• Journal of Gastric Cancer
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• 제20권3호
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• pp.267-276
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• 2020

Purpose: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator is useful in predicting postoperative adverse events. However, its accuracy in specific disorders is unclear. We validated the ACS NSQIP risk calculator in patients with gastric cancer undergoing curative laparoscopic surgery. Materials and Methods: We included 207 consecutive early gastric cancer patients who underwent laparoscopic gastrectomy between January 2018 and January 2019. The preoperative characteristics and risks of the patients were reviewed and entered into the ACS NSQIP calculator. The estimated risks of postoperative outcomes were compared with the observed outcomes using C-statistics and Brier scores. Results: Most of the patients underwent distal gastrectomy with Roux-en-Y reconstruction (74.4%). We did not observe any cases of mortality, venous thromboembolism, urinary tract infection, renal failure, or cardiac complications. The other outcomes assessed were complications such as pneumonia, surgical site infections, any complications requiring re-operation or hospital readmission, the rates of discharge to nursing homes/rehabilitation centers, and the length of stay. All C-statistics were <0 and the highest was for pneumonia (0.65; 95% confidence interval: 0.58-0.71). Brier scores ranged from 0.01 for pneumonia to 0.155 for other complications. Overall, the risk calculator was inconsistent in predicting the outcomes. Conclusions: The ACS NSQIP surgical risk calculator showed low predictive ability for postoperative adverse events after laparoscopic gastrectomy for patients with early gastric cancer. Further research to adjust the risk calculator for these patients may improve its predictive ability.

• 한국학교보건학회지
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• 제15권2호
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• pp.233-248
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• 2002

Purpose : Sexual abuse especially in younger group have been growing. This study was performed to propose the fundamental data for developing early education program to prevent damage from sexual harassment in elementary school students. Method : Questionnaire survey on cognitions and experiences about sexual harassment was done on 3125 elementary school students from seven elementary schools in Busan area from January to March, 2002. Data analysis was done with SPSS (ver 10.0). Results : Though 82% of the students have ever herd about sexual harassment previously, but self assessment of 'well-known' was only 5%. About 40% of them have ever experienced audio-visual sexual materials mainly through PC (18%), media (14%), etc. And, 60% of them have ever educated about sexual harassment. In cognitions, they agreed 'unwanted touch', 'intentional showing his (her) own body', 'send lewd mails and pictures', but disagreed 'ask massage from aged', 'gaudy joke' as one of sexual harassment. In attitudes, 'no response', 'defense with friends and family', 'express unpleasantness apparently' were desirable pattern, instead, 'his (her) own responsibility', 'problem only between person concerned', 'neglect is the best way' were undesirable. About 24% of them have ever experienced at least one of the fifteen types of sexual harassment with major types of lewd mails pictures (11%), hugging (5%), ask massage (4.7%) and unwanted touch (3.3%). The experience by gender was higher in girls (25.0%) than boys (22.4%) with no statistical significance. The mean level of cognition and attitude out of one hundred was $70.3{\pm}28.1$ and $73.5{\pm}15.9$, respectively. The mean frequency of experience was $0.4{\pm}1.1$ times. The level of cognition and attitude was higher in girls, 6th graders, and in ever educated group (p<0.001). Conclusions : The cognition level of elementary school students about sexual harassment assessed considerable. And, they also experienced several types of sexual harassment, though not too much. Therefore, compatible education program let them able to protect themselves from sexual harassment should be developed and applied even in early school age.

• Asian Journal for Public Opinion Research
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• 제4권1호
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• pp.51-72
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• 2016

Background: Adolescent mothers may find the transition to motherhood to be overwhelming when compared to adult mothers. The adaptiveness of mother and infant feeding behaviors may greatly influence the quality of adolescent mothers' feeding interactions when compared to adult mothers. Purpose: To examine the adaptiveness of early maternal and infant feeding behavior between adolescent mothers and adult mothers. Method: In this secondary analysis, six adolescent mothers (< 20 years old) and six adult mothers were videotaped while feeding. The mothers were observed 3 times: when the infants were in the hospital, 1 month old, and 4 months old. The videotapes were coded using four scales of the Parent-Child Early Relational Assessment (PCERA). The two maternal scales were Positive Affective Involvement and Sensitivity/Responsiveness (PAISR) and Regulation of Affect and Behavior (RAB). The two infant scales were Infant Positive Affect, Communication, and Social Skills (IPACS) and Infant Regulation of Affect and Behavior (IRAB). The dyads were videotaped just before hospital discharge and at one and four months corrected age. The Wilcoxon signed-rank test was used to examine the difference in the PCERA between the two groups. Results: Adolescent mothers had a significantly lower score on the PAISR before hospital discharge (p-value 0.005) and at one month corrected age (p-value 0.008) than adult mothers. Adolescent mothers also had a significantly lower score on the RAB before hospital discharge, 1 and 4 months corrected age than adult mothers. There were no significant differences in IPACS and IRAB of infants of adolescent and adult mothers. Conclusion: Clinicians need to be aware of the differences in sensitivity that occur.

• Safety and Health at Work
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• 제11권3호
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• pp.275-283
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• 2020

Background: In the absence of a vaccine or treatment, the most pragmatic strategies against an infectious disease pandemic are extensive early detection testing and social distancing. This study aimed to summarize public and workplace responses to Coronavirus Disease-19 (COVID-19) and show how the Korean system has operated during the COVID-19 pandemic. Method: Daily briefings from the Korean Center for Disease Control and the Central Disaster Management Headquarters were assembled from January 20 to May 15, 2020. Results: By May 15, 2020, 11,018 COVID-19 cases were identified, of which 15.7% occurred in workplaces such as health-care facilities, call centers, sports clubs, coin karaoke, and nightlife destinations. When the first confirmed case was diagnosed, the Korean Center for Disease Control and Central Disaster Management Headquarters responded quickly, emphasizing early detection with numerous tests and a social distancing policy. This slowed the spread of infection without intensive containment, shut down, or mitigation interventions. After entering the public health blue alert level, a business continuity plan was distributed. After entering the orange level, the Ministry of Employment and Labor developed workplace guidelines for COVID-19 consisting of social distancing, flexible working schedules, early identification of workers with suspected infections, and disinfection of workplaces. Owing to the intensive workplace social distancing policy, workplaces remained safe with only small sporadic group infections. Conclusion: The workplace social distancing policy with timely implementation of specific guidelines was a key to preventing a large outbreak of COVID-19 in Korean workplaces. However, sporadic incidents of COVID-19 are still ongoing, and risk assessment in vulnerable workplaces should be continued.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1665-1667
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• 2013

Background: Ten to 30% of early breast cancer (EBC) patients develop brain metastasis (BM) during their follow-up. In this study, we aimed to evaluate importance of the lymph node ratio (LNR) in development of BM in EBC cases. Materials and Methods: Ninety patients whom had axillary metastases in lymph nodes at their initial diagnosis and developed BM during 5-year follow-up were detected in 950 EBC patients. LNR values were calculated for all patients and after categorization into 4 molecular sub-types as luminal A, luminal B HER-2 (+), HER-2 overexpressing and basal- like. Comparison was with control group patients who had similar characteristics. Results: In the comparison of all molecular sub-types of LNR, 54.9% and 28.4% values were found in patients with and without BM respectively (p<0.001). In the comparison of the LNR with control groups, a statistically significant differences were found with luminal A with BM (p=0.001), luminal B HER-2 (p=0.001), HER-2 overexpressing (p=0.027) and basal-like groups (p<0.001). In the evaluation of patients with BM, the highest ratio was found in the basal-like group (67.9%) and there was a statistically significant difference between this group and the others (p=0.048). Conclusions: EBC patients developing BM within 5 years follow-up had significantly higher LNRs for all molecular sub-types, especially in the basal-like group. Larger scale studies are now needed for evaluating LNR prognostic importance for EBC regarding BM development.

• 대한장애인치과학회지
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• 제7권1호
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• pp.15-20
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• 2011

뇌병변장애인은 뇌성마비, 외상성 뇌손상, 뇌졸중 등 뇌의 기질적 병변에 기인한 신체적 장애로 보행 또는 일상생활의 동작 등에 상당한 제한을 받는 사람으로 정의된다. 최근에 뇌병변 장애아동의 DMFT는 비 장애아동과 유사하거나 낮다는 연구가 있었다. 그러나, 본 증례는 중증유아기우식증이 나타난 뇌병변장애 1급 아동들을 치료한 것으로, 아동들의 공통점을 통해 중증유아기우식 우식증의 특별한 원인을 찾고자 하였다. 뇌병변으로 인한 일차적인 운동장애와 이차적인 치과치료를 받기 어려울 정도의 쇠약함, 잦은 입원, 당분이 많은 음식과 약물의 섭취, 구강위생관리 소홀, 늦은 치과 내원, 협조도 저하 등이 우식 유발인자를 높이고, 우식 예방인자를 낮추어 치아우식증을 유발할 수 있는 것으로 사료되었다. 뇌병변 장애아동을 치료할 때, 치과의사는 개인적인 우식 위험도 평가를 통해 철저한 우식 예방프로그램을 만들고, 부모와 의학적 주치의는 구강관리의 중요성을 인식하여 조기 치과 내원 및 홈케어에 신경을 써야 할 것이다.

• 대한간호학회지
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• 제50권2호
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• pp.210-227
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• 2020

Purpose: This study aimed to develop a scale to measure variables related to alcohol drinking prevention behavior in early elementary school, based on the theory of planned behavior. Methods: A scale was developed to measure variables related to alcohol drinking prevention behavior. Initial items for direct evaluation were constructed through a literature review, and those for belief-based indirect measure were generated through interviews with 30 second- and third-grade elementary school students. The collected data from 286 third-grade elementary school students were then subjected to item analysis, exploratory and confirmative factor analysis, criterion-related validity testing, and internal consistency assessment. Results: The final scale consisted of 35 items. Intention, attitudes, subjective norms, and perceived behavioral control explained 82.7% of the variance; behavioral beliefs, normative beliefs, and control beliefs explained 65.6% of the variance; and evaluation of outcome, motivation to comply, and power of control beliefs explained 72.8% of the variance. The confirmatory factor analysis indicated that the theoretical models had a satisfactory goodness of fit. Criterion-related validity was confirmed between the direct evaluation variables and the indirect measure variables (attitudes r=.64, p<.001; subjective norms r=.39, p<.001; perceived behavioral control r=.62, p<.001). Cronbach's α was .89 for the direct evaluation variables and .93 for the indirect measure variables. Conclusion: The scale developed in this study is valid and reliable. It could be used to measure and explain variables related to alcohol drinking prevention behavior in early elementary school.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권3호
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• pp.276-285
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• 2020

Purpose: Non-alcoholic fatty liver disease (NAFLD) ranges in severity from simple steatosis to steatohepatitis. Early detection of NAFLD is important for preventing the disease from progressing to become an irreversible end-stage liver disease. We developed a nomogram that allows for non-invasive screening for NAFLD in obese children. Methods: Anthropometric and laboratory data of 180 patients from our pediatric obesity clinic were collected. Diagnoses of NAFLD were based on abdominal ultrasonographic findings. The nomogram was constructed using predictors from a multivariate analysis of NAFLD risk factors. Results: The subjects were divided into non-NAFLD (n=67) and NAFLD groups (n=113). Factors, including sex, body mass index, abdominal circumference, blood pressure, insulin resistance, and levels of aspartate aminotransferase, alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γGT), uric acid, triglycerides, and insulin, were significantly different between the two groups (all p<0.05) as determined using homeostatis model assessment of insulin resistance (HOMA-IR). In our multivariate logistic regression analysis, elevated serum ALT, γGT, and triglyceride levels were significantly related to NAFLD development. The nomogram was established using γGT, uric acid, triglycerides, HOMA-IR, and ALT as predictors of NAFLD probability. Conclusion: The newly developed nomogram may help predict NAFLD risk in obese children. The nomogram may also allow for early NAFLD diagnosis without the need for invasive liver biopsy or expensive liver imaging, and may also allow clinicians to intervene early to prevent the progression of NAFLD to become a more advanced liver disease.

• 한국전문물리치료학회지
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• 제13권1호
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• pp.38-46
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• 2006

The purposes of this study were to investigate the median frequency (MDF) between initiation and termination of muscle contraction through surface electromyographic (sEMG) analysis and to propose the basis of clinical treatment for movement problems in early hemiparetic upper limbs. Thirteen patients who had stroke with onset less than 3 months prior to the study and seven control subjects participated in the study. The median frequency in initiation and termination of muscle contraction was recorded from wrist flexor and extensor muscles using the sEMG, with 3 second beeper signals, during maximal isometric wrist flexion and extension. Flexion and extension must be done as quickly and forcefully as possible. The results of the study were as follows: 1. The MDF of the onset and offset sections were significantly lower on the paretic than the nonparetic and control sides. 2. The MDF of the offset section significantly decreased on the paretic and nonparetic sides. Consequently, this study showed that the lowering of the MDF was due to the hemiparetic wrist motor impairment and muscle weakness. These results are also related to Fugl-Meyer motor assessment (FMA) scores in hemiparetic upper limbs. This study also suggests that since muscle weakness of early stroke patients affects the functional decrease of upper limbs, further studies must focus on the treatment to improve muscle agility and muscle fiber recruitment efficiency that can induce the functional recovery correlated to motor control.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.711-714
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• 2011

Purpose: Angiosarcoma is a rare malignant neoplasm of endothelial type cells that line vessel walls. It tends to occur in aged male and the prognosis of angiosarcoma is very poor because of frequent local recurrence and early metastasis. The treatment regimen is yet to be established from its rare occurrence but the wide excision in early stage is known to be the most effective. The authors report two cases of near totally excised angiosarcoma with more than a safety margin of 5 cm. Methods: The two subjects were aged male patients, one of the two was diagnosed with angiosarcoma from our institution confirmed by the biopsy. The other one went through the wide excision with a safety margin of 2 cm and split-thickness skin graft but local recurrence was observed. The two patients underwent near total excision with more than a safety margin of 5 cm, leaving only the periosteum. After confirming that the angiosarcoma had not infiltrated the excision margin, reconstruction with split-thickness skin graft was performed. Results: Based on 6 months and 24 months post-surgery assessment, no local recurrence or remote metastasis in the lungs, liver, bones, and lymph nodes at the neck, where remote metastasis is common, was reported by the two subjects who underwent near total excision with a safety margin of 5 cm. Conclusion: Angiosarcoma has very poor prognosis from its frequent recurrence and metastasis. To enhance the survival rate of angiosarcoma patients, early diagnosis, timely surgical treatment, and radiotherapy after surgery are critical. In addition, authors suggest that it is necessary to further study the efficacy of wide excision using a wider safety margin as much as possible, and to apply this to more cases.