• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.30-38
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• 1998

Background : Hepatocellular carcinomoma is the 3rd most common malignancy and the 2nd most common cause of death in Korea. The prediction of life-expectancy in terminal cancer patients is a major problem for patients, families, and physicians. We would like to investigate the prognostic factors of hepatocellular carcinoma, and therefore contribute to the prediction of the survival time of patients with hepatocellular carcinoma. Methods : A total of 91 patients(male 73, female 18) with hepatocellular carcinoma who were admitted to the hospital between January and lune 1995 were entered into the study, and data were collected prospectively on 28 clinical parameters through medical obligation record. We surveyed an obligation and local district office records, and confirmed the surivival of patients till July, 1996. Using Cox-proportional hazard model, give the significant variables related to survival. These determined prognostic factors. Life regressional analysis was used, there were calculated predicted survival day based on combinations of the significant prognostic factors. Results : 1) Out of 91 patients, 73 were male, and 18 were female. The mean age was $56.7{\pm}10.6$ ears. During the study, except for 16 patients who could not follow up, out of 75 patients, the number of deaths was 57(76%) and the number of survivals was 18(24%). 2) Out of the 28 clinical parameters, the prognostic factors related to reduced survival rate were prothrombin time<40%(relative risk:10.8), weight loss(RR:4.4), past history of hypertension (RR:3.2), ascites(RR:2.8), hypocalcemia(RR:2.5)(P<0.001). 3) Out of five factors, the survival day is 1.7 in all of five, $4.2{\sim}10.0$ in four, $10.4{\sim}41.9$ in three, $29.5{\sim}118.1$ in two, $124.0{\sim}296.6$ in one, 724.0 in none. Conclusion : In hepatocellular carcinoma we found that the prognostic factors related to reduce survival rate were prolonged prothrombin time(<40%), weight loss, past history of hypertension, ascites, and hypocalcemia(<8.7mg/dl). The five prognostic factors enabled the prediction of life-expectancy in patients with hepatocellular carcinoma and may assist in managing patients with hepatocellular carcinomal.

• Clinical and Experimental Pediatrics
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• v.46 no.2
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• pp.122-127
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• 2003

Purpose : Baby-walkers are used by many parents because of the convenience they provide in keeping children occupied, quiet, happy, and in stimulating ambulation. But, these devices have more risks than benefits. Therefore, we performed a study to evaluate the effects of baby-walkers on motor development of human infants according to the hours used in a day, total duration(months), and types of injuries associated with the walkers, and to establish effective methods. Methods : 1,045 questionnaires were filled out by parents who had a baby whose aged between 8 months and 15 months that visited local pediatric clinics and medical centers in Chonju and Iksan from May 1, 2002 to July 31, 2002. They were analyzed in a control group that didn't use babywalkers, a low-user group that used baby-walkers less than 2 hours a day and a high-user group that used them more than 2 hours a day. Results : The mean age of the 1,045 babies whose parents responded to the question investigation was $12.6{\pm}2.4$ months. The number of babies who used the baby-walkers were 811(77.6%). Crawling and walking alone were delayed in the high-user group. The parents who knew the side effects of the baby-walkers totalled 392(48.3%). Conclusion : The findings of this study revealed that many parents didn't know the effects of baby-walkers on motor development in their infants and the risks associated with baby-walkers. Therefore, we should educate parents on the risks of baby-walkers and recommend reducing the use of baby-walkers.

• Journal of Environmental Impact Assessment
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• v.25 no.6
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• pp.514-524
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• 2016

The Bio-Climatic impact Assessment System, BioCAS was utilized to produce analysis maps of daily maximum perceived temperature ($PT_{max}$) and excess mortality ($r_{EM}$) over the entire Seoul area on a heat wave event. The spatial resolution was 25 m and the Aug. 5, 2012 was the selected heat event date. The analyzed results were evaluated by comparing with observed health impact data - mortality and morbidity - during heat waves in 2004-2013 and 2006-2011,respectively. They were aggregated for 25 districts in Seoul. Spatial resolution of the comparison was equalized to district to match the lower data resolution of mortality and morbidity. Spatial maximum, minimum, average, and total of $PT_{max}$ and $r_{EM}$ were generated and correlated to the health impact data of mortality and morbidity. Correlation results show that the spatial averages of $PT_{max}$ and $r_{EM}$ were not able to explain the observed health impact. Instead, spatial minimum and maximum of $PT_{max}$ were correlated with mortality (r=0.53) and morbidity (r=0.42),respectively. Spatial maximum of $PT_{max}$, determined by building density, affected increasing morbidity at daytime by heat-related diseases such as sunstroke, whereas spatial minimum, determined by vegetation, affected decreasing mortality at nighttime by reducing heat stress. On the other hand, spatial maximum of $r_{EM}$ was correlated with morbidity (r=0.52) but not with mortality. It may have been affected by the limit of district-level irregularity such as difference in base-line heat vulnerability due to the age structure of the population. Areal distribution of the heat impact by local building and vegetation, such as spatial maximum and minimum, was more important than spatial mean. Such high resolution analyses are able to produce quantitative results in health impact and can also be used for economic analyses of localized urban development.

• Radiation Oncology Journal
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• v.18 no.3
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• pp.177-181
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• 2000

Purpose : Rarity of olfactory neuroblastoma makes it difficult for treating Physician to Practice with a consistent protocol. This study is peformed to analyze our experience with various treatment modalities for patients with olfactory neuroblastoma. Discussion includes review of some recently published literatures. Methods and Materials : Between June of 1979 and April of 1997, 20 patients were treated under the diagnosis of olfactory neuroblastoma at Seoul National University Hospital. There were 14 male and 6 female patients. Age at initial treatment ranged from l3 to 77 years with median or 24 years. fifteen or 20 patients had Kadish stage C. They were treated with various combinations of surgery, radiation therapy and chemotherapy; surgery+postoperative radiation therapy+adjuvant chemotherapy for 2 patients, surgery+postoperative radiation therapy for 6, neoadjuvant chemotherapy+surgery for 1, surgery+adjuvant chemotherapy for 1, surgery only for 2, neoadiuvant chemotherapy+ radiation therapy for 3, radiation therapy+adjuvant chemotherapy for 1, radiation therapy only for 3, and no treatment for 1 patient. Results : Follow-up ranged from 2 month to 204 months with mean of 39.6 months. The overall 5- and 10-year survival rates are 20% and 10%, respectably. Four patients are alive at the time of data analysis. One of four living patients was treated with radical surgery, postoperative radiation therapy and adjuvant chemotherapy, two patients with radical surgery and postoperative radiation therapy, and one with radical surgery only. Conclusion : Multidisciplinary approach, including radical surgery, pre- or post-operative radiation therapy and chemotherapy, should be addressed at the initial time of diagnosis. Although limited by small number of the patients, this study suggests importance of local treatment modality, especially radical surgery in the treatment of lofactory neuroblastoma.

• Journal of dental hygiene science
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• v.6 no.4
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• pp.285-293
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• 2006

The purpose of this study was to examine what affected the job satisfaction of dental hygienists in J local community in a bid to help boost their job performance. The subjects in this study were 156 dental hygienists who worked in north Jeolla province. A survey was conducted from July 24 through September 24, 2006, and the collected data were analyzed with SPSS Ver. 12.0 program. The findings of the study were as follows: 1. The dental hygienists investigated got a mean of 2.84 in job satisfaction out of possible five points, which was not a high score. By factor, they were most satisfied with relationship with colleagues(3.21), followed by the future prospects of the occupation(3.10), autonomy(3.07), environments(2.99) and pay(2.55). They found workload most dissatisfactory(2.03). 2. Concerning connections between their general characteristics and job satisfaction, their age had a significant impact on their satisfaction with autonomy(p < 0.001), and their marital status exerted a significant influence on their satisfaction with autonomy(p < 0.001) and pay(p < 0.05). The married dental hygienists were more pleased with those factors than the unmarried ones. Their service area made a significant difference to their satisfaction with the prospects of the occupation and relationship with colleagues(p < 0.001), as those from university hospitals were more contented with those factors. Their educational level affected significantly their satisfaction with autonomy(p < 0.001), workload(p < 0.05) and environments(p < 0.05). The better educated dental hygienists were pleased.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.2
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• pp.51-58
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• 2001

Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.327-336
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• 2011

Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

• Tuberculosis and Respiratory Diseases
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• v.48 no.5
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• pp.720-729
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• 2000

Background : Histological analysis of tuberculosis shows a spectrum of findings, from well formed granulomatous inflammation with few bacilli in patient with normal immune response to M. tuberculosis to poorly formed granulomatous inflammation with many bacilli in patient with defective immune response. To evaluate the degree of immune response to M. tuberculosis, we studied the histologic features, including the presence of acid fast bacilli(AFB) in lymph node of patients with cervical tuberculous lymphadenitis, and compared them with clinical characteristics. Methods : We reviewed the histologic features of 33 cases of cervical tuberculous lymphadenitis and processed the excised nodes for auramine-rhodamine staining to detect AFB. The AFB positivity in tissue was compared with the histologic features(degree of granuloma formation, presence of caseation necrosis, presence of neutrophilic infiltration) and clinical characteristics(lymph node size, duration of symptom, presence of local symptom or radiologic evidence of pulmonary tuberculosis). Results : 1) The mean age at diagnosis was 42.4 years, and male to female ratio was 1:4.5. 2) Histologically, all cases showed well formed granuloma and variable degrees of caseation necrosis, and 39% of the cases showed neutrophilic infiltration in the granulomatous inflammation. 3) AFB were confirmed in 52% of the cases, and they were found extracellularly and at the periphery of caseation necrosis. 4) There was no association between AFB positivity and histological features or clinical characteristics. Conclusion : Cervical tuberculous lymphadenitis showed well formed granulomatous inflammation with caseation necrosis, and there was no association between AFB positivity in the tissue and histological or clinical characteristics.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.148-154
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• 2003

Purpose: To correlate the significant MRI findings and histologic features of the Schwannoma of the extremities and to review the clinical characteristic and the result of the surgical enucleation. Materials and Methods: 67 patients with pathologically proven Schwannoma of the extremities, who were surgically treated at our institutes between January 1996 and June 2002, were selected for this study. The clinical records, EMG, MRI and histologic findings were reviewed. Age of the patients ranged from 8 to 75 years with average of 44.7 years. Mean follow-up period was 9.7 months with raging from 3 months to 46 months. Results: On MRI, Schwannoma shows a well-demarcated fusiform mass with a low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which is connected to parent nerve. A target pattern with peripheral hyperintensive rim and central low intensity on T2-weighted images was seen in 6 cases (15%), and fasciculation pattern with inhomogenous intensity in the hyperintensity on T2-weighted images was observed in 24 cases (62%). Various degree of cystic degeneration was discovered in 25 cases (64%). Postoperative complications include tingling sense or radiating pain in 5 patients, paresthesia in 2 patients, nerve palsy in 2 patients, but all of the complications were recovered during followup period. There were no local recurrence or malignant change. Conclusion: MRI demonstrates characteristic findings of Schwannoma, and very useful tool for preoperative diagnosis and planning of surgery. Exact preoperative diagnosis and meticulous enucleation are enough option of treatment.

• Pediatric Infection and Vaccine
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• v.15 no.2
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• pp.152-161
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• 2008

Purpose : Staphylococcal scalded skin syndrome (4S) is uncommon, but reports of 4S are on the increase during the recent years. The purpose of this study is to determine the clinical features and associated factors of 4S during the recent 10 years. Methods : We retrospectively reviewed the medical records and microbiologic results of 63 patients (27 neonates and 36 children) from January 1998 to December 2007. Results : Since 2003, the incidence of 4S has increased. The mean age of the patients was 16.3 months and the gender ratio was 1:1. The clinical types of 4S were 38 cases of the abortive type (60%), 19 cases of the intermediate type (30%) and 6 cases of the generalized type (10%). The culture results were 36 cases of Methicillin resistant S. aureus (MRSA), 4 cases of Methicillin sensitive S. aureus and 17 cases of no growth. The patients were treated with semi-synthetic penicillin. For the 9 patients who had MRSA isolated and who didn't improve with penicillin, they were treated with vancomycin instead of penicillin. All the patients had no complications. 4S abruptly increased in 2005, and especially in neonates, due to an MRSA outbreak at a local nursery room. The associated factors of 4S in neonates were hospitalization (27 cases), including nursery infection in 2005 (18 cases) and dermatitis (1 case). There was an unknown origin for some children, and the suggested factors for their infection were community acquired infection (24 cases), atopic dermatitis (9 cases) and hospitalization (3 cases). Conclusion : 4S has recently been increasing. The major associated factors of 4S are a history of hospitalization, an outbreak in a nursery room, atopic dermatitis and community acquired infection.