• Journal of Chest Surgery
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• v.35 no.1
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• pp.48-51
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• 2002

The conversion of failing Fontan circuit to total cavopulmonary connection(TCPC) is recommended as a therapeutic option in patients with late Fontan complications such as atrial arrhythmia, atrial enlargement, pulmonary venous obstruction, and ventricular dysfunction. Combined TCPC with extracardiac conduit and cryoablation of arrhythmia circuit is preferred for treatment of failing Fontan coulection with atrial lachyarrhythrnia. We report a case of conversion of atriopulmonary connection to extracardiac conduit Fontan and cryoablation of atrial arrhythmia circuit in a patient with tricuspid atresia, who also had ectopic atrial tachycardia, right atrial thrombi, pulmonary venous obstruction, and ventricular dysfunction. This patient and the parents were Jehovah's Witnesses; therefore, the patient underwent the procedure without blood transfusion.

• The Journal of the Korea Contents Association
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• v.18 no.8
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• pp.503-513
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• 2018

The purpose of this study was to identify the effectiveness of oral care protocol including individual oral care education, cryotherapy and benzydamine gargling on oral cavity status and self-care performance in solid cancer patients receiving chemotherapy. Thirty-one patients were enrolled by convenience sampling in this study and allocated to control (n=18) and experimental group (n=13). In the intervention group, individual oral care education, oral cryotherapy and benzydamine gargling were applied, while the control group received pre-existed oral care. Oral cavity status and self-oral care behavior were measured in five periods. The data were analyzed using the Mann-Whitney test, Friedman test, and Chi-square test. There was no significant difference in oral cavity status between the groups. But the two groups showed the poorest oral cavity status on $14^{th}$ day. Self-care behavior was significantly higher in the intervention group than the control group. This effect had maintained for 4months after completion of study. The results showed that individual oral care education by oncology nurse is effective to encourage patients to do self-care behavior and a further study is needed to explore the effect of cryotherapy and benzydamine gargling on oral cavity status of patient with solid tumor.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.344-350
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• 2000

Incidence of crown-root fracture due to traumatic injury, have been reported 3% in the permanent dentiton, 2% in the deciduous dentition. There are two treatment methods for crown-root fractured teeth with pulp exposure, when the fracture line was located under the alveolar crest. One way is the extrusion by orthodontic force the other way is intra-alveolar transplantation which occlusally repositioning of apical fragment in the alveolar socket. Since intra-alveolar transplantation has introduced in 1970s, it was practiced as alternative to orthodontic extrusion. As the result, this method may thoughted that had a good prognosis. As a result of trauma, completely crown-root fracture was occured in the maxillary right central incisor in this case. We couldn't reposition the deepest fracture line above the alveolar crest by the conventional surgical extrusion, because apical fragment was too short. Thus, after extraction of apical fragment, we repositioned it to the socket following demineralized freezed dried bone graft, which possible to support the apical fragment. At the 15-month recall examination, the root still showed normal mobility and there was not observed any in flammatory or replacement root resorption in the periapical radiograph.

• Tuberculosis and Respiratory Diseases
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• v.68 no.1
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• pp.6-9
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• 2010

Background: The efficacious use of interventional bronchoscope for patients with central airway obstruction due to malignant or benign lesions has been proven. Among many therapeutic bronchoscopic procedures, endobronchial cryotherapy is an established recanalization method for the obstruction of the respiratory tract. Recently, the use of this procedure has been increasing in Korea. However, limited data are available in the literature regarding its efficacy in Korea. Methods: Thirty patients, who had been treated with a flexible cryoprobe for cryotherapy were enrolled; clinical characteristics and treatment outcomes were analyzed. The patients had been treated with the technique using nitrous oxide as a cryogen under local anesthesia. Objective outcomes were 3 different degrees of therapeutic success by use of follow-up bronchoscopic findings as follows: successful, partially successful, and unsuccessful response. Subjective outcomes were evaluated as an improvement in symptoms. Results: The mean age of enrolled patients was $59{\pm}11$ years and there was a male (22/30) dominance. Twenty-three patients had malignant tumor and 7 patients had benign lesions with central airway obstruction. Successful recanalization was achieved in 11 (37%) patients, and partially successful response was achieved in 15 (50%) patients. Dyspnea was improved in 84.2% (16/19) of patients. At least one respiratory symptom was resolved in 91.3% (21/23) patients. Seven patients (23.3%) needed additional bronchoscopic electrocautery because of the bleeding as a complication of cryotherapy. Conclusion: Endobronchial cryotherapy is an effective and less expensive procedure for the management of central airway obstruction. However, the procedure should be performed under the preparing for an emergency situation, such as massive bleeding.

• Tuberculosis and Respiratory Diseases
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• v.70 no.6
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• pp.521-525
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• 2011

Bronchial carcinoid tumors are relatively uncommon neoplasms that are considered to be malignant tumors of low to intermediate grade. They are classified by pathologic features as typical or atypical carcinoids and have distinctly different prognoses and therapeutic options. Surgery is the treatment of choice in typical and atypical carcinoid tumors but the approach has been changing. Recently, several studies have described experiences using other technologies as adjuncts to bronchoscopic resection, technologies such as laser and cryotherapy with curative intent in endoluminal typical carcinoids. Here we present a case of atypical bronchial carcinoid that was treated with bronchoscopic cryotherapy.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.349-353
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• 2007

Mucocele is a clinical term of the localized superficial mucosal swelling caused by salivary retention after the obstruction or the rupture of minor salivary ducts. Various treatment methods have been suggested to lower its recurrence rate, including complete excision of lesion Biopsy punch can be used easily and simply for complete excision of mucocele. It has several advantages, such as convenience in use, low bleeding tendency, and nearly no requirements for post-operative management. In this case, biopsy punch was used for the removal of mucocele in an uncooperative child, which enable fast, simple and safe procedure, with a good result.

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.205-209
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• 2009

Staphylococcal toxic shock syndrome (TSS) is a severe systemic illness caused by toxins produced by Staphylococcus aureus. We report a case of staphylococcal TSS in a 16 month-old boy who presented with high fever, vomiting, skin rash, and shock after a burn injury. He was managed with intravenous vancomycin, fresh frozen plasma, and intravenous immunoglobulin. Methicillin-resistant S. aureus (MRSA) was isolated from the burn wound site and anterior nostril of the patient. In addition, the MRSA isolate was genetically characterized.

• Journal of Oral Medicine and Pain
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• v.23 no.3
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• pp.249-255
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• 1998

Mucoceles of the minor salivary glands are the most common cystic lesions affected the oral mucosa. They are believed to be the result of trauma to the salivary duct caused, for example, by biting the lip, cheek, or tongue. Surgical excision has been the most common treatment for these lesions, but occasional recurrences develop after excision because surgical trauma may damage the surrounding minor salivary glands Although various alternative nonsurgical approaches, such as steroid infection, application of gamma-linolenic acid, have also been reported, they are not used routinely, Lasers, particularly the carbon dioxide laser, have been used in the management of mucoceles. Although this treatment requires specialized equipment. Cryotherapy is another effective nonsurgical method for treating mucoceles. Clinically, cryotherapy has primarily been applied to the treatment of leukoplakia and hyperplastic, granulomatous, vascular, and pigmented lesions. Limited information, however, is available on the application of cryotherapy in salivary gland lesions, including mucoceles. A simple and easy cryotherapy to treat a mucocele on the lower lip is described. A 25 years old female patient with a mucocele on the lower lip was treated by direct application of liquid nitrogen with a cotton swab. The lesion was exposed to 4 or 5 cycles composed of freezings of 10-30 s and thawings of double the freezing times. No anesthesia was required. The lesion nearly disappeared without scar 10 days after the cryotherapy. Cryotherapy has become an established nonsurgical method, characterized by its simple application, therapeutic effectiveness, painless during the procedure and low incidence of secondary infection and hemorrhage.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.207-212
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• 2010

Protein C deficiency increases the risk of thrombosis due to the lack of anticoagulant factor protein C. Among the numerous congenital protein C deficiencies, homozygous protein C deficiency has an especially low protein C activity level, that it is almost undetectable. It is a rare disease with a probability of 1:250000~500000. The signs and symptoms of homozygous protein C deficiency include purpuric, necrotic dermatosis, ecchymosis, blindness, and thrombosis in central nervous system. A 4-year-old girl was brought to the clinic with a chief complaint of extensive caries. The child was under warfarin medication in order to prevent possible complications during dental treatment. We consulted the pediatric department. Without warfarin intake, serious complications may occur due to thrombosis during dental treatment. Therefore, certain warfarin dosage (INR 3~5) and fresh frozen plasma as a backup for excessive hemorrhage were recommended. This child was a severely disabled child with the loss of vision, and it was difficult to manage her behavior effectively. Thus, dental treatment was carried out under general anesthesia, where bleeding control would be also easier to achieve.This report presents the case of a 4-year-old girl with protein C deficiency, who has received dental treatment for extensive caries under general anesthesia.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.138-147
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• 2001

배경: 폐암발생에 EGF의 자가 분비는 암의 성장과정에 직, 간접적인 영향을 주고 있으며, TNF-$\alpha$는 면역 반응의 급성체로서 폐암의 발생을 억제하고 이미 발생한 폐암종의 치료에도 이용되고 있는 실정이다. 폐암 조직과 혈장에서 epidermal growth factor(EGF)와 tumor necrosis factor-$\alpha$(TNF-$\alpha$)를 면역 방사선 분석법을 이용하여 정량분석 하여 발현 정도를 분석해보고자 하였다. 대상 및 방법: 폐암환자 20례와 양성종양 및 육아종 환자 4례에 대해서 AJCCS에 의한 조직학적 분류와 TNM 분류에 따라 구분하여 절제수술을 받은 환자를 대상으로 수술전 혈액을 채취하고 수술직후 적출한 표본을 암이 없는 건강하다고 판단되는 대조조직과 폐암조직에서 일정량의 조직을 절취하여 액화질소 내에 실험시까지 급속 냉동보관 하였다. 수술후 혈액을 재 채취하여 혈장을 분리하여 냉동고에 검사시까지 보관하였다. EGF의 정량은 Human Epidermal Growth Factor kit(Amersham Phamacia Biotech, England)를 사용하였으며, TNF-$\alpha$ 정량은 TNF-$\alpha$ IRMA kit(Biosouce, Belgium)을 사용하여 IRMA 방법으로 각각 정량분석하여 표현유무를 연구한 결과 다음과 같은 결론을 얻었다. 결과: 1. 대조조직, 양성종양 및 육아종과 폐암 수술전후의 조직과 혈청 모두에서 EGF와 TNF-$\alpha$가 발현되었다. 2. EGF와 TNF-$\alpha$의 농도는 대조조직과 양성종양(0.11$\pm$0.06 ng/ml, 20,3$\pm$9.08 pg/ml)에 비하여 폐암조직(0.13$\pm$0.05 ng/ml, 34.34$\pm$47.74pg/ml)에서 유의하게 높은 농도가 발현되고 있었다. 3. 폐암중 선암조직에서 특히 TNF-$\alpha$(80.92$\pm$104.08 ng/ml)의 발현이 강하게 나타났다. 4. 혈청내의 EGF와 TNF-$\alpha$의 발현되는 양이 조직내의 양보다도 높았다. EGF는 5.7배정도 TNF는 1.3배정도 강하게 표현되었다. 5. 폐암의 조직학적 종류에 따라서 EGF는 거의 차이가 없었으나 TNF-$\alpha$ 정량치에는 차이가 있었다. 6. TNM stage가 진행함에 따라 EGF는 농도가 증가하였고 TNF-$\alpha$는 오히려 감소하는 반대되는 교차현상이 있었다. 7. 수술직후 EGF는 증가하였으나 TNF-$\alpha$는 오히려 감소하였다. 결론: 결론적으로 저자는 암조직과 대조조직간에 EGF와 TNF-$\alpha$의 표현량의 차이가 있음을 관찰하였으며 또한 조직과 혈청사이에도 표현량에 차이가 있으며 조직보다도 오히려 혈청내의 농도가 높다는 사실을 관찰하였다. EFG와 TNF-$\alpha$는 정상조직이나 양성조직과 폐암조직 모두에서 분비작용되는 cytokines으로 세포기능에 따라 다양하게 표현이 되며 계속적인 연구로서 밝혀야만 할 과제라고 판단된다.