 95% confidence interval [CI], 0.79 to 0.89; p=0.02). Subgroup analyses according to drinking levels indicated a gradual risk reduction for GSD compared to nondrinkers (light: RR, 0.96; 95% CI, 0.94 to 0.99; p=0.75; moderate: RR, 0.80; 95% CI, 0.75 to 0.85; p=0.27; high: RR, 0.66; 95% CI, 0.56 to 0.79; p<0.01). A nonlinear risk reduction was observed in a doseresponse meta-analysis of all the studies (n=14, p<0.01 for nonlinearity). Conclusions: In this systematic review with meta-analysis, alcohol consumption could decrease the risk of GSD, and the dose-response analysis revealed a dosedependent linear risk reduction and a weakened linear trend between alcohol consumption levels less than and greater than 28 g/day. (Gut Liver 2019;13:114-131)

The Association between Physical Activity and Anxiety Symptoms for General Adult Populations: An Analysis of the Dose-Response Relationship

Sun-Young Kim,Sang-Won Jeon,Mi Yeon Lee,Dong-Won Shin,Weon-Jeong Lim,Young-Chul Shin,Kang-Seob Oh 대한신경정신의학회 2020 PSYCHIATRY INVESTIGATION Vol.17 No.1

Objective: The aim of this study is to determine the dose-response relationship between physical activity and anxiety symptoms. Methods: We included data of 124,434 participants who had comprehensive health-screening examinations from January 1st, 2012, to December 31st, 2016, in Kangbuk Samsung Hospital, Seoul and Suwon, South Korea. We measured the level of physical activity using the International Physical Activity Questionnaire-short form (IPAQ-SF) and estimated anxiety symptoms using the Beck Anxiety Inventory (BAI). BAI scores of 19 and above were defined as cases. Logistic regression was used to analyze the association between physical activity and BAI-defined anxiety. Furthermore, we assessed whether sex differences might affect the relationship between physical activity and BAI-defined anxiety by stratifying our data. Results: Compared with the sedentary group (0-600 METs-min/week), individuals achieving 600-6,000 METs-min/wk had a significantly lower risk of BAI-defined anxiety with a U-shaped relationship in general adults. After stratifying our data by sex, we found that optimal ranges of physical activity were 600-9,000 METs-min/wk for men, but 1,200-3,000 METs-min/wk for women. Conclusion: We identified a U- or J-shaped association between physical activity and anxiety symptoms, suggesting an optimal dose and upper limit of physical activity for decreasing anxiety symptoms. Optimal levels and upper limits of physical activity for reducing anxiety symptoms were higher for men than for women.

작업관련 근골격계 목 증상과 물리적 위험요인의 양-반응관계 : 2년간 추적 연구

설진곤,강동묵,이수일,김영기 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.2