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LONG-TERM EVALUATION OF A $SnF_2$ GEL FOR CONTROL OF GINGIVITIS AND DECALCIFICATION IN ADOLESCENT ORTHODONTIC PATIENTS (청소년 교정환자들의 치은염 및 치아탈회 조절을 위해 사용한 겔형 불화주석($SnF_2$ gel)의 장기간 평가)

  • Boyd, Robert L.;Chun, Youn-Sic
    • The korean journal of orthodontics
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    • v.25 no.3 s.50
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    • pp.235-245
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    • 1995
  • The purpose of this paper is to review two recently reported, long-term studies of several chemical methods to control gingivitis and decalcification in adolescent orthodontic patients. The first study(gingivitis study) was designed to determine whether conventional toothbrushing and twice daily use of a brush-on 0.4 per cent $SnF_2$ gel containing more than 90 per cent available $Sn^{2+}$ would be more effective for controlling plaque accumulation and gingivitis in the presence of orthodontic appliances than conventional toothbrushing alone. The second study(decalcification study) was designed to compare the effectiveness of controlling decalcification in orthodontic patients with either a II00 ppm F tooth paste used alone, this same toothpaste and a 0.05 percent NaF rinse or this toothpaste and a 0.4 percent $SnF_2$ gel. In the gingivitis study, sixty-five consecutively treated adolescents who were to receive full-mouth fixed orthodontic appliances were assigned to two groups according to age and sex criteria. In the decalcification study an additional 30 subjects(95 total) were similarly assigned to a third group. The first group(control, n=35) used only toothbrushing with a standard fluoride(1100 ppm F) toothpaste. The second group used toothbrushing with a similar dentifrice supplemented with a 0.4 percent $SnF_2$ gel($SnF_2$ gel group, n=30) used twice daily for the entire 18-month study period. The third group(in the decalcification study only) used a similar toothpaste and 0.05 percent NaF rinse(NgF rinse group, n=30). Clinical assessments of plaque accumulation using the Plaque Index, gingival inflammation using the Gingival Index, and coronal staining were completed single-blinded before appliances were placed and 1, 3, 6, 9, 12 and 18 months after appliances were placed. Decalcification was assessed single blind on all labial surfaces of all erupted teeth before appliances were placed and 3 months after appliances were removed. The results of the gingivitis study indicated that the $SnF_2$ gel gorup had significantly lower scores for the Plaque Index(p<0.01) and Gingival Index(p<0.001) at all examinations during orthodontic treatment than did the control group. In the $SnF_2$ gel group, one subject developed mild coronal staining and two subjects developed moderate staining. In the decalcification study, when pre-treatment levels of decalcification were subtracted from post-treatment values, significantly lower decalcification scores(p<0.05) were found for both whole mouth and first molars in the NaF rinse and gel groups as compared with the control gorup(toothpaste alone). Although the gel group consistently had less decalcification than the rinse group, this difference only approached statistical significance.

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Results of Treatment for Children with Primary Brain Tumors : Long-Term Follow Up Results of a Single Institute (소아 원발성 뇌종양의 치료 결과 : 단일 기관에서의 장기간 추적 관찰)

  • Choi, Sung-Yeon;Won, Sung-Chul;Lyu, Chuhl-Joo;Oh, Seung-Hwan;Yang, Chang-Hyun;Suh, Chang-Ok;Choi, Joong-Uhn;Kim, Byung-Soo
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1016-1023
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    • 2002
  • Purpose : Brain tumors are the most common solid tumor in children. We retrospectively investigated the clinical characteristics of pediatric brain tumors, such as age, sex, tumor site and survival, as seen in a single institution over the last 15 years. We tried to evaluate the role of chemotherapy on the survival of some brain tumors. Methods : Three hundred fifty four children with primary brain tumor who were treated at Severance Hospital from Jan. 1985 to Sep. 2001 were enrolled. Results : Pediatric brain tumors were found most frequently in 10-15 years of age group(35.3%) and the ratio of male to female was 1.3 : 1. Supratentorial tumors(52%) were more frequent than infratentorial tumors(48%). Medulloblastoma/primitive neuroectodermal tumor(PNET) was the most common type(24.6%), followed by cerebellar astrocytoma(14.1%). Ten year survival rate of medulloblastoma, cerebellar astrocytoma and cerebral astrocytoma were 59.4%, 79.3% and 71%, respectively. The prognosis for brain stem glioma and glioblastoma multiforme were still grim with a 10 year survival rate of 12.7% and 13.3%, respectively. The addition of chemotherapy for high grade medulloblastoma led to an improved 10 year survival rate of 54.5%, compared with 40% without chemotherapy. Conclusion : The combined use of chemotherapy and radiation and surgery improved survival rate of pediatric brain tumors in our study. Chemotherapy for high grade medulloblastoma improved the 10 year survival rate. Further data analysis of the treatment modalities will lead to better comparisons.

Division of the N2 Stage According to the Multiplicity of the Involved Nodal Stations May be Necessary in the N2-NSCLC Patients Who are Treated with Postoperative Radiotherapy (비소세포성 폐암으로 수술 후 방사선치료가 시행된 N2병기 환자들에서 다발 부위 종격동 림프절 전이 여부에 따른 N2병기 구분의 임상적 의미)

  • Yoon, Hong-In;Kim, Yong-Bae;Lee, Chang-Geol;Lee, Ik-Jae;Kim, Song-Yih;Kim, Jun-Won;Kim, Joo-Hang;Cho, Byung-Chul;Lee, Jin-Gu;Chung, Kyung-Young
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.126-132
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    • 2009
  • Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

Failure Pattern of Pineal and Ectopic Pineal Germ Cell Tumor after Gamma Knife Radiosurgery (송과선 및 이소성 송과선 생식세포종의 감마 나이프 수술 후 재발 양상)

  • Cho, Heung-Lae;Sohn, Seung-Chang
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.92-100
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    • 2000
  • Purpose :This study was performed to determine the optimal treatment velum of Patients treating with radiation therapy for intracranial germ cell tumor. Materials and Methods : From 1993 to 1998, 19 patients with intracranial germ cell tumors treated by gamma knife radiosurgery were analyzed. The location of tumor was as follows; 9 cases on pineal region, 1 case on suprasellar region, and 9 cases of multiple lesion. 7 patients were pathologically verified; 5 cases of germ cell tumor and 2 cases of non germinomatous germ cell tumor. Tumor volume was ranged from 2.4 cm$^{3}$ to 74 cm$^{3}$. Irradiation dose was 10 Gy to 20 Gy with 50% isodose curve. Follow up period was 10 months to 54 months. Results : Recurrences were observed in 14 cases among 19 (74%) patients. Complete remission and partial remission were achieved in 2 (11%) and 10 (53%) respectively. No response was observed in 7 (36%). 2 cases were recurred within original tumor bed. 6 cases were recurred beyond but contiguous with tumor bed. Ventricular relapses separated from pretreatment tumor bed were 3. Spinal recurrences were 4. Among 8 recurred cases of which tumor volume is smaller than 20 cm$^{3}$, 2 were recurred within original tumor bed, 4 were recurred beyond but contiguous with tumor bed, and 1 spinal recurrence. Meanwhile, 6 cases of which tumor volume larger than 20 cm3, 1 case was recurred beyond but contiguous with tumorbed, 2 ventricular recurrences separated with original tumor bed, and 3 spinal recurrences. 5 cases which did not show any recurrence sign showed characteristics of single lesion, tumor volume smaller than 20 cm$^{3}$ and normal tumor marker. All of 4 cases of spinal recurrences happened in the case having ventricular invasion or lesion. Among 9 cases having multiple lesion, only 3 cases recurred within original tumor bed or around tumor bed, the other 6 cases recurred separated from pretreatment tumor bed. Conclusion : Gamma knife radiosurgery is not recommended for the treatment of intracranial germ cell tumor. It is because of small treatment volume and inadequate radiation dose that are characteristics of gamma knife radiosurgery. Tumor volume, ventricular invasion or ventricular lesion in multiple lesion are important factors to be considered for the wide field radiation therapy Tumor volume smaller than 20 cm$^{3}$, single lesion, no ventricular lesion or invasion, and normal tumor marker are ideal indications for small involved field radiation therapy. Prophylactic spinal irradiation seems to be necessary when there is ventricular lesion, ventricular invasion, and multiple lesions. When the tumor volume is larger than 20 cm$^{3}$, multiple lesions, abnormal tumor marker, and whole ventricular irradiation or partial brain irradiation would be possible and neoadjuvant chemotherapy would be most beneficial in these group.

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The reliability of the cephalogram generated from cone-beam CT (Cone-beam CT로부터 제작된 측모 두부계측방사선사진의 정확도 평가)

  • Kang, Ji-Young;Kim, Kwang-Won;Lim, Sung-Hoon
    • The korean journal of orthodontics
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    • v.37 no.6
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    • pp.391-399
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    • 2007
  • Three-dimensional approaches for the diagnosis and analysis of the dentofacial area are becoming more popular in accordance with the development of cone-beam CT (CBCT). The purposes of this study were to evaluate the reliability of cephalometric measurements of lateral cephalograms generated from a CBCT image by making comparisons with the traditional digital lateral cephalogram, and to evaluate the possibility of the clinical application of CBCT generated cephalogram images. Methods: Twenty patients whose external auditory meatus could be identified in the CBCT image were selected, and both CBCT and digital cephalograms were taken. Differences between the measurements of both cephalograms were tested by paired t-test. Results: Among the 22 measurements used, only U1-FH, Mx6 to PTV, and maxillomandibular difference showed statistically significant differences between the CBCT generated cephalogram and the digital cephalogram. Conclusions: The results suggest that the CBCT generated cephalogram can be used for some cephalometric measurements not requiring porion, PTV, condylion as a landmark (SNA, SNB, U1 to SN, IMPA, interincisal angle, etc.).

An Improved Online Algorithm to Minimize Total Error of the Imprecise Tasks with 0/1 Constraint (0/1 제약조건을 갖는 부정확한 태스크들의 총오류를 최소화시키기 위한 개선된 온라인 알고리즘)

  • Song, Gi-Hyeon
    • Journal of KIISE:Computer Systems and Theory
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    • v.34 no.10
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    • pp.493-501
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    • 2007
  • The imprecise real-time system provides flexibility in scheduling time-critical tasks. Most scheduling problems of satisfying both 0/1 constraint and timing constraints, while the total error is minimized, are NP-complete when the optional tasks have arbitrary processing times. Liu suggested a reasonable strategy of scheduling tasks with the 0/1 constraint on uniprocessors for minimizing the total error. Song et at suggested a reasonable strategy of scheduling tasks with the 0/1 constraint on multiprocessors for minimizing the total error. But, these algorithms are all off-line algorithms. In the online scheduling, the NORA algorithm can find a schedule with the minimum total error for the imprecise online task system. In NORA algorithm, EDF strategy is adopted in the optional scheduling. On the other hand, for the task system with 0/1 constraint, EDF_Scheduling may not be optimal in the sense that the total error is minimized. Furthermore, when the optional tasks are scheduled in the ascending order of their required processing times, NORA algorithm which EDF strategy is adopted may not produce minimum total error. Therefore, in this paper, an online algorithm is proposed to minimize total error for the imprecise task system with 0/1 constraint. Then, to compare the performance between the proposed algorithm and NORA algorithm, a series of experiments are performed. As a conseqence of the performance comparison between two algorithms, it has been concluded that the proposed algorithm can produce similar total error to NORA algorithm when the optional tasks are scheduled in the random order of their required processing times but, the proposed algorithm can produce less total error than NORA algorithm especially when the optional tasks are scheduled in the ascending order of their required processing times.

Determinants of Successful Percutaneous Transluminal Coronary Angioplasty (경피적 관상동맥 성형술의 성공율에 영향을 미치는 인자에 대한 고찰)

  • Choi, Kyo-Won;Kweon, Jun-Young;Kim, Young-Jin;Lee, Tae-Il;Shin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Seup;Lee, Hyun-Woo;Lee, Sam-Beom
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.230-239
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    • 1994
  • In Order to evaluate determinants of successful percutaneous transluminal coronary angioplasty (PTCA), PTCA was performed for 172 coronary arterial lesions in 120 patients (89 male, 31 female) at Yeungnam university hospital from Sep. 1992 to Aug. 1993. The corinary artery luminal diameter at the site of the original stenosis was eveluated from end-diastolic frames of identical projections of the preangioplasty and immediate post angioplasty. The coronary luminal and balloon diameters were measured with using of computer measuring system. Overall success rate of 172 attempted lesions was 87.2%. Success rate of female patients was 93.5% and higher than those of male patients. According to the clinical diagnosis, success rate in stable angina was 93.7% and higher than those of post myocardial infarction angina, unstable angina and acute myocardial infarcrion. Success rate of American Heart Association type C lesion was 65.5% and lower those of type A (95.7%), type B (89.5%). There was signfifcantly difference in preangioplasty luminal stenosis, elastic recoil and length of lesion between successful PTCA group and failed PTCA group. Success rate of lesion location at a bend > $45^{\circ}$ and presence of intracoronary thrombus were lower than than those of other angiographic findings. In coclusion, primary angioplasty success was affected by specific angiographic factors. Stenosis severity, thrombus, lesion location at a bend > $45^{\circ}$, elastic recoil, and length of lesion were the principle of determinants of coronary angioplasty success rate.

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High-Dose-Rate Intraluminal Brachytherapy for Biliary Obstruction by Secondary Malignant Biliary Tumors (속발성 담도부 종양에 의한 담도 폐쇄에서 고선량률 관내 근접치료)

  • Yoon Won-Sup;Kim Tae-Hyun;Yang Dae-Sik;Choi Myung-Sun;Kim Chul-Yong
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.35-43
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    • 2003
  • Purpose :To analyze the survival period, prognostic factors and complications of patients having undergone high-dose-rate intraluminal brachytherapy (HDR-ILB) as a salvage radiation therapy, while having a catheter, for percutaneous transhepatic billary drainage (PTBD), inserted due to biliary obstruction caused by a secondary malignant biliary tumor Methods and Materials : A retrospective study was performed on 24 patients having undergone HDR-ILB, with PTBD catheter Insertion, be)ween December 1992 and August 2001. Their median age was 58.5, ranging from 35 to 82 years. The primary cancer site were the stomach, gallbladder, liver, pancreas and the colon, with 12, 6, 3, 2 and 1 cases, respectively. Eighteen patients were treated with external beam radiation therapy and HDR-lLB, while slx were treated with HDR-lLB only. The 4otal external beam, and brachytherapy radiations dose were 30$\~$61.2 and 9$\~$30 Gy, with median doses of 50 and 15 Gy, respectively. Results : Of the 24 patients analyzed, 22 died during the follow-up period, with a median survival of 7.3 months. The 6 and 12 months survival rates were 54.2 (13 patients) and 20.8$\%$ (5 patients), respectively. The median survivals for stomach and gailbladder cancers were 7.8 and 10.2 months, respectively, According to the unlvariate analysis, a significant factor affecting survival of over one year was the total radiation dose (over 50 Gy) (o=0.0200), with all )he patients surviving more than one year had been Irradiated with more than 50 Gy. The acute side effects during the radiation therapy were managed with conservative treatment. During the follow-up period, 5 patients showed symptoms of cholangltis due to the radiation therapy Conclusion :An extension to the survival of those patients treated with HDR-ILB is suggested compared to the median historical survival of 4hose patients treated with external biliary drainage. A boost radiation dose could be effectively given, by performing HDR-lLB, which is a prognostic factor In addition, the acute complications of radiation therapy were effectively controlled by conservative management, and It could be regarded as a safe treatment.

Bloodstream Infections in Children with Cancer between 2005 and 2008 in a Single Center (2005-2008년 단일 기관의 소아 혈액 종양 환자에서의 균혈증 양상: 소아 혈액 종양 환자에서의 균혈증)

  • Kim, Ji Hye;Kim, Hyung Jin;Lim, Yeon Jung;Lee, Young Ho;Oh, Sung Hee
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.36-48
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    • 2010
  • Purpose : In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. Methods : All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. Results : Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P =0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P =0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P =0.001). Conclusion : The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.

Questionnaire-based analysis of growth-promoting attempts among children visiting a university growth clinic (대학병원 성장클리닉을 내원한 아동에서 설문 조사를 통한 키성장 관리 실태분석)

  • Huh, Kyoung;Park, Mi Jung
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.576-580
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    • 2009
  • Purpose : Growth-promoting attempts are widespread in Korea, but little is known about their prevalence or associated factors. This study was designed to assess the prevalence of growth-promoting attempts among children visiting a university growth clinic. Methods : A questionnaire-based survey was carried out with 823 children (416 boys, 407 girls) who visited the growth clinic at Paik Hospital. Results : The mean age of the subjects was $10.4{\pm}2.6$ yr, and the height z-score was $-1.58{\pm}0.91$. Approximately 33.4% of the children had tried growth promotion. Among the height-gain methods, herbal medicine was the most frequently used (37.8%), followed by health-promoting supplements (37.1%), exercise or machine (3.0%), and growth hormone treatment (2.9 %). The mean age at which the parents began to worry about their children's height was 7.7 yr. The mean age at which they started height-gain methods was 8.9 yr for herbal medicine, 9.1 yr for health-promoting supplements, 9.4 yr for exercise or machine, and 9.9 yr for growth hormone treatment. Motivating factors included advice from relatives or friends (36.0%), advertisements in the Internet or newspaper (28.4%), advice from pharmacist (16.8%), and advice from their medical doctor (5.5%). The degree of satisfaction from the height-gain methods was 29.1% with growth hormone treatment, 6.6% with exercise or machine, 6.4% with herbal medicine, and 2.8% with growth-promoting supplements. Conclusion : Approximately one third of the children reported use of growth-promoting methods, but the satisfaction rate was not high. The benefits of growth-promoting methods should be carefully weighed against their costs and side effects.