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Shin JY, Yoon SJ, Ahn HS, Yun YH. Effects of Per-diem payment on the duration of hospitalization and medical expenses according to the palliative care demonstration project in Korea. Int J Health Plann Manage 2016; 32:e206-e217. [PMID: 27412878 DOI: 10.1002/hpm.2366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 02/17/2016] [Accepted: 05/19/2016] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES The aim of this study was to examine the impacts of a government-directed palliative care demonstration (PCD) project, Per-diem Payment System (PDPS), on length of stay (LOS), hospital costs, resource usage and healthcare quality during the searched period from January in 2009 to December in 2010. STUDY DESIGN A retrospective claim data review. METHODS Individuals who had been eligible for the palliative care payment policy, PDPS, during 2 years (from 2009 to 2010) were assigned to the case group including seven hospitals (n = 3117). Those (seven hospitals) who were not come eligible for the palliative care payment policy were assigned to the control group (n = 2347) with fee for service. The data used in this study were electronically submitted requests of payment to the Health Insurance Review Agency during the period January 2009 to December 2010. RESULTS After the PCD project, the length of stay for palliative patients with cancer diseases decreased by 2.56% (β = -0.026; p-value = 0.0001) among patients hospitalized in a PCD project compared with patients hospitalized in seven hospitals that was not designed as a PCD project. Compared with costs before the PCD project, costs decreased by 0.76% (β = 0.013; p-value = 0.0001). CONCLUSIONS We provided evidence regarding the change in the societal burden due to palliative care. Although there was a reduction of direct medical costs reported in limited number of hospitals, in the long term, we can anticipate an expanding impact on medical costs in all palliative hospitals. Copyright © 2016 John Wiley & Sons, Ltd.
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Sim JA, Shin JS, Park SM, Chang YJ, Shin A, Noh DY, Han W, Yang HK, Lee HJ, Kim YW, Kim YT, Jeong SY, Yoon JH, Kim YJ, Heo DS, Kim TY, Oh DY, Wu HG, Kim HJ, Chie EK, Kang KW, Yun YH. Association between information provision and decisional conflict in cancer patients. Ann Oncol 2015; 26:1974-1980. [PMID: 26116430 DOI: 10.1093/annonc/mdv275] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 06/16/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In this study, we aimed to identify demographic and clinical variables that correlate with perceived information provision among cancer patients and determine the association of information provision with decisional conflict (DC). PATIENTS AND METHODS We enrolled a total of 625 patients with cancer from two Korean hospitals in 2012. We used the European Organization for Research and Treatment of Cancer (EORTC) quality-of-life questionnaire (QLQ-INFO26) to assess patients' perception of the information received from their doctors and the Decisional Conflict Scale (DCS) to assess DC. To identify predictive sociodemographic and clinical variables for adequate information provision, backward selective logistic regression analyses were conducted. In addition, adjusted multivariate logistic regression analyses were carried out to identify clinically meaningful differences of perceived level of information subscales associated with high DC. RESULTS More than half of patients with cancer showed insufficient satisfaction with medical information about disease (56%), treatment (73%), other services (83%), and global score (80%). In multiple logistic regression analyses, lower income and education, female, unmarried status, type of cancer with good prognosis, and early stage of treatment process were associated with patients' perception of inadequate information provision. In addition, Information about the medical tests with high DCS values clarity [adjusted odds ratio (aOR), 0.54; 95% confidence interval (CI) 0.30-0.97] and support (aOR, 0.53; 95% CI 0.33-0.85) showed negative significance. For inadequate information perception about treatments and other services, all 5 DCS scales (uncertainty, informed, values clarity, support, and effective decision) were negatively related. Global score of inadequate information provision also showed negative association with high DCS effective decision (aOR, 0.43; 95% CI 0.26-0.71) and DCS uncertainty (aOR, 0.46; 95% CI 0.27-0.77). CONCLUSION This study found that inadequate levels of perceived information correlated with several demographic and clinical characteristics. In addition, sufficient perceived information levels may be related to low levels of DC.
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Affiliation(s)
- J A Sim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul
| | - J S Shin
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Education & Human Resources Development, Seoul National University Hospital, Seoul, Korea
| | - S M Park
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul
| | - Y J Chang
- Research Institute and Hospital, National Cancer Center, Goyang-si
| | - A Shin
- Department of Preventive Medicine
| | - D Y Noh
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - W Han
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - H K Yang
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - H J Lee
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - Y W Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - Y T Kim
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul
| | - S Y Jeong
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - J H Yoon
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul; Liver Research Institute, Seoul National University College of Medicine, Seoul
| | - Y J Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul; Liver Research Institute, Seoul National University College of Medicine, Seoul
| | - D S Heo
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - T Y Kim
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - D Y Oh
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - H G Wu
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Departments of Radiation Oncology
| | - H J Kim
- Departments of Radiation Oncology
| | - E K Chie
- Departments of Radiation Oncology
| | - K W Kang
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Nuclear Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - Y H Yun
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;.
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Yun YH, Son SY, Kim SH. First Report of Aecidium magnatum Anamorph of Uromyces acuminatus Causing Rust on Viburnum sargentii in Korea. Plant Dis 2013; 97:1251. [PMID: 30722459 DOI: 10.1094/pdis-02-13-0150-pdn] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Viburnum sargentii Koehne belongs to the family Caprifoliaceae. It is a deciduous shrub that grows in wet mountainous area in Korea, Japan, and China. On July 2011, rust symptoms were observed on V. sargentii Koehne in Balwang mountain, Gangwon Province, Korea, at an altitude of 1,450 meters. The specimen was coded as DUCC506 and used to study in detail. Rust symptoms were present on leaves, floral axes, and petioles. The infected lesions slightly swelled and leaflets and leaves were distorted. These caused sharp bends in the petioles and wart-like galls on twigs. Defoliation and deflowering could result when infection was severe. The first symptom was small and pale yellow spots on the upper surfaces of the leaves. As the spots increased in size, they turned brown and tanned. Bright orange or yellow powdery masses of spores were produced in tiny cup-like structures that appeared on the undersurfaces of leaves and the surface of floral axes and petioles. Aecia were gregarious, cupulate, yellowish, and erumpent with a peridium having a lacerate, somewhat recurved margin. Peridial cells were hyaline to whitish, rhomboidal, 18 to 25 (avg. 21.5) × 15 to 20 (avg. 18) μm, smooth to finely verrucose, and not observed in aecial stage on floral axes and petioles. Aeciospores were globose to ellipsoid, 14 to 16 (avg. 15.4) × 15 to 16.5 (avg. 16) μm, hyaline to yellowish, with many verrucose surface and hyaline walls. These morphological properties correspond to the aecial stage of Uromyces acuminatus (1,4). From extracted genomic DNA, the D1 and D2 region of 28S ribosomal DNA was amplified with LROR (5'- ACCCGCTGAACTTAAGC-3') and LR4 (5'-ACCAGAGTTTCCTCTGG- 3') primer set. The 28S rDNA sequence of DUCC506 was deposited in GenBank DNA database under accession number KC570451. A nucleotide sequence similarity search through BLAST in the GenBank database revealed that the DUCC506's 28S rDNA shared 98% (607/622) similarity with that of U. acuminatus LD1005 (GU058004). Aecidium magnatum Arthur is the anamorph of U. acuminatus (2). Aecial and telial hosts of U. acuminatus belong to several families of Angiosperms and Spartina spp., respectively. No telial host was found near the infected aecial host V. sargentii. These morphological and molecular results support the morphological data to identify DUCC506 specimen is A. magnatum. To our knowledge, this is the first report of rust caused by A. magnatum on V. sargentii in Korea or elsewhere in the world. Rust caused by A. viburni was reported on V. sargentii in Korea without any morphological description (3). Peoples in Asia are interested in this host plant as it is used for ornamental and medicinal purpose. Therefore, our report would be useful information for the management of V. sargentii. References: (1) G. B. Cummins. The Rust Fungi of Cereals, Grasses and Bamboos. Springer-Verlag, New York, 1971. (2) D. F. Farr et al. Fungi on Plants and Plant Products in the United States. Page 1009. American Phytopathological Society Press, St. Paul, MN, 1989. (3) C. J. Kim. Kor. J. Micorbiol. 1:51, 1963. (4) H. Y. Yun et al. Plant Dis. 94:279, 2010.
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Affiliation(s)
- Y H Yun
- Department of Microbiology, Dankook University, Cheonan, Chungnam 330-714, Korea. The present research was conducted by the research fund of Dankook University in 2011
| | - S Y Son
- Department of Microbiology, Dankook University, Cheonan, Chungnam 330-714, Korea. The present research was conducted by the research fund of Dankook University in 2011
| | - S H Kim
- Department of Microbiology, Dankook University, Cheonan, Chungnam 330-714, Korea. The present research was conducted by the research fund of Dankook University in 2011
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Stine AE, Nassar D, Miller JK, Clemons CB, Wilber JP, Young GW, Yun YH, Cannon CL, Leid JG, Youngs WJ, Milsted A. Modeling the response of a biofilm to silver-based antimicrobial. Math Biosci 2013; 244:29-39. [PMID: 23628237 DOI: 10.1016/j.mbs.2013.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 04/11/2013] [Accepted: 04/12/2013] [Indexed: 01/21/2023]
Abstract
Biofilms are found within the lungs of patients with chronic pulmonary infections, in particular patients with cystic fibrosis, and are the major cause of morbidity and mortality for these patients. The work presented here is part of a large interdisciplinary effort to develop an effective drug delivery system and treatment strategy to kill biofilms growing in the lung. The treatment strategy exploits silver-based antimicrobials, in particular, silver carbene complexes (SCC). This manuscript presents a mathematical model describing the growth of a biofilm and predicts the response of a biofilm to several basic treatment strategies. The continuum model is composed of a set of reaction-diffusion equations for the transport of soluble components (nutrient and antimicrobial), coupled to a set of reaction-advection equations for the particulate components (living, inert, and persister bacteria, extracellular polymeric substance, and void). We explore the efficacy of delivering SCC both in an aqueous solution and in biodegradable polymer nanoparticles. Minimum bactericidal concentration (MBC) levels of antimicrobial in both free and nanoparticle-encapsulated forms are estimated. Antimicrobial treatment demonstrates a biphasic killing phenomenon, where the active bacterial population is killed quickly followed by a slower killing rate, which indicates the presence of a persister population. Finally, our results suggest that a biofilm with a ready supply of nutrient throughout its depth has fewer persister bacteria and hence may be easier to treat than one with less nutrient.
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Affiliation(s)
- A E Stine
- The University of Akron, Department of Mathematics, Akron, OH 44325-4002, USA
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Yun YH, Shon EJ, Yang AJ, Kim SH, Kim YA, Chang YJ, Lee J, Kim MS, Lee HS, Zo JI, Kim J, Choi YS, Shim YM. Needs regarding care and factors associated with unmet needs in disease-free survivors of surgically treated lung cancer. Ann Oncol 2013; 24:1552-9. [PMID: 23471105 DOI: 10.1093/annonc/mdt032] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To evaluate the long-term needs of lung cancer survivors and to explore factors associated with unmet need. PATIENTS AND METHODS We recruited lung patients treated with curative surgery from 2001 through 2006 at two centers in Korea. Needs in the domains of information, supportive care, education and counseling, and socioeconomic support were measured. We selected the four most frequently reported items of unmet need among 19 items in four domains. RESULTS The most frequently reported unmet needs were Complementary and alternative medicine (CAM) and folk remedies (59.8%) in the Information domain, Counseling and treatment of depression and anxiety (63.5%) in the Supportive care domain, diet, exercise and weight control (55.1%) in the Education and counseling domain and Financial support (90.4%) in the socioeconomic support domain. Unmet needs for psychological treatment was significantly greater in participants who were employed (adjusted odds ratio [aOR], 2.25; 95% confidential interval [CI], 1.12 to 4.53). Unmet needs for diet, exercise and weight control were significantly greater in participants who had not received chemotherapy (aOR, 1.76; 95% CI, 1.09 to 2.85). Unmet need for financial support was greater in participants who were married (aOR, 4.14, 95%CI, 1.12 to 15.22) and those who had not received chemotherapy (aOR, 5.91, 95%CI, 1.91 to 18.31). CONCLUSION There were substantial unmet needs for information regarding psychological support, education for diet and exercise, and financial support among lung cancer survivors.
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Affiliation(s)
- Y H Yun
- Seoul National University College of Medicine, Seoul, Korea
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Yun YH, Lee MK, Park SM, Kim YA, Lee WJ, Lee KS, Choi JS, Jung KH, Do YR, Kim SY, Heo DS, Kim HT, Park SR. Effect of complementary and alternative medicine on the survival and health-related quality of life among terminally ill cancer patients: a prospective cohort study. Ann Oncol 2013; 24:489-494. [PMID: 23110809 DOI: 10.1093/annonc/mds469] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND We evaluated whether complementary and alternative medicine (CAM) use influenced outcomes [survival and health-related quality of life (HRQOL)] of cancer patients whose condition had just been judged terminal. PATIENTS AND METHODS From July 2005 to October 2006, we conducted a prospective cohort study of 481 terminally ill cancer patients at 11 university hospitals and the National Cancer Center in Korea. We assessed how the use of CAM affected HRQOL and survival. RESULTS In a follow-up of 481 patients and 163.8 person-years, we identified 466 deceased cases. On multivariate analyses, CAM users did not have better survival compared with nonusers [adjusted hazard ratio (aHR), 0.91; 95% confidence interval (CI) 0.74-1.10]. Among mind-body interventions, prayer showed significantly worse survival (aHR, 1.56; 95% CI, 1.00-2.43). Clinically, CAM users reported significantly worse cognitive functioning (-11.6 versus -1.3; P < 0.05) and fatigue (9.9 versus -1.0; P < 0.05) than nonusers. Compared with nonusers in subgroup analysis, users of alternative medical treatments, prayer, vitamin supplements, mushrooms, or rice and cereal reported clinically significant worse changes in some HRQOL subscales. CONCLUSION While CAM did not provide any definite survival benefit, CAM users reported clinically significant worse HRQOLs.
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Affiliation(s)
- Y H Yun
- Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul.
| | - M K Lee
- Research Institute and Hospital, National Cancer Center, Goyang
| | - S M Park
- Department of Family Medicine, Seoul National University Hospital and College of Medicine, Seoul
| | - Y A Kim
- Research Institute and Hospital, National Cancer Center, Goyang
| | - W J Lee
- Research Institute and Hospital, National Cancer Center, Goyang
| | - K S Lee
- Research Institute and Hospital, National Cancer Center, Goyang
| | - J S Choi
- Department of Oncology, Gangneung Asan Hospital, Gangneung
| | - K H Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y R Do
- Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu
| | - S Y Kim
- Department of Internal Medicine, Chungnam University School of Medicine, Daejeon
| | - D S Heo
- Department of Internal Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - H T Kim
- Research Institute and Hospital, National Cancer Center, Goyang
| | - S R Park
- Research Institute and Hospital, National Cancer Center, Goyang
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Yun YH, Kim YA, Min YH, Park S, Won YJ, Kim DY, Choi IJ, Kim YW, Park SJ, Kim JH, Lee DH, Yoon SJ, Jeong SY, Noh DY, Heo DS. The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgery. Ann Oncol 2012; 23:2731-2737. [PMID: 22553194 DOI: 10.1093/annonc/mds101] [Citation(s) in RCA: 145] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND We conducted a population-based retrospective cohort study to investigate the influence of hospital volume, delay of surgery, and both together on the long-term survival of postoperative cancer patients. METHODS Using information from the Korea Central Cancer Registry from 2001 through 2005 and the National Health Insurance claim database, we determined survival for 147 682 patients who underwent definitive surgery for any of six cancers. RESULTS Regardless of cancer site, surgical patients in low- to medium-volume hospitals showed significantly worse survival [adjusted hazard ratio (aHR) = 1.36-1.86] than those in high-volume hospitals in multivariable analyses. Among the latter, treatment delays > 1 month were not associated with worse survival for stomach, colon, pancreatic, or lung cancer but were for rectal [aHR = 1.28; 95% confidence interval (CI), 1.17-1.40] and breast (aHR = 1.59; 95% CI, 1.37-1.84) cancer. For patients in low- to medium-volume hospitals, treatment delay was associated with worse survival for all types of cancer (aHR = 1.78-3.81). CONCLUSION Our findings suggest that the effect of hospital volume and surgical treatment delay on overall survival of cancer patients should be considered in formulating or revising national health policy.
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Affiliation(s)
- Y H Yun
- Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul
| | - Y A Kim
- Research Institute and Hospital, National Cancer Center, Goyang; Department of Preventive Medicine, Korea University, Seoul
| | - Y H Min
- Research Institute and Hospital, National Cancer Center, Goyang
| | - S Park
- The Korea Central Cancer Registry, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang
| | - Y J Won
- The Korea Central Cancer Registry, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang
| | - D Y Kim
- Research Institute and Hospital, National Cancer Center, Goyang
| | - I J Choi
- Research Institute and Hospital, National Cancer Center, Goyang
| | - Y W Kim
- Research Institute and Hospital, National Cancer Center, Goyang
| | - S J Park
- Research Institute and Hospital, National Cancer Center, Goyang
| | - J H Kim
- Health Insurance Review and Assessment Service, Seoul
| | - D H Lee
- Department of Oncology, Asan Medical Center, Seoul
| | - S J Yoon
- Department of Preventive Medicine, Korea University, Seoul
| | - S Y Jeong
- Department of Surgery, Cancer Research Institute, Seoul
| | - D Y Noh
- Department of Surgery, Cancer Research Institute, Seoul.
| | - D S Heo
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
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Yun YH, Chung JY, Kang MJ, Huh JT, Park KW, Cha JK. A Retrospective Study on Intracerebral Haemorrhage Reduction by Mri versus Ct in Intravenous Thrombolysis for Acute Ischaemic Stroke. HONG KONG J EMERG ME 2010. [DOI: 10.1177/102490791001700102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Multimodal MRI may be an effective tool for selecting suitable acute ischaemic stroke patients for thrombolysis, reducing the risk of haemorrhage. In this study, we demonstrated the usefulness of our central alerting system to reduce door-to-needle time for thrombolysis following MRI. This system allowed timely intervention and reduced the rate of symptomatic haemorrhage. Methods We reviewed the records of 73 patients with hyperacute ischaemic stroke who received intravenous (IV) tissue plasminogen activator (t-PA) between January 2006 and December 2007 following the adoption of a central stroke alerting system in our hospital. Results Of the 73 patients who received IV t-PA, 44 were based on CT and 29 on MRI findings. The door-to-needle time was 10 minutes longer for the MRI group (49.9±23.2 min) compared to the CT group (39.6±19.7 min) but it was still within the recommended 60 minutes time frame. On the other hand, the rate of symptomatic haemorrhage was lower, though insignificantly, in the MRI group (0%) compared to the CT group (13.6%) (p=0.08). Conclusions In this study, we demonstrated that the combination of diagnostic MRI and a central alerting system might reduce the rate of symptomatic haemorrhage without compromising the door-to-needle time.
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Affiliation(s)
- YH Yun
- Dong-A University College of Medicine, Department of Emergency Medicine, Busan, Korea
| | - JY Chung
- Dong-A University College of Medicine, Department of Emergency Medicine, Busan, Korea
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Kim YT, Kim HC, Inada-Kim M, Jung SS, Yun YH, Jho MJ, Sandstrom K. Evaluation of tissue mimicking quality of tofu for biomedical ultrasound. Ultrasound Med Biol 2009; 35:472-481. [PMID: 19101073 DOI: 10.1016/j.ultrasmedbio.2008.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 04/14/2008] [Accepted: 09/05/2008] [Indexed: 05/27/2023]
Abstract
The tissue mimicking quality of tofu has been evaluated in terms of acoustic properties and acousto/thermal conversion as functions of frequency and diffraction corrected intensity over the 2 MHz to 18 MHz range using three unfocussed transducers with center frequencies of 5 MHz, 10 MHz and 15 MHz. The density and acoustic velocity were close to the American Institute of Ultrasound in Medicine (AIUM) recommended values for the soft tissue, however, the attenuation increases nonlinearly with frequency as alpha = 0.56 x f(1.3). As a result, the temperature rise in tofu due to ultrasound absorption is expressed by the product of the acousto/thermal conversion factor and the attenuation/diffraction corrected acoustic intensity. The decrease of temperature rise with depth measured by embedded thermocouples agrees with the theoretical exponential decrease of the attenuation/diffraction corrected acoustic intensity. The heat capacity per unit mass of tofu is 0.76 cal/g degrees C (equivalent to 3.18 J/g degrees C) of which about 76% is water. The nonlinear frequency dependence of attenuation in tofu as f(1.3) correctly describes the frequency dependence of temperature rise. The present results suggest that tofu may only be used in a limited low MHz range in view of the estimation of temperature rise and penetration depth due to nonlinear frequency dependence of attenuation.
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Affiliation(s)
- Yong Tae Kim
- Division of Physical Metrology, Korea Research Institute of Standards and Science, Yusong, Daejeon, Republic of Korea.
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Kwon YC, Shin DW, Lee JH, Heo DS, Hong YS, Kim SY, Yun YH. Impact of perception of socioeconomic burden on advocacy for patient autonomy in end-of-life decision making: a study of societal attitudes. Palliat Med 2009; 23:87-94. [PMID: 18996980 DOI: 10.1177/0269216308099244] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated the impact of perception of socioeconomic burden on beliefs regarding a patient's autonomy in end-of-life (EOL) decision making. We also sought to identify the characteristics of individuals who advocate patient autonomy and their attitudes toward other EOL issues. A total of 1055 individuals from the Korean general population were interviewed through a telephone survey using a structured questionnaire that was designed to investigate public attitudes toward various EOL issues. Of 1019 individuals included in the analysis, 635 (62.3%) specified the patient and 221 (21.7%) the family, when asked who is the appropriate decision maker in terms of EOL decisions in the absence of perception of socioeconomic burden. In contrast, the numbers were 458 (44.9%) and 500 (49.1%), respectively, if substantial burden was assumed. Respondents who favoured the patient's right to make decisions regardless of perception of socioeconomic burden numbered only 312 (30.6%) and were likely to be younger and have knowledge of hospice than who favoured family decision. Former group also favoured the disclosure of terminal illness to patients, withholding life-sustaining treatment, and preparation of advanced directives. Societal attitudes toward patient autonomy were significantly influenced by perception of socioeconomic burden. Open and balanced discussion about burden to family and adequate welfare support are thus suggested.
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Affiliation(s)
- Y C Kwon
- National Cancer Center, National Cancer Control Research Institute and Hospital, Goyang, Gyeonggi, Korea
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Lee MK, Lee KM, Bae JM, Kim S, Kim YW, Ryu KW, Lee JH, Noh JH, Sohn TS, Hong SK, Yun YH. Employment status and work-related difficulties in stomach cancer survivors compared with the general population. Br J Cancer 2008; 98:708-15. [PMID: 18283298 PMCID: PMC2259191 DOI: 10.1038/sj.bjc.6604236] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Little was known about work situation and work-related difficulties, including housework after stomach cancer diagnosis. We aimed to compare employment status and work-related difficulties between stomach cancer survivors and the general population. We enrolled 408 stomach cancer survivors from two hospitals 28 months after diagnosis and 994 representative volunteers from the general population from 15 geographic districts. Working was defined as being employed (including self-employed) and nonworking as being retired or a homemaker. Nonworking was significantly higher among stomach cancer survivors (46.6%) than in the general population (36.5%). Compared with the general population, the survivors had more fatigue in performing both housework (adjusted odds ratio (aOR)=2.08; 95% confidence interval (95% CI)=1.01-4.29) and gainful work (aOR=4.02; 2.55-6.33). More cancer survivors had reduced working hours (aOR=1.42; 95% CI=4.60-28.35) and reduced work-related ability (aOR=6.11; 95% CI=3.64-10.27) than did the general population. The association of nonworking with older age and being female was significantly more positive for survivors than for the general population. Among survivors, poorer Eastern Cooperation Oncology Group Performance Status and receiving total gastrectomy were positively associated with nonworking. Stomach cancer survivors experienced more difficulties in both housework and gainful employment than did the general population. Our findings on stomach cancer survivors' work-related difficulties and the predictors of nonworking will help physicians guide patients towards more realistic postsurgical employment plans.
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Affiliation(s)
- M K Lee
- Research Institute and Hospital, National Cancer Center, 809 Madu dong, Ilsan gu, Goyang si, Gyeonggi do 411-769, Korea
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12
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Min SD, Yoon DJ, Yoon SW, Yun YH, Lee M. A study on a non-contacting respiration signal monitoring system using Doppler ultrasound. Med Biol Eng Comput 2007; 45:1113-9. [PMID: 17786495 DOI: 10.1007/s11517-007-0246-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2006] [Accepted: 08/18/2007] [Indexed: 10/22/2022]
Abstract
We proposed non-contacting respiration signal monitoring system for sleep apnea syndrome. Experiments were conducted by emitting 40 kHz ultrasound beam, which is set tone burst mode by 1 ms period to a subject chest. Normal respiration condition and a simulated sleep apnea syndrome condition were measured while subjects were holding breath. To obtain the actual respiration signal from the raw signal, ultrasound attenuation characteristics were considered. The Doppler ultrasound signal was detectable once the received signal obtained by demodulation circuits passed through a low pass filter (LPF). The signal's ripples were eliminated by moving average method and the signal's peaks were detected by phase portrait reconstruction method to measure the respiration rate.
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Affiliation(s)
- Se Dong Min
- Department of Electrical and Electronic Engineering, Yonsei University, 134 Sinchon-dong, Seodaemun-gu, Seoul, South Korea.
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13
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Ahn SH, Park BW, Noh DY, Nam SJ, Lee ES, Lee MK, Kim SH, Lee KM, Park SM, Yun YH. Health-related quality of life in disease-free survivors of breast cancer with the general population. Ann Oncol 2006; 18:173-182. [PMID: 17030550 DOI: 10.1093/annonc/mdl333] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although most of the literature about health-related quality of life (HRQoL) focuses on breast cancer patients, few studies compared the HRQoL in disease-free breast cancer survivors with that of the general population. MATERIALS AND METHODS We administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Quality of Life Questionnaire Breast Cancer Module, McGill Quality of Life Questionnaire, Beck Depression Inventory, and Brief Fatigue Inventory to 1933 disease-free survivors for over 1 year after being diagnosed with stage 0 to III breast cancer. We performed multivariate-adjusted analyses in all HRQoL comparisons. RESULTS The scores for some health-related quality of life [corrected] HRQoL scales were comparable for both disease-free breast cancer survivors and the general female population, but [corrected] there was a [corrected] clinically significant difference between the two groups [corrected] in cognitive and social functioning, fatigue, insomnia, financial difficulties, body image, future perspective, breast symptoms, and arm symptoms. [corrected] CONCLUSIONS Disease-free survivors of breast cancer had good HRQoL, which was less affected by the type of treatment than it was by demographic characteristics, time since surgery, comorbidity, fatigue, and depression.
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Affiliation(s)
- S H Ahn
- Department of Surgery, Asan Medical Center, Seoul, Korea
| | - B W Park
- Department of Surgery, Yonsei University Medical Center, Seoul, Korea
| | - D Y Noh
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - S J Nam
- Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - E S Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Gyeonggi, Korea
| | - M K Lee
- Quality of Cancer Care Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Gyeonggi, Korea
| | - S H Kim
- Quality of Cancer Care Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Gyeonggi, Korea
| | - K M Lee
- Quality of Cancer Care Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Gyeonggi, Korea
| | - S M Park
- Quality of Cancer Care Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Y H Yun
- Quality of Cancer Care Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Gyeonggi, Korea.
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14
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Yun YH, Park SM, Lee K, Chang YJ, Heo DS, Kim SY, Hong YS, Huh BY. Predictors of prescription of morphine for severe cancer pain by physicians in Korea. Ann Oncol 2005; 16:966-71. [PMID: 15857848 DOI: 10.1093/annonc/mdi180] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study was undertaken to identify predictors of the prescription of strong opioids, which are important for the management of severe cancer pain, by Korean physicians. METHODS A questionnaire based on a hypothetical case designed to assess the prescription of morphine by physicians was administered to 800 specialists in the Korea Cancer Association, of whom 147 (18.4%) responded, and to 2200 specialists in the Korean Academy of Family Medicine, of whom 388 (17.6%) responded. We used a multidimensional approach to identify the predictors of prescription of morphine by physicians. RESULTS In the hypothetical case scenario, only 16.5% of the respondents stated that they would prescribe morphine for severe cancer pain. Multiple logistic regression analysis showed that physicians with a positive attitude regarding opioid addiction [odds ratio (OR) 2.62; 95% confidence interval (CI) 1.54-4.46], experience of pain assessment (OR 2.09; 95% CI 1.13-3.87), recent residency training (OR 2.27; 95% CI 1.30-4.0) and positive self-evaluation as an oncology specialist (OR 2.60; 95% CI 1.41-4.78) were more likely to prescribe morphine. None of the 13 variables in the knowledge dimension significantly predicted prescription of morphine for severe cancer pain. CONCLUSIONS The results of the survey suggest that we need to develop strategies to develop a positive attitude toward opioids, to increase experience in pain assessment and to improve cancer pain management training among Korean physicians.
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Affiliation(s)
- Y H Yun
- Quality of Cancer Care Branch, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
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15
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Abstract
This study evaluated the Korean version of the EORTC QLQ-C30 (version 3.0) in terms of psychometric properties and its validation. One hundred and seventy patients completed three questionnaires EORTC QLQ-C30, the Beck depression inventory (BDI), and a brief pain inventory (BPI). Multitrait scaling analyses demonstrated that all scales met multidimensional conceptualization criteria, in terms of convergence and discrimination validity. Cronbach's alpha coefficients for eight multiple-item scales were greater than 0.70, with the exception of cognitive functioning. All interscale correlations were statistically significant in the expected direction (p < 0.01). Multivariate analyses showed that physical and emotional functioning were significant explanatory variables for the global quality-of-life (QOL) scale (regression coefficients: 0.36, p < 0.001; and 0.37, p < 0.001; respectively). All scales were significantly associated with pain severity and interference of the BPI, and with the cognitive-affective and somatic scales of the BDI. The emotional-functioning scale was substantially correlated with the cognitive-affective scale and somatic scale of the BDI. These results demonstrate that the Korean version of the EORTC QLQ-C30 is a valid instrument for evaluating Korean-speaking patients with cancer, and can be used to distinguish clearly between subgroups of patients of differing performance status.
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Affiliation(s)
- Y H Yun
- Research Institute and Hospital, National Cancer Center, Goyang, Korea
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16
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Yun YH, Heo DS, Heo BY, Yoo TW, Bae JM, Ahn SH. Development of terminal cancer prognostic score as an index in terminally ill cancer patients. Oncol Rep 2001; 8:795-800. [PMID: 11410786 DOI: 10.3892/or.8.4.795] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cancer patients, families, clinicians, and health-policy administrators need accurate information about the prognosis of survival of terminally ill cancer patients. The aim of this study was to compare survival times and prognostic factors, and develop a new prognostic index for terminally ill cancer patients. This prospective study was performed on 91 patients with solid tumor, and therefore, no longer subjects of anti-cancer therapy. Association was sought between survival times and a range of clinical characteristics. The median survival time of 91 terminal cancer patients was 54.0 days. Univariate analysis showed that 11 factors provide statistically significant prognostic survival information. Multivariate analysis adjusted for the primary tumor site demonstrated that severe anorexia (aRR 1.95, 95% C.I. 1.24-3.05), severe diarrhea (aRR 3.49, 95% C.I. 1.10-11.05), and mild confusion (aRR 1.94, 95% C.I. 1.15-3.27) are independent negative predictors of survival. The Terminal Cancer Prognostic score (TCP score), which was based on three predictors proved to be a significant predictor. The TCP score might be a useful index for predicting survival.
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Affiliation(s)
- Y H Yun
- Department of Family Medicine, National Cancer Center, Koyang, Korea
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17
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Abstract
The diameter of circulating cells that may adhere to the vascular endothelium spans an order of magnitude from approximately 2 microm (e.g., platelets) to approximately 20 microm (e.g., a metastatic cell). Although mathematical models indicate that the adhesion exhibited by a cell will be a function of cell diameter, there have been few experimental investigations into the role of cell diameter in adhesion. Thus, in this study, we coated 5-, 10-, 15-, and 20-microm-diameter microspheres with the recombinant P-selectin glycoprotein ligand-1 construct 19.ek.Fc. We compared the adhesion of the 19.ek.Fc microspheres to P-selectin under in vitro flow conditions. We found that 1) at relatively high shear, the rate of attachment of the 19.ek.Fc microspheres decreased with increasing microsphere diameter whereas, at a lower shear, the rate of attachment was not affected by the microsphere diameter; 2) the shear stress required to set in motion a firmly adherent 19.ek.Fc microsphere decreased with increasing microsphere diameter; and 3) the rolling velocity of the 19.ek.Fc microspheres increased with increasing microsphere diameter. These results suggest that attachment, rolling, and firm adhesion are functions of particle diameter and provide experimental proof for theoretical models that indicate a role for cell diameter in adhesion.
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Affiliation(s)
- V R Shinde Patil
- The Department of Chemical Engineering, Ohio University, Athens 45701, USA
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18
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Koh H, Jee K, Lee B, Kim J, Kim D, Yun YH, Kim JW, Choi HS, Chung J. Cloning and characterization of a nuclear S6 kinase, S6 kinase-related kinase (SRK); a novel nuclear target of Akt. Oncogene 1999; 18:5115-9. [PMID: 10490848 DOI: 10.1038/sj.onc.1202895] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Akt is stimulated by several growth factors, and mediates their cell survival signals. Recent studies have shown that Akt may play an intermediate role between phosphatidylinositol 3-kinase (PI3K) and p70 S6 kinase (p70S6K). Here we show that a novel nuclear p70S6K-related kinase (SRK) exists and that its in vivo function is also augmented by over-expression of Akt. Conceptual translation of the SRK cDNA revealed that the catalytic domain of SRK was highly homologous to that of p70S6K, and that the treatment of wortmannin or rapamycin strongly inhibited the phosphorylation and the activation of SRK, as in p70S6K. However, the N- and C-terminal domains of SRK were quite different from those of p70S6K. In immunolocalization analyses, we demonstrated a constitutive nuclear localization of SRK and the presence of a nuclear localization signal in its C-terminus. In vitro S6 phosphotransferase activities of SRK were stimulated with a slower kinetics by a variety of agonists to p70S6K. Interestingly, over-expression of the proto-oncogene Akt resulted in EGF-independent activation of SRK, while over-expression of kinase-dead Akt actually had an inhibitory effect. This relationship between Akt and SRK suggests that SRK may be a novel target of Akt and perhaps an important downstream component in the nuclear function of Akt.
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Affiliation(s)
- H Koh
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Kusong-dong, Yusong, Taejon 305-701, Korea
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Yoo T, Huh BY, Jeon H, Yun YH. Home telecare system integrated with periodic health reminder and medical record & multimedia health information. Stud Health Technol Inform 1999; 52 Pt 1:265-8. [PMID: 10384458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
The necessity of home telecare system is growing due to increase in desire for health promotion owing to increase in chronic diseases, aged population and medical expenses. Already, we computerized patient's data and offer periodic health reminder to patients for health promotion by using Life-time Health Monitoring Program (LHMP). Our study connected LHMP to the Web on internet by CGI as an electronic medical record; enabling reference to patient's medical records anywhere. The study also made possible video teleconsultation and constructed multimedia database to provide health-related information to the patients. On these bases, a flow chart was developed using the home telecare to practice manage patients with chronic diseases, old patients, and the handicapped. Further standardization in data, establishment of law bases for home telecare system, development of rules for medical fees and active utilization of biomedical telemetry will be needed to extend home telecare system.
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Affiliation(s)
- T Yoo
- Department of Family Practice, Seoul National University Hospital.
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20
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Abstract
We report a case of myelitis after plasma-derived hepatitis B vaccination. The patient was a 31-year-old man who presented with progressive sensory symptoms in extremities that developed 2 weeks after a third vaccination. MRI of the cervicothoracic region revealed swelling and T2 high signal at the level of C4 to C5 cord, and isolated enhancement in the posterior columns between C4 and C5 cord. The significance of MRI findings and HLA haplotype of the patient will be briefly discussed.
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Affiliation(s)
- H K Song
- Department of Neurology, Hallym University Medical College, Kangdong Sacred Heart Hospital, Seoul, Korea
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21
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Yun YH, Turitto VT, Daigle KP, Kovacs P, Davidson JA, Slack SM. Initial hemocompatibility studies of titanium and zirconium alloys: prekallikrein activation, fibrinogen adsorption, and their correlation with surface electrochemical properties. J Biomed Mater Res 1996; 32:77-85. [PMID: 8864875 DOI: 10.1002/(sici)1097-4636(199609)32:1<77::aid-jbm9>3.0.co;2-m] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Two novel metal alloys, Ti-13Nb-13Zr and Zr-2.5Nb, have been engineered for applications in orthopedic implants because of their favorable mechanical properties, corrosion resistance, and compatibility with bone and tissue. These alloys also have the ability to form a hard, abrasion-resistant, ceramic surface layer upon oxidative heat treatment (diffusion hardening, DH). Previous studies have indicated that these and other ceramics cause limited hemolysis and exhibit remarkable structural integrity after extended exposure to physiological environments. Such observations suggest that DH Ti-13Nb-13Zr and ZrO2/Zr-2.5Nb could be used successfully as components in blood-contacting devices. Materials intended for such applications must possess properties that do not elicit adverse physiological responses, such as the initiation of the coagulation cascade or thrombus formation. In the present study measurements of prekallikrein activation, fibrinogen adsorption from diluted human plasma, and the strength of fibrinogen attachment as judged by residence-time experiments were performed to evaluate the potential hemocompatibility of these materials. The results of the prekallikrein activation and fibrinogen-retention studies correlated well with two electrochemical properties of the alloys, the open circuit potential and reciprocal polarization resistance. The results indicate that both the original and treated Ti and Zr alloys activate prekallikrein and adsorb as well as retain fibrinogen in amounts similar to other materials used as components of blood-contacting devices. On the basis of these studies, these alloys appear to be promising candidates for cardiovascular applications and merit further investigation.
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Affiliation(s)
- Y H Yun
- Department of Biomedical Engineering, University of Memphis, TN 38152, USA
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22
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Kwon N, Yoog SH, Yun YH, Jhe W. Observation of oscillations of the optogalvanic signal in an electrodeless discharge. Phys Rev A 1996; 54:1459-1462. [PMID: 9913613 DOI: 10.1103/physreva.54.1459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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23
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Wang JM, Kim DJ, Yun YH. Posterior pedicular screw instrumentation and anterior interbody fusion in adult lumbar spondylolysis or grade I spondylolisthesis with segmental instability. J Spinal Disord 1996; 9:83-8. [PMID: 8793773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Between 1988 and 1993, we treated 21 adults with symptomatic lumbar spondylolysis by a combined surgery of posterior stabilization and anterior interbody fusion. Our indication for this combined surgery was persistent pain that was unresponsive to conservative measures and segmental instability on flexion-extension roentgenogram. The patients' mean age at the time of surgery was 34 years (range 24-42 years). All patients showed degenerated disks on preoperative magnetic resonance imaging. The mean follow-up period was 30.4 months. The clinical result was excellent or good in 95%, and the radiographic fusion was successful in 95%. Prolonged pain at the donor site was the most common complication, which usually disappeared by 3 months after the operation. We recommend the combined surgery of posterior instrumentation and anterior fusion to stabilize symptomatic adult lumbar spondylolysis.
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Affiliation(s)
- J M Wang
- Department of Orthopaedic Surgery, College of Medicine, Ewha Womans University, Seoul, Korea
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Yun YH, Kim NH, Han DY, Kang ES. An investigation of bone necrosis and healing after cryosurgery, phenol cautery or packing with bone cement of defects in the dog femur. Int Orthop 1993; 17:176-83. [PMID: 8340174 DOI: 10.1007/bf00186382] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A corticocancellous core was removed from the lateral condyle of both femurs in 26 skeletally mature dogs. The cavity was treated with cryosurgery, phenol cautery or packing with bone cement. The animals were killed after 1, 4, and 12 weeks in the phenol and cement groups, and also after 24 weeks in the cryosurgery group. The extent of the bone necrosis and healing was assessed in each group. After cryosurgery the extent of necrosis was profound in that the area of damage was 365% compared to the area of the cavity; the depth of necrosis extended between 2.5 and 14 mm, beyond the cavity wall. The effect of phenol was negligible in that only microscopic areas of superficial focal necrosis were found around the cavity wall. Bone cement produced an area of necrosis of 153% compared with the cavity, with a depth of between 1.3 and 2.8 mm. Regeneration in the region of necrosis after cryosurgery was only scanty by 4 weeks, but by 12 weeks considerable areas of regeneration were identified and complete healing was observed by 24 weeks. Regeneration of the necrotized bone produced by bone cement packing was rapid and similar to that of the control specimens. These findings suggest that cryosurgery could play a significant role as a surgical adjunct to curettage in locally aggressive benign bone tumours and in some malignancies. Phenol cautery is not regarded as an adequate treatment after curettage of bone tumours. Although the extent of necrosis was relatively small, packing with bone cement is thought to be a useful choice in benign cases.
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Affiliation(s)
- Y H Yun
- Department of Orthopaedic Surgery, Ewha Womans University Hospital, College of Medicine, Seoul, Korea
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26
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Kim YH, Yun YH. Metastasis of lung carcinoma to proximal femur after hip implant. Orthop Rev 1986; 15:534-9. [PMID: 3453481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Adenocarcinoma of the lung metastasized to the site of hemiarthroplasty for a femoral neck fracture in a 73-year-old woman who had no evidence of preexisting primary or metastatic tumor. The mechanism of the metastasis in this patient remains a question, but it seems likely that metastatic tumor seeding occurred as the result of surgical trauma after the prosthetic implantation.
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Affiliation(s)
- Y H Kim
- Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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