• Radiation Oncology Journal
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• 제31권4호
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• pp.191-198
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• 2013

Purpose: To observe long-term clinical outcomes for patients with early-stage breast cancer treated with forward intensity-modulated radiation therapy (IMRT), including local control and clinical toxicities. Materials and Methods: We retrospectively analyzed a total of 214 patients with stage I-II breast cancer who were treated with breast conserving surgery followed by adjuvant breast radiation therapy between 2001 and 2008. All patients were treated using forward IMRT. The whole breast was irradiated to a dose of 50 to 50.4 Gy followed by an 8 to 12 Gy electron boost to the surgical bed. Results: The median age was 46 years (range, 21 to 82 years) and the medial follow-up time was 7.3 years (range, 2.4 to 11.7 years). Stage T1 was 139 (65%) and T2 was 75 (35%), respectively. Ipsilateral breast recurrence was observed in 3 patients. The 5- and 10-year local control rates were 99.1% and 97.8%, respectively. The cosmetic outcome was evaluated according to the Harvard scale and 89.4% of patients were scored as excellent or good. Conclusion: The whole breast radiation therapy as an adjuvant treatment using a forward IMRT technique showed excellent long-term local control as well as favorable outcomes of toxicity and cosmesis.

• 대한간호학회지
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• 제41권6호
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• pp.780-787
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• 2011

Purpose: This study was conducted to examine activities of daily living (ADL) of older adults admitted to Korean long-term care hospitals (LTCHs), and to explore the patient and organizational factors that have an impact on the ADL of this population. Methods: A secondary analysis of the Korean minimum data set (K-MDS) of patients (N=14,369) and of the profiles of LTCHs (N=358) from the Health Insurance Review and Assessment Service was done between January and July 2008. The outcome variable was ADL score 6 months after baseline assessment. Multi-level linear regression was employed to explore the patient and organizational factors that affected ADL scores. Results: Of the patients, 45.4% had a baseline ADL score of between 31 and 40, with a score of 40 indicating that the patient was entirely dependent for all items. None of the organizational characteristics were significantly associated with effects on the ADLs of older adults who had been in a LTHC for at least 6 months. However, patient characteristics, such as age, baseline ADL, frequency of physical therapy, urinary incontinence, fecal incontinence, pressure ulcers, and having a tube or catheter, were significantly associated with ADL 6 months after baseline. Conclusion: In order to maintain and improve the ADL of older adults in LTCHs, we should develop strategies to prevent urinary and fecal incontinence, pressure ulcers, unnecessary tubes or catheters, providing adequate physical therapy. Additional studies should include more detailed information regarding nursing staff, including RN hours for direct care, education level and turnover.

• 대한치과교정학회지
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• 제47권2호
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• pp.100-107
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• 2017

Objective: To analyze the long-term changes in maxillary arch widths and buccal corridor ratios in orthodontic patients treated with and without premolar extractions. Methods: The study included 53 patients who were divided into the extraction (n = 28) and nonextraction (n = 25) groups. These patients had complete orthodontic records from the pretreatment (T1), posttreatment (T2), and postretention (T3) periods. Their mean retention and postretention times were 4 years 2 months and 17 years 8 months, respectively. Dental models and smiling photographs from all three periods were digitized to compare the changes in three dental arch width measurements and three buccal corridor ratios over time between the extraction and nonextraction groups. Data were analyzed using analysis of variance tests. Post-hoc multiple comparisons were made using Bonferroni correction. Results: Soft-tissue extension during smiling increased with age in both groups. The maximum dental width to smile width ratio (MDW/SW) also showed a favorable increase with treatment in both groups (p < 0.05), and remained virtually stable at T3 (p > 0.05). According to the MDW/SW ratio, the mean difference in the buccal corridor space of the two groups was $2.4{\pm}0.2%$ at T3. Additionally, no significant group ${\times}$ time interaction was found for any of the buccal corridor ratios studied. Conclusions: Premolar extractions did not negatively affect transverse maxillary arch widths and buccal corridor ratios. The long-term outcome of orthodontic treatment was comparable between the study groups.

• 한국콘크리트학회:학술대회논문집
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• 한국콘크리트학회 2000년도 가을 학술발표회논문집(I)
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• pp.31-45
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• 2000

Because of the high unit cement content in the concrete mix, major concrete temperature rises are observed in the initial stages of hardening in structural members with large cross-sections made of high-strength concrete. While this temperature rise in the initial stages of hardening contributes to the initial development of the concrete strength, it also causes thermal cracking and obstructs medium to long-term increases of the concrete strength. In the study reports below, investigations were made on the effects of the concrete temperature rise in the initial stages of hardening on the medium to long-term development of the strength of structural concrete between the ages of 28 and 91 days. In the study, comparisons were made, for example, between the compressive strength of a control specimen subjected to standard curing at 28 days and the compressive strength of core specimens taken from structural members, and observations were made on the methods of evaluating the concrete strength in structure, defined here as the compressive strength of core specimens at 91 days. The results obtained indicate that, when the maximum temperature of the concrete is the structure does not exceed $60^{\circ}C$, the concrete strength in structure at the age of long-term will generally be greater than the compressive strength of the standard-curing specimens at 28 days, allowing one to evaluate the strength of the structural concrete in terms of the compressive strength of the 28-days standard-curing specimens. When, on the other hand, the maximum temperature of the concrete in the structure exceeds $60^{\circ}C$, the strength in concrete structure may be smaller than the compressive strength of the 28-days standard-curing specimens, creating risks in the evaluation of the concrete strength in structure by latter.

• 한국전산구조공학회논문집
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• 제17권3호
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• pp.251-259
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• 2004

콘크리트의 크리프와 건조수축에 의한 시간에 따른 프리스트레스 장기예측의 정확성은 프리스트레스트 큰크리트 교량과 같은 사회 기반 시설의 유지 관리 및 보수 결정 측면에서 매우 중요한 역할을 한다. 본 논문에서는 프리스트레스트 콘크리트 교량의 프리스트레스 장기예측의 불확실성 감소, 즉 예측의 정확성 향상을 위하여 현장 계측치를 이용하여 베이시안(Bayesian)통계기법을 도입하는 예측기법을 제안하였다. 베이시안 해석시 사전 확률분포는 콘크리트의 크리프와 건조수축의 확률 특성을 고려하여 나타내며, 우도 함수(likelihood function)는 현장에서의 계측치를 사용하여 나타내었다. 시간에 따른 구조적 거동 시스템으로부터의 지속적인 계측 기록은 베이시안 지식 기반에서의 확률분포를 업데이팅 하기 위하여 사용되며, 사후 확률분포는 사전확률분포와 우도 함수를 조합하여 획득한다. 실제로 가설되고 있는 프리스트레스트 콘크리트 박스 거더 교량으로부터 계측된 프리스트레스 힘의 수치 예제해석을 통하여 제안 기법의 적용성을 제시하였다.

• 한국주거학회논문집
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• 제19권2호
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• pp.1-10
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• 2008

The purpose of this research is to compare residents' movement and activities in SH apartment in Yangcheon-Gu, Seoul (SH apartment) and PHA apartment in St. Paul, Minnesota (PHA apartment) in order to improve the quality of rental housing environment. This study had surveyed 418 residents of SH apartments in Korea and used the secondary data gathered from 1,462 residents of PHA apartments in the United States. The results of this study are as follows: The criteria of Korean residents in SH apartments when choosing their residences are lower rent payment and shorter waiting time. They seemed to have no other options than public rental housing. On the contrary, American residents in PHA apartment had more option to choose from. Therefore, Korea needs to offer more variety types of residents that can be lead to better satisfaction of low income classes. Most of the SH apartments residents has lived for long-term, in the average of more than 6 years, and wanted to live continually at their current dwelling. PHA residents showed similar tendency. However, long term residency may lead to permanent occupation of the public rental apartment by the same family. Hence, a system which can provide equal residency opportunities to all low-income classes need to be developed. Residents of SH apartment were satisfied with the personal activities but were not satisfied with group activities among residents or regarding resident meetings. However, residents of PHA apartments were more satisfied with their management because there is more in-housing-complex activity programs. Therefore, more activity program for a resident should be developed after analysing programs of different apartments and current conditions in Korea. There were some noticeable divergences among residents, based on their age, term of residence and physical, emotional and mental problem, when evaluating in-housing-complex's programs. Thus, these factors are also need to be considered when planning and examining evaluation about the management of rental apartments.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.1035-1039
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• 2014

Aim: To evaluate the operative, oncologic and obstetric outcomes of the loop electrosurgical excision procedure (LEEP) in cases with cervical neoplasia. Materials and Methods: A retrospective cohort study was conducted on patients who were suspected of cervical neoplasia and therefore undergoing LEEP at Siriraj Hospital, Mahidol University, Thailand, during 1995-2000. Outcome measures included operative complications in 407 LEEP patients and long-term outcomes in the 248 patients with cervical intraepithelial neoplasia (CIN) who were treated with only LEEP. Results: There were 407 patients undergoing LEEP; their mean age was $39.7{\pm}10.5$ years. The histopathology of LEEP specimens revealed that 89 patients (21.9%) had lesions ${\leq}CIN$ I, 295 patients (72.5%) had CIN II or III, and 23 patients (5.6%) had invasive lesions. Operative complications were found in 15 patients and included bleeding (n=9), and infection (n=7). After diagnostic LEEP, 133 patients underwent hysterectomy as the definite treatment for cervical neoplasia. Of 248 CIN patients who had LEEP only, seven (2.8%) had suffered recurrence after a median of 16 (range 6-93) months; one had CIN I, one had CIN II, and five had CIN III. All of these recurrent patients achieved remission on surgical treatment with re-LEEP (n=6) or simple hysterectomy (n=1). A significant factor affecting recurrent disease was the LEEP margin involved with the lesion (p=0.05). Kaplan-Meier analysis showed 5-year and 10-year disease-free survival (DFS) estimates of 99.9%. Twelve patients became pregnant a total of 14 times, resulting in 12 term deliveries and two miscarriages - one of which was due to an incompetent cervix. Conclusions: LEEP for patients with cervical neoplasia delivers favorable surgical, oncologic and obstetric outcomes.

• Journal of Chest Surgery
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• 제44권2호
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• pp.108-114
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• 2011

Background: Homograft cardiac valves and valved-conduits have been available in our institute since 1992. We sought to determine the long-term outcome after right ventricular outflow tract (RVOT) reconstruction using homografts, and risk factors for reoperation were analyzed. Materials and Methods: We retrospectively reviewed 112 patients who had undergone repair using 116 homografts between 1992 and 2008. Median age and body weight at operation were 31.2 months and 12.2 kg, respectively. The diagnoses were pulmonary atresia or stenosis with ventricular septal defect (n=93), congenital aortic valve diseases (n=15), and truncus arteriosus (N=8). Mean follow-up duration was $79.2{\pm}14.8$ months. Results: There were 10 early and 4 late deaths. Overall survival rate was 89.6%, 88.7%, 86.1% at postoperative 1 year, 5 years and 10 years, respectively. Body weight at operation, cardiopulmonary bypass (CPB) time and aortic cross-clamping (ACC) time were identified as risk factors for death. Forty-three reoperations were performed in thirty-nine patients. Freedom from reoperation was 97.0%, 77.8%, 35.0% at postoperative 1 year, 5 years and 10 years respectively. Small-sized graft was identified as a risk factor for reoperation. Conclusion: Although long-term survival after RVOT reconstruction with homografts was excellent, freedom from reoperation was unsatisfactory, especially in patients who had small grafts upon initial repair. Thus, alternative surgical strategies not using small grafts may need to be considered in this subset.

• 대한지역사회영양학회지
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• 제18권2호
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• pp.142-153
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• 2013

The purpose of the study was to examine nutritional management and nutritional care demands of home-visit care service and the nutritional status of serviced elderly. The survey was carried out from $5^{th}$ to $21^{st}$ of January, 2011 among 37 In-Home Service institutions. The number of elderly surveyed by 143 care helpers was 281. Analysis was performed for 203 subjects (male: 44, female: 159). The age distribution was from 50 to 99 years. The grading by long-term care insuranceshowed 18,2% on level 1 and 2, and 81.8% on level 3. For the disease treatment, the proportion of implementing diet treatment turned out to be very low. The proportion of subjects living with their children was 45.3%, and living alone was 29.1%. The proportion of home-visit care among types of In-Home Service was 70%. Subjects who needed additional necessary diet management service turned out to be 40.9%. Diet management was the most necessary services from all levels. MNA (specifiy MNA) scores were significantly (p < 0.001) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), intake problems, and weight loss during the last 3 months. For studied elderly, 45.3% were malnourished, and 46.8% were at the risk of malnutrition by MNA score. Based on the result of this survey, the nutritional care was not systematic on the In-Home Service. Prevention and management of the disease was much better than the treatment to improve the quality of life. We conclude that nutrition management is necessary for the elderly. To improve nutritional status of elderly in home care services, systematic nutrition management should be implemented.

• Archives of Reconstructive Microsurgery
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• 제22권1호
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• pp.24-28
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• 2013

Purpose: Soft tissue defect of the hand, which cannot be covered with skin graft or local flap, is usually reconstructed using a free flap. Temporoparietal fascial free flap is one of the best alternatives for functional reconstruction of the hand with exposed tendons, bones, and joints. Materials and Methods: We have experienced four cases of reconstruction using a temporoparietal fascial flap with a skin graft and followed up for 20 years. We conducted a retrospective review of the patients' clinical charts and photos. Results: At the time of initial injury, the average age of patients was 50.3 (39~62) years. The radial artery was used for reconstruction of the dorsal side of the hand, whereas the ulnar artery was used for that of the volar side of the wrist. Short term complication such as skin graft loss and donor site alopecia occurred. However, during the long term follow-up period, no change of flap volume was noted, and full range of motion in the adjacent joint was maintained. In addition, hyperpigmentation of the grafted skin on the flap disappeared gradually. Conclusion: Selection of the optimal flap is important for reconstruction of the hand without functional limitation. We obtained satisfactory soft tissue coverage and functional outcomes using a temporoparietal fascial free flap and followed up for 20 years.