• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1313-1320
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• 2014

Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

• Journal of Korean Neurosurgical Society
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• 제57권5호
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• pp.342-349
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• 2015

Background : Higher reperfusion rates have been established with endovascular treatment for acute ischemic stroke patients. There are limited data on the comparative performance of mechanical thrombectomy devices. This study aimed to analyse the efficacy and safety of the stent retriever device (Solitaire stent) by comparing procedure time, angiographic outcome, complication rate and long term clinical outcome with previous chemical thrombolysis and mechanical thrombectomy using penumbra system. Method : A retrospective single-center analysis was undertaken of all consecutive patients who underwent chemical thrombolysis and mechanical thrombectomy using Penumbra or Solitaire stent retriever from March 2009 to March 2014. Baseline characteristics, rate of successful recanalization (modified Thrombolysis in Cerebral Infarction score 2b-3), symptomatic intracerebral hemorrhage, procedure time, mortality and independent functional outcomes ($mRS{\leq}2$) at 3 month were compared across the three method. Results : Our cohort included 164 patients, mechanical thrombectomy using stent retriever device had a significant impact on recanalization rate and functional independence at 3 months. In unadjusted analysis mechanical thrombectomy using Solitaire stent retriever showed higher recanalization rate than Penumbra system and chemical thrombolysis (75% vs. 64.2% vs. 49.4%, p=0.03) and higher rate of functional independence at 3 month (53.1% vs. 37.7% vs. 35.4%, p=0.213). In view of the interrelationships between all predictors of variables associated with a good clinical outcome, when the chemical thrombolysis was used as a reference, in multiple logistic regression analysis, the use of Solitaire stent retriever showed higher odds of independent functional outcome [odds ratio (OR) 2.62, 95% confidence interval (CI) 0.96-7.17; p=0.061] in comparison with penumbra system (OR 1.57, 95% CI 0.63-3.90; p=0.331). Conclusion : Our initial data suggest that mechanical thrombectomy using stent retriever is superior to the mechanical thrombectomy using penumbra system and conventional chemical thrombolysis in achieving higher rates of reperfusion and better outcomes. Randomized clinical trials are needed to establish the actual benefit to specific patient populations.

• 한국산학기술학회논문지
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• 제20권10호
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• pp.493-502
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• 2019

최근, 기후변화 및 에너지고갈 등의 문제를 대응하기 위하여, 정부에서 추진하는 재생에너지 3020 정책을 기반으로 태양광전원을 포함한 신재생에너지의 설치가 큰 폭으로 증가되고 있다. 하지만, 설치된 태양광모듈은 주변 환경요인에 따라 다양한 열화현상이 발생하여, 전기적 성능과 수명이 크게 감소될 수 있다. 이러한 문제를 해결하기 위하여, 태양광모듈 판매사업자가 제시한 기대 수명 이전에 새로운 모듈로 교체되는 경우가 증가하고 있다. 따라서, 본 논문에서는 태양광모듈의 성능저하율을 고려하여, 폐기 또는 새로운 모듈로 교체하는 시기를 평가할 수 있는 폐기진단 알고리즘을 제안한다. 또한, 비용요소와 편익요소로 구성된 경제성평가 모델링을 제시하고, 제안한 알고리즘을 바탕으로 태양광모듈의 성능저하율에 따른 경제성을 평가한 결과, 교체하기 전의 태양광모듈의 성능저하율은 3[%]이고, 교체한 경우의 성능저하율은 1[%]인 경우, 설치 후 10년째에 태양광모듈을 교체하는 것이 가장 큰 값(1.347)의 B/C ratio을 가지므로 최적의 경제적인 교체연도임을 알 수 있다. 따라서, 폐기 또는 교체 판별 여부와 어느 시기에 교체하는 것이 가장 경제적인가를 판단할 수 있어, 본 논문에서 제시한 알고리즘의 유용성을 확인하였다.

• 한국ITS학회 논문지
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• 제22권5호
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• pp.19-29
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• 2023

우리나라 도로 사고원단위는 도로 종류와 차로 수에 따라 단순 구분하고 있으나, 국외는 사고에 영향을 미치는 다양한 요소를 적용하고 있다. 본 논문은 TAAS(Traffic Accident Analysis System)의 사고 자료를 이용하여 일반국도 사고원단위를 도시부, 지방부, Older, 및 Modern 도로로 세분하였으며, 사고절감비용 산정 모형을 제시하였다. 국도 1,416.2km의 표본을 토대로 분석된 사망원단위(인/억대·km)는 도시부-Older 4.21, 도시부-Modern 1.37, 지방부-Older 2.18 및 지방부-Modern 0.99로 Older가 Modern 도로보다 높고, 도시부가 지방부보다 높게 분석되었다. 부상원단위(인/억대·km)는 도시부-Older 182.63, 도시부-Modern 103.42, 지방부-Older 67.44 및 지방부-Modern 42.96으로 사망원단위와 유사한 패턴으로 분석되었다. Modern 도로의 경우 KDI 지침의 사고원단위보다 매우 낮은 수준이다. 본 연구의 사고원단위를 적용하여 편익을 산정한 결과 사고비용절감편익 비율이 0.6%에서 14.1%로 증가하였으며, B/C는 0.626에서 0.724로 개선되었다.

• 만화애니메이션 연구
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• 통권15호
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• pp.207-220
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• 2009

이 논문에서는 수도권 및 광역시 지역에만 집중되어 있는 애니메이션 상영에 비해 지방 중소도시에는 상대적으로 부족한 애니메이션 상영의 구조에 따라 지역의 애니메이션 관람 수요층이 관람에 대한 제약을 많이 받고 있음을 조사하고 이러한 문제가 결국 저작권 침해 정도를 증가시키고 있는 점에 대해 연구하였다. 전국적으로 상영관의 혜택이 가장 적은 춘천 지역에서 저작권 침해율이 가장 높은 계층을 대상으로 전국 상영관 상영작을 모두 볼 수 있게 한다면 범법적인 저작권 침해에 대한 비율이 어떤 변화를 일으킬 수 있는가에 대해 평가하였다. 이 결과로 25.3%의 범법적 저작권 침해율을 낮출 가능성을 찾아 내었고. 애니메이션 배급과 상영의 문제 개선과 관람 수요자의 인식 개선을 통해 구조 개선이 필요함을 알게 되었다. 즉, 애니메이션 콘텐츠에 대한 구조적 접근성이 개선되어야 할 것이고 이를 통해 저작권 침해 범죄율을 감소시켜야만 할 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2509-2514
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• 2013

Background: The purpose of this study was to identify predictive factors for supraclavicular lymph node recurrence (SCLR) in N1 breast cancer patients and define a high-risk subgroup who might benefit from supraclavicular nodal radiotherapy (RT). Materials and Methods: From January 1995 to December 2009, 113 breast cancer patients with 1 to 3 positive axillary lymph nodes were enrolled in this study. All patients underwent breast-conserving surgery (BCS) or modified radical mastectomy (MRM). RT was given to all patients who received BCS. Among the patients given MRM, those with breast tumors >5 cm in size received RT. Regional nodal irradiation was not applied. Systemic chemotherapy was given to 105 patients (92.9%). Patient data were retrospectively reviewed and analyzed to identify predictive factors for SCLR. Results: The median follow-up duration was 6.5 years, with 5- and 10-year actuarial SCLR rates of 9.3% and 11.2%, respectively. Factors associated with SCLR on univariate analysis included histologic grade, number of dissected axillary lymph nodes, lymphovascular invasion, extracapsular extension (ECE), and adjuvant chemotherapy. On multivariate analysis, histologic grade and ECE remained significant. The patient group with grade 3 and ECE had a significantly higher rate of SCLR compared with the remainder (5-year SCLR rate; 71.4% vs. 4.0%, p<0.001). Conclusions: Histologic grade and ECE status are significant predictive factors for SCLR. Supraclavicular nodal RT is necessary in N1 breast cancer patients featuring histologic grade 3 and ECE.

• KDI Journal of Economic Policy
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• 제36권4호
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• pp.103-133
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• 2014

응급의료시설은 해당 지역의 보건의료환경을 결정하는 중요한 요인이다. 최근 양질의 응급의료시설 확충을 위해 국가재정 투입의 사회적 수요가 증가하고 있으며, 효율적 재정투입을 위해 관련 정책에 대한 과학적인 평가가 요구된다. 이러한 취지에서 본 연구는 응급의료시설 확충의 경제적 가치를 추정하기 위한 체계적인 방법을 모색하고자 한다. 응급의료시설의 정량적 성과지표인 예방가능사망자 수를 추정하는 방법을 실증적으로 분석하며, 이 성과를 경제적 가치로 전환하기 위해 경제학적 관점에서 응급사망 1인당 사망비용을 추정한다. 또한 본 연구의 결과를 실제 사례에 적용해 봄으로써 국가재정사업 평가에서의 활용 가능성을 살펴보았다. 과학적이고 체계적인 방법에 대한 연구와 응용은 지역 간 의료자원의 불균형을 완화시키고 국가재정의 효율성을 제고시키는 데 기여할 것으로 판단된다.

• 보건행정학회지
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• 제7권1호
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• pp.73-99
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• 1997

This study was carried out by using questionnaires with 126 insurance societies from Sept. 30, 1995 to Oct. 18, 1995. The primary data collected bythe survey have been significantly supplemented by secondary data obtained from sources such as health insurance statistical year books and internal data in the Ministry of Health and Wolfare. Major findings were summarized as follows: Two financial coordinating programs have significantly improved financial status of regional health insurance societies: the catastrophic program for high cost medical care that was initiated in 1991 and the program for hospitalization cost of the aged in 1995. Another finding is that there existed ambiguity and inconsistency of equity index that had been used by stabilization programs and its side effects could not be ignored. Regression analyses were made to identify factors that affect financial transfers. Inde pendent variables in the regression include utilization frequency, dependancy ration, insurance contribution per insured and medical expense per insured. All these variables were statistically significant in the equations of applying distribution rate (distribution/contribution) and transfer rate (transfer/contribution) as dependent variables. Policy suggestions for the catastrophic program for high cost medical care are modifying the definition of catastrophic case and setting the maximum amount of subsidies for each society based on distribution rates. To solve the problems of the financial coordinating program for the aged, we could consider reimbursing more than 50% of the copayment incurred by the aged 65 or more and determining the maximum amount of outpatient copayment at 10,000 Won per day or per visit for the elderly. More fundamental improvement could be made by amending the Welfare Benefit Act to establish and expand medical and welfare facilities for the elderly.

• Korean Journal of Acupuncture
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• 제24권4호
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• pp.25-36
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• 2007

Objectives : Acupuncture restores the flow of vital energy in the body by stimulating the organ-specific meridians and enhances cardiac vagal activity and suppresses sympathetic activity. The purpose of this review is to summarize and evaluate the acupuncture studies on autonomic nervous system (ANS). Methods : We conducted a PubMed search to obtain a fair sample of acupuncture studies related ANS published in English in 2007. Each article was reviewed for study objectives and outcomes, as well as acupuncture points, experimental and control interventions. Results : We reviewed a total of 15 studies published from 1997 to 2007. In normal states, acupuncture enhanced either vagal or sympathetic tone depending on the stimulated acupuncture point sites. On the other hand, most of studies demonstrated that acupuncture restored the autonomic dysfunctions in various kinds of stressful states. Conclusions : We reviewed studies that contributed to an understanding of the autonomic mechanisms of acupuncture with the hope that this review will be of benefit to the future studies. Although the relationship between acupuncture and ANS response is still uncertain, acupuncture would be a noteworthy modality for modulating autonomic dysfunction.

• 지역사회간호학회지
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• 제10권2호
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• pp.362-371
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• 1999

This study was conducted to explore the relationship between locus of control and health belief. the life style of gastric cancer patients. The subjects of this study were 40 of the early gastric cancer and 90 of the advanced gastric cancer who first visiting patient to general surgery out patient department of Chungnam University Hospital for operation. The data was collected with structured questionnaire from July. 1998 to Feb. 1999 The tool were Moon's Health Belief Scale and Multiple Locus of Control of Wallston. Wallston, DeVellis. The data was analysed by SAS program using frequency, $X^2$-test, Pearson's correlation coefficient, ANOVA. Scheffe-test, t-test. The results were as follows 1. 30.8% of subjects were early gastric cancer anf 69.2% were advanced gastric cancer. The subject knowing about diagnosis was 83.1%. 16.9% did'nt know about diagnosis. 2. The correlationship between Health belief and Locus of control of subjects was not supported. 3. There was statistically no difference of life style between early and advanced gastric cancer patients. 4. There were statistically significant differences in perceived sensitivity according to weight. educational level. and birth order, in perceived barrier according to educational level. and in perceived severity according to occupation among demographic characteristics of study subjects. From above results. health professional has to educate general population to detect gastric cancer early to improve survival rate because early gastric cancer is high in survival rate, and to prevent recurrence and to maintain continuing healthy status. In the future, gastroscopy also has to expand to detect early. For there was no difference in life style between early and advanced gastric cancer. carcinogen related to diet should be emphasized through education. The perceived benefit among health belief model was not supported in this study therefore further study and comparison between gastric cancer and normal population are needed.