• Radiation Oncology Journal
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• v.23 no.3
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• pp.131-136
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• 2005

Purpose: The aim of this study was to evaluate the clinical results of postoperative radiotherapy for parotid gland malignancy, and determine prognostic factors for locoregional control and survival. Materials and Methods: Between 1980 and 2002, 130 patients with parotid malignancy were registered In the database of the Department of Radiation Oncology, Seoul National University Hospital. The subjects of this analysis were the 72 of these 130 patients who underwent postoperative Irradiation, There were 42 males and 30 females, with a median age of 46.5 years. The most common histological type was a mucoepidermoid carcinoma. There were 6, 23, 23 and 20 patients in Stages I, II, III and IV, respectively. The median dose to the tumor bed was 60 Gy, with a median fraction size of 1.8 Gy. Results: The overall 5 and 10 year survival rates were 85 and $76\%$, respectively, The five-year locoregional control rate was $85\%$, which reached a plateau phase after 6 years. Sex and histological type were found to be statistically significant for overall survival from a multivariate analysis. No other factors, Including age, facial nerve palsy and stage, were related to overall survival. For locoregional control, nodal involvement and positive resection margin were associated with poor local control. Histological type, tumor size, perineural invasion and type of surgery were not significant for locoregional control. Conclusion: A high survival rate of parotid gland malignancies, with surgery and postoperative radiotherapy, was confirmed. Sex and histological type were significant prognostic factors for overall survival. Nodal Involvement and a positive resection margin were associated with poor locoregional control.

• The Korean Journal of Pharmacology
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• v.25 no.1
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• pp.67-74
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• 1989

The effect of guanabenz on volume-induced micturition reflex contraction (VIMRC) in urethane-anethetized female rats was examined under adrenalectomy, chemical-sympathectomy, ganglionectomy, alpha-1, or alpha-2 blockade. Intracerbroventricular administration of guanalberz had little effect on VIMRC, but topical application suppressed amplitude and frequency of VIMRC. Guanabenz intravenous injection dose-dependently suppressed amplitude and frequency of VIMRC, with complete inhibition at dose of $100\;{\mu}g/kg$, but phenylephrine had no effect on VIMRC. Intravesicular peak pressure and amplitude of VIMRC were increased by 6-hydroxydopamine (6-OHDA) treatment when compared with control value, but yohimbine-, prazosin-hexamethonium-treatment and adrenalectomy did not show changes in VIMRC. Dose-response curve of guanabenz on amplitude and frequency of VIMRC shifted significantly to the right by treatment of yohimbine and 6-OHDA, and adrenalectomy. Median inhibitory dose $({\mu}g/kg)$ of guanabenz to amplitude of VIMRC showed 27.3 in control group, 381.6 in yohimbine, 294.1 in 6-OHDA and 54.1 in hexamethonium, and 38.8 in prazosin. Those of guanabenz to frequency of VIMRC showed 41.7 in control group, 571.1 in yohimbine, 410.8 in 6-OHDA, 141.4 in adrenalectomy, 59.6 in hexamethoinum and 31.4 in prazosin. These results suggest that guanabenz inhibits VIMRC through alpha-2 receptor stimulation rather than alpha-1 receptor stimulation and that catecholiamines released from sympathetic nerve ending and adrenal gland play a role in the inhibition.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1089-1093
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• 1998

Background: In 1992, we first developed the technique for video-assisted thoracoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Clinically, patients suffereing from distressing hyperhidrosis in their heads and faces were observed. Materials and methods: From March 1997 to March 1998, the vidio-assisted thoracoscopic sympathectomy and sympathicotomy were performed in 60 patients suffering from craniofacial hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Thirty-nine patients underwent a conventional sympathectomy(T1 sympathectomy group), and twenty-one patients underwent division of the sympathetic nerve trunk above the T2 sympathetic ganglion(T2 sympathicotomy). The median follow up was 9 months. Results: All of the treated patients obtained satisfactory alleviation of craniofacial hyperhidrosis. No recurrence was observed in group T1 sympathectomy whereas one occurred in sympathicotomy. The global rate of compensatory sweating was about the same in both groups ; 76.9% in T1 sympathectomy and 76.2% in T2 sympathicotomy. The rate of embarrassing and disabling compensatory sweating was 38.5% in T1 sympathectomy and 38.1% in T2 sympathicotomy with no significant in the statistic analysis(p> 0.05). No transient Horner's syndrome was observed in group T2 sympathicotomy whereas seven occurred in T1 sympathectomy with improvement in follow-up. Only an overnight hospital stay was required in both group. Conclusions: The video-assist thoracoscopic sympathicotomy is minimally invasive and effective. Video-assisted thoracoscopic T2 sympathicotomy has proven to be effective method and less complicated in treating patients with distressing craniofacial hyperhidrosis and consistent in obtaining the same results as T1 sympathectomy.

• Journal of Korean Foot and Ankle Society
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• v.24 no.2
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• pp.87-93
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• 2020

Purpose: This study evaluated the clinical results of surgical treatment with minimally invasive plate osteosynthesis for treating displaced intra-articular fractures of the calcaneus in comparison with conventional lateral extensile approach plate osteosynthesis. Materials and Methods: Of 79 cases of Sanders type II or III calcaneus fractures, 15 cases treated with the minimally invasive calcaneal plate (group M) and 64 cases treated with lateral extensile approach calcaneal plate (group E) were identified. After successful propensity score matching considering age, sex, diabetes mellitus history, and Sanders type (1:3 ratio), 15 cases (group M) and 45 cases (group E) were matched and the demographic, radiologic, and clinical outcomes were compared between the two groups. Results: The median time of surgery from injury was 2.0 days in group M and 6.0 days in group E (p=0.014). At the six months follow-up, group M showed results comparable with those of group E in radiographic outcomes. In the clinical outcomes, group M showed better postoperative American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores than did group E (p=0.001, p=0.008). A greater range of subtalar motion was achieved at the six months follow-up in group M (inversion 20.0° vs. 10.0°, p=0.002; eversion 10.0° vs. 5.0°, p=0.025). Although there were no significant differences in complications between the two groups (1 [6.7%] vs. 7 [15.6%], group M vs. group E; p=0.661), there was only one sural nerve injury and no wound dehiscence and deep infection in group M. Conclusion: Minimally invasive plate osteosynthesis showed superior clinical outcomes compared with that of the conventional lateral extensile approach plate osteosynthesis in Sanders type II or III calcaneus fractures. We suggest applying minimally invasive plate osteosynthesis in Sanders type II or III calcaneus fractures.

• Clinical and Experimental Pediatrics
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• v.53 no.5
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• pp.648-652
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• 2010

Purpose: A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses. Methods: A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 1994 to June 2009 was performed at Samsung Medical Center, Seoul, Korea. Results: Twenty-five patients were included in this study. On average, 1.67 cases per year were identified and the median age was 4.3 years. The common presenting clinical manifestations were fever (18/25, 72%), seizure (12/25, 48%), altered mental status (11/25, 44%), and signs of increased intracranial pressure (9/25, 36%). A total of 14 (56%) patients had underlying illnesses, with congenital heart disease (8/25, 32%) as the most common cause. Predisposing factors were identified in 15 patients (60%). The common predisposing factors were otogenic infection (3/25, 12%) and penetrating head trauma (3/25, 12%). Causative organisms were identified in 64% of patients (16/25). The causative agents were $S$ $intermedius$ (n=3), $S$ $aureus$ (n=3), $S$ $pneumoniae$ (n=1), Group B streptococcus (n=2), $E.$ $coli$ (n=1), $P.$ $aeruginosa$ (n=1), and suspected fungal infection (n=5). Seven patients received medical treatment only while the other 18 patients also required surgical intervention. The overall fatality rate was 16% and 20% of patients had neurologic sequelae. There was no statistical association between outcomes and the factors studied. Conclusion: Although uncommon, a brain abscess is a serious disease. A high level of suspicion is very important for early diagnosis and to prevent serious consequences.

• Korean Journal of Veterinary Research
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• v.43 no.1
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• pp.57-66
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• 2003

Single and 28-day repeated dose toxicity studies of botulimnn toxin type A were carried out in ICR mice and Sprague-Dawley rats, respectively. In the single dose toxicity study, botulinwn toxin was injected intraperitoneally to male and female mice at a single dose of 40, 59, 89 133 and 200 ng/10 ml saline/kg. All animals died from 59 ng/kg group. Some clinical signs, such as decrease in locomotor activity, dyspnea, prone position and ptosis, were observed in most of both sexes from 59 ng/kg group, but no signs were seen in all animals at 40 ng/kg group. The results showed that the median lethal dose of botulinum toxin might be in the range of 40-59 ng/kg in both sexes. In the repeated dose toxicity study, the test material was administered intradermally for 28 days at doses of 0 (vehicle-treated control), 1.25, 2.5, 5.0 and $10.0ng/head/50{\mu}{\ell}$ saline in male and female rats. No test material-related changes were noted in survivals, clinical signs, food and water consumptions and gross finding in any group. Botulinum toxin treatment significantly decreased the body weight gain rate in male of 5.0 ng/head group and over and in female of 10.0 ng/head group compared to vehicle-treated control. One or more relative organ weights (i.e., spleen, thymus, liver and kidney) were increased significantly from 5.0 ng/head group compared to vehicle-treated control in both sexes. Serum biochemistry revealed increases in aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine phosphokinase, total protein and albumin in male, and increases in AST and ALT and decreases in $K^+$ and $Cl^-$ in female without dose-pendent manners. In the histopathological study, physical stimulation by needle caused slight inflammations of dennis. In addition, botulinum toxin treatment induced denervation of nerve cell and disuse of muscle, resulting in atrophy of skeletal muscle in both sexes from 2.5 ng/head group. When the antibodies to toxin were determined in all animals, a significant increase in serum antibodies was observed from 5.0 ng/head group. The results showed that the NOAEL of botulinum toxin might be 1.25 ng/head for 28-day repeated dose toxicity in rats.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.46-53
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• 2001

The prevalence of supernumerary teeth is between $1{\sim}3%$. Of these, $90{\sim}98%$ occur in the maxilla with particular predilection for the premaxilla, preceded by mandibular third premolars, mandibular forth molars and maxillary paramolars. The most common ones occur in the maxillary anterior region, they may occur singly between the central incisors(mesiodens), or they may be double(mesiodentes). Maxillary anterior supernumeraries may erupt into the oral cavity or remain unerupted. It is found that approximately 25% are erupted, while the rest are unerupted. They are usually a small tooth with a cone-shaped crown and a short root. They may cause delayed eruption, median diastema, bodily displacement or rotation of the adjacent permanent teeth. Occasionally they may lead to the developement of dentigerous cyst or primordial cyst, or eruption into nasal cavity. In this study, 109 supernumeraries surgically extracted from premaxilla in 84 patients are analysed. The results are as follows : 1. Sex distribution of male and female is 2.2 : 1. 2. Almost cases are in pediatric age from 5 to 12 years old (87%). 3. Problems with supernumeraries are tooth malpositon, diastema, delayed eruption, eruption to nasal cavity and cyst formation. 4. Of 109 supernumeraries, 16(15%) are erupted into oral cavity, 92(84%) are impacted, and 1(1%) is erupted into nasal cavity. 5. Of 84 patients, 59(70%) have one supernumeray while 25(30%) have two supernumeraries. 6. Of 109 supernumeraries, 96(88%) are found within the region of the central incisors. 7. Of 109 supernumeraries, 94(86%) are vertically impacted, 11(10%) are horizontally impacted, 3(3%) are labiopalatally impacted and 1(1%) is impacted in nasal cavity. 8. Of 84 patients, we used palatal flap in 67(80%), labial flap in 6(7%), both flaps in 4(5%) and no flap in 7(8%). And incisive nerve was cut in 33(49%) of 67 palatal flaps. 9. Extration with ostectomy was done in 72 supernumeraries(66%), without ostectomy in 37 teeth(34%). 10. Extraction with tooth sectioning was done in 21 supernumeraries(19%), without tooth sectioning was done in 88 teeth(81%). 11. We used local anesthesia in 70 patients(83%) and general anesthesia in 14 ones(17%).

• Advances in pediatric surgery
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• v.2 no.2
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• pp.119-128
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• 1996

The survey on branchial anomalies was conducted by Korean Association of Pediatric Surgeons. A total of 173 cases were reported, which were managed by 36 members and cooperators during the three years from January 1, 1993 through December 31, 1995. The following results were obtained by retrospective analysis of the 173 cases of branchial anomalies. The presenting symptoms were cervical mass in 101 cases, pit with or without discharge in 71, cervical abscess in 47 and respiratory difficulty in 3. The average age of the patients with cervical abscess was 52 months. Seventy(79%) of 89 patients with branchial anomalies and a cystic mass had their first clinical manifestations by 1 year of age, while 40(51%) of 78 patients with only a branchial cyst had their first clinical manifestation in first year of life. Radiologic studies were carried out in 77 patients (43%). The preferred diagnostic modalities were ultrasonography(47 patients), simple neck radiogram(19) and CT scan(17). Preoperative diagnosis was correctly made in 156(91%) of 173 patients. Seventeen patients were incorrectly diagnosed as thyroglossal duct cyst in 5 patients, cystic hygroma in 4, dermoid cyst in 3, and lymphadenopathy in 3. There were no remarkable difference in sex and laterality of presentation but bilateral lesions were found in 9(5%) patients and unusual locations of the anomalies were the manubrium, left subclavicular area, median cervial area, preauricular and parotid area. There were 78(45%) patients with cyst, 52(30%) patients with sinus, 35(20%) patients with fistula and 8(5%) patient with skin tag. Embryological classification was possible in only 64(37%) patients. The 2nd branchial anomaly was present in 50(78%), the 1st branchial anomaly in 10(18%), and the 3rd or 4th branchial anomaly in 4(6%). Histopathological study of the lining epithelium(N=134) is recorded that 45% were lined with squamous epithelium, 17% with respiratory epithelium, 6% with. squamous and respiratory epithelium, 14% with inflammatory change. Lymphoid tissue was common(62%) in the wall of the lesions. Twelve(7%) of 158 patients had postoperative complications including wound complication, recurrence and facial nerve palsy.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.4
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• pp.805-817
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• 2009

This study was to investigate central localization of neurons projecting to the urinary bladder and urinary bladder-related acupoints(Wijung, $BL_{40}$) and neurons of immunoreactive to hormones and hormone receptors regulating urinary bladder function by using peudorabies virus(PRV). In this experiment, Bartha's strain of pseudorabies virus was used in rats to trace central localization of urinary bladder-related neurons and urinary bladder-related acupoints($BL_{40}$) which can regulate urinary system. PRV was injected into the urinary bladder and acupoints($BL_{40}$) related urinary system. After six days survival of rats, mainly common labeled neurons projecting to the urinary bladder and urinary bladder-related acupoints were identified in spinal cord, medulla, pons and diencephalon by PRV immunohistochemical staining method. First-order PRV labeled neurons projecting to urinary bladder and urinary bladder-related acupoints were found in the cervical, thoracic, lumbar and sacral spinal cord. Commonly labeled preganglionic neurons were labeled in the lumbosacral spinal cord and thoracic spinal cord. They were found in the lateral horn area(sacral parasympathetic nucleus and intermediolateral nucleus), lamina V-X, intermediomedial nucleus and dorsal column area. The area of sensory neurons projecting to urinary bladder and Wijung($BL_{40}$) was L5-S2 spinal ganglia and T12-L1 spinal ganglia, respectively. In the brainstem, the neurons were labeled most evidently and consistently in the nucleus of tractus solitarius, area postrema, dorsal motor nucleus of vagus nerve, reticular nucleus, raphe nuclei(obscurus, magnus and pallidus), C3 adrenalin cells, parapyramidal area(lateral paragigantocellular nucleus), locus coeruleus, subcoeruleus nucleus, A5 cell group, Barrington's nucleus and periaqueductal gray matter. In the diencephalon, PRV labeled neurons were marked mostly in the paraventricular nucleus and a few ones were in the lateral hypothalamic nucleus, posterior hypothalamic nucleus, ventromedial hypothalamic nucleus, arcuate nucleus, median eminence, perifornical nucleus, periventricular nucleus and suprachiasmatic nucleus. In cerebral cortex, PRV labeled neurons were marked mostly in the frontal cortex, 1,2 area, hind limb area, agranular insular cortex. Immunoreactive neurons to Corticotropin releasiing factor(CRF), Corticotropin releasiing factor-receptor(CRF-R), c-fos and serotonin were a part of labeled areas among the virus-labeled neurons of urinary bladder and Wijung($BL_{40}$). The commonly labeled areas were nucleus tractus solitarius, area postrema, reticular nucleus, raphe nuclei(obscurus, magnus and pallidus), locus coeruleus, A5 cell group, Barrington,s nucleus, arcuate nucleus, paraventricular nucleus, frontal cortex 1, 2 area, hind limb, and perirhinal(agranular insular) cortex. These results suggest that overlapped CNS locations are related with autonomic nuclei which regulate the functions of urinary bladder-relate organs and it was revealed by tracing PRV labeled neurons projecting urinary bladder and urinary bladder-related acupoints. These commonly labeled areas often overlap with the neurons connected with hormones and hormone receptors related to urination.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4335-4340
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• 2016

Background: Bone metastasis is a single condition but presents with various patterns and severities. Skeletal-related events (SREs) deteriorate overall performance status and reduce quality of life. However, guidelines for early detection and management are limited. This study includes a survey of the prevalence of bone metastasis in cases with common cancers in Thailand as well as a focus on survival patterns and SREs. Materials and Methods: A retrospective cohort analysis was conducted using a database of the Chiang Mai Cancer Registry and the Musculoskeletal Tumor Registry of the OLARN Center, Chiang Mai University. The prevalence of bone metastasis from each type of primary cancer was noted and time-to-event analysis was performed to estimate cancer survival rates after bone metastasis. Results: There were 29,447 cases of the ten most common cancers in Thailand, accounting for 82.2% of the entire cancer registry entries during the study period. Among those cases, there were 2,263 with bone metastases, accounting for 7.68% of entries. Bone metastasis from lung, liver, breast, cervix and prostate are common in the Thai population, accounting for 83.4% of all positive cases. The median survival time of all was 6 months. Of the bone metastases, 48.9% required therapeutic intervention, including treatment of spinal cord and nerve root compression, pathological fractures, and bone pain. Conclusions: The frequency of the top five types of bone metastasis in Thailand were different from the frequencies in other countries, but corresponded to the relative prevalence of the cancers in Thailand and osteophilic properties of each cancer. The results of this study support the establishment of country specific guidelines for primary cancer identification with skeletal lesions of unknown origin. In addition, further clinical studies of the top five bone metastases should be performed to develop guidelines for optimal patient management during palliative care.