• Journal of Korean Neurosurgical Society
• /
• v.62 no.4
• /
• pp.405-413
• /
• 2019

Objective : We evaluated efficacy of combining proximal balloon guiding catheter (antegrade flow arrest) and distal access catheter (aspiration at the site of occlusion) in thrombectomy for anterior circulation ischemic stroke. Methods : We retrospectively analyzed 116 patients who underwent mechanical thrombectomy with stent retriever. The patients were divided by the techniques adopted, the combined technique (proximal balloon guiding catheter and large bore distal access catheter) group (n=57, 49.1%) and the conventional (guiding catheter with stent retriever) technique group (n=59, 50.9%). We evaluated baseline characteristics (epidemiologic data, clinical and imaging characteristics) and procedure details (the number of retrieval attempts, procedure time), as well as angiographic (thrombolysis in cerebral infarction (TICI) score, distal thrombus migration) and clinical outcome (National Institutes of Health Stroke Scale at discharge, modified Rankin Scale [mRS] at 3 months) of them. Results : The number of retrieval attempts was lower (p=0.002) and the first-pass successful reperfusion rate was higher (56.1% vs. 28.8%; p=0.003) in the combined technique group. And the rate of final result of TICI score 3 was higher (68.4% vs. 28.8%; p<0.01) and distal thrombus migration rate was also lower (15.8% vs. 40.7%; p=0.021) in the combined technique group. Early strong neurologic improvement (improvement of National Institutes of Health Stroke Scale ${\geq}11$ or National Institutes of Health Stroke Scale ${\leq}1$ at discharge) rate (57.9% vs. 36.2%; p=0.02) and favorable clinical outcome (mRS at 3 months ${\leq}2$) rate (59.6% vs. 33.9%; p=0.005) were also better in the combined technique group. Conclusion : The combined technique needs lesser attempts, decreases distal migration, increases TICI 3 reperfusion and achieves better clinical outcomes.

• Journal of Gastric Cancer
• /
• v.21 no.2
• /
• pp.169-178
• /
• 2021

Purpose: The aim of this study was to investigate the oncologic safety and identify potential candidates for proximal gastrectomy (PG) in upper third advanced gastric cancer (AGC) and esophagogastric junction (EGJ) cancers. Materials and Methods: Among 5,665 patients who underwent gastrectomy for gastric adenocarcinoma between January 2011 and December 2017, 327 patients who underwent total gastrectomy with standard lymph node (LN) dissection for upper third AGC and Siewert type II EGJ cancers were enrolled. We analyzed the correlation between the metastatic rates of distal LNs (No. 4d, 5, 6, and 12a) around the lower part of the stomach and the clinicopathological characteristics. We identified subgroups with no metastasis to the distal LNs. Results: The metastatic rate of distal LNs in proximal AGC and Siewert type II EGJ cancers was 7.0% (23 of 327 patients). On multivariate analysis, pathological T stage (P=0.001), tumor size (P=0.043), and middle third invasion (P=0.003) were significantly associated with distal LN metastases. Pathological 'T2 stage' (n=88), or 'T3 stage with ≤5 cm tumor size' (n=87) showed no metastasis in distal LNs, regardless of middle third invasion. Pathological T3 stage with tumor size > 5 cm (n=61) and T4 stage (n=91) had metastasis in the distal LNs. Conclusions: In the upper third AGC and Siewert type II EGJ cancer, pathological T2 and small-sized T3 stage groups are possible candidates for PG in cases without distal LN metastasis. Further validation studies are required for clinical application.

• Journal of Gastric Cancer
• /
• v.5 no.3 s.19
• /
• pp.152-157
• /
• 2005

Purpose: A total gastrectomy is generally peformed for the treatment of upper third gastric cancer. However, the optimal extent of resection for early-stage upper third gastric cancer is still controversial. In this research, we compared the nutritional status and the quality of life in patients who underwent a total gastrectomy with uncut Roux en Y esophagojejunostomy with those in patients who underwent a proximal gastrectomy with esophagogastrostomy for treatment of upper third gastric cancer. Materials and Methods: We reviewed 50 patients with no evidence of recurrent disease following curative surgery for upper third gastric cancer. Among this group, 25 patients underwent a total gastrectomy (TG) and 25 patients a proximal gastrectomy (PG). 8 TG and 4 PG patients were excluded from this study because of death, refusal to interview etc. The nutritional status was assessed by measuring body weight, serum albumin, serum hemoglobin, and serum total protein. The gastrointestinal function and the quality of life were assessed by Cuschieri grading and modified Visick qrading. Results: In analysis of covariance of age and preoperative serum albumin, PG patients demonstrated lower weight loss (P=0.038), elevated serum albumin (P=0.049), and better outcome based on modified Visick grading (P=0.016) than TG, but there were no significant differences in the serum hemoglobin change (P=0.165), serum total protein change (P=0.435), and Cuschieri grading (P=0.064) between the preoperative and the postoperative data. Conclusion: In this study, a proximal gastrectomy led to a better nutritional status and quality of life than a total gastrectomy, as judged from the low weight loss, elevated serum albumin and better modified Visick grade.

• Clinics in Shoulder and Elbow
• /
• v.16 no.1
• /
• pp.17-26
• /
• 2013

Purpose: A comparison of the radiographic and the clinical outcomes between two different surgical approaches-Deltoid splitting and Delto-pectoral interval-on the proximal humerus fractures treated by locking compressive plate (LCP), is done. Materials and Methods: Medical records and pre- and postoperative radiographs were reviewed retrospectively for 75 adult patients who underwent surgical fixations with locking compressive plates from May 2005 to December 2011. Patients were divided into two groups according to the surgical methods. Differences in the neck-shaft angle between immediate postoperative period and final follow-up were compared between the two groups. Differences in constant score and Korean shoulder score (KSS) between affected arms and contralateral arms at final follow-up were also compared. Results: The differences in the neck-shaft angle between immediate postoperative period and at final follow-up was 12.04 degrees on average in Deltoid splitting approach and 10.20 degrees in Delto-pectoral interval approach, which was not statistically significant. Differences in constant score/KSS between the affected arm and the contralateral arm were 13.78/22.74 points in deltoid-splitting approach on average and 19.41/31.13 points in Delto-pectoral interval approach, showing that deltoid-splitting approach is significantly superior. Conclusion: Deltoid-splitting approach showed better functional outcomes in the fracture reduction and internal fixation using LCP for the treatment of unstable proximal humerus fractures.

• The Journal of the Korean bone and joint tumor society
• /
• v.17 no.1
• /
• pp.44-50
• /
• 2011

Purpose: To compare clinical outcomes of the tumor prosthetic replacement and osteosynthetic fixation for pathologic fracture of skeletal metastatic lesion of the proximal femur. Materials and Methods: From 1994 May to 2009 May, medical records of 22 patients who underwent tumor prosthetic replacement with tumor resection (group 1) and 15 others (16 hips) who underwent osteosynthetic fixation without tumor resection (group 2) were reviewed. The mean age of overall patients were 59 (group 1) and 60 (group 2). Mean follow up periods were 23 and 11 months. The oncological and functional results were evaluated with Kaplan-Meier methods and Musculoskeletal Tumor Society (MSTS) scoring system, 1993. The statistical evaluation was assessed with Log rank test and t-test. Results: The mean survival periods were 24 months in group 1 and 11months in group 2. The 1 year survival rates were 86% in group 1 and 50 % in group 2, and 2 year survival rates were 29.7% in group 1 and 9.4% in group 2. The mean MSTS functional score were 26.4 (19-30), 87.9% in group 1 and 15.3 (10-23), 51.0% in group 2. Conclusion: The results of tumor resection and prosthetic replacement in selected cases was better than osteosynthetic fixation without tumor resection for metastatic bone tumors around proximal femur in oncological and functional aspects.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.30 no.2
• /
• pp.145-151
• /
• 2014

Purpose: The purpose of this study was to investigate the microleakage in class II cavity resin restorations used with resin-modified glass ionomer (RMGI) lining material depending on two different applying methods; classical delivery method using a dental explorer and a specially designed rotating bur. Materials and Methods: A total thirty-six extracted teeth were prepared with a class II proximal box, and randomly divided into three groups: 1) control group with no lining added and the proximal box restored (Group I), 2) the second group used RMGI as a lining material which was spread with an explorer (Group II), 3) the third group used a specially designed rotating bur to thin out RMGI (Group III). All teeth were restored with the same manner using incrementally placed resin composite. All 36 teeth were prepared and sectioned for the dye penetration test, and observed with a stereomicroscope for scoring the dye penetration. Results: When RMGI liners were used, both groups using an explorer and the special bur with the liner had significantly less microleakage than the control group with no liner (P < 0.05). The 50% of the group with RMGI liner using the bur showed no microleakage under a dye penetration test whereas all the teeth in control group showed microleakage of different degrees. However, there was no statistically significant difference between Group II and Group III. Conclusion: RMGI is an effective lining material to decrease microleakage in class II composite resin restorations regardless of applying methods.

• The Journal of the Acoustical Society of Korea
• /
• v.43 no.2
• /
• pp.214-224
• /
• 2024

Sonobuoys are disposable devices that utilize sound waves for information gathering, detecting engine noises, and capturing various acoustic characteristics. They play a crucial role in accurately detecting underwater targets, making them effective detection systems in anti-submarine warfare. Existing sonobuoy deployment methods in multistatic systems often rely on fixed patterns or heuristic-based rules, lacking efficiency in terms of the number of sonobuoys deployed and operational time due to the unpredictable mobility of the underwater targets. Thus, this paper proposes an optimal sonobuoy placement strategy for Unmanned Aerial Vehicles (UAVs) to overcome the limitations of conventional sonobuoy deployment methods. The proposed approach utilizes reinforcement learning in a simulation-based experimental environment that considers the movements of the underwater targets. The Unity ML-Agents framework is employed, and the Proximal Policy Optimization (PPO) algorithm is utilized for UAV learning in a virtual operational environment with real-time interactions. The reward function is designed to consider the number of sonobuoys deployed and the cost associated with sound sources and receivers, enabling effective learning. The proposed reinforcement learning-based deployment strategy compared to the conventional sonobuoy deployment methods in the same experimental environment demonstrates superior performance in terms of detection success rate, deployed sonobuoy count, and operational time.

• Journal of Korean Neurosurgical Society
• /
• v.50 no.2
• /
• pp.143-146
• /
• 2011

A ventriculo-peritoneal shunt is a standard surgical management for hydrocephalus, but complications may impede the management of this disease. Obstruction of the catheter is one of the most common complications and manifests clinically in various ways. Intraparenchymal cyst development after shunt malfunction has been reported by several authors, but the underlying mechanism and optimal treatment methods are debatable. The authors report a case of intraparenchymal cyst formation around a proximal catheter in a premature infant after a ventriculo-peritoneal shunt and discuss its pathogenesis and management.

• Journal of the Korean Mathematical Society
• /
• v.49 no.5
• /
• pp.893-905
• /
• 2012

Kirsi Majava and Xue-Cheng Tai [12] proposed a modified level set method for solving a free boundary problem associated with unilateral obstacle problems. The proximal bundle method and gradient method were applied to solve the nonsmooth minimization problems and the regularized problem, respectively. In this paper, we extend this approach to solve the bilateral obstacle problems and employ Rung-Kutta method to solve the initial value problem derived from the regularized problem. Numerical experiments are presented to verify the efficiency of the methods.

• Journal of Korean Foot and Ankle Society
• /
• v.6 no.1
• /
• pp.96-99
• /
• 2002

There are many reports on the various methods of treatment for hallux valgus. 1st metatarsal proximal osteotomy with distal soft tissue procedure or 1st metatarsophalangeal joint arthrodesis has been conventionally used for treatment of severe hallux valgus. We performed a new double chevron osteotomy in 3 cases and obtained satisfying results. We present this procedure as a new method of treatment for severe hallux valgus.