• Journal of Preventive Medicine and Public Health
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• v.47 no.1
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• pp.36-46
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• 2014

Objectives: To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history. Methods: We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ${\geq}65$ years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ${\leq}50{\mu}g/d$, 51 to $100{\mu}g/d$, 101 to $150{\mu}g/d$, and > $150{\mu}g/d$. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status. Results: Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to $100{\mu}g/d$ group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to 100 ${\mu}g/d$ group, was 1.93 (95% CI, 1.14 to 3.26). Conclusions: While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.

• Journal of radiological science and technology
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• v.46 no.2
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• pp.99-106
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• 2023

The height of the table should be considered important during computed tomography (CT) examination, but according to previous studies, not all radiology technologists set the table at the patient's center at the examination, which affects the exposure dose and image quality received by the patient. Therefore, this study intends to study the image quality exposure dose according to the height of the table to realize the optimal image quality and dose during the brain CT scan. The head phantom images were acquired using Philips Brilliance iCT 256. When the image was acquired, the table height was adjusted to 815, 865, 915, 965, 1015, and 1030 mm, respectively, and each scan was performed 3 times for each height. For the exposure dose measurement, optically stimulated luminescence dosimeter (OSLD) was attached to the front, side, eye, and thyroid gland of the head phantom. In the signal to noise ratio (SNR) measurement result, The SNR values for each table height were all lower than 915 mm. As a result of exposure dose, the exposure dose on each area increased as the table height decreased. The height of the table has a close relationship with the patient's radiation exposure dose in the CT scan.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.142-147
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• 1990

Malignant oral tumors occurred in the oral cavity. They were thought to result from the other primary tumors through hematogenous metastasis. Primary tumors were unusually gall bladder tumor and pancreatic tumor. Biopsy was performed and these specimens were similar to those of the primary sites histologically and clinically. Diagnoses were adenocarcinomas metastatic from the primary tumors. They did not reveal the bony changes, only soft tissue masses.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2014.05a
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• pp.816-818
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• 2014

Gas target chamber has been developed for producing $^{123}I$ which is radiopharmaceuticals for diagnosis of thyroid cancer, and modeled how to occur nuclear reaction between chamber and $^{124}Xe$ with energy 30MeV inside the gas target chamber by using the MCNPX. The beam energy was lost as the beam spread when beam hit inside the gas target chamber. The cooling water was used not to change the gas target chamber as loss of energy transfer to the thermal energy. Spiral cooling line was designed for cooling the target chamber efficiently. By using the c30 cyclotron, $^{124}Xe(p,2n)$, $^{124}Xe(p,n)$, $^{124}Xe(p,pn)$ nuclear reactions were studied. In this study, we predict the production yield.

• The Korean Journal of Nuclear Medicine
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• v.27 no.1
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• pp.112-117
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• 1993

Background Radioiodine ($^{131}I$), a major component of nuclear fallout and a valuable therapeutic agent for thyrotoxicosis and thyroid cancer, has been regarded as a mutagen or a carcinogen without any convincing evidence. To evaluate the genotoxicity of radioiodine ($^{131}I$) we performed a micronuclei test in mice bone marrow. Materials and methods : Mice (ICR strain, $25{\sim}30 g$) were divided to 4 groups: control, group 1 (0.17 mCi/kg, usual therapeutic dose for thyrotoxicosis), group 2 (1.67 mCi/kg, usual therapeutic dose for thyroid cancer), and group 3 (16.67 mCi/kg, usual accumulated dose causing bone marrow suppression). $^{131}I$ was administered intraperitoneally. Ten mice of each group were sacrificed at days 1 and 3. Bone marrow were smeared and stained with May-Grunwald Giemsa method. One thou-sand polychromatic erythrocytes (PCE) and normochromatic erythrocytes (NCE) were counted under the light microscope, and the number of micronucleated PCEs were recorded. Results : The frequency of micronuclei in PCE (and NCE in parenthesis) in the control group was $0.25{\pm}0.07$ ($0.23{\pm}0.07$)% in day 1 and $0.24{\pm}0.07$ ($0.21{\pm}0.07$)% in day 3. Those in group 1 was $0.27{\pm}0.1$ ($0.23{\pm}0.09$)% in day 1 and $0.28{\pm}0.07$ ($0.25{\pm}0.06$)% in day 3. Micronuclei was noted in $0.29{\pm}0.08$ ($0.26{\pm}0.09$)% in day 1 and $0.31{\pm}0.05$ ($0.29{\pm}0.06$)% in day 3 in group 2, and in $0.32{\pm}0.06$ ($0.25{\pm}0.09$)% in day 1 and $0.33{\pm}0.08$ ($0.3{\pm}0.06$)% in day 3 in group 3. There was no difference in the frequency of micronuclei between each groups (p> 0.05). Conclusion : Radioiodine ($^{131}I$) did not cause any genotoxicity in mice bone marrow even at the large dose (16.67 mCi/kg).

• Journal of Korean Academy of Nursing Administration
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• v.5 no.3
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• pp.445-462
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• 1999

The purpose of this study is to provide some basic data for the direction of nursing education and practice to prevent nursing malpractice as investgating perception of the nurse on the nursing malpractice and its case. Data were collected from 450 nurse working in four general hospitals which were located in Chonbuk province from November 9 to 21, 1998 through questionnare. The structured instruments developed by the reseacher were used for collecting data. The Results were as follows: 1) As for the cognition of the nursing malpractice case, the transfusion accident was 37.3%, the side-effects of KCL injection(19.3%), hymen rupture by uterus cancer test, the side-effects of aminophyllin injections on dyspnea patient and the others were 10% below. 2) With regard to the channel of the perception of the nursing malpractice case, mass-communication was taken first and followed through by neighbors, In-service education, school education, continuing education 3) As for the direct${\cdot}$indirect experience of the nursing malpractice case, transfusion accident was 51.3%, the fall of NPO patient after an operation 40.1%, the side-effect of KCL injection 32.5%, suicide of the psychiatric patient 32.5%, and the others were 30% below. 4) The possibility of nursing malpractice case was an average 2.57(${\pm}$0.91) and the highest was the fall of the NPO patient after an operation. 5) The perception on the responsibility of the nursing malpractice in its case was indicated as a joint-fault in ten nursing malpractice instances. As compared to the real decision, nurse's perception of the responsibility in the fall of the NPO patient after an operation, the side-effect of KCL injection, the tracheal edema of the patient who had a thyroid operation, the suicide of psychiatric patient, the hymen rupture by uterus cancer test accorded real decisions. But the other cases were different from the real decisions. These cases were perceived as ones of joint fault even in cases determined as Dr's single fault cases or those in which both doctor and nurse were declared free of fault. 6) Knowledge levels of the nursing malpractice, school education and In-service education were perceived as low but anxiety levels of the malpractice were high. 7) With regard to the countmeasure of the hospital after nursing malpractice, the rate answered as "the practice settled the accident temporarily and forced the person in charge to be punished" was highest. In conclusion, the level of the cognition of the clinical nurse on nursing malpractice cases was low. As nurses' perception on the responsibility of the nursing malpractice case was compared to the real decision, there was a difference in five cases out of the ten cases.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.324-331
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• 2010

The radial forearm free flap (RFFF) has become a workhorse flap as a means of reconstructing surgical defects in the head and neck region. We have transferred 12 RFFFs with fasciocutaneous type on oral cavity defects in 12 patients after cancer resection and submucous fibrotic lesion ablation from 2005 to 2007 at Department of oral and maxillofacial surgery, Pusan National University Hospital. We reviewed retrospectively patients' charts and followed up the patients. Clinical analysis on the cases with RFFFs focusing on flap morbidity, indications and available vessels was done. The results of study are follows: 1. RFFF could be applied for all kind of defects after resection of tongue, floor of mouth, buccal mucosa, denuded bone of palate, maxilla, and mandible. 2. All free flaps could be used for primary reconstruction. The survival rate of 12 RFFFs was 92%. Partial marginal loss of the flaps was shown as 3 cases among 12 cases. Large size-vessels like superior thyroid artery, facial artery, internal jugular vein were favorable for microvascular anastomosis. 3. Parenteral nutrition instead of nasal L-tube also can be favorable for postoperative a week for better healing of the flap if the patients couldn't be tolerable with nasal tubing. 4. Donor sites with thigh skin graft were repaired with wrist band for 2 weeks. The complications included scarring, abnormal sensation on hand, and reduced grip strength in few patients, but those didn't induce major side effects. 5. Most RFFFs were well healed even if mortality rate of cancer patients was shown as 50% (5/10 persons). The mortality of patients was not correlated with morbidity of the flaps. We could identify the usefulness of RFFF for restoration of oral function, esthetics if the flap design, tissue transfer indications, and well controlled operation are proceeded.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.119-125
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• 2011

Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.792-798
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• 1998

Background: There are various tracheal diseseas which cause the obstruction of the trachea: postintubation tracheal stenosis, tracheal cancer, thyroid cancer, endotracheal tuberculosis, et al. Recently surgical resection and reconstruction of the trachea has been adopted as the safe method for tracheal lesions. Materials and methods: We report our experience and results of resection and reconstruction for various obstructive tracheal lesions in 38cases from 1985 to 1996. Length of resection of the trachea was up to 6 cm. Twenty lesions were approached by cervical collar incision, 12 lesions by cervicosternal incision and 4cases needed transthoracic approach. Surgical procedures consisted of resection and tracheotracheal anastomosis in 32 cases, resection and laryngotracheal anastomosis in 6cases and in addition laryngeal release was necessary to release anastomotic tension in 3cases. Results: The complications were 4 minor wound infections, 2 mild suture line granulomas, 1 vocal cord palsy, 2 pneumonias and 1 systemic candidiasis. Two patients who had poor consciousness and pnemonia and one who developed systemic candidiasis were expired after operation. Conclusion: We suggests resection and reconstruction of trachea is optimal procedure for up to 6cm long tracheal lesions. However, for the patients with poor consciousness or poor general conditions would be the conservative treatment preferred to the tracheal reconstruction because of high serious complications and mortalities.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.7-13
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• 2014

Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.