Objectives: With the recent advances and increasing use of imaging techniques in examination of the neck, the incidence of incidentally discovered thyroid carcinoma has been increasing. This study was carried out to evaluate the clinicopathologic characteristics of incidental thyroid carcinomas and to find optimal therapeutic strategies for these lesions. Materials & Methods: From Jan. 1988 to Aug. 1998, 1,053 patients were operated on for thyroid cancer, of whom 127(12.1%) had incidentally discovered thyroid cancers which were identified during routine health checkups(n=40), diagnostic procedures for unrelated medical conditions(n=39) and mass screening for thyroid cancer(n=48). The preoperative diagnosis was obtained by ultrasound-guided FNAB and the extent of surgery was determined based on frozen section examinations, as well as prognostic factors and gross findings at the time of surgery. Results: There were 6 men and 121 women with a mean age of 45.9 years. Histopathological diagnosis included papillary carcinomas(n=1l9), follicular carcinomas(n=6), poorly differentiated carcinoma(n=l) and medullary carcinoma(n=1). Thirty patients(23.6%) had multifocallesions. The mean diameter of the tumors was 1.1 cm(0.2-3.4 cm). Capsular invasions were found in 53 patients(41.7%) and nodal metastases in 41(32.3%). The surgical procedures used were: 90 less-than total thyroidectomies and 37 total thyroidectomies with central neck node dissection. Lateral neck dissection was added in 5 patients. According to TNM staging, 79 patients(63.2%) were at stage I, 15(12.0%) at stage II, 31(24.8%) at stage III and 0(0.0%) at stage IV. By AMES scoring system, 102 patients(81.6%) were in the low-risk group and 23(18.4%) in the high-risk group. And by MACIS scoring system, 103(86.6%) of 119 papillary thyroid cancer patients were less than 6. Conclusions: The clinicopathological characteristics of incidentally discovered thyroid carcinomas are similar to ordinary thyroid carcinomas. The treatment of choice should be individualized based on the particular clinical situation encountered, as in ordinary thyroid carcinomas.
Objective: The purpose of this study was to perform gender-wise analysis of the related cephalometric factors affecting Korean patients with obstructive sleep apnea (OSA). Methods: We examined 118 adults who had visited the Sleep Disorder Clinic Center in Keimyung university, Daegu, Korea, and evaluated them by using poly-somnography (PSG) and lateral cephalograms. The patients were divided into 4 groups (male simple snorers, male OSA patients, female simple snorers, and female OSA patients) according to AHI (apnea-hypopnea index) and sex. Results: The position of the hyoid bone in the female OSA group was inferior to that in the female simple snorer group. Multiple regression analysis showed that tongue length and soft palate width were significant determinants for the severity of AHI in male OSA patients. However, inferior position of the hyoid was a significant determinant only in women. Conclusions: From a cephalometric point of view, OSA in male and female adult patients may be characterized by different pathogeneses. In particular, in female OSA patients, they might be managed by individualized treatments such as hormone replacement therapy in addition to conventional treatment.
Park, Jun Bum;Lee, Wan Su;Lee, Jung Kyo;Jeon, Sang Ryong;Kim, Jeong Hoon;Roh, Sung Woo;Ra, Young Shin;Kim, Chang Jin;Kwon, Yang;Rhim, Seung Chul;Kwun, Byung Duk;Kang, Joong Koo;Lee, Sang Ahm;Ko, Tae Sung
Journal of Korean Neurosurgical Society
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v.30
no.1
/
pp.26-32
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2001
Objective : The increasing use of sensitive neuroimaging techniques has demonstrated that significant percentage of patients with intractable complex partial seizures have brain masses, especially in temporal lobe. The optimal surgical solution for these patients is still open to debate. The purpose of our investigation is to evaluate the surgical outcome of patient with lesion-related temporal lobe epilepsy with respect to the types of surgery and the location of lesion. Patients and Methods : From DEC. 1993 to Dec. 1997, 35 patients with intractable epilepsy and space occupying temporal lobe lesion identified in preoperative MRI were included in this study. The types of surgery were lesionectomy, anterior temporal lobectomy with or without hippocampectomy. The location of lesion was divided as anteromedial group and lateral cortical group. The postoperative seizure outcomes according to the type of surgery and location of the lesion were compared. Results : Twenty-six of 34 patients(76.5%) were seizure-free after surgery. The Engel's class was favorable after anterior temporal lobectomy with or without hippocampectomy(p=.044) Conclusion : It is favorable to perform anterior temporal lobectomy for the treatment of intractable epilepsy with space-occipying lesion in temporal lobe. The resection of the hippocampus can be individualized.
Objective: To investigate the distribution and phenotypes of hemifacial microsomia (HFM) and its association with other anomalies. Methods: This study included 249 Korean patients with HFM, whose charts, photographs, radiographs, and/or computed tomography scans acquired during 1998-2018 were available from Seoul National University Hospital and Dental Hospital. Prevalence according to sex, side involvement, degree of mandibular deformity, compensatory growth of the mandibular body, and Angle's classification, and its association with other anomalies were statistically analyzed. Results: Prevalence was not different between male and female patients (55.0% vs. 45.0%, p > 0.05). Unilateral HFM (UHFM) was more prevalent than bilateral HFM (BHFM) (86.3% vs. 13.7%, p < 0.001). Although distribution of the Pruzansky-Kaban types differed significantly in patients with UHFM (I, 53.0%; IIa, 18.6%; IIb, 24.7%; III, 3.7%; p < 0.001), no difference was observed in occurrence between the right and left sides (52.6% vs. 47.4%, p > 0.05). Among patients with BHFM, prevalence of different Pruzansky-Kaban types on the right and left sides was greater than that of the same type on both sides (67.6% vs. 32.4%, p < 0.05). Despite hypoplasia of the condyle/ramus complex, compensatory growth of the mandibular body on the ipsilateral side occurred in 35 patients (14.1%). Class I and II molar relationships were more prevalent than Class III molar relationships (93.2% vs. 6.8%, p < 0.001). Forty-eight patients (19.3%) had other anomalies, with 50.0% and 14.4% in the BHFM and UHFM groups (p < 0.001). Conclusions: Patients with HFM require individualized diagnosis and treatment planning because of diverse phenotypes and associations with other anomalies.
Journal of Korea Entertainment Industry Association
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v.14
no.3
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pp.343-352
/
2020
The aim of this study was to investigate the relationship between level of participation in children's play, empathy ability and coping behavior in mothers of children with disabilities. The study included 94 mothers of children with disabilities and the study was conducted from May 2018 to August 2018 based on the questionnaire about the level of participation in children's play, empathy ability and coping behavior. According to the study, Mothers of children with disabilities actively participate in physical play with their children and have a higher emotional empathy compared to cognitive empathy, and have acted to actively solve the problems for their children. When children have been treated for more than 1 to 2 years, the level of participation in children's play and the coping behavior were the highest. The longer their children's treatment period, the higher the mothers' empathy. The correlation between level of participation in children's play and coping behavior were significant. And empathy and coping behavior had a strong positive linear relationship. These results suggest that there are differences in level of participation in children's play, empathy and coping behavior depending on mothers' of children with disabilities general characteristics and the higher level of mothers' of children with disabilities participation in children's play, the more empathetic they have. When individualized intervention is provided, we look forward to providing professional service that take into account the characteristics of mothers of children with disabilities.
Chan Young Park;Younghoo Lee;Seoung-Jin Hong;Janghyun Paek;Kwantae Noh;Ahran Pae;Hyeong-Seob Kim;Kung-Rock Kwon
The Journal of Korean Academy of Prosthodontics
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v.61
no.4
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pp.293-307
/
2023
Jaw motion tracking, which is introduced in recent case reports, is a method which records the patient's individualized pathway of the mandibular movements along with facebow transfer, and reproduces the information in the virtual space of computer-aided-design/computer-aided-manufacturing (CAD-CAM) software. In this present case, a collapse of the occlusal plane was observed, due the loss of posterior teeth for a long period. Full-mouth rehabilitation with an increase in the occlusal vertical dimension was planned. First, the patient's mandibular movements were recorded on the newly established jaw relation by jaw tracking, and this information was assembled with the patient's intraoral data to create a virtual patient. Implant planning and diagnostic wax-up was done on the virtual patient, leading the fabrication of the provisional prosthesis. On the newly established jaw relation with an increase in the occlusal vertical dimension, canine guidance of the provisional prosthesis was checked. Finally, the provisional prosthesis was carried out to the definitive prosthesis. Using the advantages of the technologies in the digital dentistry, the patient was satisfied with the function and the esthetics after the treatment.
Treatment mechanics should be individualized to be suitable for each patient's personal teeth and anatomic environment to get a best treatment result with the least harmful effects to teeth and surrounding tissues. Especially, the change of biomechanical reaction associated with that of the centers of resistance of teeth should be considered when crown-to-root ratio changed due to problematic root resorption and/or periodontal disease during adult orthodontic treatment. At the present study, in order to investigate patterns of initial displacements of anterior teeth under certain orthodontic force when crown-to-root ratio changed in not only normal periodontal condition but also abnormal periodontal and/or teeth condition, the changes of the centers of resistance for maxillary and mandibular 6 anterior teeth as a segment were studied using the laser reflection technique, the lever & pulley force applicator and the photodetector with these quantified variables reducing alveolar bone 2mm by 2mm for each of maxillary 6 anterior teeth until the total amount of 8mm and root 2mm by 2mm for each of mandibular 6 anterior ones until the total amount of 6mm. The results were as follows: 1. Under unreduced condition, the center of resistance during initial displacement of maxillary 6 anterior teeth was located at the point of about $42.4\%$ apically from cemento-enamel junction(CEJ) of the averaged tooth of them and kept shifting to about $76.7\%$ with alveolar bone reduction. 2. The distance from the averaged alveolar crest level of maxillary 6 anterior teeth to the center of resistance for the averaged tooth of them kept decreasing with alveolar bone reduction, but the ratio to length of the averaged root embedded in the alveolar bone was stable at around $33\%$ regardless of that. 3. Under unreduced condition, the center of resistance during initial displacement of mandibular 6 anterior teeth was located at the Point of about $43\%$ apically from CEJ of the averaged tooth of them and this ratio kept increasing to about $54\%$ with root reduction. But the distance from CEJ to the center of resistance decreased from around 5.3mm to around 3.3mm, that is to say, the center of resistance kept shifting toward CEJ with the shortening of root length. 4. A unit reduction of alveolar bone had greater effects on the change of the centers of resistance than that of root did during initial Phase of each reduction. But both of them had similar effects at the middle region of whole length of the averaged root.
Yang Jin Yeong;Lee Hyung Sik;Moon Sun Rock;Kim Gwi Eon;Suh Chang Ok;Loh Jojn J.K;Oh Won Yong;Whang In Soon
Radiation Oncology Journal
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v.8
no.2
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pp.219-223
/
1990
This is a retrospective review of 33 patients with large cell lung carcinoma treated at Yonsei University Cancer Center between Jan.1985 and Dec.1989. Of the thirty-three patients, twenty eight were men and five women. Median age was 59 years. Large cell undifferentiated carcinoma was the most common pathologic type, $78.8\%$. Twenty one of thirty three patients had far advanced diseases, stage IIIB-IV at the time of initial diagnosis. Pleural effusion was initially presented in 12 patients, and SVC syndrome appeared in 5 patients. As to location of the primary tumor,19($57.6\%$) appeared in the right lung and 14 ($42.4\%$) in the left. Patients with a centrally located primary tumor mass were nearly the same as those peripherally located (17 vs.16). Fifteen of thirty three patients developed metastasis involving not only bone, brain, the opposite lung, adrenal gland but also soft tissue, skin, pancreas and appendix. Treatment was individualized with 19 treated radically and 14 palliatively. After treatment, only two patients showed a complete response. Long term survival was observed in 4 patients: 1 (24 mo.),2 (41 mo.) and 1 (54 mo.). The overall 2 year survival rate was $14.3\%$ while the median survival time was 6.0 months. Through the analysis of the various factors affecting survival, we observed that pleural effusion-absent group and complete response group had a statistical significant better survival rate (p<0.01).
Nam Hee Rim;Lim Do Hoon;Ahn Yong Chan;Lee Jung I1;Nam Do-Hyun;Kim Jong Hyun;Hong Seung-Chyul;Lee Jeong Eun;Kang Min Kyu;Park Young Je;Kim Kyung Ju;Park Won;Huh Seung Jae
Radiation Oncology Journal
/
v.22
no.2
/
pp.91-97
/
2004
Propose: To Analyze the survival outcomes and prognostic factors In glioblastoma patients treated with surgery and radiation therapy. Materials and Methods : One hundred twenty glloblastoma patients treated with postoperative radiation therapy from 1994 to 2003 at Samsung Medical Center were retrospectively reviewed. Surgical extents were gross total resection in 22 patients (18$\%$), subtotal resection in 69 (58$\%$), and biopsy only in 29 (24$\%$). The median radiation dose was 50 Gy, ranging from 45 Gy to 72 Gy The median follow-up period was 12 months ranging from 2 to 52 months. Results The overall 1- and 2-year survival rates were 52$\%$ and 14$\%$, respectively, and the median survival duration was 13 months. Favorable prognostic factors by Uunivarlate analyses of prognostic factors on 1-year survival rate were revealed that age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.03), single lesion (p=0.02), and gross total resection (p=0.04), were the favorable prognostic (actors. and by Mmultlvarlate analyses were revealed that female (p<0.01), age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.05) and gross total resection (p=0.05) were the favorable prognostic factors. Conclusions : The results of our study were comparable with those previously reported. To Improve treatment outcome, various modifications, Including radiation dose escalation through newer radiation therapy techniques and use of effective chemotherapy regimen, should be further Investigated. Investigated. Also Furthermore, the application of Individualized treatment strategy based on 4he patient's prognostic factors might be needed.
A series of 510 patients with carcinoma of the uterine cervix given the curative radiation therapy from March 1979 through December 1986 was evaluated to determine the value of intravenous pyelography (IVP), cystoscopy, sigmoidoscopy, and abdomino-pelvic CT as staging work-up prior to treatment. On IVP and cystoscopy, $10.7\%$(49/456) and $5.3\%$(24/452) showed abnormality, respectively, but only $0.7\%$(3/413) did on sigmoidoscopy. As a result of these work-ups prerequisite to FIGO staging, twenty six ($5.1\%$) out of 510 patients were upstaged from the stage determined by the findings of physical examination alone. The proportions of upstaging in each stage were as follows; none in stage IB (35), IIA (89) and IIIA (8), $7.9\%$(20/252) in stage IIB (14 patients to FIGO stage IIIB, 6 patients to FIGO stage IVA), and $4.8\%$(6/126) in stage IIIB (all to FIGO stage IVA). Positive findings of staging work-ups were found only in patients with advanced stages of stage IIB or over determined by physical examination alone but not in those with earlier stages. CT was performed in 337 patients. CT detected pelvic lymph node (LN) enlargement in $25.2\%$ (85/337) and paraaortic LN enlargement in $7.4\%$(25/337). Pelvic LN positivity was well correlated with increasing stage but paraaortic LN positivity was not. In the evaluation of parametrial involvement, CT findings were in accordance with those of physical examination only in $65.6\%$ (442/674). When compared with endoscopic studeies, CT had much lower positive predictive value than negative predicitive value in the evaluation of adjacent organ invasion. The staging work-ups should be individualized by the disease extent of each patient, and then the efficiency of work-uus may be increased without compromising the appropriate FIGO staging and treatment.
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