• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7569-7576
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• 2013

Background: The purpose of this article is to present preliminary results of simultaneous boost irradiation radiotherapy for locally advanced nasopharyngeal carcinoma (NPC). Methods: Fifty-eight patients who underwent simultaneous boost irradiation radiotherapy for NPC in Cancer Center of Sun Yat-sen University between September 2004 and December 2009 were eligible. Acute and late toxicities were scored weekly according to the Radiation Therapy Oncology Group (RTOG) acute and late radiation morbidity scoring schemes. An especial focus was on evidence of post-radiation brain injury. Also quality of life was analysed according to the EORTC (European Organisation for Research and Treatment of Cancer) recommendations. Discrete variables were compared by ${\chi}^2$ test. The Kaplan-Meier method was used to calculate the survival rates and generate survival curves. Results: A total of 58 patients with a mean follow-up time of 36 months completed clinical trials.Fifty-seven patients (98.3) achieved complete remission in the primary sites and cervical lymph nodes, with only one patient (1.7%) showing partial remission.The most frequently observed acute toxicities during the concurrent chemoradiotherapy were mucositis and leucopenia. Four patients (6.9%) had RTOG grade 3 mucositis, whereas four patients (6.9%) had grade 3 leucopenia. No patient had grade 4 acute toxicity. Three (5.17%) of the patients exhibited injury to the brain on routine MRI examination, with a median observation of 32 months (range, 25-42months). All of them were RTOG grade 0. The 3-year overall, regional-free and distant metastasis-free survival rates were 85%, 94% and 91%, respectively. Conclusion: Simultaneous boost irradiation radiotherapy is feasible in patients with locally advanced nasopharyngeal carcinoma. The results showed excellent local control and overall survival, with no significant increase the incidence of radiation brain injury or the extent of damage. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and late toxicity.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.12-19
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• 2015

Objectives : This study examined the characteristics and differences of PAI(Personality Assessment Inventory) profile between compensation-seeking(CS) and treatment-seeking(TS) patients with traumatic brain injury(TBI) and assessed the clinical meaning of the characteristics and differences of profiles between the two groups. Methods : 36 TBI patients who visited the Wonkwang University Hospital were selected. The patients were categorized as compensation-seeking TBI patients(n=22) and treatment-seeking TBI patients(n=14). The PAI scales and subscales were used to compare differences between two groups. t-verification for each variable and comparison analysis were performed. Results:In validity scales, CS group showed significantly higher NIM scores and lower PIM scores than TS groups. In full scales, CS group showed significantly higher SOM, ANX, ARD, DEP, and SCZ scores than TS group. In subscales, CS group showed significantly higher SOM-S, ANX-A, ARD-P, DEP(-C, A, P), (MAN-I), PAR-H, SCZ(-T, P), BOR(-A, N), and ANT-S scores than TS groups. In supplementary scales, CS group showed significantly higher SUI, NON and AGG-P, and lower RXR scores than TS group. Conclusions:There were significant differences in PAI scales with validity scales, some full and subscales according to compensation seeking status in TBI patients. The CS patients tended to exaggerate their symptoms on PAI, and showed higher scores representing somatic preoccupation and emotional distress. These results show the usefulness of PAI in reflecting the significant psychological differences between two groups.

• Childhood Kidney Diseases
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• v.22 no.2
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• pp.52-57
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• 2018

Purpose: Rhabdomyolysis is a metabolic disorder in which the content of damaged muscle cells is released into plasma. Its manifestations include asymptomatic, myalgia, gross hematuria, and complications of acute kidney injury. Because of limited data on rhabdomyolysis in children, we performed this study to determine clinical characteristics of rhabdomyolysis in children. Methods: We retrospectively reviewed the records of patients with rhabdomyolysis who were treated at the Pusan National University Children's hospital from January 2011 to July 2016. The diagnostic criteria were serum myoglobin level of ${\geq}80ng/mL$, exclusive of acute myocardial injury, cardiac arrest, and brain damage. Results: Forty-five patients were enrolled; mean age, $116{\pm}68$ months. Of these, 35 were boys and 10 were girls. Twenty-six patients experienced myalgia and 12 patients showed gross hematuria. Among these, seven patients initially had both myalgia and gross hematuria. The most common causes of rhabdomyolysis were infection, physical exertion, prolonged seizures, metabolic abnormalities, and drug addiction. Acute kidney injury (AKI) was the most common complication, followed by disseminated intravascular coagulation. Thirty-seven patients improved with sufficient fluid supply but two patients underwent hemodialysis due to deterioration of kidney function. Gross hematuria, positive occult blood test, and positive urine protein were more common in patients with AKI than in those without AKI. Conclusions: In children, infection was the most common cause of rhabdomyolysis. Most patients recovered by sufficient fluid therapy. However, in severe cases, especially in patients with underlying kidney disease, hemodialysis may be necessary in the present study.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.603-608
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• 2022

Vertebral artery (VA) occlusion is frequently encountered, usually without acute ischemic injury of the brain. However, when it is accompanied by hypoplasia or stenosis of the opposite VA, brain ischemia may develop due to insufficient collateral supply. Both hemodynamic instability and embolic infarction can occur in VA occlusion, which may cause severe symptoms in a patient. Extracranial carotid-VA bypass should be considered for symptomatic VA occlusion patients, especially when the patient has repeated ischemic brain injuries. In this report, the cases of three extracranial carotid-VA bypass patients are introduced, along with a brief description of the surgical techniques. All three cases were treated with different bypass methods according to their disease location.

• Journal of Korean Physical Therapy Science
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• v.10 no.1
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• pp.7-17
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• 2003

The purpose of this study was to investigate the effect of the involved lower limb weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with hemiplegia including their gait velocity, cadence, stride length, step length of the non affected side, step length of the affected side, foot angle of the non affected side, foot angle of the affected side, base of support, and so on. The subject of the study was 28 men and women patients with hemiplegia from 22 to 77 age, among patients who doctor diagnosed as hemiplegia due to stroke or traumatic brain injury, were possible to do independent gait more than 45m without others assistance, the flexion contracture of hip pint was less than $15^{\circ}$, did not have contracture for knee pint and one more than $5^{\circ}$ for ankle joint, did not have contraindication for exercise or gait did not show visual defect due to brain injury. The patients, the subject of the study, were classified into 14 patients of treatment. group applying continuous involved weight bearing with general therapeutic exercise and 14 patients of control group applying general therapeutic exercise, and then analyzed their gait before and after exercise. Temporal distance gait analysis(Boening, 1977) was used to analyze their gait, and ink foot-print was applied as one of measurement methods. However, it was statistically signifiant in the change rate(%) of gait characteristics, and treatment group's patients with hemiplegia had been highly changed in gait characteristics in comparison with control group. From the above-mentioned results, could find that continuous involved weight bearing training for patients with hemiplegia was effective to improve their gait ability and it could increase the ability in comparison with general exercise.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.1
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• pp.59-72
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• 2010

Purpose: This study is a descriptive research to analyze prognostic factors of barbiturate coma therapy (BCT) for severe brain damage patients, to develop a critical pathway (CP) based on the results of analysis and to examine the effect of its clinical application. Method: We analyzed medical records of 76 patients who received BCT for more than three days between January 1999 to July 2005. Based on the results of the analysis, we developed a CP and applied it to 12 people during August-December of 2005. Result: By application of BCT CP, the mortality rate decreased from 31.6% to 16.7%. It was found that the period of staying at ICU and total period of hospitalization were shortened by 2.78 (13.9%) days and 16.43 (29.4%) days, respectively. The Glasgow coma scale of the recovery group by CP application was 9.03 (4.64) at 72 hours post of BCT and 14.28 (1.82) at discharge from hospital, and DRS was 6.62 (6.38) points. Conclusion: By verifying clinical validity of the suggested CP, we believe that we have obtained visible effects standardizing the treatment pathway of BCT for brain damage patients.

• Journal of Korean Physical Therapy Science
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• v.1 no.2
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• pp.301-311
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• 1994

Most patients treated by physical therapists have suffered some neurological trauma resulting from disease or injury. The traditional teaching used to be that damage of central neurons is irreversible. However, it has been necessary to cast aside this traditional view because of accumulating evidence that the brain is endowed with remarkable plasticity. This paper reviews the literature relating to neuroplasticity within the brain and draws implications pertinent to physical therapy practice.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.12-19
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• 2001

Objective : Albumin is a very useful drug for the improving of cerebral blood volume and the oncotic effect in cerebral ischemia or cerebral vasospasm. The purpose of this study was to examine the morphological and neurological effect of albumin therapy on reperfusion injury following transient focal cerebral ischemia. Materials and Methods : 18 Male Sprague-Dawley rats weighing 270-320g were used. The ischemia model was produced by 2-hour period of transient middle cerebral artery occlusion with a poly-L-lysin coated intraluminal suture. The agent(20% human serum albumin[HSA]) or control solution(NaCl 0.9%) was administered intravenously at a dosage of 1% of body weight immediate after reperfusion following a 2-hour period occlusion. Neurological function was evaluated by the postural reflex and the forlimb placing test during occlusion(at 60 min) and daily for 3 days thereafter. The brain was perfusion-fixed, and infarct volumes and brain edema were measured. Results : The HSA significantly improved the neurological score in treated group. The rats of albumin treatment group showed significantly reduced total infarct volume(by 34%) and brain edema(by 81%) compared with salinetreated rats. Conclusion : HSA showed a substantial effect on the transient focal cerebral ischemia and reperfusion injury model. These results may indicate its usefulness in treating reperfusion injury patients after thrombolysis treatment for the thrombo-embolic major cerebral artery occlusions.

• Journal of Korean Neurosurgical Society
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• v.58 no.3
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• pp.242-247
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• 2015

Objective : The purpose of this study is to determine whether the changes of contralateral sensorimotor cortical activation on functional magnetic resonance imaging (fMRI) can predict the neurological outcome among spinal cord injury (SCI) patients when the great toes are stimulated without notice. Methods : This study enrolled a total of 49 patients with SCI and investigated each patient's preoperative fMRI, postoperative fMRI, American Spinal Injury Association (ASIA) score, and neuropathic pain occurrence. Patients were classified into 3 groups according to the change of blood oxygenation level dependent (BOLD) response on perioperative fMRI during proprioceptive stimulation with repetitive passive toe movements : 1) patients with a response of contralateral sensorimotor cortical activation in fMRI were categorized; 2) patients with a response in other regions; and 3) patients with no response. Correlation between the result of fMRI and each parameter was analyzed. Results : In fMRI data, ASIA score was likely to show greater improvement in patients in group A compared to those belonging to group B or C (p<0.001). No statistical significance was observed between the result of fMRI and neuropathic pain (p=0.709). However, increase in neuropathic pain in response to the signal change of the ipsilateral frontal lobe on fMRI was statistically significant (p=0.030). Conclusion : When there was change of BOLD response at the contralateral sensorimotor cortex on perioperative fMRI after surgery, relief of neurological symptoms was highly likely for traumatic SCI patients. In addition, development of neuropathic pain was likely to occur when there was change of BOLD response at ipsilateral frontal lobe.

• Journal of Trauma and Injury
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• v.31 no.3
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• pp.125-134
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• 2018

Purpose: The interest in the personal mobility started to grow and as the interest increases, there are growing concerns about the safety of it. The purpose of the study is to look at the types and dynamics of patients injured by the personal mobilities. Methods: This was a retrospective 2-year observational study, from January 2016 to December 2017, on the patients who visited the emergency center and the trauma center, with an injury related to driving the personal mobility. Cases of the personal mobility-related accident were collected based on electronic medical records and hospital emergency department-based injury in-depth surveillance data. Results: A total of 65 patients visited the emergency center and the trauma center, during this study period. Six patients of 50 adults admitted the alcohol consumption (12%) and two adult patients wore the helmet as the protection gear (3.1%). The number of the patients in 2017 rises three times more than the number of patients in 2016 (51 vs. 14). Injuries to the head and neck region (67.7%) was the most common, followed by the upper extremity (46.2%). Eleven patients (16.9%) were admitted to the hospital, of whom three were admitted to the intensive care unit due to intracranial hemorrhage. Nine patients underwent surgery. Conclusions: The use of the personal mobility will continue to grow and the accidents, caused by the vehicle, will increase along with it. The study showed the damage is worse than expected. Personal mobility currently has a limited safety laws and the riders are not yet fully aware of its danger. The improvement of the regulation of the personal mobility, safety education is needed.