• Journal of Korean Neurosurgical Society
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• v.45 no.3
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• pp.157-163
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• 2009

Objective : In recent years, CyberKnife has emerged as an important treatment modality in the management of pituitary adenomas. Treatment results after performing CyberKnife and the complications of this procedure are reviewed. Methods : Twenty-six patients with pituitary adenomas received stereotactic radiosurgery with the CyberKnife (CKRS). The follow-up periods ranged from 7 months to 47 months (mean$\pm$SD : $30{\pm}12.7$ months). The patients consisted of 17 with non-functioning adenomas, 3 with prolactinomas and 6 with acromegaly. The change in the tumor volume, visual acuity, hormonal function, and complications by this therapy were analyzed in each case. Results : The tumor control rate was 92.3%. Hormonal function was improved in all of the 9 (100%) functioning adenomas. Hormonal normalization was observed in 4 of the 9 (44%) patients with a mean duration of 16 months. In two patients (7.6%), visual acuity worsened due to cystic enlargement of the tumor after CKRS. No other complications were observed. Conclusion : CyberKnife is considered safe and effective in selected patients with pituitary adenomas. However, longer follow-up is required for a more complete assessment of late toxicity and treatment efficacy.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.377-380
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• 2011

Objective : The purpose of this study was to determine the anatomic relationships between neurovascular structures and the transverse carpal ligament so as to avoid complications during endoscopic carpal tunnel surgery. Methods : Twenty-eight patients (age range, 35-69 years) with carpal tunnel syndrome were entered into the study. We examined through wrist magnetic resonance imaging in three different positions (neutral, radial flexion, and ulnar flexion) and determined several anatomic landmark (distance from the hamate hook to the median nerve, ulnar nerve, and ulnar vessel) based on the lateral margin of the hook of the hamate. The median nerve and ulnar neurovascular structure were studied with the wrist in the neutral, ulnar, and radial flexion positions. Results : The ulnar neurovascular structures usually passed just over or ulnar to the hook of the hamate. However, in 12 hands, a looped ulnar artery coursed 0.6-3.3 mm radial to the hook of the hamate and continued to the superficial palmar arch. The looped ulnar artery migrates on the ulnar side of Guyon's canal (-5.2-1.8 mm radial to the hook of the hamate) with the wrist in radial flexion. During ulnar flexion of the wrist, the ulnar artery shifts more radially beyond the hook of the hamate (-2.5-5.7 mm). Conclusion : It is appropriate to transect the ligament greater than 4 mm apart from the lateral margin of the hook of the hamate without placing the edge of the scalpel toward the ulnar side. We would also recommend not transecting the transverse carpal ligament in the ulnar flexed wrist position to protect the ulnar neurovascular structure.

• Korean Journal of Acupuncture
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• v.21 no.1
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• pp.51-60
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• 2004

Objectives : This research was performed to investigate the effect of herbal acupuncture(Ephedra sinica and Green tea) at Umnungchon(SP9) and Pungnyung(ST40) on weight gain, food intakes, food efficiency ratios, HDL-cholesterol, triglyceride, free fatty acid on rats fed high fat diet for 5weeks. Methods : Experimental groups were divided into normal group(Sham), high fat diet group(Con), high fat diet and Ephedra sinica-herbal acupuncture in SP9 ST40 treated group(ES), high fat diet and Green tea-herbal acupuncture in SP9 ST40 treated group (GT), high fat diet and Ephedra sinica+Green tea-herbal acupuncture in SP9 ST40 treated group(ES+GT). Herbal acupuncture was bilaterally treated at the level of 19.125mg/ml per 2 days during 5 weeks. Results : Body weight, feed intake and feed efficiency ratio were decreased in Sham, ES, ES+GT, compared with control group. The level of serum HDL-cholesterol was increased in sham, tender to increase in ES, ES+GT. The change on that of serum triglyceride was decreased in sham, ES, ES+GT and free fatty acid was decrease in sham, ES+GT. Conclusions : Ephedra sinica with Green tea-herbal acupuncture in SP9 ST40 can control the Body weight, feed intake and feed efficiency ratio, HDL-cholesterol, triglyceride, free fatty acid.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.2939-2943
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• 2014

Background: While many studies have shown that hormones can influence background parenchymal enhancement (BPE) in breast magnetic resonance imaging (MRI), only few have directly address the effect of radiotherapy. The purpose of this study was to evaluate the impact of radiotherapy on BPE in breast MRI. Materials and Methods: A retrospective search identified 62 women with unilateral breast cancer who had a breast MRI both before and after radiotherapy following breast-conserving surgery. In our study, we assumed that systemic therapy affected both breasts equivalently. We rated the level of BPE of both breasts using a four-point categorical scale. A change in the level of BPE prior to and after treatment was compared in the diseased and contralateral breasts. Results: All patients received a 4256 to 6480 cGy dose of whole breast radiotherapy over 3-7 weeks. The mean timing of the follow-up study was 6.6 months after completion of radiotherapy. Although the BPE showed a decrease in both breasts after treatment, there was a significant reduction of BPE in the irradiated breast compared with the contralateral breast (1.18 versus 0.98 average reduction in BPE level, p=0.042). Conclusions: Radiotherapy is associated with decrease in BPE with MRI.

• Journal of Korean Neurosurgical Society
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• v.39 no.3
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• pp.183-187
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• 2006

Objective : Hemifacial spasm has characteristic and specific electrophysiological finding, lateral spread response[LSR]. We study the correlation between change of lateral spread response during microvascular decompression[MVD] and clinical outcome after MVD. Methods : Sixty two patients with hemifacial spasm who were treated with microvascular decompression from March 2000 to February 2003 were included in this study. The monitoring of intraoperative facial electromyography[EMG] and brain stem auditory evoked potential were performed. Results : In 28 [44.7%] patients, there was persistence of lateral spread response after vascular decompression in root exit zone of facial nerve. Among these 28 patients, 9 had mild hemifacial spasm at discharge. Three out of 34 patients who had intraoperative disappearance of lateral spread response after MVD had mild hemifacial spasm. But Both groups, disappearance of LSR [Group I], and persistence [Group II] had only 2 patients with mild hemifacial spasm, and 5 patients at 3 months, respectively. Conclusion : Although intraoperative EMG monitoring is very useful in assessing the efficacy of MVD, the clinical outcome of MVD in patient with hemifacial spasm does not always correlate with EMG finding. The prognostic value of intraoperative LSR monitoring in the long-term results is questionable.

• Journal of Gastric Cancer
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• v.21 no.1
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• pp.84-92
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• 2021

Purpose: To date, no studies have been performed on staging based on the lymph node ratio (LNR) in elderly patients with gastric cancer who may require limited lymph node (LN) dissection due to morbidity and tissue fragility. We aimed to develop a new N staging system using the LNR in elderly patients with gastric cancer. Materials and Methods: The present study included patients aged over 75 years who underwent curative gastrectomy between January 1989 and December 2018. Clinicopathological data including the number of retrieved and metastatic LNs were collected and the LNR values were obtained (LNR = the number of metastatic LNs/the number of retrieved LNs). Eleven LNR groups with intervals of 0.1 were divided into four stages based on the inflection points at which the hazard ratio (HR) increased. Survival analysis was performed to evaluate the prognostic value of the LNR. Results: The four LNR stages included LNR0 (n=364), LNR1 (n=128), LNR2 (n=103), and LNR3 (n=10). In the multivariate analysis, both N staging and LNR staging exhibited significant prognostic values for predicting survival outcomes. However, the incremental change in the hazard ratio (HR) between consecutive stages was greater for the LNR staging than for the N staging (HRs: 1.607, 2.758, and 3.675 for N staging; 1.583, 3.514, and 10.261 for LNR staging). Conclusions: LNR staging is more useful than N staging in predicting the prognosis in elderly patients with gastric cancer and may be used as a complement or alternative to N staging.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.4
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• pp.192-203
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• 2023

Digital therapeutics based on software, such as artificial intelligence, virtual reality, games, and smartphone applications, are in the spotlight as new therapeutic alternatives in child and adolescent psychiatry. It draws attention to overcoming conventional therapeutics' limitations, such as toxicity, cost, and accessibility, and encourages patients to participate in the treatment attractively. The growth potential of the digital therapeutics market for psychiatric disorders in children and adolescents in Korea and abroad has been highlighted. Clinical studies and Food and Drug Administration approvals for digital therapeutics have increased, and cases approved by the Ministry of Food and Drug Safety have emerged in Korea. As seen above, digital transformation in child and adolescent psychiatry will change treatment paradigms significantly. Therefore, as this new field has just begun to emerge, it is necessary to verify the effectiveness and scope of the application of digital therapeutics and consider preparing a compensation system and institutional arrangements. Accordingly, this study analyzed the development trends and application status of digital therapeutics in children and adolescents and presented limitations and development directions from the perspective of application in healthcare. Further, the study is expected to identify the utility and limitations of digital therapeutics for children and adolescents and establish effective application measures.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.4
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• pp.167-184
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• 2023

Objectives This study was designed to assess the effectiveness of ultrasound therapy at the ST11 for regulation of sympathetic hyperactivity. Methods Forty healthy adult subjects were assigned to experimental group and control group. After taking mental stress, ultrasound therapy was applied at the ST11 in experimental group and sham-ultrasound therapy was applied in control group. The evaluation of sympathetic activity was measured by blood pressure, pulse rate, and heart rate variability at 3 times (Time 1: before the stress stimulation, Time 2: after the stress stimulation, Time 3: after the intervention). The primary end point was consisted of normalized (norm) low frequency (LF)/high frequency (HF) ratio, LF (norm), HF (norm). The secondary end point was consisted of systolic blood pressure, diastolic blood pressure, pulse rate, mean heart rate, standard deviation of NN intervals, root mean square of the successive differences, total power (log). Results After the stress stimulation, all subjects showed sympathetic hyperactivity. After the intervention, the experimental group showed lower sympathetic activity than the control group. Comparing the Time 3 and Time 1, the experimental group showed no significantly differences in sympathetic activity while the control group showed higher sympathetic activity in Time 3 than Time 1. Comparing the Time 3 and Time 2, the experimental group showed lower sympathetic activity in Time 3 than Time 2 while the control group showed higher sympathetic activity in Time 3 than Time 2. Conclusions We suggest that the ultrasound therapy at ST11 can decrease sympathetic activity in sympathetic hyperactivity condition.

• Korean Journal of Acupuncture
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• v.21 no.4
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• pp.1-19
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• 2004

Objectives : To understanding biological mechanism of acupuncture therapy, we have proposed a hypothesis. First of all, there exists electric property in meridian and meridian point. Second of all, energy flowing in meridian is related with electric property. Third of all, there is electronic interaction between the operator who performs acupuncture therapy and the receiver who is given acupuncture therapy. Forth of all, acupuncture effects may depend on the electric capacity which is transferred between the operator and the receiver via acupuncture needle. Methods : Under the hypothesis, we studied the effects of electric change in $ST_{37}(+)\;and\;ST_{39}(-)$ generated by Tanchim (彈鍼) manipulation which was stimulated at $ST_{36}$ point. And compared with data on the changes of electric change from the hand of the operator during acupuncture stimulation. Electric charge induced via acupuncture needle from the operator may be important factor that causes the changes of electric change in meridian and acupoint in the receiver. Therefore we investigated the changes of electric charge induced by the operator using Maclab 400 by the following methods. The one was in stable electric circle condition and the other was in unstable electric circle condition. Results : In this experiments, the changes of electric change from the stimulation type of Tanchim manipulation performed in our lab condition in acupuncture therapy was induced at least three factor, one was the difference of bio-potentials between the operator and the receiver of acupuncture therapy, another was the depth of acupuncture insertion from the skin of the receiver, the other was an electromyogram of the receiver. Conclusion : The data imply that the first factor should make a capacitance current when the operator touched the acupuncture needle which was inserted in the receiver. Therefore, the results suggest that capacitance currents stimulus in electronic view may be important factor in acupuncture therapy between the operator and the receiver of acupuncture therapy.

• The Journal of the Korean dental association
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• v.12 no.5
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• pp.351-352
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• 1974

This is a case report on split tooth which the author experienced. Fine hairline fracture of right 1st molar was detected by means of staining dye stoff under illumination. The patients complained sensitive to temperature change and to biting force.