• Radiation Oncology Journal
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• v.16 no.4
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• pp.399-408
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• 1998

Purpose : This study was designed to demonstrate the potential therapeutic advantage of 3-dimensional (3-D) treatment planning over the conventional 2-dimensional (2-D) approach in patients with carcinoma of the nasopharynx. Materials and Methods : The two techniques were compared both qualitatively and quantitatively for the boost portion of the treatment (19.8 Gy of a total 70.2 Gy treatment schedule) in patient with T4. The comparisons between 2-D and 3-D plans were made using dose statistics, dose-volume histogram, tumor control probabilities, and normal tissue complication probabilities. Results : The 3-D treatment planning improved the dose homogeneity in the planning target volume. In addition, it caused the mean dose of the planning target volume to increase by 15.2$\%$ over 2-D planning. The mean dose to normal structures such as the temporal lobe, brain stem, parotid gland, and temporomandibular joint was reduced with the 3-D plan. The probability of tumor control was increased by 6$\%$ with 3-D treatment planning compared to the 2-D planning, while the probability of normal tissue complication was reduced. Conclusion : This study demonstrated the potential advantage of increasing the tumor control by using 3-D planning. but prospective studies are required to define the true clinical benefit.

• The Korean Journal of Pain
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• v.5 no.2
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• pp.234-238
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• 1992

We compared the effectiveness of vasodilator therapy with histamine and stellate ganglion block(SGB) for the treatment of sudden sensoryneural hearing impairment retrospctively. 24 patients were treated with histamine and nicotinic acid(histamine group), and 30 patients were treated with SGB(SGB group). Corticosteroids and low molecular weight dextran($Rheomacrodex^{(R)}$) were given to all patients. The degree of hearing impairment and the evidence of improvement were checked with audiogram. 52.8%(10 out of l9 follow-up ckecked patients) of patients in histamine group and 56.7%(17 out of 30) of patients in SGB group had improved within three weeks of treatment, which means both histamine and SGB are equally effective. As a consequence, we concluded that SGB ia a good substitute for histamine as a vasodilator therapy for sudden sensoryneural hearing impairment with minimal complication, few absolute contraindications, and simple and safe technique.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.714-717
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• 2006

Heart and kidney transplantation has made great progress in the modern era. Coupled with the growing successes in individual solid organ transplantation, there has also been an increase in the number of multiple organ transplants, such as heart-kidney transplantation. This trend has been in part due to a better understanding of immunobiology, advances in surgical technique and postoperative care, and an often-common pathologic association between dual-organ failure. This pathologic course is representative for end-stage heart failure leading to secondary renal dysfunction or failure, or for end-stage renal failure as a cause for (uremic) cardiomyopathy. However, refractory cardiac failure has long been considered a contraindication to kidney transplantation. Additionally, cardiac transplantation has been denied for patients with end-stage renal disease. Over recent years, combined heart-kidney transplantation has been offered to select patients who were once denied transplantation. We report the first experience of combined heart-kidney transplantation with one year follow-up results.

• Journal of Oral Medicine and Pain
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• v.36 no.1
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• pp.21-24
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• 2011

Xerostomia is subjective feeling of dry mouth, a symptom that may or may not be accompanied by hyposalivation, an objective decrease in salivary flow. There are many causes induced xerostomia like drugs, salivary gland diseases, radiation therapy to the head and neck region, Sjogren syndrome, emotional stress etc. Insufficient salivary flow creates complications with oral candidiasis, dental caries, periodontitis, halitosis, dysgeusia. So finally, these complications lead to an overall decline in quality of life. Managements of xerostomia are eliminating or alterating the etiologic factors, relieving symptoms, preventing or correcting the consequences of salivary dysfunction, treating underlying disease and stimulating salivation. One of the salivation stimulation agents studied to treat xerostomia was the pilocarpine muscarinic agonist. Pilocarpine is one of salivation stimulants, a parasympathomimetic drug and non-selective muscarinic receptor agonist. Systemic pilocarpine has been used to stimulate salivary secretion. But systemic administration of pilocarpine has limitations such as increased risk of side effects and contraindications. Side effects of systemic pilocarpine administration are sweating, urinary and gastrointestinal disturbance, risk of cardiovascular and pulmonary disorders. This drug must be used carefully by patients with controlled asthma, chronic bronchitis, pulmonary or cardiac disease. Patient with acute asthma, narrow angle glaucoma, iritis should not use pilocarpine. Like this, systemic pilocarpine has many limitations. So, many investigators also have looked at the effectiveness of topical pilocarpine. Here we present patients with xerostomia which was relieved by pilocarpine mouthwash.

• Restorative Dentistry and Endodontics
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• v.36 no.1
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• pp.19-25
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• 2011

Objectives: The purpose of this retrospective study was to evaluate the success rate of intentionally replanted mandibular second molar with C-shaped canal configurations and to access the impact of preoperative periapical lesion on the success of intentional replantation procedure. Materials and Methods: This retrospective chart review study evaluated 52 intentionally replanted mandibular second molar teeth treated at Seoul National University Dental Hospital Department of Conservative Dentistry from January 2005 to December 2007. Seventeen teeth were lost for the follow-up, and another 6 teeth did not meet inclusion criteria of C-shaped root canal configurations. Healing outcome such as success, uncertain healing, and failure after follow-up was evaluated by clinical criteria and radiographs. Results: The overall success rate was 72.4% for the 29 intentionally replanted C-shaped mandibular second molars. The success rate of replanted teeth with preoperative periapical lesions was similar to that of replanted teeth which have no periapical lesions. Conclusions: Therefore, root canal treatment failure on C-shaped mandibular second molar can be predictably treated by intentional replantation regardless of the presence of periapical lesion.

• Restorative Dentistry and Endodontics
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• v.36 no.3
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• pp.196-202
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• 2011

Objectives: The aim of this study was to investigate levels of matrix metalloproteinase-8 (MMP-8) and substance P (SP) in root canal exudates during root canal treatment (RCT) of nonvital, painful teeth. Materials and Methods: Patients scheduled for nonsurgical RCT were prospectively selected; the study was performed after obtaining informed consent from the patients and was approved by the Institutional Review Board for Clinical Research of Gangnam Severance Hospital, Yonsei University (3-2008-0118). Canal exudates samples were collected using sterilized paper points from teeth scheduled for RCT across three different time periods. MMP-8 and SP levels were measured using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using a mixed model analysis and the Pearson correlation analysis (p < 0.05). Results: MMP-8 and SP levels in GCF were decreased during RCT (p < 0.0001), and they showed a weak positive correlation to each other (p < 0.05). Patients' subjective pain levels and the response from percussion test were significantly related to SP level. Conclusions: This study demonstrated that periradicular inflammation endodontic origin can elevate SP and MMP-8 levels in root canal exudates. Interestingly, SP level of canal exudates showed a possibility of being used as an indicator of pain due to periapical pathosis.

• Journal of Chest Surgery
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• v.36 no.1
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• pp.21-25
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• 2003

Video-assisted thoracoscopic surgery (VATS) for decortication or debridement in the management of empyema thoracis has increased the available treatment options but requires validation. We present and evaluate our technique and experience with thoracoscopic management of pleural empyema, irrespective of chronicity. Material and Method : VATS debridement or decortication was performed with endoscopic shaver system in 40 consecutive patients presented with pleural space infections. A retrospective review was performed and the effect of this technique on perioperative outcome was assessed. Result : VATS evacuation of infected pleural fluid and decortication was successfully performed in 35 of 40 patients. The mean duration of preoperative symptoms before referral was 23$\pm$1.8 days. The mean duration of hospitalization before transfer was 13.5$\pm$1.5 days. Blood loss was 250 to 200 mL. Intercostal drainage was required for 5$\pm$3 days. The postoperative hospital stay was 5 $\pm$0.7 days. There were no operative mortalities. Conclusion : Video-assisted evacuation of infected pleural fluid and decortication is an effective modality in the management of the fibropurulent stage of empyema. An organized empyema should be approached thoracosco-pically, but may require open decortication.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.95-100
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• 2011

Fibrodysplasia ossificans progressiva(FOP) is characterized by episodes of permanent heterotopic ossifications of soft tissues throughout the body. FOP is inherited in an autosomal dominant pattern, but most cases result from new mutations in the ACVR1 gene. Even minimal trauma can cause permanent ossifications of soft tissues and give rise to complications following routine dental care. Dental block anesthesia, severe stretching of the jaw and biopsies are all contraindicated in children with FOP. There is no effective treatment. Since the prevalence of FOP is very low and most patients with FOP are misdiagnosed during childhood, they undergo dangerous and unnecessary treatment that can lead to permanent harm. For patients with FOP, early diagnosis and prevention of complications are most important. This study aims at contemplating the characteristic features and consideration factors for the dental treatment of FOP patients in relation to the case of an eight years-and-one month old boy who was referred to Pediatric Dentistry due to prolonged retention of mandibular right and left deciduous central incisors after being diagnosed with sporadic FOP at Pediatric Orthopaedics, Seoul National University Hospital, and received dental treatment without the exacerbation of the FOP symptoms.

• Radiation Oncology Journal
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• v.24 no.4
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• pp.294-299
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• 2006

$\underline{Purpose}$: Using cone beam CT, we can compare the position of the patients at the simulation and the treatment. In on-line image guided radiation therapy, one can utilize this compared data and correct the patient position before treatments. Using cone beam CT, we investigated the errors induced by setting up the patients when use only the markings on the patients' skin. $\underline{Materials\;and\;Methods}$: We obtained the data of three patients that received radiation therapy at the Department of Radiation Oncology in Chung-Ang University during August 2006 and October 2006. Just as normal radiation therapy, patients were aligned on the treatment couch after the simulation and treatment planning. Patients were aligned with lasers according to the marking on the skin that were marked at the simulation time and then cone beam CTs were obtained. Cone beam CTs were fused and compared with simulation CTs and the displacement vectors were calculated. Treatment couches were adjusted according to the displacement vector before treatments. After the treatment, positions were verified with kV X-ray (OBI system). $\underline{Results}$: In the case of head and neck patients, the average sizes of the setup error vectors, given by the cone beam CT, were 0.19 cm for the patient A and 0.18 cm for the patient B. The standard deviations were 0.15 cm and 0.21 cm, each. On the other hand, in the case of the pelvis patient, the average and the standard deviation were 0.37 cm and 0.1 cm. $\underline{Conclusion}$: Through the on-line IGRT using cone beam CT, we could correct the setup errors that could occur in the conventional radiotherapy. The importance of the on-line IGRT should be emphasized in the case of 3D conformal therapy and intensity-modulated radiotherapy, which have complex target shapes and steep dose gradients.

• Journal of Korean Traditional Oncology
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• v.16 no.2
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• pp.9-17
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• 2011

Objectives : Contradictions for Oncology acupuncture were searched and reviewed to establish fundamentals for the appropriate contraindication guideline. Methods : In order to search contraindications for oncology acupuncture, domestic journals, books and online database of Pubmed were searched using the terms, cancer, tumor, acupuncture, safety, contraindications and guideline were below. Results : We found 7 papers and 1 book by the above methods. We reviewed and suggested the contraindications. Contraindications for oncology acupuncture are neutropenia (absolute neutrophil count : ANC less than $500/mm^3$), thrombocytopenia (platelets less than $50,000/mm^3$), anticoagulant use, spinal instability, tumour nodule, lymphedema, prosthesis, intracranial deficits, confused patients, significant arrhythmia, patient refusal to treatment, severe neurotic patients and intracardiac defribillator. Contraindications for using semi-permanent needles are neutropenia (ANC less than $500/mm^3$), splenectomy, valvular heart disease, B, C hepatitis and keloids. Conclusions : Acupuncture for cancer patients pose significant risks but these guidelines are proposed in the hopes of providing certain boundaries in practicing oncology acupuncture. A more systematic and rigorous research is needed to establish a more reliable oncology acupuncture guidelines.