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Cardiac Rehabilitation Exercise Training for High-Risk Cardiac Patients
최희은,김철,손유경 대한재활의학회 2017 Annals of Rehabilitation Medicine Vol.41 No.4
Objective To examine the effect and safety of cardiac rehabilitation (CR) program in high-risk cardiac patients and compare these results to those of control CR participants without high-risk criteria.Methods A total of 12 high-risk cardiac patients were recruited as subjects. The high-risk criteria were: advanced heart failure with left ventricular ejection fraction (LVEF) of less than 30%, a recent history of cardiac arrest or dangerous arrhythmia, and cardiac device insertion. Another 12 CR participants without any high-risk criteria mentioned above were recruited as controls. Both groups underwent 6 to 8 weeks of CR exercise training. Exercise tolerance tests were performed before and after completion of the CR program. After CR completion, both groups were evaluated and their results were compared.Results After completion of the CR exercise program, both groups showed significant increases in peak oxygen uptake (VO2peak) and LVEF. In the control group (n=12), VO2peak increased from 25.9 to 31.8 mL/kg/min (changing rate, +21.4%±22.1%) and LVEF increased from 56.1% to 59.1% (changing rate, +5.3%±8.4%). In the high-risk group (n=12), VO2peak increased from 16.8 to 21.0 mL/kg/min (changing rate, +28.6%±21.4%) and LVEF increased from 26.1% to 29.4% (changing rate, +16.1%±12.9%). There was no serious cardiovascular event during all exercise hours.Conclusion High-risk cardiac patients who completed a supervised CR program demonstrated significant improvements in VO2peak and LVEF without any serious cardiovascular event. The improvement rate was similar to that of control group.
저가용 센서가 장착된 휴대용 미세먼지 측정기기 기반의 대기오염 노출과 폐기능 변화와의 상관성 연구
최희은,서성철 한국대기환경학회 2021 한국대기환경학회 학술대회논문집 Vol.2021 No.10
산업화와 경제 성장으로 에너지 사용량 증가에 따른 대기오염물질 배출량이 증가하고 있으며, 대기오염은 사망률 및 유병률 증가와 유의한 관련성이 있다는 다수의 연구가 보고되었다. 환경과 건강 간 상호 영향력은 지속적으로 증가하고 있고 관리 기반 강화의 중요성이 커지고 있음에 따라, 대기오염노출과 질환과의 건강영향평가는 개인 모니터링 방법을 사용한 객관적이고 신뢰도 높은 노출평가가 필요하다. 본 연구에서는 저가용 센서가 장착된 휴대용 미세먼지 개인측정기기 기반의 미세먼지에 따른 건강영향평가를 하였다. 구로구에 거주하는 천식 증상 환자 대상으로 폐기능검사(PEFR) 자료와 초미세먼지 데이터 세 종류((1)휴대용 개인측정기기(PICO), (2)구로구내에 설치된 실외 간이 미세먼지 측정기(KTR), (3)국가자동측정망(AK))를 병합하여 PEFR 데이터 측정시간(오전 8시, 오후 8시) 기준 이전 72시간 동안 누적 노출량을 바탕으로 이분상관분석을 수행하였다. 전반적으로, AK에 비해 PICO가 환자들의 폐기능 변화를 보다 잘 설명하였다. 그러나, KTR의 경우 PICO와 거의 유사한 패턴을 보여, 개인 모니터링이 불가능한 경우, 좋은 대안이라고 판단하였다. 특히 최대값의 경우 KTR의 설명력이 좋았다. AK는 35 ㎍/㎥ 이상의 이상건수의 설명력에 있어서는 PICO나 KTR과 유사한 경향을 보였으나, 다른 변수에서는 설명력이 미비한 것으로 나타나, 비교적 넓은 구로구를 다 커버하기엔 한계가 있다. GPS 기반의 휴대용 센서를 이용한 새로운 방법이 개발되고 있으나 이들 방법도 제한점이 있으며 추가적인 연구와 개발이 필요하다.
Development of a quantitative system for subjective evaluation of tracked vehicle crew jackets
최희은,Youngshil Ryoo,최경미 한국의류학회 2022 Fashion and Textiles Vol.9 No.1
The purpose of this study is to develop a quantitative evaluation system that refects the required performance factors that are important for a tracked vehicle crew jacket. We identifed and analyzed the necessary performance factors obtained from a focus group interview and a questionnaire survey. Further, we proposed a new method of calculating weights and developed a quantitative evaluation system. This system featured an equation that calculated the evaluation score out of 100, using the factors’ percentages in the total factor as factor weights. The system’s application was verifed by the assessment of subfactors by active-duty soldiers, and by confrmation that the results of the developed factor scores refected the proposed development direction. The study is signifcant for its provision of a comprehensive and quantitative evaluation system which has not existed before for protective clothing design, as well as for the verifcation of the system’s application through the process of protective clothing development. The quantitative evaluation system and its development process described in this study may be referenced and widely deployed due to its use of a Likert scale, which is commonly used as a subjective sensory evaluation tool.
최희은,김철,Lee Da-Jung,Joo Jae-Eun,Kim Ho-Seob 대한의학회 2023 Journal of Korean medical science Vol.38 No.15
Background: To investigate the actual rate and quality of cardiac rehabilitation (CR) participation in South Korea and its short-term impact on clinical outcomes after acute coronary syndrome (ACS). Methods: Data, including confirmed ACS diagnosis, socio-demographics, comorbidities, clinical outcomes, and CR claim codes, were collected from the Korean National Health Insurance Service claims database and compared between the CR and non-CR groups. Results: Overall, 102,544 patients were included in the study, of which only 5.8% attended CR. Regarding testing, 83.6% of CR patients performed the cardiopulmonary exercise test, but follow-up testing was infrequently performed; in addition, 53.1% of them participated in an electrocardiogram monitoring exercise, but over half participated in only one session. After 1:1 propensity score matching, post-ACS cardiovascular events were significantly lower in the CR group than in the non-CR group. The cumulative 3-year hazard ratio for all-cause death was 0.612 (95% confidence interval [CI], 0.495–0.756), recurrent ACS was 0.92 (95% CI, 0.853–0.993), CR readmission was 0.817 (95% CI, 0.768–0.868), and major adverse cardiovascular events (MACE) was 0.827 (95% CI, 0.781–0.874) in the CR group. CR was associated with a significant dose-response effect on MACE, with a reduction in incidence from 0.854 to 0.711. Conclusion: The actual rate of CR participation in South Korea remains low, and participation quality was not outstanding despite National Health Insurance coverage. Nevertheless, the impact of CR on cardiovascular outcomes after ACS was significantly superior. Efforts to increase CR participation should be increased by establishing new CR facilities and strategies to resolve associated barriers.
Characteristics and Clinical Course of Dysphagia Caused by Anterior Cervical Osteophyte
최희은,Geun Yeol Jo,Woo Jin Kim,Hwan Kwon Do,Jun Koo Kwon,Se Heum Park 대한재활의학회 2019 Annals of Rehabilitation Medicine Vol.43 No.1
Objective To investigate swallowing characteristics of patients with dysphagia caused by anterior cervical osteophytes (ACOs) and compare clinical courses according to treatment options. Methods A retrospective analysis of 1,866 videofluoroscopic swallowing studies (VFSS) of patients with ACOs from electronic medical records was performed. Patients with other diseases that could explain the dysphagia were excluded. Dysphagia characteristics and severity and clinical and radiological characteristics of subjects with ACOs were evaluated. Dysphagia characteristics and clinical course were compared among three treatment groups: surgical treatment, swallowing rehabilitation, and conservative treatment. Results Subjects were 22 men and 1 woman with a mean age of 78.69±8.01 years. The mean osteophyte thickness was 9.07±3.84 mm. It was significantly thicker in the surgical group than that in other groups (p=0.01). ACOs were most frequently found at C5 level. This level also had the thickest osteophytes. However, videofluoroscopic dysphagia scales (VDS) were not significantly different among the three treatment groups. The pharyngeal phase score of the VDS was significantly higher in the surgical group (p=0.041). Dysphagia severity was decreased significantly in the surgical group at 3 months after the initial VFSS (p=0.004). Conclusion The main swallowing characteristics in patients with ACOs were dysphagia features of the pharyngeal phase, including inappropriate airway protection, decreased laryngeal elevation, and reduced epiglottis inversion. When determining treatment options, it may be helpful to consider dysphagia severity at pharyngeal phase and osteophyte thickness.