• 제목/요약/키워드: Actuarial Method

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꼬리가 두꺼운 분포의 고분위수에 대한 신뢰구간 (Confidence Intervals for High Quantiles of Heavy-Tailed Distributions)

  • 김지현
    • 응용통계연구
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    • 제27권3호
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    • pp.461-473
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    • 2014
  • 꼬리가 두꺼운 분포의 고분위수에 대한 신뢰구간을 연구하였다. 통계량의 극한 분포에 근거한 점근적 방법과 붓스트랩 방법을 같이 고려하였다. 이 두 방법에 모수적, 비모수적, 준모수적 기법을 각각 적용할 수 있는데, 전체 11가지 신뢰구간의 성능을 실제신뢰수준과 길이로 비교하였다. 모의실험 결과 준모수적이면서 점근적인 신뢰구간과 축량을 이용하는 준모수적 붓스트랩 신뢰구간이 실제신뢰수준의 기준에서 안정된 성능을 보인다는 것을 알 수 있었다.

Survival Following Non Surgical Treatments for Oral Cancer: a Single Institutional Result

  • Larizadeh, Mohammad Hasan;Shabani, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.4133-4136
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    • 2012
  • Aim: To report the results of radiotherapy with or without chemotherapy in the patients with oral cancer. Methods: Over the 2003-2009 periods, a total number of 69 patients with squamous cell carcinoma of the oral cavity that refused surgery or had unresectable tumor were enrolled in this study. A total dose of 60 to 70 Gy (2 Gy per day) was given to the primary tumor and clinically positive nodes. In the patients with locoregionally advanced disease (57 patients with $T_3$, $T_4$ lesions and/ or $N^+$) induction chemotherapy following by concomitant chemoradiation was used. Induction chemotherapy consisted of 3 cycles of Cisplatin and 5-Flourouracil with or without Docetaxel. Weekly cisplatin was used in concomitant protocol. Kaplan-Meier method was used to calculate overall survival. Log-rank test and Cox regression model were used for comparison purposes. Results: Median follow-up was 32 months. The mean age of the patients was 59.2 years. The overall response rate after induction chemotherapy was 68.4%. Actuarial overall survival rates after 2 and 3 years were 38% and 26%, respectively. Clinical stage emerged as the only independent predictor of survival. Conclusion: Outcome of the patients with oral cancer is poor. Presenting with an advanced stage lesion contributed to this result. The role of chemotherapy in advanced cases remains to be defined.

석유화학 제조설비의 경제적 감가상각률 산정 (A Study on the Estimation Depreciation Rate on Petrochemical Equipments)

  • 오현승;김종수;이한교;조진형
    • 산업경영시스템학회지
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    • 제32권1호
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    • pp.130-136
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    • 2009
  • Estimation of mortality behavior of a industrial property are useful for calculating depreciation and making management decisions relating to property. The common methods of computing depreciation require an estimation of service life, and some methods may require an estimate of life expectancy. Estimation of service life and life expectancy can be computed from a smoothed and extended life table of original life tables developed through life analysis techniques. Several actuarial techniques are available to construct a life table for depreciation application. Of these methods, the graphic approach and graduation by mathematical formula are the most widely used in the field of depreciation. A commonly used technique of smoothing and of extending the life table is to fit a lows type survivor curves to the observed retirement rate by the least square method. In this paper, estimates of depreciation rate based on directly observed data of the domestic petrochemical equipments are presented.

식도종양의 외과적 치료 (Surgical Treatment of Esophageal Cancer)

  • 육을수
    • Journal of Chest Surgery
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    • 제28권2호
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    • pp.170-176
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    • 1995
  • Fourty nine patients out of 127 esophageal cancer were managed surgically from January 1986 to December 1991, at the Department of Thoracic and Cardiovascular Surgery, Jeonbuk National University Hospital. Most frequent preoperative symptom was dysphagia and its mean duration was 3.1 months. In histopathologic examination, squamous cell carcinomas were 44 cases [89.8% , and adenocarcinomas 5 [10.2% . The tumor location were the upper esophagus in 6.1%, middle esophagus in 57.2%, lower and cardiac portion of stomach in 36.7%. Involved and metastatic organs, which were detected perioperatively, were celiac lymph nodes in 6 cases, aorta 2, stomach 2, pericardium 2, cervical lymph node 1. The esophagus was resected radically, and the procedures for esophageal replacement were performed with esophagogastrostomy in 45 cases, esophagocologastrostomy 3, and esophagojejunostomy 1. Postoperative complications occurred in 16 cases [hospital morbidity = 32.6% ,anastomotic leak 3, anastomotic stricture 2, respiratory insufficiency 2, hemoperitoneum 1, chylothorax 1, intussusception 1, empyema 1, non-A,non-B hepatitis 1, and mediastinitis 1. Hospital deaths were experienced 3 cases [ hospital mortality = 6.1% . The 6 month, one, two, and five year actuarial survival rates were 85.7%, 71.4%, 57.1%, and 27.9%, respectively. One year survival rates of stages were 100% in stage I, 90.9% in stage IIa, 63.6% in stage IIb, 25.0% in stage III, and 7.2% in stage IV.

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Low Income and Rural County of Residence Increase Mortality from Bone and Joint Sarcomas

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5043-5047
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    • 2013
  • Background: This is a part of a larger effort to characterize the effects on socio-economic factors (SEFs) on cancer outcome. Surveillance, Epidemiology and End Result (SEER) bone and joint sarcoma (BJS) data were used to identify potential disparities in cause specific survival (CSS). Materials and Methods: This study analyzed SEFs in conjunction with biologic and treatment factors. Absolute BJS specific risks were calculated and the areas under the receiver operating characteristic (ROC) curve were computed for predictors. Actuarial survival analysis was performed with Kaplan-Meier method. Kolmogorov-Smirnov's 2-sample test was used to for comparing two survival curves. Cox proportional hazard model was used for multivariate analysis. Results: There were 13501 patients diagnosed BJS from 1973 to 2009. The mean follow up time (SD) was 75.6 (90.1) months. Staging was the highest predictive factor of outcome (ROC area of 0.68). SEER stage, histology, primary site and sex were highly significant pre-treatment predictors of CSS. Under multivariate analysis, patients living in low income neighborhoods and rural areas had a 2% and 5% disadvantage in cause specific survival respectively. Conclusions: This study has found 2-5% decrement of CSS of BJS due to SEFs. These data may be used to generate testable hypothesis for future clinical trials to eliminate BJS outcome disparities.

대동맥근부 혹은 상행대동맥의 재수술 (Reoperations on the Aortic Root and Ascending Aorta)

  • 백만종;나찬영;김웅한;오삼세;김수철;임청;류재욱;공준혁;김욱성;이영탁;문현수;박영관;김종환
    • Journal of Chest Surgery
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    • 제35권3호
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    • pp.188-198
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    • 2002
  • 목적: 대동맥근부 혹은 상행대동맥에 대한 재수술은 증가하고 있으나 재수술에 대한 결과 및 재수술을 예방할 수 있는 적절한 방법에 대한 연구는 많지 않다. 본 연구는 대동맥근부 혹은 상행대동맥 질환에 대한 재수술 결과 및 재수술을 예방할 수 있는 적절한 방법에 대해 알아보고자 하였다. 대상 및 방법: 1995년 5월부터 2001년 4월까지 대동맥근부 혹은 상행대동맥 질환으로 재수술을 받은 환자 30명을 대상으로 후향, 조사하였다. 최종 선행수술에서 재수술까지 기간은 평균 56$\pm$50개월(3-142개월)이었다. 재수술 적응증으로는 진성 상행대동맥류 7명(23.3%), 인공판막심내막염이 6명(20%), 가성동맥류 5명(16.7%), Behcet씨 병과 관련한 대동맥판륜 주위 누출 4명(13.3%), 인공 대동맥판막 기능부전 4명(13.3%), 그리고 대동맥박리증 3명(10%) 및 대동맥판륜확장증 1명이었다. 재수술은 대동맥근부 치환술 17명(56.7%), 상행대동맥 치환술 8명(26.7%), 대동맥판-승모판 연속의 섬유체 및 판륜 재건을 이용한 이중판막치환술 2명, 패취를 이용한 상행대동맥 성형술 2명, Bentall 술식 후 이중판막 치환술 1명이었다. 수술은 7명에서 체외순환하에 흉골절개를 하였고 16명(53.3%)에서 완전순환정지를 이용하였다. 평균 순환정지 시간은 20$\pm$12분, 체외순환 및 대동맥차단 시간은 각각 228$\pm$56분과 143$\pm$64분이었다. 결과 조기 사망은 3명(10%)에서 있었다. 합병증으로는 재수술이 필요했던 출혈이 7명(23.3%), 심장 합병증 5명(16.7%), 일과성 급성 신부전 2명, 간질 발작 2명, 그리고 기타가 5명이었다. 술후 생존자 27명에서 평균 22.8$\pm$20.5개월을 추적조사한 결과: 만기사망은 2명(7.4%)에서 있었으며 술후 6년 actuarial survival rate는 92.6$\pm$5.0%였다. 대동맥근부 혹은 상행대동맥 재수술 후 다시 재수술이 필요하였던 경우는 1명이었고(3.7%), 술후 1년과 6년 재수술로부터의 actuarial freedom rate는 각각 100%와 83.3$\pm$15.2%이었다. Behce씨 질환이 있는 1명이 동종이식편으로 근부치환술 후 가성동맥류가 발생하여 재수술이 필요한 상태이다. 혈전색전증이나 항응고제 관련 합병증은 없었다. 결론: 본 연구 결과 대동맥근부 혹은 상행대동맥의 재수술은 비교적 낮은 사망률과 이환율을 보이며 또한 재수술을 예방하기 위해서는 선행수술 및 재수술시 원인질환에 따른 적절한 수술 방법의 선택이 매우 중요할 것으로 사료된다

중등도 이상의 좌심기능부전 환자에서 승모판성형술 (Mitral Valve Reconstruction in Patients with Moderate to Severe Left Ventricular Dysfunction)

  • 백만종;나찬영;오삼세;김웅한;황성욱;김수철;임청;김욱성;이영탁;김종환
    • Journal of Chest Surgery
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    • 제36권11호
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    • pp.812-819
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    • 2003
  • 배경: 좌심실 기능부전은 판막수술 후 조기사망 및 장기 생존에 영향을 미치는 중요한 요인의 하나이다. 중등도 이상의 심기능부전 환자에서의 승모판막성형술의 중기 결과에 대해 알아보고자 하였다. 대상 및 방법: 1995년 4월부터 2001년 7월까지 좌심실 구혈률이 45% 이하의 심기능부전 환자에서 승모판막성형술을 받은 44명의 환자를 후향적으로 조사하였다. 환자 연령은 46∼14세였고 32명이 NYHA III-IV였다. 승모판막 질환은 페쇄부전 28명, 협착 10명, 혼합형이 5명이었으며 원인은 류머치스성 20명, 퇴행성 14명, 허혈성 5명, 판륜확장 및 선천성이 각 2명, 그리고 심내막염이 1명이었다. 수술시 판륜성형술은 35명(79.6%)에서 시행되었으며 또한 다양한 판첨성형술이 사용되었고 총 52건의 동반수술이 시행되었다. 총체외순환 및 대동맥차단시간은 각각 160$\pm$57분과 112$\pm$45분이었다. 결과: 조기사망은 2명(4.5%)으로 좌심실 기능부전으로 사망하였다. 평균 39개월을 추적한 후 만기사망은 없었다. 심장초음파 검사에서 승모판폐쇄부전은 29명에서 없거나 I도 이하였으며(72.5%) 승모판협착은 35명에서 경도 이하 상태였다(87.5%). 4명이 승모판막 관련질환으로 치환술을 받았다(9.5%). 5년 후 actuarial survival은 100%였으며 승모판막 관련 질환으로 인한 재수술로부터의 자유도는 84$\pm$9%였다. 결론: 중등도 이상의 심한 좌심기능부전 환자들의 승모판막 질환에서 판막성형술 결과 조기 및 중기 생존율과 판막질환으로부터의 재수술률도 양호한 결과를 보임으로써 좌심기능부전 환자들에서 효과적인 치료의 한 방침으로 적용할 수 있다

직장암의 수술 후 방사선치료성적 (The Results of Postoperative Radiation Therapy in the Rectal Cancer)

  • 이경자
    • Radiation Oncology Journal
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    • 제12권1호
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    • pp.91-98
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    • 1994
  • Purpose: Despite apparently complete resection of cancer of the rectum, local recurrence rate was high. Radiation therapy has been used either alone or in combination with chemotherapy as an adjunct to surgery to reduce the risk of recurrence. This study was designed to evaluate the prognostic factors, survival rate and local recurrence rate of the rectal cancer who had received postoperative radiation therapy by retrospective analysis. Method: From 1982 to 1990, 63 patients with cancer of the rectum surgically staged as B2 or C disease received postoperative adjuvant radiation therapy after curative resection of tumor for cure. Postoperative radiation therapy was given to the whole pelvis(mean dose: 5040 cGy in 5-6weets) and perineum was included in irradiated field in case of abdominoperineal resection. Results: Three-year actuarial survival rate was 73.2$ \% $ overall, 87.7$ \% $ in stage B2+3 and 62.9$ \% $ in stage C2+3. Three-year disease-free survival rate was 69.5$ \% $ overall, 87.7$ \% $ in stage B2+3 and 56.8$ \% $ in stage C2+3, Three-year disease-free survival rate in anterior resection was 77.8$ \% $ and 44.4$ \% $ in abdominoperineal resection. The local recurrence rate was 15.9$ \% $ and distant failure rate was 20.6$ \% $. Severe late complication was small bowel obstruction in 6 patients and surgery was required in 4 patients(6.3$ \% $). The prognostic factors were stage(p=0.0221) and method of surgery(p= 0.0414) (anterior resection vs abdominoperineal resection). Conclusion: This study provides evidence supporting the use of postoperative radiation therapy for reducing the local recurrence rate in patients who have had curative resection of rectal cancer with involvement of perirectal fat or regional nodes or both(stage B2 and C).

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Prostate Cancer: A Hospital-Based Survival Study from Mumbai, India

  • Balasubramaniam, Ganesh;Talole, Sanjay;Mahantshetty, Umesh;Saoba, Sushama;Shrivastava, Shyam
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2595-2598
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    • 2013
  • Background: Prostate cancer is common in elderly men, especially in western countries, and incidences are rising in low-risk populations as well. In India, the age-standardized rates vary between registries. Under these circumstances we have estimated the survival of prostate cancer patients based on age, family history, diabetes, hypertension, tobacco habit, clinical extent of disease (risk group) and treatment received. Materials and Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India. During years 1999-2002, some 850 prostate cancer cases, including 371 new cases, treated in TMH were considered as eligible entrants for the study. Five-year survival rates using actuarial and loss-adjusted (LAR) method were estimated. Results: The patient population was distributed uniformly over the three age groups. A larger proportion of the patients were diagnosed at 'metastatic stage' and hormone treatment was most common. 20% patients had history of diabetes and 40% with hypertension. The 5-year overall survival rate was 64%. Survival was 55%, 74% and 52% for '<59 years','60-69 years' and '>70 years' respectively. Non-diabetic (70%), hypertensive (74%), with family history (80%) of cancer, with localized-disease (91%) and treated with surgery, either alone or in combination, (91%) had better survival. Conclusions: The present study showed that prostate cancer patients with localized disease at diagnosis experience a better outcome. Local treatment with either surgery or radiation achieves a reasonable outcome in prostate cancer patients. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies available now.

부부의 사망시차 및 생존기간의 종속관계 분석 -국민연금의 유족연금 데이터를 이용한 연구- (Analysis of mortality after death of spouse in relation to duration of bereavement and dependence relation between married couple -using married couples data from survivor's pension of National Pension Service-)

  • 백혜연;한정림;이항석
    • Journal of the Korean Data and Information Science Society
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    • 제26권4호
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    • pp.931-946
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    • 2015
  • 부부 또는 가족 등의 혈연관계는 생활환경 및 방식이 유사하기 때문에 그들의 생존기간 간에 상관관계가 존재한다는 것을 짐작할 수 있다. 따라서 본 연구에서는 실제 부부 데이터를 이용하여 상관 분석을 위해 피어슨의 상관계수, 스피어만의 상관계수, 그리고 켄달의 타우를 계산해 본다. 또한, 부부 중 한 명이 사망 후 최종생존자가 사망할 때까지의 사망시차를 분석하여 부부의 사망 시점 간에 종속관계에 대하여도 분석하도록 한다. 실제로 보험에 함께 가입한 부부나 가족은 생존기간 또는 사망시점 간에 상관성이 존재하기 때문에 그들의 생존기간이 독립이라 가정하는 보험 실무 방법 대신 상관성을 고려하여 보험 상품의 가치를 평가하는 것이 더 타당할 수 있다. 본 연구를 통해 부부 중 한 명의 배우자의 사망으로 인한 최종생존자의 잔존생존기간의 변화를 분석하여 연생보험의 보험료 및 준비금 산출 등에 활용할 수 있는 근거를 제시해 보고자 한다.