• 대한응급의학회지
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• 제29권5호
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• pp.449-454
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• 2018

Objective: The SAFARI score was introduced to assess the risk of convulsive seizure during admission for aneurysmal subarachnoid hemorrhage in 2017. This study was conducted to determine whether the SAFARI score derived from the afore-mentioned study could be applied to patients with aneurysmal subarachnoid hemorrhage in Korea. Methods: We conducted a retrospective study of patients who were diagnosed with aneurysmal subarachnoid hemorrhage from March 2013 to October 2017. Patients' age, sex, blood pressure, pulse rate, body temperature, Glasgow-Coma Scale, Hunt-Hess scale, modified Fisher grade, size of ruptured aneurysm, surgery type, transfusion, and SAFARI score were compared between the seizure and non-seizure groups. The area under the receiver operator characteristic curves was calculated to evaluate the predictive ability for seizure during admission. Logistic regression analysis was used to analyze predictive factors for seizure during admission. Results: A total of 220 patients were included. Ninety-seven (44.1%) were male and 123 (55.9%) were female. The mean age of the patients was 65.8 years old (range, 56-75). The area under the curve of the SAFARI score for predicting seizure was 0.813. The SAFARI score was the only significant predictor of seizure during admission, while other factors were not statistically significant upon logistic regression analysis. Conclusion: The SAFARI score could be used for predicting seizure during admission in patients with aneurysmal subarachnoid hemorrhage.

• Clinical and Experimental Pediatrics
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• 제63권11호
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• pp.438-446
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• 2020

Background: Most developmental screening tools in Korea are adopted from foreign tests. To ensure efficient screening of infants and children in Korea, a nationwide screening tool with high reliability and validity is needed. Purpose: This study aimed to independently develop, standardize, and validate the Korean Developmental Screening Test for Infants and Children (K-DST) for screening infants and children for neurodevelopmental disorders in Korea. Methods: The standardization and validation conducted in 2012-2014 of 3,284 subjects (4-71 months of age) resulted in the first edition of the K-DST. The restandardization and revalidation performed in 2015-2016 of 3.06 million attendees of the National Health Screening Program for Infants and Children resulted in the revised K-DST. We analyzed inter-item consistency and test-retest reliability for the reliability analysis. Regarding the validation of K-DST, we examined the construct validity, sensitivity and specificity, receiver operating characteristic curve analysis, and a criterion-related validity analysis. Results: We ultimately selected 8 questions in 6 developmental domains. For most age groups and each domain, internal consistency was 0.73-0.93 and test-retest reliability was 0.77-0.88. The revised K-DST had high discriminatory ability with a sensitivity of 0.833 and specificity of 0.979. The test supported construct validity by distinguishing between normal and neurodevelopmentally delayed groups. The language and cognition domain of the revised K-DST was highly correlated with the K-Bayley Scales of Infant Development-II's Mental Age Quotient (r=0.766, 0.739), while the gross and fine motor domains were highly correlated with Motor Age Quotient (r=0.695, 0.668), respectively. The Verbal Intelligence Quotient of Korean Wechsler Preschool and Primary Scales of Intelligence was highly correlated with the K-DST cognition and language domains (r=0.701, 0.770), as was the performance intelligence quotient with the fine motor domain (r=0.700). Conclusion: The K-DST is reliable and valid, suggesting its good potential as an effective screening tool for infants and children with neurodevelopmental disorders in Korea.

• 대한영상의학회지
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• 제79권6호
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• pp.340-347
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• 2018

목적: 가도세틱산-조영증강 MRI에서 간세포암 피막 발견에 대한 영상차감기법의 진단적 가치를 알아보고자 하였다. 대상과 방법: 2015년 5월부터 2017년 2월까지 가도세틱산-조영증강 MRI를 시행 받고 수술을 시행한 hepatocellular carcinoma (이하 HCC) 고위험군 108명을 대상으로 하였다. 차감영상의 질 및 간문맥기와 이행기의 일반영상과 차감영상에서 피막 여부에 대해 평가하였고, 차감영상에서의 피막 여부가 Liver Imaging Reporting and Data System에 따른 간세포암 진단에 미치는 영향을 평가하였다. 결과: 수술 전 경동맥화학색전술을 시행 받았거나 차감영상의 질이 불만족스러운 34명의 환자를 제외한 74명의 환자에서 82개의 간 병변(간세포암 73개, 그 외 악성종양 5개, 양성종양 4개)에 대해 분석하였다. 피막의 발견에 대한 차감영상의 민감도, 정확도, 그리고 곡선하면적은 일반영상과 비교하여 통계적으로 유의하게 높았고(각 95.4%, 89.0%, 0.80; p < 0.001), 특이도는 동일하였다(64.7%). HCC의 진단에 대해서도 차감영상이 일반영상과 비교하여 민감도, 정확도, 그리고 곡선하면적이 통계적으로 유의하게 높았으며(각 82.2%, 79.3%, 0.69; p = 0.011), 특이도는 동일하였다(55.6%). 결론: 가도세틱산-조영증강 MRI에서 간문맥기 또는 이행기로부터의 차감영상은 간세포암 피막의 발견에 도움이 된다.

• 대한원격탐사학회지
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• 제36권6_1호
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• pp.1367-1377
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• 2020

본 연구는 2016년 발생한 9.12 경주지진을 중심으로 경주시 건축물의 지진 취약성을 평가하고 지도를 제작하는데 목적이 있다. 지진 취약성을 평가하기위해 지질공학, 물리, 구조적 요인과 관련된 11개의 영향인자를 선정하였으며, 이는 독립변수로 적용되었다. 종속변수로는 9.12 경주지진 당시 실제 피해 입은 건축물의 위치자료가 사용되었다. 평가 모델은 기계학습 방법의 RF와 SVM을 기반으로 구축하였으며, 훈련 및 검증 데이터셋은 70:30 비율로 무작위 선별되었다. 정확도 검증은 ROC 곡선을 사용하여 최적 모델을 선별하였으며, 각 모델의 정확도는 RF(1.000), SVM(0.998), 예측 정확도는 RF(0.947), SVM(0.926) 로 나타났다. RF 모델을 기반으로 경주시 전체 건축물의 예측 값을 도출하였으며, 이를 등급화 하여 지진 취약성 지도를 작성하였다. 행정동별 건물 등급 분포를 살펴본 결과, 황남동, 월성동, 선도동, 내남면이 취약성이 높은 지역으로, 양북면, 강동면, 양남면, 감포읍이 상대적으로 안전한 지역으로 나타났다.

• 한국수자원학회논문집
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• 제53권12호
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• pp.1193-1201
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• 2020

본 논문에서는 미계측 유역에 적용할 수 있는 갈수지수 산정 회귀모형을 개발하고자 하였다. 30개의 중권역 유역을 대상으로 국가수자원종합관리시스템에서 제공하는 장기유출자료를 이용하여 평균 갈수량과 평균 저수량, 지속기간별 빈도별 갈수지수를 산정하였으며 이를 유역특성인자 18개와 기상특성인자 3개와의 상관 분석을 통하여 최종적으로 유역면적(A), 유역 평균 표고(H), 유역 평균 경사(S), 수계밀도(D), 유출곡선지수(CN), 연증발산량(ET), 연강수량(P)을 선정하여 다중회귀분석을 수행하여 갈수지수 회귀모형을 개발하였다. 개발된 회귀모형을 평가하기 위하여 10개의 검증유역을 미계측 유역으로 간주하여 평균제곱근오차(RMSE) 와 평균절대오차(MAE)를 이용하여 정확도를 추정하였다. 또한 기존의 평균갈수량산정 회귀모형과의 비교를 통하여 본 논문에서 개발한 모형의 우수성을 검토하였다.

• Journal of Gastric Cancer
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• 제21권4호
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• pp.368-378
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• 2021

Purpose: When patients with early gastric cancer (EGC) undergo non-curative endoscopic submucosal dissection requiring gastrectomy (NC-ESD-RG), additional medical resources and expenses are required for surgery. To reduce this burden, predictive model for NC-ESD-RG is required. Materials and Methods: Data from 2,997 patients undergoing ESD for 3,127 forceps biopsy-proven differentiated-type EGCs (2,345 and 782 in training and validation sets, respectively) were reviewed. Using the training set, the logistic stepwise regression analysis determined the independent predictors of NC-ESD-RG (NC-ESD other than cases with lateral resection margin involvement or piecemeal resection as the only non-curative factor). Using these predictors, a risk-scoring system for predicting NC-ESD-RG was developed. Performance of the predictive model was examined internally with the validation set. Results: Rate of NC-ESD-RG was 17.3%. Independent pre-ESD predictors for NC-ESD-RG included moderately differentiated or papillary EGC, large tumor size, proximal tumor location, lesion at greater curvature, elevated or depressed morphology, and presence of ulcers. A risk-score was assigned to each predictor of NC-ESD-RG. The area under the receiver operating characteristic curve for predicting NC-ESD-RG was 0.672 in both training and validation sets. A risk-score of 5 points was the optimal cut-off value for predicting NC-ESD-RG, and the overall accuracy was 72.7%. As the total risk score increased, the predicted risk for NC-ESD-RG increased from 3.8% to 72.6%. Conclusions: We developed and validated a risk-scoring system for predicting NC-ESD-RG based on pre-ESD variables. Our risk-scoring system can facilitate informed consent and decision-making for preoperative treatment selection between ESD and surgery in patients with EGC.

• 대한치과교정학회지
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• 제52권1호
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• pp.3-19
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• 2022

Objective: The purpose of this study was to investigate the accuracy of one-step automated orthodontic diagnosis of skeletodental discrepancies using a convolutional neural network (CNN) and lateral cephalogram images with different qualities from nationwide multi-hospitals. Methods: Among 2,174 lateral cephalograms, 1,993 cephalograms from two hospitals were used for training and internal test sets and 181 cephalograms from eight other hospitals were used for an external test set. They were divided into three classification groups according to anteroposterior skeletal discrepancies (Class I, II, and III), vertical skeletal discrepancies (normodivergent, hypodivergent, and hyperdivergent patterns), and vertical dental discrepancies (normal overbite, deep bite, and open bite) as a gold standard. Pre-trained DenseNet-169 was used as a CNN classifier model. Diagnostic performance was evaluated by receiver operating characteristic (ROC) analysis, t-stochastic neighbor embedding (t-SNE), and gradient-weighted class activation mapping (Grad-CAM). Results: In the ROC analysis, the mean area under the curve and the mean accuracy of all classifications were high with both internal and external test sets (all, > 0.89 and > 0.80). In the t-SNE analysis, our model succeeded in creating good separation between three classification groups. Grad-CAM figures showed differences in the location and size of the focus areas between three classification groups in each diagnosis. Conclusions: Since the accuracy of our model was validated with both internal and external test sets, it shows the possible usefulness of a one-step automated orthodontic diagnosis tool using a CNN model. However, it still needs technical improvement in terms of classifying vertical dental discrepancies.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권2호
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• pp.145-153
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• 2022

Background: Postoperative analgesia (POA) is an important determinant of successful treatment. Dexmedetomidine (DEX) has recently gained attention as a promising adjuvant to local anesthetics (LA). The present study aimed to evaluate the efficacy and safety of levobupivacaine (LB) as an adjuvant during inferior alveolar nerve block (IANB) in the extraction of lower impacted third molars (LITM). Methods: A prospective, randomized, placebo-controlled, triple-blind, parallel-arm, and clinical study was performed on 50 systemically healthy participants who required removal of an asymptomatic LITM. Using a 1:1 distribution, the participants were randomized into two groups (n = 25). Group L (control group) received 1.8 mL of 0.5% LB and 0.2 mL normal saline (placebo) and Group D (study group) received a blend of 1.8 mL of 0.5% LB and 0.2 mL (20 ㎍) DEX. The primary outcome variable was the duration of POA and hemodynamic stability, and the secondary variable was the total number of analgesics required postoperatively for up to 72 h. The participants were requested to record the time of rescue analgesic use and the total number of rescue analgesics taken. The area under the curve was plotted for the total number of analgesics administered. The pain was evaluated using the visual analog scale. Data analysis was performed using paired students and unpaired t-test, Mann-Whitney U test, Chi-square test, and receiver operating characteristic analysis. Statistical significance was set at P < 0.05. Results: The latency, profoundness of anesthesia, and duration of POA were statistically significant (P < 0.05). The differences between mean pain scores at 6, 12, 24, 48, and 72 h were found to be significant (each P = 0.0001). Fewer analgesics were required by participants in group D (2.12 ± 0.33) than in L (4.04 ± 0.67), with a significant difference (P = 0.0001). Conclusion: Perineurally administered LA with DEX is a safe, effective, and therapeutic approach for improving latency, providing profound POA, and reducing the need for postoperative analgesia.

• 지질공학
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• 제32권2호
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• pp.209-219
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• 2022

본 연구에서는 강우에 따른 사면 내 지반특성 변화와 사면붕괴 형상을 실험적으로 규명하기 위하여 인공강우장치와 모형토조를 이용한 실내모형실험을 수행하였다. 이를 위하여 균질한 모래를 대상으로 모형 실험을 수행하였으며, 계측장치를 이용하여 강우침투에 의한 사면 내 포화양상을 조사하였다. 모형사면은 30°의 경사면에 35°의 사면경사로 조성하였고 강우강도는 50 mm/hr를 적용하였다. 토층의 깊이는 모형토조의 크기를 고려하여 35 cm로 선정하고 TDR센서는 깊이별로 설치하여 시간에 따른 지반특성 변화를 고찰하였다. 실험결과 강우 시 모형사면은 강우침투로 인하여 지표에서 지중으로, 선단부에서 정상부로 포화가 진행됨을 알 수 있다. 즉, 강우의 침투로 인하여 사면의 선단부가 먼저 포화되고 이후 지속적인 강우로 인하여 포화의 영역이 사면의 선단부로부터 정상부로 확대됨을 알 수 있다. 모형사면의 붕괴는 사면의 선단부에서부터 붕괴가 시작되어 이후 사면의 정상부로 확장되는 진행성 사면붕괴가 발생되었으며, 최종 사면붕괴시점에서 붕괴면적이 급격하게 증가하였다. 또한 활동면은 원호활동의 형태로 발생되었다. 한편, 사면 내 모관흡수력이 흙-함수특성곡선(SWCC)에서 산정된 공기함입치(AEV)에 이르게 되면 사면붕괴가 발생되는 것으로 나타났다.

• Structural Engineering and Mechanics
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• 제83권3호
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• pp.305-326
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• 2022

To realize the recycling utilization of waste concrete and alleviate the shortage of resources, 11 specimens of steel reinforced recycled concrete (SRRC) filled circular steel tube columns were designed and manufactured in this study, and the cyclic loading tests on the specimens of columns were also carried out respectively. The hysteretic curves, skeleton curves and performance indicators of columns were obtained and analysed in detail. Besides, the finite element model of columns was established through OpenSees software, which considered the adverse effect of recycled coarse aggregate (RA) replacement rates and the constraint effect of circular steel tube on internal RAC. The numerical calculation curves of columns are in good agreement with the experimental curves, which shows that the numerical model is relatively reasonable. On this basis, a series of nonlinear parameters analysis on the hysteretic behaviors of columns were also investigated. The results are as follows: When the replacement rates of RA increases from 0 to 100%, the peak loads of columns decreases by 7.78% and the ductility decreases slightly. With the increase of axial compression ratio, the bearing capacity of columns increases first and then decreases, but the ductility of columns decreases rapidly. Increasing the wall thickness of circular steel tube is very profitable to improve the bearing capacity and ductility of columns. When the section steel ratio increases from 5.54% to 9.99%, although the bearing capacity of columns is improved, it has no obvious contribution to improve the ductility of columns. With the decrease of shear span ratio, the bearing capacity of columns increases obviously, but the ductility decreases, and the failure mode of columns develops into brittle shear failure. Therefore, in the engineering design of columns, the situation of small shear span ratio (i.e., short columns) should be avoided as far as possible. Based on this, the calculation model on the skeleton curves of columns was established by the theoretical analysis and fitting method, so as to determine the main characteristic points in the model. The effectiveness of skeleton curve model is verified by comparing with the test skeleton curves.