• 한국대기환경학회:학술대회논문집
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• 한국대기환경학회 2004년도 춘계학술대회 논문집
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• pp.108-109
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• 2004

• Toxicological Research
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• 제32권1호
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• pp.5-8
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• 2016

Risk assessment is the process of quantifying the probability of a harmful effect to individuals or populations from human activities. Mechanistic approaches to risk assessment have been generally referred to as systems toxicology. Systems toxicology makes use of advanced analytical and computational tools to integrate classical toxicology and quantitative analysis of large networks of molecular and functional changes occurring across multiple levels of biological organization. Three presentations including two case studies involving both in vitro and in vivo approaches described the current state of systems toxicology and the potential for its future application in chemical risk assessment.

• 대한소아치과학회지
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• 제40권1호
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• pp.72-81
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• 2013

최근 2세에서 5세 사이 소아의 우식 발생율이 상당히 증가하고 있다. 유아기우식증(Early Childhood Caries)은 향후 영구치의 우식 발생 가능성에 대한 예측인자이며 사회 저소득층과 다문화 가정 자녀에서 특히 발생빈도가 높은데, 이는 충분히 예방과 관리가 가능하다. 만1세때부터 정기적으로 치과를 방문하고 이 때 우식위험도를 체계적으로 평가하여 환자들에게 맞춤형 예방 전략을 제시할 수 있기 때문이다. 유아기우식증의 예방을 위한 CAMBRA (Caries Management by Risk Assessment)에 대해 가장 최신의 개념과 사용법을 소개하고자 한다. 소아치과의사는 CAMBRA를 통해 개개인의 위험인자를 분석하여 연령에 따른 적절한 예방법을 수립하고 향후 우식 발생시 치료방향의 지침을 정하게 된다.

• 한국화재소방학회논문지
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• 제14권3호
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• pp.27-32
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• 2000

산림에 대한 화재 위험성 평가는 산불의 예방, 진화 및 관리에 있어서 우선적으로 고려되어야 할 부분이다. 단일 화재로서는 축내 최대 규모인 1997년 4월에 발생한 강원도 고성산불과 2000년 4월에 발생한 강원도 영동지방 산불은 이러한 화재위험성 평가의 필요성을 절실히 요구하고 있다. 현재 국내에서의 사용하고 있는 위험도의 표현은 기상인자에 의해 연료가 화재에 노출될 수 있는 위험을 나타낸 것으로 습도측정봉 무게 환산식을 통해 산불 발생 위험지수 산정하여 산불경보시스템을 사용하며 나타내고 있다. 앞으로, 지역별 종합적인 산림화재 위험성 평가를 위해서는 주요 인자들의 위험성을 측정하고 통계적 고찰을 통한 위험성 평가를 표현할 필요성이 있다. 이에 본 연구에서는 먼저 통계적 고찰을 통해 발생 빈도와 피해의 심각성을 분석하여 위험성을 평가하였고 수목의 열량적 가치를 시차주사열량계 실험을 통해 분석하여 수목분포도에 따를 열적 상대 위험성을 평가하였다

• 의학교육논단
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• 제10권1호
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• pp.35-42
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• 2008

Purpose : Since PBL was first developed by Howard Barrows at McMaster, it has been adopted as one of the best teaching and learning methods in medical schools throughout the world. However, the educational superiority of PBL relative to traditional approaches is less clear. Given the somewhat extensive resources required for the operation of PBL curriculum, this gives reason for concern. The aim of this study is to review experiences of PBL in other medical schools and learn how to implement PBL in our school. Methods : This study was undertaken in two stages. In the first stage, PBL curricular examples in 7 medical schools (University of Pennsylvania, University of Melbourne, University of Maastricht, McMaster University, Flinders University, Harvard medical school. University of California at L.A.) were collected and summarized. In the second stage, a careful search for articles of journals published since 2000 regarding PBL group assessment, effectiveness of PBL and group facilitation skills was conducted. Results : PBL is generally introduced in a core curriculum in undergraduate medical education. Relating to small group assessment, the perception of students has been well developed. but the current PBL assessment tool needs to be revised, to develop thinking skills of students. The PBL graduates considered themselves as having much better interpersonal skills, better competencies in problem solving and self-directed learning than the non-PBL graduates. Tutors used various techniques to raise awareness, facilitate the group process and direct learning. Conclusions : The following three aspects can be regarded as important in this study. First, to implement PBL in our school more effectively, it might be considered, which curriculum content can be best learned with PBL. Second, to enhance students' thinking skills during PBL, a new assessment tool needs to be developed. Third, tutors' competencies are important to facilitate, group process, so it would be worthwhile including in staff development.

• The Korean Journal of Pain
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• 제28권2호
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• pp.75-87
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• 2015

Background: Lumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery. Methods: A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. Results: Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. Conclusions: The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.

• The Korean Journal of Pain
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• 제34권3호
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• pp.346-368
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• 2021

Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

• The Korean Journal of Physiology
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• 제6권1호
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• pp.39-42
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• 1972

This study was carried out on the energy expenditure and physical capacity of 504 persons from 17 occupations. The energy expenditure was measured by indirect calorimetry using a Douglas' bag and Scholander's gas analyser. The physical capacity was determined by the Harvard's step test and the maximum oxygen consumption using a treadmill. The assessment of the daily energy expenditure for each subject was made by the factorial method using a record of the activies throughout 24 hours of every survey day. The total daily energy expenditure is the sum of all energy expenditure. This was calculated by multiplying the caloric value of the metabolic rate by the time spent on each activity. Most of the occupations involved moderate or heavy work.

• Journal of Preventive Medicine and Public Health
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• 제56권2호
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• pp.145-153
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• 2023

Objectives: Although it is difficult to define the quality of stroke care, acute ischemic stroke (AIS) patients with moderate-to-severe neurological deficits may benefit from thrombectomy-capable hospitals (TCHs) that have a stroke unit, stroke specialists, and a substantial endovascular thrombectomy (EVT) case volume. Methods: From national audit data collected between 2013 and 2016, potential EVT candidates arriving within 24 hours with a baseline National Institutes of Health Stroke Scale score ≥6 were identified. Hospitals were classified as TCHs (≥15 EVT case/y, stroke unit, and stroke specialists), primary stroke hospitals (PSHs) without EVT (PSHs-without-EVT, 0 case/y), and PSHs-with-EVT. Thirty-day and 1-year case-fatality rates (CFRs) were analyzed using random intercept multilevel logistic regression. Results: Out of 35 004 AIS patients, 7954 (22.7%) EVT candidates were included in this study. The average 30-day CFR was 16.3% in PSHs-without-EVT, 14.8% in PSHs-with-EVT, and 11.0% in TCHs. The average 1-year CFR was 37.5% in PSHs-without-EVT, 31.3% in PSHs-with-EVT, and 26.2% in TCHs. In TCHs, a significant reduction was not found in the 30-day CFR (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.76 to 1.12), but was found in the 1-year CFR (OR, 0.84; 95% CI, 0.73 to 0.96). Conclusions: The 1-year CFR was significantly reduced when EVT candidates were treated at TCHs. TCHs are not defined based solely on the number of EVTs, but also based on the presence of a stroke unit and stroke specialists. This supports the need for TCH certification in Korea and suggests that annual EVT case volume could be used to qualify TCHs.

• Clinics in Shoulder and Elbow
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• 제18권4호
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• pp.229-236
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• 2015

Background: Twenty-six patients (12 male and 14 female) with symptomatic scapular winging caused by serratus anterior dysfunction were managed by split pectoralis major tendon transfer (sternal head) with autogenous hamstring tendon augmentation from 1998 to 2006. Methods: Twenty-five patients showed positive results upon long thoracic nerve palsy on electromyography. The mean duration of symptoms until surgery was 48 months (range, 12-120 months). Four patients had non-traumatic etiologies and 22 patients had traumatic etiologies. On follow-up assessment for functional improvement, a Constant-Murley score was used. Twenty-one patients were completely evaluated, while five patients who had less than 12 months of follow-up were excluded. Results: Pain relief was achieved in 19 of the 21 patients, with 20 patients showing functional improvement. The pain scores improved from 6.0 preoperatively to 1.8 postoperatively. The mean active forward elevation improved from $108^{\circ}$ (range, $20^{\circ}-165^{\circ}$) preoperatively to $151^{\circ}$ (range, $125^{\circ}-170^{\circ}$) postoperatively. The mean Constant-Murley score improved from 57.7 (range, 21-86) preoperatively to 86.9 (range, 42-98) postoperatively. A recurrence developed in one patient. Of the 21 patients, ten had excellent results, six had good results, four had fair results, and one had poor results. Conclusions: Most patients with severe symptomatic scapular winging showed functional improvement and pain relief with resolution of scapular winging.