Background and Objectives High-intensity focused ultrasound (HIFU) has been developed as an effective, non-invasive, skin-tightening method in response to the increasing demand for improvements in skin laxity and tightening with minimal risk and recovery time. This study evaluated the efficacy and safety of HIFU for non-invasive skin tightening of crow's feet wrinkles, with the aim of determining how long the tightening can be maintained. Materials and Methods Between January and March 2019, 21 female patients with crow's feet wrinkles were treated with HIFU. The treatment involved 200 shots, three times every 2 weeks. Three blinded, experienced plastic surgeons and patients evaluated satisfaction at 2 weeks after the first procedure, 2 weeks after the second procedure, 2 weeks after the third procedure, and 6 weeks after the first procedure based on photographs according to the Global Aesthetic Improvement Scale (GAIS). The Friedman test was used to compare data. Results Of the 21 patients treated using HIFU, one was lost to follow-up for nonstudy-related reasons. Therefore, 20 patients were evaluated and ranged in age from 28 to 48 years. Plastic surgeons' GAIS scores were 2.6, 2.3, 1.7, and 1.3 and patients' GAIS scores were 2.6, 2.2, 1.8, and 1.4 at 2 weeks after the first procedure, 2 weeks after the second procedure, 2 weeks after the third procedure, and 6 weeks after the third procedure. No serious adverse effects were observed. Conclusion The aging face with crow's feet wrinkles can be improved by using HIFU, while minimizing epidermal and dermal injury.
Objectives: The purpose of this study was to evaluate the impact of dentin roughening and the type of composite resin used (either bulk-fill flowable or nanohybrid) on the restoration of non-carious cervical lesions (NCCLs) with an 18-month follow-up period. Materials and Methods: This prospective split-mouth study included 36 patients, each with a minimum of 4 NCCLs. For each patient, 4 types of restorations were performed: unroughened dentin with nanohybrid composite, unroughened dentin with bulk-fill flowable composite, roughened dentin with nanohybrid composite, and roughened dentin with bulk-fill flowable composite. A universal bonding agent (Tetric N Bond Universal) was applied in self-etch mode for all groups. The restorations were subsequently evaluated at 6, 12, and 18 months in accordance with the criteria set by the FDI World Dental Federation. Inferential statistics were computed using the Friedman test, with the level of statistical significance established at 0.05. Results: The 4 groups exhibited no significant differences in relation to fracture and retention, marginal staining, marginal adaptation, postoperative hypersensitivity, or the recurrence of caries at any follow-up point. Conclusions: Within the limitations of the present study, over an 18-month follow-up period, no significant difference was present in the clinical performance of bulk-fill flowable and nanohybrid composite restorations of non-carious cervical lesions. This held true regardless of whether dentin roughening was performed.
Jae Hyon Park;Nieun Seo;Joon Seok Lim;Jongmoon Hahm;Myeong-Jin Kim
Korean Journal of Radiology
/
v.21
no.1
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pp.77-87
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2020
Objective: To assess the feasibility of simultaneous multislice-accelerated diffusion-weighted imaging (SMS-DWI) of the rectum in comparison with conventional DWI (C-DWI) in rectal cancer patients. Materials and Methods: This study included 65 patients with initially-diagnosed rectal cancer. All patients underwent C-DWI and SMS-DWI with acceleration factors of 2 and 3 (SMS2-DWI and SMS3-DWI, respectively) using a 3T scanner. Acquisition times of the three DWI sequences were measured. Image quality in the three DWI sequences was reviewed by two independent radiologists using a 4-point Likert scale and subsequently compared using the Friedman test. Apparent diffusion coefficient (ADC) values for rectal cancer and the normal rectal wall were compared among the three sequences using repeated measures analysis of variance. Results: Acquisition times using C-DWI, SMS2-DWI, and SMS3-DWI were 173 seconds, 107 seconds, (38.2% shorter than C-DWI), and 77 seconds (55.5% shorter than C-DWI), respectively. For all image quality parameters other than distortion (margin sharpness, artifact, lesion conspicuity, and overall image quality), C-DWI and SMS2-DWI yielded better results than did SMS3-DWI (Ps < 0.001), with no significant differences observed between C-DWI and SMS2-DWI (Ps ≥ 0.054). ADC values of rectal cancer (p = 0.943) and normal rectal wall (p = 0.360) were not significantly different among C-DWI, SMS2-DWI, and SMS3-DWI. Conclusion: SMS-DWI using an acceleration factor of 2 is feasible for rectal MRI resulting in substantial reductions in acquisition time while maintaining diagnostic image quality and similar ADC values to those of C-DWI.
It is known that aggressive treatment of chemotherapy, radiation and autogenous stem cell transplantation is effective for prevention of recurrence in the high-risk breast cancer patients. It was assumed that this procedure takes a longer time and decreases the quality of life more than the standard adjuvant chemotherapy. However, there are few studies comparing the quality of life of patients having bone marrow transplantation and adjuvant chemotherapy. Most of the studies were focused on the quality of life in one point of time, such as only during the early treatment stage, only overall quality of life rather than specific dimensions of the quality of life. The purposes of this study are 1) to identify the difference of the quality of life between two different treatment patterns, adjuvant chemotherapy and autogenous stem cell transplantation: 2) to identify the mostly affected dimension and the periods of time affected by the treatment patterns; and 3) to identify the trajectories of quality of life in each treatment pattern. This is a time series design that measures 4 different points of times. At the beginning of the study, 19 patients were placed in the chemotherapy group and 12 in the group of auto-peripheral blood stem cell transplantation. The inclusion criterion was the advanced disease stage of 3 or over with metastasis of more than 5 lymph nodes. The exclusion criteria were 1) anyone who has metastasis to other organ; 2) anyone who had psychological problems. Ferrell's Quality of Life Scale for Cancer Survivors 41 items on a 10 point scale was used. The QOL-CS includes 4 dimensions, which were labeled physical, psychological, social, and spiritual. The Cronbach‘s alpha of this scale was 0.89. Mann-Whitney U test and Friedman test were used to test each hypothesis. In comparison of the two groups, the quality of life of the bone marrow transplantation group dramatically increased at the 3rd and 6th month after transplantation, while the chemotherapy groups results stayed lower. The most affected dimension of the quality of life at the end of the treatment was the physical dimension. However, it and increased along with time, while the psychological dimension values remained low over the long-term period. Intensive nursing care is needed during the entire period of chemotherapy in all patients having chemotherapy, and is also required for right after cases of bone marrow transplantation.
Objective: The objective of the study is to develop a portable assistance device to help elderly users reduce strain on the knee and leg muscle while the elderly are standing up. Background: The pose of standing up from a chair is a basic movement, but the elderly often have difficulty standing up due to their weak muscles. We focus on designing a solution that helps the elderly reduce physical problems and support them standing up. Method: This study consists of three parts. Part I explores the way to reduce the refrain of leg muscle while standing up from a chair. In the process of structural development, we found that the moment is minimized when user pushes down the armrests due to a decrease in the force acting on the center of mass. In part II, a user test of 20 participants was carried out to rank the order of comfort of two stimuli: the chair with fixed armrests and the chair with the four-link mechanism that we created-in three different ways; (1) to stand up without touching armrests, (2) to stand up by pushing down on fixed armrests, and (3) to stand up by pushing down on armrests and being supported by the mechanism. To examine the statistically significant differences among the rank means, a Friedman test was conducted. In part III, we analyze the results of the user test and interview feedbacks, focusing on establishing a design strategy from UPO and visualizing it in 1:1 scale. Results: In part I, we decided to develop the four-link mechanism. The bottom is lifted up as the link rises. In part II, based on the rank data, we empirically found that UPO was assessed as the most comfortable during the stimuli. The thigh angle is smaller and the bottom of UPO is separated from a seat. In part III, after assessing the results and feedbacks, we created a visualization strategy for UPO: light, friendly, and novel. Conclusion: The portable and non-mechanical UPO comprises a four-link system that lifts the user's hips while standing. It can help users avoid knee and leg muscle strain. Its universal design considers the elderly's difficulties. Application: In a future study, combining light and durable material in UPO is expected to increase its usability. And this study is an opportunity to design various types of standing assistance devices.
The Objective of this study was to design the model which predict the future cash flow of hospitals and on the basis of designed model to support sound hospital management by the prediction of future cash flow. The five cash flow measurement variables discussed in financial accrual part were used as variables and these variables were defined as NI, NIDPR, CFO, CFAI, CC. To measure the cash flow B/S related variables, P/L related variables and financial ratio related variables were utilized in this study. To measure cash flow models were designed and to estimate the prediction ability of five cash flow models, the martingale model and the market model were utilized. To estimate relative prediction outcome of cash flow prediction model and simple market model, MAE and MER were used to compare and analyze relative prediction ability of the cash flow model and the market model and to prove superiority of the model of the cash flow prediction model, 32 Regional Public Hospital's cross-section data and 4 year time series data were combined and pooled cross-sectional time series regression model was used for GLS-analysis. To analyze this data, Firstly, each cash flow prediction model, martingale model and market model were made and MAE and MER were estimated. Secondly difference-test was conducted to find the difference between MAE and MER of cash flow prediction model. Thirdly after ranking by size the prediction of cash flow model, martingale model and market model, Friedman-test was evaluated to find prediction ability. The results of this study were as follows: when t-test was conducted to find prediction ability among each model, the error of prediction of cash flow model was smaller than that of martingale and market model, and the difference of prediction error cash flow was significant, so cash flow model was analyzed as excellent compare with other models. This research results can be considered conductive in that present the suitable prediction model of future cash flow to the hospital. This research can provide valuable information in policy-making of hospital's policy decision. This research provide effects as follows; (1) the research is useful to estimate the benefit of hospital, solvency and capital supply ability for substitution of fixed equipment. (2) the research is useful to estimate hospital's liqudity, solvency and financial ability. (3) the research is useful to estimate evaluation ability in hospital management. Furthermore, the research should be continued by sampling all hospitals and constructed advanced cash flow model in dimension, established type and continued by studying unified model which is related each cash flow model.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.25
no.3
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pp.56-64
/
2012
Objectives : This study was performed in order to investigate an immediate improvement effect of nasal obstruction after having patient with chronic rhinitis use nasal spray in nasal cavity after distilling Korean medicine, satisfaction for its fragrance and irritation and its effect continuance time. Methods : A questionnaire was performed for an immediate therapeutic effect of nasal spray 1, 2 and 3 weeks later after using spray by targeting 13 patients who used Korean medicine distillate spray for over 3 weeks among the patients who visited Sangji University Korean Medicine Hospital and whose symptoms were determined as chronic rhinitis and for whom Korean medicine distillate spray was prescribed. 3 weeks later after using spray, a questionnaire was performed for fragrance, irritation and continuance effect of Korean medicine. Immediate therapeutic effect being felt right after spraying was also surveyed and symptom scores was expressed from 10 to 0 and on the assumption that nasal obstruction symptom just before spraying was 10 points, symptom score after spraying was surveyed. In case of evaluation of satisfaction, satisfaction for fragrance and irritation of nasal spray was evaluated by scale based on full score of 5 point from 'very satisfied=5', 'satisfied=4', 'average=3', 'unsatisfactory=2' and 'very unsatisfactory=1', respectively. Effect continuance time after spraying was surveyed by dividing it into within 5 minutes, within 5-10 minutes, within 10-30 minutes and over 30 minutes. All the data was statistically analyzed by Friedman Test that is non-parametric test of Paired t-test and descriptive statistics. Results : Total surveyed patients were 13 persons including 6 males and 7 females and total average age was represented to be $27.1{\pm}17.7$ years old. Score of immediate nasal obstruction improvement effect at 1st week was $6.3{\pm}2.4$ points, at 2nd week $5.7{\pm}2.5$ points and at 3rd week $5.5{\pm}2.5$ points and when comparing 1st week, 2nd week and 3rd week statistically, p value was 0.047<0.05 and from this, it could be seen that the longer spray was used, the more was improvement effect represented with slight significance. In case of fragrance and irritation, both of its score was represented to be high as average $4.0{\pm}1.08 $points and average $4.4{\pm}0.8$ points, respectively. Effect continuance time below 10 minutes was represented in 8 persons who accounted for 61.5%. Conclusions: Immediate improvement effect of nasal obstruction being felt by the patients by using Korean medicine nasal spray could be confirmed and by having the patients use such spray for 3 weeks continuously, it could be realized that such effect was sustained and satisfaction for fragrance or irritation of Korean medicine nasal spray was significant. However, rather short sustained time was considered to be unsatisfactory and this shortcomings is required to be improved in the future.
Choi, Na Young;Park, Soonchan;Lee, Chung Min;Ryu, Chang-Woo;Jahng, Geon-Ho
Investigative Magnetic Resonance Imaging
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v.23
no.3
/
pp.210-219
/
2019
Purpose: The purpose of this study was to investigate if double inversion recovery (DIR) imaging can have a role in the evaluation of brain ischemia, compared with diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) imaging. Materials and Methods: Sixty-seven patients within 48 hours of onset, underwent MRI scans with FLAIR, DWI with b-value of 0 (B0) and $1000s/mm^2$, and DIR sequences. Patients were categorized into four groups: within three hours, three to six hours, six to 24 hours, and 24 to 48 hours after onset. Lesion-to-normal ratio (LNR) value was calculated and compared among all sequences within each group, by the Friedman test and conducted among all groups, for each sequence by the Kruskal-Wallis test. In qualitative assessment, signal intensity changes of DIR, B0, and FLAIR based on similarity with DWI and image quality of each sequence, were graded on a 3-point scale, respectively. Scores for detectability of lesions were compared by the McNemar's test. Results: LNR values from DWI were higher than DIR, but not statistically significant in all groups (P > 0.05). LNR values of DIR were significantly higher than FLAIR within 24 hours of onset (P < 0.05). LNR values were significantly different between, before, and after six hours onset time for DIR (P = 0.016), B0 (P = 0.008), and FLAIR (P = 0.018) but not for DWI (P = 0.051). Qualitative analysis demonstrated that detectability of DIR was higher, compared to that of FLAIR within 4.5 hours and six hours of onset (P < 0.05). Also, the DWI quality score was lower than that of DIR, particularly relative to infratentorial lesions. Conclusion: DIR provides higher detectability of hyperacute brain ischemia than B0 and FLAIR, and does not suffer from susceptibility artifact, unlike DWI. So, DIR can be used to replace evaluation of the FLAIR-DWI mismatch.
Il Heon Ha;Changmok Lim;Yeahoon Kim;Yeonsil Moon;Seol-Heui Han;Won-Jin Moon
Korean Journal of Radiology
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v.22
no.7
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pp.1152-1162
/
2021
Objective: This study aimed to determine whether there are regional differences in the blood-brain barrier (BBB) permeability of cognitively normal elderly participants and to identify factors influencing BBB permeability with a clinically feasible, 10-minute dynamic contrast-enhanced (DCE) MRI protocol. Materials and Methods: This IRB-approved prospective study recruited 35 cognitively normal adults (26 women; mean age, 64.5 ± 5.6 years) who underwent DCE T1-weighted imaging. Permeability maps (Ktrans) were coregistered with masks to calculate the mean regional values. The paired t test and Friedman test were used to compare Ktrans between different regions. The relationships between Ktrans and the factors of age, sex, education, cognition score, vascular risk burden, vascular factors on imaging, and medial temporal lobar atrophy were assessed using Pearson correlation and the Spearman rank test. Results: The mean permeability rates of the right and left hippocampi, as assessed with automatic segmentation, were 0.529 ± 0.472 and 0.585 ± 0.515 (Ktrans, x 10-3 min-1), respectively. Concerning the deep gray matter, the Ktrans of the thalamus was significantly greater than those of the putamen and hippocampus (p = 0.007, p = 0.041). Regarding the white matter, the Ktrans value of the occipital white matter was significantly greater than those of the frontal, cingulate, and temporal white matter (p < 0.0001, p = 0.0007, p = 0.0002). The variations in Ktrans across brain regions were not related to age, cognitive score, vascular risk burden, vascular risk factors on imaging, or medial temporal lobar atrophy in the study group. Conclusion: Our study demonstrated regional differences in BBB permeability (Ktrans) in cognitively normal elderly adults using a clinically acceptable 10-minutes DCE imaging protocol. The regional differences suggest that the integrity of the BBB varies across the brains of cognitively normal elderly adults. We recommend considering regional differences in Ktrans values when evaluating BBB permeability in patients with neurodegenerative diseases.
Park, Hoo-Seob;Hwang, Soo-Jeong;Cho, Min-Jeong;Kim, Do-Kyoung;Yang, Seon-Youn
Journal of dental hygiene science
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v.12
no.1
/
pp.71-77
/
2012
Sex Hormones exert significant influence in body physiology throughout life. Some reports suggested increased sex hormone levels correlate with an increased prevalence of gingivitis. The objectives of this pilot study are to(1) address the link between menstrual cycle and MMP-9, MMP-8, IL-$1{\beta}$ of gingival crevicular fluid during 4 weeks and (2) discuss the major biomarker of periodontal status. 7 female and 3 male volunteer who didn't have smoking habit, medical and dental disease after informed consent, were seen twice a week for 4 weeks. GCF samples were collected and GCF levels of MMP-9, MMP-8, IL-$1{\beta}$ were measured by enzyme-linked immunosorbent assay. The GCF levels of MMP-9, MMP-8, IL-$1{\beta}$ had fluctuation according to menstrual cycle, but the changes of those were not significant by Friedman matched samples test. There is no difference between female and male subjects by Mann-Whitney U test. The correlation of MMP-8, MMP-9 and IL-$1{\beta}$ showed strong by Spearman correlation(0.644-0.945). This study confirms menstrual cycle doesn't influence the periodontium of healthy female subjects.
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