• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.392-399
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• 2016

Objective : Brain metastases in gynecologic cancer (ovarian, endometrial, and cervical cancer) patients are rare, and the efficacy of Gamma Knife Radiosurgery (GKRS) to treat these had not been evaluated. We assessed the efficacy of GKRS and prognostic factors for tumor control and survival in brain metastasis from gynecologic cancers. Methods : This retrospective study was approved by the institutional review board. From May 1995 to October 2012, 26 women (mean age 51.3 years, range 27-70 years) with metastatic brain tumors from gynecologic cancer were treated with GKRS. We reviewed their outcomes, radiological responses, and clinical status. Results : In total 24 patients (59 lesions) were available for follow-up imaging. The median follow-up time was 9 months. The mean treated tumor volume at the time of GKRS was $8185mm^3$ (range $10-19500mm^3$), and the median dose delivered to the tumor margin was 25 Gy (range, 10-30 Gy). A local tumor control rate was 89.8% (53 of 59 tumors). The median overall survival was 9.5 months after GKRS (range, 1-102 months). Age-associated multivariate analysis indicated that the Karnofsky performance status (KPS), the recursive partitioning analysis (RPA) classification, and the number of treated lesions were significant prognostic factors for overall survival (HR=0.162, p=0.008, HR=0.107, p=0.038, and HR=2.897, p=0.045, respectively). Conclusion : GKRS is safe and effective for the management of brain metastasis from gynecologic cancers. The clinical status of the patient is important in determining the overall survival time.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.788-791
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• 2009

Purpose: Reconstruction of full - thickness defects of the nasal ala has always been a challenge. Local flaps can be used easily, and good result can be achieved when it is indicated. But local flaps often result in facial scars and bulky ala that require secondary revisions. Composite auricular chondrocutaneous graft may matches nasal alae well in terms of contour, color and texture, however, the size of composite graft is limited. We performed free vascularized helical root flaps for reconstruction of nasal ala. Methods: Bilateral ala were excised and the defects were reconstructed with a chondrocutaneous free helical root flap. Each side of ala was reconstructed in 3 months interval. Superficial temporal vessels of vascularized helical root flap were anastomosed to facial vessels. Great saphenous vein was used for interpositional vascular graft. Results: Flaps were survived successfully. The contour, texture and color match were satisfactory. Functional problem of nasal obstruction caused by scar stenosis of nostrils was also resolved. Conclusion: The free vascularized helical root flap is a reliable method in reconstruction of nasal alar defects. The donor deformity was minimal.

• Journal of Digital Convergence
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• v.13 no.5
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• pp.297-307
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• 2015

This study reviews equipped with enhanced capability of medical care, quality service, accessibility, and consumer awareness to be a competitive and representative local healthcare service provider with improved administrative efficiency. The method of analysis are ANOVA and Structural Equation Modeling. The results which revealed the significant difference among demographic factors in determining the preference or degree of satisfaction at medical service to select local healthcare institutions suggest that the close review on the needs of groups of major customers of local healthcare institutions are necessary when preparing the strategy of specialized medical service of local healthcare institutions. this suggests that both images would be important factors to secure the competitive advantage of local healthcare institution and therefore the strategy maximized the enhancement of medical service with embossed image of hospital to attract customers of medical service is needed.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.908-918
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• 2020

Objective: To categorize the radiological patterns of recurrence after bevacizumab treatment and to derive the pooled proportions of patients with recurrent malignant glioma showing the different radiological patterns. Materials and Methods: A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed to identify studies reporting radiological recurrence patterns in patients with recurrent malignant glioma after bevacizumab treatment failure until April 10, 2019. The pooled proportions according to radiological recurrence patterns (geographically local versus non-local recurrence) and predominant tumor portions (enhancing tumor versus non-enhancing tumor) after bevacizumab treatment were calculated. Subgroup and meta-regression analyses were also performed. Results: The systematic review and meta-analysis included 17 articles. The pooled proportions were 38.3% (95% confidence interval [CI], 30.6-46.1%) for a geographical radiologic pattern of non-local recurrence and 34.2% (95% CI, 27.3-41.5%) for a non-enhancing tumor-predominant recurrence pattern. In the subgroup analysis, the pooled proportion of non-local recurrence in the patients treated with bevacizumab only was slightly higher than that in patients treated with the combination with cytotoxic chemotherapy (34.9% [95% CI, 22.8-49.4%] versus 22.5% [95% CI, 9.5-44.6%]). Conclusion: A substantial proportion of high-grade glioma patients show non-local or non-enhancing radiologic patterns of recurrence after bevacizumab treatment, which may provide insight into surrogate endpoints for treatment failure in clinical trials of recurrent high-grade glioma.

• Korean Institute of Interior Design Journal
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• v.21 no.5
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• pp.399-410
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• 2012

Due to development of modern medical services and economics, people raised expectation and demand about medical services from previous disease treatment to comprehensive health care covering prevention and health care. Responses of each medical facility to these social needs and the evolution of concept of medicine rapidly occur. The health examination centers are being operated with the purpose of health examination and this trend is reflected on several aspects such as the size of the facilities, function and configuration of space in health examination centers. Thus, health examination centers consisting of various space systems appear, but this trend and interpretations are lacking. Therefore, the purpose of this study is to draw trends of system through analysis of types and its evolved space systematic analysis and establish it. Analysis targets were classified into small, medium and large groups by sizes based on number of space and a total of 12 health examination centers in four for each category were selected. As research methods, functional relationship of space was examined through analysis of type in which segmentalized type tools were applied in local units. The flow diagram was established based on direction turning point and was classified into sub-flow and main-flow in local units and the systems between local units were derived. Finally, the results of this study can be summarized as the following three results. 1) The space connection system of health examination center showed four systems such as circulation, independence, continuation, and network. 2) Local type indicators and global type indicators which were evolved more from limitation of type analysis tools in existing research were derived so that more systematic analysis could be made. 3) Network system is distributed approach system and space for each function is formed around public space.

• Radiation Oncology Journal
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• v.33 no.3
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• pp.198-206
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• 2015

Purpose: We evaluated the prognostic factors and clinical outcomes of 56 patients with vulvar cancer treated with curative radiotherapy (RT) or concurrent chemoradiotherapy. Materials and Methods: Overall survival (OS) and disease-free survival (DFS) were assessed retrospectively. Prognostic factors evaluated included age, International Federation of Gynecology and Obstetrics (FIGO) stage, TNM classification, tumor size, treatment modality, RT duration, and RT field. The association between the tumor human papillomavirus (HPV) status and survival was analyzed in 35 patients. Results: During the median follow-up of 2.8 years (range, 0.3 to 18.9 years), 21 patients (37.5%) experienced treatment failure. Fifteen patients (27%) had local failure: nine (16%) local failure only, three (5%) locoregional failure, two (4%) local and distant failure, and one (2%) locoregional and distant failure. Of 56 patients, seven (13%) had persistent disease at the first follow-up at 2 months and all but one died within a year after completing RT. The 5-year OS and DFS were 51.6% and 44.0%, respectively. In multivariate analysis, clinical size ${\geq}3$ cm predicted a poor prognostic factor for DFS (p = 0.040) and age (${\geq}70years$) was poor prognostic for DFS (p = 0.032) and OS (p = 0.048). Patients with HPV-positive tumors tended to have better 5-year OS and DFS, but the differences were not significant statistically. Conclusion: Clinical size ${\geq}3$ cm was a significant prognostic factor for DFS. However, age was the most important prognostic factor for DFS and OS in patients treated with curative RT. Further studies are needed to determine which treatment should be considered for old age ${\geq}70years$.

• Korean Journal of Radiology
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• v.24 no.8
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• pp.719-728
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• 2023

Radiofrequency ablation (RFA) has been widely used to manage hepatocellular carcinomas (HCCs) equal to or smaller than 3 cm. No-touch RFA has gained attention and has recently been implemented in local ablation therapy for HCCs, despite its technical complexity, as it provides improved local tumor control compared to conventional tumor-puncturing RFA. This article presents the practice guidelines for performing no-touch RFA for HCCs, which have been endorsed by the Korean Society of Image-Guided Tumor Ablation (KSITA). The guidelines are primarily designed to assist interventional oncologists and address the limitations of conventional tumor-puncturing RFA with describing the fundamental principles, various energy delivery methods, and clinical outcomes of no-touch RFA. The clinical outcomes include technical feasibility, local tumor progression rates, survival outcomes, and potential complications.

• Radiation Oncology Journal
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• v.34 no.4
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• pp.290-296
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• 2016

Purpose: Radiotherapy (RT) is considered a mainstay of treatment in parameningeal rhabdomyosarcoma (PM-RMS). We aim to determine the treatment outcomes and prognostic factors for PM-RMS patients who treated with RT. In addition, we tried to evaluate the adequate dose and timing of RT. Materials and Methods: Twenty-two patients with PM-RMS from 1995 to 2013 were evaluated. Seven patients had intracranial extension (ICE) and 17 patients had skull base bony erosion (SBBE). Five patients showed distant metastases at the time of diagnosis. All patients underwent chemotherapy and RT. The median radiation dose was 50.4 Gy (range, 40.0 to 56.0 Gy). Results: The median follow-up was 28.7 months. Twelve patients (54.5%) experienced failure after treatment; 4 local, 2 regional, and 6 distant failures. The 5-year local control (LC) and overall survival (OS) were 77.7% and 38.5%, respectively. The 5-year OS rate was 50.8% for patients without distant metastases and 0% for patients with metastases (p < 0.001). Radiation dose (<50 Gy vs. ${\geq}50Gy$) did not compromise the LC (p = 0.645). However, LC was affected by ICE (p = 0.031). Delayed administration (>22 weeks) of RT was related to a higher rate of local failure (40.0%). Conclusion: RT resulted in a higher rate of local control in PM-RMS. However, it was not extended to survival outcome. A more effective treatment for PM-RMS is warranted.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.6
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• pp.427-431
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• 2021

Objectives: The aim of this study was to describe a simple, convenient, and reliable new technique using local full-thickness skin graft (FTSG) for skin coverage of a donor-site defect of the radial forearm free flap (RFFF). Patients and Methods: Between April 2016 and April 2021, five patients with oral squamous cell carcinoma underwent mass resection combined with RFFF reconstruction. After RFFF harvesting, donor-site defects were restored by proportional local FTSG. Results: The donor-site defects ranged in size from 24 to 41.25 cm², with a mean of 33.05 cm². Good or acceptable esthetic outcomes were obtained in all five patients. There was no dehiscence, skin necrosis, wound infection, or severe scarring at the graft site through the end of the postoperative follow-up period, and no patient had any specific functional complaint. Conclusion: The proportional local FTSG showed promising results for skin coverage of the donor-site defect of the RFFF. This technique could decrease the need for skin grafts from other sites.

• Korean Journal of Acupuncture
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• v.19 no.2
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• pp.149-165
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• 2002

Objective : We proposed fundmental rules of prospective on legal and institutional position and role of Korean medicine doctors working at public health center. Methods : By the result of this research on the current situation, the grade and allowance given to the Korean medicine doctors working at public health center were different every self-governing body. Results : The reason the Korean Medicine Doctor can't serve as a regular order of 5th grade is that the 'The Enforcement Regulation about Administrative Organization and the Standard of Pixed Number of person of Self-Governing Body(지방자치단체의 행정기구와 정원기준등에 관한 규정 시행규칙)' prescribes the number of regular order of 5th grade is regulated within 7% among the number of regular order officials. But not appointing to office as the regular order of 5th grade infringes on the Constitution, the highest law. The reason the Korean Medicine Doctors can't be appointed to office as the regular order officials by the self-governing body is that 'The Enforcement Order of the Law of Preservation of good health of Local Area(지역보건법시행령)' prescribes the Korean Medicine Doctors are not indispensable to Public Health Center. But in fact, the Korean Medicine Doctors can execute many kinds of work such as medical examination or instructing house nursing. Conclusion : The Korean Medicine Doctors working at Public Health Center serve at low positions as daily use or common use, not receiving a regular order. All laws including the Constitution(헌법), the Medical Services Law(의료법), the Law of Preservation of good health of Local Area(지역보건법), the National Public Service Law(국가공무원법), the Local Public Service Law(지방공무원법) and the Law of Higher Education Law(고등교육법) describe that the Korean Medicine Doctors and the Western Medicine Doctors are equal to their position and right.