• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.156-163
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• 1998

Background & Objectives: Frameless fractionated stereotactic radiotherapy(FFSRT) is a modification of stereotactic radiosurgery(SRS) with radiobiologic advantage of fractionation without losing mechanical accuracy of SRS. Local recurrence of head and neck cancer at or near skull base benefit from reirradiation. Main barrier to successful palliation is dose limitation secondary to normal tissue tolerance. We try to evaluate the efficacy and safety of FFSRT as a new modality of reirradaton in these challenging patients. Materials & Methods: Seven patients with recurrent head & neck cancer involving at or near skull base received FFSRT from September 1995 to November 1997. Six patients with nasopharyngeal cancer had received induction chemotherapy and curative radiation therapy. One patient with maxillary sinus cancer had received total maxillectomy and postoperative radiation therapy as a initial treatment. Follow-up ranged from 11 to 32 months with median of 24 months. Three of 7 patients received hyperfractionated radiation therapy(1.1-1.2Gy/fraction, bid, total 19.8-24Gy) just before FFSRT. All patients received FFSRT(3-5Gy/fraction, total 15-30Gy/5-10fractions). Chemotherapy(cis-platin $100mg/m^2$) were given concurrently with FFSRT in four patients. Second course of FFSRT were given in 4 patients with progression or recurrence after initial FFSRT. Because IF(irregularity factor; ratio of surface area of target to the surface area of sphere with same volume as a target) is too big to use conventional stereotactic RT using multiple arc method for protection of radiation damage to critical normal tissue, all patients received FFSRT with conformal method using irregular static ports. Results: Five of 7 patients showed complete remission in follow-up CT &/or MRI. Three of these five patients who developed marginal, in-field, and out-field recurrences, respectively. Another one of complete responders has been dead of G-I bleeding without evidence of local recurrence. One partial responder who showed progressive disease 15 months after initial FFSRT has received additional FFSRT, and then he is well-being with symptomatic improvement. One minmal responder who showed progression of locoregional disease 9 months after $1^{st}$ FFSRT has received 2nd FFSRT, and then he is alive with stable disease. Five of 7 case had showed direct invasion to skull base and had complaint headache and various symptoms of cranial nerve involvement. Four of these five case showed improvement of neurologic symptoms after FFSRT. No significant neurologic complicaltion related to FFSRT was observed during follow-up periods. Tumor volumes were ranged from 3.9 to 50.7 cc and surface area ranged from 16.1 to $114.9cm^2$. IF ranged from 1.21 to 1.74. The average ratio of volume of prescription isodose shell to target volume was 1.02 that indicated the improvement of target coverage and dose distribution with FFSRT with conformal method compared to target coverage with FFSRT with multiple arc method. Conclusion: Our initial experience suggests that FFSRT with conformal method was relatively effective and safe modality in the treatment of recurrent head and neck cancer involving at or near skull base. Treatment benefit included good palliation of symptoms and reasonable radiographic response. However, more experience and additional follow-up are needed to better assess its ultimate role in treating these challenging patients.

• Journal of Acupuncture Research
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• v.28 no.3
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• pp.55-71
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• 2011

Objectives : The purposes of this preliminary study was to examine the feasibility of recruiting women into a clinical trial designed to examine the effects of acupuncture in treating urinary incontinence (UI) in premenopausal women with delivery history and the feasibility of performing the study procedures. We also tried to determine if there was preliminary evidence to suggest that acupuncture may be effective in reducing UI and improving disease-specific quality of life. Methods : This study was a pragmatic randomized clinical trial. Subjects between the ages of 20 and 49 years were randomly assigned to a treatment(n=11) or control group(n=11) and analyzed. Both groups were supposed to do Kegel exercise at home during 4 weeks and acupuncture was applied to the treatment group twice a week(8 sessions) additionally. Subjects performed 1 hour pad test and completed a 3-day urination diary, international consultation on incontinence modular questionnaire(ICIQ), and incontinence - quality of life(I-QOL) at base line and 5 weeks. Results : Both group showed improvement in 1 hour pad test and the reducing amount of UI was significantly larger in treatment group(p=0.0182). The significant improvements in ICIQ and I-QOL were also observed in treatment group and sustained until the follow-up measurement at 16 weeks. Any adverse reaction related to acupuncture did not happen. Conclusions : It was feasible to recruit subjects and perform the study procedures. The positive results of this study support the requirement for additional research investigating the efficacy of acupuncture in the treatment of UI in women.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7847-7852
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• 2015

Purpose: Research carried out with gynecologic cancer patients using CAM was reviewed to provide a source for discussing which CAM method is used for which purpose, patients' perceptions on the effects/side effects occurred during/after using CAM and their sources of information regarding CAM. Materials and Methods: This literature review was carried out for the period between January 2000 and March 2015 using Scopus, Dynamed, Med-Line, Science Dırect, Ulakbim, Research Starters, Ebscohost, Cinahl Complete, Academic Onefile, Directory of Open Access Journals, BMJ Online Journals (2007-2009), Ovid, Oxford Journal, Proquest Hospital Collection, Springer-Kluwer Link, Taylor & Francis, Up To Date, Web Of Science (Citation Index), Wiley Cochrane-Evidence Base, Wiley Online Library, and Pub-Med search databases with "complementary and alternative medicine, gynecologic cancer" as keywords. After searching through these results, a total of 12 full length papers in English were included. Results: CAM use in gynecologic cancer patients was discussed in 8 studies and CAM use in breast and gynecologic cancer patients in 4. It was determined that the frequency of CAM use varies between 40.3% and 94.7%. As the CAM method, herbal medicines, vitamins/minerals were used most frequently in 8 of the studies. When the reasons why gynecologic cancer patients use CAM are examined, it is determined that they generally use to strengthen the immune system, reduce the side effects of cancer treatment and for physical and psychological relaxation. In this review, most of the gynecologic cancer patients perceived use of CAM as beneficial. Conclusions: In order that the patients obtain adequate reliable information about CAM and avoid practices which may harm the efficiency of medical treatment, it is recommended that "Healthcare Professionals" develop a common language.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.62-68
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• 1997

The papillary carcinoma is the most common malignant neoplasm of thyroid gland and the prognosis is better than anyother type of thyroid carcinoma. However, the thyroid is closed to the important organs such as esophagus, trachea and larynx, there are some possibilities to invade these organs. In case of advanced disease, not only surrounding structures but also mediastinum and cervical lymphatic chain can be involved or distant metastasis develops frequently. Therefore in these cases the prognosis is worse and the rate of inoperable case is more than those of non-metastatic group. Generally, the treatment modality for papillary thyroid carcinoma consists of surgery, postoperative thyroid hormone and radioiodine therapy. If the tumor invades surrounding structures, cervical lymph node or mediastinum, total thyroidectomy and wide excision of tumor invaded area including mediastinal dissection and neck dissection is necessary. Recently, the authors have experienced a case of locally invasive and recurred papillary thyroid carcinoma without treatment for 7 years. The patient was performed previously thyroid lobectomy and isthmusectomy 13 years ago. We had determinded surgical therapy for this patient and performed mass excision with overlying skin, completion total thyroidectomy, right type I modified radical neck dissection, left lateral neck dissection, thoracotomy with supramediastinal dissection, shaving of diffusely involved trachea and skin defect reconstruction with pectoralis major myocutaneous flap. After operation 2 cycles of radioiodine therapy were taken. Now the patient is following up at the outpatient base and no evidence of disease state for postoperative 16 months. So we report on this case with a brief review of literature.

• Journal of Neurogastroenterology and Motility
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• v.25 no.3
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• pp.343-362
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• 2019

Background/Aims There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus. Methods Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method. Results Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy. Conclusions Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.

• Journal of Acupuncture Research
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• v.25 no.2
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• pp.199-210
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• 2008

Backgrounds : Electroacupuncture(EA) is commonly used in treatment of various disease. Despite an extensive evidence-base guiding the selection of stimulation parameters, little methodologically robust research regarding the level of intensity and frequency in need to provide effective doses. Objectives : This study is evaluated effects of various intensities and frequencies of EA's stimulation at $ST_{36}$, Zusanli, with sex and age in rats. Methods : In this study, we measured the effects of EA treatment on transfer capability of small intestine in rats. Under anesthesia, two intensities, 1, 5mA with three different frequencies, 2, 50, 100Hz were applied to the groups divided with sex and age for 30minutes. Results : 1mA-2Hz, 5mA-2, 100Hz in male and 1mA-2, 50, 100Hz in female without distinction of age elicited an increasing trend in transfer capability of small intestine. In case of 2Hz in male, it showed the effects of EA without strength or weakness of stimulation and it need 100Hz stimulation additionally with age. In the groups of 1mA-2Hz, 5mA-2Hz in male and 1mA-2Hz, 1mA-100Hz, we elicited the decreasing trend with growing of weeks-old in male. Conclusions : With this result, it was suggested that we should consider a correlation of sex, age and EA's intensities, frequencies for the efficient EA.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.2
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• pp.507-516
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• 2004

Alzheimer's disease(AD) is a geriatric dementia that is widespread in old age. In the near future AD will be the commom disease in public health service. Although a variety of oriental presciptions in study POD(Polygala tenuifolia extracted from dichlorometan) have been traditionally utilized for the treatment of AD, their pharmacological effects and action mechanisms have not yet fully elucidated. It has been widely believed that AP peptide divided from APP causes apoptotic neurotoxicity in AD brain. However, recent evidence suggests that CT105, carboxy terminal 105 aminoacids peptide fragment of APP, may be an important factor causing neurotoxicity in AD. SK-N-SH cells expressed with CT105 exhibited remarkable apoptotic cell damage. Based on morphological observations by phase contrast microscope and NO formation in the culture media, the CT105-induced cell death was significantly inhibited by POD. In addition, AD is one of brain degeneration disease. So We studied on herbal medicine that have a relation of brain degeneration. From old times, In Oriental Medicine, PO water extract has been used for disease in relation to brain degeneration. We were examined by ROS formation, neurite outgrowth assay and DPPH scravage assay. Additionally, we investigated the association between the CT105 and neurite degeneration caused by CT105-induced apoptotic response in neurone cells. We studied on the regeneratory and inhibitory effects of anti-Alzheimer disease in pCT105-induced neuroblastoma cell lines by POD. Findings from our experiments have shown that POD inhibits the synthesis or activities of CT105, which has neurotoxityies and apoptotic activities in cell line. In addition, treatment of POD(>50 ㎍/㎖ for 12 hours) partially prevented CT(105)-induced cytotoxicity in SK-N-SH cell lines, and were inhibited by the treatment with its. POD(>50 ㎍/㎖ for 12 hours) repaired CT105-induced neurite outgrowth when SK-N-SH cell lines was transfected with CT105. As the result of this study, In POD group, the apoptosis in the nervous system is inhibited, the repair against the degerneration of Neuroblastoma cells by CT105 expression is promoted. Decrease of memory induced by injection of scopolamin into rat was also attenuted by POD, based on passive avoidance test. Taken together, POD exhibited inhibition of CT105-induced apoptotic cell death. POD was found to reduce the activity of AchE and induced about the CA1 in rat hippocampus. Base on these findings, POD may be beneficial for the treatment of AD.

• Journal of Oriental Neuropsychiatry
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• v.34 no.3
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• pp.125-139
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• 2023

Objectives: This was a preliminary study to re-verify the reliability and validity of the Core Seven Emotions Inventory-Short Form (CSEI-s) and to establish standards for an objective scoring system such as T-scores and percentile for the normative group. Methods: Subjects were sampled through population-proportional regional allocation based on adults aged 20 or older and 65 or younger who voluntarily consented. Reliability was analyzed by performing an internal consistency (Cronbach's α) test and calculating means and standard deviations for each scale. The validity was analyzed between the CSEI-s and STAXI-K, SADS, COMOSWB, HADS, K-PANAS, Core emotions VAS. Results: The CSEI-s revealed notable gender discrepancies in aspects such as thought (思), fear (恐), and fright (驚), with women generally scoring higher than men. CSEI-s scores showed statistically significant differences in joy (喜) and thought (思) between those in their 20s and those in their 50s and 60s. As a result of the validity analysis, the seven-factor configuration was found to be statistically valid, and as a result of the correlation analysis with the coexistence scale, the correlation between each emotion and the seven emotions was found to be statistically significant. Cronbach's α for the CSEI-s was .891, showing statistically significant reliability. Conclusions: A preliminary study was conducted to standardize the shortened form of the Core Emotion Scale, and the reliability and validity were confirmed. A main survey of more people should be conducted in the future. Future results can contribute to revitalizing the development of oriental medicine evaluation tools and establishing an evidence base by standardizing the CSEI-s.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2833-2838
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• 2015

Background: Repeating a prior chemotherapy (rechallenge therapy) is an option for selected patients with metastatic colorectal cancer, but there is very little evidence in the literature for this approach. Thus, we reviewed our registry to evaluate prognostic factors and survival of patients who received irinotecan and oxaliplatin-based regimens as rechallenge third and fourth-line therapy. Materials and Methods: Patients who received irinotecan-based or oxaliplatin-base regimen as first-line had been rechallenged with third-line or fourth-line therapy. These patients were selected from the database of Turkish mCRC registry archives between October 2006 and June 2013 and evaluated retrospectively for factors effecting progression free survival (PFS) and overall survival (OS) by the Kaplan-Meire and Cox-regression methods. Results: Thirty-nine patients were enrolled. The median duration of follow-up was 36 months (14-68 months). Thirty-one patients (76%) died during follow-up. In terms of rechallenge treatments, 29 patients had received third-line and 10 patients had received fourth-line. Response rate (RR) was found to be 12.9%, with stable disease in 19 (48.7%) patients. The median PFS was 6 months (95%CI=4.64-7.35 months) and the median OS was 11 months (95%CI=8.31-13.68 months). The factors effecting survival (PFS and OS) were only being PFS after first-line chemotherapy ${\geq}12months$ (p=0.007, 95% CI=1.75-35.22 and p=0.004, 95%CI=1.44-7.11), both in univariate and multivariate analyses. Conclusions: This study indicates that rechallenge treatment could be a good option as a third or later line therapy in patients who had ${\geq}12months$ PFS onreceiving first line therapy.

• Journal of Korean Medical classics
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• v.26 no.2
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• pp.47-59
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• 2013

Objective : Syndrome differentiation(辨證) has clinical importance in East Asian Traditional Medicine. There are several ways for Syndrome differentiation. However, Eight Principle Pattern Identification(八綱辨證) is the base of other Syndrome differentiations. Of the physicians focused on Eight Principle Patterns(八綱), I have researched for Eight Principle Pattern Identification concerning with Zhang Jie-Bin(張介賓), Cheng Guo-Peng(程國彭), and Jiang Han-Tun(江涵暾) in Ming(明) and Qing(淸.) Method : Applying to Eight Principle Pattern Identification, I have researched comparatively for 3 kinds for. First, Zhang Jie-Bin's Jingyuequanshu(景岳全書) that involves Yinyangpian(陰陽篇), Liubianbian(六變辨), Biaozhengpian(表證篇), Lizhengpian(裏證篇), Xushipian(虛實篇), and Hanrepian(寒熱篇), secondly, Cheng Guo-Peng's Yixuexinwu(醫學心悟) Hanrexushibiaoliyinyangbian(寒熱虛實表裏陰陽辨), at lastly Jiang Han-Tun's Bihuayijing(筆花醫鏡) Biaolixushihanreyinyangbian(表裏虛實寒熱辨). Results : All of sick cases can be explained totally by Eight Principle Patterns. Of Eight Principle Patterns, Yin(陰) and Yang(陽) include last Six Principle Patterns(六綱 : 表裏, 寒熱, 虛實). Six Principle Patterns can be divided normally by 6 pulses(六脈 : 浮沈 遲數 虛實). In all of pain cases, feeling comfortable(可按) or discomfortable(拒按) to palpation can be important foundation for distinguishing Xu(虛) from Shi(實). Physical constitution(體質) for Hanre Xushi(寒熱 虛實) and tongue-diagnosis(舌診) for Biaoli Hanre(表裏 寒熱) are used effectively. Related with tongue-diagnosis, tongue-coating(舌苔) for Biaoli and tongue status(舌質) for Hanre are used effectively. Symptoms should be divided following this sequence, Biaoli ${\rightarrow}$ Hanre ${\rightarrow}$ Xushi and lastly should be summarized of Yinyang. Conclusion : Diagnosing with Eight Principle Patterns, digestive function, urine, and feces should be checked at first. In addition, the pulse, tongue, physical constitution, and good or bad from palpation(觸診), these should be checked and give a result. And then the result can be an important evidence of syndrome differentiation. As a result, it would be the best to diagnosis that discriminating the sequence as Biaoli Hanre Xushi and summarizing with Yinyang.