PURPOSE: The study aimed to identity specific needs for services and programs to help childhood cancer survivors adjust and adapt to life after treatment. METHODS: In-depth interviews were conducted with 31 childhood cancer survivors, diagnosed with cancer before the age of 18 and currently between 15 and 39 years of age. Each survivor had completed his/her cancer treatment. RESULTS: The participating cancer survivors reported needs for services related to psychological counseling, schooling and learning, social skills, mentorship, integrated health management, self support activities, families of survivors, and public recognition and awareness. CONCLUSION: The results of the study indicate a need to better understand childhood cancer survivors, provides a basis for developing various services and programs to improve the quality of life among childhood cancer patients, survivors, and their families, and supports the importance of psychosocial adjustment.
Counseling ; Health Services Needs and Demand ; Humans ; Learning ; Mentors ; Qualitative Research ; Quality of Life ; Social Welfare ; Survival Rate ; Survivors ; Child Health

OBJECTIVE: To evaluate the efficacy of low dose gonadotropin releasing hormone agonist(GnRH-a) therapy combined with high dose human menopausal gonadotrpin(hMG) following estrogen & progesteron therapy for poor responders. METHODS: From May 1997 to Feb 1999, 36 patients who were defined as poor responders on previous consecutive two and more superovulation cycles were randomly allocated to lowdose GnRH-a short protocol with high dose hMG protocol pretreated with estrogen & progesterone(E/P therapy)(n=16)(study group) and the clomiphene citrate with hMG(n=20)(control group). All patients were planned to undergone in-vitro- fertilization(IVF) and embryo transfer(ET) after controlled ovarian hyperstimulation(COH). RESULTS: Two groups were similar with respect to clinical features and basal FSH and E2 levels. The mean level of E2 on day 5, 304.3+/-148.ng/ml in study group was significantly higher than that in control group, 182+/-34.9ng/ml. The mean levels of E2 on hCG day was also significantly higher in study group than control group(1324+/-320ng/ml, vs 414+/-168ng/ml). The mean day of hCG day in study group, 12.3+/-0.3 was shorter than that in control group, 13.8+/-0.4. The concellation rates of cycles were significantly lower in study group than control group(13.2% vs 84.2%). But clinical pregnancy rates did not showed the significant difference between two groups. CONCLUSION: The study suggested that a lowdose GnRH-a short protocol with high dose hMG pretreated with estrogen & progesterone can improve the ovarian response in poor responder group.
Clomiphene ; Embryonic Structures ; Estrogens ; Gonadotropin-Releasing Hormone* ; Humans ; Pregnancy Rate ; Progesterone ; Superovulation

Purpose: This study examined the impact of a virtual reality intervention program based on psychological needs on behavioral and psychological symptoms, apathy, and quality of life (QOL) in patients with dementia or mild cognitive impairment living in nursing facilities. Methods: This study is nonequivalent control group pretest-posttest design of quasi-experimental study. The study collected data from November 18, 2020 to July 24, 2021 from patients with dementia or mild cognitive impairment (30 in the experimental group and 30 in the control group) at three nursing facilities in G city using self-reporting and caregiver-informant reporting methods. The analysis employed the chi-square test, Fisher’s exact test, paired t-test, independent t-test, Wilcoxon signed rank test, Mann–Whitney U, repeated measures ANOVA, GEE, using SPSS/WIN 27.0. Results: The severity of behavioral and psychological symptoms (Wald χ2 = 2.68, p = .102) and the care burden of caregivers (Wald χ2 = 1.72, p = .190) were not significant and was no significant time and group interaction effect (Wald χ2 = 0.63, p = .426, Wald χ2 = 0.52, p =. 471). The difference in apathy and QOL score were statistically significant for the group-time interaction (F = 43.65, p < .001; F = 4.35, p= .041). Conclusion The virtual reality intervention program of this study shows a positive effect on the apathy reduction and QOL of patients with dementia or mild cognitive impairment residing in nursing facilities.

No abstract available.
Graves Disease* ; Hypothyroidism*

The loss of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). The collapse of the posterior support will eventually cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance and decreased masticatory function. Patients with destroyed dentition need extensive prosthetic treatments. Proper diagnosis and treatment planning are necessary for the stability of the neuromuscular system and the TMJ, and esthetic and functional definitive restorations. In this case, 63 year-old male presented with decreased masticatory force and esthetic problems due to pathologic destruction of teeth structure on entire dentition. Based on assessment of OVD including intraoral findings, radiographic examination and diagnostic cast, full-mouth rehabilitation with increase of OVD was planned using fixed partial denture and removable partial denture. Diagnostic wax-up was done after 4 mm increase of OVD determined by assessment of OVD. The OVD was maintained with the overlay type removable interim prostheses for 12 weeks to ascertain his comfort and adaptation to the new OVD. After the adaptation period, second interim prostheses with tooth preparation maintaining the established OVD was delivered. After 4 weeks, final prostheses were fabricated and delivered. After 7 month follow-up period, occlusal stability is maintained. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.
Bite Force ; Dentition ; Denture, Partial, Fixed ; Denture, Partial, Removable ; Follow-Up Studies ; Humans ; Male ; Masticatory Muscles ; Prostheses and Implants ; Temporomandibular Joint ; Tooth ; Tooth Preparation ; Tooth Wear ; Vertical Dimension

One of the biggest change in the history of the Journal of Korean Neurosurgical Society(JKNS) had been introduced in 2005. From January 2005, all manuscripts submitted to JKNS should be written in English. This new regulation was followed by many changes in characteristics of the papers published on JKNS in 2005. The authors present an analysis of papers published on JKNS and compared with those of 2004 and 2003. In total, 184 articles were published in 2005. Since a review article was requested by the editorial office to the authors, 183 articles were peer reviewed. Eighty five clinical articles, 75 case reports, 19 laboratory investigations, two special articles and two technical reports were printed. This distribution was not statistically different from 2004's distribution (p=0.67), even though the ratio of clinical articles was decreased to 46.4% from 54.4%. Due to the change in language specification, English articles were increased with statistical significance (p<0.001). There were several events related with copyright of the contents of the papers published on JKNS. We think these are some good points came with change in official language to English. General trends of the papers seemed to be in the right way.
Copyright ; Peer Review

As the detection of thyroid nodules increases, it is important to differentiate whether thyroid nodules are malignant or not. Ultrasonography-guided fine-needle aspiration cytology is the standard method to diagnose thyroid nodules. Ultrasonographic findings of thyroid nodules can predict the risk of malignancy, and fine-needle aspiration allows the examination of cytopathology of thyroid nodules. However, both are not perfect, with a certain degree of false negative or false positive results. Therefore, we can face thyroid nodules with discordant results of ultrasonographic and fine-needle aspiration findings. In the case of benign features on ultrasonography with malignant cytology, follicular thyroid cancer, follicular variant papillary thyroid cancer, cystic or degenerative changes of thyroid cancer, and thyroiditis are candidates for diagnosis. In contrast, for the nodules with ultrasonographic features of highly suspicious of malignancy but benign cytology, we can consider the possibility of thyroiditis, changes of benign nodule, and cystic changes of thyroid cancer. These various conditions may result in discordant results of ultrasonographic features and fine-needle aspiration cytology, which need special attention not to miss the diagnosis of malignant nodules.
Biopsy, Fine-Needle ; Diagnosis ; Methods ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroiditis ; Ultrasonography

As the detection of thyroid nodules increases, it is important to differentiate whether thyroid nodules are malignant or not. Ultrasonography-guided fine-needle aspiration cytology is the standard method to diagnose thyroid nodules. Ultrasonographic findings of thyroid nodules can predict the risk of malignancy, and fine-needle aspiration allows the examination of cytopathology of thyroid nodules. However, both are not perfect, with a certain degree of false negative or false positive results. Therefore, we can face thyroid nodules with discordant results of ultrasonographic and fine-needle aspiration findings. In the case of benign features on ultrasonography with malignant cytology, follicular thyroid cancer, follicular variant papillary thyroid cancer, cystic or degenerative changes of thyroid cancer, and thyroiditis are candidates for diagnosis. In contrast, for the nodules with ultrasonographic features of highly suspicious of malignancy but benign cytology, we can consider the possibility of thyroiditis, changes of benign nodule, and cystic changes of thyroid cancer. These various conditions may result in discordant results of ultrasonographic features and fine-needle aspiration cytology, which need special attention not to miss the diagnosis of malignant nodules.

Spontaneous rupture of intrahepatic cholangiocarcinoma is rare due to its abundant fibrous stroma. We report our experience in a case of spontaneous rupture of intrahepatic cholangiocarcinoma in a pregnant patient. In our case, multiple hepatic masses with intratumoral hemorrhage were noted on post-delivery computed tomography and magnetic resonance imaging and they caused hemoperitoneum. A right hemi-hepatectomy was carried out to control the bleeding and the diagnosis of intrahepatic cholangiocarcinoma with metastasis was performed.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma* ; Diagnosis ; Hemoperitoneum ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pregnancy ; Rupture ; Rupture, Spontaneous*

Objective: To evaluate the accuracy of a multi-stage convolutional neural network (CNN) model-based automated identification system for posteroanterior (PA) cephalometric landmarks. Methods: The multi-stage CNN model was implemented with a personal computer. A total of 430 PA-cephalograms synthesized from cone-beam computed tomography scans (CBCT-PA) were selected as samples. Twenty-three landmarks used for Tweemac analysis were manually identified on all CBCT-PA images by a single examiner. Intra-examiner reproducibility was confirmed by repeating the identification on 85 randomly selected images, which were subsequently set as test data, with a two-week interval before training. For initial learning stage of the multi-stage CNN model, the data from 345 of 430 CBCT-PA images were used, after which the multi-stage CNN model was tested with previous 85 images. The first manual identification on these 85 images was set as a truth ground. The mean radial error (MRE) and successful detection rate (SDR) were calculated to evaluate the errors in manual identification and artificial intelligence (AI) prediction. Results: The AI showed an average MRE of 2.23 ± 2.02 mm with an SDR of 60.88% for errors of 2 mm or lower. However, in a comparison of the repetitive task, the AI predicted landmarks at the same position, while the MRE for the repeated manual identification was 1.31 ± 0.94 mm. Conclusions Automated identification for CBCT-synthesized PA cephalometric landmarks did not sufficiently achieve the clinically favorable error range of less than 2 mm. However, AI landmark identification on PA cephalograms showed better consistency than manual identification.