• Title/Summary/Keyword: 평균 접근법

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Oncologic Outcome of Sacral Chordoma (천골에 발생한 척색종의 치료결과)

  • Cho, Sang-Hyun;Lee, Soo Yong;Jeon, Dae-Geun;Song, Won-Seok;Kong, Chang-Bae;Lee, Jung-Dong;Cho, Wan-Hyeong
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.66-71
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    • 2012
  • Purpose: We analyzed treatment result to examine the outcome for patients with sacral chordoma and to determine relevant prognostic factors. Materials and Methods: We retrospectively reviewed 19 patients with sacral chordoma seen at out institution between 1990 and 2010. There were 9 men and 10 women with mean age of 56 years. The average follow up was 63 months (range, 25-144 months). 15 patient received surgical treatment, six of these patient had wide, eight had marginal, one had intralesional margin and 4 patient treated with Radiation therapy only. Results: The disease free and overall survival rate for all 19 patients was 34.7% and 79.7% at 5-years, respectively. Statistical analysis using the log-rank test revealed no significant difference between the surgery and radiation therapy groups in overall survival (p=0.54). Nine of 19 patients had local recurrence at a median of 2.5 years postoperatively. Seven of these 9 patients had distant metastasis at a median of 4.5 years postoperatively. Among the variables, tumor size (p=0.033) and tumor involvement of above S3 (p=0.032) were independent prognostic factor for overall survival. Nine of 15 patients who received surgical treatment had postoperative complication such as voiding difficulty and incontinence. Conclusion: Careful consideration of the patient general condition and predictable complication of the treatment might be the best way to improve patient's survival and quality of life.

Mid-Term Container Forecast for Pusan Port (부산항 컨테이너 물동량의 중간예측)

  • Gu, J.Y.
    • Journal of Korean Port Research
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    • v.11 no.1
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    • pp.1-11
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    • 1997
  • The conventional methods of container forecasting is done through regression methods based on GNP growth trends and by other forecasting methods proposed by several authors. However these efforts prove to be inadequate with visible weakness and a more reasonable approach need to be determined. The succeeding sections elaborate the methodology and approach adopted. The results are then compared through a case study involving the forecast figures derived by the Pusan Port Authority and the values obtained by MRCS model introduced in this paper.

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The detection of collapsible airways contributing to airflow limitation (기류 제한에 영향을 미치는 허탈성 기도의 분석)

  • Kim, Yun Seong;Park, Byung Gyu;Lee, Kyong In;Son, Seok Man;Lee, Hyo Jin;Lee, Min Ki;Son, Choon Hee;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.558-570
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    • 1996
  • Background : The detection of Collapsible airways has important therapeutic implications in chronic airway disease and bronchial asthma. The distinction of a purely collapsible airways disease from that of asthma is important because the treatment of the dormer may include the use of pursed lip breathing or nasal positive pressure ventilation whereas in the latter, pharmacologic approaches are used. One form of irreversible airflow limitation is collapsible airways, which has been shown to be a Component of asthma or to emphysema, it can be assessed by the volume difference between what exits the lung as determined by a spirometer and the volume compressed as measured by the plethysmography. Method : To investigate whether volume difference between slow and forced vital Capacity(SVC-FVC) by spirometry may be used as a surrogate index of airway collapse, we examined pulmonary function parameters before and after bronchodilator agent inhalation by spirometry and body plethysmography in 20 cases of patients with evidence of airflow limitation(chronic obstructive pulmonary disease 12 cases, stable bronchial asthma 7 cases, combined chronic obstructive pulmonary disease with asthma 1 case) and 20 cases of normal subjects without evidence of airflow limitation referred to the Pusan National University Hospital pulmonary function laboratory from January 1995 to July 1995 prospectively. Results : 1) Average and standard deviation of age, height, weight of patients with airflow limitation was $58.3{\pm}7.24$(yr), $166{\pm}8.0$(cm), $59.0{\pm}9.9$(kg) and those of normal subjects was $56.3{\pm}12.47$(yr), $165.9{\pm}6.9$(cm), $64.4{\pm}10.4$(kg), respectively. The differences of physical characteristics of both group were not significant statistically and male to female ratio was 14:6 in both groups. 2) The difference between slow vital capacity and forced vital capacity was $395{\pm}317ml$ in patients group and $154{\pm}176ml$ in normal group and there was statistically significance between two groups(p<0.05). Sensitivity and specificity were most higher when the cut-off value was 208ml. 3) After bronchodilator inhalation, reversible airway obstructions were shown in 16 cases of patients group, 7 cases of control group(p<0.05) by spirometry or body plethysmography d the differences of slow vital capacity and forced vital capacity in bronchodilator response group and nonresponse group were $300.4{\pm}306ml$, $144.7{\pm}180ml$ and this difference was statistically significant. 4) The difference between slow vital capacity and forced vital capacity before bronchodilator inhalation was correlated with airway resistance before bronchodilator(r=0.307 p=0.05), and the difference between slow vital capacity and forced vital capacity after bronchodilator was correlated with difference between slow vital capacity and forced vital capacity(r=0.559 p=0.0002), thoracic gas volume(r=0.488 p=0.002) before bronchodilator and airway resistance(r=0.583 p=0.0001), thoracic gas volume(r=0.375 p=0.0170) after bronchodilator, respectively. 5) The difference between slow vital capacity and forced vital capacity in smokers and nonsmokers was $257.5{\pm}303ml$, $277.5{\pm}276ml$, respectively and this difference did not reach statistical significance(p>0.05). Conclusion : The difference between slow vital capacity and forced vital capacity by spirometry may be useful for the detection of collapsible airway and may help decision making of therapeutic plans.

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Investigation of False Positive Rates Newborn Screening using Tandem Mass Spectrometry (TMS) Technology in Single Center (단일기관에서 이중 질량 분석법(tandem mass spectrometry technology)을 이용한 선천성 대사이상 검사의 위양성율에 대한 연구)

  • Kim, Hyunsoo;Shin, Son Moon;Ko, Sun Young;Lee, Yeon Kyung;Park, Sung Won
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.18-23
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    • 2016
  • Objective: Newborn screening leads to improved treatment and disease outcomes, but false-positive newborn screening results may impact include parental stress and anxiety, perception of child as unhealthy, parent-child relationship dysfunction, and increased infant hospitalizations. The purpose of this study was to investigate of the false positive rates and the causative factors of false positive results in Tandem Mass Spectrometry (TMS) in single center. Methods: Records were reviewed for all 18,872 subjects who were born in Cheill General Hospital, during January 1st, 2012 to December 31st, 2014. 17,292 neonates (91.62%) were tested for tandem mass screening almost in 2-5th day of life. Newborn babies whose first results were abnormal had been tested repeatedly by same methods in 7-14 day. If the results were abnormal again, further evaluation was performed. TMS analysis included data for the 43 disorders screened for using TMS broken down into three categories: fatty acid oxidation disorders, organic acidurias, and aminoacidopathies. The impact of several factors on increased false positive rates was analyzed using a multivariate analysis: time from birth to sample collection, birth weight, birth height, BMI, gender, gestational age, delivery type. Results: Males of the subjects were 8942 (51.7%), female 8350 (48.3%), the mean gestational age was $38.6{\pm}1.7$ weeks, the average birth weight $3,155.6{\pm}502.4g$, the average birth height $49.1{\pm}2.9cm$, and the average BMI $13.0{\pm}3.8(kg/m^2)$. Vaginal delivery cases were 9713 (56.2%), caesarean section 7,579 (43.8%). The average date of the inspection was $2.8{\pm}1.1$ days. 224 cases were identified as TMS positive. All the subjects were false positive (222/17,292, 1.30%) except 2 cases (1 male; benign phenylketonuria and 1 female; Short chain acyl-CoA dehydrogenase deficiency). The false positive rates were 0.61% in fatty acid oxidation disorders, 0.25% in organic acidurias, and 0.45% in aminoacidopathies. In our study, the date of inspection got late, the false positive rates got higher. Because almost the cases of late test date were in treatment in neonatal intensive care unit so their test date was affected by their medical conditions. False positive rate was higher in extreme immaturity${\leq}27$ weeks than newborns of gestational age >27 weeks [OR=6.957 (CI=1.273-38.008), p<0.025] and extremely low birth weight<1,000 g than newborns of birthweight ${\geq}1,000g$ [OR=5.616 (CI=1.134-27.820), p<0.035]. Conclusion: False positive rate of TMS was 1.30% in Cheil General Hospital. Lower gestational age and birth weight impacted on increased false positive rates. Better understanding of factors that influence the reporting of screening tests, and the ability to modify these important factors, may improve the screening process and reduce the need for retesting. of screening tests, and the ability to modify these important factors, may improve the screening process and reduce the need for retesting.

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Comparative Study of the Discrimination of Uni-variate Analysis and Multi-variate Analysis for Small-Business Firm's Fail Prediction (중소기업 부실예측을 위한 단일변량분석과 다변량분석의 판별력 비교에 관한 연구)

  • Moon, Jong-Geon;Ha, Kyu- Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.8
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    • pp.4881-4894
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    • 2014
  • This study selected 83 manufacturing firms that had been delisted from the KOSDAQ market from 2009 to 2012 and the sample firms for the two-paired sampling method were compared with 83 normal firms running businesses with same items or in same industry. The 75 financial ratios for five years immediately before delisting were used for Mean Difference Analysis with those of normal firms. Fifteen variables assumed to be significant variables for five consecutive years out of the analysis were used to in the Dichotomous Classification Technique, Logistic Regression Analysis and Discriminant Analysis. As a result of those three analyses, the Logistic Regression Analysis model was found to show the greatest discrimination. This study is differentiated from previous studies as it assumed that the firm's failure proceeded slowly over long period of time and it tried to predict the firm's failure earlier using the five years' historical data immediately before failure, whereas previous studies predicted it using three years' data only. This study is also differentiated from the proceeding comparative studies by its statistically complex Multi-Variate Analysis and Dichotomous Classification Analysis, which general stakeholders can easily approach.

A Numerical Model for Predicting the Radial Power Profile in CANDU-PHWR Fuel Pellet (CANDU-PHWR 핵연료 소결체의 반경방향 출력분포 수치모형)

  • Woan Hwang;Suk, Ho-Chun;Jae, Won-Mok
    • Nuclear Engineering and Technology
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    • v.23 no.4
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    • pp.444-455
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    • 1991
  • An accurate and fast running NEDAR model for calculating radial power profile throughout fuel life in both solid and annular pellets for existing and advanced CANDU-PHWR-fuel was developed in this work. This model contains resultant flux depression equations and neutron depression data tables which have been developed for CANDU-PHWR fuel of pellet with the diameter 8.0 to 19.5 mm and enrichment 0.71-6.0 wt % U-235, over a bumup range of 0 to 840 MWh /kgU (35000 MWD/T). In order to obtain the neutron flux distribution in the fuel pellet, the CE-HAMMER physics code was run for a neutron flux spectrum appropriate to a CANDU-PHWR to give predictions of radial power profile for several ranges of fuel design parameters. The results, which were calculated by the CE-HAMMER physics code, were fitted to an equation which is solved in terms of Bessel and exponential functions in order to obtain the parameters, $textsc{k}$, $\beta$ and λ in the resultant equation. The present NEDAR model produce a radial profile which, when normalized to unity at the pellet surface, is slightly higher than the profile of the original ELESIM data table. The predictions of the fission gas release by KAFEPA-NEDAR are in slightly better agreement with the experiments than those of ELESIM. The NEDAR model described in this study has been shown to provide an effective, reliable, and accurate method for determining radial power profiles in CANDU-PHWR fuel rods without incurring a significant increase in computing time.

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Simultaneous Spectrophotometric Determination of Copper, Nickel, and Zinc Using 1-(2-Thiazolylazo)-2-Naphthol in the Presence of Triton X-100 Using Chemometric Methods (화학계량학적 방법을 사용한 Triton X-100이 함유된 1-(2-Thiazolylazo)-2-Naphthol을 사용한 구리, 니켈과 아연의 동시 분광광도법적 정량)

  • Low, Kah Hin;Zain, Sharifuddin Md.;Abas, Mhd. Radzi;Misran, Misni;Mohd, Mustafa Ali
    • Journal of the Korean Chemical Society
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    • v.53 no.6
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    • pp.717-726
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    • 2009
  • Multivariate models were developed for the simultaneous spectrophotometric determination of copper (II), nickel (II) and zinc (II) in water with 1-(2-thiazolylazo)-2-naphthol as chromogenic reagent in the presence of Triton X-100. To overcome the drawback of spectral interferences, principal component regression (PCR) and partial least square (PLS) multivariate calibration approaches were applied. Performances were validated with several test sets, and their results were then compared. In general, no significant difference in analytical performance between PLS and PCR models. The root mean square error of prediction (RMSEP) using three components for $Cu^{2+}$, $Ni^{2+}$ and $Zn^{2+}$ were 0.018, 0.010, 0.011 ppm, respectively. Figures of merit such as sensitivity, analytical sensitivity, limit of detection (LOD) were also estimated. High reliability was achieved when the proposed procedure was applied to simultaneous determination of $Cu^{2+}$, $Ni^{2+}$ and $Zn^{2+}$ in synthetic mixture and tap water.

A Development of Optimum Operation Models for Express-Rail Systems (급행열차 도입을 통한 최적운행방안 수립에 관한 연구 - 수도권 광역 도시철도를 중심으로 -)

  • Park, Jeong-Soo;Lee, Hoon-Hee;Won, Jai-Mu
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.26 no.4D
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    • pp.679-686
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    • 2006
  • Recently, the city railway in the Seoul Metropolitan Area (SMA) has offered a low quality of service as a passage time, because it was operated slowly. So, the people who live in modern society are not satisfied about passage time, therefore, this study tried to make that the subway in the SMA becomes a more functional and effective wide-area-transportation-network through an express train introduction's method which examined cases from abroad and current system. and then presented how express train could be applied to current system. In a case study, We used the An-San Line and Su-In Line as a examples and developed a schedule which can minimize the delaying time of subway by using Branch & Bound Algorithm. The train operational plan was loaded to consider a railroad siding, Obtained site, and the dispatch interval(three to ten minutes) for the express and local lines and finally, We presented an alternative operational plan which made by those factors.

CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH PERVASIVE DEVELOPMENTAL DISORDER (입원한 전반적발달장애 소아청소년의 임상특성)

  • Pyo, Kyung-Sik;Bahn, Geon-Ho;Hong, Kang-E;Park, Tae-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.237-246
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    • 1998
  • Objectives and Methods:This study investigated clinical characteristics, treatment modality, outcome of 57 children and adolescent inpatients(male 53, female 4) who were diagnosed as pervasive developmental disorder(PDD) by DSM-Ⅳ criteria recent five years. Results:1) The mean age at admission was $96{\pm}28.2$ months, and the mean age at which they first visited treatment facility was $52{\pm}26.6$ months. The mean hospitalization period was $43.7{\pm}31.3$ days. 2) Diagnosis:Twenty-seven(47.4%) of subjects met DSM-Ⅳ criteria for PDD NOS. Fifteen (26.3%) met for autistic disorder, nine(15.8%) met for Asperger's syndrome, and two(3.5%) met for childhood disintegrative disorder. 3) Comorbid diagnosis:The most common comorbid dignosis was attention deficit hyperactivity disorder(23.8%). 4) IQ test:IQ test for twenty-eight subjects was possible. The Average of the subjects was $70{\pm}27.5$. Fifteen(53.6%) of the subjects were approximate or under 70. 5) Neurology Abnormality:EEG findings of eleven(21.2%) subjects were abnormal, brain CT or MRI findings of eight subjects(21.6%) were abnormal. 6) Family Hx:Depressive disorder were found in Eight mothers(14%). Familial loading was found in twenty families(35.1%), and familial loading of PDD was found in three(5.3%). Conclusion:The most important thing for the management of PDD is early detection and early treatment. To do so, multidisciplinary team approach should be emphasized.

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The Study on the Relationship Between the Duration of Chest Vibration prior to Endotracheal Suctioning and the Changes in Oxygen Saturation in Low-Birth-Weight Infants (저체중아에 있어 기관내 흡인전 흉부진동법의 기관과 산소포화 변화간의 관계 연구)

  • Ahn, Young-Mee
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.597-607
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    • 1995
  • 1960년대 이후 인공호흡기(mechanical ventilator)의 보급과 최근 의료과학의 발달, 간호의 질적 향상의 결과로 저체중출생아를 포함한 고위험 신생아의 생존율이 높아져왔다. 호흡장애증후군(RDS)은 일차적으로 폐포의 완전한 확장을 위해 필요한 계면활성물질(surfactant)의 부족, 미발달된 심폐기능에 의한 병리적 현상으로 저체중아의 가장 큰 원인이 되어왔다. RDS로 인해 인공호흡기에 의존해 있는 저체중아의 경우 적절한 산소공급과 이를 위한 호흡의 유지는 치료의 가장 큰 핵심이 되며, 이를 위한 기관내 흑은 비인두 흡인 (nasopharyngeal suction)은 신생아 중환자실(NICU)의 가장 중요한 간호행위가 되어왔다. 인공호흡기를 위한 기관삽관은 그 자체가 기도의 성모운동을 방해하고 기침반사를 억제시켜 폐 분비물의 효과적 배출을 억제하며, 특히 저체중아의 경우 조산과 관련하여 미발달된 흥곽운등과 심폐기능은 폐분비물의 이동을 저해하는 요소이다. 따라서 기도내의 분비물의 이동을 효과적으로 하여 흡인 시에 최대한의 효과를 돕기 위해 흥곽 물리요법(chest physiotheraphy : CPT)의 한 형태인 흉곽진동법 (Chest Vibration : CV)가 행해져 왔다. 그러나 저체중아를 위한CV의 임상적 적용은 그 대상의 생리적 특성, CV의 적용부위(site)와 기간(duration)에 대한 과학적 근거 없이 만성감염이나 폐질환을 가진 성인이나 cystic fibrosis환자를 위한 CV protocol을 무분별하게 채택하여 저체중아에게 행하여져 왔다 이에 본 연구자는 저체중아에 대한 CV의 안전성을 평가하고, 이에 기초하여 저체중아에게 바람직한CV의 형태를 알아보고자 본 연구를 시작하였다. 연구설계는 CV의 안전성을 평가하기 위한 실험연구이다. CV의 안전성은 RDS치료의 가장 일차적 목표인 oxygenation변화에 의해 평가될 수 있으므로, 본 실험 연구에서는 Pulse oximeter에 의해 계속적으로 측정된 산소포화 변화(oxygen saturation change)를 측정하였다. 실험대상은 미국동부에 위치한 대학병원의 NICU에 입원하여 RDS와 관련된 호흡장애로 인공호흡기에 의존해 있는 10명의 저체중아였다. 인공호흡기에 의존된 모든 저체중아는 Pulse oximeter와 심폐기능 측정기(cardiopulmonary monitor)에 의해 산소공급과 호흡상태가 계속 측정되고 있었다. 실험대상의 평균 출생시 몸무게는 평균 1,3050gm(SD=580.6)이었고, 임신월령 은 평균 28.6주(SD=3.1)였다. RDS가 그들의 일차적 진단명이었고, 그중 4명은 pneumonia, atelectasis의 합병증을 가지고 있었다. 10명중 6명은 intermittent mandatory ventilation(IMV)의 형태로, 4명은 continuous positive airway pressure(CPAP)의 형태로 인공호흡기에 의존되어 있었고 CV시의 FiO2는 평균 42.3(SD=21.2)였다. CV는 중환아용 소형진동기 (minivibrator)를 이용해 가각 10명 의 간호사에 의해 행하여 졌고, 최소 22초에서 최대 100초 동안 실시되었다. 50%의 간호사는 30초에서 40초간 CV를 실시하였으며, CV의 적용부위도, 전후 흉곽부위, 혹은 병변이 있는 좌 우측, 흑은 양쪽 흉벽 등으로 다양했고, 적용방법도 원형으로 돌려가며(circular motion), 혹은 아래에서 위로, 혹은 아무런 기준없이 간호사의 기호에 따라 다양하게 적용되었다. 산소포화의 변화는 CV가 행해지기 전.후로 5초동안 관찰되었다. 연구의 결과, 산소포화 변화는 비 모수통계(non parametric statistics)의 일종인 Matched Paired Wilcoxon test로 분석 한 결과 CV후에 3%의 감소를 보였다(P<.05). 저체중아에 있어 산소포화의 3%감소는 임상적으로 중요한 의미가 없다고 사료되어지며, 실제 흡인전의 과도호흡에 의해 CV를 행하기 이전의 산소공급수준으로 돌아 왔다. CV실시 기간과 산소포화와의 상관관계는 비 모수통계인 Spearman rho correlation coefficient를 이용하여 분석하였는데, 이 두 변수는 서로 관계가 없는 것으로 나타났다(P>.05) 또한 CV와 흡인 후에 각각의 간호사들에게 CV를 필요로 한 저체중아의 기준, 적용부위, 기간, 방법등에 대한 기준을 물었으나 대상의 특성에 따른 간호사정에 의존하기보다는 간호사 각자의 선호하는 방법이나 습관에 라 행하는 것으로 나타났다. 결론적으로 CV와 산소포화 변화와의 관계, NICU에서 관찰된 CV의 임상적 적용을 기초로 저체중아에게 안전한 CV protocol은 신생아용 소형 진동기를 이용하여, 양쪽 흉곽의 늑골하측 변연 부위(low lateral costal margin)에서 시작하여 흉골 중앙부위 방향으로 30초 동안 진동기를 적용하는 것이 좋은 것으로 나타났다. 이에 CV의 효과를 평가하기 위한 보다 과학적인 접근방법으로, CV와 흡인의 결과인 가래(sputum)에 대한 연구를 제언하는 바이다.

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