• The Korean journal of internal medicine
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• 제33권6호
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• pp.1194-1202
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• 2018

Background/Aims: This study evaluated the role of hypomethylating agents (HMA) compared to best supportive care (BSC) for patients with high or very-high (H/VH) risk myelodysplastic syndrome (MDS) according to the Revised International Prognostic Scoring System. Methods: A total of 279 H/VH risk MDS patients registered in the Korean MDS Working Party database were retrospectively analyzed. Results: HMA therapy was administered to 205 patients (73.5%), including 31 patients (11.1%) who then received allogeneic hematopoietic cell transplantation (allo-HCT), while 74 patients (26.5%) received BSC or allo-HCT without HMA. The 3-year overall survival (OS) rates were $53.1%{\pm}10.7%$ for allo-HCT with HMA, $75%{\pm}21.7%$ for allo-HCT without HMA, $17.3%{\pm}3.6%$ for HMA, and $20.8%{\pm}6.9%$ for BSC groups (p < 0.001). In the multivariate analysis, only allo-HCT was related with favorable OS (hazard ratio [HR], 0.356; p = 0.002), while very poor cytogenetic risk (HR, 5.696; p = 0.042), age ${\geq}65years$ (HR, 1.578; p = 0.022), Eastern Cooperative Oncology Group performance status (ECOG PS) 2 to 4 (HR, 2.837; p < 0.001), and transformation to acute myeloid leukemia (AML) (HR, 1.901; p = 0.001) all had an adverse effect on OS. Conclusions: For the H/VH risk group, very poor cytogenetic risk, age ${\geq}65years$, ECOG PS 2 to 4, and AML transformation were poor prognostic factors. HMA showed no benefit in terms of OS when compared to BSC. Allo-HCT was the only factor predicting a favorable long-term outcome. The use of HMA therapy did not seem to have an adverse effect on the transplantation outcomes. However, the conclusion of this study should be carefully interpreted and proven by large scale research in the future.

• 환경영향평가
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• 제24권6호
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• pp.549-560
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• 2015

농공단지에 입주제한된 31개 업종의 업종별 배출특성에 따른 화학적 유해성을 근거로 업종별 환경영향을 계량화하여 입지규제 우선순위을 도출하였다. 농공단지에 입주제한된 31개 업종의 환경상의 악영향과 환경기술발전에 따른 환경유해성 저감을 동시에 고려한 합리적 토지이용 관리방안을 수립하기 위하여 업종별로 수계, 토양 및 대기의 매체별 배출량 및 배출물질 $LC_{50}$ 자료에 의해 산정된 인체위해성과 생태위해성을 노출평가와 독성평가로 분석하는 화학적 등급화기법(CRS : Chemical Ranking and Scoring System)에 PRTR (Pollutant Release and Transfer Registers) 자료를 활용하였다. 농공단지 폐수배출관련 31개 업종에 대한 환경유해성을 도출한 결과에 의하면 2012년 기준으로 도금 착색 및 기타 표면처리강재 제조업, 생물학적 제제 제조업, 동 제련정련 및 합금 제조업, 솜 및 실 염색가공업, 그외 기타 1차철강 제조업, 기타 비철금속 압연압출 및 연신제품 제조업 등 6개 업종은 환경영향 점수가 상대적으로 낮게 산출되어 제조공정상에서 특정수질유해물질을 배출허용기준 이하로 배출된다고 인정하는 경우에 농공단지 입주제한을 완화시킬 수 있는 업종으로 평가된다.

• 한국간담췌외과학회지
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• 제28권2호
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• pp.134-143
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• 2024

Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

• Korean Circulation Journal
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• 제53권9호
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• pp.621-631
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• 2023

Background and Objectives: The morphology-voltage-P-wave duration (MVP) electrocardiography (ECG) risk score is a newly defined scoring system that has recently been used for atrial fibrillation (AF) prediction. The aim of this study was to evaluate the ability of the MVP ECG risk score to predict AF in patients with an implantable cardioverter defibrillator (ICD) and heart failure with reduced ejection fraction in long-term follow-up. Methods: The study used a single-center, and retrospective design. The study included 328 patients who underwent ICD implantation in our hospital between January 2010 and April 2021, diagnosed with heart failure. The patients were divided into low, intermediate and high-risk categories according to the MVP ECG risk scores. The long-term development of atrial fibrillation was compared among these 3 groups. Results: The low-risk group included 191 patients, the intermediate-risk group 114 patients, and the high-risk group 23 patients. The long-term AF development rate was 12.0% in the low-risk group, 21.9% in the intermediate risk group, and 78.3% in the high-risk group. Patients in the high-risk group were found to have 5.2 times higher rates of long-term AF occurrence compared to low-risk group. Conclusions: The MVP ECG risk score, which is an inexpensive, simple and easily accessible tool, was found to be a significant predictor of the development of AF in the long-term follow-up of patients with an ICD with heart failure with reduced ejection fraction. This risk score may be used to identify patients who require close follow-up for development and management of AF.

• 성인간호학회지
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• 제15권2호
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• pp.267-277
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• 2003

Purpose: The purpose of this study was to evaluate the applicability of braden scale to assess pressure ulcer risk patients and to identify additional risk factors of pressure sores in an neurologic intensive care unit. Method: The subjects of this study were 66 patients in neurologic intensive care units. Data was prospectively collected from Sep. to Dec., 2002. Data were analyzed by mean, percentage, t-test, chi-square, discriminant analysis using Spss pc+. Result: The results of this study were as follows: 1) There was a significant difference between scoring of braden scale and pressure ulcer development. The subscales that predicted pressure ulcer development using braden scale only were sensory perception, moisture, mobility, friction & shear. By using these subscales, sensitivity was 86.7%, and specificity was 61.1%, and total hit ratio was 72.7%. 2) Additional pressure ulcer risk factors which showed significance for discriminating two group were protein, albumin, gender, level of consciousness, pattern of bowel elimination. By using the combination of these additional risk factors in addition to the braden scale, total hit ratio increased to 84.8%. Conclusion: This data suggest that albumin, protein, gender, level of consciousness, pattern of bowel elimination in addition to the braden scale should be included in the pressure sore assessment tool.

• Fisheries and Aquatic Sciences
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• 제22권12호
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• pp.29.1-29.7
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• 2019

Veterinary drugs are widely used to protect production-related diseases and promote the growth of farmed fish. The use of large amounts of veterinary drugs may have potential risk and cause adverse effects on both humans and the environment. In this study, we developed risk-based ranking based on a scoring system to be applied in the national residue program. In this approach, the following three factors of veterinary drugs that may occur as residues in fishery products were considered: potency (acceptable daily intake), usage (number of dose and withdrawal period), and residue occurrence. The overall ranking score was calculated using the following equation: potency × usage (sum of the number of sales and withdrawal period) × residue occurrence. The veterinary drugs that were assigned high score by applying this approach were enrofloxacin, amoxicillin, oxolinic acid, erythromycin, and trimethoprim. The risk-based approach for monitoring veterinary drugs can provide a reliable inspection priority in fishery products. The developed ranking system can be applied in web-based systems and residuemonitoring programs and to ensure safe management of fishery products in Korea.

• 기본간호학회지
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• 제12권3호
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• pp.395-403
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• 2005

Purpose: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUS). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. Method: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. Result: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. Conclusion: Our findings give support to recent studies that suggest that frequent physical contact maγ increase the nosocomial acquisition of MRSA in a neurosurgical ICU.

• 산업경영시스템학회지
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• 제17권31호
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• pp.73-80
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• 1994

Sequentiality in decision making is an inherent characteristic of the R&D Process, Conceptual changes are noted during the Course of the Project which represent a continuous improvement in the quality of the data available during the various project stages. In this paper, Eight characteristic types of project evaluation models have been developed economic index models, portfolio models, decision theory models, risk analysis models, frontier models, scoring models, profile models and checklists. Each of these will be critically reviewed and appraised.

• 산업경영시스템학회지
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• 제23권54호
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• pp.167-177
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• 2000

The problem of system reliability is very important issue in the nuclear power plant, because the failure of its system brings about extravagant economic loss, environment destruction, and quality loss. This paper therefore proposes a normalized scoring model by the qualitative factors order to evaluate the robust reliability of nuclear power plants under uncertainty. Especially, the qualitative factors including risk, functional, human error, and quality function factors for the robust justification has been also introduced. Finally, the analytical reliability and safety assessment model developed in this paper can be used in the real nuclear power plant.

• Geomechanics and Engineering
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• 제9권1호
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• pp.57-81
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• 2015

Water inrush and mud outburst always restricts the tunnel constructions in mountain area, which becomes a major geological barrier against the development of underground engineering. In view of the complex disaster-causing mechanism and difficult quantitative predictions of water inrush and mud outburst, several theoretical methods are adopted to realize dynamic assessment of water inrush in the progressive process of tunnel construction. Concerning both the geological condition and construction situation, eleven risk factors are quantitatively described and an assessment system is developed to evaluate the water inrush risk. In the static assessment, the weights of eight risk factors about the geological condition are determined using Analytic Hierarchy Process (AHP). Each factor is scored by experts and the synthesis scores are weighted. The risk level is ultimately determined based on the scoring outcome which is derived from the sum of products of weights and comprehensive scores. In the secondary assessment, the eight risk factors in static assessment and three factors about construction situation are quantitatively analyzed using fuzzy evaluation method. Subordinate levels and weight of factors are prepared and then used to calculate the comprehensive subordinate degree and risk level. In the dynamic assessment, the classical field of the eleven risk factors is normalized by using the extension evaluation method. From the input of the matter-element, weights of risk factors are determined and correlation analysis is carried out to determine the risk level. This system has been applied to the dynamic assessment of water inrush during construction of the Yuanliangshan tunnel of Yuhuai Railway. The assessment results are consistent with the actual excavation, which verifies the rationality and feasibility of the software. The developed system is believed capable to be back-up and applied for risk assessment of water inrush in the underground engineering construction.