• Journal of Ginseng Research
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• 제34권2호
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• pp.122-131
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• 2010

This clinical study was performed to evaluate whether supplementation of proton pump inhibitor (PPI)-based triple therapy with Korean red ginseng can enhance Helicobacter pylori (H. pylori) eradication and reduce levels of halitosis-associated volatile sulfur compounds (VSCs) in the stomach. Seventy-six patients were randomized into an eradication regimen-only group (n=45) or an eradication regimen plus 10 weeks of Korean red ginseng supplementation group (n=31). The eradication regimen consisted of PPI b.i.d., clarithromycin 500 mg b.i.d., and amoxicillin 1 g b.i.d.. for seven days. Korean red ginseng supplementation commenced on the last day of the eradication regimen. $^{13}C$-urea breath test and halimeter measurements were performed prior to protocol repetition. By intention-to-treat analysis, the H. pylori eradication rate in the Korean red ginseng group (77.4%, 24 of 31) was higher than that in the control group (45.0%, 26 of 45). However, by per protocol analysis, the eradication rate in the Korean red ginseng group was significantly higher than that in the control group (92.3%, 24/26 vs. 69.4%, 26/38; p<0.05). H. pylori infection was significantly associated with increased VSC levels. However, VSC levels decreased significantly in the Korean red ginseng group (p<0.05). In conclusion, supplementation of triple therapy with Korean red ginseng increased the H. pylori eradication rate and led to significant reductions in VSC levels, suggesting the usefulness of this substance in combating H. pylori infection.

• 한국임상약학회지
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• 제27권2호
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• pp.77-82
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• 2017

Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or $H_2$ blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.

• 대한후두음성언어의학회지
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• 제32권3호
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• pp.130-134
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• 2021

Background and Objectives Voice therapy (VT) is considered to be the gold standard of treatment of vocal fold nodule in children. This study was designed to analyze the success rate of pediatric VT and investigate the predictive factors for good response of periatic VT for vocal fold nodule. Materials and Method This was a retrospective cohort study of 23 patients under 18 years old who were diagnosed with vocal fold nodule and received pediatric VT. We divided the patients into responding and non-responding groups. We analyzed clinical and voice parameters related to the voice results. Results Twelve patients showed improved findings after VT. By univariate analysis, female patients (85.7%) and adolescence children (100%) showed a good response to VT. In multivariate analysis, female sex (p<0.05) and adolescence children (p<0.05) were significantly related to a successful voice response. Proton pump inhibitor or antihistamine, mucolytics treatment and pre-VT voice parameters did not significantly influence voice outcomes. Conclusion Pediatric VT is more effective in female and adolescence children.

• Radiation Oncology Journal
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• 제36권1호
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• pp.25-34
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• 2018

Purpose: This study aimed to evaluate the initial outcomes of proton beam therapy (PBT) for hepatocellular carcinoma (HCC) in terms of tumor response and safety. Materials and Methods: HCC patients who were not indicated for standard curative local modalities and who were treated with PBT at Samsung Medical Center from January 2016 to February 2017 were enrolled. Toxicity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Tumor response was evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST). Results: A total of 101 HCC patients treated with PBT were included. Patients were treated with an equivalent dose of $62-92GyE_{10}$. Liver function status was not significantly affected after PBT. Greater than 80% of patients had Child-Pugh class A and albumin-bilirubin (ALBI) grade 1 up to 3-months after PBT. Of 78 patients followed for three months after PBT, infield complete and partial responses were achieved in 54 (69.2%) and 14 (17.9%) patients, respectively. Conclusion: PBT treatment of HCC patients showed a favorable infield complete response rate of 69.2% with acceptable acute toxicity. An additional follow-up study of these patients will be conducted.

• Journal of Gastric Cancer
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• 제17권2호
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• pp.120-131
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• 2017

Purpose: Tumor bleeding is a major complication in inoperable gastric cancer. The study aim was to investigate the effects of proton pump inhibitor (PPI) treatment for the prevention of gastric tumor bleeding. Materials and Methods: This study was a prospective double-blind, randomized, placebo-controlled trial. Patients with inoperable gastric cancer were randomly assigned to receive oral lansoprazole (30 mg) or placebo daily. The primary endpoint was the occurrence of tumor bleeding, and the secondary endpoints were transfusion requirement and overall survival (OS). Results: This study initially planned to enroll 394 patients, but prematurely ended due to low recruitment rate. Overall, 127 patients were included in the analyses: 64 in the lansoprazole group and 63 in the placebo group. During the median follow-up of 6.4 months, tumor bleeding rates were 7.8% and 9.5%, in the lansoprazole and placebo groups, respectively, with the cumulative bleeding incidence not statistically different between the groups (P=0.515, Gray's test). However, during the initial 4 months, 4 placebo-treated patients developed tumor bleeding, whereas there were no bleeding events in the lansoprazole-treated patients (P=0.041, Gray's test). There was no difference in the proportion of patients who required transfusion between the groups. The OS between the lansoprazole (11.7 months) and the placebo (11.0 months) groups was not statistically different (P=0.610). Study drug-related serious adverse event or bleeding-related death did not occur. Conclusions: Treating patients with inoperable gastric cancer with lansoprazole did not significantly reduce the incidence of tumor bleeding. However, further studies are needed to evaluate whether lansoprazole can prevent tumor bleeding during earlier phases of chemotherapy (ClinicalTrial.gov, identifier No. NCT02150447).

• 한국방사선학회논문지
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• 제18권1호
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• pp.1-9
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• 2024

양성자 치료는 브래그 피크로 인해 우수한 치료 기법으로 알려져 있다. 양성자의 치료 효과를 높이기 위해 금 나노입자를 종양에 분포시켜 흡수선량을 높이는 방법이 연구되고 있다. 마이크로미터와 나노미터 범위에서 금 나노입자를 다루었던 것을 밀리미터 범위에서 금 나노입자를 전산모사 할 수 있는 방법을 제시하였다. 전산모사를 위해 Geant4 툴킷을 사용하였다. 인체와 유사한 물과 금 나노입자가 균일하게 분포되어 있다는 것을 가정하고 밀도비를 통해 금 나노입자의 개수 또는 농도를 조절하였다. 브래그 피크 위치에서 밀도비가 5%일 때 금 나노입자로 인해 순수 물 팬텀에 비해 흡수 에너지의 이득이 거의 2배로 나타났다. 밀도비가 증가할수록 흡수 에너지의 이득은 선형적으로 증가하였다. 브래그 피크 위치에서 금 나노입자가 하나의 복셀에만 분포하고 있을 때 양성자의 에너지는 자신 주변의 복셀에만 영향을 미치지만, 넓은 영역에 금 나노입자가 분포하는 경우 순수 물 팬텀에서 최고 흡수 에너지 (9.95 keV)의 95% 흡수 에너지 (9.46 keV)를 나타내는 부피는 16배 큰 영역에서 흡수 에너지의 이득이 나타났다. 그리고 이 영역은 밀도비가 증가할수록 증가하였다. 밀리미터 범위에서 금 나노입자의 밀도비와 RBE의 관계를 정량화하는 등 추가적인 연구가 필요하다.

• 대한방사선치료학회지
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• 제17권1호
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• pp.41-43
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• 2005

목적 : 자체 제작한 Q.A tool을 이용하여 AAPM Task Group Report No.66 에서 제시하는 CT simulator의 Q.A 항목을 확인하여 보다 안전하고 정확한 CT-simulation 과정을 확보하기 위해 효율적이고 편리성을 갖춘 정도관리 과정을 제시하고자 한다. 대상 및 방법 : 본원에 CT simulator의 Q.A tool을 제작하여 Report of the AAPM Task Group No.66에서 제시하는 wall laser system, patient table, CT scanner의 imaging plane의 isocenter간의 정렬을 일간 단위로 확인한다. 결과 : Report of the AAPM Task Group No.66에서 제시하고 있는 정도관리 항목의 확인으로 wall laser의 ${\pm}\;2mm$, table의 ${\pm}\;2mm$, imaging plane의 ${\pm}\;2mm$ 허용 오차 범위내의 측정치를 확인하였다. 결론 : 방사선 치료을 위한 CT-simulation 과정에서 기존의 진단 영역의 CT Q.A protocol로는 확인되지 않는 항목이 있는데, Report of the AAPM Task Group No.66에서 제시하고 있는 Q.A 항목을 확인하여 방사선 치료전용 CT-simulator 장비의 적절한 정도 관리를 기하여 안전하고 정확한 CT-simulation 과정을 보장받을 수 있었다.

• 대한후두음성언어의학회지
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• 제19권2호
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• pp.128-132
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• 2008

Background: Laryngeal contact granuloma is an inflammatory hypertrophic granulation tissue arising at around the vocal process of arytenoid cartilage. Various approaches are currently used for the treatment, but a solid guideline has not been established. Objectives: We aimed to compare the each treatment modality in the hope of suggesting a guideline for the successful management of laryngeal contact granuloma. Method: Eighty-seven treatment cases of 56 patients were analyzed. Cases having recent intubation history were excluded from the study. All patients received vocal hygiene education. Proton pump inhibitors (PPI, N = 33) or H2 receptor antagonists ($H_{2}RA$, N =26) were used as a first-line treatment. Among the non-responders to $H_{2}RA$, 11 cases received PPI as a second-line therapy. Eight cases received botulinum toxin injection and 9 cases had laryngomicrosurgical removal. Results: As an initial therapy, response rate to PPI and $H_{2}RA$ was 60.6% and 38.5% respectively, which was not statistically different (p=0.091). Response rate of PPI as the second-line therapy was 36.3% (p=0.162 when compared to that of first-line PPI therapy). Response rate of Botulinum toxin injection was 75%. All cases of surgical removal recurred in a relatively short period (mean 1.9months). Conclusion: In patients having laryngeal contact granuloma, combined therapy with vocal hygiene education and PPI medication would provide more than 60% of therapeutic response. Botulinum toxin injection is highly effective even in non-responders to antireflux therapy. The only indications of surgery are to resolve diagnostic doubt or to treat acute airway compromise.

• 한국의학물리학회지:의학물리
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• 제23권4호
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• pp.209-218
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• 2012

최근 방사선치료기기 및 방사선치료기술이 빠르게 발전하고 복잡해짐에 따라 방사선치료의 신뢰성을 높이고 정확한 환자 치료와 환자 및 치료관련 종사자의 방사선안전을 확보하기 위하여 자격있는 의학물리사 적정 인원에 대한 재평가가 이루어지고 있다. 방사선치료분야에서 의학물리사의 적정한 인원수준에 대하여 외국의 연구사례 및 결과에 대해 미국과 유럽을 중심으로 분석하였다. 또한 외국연구결과를 토대로 국내에 필요한 의학물리사의 적정 인원을 간접적으로 계산해 보았다. 국내 중대형 6개 병원의 현재 의학물리사 적정 인원은 국제적 적정 권고 인원의 50% 이하였다. 더욱 더 객관적인 의학물리사의 필요 인원수를 예측하기 위하여는 국내 여건에 적합한 추가적인 연구가 요구되며, 특히 지속적으로 증가되고 있는 입자방사선치료를 고려한 인원수 예측이 필요하다.

• BMB Reports
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• 제51권11호
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• pp.584-589
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• 2018

Secondary prevention via earlier detection would afford the greatest chance for a cure in premalignant lesions. We investigated the exomic profiles of non-malignant and malignant changes in head and neck squamous cell carcinoma (HNSCC) and the genomic blueprint of human papillomavirus (HPV)-driven carcinogenesis in oropharyngeal squamous cell carcinoma (OPSCC). Whole-exome (WES) and whole-genome (WGS) sequencing were performed on peripheral blood and adjacent non-tumor and tumor specimens obtained from eight Korean HNSCC patients from 2013 to 2015. Next-generation sequencing yielded an average coverage of $94.3{\times}$ for WES and $35.3{\times}$ for WGS. In comparative genomic analysis of non-tumor and tumor tissue pairs, we were unable to identify common cancer-associated early mutations and copy number alterations (CNA) except in one pair. Interestingly, in this case, we observed that non-tumor tonsillar crypts adjacent to HPV-positive OPSCC appeared normal under a microscope; however, this tissue also showed weak p16 expression. WGS revealed the infection and integration of high-risk type HPV16 in this tissue as well as in the matched tumor. Furthermore, WES identified shared and tumor-specific genomic alterations for this pair. Clonal analysis enabled us to infer the process by which this transitional crypt epithelium (TrCE) evolved into a tumor; this evolution was accompanied by the subsequent accumulation of genomic alterations, including an ERBB3 mutation and large-scale CNAs, such as 3q27-qter amplification and 9p deletion. We suggest that HPV16-driven OPSCC carcinogenesis is a stepwise evolutionary process that is consistent with a multistep carcinogenesis model. Our results highlight the carcinogenic changes driven by HPV16 infection and provide a basis for the secondary prevention of OPSCC.