• 보건행정학회지
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• 제32권2호
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• pp.154-163
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• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• Journal of Gastric Cancer
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• 제23권1호
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• pp.207-223
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• 2023

Gastric cancer (GC) is the fourth leading cause of cancer-related deaths worldwide. Under the standard of care, patients with advanced GC (AGC) have a median survival time of approximately 12-15 months. With the emergence of immunotherapy as a key therapeutic strategy in medical oncology, relevant changes are expected in the systemic treatment of GC. In the phase III ATTRACTION-2 trial, nivolumab, a monoclonal anti-programmed cell death 1 (PD-1) antibody, as a third- or later-line treatment improved overall survival (OS) compared with placebo in patients with AGC. Furthermore, nivolumab in combination with 5-fluorouracil and platinum as a first-line treatment improved OS in patients with human epidermal growth factor receptor-2 (HER2)-negative AGC in the global phase III CheckMate-649 study. Another anti-PD-1 antibody, pembrolizumab, in combination with trastuzumab and cytotoxic chemotherapy as a first-line treatment, significantly improved the overall response rate in patients with HER2-positive AGC. Therefore, immune checkpoint inhibitors (ICIs) are essential components of the current treatment of GC. Subsequent treatments after ICI combination therapy, such as ICI rechallenge or combination therapy with agents having other modes of action, are being actively investigated to date. On the basis of the success of immunotherapy in the treatment of AGC, various clinical trials are underway to apply this therapeutic strategy in the perioperative and postoperative settings for patients with early GC. This review describes recent progress in immunotherapy and potential immunotherapy biomarkers for GC.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권4호
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• pp.330-336
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• 2001

Angiogenesis is an essential process for the growth, invasion and metastasis of cancer. However, it is uncertain that antiangiogenic effects can be a major treatment strategy of oral cancer. The aim of this study was to investigate whether thalidomide, which is known to be a potent inhibitor of angiogenesis, have inhibitory effect on the growth and antiangiogenic effects of oral squamous cell carcinoma(OSCC) xenografted in nude mice and whether antiangiogenesis of thalidomide can be included as a major treatment strategy of oral cancer. After human oral squamous cell carcinoma strain KB was subcutaneously implanted in 20 nude mice, the volume of tumor was measured every three days. When the tumor mass reached $75{\sim}100mm^3$, thalidomide(200mg/kg/d) was administered into 10 experimental nude mice and the same volume of distilled water was administered into 10 control nude mice and the tumor volume was measured every three days. The excised tumor masses on the 30th day after administration were frozen and processed for immunohistochemistry using vascular endothelial growth factor(VEGF) and CD31. We evaluated microvessel density and VEGF expression. The results were as follows ; 1. Thalidomide retarded the growth of human OSCC as compared with the control group, but it was not statistically significant. 2. A statistically significant lower microvessel density was observed in the thalidomide-treated group than in the control group(p<0.01) and thalidomide significantly reduced VEGF expression (p<0.01). Thalidomide exhibited significantly antiangiogenic effect, but did not inhibit the growth of human OSCC effectively. Antiangiogenic therapy of thalidomide alone is not likely to be effective in the treatment of human OSCC, but might be regarded as adjuvant chemotherapeutic strategy.

• Journal of Radiation Protection and Research
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• 제45권2호
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• pp.81-87
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• 2020

Background: Kori unit #1 is permanently shut down after a 40-year lifetime. The Nuclear Safety and Security Commission recommends establishing initial decommissioning plans for all nuclear and radwaste treatment facilities. Therefore, the Korea Atomic Energy Research Institute (KAERI) must establish an initial and final decommissioning plan for radwaste-treatment facilities. Radiation safety assessment, which constitutes one chapter of the decommissioning plan, is important for establishing a decommissioning schedule, a strategy, and cost. It is also a critical issue for the government and public to understand. Materials and Methods: This study provides a method for assessing external radiation dose to workers during decommissioning. An external dose is calculated following each exposure scenario, decommissioning strategy, and working schedule. In this study, exposure dose is evaluated using the deterministic method. Physical characterization of the facility is obtained by both direct measurement and analysis of the drawings, and radiological characterization is analyzed using the annual report of KAERI, which measures the ambient dose every month. Results and Discussion: External doses are calculated at each stage of a decommissioning strategy and found to increase with each successive stage. The maximum external dose was evaluated to be 397.06 man-mSv when working in liquid-waste storage. To satisfy the regulations, working period and manpower must be managed. In this study, average and cumulative exposure doses were calculated for three cases, and the average exposure dose was found to be about 17 mSv/yr in all the cases. Conclusion: For the three cases presented, the average exposure dose is well below the annual maximum effective dose restriction imposed by the international and domestic regulations. Working period and manpower greatly affect the cost and entire decommissioning plan; hence, the chosen option must take account of these factors with due consideration of worker safety.

• 한국초지조사료학회지
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• 제37권2호
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• pp.101-107
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• 2017

Corn is basal forage for livestock species in Republic of Korea but it lacks protein and needs nitrogenous fertilizer. This study was designed with main objective to achieve optimum growth, yield & nutritive value of forage for livestock through implementing corn-soybean intercropping strategy at 17 different places under Korean condition. Two treatments; corn as monocrop (control treatment) and corn-soybean intercrop were compared under Randomized Block Design from $28^{th}$ May to $8^{th}$ October, 2015. Each treatment had three replicates in each block, whereas seventeen different places were considered as blocks. Data were analyzed through SAS-9.1.3 software. Difference between two treatment means was tested through T-test. Findings depicted that intercropping pattern could not influence (P>0.05) corn plant & ear height, corn lodged stalk No. and corn stalks number. However, corn-soybean intercropping enhanced (P<0.05) forage productivity in terms of total fresh yield ($16.4{\pm}0.7^b$ vs. $19.9{\pm}0.7^atons\;ha^{-1}$), total dry matter yield ($5.38{\pm}0.25^b$ vs. $6.41{\pm}0.31^atons\;ha^{-1}$) and total digestible nutrients yield ($3.94{\pm}0.17^b$ vs. $4.59{\pm}0.21^atons\;ha^{-1}$). Dry matter percentage in corn stalks and corn ears was not different (P>0.05) between two treatments. It was concluded that corn-soybean intercropping strategy was promising technique in enhancing forage productivity though positive symbiotic relation between two crops.

• Asian Pacific Journal of Cancer Prevention
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• 제17권1호
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• pp.215-217
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• 2016

Background: Chronic lymphocytic leukemia (CLL) is the most frequent form of leukemia in Europe and North America, and it mainly affects older individuals. Many approaches are implemented in the management of CLL from a watch and wait (W&W) strategy to chemotherapeutic regimens. We here reviewed our clinical practice for the relevance of the W&W strategy in Lebanese CLL patients. Materials and Methods: A total of 95 patients with CLL diagnosed in four institutions in Lebanon, between 1992 and 2013, were selected and their files were reviewed. Characteristics of these patients were noted including age, sex, RAI and Binet scores, CBC values, presence of hepatomegaly or splenomegaly, performance of bone marrow biopsy or peripheral blood flux cytometry for diagnosis, adoption of W&W strategy, different chemotherapeutic regimens and the indications for treatment. Results: Some 38 patients (40%) diagnosed with CLL were women and 57 (60%) were men with a mean age of 65.1 years [36-89]. Of the total, 50.5%, 17.2%, 14%, 7.5% and 10.8% had an RAI score at diagnosis of 0, 1, 2, 3 and 4, respectively, while 65.6%, 17.2% and 17.2% had Binet scores of I, II and III. The mean lymphocyte count at diagnosis was $39885/mm^3$ [1596-290000], the mean hemoglobin level was 12.7 g/dl [6.2-17] and the mean platelet count was $191255/mm^3$ [14000-458000]. While 26.3% of patients with CLL had splenomegaly, only 7.4% had hepatomegaly. Some 33.7% had undergone a bone marrow biopsy, 66.3% flow cytometry of circulating blood and 5.3% a lymph node biopsy. Overall, the W&W was adopted in 62.4% (58) of patients with a mean duration of 37.7 months [3-216]. The W&W was used in 82.6%, 73.3%, 46.2%, 14.3% and 0% of patients having RAI scores of 0, 1, 2, 3 and 4, respectively, and, it was used in 80%, 46.7% and 6.25% with Binet scores of I, II and III. The most frequent indication for treatment was anemia and thrombocytopenia, accounting for 32.7% of cases. The most frequently used chemotherapeutical regimens were chlorambucil until the end of the last century and flufarabine-cyclophosphamide-rituximab during the last decade. Conclusions: This retrospective review of CLL clinical practice showed an important implementation of the W&W strategy with a long duration, especially in early stage cases with low RAI or Binet scores.

• Korean Journal of Radiology
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• 제22권1호
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• pp.23-40
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• 2021

In pancreatic cancer, imaging plays an essential role in surveillance, diagnosis, resectability evaluation, and treatment response evaluation. Pancreatic cancer surveillance in high-risk individuals has been attempted using endoscopic ultrasound (EUS) or magnetic resonance imaging (MRI). Imaging diagnosis and resectability evaluation are the most important factors influencing treatment decisions, where computed tomography (CT) is the preferred modality. EUS, MRI, and positron emission tomography play a complementary role to CT. Treatment response evaluation is of increasing clinical importance, especially in patients undergoing neoadjuvant therapy. This review aimed to comprehensively review the role of imaging in relation to the current treatment strategy for pancreatic cancer, including surveillance, diagnosis, evaluation of resectability and treatment response, and prediction of prognosis.

• 영어어문교육
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• 제11권4호
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• pp.21-47
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• 2005

The purpose of this study is to investigate the effectiveness of English vocabulary learning strategies such as definition-oriented/contextoriented/situated context-oriented vocabulary learning strategy according to the cognitive styles of learners and interaction effect on the achievement test score between the learners' cognitive style and vocabulary learning strategies. The results show that there is no significant difference in the achievement test scores between field-dependent learner group and field-independent learner group. And there is significant difference in the English vocabulary achievement test scores among three experimental treatment groups, definition-oriented, context-oriented, situated context-oriented vocabulary learning strategy groups. Finally, there is an interaction effect on the achievement test score between the learners' cognitive style and vocabulary learning strategies.

• 대한전기학회논문지:전력기술부문A
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• 제52권6호
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• pp.347-353
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• 2003

In models of imperfect competition of deregulated electricity markets, the key task is to find the Nash equilibrium(NE). The approaches for finding the NE have had two major bottlenecks: computation of mixed strategy equilibrium and treatment of multi-player games. This paper proposes a payoff matrix approach that resolves these bottlenecks. The proposed method can efficiently find a mixed strategy equilibrium in a multi-player game. The formulation of the m condition for a three-player game is introduced and a basic computation scheme of solving nonlinear equalities and checking inequalities is proposed. In order to relieve the inevitable burden of searching the subspace of payoffs, several techniques are adopted in this paper. Two example application problems arising from electricity markets and involving a Cournot and a Bertrand model, respectively, are investigated for verifying the proposed method.

• 대한화학회지
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• 제51권2호
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• pp.186-192
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• 2007

이 연구에서는 일반화학 수업에서의 개념도 작성이 초등 예비교사의 성취도, 개념 이해도, 과학에 대한 불안감, 과학교수효능감에 미치는 영향을 조사했다. 또한, 예비교사들의 학습 접근 방식과 개념도 작성 활동 사이의 적성-처치 상호작용 효과도 조사했다. 1개 교육대학교의 1학년 학생 69명을 처치 집단과 통제 집단으로 배정했다. 사전 검사로 학습 접근 방식, 과학에 대한 불안감, 과학교수효능감 검사를 실시했다. 처치는 9주 동안 진행되었는데, 처치 집단은 강의 후 개념도 작성을 했고, 통제 집단은 강의 후 교과서의 연습 문제를 풀었다. 처치가 끝난 후, 성취도, 개념 이해도, 과학에 대한 불안감, 과학교수효능감 검사를 실시했다. 연구 결과, 성취도 검사에서는 처치 집단의 점수가 통제 집단보다 유의미하게 높았다. 그러나 개념 이해도와 과학교수효능감에서는 처치 집단과 통제 집단 사이에 통계적으로 유의미한 차이가 나타나지 않았다. 과학에 대한 불안감 검사에서는 처치 집단 학생들의 불안감이 통제 집단에 비해 유의미하게 높았다. 학생들의 학습 접근 방식과 수업 처치 사이의 적성-처치 상호작용 효과는 발견되지 않았다.