• Neonatal Medicine
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• v.17 no.1
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• pp.75-83
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• 2010

Purpose : This study was performed to determine the predictors of failed closure of a patent ductus arteriosus (PDA) following the first course of indomethacin in symptomatic preterm infants. Methods : Forty three of 43 preterm infants, admitted to the neonatal intensive care unit diagnosed with PDA and treated with indomethacin at the Korea University Medical Center between January 1990 and October 2007, ware studied. The perinatal risk factors affecting the failed closure of PDA were retrospectively assessed. Results : The failed PDA closure group included 16 (37%) out of 43 infants three of whom underwent surgery. The closure group included 27 (63%) out of 43 infants. In the failed closure group, the Apgar scores (1 min, 5 min) were significantly higher (P<0.05) and antenatal steroid administration was significantly lower (P<0.05). In addition, dopamine administration was significantly lower (P<0.05) and the mean postnatal age at diagnosis was significantly lower (P<0.05). Multiple logistic regression for the prediction of failed PDA closure found only antenatal steroid administration (OR 0.092, CI 0,010-0.826, P=0.0331) as an associated factor. Conclusion : In patients with antenatal steroid administration the failed PDA closure rate was significantly lower. Therefore, antenatal steroid administration can be considered as an important factor for the closure of PDA in preterm pregnancies.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.183-192
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• 2006

Purpose: This study was undertaken to evaluate the factors correlated with the clinical course and outcome in patients of Henoch-Sch${\ddot{o}}$nlein Purpura. Methods: The medical records of 104 children diagnosed with Henoch-Sch${\ddot{o}}$nlein Purpura (HSP) from January 1996 to April 2006 were reviewed retrospectively. The patients were divided into two groups: patients with Gastrointestinal (GI) symptoms and those without GI symptoms. When there were joint, scrotum, and renal symptoms except for skin lesion in whole HSP, those patients were excluded. The history of acute infection, duration of admission, treatment requirement, recurrence of HSP, CBC, stool occult blood test, abdominal ultrasonographic findings and GI endoscopic findings were reviewed. Results: Among 104 patients, patients with GI symptoms included 66 cases (63.5%), those without GI symptoms accounted for 38 cases (36.5%). GI symptoms included: abdominal pain in 57 cases (54.8%), vomiting 21 cases (20.2%), GI bleeding 5 cases (4.8%), nausea 3 cases (2.9%) and diarrhea 3 case (2.9%). Positive GI symptoms and GI mucosal lesions on GI endoscopy had a statistically significant correlation with increased admission duration, treatment requirement, recurrence of HSP, and positive stool occult blood. Six cases with small intestinal wall thickening were noted on abdominal ultrasonography. Six cases of hemorrhagic gastritis and hemorrhagic duodenitis, 3 cases of duodenal ulcer, 3 cases of hemorrhagic gastritis and duodenal ulcer, 2 cases of hemorrhagic duodenitis and colitis, and 1 case of colitis were noted on GI endoscopy. Conclusion: These results suggest that GI endoscopic examination may be helpful for the diagnosis and treatment of children with HSP.

• The Journal of Korean Medicine
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• v.16 no.2 s.30
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• pp.177-194
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• 1995

The following conclusions were obtained after bibliographic investigation on the therapy of lung cancer by western, oriental, and integrated oriental and western medicine. 1. Lung cancer is classified into small cell lung cancer(SCLC) or non small cell lung cancer(NSCLC) in the treatment by western medicine, and applied with the means of surgery, radiotherapy and chemotherapy alone or combined, depending on the stage and the symptom. 2. Treatment by oriental medicine includes the means of strengthening body resistance to dispel pathogenic factors(扶正祛邪), combined approach of reinforcement and expulsion(攻補兼施), and reinforcing both qi and blood(氣血雙補), depending on the initial, middle, and terminal stage. And also treatment based on differentiation of symptom(辨證施治) is applied according to the type of symptom; deficiency of qi of both lung and spleen(肺脾氣虛), heat symptom of lung by deficiency of yin(肺熱陰虛), stagnation of damp-phlegm and blood(濕痰瘀阻), stagnation of qi and blood(氣血瘀滯), deficiency of both qi and yin(氣陰兩虛). Single or combined herb drug is used according to the symptom. 3. Treatment by integrated oriental and western medicine improved survival rate and quality of life. It promoted recovery and improved survival rate in the patients receiving surgery. Integrated radiotherapy and oriental medicine treatment reduced adverse effect by radiotherapy and improved therapeutic effect and survival rate. Integrated chemotherapy with oriental medicine treatment reduced side effect by chemotherapy and improved quality of life and survival rate. These results suggest that therapy of lung cancer should be applied with integrated oriental and western medicine from diagnosis to treatment for promoting therapeutic effect. And further study on this therapy should be ensued.

• The Journal of Korean Medicine
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• v.16 no.2 s.30
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• pp.453-489
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• 1995

The research of the phrases related with physiology of stomach and spleen in the contents of Huang Di Nei Jing(黃帝內經) known as the Bible of oriental medicine will make a contribution to a deep understanding of disease of stomach and spleen and a proper clinical diagnosis and treatment of them. In this research of the most appropriate glosses recorded nine kinds of representative medical books including Huang Di Nei Jing Somoon(黃帝內經素問) of Wang Bing(王氷) were picked out: The summaries of the selected contents are as follows: 1. The word 'saliva(涎)' in 'the spleen controls saliva(脾爲涎)' can be viewed as a generic term referring to oral cavity secretion gland as well as the secretion fluid of salivary gland. 2. The phases 'a large reservoir(太倉)', barn organs', 'a reserboir of food stuff', 'a stomach as the market(胃爲之市)', etc mean the function of stomach to receive food(胃主受納). 3. The phase 'generation of five tastes(五味出焉)' means both 'the function of stomach to transform food into chyme(胃主腐熟)' and 'the channelling function of spleen.(脾主運化)' 4. The flowing of the food-Qi(食氣) into stomach brings about spreading Jung(精) into liver and then percolating Jung(精) flow into channel. The channel-Qi(脈氣) flows into lung through channel. As a result, all kinds of channels gather together in lung and Jung(精) is sent into skin and hair. The assembly of Jung(精) with skins and channels moves Qi(氣) into fu-organ and so jung(精) and mental activity(神明) in fu-organ(府) come to be in four organs(四臟). Then if Qi(氣) comes back to power balance unit(權衡) being in the state of equilibrium(權衡以平), the hole of Qi(氣口) comes to determine the matter of life and death through achieving Chun-quan-chi(-寸-關-尺). The above mentioned phrases means the digestion, asorption and transmission of food. When food is taken in stomach, Jung-Qi(精氣) comes to be over flowed upward into spleen, back into lung, finally downward into bladders through water-conduit(水道) controlled by lung. When water- Jung(水精) radiates into whole body with channels of five organs(五臟), both of them fit together with and yin-yang(陰-陽). Therefore, the grasping of the rise and decline of yin-yang(陰C-陽) is necessary to consult patients. The above mentioned phrases is properly viewed to designate the asorption, transmission and excretion of food. 5. Spleen controls flesh(脾之合肉也), the state of spleen is known by human lips, and what this means is that liver plays functions of spread and expansion(肝主疏泄). 6. The phrase 'Jung Jung'((中精)) in 'gallbladder dominates Jung jung(膽主中精)', which in one of the specific expression of 'liver plays functions of spread and expansion(肝主疏泄). 7. It is right that the phase 'The eleven organs in all are determined by gallbladder'(凡十,一臟取決於膽也) is correctly paraphrased as 'only one of ten organs, spleen, is determined by gallbladder'.(凡十,一臟取決於膽也), 8. The small intestine is an organ. which receives the materials digested and sends them out. This means that the function of transforming materials(化物) factually refers to that of separating clearity and blur(泌別淸濁). And it is also thought to have the function of ascending clearity and descending blur(升淸降濁), 9. A large intestine is a transmitting organ(傳導之官) from which a change comes out(變化出焉). the phrase 'change'(變化) in this sentence means both the intake of water and nutrition and the formation procedure of stool through excretion of mucocele.

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.1-9
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• 2009

Liver transplantation is definitive treatment for the patients suffering from hepatitis, severe liver cirrhosis and liver cancer. In these patients, systemic infections under immunosuppression may occur easily. Therefore, primary object of dental treatments before liver transplantation is absolute removal of oral infection source. In addition, comprehensive dental management plan is essential for success of liver transplantation. The present study has been performed to investigate decayed, missing and filled permanent teeth index(DMFT index), degree of oral hygiene, past medical history, need of dental treatment, completion of dental treatment need and time interval between dental visit and operation date of liver transplantation in liver transplant candidates. Obtained results were as follows; 1. Decayed teeth of the patients were 2.68, missing teeth were 4.02 and filled teeth were 3.42. DMFT index was 10.12. 2. Twenty percents of patients showed moderate to severe food impactions, 42.2% of patients had moderate to heavy calculus and 37.8% of patients displayed gingival inflammation with swelling. 3. Patients needed periodontal treatments more than any other dental treatments. Periodontal treatments were needed for 88.9% of patients, operative & endodontic treatments were 46.7% of patients and 33.3% of patients needed for oral & maxillofacial surgical treatments. 4. Among 90 patients, time interval between scheduled operation date of liver transplantation and dental visit was within 2 weeks for 32.2% of patients, within 1 week for 20.0% of patients. In conclusion, most liver transplant candidates needed dental treatments for removal of potential infection sources. However because of insufficient interval between dental visit and operation date, they had taken liver transplantation procedures without comprehensive dental management. Development of preventive and comprehensive dental management program is mandatory for these patients. Cooperative interdisciplinary management will play a positive role for successful liver transplantation.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.375-382
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• 2008

This study was a preliminary study to establish diagnostic criterias and treatment for Orofacial Movement Disorders. The 33 Orofacial Movement Disorder patients who were visited in the department of Oral Medicine from September, 2007 to December, 2007 were selected for this study. We analyzed the age, sex, systemic diseases, the diagnosis and the cause of the patients' chief complaints, the self-consciousness and the types of orofacial movements. The obtained results were as follows : 1. Female were predominant in orofacial movement disorders(81.82% vs 18.18%) and mean age was 78.78(56 to 87) years. 2. They almost had systemic diseases(81.82%). Hypertenstion was the most common disease(22.41%) and diabetes mellitus(17.24%), depression(8.62%), gastritis(8.62%) in turns. 3. In clinical manifestation, temporomandibular disorder was the most frequently complained symptom(33.33%), and soft tissue disease(21.57%), burning mouth syndrome(17.65%), orofacial movement itself(15.69%), diffuse orofacial pain(6명, 11.76%) in turns. 4. Most orofacial movement disorders are idiopathic(72.73%), and related to prosthetic treatment(24.24%), related to antidepressant medication(3.03%) in turns. 5. The jaw-closing type was the most common type of orofacial movement disorders, and lateral type(33.33%), jaw-opening types(16.67%) in turns. 6. There were more patients who did not conscious of their orofacial movements than those who did.(54.55% vs 45.45%). In conclusion, dentists must be consider the orofacial movement disorders in patients who have orofacial pain. Also, dentists should obtain a proper history and perform a clinical examination to avoid misdiagnosis and inappropriate, irreversible treatment.

• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.4
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• pp.165-178
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• 2018

Objectives: To determine the current status of the treatment of breast cancer patients by Korean Medicine doctors (KMDs) and to examine the need for clinical practice guidelines (CPGs) for the supportive care of these patients. Methods: This cross-sectional study used a self-administered questionnaire. Participants were asked about their experience in treating breast cancer patients; the number of breast cancer patients they currently treat; the main complaints expressed by, diagnoses of, and treatments used for such patients; and their opinions about Korean Medicine (KM) as the basis for providing supportive care for breast cancer. Results: The data for this study were collected from 322 respondents. 84 of whom reported having ever treated patients with breast cancer. Most breast cancer patients who visited the KM clinic were classified as stage I or II, and their major complaints were fatigue, general weakness and musculoskeletal pain. The major diagnostic strategies were syndrome differentiation and pulse diagnosis. The major treatments administered were herbal medicine, acupuncture, and moxibustion. KMDs cited a need for medical information, such as CPGs, as their most important concern with regard to the treatment of breast cancer patients. Conclusions: This survey determined the prevalence of the use of KM for Korean breast cancer patients. Our results underscore the need for clinical practice guidelines for using of KM as the basis of supportive care for breast cancer and for informing clinicians and patients about this approach.

• Journal of Sasang Constitutional Medicine
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• v.10 no.1
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• pp.81-99
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• 1998

1. Background : Sasang Constitutional Medicine divides mankind into Taeyangin(太陽人), Taeumin(太陰人), Soyangin(少陽人) and Soeumin(少陰人) according to appearance, moral nature and characteristic of constitutional symptoms, and it is a medical science to study about different treatment for each constitution. In Sasang Constitutional Medicine, diagnosis of constitution was so important that we had the necessity of studying constitutional diagnostic method which had presented wholly and intuitively in Dongyi Soose Bowon(東醫壽世保元) with objective and analytic thinking. There were several attempts to classify Sasang Constitutional Types through morphological investigation of each parts of body. The one of them was to use measuring the body. In this study, we purposed to make clear whether the analysis of fingerprints and palm, one of the physical anthropologic methods would be helpful to classify Sasang Constitution. 2. Method : After practicing Questionnaire I and QSCC(Questionnaire of Sasang Constitution) II from 347 healthy Korean adults(242 males and 106 females), we analyzed fingerprints and palm prints of 208 people(142 males and 66 females) who were classified same constitution from two questionnaires. We analyzed the types of fingerprints according to the number of triradius and counted the number of dermal ridges from fingerprint center to triradius. We found triradius in the lower part of each finger and analyzed the courses of dermal ridges and counted the number of dermal ridges between each triradius. We mesured angle atd, and then researched relationship between fingerprints, palm prints and Sasang Constitution. 3. Result and Conclusion : The results of Sasang Constitution analysis of 208 Korean adults showed 76 Taeumin(36.5%), 81 Soeumin(39.0%) and 51 Soyangin(24.5%). The analytic results of fingerprints and palm prints are as follows : The types of fingerprints were helpful to sort Taeumin and the types of palm prints were helpful to sort Soyangin and Soeumin especially. In addition, the number of dermal ridges in fingerprints and palm prints were helpful to sort Soyangin. Fingerprints and palm prints have characteristic in each constitutions, so the investigation of fingerprints and palm prints seems to helpful to classify Sasang Constitution. We are planning to report fingerprints and palm prints of more subjects.

• Radiation Oncology Journal
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• v.15 no.1
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• pp.11-18
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• 1997

Purpose : To evaluate the efficacy of combined treatment of surgery and chemoradiotherapy for supratentorial primitive neuroectodermal tumors (SPNET) and obtain the Prognostic factors and complications Materials and Methods .The a9e of 18 patients ranged from 1 to 27 years (median=5 years). There were 12 males and 6 females The extents of surgery were gross total (n:9), subtotal (n:8), biopsy only (n: 1). Craniospinal radiotherapy was delivered to all the patients except 2 patients who were treated only with the whole brain and primary lesion. Radiation dose were 3120-5800cGy (median=5460) to primary mass, 1500-4200cGy (median=3600cGy) to the whole brain and 1320-3600cGy (median= 2400 cGy) to the spinal axis. Chemotherapy was done in 13 patients. Median follow-up period was 45 months ranged from 1 to 89 months. Results : Patterns of failure were as follows; local recurrence (1), multiple intracranial recurrence (2), spinal seeding (3), craniospinal seeding (2) and multiple bone metastasis (1). Two of two patients who did not received craniospinal radiotherapy failed at spinal area. All the relapsed cases died at 1 to 13 months after diagnosis of progression. The 2- and 5-rear overall survival rates were $61\%\;and\;49\%$, respectively The a9e, sex, tumor location did not influence the survival but aggressive resection with combined chemotherapy showed better outcome. Among 9 survivors, complications were detected as radiation necrosis (n=1), hypopituitarism (n=2), cognitive defect(n=1), memory deficit (n=1), growth retardation (n=1). Conclusion : To improve the results of treatment of SPNET, maximal surgical resection followed by radiation therapy and chemotherapy is necessary. The extended radiation field including craniospinal axis may reduce the recurrence in spinal axis.

• Radiation Oncology Journal
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• v.14 no.3
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• pp.211-219
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• 1996

Purpose : Hysterectomy without lymph node dissection was considered an inadequate treatment method for invasive uterine cervix cancer. Usually the procedure was performed inadvertently on patients who were thought to have benign or premalignant conditions preoperatively. We analysed radiotherapy results of such patients to evaluate survival rates, failure patterns and prognostic factors according to various conditions. Materials and Methods : Sixty one patients undergoing hysterectomy in the presence of invasive cervical carcinoma were reviewed retrospectively. Preoperative diagnosis were carcinoma in situ (38 cases), severe dysplasia (2), myoma (6), uterine bleeding (4), uterine prolapse (2). and early invasive cervix cancer (10) (One patient had myoma and carcinoma in situ coincidently). Patients received postoperative megavoltage radiotherapy from August 1985 to December 1993, and minimum follow-up period was 24 months. Eight patients received ICR only, 6 patients ICR and external radiation, and 47 patients received external radiation therapy only. Results : Overall 5-year survival rate and relapse-free survival rate werer $83.8\%$, $86.9\%$ respectively. For patients with retrospective stage IA, IB, IIB (gross residual after surgery), and vaginal cuff recurrence were $90.9\%$, $88.8\%$, $38.4\%$, and $100\%$ respectively There were 8 cases of treatment failure, most of them (5/8) were in patients with gross residual disease, other patients were full thickness involvement of cervix wall (2/8) except one. Patients with early vaginal cuff recurrence and microinvasive cervical cancer (stage IA) had no treatment related failure Prognostic factors affecting survival by univariate analysis were status of residual disease, tumor histology and retrospective stage. Conclusion : Adjuvant radiotherapy appeared to be effective treatment method for patients with presumed stage IA, IB and early local recurrent disease after inadvertent hysterectomy Survivals for patients with gross disease remained after inappropriate hysterectomy was poor, So, early cancer detection and Proper management with precise pretreatment s1aging is necessary to avoid inadherent hysterectomy especially in the cases of gross residual disease.