• Journal of Gastric Cancer
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• v.23 no.2
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• pp.355-364
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• 2023

Background: There are no clear guidelines to determine whether to perform D1 or D1+ lymph node dissection in early gastric cancer (EGC). This study aimed to develop a nomogram for estimating the risk of extraperigastric lymph node metastasis (LNM). Materials and Methods: Between 2009 and 2019, a total of 4,482 patients with pathologically confirmed T1 disease at 6 affiliated hospitals were included in this study. The basic clinicopathological characteristics of the positive and negative extraperigastric LNM groups were compared. The possible risk factors were evaluated using univariate and multivariate analyses. Based on these results, a risk prediction model was developed. A nomogram predicting extraperigastric LNM was used for internal validation. Results: Multivariate analyses showed that tumor size (cut-off value 3.0 cm, odds ratio [OR]=1.886, P=0.030), tumor depth (OR=1.853 for tumors with sm2 and sm3 invasion, P=0.010), cross-sectional location (OR=0.490 for tumors located on the greater curvature, P=0.0303), differentiation (OR=0.584 for differentiated tumors, P=0.0070), and lymphovascular invasion (OR=11.125, P<0.001) are possible risk factors for extraperigastric LNM. An equation for estimating the risk of extraperigastric LNM was derived from these risk factors. The equation was internally validated by comparing the actual metastatic rate with the predicted rate, which showed good agreement. Conclusions: A nomogram for estimating the risk of extraperigastric LNM in EGC was successfully developed. Although there are some limitations to applying this model because it was developed based on pathological data, it can be optimally adapted for patients who require curative gastrectomy after endoscopic submucosal dissection.

• Journal of Korean Academy of Nursing
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• v.53 no.4
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• pp.468-479
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• 2023

Purpose: This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit. Methods: A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ² test, Mann-Whitney U test, and area under the curve (AUC). Results: Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption. Conclusion: The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.

• Journal of Korea Entertainment Industry Association
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• v.13 no.8
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• pp.243-253
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• 2019

Geyonggi-geommu have developed based on the long history of Korean sword dance. Han Sung-joon, the great master of modern music and dance of Korea during the Japanese colonial period, collected and reconstructed folk dances that had disappeared or were cut off due to the policy to obliterate Korean culture through Chosun Music Dance Research Society. Since then, it has been passed down to Kang Sun-young and Kim Geun-hee that has designated as the Intangible Cultural Property No. 53. of Geyonggi-do in 2011. This study focuses on highlighting the uniqueness of Geyonggi-geommu for proper modeling and transmission of Geyonggi-geommu with historical significance so as to understand and preserve the Intangible Cultural Heritage. This study examines the transmission system of Geyonggi-geommu, followed by Kang Sun-young and Kim Geun-hee, originated by the master Han Sung-Joon of Geyonggi-geommu. Geyonggi-geommu has its uniqueness of using the pure Korean dance terminology established by the holder Kim Geun-hee at the time of designation of intangible cultural properties in Gyeonggi-do. The unique features of Geyonggi-geommu are performed and transmitted in two forms, Daemu(Group dance) and Holchum(Solo dance) which are not currently found in other regions. This is meaningful to passed down according to the original form of Geommu(Sword dance). In particular, the Holchum(Solo dance) is a form of artistic dance, showing the beauty of the sword dance during the Chosun Dynasty. In short, Gyeonggi-geommu can be described as an artistic dance with a soft and strong temperament considering its unique features.

• Nuclear Engineering and Technology
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• v.54 no.11
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• pp.4102-4110
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• 2022

Aiming at high-power and long-pulse operation up to 1000 s, some improvements have been made for both 2.45 GHz and 4.6 GHz lower hybrid (LH) systems during the recent 5 years. At first, the guard limiters of the LH antennas with graphite tiles were upgraded to tungsten, the most promising material for plasma facing components in nuclear fusion devices. These new guard limiters can operate at a peak power density of 12.9 MW/m². Strong hot spots were usually observed on the old graphite limiters when 4.6 GHz system operated with power >2.0 MW [B. N. Wan et al., Nucl. Fusion 57 (2017) 102019], leading to a reduction of the maximum power capability. With the new limiters, 4.6 GHz LH system, the main current drive (CD) and electron heating tool for EAST, can be operated with power >2.5 MW routinely. Long-pulse operation up to 100 s with 4.6 GHz LH power of 2.4 MW was achieved in 2021 and the maximal temperature on the guard limiters measured by an infrared (IR) camera was about 540 ℃, much below the permissible value of tungsten material (~1200 ℃). A discharge with a duration of 1056 s was achieved and the 4.6 GHz LH energy injected into the plasma was up to 1.05 GJ. Secondly, the fully-active-multijunction (FAM) launcher of 2.45 GHz system was upgraded to a passive-active-multijunction (PAM), for which the density of optimum coupling was relatively low (below the cut-off value). Good coupling with reflection coefficient ~3% has been achieved with plasma-antenna distance up to 11 cm for the new PAM. Finally, in order to eliminate the effect of ion cyclotron range of frequencies (ICRF) wave on 4.6 GHz LH wave coupling, the location of the ICRF launcher was changed to a port that is located 157.5° toroidally from the 4.6 GHz LH system and is not magnetically connected.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.42 no.2
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• pp.249-256
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• 2022

Various studies are being actively conducted to show that the real-time visualization technology that combines BIM (Building Information Modeling) and AR (Augmented Reality) helps to increase construction management decision-making and processing efficiency. However, when large-capacity BIM data is projected into AR, there are various limitations such as data transmission and connection problems and the image cut-off issue. To improve the high efficiency of visualizing, a mesh optimization algorithm based on the k-nearest neighbors (KNN) classification framework to reconstruct BIM data is proposed in place of existing mesh optimization methods that are complicated and cannot adequately handle meshes with numerous boundaries of the 3D models. In the proposed algorithm, our target BIM model is optimized with the Unity C# code based on triangle centroid concepts and classified using the KNN. As a result, the algorithm can check the number of mesh vertices and triangles before and after optimization of the entire model and each structure. In addition, it is able to optimize the mesh vertices of the original model by approximately 56 % and the triangles by about 42 %. Moreover, compared to the original model, the optimized model shows no visual differences in the model elements and information, meaning that high-performance visualization can be expected when using AR devices.

• Journal of Chest Surgery
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• v.56 no.4
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• pp.244-251
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• 2023

Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with cardiorespiratory failure. The serum albumin level is an important prognostic marker in critically ill patients. We evaluated the efficacy of using pre-ECMO serum albumin levels to predict 30-day mortality in patients with cardiogenic shock (CS) who underwent venoarterial (VA) ECMO. Methods: We reviewed the medical records of 114 adult patients who underwent VA-ECMO between March 2021 and September 2022. The patients were divided into survivors and non-survivors. Clinical data before and during ECMO were compared. Results: Patients' mean age was 67.8±13.6 years, and 36 (31.6%) were female. The proportion of survival to discharge was 48.6% (n=56). Cox regression analysis showed that the pre-ECMO albumin level independently predicted 30-day mortality (hazard ratio, 0.25; 95% confidence interval [CI], 0.11-0.59; p=0.002). The area under the receiver operating characteristic curve of albumin levels (pre-ECMO) was 0.73 (standard error [SE], 0.05; 95% CI, 0.63-0.81; p<0.001; cut-off value=3.4 g/dL). Kaplan-Meier survival analysis showed that the cumulative 30-day mortality was significantly higher in patients with a pre-ECMO albumin level ≤3.4 g/dL than in those with a level >3.4 g/dL (68.9% vs. 23.8%, p<0.001). As the adjusted amount of albumin infused increased, the possibility of 30-day mortality also increased (coefficient=0.140; SE, 0.037; p<0.001). Conclusion: Hypoalbuminemia during ECMO was associated with higher mortality, even with higher amounts of albumin replacement, in patients with CS who underwent VA-ECMO. Further studies are needed to predict the timing of albumin replacement during ECMO.

• 한국노년학
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• v.39 no.4
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• pp.895-902
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• 2019

This study reviewed the diagnosis accuracy and evaluation criteria of the fall risk assessment questionnaire that proved validity through factor analysis in previous studies. The purpose of this study was to diagnose high-risk groups and propose personal fall risk profiles for the Korean community-dwelling elderly. The participants of this study were 439 elderly people living in S, U, B, and Y cities Korea (mean age 75.0 ± 5.7 years). Receiver operating characteristic analysis was conducted to review the accuracy of the fall risk assessment and evaluation criteria of the FRA. The results showed that the four sub-factors of the FRA: 'Potential for fall', 'Disease and physical symptoms', 'Environment' and 'Physical function', can effectively diagnose the fall risk of the community-dwelling elderly. The evaluation criteria was presented based on the sensitivity and specificity results. In addition, as a result of analyzing the patterns by the sub factors of the fall risk, the high-risk group accounted for 80% of the elderly who had problems with two or more factors. Therefore, the four sub-factors of FRA can effectively diagnose the fall risk level, and could be present individual fall risk profiles based on the evaluation criteria.

• Journal of radiological science and technology
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• v.46 no.5
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• pp.367-377
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• 2023

This study investigates the utility of the Triglyceride-glucose(TyG) index and Cardiometabolic Index(CMI) as predictors for diagnosing metabolic syndrome. The study involved 1970 males, 1459 females, totaling 3429 participants who underwent health checkups at P Hospital in Busan between January 2023 and June 2023. Metabolic syndrome diagnosis was based on the presence of 3 or more risk factors out of the 5 criteria outlined by the American Heart Association/National Heart, Lung, and Blood Institute(AHA/NHLBI), and participants with 2 or fewer risk factors were categorized as normal. Statistical analyses included independent sample t-tests, chi-square tests, Pearson's correlation analysis, Receiver Operating Characteristic(ROC) curve analysis, and logistic regression analysis, using the Statistical Package for the Social Sciences(SPSS) program. Significance was established at p<0.05. The comparison revealed that the metabolic syndrome group exhibited attributes such as advanced age, male gender, elevated systolic and diastolic blood pressures, high blood sugar, elevated triglycerides, reduced LDL-C, elevated HDL-C, higher Cardiometabolic Index, Triglyceride-glucose index, and components linked to abdominal obesity. Pearson correlation analysis showed strong positive correlations between waist circumference/height ratio, waist circumference, Cardiometabolic Index, and triglycerides. Weak positive correlations were observed between LDL-C, body mass index, and Cardiometabolic index, while a strong negative correlation was found between Cardiometabolic Index and HDL-C. ROC analysis indicated that the Cardiometabolic Index(CMI), Triglyceride-glucose(TyG) index, and waist circumference demonstrated the highest Area Under the Curve(AUC) values, indicating their efficacy in diagnosing metabolic syndrome. Optimal cut-off values were determined as >1.34, >8.86, and >84.5 for the Cardiometabolic Index, Triglyceride-glucose index, and waist circumference, respectively. Logistic regression analysis revealed significant differences for age(p=0.037), waist circumference(p<0.001), systolic blood pressure(p<0.001), triglycerides(p<0.001), LDL-C(p=0.028), fasting blood sugar(p<0.001), Cardiometabolic Index(p<0.001), and Triglyceride-glucose index (p<0.001). The odds ratios for these variables were 1.015, 1.179, 1.090, 3.03, and 69.16, respectively. In conclusion, the Cardiometabolic Index and Triglyceride-glucose index are robust predictive indicators closely associated with metabolic syndrome diagnosis, and waist circumference is identified as an excellent predictor. Integrating these variables into clinical practice holds the potential for enhancing early diagnosis and prevention of metabolic syndrome.

• Korean Journal of Radiology
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• v.22 no.6
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• pp.959-969
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• 2021

Objective: This study aimed to evaluate the role of preoperative two-dimensional (2D) shear wave elastography (SWE) in assessing the stages of liver fibrosis in patients with suspected biliary atresia (BA) and compared its diagnostic performance with those of serum fibrosis biomarkers. Materials and Methods: This study was approved by the ethical committee, and written informed parental consent was obtained. Two hundred and sixteen patients were prospectively enrolled between January 2012 and October 2018. The 2D SWE measurements of 69 patients have been previously reported. 2D SWE measurements, serum fibrosis biomarkers, including fibrotic markers and biochemical test results, and liver histology parameters were obtained. 2D SWE values, serum biomarkers including, aspartate aminotransferase to platelet ratio index (APRi), and other serum fibrotic markers were correlated with the stages of liver fibrosis by METAVIR. Receiver operating characteristic (ROC) curves and area under the ROC (AUROC) curve analyses were used. Results: The correlation coefficient of 2D SWE value in correlation with the stages of liver fibrosis was 0.789 (p < 0.001). The cut-off values of 2D SWE were calculated as 9.1 kPa for F1, 11.6 kPa for F2, 13.0 kPa for F3, and 15.7 kPa for F4. The AUROCs of 2D SWE in the determination of the stages of liver fibrosis ranged from 0.869 to 0.941. The sensitivity and negative predictive value of 2D SWE in the diagnosis of ≥ F3 was 93.4% and 96.0%, respectively. The diagnostic performance of 2D SWE was superior to that of APRi and other serum fibrotic markers in predicting severe fibrosis and cirrhosis (all p < 0.005) and other serum biomarkers. Multivariate analysis showed that the 2D SWE value was the only statistically significant parameter for predicting liver fibrosis. Conclusion: 2D SWE is a more effective non-invasive tool for predicting the stage of liver fibrosis in patients with suspected BA, compared with serum fibrosis biomarkers.

• The Korean Society of Law and Medicine
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• v.25 no.1
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• pp.149-192
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• 2024

People with mental illness are generally either unaware of their illness or unwilling to voluntarily seek treatment, which makes treatment difficult and the pain mainly passed on to their families. Accordingly, non-face-to-face treatment, in which the patient is diagnosed by interviews with the family and unannounced medication, in which medication is secretly administered through the family, can be performed, and this has been considered a necessary evil. Even considering realistic aspects such as the special nature of mental health care and families' suffer, not-informed treatment without consent violates not only medical laws, but also human rights of mentally ill patients. Above all, if the patient finds out about this late, the trust between the patient, family, and doctor is completely broken, and a treatment is absolutely refused. Japan's Chiba decision, which presents exceptional conditions for allowance might be a solution. However, it would not be a right solution, considering that it could lead to long-term unannounced medication and completely cut off treatment through therapeutic dialogue. Ultimately, it need to approach this problem and seek alternatives through restoration of therapeutic dialogue.