• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.189-196
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• 2012

Purpose: The sufficiency of skin dose and the reemergence of patient set-up position to the success of skin cancer radiation treatment is a very important element. But the conventional methods to increase the skin dose were used to vacuum cushion, bolus and water tank have several weak points. For this reason, we producted Foxtail Millet Vacuum Cushion and evaluated the efficiency of the Foxtail Millet Vacuum Cushion in skin cancer Radiation treatment. Materials and Methods: We measured absolute dose for 3 materials (Foxtail Millet Vacuum Cushion, bolus and solid water phantom) and compared each dose distribution. We irradiated 6 MV 100 MU photon radiation to every material of 1 cm, 2 cm, 3 cm thickness at three times. We measured absolute dose and compared dose distribution. Finally we inspected the CT simulation and radiation therapy planing using the Foxtail Millet Vacuum Cushion. Results: Absolute dose of Foxtail Millet Vacuum Cushion was similar to absolute dose of bolus and solid water phantom's result in each thickness. it Showed only the difference of 0.1~0.2% between each material. Also the same result in dose distribution comparison. About 97% of the dose distribution was within the margin of error in the prescribed ranges ($100{\pm}3%$), and achieved the enough skin dose (Gross Tumor Volume dose : $100{\pm}5%$) in radiation therapy planing. Conclusion: We evaluated important fact that Foxtail Millet Vacuum Cushion is no shortage of time to replace the soft tissue equivalent material and normal vacuum cushion at the low energy radiation transmittance. Foxtail Millet Vacuum Cushion can simultaneously achieve the enough skin dose in radiation therapy planing with maintaining normal vacuum cushion' function. Therefore as above We think that Foxtail Millet Vacuum Cushion is very useful in skin cancer radiation treatment.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.2
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• pp.161-169
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• 2016

Purpose : To quantify the inter-fractional variation in prostate displacement and their dosimetric effects for prostate cancer treatment. Materials and Methods : A total of 176 daily cone-beam CT (CBCT) sets acquired for 6 prostate cancer patients treated with volumetric-modulated arc therapy (VMAT) were retrospectively reviewed. For each patient, the planning CT (pCT) was registered to each daily CBCT by aligning the bony anatomy. The prostate, rectum, and bladder were delineated on daily CBCT, and the contours of these organs in the pCT were copied to the daily CBCT. The concordance of prostate displacement, deformation, and size variation between pCT and daily CBCT was evaluated using the Dice similarity coefficient (DSC). Results : The mean volume of prostate was 37.2 cm3 in the initial pCT, and the variation was around ${\pm}5%$ during the entire course of treatment for all patients. The mean DSC was 89.9%, ranging from 70% to 100% for prostate displacement. Although the volume change of bladder and rectum per treatment fraction did not show any correlation with the value of DSC (r=-0.084, p=0.268 and r=-0.162, p=0.032, respectively), a decrease in the DSC value was observed with increasing volume change of the bladder and rectum (r=-0.230,p=0.049 and r=-0.240,p=0.020, respectively). Conclusion : Consistency of the volume of the bladder and rectum cannot guarantee the accuracy of the treatment. Our results suggest that patient setup with the registration between the pCT and daily CBCT should be considered aligning soft tissue.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.4
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• pp.139-143
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• 2001

Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.267-275
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• 2011

This prospective study was designed to compare clinical outcomes of immediately loaded implant with delayed loaded implant in partially posterior edentulous patients. For test group, 42 GS III (Osstem, Korea) implants in 17 patients were loaded within 48 hours after the placement. Control group was 27 implants in 15 patients loaded at $2.6{\pm}1.7months$ from the placement surgery. Before loading, primary stability was evaluated by ISQ value. Clinical symptoms, mobility, soft tissue state was evaluated at baseline, 3 months, 6 months and 12 months of loading. Marginal bone level change was also measured with periapical radiographs. Mann-Whitney test (${\alpha}$=0.05) and repeated measured ANOVA (${\alpha}$=0.05) was used for marginal bone level change between two groups. At the baseline, mean ISQ value of test group and control group was $80.3{\pm}7.1$ and $69{\pm}17$ respectively. Test group showed 95.23% of success rate and 100% of control group was successful. At 3 and 6months of loading, significantly more bone resorption was observed in test group than in control group (p<0.05). However, there was no significant difference in the bone level change at 12months of loading between two groups (p>0.05). Marginal bone level change showed no significant difference with gender and location (p>0.05). Within the limitation of this study, when primary stability was obtained, immediate loading of GS III implant at posterior region could be predictable treatment option.

• Journal of Oral Medicine and Pain
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• v.33 no.1
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• pp.15-26
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• 2008

Purpose : To investigate the actual conditions of diagnosis and treatment of oral medicine inpatient with systemic disease. Methods : A total of 110 subjects, inpatient due to systemic disease for diagnosis and treatment of oral disease was requested to answer the medical history and dental treatment record. Results : Systemic disease is composed of Non-insulin-dependent diabetes mellitus 26%, Cerebral infarction 25.2%, Intracerebral hemorrhage, Polyarthrosis, Coxarthrosis 4.7%, Nerve root and plexus disorders, Hypertensive heart and renal diseases, Ankylosing spondylitis 2.4%. Chief complain of oral disease is composed of toothache 28.6%, routine check 23%, tooth mobility 8.7%, hypersensitivity 7.1%, periodontal bleeding 6.4%. Oral disease is composed of Gingivitis and periodontal diseases 28.9%, Dental caries 17.1%, Diseases of pulp and periapical tissues 15.1%, Diseases of salivary glands 10.5%, Other diseases of hard tissues of teeth 8.6%, Within Normal Limit 5.3%. Treatment of oral disease is composed of periodontal treatment 17.95%, rejection of treatment 16.67%, medication for halitosis & dry mouth 13.46%, extraction 12.18%, prosthetic treatment 8.97%. Chief complain in oral medicine is composed of oral soft tissue problem 6.4%, craniomandibular disorders 5.6%, halitosis 4%, total 16%. Conclusion : These findings indicate that inpatient due to the systemic disease is significantly correlated to the oral disease. The patients of oral disease interrelationship between inpatient and outpatient of systemic disease should be validated by future research.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.3
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• pp.162-168
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• 2012

Purpose: Teeth are generally exposed when people smiling. Moreover, the exposed teeth and soft tissue when smiling becomes an important guideline for esthetically prosthetic restoration. This research is to compare and find out differences of Korean young men's smile living in presence and twenty years ago. Materials and methods: Subjects, 100 young men (50 male and 50 female), were required about several aspects; normally developed physical condition, no psychological or genetic disorders, a fine face with no loss of teeth, no experience in orthodontic or prosthetic treatment, relatively normal occlusion, aged between 20-29. The photos of the subject at rest position and front face when fully smiled were taken three times. 100 photos (50 male and 50 female) were chosen at random from the 240 university students' smile photos taken by Yoon and his colleagues in 1991. By Hulsey's method of measuring smile, several factors; the change of upper lip curvature, the change of the relation between the upper lip and teeth, parallelism between Mx. incisor and lower lip, contact relation between Mx. incisor and lower lip and teeth displayed in a smile, were measured and analyzed. Meanwhile, ten dentists assessed aesthetic evaluation about men and women's smile for twice and recorded and compared smile score. The -test (P<.05) was used to compare the measured value. The difference of smile score was analyzed by t-test (P<.05). Results: The smile score calculated in 2011 (60.22) was higher than that of 1991 (52.80). Among five measurement categories, the noticeable difference was distinguished from two factors; the change of upper lip curvature and contact relation between Mx. incisor and lower lip. Conclusion: The Korean young men's smile has been considerably improved for twenty years. And it is found that the change of upper lip curvature plays an important role, that is, the smile formed with an ascended labial commissure has been increased significantly.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.1
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• pp.27-36
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• 2010

Purpose: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. Materials and Methods: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. Results: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. Conclusion: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.1-7
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• 2018

$^{68}Ga$ was eluted from a $^{68}Ge/^{68}Ga$ radionuclide generator. $^{68}Ga$ decays into $^{68}Zn$, with a half life=67.8min. The decay is 88.9 % by ${\beta}$+ and 11.1 % by EC. The main ${\beta}$+ decay (87.7 %) is to the ground level of $^{68}Zn$ and it is a pure positron emission branch. A small fraction decays ${\beta}$+ (1.2 %) into an excited level of $^{68}Zn$, which promptly decays into the ground level with a ${\gamma}$ (1.077 Mev). This can constitute prompt gamma contamination in the PET data, if the 1.077 Mev ${\gamma}$ has a scatter interaction in the patient, and generates a lower energy ${\gamma}$ in coincidence with the positron annihilation pair. The purpose of this study was to evaluate standardized uptake value(SUV) before and after applying prompt gamma rays correction on $^{68}Ga$-DOTATOC PET/CT image. Fifty patient underwent PET/CT 1 hour after injection of the $^{68}Ga$-DOTATOC. The SUVmax and SUVmean of lesions and normal tissues (Pituitary, Lung, Liver, Spleen, Kidney, Intestine) were evaluated before and after applying prompt gamma correction on $^{68}Ga$-DOTATOC PET/CT image. Additionally, the SUVmax of each lesions and SUVmean of the soft tissues were measured on images. and target to background ratios (TBR) were calculated as quantitative indices. Among 15 patients, 25 of lesions (Pancreas, Liver, Thoracic Spine, Brain) with increased uptake on $^{68}Ga$-DOTATOC PET/CT image. SUVmax and SUVmean were increased in lesion site and normal tissue after prompt gamma rays correction. TBR was $51.51{\pm}49.28$ and $55.50{\pm}53.12$ before and after prompt gamma rays correction, respectively. (p<0.0001)

• Pediatric Infection and Vaccine
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• v.21 no.2
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• pp.129-138
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• 2014

Purpose: Streptococcus pyogenes is an important cause of invasive diseases in children. We aimed to describe the clinical characteristics of invasive infections due to S. pyogenes in children in Korea. Methods: A retrospective study of children under 18 years of age with invasive infections due to S. pyogenes at Seoul National University Children's Hospital between March 1992 and December 2012, and Seoul National University Bundang Hospital between March 2003 and December 2012 was conducted. Demographic factors, clinical characteristics, laboratory findings, treatment, mortality and morbidity of all patients were reviewed. Results: A total of 30 among 36 cases identified as invasive disease due to S. pyogenes were available for review. There was a predominance for male subjects (male:female=2.75:1). The median age was 50 months (range 12 days to 15 years) and 53.3% were under 5 years of age. Skin and soft tissue infections (9/30, 30.0%), bacteremia without identified focus (4/30, 13.3%) and bone and joint infections (6/30, 20.0%) were the most frequent clinical presentations. Streptococcal toxic shock syndrome (3/30, 10.0%) pulmonary, abdomen and central nervous system infections (2/30, 6.7%) were also seen. There was a peak in number of patients in year 2012 (9/30, 30.0%). There were no cases of mortality. Erythromycin and clindamycin resistance rates were low by 3.8% and 7.5%, respectively. Conclusion: We studied the clinical presentations of invasive infections due to S. pyogenes during the past 20 years in Korean children. The findings of this study help us understand the characteristics of the disease, enhancing early recognition and prompting adequate antibiotic therapy which is important in reducing morbidity and mortality.

• The korean journal of orthodontics
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• v.22 no.1
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• pp.253-271
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• 1992

The purpose of this study was to investigate the difference of EMG activity of the Orbicularis oris and Mentalis muscle between normal occlusion and class III malocclusion group during various lip position and to find out whether any correlations exist between the muscular activity and craniofacial morphology. In this study, 50 subjects with a mean age of 22.9 Years (range 20.0-26.0) were investigated (25 subjects were normal occlusion, and 25 subjects were class III malocclusion). EMG data were recorded from the Orbicularis oris and Mentalis muscle during rest lip posture, lip position at maximum biting, lip position at maximum sealing effort, lip position at chewing, swallowing and phonation with the Medelec MS-25 electromyographic machine. Lateral cephalometric radiographs was taken with the mandible in intercuspal position on all subjects. All data were recorded and statistically processed. The findings of this study can be summerized as follows: 1. In normal occlusion, the maximal mean amplitude of upper lip during the lip position at chewing was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 2. In Class III malocclusion, the maximal mean amplitude of upper lip during the lip position at chewing, swallowing and phonation was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 3. Compare to normal occlusion, the Class III malocclusion was showed low maximal mean amplitude of upper lip during rest lip posture and the lip position at swallowing of saliva, and showed great maximal mean amplitude of lower lip and meantalis muscle during the lip position at chewing and phonation. 4. In normal occlusion, the maximal mean amplitude of upper lip during various lip position was not correlated with the length and thickness of upper lip, but the maximal mean amplitude of lower lip during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip. 5. In Class III malocclusion, the maximal mean amplitude of upper lip during rest lip posture was negatively correlated with the thickness of upper lip, and the maximal mean amplitude of lower lip and mentalis muscle during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not correlated with the cephalometric measurements of soft tissue. 6. The correlation between the maximal mean amplitude of orbicularis oris and mentalis muscle and cephalometric measurements of incisors was not nearly present. 7. In normal occlusion, the maximal mean amplitude of lower lip and mentalis muscle during the lip position at maximum biting was negatively correlated with the angle between palatal plane and mandibular plane. In Class III malocclusion, the maximal mean amplitude of upper lip, lower lip and mentalis muscle during function was negatively correlated with the length of maxilla, the maximal mean amplitude of upper lip and lower lip during function was negatively correlated with the SNA and SNPo, and the maximal mean amplitude of lower lip during the lip position at chewing was negatively correlated with the ANB.