• Radiation Oncology Journal
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• v.34 no.4
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• pp.297-304
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• 2016

Purpose: To investigate the outcomes of postoperative radiotherapy (RT), in patients with extrahepatic bile duct (EHBD) cancer by comparing the survival rate between patients undergoing surgery alone or surgery plus postoperative RT, and to identify the prognostic factors affecting survival. Materials and Methods: Between 2000 and 2013, 52 patients with EHBD cancer underwent surgical resection. Of these, 33 patients did not receive postoperative RT (group I), and 19 patients did (group II). R1 resection was significantly more frequent in group II. The median radiation dose was 5,040 cGy. Results: The 3-year overall survival (OS) rate for group I and group II was 38% and 56%, respectively (p = 0.274). The 3-year disease free survival (DFS) rate for group I and group II was 20% and 31%, respectively (p = 0.049), and the 3-year loco-regional recurrence free survival (LRFS) rates were 19% and 58%, respectively (p = 0.002). Multivariate analyses showed that postoperative RT and lymphovascular invasion were independent prognostic factors for DFS and LRFS. Overall, 42 patients (80%) experienced treatment failure. Distant metastasis was the predominant pattern of failure in group II. Conclusion: Postoperative RT after surgical resection appeared to improve the loco-regional control and DFS rate. More effort is needed to reduce distant metastasis, the major pattern of failure, in patients who receive postoperative RT.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.922-932
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• 2021

Objective : It is challenging to make solid fusion by posterior screw fixation and laminectomy with posterolateral fusion (PLF) in thoracic and thoracolumbar (TL) diseases. In this study, we report our experience and follow-up results with a new surgical technique entitled posterior thoracic cage interbody fusion (PTCIF) for thoracic and TL spine in comparison with conventional PLF. Methods : After institutional review board approval, a total of 57 patients who underwent PTCIF (n=30) and conventional PLF (n=27) for decompression and fusion in thoracic and TL spine between 2004 and 2019 were analyzed. Clinical outcomes and radiological parameters, including bone fusion, regional Cobb angle, and proximal junctional Cobb angle, were evaluated. Results : In PTCIF and conventional PLF, the mean age was 61.2 and 58.2 years (p=0.46), and the numbers of levels fused were 2.8 and 3.1 (p=0.46), respectively. Every patient showed functional improvement except one case of PTCIF. Postoperative hematoma as a perioperative complication occurred in one and three cases, respectively. The mean difference in the regional Cobb angle immediately after surgery compared with that of the last follow-up was 1.4° in PTCIF and 7.6° in conventional PLF (p=0.003), respectively. The mean durations of postoperative follow-up were 35.6 months in PTCIF and 37.3 months in conventional PLF (p=0.86). Conclusion : PTCIF is an effective fusion method in decompression and fixation surgery with good clinical outcomes for various spinal diseases in the thoracic and TL spine. It provides more stable bone fusion than conventional PLF by anterior column support.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.253-260
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• 2003

Purpose: No general consensus has been reached regarding the necessity of postoperative radiation therapy (PORT) and the optimal techniques of its application for patients with chest wall invasion (pT3cw) and node negative (NO) non-small cell lung cancer (NSCLC). We retrospectively analyzed the PT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. Materials and Methods: From Aug. 1994 till June 2000, 21 pT3cwN0 NSCLC patients received PORT at Samsung Medical Center; all of whom underwent curative on-bloc resection of the primary tumor plus the chest wall and regional lymph node dissection. PORT was typically stalled 3 to 4 weeks after operation using 6 or 10 MV X-rays from a linear accelerator. The radiation target volume was confined to the tumor bed plus the immediate adjacent tissue, and no regional lymphatics were included. The planned radiation dose was 54 Gy by conventional fractionation schedule. The survival rates were calculated and the failure patterns analyzed. Results: Overall survival, disease-free survival, loco-regional recurrence-free survival, and distant metastases-free survival rates at 5 years were 38.8$\%$, 45.5$\%$, 90.2$\%$, and 48.1$\%$, respectively. Eleven patients experienced treatment failure: six with distant metastases, three with intra-thoracic failures, and two with combined distant and intra-thoracic failures. Among the five patients with intra-thoracic failures, two had pleural seeding, two had in-field local failures, and only one had regional lymphatic failure in the mediastinum. No patients suffered from acute and late radiation side effects of RTOG grade 3 or higher. Conclusion: The strategy of adding PORT to surgery to improve the probability, not only of local control but also of survival, was justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. The incidence and the severity of the acute and late side effects of PORT were markedly reduced, which contributed to improving the patients' qualify of life both during and after PORT, without increasing the risk of regional failures by eliminating the regional lymphatics from the radiation target volume.

• Tuberculosis and Respiratory Diseases
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• v.72 no.5
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• pp.433-440
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• 2012

Background: The pulmonary function test is the most basic test method to diagnosis lung disease. The purpose of this study was to research the correlation of the body mass index (BMI), the fat percentage of the body mass (fat%), the muscle mass, the fat-free mass (FFM) and the fat-free mass index (FFMI), waist-hip ratio (WHR), on the forced expiratory volume curve. Methods: Between March and April 2009, a total of 291 subjects were enrolled. There were 152 men and 139 female (mean age, $46.3{\pm}9.92$ years), and they were measured for the following: forced vital capacity (FVC), forced expiratory volume at 1 second ($FEV_1$), and forced expiratory flow during the middle half of the FVC ($FEF_{25-75}$) from the forced expiratory volume curve by the spirometry, and the body composition by the bioelectrical impedance method. Correlation and a multiple linear regression, between the body composition and pulmonary function, were used. Results: BMI and fat% had no correlation with FVC, $FEV_1$ in male, but FFMI showed a positive correlation. In contrast, BMI and fat% had correlation with FVC, $FEV_1$ in female, but FFMI showed no correlation. Both male and female, FVC and $FEV_1$ had a negative correlation with WHR (male, FVC r=-0.327, $FEV_1$ r=-0.36; p<0.05; female, FVC r=-0.175, $FEV_1$ r=-0.213; p<0.05). In a multiple linear regression of considering the body composition of the total group, FVC explained FFM, BMI, and FFMI in order ($r^2$=0.579, 0.657, 0.663). $FEV_1$ was explained only fat% ($r^2$=0.011), and $FEF_{25-75}$ was explained muscle mass, FFMI, FFM ($r^2$=0.126, 0.138, 0.148). Conclusion: The BMI, fat%, muscle mass, FFM, FFMI, WHR have significant association with pulmonary function but $r^2$ (adjusted coefficient of determination) were not high enough for explaining lung function.

• Proceedings of the Korean Nuclear Society Conference
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• 2004.10a
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• pp.1263-1264
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• 2004

• Radiation Oncology Journal
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• v.23 no.2
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• pp.111-115
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• 2005

Primary malignant melanoma of the vagina is an extremely rare genital neoplasm occurring mainly on postmenopausal women. It has a worse prognosis than cutaneous melanomas, because of the high rate of loco-regional recurrences and rapid systemic dissemination. In the past, radical surgical extirpation as the primary management had been recommended to improve loco-regional control, and possibly overall survival. However, the prognosis was poor In spite of such a radical approache. Recently, more conservative treatment such as wide local excision combined with adjuvant high-dose fraction radiotherapy seems to have premising results. Primary radiation therapy could be served as an alternative to surgery for patients with lesion less than 3 cm in diameter. We report 2 cases of primary vaginal malignant melanoma treated with radiotherapy.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.1
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• pp.23-30
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• 2022

Purpose: Health examination centers of regional public hospitals are essential facilities for strengthening preventive medical services in local communities. This study is to organize architectural planning data related to function, space, and area composition of health examination center by the size of the regional public hospitals. Methods: The literature review on the function and spatial composition of the health examination center and the drawings of the regional public hospitals were analyzed. Results: The result of this study can be summarized into several points. 1) The function of the health examination center consists of a diagnostic area, patient area, and staff area based on general examination and comprehensive examination. 2) The type of spatial composition of the 300-bed public hospital examination center is a spatial linkage type with examination rooms of the other departments where general examination and comprehensive examination are undifferentiated. 3) The examination center of public hospitals with 500 beds or more is composed of an independent space-separated type with self-installed examination rooms, and general examination and comprehensive examination are divided. 4) The examination center of public hospitals with 300 beds around, the diagnostic area occupies most of the total area, around 80%, but in public hospitals with 500 beds or more, the proportion of diagnostic area drops to 50-60%, and patient area increases to 30-40%. Implications: The examination center planning of public hospitals requires an architectural planning approach to the function and spatial composition according to the size of the hospital.

• Journal of Trauma and Injury
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• v.35 no.2
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• pp.128-130
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• 2022

Abdominal wall hematoma (AWH) after blunt trauma is common, and most cases can be treated conservatively. More invasive treatment is required in patients with traumatic AWH if active bleeding is identified or there is no response to medical treatment. Herein, we report a case of endovascular embolization for traumatic subcutaneous AWH. Almost endovascular treatment for AWH is done through the deep inferior epigastric artery. However, in this case, the superficial inferior epigastric artery was the bleeding focus and embolization target. After understanding the vascular system of the abdominal wall, an endovascular approach and embolization is a safe and effective treatment option for AWH.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.39-44
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• 2014

Purpose: To investigate adverse drug reactions (ADR) and causative drugs in the elderly 65 years of age or older, using Korean spontaneous reporting adverse events reporting database from June 2009 to December 2010. Methods: We estimated the association between ADRs and implicated medications by calculating a proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC). We reexamined the most frequently implicated medications and ADRs, and the seriousness of ADRs. Then, we assessed reports and concordant rate of ADRs due to medications designated as "high-risk" in elderly by 2012 healthcare effectiveness data and information set (HEDIS) or "potentially inappropriate" by 2012 American Geriatrics Society updated Beers criteria for potentially inappropriate medications (PIMs). Results: Among 15,484 elderly reports, data-mining analysis by PRR, ROR and IC showed that 421 drug-ADR pairs were detected as signals (3,189). The most frequently reported ADR and causative drug were urticaria (470) and contrast media agents (647), respectively. One hundred eighty nine ADR cases were graded as serious. Twenty-two kinds of high-risk medications were shown to be implicated in only 0.9% of ADRs. Only thirty-nine cases were consistent with 2012 Beers criteria or HEDIS. Conclusion: These results suggest that management of the other medications including contrast media agents as well as close monitoring of PIMs are necessary for reducing ADRs in the elderly.

• Journal of Oriental Medical Thermology
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• v.8 no.1
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• pp.13-17
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• 2010

Purpose : This study is to the recent trends of clinical trial using infrared thermography and to review its application in medicine. Methods : We searched for papers which had used infrared thermography in Medicine within 5 years, using English. Results : A total of 23 papers were but 8 were found, but 8 were not related to non-invasive infrared thermography. The other 15 papers were clinical trials about the effect of acupuncture and therapeutic massage, evaluation of post-hepatic neuralgia, sleep disorder, and regional circulation. Conclusion : These results suggest that infrared thermography can be used as a reliable and helpful method in many clinical trials.