• Radiation Oncology Journal
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• v.36 no.3
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• pp.210-217
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• 2018

Purpose: Pancreatic cancer (PC) has not changed overall survival in recent years despite therapeutic efforts. Surgery with curative intent has shown the best long-term oncological results. However, 80%-85% of patients with these tumors are unresectable at the time of diagnosis. In those patients, first therapeutic attempts are minimally invasive or surgical procedures to alleviate symptoms. The addition of radiotherapy (RT) to standard chemotherapy, ergo chemoradiation, in patients with locally advanced pancreatic cancer (LAPC) is still controversial. The study aims to compare outcomes in patients with a double bypass surgery due to LAPC treated or not with RT. Materials and Methods: A retrospective cohort study of patients with double bypass for LAPC were registered and divided into two groups: treated or not with postoperative RT. Baseline characteristics, postoperative complications, those related to RT and their relation to the main event (mortality) were compared. Results: Seventy-four patients were included. Surgical complications between the groups did not offer significant differences. Complications related to RT were mostly mild, and 86% of patients completed the treatment. Overall survival at 1 and 2 years for patients in the exposed group was 64% and 35% vs. 50% and 28% in the non-exposed group, respectively (p = 0.11; power 72%; hazard ratio = 0.53; 95% confidence interval, 0.24-1.18). Conclusion: We observed a tendency for survival improvement in patients with postoperative RT. However, we've not had enough power to demonstrate this difference, possibly due to the small sample size. It is indispensable to develop randomized and prospective trials to guide more specific treatment lines in this patients.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.336-344
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• 2000

Objective : The treatment for prolactin secreting pituitary adenoma(prolactinoma) include pharmacology, surgery, radiation therapy or radiosurgery. The recent development of radiological imaging and microsurgery has made transsphenoidal microsurgery the treatment of choice for most prolactin secreting pituitary adenoma. Despite its low morbidity and mortality, relatively high recurrence and failure rate have been reported. Recent advances in neuroimaging provide a precise targeting in radiosurgery for treatment of prolactin secreting pituitary adenoma. In this regard, Gamma knife radiosurgery has been proposed as an alternative primary treatment modality or adjuvant therapy. Patients and Methods : Twenty three patients with prolactin secreting pituitary adenoma have been treated with Gamma knife radiosurgery in our institute from March 1992 to September 1998. We analyzed clinical, radiological and endocrinological changes in 21 patients who were followed up for an average of 35.7 months. Results : The mean age was 34.9 years and 16 patients were treated with Gamma knife radiosurgery as primary treatment and 5 patients underwent Gamma knife radiosurgery for residual tumors after microsurgery. The margin of the tumor was incorporated within the 40 to 80% and the mean marginal dose was 24.5 Gy. Clinical improvement in the last follow-up were present in 17 cases(81.0%) and 3 of 5 infertility patients became pregnant after Gamma knife radiosurgery. Tumor control rate after Gamma knife radiosurgery was 100%. Endocrinological normalization in the last follow-up were obtained in 12 cases(57.1%). In three cases, hormonal normalizations were present in early period(3-32 months) but serum hormone levels were elevated subsequently. Conclusion : We conclude that the Gamma knife radiosurgery for prolactin secreting pituitary adenoma seems to be safe and effective as adjuvant therapy after microsurgery and primary treatment modality in selective patients.

• Korea journal of population studies
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• v.9 no.2
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• pp.93-105
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• 1986

The historical study reveals that our ancestors had maintained a system which could produce data on the number of population and households as well as on their characteristics. For example, such data on age structure of the population, number of births, number of deaths by age & sex, number of in & out migrants were found in an historical document for the year 755. The main purposes of maintaining the system at that time were taxation and conscription. As the system evolves, another function of identifying the legal status of people was also added. Looking into the figures for those days reveals that ommission rates of the number of population and households were high. Thus, in an effort to obtain a reliable data, the annual population survey system was introduced as of 1 September 1896. This date is now cerebrated as the Statistics Day. Since then, the survey system has been diversified. At the present time, there are three major data sources which produce the statistics on population and households: Civil Registration System (vital statistics), Resident Registratiton System (migration statistics) and Population Census. However, these three systems are found to have some problems to produce the accurate data. There are some inherent problems in the registration systems such as problems in its coverage, accuracies in contents and timeliness in reporting the vital events and publishing the results. The population census has also non-sampling errors such as errors in coverage, response and non-response. Apart from the above mentioned problems, there are also conflicting problems arised from having different three data source. We can find some overlapping problems in laws and difficulties in comparative studies between regions. In the future, these problems should be taken into consideration for the improvement of the quality of statistics on population and households.

• Journal of Digital Convergence
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• v.19 no.5
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• pp.263-268
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• 2021

The purpose of this study was to propose a model which is suitable for the actual delivery system by designing a fetal delivery hospital operation management and fetal health classification model. The number of deaths during childbirth is similar to the number of maternal mortality rate of 295,000 as of 2017. Among those numbers, 94% of deaths are preventable in most cases. Therefore, in this paper, we proposed a model that predicts the health condition of the fetus using data like heart rate of fetuses, fetal movements, uterine contractions, etc. that are extracted from the Cardiotocograms(CTG) test using a random forest. If the redundancy of the data is unbalanced, This proposed model guarantees a stable management of the fetal delivery health management system. To secure the accuracy of the fetal delivery health management system, we remove the outlier which embedded in the system, by setting thresholds for the upper and lower standard deviations. In addition, as the proportion of the sequence class uses the health status of fetus, a small number of classes were replicated by data-resampling to balance the classes. We had the 4~5% improvement and as the result we reached the accuracy of 97.75%. It is expected that the developed model will contribute to prevent death and effective fetal health management, also disease prevention by predicting and managing the fetus'deaths and diseases accurately in advance.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.86-92
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• 2018

Purpose: Cardiovascular or respiratory complications of acute intoxication are the most common causes of mortality. Advanced cardiac life support (ACLS) or specific antidotes help manage these cardiac or respiratory complications in acute intoxication. On the other hand, some cases do not respond to ACLS or antidotes and they require some special treatment, such as extracorporeal life support (ECLS). ECLS will provide the chance of recovery from acute intoxication. This study examined the optimal timing of ECLS in acute intoxication cases. Methods: This paper is a brief report of a case series about ECLS in acute poisoning. The cases of ECLS were reviewed and the effects of ECLS on the blood pressure and serum lactate level of the patients were analyzed. Results: A total of four cases were reviewed; three of them were antihypertensive agent-induced shock, and one was respiratory failure after the inhalation of acid. The time range of ECLS application was 4.8-23.5 hours after toxic exposure. The causes of ECLS implementation were one for recurrent cardiac arrest, two for shock that did not respond to ACLS, and one for respiratory failure that did not respond to mechanical ventilator support. Three patients showed an improvement in blood pressure and serum lactate level and were discharged alive. In case 1, ECLS was stared at 23.5 hours post toxic exposure; the patient died due to refractory shock and multiple organ failure. Conclusion: The specific management of ECLS should be considered when a patient with acute intoxication does not recovery from shock or respiratory failure despite ACLS, antidote therapies, or mechanical ventilator support. ECLS improved the hemodynamic and ventilator condition in complicated poisoned patients. The early application of ECLS may improve the tissue perfusion state and outcomes of these patients before the toxic damage becomes irreversible.

• Animal Bioscience
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• v.34 no.3_spc
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• pp.434-442
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• 2021

Objective: This study aims to evaluate the influence of dietary flavonoids on the growth performance, blood and intestinal profiles, and carcass characteristics of broilers by employing a meta-analysis method. Methods: A database was built from published studies which have reported on the addition of various levels of flavonoids from herbs into broiler diets and then monitored growth performance, blood constituents, carcass proportion and small intestinal morphology. A total of 42 articles were integrated into the database. Several forms of flavonoids in herbs were applied in the form of unextracted and crude extracts. The database compiled was statistically analyzed using mixed model methodology. Different studies were considered as random effects, and the doses of flavonoids were treated as fixed effects. The model statistics used were the p-values and the Akaike information criterion. The significance of an effect was stated when its p-value was <0.05. Results: Dietary flavonoids increased (quadratic pattern; p<0.05) the average daily gain of broilers in the finisher phase. There was a reduction (p<0.01) in the feed conversion ratio of the broilers both in the starter (linear pattern) and finisher phases (quadratic pattern). The mortality rate tended to decrease linearly (p<0.1) with the addition of flavonoids, while the carcass parameter was generally not influenced. A reduction (p<0.001) in cholesterol and malondialdehyde concentrations (both linearly) was observed, while super oxide dismutase activity increased linearly (p<0.001). Increasing the dose of flavonoids increased (p<0.01) the villus height (VH) and villus height and crypt depth (VH:CD) ratio (p<0.05) in the duodenum. Similarly, the VH:CD ratio was elevated (p<0.001) in the jejunum following flavonoid supplementation. Conclusion: Increasing levels of flavonoids in broilers diet leads to an improvement in growth performance, blood constituents, carcass composition and small intestinal morphology.

• Journal of Chest Surgery
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• v.56 no.3
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• pp.155-161
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• 2023

Background: Surgical closure of an atrial septal defect (ASD) is infrequently indicated during infancy. We evaluated the clinical characteristics and outcomes of patients who underwent surgical ASD closure during infancy. Methods: A single-center retrospective review was performed for 39 patients (19 males) who underwent surgical ASD closure during infancy between 1993 and 2020. The median body weight percentile at the time of operation was 9.3. Results: During a median follow-up of 60.9 months, 4 late deaths occurred due to chronic respiratory failure. A preoperative history of bronchopulmonary dysplasia (BPD) was the only risk factor for late mortality identified in Cox regression (hazard ratio, 3.54; 95% confidence interval [CI], 1.75-163.04; p=0.015). The 5-year survival rate was significantly lower in patients with preoperative history of BPD (97.0% vs. 50.0%, p<0.001) and preoperative ventilatory support (97.1% vs. 40.4%, p<0.001). There were significant postoperative increases in left ventricular end-diastolic (p=0.017), end-systolic (p=0.014), and stroke volume (p=0.013) indices. A generalized estimated equation model showed significantly better postoperative improvement in body weight percentiles in patients with lower weight percentiles at the time of operation (<10th percentile, p=0.01) and larger indexed ASD diameter (≥45 mm/m², p=0.025). Conclusion: Patients with ASD necessitating surgical closure during infancy are extremely small preoperatively and remain small even after surgical closure. However, postoperative somatic growth was more prominent in smaller patients with larger defects, which may be attributable to an increase in postoperative cardiac output due to changes in ventricular septal configuration. The benefits of ASD closure in patients with BPD are undetermined.

• Journal of Chest Surgery
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• v.57 no.4
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• pp.371-379
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• 2024

Background: Sutureless valves are widely used in aortic valve replacement surgery, with Perceval valves and Intuity valves being particularly prominent. However, concerns have been raised about postoperative thrombocytopenia with Perceval valves (Corcym, UK). We conducted a comparative analysis with the Intuity valve (Edwards Lifesciences, USA), and assessed how thrombocytopenia affected patient and transfusion outcomes. Methods: Among 595 patients who underwent aortic valve replacement from June 2016 to March 2023, sutureless valves were used in 53 (Perceval: n=23; Intuity: n=30). Platelet counts were monitored during hospitalization and outpatient visits. Daily platelet count changes were compared between groups, and the results from patients who underwent procedures using Carpentier Edwards Perimount Magna valves were used as a reference group. Results: Compared to the Intuity group, the Perceval group showed a significantly higher amount of platelet transfusion (5.48±1.64 packs vs. 0.60±0.44 packs, p=0.008). During the postoperative period, severe thrombocytopenia (<50,000/μL) was significantly more prevalent in the Perceval group (56.5%, n=13) than in the Intuity group (6.7%, n=2). After initial postoperative depletion, daily platelet counts increased, with significant differences observed in the extent of improvement between the Perceval and Intuity groups (p<0.001). However, there was no significant difference in early mortality or the incidence of neurological complications between the 2 groups. Conclusion: The severity of postoperative thrombocytopenia differed significantly between the Perceval and Intuity valves. The Perceval group showed a significantly higher prevalence of severe thrombocytopenia and higher platelet transfusion volumes. However, thrombocytopenia gradually recovered during the postoperative period in both groups, and the early outcomes were similar in both groups.

• Microbiology and Biotechnology Letters
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• v.44 no.3
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• pp.261-267
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• 2016

The present study examined the effect of the dietary administration of a halophilic bacterium Bacillus sp. Mk22 on the growth improvement of black tiger shrimp, Penaeus monodon, and reduced shrimp infection by Vibrio parahaemolyticus and white spot syndrome virus (WSSV). The shrimp were fed 45 days using three experimental diets: no addition (control), commercial probiotic, and Bacillus sp. Mk22. The shrimp treated with the halophilic bacterium Mk22 showed a significant improvement of growth (7.1 ± 0.21 g), survival (94.3 ± 0.58%), weight gain (178 ± 4.93 g), and reduced feed conversion rate (0.8 ± 0.03 g) compared with the shrimp in the other groups. The shrimp treated with Bacillus sp. Mk22 also showed a lower Vibrio count (0.02 ± 0.01 × 10² CFU/ml) in the shrimp culture water compared with the other groups. The shrimp in the three groups were challenged with either Vibrio or WSSV. For the Vibrio infection, no mortality was observed from water infection or oral feeding infection in the commercial probiotic group and Mk 22 group. For the WSSV infection, a 68% survival rate from water infection and 20% survival rate from oral feeding infection was observed on day 45 in the Mk22 group, while 100% mortalities were recorded at a much earlier time in both the control and commercial probiotic groups. The antioxidant enzyme activities, indicators of oxidative stress, such as catalase and superoxide dismutase, significantly decreased in both the Vibrio and WSSV-infected Mk22 groups compared with the other groups, indicating that Bacillus sp. Mk22 was effective in reducing oxidative stress, possibly due to the reduced infection.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.383-389
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• 1997

From March, 1992 to March, 1996, a total of 279 patients underwent coronary bypass surgery at the Sejong General Hospital, Puchon. We selected 22 patients with severe left ventricular(LV) dysfunction from them. The criteria were the presence of global or segmental abnormalities of left ventricular contraction and LV ejection fraction(EF) less than 35% based on biplane LV angiography by planimetry method. The mean age of 17 male and 5 female patients was 60$\pm$5.6years(range:47~73 years). All had the anginas, which were Canadian class II in 6, class 111 in 12 and class IV in 4. All patients except one had the history of previous myocardial infarction more than once. Seven of them had the symptoms and signs of congestive heart failure, such as dyspnea on excertion and increased pulmonary vascular markings. Their mean LVEF was 29.4$\pm$4 5%(range : 18~35%) and mean LV end-diastolic pressure was 18.7 $\pm$8. 2mmHg(range:10~42mmHg). 21 patients had 3 vessel-disease and 1 had 2 vessel-disease. Complete revascularization was tried with the use of 16 internal mammary arteries and 60 sapheuous veins and 3 radial arteries grafts. The mean number of distal anastomosis was 3.5$\pm$ 1.1. Concomitantly, one mitral valvuloplasty and annuloplasty was performed in the patient with moderate mitral regurtigation. The hospital mortality was 4.5%. During the follow-up, there were 3 late deaths. Of 18 survivors, 2 patients were lost in follow-up 24 and 27 month respectively after operation and the remaining 16 patients have bcen followed up with an average of 30.4 $\pm$ 13.4 months.15 patients had improvement with respect to angina but 8 patients still have the continuing or progressing heart failure. The 1-year, 2-year and 3-year actuarial survival rate was 85.2, 69.1, 46.1%, respectively. This study indicates that coronary artery bypass sur ery can be performed in the patients with severe LV dysfunction at acceptable risk but does not greatly contribute to the improvement of congestive heart failure.