• Journal of Gastric Cancer
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• v.1 no.2
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• pp.106-112
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• 2001

Purpose: Even with excellent surgical outcome, recurrence of early gastric cancer (EGC) after a curative resection is not declining because the incidence of EGC is increasing. The aim of this study was to propose an appropriate treatment strategy by assessing the risk factors for recurrence of curatively resected early gastric cancer. Materials and Methods: Of 3662 patients who had undergone gastric resections for gastric cancer from 1987 to 1996, the cases of 1050 curatively resected EGC patients were reviewed retrospectively. Among those 1050 patients, 50 patients ($4.8\%$) were diagnosed as having recurrent cancer, which was confirmed by clinico-radiological examination or re-operation. The risk factors that determined the recurrence patterns were investigated by using univariate and multivariate analyses. Results: The mean time to recurrence was 30.9 months, and hematogenous recurrence was the most frequent type ($32.0\%$). Among the 50 recurred patients, peritoneal recurrence showed the shortest mean time to recurrence ($18.5\pm17.7$months). Between the recurred and the non-recurred patients, there was no statistically significant difference with respect to age, sex, operation type, tumor size, tumor location, gross appearance, or histological differentiation. However, depth of invasion (submucosal invasion) and nodal involvement were significantly different (P<0.001) between the two groups. Using logistic regression analyses, nodal involvement was the only significant risk factor for recurrence in early gastric cancer (P<0.001). The median survival after the recurrence had been diagnosed was 4 months. Conclusion: Although the prognosis for EGC patients is excellent and recurrence of EGC after a curative resection is rare, the time to recurrence and the patterns of recurrence in EGC patients were diverse and unpredictable, and the result after recurrence is dismal. Considering the impact of lymph node metastasis on recurrence of EGC, a systematic lymphadenectomy, rather than limited surgery, should be performed if lymph node involvement is confirmed pre- or intraoperatively. Also if the postoperative pathologic findings reveal lymph node involvement, adjuvant chemotherapy is recommended.

• Journal of Digital Convergence
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• v.17 no.7
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• pp.225-233
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• 2019

The purpose of this study is to investigate the affecting factors on perception of marriage needs in 20-30s unmarried workers. This study used raw data from the survey on the actual social and economic conditions of the youth of 2016. Among the 2,534 subjects, 904 unmarried workers in their 20s and 30s were included in the analysis. Dependent variables were marriage needs, and independent variables were age, sex, height, weight, education level, monthly income, parents' economic level, and health-related variables were self-rate health, stress, regular exercise, and life satisfaction included. Statistical analysis was performed binominal logistic regression analysis. In results, there were no factors influencing perception of marriage needs in 20s men, and Education was a predictor in 20s women. In 30s men, the more regular exercise, the less the monthly income, the more positive the perception of marriage needs was. In the 30s women, the better the self-rate health, the more positive the perception of marriage needs was. These findings suggest that health may affect the marriage perception of 30s unmarried workers.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.442-449
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• 2019

Objective : Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT. Methods : We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation. Results : The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900). Conclusion : This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.

• Korean Journal of Head & Neck Oncology
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• v.27 no.2
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• pp.198-203
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• 2011

Background and Objectives : Distinguishing benign from malignant lesion in thyroid noddex is important but clinically difficult. FNAB is the first investigation of choice. However, cytologic results are often indeterminable. In those cases, additional molecular biologic tests are helpful. If serologic tests are available to predict malignancy, it can be useful to fortify accurate diagnosis. We analyzed whether TSH or FreeT4 level could be used as a predictor of malignancy. Materials and Methods : From January 2008 to March 2009, 540 patients received one of thyroidectomy in a single center. We only included 167 patients from 18 to 65 years old without cardiopulmonary or renal disorders. All the patients were in euthyroid state and took no medications, which affect the thyroid function. We reviewed charts retrospectively to find out differences in TSH level and FreeT4 level between the benign and malignant groups. Results : In this study, all the patients with malignancy had the papillary cancer. In benign group, average TSH level came out to be 1.48mU/L, whereas the average TSH level of malignant group was 1.98 mU/L. Moreover, the higher the cancer stage was, the higher the TSH level was. Although we have adjusted factors that can affect TSH level(age, sex, race, goiter type), we still received the same result. The risk of malignant cancer increased in proportion with TSH level within the normal range. In free T4 level, there was no difference between benign and malignant group. Conclusion : We propose that TSH level can play a role as one of the predictors for thyroid cancer. However, there is limitation because all the patients with malignancy in this study have papillary cancer. Thus, we can apply this result only in papillary cancer, and we need more study for other types of thyroid cancer.

• Sleep Medicine and Psychophysiology
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• v.25 no.1
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• pp.9-14
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• 2018

Objectives: Chronic insomnia disorder is a common and one of the most distressing sleep disorders. This pilot study was conducted to compare the spatial function between insomnia disorder patients and good sleeping control. Methods: We enrolled the 22 patients with chronic insomnia during over one year who met the DSM-5 diagnostic criteria of insomnia disorder and 27 normal sleeping controls. The Cambridge Neuropsychological Test Automated Battery (CANTAB) has been performed to compare the spatial cognitive function between insomnia disorder patients and good sleeping controls. Results: The CANTAB results showed significant differences in the problems solved in minimum moves of Stockings of Cambridge test (t = -2.499, p = 0.017). The significant difference between two groups remained after controlling age, sex, and Beck Depression Index non-sleep scores (F = 5.631, p = 0.022). Conclusion: This study suggests that the patients with insomnia disorder have poor spatial planning function.

• Journal of Acupuncture Research
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• v.19 no.6
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• pp.35-48
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• 2002

Objective : The study was performed to evaluate the effect of treatment for thoracolumbar compression fracture by using Bee Venom Acupuncture that is well known for anti-inflammatory and analgesic effect. Methods : We investigated 39 cases of patient with thoracolumbar compression fracture. The patients with thoracolumbar compression fracture were treated at the department of acupuncture & moxibustion of Kyung-Won University Oriental Hospital from 1st January 2001 to 30th August 2002. We selected for two groups. One group was treated by Bee Venom Acupuncture therapy(Bee Venom Acupuncture Group : BAG), the other group was treated by Filiform Acupuncture therapy(None Bee Venom Acupuncture Group : NBAG). Results : 1. The distribution showed female predominance in sex and 70's predominance in age. The largest group was "accidental fall" and the next was "lifting heavy objects" in causes, and within 2 weeks in the duration of disease 2. In the duration of admission, the largest group was within 4 weeks. In regard to level of injury, T12 was found to be most predominant, followed in turn by L1, L2, L5. In regard to grade of clinical symptoms, Grade III was most predominant, followed by Grade II, Grade IV. 3. In the results of treatment, 87.5% were above "Good" in BAG and 47.8% in NBAG. 4. In the result of treatment due to the grade of clinical symptoms, BAG was more excellent than NBAG on the whols grade. 5. In the result of treatment due to duration of admission, the duration of admission was not in proportion to the results of treatment. 6. In the change of lumber flexion, the improvement above $80^{\circ}$ was 50% in BAG and 21.7% in NBAG 7. In the stability of treatment, the BAG and NBAG did't show any detrimental change in GOT, GPT, r-GTP, BUN, creatinine. Conclusions : In the treatment of thoracolumbar compression fracture, the Bee Venom Acupuncture can be regarded as more effective treatment than Filiform Acupuncture in the clinical practice. This is expected to be available for clinical use.

• Journal of Acupuncture Research
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• v.24 no.1
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• pp.1-12
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• 2007

Objectives : Functional dyspepsia is a prevalent disease. It impedes subjective quality of life. The purpose of this research is to examine the effect of acupuncture treatment for functional dyspepsia. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture for the treatment of functional dyspepsia. Volunteers who satisfied the requirements were enrolled in study. Severity of dyspepsia was measured by Nepean Dyspepsia Index(NDI) and Functional Dyspepsia Quality fo Life(FD-QOL) before and after treatments. Results : 68 subjects finished study. There were not difference between two groups on age, sex, weight, height, severity of dyspepsia, subtype, Byeonjeung, surmise of treatment. After treatment total key symptoms score, improve rate of key symptoms were decreased than before treatment in active acupuncture group, but there were no statistical significance compared with sham acupuncture group. After treatment "pressure in upper abdomen" and " cramps in upper abdomen" were more decreased in active acupuncture group compared with sham acupuncture group(p=0.001, p=0.014). After treatment total symptom score and QOL of NDI were decreased than before treatment in active acupuncture group, but there were no statistical significance compared with sham acupuncture group. After treatment eating status of FD-QOL in active acupuncture group was significantly increased than sham acupuncture group(p=0.008). After treatment liveliness status of FD-QOL and total score of FDQOL in active acupuncture group was increased than sham acupuncture group though statistically insignificant(p=0.095, p=0.077). Conclusion : Acupuncture treatment is effective to improve the symptoms and quality of life in patients with functional dyspepsia.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1545-1551
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• 2015

Purpose: Rectal cancers with high microsatellite-instable have clinical and pathological features that differentiate them from microsatellite-stable or low-frequency carcinomas, which was studied rarely in stage II rectal cancer, promoting the present investigation of the usefulness of microsatellite-instability status as a predictor of the benefit of adjuvant chemotherapy with fluorouracil in stage II rectal cancer. Patients and Methods: Data of 460 patients who underwent primary anterior resection with a double stapling technique for rectal carcinoma at a single institution from 2008 to 2012 were retrospectively collected. All patients experienced a total mesorectal excision (TME) operation. Survival analysis were analyzed using the Cox regression method. Results: Five-year rate of disease-free survival (DFS) was noted in 390 (84.8%) of 460 patients with stage II rectal cancer. Of 460 tissue specimens, 97 (21.1%) exhibited high-frequency microsatellite instability. Median age of the patients was 65 (50-71) and 185 (40.2%) were male. After univariate and multivariate analysis, microsatellite instability (p= 0.001), female sex (p<0.05) and fluorouracil-based adjuvant chemotherapy (p<0.001), the 3 factors were attributed to a favorable survival status independently. Among 201 patients who did not receive adjuvant chemotherapy, those cancers displaying high-frequency microsatellite instability had a better 5-year rate of DFS than tumors exhibiting microsatellite stability or low-frequency instability (HR, 13.61 [95% CI, 1.88 to 99.28]; p= 0.010), while in 259 patients who received adjuvant chemotherapy, there was no DFS difference between the two groups (p= 0.145). Furthermore, patients exhibiting microsatellite stability or low-frequency instability who received adjuvant chemotherapy had a better 5-year rate of DFS than patients did not (HR, 5.16 [95% CI, 2.90 to 9.18]; p<0.001), while patients exhibiting high-frequency microsatellite instability were not connected with increased DFS (p= 0.696). It was implied that female patients had better survival than male. Conclusion: Survival status after anterior resection of rectal carcinoma is related to the microsatellite instability status, adjuvant chemotherapy and gender. Fluorouracil-based adjuvant chemotherapy benefits patients of stage II rectal cancer with microsatellite-stable or low microsatellite-instable, but not those with high microsatellite-instable. Additionally, free of adjuvant chemotherapy, carcinomas with high microsatellite-instable have a better 5-year rate of DFS than those with microsatellite-stable or low microsatellite-instable, and female patients have a better survival as well.

• The Journal of the Korea Contents Association
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• v.11 no.8
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• pp.198-203
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• 2011

The BMD difference depending on QCT and QUS, whose usages are recently being increased for the test of BMD, was accessed for 106 subjects of a general health examination who were aged between 24~69 year-old and results were derived as follows. The measured value of BMD by QCT and QUS showed significant correlation in general (p>0.05). In terms of the difference generated between the measurement methods depending on sexes, the female subjects showed significantly low T-score in the test made through QUS (p<0.05). Depending on ages, there was T-score difference among the subjects aged more than 40 year-old within significant range (p<0.05). When it came to the effect depending on heights and on weights, no group showed significant difference and in a group with less than 22.9 of BMI value, the T-score was measured significantly low when testing it through QCT while other groups were not affected by any testing methods. Likewise, it may require a different measurement method when it comes to the measurement of bone mineral density depending on sex, age, height, and BMI among patients. Thus, it suggests obtaining accurate data by conducting various testing methods in case of a special occasion.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.855-860
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• 1998

Background: Adequate exposure of the mitral valve is a prerequisite for mitral procedures including the repair. An extended transseptal approach in mitral valvular operations is known to have certain technical advantages in recent years because of the anatomic posterior location of the mitral valve, especially in reoperations and in the presence of the small atrium in spite of the possibility of arrhythmia due to injury of sinus nodal artery. Material and Method: We compared the preoperative status, operative, and postoperative factors among patients in two study groups, transseptal only (Group I, n=10) and extended transseptal approach(Group II, n=25). Result: There were no differences in age, sex, NYHA functional class, left atrial size, and left ventricular function. The incidence of the redo-operation was high and early postoperative arrhythmia, which was improved later, appeared in 3 patients in Group II, but not in Group I. Conclusion: We believe that atrial septal incision could be extended up to the atrial roof whenever exposure of the mitral valve during a transseptal approach is inadequate because the late results were similar.