• Journal of Yeungnam Medical Science
• /
• 제37권4호
• /
• pp.302-307
• /
• 2020

Background: This study evaluated the usefulness of judgment of central lymph node (LN) metastasis by surgeon's palpation in papillary thyroid cancer. Methods: This study included 127 patients who underwent thyroidectomy and central compartment node dissection between October 2014 and February 2015. The criterion for suspicious LNs was hardness. Results: Of the 20.5% (28/127) of suspicious for metastatic LNs according to surgeon determination, 92.8% (26/28) were confirmed to be metastatic in the final pathological examinations. Metastatic LNs were found in 38 (38.3%) of 99 patients without suspicious LNs, 29 of whom (76.3%) had micrometastases. The sensitivity, specificity, and positive and negative predictive values for the determination of LN metastasis by a surgeon were 40.6%, 96.8%, 92.9%, and 61.6%, respectively. Conclusion: Determination of central LN metastasis by a surgeon's palpation may be useful to evaluate LNs owing to the high specificity and positive predictive values, especially in macrometastasis or high-risk LN disease.

• 대한간호학회지
• /
• 제34권7호
• /
• pp.1315-1325
• /
• 2004

Purpose: The purpose of this study was to examine the effects of a closed endotracheal suction system(CES) on oxygen saturation, ventilator associated pneumonia(VAP), and nursing efficacy in mechanically ventilated patients. Method: This study was conducted in the intensive care unit of a University Hospital in Gwangju City. Data was collected from July to October, 2003. Seventy mechanically ventilated patients were randomly divided into two groups; 32 for CES and 38 for open endotracheal suction system(OES) protocol. Twenty one nurses were also involved to examine the nurses' attitude of usefulness about CES. Result: $SaO_2$ was significantly different between CES and OES. The incidence of VAP in CES was lower than that of OES. Nursing efficacy was related to time, cost, and usefulness of the suction system. Time of suctioning in CES was shorter than that of OES. CES also contributed significantly to lower the cost of treatment than OES. The usefulness score of CES increased after 6 months of use. Conclusion: CES prevented VAP, was cost effective, and a safe suctioning system. CES can be used with patients with sensitivity to hypoxygenation and with a high risk of VAP.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권16호
• /
• pp.7343-7350
• /
• 2015

Genetic changes associated with acute lymphoblastic leukemia (ALL) provide very important diagnostic and prognostic information with a direct impact on patient management. Detection of chromosome abnormalities by conventional cytogenetics combined with fluorescence in situ hybridization (FISH) play a very significant role in assessing risk stratification. Identification of specific chromosome abnormalities has led to the recognition of genetic subgroups based on reciprocal translocations, deletions and modal number in B or T-cell ALL. In the last twelve years 102 newly diagnosed childhood/adult ALL bone marrow samples were analysed for chromosomal abnormalities with conventional G-banding, and FISH (selected cases) using specific probes in our hospital. G-banded karyotype analysis found clonal numerical and/or structural chromosomal aberrations in 74.2% of cases. Patients with pseudodiploidy represented the most frequent group (38.7%) followed by high hyperdiploidy group (12.9%), low hyperdiploidy group (9.7%), hypodiploidy (<46) group (9.7%) and high hypertriploidy group (3.2%). The highest observed numerical chromosomal alteration was high hyperdiploidy (12.9%) with abnormal karyotypes while abnormal 12p (7.5%) was the highest observed structural abnormality followed by t(12;21)(p13.3;q22) resulting in ETV6/RUNX1 fusion (5.4%) and t(9;22)(q34.1;q11.2) resulting in BCR/ABL1 fusion (4.3%). Interestingly, we identified 16 cases with rare and complex structural aberrations. Application of the FISH technique produced major improvements in the sensitivity and accuracy of cytogenetic analysis with ALL patients. In conclusion it confirmed heterogeneity of ALL by identifying various recurrent chromosomal aberrations along with non-specific rearrangements and their association with specific immunophenotypes. This study pool is representative of paediatric/adult ALL patients in Oman.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권19호
• /
• pp.8503-8508
• /
• 2014

Background: After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Materials and Methods: Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. Results: In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. Conclusions: The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

• 한국지하수토양환경학회지:지하수토양환경
• /
• 제8권3호
• /
• pp.1-7
• /
• 2003

지하 유류저장탱크에서 유류가 지속적으로 누출되는 경우에는 지하수 이동에 비해서 LNAPL의 이동을 무시할 수 없다. 본 연구에서는 지하수면 위에서 LNAPL의 이동을 고려한 수정된 용질이동 모델을 개발하였다 LNAPL 이동을 고려하지 않는 기존 모델과 비교한 결과 수두 구배, 누출되는 기름의 양, 분산지수에 따라 두 모델은 차이점을 보였다. 수두 구배가 낮을수록, 누출되는 유류의 양이 증가할수록 수정된 모델과 기존 모델 사이의 평균편차가 증가하였다. 분산지수가 변화함에 따라서 평균편차는 변하지 않았지만, 분산지수가 증가할수록 두 모델 사이의 편차는 공간적으로 보다 넓게 나타났다. 수직방향으로의 분산이 크게 나타날 경우에는 LNAPL의 이동을 고려한 모델과 이동을 고려하지 않은 모델과의 차이가 지하수 유동 방향뿐만 아니라 수직방향으로도 크게 나타났다. 결국 LNAPL의 이동을 무시할 수 없는 지하환경에서는 기존의 모델을 가지고 용질이동을 모사할 경우 실제보다 농도가 낮게 추정될 가능성이 높다. 이 연구의 결과로 LNAPL이 지하수면 위에서 얼마나 빨리 이동하는지 아는 것이 올바른 오염물의 농도 예측에 중요하다는 것을 파악하였다.

• Journal of Preventive Medicine and Public Health
• /
• 제38권3호
• /
• pp.276-282
• /
• 2005

Objectives : To evaluate the predictive validity of three scoring systems; the acute physiology and chronic health evaluation(APACHE) III, simplified acute physiology score(SAPS) II, and mortality probability model(MPM) II systems in critically ill patients. Methods : A concurrent and retrospective study conducted by collecting data on consecutive patients admitted to the intensive care unit(ICU) including surgical, medical and coronary care unit between January 1, 2004, and March 31, 2004. Data were collected on 348 patients consecutively admitted to the ICU(aged 16 years or older, no transfer, ICU stay at least 8 hours). Three models were analyzed using logistic regression. Discrimination was assessed using receiver operating characteristic(ROC) curves, sensitivity, specificity, and correct classification rate. Calibration was assessed using the Lemeshow-Hosmer goodness of fit H-statistic. Results : For the APACHE III, SAPS II and MPM II systems, the area under the receiver operating characterist ic(ROC) curves were 0.981, 0.978, and 0.941 respectively. With a predicted risk of 0.5, the sensitivities for the APACHE III, SAPS II, and MPM II systems were 81.1, 79.2 and 71.7%, the specificities 98.3, 98.6, and 98.3%, and the correct classification rates 95.7, 95.7, and 94.3%, respectively. The SAPS II and APACHE III systems showed good calibrations(chi-squared H=2.5838 p=0.9577 for SAPS II, and chi-squared H=4.3761 p=0.8217 for APACHE III). Conclusions : The APACHE III and SAPS II systems have excellent powers of mortality prediction, and calibration, and can be useful tools for the quality assessment of intensive care units(ICUs).

• Journal of Gastric Cancer
• /
• 제18권3호
• /
• pp.218-229
• /
• 2018

Purpose: This study investigated whether the metabolic avidity of primary tumors and/or metastatic lymph nodes (LNs) measured by $^{18}F$-fluorodeoxyglucose ($^{18}F-FDG$) positron emission tomography/computed tomography (PET/CT) was related to survival after surgery in patients with advanced gastric cancer (AGC). Materials and Methods: One hundred sixty-eight patients with AGC who underwent preoperative $^{18}F-FDG$ PET/CT and curative resection were included. The $^{18}F-FDG$ avidity of the primary gastric tumor and LNs was determined quantitatively and qualitatively. The diagnostic performance of $^{18}F-FDG$ PET/CT was calculated, and the prognostic significance of $^{18}F-FDG$ avidity for recurrence-free survival (RFS) and overall survival (OS) was assessed. Results: In all, 51 (30.4%) patients experienced recurrence, and 32 (19.0%) died during follow-up (median follow-up duration, 35 months; range, 3-81 months); 119 (70.8%) and 33 (19.6%) patients showed $^{18}F-FDG$-avid primary tumors and LNs, respectively. $^{18}F-FDG$ PET/CT showed high sensitivity (73.8%) for the detection of advanced pathologic T ($pT{\geq}3$) stage and high specificity (92.2%) for the detection of advanced pN (${\geq}2$) stage. $^{18}F-FDG$ avidity of LNs was significantly associated with RFS (P=0.012), whereas that of primary tumors did not show significance (P=0.532). Univariate and multivariate analyses revealed that $^{18}F-FDG$ avidity of LNs was an independent prognostic factor for RFS (hazard ratio=2.068; P=0.029). Conclusions: $^{18}F-FDG$ avidity of LNs is an independent prognostic factor for predicting RFS. Preoperative $^{18}F-FDG$ PET/CT can be used to determine the risk and prognosis of patients with AGC after curative resection.

• 대한치과교정학회지
• /
• 제46권2호
• /
• pp.111-126
• /
• 2016

Objective: To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region. Methods: Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed. Results: Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ${\geq}20$ years of age, and for long MIs (${\geq}8mm$) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74). Conclusions: When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.

• Journal of Oral Medicine and Pain
• /
• 제45권3호
• /
• pp.56-64
• /
• 2020

Purpose: Temporomandibular disorders (TMD) is a mosaic of clinical signs and symptoms that can be regarded as a set of phenotypes that are affected by various factors including pain sensitivity, pain disability, sleep and psychological functioning. The aims of this study were to evaluate association of pain experience, sleep quality and psychological distress with different phenotypes of TMD patients. Methods: This retrospective study included a cohort (n=1,858; 63.8% for female, mean age=34.9±15.9 years) of patients with TMD. A set of self-administered questionnaires concerning pain interference (Brief Pain Inventory), pain disability (Graded Chronic Pain Scale), sleep quality (Pittsburg Sleep Questionnaire Index), psychological distress (Symptom Checklist-90 revised), and pain catastrophizing (Pain Catastrophizing Scale) were administered to all participants at the first consultation. All TMD patients were classified into four groups including TMD with internal derangement without pain (TMD_ID, n=370), TMD with joint pain (TMD_J, n=571), TMD with muscle pain (TMD_M, n=541) and TMD with muscle-joint combined pain (TMD_MJ, n=376). Results: The female ratio was particularly high in the group with TMD_MJ (p=0.001). The patients with muscle pain and both muscle and joint pain had longer symptom duration (p=0.004) and presented significantly higher scores in pain experience (p<0.001), subjective sleep quality (p<0.001), pain catastrophizing (p<0.001) and psychological distress (p<0.05) except for paranoid-ideation than the groups with only joint problems. Conclusions: The results of this study highlight the importance of multi-dimensional approach that consider pain disability, sleep quality, and psychological functioning in the management of TMD with muscle component. This study would contribute to a better understanding of interaction between heterogeneous TMD and multiple risk factors in order to build tailored treatment based on different phenotypes.

• 한국전자통신학회논문지
• /
• 제9권10호
• /
• pp.1145-1152
• /
• 2014

RFID(Radio-Frequency IDentification)시스템은 무선으로 사물을 식별하는 기술로 물류, 운송, 유통, 재고관리 등과 같은 물품관리를 획기적으로 개선할 수 있는 새로운 방법이다. 그러나 무선을 사용하고 있는 RFID는 통신구간에 대한 보안의 취약성 때문에 정보 누출 및 변조 같은 위험성을 가지고 있다. 우리는 이런 RFID 통신 시스템에 복잡계의 대표적인 계인 Tent-Map을 적용하여 새로운 인증 프로토콜을 설계하였다. 복잡계의 대표적인 특징인 초기치 민감성과 불규칙성을 RFID의 Reader 와 Tag에 적용하여 보다 견고하고 간략한 인증시스템을 설계하였다. 본 논문에서 보인 복잡계를 이용한 RFID 인증 프로토콜 설계는 기존의 Hash 함수나 난수에 의존되었던 인증 시스템에 차별화된 새로운 방법으로 그 활용성을 검증하는데 그 목적이 있다.