• Radiation Oncology Journal
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• v.11 no.2
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• pp.377-385
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• 1993

Five hundred and fifty patients treated for carcinoma of the uterine cervix at the Department of Therapeutic Radiology, Seoul National University Hospital from 1979 to 1986, were analyzed retrospectively for late bladder complications. Of them,468 patients received primary radiotherapy for the cervix cancer in intact uterus, and the other 82 patients were treated postoperatively. The cumulative incidence of radiation induced bladder complication of grade 2 or 3 was $2.5\%$ at five years. The mean bladder dose for the group of patients with complication was higher than that of the group without complication, and the difference was statistically significant (p<0.01). But relationship between mean bladder dose and severity of complication was not found. The frequency of complication (grade I, II, III) increased as a function of radiation dose to bladder from $5.0\%$ for patients with bladder dose less than 6,500 cGy to $27.7\%$ for patients with bladder dose higher than 8,000 cGy. Among various factors, the age of patient and the distance between ovoids turned out to have significant effect on the complication.

• Korean Journal of Head & Neck Oncology
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• v.35 no.2
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• pp.11-17
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• 2019

Background/Objectives: Papillary thyroid carcinoma (PTC) has generally an indolent character with a good prognosis. However, recurrence remains a major concern for the patients during their lifetime. Despite the slowly progressing character of PTC, recurrence can occur within a short period after initial surgery. This study aimed to determine the clinical findings and cause of recurrence in patients who underwent re-operative surgery due to neck node recurrence by reviewing the CT (computed tomographic) scan imaging of the recurrence of PTC retrospectively. Materials & Methods: We reviewed the medical records of patients referred to Ajou University Hospital from January 2002 to January 2018. All patients had re-operative surgery due to neck node recurrence and CT scan results of preoperative evaluation and postoperative follow up. Over this period, 110 patients who underwent re-operation due to neck node recurrence with a CT scan were included in our cohort, resulting in a total of 220 re-operations. Results: The time from initial operation to first re-operation was examined in 110 patients. The median time to re-operation was 28 months, with a range of 4 months to 186 months. Most re-operations (82.7%) occurred within the first five years, 43.6% were in the first two years from the initial surgery. The result of the retrospective CT review showed newly developed cases (21,19.1%), missed diagnosis cases (42,38.2%), real recur cases after surgery (33,30.0%), and remnant lymph nodes (LNs) cases (14,12.7%). We further sub-analyzed 14 cases with remnant LNs. Reasons for remnant LNs included insufficient operation (N=5) and beyond general surgical extent. (N=9). Conclusion: Re-operation due to cervical lymph node recurrence is mostly a persistent disease. They included a missed diagnosis and incomplete operation. These finding may reduce the reoperation of cervical lymph node recurrence by accurate preoperative evaluation and complete surgical resection at the initial surgery.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.7.1-7
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• 1977

According to Bryce and Cranston, prolapse of the laryngeal ventricle is a protrusion of the ventricular mucosa into the laryngeal cavity from inflammatory hyperplasia or edema. This 53 year old female patient was admitted to our hospital March 11, 1977 with the chief complaints of dyspnea and hoarseness. On admission, evaluation of the larynx revealed smooth surfaced round pink-reddish mass protruding bilaterally beneath the false cord. The airway was almost completely obstructed by the tumor mass, but neither ulceration nor infiltration was seen, also no lymphnode was palpable in the neck. Tracheotomy was performed for the relief of dyspnea and biopsy was done endoscopically. Histologic study showed chronic inflammation. On April 2, 1977 laryngofissure was performed under general anesthesia. Laryngeal examination revealed smooth surfaced, plate like, pinkreddish mass protruding bilaterally from both laryngeal ventricles into the laryngeal cavity and extending the whole length of the ventricle antero-posteriorly and touching each other. Biopsy was taken of the mass and the result was non-specific inflammatory hyperplasia of the larynx. Postoperatively, the air way is completely clear of obstruction but mild hoarseness still remains. No recurrent mass is visible in the larynx. In view of the symptoms, operative findings and histological findings, this case is diagnosed as "Prolapse of the laryngeal ventricle". The prolapse of the laryngeal ventricle is a very rare lesion and is reported with review of the literature.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.769-774
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• 2001

Background: Descending necrotizing mediastinitis(DNM) is a serious complication originating in odontogenic or oropharyngeal infection with previously reported mortality rates of 25% to 40%. We retrospectively reviewed the 4 years of our surgical drainage and debridement in DNM. Material and Method: We studied 7 cases diagnosed as DNM from 1997 through 2000. Primary oropharyngeal infection lead to DNM in four cases(57%) and odontogenic abscess in three cases(43%). All patients were received emergent cervicotomy and thoracotomy or sternotomy for debridement of necrotic tissue and mediastinal or pleural drainage. Result: Five cases were evolved well and were discharged after a mean of 42 days. Two patients(28.6%) died. Three patients required reoperation due to local surgical complication; empyema(two) and impending cardiac tamponade. One of these patients died on 12 post-reoperative day due to great vessel erosion, renal and respiratory insufficiency. The other patient died of broncho- esophageal fistula and asphyxia on 10 postoperative day without reoperation. Conclusion: On the basis of experience accrued in treating these patients, early diagnosis by cervicothoracic computed tomographic scan of neck and thorax aids in rapid indication of a surgical approach of DNM. We emphasize that performing early surgical drainage and debridement of necrotic tissues with intensive postoperative care can significantly reduce the mortality rate.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.875-881
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• 2006

Purpose : The aims of this study were to analyze the clinical characteristics of children with Kikuchi's disease(KD) at a medical center and to investigate the etiologic role of human herpesvirus 8(HHV 8) or Epstein-Barr virus(EBV) in children with KD. Methods : Twenty six children who were diagnosed as KD between Jan. 1998 and Dec. 2005 were included. Medical records were reviewed on the clinical characteristics of children with KD. Follow up data were collected by chart review and telephone contact. Polymerase chain reaction(PCR) was performed in order to detect HHV 8 DNA, and in situ hybridization(ISH) was perfomed in order to detect EBV RNA from 20 lymph node tissues. Results : There were 15 girls and 11 boys with a mean age of 13 years. Posterior cervical lymph nodes were involved in 72 percent(18/25) of the patients. Extracervical lymphadenopathy was associated in one patient. Fever was an associated symptom in 31 percent(8/26) of the patients. Leukopenia was observed in six (46 percent) patients. The cervical lymphadenopathy usually resolved spontaneously within 6 months. Only one patient had a recurrence of lymphadenopathy with fever during follow-up. No children with KD in our series developed systemic lupus erythematosus. HHV 8 DNA was not amplified by nested PCR in any of the cases, and all cases were negative for EBV RNA by ISH. Conclusion : KD should be differentiated as a cause of cervical lymphadenopathy in children. HHV 8 and EBV may not play major causative roles in KD in children.

• Radiation Oncology Journal
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• v.15 no.2
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• pp.97-104
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• 1997

of $PLC-\gamma$ 1 activity. Results : In the immunohistochemistry, the expression of $PLC-\beta$ was negative for all grnups. The expression of $PLC-\gamma$ 1 was highest in the group III followed by group II in the proliferative zone of mucosa. The expression of PKC-01 was strong1y positive in group I followed by group II in the damaged surface epithelium. The above findings were also confirmed in the immunoblotting study. In the irnrnunoblotting study, the expressions of $PLC-\beta,\;PLC-\gamma\;1,\;and\;PLC-\delta$ were the same as the results of immunohistochemistry The expression of ras oncoprotein was weakly Positive in groups II, III and IV. The of EGFR was the highest in the group II, III, followed by group W and the expression of PKC was weakly positive in the group II and III. Conclusion : $PLC-\gamma$ 1 mediated signal transduction including ras oncoprotein, EGFR, and PKC play a significant role irL mucosal regeneration after irradiation. $PLC-\delta$ 1 mediated signal transduction might have an important role in mucosal damage after irradiation. Further studies will be necessary to confirm the signal transduction mediating the $PLC-\delta$ 1.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.71-74
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• 2002

Purpose : To evaluate the clinical and radiological characteristics of osteochondral ridges of talus and ankle. Materials and Methods : We have analyzed their clinical symptoms and signs, radiologic and CT findings and post-operative results in 17 ankle joints of 14 patients (bilateral in 3), followed them for average 13 months after surgical excision. Results : No definite trauma, but mostly in male after middle age. Their chief complaints are pain on ankle, especially in dorsiflexion or squatting position, and symptom durations are very long, more than average 15 months. Definite diagnosis was made by lateral radiograms of ankle joint. Osteochondral ridges are common in talar neck (10 cases), tibia (4 cases) and both side (3 cases). After excision of osteophytes, all patients gained normal ankle without pain and any limited motion. Conclusions : Anterior impingement syndromes are common in middle aged male, but no definite correlation with sports. Plantar and dorsiflexed lateral radiographs are helpful in definite diagnosis for impingement, and surgical excision is best for treatment.

• Journal of Preventive Medicine and Public Health
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• v.36 no.3
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• pp.255-262
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• 2003

Objectives : We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. Methods : Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1:1 , Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test, Results : Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, add systolic blood pressure. From multivariate regression analysis, there was significant difference (p<0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. Conclusions : We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier defection for neurological abnormality in lacunar infarction.

• Radiation Oncology Journal
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• v.19 no.4
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• pp.345-352
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• 2001

Purpose : To evaluate the treatment results and prognostic factors after radiotherapy in stage IIB uterine cervix cancer. Materials and methods : We retrospectively analyzed the records of 90 patients with stage IIB uterine cervix cancer who received radiotherapy between 9/94 and 12/99. Age was ranged from 28 to 79 years (median 57). Tumor size was $\geq4\;cm$ in 64 patients. Preteatment SCC level was measured in 75 patients. Twenty nine patients received conventional radiotherapy (QD) and the others received modified hyper-fractionated radiotherapy (BID). Only 7 patients in BID had tumor size <4 cm. All patients received high dose rate brachytherapy $(4\;Gy\times7\;or\;5\;Gy\times6)$. No Patient received concurrent chemotherapy during radiotherapy. Follow up period was ranging from 9 to 76 months (median 38). Results : The 5-year overall and disease free survival rates were $73.4\%\;and\;71.6\%$, respectively. Local recurrences occurred in $10\%$ of patients, and distant metastasis in $18.9\%$. There was a significant correlation between OS/DFS and tumor size $(<4cm;\;OS\;95.2\%,\;DFS\;91.4\%,\;\geq4cm;\;OS\;63.4\%,\;DFS\;63.4\%)$. Pretreatment SCC level was one of prognostic factors only in univariate analysis. Conclusion : With modified hyperfractionated radiotherapy, there was very low local recurrence rate $(6.6\%)$ and high 5-year overall and disease free survival rate $(75.4\%\;and\;70.5\%)$, which is comparable to results after concurrent chemoradiotherapy in bulky, locally advanced stage IIB uterine cervix cancer.

• Radiation Oncology Journal
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• v.27 no.3
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• pp.120-125
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• 2009

Purpose: We wanted to present the preliminary results of intensity-modulated radiotherapy (IMRT) for the treatment of tonsillar cancer. Materials and Methods: We retrospectively analyzed 12 patients who underwent IMRT for tonsillar cancer at Asan Medical Center between November 2002 and February 2007. Seven patients (58%) received definitive treatment, and five (42%) were treated in the postoperative setting. Among the definitively treated patients, 6 patients received cisplatin-based chemotherapy regimens. Simultaneous modulated accelerated radiation therapy (SMART) was used in nine patients. The prescribed dose was 72 Gy at 2.4 Gy/fraction for the definitively treated cases and 61.6 Gy at 2.2 Gy/fraction for the postoperative cases. The median follow-up period was 34 months. Results: All twelve patients completed treatment without interruption, and eleven showed a complete response. One patient had persistent loco-regional disease after treatment. The three-year estimates of loco-regional control, disease-free survival and overall survival were 91.7%, 91.7%, and 100%. The worst acute mucositis was Grade 1 in four patients, Grade 2 in five patients, Grade 3 in two patients and Grade 4 in one patient. Grade 3 xerostomia was observed in six patients. Conclusion: Intensity-modulated radiotherapy was shown to be a safe and effective treatment modality for tonsillar cancer. Further studies with a larger number of patients and a longer follow-up period are needed to evaluate the ultimate tumor control and late toxicity of IMRT for treating tonsillar cancer.