• Journal of Korean Neurosurgical Society
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• v.40 no.5
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• pp.342-345
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• 2006

Objective : Gamma Knife Surgery[GKS] for the management of pineal region tumors is challengeable strategy as direct access to this area is not easy. The experiences of pineal region tumor patients treated with GKS were analyzed to evaluate the effectiveness. Methods : Seven patients with tumors in the pineal region were treated with GKS between September 1998 and May 2005. The histological diagnosis were pineal parenchymal tumor [2 patients], low-grade astrocytoma [2 patients], immature teratoma [1 patient], and choriocarninoma [1 patient]. One patient was diagnosed as metastatic brain tumor based on histological diagnosis for primary site and brain imaging study. The median marginal dose was 15Gy [range; $11{\sim}20$] at the 50% isodose line. The median target volume was $2.5cm^3$ [range; $0.8{\sim}12.5$]. The median clinical follow up period was 29 months [range; $13{\sim}93$] and the median radiological follow up period was 18 months [range; $6{\sim}73$]. Results : Tumor volume measured in follow-up images showed reduction in six patients, disappearance in one. No adverse effect due to GKS was found during the follow-up period. The performance status was preserved in all patients except one who died due to progression of primary cancer in spite of controlled metastatic brain lesion. Conclusion : Gamma Knife Surgery can be applied to pineal region tumors irrespective of their histology whenever surgery is not indicated.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.71-76
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• 2017

Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made. When inducing deep sedation in a patient with OSA, airway obstruction may increase, causing oxygen saturation to drop; airway interventions are necessary in such cases. Effective DISE and MMA surgery can be performed by administering propofol through target-controlled infusion while monitoring the bispectral index (BIS).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.2
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• pp.107-113
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• 2017

Purpose: This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens. Methods: Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed. Results: Twenty-four patients (70.6%) were male. The mean age of the patients was $8.5{\pm}6.2$ (range, 1.1-17.1) years. Six bacterial pathogens were isolated: Salmonella species (spp.) (32.4%), Campylobacter spp. (20.6%), verotoxin-producing Escherichia coli (14.7%), Staphylococcus aureus (11.8%), Clostridium difficile (8.8%), and Shigella spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with Salmonella were older than those infected with verotoxin-producing E. coli (p<0.05). C-reactive protein levels were higher in patients with Salmonella and Campylobacter infections than in those with verotoxin-producing E. coli infection (p< 0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrated diverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen. Conclusion: Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detect the disease extent and severity.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2739-2742
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• 2013

Background: This survey aim was to evaluate the epidemiology and outcomes of neuroblastoma patients in one the most important children referral hospitals in Iran as a model from developing countries. Materials and Methods: This retrospective, non-randomized analytic study was conducted on 219 newly diagnosed neuroblastoma cases. Results: The age of patients ranged from 1-156 months with the average of $40.5{\pm}2.44$, with a male/female ratio of 1.9/1. Of the total, 172 (78.5%) were children and 47 (21.5%) were infants The adrenals were the most common primary site (60%). Stage 4 at diagnosis accounted for about 54% of all enrolled patients. Infants had significantly better cumulative survival ($85{\pm}8%$) than children ($33{\pm}7%$) during the follow up period and the survival rate improved from $33{\pm}7%$ in 1974-1994 to $58{\pm}9%$ in 1995-2005. Conclusions: This study indicates that our patient population with neuroblastomas tends to have more advanced disease, perhaps with poor biologic markers, but our analysis shows that the outcomes have improved over 32 years although the overall survival of Iranian neuroblastoma patients is still lower than developed countries. Late diagnosis, inability to determine risk group during the years of study and using single protocol for all enrolled patients can be the reasons of lower survival rate.

• Journal of the Korean Society of Environmental Restoration Technology
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• v.15 no.3
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• pp.55-66
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• 2012

This study was carried out to investigate vegetation of Rhododendron mucronulatum habitat in Mt. Biseul to recommend basic information for synecological characteristics and management methods. The survey was carried out from May to July, 2011 and totally 46 vegetation data including 42 families 93 genera 108 species 16 varieties and 5 forma were collected and analyzed. Among the investigated 129 taxa, the numbers of rare plant resources were summarized as 19 taxa; The rare plants designated by Korea Forest Service, the specific plants by floristic region and the endemic plants were listed as 3 taxa, 15 taxa and 4 taxa, respectively. Rhododendron mucronulatum habitat of Mt. Biseul was classified into 3 plant communities (Carex lanceolata-Rhododendron mucronulatum community, Potentilla dickinsii-Selaginella rossii community, Carex lanceolata-Quercus mongolica community). Carex lanceolata-Rhododendron mucronulatum community was subdivided into Tripterygium regelii subunit and Miscanthus sinensis for. purpurascens subunit by human interference degree. And synecology, syndynamics, synchorology of these plant communities were identified, and Site-species ordination analysis by Principal Coordinate Analysis (PCoA) reflected that human impact, soil moisture condition were main ecological factors determining the distribution pattern of classified plant communities. Therefore these plant communities correspond to quite distinctive 4 habitat types : unstable-dry type=Miscanthus sinensis for. purpurascens subunit, unstable-moderate type=Tripterygium regelii subunit, stable-dry type=Potentilla dickinsii-Selaginella rossii community, stable-moderate type=Carex lanceolata-Quercus mongolica community. Finally, through the vegetational diagnosis, proper management methods such as a limit on the access of visitors, planting of native woody plants after removing unwanted vines or grass were suggested.

• The Korean Journal of Nuclear Medicine
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• v.25 no.1
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• pp.61-67
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• 1991

The usefulness of $^{99m}Tc-labeled$ RBC single photon emission CT (SPECT) scanning in the diagnosis of hepatic heminagiomas was evaluated in 22 patients with various focal hepatic lesions including 15 cases of hemangiomas, 3 cases each of hepatomas and metastasis and 1 case of abscess. The diagnoses were based on ultrasonography and/or CT scanning, clinical stability of lesion for at least 6 months or surgical exploration. Seven cases of 15 hemangiomas were detected by delayed planar RBC scanning, whereas 4 cases were detected by delayed RBC-SPECT scanning. The smallest hemangioma shown by delayed RBC-SPECT scanning was 1.0 cm in diameter. compared with 2.2 cm by planar RBC scanning. One small hemangioma (2.0 cm) located adjacent to the heart was not found by either method. The sensitivities in detecting the hemangioma according to the site by planar imaging were 16.6% $(1.0\sim1.9cm)$, 66.7% $(2.0\sim2.9cm)$ and 83.3% (more than 3.0 cm) and by SPECT were 50.0%, 66.7% and 100%, respectively. Seven cases of non-hemangiomatous lesions did not show any significant increase in activity in the delayed blood pool images. It is concluded that $^{99m}Tc-RBC$ blood-pool SPECT scanning is clearly more sensitive in detecting small hemangioma than planar scanning and is, therefore, a choice of method for the detection of hepatic hemangioma.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.174-180
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• 2007

Background: The diagnosis of trigeminal neuralgia (TN) is based on only clinical criteria. The purpose of this study was to estimate the clinical manifestations of TN patients treated at our pain clinic. Methods: A total of 341 patients with TN from Jan. 2004 to Dec. 2006 was evaluated the intensity, site, and onset of pain, facial sensation, duration of pain attack, pain free interval, triggering factors, and effects of the previous treatments with TN specific questionnaire and interview at the first visit of our pain clinic. Results: About 80% of the patients were over 50 years of age and 256 (75%) patients were women. Average durations from first attack of their pain and from current pain attack were 7 years and 16 weeks, respectively. The two most frequently involved trigeminal nerve branches were maxillary (40%) and mandibular (39%) branches. Three quarters of the total patients experienced only paroxysmal pain that lasted less than one minute. About 90% of patients had pain free period at least one time. Most common triggering factors were chewing (88%), brushing teeth (82%), washing face (79%), and talking (70%). Only 16 patients (5%) had no previous treatment and the others had more than one treatment, such as medication (68%) and interventional procedures (35%). The most common reasons for early discontinuation of carbamazepine were dizziness, ataxia, and vomiting. Conclusions: TN has specific clinical features of pain, which should be considered at diagnosis.

• Journal of Yeungnam Medical Science
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• v.38 no.4
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• pp.289-307
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• 2021

Avulsion injuries result from the application of a tensile force to a musculoskeletal unit or ligament. Although injuries tend to occur more commonly in skeletally immature populations due to the weakness of their apophysis, adults may also be subject to avulsion fractures, particularly those with osteoporotic bones. The most common sites of avulsion injuries in adolescents and children are apophyses of the pelvis and knee. In adults, avulsion injuries commonly occur within the tendon due to underlying degeneration or tendinosis. However, any location can be involved in avulsion injuries. Radiography is the first imaging modality to diagnose avulsion injury, although advanced imaging modalities are occasionally required to identify subtle lesions or to fully delineate the extent of the injury. Ultrasonography has a high spatial resolution with a dynamic assessment potential and allows the comparison of a bone avulsion with the opposite side. Computed tomography is more sensitive for depicting a tiny osseous fragment located adjacent to the expected attachment site of a ligament, tendon, or capsule. Moreover, magnetic resonance imaging is the best imaging modality for the evaluation of soft tissue abnormalities, especially the affected muscles, tendons, and ligaments. Acute avulsion injuries usually manifest as avulsed bone fragments. In contrast, chronic injuries can easily mimic other disease processes, such as infections or neoplasms. Therefore, recognizing the vulnerable sites and characteristic imaging features of avulsion fractures would be helpful in ensuring accurate diagnosis and appropriate patient management. To this end, familiarity with musculoskeletal anatomy and mechanism of injury is necessary.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.206-209
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• 2023

Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

• Journal of the Korean Society of Radiology
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• v.18 no.3
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• pp.267-273
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• 2024

Using a cloud-based vertex AI platform that can develop an artificial intelligence learning model without coding, this study easily developed an artificial intelligence learning model by the non-professional general public and confirmed its clinical applicability. Nine dental diseases and 2,999 root disease X-ray images released on the Kaggle site were used for the learning data, and learning, verification, and test data images were randomly classified. Image classification and multi-label learning were performed through hyper-parameter tuning work using a learning pipeline in vertex AI's basic learning model workflow. As a result of performing AutoML(Automated Machine Learning), AUC(Area Under Curve) was found to be 0.967, precision was 95.6%, and reproduction rate was 95.2%. It was confirmed that the learned artificial intelligence model was sufficient for clinical diagnosis.