• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.711-734
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• 1994

Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1994년도 교수 연수회(환경)
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• pp.440-449
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• 1994

Current risk assessment practices largely reflect the need for a consistent set of relatively rapid, first-cut procedures to assess 'plausible upper limits' of various risks. These practices have important roles to play in 1) screening candidate hazards for initial attention and 2) directing attention to cases where moderate-cost measures to control exposures are likely to be warranted, in the absence of further extensive (and expensive) data gathering and analysis. A problem with the current practices, however, is that they have led assessors to do a generally poor job of analyzing and expressing uncertainties, fostering 'One-Number Disease' (in which everything from one's social policy position on risk acceptance to one's technical judgment on the likelihood of different cancer dose-response relationships is rolled into a single quantity). At least for analyses that involve relatively important decisions for society (both relatively large potential health risks and relatively large potential economic costs or other disruptions), we can and should at least go one further step - and that is to assess and convey both a central tendency estimate of exposure and risk as well as our more conventional 'conservative' upper-confidence-limit values. To accomplish this, more sophisticated efforts are needed to appropriately represent the likely effects of various sources of uncertainty along the casual chain from the release of toxicants to the production of adverse effects. When the effects of individual sources of uncertainty are assessed (and any important interactions included), Monte Carlo simulation procedures can be used to produce an overall analysis of uncertainties and to highlight areas where uncertainties might be appreciably reduced by further study. Beyond the information yielded by such analyses for decision-making in a few important cases, the value of doing several exemplary risk assessments in. this way is that a set of benchmarks can be defined that will help calibrate the assumptions used in the larger number of risk assessments that must be done by 'default' procedures.

• Advances in Traditional Medicine
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• 제8권3호
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• pp.222-227
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• 2008

Citrus aurantium var. amara L., commonly known as 'bitter orange' or 'sour orange', of the family Rutaceae, has traditionally been used in the treatment of various ailments, and it possesses different types of pharmacological properties. As a part of our on-going studies on the plantsfrom the Iranian flora, the extract of C. aurantium var. amara has been studied for its weight lossproperties using the mice model. While the Sep-Pak fraction, 20% methanol (MeOH) in water, of the hydro-methanolic extract of the peels of C. aurantium var. amara fruits, when injectedintraperitoneal (i.p.) at a dose of 10 mg/kg, significantly decreased the level of weight gain of the mice in comparison with control the group (P < 0.01), the Sep-Pak fraction 80% MeOH in water decreased the initial weight of mice by 0.44% in six weeks. The administration of the total extract(10 and 20 mg/kg, i.p.), and the Sep-Pak fractions, 40% and 60% MeOH in water (10 mg/kg, i.p.)did not show any significant change of weight of the test mice. Of the two active fractions, the80% MeOH in water fraction did not show any noticeable adverse effects on mice, and was therefore analysed by reversed-phase preparative high performance liquid chromatography resulting in the isolation and identification of four major components, two coumarins, meranzin hydrate (1) and bergamottin (2), and two flavonoids, xanthomicrol 5,4'-di-methyl ether (tangeritin, 3) and hymenoxin 5,7-di-methyl ether (nobiletin, 4).

• Asian-Australasian Journal of Animal Sciences
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• 제22권8호
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• pp.1186-1194
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• 2009

The objective of this study was to estimate the optimum dietary essential amino acid pattern for male Taiwan country chicks. A series of experiments was conducted with chicks, 14 d of age, for 2 wks. A basal synthetic diet was established using a dose response test for all essential amino acids referring to the broiler requirements recommended by NRC (1994). Twelve chicks were sacrificed at the beginning to provide initial body nitrogen data, and every group of six birds received the basal diet or a diet with a deficiency in a single essential amino acid in twenty one treatments by intubation according to their daily metabolic body weight (MBW). Deposited body nitrogen was determined using comparative slaughtering. According to the daily intake from the limiting amino acid per unit of MBW and the body nitrogen accretion rates for every two deficient groups with the same limiting amino acid but at different levels, a corresponding straight line was computed for each essential amino acid to intersect with a horizontal line made by the body nitrogen accretion rate of the control group. The x coordinate of the intersection represented the daily requirement for growth plus maintenance based on MBW corresponding to the essential amino acid. The amino acid ratios can be considered as the optimum pattern of dietary essential amino acids. The results, expressed with respect to lysine = 100, were arginine 105, methionine 81, histidine 34, tryptophan 18, leucine 103, phenylalanine 135, isoleucine 69, threonine 65 and valine 79. This pattern could be utilized to compute the dietary requirements (g/kg feed) for all essential amino acids by multiplying by the requirement of a single essential amino acid cited from the literature.

• Radiation Oncology Journal
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• 제35권2호
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• pp.144-152
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• 2017

Purpose: The role of radiotherapy (RT) was largely deserted after the introduction of platinum-based chemotherapy, but still survival rates are disappointingly low. This study focuses on assessing the clinical efficacy of RT in relation to chemotherapy resistance. Materials and Methods: From October 2002 to January 2015, 44 patients were diagnosed with epithelial ovarian cancer (EOC) and treated with palliative RT for persistent or recurrent EOC. All patients received initial treatment with optimal debulking surgery and adjuvant platinum-based chemotherapy. The biologically effective dose (BED) was calculated with ${\alpha}/{\beta}$ set at 10. Ninety-four sites were treated with RT with a median BED of 50.7 Gy (range 28.0 to 79.2 Gy). The primary end-point was the in-field local control (LC) interval, defined as the time interval from the date RT was completed to the date any progressive or newly recurring disease within the RT field was detected on radiographic imaging. Results: The median follow-up duration was 52.3 months (range 7.7 to 179.0 months). The 1-year and 2-year in-field LC rates were 66.0% and 55.0%, respectively. Comparisons of percent change of in-field tumor response showed similar distribution of responses among chemoresistant and chemosensitive tumors. On multivariate analysis of predictive factors for in-field LC analyzed by sites treated, $BED{\geq}50Gy$ (hazard ratio, 0.4; confidence interval, 0.2-0.9; p = 0.025) showed better outcomes. Conclusion: Regardless of resistance to platinum-based chemotherapy, RT can be a feasible treatment modality for patients with persistent of recurrent EOC. The specific role of RT using updated approaches needs to be reassessed.

• Radiation Oncology Journal
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• 제31권3호
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• pp.162-170
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• 2013

Purpose: To analyze the outcome of adjuvant postoperative external beam radiotherapy (EBRT) in well-differentiated thyroid cancer (WDTC). Materials and Methods: We identified 84 patients treated with EBRT for WDTC from February 1981 to December 2010. Among them, we analyzed 39 patients who received EBRT after initial radical surgery. Twenty-four females and 15 males were included. The median age was 49 years (range, 16 to 72 years). There were 34 papillary thyroid carcinomas and 5 follicular thyroid carcinomas. Most patients showed pathologic T3/T4 stage (54%/26%). Ten patients (25.6%) had gross residual tumors. Five patients (12.8%) had tumor cells at the margin. The median EBRT dose and fraction size were 62.6 Gy and 1.8 to 2.0 Gy, respectively. Results: The median follow-up was 73 months (range, 21 to 372 months). The five-year overall survival (OS) and locoregional recurrence free survival (LRFS) were 97.4% and 86.9%, respectively. Locoregional failures occurred in 5 and all failure sites were the neck node area. In univariate analysis, OS was significantly influenced by invasion of the trachea (p = 0.016) or esophagus (p = 0.006). LRFS was significantly decreased by male (p = 0.020), gross residuum after resection (p = 0.002), close or positive tumor at surgical margin involvement (p = 0.044), and tracheal invasion (p = 0.040). No significant prognostic factor was identified in the multivariate analysis. No patient experienced the Radiation Therapy Oncology Group grade 3 or more toxicity. Conclusion: Our locoregional control rate of 87.2% is comparable to historical controls with surgery alone, even though our study had a large proportion of advanced stage. Adjuvant EBRT may an effective and safe treatment option in patients with WDTC.

• Radiation Oncology Journal
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• 제38권1호
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• pp.26-34
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• 2020

Purpose: Intensity-modulated radiotherapy (IMRT) allows for more precise treatment, reducing unwanted radiation to nearby structures. We investigated the safety and feasibility of IMRT for anaplastic ependymoma patients below 3 years of age. Materials and Methods: A total of 9 anaplastic ependymoma patients below 3 years of age, who received IMRT between October 2011 and December 2017 were retrospectively reviewed. The median equivalent dose in 2 Gy fractions was 52.0 Gy (range, 48.0 to 60.0 Gy). Treatment outcomes and neurologic morbidities were reviewed in detail. Results: The median patient age was 20.9 months (range, 12.1 to 31.2 months). All patients underwent surgery. The rates of 5-year overall survival, freedom from local recurrence, and progression-free survival were 40.6%, 53.3%, and 26.7%, respectively. Of the 9 patients, 5 experienced recurrences (3 had local recurrence, 1 had both local recurrence and cerebrospinal fluid [CSF] seeding, and 1 had CSF seeding alone). Five patients died because of disease progression. Assessment of neurologic morbidity revealed motor dysfunction in 3 patients, all of whom presented with hydrocephalus at initial diagnosis because of the location of the tumor and already had neurologic deficits before radiotherapy (RT). Conclusion: Neurologic morbidity is not caused by RT alone but may result from mass effects of the tumor and surgical sequelae. Administration of IMRT to anaplastic ependymoma patients below 3 years of age yielded encouraging local control and tolerable morbidities. High-precision modern RT such as IMRT can be considered for very young patients with anaplastic ependymoma.

• 한국정보통신학회논문지
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• 제20권2호
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• pp.359-366
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• 2016

방사선 치료에 있어서 정상 조직에는 방사선을 최소화 하고 종양 부위에 정확한 방사선을 집중해서 조사하여 국소 종양 제어율(Local Tumor Rate)을 극대화 하는 것이 가장 중요하다. 이를 위해서 초기에는 치료사들이 직접 환자의 움직임을 감지했으나 정확도가 떨어지고 치료사들의 피로가 가중되는 문제점들이 있었다. 또한 웹카메라를 이용하여 기준영상과 갱신되는 영상의 차분값을 계산하여 그 결과가 기준값을 초과하면 움직임이 발생한 것으로 판단하는 시스템을 사용하였다. 그러나 이 시스템은 환자의 움직임을 정량적으로 분석할 수 없고 토모치료기의 치료베드 이동시 변화되는 배경을 환자와 가려낼 수 없었다. 이에 본 논문에서는 이러한 한계점을 해결하고자 지수가중치(${\alpha}$) 필터를 이용하여 환자의 움직임을 정량화 하고 환자와 치료환경의 배경이미지를 분리하여 치료중 환자의 움직임만을 감지하여 환자의 움직임으로 인한 문제를 줄일 수 있었다.

• Journal of Ginseng Research
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• 제33권2호
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• pp.149-154
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• 2009

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation and progressive cartilage and bone erosion. Korean red ginseng (KRG) has been shown to have an anti-inflammatory effect by inhibiting the secretion of inflammatory cytokines like $TNF-{\alpha}$, IL-1, -6, and -8, and $IPN-{\gamma}$. In this study, whether KRG extract has an inhibitory effect on the collagen-inducible development of arthritis in DBA/1J mice was investigated. To induce arthritis, type II collagen emulsified in Complete Freund's Adjuvant was intradermally injected into the base of the tails of mice. Three weeks after the initial injection, a booster injection of type II collagen emulsified in Incomplete Freund's Adjuvant was administered. The oral administration of KRG extract for 8${\sim}$10 weeks at the dose of 300 mg/kg (three days a week) inhibited the development of arthritis in the experimental group, compared to the control group which was given saline. While the administration of KRG extract three times a week demonstrated both preventive and inhibitory effects, the administration of KRG extract once a week had little inhibitory effect. In other studies, the regimen of KRG administration has been shown to decrease the plasma level of inflammatory cytokines like IL-8 and TNF-${\alpha}$, but the plasma levels of these cytokines were not decreased in the present study. The results of the present study suggest that KRG has preventive and inhibitory effects on collagen-induced arthritis.

• 대한치과교정학회지
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• 제51권5호
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• pp.313-320
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• 2021

Objective: The purpose of this study was to evaluate the effects of chewing gum and low-level laser therapy in alleviating orthodontic pain induced by the initial archwire. Methods: Patients with 3-6 mm maxillary crowding who planned to receive non-extraction orthodontic treatment were recruited for the study. Sixty-three participants (33 females and 30 males) were randomly allocated into three groups: laser, chewing gum, and control. In the laser group, a gallium aluminum arsenide (GaAlAs) diode laser with a wavelength of 820 nm was used to apply a single dose immediately after orthodontic treatment began. In the chewing gum group, sugar-free gum was chewed three times for 20 minutes-immediately after starting treatment, and at the twenty-fourth and forty-eighth hours of treatment. Pain perception was measured using a visual analog scale at the second, sixth, and twenty-fourth hours, and on the second, third, and seventh days. Results: There were no statistically significant differences between the groups at any measured time point (p > 0.05). The highest pain scores were detected at the twenty-fourth hour of treatment in all groups. Conclusions: Within the limitations of the study, we could not detect whether low-level laser therapy and chewing gum had any clinically significant effect on orthodontic pain. Different results may be obtained with a higher number of participants or using lasers with different wavelengths and specifications. Although the study had a sufficient number of participants according to statistical analysis, higher number of participants could have provided more definitive outcomes.