• Radiation Oncology Journal
• /
• v.15 no.2
• /
• pp.145-151
• /
• 1997

Purpose : To evaluate the loss of bone mineral contents(BMC) in lumbar spine within the radiation field for cervical cancer treatment, BMC in the irradiated patient group was compared with that of a normal control group. Method and materials : Measurements of BMC in the trabecular bone in lumbar spines(L3-L5) were performed in the both patient and normal control groups. Investigators used dual-energy quantitative computerized tomography(DEQCT) using Photon energy of 120 and 80kVp, The numbers of Patient and control groups were 43 in each with age distribution of fifth to seventh decade of women. The numbers of control group were 22 in fifth, 10 in sixth and 11 in seventh decade, those of patient group were 14 in filth, 14 in sixth, and 15 in seventh decade of women. The radiation field was extended to L5 spine for Pelvic irrdiation with 45-54Gy of external radiation dose and 30Gy of high dose rate brachytherapy in cervical cancer, Results : The BMC is decreased as increasing age in both control and patient groups. BMC in lumbar spine of patient group was decreased by about $13\%\;to\;40\%$ maximally. The BMC of L3 and L4 a region that is out of a radiation field for the Patient group demonstrated $119.5\pm30.6,\;117.0\pm31.7\;for\;fifth,\;83.3\pm37.8,\;88.3\pm46.8\;for\;sixth\;and\;61.5\pm18.3,\;56.2\pm26.6mg/cc$ for seventh, Contrasted by the normal control group has shown $148.0\pm19.9,\;153.2\pm23.2\;for\;fifth,\;96.1\pm30.2,\;105.6\pm26.5\;for\;sixth\;and\;73.9\pm27.9,\;77.2\pm27.2mg/cc$ for seventh decade, respectively The BMG of patient group was decreased as near the radiation field, while the lower lumbar spine has shown more large amounts of BMC in the normal control group. In Particular, the BMC of L5 within the radiation field was significantly decresed to $33\%,\;31\%,\;40\%$ compared with the control group of the fifth, sixth and seventh decades, respectively. Conclusion : The pelvic irradiation in cervical cancer has much effected on the loss of bone mineral content of lumbar spine within the radiation field, as the lower lumbar spine has shown a smaller BMC in Patient group with Pelvic irradiation in contrast to that of the normal control groups.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.39 no.5
• /
• pp.207-216
• /
• 2013

Objectives: The purpose of this study is to analyze clinical impact factors on the survival rate, and to acquire basic clinical data for the diagnosis of oral cancer, for a determination of the treatment plan with long-term survival in oral cancer patients. Materials and Methods: Through a retrospective review of the medical records, the factors for long-term survival rate were analyzed. Thirty-seven patients, among patient database with oral cancer treated in the Department of Oral and Maxillofacial Surgery at Pusan National University Hospital within a period from March 1998 to March 2008, were selected within the study criteria and were followed-up for more than 5 years. The analyzed factors were gender, age, drinking, smoking, primary tumor site, type of cancer, TNM stage, recurrence of affected region, and metastasis of cervical lymph node. The 5-year survival rate on the impact factors was calculated statistically using the Kaplan-Meier method. Results: By classification of clinical TNM at the 1st visit, there were 11 (29.7%) cases for stage I, 11 (29.7%) cases for stage II, 3 (8.1%) cases for stage III, and 12 (32.5%) cases for stage IV. The 5-year survival rate of total oral cancer patients after the operation were 75.7%, pathological TNM stage related 5-year survival rate were as follows: stage I 90.0%, stage II 81.8%, stage III 100% and stage IV 45.5%; in which the survival rate difference by each stage was significantly observed. The recurrence of cervical lymph node was the significant impact factor for the survival rate, because only 30.0% the survival rate in recurrent cases existed. During the follow-up, there were 15 (40.5%) patients with confirmed recurrence, and the 5-year survival rate of these patients was decreased as 46.7%. Conclusion: The classification of clinical and pathological TNM stage, local recurrence after surgery, and metastasis of cervical lymph node after surgery were analyzed as the 3 most significant factors.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.16 no.1
• /
• pp.17-26
• /
• 2012

Purpose: This study mainly focuses on the patients treated with chemically stable radiopharmaceutical product $^{99m}Tc$-HMPAO (d,l-hexamethylpropylene amine oxime) which yielded reduced image quality due to a decreased brain extraction rate. $^{99m}Tc$-HMPAO will be examined further to determine whether this product may be accounted as a factor for this cause. Material and Methods: From January 2010 until December 2010, out of 272 patients who were all subjected to $^{99m}Tc$-HMPAO brain blood flow SPECT scans resulting from Cerebral Infarction; 23 patients(ages $55.3{\pm}9$, 21 males, 3 females) with decreased tissue extraction rate were examined in detail. The radiopharmaceutical product $^{99m}Tc$-HMPAO was used on patients with normal brain tissue exchange rate as well as those with reduced rate in order to prove its' chemical stability. The patients' age, sex, blood pressure, existence of diabetes, drug use, current health status, known side effects from CT/MRI, examination of the patients' past SPECT before/after images were accounted to determine the factors and correlations affecting the rate of blood tissue extractions. Result: After multiple linear regression analysis, there were no unusual correlations between the 6 factors excluding sex, and before/after examination images. Male subjects showed reduced brain tissue extraction rate than the females ($p$ > 0.05) 91.3% male, 8.7% female. Wilcoxon Matched-Pairs Signed-Ranks Test was used on the before/after images which yielded a value of 0.06, which did not indicate a significant amount of difference on the 2 tests ($p$ > 0.05). As a result, the before/after images indicated similar brain tissue extraction rates, and there were variations depending on the individual patient. Conclusion: The effects of the chemically stable radiopharmaceutical product $^{99m}Tc$-HMPAO depended on the patient's personal characteristics and status, therefore was considered to be a factor in reducing brain tissue extraction rate. The related articles of $^{99m}Tc$-HMPAO cerebral blood flow SPECT speculates a cerebrovascular disease and factors resulting from portal veins, and it was not possible to pin point the exact cause of decreasing brain tissue extraction rate. However, the $^{99m}Tc$-HMPAO cerebral blood flow SPECT scan proved to be extremely useful in tracking and inspecting brain diseases, as well as offering accurate results from patients suffering from reduced brain tissue extraction rates.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.16 no.1
• /
• pp.42-48
• /
• 2018

Purpose: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. Methods: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Results: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. Conclusion: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.

• Journal of Acupuncture Research
• /
• v.35 no.4
• /
• pp.219-225
• /
• 2018

Background: The purpose of this study was to review whether Korean medicine treatment was effective to maintain the spinal stability and to relieve spinal symptom by reviewing medical records of 18 vertebral compression fracture patients. Methods: The subjects were 18 thoracolumbar compression fracture patients who were taken more than two lateral view x-rays of fractured vertebra from Jan, 2010 to June, 2018. They were divided into two groups: the time admitted into Department of Acupuncture & Moxibustion Medicine, Pohang Korean Medical Hospital of Daegu Hanny University from onset (Research 1) and whether or not they have a past history of osteoporosis (Research 2). Then, they were follow-up observed and compared by compression ratio and numerical rating scale (NRS) and so on. Results: The amount of weekly compression rate increase of 18 patients was 1.76% per week. According to the result of Research 1, the patients group (14 patients) who were admitted into the hospital within 1-2 weeks from getting injury was 1.88% per week whereas the patients group(4 patients) who were admitted into the hospital within 3-4 weeks from getting injury was 1.22% per week. By Research 2 result, the patients group (7 patients) who had been diagnosed as an osteoporosis patient was 2.19% per week, and those (11 patients) who had not was 1.49% per week. There was a statistical significance in the change of the amount of compression rate increase in the case of Research 1, but there was not in the case of Research 2. NRS was decreased without significant difference regardless of the time admitted into the hospital and whether or not the patients had the past history of osteoporosis. Conclusion: Considering that there were more amount of compression rate increase at 1-4 weeks from onset, it is necessary to offer treatment more actively on early time from onset. Further research is needed into the increase of compression rate by the patients' having a past history of osteoporosis or not. Given that NRS decreased without significant difference, it is assumed that Korean medicine treatment has a meaningful effect on relieving subjective symptom of patients who are diagnosed as vertebral compression fractures.

• Korean Journal of Clinical Pharmacy
• /
• v.24 no.2
• /
• pp.106-114
• /
• 2014

Purpose: Recent investigations suggest that the antiplatelet effect of clopidogrel may be decreased when this medication is taken together with certain proton pump inhibitors (PPIs). However, there has been no study conducted in Korea regarding the clinical effect of clopidogrel-PPI interaction. This study targeted patients who received stents to investigate the effect of the concomitant use of clopidogrel and PPIs on the occurrence of adverse cardiovascular events in Korean patients. Methods: The patients who received a stent insertion at the Yeouido St. Mary's Hospital between January 2010 and April 2011 were included. The patients were divided into two groups, clopidogrel and clopidogrel + PPI, and followed for 12 months after the date of stent insertion using prescription history and medical records. The recurrence rates of the cardiovascular events among the two patient groups were statistically analyzed. Results: There was no difference between the two groups in the basic characteristics of the 157 patients in the clopidogrel group and the 62 patients in the clopidogrel+PPI group. Simple logistic regression showed a significantly higher rate of re-hospitalization in the clopidogrel+PPI group (OR=1.893, 95% CI 1.040-3.445, p=0.037). However, the results of the multivariate logistic regression of the variables found to have statistical significance by crosstabulation showed no significant difference in the rate of adverse cardiovascular events or re-hospitalization between the two groups. Conclusions: There was no significant difference between the clopidogrel and clopidogrel+PPI group among new patients with cardiovascular stents with respect to the occurrence of revascularization procedures, stent thrombosis, or chest pain, or with respect to the re-hospitalization rate for all cardiovascular events.

• Journal of Chest Surgery
• /
• v.19 no.1
• /
• pp.108-115
• /
• 1986

During 12 years period from 1974 to 1985, 76 valve replacement procedures were performed at Seoul National University Hospital in 67 pediatric patients aging up to 15 years [mean 12.3 years] and it was 7.3% of total valve replacement procedures in same period. Sixty seven patients were composed of 44 males and 23 females. Of the 67 patients, 43 patients had acquired valve lesions and 24 patients congenital valve lesions. Sixty cases received single valve replacement, 7 cases double or triple valve replacement and 9 cases redo-valve replacement. Sixty seven patients received 84 valves [65 bioprosthetic valves and 19 prosthetic valves by] 76 operations, Sixty three of 65 bioprosthetic valves had been replaced before 1983 and 15 of 19 prosthetic valves in recent 2 years. Eleven patients [14.6%] died within one month post-operatively and 8 patients [10.5%] during the follow-up period with the overall mortality rate of 25.1%. There were early post-operative complication of 23 cases [30.3%] and late post-operative complication of 27 cases [35.3%] with the total complication rate of 65.8%. In 58 patients received bioprosthetic valves, there were 14 cases of restenosis of replaced valves. Of the 14 cases of bioprosthetic valve restenosis, 8 cases received redo-valve replacement procedures without mortality in 1 5/12-5 years after initial operation but 4 cases died without reoperation and 2 cases lost during follow-up. The overall mortality and complication rate were still high but they markedly decreased during recent 2 years. So, in spite of its containing many problems, valve replacement in children is becoming safe and useful procedure in whom valve reconstructive procedures are impossible.

• Journal of Korean Neurosurgical Society
• /
• v.60 no.6
• /
• pp.676-683
• /
• 2017

Objective : The purpose of this study is to evaluate the efficacy and safety of 3-level hybrid surgery (HS), which combines fusion and cervical disc replacement (CDR), compared to 3-level fusionin patient with cervical spondylosis involving 3 levels. Methods : Patients in the anterior cervical discectomy and fusion (ACDF) group (n=30) underwent 3-level fusion and the HS group (n=19) underwent combined surgery with fusion and CDR. Clinical outcomes were evaluated using the visual analogue scale for the arm, the neck disability index (NDI), Odom criteria and postoperative complications. The cervical range of motion (ROM), fusion rate and adjacent segments degeneration were assessed with radiographs. Results : Significant improvements in arm pain relief and functional outcome were observed in ACDF and HS group. The NDI in the HS group showed better improvement 6 months after surgery than that of the ACDF group. The ACDF group had a lower fusion rate, higher incidence of device related complications and radiological changes in adjacent segments compared with the HS group. The better recovery of cervical ROM was observed in HS group. However, that of the ACDF group was significantly decreased and did not recover. Conclusion : The HS group was better than the ACDF group in terms of NDI, cervical ROM, fusion rate, incidence of postoperative complications and adjacent segment degeneration.

• Journal of Korean Academy of Nursing
• /
• v.28 no.4
• /
• pp.980-991
• /
• 1998

The purpose of this study was to examnin the effect of slow stroke back massage(SSBM) on anxiety and immune response in patients undergoing open heart surgery and to compare the effect of 5-minutes with 10-minutes SSBM. Among the sixty-four patient subjects, twenty-one were one experimental group receiving massage for 10-minutes, twenty for the other experimental group receiving massage for 5-minutes and twenty-three for the control group. Subjects were admitted at Hospitals in Inchon and Puchon for open heart surgery. This study was carried out from October 10, 1997 to May 10, 1998. The levels of anxiety were measured by the Visual Analogue Scale(VAS), Trait anxiety scale, systolic and diastolic blood pressure, pulse rate, blood cortisol and the levels of immune response were measured by the blood T-lymphocyte and Natural killer cell. Study measurements were taken before and after SSBM on the 1st post operative day. Data were analyzed using x$^2$ test, oneway ANOVA, paired t-test, t-test and Pearson product moment correlation. The results were summarized as follows : 1. After SSBM, VAS anxiety level, systolic and diastolic blood pressure and pulse rate of the experimental group were decreased significantly than those measurements before the SSBM. After SSBM, significant difference in the VAS anxiety level, systolic blood pressure and pulse rate between the experimental and control groups were found. 2. After SSBM, the blood cortisol of the experimental and control groups were increased significantly compared with before SSBM. But the significant difference in blood cortisol between the two groups was not found. 3. After SSBM, the blood T-lymphocyte percentages of the experimental and control groups were decreased signigicantly and blood Natural killer cell percentages of the two groups were increased compared with before SSBM. But significant difference in blood T-lymphocyte and Natural killer cell percentages between the two groups was not found. 4. Significant difference in VAS anxiety level, systolic and diastolic blood pressure, pulse rate, blood cortisol, blood T-lymphocyte and Natural killer cell percentages between SSBM for 5 minutes and SSBM for 10 minutes were not found. Based upon the results, this study concludes that the slow stroke back massage for 5 minutes is a useful intervention that decreases anxiety and produces relaxation in patients undergoing open heart surgery.

• Journal of Pharmacopuncture
• /
• v.18 no.2
• /
• pp.33-41
• /
• 2015

Objectives: The present study evaluated the effects of sa-am acupuncture (SAA) simpo-jeongkyeok (SPJK) treatment on the blood pressure (BP), pulse rate (PR), and body temperature (BT) of patients with hwa byung (HB). Methods: This patient assessor blind, randomized, placebo controlled trial included 50 volunteers, divided randomly into two groups. The treatment group underwent SPJK (PC9, LR1, PC3, KI10) while the control (sham) group received minimal needle insertion at non acupoints. The BP in both arms, PR, and BT at several acupoints were measured before and after treatment at the $1^{st}$, $2^{nd}$, $3^{rd}$, and $4^{th}$ visits and before treatment at the follow-up visit. We analyzed data by using the repeated measured analysis of variance (RM ANOVA), Mann-Whitney U, and wilcoxon signed rank tests; differences at P < 0.05 were considered significant. Results: No significant differences in the systolic blood pressure (SBP), diastolic blood pressure (DBP) and PR between the treatment and control group were observed at each visit. However, the decrease in the SBP for the treatment group before and after each visit was significantly higher than it was in the control group. The SBP in both arms in the treatment group was decreased between visits 1 and 2, 1 and 3, 1 and 4, and 1 and follow-up. The DBP in both arms and in the right arm between visits 1 and 3 in the treatment group showed decreases. A minimal BT increase for treatment at CV06 and CV12 and a minimal BT decrease for treatment at CV17 and (Ex) Yintang were found. Patients in the treatment group who visited more frequently experienced a greater decrease in the PR, but that effect was not maintained. Conclusion: The results suggest that SAA SPJK treatment has instant positive effects on the BP, PR, and BT in patients with HB, but the effects on the BP and PR are not maintained.