• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6129-6132
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• 2012

Objectives: To evaluate the feasibility and efficacy of simultaneous accelerated radiation therapy (SMART) and concurrent weekly paclitaxel in the treatment of locally advanced nasopharyngeal carcinoma. Methods: Forty-one patients with pathologically confirmed nasopharyngeal carcinoma were treated by SMART with concurrent weekly paclitaxel. Daily fraction doses of 2.5 Gy and 2.0 Gy were prescribed to the gross tumor volume (GTV) and clinical target volume (CTV) to a total dose of 70 Gy and 56 Gy, respectively. Paclitaxel of $45mg/m^2$ was administered concurrently with radiation therapy every week. Adjuvant chemotherapy was given four weeks after the completion of the radiotherapy (RT) if the tumor demonstrated only a partial response (PR). Results: All patients completed the radiotherapy (RT) course. Adjuvant chemotherapy was administered to 12 patients due to PR. The CR (complete remission) rate was 82.9% three months after RT. Thirty-nine (95.1%) patients completed the concurrent weekly chemotherapy with paclitaxel, and two patients skipped their sixth course. Seven patients had a 15% dosage reduction at the fifth and sixth course due to grade 3 mucositis. The median follow-up was 30 (range, 14-42) months. The three-year overall survival (OS), metastases-free survival (MFS), and local control rates were 77.0%, 64.4%, and 97.6%, respectively. No correlation between survival rate and T or N stage was observed. Grade 3 acute mucositis and xerostomia were present in 17.1% and 7.1%, respectively. Conclusion: SMART with concurrent weekly paclitaxel is a potentially effective and toxicity tolerable approach in the treatment of locally advanced NPC.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.19 no.4
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• pp.381-389
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• 2009

Confined spaces are inherently dangerous workplace and many fatal and nonfatal accidents have been reported. Even though these accidents occur in various kinds of confined spaces, there has rarely been reported on the health hazard agent, i.e., the types of gases and their concentration ranges. Therefore in this study, we evaluated several toxic and asphyxiating gas concentrations in various confined spaces. We surveyed 57 manholes, 3 sewage treatment plants, 2 yellow radish manufacturing companies and 7 barges to measure the concentrations of oxygen($O_2$), hydrogen sulfide($H_2S$), carbon monoxide(CO), ammonia($NH_3$). Lower Explosion Limits(LEL) and Volatile Organic Compounds (VOCs). Those four types of confined spaces occupies 56% of accidents during last 9 years in Korea. In 57 manholes, the concentration varied according to the types of manholes; rainfall and sewage, and by location; residential and industrial areas. Sewage manhole in industrial area was evaluated as the most hazardous than other types of manhole like rainfall manholes, residential sewage manholes. The highest $H_2S$ concentration and the lowest $O_2$ concentration at sewage manhole in industrial area were 300 ppm, 8.7% respectively. In 3 sewage treatment plants, $H_2S$ and $NH_3$ concentrations were reached up to the 500 ppm and 200 ppm respectively. Two yellow radish manufacturing companies showed the concentrations of 316 ppm, 505.2 ppm, 90 ppm and 15.7% for $H_2S$, CO, VOCs and $O_2$, respectively. Seven barges showed 15.9%~20.9% oxygen concentration. Gas species and concentration ranges varied by the types and location of confined spaces; CO, $H_2S$, $O_2$ could be hazardous in manhole, especially manhole connected to sewage plants. CO, $H_2S$, LEL, $O_2$, $NH_3$ should be controlled in sludge silo and sluge pumping confined spaces in sewage treatment plant. The activity of lifting out radish from the storage tank was evaluated more hazardous rather than the other activities in yellow radish manufacturing industry. The employers must conduct the survey to identify all possible confined spaces in their local workplace prior to performing the tasks. At the national level to reduce the accidents in the confined spaces, we suggest that systemic approach and active education program including possible hazards, standard operation procedures, ventilation plan, and personal protective equipment in confined spaces should be implemented.

• Journal of Veterinary Clinics
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• v.32 no.3
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• pp.268-271
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• 2015

About 2-year old northern goshawk (Accipiter gentilis) which is designated as natural monument (#323-1) in Republic of Korea was rescued by a local farmer and presented with a 2-weeks history of pain, swelling, stiffness and limping. On physical examination, plantar pododermatitis and digit IV weakness were observed. Radiographic findings also showed bone lyses with soft tissue swelling in the foot. A definite diagnosis was made as stage III bumble foot after multidisciplinary approach of the patient. Bacterial culture was performed, and concurrently antibiotic susceptibility testing is determined using wound site exudates specimen. Bacterial isolates were identified as Staphylococcus aureus, known normal skin flora. Treatment was initiated with surgical incision and necrotized tissues removal. Lavage-drainage and ball bandage were applied with topical mupirocin ointment application. Doughnut shaped pad was attached on bottom of the ball bandage to reduce weight bearing. After three weeks of intensive care, the wound site completely healed but digit IV weakness remained permanently. The goshawk returned to nature after eight weeks after treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.3
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• pp.368-373
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• 2010

The incisors function as instruments for biting and cutting food during mastication. They also support the lips and face and maintain vertical dimension. In addition, they contribute to overall normal arch appearance. They play important role during the articulation of speech and assist in guiding jaw closure. Extraction and space maintenance are the most common treatment for a tooth with poor prognosis. However, in the mixed dentition, extraction of the upper permanent incisors results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation, and mastication. Considering these various roles of incisors in oral cavity, approach for traumatized incisors, even the ones with poor prognosis, should be considered first prior to simple extraction. The dentist must take into account the age of the patient, growth potential, occlusion, oral hygiene status, economic status and motivation towards dental health in addition to patient compliance. In this case, although the prognosis was predicted to be unfavorable due to short root and mobility, we could save the central incisor using conservative treatment, reposition by orthodontic appliance instead of extraction.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1097-1104
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• 1997

The expectoration of blood is always a fearful experience for the patient and a matter of grave concern to the attending physician, because it may be the warning sign of serious diseases. When such bleeding occurs, the possibility of its being due to pulmonary tuberculosis, bronchiectasis or carcinoma of the lung is promptly suggested. Nowadays, with the advance of modern diagnostic studies, differential diagnosis has become possible for the hemoptysis patients to have appropriate treatment. This evaluation is based on the review of 75 cases of patients whom we performed emergency open thoracotomies for 6 years from March 1992 to February 1997 in the Department of Thoracic and Cardiovascular Surgery, Seoul Adventist Hospital. The mean age of the patients was 36.6 years old with a range from 19 to 68, and most prevalent age group was thirties. The most common underlying lung disease causin hemoptysis was tuberculosis(44%). Most accurate diagnostic study was bronchoscopy during hemoptysis(95 Vo) and right middle & lower lobe(17.3%) was the most common site of lesion. Lobectomy(50%) was the most frequent operative method and recurrent hemoptysis(31.6%) was the most common postoperative complication. But most of the patients(82.6%) were completely recovered by surgical treatment. Now we concluded that the proper management of hemoptysis was completed by surgical approach with definite diagnosis and supportive medication.

• Journal of Pharmacopuncture
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• v.18 no.1
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• pp.79-85
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• 2015

Objectives: A vertebral compression fracture (VCF) is characterized by back pain and fracture of a vertebral body on spinal radiography. VCFs of the thoraco lumbar spine are common in the elderly. In general, appropriate analgesics should be prescribed to reduce pain and, thus, promote early mobilization. The ideal treatment approach for VCFs has not been determined. In Korea, acupuncture and herbal medication have been used to treat VCFs for many years. There is empirical evidence that acupuncture might benefit patients with a VCF. However, no randomized, controlled, clinical trials evaluating the efficacy and the safety of acupuncture for treating a VCF have been published. Therefore, we designed a randomized, controlled, pilot, clinical trial to obtain information for the design of a further full scale trial. Methods: A five week protocol for a randomized, controlled, pilot, clinical trial is presented. Fourteen patients will be recruited and randomly allocated to two groups: a control group receiving interlaminar epidural steroid injections once a week for three weeks, and an experimental group receiving interlaminar epidural steroid injections plus acupuncture treatment (three acupuncture sessions per week for three weeks, nine sessions in total). The primary outcomes will be the pain intensity (visual analogue scale and PainVision$^{TM}$ system). The secondary outcome measurements will be the answers on the short form McGill pain questionnaire and the oswestry disability index. Assessments will be made at baseline and at one, three, and five weeks. The last assessment (week five) will take place two weeks after treatment cessation. This study will provide both an indication of feasibility and a clinical foundation for a future large scale trial. The outcomes will provide additional resources for incorporating acupuncture into existing treatments, such as nonsteroidal anti-inflammatory medications, narcotics and vertebral augmentation. This article describes the protocol.

• Journal of Embryo Transfer
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• v.30 no.3
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• pp.249-255
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• 2015

Diabetes mellitus, the most common metabolic disorder, is divided into two types: type 1 and type 2. The essential treatment of type 1 diabetes, caused by immune-mediated destruction of ${\beta}-cells$, is transplantation of the pancreas; however, this treatment is limited by issues such as the lack of donors for islet transplantation and immune rejection. As an alternative approach, stem cell therapy has been used as a new tool. The present study revealed that bone marrowderived mesenchymal stromal cells (BM-MSCs) could be transdifferentiated into pancreatic cells by the insertion of a key gene for embryonic development of the pancreas, the pancreatic and duodenal homeobox factor 1 (PDX1). To avoid immune rejection associated with xenotransplantation and to develop a new cell-based treatment, BM-MSCs from ${\alpha}$-1,3-galactosyltransferase knockout (GalT KO) pigs were used as the source of the cells. Transfection of the EGFP-hPDX1 gene into GalT KO pig-derived BM-MSCs was performed by electroporation. Cells were evaluated for hPDX1 expression by immunofluorescence and RT-PCR. Transdifferentiation into pancreatic cells was confirmed by morphological transformation, immunofluorescence, and endogenous pPDX1 gene expression. At 3~4 weeks after transduction, cell morphology changed from spindle-like shape to round shape, similar to that observed in cuboidal epithelium expressing EGFP. Results of RT-PCR confirmed the expression of both exogenous hPDX1 and endogenous pPDX1. Therefore, GalT KO pig-derived BM-MSCs transdifferentiated into pancreatic cells by transfection of hPDX1. The present results are indicative of the therapeutic potential of PDX1-expressing GalT KO pig-derived BM-MSCs in ${\beta}-cell$ replacement. This potential needs to be explored further by using in vivo studies to confirm these findings.

• Journal of Trauma and Injury
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• v.20 no.1
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• pp.52-56
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• 2007

Marjolin's ulcer is a rare and often-aggressive cutaneous malignancy that arises in previously traumatized or chronically inflamed skin, particularly after burns. We experienced two cases after burns. Case I involved a forty eight year-old man who had suffered from a flame burn at the parietal scalp area, where had been initially described three years earlier as a full-thickness wound including the pericranium. The man consulted us for a persistent ulcerative and infected wound on the burned lesion during the last 24 months, which turned out on the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) to be the squamous cell carcinoma with involving the skull and the dura mater. Although the posterior auricular lymph node was enlarged on the ipsilateral side, recent positron emission tomography (PET) CT did not show any metastatic lesion. It was impossible for us to resect the intracranial involvement of the tumor radically, and the postoperative PET CT still showed a focal fluorodeoxyglucose (FDG) uptake around the wall of the superior sagittal sinus. We think that an aggressive combined approach is essential for treatment in early stages for a high success rate, before the intracranial structures are involved because there is no consensus on the treatment for advanced disease, and the results are generally poor. Case 1 also did not involve a radical resection because of the intracranial invasion to the wall of superior sagittal sinus and the possibility of damage to the major cortical veins. He received adjuvant radiotherapy and must be followed periodically. Case 2 involved an eighty six year-old women who suffered from a painful scalp ulcer lesion after flame burns three years earlier. Unlike case 1, neither tumor infiltration into the dura nor lymph node enlargement was observed on the contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) CT. We did a radical resection of the tumor, including the involved bone, and a cranioplasty with bone cement.

• Journal of the Korea Society of Computer and Information
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• v.18 no.12
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• pp.197-205
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• 2013

In this study, we developed a program of optimizing stand-level carbon stock using a stand-level yield model and the Simulated Annealing (SA) heuristic method to derive a optimized forest treatment solution. The SA is one of the heuristic algorithms that can provide a desirable management solution when dealing with various management purposes. The SA heuristic algorithm applied 'thermal equilibrium test', a thresholds approach to solve the phenomenon that does not find an optimum solution and stays at a local optimum value during the process. We conducted a sensitivity test for the temperature reduction rate, the major parameter of the thermal equilibrium test, to analyze its influence on the objective function value and the total iteration of the optimization process. Using the developed program, three scenarios were compared: a common treatment in forestry (baseline), the optimized solution of maximizing the amount of harvest(alternative 1), and the optimized solution of maximizing the amount of carbon stocks(alternative 2). As the results, we found that the alternative 1 showed provide acceptable solutions for the objectives. From the sensitivity test, we found that the objective function value and the total iteration of the process can be significantly influenced by the temperature reduction rate. The developed program will be practically used for optimizing stand-level carbon stock and developing optimized treatment solutions.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.95-101
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• 2021

Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.