• Journal of Chest Surgery
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• v.42 no.2
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• pp.201-205
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• 2009

Background: Cryosurgery has been used to treat primary malignant pulmonary tumors at our institute since November 2004. In this study we analyzed our treatment results and complication rates. Material and Method: A retrospective study using medical charts and imaging data was conducted involving 17 patients with a total of 17 malignant pulmonary tumors who were treated between November 2004 and March 2007. Fourteen patients were males and 3 were females. The median age of the patients was 64 years (range, $54{\sim}77$ years). The average size of the tumors was 48.8mm (range, $36{\sim}111mm$) in diameter. The patients were followed with chest CT scans 7 days, 1 month, 3 months, and 6 months postoperatively. PET scans were obtained between 6 and 9 months postoperatively. The treatment response was analyzed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Result: Six months after treatment, 6 tumors (35.3%) showed a complete response, 4 (23.5%) had a partial response, 3 (17.6%) had stable disease, and 4 (23.5%) showed disease progression. In tumors <4 cm in diameter, a complete response was reported in 50% of the tumors. A $x^2$-test showed that in tumors <4 cm in diameter, the p-value for results better than a partial response was 0.034. With respect to procedural complications, there was 1 case of blood-tinged sputum which resolved spontaneously within 1 or 2 days, a spontaneously relieved case of subcutaneous emphysema, and 1 patient with a fever. There were no mortalities and the average hospital stay was 6.3 days. Conclusion: The effects of cryosurgery on primary lung cancer is greatest in patients with small tumors. Considering the facts that cryosurgery is minimally invasive, has a low complication rate, and can be performed repetitively, we believe that it may play an important role in the treatment of high risk lung cancer patients.

• Journal of the Society of Disaster Information
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• v.17 no.4
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• pp.864-881
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• 2021

Purpose: This study aims is to provide a total care solution preventing disaster based on Big Data and AI technology and to service safety considered by individual situations and various risk characteristics. The purpose is to suggest a method that customized comprehensive index services to prevent and respond to safety accidents for calculating the living safety index that quantitatively represent individual safety levels in relation to daily life safety. Method: In this study, we use method of mixing AHP(Analysis Hierarchy Process) and Likert Scale that extracted from consensus formation model of the expert group. We organize evaluation items that can evaluate life safety prevention services into risk indicators, vulnerability indicators, and prevention indicators. And We made up AHP hierarchical structure according to the AHP decision methodology and proposed a method to calculate relative weights between evaluation criteria through pairwise comparison of each level item. In addition, in consideration of the expansion of life safety prevention services in the future, the Likert scale is used instead of the AHP pair comparison and the weights between individual services are calculated. Result: We obtain result that is weights for life safety prevention services and reflected them in the individual risk index calculated through the artificial intelligence prediction model of life safety prevention services, so the comprehensive index was calculated. Conclusion: In order to apply the implemented model, a test environment consisting of a life safety prevention service app and platform was built, and the efficacy of the function was evaluated based on the user scenario. Through this, the life safety index presented in this study was confirmed to support the golden time for diagnosis, response and prevention of safety risks by comprehensively indication the user's current safety level.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4053-4056
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• 2013

Background: Colposcopy is the gold standard procedure for evaluating cervical cytological abnormalities. Although it is essentially a minimally invasive intervention, referral for colposcopy may cause significant distress on patients. In this study, we aimed to determine if pre-procedural anxiety levels have a significant association with procedure related pain and discomfort in women undergoing colposcopy for evaluation of abnormal cervical cytology. We also assessed the impact of various clinical factors on anxiety, pain and discomfort in these patients. Materials and Methods: This prospective study was performed at the gynecologic oncology department of Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey between January and June 2013. After taking informed consent, State-Trait Anxiety Inventory (STAI) form and a 14-item questionnaire were filled for women who were admitted to our outpatient colposcopy unit for evaluation of abnormal cervical cytology. STAI scores were calculated for each participant. Immediately after the procedure, visual analog scale (VAS) scores for procedure-related pain and discomfort were obtained. Associations between STAI and VAS scores were investigated using correlation analyses. The effect of various contributing factors on anxiety, pain and discomfort were evaluated with linear regression analysis. The p values less than 0.05 were considered statistically significant. Results: A total of 222 women met the inclusion criteria within the study period. Mean patient age was $38.5{\pm}9.6$. Median state and trait anxiety scores were 47 and 46, respectively. Median VAS scores for pain and discomfort were 4 for both variables. State anxiety had a significant correlation with procedure related discomfort (p=0.02). Colposcopy related pain VAS scores were significantly affected by state anxiety level, marital status and prior gynecological examination (p<0.05). Colposcopy related discomfort VAS scores were significantly affected by state anxiety level, marital status, prior gynecological examination and educational status. Conclusions: Additional measures should be implemented in women that carry higher risk for experiencing pain and discomfort. Social, cultural and lifestyle issues may also affect women's experiences during colposcopy, therefore further studies are needed to define specific determining factors in various populations.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.5263-5272
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• 2012

Background: Gastric cancer (GC) is one of the most common cancers in China. Adjuvant chemotherapy (AC) is a routine auxiliary treatment for GC recommended by the guidelines issued in 2011 by the Ministry of Health of the People's Republic of China, but the relevant credible consequences in China have been insufficient because of China's late start and ethical concerns. Methods: A series of databases, including Cochrane Library, MEDLINE, EMBASE, the Chinese database of the National Knowledge Infrastructure and the VIP database, were searched by 2 reviewers independently for studies investigating AC for GC through March 2012. The retrieved literature was screened according to the eligibility criteria. Results: A total of 35 randomized control trials (RCTs) were subjected to the final analysis, including 4,043 patients in treatment group and 3,884 in the control group, as well as 4 clinical-control trials (CCTs), which accessed the final analysis with 238 and 252 patients, respectively. AC reduced the risk of death as a protective treatment with statistical significance (HR=0.91, 95%CI: [0.85, 0.97], P=0.002), and it seemed more effective for Asian than non-Asian patients. The effects of AC were not influenced by the starting time (P>0.05). D2 lymphadenectomy-based chemotherapy was effective (HR=0.89, 95%CI: [0.80, 0.99], P=0.04). Oral S-1 40 mg/m2 after D2 lymphadenectomy might be a better choice for Asians with advanced GC and might result in a greater reduction of adverse events than in non-Asian patients. GRADE quality assessment determined that the strength of the evidence from foreign studies from Europe, the United States and Asian countries other than China was high, while it was moderate for Chinese studies. Conclusion: AC was effective or even curative in Chinese patients in general, although it is still necessary to optimize a targeted AC scheme for Chinese patients with GC.

• Journal of the Korean Society of Safety
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• v.35 no.5
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• pp.49-58
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• 2020

In domestic construction sites, when installing steel pipe scaffolding and system scaffolding, the guardrails are installed after the installation of the work platforms. This conventional guardrail system (CGS) is always exposed to the risk of falls because the safety railing is installed later. In order to prevent fall disasters during erecting and dismantling scaffolds, it is necessary to introduce the advanced guardrail system (AGS) which installs railings in advance of climbing onto a work platform. For the introduction of the AGS, the structural performance of the system scaffolding applying the CGS and the AGS was compared and evaluated. The structural analysis of the system scaffold (height: 31 m and width: 27.4 m) with AGS confirmed that structural safety was ensured because the maximum stress of each element of the system scaffolding satisfies the allowable stress of each element. As a result of performance comparison of CGS and AGS for each element, the combined stress ratio of vertical posts in AGS was 6.4% lower than that of CGS. In addition, in the case of ledger and transom, the combined stress ratios of AGS and CGS were almost the same. The compression test of the assembled system scaffolding (three-storied, 1 bay) showed that the AGS had better performance than the CGS by 9.7% (8.91 kN). The cross bracing exceeds the limit on slenderness ratio of codes for structural steel design. But the safety factor for the compressive load of the cross bracing was evaluated as meeting the design criteria by securing 3 or more. In actual experiments, it was confirmed that brace buckling did not occur even though the overall scaffold was buckled. Therefore, in the case of temporary structures, it was proposed to revise the standards for limiting on slenderness ratio of secondary or auxiliary elements to recommendations. This study can be used as basic data for the introduction of AGS for installing guardrails in advance at domestic construction sites.

• Journal of Radiation Industry
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• v.9 no.1
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• pp.47-55
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• 2015

Research and investigation is required for the exposure dose of radiation workers to work in the dental hospital as increasing interest in exposure dose of the dental hospital recently accordingly, study aim to minimize radiation exposure by making a follow-up study of individual exposure doses of radiation workers, analyzing the status on individual radiation exposure management, prediction the radiation disability risk levels by radiation, and alerting the workers to the danger of radiation exposure. Especially given the changes in the dental hospital radiation safety awareness conducted the study in order to minimize radiation exposure. This study performed analyses by a comparison between general and dental hospital, comparing each occupation, with the 116,220 exposure dose data by quarter and year of 5,811 subjects at general and dental hospital across South Korea from January 1, 2008 through December 31, 2012. The following are the results obtained by analyzing average values year and quarter. In term of hospital, average doses were significantly higer in general hospitals than detal ones. In terms of job, average doses were higher in radiological technologists the other workes. Especially, they showed statistically significant differences between radiological technologists than dentists. The above-mentioned results indicate that radiation workers were exposed to radiation for the past 5 years to the extent not exceeding the dose limit (maximum $50mSv\;y^{-1}$). The limitation of this study is that radiation workers before 2008 were excluded from the study. Objective evaluation standards did not apply to the work circumstance or condition of each hospital. Therefore, it is deemed necessary to work out analysis criteria that will be used as objective evaluation standard. It will be necessary to study radiation exposure in more precise ways on the basis of objective analysis standard in the furture. Should try to minimize the radiation individual dose of radiation workers.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.55-84
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• 2015

The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.

• Journal of the Korean Society of Marine Environment & Safety
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• v.28 no.1
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• pp.1-9
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• 2022

The effect of sediments in a waste dumping area on marine organisms was evaluated using sediment toxicity tests with a benthic amphipod (Monocorophium acherusicum) and bioluminescent bacterium (Vibrio fischeri) in accordance with the Korean Standard Method for Marine Wastes (KSMMW). Nine sites in the East Sea-Byeong, East Sea-Jeong, and Yellow Sea-Byeong areas were sampled from 2016 to 2019. The test results showed that the relative average survival rate (benthic amphipods) and relative luminescence inhibition rate (luminescent bacteria) were below 30%, which were judged to be "non-toxic." However, in the t-test, a total of 12 benthic amphipod samples (6, 1, 1, and 4 in 2016, 2017, 2018, and 2019, respectively) were significantly different (p<0.05) from the control samples. To identify the source of toxicity on benthic amphipods, a simple linear regression analysis was performed between the levels of eight heavy metals (Cr, As, Ni, Cd, Cu, Pb, Zn, and Hg) in sediments and the relative average survival rate. The results indicated that Cr had the highest contribution to the toxicity of benthic amphipods (p = 0.000, R2 = 0.355). In addition, Cr was detected at the highest concentration at the DB-85 station and exceeded the Marine Environment Standards every year. Although the sediments were determined as "not toxic" according to the ecotoxicity criteria of the KSMMW, the results of the statistical significance tests and toxicity identification evaluation indicated that the toxic effect was not acceptable. Therefore, revising the criteria for determining the toxic effect by deriving a reference value through quantitative risk assessment using species sensitivity distribution curves is necessary in the future.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.33-42
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• 2004

Purpose : Children with nephrotic syndrome(NS) are under high risk for metabolic bone disease(MBD) as a complication of long-term glucocorticoid therapy. We prospectively evaluated the effect of oral bisphosphonate(alendronate) therapy in children with NS, which has proven efficacy in adult patients with glucocorticoid induced MBD. Methods : Among 58 children with NS, aged 5 to 8 years and haying a disease duration of more than 2 years, 30(51.7%) were enrolled to meet the selection criteria, less than -1.0 Z-scores of lumbar spine bone mineral density(BMD) by dual energy X-ray absorptiometry (DEXA). These 30 children were divided into three groups and each were assigned to receive alendronate, calcitriol, and no-medication, respectively for one year. Lumbar spine BMD was followed up every 6 months and the biochemical indexes were measured before and 1 year after the treatment. There were no significant difference among groups with respect to the average age, the initial BMD, and the cumulative steroid doses. Analysis of the treatment efficacy was done by the % change of BMD and by the changes in Z-scores of lumbar spine BMD. Results : Mean age and disease duration of patients at the initial lumbar spine BMD evaluation was $7.4{\pm}1.7$ years and $2.2{\pm}1.2$ years, respectively. Twenty-three of 30 children(76%) had osteopenia, and seven(23%) had osteoporosis. There was no difference in the biochemical values among the groups, before and 1 year after the treatment(P<0.05). Twenty two children(73.3%) with frequent relapsing or steroid dependant NS had more frequent MBD, compared to the 8 children(26.6%) with infrequent relapsing NS. The one year % changes of BMD were 8.56 in alendronate group, 5.79 in calcitriol group, and 1.9 in no-medication group. The changes in Z-score of lumbar spine BMD increased in the alendronate group and the calcitriol group, but not in the no-medication group. One year % changes of BMD were different among groups(P=0.0002). Significant differences were found between the alendronate and the no-medication group, and between the calcitriol and the no-medication group(P<0.05). There was no difference between the alendronate and the calcitriol group. No serious adverse effect was observed in the alendronate group. Conclusion : Children with NS receiving high dose steroids are under the high risk of BMD and should undergo regular BMD evaluation. Z-score of lumbar spine BMD was a useful parameter in diagnosing low bone mass in children. Alendronate weekly oral therapy was effective and relatively safe in increasing the lumbar spine BMD in children with NS having steroid induced MBD.

• Journal of Korea Water Resources Association
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• v.47 no.10
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• pp.891-906
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• 2014

This study suggests the hedging rule of MIP (Mixed Integer Programing) in counting the risk evaluation criteria of the objective function and constraints in order to provide the optimum operating rule in reservoir system as constraining water shortage as much as possible which may happen in the downstream control point of water supply in the aspect of water system management. The proposed model is applied to the Han-river reservoir system for two testing periods (Case I: Jan. 1993~Dec. 1997, Case II: Jan. 1999~Dec. 2003). The model based on the hedging rule with trigger volume, estimated in this study shows that in Case I, the monthly minimum discharge was $310.6{\times}10^6m^3$ in the single operation, $56.3{\times}10^6m^3$ in the joint operation, and $317.5{\times}10^6m^3$ in the hedging rule and also, in Case II, the monthly minimum discharge was found to be $204.2{\times}10^6m^3$ in the single operation, $111.2{\times}10^6m^3$ in the joint operation, and $243.7{\times}10^6m^3$ in the hedging rule. In conclusion, the hedging rule, proposed in this study can decrease vulnerability while guarantees reliability and resiliency.