• Tuberculosis and Respiratory Diseases
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• v.66 no.4
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• pp.280-287
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• 2009

Background: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib. Methods: We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method. Results: Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib. Conclusion: Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.5
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• pp.436-442
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• 2009

Purpose: We underwent this study to evaluate the diagnostic potential of I-123/I-131 metaiodobenzylguanidine (MIBG) scintigraphy alone in the initial diagnosis of pheochromocytoma, compared with biochemical test and anatomic imaging. Materials & Methods: Twenty two patients (M:F=13:9, Age: $44.3{\pm}\;19.3$ years) having the clinical evaluation due to suspicious pheochromocytoma received the biochemical test, anatomic imaging modality (CT and/or MRI) and I-123/I-131 MIBG scan for diagnosis of pheochromocytoma, prior to histopathological confirmation. MIBG scans were independently reviewed by 2 nuclear medicine physicians. Results: All patients were confirmed histopathologically by operation or biopsy (incisional or excisonal). In comparison of final diagnosis and findings of each diagnostic modality, the sensitivities of the biochemical test, anatomic imaging, and MIBG scan were 88.9%, 55.6%, and 88.9%, respectively. And the specificities of the biochemical test, anatomic imaging, and MIBG scan also were 69.2%, 69.2%, and 92.3%, respectively. MIBG scan showed one false positive (neuroblastoma) and one false negative finding. There was one patient with positive MIBG scan and negative findings of the biochemical test, anatomic imaging. Conclusion: Our data suggest that I-123/I-131 MIBG scan has higher sensitivity, specificity, positive predictive value, negative predictive value and accuracy than those of biochemical test and anatomic imaging. Thus, we expect that MIBG scan is e tectively used for initial diagnosis of pheochromocytoma alone as well as biochemical test and anatomic imaging.

• Sleep Medicine and Psychophysiology
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• v.28 no.2
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• pp.78-85
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• 2021

Objectives: When elderly patients show depressive symptoms, discrimination between depressive disorder and prodromal phase of Alzheimer's disease is important. We tested whether a quantitative electroencephalogram (qEEG) marker was associated with cerebral amyloid-β (Aβ) deposition in older adults with depression. Methods: Non-demented older individuals (≥ 55years) diagnosed with depression were included in the analyses (n = 63; 76.2% female; mean age ± standard deviation 73.7 ± 6.87 years). The participants were divided into Aβ+ (n = 32) and Aβ- (n = 31) groups based on amyloid PET assessment. EEG was recorded during the 7min eye-closed (EC) phase and 3min eye-open (EO) phase, and all EEG data were analyzed using Fourier transform spectral analysis. We tested interaction effects among Aβ positivity, condition (EC vs. EO), laterality (left, midline, or right), and polarity (frontal, central, or posterior) for EEG alpha band power. Then, the EC-to-EO alpha reactivity index (ARI) was examined as a neurophysiological marker for predicting Aβ+ in depressed older adults. Results: The mean power spectral density of the alpha band in EO phase showed a significant difference between the Aβ+ and Aβ- groups (F = 6.258, p = 0.015). A significant 3-way interaction was observed among Aβ positivity, condition, and laterality on alpha-band power after adjusting for age, sex, educational years, global cognitive function, medication use, and white matter hyperintensities on MRI (F = 3.720, p = 0.030). However, post-hoc analyses showed no significant difference in ARI according to Aβ status in any regions of interest. Conclusion: Among older adults with depression, increased power in EO phase alpha band was associated with Aβ positivity. However, EC-to-EO ARI was not confirmed as a predictor for Aβ+ in depressed older individuals. Future studies with larger samples are needed to confirm our results.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.185-196
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• 2023

Purpose This study aimed to investigate radiomics analysis of ultrasonographic images to develop a potential biomarker for predicting lymph node metastasis in papillary thyroid carcinoma (PTC) patients. Materials and Methods This study included 431 PTC patients from August 2013 to May 2014 and classified them into the training and validation sets. A total of 730 radiomics features, including texture matrices of gray-level co-occurrence matrix and gray-level run-length matrix and single-level discrete two-dimensional wavelet transform and other functions, were obtained. The least absolute shrinkage and selection operator method was used for selecting the most predictive features in the training data set. Results Lymph node metastasis was associated with the radiomics score (p < 0.001). It was also associated with other clinical variables such as young age (p = 0.007) and large tumor size (p = 0.007). The area under the receiver operating characteristic curve was 0.687 (95% confidence interval: 0.616-0.759) for the training set and 0.650 (95% confidence interval: 0.575-0.726) for the validation set. Conclusion This study showed the potential of ultrasonography-based radiomics to predict cervical lymph node metastasis in patients with PTC; thus, ultrasonography-based radiomics can act as a biomarker for PTC.

• Pediatric Infection and Vaccine
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• v.25 no.3
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• pp.148-155
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• 2018

Purpose: The purpose of this study was to investigate the clinical significance of Bacille Calmette-$Gu{\acute{e}}rin$ (BCG) site reaction in terms of diagnosis and outcome prediction in young children with Kawasaki disease (KD). Methods: The incidence of BCG site reaction in the respective age ranges was investigated in 1,058 patients who were admitted at Asan Medical Center between January 2006 and February 2017. The 416 patients under 18 months of age were enrolled as subjects for the analysis of the association between BCG site reaction and other laboratory and clinical findings. The analysis was performed separately in complete and incomplete KD groups. Results: The incidence rate of BCG site reaction was peaked at 6-12 months (83%) and decreased with increasing age after 12 months in 1,058 patients (P<0.001). The incidence rate was above 70% in KD aged less than 18 months and more frequent than those of cervical lymphadenopathy. The logistic regression analyses showed that the principal clinical findings including conjunctivitis (P=0.781), red lips/oral mucosa (P=0.963), rash (P=0.510), cervical lymphadenopathy (P=0.363), changes in extremities (P=0.283) and the coronary artery aneurysm (P=0.776) were not associated with the BCG site reaction. Conclusions: The BCG site reaction could be a useful diagnostic tool independent to principal clinical findings in KD developing in children aged <18 months, who underwent BCG vaccination. Outcome of KD patients was not different between groups with or without the BCG site reaction in both complete KD and incomplete KD.

• Journal of Biomedical Engineering Research
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• v.19 no.6
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• pp.603-609
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• 1998

To anlyze the diffuse axonal injury of the human brain, 3-D finite element models of the adult, two and three years child were developed. Triangular type acceleration which had its maximum value 200g was applied to investigate the effects of acceleration direction and duration time. The pattern of high shear stress generated at the brain stem, pones and midbrain was similar to the pattern of DAI seen in the clinical observation, especially high maximum shear stress was detected in the brain stem of the six year old child model under flexional acceleration. As the duration of acceleration increased generated pressure and maximum shear stress also increased. For the children's model relatively small pressure was generated regardless of the acceleration direction and continued much longer compared with adult's model. From this analysis maximum shear stress was revealed more proper indicator to predict DAI compared to HIC in case of angular acceleration loading.

• Journal of the Korea Convergence Society
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• v.8 no.7
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• pp.85-92
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• 2017

This study attempted to identify convergence effect factors affecting career-preparation behavior among nursing students with clinical practice. Study participants were 159 students in D city and data were collected from September 25 to October 4, 2014. Participants' responses were analyzed using a stepwise regression analysis. As results, satisfaction with major, professional values, and positive psychological capital were positively correlated with career-preparation behavior. Significant and convergence predictors of career-preparation behavior were curriculum satisfaction, a subdomain of major satisfaction, and social awareness as a professional value. These findings showed that nursing students' career-preparation behavior was partly determined by major satisfaction and nursing professional values. positive psychological capital need to be investigated as a convergent influence factor of career preparation behavior of nursing students by further study.

• The Journal of the Convergence on Culture Technology
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• v.9 no.3
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• pp.49-56
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• 2023

This study is a qualitative study that explores the essential meaning of nursing through a simulation curriculum targeting nursing students. In this study, 18 students, who were 4th grade nursing students at a university in M city, Gyeongsangbuk-do, completed a simulation during the curriculum. Data collection was done through free-form reports and interviews to help students understand the part of nursing they thought through simulation classes. The collected data was analyzed using Krippendorff's phenomenological method. As a result of analyzing the meaning of nursing through simulation class, 3 categories, 10 topics, and 28 meaningful statements were derived. The three categories were derived as 'virtual nursing', 'thinking nursing', and 'together nursing'. As a result of this study, nursing students were seeking their own solution to solve nursing in unpredictable situations based on the philosophy of nursing through virtual simulation. It is expected that this will be used as basic data to develop various and in-depth simulation education programs in the future.

• Restorative Dentistry and Endodontics
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• v.36 no.3
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• pp.211-218
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• 2011

Purpose: Intentional replantation (IR) is a suitable treatment option when nonsurgical retreatment and periradicular surgery are unfeasible. For successful IR, fracture-free safe extraction is crucial step. Recently, a new extraction method of atraumatic safe extraction (ASE) for IR has been introduced. Patients and Methods: Ninety-six patients with the following conditions who underwent IR at the Department of Conservative Dentistry, Seoul National University Bundang Hospital, in 2010 were enrolled in this study: failed nonsurgical retreatment and periradicular surgery not recommended because of anatomical limitations or when rejected by the patient. Preoperative orthodontic extrusive force was applied for 2-3 weeks to increase mobility and periodontal ligament volume. A Physics Forceps was used for extraction and the success rate of ASE was assessed. Results: Ninety-six premolars and molars were treated by IR. The complete success rate (no crown and root fracture) was 93% (n = 89); the limited success rates because of partial root tip fracture and partial osteotomy were 2% (n = 2) and 5% (n = 5), respectively. The clinical and overall success rates of ASE were 95% and 100%, respectively; no failure was observed. Conclusions: ASE can be regarded as a reproducible, predictable method of extraction for IR.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.5-14
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• 2003

Background : According to the study in ICOPER (International Cooperative Pulmonary Embolism Registry), the overall mortality rate of acute pulmonary thromboembolism (APTE) at 3 months is 17.4%. According to the study for current status of APTE in Japan, the hospital mortality rate is 14%. Although the incidence and mortality rate of APTE has been increasing, patient characteristics, management strategies, and outcome of APTE in the Korean population have not yet been assessed in large series. We therefore performed the national survey for the current status of APTE in the Korean population. Methods : 808 registry patients with APTE were analyzed with respect to clinical characteristics, risk factors, diagnostic procedures, treatment, and clinical outcome. Results : Main risk factors were immobilization, recent major surgery, and cancer. Common symptoms were dyspnea and chest pain. Common signs were tachypnea and tachycardia. The majority of registry patients underwent lung perfusion scanning. Spiral CT was used in 309 patients(42.9%), and angiography in 48 patients(7.9%). Heparin was the most widely used treatment. On multivariate logistic regression analysis, onset in hospital (odds ratio 1.88, p=0.0385), lung cancer (odds ratio 9.20, p=0.0050), tachypnea (odds ratio 3.50, p=0.0001), shock (odds ratio 6.74, p=0.0001), and cyanosis (odds ratio 3.45, p=0.0153) were identified as significant prognostic factors. The overall mortality rate was 16.9% and mortality associated with APTE was 9.0%. Conclusions : The present registry demonstrated the clinical characteristics, diagnostic strategies, management and outcome of patient with APTE in Korea. The mortality rate was 9.0%, and the predictors of mortality were onset in hospital, lung cancer, tachypnea, shock, and cyanosis. These results may be important for risk stratification as well as for the identification of potential candidates for more aggressive treatment.