• 대한후두음성언어의학회지
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• 제30권1호
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• pp.28-33
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• 2019

Background and Objectives : Laryngeal electromyography (LEMG) is valuable to evaluate the innervation status of the laryngeal muscles and the prognosis of vocal fold paralysis (VFP). However, there is a lack of agreement on quantitative interpretation of LEMG. The aim of this study is to measure the motor unit action potentials (MUAP) quantitatively in order to find cut-off values of amplitude, duration, phase for unilateral vocal fold paralysis patients. Materials and Method : Retrospective chart review was performed for the unilateral VFP patients who underwent LEMG from March 2016 to May 2018. Patient's demography, cause of VFP, vocal cord mobility, and LEMG finding were analyzed. The difference between normal and paralyzed vocal folds and cut-off values of duration, amplitude, and phase in MUAP were evaluated. Results : Thirty-six patients were enrolled in this study. Paralyzed vocal fold had significantly longer duration (p=0.021), lower amplitude (p=0.000), and smaller phase (p=0.012) than the normal. The cut-off values of duration, amplitude, and phase in MUAP for unilateral VFP were 5.15 ms, $68.35{\mu}V$, and 1.85 respectively. Conclusion : An analysis of MUAP successfully provided quantitative differences between normal and paralyzed vocal folds. But, additional research is needed to get more available cut-off value which is helpful to evaluate the status of laryngeal innervations.

• 대한치과교정학회지
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• 제47권5호
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• pp.298-305
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• 2017

Objective: This paper describes changes in the characteristics of patients seeking orthodontic treatment over the past decade and the treatment they received, to identify any seasonal variations or trends. Methods: This single-center retrospective cohort study included all patients who presented to Seoul National University Dental Hospital for orthodontic diagnosis and treatment between January 1, 2005 and December 31, 2015. The study analyzed a set of heterogeneous variables grouped into the following categories: demographic (age, gender, and address), clinical (Angle Classification, anomaly, mode of orthodontic treatment, removable appliances for Phase 1 treatment, fixed appliances for Phase 2 treatment, orthognathic surgery, extraction, mini-plate, mini-implant, and patient transfer) and time-related variables (date of first visit and orthodontic treatment time). Time series analysis was applied to each variable. Results: The sample included 14,510 patients with a median age of 19.5 years. The number of patients and their ages demonstrated a clear seasonal variation, which peaked in the summer and winter. Increasing trends were observed for the proportion of male patients, use of non-extraction treatment modality, use of ceramic brackets, patients from provinces outside the Seoul region at large, patients transferred from private practitioners, and patients who underwent orthognathic surgery performed by university surgeons. Decreasing trends included the use of metal brackets and orthodontic treatment time. Conclusions: Time series analysis revealed a seasonal variation in some characteristics, and several variables showed changing trends over the past decade.

• Journal of Oral Medicine and Pain
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• 제45권4호
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• pp.97-109
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• 2020

Purpose: Cervicogenic headache (CGH) is pain referred to the head/ face from the structures in vicinity of upper cervical spinal nerves via trigeminocervical pathway. Ponticulus Posticus (PP) and Elongated Styloid Process (ESP) are anatomical structures that cause compression of vasculature present around upper cervical nerve plexus. Recently, computational fluid dynamics (CFD) has shown to play an essential role in identification of these high-pressure zones in the brain. The aim of this research is to study the association of ESP and PP in patients with CGH and to develop a hypothesis by CFD to analyse vertebrobasilar insufficiency as a contributing factor in occurrence of CGH. Methods: Retrospective analysis of 4500 full skull CBCT scans was done for the presence of partial or complete PP and length of Styloid Process (SP). Research was divided into two phases; In first Preliminary Phase, 150 scans that showed the presence of PP and ESP were analysed, and only 134 patients gave consent to fill the questionnaire containing 96 question items pertaining to symptoms associated with CGH. In the second phase, simulation of Vertebral and Carotid Artery was done using Fluent 14.5 Software and by CFD, pressure distribution on arteries was obtained that helped to identify high pressure regions. Results: Both PP and ESP showed a statistically significant association with CGH (p<0.001). By CFD analysis, both steady and transient phases of simulation showed drop in pressure due to constriction of internal carotid and vertebral artery by ESP and PP respectively and were found to decrease the volume of blood reaching the brain, 0.12 /0.13 mL and 0.06 mL respectively. Conclusions: Our analysis proves ESP and PP as contributing factors towards CGH. Hence for proper diagnosis and management of headache disorders, clinicians should have adequate knowledge about these anatomical structures and their resulting clinical symptoms.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1837-1840
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• 2012

Background: In spite of the fact that platinum-based doublets are considered the standard therapy for patients with advanced non-small-cell lung cancer (NSCLC), no elderly-specific platinum based prospective phase III regimen has been explored. The aim of this retrospective singlecenter study was to evaluate the efficacy and side effects of cisplatin-based therapy specifically for the elderly. Methods: Patients receiving platinum-based treatment were divided into three groups. In the first group (GC), Gemcitabine was administrated at 1000 $mg/m^2$ on days 1, 8 and cisplatin was added at 75 $mg/m^2$ on day 1. In the second group (DC), 75 $mg/m^2$ docetaxel and cisplatin were administered on day 1. The third group (PC) received 175 mg of paclitaxel and 75 mg of cisplatin on day 1. These treatments were repeated every three weeks. Result: GC arm had 36, the DC arm 42 and the PC arm 29 patients. Grade III-IV thrombocytopenia was higher in the GC arm (21.2% received GC, 2.8% received DC, and 3.8% received PC), while sensory neuropathy was lower in patients with GC arm (3.0%, 22.2%, and 23.1% received GC, DC and PC, respectively). There were no statistically significant difference in the response rates among the three groups (p>0.05). The median Progression-free survival (PFS) was 5.0 months and the median Overall survival (OS) in each group was 7.1, 7.4 and 7.1 months, respectively (p>0.05). Conclusion: The response rate, median PFS and OS were similar among the three treatment arms. Grade III-IV thrombocytopenia was higher in the GC arm, while the GC regimen was more favorable than the other cisplatin-based treatmetns with regard to sensory neuropathy.

• 대한두개안면성형외과학회지
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• 제24권2호
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• pp.59-65
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• 2023

Background: Fibrous dysplasia (FD) is a localized bone disorder in which fibro-osseous tissue replaces the normal bone structure. Patients with craniofacial FD often present with gradual swelling, deformity, and compromised vision or hearing. We previously introduced "the core extirpation method," a novel surgical technique that is minimally invasive like traditional bone shaving but has longer-lasting effects. This study presents the long-term outcomes of our core extirpation method. Methods: We conducted a retrospective analysis of patients who underwent core extirpation for FD of the zygomaticomaxillary region from 2012 through 2021. Computed tomography (CT) scans were performed 6 to 12 months before the operation, immediately before and after the operation, and during follow-up visits. We performed all operations using the upper gingivobuccal approach, and we extirpated the core of the lesion while preserving the cortical structures of the zygoma and the maxilla to maintain symmetrical facial contour. Results: In 12 patients with lesions in the growth phase, anteroposterior/mediolateral (AP/ML) length discrepancies and the volume increased between preoperative and immediate postoperative CT scans. All patients' immediate postoperative AP/ML discrepancies were stable up to 12-17 months postoperatively. Postoperative volume showed continuous lesion growth; the median volume growth rate was 0.61 cc per month. Conclusion: In this article, we present our experiences managing FD using the minimally invasive core extirpation technique, which entails small expected blood loss and can be performed as day surgery. It provides similar cosmetic outcomes as traditional bone shaving but with longer-lasting results. Although there are some limitations with the study's retrospective nature and small sample size, our 4-year follow-up results show promising results of the core extirpation method in well-indicated patients.

• 대한한방내과학회지
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• 제37권6호
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• pp.990-997
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• 2016

Objectives: This study observed changes in gait pattern according to the motor grade of the paretic lower limb in patients with basal ganglia stroke who are in the subacute phase. Methods: We used the Manual Muscle Test (MMT) to evaluate the motor grade of the paretic lower limb of 21 patients with subacute basal ganglia stroke and then divided them into two groups based on the MMT results. Stroke patients with a motor grade above Gr. III were put in group I (15 people) and those with a grade less than Gr. III in group II (6 people). We also estimated spatiotemporal factors using treadmill gait analysis equipment. The values were gait velocity, step length, step time, double support phase, and cadence. The first measure was conducted during the early period of admission and the second was between four and five weeks after admission. Results: In Group I, the gait velocity and step length of both legs significantly increased. In Group II, the step length and step time of the paretic side and the gait velocity tended to decrease, but not significantly. The step length of the paretic side in Group II was significantly longer than that in Group I at the first measure. The step time of the paretic side in Group I was significantly shorter than that in Group II and gait velocity and cadence in Group I were significantly higher than in Group II at the second measure. Conclusions: The gait parameters of all stroke patients improved in terms of time. In addition, the changes in gait pattern were different depending on the motor grade of the paretic lower limb.

• Korean Journal of Radiology
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• 제22권4호
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• pp.525-534
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• 2021

Objective: To assess the effect of left atrial appendage (LAA) isolation on LAA emptying and left atrial (LA) function using cardiac MRI in patients who underwent successful catheter ablation of atrial fibrillation (AF). Materials and Methods: This retrospective study included 84 patients (mean age, 59 ± 10 years; 67 males) who underwent cardiac MRI after successful catheter ablation of AF. According to the electrical activity of LAA after catheter ablation, patients showed either LAA isolation or LAA normal activity. The LAA emptying phase (LAA-EP, in the systolic phase [SP] or diastolic phase), LAA emptying flux (LAA-EF, mL/s), and LA ejection fraction (LAEF, %) were evaluated by cardiac MRI. Results: Of the 84 patients, 61 (73%) and 23 (27%) patients showed LAA normal activity and LAA isolation, respectively. Incidence of LAA emptying in SP was significantly higher in LAA isolation (91% vs. 0%, p < 0.001) than in LAA normal activation. LAA-EF was significantly lower in LAA isolation (40.1 ± 16.2 mL/s vs. 80.2 ± 25.1 mL/s, p < 0.001) than in LAA normal activity. Furthermore, LAEF was significantly lower in LAA isolation (23.7% ± 11.2% vs. 31.1% ± 16.6%, p = 0.04) than in LAA normal activity. Multivariate analysis demonstrated that the LAA-EP was independent from LAEF (p = 0.01). Conclusion: LAA emptying in SP may be a critical characteristic of LAA isolation, and it may adversely affect the LAEF after catheter ablation of AF.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7555-7559
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• 2015

Background: CML includes 30% of all leukemias, and occurs from childhood to old age. The present study was a retrospective analysis of chronic phase CML patients registered to a Hematology Clinic in Kermanshah, Iran, with checking of treatment options. Materials and Methods: Between 2002 and 2014, 85 CML patients referred to our hematology clinic were enrolled in our study. We surveyed age, sex, B-symptoms, splenomegaly, Sokal score, Hasford score, treatment and survival in all patients. Philadelphia chromosome analysis was conducted for each patient by conventional cytogenetics. We compared treatment in the patients with three drugs, imatinib, hydroxyurea (HU) and interferon alpha (IFN-${\alpha}$). Results: The mean age of the patients at diagnosis was $47.5{\pm}14.5years$ (range, 23-82 years), with 43 (50.6%) being male. Some 13 (15.3%) were referred to our clinic for the first time with B-symptoms and 44 patients (51.8%) had splenomegaly. The Sokal score for 77 (90.6%) was low, 4 (4.7%) was intermediate and 4(4.7%) was high, but Hasford (Euro) scores for all patients were low. The 5-year survival rate for treated patients with imatinib, imatinib plus HU and imatinib plus HU plus IFN-${\alpha}$ was 90.5%, 81.1% and 55.6%, respectively Conclusions: The results show that imatinib therapy alone provides better survival in CML patients compared to HU or IFN-${\alpha}$. Combinations of IFN-${\alpha}$ and/or HU with imatinib probably reduce survival.

• 대한골관절종양학회지
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• 제18권2호
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• pp.51-58
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• 2012

목적: 슬관절 주위에 발생한 골종양 환자에서 종양 대치물을 이용한 재건술의 결과와 보행 분석의 유용성을 알아보고자 하였다. 대상 및 방법: 2001년부터 2010년까지 슬관절 주위에 발생한 골종양에 대하여 광범위 절제술 후 종양 대치물을 이용한 재건술을 시행 받은 30명 중 7명을 대상으로 하였으며 기능적 결과 및 보행 분석 검사를 평가하였다. 결과: SF-36 점수는 신체적, 정신적 역할제한 항목에서 각각 100% (100점)으로 높은 점수를 보였으며 일반 건강상태, 신체적 기능 정도, 활력, 사회적 기능에서 낮은 점수를 나타냈다. 또한 MSTS 평가의 종합 평균 점수는 88.1% (23.8점[17-27])였다. 보행 분석 검사상 평균 보행속도 97.2 m/s, 평균 분속수 105.6 step/min, 평균 활보장 111.3 m, 평균 보장 61.5 cm, 유각기 39.8%cycle, 입각기 60.1%cycle, 평균 단하지 지지기 37.1%cycle, 평균 양하지 지지기 13.0%cycle, 평균 발 들림시기 60.7%cycle였다. 결론: 슬관절 주위 종양에 대한 광범위 절제술 후 종양 대치물을 이용한 재건술은 좋은 기능적결과를 기대할 수 있으며, 보행 분석 검사는 술후 환자의 상태를 정량적으로 평가함으로써 보행 모습 및 기능을 객관화 할 수 있는 한 방법으로 사료되며 기능적 평가 방법과 함께 치료 및 술 후 재활 계획을 세우는데 도움이 되리라 생각된다.

• Korean Journal of Radiology
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• 제22권4호
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• pp.502-512
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• 2021

Objective: To objectively and subjectively assess and compare the characteristics of monoenergetic images [MEI (+)] and polyenergetic images (PEI) acquired by dual-energy CT (DECT) of patients with breast cancer. Materials and Methods: This retrospective study evaluated the images and data of 42 patients with breast cancer who had undergone dual-phase contrast-enhanced DECT from June to September 2019. One standard PEI, five MEI (+) in 10-kiloelectron volt (keV) intervals (range, 40-80 keV), iodine density (ID) maps, iodine overlay images, and Z effective (Z_eff) maps were reconstructed. The contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were calculated. Multiple quantitative parameters of the malignant breast lesions were compared between the arterial and the venous phase images. Two readers independently assessed lesion conspicuity and performed a morphology analysis. Results: Low keV MEI (+) at 40-50 keV showed increased CNR and SNR_{breast lesion} compared with PEI, especially in the venous phase ([CNR: 40 keV, 20.10; 50 keV, 14.45; vs. PEI, 7.27; p < 0.001], [SNR_{breast lesion}: 40 keV, 21.01; 50 keV, 16.28; vs. PEI, 10.77; p < 0.001]). Multiple quantitative DECT parameters of malignant breast lesions were higher in the venous phase images than in the arterial phase images (p < 0.001). MEI (+) at 40 keV, ID, and Z_eff reconstructions yielded the highest Likert scores for lesion conspicuity. The conspicuity of the mass margin and the visual enhancement were significantly better in 40-keV MEI (+) than in the PEI (p = 0.022, p = 0.033, respectively). Conclusion: Compared with PEI, MEI (+) reconstructions at low keV in the venous phase acquired by DECT improved the objective and subjective assessment of lesion conspicuity in patients with malignant breast lesions. MEI (+) reconstruction acquired by DECT may be helpful for the preoperative evaluation of breast cancer.