• Korean Journal of Head & Neck Oncology
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• v.35 no.1
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• pp.1-11
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• 2019

In head and neck reconstruction, microsurgeons are faced with various demands, such as thin resurfacing, or three-dimensional reconstruction, and therefore, conventional flap as well as perforator flaps are all useful for the functional and aesthetic reconstruction successfully. Among perforator flaps, the pros and cons of anterolateral thigh perforator flap(ALTp) and thoracodorsal perforator flap(TAp) is compared and selected depending on the surgeon's preference, recipient site condition or patient status. Both flaps can be elevated in a chimeric pattern by combining different aspects of tissue components. Customized or tailored reconstruction as well as 3 dimensional reconstructions are all available with perforator flaps and it is useful in head and neck reconstruction. The most outstanding update in head and neck reconstruction is the perforator based island flap (PBIF) compared to conventional flaps. The conventional local flap has evolved on behalf of the perforator concept and its design becomes more flexible and freestyle with less limitations. Actually, random pattern flap is now a misnomer and most conventional local flaps turn into PBIFs. Finally we can say all conventional donor site becomes universal, depending on the surgeons' preference or idea. Moreover, there is no more "flap of choice" and postoperative results are quite variable by surgeons' ability. Operative procedures and plans are very flexible to freestyle flap. With all these advantages, surgeons should be armed with both conventional and perforator concepts for solving any defects or problems.

• Tuberculosis and Respiratory Diseases
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• v.61 no.6
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• pp.547-553
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• 2006

Background: Liquid-based cytology is currently known as an effective method, and cervical cytology has been shown to be especially effective from of malignancy detection. In our study, the cytological detection rates of the Thinprep (Liquid-based cytology) and conventional cytology (bronchial washing & brushing) for endobronchial lesions were compared. Methods: Between July 2005 and September 2005, the data from 30 patients with respiration symptom, who had shown abnormal lesion on bronchoscopy, were collected. Results: The bronchoscopic biopsy group was consisted of 30 cytodiagnosis specimens, 24 of which were confirmed to be malignant. The others were tuberculosis (4), bronchiectasis and bronchopulmonary fistula (1 each). Of the 24 malignant case, cancer or atypical cells were detected in 19, 17 and 12 of the Thinprep, brushing cytology and washing cytology cases, respectively. None one of the methods detected cancer cells in the non-malignant specimens. Washing cytology has shown sensitivity, specificity, and positive and negative predictive values of 50, 100, 100 and 33.3% respectively. Brushing cytology has shown sensitivity, specificity, and positive and negative predictive values of 70.8, 100, 100 and 46.2%, respectively. Thinprep has shown sensitivity, specificity, and positive and negative predictive values of 79.2, 100, 100 and 54%, respectively. Conclusions: Thinprep (liquid-based cytology) showed better sensitivity and negative predictive values for the evaluation of lung cancer than conventional cytology. However a large-scale study will be needed in the future.

• Journal of Preventive Medicine and Public Health
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• v.36 no.4
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• pp.339-348
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• 2003

Objective : To quantify the economic value of the Sirolimus fluting Stent ($CYPHER^{TM}$) in treating acute coronary heart disease (CMD), and to assist in determining an adequate level of reimbursement for $CYPHER^{TM}$ in Korea. Methods : A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of $CYPHER^{TM}$ versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization, The follow-vp costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Defending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were peformed for discount rates of 3, 5 and 7%. Since the major clinical advantage of $CYPHER^{TM}$ over conventional stenting was the reduction in the revascularization rates, the economic value of $CYPHER^{TM}$, in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of $CYPHER^{TM}$ per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, $CYPHER^{TM}$ would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of $CYPHER^{TM}$ making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. Results : The average weighted initial insurance covered and total medical costs of conventional stenting were about 6,275,000 and 8,058,000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13,659,000 and 17,353,000 Won, respectively. The estimated maximum level of reimbursement price of $CYPHER^{TM}$ from the perspectives of the insurer and society were $4,126,897{\sim}4,325,161$ and $4,939,939{\sim}5,078,181$ Won, respectively. Conclusion : By evaluating the economic value of $CYPHER^{TM}$, as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for $CYPHER^{TM}$.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6991-6996
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• 2015

In the past decade, the incidence and mortality rates of cholangiocarcinoma (CCA) have been increasing worldwide. The relatively low responsiveness of CCA to conventional chemotherapy leads to poor overall survival. Recently, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL or Apo2L) has emerged as the most promising anti-cancer therapeutic agent since it is able to selectively induce apoptosis of tumor cells but not normal cells. In this study, we aimed to investigate the therapeutic effect of TRAIL in CCA cell lines (M213, M214 and KKU100) compared with the immortal biliary cell line, MMNK1, either alone or in combination with a subtoxic dose of 5-fluorouracil (5-FU). We found that recombinant human TRAIL (rhTRAIL) was a potential agent which significantly inhibited cell proliferation and mediated caspase activities (caspases 8, 9 and 3/7) and apoptosis of CCA cells. The combined treatment of rhTRAIL and 5-FU effectively enhanced inhibition of CCA cell growth with a smaller effect on MMNK1. Our finding suggests TRAIL to be a novel anti-cancer therapeutic agent and advantage of its combination with a conventional chemotherapeutic drug for effective treatment of CCA.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.75-82
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• 2014

PURPOSE: PURPOSE: The purpose of this study was to analyze the effect and examine the feasibility of an intervention of ankle strategy exercise on balance of patients with hemiplegia. METHODS: The subject were randomly allocated to three groups: ankle strategy exercise (group A), balance exercise (group B) and control (group C). Group A was received the conventional physical therapy plus ankle strategy exercises for 20 minutes in one session. Group B was received the same conventional physical therapy plus balance exercises for 20 minutes in one session. Two active groups were performed in the session 3 times a week, for a total of 6 weeks. and Group C was only received the same conventional physical therapy. Balance test was assessed using center of pressure (COP) in the anteroposterior (A-P), mediolateral (M-L) direction, Berg balance scale (BBS) and Timed Up and Go Test (TUG). RESULTS: All groups showed improvements in balance parameters. In especial, the Group A was statistically significant differences in almost part evaluation items and showed more improvements in BBS and TUG parameters than Group B and Group C. and moving distance of M-L COP was more improvements than Group B. CONCLUSION: Ankle strategy exercises had more influence on balance than balance exercises and neurodevelopmental treatment.

• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.373-378
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• 2013

Objective : We present our experience of conventional posterior approach without fat lateral approach for ventral foramen magnum (FM) meningioma (FM meningioma) and tried to evaluate the approach is applicable to ventral FM meningioma. Methods : From January 1999 to March 2011, 11 patients with a ventral FM meningioma underwent a conventional posterior approach without further extension of lateral bony window. The tumor was removed through a working space between the dura and arachnoid membrane at the cervicomedullary junction with minimal retraction of medulla, spinal cord or cerebellum. Care should be taken not to violate arachnoid membrane. Results : Preoperatively, six patients were of Nurick grade 1, three were of grade 2, and two were of grade 3. Median follow-up period was 55 months (range, 20-163 months). The extent of resection was Simpson grade I in one case and Simpson grade II in remaining 10 cases. Clinical symptoms improved in eight patients and stable in three patients. There were no recurrences during the follow-up period. Postoperative morbidities included one pseudomeningocele and one transient dysphagia with dysarthria. Conclusion : Ventral FM meningiomas can be removed gross totally using a posterior approach without fat lateral approach. The arachnoid membrane can then be exploited as an anatomical barrier. However, this approach should be taken with a thorough understanding of its anatomical limitation.

• Clinical and Experimental Reproductive Medicine
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• v.41 no.1
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• pp.9-14
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• 2014

Objective: The aim of this study was to evaluate the efficiency of the intracytoplasmic morphologically selected sperm injection (IMSI) technique compared with conventional ICSI and previous ICSI attempts in oligo-astheno-teratozoospermia (OAT) patients. Methods: The sperms were selected under high magnification ($6,600{\times}$) and used to induce fertilization in previous ICSI patients by IMSI. These results were compared with previous conventional ICSI cycles in patients with OAT infertility. Results: These results demonstrated no significant difference in the fertilization rate between IMSI and previous ICSI cycles (67.7% vs. 65.0%). However, the pregnancy and implantation rates with IMSI were significantly higher than those of the ICSI cycles (33.3% vs. 12.5% and 14.6% vs. 5.4%, respectively; p<0.05). The miscarriage rate among pregnant patients (18.2% vs. 37.5%) showed no statistically significant difference between groups. Conclusion: Compared to conventional ICSI, this study found that IMSI increased the IVF-ET success rates in patients with OAT.

• Archives of Craniofacial Surgery
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• v.20 no.3
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• pp.164-169
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• 2019

Background: The conventional surgical method for reconstructing orbital floor fractures involves restoration of orbital continuity by covering an onlay with a thin material under the periorbital region. However, in large orbital floor fractures, the implant after inserting is often dislocated, leading to malposition. This study aimed to propose a novel implanting method and compare it with existing methods. Methods: Among patients who underwent surgery for large orbital floor fractures, 24 who underwent the conventional onlay implanting method were compared with 21 who underwent the novel ${\gamma}$ implanting method that two implant sheets were stacked and bent to resemble the shape of the Greek alphabet ${\gamma}$. When inserting a ${\gamma}$-shaped implant, the posterior ledge of the orbital floor was placed between the two sheets and the bottom sheet was impacted onto the posterior wall of the maxilla to play a fixative role while the top sheet was placed above the residual orbital floor to support orbital contents. Wilcoxon signed-rank test and Mann-Whitney U test were used for data analyses. Results: Compared to the conventional onlay method, the gamma method resulted in better restoration of orbital contents, better improvement of enophthalmos, and fewer revision surgeries. Conclusion: Achieving good surgical outcomes for extended orbital floor fractures is known to be difficult. However, better surgical outcomes could be obtained by using the novel implantation method of impacting a ${\gamma}$-shaped porous polyethylene posteriorly.

• Journal of Food Hygiene and Safety
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• v.16 no.3
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• pp.194-199
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• 2001

This study was designed to compare the effectiveness and applicability of the HApS$^{TM}$ (Hazard Analysis process System; HUKO, Seoul, Korea) based on Petrifilm$^{TM}$ (3M, St. Paul, MN, USA) with the AOAC (the Association of Official Analytical Chemists) standard total aerobic count (TAC) method and coliform count (CC) method for meat products. The comparisons were carried out using 230 meat samples collected from various retailers: 80 pork samples, 80 chicken samples, and 70 beef samples. In the comparison of the correlation coefficient (r) between conventional method and HApS$^{TM}$ method by a linear regression analysis, the correlation coefficients in total microorganism were 0.97767, 0.90712, and 0.95594 in pork, beef, and chicken samples, respectively. The correlation coefficients in coliform count were 0.82062, 0.94833, and 0.96839 in pork, beef and chicken samples, respectively. All the independent t-test on measurement values between conventional method and HApS$^{TM}$ method represented no significant differences in the means between two methods at the 0.05 of significance level($\alpha$=0.05). Based on the high correlation between HApS$^{TM}$ and the AOAC standard methods in the TAC and CC, it might be compatible to employ the HApS$^{TM}$ method to measure the microbial contamination in livestock products. HApS$^{TM}$ method was simpler and less time-consuming in sample preparation and procedures faster than the conventional method. These results suggested that the HApS$^{TM}$ method could be substitute for the conventional methods in the analysis of microbial contamination measurement in meat products.n meat products.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.371-376
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• 2005

Background: Retrospective study was carried out on patients with primary spontaneous pneumothorax with the aim of determining if conventional thoracoscopic wedge resection is superior to modified transaxillary minithoracotomy with thoracoscopy in the surgical treatment. Material and Method: 160 patients, aged 14 to 35 years with primary spontaneous pneumothorax were involved in this study. Patients were assigned to two groups by surgical technique; Conventional thoracoscopic wedge resection (group A; n=80) and modified transaxillary minithoracotomy with thoracoscopy (group B; n=80). Apical pleural abrasion & talc poudrage were performed in all cases. This study evaluated the following factors: duration of operation, days of analgesics used after operation, number of no air leak on the first postoperative day, duration of indwelling chest tube, hospital stay, postoperative complications, chronic chest pain (during follow-up) and resumption of normal activity. Relapses (ipsilateral recurrence after discharge) during follow-up periods were evaluated. Result: No significant differences were found in any of the factors studied in either group. Conclusion: Conventional thoracoscopic wedge resection and modified transaxillary minithoracotomy with thoracoscopy offer similar results in the surgical treatment of primary spontaneous pneumothorax. The rate of complication is low and the level of pain is acceptable without long-term sequele. Therefore, modified transaxillary minithoracotomy with thoracoscopy method appears as a valuable alternative surgical technique.