비만 및 과체중 성인에서 주관적 비만 인식과 신체계측에 의한 비만과의 일치도

정휘수 ( Hwee Soo Jeong ) 한국보건정보통계학회 (구 한국보건통계학회) 2009 보건정보통계학회지 Vol.34 No.2

Objective: Weight control in obese people have been affected by self perception of body image more than body mass index. We conducted this study to identify the agreement and associating factors between self-perceived obesity and obesity classified by body measure in obese and overweighted adults. Methods: The data were collected from 293 subjects who visited health examination center of a university hospital located in Gyeong-ju between July 7th, 2008 and Oct 31th, 2008 and had body mass index(BMI) ≥23kg/m2 by self questionnaire. Results: One hundred and ninety three(65.9%) participants had the agreement between self perception and measurement of obesity classified body mass index, but the agreement was lower for abdominal obesity with 134(45.7%) participants agreeing. Factors related to disagreement of self perception as obese and obesity classified by body measure were sex, age, family history of obesity. Conclusion: Considerable disagreement was identified between self perception as obese and obesity classified by body measure in obese and overweight adults. We should check disagreement before recommending weight control in these people.

아토바스타틴의 새로운 약물 적응증 탐색을 위한 비정형 데이터 분석

정휘수 ( Hwee-soo Jeong ),강길원 ( Gil-won Kang ),최웅 ( Woong Choi ),박종혁 ( Jong-hyock Park ),신광수 ( Kwang-soo Shin ),서영성 ( Young-sung Suh ) 한국보건정보통계학회(구 한국보건통계학회) 2018 한국보건정보통계학회지 Vol.43 No.4

Objectives: In recent years, there has been an increased need for a way to extract desired information from multiple medical literatures at once. This study was conducted to confirm the usefulness of unstructured data analysis using previously published medical literatures to search for new indications. Methods: The new indications were searched through text mining, network analysis, and topic modeling analysis using 5,057 articles of atorvastatin, a treatment for hyperlipidemia, from 1990 to 2017. Results: The extracted keywords was 273. In the frequency of text mining and network analysis, the existing indications of atorvastatin were extracted in top level. The novel indications by Term Frequency-Inverse Document Frequency (TF-IDF) were atrial fibrillation, heart failure, breast cancer, rheumatoid arthritis, combined hyperlipidemia, arrhythmias, multiple sclerosis, non-alcoholic fatty liver disease, contrast-induced acute kidney injury and prostate cancer. Conclusions: Unstructured data analysis for discovering new indications from massive medical literature is expected to be used in drug repositioning industries.

말기 암 환자에서 감염에 대한 항생제 사용 - 대한가정의학회 완화의학연구회 세미나에 기초한 -

정휘수,김대영,송경포,대한가정의학회 완화의학연구회,서상연,Jeong, Hwee-Soo,Kim, Dae-Young,Song, Kyoung-Po,Korean Family Medicine Palliative Medicine Research Group, Korean Family Medicine Palliative Medicine Research Group,Suh, 한국호스피스완화의료학회 2007 한국호스피스.완화의료학회지 Vol.10 No.1

말기 암 환자에서 감염에 대한 항생제 사용은 의학적 문제에 대해 해결해야 하는 의무와 임종을 앞둔 시점에 생명 연장으로 인한 환자의 고통증가에 대한 부담으로 명확하게 결정하기 어려운 문제이다. 대한가정의학회 완화의학연구회 세미나에서는 65세 남자환자로 직장암 말기에 악취를 동반한 광범위한 피부감염증으로 입원 후 국소 항생제 치료로 증상 호전 중 임종을 맞이한 증례를 토의하였고, 이를 통해 말기 암 환자에서 항생제 치료에 대한 문헌고찰과 토론 후 다음과 같이 의견을 제시하고자 한다. 항생제 치료 목적에 있어 증상조절을 고려해야 하며, 특히 요로계 감염이 있는 경우는 증상조절을 위해 항생제를 사용한다. 또한 감수성 검사를 통해 적절한 항생제를 처방해야 한다. 무엇보다도 우선적으로 고려되어야 할 점은 환자입장에서 무엇이 가장 득이 되는지를 생각하고, 항생제 사용에 대해 환자와 가족들의 의견을 존중하여 판단하며, 환자나 가족이 적극적으로 치료를 요구하는 경우에는 치료로 인한 득실에 대해 환자와 토의를 한 후 사용한다. Decision-making of antibiotics use in infected patients with terminal stage of cancer was difficult for physicians, because of responsibility of solving a medical problem and burden on patients distressed by worthless life expansion. Korean Family Medicine Palliative Medicine Research Group discussed this subject using a case of a 65 year-old male having terminal stage of sigmoid colon cancer with extended cutaneous infection who was treated local antibiotics, improved but expired at the 12th hospital day. We reviewed related literatures and proposed a guide for antibiotics use in inferred patients with terminal stage of cancer. Antibiotics should be used for symptom control as major indication, especially when patients suffered from urinary symptoms. Appropriate antibiotics should be chosen based or sensitivity test. the most important considering factor should be patient and family members' wish about antibiotics use.

입원환자 영양지원에 대한 일개대학병원 의료진의 태도 및 관련 요인

정휘수 ( Hwee Soo Jeong ),등건훈 ( Chen Hsuen Teong ),최유정 ( You Jung Choi ),김우정 ( Woo Jeng Kim ),이아란 ( Ah Ran Lee ) 한국정맥경장영양학회 2014 한국정맥경장영양학회지 Vol.6 No.1

Purpose: Knowledge of nutritional support and attitudes of medical staff both affect patient care. We identified attitudes regarding nutritional support among medical staff as well as changes in attitudes when a nutritional support team is present. Methods: Data were collected from 172 medical staff members who served at a university hospital located in Gyeongju by self-administered questionnaire from June 12∼August 30, 2013. The questionnaire inquired about importance of nutritional support, self-confidence about nutritional support, consideration of nutritional support for patient care, consideration of nutritional support when a nutritional support team is present, and nutritional knowledge training during the past year. Results: A total of 169 subjects (98.3%) thought that nutritional support is important for patient care. Only 19 subjects (11.0%) were highly self-confident about nutritional support. In total, 147 subjects (85.5%) considered nutritional support for some or all patients, whereas 169 (98.3%) considered nutritional support for patient care when a nutritional support team is present. Thirty-eight subjects (22.1%) received nutritional knowledge training during the past year. High self-confidence for nutritional support was related to nutritional knowledge training and service part. Positive changes regarding nutritional support when a nutritional support team is present were associated with nutritional knowledge training and high self-confidence for nutritional support. Conclusion: No differences in nutritional support attitudes for patient care were observed among the medical staff. Nutritional knowledge training and service part affected self-confidence of nutritional support and induced positive changes in attitudes for nutritional support.

초기 두부외상 기간 동안 지속적 외상성 뇌실질내 혈종에 관계되는 위험인자

이영배 ( Young Bae Lee ),정휘수 ( Hwee Soo Jeong ) 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.2

Purpose: In this study, patients in whom two computed tomography (CT) scans had been obtained within 24 hours of injury were analyzed to determine the incidence, risk factors and clinical significance of a progressive intracerebral hematoma (PIH). Methods: Participants were 182 patients with a traumatic intracerebral hematoma and contusion who underwent a repeat CT scan within 24 hours of injury. Univarite and multivariate statistics were used to define growth (volume increase) and to examine the relationship between the risk factors and hemorrhage expansion. Results: Fifty-four percent of the patients experienced progression in the size of the lesion in the initial 24 hours postinjury. A PIH was independently associated with worsened Glasgow coma scale (GCS) score (2.99, 1.04~8.60), the presence of subarachnoid hemorrhage (6.29, 2.48~16.00), the presence of a subdural hematoma (6.18, 2.13~17.98), the presence of an epidural hematoma (5.73, 1.18~27.76), and the presence of a basal cistern effacement (10.93, 1.19~99.57). Conclusion: For patients undergoing scanning within 2 hours of injury, the rate of PIH approaches 61%. Early repeated CT scanning is indicated in patients with a nonsurgically-treated hemorrhage revealed on the first CT scan. Worsened GCS score, significant hematoma growth and effacement of the basal cisterns on the initial CT scan are powerful predictors of which patients will require surgery. These findings should be important factors in understanding and managing of PIH. (J Korean Soc Traumatol 2010;23:142-150)

대사증후군 진단기준 개수와 관련된 임상 요인들

김누리 ( Nu Lee Kim ),정휘수 ( Hwee Soo Jeong ),김성우 ( Sung Woo Kim ),이동욱 ( Dong Wook Lee ),심민성 ( Min Sung Shim ),등건훈 ( Chen Hsuen Teong ) 한국보건정보통계학회(구 한국보건통계학회) 2012 한국보건정보통계학회지 Vol.37 No.2

Objectives: Many clinical factors has associated with metabolic syndrome, but well-known factors related to number of diagnosing criteria of metabolic syndrome have been a few. This study was conducted in order to find out clinical factors associated with number of metabolic syndrome`s component. 43 Methods: This study was a cross-sectional study. Using medical records of 324 participants who received health check ups at health promotion center of a university hospital in Gyeongju from March to July 2011, age, body mass index (BMI), white blood cell count, liver enzyme, fasting insulin, total cholesterol, uric acid, ferreting, the degree of fatty liver and esophagi is were collected and analyzed. The diagnostic criteria of metabolic syndrome were based on the National Cholesterol Education Program`s Adults Treatment Panel (NCEP ATP) III study.91 Results: Subjects who met to the diagnostic criteria of metabolic syndrome were 47 (14.5%). On ordinal logistic regression analysis, the clinical factors increasing components of metabolic syndrome were fatty liver (Odds ratio 2.60, 95% CI 1.48~4.537) elevated fasting insulin level (1.19, 1.08~1.31) and increasing age (1.07, 1.03~1.12).40 Conclusions: Clinical factors related to number of diagnosing criteria of metabolic syndrome were fatty liver, elevated fasting insulin level and increasing age.22

말기암환자에 대한 여명 예측교육 후의 의료인의 자신감과 정확도 및 지식의 변화

박준석,백나영,서상연,김유일,정휘수,오상우,성낙진,안홍엽,서아람,이용주,Park, Jun-Seok,Baek, Na-Young,Suh, Sang-Yeon,Kim, Yu-Il,Jeong, Hwee-Soo,Oh, Sang-Woo,Sung, Nak-Jin,Ahn, Hong-Yup,Seo, Ah-Ram,Lee, Yong-Joo 한국호스피스완화의료학회 2012 한국호스피스.완화의료학회지 Vol.15 No.3

목적: 많은 의료인들은 여명 예측을 어려워하는데, 교육의 부족이 이러한 어려움을 가져오는 요인들 중 하나이다. 그러나 최근 여명 예측에 도움이 되는 여러 가지 예후 지수가 발표되었다. 본 연구에서는 의료인들을 대상으로 예후 지수에 대해 교육을 실시하고 이러한 교육이 여명 예측의 정확도, 자신감, 지식을 향상시키는지 알아보고자 하였다. 방법: 2009년 7월 22일, 경기도 소재 일개 대학병원에서 '말기암환자의 여명 예측'에 대한 교육을 실시하고 간호사 및 의사 29명의 참가자를 대상으로 교육 전 후의 여명 예측에 대한 자신감, 정확도, 지식의 항목을 중심으로 변화를 측정하였다. 교육은 완화의학을 전공한 1인의 가정의학과 교수가 파워포인트를 사용하여 Palliative Prognostic score (PaP score)와 Objective Prognostic Score (OPS)에 대해 강의하고 상호문답 방식으로 40여분간 진행하였다. 결과: 교육 전 후의 자신감 평균은 교육 전의 $4.00{\pm}1.73$ (평균${\pm}$표준편차)점 (0~10 visual analog scale)에 비해서 교육 후가 $5.83{\pm}1.71$점으로 유의하게 높았으며(P<0.001) 나이가 많을수록 교육 전 여명 예측의 자신감이 유의하게 높았고(P=0.04), 진료 또는 간호 증례 수가 많을수록 여명 예측 교육 전 후의 자신감이 유의하게 높게 나왔다(각각 P=0.005, P=0.017). 교육 전 후의 여명 예측 정확도도 교육 후가 27/29명(93.1%), 교육 전이 14/29명(48.0%)으로, 교육 후가 교육 전보다 유의하게 높게 나왔다(P<0.001). 결론: 예후 지수를 활용하여 여명 예측을 교육했을 때 여명 예측에 대한 자신감, 정확도의 상승은 유의하였다. 이러한 결과의 일반화를 위해 앞으로 의료인들을 대상으로 하는 생존 기간 예측 교육이 필요할 것이다. Purpose: In this study, we evaluated the effects of training for survival prediction of terminally ill patients in terms of medical professionals' confidence, accuracy and knowledge of survival prediction. Methods: Twenty-nine participants completed a self-administered questionnaire where they scored their confidence, accuracy and knowledge of survival prediction before and after the training session. The training was provided in July 2009 at a university hospital located in Gyeonggi province, Republic of Korea. The participants were instructed by a professor of family medicine specialized in hospice palliative medicine to predict survival of a case using the palliative prognostic score and objective prognostic score. The training was provided in the form of a PowerPoint presentation for 40 minutes. Results: Participants' confidence in survival prediction significantly increased from $4.00{\pm}1.73$ ($mean{\pm}SD$) (0~10, visual analogue scale) to $5.83{\pm}1.71$ after the training (P<0.001). Before training, participant's level of confidence significantly correlated with their age (P=0.04). The training significantly improved the correlation between the confidence level and the number of terminal cancer patients whom they have experienced (P=0.005 before training, P=0.017 after training). Participant's accuracy in survival prediction also significantly improved from 14 of 29 (48%) to 27 of 29 (93.1%) (P<0.001). The change in knowledge of survival prediction was too small to be statistically analyzed. Conclusion: After training, the confidence and accuracy scores significantly improved. Further study with a greater number of participants is needed to generalize this finding.

심장대사 위험인자와 심박수 변이 성분들 간의 상관관계

정호근 ( Ho-geun Jung ),정휘수 ( Hwee-soo Jeong ) 한국보건정보통계학회(구 한국보건통계학회) 2017 한국보건정보통계학회지 Vol.42 No.4

Objectives: This study was conducted to investigate the relationship between triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) index, waist-to-height ratio (WHtR) which were evaluated as cardiometabolic risk factors and components of heart rate variability (HRV). Methods: This study was conducted on 2,008 subjects who underwent HRV test among those who had health-check up at a university hospital in Korea during 2016. The presence of metabolic syndrome in the subjects was identified. TG/HDL and WHtR were calculated and blood level of leukocyte, erythrocyte, amino transferase, uric acid were used for analysis. Standard deviation of the NN interval (SDNN), low frequency (LF), high frequency (HF), and LF/HF were used for the components of HRV. Results: Among the total subjects, 330 (16.4%) had metabolic syndrome. The mean SDNN in the subjects with metabolic syndrome was 32.78±16.49 (ms), which was significantly lower than that (36.16±18.75 ms) of the control group (p<0.01). The HF values were also significantly different between the two groups (162.77±278.08 ms² vs. 225.74±330.99 ms2, p<0.05). Except HDL, waist circumference, blood pressure, fasting blood glucose, and triglyceride concentration among metabolic syndrome components were negatively correlated with SDNN and HF. Significant negative correlations were found in SDNN (p<0.01) and HF (p<0.05) with WHtR and only SDNN (p<0.05) with TG/HDL. Conclusions: TG/HDL and WHtR, including the metabolic syndrome, showed a negative correlation between SDNN indicating left ventricular function and HF indicating activation of parasympathetic nerve.

1년간 체중감량 노력을 한 대상자들에서 성공적인 체중감량과 관련된 요인: 국민건강영양조사 제6기(2015년) 자료

정호근 ( Ho-geun Jung ),정휘수 ( Hwee-soo Jeong ) 한국보건정보통계학회(구 한국보건통계학회) 2017 보건정보통계학회지 Vol.42 No.4

Objectives: Behaviors of weight control for obesity, which is closely related to all causes death, are affected by the subjective perception of obesity, degree of body mass index (BMI), and the state of multiple chronic diseases. The purpose of this study was to identify factors related to successful weight reduction among subjects who tried to reduce their weight. Methods: This study was conducted using data of the Korea National Health and Nutrition Examination Survey (2015). Among 1,687 subjects who answered “I tried to reduce my weight for 1 years.”, the subjects who answered “I have lost weight” in the question of change in weight were the group of successful weight reduction. We compared gender, demographics, lifestyle, obesity, morbidity, and weight control methods between successful weight reduction group and control group. Results: Two hundreds sixty (15.4%) among total subjects reported successful weight reduction. Young age (odds ratio=1.02, 95% confidence interval=1.00-1.04), aerobic exercise activity (1.36, 1.01- 1.81), subjective perception of obesity (0.68, 0.47-0.97), obesity by BMI (0.62, 0.43-0.89), history of diabetes (2.35, 1.28-4.32) and prescriptive anti-obesity agents (3.44, 1.80-6.57) were associated with successful weight reduction. Conclusions: In order to achieve successful weight reduction, intervention strategies based on this results will be needed.

지역사회 성인 남성에서 금연시도 및 금연유지와 만성질환과 연관성 : 2014년 지역사회 건강조사 자료를 중심으로

정진욱(Jin-Wook Chung),김상규(Sang-Kyu Kim),정호근(Ho-Geun Jung),정휘수(Hwee-Soo Jeong) 한국자료분석학회 2018 Journal of the Korean Data Analysis Society Vol.20 No.1

고혈압이나 당뇨와 같은 만성질환은 흡연자들에서 금연시도 및 금연유지와 관련된 요인 중 하나이다. 본 연구는 고혈압, 당뇨, 이상지질혈증 등의 만성질환 인지와 금연시도 및 금연유지와의 연관성을 확인하기 위하여 지역사회 건강조사 자료를 이용하여 수행되었다. 평생 흡연력을 가진 19세 이상 성인 남성 76,065명 중 현재 흡연자는 41,509(54.6%)명, 금연자는 34,556(45.4%)명이었다. 현재 흡연자 중 금연 미시도자는 14,206(34.2%)명, 금연 시도자는 27,303(65.8%)명이었다. 평생 흡연력을 가진 성인 남성들 중 고혈압, 고지혈증, 심장질환의 질병력이 있을 때 금연 시도의 교차비는 각각 1.100(95% 신뢰구간, 1.019∼1.187), 1.284(1.173∼1.406), 1.499(1.277∼1.833)이었다. 금연유지에 대해서는 고혈압, 고지혈증, 뇌졸중, 심장질환 질병력이 있는 경우 교차비가 각각 1.364(1.270∼1.465), 1.426(1.306∼1.557), 1.362(1.097∼1.690), 1.590(1.319∼1.915)이었다. 당뇨 병력은 금연 시도 및 금연유지와 관련이 없었다. 향후 금연 상담 시 각각의 만성질환을 가진 흡연자들에서 금연시도 및 유지에 영향을 주는 요인을 확인하고 이를 바탕으로 질환별로 맞춤형 금연중재에 대한 연구를 실시할 것을 제언한다. Chronic diseases as hypertension or diabetes are known to be one of the related factors for quit smoking attempt and smoking cessation. This study was conducted to confirm the association between smoking cessation and chronic diseases such as hypertension, diabetes, and dyslipidemia using community health survey data. There were 41,509 (54.6%) current smokers and 34,556 (45.4%) former smokers among 76,065 who were 19 years old and older male adults with lifetime smoking habits. Among current smokers, 14,206 (34.2%) were no-quit smoking attempt and 27,303 (65.8%) were quit smoking attempt. The odds ratio for quit smoking attempt was 1.100 (95% confidence interval, 1.019 ∼ 1.187), 1.284 (1.173 ∼ 1.406) and 1.499 (1.277 ∼ 1.833), respectively, when the patients were diagnosed with hypertension, dyslipidemia and heart disease. The odds ratios for smoking cessation were 1.364 (1.270 ∼ 1.455), 1.426 (1.306 ∼ 1.557), 1.362 (1.097 ∼ 1.990) and 1.590 (1.319 ∼ 1.915) for hypertension, dyslipidemia, stroke and heart disease. Diabetes was not associated with quit smoking attempt and smoking cessation. Smoking cessation counselors identify the factors for smoking cessation in smokers with chronic diseases. It is suggested to conduct a study on customized smoking cessation intervention for each disease.