• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.2
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• pp.157-166
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• 2020

The first dental visit is recommended at the time of the eruption of the first tooth and no later than 12 months of age. However, even before the age of 1, children can visit the dental hospital for various reasons. The purpose of this study was to analyze the reasons for the dental visit of infant. From January 2006 to December 2015, medical records of infants who visited the Department of Pediatric Dentistry of Kyung Hee University were analyzed. The total number of patients was 419 (238 males and 181 females). The reasons for the dental visits were trauma (47.5%), natal/neonatal tooth (19.8%), dental caries (8.1%), teething problem (4.3%), abnormal frenum (3.6%), soft tissue swelling (3.6%), Bohn's nodule (3.3%), cleft lip and palate (2.9%), gingival neoplasm (1.9%), tongue ulceration (1.7%), oral examination (1.4%), enamel hypoplasia (1.2%) and abnormal temporomandibular joint sound (0.7%). According to this study, there were various oral diseases that could occur in infants. Since infants are usually cared by caregivers, pediatricians, and obstetricians, education of oral diseases of infants is needed to manage the oral symptoms properly.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.2
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• pp.98-105
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• 2000

In the case of osteosarcoma, secondary acute myeloid leukemia which occurs as the consequences of the complication of chemotherapy, is rare. We are reporting the case that we have recently experienced in the laboratory. A case of secondary acute myeloid leukemia have been occurred to among 77 patients who have been diagnosed as osteosarcoma and received chemotherapy from 1995 to 1999. This case was compared with the cases of other reports for the analysis of its cause and results. A 17-year-old man was diagnosed as a osteosarcoma in the distal part of femur, and recieved chemotherapy. Within 28months, the hematological analysis of the case indicated the severe increase in the number of the white cell (over 200,000) and the profound decrease in the number of platelets. A test of bone marrow needle aspiration and peripheral blood smear showed a tremendous increase in the number of the monocytoid immature cell, which mostly are blasts and promonocytes. Due to this clinical results, the case was diagnosed as the secondary acute myeloid leukemia after the chemotherapy. The frequency of occurrence of secondary acute myeloid leukemia after chemotherapy is quite phenomenal. But the disease could be fatal leading to a high rate of morbidity and mortality without early diagnosis and treatment. Hence, an enough recognition of the possibility of its development, the periodical observation and inspection after chemotherapy and an immediate treatment in the case of occurrence are essential.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.2
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• pp.82-87
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• 2000

Tumoral calcinosis is a disease of unclear etiology which presents with periarticular and intramuscular calcification without the disorder of calcium and phosphorus metabolism. The incidence is very rare but the rate is higher among the blacks than whites. There has been no report on the recurrent occurrence on the asian race. We report a case that recurred several times with tumoral calcinosis of both knee and thigh. A 21-year-old woman visited to our department with masses in both right thigh and knee. She had a history of local excisions and biopsies(4 times at other hospital) and showed prompt recurrences. The complete marginal excision was performed for the treatment. The histological examination showed the findings that are compatible with tumoral calcinosis. There has been a free of recurrence over the past two years.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.1
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• pp.41-46
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• 2000

We experienced the case of familiar hypercholesterolemia with multiple xanthomas which was treated by combined surgical and medical therapy. He was 26-year-old male patient of familiar hypercholesterolemia with multiple xanthomas in 22 sites on whole body, and was treated by 17 surgical excisions of the xanthomas and by medical therapy of the hypercholesterolemia. There was a normal healing process of the surgical wounds. Continual postoperative medical therapy of the hypercholesterolemia was done. There was no recurrence of the symptoms during more than 13 months of follow-up. But the serum level of the cholesterol was not lowered significantly, so we are treating him with drug therapy. Familial hypercholesterolemia is caused by a specific disorder of lipid metabolism, and is characterized by increased LDL cholesterol, tendon xanthomas, coronary disease associated with autosomal dominant transmission. Xanthomas usually appear in the second decade of life with familiar hypercholesterolemia which may have high risk for premature coronary atherosclerosis, which might be prevented with early diagnosis and medical treatment. So, orthopedic surgeons do not only excise the xanthomatosis surgically but also can diagnose the underlying hypercholesterolemia.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.3
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• pp.169-177
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• 1999

Osteosarcoma in patients older than 40 years are rare, however they have different clinical, radiological and pathological features from those of younger patients. Sometimes accurate histologic diagnosis is not easy, which is important in determining the correct surgical treatment and appropriate chemotherapy. Since January 1995, 11 patients with osteosarcoma occurring in patients older than 40 years have been diagnosed, treated and followed up for more than 6 months. In contrast to osteosarcoma in children and adolescents, only 4 cases(36.4%) were conventional types, while the others included 2 malignant fibrous histiocytoma-like types, 2 small cell types, 2 periosteal osteosarcomas and 1 giant cell-rich type. Seven cases showed purely osteolytic or predominantly osteolytic bony lesions and 8 were in Enneking stage IIB. Performed surgical treatments included 2 amputations, 6 wide resections and reconstructions, and one curettage and autogenous bone graft. In the remaining 2 cases, definitive surgical treatments included not carried out because of old age, multifocal involvement or poor medical tolerance. Neoadjuvant and adjuvant chemotherapies were performed in 9 of 11 patients. At last follow-up, there were 6 continuously disease-free survivals, 3 alive with diseases and 2 died of diseases. The overall cumulative 4-year survival rate calculated using Kaplan-Meier's productlimit method was 59.3%. For improved oncologic outcomes and survivals, early and accurate diagnosis, surgical treatment with adequate margin and neoadjuvant and adjuvant chemotherapy will be necessary.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.1
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• pp.17-21
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• 2000

Purpose : Dermatofibrosarcoma protuberans(DFSP) is a rare tumor of the skin with a strong tendency of infiltration to surrounding tissues. Inadequate surgical intervention brings about frequent recurrence and poor prognosis. We attempted to find a guideline for adequate treatment for DFSP. Materials and Methods : Fourteen cases who had been treated in our department since Mar. 1993 and followed up for more than 12 months postoperatively were reviewed. Including nine cases who were transferred from other hospital after recurrence, thirteen cases underwent wide resection. One case was treated by intralesional resection followed by chemotherapy (CYVADIC) due to neurovascular abutment to the mass in the inguinal area. Results : The nine cases who were transferred due to recurrences experienced recurrence in average 1.3(1-2) times and the average period until first local recurrence from primary operation was 11.8(2-24) months. The thirteen cases with wide surgical margin showed no recurrence at the final follow up. One case treated by intralesional resection and chemotherapy showed multiple recurrence and died of the disease due to lung metastasis. Conclusions : From these data, we could find that primary wide resection can be the way of reducing recurrence and metastasis, and the follow up period for the detection of recurrence should be at least two years.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.148-154
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• 2005

Purpose: To evaluate the long term results of surgical treatment for sacral chordoma. Material and Method: We reviewed the records of 4 patients with sacral tumor treated surgical resection. Mean follow-up duration was 8.3 year(3~11). All cases were performed complete resection of tumor mass through posterior approach in 3 cases and anterior-posterior approach in one. The most caudad nerve-roots spared were the second sacral roots in one and the third sacral roots in 3 cases. Functions of voiding and defecation including neurological symptoms of lower extremities, other complications of surgical treatment, and local recurrence or distant metastasis of tumor were evaluated. Result: There was no motor deficit in all cases, but radiating pain was developed in one and wound infection in one. Bladder function was preserved in 2 cases, intermittent incontinence in one, and doing intermittent catheterization in one. Bowel function was preserved in one and 2 cases were suffered from constipation. At the last follow-up, disease-free was in one, local recurrence in one, and local recurrence with distant metastasis in one. Conclusion: The result of surgical resection for sacral chordoma is satisfactory showing average 8 years survival. Early detection and aggressive surgical treatment is the best to prolong survival and to minimize functional deficit with preservation of upper sacral nerves.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.4
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• pp.871-877
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• 2008

Heme oxygenase-1 (HO-1), an inducible heme-degrading enzyme, is expressed by macrophages and endothelial cells in response to various stresses and mediators of inflammation. HO-1 has been recently implicated in regulation of angiogenesis via expression of VEGF. The purpose of this study was to determine the effects of HO-1 modulation on the collagen-induced arthritis (CIA) model and on angiogenesis via up- regulation of VEGF expression in human synovial fibroblast. DBA/1J mice were treated with an inhibitor of HO-1, tin protoporphyrin IX (SnPP), or with an inducer of HO-1, cobalt protoporphyrin IX (CoPP), from day 1 to day 35 after CIA induction. The clinical evolution of disease was monitored visually. At the end of the experiment, histopathologic changes were examined on the joints. VEGF expression in paws were measured by immunohistochemical stain. mRNA expression of HO-1 and VEGF stimulated with various concentration of $TNF-{\alpha}$, CoPP accessed on human synovial fibroblast by RT-PCR. Effects of pretreatment with SnPP on mRNA expression of HO-1 and VEGF in the presence of CoPP and $TNF-{\alpha}$ in synovial fibroblast was accessed by Real-time RT-PCR. Administration of cobalt protoporphyrin IX significantly induced the inflammatory response, with increased arthritis index and expression of VEGF in the paws of the arthritis models. Treatment with SnPP significantly reduced the severity of CIA through inhibition of joint inflammation and cartilage destruction. The expression of VEGF were also significantly reduced by SnPP treatment in the paw. CoPPIX as inducer of HO-1, increased HO-1 and VEGF expression dose dependently in synovial fibroblast. In contrast, inhibition of HO-1 activity by SnPPIX abrogated CoPPIX-induced HO-1 and VEGF production in synovial fibroblast. Stimulation with $TNF-{\alpha}$ increased HO-1 and VEGF expression itself and showed additive effect on HO-1 and VEGF expression when it treated with CoPP. When SnPP was treated with CoPP and $TNF-{\alpha}$, it abrogated the CoPP induced HO-1 and VEGF expression and also abrogated $TNF-{\alpha}$ induced HO-1 and VEGF expression in synovial fibroblast. The effects of HO-1 induction in rheumatoid arthritis results in aggravation of arthritis via up-regulation of VEGF. I concluded that inhibition of the expression or activity of HO-1 could be a therapeutic target of rheumatoid arthritis.

• Radiation Oncology Journal
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• v.33 no.2
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• pp.75-82
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• 2015

Purpose: We evaluated the prognostic significance of T3 subtypes and the role of adjuvant radiotherapy in patients with resected the American Joint Committee on Cancer stage IIB T3N0M0 non-small cell lung cancer (NSCLC). Materials and Methods: T3N0 NSCLC patients who underwent resection from January 1990 to October 2009 (n = 102) were enrolled and categorized into 6 subgroups according to the extent of invasion: parietal pleura chest wall invasion, mediastinal pleural invasion, diaphragm invasion, separated tumor nodules in the same lobe, endobronchial tumor <2 cm distal to the carina, and tumor-associated collapse. Results: The median overall survival (OS) and disease-free survival (DFS) were 55.3 months and 51.2 months, respectively. In postoperative T3N0M0 patients, the tumor size was a significant prognostic factor for survival (OS, p = 0.035 and DFS, p = 0.035, respectively). Patients with endobronchial tumors within 2 cm of the carina also showed better OS and DFS than those in the other T3 subtypes (p = 0.018 and p = 0.016, respectively). However, adjuvant radiotherapy did not cause any improvement in survival (OS, p = 0.518 and DFS, p = 0.463, respectively). Only patients with mediastinal pleural invasion (n = 25) demonstrated improved OS and DFS after adjuvant radiotherapy (n = 18) (p = 0.012 and p = 0.040, respectively). Conclusion: The T3N0 NSCLC subtype that showed the most favorable prognosis is the one with endobronchial tumors within 2 cm of the carina. Adjuvant radiotherapy is not effective in improving survival outcome in resected T3N0 NSCLC.

• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.275-307
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• 2010

In the presidential new-year address in January 2, 2009, the President declared that 17 kinds of new driving force of growth that could create high-added value be selected to step up job creation and an increase in national wealth. The Ministry of Strategy & Finance announced plans for the 17 kinds of new driving force of growth after the presidential address. Specifically, that ministry announced an ambitious plan to select health care service named 'Global Health Care' as one of the five service industries that could create high-added value in a move to provide jobs to approximately 7,000 people and produce pervasive economic effects coming up to a trillion and 10 billion won. To attain the goal, several action plans were mapped out to globalize domestic medical institutions, to rearrange the relevant law and system for the purposes of raising awareness of domestic medical institutions among foreign patients and improving their accessibility and post-satisfaction level, and to lure lots of foreign patients through financial assistance. At the same time, the government announced plans to lure severe patients such as those in want of surgery or organ transplant, cancer patients or patients with heart diseases to create high-added value on a long-term basis. Thus, the government announced that it planned to formulate such strategies and to enter an agreement with foreign governments to attract plenty of foreign patients. In fact, however, there are little full-scale evaluation of medical tourism though it's been a year since it was introduced, and there are few actual efforts to implement what the government announced, either. According to the results of the evaluation of medical tourism, domestic hospitals are said to undergo little significant changes after the introduction of medical tourism, which shows that they take a dim view of medical tourism instead of having expectations for that. The medical tourism industries in major Asian countries have been dynamized, and there are several factors of their success. First of all, they are successful in creating new market opportunities by incorporating related industries such as medicine, tourism and IT and in developing medical tourism products and differentiated marketing by taking advantage of their competitive edge. They have offered full-fledged assistance to this sector, and another reason is the improved international credibility of their medical service. If our country fails to pinpoint our problems in consideration of the cases of the Asian countries or to provide appropriate financial aid, our country is bound to lag behind them. Given this reality, how to assess medical tourism and what challenges this sector is confronted with are discussed.