• 보건세계
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• v.40 no.5 s.441
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• pp.6-11
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• 1993

초치료나 재치료를 막론하고 결핵환자치료의 대원칙은 첫째. 의사가 적절한 처방을 내리고 둘째. 환자가 적절한 처방을 정해진 기간동안 중단 없이 규칙적으로 복용하는 것이다. 의사와 환자가 각자의 원칙을 잘 지킨다면 초치료 때에도 치료에 실패하여 난치성 환자가 되는 경우가 많이 줄어들 것이다. 그러나 원칙은 간단하여도 그것을 실행한다는 것은 매우 어렵다. 더구나 초치료 때 보다도 재치료 때가 더욱 어렵다. 왜냐하면 의사의 입장에서는 초치료에 실패한 환자에게 적절한 재치료 처방을 하기가 꽤 까다롭고, 환자의 입장에서는 적절한 처방이라도 초치료처방 보다 치료기간이 더 길며 부작용 발생도 더 많은 재치료처방을 중단 없이 규칙적으로 복용하는 것이 상당히 어렵기 때문이다.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1165-1171
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• 1998

Background: All currently available mechanical and bioprosthetic valves are associated with various types of deterioration leading to dysfunction and/or valvular complications. Reoperation on prosthetic heart valves is increasingly under consideration for both clinical and prophylactic indications. This review was conducted to determine the factors affecting the risk of reoperation for prosthetic valve replacement. Material and method: From January 1985 to July 1996, 124 patients underwent reoperation on prosthetic heart valves, and 3 patients had a second valve reoperation. The causes of reoperation were prosthetic valve failure(96 cases, 77.4%), prosthetic valve thrombosis(16 cases, 12.9%), prosthetic valve endocarditis(7 cases, 5.6%) and paravalvular leak(5 cases, 4.1%). This article is based on the analysis of the experience with particular emphasis on the preoperative risks affecting the outcome of the reoperation. Result: Overall hospital mortality rate was 8.9%(11/124). Low cardiac output was the most common cause of death(70.6%). Left ventricular systolic dimension(p=0.001), New York Heart Association functional class IV(p=0.003) and serum creatinine level(p=0.007) were the independent risk factors, but age, sex and cardiothoracic ratio did not have any influence on the operative mortality. Follow-up period was ranged from 3 to 141 months (mean, 50.6 months). A late mortality rate was 1.8%. Conclusion: The surgical risk of reoperation on heart valve prostheses in the advanced NYHA class patients is higher, therefore reoperation is recommended before the hemodynamic impairment become severe.

• Progress in Medical Physics
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• v.26 no.3
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• pp.137-142
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• 2015

We retrospectively analyzed the outcomes in patients who underwent reirradiation for brain metastasis. Twenty-three patients with brain metastases who were initially treated with palliative brain radiotherapy and were retreated with a second course of brain RT between June 2008 and December 2012. WBRT, 3DCRT and SRS were used for brain metastasis. The median dose of the first course of WBRT was 30 Gy (range, 23.4~30 Gy). The dose of the first course 3DCRT for lesion was 30 Gy in 3 Gy per fraction. The median dose of the first course of SRS was 16 Gy in 1 fraction (range, 12~24 Gy). The median dose of the second course of WBRT was 27.5 (range, 12~30 Gy). The median dose of the second course of 3DCRT for lesion was 30 Gy (range, 25~30 Gy). The dose of the second course of SRS was 16 Gy in 1 fraction. The second course of WBRT was administered on radiographic disease progression with symptom in all patients. With median follow-up of 25 months, overall symptom resolution rates were 47.8%. Rate of palliative efficacy was 82.6% including stable disease. The median survival time after initiation of reirradiation was 3.2 months. Median value of KPS prior to reirradiation was 30. Median value of KPS after reirradiation was 60. Reirradiation of brain metastasis maybe feasible and effective in select patients with a good performance status $KPS{\geq}60$ (: ECOG 0~2) prior to reirradiation.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.100-109
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• 2019

The rapidly increasing rate of shoulder arthroplasty is certain to increase the number of revision arthroplasties because of parallel increases in complication numbers. It has been widely reported that the causes of revision shoulder arthroplasty include rotator cuff deficiency, instability, glenoid or humeral component loosening, implant failure, periprosthetic fracture, and infection. Revision arthroplasty can be technically challenging, and surgical options available for failed shoulder arthroplasty are limited, especially in patients with glenoid bone loss or an irreparable rotator cuff tear. Furthermore, the outcomes of revision arthroplasty are consistently inferior to those of primary arthroplasty. Accordingly, surgical decision making requires a good understanding of the etiology of failure. Here, we provide a review of indications of revision arthroplasty and of the surgical techniques used by failure etiology.

• The Journal of the Korean dental association
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• v.27 no.6 s.241
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• pp.509-514
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• 1989

국소의치나 총의치에 사용하는 인공치는 대부분 도재치(porcelain teeth)와 레진치(resin teeth, plastic teeth)이다. 도재치나 레진치 모두 자연치아와 유사한 색조를 갖고 있어 자연감을 나타내기 때문이다. 인공치의 대표적인 도재치와 레진치에 대하여 이공학적 측면, 임상측면, 기공측면에서 재료학적 고찰을 한다.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.785-791
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• 2002

The results of reoperative valve replacement can be improved if appropriate analysis for the risk of reoperation was achieved. The purpose of our study was to analyze the results of reoperations for failure of bioprosthesis, and to define the risk factors in high-risk populations for reoperative procedures. Material and Method The series of 46 consecutive patients who had undergone first reoperative replacement for failed bioprosthesis between 1993 and 2001 were reviewed retrospectively. Mean age was 42 $\pm$ 12 years, mean body surface area was 1.52 $\pm$0.15 $m^2$. The reoperative procedure comprised of 36 MVR, 8 DVR, and 2 AVR. The first operation comprised of 2 DVR, 1 AVR, and 43 MVR. Factors which were choose to assess a predictor of results in reoperative valve replacement were sex, old age(＞60 years), early age at first operation(＜30 years), long interval between first and redo operation(.15years), poor NYHA functional class(＞3), LV dysfunction(LVEF＜45%), long operation time(＞8hours), endocarditis, combined procedures, and renal insufficiency, Result : Overall mortality was 4.3%(2 cases). The risk factors that influenced postoperative complications and unexpected postoperative results were lower ejection fraction(p＝0.012), older age(p＝0.045), endocarditis(p＝0.023), long operation time above 8 hours(p＝0.027). There was no statistically significant factor influencing hospital mortality. Conclusion : No factor influenced the mortality. Better results could be achieved if reoferation was performed carefully in poor left ventricular function, old aged patient, and with endocarditis. Effort to shorten the operation time would be helpful on postoperative results.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.817-824
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• 2007

Background: There are two choices for heart valve replacement-the use of a tissue valve and the use of a mechanical valve. Using a tissue valve, additional surgery will be problematic due to valve degeneration. If the risk of additional surgery could be reduced, the tissue valve could be more widely used. Therefore, we analyzed the risk factors and mortality of patients undergoing repeated heart valve replacement and primary replacement. Material and Method: We analyzed 25 consecutive patients who underwent repeated heart valve replacement and 158 patients who underwent primary heart valve replacement among 239 patients that underwent heart vale replacement in out hospital from January 1995 to December 2004. Result: There were no differences in age, sex, and preoperative ejection fraction between the repeated valve replacement group of patients and the primary valve replacement group of patients. In the repeated valve replacement group, the previously used artificial valves were 3 mechanical valves and 23 tissue valves. One of these cases had simultaneous replacement of the tricuspid and aortic valve with tissue valves. The mean duration after a previous operation was 92 months for the use of a mechanical valve and 160 months for the use of a tissue valve. The mean cardiopulmonary bypass time and aortic cross clamp time were 152 minutes and 108 minutes, respectively, for the repeated valve replacement group of patients and 130 minutes and 89 minutes, respectively, for the primary valve replacement group of patients. These results were statistically significant. The use of an intra aortic balloon pump (IABP) was required for 2 cases (8%) in the repeated valve replacement group of patients and 6 cases (3.8%) in the primary valve replacement group of patients. An operative death occurred in one case (4%) in the repeated valve replacement group of patients and occurred in nine cases (5.1%) in the primary valve replacement group of patients. Among postoperative complications, the need for mechanical ventilation over 48 hours was different between the two groups. The mean follow up period after surgery was $6.5{\pm}3.2$ years. The 5-year survival of patients in the repeated valve replacement group was 74% and the 5-year survival of patients in the primary valve replacement group was 95%. Conclusion: The risk was slightly increased, but there was little difference in mortality between the repeated and primary heart valve replacement group of patients. Therefore, it is necessary to reconsider the issue of avoiding the use of a tissue valve due to the risk of additional surgery, and it is encouraged to use the tissue valve selectively, which has several advantages over the use of a mechanical valve. In the case of a repeated replacement, however, the mortality rate was high for a patient whose preoperative status was not poor. A proper as sessment of cardiac function and patient status is required after the primary valve replacement. Subsequently, a secondary replacement could then be considered.

• Annual Conference on Human and Language Technology
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• 2023.10a
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• pp.25-30
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• 2023

초거대 언어모델은 과연 수수께끼 문제에 재치있는 답변을 할 수 있을까? 최근 초거대 언어모델(Large language model, LLM)은 강력한 성능 및 유저 만족도를 보이며 세계의 이목을 집중시키고 있다. 여러 태스크들에 대한 정량 평가를 넘어서 최근에는 LLM의 창의력 및 고도화된 언어능력을 평가하는 연구들이 등장하고 있다. 본 논문에서는 이러한 연구 흐름에 따라 LLM의 재치에 관해 고찰해본다. 이때 재치를 평가하기 위한 태스크로 이를 요구하는 말놀이인 수수께끼를 활용한다. 본 논문은 LLM이 수수께끼를 잘 수행하는지를 모델 추론을 통해 평가하며, 모델 추론 시 활용되는 프롬프트들의 성격에 따른 성능 변화를 관찰한다. 또한 수수께끼의 종류에 따른 모델의 능력을 비교 분석하며 LLM의 추론 결과에 대한 오류 분석을 수행한다. 본 논문은 실험을 통해 GPT-4가 가장 높은 성능을 보이며, 설명글이나 데이터 예시를 추가할 시 성능을 한층 더 향상시킬 수 있음을 확인한다. 또한 단어 기반보다는 특성 기반의 수수께끼에 더욱 강력한 성능을 보이며, 오류 유형 분석을 통해 LLM이 환각(hallucination) 문제와 창의력을 동시에 가지고 있다고 분석한다.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.1
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• pp.99-107
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• 2011

The main objective of nonsurgical retreatment is to disinfect the root canal space for periradicular healing. Thus, efficient removal of the filling material from the root canal system is essential to ensure a favorable outcome. Traditionally, the removal of root canal filling material was performed by stainless steel hand instrument and this procedure is time and effort-consuming. Recently, rotary NiTi retreatment instruments are developed to effective removal of root canal filling material. The aim of this study was to evaluate the effectiveness of stainless-steel hand instrument and rotary NiTi retreatment instrument when removing gutta-percha in curved root canals. For the remaining materials, there were no significant differences between groups. But the rotary NiTi system proved to be faster than hand instruments in removing root filling materials.

• Tuberculosis and Respiratory Diseases
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• v.49 no.6
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• pp.684-690
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• 2000

Background : The most common cause of treatment failure of pulmonary tuberculosis is early stoppage of treatment or irregular medication. The most important aspect of a retreatment is regular medication provided over a long period. Inadequate treatment may cause drug resistance and prolong the duration of chemotherapy. This study analyzed the risk factors of pulmonary tuberculosis patients, who failed in retreatment, and to use the results as basic data in the management of intractable tuberculosis patients with improving the rate of retreatment success. Methods : We performed a retroactive study of 62 pulmonary tuberculosis patients in retreatment at National Mokpo Tuberculosis Hospital from Jan. 1994 to Dec. 1995. The patients were separated into two groups: group I was retreatment failure and group II was retreatrnent success. For the analysis of risk factors in retreatment failure, we compared the difference between the two groups and tested the confidence limit about results of the results by independent t-test, ${\chi}^2$ test and Fisher's exact test. Results : The treatment failure rate of retreatment patients was 13(21%), and treatment success 49(79%). No significant difference (p>0.05)in age, sex, number of treatment, irregular rate of treatment, extent of the disease & cavitary lesion on the chest X-ray, number of resistance drugs, number of used drugs to medication, number of sensitive bactericidal drugs to medication, rate of sensitive drugs to medication and resisiance to INH & RFP had not significant difference. was found. However, the number of treatment was $2.4{\pm}0.8$ in group I and $1.6{\pm}0.9$ in group II, and had showing a significant difference(p<0.05) between the two groups. Conclusion : The risk factor of retreatment failure was more irregular previous treatment the irregularity of the previous treatment. For reducing the retreatment failure of pulmonary tuberculosis, greater efforts are needed more need to be done to prevent failure of first treatment.