• Title/Summary/Keyword: High-risk

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Ultrasound-Guided Percutaneous Biopsy With Needle Track Plugging in Patients With Focal Liver Lesions on an Outpatient Basis: A Randomized Controlled Trial

  • Ja Kyung Yoon;Choong-kun Lee;Hongjeong Yoon;Hye Jin Choi;Seung-seob Kim
    • Korean Journal of Radiology
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    • v.25 no.10
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    • pp.902-912
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    • 2024
  • Objective: The increasing utilization of various molecular tests for diagnosing and selecting treatments for patients with malignancies has led to a rising trend in both the frequency of biopsies and the required tissue volume. We aimed to compare the safety of outpatient ultrasound (US)-guided percutaneous liver biopsy (PLB) between the coaxial method with needle track plugging (NTP) and the conventional method. Materials and Methods: This single-center, prospective, randomized controlled study was conducted from October 2022 to May 2023. Patients referred for US-guided PLB with target liver lesions measuring ≥1 cm and requiring ≥3 tissue cores were enrolled. Patients with severe coagulopathy or a substantial volume of ascites were excluded. Patients were randomly assigned to undergo PLB using either the coaxial method with NTP or the conventional method, in a 1:1 ratio, and were subsequently discharged after 2 hours. The primary endpoint was the presence of a patent track sign, defined as a linear color flow along the biopsy track on Doppler US, as an indication of bleeding. The secondary endpoints included clinically significant bleeding, delayed bleeding after discharge, and diagnostic yield. The incidences of these endpoints were compared between the two methods. Results: A total of 107 patients completed the study protocol. Patent track signs were observed significantly less frequently in the coaxial method with NTP group than in the conventional method group: 16.7% (9/54) vs. 35.8% (19/53; P = 0.042). Clinically significant bleeding and delayed bleeding did not occur in either group, and both methods achieved a high diagnostic yield: 94.4% (51/54) vs. 98.1% (52/53; P = 0.624). Conclusion: Compared with the conventional method, the coaxial method with NTP may potentially be safer, with a reduced risk of overall bleeding complications after PLB when retrieving ≥3 tissue cores. The coaxial method with NTP could be considered a viable option for acquiring multiple liver tissues on an outpatient basis.

First Record of the Invasive Alien Mollusk Melanoides tuberculata (Müller, 1774) (Gastropoda, Thiaridae) in South Korea (침입성 외래연체동물 서양다슬기(Melanoides tuberculata)에 대한 국내 최초 기록)

  • Youngjun Park;Soon Jae Eum;Youngho Cho;Yonglak Jeon;Yungchul Jun;InChul Hwang;Soon Jik Kwon
    • Korean Journal of Ecology and Environment
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    • v.57 no.3
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    • pp.162-168
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    • 2024
  • The purpose of this study was to record for the first time in Korea the presence of Melanoides tuberculata (an invasive alien species), which was confirmed during the "National Survey on the Status of Alien Species" in Jukdang stream (also known as Guppy Stream, located in Icheon, Gyeonggi Province), which is affected by the year-round discharge of heated effluent from a large semiconductor factory and where various tropical organisms, including ornamental fish, appear due to artificial release. A Total of 52 specimens were collected, and they can be visually distinguished from native melanian snails by their reddish-brown flames and spots. Genetic analysis further confirmed the species as Melanoides tuberculate. Melanoides tuberculata typically inhabits tropical climates, but its presence has been confirmed in altered aquatic environments such as Jukdang stream, where the water temperature remains warm even in a temperate climate. This indicates the need for further monitoring of domestic streams with similar conditions, particularly those receiving heated effluent, like Jukdang stream. Additionally, due to its strong reproductive capacity, including parthenogenesis, and its adaptability to various environments, there have been cases where the populations of Pomacea lineata and Aylacostoma tenuilabris have declined. This suggests that Melanoides tuberculata may have a competitive advantage in interspecific competition, potentially suppressing native species populations if it spreads within the domestic ecosystem. Melanoides tuberculata serves as an intermediate host for parasites that can cause diseases in both humans and animals, raising public health concerns in many countries. There is also a significant risk that it could be mistaken for native melanian snail species and consumed, which necessitates a high level of caution.

Multivariate statistical study on naturally occurring radioactive materials and radiation hazards in lakes around a Chinese petroleum industrial area

  • Yan Shi;Junfeng Zhao;Baiyao Ding;Yue Zhang;Zhigang Li;Mohsen M.M.Ali;Tuya Siqin;Hongtao Zhao;Yongjun Liu;Weiguo Jiang;Peng Wu
    • Nuclear Engineering and Technology
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    • v.56 no.6
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    • pp.2182-2189
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    • 2024
  • The high-purity germanium gamma-ray spectrometer was used to measure the radioisotope in surface water of lakes in a Chinee petroleum industrial area. 92 samples were collected from surface water of three lakes. Activity concentrations of 232Th, 226Ra and 40K in three lakes were measured, distributed in the range of 101.8-209.4, 192.1-224.9 and 335.0-548.9 mBq/L, respectively. Results were all within the limits of WHO and China. Potential environmental and health risks were assessed by calculating some radiation hazard indicators, radium equivalent index, annual effective dose, excess lifetime cancer risk, absorbed dose rate, external hazard index, internal hazard index, annual gonadal dose equivalent, activity utilization index and representative gamma index, which ranged 0.38-0.54 Bq/L, 0.06-0.08 mSv/y, 0.23 × 10-3-0.31 × 10-3, 0.17-0.24 nGy/h, 1.01 × 10-3-1.46 × 10-3, 1.55 × 10-3-2.02 × 10-3, 1.16-1.66 μSv/y, 3.13 × 10-3-4.45 × 10-3 and 2.60 × 10-3-3.77 × 10-3. The results were all at acceptable levels, meaning no impact on human health. The relationship between the electrical conductivity of surface water and the activity concentration of 232Th, 226Ra and 40K was evaluated. The electrical conductivity value was 0.241-0.369 mS/cm, showing a significant correlation coefficient between 226Ra and 40K and electrical conductivity. Multivariate statistical methods were used to determine the relationship between the activity concentrations of 232Th, 226Ra, and 40K, radiation hazard indicators and electrical conductivity.

The Combination of Gefitinib and Acetaminophen Exacerbates Hepatotoxicity via ROS-Mediated Apoptosis

  • Jiangxin Xu;Xiangliang Huang;Yourong Zhou;Zhifei Xu;Xinjun Cai;Bo Yang;Qiaojun He;Peihua Luo;Hao Yan;Jie Jin
    • Biomolecules & Therapeutics
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    • v.32 no.5
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    • pp.647-657
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    • 2024
  • Gefitinib is the well-tolerated first-line treatment of non-small cell lung cancer. As it needs analgesics during oncology treatment, particularly in the context of the coronavirus disease, where patients are more susceptible to contract high fever and sore throat. This has increased the likelihood of taking both gefitinib and antipyretic analgesic acetaminophen (APAP). Given that gefitinib and APAP overdose can predispose patients to liver injury or even acute liver failure, there is a risk of severe hepatotoxicity when these two drugs are used concomitantly. However, little is known regarding their safety at therapeutic doses. This study simulated the administration of gefitinib and APAP at clinically relevant doses in an animal model and confirmed that gefitinib in combination with APAP exhibited additional hepatotoxicity. We found that gefitinib plus APAP significantly exacerbated cell death, whereas each drug by itself had little or minor effect on hepatocyte survival. Mechanistically, combination of gefitinib and APAP induces hepatocyte death via the apoptotic pathway obviously. Reactive oxygen species (ROS) generation and DNA damage accumulation are involved in hepatocyte apoptosis. Gefitinib plus APAP also promotes the expression of Kelch-like ECH-associated protein 1 (Keap1) and downregulated the antioxidant factor, Nuclear factor erythroid 2-related factor 2 (Nrf2), by inhibiting p62 expression. Taken together, this study revealed the potential ROS-mediated apoptosis-dependent hepatotoxicity effect of the combination of gefitinib and APAP, in which the p62/Keap1/Nrf2 signaling pathway participates and plays an important regulatory role.

A Study on Selection of Bicycle Road Hazard Detection Elements For Mobile IoT Sensor Device Operation (이동형 IoT 센서 장비 운용을 위한 자전거도로 위험 감지요소 선정 연구)

  • Woochul Choi;Bong-Joo Jang;Sun-Kyum Kim;Intaek Jung
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.23 no.4
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    • pp.37-53
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    • 2024
  • This study selected bicycle road hazard detection factors for mobile IoT sensor device operation and developed service application plans. Twelve bicycle road hazard detection factors were derived through a focused group interview, and a fuzzy AHP-based importance analysis was conducted on 30 road and transportation experts. As a result, 'damage to pavement' (1st overall) and 'environmental obstacle' (2nd) with low visibility but a high risk of accidents were selected the most. The factors in terms of facility management, such as 'disconnected route occurrence' (4th), 'artificial obstacle' (5th), 'effective width' (6th), and 'poor drainage' (7th), were selected as the upper and middle areas. Factors that are not direct accident-inducing factors, such as 'loss of road markings' (11th) and 'free space width' (12th), were selected the least. Based on this, a plan was presented to apply the bicycle road hazard detection service and a service operation strategy according to real-time performance. Nevertheless, follow-up studies, such as human behavioral analysis based on bicycle operators, analysis according to the bicycle road type, service demonstration, and pilot operation, will be needed to develop safe bicycle road management is expected.

A Study on the Perception of Medical Radiation Exposure and Irradiated Foods among College Students in Nursing and Health-related and Health-unrelated Majors (간호보건계열과 비보건계열 대학생들의 의료용 방사선피폭과 방사선조사식품의 인식에 관한 연구)

  • Young-Nam PARK;Jae-Ki RYU
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.3
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    • pp.265-272
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    • 2024
  • This study aimed to investigate the knowledge and awareness of medical radiation and irradiated foods among nursing college students and those pursuing health-related and health-unrelated majors and to provide basic data for developing and promoting appropriate educational programs on the use of radiation. The knowledge of medical radiation was the highest among those over 30 years of age (3.0 points), and members of the Department of Clinical Laboratory Science (3.0 points). The awareness of the risk of medical radiation was the highest among female (3.34 points), among members of the Department of Nursing and Health Science (3.40 points), and among third-year students (3.41 points). The awareness of the benefits of medical radiation was the highest in male (3.90 points). The awareness of irradiated foods and its safety was low in all departments. The need for education regarding irradiated foods and the willingness to provide information on such foods were high. In conclusion, it is thought that specific promotional activities and educational programs are needed to improve the accuracy of knowledge regarding medical radiation among college students and increase their awareness on the safety of irradiated foods.

Comparison of the Right-to-left Shunt Test by Transcranial Doppler Based on the Addition of Blood and Patient Posture (경두개 초음파를 이용한 좌우단락검사 시 Blood 사용 유무와 환자 자세에 따른 실증적 결과 비교)

  • Kun-Woo KANG;Eui-Jeong LEE;Hyun-Kyung LEE;Eun-Son LEE;Yang-Hee LIM
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.3
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    • pp.228-235
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    • 2024
  • Using transcranial doppler ultrasonography (TCD) to measure the presence or absence of abnormalities in patent foramen ovale (PFO) is more effective than transesophageal echocardiography (TEE) because it is simple, inexpensive, and non-invasive. Thus, it can be a good alternative test in cases where it is difficult to perform TEE or in groups at a high risk of complications. Therefore, in this study, we sought to assist in arriving at a diagnosis by suggesting an appropriate method through the comparison of empirical results according to the presence or absence of blood use and varying patient posture. The results were compared depending on the patient's posture and whether blood was used. Patients in whom both middle cerebral arteries were observed were targeted. In cases where the temporal window was defective, it was replaced with basilar artery and compared. There were higher positivity rate and accuracy for sitting position using valsalva maneuver (VM) than for Resting and supine position using VM. Therefore, if it is possible to perform a sitting position using VM with a mixture of blood, it would be a good idea to perform it.

A Review of Herbal Medicine Treatments on Aftereffects of Thyroidectomy (갑상선 절제술 후 후유증의 한약 치료에 대한 최신 임상 연구 동향)

  • Soo-duk Kim;Min-jo Seo;Su-na Park;Hye-ri Jo;So-hyeon Ryu;Geon-sik Kong;Yo-sup Choi
    • The Journal of Internal Korean Medicine
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    • v.45 no.4
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    • pp.615-634
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    • 2024
  • Objectives: This study summarizes the current trends and results in clinical studies on herbal medicine treatments after thyroidectomy. Methods: Studies published between 2019 and 2024 were searched for on the China National Knowledge Infrastructure (CNKI), PubMed, and Research Information Sharing Service (RISS). The studies were analyzed according to year, study design, characteristics of the patients, and traditional Chinese medicine (TCM) intervention. A meta-analysis was conducted and classified according to the outcome measurements, such as the total effective rate (TER), thyroid stimulating hormone (TSH), free T4 (FT4), self-rating depression scale (SDS), CD3+, CD4+, and CD8+. CD8+. Results: A total of 18 randomized controlled trials (RCTs) and 5 non-randomized controlled trials were reviewed. The most common herbal prescriptions were decoctions made from Yangyin Sanjie (Yangeumsangyeol-tang), Yiqi Sanjie (Ikgisangyeol-tang), Yiqi Yangyin Sanjie (Ikgiyangeumsangyeol-tang), Yiqi Yangyin (Ikgiyangeum-tang), and Huiyan Zhuyu (Hoeyeomchugeo-tang). The most frequently used herbs were Prunellae Spica, Scrophulariae Radix, and Astragali Radix. The meta-analysis found that the group using both herbal and Western medicine was benefited more than the group using Western medicine alone (RR: 1.28, 95% CI: 1.20-1.37, P<0.00001). The experimental group had higher TSH, CD3+, and CD4+ levels, while FT4, SDS, and CD8++ were lower. However, due to high study heterogeneity, the results were not statistically significant. Conclusion: Complications after thyroidectomy include hypothyroidism, hypoparathyroidism, and psychological aftereffects. Herbal and conventional treatments showed potential in improving hormone levels, immune function, and depression, but statistical significance was limited due to study variability. These results should be interpreted cautiously given the risk of bias in the trials.

Development and Assessment Individual Maximum Permissible Dose Method of I-131 Therapy in High Risk Patients with Differentiated Papillary Thyroid Cancer (물리학 선량법을 이용한 갑상선암의 개인별 최대안전용량 I-131 치료법 개발과 유용성 평가)

  • Kim, Jeong-Chul;Yoon, Jung-Han;Bom, Hee-Seung;JaeGal, Young-Jong;Song, Ho-Chun;Min, Jung-Joon;Jeong, Heong;Kim, Seong-Min;Heo, Young-Jun;Li, Ming-Hao;Park, Young-Kyu;Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.110-119
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    • 2003
  • Purpose: Radioiodine (I-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. Materials and Methods: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age $50{\pm}11$ years) of papillary thyroid cancer. Among them 43 patients were treated with ${\Leq}7.4GBq$, while 15 patients with ${\geq}9.25GBq$. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up I-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. Results: MPD measured by CF method using tracer and therapeutic doses were $13.3{\pm}1.9\;and\;13.8{\pm}2.1GBq$, respectively (p=0.20). They showed a significant correlation (r=0.8, p<0.0001). Exposed doses to blood measured by CF and biological methods were $1.54{\pm}0.03\;and\;1.78{\pm}0.03Gy$ (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-dose group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). Conclusion: Measurement of MPD using CF method is reliable, and the high-dose I-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.

The Relations between Financial Constraints and Dividend Smoothing of Innovative Small and Medium Sized Enterprises (혁신형 중소기업의 재무적 제약과 배당스무딩간의 관계)

  • Shin, Min-Shik;Kim, Soo-Eun
    • Korean small business review
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    • v.31 no.4
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    • pp.67-93
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    • 2009
  • The purpose of this paper is to explore the relations between financial constraints and dividend smoothing of innovative small and medium sized enterprises(SMEs) listed on Korea Securities Market and Kosdaq Market of Korea Exchange. The innovative SMEs is defined as the firms with high level of R&D intensity which is measured by (R&D investment/total sales) ratio, according to Chauvin and Hirschey (1993). The R&D investment plays an important role as the innovative driver that can increase the future growth opportunity and profitability of the firms. Therefore, the R&D investment have large, positive, and consistent influences on the market value of the firm. In this point of view, we expect that the innovative SMEs can adjust dividend payment faster than the noninnovative SMEs, on the ground of their future growth opportunity and profitability. And also, we expect that the financial unconstrained firms can adjust dividend payment faster than the financial constrained firms, on the ground of their financing ability of investment funds through the market accessibility. Aivazian et al.(2006) exert that the financial unconstrained firms with the high accessibility to capital market can adjust dividend payment faster than the financial constrained firms. We collect the sample firms among the total SMEs listed on Korea Securities Market and Kosdaq Market of Korea Exchange during the periods from January 1999 to December 2007 from the KIS Value Library database. The total number of firm-year observations of the total sample firms throughout the entire period is 5,544, the number of firm-year observations of the dividend firms is 2,919, and the number of firm-year observations of the non-dividend firms is 2,625. About 53%(or 2,919) of these total 5,544 observations involve firms that make a dividend payment. The dividend firms are divided into two groups according to the R&D intensity, such as the innovative SMEs with larger than median of R&D intensity and the noninnovative SMEs with smaller than median of R&D intensity. The number of firm-year observations of the innovative SMEs is 1,506, and the number of firm-year observations of the noninnovative SMEs is 1,413. Furthermore, the innovative SMEs are divided into two groups according to level of financial constraints, such as the financial unconstrained firms and the financial constrained firms. The number of firm-year observations of the former is 894, and the number of firm-year observations of the latter is 612. Although all available firm-year observations of the dividend firms are collected, deletions are made in the case of financial industries such as banks, securities company, insurance company, and other financial services company, because their capital structure and business style are widely different from the general manufacturing firms. The stock repurchase was involved in dividend payment because Grullon and Michaely (2002) examined the substitution hypothesis between dividends and stock repurchases. However, our data structure is an unbalanced panel data since there is no requirement that the firm-year observations data are all available for each firms during the entire periods from January 1999 to December 2007 from the KIS Value Library database. We firstly estimate the classic Lintner(1956) dividend adjustment model, where the decision to smooth dividend or to adopt a residual dividend policy depends on financial constraints measured by market accessibility. Lintner model indicates that firms maintain stable and long run target payout ratio, and that firms adjust partially the gap between current payout rato and target payout ratio each year. In the Lintner model, dependent variable is the current dividend per share(DPSt), and independent variables are the past dividend per share(DPSt-1) and the current earnings per share(EPSt). We hypothesized that firms adjust partially the gap between the current dividend per share(DPSt) and the target payout ratio(Ω) each year, when the past dividend per share(DPSt-1) deviate from the target payout ratio(Ω). We secondly estimate the expansion model that extend the Lintner model by including the determinants suggested by the major theories of dividend, namely, residual dividend theory, dividend signaling theory, agency theory, catering theory, and transactions cost theory. In the expansion model, dependent variable is the current dividend per share(DPSt), explanatory variables are the past dividend per share(DPSt-1) and the current earnings per share(EPSt), and control variables are the current capital expenditure ratio(CEAt), the current leverage ratio(LEVt), the current operating return on assets(ROAt), the current business risk(RISKt), the current trading volume turnover ratio(TURNt), and the current dividend premium(DPREMt). In these control variables, CEAt, LEVt, and ROAt are the determinants suggested by the residual dividend theory and the agency theory, ROAt and RISKt are the determinants suggested by the dividend signaling theory, TURNt is the determinant suggested by the transactions cost theory, and DPREMt is the determinant suggested by the catering theory. Furthermore, we thirdly estimate the Lintner model and the expansion model by using the panel data of the financial unconstrained firms and the financial constrained firms, that are divided into two groups according to level of financial constraints. We expect that the financial unconstrained firms can adjust dividend payment faster than the financial constrained firms, because the former can finance more easily the investment funds through the market accessibility than the latter. We analyzed descriptive statistics such as mean, standard deviation, and median to delete the outliers from the panel data, conducted one way analysis of variance to check up the industry-specfic effects, and conducted difference test of firms characteristic variables between innovative SMEs and noninnovative SMEs as well as difference test of firms characteristic variables between financial unconstrained firms and financial constrained firms. We also conducted the correlation analysis and the variance inflation factors analysis to detect any multicollinearity among the independent variables. Both of the correlation coefficients and the variance inflation factors are roughly low to the extent that may be ignored the multicollinearity among the independent variables. Furthermore, we estimate both of the Lintner model and the expansion model using the panel regression analysis. We firstly test the time-specific effects and the firm-specific effects may be involved in our panel data through the Lagrange multiplier test that was proposed by Breusch and Pagan(1980), and secondly conduct Hausman test to prove that fixed effect model is fitter with our panel data than the random effect model. The main results of this study can be summarized as follows. The determinants suggested by the major theories of dividend, namely, residual dividend theory, dividend signaling theory, agency theory, catering theory, and transactions cost theory explain significantly the dividend policy of the innovative SMEs. Lintner model indicates that firms maintain stable and long run target payout ratio, and that firms adjust partially the gap between the current payout ratio and the target payout ratio each year. In the core variables of Lintner model, the past dividend per share has more effects to dividend smoothing than the current earnings per share. These results suggest that the innovative SMEs maintain stable and long run dividend policy which sustains the past dividend per share level without corporate special reasons. The main results show that dividend adjustment speed of the innovative SMEs is faster than that of the noninnovative SMEs. This means that the innovative SMEs with high level of R&D intensity can adjust dividend payment faster than the noninnovative SMEs, on the ground of their future growth opportunity and profitability. The other main results show that dividend adjustment speed of the financial unconstrained SMEs is faster than that of the financial constrained SMEs. This means that the financial unconstrained firms with high accessibility to capital market can adjust dividend payment faster than the financial constrained firms, on the ground of their financing ability of investment funds through the market accessibility. Futhermore, the other additional results show that dividend adjustment speed of the innovative SMEs classified by the Small and Medium Business Administration is faster than that of the unclassified SMEs. They are linked with various financial policies and services such as credit guaranteed service, policy fund for SMEs, venture investment fund, insurance program, and so on. In conclusion, the past dividend per share and the current earnings per share suggested by the Lintner model explain mainly dividend adjustment speed of the innovative SMEs, and also the financial constraints explain partially. Therefore, if managers can properly understand of the relations between financial constraints and dividend smoothing of innovative SMEs, they can maintain stable and long run dividend policy of the innovative SMEs through dividend smoothing. These are encouraging results for Korea government, that is, the Small and Medium Business Administration as it has implemented many policies to commit to the innovative SMEs. This paper may have a few limitations because it may be only early study about the relations between financial constraints and dividend smoothing of the innovative SMEs. Specifically, this paper may not adequately capture all of the subtle features of the innovative SMEs and the financial unconstrained SMEs. Therefore, we think that it is necessary to expand sample firms and control variables, and use more elaborate analysis methods in the future studies.