• The korean journal of orthodontics
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• v.34 no.2 s.103
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• pp.165-175
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• 2004

Information on the limits of treatment could allow for more rational treatment Planning and better results after treatment. From this point of view, this article has attempted to discuss the limits of orthodontic tooth movement. A relatively wider range of tooth movement is expected after Class III surgical-orthodontics than after conventional orthodontic treatment in general. The purposes of this Paper were: first, to evaluate the reliability of teeth position measuring gauge; and second, to elucidate the limits of orthodontic tooth movement. Dental casts of fifty-fine subjects were analyzed by using Set-up model checker (InVisitec Co., Korea) before and aster the Class III surgical-orthodontic treatment. The changes of maxillary and mandibular dental arch widths were also measured from the canines to the second molars. To test the inter-examiner reliability, randomly selected casts were measured by another examiner. Descriptive statistics and paired t tests were used to explain the tooth movement during treatment. The results showed a relatively good reliability of measuring instruments and a very diverse range of tooth movement. Collective changes by the orthodontic tooth movement evaluated in Class III surgical-orthodontics allowed for a suggestive interpretation of specific treatment patterns. Arch width changes during the inter-arch coordination were mainly the result of tipping in both buccal segments. Based on the results of this study, the possibility of a change in dentition as a result of orthodontic treatment should be understood in order to launch a well-organized plan of treatment.

• Journal of Korean Foot and Ankle Society
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• v.23 no.1
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• pp.24-30
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• 2019

Purpose: To evaluate the efficiency of the electronic foot function index (eFFI) through a prospective, random based, multi-institutional study. Materials and Methods: The study included 227 patients ranging in age from 20 to 79 years, visited for surgery in different 15 institutes, and agreed to volunteer. The patients were assigned randomly into a paper-based evaluated group (n=113) and tablet-based evaluated group (n=114). The evaluation was done on the day of hospital admission and the method was changed on the second day of surgery and re-evaluated. PADAS 2.0 (https://www.proscore.kr) was used as an electronic evaluation program. Results: There were no differences in age and sex in both groups. The intraclass correlation coefficient (ICC) evaluation revealed an eFFI ICC of 0.924, showing that both results were similar. The evaluation time was shorter in the tablet-based group than the paper-based group (paper vs tablet, $3.7{\pm}3.8$ vs $2.3{\pm}1.3minutes$). Thirty-nine patients (17.2%) preferred to use paper and 131 patients (57.7%) preferred the tablet. Fifty-seven patients (25.1%) found both ways to be acceptable. Conclusion: eFFI through tablet devices appears to be more constant than the paper-based program. In addition, it required a shorter amount of time and the patients tended to prefer the tablet-based program. Overall, tablet and cloud system can be beneficial to a clinical study.

• Herbal Formula Science
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• v.15 no.1
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• pp.137-144
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• 2007

Background and Objectives : There are three kinds of formulas for purging the spleen to cure its sthenic syndrome based on the types of preparation formulas : Sabeetang, Sabeehwan, Sabeesan and Sabeeeum. Another formulas called Sahwangtang, Sahwangsan. Sahwangeum is to purge the yellow colour of spleen. There are 8 kinds of Sabeetang, 3 kinds of Sabeehwan, 3 kinds of Sabeesan, 1 kind of Sabeeeum, 4 kinds of Sahwangtang, 7 kinds of Sahwangsan, and 1 kind of Sahwangeum. Combination of herbal medicines, carried out in formulas for purging the spleen, consists of various kinds depending on medical scientists' personal experience in medical treatment without any general principles, which makes it difficult to apply it to clinical use. The objectives of this study lie in theoretical establishment of Sabeetang for curing the sthenic syndrome of spleen through analyzing the component medicines and combination principles of Hyeongok's Sabeetang, and furthermore, maximizing the clinical use of Sabeetang. Methods : This study analyzed the component medicines and combination principles of Hyeongok's Sabeetang based on the theory for properties and tastes of herbal medicines from the ${\ulcorner}$Yellow Emperor's Canon of Internal Medicine${\lrcorner}$ , the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine, and the five elements doctrine. Hyeongok's Sabeetang is an odd prescription, composed of 7 kinds of ingredients : No.1 Rhizoma Coptidis (2don;7.5g), No.2 Fructus Gardeniae (1don;3.75g), No.3 Ramulus Cinnamomi (1don), No.4 Gypsum Fibrosum (1don), No.5 Fructus Aurantii Immaturus (1don), No.6 Cortex Magnoliae Omcinalis (1don), and No.7 Radix Et Rhizoma Rhei (1don) Results : There are three methods for curing the sthenic syndrome of spleen according to the five elements doctrine : purging the spleen, purging the lung and invigorating the liver. First, if you suffer from the sthenic syndrome of the spleen, you need to purge your spleen. There are two available methods, including taste and property purgation according to the theory for properties and tastes of herbal medicines. They each imply the bitter taste and the cool property purge the spleen. In the case of taste purgation, two herbal medicines with bitter taste. Rhizoma Coptidis and Fructus Gardeniae, are combined into the principal and assistant herbal medicine, respectively. For property purgation, three herbal medicines with the cool property, Gypsum Fibrosum, Fructus Aurantii Immaturus and Radix Et Rhizoma Rhei, are combined into adjuvant herbal medicines. Secondly, if you suffer from the sthenic syndrome of the spleen, you need to purge your lung which is child in the mother-child relationship in inter-promotion among the five elements. There are two methods to purge the lung, including taste and property purgation according to the theory for properties and tastes of herbal medicines. They each mean the pungent taste and the warm property purge the lung. Therefore, it is important to use pungent herbal medicines for taste purgation and warm ones for property purgation. Both pungent and warm herb and property invigoration to invigorate the liver with warm property. Therefore, it is important to use pungent herbal medicines for taste invigoration and warm ones for property invigoration. Both pungent and warm herbal medicines, Ramulus Cinnamomi and Cortex Magnoliae Officinalis, were combined to invigorate the liver and purge the lung. In addition, Gypsum Fibrosum are combined as dispatcher herbal medicine, leading all the herbal medicines composing the formula to the spleen. Conclusions : First, to cure the sthenic syndrome of the spleen, the methods of purging the spleen and the lung, and invigorating the liver should be used according to the five elements doctrine. Secondly, herbal medicines appropriate for those treatment methods should be chosen according to the theory for properties and tastes of herbal medicine and thirdly, the combination of those herbal medicines should be carried out according to the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine. As a good example, Hyeongok's Sabeetang is combined according to the above theories. In conclusion, this formula was created by applying to the theory for properties and tastes of herbal medicines.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.16 no.2
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• pp.86-92
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• 2016

Purpose: The $BH_4$ loading test is an important test that distinguishes PKU from $BH_4$ deficiency and identifies the $BH_4$ reactivity of PKU patients. Phenylalanine and $BH_4$ loading tests are useful methods that can shorten the length of hospital stay while improving patients' convenience. However, sufficient research on the dose of phenylalanine loading and $BH_4$ administration time after the loading has not been carried out. The present study investigates the effectiveness of the existing phenylalanine loading method by analyzing the medical records of six patients who underwent the $BH_4$ loading test after taking 100 mg/kg of phenylalanine patients. Methods: The medical records of six patients who underwent the $BH_4$ load test after taking 100 mg/kg of phenylalanine were examined out of 207 patients who were followed up in the Genetic Metabolic Clinic in Soonchunhyang University Hospital. All of the six patients had a low phenylalanine diet. First, they were taking 100 mg/kg of phenylalanine. 3 hours later, 20 mg/kg of $BH_4$ were loaded. The phenylalanine levels in the blood were continuously measured at 1, 2, 4, 6, 8, 12, and 24 hours by setting the time the $BH_4$ was loaded as the basal. Results: The average of the highest phenylalanine concentrations of six patients was $20.0{\pm}11.70mg/dL$. One reached the highest concentration seven hours after taking phenylalanine; another reached it five hours after that, and the remaining three reached it four hours after that. Only one patient reached the highest concentration within three hours. The phenylalanine levels of four out of six patients (66%) rose above $400{\mu}mol/L$ after being loaded with phenylalanine. The phenylalanine levels of the remaining two were 6.1 mg/dL ($366{\mu}mol/L$) and 5 mg/dL ($300{\mu}mol/L$), respectively. Conclusion: One of six patients (16%) reached the highest concentration three hours after taking 100 mg/kg of phenylalanine and four patients (66%) reached $400{\mu}mol/L$ or higher phenylalanine levels. There were patients whose phenylalanine levels did not rise above $400{\mu}mol/L$ using a commonly known test method; moreover, this method had the disadvantage of reaching the highest concentration after more than three hours. Therefore, it is considered that taking 200 mg/kg or more of phenylalanine and performing $BH_4$ loading four to six hours after taking phenylalanine are helpful in proper diagnosis.

• Progress in Medical Physics
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• v.22 no.2
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• pp.61-66
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• 2011

In this study, we evaluated the effect of grid size on dose calculation accuracy using 2 head & neck and 2 prostate IMRT cases and based on this study's findings, we also evaluated the efficiency of a 2D diode array detector for IMRT quality assurance. Dose distributions of four IMRT plan data were calculated at four calculation grid sizes (1.25, 2.5, 5, and 10 mm) and the calculated dose distributions were compared with measured dose distributions using 2D diode array detector. Although there was no obvious difference in pass rate of gamma analysis with 3 mm/3% acceptance criteria for the others except 10 mm grid size, we found that the pass rates of 2.5, 5 and 10 mm grid size were decreased 5%, 20% and 31.53% respectively according to the application of the fine acceptance criteria, 3 mm/3%, 2 mm/2% and 1 mm/1%. The calculation time were about 11.5 min, 4.77 min, 2.95 min, and 11.5 min at 1.25, 2.5, 5, and 10 mm, respectively and as the grid size increased to double, the calculation time decreased about one-half. The grid size effect was observed more clearly in the high gradient area than the low gradient area. In conclusion, 2.5 mm grid size is considered acceptable for most IMRT plans but at least in the high gradient area, 1.25 mm grid size is required to accurately predict the dose distribution. These results are exactly same as the precious studies' results and theory. So we confirmed that 2D array diode detector was suitable for the IMRT QA.

• Progress in Medical Physics
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• v.26 no.4
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• pp.250-257
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• 2015

Multi-leaf collimator (MLC) systems are frequently used to deliver photon-based radiation, and allow conformal shaping of treatment beams. Many proton beam centers currently make use of aperture and snout systems, which involve use of a snout to shape and focus the proton beam, a brass aperture to modify field shape, and an acrylic compensator to modulate depth. However, it needs a lot of time and cost of preparing treatment, therefore, we developed the manual MLC for solving this problem. This study was carried out with the intent of designing an MLC system as an alternative to an aperture block system. Radio-activation and dose due to primary proton beam leakage and the presence of secondary neutrons were taken into account during these iterations. Analytical calculations were used to study the effects of leaf material on activation. We have fabricated tray model for adoption with a wobbling snout ($30{\times}40cm^2$) system which used uniform scanning beam. We designed the manual MLC and tray and can reduce the cost and time for treatment. After leakage test of new tray, we upgrade the tray with brass and made the safety tool. First, we have tested the radio-activation with usually brass and new brass for new manual MLC. It shows similar behavior and decay trend. In addition, we have measured the leakage test of a gantry with new tray and MLC tray, while we exposed the high energy with full modulation process on film dosimetry. The radiation leakage is less than 1%. From these results, we have developed the design of the tray and upgrade for safety. Through the radio-activation behavior, we figure out the proton beam leakage level of safety, where there detects the secondary particle, including neutron. After developing new design of the tray, it will be able to reduce the time and cost of proton treatment. Finally, we have applied in clinic test with original brass aperture and manual MLC and calculated the gamma index, 99.74% between them.

• Progress in Medical Physics
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• v.21 no.2
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• pp.192-200
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• 2010

Cyberknife with small field size is more difficult and complex for dosimetry compared with conventional radiotherapy due to electronic disequilibrium, steep dose gradients and spectrum change of photons and electrons. The purpose of this study demonstrate the usefulness of Geant4 as verification tool of measurement dose for delivering accurate dose by comparing measurement data using the diode detector with results by Geant4 simulation. The development of Monte Carlo Model for Cyberknife was done through the two-step process. In the first step, the treatment head was simulated and Bremsstrahlung spectrum was calculated. Secondly, percent depth dose (PDD) was calculated for six cones with different size, i.e., 5 mm, 10 mm, 20 mm, 30 mm, 50 mm and 60 mm in the model of water phantom. The relative output factor was calculated about 12 fields from 5 mm to 60 mm and then it compared with measurement data by the diode detector. The beam profiles and depth profiles were calculated about different six cones and about each depth of 1.5 cm, 10 cm and 20 cm, respectively. The results about PDD were shown the error the less than 2% which means acceptable in clinical setting. For comparison of relative output factors, the difference was less than 3% in the cones lager than 7.5 mm. However, there was the difference of 6.91% in the 5 mm cone. Although beam profiles were shown the difference less than 2% in the cones larger than 20 mm, there was the error less than 3.5% in the cones smaller than 20 mm. From results, we could demonstrate the usefulness of Geant4 as dose verification tool.

• Journal of radiological science and technology
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• v.27 no.3
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• pp.5-12
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• 2004

I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.

• Journal of Periodontal and Implant Science
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• v.27 no.3
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• pp.533-547
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• 1997

In periodontics, much progress was made in the understanding of periodontal disease from 1960s to 1980s and in prevention and management of periodontal disease since the end of 1980s. This presentation will discuss about the prevalence of periodontal disease, treatment need, and provision of periodontal treatment in Korea, and how we could manage the periodontal disease efficiently in the future. According to an epidemiological study in Korea, periodontal disease(including gingivitis) was present in 82% of general population and periodontitis in 30-40% in adult population over 30y and juvenile periodontitis in 0.1% of adolescents. If we consider that at least 17% of these patients may have recurrent or refractory forms, there is obviously an abundance of disease that needs treatment, As a result of increase in life expectancy, senile population over 65 y will be increased from 6% in 1996 to 6.9% in 2000, and tooth retention rate and periodontal treatment need are expected to increase. Periodontists need all the help they can get from the general dentists to control periodontal disease. As for provision, postgraduate course in periodontics started in 1957 in Korea and produced over 700 specialized dentists in periodontics. One report indicated that the periodontists as well as general practitioners did periodontal therapy on only a few periodontal patients, because of specific control by current medical insurance system in Korea. Comprehensive periodontal examination is rarely done in local dental clinic. Therefore, enhancement of periodontal care in medical insurance system and education of simplified periodontal examination such as Periodontal Screening & Recording will make dentists diagnose and manage the management of adult patients is based on the recognition that there are multiple diseases, including gingivitis, chronic adlt periodontitis, and other more aggressive forms of periodontitis, and requires the earliest possible recognition of these three disease categories. In this presentation, we discuss practical approach using PSR to diagnose, manage and refer the patients, to facilitate the separation of the simple from the complex and the predictable from the unpredictable form of periodontal diseases and to integrate diagnostic and therapeutic techniques into private practice today.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.19 no.1
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• pp.20-25
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• 2019

Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.