• Journal of Trauma and Injury
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• 제23권2호
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• pp.113-118
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• 2010

Purpose: Prolonged stay in the emergency department (ED), which is closely related with the time interval from the ED visit to a decision to admit, might be associated with poor outcomes for trauma patients and with overcrowding of the ED. Therefore, we examined the factors affecting the delay in the decision to admit severe trauma patients. Also, a multidisciplinary department system was preliminarily evaluated to see if it could reduce the time from triage to the admission decision. Methods: A retrospective observational study was conducted at a tertiary care university hospital without a specialized trauma team or specialized trauma surgeons from January 2009 to March 2010. Severe trauma patients with an International Classification of Disease Based Injury Severity Score (ICISS) below 0.9 were included. A multivariable logistic regression analysis was used to find independent variables associated with a delay in the decision for admission which was defined as the time interval between ED arrival and admission decision exceeded 4 hours. We also simulated the time from triage to the decision for admission by a multidisciplinary department system. Results: A total of 89 patients were enrolled. The average time from triage to the admission decision was $5.2{\pm}7.1$ hours and the average length of the ED stay was $9.0{\pm}11.5$ hours. The rate of decision delay for admission was 31.5%. A multivariable regression analysis revealed that multiple trauma (odds ratio [OR]: 30.6, 95%; confidence interval [CI]: 3.18-294.71), emergency operation (OR: 0.55, 95%; CI: 0.01-0.96), and treatment in the Department of Neurosurgery (OR: 0.07, 95%; CI: 0.01-0.78) were significantly associated with the decision delay. In a simulation based on a multidisciplinary department system, the virtual time from triage to admission decision was $2.1{\pm}1.5$ hours. Conclusion: In the ED, patients with severe trauma, multiple trauma was a significant factor causing a delay in the admission decision. On the other hand, emergency operation and treatment in Department of Neurosurgery were negatively associated with the delay. The simulated time from triage to the decision for admission by a multidisciplinary department system was 3 hours shorter than the real one.

• 대한예방한의학회지
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• 제21권2호
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• pp.1-13
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• 2017

Objectives : This paper serves to explore current trends of systems biology in Traditional Chinese Medicine (TCM) and examine how it may influence the Traditional Korean medicine. Methods : Literature review method was collectively used to classify Introduction to systems biology, diagnosis and syndrome classification of systems biology in TCM perspective, physiotherapy including acupuncture, herbs and formula functions, TCM systems biology, and directions of academic development. Results : The term 'Systems biology' is coined as a combination of systems science and biology. It is a field of study that tries to understand living organism by establishing a theory based on an ideal model that analyzes and predicts the desired output with understanding of interrelationships and dynamics between variables. Systems biology has an integrated and multi-dimensional nature that observes the interaction among the elements constructing the network. The current state of systems biology in TCM is categorized into 4 parts: diagnosis and syndrome, physical therapy, herbs and formulas and academic development of TCM systems biology and its technology. Diagnosis and syndrome field is focusing on developing TCM into personalized medicine by clarifying Kidney yin deficiency patterns and metabolic differences among five patterns of diabetes and analyzing plasma metabolism and biomarkers of coronary heart disease patients. In the field of physical therapy such as acupuncture and moxibustion, researchers discovered the effect of stimulating acupoint ST40 on gene expression and the effects of acupuncture on treating functional dyspepsia and acute ischemic stroke. Herbs and formulas were analyzed with TCM network pharmacology. The therapeutic mechanisms of Si Wu Tang and its series formulas are explained by identifying potential active substances, targets and mechanism of action, including metabolic pathways of amino acid and fatty acid. For the academic development of TCM systems biology and its technology, it is necessary to integrate massive database, integrate pharmacokinetics and pharmacodynamics, as well as systems biology. It is also essential to establish a platform to maximize herbal treatment through accumulation of research data and diseases-specific, or drug-specific network combined with clinical experiences, and identify functions and roles of molecules in herbs and conduct animal-based studies within TCM frame. So far, few literature reviews exist for systems biology in traditional Korean medicine and they merely re-examine known efficacies of simple substances, herbs and formulas. For the future, it is necessary to identify specific mechanisms of working agents and targets to maximize the effects of traditional medicine modalities. Conclusions : Systems biology is widely accepted and studied in TCM and already advanced into a field known as 'TCM systems biology', which calls for the study of incorporating TCM and systems biology. It is time for traditional Korean medicine to acknowledge the importance of systems biology and present scientific basis of traditional medicine and establish the principles of diagnosis, prevention and treatment of diseases. By doing so, traditional Korean medicine would be innovated and further developed into a personalized medicine.

• Journal of Chest Surgery
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• 제46권5호
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• pp.340-345
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• 2013

Background: This study aims to evaluate whether or not the method of right vertical axillary minithoracotomy (RVAM) is preferable to and as reliable as conventional sternotomy surgery, and also assesses its cosmetic results. Methods: Thirty-three patients (7 males, 26 females) with atrial septal defect were admitted to the Cardiovascular Surgery Clinic of Cukurova University from December 2005 until January 2010. The patients' ages ranged from 3 to 22. Patients who underwent vertical axillary minithracotomy were assigned to group I, and those undergoing conventional sternotomy, to group II. Group I and group II were compared with regard to the preoperative, perioperative and postoperative variables. Group I included 12 females and 4 males with an average age of $16.5{\pm}9.7$. Group II comprised 14 female and 3 male patients with an average age of $18.5{\pm}9.8$ showing similar features and pathologies. The cases were in Class I-II according to the New York Heart Association (NYHA) Classification, and patients with other cardiac and systemic problems were not included in the study. The ratio of the systemic blood flow to the pulmonary blood flow (Qp/Qs) was $1.8{\pm}0.2$. The average pulmonary artery pressure was $35{\pm}10$ mmHg. Following the diagnosis, performing elective surgery was planned. Results: No significant difference was detected in the average time of the patients' extraportal circulation, cross-clamp and surgery (p>0.05). In the early postoperative period of the cases, the duration of mechanical ventilator support, the drainage volume in the first 24 hours, and the hospitalization time in the intensive care unit were similar (p>0.05). Postoperative pains were evaluated together with narcotic analgesics taken intravenously or orally. While 7 cases (43.7%) in group I needed postoperative analgesics, 12 cases (70.6%) in group II needed them. No mortality or major morbidity has occurred in the patients. The incision style and sizes in all of the patients undergoing RVAM were preserved as they were at the beginning. Furthermore, the patients of group I were mobilized more quickly than the patients of group II. The patients of group I were quite pleased with the psychological and cosmetic results. No residual defects have been found in the early postoperative period and after the end of the follow-up periods. All of the patients achieved functional capacity per NYHA. No deformation of breast growth has been detected during 18 months of follow-up for the group I patients, who underwent RVAM. Conclusion: To conclude, the repair of atrial septal defect by RVAM, apart from the limited working zone for the surgeon in these pathologies as compared to sternotomymay be considered in terms of the outcomes, and early and late complications. And this has accounted for less need of analgesics and better cosmetic results in recent years.

• 한국콘텐츠학회논문지
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• 제15권5호
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• pp.375-385
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• 2015

본 연구는 의사결정나무 분석을 활용하여 청소년의 우울 보호요인을 예측하여 우울 예방과 조기발견 및 중재 방안을 마련하고자 시도된 서술적 조사연구이다. 연구대상은 G광역시에 소재한 청소년 총 485명이고, 자료 수집은 2013년 9월 23일부터 9월 26일 사이에 이루어졌다. 자료 분석은 SPSS 20.0 프로그램을 이용하여 빈도, 백분율, 평균과 표준편차 및 ${\chi}^2$-test, t-test, 의사결정나무 분석으로 분석하였다. 본 연구 결과, 4개의 경로, 총 12노드가 구축되었고 가족 결속력, 부모 자녀간 의사소통과 또래와의 의사소통이 청소년 우울 보호요인이었다. 우울의 보호요인 예측 정확도에서 분석용은 특이도 76.0%, 민감도 65.4%이었고, 검정용은 특이도 78.2%, 민감도 63.7%이었으며, 전체 분류 정확도는 분석용 70.1%, 검정용 69.7%이었다. 이에 본 연구 결과가 학교와 지역사회에서 청소년 정신보건을 담당하는 전문가들에게 우울을 예방을 위한 프로그램 개발의 기초자료로 제공되고, 나아가 청소년들이 자신들의 목소리를 되찾고 힘차게 성장하기 위한 보호요인 강화를 위한 우울예방 정책 전략에 활용되기를 기대해 본다.

• 농촌의학ㆍ지역보건
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• 제40권2호
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• pp.72-79
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• 2015

본 연구는 HIV병 사망자 중 HIV병과 결핵이 동반사망한 분율을 조사하고 그 관련 요인을 분석하였다. 2002년부터 2010년까지 사이에 HIV병 사망자는 모두 774명으로 결핵이 동반사망한 분율은 10.1%로 나타났다. 그런데 이러한 분율은 2005년부터 2007년 사이에 16.3%까지 치솟았지만 2008년부터 2010년 사이에는 4%까지 감소하는 경향을 보였다. 또한 HIV-결핵 동반사망 분율은 젊은 계층에서 더 높았고 배우자가 있는 그룹과 교육을 잘 받은 그룹에서는 유의하게 낮은 경향을 보였다. 이처럼 활동성이 높은 젊은층에서 HIV-결핵 동반사망 분율이 높고 사회경제적 안정계층에서 HIV-결핵 동반사망 분율이 낮은 것은 비슷한 해외 연구에서도 유사하게 나타나고 있어 HIV-결핵 동반사망의 예방 가능성을 시사한다. 한국은 다행히 점차 HIV-결핵 동반사망 분율이 낮아지고 있어 HIV감염자에 대한 결핵 예방사업의 효과가 나타나고 있음을 시사하고 이후 이러한 지표의 지속적인 모니터링이 필요함을 보여주고 있다.

• 한국건축시공학회지
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• 제16권4호
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• pp.349-357
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• 2016

최근 건설프로젝트는 산업성장의 영향으로 대형화 복잡화 첨단화 되어 가며, 이로 인해 건설공사 리스크의 불확실 요소가 증가하고 있다. 이에 따라, 복잡해진 현대 건설 프로젝트에서 예측 및 대응할 수 없는 리스크 관리 방법에 관한 연구가 필요하다. 이에 본 연구는 A보험사의 클레임레코드를 토대로 실제 건설 공사 현장 내에 보상금 지급액 데이터를 수집하였으며, 사고원인 분석 및 회귀분석을 실시하였다. 사고원인 분석을 위해 본 연구에서는 공정률별, 계절별, 총공사금액별로 분류하고, 사고 빈도와 보상금 지급액으로 분석하여 리스크 중점관리요인을 도출하였다. 두 번째, 종속변수로 피해율을, 독립변수로 자연재해 위험도와 지리정보, 시공방법 및 능력, 프로젝트 규모로 분류하여 다중회귀분석을 실시하여, 총공사금액 대비 보상금 지급액에 대한 피해율 예측 모델을 개발하였다. 회귀분석 결과 45.5%의 설명력을 가진 피해율예측모델을 개발 및 검증하였다. 본 연구의 결과는 향후 건설 공사의 정량적인 리스크 분석 모델 개발 및 리스크 인자에 대한 검토를 위한 자료로 활용될 것이다.

• 전기전자학회논문지
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• 제21권4호
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• pp.388-396
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• 2017

얼굴 검출에는 다양한 포즈, 빛의 세기, 얼굴이 가려지는 현상 등의 많은 변수가 존재하므로, 높은 성능의 검출 시스템이 요구된다. 이에 영상 분류에 뛰어난 Convolutional Neural Network (CNN)이 적절하나, CNN의 많은 연산은 고성능 하드웨어 자원을 필요로한다. 그러나 얼굴 검출을 위한 소형, 모바일 시스템의 개발에는 저가의 저전력 환경이 필수적이고, 이를 위해 본 논문에서는 소형의 FPGA를 타겟으로, 얼굴 검출에 적절한 3-Stage Cascade CNN 구조를 기반으로하는 CPU-FPGA 통합 시스템을 설계 구현한다. 가속을 위해 알고리즘 단계에서 Adaptive Region of Interest (ROI)를 적용했으며, Adaptive ROI는 이전 프레임에 검출된 얼굴 영역 정보를 활용하여 CNN이 동작해야 할 횟수를 줄인다. CNN 연산 자체를 가속하기 위해서는 FPGA Accelerator를 이용한다. 가속기는 Bottleneck에 해당하는 Convolution 연산의 가속을 위해 FPGA 상에 다수의 FeatureMap을 한번에 읽어오고, Multiply-Accumulate (MAC) 연산을 병렬로 수행한다. 본 시스템은 Terasic사의 DE1-SoC 보드에서 ARM Cortex A-9와 Cyclone V FPGA를 이용하여 구현되었으며, HD ($1280{\times}720$)급 입력영상에 대해 30FPS로 실시간 동작하였다. CPU-FPGA 통합 시스템은 CPU만을 이용한 시스템 대비 8.5배의 전력 효율성을 보였다.

• 한국지리정보학회지
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• 제14권2호
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• pp.82-95
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• 2011

본 연구는 경상남도의 효율적인 빗물관리를 위해서 강우량, 증발산량, 표면유출량의 물순환 체계를 GIS 기반으로 분석하였다. 공간내삽법에 의한 강우량(1999~2008) 분포는 경상남도 남서부 해안지역의 하동군, 산청군, 사천시 등이 중동부 내륙지역의 창녕군, 밀양시, 창원시 등보다 많게 나타났다. 증발산량은 기온, 토지이용, 식생지수를 독립변수로 한 추정식으로 산출하였으며, 남해군이 평균 93.71mm로 가장 많았고, 진해시와 창원시가 각각 81.78mm와 84.37mm로 가장 적었다. 표면유출량은 SCS 수문학적 토양분류와 토지이용에 의한 산정식으로 분석하였으며, 하동군이 90.40mm로 가장 많았고, 거창군이 46.69mm로 가장 적게 나타났다. 이상의 GIS기반 물순환체계 분석결과는 경상남도의 효율적인 빗물관리를 위한 계획 및 정책마련의 기초자료로 활용될 수 있을 것으로 사료된다.

• Journal of Gastric Cancer
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• 제12권2호
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• pp.113-119
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• 2012

Purpose: The aim of this study is to compare the characteristics of tumor and prognosis, depending on the status of resection margin involvement, on the frozen section diagnosis in gastric cancer. Materials and Methods: This study was conducted retrospectively, in 83 margin-positive patients on the frozen section diagnosis, who underwent gastrectomy from July 1995 to September 2006. The control group was selected by matching the age, gender, TNM stage and status of adjuvant chemoradiotherapy, among those who had shown clear resection margins. The characteristics of tumor and patient survival are investigated, and they were analyzed between the two groups. Results: The tumor size was significantly larger in the study group than that of the control group (P=0.037). There was significant difference between the two groups in location of the tumors (P=0.003). Multivariate analysis indicated that only the location and Lauren's classification are independent factors, which affected the resection margin involvement. Median survival was $41.0{\pm}11.5$ months in the study group and $93.0{\pm}30.3$ months in the control group (P=0.049). In the survival analysis, it was investigated that TNM stage and the resection margin involvement of the frozen section diagnosis were the critical variables. Conclusions: When the tumor is located at the middle or the upper third, or the Lauren's indeterminate type, they are highly likely to show the resection margin involvement on the frozen section diagnosis, and it can, therefore, have negative effects on the prognosis. It is considered as good to perform more extensive resection as possible, during the initial resection.

• 한국치위생학회지
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• 제5권2호
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• pp.171-184
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• 2005

In order to investigate correlation between mother's dental ca re for her children and their dental caries, this study was conducted wi th the dental examination record of 365 children who showed the same number of questionnaires with those examined for dental conditions and questionnaires written by mothers among children between three and six years of age and their mothers in Yeoncheon, Gyeonggi province in June 2004 to estimate frequency and percentage of general properties of subjects and mother's oral health care behaviors for her children by research items, to carry out cross-tabulation analysis and correlation analysis following Chi-square distribution for the presence of dental caries in deciduous teeth and oral health care behaviors, and to use decision tree analysis among data mining techniques for those factors associated with the presence of dental caries in deciduous teeth, and drew the following conclusions. 1. For mother's oral health care behaviors and attitudes for her children, 225 mothers(61.6%) confirmed their children's teeth-brushing; 278(76.2%) used no fluorine; and 286(78.6%) observed their children's teeth, 322 mothers(88.2%) instructed their children in teeth-brushing while 268 (73.4%) provided dental care, 232 mothers(63.7%) treated their children's cavity; 290(79.4%) believed that their children had good dental conditions; and 294(80.5%) answered that they began to provide their children with dental care in deciduous teeth. 2. As for the presence of dental caries in deciduous teeth and dental health care behaviors, there were statistically significant differences in employment, confirmation after teeth-brushing, teeth observation, instruction in time for teeth-brushing, use of fluorine, cavity treatment, time for dental care, and perception of dental conditions(p<0.05). 3. As for correlation between dental caries in deciduous teeth and oral health care behaviors, mothers who worked, who believed that their children didn't have good dental condition, and who thought that it was necessary to begin to provide dental care in permanent teeth were found to get their children to suffer from dental caries in deciduous teeth. Besides, those who failed to confirm teeth-brushing, who used no fluorine, and who failed to observe teeth and gave no instruction in time for teeth-brushing were shown to get their children to suffer from dental caries in deciduous teeth. 4. Variables to determine the presence of dental caries in deciduous teeth were classified by cavity treatment, mother's employment, time for dental care, and observation of children's teeth. The first node to determine the presence of dental caries in deciduous teeth was found to be cavity treatment; the next criteria for classification after cavity treatment were shown to be mother's employment and time for dental care. In case of children with no cavity, they were found to be mother's employment and teeth observation.