• Radiation Oncology Journal
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• v.36 no.2
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• pp.103-113
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• 2018

Purpose: Anaplastic thyroid cancer (ATC) is a rare tumor with a lethal clinical course despite aggressive multimodal therapy. Intensity-modulated radiotherapy (IMRT) may achieve a good therapeutic outcome in ATC patients, and the role of IMRT should be assessed. We retrospectively reviewed outcomes for ATC treated with three-dimensional conformal radiotherapy (3D-CRT) or IMRT to determine the optimal treatment option and explore the role of radiotherapy (RT). Materials and Methods: Between December 2000 and December 2015, 41 patients with pathologically proven ATC received RT with a sufficient dose of ${\geq}40Gy$. Among them, 21 patients (51%) underwent surgery before RT. Twenty-eight patients received IMRT, and 13 received 3D-CRT. Overall survival (OS) and progression-free survival (PFS), patterns of failure, and toxicity were examined. Results: The median follow-up time for survivors was 38.0 months. The median and 1-year OS and PFS rates were 7.2 months and 29%, 4.5 months and 15%, respectively. Surgery significantly improved the prognosis (median OS: 10.7 vs. 3.9 months, p = 0.001; median PFS: 5.9 vs. 2.5 months, p = 0.007). IMRT showed significantly better PFS and OS than 3D-CRT, even in multivariate analysis (OS: hazard ratio [HR] = 0.30, p = 0.005; PFS: HR = 0.33, p = 0.005). Significantly higher radiation dose could be delivered with IMRT than 3D-CRT ($EQD2_{10}$ 66 vs. 60 Gy, p = 0.005). Only 2 patients had grade III dermatitis after IMRT. No other severe toxicity ${\geq}grade$ III occurred. Conclusion: Patients with ATC showed better prognosis through multimodal treatment. Furthermore, IMRT could achieve favorable survival rates by safely delivering higher dose than 3D-CRT.

• Journal of Veterinary Clinics
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• v.29 no.5
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• pp.368-371
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• 2012

The present study evaluated the outcome of use of thoracostomy tube tunneling technique under the latissimus dorsi muscle for the evacuation of postoperative pneumothorax induced by thoracotomy in 11 dogs. A stab incision was made through the skin and the latissimus dorsi muscle over the rib in the fifth intercostal space caudal to a surgical window. The thoracostomy tube with a Kelly hemostat was advanced into the thoracic cavity in a cranioventral direction through the sublatissimal tunnel. After tube placement, a # 1 nylon horizontal mattress suture was placed around the skin incision. The thoracostomy tube was removed after creating a negative pressure in the thoracic cavity. Dogs were monitored after surgery for pneumothorax, subcutaneous emphysema, clinical signs including dyspnea, and tube kinking in a muscle tunnel using physical examination and postoperative radiography. There was no tube kinking in the sublatissimal tunnel in 11 dogs on introducing the tubes into the thoracic cavity. The mean (${\pm}SD$) follow-up period was $19{\pm}10$ months. On postoperative radiography, there was no evidence of pneumothorax in 11 dogs. Subcutaneous emphysema was identified around the stab incision in a dog postoperatively. The subcutaneous emphysema disappeared spontaneously within 3 days. On postoperative physical examination, there was no evidence of dyspnea in 11 dogs. Our results suggest that the sublatissimal tunneling technique for thoracostomy tube placement is effective to prevent air leakage around the thoracostomy tube while the tube remains in the thoracic cavity and along the thoracostomy tunnel after tube removal. Tunneling under the latissimus dorsi muscle should be considered the thoracostomy tube placement technique to prevent iatrogenic pneumothorax with first priority.

• Journal of Veterinary Clinics
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• v.26 no.3
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• pp.273-275
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• 2009

A 6-year-old castrated male Shih-tzu was presented because of a 1-month history of progressive tetraplegia. On the basis of the findings of neurological examination, radiographs and magnetic resonance imaging, herniated intervertebral disc of C4-C5, C5-C6 and C6-C7 compressed spinal cord. The oxygen-ozone was intra-operatively injected into the C4-C5 and C6-C7 intervertebral disc and a ventral decompression performed at C5-C6 intervertebral space. Immediately after the surgery, neck pain was disappeared and three weeks after surgery, there was complete resolution of the neurological deficits with normal gaits. On magnetic resonance images at 2-month after surgery, herniated disc materials of C5-C6 and C6-C7 were completely removed and that of C4-C5 remarkably reduced. Consequently decompression which was performed at all of the three lesions resulted in good clinical outcome without additional internal fixation for minimizing postoperative instability.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.757-760
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• 2007

Purpose : Febrile convulsions (FC) were considered to be a benign seizure syndrome that is distinct from epilepsy. But it is thought that children with complex features i.e., partial or prolonged seizures or multiple episodes of FC would bear a higher risk of developing unprovoked seizures. The aim of this study is to look into the relative significance of each criteria that define complex febrile convulsions (CFC) as a predictor of subsequent epilepsy. Methods : All children were retrospectively identified for a febrile seizure through pediatric departments of the Konyang University Hospital. Information was collected from medical records and interviews with parents. Patients with abnormal neurological examinations at presentation were excluded. Results : This study was performed from March 2000 to December 2003. Sixty-three out of 314 children (20.0%) with febrile convulsion fulfilled the criteria for CFC and forty-four children of them have been followed for 12 months or more. Ten of these (23.2%) had unprovoked seizures for 14-62 months (median $34.2{\pm}11.6$ months). The patients with partial FC showed a trend toward a higher risk (57.1%) of developing epilepsy than the patients with multiple or prolonged febrile convulsions (26.7%, 24.1% respectively). Conclusion : We found that the partial feature of febrile convulsion is associated with subsequent epilepsy.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• Journal of Acupuncture Research
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• v.22 no.1
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• pp.109-115
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• 2005

Objective : The purpose of this case is to report the improvement after treatment about a patient with meralgia paresthetica. Methods : We treated the patient with acupuncture therapy and Herbal medication from 11th October 2004 to 15th October 2004 by evaluating femoral function with VAS score and R.O.M of femur joint. Results : After 5 times of treatment, this patient achieved excellent outcome following the technique, showing that clinical symptom as like heating sense, edema and pain was disappeared, VAS changed from 10 to 1 and there was no limitation of ROM of femur. Conclusions : Meralgia paresthetica is a symptom complex that includes numbness, paresthesias, and pain in the anterolateral thigh, which may result from either an entrapment neuropathy or a neuroma of the lateral femoral cutaneous nerve(LFCN). Oriental medical treatment for meralgia paresthetica resulted in satisfactory results by diminishing the symptoms progressively during the five days of treatment. Differential diagnosis was based on careful physical examination. More research of meralgia paresthetica is needed.

• Journal of Acupuncture Research
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• v.30 no.4
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• pp.115-123
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• 2013

Objectives : This study was performed to confirm the usefulness of EMG and early-performed ENoG as predicting factor for facial palsy by clinical outcome. Methods : We gathered patients who visited the Facial Palsy Center in Kyung Hee University Hospital at Gangdong between January 2010 and September 2012. We used inclusion/exclusion criteria and reviewed 231 patients' medical records including gender, age, HB grade and EMG & ENoG axonal loss. We compared the relation between EMG axonal loss and improvement degree at 4 & 6 weeks after treatment, and between ENoG axonal loss at 3-5 & 6-8 days after onset and EMG axnoal loss using regression analysis. Results : Each analysis had statistical significance, but EMG & improvement degree at 6 weeks after treatment showed statistically higher correlation than that at 4 weeks after treatment, and ENoG at 6~8 days after onset & EMG showed statistically higher correlation than that at 3~5 day after onset. Conclusions : We could get the evidence of the validity of EMG and early-performed ENoG as predicting factor for facial palsy based on collaborative treatment between Korean and western medicine.

• Journal of Korean Foot and Ankle Society
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• v.23 no.4
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• pp.159-165
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• 2019

Purpose: This study investigated the recurrence rate after performing hallux valgus correction using scarf and Akin osteotomy, and also identified the correlation and cut-off values of both the preoperative and postoperative radiographic parameters as risk factors for the recurrence of hallux valgus. Materials and Methods: We reviewed 87 hallux valgus patients (122 feet) who received scarf and Akin osteotomy from January 2007 to August 2015. The clinical outcomes were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. The radiological outcome measures included the hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) as determined on the serial weight bearing radiographs. Recurrence was defined as more than 20 degrees of HVA noted on the final follow-up radiograph. Those radiological factors associated with recurrence were evaluated and analyzed. Results: The mean follow-up duration was 20.6 months (12.0~46.5 months) and the mean age was 44 years (13~80 years). The VAS and AOFAS scores were significantly improved at the time of the final follow-up (7.0 to 2.0, p<0.001; 78.0 to 92.0, p<0.001; respectively). Significant corrections in the HVA, IMA, and DMAA were obtained (p<0.001). Eleven (9.0%: 11/122) cases experienced recurrent hallux valgus deformity. The postoperative IMA, DMAA and HVA showed significant moderate to strong correlation with HVA at the final follow-up (Pearson correlation coefficient: 0.44, 0.70, and 0.88, respectively; p<0.001). Postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees showed statistically significant correlation with radiological recurrence at the last follow-up, and the odds ratio of each variable was high in order. Conclusion: Our radiographic results indicated that postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees can be risk factors for hallux valgus recurrence. These risk factors may be helpful for modifying surgical procedures and preventing the recurrence of hallux valgus.

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.813-822
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• 2005

The predictable outcome of implant placement in the atrophic maxilla with sinus floor elevation procedure(osteotome sinus floor elevation technique and window opening technique) is well documented. Aim of this study was to evaluate the efficacy of $Br{\aa}nemark$ Ti-Unite implant system and ITI SLA implant system placed in the atrophic posterior maxilla with sinus floor elevation procedure. Eighty patients received placement of $Br{\aa}nemark$ Ti-Unite implants(195 implants) in their atrophic posterior Maxilla with sinus floor elevation procedure(153 osteotome sinus floor elevation technique and 42 window opening procedure). Fifty patients received placement of ITI SLA implants(83 implants) in their atrophic posterior Maxilla with sinus floor elevation procedure(77 osteotome sinus floor elevation technique and 6 window opening procedure). Chart review were taken from each patient. The total failed implants were seven and the total implant survival rate was 96.4% in $Br{\aa}nemark$ Ti-Unite system. The total failed implants were one and the total implant survival rate was 98.8% in ITI SLA system. The implant survival rate with osteotome technique was 96% and 97.6% with window opening in $Br{\aa}nemark$ Ti-Unite system. The implant survival rate with osteotome technique was 98.7% and 100% with window opening. The implant survival rate with osteotome technique was 96% and 97.6% with window opening in ITI SLA system. The results of this evaluation show that the placement of $Br{\aa}nemark$ Ti-Unite system as well as ITI SLA system is a reasonable treatment option for patients with the atrophic posterior maxillary area.

• Journal of Gastric Cancer
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• v.5 no.3 s.19
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• pp.139-145
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• 2005

Gastric cancer is the most prevalent cancer in Korea and comprises the second cause of cancer death. Surgery only can provide chance of cure, but most locally advanced cancers recur after a curative resection, even though important advances in the surgical and nonsurgical treatments of gastric cancer have taken place. Preoperative chemotherapy theoretically can provide the advantages of reducing the bulk of tumor, which might improve the R0 resection rate, and of treating micrometastases early. Also, preoperative chemotherapy is expected to render unresectable tumors resectable without increasing postoperative morbidity and mortality. There are many new chemo-therapeutic agents available for the treatment of advanced gastric cancer, but still the most effective agent, the optimal time and number of cycle for administration are still not known. The addition of postoperative chemotherapy through an intraperitoneal route and/or radiotherapy might affect the outcome of surgery favorably, but that hasn't been proved yet. A multicenter prospective randomized phase III trial should be peformed to answer for those questions and to improve the curability of gastric cancer treatment.