• Journal of Preventive Medicine and Public Health
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• v.30 no.3 s.58
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• pp.643-664
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• 1997

This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.

• The Journal of Korean Obstetrics and Gynecology
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• v.20 no.3
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• pp.200-212
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• 2007

Purpose: To find objective validity of minimal acupuncture using a modified guide tube as a method to verify the effect of acupuncture. Methods: Subjects of this study were participants of a randomized clinical trial which was practiced to verify the effect of acupuncture on postmenopausal hot flash. There were 2 arms of treatment, one's for active acupuncture group(AG) with manipulation and De qi, the other's for minimal acupuncture group(MG) using a modified guide tube which was designed to give minimal stimulation to the patient. After 8 weeks' treatment followed by 4 weeks' observation, participants were asked to fill in self-report forms on their education, previous experiences of acupuncture, original idea on the efficacy of acupuncture and recognition of blinding. Results: 19 participants of 26 in AG and 19 of 26 in MG completed the self-report form. There was no difference between AG and MG in their education(p=0.5976, Fisher exact test) and previous experiences of acupuncture(p=0.9999, Fisher exact test). In their original ideas on the efficacy of acupuncture, most of AG and MG respondents have been thought that acupuncture is very effective or quite effective, and there was no difference between 2 groups(p=0.5065). 16 of 19 in AG and 14 of 19 in MG believed that they underwent more effective way, there was no statistical difference between 2 groups(p=0.6928, Fisher exact test). Participants believed in undergoing more effective way not because they recognized treatment method, but they were satisfied with the effectiveness of treatment retrospectively. Conclusion: As the result of this study, these authors suggest that minimal acupuncture using a modified guide tube is acceptable as a method to verify the effect of acupuncture in acupuncture-familiar Korean culture. Also further studies on the stimulation-specific effect of minimal acupuncture are demanded.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.995-1003
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• 2021

Objective : People are living longer and the elderly population continues to increase. The incidence of degenerative spinal diseases (DSDs) in the elderly population is quite high. Therefore, we are facing more cases of DSD and offering more surgical solutions in geriatric patients. Understanding the significance and association of frailty and central sarcopenia as risk factors for spinal surgery in elderly patients will be helpful in improving surgical outcomes. We conducted a retrospective cohort analysis of prospectively collected data to assess the impact of preoperative central sarcopenia, frailty, and comorbidity on surgical outcome in elderly patients with DSD. Methods : We conducted a retrospective analysis of patients who underwent elective spinal surgery performed from January 1, 2019 to September 30, 2020 at our hospital. We included patients aged 65 and over who underwent surgery on the thoracic or lumbar spine and were diagnosed as DSD. Central sarcopenia was measured by the 50th percentile of psoas : L4 vertebral index (PLVI) using the cross-sectional area of the psoas muscle. We used the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight (K-FRAIL) scale to measure frailty. Comorbidity was confirmed and scored using the Charlson Comorbidity Index (CCI). As a tool for measuring surgical outcome, we used the Clavien-Dindo (CD) classification for postoperative complications and the length of stay (LOS). Results : This study included 85 patients (35 males and 50 females). The mean age was 74.05±6.47 years. Using the K-FRAIL scale, four patients were scored as robust, 44 patients were pre-frail and 37 patients were frail. The mean PLVI was 0.61±0.19. According to the CD classification, 50 patients were classified as grade 1, 19 as grade 2, and four as grade 4. The mean LOS was 12.35±8.17 days. Multivariate stepwise regression analysis showed that postoperative complication was significantly associated with surgical invasiveness and K-FRAIL scale. LOS was significantly associated with surgical invasiveness and CCI. K-FRAIL scale showed a significant correlation with CCI and PLVI. Conclusion : The present study demonstrates that frailty, comorbidity, and surgical invasiveness are important risk factors for postoperative complications and LOS in elderly patients with DSD. Preoperative recognition of these factors may be useful for perioperative optimization, risk stratification, and patient counseling.

• Journal of Digital Convergence
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• v.17 no.1
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• pp.239-247
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• 2019

An accurate prediction of emotion is a very important issue for the sake of patient-centered medical device development and emotion-related psychology fields. Although there have been many studies on emotion prediction, no studies have applied the heart rate variability and neuro-fuzzy approach to emotion prediction. We propose ANFEP(Adaptive Neuro Fuzzy System for Emotion Prediction) HRV. The ANFEP bases its core functions on an ANFIS(Adaptive Neuro-Fuzzy Inference System) which integrates neural networks with fuzzy systems as a vehicle for training predictive models. To prove the proposed model, 50 participants were invited to join the experiment and Heart rate variability was obtained and used to input the ANFEP model. The ANFEP model with STDRR and RMSSD as inputs and two membership functions per input variable showed the best results. The result out of applying the ANFEP to the HRV metrics proved to be significantly robust when compared with benchmarking methods like linear regression, support vector regression, neural network, and random forest. The results show that reliable prediction of emotion is possible with less input and it is necessary to develop a more accurate and reliable emotion recognition system.

• Journal of Life Science
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• v.34 no.7
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• pp.520-530
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• 2024

Tumor suppressor genes (TSGs) play a crucial role in maintaining cellular homeostasis. When the function of these genes is lost, it can lead to cellular plasticity that drives the development of various cancers, including small-cell lung cancer (SCLC), which is known for its aggressive nature. SCLC is primarily driven by numerous loss-of-function mutations in TSGs, often involving genes that encode epigenetic regulators. These mutations pose a significant therapeutic challenge as they are not directly targetable. However, understanding the molecular changes resulting from these mutations might provide insights for developing tumor intervention strategies. We propose that despite the heterogeneous genomic landscape of SCLC, the effects of mutations in patient tumors converge on a few critical pathways that drive malignancy. Specifically, alterations in epigenetic regulators lead to transcriptional dysregulation, pushing mutant cells toward a highly plastic state that makes them immune evasive and highly metastatic. This review will highlight studies showing how an imbalance of epigenetic regulators with opposing functions leads to the loss of immune recognition markers, effectively hiding tumor cells from the immune system. Additionally, we will discuss the role of epigenetic regulators in maintaining neuroendocrine features and how aberrant transcriptional control promotes epithelial-to-mesenchymal transition during tumor development. Although these pathways seem distinct, we emphasize that they often share common molecular drivers and mediators. Understanding the connection among frequently altered epigenetic regulators will provide valuable insights into the molecular mechanisms underlying SCLC development, potentially revealing preventive and therapeutic vulnerabilities for SCLC and other cancers with similar mutations.

• Journal of agricultural medicine and community health
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• v.18 no.1
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• pp.77-91
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• 1993

This study was conducted to assess health medical center utilization pattern and its related factors among the rural inhabitants for the purpose of contribution to establishment of health medical center institutions. A questionnaire survey was carried out for object of 3,754 population of three primary school and three middle school student's parents (total 832 household) in Kyungbook Ulchin Gun rural area from 24 to 28 September, 1990. The summarized result are as follows, Respondents are 60.3% in male, 39.7% in female and 30-40s 81.3% in age, high school graduates 40.3% in education level and a regional medical insurance scheme in 44.1% in forms of health insurance. Recognition for health medical center was showed higher according to high educational, high income level, and short distance for location of health medical center of respondents (p < 0.01). Recognition for health medical center services was showed higher about care of medicaid in medical treatment services and higher preventive vaccination in health prevention services by respondents. Utilization rates of health medical center by out-patient care and preventive care service were 11.1 and 4.5 per 100 persons by year, but admission utilization rate was 34.6 per 10.000 persons by year. Motivations of health medical center utilization were showed a good care(45.7%), a good drugs(45.2%), and nearby health medical center(42.9%). In comparison health service levels of health medical center with general clinic was better (16.3%), similar(38.7%), 7(19.0%), and worse(19.0%) in view of health medical center utilizators. Inconvinience about health medical center utilized was the most higher longtime waiting, the next was limited utilization times. Transportation utilited were on foot(55%), by bus(35.5%), and so on. As mentioned above, there are many inhabitants who less understanding and less acknowledgement about health medical center and even mistake health center for health medical center. Therefore, there must be more information about health medical center. For higher utilization of health medical center, there must be considered expansion of health equipment, facilities, accomplishment with reinforcement of health staffs and efficiency management.

• Journal of dental hygiene science
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• v.13 no.4
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• pp.501-509
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• 2013

The purpose of the study is to confirm the effect of the oral health management program in exemplary kindergartens for prevent the dental caries. The study performs the survey on the parents about the changes in the oral health behaviors after the oral health education in April 2012 and measures the patient hygiene performance (PHP) index before the education, after the education and 3 weeks after the education to assess the removal capability to plaque on the teeth surface for the children. The analysis is performed on 130 people who join the program and respond the survey. There is no change in the behavior related to the tooth brushing of children after the oral health education. No change is found from the interest in the oral health education (p>0.05) but the recognition in the importance of the tooth positively change, as well as recognition of the tooth brushing method and the reaction to recommending to tooth brushing. The PHP index of children is significantly improved from 3.87 before the education through 2.71 after the education and 3.27 3 weeks after the education (p<0.001). The observation from the patents shows that their children have interest in preventing the cavities including 33.1% after having xylitol and 60.7% after the oral health education. In conclusion, the study confirms the effect of the oral health management program in exemplary kindergartens to prevent the cavities, meaning that it is required to activate the programs and keep implementing the programs including providing xylitol and education for teachers, parents and children to habituate the oral health behavior of the children and completely learn toothbrushing method under continuous management and reeducation.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.246-267
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• 1995

Recently the request of the patients to participate in the medical courses has been expanding due to the elevated sense of right on the people's health, merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the patients have been in the thought of solving such accidents only by regulation of the laws which they think to be all powerful, Such trends are same in the area of nursing service. Also today the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurse has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accident. The following is the conclusion based by the above examination. 1) The experience degree of the whole nursing accidents has been appeared as 1.90 in average. And the degree according to service area has been 1.77 in the area of supervising management of patients, 1.54 in the area of the same management of patients by head-nurses, 1.84 in the area of doctors' treatment performances, 14 in the enforcement and education areas of the nursing technology, 2.04 in the area of observing patients and judgement and 2.07 in the area of nursing records and maintaining confidentials. Accordingly there has been higher degree of accidental experiences in the independent service areas of the patients than in the dependent ones directed by the doctors. 2) The perception of the nurses showed that the cause of the nursing accident has been due to the heavy work of the nurses with the 60.4% of the response rate, the highest rate. They report the accident to the head nurse first by 2/3 nurses after accident. And the hour of the accident has been frequently happened regardless of service hours with 48.1% in response rate, the highest rate, and the nursing accident happens in the night more than the daytime with the rate of 37.5% at night while 14. 4% daytime. 3) The nurses are in the perception that the patients are responsible for the accident with 48.2% response rate while 43.9% rate in response showed that it has been caused by many people. They are in the perception that 41.7% when the nursing power was lacking, 46.7% lower recognition of actual state about indivitual patient in the section of technical speciality and 35.8% when the patients were not cooperative and 37.8% when the wards were dirty and in disorder. 4) the attitude of the patients after the various nursing accidents has been violent words in 72.7%, violence in 17.4% and 3.9% in attending the court by the sue of the patient's side(18 nurses). 5) The action of the hospital has been : requesting the submission of the story of the accident in 22.8%, the report of the accidents in 14.4%, thus the written statement disposal was most, 4.5% was the transfer to the other departments when the accident was larger or the patients' guardians protested strongly and 0.6% of the dismissals of the nurses. 6) In regard to the responsiblity of the nurse accidents, 78.9% was the highest rate of supplying the nursing manpowers, 48.4% of mutual cooperation of the medical personnels, 37.2% of strengthening the education for the nurses and hospital facilities reformation in 32.7%. 7) The review of relation between the general characters of the object of the study and the degree of experience of nursing accidents showed the significant differences in ages (F=4.04, p=0.000).

• Progress in Medical Physics
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• v.17 no.3
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• pp.136-143
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• 2006

The respiratory gating radiation therapy which Irradiates only in the stable respiratory period with analyzing the periodic motion of a reflective marker on the patient's abdomen has been applied to the precise radiation treatment in order to minimize the effect of organ motion induced by the respiration. This respiratory gating system establishes irradiation region using the amplitude-based or phase-based method. Although phase-based method Is preferred because of the stability in the real treatment conditions, it has some limits to explain the exact correlation between the marker motion and organ motion. Even when the variation of amplitude which can introduce target motion considered as an error is produced, the phase-based method has the possibility to irradiate including the error positions. In this study, the error analysis program was developed for the verification of the tumor position's variation correlated with the variation of marker's amplitude which can be occurred during a phase-based respiratory sating treatment. The analysis program was tested with a virtual treatment record file and with a record file using moving phantom which were modified considering the irregular amplitude's variation simulating the real clinical situations. In both cases, accurate discrimination of error points and error calculation were produced. When the treatment record files of a real patient were analyzed with the program, the accurate recognition and calculation of the error points were also verified. The analysis program developed in this study will be applied as a useful tool for the analysis of errors due to the irregular variation of patients' respiration during the phase-base respiratory gating radiation treatment.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.65-76
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• 2010

Purpose: he use of PET scanners and the number of patient in Korea have been increased for recent several years dramatically. For this reason, technologists have more possibilities to be exposed to the radiation. The hospitals using PET scanners should make an effort to reduce the radiation exposure dose. The purpose of this study was to evaluate the radiation exposure does when using radiation shielding devices. The evaluation was performed through questionnaire survey and experiment. Materials and Methods: First, the technologists who had experience working in PET center in 2008-2009 were surveyed with questionnaire and TLD Figures, personal opinion of utilization of radiation shielding devices are analyzed. Second, we measured the shielding rate of shielding devices which have been using in PET study procedures. We divided the procedures into four steps; distribution, moving, injection of $^{18}F$-FDG and patient setup. Results: First, the results of this survey, using of L-block+Syringe shield, L-block, Syringe shield, No shield during the injection, were each 58.5%, 20%, 9%, 12.3%. The TLD values according to utilization of radiation shield, using both L-block+Syringe Shield and L-block showed the lower TLD values, and Syringe shield only or No shield showed the higher TLD values. Second, the results of experiments according to PET study procedures measured the shielding rates as follows. The shielding rates during the distribution using L-block, L-block+Apron shield were measured 97.4%, 97.7%. The shielding rates during the $^{18}F$-FDG delivery to the injection room using mobile Syringe shield, Syringe holder, Syringe shield carrier were each 81.7%, 98.9%, 99.7%. The shielding rates during the injection using Syringe shield, L-block, L-block+Syringe shield were measured each 51.9%, 98.3%, 98.7%. The shielding rates of Apron were measured in each 30, 60, 90, 120, 150 cm distance. The measurement were each 16.9%, 14.2%, 16.6%, 17.1%, 18.1%, 18.6%. Conclusion: The most effective method for radiation shielding is to using L-block during the $^{18}F$-FDG distribution and Syringe shield carrier during in moving $^{18}F$-FDG. For the $^{18}F$-FDG injection, L-block+Syringe shield have to be used. The shielding effect of Apron has shown average 16.4%. According to the survey of questionnaire, the operators recognized well risk of the radiation exposure but, tended ignore in working. The radiation dose according to recognition of radiation exposure risk was not relevant. but radiation dose according to utilization of radiation shield lower the more use it. The main reason of no use of shielding devices is cumbersome, 55% of the respondents answered. I'm sure, by use of radiation shield in all PET procedure, radiation exposure will be reduced considerably.