• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.199-204
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• 2008

Objective : This study was designed to compare the efficacy of micro-vascular decompression (MVD) and Gamma knife radiosurgery (GKRS) for elderly idiopathic trigeminal neuralgia patients by analyzing the clinical outcome. Methods : In the past 10 years, 27 elderly patients were treated with MVD while 18 patients were treated with GKRS (>65-years-old). We reviewed their clinical characteristics and clinical courses after treatment as well as the treatment outcomes. For patients who were treated with MVD, additional treatment methods such as rhizotomy were combined in some areas. In GKRS, we radiated the root entry zone (REZ) with the mean maximum dose of 77.8 (70-84.3) Gy and one 4 mm collimator. Results : The mean age was 68.1 years for MVD, and 71.1 years for GKS group. The average time interval between first presenting symptom and surgery was 84.1 (1-361) months, and 51.4 (1-120) months, respectively. The mean follow-up period after the surgery was 35.9 months for MVD, and 33.1 months for GKRS. According to Pain Intensity Scale, MVD group showed better prognosis with 17 (63%) cases in grade I-II versus 10 (55.6%) cases in GKRS group after the treatment. The pain recurrence rate during follow up did not show much difference with 3 (11.1%) in MVD, and 2 (11.1%) in GKRS. After the treatment, 2 cases of facial numbness, and 1 case each of herpes zoster, cerebrospinal fluid (CSF) leakage, hearing disturbance, and subdural hematoma occurred in MVD Group. In GKRS, there was 1 (5.6%) case of dysesthesia but was not permanent. Three cases were retreated by GKRS but the prognosis was not as good as when the surgery was used as primary treatment, with 1 case of grade I-II, and 1 case of recurrence. The maximal relieve of pain was seen just after surgery in MVD group, and 1 year after treatment in GKRS group. Conclusion : For trigeminal neuralgia patients with advanced age, MVD showed advantages in immediately relieving the pain. However, in overall, GKRS was preferable, despite the delayed pain relief, due to the lower rate of surgical complications that arise owing to the old age.

• Korean Journal of Psychosomatic Medicine
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• v.17 no.2
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• pp.82-89
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• 2009

Objectives : Anxiety is a common co-morbid symptom in patients with epilepsy, which can affect the treatment and prognosis of epilepsy patients. This study is designed to compare the characteristics of anxiety between epilepsy patients and normal controls and also analyze them in epilepsy patients by examining both seizure-related and socio-demographic variables. Methods : As cross-sectional study, 80 epilepsy patients were enrolled from January to July 2008. The State-Trait Anxiety Inventory-(STAI) was used to assess the characteristics of anxiety. STAI is composed of transitory episodes of anxiety-(state subscale of STAI ; STAI-S) and stable personality features presenting chronic levels of anxiety-(trait subscale of STAI ; STAI-T). As controls, 113 healthy age-and sex-matched people were included. Results : The mean score of STAI-S and STAI-T were not different in both groups(STAI-S ; p=0.998, STAIT ; p=0.343). Within patients, patients without occupational engagement showed higher STAI-S(p<0.001) and tendency to higher STAI-T(p=0.052). Patients with depression showed higher score in both modalities(STAIS and STAI-T ; p<0.001). Patients with aura showed higher STAI-T(p=0.031). Conclusions : STAI-S and STAI-T was not significantly different between patients and controls. Of 3 factors related to anxiety, higher STAI-T in patients with aura is likely to represent misunderstanding internal and external changes as an aura and worrying about impending seizure. Occupational engagement and depression had relation to both STAI-S and STAI-T and more concern is needed to evaluate the risk of anxiety and manage it appropriately.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.4
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• pp.679-684
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• 2007

Odontoma is the most common benign odontogenic tumors, and have been defined as mixed odontogenic tumor composed of epithelial and mesenchymal cells. Odontoma is believed to be hamartomatous rather than neoplastic in nature. The classification by WHO divides odontoma into 2 groups such as complex odontoma and compound odontoma. Compound odontoma comprises dental tissues, resembling the morphology of a tooth and has predilection for the anterior maxilla. In contrast, complex odontoma has unorganized mass, not resembling the normal tooth and has predilection for the posterior mandible. Odontoma is almost asymptomatic, so it is usually found on routine radiographic examination. Common presenting symptom is impacted or unerupted permanent teeth and retained primary teeth, but coexistent odontoma and congenital missing of permanent teeth is a very rare condition. The recommended treatment for an odontoma is conservative surgical excision, with care taken to remove the surrounding soft tissue. This report presents 2 patients with compound odontoma of the mandible who have congenital missing of the permanent teeth.

• Advances in pediatric surgery
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• v.10 no.2
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• pp.99-106
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• 2004

Intestinal atresia is a frequent cause of intestinal obstruction in the newborn. We reviewed the clinical presentation, associated anomalies, types of atresias, operative managements, and early postoperative complications in 36 cases of intestinal atresia treated at the Department of Surgery, Kyungpook National University Hospital between January 1994 and February 2003. Location of the lesion was duodenum in 17 patients, jejunum in 11 patients and ileum in 8 patients. The male to female ratio was 1:1.4 in duodenal atresia (DA), 2.7:1 in jejunal atresia (JA) and 7:1 in ileal atresia (IA). The most common type was type III (41.1 %) in DA, and type I (52.6 %) in JA and IA. The most common presenting symptoms was vomiting(88.2 %) in DA, but in jejunoileal atresia, vomiting(89.4 %) and abdominal distension(89.4 %) were the most common sign and symptom. All cases of DA were diagnosed by plain abdominal radiography. There were 6 cases of DA with congenital heart disease, 3 cases of DA with Down syndrome and 3 cases of JA with meconium peritonitis. Segmental resection was performed in 13 cases, duodenoduodenostomy in 11 cases, membrane excision in 7 cases, jejunojejunostomy in 2 cases, gastroduodenostomy in 2 cases and ileocolic anastomosis in 1 case. There were 9 postoperative complications including 3 each of anastomotic leakage, wound infection, and intestinal obstruction 3 cases. The mortality rate for DA was 11.8 %(2/17). Both deaths in DA were attributed to congenital heart disease. The mortality rate for JA was 18% (2/11). Both cases died with sepsis and short bowel syndrome.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.1
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• pp.48-51
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• 2006

With well-being boom recently, the common people, but not experts, are increasingly taking in them directly by picking wild herbs. However, only experts can distinguish between edible vegetables and poisonous herbs from the wild herbs. Especially, it is not even easy for experts to distinguish them only by looking into buds in spring without flowers or fruit. So, sometimes many patients are being carried into the emergency room by the toxic symptom after taking by misunderstanding the poisonous herbs as edible vegetables. For herb intoxication as well as drug intoxication, what kinds of vegetables patients took in, and when and how much they took in them are important information for curing. Of course, in the case of intoxicating in the wild herbs, the patients can have a lot of symptoms and sings-hemodynamic alteration and abnormal neurologic sign as well as gastrointestinal symptoms-according to the kinds of herbs which they took in. Therefore, it is difficult to find the kinds of herbs which they took in through the specific symptoms. Recently we experienced a case with showing typical anticholinergic symptoms after ingestion of Scopolia japonica. As a result, the publicity activities about the wild plants needs because if the person without their previous knowledge take in the poisonous herbs, serious side effects can be produced..

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.575-579
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• 2009

Behcet's disease(BD) is a multisystem vasculitis that almost any organ in the body may be involved. Its diagnosis bases on clinical criteria in the absence of any specific laboratory test to confirm it. The clinical criteria proposed for the diagnosis for BD include recurrent oral and genital ulceration, skin lesion, ocular changes, and positive response to pathergy test. Besides these essential features, BD may manifest itself on the gastrointestinal tract, central nervous system, and other systemic involvements. Among these clinical features, recurrent oral ulcers are present in most BD patients, often as the initial symptom, preceding other manifestations by many years. Therefore, dentists are in the important position for the early detection and diagnosis of BD. In this case report, we are presenting a case of 6 year-old girl, who came to the pediatric dentistry department for evaluation and treatment of pain and dysphagia caused by severe recurrent oral ulcers. Through taking detailed dental and medical history and clinical examination, we reported the possibility of BD to the medical team and prescribed topical lidocaine to relief pain during swallowing. The medical team, which involved pediatrics, ophthalmology, dermatology, and gastroenterology, finally confirmed BD through various examinations. Detection of the possibility of BD in the dental field helped early diagnosis and proper management by the medical team.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.35-41
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• 1994

Newborns with ileal atresia freqently present with abdominal distension, bilious vomiting. and failure to pass meconium. Diagnosis is usually established on plain x-ray of the abdomen by the findings of distended small bowel loops and air-fluid levels. In the period of October 1988 to February 1994, 8 patients with congenital ileal atresia were operated and the following results were obtained. 1. Eight patients were comprised of 4 males and 4 females, the ratio of male and female was 1 : 1. 2. Six patients(75%) had been admittted to our hospital during three days of life. 3. Congenital ileal atresia was in 8 cases : Type I in two(25%), Type II in two(25%), Type IIIa in three(37.5%), Type IIIb in one(12.5%). 4. There was one premature patient who was small for gestational age. 5. Overall, abdominal distension and bilious vomiting occurring in seven patients, were frequent presenting complaints. 6. Diagnosis was possible with clinical symptom and simple abdomen. 7. Operative treatment was undertaken as soon as the diagnosis was made. In seven cases a primary end-to-end anastomosis was performed after resection of dilated proximal loop. 8. A total of four associated congenital anomalies were found in one patient. 9. Postoperative complications occurred in three cases(37.5%).

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1759-1767
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• 2016

Background: Uterine sarcoma is a group of rare gynecologic tumors with various natures, and different lines of treatment. Most have a poor treatment outcome. This study targeted clinical characteristics, treatment, overall survival (OS), progression-free survival (PFS), and prognostic factors in uterine sarcoma patients in one tertiary center for cancer care. Materials and Methods: Uterine sarcoma patients who were treated at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital between January 1994 and December 2014 were identified. Clinico-pathological data were analyzed. Prognostic outcomes were examined by Kaplan-Meier curves and Cox regression analysis. Results: We identified 46 uterine sarcoma patients: 25 carcinosarcoma (CS) (54.3%), 15 leiomyosarcoma (LMS) (32.6%), and 6 undifferentiated uterine sarcoma (UUS) (13.1%) cases. Mean age was $54.0{\pm}11.9years$ (range 25-82 years). Abnormal uterine bleeding was the most common presenting symptom (63.0%). Among 33 patients (71.7%) who had pre-operative tissue collected, diagnosis of malignancy was correct in 29 (87.9%). All patients received primary surgery and retroperitoneal lymph nodes were resected in 34 (73.9%). After surgery, 5 (10.9%) had gross residual tumors. Stage I disease was most commonly found (56.5%). Adjuvant treatment was given to 27 (58.7%), most commonly chemotherapy. After a median follow-up of 16.0 months (range 0.8-187.4 months), recurrence was encountered in 22 patients (47.8%). Median time to recurrence was 5.8 months (range1.0-105.5 months). Distant metastasis was more common than local or locoregional failure. The 2-year PFS was 45.2% (95% confidence interval [CI], 30.6%-59.7%) and the 2-year OS was 48.3% (95% CI, 33.3%-60.7%). Multivariable analyses found residual disease after surgery as a significant factor only for PFS. Conclusions: Uterine sarcoma is a rare tumor entity. Even with multimodalities of treatment, the prognosis is still poor. Successful cytoreductive surgery is a key factor for a good survival outcome.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.53-59
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• 1989

The ameloblastoma is the most common form of the odontogenic tumors exhibiting minimal inductive change in connective tissue, it comprising 1% of all tumor and cysts of the jaws. It is a true neoplasm, generally considered to be a benign but persistent or, locally malignant lesion. The tumor occurs most commonly in persons between the age of 20 and 50 years. 80% and 90% of all lesions are in the mandible. The presenting clinical signs and symptoms of the ameloblastoma very from patient to patient, but most common symptom was swelling, followed by pain, draining sinuses, and superficial ulcerations. It is slow-growing lesion, and the radiographic features of the ameloblastoma depend large one the nature and the local bone reaction to the particular tumor. Recurrence rate is about 33%, but this is probably due to incommplete initial removal of lesion. We had operated a patient ; 29-year-old female immediate reconstruction combined with autocompression plate and iliac bone graft and screw fixation after hemimandibulaectomy with recurred ameloblastoma involving from premolar to ascending ramus at right side mandible. We obtained favorable results of good function, short intermaxillary fixation periods and easy operation precedure than the other reconstruction methods.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.1
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• pp.9-18
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• 2013

Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.