• Journal of Korean Neurosurgical Society
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• v.37 no.6
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• pp.416-421
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• 2005

Objective: Despite general agreement on the goals of surgical treatment in thoracolumbar burst fractures, considerable controversy exists regarding the choice of operative techniques. This study is to evaluate the efficacy of short-segment fixation for thoracolumbar burst fractures after long-term follow-up and to analyze the causes of treatment failures. Methods: 48 out of 60 patients who underwent short-segment fixation for thoracolumbar burst fractures between January 1999 and October 2002 were enrolled in this study. Their neurological status, radiological images, and hospital records were retrospectively reviewed. Simple radiographs were evaluated to calculate kyphotic angles and percentages of anterior body compression (%ABC). Results: The average kyphotic angles were $20.0^{\circ}$ preoperatively, $9.6^{\circ}$ postoperatively, and $13.1^{\circ}$ at the latest follow-up. The average %ABC were 47.3% preoperatively, 31.2% postoperatively, and 33.3% at the latest follow-up. The treatment failure, defined as correction loss by $10^{\circ}$ or more or implant failure, was detected in 6 patients (12.5%). 5 out of 6 patients had implant failures. 2 out of 5 patients were related with osteoporosis, and the other 2 were related with poor compliance of spinal bracing. 3 patients with poor initial postoperative alignment had implant failure. 4 patients with screws only on the adjacent vertebrae and not on the injured vertebra itself showed poor initial and overall correction. Conclusion: With proper patient selection, adequate intraoperative reduction with screw fixation involving the injured vertebra, and strict postoperative spinal bracing, the short-segment fixation is an efficient and safe method in the treatment of thoracolumbar burst fracture.

• Journal of Ecology and Environment
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• v.30 no.1
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• pp.23-38
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• 2007

Based on a time series of ocean climate indices and catch records for seven pelagic fish species in the Tsushima Warm Current (TWC) and Kuroshio-Oyashio Current (KOC) regions from 1910 to 2004, we detected regional synchrony in the long-term fluctuations of the fish populations and identified alternation patterns of dominant species related to climate shifts. The annual catches of Pacific herring, Japanese sardines, Japanese anchovies, jack mackerel, chub mackerel, Pacific saury and common squid in the TWC region fluctuated in phase with those in the KOC region, which suggests that they were controlled by the same basin-wide climate forcing. After the collapse of the herring fishery, the alternation sequence was: sardines (1930s), Pacific saury, jack mackerel, common squid and anchovies ($1950s{\sim}1960s$), herring ($late\;1960s{\sim}early\;1970s$), chub mackerel (1970s) and then sardines (1980s). As sardine biomass decreased in the late stages of the cool regime, catch of the other four species increased immediately during the warm period of the 1990s. Regional differences in the amplitude of long-term catch fluctuations for the seven pelagic fishes could be explained by regional differences in availability, fishing techniques and activity.

• Health Policy and Management
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• v.13 no.1
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• pp.1-22
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• 2003

The principal objective of this study was to analyze and conceptualize the socio-psychological burden in utilizing a nursing home for elderly. The subjects were five elderly from a private nursing home located in Seoul and their familial caregivers. An old male and three females were currently staying at the facility, and a female had been discharged already from there. Data were collected through depth interviews, observations and review of records at the facility For analysis, the data were classified by similar contents among significant expressions and factors in common. The subjects' motives to consider admission to the nursing home might be attributed to familial caregivers' burden, a shortage of support, environmental improvement and feeling of helplessness for the case elderly. The concept of burden is including family members' being badly off in living, their weariness, complications among family members, feeling psychological uneasiness, and hospital expenses. The identified image of nursing homes for the elderly in Korea was generally negative at the point of high cost, unreasonable requisites and limitations for admission to the facilities, inferior situations, and especially in that there were few long-term care facilities within the community boundary. From their experience of nursing homes, the interviewees have felt the sentiments of sorry for their old parents, with the thought of being an undutiful, bitterness, and empathy. Additionally, they expressed a sense of anxiety of relative deprivation against the fact that there were no long-term care facilities available for the middle class. On the basis of these, multi-dimensional needs could be identified for the elderly with chronic illnesses.

• Korean Journal of Ecology and Environment
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• v.38 no.4 s.114
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• pp.439-444
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• 2005

The environmental quality of the middle-reach of the Yahagi River has deteriorated in recent years. The nutrient dynamics within the reach were investigated to explain the changes. Seasonal pattern of $NO_3\;^--N$ concentration tended to stay low from April or May through July or August and then increased till winter or early spring, although there were peaks during high flow periods in mid-September, 2000 and late-August, 2001. No clear seasonal changes were observed in $PO_4\;^{3-}-P$ concentration. In the bimonthly records from 1980-2002, the DIN concentrations on January and March were higher than other months whereas the average daily flows on January and March were lower than they were in other months. The mean DIN concentration showed a high negative correlation with the median of average daily flow. In the past 50 years, the average concentration of DIN (excluding nitrite) was 0.21 mg $L^{-1}$ in 1952-1953. The concentration was about twice this high around 1980, and it is about three times this high at present. On the other hand, the average concentration of $PO_4\;^{3-}-P$ was below the limit of detection in 1952-53. However, it increased to almost 0.03 mg $L^{-1}$ around 1980, then decreased to approximately 0.016mg $L^{-1}$ at present. Our results suggest that the increasing DIN concentration is one of the causes of environmental change in the Yahagi River. We conclude that controlling the DIN concentration is essential for improving the river environment.

• Journal of Chest Surgery
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• v.53 no.3
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• pp.114-120
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• 2020

Background: Evidence is lacking on whether the resection of lung parenchymal cancer improves the survival of patients with unexpected pleural metastasis encountered during surgery. We conducted a single-center retrospective study to determine the role of lung resection in the long-term survival of these patients. Methods: Among 4683 patients who underwent lung surgery between 1995 and 2014, 132 (2.8%) had pleural metastasis. After excluding 2 patients who had incomplete medical records, 130 patients' data were collected. Only a diagnostic pleural and/or lung biopsy was performed in 90 patients, while the lung parenchymal mass was resected in 40 patients. Results: The mean follow-up duration was 29.8 months. The 5-year survival rate of the resection group (34.7%±9.4%) was superior to that of the biopsy group (15.9%±4.3%, p=0.016). Multivariate Cox regression analysis demonstrated that primary tumor resection (p=0.041), systemic treatment (p<0.001), lower clinical N stage (p=0.018), and adenocarcinoma histology (p=0.009) were significant predictors of a favorable outcome. Interestingly, primary tumor resection only played a significant prognostic role in patients who received systemic treatment. Conclusion: When pleural metastasis is unexpectedly encountered during surgical exploration, resection in conjunction with systemic treatment may improve long-term survival, especially in adenocarcinoma patients without lymph node metastasis.

• Archives of Plastic Surgery
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• v.44 no.1
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• pp.48-52
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• 2017

Background The ideal vaginoplasty must be successful functionally as well as have a natural appearance, and also must retain its functionality and appearance over the long term. Conventional vaginoplasty techniques have functional limitations and are associated with recurrent complications, but rectosigmoid vaginoplasty is known to have a high satisfaction rate due to its functional similarity with the vagina. We conducted the present study to assess the usability of rectosigmoid vaginoplasty over the course of long-term follow-up. Methods From March 1992 to February 2014, 84 patients were treated with rectosigmoid vaginoplasty; 44 had gender identity disorder, 29 had vaginal agenesis, 8 had female pseudohermaphroditism, and 3 had gynecologic malignancies after radical pelvic surgery. This retrospective study was based on a review of the patients' records, clinical examinations, complications, and questionnaires about appearance, function, and sexual intercourse. Results All patients who underwent rectosigmoid vaginoplasty were discharged within 2 weeks without surgical flap loss. The early complications were partial flap necrosis, difficulty in defecation, mucous hypersecretion, and postoperative ileus. The late complications were vaginal introitus contracture, vaginal prolapse, and difficulty in urination. The mean length and diameter of the neovagina 3.4 years after rectosigmoid vaginoplasty were 13.2 cm and 3.8 cm, respectively. On questionnaires about satisfaction, 70% of patients reported excellent satisfaction, 11% good, 12% fair, and 7% poor. Conclusions Rectosigmoid vaginoplasty is useful, safe, and well-accepted operative method with good functional and cosmetic results, such as natural lubrication and adequate vaginal length and width obtained without requiring the use of a dilator.

• Journal of Gastric Cancer
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• v.10 no.4
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• pp.219-225
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• 2010

Purpose: The long-term survival rate of gastric cancer patients after surgery has recently increased as a result of making an early diagnosis of gastric cancer. Therefore, the incidence of remnant gastric cancer is increasing. This study was performed to evaluate the clinicopathological characteristics and prognosis of patients with remnant gastric cancer. Materials and Methods: From January 2005 to December 2009, twenty-nine patients with remnant gastric cancer and who underwent surgery at Pusan National University Hospital were enrolled in this study. We retrospectively reviewed and analyzed their medical records. We also divided them into two groups: the remnant gastric cancer (RGC)-B group (first operation for benign disease) and the RGC-M group (first operation for malignant disease). Results: The RGC-B group included ten patients and the RGC-M group included nineteen patients. The mean interval between the first and second operations was 17 years. The curative resection rate was 93.1% (27/29). The postoperative complication rate was 20.7% (6/29) and there was no perioperative mortality. Ten (37%) of twenty-seven patients experienced recurrence after curative resection and eight patients (27.6%) expired due to aggravation of remnant stomach cancer. An advanced TNM stage and non-curative resection were the negative prognostic factors for survival for patients with remnant stomach cancer (P=0.0453 and P<0.001). The RGC-M group showed a shorter interval (P<0.001) and the RGC-B group had more advanced TNM stage (P=0.003). Conclusions: Long-term follow-up should be considered not only for patients who undergo an operation for malignant disease, but also for the patients who underwent an operation for benign disease. When remnant gastric cancer is diagnosed, curative resection is essential to improve the survival.

• The Journal of Advanced Prosthodontics
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• v.8 no.4
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• pp.321-328
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• 2016

PURPOSE. This study was designed to investigate the maintenance of teeth and implants in patients with viral liver disease. MATERIALS AND METHODS. 316 patients without any significant systemic disease were selected as a control group. Liver disease group was consisted of 230 patients. Necessary data were collected using clinical records and panoramic radiographs. Then, the patients were subdivided into 2 groups based on the type of active dental therapy received before maintenance period (Pre-Tx). Analysis for finding statistically significant difference was performed based on the need for re-treatment of active dental therapy (Re-Tx) and change in the number of teeth (N-teeth) and implants (N-implants). RESULTS. Comparing to control group, the patients with liver disease showed higher value on N-teeth, N-implants, and Re-Tx. Statistically significant differences were found on N-teeth (P=.000) and Re-Tx (P=.000) in patients with non-surgical Pre-Tx. Analysis based on severity of liver disease showed that N-teeth and Re-Tx were directly related to severity of liver disease regardless of received type of Pre-Tx. Significant differences were found on N-teeth (P=.003) and Re-Tx (P=.044) in patients with non-surgical Pre-Tx. CONCLUSION. In this study, it was concluded that liver disease might influence the loss of teeth and cause the relapse of dental disease during maintenance period in patients. A significant positive relationship between tooth and implant loss and severity of liver disease seems to exist.

• Journal of the Institute of Convergence Signal Processing
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• v.5 no.3
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• pp.190-197
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• 2004

This paper presents automated prediction of transient ischemic episodes using neural networks(NN) based pattern matching method. The learning algorithm used to train the multilayer networks is a modified backpropagation algorithm. The algorithm updates parameters of nonlinear function in a neuron as well as connecting weights between neurons to improve learning speed. The performance of the method was evaluated using ECG signals of the MIT/BIH long-term database. Experimental results for 15 records(237 ischemic episodes) show that the average sensitivity and specificity of ischemic episode prediction are 85.71% and 71.11%, respectively. It is also found that the proposed method predicts an average of 45.53［sec］ ahead real ischemia. These results indicate that the NN approach as the pattern matching classifier can be a useful tool for the prediction of transient ischemic episodes.

• Journal of Gastric Cancer
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• v.19 no.1
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• pp.62-71
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• 2019

Purpose: The laparoscopic transhiatal approach (LA) for adenocarcinoma of the esophagogastric junction (AEJ) is advantageous since it allows better visualization of the surgical field than the open approach (OA). We compared the surgical outcomes of the 2 approaches. Materials and Methods: We analyzed 108 patients with AEJ who underwent transhiatal distal esophagectomy and gastrectomy with curative intent between 2003 and 2015. Surgical outcomes were reviewed using electronic medical records. Results: The LA and OA were performed in 37 and 71 patients, respectively. Compared to the OA, the LA was associated with significantly shorter duration of postoperative hospital stay (9 vs. 11 days, P=0.001), shorter proximal resection margins (3 vs. 7 mm, P=0.004), and extended operative times (240 vs. 191 min, P=0.001). No significant difference was observed between the LA and OA for intraoperative blood loss (100 vs. 100 mL, P=0.392) or surgical morbidity rate ($grade{\geq}II$) for complications (8.1% vs. 23.9%, P=0.080). Two cases of anastomotic leakage occurred in the OA group. The number of harvested lymph nodes was not significantly different between the LA and OA groups (54 vs. 51, P=0.889). The 5-year overall and 3-year relapse-free survival rates were 81.8% and 50.7% (P=0.024) and 77.3% and 46.4% (P=0.009) for the LA and OA groups, respectively. Multivariable analyses revealed no independent factors associated with overall survival. Conclusions: The LA is feasible and safe with short- and long-term oncologic outcomes similar to those of the OA.