• Journal of Korean Neurosurgical Society
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• v.67 no.5
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• pp.560-567
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• 2024

Objective : We investigated how treating large brain metastasis (LBM) using 2-day fraction Gamma Knife radiosurgery (GKRS) affects tumor control and patient survival. A prescription dose of 10.3 Gy was applied for 2 consecutive days, with a biologically effective dose equivalent to a tumor single-fraction dose of 16.05 Gy and a brain single-fraction dose of 15.12 Gy. Methods : Between November 2017 and December 2021, 42 patients (mean age, 68.3 years; range, 50-84 years; male, 29 [69.1%]; female, 13 [30.9%]) with 44 tumors underwent 2-day fraction GKRS to treat large volume brain metastasis. The main cancer types were non-small cell lung cancer (n=16), small cell lung cancer (n=7), colorectal cancer (n=7), breast cancer (n=3), gastric cancer (n=2), and other cancers (n=7). Twenty-one patients (50.0%) had a single LBM, 19 (46.3%) had a single LBM and other metastases, and two had two (4.7%) large brain metastases. At the time of the 2-day fraction GKRS, the tumors had a mean volume of 23.1 mL (range, 12.5-67.4). On each day, radiation was administered at a dose of 10.3 Gy, mainly using a 50% isodose-line. Results : We obtained clinical and magnetic resonance imaging follow-up data for 34 patients (81%) with 35 tumors, who had undergone 2-day fraction GKRS. These patients did not experience acute or late radiation-induced complications during follow-up. The median and mean progression-free survival (PFS) periods were 188 and 194 days, respectively. The local control rates at 6, 9, and 12 months were 77%, 40%, and 34%, respectively. The prognostic factors related to PFS were prior radiotherapy (p=0.019) and lung cancer origin (p=0.041). Other factors such as tumor volumes, each isodose volumes, and peri-GKRS systemic treatment were not significantly related to PFS. The overall survival period of the 44 patients following repeat stereotactic radiosurgery (SRS) ranged from 15-878 days (median, 263±38 days; mean, 174±43 days) after the 2-day fraction GKRS. Eight patients (18.2%) were still alive. Conclusion : Considering the unsatisfactory tumor control, a higher prescription dose should be needed in this procedure as a salvage management. Moreover, in the treatment for LBM with fractionated SRS, using different isodoses and prescription doses at the treatment planning for LBMs should be important. However, this report might be a basic reference with the same fraction number and prescription dose in the treatment for LBMs with frame-based SRS.

• Clinical and Experimental Reproductive Medicine
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• v.21 no.1
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• pp.69-76
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• 1994

The survival and pregnancy rates were compared between non-frozen embryos and cryopreserved embryos at either pronucleate or 2-4 cell stages using the freezing and thawing techniques being identical in both groups were compared with fresh embryos. 496 embryos were frozen with 1, 2-propanediol and sucrose and 117 2-4 cell stages embryos had been thawed and 79.6 and 66.0% of them respectively were survival. Clinical pregnancy rate was 19.2% for embryos frozen at the pronucleate stage and 19.0% for embryos frozen at the 2-4 cell stages while the pregnancy rate of non-frozen embryos was 21.3%. There were no significant difference in the survival and pregnancy rates of embryos frozen at pronucleate and 2-4 cell stages. The current cumulative pregnancy rate per retrieval in all cycles with frozen zygotes is 35.4 %, consid~ erably higher than observed in single transfers of embryos without cryopreservation(21.3%); predicted pregnancy rate after transfer of all frozen embryos is 43.3 %. It is concluded that firstly, the survival and pregnancy rate of cryopreserved embryos at pronucleate or 2-4 cell stages are very similar to those from their fresh embryos and non-frozen embryos and secondly, cryopreservation substantially enhances pregnancy attainment from in vitro fertilization.

• Journal of Preventive Medicine and Public Health
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• v.10 no.1
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• pp.102-108
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• 1977

A study on the sickness distribution and mode of treatment in rural area was conducted during the period from July '75 to Aug. '75 using 1,225 households, 7,918 population (4,017 male, 3,901female) and 343 cases th at found during the period of survey who had beenlived in Nammyon, Hwasoongun, Chonnam. The summarized results were as follows : 1. Average family number per household was 6.5 and prevalence rate was 43.3 (21.2 for male, 22.1 for female). 2. General sickness distribution by classification of disease according to W.H.O. was highest in disease of the nervous system and sense organs (21.3%), and important others were disease of the digestive system (16.9%) and disease of the respiratory system(14.8%). In male, distribution was in order of downward disease of digestive system, disease of nervous system and sense organs, disease of skin, cellular tissue, bones and organs of movement, and disease of respiratory system. In female, distribution was in order of downward disease of nervou s system and sense organs, disease of respiratory system, disease of digestive system, and disease of skin, cellular tssue, bones and organs of movement. 5. Types of treatment in both sexes were showed that home and folkmedicine (41.1%), pharmacy(24.5%), admission to hospital or clinic (16.9%), out-patient clinic (10.8%) and herbmedicine (6.7%) in downward order. Hospital and clinic utility rate was 27.5% (31.5 for male, 24.0 for female) and it was highest in 0-4 age groups and lowest in 40-49 year age groups. 4. Hospital and clinic utility rate was highest in neoplasms, and the other hands, disease of the nervous system and sense organs and disease of the digestive system were the highest groups in the all types of treatment other than hospital and clinic. 5. On the results of treatment not, exactly replied answer was the highest (41.7%) and only 16.0% said complete recovery. In completely recovered cases, hospital and clinic using group was predominant (58.2%) and in aggravated cases, home and folkmedicine using group was highest.

• Clinical and Experimental Reproductive Medicine
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• v.20 no.1
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• pp.31-36
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• 1993

The effects of freezing and 1,2-propanediol on early and late pronucleate stage mouse ova were investigated in terms of survival after thawing and development in vitro. The samples were divided into two groups according to different age in pronucleate ova: ova in(1) early pronuclear stage with two distant pronuclei at 18h after hCG injection, and (2) late pronuclear stage with adjacent pronuclei at 30h. Zygotes in the late pronuclear stage have been proven to be more resistant to 1,2-propanediol, showing a significantly higher developmental rate than zygotes in early stage (80.3 versus 66.3%, <0.05), but survival rate was similar in the two groups (91.0 versus 93.5%). After freezing and thawing, survival and developmental rates were decreased in both groups when compared to the control group (54.3 versus 92.3%, 47.7 versus 73.3%. respectively). And developmental rate in the late pronuclear stage zygotes showed significantly higher than in early (55.4 versus 40.0%) after thawing. In conclusion, early pronucleate mouse ova have a lower developmental capacity in vitro and a lower survival rate after freezing and thawing than late ova. These findings suggest that the timing of freezing could be important for survival and further development in vitro in cryopreservation of human pronucleate ova.

• Korea Journal of Hospital Management
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• v.26 no.3
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• pp.28-42
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• 2021

Purposes: The objective of this study is to analyze service design process of dental clinic preventive service by using 'Double Diamond Design Process' which is user-centered for improving dental clinic management efficiency. Methodology: We examine case study that dental clinic preventive service of local dental clinic. Following the double diamond design four steps(①discover, ②define, ③develop, ④deliver), we use suitable analytic tools in each steps. In discover step, we perform observation and desk research. Next, in define step, affinity diagram, user persona, and user journey map are performed. We then make service blueprint in develop step. Finally, in deliver step, virtual scenario and confirm some outputs which are based on results of former steps are suggested. Findings: As a result of this study, waiting and consulting phases turn out that these phases are in the most trouble than others. Users(patients) have lots of complain and dissatisfaction in these phases. These touch-points will have to be modified Practical Implication: After checking this study result, it could suggest improvement schemes. To apply these, we try to make some scenarios, and finally realize some outputs. Service design has arisen to strengthen the competitiveness by reflecting user's experience and needs. Especially, service design is not typical, it is so flexible that can apply to various situation and objects. We hope that result of this study is made good use for dental clinics in need.

• Journal of the Korea Society of Computer and Information
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• v.23 no.11
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• pp.143-149
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• 2018

The purpose of this study is to propose a management method to maintain the pleasant indoor air quality of the dental clinic by measuring and analyzing the indoor air quality of the dental clinic. The measurement was conducted in two rooms, a lobby where many residents stay in the reception room for waiting for medical treatment, and a VIP room where treatment activities are mainly performed. Measurement items are Temperature, Humidity, $CO_2$, CO, $NO_2$, $CH_2O$, VOC, $PM_{10}$ and measurement were taken on April 27, 2018. As a result of analyzing the temperature and humidity of the dental clinic, it was analyzed that the average indoor temperature was maintained at $25^{\circ}C$ and the humidity was kept at around 50%, maintaining proper indoor temperature and humidity environment. $CO_2$ was 855ppm in the VIP Room, which satisfied the maintenance standard. In the case of the lobby, it was analyzed to be 1,160ppm, which exceeded the maintenance standard and it is judged that the carbon dioxide generated by the respiration of the people staying in the lobby is the main reason. The mean concentration of formaldehyde in the VIP room was analyzed as $436{\mu}g/m^3$, exceeding the maintenance standard, and $2,100{\mu}g/m^3$ for the VOC exceeded the recommended standard. It was analyzed that the concentration was relatively higher due to the use of disinfectant and other drugs. The mean concentration of PM-10 in the lobby was analyzed as $65{\mu}g/m^3$ and it was analyzed that it satisfied the maintenance standard. To maintain a pleasant indoor air quality in a dental clinic it is necessary to minimize the effects of formaldehyde, VOC, $CO_2$ in the VIP rooms and lobby. For this purpose, the entire ventilation system and air purification system of the dental clinic should be installed. In case of the VIP room, local exhaust ventilation should be installed and workers should wear personal protective equipment.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.135-140
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• 2021

Background: We hypothesized in this study that the characteristics of retear cases vary according to surgeon volume and that surgical outcomes differ between primary and revision arthroscopic rotator cuff repair (revisional ARCR). Methods: Surgeons performing more than 12 rotator cuff repairs (RCRs) per year were defined as high-volume surgeons, and those performing fewer than 12 RCRs were considered low-volume surgeons. Of the 47 patients who underwent revisional ARCR at our clinic enrolled in this study, 21 cases were treated by high-volume surgeons and 26 cases by low-volume surgeons. In all cases, the interval between primary surgery and revisional ARCR, degree of "acromial scuffing," number of anchors, RCR technique, retear pattern, fatty infiltration, retear size, operating time, and clinical outcome were recorded. Results: During primary surgery, significantly more lateral anchors (p=0.004) were used, and the rate of use of the double-row repair technique was significantly higher (p<0.001) in the high- versus low-volume surgeon group. Moreover, the "cut-through pattern" was observed significantly more frequently among the cases treated by high- versus low-volume surgeons (p=0.008). The clinical outcomes after revisional ARCR were not different between the two groups. Conclusions: Double-row repair during primary surgery and the cut-through pattern during revisional ARCR were more frequent in the high- versus low-volume surgeon groups. However, no differences in retear site or size, fatty infiltration grade, or outcomes were observed between the groups.

• Journal of Periodontal and Implant Science
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• v.54 no.2
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• pp.108-121
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• 2024

Purpose: The aim of this study was to compare changes in soft and hard tissue and the histologic composition following early implant placement in sites with alveolar ridge preservation or spontaneous healing (SH), as well as implant performance up to 1 year after crown insertion. Methods: Thirty-five patients with either intact buccal bone plates or dehiscence of up to 50% following single-tooth extraction of incisors, canines, or premolars were included in the study. They were randomly assigned to undergo one of three procedures: deproteinized bovine bone mineral with 10% collagen (DBBM-C) covered by a collagen matrix (DBBM-C/CM), DBBM-C alone, or SH. At 8 weeks, implant placement was carried out, and cone-beam computed tomography scans and impressions were obtained for profilometric analysis. Patients were followed up after the final crown insertion and again at 1 year post-procedure. Results: Within the first 8 weeks following tooth extraction, the median height of the buccal soft tissue contour changed by -2.11 mm for the DBBM-C/CM group, -1.62 mm for the DBBM-C group, and -1.93 mm for the SH group. The corresponding height of the buccal mineralized tissue changed by -0.27 mm for the DBBM-C/CM group, -2.73 mm for the DBBM-C group, and -1.48 mm for the SH group. The median contour changes between crown insertion and 1 year were -0.19 mm in the DBBM-C/CM group, -0.09 mm in the DBBM-C group, and -0.29 mm in the SH group. Conclusions: Major vertical and horizontal ridge contour changes occurred, irrespective of the treatment modality, up to 8 weeks following tooth extraction. The DBBM-C/CM preserved more mineralized tissue throughout this period, despite a substantial reduction in the overall contour. All 3 protocols led to stable tissues for up to 1 year.

• Archives of Plastic Surgery
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• v.51 no.2
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• pp.169-181
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• 2024

Background With the advent of cranial orthoses as therapeutic medical devices for the treatment of severe positional head deformities in Japan, an increasing number of patients are being treated with them. However, assessing the effectiveness of a treatment is often difficult due to the use of different metrics. This study aimed to evaluate the effectiveness of cranial orthoses for deformational plagiocephaly using two- (2D) and three-dimensional (3D) evaluation metrics. Methods We conducted a retrospective study of infant patients with deformational plagiocephaly who underwent cranial orthosis treatment. We evaluated the severity of deformational plagiocephaly using cranial asymmetry (CA) and the cranial vault asymmetry index (CVAI) as 2D metrics, and anterior and posterior symmetry ratios as 3D metrics. The patients were divided into 24 subgroups based on the initial severity of each outcome and their age at the start of treatment. We analyzed the changes in outcomes and correlations within improvements across the age and severity categories. Results Overall, 1,038 infants were included in this study. The mean CA, CVAI, and anterior and posterior symmetry ratios improved significantly after cranial orthosis treatment. The improvement in each score was greater in patients with more severe initial deformities and in those who underwent treatment at a younger age. Conclusion Cranial orthosis treatment was effective in correcting deformational plagiocephaly in infants, as demonstrated by improvements in both 2D and 3D metrics. Patients with more severe initial deformities and those who underwent treatment at a younger age showed greater improvement.

• Journal of Korean Medicine for Obesity Research
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• v.18 no.1
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• pp.1-9
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• 2018

Objectives: The objective of this study was to assess the safety of 'Gamitaeeumjowee-tang' by analyzing adverse events in weight loss program in combination with 'Gamitaeeumjowee-tang' and low-calorie diet. Methods: A retrospective review of adverse events in weight loss program in combination with 'Gamitaeeumjowee-tang' and low-calorie diet from the electronic medical chart (n=124) between June 2015 and December 2016 was conducted. Three Korean Medicine Doctors (KMDs) reviewed adverse events for two times, during week 2 to 4 and at week 10, after starting weight loss program. Adverse events were evaluated in terms of causality, severity and system-organ classes. Also, agreement among the three KMDs was made through further discussion in case of disagreement after independent review. Results: The overall rate of adverse events was 37.1% during week 2 to 4 and 16.9% at week 10. For causality of adverse events using the World Health Organization-Uppsala Monitoring Centre causality categories, 52.2% were evaluated 'possible' at week 2-4 and 57.1% were evaluated 'unlikely' at week 10. All symptoms were evaluated as 'mild' by LDS scale. Nausea (15, 12.1%) was the most frequent adverse event at week 2-4 and dizziness (6, 4.8%) was the most common at week 10. Conclusions: Adverse events decreased over time. There were no serious adverse events and none of the subjects were dropped due to adverse events. Continuous study is needed to prove the safety of 'Gamitaeeumjowee-tang' for treating obesity.