• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.89-95
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• 2021

Lung cancer is one of the leading causes of cancer-related deaths in Korea. Although the smoking rate has decreased over time, the prevalence of lung cancer still remains high. In this study, we reviewed recent trends on the incidence, epidemiology, screening, diagnosis, and treatment of lung cancer in Korea by analyzing data from the national lung cancer registry and recently-published studies. Although approximately 40% of patients with non-small cell lung cancer (NSCLC) were diagnosed as stage IV, the 5-year relative survival rate improved from 11.3% (1993-1995) to 30.2% (2013-2017), possibly due to advances in methods of diagnosis and therapy. In addition, the 2019 implementation of the national lung cancer screening program with low-dose computed tomography may have also contributed to these improvements in survival rates. Recently, molecular diagnosis has become more widely used in the identification of genetic mutations in tissue specimens. Target therapy and immune checkpoint inhibitors have also been successfully used, particularly in cases of advanced NSCLC. In the future, further research on the optimal management of lung cancer remains necessary.

• Wind and Structures
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• 제32권2호
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• pp.127-142
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• 2021

Wind load acting on a standalone structure is different from that acting on a similar structure which is surrounded by other structures in close proximity. The presence of other structures in the surrounding can change the wind flow regime around the principal structure and thus causing variation in wind loads compared to a standalone case. This variation on wind loads termed as interference effect depends on several factors like terrain category, geometry of the structure, orientation, wind incident angle, interfering distances etc., In the present study, a three building configuration is considered and the mean pressure coefficients on each face of principle building are determined in presence of two interfering buildings. Generally, wind loads on interfering buildings are determined from wind tunnel experiments. Computational fluid dynamic studies are being increasingly used to determine the wind loads recently. Whereas, wind tunnel tests are very expensive, the CFD simulation requires high computational cost and time. In this scenario, Artificial Neural Network (ANN) technique and Support Vector Regression (SVR) can be explored as alternative tools to study wind loads on structures. The present study uses these data-driven approaches to predict mean pressure coefficients on each face of principle building. Three typical arrangements of three building configuration viz. L shape, V shape and mirror of L shape arrangement are considered with varying interfering distances and wind incidence angles. Mean pressure coefficients (Cp mean) are predicted for 45 degrees wind incidence angle through ANN and SVR. Further, the critical faces of principal building, critical interfering distances and building arrangement which are more prone to wind loads are identified through this study. Among three types of building arrangements considered, a maximum of 3.9 times reduction in Cp mean values are noticed under Case B (V shape) building arrangement with 2.5B interfering distance. Effect of interfering distance and building arrangement on suction pressure on building faces has also been studied. Accordingly, Case C (mirror of L shape) building arrangement at a wind angle of 45º shows less suction pressure. Through this study, it was also observed that the increase of interfering distance may increase the suction pressure for all the cases of building configurations considered.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.11-17
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• 2022

Background: In asthma, consistent control of chronic airway inflammation is crucial, and the use of asthma-controller medication has been emphasized. Our purpose in this study is to compare the incidence of acute exacerbation and healthcare costs related to the use of asthma-controller medication. Methods: By using data collected by the National Health Insurance Review and Assessment Service, we compared one-year clinical outcomes and medical costs from July 2014 to June 2015 (follow-up period) between two groups of patients with asthma who received different prescriptions for recommended asthma-controller medication (inhaled corticosteroids or leukotriene receptor antagonists) at least once from July 2013 to June 2014 (assessment period). Results: There were 51,757 patients who satisfied our inclusion criteria. Among them, 13,702 patients (26.5%) were prescribed a recommended asthma-controller medication during the assessment period. In patients using a recommended asthma-controller medication, the frequency of acute exacerbations decreased in the follow-up period, from 2.7% to 1.1%. The total medical costs of the controller group decreased during the follow-up period compared to the assessment period, from $3,772,692 to $1,985,475. Only 50.9% of patients in the controller group used healthcare services in the follow-up period, and the use of asthma-controller medication decreased in the follow-up period. Conclusion: Overall, patients using a recommended asthma-controller medication showed decreased acute exacerbation and reduced total healthcare cost by half.

• 중환자간호학회지
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• 제15권3호
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• pp.75-87
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• 2022

Purpose : This retrospective investigation study aimed to determine the predictive validity of superficial surgical site infection assessment tools by measuring the risk score at the surgical site. Methods : This study included patients hospitalized to the general surgery department of a Hospital from January 2021 to December 31, 2021. The inclusion criteria were age ≥19 years, general abdominal surgery under general anesthesia, and hospital stay longer than 2 days. Patients who had undergone transplantation were excluded. Results : Tool validity results showed that tools including surgical time and operative procedure were more accurate than previously developed tools, with a sensitivity of 71.1%, specificity of 71.4%, positive prediction of 12.3%, negative prediction of 97.8%, and area under the curve of 0.743 (95% confidence interval, 0.678~0.745). The tool's cut-off score was 15, and the risks of infection was increased by 6.14 times at or above this cut-off point. Preoperative hair removal period, surgical wound classification, surgery time, body temperature on the second day after surgery, drainage tube type, and suture type affected the risk of infection at the surgical site. Conclusion : The incidence of healthcare-associated infections has been declining in the past decade; however, surgical site infections still account for a considerable proportion. Therefore, early identification of high-risk groups for surgical site infection is crucial for reducing the incidence of surgical site infection using appropriate management.

• Tuberculosis and Respiratory Diseases
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• 제48권1호
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• pp.67-71
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• 2000

문맥고혈압에 동반된 폐고혈압은 비교적 드문 질환으로 1951년 Mantz와 Craig가 처음 보고한 후 꾸준히 보고되고 있으나 국내엔 아직 보고된 바가 없다. 최근 간경변증으로 인한 복수와 호흡곤란을 주소로 내원한 49세 여자 환자에서 폐고혈압이 동반되어 있었던 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Trauma and Injury
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• 제34권3호
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• pp.155-161
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• 2021

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has necessitated a redistribution of resources to meet hospitals' service needs. This study investigated the impact of COVID-19 on a regional trauma center in South Korea. Methods: We retrospectively reviewed cases of polytrauma at a single regional trauma center in South Korea between January 20 and September 30, 2020 (the COVID-19 period) and compared them to cases reported during the same time frame (January 20 to September 30) between 2016 and 2019 (the pre-COVID-19 period). The primary outcome was in-hospital mortality, and secondary outcomes included the number of daily admissions, hospital length of stay (LOS), and intensive care unit (ICU) LOS. Results: The mean number of daily admissions decreased by 15% during the COVID-19 period (4.0±2.0 vs. 4.7±2.2, p=0.010). There was no difference in mechanisms of injury between the two periods. For patients admitted during the COVID-19 period, the hospital LOS was significantly shorter (10 days [interquartile range (IQR) 4-19 days] vs. 16 days [IQR 8-28 days], p<0.001); however, no significant differences in ICU LOS and mortality were found. Conclusions: The observations at Regional Trauma Center, Pusan National University Hospital corroborate anecdotal reports that there has been a decline in the number of patients admitted to hospitals during the COVID-19 period. In addition, patients admitted during the COVID-19 pandemic had a significantly shorter hospital LOS than those admitted before the COVID-19 pandemic. These preliminary data warrant validation in larger, multi-center studies.

• Tuberculosis and Respiratory Diseases
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• 제79권4호
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• pp.214-233
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• 2016

There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.

• 한국경영과학회지
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• 제23권4호
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• pp.87-96
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• 1998

Using the concept of cellular manufacturing systems(CMS) in job shop manufacturing system is one of the most innovative approaches to improving plant productivity. However. several constraints in machine duplication cost, machining capability, cell space capacity, intercell moves and exceptional elements(EEs) are main problems that prevent achieving the goal of maintaining an ideal CMS environment. Minimizing intercell part traffics and EEs are the main objective of the cell formation problem because it is a critical point that improving production efficiency. Because the intercell moves could be changed according to the sequence of operation, it should be considered in assigning parts and machines to machine ceil. This paper presents a method that eliminates EEs under the constraints of machine duplication cost and ceil space capacity attaining two goals of minimizing machine duplications and minimizing intercell moves simultaneously. Developing an algorithm that calculates the machine duplications by cell-machine incidence matrix and part-machine Incidence matrix, and calculates the exact intercell moves considering the sequence of operation. Based on the number of machine duplications and exact intercell moves, the goal programming model which satisfying minimum machine duplications and minimum intercell moves is developed. A linear programming model is suggested that could calculates more effectively without damaging optimal solution. A numerical example is provided to illustrate these methods.

• Journal of Korean Neurosurgical Society
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• 제41권4호
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• pp.217-223
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• 2007

Objective : The apparent increase in the incidence of the intracranial meningiomas in the elderly is due in part to improved diagnostic tools and improved span of life. The authors carried out a retrospect study to validate the use of the Clinical-Radiological Grading System [CRGS] as a clinical tool to orientate surgical decision making in elderly patients and to explore prognostic factors of survival. Methods : From January 1997 to January 2006, the authors consecutively recruited and surgically treated 20 patients older than 65 years of age with radiologic findings of intracranial meningiomas and a preoperative evaluation based on the CRGS. Results : High CRGS score was associated with a higher probability of good outcome [p=0.004] and a lower probability of postoperative complications [p=0.049]. Among the different subset items of the CRGS score, larger maximum tumor diameters [$D{\geqq}4cm$] and the presence of a severe peritumoral edema were associated with incidence rate of postoperative poor outcome and complications [p<0.05]. Additionally, the critical location of the tumor was also correlated with poor outcome [p<0.05]. Conclusion : A CRGS score higher than 13 is a good prognostic indication of survival. The CRGS score is a useful and practical tool for the selection of elderly patients affected by intracranial meningiomas as surgical candidates.

• 한국경영과학회:학술대회논문집
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• 한국경영과학회 1998년도 추계학술대회 논문집
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• pp.263-266
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• 1998

Several constraints in machine duplication cost, machining capability, cell space capacity, intercell moves and exceptional elements(EEs) are main problems that prevent achieving the goal of ideal Cellular Manufacturin System (CMS) environment. Minimizing intercell part traffics and EEs are the main objective of the cell formation problem as it's a critical point that improving production efficiency. Because the intercell moves could be changed according to the sequence of operation, it should be considered in assigning parts and machines to machine cells. This paper presents a method that eliminates EEs under the constraints of machine duplication cost and cell space capacity attaining two goals of minimizing machine duplications and minimizing intercell moves simultaneously. Developing an algorithm that calculates the machine duplications by cell-machine incidence matrix and part-machine incidence matrix, and calculates the exact intercell moves considering the sequence of operation. Based on the number of machine duplications and exact intercell moves, the goal programming model which satisfying minimum machine duplications and minimum intercell moves is developed. A linear programming model is suggested that could calculates more effectively without damaging optimal solution. A numerical example is provided to illustrate these methods.