• Radiation Oncology Journal
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• v.20 no.2
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• pp.93-99
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• 2002

Purpose : We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. Materials and Methods : Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. Results : The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia In 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. Conclusion : A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.2
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• pp.128-134
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• 2010

Purpose: The aim of this study was to evaluate the changes in bone density and reduction of time consumed for osteogenesis by $PostPlant^{TM}$ Calcium and to find out efficacy of $PostPlant^{TM}$ Calcium by comparing the group prescribed with $PostPlant^{TM}$ Calcium with the group without $PostPlant^{TM}$ Calcium prescription. Material and methods: The experimental group of 18 patients with 25 dental implant placement and the control group of 7 patients with 9 dental implant placement were randomly selected from the patients who visited prosthetic department of Dankook University Dental Hospital since July, 2006 (IRB Number ; 20060710). The experimental group was instructed to take $PostPlant^{TM}$ Calcium for 6 months after the implant surgery while the control group was instructed not to. Both experimental and control group were assigned for measurement using $Osstell^{TM}$ Mentor and $Periotest^{(R)}$ and radiographic examination was performed using specifically manufactured Aluminum Step Wedge. The results were compared and analyzed. Results: 1. According to the $Osstell^{TM}$ Mentor measurement, both the experimental and control group showed increase in values as time elapses and the experimental group showed significantly higher rate of increase (P < .05). 2. According to the $Periotest^{(R)}$ measurement, both the experimental and control group showed decrease in values as time elapses. In addition, greater decrease can be seen in the experimental group but no statistical significance was found. 3. By examining the radiographic images, both the experimental and control group showed tendency of increase in bone density. In addition, greater increase can be seen in the experimental group but no statistical significance was found. Conclusion: Clinically, taking $PostPlant^{TM}$ Calcium medicine for a long period of time after implant placement is expected for a better prognosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.2
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• pp.272-285
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• 2003

This study was conducted to observe the microscopic structures of cavities formed after ablation of primary teeth, permanent teeth, enamel and dentin in using a bur and cavities formed after ablation using laser and the following results were obtained after comparing the effects of ablation. Using a #330 bur and Er:YAG laser irradiated at 150 mJ, 200 mJ, 250 mJ and 300 mJ all at the frequency of 5 Hz, 1 mm enamel and dentin samples were ablated and the ablation time was measured. In order to measure the surfaces ablated, 5 each of primary teeth and permanent teeth were ablated using a #330 bur and Er:YAG laser at 150 mJ, 200 mJ, 250 mJ and 300 mJ for 1 sec and the cross section and vertical section were observed. The following results were obtained : 1. Cutting time of Er:YAG laser was longer than that of conventinal high-speed bur regardless of teeth type. 2. Cutting on enamel, Cutting time of conventional high-speed bur in deciduous teeth was longer than in permanent teeth(P<0.05). But Er:YAG laser was not showed any difference between the deciduous and permanent teeth(P>0.05). 3. Cutting on dentin, Cutting time of conventional high-speed bur in permanent teeth was longer than deciduous teeth. Er:YAG laser of 150 mJ, 5 Hz in permanent teeth was longer than in deciduous teeth(p<0.05). But laser of other power did not showed mean difference. 4. The cavity surface treated with the convetional high-speed bur revealed a relatively flat appearance, almost covered with a debris-like smear layer. Cavity wall showed striped appearance because of blade of bur. 5. The cavity surface treated by the Er:YAG laser system was irregular or rough surface with the absence charring, carbonization, or cracking of the dentin. In addition, there was an absence of a smear layer. Cavity floor was round and relatively smooth. According to these results, cutting time of Er:YAG laser was almostly same in permanent and deciduous teeth, but more effective in dentin than enamel. Cutting the sample, Er:YAG laser was needed more time than conventional bur. But SEM findings suggested that laser device produced favorable surface characteristic(i.e, no smear layer, irregular surface, cracking).

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.726-731
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• 2006

Purpose : We reported previously that intramuscular ketamine with adjunctive midazolam is more effective than ketamine alone in pediatric procedural sedation, but with limited satisfactory sedation by suboptimal ketamine dose. The optimal dose of intramuscular ketamine in children has never been studied in Korea. In this study, we investigated the effectiveness and adverse events of ketamine 4mg/kg with adjunctive midazolam in pediatric laceration repair. Methods : From Jan. 2005 to July 2005, we enrolled 60 children, aged 3 months-7 years, who needed laceration repair under sedation. After verbal consent from parents, patients were randomly assigned to KMA group(IM ketamine 4 mg/kg＋atropine 0.01 mg/kg＋intramuscular midazolam 0.05 mg/kg) or KA group(without midazolam). We compared both groups with the induction time, recovery time, total sedation time, efficacy of sedation, adverse effects, and the satisfaction score of treating physicians. Results : Potentially confounding variables, age, weight, injury site and anxiety score, were similar between groups. The induction time, recovery time and total sedation time were not different statistically. In KMA group, 90.9 percent of patients showed satisfactory sedation compared to 66.7 percent of KA group(P=0.02) and the occurrence rate of significant adverse effect was 0.0 percent and 37.0 percent respectively. Conclusion : We found adjunctive midazolam with ketamine doses of 4 mg/kg IM produced more effective, satisfactory sedation and less adverse effect than without midazolam in pediatric laceration repair. The emergence phenomenon(agitation during recovery) only occurred in 9 KA group patients. In spite of adverse effect, all patients recovered, were discharged and there were no reported delayed events.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.868-873
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• 2008

Purpose : Immunotherapy is accepted as the only treatment of allergic disease that can modify the natural course of the disease and ameliorate symptoms. This study aimed to evaluate the safety and efficacy of ultra-rush therapy using Dermatophagoides extracts in children. Methods : Of children older than four years who had visited Bundang CHA Pediatric Allergy Clinic, those showing positive reactions only to Dermatophagoides in the skin prick test and to the nasal provocation test were included. In all, 11 and 12 patients respectively preferred conventional and ultra-rush immunotherapy. We elevated allergen concentrations diluted to 1,000:1 of the end strength by 2-3 times with 30-minute intervals and checked oxygen saturation, pulse rate, blood pressure, and systemic reactions every 15 minutes. Immunotherapy effectiveness was valued by changes in nasal provocation test scores before and after immunotherapy. Results : The average ages of patients in the conventional and ultra-rush immunotherapy groups were $8.3{\pm}2.3$ and $9.2{\pm}2.8years$, respectively. Systemic reactions were observed in six in the ultra-rush group (50%) without anaphylaxis and one (9%) in the conventional group. The average scores in the nasal provocation test before and after treatment in the conventional group were $8.2{\pm}1.5$ and $4.6{\pm}2.1$, respectively (P=0.043). In the ultra-rush immunotherapy group, the scores changed from $6.2{\pm}2.2$ to $3.7{\pm}2.5$ (P=0.017). Conclusion : Ultra-rush immunotherapy using Dermatophagoides in children is effective for treating allergic disease but can induce systemic effects rather than conventional immunotherapy.

• Journal of Yeungnam Medical Science
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• v.25 no.1
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• pp.1-18
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• 2008

Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of $10^4$ copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the $21^{st}$ century.

• Pediatric Infection and Vaccine
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• v.12 no.1
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• pp.75-85
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• 2005

Purpose : Fungal infection is one of the important causes of morbidity and mortality in patients with hematologic malignancies. Amphotericin B(ABV) and itraconazole(ITZA) have been used as the standard empirical antifungal therapy in neutropenic patients with acute leukemia who have persistent fever that does not respond to antibiotic therapy. ABV is an antifungal drug associated with side effects such as fever and chills, symptoms which may be mediated by pro-inflammatory cytokines such as interleukin-$1{\beta}$(IL-$1{\beta}$) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$). We assessed modulation of these pro-inflammatory cytokines as well as the anti-inflammatory cytokines(IL-4, IL-1Ra) by ABV and ITZA. Methods : From March 2004 to February 2005, a total of 30 episodes from acute leukemia patients with febrile neutropenia were analyzed for this study. They were randomly allocated to receive intravenous ABV or ITZA for 14 days. Clinical responses were evaluated at the completion of therapy, and cytokine IL-$1{\beta}$, TNF-${\alpha}$, IL-4, and IL-1Ra were measured for determination to know the correlation between two antifungal agents and inflammatory cytokines. Results : Empirical antifungal agents were given to 37 patients(ABV 20, ITZA 17), and 30 patients(ABV 15, ITZA 15) were evaluable for efficacy. White blood cell and absolute neutrophil count in the group treated with ITZA increased early days of treatment, so the duration of neutropenia in ITZA group is shorter. Serum creatinine level is lower in ITZA group than in ABV group but this is not statistically significant. There was no significant difference in response rate between two groups. The IL-$1{\beta}$ was increased in ABV treatment group and the ratio of IL-1Ra/IL-$1{\beta}$ is markedly decreased in ABV treatment group while increased in ITZA group. Conclusion : ITZA and ABV have at least equivalent efficacy as empirical antifungal therapy in neutropenic children with acute leukemia. However ITZA is associated with significantly less toxicity in clinical and molecular aspects.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.210-217
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• 2006

Purpose: Crohn disease (CD) in children is frequently complicated by malnutrition and growth retardation. Conventional treatment with corticosteroid may also affect the growth of children, which may be alleviated by nutritional therapy. Therefore, we performed this study to evaluate the role of nutritional therapy in the treatment of CD in children. Methods: The study cohort consisted of thirty children under the age of 17 years, admitted to the Asan Medical Center from 2001 to 2005. While 11 children received nutritional therapy (NT) with an elemental diet, 19 received conventional corticosteroid therapy (ST). Comparative analysis was performed for the rate of the induction of remission, recurrence, disease activity index of pre and post-treatment, and changes of the growth using mean standard deviation score for weight (zW) and height (zH). Results: Ten of 11 children with NT and 18 of 19 children with ST completed the therapy. Two of them were lost to follow-up during the treatment. All 10 children with NT and 15 of 18 children with ST achieved remission. While there was no recurrence in children with NT, 7 with ST showed recurrence within 1 year. Pre- and post treatment Pediatric Crohn disease Activity Index (PCDAI) did not show a difference between the two groups. There were no differences in zW and zH between the two groups after 1 year of follow-up. Conclusion: This study showed that nutritional therapy could be considered instead of steroid therapy for treatment of children with CD. However, a long-term study will be needed to determine the long-term efficacy.

• Journal of Radiation Protection and Research
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• v.38 no.4
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• pp.214-227
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• 2013

Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

• Korean Journal of Weed Science
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• v.7 no.2
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• pp.208-219
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• 1987

Newly developed several herbicides were evaluated as paddy rice herbicide at the Yeongnam Crop Experiment in 1986. And also, the general situation of rice cultivation between Korea and Japan was compared. Twenty-nine herbicides of the total 59 herbicides were used as paddy rice field in Korea while these were 100 and 187, respectively, in Japan. Among paddy rice herbicides, butachlor was the most important herbicide in both countries. However, the degree of concentration to a particular herbicide was greater in Korea compared to Japan; consumption rate of single butachlor to the total herbicide were 66.5% for Korea and 11.9%r for Japan, respectively. Pyrazolate, pyrazoxyfen and quinclorac were the most promising hebicides in pressed-type rice nurserybed in terms of herbicidal efficacy and phytotoxic effect. For transplanted paddy rice field, single application of NC-311 or combining applications of NC-311 with butachlor or quinclorac gave excellent results at the weed community that was dominated by Echinochloa crus-galli, Aneilema japonica, Ludwigia prostrata, Scirpus hotarui, Cyperus serotinus, Potamogeton distinctus and Eleocharis kuroguwai. Particularly the above combining applications maintained their excellent herbicidal effect up to 3 leaf stage of E. crus-galli without arising herbicidal phytotoxicity. Pyrazolate and three sulfonyl urea herbicides (DPX-5384, NC-311 and CGA 142464) exhibited very high safety against rice. However, Japonica type rice cultivar was a little bit more sensitive than Indica/Japonica type rice cultivar. On the other hand, the effect of these herbicides against E. crus-galli was very strong. Herbicidal effect against E. crus-galli was enhanced through shoot absorption for sulfonyl urea herbicides and root abosorption for pyrazolate and quinclorac, respectively.