• Korean Journal of Radiology
• /
• v.21 no.9
• /
• pp.1077-1086
• /
• 2020

Objective: To evaluate the effect of perfluorobutane microbubbles (Sonazoid^®, GE Healthcare) on steam popping during radiofrequency (RF) ablation for treating hepatocellular carcinoma (HCC), and to assess whether popping affects treatment outcomes. Materials and Methods: The institutional review board approved this retrospective study, which included 90 consecutive patients with single HCC, who received percutaneous RF ablation as the first-line treatment. The patients were divided into two groups, based on the presence or absence of the popping phenomenon, which was defined as an audible sound with a simultaneous sudden explosion within the ablation zone as detected via ultrasonography during the procedure. The factors contributing to the popping phenomenon were identified using multivariable logistic regression analysis. Local tumor progression (LTP) and disease-free survival (DFS) were assessed using the Kaplan-Meier method with the log-rank test for performing comparisons between the two groups. Results: The overall incidence of the popping phenomenon was 25.8% (24/93). Sonazoid^® was used in 1 patient (4.2%) in the popping group (n = 24), while it was used in 15 patients (21.7%) in the non-popping group (n = 69). Multivariable analysis revealed that the use of Sonazoid^® was the only significant factor for absence of the popping phenomenon (odds ratio = 0.10, p = 0.048). There were no significant differences in cumulative LTP and DFS between the two groups (p = 0.479 and p = 0.424, respectively). Conclusion: The use of Sonazoid^® has a suppressive effect on the popping phenomenon during RF ablation in patients with HCC. However, the presence of the popping phenomenon may not affect clinical outcomes.

• Korean Journal of Radiology
• /
• v.21 no.6
• /
• pp.695-706
• /
• 2020

Objective: To investigate the technical and clinical efficacy of the percutaneous insertion of a biliary metallic stent, and to identify the factors associated with biliary stent dysfunction in patients with malignant duodenobiliary obstruction. Materials and Methods: The medical records of 70 patients (39 men and 31 women; mean age, 63 years; range, 38-90 years) who were treated for malignant duodenobiliary obstruction at our institution between April 2007 and December 2018, were retrospectively reviewed. Variables found significant by univariate log-rank analysis (p < 0.2) were considered as suitable candidates for a multiple Cox's proportional hazard model. Results: The biliary stents were successfully placed in all 70 study patients. Biliary stent insertion with subsequent duodenal stent insertion was performed in 33 patients and duodenal stent insertion with subsequent biliary stent insertion was performed in the other 37 study subjects. The median patient survival and stent patency time were 107 days (95% confidence interval [CI], 78-135 days) and 270 days (95% CI, 95-444 days), respectively. Biliary stent dysfunction was observed in 24 (34.3%) cases. Multiple Cox's proportional hazard analysis revealed that the location of the distal biliary stent was the only independent factor affecting biliary stent patency (hazard ratio, 3.771; 95% CI, 1.157-12.283). The median biliary stent patency was significantly longer in patients in whom the distal end of the biliary stent was beyond the distal end of the duodenal stent (median, 327 days; 95% CI, 249-450 days), rather than within the duodenal stent (median, 170 days; 95% CI, 115-225 days). Conclusion: The percutaneous insertion of the biliary metallic stent appears to be a technically feasible, safe, and effective method of treating malignant duodenobiliary obstruction. In addition, a biliary stent system with a distal end located beyond the distal end of the duodenal stent will contribute towards longer stent patency in these patients.

• Korean Journal of Radiology
• /
• v.25 no.8
• /
• pp.715-725
• /
• 2024

Objective: To evaluate the outcomes of drug-eluting bead transarterial chemoembolization (DEB-TACE) according to the size of the beads for the treatment of small hepatocellular carcinoma (HCC). Materials and Methods: This retrospective study included 212 patients with a single HCC ≤5 cm from five tertiary institutions. One hundred and nine patients were treated with 70-150-㎛ doxorubicin DEBs (group A), and 103 patients received 100-300-㎛ doxorubicin DEBs (group B). The initial tumor response (assessed between 3 weeks and 2 months after DEB-TACE), time to local tumor progression (TTLTP), restricted mean duration of complete response (RMDCR), rate of complications, incidence of post-embolization syndrome, and length of hospital stay were compared between the two groups. Logistic regression was used to analyze prognostic factors for initial tumor response. Results: The initial objective response rates were 91.7% (100/109) and 84.5% (87/103) for groups A and B, respectively (P = 0.101). In the subgroup analysis of tumors ≤3 cm, the initial objective response rates were 94.6% (53/56) and 78.0% (39/50) for groups A and B, respectively (P = 0.012). There was no significant difference in the TTLTP (median, 23.7 months for group A vs. 19.0 months for group B; P = 0.278 [log-rank], 0.190 [multivariable Cox regression]) or RMDCR at 24 months (11.4 months vs. 8.5 months, respectively; P = 0.088). In the subgroup analysis of tumors >3-cm, the RMDCR at 24 months was significantly longer in group A than in group B (11.8 months vs. 5.7 months, P = 0.024). The incidence of mild bile duct dilatation after DEB-TACE was significantly higher in group B than in group A (5.5% [6/109] vs. 18.4% [19/103], P = 0.003). Conclusion: DEB-TACE using 70-150-㎛ microspheres demonstrated a higher initial objective response rate in ≤3-cm HCCs and a longer RMDCR at 24 months in 3.1-5-cm HCCs compared to larger DEBs (100-300-㎛).

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.7 no.1
• /
• pp.27-32
• /
• 2008

Purpose: To evaluate the clinical results of the patients who underwent radiofrequency thermal shrinkage (RFTS) for treatment of anterior cruciate ligament (ACL) laxity after ACL reconstruction. Material and Methods: From October 1999 to March 2006, we performed 133 cases of ACL reconstruction. Among them we experienced 16 patients who had the laxity of reconstructed ACL in second look arthroscopy. Mean follow-up was 20.4 months. Mean age was 33.5 years. 12 cases were male and 4 cases were female. The elongated ACL were treated by bipolar radiofrequency energy with an output of grade II. Subjective and objective parameters were utilized in analyses, such as: the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test, IKDC score. Wilcoxon signed-rank test was used to perform the data analysis. P<0.05 was considered to be statistically significant. Results: Postoperative mean Lysholm knee score (preop: $82.2{\pm}5.2(77{\sim}85))$ (P=0.04), postop: $85.2{\pm}4.8$(82-90)) and anterior displacement by the Telos stress test (preop: $5.4{\pm}4.6(3{\sim}10)mm$, postop: $2.1{\pm}1.9(0{\sim}4)mm)$ (P=0.02), Lachman's test, and IKDC scores (P=0.04) demonstrated significant differences statistically compared to the preoperative. There were no statistical differences in mean range of motion, Tegner activity scale. Conclusions: Arthroscopic shrinkage for the ACL laxity after ACL reconstruction with radiofrequency device showed good clinical results and was applicable operative technique.

• Women's Health Nursing
• /
• v.7 no.1
• /
• pp.30-43
• /
• 2001

This was a pre-experimental study to confirm the breast-feeding ability and effect of follow up care on the breast-feeding rate and the breast-feeding method by the mother-infant breast-feeding assessment tool for the mothers who got the breast-feeding education. The subjects were 46 mothers who experienced normal delivery of infants at a college hospital in K-city, Kyungsangbuk-do, from July 1 to October 21, 2000. The instrument for data obtainment were The Mother-Infant Breast-Feeding Assessment Tool of Johnson et al. (1999), and The Breast- Feeding Method Measurement Tool of Jeong, Geum-hee(1997). This instrument was reliable, showing Cronbach $\alpha$.751. This study classified them into 3 groups: at high risk for breast-feeding failure, at risk for breast-feeding problems, and at low risk for breast-feeding failure by the mother-infant breast-feeding assessment tool on the day of discharge from the hospital after delivering individual breast-feeding education to the subjects. This study investigated the breast-feeding rate and the breast-feeding method through mail questionnaire at the four week after childbirth, and through the phone counselling and the home visit for follow up care at the first week and the second week after childbirth. The sixth week after childbirth, this study investigated the breast-feeding rate by phone. The data analyzed the hypothesizes by $x^2$-test, paired t-test, ANOVA, Wilcoxon signed rank test, Wilcoxon rank sum test and trend analysis using SPSS/PC+ WIN 10.0 program. The results were as follows : 1) Hypothesis 1-1, "there won't be any difference the breast-feeding rate of a group at risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t= -1.501, p=.270). Hypothesis 1-2, "there won't be any difference the breast-feeding rate of group at low risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t=-1.732, p=.225). 2) Hypothesis 2-1, "there won't be any difference between the breast-feeding method of group at risk for breast-feeding failure for four weeks after childbirth and just after childbirth” was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-7.267, p=.000). Hypothesis 2-2, "there won't be any difference between the breast-feeding method of the group at low risk for breast-feeding failure for four weeks after childbirth and just after childbirth" was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-2.501, p=.012). 3)The 3rd hypothesis, "there won't be any difference between breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure at the 4th week after childbirth and just after childbirth" didn't show any difference between the breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure in the advance test(t=-1.521, p=.130) but there was difference between them in post test (t=-2.012, p=.044). As a result, the 3rd hypothesis was supported by pre test, but it was rejected by post test. In conclusion, this study confirmed breast- feeding education and follow up care just after childbirth were effective for the breast-feeding rate and method. Accordingly, it is proposed that successful nursing intervention of breast-feeding to be necessary by continuously providing follow up care through the mother-infant breast-feeding assessment tool as well as to execute individual breast-feeding education to mothers just after childbirth.

• Journal of Korean Academy of Nursing
• /
• v.11 no.2
• /
• pp.23-32
• /
• 1981

The purpose of the study was to evaluate the educational content which had been given by midwifery training program. It was hoped that this result would help. It was sponsored by com-munity health worker plan effective health education. College of Nursing Ewha Womans University and The Korean Nurses Academic Society during the November 19 thru 24, 1979. It was carried out on July through on September 1980, and involved 22 community health workers. The results were as follows: 1. Most of the community health workers came from Seoul ＆ Pusan areas and have been working at the hospitals. There were 31.82% of Head Nurses, 27.2% of Staff Nurses, 22.73% Nurse Supervisons, 13.6% of Nurse Directors and 4.5％ of educational coordinator for Nurses. These participant had nurse-midwifery lincences by 63.64%. None of there had just midwifery lincences. 2, Age structures of the study population shows 31.82% of whom are.26-30 years and 22.73% of whom are 36. 40 years of age. This shown that seniority proportion is higher than the younger. There are 31.82% of 1-5 years, 27.27% of 6-10 year and 11-15 years, respectively by work career. 3. There are 54.55% of the institutions have opened their own midwifery training course for their nursing staff members. Because of lack of the facilities, shortage of instructors, and problems of administrative process. 4. According to the institution which opened for midwifery training courses, the participant was responsible for “midwifery”“Infant care”“MCH”“practice of midwifery”“Nursing adjustment”and“F. P.”5. During the midwifery couse, there were 8 institution who used the textbook and 4 institution who did not. Least of there referned to content matinals which was given by the sponsored. 6. There are 7 insititues who kept their training courses with other professional helps such as physicians., professiors and nurses. Some problems are pointed out by respondents such as“conflict with residents”“poor suportive administration”and“lake of manpower”. 8. The participant showed that they learned new knowledge as trends during this programs for there quality work so it need (one or twice times) a year. But they suggested that it needed more emphasis on the“maternal health care”and“role of the nurse-midwifery”. 9. The analysis of the results are as follows within the 6 areas which are given by the sponsored: There are highest ranks between“basic theory & family planning”“role of midwifery & nursing practice”. In the prenatal care the highest rank ware related to“health risk”on“idenify of risk symtoms”. In the health care areas which related to delivery, the responsers were related to“general conditions”or“high risk criteria”. In the health care area which related to high risk maternity care. In the neonatal health care, the highest rank was related to”health assessment of normal infant”. In the infant health care the responses was related to“abnormal symptoms”and“risk symptoms”. Actually, the participants show that they are more interested in“role of midwifery”“health assessment”and “high risk maternity care”are which emphasised on health promotion, health maintenance & disease preventive. 1) The midwifery training program need higher education for midwifery on a regular basis. 2) Within the open institution of midwifery training program, the nurses must be supported by their own institution and administry of social welfare must give systematic support. Also non-open institution must be open very soon. 3) All health workers including the residents & other workers, must cooperate for their phased common good of impovement of the maternity health. 4) Administration agonies & education institutions must provide the curriculum facilitis and administration systems which are needed for training of nurse-midwifery.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.22 no.1
• /
• pp.23-27
• /
• 2018

Purpose The introduction of bone scan has been reported as a useful tool in the diagnosis, treatment, and treatment response of skeletal disease. The purpose of this study is to improve the anatomical information and tolerance of the bone by combining bone scan and pelvic X-ray without additional radiation exposure. Materials and Methods From November 2015 to August 2016, 236 patients(64 men and 172 women, average age $50.96{\pm}15.39years$) take Bone scan and Pelvis AP(Anteroposterior) X-ray scan at the National Cancer Center. The scan equipment was a gamma camera, Symbia Ecam (SIEMENS, Germany), and a digital x-ray, DRS-800 (Listem, Korea). Osirix version 3.8.1 (Osirix, USA) and Stata/SE version 14.0 (StataCorp, USA) were used for image combination and analysis. The patient was intravenously injected with $^{99m}Tc-DPD$ (740 MBq), and the scan was performed 2 to 4 hours later. Gamma camera image acquisition were Matrix size $256{\times}1024$, Zoom 1.00, and scan speed 17 cm/min. The digital X-ray was made with a collimator size of $14^{{\prime}{\prime}}{\times}17^{{\prime}{\prime}}$, 77 kVp (60 to 97 kVp) and an average of 30 mAs (20 to 48). ASIS and pubic symphysis Select virtual points then Combine three virtual points and pelvic contour lines. The acquired images were evaluated by three radiologists who worked for more than 5 years in the nuclear medicine department. Results Of the total 236 patients, 216 (91.53%) were matched. The median and range (min~max) of the age were 67 (46~81) years old in the unmatched group and 52 (22~87) years old in the matched group, The Wilcoxon rank-sum test was performed to determine whether age was different between the two groups. As a result, the age difference between the two groups was statistically significant at p < 0.0001. Of the 64 men, 60 (93.75%) were match and of the 172 women, 156 (93.75%) were match. There was no statistically significant difference according to gender(p = 0.4542). Of the 54 patients without pelvic lesions, 54 (100.00%) were match, and 162 (89.01%) of 182 patients with pelvic lesions were match. There was a statistically significant difference according to the presence of pelvic lesions. Conclusion There are many variables in the combination of bone scan and pelvic X-ray imaging, and the patient's age and pelvic lesion may have some effect on the image combination. This study is expected to be useful for the diagnosis of pelvic osteosarcoma of children without radiation exposure. It is expected that this combination of images will help to develop the nuclear medicine image.

• The Journal of Korean Academy of Prosthodontics
• /
• v.48 no.4
• /
• pp.259-265
• /
• 2010

Purpose: This study was aimed to evaluate the effect of different sizes of $\beta$-TCP/ HA particles on vertical bone augmentation using titanium mesh in the cranium of rabbits. Materials and methods: Six white rabbits weighing 5kg were used. Four circular grooves of 6mm diameter were made by trephine, and five small holes were drilled in the inner surface of each circular gooves. Different sizes of grafts (small 0.3 - 0.5 mm, medium 0.5 - 1.0, large 1.0 - 2.0 mm) were placed respectively in the experimental groups. Titanium mesh (height 3 mm, width 6 mm) was placed. After 8weeks healing period, the rabbits were euthanized, and the specimens were prepared for histological findings. New bone formation and remaining graft area were measured to calculate the ratio of areas occupying the inner space of titanium mesh. Mann-Whitney U-test and Wilcoxon signed rank-test were used for statistical analysis ($\alpha$ = .05). Results: The experimental groups with $\beta$-TCP/HA graft showed a significantly higher new bone formation (P = .003). Comparing different sizes of $\beta$-TCP/HA, there was no statistical difference in terms of new bone formation. The vertical bone formation (i.e. new bone and graft area) was significantly greater in $\beta$-TCP/HA groups (P = .001). In comparison between different sizes of $\beta$-TCP/HA, medium size group had significantly greater area than large particle size group (P = .039). Conclusion: The use of $\beta$-TCP/HA with titanium mesh showed a higher vertical bone formation, particularly the medium sized $\beta$-TCP/HA particles (0.5 - 1.0 mm) produced better results in vertical bone augmentation.

• The Journal of the Korean bone and joint tumor society
• /
• v.9 no.2
• /
• pp.131-138
• /
• 2003

Purpose: We analyzed our malignant peripheral nerve sheath tumor (MPNST) cases to find out their oncologic results following by each treatment modalities. Materials and Methods: Thirty four patients with MPNST were registered in Korea Cancer Center Hospital from Feb. 1986 to Nov. 1996. Seventeen cases were male and 17, female. Average age was 41 years (range 18 to 74). Location of the tumor was as follows; 17 in lower extremity, 11 upper extremity, 4 trunk, and 2 retroperitoneum. Following the AJC classification, stage IA were 2 cases, stage IIA 2, stage IIB 6, stage III 16 and stage IV 8. Twenty six patients took operations and adjuvant chemotherapy and/or radiation therapy, 3 operation only and 3 adjuvant chemotherapy or radiation therapy. Average follow up period was 33.5 months (5.6 to 146.1). Kaplan-Meiyer method was done for survival curve, and log rank test for comparison analysis. Results: Fourteen cases were continuous disease free, 2 no evidence of disease, 2 alive with disease and 14 dead of disease states at final follow up. Actual 5-year and 10-year survival rates were 53.5%, 35.7%. Local recurrence rate after operation was 24.1%. 5-year survival rates of stage I/II/III were 100/85.7/55.9% and 2-year survival rate of stage IV was 14.3% (p=0.04). In 21 cases operated with stage II-III, wide margin (15cases) had 76.0% 5-year survival rate, and marginal or intralesional marigin (6cases) had 40.0%. The actual 5-year survival rate of the group which were done 4 or more cycles chemotherapy (8cases) was 71.4% and the actual 3-year survival rate less than 4cycles chemotherapy (6cases) was 83.3% (p=0.96). In 19 cases operated with stage II-III and which had no radiotherapy, marginal or intralesional margin (5cases) had 3 cases of local recurrences (60.0%), though wide margin (14cases) had 4 cases recurrences (28.6%). There was no local recurrence in 8cases which had pre-or post-operative radiotherapy. Conclusions: Surgical margin is an important factor in local recurrence. Resection margin has a tendency to influence the survival despite insufficient statistical significance. Conventional chemotherapy has no defnite statistical sigficance in the effect on local control and survival. Preoperative and postoperative radiotherapy has some positive effect on local control.

• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.1
• /
• pp.72-78
• /
• 2009

Purpose: Bone mineral density (BMD) measurements need to be precise enough to be capable of detecting small changes in bone mass of rats. Using a regular dual-energy X-ray absorptiometry (DXA), we measured many BMD of various skeletal sites in rats to examine precision of DXA in relation to the repositioning on the bones of rats. Materials and Methods: Using DXA and small animal software, scans were performed 4 times in all 12 male rats without repositioning (Group 1a). Another four scans for 6 of 12 rats were done with repositioning between scans (Group 2). Customized regions of interest (ROIs), encapsulate the right hind limb, L1-4, skull and pelvic bones were drawn at each measurement. The precision of the measurements was evaluated by measuring the coefficient of variation (CV) of four measurements of BMD at each skeletal site of all rats with or without repositioning. Significance of differences between group 1b (six rats out of group 1a, which were come under group 2) and group2 were evaluated with Wilcoxon Signed Rank Sum Test. Results: CVs obtained at different skeletal sites of all measurements in Group 1b and 2. It was $3.51{\pm}1.20$, $ 2.62{\pm}1.20$ for the hindlimb (p=0.173), $3.83{\pm}2.02$, $4.59{\pm}2.02$ for L1-4 (p=0.600), $3.73{\pm}1.87$, $1.53{\pm}0.89$ for skull (p=0.046), and $2.92{\pm}0.60$, $1.45{\pm}0.60$ for pelvic bones (p=0.075). Conclusion: Our study demonstrates that the DXA technique has the precision necessary when used to assess BMD for various skeletal sites in rats regardless of repositioning.