• 제목/요약/키워드: Staging system

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Staging 영역을 활용한 분산 의료정보시스템 통합 (Integration of Distributed Medical Information System using Staging Area)

  • 전영희;박건우;이상훈
    • 한국정보과학회:학술대회논문집
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    • 한국정보과학회 2008년도 한국컴퓨터종합학술대회논문집 Vol.35 No.1 (C)
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    • pp.184-188
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    • 2008
  • 최근 국내 디지털 병원들이 점차 기업화 되면서 각 지역별 분산 및 독립 운영되는 의료통계 정보 활용의 중요성이 증대되고 있다. 또한 각종 연구목적 및 의료 서비스 경쟁력 향상 등을 위해 신속 정확한 의사결정지원 시스템인 데이터 웨어하우스(DW; Data Warehouse) 구축의 필요성이 대두되고 있다. 본 논문에서는 단일 병원 내의 데이터 웨어하우스가 아닌, 전국적으로 분산 운영되고 있는 병원의 다양한 의료정보를 통합하고자 한다. 따라서 Staging 영역을 활용한 분산된 의료정보시스템 통합 방안을 제시한다.

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영상처리기를 이용한 대상물체의 자동계측 (Auto-measurement of object by using image processor)

  • 백남칠;김영일;정영기;최호현
    • 제어로봇시스템학회:학술대회논문집
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    • 제어로봇시스템학회 1987년도 한국자동제어학술회의논문집; 한국과학기술대학, 충남; 16-17 Oct. 1987
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    • pp.484-487
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    • 1987
  • In order to measure object larger than the optical field-of-view most video measurement systems utilize some sort of precision staging mechanism, and to utilize such a staging systems, Auto-Measurement System implemented in this paper has a precision of its own which affect the overall repeatability of the measuring instrument.

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두경부암 병기 설정의 최신 변화: AJCC 암 병기설정 매뉴얼8판 (Update of Head and Neck Cancer Staging in the 8th Edition Cancer Staging Manual of the American Joint Committee on Cancer)

  • 홍현준
    • 대한두경부종양학회지
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    • 제33권2호
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    • pp.9-15
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    • 2017
  • The recently released the $8^{th}$ edition of the American Joint Committee on Cancer (AJCC) Staging Manual introduces significant modifications from the prior $7^{th}$ edition. In this paper, the contents of the new changes in the decision of cancer of the head and neck is summarized except changes in staging of skin and thyroid cancer. In addition to the 8th edition, 1) Addition of extracapsular involvement in metastatic lymph nodes (N category) 2) Oral cancer T classification change, 3) Staging of the pharyngeal cancer was divided into 3 chapters: high-risk human papilloma virus (HR-HPV) associated oropharyngeal cancer (OPC), non HR-HPV associated OPC and hypopharynx cancer (HPC), and nasopharynx cancer (NPC) 4) Changes in T and N classification in NPC, 5) In the case of cancer of unknown primary, P16-positive case is defined as HR-HPV related OPC, and EBV-positive case is defined as NPC. The process that led to these changes highlights the need to collect high-fidelity cancer registry-level data that can be used to confirm prognostic observations identified in institutional data sets. Clinicians will continue to use the latest information for patient care, including scientific content of the 8th Edition Manual. All newly diagnosed cases through December $31^{st}$ 2017 should be staged with the 7th edition. The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the 8th edition in 2018. The 8th edition strikes a balance between a personalized, complex system and a more general, simpler one that maintains the user-friendliness and worldwide acceptability of the traditional TNM staging paradigm.

비인강암에서 AJCC와 Ho 병기 결정법에 따른 T병기의 비교 (A Comparison of T Classification of the AJCC and Ho Staging Systems for Nasopharyngeal Carcinoma)

  • 이상욱;서인석;강미정;조석현;김경래;이형석
    • 대한두경부종양학회지
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    • 제18권2호
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    • pp.179-183
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    • 2002
  • Objective: A comparison of American Joint Committee on Cancer (AJCC) 1988 and 1997 nasopharyngeal carcinoma (NPC) classifications was made in terms of patient distribution and efficacy in predicting prognosis. Materials and Methods: Between Jan. 1981 and Dec. 1998, 60 cases of node negative nasopharyngeal carcinoma were retrospectively reviewed. The extent of disease each patients restaged according to the 4th and 5th AJCC system and Ho system, respectively. Results: The overall and disease free 5-year survival rates were 61.1% and 62.6%, respectively. Among T classifications of 4th AJCC, 5th AJCC and Ho staging system were not observed significantly different in disease-free survival rates, respectively. Conclusion: We observed a better patient distribution with AJCC 1997 comparing to AJCC 1988. The new classification also attained better statistical significances among stages in the overall survival and disease free survival rates was needed.

일개 대도시의 병원전 단계와 병원 단계의 중증도 분류체계 간의 결과 분석 (Comparison with in-hospital Korean Triage and Acuity Scale (KTAS) and prehospital triage system in a metropolitan city)

  • 최효정;김호중;이효주;이보라
    • 대한응급의학회지
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    • 제29권5호
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    • pp.391-398
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    • 2018
  • Objective: This study was conducted to analyze and compare the classifications of a prehospital triage system and an in-hospital triage system. Methods: The records of patients transferred from the '119' emergency service for 5 months (from January 1 to May 31, 2016) were collected and records of first aid activities were assessed. We examined cases classified as four (urgent, semi-urgent, potentially urgent, and non-urgent) of five stages, excluding death. In the hospital, data were collected from medical records and classifications made using the five Korean Triage and Acuity Scale (KTAS) stages (1, resuscitation; 2, emergency; 3, urgent; 4, less urgent; and 5, non-urgent) were analyzed. Results: The number of patients enrolled in the study was 3,457. Of them, 2,301 were discharged after treatment and 1,156 were hospitalized. According to the prehospital triage classification, 726 of the 3,457 cases were urgent, 593 were semi-urgent, 1,944 were potentially urgent, and 194 were non-urgent. The results of the in-hospital triage were as follows: 114 KTAS 1 (3.3%), 491 KTAS 2 (14.2%), 1,345 KTAS 3 (38.9%), 1,227 KTAS 4 (35.5%), and 280 KTAS 5 (8.1%). The odds ratio trend for hospitalization showed a larger decrease according to in-hospital staging (95% CI, 0.32-0.39) than according to prehospital staging (95% CI, 0.50-0.60). The odds ratio trend for intensive care unit (ICU) admission also showed a larger decrease according to in-hospital staging (95% CI, 0.16-0.22) than according to prehospital staging (95% CI, 0.37-0.48). Conclusion: We found little correspondence in classifications made according to the KTAS and prehospital triage systems. However, the tendencies toward decreases in the hospitalization and ICU admission rates were similar.

NO Reduction and High Efficiency Combustion by Externally Oscillated Staging Burner

  • Lim, Mun-Sup;Yang, Won;Chun, Young-Nam
    • Environmental Engineering Research
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    • 제14권3호
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    • pp.158-163
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    • 2009
  • It is difficult for a burner to achieve an increase in combustibility and a reduction of NOx emission, simultaneously. The reason is because thermal NOx could be reduced at low temperature, while the combustibility should be decreased. To solve this problem, an externally oscillated staging burner was developed, and experiment was conducted according to effective parameters. The combustibility could be improved through the accelerated transfer of heat, mass and momentum obtained by external oscillation. Also, NO is reduced by the decrease of residence time of burning gas in the local highest-temperature spot, which is decreased by the external oscillation and fuel staging. Experiments on variables were conducted to determine the reference flame, and the flame generating the lowest NO concentration was selected. The conditions of reference flame were oscillation frequency 250 Hz, sound pressure 1 VPP, and air ratio 1.1, and NO and CO concentrations were 1ppm and 20 ppm, respectively.

소세포폐암의 TNM 병기에 따른 예후 (Prognostic Value of TNM Staging in Small Cell Lung Cancer)

  • 박재용;김관영;채상철;김정석;김건엽;박기수;차승익;김창호;감신;정태훈
    • Tuberculosis and Respiratory Diseases
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    • 제45권2호
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    • pp.322-332
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    • 1998
  • 연구배경: 폐암환자에 있어서 병기판정은 적절한 치료방침과 환자의 예후를 예측하기 위해 필요하다. 소세포폐암은 진단시 광범위한 종격동침범이 있거나 전신적으로 전이된 경우가 많아 VALG이 제시한 two staging system이 주로 사용되어져왔다. 그러나 이러한 병기분류법은 환자의 예후 변별력에 한계가 있을 뿐 아니라 최근에는 완치 가능성이 높은 환자들을 대상으로 근치적절제술과 항암화학요법의 병용치료와 같은 보다 적극적인 치료들이 시도됨에 따라 균일하고 세분화된 병기분류의 필요성이 대두되고 있다. 저자들은 소세포폐암을 비소세포폐암과 같이 I, II, IIIa, IIIb 및 IV로 세분화되어 예후를 비교함으로써 소세포폐암의 경우에도 TNM 병기가 예후인자로서의 가치가 있는 지를 조사하였다. 대상 및 방법: 1989년 1월부터 1996년 12월까지 경북대학교 병원에서 소세포폐암으로 진단된 환자 166명 가운데 TNM 병기분류가 가능하였던 147명을 대상으로 하였으며, TNM 병기는 1997년에 새로이 개정된 International staging system에 의거하여 분류하였다. 환자의 생존여부는 환자기록부와 전화 및 우편조회로 조사하였으며 생존기간은 Kaplan-Meier method를 이용하여 산출하였고 생존기간의 차이는 log-rank test를 이용하여 비교하였다. 결 과: 전체대상환자 147예의 TNM 병기에 따른 중앙생존기간은 I/II기 18.5개월, IIIa기 11.3개월, IIIb가 9.4개월, 그리고 IV기가 5.4개월이었으며, 1년 및 2년 생존율은 I/II기의 경우 75% 와 37.5%, IIIa기는 46.7% 와 25.0%, IIIb기는 34.3% 와 11.3%, 그리고 IV기는 2.6%와 0%로 병기에 따라 유의한 차이가 있었다 (p<0.001). 2회 이상의 항암화학요법을 받은 84예의 TNM 병기에 따른 중앙생존기간은 I/II기 18.5개월, IIIa기 16.0개월, IIIb기 12.2개월, 그리고 병기 IV기 7.4개월이었으며, 1년 및 2년 생존율은 I/II기는 75%와 37.5%, IIIa기는 58.3%와 31.3%, IIIb기는 51.7%와 13.53%, 그리고 IV기는 3.8%와 0%로 병기에 따라 유의한 차이가 있었다(p<0.001). 병기에 따른 중앙생존기간과 생존율은 I-IIIb기는 IV 기와 유의한 차이가 있었고, 병기 I/II는 IIIa기와는 유의한 차이는 없었으나 IIIb기와는 유의한 차이가 있었으며, 병기 IIIa는 IIIb기에 비해 중앙생존기간 및 2년 생존율이 높았으나 통계학적으로 유의한 차이는 없었다. I-IIIb에서 T 병기와 N병기에 따른 예후는 전체환자와 2회 이상 항암화학요법을 받은 환자모두에서 T1-2와 T3와 T4에 비해 양호하였으며 T3와 T4는 차이가 없었고, N2는 N3에 비해 중앙 생존기간과 2년 생존율이 높았으나 통계학적 유의성은 없었다. 결 론: 이상의 결과로 소세포폐암의 경우에도 TNM 병가분류가 예후를 예측할 수 있는 인자로 생각되며, 제한기의 환자들만을 대상으로 하는 전향적인 연구는 환자들을 TNM 병기를 고려하여 환자들을 보다 세분화하는 것이 좋을 것 같다. 그러나 TNM 병기분류가 임상에서 적용되기 위해서는 보다 많은 환자들을 대상으로 한 연구가 필요할 것으로 생각된다.

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The International Association for the Study of Lung Cancer Lymph Node Map: A Radiologic Atlas and Review

  • Kim, Jin Hwan;van Beek JR, Edwin;Murchison, John T;Marin, Aleksander;Mirsadraee, Saeed
    • Tuberculosis and Respiratory Diseases
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    • 제78권3호
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    • pp.180-189
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    • 2015
  • Accurate lymph node staging of lung cancer is crucial in determining optimal treatment plans and predicting patient outcome. Currently used lymph node maps have been reconciled to the internationally accepted International Association for the Study of Lung Cancer (IASLC) map published in the seventh edition of TNM classification system of malignant tumours. This article provides computed tomographic illustrations of the IASLC nodal map, to facilitate its application in day-to-day clinical practice in order to increase the appropriate classification in lung cancer staging.

공기 다단 연소 기법 적용에 따른 미연탄소분 및 질소산화물 배출특성 (Characteristics of UBC and NOx Emission in Air Staging Combustion)

  • 김정우;임호;고영건;전충환
    • 대한기계학회논문집B
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    • 제40권10호
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    • pp.637-644
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    • 2016
  • 본 연구의 목적은 석탄 입자 연소 시 공기 다단 연소 적용에 따른 UBC(Unburned Carbon) 및 질소 산화물(NOx) 배출 특성을 분석하는 것이다. 이를 위해 공기 다단 연소가 가능한 2단 하향 분류층 반응기(Two Staged Drop Tube Furnace, Two Staged DTF)를 설계 및 제작하였다. 아역청탄(Tanito)의 단일 및 다단 연소 실험을 진행하여 UBC 및 NOx 배출 특성을 분석하였다. 그 결과, 단일 연소 조건에서 온도 및 공기비가 증가함에 따라서 UBC 함량이 감소했지만 NOx의 농도는 증가했다. 특히 과농 연료 연소 영역에서 NOx 저감 반응이 일어났으며, 이때 반응 온도가 증가할수록 NOx 저감 반응이 활성화 될 뿐아니라 UBC는 감소되었다. 공기 다단 연소 실험의 경우 석탄 입자의 UBC 증가량에 비해 높은 NOx 저감 효과를 얻을 수 있었다.

비소세포폐암 환자의 국소 림프절 전이 발견을 위한 FDG PET의 이용 (The Use of FDG PET for Nodal Staging of Non-Small-Cell Lung Cancer)

  • 백희종;박종호;최창운;임상무;최두환;조경자;원경준;조재일
    • Journal of Chest Surgery
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    • 제32권10호
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    • pp.910-915
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    • 1999
  • Background: Positron emission tomography(PEFT) using fluorine-18 deoxyglucose(FDG), showing increased FDG uptake and retention in malignant cells, has been proven to be useful in differentiating malignant from benign tissues. We indertook the prospective study to compare the accuracy of the whole-body FDG PET with that of the conventional chest computed tomography(CT) for nodal staging of non-small-cell lung cancers(NSCLC). Material and Method: FDG PET and contrast enhanced CT were performed in 36 patients with potentially resectable NSCLC. Each Imaging study was evaluated independently, and nodal stations were localized according to the AJCC regional lymph nodes mapping system. Extensive lymph node dissection(1101 nodes) of ipsi- and contralateral mediastinal nodal stations was performed at thoracotomy and/or mediastinoscopy. Image findings were compared with the histopathologic staging results and were analyzed with the McNema test(p) and Kappa value(k). Result: The sensitivity, specificity, positive predictive value, and negative predictive value of CT for ipsilateral mediastinal nodal staging were 38%, 68%, 25%, 79%, and 61%, and those of PET were 88%, 71%, 47%, 95%, and 75%(p>0.05, K=0.29). When analyzed by individual nodal group(superior, aortopulmonary window, and inferior), the sensitivity, specificity, positive predictive value, and negative predictive value of CT were 27%, 82%, 22%, 85%, and 73%, and those of PET were 60%, 87%, 92%, and 82%(p<0.05, k=0.27). Conclusion: FDG PET in addition to CT appears to be superior to CT alone for mediastinal staging of non-small cell lung cancers.

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