• 제목/요약/키워드: Risk Presentation

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Comparison of Clinical Characteristics Between Benign Borderline and Malignant Phyllodes Tumors of the Breast

  • Wang, Hui;Wang, Xiang;Wang, Cheng-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10791-10795
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    • 2015
  • Background: Phyllodes tumors of the breast are rare fibroepithelial lesions, so relatively little is known about this disease entity. The present study was designed to identify differences in clinical features between benign borderline and malignant phyllodes tumors. Materials and Methods: Data from 246 women with phyllodes tumors of the breast treated in Cancer Hospital Chinese Academy of Medical Sciences between 2002 and 2012 were collected and analyzed, including age at presentation, age at treatment, course, size of primary tumor, location, histological type, type of surgery and treatment, local recurrence, distant metastasis, fibroadenoma history, disease-free survival and number of mitosis per 10hpf. There are 125 (55%) benign, 55 (24%) borderline and 47 (21%) malignant tumors. Results: In univariate analysis, average age at presentation, average age at treatment, size of primary tumor, ulceration or not, type of primary surgery, distant metastasis and number of mitosis per 10 hpf turned out to be statistically different among the three PT types (p=0.014, 0.018, <0.000, 0.003, <0.000, 0.001 and <0.000, respectively), while recurrence and disease-free survival (DFS) demonstrated trends for statistical significance (P =0.055 and 0.060, respectively). Multivariate analysis revealed distant metastasis and excision were significantly different in benign, borderline and malignant phyllodes tumors of the breast (p=0.041 and 0.018, OR=0.061 and 0.051). At the same time, size of primary tumor with p=0.052 tended to be different between groups (OR=1.127). However, age at treatment, ulceration and DFS showed no statistically significant variation (p=0.400, 0.286 and 0.413, respectively). Conclusions: Benign borderline and malignant phyllode tumors have different distant metastasis risk, different primary tumor size and different surgical procedures, and malignant PTs are more likely to be bigger and to metastasize.

Solar Photovoltaics Technology: No longer an Outlier

  • Kazmerski, Lawrence L.
    • 한국진공학회:학술대회논문집
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    • 한국진공학회 2011년도 제41회 하계 정기 학술대회 초록집
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    • pp.70-70
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    • 2011
  • The prospects of current and coming solar-photovoltaic (PV) technologies are envisioned, arguing this solar-electricity source is beyond a tipping point in the complex worldwide energy outlook. Truly, a revolution in both the technological advancements of solar PV and the deployment of this energy technology is underway; PV is no longer an outlier. The birth of modern photovoltaics (PV) traces only to the mid-1950s, with the Bell Telephone Laboratories' development of an efficient, single-crystal Si solar cell. Since then, Si has dominated the technology and the markets, from space through terrestrial applications. Recently, some significant shift toward technology diversity have taken place. Some focus of this presentation will be directed toward PV R&D and technology advances, with indications of the limitations and relative strengths of crystalline (Si and GaAs) and thin-film (a-Si:H, Si, Cu(In,Ga)(Se,S)2, CdTe). Recent advances, contributions, industry growth, and technological pathways for transformational now and near-term technologies (Si and primarily thin films) and status and forecasts for next-generation PV (nanotechnologies and non-conventional and "new-physics" approaches) are evaluated. The need for R&D accelerating the now and imminent (evolutionary) technologies balanced with work in mid-term (disruptive) approaches is highlighted. Moreover, technology progress and ownership for next generation solar PV mandates a balanced investment in research on longer-term (the revolution needs revolutionary approaches to sustain itself) technologies (quantum dots, multi-multijunctions, intermediate-band concepts, nanotubes, bio-inspired, thermophotonics, ${\ldots}$ and solar hydrogen) having high-risk, but extremely high performance and cost returns for our next generations of energy consumers. This presentation provides insights to the reasons for PV technology emergence, how these technologies have to be developed (an appreciation of the history of solar PV)-and where we can expect to be by this mid-21st century.

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Posterior Cerebral Artery Aneurysm : Surgical Result of 11 Patients

  • Ko, Che-Kyu;Shin, Il-Young;Ahn, Jae-Sung;Kwon, Yang;Kwun, Byung-Duk;Lee, Jung-Kyo
    • Journal of Korean Neurosurgical Society
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    • 제39권3호
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    • pp.192-197
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    • 2006
  • Objective : Eleven patients treated with posterior cerebral artery[PCA] aneurysm during 6.3-years period are retrospectively reviewed to determine treatment outcome. Methods : Eleven patients with PCA aneurysm were treated from January 1998 to May 2004. Their medical records and radiologic studies were reviewed retrospectively. The records of these patients were analysed with particular reference to their demographic details, mode of presentation, and treatment outcome. Results : Of the 11 patients, 8 patients presented with symptoms related aneurysmal bleeding. Three patients had unruptured PCA aneurysms. Open or endovascular surgery was performed in 9 patients; None of these patients exhibited a third nerve palsy, visual field deficit, or hemiparesis at the time of presentation. Postoperatively, 2 made a good recovery, 2 had a moderate disability because of cerebral infarction after surgery, and 5 had a severe disability because of cerebral infarction after surgery. Of 2 conservatively treated patients, 1 was doing well but the other died as a result of brain swelling. Conclusion : The treatment of the PCA aneurysms is difficult regardless of the aneurysmal size, site, and treatment modality. All reasonable treatment to reduce the risk of associated morbidity should be considered.

Clinical presentation and treatment outcomes of primary ocular adnexal MALT lymphoma in Thailand

  • Seresirikachorn, Kasem;Norasetthada, Lalita;Ausayakhun, Sakarin;Apivatthakakul, Atitaya;Tangchittam, Sirima;Pruksakorn, Vannakorn;Wudhikarn, Kitsada;Wiwatwongwana, Damrong
    • BLOOD RESEARCH
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    • 제53권4호
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    • pp.307-313
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    • 2018
  • Background Primary ocular adnexal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (POML) is the most common subtype of lymphoma involving the eyes in Thailand. We sought to assess the characteristics and treatment outcomes of patients with POML in Thailand. Methods We retrospectively reviewed patient data and included patients diagnosed with POML between January 2004 and December 2016 at Chiang Mai University Hospital and King Chulalongkorn Memorial Hospital, Thailand. We collected and analyzed patients' clinical characteristics and treatment outcomes. Results Among 146 patients with lymphoma involving the eyes, 121 (82%) were diagnosed with POML. Sixty-four (52.9%) were women with median age 58 (range, 22-86) years. The most common presenting symptom was orbital mass (71.1%). Common sites of origin were the orbit (46.3%) and lacrimal gland (34.7%). At presentation, 22.3% of patients had bilateral eye involvement. About half of patients had stage I disease (N=59, 56.2%) and 20% had stage IV. Most patients (73.3%) had a low-risk International Prognostic Index. Radiotherapy was the main treatment for patients with limited-stage disease (66.7% in stage I and 56.5% in stage II). The overall response rate was 100% with complete response rates 80%, 77.3%, and 64.7% for stages I, II, and IV, respectively. Five-year progression-free survival (PFS) and overall survival were 66.1% and 94.0%, respectively. For patients with limited-stage disease, radiotherapy significantly improved PFS compared with treatment not involving radiotherapy (5-year PFS 89.9% vs. 37.3%, P=0.01). Conclusion We revealed that POML has good response to treatment, especially radiotherapy, with excellent long-term outcome.

Detection of Deep Vein Thrombosis by Follow-up Indirect Computed Tomography Venography after Pulmonary Embolism

  • Lee, Hye Jin;Cha, Seung-Ick;Shin, Kyung-Min;Lim, Jae-Kwang;Yoo, Seung-Soo;Lee, Shin-Yup;Lee, Jaehee;Kim, Chang-Ho;Park, Jae-Yong
    • Tuberculosis and Respiratory Diseases
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    • 제81권1호
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    • pp.49-58
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    • 2018
  • Background: Information regarding the incidence and risk factors for deep vein thrombosis (DVT) detected by follow-up computed tomographic (CT) venography after pulmonary embolism (PE) is sparse. The aim of the present study was to identify the predictors of DVT in follow-up CT images, and to elucidate their clinical significance. Methods: Patients with PE were classified into the following three cohorts based on the time of indirect CT venography follow-up: within 1 month, 1 to 3 months, and 3 to 9 months after the initial CT scan. Each cohort was subdivided into patients with or without DVT detected by follow-up CT. Clinical variables were compared between the two groups. Results: Follow-up CT revealed DVT in 61% of patients with PE within 1 month, in 15% of patients with PE at 1 to 3 months, and in 9% of patients with PE at 3 to 9 months after the initial CT scan. Right ventricular (RV) dilation on the initial CT (odds ratio [OR], 8.30; 95% confidence interval [CI], 1.89-36.40; p=0.005) and proximal DVT at the initial presentation (OR, 6.93; 95% CI, 1.90-25.20; p=0.003) were found to independently predict DVT in follow-up CT images within 1 month, proximal DVT at the initial presentation was found to independently predict DVT in follow-up CT images at 1 to 3 months (OR, 6.69; 95% CI, 1.53-29.23; p=0.012), and central PE was found to independently predict DVT in follow-up CT images at 3 to 9 months (OR, 4.25; 95% CI, 1.22-4.83; p=0.023) after the initial CT scan. Furthermore, the detection of DVT by follow-up CT independently predicted the recurrence of venous thromboembolism (VTE) (OR, 4.67; 95% CI, 2.24-9.74; p<0.001). Conclusion: Three months after PE, DVT was not detected by follow-up CT in most patients with PE. RV dilation on the initial CT, central PE, and proximal DVT at the initial presentation were found to predict DVT on follow-up CT, which might predict VTE recurrence.

Contralateral Breast Cancer: a Clinico-pathological Study of Second Primaries in Opposite Breasts after Treatment of Breast Malignancy

  • Shankar, Abhishek;Roy, Shubham;Malik, Abhidha;Kamal, Vineet Kumar;Bhandari, Ruchir;Kishor, Kunal;Mahajan, M.K.;Sachdev, Jaineet;Jeyaraj, Pamela;Rath, G.K.
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권3호
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    • pp.1207-1211
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    • 2015
  • Background: Breast cancer is by far the most frequent cancer of women (23 % of all cancers), ranking second overall when both sexes are considered together. Contralateral breast cancer (CBC) is becoming an important public health issue because of the increased incidence of primary breast cancer and improved survival. The present communication concerns a study to evaluate the role of various clinico-pathological factors on the occurrence of contralateral breast cancer. Materials and Methods: A detailed analysis was carried out with respect to age, menopausal status, family history, disease stage, surgery performed, histopathology, hormone receptor status, and use of chemotherapy or hormonal therapy. The diagnosis of CBC was confirmed on histopathology report. Relative risk with 95%CI was calculated for different risk factors of contralateral breast cancer development. Results: CBC was found in 24 (4.5%) out of 532 patients. Mean age of presentation was 43.2 years. Family history of breast cancer was found in 37.5% of the patients. There was statistically significant higher rate (83.3%) of CBC in patients in age group of 20-40 years with RR=11.3 (95% CI: 1.4, 89.4, p=0.006) seen in 20-30 years and RR=10.8 (95% CI:1.5-79.6, p=0.002) in 30-40 years as compared to older age of 60-70 years. Risk of development was higher in premenopausal women (RR=8.6, 95% CI: 3.5-21.3, $p{\leq}0.001$). Women with family history of breast cancer had highest rate (20.9%) of CBC (RR=5.4, 95% CI: 2.5-11.6, $p{\leq}0.001$). Use of hormonal therapy in hormone receptor positive patients was protective factor in occurrence of CBC but not significant (RR=0.7, 95% CI: 0.3-1.5, p=0.333). Conclusions: Younger age, premenopausal status, and presence of family history were found to be significant risk factors for the development of CBC. Use of hormonal therapy in hormone receptor positive patients might be protective against occurrence of CBC but did not reach significance.

신념함수모형(信念函數模型)에 관한 연구 (A Study on the Belief Function Model)

  • 김주택
    • 산학경영연구
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    • 제14권
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    • pp.31-44
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    • 2001
  • 현대의 회계감사는 피 감사회사의 재무제표에 대하여 합리적인 확신을 요구하기 때문에 피 감사 회사의 재무제표에 대하여 정밀감사를 실시하여 감사의견을 표명하는 것이 아니라 중요성의 원칙에 따라 피 감사회사의 재무제표에 대하여 표본감사를 실시하는 것을 원칙으로 하고 있기 때문에 감사위험이 필연적으로 발생한다. 감사위험이란 피 감사회사의 재무제표가 중요하게 잘못 표시되어 있음에도 불구하고 적정하게 표시되어 있는 것으로 잘못 판단하는 경우와 반대로 재무제표가 적정하게 표시되어 있음에도 이를 적정하게 표시되어 있지 아니한 것으로 잘못 판단하여 감사범위를 확대하는 경우가 있다. 지금까지의 감사위험은 주로 AICPA의 SAS NO. 47에서 발표한 감사위험모형을 사용하여 왔어나 이 모형은 감사위험수준의 결정문제와 감사인의 판단과정을 적정하게 절명하지 못하는 등의 부정적인 견해가 대두되고 있다. 한편 Dempster-Shafer의 신념함수(belief functions)모형은 수학적 증거이론(Mathematical Theory of Evidence)에 기초하여 주어진 자료가 불충분하고 부정확한 상황하에서 보다 정확한 정보를 얻기 위한 문제들을 다루기 위한 수학적 기법들을 제공하여 불확실한 상황에서 판단의 정확성을 높일 수 있게된다. 이러한 신념함수모형을 사용하여 감사위험모형 보다 판단과정을 더 정확히 묘사하는 것으로 나타나고 있다. 따라서 본 연구는 재무제표의 신뢰성을 제고하고 감사의 유효성과 효율성을 높이기 위하여 감사 위험모형의 문제점을 알아보고 신념함수모형에 대한 이론과 기존연구를 고찰하여 신념함수모형을 제시하고자 한다.

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모자건강관리를 위한 위험요인별 감별평점분류기준 개발에 관한 연구 (A Study on the Risk Factors for Maternal and Child Health Care Program with Emphasis on Developing the Risk Score System)

  • 이광옥
    • 대한간호학회지
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    • 제13권1호
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    • pp.7-21
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    • 1983
  • For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

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과학에 관련된 위험 인식과 대응의 역사와 특징 -혈압을 중심으로- (History and Characteristics of Risk Perception and Response Related to Science: Focused on Blood Pressure)

  • 장원빈;김민철
    • 한국과학교육학회지
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    • 제43권6호
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    • pp.549-562
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    • 2023
  • 최근 사회는 과학기술의 발달과 함께 인간이 생산하는 다양한 위험이 확산되는 VUCA 시대에 접어들었다. 시민들의 위험 소양 수준을 높여 이러한 위험에 대응할 수 있는 일상적인 대비를 강화할 필요가 있다. 이를 위해서 위험을 과학적이고 객관적으로 판단하고 대응할 수 있도록 과학 교육의 역할에 대한 재고가 필요하다. 이에 위험 사회에서 과학 교육의 역할을 규명하기 위해 본 연구는 과학과 관련된 위험 인식과 위험 대응의 역사를 검토하고 그 특징을 분석하였다. 이 과정에서 혈압으로 인해 발생하는 위험에 대한 인식과 대응을 세 가지 맥락(역사적 맥락, 교육과정 맥락, 교과서 맥락)에서 분석하였다. 역사적 맥락은 심혈관계 지식의 역사와 관련된 연구가 이루어진 학술지 중 SCIE에 등재된 학술지를 연구대상으로 선정하였다. 선정된 학술지에서 'Hypertenstion', 'History'라는 키워드로 논문을 선정하였고, 이를 시대별로 비교 분석하였다. 교육과정 맥락은 제1차 교육과정부터 2022 개정 교육과정까지 분석하였고, 혈압과 관련한 내용요소, 그리고 성취기준을 비교 분석하였다. 제1차부터 제6차 교육과정까지는 혈압으로 인해 발생하는 위험이 제시되지 않았고, 제7차 교육과정부터 혈압으로 인해 발생하는 위험이 포함된 것으로 확인되었다. 교과서 맥락은 제7차 교육과정 생물Ⅰ, 2015 개정 교육과정 생명과학Ⅰ 과 보건을 선정하여 텍스트 추출을 통해 교과목을 대표하는 키워드를 선정하였다. 이 키워드를 바탕으로 위험 인식과 위험 대응을 어떻게 제시하고 있는지 분석하였다. 그리고 교과서에서 제시된 자료들을 분석하여 위험 인식과 위험 대응의 특징을 도출하였다. 본 연구는 과학 교육에서 위험 인식과 위험 대응의 역할을 확인하였다는 점에서 의미를 갖는다.

Epigenetic Changes in Asthma: Role of DNA CpG Methylation

  • Bae, Da-Jeong;Jun, Ji Ae;Chang, Hun Soo;Park, Jong Sook;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • 제83권1호
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    • pp.1-13
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    • 2020
  • For the past three decades, more than a thousand of genetic studies have been performed to find out the genetic variants responsible for the risk of asthma. Until now, all of the discovered single nucleotide polymorphisms have explained genetic effects less than initially expected. Thus, clarification of environmental factors has been brought up to overcome the 'missing' heritability. The most exciting solution is epigenesis because it intervenes at the junction between the genome and the environment. Epigenesis is an alteration of genetic expression without changes of DNA sequence caused by environmental factors such as nutrients, allergens, cigarette smoke, air pollutants, use of drugs and infectious agents during pre- and post-natal periods and even in adulthood. Three major forms of epigenesis are composed of DNA methylation, histone modifications, and specific microRNA. Recently, several studies have been published on epigenesis in asthma and allergy as a powerful tool for research of genetic heritability in asthma albeit epigenetic changes are at the starting point to obtain the data on specific phenotypes of asthma. In this presentation, we mainly review the potential role of DNA CpG methylation in the risk of asthma and its sub-phenotypes including nonsteroidal anti-inflammatory exacerbated respiratory diseases.