• Title/Summary/Keyword: alternative sensitivity

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Development of a simplified malnutrition screening tool for hospitalized patients and evaluation of its inter-methods reliability (입원환자의 초기영양평가를 위한 단순영양검색도구 개발 및 도구 간 신뢰도 검증)

  • Yun, Oak Hee;Lee, Gyuhwi;Park, Yoon Jung
    • Journal of Nutrition and Health
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    • v.47 no.2
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    • pp.124-133
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    • 2014
  • Purpose: The current study was designed for development of a simplified malnutrition screening tool (SMST) for hospitalized patients using readily available laboratory and patient information and for evaluation of its reliability compared to well-established tools, such as PGSGA and NRS-2002. Methods: Anthropometric and biochemical measurements, as well as a few subjective assessments, of 903 patients who were preclassified by their nutritional status according to PGSGA were analyzed. Among them, a combination of factors, including age, BMI, albumin, cholesterol, total protein, hematocrit, and changes in body weight and food intake, were statistically selected as variables for SMST. Results: According to SMST, 620 patients (68.7%) were classified as the normal group and 283 patients (31.3%) were classified as the malnutrition group. Significant differences in age, albumin, TLC, BMI, hemoglobin, hematocrit, total protein, cholesterol, and length of stay were observed between the two groups. For inter-methods reliability, the screening results by SMST were compared with those by PGSGA and NRS-2002. The comparison with PGSGA and NRS-2002 showed 'Substantial agreement' (sensitivity 94.4%, specificity 88.4%, ${\kappa}$ = 0.747) and 'Moderate agreement' (sensitivity 96.1%, specificity 79.5%, ${\kappa}$ = 0.505), respectively, indicating that SMST held high inter-methods reliability. Conclusion: In conclusion, SMST, based on readily available laboratory and patient information and simple subjective assessments on changes in food intake and body weight, may be a useful alternative tool with a simple but reliable risk index, especially in resource-limited domestic hospitals.

Searching for a Curriculum to Reconceptualize Sexuality for Youth Sex Education : Nth Room Era, New Talk of 'Body' and 'Sex' from a Feminist Theological Point of View (청소년 성교육을 위한 성성(性性)의 재개념화 커리큘럼 모색 : N번방 시대, 여성신학적 관점에서 '몸'과 '성'을 새롭게 이야기하다)

  • Lee, Jooah
    • Journal of Christian Education in Korea
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    • v.67
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    • pp.301-337
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    • 2021
  • The researcher looked at the differences in views and various controversies surrounding Korean youth sexuality education in the wake of the Nth Room incident, which had a great impact on modern Korean society. Sex education for adolescents in Korea can be divided into public sex education through school sex education and the Youth Sexuality Center, and conservative/traditional Protestant sex education. Public sex education is partly influenced by feminist sexual ethics and comprehensive sex education abroad. Based on gender sensitivity and the right to sexual self-determination, four major projects are prevention of sexual harassment, prostitution, sexual violence, and domestic violence. However, the school sex education standard was criticized for stereotypes of gender roles and gender-discriminatory content, reinforced distorted myths about sexual violence, and exclusion of sexual diversity and various family types. Conservative/traditional Protestantism is based on the normal family ideology such as bisexual marriage, premarital chastity, and sexual ethics recognized only within marital relationships. It is a form of confrontation with public sex education while strongly opposing it. The researcher first analyzed the characteristics of public sex education, conservative/traditional Protestant sexual ethics and sex education, feminist sex ethics and sex education, and overseas youth sex education, respectively, while composing the curriculum for Korean youth sexuality education. And as a more fundamental solution to youth sexuality education, I pointed out that there are limits to asceticism, premarital chastity, gender sensitivity and sexual self-determination education, and found an alternative to the concept of body and sex in feminist theology. The researcher pointed out that it is necessary to reconceptualize the body and sex under the recognition that the most fundamental cause of distorted sexual culture is dualistic sex and understanding the body, centering on the research of various feminist theologians. And this was conceptualized into three concepts: holistic sexuality, mutual solidarity understood in relationships with others, and sexuality as a spirituality that extends to the global community. And with each curriculum, 1) Holistic Sexuality: Breathing, Narrative, Making the Shape of One's Body and Mind 2) mutual solidarity : Feeling the Breath of Others, Media Literacy through Conscientization, Sending a Good Wind 3) Sexuality as a spirituality that extends to global concern: It was proposed to pay attention to nature and to co-cultivate it, to listen to the earth's moans and create a new way of life, and to write a prayer with the earth and fellow living beings.

The Role and Efficacy of Diagnostic Laparoscopy to Detect the Peritoneal Recurrence of Gastric Cancer (복막 전이가 의심되는 위암 환자에서 진단적 복강경 검사의 의의와 역할)

  • Song, Sun-Choon;Lee, Sang-Lim;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.51-56
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    • 2009
  • Purpose: Peritoneal recurrence has been reported to be the most common form of recurrence of gastric cancer. Peritoneal recurrence can generally be suggested by several types of image studies and also if there is evidence of ascites or Bloomer's rectal shelf. It can be confirmed by explorative laparotomy, but diagnostic laparoscopy is a good alternative method and laparoscopic surgery has also been widely used. We reviewed and analyzed the ability of diagnostic laparoscopy to detect peritoneal recurrence or carcinomatosis, and especially for gastric cancer. Materials and Methods: We performed a retrospective review the 45 gastric cancer patients who were operated via diagnostic laparoscopy between 2004. 2. and 2009. 3. We analyzed the perioperative clinical characteristics and the accuracy of the diagnostic methods. Results: The study groups included 14 patients who had confirmed gastric cancer, but they suspected to have carcinomatosis, and 31 patients who had previously underwent gastric resection, but they suspected to have recurrence. The mean operation time was $44.1\pm26.9$ minutes and the mean postoperative hospital stay was $2.7\pm2.8$ days. There was one case of operation-related complication and no postoperative mortality occurred. The sensitivities for detecting peritoneal recurrence or carcinomatosis were 92.1% for diagnostic laparoscopy, 29.7% for detecting ascites and rectal shelf on the physical examination, 86.5% for abdominal computed tomography, 69.2% for PET CT and 18.8% for CEA. Conclusion: Diagnostic laparoscopy does not require a long operation time or a long hospital stay, and it showed a low complication rate in our study. It has high sensitivity for detecting peritoneal recurrence of gastric cancer. It can be an alternative diagnostic confirmative method and it is useful for deciding on further treatment.

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Development of B4C Thin Films for Neutron Detection (스퍼터링 코팅기법을 이용한 중성자 검출용 B4C 박막 개발)

  • Lim, Chang Hwy;Kim, Jongyul;Lee, Suhyun;Cho, Sang-Jin;Choi, Young-Hyun;Park, Jong-Won;Moon, Myung Kook
    • Journal of Radiation Protection and Research
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    • v.40 no.2
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    • pp.79-86
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    • 2015
  • $^3He$ gas has been used for neutron monitors as the neutron converter owing to its advantages such as high sensitivity, good ${\gamma}$-discrimination capability, and long-term stability. However, $^3He$ is becoming more difficult to obtain in last few years due to a global shortage of $^3He$ gas. Accordingly, the cost of a neutron monitor using $^3He$ gas as a neutron converter is becoming more expensive. Demand on a neutron monitor using an alternative neutron conversion material is widely increased. $^{10}B$ has many advantages among various $^3He$ alternative materials, as a neutron converter. In order to develop a neutron converter using $^{10}B$ (actually $B_4C$), we calculated the optimal thickness of a neutron converter with a Monte Carlo simulation using MCNP6. In addition, a neutron converter was fabricated by the Ar sputtering method and the neutron signal detection efficiencies were measured with respect to various thicknesses of fabricated a neutron converter. Also, we developed a 2-dimensional multi-wire proportional chamber (MWPC) for neutron beam profile monitoring using the fabricated a neutron converter, and performed experiments for neutron response of the neutron monitor at the 30 MW research reactor HANARO at the Korea Atomic Energy Research Institute. The 2-dimensional MWPC with boron ($B_4C$) neutron converter was proved to be useful for neutron beam monitoring, and can be applied to other types of neutron imaging.

Economic Value of the Sirolimus Eluting Stent($CYPHER^{TM}$) in Treating Acute Coronary Heart Disease (관상동맥질환 치료를 위한 시롤리무스 방출 스텐트 ($CYPHER^{TM}$)의 경제성 분석)

  • Lee, Hoo-Yeon;Park, Eun-Cheol;Park, Ki-Dong;Park, Ji-Eun;Kim, Young;Lee, Sang-Soo;Kang, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.339-348
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    • 2003
  • Objective : To quantify the economic value of the Sirolimus fluting Stent ($CYPHER^{TM}$) in treating acute coronary heart disease (CMD), and to assist in determining an adequate level of reimbursement for $CYPHER^{TM}$ in Korea. Methods : A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of $CYPHER^{TM}$ versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization, The follow-vp costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Defending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were peformed for discount rates of 3, 5 and 7%. Since the major clinical advantage of $CYPHER^{TM}$ over conventional stenting was the reduction in the revascularization rates, the economic value of $CYPHER^{TM}$, in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of $CYPHER^{TM}$ per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, $CYPHER^{TM}$ would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of $CYPHER^{TM}$ making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. Results : The average weighted initial insurance covered and total medical costs of conventional stenting were about 6,275,000 and 8,058,000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13,659,000 and 17,353,000 Won, respectively. The estimated maximum level of reimbursement price of $CYPHER^{TM}$ from the perspectives of the insurer and society were $4,126,897{\sim}4,325,161$ and $4,939,939{\sim}5,078,181$ Won, respectively. Conclusion : By evaluating the economic value of $CYPHER^{TM}$, as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for $CYPHER^{TM}$.

Comparison of the Standard Culture Method and Real-time PCR for the Detection of Vibrio parahaemolyticus in Seafoods and Vegetables (해산식품과 채소에서 Vibrio parahaemolyticus 검출을 위한 배지배양법과 real-time PCR의 비교검증)

  • Chon, Jung-Whan;Hyeon, Ji-Yeon;Hwang, In-Gyun;Kwak, Hyo-Sun;Han, Jeong-A;Chung, Yun-Hee;Song, Kwang-Young;Seo, Kun-Ho
    • Korean Journal of Food Science and Technology
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    • v.42 no.3
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    • pp.355-360
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    • 2010
  • Vibrio parahaemolyticus (V. parahaemolyticus), which is commonly found in raw seafood, causes gastroenteritis in humans. Rapid and effective methods have been developed as culture methods require up to 5-7 days. In this study, real-time PCR was compared with the standard culture method for detecting V. parahaemolyticus in seafood and radish sprout samples. Five hundred grams of the samples were artificially contaminated with V. parahaemolyticus then divided into 20 samples. The samples were incubated in alkaline peptone water and then streaked onto thiosulfate-citrate-bile saltssucrose agar. Biochemical tests for suspicious colonies were performed using the API 20NE strip. In parallel, real-time PCR was performed targeting the toxR gene using the enrichment broth. The real-time PCR was sensitive in discriminating V. parahaemolyticus from other foodborne pathogens. The detection limit of the real-time PCR was $10^3\;CFU/mL$ in phosphate-buffered saline. Although the real-time PCR detected more positive samples (76 out of 180, 42%) than the culture method (66 out of 180, 37%), there was no significant statistical difference (p>0.05) between the two methods. In conclusion, real-time PCR assays could be an alternative to the standard culture method for detecting V. parahaemolyticus in seafood and radish sprouts, which has many advantages in terms of detection time, labor, and sensitivity.

Voiding cystourethrography in children with an initial episode of febrile urinary tract infection (생후 처음으로 발생한 발열성 요로감염 환자의 배뇨성 방광 요도 조영술)

  • Lee, Hae Jeong;Lee, Won Deok;Kim, Hyun Seok;Kim, Tae Hong;Lee, Joo Seok;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.653-658
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    • 2006
  • Purpose : Because voiding cystourethrography(VCUG) is an invasive method, we studied whether VCUG could be postponed through evaluation of alternative non-invasive tests including renal ultrasonography and $^{99m}Tc$-DMSA renal scan. Methods : We reviewed the medical records of 175 patients initially diagnosed with febrile urinary tract infection during the one year period of 1999, and compared 3-tests : renal ultrasongraphy, $^{99m}Tc$-DMSA renal scan, and VCUG. Results : Renal ultrasonography didn't contribute to the prognostication of pyelonephritis(photopenic areas) or vesicoureteral reflux(VUR). Presentation of photopenic areas in $^{99m}Tc$-DMSA renal scan was related to VUR. If both findings of renal ultrasonography and $^{99m}Tc$-DMSA renal scans were normal, this condition was closely related to normal results in VCUG. And if both examinations were abnormal, the condition was closely related to VUR. But this state could not always guarantee the normal result from VCUG because of low sensitivity in finding VUR. Conclusion : In cases in which acute phyelonephritis is demonstrated by $^{99m}Tc$-DMSA renal scan, VCUG is required. In addition to this, if the conditions of hydronephrosis, vesicoureteral dilatation, increases of renal volume, and changes of echogenesity are shown by renal ultrasonography, VCUG should be performed. If a patient has difficulty undergoing VCUG, temporary postponement of VCUG can be taken into consideration, but only in cases where both examinations of renal ultrasonography and $^{99m}Tc$-DMSA renal scan are normal. Nevertheless, close observation is be advised even in this case.

Perspective on Rapid and Selective Method for Detecting Microbiology in Dairy Industry: A Review (낙농산업에 필요한 미생물 검사방법과 전망: 총설)

  • Chon, Jung-Whan;Kim, Hyun-Sook;Kim, Hong-Seok;Kim, Dong-Hyeon;Song, Kwang-Young;Yim, Jin-Hyuk;Choi, Dasom;Lim, Jong-Soo;Jeong, Dong-Gwan;Kim, Soo-Ki;Seo, Kun-Ho
    • Journal of Dairy Science and Biotechnology
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    • v.33 no.2
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    • pp.119-127
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    • 2015
  • To date, detection of microbial populations in dairy products has been performed using culture media, which is a time-consuming and laborious method. The recently developed chromogenic media could be more rapid and specific than classical culture media. However, the newly developed molecular-based technology can detect microbial populations with greater rapidity and sensitivity than the classical method involving culture media and chromogenic media. This molecular-based technology could provide various options for monitoring the characterization of different states of bacteria and cells. Thus, it could help upgrade the processing system of the dairy industry so as to maintain the safety and quality of dairy foods. Among the various newly developed molecular-based technologies, flow cytometry can potentially be used for monitoring microbiological populations in the dairy industry if official international standards are available for this purpose. When omics technology would have biomarker identification, it could be regarded as the rapid and sensitive analytical methods. Methods based on PCR, which has become a basic technique in microbiological research, can be developed and validated as alternative methods for quantification of dairy microorganisms. This review discusses methods for monitoring microbiological populations in dairy foods and the limitations of these studies, as well as the need for further research on such methods in the dairy industry.

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Methods of Incorporating Design for Production Considerations into Concept Design Investigations (개념설계 단계에서 총 건조비를 최소로 하는 생산지향적 설계 적용 방법)

  • H.S.,Bong
    • Bulletin of the Society of Naval Architects of Korea
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    • v.27 no.3
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    • pp.131-136
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    • 1990
  • 여러해 전부터 선박의 생산실적이나 생산성 관련 자료를 기록하고 보완하는 작업을 꾸준히 개선토록 노력해온 결과중 중요한 것 하나는, 선박의 여러 가지 설계 검토과정에서 충분히 활용할 수 있는 함축성 있고 믿을만한 형태의 생산정보를 제공해줄 수 있게 되었다는 것이라고 말 할 수 있겠다. 이러한 자료들은 생산계획상 각 단계(stage)에서의 작업량, 예상재료비와 인건비의 산출등이 포함될 수 있으며, 선박이나 해상구조물의 전반적인 설계방법론(design methodology)을 개선코자 한다면 ''생산지향적 설계(Design for Production)''의 근간이 되는 선박건조전략(build strategy), 구매정책(purchasing policy)과 생산기술(production technology)에 대한 폭넓은 지식이 한데 어우러져야 한다. 최근에는 CIMS의 일부분에서 보는 바와 같은 경영관리, 설계 및 생산지원 시스템의 도입으로 이와 같은 설계 프로세스의 추진을 가능케하고 있다. 이와 병행하여 설계를 지원하기 위한 전산기술, 특히 대화형 화상처리기술(interactive graphics)의 발달은 설계자가 선박의 형상이나 구조 배치를 여러 가지로 변화시켜 가면서 눈으로 즉시 확인할 수 있도록 설계자의 능력을 배가시키는데 크게 기여하고 있다. 여러 가지의 설계안(alternative design arrangement)을 신속히 만들어내고 이를 즉시 검토 평가할 수 있는 능력을 초기설계 단계에서 가질 수 있다면 이는 분명히 큰 장점일 것이며, 더구나 설계초기 단계에 생산관련인자를 설계에서 고려할 수 있다면 이는 더욱 두드러진 발전일 것이다. 생산공법과 관련생산 비용을 정확히 반영한 각 가지의 설계안을 짧은 시간내에 검토하고 생산소요 비용을 산출하여 비교함으로써, 수주계약단계에서 실제적인 생산공법과 신뢰성있는 생산실적자료를 기준으로 하여 총 건조비(total production cost)를 최소로 하는 최적의 설계를 선택할 수 있도록 해 줄 것이다. 이제 이와 같은 새로운 설계도구(design tool)를 제공해 주므로써 초기설계에 각종 생산관련 정보나 지식 및 실적자료가 반영가능토록 발전되었다. 본 논문은 영국의 뉴카슬대학교(Univ. of Newcastle upon Type)에서 위에 언급한 특징들을 반영하여 새로운 선박구조 설계 방법을 개발한 연구결과를 보여주고 있다. 본 선계연구는 5단계로 구분되는데; (1) 컴퓨터 그라픽스를 이용하고 생산정보 데이타베이스와 연결시켜 구조형상(geometry)을 정의하고 구조부재 칫수(scantling) 계산/결정 (2) 블럭 분할(block division) 및 강재 배치(panel arrangement)의 확정을 위해 생산기술 및 건조방식에 대한 정보 제공 (3) 상기 (1) 및 (2)를 활용하여 아래 각 생산 단계에서의 생산작업 분석(work content assessment) a) 생산 준비 단계(Preparation) b) 가공 조립 단계(Fabrication/Assembly) c) 탑재 단계(Erection) (4) 각각의 설계(안)에 대하여 재료비(material cost), 인건비(labour cost) 및 오버헤드 비용(overhead cost)을 산출키 위한 조선소의 생산시설 및 각종 품셈 정보 (5) 총 건조 비용(total production cost)을 산출하여 각각의 설계안을 비교 검토. 본 설계 방식을 산적화물선(Bulk Carrier) 설계에 적용하여 구조배치(structural geometry), 표준화의 정도(levels of standardisation), 구조생산공법(structural topology) 등의 변화에 따른 설계 결과의 민감도를 분석(sensitivity studies)하였다. 전산장비는 설계자의 대화형 접근을 용이하도록 하기 위해 VAX의 화상 처리장치를 이용하여 각 설계안에 대한 구조형상과 작업분석, 건조비 현황 등을 제시할 수 있도록 하였다. 결론적으로 본 연구는 설계초기 단계에서 상세한 건조비 모델(detailed production cost model)을 대화형 화상 처리방법에 접합시켜 이를 이용하여 여러가지 설계안의 도출과 비교검토를 신속히 처리할 수 있도록 함은 물론, 각종 생산 실적정보를 초기설계에 반영하는 최초의 시도라고 믿으며, 생산지향적(Design for Production) 최적설계분야의 발전에 많은 도움이 되기를 기대해 마지 않는다. 참고로 본 시스템의 설계 적용결과를 부록에 요약 소개하며, 상세한 내용은 참고문헌 [4] 또는 [7]을 참조 요망한다.

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A Study on Moltmann's Creationism and the Ecological Integrity of Christian Education (몰트만의 창조론과 기독교교육의 생태학적 통전성 고찰)

  • Lee, Hyangsoon
    • Journal of Christian Education in Korea
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    • v.70
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    • pp.107-140
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    • 2022
  • This study is a review of the role of Christian education in the face of ecological crisis and the task of its recovery from the perspective of Moltmann's creation theory. Mankind has achieved epoch-making industrial development through several industrial revolutions. However, as a result, the ecosystem has suffered severe physical aches and has reached the point of revealing anomalies. In the face of such destruction and suffering of the ecosystem, Christian education needs to approach the ecological sensitivity toward the natural world more holistically and present a practical alternative. Moltmann reminds us that today's growing exploitation of nature by humans stems from a human-centered ecological consciousness that the world belongs to humans. At the same time, it suggests a transition to a God-centered ecological world consciousness. 'A community of creation', 'the fellowship of the Triune God', and 'eschatological new creation through the Sabbath' are key concepts that integrate God-centered ecological world consciousness. Based on Moltmann's creation theory, this article examines the ecological sensibility that Christian education should pursue from the point of view of the sacramental creative community, and reviews the role and practical alternatives of Christian education. Through this, it was derived that the world, including humans, is not owned by humans, but is a sacramental community that is built together toward the end as a part of nature and reveals the glory of God. In addition, it was suggested that Christian education need to be recognized as a suffering subject which mediates humanity and the nature of the mutual fellowship of reconciliation. in the fellowship of God. Sabbath keeping education, which celebrates God's creation and aims for the completion of the eschatological creation, will become a practical area for Christian education to practice for the restoration of the collapsed ecosystem. Moltmann's creation theory is significant in that it provides a meaningful Christian educational insight to restore the ecological environment as well as interest in the ecological environment that has been overlooked or ignored by Christian education.