• Clinical Endoscopy
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• v.56 no.2
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• pp.188-193
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• 2023

Background/Aims: Data on the incidence of adverse respiratory events during recovery from gastrointestinal endoscopy are limited. The aim of this study was to investigate the incidence of these complications. Methods: In this retrospective cohort study, data were obtained from the electronic records of 657 consecutive patients, who underwent gastroenterological procedures under sedation. Results: Pulse oximetry oxygen saturation (SpO₂) <90% for <60 seconds occurred in 82 patients (12.5%), and in 11 patients (1.7%), SpO₂ of <90% for >60 seconds occurred in 79 patients (12.0%) and in 14 patients (2.1%), and SpO₂ <75% occurred in four patients (0.6%) and in no patients during the procedure and recovery period, respectively. No major complications were noted. The occurrence of desaturation during recovery was correlated with desaturation during the procedure (p<0.001). Higher American Society of Anesthesiologists score (odds ratio [OR], 1.867; 95% confidence interval [CI], 1.008-3.458), ischemic heart disease (OR, 1.815; 95% CI, 0.649-5.080), hypertension (OR, 1.289; 95% CI, 0.472-3.516), and diabetes mellitus (OR, 2.406; 95% CI, 0.950-6.095) increased the occurrence of desaturation during recovery. Conclusions: We found no major complications during recovery after balanced propofol-based sedation administered by a gastroenterologist-nurse team. Patients with the identified risk predictors must be monitored carefully.

• Clinical and Experimental Reproductive Medicine
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• v.51 no.2
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• pp.151-157
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• 2024

Objective: People vaccinated with the coronavirus disease 2019 (COVID-19) (severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]) mRNA vaccine have reported experiencing various adverse effects. For instance, reproductive-age women have presented with complaints of abnormal uterine bleeding or menstrual cycle changes. We speculated that differences in basal sex hormone levels before and after vaccination may be present in women who experienced irregular bleeding or menstrual cycle changes; thus, this study aimed to investigate the differences in basal sex hormone levels of women before and after two doses of SARS-CoV-2 mRNA vaccination. Methods: This retrospective study included patients who received SARS-CoV-2 mRNA vaccines between January 2021 and February 2022 at a single center. In an outpatient setting, patients were queried regarding their menstrual cycle, the date of SARS-CoV-2 mRNA vaccination, vaccination type, and vaccination side effects. Differences in basal hormone levels (menstrual cycle days 2-3, follicle-stimulating hormone [FSH], luteinizing hormone [LH], and estradiol) before and after vaccination were compared. Results: Among the 326 patients, patients with no laboratory records of the hormones were excluded. The median time interval between SARS-CoV-2 mRNA vaccination and the laboratory test day was 79 days (interquartile range, 44 to 127). A comparative analysis of these hormones before and after vaccination revealed no significant differences. Subgroup analyses based on age and reported adverse events also found no statistically significant differences. Conclusion: This study showed no significant differences in basal hormone levels (FSH, LH, and estradiol) before and after SARS-CoV-2 mRNA vaccination.

• Clinical Endoscopy
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• v.57 no.4
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• pp.476-485
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• 2024

Background/Aims: Sedation has become a standard practice for patients undergoing gastrointestinal (GI) endoscopy. However, considering the serious cardiopulmonary adverse events associated with sedatives, it is important to identify patients at high risk. Machine learning can generate reasonable prediction for a wide range of medical conditions. This study aimed to evaluate the risk factors associated with sedation during GI endoscopy and develop a predictive model for hypoxia during endoscopy under sedation. Methods: This prospective observational study enrolled 446 patients who underwent sedative endoscopy at the Korea University Ansan Hospital. Clinical data were used as predictor variables to construct predictive models using the random forest method that is a machine learning algorithm. Results: Seventy-two of the 446 patients (16.1%) experienced life-threatening hypoxia requiring immediate medical intervention. Patients who developed hypoxia had higher body weight, body mass index (BMI), neck circumference, and Mallampati scores. Propofol alone and higher initial and total dose of propofol were significantly associated with hypoxia during sedative endoscopy. Among these variables, high BMI, neck circumference, and Mallampati score were independent risk factors for hypoxia. The area under the receiver operating characteristic curve for the random forest-based predictive model for hypoxia during sedative endoscopy was 0.82 (95% confidence interval, 0.79-0.86) and displayed a moderate discriminatory power. Conclusions: High BMI, neck circumference, and Mallampati score were independently associated with hypoxia during sedative endoscopy. We constructed a model with acceptable performance for predicting hypoxia during sedative endoscopy.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.12-24
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• 2024

The number of pediatric coronavirus disease 2019 (COVID-19) cases worldwide are increasing compared to the early phase of the pandemic, along with highly transmissible severe acute respiratory syndrome coronavirus variant and the increase in adult COVID-19 vaccination. We conducted a rapid systematic review and meta-analysis of published randomized clinical trials (RCTs) of the COVID-19 vaccines and the observational retrospective studies on adverse events after COVID-19 vaccination in adolescents. Seventeen studies were finally included in this systematic review. Meta-analysis showed that although vaccination in adolescents was significantly effective to prevent COVID-19 infection in retrospective studies (risk ratio [RR], 0.29; 95% confidence interval [CI], 0.22-0.37; I² =100%), however the effect of preventing COVID-19 infection was lower than in RCTs (RR, 0.05; 95% CI, 0.01-0.27). In five retrospective studies, the pooled estimated proportion of participants with myocarditis and/or pericarditis was 2.33 per 100,000 of the population (95% CI, 0.97-5.61 per 100,000). Sub-group analysis with sex and vaccine doses showed that male (5.35 per 100,000) and the second dose (9.71 per 100,000) had significantly higher incidence of myocarditis and/or pericarditis than female (1.09 per 100,000) and the first dose (1.61 per 100,000), respectively. Our study showed that mRNA COVID-19 vaccines in adolescent recipients were favorable and effective against COVID-19 in RCT as well as observational studies. The safety findings of BNT162b2 vaccine in adolescents were explored and we found the difference of safety according to sex and vaccine doses. The occurrence of adverse events after mRNA COVID-19 vaccination should be monitored.

• The Korean Journal of Financial Management
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• v.25 no.1
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• pp.51-84
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• 2008

We investigate the signaling effect of repurchase preceding new equity issue using Korean data. In a short time span, firms announce stock repurchases and equity offerings. The proximity of two events in Korean firms indicates that those are not independent of each other. In this paper, we test the signaling effect of repurchase on equity offerings on the two measures. One is announcement effect, which is measured as CAR(0, +2). The other is the effectiveness which is measured as CAR(0, +30) because the price movement during this window influences on the price of new issues. Previous studies that stock repurchase convey positive signal to equity offerings-Billet and Xue(2004) and Jung(2004)-construct sample without the limit of time interval between two events. This causes the unclear relation between those because of the long time interval. In this study we consider only samples of being within one year each other to reduce this problem and clarify the signal of repurchase on equity offerings. Korean firms are allowed to repurchase own shares with two different method. One is direct repurchase as same as open market repurchase. The other is stock stabilization fund and stock trust fund which trust company or bank buy and sell their shares on the behalf of firms. Generally, the striking different characteristic between direct repurchase and indirect repurchase is following. Direct repurchase is applied by more strict regulation than indirect repurchase. Therefore, the direct repurchase is more informative signal to the equity offering than the indirect repurchase. We construct two sample firms- firms with direct repurchase preceding-equity offerings and indirect repurchase-preceding equity offering, and one control firms-equity offerings only firms-to investigate the announcement effect and the effectiveness of repurchases. Our findings are as follows. Direct repurchase favorably affect the price of new issues favorably. CAR(0, +2) of firms with direct repurchase is not different from that of equity offerings only firms but CAR(0, +30) is higher than that of equity offerings only firms. For firms with indirect repurchase and equity offerings, Both the announcement effect and the effectiveness does not exist. Jung(2004) suggest the possibilities of how indirect stock repurchase can be regarded as one of unfair trading practices on based on the survey results that financial managers of some of KSE listed firms have been asked of their opinion on the likelihood of the stock repurchase being used in unfair trading. This is not objective empirical evidence but opinion of financial managers. To investigate whether firms announce false signal before equity offerings to boost the price of new issues, we calculate the long-run performance following equity offerings. If firms have announced repurchase to boost the price of new issues intentionally, they would undergo the severe underperformance. The empirical results do not show the severer underperformance of both sample firms than equity offerings only firms. The suggestion of false signaling of repurchase preceding equity offerings is not supported by our evidence.

• Geophysics and Geophysical Exploration
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• v.19 no.1
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• pp.1-10
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• 2016

The hypocenter distribution of microseismic events generated by hydraulic fracturing for shale gas development provides essential information for understanding characteristics of fracture network. In this study, we evaluate how inaccurate velocity models influence the inversion results of two widely used location programs, hypoellipse and hypoDD, which are developed based on an iterative linear inversion. We assume that 98 stations are densely located inside the circle with a radius of 4 km and 5 artificial hypocenter sets (S0 ~ S4) are located from the center of the network to the south with 1 km interval. Each hypocenter set contains 25 events placed on the plane. To quantify accuracies of the inversion results, we defined 6 parameters: difference between average hypocenters of assumed and inverted locations, $d_1$; ratio of assumed and inverted areas estimated by hypocenters, r; difference between dip of the reference plane and the best fitting plane for determined hypocenters, ${\theta}$; difference between strike of the reference plane and the best fitting plane for determined hypocenters, ${\phi}$; root-mean-square distance between hypocenters and the best fitting plane, $d_2$; root-mean-square error in horizontal direction on the best fitting plane, $d_3$. Synthetic travel times are calculated for the reference model having 1D layered structure and the inaccurate velocity model for the inversion is constructed by using normal distribution with standard deviations of 0.1, 0.2, and 0.3 km/s, respectively, with respect to the reference model. The parameters $d_1$, r, ${\theta}$, and $d_2$ show positive correlation with the level of velocity perturbations, but the others are not sensitive to the perturbations except S4, which is located at the outer boundary of the network. In cases of S0, S1, S2, and S3, hypoellipse and hypoDD provide similar results for $d_1$. However, for other parameters, hypoDD shows much better results and errors of locations can be reduced by about several meters regardless of the level of perturbations. In light of the purpose to understand the characteristics of hydraulic fracturing, $1{\sigma}$ error of velocity structure should be under 0.2 km/s in hypoellipse and 0.3 km/s in hypoDD.

• Korean Circulation Journal
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• v.54 no.4
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• pp.189-200
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• 2024

Background and Objectives: Concerns remain that early aspirin cessation may be associated with potential harm in subsets at high risk of ischemic events. This study aimed to assess the effects of P2Y12 inhibitor monotherapy after 3-month dual antiplatelet therapy (DAPT) vs. prolonged DAPT (12-month or longer) based on the ischemic risk stratification, the CHADS-P2A2RC, after percutaneous coronary intervention (PCI). Methods: This was a sub-study of the SMART-CHOICE trial. The effect of the randomized antiplatelet strategies was assessed across 3 CHADS-P2A2RC risk score categories. The primary outcome was a major adverse cardiac and cerebral event (MACCE), a composite of all-cause death, myocardial infarction, or stroke. Results: Up to 3 years, the high CHADS-P2A2RC risk score group had the highest incidence of MACCE (105 [12.1%], adjusted hazard ratio [HR], 2.927; 95% confidence interval [CI], 1.358-6.309; p=0.006) followed by moderate-risk (40 [1.4%], adjusted HR, 1.786; 95% CI, 0.868-3.674; p=0.115) and low-risk (9 [0.5%], reference). In secondary analyses, P2Y12 inhibitor monotherapy reduced the Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding without increasing the risk of MACCE as compared with prolonged DAPT across the 3 CHADS-P2A2RC risk strata without significant interaction term (interaction p for MACCE=0.705 and interaction p for BARC types 2, 3, or 5 bleeding=0.055). Conclusions: The CHADS-P2A2RC risk score is valuable in discriminating high-ischemic-risk patients. Even in such patients with a high risk of ischemic events, P2Y12 inhibitor monotherapy was associated with a lower incidence of bleeding without increased risk of ischemic events compared with prolonged DAPT.

• Journal of Distribution Science
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• v.12 no.4
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• pp.23-30
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• 2014

Purpose - The purpose of this study is to analyze the efficiency of retail businesses by dividing domestic retailers into discount stores, super supermarkets (SSMs), and department stores. It suggests retail-business investment strategies by using data environment analysis (DEA) to analyze how input elements such as store area, parking lot area, number of employees, and sales management expenses for the convenience of customers positively affect business performance measurements such as sales and visiting customers per day. Research Design, Data, and Methodology - The DEA model calculates a ratio of the weighted mean of various inputs to the weighted mean of various outputs and measures the efficiency of a specific decision making unit (DMU). The study included 19 companies (five discount store DMUs, ten SSM DMUs, and four department store DMUs). Because the business elements and sizes of retail store DMUs used in this analysis are different, average per-store input and output variables were used. Data were collected from "The Yearbook of Retail Industry in Korea (2012)." DEA analysis was used to determine differences in efficiency among discount stores, SSMs, and department stores in terms of the business elements of each retail business. It was also used to determine what business elements were excessively invested in by comparing and analyzing efficiency by business elements using SPSS software's ANOVA (Analysis of Variance). Results - The CCR and BCC efficiency analysis found that the efficiency of discount stores is low. We believe that the saturation state of discount stores is a major factor. The ANOVA analysis confirms the VRS hypothesis with a statistically significant difference among the three groups, based on an analysis confidence interval of 95%. CRS and SE were not found to be significantly different among the three groups. As for the post hoc test, which concretely shows differences by group, the Scheffe's multiple comparison analysis test found the average differences between group 1 (discount stores) and group 2 (SSM) to be statistically significant. Conclusions - The DEA efficiency analysis implies that investment in input elements, including store area, parking lot area, and sales management expenses, were excessive in the case of discount stores, while SSMs need to invest more in promotion activities such as gifts, events, and coupons for customer management. Department stores have found that small companies invest excessively in input elements. Department stores need to invest in differentiated shopping mall complexes. This study was limited in acquiring statistical data; various input variables which might have shown more secure customer management and promotional expenses could not be applied. As the study was limited in various aspects of the efficiency analyses because financial analyses of the companies and of causal relationships, including satisfaction and loyalty of visiting customers, were not done, these aspects will be examined in the next study.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1313-1320
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• 2014

Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

• Journal of Chest Surgery
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• v.55 no.5
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• pp.378-387
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• 2022

Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th revision. Results: We included 1,037 patients (0.1%) who had undergone cardiac surgery from a randomized 1,000,000-patient cohort, and 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of these 1,022 patients, 412 (39.7%), 303 (29.2%), and 92 (9.0%) underwent coronary artery bypass, heart valve surgery, and Cox-maze surgery, respectively. Preoperative Afib was associated with higher patient mortality (p=0.028), regardless of the surgical procedure. Patients with preoperative Afib (n=190, 18.6%) experienced a higher cumulative risk of overall mortality (hazard ratio [HR], 1.435; 95% confidence interval [CI], 1.263-2.107; p=0.034). Subgroup analysis revealed a reduced risk of overall mortality with Cox-maze surgery in Afib patients (HR, 0.500; 95% CI, 0.266-0.938; p=0.031). Postoperative cerebral ischemia or hemorrhage events were not related to Afib. Conclusion: Preoperative Afib was independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-maze surgery may improve the survival rate.