• Archives of Reconstructive Microsurgery
• /
• v.21 no.2
• /
• pp.118-130
• /
• 2012

Background: Women receiving mastectomy usually prefer a single-stage surgical procedure without the need for additional surgery. Hence, nipple sparing mastectomy was introduced, and the follow-up data on the aesthetic outcome and recurrence of breast cancer were investigated in this study. Materials and Methods: The study subjects comprised 22 patients who received nipple-sparing mastectomy and immediate breast reconstruction using the free transverse abdominal rectus abdominis myocutaneous flap between June of 2007 and June of 2012. The patients' aesthetic outcomes were measured with 2 methods for the objective result: Breast size measurements and breast volume calculation both at preoperative phase and postoperative 1 years phase. Also, the patients' satisfaction was evaluated at postoperative 1 year with the self-assessment questionnaire. Follow up check for assessing cancer recurrence was performed for an average period of postoperative 1063 days. Results: First, in objective aesthetic outcome, there were no significant differences between the preoperative and postoperative results on both the breast size and the volume. Second, the patient satisfaction analysis scores were graded as very good in 15 patients (68.2%), and as good in 6 patient (27.3%). Most of the patients were very satisfied with our surgery method. Last, there was no local or distant recurrence in these 22 patients during the follow-up period. Conclusion: In this study, the nipple-sparing mastectomy achieved satisfactory results for the breast scar and shape with a single-stage surgical procedure, and the cancer recurrence rate was not significantly different from that of the conventional mastectomy. Besides, the nipple-sparing mastectomy is more cost-effective than the conventional mastectomy since it reduces the need for additional procedures. However, we think that it is necessary to determine the long-term outcomes about the recurrence rate.

• Quality Improvement in Health Care
• /
• v.12 no.2
• /
• pp.75-83
• /
• 2006

Background : Utilization review has been adopted as a vehicle for cost and utilization control of health care services. Its role was further stressed and expanded through the establishment of Health Insurance Review Agency in 2001. This article is to introduce concept, activities, and effect of utilization review based on the experiences of U.S. and to suggest important characteristics for ideal utilization review activities at the national level in Korea. Method : Twenty-five articles related with utilization review were reviewed after being selected through web site search through Med Line and Richis. Result : Utilization review was introduced mainly for health care expenditure control either by insurer, provider or the third parties under the pressure of increasing health care cost. It's activities can be categorized to prospective, concurrent and retrospective review according to the time of service provision. Based on most of studies, utilization review has been effective in controling rising health care cost and utilization. However it's effectiveness assumes a reimbursement structure of managed care like capitation payment. More worse, it is still unknown it's effectiveness on quality of care. Conclusion : Utilization review should be employed to increase the cost effectiveness of medical care by optimizing quality and patient's outcomes while also attempting to reduce the use of resources. So, it should consider outcomes before expenditures, check for both under and over-use, and construct an structure in which consumption is reduced equitably. Aggressive adoption of utilization review in Korean health care setting with fee-for-service reimbursement structure might not be a cost-effective approach before adoption of prospective payment system such as D.R.G. and capitation.

• Journal of Chest Surgery
• /
• v.46 no.6
• /
• pp.413-425
• /
• 2013

Background: Graft vessel preservation solution in coronary artery bypass surgery is used to maintain the graft conduit in optimal condition during the perioperative period. Nafamostat mesilate (NM) has anticoagulation and anti-inflammatory properties. Therefore, we investigated NM as a conduit preservative agent and compared it to papaverine. Methods: Sprague-Dawley (SD) rat thoracic aortas were examined for their contraction-relaxation ability using phenylephrine (PE) and acetylcholine (ACh) following preincubation with papaverine and NM in standard classical organ baths. Human umbilical vein endothelial cells (HUVECs) were cultured to check for the endothelial cell viability. Histopathological examination and terminal deoxynucleotidyl transferase dUTP nick end labeling assay were performed on the thoracic aortas of SD rats. Results: The anti-contraction effects of papaverine were superior to those of NM at PE (p<0.05). The relaxation effect of NM on ACh-induced vasodilatation was not statistically different from that of papaverine. Viability assays using HUVECs showed endothelial cell survival rates of >90% in various concentrations of both NM and papaverine. A histopathological study showed a protective effect against necrosis and apoptosis (p<0.05) in the NM group. Conclusion: NM exhibited good vascular relaxation and a reasonable anti-vasocontraction effect with a better cell protecting effect than papaverine; therefore, we concluded that NM is a good potential conduit preserving agent.

• Journal of the Ergonomics Society of Korea
• /
• v.36 no.2
• /
• pp.109-121
• /
• 2017

Objective: This study aims to find suitable types and styles for gesture interaction as remote control on smart TVs. Background: Smart TV is being developed rapidly in the world, and gesture interaction has a wide range of research areas, especially based on vision techniques. However, most studies are focused on the gesture recognition technology. Also, not many previous studies of gestures types and styles on smart TVs were carried out. Therefore, it is necessary to check what users prefer in terms of gesture types and styles for each operation command. Method: We conducted an experiment to extract the target user manipulation commands required for smart TVs and select the corresponding gestures. To do this, we looked at gesture styles people use for every operation command, and checked whether there are any gesture styles they prefer over others. Through these results, this study was carried out with a process selecting smart TV operation commands and gestures. Results: Eighteen TV commands have been used in this study. With agreement level as a basis, we compared the six types of gestures and five styles of gestures for each command. As for gesture type, participants generally preferred a gesture of Path-Moving type. In the case of Pan and Scroll commands, the highest agreement level (1.00) of 18 commands was shown. As for gesture styles, the participants preferred a manipulative style in 11 commands (Next, Previous, Volume up, Volume down, Play, Stop, Zoom in, Zoom out, Pan, Rotate, Scroll). Conclusion: By conducting an analysis on user-preferred gestures, nine gesture commands are proposed for gesture control on smart TVs. Most participants preferred Path-Moving type and Manipulative style gestures based on the actual operations. Application: The results can be applied to a more advanced form of the gestures in the 3D environment, such as a study on VR. The method used in this study will be utilized in various domains.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.11
• /
• pp.5433-5438
• /
• 2012

Background: Hepatocellular carcinoma (HCC) is a common and aggressive malignancy. Despite of the improvements in its treatment, HCC prognosis remains poor due to its recurrence after resection. This study provides complete genetic profile for Egyptian HCC. Genome-wide analyses were performed to identify the predictive signatures. Patients and Methods: Liver tissue was collected from 31 patients with diagnosis of HCC and gene expression levels in the tumours and their adjacent non-neoplastic tissues samples were studied by analyzing changes by microarray then correlate these with the clinico-pathological parameters. Genes were validated in an independent set by qPCR. The genomic profile was associated with genetic disorders and cancer focused on gene expression, cell cycle and cell death. Molecular profile analysis revealed cell cycle progression and arrest at G2/M, but progression to mitosis; unregulated DNA damage check-points, and apoptosis. Result: Nine hundred fifty eight transcripts out of the 25,000 studied cDNAs were differentially expressed; 503 were up-regulated and 455 were down-regulated. A total of 19 pathways were up-regulated through 27 genes and 13 pathways were down-regulated through 19 genes. Thirty-seven genes showed significant differences in their expression between HCC cases with high and low Alpha Feto Protein ($AFP{\geq}600$ IU/ml). The validation for the microarray was done by real time PCR assay in which PPP3CA, ATG-5, BACE genes showed down-regulation and ABCG2, RXRA, ELOVL2, CXR3 genes showed up-regulation. cDNA microarrays showed that among the major upregulated genes in HCC are sets. Conclusion: The identified genes could provide a panel of new diagnostic and prognostic aids for HCC.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.9
• /
• pp.4321-4326
• /
• 2012

The current study aimed at exploring the knowledge and beliefs of men aged forty years and over towards prostate cancer screening and early detection in three Arab countries. The field work was conducted in three countries; Saudi Arabia, Egypt and Jordan, during the period February through December 2011. Our target population were men aged 40 years and over. It was a population-based cross sectional study comprising 400 subjects at each site. In addition to socio-demographic data, history of the present and past medical illness, practice history of prostatic cancer examination, family history of cancer prostate; participants were inquired about their knowledge and attitude towards prostate cancer and screening behavior using two different likert scales. The percentage of participants who practiced regular prostate check up ranged from 8-30%. They had poor knowledge and fair attitude towards prostate cancer screening behavior, where the mean total knowledge score was $10.25{\pm}2.5$, $10.76{\pm}3.39$ and $11.24{\pm}3.39$ whereas the mean total attitude score was $18.3{\pm}4.08$, $20.68{\pm}6.4$ and $17.96{\pm}5.3$ for Saudi Arabia, Egypt and Jordan respectively. The respondents identified the physicians as the main sources of this information (62.4%), though they were not the main motives for regular checkup. Knowledge was the only significant predictor for participants' attitude in the multiple regression models. Participants' attitudes depends mainly on level of knowledge and quantity of information provided to the patients and their families. Such attitudes should rely on a solid background of proper information and motivation from physicians to enhance and empower behaviors towards prostate cancer screening practices.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.6
• /
• pp.3975-3978
• /
• 2013

Background: Proteases play a regulatory role in a variety of pathologies including cancer, pancreatitis, thromboembolic disorders, viral infections and many others. One of the possible strategies to combat these pathologies seems to be the use of protease inhibitors. LC-pi I, II, III and IV (Lavatera cashmerian-protease inhibitors) have been found in vitro to strongly inhibit trypsin, chymotrypsin and elastase, proteases contributing to tumour invasion and metastasis, indicated possible anticancer effects. The purpose of this study was to check in vitro anticancer activity of these four inhibitors on human lung cancer cell lines. Material and Methods: In order to assess whether these inhibitors induced in vitro cytoxicity, SRB assay was conducted with THP-1 (leukemia), NCIH322 (lung) and Colo205, HCT-116 (colon) lines. Results: LC-pi I significantly inhibited the cell proliferation of all cells tested and also LC-pi II was active in all except HCT-116. Inhibition of cell growth by LC-pi III and IV was negligible. $IC_{50}$ values of LC-pi I and II for NCIH322, were less compared to other cell lines suggesting that lung cancer cells are more inhibited. Conclusion: These investigations might point to future preventive as well as curative solutions using plant protease inhibitors for various cancers, especially in the lung, hence warranting their further investigation.

• Journal of the Ergonomics Society of Korea
• /
• v.36 no.4
• /
• pp.267-280
• /
• 2017

Objective: The aim of this study is to investigate key user experience factors of interactions for Head Mounted Display (HMD) devices in the Virtual Reality Environment (VRE). Background: Virtual reality interaction research has been conducted steadily, while interaction methods and virtual reality devices have improved. Recently, all of the virtual reality devices are head mounted display based ones. Also, HMD-based interaction types include Remote Controller, Head Tracking, and Hand Gesture. However, there is few study on usability evaluation of virtual reality. Especially, the usability of HMD-based virtual reality was not investigated. Therefore, it is necessary to study the usability of HMD-based virtual reality. Method: HMD-based VR devices released recently have only three interaction types, 'Remote Controller', 'Head Tracking', and 'Hand Gesture'. We search 113 types of research to check the user experience factors or evaluation scales by interaction type. Finally, the key user experience factors or relevant evaluation scales are summarized considering the frequency used in the studies. Results: There are various key user experience factors by each interaction type. First, Remote controller's key user experience factors are 'Ease of learning', 'Ease of use', 'Satisfaction', 'Effectiveness', and 'Efficiency'. Also, Head tracking's key user experience factors are 'Sickness', 'Immersion', 'Intuitiveness', 'Stress', 'Fatigue', and 'Ease of learning'. Finally, Hand gesture's key user experience factors are 'Ease of learning', 'Ease of use', 'Feedback', 'Consistent', 'Simple', 'Natural', 'Efficiency', 'Responsiveness', 'Usefulness', 'Intuitiveness', and 'Adaptability'. Conclusion: We identified key user experience factors for each interaction type through literature review. However, we did not consider objective measures because each study adopted different performance factors. Application: The results of this study can be used when evaluating HMD-based interactions in virtual reality in terms of usability.

• Safety and Health at Work
• /
• v.7 no.4
• /
• pp.331-339
• /
• 2016

Background: Occupational risk management is known as a catalyst in generating superior returns for all stakeholders on a sustainable basis. A number of companies in Ghana implemented health and safety measures adopted from international companies to ensure the safety of their employees. However, there exist great threats to employees' safety in these companies. The purpose of this paper is to investigate the level of compliance of Occupational Health and Safety management systems and standards set by international and local legislation in power producing companies in Ghana. Methods: The methodology is conducted by administering questionnaires and in-depth interviews as measuring instruments. A random sampling technique was applied to 60 respondents; only 50 respondents returned their responses. The questionnaire was developed from a literature review and contained questions and items relevant to the initial research problem. A factor analysis was also carried out to investigate the influence of some variables on safety in general. Results: Results showed that the significant factors that influence the safety of employees at the hydroelectric power plant stations are: lack of training and supervision, non-observance of safe work procedures, lack of management commitment, and lack of periodical check on machine operations. The study pointed out the safety loopholes and therefore helped improve the health and safety measures of employees in the selected company by providing effective recommendations. Conclusion: The implementation of the proposed recommendations in this paper, would lead to the prevention of work-related injuries and illnesses of employees as well as property damage and incidents in hydroelectric power plants. The recommendations may equally be considered as benchmark for the Safety and Health Management System with international standards.

• Journal of the Ergonomics Society of Korea
• /
• v.36 no.1
• /
• pp.37-52
• /
• 2017

Objective: The present study developed a user-centered 3D virtual liver surgery planning (VLSP) system called Dr. Liver to provide preoperative information for safe and rational surgery. Background: Preoperative 3D VLSP is needed for patients' safety in liver surgery. Existing systems either do not provide functions specialized for liver surgery planning or do not provide functions for cross-check of the accuracy of analysis results. Method: Use scenarios of Dr. Liver were developed through literature review, benchmarking, and interviews with surgeons. User interfaces of Dr. Liver with various user-friendly features (e.g., context-sensitive hotkey menu and 3D view navigation box) was designed. Novel image processing algorithms (e.g., hybrid semi-automatic algorithm for liver extraction and customized region growing algorithm for vessel extraction) were developed for accurate and efficient liver surgery planning. Usability problems of a preliminary version of Dr. Liver were identified by surgeons and system developers and then design changes were made to resolve the identified usability problems. Results: A usability testing showed that the revised version of Dr. Liver achieved a high level of satisfaction ($6.1{\pm}0.8$ out of 7) and an acceptable time efficiency ($26.7{\pm}0.9 min$) in liver surgery planning. Conclusion: Involvement of usability testing in system development process from the beginning is useful to identify potential usability problems to improve for shortening system development period and cost. Application: The development and evaluation process of Dr. Liver in this study can be referred in designing a user-centered system.