• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.831-835
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• 2014

Background: Predictor factors determining complete response to treatment are still not clearly defined. We aimed to evaluate clinicopathological features, risk factors, treatment responses, and survival analysis of patient with advanced nonseminomatous GCTs (NSGCTs). Materials and Methods: Between November 1999 and September 2011, 140 patients with stage II and III NSGCTs were referred to our institutions and 125 patients with complete clinical data were included in this retrospective study. Four cycles of BEP regimen were applied as a first-line treatment. Salvage chemotherapy and/or high-dose chemotherapy (HDCT) with autologous stem cell transplantation were given in patients who progressed after BEP chemotherapy. Post-chemotherapy surgery was performed in selected patients with incomplete radiographic response and normal tumor markers. Results: The median age was 28 years. For the good, intermediate and poor risk groups, compete response rates (CRR) were, 84.6%, 67.9% and 59.4%, respectively. Extragonadal tumors, stage 3 disease, intermediate and poor risk factors, rete testis invasion were associated with worse outcomes. There were 32 patients (25.6%) with non-CR who were treated with salvage treatment. Thirty-one patients died from GCTs and 94% of them had stage III disease. Conclusions: Even though response rates are high, some patients with GCTs still need salvage treatment and cure cannot be achieved. Non-complete response to platinium-based first-line treatment is a negative prognostic factor. Our study confirmed the need for a prognostic and predictive model and more effective salvage approaches.

• Journal of Digital Convergence
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• v.15 no.7
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• pp.367-373
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• 2017

The study aims to suggests mobile application service that helps to reduce physical and mental suffering after surgery for breast cancer patients constantly increasing. At first, I analyze literature research to understand the breast cancer and similar services for achieving study purposes. After I finally design a mobile application that offers to customed one-to-one specialist coaching service focused on post-treatment management by using a double diamond design process model. In detail, first, I analyze the current program and comprehend user needs through interviews with the person such as breast patient, protector, nurse, salesperson in cancer center. Second, I specify the entire scenario, concept and keyword based on the persona and the customer journey map representing user. Third, I propose the mobile application for the ultimate goal by producing prototype to effectively communicate with specific functional descriptions. I hope this service will improve the quality of their lives.

• Journal of Korean Neurosurgical Society
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• v.56 no.3
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• pp.224-229
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• 2014

Objective : To report long-term clinical and radiological outcomes of minimally invasive posterior cervical foraminotomy (MI-PCF) performed in patients with unilateral single-level cervical radiculopathy. Methods : Of forty-six patients who underwent MI-PCF for unilateral single-level radiculopathy between 2005 and 2013, 33 patients were included in the study, with a mean follow-up of 32.7 months. Patients were regularly followed for clinical and radiological assessment. Clinical outcome was measured by visual analogue scale (VAS) for the neck/shoulder and arm, and the neck disability index (NDI). Radiological outcome was measured by focal/global angulation and disc height index (DHI). Outcomes after MI-PCF were evaluated as changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect was used to test for differences in the clinical and radiological parameters repeat measures. Results : There were no complications and all patients had an uneventful recovery during the early postoperative period. VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001). NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001). There were no statistically significant changes in focal and global angulation at follow-up. Percent DHIs of the upper adjacent or operated disc were maintained without significant changes with time. During the follow-up, same site recurrence was not noted and adjacent segment disease requiring additional surgery occurred in two patients (6%) on the contra-lateral side. Conclusion : MI-PCF provides long-term pain relief and functional restoration, accompanied by good long-term radiological outcome.

• Journal of Korean Academy of Nursing
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• v.12 no.2
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• pp.1-26
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• 1982

The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.1
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• pp.93-108
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• 2016

One of the fields to which the 3D printing technology can be applied is the field of medicine. Recently, the application of 3D printing technology to the bio-medical field has been gradually increasing with the commercializing of the bio-compatible or bio-degradable materials. The technology is currently contributing to the biomedical field by reducing times required for operations or minimizing adverse effects through preoperative identification of post-surgical consequences or model surgery with artificial bones and organs. This technology also enables the production of customized biomedical auxiliary products like hearing aids or artificial legs etc. For the field of dentistry, the 3D printing technology is also expected to elevate the level of dental treatment by making the customized orthodontic models, crown, bridge, inlay, and surgical guides for implant and surgery. However, issues remaining unidentified or incomplete in printing materials, modeling technology, software technology associated with CAD, verification of bio-stability and bio-effectiveness of materials or in compatibility and standardization of the technology are yet to be solved or be clarified for the full-scale application of the 3D printing technology, thus, it seems such issues should be resolved through further studies.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.237-243
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• 2008

Purpose: Postoperative Infectious complications are recognized as major complications that are associated with surgery. Although many studies have focused on the risk factors of postoperative complications, little is known about the risk factors of infectious complications after gastric cancer surgery, and especially after elective gastrectomy. There is now more and more interest in the risk factors of infectious complications in relation to controlling infection and as indicators of qualitatively assessing infectious complications. The aim of this study was to evaluate the risk factors related with infectious complications after performing elective gastrectomy for treating gastric cancer. Materials and Methods: We retrospectively reviewed a total of 788 patients who had undergone elective gastrectomy for gastric cancer between Jan. 2000 and Dec. 2007. The characteristics of the patients were divided according to the patients' factors and the operations' factors. Results: The patients' mean age was 58.9 (range: 24~91) years; 545 were male and 243 were female. The mean duration of the hospital stay was 20.3 days (range: 5~135 days), the mean operation time was 181.3 minutes (range: 65~440 minutes). The total complication rate was 17.1% (n=135) and the complication rate was 38.5% (n=52) among the 135 patients with infectious complications. The infectious complications were surgical site infection (59.7%), Pneumonia (19.3%), intra-abdominal abscess (11.5%), pseudomembranous colitis (5.7%), bacteremia (1.9%) and hepatic abscess (1.9%). On the univariate analysis, the significant risk factors were male gender, blood transfusion, smoking at the time of diagnosis, alcohol drinking, diabetes mellitus and previous cardiovascular disease (P<0.05 for all). On multivariate analysis that used a logistic regression model, the significant independent risk factors were smoking at the time of diagnosis (OR: 2.877. 95% CI: 1.449~5.713), blood transfusion (OR: 3.440, 95% CI: 1.241~9.534), diabetes mellitus (OR: 3.150, 95% CI: 1.518~6.538), and previous cardiovascular disease (OR: 2.784, 95% CI: 1.4731~5.2539). Conclusion: Pre- or post-operative blood transfusion and the patient's medical history such as previous cardiovascular disease, diabetes mellitus, smoking etc. are the risk factors for infectious complications after undergoing elective gastrectomy for gastric cancer. The patients that have these risk factors need to be treated with great care to prevent infectious disease after elective gastrectomy.

• Journal of Periodontal and Implant Science
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• v.38 no.1
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• pp.51-58
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• 2008

Purpose: In dental clinical fields, various periodontal membranes are currently used for periodontal regeneration. The periodontal membranes are categorized into two basic types: resorbable and non-resorbable. According to the case, clinician select which membrane is used. Comparing different membranes that are generally used in clinic is meaningful. For this purpose, this study evaluates histological effects of various membranes in canine one wall intrabony defect models and it suggest a valuation basis about study model. Material and Method: The membranes were non-resorbable TefGen $Plus^{(R)}$, resorbable Gore Resolut $XT^{(R)}$ and resorbable $Osteoguide^{(R)}$. One wall intrabony defects were surgically created at the second and the mesial aspect of the fourth mandibular premolars in either right or left jaw quadrants in two dogs. The animals were euthanized 8 weeks post-surgery when block sections of the defect sites were collected and prepared for histological evaluation. Results: 1. While infiltration of inflammatory cells were observed in control, TefGen $Plus^{(R)}$ and Gore Resolut $XT^{(R)}$, it was not observed in $Osteoguide^{(R)}$. 2. TefGen $Plus^{(R)}$ had higher integrity than others and $Osteoguide^{(R)}$ was absorbed with folding shape. Gore Resolut $XT^{(R)}$ was divided everal parts during resorbtion and it was also absorbed from inside. 3. Quantity of new bone and new cementum was not abundant in all membranes. 4. For histologic evaluation of membranes we should consider infiltration of inflammatory, migration of junctional epithelium, integrity of membrane, quantity of new bone and new cementum, connective tissue formation and aspect of resorption. Conclusion: This histologic evaluation suggests that $Osteoguide^{(R)}$ provides periodontal regenerative environment with less inflammatory state. It is meangful that this study model suggests a valuation basis about other study model.

• Korean Journal of Radiology
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• v.24 no.7
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• pp.647-659
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• 2023

Objective: The study was conducted to investigate the effect of correct occlusion of the left atrial appendage (LAA) on intracardiac blood flow and thrombus formation in patients with atrial fibrillation (AF) using four-dimensional (4D) flow magnetic resonance imaging (MRI) and three-dimensional (3D)-printed phantoms. Materials and Methods: Three life-sized 3D-printed left atrium (LA) phantoms, including a pre-occlusion (i.e., before the occlusion procedure) model and correctly and incorrectly occluded post-procedural models, were constructed based on cardiac computed tomography images from an 86-year-old male with long-standing persistent AF. A custom-made closed-loop flow circuit was set up, and pulsatile simulated pulmonary venous flow was delivered by a pump. 4D flow MRI was performed using a 3T scanner, and the images were analyzed using MATLAB-based software (R2020b; Mathworks). Flow metrics associated with blood stasis and thrombogenicity, such as the volume of stasis defined by the velocity threshold ($\left|\vec{V}\right|$ < 3 cm/s), surface-and-time-averaged wall shear stress (WSS), and endothelial cell activation potential (ECAP), were analyzed and compared among the three LA phantom models. Results: Different spatial distributions, orientations, and magnitudes of LA flow were directly visualized within the three LA phantoms using 4D flow MRI. The time-averaged volume and its ratio to the corresponding entire volume of LA flow stasis were consistently reduced in the correctly occluded model (70.82 mL and 39.0%, respectively), followed by the incorrectly occluded (73.17 mL and 39.0%, respectively) and pre-occlusion (79.11 mL and 39.7%, respectively) models. The surfaceand-time-averaged WSS and ECAP were also lowest in the correctly occluded model (0.048 Pa and 4.004 Pa^-1, respectively), followed by the incorrectly occluded (0.059 Pa and 4.792 Pa^-1, respectively) and pre-occlusion (0.072 Pa and 5.861 Pa^-1, respectively) models. Conclusion: These findings suggest that a correctly occluded LAA leads to the greatest reduction in LA flow stasis and thrombogenicity, presenting a tentative procedural goal to maximize clinical benefits in patients with AF.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.495-503
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• 1999

Background: We tested the technical feasibility of fetal cardiac bypass and collected baseline data on the fetal hemodynamics and placental functions related to the cardiopulmonary bypass in the fetal lamb model. Material and Method: Eleven fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Eight served as a group in which placenta was excluded from the extracorporeal circulation by clamping the umbilical cord during the bypass(the oxygenator group) and in the remaining three, the placenta worked as the only source of oxygen supply(the placenta group). Observations were made every 10 minute during a 30-minute bypass and 30-minute post bypass period. No prostaglandin inhibitors were used both in ewes and in fetuses. Result: Weights of the fetuses ranged from 1.9 to 5.2 kg. In the oxygenator group, means of arterial pressure, PaO2, atrial pressure, heart rate, and bypass flow rate ranged 69.8 to 82.6 mmHg, 201.7 to 220.9 mmHg, 4.1 to 4.3 mmHg, 169 to 182/min, and 140.3 to 164.0 ml/kg/min, respectively during bypass, but rapid deterioration of the fetal cardiac functions and the placental gas exchange was observed after the cessation of bypass. In the placenta group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of PaCO2 increased from 61.9 to 129.6 mmHg during bypass. Flow rate was suboptimal(74.3 to 97.0 ml/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. Conclusion: In this study, the technical feasibility of fetal cardiopulmonary bypass was confirmed in the fetal lamb model. However, further studies with modifications of the bypass including an addition of prostaglandin inhibitor, an application of the total spinal anesthesia on the fetus, a creation of more concise bypass circuit, and a use of active pump are mandatory to improve the outcome.

• Journal of Periodontal and Implant Science
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• v.40 no.1
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• pp.3-10
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• 2010

Purpose: Periodontal regenerative therapies for defects created by severe periodontitis are mainly focused on bone regeneration. Although cementum regeneration needs to be better understood, it is believed to play an important role in periodontal regeneration. The first step toward a full understanding of cementum regeneration is to compare repaired cementum to pristine cementum. This study, which used histological techniques, was designed to focus on cementum regeneration and to compare pristine cementum to repaired cementum after surgical procedures with 8 and 24 week healing periods in a canine model. Methods: Buccal and lingual mucoperiosteal flaps of 10 beagle dogs were surgically reflected to create critical-sized defects. Intrabony one-wall defects, of which dimension is 4 mm width and 5 mm depth, were made at the distal aspect of mandibular second premolars and the mesial aspect of mandibular fourth premolars in the right and left jaw quadrants. Animals were sacrificed after 8 and 24 weeks post-surgery for histological specimen preparation and histometric analysis. Results: The repaired cementum was composed mostly of acellular cementum and cellular mixed fiber cementum and was thicker in the apical area than in the coronal area. The acellular cementum of the supracrestal area appeared to be amorphous. The newly formed cellular cementum was partially detached from the underlying circumpulpal dentin, which implied a weak attachment between new cementum and dentin, and this split was observed to a lesser extent in the 24 week group than in the 8 week group. The vertical height of the repaired cementum was greater in the 24 week group than in the 8 week group. Conclusions: Within the limitations of this study, we can conclude that repaired cementum after root planing was mainly acellular cementum and cementum tissue that matured to a shape similar to pristine cementum as the healing progressed from 8 to 24 weeks.