• 문화기술의 융합
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• 제10권1호
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• pp.153-158
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• 2024

최근 중국의 부동산발 신용위험 확산에 대한 우려가 점차 증가하는 가운데, 중국 상업은행의 경영안정성을 진단하는 것은 매우 의의가 있을 것이다. 본 연구는 부동산시장의 주택가격이 중국 상업은행의 대출비중과 경영안정성에 미치는 영향을 분석하고자 한다. 또한 중국 상업은행을 규모별로 구분하여 대출비중과 경영안정성에 차이가 있는지를 검증하고자 한다. 규모별로 차이가 존재한다면, 부동산가격 변동과의 교호작용에 의한 효과인지도 검증한다. 분석결과를 요약하면 다음과 같다. 첫째, 주택가격상승률이 증가할수록 중국 상업은행의 대출비중이 증가하는 것으로 나타났다. 둘째, 주택가격상승률과 총대출비중이 증가할수록 중국 상업은행의 경영안정성은 낮아지는 것으로 나타났다. 셋째, 규모가 큰 은행일수록 대출비중이 더 높은 것으로 분석되었으며, 규모가 작은 은행일수록 경영안정성이 더 큰 것으로 나타났다. 이러한 분석결과는 중국 상업은행의 수익성 제고를 위한 공격적인 대출비중 확대는 경영안정성을 저해함을 시사하고 있다. 따라서 경영안정성을 제고하기 위해 대출비중을 적정규모 수준으로 조정하여 변동성을 줄이고 대출규모에 따른 차별화된 전략으로 안정성을 확보해 나가기 위한 실무적 전략이 요구된다.

• 방사선산업학회지
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• 제17권1호
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• pp.33-44
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• 2023

The deep geological repository of high-level radioactive waste shall be designed to meet the safety objective set in the form of radiation dose or corresponding risk to protect human and the environment from radiation exposure. Engineering feasibility and conformity with the safety objective of the facility conceptual design can be demonstrated by comparing the assessment result using the computational model for scenario(s) describing the radionuclide release and transport from repository to biosphere system. In this study, as the preliminary study for developing the high-level radioactive waste disposal facility in Korea, we reviewed and analyzed the entire list of FEPs and how to handle each FEP from a general point of view, which are selected for the geosphere region in the radiological safety assessment performed for the license application of the KBS-3 type deep geological repository in Finland and Sweden. In Finland, five FEPs (i.e., stress redistribution, creep, stress redistribution, erosion and sedimentation in fractures, methane hydrate formation, and salt exclusion) were excluded or ignored in the radionuclide release and transport assessment. And, in Sweden, six FEPs (i.e., creep, surface weathering and erosion, erosion/sedimentation in fractures, methane hydrate formation, radiation effects (rock and grout), and earth current) were not considered for all time frames and earthquake out of a total of 25 FEPs for the geosphere. Based on these results, an FEP list (draft) for the geosphere was derived, and the relative importance of each item was evaluated for conducting the radiological safety assessment of the domestic deep geological disposal facility. Since most of information on the disposal facility in Korea has not been determined as of now, it is judged that all FEP items presented in Table 3 should be considered for the radiological safety assessment, and the relative importance derived from this study can be used in determining whether to apply each item in the future.

• Korean Circulation Journal
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• 제54권6호
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• pp.311-322
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• 2024

Background and Objectives: Early diastolic mitral annular tissue (e') velocity is a commonly used marker of left ventricular (LV) diastolic function. This study aimed to investigate the prognostic implications of e' velocity in patients with mitral regurgitation (MR). Methods: This retrospective cohort study included 1,536 consecutive patients aged <65 years with moderate or severe chronic primary MR diagnosed between 2009 and 2018. The primary and secondary outcomes were all-cause and cardiovascular mortality, respectively. According to the current guidelines, the cut-off value of e' velocity was defined as 7 cm/s. Results: A total of 404 individuals were enrolled (median age, 51.0 years; 64.1% male; 47.8% severe MR). During a median 6.0-year follow-up, there were 40 all-cause mortality and 16 cardiovascular deaths. Multivariate analysis revealed a significant association between e' velocity and all-cause death (adjusted hazard ratio [aHR], 0.770; 95% confidence interval [CI], 0.634-0.935; p=0.008) and cardiovascular death (aHR, 0.690; 95% CI, 0.477-0.998; p=0.049). Abnormal e' velocity (≤7 cm/s) independently predicted all-cause death (aHR, 2.467; 95% CI, 1.170-5.200; p=0.018) and cardiovascular death (aHR, 5.021; 95% CI, 1.189-21.211; p=0.028), regardless of symptoms, LV dimension and ejection fraction. Subgroup analysis according to sex, MR severity, mitral valve replacement/repair, and symptoms, showed no significant interactions. Including e' velocity in the 10-year risk score improved reclassification for mortality (net reclassification improvement [NRI], 0.154; 95% CI, 0.308-0.910; p<0.001) and cardiovascular death (NRI, 1.018; 95% CI, 0.680-1.356; p<0.001). Conclusions: In patients aged <65 years with primary MR, e' velocity served as an independent predictor of all-cause and cardiovascular deaths.

• 한국간담췌외과학회지
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• 제26권1호
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• pp.84-90
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• 2022

Backgrounds/Aims: Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) remains a dreadful complication. Duct-to-mucosa pancreaticojejunostomy (DTMPJ) is a commonly performed anastomosis after PD. This study aims to evaluate whether there is a size limit of pancreatic duct below which POPF rate increases significantly after DTMPJ. Methods: A retrospective study was performed from a database with prospectively collected data on consecutive patients undergoing DTMPJ. Results: Between the years 2003 and 2019, a total of 288 patients with DTMPJ were recruited. POPF occurred in 56.3% of the patients, of which 43.8% were biochemical leak, 8.7% were grade B, and 1.4% were grade C. Overall operative morbidity was 51.4%, of which 19.1% were major complications. Five patients (1.7%) died within 90 days of operation. Patients with grade B/C POPF had significantly soft pancreas (p < 0.001), smaller duct size (p = 0.031), and a diagnosis of carcinoma of the pancreas (p = 0.027). When a clinically significant POPF rate was analysed based on the pancreatic duct diameter, pancreatic duct size ≤ 1 mm had the highest POPF rate (35.7%). There was a significant difference in POPF rate between adjacent ductal diameter ≤ 1 mm and > 1 mm to 2 mm (35.7% vs 13.3%; p = 0.040). Multivariable analysis showed that for the soft pancreas, pancreatic duct diameter ≤ 1 mm was the only significant predictive factor for POPF (p = 0.027). Conclusions: DTMPJ can be safely performed for pancreatic duct > 1 mm without significantly increased POPF risk.

• 한국간담췌외과학회지
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• 제26권4호
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• pp.386-394
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• 2022

Splenic artery steal syndrome (SASS) is a cause of graft hypoperfusion leading to the development of biliary tract complications, graft failure, and in some cases to retransplantation. Its management is still controversial since there is no universal consensus about its prophylaxis and consequently treatment. We present a case of SASS that occurred 48 hours after orthotopic liver transplantation (OLTx) in a 56-year-old male patient with alcoholic cirrhosis and severe portal hypertension, and who was successfully treated by splenic artery embolization. A literature search was performed using the PubMed database, and a total of 22 studies including 4,789 patients who underwent OLTx were relevant to this review. A prophylactic treatment was performed in 260 cases (6.2%) through splenic artery ligation in 98 patients (37.7%) and splenic artery banding in 102 (39.2%). In the patients who did not receive prophylaxis, SASS occurred after OLTx in 266 (5.5%) and was mainly treated by splenic artery embolization (78.9%). Splenic artery ligation and splenectomies were performed, respectively, in 6 and 20 patients (2.3% and 7.5%). The higher rate of complications registered was represented by biliary tract complications (9.7% in patients who received prophylaxis and 11.6% in patients who developed SASS), portal vein thrombosis (respectively, 7.3% and 6.9%), splenectomy (4.8% and 20.9%), and death from sepsis (4.8% and 30.2%). Whenever possible, prevention is the best way to approach SASS, considering all the potential damage arising from an arterial graft hypoperfusion. Where clinical conditions do not permit prophylaxis, an accurate risk assessment and postoperative monitoring are mandatory.

• Annals of Occupational and Environmental Medicine
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• 제34권
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• pp.31.1-31.14
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• 2022

Background: This study aimed to investigate the characteristics of work-related musculoskeletal disorders (WRMSDs) in occupational disease claims and identify patterns of WRMSDs for each body part by industry and occupation. Methods: This study analyzed the raw data of occupational disease claims for musculoskeletal disorders deliberated by the Occupational Disease Decision Committee of the Korea Workers' Compensation & Welfare Service in 2020. The data was classified into 6 body parts with the highest numbers of occupational disease cases by using the complete enumeration data on principal diagnoses and 4 types of subdiagnoses in the raw data. The characteristics and approval rates of WRMSDs by body part, industry and occupation were examined and summarized. Results: A total of 13,015 occupational disease cases for WRMSDs were classified, and lumbar spinal (back) diseases accounted for the largest proportion of claimed diseases, followed by shoulder, elbow, wrist, knee, and neck diseases in a descending order. The occupations with the highest and second highest numbers of occupational disease cases by body part were found to be automobile assemblers and production-related elementary workers for the neck, school meal service workers and cooks for the back, construction frame mold carpenters and school meal service workers for the shoulder, elementary workers in mining and food service workers for the elbow, food service workers and automobile parts assemblers for the wrist, and ship welders and school meal service workers for the knee. Conclusions: This study examined the characteristics and approval status of WRMSDs by body part and occupation. Based on the study results, management strategies for the prevention of WRMSDs should be established regarding occupations with a high risk of WRMSDs for each body part.

• Korean Journal of Radiology
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• 제25권7호
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• pp.634-643
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• 2024

Objective: This study aimed to evaluate the diagnostic efficacy and safety of low-contrast-dose, dual-source dual-energy CT before transcatheter aortic valve replacement (TAVR) in patients with compromised renal function. Materials and Methods: A total of 54 consecutive patients (female:male, 26:38; 81.9 ± 7.3 years) with reduced renal function underwent pre-TAVR dual-energy CT with a 30-mL contrast agent between June 2022 and March 2023. Monochromatic (40- and 50-keV) and conventional (120-kVp) images were reconstructed and analyzed. The subjective quality score, vascular attenuation, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were compared among the imaging techniques using the Friedman test and post-hoc analysis. Interobserver reliability for aortic annular measurement was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. The procedural outcomes and incidence of post-contrast acute kidney injury (AKI) were assessed. Results: Monochromatic images achieved diagnostic quality in all patients. The 50-keV images achieved superior vascular attenuation and CNR (P < 0.001 in all) while maintaining a similar SNR compared to conventional CT. For aortic annular measurement, the 50-keV images showed higher interobserver reliability compared to conventional CT: ICC, 0.98 vs. 0.90 for area and 0.97 vs. 0.95 for perimeter; 95% limits of agreement width, 0.63 cm² vs. 0.92 cm² for area and 5.78 mm vs. 8.50 mm for perimeter. The size of the implanted device matched CT-measured values in all patients, achieving a procedural success rate of 92.6%. No patient experienced a serum creatinine increase of ≥ 1.5 times baseline in the 48-72 hours following CT. However, one patient had a procedural delay due to gradual renal function deterioration. Conclusion: Low-contrast-dose imaging with 50-keV reconstruction enables precise pre-TAVR evaluation with improved image quality and minimal risk of post-contrast AKI. This approach may be an effective and safe option for pre-TAVR evaluation in patients with compromised renal function.

• Korean Circulation Journal
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• 제52권8호
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• pp.606-620
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• 2022

Background and Objectives: Protein-losing enteropathy (PLE) is a devastating complication after the Fontan operation. This study aimed to investigate the clinical characteristics, treatment response, and outcomes of Fontan-associated PLE. Methods: We reviewed the medical records of 38 patients with Fontan-associated PLE from 1992 to 2018 in 2 institutions in Korea. Results: PLE occurred in 4.6% of the total 832 patients after the Fontan operation. After a mean period of 7.7 years after Fontan operation, PLE was diagnosed at a mean age of 11.6 years. The mean follow-up period was 8.9 years. The survival rates were 81.6% at 5 years and 76.5% at 10 years. In the multivariate analysis, New York Heart Association Functional classification III or IV (p=0.002), low aortic oxygen saturation (<90%) (p=0.003), and ventricular dysfunction (p=0.032) at the time of PLE diagnosis were found as predictors of mortality. PLE was resolved in 10 of the 38 patients after treatment. Among medical managements, an initial heparin response was associated with survival (p=0.043). Heparin treatment resulted in resolution in 4 patients. We found no evidence on pulmonary vasodilator therapy alone. PLE was also resolved after surgical Fontan fenestration (2/6), aortopulmonary collateral ligation (1/1), and transplantation (1/1). Conclusions: The survival rate of patients with Fontan-associated PLE has improved with the advancement of conservative care. Although there is no definitive method, some treatments led to the resolution of PLE in one-fourth of the patients. Further investigations are needed to develop the best prevention and therapeutic strategies for PLE.

• Korean Circulation Journal
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• 제52권7호
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• pp.544-555
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• 2022

Background and Objectives: The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI). Methods: A total of 3,075 patients with chronic CAD were included from the Grand Drug-Eluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers. Results: During a median (interquartile range) follow-up of 3.1 (3.0-3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63-1.24), all-cause death (HR, 0.87; 95% CI, 0.60-1.25), and MI (HR, 1.25; 95% CI, 0.49-3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/or revascularization (HR, 0.38; 95% CI, 0.14-0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers. Conclusions: Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization.

• 한국유기농업학회지
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• 제32권2호
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• pp.233-245
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• 2024

고추재배지에 6월 7일부터 8월 26일까지 총 7회 항생제가 처리된 토양중 항생제의 잔류량을 조사한 결과, 조사대상 3종의 항생제(아목시실린, 옥시테트라사이클린 및 클로르테트라사이클린) 모두 background level에서 검출되지 않았으나, background 농도의 10배 농도 처리구와 50배 농도 처리구에서는 2-10 ㎍/kg 이상 수준으로 검출되었다. 자연함유량 수준의 50배 농도 수준으로 고농도로 처리된 경우에도 고추잎(줄기)과 고추 과실에서 모두 검출한계 미만으로 나타났고, 고추뿌리에서만 미량으로 검출되어 농작물의 안전성이 확보된 것으로 판단되지만 다양한 환경에서 다양한 항생제를 대상으로 작물체로의 흡수이행 및 토양환경중 잔류에 대한 장기적인 환경영향평가가 필요할 것으로 판단된다. Background level의 농도 처리구에서는 TF 값이 0으로 나타났으나, backgroud level의 10배 농도 처리구에서 TF 값은 아목시실린 0.45, 옥시테트라사이클린 0.17 클로로테트라사이클린 0.18 이하로 나타났고, background level의 50배 농도 처리구에서 TF 값은 아목시실린 0.52, 옥시테트라사이클린 0.16, 테트라사이클린 0.15 이하로 나타났다. 단기간에 축산용 항생제가 비의도적으로 농경지 토양에 유입될 경우 농경지 토양환경과 농작물 안전성은 우려할 만한 수준은 아니지만, 장기적이고 지속적으로 축산용 항생제가 농경지 토양에 유입될 경우에는 바람직하지 못한 영향을 끼칠 수 있으므로 모니터링과 환경영향평가가 수행되어야 할 것이다.