• 중소기업연구
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• 제43권3호
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• pp.1-20
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• 2021

약 22,500개의 서비스업 혁신 중소기업을 대상으로 기술수준에 따른 생존기간을 분석하였다. 생존기간은 연체 및 부도의 발생으로 정의하였으며, 기술수준은 기술력 우수기업 군집(T1-T4등급)과 혁신금융 적합기업 군집(T5-T6등급)으로 구분하였다. 카플란-마이어 분석을 통해 기술수준에 따른 생존기간을 추정한 결과 연체와 부도 모두에서 T1-T4등급 서비스업 혁신 중소기업의 추정 생존기간이 T5-T6등급 서비스업 혁신 중소기업에 비해 유의하게 큰 것으로 확인되었다. 이러한 기술수준의 생존기간에 대한 영향력이 통제변수를 적용했을 때에도 유지되는지 Cox 비례위험 모형을 통해 확인하였다. 분석 결과 창업기업군(업력 7년 이하)에서는 기술수준이 낮을수록 위험도가 증가하는 것으로 확인되었지만, 비(非)창업기업군(업력 7년 초과)에서는 기술수준이 생존기간에 유의한 영향을 미치지 못하며 기업의 규모와 관련된 변수의 영향력이 커지는 것으로 나타났다. 따라서 기술수준은 서비스업 창업기업군에서 혁신 중소기업의 생존기간에 유의한 영향력이 있는 부가정보로 의미가 있으며, 서비스업 창업기업군의 중소기업 지원정책 및 육성정책 수립 시 기술수준에 대한 반영이 필요하다는 결론을 도출하였다.

• Journal of Chest Surgery
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• 제50권2호
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• pp.78-85
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• 2017

Background: Closure of a secundum atrial septal defect (ASD) is possible through surgical intervention or device placement. During surgical intervention, concomitant pathologies are corrected. The present study was conducted to investigate the outcomes of surgical ASD closure, to determine the risk factors of mortality, and establish the effects of concomitant disease correction. Methods: Between October 1989 and October 2009, 693 adults underwent surgery for secundum ASD. Their mean age was $40.9{\pm}13.1years$, and 199 (28.7%) were male. Preoperatively, atrial fibrillation was noted in 39 patients (5.6%) and significant tricuspid regurgitation (TR) in 137 patients (19.8%). The mean follow-up duration was $12.4{\pm}4.7years$. Results: There was no 30-day mortality. The 1-, 5-, 10-, and 20-year survival rates were 99.4%, 96.8%, 94.5%, and 81.6%, respectively. In multivariate analysis, significant preoperative TR (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.09 to 3.16; p=0.023) and preoperative age (HR, 1.04; 95% CI, 1.01 to 1.06; p=0.001) were independent risk factors for late mortality. The TR grade significantly decreased after ASD closure with tricuspid repair. However, in patients with more than mild TR, repair was not associated with improved long-term survival (p=0.518). Conclusion: Surgical ASD closure is safe. Significant preoperative TR and age showed a strong negative correlation with survival. Our data showed that tricuspid valve repair improved the TR grade effectively. However, no effect on long-term survival was found. Therefore, early surgery before the development of significant TR mat be beneficial for improving postoperative survival.

• Radiation Oncology Journal
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• 제36권2호
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• pp.103-113
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• 2018

Purpose: Anaplastic thyroid cancer (ATC) is a rare tumor with a lethal clinical course despite aggressive multimodal therapy. Intensity-modulated radiotherapy (IMRT) may achieve a good therapeutic outcome in ATC patients, and the role of IMRT should be assessed. We retrospectively reviewed outcomes for ATC treated with three-dimensional conformal radiotherapy (3D-CRT) or IMRT to determine the optimal treatment option and explore the role of radiotherapy (RT). Materials and Methods: Between December 2000 and December 2015, 41 patients with pathologically proven ATC received RT with a sufficient dose of ${\geq}40Gy$. Among them, 21 patients (51%) underwent surgery before RT. Twenty-eight patients received IMRT, and 13 received 3D-CRT. Overall survival (OS) and progression-free survival (PFS), patterns of failure, and toxicity were examined. Results: The median follow-up time for survivors was 38.0 months. The median and 1-year OS and PFS rates were 7.2 months and 29%, 4.5 months and 15%, respectively. Surgery significantly improved the prognosis (median OS: 10.7 vs. 3.9 months, p = 0.001; median PFS: 5.9 vs. 2.5 months, p = 0.007). IMRT showed significantly better PFS and OS than 3D-CRT, even in multivariate analysis (OS: hazard ratio [HR] = 0.30, p = 0.005; PFS: HR = 0.33, p = 0.005). Significantly higher radiation dose could be delivered with IMRT than 3D-CRT ($EQD2_{10}$ 66 vs. 60 Gy, p = 0.005). Only 2 patients had grade III dermatitis after IMRT. No other severe toxicity ${\geq}grade$ III occurred. Conclusion: Patients with ATC showed better prognosis through multimodal treatment. Furthermore, IMRT could achieve favorable survival rates by safely delivering higher dose than 3D-CRT.

• 한국방재안전학회논문집
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• 제11권2호
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• pp.37-43
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• 2018

태풍에 의해 발생하는 폭풍해일은 태풍의 경로, 강도, 발생위치 등을 예측하기가 어려운 실정이기 때문에 발생 시나리오를 기반으로 연구가 수행되어왔다. 국내는 다양한 시나리오에 대해 수치모의를 수행하였고 그 결과를 침수 예측지도로 제작하였다. 하지만, 이 같은 방법은 수행한 시나리오 외에 발생가능한 모든 경우에 대해 예측하기 어렵고, 실제로 수치모의 수행시간이 길기 때문에 실시간으로 대응하기 어렵다는 단점이 있다. 따라서 본 연구에서는 기존의 데이터베이스를 활용하여 폭풍해일의 위험도를 예측하는 방법을 개발하였다. 동해안 지역을 대상으로 폭풍해일에 의한 위험도 예측을 수행하였고 예측을 위한 방정식을 산정하기 위해 COMSOL AB사에서 개발한 COMSOL을 이용하였다. 몇 가지 가정사항과 제한조건으로 기본방정식을 유도하였으며 방정식의 계수와 상수는 시행착오법으로 도출하였다. 그 결과, 해일에 의한 침수 예측지도와 공간적 분포는 지도의 상부를 제외하면 매우 유사하게 나타났다. 오차가 큰 지도 상부의 경우 기초 데이터로 사용한 지도의 해상도로 인해 저항상수 k의 값이 제대로 반영되지 못한 것으로 판단된다. SIND 모형은 실시간 예측이 가능한 모형으로 향후 모형의 정확성을 향상시킨다면 이상기후로 인해 재난이 발생하였을 경우 빠르게 대처가 가능할 것으로 기대된다.

• Journal of Yeungnam Medical Science
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• 제35권2호
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• pp.171-178
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• 2018

Background: To evaluate mid-term oncological and functional outcomes in patients with prostate cancer treated by robot-assisted laparoscopic radical prostatectomy (RALP) at our institution. Methods: We retrospectively reviewed the medical records of 128 patients with prostate cancer who underwent RALP at our institution between February 2008 and April 2010. All patients enrolled in this study were followed up for at least 5 years. We analyzed biochemical recurrence (BCR)-free survival using a Kaplan-Meier survival curve analysis and predictive factors for BCR using multivariate Cox regression analysis. Continence recovery rate, defined as no use of urinary pads, was also evaluated. Results: Based on the D'Amico risk classification, there were 30 low-risk patients (23.4%), 47 intermediaterisk patients (38.8%), and 51 high-risk patients (39.8%), preoperatively. Based on pathological findings, 50.0% of patients (64/128) showed non-organ confined disease (${\geq}T3a$) and 26.6% (34/128) had high grade disease (Gleason score ${\geq}8$). During a median follow-up period of 71 months (range, 66-78 months), the frequency of BCR was 33.6% (43/128) and the median BCR-free survival was 65.9 (0.4-88.0) months. Multivariate Cox regression analysis revealed that high grade disease (Gleason score ${\geq}8$) was an independent predictor for BCR (hazard ratio=4.180, 95% confidence interval=1.02-17.12, p=0.047). In addition, a majority of patients remained continent following the RALP procedure, without the need for additional intervention for post-prostatectomy incontinence. Conclusion: Our study demonstrated acceptable outcomes following an initial RALP procedure, despite 50% of the patients investigated demonstrating high-risk features associated with non-organ confined disease.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5767-5772
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• 2012

Introduction: Identification of simple and measurable prognostic factors is an important issue in treatment evaluation of breast cancer. The present study was conducted to evaluate the prognostic role of vascular invasion in lymph node negative breast cancer patients. Methods: in a retrospective design, we analyzed the recorded profiles of the 1,640 patients treated in the breast cancer department of Motahari clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, from January 1999 to December 2012. Overall and adjusted survivals were evaluated by the Cox proportional hazard model. All the hypotheses were considered two-sided and a p-value of 0.05 or less was considered as statistically significant. Results: Mean age in lymph node negative and positive patients was 50.0 and 49.8 respectively. In lymph node negative patients, the number of nodes, tumor size, lymphatic invasion, vascular invasion, progesterone receptor, and nuclear grade were significant predictors. In lymph node and lymphatic negative patients, vascular invasion also played a significant prognostic role in the survival which was not evident in lymph node negative patients with lymphatic invasion. Discussion: The results of our large cohort study, with long term follow up and using multivariate Cox proportional model and comparative design showed a significant prognostic role of vascular invasion in early breast cancer patients. Vascular invasion as an independent prognostic factor in lymph node negative invasive breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4505-4510
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• 2012

Purpose: To determine the efficacy of post-operative chemotherapy with cisplatin plus vinorelbine (NP) in Chinese patients with non-small cell lung cancer (NSCLC). Methods: A total of 451 patients with NSCLCs at stages I, II, and IIIA after surgical resection were treated with cisplatin plus vinorelbine for 4 cycles or volunteers observed between January 2002 and November 2004 and were followed for five years. The therapeutic efficacy was evaluated with reference to overall survival (OS) and disease-free survival (DFS), and adverse effects were also recorded. Potential factors affecting the lengths of OS and DFS were analyzed by multivariate analysis. Results: Most patients (86.7%) completed at least 4 cycles of treatment. Patients with chemotherapy survived significantly longer than those in the observation group (p<0.001). The absolute improvements in the 2 and 5-year OS were 3.8% [hazard ratio (HR) =0.674, 95% confidence interval (CI): 0.554-0.820, P<0.0001] and 13.0% (HR=0.732, 95% CI: 0.579-0.926, P=0.009), respectively. The improvement at 4-year DFS was 2.1% (HR=0.327, 95% CI: 0.214-0.500, P<0.0001). Stratification analysis revealed that older age, histological type, pathological degree, but not the gender and smoking status, are independent factors affecting the length of survival in this population. Many patients (63.3%) had grade 1-III tolerable adverse effects, and there was no treatment-related death. Conclusions: Post-operative chemotherapy with NP regimen is effective and tolerable in Chinese patients with NSCLC.

• 한국가스학회지
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• 제22권4호
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• pp.13-26
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• 2018

현재 KS Code 등 국내규정에서는 폭발위험장소의 범위를 계산하는 방법이 명확하게 나타나지 않아, 정확한 범위 선정을 위해서는 확산 모델링 해석을 이용하여야 한다. 본 연구애서는 대표적인 물질과 운전조건을 활용하여 확산 모델링에 비하여 간편하면서도 비교적 합리적인 폭발위험장소의 범위를 산정하는 방법을 제시하고자 하였다. 현재 시행되고 있는 국내외 표준을 바탕으로 폭발하한계(LFL, Lower Flammable Limit)까지 거리에 영향을 미치는 변수를 선정하였다. 총 16종의 인화성물질을 대상으로 물질변수, 운전변수, 기상조건에 대하여 모델링을 진행하였으며, 통계분석을 통해 영향을 미치는 변수를 선별하였다. 선별된 변수를 이용하여 폭발위험장소의 범위 선정을 위한 3단계 분류화 방법(3Step Classification Method)을 작성하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2815-2819
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• 2014

Background: The aim of this study was to evaluate the prognosis of patients with stage IA-IIB cervical carcinoma and to investigate a possible correlation of histology with prognosis. Materials and Methods: Two hundred fifty one patients with adenocarcinoma and squamous cell carcinoma (SCC) histology for FIGO (International Federation of Gynecology and Obstetrics) stage IA-IIB uterine cervical carcinomas at the Radiation Oncology Clinic of GH Okmeydan Training and Research Hospital between January 1996 and December 2006 were selected, analyzed retrospectively and evaluated in terms of general characteristics and survival. Disease-free survival (DFS) and overall survival (OS) was calculated using the Kaplan-Meier method and differences were compared with the log-rank test. Multivariate analysis using a Cox-proportional hazards model was used to adjust for prognostic factors and to estimate hazard ratio (HR) with 95% confidence interval (CI). Results: There was no differences between the two tumour types in age, stage, pelvic nodal metastasis, parametrial invasion, surgical margin status, DSI, LVSI, maximal tumor diameter, grade, and treatment modalities. 5-year OS and DFS were 73% and 77%, versus 64% and 69%, for SCC and adenocarcinoma, respectively (p> 0.05). Multivariate analysis revealed independent prognostic factors including pelvic nodal metastasis and resection margin status for OS (p=0.008, p=0.002, respectively). Conclusions: Prognosis of FIGO stage IA-IIB cervical cancer patients was found to be the same for those with adenocarcinoma and SCC.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2577-2581
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• 2014

Background: Triple negative breast cancer is associated with aggressive behavior and high risk of local and regional failure. Aggressive surgical intervention is considered suitable. This makes role of breast conserving therapy (BCT) debatable in these patients. The objective of this study was to compare outcome of BCT for triple negative versus non-triple negative breast cancer. Materials and Methods: Medical records of patients who underwent breast conserving therapy from 1999 to 2009 at Shaukat Khanum Cancer Hospital and had complete receptor status information were extracted. Patients were divided into triple negative breast cancer (TNBC) and non-TNBC. Patient characteristics, medical treatment modalities and adverse events were compared. Expected five year locoregional recurrence free, disease free and overall survival was calculated. The Cox proportional hazard model was used to identify independent predictors of outcome. Results: A total of 194 patients with TNBC and 443 with non-TNBC were compared. Significant difference was present for age at presentation (p<0.0001), family history (p=0.005), grade (p<0.0001) and use of hormonal therapy (p<0.0001). The number of locoregional failures, distant failures and mortalities were not significantly different. No significant difference was present in 5 year locoregional recurrence free (96% vs 92%, p=0.3), disease free (75% vs 74%, p=0.7) and overall survival (78% vs 83%, p=0.2). On multivariate analysis, tumor size, nodal involvement and hormonal treatment were independent predictors of negative events. Conclusions: Breast conserving therapy has comparable outcomes for triple negative and non-triple negative breast cancers.