• Radiation Oncology Journal
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• v.10 no.2
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• pp.219-225
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• 1992

Fifty patients with carcinoma of the uterine cervix received curative radiotherapy by external irradiation of the whole pelvis and intracavitary radiation at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital from September, 1983 to October, 1986. External beam whole pelvic irradiation was done first up to 4500-5940 cGy in 5 weeks to 6.5 weeks, followed by an intracavitary radiation. Total dose of radiation to point A varied from 6500 cGy to 11344 cGy (average 6764 cGy). Of the 50 patients, one patient was lost to follow up and follow up period of the remaining 49 patients ranged from 3 months to 93 months (median 32 months). According to FIGO classification, 6 ($12.2\%$) were in stage Ib, 6 ($12.2\%$) in stage IIa, 25 ($51\%$) in stage IIb, 7 ($14\%$) in stage III, and 5 ($10.2\%$) in stage IV. Age of the patients ranged from 33 to 76 years (median 60 years). Pathologically, fourty six ($94\%$) patients had squamous cell carcinoma, 2 ($4\%$) had adenocarcinoma, and 1 ($2\%$) had adenosquamous cell carcinoma. Overall response rate was $84\%$. 5-year survival rate was $49\%$ for entire group ($75\%$ for stage Ib, $83\%$ for Stage IIa, $42.5\%$ for stage IIb, $25\%$ for stage III, $40\%$ for stage IV). Complications were observed in 11 ($22.4\%$) patients, who revealed rectal complications with most common frequency. Others were self limiting trifle ones such as wet desquamation, fatigue, mild leukopenia, etc. The correlation of the survival rate with various factors (age, dose, Hb level, pelvic lymph node status, performance status, local recurrence) was evaluated but showed no statistical significance except the age and local recurrence in this series; survival of patients less than 50 years of age was worse than that of the older, and the presence of local recurrence had worse prognosis (p<0.05).

• Proceedings of the Korean Society of Near Infrared Spectroscopy Conference
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• 2001.06a
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• pp.1031-1031
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• 2001

The mammary gland is made up of remarkably sensitive tissue, which has the capability of producing a large volume of secretion, milk, under normal or healthy conditions. When bacteria enter the gland and establish an infection (mastitis), inflammation is initiated accompanied by an influx of white cells from the blood stream, by altered secretory function, and changes in the volume and composition of secretion. Cell numbers in milk are closely associated with inflammation and udder health. These somatic cell counts (SCC) are accepted as the international standard measurement of milk quality in dairy and for mastitis diagnosis. NIR Spectra of unhomogenized composite milk samples from 14 cows (healthy and mastitic), 7days after parturition and during the next 30 days of lactation were measured. Different multivariate analysis techniques were used to diagnose the disease at very early stage and determine how the spectral properties of milk vary with its composition and animal health. PLS model for prediction of somatic cell count (SCC) based on NIR milk spectra was made. The best accuracy of determination for the 1100-2500nm range was found using smoothed absorbance data and 10 PLS factors. The standard error of prediction for independent validation set of samples was 0.382, correlation coefficient 0.854 and the variation coefficient 7.63%. It has been found that SCC determination by NIR milk spectra was indirect and based on the related changes in milk composition. From the spectral changes, we learned that when mastitis occurred, the most significant factors that simultaneously influenced milk spectra were alteration of milk proteins and changes in ionic concentration of milk. It was consistent with the results we obtained further when applied 2DCOS. Two-dimensional correlation analysis of NIR milk spectra was done to assess the changes in milk composition, which occur when somatic cell count (SCC) levels vary. The synchronous correlation map revealed that when SCC increases, protein levels increase while water and lactose levels decrease. Results from the analysis of the asynchronous plot indicated that changes in water and fat absorptions occur before other milk components. In addition, the technique was used to assess the changes in milk during a period when SCC levels do not vary appreciably. Results indicated that milk components are in equilibrium and no appreciable change in a given component was seen with respect to another. This was found in both healthy and mastitic animals. However, milk components were found to vary with SCC content regardless of the range considered. This important finding demonstrates that 2-D correlation analysis may be used to track even subtle changes in milk composition in individual cows. To find out the right threshold for SCC when used for mastitis diagnosis at cow level, classification of milk samples was performed using soft independent modeling of class analogy (SIMCA) and different spectral data pretreatment. Two levels of SCC - 200 000 cells/$m\ell$ and 300 000 cells/$m\ell$, respectively, were set up and compared as thresholds to discriminate between healthy and mastitic cows. The best detection accuracy was found with 200 000 cells/$m\ell$ as threshold for mastitis and smoothed absorbance data: - 98% of the milk samples in the calibration set and 87% of the samples in the independent test set were correctly classified. When the spectral information was studied it was found that the successful mastitis diagnosis was based on reviling the spectral changes related to the corresponding changes in milk composition. NIRS combined with different ways of spectral data ruining can provide faster and nondestructive alternative to current methods for mastitis diagnosis and a new inside into disease understanding at molecular level.

• Radiation Oncology Journal
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• v.29 no.2
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• pp.63-70
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• 2011

Purpose: To evaluate the extent of pain response and objective response to palliative radiotherapy (RT) for bone metastases from hepatocellular carcinoma according to RT dose. Materials and Methods: From January 2007 to June 2010, palliative RT was conducted for 103 patients (223 sites) with bone metastases from hepatocellular carcinoma. Treatment sites were divided into the high RT dose and low RT dose groups by biologically effective dose (BED) of 39 $Gy_{10}$. Pain responses were evaluated using the numeric rating scale. Pain scores before and after RT were compared and categorized into 'Decreased', 'No change' and 'Increased'. Radiological objective responses were categorized into complete response, partial response, stable disease and progression using modified RECIST (Response Evaluation Criteria In Solid Tumors) criteria; the factors predicting patients' survival were analyzed. Results: The median follow-up period was 6 months (range, 0 to 46 months), and the radiologic responses existed in 67 RT sites (66.3%) and 44 sites (89.8%) in the high and low RT dose group, respectively. A dose-response relationship was found in relation to RT dose (p=0.02). Pain responses were 75% and 65% in the high and low RT dose groups, respectively. However, no statistical difference in pain response was found between the two groups (p=0.24). There were no differences in the toxicity profiles between the high and low RT dose groups. Median survival from the time of bone metastases diagnosis was 11 months (range, 0 to 46 months). The Child-Pugh classification at the time of palliative RT was the only significant predictive factor for patient survival after RT. Median survival time was 14 months under Child-Pugh A and 2 months under Child-Pugh B and C. Conclusion: The rate of radiologic objective response was higher in the high RT dose group. Palliative AT with a high dose would provide an improvement in patient quality of life through enhanced tumor response, especially in patients with proper liver function.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.148-153
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• 2005

Purpose: To analyze the clinical result of the arthroscopic reduction and fixation for the displaced tibial spine fractures in children and report the utility of the arthroscopic treatment with the review of the literature. Methods: Between December 2000 and July 2004, five patients (average age 9.1 years) received an arthroscopic reduction and fixation of displaced tibial spine fracture. A male-to-female ratio was 3:2 and mean follow-up was 38.2$(13{\sim}56)$ months. All five patients were classified type III by Movers and McKeever classification. The average period from injury to operation was 4.8 days $(3{\sim}8days)$, the avulsed fragment was reduced by operative arthroscopy and fixated by pull-out suture in 3 patients and by cannulated screw in 2 patients. Postoperatively long leg cast was applied for 2 weeks, and then gradual range-of-motion exercise was permitted. Full weight-bearing ambulation was permitted after 6 weeks. The clinical evaluation was performed by range of motion, Lachman and pivot shift test, KT-1000 arthrometer, Lysholm knee score and the modified Feagin score. Results: All five patients had no symptom and recovered full range of motion of the affected knees. Lachman test was positive finding of 1+ laxity in one patient, the others were negative, and all patients were negative findings for pivot shift test. The result of KT-1000 arthrometric assessment is mean maximum side-to-side differences 1.9 mm. Average Lysholm knee score was 99.4. All patients had excellent results in modified Feagin score. Conclusion: Arthroscopic reduction and fixation of displaced tibial spine fracture in children showed excellent result without complication. Both pull-out suture fixation and cannulated fixation provide an effective treatment option for fixation of the displaced anterior tibial spine fracture.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.206-213
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• 2005

Purpose: To evaluate the outcome of symptomatic osteochondritis dissecans of the talus treated with arthroscopic debridement and multiple drilling. Materials and Methods: Between 1997 and 2003, 14 arthroscopic debridement(group I) and 15 arthroscopic multiple drilling(group II) were performed. There are 21 male and 8 female patients. Mean age was 34.4 years(33.8 years in group I, 37.5 years in group II) and average follow-up period was 43.2 months(46.4 months in group I, 40.1 months in group II). Simple radiographs and MRI were performed preoperatively and postoperatively, and the progressive stage of the lesions was evaluated through the arthroscopic surgery. Clinical results were evaluated with ankle-hindfoot scale and scoring scale for subjective and objective functional outcomes. The results were compared between 2 groups. Results: There are 20 medial(7 in group I, 13 in group II), 6 lateral(5 in group I, 1 in group II), and 3 both-side(2 in group I, 1 in group II) lesions. According to the classification of Berndt and Harty, there are 4 stage II(4 in group I, 0 in group II), 19 stage III(9 in group I, 10 in group II), and 6 stage IV(1 in group I, 5 in group II). According to the ankle-hindfoot score, the mean score was significantly improved $53.1{\pm}2.7$ points preoperatively to $85.1{\pm}8.5$ points postoperatively in group I and $54.6{\pm}6.8\;to\;80.7{\pm}8.5$ points group II. Subjective and functional scores was also improved $49.6{\pm}10.5$ points preoperatively to $84.6{\pm}7.7$ points postoperatively in group I and $50.7{\pm}9.2\;to\;83.0{\pm}9.6$ points in group II. But there were no statistical significance between them. Conclusion: Arthroscopic debridement and multiple drilling for the treatment of osteochondral lesions of the talus showed successful results and there was no statistically significant difference between them.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.24-30
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• 2003

Purpose: To clarify the results of simple bone cyst (SBC) treatment in children by percutaneous autologous bone marrow grafting and xenografting. Materials and Methods: We studied seven cases (4 males, 3 females) of SBC, which were treated by percutaneous autologous marrow and heterograft bone grafting from January 1996 to February 1999. Their mean age at surgery was 10 years (6 to 15), and the mean follow-up period was 35.6 months (20 to 52). Three cases were located in the proximal and middle humerus; three cases were in the proximal femur; and one case occurred in the ilium. Mean volume was 14.7 $cm^2$ (10 to 23). Six cases were active, and one was inactive. Five patients had a history of receiving a mean of 3.2 steroid injections. The mean quantity of bone marrow used in treatment was 14.3 ml (10 to 20), and the mean amount of $Lubboc^{(R)}$ heterograft bone (Transphyto S.A. Clermont Ferrand, France) used was 6.4 blocks (5 to 10). Results were analyzed using the modified Neer classification. Results: Five cases completely healed with obliteration of the cyst cavity (Grade IV). Two cases demonstrated sclerosis around a partially visible cyst (Grade III). All treatment results were satisfactory and without intraoperative or postoperative complications. Conclusione: Percutaneous autologous marrow and heterograft bone grafting is recommended as an effective treatment method for simple bone cyst. It offers ease of operative technique, a high rate of healing, a low recurrence rate, low morbidity, a low incidence of postoperative complications, and free from bone graft donor site problems.

• Journal of Korean Neurosurgical Society
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• v.29 no.11
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• pp.1437-1444
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• 2000

Objectives : Traditionally intracranial meningiomas are regarded as benign and curable tumors. About half of all intracranial meningiomas locate in the skull base region. However, surgical removal of these tumors may be challenging and require special considerations. Here general aspects of skull base meningiomas including clinical presentation, surgical approaches, complications and their recurrence rate are discussed based on our experiences. Methods : A retrospective analysis of 61 consecutive patients with skull base meningioma among 210 patients of meningioma between 1989 and 1998 were done. Results : There were 41 women and 20 men ranging from 13 to 74 years(mean 52 years). These tumors were divided into seven categories according to location : olfactory groove(n＝9), sphenoid ridge(n＝16), cavernous sinus(n ＝2), tuberculum sellae(n＝8), tentorium(n＝13), cerebellopontine angle(n＝12), and foramen magnum meningiomas (n＝1). Surgical approaches were selected on the basis of the tumor attachment, size and extension on preoperative radiologic findings. Total removal(Simpson grade I and II) was achieved in 50 cases(82%), and subtotal removal (Simpson grade III) in 11 patients(18%). According to WHO classification, there were 52 of cases of benign meningioma( 86%), 6 atypical cases(10%), and 3 malignant cases(5%). The most common postoperative complications were CSF leakage(23.0%) and cranial nerve injury(8.2%). Three patient died related with tumor(one was due to surgical complication and the other two due to recurrence) but three patients died from other systemic causes. Mean follow-up period was 51.7 months after surgery. Recurrence occurred in six patients(10.9%) ; three with tentorial meningioma, two with sphenoid ridge, and one in cerebellopontine angle. Conclusion : With advances in neuroradiology and microsurgical techniques, the surgical outcome of miningiomas has been markedly improved with acceptable morbidity and mortality rates. Overall, our surgical results of skull base meningiomas is comparable to other reports. Therefore, with the appropriate operative strategy and techniques, these tumors can be completely removed and good surgical results can be expected.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.33-38
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• 2009

Purpose: We wanted to report the clinical characteristics and arthroscopic findings of radial tear in medial meniscus posterior horn insertion, commonly occurs in patient over middle age with documentary review. Materials and Methods: Retrograde study using hospital records was done to 40 cases in 40 patients who visited our hospital and had been performed knee arthroscopic surgery due to medial meniscus posterior horn insertion tear between January, 2005 to April, 2007. Seven cases were male and 33 cases were female with the mean age of 61 (range, 47-80). Trauma history, stage of arthritis, period between pain and operation, MRI findings, clinical symptoms and operation methods were evaluated. Results : Six cases had trauma history while 34 cases didn't. In simple x-ray, using Kellgren-Lawrence classification, 31 cases were between stage 0 and II while 9 cases were stage III. In arthroscopic exam, there were 17 cases of Outerbridge grade IV, 4 cases of grade III, 9 cases of grade II, 9 cases of grade I. The mean duration of pain was 5.3 months. In MRI, at least one finding of cleft in axial or coronal view or ghost sign in sagittal view was found in all cases. The shape of meniscus tears were blunt in 18 cases, transverse in 12 and degenerative tear in 10. Subtotal meniscectomy was performed in 16 cases, partial meniscectomy in 10 cases and meniscal repair in 14 cases. Conclusion : Medial meniscus posterior horn insertion tear occurs in patients over middle age is rarely related to trauma history but causes painful mechanical symptom and usually accompany arthritis. Meniscectomy can be done for the treatment but repair can be considered is some cases. Further study on the treatment result will be needed.

• Herbal Formula Science
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• v.11 no.2
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• pp.1-18
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• 2003

The Theory for Monarch, Minister, Adjuvant and Dispatcher (or the Theory of Principal, Assistant, Adjuvant and Guiding Korean Oriental Herbal Medicines) has served as a standard principle for newly developed prescription formulas as well as established ones. Despite its significance, however, this theory hasn't been thoroughly studied and covered in the academic journals of Korean Oriental Herbal Medicines (KOHM) yet. This paper inquires into the origin of the theory while presenting the definitions and functions of Principal, Assistant, Adjuvant, and Guiding KOHM. In the end, the recommended doses and number of the KOHM comprising each of Principal, Assistant, Adjuvant, and Guiding KOHM are suggested. The compatibility theory of Principal, Assistant, Adjuvant, and Guiding KOHM can be traced back to the Warring States Period during which it was recorded in the treatise of the various schools of thoughts and their exponents. The theory was firmly established as a full system in ${\ulcorner}Shinnong's\;Pharmacopoeia{\lrcorner}\;and\;{\ulcorner}Yellow\;Emperor's\;Cannon\;of\;Internal\;Medicine{\lrcorner}$. While ${\ulcorner}Shinnong's\;Pharmacopoeia{\lrcorner}$ focuses on the classification of the properties of KOHM, ${\ulcorner}Yellow\;Emperor's\;Cannon\;of\;Internal\;Medicine{\lrcorner}$ mainly deals with the principles for writing prescriptions. In this regard, it is ${\ulcorner}Yellow\;Emperor's\;Cannon\;of\;Internal\;Medicine{\lrcorner}$ that systemized the Theory of Principal, Assistant, Adjuvant, and Guiding KOHM in a real sense. Principal KOHM aims at the causes of diseases and treat main symptoms. The doses are greater than Assistant, Adjuvant and Guiding KOHM. With their comprehensive effects, Principal KOHM is a leading ingredient of any prescription formula. Assistant KOHM are similar to Principal KOHM in its natures and flavors. Although its natures, flavors as well as efficacies may slightly differ from those of Principal KOHM, Assistant KOHM strengthens the therapeutic effects, jointly working with Principal KOHM. They mainly treat accompanying diseases and symptoms. Adjuvant KOHM is divided into two types: facilitator and inhibitor. Facilitators with the similar properties to those of Principal and Assistant KOHM help strengthen the therapeutic effects. Since they usually treat accompanying symptoms or secondary accompanying symptoms (minor accompanying symptoms), there are two kinds of facilitators. (1) The first kind of facilitators assists Principal KOHM, targeting accompanying symptoms. (2) The second ones supporting Assistant KOHM are for accompanying or secondary accompanying symptoms (or minor accompanying symptoms). Inhibitors counteract and thereby complement Principal and Assistant KOHM. Some of them inhibit the side effects or toxicity of Principal KOHM for the sake of the safety of the whole prescription formula while the others generate induced interactions. Guiding KOHM can be used for two purposes: guiding and mediating. The Guiding KOHM for the former purpose leads the other KOHM in a prescription formula to the lesion. But, the Guiding KOHM for mediating coodinate and harmonize all the ingredients in a prescription formula. The number of KOHM for those Principal, Assistant, Adjuvant and Guiding KOHM and their doses are different, depending on the types of prescriptions: classical prescriptions, prescriptions after ${\ulcorner}$Treatise of Cold-Induced Diseases${\lrcorner}$ and prescriptions of Sasang Constitutions Medicines. In the case of the prescriptions after ${\ulcorner}$Treatise of Cold-Induced Diseases${\lrcorner}$, it is highly recommended to follow the view of ${\ulcorner}$Thesaurus of Korean Oriental Medicine Doctors in Chosun Dynasty${\lrcorner}$ for the number of KOHM to be used. For the doses, however, ${\ulcorner}$Elementary Course for Medicine${\lrcorner}$, is found to be more accurate. The most appropriate number of KOHM per prescription is 11-13. To be more specific, for one prescription formula, it is recommended to administer one kind of KOHM for Principal KOHM, 2-3 for Assistant KOHM, 3-4 for Adjuvant KOHM and 5 for Guiding KOHM. As for the proportion of the doses, when 10 units are to be administered for Principal KOHM in a formula, the doses for the other three should be 7-8 units for Assistant KOHM, 5-6 for Adjuvant KOHM and 3-4 for Guiding KOHM. The doses of the KOHM added to or taken out of the prescription correspond to those of Adjuvant and Guiding KOHM.

• Radiation Oncology Journal
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• v.13 no.2
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• pp.191-198
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• 1995

Purpose: This analysis was to compare the result of radiation alone and chemoradiation in cervical cancer in terms of response, survival, failure, and complication. Materials and Methods: A retrospective analysis of 135 cervical cancer patients treated with definitive radiotherapy from November 1985 to December 1991 was performed. Fifty-six patients were treated with radiation alone and 79 patients were treated with cisplatin-based chemotherapy plus radiation. Follow-up period ranged from 5 to 105 months with a median 47 months. According to the FIGO classification, the patients were subdivided into 18 $(13.3\%)$ stage IB, 7 $(5.2\%)$ stage IIA, 97 $(71.9\%)$ stage IIB, and 9 $(6.7\%)$ stage IIIB. Results: A complete response was noted in 51 patients $(91.1\%)$ of the radiation alone group, and 68 patients $(86.1\%)$ of the chemoradiation group. There was no statistical difference in complete response rate between the two groups. Overall survival rate at 5 years was $73.3\%$. According to stage, overall survival rates at 5 years were $88.9\%$ in stage IB, $85.7\%$ in stage IIA, $73.8\%$ in stage IIB, and $37.5\%$ in stage IIIB, respectively. According to treatment modality, overall survival rates at 5 years were $81.9\%$ in the radiation alone group, $67.0\%$ in the chemoradiation group (p=0.22). Disease-free survival rate at 5 years were $70.4\%$ in the radiation alone group. $68.5\%$ in the chemoradiation group (p=0.85) Locoregional control rates at 5 years were $76.1\%$ in the radiation alone group, $73.8\%$ In the chemoradiation group (p=0.70). Distant disease-free survival rates at 5 years were $83.9\%$ in the radiation alone group, $90.3\%$ in the chemoradiation group (p=0.59). Treatment-related bone marrow suppressions were noted in 3 $(5.4\%)$ patients of the radiation alone group, 14 patients $(17.7\%)$ of the chemoradiation group (p(0.05). Grade 2 vesical complications were noted in 14 patients of the radiation alone group. and 10 Patients of the chemoradiation group. Grade 2 rectal complications were noted in 2 patients of the radiation alone group, and 3 Patients of the chemoradiation group. One case of rectal perforation was noted in the chemoradiation group, and grade 2 small bowel obstructions were noted in 2 patients of the radiation alone group. There were no statistical differences in the incidence of vesicar, rectal, and small bowel complicaions between the two groups. Conclusion: No statistical difference was found between the radiation alone group and the chemoradiation group in terms of response, survival, and failure. but the incidence of bone marrow suppression was higher in the chemoradiation group.