• Radiation Oncology Journal
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• 제35권1호
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• pp.32-38
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• 2017

Purpose: Several accelerated partial breast radiation (APBR) techniques have been investigated in patients with early-stage breast cancer (BC); however, the optimal treatment delivery techniques remain unclear. We evaluated the feasibility and toxicity of APBR delivered using intensity-modulated radiation therapy (IMRT) in elderly patients with stage I BC, using a novel fractionation schedule. Materials and Methods: Forty-two patients aged ${\geq}65$ years, with stage I BC who underwent breast conserving surgery were enrolled in a phase I/II study evaluating APBR using IMRT. Forty eligible patients received 40 Gy in 4 Gy daily fractions. Patients were assessed for treatment related toxicities, and cosmesis, before APBR, during, and after completion of the treatment. Results: The median age was 73 years, median tumor size 0.8 cm and the median follow-up was 54 months. The 5-year locoregional control was 97.5% and overall survival 90%. Erythema and skin pigmentation was the most common acute adverse event, reported by 27 patients (69%). Twenty-six patients (65%) reported mild pain, rated 1-4/10. This improved at last follow-up to only 2 (15%). Overall the patient and physician reported worst late toxicities were lower than the baseline and at last follow-up, patients and physicians rated cosmesis as excellent/good in 93% and 86 %, respectively. Conclusion: In this prospective trial, we observed an excellent rate of tumor control with daily APBR. The acceptable toxicity profile and cosmetic results of this study support the use of IMRT planned APBR with daily schedule in elderly patients with early stage BC.

• 대한한방내과학회지
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• 제39권5호
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• pp.904-913
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• 2018

Rhabdomyolysis is a syndrome that evokes either myopathy or cola-colored urine with elevated creatine kinase and myoglobin levels. The most common complication of rhabdomyolysis is acute renal failure (ARF). A large quantity of fluid must be injected promptly the first time symptoms appear, whereas sequela of symptoms has remained in the long run. In this report, a 58-year-woman was diagnosed with ARF due to rhabdomyolysis induced by exercise, alcohol, and medication. A treatment of acupuncture and herbal medicines was carried out for over 2 months. To evaluate the condition of the patient's lower limb, a short form of the McGill Pain Questionnaire, Visual Analogue Scale (VAS), European Quality of Life-5 Dimensions (EQ-5D), and Manual Muscle Test (MMT) points were used. As a result, clinical symptoms and quality of life improved noticeably after treatment with Korean medicine. This suggests that Korean medicine has an effect on rhabdomyolysis.

• Journal of Chest Surgery
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• 제19권4호
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• pp.744-749
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• 1986

Even in the hands of the expert endoscopists, an occasional instrumental perforation of the esophagus occurs. But instrumental perforation of the esophagus should not be difficult to diagnose if the possibility is borne in mind. Occasionally patient with esophageal perforations show little reaction at first, but usually they develop systemic manifestation if surgical management is delayed. Early surgical drainage of esophageal perforation is very important & effective therapeutic method. The delayed surgical treatment of esophageal perforation would have increased the morbidity & mortality by allowing mediastinitis & empyema thoracis. We have experienced 6 cases of delayed surgical management of instrumental perforation of esophagus from May 1974 to April 1986 in the department of thoracic and cardiovascular surgery, Yonsei University, college of the medicine. The ages ranged from 4 years to 57 years. The underlying esophageal diseases consisted of esophageal stricture in 3 cases, foreign bodies in the esophagus in 2 cases and esophageal ca. in one case. Most clinical manifestations on admission were high fever, chest discomfort, chest pain, dysphagia and subcutaneous emphysema. Most complications due to esophageal rupture were acute mediastinitis with or without empyema thoracis. Failure to diagnose promptly and failure to promptly institute adequate treatment undoubtedly were largely responsible for this patients death. All 6 patients had been taken delayed surgical drainage more than 24 hours following esophageal perforation. One patient had been in the open drainage state for long time and the another patient has been in the tracheostomy with postintubation vocal cord ulceration. The third patient died due to respiratory failure and sepsis due to fulminant mediastinitis & empyema thoracis. Even if the patients with esophageal perforation have been taken delayed surgical management, the patients should be survived with aggressive & effective surgical drainage with intensive post-operative care.

• Journal of Chest Surgery
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• 제22권2호
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• pp.308-314
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• 1989

Pulmonary sequestration is a congenital malformation characterized by an area of embryonic lung tissue that derives its blood supply from an anomalous systemic artery. Two forms recognized: extralobar and intralobar. Extralobar form is a very rare congenital malformation, usually located in the lower chest, and may be found in newborn infants at the time a congenital diaphragmatic hernia is repaired. Large sequestrated segments may be cause acute respiratory distress in the neonate. The condition is asymptomatic in 15 per cent of patients. This report presents two cases of pulmonary sequestration which misdiagnosed a superior mediastinal tumor and a benign lung tumor. First case was 30-year-old male patient and chief complaints were dyspnea, dry cough and right chest pain. Chest X-ray showed a homogenous increased density of smooth margin at the right superior mediastinal area and suggested a benign mediastinal tumor. And so explothoracotomy was made without other special studies. Second case was 28-year-old male patient. One month ago, he had tracheostomy and right closed thoracostomy due to massive hemoptysis and spontaneous hemothorax. Chest X-ray showed a benign cystic lesion at RLL area. At the time of operation, in first case, a mass of adult fist size was placed medial to the right upper lobe and densely adhesive to trachea, SVC and esophagus. Blood supply of the mass was bronchial arteries of trachea and RUL bronchus and drained to SVC and azygos vein through anomalous systemic veins. There was no bronchial communication on Frozen biopsy. In 2nd case, large cystic lesion contained old blood hematoma was located in RLL and anomalous blood vessel from thoracic aorta was drained to posterior segment of RLL. In operation field, intralobar pulmonary sequestration was diagnosed, and RLL lobectomy was carried out.

• 동의생리병리학회지
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• 제24권2호
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• pp.345-351
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• 2010

Alcoholic hepatitis is an acute and severe liver disease associated with high mortality rate. This study was conducted to develop the instrument of criterion for symptoms improvement after temperance. We made the symptoms improvement questionnaire for alcoholic hepatitis patients through reviewing traditional oriental medical literatures and got advices from the advisor committee with delphi technique. The advisor committee on this study was organized by 10 professors of internal medicine of oriental medical colleges nationwide. The questionnaire was composed of questions about 10 symptoms - fatigue, pain, anorexia, abdominal bloat, heaviness of the body, itch, nausea, sleep, dryness in the mouth and stools. We named it Alcoholic Hepatitis Symptoms Improvement Questionnaire(AHSIQ). We surveyed 65 male alcoholic hepatitis patients and checked liver function profile and AHSIQ before and after temperance four times for six weeks. As a result of factor analysis the scales of AHSIQ had content validity and construct validity. And internal consistency reliability was good(Cronbach's alpha=0.768-0.871). The total scale scores were statistically significant in gamma-GTP related validity. We suggest that AHSIQ would be effective for measuring symptoms improvement degree in alcoholic hepatitis patients through further investigations with larger clinical trials.

• 동의생리병리학회지
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• 제24권2호
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• pp.249-257
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• 2010

Crataegii Fructus is commonly used as a improving digestion, removing retention of food, promoting blood circulation and resolving blood stasis agent in East Asia. Cadmium (Cd) is widely distributed in the environment due to its use in industry. An exposure to Cd causes dysuria, polyuria, chest pain, hepatic and renal tubular diseases. The liver is the most important target organ when considering Cd-induced toxicity because Cd primarily accumulates in the liver. This study investigated the protective effect of Crataegii Fructus water extract against cadmium ($CdCl_2$, Cd)-induced liver toxicity in H4IIE cells, a rat hepatocyte-derived cell line and in rats. Cell viability was significantly reduced in Cd-treated H4IIE cells in a time and concentration-dependent manner. However, Crataegii Fructus water extract (CFE) protected the cells from Cd-induced cytotoxicity via inhibition of PARP cleavage. To induce acute toxicity in rats, Cd (4 mg/kg body weight) was dissolved in normal saline and intravenously injected into rats. The rats then received either a vehicle or silymarin (as a positive control) or CFE (50, 100 mg/kg/day) for 3 days, and were subsequently exposed to a single injection of Cd. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were significantly increased by Cd treatment. In contrast, pretreatment with CFE reduced ALT, AST and LDH. In histopathological analysis, CFE reduced the hepatic degenerative regions and the number of degenerative hepatocytes. These are considered as direct evidences that Crataegii Fructus has favorable inhibitory effects on the Cd-intoxicated liver damages. The efficacy of Crataegii Fructus shows slight lower than that of silymarin in the present study.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1998년도 Proceedings of UNESCO-internetwork Cooperative Regional Seminar and Workshop on Bioassay Guided Isolation of Bioactive Substances from Natural Products and Microbial Products
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• pp.178-178
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• 1998

We reported that the hexane fraction of Torilis Fructus have an anti-inflammatory and analgesic effect. Therefore, in order to isolate the active compound, the hexan fraction of Torilis Fructus was chromatographed on silica gel column. The subfraction of hexane fraction was crystallized as colorless stout needles. The chemical structure of this compound was verified to be torilin through m.p., UV, IR, GC-MS, and NMR spectral data. In pharmacological tests, torilin exhibited strong anticarrageenan activity at the dose of 90 and 270 mg/kg, p.o. in rats, and it had inhibitory effect on the vascular permeability at the dose of 30 and 90 mg/kg, p.o. in mice. Torilin showed potent inhibition of leucocyte emigration in CMC-pouch at the dose of 3 and 9 mg/rat, s.c. Torilin have the analgesic effect at the dose of 30, 90 and 270 mg/kg, p.o. in both of the acetic acid- and phenyl-p-benzoquinone-induced writhing syndrome. It also increased the pain threshold at the dose of 30, 90 and 270 mg/kg, p.o. in the tail pressure method and the Randall-Selitto method. Torilin did not show a hypothermic action at the dose of 30 and 90 mg/kg, p.o. in mice. The acute toxicity of torilin was very weak: the LD$\_$50/ value was more than 5000 mg/kg, p.o. and 2000 mg/kg, Lp. in mice. From the above mentioned results, it was suggested that torilin had potent anti-inflammatory and analgesic activities in animals.

• Restorative Dentistry and Endodontics
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• 제39권3호
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• pp.215-219
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• 2014

Whenever endodontic therapy is performed on mandibular posterior teeth, damage to the inferior alveolar nerve or any of its branches is possible. Acute periapical infection in mandibular posterior teeth may also sometimes disturb the normal functioning of the inferior alveolar nerve. The most common clinical manifestation of these insults is the paresthesia of the inferior alveolar nerve or mental nerve paresthesia. Paresthesia usually manifests as burning, prickling, tingling, numbness, itching or any deviation from normal sensation. Altered sensation and pain in the involved areas may interfere with speaking, eating, drinking, shaving, tooth brushing and other events of social interaction which will have a disturbing impact on the patient. Paresthesia can be short term, long term or even permanent. The duration of the paresthesia depends upon the extent of the nerve damage or persistence of the etiology. Permanent paresthesia is the result of nerve trunk laceration or actual total nerve damage. Paresthesia must be treated as soon as diagnosed to have better treatment outcomes. The present paper describes a case of mental nerve paresthesia arising after the start of the endodontic therapy in left mandibular first molar which was managed successfully by conservative treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권3호
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• pp.251-254
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• 2004

Osteomyelitis is the inflammatory disease occured in the bone, involving a bone marrow, a Harversian system and the underlying cortical bone. Osteomyelitis is divided into acute and chronic osteomyelitis. Chronic osteomyelitis. is presented as a pain, swelling, pus discharge and radiographic change. The pathogenesis of osteomyelitis occcuring in the facial bone is predominately due to odontogenic microorgarnisms, Staphylococcus, resulted in odontogenic infection or post-traumatic infection. The mandible is the most commonly involved facial bone and the bones in the middle of third of the face is rare because of a abundant blood supply. Moreover, Osteomyelitis occuring in the zygoma is extremely rare. In our department, we report the case that osteomyelitis occuring in the zygoma with diabetes is resulted by odontogenic maxillary sinusitis.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권3호
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• pp.163-181
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• 2017

In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation. Many studies and guidelines have suggested RBCT is considered when hemoglobin levels recorded are 7 g/dL for general patients and 8-9 g/dL for patients with cardiovascular disease or hemodynamically unstable patients. However, RBCT is occasionally an essential treatment during surgeries and it is often required in emergency cases. We need to comprehensively consider postoperative bleeding, different clinical situations, the level of intra- and postoperative patient monitoring, and various problems that may arise from a transfusion, in the perspective of patient safety. Since orofacial surgery has an especially high risk of bleeding due to the complex structures involved and the extensive vascular distribution, measures to prevent bleeding should be taken and the conditions for a transfusion should be optimized and appropriate in order to promote patient safety.