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Precision Medicine in Head and Neck Cancer (두경부암에서 정밀의료)

  • Hye-sung Park;Jin-Hyoung Kang
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.1
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    • pp.1-9
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    • 2023
  • Technological advancement in human genome analysis and ICT (information & communication technologies) brought 'precision medicine' into our clinical practice. Precision medicine is a novel medical approach that provides personalized treatments tailored to each individual by precisely segmenting patient populations, based on robust data including a person's genetic information, disease information, lifestyle information, etc. Precision medicine has a potential to be applied to treating a range of tumors, in addition to non-small cell lung cancer, in which precision oncology has been actively practiced. In this article, we are reviewing precision medicine in head and neck cancer (HNC) with focus on tumor agnostic biomarkers and treatments such as NTRK, MSI-H/dMMR, TMB-H and BRAF V600E, all of which were recently approved by U.S. Food and Drug Administration (FDA).

The neutral zone approach for restoration of patient with severe mandibular ridge resorption: A case report (하악 치조제가 심하게 흡수된 환자에서 중립대 인상을 통한 총의치 수복 증례)

  • Cheol Namgung
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.1
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    • pp.8-15
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    • 2023
  • In case with severely atrophied mandibular ridges, it may be difficult to achieve adequate retention and stability of dentures through the normal functional impression process of complete dentures. In these patients, an approach using the neutral zone raising technique may be an effective alternative. The neutral zone is defined as the area where the pressure of the tongue towards the outside of the mouth and the pressure of the cheek and lips towards the inside are balanced during the normal oral function of the muscular-nervous system. Complete dentures made through neutral zone impression not only improve retention and stability, but also provide adequate tongue space in the posterior teeth area. Additionally, food residues are reduced in the area around artificial teeth, and aesthetics are improved through appropriate facial support.

A Survey on Radiation Exposure of Patient in Mammography (유방 X선촬영 시 피폭선량에 대한 조사 연구)

  • Kim, Hyung-Chul;Cho, Pyung-Gon;Kim, Sung-Soo;Choi, Jong-Hak;Kim, You-Hyun
    • Journal of radiological science and technology
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    • v.27 no.4
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    • pp.55-60
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    • 2004
  • The purpose of this study was to examine both patient exposure dose during mammography and the utility status of mammograpy equipments. The data of this study were collected through questionnaire survey for 278 medical facilities registered at Korean Hospital Association and finally 161 medical facilities's data were analyzed. According to data analysis, medical facilities of 14.9% used the average glandular dose of less than 0.5 mGy, $0.51{\sim}1.0\;mGy$ 8.6%, $1.01{\sim}1.5\;mGy$ 14.9%, $1.51{\sim}2.0\;mGy$ 11.1%, $2.01{\sim}2.5\;mGy$ 9.8%, $2.51{\sim}3.0\;mGy$ 33.3%, and 7.4% more than 3.01 mGy. It was found that medical facilities of 92.6% used less than 3 mGy, showing that this figure is similar to the limit value of 3 mGy recommended by Korea Food & Drug Administration(KFDA). Recently, international organizations such as ICRP associated with radiation protection suggests that less than 3 mGy of average mammary gland dose be used during mammography in case of using Mo target+Mo filter, film/screen system and craniocaudal projection with the breast pressed to 4.2 cm. The standard dose is being strictly observed and that of the limits is going down to 2 mGy or 1.5 mGy. The major results of this study indicate that interests and a counterplan to reduce patient dose during mammography should be considered. Based on this study, the authors of this study will continue to measure exposure dose to set a new standard for patient exposure dose during mammography.

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Study on the Effect of Chicken Egg Containing IgY against Helicobacter pylori (항헬리코박터 IgY 항체의 위염(위궤양) 치료효과에 관한 연구)

  • 배만종;김수정;김병기;박창호;서정일;김욱년;장태정;권상호
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.8
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    • pp.1357-1363
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    • 2003
  • This study was conducted to investigate the effect of chicken egg containing IgY against H. pylori in patients with gastritis. Sixty three H. pylori-infected volunteers (20∼43 year, Male Female=49 : 14) were randomized into four groups which were treated with one chicken egg containing IgY b.i.d. (IgY group; n=17) or omeprazole 20 mg b.i.d., amoxicillin 1.0 g b.i.d. and clarithromycin 500 mg b.i.d. (OAC group; n=17) or omeprazole 20 mg b.i.d., amoxicillin 1.0 g b.i.d., clarithromycin 500 mg b.i.d. and one chicken egg containing IgY b.i.d. (OAC with IgY group; n=16) for 2 weeks or lyophilized IgY 1 g b.i.d (lyophilized IgY group) for 1 month. $\Delta$$^{13}$ $CO_2$ before and after treatment, the eradication rate of H. pylori and histologic change including H. pylori density, acute and chronic inflammation activity, intestinal metaplasia and glandular atrophy by updated sydney system were evaluated. Eradication rate of OAC with IgY group (94%) was higher than IgY group (0%), lyophilized IgY group (0%) and OAC group (88%). $\Delta$$^{13}$ $CO_2$at 2 weeks after treatment in one patient of IgY group was decreased. But that was not changed in the other patients. $\Delta$$^{13}$ $CO_2$ at 1 week after treatment in 15 patients of OAC with IgY group was significantly lower than pretreatment level (p<0.05), and $\Delta$$^{13}$ $CO_2$ at 1 week and 2 week after treatment was decreased in the other patient. Acute inflammation activity at antrum was significantly decreased after treatment in IgY and lyophilized IgY group (p<0.01), H. pylori density at antrum was significantly decreased after treatment in IgY and lyophilized IgY group (p<0.05). Chronic inflammation activity at body was decreased after treatment in lyophilized IgY group. Intestinal metaplasia and glandular atrophy at antrum and body were not changed after treatment in IgY group. Mild intestinal metaplasia in one patient of lyophilized IgY group changed to normal after 1 month treatment. Gandular atrophy at antrum and body were not changed after treatment in lyophilized IgY group.

Evaluation of Peri-procedural Anticoagulation Drug Therapy undergoing Radiofrequency Ablation in Patients with Atrial Fibrillation (심방세동 환자의 고주파 도자절제술 전.후의 항응고약물요법 사용실태 분석)

  • Kim, Su-Hyun;An, Sung-Shim;Kim, Soon-Joo;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.2
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    • pp.159-164
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    • 2010
  • Radiofrequency ablation (RA) is being used to manage atrial fibrillation (AF) with patients failed at the $1^{st}$-line anti-arrhythmic medications. Patients undergoing this procedure are at increased risk of thromboembolism after ablation, and anticoagulation management surrounding the ablation remains controversial. Although no conclusive recommendations can be made, published guidelines and data support therapeutic anticoagulation with warfarin. The purpose of this study was to analyze effectiveness of current therapy and to find factors fluctuate International Normalized Ratio (INR) values in patients undergone RA followed by anticoagulation service (ACS). Retrospective review was conducted utilizing database in a hospital. Among 110 patients under warfarin around ablation between January 2006 to September 2007, 54 patients were selected and allocated into 2 groups: Group A included 47 who discontinued warfarin after ablation, while 7 in B continued the medication. Information on demographics, amount and length of warfarin dosing, INR values and measuring frequencies, and the causing factors on INR fluctuation were abstracted. Differences were analyzed using chi-squared test, Fisher's Exact test, and unpaired Student t-test. Mean amount of warfarin before and after surgery was 4.0 mg, 4.1 mg in Group A and was 5.1 mg, 4.6 mg in Group B, respectively. Average duration of warfarin doing before ablation was 73.7 days in Group A, 129.9 days in B with no significant difference (p = 0.312). The duration time of warfarin on groups after ablation lasted several months. The number of checking INRs was 4.1 and 7.6, respectively. Inter-individual variability of INR fluctuations were $2.1{\pm}0.6$ in Group A and $2.2{\pm}0.7$ in B which were not significantly different (p = 0.062). 164 cases of decreased INR were: 'omission in taking medication, stressfulness and headache, 'increased intake of high vitamin K foods', 'lifestyle change of increased physical activities', and 'increase of food-intakes'. To the contrary, 36 cases of increased INR were: 'reduce of food-intake', 'use of non-prescription drugs', 'reduction in physical activities', and 'excessive restriction on food-intake', consecutively. In conclusion, the study validated therapeutic outcomes of RA patients who we treated with standard guideline and demonstrated 9 factors of INR fluctuations in the patient. A well-trained, pharmacist-monitored anticoagulation service could reduce the risk of adverse effects and prevent complications in patients with AF around RA operation.

Report for Spreading Culture of Medical Radiation Safety in Korea : Mainly the Activities of the Korean Alliance for Radiation Safety and Culture in Medicine(KARSM) (국내 의료 방사선 안전문화 활동 현황 : 의료방사선안전문화연합회 중심으로)

  • Yoon, Yong-Su;Kim, Jung-Min;Kim, Hyun-Ji;Choi, In-Seok;Sung, Dong-Wook;Do, Kyung-Hyun;Jung, Seung-Eun;Kim, Hyung-Soo
    • Journal of radiological science and technology
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    • v.36 no.3
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    • pp.193-200
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    • 2013
  • There are many concerns about radiation exposure in Korea after Fukushima Nuclear Plant Accident on 2011 in Japan. As some isotope materials are detected in Korea, people get worried about the radioactive material. In addition, the mass media create an air of anxiety that jump on the people's fear instead of scientific approach. Therefore, for curbing this flow, health, medical institute from the world provide a variety of information about medical radiation safety and hold the campaign which can give people the image that medical radiation is safe. At this, the Korean Food and Drug Administration(KFDA) suggested that make the alliance of medical radiation safety and culture on August, 2011. Seven societies and institutions related medical radiation started to research and advertise the culture of medical radiation safety in Korea. In this report, mainly introduce the activities of the Korean Alliance for Radiation Safety and Culture in Medicine(KARSM) for spreading culture of medical radiation safety from 2011 to 2012.

A Factor Analysis Study on Blood Glucose Control in Diabetics Mellitus Patients(1) -Focus on Blood Glucose Control and Lifestyle Factors- (당뇨환자의 혈당관리 태도에 대한 요인분석(I) - 혈당관리 요소와 식생활 태도를 중심으로 -)

  • Jun, Jung-Eun;Lee, Young-Mee;Oh, Yu-Jin
    • Korean Journal of Community Nutrition
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    • v.14 no.2
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    • pp.236-244
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    • 2009
  • Dietary therapy is a basic and emphasized treatment for diabetes. Several clinical studies have shown that diet can play a major role in preventing and managing diabetes. The purposes of this study were to evaluate the dietary behavior and to find solutions to barriers of diabetes mellitus patients. From February to July in 2007, questionnaires were distributed to one hundred and ten patients who were diagnosed DM by physicians and excluded first coming out-patients. One hundred and three data were used for statistical analysis using SPSS/Win 12.0. The main results of this study included the following: To measure dietary behaviors and barriers, a five point scale was used with the following labels: 'strongly yes', 'yes', 'fair', 'no', 'strongly no'. Thirteen dietary behaviors related to diabetes were grouped into the following 4 factors using factor analysis; 'taste control factor', 'blood glucose influence factor', 'practice volition factor', and 'exercise factor'. The mean scores of 4 factors were 3.88, 3.48, 3.55, 3.21, respectively. The 'taste control behaviors' score of subjects who had practiced diet therapy(4.00) was higher than those who had not practiced diet therapy(P<0.05). The 'blood glucose influence behaviors' score of subjects who had nutrition education(3.59) was higher than those who had no nutrition education(P<0.05) and subjects who had practiced diet therapy showed higher score(3.59) than those who had not practiced diet therapy(P<0.05). 'Exercise behaviors score' of subjects who were over 60(3.59) was the lowest(P<0.05). Subjects who had nutrition education showed higher 'exercise behaviors' scores(3.38) than those who had no nutrition education(P<0.05). Subjects who had practiced diet therapy showed higher 'practice volition behaviors' scores(3.72) than those who had not practiced diet therapy(P<0.001). Subjects who were over weight showed the highest 'practice volition behaviors' scores(3.78) concerning BMI(P<0.05). In conclusion, this study expected that Nutrition educators(Dietitian) applied to patient effective nutrition education and counseling through evaluation of Dietary behaviors and barriers considered management types and ecological factors of diabetes patients. Also diabetic patients were easy to change dietary habits because they formed behaviors through education and counsel and there were positive effects in their blood glucose control through removing barriers related to dietary therapy.

A Study on Correlation between Blood Pressure and Na, K Intakes Pattern in the Family Members of Normal and Hypertension Patients (고혈압 환자 가족과 정상인에 있어서 혈압과 Na, K 섭취간의 상관관계)

  • Choe, Myeon;Kim, Jong-Dai;Kim, Sung-Sil
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.6
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    • pp.1045-1049
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    • 1996
  • Purpose of this study was to investigate correlation between blood pressure(systolic and diastolic) and dietary Na, K intake pattern in the family members of normal and hypertension disease patients, besides patients themselves. Mean values of $systolic(126.6\pm18.0$ vs $119.3\pm17.2mmHg)$ and diastolic $(77.6\pm14.6$ vs $71.6\pm12.5mmHg)$ blood pressure in the family members of hypertension patients were significantly higher than those of normal subjects. Systolic blood pressure in normal subject group was positively correlated with age, body weight, sodium in soybean paste, and was negatively correlated with potassium in hotpepper paste, soybean paste and meats. Systolic blood pressure in the family member of hypertension patient was positively correlated with age, body weight, sodium in soybean Paste, and table salt intake, but urinary potassium excretion was negatively correlated. Diastolic blood pressure was positively correlated with age, body weight, and table salt intake, and was negatively correlated with potassium in hotpepper paste and soybean paste in normal subjects groups. In the family members of hypertension patients group, diastolic blood pressure was positively correlated with age, body weight, and table salt intake, and was negatively correlated with sodium in hotpepper Paste and soybean paste and urinary potassium excretion. In total, tendency of negative correlation between Na intake pattern and systolic blood pressure in normal subjects was much obvious than that in the family members of hypertension patients. Urinary potassium excretion in the family members of hypertension patients was also negatively correlated with both systolic and diastolic blood pressure.

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Mineral Imbalance: Bone Decalcification and Soft Tissue Calcification (무기질 불균형: 골 탈석회화와 연조직 석회화)

  • Jeong, Dae-Won;Lim, Hyun-Sook;Kang, Young-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.12
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    • pp.1815-1819
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    • 2009
  • Based on the soft and rigid extents, tissues are mainly divided into two groups in mammals, soft tissues including heart, lung, kidney and brain, and hard tissues including tendon, cartilage, teeth and bone. Among various tissues, bone, a dynamic rigid organ, is continuously remodeled by the opposing functional activity between bone formation by osteoblasts and bone destruction by osteoclasts. Bone protects the soft tissues and provides mineral reservoirs, which can supply the mineral needs of other soft tissues to normally maintain cellular function. While calcification in bone is an important action to fundamentally support the body and protect the soft tissues, calcification in soft tissues, including the heart, aorta, kidney, lung and spleen, results in severe organ damages, eventually causing sudden death. A growing body of evidence indicates that the osteoporotic patient who are aging, post-menopausal, diabetes and chronic kidney disease simultaneously represent a high clinical incidence of soft tissue calcification, illustrating a link between soft tissue calcification and bone decalcification (osteoporosis). This study will review what is currently known about the connection between bone decalcification and soft tissue calcification.

Determination of Self-Disposal date by the Analysis of Radioactive Waste Contamination for 1131I Therapy Ward (131I 치료입원실 폐기물 방사능 오염도 분석 및 자체처분가능일자 산출)

  • Kim, Gi-sub;Jung, Haijo;Park, Min-seok;Jeon, Gjin-seong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.3-6
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    • 2013
  • Purpose: The treatment of thyroid cancer patients was continuously increased. According to the increment of thyroid cancer patients, the establishment of iodine therapy site was also increased in each hospital. This treatment involves the administration of radioactive iodine, which will be given in the form of a capsule. Therefore, protections and managements for radioactive source pollution and radiation exposure should be necessary for radiation safety. Among the many problems, the problem of disposing the radioactive wastes was occurred. In this study, The date for self-disposal for radioactive wastes, which were contaminated in clothes, bedclothes and trash, were calculated. Materials and Methods: The number of iodine therapy ward was 15 in Korea Institute of Radiological Medical and Sciences. Recently, 8 therapy wards were operated for iodine therapy patients and others were on standby for emergency treatment ward of any radiation accidents. Radioactive wastes, which were occurred in therapy ward, were clothes, bedclothes, bath cover for patients washing water and food and drink which was leftover by patients. Each sample was hold into the marinelli beaker (clothes, bedclothes, bath covers) and 90 ml beaker (food, drink, and washing water). The activities of collected samples were measured by HpGe MCA device (Multi Channel Analysis, CANBERRA, USA) Results: The storage period for the each kind of radioactive wastes was calculated by equation of storage periods based on the measurement outcomes. The average storage period was 60 days for the case of clothes, and the maximum storage period was 93 days for patient bottoms. The average storage period and the maximum storage period for the trash were 69 days and 97 days, respectively. The leftover foods and drinks had short storage period (the average storage period was 25 days and maximum storage period was 39 days), compared with other wastes. Conclusion: The proper storage period for disposing the radioactive waste (clothes, bedclothes and bath cover) was 100 days by the regulation on self-disposal of radioactive waste. In addition, the storage period for disposing the liquid radioactive waste was 120 days. The current regulation for radioactive waste self-disposing was not suitable for the circumstances of each radioactive therapy facility. Therefore, it was necessary to reduce the leftover food and drinks by adequate table setting for patients, and improve the process and regulation for disposing the short-half life radioactive wastes.

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