• Title/Summary/Keyword: 실패 요인

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Treatment Result in Advanced T3 and T4 Glottic Carcinoma: YUMC Experience (T3, T4병기 성문암의 치료성적)

  • Shin Hyun Soo;Lee Hyung Sik;Chung Eun Ji;Kim Gwi Eon;Loh Juhn Kyu;Suh Chcng Ok;Kim Kwang Hoon;Hong Won Pyo
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.73-79
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    • 1991
  • Between January 1980 and September 1988,08 patients with advanced T3 & T4 glottic carcinoma were treated with RT and surgery/RT in the Department of Radiation Oncology, Yonsei Cancer Center and ENT, Yonsei University College of Medicine. The mean age was 60 years old (range 33 to 79 years old). The 34 patients were treated with irradiation alone, and the remaining 34 patients with surgery and irradiation. Initial nodal presentation was $37\% (25/68);\;31\%$ (l1/34) in RT alone group and $41\%$ (14/34) in combined treatment group. The minimum follow-up was 2 years. The local control rate after treatment was $47\%$ in RT alone group and $65\%$ in combined treatment group; $57\%$ for node negative and $27\%$ for node positive patients treated with RT alone; $65\%$ for node negative and $54\%$ for node positive patients treated with combined treatment. The treatment failure was observed in 30 patients; 14 patients for primary local failure, 6 patients for regional nodal failure,5 patients for local and regional failure, 26 patients for primary failure and/or distant metastasis, and 2 patient for regional failure and/or distant metastasis. The overall 5-year suwival rate was $57\%;\;37\%$ in RT alone group and $70\%$ in combined treatment group; $55\%$ for node negative and $20\%$ for node positive patients treated with RT alone; $73\%$ for node negative and $77\%$ for node positive patients treated with combined treatment. In conclusion, the combined treatment groups in the treatment of advanced 73 and 74 glottic cancer showed the better results in local control rates and S-year actuarial survival rates than RT alone group. We suggest that total laryngectomy and postoperative RT in the most patients of advanced glottic cancer were performed. However, in cases of node negative patints, RT alone is prefer as a treatment modality over combined surgery and RT since the treatment results were comparable and furthermore functional preservation could be achieved.

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The Characteristics of Korean Smoker, Enrolled in '5 day Smoking Cessation School' and The Effect of Inpatient Smoking Cessation Program (서울 위생 병원 5일 금연 학교를 방문한 우리나라 흡연자의 특성 및 입원 금연 교육 프로그램의 효과)

  • Lee, Byung Soo;Kang, Ki Hoon;Chae, Eun Ha;Kim, Myung Chan;Jung, Jae Il;Chang, Hee Jong;Lee, Sang Hoon;Cho, Dong Sik;Shin, Jai Gyu;Kim, Hui Jung
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.5
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    • pp.411-418
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    • 2004
  • Background : Cigarette smoking is the single biggest avoidable cause of death and disability in most countries. Effective prevention of cigarette Smoking and help for those wishing to quit can therefore yield enormous health benefits for populations and individuals. Although most of smokers try to stop smoking for themselves, the success rate of quitting smoking is very low. Promoting and supporting smoking cessation should be an important health policy priority for healthcare professionals in all clinical settings. In this study, we tried to evaluate the effect of the educational program for smoking cessation of our hospital, the smoking pattern, and characteristics of adult smokers enrolled in the program. Methods : We enrolled 640 smokers, who has visited the '5 day stop smoking school' for smoking cessation from Jan 1998 to 2001. we evaluated the characteristics of the smokers based on the self report questionnaire at the beginning of the program and we also checked 100 smokers, enrolled in Inpatient Smoking Cessation Educational program, their smoking behavior and the cessation rate with postal questionnaire after finishing this program from Nov 2002 to Jan 2003. Results : The health was most common motivation for smoking cessation. The stress was the most important motivation of smoking. The overall smoking cessation rate of the smokers enrolled in inpatient smoking cessation school was 60%. The age of starting smoking and the kind of occupation have a significant difference between the success group and failure group of smoking cessation. Conclusion : The inpatient smoking cessation program was effective smoking cessation intervention in the adult smokers who enrolled in '5 day stop smoking school'.

A Follow-up Survey of Mothers' Antenatal Breast-feeding Plans (임신시 모유 수유 계획의 실천에 대한 추적 관찰)

  • Kim, Hae Soon;Seo, Jeong Wan;Kim, Yong Joo;Lee, Kee Hyoung;Kim, Jae Young;Ko, Jae Sung;Bae, Sun Hwan;Park, Hye Sook
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.635-641
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    • 2003
  • Purpose : To investigate the success rate and factors that influence breast-feeding among women having antenatal breast-feeding plans. Methods : Questionnaires included items on success in breast-feeding, reasons for failure and perinatal factors. It was done by telephone calls to 152 randomly selected women having antenatal breast-feeding plans at 4 months after delivery. The questionnaires were analysed by bivariate ${\chi}^2$-analysis. Results : The breast-feeding rate for the first four months among women having antenatal breast-feeding plans was 37.5%. The major reason for breast-feeding failure was insufficient amount of breast milk(66.3%). The breast-feeding rate was 2.3(95% CI 1.15-4.62) times higher in women having antenatal breast-feeding plans for longer than 4 months(P<0.05), but maternal age, breast-feeding for previous baby, person advocating breast-feeding, and family size were not significant factors of success in breast-feeding. The breast-feeding rate of graduates of college was 0.43(95% CI 0.21-0.86) times lower than that of graduates of high school. The breast-feeding rate of employed mothers was 0.37(95% CI 0.17-0.83) times lower than that of housewives(P<0.05). Maternal disease, smoking, alcohol drinking, and understanding and knowledge about breast-feeding were not significant determinant factors of success in breast-feeding. Breast-feeding rate of infant born at local obstetric clinics was 3.97(95% CI 11-14.23) times higher than that of infant at general hospital(P<0.05). Conclusion : To increase the breast-feeding, medical personnel should educate mothers on problems during breast-feeding. Hospital polices that facilitate breast-feeding such as rooming-in must be promoted. For employed mothers, strategies for breast-feeding within companies must be encouraged.

A Study on the Development of University Start-up through the Analysis of University Start-up Education and Start-up Support System: Focusing on the Start-up Education and Start-up Support System of D University (대학 창업교육 및 창업지원제도 분석을 통한 대학창업발전방안 연구: D대학 창업교육 및 창업지원제도를 중심으로)

  • Lee, Sung Ho;Kim, Jeung Eum;Nam, Jung Min
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.4
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    • pp.151-160
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    • 2020
  • This study aims to figure out the status of university start-up education and support scheme, which are becoming more important as a major project of recent university policy, and to present policy tasks for promoting university start-ups by analyzing problems. A survey on education and support scheme about start-up was carried out from 800 students including those on leave of absence at D university located in metropolitan area and the analysis results are as follows. First, perception about start-up was highly positive due to various start-up education and support scheme from universities, but it was surveyed that university students have still low willingness to challenge start-up. Second, the biggest reason why university students avoid the start-up is 'the risk of start-up failure' at 40.8%, followed by 'Prioritizing getting a job' at 24.9% and 'lack of knowledge on start-up' at 13.4%. Also, difficulty from those who have already started business was mainly financing at 26.9%. The second was 14.0% for securing manpower, and the third was 11.8% for technology development. Third, the necessity of start-up education was in the order of 'starting-up' > 'preparing to start-up' > 'no intention to start-up'. The reason for the necessity of start-up education was 'motivation for various career choices' with 24.8%, followed by 'acquisition of various knowledge and skills for start-up' with 23.9%. Finally, efforts are needed to understand the importance of public relations for start-up policies in universities and figure out the problems of the start-up support scheme. The start-up education and support scheme should reflect the needs of university students, who are actual policy consumers, by shifting away from the method provided by existing suppliers.

Discontinuation Rate of Doxepin in Insomnia Patients (불면증 환자의 Doxepin 치료 중단율)

  • Lee, Ji Hyeon;Kim, Sung-Min;Hong, Seung-Chul;Seo, Ho-Jun;Kim, Tae-Won;Um, Yoo-Hyun;Jeong, Jong-Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.51-58
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    • 2018
  • Objectives : We aimed to investigate the discontinuation rate and reasons of doxepin base prescription pattern in insomnia outpatients of psychiatry department of a university hospital. Methods : 534 patients prescribed doxepin were screened. 201 patients were included and reviewed for their medical records retrospectively. The discontinuation rate and reasons of doxepin after 2 months of prescription were investigated. Patients were divided into three groups according to the prescription patterns. The initial group, prescribed doxepin as the first hypnotic, the add-on group, prescribed doxepin while maintaining existing hypnotics, and the switching group, prescribed doxepin after discontinuation of existing hypnotics. Results : The discontinuation rate after 2 months of prescription of doxepin was 56.2%. There were significant differences in the discontinuation rate among three groups. The initial group had the highest while the add-on group had the lowest (p=0.018). In reasons for discontinuation of doxepin among three groups, lack of efficacy (p<0.001) and adverse events (p<0.001) were significantly higher in the add-on group. In the initial group, patient's refusal (p=0.022) and unknown or loss to follow up (p<0.001) were significantly higher. Conclusions : The results of this study suggested that add-on is superior than switching method and gradual reduction of existing hypnotics is necessary to maintain doxepin treatment and prevent adverse events. Additional large scale prospective studies are needed to evaluate various factors and risks of discontinuation of doxepin.

A Study on the Design of Case-based Reasoning Office Knowledge Recommender System for Office Professionals (사례기반추론을 이용한 사무지식 추천시스템)

  • Kim, Myong-Ok;Na, Jung-Ah
    • Journal of Intelligence and Information Systems
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    • v.17 no.3
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    • pp.131-146
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    • 2011
  • It is becoming more essential than ever for office professionals to become competent in information collection/gathering and problem solving in today's global business society. In particular, office professionals do not only assist simple chores but are also forced to make decisions as quickly and efficiently as possible in problematic situations that can end in either profit or loss to their company. Since office professionals rely heavily on their tacit knowledge to solve problems that arise in everyday business situations, it is truly helpful and efficient to refer to similar business cases from the past and share or reuse such previous business knowledge for better performance results. Case-based reasoning(CBR) is a problem-solving method which utilizes previous similar cases to solve problems. Through CBR, the closest case to the current business situation can be searched and retrieved from the case or knowledge base and can be referred to for a new solution. This reduces the time and resources needed and increase success probability. The main purpose of this study is to design a system called COKRS(Case-based reasoning Office Knowledge Recommender System) and develop a prototype for it. COKRS manages cases and their meta data, accepts key words from the user and searches the casebase for the most similar past case to the input keyword, and communicates with users to collect information about the quality of the case provided and continuously apply the information to update values on the similarity table. Core concepts like system architecture, definition of a case, meta database, similarity table have been introduced, and also an algorithm to retrieve all similar cases from past work history has also been proposed. In this research, a case is best defined as a work experience in office administration. However, defining a case in office administration was not an easy task in reality. We surveyed 10 office professionals in order to get an idea of how to define a case in office administration and found out that in most cases any type of office work is to be recorded digitally and/or non-digitally. Therefore, we have defined a record or document case as for COKRS. Similarity table was composed of items of the result of job analysis for office professionals conducted in a previous research. Values between items of the similarity table were initially set to those from researchers' experiences and literature review. The results of this study could also be utilized in other areas of business for knowledge sharing wherever it is necessary and beneficial to share and learn from past experiences. We expect this research to be a reference for researchers and developers who are in this area or interested in office knowledge recommendation system based on CBR. Focus group interview(FGI) was conducted with ten administrative assistants carefully selected from various areas of business. They were given a chance to try out COKRS in an actual work setting and make some suggestions for future improvement. FGI has identified the user-interface for saving and searching cases for keywords as the most positive aspect of COKRS, and has identified the most urgently needed improvement as transforming tacit knowledge and knowhow into recorded documents more efficiently. Also, the focus group has mentioned that it is essential to secure enough support, encouragement, and reward from the company and promote positive attitude and atmosphere for knowledge sharing for everybody's benefit in the company.

Sexuality, Contraception, and Induced Abortion among Adolescents and Young Adults in the Export Processing Zones of Korea (미혼여성의 성, 피임, 그리고 인공유산 - 수출공단지역의 사례연구)

  • 조성남
    • Korea journal of population studies
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    • v.19 no.1
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    • pp.93-122
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    • 1996
  • This is a study of the determinants of sexual, contraceptive, and abortion behavior among unmarried female adolescents and young adults, which has emerged as a growing and serious health problem in Korea. As part of a larger project, data were gathered in three export zones: Kuro (Seoul), Kumi (Kyngbuk) Masan Changwon (Kyongnam) ; and the study samples are regrouped into three categories: 1) factory workers, i.e. , the reference group serving as program participants, 2) entertainment workers, and 3) ob-gyn patients. This study indicates that entertainment workers are at highest risk of experiencing premarital sex, STDs, contraceptive failure, unwanted pregnancies, and induced abortion. Of them, 20 percent had STDs as a result of first sexual experience: and about seven tenths had two or more pregnancies due to the adoption of low-efficacy methods. The proportion of those who had ever been pregnant was 60 percent for the group as a whole: 36 percent for the program participants: 64 percent for the entertainment workers ; and 91 percent four the ob-gyn patients. These proportions are exactly the same for abortion in each group, which means that all pregnancies ended in induced abortion. Of the respondents who said that they were sexually active at the time of survey, abortions were very high: 1.6 for the program participants, 2.3 for the entertainment workers, and 1.9 for the ob-gyn patients. About 80 percent of the women had abortions during the first trimester, and two thirds of the first abortions took place between the ages of 20 and 23. About one fourth experienced post-abortion complication, which was highest among the program participants (39 percent). Sixty percent of those with complications visited a hospital or took medicine to treat the problem. Even after the experience of induced abortion, the use of contraception was very low, except among the entertainment workers, whose level of use reached 53 percent. The most obvious recommendation, arising from this research, is that 'good-quality' counselling and family planning services be established under the auspices of both national and local government, particularly targeted for the entertainment workers as well as the factory workers in various textile, electronic, manufacturing, and other industrial sectors. We believe that entertainment sectors should be restructured radically so that young women who work for amusement bars and other entertainment sectors obtain protection from the risk of having unwanted pregnancies, STDs, and induced abortion.

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Immune responses of hepatitis B vaccination among very low birth weight infant (극소 저출생체중아의 영아기 B형 간염 항체 생성률 조사)

  • Kim, Young-Deuk;Han, Myung-Ki;Kim, Ai-Rhan E.;Kim, Ki-Soo;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.857-863
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    • 2006
  • Purpose : To evaluate the immunogenicity of hepatitis B vaccine among very low birth weight infants(VLBWI) who were vaccinated at 0, 1, 6 months of chronological age and to determine the factors associated with antibody formations. Methods : A total of 243 VLBWI admitted to Seoul and Gangneung Asan Medical Center neonatal intensive care units from 1997 to 2004 were included. Of 243, 13 infants were born to HBs Ag positive mother. All infants were given DNA recombinant vaccine at 0, 1, and 6 months of chronological age. Infants born to HBs Ag positive mothers received hepatitis B immunoglobulin at birth and a total of 4 doses of vaccinations. An antibody level over 10 mIU/mL, tested at 3-4 months after last vaccination, was regarded as a positive seroconversion. Results : The seroconversion rates were 84.4 percent and 84.5 percent for VLBWI and extremely low birth weight infants(ELBWI), respectively. Of 28 seronegative infants who were given revaccinations, 60.7 percent seroconverted, resulting in 95.3 percent, 97.5 percent seroconversion rates for VLBWI and ELBWI, respectively. 76.9 percent of infants born to HBsAg positive mothers seroconverted and none became hepatitis B carriers. Factors such as gestational age, sex, various neonatal illness, and kinds of vaccinations did not influence the formation of the hepatits B antibody, however, the higher the weight at time of first vacciation yielded better seroconversion rate. Conclusion : Revaccination of seronegative VLBWI after 3 doses of hepatitis B vaccinaton is very effective. Therefore, testing the immune status after the hepatitis B vaccination, a practice not routinely done, is highly recommended.

A Study on the Retransmission Consent and Arbitration for the Retransmission of Terrestrial Broadcasting Signal in Japan (지상파채널의 재전송 동의와 중재 기준에 관한 연구 - 일본의 사례분석을 중심으로)

  • Kim, Kyung-Hwan
    • Korean journal of communication and information
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    • v.48
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    • pp.46-62
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    • 2009
  • The current study attempted to review the standards of retransmisison consent and arbitration for the terrestrial broadcasting signal. The standards are based upon the principles encouraged by the MIAC(Ministry of Internal Affairs and Communications). It has been criticized that the standards of judgement for the retransimission consent and arbitration are ambiguous and arbitrary in Japan. In 2009, MIAC announced five decisions regarding the retransmission of over-the-air. The result of the current study found that the regulations of compulsory over-the-air signal retransmission have been sustained until now. The retransmission policy of the Japan government based upon three principles; localism, proper cause and copyright act. The judgment is dependent on the intrepretation of MIAC's standard about these three principles.

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Effect of Auriculotemporal Nerve Block Anesthesia on Manual Reduction of Disc Displacement without Reduction of the Temporomandibular Joint (악관절의 비정복성관절원판변위의 수조작 정복에 대한 이개측두신경 전달마취의 효과)

  • Kim, Sook-Young;Kim, Ji-Yeon;Hong, Su-Min;Kim, Byung-Gook;Park, Byung-Ju;Im, Yeong-Gwan
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.71-79
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    • 2011
  • Aim: Disc displacement without reduction of the temporomandibular joint (TMJ) has been managed by mandibular manipulation to reduce the displaced disc but with a low success rate. The purpose of this study was to determine whether auriculotemporal nerve block anesthesia had an effect on the reduction of the displaced disc and to analyze the factors that influenced the result. Methods: 112 patients were diagnosed with disc displacement without reduction and treated by mandibular manipulation. Disc was recaptured in 35 patients. Among the 77 patients with whom disc recapture had failed, the auriculotemporal nerve was blocked with a local anesthetic in the 49 patients (mean $age \;{\pm}\; SD\; =\; 34.4\;{\pm}\; 15.1$; male 24, female 25) and then mandibular manipulation was performed again. Factors including age, elapsed time from the onset, and opening amount were analyzed in association with disc reduction rate with the auriculotemporal nerve block. Results: Among 49 patients who did not respond to manipulation only, manual reduction with auriculotemporal nerve block anesthesia was successful in 19 patients (38.8%). Maximum unassisted opening amount significantly increased in the 19 patients with successful recapture of the disc ($mean \;{\pm}\; SD\; =\; 46.1 \;{\pm}\; 4.5\; mm$), in contrast to the limited opening amount of the 49 patients before local anesthesia of the auriculotemporal nerve ($mean \;{\pm}\; SD\; =\; 25.7 \;{\pm}\; 6.0\; mm$). Age, elapsed time after the onset, and preoperative opening amount were not associated with the reduction rate. Conclusion: The results of this study suggest that auriculotemporal nerve block anesthesia increases the reduction rate of the disc displacement without reduction of the TMJ when combined with mandibular manipulation, and such anesthesia should be applied at the first stage of manual treatment of disc displacement without reduction.