• Korean Journal of Schizophrenia Research
• /
• v.22 no.2
• /
• pp.42-50
• /
• 2019

Objectives: In this preliminary study, we investigated the clinical characteristics of patients who were first diagnosed with psychotic disorder and explored the impact of the adherence to antipsychotics on long-term medical use. Methods: All national health insurance claims related to psychotic disorders including gender, age, income, and drug compliance, from January 1, 2008 to December 31, 2015, were examined. With trend test using Medication Possession Ratio (MPR), we compared the medical use between the compliant group (MRP≥0.8) and the comparative non-compliant group (0.2≤MPR<0.8). Results: Among 28,095 participants in total, 16,239 patients (57.8%) were diagnosed as schizophrenia; the 30s were the most common (n=7,151, 25.5%). Drug compliance was generally low regardless of the diagnosis and was the lowest among 20s with the 40-60% range of income. The compliant group showed lower psychiatric and medical use than the comparative group in the following years (p<0.0001). Conclusion: These findings suggest that patients in the 20s and 30s with the 40-60% range of income, who are diagnosed with schizophrenia at the first psychiatric visit, may need more clinical and political attention. The results also emphasize the importance of initial drug adherence to antipsychotics in reducing long-term psychiatric costs.

• Radiation Oncology Journal
• /
• v.26 no.4
• /
• pp.229-236
• /
• 2008

Purpose: The purpose of this study was to evaluate the impact of the use of external radiation therapy (ERT) in terms of survival and compliance in patients with anaplastic thyroid carcinoma. Materials and Methods: The medical records of 17 patients with anaplastic thyroid carcinoma treated with ERT between 1993 and 2002 were retrospectively reviewed. ERT was administered after surgery in 14 patients and after a biopsy in three patients. Among the 14 patients who had undergone surgery, nine underwent a curative resection and five underwent a palliative resection. Six patients had associated well-differentiated thyroid carcinomas and 14 patients were diagnosed with a tumor size exceeding 5 cm. The radiation dose ranged from $6{\sim}70\;Gy$ (median dose, 37.5 Gy). Eleven patients completed the planned course of ERT, whereas six patients did not. The follow-up period ranged from $1{\sim}104$ months (median, 5 months; mean, 20 months). Results: Five patients started the ERT without the presence of a gross mass and all of the patients competed ERT without a re-growth of tumor. Twelve patients (four patients after a curative resection, five patients after a palliative resection and three patients after a biopsy) started ERT with a gross mass present and only six patients were able to complete the planned course of ERT. Among the six patients who completed ERT, two patients showed a marked regression of the tumor mass, whereas two patients showed slight regression and two patients showed no response. The median survival was five months (range, $1{\sim}104$ months) and the mean survival was 21 months. The overall survival was 41% at 1-year, 24% at 2-years and 12% at 5-years. Significant prognostic factors included the number of primary tumors present, tumor size, whether surgery was performed and completion of ERT as planned. Long-term survivors showed a tendency of having smaller sized initial tumors and smaller sized pre-ERT tumors than the short-term survivors. Conclusion: This study suggests that patients with a small initial tumor (${\leq}5\;cm$), which was treated by surgery (curative resection or palliative resection) before ERT, and without rapid re-growth of the mass seen at the surgical site at the beginning of the ERT course, would be the best candidates for postoperative ERT. In contrast, patients with a large initial tumor (>5 cm) and did not undergo surgery before ERT or that rapid re-growth of the mass was observed at the surgical site are likely to have a short survival time, along with the interruption of ERT. In these cases, the role of ERT is very limited and the omission of ERT could be considered.

• Journal of the Korean Wood Science and Technology
• /
• v.44 no.1
• /
• pp.57-66
• /
• 2016

In order to develop materials with a low environmental load for restoring the destroyed forest, seven types of wood-concrete hybrid laminated materials were manufactured with four softwoods, three hardwoods and concrete, and the effect of wood density on bending creep property was investigated. The bending creep curves showed a shape to considerably increase at the upper right side, and the curves were found to show a linear behavior beyond about 30 min - 1 hour, as behaviors of solid woods and wood-based materials. The initial compliances of wood-concrete hybrid-laminated materials decreased with an increase in the wood density, and those values showed 0.9 - 1.2 times of the concrete one. The creep compliances of hybrid laminated materials showed very low values, which were 0.4 - 0.8 times of the concrete ones. The relative creep were very low with a range from 8.2% to 17.0% range, which were 0.3 - 0.7 times of the concrete ones. These results indicate that these materials can be applied for restoring the destroyed forest to reduce creep deformation of the conventional concrete materials by hybrid-laminating concrete and woods.

• Journal of Convergence for Information Technology
• /
• v.10 no.8
• /
• pp.77-86
• /
• 2020

The study aims to analyze the compliance and non-compliance of the Korean health authorities regarding WHO's mask use recommendations following the spread of Covid-19, and to suggest the limitations and implications of the recommendations in the prevention of epidemics by deriving the causes of non-compliance with the results of alternative options. To this end, documents related to masks at home and abroad are reviewed, and WHO's mask recommendations and the Korean health authorities' mask guidelines are targeted for analysis. The analysis results are as follows. First, Korea's health authorities have basically accepted and applied WHO's "limited mask user perspective" in two recommendations. Second, Korea's health authorities have implemented differently from WHO mask recommendations due to the lack of supply and demand of masks. Third, Korea's health authorities were able to succeed in the initial prevention of Corona 19 based on the stabilization of the mask supply. Fourth, in the WHO mask recommendations, mask user restriction resulted in partial errors as a recommendation. The implication derived from the analysis is that even international recommendations based on medical evidence need to be allowed to follow autonomous guidelines according to the country's quarantine situation and competence, rather than strict adherence to international rules, in the infectious disease pandemic situation.

• Journal of Korean Neurosurgical Society
• /
• v.37 no.6
• /
• pp.416-421
• /
• 2005

Objective: Despite general agreement on the goals of surgical treatment in thoracolumbar burst fractures, considerable controversy exists regarding the choice of operative techniques. This study is to evaluate the efficacy of short-segment fixation for thoracolumbar burst fractures after long-term follow-up and to analyze the causes of treatment failures. Methods: 48 out of 60 patients who underwent short-segment fixation for thoracolumbar burst fractures between January 1999 and October 2002 were enrolled in this study. Their neurological status, radiological images, and hospital records were retrospectively reviewed. Simple radiographs were evaluated to calculate kyphotic angles and percentages of anterior body compression (%ABC). Results: The average kyphotic angles were $20.0^{\circ}$ preoperatively, $9.6^{\circ}$ postoperatively, and $13.1^{\circ}$ at the latest follow-up. The average %ABC were 47.3% preoperatively, 31.2% postoperatively, and 33.3% at the latest follow-up. The treatment failure, defined as correction loss by $10^{\circ}$ or more or implant failure, was detected in 6 patients (12.5%). 5 out of 6 patients had implant failures. 2 out of 5 patients were related with osteoporosis, and the other 2 were related with poor compliance of spinal bracing. 3 patients with poor initial postoperative alignment had implant failure. 4 patients with screws only on the adjacent vertebrae and not on the injured vertebra itself showed poor initial and overall correction. Conclusion: With proper patient selection, adequate intraoperative reduction with screw fixation involving the injured vertebra, and strict postoperative spinal bracing, the short-segment fixation is an efficient and safe method in the treatment of thoracolumbar burst fracture.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.4
• /
• pp.2329-2336
• /
• 2016

Background: Despite the existence of established guidelines advocating the use and value of chemotherapy order templates, chemotherapy orders are still handwritten in many hospitals in Lebanon. This manuscript describes the implementation of standardized chemotherapy order templates (COT) in a Lebanese tertiary teaching hospital through multiple steps. Initial Assessment: An initial assessment was conducted through a retrospective appraisal of completeness of handwritten chemotherapy orders for 100 adult patients to serve as a baseline for the project and identify parameters that might afford improvement. Choice of solution: Development of over 300 standardized pre-printed COTs based on the National Comprehensive Cancer Network templates and adapted to the practice culture and patient population. Implementation: The COTs were implemented, using Kotter's 8-step model for leading change, by engaging health care providers, and identifying and removing barriers. Evaluation: Assessment of physicians' compliance with the new practice (122 orders assessed) was completed through two phases and allowed for the identification of areas of improvement. Lessons Learned: Overall, COT implementation showed an average improvement in order completion from 49.5% (handwritten orders) to 77.6% (phase 1-COT) to 87.6% (phase 2-COT) reflecting an increase of 38.1% between baseline and phase 2 and demonstrating that chemotherapy orders completeness was improved by pre-printed COT. As many of the hospitals in Lebanon are moving towards standardized COTs and computerized physician order entry (CPOE) in the next few years, this study provides a prototype for the successful implementation of COT and demonstrates their role in promoting quality improvement of cancer care.

• Journal of the Computational Structural Engineering Institute of Korea
• /
• v.27 no.1
• /
• pp.9-16
• /
• 2014

Using a level set method and topological derivatives, a topological shape optimization method that is independent of an initial design is developed for linearly elastic structures. In the level set method, the initial domain is kept fixed and its boundary is represented by an implicit moving boundary embedded in the level set function, which facilitates to handle complicated topological shape changes. The "Hamilton-Jacobi(H-J)" equation and computationally robust numerical technique of "up-wind scheme" lead the initial implicit boundary to an optimal one according to the normal velocity field while minimizing the objective function of compliance and satisfying the constraint of allowable volume. Based on the asymptotic regularization concept, the topological derivative is considered as the limit of shape derivative as the radius of hole approaches to zero. The required velocity field to update the H-J equation is determined from the descent direction of Lagrangian derived from optimality conditions. It turns out that the initial holes are not required to get the optimal result since the developed method can create holes whenever and wherever necessary using indicators obtained from the topological derivatives. It is demonstrated that the proper choice of control parameters for nucleation is crucial for efficient optimization process.

• Journal of Korean Academy of Nursing
• /
• v.44 no.6
• /
• pp.630-638
• /
• 2014

Purpose: The purpose of this study was to develop a scale to evaluate stress in elderly patients with coronary artery diseases (CAD) and to examine validity and reliability of the scale. Methods: The development process for the preliminary scale included construction of a conceptual framework and initial items, verification of content analysis, sentence correction, and pilot study. This study was conducted using a questionnaire survey with one-to-one interviews during January and February, 2012. Participants were 240 elderly patients with CAD. Data were analyzed using item analysis, factor analysis, criterion related validity, and internal consistency. Results: The developed scale consisted of 32 items and 6 factors - aging and disease (7 items), family relations (5 items), anxiety and withdrawal (9 items), management of daily living (3 items), compliance of medical regimen (4 items), poverty and finance (4 items), and explained 68.5% of total variance. The scale had significantly positive correlation with the Korean Perceived Stress Scale (KPSS). Cronbach's alpha was .96, and Guttman split half coefficient was .91. Conclusion: Results indicate that the Stress Scale for Elderly Patients with CAD has validity and reliability, and is a suitable scale in health care settings to assess stress in elderly patients with CAD.

• Transactions of the Korean Society of Mechanical Engineers A
• /
• v.23 no.6 s.165
• /
• pp.1026-1038
• /
• 1999

Interlaminar fracture toughness of carbon/epoxy composite materials has been studied under tensile and flexural loading by the use of width tapered double cantilever beam(WTDCB) and end notched flexure(ENF) specimens. This study has significantly examined the effect of various interfacial ply orientation, ${\alpha}(0^{\circ},\;45^{\circ}\;and\;90^{\circ})$ and crack propagation direction, ${\theta}(0^{\circ},\;15^{\circ},\;30^{\circ}\;and\;45^{\circ})$ in terms of critical strain energy release rate through experiments. Twelve differently layered laminates were investigated. The data reduction for evaluating the fracture energy is based on compliance method and beam theory. Beam theory is used to analyze the effect of crack propagation direction. The geometry and lay-up sequence of specimens are considered various conditions such as skewness parameter, beam volume, and so on. The results show that the fiber bridging occurred due to the non-midplane crack propagation and causes the difference of fracture energy evaluated by both methods. For safer and more reliable composite structures, we obtain the optimal stacking sequence from initial fracture energy in each mode.

• Proceedings of the KSME Conference
• /
• 2004.11a
• /
• pp.202-207
• /
• 2004

An elastic-plastic finite element analysis of fatigue crack closure is performed for plane strain conditions. The stabilization behavior of crack opening level and the effect of mesh size on the crack opening stress are investigated. In order to obtain a stabilized crack opening level for plane strain conditions, the crack must be advanced through approximately four times the initial monotonic plastic zone. The crack opening load tends to increase with the decrease of mesh size. The mesh size nearly equal to the theoretical plane strain cyclic plastic zone size may provide reasonable numerical results comparable with experimental crack opening data. The crack opening behavior is influenced by the crack growth increment and discontinuous opening behavior is observed. A procedure to predict the most appropriate mesh size for different stress ratio is suggested. Crack opening loads predicted by the FE analysis based on the procedure suggested resulted in good agreement with experimental ones within the error of 5 %. Effect of the distance behind the crack tip on the crack opening load determined by the ASTM compliance offset method based on the load-displacement relation and by the rotational offset method based on the load-differential displacement relation is investigated. Optimal gage location and method to determine the crack opening load is suggested.