• Archives of Plastic Surgery
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• v.34 no.2
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• pp.209-216
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• 2007

Purpose: The ischial area is by far the most common site of pressure sores found in wheel chair bound paraplegic patients, because greatest pressure is exerted from the body on this area in a sitting position. Even after a series of successful pressure sore treatments, the site is very prone to relapse by the simplest ordinary tasks of everyday life. Therefore, it is crucial to preserve the main pedicle during primary surgery. Various surgical procedures employed to treat pressure sores such as myocutaneous flap and perforator flap have been introduced. After introduction of ischial sore treatment using the inferior gluteal artery perforator (IGAP) has been made, the authors experienced favorable clinical results of patients who have undergone IGAP flap procedure in a three year time period. Methods: A total of 17 patients received IGAP flap surgery in our hospital from January 2003 to May 2006, among which 14 of them being males and 3 females. Surgery was performed on the same site again in 6(35%) patients who had originally relapsed after receiving the conventional method of pressure sore surgery. Patients' average age was 49.4(27-71) years old. Most of the patients were paraplegic(11 cases, 65%) and others were either quadriplegic(4 cases, 23%) or ambulatory(2 cases, 12%). Based on hospital records and clinical photographs, we have attempted to assess the feasibility and practicability of the IGAP flap procedure through comparative analysis of several parameters: size of defective area, treatment modalities, occurrence of relapses, complications, and postoperative treatments. Results: The average follow-up duration of 17 subjects was 25.4 months(5-42 months). All flaps survived without any necrosis. Six cases were relapsed cases from conventional surgical procedures. All of them healed well during our follow-up study. Postoperative complications such as wound dehiscence and fistula developed in some subjects, but all were well healed through secondary treatment. A total of 2 cases relapsed after surgery. Conclusion: The inferior gluteal artery perforator flap is an effective method that can be primarily applied in replacement to the conventional ischial pressure sore reconstructive surgery owing to its many advantages: ability to preserve peripheral muscle tissue, numerous possible flap designs, relatively good durability, and the low donor site morbidity rate.

• Journal of Veterinary Clinics
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• v.32 no.6
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• pp.530-535
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• 2015

An 11-year-old intact female miniature poodle presented with a four-month history of hemorrhagic effusion. The patient was alert on physical examination, although muffled heart sounds were noted upon auscultation of the right hemithorax. The radiographic finding was pleural effusion. Ultrasonography revealed cystic changes in both ovaries and several nodules in the liver. A refractory opacity in the right lung field, as visualized with computer tomography (CT), was diagnosed as right middle lung lobe torsion with a collapsed bronchus. Five days after diagnosis, a right fifth intercostal thoracotomy was performed to remove the right middle lung lobe; the right middle lung lobe was grossly shrunken as a result of chronic lung lobe torsion. Ovariohysterectomy was also performed. Histopathologic examination revealed papillary adenocarcinoma in both ovaries and suspected metastasized ovarian adenocarcinoma cells in the lung lobe. The patient recovered favorably and had been doing well up to two months post-surgery. However, after four months, the dog presented with respiratory difficulty. The radiographic findings were pleural effusion and collapse of the right cranial and left caudal lung lobes. Malignant cells of epithelial origin were observed in the pleural effusion. The tumor cells were suspected to be metastasized cells from the previously resected lung lobe. Although cancer treatment was recommended, the suggestion was suspended and the dog was discharged from hospital. This was a case of lung lobe torsion that had occurred because of hemorrhagic effusion due to tumor. Although ovariohysterectomy and lobectomy were performed, there was a relapse of hemorrhagic effusion because of metastasized tumor from the previously resected lung lobe.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2995-2999
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• 2016

Background: Triple-negative breast cancer (TNBC) often presents as an interval cancer with short survival upon metastasis and thus represents an important clinical challenge. The present study investigated the clinicopathologic characteristics and long term survival outcome of early and locally advanced TNBC. Materials and Methods: Medical records were reviewed retrospectively for 148 consecutive confirmed cases of TNBC treated in a single unit at our centre. Demographic profile, tumor type, histopathology details, treatment and follow-up information was recorded and immunohistochemistry was performed. Results: Age group >50 years was associated with tumors of clinical stage 3 (53.8%), pathological stage 3 (46.2%), pathological grade 3 (45.7%), presence of extracapsular extension (ECE, 48.5%) and lymphovascular invasion (LVI, 64.9%). Locally advanced breast cancers (LABCs) were characterized by pathological stage 3 (96.2%), presence of ECE (100%) and absence of LVI (46.7%) as compared to early breast cancers (EBCs) which had higher incidence of lower stage tumors (100%), absence of ECE (82%) and presence of LVI (91.9%; p-value <0.001. Better relapse free survival was observed in patients with no axillary involvement (69%; p-value <0.001) and absence of ECE (64%; p-value <0.001). Improved overall survival was seen in patients with EBC (90%; p-value 0.008), clear axilla (86%; p-value <0.001), absence of ECE (87%; p-value <0.001) and negative lymph nodes (90%; p-value 0.006). Conclusions: TNBCs are aggressive tumors which show poor long term survival. Patients with TNBC benefit from chemotherapy, thus better and less toxic treatment options are needed. Identification of newer targets and development of targeted therapies are the need of the hour.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.32 no.4
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• pp.13-28
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• 2019

Objectives : The purpose of this study is to report the effectiveness of Korean medical treatment on 222 patients with alopecia areata. Methods : The subjects of this study were 222 patients who had received Korean medical treatment among the patients who visited the Balmer's Korean Medicine Clinic from January 1, 2016 to December 31, 2017. The extent of the alopecia areata was measured every month to determine the improvement. We analyzed the relationship between the types of alopecia areata, the extent of hair loss, duration of illness, age at first visit, and the treatment of alopecia areata. Results : 1. There were 100 males(45.0%) and 122 females(55.0%). The mean age of patients was 35.3 years old. 2. Of the 222 patients, 142(64%) were "cured". 31(14%) showed "good", 21(9.5%) showed "fair", 28(12.6%) showed "poor" improvement. 3. According to clinical records, of the 64 patients with alopecia areata(AA), 48(75.0%) were cured. Of the 100 patients with alopecia areata multiplex(AAM), 68 patients (68.0%), 12(50.0%) out of 24 patients with ophiasis, 5(55.6%) out of 9 with alopecia semi-totalis(AST), 3(50.0%) out of 6 patients with alopecia totalis(AT), 6(31.6%) out of 19 patients with alopecia universalis(AU) were cured. 4. Patients with the wider hair loss extent and with more severe type of alopecia areata required longer treatment period to cure, and the cure rate was lowered(p<0.05). 5. The shorter duration of the disease was related to the higher cure rate(p<0.05). If the treatment was started after six months of the duration, the cure rate was lowered. Therefore, beginning treatment within six months of the onset is recommended. 6. The period until terminal hair showed was 1.5 months for AA, 1.7 months for AAM, 1.6 months for ophiasis, 1.9 months for AST, 2.3 months for AT, 3.2 months for AU. 7. The treatment period to cure was 4.9 months for AA, 7.3 months for AAM, 7.7 months for ophiasis, 6.8 months for AST, 7.7 months for AT, 16.3 months for AU. 8. The major prognostic factors were extent and type of alopecia, duration of the disease and relapse. Conclusions : We analyzed the effectiveness of Korean medical treatment through cure rate according to the prognostic factors. This study will provide useful data for the treatment of alopecia areata.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.23 no.1
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• pp.59-74
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• 2010

Objectives : Atopic dermatitis(AD) is a chronic recurrent skin disease which usually developed in infancy or childhood. AD often repeat improvement and relapse. The cause of AD is so indefinite that many methods of therapies(moisturizer, steroid ointment, antihistamine, immunomodulator, immunosuppressant, herbal medicine, alternative medicine, etc.) are tried. Recently, a lot of studies were made. But there is no report about the effect of Samulsopungeum(SM) and Prednisolone(PN) on AD. So, author aimed to investigate the effects of SM and PN on AD of NC/Nga mice. Methods : Thirty two mice(8 Balb/c mice and 24 NC.Nga mice) were divided into four groups; Balb/c mice was normal group. NC/Nga mice were divide into three group : control, PN, SM group. AD was induced in the control, PN, SM group by spreading DNCB. Then normal saline, PN and SM were orally administered three times in a week for 8 weeks to the control, PN, SM group, respectively. We observed changes of clinical skin severity score, serum IgE, IgG1, IFN-$\gamma$, IL-2, IL-4, IL-5, IL-10, IL-13, and so on. We used one-way ANOVA test statistically(p<0.01). Results : The clinical skin severity scores of PN group and SM group in 8th week were decreased compared to the control group. Serum IgE, IgGl levels of PN group and SM group were significantly decreased compared to the control group. Serum IFN-$\gamma$ in SM group was significantly increased compared to the control group. But, Serum IFN-$\gamma$ in PN group was significantly decreased compared to the control group. Serum IL-10 levels of PN group and SM group were significantly decreased compared to the control group. Serum IL-2, IL-4, IL-5, IL-13 levels of PN group and SM group were significantly decreased compared to the control group. mRNA expression levels of IL-2, IL-4, IL-5, IL-13 in the dorsal skin tissues of PN group and SM group were significantly decreased compared to the control group. According to biopsy reports of the ear and skin tissues showed that the tissue damage of PN group and SM group were highly reduced compared to the control group. Creatinine, BUN, ALT, AST levels of PN group and SM group were normal. Conclusion : According to the above results, it is considered that SM is effective treatment for the AD.

• Journal of the Korean Society of Radiology
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• v.15 no.7
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• pp.1021-1030
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• 2021

This study analyzed the status of tuberculosis patients in Korea by collecting data from the Statistics Korea and the KDCA's GLOBAL Tuberculosis Report from 2010 to 2018 to find ways to manage tuberculosis patients in Korea and provide basic data on tuberculosis policies. The results are as follows. First, the results of tuberculosis patients in Korea decreased by about 21.3% to 33,796 (65.9%) in 2018 and 26,433 (51.5%) in 2018. Second, the status of tuberculosis patient treatment in Korea was found to be 655 in 2018, an increase of about 160% compared to 2014. Third, the incidence of tuberculosis among adolescents was 1.8% in 2018 for those aged 10 to 14 and 15.0% for those aged 15 to 19, the highest rate of tuberculosis among high school students, Fourth, looking at the incidence of tuberculosis patients by age, subjects in their 60s or older showed a prevalence of tuberculosis by 60% or more, especially elderly tuberculosis patients over 80 years of age. Fifth, the status of the incidence of tuberculosis patients by gender was found to be 1.4 times higher in men than in women in 2018 compared to 2010. Sixth, 1,419 people (75.6%) in Jeollanam-do had the highest prevalence of tuberculosis nationwide, and 99 people (33.4%) in Sejong had the lowest prevalence. Seventh, the number of foreign patients in Korea continued to increase to 1,510 in 2012, increasing to 2,569 in 2016. The results this study indicate the need for rapid and accurate early tuberculosis screening policies and management for tuberculosis relapse patients, high school student, age groups over 60, a group of men such as the military, the elderly over 80, and foreigners.

• Journal of Breast Cancer
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• v.21 no.4
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• pp.406-414
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• 2018

Purpose: T-cell immunoglobulin and mucin domain-containing molecule 3 (TIM-3) is an emerging immune response molecule related to T-cell anergy. There has been tremendous interest in breast cancer targeting immune checkpoint molecules, especially in the triple-negative breast cancer (TNBC). This study was designed to investigate TIM-3 expression on tumor infiltrating lymphocytes (TILs), its relationships with clinicopathological parameters and expression of programmed death receptor 1 (PD-1)/programmed death receptor ligand 1 (PD-L1), and its prognostic role. Methods: Immunohistochemistry on tissue microarray blocks produced from 109 samples of invasive ductal carcinoma type TNBC was performed with antibodies toward TIM-3, PD-1, PD-L1 and breast cancer-related molecular markers. Associations between their expression and clinicopathological parameters as well as survival analyses were performed. Results: TIM-3 was expressed in TILs from all 109 TNBCs, consisting of 17 cases (<5%), 31 cases (6%-25%), 48 cases (26%-50%), and 13 cases (>51%). High TIM-3 was significantly correlated with younger patients (p=0.0101), high TILs (p=0.0029), high tumor stage (p=0.0018), high PD-1 (p=0.0001) and high PD-L1 (p=0.0019), and tended to be associated with higher histologic grade, absence of extensive in situ components and microcalcification. High TIM-3 expression was significantly associated with a combinational immunophenotype group of high PD-L1 and high PD-1 (p<0.0001). High TIM-3 demonstrated a significantly better disease-free survival (DFS) (p<0.0001) and longer overall survival (OS) (p=0.0001), together with high TILs and high PD-1. In univariate survival analysis, high TIM-3 showed reduced relapse risk (p<0.0001) and longer OS (p=0.0003), together with high PD-1 expression. In multivariate analysis, high TIM-3 was statistically significant in predicting prognosis, showing better DFS (hazard ratio [HR], 0.0994; 95% confidence interval [CI], 0.0296-0.3337; p=0.0002) and longer OS (HR, 0.1109; 95% CI, 0.0314-0.3912; p=0.0006). Conclusion: In this study, we demonstrate that TIM-3 expression is an independent positive prognostic factor in TNBC, despite its association with poor clinical and pathologic features.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.2
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• pp.721-731
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• 2019

The purpose of this study was to investigate the knowledge, attitude, infection management intention and educational needs among nurses with no experience of new respiratory infectious diseases (NRID: SARS and MERS). Data were collected from 162 nurses working at the general hospitals in B city using structured questionnaires from October 10 to 31, 2017. The infection management intention of NRID was high in those who were over 30 years old, married, highly educated, and had a total working experience of more than 5 years. Nurses' infection management intention for NRID showed a positive correlation between knowledge of NRID (r=.27, p<.001) and attitude toward NRID (r=.65, p<.001). In other words, the higher the knowledge score for NRID, the more positive the attitude and the higher the infection management intention. In addition, the knowledge score related to incubation period, treatment, isolation, and release criteria was low while the educational needs were high. Therefore, in preparation for the possibility of NRID relapse and other NRID in the future, a systematic program addressing these educational needs for nurses should be periodically implemented to enhance infection management.

• The Journal of the Korea Contents Association
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• v.19 no.3
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• pp.365-374
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• 2019

Unlike benign tumors, malignant tumors are capable of metastasis, easy to relapse, poor survival, and low quality of life. In Korea, here is a tendency to treat the tumors collectively according to the General Principles of Cancer Chemotherapy(GPCC) of the Health Insurance Review & Assessment Service (HIRA). But recently, companion diagnostics(CDx) is recommended rather than unilateral medication because biomarker-based molecular diagnostics is possible to predict the drug response of patients before drug treatment. Not only domestic but also overseas Food and Drug Administratio (FDA) recommends the development of the CDx system at the stage of drug development to ensure the responsiveness and safety of medicines. In this study, I focused on the necessity of CDx development direction as well as CDx development status through literature review. Furthermore I also discussed CDx types according to the molecular diagnostic technology such as immunohistochemistry (IHC), polymerase chain reaction (PCR), in situ hybridization (ISH), and next-generation sequencing (NGS) not only in the approved CDx but also in the developing one by US FDA. And I suggested the technology issue of CDx development process such as a selection of molecular diagnostics at the time of release, a clear understanding of the CDx mechanism, and a convergence of drug with CDx development. The necessity of social insurance system also was proposed for CDx development.

• Parasites, Hosts and Diseases
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• v.58 no.6
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• pp.609-617
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• 2020

Plasmodium vivax reemerged in 1993. It has been sustained for more than 25 years and become one of the important indigenous parasitic diseases in northern and western parts of the Republic of Korea near the demilitarized zone. In particular, relapse is a significant concern for the control of malaria, as short- and long-term incubation periods vary among those infected in Korea. In this study, the prevalence of asymptomatic carriers was examined among residents of high endemic areas of vivax malaria during nonseasonal transmission of mosquitoes. Blood samples from 3 endemic regions in northwestern Korea were evaluated by microscopic examination, rapid diagnostic testing, and nested PCR to identify asymptomatic patients carrying malaria parasites in the community. However, no positive malaria case among residents of endemic areas was detected. Additionally, serological analysis was carried out to measure antibodies against 3 antigenic recombinant proteins of P. vivax, merozoite surface protein 1-19, circumsporozoite surface protein-VK210, and liver-stage antigen (PvLSA-N), by the protein array method. Interestingly, seropositivity of sera between previous exposure and samples without exposure to malaria was significantly higher using the PvLSA-N antigen than the other antigens, suggesting that PvLSA-N can be used as a serological marker to analyze the degree of exposure for malaria transmission in endemic areas. This indicates a very low asymptomatic carrier prevalence during the nonmalaria season in the endemic areas of Korea.