• Clinics in Shoulder and Elbow
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• 제22권2호
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• pp.93-99
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• 2019

Background: Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation. Methods: Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments. Results: At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was $164.6^{\circ}$, external rotation at the side was $61.2^{\circ}$ and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values. Conclusions: The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation.

• 한국지하수토양환경학회지:지하수토양환경
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• 제27권spc호
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• pp.92-98
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• 2022

Although various methods have been proposed to assess groundwater vulnerability, most of the models merely consider the mobility of contaminants (i.e., intrinsic vulnerability), and the attenuation capacity of vadose zone is often neglected. This study proposed an evaluation model for the attenuation capacity of vadose zone to supplement the limitations of the existing index method models for assessing groundwater vulnerability. The evaluation equation for quantifying the attenuation capacity was developed from the combined linear regression and weighted scaling methods based on the lab-scale experiments using various vadose zone soils having different physical and biogeochemical properties. The proposed semi-quantifying model is expected to effectively assess the attenuation capacity of vadose zone by identifying the main influencing factors as input parameters together with proper weights derived from the coefficients of the regression results. The subsequent scoring and grading system has great versatility while securing the objectivity by effectively incorporating the experimental results.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8741-8747
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• 2014

Purpose: We aimed to investigate the associations between polymorphisms of interleukin-1A (IL-1A), IL-1B, and IL-1 receptor antagonist (IL-1RN) and prostate cancer (PCa) risk. Materials and Methods: A comprehensive search for articles of MEDLINE and EMBASE databases and bibliographies of retrieved articles published up to August 3, 2014 was performed. Methodological quality assessment of the trials was based on a standard quality scoring system. The meta-analysis was performed using STATA 12.0. Results: We included 9 studies (1 study for IL-1A, 5 studies for IL-1B, and 3 studies for IL-1RN), and significant association was found between polymorphisms of IL-1B-511 (rs16944) as well as IL-1B-31 (rs1143627) and PCa risk. IL-1B-511 (rs16944) polymorphism was significantly associated with PCa risk in homozygote and recessive models, as well as allele contrast (TT vs CC: OR, 0.74; 95%CI, 0.58-0.94; P=0.012; TT vs TC+CC; OR, 0.79; 95%CI, 0.63-0.98; P=0.033; T vs C: OR, 0.86; 95%CI, 0.77-0.96; P=0.008). The association between IL-1B-31 (rs1143627) polymorphism and PCa risk was weakly significant under a heterozygote model (OR, 1.35; 95%CI, 1.00-1.80; P=0.047). Conclusions: Sequence variants in IL-1B-511 (rs16944) and IL-1B-31 (rs1143627) are significantly associated with PCa risk, which provides additional novel evidence that proinflammatory cytokines and inflammation play an important role in the etiology of PCa.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.189-194
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• 2017

Objective : We evaluated the validity of bone cement-augmented percutaneous screw fixation for treating malignant spinal metastases. Methods : Between 2011 and 2015, 14 patients (eight men and six women) who underwent bone cement-augmented percutaneous screw fixation for malignant spinal metastases were enrolled in this study. Their life expectancy was considered to be more than one month and less than one year, based on the revised Tokuhashi scoring system. Clinical findings including the back pain scale score, functional outcome, procedure related complications, and survival were assessed preoperatively, postoperatively, and then six months after the procedure. Results : Twelve of the patients (86%) survived up to six months after the procedure. Three required mini-open decompressive laminectomy for severe epidural compression. Bone cement-augmented percutaneous screw fixation was performed one level above, one level below, and at the pathologic level itself. The mean operation time was 60 minutes (45-180) and blood loss was less than 100 mL. Prior to surgery, the mean pain score on the visual analogue scale was 8.8, while one month after the procedure, it had reduced to 3.0; this improvement was maintained until the six-month assessment in the surviving patients. All patients were able to sit within the first two days after surgery, and no patient experienced neurological deterioration at the one-month follow up after the surgery. No patient experienced screw loosening during the six months of follow-up. Asymptomatic cement leakage into the epidural space was observed in two patients, but no major complications were observed. Conclusion : For selected patients with malignant spinal metastases, bone cement-augmented percutaneous screw fixation can provide significant pain relief and improve quality of life.

• 성인간호학회지
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• 제18권5호
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• pp.819-827
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• 2006

Purposes: The purpose of this study was to evaluate the extent of performance on activities in critical pathway (CP) according to eight domains and six admission days on nursing records of patients who received total hip replacement surgery. Methods: We reviewed 90 nursing records of patients who received total hip replacement surgery from June, 2004 to July, 2005 at C University Hospital. Data were collected using Hong's CP (2002) and were analyzed using ANOVA. Results: The domain of diet was valued the highest in CP performance scoring, followed by the domains of assessment, activities, and test. There were differences in the performance scores according to the period of admission in all of the domains. Among 132 activities in the CP, 18 activities were completely performed, of which most included activities belonging to the domain of assessment on the admission day. Twelve activities were never performed, of which most included activities belonging to the domain of treatment on the day of operation and the first day after operation. Conclusions: Therefore, further studies on the development of a new system to increase CP utilization and on updating the contents of CP from the best practice based on evidence is recommended.

• 한국건설관리학회논문집
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• 제8권4호
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• pp.128-136
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• 2007

1997년 교토의정서 체결과 같은 국제적 차원의 환경관련 규제와 관심이 고조됨에 따라, 많은 연구들이 효과적으로 친환경성을 평가할 수 있는 도구나 기술의 필요성을 강조해왔다. 본 연구는 건설 프로젝트의 친환경성을 평가하는 도구의 일환으로 건설현장의 폐기물 관리 성과 평가 툴을 구축하고자 한다. 이 평가 툴의 목적은 폐기물 저감 및 재활용 확대 측면에서 건설현장의 폐기물 관리 성과가 어느 정도 수준인지 정량적으로 평가하는 것이다. 본 연구에서는 평가 툴을 구축하기 위한 기반으로서, 선행연구에서 파악된 폐기물 관리 성과 요인의 성과 수준을 정량적으로 산정하기 위해 전문가 면담 및 설문을 통해 각 요인별 관리 행위 수준과 이들의 중요도를 파악하였다. 또한, 선행연구에서 제시한 평가 툴 구축 개념을 기반으로 실질적으로 전산화된 평가 툴을 개발하여 개별 건설현장 차원에서의 평가가 용이하도록 했다. 특히, 평가의 결과로서 제시되는 최종지표(TI) 및 지표등급(IR)은 건설현장의 폐기물 관리 수준을 정량적으로 비교 평가할 수 있는 기준이 될 수 있다. 폐기물 관리 성과 평가 툴은 건설현장의 폐기물 관리효과를 증진시키기 원하는 시공자 측면뿐만 아니라, 발주자 측면에서도 일정정도의 폐기물 관리수준을 객관적으로 요구할 수 있으므로 그 활용범위가 넓을 것으로 판단된다. 실제 현장에서의 적용가능성과 신뢰도를 검증하는 등의 세부적인 연구가 뒤따른다면 보다 효과적인 건설폐기물 관리방안이 될 수 있을 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2527-2530
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• 2015

Background: The cancer of the prostate risk assessment (CAPRA) score has been defined to predict prostate cancer recurrence based on the pre-clinical data, then pathological data have also been incorporated. Thus, CAPRA post-surgical (CAPRA-S) score has been developed based on six criteria (prostate specific antigen (PSA) at diagnosis, pathological Gleason score, and information on surgical margin, seminal vesicle invasion, extracapsular extension and lymph node involvement) for the prediction of post-surgical recurrences. In the present study, biochemical recurrence (BCR)-free probabilities after open retropubic radical prostatectomy (RP) were evaluated by the CAPRA-S scoring system and its three-risk level model. Materials and Methods: CAPRA-S scores (0-12) of our 240 radical prostatectomies performed between January 2000-May 2011 were calculated. Patients were distributed into CAPRA-S score groups and also into three-risk groups as low, intermediate and high. BCR-free probabilities were assessed and compared using Kaplan-Meier analysis and Cox proportional hazards regression. Ability of CAPRA-S in BCR detection was evaluated by concordance index (c-index). Results: BCR was present in 41 of total 240 patients (17.1%) and the mean follow-up time was $51.7{\pm}33.0$ months. Mean BCR-free survival time was 98.3 months (95% CI: 92.3-104.2). Of the patients in low, intermediate and high risk groups, 5.4%, 22.0% and 58.8% had BCR, respectively and the difference among the three groups was significant (P = 0.0001). C-indices of CAPRA-S score and three-risk groups for detecting BCR-free probabilities in 5-yr were 0.87 and 0.81, respectively. Conclusions: Both CAPRA-S score and its three-risk level model well predicted BCR after RP with high c-index levels in our center. Therefore, it is a clinically reliable post-operative risk stratifier and disease recurrence predictor for prostate cancer.

• Tuberculosis and Respiratory Diseases
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• 제57권4호
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• pp.329-335
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• 2004

연구 배경 : 중환자의 예후를 예측할 수 있는 지표로 현재까지 APACHE II, III 점수체계와 SAPS 등이 임상에 응용되고 있다. 1996년 유럽에서 SOFA 점수체계가 제안되었고 1998년 다기관 전향적 연구를 통하여 장기부전을 평가하고 경과를 감시하는 간편하고 효과적인 점수체계임을 입증하였다. 이 연구는 춘천성심병원에서 내과계 중환자만을 대상으로 SOFA 점수체계의 유용성을 조사하였다. 방 법 : 2000년 5월 1일부터 6월 30일까지 춘천성심병원 내과계 중환자실에 입원한 154명을 대상으로 하였고, 이중 타과환자, 타병원으로 전원된 경우, ECG 관찰만을 위하여 입원한 경우, 처치 후 관찰을 위해 48시간 이내만 체류한 환자를 제외한 105명을 연구에 포함시켰으며, 91명에서 평가가 가능하였다. SOFA 점수와 APACHE III 점수는 입원 시부터 매일 24시간 간격으로 중환자실에서 퇴실할 때까지 하였다. 결 과 : 1) 사망률은 20%였고 중환자실 체류기간의 중앙값은 3일이었다. 2) 사망군과 생존군 간의 24시간 내 SOFA 점수는 각각 $8.17{\pm}4.05$, $3.85{\pm}3.24$로 유의한 차이가 있었다. 3) 장기부전이 없는 경우의 사망률은 6.5%, 5개의 다발성 장기부전이 있는 경우 사망률은 100%였다. 4) 48시간 이상 체류했던 74명을 분석한 결과 사망군에서는 최대 SOFA 점수가 81%에서 증가하였고 생존군에서는 21%에서 증가하여 유의한 차이를 보였다. 5) 24시간 내 SOFA 점수와 APACHE III 점수와의 관련성을 평가한 결과 r=0.85 (p<0.01)로 유의한 상관관계가 있었다. 결 론 : SOFA 점수체계는 다발성 장기부전이 있는 환자에서 장기부전을 평가하고 예후를 예측하며 임상경과를 관찰하는데 이용할 수 있는 간편하고 임상적 효용성이 있는 지표로서 임상적으로 많은 도움이 될 것으로 생각한다.

• Korean Journal of Radiology
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• 제22권8호
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• pp.1323-1331
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• 2021

Objective: To identify the association between renal tumor complexity and pathologic renal sinus invasion (RSI) and evaluate the usefulness of computed tomography tumor features for predicting RSI in patients with renal cell carcinoma (RCC). Materials and Methods: This retrospective study included 276 consecutive patients who underwent radical nephrectomy for RCC with a size of ≤ 7 cm between January 2014 and October 2017. Tumor complexity and anatomical renal sinus involvement were evaluated using two standardized scoring systems: the radius (R), exophytic or endophytic (E), nearness to collecting system or sinus (N), anterior or posterior (A), and location relative to polar lines (RENAL) nephrometry and preoperative aspects and dimensions used for anatomical classification (PADUA) system. CT-based tumor features, including shape, enhancement pattern, margin at the interface of the renal sinus (smooth vs. non-smooth), and finger-like projection of the mass, were also assessed by two independent radiologists. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of RSI. The positive predictive value, negative predictive value (NPV), accuracy of anatomical renal sinus involvement, and tumor features were evaluated. Results: Eighty-one of 276 patients (29.3%) demonstrated RSI. Among highly complex tumors (RENAL or PADUA score ≥ 10), the frequencies of RSI were 42.4% (39/92) and 38.0% (71/187) using RENAL and PADUA scores, respectively. Multivariable analysis showed that a non-smooth margin and the presence of a finger-like projection were significant predictors of RSI. Anatomical renal sinus involvement showed high NPVs (91.7% and 95.2%) but low accuracy (40.2% and 43.1%) for RSI, whereas the presence of a non-smooth margin or finger-like projection demonstrated comparably high NPVs (90.0% and 91.3% for both readers) and improved accuracy (67.0% and 73.9%, respectively). Conclusion: A non-smooth margin or the presence of a finger-like projection can be used as a preoperative CT-based tumor feature for predicting RSI in patients with RCC.

• 한국식품위생안전성학회지
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• 제27권4호
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• pp.349-355
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• 2012

통합노출을 고려한 식품, 건강기능식품, 생약/한약제제, 화장품에서의 유해물질 관리의 우선순위를 선정하기 위해 기존 CRS에서 활용한 위해크기 뿐만 아니라 사회적 인식도를 조사한 후 전문가 평가를 통해 합의된 결과를 점수화하는 우선순위 선정 시스템을 구성하였다. 본 연구에서는 카드뮴, 납, 수은 및 비소 등 25종의 유해물질을 선별하고 선정된 25개 물질에 대해 기존의 우선순위 선정 시스템을 토대로 대상물질별 1) 위해의 크기 (노출 또는 위해수준), 2) 노출원을 고려한 가중치, 3) 관심도의 3가지면에 대해 점수를 산출하였다. 그 결과 25개 물질 중 최종점수는 카드뮴이 178.5점으로 가장 높았으며, 비스페놀 A가 56.8점으로 가장 낮았다. 최종점수가 100점 이상인 물질은 카드뮴, 납, 수은, 비소, 타르, 아크릴아마이드, 벤조피렌, 알루미늄, 벤젠 및 PAHs의 10종이었으며, 아플라톡신, 망간, 프탈레이트, 크롬, 아질산염, 에틸카바메이트, 포름알데히드 및 구리의 8종 물질은 70점 이상이었다. 그 외 이산화황, 오크라톡신 등 7종의 물질이 50점 이상으로 평가되었다. 평가된 최종점수의 타당성 평가를 위해 변수 간의 관련성과 지표간의 상관성분석을 분석한 결과, 노출원에 가중치를 고려한 위해크기가 가중치를 고려하지 않은 위해크기에 비해 최종점수와 관심도 모두 상관성이 높게 나타났으며, 통계적으로 매우 유의한 것으로 나타났다. 이처럼 통합노출을 고려한 유해물질 관리의 우선순위 연구는 위해평가 및 위해관리 측면에서 활용 가능 할 것으로 판단되어 진다.