• Tuberculosis and Respiratory Diseases
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• 제58권6호
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• pp.582-589
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• 2005

Background : The incidence of lung adenocarcinoma, which is more prevalent in women and nonsmokers, is increasing. The aim of this study was to determine the prognostic factors of an adenocarcinoma of the lung. Material and method : The clinical information of patients diagnosed with an adenocarcinoma of the lung at the Kosin University Gospel Hospital from January 1994 to July 2004 was reviewed retrospectively. The survival time of these patients was analyzed by the patient's age, gender, performance status, weight loss, smoking history, location of the primary tumor, clinical stage, serologic tumor markers, and treatment modality. Results : For all 422 patients with an adenocarcinoma of the lung, 247 (58.5%) were male, and their mean age was 59.8 years the. The majority of patients were smokers (58.3%), and the tumors were located in the periphery (59.7%). In the smokers, the tumor was located more in the central airway compared to the non-smokers (42.8% vs. 31.9%, p=0.12). The overall median survival time was 390 days (95% CI;304-436 days). Univariate survival analysis revealed that an older age (${\geq}65$ years old), male, weight loss, smoker, central type, advanced clinical stage, elevated serum carcinoembryonic antigen (CEA, >5 ng/ml) and neuron specific enolase (NSE, >15 ng/ml), and the supportive care only were significantly poor prognostic factors. The median survival time was shorter in the smokers than nonsmokers (289 days vs. 533 days, p<0.001). In addition, it was also shorter in the elevated NSE group than in the normal range group (207 days vs. 469 days, p<0.001). Multivariate analysis showed that age, clinical stage, serum NSE, smoking status, and treatment modality were independent predictors of survival (hazard ratios: 1.68, 1.94, 1.92, 2.39 and 1.57, respectively). Conclusions : Smoking is an important prognostic factor in an adenocarcinoma of the lung, but not gender. This suggests that the better prognosis of women is more related with the lower rate of smoking. In addition, the elevated serum NSE is also an important prognostic in an adenocarcinoma of the lung.

• The Journal of Korean Academy of Prosthodontics
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• 제47권2호
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• pp.99-107
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• 2009

Statement of problem: Restoring and replacing teeth with fixed prostheses commonly used in dental practice. Because of improper oral hygiene care and inaccurate laboratory procedure, complications of fixed prostheses were found in the mouth of patients. Although many efforts have been continually made to obtain the data of long term prognosis of fixed prostheses, it was difficult to do it. Purpose: The purpose of this study was to evaluate the clinical status of fixed prostheses. Material and methods: In order to assess the clinical status of fixed prostheses, a total of 161 individuals(aged 17-85, 99 women and 62 men with 1596 unit of fixed prostheses, and 1169 abutments) who first visited the Department of Prosthodontics, Pusan National University Hospital, between April to September, in 2007 were examined. Results and conclusion: The results of this study were as follows: 1. Length of service of fixed prostheses was $8.6{\pm}0.6$ years(mean), 10.0 years(median). 2. Location of fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in posterior region and in mandible where the failure rate was high in combination(P<.05). 3. Longevity of fixed prostheses made of metal was longest(mean: $13.0{\pm}9.3$, median: 14.0), gold, precious ceramic, non-precious ceramic trailing behind(P<.05). 4. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in Single-unit and the failure rate was high in over 3-unit(P<.05). 5. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in natural dentition(P<.05). 6. Defective margin(28.2%), dental caries(23.0%), periodontal disease(19.3%), periapical disease(16.9%) were frequent complications. In 30.1% of the cases, abutment state after removing fixed prostheses was needed to be extracted.

• Journal of the korean academy of Pediatric Dentistry
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• 제37권1호
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• pp.117-123
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• 2010

Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.

• Journal of Gastric Cancer
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• 제6권4호
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• pp.270-276
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• 2006

Purpose: The prognosis of Borrmann type IV gastric cancer is poorer than that of the other gastric carcinomas. We compared the clinicopathological features of Borrmann type IV gastric cancer with those of other types of cancer and analyzed the significance of a Borrmann type IV carcinoma as a prognostic factor Materials and Methods: We retrospectively reviewed the clinicopathologic features, TNM stage and survival rates of 4,389 gastric cancer patients who received surgical management at Samsung Medical Center between January 1995 and December 2004. Results: Patients with a Borrmann type IV gastric carcinoma had a more advanced stage than patients with other types of gastric carcinomas at the initial diagnosis, and the curative resection rate was lower. The 5-year survival rate of patients with Borrmann type IV cancer was 20.7%, and that of patients with other types of cancer was 50.3%. The 5-year survival rate of patients with Borrmann type IV gastric carcinomas was significantly lower than that of patients with other types of gastric carcinomas at the same TNM stage. In univariate and multivariate analyses, the depth of invasion, the nodal state, distant metastasis, the TNM stage, curability and the presence of a Borrmann type IV carcinoma were independent prognostic factors in cases of gastric cancer. Conclusion: Compared to the other types of gastric carcinomas, a Borrmann type IV carcinoma has unique clinicopathological features. The prognosis should be predicated considering the differences between Borrmann type IV qastric carcinomas and other types of gastric carcinomas, and multimodal and intensive therapies are needed in patients with a Borrmann type IV gastric carcinoma.

• The Korean Journal of Nuclear Medicine
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• 제33권2호
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• pp.143-151
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• 1999

Purpose: Dermatolymphangioadenitis (DLA) is a common and serious complication of lymphedema which deteriorates lymphatic function. The purpose of this study was to assess the risk of DLA by lymphos-cintigraphy in patients with lower extremity lymphedema. Materials and Methods: The subjects were 59 edematous lower extremities of 50 patients without previous episode of DLA and 12 lower extremities of 6 controls. Whole body images were acquired 1 min and 2 hr after subcutaneous injection of 37 MBq of Tc-99m-antimony sulfide colloid into interdigital spaces of both feet before therapy for lymphedema. The lymphosintigraphic and clinical variables were compared between groups with or without occurrence of DLA during clinical follow up. Results: There were 20 episodes of DLA in 12 extremities during clinical follow-up (19 :6 months). On univariate analysis, there were significant differences in ilioinguinal lymph node uptake, uptake pattern of main lymphatic vessel, clinical stage and therapy compliance between the two groups. After multivariate analysis, only the uptake pattern of main lymphatic vessel and therapy compliance fore confirmed to be independent variables. In other words, non-visualized main lymphatic vessel and poor compliance to therapy were more frequent in extremities with subsequent occurrence of DLA. Conclusion: Lymphoscintigraphy can be used to predict the risk of DLA and may thus be helpful for determining the initial therapeutic plan in patients with lower extremity lymphedema.

• Journal of Chest Surgery
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• 제38권6호
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• pp.421-427
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• 2005

Complete surgical resection is the most effective treatment for pT1/2N1 non-small cell lung cancer, however 5 year survival rate of these patients is about $40\%$ and the major cause of death is recurrent disease. We intended to clarify the risk factors of recurrence in completely resected pT1/2N1 non-small cell lung cancer. Material and Method: From Jan. f990 to Jul. 2003, total of 117 patients were operated for pT1/2N1 non-small cell lung cancer. The risk of recurrence according to patients characteristics, histopathologic findings, type of resection, pattern of lymph node metastasis, postoperative adjuvant treatment were evaluated retrospectively. Result: Mean age of patients was 59.3 years. There were 14 patients with T1N1 and 103 patients with T2N1 disease. Median follow-up time was 27.5 months and overall 5 year suwival rate was $41.3\%$. 5 year freedom-from recurrence rate was $54.1\%$. Recurrence was observed in $44 (37.6\%)$ patients and distant recurrence developed in 40 patients. 5 year survival rate of patients with recurence was $3.3\%$, which was significantly lower than patients without recurrence $(61.3\%,\;p=0.000).$ In multi-variate analysis of risk factors for freedom-from recurrence rate, multi-station N1 $(hazard\;ratio=1.997,\;p=0.047)$ was a poor prognostic factor. Conclusion: Multi-station N1 is the risk factor for recurrence in completely resected pT1/2N1 non-small cell lung cancer.

• Radiation Oncology Journal
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• 제9권2호
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• pp.185-195
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• 1991

Seventy four patients with pituitary adenoma received radiation therapy (RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five ($88\%$) patients were treated postoperatively and 9 ($12\%$) primary RT, To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin (PRL), growth hormone (GH), adrenocorticotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone (FSH) and thyroid stimulating hormone (TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with invasive tumor mass around supra- and/or parasella area. The patients were classified as 23 ($29\%$) prolactinomas and 20 ($26\%$) growth hormone (GH) secreting tumors, and 6 ($8\%$ ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine ($37\%$) had nonfunctioning tumor and four ($5\%$) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15 ($65\%$) of 23 PRL and 3 ($15\%$) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively. Fifteen ($20\%$) patients were lost to follow up after RT.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권2호
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• pp.194-203
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• 1999

Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.

• Pediatric Infection and Vaccine
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• 제22권3호
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• pp.172-177
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• 2015

Purpose: This study aimed to analyze the epidemic period of RSV infection and evaluate the appropriate time of palivizumab immunoprophylaxis. Methods: From January 1991 to July 2012, nasopharyngeal (NP) aspirates were obtained from patients who visited Seoul National University Children's Hospital for respiratory symptoms. NP samples were used to detect respiratory viruses. Among them, we analyzed the positive number and detection rate of RSV infection in two-week interval. The beginning of RSV season was defined when RSV positive number was more than 4 and RSV detection rate was over 10%. From January 2007 to March 2014, we analyzed the starting time of palivizumab immunoprophylaxis for the infants at high risk. Results: The RSV detection rate was 2,013/21,698 (9.69%) over 22 years. The median RSV season was from $2^{nd}-3^{rd}$ week of October to $1^{st}-2^{nd}$ week of February. The earliest starting week was the 3rd week of July in year 2001, and the latest end week was the 3rd week of May in year 1990. Palivizumab immunoprophylaxis was initiated most frequently at the 3rd week of October (18.7%). However, the percentage of starting palivizumab on the 1st week of September has increased from 3.8% in the year 2007 to 14.1% in 2013. Conclusions: The year to year variability of RSV season exists. The starting time of palivizumab immunoprophylaxis should be adjusted based on the season of RSV epidemic.

• Childhood Kidney Diseases
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• 제17권2호
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• pp.101-109
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• 2013

Purpose: Pediatric urolithiasis is uncommon in children but is a cause of significant morbidity and damage to the kidney. Although much information on adult urolithiasis is available in the literature, large studies on the pediatric population are still scarce. In this report, we review our experience with pediatric urolithiasis over 22 years at a tertiary referral center. Method: We retrospectively reviewed the records of children with newly diagnosed urolithiasis between January 1991 and May 2013. We assessed the age, sex, family history, initial symptoms, location of stones, underlying cause, stone analysis, treatment, and recurrence among the patients. Results: In total, 137 patients (96 male, 41 female) were assessed. The age range was 0-17 years (mean age, 6.0 years). Forty-three (31%) children were aged <1 year, and 37% (16/43) had a history of intensive care unit (ICU) admission. Thirteen patients (9.5%) had a family history of stones. The most common symptoms at presentation among the patients were gross hematuria (56/137, 41%) and flank or abdominal pain (46/137, 34%). The stones were located in the kidney (85/137, 62%), ureter (29/137, 21%), bladder (2/137, 1.4%), and multiple locations (20/137, 15 %). Congenital abnormalities of the genitourinary (G-U) tract, with or without metabolic abnormality, or urinary tract infection (UTI) was detected in 26 children (19%). Ninety-one patients (66%) underwent metabolic examination, and 38% of these patients exhibited an abnormality. UTI, with or without abnormalities of the G-U tract, or metabolic abnormality was detected in 26 children (19%). Of the 35 stones analyzed, the majority were calcium stones (20/35, 57%), followed by infected stones (5/35, 14%), uric acid stones (4/35, 11%), carbonate apatite stones (3/35, 7%), cystine stones (2/35, 6%), and phosphate stones (1/35, 3%). Five patients (4%) required open procedures, with or without non-open procedures, whereas 77 patients (56%) were managed conservatively; the remaining 55 patients (40%) received some other form of intervention. Eighteen patients (13%) had stone recurrence during the follow-up period. Conclusions: Pediatric urolithiasis is commonly associated with abnormalities of the G-U tract and/or metabolic disorders and/or UTI. Half of the patients will pass their stones spontaneously, and all the techniques of minimally invasive surgery are applicable in the treatment of children with stones. As the recurrence rates are high among this population, long-term follow-up is recommended and the complete clearance of stones is important.