• Radiation Oncology Journal
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• v.12 no.2
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• pp.165-173
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• 1994

Purpose : Metastatic cancer to the brain is a major problem for the patients with bronchogenic carcinoma, and most of these patients have a limited survival expectancy. To increase tumor control and / or to decrease late morbidity with possible shortening in over-all treatment period, multiple daily fraction technique for brain metastasis was performed. The author reperesented the results of accelerated fractionation radiotherapy in patients with brain metastases from non-small cell lung cancer. Materals and Methods : Twenty-six patients with brain metastases from non-small cell lung cancer between 1991 and 1993 received brain radiotherapy with a total dose of 48 Gy, at 2 Gy per fraction, twice a day with a interfractional period of 6 hours, and delivered 5 days a week. The whole brain was treated to 40 Gy and boost dose escalated to 8 Gy for single metastatic lesion by reduced field. Twenty-four of the 26 patients completed the radiotherapy. Radiotherapy was interupted in two patients suggesting progressive intracerebral diseases. Results : This radiotherapy regimen appears to be comparable to the conventional scheme in relief from symptoms. Three of the 24 patients experienced nausea and or vomiting during the course of treatment because of acute irradiation toxicity. The author observed no excessive toxicity with escalating dose of irradiation. An increment in median survival, although not statistically significant(p>0.05), was noted with escalating doses(48 Gy) of accelerated fractionation(7 months) compared to conventional treatment(4.5 months). Median survival also increased in patients with brain solitary metastasis(9 months) compared to multiple extrathoracic sites(4 months), and in patients with good performance status(9 months versus 3.5 months), they were statistically significant (p<0.01). Conclusion : The increment in survival in patients with good prognostic factors such as controlled primary lesion, metastasis in brain only and good perfomance status appeared encouraging. Based on these results, a multi-institutional prospective randomized trial should be initiated to compare the twice-a-day and once-a-day radiotherapy schemes on patients with brain metastasis with careful consideration for the patients' quality of life.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.61-65
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• 2012

Purpose: The aim of this study was to evaluate the effectiveness of ultrasound-guide steroid injection according to Morton's neuroma size. Materials and Methods: From October 2008 to September 2011, 17 patients (23 cases) diagnosed with Morton's neuroma were investigated. All cases were female and mean age was 52.6 years old. Neuroma were measured by the horizontal and longitudinal length of the mass and underwent ultrasound-guided steroid (5 mg dexamethasone) injection. The efficacy of the injection was determined by Visual Analogue Scale pain score and patient satisfaction(subdivided 4 group-much improved, improved, not improved, aggrevation) Results: 7 of 23(30.4%) cases showed much improved and improved satisfaction and mean longitudinal and horizontal length were $0.71{\pm}0.39cm$ and $0.47{\pm}0.24cm$, respectively. 16 of 23(69.6%) cases showed not improved and aggrevation satisfaction and mean longitudinal and horizontal length were $0.83{\pm}0.42cm$ and $0.54{\pm}0.14cm$, repectively. There was a significant difference in VAS and patient satisfaction in case longitudinal and horizontal length were smaller than 0.5 cm and 0.4 cm. (p<0.05) Conclusion: The ultrasonography is a important modality in diagnosis and treatment of morton's neuroma. Ultrasound-guide steroid injection is effective in case longitudinal and horizontal length were smaller than 0.5 cm and 0.4 cm, respectively.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.113-119
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• 2014

Purpose: This study was to evaluate effect and efficiency of S1 selective nerve root block using ultrasonography-guided compared with fluoroscopy-guided for lumbar disc herniation or spinal stenosis patients. Materials and Methods: Between February 2012 and December 2013, 38 patients who were with lower leg radiating pain for more than 1months and underwent S1 selective spinal nerve root block in our institution, were reviewed. They divided into two groups: Group A included 18 patients with ultrasonography-guided and Group B included 20 patients with fluoroscopy-guided. Treatment effectiveness was assessed using a visual analogue scale (VAS) and the Korea Modified Oswestry Disability Index (K-MODI). They were evaluated its preoperatively, postoperatively and 1 month later. We were recorded whole procedure time. Results: VAS was improved from 7.4 to 4.7 at 1 month in group A and from 7.39 to 4.36 at 1month in group B. K-MODI was improved from 72.8 to 43.3 at 1month in group A and from 73.8 to 44.1 at 1month in group B. Whole procedure time were $477.53{\pm}115.02s$, $492.47{\pm}144.38s$ in group A, group B, respectively. But there was no significant difference in VAS and K-MODI between two groups. Conclusion: Ultrasonography-guided sacral nerve root block is effective and accurate method in sacral radiating pain.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1248-1252
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• 2003

Purpose : Chest pain in the pediatric population is not rare and mostly benign. Causes of chest pain are diverse, and differential diagnosis is not easy. Chest pain in children is less likely to be cardiac in origin. Furthermore, chest pain in the pediatric population is rarely associated with life-threatening disease. This study was designed to evaluate children with chest pain and the usefulness of several diagnostic examinations. Methods : Between March 2001 and August 2002, 33 patients(15 boys and 18 girls, aged four to 15 years) presented with chronic chest pain. The records of these patients were reviewed. Chest radiography and electrocardiogram were performed in all patients. Cardiologic and gastrointestinal evaluations were carried out when considered necessary. Results : Chest pain was most common in the age group of 10 to 12 years old, and the four to six years old group. The most common diagnostic findings of chest pain were idiopathic(15 cases, 45.5 %), heart disease(9 cases, 27.3%), upper gastrointestinal disease(6 cases, 18.2%), respiratory disease (2 cases, 6%) and trauma(1 case, 3%). In children with abnormal results of cardiologic evaluation, these findings are not major etiologic categories of chest pain. Through history taking and physical examinations, six cases were evaluated concerning gastrointestinal disease and all of them showed gastrointestinal diseases(esophagitis, gastroesophageal reflux disease, nodular gastritis and chronic superficial gastritis). Conclusion : Chest pain is usually benign in children but the possibility of cardiovascular or gastrointestinal disease is considered. Careful history taking, physical examination and proper clinical examinations are usually required to find out the rare life-threatening causes of chest pain.

• Journal of Chest Surgery
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• v.37 no.7
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• pp.591-596
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• 2004

Recently, thoracic sympathicotomy for craniofacial hyperhidrosis (FH) is increasingly avoided contrast to palmar hyperhidrosis. We recently demonstrated that selective T2 sympathicotomy for FH in woman might be recommended because of differences of the postoperative satisfaction between man and woman. Therefore, this study was designed to analyze the postoperative long term results, evaluate the effectiveness of T2 sympathicotomy and establish the new strategy in treatment of FH in woman. Material and Method: From May 1998 to July 2001, 27 cases of FH in woman that were performed T2 sympathicotomy and minimum 2 years have passed since then at the follow up period. Among them, 20 cases were evaluated by telephone review and medical record. Bilateral sympathetic trunks were severed on the 2nd rib with 2mm thoracoscopic instruments. 7 patients combined with gustatory sweating (GS). Ages ranged from 25 to 62 (mean age, 46.4 years). Result: All patients were relieved of symptom immediately after operation. At postoperative 1 week, all patients were satisfied: 15 patients, “very satisfaction” and 5 patients, “relatively satisfaction”. However, during long term follow up period (from 25 to 63 months postoperatively), 9 patients (45%) were relatively satisfied, 8 patients (40%) complained that there was no difference of postoperative satisfaction and 3 patients (15%) complained of non satisfactory results (regret for surgery). 16 patients (80%) had complaint of uncomfortable feeling because of postoperative GS. Some degree of compensatory sweating (CS) had occurred in all patients: severe 10 patients (50%), severe but acceptable 6 patients (30%), and just conventional 4 patients (20%). The sites of CS were trunk, back, axilla and extremities. Conclusion: Thoracoscopic T2 sympathicotomy is relatively considerable method for FH in woman and the postoperative satisfaction depends on GS and the degree of individual adaptation for CS. Therefore, it is required that the prediction of preoperative risk factors for GS and CS and then careful selection of patients to increase the postoperative satisfaction, and the development of acceptable new treatment modalities.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.1
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• pp.27-41
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• 2000

Objects：This study was designed for studying of current Korean adolescents computer game playing habits and exploring associations with parental rearing patterns and individual psychopathology. Methods：One hundred twenty four adolescents(age 13-15) who reside in urban area completed self-report questionnaires containing Questionnaires designed by authors, Symptom Checklist-90-Revision of Korean Version(SCL-90-R) and Parental Bonding Instrument(PBI). Results：1) Computer game playing appears to be one of the social and leisure phenomena in these days. Although Adolescents spend a lot of times on computer game, Many of them perceive not problematic. 2) Compared with females, Male play computer games more regularly, more longer, spent more times in gamebang. 3) There was positive relationship between anxiety subscale in SCL-90-R and detrimental effects of computer game. 4) There was positive relationship between game frequency and maternal overprotection. 5) The main reasons for playing are 'for an avoidance of stressful life events', academic burden was the most troublesome issues in korean adolescents. 6) Many adolescents use gamebang as a social place, but they thought that gamebang is not good places to have a good time. Conclusion：This papers shows that computer game playing is a popular social leisure activity in Korean adolescents. And, Most of korean adolescents reported that they are suffered from pressure of academic achievements. They use computer game mainly by means of relieving academic pressures. In a heavy game users who have many conflicts with parents, teacher and who has frequent truancy and social withdrawal show significant anxiety. Maternal overprotection was observed in heavy game users. Authors recommended that clinicians should be careful in examining heavy computer game behaviors. Both underlying affective states and environmental influences, including family situations should be vicariously examined.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.1
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• pp.82-90
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• 1998

This study is attempted to examine Korean teachers’ perceptions of mental health problems in students and their attitudes towards psychiatric consultations through a questionnaire survey. The results of this study are as follows. 1) Teachers thought that 5.3% of their students had mental health problems, 1.9% of students required psychiatric evaluation, and 1.2% of students were referred or recommended psychiatric evaluation by their teachers. 2) The most frequent mental health problems in students discovered by teachers were distractibility and inattention, lack of academic skills, and language difficulties in elementary schools；distractibility and inattention, conduct problems, and lack of academic skills in middle schools；and conduct problems, distractibility and inattention, physical symptoms, and substance abuse in high schools. 3) Teachers thought the mental health problems in students were caused by the family environment, psychological factors, the educational system, and a lack of mental health services. 4) Teachers desired smaller classes, improvement of the school environment, more time, regular mental health education, a special program for students with mental health problems, and the counseling staffs or consultants for the school mental health. 5) Teachers consulted with other teachers, the parents of the students, the counseling teachers, the health care teachers, the counseling institutes, the psychiatric clinics, and the principals in descending order to handle the hard case problems. The frequent reasons for failing in psychiatric consultations were the prejudice of parents against psychiatric services, the teachers’ sense of superiority in dealing with the problems of students, the prejudice of teachers themselves against psychiatric practice, and inaccessible professional consultation. 6) About 20.4% of teachers reported they had proposed psychiatric consultations or had recommended their students to receive psychiatric evaluations.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.57-69
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• 1997

Objective：At the present time in Korea, for a considerable proportion of children and adolescent, delinquent behavior and violence has become as a way of life in their lives and a major social problem issue as well. The contributing factors to this problem were assumed to be the negative interaction between family environment and character of adolescent. The purpose of this study is to search the relationship between these constructs and juvenile delinquency. Method：Data were collected through questionnaire survey over a period of 2 months. Subjects served for this study consisted of 1,863 adolescents including 657 delinquent adolescents and 1,206 student adolescents in Korea, sampled from Korean student population and delinquent adolescent population confined in juvenile corrective institutions, using proportional stratified random sampling method. Their age ranged between 12 and 18 years. Data were analysed by IBM PC using SAS program. Statistical methods employed were Chi-square and principal component analysis. Results：The results of this study were as follows：Inconsistency by parental child rearing patterns tended to affect delinquent behavior among delinquent adolescents. On the other hand, adolescent students were consistently reared by their parent with democratic, flexible, trusting their children and reward-oriented attitudes. In comparison of both parents in the degree of influence on their children, it was revealed that paternal child rearing pattern was more influential on their children’s behaviors than maternal’s. The psychological instability of family, disharmonious parent-child relationships tended to be contributing to delinquent behavior among delinquent adolescents. Especially, It was an interesting finding that student’s mother is the higher employed than delinquent’s mother. However working mother was more prevalent in the student’ adolescents than in student adolescents in previous studies. The delinquent adolescents have more depressive trend, more complaints of psychosomatic symptoms, the higher degree of need frustration, the more maladaptive and antisocial personality pattern than student adolescents. Conclusion：Recently, many studies on association between family factor, character of adolescent and juvenile delinquent behavior have produced relatively consistent results. This study showed that family environment and character trait of adolescent also were linked with delinquent behavior such as smoking, drinking, runaway and physical assaults etc. The results of this survey may provide impetus for future speculation and study of correlation or reciprocal interaction between family factor, character trait of adolescent and delinquent behavior during adolescence and beyond.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.579-583
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• 1999

Background: Thoracic sympathicotomy has been used safely and successfully to manage palmar hyperhidrosis. The preoperative and postoperative recording of Sympathetic Skin Responses(SSR) was performed for objective evaluation and follow-up of thoracic sympathicotomy in hyperhidrosis patients, and also for ascertaining the clinical usefullness of SSR. Material and Method: The recording of SSR was performed on 15 patients suffering from palmar hyperhidrosis with Medelec Sapphire Plus electromyogragh before and after thoracic sympathicotomy. Eletrical stimuli on the right median nerve was made in patients in supine position and results were recorded on right and left palms with soles at the same time by 4 channels. Skin temperatures were also monitored simultaneously. T2,3 sympathicotomy was performed with VATS in every patients. SSR was done in 2 patients one month later. Result: Clinically, all patients had symptomatic improvement with satisfaction. Postoperative complication was small amount of residual pneumothorax in 5 patients but it was absorbed sponteneously. There was no recurrence during follow-up period and ten patients(66%) complained compensatory hyperhidrosis. After operation, SSR change was shown in every 15 patients. Abolition of SSR on both palms was achieved in 12 patients(80%) and on both soles in 6 patients. In the other 3 patients, the latencies were significantly delayed and the amplitudes were significantly reduced at both palms and soles. In two patients who were examined at one month later after operation, similar results with postoperative SSRs were shown. The skin temperature on preoperative both palm and sole were lower than normal temperature, and those on postoperative both palm and sole were increased. Those had statistical significance(p<0.05), and the temperature on the palm was increased higher that than on the sole. Conclusion: After thoracic sympathicotomy was performed on palmar hyperhidrosis patients, an increment of skin temperatures and SSR changes were achieved at both palms and soles of all patients. Palmar SSRs were completely abolished in 12 patients(80%), and similar results of postoperative SSRs were achieved. The recording of SSR may be useful to easily and objectively assess the completeness of sympathicotomy and the follow-up of recurrence in hyperhidrosis patients.

• Sleep Medicine and Psychophysiology
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• v.22 no.1
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• pp.11-19
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• 2015

Objectives: Whether daytime sleepiness is proportional to the severity of sleep apnea in obstructive sleep apnea syndrome (OSAS) is controversial. In this study we investigated how insomnia severity affects the association between daytime sleepiness and sleep apnea severity in OSAS. Methods: The present study included 235 male subjects who were diagnosed with OSAS based on clinical history and nocturnal polysomnography. Pearson's correlation analysis was conducted among sleep and mood-related self-reported data, polysomnographic data and demographic data of all subjects. Based on Pittsburgh Sleep Quality Index (PSQI), the subjects were divided into 2 groups; group A (n = 75; $PSQI{\leq}5$) and group B (n = 160; PSQI > 5). Partial correlation analysis was performed between the Epworth Sleepiness Scale (ESS) and other data in both groups. Multiple linear regression analysis was conducted to investigate the factors which affected the ESS in group A. Results: Pearson's correlation analysis showed weak or non-existent correlations between ESS and apnea severity data such as apnea-hypopnea index (AHI) (r = 0.148, p = 0.023), apnea index (AI) (r = 0.137, p = 0.036), hypopnea index (HI) (r = 0.058, p = 0.377), oxygen desaturation index (ODI) (r = 0.149, p = 0.022) and arousal total index (ATI) (r = 0.129, p = 0.048). Positive correlations between ESS and apnea severity data such as AHI ($r_p=0.313$, p = 0.008), AI ($r_p=0.339$, p = 0.004), ODI ($r_p=0.289$, p = 0.015) and ATI ($r_p=0.256$, p = 0.031) were observed only in group A. Multiple regression analysis showed that AI (t = 2.996, p = 0.004) and BAI (t = 2.721, p = 0.008) were associated with ESS in group A. Conclusion: The correlation between daytime sleepiness and sleep apnea severity was shown only in group A. This result suggests that associations between daytime sleepiness in OSAS and sleep apnea severity will become prominent when controlling for insomnia-related variables.