• Korean Journal of Radiology
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• 제24권9호
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• pp.903-911
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• 2023

Objective: Regrowth after radiofrequency ablation (RFA) of symptomatic large thyroid nodules, initially treated as benign, sometimes turns out to be malignancies. This study aimed to assess the ultrasound (US) characteristics of thyroid nodules initially treated as benign with RFA and later diagnosed as cancers, predictive factors for cancers masquerading as benign, and methods to avoid RFA in these cancers. Materials and Methods: We reviewed the medical records of 134 consecutive patients with 148 nodules who underwent RFA between February 2008 and November 2016 for the debulking of symptomatic thyroid nodules diagnosed as benign using US-guided biopsy. We investigated the pre-RFA characteristics of the thyroid nodules, changes at follow-up after RFA, and the final surgical pathology. Results: Nodule regrowth after RFA was observed in 36 (24.3%) of the 148 benign nodules. Twenty-two of the 36 nodules were surgically removed, and malignancies were confirmed in seven (19.4% of 36). Of the 22 nodules removed surgically, pre-RFA median volume (range) was significantly larger for malignant nodules than for benign nodules: 22.4 (13.9-84.5) vs. 13.4 (7.3-16.8) mL (P = 0.04). There was no significant difference in the regrowth interval between benign and malignant nodules (P = 0.49). The median volume reduction rate (range) at 12 months was significantly lower for malignant nodules than for benign nodules (51.4% [0-57.8] vs. 83.8% [47.9-89.6]) (P = 0.01). The pre-RFA benignity of all seven malignant nodules was confirmed using two US-guided fine-needle aspirations (FNAs), except for one nodule, which was confirmed using US-guided core-needle biopsy (CNB). Regrown malignant nodules were diagnosed as suspicious follicular neoplasms by CNB. Histological examination of the malignant nodules revealed follicular thyroid carcinomas, except for one follicular variant, a papillary thyroid carcinoma. Conclusion: Symptomatic large benign thyroid nodules showing regrowth or suboptimal reduction after RFA may have malignant potential. The confirmation of these nodules is better with CNB than with FNA.

• Advances in aircraft and spacecraft science
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• 제11권1호
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• pp.83-103
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• 2024

Adhesive bonding is currently widely used in many industrial fields, particularly in the aeronautics sector. Despite its advantages over mechanical joints such as riveting and welding, adhesive bonding is mostly used for secondary structures due to its low peel strength; especially if it is simultaneously exposed to temperature and humidity; and often presence of bonding defects. In fact, during joint preparation, several types of defects can be introduced into the adhesive layer such as air bubbles, cavities, or cracks, which induce stress concentrations potentially leading to premature failure. Indeed, the presence of defects in the adhesive joint has a significant effect on adhesive stresses, which emphasizes the need for a good surface treatment. The research in this field is aimed at minimizing the stresses in the adhesive joint at its free edges by geometric modifications of the ovelapping part and/or by changing the nature of the substrates. In this study, the finite element method is used to describe the mechanical behavior of bonded joints. Thus, a three-dimensional model is made to analyze the effect of defects in the adhesive joint at areas of high stress concentrations. The analysis consists of estimating the different stresses in an adhesive joint between two 2024-T3 aluminum plates. Two types of single lap joints(SLJ) were analyzed: a standard SLJ and another modified by removing 0.2 mm of material from the thickness of one plate along the overlap length, taking into account several factors such as the applied load, shape, size and position of the defect. The obtained results clearly show that the presence of a bonding defect significantly affects stresses in the adhesive joint, which become important if the joint is subjected to a higher applied load. On the other hand, the geometric modification made to the plate considerably reduces the various stresses in the adhesive joint even in the presence of a bonding defect.

• Journal of Gastric Cancer
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• 제24권3호
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• pp.257-266
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• 2024

Purpose: We conducted a randomized prospective trial (KLASS-07 trial) to compare laparoscopy-assisted distal gastrectomy (LADG) and totally laparoscopic distal gastrectomy (TLDG) for gastric cancer. In this interim report, we describe short-term results in terms of morbidity and mortality. Methods and Methods: The sample size was 442 participants. At the time of the interim analysis, 314 patients were enrolled and randomized. After excluding patients who did not undergo planned surgeries, we performed a modified per-protocol analysis of 151 and 145 patients in the LADG and TLDG groups, respectively. Results: The baseline characteristics, including comorbidity status, did not differ between the LADG and TLDG groups. Blood loss was somewhat higher in the LADG group, but statistical significance was not attained (76.76±72.63 vs. 62.91±65.68 mL; P=0.087). Neither the required transfusion level nor the operation or reconstruction time differed between the 2 groups. The mini-laparotomy incision in the LADG group was significantly longer than the extended umbilical incision required for specimen removal in the TLDG group (4.79±0.82 vs. 3.89±0.83 cm; P<0.001). There were no between-group differences in the time to solid food intake, hospital stay, pain score, or complications within 30 days postoperatively. No mortality was observed in either group. Conclusions: Short-term morbidity and mortality rates did not differ between the LADG and TLDG groups. The KLASS-07 trial is currently underway.

• Journal of Cardiovascular Imaging
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• 제30권4호
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• pp.292-304
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• 2022

BACKGROUND: Calcium is a determinant of paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI). This is based on a fixed contrast attenuation value while X-ray attenuation is patient-dependent and without considering frame expansion and PVL location. We examined the role of calcium in (site-specific) PVL after TAVI using a patient-specific contrast attenuation coefficient combined with frame expansion. METHODS: 57 patients were included with baseline CT, post-TAVI transthoracic echocardiography and rotational angiography (R-angio). Calcium load was assessed using a patient-specific contrast attenuation coefficient. Baseline CT and post-TAVI R-angio were fused to assess frame expansion. PVL was assessed by a core lab. RESULTS: Overall, the highest calcium load was at the non-coronary-cusp-region (NCR, 436 mm³) vs. the right-coronary-cusp-region (RCR, 233 mm³) and the left-coronary-cusp-region (LCR, 244 mm³), p < 0.001. Calcium load was higher in patients with vs. without PVL (1,137 vs. 742 mm³, p = 0.012) and was an independent predictor of PVL (odds ratio, 4.83, p = 0.004). PVL was seen most often in the LCR (39% vs. 21% [RCR] and 19% [NCR]). The degree of frame expansion was 71% at the NCR, 70% at the RCR and 74% at the LCR without difference between patients with or without PVL. CONCLUSIONS: Calcium load was higher in patients with PVL and was an independent predictor of PVL. While calcium was predominantly seen at the NCR, PVL was most often at the LCR. These findings indicate that in addition to calcium, specific anatomic features play a role in PVL after TAVI.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제26권2호
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• pp.141-151
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• 2024

Objective: Double microcatheter technique (dMC) can be the alternative to Single microcatheter technique (sMC) for challenging cases, but there is lack of studies comparing dMC to sMC especifically for small ruptured aneurysms. Our objective was to compare the safety and efficacy of dMC to sMC in treating small (≤5 mm) and tiny (≤3 mm) ruptured aneurysms. Methods: This study focused on 91 out of 280 patients who had ruptured aneurysms and underwent either single or double microcatheter coil embolization. These patients were treated with either single or double microcatheter coil embolization. We divided the patients into two groups based on the procedural method and evaluated clinical features and outcomes. Subgroup analyses were conducted specifically for tiny aneurysms, comparing the two methods, and within the dMC group, we also examined whether the aneurysm was tiny or not. In addition, univariate logistic regression analysis was performed to assess the impact of coil packing density. Results: The mean values for most outcome measures in the dMC group were higher than those in the sMC group, but these differences did not reach statistical significance (coil packing density, 45.739% vs. 39.943%; procedural complication, 4.17% vs. 11.94%; recanalization, 8.3% vs. 10.45%; discharge discharge modified Rankin Scale (mRS), 1.83 vs. 1.97). The comparison between tiny aneurysms and other sizes within the dMC group did not reveal any significant differences in terms of worse outcomes or increased risk. The only factor that significantly influenced coil packing density in the univariate logistic regression analysis was the size of the aneurysm (OR 0.309, 95% CI 0.169-0.566, p=0.000). Conclusions: The dMC proved to be a safe and viable alternative to the sMC for treating small ruptured aneurysms in challenging cases.

• 동아시아식생활학회지
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• 제21권5호
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• pp.625-636
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• 2011

본 연구는 여대생 248명을 대상으로 음식섭취빈도조사지에 의한 나트륨 섭취량과 골밀도와의 관련성을 규명하고자 하였다. 조사 대상자의 평균 연령은 정상군 20.15세, 골감소군 20.04세였으며, 두 군간 유의적인 차이는 보이지 않았다. 평균 신장과 체중은 정상군 161.14 cm, 54.99 kg, 골감소군은 161.02 cm, 52.20 kg으로 나타나, 골감소군에서 체중이 유의적으로 낮은 것으로 나타났다. 평균 체질량지수와 체지방량은 정상군 20.90 kg/$m^2$, 26.09%, 골감소군은 20.08 kg/$m^2$, 24.27%으로 체질량지수와 체지방이 골감소군에서 유의적으로 낮은 것으로 나타났다. 평균 종골의 골격 상태 측정 결과에서 BUA, SOS, QUI는 정상군 118.44 dB/MHz, SOS 1,578.12 m/s, QUI 124.59%, 골감소군은 99.24 dB/MHz, SOS 1534.50 m/s, QUI 98.83%로 골감소군이 유의적으로 낮은 것으로 나타났다. 음식섭취빈도지에 의한 나트륨 섭취량(3,176.51 mg)은 식사 기록법에 의한 나트륨 섭취량(1,898.62 mg)과 유의한 양의 상관관계를 보였으며, 정상군 3,598.60 mg, 골감소군 3,748.25 mg으로 두 군간 유의적인 차이를 보이지 않았다. 나트륨 섭취의 주요 급원식품으로 정상군은 배추김치(10.13%), 라면(5.05%), 된장찌개(3.27%), 김치찌개(3.23%), 멸치볶음(2.48%) 순으로나타났으며, 골감소군은 배추김치(12.78%), 라면(6.04%), 김치찌개(2.94%), 된장찌개(2.62%), 자반고등어(2.34%) 순으로 나트륨 섭취량이 많게 나타났다. 음식군별 나트륨 섭취에 기여하는 음식군별 결과를 살펴보면, 정상군은 김치류(16.91%), 면류 및 만두류(16.34%), 찌개 및 탕류(13.88%), 주반찬(육류, 난류, 콩류, 11.73%), 어패류(11.02%) 순으로 나타났으며, 골감소군은 김치류(20.51%), 면류 및 만두류(17.03%), 찌개 및 탕류(12.98%), 어패류(10.76%), 주반찬(육류, 난류, 콩류, 10.63%) 순으로 나타났다. 두 군 모두에서 김치류, 면류 및 만두류, 찌개 및 탕류, 주반찬(육류, 난류, 콩류), 어패류로부터 전체 나트륨 섭취의 70% 정도를 공급받고 있는 것으로 나타났다. 조사대상자의 각 식품군의 나트륨 섭취량과 골밀도와의 상관 관계 분석결과, 면류 및 만두류(r=-0.0276, p=0.0426)와 나물 및 생채류(r=-0.0587, p=0.0015)와 골밀도간의 유의적인 음의 상관관계를 나타내었다. 각 식품군의 섭취빈도와 골밀도와의 상관관계 결과, 면류 및 만두류(r=-0.0344, p=0.0116), 찌개 및 탕류(r=-0.0376, p=0.0008), 김치류(r=-0.0421, p=0.0482), 어패류(r=-0.0160, p=0.0362), 나물 및 생채류(r=-0.0503, p= 0.0064), 양념류(r=-0.0407, p=0.0347) 등과 유의적인 음의 상관관계를 보였다. 나트륨 섭취 상태와 골밀도와의 관련성을 알아보기 위하여 나트륨 섭취량에 따라 4분 위수로 대상자를 나누어 비교한 결과, 정상군의 T-score는 Q1 군 0.90 g/$cm^2$, Q2군 1.03 g/$cm^2$, Q3군 0.91 g/$cm^2$, Q4군 0.98 g/$cm^2$으로 군간 유의적인 차이를 보이지 않았고, 골감소군은 Q1군 -1.48 g/$cm^2$, Q2군 -1.61 g/$cm^2$, Q3군 -1.59 g/$cm^2$, Q4군 -1.71 g/$cm^2$으로 군간 유의적인 차이를 보이지 않았다. 이상의 연구 결과에서 여대생의 주요 나트륨 급원 식품인 배추김치, 김치찌개, 된장찌개 이외의 라면, 멸치볶음, 스낵 과자의 식품으로부터 나트륨 섭취가 높은 것으로 나타났다. 또한 나트륨 총 섭취량과 골밀도는 상관성이 없었고 나트륨 섭취 기여도가 높은 식품의 섭취빈도가 높은 경우 나트륨 섭취도 높았는데, 이는 골밀도에 따른 군간 나트륨 섭취가 유사하여 나트륨 섭취가 골밀도에 미치는 효과가 미약하게 나타나 것으로 보인다. 따라서 골밀도에 관련성이 있는 골대사 지표 및 다양한 측정 방법을 통한 골밀도와 나트륨 섭취수준과의 관련성 연구가 필요하다고 생각된다.

• 벤처창업연구
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• 제9권5호
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• pp.83-94
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• 2014

본 연구는 최근 들어 가속화되고 있는 글로벌화와 인소싱(Insourcing)에 주력 기업들이 조직의 핵심역량강화를 목표로 도입하고 있는 아웃소싱(Outsourcing)을 분석하는데 목적이 있다. 특히 국내기업의 경우 자원의 해외조달, 높은 인건비의 상승, 부동산 가격의 급증 등 경영환경 변화에 대한 능동적 대처와 유력한 분야나 핵심역량에 자원을 집중시키기 위하여 아웃소싱을 실시하고 있다. 아웃소싱은 기업이 당면한 문제를 효율적으로 처리할 수 있고 핵심역량 이 외의 분야를 위탁 처리할 수 있어 기업의 경쟁력 확대가 가능하다. 이러한 변화 속에서 아웃소싱은 전문성을 확보할 수 있으며 고객의 니즈(Needs)를 충족할 수 있는 방법의 하나로 효율성과 경쟁력 확보 수단으로 활용되고 있다. 최근에는 대기업뿐 만아니라 중소기업 및 정부에서도 시장의 경쟁력 확보 수단으로 활용범위가 넓어지고 있다. 이와 같은 아웃소싱 시장의 흐름은 선진국에서부터 시작되었으나, 우리나라와 경영환경이 비슷한 일본의 경우 글로벌 아웃소싱의 시장규모가 급속하게 성장하고 있는 추세에 있다. 이에 본 연구는 기업의 경쟁력 강화를 위하여 추구하고 있는 경영형태인 아웃소싱에 대하여 아웃소싱을 운영하고 있는 업체를 주 대상으로 아웃소싱이 기업성과에 미치는 영향에 대하여 실증 분석함으로써 시사점을 제시하고자 한다.

• 한국가금학회지
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• 제45권3호
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• pp.201-207
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• 2018

본 연구는 산란 후기사료에 마늘발효액을 수준별로 첨가 급여시 산란계의 생산성, 계란품질 및 혈액성상에 미치는 영향을 구명하고자 실시하였다. 79주령 로만브라운 산란계를 4개 처리구 6반복으로 반복 당 18수씩 총 432수를 배치하였고, 각 처리구에 마늘발효액을 0%, 0.05%, 0.10% 및 0.20%로 4주간 급여하였다. 산란 수와 난중은 매일 조사하였고, 계란품질, 난황지방산 및 혈액성상은 사양실험 종료 후 분석하였다. 본 연구결과, 산란율과 사료요구율은 마늘발효액 급여구에서 대조구에 비하여 수치적으로 개선되었지만, 처리구간에 통계적 차이가 없었고, 난각강도와 두께도 마늘발효액 첨가수준에 따른 유의성이 없었다. 계란의 난백 높이와 호우유닛은 마늘발효액 첨가수준에 따라 일관적으로 증가하여 0.20%급여구에서 제일 높게 나타났으며, 대조구에 비하여 통계적으로 차이를 보였다(P<0.05). 난황지방산은 마늘발효액의 0.10%와 0.20% 첨가구에서 포화지방산은 감소되었고, 단일불포화지방산과 전체 불포화지방산은 현저하게 증가하였다(P<0.05). 혈중 알부민, AST 및 ALT은 처리구간에 차이가 없었지만, 중성지방과 콜레스테롤은 0.20% 급여구에서 대조구에 비해 매우 감소하였다(P<0.05). 또한 HDL콜레스테롤은 마늘발효액 0.10%와 0.20% 급여구에서 대조구에 비하여 유의적으로 증가하였고(P<0.05), 세포성 면역능 지표인 IL-2 mRNA와 CD4+CD8+의 비율도 0.10%와 0.20% 급여구에서 다른 처리구에 비하여 통계적으로 높게 나타났다(P<0.01). 본 실험 결과, 산란 말기 사료에 마늘발효액 0.20% 수준의 급여로 대조구에 비하여 계란품질과 건강 및 혈중 면역인자는 개선되었다.

• Journal of Periodontal and Implant Science
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• 제33권4호
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• pp.625-641
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• 2003

Background: This study presents a biomechanical and histometric comparison of bone response to implants with various area of hydroxyapatite(HA) coating. Methods: The implants were placed in the tibia of 10 rabbits weighing 2.5-3.5kg. The control group had a machined surface, the experimental group 1 had 50${\mu}m$ thick HA coated in a band form, and the experimental group 2 had 50${\mu}m$ thick HA coated on the entire surface. 8 weeks after implantation, the animals were sacrificed. Removal torque was measured and histologic preparation was also performed for histologic and histometric analysis. Bone to implant contact as well as percentage of bone area inside threads were measured. ANOVA post hoc, and t-test were used for statistical analysis with p-value p<0.05. Results: 1. The removal torques were 9.36${\pm}$5.64 Ncm, 48.40 ${\pm}$ 16.66 Ncm, and 82.37${\pm}$22.56 Ncm for the control, exp. 1, and exp. 2 group respectively. Statistically significant difference were found among all the groups(p<0.05). 2. Bone to implant contact in the cortical bone were 38.94${\pm}$10.9 %, 66.90${\pm}$14.1 %, 73.00${\pm}$19.4 %, in the marrow bone, 8.30${\pm}$5.4%, 14.59${\pm}$5.9%, 18.54${\pm}$11.8%, and in total, 22.40${\pm}$10.1%, 31,17${\pm}$7.5%, 41.41${\pm}$12.2% for the control, exp. 1, and exp. 2 group respectively . In the cortical bone, exp. 1, and exp. 2 group showed statistically significantly higher contact compared to control group. Total contact and in the marrow bone, only exp. 2 group showed statistically significantly higher contact compared to control group(p<0.05). In all the groups significantly higher contact were observed in the cortical bone compared to the marrow bone(p<0.05). 3. Percentage of bone area inside threads in the cortical bone were 55.68${\pm}$7.25%, 55.19${\pm}$13.19%, 57.04${\pm}$13.33%, in the marrow bone, 12.34${\pm}$14.61%, 17.56${\pm}$20.04%, 20.26${\pm}$12.83%, and in total, 30.30${\pm}$12.46%, 31.57 ${\pm}$15.15%, 34.25${\pm}$12.56% for the control, exp.1, and exp. 2 group respectively. There was no statistical difference among the groups. In all the groups significantly higher bone area were observed in the cortical bone compared to the marrow bone(p<0.05)

• 한국식품영양과학회지
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• 제38권10호
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• pp.1406-1413
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• 2009

감국, 산국 및 구절초 열수추출물의 첨가량을 달리하여 캔디를 제조하고 이들의 품질특성과 항산화특성 및 관능특성을 조사하였다. 색도의 경우 추출물의 첨가량의 증가와 함께 L값(명도)은 감소하였고, a값(적색도)과 b값(황색도)은 증가하였다. pH의 경우 감국, 산국 및 구절초 캔디는 각각 5.81$\sim$5.92, 5.77$\sim$5.85 및 5.83$\sim$5.94로 추출물 첨가량이 증가할수록 감소하였으며, 산도는 추출물의 첨가량이 증가함에 따라 증가하였다. 수분함량도 추출물의 첨가량이 증가함에 따라 증가하였다. 용해도는 초기에 급격하게 증가하였으며, 경도는 추출물의 첨가량이 증가할수록 감소하였다. 총 폴리페놀 및 플라보노이드 함량, 전자공여능, 총 항산화력은 추출물 첨가량의 증가에 따라 증가하였으며, 구절초 캔디가 각각 0.815$\sim$2.706 mg/g, 0.147$\sim$0.856 mg/g, 15.217$\sim$76.236% 및 0.514$\sim$3.167 mg AA eq/g으로 감국 및 산국 캔디보다 높았다. 관능평가 결과 색은 추출물 첨가량이 증가함에 따라 감소하였으며, 향의 경우 감국 캔디는 15% 첨가구, 구절초 캔디는 10% 첨가구에서 각각 5.20과 5.35로 높게 평가되었다. 맛의 경우 산국 캔디는 추출물 첨가량의 증가에 따라 감소하였으며, 감국과 구절초 캔디의 경우는 10% 첨가구에서 각각 5.30과 5.60으로 높게 나타났다. 조직감은 경도가 낮을수록 낮은 점수를 얻었다. 종합적인 기호도에서 감국과 구절초 캔디의 경우 10% 첨가구에서 각각 5.75와 6.00으로 높은 평가를 받았으나, 추출물의 첨가량이 증가할수록 낮은 점수를 받았다.