• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.26 no.4
• /
• pp.347-354
• /
• 2022

Backgrounds/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) remains the primary treatment for a subset of patients with pancreatic fistulae. The objective of this study was reporting outcomes of ERCP and predictors of resolution in patients with pancreatic fistulae refractory to conservative therapy. Methods: Retrospective review of patients who underwent ERCP and pancreatic stent placement for pancreatic fistula not responding to medical therapy was performed. Clinical features, laboratory parameters, radiological features and pancreatogram findings were noted. Clinical resolution of fistula was the primary outcome measure. Results: Sixty-eight patients underwent ERCP for high-output pancreatic fistula (Mean age 34.1 years, 91.1% males, 35/68 chronic pancreatitis, 52.9% alcohol etiology). Internal fistulae (pancreatic ascites, pleural effusion, or pericardial effusion) were seen in 55 (80.9%) patients and external fistula in 13 (19.1%) patients. Technical success for ERCP was 92.6% (63/68). Leak was seen in 98.4% (62/63). The most common leak site was body (69.8%). Multiple leak sites were seen in 23.1%. Pancreatic stricture was found in 36.5%. In 44 (69.4%) patients, stent was placed beyond the site of the leak. Resolution at six weeks was achieved in 76.4% (52/68). On univariate and multivariate analyses, placement of stent beyond site of leak was significantly associated with resolution of high-output fistulae (3/41 [7.3%] vs. 5/19 [26.3%], p = 0.03; odds ratio: 6.5, 95% confidence interval: 1.211-34.94). Conclusions: In our experience, ERCP was successful in 76% of patients with pancreatic fistulae refractory to conservative therapy. Stent placement beyond the site of leak was associated with higher resolution of fistulae.

• Journal of Service Research and Studies
• /
• v.11 no.1
• /
• pp.31-44
• /
• 2021

The net function of the domestic medical insurance system is highly regarded, but due to the problem of incomplete coverage, the public wants to secure coverage through private medical insurance subscription. As a result, the subscription rate of private medical insurance has recently increased, and the billing rate has also increased. As the number of people seeking private medical insurance increased, workers at private medical insurance companies are experiencing increased job stress and side effects, especially for insurance reviewers who are in charge of paying insurance, such as communicating with customers who claimed insurance and contributing to the company's profit. In response, this study analyzed the effects of job stress on mental health of insurance reviewers and conducted a descriptive survey study to reduce job stress of insurance reviewers and promote mental health. The analysis shows that job stress for insurance reviewers has a significant impact on mental health (+). In detail, job stress has a significant impact on all four factors: social performance and self-confidence, depression, sleeping disturbance and anxiety, and general well-being and vitality. This study showed that job stress in insurance reviewers has a significant (+) impact on mental health. Job stress can cause side effects in organizational aspects, such as reducing enthusiasm for job performance and increasing turnover and resignation rates, but it can also worsen individual physical health and cause diseases such as depression and anxiety, causing mental health to be impoverished. Therefore, in order to prevent this, appropriate work stress prevention methods and countermeasures should be provided to help reduce work stress and improve mental health.

• The Journal of Korean Association of Computer Education
• /
• v.9 no.5
• /
• pp.65-75
• /
• 2006

With rapid developments in technology and communications' many teachers are increasingly exposed to a variety of e-Learning environments that they must develop new competencies and skills to be successful e-Learning teachers. The purpose of this training program, sponsored by HRD Korea (Human Resources Development Services of Korea), is to provide e-Learning teachers with meaningful opportunities for promoting quality e-Learning teaching. This program covers pedagogical issues as well as technical and practical aspects of the e-Learning environments. Before starting the program development the survey and the current e-Learning program assessments were conducted. The training program is divided into three modules as follows: 1) theoretical issues of e-Learning, 2) development of e-Learning contents, and 3) implementation of e-Learning environments. These three modules can be selectively reorganized in response to teacher requirements and demands. ln each module, there are five subtopics that include creative teaching and interaction strategies for promoting the effective e-Learning teaching. ln conclusion, teachers will gain greater understanding of teacher roles in e-Learning instruction, more flexibility in teaching jobs, increased confidence and knowledge to act as e-Learning facilitators through the completion of this training program.

• The Korean Journal of Applied Statistics
• /
• v.30 no.3
• /
• pp.377-390
• /
• 2017

When conducting a survey, item nonresponse occurs if the respondent does not respond to some items. Since analysis based only on completely observed data may cause biased results, imputation is often conducted to analyze data in its complete form. The panel study is a survey method that examines changes of responses over time. In panel studies, there has been a preference for using information from response values of previous waves when the imputation of item nonresponses is performed; however, limited research has been conducted to support this preference. Therefore, this study compares the performance of imputation methods according to whether or not information from previous waves is utilized in the panel study. Among imputation methods that utilize information from previous responses, we consider ratio imputation, imputation based on the linear mixed model, and imputation based on the Bayesian linear mixed model approach. We compare the results from these methods against the results of methods that do not use information from previous responses, such as mean imputation and hot deck imputation. Simulation results show that imputation based on the Bayesian linear mixed model performs best and yields small biases and high coverage rates of the 95% confidence interval even at higher nonresponse rates.

• Journal of The Korean Association For Science Education
• /
• v.25 no.3
• /
• pp.400-410
• /
• 2005

According to the cognitive conflict process model, student anxiety factor is known to have both positive and negative effects on student response behaviors in a conflict situation for conceptual change learning. However, there is little research that reveals what type of anxiety, either constructive or destructive, is related when conducting step-by-step experiments to resolve cognitive conflicts. This study attempted to learn the characteristic of explanatory hypothesis according to anxiety type after conducting five step-by-step experiments related to action and reaction concept. Results found that students who belonged to the types of 'conviction in logical misconception', 'insisting on additional variables', and 'reasonable modification' suggested explanatory hypothesis close to physical nature. On the other hand, those who showed the other five types of anxiety ('compatible predictions', 'dependence on others', 'fusion of past experience', 'lack of confidence', and 'conflict with past experience') suggested temporary supported hypothesis or simple explanatory hypothesis according to student intuition and simple observation. These results indicate that students in the above-mentioned five categories need more external interactions with instructors based on the type of anxiety related to student behavior. In addition, the results present student characteristics which instructors should be more attentive to when using step-by-step experiments to resolve cognitive conflicts.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.11
• /
• pp.4637-4642
• /
• 2014

Background: Hypoxia-inducible factor $1{\alpha}$ (HIF-$1{\alpha}$) plays an important role in regulating cell survival and angiogenesis, which are critical for tumor growth and metastasis. Genetic variations of HIF1A have been shown to influence the susceptibility to many kinds of human tumors. Increased expression of HIF-$1{\alpha}$ has also been demonstrated to be involved in tumor progression. However, the prognostic value of single nucleotide polymorphisms (SNPs) inthe HIF1A gene remains to be determined in most cancer types, including colorectal cancer (CRC). In this study, we sought to investigate the predictive role of HIF1A SNPs in prognosis of CRC patients and efficacy of chemotherapy. Materials and Methods: We genotyped two functional SNPs in HIF1A gene using the Sequenom iPLEX genotyping system and then assessed their associations with clinicopathological parameters and clinical outcomes of 697 CRC patients receiving radical surgery using Cox logistic regression model and Kaplan Meier curves. Results: Generally, no significant association was found between these 2 SNPs and clinical outcomes of CRC. In stratified analysis of subgroup without adjuvant chemotherapy, patients carrying CT/TT genotypes of rs2057482 exhibited a borderline significant association with better overall survival when compared with those carrying CC genotype [Hazard ratio (HR), 0.47; 95% confidence interval (95% CI): 0.29-0.76; P < 0.01]. Moreover, significant protective effects on CRC outcomes conferred by adjuvant chemotherapy were exclusively observed in patients carrying CC genotype of rs2057482 and in those carrying AC/CC genotype of rs2301113. Conclusions: Genetic variations in HIF1A gene may modulate the efficacy of adjuvant chemotherapy after surgery in CRC patients.

• Journal of Nutrition and Health
• /
• v.52 no.6
• /
• pp.552-558
• /
• 2019

Purpose: Although vitamin D deficiency is common among Korean adolescent girls and young women, few studies have explored the potential health effects of vitamin D deficiency in this vulnerable population. This study examined the association between vitamin D deficiency and anemia in Korean adolescent girls and young women. Methods: The data from the Korea National Health and Nutrition Examination Survey 2008 ~ 2014 were used. A total of 3,643 girls and adult women aged 12 to 29 who provided all the information (including serum 25-hydroxy vitamin D, hemoglobin, and/or serum ferritin) needed for the analysis were included in the analysis. Demographic, lifestyle, and health data were obtained through survey questionnaires. Anemia and iron deficiency anemia were defined according to the World Health Organization cut-offs. Multivariable logistic regression, and restricted cubic spline regression were used in the analysis. Results: In fully adjusted logistic regression models, the vitamin D deficiency was significantly associated with higher prevalences of anemia (odds ratio (OR): 1.61, 95% confidence interval (CI): 1.04 ~ 2.49) and iron deficiency anemia (OR: 1.43, 95% CI: 1.01 ~ 2.03). In a cubic spline regression model, we observed a dose-response relationship between serum 25(OH)D concentration and anemia, and this linear relationship was also clearly observed between serum 25(OH)D concentration and iron deficiency anemia. Conclusion: Vitamin D deficiency may be associated with a higher prevalence of iron deficiency anemia and anemia in adolescent girls and young women. Alternatively, vitamin D deficiency may be a concurrent event for patients with anemia, which we cannot distinguish in this cross-sectional study. Further studies are needed to verify the causality in this population of low vitamin D levels.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.22 no.1
• /
• pp.1-8
• /
• 2021

This study developed low-cost and high-efficiency pavement condition monitoring technology to produce the key information required for pavement management. A noise and artificial intelligence-based monitoring system was devised to compensate for the shortcomings of existing high-end equipment that relies on visual information and high-end sensors. From idea establishment to system development, functional definition, information flow, architecture design, and finally, on-site field evaluations were carried out. As a result, confidence in the high level of artificial intelligence evaluation was secured. In addition, hardware and software elements and well-organized guidelines on system utilization were developed. The on-site evaluation process confirmed that non-experts could easily and quickly investigate and visualized the data. The evaluation results could support the management works of road managers. Furthermore, it could improve the completeness of the technologies, such as prior discriminating techniques for external conditions that are not considered in AI learning, system simplification, and variable speed response techniques. This paper presents a new paradigm for pavement monitoring technology that has lasted since the 1960s.

• Education of Primary School Mathematics
• /
• v.26 no.4
• /
• pp.333-348
• /
• 2023

Clear analysis and diagnosis of various characteristic factors of individual students is the most important in order to realize individual customized teaching and learning, which is considered the most essential function of math artificial intelligence-based digital textbooks. In this study, analysis factors and tools for individual customized learning diagnosis and construction models for data collection and analysis were derived from mathematical AI digital textbooks. To this end, according to the Ministry of Education's recent plan to apply AI digital textbooks, the demand for AI digital textbooks in mathematics, personalized learning and prior research on data for it, and factors for learner analysis in mathematics digital platforms were reviewed. As a result of the study, the researcher summarized the factors for learning analysis as factors for learning readiness, process and performance, achievement, weakness, and propensity analysis as factors for learning duration, problem solving time, concentration, math learning habits, and emotional analysis as factors for confidence, interest, anxiety, learning motivation, value perception, and attitude analysis as factors for learning analysis. In addition, the researcher proposed noon data on the problem, learning progress rate, screen recording data on student activities, event data, eye tracking device, and self-response questionnaires as data collection tools for these factors. Finally, a data collection model was proposed that time-series these factors before, during, and after learning.

• Journal of Chest Surgery
• /
• v.57 no.2
• /
• pp.160-168
• /
• 2024

Background: Data on perioperative outcomes of emergent versus elective resection in esophageal cancer patients requiring esophagectomy are lacking. We investigated whether emergent resection was associated with increased risks of morbidity and mortality. Methods: Data on patients with esophageal malignancy who underwent esophagectomy from 2005 to 2020 were retrospectively analyzed from the American College of Surgeons National Surgical Quality Improvement Program database. Thirty-day complication and mortality rates were compared between emergent esophagectomy (EE) and non-emergent esophagectomy. Logistic regression assessed factors associated with complications and mortality. Results: Of 10,067 patients with malignancy who underwent esophagectomy, 181 (1.8%) had EE, 64% had preoperative systemic inflammatory response syndrome, sepsis, or septic shock, and 44% had bleeding requiring transfusion. The EE group had higher American Society of Anesthesiologists (ASA) class and functional dependency. More transhiatal esophagectomies and diversions were performed in the EE group. After EE, the rates of 30-day mortality (6.1% vs. 2.8%), overall complications (65.2% vs. 44.2%), bleeding, pneumonia, prolonged intubation, and positive margin (17.7% vs. 7.4%) were higher, while that of anastomotic leak was similar. On adjusted logistic regression, older age, lower albumin, higher ASA class, and fragility were associated with increased complications and mortality. McKeown esophagectomy and esophageal diversion were associated with a higher risk of postoperative complications. EE was associated with 30-day postoperative complications (odds ratio, 2.39; 95% confidence interval, 1.66-3.43; p<0.0001). Conclusion: EE was associated with a more than 2-fold increase in complications compared to elective procedures, but no independent increase in short-term mortality. These findings may help guide data-driven critical decision-making for surgery in select cases of complicated esophageal malignancy.