• Radiation Oncology Journal
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• v.22 no.3
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• pp.184-191
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• 2004

Purpose: In order to improve the proper use of radiotherapy and breast-conserving treatment (BCT) in the management of breast cancer, current status of breast cancer treatment in Korea was surveyed nationwide and the use of BCT were evaluated. Materials and Methods: Patients characteristics and treatment pattern of 1048 breast cancer patients from 27 institutions diagnosed between January, 1998 and June, 1998 were analyzed. The incidence of receiving BCT was analyzed according to the stage, age, geography, type of hospital, and the availability of radiotherapy facility. Results: Radical mastectomy was peformed in 64.8$\%$ of total patients and 26$\%$ of patients received breast- conserving surgery (BCS). The proportions of patients receiving BCT were 47.5$\%$ in stage 0, 54.4$\%$ in stage I, and 20.3$\%$ in stage II, Some of the patients (6.6$\%$ of stage I, 10.1$\%$ of stage II and 66.7$\%$ of stage III) not received radiotherapy after BCS. Only 45$\%$ of stage III patients received post-operative radiotherapy after radical mastectomy. The proportion of patients receiving BCT was different according to the geography and availability of radiotherapy facilities. Conclusion: Radiotherapy was not fully used in the management of breast cancer, even in the patients received breast-conserving surgery. The proportion of the patients who received BCT was lower than the report of western countries. To improve the application of proper management of breast cancer, every efforts such as a training of physicians, public education, and improving accessibility of radiotherapy facilities should be done. The factors predicting receipt of BCT were accessibility of radiotherapy facility and geography. Also, periodic survey like current research is warranted.

• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.29-56
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• 2016

$F{\ddot{u}}r$ den Schadensersatzhaftung des Arztes, sog. die Arzthaftung, ist es vornehmlich vorauszusetzen: die $Sch{\ddot{a}}digungsbehandlung$ des Arztes, die Rechtswidrigkeit und das Verschulden. Zur Problematik der $Fahrl{\ddot{a}}ssigkeit$ in der Stufe des Verschuldens handelt sich es in dieser Beitrag um die Kritisierung der Rechtsprechung. $F{\ddot{u}}r$ die Entscheidung des Verschulden im medizinischen Fehler kommt es darauf an, ob die Sorgfaltspflicht des Arztes verletzt wird. $Daf{\ddot{u}}r$ wird der medizinische Standard rekurriert, den die Rechtsprechung nicht aus materieller, sondern aus normativer Sicht begreift. Erstaunlich $un{\ddot{u}}bereinstimmend$ mit deren Leitsatz wird der medizinische Standard als $Ma{\ss}stab$ der Sorgfaltspflicht materiell - zutreffend nur im Ergebnis - behandelt. Die Sorgfaltspflicht in der Medizin bedeutet nicht die natur-wissenschaftliche Erkenntnisse, sondern eine "Best-$M{\ddot{u}}ssen$" Pflicht. Demnach ist der Standpunkt der Rechtsprechung, wonach den med. Standard normativ bewertet und die Sorgfaltspflicht darduch wieder normativ entscheidet, nicht anders als eine $w{\ddot{o}}rtliche$ Wiederholung. Die Arzthaftung in der Rechtsprechung ist aufgrund mit der Verneinung von der Sorgfaltspflichtverletzung nicht angenommen, welche in der Tat jedoch aus verschiedenen $Gr{\ddot{u}}nden$, wie die Rechtswidrigkeit, die $Fahrl{\ddot{a}}ssigkeit$ oder $Kausalit{\ddot{a}}t$, nicht angenommen. Der $Fahrl{\ddot{a}}ssigkeitsbeweis$ in der Rechtsprechung entwickelt sich mit dem Beweis nach objektivem $Ma{\ss}stab$, der Vermutung nach Anschein-Beweis und der $Beschr{\ddot{a}}nkung$ mit der Wahrscheinlichkeit. Bei Letzterem $geh{\ddot{o}}rt$ es $schlie{\ss}lich$ zum medizinischen Bereich. Ein Eintritt in den fachliche Bereich im Rahmen der Beweislast stellt der Beweiserleichterung $gegen{\ddot{u}}ber$. Aus diesem Hintergrund ist ${\S}630$ h Abs. 5 BGB bemerkenswert, wonach das Vorliegen eines groben Behandlungsfehler $regelm{\ddot{a}}{\ss}ig$ zur Vermutung von der $Kausalit{\ddot{a}}tszusammenhang$ $f{\ddot{u}}hrt$. Dieser Paragraph ist inhaltlich als Beweislastumkehr angesehen. Damit ist es von Nutzen im Fall des groben Fehler, der beim - elementaren - kunstgerechten Verhalten nicht entstanden $h{\ddot{a}}tte$, wie $Hygienem{\ddot{a}}ngel$, ${\ddot{U}}berdosierung$ des Narkotikum.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.37-43
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• 1994

The coronary collateral vessels have revealed their significance in terms of reduction of infarct size, preservation left ventricular function, and prevention of left ventricular aneurysm in patients with myocardial infarction. The purpose of this study were to evaluated the relation between collateral circulation and $^{99m}Tc$-MIBI Heart SPECT in patient with acute myocardial infarction and their clinical significance. The fifty six MI patients with antegrade TIMI perfusion grade 0 and 1 were studied. The patients were classified into two groups; Group I inclueded 30 patients with grade 2, 3 Collateral flow. Group II inclueded 26 patients with grade 0, 1 Collateral flow. Collateral filling were graded from 0 to 3: 0- none, 1- Filling of side branch only, 2- Partial filling of the epicardial segment, 3- Complete filling of epicardial segment. Clinical variables, left ventricular function, $^{99m}Tc$-MIBI Heart SPECT were analyzed with angiographic finding. Results were following: 1) Collateral visualization was found to be greater in patient with involvement of right coronary artery (RCA). The collateral development site of infarct related artery was RCA 15 cases, left anterior descending artery (LAD) 10 cases, left circumflex artery (LCX) 5 cases, and the collateral circulation from LAD to RCA was 13 cases (40.6%). 2) There was a tendency to be decreased in peak CK activity with group I. 3) The presence of good collateral channels was more frequently $^{99m}Tc$-MIBI reversible perfusion defect (83.4% vs 15.3%, p<0.05). 4) No differences of left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), ejection fraction (EF) were noted between group I and group II. The presence of good collateral channels did affect the frequency of occurrence of $^{99m}Tc$-MIBI reversible perfusion defect.

• The Korean Journal of Nuclear Medicine
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• v.29 no.4
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• pp.533-540
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• 1995

Attenuation correction is important in producing quantitative positron emission tomography (PET) images. Conventionally, photon attenuation effects are corrected using transmission measurements performed before tracer administration. The pre-injection transmission measurement approach may require a time delay between transmission and emission scans for the tracer studies requiring a long uptake period, about 45 minutes for F-18 deoxyglucose study. The time delay will limit patient throughput and increase the likelihood of patient motion. A technique lot performing simultaneous transmission and emission scans (T+E method) after the tracer injection has been validated. The T+E method substracts the emission counts contaminating the transmission measurements to produce accurate attenuation correction coefficients. This method has been evaluated in experiments using a cylindrical phantom filled with background water (5750 cc) containing $0.4{\mu}Ci/cc$ of F-18 fluoride ion and one insert cylinder (276 cc) containing $4.3{\mu}Ci/cc$. GE $Advance^{TM}$ PET scanner and Ge-68 rotating pin sources for transmission scanning were used for this investigation. Post-injection transmission scan and emission scan were peformed alternatively over time. The error in emission images corrected using post-infection transmission scan to emission images corrected transmission scan was 2.6% at the concentration of $1.0{\mu}Ci/cc$. No obvious differences in image quality and noise were apparent between the two images. The attenuation correction can be accomplished with post-injection transmission measurement using rotating pin sources and this method can significantly shorten the time between transmission and omission scans and thereby reduce the likelihood of patient motion and increase scanning throughput in PET.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.293-300
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• 1994

It is well known that Tc-99m HMPAO brain SPECT can reflect the functional lesions better than X-ray computerized tomography(CT) and magnetic resonance imaging(MRI) in the cerebral disorders. In order to evaluate the clinical utilities of Tc-99m HMPAO brain SPECT in patients with post-traumatic chronic organic mental disorder(OMD), we included 28 patients diagnosed as OMD in department of psychiatry after traumatic head injury. And we compared the results of Tc-99m HMPAO SPECT with those of MRI, EEG and MINI mental status ex amination(MMSE). The results were as follows 1) All patients diagnosed as OMD showed diffuse or focal decreased cerebral perfusion on Tc-99m HMPAO SPECT. 2) Most frequent lesion on brain Tc-99m HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain Tc-99m HMPAO SPECT showing normal brain MRI result was also decreased both frontal perfusion. 3) Eight of 28 patients showed focal brain MRI lesions(4 small frontal hygroma, 3 small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain Tc-99m HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20 points. In conclusion, we think that Tc-99m HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disorder.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.5
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• pp.395-401
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• 2009

Purpose: We evaluated $^{18}F$-FDG PET/CT findings in initially diagnosed adenoid cystic carcinoma (ACC) of the head and neck in association with pathological subtype, staging, uptake comparison with squamous cell carcinoma (SqCC) and prognosis. Materials and Methods: The subjects were 16 patients with initially diagnosed ACC of head and neck who underwent pretreatment $^{18}F$-FDG PET/CT. Histological subtype (solid pattern vs. tubular/cribriform pattern), $SUV_{max}$ of size-matched SqCC of the head and neck as control group, disease-free survival (DFS) were compared with the $SUV_{max}$ of ACC of the head and neck. Results: Of total 16 patients, 6 had solid pattern and the remaining 10 had tubular/cribriform pattern. The $SUV_{max}$ were significantly higher in solid pattern group than in tubular/cribriform pattern group ($6.7{\pm}3.2$ vs. $4.2{\pm}0.9$, p=0.03). PET/CT found unexpected distant metastasis in 18.7% of patients (3/16) and changed the therapeutic plan in those patients. The $SUV_{max}$ of ACC was significantly lower than that of size-matched SqCC ($5.1{\pm}2.4$ vs. $13.6{\pm}6.0$, p<0.001). DFS was not significantly different according to the histological subtype. In contrast, patients with high $^{18}F$-FDG uptake ($SUV_{max}$ ${\geq}$6.0) had significantly shorter DFS than those with low $^{18}F$-FDG uptake ($SUV_{max}$ <6.0). Conclusion: $^{18}F$-FDG uptake of ACC of the head and neck is significantly associated with histological subtype and DFS. $^{18}F$-FDG PET/CT may be useful for detecting unexpected metastasis. Since $^{18}F$-FDG uptake of tubular/cribriform ACC compared with SqCC is relatively low, it is necessary to interpret PET images carefully in patients without alleged ACC.

• Journal of Chest Surgery
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• v.29 no.6
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• pp.599-605
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• 1996

A total of 249 patients undergoing isolated coronary revascularization were studied for the occurrence of postoperative atrial fibrillation(AF). Possible associations of this arrhythmia with various preoperative, intraoperative and postoperative factors were studied by univariate and multivariate analysis. The overall incidence of postoperative AF was 15%, with the median time occurence of 48 hours(mean time : 59.1 $\pm$ 56.9 hours) after arrival to the intensive care unit. Cardiac index decreased significantly after occurence of AF(p=0.001). There were no in-hospital complications in those patients with AF. Univariate studies indicated preoperative ejection fract on(EF), triglyceride level, postoperative peak CKMB isoenzpme and atrial pacing to be the dominant factor promoting postoperative AF, with an increasing prevalence in lower EF(p=0.025), triglyceride(p=0.006) and peak CKMB isoenzyme(p=0.002), and in patients with atrial pacing(p=0.001). Hospital stay(p=0.001) and late mortality(p=0.003) were significantly increased in patients with postoperative AF Multivariate analysis showed that body weight and postoperative atrial pacing to be the dominant factor promoting postoperative AF, with an increasing prevalence in over- weight patients(p=0.011) and patients with atrial pacing(p=0.001). Both univariate and multivariate analy- sis showed that the age was not a significant factor but tended to promote postoperative AF respectively (p=0.053, 0.064). After 30.1 $\pm$ 11.4 months gfollow-up, those patients with AF had sinus rhythm. We think that we must try to prevent postoperative AF after ccoronary artery bypass grafting because of its deleterio s hemodynamic effect, prolonged hospital stay, and increased late mortality.

• Restorative Dentistry and Endodontics
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• v.32 no.2
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• pp.130-137
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• 2007

This in vitro study examined the effect of surface defects on cutting blades on the extent of the cyclic fatigue fracture of HEROShaper Ni-Ti rotary files using fractographic analysis of the fractured surfaces. A total of 45 HEROShaper (MicroMega) Ni-Ti rotary flies with a #30/.04 taper were divided into three groups of 15 each. Group 1 contained new HEROShapers without any surface defects. Group 2 contained HEROShapers with manufacturing defects such as metal rollover and machining marks. Croup 3 contained HEROShapers that had been clinically used for the canal preparation of 4-6 molars A fatigue-testing device was designed to allow cyclic tension and compressive stress on the tip of the instrument whilst maintaining similar conditions to those experienced in a clinic. The level of fatigue fracture time was measured using a computer connected the system. Statistical analysis was performed using a Tukey's test. Scanning electron microscopy (SEM) was used for fractographic analysis of the fractured surfaces. The fatigue fracture time between groups 1 and 2, and between groups 1 and 3 was significantly different (p<0.05) but there was no significant difference between groups 2 and 3 (p>0.05). A low magnification SEM views show brittle fracture as the main initial failure mode At higher magnification, the brittle fracture region showed clusters of fatigue striations and a large number of secondary cracks. These fractures typically led to a central region of catastrophic ductile failure. Qualitatively, the ductile fracture region was characterized by the formation of microvoids and dimpling. The fractured surfaces of the HEROShapers in groups 2 and 3 were always associated with pre-existing surface defects. Typically, the fractured surface in the brittle fracture region showed evidence of cleavage (transgranular) facets across the grains, as well as intergranular facets along the grain boundaries. These results show that surface defects on cutting blades of Ni-Ti rotary files might be the preferred sites for the origin of fatigue fracture under experimental conditions. Furthermore this work demonstrates the utility of fractography in evaluating the failure of Ni-Ti rotary flies.

• Journal of Dairy Science and Biotechnology
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• v.34 no.4
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• pp.203-216
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• 2016

Probiotic microorganisms are thought to provide health benefits when consumed. In 2001, the World Health Organization defined probiotics as "live microorganisms which confer a health benefit on the host, when administered in adequate amounts." Three methods for screening potential probiotics have currently widely available. (1) In vitro assays of potential probiotics are preferred because of their simplicity and low cost. (2) The use of in vivo approaches for exploring various potential probiotics reflects the enormous diversity in biological models with various complex mechanisms. (3) Potential probiotics have been analyzed using several genetic and omics technologies to identify gene expression or protein production patterns under various conditions. However, there is no ideal procedure for selecting potential probiotics than testing cadidate strains on the target population. Hence, in this review, we provide an overview of the different methodologies used to identify new probiotic strains. Furthermore, we describe futre perspectives for the use of in vitro, in vivo and omics in probiotic research.

• Journal of Life Science
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• v.28 no.5
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• pp.605-614
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• 2018

Bee pollen has an outer wall which is resistant to both acidic and basic solutions and even the digestive enzymes in the gastrointestinal tract. Therefore, the oral bioavailability of bee pollen is only 10-15%. A previous study reported on wet-grinding technology which increased the extraction of active ingredients from bee pollen by 11 times. This study was designed to investigate the safety of wet-ground bee pollen. First, a single dose of wet-ground bee pollen was tested in both rats and beagle dogs at dosages of 5, 10, and 20 g/kg and 1.5, 3, and 6 g/kg, respectively. In rats, compound-colored stools were found in those administered 10 g/kg or more of wet-ground bee pollen. In beagle dogs, 6 g/kg of wet-ground bee pollen induced diarrhea in one male for four hours. However, no obvious clinical signs were found through the end of the experiment in rats and beagle dogs. In addition, no histological abnormality was found in all animals. The data indicates that a single dose of up to 20 g/kg of wet-ground bee pollen is safe. Next, the genetic toxicity of nano-sized bee pollen was tested. This study employed a bacterial reverse mutation test, a micronucleus assay, and a chromosomal aberration assay. In the micronucleus assay, there was no genetic toxicity up to the dosage of 2 g/kg. There was also no genetic toxicity in the bacterial reverse mutation test and chromosomal aberration assay. This data provides important information in developing nano-sized bee pollen into more advanced functional foods and herbal medicines.