• Radiation Oncology Journal
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• v.35 no.1
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• pp.65-70
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• 2017

Purpose: To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Methods and Materials: Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip_p, ${\leq}2cm$) and 3 distal clips (clip_d, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. Results: The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Conclusion: Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.11 no.1
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• pp.88-98
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• 2011

Lesch-Nyhan syndrome is a X-linked recessive disorder caused by a deficiency of the enzyme hypoxanthine-guanidine phosphoribosyltransferase (HPRT), enzyme to recycle purines. Case history: born induced vaginal delivery at 40 weeks complicated by premature membrane ruputure, body weight 2.820 gm. He showed failure to thrive showing severe protein aversion like milk products and pink daper. Developmental delay revealing rolling over at 10.5 month, followed by regression. Seizure at 2 months, His poor oral feeding was lifelong problem. Weak crying, spastic, choreoathetoid movement. Self mutilating behavior noted and diagnosed at age 3 years. No family history of consanguinity and neurological disorders. Method: Laboratory test, physical exam, imaging study and molecular. Clinical follow up Treat ment with allopurinol. Result: uric acid 10.5 mg/dL (N 3.5-7.9), APRT 151.1uM/ min/ml pro(25.7-101), HPRT 7.6 (N 233.5-701) and c.151C>T hemizygote (p,Arg51X). Abdominal sonogram showed staghorn calculi in both kidneys, brain MRI brain atrophy. Clinical follow up showed, seizure at 2 mo, developmental delay (head control and, rolling over at at 11mo, pointing body part at 2 yr 7 mo, eye hand coordination at 2 y 11mo,creeping at 3 y 7 mo, speaking words at 6 y 6 mo ),and developmental regression at 3 yr of age. Sleeping problem including insomnia and severe constipation. Self mutilating behavior (lip bite) started at 2.5 yr, neurologic sx including intermittent upward gaze accompanied by swallowing difficulty at 3 y 7 mo grand mal seizure at 4.5 yr and spastic extremity and trunchal hypotonia and choleoathetoid movement and ataxia at 6.5 yr. Scoliosis with severe spasticity at 9 yr 9 mo. Acute life threatening episode with irregular breathing at 9 yr and 9 mo, Emaciation and nephrolithiasis and recurrent pneumonia. Died suddenly at 10 yr 3 mo. Conclusion: life long feeding problem, chronic gut motility dysfunction, sleeping difficulty and progressing neurologic deterioration and nephrolithiasis despite normal serum uric acid maintence by allopurinol treatment.

• Phonetics and Speech Sciences
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• v.2 no.4
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• pp.165-171
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• 2010

Vocal process granuloma can occur commonly by laryngopharyngeal reflux (LPR), vocal abuse or misuse. It has been reported that voice therapy is employed with medication therapy for the patients who has vocal process granuloma, however research about effect of voice therapy can be hardly founded. For that matter, the primary aim of this study was to evaluate the effect of therapeutic method we implement. Thirty one patients who has been diagnosed with vocal process granuloma from January, 2007 to June, 2009 participated in this study. 19 patients among them are provided voice therapy and medication, 12 patients take only medication. Voice therapy is implemented ranging from 5 to 19 sessions (mean: 8.6 sessions). We provided explanation about problem each patient has, voice rest, SKMVTT$^{(R)}$, abdominal breathing, and relaxation in session. All subjects were examined by videostroboscopy, perceptual assessment, acoustic and aerodynamic measures. Consequantly, the greater part of the patients (78.9%) who is treated by voice therapy and medication are confirmed disappearance or decrease of granuloma, it shows better results compared with the group provided only medication (66.7%). Especially, the period of drug administration is 3.7 months in the group runs parallel with voice therapy, the period of other group is 7.8 months. The results of acoustic and aerodynamic measures after treating indicates there are significant decrease in Jitter, Shimmer, and NHR, and increase in MPT, Psub (p<.05). However, there is no large difference statistically even though voice quality has improved since the therapy. In conclusion, it is verified that the voice therapy to the vocal process granuloma patients taking medication is effectual method, we recommend combining voice therapy with medication when treatment is needed for the vocal process granuloma patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.5
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• pp.509-519
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• 2013

Through the study on judgment of Body form and settle Energy flow(立形定氣) before diagnose the patients, the results are as follows. The observation of the body form is to determine prosperity and deficiency of each internal organ. It is necessary to distinguish Body form loss(形脫) and Body form fullness(形充). Fat man(肥人), Thin man(瘦人), Creamy man(膏人), Muscular man(肉人), Small Fat man(脂人) are discriminated by fat distribution, fat content, and muscle mass. The observation of the body form means the observation of structure disorder, color change, develop part at body, head and face. The observation of the body form that is to determine prosperity and deficiency of each internal organ is from the limited knowledge of the anatomy. The observation of face color is considered by blood perfusion, blood oxygenation and accumulation of carotinoid, bilirubin and change of melanin in the facial skin. The prosperity and the deficiency of energy flow is considered by symptom combined with growth (<40 years) and aging (>40 years). The prosperity of energy flow includes the anger, anxious emotion and the deficiency of energy flow includes the fear, depressive emotion. The breathing type is expiratory exhalation like asthma patients in the prosperity of energy flow. The deficiency of energy flow is weakness to overcome the disease. The prosperity and the deficiency of energy flow are considered by body metabolic ratios (Basal metabolic Rate: BMR, Resting metabolic rate: RMR, Physical activity ratios: PASs). Development of subcutaneous fat is good in the person of prosperous energy flow. The person of prosperous energy flow is hard to overcome to heat weather than cold weather. The person of deficiency of energy flow has tendencies of low blood pressure, insufficiency of blood flow in the peripheral and being shocked. The person of deficiency of energy flow has tendencies of chronic fatigue syndrome or automatic nerve disorder. If the patient who has deficiency of energy flow has severe weight loss should be checked for the presence of disease. The observation of small and large of bone is to check the development and disorder of bone growth and aging. The observation of thickness and weakness of muscle is to check the development of muscle, particularly biceps, gastrocnemius, and rectus abdominal muscle. The observation of thickness and weakness of skin is to check the ability of regulating body temperature by sweating.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.7-14
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• 2001

Cases of green tobacco sickness were described. During the cutting of tobacco plants throughout harvest, four cases of green tobacco sickness occurred in August 2001, Korea. The range of age was 42-55 years. The most frequent symptoms included dizziness, weakness, nausea, vomiting, abdominal cramps, headache, and difficulty breathing. All affected individuals worked in fields of wet tobacco, where their clothes became wet from moisture on the plants or sweating. They were all healthy, except one with hypertension. They are all non-smokers. They recovered after fluid and antiemetic administrations within two days. Most of doctors misdiagnosed their symptoms as a pesticide poisoning or heat injury. Green tobacco sickness is a condition that has long been known as an occupational health risk among tobacco harvesters. Nicotine poisoning by dermal absorption is reported to be the cause of green tobacco sickness. In Korea, there are many tobacco harvesters, and most of them may be sticken with green tobacco sickness. But, no case of green tobacco sickness has been reported. We report cases of green tobacco sickness occurred to the tobacco harvesters with a review of articles.

• Journal of Korean Biological Nursing Science
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• v.4 no.2
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• pp.79-92
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• 2002

This study was aimed to analyze the variables measuring stress and immune responses, to identify the relationship between stress and immune responses, and to find out the effect of nursing interventions associated with stress and immune responses by reviewing thirty-four published articles since 1970 in Korea. The articles were selected in the field of nursing, stress management, and masters or doctoral dissertations and limited to human subject. Among these, the thirty-one articles were published since 1996 and mainly distributed in nursing (44.1%) and medicine(44.1%). The prevailing research design was nonequivalent control pre-post experimental design(41.1%). The research subjects were 55.9% for patients and 44.1% for healthy general persons including 20.6% of university students. To evaluate stress, both physiologic and psychosocial measures were adapted together in 35.3% of the articles. The most frequent two variables measuring stress and immune response were cortisol level(15.9%) and number or activity of natural killer cell(25.9%). The relation between stress and immune responses was positive in 4 articles, negative in 9 cases, and none in 12 cases. Decreased stress and enhanced immune function have been found when massage, abdominal breathing, exercise, relaxation, and touch were provided as nursing interventions. The articles to investigate the relationship between stress and immune function were limited and the tested variables were diverse. Also there was no consistent evidence to correlate the stress and immune function at present. Further studies are needed to construct a valid research design and to investigate the relationship between stress and immune responses. Nursing interventions to decrease stress should be developed to result in the increased immune function and the effect of these interventions would be verified.

• Investigative Magnetic Resonance Imaging
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• v.18 no.2
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• pp.87-106
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• 2014

Purpose : To describe how a robust implementation of a radial 3D gradient-echo sequence with stack-of-stars sampling can be achieved, to review the imaging properties of radial acquisitions, and to share the experience from more than 5000 clinical patient scans. Materials and Methods: A radial stack-of-stars sequence was implemented and installed on 9 clinical MR systems operating at 1.5 and 3 Tesla. Protocols were designed for various applications in which motion artifacts frequently pose a problem with conventional Cartesian techniques. Radial scans were added to routine examinations without selection of specific patient cohorts. Results: Radial acquisitions show significantly lower sensitivity to motion and allow examinations during free breathing. Elimination of breath-holding reduces failure rates for non-compliant patients and enables imaging at higher resolution. Residual artifacts appear as streaks, which are easy to identify and rarely obscure diagnostic information. The improved robustness comes at the expense of longer scan durations, the requirement for fat suppression, and the nonexistence of a time-to-center value. Care needs to be taken during the configuration of receive coils. Conclusion: Routine clinical use of radial stack-of-stars sequences is feasible with current MR systems and may serve as substitute for conventional fat-suppressed T1-weighted protocols in applications where motion is likely to degrade the image quality.

• The Journal of Internal Korean Medicine
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• v.21 no.1
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• pp.169-180
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• 2000

Objectives : To satisfy the demand of good treatment of constipation Methods : we investigated the literatures of Oriental Medicine about Constipation. Results: 1. There are three categories of etimological factors of constipation, that is, endogenous, exogenous and non-exo-endogenous factor. The endogenous factor is caused by seven emotions, called depression of Ki and stagnation of Ki. The exogenous factor is six excessive atmospheric influences, for example, wind, cold, dampness, heat and dryness. And the non-exo-endogenous factors are overfatigue, improper diet, stagnated blood and deficiency of Ki and blood that comes from old age, long disease and after delivery. 2. Classification: According to cause of disease it is classified by constipation due to cold, heat, wind, dryness, retention of undigested and phlegm. According to Internal Organs there are constipation due to deficiency syndrome of the stomach, excess syndrome of the stomach, deficiency syndrome of kidney and splenic constipation. And Differentiation of syndromes according to Ki and blood, there are constipation of deficiency type and excess type. There are constipation due to stagnation and deficiency of Ki, deficiency of blood and stagnated blood. 3. Principles and Methods of treatment 1) Herbal Medicine (1) Excess type [1] Constipation due to heat : Seunggitang(承氣湯) and Majainwhan(麻子仁丸) [2] Constipation due to stagnation of Ki : Samatang(四磨湯) and Yukmatang(六磨湯) (2) Deficiency type [1] Constipation due to deficiency of Ki : Whanggitang(黃?湯) [2] Constipation due to deficiency of blood: Yunjangwhan(潤腸丸) [3] Constipation due to cold : Jechunjun(濟川煎) and Banyuwhan(半硫丸) 2) Enema therapy: It is a method to induce defecation by honey or pig's bile juice for weak people. 3) Acupuncture and Moxibustion: Acupoints used to treat constipation are BL25, ST25 and TE6. Moxibustion at CV8, CV6 is good for constipation due to cold. (4) Diet therapy: It is very important that we eat meals regularly and defecate on the same time even if you don't. And we have to eat food like fruits, vegetables and beans. (5) finger pressure: Finger pressing around these points like ST25, SP25, BL25, BL31, BL32, BL33 and BL34 is good for it. (6) Kigong therapy: Abdominal breathing (7) Old man' s constipation: Hip bath or diet therapy is commended. Laxation with lubricant like Supungyunjangwhan(搜風潤腸丸) is used. (8) Women' s constipation: After delivery, we have to administer tonifying prescription Sipjundaebotang(十全大補湯) and enema can be used. Conclusion : We have to examine the cause of disease and bowl movement carefully. After comprehensive analysis of the data gained by the four methods of diagnosis, we diagnose and treat patients on the base of overall of symptoms and signs.

• The Journal of Internal Korean Medicine
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• v.19 no.1
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• pp.144-156
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• 1998

This study has been carried out to investigate the cause, pathological mechanism and treatment of symptoms regarded as the ischemic heart disease in Nei-jing(內經). I've got the following conclusions. 1. From the side of xing-bi(胸痺), the ischemic heart disease(IHD) was caused by that the energy in one's heart wasn't extended in the way of Yin-xie(飮邪), namely waste matter of human body and symptoms and treatment wern't written. 2. From the side of xin-bi (心痺), HID was catched by the mechanisms that the blood vessel is blocked. or the heart's blood was deficient owing to the mutation of mo-bi(脈痺), the lack of yang-ming(陽明) and excessive thoughts and worry and others. The symptoms were feeling oppressed in one's brest, palpitating, sudden dyspnea, the dryness of thorat, frequent belching and the fear by the inverse flow of the energy(氣). The treatment was that the yin(陰) was cured immediately, but the yang(陽) mustn't be attacked. 3. From the side of xing-tong(心痛), IHD was suffered from by mechanisms that following the han-sa(寒邪), namely the cold makes a invasion on humanbody, the vessel was blocked, spasm, filled and the amount of blood flow was poor, or caused by injury of vessel, the inverse flow and the disease of shi-dong(是動病) of shou-shao-xin-jing(手少陰心經) and so on. The pain was cramped into the upper and lower back or lower abdomen or throat and accompanied with nausea, abdominal dropsy, constipation, the impending of breathing and so on. The cure was mainly that acupuncture was applied at the jin-su(筋縮) region or meridian in relation to symptoms, but if the pain were severe, acupuncture mustn't be applied. The prog nosis was worse. 4. From the side of xing-tonge(心痛), IHD was divided into zhen-xing-tong(眞心痛) and jue-xing-tong(厥心痛), but pi-xiog-tong(脾心痛) and wei-xing-tong(胃心痛) out of jue-xing-tong(厥心痛) also included the symptoms of the digestive disease.

• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.154-162
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• 1996

Purpose : Adenoviruses(Ad) have been shown to play an important role in the etiology of severely acute respiratory diseases, particulary in infants and young children, and the occurrence of fatal outcome and chronic pulmonary sequelae in association with adenoviral infection has been a cause of great interest and concern. This report presents the resul of a retrospective analysis on 30 cases of lower respiratory infection from which adenovirus was isolated. Patients & Methods : The 30 patients in this study represent all detected cases of adenovial infection out of 240 children who were admitted to Sang Sung Medical Center between February to June 1996 showing signs and symptoms of lower respiratory tract infection. The diagnosis of adenovirus infection was based on microscopic visualization of typical cytopathic effect in HEp-2 tissue culture and used monoclonal Ab with nasopharyngeal aspiration. Results : The male/female ratio was 2:1 and the majority of age range was below 36months. Clinical diagnoses in all 30 patients were pneumonia(n=21), bronchitis and Bronchiolitis(n=5) and ARDS(n=4). We recieved the most of patients in the month of May. The chief complaints were fever(93.3%) and cough(80%) and extrapulmonary symptoms were diarrhea(n=5), seizure(n=4), abdominal pain(n=1). The mean duration of fever was $11.95{\pm}6.54$days. Physical examination on admission were crackles(73.3%), coarse breathing sounds(60%), hepatosplenomegaly(33.3%), decreased brething sounds(30%). In WBC counts, 8cases were below $4000/mm^3$ and 14 cases were above $10,000/mm^3$. In platelets counts, 4cases were below $150,000/mm^3$ and 10 cases were above $450,000/mm^3$. 21 cases were above 1 in CRP. GOT and GPT were abnormal in some cases. Chest X-ray revealed diffuse pulmonary infiltration(n=15), pleural effusion(n=6), consolidation(n=4) and hyperaeration(n=3). Seven patients were treated at the peditric intensive care unit with respiratory support and high dose of gammaglobulin. However, one patients died even through he was treated with NO ventilation and high frequency ventilation. Conclusion : Those with adenoviral pneumonia and respiratory infection having long fever duration and symptoms like bacterial pneumonia must be carefully differentiated in order to provide proper treatement and preventive measures due to possible fatal outcome.