• Tuberculosis and Respiratory Diseases
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• v.87 no.2
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• pp.134-144
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• 2024

Interstitial lung abnormalities (ILAs) are radiologic abnormalities found incidentally on chest computed tomography (CT) that can be show a wide range of diseases, from subclinical lung fibrosis to early pulmonary fibrosis including definitive usual interstitial pneumonia. To clear up confusion about ILA, the Fleischner society published a position paper on the definition, clinical symptoms, increased mortality, radiologic progression, and management of ILAs based on several Western cohorts and articles. Recently, studies on long-term outcome, risk factors, and quantification of ILA to address the confusion have been published in Asia. The incidence of ILA was 7% to 10% for Westerners, while the prevalence of ILA was about 4% for Asians. ILA is closely related to various respiratory symptoms or increased rate of treatment-related complication in lung cancer. There is little difference between Westerners and Asians regarding the clinical importance of ILA. Although the role of quantitative CT as a screening tool for ILA requires further validation and standardized imaging protocols, using a threshold of 5% in at least one zone demonstrated 67.6% sensitivity, 93.3% specificity, and 90.5% accuracy, and a 1.8% area threshold showed 100% sensitivity and 99% specificity in South Korea. Based on the position paper released by the Fleischner society, I would like to report how much ILA occurs in the Asian population, what the prognosis is, and review what management strategies should be pursued in the future.

• Pediatric Infection and Vaccine
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• v.28 no.2
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• pp.66-81
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• 2021

The coronavirus disease 2019 pandemic has been continuously spreading throughout the world. As of July 15, 2021, there have been more than 188 million confirmed cases and more than 4.06 million deaths. Although the incidence of severe infections is relatively low in children and adolescents compared to adults, a complication called multisystem inflammatory syndrome in children (MIS-C) may occur in some cases at approximately 2-6 weeks after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. MIS-C can be seen in patients of various ages, from young infants to adolescents, and may present with diverse clinical manifestations. While fever present in a great majority of patients, symptoms suggesting the involvement of the digestive or nervous system and the skin and mucous membranes (Kawasaki disease-like symptoms) also appear in many cases. Cardiac involvement may also be observed, including left ventricular dysfunction, myocarditis, coronary artery dilatation, and coronary aneurysm. In some cases, hypotension or shock can occur, and mechanical ventilation or treatment in the intensive care unit may be necessary. Fortunately, recovery is generally reported after appropriate treatment. MIS-C is a rare but important complication of SARS-CoV-2 infection in children and adolescents. As such, it is important to recognize the clinical symptoms and provide appropriate treatment at an early stage. In this review, the epidemiology, clinical symptoms, suggested pathophysiology, diagnostic approach, and treatment of MIS-C will be discussed.

• Radiation Oncology Journal
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• v.30 no.2
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• pp.62-69
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• 2012

Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.458-463
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• 2006

The osteoradionecrosis of the mandible can be a serious complication of radiotherapy for malignancies of the head and neck. The cause and pathogenesis of osteoradionecrosis are unclear and anecdotal. There are various treatment-, patient- and tumor-related risk factors on development of osteoradionecrosis. The treatment of osteoradionecrosis relies on conservative measures (antibiotics, debridement, irrigation and HBO) and surgical measures (sequestrectomy, marginal resection and segmental resection with or without reconstruction). But the indications are not defined. We present the two cases of patients who were not controlled by conservative treatment but good-resulted by surgical treatment.

• Journal of Preventive Medicine and Public Health
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• v.33 no.2
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• pp.215-225
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• 2000

Objective : The purpose of this study was to examine the therapeutic compliance and its related factors in the rural hypertensives. Method : A questionnaire survey and blood pressure measurement were performed to 3,876 residents of a rural area, and 660 hypertensives were selected as subjects of study. The study employed a hypothetical model which was composed of constructs from the health belief model and KAP model. The analysis techniques employed included contingency table analysis and structural equation modeling. Result : The proportion of those who were compliant to the treatment of hypertension was 44.2% of subjects. As the result of structural equation modeling, when patients had more favorable attitude toward treatment, higher perceived benefit, or lower perceived barriers to treatment, the therapeutic compliance was significantly higher(T>2.0). When patients had more knowledge about hypertension, or higher perceived severity of hypertension, the attitude toward the treatment of hypertension was more favorable significantly(T>2.0). And when patients had the support for treatment from family or neighbor, the attitude toward treatment was more favorable(T>2.0). When patients had experience of health education, they had more knowledge, higher perceived susceptibility of complication, perceived severity for hypertension, and perceived benefit of treatment, compare to patients without health education(T>2.0). Conclusion : In consideration of above findings, in order to improve the therapeutic compliance in the rural hypertensives, it would be necessary to change attitude, perception, knowledge about hypertension and its treatment, by various methods such as effective health education and programs for maintaining the supportive environment for hypertension treatment.

• Advances in pediatric surgery
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• v.16 no.1
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• pp.25-31
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• 2010

Hickman catheters are tunneled central venous catheters used for long-term venous access in children with malignancies. The appropriate management for various kinds of catheter related complications has become a major issue. We retrospectively analyzed the clinical, demographic, and surgical characteristics in 154 pediatric hemato-oncology patients who underwent Hickman catheter insertion between January 2005 and December 2009. There were 92 boys and 62 girls. The mean age at surgery was $7.6{\pm}5.1$ years old. The mean operation time was $67.4{\pm}21.3$ minutes and C-arm fluoroscopy was used in 47(30.5 %). The causes of Hickman catheter removal were termination of use in 82 (57.3 %), catheter related bloodstream infection in 44(30.8 %), mechanical malfunction in 11(7.7 %), and accidents in 6(4.2 %). Univariate and multivariate analysis for associated factors with catheter related bloodstream infection showed that there were no statistically significant associated factors with catheter related infection complications. All cases except two showed clinical improvement with catheter removal and relevant antibiotics treatment. The mean catheter maintenance period in patients of catheter removal without complications was $214.9{\pm}140.2$ days. And, The mean catheter maintenance period in patients of late catheter related bloodstream infection was $198.0{\pm}116.0$ days. These data suggest that it is important to remove Hickman catheter as soon as possible after the termination of use. When symptoms and signs of complications were noticed, prompt diagnostic approach and management can lead to clinical improvements.

• Herbal Formula Science
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• v.32 no.1
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• pp.11-28
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• 2024

Objectives : GunRyeong-Tang(GRT) is a traditional herbal prescription that combines Oryeongsan and Sagunja-tang. This study employed network analysis methods on the components of GRT and target genes related to diabetes complications to predict the improvement effects of GRT on diabetes complications. Methods : The collection of active compounds of GRT and related target genes involved the utilization of public databases and the PubChem database. We selected diabetes complication-related genes using GeneCards and confirmed their correlation through comparative analysis with the target genes of GRT. We constructed a network using Cytoscape 3.9.1 and conducted topological analysis. To predict the mechanism, we performed functional enrichment analysis based on Gene Ontology (GO) biological processes and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Results : Through network analysis, 234 active compounds and 1361 related genes were collected from GRT. A total of 9,136 genes related to diabetes complications were collected, and 1,039 target genes overlapping with the components of GRT were identified. The core genes of this network were TP53, INS, AKT1, ALB, and EGFR. In addition, GRT significantly reduced the H9c2 cell size and the expression of myocardial hypertrophy biomarkers (ANP, BNP), which were increased by high glucose (HG). Conclusions : Through this study, we were able to predict the activity and mechanism of action of GRT on diabetes and diabetic complications, and confirmed the potential of GRT as a treatment for diabetes complications through the effect of GRT on improving myocardial hypertrophy for diabetic cardiomyopathy.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.133-146
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• 2001

The purpose of this study was to investigate the treatment status and its related factors of the newly detected rural hypertensives through community health promotion program. A questionnaire survey and blood pressure measurement were performed to 6,977 residents of a rural area, and 282 hypertensives detected by blood pressure measurement were selected as subjects of the study. The study employed the health belief model as a hypothetical model. The major results of this study were as follows: The proportion of person experienced treatment among hypertensives was 12.0%. Treatment experience rate was significantly related with age and educational level(p<0.01). That is, if they were older, lower educational level, the treatment experience rate was higher. The major reasons of no treatment were 'they had not hypertensive symptoms ' (45.6%), 'their blood pressure was not high so much that they received treatment ' (43.2%). The chief facilities for treatment were public health institutions(57.9%) such as health center and health subcenter, and hospital/ clinics(29.8%). The treatment experience rate was higher when they had higher perceived severity for hypertension, lower perceived barrier to treatment, although statistically not significant. Treatment experience rate was significantly related with cues to action and health education experience(p<0.05). That is, if they had hypertension related symptoms such as headache previously, patients suffered from hypertension complication and health education experience for hypertension, the treatment experience rate was higher. In multiple logistic regression analysis for treatment experience, having a cerebrovascular patient in their acquaintance and the experience of health education for hypertension were significant variables. On consideration of above findings, it would to be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

• Journal of Korean Neurosurgical Society
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• v.50 no.5
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• pp.446-452
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• 2011

Objective : We retrospectively investigated the long-term results of percutaneous radiofrequency thermocoagulation (RFT) using fluoroscopic image-guidance for treatment of trigeminal neuralgia. Methods : A total of 38 patients diagnosed and treated with RFT as an idiopathic trigeminal neuralgia were investigated. To minimize the risks related to conventional technique based on cutaneous landmarks, and to eliminate the need to frequent reposition of cannula, we adopted a technique of image-guided fluoroscopic cannulation of the foramen ovale. To minimize sensory complication following thermal lesion, our target response was a generation of a lesion with mild to moderate hypalgesia rather than dense hypalgesia. Results : The immediate pain-relief was achieved in all patients underwent RFT. With mean duration of follow-up of 38.2 months (range,12-72), 11 (28.9%) experienced recurrence of pain. The mean timing of recurrence was 26.1 months (range,12-46). A 42.7% recurrence rate was estimated by Kaplan-Meier analysis for the 38 patients at 46 months; 20.2% within 2 years, 29.1% within 3 years. In the long-term, 27 patients (71%) and 6 patients (15.8%) showed Barrow Neurological Institute (BNI) score I and BNI score II responses. Three (7.9%) patients was assessed as BNI score III, 2 patients (5.3%) showed BNI score IV response. As a complication, troublesome dysesthesia occurred in 3 of 38 patients (7.9%), however, there was no permanent cranial nerve palsy or morbidity. Conclusion : These results indicates that RFT under fluoroscopic image-guided cannulation of foramen ovale is a safe, effective, and reliable means of treating trigeminal neuralgia.

• Clinical and Experimental Pediatrics
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• v.61 no.12
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• pp.397-402
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• 2018

Purpose: Transcatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old. Methods: We performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6-12 months in the same study period were reviewed. Results: A total of 22 patients underwent transcatheter PDA closure during the study period. Patient mean age was $3.3{\pm}1.5months$, and weight was $5.7{\pm}1.3kg$. The duct diameter at the narrowest point was $3.0{\pm}0.8mm$ as measured by angiography. The most common duct type was C in the Krichenko classification. Procedural success was achieved in 19 patients (86.3%). Major complications occurred in 5 patients (22.7%), including device embolization (n=1), acquired aortic coarctation (n=2), access-related vascular injury requiring surgery (n=1), and acute deterioration requiring intubation during the procedure (n=1). Two patients had minor complications (9.1%). Twenty-four infants aged 6-12 months received transcatheter device closure. The procedural success rate was 100%, and there were no major complications. The major complication rate was significantly higher in the group less than 6 months of age (P=0.045). There was a trend toward increased major complication and procedural failure rates in the younger age group (P<0.01). Conclusion: A relatively higher incidence of major complications was observed in infants less than 6 months of age. The decision regarding treatment modality should be individualized.