• Journal of Yeungnam Medical Science
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• 제27권2호
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• pp.159-164
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• 2010

Hematoma of gastric wall is very rare, and occasionally associated with coagulopathy, trauma, peptic ulcer disease, and therapeutic endoscopy. Ischemic gastric necrosis is also rare because of the abundant anastomotic supply to the stomach, and it is usually associated with surgery and disruption of the major vessels. Endoscopic submucosal injection of hypertonic saline-epinephrine (HS-E) is a safe, cost-effective, and widely used therapy for hemostasis but it may cause tissue necrosis and perforation. We describe a case of gastric wall hematoma with oozing bleeding after endoscopic gastric mucosa biopsy in 71-year old woman with chronic renal failure and angina pectoris undergoing anti-platelet medication. We injected a small dose of HS-E (7ml) for controlling oozing bleeding. Two days later, endoscopy showed huge ulcer with necrotic tissue at the site of previously hematoma. Therefore we should pay particular attention for hematoma and mucosal necrosis when performing endoscopic procedure in a patients with high bleeding and atherosclerotic risk.

• Journal of Acupuncture Research
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• 제26권6호
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• pp.21-30
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• 2009

Objectives : Being introduced in the 1980s, laser acupuncture studies have been steadily carried on such as its thermal effects on human body. However, the mechanisms of effect are not yet clearly explained. Generally, laser acupuncture could be favorable for pediatric patients or people under special conditions (hemophilia, needle-phobia, pathogen-carriers, etc.) because of lower risk of infection, bleeding, pain or fainting. But there are still problems for using laser acupuncture equivalently as the traditional metal needle. The goal of this study is to review the fundamentals, history and present trend of laser acupuncture study, and to suggest how to develop laser acupuncture as an oriental medical device. Method : We performed literature search using PubMed(http://www.ncbi.nlm.nih.gov/pubmed) and Scopus(http://www.scopus.com). Search conditions are laser acupuncture, laser needle, LLLT(as title or abstract) or Litscher G(as author). Main target studies are physical fundamentals, clinical trials, physiological results and device proposals. Results : Many research have shown the similarities of laser acupuncture and traditional metal acupuncture and have reported clinical and physiological effects of laser acupuncture. But, still laser acupuncture is not widely used in Korea due to high-cost of equipments and the lack of clear understanding of laser devices. Additionally, there are still challenges in standardization and device development. Conclusions : Frequencies, laser modes, waveguides, adaptor types, polarization and signal modulations are suggested as future study subjects on laser acupuncture. More various studies and efforts for device development have to be performed to provide oriental medical doctors with evidence based confidence about usage of laser acupuncture.

• 대한인간공학회지
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• 제36권1호
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• pp.37-52
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• 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.

• 보건행정학회지
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• 제12권1호
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• Journal of Microbiology
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• 제44권1호
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• pp.106-112
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• 2006

In this study, the genetic diversities of multi-resistant Salmonella typhimurium (ST) isolates were analyzed via the application of both pulsed field gel electrophoresis (PFGE) and Polymerase chain reaction (PCR) analysis methods, using 6 kinds of primers (REP, ERIC, SERE, BOX, P-1254 and OPB-17). And their discriminative abilities (DA) were also compared in order to determine the most effective and reliable analysis method. 118 S. typhimurium isolates, cultured from diverse animals and human patients in Korea beginning in 1993, were analyzed and subjected to a comparison of Simpson's index of diversity (SID), using both PFGE and PCR methods. PFGE by XbaI enzyme digestion allowed for discrimination into 9 pulsotypes, with high SID values (0.991) on the genomic DNA level. This shows that PFGE is a very discriminative genotypic tool, and also that multiple clones of S. typhimurium isolates had existed in domestic animals and humans in Korea since 1993. However, we could ultimately not to trace the definitive sources or animal reservoirs of specific S. typhimurium isolates examined in this study. Depending on the SID values, the combined method (7 kinds of method) was found to be the most discriminative method, followed by (in order) SERE-PCR, REP-PCR, ERIC-PCR, PFGE & OPB-17 (RAPD), P-1254 (RAPD), and BOX-PCR at the $80\%$ clone cut-off value. This finding suggests that the REP-PCR method (which utilizes 4 primer types) may be an alternative tool to PFGE for the genotyping of S. typhimurium isolates, with comparable cost, time, and labor requirement. The establishment of a highly reliable and discriminatory method for epidemiologic analysis is considered necessary in order for researchers to trace the sources of specific pathogens and, consequently, to control and prevent the spread of epidemic S. typhimurium isolates to humans.

• 대한약침학회지
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• 제19권2호
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• pp.114-121
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• 2016

Objectives: Lung cancer remains a deadly disease with unsatisfactory overall survival. Cisplatin, a standard platinum (Pt)-based chemotherapeutic agent, has the potential to inhibit the growth of lung cancer. Its use, however, is occasionally limited by severe organ toxicity. However, until now, no systematic study has been conducted to verify its efficacy with proper experimental support in vivo. Therefore, we examined whether biosynthesized Pt nanoparticles (NPs) inhibited human lung cancer in vitro and in vivo to validate their use in alternative and complementary medicine. Methods: We evaluated the in vitro and the in vivo anticancer efficiencies of biosynthesized Pt NPs in a subcutaneous xenograft model with A549 cells. Severe combined immune deficient mice (SCID) were divided into four groups: group 1 being the vehicle control group and groups 2, 3 and 4 being the experimental groups. Once the tumor volume had reached $70-75mm^3$, the progression profile of the tumor growth kinetics and the body weights of the mice were measured every week for 6 weeks after oral administration of Pt NPs. Doses of Pt NPs of 500, 1,000 and 2,000 mg/kg of body weight were administered to the experimental groups and a dose of honey was administered to the vehicle control group. The efficacy was quantified by using the delay in tumor growth following the administration of Pt NPs of A549 human-lung-cancer xenografts growing in SCID mice. Results: The in vitro cytotoxicity evaluation indicated that Pt NPs, in a dose-dependent manner, inhibited the growth of A549 cells, and the in vivo evaluation showed that Pt NPs at the mid and high doses effectively inhibited and delayed the growth of lung cancer in SCID mice. Conclusion: These findings confirm the antitumor properties of biosynthesized Pt NPs and suggest that they may be a cost-effective alternative for the treatment of patients with lung cancer.

• Journal of Gastric Cancer
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• 제13권3호
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• pp.136-148
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• 2013

Purpose: To define the role of robotic gastrectomy for the treatment of gastric cancer, the present systematic review with meta-analysis was performed. Materials and Methods: A comprehensive search up to July 2012 was conducted on PubMed, EMBASE, and the Cochrane Library. All eligible studies comparing robotic gastrectomy versus laparoscopic gastrectomy or open gastrectomy were included. Results: Included in our meta-analysis were seven studies of 1,967 patients that compared robotic (n=404) with open (n=718) or laparoscopic (n=845) gastrectomy. In the complete analysis, a shorter hospital stay was noted with robotic gastrectomy than with open gastrectomy (weighted mean difference: -2.92, 95% confidence interval: -4.94 to -0.89, P=0.005). Additionally, there was a significant reduction in intraoperative blood loss with robotic gastrectomy compared with laparoscopic gastrectomy (weighted mean difference: -35.53, 95% confidence interval: -66.98 to -4.09, P=0.03). These advantages were at the price of a significantly prolonged operative time for both robotic gastrectomy versus laparoscopic gastrectomy (weighted mean difference: 63.70, 95% confidence interval: 44.22 to 83.17, P<0.00001) and robotic gastrectomy versus open gastrectomy (weighted mean difference: 95.83, 95% confidence interval: 54.48 to 137.18, P<0.00001). Analysis of the number of lymph nodes retrieved and overall complication rates revealed that these outcomes did not differ significantly between the groups. Conclusions: Robotic gastrectomy for gastric cancer reduces intraoperative blood loss and the postoperative hospital length of stay compared with laparoscopic gastrectomy and open gastrectomy at a cost of a longer operating time. Robotic gastrectomy also provides an oncologically adequate lymphadenectomy. Additional high-quality prospective studies are recommended to better evaluate both short and long-term outcomes.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제14권6호
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• pp.2480-2496
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• 2020

Considering that high-dose X-ray radiation during CT scans may bring potential risks to patients, in the medical imaging industry there has been increasing emphasis on low-dose CT. Due to complex statistical characteristics of noise found in low-dose CT images, many traditional methods are difficult to preserve structural details effectively while suppressing noise and artifacts. Inspired by the deep learning techniques, we propose a densely connected residual network (DCRN) for low-dose CT image noise cancelation, which combines the ideas of dense connection with residual learning. On one hand, dense connection maximizes information flow between layers in the network, which is beneficial to maintain structural details when denoising images. On the other hand, residual learning paired with batch normalization would allow for decreased training speed and better noise reduction performance in images. The experiments are performed on the 100 CT images selected from a public medical dataset-TCIA(The Cancer Imaging Archive). Compared with the other three competitive denoising algorithms, both subjective visual effect and objective evaluation indexes which include PSNR, RMSE, MAE and SSIM show that the proposed network can improve LDCT images quality more effectively while maintaining a low computational cost. In the objective evaluation indexes, the highest PSNR 33.67, RMSE 5.659, MAE 1.965 and SSIM 0.9434 are achieved by the proposed method. Especially for RMSE, compare with the best performing algorithm in the comparison algorithms, the proposed network increases it by 7 percentage points.

• 한국방사선학회논문지
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• 제14권6호
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• pp.833-839
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• 2020

전 세계적으로 중증 급성 호흡 증후군 코로나바이러스에 의해 감염예방 및 사회적 인식이 크게 변화되었으며, 그로 인해 의료 원내감염 노출이 높은 환자에 관한 감염관리 지침 및 과정을 더 강화하고 관리감시를 더 철저히 하고 있다. 감염예방을 위해서는 멸균이 최우선으로 시행이 되어야 하며, 저비용, 쉬운 설치와 조작이 쉬운 멸균법을 찾아 적절한 멸균효과를 제시하고자 한다. 본 연구에서는 충치균을 오염시켜 출력 4 W, 조사 시간 60, 150, 300 sec로 자외선 살균기를 이용하였으며, 레이저는 출력 0.8, 1.5 W로 각각 파장 266, 355 nm로 조사하였다. 자외선 살균기는 150 sec 이상에서 감염예방에 안전성을 나타내었으며, 레이저는 1.5 W와 0.8 W, 266 nm에서 예방의 안전성을 나타내었다. 결과에서 출력이 높고 253.7 nm에 가까운 파장일수록 멸균효과는 뛰어났다.

• Genomics & Informatics
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• 제6권1호
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• pp.36-43
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• 2008

Radiotherapy would be the choice of treatment for human cancers, because of high cost-effectiveness. However, a certain population of patients shows a resistance to radiotherapy and recurrence. In an effort to increase the efficacy of radiotherapy, many efforts were driven to find the genes causing the unresponsiveness to ionizing radiation. In this paper, we compared the gene expression profiles of two lung cancer cell lines, H460 and H1299, which showed differential responses to ionizing radiations. Each cell were irradiated at 2 Gy, and harvested after 0, 2, 4, 8, 12 and 24 hours to examine the expressions. Two-way ANOVA analysis on time-series experiments of two cells could select 2863 genes differentially expressed upon ionizing radiation among 32,321 genes in microarray (p<0.05). We classified these genes into 21 clusters by SOM clustering according to the interaction between cell types and time. Two SOM clusters were enriched with apoptosis-related genes in pathway analysis. One cluster contained higher levels of phosphatidyl inositol 3-phosphate kinase (PI3K) subunits in H1299, radio-resistant cells than H460, radiosensitive cells. TRAIL receptors were expressed in H460 cells while the decoy receptor for TRAIL was expressed in H1299 cells. From these results, we could characterize the differential responsiveness to ionizing radiation according to their differential expressions of apoptosis-related genes, which might be the candidates to increase the power of radiotherapy.