• Tuberculosis and Respiratory Diseases
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• v.49 no.3
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• pp.323-331
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• 2000

Purpose: Brain metastases are present in approximately 10-16% of small cell lung cancer patients at diagnosis. Brain metastasis is an important clinical problem associated with increasing the survival rate, with a cumulative incidence of up to 80% in patients surviving 2 years. Prophylactic cranial irradiation(PCI) reduces the incidence of brain matastasis and may prolong survival in patients with limited small-cell lung cancer who achieved complete remission. This study was performed to analyze the incidence of brain metastasis, survival and clinical aspects after PCI in patients with limited small-cell lung cancer who achieved complete remission. Methods : Between 1989 and 1999, forty-two patients with limited small-cell lung cancer who achived achieved complete remission after therapy were enrolled into this study retrospectively. All patients received etoposide and cisplatin(VPP) alternating with cytoxan, adriamycin, and vincristine(CAV) every 3 weeks for at least 6 cycles initially. All patients received thoracic radiotherapy: concurrent(38.1%) and sequential(61.9%). All patients received late PCI. Results : Most patients(88.1%) were men, and the median age was 58 years. The median follow-up duration was 18.1 months. During the follow-up period, 57.1% of the patients developed relapse. The most frequent site of relapse was chest(35.7%), followed by brain(14.3%), liver(11.9%), adrenal gland(44%), and bone(2.2%). With the Kaplan-Meier method, the average disease-free interval was 1,090 days(median 305 days). The average time to development of brain relapse after PCI and other sites relapse(except brain) were 2,548 days and 1,395 days(median 460 days), respectively. The average overall survival was 1,233 days(median 634 days, 21.1 months), and 2-year survival rates was 41.7%. The average overall survival in the relapse group was 642 days(median 489 days) and in the no relapse group was 2,622 days(p<0.001). The average overall survival in the brain relapse group was 928 days(median 822 days) and in the no brain relapse group was 1,308 days(median 634 days)(p=0.772). In most patients(85.7%), relapse(except brain) or systemic disease was the usual cause of death. Brain matastasis was the cause of death in 14.3% of the cases. Conclusions : We may conclude that PCI reduces and delays brain metastasis in patients with limited small cell lung cancer who achieved complete remission. We found decreased survival in relapse group but, no significant survival difference was noted according to brain matastasis. And relapse(except brain) or systemic disease was the usual cause of death. In order to increase survival, new treatment strategies for control methods for relapse and systemic disease are required.

• Journal of Sasang Constitutional Medicine
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• v.10 no.2
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• pp.351-429
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• 1998

The Purpose of Study 1. Inspection of clinical application on TCD to CVA 2. Objective Comparement and analysis about treatment effect of Western-Medicine, Korean Medicine, Cooperative consultation of Korean and Western medicice for CVA The Subject of Study We intended for the eighty six patient of CVA who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center from 1997. 8. I to 1998. 7. 31 1. View of CT, MRI : the patient of Cb infarction 2. Attack Time : The patient who coming hospital falling ill within the early one week The method of study 1. Treat four group of Korean medicine, Constitution medicine, Western medicine, cooperative consultation of Korean medicine and Western medicine. 2. Application of TCD Check the result for three times, immediatly after the attack, two months later, four months later 3. Comparative analysis of each treatment effect by clinical symptoms and pathologic examination 4. The Judgement of the patient The Result From 8/1/1997 to 7/31/1998, We have the following result by clinical analysis intended for CVA 86 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center from 1997. 8. 1 to 1998. 7. 31 in 1. Analysis according to Age The first stage of thirties, forties, seventies is heavier than forties, fifties in improvement and Index of improvement of symptom 2. Analysis according to sex We have no special relation in an average of symptom and improvement, Index improvement 3. Analysis according to Family History We have the better result in first stage and improvement, index improvement when no family history. 4. Analysis according to Past History We have no special relation in past history like hypertension, DM, heart problem 5. Analysis devided two group, above group and under group on the basis of the average in first stage of all patient. We have the better result when the first stage is light, that the first score of barthel index and CNS is high. 6. Analysis of the effect of treatment about Korean medical treatment, Western medical treatment, cooperative treatment. In this study, the highest group of rate of treatment at four contrast groups (Korean medicine, Constitution medicine, Western medicine, cooperative treatment according to dyagnosis and range of treatment was the patient group of doing dyagnosis and method of treatment based on constitution medicine theory. This is that of doing demostation, A-Tx, po-herb-medication according to dyagnosis and treat method of constitution of Lee Je-ma In case of left, the case of dyagnosis any disease according to doctor view but, normal in TCDwas 22-beginning of attack, 20- two weeks later, 11 case-four weeks later in case of right, 15-beginning of attack, 12-two weeks later, 9 case four weeks later. So left vessel compares to right vessel is more interference, in fact more than a 1/2 of the patients of MCA disease can't do dyagnosis. In rate of imparement, the state of pacient improved but there isn't the improved case of result in TCD. 7. In TCD dyagnosis, between the case of inconsus the doctor view specially MCA in brain blood vessel is in large numbers and in total 86's patient, impossible case of dyagnosis according to interferiance of temporal is 21 case. 7. Result study about application of Kreaan medical treatment 1) The impossible patient of observation MCA blood vescular for interference temporal bone happened in large numbers. 2) There is the case having difference result to CT,MRI, MRA result. 3) Because individual difference is large, excluding to ananalogy of symptom. This is normal numerical value that has possibility of being checked as abnormal numerical value 4) there are a lot of cases that the speed of normal part is as similarly measured as that of abnormal part. It means that we cannot judge the disease by this measure 5) It is rare that this measure represent degree of improvement in patient's condition of disease. When we observe patient's condition become better, but we have no case that the result of TCD test better. 6) The result could be appear differently by the technique of the tester or by the experience of the tester 7) In the TCD test, abnormal symptoms is checked at 0 week, but at 2th week, normal symptoms is checked, again at 4th week abnormal is checked. According to the above result, CVA diagnosis is difficult only with TCD, as it appear in diagnosis error check which is suggested in the problem connected to project, for the aged persons who have the worst hardening of part of the cranium (1998. 5. 26 77 of 83 patients is 50s) there is a lot of cases that the measurement is impossible by TCD and the correction of measurement numerical value is decreased, as the age of cerebral infarction is high, TCD is inappropriate to diagnosis equipment through this study.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.46-50
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• 2018

Purpose Generally, a collimator that installed in front of detector set a direction of gamma ray and remove a scatter ray. By the way, a lateral or oblique scatter ray is detected into crystal through collimator. At this study, we will evaluate a mount of count and spectrums of lateral scatter ray. Materials and Methods We used the SKY LITE (philips, netherlands) as a gamma camera, and $^{99m}Tc$, 1.11 GBq point source as a phantom. we put this point source at backside 50 cm of detector. After acquiring this for 1 min, we turned a detector next 10 degrees. Likely this, we acquired images at every 10 degrees from $0^{\circ}$ to $360^{\circ}$, analyzed images and spectrums. In case of patient study, we choose a 3 phase bone scan patient who had a hand disease, because scatter rays from body would detect on crystal. After acquiring blood flow and blood pool images, we analyzed images and spectrums. Additional, we put a lead gown on patient's hand, body. And then we compared and evaluated 3 type blood pool images (non lead gown, lead gown on a hand and on body). Results In case of phantom study, scatter ray counts at backside ($270^{\circ}-90^{\circ}$) are same with a background count. By the way, counts of scatter ray of oblique side ($0^{\circ}-50^{\circ}$, $220^{\circ}-270^{\circ}$) are 100-600 cps, furthermore, counts at frontside are over 4 Mcps. In case of patient study, a counts of hand blood pool scan are 1510 cps. But counts of hand with lead gown on hands and on body are each 1554 cps, 1299 cps. Conclusion Therefore, even though there is a collimator in front of detector, lateral scatter rays detect on crystal and affect to images and spectrums. Especially, if there is a high activity source at outside of detector when we examine low activity organs like hands or foot, we have to shield and remove the source at outside for a good image.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.195-204
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• 2004

Purpose: Hypophosphatemic rickets is a hereditary disease, characterized by hypophosphatemia due to renal phosphate wasting, impaired renal production of 1,25-dihydroxyvitamin $D_3$, rachitic bone deformities and impaired growth. The purpose of this study is to provide clinical profiles of patients with hypophosphatemic rickets in our hospital. Methods: Between July 1983 and February 2004, 56 patients were diagnosed as having hypophosphatemic rickets. The medical records of these patients were reviewed retrospectively. Clinical manifestations, family histories, laboratory data, treatment outcomes were described. Results: Fifty six patients were enrolled in this study. The average age at symptom onset and diagnosis were 20 months and 5 years respectively. Fourteen patients had family histories. The main clinical manifestations were bow legs and short stature. There was a significant negative correlation between the ages and the height z-scores at the time of diagnosis(r=-0.47, P=0.005). Initial laboratory data showed normocalcemia, hypophosphatemia, elevated serum alkaline phosphatase, decreased tubular reabsorption of phosphate and a normal range of 1,25-dihydroxyvitamin $D_3$ Radiographic examinations of bone revealed fraying, widening and cupping of the metaphyseal ends. Treatment consisted of Joulie solution and vitamin D metabolites, and resulted in improved biochemical and radiographic findings. However, height z-scores remained essentially unchanged(P=0.224). Complications of treatment were frequently observed, including hyperparathyroidism, nephrocalcinosis, and hypercalciuria. Sixteen patients had corrective osteotomy and 4 of them underwent leg lengthening together. Conclusion: There was a gap of several years between the onset of symptoms and the diagnosis. Early treatment seems to be essential to growth. For the earlier treatment, the offsprings of affected parents should be followed up closely.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.149-156
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• 2005

Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.79-86
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• 2011

Purpose: Modular tumor prosthesis is the most popular recontructive modality after resection of malignat tumor in extremity. Complications and survival of tumor prosthesis reconstruction are well-known. however, reports on the long-term outcome of tumor prosthesis in osteosarcoma patientss are scarece. Materials and Methods: In 158 cases as diagnosed as osteosarcoma from feburary 1989 to December 2006 in a single cancer center. We retrospectively reviewd 48 osteosarcoma patients who under went tumor prosthetic reconstruction. Mean follow up preiod was 75.6 months (range; 60 to 179 months). There were 28 males, 20 females and mean age was 22.4 years (range; 11-71). Pathologic subtypes were conventional central osteosarcoma in 46 cases and periosteal in 2 cases. The location of the tumor was proximal tibia (26 cases), distal femor (20 cases), femor diaphysis (1 case), and tibia diaphysis (1 case). In 41 cases built-up-type tumor prosthesis have been used and 7 cases expansion-type tumor prosthesis have been used. We used Musculoskeletal tumor society (MSTS) grading system to asses post operation function, and we analyzed survival rate of patient and tumor prosthesis and complication. Results: The overall survival rate was 77.7% and disease free survival rate was 68.9%. The survival rate of tumor prosthesis was 73%, in last follow up tumor prosthesis has been removed in 12 cases. All of them, 17 complications occurred, which included infection in 16 cases, Periprosthetic Fracture and Loosening of tumor prosthesis in 4 cases, articular instability in 4 cases. MSTS functional score was 74.1% in post operation. Conclusion: In long term follow up result, Primary tumor prosthesis -a reconstruction method after a wide extensional resecion of a bone tumor- can be a effective treatment method in asepect of survival rate, functional assesment and complication.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.346-353
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• 2001

Background : Pulmonary Langerhans cell histiocytosis forms part of a spectrum of diseases that are characterized by a monoclonal proliferation and infiltration of organs by Langerhans cells. Several organ systems may be involved in Langerhans cell histiocytosis, including the lungs, bone, skin, pituitary gland, liver, lymph nodes and thyroid. Pulmonary histiocytosis X represents 2.8% of interstitial lung disease. Here we present the clinical, radiological, therapeutic aspects of pulmonary histiocytosis X. Method : Fourteen cases of biopsy-proven pulmonary histiocytosis X patients who were diagnosed in Seoul National University Hospital during the period from January 1990 to December 1998 were analyzed retrospectively. Result : There were 12 men and 2 women in this study. The initial presenting symptoms were dyspnea, cough, chest pain, which was associated with the pneumothorax, and chest radiography abnormalities. Only 8 patients (57%) were smokers. There were 5 patients with extra-pulmonary histiocytosis (pituitary, bone, skin). Eight patients had received the chemotherapy. There were no mortalities and only one patient experienced an aggravation of symptom during the follow-up period. Conclusion : In contrast to previous reports from other countries, the patients with pulmonary histiocytosis X in this study presented with several different clinical characteristics, such as a male predominance, relatively low smoker's rate, and a better prognosis.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.1
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• pp.1-7
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• 2010

Purpose: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. Materials and Methods: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. Results: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. Conclusion: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.208-218
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• 1999

Background: Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic disorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advanced stage with obvious bulky tumor and carry a poor prognosis. Materials and Methods: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level ${\geq}$ 10.5 mg/dL, and symptoms which could possibly be attributed to hypercalcemia. In this retrospective study, we evaluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics. Results: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance status, and bone metastasis, it was not significant statistically. Altered consciousness was significantly more frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. Conclusion: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of death and should be treated aggressively to prevent sudden deterioration or death.

• Molecules and Cells
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• v.42 no.12
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• pp.906-918
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• 2019

MicroRNA-223-3p (miR-223-3p) is one of the potential microRNAs that have been shown to alleviate inflammatory responses in pre-clinical investigations and is highly encased in exosomes derived from bone mesenchymal stem cells (MSC-exosomes). MSC-exosomes are able to function as carriers to deliver microRNAs into cells. Autoimmune hepatitis is one of the challenging liver diseases with no effective treatment other than steroid hormones. Here, we examined whether MSC-exosomes can transfer miR-223-3p to treat autoimmune hepatitis in an experimental model. We found that MSC-exosomes were successfully incorporated with miR-223-3p and delivered miR-223-3p into macrophages. Moreover, there was no toxic effect of exosomes on the macrophages. Furthermore, treatments of either exosomes or exosomes with miR-223-3p successfully attenuated inflammatory responses in the liver of autoimmune hepatitis and inflammatory cytokine release in both the liver and macrophages. The mechanism may be related to the regulation of miR-223-3p level and STAT3 expression in the liver and macrophages. These results suggest that MSC-exosomes can be used to deliver miR-223-3p for the treatment of autoimmune hepatitis.