• Korean Journal of Radiology
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• v.22 no.2
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• pp.159-167
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• 2021

Objective: The aim of this study was to compare the survival rates of Korean females aged 40 to 49 years with breast cancer detected by supplemental screening ultrasound (US) or screening mammography alone. Materials and Methods: This single-institution retrospective study included 240 patients with breast cancer (mean age, 45.1 ± 2.8 years) detected by US or mammography who had undergone breast surgery between 2003 and 2008. Medical records were reviewed for clinicopathologic characteristics and detection methods. Disease-free survival (DFS) and overall survival (OS) were compared between patients with breast cancer in the US and mammography groups using the log-rank test. Multivariable cox regression analysis was used to identify independent variables associated with DFS and OS. Results: Among the 240 cases of breast cancer, 43 were detected by supplemental screening US and 197 by screening mammography (mean follow-up: 7.4 years, 93.3% with dense breasts). There were 19 recurrences and 16 deaths, all occurring in the mammography group. While the US group did not differ from the mammography group in tumor stage, the patients in this group were more likely to undergo breast-conserving surgery and radiation therapy than the mammography group. The US group also showed better DFS (p = 0.016); however, OS did not differ between the two groups (p = 0.058). In the multivariable analysis, the US group showed a lower risk of recurrence (hazard ratio, 0.097; 95% confidence interval, 0.001-0.705) compared to the mammography group. Conclusion: Our study found that Korean females aged 40-49 years with US-detected breast cancer showed better DFS than those with mammography-detected breast cancer. However, there were no statistically significant differences in OS.

• International Journal of Highway Engineering
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• v.12 no.1
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• pp.21-27
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• 2010

Management of driver hours of service (HOS) for commercial vehicle operators has been a continual safety challenge. One of the more critical issues to government and motor carriers is fatigue and fatigue-related accidents. To reduce truck drivers’fatigue-related accident risk in other countries, the government issued the HOS regulations. However, korea government does not have any HOS regulations. The objective of this research gives the clues that korea should have the HOS regulation to reduce truck drivers’fatigue-related accident risk. This study examines the HOS regulation over other countries and conducts relative accident risk analysis using the real data from 3 freight companies. The data set includes 231 accident involved drivers and 462 non-accident drivers. Therefore, the size of the total data set is 693 drivers. One of the most important aspects of early studies of safety and HOS was the need to characterize continuous driving by using the notion of "survival". Subsequent research used a data replication scheme and logistic regression to capture the survival effect. This study uses time-dependent logistic regression. The test of significance between parameters indicates that the first three hours are almost the same risk. In the 10th hour of driving, the risk was more than 2.2times that in the baseline first hour. In conclusion, as driving time goes on, the crash risk increases.

• The Korean Journal of Applied Statistics
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• v.28 no.5
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• pp.965-976
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• 2015

Determining relevant variables for a regression model is important in regression analysis. Recently, a variable selection methods using a penalized likelihood with various penalty functions (e.g. LASSO and SCAD) have been widely studied in simple statistical models such as linear models and generalized linear models. The advantage of these methods is that they select important variables and estimate regression coefficients, simultaneously; therefore, they delete insignificant variables by estimating their coefficients as zero. We study how to select proper variables based on penalized hierarchical likelihood (HL) in semi-parametric frailty models that allow three penalty functions, LASSO, SCAD and HL. For the variable selection we develop a new function in the "frailtyHL" R package. Our methods are illustrated with breast cancer survival data from the Medical Center at Chonnam National University in Korea. We compare the results from three variable-selection methods and discuss advantages and disadvantages.

• Journal of The Korean Digital Architecture Interior Association
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• v.13 no.3
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• pp.15-23
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• 2013

As a succeeding analysis on the variables' significance to 'Quality of Life(QOL)'(Kim, Dong-Yoon, 2012a), which has a purpose of trying to enhance the intersubjectiveness by means of quantitive methods to find the factors on the QOL, this study aims at finding the time serial change in the deciding factors to deepen the related researches on the theme. Using the similar statistical methods such as multiple regression and factor analysis for "2012 Seoul Survey" this study shows two similar points and one differentia. The similarities include the fact that five subcategories of happiness have relative statistical importance in the order of (1)financial condition, (2)health condition, (3)social activities, (4)community relationship and (5)family life and the fact that the five subcategories are conceptually different from the 5 deciding factors, which means the possibility to improve the survey design. And the difference is the 5 factors such as (1) social trust - amenities, (2)cultural life, (3)social indiscrimination - hope for elevation, (4)sharing - giving and (5)community spirit which are largely different from preceding study. Although only the first two factors have statistical significance this result has a implication that they reflect the new paradigm of social capital and the essential necessity of human survival; sharing-community-culture.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.11-23
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• 2020

Purpose : This study examined factors influencing the attitudes towards nurse-led defibrillation in the emergency department (ED) and intensive care unit (ICU). Methods : This was a cross-sectional study. A total of 212 nurses in the ED and ICU from three general hospitals responded to the survey. Data were collected between September and October 2015 using structured questionnaires. Independent t-test, Mann-Whitney U test, one-way analysis of variance (ANOVA), Pearson's correlation coefficient, and hierarchical multiple regression were used to analyze factors affecting nurses' attitudes towards nurse-led defibrillation. Results : The mean score of nurses' attitudes towards nurse-led defibrillation was 61.37 of a possible 91. Hierarchical multiple regression showed that nurses' attitudes towards nurse-led defibrillation were significantly affected by their experiences regarding cardiopulmonary resuscitation (p=.003), knowledge regarding electrocardiogram interpretation and defibrillation (p=.007), and tenure in ED or ICU (p=.043). Conclusion : Results indicate that employers should set policies to support nurses in maintaining their careers in the ED or ICU and conduct systematic educational programs for them. This will increase nurses' confidence in performing defibrillation, which will lead to early defibrillation during in-hospital cardiac arrest. Consequently, it can be a strategy to increase the survival rate of cardiac arrest patients.

• The Journal of Korean Academic Society of Nursing Education
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• v.16 no.2
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• pp.339-346
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• 2010

Purpose: Bystander cardiopulmonary resuscitation (CPR) improves survival. However, there have been few studies on the performance of bystander CPR in Korea. This study was done to identify the reasons for being unwilling to perform CPR, and to investigate the factors associated with performing CPR on a stranger in an emergency situation. Method: The participants in this study were 444 local residents. Data were collected by using self-reported questionnaires from May 1 to June 30, 2010. For data analysis, descriptive statistics and multiple logistic regression were performed using SAS version 9.1. Result: Only 32.2% of respondents reported being willing to perform CPR on a stranger. The major reason for not being willing to perform CPR on a stranger was "have no confidence to perform CPR well". From multiple logistic regression analysis, statistically significant predictors of CPR performance on a stranger were found to be a higher educational level (OR=6.11, 95% CI 1.46-25.52), neighbors with angina pectoris or myocardial infarction (OR=6.65, 95% CI 3.93-11.24), and having confidence of performing CPR (OR=3.02, 95% CI1.78-5.14). Conclusion: CPR education (including automatic external defibrillator) should be offered to family members and neighbors. In addition, the Good Samaritan Law must be given wider publicity at the national level.

• Journal of Chest Surgery
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• v.40 no.2 s.271
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• pp.109-113
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• 2007

Background: In non-small cell lung cancer (NSCLC), malignant pleural effusion is a frequently observed com-plication, and is an important negative prognostic factor. Although many studies concerned to diagnosis and treatment of malignant pleural effusion have been performed, prognostic factors of malignant pleural effusion have rarely been investigated. This study was performed to determine the prognostic factors of malignant pleural effusion n non-small cell lung cancer. Material and Method: We evaluated 33 NSCLC patients with malignant effusion treated between January 2002 and December 2003. We analyzed possible factors: gender, age, TNM Stage, fluid analysis (pH, CEA, LDH, glucose, albumin) and treatment modality. Median survival time of each factor was calculated by Kaplan-Meier method and difference of median survival time between groups of factor compared by log-rank test. The Cox proportional hazards regression model was used to confirm the significance of prognostic factor. Results: Of the 33 patients, 23 (69.7%) patients were adenocarcinoma. The median interval of the diagnosis of lung cancer and malignant effusion was 7.3 months ($25^{th}{\sim}75^{th}:\;3.9{\sim}11.8$), and the median survival time was 3.6 months (95% Confidence Interval: $1.14{\sim}5.99$). In the univariate analysis, using the log-rank test, those with an adenocarcinoma showed a relatively longer median survival time than those of a non-adenocarcinoma (4.067 vs. 1.867 months, p=0.067) without statistical significance. In the multivariate analysis, using the Cox regression, those with a non-adenocarcinoma showed a trend of high risk of cancer death than those with an adenocarcinoma without statistical significance (Relative risk; 2.754, 95% Cl: $0.988{\sim}7.672$, p=0.053). Conclusion: We could not find an independent prognostic factor of malignant pleural effusion in NSCLC. As there was a trend of high risk of cancer death according to histology, further study will be needed.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.379-388
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• 2002

Background : Although patients with stage IV non-small cell lung cancer are known to have a poor prognosis, the prognostic factors for survival have not been well evaluated. Such factors may be different from those for overall survival. This study was performed to analyze the prognostic factors for survuval and the variation of survival according to metastatic organ, in patients with stage IV non-small cell lung cancer. Materials and Methods : From January 1997 to December 2000, 151 patients with confirmed stage IV non-small cell lung cancer were enrolled into this study retrospectively. The clinical and laboratory data were analyzed using univareate Kaplan-Meied and Multivariate Cox regression models. Results : On univariate analysis, age, performance status, serum albumin level, weight loss, forced expiratory volume in one second (FEV1), systemic chemotherapy, the number of metastatic organs and serum lactate dehydrogenase (LDH) level were significant factors (p<0.05). In multivariate analysis, important factors for survival were ECOG performance (relative risk of death [RR]: 2.709), systemic chemotherapy (RR: 1.944), serum LDH level (RR: 1.819) and FEV1 (RR: 1.774) (p<0.05), Metastasis to the brain and liver was also a significant factor on univariate analysis). The presence of single lung metastasis was associated with better survival than that of other metastatic organs (p=0.000). Conclusion : We confirmed that performance status and systemic chemotherapy were independent prognostic factors, as has been recognized. The survival of stage IV non-small cell lung cancer patients was different according to the metastatic organs. Among the metastatic sites, only patients with metastasis to the lung showed bettrer survival than that of other sites, while metastasis of the brain or liver was associated with worse survival than that of other sites.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.2
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• pp.560-569
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• 2016

Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2465-2472
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• 2014

Background: The American Joint Committee on Cancer (AJCC) published a new staging system ($7^{th}$ edition) in 2009. In our study, we evaluated the survival results and prognostic factors among T4 local advanced non-small cell lung cancer (LA-NSCLC) patients in a large heterogeneous group, in accordance with this new system. Materials and Methods: We retrospectively evaluated the files of 122 T4 N0-3 M0 LA-NSCLC patients, identified according to the new staging system, treated at two centers between November 2003 and June 2012. Variables correlating with univariate survival at p<0.20 were later included in multivariate Cox regression analysis. Here, selection of relevant predictors of survival was carried out in accordance with the likelihood ratio formula with p<0.05 regarded as significant. Results: The median age was 60 and the median follow-up period was 17.4 months. Median overall survival (OS) was 18.3 months, the 1 year overall survival (OS) rate was 72%, and the 5 year OS rate was 28%. Statistically significant predictors of survival were (p<0.20) ECOG-PS (Eastern Cooperative Oncology Group Performance Status), age, T4 factor subgroup, stage and primary treatment in OS univariate analysis. On multivariate analysis for OS ECOG-PS (p=0.001), diagnostic stage (p=0.021), and primary treatment (p=0.004) were significant. In the group receiving non-curative treatment, the median OS was 11.0 months, while it was 19.0 months in the definitive RT group and 26.6 months in the curative treatment group. There was a significant difference between the non-curative group and the groups which had definitive RT and curative operations (respectively p<0.001 and p=0.001) in terms of OS, but not between the groups which had definitive RT and curative operations. The median event free survival (EFS) rate was 9.9 months, with rates of 46% and 19% at 3 and 5 years, respectively. On univariate analysis of EFS rate with ECOG-PS, weight loss and staging, statistical significance was found only for thorax computerized tomography (CT)+18F-fluorodeoxy-glucose positron emission tomography-CT (PET-CT) use, stage and primary treatment (p<0.20). In multivariate analysis with EFS, only the primary treatment was statistically significant (p=0.001). In the group receiving non-curative treatment, the median EFS was 10.5 months while in the curative operation group it was 14.7 months. When all the primary treatment groups were taken into consideration, grade III/IV side effect swas observed in 57 patients (46.6%). Esophagitis was most prominent among those that received definitive radiotherapy. Conclusions: Independent prognostic factors among these 122 heterogeneous LA-NSCLC T4 N0-3 M0 patients were age at diagnosis, ECOG-PS, stage and primary treatment, the last also being a significant prognostic indicator of EFS. Our findings point to the importance of appropriate staging and a multidisciplinary approach with modern imaging methods in this patient group. In those with T4 lesions, treatment selection and the effective use of curative potential should be the most important goal of clinical care.