• Radiation Oncology Journal
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• v.24 no.1
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• pp.11-20
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• 2006

Puroose: In order to find out whether stereotactic radiation therapy (RT) using CyberKnife (CK) could improve survival rate and lower acute toxicity compared to conventional RT. Materials and Methods: From April 2003 through April 2004, 19 patients with Eastern Cooperative Oncology Group (ECOG) performance status ${\leq}3$ and locally advanced pancreas cancer without distant metastasis, evaluated by CT or PET/CT, were included. We administered stereotactic RT consisting of either 33 Gy, 36 Gy or 39 Gy in 3 fractions to 6, 4 and 9 patients, respectively, in an effort to increase the radiation dose step by step, and analyzed the survival rate and gastrointestinal toxicities by the acute radiation morbidity criteria of Radiation Therapeutic Oncology Group (RTOG). Prognostic factors of age, sex, ECOG performance score, chemotherapy, bypass surgery, radiation dose, CA 19-9, planning target volume (PTV), and adjacent organ and vessel invasion on CT scan were evaluated by Log Rank test. Results: The median survival time was 11 months with 1-year survival rate of 36.8%. During follow-up period (range $3{\sim}20$ months, median 10 months), no significant gastrointestinal acute toxicity (RTOG grade 3) was observed. In univariate analysis, age, sex, ECOG performance score, chemotherapy, bypass surgery, radiation dose, CA 19-9 level, and adjacent organ and vessel invasion did not show any significant changes of survival rate, however, patients with PTV (80 cc showed more favorable survival rate than those with PTV>80 cc (p-value<0.05). In multivariate analysis, age younger than 65 years and PTV>80 cc showed better survival rate. Conclusion: In terms of survival, the efficacy of stereotactic radiation therapy using CK was found to be superior or similar to other recent studies achieved with conventional RT with intensive chemotherapy, high dose conformal RT, intraoperative RT (IORT), or intensity modulated RT (IMRT). Furthermore, severe toxicity was not observed. Short treatment time in relation to the short life expectancy gave patients more convenience and, finally, quality of life would be increased. Consequently, this could be regarded as an effective novel treatment modality for locally advanced, unresectable pancreas cancer. PTV would be a helpful prognostic factor for CK.

• Physical Therapy Korea
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• v.7 no.3
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• pp.1-18
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• 2000

The present study was performed to investigate the prevalence rate of idiopathic scoliosis and to determine the effect of exercise training on scoliotic angle in elementary school children. In this study, two out of five elementary schools in Seosan city were chosen by random sampling. Seven hundred sixty four students (from four grade to the sixth grade student) were selected in two schools. Screening tests were conducted to find idiopathic scoliosis. Among the 764 individuals, 139 subjects who showed positive sign in physical examination took whole spine radiography. Thirty six subjects who had a curve of 10 or greater and consented to participate in the exercise program were selected for the exercise program. The exercise program was performed four times a week for 5 months. The results of this study were as follows: 1) One hundred thirty nine subjects showed positive sign in the scoliosis screening test. 2) The overall prevalence of curve of $10^{\circ}or$ greater in X-ray finding was 8.15%. The prevalencies of curve of $10^{\circ}or$ greater in male and female were 7.1% and 9.2%, respectively. 3) Scoliosis curves were observed at thoracic area (48.4%), at thoracolumbar area (27.4%) and at lumbar area(24.4%). 4) Right side curve was 59.7%, and left side curve was 40.3%. 5) After the 5 month exercise program for scoliosis, the Cobb's angle was significantly decreased. 6) There was no significant difference of Cobb's angle change respect to sex, grades, and scoliosis curve site. Results shown here indicates that an early detection and early exercise for scoliosis can result in decreased the Cobb's angle in elementary school children.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.7-12
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• 2004

Background and Objectives: Brain metastasis from well-differentiated thyroid carcinoma is uncommon, and the treatment remains controversial. In this study, we analyzed cases of brain metastasis from well differentiated thyroid carcinoma to determine optimal treatment. Material and Methods: From March 1986 to May 2003, we experienced 13 cases of brain metastases from well-differentiated thyroid carcinomas. There were 6 men and 7 women with a mean age of 62.3 years. The time interval detecting the brain metastasis, treatment methods, outcomes, and the prognostic factors were analyzed. Results: In 11 patients, brain metastasis was found at a mean of 96 months after thyroid surgery (range, 1-204months). In 1 patient, brain metastasis was found simultaneously with the thyroid cancer. In the remaining one, brain metastasis was presented as the first sign. Treatment included gamma knife therapy in 2, external radiation therapy (ExRT) in 2, resection and ExRT in 2, gamma knife therapy and ExRT in 2 and intracranial holmium injection in 1. Three patients received no treatment. The mean survival was 20.5months (1-119 months). Only 2 patients with early detection remained alive after treatment (23months and 119months). The age, sex, primary tumor size, combined organs of distant metastasis and treatment methods did not affect the prognosis. There were noticeable symptomatic improvements in patients who received any kind of treatment for brain metastasis. Conclusion: Early detection and treatment of brain metastasis appears to bring symptomatic relief and improve survival. Therefore, early screening for brain metastasis is recommended for patients with symptoms. However, further study is needed to determine the optimal method of treatment.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.583-588
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• 2010

Purpose: Angiosarcoma is a tumor of mesenchymal origin with an extremely high rate of metastasis and invasiveness. This tumor is notorious for its very poor prognosis, although surgical excision followed by radiation therapy is considered to be effective by many. The authors experienced three angiosarcoma patients with their tumors removed and wounds covered with split-thickness skin grafts and/or latissimus dorsi free flaps. Methods: Three patients were admitted to our hospital showed plaques of different morphology. Based on their medical records, these patients were classified by sex, age, type of reconstruction, recurrence, and further treatment after surgical removal. Results: All patients were male, with a mean age of 72 years (range, 66 to 77 years). Split-thickness skin grafts with latissimus dorsi free flaps were performed on two cases, and of these two cases, cervical lymph node biopsy was done in one case, and radical neck dissection was done in the other. In all cases, radiation therapy was done within two weeks of tumor removal. Distant metastasis occurred without local recurrence in two of the cases. Lung was the first organ affected by metastasis. In the remaining case, the tumor recurred locally 6 times, and additional excision was necessary. All patients died due to local recurrence and lung metastasis. Conclusion: Irregular margins and high recurrence and metastasis rates cause a poor prognosis in large angiosarcoma of the scalp. Radiotherapy and chemotherapy should be strongly considered in large angiosarcomas.

• The Journal of Korean Physical Therapy
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• v.13 no.2
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• pp.359-371
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• 2001

The purpose of this study is to find out the effectiveness of the therapeutic sports massage(TSM) applied to the patients with delayed onset muscle soreness(DOMS) by measuring, assessing and analyzing the changes in intensity and unpleasantness of muscle pains before and after TSM. In the therapeutic sports massage program, such methods as effleurage, petrissage and deep transverse friction were selected as traditional massage treatments frequently used for muscles with pain and spasm. Effleurage and petrissage were applied for 20 minutes in total before and after deep transverse friction treatment. After TSM, the McGill pain questionnaire word list(MPQWL), verbal rating scale(VRS), visual analogue scale(VAS) were used to measure the degree of the pain on the patients. The major findings from this study are as follows; 1. The surveyed patients range from 15 to 63 in age, with highest numbers of 18(37.50%) registered in the twenties and next ones of 14(29.17%) in the thirties. Divided by sex, 27 are men and 21 are women totalling 48 with average age of 25.7. 2. There was significant decrease in the numerical values of VAS & VRS and MPQWL immediately after TSM(p<.05). There was also significant decrease in the numerical values of MPQWL, VRS and VAS after the 2nd, 3rd, 4th, 5th TSM(p<.05). 3. There was significant decrease in the intensity and unpleasantness of pains after TSM(p<.05). 4. From the analysis into chronological changes in the intensity and unpleasantness of pains before and after TSM with ANOVA, it became evident that the longer the period of treatment was, the higher the pains decreases drastically, while significant difference was shown in the intensity and unpleasantness of pains(p<.05). Summed up, it can be generally concluded that TSM is an effective treatment to rid the patients with DOMS of pains safely and promptly.

• Journal of Oriental Neuropsychiatry
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• v.14 no.1
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• pp.183-192
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• 2003

Objective : Obesity is related to psychological problems as well as physical problems. This study was designed to investigate the depression of over weight and normal group who visited to obesity clinic for diet therapy. Methods : 67 patients were selected(obesity group 42, normal group 25), they were treated medically in obesity clinic of Dong-Seo Oriental Hospital. We checked age, sex, education level, relative weight, BMI and Beck Depression Inventory(BDI) in two group. Results : The results were summarized as followed. 1. The ratio of Relative Weights are $137.45{\pm}12.77$ in over weight group, $108.48{\pm}9.11$ in normal group. 2. The ratio of BMI are $28.61{\pm}2.94$ in over weight group, $23.04{\pm}1.83$ in normal group. 3. The results of BDI score are $10.60{\pm}7.15$ in over weight group, $12.56{\pm}8.33$ in normal group. Conclusions : These results suggested that the patients who participated in diet therapy had mild depression and we should pay attention to psycological problem as well as the physical problem when we treat obesity.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.210-219
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• 1995

Many different factors which may affect the prognosis of the soft tissue sarcomas have been reported by many authors ; Generally, tumor size, histologic type, surgical margin, and multi modality therapy therapy as the prognostic factors were reported. The objectives of this retrospective study of soft tissue sarcomas are : 1) to define more clearly prognostic variables that have significant predictive value for disease-free and overall survival ; and 2) to evaluate tumor histologic grade based upon extent of tumor necrosis as a means of stratifying more aggressive soft tissue sarcomas(grade II & III) of the extremities. We treated 94 patients who had soft tissue sarcoma of the extremities and trunk from May 1984 to September 1994(average duration of follow-up was 5 years ranging from 2 months to 10 years) and evaluated the prognostic factors of the soft tissue sarcomas; age, sex, depth, size, location, histologic type and grade, stage, therapy modality, surgical margin, local recurrence and distant metastasis. The results were as follows. 1. The patients with poorer prognosis were over the age of fifty, whose mass was deeply located, size of the mass was over 10cm in diameter, grade III in histology, who had local recurrence, metastasis, and received only surgery. 2. Among these prognostic factors, the most significant prognostic factor was histologic grade base upon extent of tumor necrosis.

• Journal of Korean Physical Therapy Science
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• v.9 no.2
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• pp.87-98
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• 2002

The main objective of this study is to evaluate role-related job stressors of physical therapists and to examine the relationship between job stress and organizational effectiveness. A survey was conducted through structured questionnaire for the physical therapists working in Busan area, and data from 175 therapists were utilized in the final analysis. Survey items included general characteristics of the therapists(sex, age, education, marital status, religion, income, etc.), various kinds of job stressors(role conflict, role overload, role ambiguity, physical burden), and organizational effectiveness measured in terms of job satisfaction, organizational commitment and organizational citizenship behavior. Major results are as follows: 1) The level of physical therapists' job stress was found to be in average range, recording 2.65 on 4-point scale. 2) It appeared that main job stressors of physical therapists were role ambiguity and role overload, and this was more apparent in the case of younger, relatively less-educated, unmarried, and lower-grade employees. 3) On the other hand, in the case of relatively more-educated and higher-paid employees, role conflict was comparatively more important job stressor. 4) Regression analysis suggested that, as Job stress increased, job satisfaction and organizational commitment decreased; however, no significant relationship was found between job stress and organizational citizenship behavior. 5) These results imply that, in order to perform effective and efficient personnel administration of physical therapists, adequate job stress management would be very important task for the hospital managers.

• Journal of Korean Physical Therapy Science
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• v.15 no.2
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• pp.87-95
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• 2008

Background: Hemiplegic patients usually have difficulty maintaining balance. Balance training is a major component of there habilitation program for patients with neurological impairment. The purpose of this study was to investigate the effects of PLS(Posterior Leaf Spring), FES(Functional Electrical stimulation), treadmill training, and neurodevelopmental treatment on the improvement of balance in patients with hemiplegia. Methods: We looked into published studies from Dankook University’s electronic library databases of RISS4U, KMbase, NCBI, and MEDLIS concerning the effectiveness of any form of intervention leading to improvement of balance. All types of studies relevant to the topic that were published in English during the time period of 1986 to 2005 were included. Results: 1. There were significant differences in standing balance, dynamic activity balance, and gait speed between barefoot subjects and subjects who wore SPAFO and HPAFO(p<.05). 2. The changes in ROM and FRT related to sex, age, height, and weight part of the diagnosis, as well as experience relapse, was of meaningless value. Changes in ROM related to the duration of pain and experiences of falling down were also meaningless. However, FRT showed significant static differences(p<.05). 3. The body-weight-support treadmill training scoring of standing balance, step length, and a timed 10m walking test showed definite improvement. 4. The proprioceptive control approach improved dynamic balance in patients with hemiplegia. Conclusion: Consequently, further study is needed to verify methods when physical therapists are researching balance ability in hemiplegic patient.

• Journal of Korean Neurosurgical Society
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• v.59 no.1
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• pp.37-43
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• 2016

Objective : The aim of this multicenter, matched-pair study was to compare the outcomes of stereotactic radiosurgery (SRS) and conventional external radiation therapy (RT) when used as a primary treatment in spine metastasis from hepatocellular carcinoma (HCC). Methods : From 2005 to 2012, 28 patients underwent SRS as the primary treatment in spine metastasis from HCC. Based on sex, age, number of spine metastasis, Child-Pugh classification, interval from original tumor to spine metastasis, and year of treatment, 28 patients who underwent RT were paired. Outcomes of interest were pain relief, progression free survival, toxicities, and further treatment. Results : The perioperative visual analog scale (VAS) decrease was larger in SRS group than in RT group, but the difference was not significant (3.7 vs. 2.8, p=0.13). When pain medication was adjusted, the number of patients with complete (n=6 vs.3) or partial (n=12 vs.13) relief was larger in SRS group than in RT group; however, the difference was not significant (p=0.83). There was no significant difference in progression free survival (p=0.48). In SRS group, 32.1% of patients had 1 or more toxicities whereas the percentage in RT group was 63.0%, a significant difference (p=0.04). Six SRS patients and 7 RT patients received further intervention at the treated segment. Conclusion : Clinical and radiological outcome were not significantly different between the two treatments. Toxicities, however, were more prevalent in the RT group.