• Journal of Korean Neurosurgical Society
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• v.60 no.3
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• pp.335-347
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• 2017

Intravenous recombinant tissue plasminogen activator had been the only approved treatment for acute ischemic stroke since its approval in 1995. However, the restrictive time window, numerous contraindications, and its low recanalization rate were all limitations of this modality. Under those circumstances, endovascular stroke therapy went through a great evolution during the past two decades of intravenous thrombolysis. The results of the 2013 randomized trials for endovascular stroke therapy were neutral, although they were limited by insufficient imaging screening at enrollment, early-generation devices with less efficacy, and treatment delays. Huge progress was made in 2015, as there were five randomized clinical trials which all demonstrated the safety and efficacy of endovascular stroke treatment. Despite differences in detail patient enrollment criteria, all 5 trials employed key factors for good functional recovery; (1) screening with non-invasive imaging to identify the proximal occlusion and exclude a large infarct core, (2) using highly effective modern thrombectomy devices mainly with stent retriever, and (3) establishment of a fast workflow to achieve effective reperfusion. The results of those trials indicate that modern thrombectomy devices can allow for faster and more effective reperfusion, which can lead to improved clinical outcomes compared to intravenous thrombolysis alone. These advances in mechanical thrombectomy are promising in the global fight against ischemic stroke-related disability and mortality. Two current mainstreams among such mechanical thrombectomy techniques, "stent retriever thrombectomy" and "direct clot aspiration", are the topic of this review. Stent retriever thrombectomy using Solitaire and Trevo retriever will be firstly discussed. And, the commonalities and the differences between two major clot aspiration thrombectomy techniques; a direct aspiration first pass technique (ADAPT) and forced arterial suction thrombectomy (FAST), will be additionally explained. Finally, details regarding the combination of direct clot aspiration and stent retriever thrombectomy, the switching strategy and the Solumbra technique, will be described.

• Clinical and Experimental Pediatrics
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• v.65 no.4
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• pp.201-208
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• 2022

Background: According to the National Family Health Survey-4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery. Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them. Methods: This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24. Results: The median breastfeeding initiation time was 90 minutes (interquartile range, 30-180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12-16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57-13.92; P=0.005), and mother's poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44-14.72; P=0.010) were more likely to delay the initiation of breastfeeding. Conclusion: EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby's birth weight, and mothers' awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals' training to facilitate EIBF, even in circumstances such as cesarean section.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2253-2255
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• 2012

Objective: The objective of our present study was to assess the role of serum amyloid A (SAA) in stages and prognosis of renal cell carcinoma. Material and Methods: It was a hospital based retrospective study carried out in the Department of Medicine and Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January 2008 and $31^{st}$ December 2011. The variables collected were SAA, CRP. Approval for the study was obtained from the institutional research ethical committee. Quantitative analysis of human SAA and C-reactive protein (CRP) was performed by radial immune diffusion (RID) assay for all cases. Results: Of the 422 total cases of renal cell carcinoma, 218 patients had normal and 204 abnormal SAA. SAA levels were grossly elevated in T3 stage ($122.3{\pm}SD35.7$) when compared to the mean for the T2 stage ($84.2{\pm}SD24.4$) (p value: 0.0001). Similarly, SAA levels were grossly elevated in M1 stage ($190.0{\pm}SD12.7$) when compared to the M0 stage ($160.9{\pm}SD24.8$) (p: 0.0001). There was no significant association with elevated CRP levels ($209.1{\pm}SD22.7$, normal $199.0{\pm}SD19.5$). Conclusion: The validity of SAA in serum as being of independent prognostic significance in RCC was demonstrated with higher levels in advanced stage disease.

• Tissue Engineering and Regenerative Medicine
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• v.15 no.6
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• pp.673-697
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• 2018

BACKGROUND: Cartilage tissue engineering (CTE) aims to obtain a structure mimicking native cartilage tissue through the combination of relevant cells, three-dimensional scaffolds, and extraneous signals. Implantation of 'matured' constructs is thus expected to provide solution for treating large injury of articular cartilage. Type I collagen is widely used as scaffolds for CTE products undergoing clinical trial, owing to its ubiquitous biocompatibility and vast clinical approval. However, the long-term performance of pure type I collagen scaffolds would suffer from its limited chondrogenic capacity and inferior mechanical properties. This paper aims to provide insights necessary for advancing type I collagen scaffolds in the CTE applications. METHODS: Initially, the interactions of type I/II collagen with CTE-relevant cells [i.e., articular chondrocytes (ACs) and mesenchymal stem cells (MSCs)] are discussed. Next, the physical features and chemical composition of the scaffolds crucial to support chondrogenic activities of AC and MSC are highlighted. Attempts to optimize the collagen scaffolds by blending with natural/synthetic polymers are described. Hybrid strategy in which collagen and structural polymers are combined in non-blending manner is detailed. RESULTS: Type I collagen is sufficient to support cellular activities of ACs and MSCs; however it shows limited chondrogenic performance than type II collagen. Nonetheless, type I collagen is the clinically feasible option since type II collagen shows arthritogenic potency. Physical features of scaffolds such as internal structure, pore size, stiffness, etc. are shown to be crucial in influencing the differentiation fate and secreting extracellular matrixes from ACs and MSCs. Collagen can be blended with native or synthetic polymer to improve the mechanical and bioactivities of final composites. However, the versatility of blending strategy is limited due to denaturation of type I collagen at harsh processing condition. Hybrid strategy is successful in maximizing bioactivity of collagen scaffolds and mechanical robustness of structural polymer. CONCLUSION: Considering the previous improvements of physical and compositional properties of collagen scaffolds and recent manufacturing developments of structural polymer, it is concluded that hybrid strategy is a promising approach to advance further collagen-based scaffolds in CTE.

• Journal of Pharmacopuncture
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• v.14 no.3
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• pp.91-97
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• 2011

Objectives : The purpose of 29 case series is to report the possibility that a hand acupuncture is effective in relieving headache. Methods : After approval from the Institutional Review Board (IRB), I analyzed 29 cases medical records of outpatients with headache, who visited ${\bigcirc}{\bigcirc}$ oriental medical hospital from December 2008 to December 2010, who have taken a hand acupuncture's treatment without other intervention, and who were diagnosed with one disease of international classification of headache disease second version (ICHD-2). The data was analyzed with Wilcoxon signed rank test to determine whether a hand acupuncture's treatment differed between before and after treatment's Visual Analogue Scale(VAS) according to types of headache and syndrome differentiation. Statistics program was used SPSS 18.0. Differences were considered significant at P<0.05. Results : The VAS of patients with headache was reduced after treatment of hand acupuncture from $6.57{\pm}2.04$ to $2.90{\pm}2.04$ for overall headache, from $6.32{\pm}2.05$ to $2.47{\pm}2.03$ for tension-type headache(P<0.001), from $7.10{\pm}2.18$ to $3.70{\pm}1.77$ for migraine(P<0.001), and from $6.00{\pm}1.41$ to $2.50{\pm}3.54$ for headache unspecified. A hand acupuncture produced a decrease in VAS of both ascendant hyperactivity of liver yang(P<0.001) and phlegm turbidity according to syndrome differentiation(P=0.002). No adverse event were encountered in any of the patients. Conclusions : It is suggested that a hand acupuncture may be effective in relieving headache, and could be applicable to first choice of acupuncture treatment for headache.

• Journal of Korean Neurosurgical Society
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• v.60 no.4
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• pp.448-455
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• 2017

Objective : To investigate the magnetic resonance imaging (MRI) findings and the patterns of postoperative spinal infection according to the passage of time. Methods : Institutional review board approval was obtained, and informed consent was not obtained for the retrospective review of patients' medical records. A total of 43 patients (27 men and 16 women; mean age, 64) diagnosed with postoperative spinal infection were included in this study. We retrospectively reviewed the MRI findings and the medical records and categorized the infection sites based on MRI, i.e., anterior, posterior, and both parts. The duration of the clinical onset from surgery was divided, i.e., acute (${\leq}2weeks$), subacute (2-4 weeks), and late (>4 weeks). Results : Postoperative spinal infection was involved in the posterior part in 31 (72%), anterior part in two (4.7%), and both parts in 10 patients (23.3%). Abscess or phlegmon in the back muscles and laminectomy site were the most common MRI findings. The number of patients with acute, subacute, and late clinical onset were 35, two, and six, respectively (mean, 33.4 days; range, 1-730 days). The mean duration of the clinical onset was 12 days in the posterior part, 15.2 days in both parts, and 456.5 days in the anterior part. Conclusion : Postoperative spinal infection usually occurred within four weeks in the posterior part and over time the infection was considered to spread into the anterior part. For the evaluation of postoperative spinal infection, the posterior surgical field was more important than the vertebral body or the disc space on MRI.

• The Korean Journal of Nuclear Medicine Technology
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• v.26 no.1
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• pp.15-26
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• 2022

Purpose Recently, in the process of examining the self-disposal of radioactive waste by the Korea Institute of Nuclear Safety, it is difficult to reach the final approval process for self-disposal. In connection with this, we intend to increase the processing efficiency of self-disposal and strengthen safety by analyzing cases of recent supplementary matters. Materials and Methods From 2018 to 2021, we compare and review a supplementary requests that preparing the procedures and plans for the self-disposal of radioactive waste by 20 institutions. In this regard, based on the provisions of the Atomic Energy Safety Act, we derive a detailed proposals for the self-disposal of radioactive waste by arranging the review processing period calculation and supplementary requests that occurred during the review process. Results The representative supplementary requests of the Korea Institute of Nuclear Safety are the calculation of the storage period by type and nuclide of radioactive waste, the contents of the packaging container, the RASIS reporting method, the planned storage method for self-disposal, confirmation of the final disposal company, and the storage period of the waste filter Calculation, radioactive labeling, etc. And it is emphasized as important. Conclusion The expected effects of the guidelines reflecting the latest supplements include reduction of the time required for document preparation and increase of work processing efficiency, improvement of storage efficiency in the radioactive waste storage room, and economic cost reduction. If the radioactive waste self-disposal guideline presented in this study is applied to the field, it is thought that it will be helpful in improving the work efficiency of those who are experiencing difficulties.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.1
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• pp.406-416
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• 2017

The purpose of this study was to examine violence response, burnout, and job satisfaction according to violent episodes of emergency room workers. Methods : This Study was a descriptive survey design using convenience sampling. This study was exempt from needing an IRB approval. There were 167 emergency room workers, who agreed to participate in this study, and took a self-report questionnaire between July and August 2015. SPSS 21.0 version was used for descriptive analysis, frequency, percentage, mean, standard deviation, independent t-test, Pearson correlation coefficients, and multiple regression. The major findings of this study were as follows: 1) 84.4% of participant experienced violent episodes. The frequency of verbal violence was highest. Violent attackers were patients and guardians with drunken state. The time of violence episodes was usually during the night. Violent experience of doctors and nurses was very high. 2) There were significant differences in the emotional response according to violent episodes (t=2.528, p=0.12) 3) The correlation between \response and burnout was statistically significant, and indicates a high positive correlation (r=.616, p=<.001). The correlation between violence response and job satisfaction was statistically significant, indicating a negative correlation (r=-.512, p=<.001). There was a negative correlation between burnout and job satisfaction with statistical significance (r=-.568, p=<.001). 4) Significant factors influencing job satisfaction were emotional response to violence and burnout. Conclusion: The findings of this study provide basic information for the strategies of preventing violence, decreasing burnout, and improving job satisfaction by developing a violence management program.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.412-419
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• 2017

Purpose:This study was conducted to identify the effects of theSemi-Fowler's position on post-operative recovery and pain for patients with laparoscopic abdominal surgery Methods: This study utilized a non-equivalent control group non-synchronized design to validate the effects of theSemi-Fowler's position. After IRB approval, 56 patients took part in this study, 29 in the experimental group and 27 in the control group. Consent was obtained from the participants. The Semi-Folwer's position was applied to experimental group and the supine position was applied to the control group for 24 hours after surgery. All data were reviewed retrospectively from April to June 2016. Collected data, frequency, percentage, average, standard deviation, chi-squared test, independent t-test and repeated measures ANOVA were conducted using SPSS 20.0. Results: There was no significant difference between the experimental and control group with regard to recovery outcomes; however, there was a significance differencebetween groups and among check times with regard to post operational pain. Conclusion:The results of this study provide information that will be usefulto the development of strategies for improving recovery outcomes and pain for laparoscopic operation patients.

• Korean Journal of Biological Psychiatry
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• v.24 no.3
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• pp.95-109
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• 2017

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique which can change cortical excitability in targeted area by producing magnetic field pulses with an electromagnetic coil. rTMS treatment has been used to treat various neuropsychiatric disorders including depression. In this review, we evaluate the literature on rTMS for depression by assessing its efficacy on different subtypes of depression and different technical parameters. In particular, we focus on the results of randomized clinical trials and meta-analyses for depression after the US Food and Drug Administration approval in 2008, which acknowledged its efficacy and acceptability. We also review the new forms of rTMS therapy including deep TMS, theta-burst stimulation, and magnetic seizure therapy (MST) that have been under recent investigation. High frequency rTMS over left dorsolateral prefrontal cortex (DLPFC), low frequency rTMS over right DLPFC, or bilateral rTMS is shown to be effective and acceptable in treatment for patients with non-psychotic, unipolar depression either as monotherapy or adjuvant. Deep TMS, theta-burst stimulation and MST are promising new TMS techniques which warrant further research.