• Journal of Yeungnam Medical Science
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• v.39 no.2
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• pp.124-132
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• 2022

Background: Despite recent advances in first-line chemotherapy for advanced pancreatic cancer, standard treatment after the failure of initial chemotherapy has not been established. Hence, we aimed to retrospectively analyze the clinical characteristics and outcomes of second-line chemotherapy in patients with advanced pancreatic cancer. Methods: We reviewed the clinical data of patients with advanced pancreatic cancer who underwent palliative chemotherapy at Kosin University Gospel Hospital between January 2013 and October 2020. Results: Among 366 patients with advanced pancreatic cancer who had received palliative chemotherapy, 104 (28.4%) underwent at least one cycle of second-line chemotherapy. The median age of the patients at the time of initiating second-line treatment was 62 years (interquartile range, 57-62 years), and 58.7% (61 patients) of them were male. The common second-line chemotherapy regimens were 5-fluorouracil (FU) plus leucovorin, irinotecan, and oxaliplatin (33 patients, 31.7%); gemcitabine/nab-paclitaxel (29, 27.9%), gemcitabine±erlotinib (13, 12.5%); and oxaliplatin and 5-FU/leucovorin (12, 11.5%). The median overall survival (OS) and progression-free survival were 6.4 months (95% confidence interval [CI], 4.5-8.6 months) and 4.5 months (95% CI, 2.7-6.3 months), respectively. In a multivariate analysis, poor performance status (PS) (hazard ratio [HR], 2.247; p=0.021), metastatic disease (HR, 2.745; p=0.011), and elevated carcinoembryonic antigen (CEA) levels (HR, 1.939; p=0.030) at the beginning of second-line chemotherapy were associated with poor OS. Conclusion: The survival outcome of second-line chemotherapy for advanced pancreatic cancer remains poor. However, PS, disease extent (locally advanced or metastatic), and CEA level may help determine patients who could benefit from second-line treatment.

• Journal of Gastric Cancer
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• v.22 no.1
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• pp.56-66
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• 2022

Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19-12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90-19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26-8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.

• Journal of the Society of Disaster Information
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• v.18 no.2
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• pp.395-404
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• 2022

Purpose: Small-scale construction sites have insufficient systematic safety management activities, and due to the characteristics of the construction site, the production structure is complex due to external environmental factors, and the risk of construction equipment is very high. We would like to propose a checklist method among practical risk assessment techniques that can derive risk factors for disaster prevention at small construction sites and reduce disasters. Method: Risk factors were derived by analyzing literature research and disaster cases, and detailed work for a checklist of risk assessment suitable for small-scale construction sites was classified based on risk factor items. Result: Hazard factors were divided into 6 major categories, and 29 detailed types of work were classified based on actual work types, and 80 detailed works were classified accordingly. Conclusion: By arranging risk factors suitable for small-scale construction sites according to the classification system, the lack of expertise in the construction site can be supplemented, and risk factors can be derived more easily and disaster reduction can be expected through establishment of safety measures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.5
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• pp.284-291
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• 2022

Objectives: This study aimed to analyze the clinicopathological prognostic factors affecting the survival of patients with oral squamous cell carcinoma (OSCC). Materials and Methods: A retrospective study was conducted on patients with OSCC who received treatment at the Oral Oncology Clinic of the National Cancer Center (NCC) from June 2001 to December 2020. The patients' sex, age, primary site, T stage, node metastasis, TNM staging, perineural invasion (PNI), lymphovascular invasion (LVI), differentiation, surgical resection margin, smoking, and drinking habits were investigated to analyze risk factors. For the univariate analysis, a Kaplan-Meier survival analysis and log-rank test were used. Additionally, for the multivariable analysis, a Cox proportional hazard model analysis was used. For both analyses, statistical significance was considered when P<0.05. Results: During the investigation period, 407 patients were received surgical treatment at the NCC. Their overall survival rate (OS) for five years was 70.7%, and the disease-free survival rate (DFS) was 60.6%. The multivariable analysis revealed that node metastasis, PNI, and differentiation were significantly associated with poor OS. For DFS, PNI and differentiation were associated with poor survival rates. Conclusion: In patients with OSCC, cervical node metastasis, PNI, and differentiation should be considered important prognostic factors for postoperative survival.

• Journal of The Korean Society of Agricultural Engineers
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• v.63 no.3
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• pp.13-26
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• 2021

Recent drought events in the South Korea and the magnitude of drought losses indicate the continuing vulnerability of the agricultural drought. Various studies have been performed on drought hazard assessment at the regional scales, but until recently, drought management has been response oriented with little attention to mitigation and preparedness. A vulnerability assessment is introduced in order to preemptively respond to agricultural drought and to predict the occurrence of drought. This paper presents a method for spatial, Geographic Information Systems-based assessment of agricultural drought vulnerability in South Korea. It was hypothesized that the key 14 items that define agricultural drought vulnerability were meteorological, agricultural reservoir, social, and adaptability factors. Also, this study is to analyze agricultural drought vulnerability by comparing vulnerability assessment according to weighting method. The weight of the evaluation elements is expressed through the Analytic Hierarchy Process (AHP), which includes subjective elements such as surveys, and the Entropy method using attribute information of the evaluation items. The agricultural drought vulnerability map was created through development of a numerical weighting scheme to evaluate the drought potential of the classes within each factor. This vulnerability assessment is calculated the vulnerability index based on the weight, and analyze the vulnerable map from 2015 to 2019. The identification of agricultural drought vulnerability is an essential step in addressing the issue of drought vulnerability in the South Korea and can lead to mitigation-oriented drought management and supports government policymaking.

• Safety and Health at Work
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• v.11 no.4
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• pp.543-549
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• 2020

Background: The working conditions of bus drivers are difficult; they lead to occupational diseases and require careful study, particularly in Ukraine. The objective of the article is the description of occupational health risks of passenger bus drivers that lead to deteriorating health. Methods: The risk assessment was performed using a modified Risk Score method, which allowed determining the generalized level of danger to the driver's health. The hygienic hazards level was assessed as based on Stevenson's law, which was generalized later. Results: Based on the modification of the Risk Score method, it was possible to depart from expert assessments method of the risk level and calculate the general indicator based on the degree of dependence of the impact on the human body on its intensity, proposed by V. Minko. This allows objective determining of the impact of hygiene hazards on the health of the driver and to predict the occurrence of occupational diseases associated with the cardiovascular system, musculoskeletal system, and partial or complete disability due to the accumulation of emotional fatigue. The hazard assessment was carried out for three brands of passenger buses common in Ukraine, in which the driver is exposed to the dangers of fever, vibration, noise, harmful impurities in the bus cabin, and emotional load. Conclusion: The health of drivers in the cabins of passenger buses is most affected by hygiene hazards: fever, vibration, and emotional stress. The generalized level of risk is calculated by the modified method of Risk Score is 0.83; -0.99, -0.92 respectively.

• Journal of Korean Neurosurgical Society
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• v.64 no.3
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• pp.460-468
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• 2021

Objective : Extremely low alanine transaminase (ALT) levels are associated with all-cause mortality in frail elderly individuals; the clinical significance of ALT as a reliable biomarker is now being considered. Predicting mortality with routine tests at the time of diagnosis is important for managing patients after intracranial hemorrhage. We aimed to investigate whether an extremely low ALT level is associated with mortality in the elderly after intracranial hemorrhage. Methods : A retrospective review was performed on 455 patients with intracranial hemorrhage admitted to a university-affiliated tertiary care hospital from February 2014 to May 2019. Multivariate Cox regression analysis was performed for all ages and for each age group to determine whether an extremely low ALT level is an independent predictor of mortality only in the elderly. Results : Overall, 294 patients were enrolled, and the mean age of the subjects was 59.1 years, with 99 (33.8%) aged ≥65 years. The variables associated with all-cause mortality in all subjects were age, C-reactive protein (CRP) levels, hemoglobin (Hb) levels (<11 g/dL), and initial Glasgow coma scale (GCS) scores. In young patients, CRP, low Hb levels, and initial GCS scores were significantly associated with all-cause mortality. However, in the elderly (≥65 years), the variables significantly associated with all-cause mortality were extremely low levels of ALT (<10 U/L) (adjusted hazard ratio, 3.313; 95% confidence interval, 1.232-8.909; p=0.018) and initial GCS scores. Conclusion : Extremely low ALT level (<10 U/L) at the time of diagnosis is a significant risk factor for all-cause mortality in the elderly after intracranial hemorrhage.

• Journal of Chest Surgery
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• v.55 no.3
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• pp.189-196
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• 2022

Background: This study investigated the predictive value of the frailty index calculated using laboratory data and vital signs (FI-L) in patients who underwent coronary artery bypass grafting (CABG). Methods: This study included 508 patients (age 67.3±9.7 years, male 78.0%) who underwent CABG between 2018 and 2021. The FI-L, which estimates patients' frailty based on laboratory data and vital signs, was calculated as the ratio of variables outside the normal range for 32 preoperative parameters. The primary endpoints were operative and medium-term all-cause mortality. The secondary endpoints were early postoperative complications and major adverse cardiac and cerebrovascular events (MACCEs). Results: The mean FI-L was 20.9%±10.9%. The early mortality rate was 1.6% (n=8). Postoperative complications were atrial fibrillation (n=148, 29.1%), respiratory complications (n=38, 7.5%), and acute kidney injury (n=15, 3.0%). The 1- and 3-year survival rates were 96.0% and 88.7%, and the 1- and 3-year cumulative incidence rates of MACCEs were 4.87% and 8.98%. In multivariable analyses, the FI-L showed statistically significant associations with medium-term all-cause mortality (hazard ratio [HR], 1.042; 95% confidence interval [CI], 1.010-1.076), MACCEs (subdistribution HR, 1.054; 95% CI, 1.030-1.078), atrial fibrillation (odds ratio [OR], 1.02; 95% CI, 1.002-1.039), acute kidney injury (OR, 1.06; 95% CI, 1.014-1.108), and re-operation for bleeding (OR, 1.09; 95% CI, 1.032-1.152). The minimal p-value approach showed that 32% was the best cutoff for the FI-L as a predictor of all-cause mortality post-CABG. Conclusion: The FI-L was a significant prognostic factor related to all-cause mortality and postoperative complications in patients who underwent CABG.

• Safety and Health at Work
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• v.12 no.4
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• pp.496-504
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• 2021

Background: With the increasing demand for industrial robots and the "noncontact" trend, it is an appropriate point in time to examine whether risk assessments conducted for robot operations are performed effectively to identify and eliminate the risks of injury or harm to operators. This study discusses why robot accidents resulting in harm to operators occur repetitively despite implementing control measures and proposes corrective actions for risk assessments. Methods: This study collected 369 operator-injured robot accidents in Korea over the last decade and reconstructed them into the mechanism of injury, work being undertaken, and bodily location of the injury. Then, through the techniques of Systematic Cause Analysis Technique (SCAT) and Root Cause Analysis (RCA), this study analyzed the root and direct causes of robot accidents that had occurred. Causes identified included physical hazards and complex combinations of hazards, such as psychological, organizational, and systematic errors. The requirements of risk assessments regarding robot operations were examined, and three case studies of robot-involved tasks were investigated. The three assessments presented were: camera module processing, electrical discharge machining, and a panel-flipping robot installation. Results: After conducting RCA and comparing the three assessments, it was found that two-thirds of injury-occurring from robot accidents, causative factors included psychological and personal traits of robot operators. However, there were no evaluations of the identifications of personal aspects in the three assessment cases. Conclusion: Therefore, it was concluded that personal factors of operators, which had been overlooked in risk assessments so far, need to be included in future risk assessments on robot operations.

• The Journal of the Convergence on Culture Technology
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• v.7 no.4
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• pp.163-170
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• 2021

The purpose of this study is to identify the harmful factors of teacher's job stress and occupational-related musculoskeletal diseases, and to investigate according to job types to seek solutions and improvement measures for removing harmful factors. A total of 168 elementary and high school teachers in Seoul were surveyed. As a result, the average RULA score of the teacher was 4.2 points, and the average RULA score of the teacher who did not complain of musculoskeletal diseases was 4.3 points. In addition, the average job stress score of the teacher was 58.9 points, and the stress score by factor was in the order of student guidance, work burden, loss of authority, organizational structure and curriculum, treatment and welfare, human relations. As a result of analyzing the teacher's RULA score and job stress, it was possible to derive a correlation between musculoskeletal disorders and job stress caused by occupation.