• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6293-6299
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• 2013

Background: A number of clinicopathologic factors have been found to be associated with pathological lymph node metastasis (pLNM) in rectal cancer; however, most of them can only be identified by expensive high resolution imaging or obtained after surgical treatment. Just like the Child-Turcotte-Pugh (CTP) and the model for end-stage liver disease (MELD) scores which have been widely used in clinical practice, our study was designed to assess the pre-operative factors which could be obtained easily to predict intra-operative pLNM in rectal cancer. Methods: A cohort of 469 patients who were treated at our hospital in the period from January 2003 to June 2011, and with a pathologically hospital discharge diagnosis of rectal cancer, were included. Clinical, laboratory and pathologic parameters were analyzed. A multivariate unconditional logistic regression model, areas under the curve (AUC), the Kaplan-Meier method (log-rank test) and the Cox regression model were used. Results: Of the 469 patients, 231 were diagnosed with pLNM (49.3%). Four variables were associated with pLNM by multivariate logistic analysis, age<60 yr (OR=1.819; 95% CI, 1.231-2.687; P=0.003), presence of abdominal pain or discomfort (OR=1.637; 95% CI, 1.052-2.547; P=0.029), absence of allergic history (OR=1.879; 95% CI, 1.041-3.392; P=0.036), and direct $bilirubin{\geq}2.60{\mu}mol/L$ (OR=1.540; 95% CI, 1.054-2.250; P=0.026). The combination of all 4 variables had the highest sensitivity (98.7%) for diagnostic performance. In addition, age<60 yr and direct $bilirubin{\geq}2.60{\mu}mol/L$ were found to be associated with prognosis. Conclusion: Age, abdominal pain or discomfort, allergic history and direct bilirubin were associated with pLNM, which may be helpful for preoperative selection.

• Journal of Korea Port Economic Association
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• v.31 no.1
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• pp.85-110
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• 2015

The purpose of this paper is to show the clustering trend and the empirical comparison and to choose the clustering ports for 3 Korean ports(Busan, Incheon and Gwangyang Ports) by using the Fuzzy(Average Index Transformation) DEA and Cross-efficiency models for 38 Asian ports during 11 years(2001-2011) with 4 input variables(birth length, depth, total area, and number of crane) and 1 output variable(container TEU). The main empirical results of this paper are as follows. First, clustering results by using Fuzzy(AIT)DEA show that 3 Korean ports[Busan(56.29%), Incheon(57.96%), and Gwangyang(66.80%) each]can increase the efficiency. Second, according to Cross-efficiency model, Busan(Hongkong, Kobe, Manila, Singapore, and Kaosiung etc.), Incheon(Aquaba, Dammam, Karachi, Mohammad Byin Oasim and Davao), and Gwangyang(Damman, Yokohama, Nogoya, Keelong, Kaosiung, and Bangkok) should be clustered with those ports in parentheses. Third, when both Fuzzy(AIT)DEA and Cross-efficiency models are mixed, the empirical result shows that 3 Korean ports[Busan(71.38%), Incheon(103.89%), and Gwangyang(168.55%) each]can increase the efficiency. The efficiency ranking comparison among the three models by using Wilcoxon Signed-rank Test was matched with the average level of 66%-67%. The policy implication of this paper is that Korean port policy planner should introduce the Fuzzy(AIT)DEA, and Cross-efficiency models with the mixed two models when clustering is needed among the Asian ports for enhancing the efficiency of inputs and outputs. Also, the results of SWOT analysis among the clustering ports should be considered.

• Korean Chemical Engineering Research
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• v.51 no.4
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• pp.506-512
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• 2013

Biomass and low-grade coals are known to be better potential sources of energy compared to crude oil and natural gas since these materials are readily available and found to have large reserves, respectively. Gasification of these carbonaceous materials produced syngas for chemical synthesis and power generation. Woodchip, sawdust and lignite were gasified with steam in a thermobalance reactor under atmospheric pressure in order to evaluate their kinetic rate information. The effects of gasification temperature ($600{\sim}900^{\circ}C$) and partial pressure of steam (20~90 kPa) on the gasification rate were investigated. The three different types of gas-solid reaction models were applied to the experimental data to predict the behavior of the gasification reactions. The modified volumetric model predicted the conversion data well, thus the model was used to evaluate kinetic parameters in this study. The observed activation energy of biomass, sawdust and lignite gasification reactions were found to be in reasonable range and their rank was found to be sawdust > woodchip > lignite. The expression of apparent reaction rates for steam gasification of the three solids was proposed to provide basic information on the design of coal gasification processes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.2
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• pp.153-159
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• 2019

Job creation is the most important issue in the labor market these days, and the quality of jobs is also very important in order to resolve the mismatches that are taking place in the labor market. Kim Young-min (2014) developed the "2012 Quality of Employment Index" with twenty indicators in seven categories, including employment opportunities, to objectively assess the local labor market. This method presents the concept of the aggregate indicator, 'Quality of Work Index', and has the advantage of being easy to produce. However, it is difficult to statistically verify the adequacy of the constitutive indicators and, based on this, make them a single aggregate index through statistical techniques. Therefore, we developed an alternative '2012 Descent Work Index' and a confidence interval using Principal Component Analysis(PCA) and Unobserved Component Model(UCM) presented by Gi-Choon Kang & Myung-jig Kim (2014) and also calculated an alternative '2017 Descent Work Index' using the first half of 2017 local area labour force survey and compared its changes by region. The results of the empirical analysis show that the rank correlation coefficient between two methods of aggregating indicators, simple weight used in Young-min Kim's research, PCA method and UCM used in this study, were found to be statistically significant under 5% significance level. This implies that all methods are found to be useful. However, the PCA and UCM which determine scientific and objective weights based on data are preferred to Young-min Kim's approach. Since it provides us not only the level of aggregate indicator but also its confidence intervals, it is possible to compare ranking with the consideration of statistical significance. Therefore, it is expected that the method of constructing an aggregating indicator using UCM will be widely used in many areas in the future.

• Korean Journal of Radiology
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• v.21 no.9
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• pp.1055-1064
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• 2020

Objective: To assess the incremental prognostic value of coronary computed tomography angiography (CCTA) in comparison to a clinical risk model (Framingham risk score, FRS) and coronary artery calcium score (CACS) for future cardiac events in ischemic stroke patients without chest pain. Materials and Methods: This retrospective study included 1418 patients with acute stroke who had no previous cardiac disease and underwent CCTA, including CACS. Stenosis degree and plaque types (high-risk, non-calcified, mixed, or calcified plaques) were assessed as CCTA variables. High-risk plaque was defined when at least two of the following characteristics were observed: low-density plaque, positive remodeling, spotty calcification, or napkin-ring sign. We compared the incremental prognostic value of CCTA for major adverse cardiovascular events (MACE) over CACS and FRS. Results: The prevalence of any plaque and obstructive coronary artery disease (CAD) (stenosis ≥ 50%) were 70.7% and 30.2%, respectively. During the median follow-up period of 48 months, 108 patients (7.6%) experienced MACE. Increasing FRS, CACS, and stenosis degree were positively associated with MACE (all p < 0.05). Patients with high-risk plaque type showed the highest incidence of MACE, followed by non-calcified, mixed, and calcified plaque, respectively (log-rank p < 0.001). Among the prediction models for MACE, adding stenosis degree to FRS showed better discrimination and risk reclassification compared to FRS or the FRS + CACS model (all p < 0.05). Furthermore, incorporating plaque type in the prediction model significantly improved reclassification (integrated discrimination improvement, 0.08; p = 0.023) and showed the highest discrimination index (C-statistics, 0.85). However, the addition of CACS on CCTA with FRS did not add to the prediction ability for MACE (p > 0.05). Conclusion: Assessment of stenosis degree and plaque type using CCTA provided additional prognostic value over CACS and FRS to risk stratify stroke patients without prior history of CAD better.

• Korean Journal of Radiology
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• v.24 no.3
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• pp.190-203
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• 2023

Objective: We aimed to assess and validate the radiologic and clinical factors that were associated with recurrence and survival after curative surgery for heterogeneous targetoid primary liver malignancies in patients with chronic liver disease and to develop scoring systems for risk stratification. Materials and Methods: This multicenter retrospective study included 197 consecutive patients with chronic liver disease who had a single targetoid primary liver malignancy (142 hepatocellular carcinomas, 37 cholangiocarcinomas, 17 combined hepatocellular carcinoma-cholangiocarcinomas, and one neuroendocrine carcinoma) identified on preoperative gadoxetic acid-enhanced MRI and subsequently surgically removed between 2010 and 2017. Of these, 120 patients constituted the development cohort, and 77 patients from separate institution served as an external validation cohort. Factors associated with recurrence-free survival (RFS) and overall survival (OS) were identified using a Cox proportional hazards analysis, and risk scores were developed. The discriminatory power of the risk scores in the external validation cohort was evaluated using the Harrell C-index. The Kaplan-Meier curves were used to estimate RFS and OS for the different risk-score groups. Results: In RFS model 1, which eliminated features exclusively accessible on the hepatobiliary phase (HBP), tumor size of 2-5 cm or > 5 cm, and thin-rim arterial phase hyperenhancement (APHE) were included. In RFS model 2, tumors with a size of > 5 cm, tumor in vein (TIV), and HBP hypointense nodules without APHE were included. The OS model included a tumor size of > 5 cm, thin-rim APHE, TIV, and tumor vascular involvement other than TIV. The risk scores of the models showed good discriminatory performance in the external validation set (C-index, 0.62-0.76). The scoring system categorized the patients into three risk groups: favorable, intermediate, and poor, each with a distinct survival outcome (all log-rank p < 0.05). Conclusion: Risk scores based on rim arterial enhancement pattern, tumor size, HBP findings, and radiologic vascular invasion status may help predict postoperative RFS and OS in patients with targetoid primary liver malignancies.

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.111-124
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• 2002

Purpose : Although the average life expectancy has increased due to advances in medicine, mortality due to cancer is on an increasing trend. Consequently, the number of terminally ill cancer patients is also on the rise. Predicting the survival period is an important issue in the treatment of terminally ill cancer patients since the choice of treatment would vary significantly by the patents, their families, and physicians according to the expected survival. Therefore, we investigated the prognostic factors for increased mortality risk in terminally ill cancer patients to help treat these patients by predicting the survival period. Methods : We investigated 31 clinical parameters in 157 terminally ill cancer patients admitted to in the Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital between July 1, 2000 and August 31, 2001. We confirmed the patients' survival as of October 31, 2001 based on medical records and personal data. The survival rates and median survival times were estimated by the Kaplan-Meier method and Log-rank test was used to compare the differences between the survival rates according to each clinical parameter. Cox's proportional hazard model was used to determine the most predictive subset from the prognostic factors among many clinical parameters which affect the risk of death. We predicted the mean, median, the first quartile value and third quartile value of the expected lifetimes by Weibull proportional hazard regression model. Results : Out of 157 patients, 79 were male (50.3%). The mean age was $65.1{\pm}13.0$ years in males and was $64.3{\pm}13.7$ years in females. The most prevalent cancer was gastric cancer (36 patients, 22.9%), followed by lung cancer (27, 17.2%), and cervical cancer (20, 12.7%). The survival time decreased with to the following factors; mental change, anorexia, hypotension, poor performance status, leukocytosis, neutrophilia, elevated serum creatinine level, hypoalbuminemia, hyperbilirubinemia, elevated SGPT, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), hyponatremia, and hyperkalemia. Among these factors, poor performance status, neutrophilia, prolonged PT and aPTT were significant prognostic factors of death risk in these patients according to the results of Cox's proportional hazard model. We predicted that the median life expectancy was 3.0 days when all of the above 4 factors were present, $5.7{\sim}8.2$ days when 3 of these 4 factors were present, $11.4{\sim}20.0$ days when 2 of the 4 were present, and $27.9{\sim}40.0$ when 1 of the 4 was present, and 77 days when none of these 4 factors were present. Conclusions : In terminally ill cancer patients, we found that the prognostic factors related to reduced survival time were poor performance status, neutrophilia, prolonged PT and prolonged am. The four prognostic factors enabled the prediction of life expectancy in terminally ill cancer patients.

• Journal of Environmental Impact Assessment
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• v.21 no.3
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• pp.483-501
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• 2012

The purpose of this study was to apply a multi-metric model of Lentic Ecosystem Health Assessments(LEHA) for environmental impact assessments of Cheongpyung Reservoir during 2005 - 2006 and assessed the ecological model values. The ecosystem model of LEHA was composed of eleven metrics such as biological parameters($B_p$), physical parameters($P_p$), and chemical parameters($C_p$), and determined the rank of ecological health by the criteria. The variables of $B_p$ were metrics of % sensitive species($M_2$, NMS) and insectivore species($M_5$, % $I_n$), which decrease as the water quality degradates, and these metric values were low as 1.5% and 32.4%, respectively. In contrast, the proportions of tolerant species and omnivore species as the other $B_p$ parameters were 43% and 62%, respectively, which indicate a degradation and disturbance of the ecosystem. Riparian vegetation coverage($M_9$, % $V_c$) as a variable of $P_p$, were higher in the 2nd than 1st survey, and decreased toward the dam site from the headwaters. This was due to a habitat simplification(modifications) by frequent bottom dredging of sand and rocks. The variables of $C_p$ were two metrics of specific conductivity($M_{10}$, $C_I$) as an indicator of ionic contents(cations and anions) and the Trophic State Index(TSI) based on chlorophyll-a($M_{11}$, $TSI_{CHL}$) as an indicator of trophic state. These metric values of $C_p$ had high temporal variations, but low spatial variations on the main axis of the reservoir along with the ecological health of a good condition. The environmental impact assessments using the LEHA multi-metric model indicated that the model values of LEHA averaged 30.7 in 1st survey(fair - poor condition) vs. 28 in 2nd survey(poor condition), indicating a temporal variation of the ecological health. The model values of LEHA showed a minimum(28) in the lacustrine zone(S5) and ranged from 29 to 30 in the other locations sampled, indicating a low longitudinal variation. Overall, environmental impact assessments, based on LEHA model, suggest that chemical water quality conditions were in good, but biological conditions were disturbed due to habitat modifications by frequent dredgings in the system.

• Child Health Nursing Research
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• v.2 no.1
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• pp.13-26
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• 1996

This descriptive study was done to detect the possibilities of the development of the advocacy concept in nursing. The subjects consisted of 3 nurses who had agreed to participate to the study, working at nursery room in a general hospital. Data was collected from May 22 to June 13 in 1995 through tape recorded intensive-interview, and written down, then content analyzed qualitatively related to the infant advocacy. 1. Derivation fo the meaning about advocacy concept 1) The situations in need of infant advocacy were 12 categories : malpractice, overcharing, negligence, unnecessary services, and services without consent, and so on. 2) Fourteen categories of advocacy activities percived by nurses were derived from participants' statements. Protesting infant or his /her families against their counterpart, providing informations to families, cooperating with medical staffs for her patient, then calling medical staff not so as to be maleficient to her patient in its rank. 3) The expected result of advocacy activities perceived by nurses was respectively positive to her patient or families, but negative to nurse. 4) The feelings of nurses in the sitution of advocacy were expressed in to concern, comprehension, regret, powerlessness, charity, desire, and so on. 5) Nurses perceived that advocacy activities could be influenced positively by factors related to nurses' qualification and negatively by factors related to doctor's overdo and nurse's underdo. 2. Categorization of the meaning and their relationships In case of antecedental situation in need of infant advocacy, nurse perceives her patients need the advocacy to get a benefit through nurse's information, intervention speaking, building cooperations. The expected factors to influence advocacy activities perceived by nurses, are the power imbalance between medical staffs, the nurse's qualification, and the nurse's feeling from the situation. The above results suggest that the infant care situation will be recommendable field work place for concept development of advocacy with hybride model when it involves infant's families.

• Journal of Korea Water Resources Association
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• v.45 no.9
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• pp.901-913
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• 2012

This study will be a new attempt to quantify flood vulnerability taking into account uncertainty. Information obtained from the real world has lots of uncertainties. Therefore, this study developed an approach to quantify spatial flood vulnerability of Korea using Fuzzy TOPSIS approach. Also, Fuzzy TOPSIS were compared with TOPSIS and weighted sum method. As a result, rankings of some areas were changed dramatically due to the uncertainty. Spearman rank correlation analysis indicated that the rankings of TOPSIS and weighted sum method were almost similar, but quite different from ranking of Fuzzy TOPSIS. In other words, because applying Fuzzy concept in regional vulnerability assessment may cause a significant change in priorities, the model presented in this study may be a method of vulnerability assessment.