• Korean Journal of Biological Psychiatry
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• v.20 no.2
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• pp.54-60
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• 2013

Objectives The purpose of this study is to find the influential clinical and physical characteristics which affect apnea-hypopnea index (AHI) in suspected obstructive sleep apnea (OSA) patients. Methods We evaluated the comprehensive factors including sleep related symptoms, clinical scales, medical history, substance use, and anthropometric data of the 119 participants who complained of the symptoms of OSA. All the participants underwent attended-full night laboratory polysomnography. The correlation and multiple regression analysis were conducted to find the influential and predictive factors of AHI. Results A multiple linear regression model 1 showed that higher AHI was associated with higher body mass index (BMI)(p < 0.001) and higher frequency of observed apnea (p = 0.002). In multiple linear regression model 2, AHI was associated with higher BMI (p < 0.001) and loudness of snoring (p = 0.018). Conclusions The present preliminary results suggest that BMI and observed apnea are most influential factors that affect AHI in suspected OSA patients. In the future study we will design the prediction formula for the OSA and AHI, which is useful in the clinical medical field.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.8
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• pp.417-421
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• 2018

Carboxytherapy is very similar to mesotherapy in terms of methods, conditions it treats, and outcomes. An important difference consider, however, is that carboxytherapy administers carbon dioxide gas into the subcutaneous layer, just underneath the skin, whereas mesotherapy administers a cocktail of vitamins, minerals, and drugs and into the mesoderm of the skin. There have been many previous case reports of complications of mesotherapy such as hematoma, granulomatous panniculitis, cellulitis, and abscesses. However, complications of carboxytherapy have rarely been reported because the carbon dioxide gas is absorbed within a week and is infused into the subcutaneous and superficial layers. A 27-year-old woman who had twice undergone carboxytherapy to reduce abdominal fat (3 days and 2 weeks ago) at an oriental medical clinic visited the emergency department due to high fever, myalgia, severe back pain, and subcutaneous emphysema from the buttocks to the lower chest wall area. A computed tomography (CT) scan was performed for diagnosis and treatment. We immediately started broad spectrum antibiotics and consulted with the department of radiology, which could not rule out acute peritonitis due to needle injury. A radiologist confirmed abdominal myositis and needle puncture induced acute pyelonephritis. Pyelonephritis can even lead to septicemia, which can have fatal consequences. Therefore, if the patient has costovertebral or back pain after undergoing needle puncture or acupuncture therapy, the emergency physcians need careful initial evaluation for diagnosis and treatment.

• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.684-689
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• 2005

Silicosis is a chronic fibrosing lung disease that is initiated by prolonged and extensive exposure to respirable free crystalline silica. Accelerated silicosis is rare and is clinically identical to the classic form of silicosis with the exception that the time from initial exposure to the onset of the disease is shorter and the rate of disease progression is dramatically faster. We describe a case of accelerated silicosis, which mimicked miliary pulmonary tuberculosis. The patient had worked in a mine coal for a period of 9 years. Subsequently, he worked in construction dealing with cement and sand for 14 years until he visited this clinic. The clinical course was notable for the rapid progression of the radiological features of silicosis over a period of 2 months. Polarizing light microscopic studies of the biopsied specimens by a transbronchial lung biopsy showed polarizing particles, which were typical of silica. To the best of our knowledge, this is the first case report of accelerated silicosis in Korea.

• Korean Journal of Biological Psychiatry
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• v.22 no.4
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• pp.223-232
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• 2015

Objectives In this study, the authors evaluated the correlation between levels of serum lipid, homocysteine, and folate with volumes of hippocampus, amygdala, corpus callosum, and in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD) type. Methods The study recruited patients who visited the dementia clinic of Haeundae Paik Hospital in Korea between March 2010 and June 2014. Among those, patients who had taken the neurocognitive test, brain magnetic resonance imaing, tests for serum lipid, homocysteine, folate, and apolipoprotein E (APOE) genotyping and diagnosed with aMCI or AD were included for analysis. Bilateral hippocampus, entorhinal cortex, amygdala and corpus callosum were selected for region of interest (ROI). The cross-sectional relationships between serum lipid, homocysteine, folate and ROI were assessed by partial correlation analysis and multiple linear regression analysis. Results In patients with aMCI, old age (> 80) and APOE ${\varepsilon}4$ carrier were associated with AD [odds ration (OR) : 12.80 ; 95% confidence interval (CI) : 2.25-72.98 and OR : 4.48 ; 95% CI : 1.58-12.67, respectively]. In patients with aMCI or AD, volumes and thickness of ROI were inversely correlated with levels of serum lipid and homocysteine. In multiple linear regression analyses, higher total cholesterol level was related to lower left, right hippocampus volume and left amygdala volume ; higher low-density lipoprotein cholesterol was related to lower right entorhinal cortex thickness ; higher homocysteine level was related to lower corpus callosum volume. Conclusions Higher serum lipid and homocysteine levels are associated with decreased volume of hippocampus, amygdala, corpus callosum and entorhinal cortex thickness in patients with aMCI or AD. These findings suggest that serum lipid and homocysteine levels are associated with AD as a modifiable risk factor.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.677-683
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• 2009

May-Thurner syndrome is a deep vein thrombosis of the ilio-femoral vein due to compression of the left common iliac vein by the overlying right common iliac artery. Although, catheter directed thrombectomy (CDT) and thrombolysis with stent insertion has become the standard treatment method for acute or subacute May-Thurner syndrome, because of technical feasibility and lower recurrence rate, however, sometimes this methods make fatal complications. Furthermore, there are few reports on optimal treatment strategies for patients in a chronic state of May-Thurner syndrome. We now present two cases of chronic (> 1 month since onset of symptoms) May-Thurner syndrome treated by surgical thrombectomy and femoral arteriovenous shunt with simultaneous stent insertion after failed endovascular treatment. This technique may provide a significant benefit for patients who are not suitable for conventional endovascular treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1255-1258
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• 2015

Background: Locally advanced head and neck cancer is generally incurable and has a short survival rate. This study aimed to evaluate symptom relief, disease response, and acute toxicity after palliative hypo-fractionated radiotherapy and long-term survival in affected patients. Materials and Methods: Between January 2011 to December 2011, 80 patients who were histopathologically diagnosed as having stage III or stage IV head and neck squamous cell carcinoma based on Eastern Cooperative Oncology Group (ECOG) performance status 1-3, were offered palliative radiotherapy (20 Gy/5Fr/5 Days). Later these patients were evaluated on 30th day after completion of treatment for disease response based on World Health Organisation (WHO) criteria and palliation of symptoms using symptomatic response grading and acute toxicities by the Radiation Therapy Oncology Group (RTOG). Many patients were given post radiation therapy (RT) palliative chemotherapy for appropriate palliative care and a few patients were selected for further curative RT. The overall survival was also evaluated among this group of patients with last follow up date of 1st May, 2014. Results: The most common presenting complaint was pain followed by dysphagia. Most patients (60-70%) had appreciable relief in their presenting symptoms. A good response was observed in the majority following palliative RT; a few patients had progressive disease and some had stable and regressed disease. None of the patients experienced radiation toxicity that required hospital admission. Almost all showed grade one and two acute skin and mucosal toxicity one month after completion of treatment. The mean survival days for patients given only hypofractionated palliative RT was 307 days, those with post palliative RT and palliative chemotherapy was 390 days and patients who went on to receive further palliative RT and curative RT dose had significantly overall survival of 582 days. Conclusions: Advanced head and neck cancer should be identified for suitable palliative hypofractionated radiotherapy to achieve acceptable symptom relief in a great proportion of patients and should be followed by palliative chemotherapy or curative RT in suitable cases for long-term symptom-free survival.

• Progress in Medical Physics
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• v.21 no.2
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• pp.223-231
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• 2010

We have taken surveys about total 72 departments of radiation oncology which is performing the treatment with linear accelerator and brachytherapy unit in Korea. The survey was included the research about the linear accelerator, brachytherapy, Also, we surveyed the various performance (QA period, manpower, time) of quality control for understanding of efficiency. The survey results show that the QA test of daily and weekly are almost same comparing to USA and Europe but the QA performance of monthly and yearly in Korea are 15.5 which is less than USA and Europe recommended QA item number of 17 to 21. The manpower and QA time in Korea also lower than 50% of USA and Europe recommended because the manpower and QA time limitation in Korea. It will be expected that the manual of quality management in each clinic could be appropriately established when combining the present results with previously published AAPM TG-40 and other protocols.

• Journal of radiological science and technology
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• v.40 no.3
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• pp.433-441
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• 2017

The 3D printing selective laser sintering (SLS) and stereo lithography apparatus (SLA) method used for bone model production has good precision and resolution, but the printers are expensive and need professional knowledge for operation. The program that converts computed tomography digital imaging and communications in medicine (DICOM) file into STL (stereolithography) file is also expensive so requesting 3D printing companies takes a lot of time and cost, which is why they are not generally utilized in surgery. To produce bone models of fractured patients, the use of 3D imaging conversion program and 3D printing system should be convenient, and the cost of device and operation should be low. Besides, they should be able to produce big size bone models for application to surgery. Therefore, by using an fused deposition modeling (FDM) method 3D printer that uses thermoplastic materials such as DICOM Viewer OsiriX and plastic wires, this study developed 3D printing system for Fracture surgery Patients customized bone model production for many clinics to use for surgery of fracture patients by universalizing with no limit in printing sizes and low maintenance and production cost. It is expected to be widely applied to the overall areas of orthopedics' education, research and clinic. It is also expected to be conveniently used in not only university hospitals but also regular general hospitals.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.166-171
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• 1999

Purpose : To get the data for public information and education of medical students about radiation therapy (RT). Materials and Methods : We evaluated the knowledge and attitudes towards the RT and cancer in the third grade medical students who did not receive a lecture before starting the poly-clinic education about radiation oncology in our medical school, We obtained a total of 142 answers from the students that completed the questionnaire. Results : More than half of the third grade medical students answered 1 question correctly and 5 questions incorrectly among 6 questions about knowledge of RT. Incorrect answers were done about the frequency of RT, hair loss, the period of RT, re-RT, cost of RT, Fifty-six percent of students didn't wish to prolong the survival time from 1 year to 3 years with long courses of chemotherapy and RT. They had bad images about cancer of colorectum, lung, esophagus, liver, breast, cervix which consist of 56.3$\%$ of patients receiving RT. Conclusions : Public information about the basic points of RT should be considered. Also the students showed the pessimism about the anticancer treatments such as chemotherapy and RT, so the exact results and positive aspects of anticancer treatment should be educated more. Especially it is needed to inform the students and the public the positive aspects of RT in some cancers (colorectal, lung, esophageal, hepatic, breast, cervix cancers) which the students had bad images about.

• Parasites, Hosts and Diseases
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• v.53 no.3
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• pp.321-327
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• 2015

A 50-year-old male visited the outpatient clinic and complained of fever, poor oral intake, and weight loss. A chest X-ray demonstrated streaky and fibrotic lesions in both lungs, and chest CT revealed multifocal peribronchial patchy ground-glass opacities with septated cystic lesions in both lungs. Cell counts in the bronchoalveolar lavage fluid revealed lymphocyte-dominant leukocytosis, and further analysis of lymphocyte subsets showed a predominance of cytotoxic T cells and few T helper cells. Video-assisted wedge resection of the left upper lobe was performed, and the histologic examination was indicative of a Pneumocystis jirovecii infection. Trimethoprim-sulfamethoxazole (TMP-SMX) was orally administered for 3 weeks; however, the patient complained of cough, and the pneumonia was aggravated in the follow-up chest X-ray and chest CT. Molecular studies demonstrated mutations at codons 55 and 57 of the dihydropteroate synthase (DHPS) gene, which is associated with the resistance to TMP-SMX. Clindamycin-primaquine was subsequently administered for 3 weeks replacing the TMP-SMX. A follow-up chest X-ray showed that the pneumonia was resolving, and the cough was also alleviated. A positive result of HIV immunoassay and elevated titer of HCV RNA indicated HIV infection as an underlying condition. This case highlights the importance of careful monitoring of patients with P. jirovecii pneumonia (PCP) during the course of treatment, and the molecular study of DHPS mutations. Additionally, altering the anti-PCP drug utilized as treatment must be considered when infection with drug-resistant P. jirovecii is suspected. To the best of our knowledge, this is the first case of TMP-SMX-resistant PCP described in Korea.