• Journal of Korean Neurosurgical Society
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• 제30권8호
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• pp.970-975
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• 2001

Objective : By conducing a review of clinical outcomes for patients with aneurysm treated using current microneurosurgical techniques and intensive care unit management, we speculated that grading systems based only on clinical condition or CT finding after admission failed to provide a significant stratification of outcome between individual grades of patients, because these systems did not include the factor for postoperative vasospasm. We hypothesized that postoperative blood flow velocity could have a significant impact on outcome prediction for patients surgically treated for intracranial aneurysms. Methods : We conducted a analysis on patient- and lesion-specific factors that might have been associated with outcome in a series of 55 aneurysm operations performed with measurements of blood-flow velocity with transcranial Doppler ultrasonography(TCD). In the new scale(NS) score system, 1 point is assigned additionally for the case with Hunt and Hess(H-H)/World Federation of Neurological Surgeons(WFNS) Grade IV or V, Fisher Scale(FS) score 3 or 4, aneurysm size greater than 10mm, patient age older than 60 years, blood-flow velocity higher than 120cm/sec, and posterior circulation lesion. By adding the total points, a 6-point scale score(score 0-6) is obtained. Results : Age of patient, size of aneurysm, clinical condition(H-H grade and WFNS), FS score, and blood flow velocity(TCD 1day after operation) were independently and strongly associated with long-term outcome. When NS scores were applied to 55 patients with at least 6 months follow-up, the correlation of individual scores with outcome was strongly validated the retrospective findings. Conclusion : It was speculated that TCD could be used to assess postoperative vasospasm and to monitor noninvasively the patients with aneurysmal SAH. This NS score system is easy to apply, divide patients into groups with different outcome, and is comprehensive, allowing for more accurate prediction of surgical outcome.

• Journal of Korean Neurosurgical Society
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• 제61권4호
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• pp.537-537
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• 2018

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6227-6232
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• 2014

Background: Oral squamous cell carcinoma (OSCC) remains as one of the most difficult malignancies to control because of its high propensity for local invasion and cervical lymph node dissemination. The aim of present study was to evaluate the efficacy of novel pH and temperature sensitive doxorubicin-methotrexate-loaded nanoparticles (DOX-MTX NP) in terms of their potential to change the VEGF-C expression profile in a rat OSCC model. Materials and Methods: 120 male rats were divided into 8 groups of 15 animals administrated with 4-nitroquinoline-1-oxide to induce OSCCs. Newly formulated doxorubicin-methotrexate-loaded nanoparticles (DOX-MTX NP) and free doxorubicin were IV and orally administered. Results: Results indicated that both oral and IV forms of DOX-MTX-nanoparticle complexes caused significant decrease in the mRNA level of VEGF-C compared to untreated cancerous rats (p<0.05). Surprisingly, the VEGF-C mRNA was not affected by free DOX in both IV and oral modalities (p>0.05). Furthermore, in DOX-MTX NP treated group, less tumors characterized with advanced stage and VEGF-C mRNA level paralleled with improved clinical outcome (p<0.05). In addition, compared to untreated healthy rats, the VEGF-C expression was not affected in healthy groups that were treated with IV and oral dosages of nanodrug (p>0.05). Conclusions: VEGF-C is one of the main prognosticators for lymph node metastasis in OSCC. Down-regulation of this lymph-angiogenesis promoting factor is a new feature acquired in group treated with dual action DOX-MTX-NPs. Beside the synergic apoptotic properties of concomitant use of DOX and MTX on OSCC, DOX-MTX NPs possessed anti-angiogenesis properties which was related to the improved clinical outcome in treated rats. Taking together, we conclude that our multifunctional doxorubicin-methotrexate complex exerts specific potent apoptotic and anti-angiogenesis properties that could ameliorate the clinical outcome presumably via down-regulating dissemination factor-VEGF-C expression in a rat OSCC model.

• 산업경영시스템학회지
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• 제40권1호
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• pp.150-164
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• 2017

The development of an appropriate public service quality model has become increasingly recognised as an important subject of interest in the public sector as well as academia. In particular, the public systems enacted by governments are widely used and have a significant impact on national competitiveness. But few researches have been conducted to explore the quality dimensions of a public system service and empirically examine the relationship among related variables. Therefore, in this study, we strive to develop a quality measurement model of public system service that can be effectively used in practice. Using 601 samples gathered through a structured survey from project engineers, a conceptual quality model of public system is presented and discussed. Given the exploratory nature of this study, an exploratory factor analysis is used to investigate quality dimensions and partial least square (PLS) is employed in determining the structural relationships. From empirical results, we found that the quality dimensions of the public system had four distinct quality dimensions (design quality, environment quality, primary outcome quality, additive outcome quality). All four quality dimensions showed good representative factors in explaining user satisfaction. Perceived trust was proved to significantly mediate the relationship between quality dimensions and user satisfaction. Our research is expected to contribute to the literature by providing a good conceptual framework for assessing public system quality by linking four quality dimensions with user satisfaction. In particular, the developed model can elaborately measure process quality and multi-functional outcome quality of the system by the supplementation of design quality and additive outcome quality respectively. Practical implications are also suggested on the basis of our analysis.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.34-41
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• 2014

Objective : The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period. Methods : Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ${\geq}4$] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration. Results : The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ${\geq}13$) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (${\geq}140mg/dL$) was an independent risk factor for prolonged antibiotic therapy (p=0.032). Conclusion : We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.

• Radiation Oncology Journal
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• 제30권2호
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• pp.62-69
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• 2012

Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.

• Radiation Oncology Journal
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• 제32권1호
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• pp.1-6
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• 2014

Purpose: To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). Materials and Methods: We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. Results: The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or ${\geq}1$ mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). Conclusion: Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.

• 산업경영시스템학회지
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• 제39권1호
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• pp.1-8
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• 2016

Patent management activities are considered to play a key role for technology-based firms under the recent knowledge-based economies. This is because intellectual property, including patents, can act as a system for continuous profit generation by protecting firms' products, processes and services. In Korea, healthcare industry is now regarded as one of the promising next generation industries. Despite the promise of healthcare industry, Korean healthcare product manufacturers are faced with turbulent business changes, such as market opening. Even though there are various industrial studies on the effect of patent management activities on firm outcome, previous studies have hardly paid attention to Korean healthcare product manufacturing firms. For this reason, this study identifies the effect of patent management activities, such as patenting activeness, technical excellence and cooperation degree, on firm outcomes, including financial profitability and firm growth, with respect to the Korean healthcare product manufacturers. In this study, we located 86 Korean healthcare manufacturing firms from KORCHAMBIZ and DART, and then collected the data of their patenting activities and outcomes between 2001 and 2013. By applying factor analysis and regression analysis, our empirical study found that firms' patenting activeness has the significant positive relationship on firms' financial profitability, and firms' patenting activeness and technical excellence have the significant positive relationship on firms' financial growth. Our study is an initial attempt to identify the effect of patent management activities on firm outcome within Korean healthcare product manufacturing industry, and thus its results can be used as the basis to formulate national policies for Korean healthcare product industry.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8793-8796
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• 2014

Objective: To explore the influence of serum vascular endothelial growth factor (VEGF) level on therapeutic outcome and diagnosis/prognostic value in patients with cervical cancer. Materials and Methods: A total of 37 patients diagnosed with cervical cancer by biopsy were selected and treated with concurrent chemoradiotherapy. Double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was adopted before treatment to assess VEGF levels, and its relationships with clinicopathological features and short-term therapeutic effects were analyzed. Results: The median VEGF level in 37 patients before treatment was 647.15 (393.35~1125.16) pg/mL. Serum VEGF levels in patients aged <50 years, in International Federation of Gynecology and Obstetrics (FIGO) stage IIIa~IVa, with lymph node metastasis and tumor size >4 cm were significantly increased (P<0.05). The complete remission (CR) rate was 48.7% (18/37), partial remission (PR) rate was 35.1% (13/37), stable disease (SD) rate was 13.5% (5/37) and progressive disease (PD) rate was 2.70% (1/37), so the objective remission rate (ORR) after treatment was 83.8% (31/37). Logistic regression analysis showed that tumor size and serum VEGF level before treatment were independent risk factors affecting the therapeutic outcome, and the higher the level of serum VEGF, the worse the prognosis when tumor size>4 cm. Some 56.8% of patients manifested with myelosuppression, 37.8% with leucopenia, 24.3% with thrombocytopenia, 5.41% with diarrhea, 46.0% with nausea and vomiting, 21.6% with hair loss and 8.11% with hepatic and renal injury during the treatment. Conclusions: Serum VEGF level may reflect the degree of malignancy of cervical cancer and predict therapeutic effect, which is of great importance to cancer diagnosis and prognosis.

• Journal of Korean Neurosurgical Society
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• 제38권1호
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• pp.35-40
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• 2005

Objective : Limited data are available concerning the outcome of the patients with atypical meningioma due to lack of the studies with large series. The authors review atypical meningioma retrospectively and analyzed various parameters concerning its outcome. Methods : Of the 866 meningioma patients treated between 1990 and 2003, pathologically proven 54 atypical meningiomas were reviewed. Various factors of the patients were analyzed, and surgical specimens were re-examined blindly by neuropathologist without any patient information. Extent of surgical resection was determined according to Simpson's classification by reviewing the chart and postoperative scan if possible. Results : Twenty-three [42.6%] had local recurrences during the follow-up, of which 13 [32.5%] of 40 complete excisions and 10 [71.4%] of 14 incomplete excisions. The median time to recurrence was 47 months, and the overall 3-, 5-, and 10-year local control rates were 62.4%, 41.5%, and 31.1%, respectively. Five [9.3%] died during follow-up period. The mean survival time was 123months, and the overall 3-, 5-, and 10-year survival rates were 94.2%, 87.2%, and 78.5%, respectively. The extent of surgical excision was the most significant prognostic factor not for survival but for local control [p=0.2179 and 0.0005, respectively]. Extracranial metastasis was not seen in our cases. Conclusion : Complete surgical excision is the most important factor in improving local control. Careful long-term follow-up is mandatory because atypical meningioma shows a broad range of aggressiveness and natural history.