• Nutrition Research and Practice
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• 제14권2호
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• pp.117-126
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• 2020

BACKGROUND/OBJECTIVES: Vitamin D and zinc are recognized for their roles in immune-modulation, and their deficiencies are suggested to be important risk factors for childhood infections. This study, therefore, undertook to assess the occurrence of infections in rural Indian schoolchildren, subsequent to daily supplementation with vitamin D-calcium or zinc for 6 months. SUBJECTS/METHODS: This was a randomized, double-blind, placebo-controlled trial in apparently healthy 6-12 year-old rural Indian children, recruited to 3 study arms: vitamin D arm (1,000 IU D3 - 500 mg calcium, n = 135), zinc arm (10 mg, n = 150) and placebo arm (n = 150). The infection status was assessed using a validated questionnaire, and the biochemical parameters of serum 25(OH)D and serum zinc were measured by ELISA and colorimetry, respectively. The primary outcome variable was occurrence of infections (upper respiratory and total infections). RESULTS: Serum 25(OH)D concentration in the vitamin D arm improved significantly by 34%, from 59.7 ± 10.9 nmol/L to 80 ± 23.3 nmol/L (P < 0.0001), but no improvement was observed for serum zinc concentration. While there was significant increase in the percentage of children reporting no or mild upper respiratory tract infections (URTI) and total infections (TI) in all three groups, improvements in the supplemented groups were similar to the placebo group. However, the vitamin D arm reported lower URTI and TI status in the vitamin D sufficient versus insufficient children. Also, URTI and TI status were found to be significantly (P < 0.0001) lower in children with improved 25(OH)D versus unchanged 25(OH)D. CONCLUSIONS: Vitamin D-calcium supplementation helped to improve the vitamin D status but exerts no effect on the occurrence of infections when compared to the placebo group. Improvement in the serum 25(OH)D concentrations and attainment of vitamin D sufficiency may exert a beneficial effect on the infection status and needs to be investigated further. To evaluate the efficacy of zinc supplementation, higher dosages need to be administered in future studies.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.759-765
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• 2016

Background: Breast cancer is the most frequent cancer of women in Pakistan with the majority presenting with stage III or IV lesionsat initial diagnosis. Patient and health system related factors are well known determinants of delay in presentation and diagnosis. Additionally, breast cancer being a heterogeneous disease, the various molecular subtypes featuring different aggressiveness also need to be considered. The present study evaluated the association of stage at initial diagnosis of breast cancer with these two factors in local women at a tertiary level health care facility in Lahore, Pakistan. Materials and Methods: Patient and tumor features were recorded separately during diagnostic workup in Breast Clinics at INMOL and at Services Hospital, Lahore. Data were entered in MS Excel and analyzed by descriptive statistics and Chi-Square test. Results: Among the 261 patients, 64% were staged as late breast cancer (LBC), the mean age was 46.8 with standard deviation of 13 years. Some 92% had invasive ductal carcinoma (IDC), 61% had luminal types (LT) of non-aggressive tumor while 39% had the non-luminal types (NLT) of of HER2-enriched or basal aggressive tumors. While 70% of patients presented within one year of symptomatic disease (early report group "ERG"), 30% reported after a mean delay of 4 years with a standard deviation of 3.75 years. The stage distribution among ERG patients was not statistically different from those reporting late (P=0.123). Statistically larger proportion of patients with NLT presented as LBC as compared to the LT (P =0.034). Among the ERG, statistically different stage distribution of disease was observed for the NLT versus LT (P=0.047). Among those presenting late, this difference was insignificant (P=0.416). Conclusions: Breast cancer is a distinct disease in Pakistan with a high frequency of aggressive molecular types affecting younger women, with the majority presenting as LBC. Association of NLT with higher stage at diagnosis is statistically significant whereas time delay in diagnosis is not. Further research is required to define the risk profile and features in local patients. The burden of LBC can be reduced by promoting breast health awareness and by establishing easily accessible dedicated breast care set ups in the hospitals.

• 한국정보과학회논문지:소프트웨어및응용
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• 제33권5호
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• pp.508-524
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• 2006

이 논문에서는 정적 프로그램 분석(static program analysis)과 통계적 분석(statistical analysis)의 조합을 가지고 실제적인 C 프로그램을 검증한 경험을 보고한다. 정적 분석과 통계적 분석의 조합은 입력 프로그램에 제한을 두지 않는 정적 분석기에서 발생하는 불가피한 허위 경보를 줄이기 위한 것이다. 우리는 ANSI C 프로그램이 실행 중에 겪을 수 있는 모든 배열 참조 오류(buffer overrun)를 찾아주는 정적 프로그램 분석기 아이락(Airac, Array Index Range Analyzer for C)을 고안하고 구현하였다. 분석의 안전성(soundness)을 유지하면서 프로그램 분석 분야에서 오랫동안 축적된 기술들을 활용하여 분석 비용 절감 및 정확도 향상을 달성했다. 대상 프로그램에 제한을 두지 않는 안전한 분석은 정확도에 한계가 있으므로 불가피한 허위 경보가 존재할 수 있다. 이러한 허위 경보(예를 들어 530만 줄짜리 상용 C 프로그램에 대한 분석 결과 아이락은 970개의 배열 참조 오류 경보를 발생시켰으나 그 중 737개는 허위 경보였다.)에 대처하기 위해 우리는 통계적 사후 분석을 시도하였다. 통계적 사후 분석은 주어진 경보가 실제 오류를 가리킬 확률을 계산한다. 이렇게 계산된 확률은 두 가지 방법으로 사용된다. 1) 경보를 걸러내거나, 2) 실제 오류에 대한 경보일 가능성이 높은 것들을 우선적으로 사용자에게 보여준다. 우리는 리눅스 커널 프로그램과 알고리즘 교과서의 프로그램들을 대상으로 실험을 수행했다. 우리 실험에서 실제 오류를 놓칠 위험이 허위 경보의 위험의 3배라고 설정한 경우 74.83%의 허위 경보를 걸러낼 수 있었고, 참일 확률이 높은 경보부터 검증하는 경우 15.17%의 허위 경보만이 실제 오류 50%와 섞여 있었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권4호
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• pp.231-239
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• 2012

Objectives: This study sought to provide guidelines in order to decrease the incidence of nerve injury during mandibular ramus bone harvesting, and to improve understanding of the anatomical structure of the inferior alveolar canal (IAC) to include its distance from the exterior buccal cortex. Materials and Methods: In January and February 2009, 20 patients who visited the Wonkwang University Department of Oral and Maxillofacial Surgery reporting various conditions underwent cone beam computed tomography and were included in this study. Patients with missing left or right mandibular first molars or incisors, or who had jaw fracture or bone pathologies, were excluded. The reference point (R point) was defined as the point where the occlusal plane reached the anterior ramus of the mandible. The position of the IAC in relation to the R point, the buccal bone width (BW), the alveolar crest distance (ACD), the distance from the alveolar crest to the occlusal plane (COD), and the distance from the IAC to the sagittal plane (CS) were determined using proprietary image analysis software which produced cross-sectional coronal and axial images. Results: The distance medially from the R point to the IAC along the axial plane was $6.19{\pm}1.21mm$. The HD from the R point, posteriorly to IAC, in the lateral view was $13.07{\pm}2.45mm$, the VD from the R point was $14.24{\pm}2.41mm$, and the ND from the R point was $10.12{\pm}1.76mm$. The pathway of the IAC was positioned almost in a straight line along a sagittal plane within $0.56{\pm}0.70mm$. The distance from the buccal bone surface to the IAC increased anteriorly from the R point. Conclusion: Marking osteotomy lines in the retromolar area in procedures involving bone harvesting should be discouraged due to the risk of damage to IAC structures. Our measurements indicated that the area from the R point in the ramus of the mandible to 10 mm anterior can be safely harvested for bone grafting purposes.

• Journal of Periodontal and Implant Science
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• 제34권1호
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• pp.101-112
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• 2004

Osseointegrated implnats have proven to be successful in both full and partial edentulous patients since the 1960s and recently have shown successful results when used to restore single tooth missing. However, in most studies reporting the success of single implants, single implants replacing anterior teeth are more frequently mentioned than posterior single implants. Moreover, in studies regarding posterior single implants, the replaced region seemed to be variable; the maxilla, mandible and areas from the first premolar to the second molar were mentioned. However, considering the difference in bone quality in the mandible and maxilla, and the increased occlusal force in the posterior region, the success rates in each region may be different. In this study, the cumulative success rates and amount of bone loss of single implants replacing the mandibular first and second molar, respectively, were compared and analyzed to come to the following conclusion. 1. The 20 (20 persons) single implants that were placed in the mandibular first molar region were all successful and showed a 100% 5 year cumulative success rate. Among the 27 (24 persons) single implants replacing the mandibular second molar, 8 failed (27.63%) showing a 5 year cumulative success rate of 70.37%. 2. Among the 8 failed implants, one showed symptoms of postoperative infection and one complained of parenthesia. 6 implants failed after functional loading; 5 showed mobility and one resulted in fixture fracture. 3. After the attachment of the prosthesis, there was no significant statistical difference regarding the marginal bone loss in group 1 and group 2 during the checkup period (P>0.05). In conclusion, restoration of the mandibular first molar using single implants was found to be an excellent treatment modality, and when replacing mandibular second molars with single implants, poor bone quality and risk of overloading must be considered.

• 우울조울병
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• 제16권3호
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• pp.158-162
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• 2018

Objectives : The purpose of this study was to examine psychosocial factors related to burnout of social welfare officers working in Jeonnam Province. Methods : A total of 395 social welfare officers (male 99, female 296) working in 22 areas of Jeollanam-do province, were subjects of this study. We examined socio-demographic factors, using a self-reporting questionnaire. Subjects were asked to complete the Maslach Burnout Inventory-General Survey (MBI-GS), Center for Epidemiological Studies Depression Scale (CES-D), Perceived Stress Scale (PSS), and the Generalized Self-Efficacy Scale (GSS), to assess psychosocial factors affecting to burnout of social welfare officers. Results : Among 395 subjects, 221 (55.9%) reported recent experiences of burnout. There was no significant difference in age between two groups, divided by burnout. Sex (p<0.001), rank (p=0.003), working period (p=0.034), depression (p<0.001) revealed differences between the burnout group and control group. Scores of PSS (p<0.001) were higher, while the scores of GSS (p<0.001) were lower in the burnout group, than control group. Multivariate logistic regression analysis revealed that female (OR 2.840, 95%CI 1.466-5.504, p=0.002), depressive high-risk group (OR 6.824, 95%CI 2.893-16.096, p<0.001) PSS (OR 1.247, 95%CI 1.153-1.349, p<0.001) and GSS (OR 0.950, 95%CI 0.930-0.971, p<0.001), were significantly associated with burnout. Conclusion : We found that some factors, were associated with experienced burnout in social welfare officers. Depressive symptoms were the strongest associative factor, for burnout in public servants in charge of social welfare. Sex, stress and self-efficacy also correlated with burnout, and especially self-efficacy was a protecting factor.

• 한국터널지하공간학회 논문집
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• 제21권1호
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• pp.1-29
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• 2019

NATM (무근)터널의 라이닝 균열을 분석한 논문과 연계하여 NATM (철근)터널의 결함을 정밀안전진단 사례를 정리하여 결함별 원인을 분석하고자 하였다. NATM (철근)터널에서 콘크리트라이닝은 그 역할에 따라 철근과 같은 보강재를 사용하게 된다. 지반이 불량하거나 안전성 확보를 위한 라이닝 두께의 증가는 굴착단면의 증가와 라이닝 타설 물량의 증가를 유발하나, 철근보강 단면을 설계하여 경제성과 안전성을 함께 도모하게 된다. 시설물안전법에 의한 국내 1종 터널 시설물 중에서 NATM으로 시공된 구간에 철근보강을 실시한 라이닝의 결함 특성을 정리하여 형태별 발생원인을 분석하고자 하였다. 단철근, 복철근과 무근라이닝에 발생되는 균열을 비교하여 철근으로 인한 균열제어 효과를 분석하였다. 다양한 위치에서의 철근노출 사례와 함께 기술하였고 터널에서 고려될 수 있는 라이닝 두께 부족의 원인으로 정밀시공 미흡, 박락, 공용중 라이닝 화재에 의한 폭열, 지진, 용탈의 사례를 기존 연구와 비교하여 분석하였다. 향후 본 연구를 통해 정밀안전진단(터널) 세부지침의 보완 및 개정방향 등을 제시하고자 한다.

• 대한영상의학회지
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• 제79권6호
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• pp.340-347
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• 2018

목적: 가도세틱산-조영증강 MRI에서 간세포암 피막 발견에 대한 영상차감기법의 진단적 가치를 알아보고자 하였다. 대상과 방법: 2015년 5월부터 2017년 2월까지 가도세틱산-조영증강 MRI를 시행 받고 수술을 시행한 hepatocellular carcinoma (이하 HCC) 고위험군 108명을 대상으로 하였다. 차감영상의 질 및 간문맥기와 이행기의 일반영상과 차감영상에서 피막 여부에 대해 평가하였고, 차감영상에서의 피막 여부가 Liver Imaging Reporting and Data System에 따른 간세포암 진단에 미치는 영향을 평가하였다. 결과: 수술 전 경동맥화학색전술을 시행 받았거나 차감영상의 질이 불만족스러운 34명의 환자를 제외한 74명의 환자에서 82개의 간 병변(간세포암 73개, 그 외 악성종양 5개, 양성종양 4개)에 대해 분석하였다. 피막의 발견에 대한 차감영상의 민감도, 정확도, 그리고 곡선하면적은 일반영상과 비교하여 통계적으로 유의하게 높았고(각 95.4%, 89.0%, 0.80; p < 0.001), 특이도는 동일하였다(64.7%). HCC의 진단에 대해서도 차감영상이 일반영상과 비교하여 민감도, 정확도, 그리고 곡선하면적이 통계적으로 유의하게 높았으며(각 82.2%, 79.3%, 0.69; p = 0.011), 특이도는 동일하였다(55.6%). 결론: 가도세틱산-조영증강 MRI에서 간문맥기 또는 이행기로부터의 차감영상은 간세포암 피막의 발견에 도움이 된다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권4호
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• pp.283-309
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• 2021

Achieving profound anesthesia in mandibular molars with irreversible pulpitis is a tedious task. This review aimed at evaluating the success of buccal/lingual infiltrations administered with a primary inferior alveolar nerve block (IANB) injection or as a supplemental injection after the failure of the primary injection in symptomatic and asymptomatic patients with irreversible pulpitis in human mandibular molars. The review question was "What will be the success of primary and supplemental infiltration injection in the endodontic treatment of patients with irreversible pulpitis in human mandibular molars?" We searched electronic databases, including Pubmed, Scopus, and Ebsco host and we did a comprehensive manual search. The review protocol was framed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. We included clinical studies that evaluated and compared the anesthetic outcomes of primary IANB with primary and/or supplementary infiltration injections. Standard evaluation of the included studies was performed and suitable data and inferences were assessed. Twenty-six studies were included, of which 13 were selected for the meta-analysis. In the forest plot representation of the studies evaluating infiltrations, the combined risk ratio (RR) was 1.88 (95% CI: 1.49, 2.37), in favor of the secondary infiltrations with a statistical heterogeneity of 77%. The forest plot analysis for studies comparing primary IANB + infiltration versus primary IANB alone showed a low heterogeneity (0%). The included studies had similar RRs and the combined RR was 1.84 (95% CI: 1.44, 2.34). These findings suggest that supplemental infiltrations given along with a primary IANB provide a better success rate. L'Abbe plots were generated to measure the statistical heterogeneity among the studies. Trial sequential analysis suggested that the number of patients included in the analysis was adequate. Based on the qualitative and quantitative analyses, we concluded that the infiltration technique, either as a primary injection or as a supplementary injection, given after the failure of primary IANB, increases the overall anesthetic efficacy.

• 문화기술의 융합
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• 제8권6호
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• pp.515-522
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• 2022

본 연구는 독일의 아동학대 대응체계를 예방적 관점에서 분석하고, 우리나라에 적용가능한 함의점을 찾아보고자 하였다. 연구방법으로는 법적차원, 정책적 차원, 전문성 차원에서 분석틀을 제시하고 시사점을 도출하였다. 연구결과는 다음과 같다. 첫째, 독일 아동청소년지원법은 국가의 개입 이전에 가정의 역기능을 회복할 수 있도록 예방적 지원체계를 규정하였다. 둘째, 민법에 따라 가정법원이 조기개입이 가능하도록 규정하였다. 셋째, 연방아동보호법을 통해 아동학대 대응체계를 위한 지역사회 협력을 규정하였다. 넷째, 아동학대 대응체계의 책임기구인 청소년청은 예방적 지원과 개입이 동시에 가능하도록 하였다. 다섯째, 인력의 전문성을 위해 아동청소년지원법에 자격기준을 명시하고, 3년 이상 전담공무원에게 아동보호전문인력 자격을 부여한다. 시사점은 다음과 같다. 첫째, 아동학대 신고체계로 작동하는 아동학대 대응체계를 예방적 지원체계로 확대해야 한다. 둘째, 학대받은 아동을 위한 보호조치뿐만 아니라 잠재적 위험아동에 대한 지원체계를 확립하기 위하여 네트워크 간 조기경보체계를 시스템으로 구축하여 모니터링을 확대해야한다. 셋째, 아동과 부모가 가정의 어려움으로 인해 발생하는 역기능을 지방자치단체가 유연하고 포괄적으로 지원해야 한다. 넷째, 네트워크 협력체계를 위해 아동보호협력법의 제정이 필요하다.