• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4567-4570
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• 2013

Background: Nasopharyngeal carcinoma (NPC) is the commonest radiocurable cancer in Malaysia. This study aimed to determine the treatment outcomes and late effects of radiotherapy for NPC patients treated in University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with NPC referred for treatment to the Oncology unit at UMMC from 2004-2008 were retrospectively analyzed. Treatment outcomes were 5 years overall survival (OS), disease free survival (DFS), cause-specific survival (CSS), locoregional control (LRC) and radiotherapy-related late effects. The Kaplan-Meier method was used for survival analysis and differences in survival according to AJCC stage was compared using the log-rank test. Results: A total of 176 patients with newly diagnosed NPC were treated in UMMC during this period. Late presentation was common, with 33.5% presenting with T3-4 disease, 84.7% with N1-3 disease and 75.6% with AJCC stage 3-4 disease. Radical RT was given to 162 patients with 22.7% having RT alone and 69.3% having CCRT. The stipulated OTT was 7 weeks and 72.2% managed to complete their RT within this time period. Neoadjuvant chemotherapy was given to 14.8% while adjuvant chemotherapy was administered to 16.5%. The 5 years OS was 51.6% with a median follow up of 58 months. The 5 years OS according to stage were 81.8% for stage I, 77.9% for stage II, 47.4% for stage III and 25.9% for stage IV. The 5 years overall CSS, DFS and LRC were 54.4%, 48.4% and 70.6%, respectively. RT related late effects were documented in 80.2%. The commonest was xerostomia (66.7%). Other documented late effects were hearing deficit (17.3%), visual deficit (3.1%), neck stiffness (3.1%), dysphagia (3.4%), cranial nerve palsy (2.5%), pneumonitis (0.6%) and hypothyroidism (1.2%). Conclusions: The 5 years OS and LRC in this study are low compared to the latest studies especially those utilizing IMRT. Implementation of IMRT for NPC treatment should be strongly encouraged.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3253-3256
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• 2015

Background: Chronic hepatitis B virus (HBV) infection related hepatocellular carcinoma (HCC) is a major health problem in the Asia-Pacific region including Thailand. Several factors have been proposed as contributing to hepatocarcinogenesis. This study was aimed to investigate the impact of CYP2C19 genotypic polymorphism in HCC related to chronic HBV infection in Thailand. Materials and Methods: A cross-sectional study was performed between April 2014 and January 2015. Chronic HBV patients with HCC (n=50) and without HCC (n=50) were included. Clinical information and blood samples of all patients were collected. The CYP2C19 genotype was determined by polymerase chain reaction-restriction fragment length polymorphism method, and was classified as rapid metabolizer (RM), intermediate metabolizer (IM) or poor metabolizer (PM). Results: The CYP2C19 genotype frequencies of RM, IM and PM in HBV patients were found to be 19/50 (38%), 25/50 (50%) and 6/50 (12%), respectively. The CYP2C19 genotype frequencies of RM, IM and PM in HBV with HCC patients were 21/50 (42%), 25/50 (50%) and 4/50 (8%), respectively. The distribution of CYP2C19 genotype was not different between patients with and without HCC. Interestingly, among HBV with HCC patients, the RM genotype of CYP2C19 tended to increase risk of aggressive manifestation (OR=2.89, 95%CI=0.76-11.25, P-value=0.07), compared with non RM genotype carriers. Conclusions: CYP2C19 genotype IM was the most common genotype in Thai patients with chronic HBV infection. In addition, genotype RM could be an associated factor for aggressive presentation in HCC related to chronic HBV infection.

• Herbal Formula Science
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• v.11 no.1
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• pp.57-90
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• 2003

The result of Bibliographic studies on the pathological mechanism of the sudden coma, we got the conclusion like this. 1. The sudden coma is an acute syndrome that refers to be a sudden fainting, an unconsciousness, an aphasia or a cold clammy limb, and immediately awakes or dies, and awakes in a short time, and if we awake, it doesn't leave over and above a sequela. 2. The clinical presentation of the sudden coma can be summarized as follows : The 1st is a disease raising the sudden death due to unconsciousness accompanied by wry mouth & sudden syncope with coma. The 2nd is simply the state of cold limbs. The 3rd is the meaning of the physique and symptomes of the six meridians. The last is the ancient method of expression in contrast of the beriberi. 3. The pathological mechanism of the sudden coma consists of the toxoid from outside, Qi and Xie, fatigue, damp phegm, the damage from seven emotions and the damage from five mental elements, especially the mental disorder due to the angry energy, causes the problems when the fleming-up of liver fire and the depressed of liver qi raise the physiological disorder. 4. Therapeutic methods of sudden coma are soothing the liver and remove stasis, soothing depression and circulating of the qi, calming the liver and suppressing yang. When that is early stage, at first, we must checking upward adverse flow of the qi after promoting the circulation of qi and awakening, and then, we must regulate excessive deficiency of yin yang by therapy that is based on differentiated in symptoms according to heat & cold, deficiency & excess, and use invigorating herb medicine for supporting vigour.

• The Journal of the Korea Contents Association
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• v.10 no.3
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• pp.204-214
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• 2010

This research was intended to provide a basic data on the study of utilization of assistive technology to improve vocational ability for people with intellectual disabilities. As this study was literature review, it was analyzed the qualitative level, methodology contents, and general characteristic of a study, related assistive technology application for improvement of vocational ability in people with intellectual disabilities. The results of this study were as follows; Firstly, experimental environments mostly consisted of separated experimental conditions and design employed multiple probe design; Secondly, all of studies were involved in the standard of selection of subjects, but the proportions of study describing the contents related to subjects was low. The proportions of study describing the behavior-control and exterior-variable control method was low; Thirdly, most study evaluated independent variable and presented fidelity of treatment but, the presentation of social validity was proved to be insufficient. In order to effective application of assistive technology in vocational rehabilitation, it is need a evidence that the application of assistive technology is evidence-based practice in vocational rehabilitation. We also need a supplementation between methodology contents and qualitative level of study in more study.

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.21-27
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• 2014

Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

• Science of Emotion and Sensibility
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• v.6 no.4
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• pp.15-23
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• 2003

Recently, there have been many attempts to develop BCI (brain computer interface) based on EEG (electroencephalogram). Measurement and analysis of EEG evoked by particular stimulation is important for the design of brain wave pattern and interface of BCI. The purpose of this study is to develop a general-purpose system that measures subject's reaction time after audio-visual stimulation which can work together with any other biosignal measurement systems. The entire system is divided into four modules, which are stimulation signal generation, reaction time measurement, evoked potential measurement and synchronization. Stimulation signal generation module was implemented by means of Flash. Measurement of the reaction time (the period between the answer request and the subject reaction) was achieved by self-made microcontroller system. EEG measurement was performed using the ready-made hardware and software without any modification. Synchronization of all modules was achieved by, first, the black-and-white signals on the stimulation screen synchronized with the problem presentation and the answer request, second, the photodetectors sensing the signals. The proposed method offers easy design of purpose-specific system only by adding simple modules (reaction time measurement, synchronization) to the ready-made stimulation and EEG system, and therefore, it is expected to accelerate the researches requiring the measurement of evoked response and reaction time.

• Journal of the Korean Society of Radiology
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• v.12 no.2
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• pp.149-157
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• 2018

One of the purposes of radiation protection is to minimize stochastic effects. PCXMC 2.0 is a Monte Carlo Simulation based program and makes it possible to predict effective dose and the probability of cancer development through entrance surface dose. Therefore, it is especially important to measure entrance surface dose through dosimeter. The purpose of this study is to measure entrance surface dose through semiconductor dosimeter, general dosimeter, glass dosimeter, and to compare and analyze the effective dose and probability of disease of critical organs. As an experimental method, the entrance surface dose of skull, chest, abdomen was measured per dosimeter and the effective dose and the probability of cancer development of critical organs per area was evaluated by PCXMC 2.0. As a result, the entrance surface dose per area was different in the order of a general dosimeter, a semiconductor dosimeter, and a glass dosimeter even under the same condition. Base on this analysis, the effective dose and probability of developing cancer of critical organs were also different in the order of a general dosimeter, a semiconductor dosimeter, and a glass dosimeter. In conclusion, it was found that the effective dose and the risk of diseases differ according to the dosimeter used, even under the same conditions, and through this study it was found that it is important to present an accurate entrance surface dose model according to each dosimeter.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.911-917
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• 2004

Background: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. Material and Method: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was $57.6\pm2$ years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. Result: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients. Conclusion: it is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.

• Proceedings of the Korean Radioactive Waste Society Conference
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• 2009.06a
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• pp.187-187
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• 2009

Opening of fractures induced by shear dilation or normal deformation can be a significant source of fracture permeability change in fractured rock, which is important for the performance assessment of geological repositories for spent nuclear fuel. As the repository generates heat and later cools the fluid-carrying ability of the rocks becomes a dynamic variable during the lifespan of the repository. Heating causes expansion of the rock close to the repository and, at the same time, contraction close to the surface. During the cooling phase of the repository, the opposite takes place. Heating and cooling together with the, virgin stress can induce shear dilation of fractures and deformation zones and change the flow field around the repository. The objectives of this work are to examine the contribution of thermal stress to the shear slip of fracture in mid- and far-field around a KBS-3 type of repository and to investigate the effect of evolution of stress on the rock mass permeability. In the first part of this study, zones of fracture shear slip were examined by conducting a three-dimensional, thermo-mechanical analysis of a spent fuel repository model in the size of 2 km $\times$ 2 km $\times$ 800 m. Stress evolutions of importance for fracture shear slip are: (1) comparatively high horizontal compressive thermal stress at the repository level, (2) generation of vertical tensile thermal stress right above the repository, (3) horizontal tensile stress near the surface, which can induce tensile failure, and generation of shear stresses at the comers of the repository. In the second part of the study, fracture data from Forsmark, Sweden is used to establish fracture network models (DFN). Stress paths obtained from the thermo-mechanical analysis were used as boundary conditions in DFN-DEM (Discrete Element Method) analysis of six DFN models at the repository level. Increases of permeability up to a factor of four were observed during thermal loading history and shear dilation of fractures was not recovered after cooling of the repository. An understanding of the stress path and potential areas of slip induced shear dilation and related permeability changes during the lifetime of a repository for spent nuclear fuel is of utmost importance for analysing long-term safety. The result of this study will assist in identifying critical areas around a repository where fracture shear slip is likely to develop. The presentation also includes a brief introduction to the ongoing site investigation on two candidate sites for geological repository in Sweden.

• Archives of Plastic Surgery
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• v.38 no.2
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• pp.207-211
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• 2011

Purpose: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia (CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A (BTA, Botox$^{(R)}$, Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. Methods: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1 mL solution was administered in a 1 mL tuberculin syringe. Results: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. Conclusion: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.