• The Korean Journal of Pain
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• 제10권2호
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• pp.254-257
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• 1997

Ganglion impar lies immediately anterior to the sacrococcygeal junction and blockade of the ganglion is used to treat anorectal and perineal pain. Although the technique introduced by Plancarte et at is widely practised, the bent needle is sometimes difficult to position precisely and patients find the procedure painful. We modified this approach of block of ganglion impar by positioning the needle into the sacrococcygeal junction and using the loss of resistance technique. With the patient in the lateral position, a skin wheal was raised at 1-1.5cm below the sacral hiatus. Twenty-three gauge short needle was directly placed into the sacrococcygeal junction with aid of fluoroscopic guidance. From 1 cm behind the anterior margin of the vertebral body in lateral view, we used the loss of resistance technique to confirm the retroperitoneal space. We found this modified approach easier to perform during six blocks for three patients with anorectal or perineal pain. Our modified approach through the sacrococcygeal junction may provide opportunity for wider administration of this procedure because of its simple technique, reduced pain during procedure and decreased risk of infection.

• Clinical and Experimental Reproductive Medicine
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• 제48권1호
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• pp.80-84
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• 2021

Objective: The aim of the study was to investigate pregnancy, obstetric, and neonatal outcomes in women with small (<4 cm) unilateral endometriomas. Methods: This retrospective study included 177 patients: 91 patients with small endometriomas and 86 controls with unexplained or tubal factor infertility who were treated at the Süleymaniye Gynecology and Maternity Training and Research Hospital Infertility Unit between January 2010 and July 2015. The groups were matched with regards to demographic characteristics such as age, body mass index, and infertility duration. All of the women in this study conceived via intracytoplasmic sperm injection. We compared pregnancy, obstetric, and neonatal outcomes between these groups. Results: Women with endometriomas had a higher biochemical pregnancy rate, but lower clinical pregnancy and live birth rates than women with unexplained and tubal factor infertility (p<0.05 for all). However no significant differences were found in terms of obstetric and neonatal complications between the two groups (p>0.05 for all). Conclusion: In this study, we found that women with endometriomas less than 4 cm were more prone to early pregnancy complications. We also showed that this group did not have any increased risks of late pregnancy, obstetric, and neonatal complications.

• 국제학술발표논문집
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• The 5th International Conference on Construction Engineering and Project Management
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• pp.338-343
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• 2013

Integrated Project Delivery (IPD) as a delivery method fully capitalizes on an integrated project team that takes advantage of the knowledge of all team members to maximize project outcomes. IPD is currently the highest form of collaboration available because all three core project stakeholders, owner, designer and contractor, are aligned to the same purpose. Compared with traditional project delivery approaches such as Design-Bid-Build (DBB), Design-Build (DB), and CM at-Risk, IPD is distinguished in that it eliminates the adversarial nature of the business by encouraging transparency, open communication, honesty and collaboration among all project stakeholders. The team appropriately shares the project risk and reward. Sharing reward is easy, while it is hard to fairly share a failure. So the compensation structure and the contingency in IPD are very different from those in traditional delivery methods and they are expected to encourage motivation, inspiration and creativity of all project stakeholders to achieve project success. This paper investigates the compensation structure in IPD and provides a method to determine the proper level of contingency allocation to reduce the risk of cost overrun. It also proposes a method in which contingency could be used as a functional monetary incentive when established to produce the desired level of collaboration in IPD. Based on the compensation structure scenario discovered, a probabilistic contingency calculation model was created by evaluating the random nature of changes and various risk drivers. The model can be used by the IPD team to forecast the probability of the cost overrun and equip the IPD team with confidence to really enjoy the benefits of collaborative team work.

• Nutrition Research and Practice
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• 제7권5호
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• pp.400-408
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• 2013

Obesity may be the consequence of various environmental or genetic factors, which may be highly correlated with each other. We aimed to examine whether grandmaternal and maternal obesity and environmental risk factors are related to obesity in daughters. Daughters (n = 182) recruited from female students, their mothers (n = 147) and their grandmothers (n = 67) were included in this study. Multivariable logistic regression was used to analyze the association between the daughter's obesity and maternal, grandmaternal, and environmental factors. Maternal heights of 161-175cm (OD: 8.48, 95% CI: 3.61-19.93) and 156-160 cm (2.37, 1.14-4.91) showed positive associations with a higher height of daughter, compared to those of 149-155 cm. Mothers receiving a university or a higher education had a significant OR (3.82, 1.27-11.50) for a higher height of daughter compared to those having a low education (elementary school). Mother having the heaviest weight at current time (59-80 kg, 3.78, 1.73-8.28) and the heaviest weight at 20 years of age (51-65 kg, 3.17, 1.53-6.55) had significant associations with a higher height of daughters, compared to those having the lightest weight at the same times. There was no association between the height, weight, and BMI of daughters and the characteristics and education of her grandmothers. In conclusion, although genetic factors appear to influence the daughter's height more than environmental factors, the daughter's weight appears to be more strongly associated with individual factors than the genetic factors.

• 한국약용작물학회지
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• 제17권3호
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• pp.204-209
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• 2009

This study was conducted to assess water movement in paddy-upland rotation soil scheduled for ginseng cultivation through the measurement of infiltration and permeability of soil water. Soil sample was divided with four soil layers. The first soil layer (to 30cm from top soil) was loamy sand, the second and the third soil layers (30$\sim$70 ㎝) were sand, and the fourth (< 120 ㎝) was sandy loam. The soil below 130 ㎝ of fourth soil layer was submerged under water. The shear strength, which represents the resisting power of soil against external force, was 3.1 kPa in the first soil layer. This corresponded to 1/8 of those of another soil layer and this value could result in soil erosion by small amount of rainfall. The rates of infiltration and permeability depending on soil layers were 39.86 cm $hr^{-1}$ in top soil, 2.34 cm $hr^{-1}$ in 30$\sim$70 ㎝ soil layer, 5.23 cm $hr^{-1}$ and 0.18 cm $hr^{-1}$ in 70$\sim$120 ㎝ soil layer, with drain tile, and without drain tile, respectively. We consider that ground water pooled in paddy soil and artificial formation of soil layer could interrupt water canal within soil and affect negatively on water movement. Therefore, we suggest that to drain at 5 m intervals be preferable when it makes soil dressing or soil accumulation to cultivate ginseng in paddy-upland rotation soil to reduce failure risk of ginseng cultivation.

• 대한영상의학회지
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• 제81권3호
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• pp.620-631
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• 2020

목적 5 cm 이하 크기의 간암을 가진 92명의 환자군에서 식염수 주입방식 전극을 이용한 고주파 소작술의 국소 재발률과 예후인자를 평가하였다. 대상과 방법 2009년부터 2015년까지 간암으로 식염수 주입전극 고주파 소작술을 받은 92명 환자(148개 간암)를 대상으로 하였다. 후향적으로 기술적인 성공과 효능, 국소 재발률을 분석하였다. 국소 재발의 가능한 예후인자로써 혈관주위종양, 횡경막하종양, 인공복수 유무, 2 cm이상 크기, 이전 간동맥색전술 치료 여부를 평가하였다. 결과는 각각의 병변 별로 분석하였다. 결과 1~97.4개월의 추적관찰 기간 동안 누적 국소 재발률은 1년, 3년, 5년에서 각각 7.9%, 11.4%, 14.6%였다. 5년 누적 국소 재발률은 혈관주위간암과(35.1%; p = 0.009) 횡경막하간 암에서(38.9%; p = 0.002) 각각 비교군에 비해 유의미하게 높았다. 다른 예후인자들에서 국소 재발률의 유의미한 차이는 없었다(p > 0.05). 결론 식염수 주입전극을 이용한 고주파 소작술은 5 cm 이하 크기의 간암을 국소 재발률 증가없이 안전하고 효과적으로 치료할 수 있다. 그렇지만 식염수 주입전극으로도 혈관 주위와 횡경막하 위치의 간암은 다른 부위에 비해 국소 재발률이 높으므로, 혈관주위간암과 횡경막하간암은 식염수 주입전극을 이용한 고주파 소작술에서도 국소 재발의 위험성이 크다는 것을 유념하여야 한다.

• 한국의학물리학회지:의학물리
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• 제13권1호
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• pp.32-36
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• 2002

세기조절방사선치료(Intensity Modulated Radiation TheraIntensity modulated radiation therapy ; Virtual micro-IMRT ; Intensity map ; MLCpy)에서 세기분포도(intensity map; IM)의 공간적 분해능은 방사선 민감장기(Critical Organ)를 보호하면서 종양에 최대 선량을 주는데 매우 중요하며, 일반적으로 다엽콜리메이터(MLC)의 폭에 좌우된다. 세기분포도의 공간적 분해능을 향상시키기 위한 방법으로는 두. 가지 방법이 있는데, 하드웨어를 추가하는 방법과 방사선 조사 기술을 변경하는 것이다. 물론 다엽콜리메이터의 폭을 작게 만드는 것이 최상의 방법이나, 하드웨어 기술적으로 어렵고 또한 추가비용이 많이 들게 된다. 따라서 여기에서는 추가적 비용이 들지 않으면서 기존의 장비를 그대로 활용할 수 있는 기술적 방법 중의 하나인 가상 미세 세기조절방사선치료(Virtual micro-IMRT) 기법을 구현하여 임상적으로 적용을 하기 위한 예비적 연구를 수행하였다. 가상의 42$\times$54 픽셀크기, 0.5cm의 15 level IM을 이용하여 1$\times$1cm, 0.5$\times$lcm, 0.5$\times$0.5cm(VMIM) beamlet 크기에 대해 비교하였다. 분석결과, 기대와는 달리, 1cm 폭의 MLC로 전달가능한 0.5$\times$lcm beamlet에 비해 크게 개선되지 않았다. 이는 VMIM의 제약조건에 기인되는 것으로 판단된다. 향후, 두경부암에서와 같이 1cm이하의 beamlet 분해능이 요구되는 경우에 적용시켜 추가적인 연구가 필요하다 하겠다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.855-860
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• 2014

Background: The purpose of this study was to assess the relationship between different sonographic features of papillary thyroid carcinoma (PTC) on high-frequency ultrasound and cervical lymph node metastasis (CLNM). Materials and Methods: We enrolled 548 patients who underwent initial surgery for PTC between May 2011 and December 2012 in our hospital at diagnosis. The sonographic features of 513 PTC nodules in 513 eligible patients, who had single PTC nodules in their thyroid glands, were retrospectively investigated. All patients with a suspect malignant nodule (d<0.5cm) among multiple nodules were initially diagnosed by fine-needle aspiration biopsy (FNAB) to ascertain if the suspect nodule was PTC. The final diagnosis of all the thyroid nodules and existence of CLNM were based on postoperative pathology. Patients were divided into two groups: a positive group with CLNM (224 nodules) and a negative group without CLNM (289 nodules). The following factors were investigated: gender, age, echogenicity, echotexture, size, shape, location, margin, contour, calcification morphology, distance between the nodule and pre- or post-border of the thyroid capsule, vascularity and the differences between the two groups. Results: Correlation analysis showed that shorter distances between the nodule and pre- or postborder of thyroid capsule resulted in greater risk of CLNM (Spearman correlation coefficient=-0.22, p<0.0001). The significant factors in multivariate analysis were age<45yrs, larger size (d>1cm), "wider than tall" shape, extrathyroid extension and mixed flow (internal and peripheral) (p<0.05, OR=0.406, 2.093, 0.461, 1.610, 1.322). Conclusions: Significant sonographic features of PTC nodules in preoperative high-frequency ultrasound are crucial for predicting CLNM.

• 한국축산식품학회지
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• 제38권6호
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• pp.1189-1195
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• 2018

This study developed an antimicrobial hydrogel to control Listeria monocytogenes in Yukhoe (Korean beef tartare). Four hydrogels (hydrogel 1: 5% alginate+1% chitosan+0.2% $CaCl_2$, hydrogel 2: 1% ${\kappa}$-carrageenan+1% chitosan, hydrogel 3: 2% ${\kappa}$-carrageenan+1% $CaCl_2$, and hydrogel 4: 2% ${\kappa}$-carrageenan+3% $CaCl_2$) were prepared. The hydrogels then absorbed 0.1% grapefruit seed extract (GSE) and 0.1% citrus extract (CE) for 30, 60, 120, and 240 min to be antimicrobial hydrogels. To select the most effective antimicrobial hydrogel, their swelling ratio (SR) and antilisterial activities were determined. The selected hydrogel ($2{\times}2cm$) was then placed on surface of beef (round; $3{\times}3cm$), where L. monocytogenes (ca. $10^6CFU/g$) were inoculated, and the cell counts were enumerated on PALCAM agar. Among the hydrogels, the SR of hydrogel 1 increased with absorbing time, but other hydrogels showed no significant changes. Antimicrobial hydrogel 1 showed higher (p<0.05) antilisterial activity than other antimicrobial hydrogels, especially for the one absorbed the antimicrobial for 120 min. Thus, the antimicrobial hydrogel 1 absorbed antimicrobials for 120 min was applied on raw beef at $4^{\circ}C$, and reduced (p<0.05) more than 90% of L. monocytogenes on raw beef. These results indicate that antimicrobial hydrogel 1 formulated with 0.1% GSE or 0.1% CE is appropriate to improve the safety of Yukhoe by reducing psychrotrophic L. monocytogenes cell counts on raw beef.

• Radiation Oncology Journal
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• 제23권1호
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• pp.32-42
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• 2005

목적 : 본 연구의 목적은 유방암 치료 후 상지의 림프부종, 어깨관절 운동범위 감소, 주관적 증상과 이에 영향을 미치는 변수를 파악하기 위함이다. 대상 및 방법 : 본 대학 병원에서 유방암 진단을 받고 수술 또는 수술 후 방사선치료 및 항암치료를 받은 환자 159 명을 대상으로 림프부종 정도와 어깨관절 운동범위를 측정하였고, 질문지를 이용하여 주관적 증상을 측정하였다. 대상 환자의 $47.2\%$인 75명이 40대였으며 89의 환자가 병기 I 또는 II 이었다. 결과 : 림프부종(건측과 환측의 차이가 2 cm 이상)은 52명($32.7\%$)의 환자에서 발생하였다. 이 중 상지 하부 림프부종은 3명, 상지 상부 림프부종은 34명에서 발생하였으며 상지 상부와 하부 모두 림프부종이 발생한 경우는 15명이었다. 각 부위별 발생 빈도는 손목으로부터 10 cm 지점에서 $6.3\%$, 20 cm 지점에서 $10.7\%$, 30 cm 지점에서 $22.6\%$, 40 cm 지점에서 $23.3\%$이었다. 어깨관절 운동범위 감소(건측과 환측의 차이가 $20^{\circ}$ 이상)의 빈도는 굴곡에서 $37.2\%$, 외전에서 $37.7\%$, 내회전에서 $48.4\%$, 외회전에서 $24.5\%$이었다. 이 중 내회전의 경우 정상운동범위의 $50\%$ 이상 감소되는 경우도 흔하였다. 주관적 증상으로 통증 호소가 $63.5\%$, 팔을 움직이기 힘들다고 하는 경우가 $48.4\%$, 팔저림 호소가 $59.8\%$, 뻣뻣함(stiffness) 호소가 $69.2\%$이었다. 특히 림프부종이 없는 108명의 환자 중 65명($61.1\%$)이 통증을 호소하였다. 림프부종의 발생과 유의한 관계가 있는 요인으로는 연령, 체질량지수(BMI), 치료방법 및 수술 후 경과 기간이 있었고, 어깨관절 운동범위 감소의 경우 치료방법과 수술 후 경과기간이었다. 주관적 증상의 경우는 치료방법과 수술 후 경과기간 그리고 항암화학요법 종류가 유의한 관계가 있는 요인이었다. 다변량분석 결과 체질량지수(BMI)와 수술 후 경과기간이 림프부종에 영향을 미치는 유의한 변수인 것으로 나타났다. 결론 : 림프부종은 수술 후 기간이 경과되어도 계속 진행되며 특히 체질량지수가 유의한 요인으로 확인되어 지속적인 체중관리를 포함한 예방대책이 필요하다. 그리고 어깨관절 운동범위의 감소도 환자의 약 1/3에서 발생하였으며 특히 굴곡, 외전, 내회전 운동범위의 감소가 빈번하였고 내회전의 경우 그 정도가 심하였으며 이를 근거로 한 치료 후 재활관리 프로그램이 환자에게 도움을 줄 것으로 기대한다.