대한류마티스학회지에 사용된 통계기법의 평가

박일규 ( Ile Kyu Park ),김신규 ( Think You Kim ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.2

Objective: Quantitative experiment and analysis of the result with statistical techniques are an essential part of the medical article for acquiring objective confidence. But errors on application, calculation, and interpretation of statistics and insufficient explanation of the used statistical technique deprive the reader of reliance on the article. We identified the statistical techniques and errors that were commonly encountered, and both of researchers and readers should recognize, in the Journal of the Korean Rheumatism Association (JKRA). Methods: We identified the frequency of the statistical techniques and errors from the 136 articles in the 1994~1998 editions of the JKRA. Each different kind of statistical techniques and errors in the same article were counted separately, but two or more of the same kind of statistical techniques and errors in an article were counted as one. Results: One hundred and seventy-seven statistical techniques were encountered and 75 statistical errors were identified. The most frequently used techniques were descriptive statistics, and common errors and the observed numbers of the errors were as follow: 1. performing statistical techniques for two groups on the comparison of three or more groups(14), 2. mentioning the statistical technique without using it(14), 3. using mean and standard deviation instead of median and range on the ordinal data(12), 4. using standard error instead of standard deviation for the description of data spread(11), 5. using p value without the statistical name(11). Conclusion: The most frequently encountered statistical technique and error are descriptive technique and performing statistical techniques for 2 groups on the comparison of 3 or more groups, respectively. The authors` careful application of the basic statistics would be the real solution to reduce the statistical errors.

간경변증 환자에서의 혈장 D-lactate 농도와 산염기 장애

이동규(Dong Kyu Lee),유준호(Jun Ho Ryu),한상웅(Sang Woong Han),김호중(Ho Jung Kim),박일규(Ile Kyu Park),손주현(Joo Hyun Sohn),기춘석(Choon Suk Kee) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.1

목 적 : 인간은 D- lactate dehyrogenase (LDH)가 없기 때문에 L- lactate의 광학이성질체인 D- lactate는 인간의 대사물이 아니다. 전반적인 대사능력이 제한된 간경변증 환자에서 항생제 및 lactulose 사용으로 인한 장내세균총의 변화와 기질의 증가로 D- lactate가 체외에서 유입되어 혈액내 D- lactate를 상승시킬 수 있다. 이 연구는 간경변증의 중등도 및 산- 염기장애에 대한 혈액내 L- lactate와 D- lactate농도의 연관성과 항생제와 lactulose사용이 D- lactate의 상승에 미치는 영향을 분석하고자 하였다. 방 법 : 한양대학교 구리병원에 입원한 간경변증 환자 40명을 대상으로 Child- Pugh 분류에 따라 분류하고, L- LDH와 D- LDH을 사용하여 혈장 L- lactate와 D- lactate을 측정하였다. 이들 중 14명은 혈장 L-, D-lactate를 추적 검사하여 lactulose와 항생제 각각의 사용유무에 따른 변화양상을 비교하였다. 결 과 : 혈장 D- lactate는 대조군(15명)에서 1.63±0.26 m㏖/ L이고 간경변증 환자(40명)에서는 2.34±0.48 m㏖/L로 증가하는 경향이나 통계적으로 의미 있는 차이는 없었고, 간경변증환자 중 4명(10%)이 비정상적인 혈장 D- lactate 상승을 보였다. Child 분류와 간경변증의 원인들간의 혈장 L-, D- lactate치의 차이는 없었다. 동맥혈가스분석을 시행한 환자 35명 중 산- 염기장애는 호흡성 알칼리증이 63%(n =22), 호흡성- 대사성 혼합성 알칼리증이 17%(n =6), 호흡성 알칼리증- 대사성산증이 9%(n =3), 그리고 정상이 11%(n =4)이었으며 대사성 산증이 동반된 군에서는 혈장 D- lactate가 상승되어 있었다(12.00±2.98 m㏖/L, p<0.05). 입원기간 중 lactulose와 항생제를 사용한 군에서 사용전후 혈장 L- lactate와 D- lactate의 차이는 관찰되지 않았다. 결 론 : 원인은 알 수 없으나 일부 간경변증 환자는 중증도와 관계없이 혈장 D- lactate가 비정상적으로 상승되어 있다. 이는 간경변증 환자들에서 저하된 간의 대사능력이외 다른 요인이 간여할 것으로 생각된다. 또한 간경변증 환자의 산- 염기 장애는 대부분 호흡성 알칼리증을 나타내지만, 대사성 산증이 동반된 간경변증 환자는 혈장 D- lactate의 상승을 한 원인으로 고려해야 할 것이다. Purpose : D-lactate, optical isomer of L-lactate is not a human metabolite. Once the D-lactate enters the human body, it is mainly metabolized in liver. The metabolism of D-lactate can be changed in patients with decompensated liver cirrhosis with the exposure of antibiotics and the frequent trial of lactulose, if neccessory. T he aim of this study is to analyze blood D-lactate level in cirrhotic patients and it`s relationship with the degree of hepatic insufficiency and acid-base imbalance. Methods : Plasma L-lactate and D-lactate levels were measured in 40 cirrhotic patients classified by Child-Pugh system with L-LDH and D-LDH with comparison of their changes before and after the use of antibiotics and lactulose(n=14). Also, acid-base disorders were analyzed in 35 cirrhotic patients, and plasma L, D-lactate levels were determined in each acid-base disorder. Results : Plasma D-lactate level w as not significantly elevated in cirrhotic patients compared to the control group(2.34± 0.48 m㏖/L vs. 1.63± 0.26 m㏖/L, p=NS), but some patients (n=4, 10%) revealed abnormally elevated D-lactate level. The plasma L, Dlactate levels were not different in subgroups classified by Child-Pugh system as well as by underlying causes of liver cirrhosis, and plasma D-lactate level w as not sugnificnatly different before and after the exposure of antibiotics and lactulose. Plasma D-lactate level w as significantly increased in 3 patients with respiratory alkalosis and metabolic acidosis (12±2.98 m㏖/L) compared to others (p<0.05). Conclusion : These results suggest that, regardless of its decompensated degree and exposure to drugs, a subset of patients with liver cirrhosis can develop elevation of D-lactate in blood, particularly when metabolic acidosis is accompanied.

만성신부전 환자에서의 초기 투석 시작시와 장기 투석 후의 임상적, 실험적 특징의 고찰

김호중(Ho Jung Kim),박일규(Ile Kyu Park),한상웅(Sang Woong Han),양성규(Seong Kyu Yang),유준호 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.2

N/A Objective: We examined clinical and laoratory features retrospectively in 56 patients at the start and after the chronic maintenance hemodialysis in order to provide a more complete picture of the uremic symdrome in the dialysis era. for deciding the time when chronic hemodialysis must be started. Methods: The records of 56 patients began chro-nic hemodialysis treatment at the Han Yang University Hospital from 1995 august until 1997 august were reviewed retrospectively. The information gathered in-cluded demographic data, renal diagnosis, uremic symptoms, biochemical values. Results: The most prevalence of manifestation of uremia was general weakness(67.9%). Unexpected fin-dings were the wide ranges of serum creatinine levels(3.5 to 19.4mg/dL) and blood urea nitrogen levels (19 to 204mg/dL), creatinine clearance rate(1.2-17.4mL/ min), and the frequency of hyponatremia(19.6%), hypo-albuminemia(69.6%), and the anion gap above 14mByL was(66.7%). There was higher potassium leve1 in dia-betes mellitus patients than non-diabetes mellitus pa-tients(6.2±1.6mEq/L VS. 4.9±1.0mEq/L,p=01). Patients laboratory values were changed after the chronic main- tenance hemodialysis-Albumin(3.2±0.8 to 3.6±0.5gm/dL, p=0.01), calcium(7.6±1.2 to 8.7±1.9mg/dL, p=0.01), he-matocrit(23.0±4.7 to 27.7±4.2% , p=0.01), phosphorus (5.6±2.1 to 4,6±1.4mg/dL, p=0.01), pH(7.30±0,1 to 7.35±0.2, p>0.05), anion gap(22,0±11.0 to 12.1±8.8mg/dL, p>0.05). Conclusion: Finally, uremic symptoms were ex-pressed mainly gastro-intestinal and respiratory sym-ptoms. Chronic renal failure associated with diabetes mellitus was earlier on set of uremic symptoms and higher level of serum potassium level than other underlying diseases. Uremic symptoms and laboratory values were almost corrected but metabolic acidosis was not corrected significantly after the chronic main- tenance hemodialysis.

1,5-Anhydroglucitol 측정 시약 Lana^TM의 분석능 및 임상적 유용성 평가

박일규,안유헌,박용수,이창범,백홍규 대한임상병리학회 2002 대한임상병리학회지 Vol.22 No.1

급성 췌장염 진단에 있어서 Lipase검사의 유용성 평가

박일규,강정옥,김홍석,박동우 대한임상병리학회 1997 대한임상병리학회지 Vol.17 No.6

골다공증의 생화학적 지표

박일규 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.1

Therapy of osteoporosis like hormone replacement and bisphosphonates results increase in bone mineral density but detection of the change takes 1 or 2 years, but decrease in biochemical marker of bone remodeling is fast and the change can be detected in 3 or 6 months. Biochemical markers of bone formation include bone specific alkaline phosphatase(BAP), osteocalcin(OC) and procollagen I extension peptide, and resorption markers include collagen cross-link molecule and cross-linked telopeptide of collagen. Biochemical markers can be used in clinical situation to determine 1) Which patients are likely to lose bone? 2) Which patients are likely to have fracture? 3) Which therapy would be the best? 3) Which patients would response better for the therapy? 5) Is the patient responding to treatment? Doctors have been confused and hesitated to order the biochemical markers because there were so many kind of tests and controversial reports about them. Causes of the controversial reports are analytical imprecision and pre-analytical variation. New tests measuring markers in blood with automatic analyzer were developed, possible pre-analytic factors causing imprecision of the test were recognized. Therefore, more tests will be ordered and correct result with rich clinical information will be given in the future, soon.

다운 증후군 산모 선별검사를 위한 컴퓨터 프로그램

박일규,강정옥,유진우,이성윤 대한임상병리학회 2000 대한임상병리학회지 Vol.20 No.4

혈청 빌리루빈 농도가 혈청 요산 농도 측정에 미치는 영향

박일규,김홍석,김신규 대한임상검사정도관리학회 2002 臨床檢査와 精度管理 Vol.24 No.1

침전제에 따른 High-Density Lipoprotein Cholesterol 측정치의 비교

박일규,정화순,김춘원,강종명 대한임상병리학회 1987 대한임상병리학회지 Vol.7 No.2

생소한 HBsAg 선별검사키트 bioelisa와 IEMA Well의 평가

김덕언,김홍석,김신규,이혜림,박일규,강정옥,최태열 대한임상검사정도관리학회 1997 臨床檢査와 精度管理 Vol.19 No.2