수술적 치료를 고려하는 전립선비대증 환자에서의 술 전 요역동학 검사의 진단적 가치: 체계적 문헌고찰 및 메타분석

학위논문 (박사)-- 서울대학교 대학원 : 의과대학 의학과, 2018. 2. 오승준.Purpose: To investigate the diagnostic value of urodynamic study (UDS) for benign prostatic hyperplasia (BPH) patients who are considering transurethral surgery. Methods: We systematically searched online Pubmed, Embase, and Cochrane Library database from January 1989 to June 2014. Results: A total of 22 articles met the eligibility criteria for this systematic review. The eligible studies included a total of 2,578 patients with a median number of 83 patients per study (range: 12-437). Of the 22 studies, 15 conducted conventional transurethral prostatectomy (TURP), 7 performed the other ore multiple modalities. In patients with urodynamic bladder outlet obstruction (BOO) positive patients, the pooled mean difference (MD) was significant for the better improvement of International Prostatic Symptom Score (IPSS) (pooled MD, 3.4895% confidence interval [CI], 1.72-5.24studies, 16participants, 1726), quality of life score (QoL) (pooled MD, 0.5695% CI, 0.14-1.02studies, 9participants, 1052), maximal flow rate (Qmax) (pooled MD, 3.8695% CI, 2.17-5.54studies, 17participants, 1852), and post-void residual volume (PVR) (pooled MD, 32.4695% CI, 23.34-41.58studies, 10participants, 1219) compared to non-BOO patients. In patients with detrusor underactivity (DUA), pooled MDs were significant for the poorer improvement of IPSS (pooled MD, -5.8395% CI, -7.18--4.49studies, 6participants, 340) and Qmax (pooled MD, -3.8695% CI, -4.93--2.80studies, 5participants, 355), but not in that of QoL and PVR. On the other hands, urodynamic detrusor overactivity (DO) did not correlate with improvement of all outcome parameters. Some comparisons showed between-study heterogeneity in spite of strict selection criteria of included studies. However, there was no clear evidence of publication bias in this meta-analysis. Conclusions: Our meta-analysis results showed significant association between urodynamic BOO and better improvements of all parameters of treatment outcomes. Urodynamic DUA was correlated with poorer improvement of IPSS and Qmax. However, urodynamic DO was not associated with surgical outcomes. Preoperative UDS may add insight into postoperative outcomes after surgical treatment of BPH.Introduction 1 Material and Methods 6 Results 12 Discussion 18 Conclusions 30 Acknowledgements 31 References 32 Figures 43 Tables 59 Abstract in Korean 69Docto

Social and Physical Environments and Self-Rated Health in Urban and Rural Communities in Korea

This study evaluated the associations between social and physical environments and self-rated health (SRH) for urban and rural Korean adults, using data from the Korean Community Health Survey (KCHS) of 199,790 participants (115,454 urban and 84,336 rural). The main dependent variable was SRH, while the primary independent variables were social and physical characteristics. Urban residents reported better SRH than did rural residents. Five social environmental variables (trust of neighbors, residence in the area for over 20 years, exchanging help with neighbors, friend and fellowship activities, contact with relatives and neighbors over five times per month) were more prevalent among rural residents. Satisfaction with physical environment was more common among rural residents, but satisfaction with traffic and healthcare facilities was more common among urban areas. After adjusting for relevant factors, positive associations between SRH and trust of neighbors, exchanging help with neighbors, participation in social activities or organizations, and physical environment existed in both rural and urban populations. Also, in both areas, there was no demonstrated association between SRH and years of residence or frequency of contact with relatives. Our findings suggest the existence of an association between social and physical factors and perceived health status among the general population of Korea

An XPATH query processor for a decomposition storage scheme

XML is a markup language that is widely accepted as a standard way of information sharing and exchange, especially on the Web. One of the recent database research issues is to devise ways of storing XML documents as well as retrieving them efficiently. In this paper, we present an XPath query processor that can be used for retrieving XML documents that are stored in a relational database by a decomposition storage scheme. Our XPath query processor, when given an XPath query, translates it to appropriate SQL statements. The SQL query results are then transformed to a DOM tree that is a way of representing part of an XML document. The proposed query processor is optimized for element range queries by using DFS numbers along with path expressions. We evaluated the performance of the proposed query processor using XML documents of various sizes and common types of XML queries. © Springer-Verlag Berlin Heidelberg 2003

Efficient multiple aggregations of stream data

Recently there has been a great deal of interests in analyzing stream data that can be seen in applications such as network monitoring, web click stream analysis, and sensor networks. Multiple aggregations are regarded as one of the important operations for the high level analysis of stream data as well as business data. However, existing multiple aggregation algorithms for business data are not adequate for stream data because aggregation should be done on a rapidly flowing unsorted data stream, which requires tremendous amount of time and space. We propose an algorithm for efficiently generating user selected aggregation tables from unsorted data stream. For fast aggregation, we use a combination of arrays and AVL trees as temporary storage of aggregation tables. The proposed algorithm can also be used for the cases where aggregation tables are too large to be stored in main memory during aggregation. We showed by experiments that our algorithm is practical. © 2007 IEEE

Clinical and pathologic characteristics of familial prostate cancer in Asian population

Background: We investigated prevalence of familial and hereditary prostate cancer (PCa) in Asian population, and compared clinical characteristics between familial and sporadic disease. Methods: Pedigrees of 1102 patients who were treated for PCa were prospectively acquired. Clinical and pathologic characteristics and biochemical recurrence (BCR)-free survival were compared between familial PCa and sporadic PCa in patients who underwent radical prostatectomy (RP; n = 751). Results: The prevalence of familial, first-degree familial, and hereditary PCa was found to be 8.4%, 6.7%, and 0.9%, respectively; similar result was obtained in patients who underwent RP (8.4%, 6.4%, and 0.9%). Patients with familial PCa were significantly younger than those with sporadic PCa (63.3 vs 65.6 years; P =.015). However, preoperative variables (prostate-specific antigen, clinical stage, biopsy Gleason score [GS], and percentage of positive biopsy cores) and postoperative variables (surgical GS, upgrading rate, pathologic stage, and percentage of tumor volume) did not correlate with family history (P range:.114–.982). Kaplan-Meier analysis of 5-year BCR-free survival revealed no significant difference between sporadic (82.7%), familial (89.4%; P =.594), and first-degree familial (87.1%; P =.774) PCa. Analysis of p53, Bcl-2, Ki67, and other immunohistochemistry biomarkers revealed that only increasing p53 expression and first-degree familial PCa approached significance (P =.059). Conclusion: The prevalence of familial PCa was somewhat lower in the Asian population than in other ethnic groups. Clinical and pathologic variables and selected histologic biomarker abnormalities were not significantly different in patients with and without a family history of PCa. BCR-free survival following RP was also unaffected by family history. © 2019 Wiley Periodicals, Inc

A reuse-based software development method

One of the primary obstacles to the reuse of independently-developed binary components on the industrial level lies in that the existing component technologies do not clearly separate component assembly from component development. To tackle this problem, we propose a new component model, a component assembly method, and a runtime framework, which together amounts to what we call Active Binding Technology. This new component model suggests how to make software components as pure parts, and the assembly method expresses message flows between these components in a model, while the runtime framework performs dependency injection to make the components interact with each other observing type safety constraints. © 2008 IEEE

An enterprise security management system as an ASP solution

Advances in Internet technologies have enabled not only large corporations but also small/medium businesses to utilize the Internet for their businesses. While enterprises can be more competitive with such high-tech tools, they are now inevitably exposed to various security risks and threats. In order to protect their information assets, large corporations purchase and operate enterprise security management systems which provide enterprise-level integrated security. However, they are so expensive that small/medium businesses can hardly afford to utilize one. We hold that one way of providing integrated security to small/medium businesses in a cost-effective manner is by means of an ASP solution. In this paper, we justify our proposition by analyzing the market trends for ASP in conjunction with security management software. We also propose a web-based security management system that can be used as an ASP solution. To the best of our knowledge, it is the first such system and is currently running as a commercial solution at a Korean ASP which provides services to 3,000 small/medium businesses. © 2006 IEEE

An e-learning framework supporting personalization and collaboration

Advances in Internet technology have made possible, rapid adoption of e-learning in many fields of society. Various educational methods for e-learning have been developed because personalization can be easily implemented through web services. However, these e-learning methods are not widely used because it is difficult for instructors to apply them in developing their courseware. Currently, the most widely used style of e-learning courseware is viewing video clips of lectures and discussing the lecture using bulletin boards. It is an electronic version of the traditional classroom. In this paper, we propose a user-friendly e-learning framework that supports personalization and collaboration between the instructor and the students. Instructors can create various levels of learning objects and define the relationships between the objects. Students can select the topics of their interest and dynamically adjust the level of learning in real time. Multiple instructors can cooperate in expanding the courseware. All the participants can also annotate the learning materials independently. Copyright 2009 ACM

Internet at a crossroads of education

The Internet has grown rapidly in the past few years to impact all aspects of modern life. While many areas of the Internet such as commerce has shown tremendous improvements in providing convenient and complex transaction services from shopping to banking, the area of education has seen less development in terms of meeting the potential of the Internet for education. The number of web sites related to education and the types of educational uses have clearly increased on the Internet but the overall consensus is that more should be done in the area of using the Internet to enhance the educational experience of learners. Many technological innovations have been previously touted as a new paradigm for education only to see it disappear from view quietly with time. In order to make sure that the vast potential of the Internet is fully utilized for education, more structured approach and a change in the mindset of educators are needed. © Springer-Verlag Berlin Heidelberg 2005.japan Society for the Promotion of Sccience, Japan;National Internet Development Agency of Korea, Korea;Ministry of Internal Affairs and Communications, Japa