• Radiation Oncology Journal
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• v.12 no.3
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• pp.393-399
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• 1994

Spinal cord compression, an oncologic emergency, is a rare complication of hematologic malignancy Our experience was obtained with a series 32 Patients following retrospective analysis for assessing the role of radiation therapy and identifying the prognostic factors affecting on treatment outcome. Diagnosis was usually made by means of radiologic study such as myelography or computerized tomography (CT) or magnetic resonance imaging (MRI) and neurologic examination. Five cases were diagnosed by subjective symptom only with high index of suspicion. In 31 cases, the treatment consisted in radiation therapy alone and the remained one patient had laminectomy before radiation therapy because of diagnostic doubts. Total treatment doses ranged from 800 cGy to 4000 cGy with median of 2000 cGy. Initially large fraction size more than 250 cGy were used in 13 patients with rapidly progressed neurologic deficit. The clinical parameters considered in evaluating the response to treatment were backache, motor-sensory performance and sphincter function. Half of all patients showed good response. Partial response and no response were noted in $37.5\%$ and $12.5\%$, respectively. Our results showed higher response rate than those of other solid tumor series. The degree of neurologic deficit at that time of diagnosis was the most important predictor of treatment outcome. The elapsed time from development of symptoms to start of treatment was significantly affected on the outcome. But histology of primary tumor total dose and use of initial large fraction size were not significantly affect on the outcome. These results confirmed the value of early diagnosis and treatment especially in radiosensitive hematologic malignancy.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.277-282
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• 2000

Purpose : Though It has been known that the to tolerance of the liver to external beam irradiation depends on the irradiated volume and dose, few data exist which Quantify this dependence. However, recently, with the development of three dimensional (3-D) treatment planning, have the tools to Quantify the relationships between dose, volume, and normal tissue complications become available. The objective of this study is to investigate the relationships between normal tissue complication probabili쇼 (WCP) and the risk of radiation hepatitis for patients who received variant dose partial liver irradiation. Materials and Methods : From March 1992 to December 1994, 10 patients with hepatoma and 10 patients with bile duct cancer were included in this study. Eighteen patients had normal hepatic function, but 2 patients (prothrombin time 73$\%$, 68$\%$) had mild liver cirrhosis before irradiation. Radiation therapy was delivered with 10MV linear accelerator, 180$\~$200 cGy fraction per day. The total dose ranged from 3,960 cGy to 6,000 cGy (median dose 5,040 cGy). The normal tissue complication probability was calculated by using Lyman's model. Radiation hepatitis was defined as the development of anicteric elevation of alkaline phosphatase of at least two fold and non-malignant ascites in the absence of documented progressive. Results: The calculated NTCP ranged from 0.001 to 0.840 (median 0.05). Three of the 20 patients developed radiation hepatitis. The NTCP of the patients with radiation hepatitis were 0.390, 0.528, 0.844(median : 0.58$\pm$0.23), but that of the patients without radiation hepatitis ranged fro 0.001 to 0.308 (median .0.09$\pm$0.09). When the NTCP was calculated by using the volume factor of 0.32, a radiation hepatitis was observed only in patients with the NTCP value more than 0.39. By contrast, clinical results of evolving radiation hepatitis were not well correlated with NTCP value calculated when the volume factor of 0.69 was applied. On the basis of these observations, the volume factor of 0.32 was more correlated to predict a radiation hepatitis. Conclusion : The risk of radiation hepatitis was increased above the cut-off value. Therefore the NTCP seems to be used for predicting the radiation hepatitis.

• Journal of Music and Human Behavior
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• v.2 no.2
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• pp.33-56
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• 2005

The purpose of this study is to measure the effect of musical activities on children's aggressiveness using percussion playing through case studies and to present the therapeutic programs. Musical activities using percussion playing were organized for three aggressive children. Twenty-one small group sessions were conducted over seven weeks with 30 minutes given each session. Fourth-grade children involved in using Aggressiveness Measuring Tool for Teachers-revised by Gwak Geum-Joo(1992) was selected for case studies. Children's impulsiveness was also tested through self-test measuring tool for impulsiveness-revision of 16 questions used by Cho Hae Yeon (2001) and Lee Joo Shik (2003). As quantitative method, comparative analysis was made between the pre and post test results using measuring tools for aggressiveness and impulsiveness of children as well as between aggressive behaviors occurring in the initial stage of the first three sessions and in the latter stage of the last three sessions. Qualitative method was used at the same time to examine the effect of percussion playing on children. After the musical activities, child A showed reduced Aggressive Measuring Tool scores from 19 to 18, with child B from 23 to 19 and child C from 21 to 18. The results show that occurrence of aggressive behaviors were lowered in the post test. Impulsiveness Measuring Tool scores in the post test were decreased as well in all three children. During the music therapy programs, it was also observed that the frequency of the target behaviors in all three children has reduced more in the latter stage than the initial stage of music therapy. The qualitative findings indicate that the children experienced releasing stress through self-expression after percussion playing. These findings indicate therapeutic effectiveness of music therapy using on percussion playing in reducing aggressiveness of children as well as the effectiveness of percussion as a therapeutic intervention for aggressive children. These results can be adapted and reapplied by teachers in primary schools to approach children with behavior problems, and can present a useful therapeutic approach to therapists practicing in clinical environments.

• Clinical and Experimental Pediatrics
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• v.49 no.2
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• pp.173-180
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• 2006

Purpose : Cytomegalovirus(CMV) infection still remains as a major cause of morbidity and mortality after stem cell transplantation. In this study, we analyzed the results of antigenemia-guided preemptive therapy among children with allogeneic hematopoietic stem cell transplantation to determine the incidence and risk factors associated with CMV antigenemia, and evaluated the efficacy of the CMV antigenemia based preemptive therapy. Methods : We enrolled 213 pediatric patients following allogeneic hematopoietic stem cell transplantation(HSCT), at the Catholic HSCT center between October 1998 and December 2003. Pre-emptive ganciclovir was started when more than 5 CMV Ag-positive cells were detected in matched sibling HSCT, and when any Ag-positive cells were seen in unrelated allogenic HSCT. Results : CMV antigenemia was observed in 88(41.3 percent) of 213 patients on median day 28(day 11-99). In univariated analysis, use of unrelated donors(other than siblings), age of recipient(more than 5 years at transplant) at transplantation, the presence of recipient CMV-IgG before transplantation, TBI-based conditioning regimen and the presence of acute GvHD(grade ${\geq}II$) were the risk factors for positive CMV antigenemia. In multivariate analysis, unrelated bone marrow transplantation, positive recipient CMV serology and acute GvHD(grade ${\geq}II$) were the independent risk factors for positive CMV antigenemia. Conclusion : Risk factors of CMV infection in children were CMV serostatus of the recipient, the source of stem cells, and acute graft-versus-host disease. The pre-emptive therapy based on CMV antigenemia was effective in the prevention of CMV disease.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.107-114
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• 2014

Purpose : The purpose of this study is evaluation for the applicability of O-MAR(Metal artifact Reduction for Orthopedic Implants)(ver. 3.6.0, Philips, Netherlands) in head & neck radiation treatment planning CT with metal artifact created by dental implant. Materials and Methods : All of the in this study's CT images were scanned by Brilliance Big Bore CT(Philips, Netherlands) at 120kVp, 2mm sliced and Metal artifact reduced by O-MAR. To compare the original and reconstructed CT images worked on RTPS(Eclipse ver 10.0.42, Varian, USA). In order to test the basic performance of the O-MAR, The phantom was made to create metal artifact by dental implant and other phantoms used for without artifact images. To measure a difference of HU in with artifact images and without artifact images, homogeneous phantom and inhomogeneous phantoms were used with cerrobend rods. Each of images were compared a difference of HU in ROIs. And also, 1 case of patient's original CT image applied O-MAR and density corrected CT were evaluated for dose distributions with SNC Patient(Sun Nuclear Co., USA). Results : In cases of head&neck phantom, the difference of dose distibution is appeared 99.8% gamma passing rate(criteria 2 mm / 2%) between original and CT images applied O-MAR. And 98.5% appeared in patient case, among original CT, O-MAR and density corrected CT. The difference of total dose distribution is less than 2% that appeared both phantom and patient case study. Though the dose deviations are little, there are still matters to discuss that the dose deviations are concentrated so locally. In this study, The quality of all images applied O-MAR was improved. Unexpectedly, Increase of max. HU was founded in air cavity of the O-MAR images compare to cavity of the original images and wrong corrections were appeared, too. Conclusion : The result of study assuming restrained case of O-MAR adapted to near skin and low density area, it appeared image distortion and artifact correction simultaneously. In O-MAR CT, air cavity area even turned tissue HU by wrong correction was founded, too. Consequentially, It seems O-MAR algorithm is not perfect to distinguish air cavity and photon starvation artifact. Nevertheless, the differences of HU and dose distribution are not a huge that is not suitable for clinical use. And there are more advantages in clinic for improved quality of CT images and DRRs, precision of contouring OARs or tumors and correcting artifact area. So original and O-MAR CT must be used together in clinic for more accurate treatment plan.

• Journal of Acupuncture Research
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• v.22 no.3
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• pp.105-112
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• 2005

Obiective : The purpose of this study was to assess the effect of acupuncture treatment for chronic headache patients using power spectrum analysis of the heart rate variability(HRV). Methods : 15 clinical experiment participants were gathered and through a questionnaire patients who experienced headache for more than 4 hours a day and more than IS days per month were qualified as Chronic Headache patients. Treatment was afplied 2 times a weeks for 8 weeks. The acupoints, GV2O, HN23, ST8, HN46, TEl7, GB2O, LI2O, LI11, LI14, ST36, and LR3 were stimulated for 20 minutes. The effects of acupuncture treatment were analyzed using power spectrum analysis of the HRV. HRV was recorded before and after acupuncture treatment. Results : HRV before and after treatment was compared after 8 weeks of acupuncture treatment. Increase in mean values of SDNN and RMSSD were observed but the increases were not statistically significant. Increase in mean values of TP, LF and HF were observed but, the increase was significant(p<0.05) only in TP. Conclusions : The results suggest that acupuncture treatment on chronic headache patients can increase the activity of autonomic nervous system. Further use of HRV for quantitative analysis of acupuncture treatment on autonomic nervous system related symptoms is suggested.

• Journal of Technologic Dentistry
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• v.21 no.1
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• pp.27-41
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• 1999

The Ag-Pd-Cu alloys containing a small amount of Au is commonly used for dental purposes, because this alloy cheaper than Au-base alloys for clinical use. However, the most important characteristic of this alloy is age-hardenability, which is not exhibited by other Ag-base dental alloys. The specimens used were Ag-30Pd-10Cu ternary alloy and Au addition alloy. These alloys were melted and casted by induction electric furnace and centrifugal casting machine in Ar atmosphere. These specimens were solution treated for 2hr at $800^{\circ}C$ and were then quenched into iced water, and aged at 350-$550^{\circ}C$ Age-hardening characteristic of the small Au-containing Ag-Pd-Cu dental alloys were investigated by means of hardness testing, X-ray diffraction and electron microscope observations, electrical resistance, differential scanning calorimetric, energy dispersed spectra and electron probe microanalysis. Principal results are as follows ; Maximum hardening occured in two co-phases of ${\alpha}_2$ + PdCu In stage II, decomposition of the $\alpha$ solid solution to a PdCu ordered phase($L1_o$ type) and an Ag-rich ${\alpha}_2$ phase occurred and a discontinuous precipitation occurred at the grain boundary. From the electron microscope study, it was concluded that the cause of age-hardening in this alloy is the precipitation of the PdCu redered phase, which has AuCu I type face-centered tetragonal structure. Precipitation procedure was ${\alpha}{\to}{\alpha}_1+PdCu{\to}{\alpha}_2+PdCu$ at Pd/Cu = 3 Pd element of Ag-Pd-Cu alloy is more effective dental alloy on anti-corrosion and is suitable to isothermal ageing at $450^{\circ}C$.

• Journal of Technologic Dentistry
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• v.19 no.1
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• pp.21-35
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• 1997

The Ag-Pd-Cu alloys containing a small amount of Au is commonly used for dental purposes, because this alloy is cheaper than Au-base alloys for clinical use. However, the most important characteristic of this alloy is age-hardenability, which is not exhibited by other Ag-base dental alloys. The specimens used were Ag-20Pd-20Cu ternary alloy and Au addition alloy. These alloys were melted and casted by induction electic furace and centrifugal casting machine in Ar atmoshpere. These specimens were solution treated for 2hr at $800^{\circ}C$ and were then quenched into iced water, and aged at $350{\sim}550^{\circ}C$ Age-hardening characteristics of the small Au-containing Ag-pPd-Cu dental alloys were investigated by means of hardness testing, X-ray diffraction and electron microscope observations, electrical resistance, differential scanning calorimetric, emergy dispersed spectra and electron probe microanalysis. Principal results are as follows : Hardening occured in two stages, I. e., stage I in low temperature and stage II in high temperature regions, during continuous aging. The case of hardening in stage I was due to the formation of the Llo type face centered tetragonal PdCu-ordered phase in the grain interior and hardening in stage I was affedted by the Cu concentration. In stage II, decomposition of the $\alpha$ solid solution to a PdCu ordered phase(L1o type) and an Agrich ${\alpha}2$ phase occurred and a discontiunous precipitation occurred at the grain boundary. Form the electron microscope study, it was concluded that the cause of age-hardening in this alloy is the precipitation of the PdCu ordered phase, which has AuCu I type face-centered tetragonal structure. Precipitation procedure was ${\alpha}\to{\alpha}+{\alpha}2+PdCu\to{\alpha}1+{\alpha}2+PdCu$ at Pd/Cu = 1 Ag-Pd-Cu alloy is more effective dental alloy as ageing treatment and is suitable to isothermal ageing at $450^{\circ}C$.

• The korean journal of orthodontics
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• v.26 no.2 s.55
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• pp.233-244
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• 1996

The purpose of this study was to compare the shear bond strength obtained from ceramic and plastic brackets bonded with various light-cured adhesives and to evaluate their debonded failure sites. Plastic brackets, Transcend 6000, Signature and Starflre TMB brackets were bonded with Orthobond, Light Bond and Transbond on one hundred forty extracted human premolar teeth as manufacturer's descriptions. After thermocycling the brackets were debonded with an Instron universal testing machine and the debonded bracket base surfaces were inspected under stereoscope to evaluate the failure sites. Also the shear bond strength and failure patterns with different curing time and with two different source of light were compared. The results were as follows. 1. There were no statistically significant differences among the mean shear bond strength of Orthobond, Light Bond and Transbond in a same bracket group except Plastic bracket group(p<0.05). 2. The mean shear bond strength of each adhesive with different bracket groups showed statistically significant differences. Stafire TMB showed the highest shear bond strenght among the brackets in this study, but there was no statistically singnificant difference with Transcend 6000 while there was statistically significant difference with Signature.(p<0.05) 3. The various bonding failure patterns were occurred among different bracket groups but most of failure sites were bracket base -adhesive interfaces. 4. There were no statistically significant differences in shear bond strength between the groups with curing time of 10 second and 20 second, and between the groups with two different sources of light as long as sufficient light intensity(above $400mWcm^2$) were provided(p<0.05). According to the result, it should be considered in clinical use of ceramic bracket with light-cured adhesives that the shear strengths of ceramic brackets were influenced by the retention from of bracket base as well as the composition of bracket and there was no difference in the shear bond strenght among various light-cured adhesives used in this study.

• Advances in pediatric surgery
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• v.9 no.1
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• pp.45-51
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• 2003

A nationwide survey on choledochal cyst was undertaken among 39 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the five year period of 1997 to 2001. Three hundred and forty eight patients were registered from 32 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:3.4. The age of patients on diagnosis was $49.0{\pm}44.4$ months. The geographic distribution was 34.8% in Seoul and Kyoungki-do, 33.3% in Kyoungsang-do, 17.9% in Cholla-do, and 8.5% in Choongchung-do, in order of frequency. The three common clinical presentations were abdominal pain (63.8%), vomiting (35.3%), and jaundice (29.1%). Only seven patients (2%) presented with classic triad, and 25 patients were diagnosed by antenatal ultrasonographic examination. According to the Todani Classification, 238 patients (7l.3%) were type 1, 3 (0.9%) type 11, and 93 (27.8%) type IV. At the time of the operation, three important associated conditions were choledocholithiasis in 45 patients (15.1%), liver fibrosis (Grade 1-4) in 35, and previous operative procedure for biliary diseases in 10. Associated anomalies were observed in 13 patients (3.8%). Three hundred thirty nine (98.8%) of 343 lesions were treated by Cyst excision and Roux-Y hepaticoiejunostomy. One hundred seventy-six patients had an anomalous arrangement of the pancreatobiliary ductal system (APBD): APBD was not in 92 patients, biliary duct joined to the pancreatic duct in 51, and pancreatic duct joined to the biliary duct in 26. There were 8.5% early, and 7.7% late phase operative complications. The major complications were bleeding, anastomotic leakage, and acute pancreatitis. The combination of acute abdomen and choledochal cyst may suggest spontaneous rupture. Because of the development of late intrahepatic bile duct stones, long term follow up after cyst excision and hepaticojejunostomy is required. The optimal time of surgical intervention should also be considered in the situation of routine use of antenatal ultrasonographic examination. This is the first review of the choledochal cyst in Korea and provides baseline data for future comparisons.