• Title/Summary/Keyword: 위험성평가분석

Search Result 1,967, Processing Time 0.043 seconds

Preliminary Inspection Prediction Model to select the on-Site Inspected Foreign Food Facility using Multiple Correspondence Analysis (차원축소를 활용한 해외제조업체 대상 사전점검 예측 모형에 관한 연구)

  • Hae Jin Park;Jae Suk Choi;Sang Goo Cho
    • Journal of Intelligence and Information Systems
    • /
    • v.29 no.1
    • /
    • pp.121-142
    • /
    • 2023
  • As the number and weight of imported food are steadily increasing, safety management of imported food to prevent food safety accidents is becoming more important. The Ministry of Food and Drug Safety conducts on-site inspections of foreign food facilities before customs clearance as well as import inspection at the customs clearance stage. However, a data-based safety management plan for imported food is needed due to time, cost, and limited resources. In this study, we tried to increase the efficiency of the on-site inspection by preparing a machine learning prediction model that pre-selects the companies that are expected to fail before the on-site inspection. Basic information of 303,272 foreign food facilities and processing businesses collected in the Integrated Food Safety Information Network and 1,689 cases of on-site inspection information data collected from 2019 to April 2022 were collected. After preprocessing the data of foreign food facilities, only the data subject to on-site inspection were extracted using the foreign food facility_code. As a result, it consisted of a total of 1,689 data and 103 variables. For 103 variables, variables that were '0' were removed based on the Theil-U index, and after reducing by applying Multiple Correspondence Analysis, 49 characteristic variables were finally derived. We build eight different models and perform hyperparameter tuning through 5-fold cross validation. Then, the performance of the generated models are evaluated. The research purpose of selecting companies subject to on-site inspection is to maximize the recall, which is the probability of judging nonconforming companies as nonconforming. As a result of applying various algorithms of machine learning, the Random Forest model with the highest Recall_macro, AUROC, Average PR, F1-score, and Balanced Accuracy was evaluated as the best model. Finally, we apply Kernal SHAP (SHapley Additive exPlanations) to present the selection reason for nonconforming facilities of individual instances, and discuss applicability to the on-site inspection facility selection system. Based on the results of this study, it is expected that it will contribute to the efficient operation of limited resources such as manpower and budget by establishing an imported food management system through a data-based scientific risk management model.

The Effect of Accounts Receivable Management on Business Performance & Organizational Satisfaction: Focused on Micro Manufacturing Industries (매출채권관리가 재무적 경영성과와 조직만족에 미치는 영향: 도시형소공인을 중심으로)

  • Lee, Jong Gab;Ha, Kyu Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
    • /
    • v.12 no.6
    • /
    • pp.13-24
    • /
    • 2017
  • The purpose of this study is to examine the effect of the management of receivables on the management performance of micro manufacturing industries. The results of the survey are as follows. First, among the factors of management of pre- and post-trade receivables in the micro manufacturing industries, management organization and regulations, contract execution management, bad debt control, which are the subordinate factors of credit control, are positive (+) significant effect on stability. In terms of profitability, management organizations and regulations, which are subordinate factors of credit control management, have a positive (+) significant effect on profitability. The recovery management, which is a factor of management of post - receivable receivables, did not have a significant effect on the stability and profitability of financial management performance. Second, the effect of financial performance on organizational satisfaction is positively related to stability, while profitability has no significant effect on organizational satisfaction. The implication of this study is that pre - trade receivables management is more important than post - trade receivables management in the management of accounts receivables of micro manufacturing industries. Proactive credit management refers to the procedure of establishing and managing personal guarantees and physical guarantees in order to smooth the execution of the obligations at the same time as the contract is concluded through processes such as credit investigation, analysis and evaluation, and sales decision before the contract is concluded. Post receivables management based on the assumption of default is a receivables management procedure from receipt of receivables that are already defaulted to bad debts to bad debt processing. If the collection of receivables is delayed or bad debt is increased, Furthermore, a corporation may be subject to bankruptcy risk (insolvency by paper profits). Therefore, it is meaningful that this study suggests direction to induce change of contract type in advance by understanding the possibility of settlement of accounts receivable and recovery of bad debts within the day of transition in case of contract of micro manufacturing industries.

  • PDF

Is Video-assisted Thoracoscopic Resection for Treating Apical Neurogenic Tumors Always Safe? (흉강 첨부 양성 신경종의 흉강경을 이용한 절제술: 언제나 안전하게 시행할 수 있나?)

  • Cho, Deog Gon;Jo, Min Seop;Kang, Chul Ung;Cho, Kyu Do;Choi, Si Young;Park, Jae Kil;Jo, Keon Hyeon
    • Journal of Chest Surgery
    • /
    • v.42 no.1
    • /
    • pp.72-78
    • /
    • 2009
  • Background: Mediastinal neurogenic tumors are generally benign lesions and they are ideal candidates for performing resection via video-assisted thoracoscopic surgery (VATS). However, benign neurogenic tumors at the thoracic apex present technical problems for the surgeon because of the limited exposure of the neurovascular structures, and the optimal way to surgically access these tumors is still a matter of debate. This study aims to clarify the feasibility and safety of the VATS approach for performing surgical resection of benign apical neurogenic tumors (ANT). Material and Method: From January 1996 to September 2008, 31 patients with benign ANT (15 males/16 females, mean age: 45 years, range: 8~73), were operated on by various surgical methods: 14 VATS, 10 lateral thoracotomies, 6 cervical or cervicothoracic incisions and 1 median sternotomy. 3 patients had associated von Recklinhausen's disease. The perioperative variables and complications were retrospectively reviewed according to the surgical approaches, and the surgical results of VATS were compared with those of the other invasive surgeries. Result: In the VATS group, the histologic diagnosis was schwannoma in 9 cases, neurofibroma in 4 cases and ganglioneuroma in 1 case, and the median tumor size was 4.3 cm (range: 1.2~7.0 cm). The operation time, amount of chest tube drainage and the postoperative stay in the VATS group were significantly less than that in the other invasive surgical group (p<0.05). No conversion thoracotomy was required. There were 2 cases of Hornor's syndrome and 2 brachial plexus neuropathies in the VATS group; there was 1 case of Honor's syndrome, 1 brachial plexus neuropathy, 1 vocal cord palsy and 2 non-neurologic complications in the invasive surgical group, and all the complications developed postoperatively. The operative method was an independent predictor for postoperative neuropathies in the VATS group (that is, non-enucleation of the tumor) (p=0.029). Conclusion: The VATS approach for treating benign ANT is a less invasive, safe and feasible method. Enucleation of the tumor during the VATS procedure may be an important technique to decrease the postoperative neurological complications.

Modified Blalock-Taussig Shunt in Neonates (신생아에서 변형 Blalock-Taussig 단락술)

  • 조광조;성시찬
    • Journal of Chest Surgery
    • /
    • v.30 no.4
    • /
    • pp.378-382
    • /
    • 1997
  • To evaulate the effectiveness and risk factors for shunt failure of the Blalock-Taussig shunt in neonates, we analyzed the 21 neonates who were undergone Blalok-Taussig shunt operation at Dong-A University Hospital from December 1991 to Feburary 1996. We evaluated operative mortality, patency of the shunt. and distortion of pulmonary artery. We also determined the risk factors for the shunt failure. Age at operation was from 1 day to 30 days(mean 11.7 days). We ghts were 2.4 to 4.5kg(mean 3.1 kg). The underlying lesions included severe tetralogy of Fallot with pulmonary stenosls or atresia(N=11) and single ventricle varieties with. pulmonary stenosis or atresia(N=10). Prostaglandin El was given in 13 neonates prior to operation. The mean preoperative(prior to prostaglandin El therapy) and postoperative arterial oxygen tension were 30.1 mmHg and 46.3 mmHg respectively(P(0.01). The shunt was performed through a left thoracotomy in 11 patients and through a right thoracotomy In 10. A 5 mm graft was used in 15 patients and a 4 mm graft in 6 patients. The incidence of early shunt occlusion was 9.5%(2 patients). The hospital mortality was 9.5%(2 patients with early shunt occlusion). Univariate analysis revealed that body weight of 2.6 kg or less(p=0.021), pulmonary artery size of 3mm or less(p=0.008), and 4 mm graft (p=0.021) were risk factors predictive of early shunt failure. The patency rate of the shunt in hospital survivors was 100% at mean ollow-up of ll.3 months(There was not death or reoperation related to shunt failure). 10 patients were catheterized during postoperative follow-up. There was no significant distorsion of pulmonary artery. So we concluded that the modified Blalock-Taussig shunt in neonates was excellent in the hospital survivors.

  • PDF

Clinical Manifestations and Characteristics in Patients with Horseshoe Kidney (소아 및 성인 마제신 환자들의 임상적 특징과 비교)

  • Kim, Yu Kyong;Kwon, Nam Hee;Kang, Dong Il;Chung, Woo Yeong
    • Childhood Kidney Diseases
    • /
    • v.17 no.2
    • /
    • pp.73-78
    • /
    • 2013
  • Purpose: We aimed to investigate the clinical characteristics and associated diseases in children with a horseshoe kidney and compared these data between children and adults. Method: We performed a retrospective analysis of the medical records and radiological findings of 43 patients diagnosed with a horseshoe kidney in the Busan Paik Hospital. The subjects were divided into the children's group (14 cases, age <18 years) and the adult group (29 cases, age ${\geq}18$ years). Results: The study group consisted of 17 males and 26 females with a median age of 34 years. In the children's group (14 cases), 5 subjects were male and 9 were female, with a mean age of $6.7{\pm}6.2$ years. Most of the subjects were asymptomatic and were incidentally diagnosed with horseshoe kidney during their evaluation for another disease. Among the associated diseases in the children's group, Turner syndrome was the most common (5 cases), whereas ureteropelvic junction (UPJ) stricture was observed in 2 cases (14.2%). None of the children exhibited abnormal renal function during the follow-up period. In the adult group (29 cases), 12 subjects were male and 17 were female, with a mean age of 48 years. Eighteen patients were incidentally diagnosed with horseshoe kidney during their evaluation for another disease, and 11 patients had hematuria or abdominal pain due to renal stones. Among the associated diseases in the adult group, Turner syndrome was the most common (5 cases), and UPJ stricture was observed in 5 cases; the other accompanying diseases included hydronephrosis and overactive bladder. Six patients exhibited decreased renal function (serum creatinine level >1.5) during the follow-up period. Conclusion: Horseshoe kidney is usually diagnosed incidentally in both children and adults. In the present study, we noted that Turner syndrome was the most common associated disease in children. In addition, most children were asymptomatic but had a high risk of urologic complications after the transition to adulthood. Therefore, children with horseshoe kidney require continuous follow-up.

Status of Health and Safety Management in Occupational Hygiene Laboratories in Korea

  • Yang, Hyukseung;Choi, Jaewook;Yoon, Seokjoon;FARR, Terry
    • Journal of Korean Society of Occupational and Environmental Hygiene
    • /
    • v.17 no.1
    • /
    • pp.53-62
    • /
    • 2007
  • 목적: 1990년대 초반부터 시작된 우리나라의 산업 보건에 대한 사회적 관심의 증대와 시장의 요구에 따라 산업위생기관의 양적인 팽창이 이루어지긴 하였으나 실험실 관련 안전보건규정이 미비한 상태에서 추진되어 산업위생 실험실에서 다양한 유해 위험성 인자를 취급함에도 불구하고 사용되는 량이 소규모로 인해 안전보건과 관련된 사항은 대부분 간과하고 있으며, 산업위생 실험실의 안전보건관리 실태는 선진외국에 비해 상당히 낙후되어 있는 실정이다. 따라서 본 연구는 우리나라 산업위생 실험실과 관련한 안전보건관리 실태를 평가함으로써 향후 실험실의 안전보건관리 수준을 향상 시키는데 효과적인 자료로 활용하는데 기여하고자 한다. 방법: 산업위생실험실의 안전보건 실태를 파악하기 위해 설문조사를 수행하였으며, 설문은 실험실의 전반적인 안전보건, 화학물질 저장 및 용기, 가연성 및 인화성 화학물질, 가스 실린더, 의사전달, 응급처치 및 비상사태 장비, 정리정돈, 소방안전, 전기안전, 개인보호구, 흄후드 및 환기, 및 이황화탄소 취급 사례로서 12개 영역으로 구성되었다. 연구대상은 2001년 한국산업안전공단 정도관리프로그램에 참여한 기관으로서 총 대상은 119개 기관이었다. 연구기간은 2002년 7월 01일부터 8월 30일까지 약 60일 이었다. 설문은 반송봉투에 넣어 설문완성 후 연구자에게 보낼 수 있도록 배려하였으며, 1차 설문을 보낸 후 2주 후에 설문 참여를 독려하기 위해 엽서를 발송하였고, 다시 2주 후에 각 산업위생기관에 개별 전화 연락을 취하였다. 그 결과 63% (75개 기관)의 완성된 설문을 얻을 수 있었다. 설문의 총 조사항목은 79문항으로 구성되어 있으며, 산업위생실험실의 안전보건 수준을 정량적으로 평가하기 위해 안전보건 매뉴얼, 교육훈련프로그램 및 한국산업안전공단 실험실 지침서를 보유한 기관과 그렇지 않은 기관간의 차이는 선별된 67문항에 대해 각 문항에 합당하거나 적절할 경우 1점을 부여하는 방식으로 점수화하였다. 이들의 관련성을 파악하기 위하여 Microsoft-Excel 2000 프로그램을 이용하여 two-tailed t-test 분석을 실시하였다. 결과 1. 산업위생실험실 운영과 관련한 67개 항목(항목별로 각 1점 부여)에 대한 안전보건 성과지수화 (100점으로 점수 환산) 결과 안전보건 매뉴얼을 보유한 기관은 $42.98{\pm}13.36$(p<0.001)점, 교육훈련프로그램을 보유한 기관은 $50.75{\pm}14.12$(p<0.01)점, 한국산업안전공단 실험실 지침서를 보유한 기관은 $43.58{\pm}11.92$(p<0.01)점으로 그렇지 않은 기관에 비해 통계적으로 유의하게 높은 점수분포를 보였다. 2. 화학물질 보관 캐비닛이 있는 기관 중 64.8%의 기관은 화학물질을 알파벳 순으로, 27.8%는 분류 기준에 따라, 그리고 7.4%는 무작위로 보관하고 있었다. 3. 단지 8.0% (6개)의 기관만이 실험실내에 눈세정 분수(2 개), 샤워기(3개) 및 눈세정물병(3개, 2개 중복 응답 기관)과 같은 응급처치 장치 및 물품을 갖추고 있었다. 4. 89.0%의 기관이 흄후드내에 화학물질을 보관하고 있었다. 5. 물질안전보건자료, 흄후드 기록지, 비상사태 절차서 및 한국산업안전공단 실험실 지침서와 같은 문서관리는 부적절하게 관리 및 기록되고 있었다. 6. 대부분의 산업위생 실험실은 응급처치 장비, 화학물질 또는 가스용기 보관실과 같은 실험실 안전설비가 부족할 뿐만 아니라 정리정돈, 화학물질 저장 캐비닛, 안전보호구 및 흄후드와 같은 관리가 미비하였다. 결론: 이상의 결과에 근거하여 기관장은 실험실의 안전보건관리를 위하여 문서관리체계를 제공하고, 모든 실험실 종사자가 적절한 개인보호구를 착용할 수 있도록 하며, 비상 장비를 설치하고, 실험실과 관련한 적절한 규정을 제정하며, 교육훈련 프로그램을 제공하여야 한다. 또한 실험실 종사자는 실험 중 적절한 개인보호구의 착용하고, 비상장비 이용에 대한 교육훈련에 참여하며, 적절한 실험실 운영관리에 대한 책임감을 가져야 한다. 위의 권고사항 이행을 위해서 KOSHA는 KQCP 프로그램에 실험실 안전보건관리 항목을 삽입하여 주기적인 평가를 수행할 필요가 있다. 우리나라 실험실의 특성을 고려할 때 본 연구결과는 일반 실험실에도 적용될 수 있을 것으로 생각된다.

Evaluation of the Jaw-Tracking Technique for Volume-Modulated Radiation Therapy in Brain Cancer and Head and Neck Cancer (뇌암 및 두경부암 체적변조방사선치료시 Jaw-Tracking 기법의 선량학적 유용성 평가)

  • Kim, Hee Sung;Moon, Jae Hee;Kim, Koon Joo;Seo, Jung Min;Lee, Joung Jin;Choi, Jae Hoon;Kim, Sung Ki;Jang, In-Gi
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.30 no.1_2
    • /
    • pp.177-183
    • /
    • 2018
  • Purpose : Volumetric Modulated Arc Therapy(VMAT) has the advantage of uniformly and precisely irradiating the tumor to the shape of the tumor while reducing the risk of radiation damage to normal tissues. such as brain cancer, head and neck cancer and prostate cancer, It is being used for treatment. The purpose of this study is to evaluate the usefulness of the Jaw-Tracking technique(JTT) in VMAT for brain and head and neck cancer. Materials and Methods : We selected eight patients with brain and head and neck cancer(4 Brain, 4 head and neck) who were treated with the VMAT treatment technique. Contouring information of the patient's tumor and normal organ was fused to the Rando phantom using the deformable registration of Velocity(Varian, USA). A treatment plan was developed using the Varian Eclipse(ver 15.5, Varian, USA) with the same patient actual beam parameters except for the use of jaw-tracking. As the evaluation index, the maximum dose and mean dose of target and OAR were compared and a portal dosimetry was performed for the treatment plan verification. Results : When using JTT, the relative dose of OAR decreased by 5.24 % and the maximum dose by 7.05 %, respectively, compared with the Static-Jaw technique(SJT). In the various OARs, the mean dose and maximum dose reduction ranges ranged from 0.01 to 3.16 Gy and from 0.12 to 6.27 Gy, respectively. In the case of the target, the maximum dose of GTV, CTV, PTV decreased by 0.17 %, 0.43 %, and 0.37 % in JTT, and the mean dose decreased by 0.24 %, 0.47 % and 0.47 %, respectively. Gamma analysis The JTT and SJT passing rates were $98{\pm}1.73%$ and $97{\pm}1.83%$ on the basis of 3 % / 3 mm, respectively. Comparing the doses of all OARs applied to the experiment, it was found that the use of JTT resulted in a significant decrease in dose due to additional jaw shielding besides MLC than SJT. Conclusion : In radiation therapy using VMAT treatment plan, we can apply JTT in the case of adjacent tumor and normal organs such as brain cancer and head and neck cancer, and in radiotherapy required large field and high energy caused increase leakage dose through MLC. It is considered that the target dose of PTV can be increased by lowering the dose of normal tissue surrounding the tumor.

  • PDF

Financial Impact of Off-Pump Coronary Artery Bypass (체외순환 없이 시행하는 관상동맥우회술의 경제성 분석)

  • Lim, Cheong;Chang, Woo-Ik;Kim, Ki-Bong;Kim, Yoon
    • Journal of Chest Surgery
    • /
    • v.35 no.5
    • /
    • pp.365-368
    • /
    • 2002
  • Background: Coronary artery bypass grafting(CABG) imposes large amount of medical costs, which are greatly affected by the surgical approach, quality of perioperative care and associated co-morbidities. Recently, off-pump CABG(OPCAB) has been introduced and performed with increasing frequency. To evaluate the efficacy of OPCAB in view of financial impact, we analyzed the costs and medical resources of OPCAB and compared with conventional CABG. Material and Method: From January 1998 to July 1999, 184 patients underwent CABG operation; 111 patients with OPCAB(group I) and 73 patients with conventional CABG(group II). We prospectively collected clinical data including risk factors and retrospectively reviewed the hospital resources. Result: Preoperative parameters including risk factors, postoperative mortality, morbidity and length of hospital stay were not different between the two groups, Duration of stay in the intensive care unit(ICU) (51.3 vs 128.3 hours, p<0.01) and ventilator, support time(14.9 vs 56.2 hours, p<0.01) were significantly shorter in the OPCAB group. Total hospital coats were 17,220,000 add 21,250,000(Korean Won) in group I and II, respectively(p<0.01). There were significant differences in operation fee, costs for operative materials, transfusion and diagnostic radiology between two groups. In group I, all the resources except diagnostic radiology were significantly decreased compared with group II. Conclusion: OPCAB has a beneficial effect on hospital charge and resource utilization. Shorter duration of the ICU stay and ventilatory support time may reduce the total hospital costs.

Comparison of the seroconversion rate after primary hepatitis B vaccination and after revaccination of non-responders in full-term infants according to mother's HBsAg seropositivity (산모의 HBsAg 보유 여부에 따른 만삭아의 B형간염 기본접종 및 무반응자에서 재접종 후 항체 양전율에 대한 연구)

  • Kang, Jang Hee;Moon, Jae Won;Kong, Seung Hyun;Hwang, Kwang Su;Mok, Ji Sun;Lee, Hyeon Jung
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.11
    • /
    • pp.1165-1171
    • /
    • 2008
  • Purpose : This study aimed to identify the true extent of non-responsiveness in full-term infants born from HBsAg-negative or HBsAg-positive mothers and vaccinated against hepatitis B virus (HBV) at 0, 1, and 6 months of age and to evaluate the effect of revaccination among non-responders. Methods : The study included 716 full-term infants born in 2004-2007. Of 716, 662 infants (A group) were born to HBsAg-negative mothers and 54 infants (B group: 50, except HBsAg-positive infants) were born to HBsAg-positive mothers. All infants were administered DNA recombinant vaccines at 0, 1, and 6 months of age. B group infants received hepatitis B immunoglobulin at birth. Anti-HBs titers were tested at 7-12 and 9-15 months in A and B groups, respectively. Three revaccination doses were administered to non-responders whose anti-HBs titers were under 10 mIU/ml; revaccinated infants were retested at 1-3 months after last vaccination. The association between HBeAg seropositivity of mother and the failure of HBV immunoprophylaxis was evaluated. Results : The seroconversion rates after primary hepatitis B vaccination were higher in A group (94.1%) than in B group (78%, P<0.001). The seroconversion rates were high in revaccinated infants (A group non-responders: 96.9%, B group non-responders: 87.5%). The failure of HBV immunoprophylaxis was significantly associated with maternal HBeAg seropositivity (P<0.001). Conclusion : The seroconversion rates after primary hepatitis B vaccination were low in B group infants. Revaccination of non-responders in B group was very effective. Therefore, anti-HBs testing and revaccination of B group is very important. Revaccination of non-responders in A group was also very effective. Thus, testing the immune status of infants born to HBsAg-negative mothers even after primary hepatitis B vaccination should be considered. However, to realize this, further studies on the cost-effectiveness of anti-HBs testing in healthy full-term infants are necessary.

Clinical Significance of Coagulation Screening Tests and Platelet Counts in Children Undergoing Endoscopy (소아에서 내시경 검사의 출혈 위험 예측 인자로서 혈액 응고 검사 및 혈소판 검사의 의의)

  • Lee, Eun-Hye;Yang, Hye-Ran;Ko, Jae-Sung;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.13 no.1
    • /
    • pp.23-29
    • /
    • 2010
  • Purpose: The aim of this study was to assess the benefits of routine pre-endoscopy coagulation screening tests and platelet counts in Korean children. Methods: Between March 2004 and December 2009, children who underwent gastrointestinal endoscopy for the evaluation of various gastrointestinal symptoms were included. All of the subjects included in the study also underwent routine coagulation screening and platelet count determinations prior to endoscopy and biopsy. The clinical records and laboratory tests were retrospectively reviewed in all patients. Results: One hundred sixty-two of 1,476 (11%) patients who underwent endoscopy had abnormal results on pre-screening coagulation tests. Fourteen patients underwent coagulation factor assays due to abnormal clotting results in consecutive tests or due to clinical evidence of a bleeding tendency. Seven patients were diagnosed with factor XII deficiency, one patient was diagnosed with von Willebrand disease, one patient had von Willebrand disease and factor XII deficiency, and one patient was presumed to have mild hemophilia. The remaining 4 patients had normal results with the factor assays. The results of platelet counts were normal with the exception of 1 patient. No patient had significant bleeding during the endoscopic procedures, despite abnormal pre-endoscopic coagulation tests. Conclusion: Routine coagulation screening tests and platelet counts revealed abnormal results in some patients. Most of the patients with abnormal clotting were shown to have a factor XII deficiency, which had no significant associated bleeding tendencies; the other patients were diagnosed with hemophilia or von Willebrand disease. Therefore, although abnormal pre-endoscopic coagulation is not always related to significant bleeding complications, pre-endoscopic coagulation screening may be useful in some children in predicting the risk of bleeding tendency during endoscopic procedures.