• Radiation Oncology Journal
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• v.33 no.4
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• pp.310-319
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• 2015

Purpose: Follicular lymphoma (FL) is an indolent non-Hodgkin's lymphoma that is highly sensitive to radiotherapy (RT). However, the effectiveness of RT has not been well established. We reviewed our experiences to assess the role of RT for FL and analyze treatment results. Materials and Methods: Retrospective analysis was done on 29 patients who received first RT between January 2003 and August 2013. Of 23 early stage (stage I, II) patients, 16 received RT alone, four received chemotherapy followed by RT, two received RT postoperatively, and one received salvage RT for relapse after resection. Six advanced-stage (stage III, IV) patients received RT after chemotherapy: two received consolidation RT, three received salvage RT for residual lesions, and one received RT for progressive sites. Median RT dose was 30.6 Gy (range, 21.6 to 48.6 Gy). Median follow-up duration was 62 months (range, 6 to 141 months). Results: All patients showed complete response in the radiation field. Eight outfield relapses were reported. Seven patients received salvage treatment (three chemotherapy, four RT). Four patients showed excellent responses, especially to RT. Estimated 5-year and 10-year relapse-free survivals were 72% and 60%. In the RT-alone group, 5-year relapse-free survival was 74.5%. All advanced-stage patients were disease-free with 100% 5-year overall survival. Disease-specific death was noted in only one patient; four others died of other unrelated causes. No significant toxicity was reported. Conclusion: RT resulted in excellent treatment outcomes for all FL stages when used as a primary treatment modality for early stage or salvage-treatment modality for advanced-stage disease.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8383-8386
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• 2016

Background: To evaluate the safety, convenience and effectiveness of 940nm diode laser for treatment of homogenous leukoplakia. Materials and Methods: Ten patients having homogenous leukoplakia which were diagnosed clinically were selected from an Indian dental educational institution for the study. Toludine blue staining was applied locally over the lesion. The area where there was increased uptake of stain was excised using a 940 nm EZLASE TM diode laser (BIOLASE-USA). Results: Although various treatment modalities have been tried and the search continues for novel treatment modalities for complete removal of homogenous leukoplakia, from results of our preliminary pilot study it is clear that the use of 940 nm diode laser as a treatment modality for homogenous leukoplakia is a good substitute. Healing was perfect without any complication within a duration of 1 month. Pain intensity was also mild and absolutely zero on the VAS scale after 1 month follow up. Conclusions: 940 nm diode lasers are safe and can be effectively used as a treatment modality of homogenous leukoplakia, without any complication and without compromising health and oral function of patients. Considering recurrence factor, long term follow up for patients is a must.

• The Journal of the Korea Contents Association
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• v.11 no.11
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• pp.274-285
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• 2011

This study deals with an analysis into the details of medical treatment and expenses by items of treatment as well as the factors related to the ratio between the medical treatment and expenses for 1583 patients who were hospitalized in and discharged from 2 general hospitals located at a city under the coverage of car insurance during the year 2009. As a result, there was statistically significant difference in the details of medical treatment and expenses by items of treatment as well as their composition ratio depending on the individual characters as sex, age and the number of days staying in hospital. Each medical institution should conduct a close analysis of its patients under the car insurance program as well as the factors related to medical expenses with a view to utilize them as basic data for mapping out plans for effective operation of its organization in consideration of the characters as a medicalinstitution.

• Clinical and Experimental Pediatrics
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• v.55 no.5
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• pp.164-170
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• 2012

Purpose: Dramatic improvement of hemangioma to propranolol has been recently reported; however, details on dose and duration of treatment, potential risks, and monitoring have not been determined. The objective of this study is to describe and analyze the use of propranolol as a first-line treatment or as a single therapy in management of complicated hemangioma. Methods: A retrospective chart review of eight patients diagnosed with hemangioma and treated with propranolol in Kangbuk Samsung Hospital from February 2010 to April 2011 was performed. Results: Eight patients with hemangioma with functional impairment, cosmetic disfigurement, or rapid growth were treated with propranolol. Five patients had solitary facial hemangioma. The mean age of symptoms at onset was 5 weeks. The median age for starting propranolol treatment was 5.5 months. Propranolol at 2 mg/kg/day was finally administered in divided doses with a gradual increase. Significant regression was observed in seven patients, and shrinkage in size, softening in consistency, and decrease in redness were evident within 4 weeks. Among them, six patients were still taking propranolol, and one patient had stopped after 12 months. Other one patient did not show significant improvement with satisfactory result after 3 months of propranolol use. Treatment with propranolol was well tolerated and had few side effects. No rebound growth was observed in any of the patients. Conclusion: We observed that use of propranolol was very effective in treatment of hemangioma without obvious adverse effects or relapse.

• Archives of Plastic Surgery
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• v.40 no.2
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• pp.123-128
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• 2013

Background Some diabetic feet heal without complication, but others undergo amputation due to progressive wounds. This study investigates the risk factors for amputation of diabetic feet. Methods A total of 55 patients who visited our institution from 2008 to 2012 were included in the study. The patients with abnormal fasting blood sugar levels, lower leg vascularity, and poor nutrition were excluded from the study group, and the wound states were unified. The patients were categorized into a treatment success group (n=47) and a treatment failure group (n=8), and their hemoglobin A1C (HgA1C), C-reactive protein (CRP), white blood cell count (WBC), and serum creatinine levels were analyzed. Results The initial CRP, WBC, and serum creatinine levels in the treatment failure group were significantly higher than that of the treatment success group, and the initial HgA1C level was significantly higher in the treatment success group. The CRP and WBC levels of both groups changed significantly as time passed, but their serum creatinine levels did not. Conclusions The initial CRP, WBC, and serum creatinine levels were considered to be risk factors for amputation. Among them, the serum creatinine level was found to be the most important predictive risk factor. Because serum creatinine represents the renal function, thorough care is needed for the feet of diabetic patients with renal impairment.

• Journal of Chest Surgery
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• v.53 no.2
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• pp.41-48
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• 2020

Background: Chylothorax after congenital heart surgery is not an uncommon complication, and it is associated with significant morbidity. However, consensus treatment guidelines are lacking. To improve the treatment outcomes of patients with postoperative chylothorax, we implemented a standardized management protocol at Severance Hospital in September 2014. Methods: A retrospective review of patients treated at a single center was done. All corrective and palliative operations for congenital heart disease performed at our institution between January 2008 and April 2018 were reviewed. The incidence and treatment outcomes of postoperative chylothorax were analyzed. Results: The incidence of chylothorax was 1.9%. Sixty-one percent of the patients could be managed with a low-fat diet, while 28% of the patients required complete restriction of enteral feeding. Thoracic duct embolization was performed in 2 patients and chest tube drainage decreased immediately after the procedure. No patient required thoracic duct ligation or pleurodesis. After implementation of the institutional management protocol, the number of chest tube drainage days decreased (median, 24 vs. 14 days; p=0.45). Conclusion: Implementing a strategy to reduce postoperative chylothorax resulted in an acceptable incidence of postoperative chylothorax. Instituting a clinical practice protocol helped to curtail the treatment duration and to decrease the requirement for surgical treatment. Image-guided embolization of the thoracic duct is an effective treatment for postoperative chylothorax.

• Radiation Oncology Journal
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• v.37 no.1
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• pp.60-65
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• 2019

Purpose: The quality assurance (QA) chart rounds are multidisciplinary meetings to review radiation therapy (RT) treatment plans. This study focus on describing the changes in RT management based on QA round reviews in a single institution. Materials and Methods: After 9 full years of implementation, a retrospective review of all patients whose charts passed through departmental QA chart rounds from 2007 to 2015. The reviewed cases were presented for RT plan review; subcategorized based on decision in QA rounds into: approved, minor modifications or major modifications. Major modification defined as any substantial change which required patient re-simulation or re-planning prior to commencement of RT. Minor modification included treatment plan changes which didn't necessarily require RT re-planning. Results: Overall 7,149 RT treatment plans for different anatomical sites were reviewed at QA rounds. From these treatment plans, 6,654 (93%) were approved, 144 (2%) required minor modifications, while 351 (5%) required major modifications. Major modification included changes in: selected RT dose (96/351, 27%), target volume definition (127/351, 36%), organs-at-risk contouring (10/351, 3%), dose volume objectives/constraints criteria (90/351, 26%), and intent of treatment (28/351, 8%). The RT plans which required major modification according to the tumor subtype were as follows: head and neck (104/904, 12%), thoracic (12/199, 6%), gastrointestinal (33/687,5%), skin (5/106, 5%), genitourinary (16/359, 4%), breast (104/2387, 4%), central nervous system (36/846, 4%), sarcoma (11/277, 4%), pediatric (7/251, 3%), lymphoma (10/423, 2%), gynecological tumors (2/359, 1%), and others (11/351, 3%). Conclusion: Multi-disciplinary standardized QA chart rounds provide a comprehensive and an influential method on RT plans and/or treatment decisions.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.30 no.4
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• pp.75-96
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• 2017

Objectives : The purpose of this study was to investigate the treatment trend for allergic rhinitis in Korean Medicine. Methods : We conducted an online survey for Korean Medicine Doctors who were registered in the association of Korean Medicine. The questionnaire was consisted of patient characteristics, diagnosis status, treatment status, and future research needs. Results : Data from total of 396 respondents were analyzed. More than 70% of the patient came to the Korean Medicine Clinic after visiting the Western Medicine Clinic in 43.9% of the respondents. 55.6% of the respondents performed combination therapy. History taking, nasal examination, x-ray, and Korean Medicine diagnostic test were used for diagnosis. The mean duration of treatment ranged from $4.9{\pm}2.91$ to $15.2{\pm}8.45$ for pediatric and early childhood patients and from $17.5{\pm}16.15$ to $5.3{\pm}3.85$ weeks for adolescents and adult patients. The mean number of treatment times was from $9.8{\pm}7.00$ to $33.5{\pm}24.45$ for pediatric and early childhood patients and from $10.8{\pm}11.55$ to $40.4{\pm}48.18$ times for adolescents and adult patients. 64.5%, 48.0%, and 91.2% of the respondents used herbal medication in national health insurance coverage, herbal medication uninsured in health insurance and herbal prescription filled at each medical institution, respectively for pediatric and early childhood patients and 67.6%, 42.8% and 86.1% for adolescents and adult patients. 36.9% and 36.4% of respondents answered that the study of acupuncture and herbal medicine are needed preferentially. Conclusions : The results of this survey will be used to develop clinical practice guideline that reflect actual clinical practice.

• Korean Journal of Acupuncture
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• v.35 no.4
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• pp.174-186
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• 2018

Objectives : The aim of this survey was to investigate the general characteristics of sports injury patients in Korean medical institutions by Korean Medicine Doctors (KMDs) and the treatment patterns of Korean medicine for ankle sprain which is one of the common sports injuries. Methods : An online survey was conducted on KMDs interested in sports injuries to assess their experience and perception of sports injuries including diagnosis, intervention, and treatment plan for ankle sprain. Results : A total of 276 KMDs participated in the survey. They answered that 12% (median, range 0~80%) of patients visiting a Korean medical institution had sports injuries. Sports injuries frequently occur in the ankle, back, shoulder, knee, and elbow and the most common sports injury was sprain/strain. Many participants were aware that sports injuries should be treated differently from other musculoskeletal diseases in general. They reported that confirmation of fracture, swelling, and tenderness was essential to diagnose ankle sprains. Acupuncture was the most commonly used treatment and reported to need 2 to 6 weeks of treatment period, depending on the severity. Conclusions : Based on the findings regarding treatment of sports injury patients by KMDs, this study would be utilized as basic information for pragmatic clinical research design related to sports medicine in the future.

• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.2
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• pp.54-69
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• 2022

Objectives: The purpose of this study is to reflect the patient's perspective in the process of developing Korean medicine clinical practice guideline (CPG) of puerperal wind disorder by survey. Methods: Five hundred fifty patients were surveyed from November 3rd, 2021 to November 8th, 2021 by internet. This study is an exploratory cross-sectional survey study, and descriptive statistics and frequency analysis were conducted on respondents' general characteristics, postpartum symptoms, the history of using treatment institution for puerperal wind disorder, satisfaction of medical institutions and perception of postpartum care. Results: Survey results showed that 92.0% of respondents experienced symptoms after childbirth, and 56.2% of the symptoms were arthralgia, followed by obesity with 41.8%. Among puerperal wind disorder patients, 34.2% had treatment history, and 54.3% received Korean medical treatment. Treatment satisfaction was confirmed to be higher in Korean medical treatment. The necessity of postpartum care was recognized at 95.7% of respondents, and the performance rate of traditional Korean postpartum care was also high. Conclusions: Based on a realistic patient-centered basis, it is a study that can lay the foundation for standardizing Korean medicine treatment and strengthening coverage in the future.