• Radiation Oncology Journal
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• v.35 no.1
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• pp.16-24
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• 2017

Locally advanced non-small cell lung cancer (LA-NSCLC) is composed of heterogeneous subgroups that require a multidisciplinary team approach in order to ensure optimal therapy for each patient. Since 2010, the National Comprehensive Cancer Network has recommended chemoradiation therapy (CRT) for bulky mediastinal disease and surgical combination for those patients with single-station N2 involvement who respond to neoadjuvant therapy. According to lung cancer tumor boards, thoracic surgeons make a decision on the resectability of the tumor, if it is determined to be unresectable, concurrent CRT (CCRT) is considered the next choice. However, the survival benefit of CCRT over sequential CRT or radiotherapy alone carries the risk of additional toxicity. Considering severe adverse events that may lead to death, fit patients who are able to tolerate CCRT must be identified by multidisciplinary tumor board. Decelerated approaches, such as sequential CRT or high-dose radiation alone may be a valuable alternative for patients who are not eligible for CCRT. As a new treatment strategy, investigators are interested in the application of the innovative radiation techniques, trimodality therapy combining surgery after high-dose definitive CCRT, and the combination of radiation with targeted or immunotherapy agents. The updated results and on-going studies are thoroughly reviewed in this article.

• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.27-38
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• 2020

Purpose: Stroke is a time-sensitive disease that could have reduced complications and mortality with timely diagnosis and treatment. This study aimed to analyze the causes of delay in detecting the clinical signs and symptoms of stroke. Methods: This retrospective observational study analyzed the emergency medical services reports of suspected stroke patients with positive predictive values on the Cincinnati Prehospital Stroke Scale. The study was conducted in Daejeon, Republic of Korea from January 1, 2016 through December 31, 2017. Results: Prolonged prehospital time was associated with high blood pressure, history of cerebrovascular disease, and incidences during daily activities, and sleep. High blood pressure and complications from a previous stroke strongly associated with the prolonged stroke-detection phase (p<.05). Total prehospital time was shortened when patients had evident stroke symptoms, such as decreased level of consciousness, dysarthria, and hemiplegia (p<.05). There was no significant difference in gender or age as a factor that delayed the total prehospital time of the suspected stroke patients. Conclusion: Many patients did not recognize the early clinical symptoms and signs of a stroke. Furthermore, risk factors, such as high blood pressure and history of stroke, prolonged the total prehospital time. Therefore, we need targeted interventions that educate about warning symptoms of stroke, along with emphasis on the importance of emergency calls to substantially reduce the prehospital delays.

• Korean Journal of Construction Engineering and Management
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• v.5 no.2 s.18
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• pp.144-152
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• 2004

Defining value as a measure of how well the project value objectives are met, Value Management Process (VMP) is considered to be any management effort or process that can proactively pursue one or more project objectives (i.e., security/safety, cost effectiveness, schedule optimization, and risk containment). The collection of 44 VMPs has been established based on a rigorous effort conducted by Construction Industry Institute (CII). Because varying circumstances on each project determine the level of suitability, it is crucial to identify which VMP should be implemented on a particular project. The current VMP selection process is primarily based on human intuition. The main objective of this paper is to provide a systematic method to facilitate the usage of VMPs on a particular project. This paper identified and quantified the selection principles (i.e., targeted value objectives, timing of initiation, project characteristics, and relative impact). The data collected from industry practitioners and VMP experts characterized each VMP in terms of the magnitude of benefit. An automated selection tool by Visual Basic Application (VBA) on MS Excel TM, was developed and proved its validity. As a pioneering study, this paper provides a comprehensive and structured knowledge on the subject of VMPs. From the industry's perspective, the automated selection tool, the premier of this study, contributes the facilitation of the VMP implementations in the construction industry thereby maximizing the potential benefits to a particular project.

• Journal of Korean Public Health Nursing
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• v.33 no.2
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• pp.214-227
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• 2019

Purpose: This study examined the socio-demographic factors, the disaster related factors, the physical health related factors and the psychological factors of older adults exposed to natural disaster and these factors may possibly cause the occurrence of PTSD. Methods: A cross-sectional study was designed using the secondary data from the 3rd Disaster Victims Panel Survey (2012-2017). The data from 1,397 disaster victims were analyzed using descriptive statistics and logistic regression analysis. Results: Compared with the younger adult disaster victims, the elderly were more likely to have symptoms of PTSD (15.0% vs. 12.1%). Factors such as the number of years since being exposed to the disaster, anxiety, depression and social adjustment were significantly associated with occurrence of PTSD for both older and younger adults. Female gender was the additional risk factors for the older adults, while marital status, income, having witnessed another person's injury or death, and having lost a home were associated with the occurrence of PTSD. Conclusion: The elderly were more likely to develop PTSD as compared with younger adults. More targeted post-disaster mental health services to the elderly with the symptoms of depressive, anxiety and impaired social adjustments, should be provided to improve their mental health.

• Journal of Pharmacopuncture
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• v.25 no.2
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• pp.88-100
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• 2022

Gastric cancer (GC) is a significant cause of cancer mortality which has led to focused exploration of the pathology of GC. The advent of genome-wide analysis methods has made it possible to uncover genetic and epigenetic fluctuation such as abnormal DNA methylation in gene promoter regions that is expected to play a key role in GC. The study of gastric malignancies requires an etiological perspective, and Helicobacter pylori (H. pylori) was identified to play a role in GC. H. pylori infection causes chronic inflammation of the gastric epithelium causing abnormal polyclonal methylation, which might raise the risk of GC. In the last two decades, various pathogenic factors by which H. pylori infection causes GC have been discovered. Abnormal DNA methylation is triggered in several genes, rendering them inactive. In GC, methylation patterns are linked to certain subtypes including microsatellite instability. Multiple cancer-related processes are more usually changed by abnormal DNA methylation than through mutations, according to current general and combined investigations. Furthermore, the amount of acquired abnormal DNA methylation is heavily linked to the chances of developing GC. Therefore, we investigated abnormal DNA methylation in GC and the link between methylation and H. pylori infection.

• Clinical and Experimental Pediatrics
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• v.64 no.12
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• pp.608-618
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• 2021

Hypoxic-ischemic encephalopathy (HIE) is the most common cause of neonatal encephalopathy with a global incidence of approximately 1 to 8 per 1,000 live births. Neonatal encephalopathy can cause neurodevelopmental and cognitive impairments in survivors of hypoxic-ischemic insults with and without functional motor deficits. Normal neurodevelopmental outcomes in early childhood do not preclude cognitive and behavioral difficulties in late childhood and adolescence because cognitive functions are not yet fully developed at this early age. Therapeutic hypothermia has been shown to significantly reduced death and severe disabilities in term newborns with HIE. However, children treated with hypothermia therapy remain at risk for cognitive impairments and follow-up is necessary throughout late childhood and adolescence. Novel adjunctive neuroprotective therapies combined with therapeutic hypothermia may enhance the survival and neurodevelopmental outcomes of infants with HIE. The extent and severity of brain injury on magnetic resonance imaging might predict neurodevelopmental outcomes and lead to targeted interven tions in children with a history of neonatal encephalopathy. We provide a summary of the long-term cognitive outcomes in late childhood and adolescence in children with a history of HIE and the association between pattern of brain injury and neurodevelopmental outcomes.

• Journal of Korean Biological Nursing Science
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• v.25 no.4
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• pp.295-305
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• 2023

Purpose: This study compared health behaviors and health-related clinical characteristics between individuals with normal glucose levels without diabetes and those with undiagnosed diabetes. Factors that were associated with undiagnosed diabetes were identified by sex. Methods: This was an observational study with a cross-sectional design based on data from the eighth Korea National Health and Nutrition Examination Survey, which used a stratified, multi-stage, cluster-sampling design to obtain a nationally representative sample. Multiple logistic regression analysis was employed to compute the odds ratios of health behaviors and clinical characteristics to identify risk factors for undiagnosed diabetes. Results: The overall prevalence of undiagnosed diabetes was 5.2% (weighted %, n = 700, p < .001). Among individuals with undiagnosed diabetes, 58.3% were men. Univariate logistic regression for undiagnosed diabetes identified sex, age, house income, educational level, and triglycerides as influencing factors. In multiple logistic regression by sex, the factors associated with undiagnosed diabetes in men were age, perceived health status, a diagnosis of angina, and triglycerides. Conclusion: Strategies should be targeted to improve health behaviors and clinical characteristics for specific age groups, men in bad perceived health status, women with high systolic blood pressure, and high triglycerides. Moreover, healthcare providers should understand the barriers to health behaviors and health-related quality of life to effectively deliver healthcare services.

• Journal of East-West Nursing Research
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• v.30 no.1
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• pp.31-41
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• 2024

Purpose: This study aimed to identify factors affecting subjective cognitive decline (SCD) in men and women. Methods: This study was conducted based on data from the 2021 Korea Community Health Survey, and targeted a total of 80,026 men and 98,753 women aged 40 or older who responded to the SCD assessment. Multivariate logistic regression analysis using a complex sample was performed to identify factors influencing SCD. Results: Of the participants, 19,438 (22.7%) men and 30,826 (29.9%) women in the community reported SCD. Significant factors that influence SCD in both groups were age, education level, subjective health status, and depressive symptoms, and the strongest risk factor was depressive symptoms. Compared to women, men's monthly income, flexibility exercise, hypertension, and diabetes mellitus were found to be significant factors on SCD and Healthcare services affected SCD only in women. Medical services affected SCD only in women. Conclusions: When planning and providing intervention programs for cognitive function, it is necessary to reflect differences in factors associated with SCD according to sex.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1407-1412
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• 2012

Background & Objectives: Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people > 50 years targeted in a mass screening program in a hot-point region. Methods: Based on the pilot results in Guilan Cancer Registry study (GCRS), one of the high point regions for GC-Lashtenesha- was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Results: Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of $61.7{\pm}9.0$ years (range: 50-87 years) underwent upper GI endoscopy. H. pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one (0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia (38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Conclusion: Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for the GC surveillance program at the national level.

• Journal of the Korean Institute of Gas
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• v.20 no.6
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• pp.1-8
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• 2016

Gu-mi hydrogen fluoride leak accident in 2012 was amplified social anxiety for chemical accidents. To relieve these anxieties Off-site Risk Assessment was introduced in 2015. Off-site Risk Assessment is targeted at most chemicals, and most of the high-pressure-toxic gases which are mainly used in high-tech industries such as semi conductor, display, Photovoltaic panels industry are included in the substance of the Off-site Risk Assessment. Since Korean companies occupy a high market share in high-tech industries, high pressure-toxic domestic gas consumption is constantly increasing. Accordingly, it is expected to increase the possibility of accidents. In accordance with the circumstances, this study was to conducted Consequence Analysis(CA) about high pressure-toxic gases those are high demand in domestic. CA was used for ALOHA developed by US EPA & US NOAA and the CA result of Arsine was the largest at 4,700 m. CA results are expected to be utilized for determining the effective Safety distances when high pressure-toxic gas leak.