• Journal of Gastric Cancer
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• v.23 no.2
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• pp.289-302
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• 2023

Purpose: Liver metastasis (LM) is reported in approximately 40% of patients with advanced/metastatic gastric/gastroesophageal junction adenocarcinoma (metastatic esophagogastric adenocarcinoma; mGEA) and is associated with a worse prognosis. This post-hoc analysis from the RAINBOW trial reported the efficacy, safety, and biomarker outcomes of ramucirumab and paclitaxel combination treatment (RAM+PAC) in patients with (LM+) and without (LM-) LM at baseline. Materials and Methods: Patients (n=665) were randomly assigned on a 1:1 basis to receive either RAM+PAC (LM+: 150, LM-: 180) or placebo and paclitaxel (PL+PAC) (LM+: 138, LM-: 197). The overall survival (OS) and progression-free survival (PFS) were evaluated using stratified Kaplan-Meier and Cox regression models. The correlation of dichotomized biomarkers (VEGF-C, D; VEGFR-1,2) with efficacy in the LM+ versus LM- subgroups was analyzed using the Cox regression model with reported interaction P-values. Results: The presence of LM was associated with earlier progression than those without LM, particularly in patients receiving PL+PAC (hazard ratio [HR], 1.68). RAM+PAC treatment improved OS and PFS irrespective of LM status but showed greater improvement in LM+ than that in LM- (OS HR, 0.71 [LM+] vs. 0.88 [LM-]; PFS HR, 0.47 [LM+] vs. 0.76 [LM-]). Treatment-emergent adverse events were similar between patients with and without LM. No predictive relationship was observed between biomarker levels (VEGF-C, D; VEGFR-1,2) and efficacy outcome (OS, PFS) (all interaction P-values >0.05). Conclusions: RAM provided a significant benefit, irrespective of LM status; however, its effect was numerically stronger in patients with LM. Therefore, RAM+PAC is a clinically meaningful therapeutic option for patients with mGEA and LM.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.12
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• pp.581-588
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• 2017

This study was conducted to determine which factors would predict metabolic syndrome (MetS) perception and exercise by applying a machine learning classifier, or Extreme Gradient Boosting algorithm (XGBoost) from July 2014 to December 2015. Data were obtained from the Korean Community Health Survey (KCHS), representing different community-dwelling Korean adults 19 years and older, from 2009 to 2013. The dataset includes 370,430 adults. Outcomes were categorized as follows based on the perception of MetS and physical activity (PA): Stage 1 (no perception, no PA), Stage 2 (perception, no PA), and Stage 3 (perception, PA). Features common to all questionnaires for the last 5 years were selected for modeling. Overall, there were 161 features, categorical except for age and the visual analogue scale (EQ-VAS). We used the Extreme Boosting algorithm in R programming for a model to predict factors and achieved prediction accuracy in 0.735 submissions. The top 10 predictive factors in Stage 3 were: age, education level, attempt to control weight, EQ mobility, nutrition label checks, private health insurance, EQ-5D usual activities, anti-smoking advertising, EQ-VAS, education in health centers for diabetes, and dental care. In conclusion, the results showed that XGBoost can be used to identify factors influencing disease prevention and management using healthcare bigdata.

• Journal of Preventive Medicine and Public Health
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• v.50 no.6
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• pp.361-368
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• 2017

Objectives: This study aimed to explore dimensions in addition to the 5 dimensions of the 5-level EQ-5D version (EQ-5D-5L) that could satisfactorily explain variation in health-related quality of life (HRQoL) in the general population of South Korea. Methods: Domains related to HRQoL were searched through a review of existing HRQoL instruments. Among the 28 potential dimensions, the 5 dimensions of the EQ-5D-5L and 7 additional dimensions (vision, hearing, communication, cognitive function, social relationships, vitality, and sleep) were included. A representative sample of 600 subjects was selected for the survey, which was administered through face-to-face interviews. Subjects were asked to report problems in 12 health dimensions at 5 levels, as well as their self-rated health status using the EuroQol visual analogue scale (EQ-VAS) and a 5-point Likert scale. Among subjects who reported no problems for any of the parameters in the EQ-5D-5L, we analyzed the frequencies of problems in the additional dimensions. A linear regression model with the EQ-VAS as the dependent variable was performed to identify additional significant dimensions. Results: Among respondents who reported full health on the EQ-5D-5L (n=365), 32% reported a problem for at least 1 additional dimension, and 14% reported worse than moderate self-rated health. Regression analysis revealed a $R^2$ of 0.228 for the original EQ-5D-5L dimensions, 0.200 for the new dimensions, and 0.263 for the 12 dimensions together. Among the added dimensions, vitality and sleep were significantly associated with EQ-VAS scores. Conclusions: This study identified significant dimensions for assessing self-rated health among members of the general public, in addition to the 5 dimensions of the EQ-5D-5L. These dimensions could be considered for inclusion in a new preference-based instrument or for developing a country-specific HRQoL instrument.

• Clinical Endoscopy
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• v.55 no.3
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• pp.417-425
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• 2022

Background/Aims: Endoscopic submucosal dissection (ESD) for diverticulum-associated colorectal lesions is generally contraindicated because of the high risk of perforation. Several studies on patients with such lesions treated with ESD have been reported recently. However, the feasibility and safety of ESD for lesions in proximity to a colonic diverticulum (D-ESD) have not been fully clarified. The aim of this study was to evaluate the feasibility and safety of D-ESD. Methods: D-ESD was defined as ESD for lesions within approximately 3 mm of a diverticulum. Twenty-six consecutive patients who underwent D-ESD were included. Two strategic approaches were used depending on whether submucosal dissection of the diverticulum-related part was required (strategy B) or not (strategy A). Treatment outcomes and adverse events associated with each strategy were analyzed. Results: The en bloc resection rate was 96.2%. The R0 and curative resection rates were 76.4% and 70.6% in strategy A and 88.9% and 77.8% in strategy B, respectively. Two cases of intraoperative perforation and one case of delayed perforation occurred. The delayed perforation case required emergency surgery, but the other cases were managed conservatively. Conclusions: D-ESD may be a feasible treatment option. However, it should be performed in a high-volume center by expert hands because it requires highly skilled endoscopic techniques.

• Journal of the Korean GEO-environmental Society
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• v.15 no.7
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• pp.39-50
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• 2014

The goal of this work is to develop a framework of methods to entirely evaluate effects of LID (Low Impact Development) on soil-groundwater environmental quality as well as land-scape and ecological factors. For this study, we conducted an extensive literature review. As outcomes, soil-groundwater environmental quality is newly conceptualized as a comprehensive index reflecting (i) groundwater pollution sensitivity (hydrogeological factor), (ii) biochemical contamination, and (iii) biodegradability. The methods of classifying and indexing is shown by combining selection of the items to be measured for soil-groundwater environmental quality and integrating the resulted items comprehensively. In addition, from soil-groundwater environmental quality, land-scape and ecological factors in existing environmental impact assessment a method was developed an overall index which can evaluate effects to environment by using GIS (Geographic Information System) and AHP (Analytic Hierachy Process). For optimizing LID planning, designing and post-evaluation, LCIA (Life Cycle Impact Assessment) was regarded as an appropriate method.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.1
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• pp.70-79
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• 2024

Backgrounds/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes. Methods: Data were extracted from the Recurrence After Whipple's study, a retrospective multicenter study of PD outcomes. Results: In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was "enteral only," "parenteral only," and "enteral and parenteral" in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m² (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN. Conclusions: A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.

• Journal of Korea Technology Innovation Society
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• v.17 no.1
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• pp.146-173
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• 2014

Extant studies have explained that firm's innovations including technological product and process innovations contribute to its competitive advantage and growth, thereby supporting competitiveness and growth of industry. These studies, however, have focused mainly on the role and effect of technological change that is primarily measured by the patent numbers and R&D intensity. Aside from these traditional streams, there has been growing interest on the impact by various dimensions of innovation including non-technological innovations. Apart from the discussions on the dimensions and scope of innovation, stages or processes of innovation also have been studied. Extant studies on innovation process model, however, has limited its interests in the structure of the transformation of knowledge. This study have established a comprehensive model embracing operational and financial performance to investigate the causal paths between innovation and firm performance. Using multi-level generalized linear model with path analysis, this study have found results as follows: First, the processes from innovative activities to innovation output and outcomes including operational and financial performance at firm level were verified. Secondly, the influence of innovation decreases gradually as the distance away from the direct outputs of the innovation increase in the direction of financial outcomes. Third, the effect of innovation on the sales growth rate is higher for small businesses than for medium-sized businesses. The effect of innovation on the profit rate, however, is significant only for medium-sized businesses. For large businesses, innovation has no positive significant impact on any financial performance at all. Fourth, Fourth, the appropriability of innovation has positive impacts on innovative performance, patent applications, and operational performance.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.3
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• pp.745-753
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• 2021

Recently, a large fire occurred in a multi-use facility used by a large number of citizens, including the vulnerable, resulting in a lot of injuries and damages. Although several pilot studies have been conducted to reduce such incidents, the development of advanced disaster response technology using the latest spatial information and IoT technology is still insufficient. In this study, a pilot test bed is built to demonstrate detailed technologies derived through the first stage of realistic fire management technology research for the development of applied technology in the field. In detail, the building conditions and candidate sites of the test bed were first investigated and analyzed to derive satisfactory conditions and candidate target buildings. A second pilot test bed was then selected, and the necessary sensor and facility infrastructure were built to demonstrate the outcomes. Finally, a scenario was produced for technology verification, and a test bed system was developed. The pilot test bed is expected to contribute to verifying intermediate outcomes of realistic fire management research projects, enhancing the quality of the developed technologies.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.9 no.2
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• pp.89-103
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• 2015

The purpose of this research attempted to developed the Community Reintegration support Program(H-CRsP) on patients with Spinal Cord Injury(SCI) and identity the effect. To assess the effectiveness of a Hospital based H-CRsP with a comprehensive team approach for treating inpatients with Spinal Cord Injury(SCI), offered by the Korea National Rehabilitation Hospital. Participants with SCI were recruited from the Korean National Rehabilitation Hospital. Twenty-five participants who met inclusion criteria were provided with a H-CRsP. A H-CRsP with modules related to the training of daily living skills, driving, vocations and school support activities, leisure or recreational activities, peer counseling, sexual rehabilitation, and others support activities. The 25 enrolled patients had been treated with average of 6.1 programs 2 times a week for over 2 or 3months. COPM, HADS, WHOQOL-BREF, AD-R were administered before the treatment(pre-test) and also at the time of discharge(post-test) to compare the treatment outcomes in the 25 program participants. Measured level of community integration by CIQ at discharge. The data were analyzed by such statistical methods as frequency and paired t-test analysis. Significant improvements were found on the Occupational Performance and Satisfaction, Acceptance of Disability, Quality of Life score in the COPM, AD-R, WHOQOL-BREF (p<0.05). In addition, 10 of the 25 patients returned to home, work or school. These results demonstrated the effectiveness of the H-CRsP in helping patients with SCI return their communities to which they belong. It considered development of the variety of programs and prepare systematically related system.

• Journal of Gynecologic Oncology
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• v.29 no.6
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• pp.100.1-100.13
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• 2018

Objective: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. Methods: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. Results: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). Conclusion: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.