• Korean Journal of Radiology
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• v.24 no.10
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• pp.1028-1037
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• 2023

Objective: To evaluate the computed tomography (CT) features for diagnosing metastatic cervical lymph nodes (LNs) in patients with differentiated thyroid cancer (DTC) and validate the CT-based risk stratification system suggested by the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) guidelines. Materials and Methods: A total of 463 LNs from 399 patients with DTC who underwent preoperative CT staging and ultrasound-guided fine-needle aspiration were included. The following CT features for each LN were evaluated: absence of hilum, cystic changes, calcification, strong enhancement, and heterogeneous enhancement. Multivariable logistic regression analysis was performed to identify independent CT features associated with metastatic LNs, and their diagnostic performances were evaluated. LNs were classified into probably benign, indeterminate, and suspicious categories according to the K-TIRADS and the modified LN classification proposed in our study. The diagnostic performance of both classification systems was compared using the exact McNemar and Kosinski tests. Results: The absence of hilum (odds ratio [OR], 4.859; 95% confidence interval [CI], 1.593-14.823; P = 0.005), strong enhancement (OR, 28.755; 95% CI, 12.719-65.007; P < 0.001), and cystic changes (OR, 46.157; 95% CI, 5.07-420.234; P = 0.001) were independently associated with metastatic LNs. All LNs showing calcification were diagnosed as metastases. Heterogeneous enhancement did not show a significant independent association with metastatic LNs. Strong enhancement, calcification, and cystic changes showed moderate to high specificity (70.1%-100%) and positive predictive value (PPV) (91.8%-100%). The absence of the hilum showed high sensitivity (97.8%) but low specificity (34.0%). The modified LN classification, which excluded heterogeneous enhancement from the K-TIRADS, demonstrated higher specificity (70.1% vs. 62.9%, P = 0.016) and PPV (92.5% vs. 90.9%, P = 0.011) than the K-TIRADS. Conclusion: Excluding heterogeneous enhancement as a suspicious feature resulted in a higher specificity and PPV for diagnosing metastatic LNs than the K-TIRADS. Our research results may provide a basis for revising the LN classification in future guidelines.

• Korean Journal of Radiology
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• v.23 no.11
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• pp.1102-1111
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• 2022

Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.

• Journal of Korea Water Resources Association
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• v.57 no.5
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• pp.359-369
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• 2024

Korea prepares for potential floods by designating June 21st to September 20th as the flood season. However, many dams in Korea have suffered from extreme floods caused by different climate patterns, as in the case of the longest consecutive rain of 54 days in the 2020's flood season. In this context, various studies have tried to develop novel methodologies to reduce flood damage, but no study has ever dealt with the validity of the current statutory flood season thus far. This study first checked the validity of the current flood season through the observation data in the 21st century and proved that the current flood season does not consider the effects of increasing precipitation trends and the changing regional rainfall characteristics. In order to deal with these limitations, this study suggested seven new alternative flood seasons in the research area. The rigid reservoir operation method (ROM) was used for reservoir simulation, and the long short-term memory (LSTM) model was used to derive predicted inflow. Finally, all alternatives were evaluated based on whether if they exceeded the design discharge of the dam and the design flood of the river. As a result, the floods in the shifted period were reduced by 0.068% and 0.33% in terms of frequency and duration, and the magnitude also decreased by 24.6%, respectively. During this period, the second evaluation method also demonstrated that flood decreased from four to two occurrences. As the result of this study, the authors expect a formal reassessment of the flood season to take place, which will ultimately lead to the preemptive flood response to changing precipitation patterns.

• Journal of the Korean Regional Science Association
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• v.40 no.3
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• pp.23-42
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• 2024

This study examines changes in housing insecurity among young adults from a longitudinal perspective, recognizing the dynamic nature of young adulthood. The objective of the study is to explore shifts in housing insecurity and to identify the factors affecting entry into and exit from housing insecurity. Using data from the Seoul Youth Panel in 2021 and 2022, housing insecurity is measured across three dimensions, and changes over one year are categorized. The sample consists of 40% of individuals experiencing persistent security, 33% experiencing persistent insecurity, 14% exiting insecurity, and 13% entering security, indicating that the transition into and out of housing insecurity is quite dynamic. Empirical results from the logistic regression models reveal several key findings. Firstly, crises in employment and social domains significantly correlate shifts in housing insecurity among young people. Unstable employment and unsatisfactory job conditions increase the risk of entering, and decrease the likelihood of exiting housing insecurity. Social isolation and lower social support increase the risk of entry into housing insecurity, while higher social support enhances the likelihood of exiting housing insecurity. Secondly, residential characteristics play a pivotal role in the transition of housing insecurity. Those living in non-apartments and renters are considerably less likely to exit housing insecurity compared to those living in apartments and homeowners, respectively. Furthermore, residing in rooftop or semi-subterranean location, or undergoing residential moves, significantly elevate the risk of entering housing insecurity. Thirdly, external supports appear to have a limited role in achieving housing security for young adults. Parental economic resources significantly facilitate exiting housing insecurity, whereas governmental housing policy benefits show no significant effect. These findings provide important implications for policy-making aimed at addressing and preventing housing insecurity among young adults.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.27 no.3
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• pp.127-143
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• 2022

Recently, many attempts to run numerical ocean models in cloud computing environments have been tried actively. A cloud computing environment can be an effective means to implement numerical ocean models requiring a large-scale resource or quickly preparing modeling environment for global or large-scale grids. Many commercial and private cloud computing systems provide technologies such as virtualization, high-performance CPUs and instances, ether-net based high-performance-networking, and remote direct memory access for High Performance Computing (HPC). These new features facilitate ocean modeling experimentation on commercial cloud computing systems. Many scientists and engineers expect cloud computing to become mainstream in the near future. Analysis of the performance and features of commercial cloud services for numerical modeling is essential in order to select appropriate systems as this can help to minimize execution time and the amount of resources utilized. The effect of cache memory is large in the processing structure of the ocean numerical model, which processes input/output of data in a multidimensional array structure, and the speed of the network is important due to the communication characteristics through which a large amount of data moves. In this study, the performance of the Regional Ocean Modeling System (ROMS), the High Performance Linpack (HPL) benchmarking software package, and STREAM, the memory benchmark were evaluated and compared on commercial cloud systems to provide information for the transition of other ocean models into cloud computing. Through analysis of actual performance data and configuration settings obtained from virtualization-based commercial clouds, we evaluated the efficiency of the computer resources for the various model grid sizes in the virtualization-based cloud systems. We found that cache hierarchy and capacity are crucial in the performance of ROMS using huge memory. The memory latency time is also important in the performance. Increasing the number of cores to reduce the running time for numerical modeling is more effective with large grid sizes than with small grid sizes. Our analysis results will be helpful as a reference for constructing the best computing system in the cloud to minimize time and cost for numerical ocean modeling.

• The Journal of Korean Academic Society of Nursing Education
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• v.2
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• pp.75-94
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• 1996

This survey study was aimed at identifying the degree of educational need of the KNOU(Korea National Open University) nursing students defined as admission purposes, satisfaction of distance learning education, learning methods, and courses after graduation. Among randomly assigned 1000 students, 320 KNOU nursing students who allowed to participate in the study completed the questionnaires. The data were analyzed using descriptive statistics, chi-square test, and t-test, Results of this study were as follows : 1. The admission purposes of the KNOU nursing students were 'in order to get a bachelor's degree(83.8%)', 'to acquire knowledge for task(61.3%)', or 'to be admitted for the graduate school (53.1%)' etc. Comparing the admission purposes by age, tow items- 'to explore new possibilities for myself' and 'excellent curriculum' showed statistically significant differences. These two items were also found to show significant differences by marital status. 2. For the media maintenance, the results showed that students use their own cassett radios(96.3%), VTR(49.4%), TV only for the study (44.1%), personal computer (3.31%), or joining Hitel (6.3%). 3. Listening rates of the radio lecture were 'over 80%(9.1%)', '50-80%(9.1%)', '20-50%(18.1%)', 'below 20%(30%)' and 'never(33.1%)', And record lecture showed listening rates as follows : 'over80%(17.2%)', '50-80%(15.9%)', '20-50%(24.4%)', 'below 20%(27,2%)' and 'never(14.4%)'. 4. The difficulties with KNOU life were 'listening radio lectures(38.8%)', studying by following teaching schedules (37.8%)', 'isolated self-study(10.3%)', and 'appearance in the attending classes(8.1%)'. 5. As for satisfaction with teaching methods, the data showed that 81.2% of the respondents were satisfied (or very satisfied) with 'attending classes' and 75%, with 'paper lectures'. On the other hand some of respondents were very dissatisfied with 'recorded lecture(12.8%)' and 'radio lecture(10.9%)' 6. The results also showed that the students want to have 'video conferencing lecture(77.2%)', 'cable TV(64.1%)' and 'CD ROM program' to improve learning effects. 7. Concerning learning attitudes, 48.8% of the students reported 'study mainly for examnination', and only 4.1% answered 'study every day with plan'. The learning attitude showed significant differences by marital status and age. The students also evaluated themelves as 'study very hard(5.9%)', 'study hard in general(41.6%)', 'study a little(40.3%)' and 'study little(11.9%)'. 8. The students responded the most effective learning material was the 'textbook (92.2%)'. 9. For the purposes of using the local center, the results showed 'for the attending classes(76.3%)', 'for the use of references(14.7%)', and 'for the study group(66.7%)'. 10. The results revealed that 20.3% of the respondents had ever experienced unregistration or temporary withdrawal, and 53.4% among them did not register more than one time. The most common reason for the unregistration was 'due to family affairs or their job (70.8%)'. 11. 88.1% of the respondents answered 'they will graduate without fail'. 12. Regarding the benefits from the KNOU graduation, respondents indicated 'graduate school admission(38.1%)', 'self-confidence in social life(17.5%)', and understanding social problems (10.9%)'. 13. 64.4% of the students showed that they have intention to enter the graduate school. The item 'changing work place' showed statistically significant differences by marital status and age.

• The Korean Nurse
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• v.30 no.3
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• pp.49-65
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• 1991

This study was carried out to assess the problems with the pregnant women, and check out the risk-factors in the high-risk pregnancies, using a simplified antepartum risk-scoring system, which was revised from Edwards' scoring system to be suitable for Korean situaition. This instrument was included 4 categories, demographic, obstetric, medical and miscellaneous factors. This survey was based on the 1300 pregnant women who were admitted, $x^2$-test, F-test, Pearsons correation, using statistical package SAS in NAS computer system, KIST. The results of the study were as follows; 1. 1313 infants were deliveried of these 560 infants(42.7%) were born to mothers with risk-scores > 7, and 753 infants(57.3%) were born to mothers risk-scores <7. 2. Maternal age" parity, education level, of the demographic factors were significant relation statistically to identify the high risk pregnancies($X^2$=20.88, 42.87, 15.60 P < 0.01). 3. C-section, post term, incompetent cervix, uterine anomaly, polyhydramnios, congenital anomaly, sensitized RH negative, abortion, preeclampsia, excessive size infant, premature, low birth weight infanl, abnormal presentation, perinatal loss, multiple pregnancy, of the obstetric factors were significant relation statistically to identify the high risk-pregnancies. ($X^2$ = 175.96, 87.5, 16.28, 21.78, 9.46, 8. 10, 6.75, 22.9, 64.84, 6.93, 361.43, 185.55, 78.65, 45.52, P < 0.01). 4. Abnormal nutrition, anemia, UTI, other medicalcondition(pulmonary disease, severe influenza), heart disease, V.D., of the miscellaneous and medical factors, were significant relation statistically to identify the high risk-pregnancies. 5. Premature, low birth weight infant, contracted pelvis, abnormal presentation, of the risk factors were significantly related with Apgar score at 1 '||'&'||' 5 minute after birth and neonatal body weight. 6. Apgar score at 1 '||'&'||' 5 minute after, birth and neonatal body weight were significantly negative correlated with risk-score. 7. There were statistically significant difference between risk-score and Apgar score at 1 '||'&'||' 5 minute after birth, 3 group(0-3, 4-6, above 7), and neonatal body weight, 2 group(below 2.5kg, the other group) (F=104.65, 96.61, 284.92, P<0.01). 8. Apgar score at 1 '||'&'||' 5 minute after birth(below 7), and neonatal body weight(below 2.5kg), were significant relation statistically with risk score.($x^2$=65.99, 60.88, 177.07, P<0.01) were 60.8 %, 60% . 9. Correct classifications of morbid infants(l '||'&'||' 5 minute Apgar score < 7) were 77.8%, 83.8% and that of nonmorbid infants(l '||'&'||' 5 minute Apgar score > 7) were 60.8%, 60%. 10. There were statistically significant difference between dislribution of maternal risk-score among the morbid infants(l '||'&'||' 5 minute Apgar score < 7) and non morbid infants(l '||'&'||' 5 minute Apgar score> 7) ($x^2$=64.8, 58.8, P < 0.001). 11. There were statistically significant difference between distribution of morbid infants(l '||'&'||' 5 minute Apgar score < 7) and fetal death. 12. The predictivity for classifying high.risk cases was 12 % and for classifying low-risk cases was 98.3 % in 5 minute Apgar score. Suggestions for further studies are as follows; 1. Contineous prospective studies, using this newly revised scoring system are strongly recommended in the stetric service. 2. Besides risk facto~s used in this study, assessmenl of risks by factors in another scoring system and paralled studies related to perinatal outcome are strongly recommended.

• Journal of Nutrition and Health
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• v.50 no.3
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• pp.246-256
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• 2017

Purpose: This study aimed to investigate the association of total dietary antioxidant capacity (TAC) with oxidative stress and metabolic markers among patients with metabolic syndrome according to gender. Methods: A total of 346 subjects aged 30~59 years with two or more risk factors of metabolic syndrome were recruited from a general hospital near Seoul in South Korea between 2010 and 2012 based on data from the medical checkup. Biochemical indices for oxidative stress and metabolic markers were measured. Food consumption data from 3-day food records were linked with the antioxidant capacity database for commonly consumed Korean foods to estimate individual's TAC. Results: Average dietary TAC of the study subjects was 132.0 mg VCE/d/1,000 kcal in men and 196.4 mg VCE/d/1,000 kcal in women. Levels of ${\gamma}$-glutamyltransferase (GGT), systolic blood pressure, diastolic blood pressure, and blood triglycerides were reduced significantly according to increasing TAC in men, but there was no significant trend in women. Intakes of total flavonoids and carotenoids were significantly negatively correlated with GGT (p < 0.05) and d-ROMs (p < 0.01) in men, whereas those of ${\alpha}$-tocopherol (p < 0.05) and ${\gamma}$-tocopherol (p < 0.05) were positively correlated with biological antioxidant potential (BAP) in women. The odds ratio of high oxidative stress indices and abnormal metabolic markers according to TAC level were not significant in either men or women. Conclusion: The results show that dietary TAC was partially associated with oxidative stress and metabolic markers among patients with metabolic syndrome. Further research is required for elucidating the association between dietary TAC and incidence of metabolic syndrome and chronic diseases within a large population in prospective studies.

• Korean Journal of Radiology
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• v.22 no.12
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• pp.2094-2123
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• 2021

Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1-2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.