• Archives of Plastic Surgery
• /
• v.40 no.4
• /
• pp.302-303
• /
• 2013

Current educational interventions and training courses in microsurgery are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess current training tools in microsurgery education and devise alternative methods that would enhance training. Simulation is an increasingly important tool for educators because, whilst facilitating improved technical proficiency, it provides a way to reduce risks to both trainees and patients. The International Microsurgery Simulation Society has been founded in 2012 in order to consolidate the global effort in promoting excellence in microsurgical training. The society's aim to achieve standarisation of microsurgical training worldwide could be realised through the development of evidence based educational interventions and sharing best practices.

• Archives of Plastic Surgery
• /
• v.41 no.3
• /
• pp.218-224
• /
• 2014

Plastic surgery training worldwide has seen a thorough restructuring over the past decade, with the introduction of formal training curricula and work-based assessment tools. Part of this process has been the introduction of revalidation and a greater use of simulation in training delivery. Simulation is an increasingly important tool for educators because it provides a way to reduce risks to both trainees and patients, whilst facilitating improved technical proficiency. Current microsurgery training interventions are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess the potential benefits of alternative models, particularly cross-training, a model now widely used in non-medical areas with significant benefits. Furthermore, with the proliferation of microsurgery training interventions and therefore diversity in length, cost, content and models used, appropriate standardisation will be an important factor to ensure that courses deliver consistent and effective training that achieves appropriate levels of competency. Key research requirements should be gathered and used in directing further research in these areas to achieve on-going improvement of microsurgery training.

• Journal of Korean Society of Rural Planning
• /
• v.22 no.1
• /
• pp.93-100
• /
• 2016

Land price can be affected by convenience or psychological repulsion like PIMFY (Please In My Front Yard) or NIMBY (Not In My Back Yard) for various facilities. Services related to public establishment, welfare, medical attention, and amenities in rural areas are comparatively poorer than those in urban areas. The purpose of this study is to estimate the implications of the accessibility to community facilities in rural areas for land prices using a hedonic price model. The accessibility to facilities is estimated by real road distances and the land prices are applied for four types of land usages: field, rice paddy, building lots, and village halls. Community facilities are classified from public and community services view: education, safety, culture, transport, environment, health care, and finance. The results show that the accessibility to health care and transport can positively affect land prices and the accessibility to environment (waste facilities and junkyard) and unpleasant services (funeral hall and charnel house) can negatively affect land prices. Especially, the accessibility to hospital is the most positive influential factor for all types of land usages.

• Childhood Kidney Diseases
• /
• v.28 no.1
• /
• pp.8-15
• /
• 2024

With the rapid evolution of diagnostic tools, particularly next-generation sequencing, the identification of genetic diseases, predominantly those with pediatric-onset, has significantly advanced. However, this progress presents challenges that span from selecting appropriate tests to the final interpretation of results. This review examines various genetic testing methodologies, each with specific indications and characteristics, emphasizing the importance of selecting the appropriate genetic test in clinical practice, taking into account factors like detection range, cost, turnaround time, and specificity of the clinical diagnosis. Interpretation of variants has become more challenging, often requiring further validation and significant resource allocation. Laboratories primarily classify variants based on the American College of Medical Genetics and Genomics and the Association for Clinical Genomic Science guidelines, however, this process has limitations. This review underscores the critical role of clinicians in matching patient phenotypes with reported genes/variants and considering additional factors such as variable expressivity, disease pleiotropy, and incomplete penetrance. These considerations should be aligned with specific gene-disease characteristics and segregation results based on an extended pedigree. In conclusion, this review aims to enhance understanding of the complexities of clinical genetic testing, advocating for a multidisciplinary approach to ensure accurate diagnosis and effective management of rare genetic diseases.

• Korean Journal of Radiology
• /
• v.23 no.6
• /
• pp.598-614
• /
• 2022

While ultrasound (US) is considered an important tool for hepatocellular carcinoma (HCC) surveillance, it has limited sensitivity for detecting early-stage HCC. Abbreviated MRI (AMRI) has recently gained popularity owing to better sensitivity in its detection of early-stage HCC than US, while also minimizing the time and cost in comparison to complete contrast-enhanced MRI, as AMRI includes only a few essential sequences tailored for detecting HCC. Currently, three AMRI protocols exist, namely gadoxetic acid-enhanced hepatobiliary-phase AMRI, dynamic contrast-enhanced AMRI, and non-enhanced AMRI. In this study, we discussed the rationale and technical details of AMRI techniques for achieving optimal surveillance performance. The strengths, weaknesses, and current issues of each AMRI protocol were also elucidated. Moreover, we scrutinized previously performed AMRI studies regarding clinical and technical factors. Reporting and recall strategies were discussed while considering the differences in AMRI protocols. A risk-stratified approach for the target population should be taken to maximize the benefits of AMRI and the cost-effectiveness should be considered. In the era of multiple HCC surveillance tools, patients need to be fully informed about their choices for better adherence to a surveillance program.

• IMMUNE NETWORK
• /
• v.20 no.1
• /
• pp.11.1-11.14
• /
• 2020

Most patients with hepatocellular carcinoma (HCC) are diagnosed at an advanced stage of disease. Until recently, systemic treatment options that showed survival benefits in HCC have been limited to tyrosine kinase inhibitors, antibodies targeting oncogenic signaling pathways or VEGF receptors. The HCC tumor microenvironment is characterized by a dysfunction of the immune system through multiple mechanisms, including accumulation of various immunosuppressive factors, recruitment of regulatory T cells and myeloid-derived suppressor cells, and induction of T cell exhaustion accompanied with the interaction between immune checkpoint ligands and receptors. Immune checkpoint inhibitors (ICIs) have been interfered this interaction and have altered therapeutic landscape of multiple cancer types including HCC. In this review, we discuss the use of anti-PD-1, anti-PD-L1, and anti-CTLA-4 antibodies in the treatment of advanced HCC. However, ICIs as a single agent do not benefit a significant portion of patients. Therefore, various clinical trials are exploring possible synergistic effects of combinations of different ICIs (anti-PD-1/PD-L1 and anti-CTLA-4 antibodies) or ICIs and target agents. Combinations of ICIs with locoregional therapies may also improve therapeutic responses.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.43 no.1
• /
• pp.82-95
• /
• 2015

This study is intended to obtain a guideline for creating a therapeutic garden soundscape in a psychiatric hospital by analyzing the psychological and physiological effects of auditory components on mental patients. The subjects were 27 inpatients at a psychiatric institute located in Jeollabuk-do. They were recommended by their doctors and had been diagnosed with mild cases of schizophrenia. The survey was carried out in October 2011. With regard to the study, the subjects listened to single sounds(the sound of flowing water, birdsong, wind chimes and music) and 4 sounds composed of some of these, and then Electroencephalography(EEG) and psychological effects were measured. The moving water sound was perceived as pleasing and revitalizing and the birdsong as sonorous and delightful. When designing a healing garden in a psychiatric hospital, the vitality of sound should be considered. In comparison to other single sounds, water sounds were highly preferred and had greater effects on psychological vitality. Music sounds had a significant effect on enhancing tranquility while water sounds affected on both psychological vitality and tranquillity. When comparing single sounds with combined sounds, single sounds such as running water for vitality and music for tranquility had a greater psychological effect than combined sounds. In terms of combined sound preferences, the combination of water and bird sounds had higher preference rates. Generally, combined sounds including water tended to have higher preference rates. The physiological effects of single sounds showed that music had a greater therapeutic effect than natural sounds such as water sounds and birdsong in promoting tranquility. As for combined sounds adopted to enhance physiological tranquility, it is most appropriate to combine music and birdsong or music and water sounds. However, a single music sound is more effective than combined sounds. Overall, analyses of both psychological and physiological reactions showed music and water sounds to be most calming while water sounds promoted the greatest vitality.

• Journal of the Korean Institute of Traditional Landscape Architecture
• /
• v.31 no.2
• /
• pp.92-102
• /
• 2013

This study aimed to reveal the establishment process and spatial composition of TaiSho park in modern Busan. The TaiSho park is an athletic park which combines a playground and a rest facilities. The arguments on construction of playground commenced for commemorating Kameyama, Busan director official, when he moved to Taiwan in 1910. First Proposers which construct to sport park were businessman in that time. However, construction of playground was progress as a commemoration business of accession of Taisho Tenno. Playground construction got into stride by the proposal of the Busan mayor Wakamatsu in 1917. When it looks into process of discussion about a site selection candidate, norms of playground site selection are the paly ground which appropriate with effective site area and distance between park and a section of a city, in other hand, those are accessibility and budget. As a result of several arguments and actual site investigation, it was decide to select a site which enters to elementary school, after the isolation hospital relocates. The cost of construction of the TaiSho park is prepared by donation of the Busan civil. The donation fund raising committee was constituted by local commerce and industry people, a company, government, municipal offices and area, and funds was raised systematically. As a result, total amount of construction cost was made from the donation of local civil. The TaiSho park is broadly into two sectors; exercise area and rest and pleasure space. Entrance was set up in three aspects of the park and the subcontract planted. The baseball field took the seat in the central part of the park, and also prepared two tennis courts. Japanese Sumo field was also prepared for the north side of the park. The significance of the TaiSho park in Korea Park history can be summarized in South Korea's first sports park and which was made from the donation of local civil. The remained subjects from this study are to clarify the disappearance process of TaiSho park and a reason why modern Busan people want to get playground.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.19
• /
• pp.8041-8046
• /
• 2014

In-depth analysis of how TRAIL signals through death receptors to induce apoptosis in cancer cells using high throughput technologies has added new layers of knowledge. However, the wealth of information has also highlighted the fact that TRAIL induced apoptosis may be impaired as evidenced by experimental findings obtained from TRAIL resistant cancer cell lines. Overwhelmingly, increasing understanding of TRAIL mediated apoptosis has helped in identifying synthetic and natural compounds which can restore TRAIL induced apoptosis via functionalization of either extrinsic or intrinsic pathways. Increasingly it is being realized that biologically active phytochemicals modulate TRAIL induced apoptosis, as evidenced by cell-based studies. In this review we have attempted to provide an overview of how different phytonutrients have shown efficacy in restoring apoptosis in TRAIL resistant cancer cells. We partition this review into how the TRAIL mediated signaling landscape has broadened over the years and how TRAIL induced signaling machinery crosstalks with autophagic protein networks. Subsequently, we provide a generalized view of considerable biological activity of coumarins against a wide range of cancer cell lines and how coumarins (psoralidin and esculetin) isolated from natural sources have improved TRAIL induced apoptosis in resistant cancer cells. We summarize recent updates on piperlongumine, phenethyl isothiocyanate and luteolin induced activation of TRAIL mediated apoptosis. The data obtained from pre-clinical studies will be helpful in translation of information from benchtop to the bedside.

• Journal of the Korean Society of Environmental Restoration Technology
• /
• v.6 no.3
• /
• pp.35-45
• /
• 2003

This study was performed to suggest growth status data of the large old trees as the natural monuments of Korea. Field investigation of 70 large old trees as the natural monuments of Korea was carried out in Seoul, Inchon, Kyungki, Chungbuk, Chungnam, Chonbuk, Chonnam. The main field of this study is classified into the growth condition, soil state and management situation. The results of this study are below : The age distribution of the large old trees as the natural monuments of Korea is as follows : above l00years in 5.9%, above 200years in 8.9%, above 300 years in 11.8%, above 400 years in 16.2%, above 500 years in 16.2% and above 600years in 41.1%. Location types of the large old trees as the natural monuments of Korea are found in 11 types; the types are hill side(22.9%), historical monument area(15.7%), field(l4.3%) and building area(12.9%), etc. Also, growth type of the trees is individually placed. In the aspect of soil environment, the acidification of soils has been appearing in all surveyed areas, and the soil of Seoul area has much acidum phosphoricum because of excessive fertilizer. Finally, in management situation. major factors inhibiting growth of the large old trees as the natural monuments of Korea are soil covering of protruded root above ground, soil hardening by human, embankments, small area that has been surrounded fence. Continuous monitoring and accumulation of status data are necessary to preserve the large old trees as the natural monuments of Korea.