• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.2
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• pp.159-167
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• 2022

Backgrounds/Aims: The optimal timing of percutaneous transhepatic gallbladder drainage (PTGBD) and subsequent laparoscopic cholecystectomy (LC) according to the severity of acute cholecystitis (AC) has not been established yet. Methods: This single-center, retrospective study included 695 patients with grade I or II AC without common bile duct stones who underwent PTGBD and subsequent LC between January 2010 and December 2019. Difficult surgery (DS) (open conversion, subtotal cholecystectomy, adjacent organ injury, transfusion, operation time ≥ 90 minutes, or estimated blood loss ≥ 100 mL) and poor postoperative outcome (PPO) (postoperative hospital stay ≥ 7 days or Clavien-Dindo grade ≥ II postoperative complication) were defined to comprehensively evaluate intraoperative and postoperative outcomes, respectively. Results: Of 695 patients, 403 had grade I AC and 292 had grade II AC. According to the receiver operating characteristic curve and multivariate logistic regression analyses, an interval from symptom onset to PTGBD of > 3.5 days and an interval from PTGBD to LC of > 7.5 days were significant predictors of DS and PPO, respectively, in grade I AC. In grade II AC, the timing of PTGBD and subsequent LC were not statistically related to DS or PPO. Conclusions: In grade I AC, performing PTGBD within 3.5 days after symptom onset can reduce surgical difficulties and subsequently performing LC within 7.5 days after PTGBD can improve postoperative outcomes. In grade II AC, early PTGBD cannot improve the surgical difficulty. In addition, the timing of subsequent LC is not correlated with surgical difficulties or postoperative outcomes.

• Tuberculosis and Respiratory Diseases
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• v.87 no.3
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• pp.349-356
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• 2024

Background: Acute pulmonary embolism (APE) is a fatal disease with varying clinical characteristics and imaging. The aim of this study was to define the clinical characteristics, risk factors, and outcomes in patients with APE at a university hospital in Thailand. Methods: Patients diagnosed with APE and admitted to our institute between January 1, 2017 and December 31, 2022 were retrospectively enrolled. The clinical characteristics, investigations, and outcomes were recorded. Results: Over the 6-year study period, 369 patients were diagnosed with APE. The mean age was 65 years; 64.2% were female. The most common risk factor for APE was malignancy (46.1%). In-hospital mortality rate was 23.6%. The computed tomography pulmonary artery revealed the most proximal clots largely in segmental pulmonary artery (39.0%), followed by main pulmonary artery (36.3%). This distribution was consistent between survivors and non-survivors. Multivariate logistic regression analysis revealed that APE mortality was associated with active malignancy, higher serum creatinine, lower body mass index (BMI), and tachycardia with adjusted odds ratio (95% confidence interval [CI]) of 3.70 (1.59 to 8.58), 3.54 (1.35 to 9.25), 2.91 (1.26 to 6.75), and 2.54 (1.14 to 5.64), respectively. The prediction model was constructed with area under the curve of 0.77 (95% CI, 0.70 to 0.84). Conclusion: The overall mortality rate among APE patients was 23.6%, with APE-related death accounting for 5.1%. APE mortality was associated with active malignancy, higher serum creatinine, lower BMI, and tachycardia.

• Clinics in Shoulder and Elbow
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• v.27 no.2
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• pp.149-159
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• 2024

Background: In rotator cuff repair, the long head of the biceps tendon (LHB) is commonly used as graft material. However, factors influencing LHB tear severity are poorly understood, and predicting grade II LHB tears is challenging. This study aimed to identify these factors preoperatively. Methods: The demographics, medical parameters, and pain severity of 750 patients who underwent arthroscopic surgery from January 2010 to February 2021 were evaluated to determine the factors associated with LHB tear severity and grade II tears. Both overall and large-to-massive rotator cuff tear (RCT) cohorts underwent ordinal and binary logistic regression analyses. Predictive accuracy for grade II LHB tears was determined using the area under the receiver operating characteristic curve (AUC). Results: In the overall cohort, high-sensitivity C-reactive protein (hs-CRP) >1 mg/L (P<0.001), subscapularis tear (P<0.001), hypothyroidism (P=0.031), and the tangent sign (P=0.003) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L, subscapularis tear, and Patte retraction degree were significantly associated with grade II LHB tears (P<0.001). In the large-to-massive RCT cohort, hs-CRP>1 mg/L, hypertension, and age ≥50 years (P<0.05) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L (P<0.001) and hypertension (P=0.026) were significantly associated with grade II LHB tears. In both cohorts, hs-CRP >1 mg/L demonstrated good predictive accuracy for grade II LHB tears (AUCs: 0.72 and 0.70). Conclusions: Serum hs-CRP >1 mg/L is associated with LHB tear severity and serves as a reliable predictor of grade II LHB tears, facilitating preoperative assessment of the LHB as potential graft material in arthroscopic rotator cuff repair. serves as a reliable predictor of grade II LHB tears, facilitating preoperative assessment of the LHB as potential graft material in arthroscopic rotator cuff repair. Level of evidence: III.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.40 no.1
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• pp.86-94
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• 2004

This study was conducted to mesh selectivity of Beam trawl for shrimps fishing experiment in the coastal waters around Geomundo, South sea of Korea, during from Oct. to Nov. 2002. The selectivity parameters of big head shrimp (Solenocera melantho) have been studied on the covered con-end method. with mesh of 8, 38, 51 and 61 mm. Selection curves and selection parameters were calculated by using a logistic function S=1/(1+exp-(aCL+b)). The mesh selection master curves were estimated by S=1/(1+exp$^{({\alpha}(CL/M)+{\beta}}$), and the optimum mesh size were calculated with (L/M)50 of master curve. Optimum mesh size and selectivity master curves for the southern rough shrimp (Yrachysalambria curvirostris) and smoothshell shrimp (Parapenaeopsis tenella) optimum mesh size and selectivity master curves were estimated by big head shrimp master curves. The results obtained are summarized as follows : Selection parameters '${\alpha}$' and '${\beta}$' of the master curve for big head shrimp were 8.84 and -5.89, and The selection factor of the master curve (L/M)$_{50}$ was 0.67. The optimum mesh size of minimum length for sexual maturity for big head shrimp was 30.7 mm. Estimated (L/M)$_{50}$ for southern rough shrimp and smoothshell shrimp by using the master curve of big head shrimp was 0.73 and the optimum mesh sizes were 25.5 mm for southern rough shrimp and 16.9 mm for smoothshell shrimp, respectively.

• Journal of Korea Technology Innovation Society
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• v.10 no.4
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• pp.654-686
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• 2007

To estimate and analyze an interested science and technology level in any case requires three basic informations: (1) relative positions of our technology level, (2) other relevant technology level of the world best country holding the state of the art technology, and (3) its theoretical or practical maximum level within a certain period of time. Further, additional information from analyzing its respective rate of technology changes is necessary. It seems that most previous empirical or case studies on technology level have not considered third and fourth informations seriously, and thus critically have missed important findings from a dynamic point of view on the matter. A dynamic approach considering types of development processes and paths as well as current position needs an application of a concept of technology development stages and respective growth curves. This paper proposes a new method of approach and application by implementing relatively simple types of the growth curve(S-curve) such as logistic and Comports curves and applying estimation results of these curves to ten core technologies of the growth engines for the next future generation in Korea. The study implies that Korean science and technology level in general clearly gets higher as it approaches to a recent time of period, but relative technology gap from the world best in terms of catching-up period does not get better or narrower in case of at least part of the concerned technologies such as bio new drugs and human organs, and intelligence robots. The possibility does exist that some of our concerned technologies shooting for the next future generation may not come to the world highest level in the near future. The purpose of this study is to propose possibilities of catching-up, if any, by estimating its relevant type of growth pattern by way of measuring and analyzing technology level and by analyzing the technology development process through a position analysis. At this stage this study tries to introduce a new theoretical approach of estimating technology level and its application to existing case study results(data) from Korea Institute of Science and Technology Planning and Evaluation(KISTEP) and Korea Institute of Industrial Technology Evaluation and Planing(ITEP), for years of 2004 and 2006 respectively. The study has some limitations in terms of accuracy of measuring(estimating) a relevant growth curve to a particular technology, feasibility of applying estimated results, accessing and analyzing panel experts opinions. Hence, it is recommended that further study would follow soon enough to verify practical applicability and possible expansion of the study results.

• Journal of Technology Innovation
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• v.11 no.1
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• pp.147-176
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• 2003

This Paper Presents a new measurement technique to derive the level of BSRC (Basic Science and Research Capacity) index by use of the factor analysis which is extended with the assumption of the standard normal probability distribution of the selected explanatory variables. The new measurement method is used to forecast the gap of Korea's BSRC level compared with those of major OECD countries in terms of time lag and to make their international comparison during the time period of 1981∼1999, based on the assumption that the BSRC progress function of each country takes the form of the logistic curve. The US BSRC index is estimated to be 0.9878 in 1981, 0.9996 in 1990 and 0.99991 in 1999, taking the 1st place. The US BSRC level has been consistently the top among the 16 selected variables, followed by Japan, Germany, France and the United Kingdom, in order. Korea's BSRC is estimated to be 0.2293 in 1981, taking the lowest place among the 16 OECD countries. However, Korea's BSRC indices are estimated to have been increased to 0.3216 (in 1990) and 0.44652 (in 1999) respectively, taking 10th place. Meanwhile, Korea's BSRC level in 1999 (0.44652) is estimated to reach those of the US and Japan in 2233 and 2101, respectively. This means that Korea falls 234 years behind USA and 102 years behind Japan, respectively. Korea is also estimated to lag 34 years behind Germany, 16 years behind France and the UK, 15 years behind Sweden, 11 years behind Canada, 7 years behind Finland, and 5 years behind the Netherlands. For the period of 1981∼1999, the BSRC development speed of the US is estimated to be 0.29700. Its rank is the top among the selected OECD countries, followed by Japan (0.12800), Korea (0.04443), and Germany (0.04029). the US BSRC development speed (0.2970) is estimated to be 2.3 times higher than that of Japan (0.1280), and 6.7 times higher than that of Korea. German BSRC development speed (0.04029) is estimated to be fastest in Europe, but it is 7.4 times slower than that of the US. The estimated BSRC development speeds of Belgium, Finland, Italy, Denmark and the UK stand between 0.01 and 0.02, which are very slow. Particularly, the BSRC development speed of Spain is estimated to be minus 0.0065, staying at the almost same level of BSRC over time (1981 ∼ 1999). Since Korea shows BSRC development speed much slower than those of the US and Japan but relative]y faster than those of other countries, the gaps in BSRC level between Korea and the other countries may get considerably narrower or even Korea will surpass possibly several countries in BSRC level, as time goes by. Korea's BSRC level had taken 10th place till 1993. However, it is estimated to be 6th place in 2010 by catching up the UK, Sweden, Finland and Holland, and 4th place in 2020 by catching up France and Canada. The empirical results are consistent with OECD (2001a)'s computation that Korea had the highest R&D expenditures growth during 1991∼1999 among all OECD countries ; and the value-added of ICT industries in total business sectors value added is 12% in Korea, but only 8% in Japan. And OECD (2001b) observed that Korea, together with the US, Sweden, and Finland, are already the four most knowledge-based countries. Hence, the rank of the knowledge-based country was measured by investment in knowledge which is defined as public and private spending on higher education, expenditures on R&D and investment in software.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.101-110
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• 2019

Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1158-1164
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• 2008

Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.

• Journal of Gastric Cancer
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• v.8 no.1
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• pp.27-34
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• 2008

Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

• Korean Journal of Soil Science and Fertilizer
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• v.39 no.6
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• pp.329-333
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• 2006

Most of volcanic ash soils in South Korea are distributed in Jeju province which is an island placed on southern part of Korea and has steep slope mountain area. There are many soils containing high contents of organic matter (OM) derived from volcanic ash in Jejudo, also. Therefore, irrigation and drainage in volcanic ash soil different with general soil which has low OM content have to be applied with another management way, but studies searching appropriate methods for them are set on insufficient situation because the area of volcanic ash soil in South Korea is only 1.3% (130,000ha). This study was conducted for analysis of soil water content and irrigation quantity appropriate for crops cultivated in volcanic ash soil with high OM content. Although soils with different soil color have the same soil texture, soil water characteristics curve by soil color showed the difference of water retention capability by OM content. But, this characteristics classified with soil color could be unified by scaling technique with similitude analysis method which get dimensionless water content using a present water content, a residual water content and saturated water content (or water content at 10kPa). A relation of gravimetric soil water content (GSWC) and dimensionless water content by the results showed a form of power function. The dimensionless water content (DWC) express a relative saturation degree of present water content. This was also expressed by van Genuchten model which describe the relation between relative saturation degrees and matric potentials. These results on soil water characteristics curve (SWCC) of volcanic ash soil will be the basic of irrigation plan in area having high organic contents into soil.