• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.216-223
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• 2011

Objective : The purposes of this study are to estimate postoperative survival and ambulatory outcome and to identify prognostic factors thereafter of metastatic spinal tumors in a single institute. Methods : We reviewed the medical records of 182 patients who underwent surgery for a metastatic spinal tumor from January 1987 to January 2009 retrospectively. Twelve potential prognostic factors (age, gender, primary tumor, extent and location of spinal metastases, interval between primary tumor diagnosis and metastatic spinal cord compression, preoperative treatment, surgical approach and extent, preoperative Eastern Cooperative Oncology Group (ECOG) performance status, Nurick score, Tokuhashi and Tomita score) were investigated. Results : The median survival of the entire patients was 8 months. Of the 182 patients, 80 (44%) died within 6 months after surgery, 113 (62%) died within 1 year after surgery, 138 (76%) died within 2 years after surgery. Postoperatively 47 (26%) patients had improvement in ambulatory function, 126 (69%) had no change, and 9 (5%) had deterioration. On multivariate analysis, better ambulatory outcome was associated with being ambulatory before surgery (p=0.026) and lower preoperative ECOG score (p=0.016). Survival rate was affected by preoperative ECOG performance status (p<0.001) and Tomita score (p<0.001). Conclusion : Survival after metastatic spinal tumor surgery was dependent on preoperative ECOG performance status and Tomita score. The ambulatory functional outcomes after surgery were dependent on preoperative ambulatory status and preoperative ECOG performance status. Thus, prompt decompressive surgery may be warranted to improve patient's survival and gait, before general condition and ambulatory function of patient become worse.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.449-456
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• 2022

Objective : The aim of this study was to evaluate the clinical outcome of sphenoid wing meningioma with periorbital invasion (PI) after operation. Methods : Sixty one patients with sphenoid wing meningioma were enrolled in this study. Their clinical conditions were monitored after the operation and followed up more than 5 years at the outpatient clinic of a single institution. Clinical and radiologic information of the patients were all recorded including the following parameters : presence of PI, presence of peri-tumor structure invasion, pathologic grade, extents of resection, presence of hyperostosis, exophthalmos index (EI), and surgical complications. We compared the above clinical parameters of the patients with sphenoid wing meningioma in the presence or absence of PI (non-PI), then linked the analyzed data with the clinical outcome of the patients. Results : Of 61 cases, there were 14 PI and 47 non-PI patients. PI group showed a significantly higher score of EI (1.37±0.24 vs. 1.00±0.01, p<0.001), more frequent presence of hyperostosis (85.7% vs. 14.3%, p<0.001), and lower rate of gross total resection (GTR) (35.7% vs. 68.1%, p=0.032). The lower score of pre-operative EI, the absence of both PI and hyperostosis, smaller tumor size, and the performance of GTR were associated with lower recurrence rates in the univariate analysis. However, in the multivariate analysis, the performance of GTR was the only significant factor to determine the recurrence rate (p=0.043). The incidences of surgical complications were not statistically different between the subtotal resection (STR) and GTR groups, but it was strongly associated tumor size (p=0.017). Conclusion : The GTR group showed lower recurrence rate than the STR group without differences in the surgical complications. Therefore, the GTR is strongly recommended to treat sphenoid wing meningioma with PI for the better clinical outcome.

• Restorative Dentistry and Endodontics
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• 제47권3호
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• pp.34.1-34.12
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• 2022

Objectives: This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome. Materials and Methods: A follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level. Results: The success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17-9.54). Conclusions: The success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.

• 한국환경보건학회지
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• 제50권2호
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• pp.113-124
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• 2024

Background: The increasing need to minimize animal testing has sparked interest in alternative methods with more humane, cost-effective, and time-saving attributes. In particular, in silico-based computational toxicology is gaining prominence. Adverse outcome pathway (AOP) is a biological map depicting toxicological mechanisms, composed of molecular initiating events (MIEs), key events (KEs), and adverse outcomes (AOs). To understand toxicological mechanisms, predictive models are essential for AOP components in computational toxicology, including molecular structures. Objectives: This study reviewed the literature and investigated previous research cases related to AOP and in silico methodologies. We describe the results obtained from the analysis, including predictive techniques and approaches that can be used for future in silico-based alternative methods to animal testing using AOP. Methods: We analyzed in silico methods and databases used in the literature to identify trends in research on in silico prediction models. Results: We reviewed 26 studies related to AOP and in silico methodologies. The ToxCast/Tox21 database was commonly used for toxicity studies, and MIE was the most frequently used predictive factor among the AOP components. Machine learning was most widely used among prediction techniques, and various in silico methods, such as deep learning, molecular docking, and molecular dynamics, were also utilized. Conclusions: We analyzed the current research trends regarding in silico-based alternative methods for animal testing using AOPs. Developing predictive techniques that reflect toxicological mechanisms will be essential to replace animal testing with in silico methods. In the future, since the applicability of various predictive techniques is increasing, it will be necessary to continue monitoring the trend of predictive techniques and in silico-based approaches.

• 한국컴퓨터정보학회논문지
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• 제19권1호
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• pp.95-110
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• 2014

본 논문은 기존 연구되어졌던 파트너십이 공급 사슬 관리의 성과에 미치는 영향에 대한 연구에서 한 단계 더 나아가, 파트너십과 SCM 성과의 관계에서 소셜 비즈니스 매개효과에 대해 파악한다. 최근 공급 사슬 관리에도 전자태그, 모바일, 클라우드 컴퓨팅 등 IT 기술 접목이 활성화되면서 업무가 더 빠르고 스마트해지고 있다. 여기에 소셜 비즈니스가 더해진다면 거래 파트너, 혹은 고객과 직접 소통이 가능해져 파트너십의 관계를 한층 높일 수 있을 것이다. 연구 대상으로는 공급 사슬 관리을 도입하여 운용중인 기업을 대상으로 하였으며 설문지 150부 중 결측치를 제외한 127부를 최종 분석하였다. 자료 분석은 SPSS 21.0과 AMOS 18.0 Version 프로그램을 사용하여 빈도 분석, 신뢰도 분석, t-test, ANOVA, 경로분석, 매개효과 분석을 위한 Sobel test를 실시하였다. 분석 결과는 다음과 같다. 첫째, 파트너십에서 신뢰도, 정보 공유, 거래 지속이 높을수록 소셜 비즈니스에 미치는 영향이 높을 것으로 분석되었으나, 상호의존성은 영향력이 크지 않은 것으로 나타났다. 둘째, 파트너십이 SCM 성과에 대한 영향에 대해서는 신뢰도, 정보 공유, 거래 지속은 유의한 영향을 보였으나 상호의존성은 영향 요인이 나타나지 않았다. 셋째, 소셜 비즈니스가 파트너십과 SCM 성과 관계의 매개효과가 있는 것으로 분석되었다.

• Clinical and Experimental Pediatrics
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• 제50권4호
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• pp.348-354
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• 2007

목 적 : B형 간염 바이러스 주산기 감염은 현재 감소하고 있지만 HBeAg 양성 산모로부터 분만된 신생아의 10%는 예방조치에도 불구하고 보유자가 된다. 비록 예방조치 실패의 원인이 아직 불확실하나 산모의 분만시 HBV-DNA 수치의 중요성이 제시되고 있다. 본 연구는 산모의 분만시 HBV-DNA 수치가 주산기 예방조치 결과의 유용한 예측인자임을 확인하기 위하여 시행하였다. 방 법 : 주산기 예방조치의 결과를 이미 알고 있는 29명의 HBeAg 양성 산모를 선정하였다. 산모의 HBV-DNA 양을 측정하기 위하여 WHO International Standard For Hepatitis B Virus DNA For NAT Assay를 이용한 정량적 PCR을 시행하였다. 결 과 : 주산기 예방조치 실패군 산모의 로그 HBV-DNA 수치가 성공군 산모의 수치보다 유의하게 높았다(7.99 vs. 6.72, P=0.015). 주산기 예방조치 결과를 예측할 수 있는 산모의 HBV-DNA 수치의 기준은 $2.83{\times}10^7$ 개체/mL(100 pg/mL)로 정할 수 있었는데, 산모의 HBV-DNA 수치가 기준치 미만인 16명 중 예방조치에 실패한 경우는 없었으며(0%), 기준치 이상인 경우는 13명 중 5명(38.5%)이 실패하였다. 결 론 : 현재의 예방조치법으로는 분만시 높은 HBV-DNA 수치를 가지는 산모의 주산기 예방조치 결과는 좋지 않을 가능성이 높다. 따라서 주산기 예방조치의 실패율을 낮추기 위해서는 이러한 위험요인이 있는 경우에 보다 강력한 방법을 적용시켜야 하겠다.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.584-590
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• 2017

Objective : Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. Methods : We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI. Specifically, we analyzed age, cause of injury, initial Glasgow coma scale (GCS) score, radiological diagnosis, seizure, hydrocephalus, subdural hygroma, and Glasgow outcome scale (GOS) score, and we divided outcomes into good (GOS 4-5) or poor (GOS 1-3). We identified the risk factors for post-traumatic seizure (PTS) and outcomes using univariate and multivariate analyses. Results : The total number of patients was 60, 39 males and 21 females. Most common age group was between 0 to 5 months, and the median age was 6 months. Falls were the most common cause of injury (n=29, 48.3%); among them, 15 were falls from household furniture such as beds and chairs. Ten patients (16.7%) developed PTS, nine in one week; thirty-seven patients (61.7%) had skull fractures. Forty-eight patients had initial GCS scores of 13-15, 8 had scores of 12-8, and 4 had scored 3-7. The diagnoses were as follows : 26 acute subdural hematomas, 8 acute epidural hematomas, 7 focal contusional hemorrhages, 13 subdural hygromas, and 4 traumatic intracerebral hematomas larger than 2 cm in diameter. Among them, two patients underwent craniotomy for hematoma removal. Four patients were victims of child abuse, and all of them had PTS. Fifty-five patients improved to good-to-moderate disability. Child abuse, acute subdural hematoma, and subdural hygroma were risk factors for PTS in univariate analyses. Multivariate analysis found that the salient risk factor for a poor outcome was initial GCS on admission. Conclusion : The most common cause of traumatic head injury in individuals aged less than 24 months was falls, especially from household furniture. Child abuse, moderate to severe TBI, acute subdural hematoma, and subdural hygroma were risk factors for PTS. Most of the patients recovered with good outcomes, and the risk factor for a poor outcome was initial mental status.

• Spatial Information Research
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• 제23권6호
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• pp.1-8
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• 2015

본 연구의 목적은 토지정보시스템의 성공적인 구축을 위한 핵심 전략을 제시하는데 있다. 이를 위해 토지정보시스템의 사용자와 개발자를 대상으로 토지정보시스템 구축의 영향요인과 성과요인을 설문조사하고, 상관관계분석을 통해 성공요인을 도출하였다. 본 연구결과에 의하면 사용자 참여는 업무 효율성, 사용자 만족성, 데이터 공유 및 서비스 등 모든 성과에 유의하게 긍정적인 영향을 미치고 있는 것으로 나타났다. 정부 지원과 개발자 기술력은 토지정보시스템의 업무 효율성과 사용자 만족도에 긍정적인 영향을 미치는 중요 요소임을 알 수 있다. 이와 같은 분석결과를 바탕으로 본 연구는 토지정보시스템의 성공적인 구축전략으로 사용자의 역할정립과 적극적 참여, 정부의 선도적 역할과 지원, 협력관계 기반의 정부 지원과 사용자 참여, 토지정보화에 필요 충분한 기술력 확보 등의 전략을 제시하였다. 이 연구를 통해 우리나라 토지정보시스템 구축의 상황요인이 성과에 미친 영향에 대해 보다 체계적인 정리가 이루어졌다고 할 수 있다. 그리고 이것은 국내 공간정보기업의 글로벌 경쟁역량을 강화하는데 활용할 수 있을 것으로 판단된다. 이를 통해 많은 개발도상국의 토지정보 구축사업에 국내기업이 진출할 수 있기를 기대한다.

• Radiation Oncology Journal
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• 제29권4호
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• pp.260-268
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• 2011

Purpose: To evaluate the treatment outcome and prognostic factor after postoperative radiotherapy in retroperitoneal sarcoma. Materials and Methods: Forty patients were treated with surgical resection and postoperative radiotherapy for retroperitoneal sarcoma from August 1990 to August 2008. Treatment volume was judged by the location of initial tumor and surgical field, and 45-50 Gy of radiation was basically delivered and additional dose was considered to the high-risk area. Results: The median follow-up period was 41.4 months (range, 3.9 to 140.6 months). The 5-year overall survival (OS) was 51.8% and disease free survival was 31.5%. The 5-year locoregional recurrence free survival was 61.9% and distant metastasis free survival was 50.6%. In univariate analysis, histologic type (p = 0.006) was the strongest prognostic factor for the OS and histologic grade (p = 0.044) or resection margin (p = 0.032) had also effect on the OS. Histologic type (p = 0.004) was unique significant prognostic factor for the actuarial local control. Conclusion: Retroperitoneal sarcoma still remains as a poor prognostic disease despite the combined modality treatment including surgery and postoperative radiotherapy. Selective dose-escalation of radiotherapy or combination of effective chemotherapeutic agent must be considered to improve the treatment result especially for the histopathologic type showing poor prognosls.

• 한국산학기술학회논문지
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• 제18권4호
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• pp.154-162
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• 2017

본 연구는 여성건강간호학 시뮬레이션 실습교육에서 비판적 추론과정을 통한 간호과정 적용의 학습성과에 기반한 시뮬레이션 실습교육 평가를 위해 개발된 루브릭 형태의 도구에 대해 신뢰도와 타당도를 확인하기 위한 방법론적 연구이다. 본 연구의 대상자는 2014년 8월부터 12월까지 일 대학 시뮬레이션 실습교과를 이수한 간호학과 3학년 재학생 110명으로 요인분석, 신뢰도 분석 및 관련변인과의 상관분석을 실시하였다. 요인분석 결과 총 10문항 4요인 구조가 확인되었으며 '인지', '해석', '반응', '반영'으로 구분되었다. 비판적 사고 경향 도구와의 상관분석을 실시한 결과 유의한 양의 상관관계가 있는 것으로 나타나 비판적 사고와 관련된 학습성과에 기반한 평가도구의 준거타당도를 확인하였다. 수렴타당도와 판별타당도를 살펴보기 위해 다속성-다문항 매트릭스 분석을 실시한 결과 10개 문항과 4개 요인구조 간 개별 상관계수가 .83~.95로 수렴타당도와 판별타당도가 충족되었다. 내적일관성을 나타내는 신뢰도 Cronbach's alpha 값은 .89로 높게 나타나 본 도구의 타당도와 신뢰도가 높음을 확인하였다. 본 연구결과는 임상실습 교육을 시뮬레이션 실습교육으로 대체하고 있는 현실에서 시뮬레이션 교육과정에서 학습성과 달성을 위한 평가도구로 타당도와 신뢰도를 확인함으로써 시뮬레이션 실습 평가도구로서 적용 가능성을 제시하였다는 것에 의의가 있다 하겠다.