• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.28 no.3
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• pp.30-47
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• 2015

Objective : Melanoma is a very critical and devastating disease. Although many people have depended on surgical operation in melanoma treatment, they have placed importance on non-invasive methods constantly. So we planned to establish a research methodology by analysing existing articles containing conservative melanoma treatments in Journals of Korean Medicine published in Korea.Methods : Using search words of anti-cancer, B16, cancer, lung metastasis, melanoma, metastasis, S-100, SK-MEL, tumor, tyrosinase, we collected 26 articles by searching internet portal sites as following;Using search words of anti-cancer, B16, cancer, lung metastasis, melanoma, metastasis, S-100, SK-MEL, tumor, tyrosinase, we collected 26 articles by searching internet portal sites as followinghttp://oasis.kiom.re.kr,http://www.koreantk.com,http://www.riss.kr,http://www.dbpia.co.kr,http://www.ndsl.kr,http://kiss.kstudy.com,http://www.naver.com,http://www.google.com.Result : The number of articles is 26 and in the year of 2003, 2004 is ranked the highest number in publication. The journal of acupuncture & moxibustion society ranked the highest(30.8%). 2 and 4 authors ranked the highest(26.9%) in number of authors. T-test ranked the highest(58.1%) in statistics methods. P.O. med indicated in 11 articles and Pharmacopuncture in 15 articles. B16 murine melanoma cell was indicated in 25 articles by cancer-induced methods. In measurement, T cell activity was indicated in 14 articles, NK activity in 4 articles, IL-2 in 6 articles, apoptosis in 1 article, lung metastasis in 14 articles.Conclusion : Considering overall results, it is necessary to diversify cancer-induced methods and measurement methods in experimental melanoma research.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.3
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• pp.171-176
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• 2021

Pneumomediastinum is a very rare and potentially catastrophic complication of dental procedures. Its common causes are tooth extraction, endodontic treatment, and subgingival curettage using handpieces and high-pressure air/water syringes. We present a case of massive pneumomediastinum with subcutaneous emphysema in a 61-year-old female who underwent bone grafting into the maxilla for pretreatment of dental implantation using a syringe. The patient suffered from abrupt severe odynophagia and loss of consciousness. The patient transferred to emergency department and images work-up revealed a pneumomediastinum and subcutaneous emphysema on the entire face and neck. We performed conservative treatments including prophylactic antibiotics, oxygen inhalation, and fasting meals, and then discharge after 7 days uneventfully. The patient's syncope might be resulting from hypotension and pain shock induced by pneumomediastinum with a sudden chest compression. The pneumomediastinum could be resulting from concurrent perforation and massive air infiltration into the maxillary sinus during bone grafting. We suggest that pneumomediastinum needs prompt diagnosis and management because of the risk of airway obstruction when a patient present syncope in the dental room.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.2
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• pp.97-101
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• 2018

Lesch-Nyhan syndrome is a rare X-linked recessive genetic disorder. During purine metabolism, the hypoxanthine guanine phosphribosyl transferase (HGPRT) enzyme is deficient causing phosphoribosyl transferase to accumulate and resulting in excessive uric acid. Clinical symptoms include hypercalcemia, choreoathetosis, spasticity, mental retardation, and self-injury to lips, tongue or fingers. This results not only in pain caused by the self-injury but also secondary infection of the wound site and the esthetic damage of the soft tissue defect. Dental treatments include conservative methods using intraoral appliances such as soft mouthguards, fixed lip bumpers, and occlusal guards, and invasive methods such as extraction of all teeth or forming an artificial anterior open bite. We report two cases of Lesch-Nyhan syndrome patients with self-mutilation behavior; one was treated with a preservative method using a soft mouthguard, and the other was treated with extraction of all teeth.

• Clinics in Shoulder and Elbow
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• v.24 no.4
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• pp.231-238
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• 2021

Background: Extensor muscle strengthening exercises with counterforce braces (EX) is a conventional conservative treatment for lateral epicondylitis (LE) of the elbow. In addition, polydeoxyribonucleotide (PDRN) or extracorporeal shockwave therapy (ESWT) has been recently used for LE. Methods: Sixty-three patients with chronic LE participated in this study and randomly allocated in three groups (G1: EX, G2: EX+PDRN injection, and G3: EX+ESWT). All of the three groups were taught to perform EX at the first out-patient department (OPD) visit. Group 2 was injected with 3 mL PDRN (5.625 mg/3 mL), while group 3 received ESWT at the first OPD visit. Visual analog scale pain score, Mayo elbow performance score (MEPS), and ultrasonographic examination were checked before, 6 weeks, and 12 weeks after the treatments. Results: Overall functional scores and ultrasonographic findings in all three groups improved after treatment. The mean MEPS in group 2 improved more than groups 1 and 3 at 6 weeks (G1, 56.9>62.4; G2, 54.3>65.0; G3, 55.7>62.6), and more than group 1 at 12 weeks (G1, 56.9>67.9; G2, 54.3>73.6). The mean common extensor tendon depth (CETD) on ultrasonography in group 2 increased more than groups 1 and 3 at 6 and 12 weeks (6 weeks: G1, 0.385>0.386; G2, 0.332>0.392; G3, 0.334>0.357; 12 weeks: G1, 0.385>0.409; G2, 0.332>0.438; G3, 0.334>0.405 [cm]). Conclusions: PDRN injections combined with EX exhibited a greater improvement in mean MEPS and mean CETD compared to EX only or EX combined with ESWT for LE within the 12 weeks follow-up.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.1
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• pp.1-9
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• 2000

Purpose : Spine is one of the most common sites of the metastatic bone tumors. Conservative management such as chemotherapy or radiotherapy has been preferred in most cases. However, the neurologic deficit has not been usually improved, and the quality of life was poor. The purpose of this study was to show the efficacy of the surgical treatments for metastatic spinal tumors in terms of postoperative improvements of neurologic deficit and survival time. Materials and Methods : Authors have reviewed the literatures and analyzed 14 patients of metastatic spinal tumors who were received operative treatments between August 1991 and June 1999 at the our department of orthopaedic surgery. Results : The most frequent primary tumor was breast cancer in women and lung cancer in men. The thoracic region was the most common site. There was a preponderance of females over males, and the age ranged between 4th and 8th decade. The indications of surgical treatment comprised instability, progressive neurologic findings, resistance to radiotherapy, pathological fracture, long life expectancy( >6weeks), isolated metastasis and need for pathological diagnosis. The degree of preoperative neurological deficit might influence on the improvement of clinical symptoms after surgery. Conclusion : The surgical treatment reduced the neurological deficit and pain regardless of the operative methods. In the early stage of neurological deficit, the surgical treatment was important for better prognosis. Recently early active operative treatment was performed for metastatic spinal tumor to minimize the intractable pain and to prevent the progression of the neurologic deficit. Early intervention can improve the quality of life and long term survival.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.153-160
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• 2018

Purpose : We retrospectively analyzed doses of each radiation therapy technique used in the treatment for left breast cancer patients after partial mastectomy through dose results for normalorgans and tumor volume to use this as a clinical reference for radiation therapy of domestic left breast cancer patients. Materials and Methods : 40 patients who underwent partial mastectomy on left breast cancer were classified in 3 treatment methods. The treatment plan was evaluated by HI(homogeneity index), $D_{95%}$, and CI(conformity index), and the $V_{hot}$ for gross tumor volume and clinical target volume of each treatment method. In Cyberknife treatment, tumor volume was the same as high dose volume in the other techniques, so no consideration was given to clinical target volume. Treatment plan evaluation for normal organs were evaluated by mean dose on ipsilateral lung, heart, left anterior descending artery, opposite breast and lung, and non-target tissue. Result : Treatment with volumetric arc radiotherapy(VMAT) showed $95.84{\pm}0.75%$ of $D_{95%}$ on the clinical target volume, significantly higher than that of 3D-CRT. The $D_{95%}$ value of the total tumor volume was slightly higher than the other treatments. In Cyberknife treatment, the dose to the normal organs was significantly lower than other treatments. Overall, the maximum dose and mean dose to the heart were $26.2{\pm}6.12Gy$ and $1.88{\pm}0.2Gy$ in VMAT treatment and $20.25{\pm}9.35Gy$ and $1.04{\pm}0.19Gy$ in 3D-CRT therapy, respectively. Conclusion : In comparison on 3D-CRT and VMAT, most of the dosimetric parameters for the evaluation of the treatment plan showed similar values, so that there is no significant difference in treatment plan evaluation. It is possible to select the treatment method according to the patient's anatomical structure or possibility of breath control. Cyberknife treatment is very useful treatment for normal organs because of its accurate dose exposure to the tumor volume However, it has restrictions to treat the local area, to have relatively long treatment time and to involve invasive procedure.

• Economic and Environmental Geology
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• v.40 no.3 s.184
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• pp.277-293
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• 2007

Seasonal and spatial variations in the concentrations of trace elements, pH and Eh were found in a creek watershed affected by mine drainage and leachate from several waste rock dumps within the As-Pb-rich Indae mine site. Because of mining activity dating back to about 40 years ago and rupture of the waste rock dumps, this creek was heavily contaminated. Due to the influx of leachate and mine drainage, the water quality of upstream reach in this creek was characterized by largest seasonal and spatial variations in concentrations of Zn(up to $5.830 mg/{\ell}$), Cu(up to $1.333 mg/{\ell}$), Cd(up to $0.031 mg/{\ell}$) and $SO_4^{2-}$(up to $173 mg/{\ell}$), relatively acidic pH values (3.8-5.1) and highly oxidized condition. The most abundant metals in the leachate samples were in order of Zn($0.045-13.909 mg/{\ell}$), Fe($0.017-8.730mg/{\ell}$), Cu($0.010-4.154mg/{\ell}$) and Cd($n.d.-0.077mg/{\ell}$), with low pH(3.1-6.1), and high $SO_4^{2-}$(up to $310 mg/{\ell}$). The mine drainage also contained high concentrations of Zn, Cu, Cd and $SO_4^{2-}$ and remained constantly near-neutral pH values(6.5-7.0) in all the year. While the leachate and mine drainage might not affect short-term fluctuations in flow, it may significantly influence the concentrations of chemicals in the stream. The abundance and chemistry of Fe-(oxy)hydroxide within this creek indicated that the Fe-(oxy)hydroxide formation could be responsible for some removal of trace elements from the creek waters. Spatial and seasonal variations along down-stream reach of this creek were caused largely by the influx of water from uncontaminated tributaries. In addition, the trace metal concentrations in this creek have been decreased nearly down to the background level at a short distance from the discharge points without any artificial treatments after hydrologic mixing in a tributary. The nonconservative(i.e. precipitation, adsorption, oxidation, dissolution etc.) and conservative(hydrologic mixing) reactions constituted an efficient mechanism of natural attenuation which reduces considerably the transference of trace elements to rivers.

• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.61-66
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• 2000

Purpose : The diagnosis of the causes of residual pain after ankle fractures and the treatment is not simple. The authors analyzed the clinical results of the patients with residual pain after ankle fracture fur whom ankle arthroscopy was undertaken, for the purpose of evaluating the efficacy of arthroscopic diagnosis and treatment. Materials and Methods : From January 1997 to June 1998, ankle arthroscopy was done for the seventeen patients suffering from residual ankle pain and limitation of motion after ankle fracture. Their symptoms were not improved despite conservative treatment. There were sixteen men and one woman, and their mean age was 37.4 years. Result : Radiological examination revealed loose bodies in two patients, and osteophytes at the anterior rim of the tibia in fourteen patients. By the classification of osteoarthritic change, three ankles were assigned to grade 0, eight to grade I, six to grade II, and none to grade III. On arthroscopic examination, soft tissue impingement was found In thirteen cases, loose bodies in five cases, and osteochondral lesions in four cases. For arthroscopic treatments, removal of soft tissue, abrasion of osteophytes, cartilage shaving and removal of loose bodies were done. Clinical results were evaluated using Evanski and Waugh score. Preoperative overall score of 58.7 points jumped to 74.6 points after the operation, and in fourteen patients$(82\%)$ the symptoms were improved. Conclusion : Ankle arthroscopy is considered to be a very useful diagnostic and treatment method fer the patients with residual complaints after ankle fracture.

• Journal of Gastric Cancer
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• v.8 no.1
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• pp.27-34
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• 2008

Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.106-119
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• 1988

For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.