• Radiation Oncology Journal
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• 제36권2호
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• pp.103-113
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• 2018

Purpose: Anaplastic thyroid cancer (ATC) is a rare tumor with a lethal clinical course despite aggressive multimodal therapy. Intensity-modulated radiotherapy (IMRT) may achieve a good therapeutic outcome in ATC patients, and the role of IMRT should be assessed. We retrospectively reviewed outcomes for ATC treated with three-dimensional conformal radiotherapy (3D-CRT) or IMRT to determine the optimal treatment option and explore the role of radiotherapy (RT). Materials and Methods: Between December 2000 and December 2015, 41 patients with pathologically proven ATC received RT with a sufficient dose of ${\geq}40Gy$. Among them, 21 patients (51%) underwent surgery before RT. Twenty-eight patients received IMRT, and 13 received 3D-CRT. Overall survival (OS) and progression-free survival (PFS), patterns of failure, and toxicity were examined. Results: The median follow-up time for survivors was 38.0 months. The median and 1-year OS and PFS rates were 7.2 months and 29%, 4.5 months and 15%, respectively. Surgery significantly improved the prognosis (median OS: 10.7 vs. 3.9 months, p = 0.001; median PFS: 5.9 vs. 2.5 months, p = 0.007). IMRT showed significantly better PFS and OS than 3D-CRT, even in multivariate analysis (OS: hazard ratio [HR] = 0.30, p = 0.005; PFS: HR = 0.33, p = 0.005). Significantly higher radiation dose could be delivered with IMRT than 3D-CRT ($EQD2_{10}$ 66 vs. 60 Gy, p = 0.005). Only 2 patients had grade III dermatitis after IMRT. No other severe toxicity ${\geq}grade$ III occurred. Conclusion: Patients with ATC showed better prognosis through multimodal treatment. Furthermore, IMRT could achieve favorable survival rates by safely delivering higher dose than 3D-CRT.

• Tuberculosis and Respiratory Diseases
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• 제68권2호
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• pp.62-66
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• 2010

Background: Extracorporeal membrane oxygenation (ECMO) during severe acute respiratory failure helps to recover the pulmonary function. This study evaluated our experience with veno-venous ECMO in adult patients with acute respiratory failure. Methods: From January 2007 to July 2009, ECMO was used on 54 patients. Of these 54 patients, 7 were placed on veno-venous ECMO for acute respiratory failure. The indications of ECMO were based on the lung dysfunction measured as a $PaO_2/FiO_2$ ratio <100 mm Hg on $FiO_2$ of 1.0, or an arterial blood gas pH <7.25 due to hypercapnia despite the optimal treatment. $EBS^{(R)}$, $Bio-pump^{(R)}$, and Centrifugal Rotaflow $pump^{(R)}$ were used and all cannulations were performed percutaneously via both femoral veins. When the lung function was improved, an attempt was made to wean on ECMO at moderate ventilator settings followed by decannulation. Results: Five of the 7 patients were male and the mean age was $46.3{\pm}18.3$. The causes of acute respiratory failure were 3 cases of pneumonia, 2 near-drownings, 1 pulmonary hemorrhage due to acute hepatic failure and 1 mercury vapor poisoning. The mean support time of ECMO was $17.3{\pm}13.7$ days. Of the 7 patients implanted with ECMO, 5 patients (71%) were weaned off ECMO and 3 patients (43%) survived to hospital discharge after a mean 89.6 hospital days. Conclusion: The early use of ECMO for acute respiratory failure in adults due to any cause is a good therapeutic option for those unresponsive to the optimal conventional treatments.

• 대한임상검사과학회지
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• 제51권4호
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• pp.475-483
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• 2019

세포기반 치료제에 사용되는 줄기세포는 재생능력과 다양한 세포로의 분화능력으로 인해 재생 의학 분야에서 광범위하게 관심을 끌었으며, 많은 불치병에 적용된다. 하지만, 이러한 줄기세포는 여전히 치료 전 세포증식 및 질병 투여부위에서의 낮은 생존률로 인해 충분한 치료효과가 나타나지 않는 단점이 있다. 이것을 해결하고자, 우리는 세포부착능과 항세포자살 기능을 가지고 있는 carcinoembryonic antigen (CEA) gene family의 하나인 CEACAM 6를 사용하였다. 이것을 줄기세포에 적용 전, 먼저 세포별로 이 단백질이 발현되는지를 확인하였고, 이 유전자가 발현되는 벡터를 줄기세포에 삽입시키기 위한 최적 조건을 선정하였다. 그 후, 도입된 CEACAM 6발현벡터로부터 줄기세포에서 이 유전자가 발현되는지를 확인하였다. 그리고 인체투여 시 발생되는 산화적 스트레스와 유사한 조건에서의 이 유전자의 기능을 평가하기 위해 과산화수소(H₂O₂)를 처리하였다. 산화적 스트레스 조건하에서 CEACAM 6가 발현되는 줄기세포는 그렇지 않은 세포에 비해 세포의 생존률이 현저히 증가하는 것을 확인하였다. 이를 통해, 이 CEACAM 6는 줄기세포의 치료효능과 세포증식을 강화시킬 수 있는 다른 선택지로서의 가능성이 있음을 확인하였다.

• 대한소아신경학회지
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• 제23권2호
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• pp.45-50
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• 2015

목적: X-ALD는 Xq28에 위치한 ABCD1 유전자의 돌연변이로 긴사슬지방산이 신경 조직과 부신에 축적되어 일어나는 퇴행 뇌질환이며, 소아기 대뇌형의 경우 빠르고 심한 임상 경과를 보인다. 이 과정에서 산화스트레스도 조직 손상에 영향을 주는 것으로 알려져 있다. 골수이식이나 로렌조 기름 등이 치료 방법으로 이용되나 치료의 위험성과 효과에서 한계를 보이는 실정이다. 이에 저자들은 X-ALD 환자에게 채취한 섬유모세포를 이용하여, X-ALD의 치료 가능성을 알아보기 위하여 VPA의 효과를 연구해보고자 하였다. 방법: X-ALD 환자의 피부에서 채취한 섬유모세포와 정상인의 피부에서 채취한 섬유모세포를 배양하였다. 배양된 섬유모세포에 VPA를 처리한 후 RNA발현 정도를 통해 ABCD2 발현을 확인하고 유동세포계측법으로 활성산소종을 측정하였다. 결과: VPA을 처리한 후 정상과 X-ALD 섬유모세포 모두에서 ABCD2의 mRNA 발현이 증가하였다. 특히 X-ALD 섬유모세포에서 ABCD2 유전자 mRNA 발현이 2.22배로 정상의 1.76배보다 더 증가하였다. 유동세포계측법으로 활성산소종을 확인한 결과 대조군에서 13.7, VPA를 처리한 군에서는 각각 0.25 mM에서 8.67, 0.5 mM에서 9.37, 1 mM에서 5.83을 나타내었다. 결론: X-ALD 환자에서 VPA의 항산화능을 이용하여 신경손상을 막을 수 있는 가능성이 있을 것으로 보이며, 이를 실제 환자에 적용하는 연구가 필요할 것이다.

• 인간행동과 음악연구
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• 제18권2호
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• pp.45-66
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• 2021

본 연구는 경도지적장애 청소년 대상 그룹 랩만들기가 해당 청소년의 의사소통기술을 향상시키는지 알아보고자 실시된 사례연구이다. 연구 대상은 경도지적장애로 진단받은 만 14-15세의 청소년 3명이다. 본 연구에서 그룹 랩만들기는 랩의 구성요소인 비트, 벌스, 훅, 추임새를 치료적으로 활용하여 소통 맥락 구성, 소통 내용 완성 및 창작, 소통 내용의 적용이라는 3단계로 구성되었고, 회기별 50분씩, 주 2회, 총 6회기 진행되었다. 랩만들기가 적용된 후 경도지적장애 청소년의 의사소통기술 변화를 알아보기 위해 대상자들이 구성하고 부른 랩 가사를 분석하였고, 음악 활동 안에서 나타나는 요구·질문하기 및 정보제공하기 행동을 사건 기록법으로 측정하였다. 또한 프로그램 전후 대상자의 보호자들이 사회적 의사소통 체크리스트를 평정하도록 하였다. 연구 결과, 랩 가사에서 대상자들이 자신의 의견을 자발적으로 표현하는 시도가 증가하는 것을 확인할 수 있었고, 랩 구성 과정에서 자신의 의견을 요구하거나 질문하는 행동 역시 증가하는 것으로 나타났다. 사회적 의사소통 체크리스트에서도 대상자의 기능수준에 따라 개별 차이가 있긴 했지만 전반적으로는 평정 점수가 향상된 것으로 나타났다. 이러한 연구결과를 통해 일부 임상 대상군에게 제한적으로 사용되었던 랩만들기가 경도지적장애 청소년에게도 적용할 수 있음을 제시할 수 있었고, 자신의 의견을 표현하고 타인과 의견을 공유하고 조율하는 능력을 촉진할 수 있는 의미 있는 중재 방안이 될 수 있음 역시 확인할 수 있었다.

• 동의생리병리학회지
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• 제33권2호
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• pp.141-150
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• 2019

Despite the development of assisted reproduction technologies (ART) including in vitro fertilization (IVF), the poor ovarian response and endometrial receptivity remains clinically a major unmet need. Although these problems are difficulties to solve in infertility treatment, there are no good therapeutic option yet. Traditional herbal remedies and acupuncture, therefore are being proposed as alternative treatment. Our group found that traditional herbal medicines such as Paeonia lactiflora L.(PL, 芍藥), Cyperus rotundus L.(CR, 香附子), and Perilla frutescens (PF, 紫蘇葉) could improve endometrial receptivity. In this study, we found out Yeosin-san (如神散) as an optimal herbal formula via combination of the previously established herbal medicines. Yeosin-san is a traditional Korean medical formula which was established by Ziming Jin (陳自明) and recorded in Furendaiquanliangfang (婦人大全良方) at first. The formula traditionally used for treating abnormal uterine bleeding and leukorrhea. It showed a highest effect on leukemia inhibitory factor (LIF) expression and on the adhesion between trophoblastic cells and endometrial cells. In addition, it has been shown that the Yeosin-san not only increases the endometrial receptivity to improve the embryo implantation but also enhances the ovary function by expressing the angiogenesis-related genes. Here we suggest that Yeosin-san could be a novel and effective candidate for treating female infertility.

• Brain Tumor Research and Treatment
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• 제6권2호
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• pp.60-67
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• 2018

Background Recently, modern technology such as diffusion tensor imaging (DTI), neuro-navigation and intraoperative neurophysiological monitoring (IOM) have been actively adopted for the treatment of thalamic tumors. We evaluated surgical outcomes and efficacy of the aforementioned technologies for the treatment of pediatric thalamic tumors. Methods We retrospectively reviewed clinical data from 37 children with thalamic tumors between 2004 and 2017. There were 44 operations (27 tumor resections, 17 biopsies). DTI was employed in 17 cases, neuro-navigation in 23 cases and IOM in 14 cases. All diagnoses were revised according to the 2016 World Health Organization Classification of Tumors of the Central Nervous System. Progression-free survival (PFS) and overall survival (OS) rates were calculated, and relevant prognostic factors were analyzed. The median follow-up duration was 19 months. Results Fifteen cases were gross total resections (GTR), 6 subtotal resections (STR), and 6 partial resections (PR). Neurological status did not worsen after 22 tumor resections. There were statistically significant differences in terms of the extent of resection between the groups with DTI, neuro-navigation and IOM (n=12, GTR or STR=12) and the group without at least one of the three techniques (n= 15, GTR or STR=9, p=0.020). The mean PFS was $87.2{\pm}38.0$ months, and the mean OS $90.7{\pm}36.1$ months. The 5-year PFS was 37%, and the 5-year OS 47%. The histological grade ($p{\leq}0.001$) and adjuvant therapy (done vs. not done, p=0.016) were significantly related to longer PFS. The histological grade (p=0.002) and the extent of removal (GTR/STR vs. PR/biopsy, p=0.047) were significantly related to longer OS. Conclusion Maximal surgical resection was achieved with acceptable morbidity in children with thalamic tumors by employing DTI, neuro-navigation and IOM. Maximal tumor resection was a relevant clinical factor affecting OS; therefore, it should be considered the initial therapeutic option for pediatric thalamic tumors.

• 대한한방내과학회지
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• 제41권6호
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• pp.1245-1254
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• 2020

Introduction: The aim of this study was to report the effect of Korean medicine treatments on a stroke patient with acute cerebral infarction. Method: A 63-year-old male with anterior and middle cerebral artery infarction had symptoms of dizziness and disorientation. The patient was treated with Korean medicine therapy, including the herbal medicine "Sunghyuangjunggi-san-gamibang." Treatment progress was assessed using the Korean version of the Modified Barthel Index (K-MBI) and the Korean dizziness handicap inventory (K-DHI). Results: After 14 days of treatment, the K-DHI score decreased from 78 to 7 and the K-MBI score increased from 18 to 24. The patient's main symptoms were improved after the treatment, and no side effects were observed. Conclusion: Korean medicine treatment, including Sunghyuangjunggi-san, might be a recommended therapeutic option for dizziness and disorientation in stroke patients.

• 대한중풍순환신경학회지
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• 제22권1호
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• pp.45-56
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• 2021

■ Background Heart Failure with Preserved Ejection Fraction(HFpEF) is a heart failure that appears to have normal contraction function. In the case of HFpEF, no pharmacological therapy has been found to improve clinical prognosis, so it should be approached as an symptomatic treatment, therefore alternatives are needed due to concerns over adverse effects such as electrolyte imbalance caused by medication. ■ Case report A 81 year old female patient with Heart Failure with Preserved Ejection Fraction(HFpEF) patient complained dyspnea. Herbal prescription Mokbanggi-tang and Oryeongsan was administered on 6th day and 8th day respectively since the symptoms started. The NYHA Classification and Chest X-ray had been evaluated during the treatment period. Until the 7th day, the patient was classified as Class II, and when discharged from the hospital on the 28th day, it gradually improved and was classified as Class II. Chest X-Ray took on 2nd day showed pleural effusion and it was aggravated until 13th day. Follow up Chest X-Ray showed improving state of pleural effusion from 20th day and gradually got better. Mokbanggi-tang treatment continued for 52 days and stopped on 58th day. After Mokbanggi-tang treatment ended, only Oryeongsan treatment was maintained. ■ Conclusion The present case report suggests that Korean-Western medicine approach with Mokbangki-tang and Oryeongsan might be effective to pleural effusion and heart failure symptoms such as poor physical activity shown in a NYHA Classification. This shows that Mokbanggi-tang and Oryeongsan can be a therapeutic option as a treatment for patient with Heart Failure with Preserved Ejection Fraction(HFpEF).

• 동의생리병리학회지
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• 제36권6호
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• pp.247-251
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• 2022

This study is to show the clinical effect of Korean medicine integrated treatment for medial collateral ligament tear with bone contusion by traffic accident. The patients were treated using Korean medicine integrated treatment including acupunture, pharmacoacupunture and herbal medication. The effect of treatment was measured by Western Ontario and McMaster Universities Arthritis Index (WOMAC), EuroQol-5 Dimension Index (EQ-5D) and Numeric Rating Scale (NRS). After treatment, case 1 improved WOMAC from 94 to 24, EQ-5D from -0.056 to 0.72, and NRS from 10 to 2. Case 2 showed an improvement in symptoms from WOMAC 91 to 14, EQ-5D from 0.077 to 0.862, NRS from 10 to 2.5. In addition, as a result of follow-up about 5 months after each onset, case 1 showed a further improvement with WOMAC 0, EQ-5D 0.95 and case 2 WOMAC 7, EQ-5D 0.913. These results suggest that Korean medicine integrated treatment might be a possible therapeutic option for the medial collateral ligament tear with bone contusion by traffic accident.