• Journal of the Korean Society of Radiology
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• v.79 no.6
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• pp.340-347
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• 2018

Purpose: To evaluate value of image subtraction for identifying hepatocellular carcinoma (HCC) capsule on gadoxetic acid-enhanced MR images. Materials and Methods: This study involved 108 patients at risk of HCC preoperatively examined using gadoxetic acid-enhanced MRI with hepatic resection between May 2015 and February 2017. We evaluated qualities of subtraction images and presence of capsular appearance on portal venous or transitional phases conventional and subtraction images. We assessed effect of capsular appearance on subtraction images on HCC. Results: After excluding 1 patient who had treated by transarterial chemoembolization prior to surgery and 33 patients with unsatisfactory subtraction image qualities, 82 focal hepatic lesions (73 HCC, 5 non-HCC malignancies, and 4 benign) from 74 patients were analyzed. Regarding detection of capsules, sensitivity, accuracy, and area under the receiver operating characteristic curve (AUC) on subtraction images were significantly higher than those on conventional images (95.4%, 89.0%, and 0.80, respectively; p < 0.001), though specificities were same (64.7%). For diagnosis of HCC, sensitivity, accuracy, and AUC on subtraction images were significantly higher than on conventional images (82.2%, 79.3%, and 0.69, respectively; p = 0.011), though specificities were identical (55.6%). Conclusion: Portal venous or transitional phase gadoxetic acid-enhanced MRI subtraction images could improve detection of HCC capsule.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.283-309
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• 2021

Achieving profound anesthesia in mandibular molars with irreversible pulpitis is a tedious task. This review aimed at evaluating the success of buccal/lingual infiltrations administered with a primary inferior alveolar nerve block (IANB) injection or as a supplemental injection after the failure of the primary injection in symptomatic and asymptomatic patients with irreversible pulpitis in human mandibular molars. The review question was "What will be the success of primary and supplemental infiltration injection in the endodontic treatment of patients with irreversible pulpitis in human mandibular molars?" We searched electronic databases, including Pubmed, Scopus, and Ebsco host and we did a comprehensive manual search. The review protocol was framed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. We included clinical studies that evaluated and compared the anesthetic outcomes of primary IANB with primary and/or supplementary infiltration injections. Standard evaluation of the included studies was performed and suitable data and inferences were assessed. Twenty-six studies were included, of which 13 were selected for the meta-analysis. In the forest plot representation of the studies evaluating infiltrations, the combined risk ratio (RR) was 1.88 (95% CI: 1.49, 2.37), in favor of the secondary infiltrations with a statistical heterogeneity of 77%. The forest plot analysis for studies comparing primary IANB + infiltration versus primary IANB alone showed a low heterogeneity (0%). The included studies had similar RRs and the combined RR was 1.84 (95% CI: 1.44, 2.34). These findings suggest that supplemental infiltrations given along with a primary IANB provide a better success rate. L'Abbe plots were generated to measure the statistical heterogeneity among the studies. Trial sequential analysis suggested that the number of patients included in the analysis was adequate. Based on the qualitative and quantitative analyses, we concluded that the infiltration technique, either as a primary injection or as a supplementary injection, given after the failure of primary IANB, increases the overall anesthetic efficacy.

• The Journal of the Convergence on Culture Technology
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• v.8 no.6
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• pp.515-522
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• 2022

This study analyzed the child protection system in Germany from a preventive perspective and attempts to find the applicable implications to Korea. The research method was analyzed in terms of legal, policy and professionalism. The result is as follows. First, Child and Youth Support Act in Germany stipulated a preventive support system to restore the function of the family. Second, according to the Civil Act, it was stipulated that the family court could intervene early. Third, the federal Child Protection Act stipulated community cooperation for thd child protection system. Fourth, the Youth Agency as the general authority made it possible to provide preventive support and intervention at the same time. Firth, qualification standards were specified in the Child and Youth Support Act. Child protection specialists are granted to public officials who have worked for more than three years. The implications are as follows. First, the child protection system, which operates as a child abuse reporting system, should be expanded to a preventive support system. Second, it is necessary to expand monitoring by establishing an early warning system between networks in order to establish a support system for potentially at-risk children. Third, local governments should support children and parents flexibly and comprehensively for dysfunction caused by difficulties at home. Fourth, it is necessary to enact the Child Protection System Cooperation Act for a network cooperation system.

• Korean Journal of Clinical Pharmacy
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• v.32 no.2
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• pp.116-124
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• 2022

Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.

• Journal of Korean Medicine Rehabilitation
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• v.34 no.2
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• pp.101-134
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• 2024

Objectives The purpose of this study is to observe the effectiveness of acupotomy treatment for lateral epicondylitis by comparing it with various control groups. Methods We searched 11 domestic and international databases for systematic reviews and meta-analysis. The subjects were studies published from January 1, 2017 to September 1, 2023, and only randomised controlled trials were included. Results 208 studies were searched, of which 21 studies were finally selected. Among the studies published after 2017, the largest number of studies was published in 2019. The average number of participants per study was 72.28±20.26 and the average age was in the 40s. The most frequent intervention in the study was acupotomy alone, and the treatment most often mentioned as a control group was local nerve block. The most used evaluation tool is efficiency. Acupotomy+manipulation had statistically better effect than that of local nerve block in terms of pain (standard mean difference -1.87, 95% confidence interval, -2.18 to -1.57, p<0.00001) and elbow joint function (standard mean difference 2.25, 95% confidence interval, 1.65 to 2.86, p<0.00001). Conclusions As a result of the meta-analysis, the effect of acupotomy added manual therapy treatment was statistically significant compared to the local nerve block frequently used for lateral epicondylitis. Based on these results, it appears that more research on combination treatments other than acupotomy treatment will be needed. Also, it appears that more large-scale randomized controlled studies that strictly adhere to the standards for reporting interventions in controlled trials of acupuncture, risk of bias 2 criteria will be needed.

• Clinical Endoscopy
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• v.57 no.2
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• pp.181-190
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• 2024

Background/Aims: Radiofrequency ablation (RFA) is the first-line therapy for dysplastic Barrett's esophagus (BE). Therefore, cryotherapy has emerged as an alternative treatment option. This study aimed to compare the efficacies of these two techniques based on the rates of complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D). Adverse events and recurrence have also been reported. Methods: An electronic search was conducted using the Medline (PubMed), Embase, LILACS, and Google Scholar databases until December 2022. Studies were included comparing cryotherapy and RFA for treating dysplastic BE with or without early esophageal neoplasia. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Three retrospective cohort studies involving 627 patients were included. Of these, 399 patients underwent RFA, and 228 were treated with cryotherapy. There was no difference in CE-IM (risk difference [RD], -0.03; 95% confidence interval [CI], -0.25 to 0.19; p=0.78; I²=86%) as well as in CE-D (RD, -0.03; 95% CI, -0.15 to 0.09; p=0.64; I²=70%) between the groups. The absolute number of adverse events was low, and there was no difference in the recurrence rate. Conclusions: Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.6
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• pp.438-448
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• 2017

This study was a systematic review and meta-analysis that evaluated the results of research on the pain reduction effects of lidocaine gel for urethral catheterization in adults. A literature search was conducted using seven electronic databases, gray literature and other resources based on the guidelines of Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA). A Risk of Bias (RoB) tool was applied to assess the quality of selected studies. Data were analyzed using the RevMan 5.3.-program. Sixteen randomized controlled trials involving 1904 adults were included. RoB was not observed in the funnel plot. Overall, lidocaine gel was effective for pain reduction during urethral catheterization (Standard Mean Difference[SMD] -0.96;95% CI: -1.43, -0.49). To explore the cause of heterogeneity (I2=95%, p<.001), subgroup analysis was conducted according to three catheter types (urinary catheter, flexible cystoscopy, and rigid cystoscopy) and the SMDs were -0.88 (95% CI:-1.51, -0.26), -0.31 (95% CI:-0.63, 0.01), and -1.93 (95% CI:-2.88, -0.97), respectively. A significant pain reduction effect was observed regardless of gender in urinary catheterization. However, in rigid cystoscopy, a significant pain reduction effect was observed only in male subjects. Pain reduction effects were observed when 10~11ml lidocaine gel was used during rigid cystoscopy and when lubrication was used during urinary catheterization, irrespective of application time. These findings suggest that lidocaine gel is a useful anesthetic lubricant for urinary catheterization and rigid cystoscopy in male adults.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.103-115
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• 1999

Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

• Journal of the Korean Society for Marine Environment & Energy
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• v.13 no.4
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• pp.335-340
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• 2010

The paper describes the objectives of Yellow Sea Large Marine Ecosystem (YSLME) project, focusing on procedural and practical aspects. YSLME is a highly productive sea yet possibly one of the most impacted large marine ecosystems, in terms of anthropogenic stressors, due the enormous coastal population. The aim of the YSLME project is the reduction of ecosystem stress through identification of the environmental problems in the Transboundary Diagnostic Analysis (TDA) that are then addressed in the Strategic Action Programme (SAP). One of the major problems found to be affecting biological diversity is habitat modification through wetland reclamation, conversion and degradation. Since the early 1900's more than 40% of intertidal wetlands have been reclaimed in Korea, and 60% of Chinese coastal wetlands have been converted or reclaimed. Damaging fishing practices, pollution and coastal eutrophication have further degraded the coastal environment reducing the biological diversity. To combat this loss, the YSLME project has mounted a public awareness campaign to raise environmental consciousness targeted at all different levels of society, from politicians at parliamentary workshops, local government officer training events, scientific conferences and involvement of scientists in the project research and reporting, to university and high school students in our visiting internship programmes and environmental camps. We have also built networks through the Yellow Sea Partnership and by liaising and working with other environmental organizations and NGOs. NGO's are recognised as important partners in the environmental conservation as they already have extensive local networks that can be lacking in international organisations. Effective links have been built with many of these NGOs through the small grants programme. Working with WWF's YSESP project and other academic and research institutions we have conducted our own biodiversity assessments that have contributed to the science-based development of the SAP for the YSLME. Our regional targets for biodiversity outlined in the SAP include: Improvements in the densities, distributions and genetic diversity of current populations of all living organisms including endangered and endemic species; Maintenance of habitats according to standards and regulations of 2007; and a reduction in the risk of introduced species. Endorsement of the SAP and its successful implementation, during the proposed second phase of the YSLEM project, will ensure that biological diversity is here to benefit future generations.

• Management & Information Systems Review
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• v.39 no.3
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• pp.1-16
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• 2020

The current tariff return system requires tax officials to calculate tax amount by themselves and pay the tax amount on their own responsibility. In other words, in principle, the duty and responsibility of reporting payment system are imposed only on the taxee who is required to calculate and pay the tax accurately. In case the tax payment system fails to fulfill the duty and responsibility, the additional tax is imposed on the taxee by collecting the tax shortfall and imposing the tax deduction on For this reason, item classifications, together with tariff assessments, are the most difficult and could pose a significant risk to entities if they are misclassified. For this reason, import reports are consigned to customs officials, who are customs experts, while paying a substantial fee. The purpose of this study is to classify HS items to be reported upon import declaration and to indicate HS codes to be recorded on import declaration. HS items were classified using the attached image in the case of item classification based on the case of the classification of items by the Korea Customs Service for classification of HS items. For image classification, CNN was used as a deep learning algorithm commonly used for image recognition and Vgg16, Vgg19, ResNet50 and Inception-V3 models were used among CNN models. To improve classification accuracy, two datasets were created. Dataset1 selected five types with the most HS code images, and Dataset2 was tested by dividing them into five types with 87 Chapter, the most among HS code 2 units. The classification accuracy was highest when HS item classification was performed by learning with dual database2, the corresponding model was Inception-V3, and the ResNet50 had the lowest classification accuracy. The study identified the possibility of HS item classification based on the first item image registered in the item classification determination case, and the second point of this study is that HS item classification, which has not been attempted before, was attempted through the CNN model.