• Childhood Kidney Diseases
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• v.1 no.1
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• pp.38-45
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• 1997

Purpose : Vesicoureteral reflux(VUR) in childhood may be the primary cause of recurrent urinary tract infection and renal scarring. Renal ultrasonography, DMSA, and voiding cystourethrogram are the standard clinical methods for detection of vesicoureteral reflux. But these methods have many disadvantages such as invasiveness and high cost. So, we studied to observe the significance of urine ${\beta}_2$-microglobulin in association with other non-radiologic methods for predictng vesicoureteral reflux. Methods : We evaluated 40 patients with urinary tract infection who were admitted to Korea university Hospital from July 1993 to June 1994. Among them, 24 patients revealed urinary tract infection and vesicoureteral reflux(group A), 16 patients revealed only urinary tract infection(group B). Both groups were compared by presence of fever, hematuria, and proteinuria, positivity of CRP, and level of BUN, Cr, GFR by 99mTc-DTPA, urine ${\beta}_2$-microglobulin, 24 hours urine albumin. Results : 1) Among 24 patients who had vesicoureteral reflux, 14 had unilateral VUR, 10 had bilateral VUR, three kidneys with grade I, nine with grade II, eleven with grade III, eleven with grade IV by classification of International Reflux Study Committee. Among them, 14 patients had renal scar, five with type A, five with type B, four with type C, none with type D by Smellie's classification. 2) The mean of GFR, BUN, Cr, 24hrs urine albumin and the presence of hematuria and proteinuria showed no significant difference between group A and group B. The mean of urine ${\beta}_2$ microglobulin in group A and group B were $283.6{\pm}195.8{\mu}g/l$ and $78.7{\pm}48.5{\mu}g/l$ respectively, showing that group A had a higher value than group B (p<0.01). In case of ${\beta}_2$ microglobulin > $120{\mu}g/l$ and CRP(+), the sensitivity was 93.3% and the specificity is 77.8% for detecting of VUR. In case of ${\beta}_2$-microglobulin>$120{\mu}g/l$ and fever(+), the sensitivity was 92.2%, and the specificity was 62.5% for detecting of VUR Conclusions : If the level of urinary ${\beta}_2$-microglobulin is more than 120ug/l in children with urinary tract infection in association with fever(+) or CRP(+), it can predict VUR. So we can use it for early detection of VUR.

• Journal of Korean Neurosurgical Society
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• v.40 no.5
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• pp.346-350
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• 2006

Objective : The ability to induce segmental lordosis has been reported to be marginal with transforaminal lumbar interbody fusion[TLIF]. Therefore, we analyzed the short-term radiological outcomes of TLIF using $8^{\circ}$ wedged cages for isthmic spondylolisthesis. Methods : Twenty-seven patients with isthmic spondylolisthesis who underwent single level TLIF with pedicle screw fixation[PSF] using $8^{\circ}$ wedged cages were retrospectively evaluated. Changes in disc height, degree of anterolisthesis, segmental lumbar lordosis, whole lumbar lordosis and L1 axis S1 distance were evaluated using standing lateral radiographs before surgery, at 6 weeks follow-up and at the final follow-up. Results : The mean age of the patients was 49.9 years [range, 38 to 64 years]. The affected levels were L4-5 in 17 cases and L5-S1 in 10. There were 18 cases of Grade I isthmic spondylolisthesis and 9 cases of Grade II. At a mean follow-up duration of 9.9 months [range, 6 to 18 months], the disc height [p< 0.001] was significantly increased, and the degree of anterolisthesis was significantly reduced [p< 0.001]. Regarding the sagittal balance, the segmental lumbar lordosis was significantly increased [p=0.01], but other parameters were not significantly changed after surgery. Conclusion : TLIF with PSF using $8^{\circ}$ wedged cages significantly increased the segmental lumbar lordosis.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.253-258
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• 1995

Purpose : To evaluate the effects of postoperative radiotherapy and chemotherapy on the pattern of failure and survival for locally advanced rectal carcinoma, we analyzed the two groups of patients who received curative resection only and who received postoperative radiochemotherapy retro-spectively. Materials and Methods : From June 1989 to December 1992, ninety nine patients with rectal cancer were treated by curative resection and staged as B2-3 or C. Group I(25) patients received curative resection only and group II(74) patients postoperative adjuvant therapy. Postoperative adiuvant group received radiation therapy (4500cGy/25fx to whole pelvis) with 5-FU (500mg/$m^2$, day 1-3 IV infusion) as radiosensitizer and maintenance chemotherapy with 5-FU(400mg/$m^2$ for 5 days) and leucovorin (20mg/m^2$ for 5 days) for 6 cycles. Results : The patients in group I and group II were comparable in terms of age sex, performance status, but in group II $74{\%}$ of patients showed stage C compared with $56{\%}$ of group I. All patients were followed from 6 to 60 months with a median follow up of 29 months. Three year overall survival rates and disease free survival rates were $68\%,\;64\%$ respectively in group I and $64\%,\;61\%$, respectively in group II. There was no statistical difference between the two treatment groups in overall survival rate and disease free survival rate. Local recurrences occurred in $28{\%}$ of group I, $21{\%}$ of group II (p>.05) and distant metastases occurred in $20{\%}$ of group I, $27{\%}$ of group II(p>.05). The prognostic value of several variables other than treatment modality was assessed. In multivariate analysis for prognostic factors stage and histologic grade showed statistically significant effect on local recurrences and lymphatic or vessel invasion on distant metastasis. Conclusion : This retrospective study showed no statistical difference between two groups on the pattern of failure and survival. But considering that group II had more advanced stage and poor prognostic factors than group I, postoperative adjuvant radiochemotherapy improves the results for locally advanced rectal carcinoma as compared with curative surgery alone.

• Journal of Acupuncture Research
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• v.17 no.4
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• pp.79-87
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• 2000

Objectives : To evaluate the findings useful for differential diagnosis and associated abnormaiities of isthmic spondylolisthesis and degenerative spondylolisthesis on CT. Materials and methods : We reviewed retrospectively the CT images of 65 patients who were diagnosed spondylolisthesis during 3 years period. Our technique was 5mm slices at 5mm intervals with gantry angle to parallel the interspaces. Also reformatted sagittal views were taken. 41 patients were isthmic spondylolisthesis and 24 patients were degenerative spondylolisthesis. Resuits : Isthmic spondylolisthesis. 1. Isthmic type was more common at L5-S1. 2. The degree of anterior displacement was grade I and II. 3. The plane of defect was more horizontal than the usual facet joint. 4. The defect had an irregular shape. 5. Medial aspect of bone just anterior to defect had a small round prominence. 6. Anteroposterior elongation of the spinal canal was common. 7. Pseudobulging disk was common. 8. The most common associated abnormality was a HNP at the upper level of the defect. Degenerative spondylolisthesis. 1. Degenerative type was more common at L4-5. 2. The degree of anterior disptacement was grade I and II. 3. The Plane of facet joint was oriented obliquely instead of horizontally. 4. The posterior facet(inferior facet of superior vertebra) was anteriorly displaced. 5. Bony spur of the posterior portion of anterior facet was seen. 6. The facet joints often contain gas(vaccum phenomenum). 7. The most common associated abnormality was a HNP at the level of the displacement. Conclusions : CT is a highly accurate and most sensitive technique for recognition, differential diagnosis of isthmic and degenerative types and the detection of associated abnormalities.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.3
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• pp.120-127
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• 2018

Objectives: The aim of this study was to reveal how collagenases (matrix metalloproteinase [MMP]-1, 8, 13) and tissue inhibitor of metalloproteinase 1 (TIMP-1) are expressed in immunohistochemistry of retrodiscal tissue in temporomandibular joint disorder patients. Materials and Methods: This study was conducted on 39 patients who underwent discoplasty or discectomy. Immunohistochemical staining was undertaken and expression levels of MMP-1, 8, 13, and TIMP-1 were evaluated. The status of internal derangement of disc, osteoarthritis, and joint effusion were analyzed using magnetic resonance imaging (MRI). Disc status observed during operation was also categorized. Results: The more severe disc derangement was observed on MRI, the more increased expression of MMPs and TIMP-1 appeared. Regarding MMP-13 expression, 86.7% of late-stage disc displacement patients showed grade II or III. Expression level of MMPs or TIMP was not statistically significant associated with joint effusion level. In perforation and/or adhesion groups, all patients showed grade II or III expression of MMP-13. Once perforation occurred, MMP-13 showed increased expression with statistical significance. Conclusion: MMP-1 and MMP-13 expression seem to be related to progression of osteoarthritis whereas MMP-8 does not seem to have a specific role with regard to temporomandibular joint disorders. TIMP-1 is considered to be partly related to internal derangement rather than osteoarthritis, but it is not significant.

• Restorative Dentistry and Endodontics
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• v.42 no.1
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• pp.48-53
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• 2017

Objectives: The aim of this study was to investigate the ability of the fluorescence-aided caries excavation (FACE) device to detect residual caries by comparing conventional methods in vivo. Materials and Methods: A total of 301 females and 202 males with carious teeth participated in this study. The cavity preparations were done by grade 4 (Group 1, 154 teeth), grade 5 (Group 2, 176 teeth), and postgraduate (Group 3, 173 teeth) students. After caries excavation using a handpiece and hand instruments, the presence of residual caries was evaluated by 2 investigators who were previously calibrated for visual-tactile assessment with and without magnifying glasses and trained in the use of a FACE device. The tooth number, cavity type, and presence or absence of residual caries were recorded. The data were analyzed using the Chi-square test, the Fisher's Exact test, or the McNemar test as appropriate. Kappa statistics was used for calibration. In all tests, the level of significance was set at p = 0.05. Results: Almost half of the cavities prepared were Class II (Class I, 20.9%; Class II, 48.9%; Class III, 20.1%; Class IV, 3.4%; Class V, 6.8%). Higher numbers of cavities left with caries were observed in Groups 1 and 2 than in Group 3 for all examination methods. Significant differences were found between visual inspection with or without magnifying glasses and inspection with a FACE device for all groups (p < 0.001). More residual caries were detected through inspection with a FACE device (46.5%) than through either visual inspection (31.8%) or inspection with a magnifying glass (37.6%). Conclusions: Within the limitations of this study, the FACE device may be an effective method for the detection of residual caries.

• Journal of Yeungnam Medical Science
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• v.39 no.4
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• pp.285-293
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• 2022

Background: This study was conducted to analyze the effects of low skeletal muscle mass index (SMI) and obesity on aging-related osteoarthritis (OA) in the Korean population. Methods: A total of 16,601 participants who underwent a dual-energy X-ray absorptiometry and 3,976 subjects with knee X-rays according to the modified Kellgren-Lawrence (KL) system were enrolled. Knees of ≥KL grade 2 were classified as radiologic OA. The severity of joint space narrowing (JSN) was classified by X-rays as normal, mild-to-moderate, and severe JSN in radiologic OA. The subjects were grouped as normal SMI (SMI of ≥-1 standard deviation [SD] of the mean), low SMI class I (SMI of ≥-2 SDs and <-1 SD), and low SMI class II (SMI of <-2 SDs). Obesity was defined as a body mass index (BMI) of ≥27.5 kg/m². Results: The modified KL grade and JSN severity were negatively correlated with the SMI and positively correlated with BMI and age. The SMI was negatively correlated with age. JSN severity was significantly associated with a low SMI class compared to a normal SMI, which was more prominent in low SMI class II than class I. Obesity was significantly associated with more severe JSN, only for obesity with a low SMI class. Furthermore, patients with a low SMI class, regardless of obesity, were prone to having more severe JSN. Conclusion: This study suggested that a low SMI class was associated with aging and that an age-related low SMI was more critically related to the severity of JSN in OA.

• Journal of Acupuncture Research
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• v.28 no.5
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• pp.77-86
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• 2011

Objective : This study was designed to evaluate the effect of bee venom pharmacopuncture therapy in patients with FBSS(failed back surgery syndrome). Methods : We investigated 30 cases of patients with FBSS, who had been treated from October 2010 to July 2011. We divided patients into two groups : group I was treated by acupuncture therapy only, and group II was treated by bee venom pharmacopuncture therapy and general acupuncture. We measured the efficacy of treatments using the numerical rating scale(NRS) and grade and straight leg raising(SLR) test. Results : 1. The treatment method for group II was more effective than that of group I in reducing the NRS score on the fifteenth day after admission but there was no statistically significant difference between the results of two groups on the fifth day after admission and the tenth day after admission. 2. The treatment method for group II was more effective than that of group I in NRS improvement rate from its admission day to the fifth day after admission and from the tenth day after admission to the fifteenth day after admission but there was no statistically significant difference between the performance of two groups from the fifth day after admission to the tenth day after admission. 3. Group II had a higher grade improvement rate from the seventh day after admission to the fifteenth day after admission than group I but no statistically significant difference was observed between the results of two groups from its admission day to the seventh day after admission. 4. In SLR test improvement rate the treatments applied to group II was more effective than those applied to group I. Conclusion : The results of this study suggest that bee venom pharmacopuncture therapy is effective in reducing pain for patients with FBSS. Further clinical research is needed to verify these results and findings.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4297-4302
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• 2015

Background: To evaluate HPV testing by Hybrid Capture II (HCII) in conjunction with cytology in detecting the residual/recurrence disease after treatment of high-grade cervical intraepithelial neoplasia (CIN II-III) with loop electrosurgical excision procedure (LEEP). Materials and Methods: A retrospective review of 158 patients with histologically confirmed CIN II-III who underwent LEEP between January 2011 and October 2012 was conducted. Post-treatment control was scheduled at the 3rd, 6th, 12th and 18th month. All patients were followed up by Pap smear and HR-HPV genotype and viral load testing. Results: Pre-treatment, HR-HPV DNA, was detected in all specimens of the patients. At follow-up, 25 patients were diagnosed as the residual/recurrent disease during the FU visit, among whom, 16 patients with positive margin: 13 patients (52%) with HR-HPV DNA+/cytology+, 2 patients (8%) with HR-HPV DNA+/cytology-, 1 patient (4%) with cytology+/HR-HPV DNA-; 9 patients with clean margin - 5 patients (55.6%) with HR-HPV DNA+/cytology+; 2 patients (22.2%) with HRHPV DNA+/cytology-, 2 patients (22.2%) with cytology+/HR-HPV DNA-. None of them persisting HR-HPV DNA-/cytology-with positive or negative margin was identified as the residual/recurrent disease. The majority of residual/recurrent disease was detected at the 12th and 18th month FU, and there was almost no difference in the sensitivity and negative predictive value (NPV) between at the 3rd month and the 6th month FU visits. 14 residual/recurrence disease (14/46:30.4%) had pre-treatment high viral load (>5 000 RUL/PC) and 11 (11/112, 9.8%) with pre-treatment low viral load, P<0.05. Conclusions: (1) The persistence HR-HPV DNA is the root cause of the residual/recurrent disease for the women treated for high-grade CIN; the pre-treatment viral load and margin can be seen as the predictor. (2) The FU visit beginning at the 6th month post-treatment and lasting at least 24 months with the combination of cytology and HPV testing. (3) Patients with high pre-treatment HPV load, which is considered as one risk of developing the residual/recurrent disease, should be paid more attention (especially above 500RUL/PC) to by clinicians.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.46-52
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• 1997

Urinary tract infection (UTI) in children has been known to be a cause of renal damage, leading to scar formation, hypertension and renal failure. And vesico-ureteral reflex (VUR), frequently accompanying UTI in young children, has been incriminated as the main factor causing scar formation. This retrospective study has been undertaken to see the relationship among UTI, VUR and renal scar formation. Study population consisted of 291 children (boy 134, girl 42) with UTI, who have been admitted to the Pediatric Department of Kyungpook University Hospital during 6 1/2 year period from January 1990 to June 1996. VUR was diagnosed by VCUG and renal scar by ultrasonogram, DMSA scan (or DMSA SPECT) and IVP. The following result were obtained. Sexual difference showed male predominance (male to female, 134:42) below 1 year of age, and female predominance (male to female, 11:35) over 5 years of age were rioted. VUR has been found in 64 children (22%) and the degree of reflux, classfied by the method proposed by 'International Reflux Study in Children', were as follows ; Grade I : 4.0%, Grade II : 3.0%, Grade III : 2.7%, Grade IV : 5.8% and Grade V : 6.2%. There was no sexual difference E.coli was the most predominant infecting agent occurring in 167 children (57%), and end-stage renal failure was diagnosed at the time of first admission in 5 children with Grade V VUR. Renal scar has been noted in 49 out of 582 kidneys (8.4%), and the incidence of scar foramation according to the degree of VUR were as follow ; Grade 0 (No reflux) : 1.2%, Grade I : 6.7%, Grade II 27.3%, Grade III 29.4%, Grade IV : 57.1%, and Grade V : 100%. In summary, present study shows that renal scar formation in UTI has close correlation with the severity of VUR occurring more frequently in severe reflux, so that early diagnosis and proper treatment of UTI and VUR is of paramount importance in preventing renal damage in children with UTI.