• Asian Pacific Journal of Cancer Prevention
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• 제15권9호
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• pp.4049-4054
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• 2014

Background: Race and ethnicity are significant factors in predicting survival time of breast cancer patients. In this study, we applied advanced statistical methods to predict the survival of White non-Hispanic female breast cancer patients, who were diagnosed between the years 1973 and 2009 in the United States (U.S.). Materials and Methods: Demographic data from the Surveillance Epidemiology and End Results (SEER) database were used for the purpose of this study. Nine states were randomly selected from 12 U.S. cancer registries. A stratified random sampling method was used to select 2,000 female breast cancer patients from these nine states. We compared four types of advanced statistical probability models to identify the best-fit model for the White non-Hispanic female breast cancer survival data. Three model building criterion were used to measure and compare goodness of fit of the models. These include Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), and Deviance Information Criteria (DIC). In addition, we used a novel Bayesian method and the Markov Chain Monte Carlo technique to determine the posterior density function of the parameters. After evaluating the model parameters, we selected the model having the lowest DIC value. Using this Bayesian method, we derived the predictive survival density for future survival time and its related inferences. Results: The analytical sample of White non-Hispanic women included 2,000 breast cancer cases from the SEER database (1973-2009). The majority of cases were married (55.2%), the mean age of diagnosis was 63.61 years (SD = 14.24) and the mean survival time was 84 months (SD = 35.01). After comparing the four statistical models, results suggested that the exponentiated Weibull model (DIC= 19818.220) was a better fit for White non-Hispanic females' breast cancer survival data. This model predicted the survival times (in months) for White non-Hispanic women after implementation of precise estimates of the model parameters. Conclusions: By using modern model building criteria, we determined that the data best fit the exponentiated Weibull model. We incorporated precise estimates of the parameter into the predictive model and evaluated the survival inference for the White non-Hispanic female population. This method of analysis will assist researchers in making scientific and clinical conclusions when assessing survival time of breast cancer patients.

• 대한한의학원전학회지
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• 제11권2호
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• pp.146-168
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• 1998

This thesis is a study on the diagnostic theory and methods of Macjin(checking of pulse) as described in the Whang Di Nei Qing. There are four methods of Macjin in this text, namely: Dong Macjin(動脈法), Sam Bu Gu Who Macjin(三部九脈診). In Young Gi Gu Macjin(人迎氣口脈診法), Nei Qing's Gi Gu Macjin(內徑의 氣口脈法). Each method developed in it's own way, but they are all closely related and became the basis of today's Macjin. I examined the methods of Macjin in the Whang Di Nei Qing from a perspective of "change". The main questions of this study are: "What brought about the development of the different methods?". "How do the methods differ?", and "how did these methods evoke into today's Macjin?". The method of Macjin generated spontaneously from the observation and treatment of disease. Dong Macjin was the first method developed and became the basis of subsequent forms of Macjin. The accumulation of medical knowledge and the influence of oriental philosophy fueled the evolution of Macjin. Chronologically, Macjin methods developed starting with Dong Macjin and eventually into Sam Bu Gu Who Macjin. In Young Gi Gu Macjin, and Nei Qing's Gi Gu Macjin. The different methods of Macjin vary in how many pulse points are checked, and were established with simplicity and effectiveness in mind. Dong Macjin involves the checking the whole body. Sam Bu Gu Who Macjin involves nine points. In Young Gi Gu Macjin involves four points. and Nei Qing's Gi Gu Macjin involves two. In it's early development, the checking of a patient's pulse was used to diagnose only localized disorders in comparison with symptoms. It evolved with Oh Jang Mad(五臟脈, five main types of pulse) to be able to check internal organs with the introduction of Nei Qing's Gi Gu Macjin. After the division of Chon Kwan Chuck(寸關尺), it evolved further to be able to make a detailed diagnosis by using the result of pules checks. Nowadays, we can make 28 forms of diagnostic indices from these development. In conclusion, Macjin can be used practically and effectively in the diagnosis of disease. In using three methods of Macjin(In Young Gi Gu Macjin, Nei Qing's Gi Gu Macjin, and today's Gi Gu Macjin, which can determine the whole body's Siate of well-being) in conjunction with Dong Macjin(which helps pinpoint the localized disorder), an exact diagnosis can be obtained. I strongly feel that we should acquire objectivity by accommodating Macjin with modern methods of medicine.

• Radiation Oncology Journal
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• 제29권3호
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• pp.156-163
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• 2011

Purpose: To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. Materials and Methods: We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-five patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Results: Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing's disease). Amenorrhea was abated in 7 of 10 patients, galactorrhea in 8 of 8 patients, acromegaly in 7 of 11 patients, Cushing's disease in 4 of 4 patients. Long-term complication was observed in 4 patients; 3 patients with cerebrovascular accident, 1 patient developed dementia. Of these patients, 3 of 4 received more than 60 Gy of irradiation. Conclusion: EBRT is highly effective in preventing recurrence and reducing mass effect of non-secreting adenoma. Effort to improve tumor control of secreting adenoma is required. Careful long-term follow-up is required when relatively high dose is applied. Modern radiosurgery or proton RT may be options to decrease late complications.

• Journal of Acupuncture Research
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• 제15권2호
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• pp.537-550
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• 1998

Purpose ; This Investigation was aimed to find out the Acupuncture therapy of verbal disturbance after stroke in Oriental Medicine. Methods ; We surveyed the oriental medical books which are from to recent published books that have articles about verbal disturbance. Results ; It is used on Acupuncture points: Yomchon(CV23), Amun(GV15), Chondol(CV22), Tongni(HT5), Pungnyung(ST40), Pungbu(GV16), Crugu(TE6), Yongchon(KI1), Hapkok(LI4), Paekoe(GV20), Kokchi(LI11), Puryu(KI7), Shinsu(BL23), Kumjin-okaek, Chohae(KI6). Conclusions ; The concept of phonation organ in Neiching is same as that of modern physiology. Verbal disturbance includes aphasia, dysarthrosis, aphonia, etc. The acupuncture treatment of verbal disturbance after stroke could be effective. Verbal disturbance of central nervous disease is relative with Sul-um(舌?) and that of periperal nervous disease is relative with Hu-um(侯?) in oriental medicine. From the above research, we could conclude that the acupuncture therapy on verbal disturbance should start from finding out the proper acu-points and theories in ancient oriental books and recent books and we will apply those acu-points and theories in clinic. We also concluded that the more research on clinical part should be performed.

• 한국보건간호학회지
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• 제12권2호
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• pp.12-26
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• 1998

The occupational health problems are the major issue in the modern industrial society. Especially the small scale industries have many hazardous factors and not any occupational health programs in itself. Fortunately. the government-funded subsidiary program was developed and carried out in the past six years in our country. The purposes of this study were to find out the actual condition of the occupational health personnel's accomplishments for the government-funded subsidiary program for small scale industries and to provide basic data for setting up more developed subsidiary occupational health program. Data were collected through 6 kinds of service records review. These service records were written by 3 occupational health personnels were attached to the one subject center of KIHA. were undertaken during March to December, 1997. at 95 small scale industries which were applied the government-funded subsidiary occupational health program. Results were as follows 1. Concerning 95 small scale industries showed characteristics of a typical small scale industry. 2. A doctor visited in industries total 190 times per year, average 19 industries per month, twice per year and industry. A hygienist visited in industries total 378 times per year, average 38 industries per month, four times per year and industry. A nurse visited in industries total 477 times per year. average 47 industries per month, 5 times per year and industry. 3. 3 occupational health personnels accomplished total 3,869 items. A doctor accomplished total 539 items per year, each time 3 items In an industry. A hygienist accomplished total 1.581 items per year, each time 4 items in an industry. A nurse accomplished total 1.749 items per year, each time 4 items in an industry. 4. The major contents of doctor's accomplishment were 'health consultation for suspicious worker with general & occupational disease', 'a check of the workplace & special health education', 'guidance of special medical examination in the second half of year', etc. The major contents of hygienist's accomplishment were 'pretest & guidance of planning for evaluation of working environment'. 'evaluation for ventilating facilities & suporting self inspection', 'guidance of MSDS recording & chemicals management', etc. The major contents of nurse's accamplishment were 'health counseling of general & special medical examination results'. 'health education of preventing occupational disease & health disorder'. 'guidance of subsidiary program planning', 'selecting & guidance of health monitor', etc. It was concluded that the occupaional health personnels implemented the subsidiary program according to the order of health management guide. The current health management guide of subsidiary occupational health program in which the fixed contents, visiting number & periods is not desirable. That guide is left the characteristics of small scale industries out of consideration. It is suggested that occupational health management guide should be developed according to the general & environmental characteristics of each small scale industry, and on the other hand, the more specific guide for each occupational health personnel should be developed.

• Tuberculosis and Respiratory Diseases
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• 제38권3호
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• pp.236-244
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• 1991

The prevalence rate of pulmonary tuberculosis is 1.8% in 1990, and endobronchial tuberculosis may exist in 10 to 40% of active disease. Endobronchial tuberculosis usually leaves bronchial stenosis as the complication despite of modern chemotherapy, and it is often misdiagnosed as bronchial asthma. When bronchial stenosis involves major airway, its treatment needs such special measures as steroid therapy, surgical intervention and/or laser therapy, but the therapeutic result is often disappointing. To exploit a new treatment modality for bronchial stenosis, balloon dilatation was carried out in 12 patients with endobronchial tuberculosis. Under local anesthesia, 4F-Fogarty balloon was inserted via bronchofiberscope in ten cases and 10F-Gruentzig balloon was introduced under fluoroscopic guide in two others. Endobronchial tuberculoses were subdivided into two(16.7%) with actively caseating type, seven (58.3%) with fibrostenotic type, and three (25.0%) with stenotic type without fibrosis, according to the bronchoscopic findings. In 7 healed cases which were all stenotic with fibrosis, three (42.9%) took favorable turn in clinical status but four (57.1%) were not improved with balloon dilatation. In 5 active cases, all (two with actively-caseating type and three with stenotic type without fibrosis) were improved with this method. $FEV_{1.0}$ or FVC increased 10% or more after procedure in seven (70.0%) of ten and bronchial lumen remained enlarged in eight (66.7%) of twelve, in whom follow-up examination was done after the procedure. Balloon dilatation of bronchial stenosis is more effective, when endobronchial tuberculosis is in active stage than in healed fibrotic stage. It is suggested that bronchial stenosis can be minimized by early diagnosis and early application of balloon dilatation in the course of disease.

• 대한방사선기술학회지:방사선기술과학
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• 제39권3호
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• pp.369-376
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• 2016

양전자방출단영상(Positron Emission Tomography, PET)은 여러 화합물과 방사성 동위원소를 결합하여 인체 내에 주입하여 인체 내의 대사율을 정량적으로 측정할 수 있는 핵의학적 검사이다. 특히, 암 조직에서 포도당 대사가 증가되는 현상을 $^{18}F$-FDG(Fluorodeoxyglucose)를 사용하여 널리 암 진단에 활용하며, 현대에서 발병 빈도가 높은 뇌질환 중 치매 및 파킨슨 진단에도 높은 유용성을 보인다는 연구가 다수 진행되었다. 이러한 현재의 정적 정보에 시간의 동적 정보를 포함하는 동적 양전자방출단층영상(dynamic PET, dPET)을 이용할 경우, 진단을 위한 추가적인 정보가 제공되므로 진단의 정확도 향상에 기여할 수 있다. 이러한 이유로 임상 연구자 및 방사선사의 큰 관심을 받고 있으나 연구를 진행하기 위해 손쉽게 사용 가능한 도구가 부족한 실정이며, 다양하고 복잡한 수학적 알고리즘(algorithm)이나 프로그래밍(programming) 기술이 부족할 경우 연구의 활성화를 방해하는 높은 진입장벽으로 존재하게 되므로, 본 연구에서는 dPET 연구의 활성화와 손쉬운 사용을 위해서 MATLAB을 이용하여 그래픽 유저(GUI) 기반으로 하여 무료 소프트웨어를 개발하였으며, 개발된 소프트웨어인 DIA-Tool(Dynamic Image analysis-Tool)은 복잡한 수학적 영상 분석 알고리즘을 누구나 손쉽게 사용할 수 있도록 설계되었다. 향후, 많은 임상 연구자들이 DIA-Tool을 이용하여 국내의 dPET 연구 발전에 큰 도움이 될 것이라 기대된다.

• Restorative Dentistry and Endodontics
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• 제36권2호
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• pp.98-107
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• 2011

치아우식증은 현대 사회에서 여전히 유병률이 높으며, 치과 분야의 주요 상병으로 자리잡고 있다. 치아우식증에 대한 연구에 매우 다양한 방법들이 동원되고 있으나, 최근 미세전산화 단층촬영은 비파괴적인 3차원 분석 기술로서 인기를 얻어 왔으며, 기존의 방법들에 비해 다양한 장점들을 가지고 있다. 미세전산화 단층촬영술은 X선원의 종류에 따라, 모노크로매틱 혹은 폴리크로매틱으로 나뉘어지고, 전자의 경우 몇몇 장점에도 불구하고, 고가의 장비를 요구하므로 후자가 훨씬 널리 사용된다. 투과방사선량의 감소에 따라 결정되는 미네랄 밀도의 차이가 기본 원리이며, 보다 좋은 이미지와 재현 가능한 측정을 위해서는 장비의 교정과 이미지 보정 작업등이 요구된다. 또한, 미세전산화 단층촬영술을 이용하면, 치아우식 병소의 3차원적인 재건이 가능하며, 병소의 내부 구조를 가시화할 수 있다. 최근 컴퓨터 기술의 발전과 더불어 다양한 응용이 시도되고 있는데, 자동화된 충치의 정량적 분석 알고리즘 등이 그 예에 해당된다.

• 시큐리티연구
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• 제42호
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• pp.229-249
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• 2015

탈냉전과 세계화의 추세로 테러리즘, 범죄, 환경재난, 인종갈등, 경제위기, 사이버테러, 질병, 에너지 등의 비안보적인 안보의 문제들이 인류와 국가를 위협하며 변화를 요구하고 있다. 또한 이 시대에 맞춰서 국가의 역할이 점차적으로 확대되면서 최대의 국가론이 부상하였다. 이처럼 현대사회는 복지국가의 실현이라는 목표 구현을 위하여 모든 국가가 '작은 정부론'에서 '큰 정부론'의 국가관으로 변화하게 된 것이다. 이와 같이 각종 범죄와 치안 유지 및 신종재난과 테러의 위협, 인간안보의 개념 등 외부의 침입뿐만 아니라 포괄적인 국민의 안전과 보호를 위해 안보의 개념을 종합적으로 넓게 해석해야 할 것 같다. 이러한 시대에 맞추어 국내적으로는 천안함, 연평도, 구제역, DDos 테러, 해적 피랍, 광우병, 조류독감 등과 남북관계의 인도적 지원과 남북 정상회담의 추진이 답보상태에 빠져 있다. 그에 따른 국가위기 대응체제와 종합적인 위기관리센터, 컨트롤 타워, 안보조직체계, 일반 국민들과의 협력기반, 법률적, 제도적 체제의 구축이 종합적으로 이루어져야 한다. 그에 따라 한국의 국가안보 및 테러, 위기관리 체계와 선진국인 미국 안보, 위기관리의 체제를 비교하여 앞으로 한국의 발전적인 국가안보 위기관리체제를 재정립하고 새로운 방향모색을 하고자 하는데 본 연구의 의의가 있다고 할 수 있다. 또한 각 정부부처의 다양한 법령과 행정조직이 제각각 분산되어 있어 통합적으로 효율적 기능을 발휘할 수 있는 상위법 제정, 가칭 테러방지법의 입법 제정이 필요하다고 사료된다.

• Laboratory Medicine Online
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• 제7권3호
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• pp.94-102
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• 2017

말라리아, 결핵, 간염은 미얀마의 중요한 감염 질환으로, 퇴치를 위한 노력에도 불구하고 여전히 심각한 상황이다. 곤충 매개 질환의 하나인 말라리아는 관리 목표치에 도달하여 관리가 잘 이루어지고 있음을 보여주고 있다. 하지만 결핵은 과거 수십년간 오히려 증가하고 있으며, 만성 바이러스성 간염은 주변 국가들에 비해 여전히 높은 수준이다. 이들 감염 질환을 통제하는데 중요한 방법은 조기 진단과 치료이다. 저자들은 최근 4년간 KOICA의 지원으로 미얀마의 주요 감염병의 실태를 파악하고, 감염병 퇴치를 위한 노력을 기울여 왔다. 지금은 이동 수단의 발달로 인해 감염병의 전파에서 국경의 한계가 없어졌기에, 세계 어느 곳에서의 감염도 다른 지역의 사람들에게 끼치는 영향이 크다. 비록 우리나라에서 멀리 떨어진 곳이기는 하나, 미얀마의 감염병 퇴치 노력이 우리나라와 전 세계의 인류 보건 향상에 중요한 영향을 끼칠 것으로 생각한다.