Purpose: Breast conserving surgery(BCS) for breast cancer has a common treatment protocol. Oncoplastic surgery represents a form of BCS which combines both a cosmetic mammoplasty approach and oncologic resection for the treatment of breast cancer. Depending on the tumor site, BCS can make an unsatisfactory cosmetic result, especially in inferiorly placed tumors. This study describes the use of oncoplastic techniques for inferiorly located breast tumors in immediate partial mastectomy reconstruction. Methods: From September of 2006 to February of 2008, these techniques were used in 11 patients at the ${\bigcirc}{\bigcirc}$ hospital. After BCS was preceded, breast reshaping by oncoplastic techniques were selected depending on the location and size of the tumor within the breast as well as the size of breast itself. Oncoplastic techniques after partial mastectomy included 'Wise pattern (inverted T)' reduction mammoplasty, 'vertical pattern' mammoplasty, 'J-pattern' mammoplasty. In order to improve the cosmetic outcome, repositioning of the nipple areola complex(NAC) or reshaping of the contralateral breast may be considered additionally. Results: These techniques have been used in 11 patients. The mean age was 51 and the average follow-up period was 8 months. Eleven of these patients underwent the 'Wise pattern(inverted T)' reduction mammoplasty(n=6), 'vertical pattern' mammoplasty(n=3) and 'J-pattern' mammoplasty(n=2). There was one wound dehiscence during the follow-up periods. This complication was treated by conservative approach. The overall cosmetic result was evaluated in 6 months. The majority of patients were satisfied at the cosmetic result. Conclusion: Oncoplastic techniques in inferiorly located breast tumors could be a reasonable and safe option for breast cancer patients who desire conserving surgery with esthetical breast.
Purpose: To evaluate the treatment outcome and prognostic factor after postoperative radiotherapy in retroperitoneal sarcoma. Materials and Methods: Forty patients were treated with surgical resection and postoperative radiotherapy for retroperitoneal sarcoma from August 1990 to August 2008. Treatment volume was judged by the location of initial tumor and surgical field, and 45-50 Gy of radiation was basically delivered and additional dose was considered to the high-risk area. Results: The median follow-up period was 41.4 months (range, 3.9 to 140.6 months). The 5-year overall survival (OS) was 51.8% and disease free survival was 31.5%. The 5-year locoregional recurrence free survival was 61.9% and distant metastasis free survival was 50.6%. In univariate analysis, histologic type (p = 0.006) was the strongest prognostic factor for the OS and histologic grade (p = 0.044) or resection margin (p = 0.032) had also effect on the OS. Histologic type (p = 0.004) was unique significant prognostic factor for the actuarial local control. Conclusion: Retroperitoneal sarcoma still remains as a poor prognostic disease despite the combined modality treatment including surgery and postoperative radiotherapy. Selective dose-escalation of radiotherapy or combination of effective chemotherapeutic agent must be considered to improve the treatment result especially for the histopathologic type showing poor prognosls.
The Journal of Korea Assosiation for Disability and Oral Health
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v.8
no.2
/
pp.122-126
/
2012
Epidermolysis bullosa (EB) is a genetic disorder, characterized by blisters on skin and mucosal surfaces even upon light mechanical damage. EB is caused by genetic mutations in at least seven proteins on the basement membrane zone, which is the boundary between the epidermis and the dermis. There are many types of EB differing in clinical and genetic aspects, and the prognosis varies depending on the EB type. There are largely three types of EB, categorized by the electron-microscopic location of the blisters. The blisters form within the epidermis in epidermolysis bullosa simplex, in the lamina lucida in junctional epidermolysis bullosa, and just beneath the basal lamina in dystrophic epidermolysis bullosa. To date, there is no medication or treatment that cures EB or completely prevents the blisters, so generally symptomatic treatment is performed. EB patients must always be cautious, for blisters can form at the slightest injuries, and the patients must be dealt with gently. Injuries and infections have to be prevented and treated, and deficient nutrients must be supplied during dental treatment period. Some patients may experience pain when swallowing food or dental treatment due to blisters and resulting scars in the mouth, pharynx, and esophagus. Recently, two pediatric patients were diagnosed with EB at Pusan National University Hospital and visited the Department of Pediatric Dentistry for oral care and dental treatment. The treatment results are reported here.
Kim, Ki-Rim;Song, Je-Seon;Choi, Byung-Jai;Kim, Seung-Hye;Lee, Jae-Ho
The Journal of Korea Assosiation for Disability and Oral Health
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v.7
no.1
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pp.25-28
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2011
Autism is a developmental, neuropsychiatric disorder that begins in early childhood. A patient with autism seen in the dental office frequently may have many complications. Therefore, it may be needed to consider modified or alternative therapy for dental care of autistic patients. This is the case of a 16-year old boy who have autism. He came to the department of the pediatric dentistry, Yonsei University Dental Hospital, for evaluation and treatment of dentigerous cyst associated with impacted teeth(#33,34,35). Under daily hospitalization and general anesthesia, the cyst was enucleated with surgical extraction of #34 and autotransplantation of #33,35. And during the periodic dental followup, apexification of #33,35 was performed for periapical lesion and root maturity. At 2 year 6 months follow- up, now, bony healing was completed and there are some complications like external resorption of #33 and space loss of #34 area. Generally, the marsupialization has been widely recommended for treatment of dentigerous cyst. However, in this case, there is a little possibility of spontaneous eruption after marsupialization considering of patient's age, location and angulation of the impacted tooth, root maturity. And there is necessity to choose the treatment that has low recurrence risk and needs short-term follow-up for autism. Above all, poor oral hygiene and lack of cooperation for decompression treatment is a matter of primary consideration. Consequently, enucleation of the cyst was chosen for the final treatment plan in this case. It is important to consider the conditions that affect the eruption of a dentigerous cyst-associated tooth to predict the successful eruption and special health care needs of the patient when the treatment plan is settled.
Journal of the korean academy of Pediatric Dentistry
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v.40
no.4
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pp.260-267
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2013
The aim of this study was to analyze the three dimensional characteristics of the size, shape and location of mesiodens and their effect on permanent teeth arrangement using Cone-beam computed tomography(CBCT). 191 patients under 15 years old who had visited the hospital between June 2006 and December 2012 and taken CBCT were investigated. Among them, 43 patients with diastema were analyzed to investigate the correlation between the amount of diastema and the mesiodens. The results showed that mesiodens were found in males 3.9 times more than females and found most in 7 years old. The mean length of mesiodens was 13 mm and the width was 6.8 mm. The conical shape comprised of 52.9%. Many mesiodens were located in the palatal side rather than the labial side and located vertically near the crown. 63.0% of mesiodens were reversed and the common complications were delayed eruption followed by diastema, and teeth rotation. And the amount of diastema had correlation with size and mesiodistal position of the mesiodens. The current study used 3D analysis to show the size and position of mesiodens and occurrence distribution of complication. Among these, the amount of diastema had shown the correlation with the size and mesiodistal position of mesiodens.
Objective: This study aimed to investigate expression of the proto-oncogene POK erythroid myeloid ontogenic factor (Pokemon) in colorectal cancer (CRC), and assess inhibitory effects of a small interference RNA (siRNA) expression vector in SW480 and SW620 cells. Methods: Semi-quantitative reverse transcription-polymerase chain reaction (PCR) and immunohistochemistry were performed to determine mRNA and protein expression levels of Pokemon in CRC tissues. Indirect immunofluorescence staining was applied to investigate the location of Pokemon in SW480 and SW620 cells. The siRNA expression vectors that were constructed to express a short hairpin RNA against Pokemon were transfected to the SW480 and SW620 cells with a liposome. Expression levels of Pokemon mRNA and protein were examined by real-time quantitative-fluorescent PCR and western blot analysis. The effects of Pokemon silencing on proliferation of SW480 and SW620 cells were evaluated with reference to growth curves with MTT assays. Results: The mRNA expression level of Pokemon in tumor tissues ($0.845{\pm}0.344$) was significantly higher than that in adjacent tumor specimens ($0.321{\pm}0.197$). The positive expression ratio of Pokemon protein in CRC (87.0%) was significantly higher than that in the adjacent tissues (19.6%). Strong fluorescence staining of Pokemon protein was observed in the cytoplasm of the SW480 and SW620 cells. The inhibition ratios of Pokemon mRNA and protein in the SW480 cells were 83.1% and 73.5% at 48 and 72 h, respectively, compared with those of the negative control cells with the siRNA. In the SW620 cells, the inhibition ratios of Pokemon mRNA and protein were 76.3% and 68.7% at 48 and 72 h, respectively. MTT showed that Pokemon gene silencing inhibited the proliferation of SW480 and SW620 cells. Conclusion: Overexpression of Pokemon in CRC may have a function in carcinogenesis and progression. siRNA expression vectors could effectively inhibit mRNA and protein expression of Pokemon in SW480 and SW620 cells, thereby reducing malignant cell proliferation.
Journal of the Korea Academia-Industrial cooperation Society
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v.21
no.3
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pp.488-496
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2020
This study was based on nitrate chemical accidents at home and abroad. Toxic gases due to adverse reactions are generated in the workplace, laboratory, hospital, container damage, and chemical misinjection. Through a case review of possible situations and safety, this study analyzed various cases of accidents, accident status, accident type, cause of the accident, location of the accidents, etc. from 2014 to 2018. The plans for improvement in education and nitrate accidents were reviewed. As a result, 36 nitrate chemical accidents were investigated, including 16 careless worker accidents, eight transportation accidents, and 12 facilities shortages. Nitrate chemical accidents are occurring continuously. Based on this, the range of toxic effects using CARIS was calculated at the worst-case scenario, and the effective response range was measured through the damage impact range. For this purpose, the impact range was predicted based on the strengthening of safety education, emergency action plan and correlation, and the quantified data was identified. In addition, the reliability of the scope of impact was reviewed based on the correlation formula that could facilitate the evacuation of residents, and it was applied to actual accident scenarios of the workplace to present the effects of the accident response and preventive measures.
Background: In recent years, pediatric chronic sinusitis patients who don't respond with antibiotics are increasing, but there are a few reports on the herbal medicine therapy treating pediatric chronic sinusitis, so this report was studied. Objective: To demonstrate the effect of herbal medicine therapy in the chronic sinusitis before and after treatment using computed tomograpy (CT) and plain radiograpy. Materials and methods: Ninty patients (45 mail and 45 femail) treated in our hospital between February 1998 and August 1999 were studied. Ages ranged from 3 to 13 years (mean age :6.5 years). Sixty two patients had a underlyiing family history (allergy or sinusitis of parents or brothers), In the past history, 68 patients had asthma, allergy of milk, atopic dermatitis, bronchiollitis and irritable bowel syndrom. Illness period was from 10 days to 96 months (mean period:12.4 month). Duration of treatment were from 25 days to 200days (mean:96 days). To ascertain the efficacy of treatment, CT in the 42 and plain radiopgrapy in the 48 patients were checked out. In the CT, three images were obtained 2cm interval on the coronal and axial plan. CT findings of the chronic sinusitis were analyzed for mucoperiostal thickening before and after treatment using 4 grades;(normal, mild, moderate, severe). Normal was defined as below 3mm thickening of mucoperiosteum; mild was 3-5mm thickening; moderate was 5mm-1cm thickening; severe was above 1cm thickening. Plain radiograpy using Water's view provided maxillary sinus, anterior ethmoid sinus, frontal sinus. Normal was defined as simillar to density between sinus and oronasal cavity; mild was defined as generally increased density with no significant mucoperiosteal thickning; moderate was partial mucosal thickening without bony hypertropy; severe was total haziness with mucoperiosteal thickening. Gamihyunggyeyungyo-tang was administered mainly. Gamigwaghyangjeungki-san, Gamizwakwi-eum and Gamihyangso-san were administered for through oral route additional symptoms Results: Of the 90 patients, 84 patients showed complete recovery (93%), 4 patients showed no significant interval change(4%) and 2 patients were aggrevated (2%). Sixty patients were severe(67%) and 26 patients were moderate (29%), 4 patients were mild(4%) The duration of treatment was varied with patient conditions (91 days in average); severe were 101.7 days, moderate were 70 days and mild were 63 days. Fifty three patients with maxillary and ethmoid sinusitis were 114 days, 35 patients with maxillary sinusitis only were 71.5 days. Fifty eight patients with both maxillary sinusitis were 94.6 days, 26 patients with either maxillary sinusitis were 65 days. The symtoms of chronic sinusitis were nasal obstruction(75%), cough(69%), purulunt or mucosal discharge(62%), lymphoid follicle(54%), postnasal dripping(49%), headache(23%) and nose bleeding(22%). Conclusion: We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis using plain radiograpy and CT. The duration of treatment may be significant assosiation with the location and degree of chronic sinusitis.
The purpose of this study is to analyze the structural relationship between internal capabilities and job satisfaction using the 7S model and propose measures to improve management performance through internal factors. For this study, seven research hypotheses were set up, and the survey conducted among members of all professions working in general hospitals in small and medium-sized cities in the provinces. From September 20 to October 20, 2016, 385 people were surveyed, and 327 pieces of data (84.9%) used for the study. Multiple regression analyses were performed to verify the effects of internal capabilities on job satisfaction. The analysis results showed that the explanatory power of the research model was suitable by showing 69.1%, and among the 7S factors, the leadership style (β=.392**), the organizational structure (β=.129*), the membership (β=.232**), and the management technique (β=.204*) showed a positive influence on job satisfaction. That has been confirmed to affect job satisfaction as the standardized factor values increase. Relationships between strategies, systems, and shared values on job satisfaction could not be identified. Significantly observed in the relationship between some internal capacity factors and job satisfaction is that internal capacity can be used as an alternative to an organization's performance improvement measures. Internal capacity can be affected by various environmental variables, such as establishment classification, size, and location. Further implications will also be provided for measuring future internal satisfaction levels separately from internal and external factors.
From 1982 to 1991, sixteen Patients with primary non-Hodgkin's lymphoma of the central nervous system(CNS) were seen at Kyung Hee University Hospital. The most common subtypes were large, noncleaved cell lymphoma and immunoblastic lymphoma of B cells. Lesions most commonly involved were the parietal lobes and/or deep nuclei. Positive cerebrospinal fluid cytology was rare at initial presentation. Sixteen patients were treated with surgical biopsy or resection followed by whole brain radiotherapy at a median dose of 40 Gy(range=30-50 Gy) with variable boost doses. Of 16 patients who underwent surgery and postoperative radiotherapy, fourteen patients died between 2 and 49 months following treatment, and two are alive with no evidence of disease at 8 and 22 months. The 1-and 2-year survival rates were 55.6$ \% $ and 34.7$ \% $, respectively with 12 months of median survival. Patterns of failure were analyzed in eleven patients of total 16 patients. Failure at the original site of involvement was uncommon after radiotherapy treatment. In contrast, failure in the brain at sites other than those originally invovled was common in spite of the use of whole brain irradiation. Failure occurred in the brain 11/16(68.7$ \% $), in spinal axis 4/16(25.0$ \% $). The age, sex, location of involvement within CNS, numbers of lesion, or radiation dose did not influence on survival. The authors conclude that Primary CNS lymphoma is a locally aggressive disease that is poorly controlled with conventional radiation therapy. The limitation of current therapy for this disease are discussed, and certain promising modality should be made in regarding the management of future patients with this disease.
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