• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.1
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• pp.16-22
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• 2017

Objectives: Bisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ. Materials and Methods: Ninety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient's medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level. Results: BRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and 'responder group' and 'non-responder group,' but there was no significant difference with the 'worsened group.' In addition, the age of the patients was a relative factor with BRONJ stage. Conclusion: With older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment.

• Reproductive and Developmental Biology
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• v.35 no.3
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• pp.273-280
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• 2011

It was conducted the experiment, divided into three groups as normal, poor and polycystic ovary syndrome, to detect the change of protein patterns in follicular fluid on ovarian response following controlled ovarian hyperstimulation for human IVF outcome. In the normal group, it was confirmed reproducible 57 spots in the detected total 81 spots. Then 1 spot was not found in the other groups. In the poor responder group, it was found reproducible 53 spots in the detected total 98 spots. 6 spots were down-regulation and 7 spots were up-regulation comparable with normal group. There were not 5 spots in poor responder group comparable with other groups. In the polycystic ovary syndrome group, it was expressed reproducible 53 spots in the detected total 80 spots and 3 spots were just expressed in this group. However, 4 spots were not found in polycystic ovary syndrome. 9 spots were up-regulation comparable with normal group. Significant up and down-regulation spots among the each groups were identified. The results were a cytosolic carboxypeptidase, a signal-induced proliferation-associated protein 1, a ceruloplasmin, a keratin(type II cytoskeletal 1), a polypeptide N-acetylgalactosantinyltransferase 2, a serine/threonine-protein phosphatase 4 regulatory subunit 4. It was identified that 8 spots, 6 kinds of protein are corresponded with NCBInr database research, but 10 spots were failed in the identification. In conclusion, it has been confirmed change and expression of protein on the ovarian response following COH of human.

• Journal of Hospice and Palliative Care
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• v.4 no.2
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• pp.130-136
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• 2001

Purpose : It is very important to endow the cancer patients underwent chemotherapy with satisfactory quality of life (QOL). However, little is known about the factors influencing QOL during chemotherapy. Therefore, we designed this study to find out the factors influencing QOL in the cancer patients who underwent chemotherapy. Methods : Ninety-seven cancer patients were studied, prospectively. The patients' characteristics were as follows; median age(range): 48(19{\sim}83) years, male:female; 57:40, PS:0,1/2,3;55/42 patients, diagnosis(number): lymphoma (28), lung cancer (22), gastrointestinal cancer (18), sarcoma (12), breast cancer (12), gynecological cancer (5), Stage: I,II/III.IV;37/60 patients. We used EORTC QLQ-C30 questionnaires to evaluate QOL. EORTC QLQ-C30 scores were performed before the onset of chemotherapy and after the end of 3 cycles of chemotherapy. The correlation of these scores with performance status (PS), diagnosis, disease stage, response to chemotherapy, and regimen related toxicity was evaluated. Results : The responder group (CR, PR) demonstrated marked improvement of social functional and emotional scales to non-responder group (SD,PD) (P=0.024, 0.045). Non-hematologic regimen related toxicity such as mucositis, nausea and vomiting was significantly correlated with pain scale change (P=0.043). Other factors had no notable correlation with QOL changes. Conclusion : Our preliminary study results may suggest as follows. The response to chemotherapy is associated with the change of social functional and emotional scales and the severity of non-hematologic regimen related toxicity is associated with pain scale change.

• Clinical and Experimental Reproductive Medicine
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• v.25 no.3
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• pp.239-244
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• 1998

The purpose of this study is compare IVF cycle outcome in poor responders between clomiphene citrate (CC) stimulated and controlled ovarian hyperstimulation (COH) protocol. A total of 94 patients responding poorly in previous IVF cycles (estradiol<600 pg/ml or less than 3 oocytes retrieved) subsequently underwent either COH (COH group: 122 cycles, 68 patients) or CC-stimulated cycles (CC group: 43 cycles, 26 patients). CC was administered for five consecutive days starting on cycle day 3 at a dose of 100 mg daily. Serial transvaginal ultrasound examination was done from cycle day 8. Urine was collected $3\sim4$ times before hCG injection for the detection of LH surge. The hCG was administered when serum estradiol reached greater than 150 pg/ml and mean follicle diameter>16 mm. In COH group, ovarian stimulation was done using short protocol (GnRH-a/FSH/HMG/hCG). No difference in age or number of transferred embryos was found between CC group and COH group. COH group had significantly (p<0.05) higher mean peak level of $E_2$ ($810{\pm}112$ vs $412{\pm}55$ pg/ml) and greater number of retrieved oocytes ($3.0{\pm}0.2$ vs $2.0{\pm}0.2$) than CC group. CC group had transferred embryos $(1.8{\pm}0.2)$ compared with $(2.1{\pm}0.2)$ in COH group. However, CC group had higher pregnancy rate than COH group per retrieval [26.9% (7/26) vs 6.2% (6/97)], or per transfer [31.8% (7/22) vs 7% (6/86)]. Although cycle cancellation rate in CC group (48.8%) was higher than that of COH group (21.3%), the pregnancy rate per cycle in CC group was still higher (16.3%) than COH group (4.9%). In addition, implantation rate in CC group was 17.5% (7/40), which was significantly (p<0.01) higher than 3.9% (7/180) in COH group. These data suggest that oocyte and embryo quality are lower in COH cycles of poor responders than CC cycles. We suggest that clomiphene citrate stimulated IVF cycle may be more efficient than COH IVF cycle in poor responders in terms of lower costs and higher pregnancy performance.

• Radiation Oncology Journal
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• v.32 no.3
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• pp.170-178
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• 2014

Purpose: We sought to evaluate the clinical outcomes of 3-dimensional conformal radiation therapy (3D-CRT) for portal vein tumor thrombosis (PVTT) alone in patients with advanced hepatocellular carcinoma. Materials and Methods: We retrospectively analyzed data on 46 patients who received 3D-CRT for PVTT alone between June 2002 and December 2011. Response was evaluated following the Response Evaluation Criteria in Solid Tumors. Prognostic factors and 1-year survival rates were compared between responders and non-responders. Results: Thirty-seven patients (80.4%) had category B Child-Pugh scores. The Eastern Cooperative Oncology Group performance status score was 2 in 20 patients. Thirty patients (65.2%) had main or bilateral PVTT. The median irradiation dose was 50 Gy (range, 35 to 60 Gy) and the daily median dose was 2 Gy (range, 2.0 to 2.5 Gy). PVTT response was classified as complete response in 3 patients (6.5%), partial response in 12 (26.1%), stable disease in 19 (41.3%), and progressive disease in 12 (26.1%). There were 2 cases of grade 3 toxicities during or 3 months after radiotherapy. Twelve patients in the responder group (15 patients) received at least 50 Gy irradiation, but about 84% of patients in the non-responder group received less than 50 Gy. The 1-year survival rate was 66.8% in responders and 27.4% in non-responders constituting a statistically significant difference (p = 0.008). Conclusion: Conformal radiotherapy for PVTT alone could be chosen as a palliative treatment modality in patients with unfavorable conditions (liver, patient, or tumor factors). However, more than 50 Gy of radiation may be required.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.3
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• pp.633-642
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• 2003

A pain is the symptom which defends against noxious stimulus about a human body, it is known that if the periphery of perceptive nerve were stimulated by a physical or chemical factors, the stimulation is induced by transmission to pain center in the cerebral cortex according to pain conduction tract. The treatment of pain is to decrease a stimulus that causes a pain or block off a nerve transmitting a stimulus or puts on a way to calm down pain center, but It is for adjustment of a pain to be the most representative in acupuncture among various ways to cure a pain in Oriental medicine. However, the analgesic effect of an individual response to acupuncture stimulation shows marked individual variations, so these days genetic a few approach is attempted. On this the author determined that the responding group was appointed those whose tail flick latency (TFL) responding time delayed the minimum of 30 % comparing with basal reaction time. For those whose TFL time had shorter than 30 % was grouped as a non-responding group. And then the hypothalamus of each group was dissected and RNA was further purified. After synthesizing cDNA using oligo dT primer, products were finally applied to the PCR. The results were as follows; The ratio of responding group to non-responding group was 6:4. Ach T (acetylcholinesterase T subunit), BF-I (Brain factor-I), DBH (Dopamine β-hydroxylase) and PNM (Phosphotidylethanolamine N-Methyltransferase) were revealed significantly in the responding group. Cathepsin B and Tau were revealed significantly in the non-responding group. The PCR results show that Ach T, BF-I, DBH and PNM are expressed abundantly in the responding group, where as cathepsin B and tau are abundant in the non-responding group. These results suggest that the analgesic effect on acupuncture stimulation is related to regulation of neurotransmitter as well as neurodegeration of cerebrum.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.55-78
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• 2005

The purpose of this study was to provide basic data for the improvement of the guidelines and training programs regarding the cardiopulmonary resuscitation performance of bystanders who can respond to the incidents in earlier times as the first responder of the cardiac arrest incident, by reviewing the performance of basic CPR and the influencing factors after providing 70 students of Department of Emergency Medical Technology with the CPR training. For the purpose of the study, the collected data were computerized and analyzed by SPSS-WIN program(ver. 10.1). The results for this study were as follows The duration of session between the groups in the BLS CPR were 3 minutes and 36 seconds, 2 minutes and 32 seconds respectively. The average compression number per minute were 24.3 times and 33,2 times respectively(p=.000), and the average compression rate per minute were 112 times and 122 times respectively(p=.000). The average ventilation number per minute were 3.54 times and 5.1 times respectively(p=.000). The errors in compression "Too shallow" were 20.73 times(34.6%) and 23,23 times(38,7%) out of 60 times in 4 cycles with the standard of 38 nun. In CPR performance results according to gender in the first episode, males showed better results in compression depth as 41.5 mm comparing to females average 38.2 mm(p=.015). When ventilation results were compared according to the use of FS, the average ventilation number per minute, total ventilation per minute and the average volume per episode were significantly higher when FS was not used(<.040), There was no significant difference in ventilation accuracy between two groups. According to the results, we need to improve and distribute portable barrier devices, and to be familiar with those devices. We need to enforce ventilations as well as to include compressions so that faster and more accurate CPR can be performed. Additionally, we need to exclude ventilation only cases, minimize the interference time of chest compression due to inaccurate ventilation, simplify or minimize the complicatedness of CPR performance and responding time related to breathing, provide first responders with various training programs such as initial assessment and ventilations only, or initial assessment and chest compression-only CPR and than provide advanced training with AHA BLS education including CPR for more than two people according to CPR skills and target characteristics.

• Journal of Life Science
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• v.26 no.12
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• pp.1367-1375
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• 2016

Cilostazol is known to be a selective inhibitor of phosphodiesterase III and is generally used to treat stroke. Our previous findings showed that cilostazol enhanced capillary density through angiogenesis after focal cerebral ischemia. Angiogenesis is an important physiological process for promoting revascularization to overcome tissue ischemia. It is a multistep process consisting of endothelial cell proliferation, migration, and tubular structure formation. Here, we examined the modulatory effect of cilostazol at each step of the angiogenic mechanism by using human brain microvascular endothelial cells (HBMECs). We found that cilostazol increased the migration of HBMECs in a dose-dependent manner. However, it did not enhance HBMEC proliferation and capillary-like tube formation. We used a cDNA microarray to analyze the mechanisms of cilostazol in cell migration. We picked five candidate genes that were potentially related to cell migration, and we confirmed the gene expression levels by real-time PCR. The genes phosphoserine aminotransferase 1 (PSAT1) and CCAAT/enhancer binding protein ${\beta}$ ($C/EBP{\beta}$) were up-regulated. The genes tissue factor pathway inhibitor 2 (TFPI2), retinoic acid receptor responder 1 (RARRES1), and RARRES3 were down-regulated. Our observations suggest that cilostazol can promote angiogenesis by promoting endothelial migration. Understanding the cilostazol-modulated regulatory mechanisms in brain endothelial cells may help stimulate blood vessel formation for the treatment of ischemic diseases.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.233-241
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• 1995

Purpose : To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer Materials and Methods : One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients($95{\%}$) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus. and concurrent esophageal irradiation to 30 Gy. After that patients received 5-FU continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000mg/$m^2$ administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100mg/$m^2$ bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrentm chemoradiation twenty-six patients underwent radical esophagectomy. Results : Ninety-three patients could be examined for response assessment, By treatment modality, response rates were $85.1{\%}$ for radiation alone group and $86.3{\%}$ for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was $61.9{\%}$. The pathologic complete response were $15.4{\%}$ in operation group. Overall median survival was II months and actuarial 5-year survival rate was $8{\%}$. The median survival interval was 6 months for radiation alone group, 11 months for combined chemoradiation group and 19 months for operation group. And also median survival was 19 months for complete responder group that 8 months for noncomplete responder group. In univariative analysis, statistically significant prognostic factors were tumor size, clinical stage, tumor response, and operation. In multivariative analysis, significantly better survival was associated with clinical stage, tumor response, radiation dose, and operation. Conclusion : Compared with radiotherapy alone, combined multimodality may improve the median survival in patients with localized carcinoma of the esophagus and toxicity is acceptable.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.2
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• pp.121-127
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• 2010

Background and Objectives : Unilateral vocal fold paralysis is generally treated using injection laryngoplasty or voice therapy. However, the decision of treatment method is dependent on clinician's preference and hospital facilities without specific criteria. The purpose of the study was to examine factors predictive of voice therapy outcome in patients with unilateral vocal fold paralysis. Materials and Method : 38 patients diagnosed as unilateral vocal fold paralysis, aged from 24 to 81 years and undergone voice therapy more than 1 month were included. After 3 to 12 (mean 5.1) sessions of voice therapy, subjects had divided into responder group (RG, 28 patients) and non-responder group (NRG, 10 patients) according to G scale change. Paramters of perceptual assessment, acoustic and aerodynamic measure, and videostroboscopy were compared between two groups, and factors predictive of voice therapy result were analyzed. Results : RG patients showed significantly reduced rough, breathy, asthenic voice after voice therapy. Change of MPT and MFR was more substantial in RG than in NRG. By videostroboscopy, RG patients showed significantly more mucosal wave symmetry, glottal closure, reduced glottal gap index during the closed phase of phonation, while NRG patients showed more occurrences of abnomal supraglottic activities during phonation (p < 0.05). Poor outcome of voice therapy significantly associated with increased asthenic scale, short MPT, and less glottal closure (p=0.02). In addition, 90% of patients with MPT more than 5 seconds were in RG, whereas 56% of patients with MPT less than 5 secondes were in RG. Conclusion : Voice therapy is useful for large proportion of patients with unilateral vocal fold paralysis as an initial treatment method. However, patients with large asthenia scale, large glottic gap or MPT less than 5 seconds tend to have poor voice therapy outcome, and early injection laryngoplasty maybe recommended for these patients.