• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1779-1784
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• 2016

Background: Western physicians tend to favour complete disclosure of a cancer diagnosis to the patient, while non-Western physicians tend to limit disclosure and include families in the process; the latter approach is prevalent in clinical oncology practice in India. Few studies, however, have examined patient preferences with respect to disclosure or the role of family members in the process. Materials and Methods: Structured interviews were conducted with patients (N=127) in the medical oncology clinic of a tertiary referral hospital in Bangalore, India. Results: Patients ranged in age from 18-88 (M=52) and were mostly male (59%). Most patients (72%) wanted disclosure of the diagnosis cancer, a preference significantly associated with higher education and English proficiency. A majority wanted their families to be involved in the process. Patients who had wanted and not wanted disclosure differed with respect to their preferences regarding the particulars of disclosure (timing, approach, individuals involved, role of family members). Almost all patients wanted more information concerning their condition, about immediate medical issues such as treatments or side effects, rather than long-term or non-medical issues. Conclusions: While most cancer patients wanted disclosure of their disease, a smaller group wished that their cancer diagnosis had not been disclosed to them. Regardless of this difference in desire for disclosure, both groups sought similar specific information regarding their cancer and largely favoured involvement of close family in decision making. Additional studies evaluating the influence of factors such as disease stage or family relationships could help guide physicians when breaking bad news.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.19.1-19.7
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• 2015

Background: The purpose of this retrospective study was to investigate the usefulness of tracheostomy scoring system in the decision of postoperative airway management in oral cancer patients. Materials and methods: A total of 104 patients were reviewed in this retrospective study, who underwent radical resection with or without neck dissection and free flap reconstruction due to oral cancer. The patients were classified into three groups according to the timing of the extubation; extubated groups (n = 51), overnight intubation group (n = 45), and tracheostomy group (n = 8). Cameron's score was used to evaluate the relation between the state of the patient's airway and the type of the operation. Results: Tracheostomy was performed in eight patients (8/104, 7.7 %). A total of 22 patients (21.2 %) had more than 5 points of which 17 patients (77.3 %) did not have a tracheostomy and any postoperative emergency airway problems. The tracheostomy scores were significantly different among the three groups. Hospital stay showed a significant correlation with the tracheostomy score. Conclusions: The scoring system did not quite agree with the airway management of the authors' clinic; however, it can be one of the clinical factors predicting the degree of the postoperative airway obstruction and surgical aggressiveness for recovery. The further studies are needed for clinically more reliable scoring systems.

• Journal of Chest Surgery
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• 제19권4호
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• pp.618-626
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• 1986

Univentricular heart is a rare congenital cardiac anomaly in which the atrial chambers are connected to only one ventricular chamber and it consists of a diverse group of cardiac malformation characterized by both AV valves or a common AV valve opening into the same ventricle, or the presence of only a solitary AV valve. In spite of recent development in cardiac surgery, corrective operations for univentricular heart still have high mortality and complication rate. Twenty eight patients underwent corrective operation for univentricular heart at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital from February 1979 to July 1986. Of the 28 patients, 7 patients were operated on by ventricular septation and 21 patients by modified Fontan operation. Of the 28 patients, 19 patients were male and 9 patients female and ages ranged from 5 months to 18 years old with the average age of 7.3 years. There were 2 mortalities in 7 patients operated on by septation with the mortality rate of 28.6% and 5 complications, 3 complete AV block, 1 low cardiac output and 1 arrhythmia. All survived patients are being followed up without specific problem till now. There were 10 mortalities in 21 patients operated on by modified Fontan operation with the mortality rate of 47.6% and 10 complications, 2 low cardiac output, 2 respiratory failure necessitating tracheostomy, 2 persistent cyanosis, 2 arrhythmia, 1 missing of left AV valve in situs inversus patient due to misdiagnosis and one rupture of closed right AV valve. Incremental risk factors for operative mortality are young age less than 5 years old, anomalous pulmonary and systemic venous drainage and atrial septation procedure. In 11 survived patients, 9 patients show good follow-up results but one patient complains of persistent cyanosis and another one patient is suffered from CHF. In our series, results of corrective operation for univentricular heart shows continuing improvement but still high mortality and complication rate. So there must be continuing improvement in surgical result by selection of patient, by adequate decision making for timing and method of operation and by improving operative methods.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.106-115
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• 2018

Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (${\leq}14F$) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains. Chest tube insertion should be guided by imaging, either bedside ultrasonography or, less commonly, computed tomography. The so-called trocar technique must be avoided. Instead, blunt dissection (for tubes >24F) or the Seldinger technique should be used. All chest tubes are connected to a drainage system device: flutter valve, underwater seal, electronic systems or, for indwelling pleural catheters (IPC), vacuum bottles. The classic, three-bottle drainage system requires either (external) wall suction or gravity ("water seal") drainage (the former not being routinely recommended unless the latter is not effective). The optimal timing for tube removal is still a matter of controversy; however, the use of digital drainage systems facilitates informed and prudent decision-making in that area. A drain-clamping test before tube withdrawal is generally not advocated. Pain, drain blockage and accidental dislodgment are common complications of small-bore drains; the most dreaded complications include organ injury, hemothorax, infections, and re-expansion pulmonary edema. IPC represent a first-line palliative therapy of malignant pleural effusions in many centers. The optimal frequency of drainage, for IPC, has not been formally agreed upon or otherwise officially established.

• 정보화정책
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• 제19권2호
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• pp.85-105
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• 2012

지금까지 정보화의 중요성과 더불어 정보화 투자 규모는 지속적으로 증가하고 있으며 정보기술 도입에 수반되는 위험, 불확실성 및 복잡성 등으로 인해 대규모 정보화 투자 시 보다 체계적인 의사결정이 요구되고 있다. 본 연구에서는 금융권 정보시스템의 교체 전략 시 고려할 수 있는 여러 요인 중의 하나인 경제적 비용 절감 관점에서, 최적의 경제수명을 도출하기 하기 위한 방법을 제시하고자 한다. 지금까지 비용 집계가 어려워 가정된 데이터를 가지고 연구된 경제 수명에 대한 연구를 활용하여 국내 K금융에서 실제 정보시스템이 구축/운영되면서 발생한 모든 IT비용을 집계하여, 경제적 비용 관점에서 유형별로 정보시스템의 최적 수명을 제시하였다. 향후 같은 유형의 정보시스템의 경제적인 교체시기를 예측하여 IT투자의사결정에서 활용할 수 있도록 하는 것이 본 연구의 목적이라 할 수 있다.

• Journal of the Korean Data and Information Science Society
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• 제23권1호
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• pp.151-159
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• 2012

본 논문에서는 외환시장에서 주성분 분석과 로지스틱 회귀분석을 이용한 다국 통화 포트폴리오 전략을 개발하는 것을 제안한다. 과거 환율시장의 분석에 대한 많은 연구가 진행되어 왔으나 상대적으로 외환시장에서의 거래 전략을 개발하는 연구는 거의 없었다. 본 연구는 크게 두 가지 목적을 가지고 있다. 첫 번째 목적은 주성분 분석을 적용시켜 포트폴리오를 구성하는 다양한 나라의 환율에 가중치 할당 방법을 제안하는 것이다. 두 번째 목적은 로지스틱 회귀분석을 이용하여 구성된 포트폴리오의 적절한 매수시점과 매도시점을 정하는 것이다. 이 논문의 실험결과는 제안한 투자전략의 유용성을 증명할 수 있을 것이며, 또한 이를 통해 시장참여자들에게 투자 결정에 있어 도움을 줄 수 있을 것이다.

• 환경정책연구
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• 제13권2호
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• pp.21-38
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• 2014

지구의 온난화로 인하여 기온이 상승하고 이에 대응하여 수온 증가가 감지되고 있다. 하천의 수온 변화는 수질과 생태계, 특히 용존산소변화와 생물체의 이동으로 이어진다. 기온 변화가 하천의 수질과 생태 환경에 미치는 영향을 추정하기 위해서 수온 상승의 시기와 하천 어종에 대한 이해가 필요한데 이를 위하여 미래의 수온을 예측할 필요가 있다. 환경부 산하 국립환경과학원에서 설치한 국가수질관측망 자료와 기상청 기상관측소의 기온 자료를 활용하여 기온-수온 비선형 상관관계모형을 구축하였다. 기온-수온 대표 관계인 비선형 로지스틱(Logistic) 함수에 포함된 4개의 매개변수를 결정하기 위하여 SCE최적화 기법을 이용하였다. 기온-수온 상관관계는 시간규모에 따른 최대 온도와 최소 온도에 차이가 있으나 수질 또는 생태 반응의 적당한 시간규모에 해당하는 주 평균 온도를 이용하여 분석하였다. 전반적으로 우리나라 하천의 기온-수온 관계는 선형보다는 비선형 모형에서 NSC와 RMSE가 더 우수하여 비선형 모형이 적합한 것으로 나타났다. 연구 결과는 미래의 기온 상승 변화에 반응하는 수질, 수문 및 생태반응에 대비하여 공학기술자 또는 정책입안자에게 적절한 기후변화 대책 방향을 설정하는 데 지침을 제공할 것이다.

• 동남아시아연구
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• 제27권4호
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• pp.117-159
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• 2017

본 연구는 1995년부터 1999년까지 진행된 아세안 회원국 확대 과정의 추동 요인을 가입 희망국을 중심으로 분석하였다. 주요 연구 질문은 지역협력체 가입을 희망하는 국가들의 가입 결정 시기의 차이는 어떻게 설명할 수 있는가이다. 본 연구는 아세안 창설 초기 아세안에 가입하지 않았던 국가들이 왜 1990년대 중반 이후 가입을 했는지, 그리고 냉전 종식 이후 왜 각기 다른 시기에 가입을 했는지, 그 시기적 차이에 대해 주목하고 있다. 이를 위해 베트남, 라오스, 미얀마, 캄보디아의 가입 과정을 비교 분석하였다. 연구의 주요 주장은 아세안 가입의 시기적 차이는 존재하지만 궁극적으로 체제 유지와 같은 정당성 확보를 위해 지역협력체를 활용했다는 것이다. 무엇보다 지역협력체 확대에 대한 기존연구들은 국제체제 변화와 같은 거시적 측면에서 지역협력체 확대를 논의하고 있는 반면 본 연구는 개별회원국이 지역협력체에 가입하는 동기를 국내 정치 및 경제 상황에 초점을 맞춰 분석한 미시적 접근으로 이를 보완하였다.

• 산업경영시스템학회지
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• 제44권4호
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• pp.227-233
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• 2021

Predictive maintenance has been one of important applications of data science technology that creates a predictive model by collecting numerous data related to management targeted equipment. It does not predict equipment failure with just one or two signs, but quantifies and models numerous symptoms and historical data of actual failure. Statistical methods were used a lot in the past as this predictive maintenance method, but recently, many machine learning-based methods have been proposed. Such proposed machine learning-based methods are preferable in that they show more accurate prediction performance. However, with the exception of some learning models such as decision tree-based models, it is very difficult to explicitly know the structure of learning models (Black-Box Model) and to explain to what extent certain attributes (features or variables) of the learning model affected the prediction results. To overcome this problem, a recently proposed study is an explainable artificial intelligence (AI). It is a methodology that makes it easy for users to understand and trust the results of machine learning-based learning models. In this paper, we propose an explainable AI method to further enhance the explanatory power of the existing learning model by targeting the previously proposedpredictive model [5] that learned data from a core facility (Hyper Compressor) of a domestic chemical plant that produces polyethylene. The ensemble prediction model, which is a black box model, wasconverted to a white box model using the Explainable AI. The proposed methodology explains the direction of control for the major features in the failure prediction results through the Explainable AI. Through this methodology, it is possible to flexibly replace the timing of maintenance of the machine and supply and demand of parts, and to improve the efficiency of the facility operation through proper pre-control.

• 척추신경추나의학회지
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• 제16권2호
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• pp.97-105
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• 2021

Objectives This study is aimed to evaluate cost-effectiveness of treatment of Korean Medicine for whiplash associated disorders (WAD) and to suggest the direction of future research. Methods We searched papers in Pubmed database to use some keywords indicating whiplash injury syndrome, treatment of Korean Medicine and cost-effectiveness. After searching, appropriate papers were selected depending on the exclusion criteria. The selected papers were analyzed in the sections of author, publication year, intervention and control groups, outcome measurement, the list including in the cost, cost-effectiveness, cost-utility and study design. Results Four studies about effect of Korean medicine and 3 studies about economic evaluation were finally included. Acupuncture was effective for balance disorder and neck pain. Economic evaluation studies used analytical decision model or cost-consequence analysis. Cost-effectiveness analysis using visual analog scale and cost-utility analysis using quality adjusted life years were performed. Initiating timing of proper management affected the consequence of treatments. Direct and indirect medical costs including supportive devices, and non-medical costs such as litigation were considered. Conclusions We conclude that studies haven't been conducted so far to evaluate the cost-effectiveness of Korean Medicine in whiplash injury syndrome. Thus, future studies are needed in this section.