• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.4
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• pp.18-44
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• 2017

Purpose: The object of this study was to observe the anti-climacterium activity of Gagamguibiondam-tang (GGOT) on ovariectomized (OVX) rats, a well-documented rodent models resembles with women postmenopausal climacterium symptoms, as including cardiovascular diseases, obesity, hyperlipidemia, osteoporosis, organ steatosis and mental disorders. Methods: In this study, anti-climacteric effects were evaluated separated into three categories; 1) anti-obese, 2) anti-uterine atrophy and 3) anti-osteoporotic effects. Five groups were used (8 rats in each group); sham control, OVX control, GGOT 500, 250 and 125 mg/kg administered groups. Twenty-eight days after bilateral OVX surgery, GGOT were orally administered, once a day for 84 days, and then the changes on the body weight and gain during experimental periods, serum estradiol levels, abdominal fat pad and uterus weights with histopathology of abdominal fat pads (total thickness and mean adipocyte diameters) and uterus (total, epithelial and mucosal thickness, percentages of uterine gland regions) for anti-obese and estrogenic effects. In addition, femur, tibia and fourth or fifth lumbar vertebrae (L4 or L5) wet, dry and ash weights, mineral density (BMD), bone strength (failure load), serum osteocalcin and bone specific alkaline phosphatase (bALP) contents, histological and histomorphometrical analyses - bone mass and structure with bone resorption, were monitored for anti-osteoporosis activity. Results: As a result of OVX, noticeable increases of body weight and gains, food and water consumption, weights of abdominal fat pad deposited in dorsal abdominal cavity, serum osteocalcin levels were demonstrated in this experiment with decrease of uterus, femur, tibia and L5 weights, serum bALP and estradiol levels. In addition, marked hypertrophic changes of adipocytes located in deposited abdominal fat pads, uterine disused atrophic changes, decreases of bone mass and structures of femur, tibia and L4 were also observed in OVX control rats with dramatic increases of bone resorption markers, the Ocn and OS/BS at histopathological and histomorphometrical analysis in this study as compared with sham-operated control rats, suggesting the estrogen-deficient climacterium symptoms - obese and osteoporosis were induced by OVX, respectively. However, these estrogen-deficient climacterium symptoms induced by bilateral OVX in rats were significantly inhibited by 84 days of continuous oral treatment of GGOT 500, 250 and 125 mg/kg, respectively. Especially, GGOT 500, 250 and 125 mg/kg showed clear dose-dependent inhibitory activities on the OVX-induced climacterium signs. Conclusion: The results suggest that oral administration of GGOT 500, 250 and 125 mg/kg has clear dose-dependent favorable anti-climacterium effects - estrogenic, anti-obese and anti-osteoporotic activities in OVX rats in this experiment.

• The Korean Journal of Nuclear Medicine
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• v.34 no.5
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• pp.393-402
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• 2000

Purpose: Tc-99m-MIBI (MIBI) and Tc-99m-Tetrofosmin (TF) are commonly used for scintimammog (SMM). We compared the diagnostic ability of SMM using Tc-99m-MIBI and Tc-99m-TF for the diagnosis of breast mass. Materials and Methods: The study subjects were comprised of 123 breast lesior 86 normal breasts of 114 patients who underwent SMM. Bilateral prone images and anterior supine images obtained at 5 minutes and 1 or 3 hours after intravenous injection of 740 MBq of either MIBI or TF. of tumors were not significantly different between the MIBI and TF groups. First, two observers read the SMM without clinical information (1st interpretation), then read again with information about location (2nd interpretation). Sensitivity and specificity of each radiopharmaceutical for the diagnosis of cancer were evaluated in terms of image acquisition time, tumor size, and location. Results: The SMM a good agreement between two observers for 1st and 2nd interpretation, except for TF SMM at 3 hr. first interpretation, the sensitivities at 5 min, 1 hr, and 3 hr were not significantly different between MIBI TF SMM (81.6%, 80.0%, 60.9% in MIBI vs. 88.9%, 80.6%, 42.9% in TF), although the sensitivities of images were significantly lower than 5 min images in both MIBI and TF SMM. The specificity of TF at was superior to that of MIBI (81.5%, 90.0%, 82.9% in MIBI vs. 96.7%, 100%, 90.0% in TF, p<0.01 MIBI TF at 5 min). For the second interpretation with information of mass location, the sensitivities at 3 hr were significantly lower than 5 min images (86.8%, 86.7%, 78.3% in MIBI vs. 88.9%, 93.5%, 57.1% between MIBI and TF SMM. However, there was no significant difference in the specificity (60.0%, 75.0% for MIBI vs. 86.7%, 100%, 100% for TF). MIBI and TF SMM showed lower sensitivities for the with less than 1 cm than tumors with more than 1 cm. However, the location of tumors did not sensitivity and specificity between MIBI and TF SMM. Conclusion: The ability for the differential of breast tumor is similar between MIBI and TF SMM, and delayed image is not necessary. TF may be than MIBI considering the specificity of SMM without clinical information and labeling convenience.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.2
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• pp.16-36
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• 2017

Objectives: The purpose of this study was to evaluate the anti-climacterium effects of Jibaekjihwang-tang (JBJHT), especially on estrogenic, anti-obesity, hypolipidemic, hepatoprotective against fatty liver and anti-osteoporotic effects by Ovariectomy (OVX) mice. Methods: In order to evaluate anti-climacterium effects of JBJHT, we used bilateral OVX female ddY mice. In this study, six groups were used; sham control, OVX control, estradiol, JBJHT 500, 250 and 125 mg/kg treated groups. Since 28 days after OVX surgery, JBJHT extracts were orally treated, and $17{\beta}$-estradiol $0.03{\mu}g/head$ were subcutaneously injected for 84 days, once a day. And then, we observed anti-climacterium effects classified into five categories; estrogenic, anti-obesity, hypolipidemic, hepatoprotective against fatty liver and anti-osteoporotic effects. The results were compared with $17{\beta}$-estradiol $0.03{\mu}g/head$/day subcutaneous treated OVX mice. Results: OVX control mice showed noticeable hypertrophic changes of adipocytes in abdominal fat pads, fatty liver, uterine atrophic changes, decreases of bone strength were also observed in OVX control. However, these estrogen-deficient climacterium symptoms were significantly and dose-dependently inhibited by JBJHT 500, 250 and 125 mg/kg treatment. Moreover, JBJHT 500 mg/kg showed comparable inhibitory effects as compared to those of estradiol $0.03{\mu}g/head$/day subcutaneous treatment. Conclusions: The results suggest that oral administration of JBJHT 500, 250 and 125 mg/kg has clear dose-dependent anti-climacterium effects in OVX mice.

• Radiation Oncology Journal
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• v.24 no.2
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• pp.123-127
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• 2006

Purpose: The purpose of this study was to investigate the clinical findings, treatment, and outcome of patients with glassy cell carcinoma of cervix. Materials and Methods: We reviewed all cases of glassy cell carcinoma of the uterine cervix confirmed and treated at the Dongsan Medical Center, Keimyung University, between January 1993 and December 2005. There were 7 cases with histopathologically confirmed gassy cell carcinoma. A tumor was diagnosed as glassy cell carcinoma if over 50% of the tumor cell type displayed glassy cell features. Six patients with stage IB had radical hysterectomy and bilateral pelvic node dissection, and 2 of them received adjuvant external pelvic irradiation with concurrent chemotherapy. Remaining one patient with stage IIA had curative concurrent chemoradiotherapy with external pelvic irradiation and brachytherapy. Results: There were 7 patients diagnosed as glassy cell carcinoma among the 3,745 (0.2%) patients of carcinoma of uterine cervix. The mean age of 7 patients was 44 years with range of 35 to 53 years of age. The most frequent symptom was vaginal bleeding (86%). By the punch biopsy undertaken before treatment of 7 cases, 2 only cases could diagnose as glassy cell carcinoma of uterine cervix, but remaining of them confirmed by surgical pathological examination. The mean follow up duration was 73 months with range of 13 to 150 months. All 7 patients were alive without disease after treatment. Conclusion: Glassy cell carcinoma of the uterine cervix is a distinct clinicopathologic entity that demonstrates an aggressive biologic behavior. However for early-stage disease, we may have more favorable clinical outcome with radical surgery followed by chemoradiothery.

• The korean journal of orthodontics
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• v.29 no.1 s.72
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• pp.83-94
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• 1999

The purpose of this study was to evaluate the changes of cancellous and cortical bone and the effect of estrogen in ovariectomized rats. Fifty female rats, 250gm in body weight, were divided into three groups : ovariectomized group(OVE), ovariectomized and estrogen-injected group(OVE-EST), and sham operated and estrogen-injected group(EST). Bilateral ovariectomy was performed at the onset of the experiment. In OVE-EST group and EST group, estrogen was injected $50{\mu}g/kg$ B.W. every other days from 3 weeks after surgery to sacrifice. Each five rats were sacrificed after 5, 6, 7 weeks. One side of mandibular body was radiographed with a soft x-ray apparatus(Hitex Co., Ltd., Japan). Thereafter the obtained microradiographs were used for the morphometric analysis using a Image analyzer. The morphometric analysis was perforrmed for parameters such as total bone area, cortex bone area and medullary bone area. The other side of the mandibular bone was decalcified and embedded in paraffin as using a general method. The specimens were sectioned and stained with Mallory's anilline blue and observed light microscopically. The results were as follows. 1 In all groups, the proportion of cortex to total bone area was not significantly different. 2. In ovariectomized(OVE) group, the proportion of marrow cavity to medullary bone area increased significantly from 5 to 7 weeks(p<0.05). In ovariectomized and estrogen-injected(OVE-EST) group, it decreased significantly at 7 weeks, and in estrogen-injected(EST) group, it decreased significantly from 6 weeks(p<0.05). 3. Microradiogram and histopathologic findings revealed that marrow cavity was enlarged and osteoclasts were observed around irregular bone surface in OVE group. In OVE-EST group, the size of marrow cavity at 7 weeks was similar to that of control group. In EST group, as dense trabecular bone increased from 5 to 7 weeks, marrow cavity decreased.

• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.644-650
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• 2005

Background : Bilateral pulmonary thromboendarterectomy(PTE) is recognized as the definitive treatment for chronic thromboembolic pulmonary hypertension (CTEPH). We investigated the symptomatic, hemodynamic and prognostic effects of PTE in comparison with medical treatment. Methods : Twenty-four patients diagnosed with CTEPH from 1995 to 2003 at the Asan Medical Center were divided into two groups: patients treated with PTE(PTE group, n=12) and those not treated with PTE(Med group, n=12). The serial changes in dyspnea, the tricuspid regurgitation maximal velocity (TRVmax) and survival of the PTE and Med groups were compared retrospectively. Results : In PTE group, during a follow-up period of 1 year, the New York Heart Association(NYHA) functional class significantly improved, while there was no significant improvement in the Med group. PTE significantly lowered the TRVmax from $4.23{\pm}0.54m/sec$ to $3.22{\pm}0.70m/sec$ over a follow up period of 2 years. (p=0.028) However, the TRVmax in the medically treated group did not show any significant improvement, changing from $3.98{\pm}0.68m/sec$ to $4.27{\pm}0.95m/sec$ during 1 year. The 5-year survival of the PTE group was 77.9% compared with 64.3% in the medically treated group. Conclusion : PTE provides substantial long-term improvement in dyspnea and the echocardiographic changes compared with medically treated patients.

• The Korean Journal of Nuclear Medicine
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• v.32 no.2
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• pp.151-160
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• 1998

Purpose: Piccolo et al. advocated the usefulness of $^{99m}Tc$-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied $^{99m}Tc$-MDP uptake pattern and lesion/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of $^{99m}Tc$-MDP scan. Materials and Methods: Total 34 patients were studied with physical examination, mammo-gram and $^{99m}Tc$-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq $^{99m}Tc$-MDP. Breast uptake pattern of $^{99m}Tc$-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammogram. Results: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of $^{99m}Tc$-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 217, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. Conclusion: $^{99m}Tc$-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.

• The korean journal of orthodontics
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• v.29 no.4 s.75
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• pp.467-481
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• 1999

Cleft lip and/or palate is one of the most common congenital craniofacial anomalies. According to previous epidemiologic studies, incidence of cleft lip and/or palate has been increasing nowadays. However, there is no report about epidemiologic study of cleft lip and/or palate patients who visited dept. of orthodontics in Korea. So the purpose of this study was to provide the epidemiological characteristics and important basic clinical data for the diagnosis and the treatment of the cleft lip and/or palate patients. With the orthodontic and cleft charts, diagnostic models and X-ray films from 250 patients with cleft lip and/or palate who visited Dept. of Orthodontics, Seoul National University Dental Hospital during the last 11 years, the authors investigated patient's visiting yew, types of cleft, patient's gender, and Angle's classification of malocclusion, and surgery timing. The results were as follows ; 1. The number of cleft patients who visited Dept. of Orthodontics, SNUDH increased during 1988-1990 and then it declined until 1992. From 1993 to 1996, it showed a stationary trend. After 1997 it showed an overwhelmingly increasing trend. 2. In the cleft type, the ratio of cleft lip cleft lip and alveolus cleft palate : cleft lip and palate was 7.6:19.2:9.6:63.6. In cleft position, unilateral clefts were more than bilateral ones (cleft lip 79:21, cleft lip and alveolus 77:23, cleft lip and palate 75.5:24.5). In cleft side, left clefts were mote than right clefts (cleft lip 53.3:46.7 cleft lip and alveolus 59.5:40.5, cleft lip and palate 59.2:40.8). 3. In gender ratio, males were more than females in cleft lip (57.9:42.1), cleft lip and alveolus (68.8:31.2) and cleft lip and palate (76.1:23.9). But in cleft Palate females were more than males as 41.7: 58.3. 4. In the age groups, 7-12 year group was the most abundant as $52\%$, and then 0-6 year group ($20.4\%$), 13-18 year group ($17.2\%$), more than 18 yew group ($10.4\%$) were followed as descending order. 5. Most of the cleft lip repair surgeries were operated in 0-3 month ($60.3\%$) and 4-6 month ($17.9\%$). 6. The cleft palate repair surgeries were done in 1-2 year ($31.7\%$), 0-1 year ($25.6\%$), 2-3 year ($12.1\%$), more than 5 year ($11.6\%$) as descending order. 7. The lip scar revision surgeries were done before admission at elementary school in $60\%$. (4-6 you ($27.5\%$), 6-8 year ($19.6\%$), more than 10 year ($19.6\%$), 2-4 year ($13.7\%$) as descending order) 8. The rhinoplasties were done before admission at elementary school in $51.7\%$. (0-2 year ($7.1\%$), 2-4 year ($14.3\%$), 4-6 year ($21.4\%$), 6-8 year ($14.3\%$)). 9. The pharyngeal flap were done at 6 Y (72.5 months) after birth on average and there was even distribution of surgery timing. 10. In relationship between Angle's classification of malocclusion and cleft types, Class I was most abundant and Class III, Class II were followed as descending order in cleft lip group. But Class III was most abundant and Class I, Class II were followed as descending order in cleft lip and alveolus group, cleft palate group, and cleft lip and Palate group. The percentage of frequency in Class III malocclusion was overwhelmingly higher in cleft lip and palate group than any other groups. 11. Because the frequency of class III malocclusion was most prevalent in all age groups, anterior crossbite was the most common chief complaint of cleft patients.

• Radiation Oncology Journal
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• v.18 no.3
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• pp.194-199
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• 2000

Purpose : Then determining the lower margin of post-operative pelvic radiation therapy field according to the traditional method (recommended by Gunderson), the organs located in the low pelvic cavity and the perineum are vulnerable to unnecessary radiation. This study evaluated the effect of individualized determination of the lower margin at 2 cm to 3 cm below the anastomotic site on the failure patterns. Materials and Methods . Authors included ぉ patients with modified Astler-Coiler (MAC) stages from B2 through C3, who received low anterior resection and post-operative pelvic radiation therapy from Sept. 1994 to May 1998 at Samsung Medical Center, Sungkyunkwan University. The numbers of male and female patients were 44 and 44, and the median age was 57 years (range: 32-81 years). Three field technique (posterior-anterior and bilateral portals) by 6, 10, 15 MV X-rays was used to deliver 4,500 cGy to the whole pelvis followed by Sn cGy's small field boost to the tumor bed over 5.5 weeks. Sixteen patients received radiation therapy by traditional field margin determination, and the lower margin was set either at the low margin of the obturator foramen or at 2 cm to 3 cm below the anastomotic site, whichever is lower. In 72 patients, the lower margin was set at 2 cm to 3 cm below the anastomotic site, irrespectively of the obturator foramen, by which the reduction of radiation volume was possible in 55 patients ($76\%$). Authors evaluated and compared survival, local control, and disease-free survival rates of these two groups. Results : The median follow-up period was 27 months (range : 7-58 months). MAC stages B2 in 32($36\%$), B3 in 2 ($2\%$), Cl in 2 ($2\%$), C2 in 50 ($57\%$), and C3 in 2 ($2\%$) Patients, respectively. The entire patients' overall survival rates at 2 and 4 years were $94\%$ and $68\%$, respectively, and disease-free survival rates at 2 and 4 years were $86\%$ and $58\%$, respectively. The first failure sites were local only in 4, distant only in 14, and combined local and distant in 1 patient, respectively. There was no significant difference with respect to local control and disease-free survival rates ( p=0.42, p=0.68) between two groups of different lower margin determination policies. Conclusion : The new concept in the individualized determination of the lower margin depending on the anastomotic site has led to the equivalent local control and disease-free survival rates, and is expected to contribute to the reduction of unnecessary radiation-related morbidity by reduction of radiation volume, compared with the traditional method of lower margin determination.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1210-1219
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• 2001

Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.