• Title/Summary/Keyword: 방사선 위험성 평가

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Bladder Preserving Treatment in Patients with Muscle Invasive Bladder Cancer (근침윤성 방광암 환자의 방광 보존적 치료 결과)

  • Yu, Jeong-Il;Oh, Dong-Ryol;Huh, Seung-Jae;Choi, Han-Yong;Lee, Hyon-Moo;Jeon, Seong-Soo;Yim, Ho-Young;Kim, Won-Suk;Lim, Do-Hoon;Ahn, Yong-Chan;Park, Won
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.70-78
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    • 2007
  • [ $\underline{Purpose}$ ]: This study analyzed the tumor response, overall survival, progression free survival and related prognostic factors in patients with muscle invasive bladder cancer subjected to bladder preserving treatment. $\underline{Materials\;and\;Methods}$: Between August 1995 and June 2004, 37 patients with muscle invasive (transitional cell carcinoma, clinically stage T2-4) bladder cancer were enrolled for the treatment protocol of bladder preservation. There were 33 males and 4 females, and the median age was 67 years (range $38{\sim}86\;years$). Transurethral resection of the bladder (TURB) was performed in 17 patients who underwent complete resection. The median radiation dose administered was 64.8 Gy (range $55.8{\sim}67\;Gy$). The survival rate was calculated by the Kaplan-Meier method. $\underline{Results}$: An evaluation of the response rate was determined by abdomen-pelvic CT and cystoscopy at three months after radiotherapy. A complete response was seen in 17 patients (46%). The survival rate at three years was 54.7%, with 54 months of median survival (range $3{\sim}91$ months). During the study, 17 patients died and 13 patients had died from bladder cancer. The progression free survival rate at three years was 37.2%. There were 24 patients (64.9%) who had disease recurrence: 16 patients (43.2%) had local recurrence, 6 patients (16.2%) had a distant recurrence, and 2 patients (5.4%) had both a local and distant recurrence. The survival rate (p=0.0009) and progression free survival rates (p=0.001) were statistically significant when compared to the response rate after radiotherapy. $\underline{Conclusion}$: The availability of complete TURB and appropriate chemoradiotherapy were important predictors for bladder preservation and survival.

U.S. Policy and Current Practices for Blending Low-Level Radioactive Waste for Disposal (저준위 방사성폐기물의 혼합 관련 미국의 정책과 실제 적용)

  • Kessel, David S.;Kim, Chang-Lak
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.14 no.3
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    • pp.235-243
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    • 2016
  • In the near future, many countries, including the Republic of Korea, will face a significant increase in low level radioactive waste (LLW) from nuclear power plant decommissioning. The purpose of this paper is to look at blending as a method for enhancing disposal options for low-level radioactive waste from the decommissioning of nuclear reactors. The 2007 U.S. Nuclear Regulatory Commission strategic assessment of the status of the U.S. LLW program identified the need to move to a risk-informed and performance-based regulatory approach for managing LLW. The strategic assessment identified blending waste of varying radionuclide concentrations as a potential means of enhancing options for LLW disposal. The NRC's position is that concentration averaging or blending can be performed in a way that does not diminish the overall safety of LLW disposal. The revised regulatory requirements for blending LLW are presented in the revised NRC Branch Technical Position for Concentration Averaging and Encapsulation (CA BTP 2015). The changes to the CA BTP that are the most significant for NPP operation, maintenance and decommissioning are reviewed in this paper and a potential application is identified for decommissioning waste in Korea. By far the largest volume of LLW from NPPs will come from decommissioning rather than operation. The large volumes in decommissioning present an opportunity for significant gains in disposal efficiency from blending and concentration averaging. The application of concentration averaging waste from a reactor bio-shield is also presented.

The effects of local factors on the survival of dental implants: A 19 year retrospective study (임플란트의 생존율에 영향을 미치는 국소적 인자에 대한 19년간의 후향적 연구)

  • Kim, Sung-Hoi;Kim, Sun-Jai;Lee, Keun-Woo;Han, Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.1
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    • pp.28-40
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    • 2010
  • Purpose: The aim of this retrospective study was to provide long-term data about the correlation between multifactorial local factors and the survival of implants. Material and methods: During 19 years (1991 to 2009), 2796 implants were placed in 879 patients. From dental charts and radiographs, the following data were collected: patient's age at implant placement, gender, implant system, surface, length, diameter, location of implant placement, bone quality, primary stability, type of prosthesis. The correlations between these data and implant survival were analyzed. Statistical analysis was performed using Kaplan-Meier survival analysis, Chi-square test, odds ratio. Results: 1. Among the 2796 implants, 150 implants failed that resulted in a cumulative survival rate of 94.64%. The cumulative survival rate of smooth surface implants (91.76%) was lower than rough surface implants (96.02%). 2. Anatomic location, implant surface, diameter of smooth surface implant, primary stability, type of prosthesis, patient's age and gender were significantly associated with implant survival (P < .05). 3. No significant difference in implant survival was found in relation to the following factors: implant length, bone quality, diameter of rough surface implants and type of rough surface according to implant manufacturer (P < .05). Conclusions: Local factors such as anatomic location, implant surface, diameter of smooth surface implant, primary stability and type of prosthesis have a significant effect on implant survival.

Analysis of Hematological Factor to Predict Plaque of the Carotid Artery in Ultrasound Images (경동맥초음파에서 죽상경화반을 예측하는 혈액학적 수치의 분석)

  • Yang, Sung Hee;Kang, Se Sik;Lee, Jinsoo
    • Journal of the Korean Society of Radiology
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    • v.10 no.3
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    • pp.187-193
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    • 2016
  • In this study, we performed the carotid artery ultrasound targeting 140 subjects who have conducted to evaluate the changes in intima-media thickness(IMT) and plaque correlated with the presence or absence of a hematological test of the carotid artery. Considering that the IMT thickness more than 1mm is abnormal based on the carotid artery ultrasound to assess the presence or absence of plaque, and examined the correlation by classifying the blood lipid value and the fasting blood glucose level through the serum test. Consequently, the fasting blood glucose level is being analyzed as independent predictors of causing dental plaque(p=0.033), cut off value was determined as 126 mg/dL(sensitivity 56.25%, specificity 68.38%) in ROC curve analysis. Furthermore, the odds ratio appeared 1.01 times the value in the Logistic regression. Therefore, it seemed that the necessity to prospective studies in a number of subjects are considered, and also taking into account a number of blood test values along with the sonography of the carotid artery as a valuable part for effective primary prevention and follow-up observation of the cardiac and brain vascular disease is highly recommended.

Comparison of Radioactive Waste Transportation Risk Assessment Using Deterministic and Probabilistic Methods (결정론적 및 확률론적 방법을 이용한 방사성폐기물 운반 위험도 평가 비교·분석 )

  • Min Woo Kwak;Hyeok Jae Kim;Ga Eun Oh;Shin Dong Lee;Kwang Pyo Kim
    • Journal of Radiation Industry
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    • v.17 no.1
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    • pp.83-92
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    • 2023
  • When assessing the risk of radioactive wastes transportation on land, computer codes such as RADTRAN and RISKIND are used as deterministic methods. Transportation risk assessment using the deterministic method requires a relatively short assessment time. On the other hand, transportation risk assessment using the probabilistic method requires a relatively long assessment time, but produces more reliable results. Therefore, a study is needed to evaluate the exposure dose using a deterministic method that can be evaluated relatively quickly, and to compare and analyze the exposure dose result using a probabilistic method. The purpose of this study is to evaluate the exposure dose during transportation of radioactive wastes using deterministic and probabilistic methods, and to compare and analyze them. For this purpose, the main exposure factors were selected and various exposure situations were set. The distance between the radioactive waste and the receptor, the size of the package, and the speed of vehicle were selected as the main exposure factors. The exposure situation was largely divided into when the radioactive wastes were stationary and when they were passing. And the dose (rate) model of the deterministic overland transportation risk assessment computer code was analyzed. Finally, the deterministic method of the RADTRAN computer code and the RISKIND computer code and the probabilistic method of the MCNP 6 computer code were used to evaluate the exposure dose in various exposure situations during transportation of radioactive wastes. Then we compared and analyzed them. As a result of the evaluation, the tendency of the exposure dose (rate) was similar when the radioactive wastes were stationary and passing. For the same situation, the evaluation results of the RADTRAN computer code were generally more conservative than the results of the RISKIND computer code and the MCNP 6 computer code. The evaluation results of the RISKIND computer code and the MCNP 6 computer code were relatively similar. The results of this study are expected to be used as basic data for establishing the radioactive wastes transportation risk assessment system in Korea in the future.

Financial Impact of Off-Pump Coronary Artery Bypass (체외순환 없이 시행하는 관상동맥우회술의 경제성 분석)

  • Lim, Cheong;Chang, Woo-Ik;Kim, Ki-Bong;Kim, Yoon
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.365-368
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    • 2002
  • Background: Coronary artery bypass grafting(CABG) imposes large amount of medical costs, which are greatly affected by the surgical approach, quality of perioperative care and associated co-morbidities. Recently, off-pump CABG(OPCAB) has been introduced and performed with increasing frequency. To evaluate the efficacy of OPCAB in view of financial impact, we analyzed the costs and medical resources of OPCAB and compared with conventional CABG. Material and Method: From January 1998 to July 1999, 184 patients underwent CABG operation; 111 patients with OPCAB(group I) and 73 patients with conventional CABG(group II). We prospectively collected clinical data including risk factors and retrospectively reviewed the hospital resources. Result: Preoperative parameters including risk factors, postoperative mortality, morbidity and length of hospital stay were not different between the two groups, Duration of stay in the intensive care unit(ICU) (51.3 vs 128.3 hours, p<0.01) and ventilator, support time(14.9 vs 56.2 hours, p<0.01) were significantly shorter in the OPCAB group. Total hospital coats were 17,220,000 add 21,250,000(Korean Won) in group I and II, respectively(p<0.01). There were significant differences in operation fee, costs for operative materials, transfusion and diagnostic radiology between two groups. In group I, all the resources except diagnostic radiology were significantly decreased compared with group II. Conclusion: OPCAB has a beneficial effect on hospital charge and resource utilization. Shorter duration of the ICU stay and ventilatory support time may reduce the total hospital costs.

Clinical Assessment and Cephalometric Characteristics in Patients with Condylar Resorption (하악과두흡수 환자의 임상적 평가 및 악안면 골격형태에 대한 연구)

  • Koo, Seon-Ju;Kim, Kyun-Yo;Hur, Yun-Kyung;Chae, Jong-Moon;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.91-102
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    • 2009
  • Condylar resorption, or condylysis can be defined as progressive alteration of condylar shape and decrease in mass. Condylar resorption is a poorly understood progressive disease that affects the TMJ and that can result in malocclusion, facial disfigurement, TMJ dysfunction, and pain. The aim of this study was to investigate clinical assessment and cephalometric characteristics in 224 patients with condylar resorption, who visited in the Department of Oral Medicine Kyungpook National University Hospital at 2006, by use of panorama, transcranial view and lateral cephalometric radiograph. The results were as follows; 1. Clinical assessment 1) Total number of patients who visited with chief complaints of TMD were 2419 and 224 (9.3%) among them revealed the condylar resorption, Among patients group with condylar resorption, female was 183 and male was 41, females were predominant. 2) Patient's age ranged from 12 to 70 and mean age was 30.6 years old with a strong predominance for 10s and 20s. Distribution of a showed as follows; 10s was 26.3%, 20s was 34,8%, 30s was 13.8%, 40s was 11.2%, 50s was 7.1%, 60s was 6.3% and 70s was 0.4%. 3) Most of the patients had parafunctional habit. 4) The case of showing the pain in condylar resorption was 145, the case of not showing the pain was 79. 5) Treatment duration of the patients was relatively short. 2. Cephalometric Characteristics 1) ANB which means the retruding of the mandible increased significantly than normal group. The ANB of female was lager than male group as the means of ANB were 5.05 in female and 3.57 in male, 2) SN-GoMe and FMA increased in resorption patients, but FH-PP did not show any significant difference. The FMA of female was lager than male group as the means were 31.69 in female and 30.44 in male. 3) Total posterior facial height was significantly smaller and total anterior facial height showed no significant increase as compared with those of the normal group. Condylar resorption was predominant in young female which was caused by more vertical facial pattern in female than male and increase of parafunctional habit in young age. It was thought that the patients who have a risk factor increasing the compressive stress at condyle caused by obliquely inclined masseter and medial pterygoid show high prevalence of condylar resorption.

Etiology and Risk Factors of Community-Acquired Pneumonia in Hospitalized Children During the COVID-19 Pandemic in South Korea (국내 코로나19 판데믹 기간 발생한 입원을 요하는 소아청소년 지역사회폐렴의 원인과 위험 인자)

  • Hae Min Kang;Seung Ha Song;Bin Ahn;Ji Young Park;Hyunmi Kang;Byung Ok Kwak;Dong Hyun Kim;Joon Kee Lee;Soo-Han Choi ;Jae Hong Choi;Eun Hwa Choi;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.20-32
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    • 2023
  • Purpose: This study aimed to identify the etiology and risk factors of community-acquired pneumonia (CAP) requiring hospitalization in Korean children during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Clinical information of children admitted with CAP to Seoul National University Children's Hospital (SNUCH) between January 1, 2021, and February 28, 2022, was retrospectively collected and analyzed. In addition, the etiologic diagnosis and demographic data of children with CAP who were discharged at the other seven hospitals between January and February 2022 were collected. Pneumonia was diagnosed using strict criteria comprising clinical symptoms, physical examination findings, and chest radiographic findings. Results: Among 91 children hospitalized with CAP at SNUCH during the 14-month period, 68.4% were aged <5 years and 79.1% had underlying diseases. Among the 95 CAP cases, respiratory assistance was required in 70.5%, and the use of a ventilator was required in 20.0%. A total of five patients expired, all of whom were either immunocompromised or had underlying neurological diseases. Neurological diseases and immunosuppression were significantly correlated with respiratory assistance (P=0.003) and death (P=0.014). A total of 55% of the detected respiratory pathogens were viruses, the most common of which was rhinovirus at 35.9%. Among the 169 children hospitalized for CAP at the eight institutions, ≥1 respiratory virus was detected in 92.3%, among which respiratory syncytial virus (79.8%) was the most prevalent. Conclusions: Even during the COVID-19 pandemic, Korean children were hospitalized with CAP caused by seasonal respiratory viral pathogens. Although atypical and pyogenic bacteria were not detected, continuous clinical monitoring and further prospective studies should be conducted.

The Effect of Arthroscopic Medial Meniscectomy in Degenerative Arthritis of the Knee (슬관절 퇴행성 관절염에서 관절경적 내측 반월상 연골 절제술의 효과)

  • Kim, Do-Yeon;Choi, Yun-Jin;Lee, Seung-Joo;Ko, Min-Seok;Choi, Chong-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.79-84
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    • 2010
  • Purpose: In patients with meniscal tear with degenerative arthritis, controversy remains as to whether arthroscopic menisectomy is worthwhile or not. The purpose of this study was to evaluate the effect of arthroscopic medial meniscectomy in degenerative arthritis of the knee with meniscal tear. We also intended to identify pertinent indications and risk factors. Materials and Methods: 287 patients underwent arthroscopic medial meniscectomy from 2006 to 2008; 103 patients who had Kellgren-Lawrence grade II, III arthritis of the knee, were over 50 years old, and had minimum 1 year follow-up, were analyzed in this study. Clinical assessment was performed retrospectively using the arthroscopic surgery database, medical records, questionnires and interviews. Assessment included visual analogue scale (VAS) scores and Lysholm scores. Results: The mean Lysholm score increased from 69 to 85 after surgery. The mean VAS score improved from 7 to 3.1 after surgery. Kellgren-Lawrence grade II group and group with trauma history showed significant improvement of pain and function compared with grade III and group without trauma history. Outerbridge grade I showed significantly more improvement of pain than grade III and IV. Multiple regression analysis showed that trauma history and Outerbridge grade affect the improvement of Lysholm score. Conclusion: In one year follow-up, arthroscopic medial menisectomy can improve pain and function of patients in Kellgren-Lawrence grade II, III degenerative arthritis of the knee. We could expect good results especially in group with low Kellgren-Lawrence grade, trauma history, and mild articular cartilage lesion.

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A Study on Trust and Commitment between Buyer and Supplier of Industrial Parts, and Their Usage of Information Technology (산업재 부품 구매자와 공급자의 신뢰와 몰입, 그리고 정보기술의 이용에 관한 연구)

  • Kim, Jong-Hun;Yun, Hui-Taek
    • Proceedings of the Korean DIstribution Association Conference
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    • 2006.08a
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    • pp.47-68
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    • 2006
  • This study aims to determine the association structure of the behavioral relationship variables, such as trust, commitment, cooperation, communication and coercive power, in the relationship between the buyers and suppliers of industrial parts. It also investigates the impact of the use of IT technologies on the relationships quality. Data was collected from 216 part suppliers of machinery, electronics and automobiles located in Incheon. Data supported all of the proposed hypotheses. First, it was confirmed that parts suppliers' trust in buyers leads to the commitment into relationships with buyers. Second, cooperation and communication showed a positive influence on parts suppliers' trust in buyers, and coercive power gave a negative influence on trust. Third, the use of IT technologies like Internet and E-Mail between parts suppliers and buyers was verified to have generally a positive influence on the quality of relationships. At the same time, cooperation and communication were confirmed to have a positive influence on each other, and cooperation and coercive power as well as communication and coercive power were confirmed to have negative influence on each other. This study is a pioneering attempt to examine the relationships between suppliers and buyers of industrial parts, and the influence IT technologies on the relationship quality. Also, the findings will be practically much helpful to find how to reinforce the relationships between parts suppliers and buyers.

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