• 대한한의학원전학회지
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• 제29권1호
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• pp.125-137
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• 2016

Objectives : Introduction to Medicine(醫學入門, Yixuerumen) is one of the basic clinical texts in Korean medical history. This study is designed to prove clinical value of Introduction to Medicine for practitioners in their early stage of clinical practice. Methods : Introduction to Medicine is closely reviewed in various aspects in order to examine broad outlines of specificity as well as its distinctive constructional feature. Results : Since Introduction to Medicine showed peculiar intention of developing practitioner's clinical ability, it has been a preferential choice for Korean medicine practitioners to enhance their qualification at the early stage of one's career in Korean history. It is still valid for modern practitioners because composite medical texts are needed in order to systematize one's fragmental knowledge acquired from institutional education. Conclusions : Introduction to Medicine shows a large potential as a clinical textbook in the course of maximizing one's clinical ability with its aid. Through understanding multilateral aspects of clinical guidelines and directions engraved in Introduction to Medicine, learners will be able to derive full capacity from the text.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3287-3292
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• 2012

Purpose: To study the overall treatment time (OTT) and acute toxicity of intensity-modulated radiotherapy (IMRT) treatment for nasopharyngeal carcinoma (NPC). Methods: This retrospective study covered all NPC patients who underwent radical IMRT treatment at the Penang General Hospital from June 2011 to February 2012. Patients of any age and stage of disease with histologically proven diagnosis were included. Information was collected on patient demographics, clinical stage, treatment received, including any neoadjuvant and/or concurrent chemotherapy, acute toxity and completion of IMRT within the OTT. Results: A total of 26 NPC patients were treated with IMRT during the study period; 88.5% had stage III/IV disease. 45.2% received neo-adjuvant chemotherapy while 50.0% were given concurrent chemo-irradiation. All patients completed the treatment and 92.3% within the 7 weeks OTT. Xerostomia was present in all patients with 92.3% having grade 2. Severe grade III/IV acute toxicity occurred in 73.1% of patients, the commonest of which was oral mucositis (57.6%). This was followed by dysphagia which occurred in 53.8%, skin reactions in 42.3% and weight loss in 19.2%. However, haematological toxicity was mild with only one patient having leucopaenia. Conclusion: IMRT treatment for NPC is feasible in our center. More importantly, it can be delivered within the 7 weeks OTT in the majority of patients. Severe grade 3/4 toxicity is very common (73.1%) and thus maximal nutritional and analgesic support is required throughout the treatment.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5729-5732
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• 2014

Background: Cervical cancer is the third most common gynecological cancer and a widespread malignancy in women, accounting for a large proportion of the cancer burden in developing countries. We compared accuracy of MRI staging with clinical staging and also concordance between the two methods for newly diagnosed patients with cervical cancer, using clinical staging as the reference. Materials and Methods: This prospective study was conducted on 27 newly diagnosed patients with cervical cancer from Imam Khomeini hospital from June 2012 to Feb 2014. New cases of cervical cancer with positive PAP test were staged separately with a clinical exam based on the FIGO system by a gynecologist, oncologist and also with MRI by an expert radiologist. Then we compared the predicted stage for each patient with the two methods. Results: Based on clinical staging 9 patients (33%) were observed at stage 1. MRI staging was in coordination with clinical staging in eight of them and for one patient MRI accorded stage 2B (88% concordance). Conclusions: MRI is a reliable noninvasive method with high accuracy for cervical cancer staging. Also presently it is easily obtainable, so we recommend using this technique along with clinical examination for staging cervical cancer patients. We also recommend to radiologists and residents of radiology to get experience with this method of staging.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권5호
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• pp.401-407
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• 2009

Purpose : This study was designed to evaluate the clinical aspect of cysts which arised in the oral and maxillofacial region. Patients and Methods : We reviewed clinical record, radiograph, histopathologic and operative report of 155 patients who had been diagnosed as cysts and treated at the department of oral and maxillofacial surgery in Chonnam National University Hospital from January 2003 to December 2008. Gender, age, classifiaction, anatomic distribution, clinical sign and symptoms, treatment, complications and recurrence rate were studied. Results : 1. Among 155 patients, the male patients(64.5%) were more than the female(35.5%). 2. The average age ofthe patients was 37.2 years(ranging from 5 to 79 years). 3. In pathologic classification, radicular cyst and dentigerous cyst were most common cysts, irrespective of 73 cases(48.3%) and 35 cases(23.2%). 4. The frequently involved cystic regions were followed as mandibular molars(38.1%), and maxillary incisors(30.2%). 5. The frequent sequence of clinical symptoms was edema(29.9%), no symptom(18.9%), tenderness(13.9%), pain(11.5%) and abscess(9.4%). 6. The most prevalent treatment was the combination operation, such as cyst enucleation with extraction or endodontic treatment of the causative tooth(76.8%) 7. Among 155 cases, 2 cases that were treated using enucleation method were recurred(1.3%).

• 대한중풍순환신경학회지
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• 제23권1호
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• pp.25-40
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• 2022

■Objectives This study aimed to collect and analyze clinical studies on the significance of acupuncture in the treatment of hypertension among Korean patients. ■Methods Among Korean patients with a blood pressure (BP) of 120 mmHg or higher and a diastolic BP of 80 mmHg or higher, those, treated with acupuncture only, were included. A literature search was conducted through 'Embase', 'Medline', 'Science and Technology Information Integration Service (NDSL)', 'Traditional Korean Knowledge Portal (OASIS)', 'PubMed', and 'Scopus'. The search keywords were (hypertension OR 'blood pressure') AND acupuncture. The papers, published before the day of the search (02. January 2022), were included in this study. ■Results Among the 12 selected papers, seven involved randomized controlled trial (RCT), four before-and-after studies, and one case series. The number of RCTs has increased yearly. The treatment methods used in the studies included needle acupuncture in eight studies, auricular acupuncture in two, pharmacopuncture in one, and si-acupuncture in one. The average numbers of patients enrolled in RCTs, before-and-after studies, and case series were 21.1, 30, and 23 respectively. Six studies were conducted on prehypertensive patients, two on stage 1 hypertension patients, and four on stage 2 hypertension patients. The involved acupoints have been reported to be ST36 in eight papers, LI11 in four papers, and PC6 in three papers. The treatment period lasted for < 1 week in eight studies and 8 weeks in four studies. Acupuncture successfully lowered blood pressure in nine out of 12 studies ■Conclusions Acupuncture is a viable alternative treatment option for prehypertensive patients, who are not taking medications. Additionally, it is also useful in further lowering the BP of patients with stage 1 and stage 2 hypertension in the short term. Large-scale and long-term studies on acupuncture for hypertension should be conducted.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3159-3163
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• 2012

Background: For cervical cancer the epidemiological profile is poorly known in Morocco and no data is available concerning the direct medical costs. The purpose of this work is to estimate the direct cost of medical management of invasive cervical cancer during the first year after diagnosis in Morocco. Methods: The estimation of direct costs of medical management of invasive cervical cancer during the first year after diagnosis in Morocco is based on the estimation of individual cost in each stage which covers diagnosis, treatment and follow-up during first year. The cost was estimated per patient and whole cycle-set using the costs for each drug and procedure as indicated by the Moroccan National Agency for Health Insurance. Extrapolation of the results to the whole country was used to calculate the total annual cost of cervical cancer treatments in Morocco. Results: Overall approximately 1,978 new cases of cervical cancer occur each year in Morocco. The majority (82.96%) of these cases were diagnosed at a late stage (stageII or more). The cost of one case of cervical cancer depends on stage of diagnosis, the lowest cost is $382 for stageCis followed by the cost of stageIA1 for young women (< 40 years) which is $2,952. The highest cost is for stageIV, which is $7,827. The total cost of cervical cancer care for one year after diagnosis is estimated at $13,589,360. The share allocated to treatment is the most important part of the global care budget with an annual sum of $13,027,609 whereas other cost components are represented as follows: $435,694 for annual follow-up activity and $126,057 for diagnosis and preclinical staging. Conclusion: This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of health facilities in Morocco.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5301-5310
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• 2013

The biological mechanisms of cancer and associations with behavior of tumours need to be studied to understand progression and determine appropriate treatments. Here we investigated expression of VEGF, MMP-9 and E-cadherin in laryngeal SCCs and their relations with clinical behavior. This prospective study was based on 38 surgical specimens from patients with primary laryngeal SCC and data recorded in their cards. Expression of the three factors in tumor tissue was examined using immunohistochemistry and correlations with clinical parameters of primary tumors, regional lymph node metastases, stage of disease, histopathologic differentiation, and vascular/cartilage invasion were investigated. Regarding the cases with positive MMP-9 expression, the difference between well and moderately/poorly differentiated tumors was statistically significant. However, differences between early stage (stage I and II) and late-stage (stage III and IV) tumours, and between positive and negative for pLN metastasis were not. No significant relationship between positive VEGF and tumor differentiation or stage was apparent, but E-cadherin levels significantly differed between well and moderately/poorly differentiated tumours and with the presence of pLN metastasis. E-cadherin staining did not vary between MMP-9 positive and negative cases. In conclusion, MMP-9 may be a negative predictor of differentiation in laryngeal SCC, while E-cadherin is a predictor of differentiation and nodal metastases. Even if the difference between VEGF expression and tumor stage was not statistically significant, it seems that there exists some relationship, which might be clarified with a greater number of cases.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4661-4666
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• 2013

Background: The wide spectrum of clinical features in advanced stages of non-small cell lung cancer (NSCLC) probably contributes to disparities in outcomes because of different prognostic variables significant for stage IIIB/IV patients. Hence the aim of this study was to check for favorable response of patients to various chemotherapeutic combinations with respect to patient survival in stage IIIB and stage IV NSCLC disease. We selected those patients for our study who were receiving treatment with paclitaxel, gemcitabine or etoposide in combination with platinum based drugs. Materials and Methods: Seventy-two patients who visited the hospital from June 2009 to November 2012 with confirmed diagnosis of lung cancer were included, and data were collected for follow up and classified according to treatment received with respect to patients' regimen and response, and overall survival. This study analyzed tumor variables that were associated with clinical outcome in advanced NSCLC patients who were undergoing first-line chemotherapy for stage IIIB/IV NSCLC. Results: Comparative data on various parameters like age, gender, stage, histology, site of disease, metastatic site and chemo-regimens was analyzed; these parameters predicted variable significant improvement for overall survival ($p{\geq}0.05$). One and two year survival rates were 20.8% and 15.3%. Conclusions: In this study we found slight improvement in survival rates in NSCLC and clinical outcomes with one combination (carboplatin+paclitaxel). Overall there were only marginal differences in survival rates for other chemo-regimens evaluated in this study.

• 한국한의학연구원논문집
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• 제8권2호통권9호
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• pp.37-46
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• 2002

Clinical trials are experimental studies with human subjects in which various limitations and variables exist by their nature. As a preparatory stage for designing clinical trials in Oriental medicine, this study considers a virtual protocol to show guideline regarding tasks necessary when writing a trials protocol. Clinical trials have many difficulties in planning, procedure, and interpretation of results, and these may be influenced by various biases that are difficult to predict and eliminate. To deal with these issues, clinical trials need a collaboration between medical experts and biostatisticians from the beginning, through the entire trial, until the final analysis. Therefore, the first stage of clinical trials is to write out a trial plan among the experts in each field to derive the best design for the trial.

• 대한족부족관절학회지
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• 제10권1호
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• pp.18-23
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• 2006

Purpose: We reviewed the clinical finding of malignant melanoma of the foot in korean because it's advanced stage and extended lesion at diagnosis. Materials and Methods: Retrospective study was enforced about the 11 cases who has diagnosed to malignant melanoma of the foot from February 1995 to March 2004. The mean follow up period was 61 months. In this study we used age, sex, site, depth, histology, clinical stage, precursor lesion, misdiagnosis, interval to diagnosis, survival time, survival. Results: Average age was 58 years and number of female was six. Common site of involvement were heel of plantar surface (6 cases) and subungual area (2 cases). Depths of involvement were 0.3 to 10 mm, most common histological type was acral lentiginous melanoma (7 cases), stage 5 according to classification of Clark were 5 cases and stage 2 or more according to clinical staging were 8 cases. precursor lesion were benign melanocytic nevi (2 cases) and ill defined (9 cases). Chief complaint were increasing of size, color change, pain and ulceration. Conclusion: Malignant melanoma of the foot usually arise at nonvisible area and is easy to be misdiagnosed or delayed treatment. So it is hard to early diagnosis and have poor prognosis. So we need education and effort to early detection and diagnosis.