Collagen is the most common structural protein in the connective tissues of vertebrates, playing a crucial role in maintaining the tissue structure and wound healing. Atelocollagen retains the original properties of collagen but does not induce inflammatory cytokines. Atelocollagen is extracted from various animals and humans, with bovine-derived collagen being the most commonly used. The safety and efficacy of atelocollagen have been demonstrated through multiple studies, but further research will be needed in the field of orthopedics regarding its range of use and effects. Foot and ankle diseases have attracted little research attention, highlighting the need for further studies.

PURPOSE: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced unresectable pancreatic cancer. However, the introduction of gemcitabine and the recognition of a benefit in patients with advanced disease stimulated the design of trials that compare chemotherapy alone to concurrent chemoradiation. Therefore, we evaluated role of CCRT for locally advanced unresectable pancreatic cancer. MATERIALS AND METHODS: We carried out a retrospective analysis of treatment results for patients with locally advanced unresectable pancreatic cancer between January 2000 and January 2008. The radiation was delivered to the primary tumor and regional lymph nodes with a 1~2 cm margin at a total dose of 36.0~59.4 Gy (median: 54 Gy). The chemotherapeutic agent delivered with the radiation was 5-FU (500 mg/m2). The patients who underwent chemotherapy alone received gemcitabine (1,000 mg/m2) alone or gemcitabine with 5-FU. The follow-up period ranged from 2 to 38 months. The survival and prognostic factors were analyzed using Kaplan-Meier method and log-rank test, respectively. RESULTS: Thirty-four patients received concurrent chemoradiotherapy, whereas 21 patients received chemotherapy alone. The median survival time was 12 months for CCRT patients, compared to 11 months for chemotherapy alone patients (p=0.453). The median progression-free survival was 8 months for CCRT patients, compared to 5 months for chemotherapy alone patients (p=0.242). The overall response included 9 partial responses for CCRT and 1 partial response for chemotherapy alone. In total, 26% of patients from the CCRT group experienced grade 3~4 bowel toxicity. In contract, no grade 3~4 bowel toxicity was observed in the chemotherapy alone group. The significant prognostic factors of overall survival were lymph node status, high CA19-9, and tumor location. CONCLUSION: The response rate and progression-free survival were more favorable in the CCRT group, when compared with the chemotherapy alone group. Therefore, radiation therapy seems to be an effective tool for local tumor control.
Chemoradiotherapy ; Contracts ; Deoxycytidine ; Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Lymph Nodes ; Pancreatic Neoplasms ; Retrospective Studies

The aim of this study was to investigate the dose-related effects of extracorporeal shock wave therapy (ESWT) on the lateral epicondylitis of the elbow. Between March 2005 and March 2008, 66 patients who had been treated with extracorporeal shock wave therapy due to lateral epicondylitis of elbow formed the subjects. The subjects were divided into the 1st, 2nd and the 3rd treatment group and evaluated the clinical outcomes by visual analog scale (VAS) and a simple elbow test (SET) at immediate treatment, posttreatment 6 and 12 months, retrospectively. Changes in VAS score between the 2nd and 3rd treatment group and between the 1st and 3rd treatment group showed significant difference only at posttreatment 1 month group (p=0.001, 0.2, 0.1), (p=0.03, 0.08, 0.3), but Visual Analog Scale score at posttreatment 1 month showed no difference within the groups (p=1.0, 0.2, 0.07). SET within and between the groups showed significant difference at posttreatment 6 and 12 months (p<0.05).
Elbow ; Humans ; Retrospective Studies ; Shock

No abstract available.
Adult* ; Humans ; Treatment Outcome*

PURPOSE: The survey aimed to obtain opinions about a proposed implementation of pharmacy skills assessment in Korean pharmacist licensure examination (KPLE). METHODS: A 16-question survey was distributed electronically to 2,738 people including 570 pharmacy professors of 35 pharmacy schools, 550 preceptors from 865 practice sites and 1,618 students who graduated in 2015. The survey solicited responses concerning the adequacy of the current KPLE in assessing pharmacy knowledge/skills/attitudes, deficiencies of pharmacy skills testing in assessing the professional competencies necessary for pharmacists, plans for pharmacy skills tests in the current KPLE, and subject areas of pharmacy practice. RESULTS: A total of 466 surveys were returned. The current exam is not adequate for assessing skills and attitudes according to 42%–48% of respondents. Sixty percent felt that skills test is necessary to assess qualifications and professional competencies. Almost two-thirds of participants stated that testing should be implemented within 5 years. More than 60% agreed that candidates should be graduates and that written and skills test scores can be combined for pass-fail decisions. About 70% of respondents felt that the test should be less than 2 hours in duration. Over half of the respondents thought that the assessor should be a pharmacy faculty member with at least 5 years of clinical experience. Up to 70% stated that activities related to patient care were appropriate and practical for the scope of skills test. CONCLUSION: Pharmacy skills assessment was supported by the majority of respondents.
Humans ; Licensure* ; Patient Care ; Pharmacists* ; Pharmacy* ; Schools, Pharmacy ; Surveys and Questionnaires

PURPOSE: The purpose of this study is to evaluate the clinical outcomes after removing the volar locking plate for distal radius fracture. MATERIALS AND METHODS: We reviewed retrospectively the medical records of 34 patients, 36 cases after removing the plates among 150 patients, with 162 cases that underwent open reduction and internal fixation using the volar locking plate between January 2006 and May 2011. We performed preoperative and postoperative clinical assessments using the quick-disabilities of the arm, shoulder and hand (Q-DASH), the visual analog scale (VAS) score, and the range of motion on wrist, grip and pinch power. RESULTS: The major reason for plate removal was the time to remove the plate according to the fracture union and the patient's demand without other specific complaints (28 cases). The mean preoperative VAS score was 1.78 and the mean postoperative VAS score 1.81 (p=0.64). The mean preoperative Q-DASH score was 30.02 and the mean postoperative Q-DASH score 38.46 (p<0.001). The mean preoperative grip and pinch power were 18.14 kg and 7.67 kg. The mean postoperative grip and pinch power were 15.27 kg and 6.94 kg (p=0.23). CONCLUSION: The removal of the volar locking plate for distal radius fracture should be decided by considering the patient's clinical and socioeconomic conditions carefully.
Arm ; Hand ; Hand Strength ; Humans ; Medical Records ; Radius Fractures* ; Radius* ; Range of Motion, Articular ; Retrospective Studies ; Shoulder ; Visual Analog Scale ; Wrist

PURPOSE: This study was performed to retrospectively analyze patient survival by weighting according to the primary tumor oncotype in 160 patients with brain metastasis and who underwent whole brain radiotherapy. MATERIALS AND METHODS: A total of 160 metastatic brain cancer patients who were treated with whole brain radiotherapy of 30 Gy between 2002 and 2008 were retrospectively analyzed. The primary tumor oncotype of 20 patients was breast cancer, and that of 103 patients was lung cancer. Except for 18 patients with leptomeningeal seeding, a total of 142 patients were analyzed according to the prognostic factors and the Recursive Partitioning Analysis (RPA) class. Weighted Partitioning Analysis (WPA), with the weighting being done according to the primary tumor oncotype, was performed and the results were correlated with survival and then compared with the RPA Class. RESULTS: The median survival of the patients in RPA Class I (8 patients) was 20.0 months, that for Class II (76 patients) was 10.0 months and that for Class III (58 patients) was 3.0 months (p<0.003). The median survival of patients in WPA Class I (3 patients) was 36 months, that for the patients in Class II (9 patients) was 23.7 months, that for the patients in Class III (70 patients) was 10.9 months and that for the patients in Class IV (60 patients) was 8.6 months (p<0.001). The WPA Class might have more accuracy in assessing survival, and it may be superior to the RPA Class for assessing survival. CONCLUSION: A new prognostic index, the WPA Class, has more prognostic value than the RPA Class for the treatment of patients with metastatic brain cancer. This WPA Class may be useful to guide the appropriate treatment of metastatic brain lesions.
Brain ; Brain Neoplasms ; Breast Neoplasms ; Humans ; Lung Neoplasms ; Neoplasm Metastasis ; Retrospective Studies ; Seeds ; Survival Analysis*

BACKGROUND/AIMS: We assessed the clinical features and prognosis of acute viral hepatitis A (AHA) complicated with acute kidney injury (AKI) and elucidated predictive factors for AKI in patients with AHA. METHODS: We reviewed medical record of 391 patients with AHA admitted at our institution since 2000. RESULTS: AKI was present in 45 patients (11.5%). The proportion of the AKI group increased since 2008 (5.4% before 2008 vs. 15.9% since 2008, p=0.001). The AKI group was older than the non-AKI group (35.7+/-8.7 years vs. 31.3+/-7.8 years, p=0.002). Other baseline clinical characteristics were similar between two groups. Initial hemoglobin, platelet, and serum albumin were significantly low and prothrombin time, serum bilirubin, creatinine, AST, and ALT were significantly high in the AKI group. Hepatic encephalopathy, ascites, gastrointestinal bleeding, and sepsis were more frequently observed in the AKI group. While six patients (13%) in the AKI group received liver transplantation (LT) but three patients died within one month, one patient in the non-AKI group receiving LT is alive. Multivariate analysis showed that older age (OR 1.07, 95% CI 1.02-1.12), initial thrombocytopenia <150,000/mm2 (OR 2.85, 95% CI 1.24-6.57), prothrombin time (PT) prolongation (OR 5.34, 95% CI 2.55-11.19), and hypoalbuminemia (OR 8.24, 95% CI 2.53-26.86) were independently associated with the occurrence of AKI. CONCLUSIONS: AHA with AKI is an increasing problem showing significant morbidity and mortality in Korea. AKI is highly associated with older age, initial thrombocytopenia, PT prolongation, or low serum albumin, and has bad prognostic effect.
Acute Disease ; Acute Kidney Injury/complications/*diagnosis/therapy ; Adult ; Age Factors ; Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Bilirubin/blood ; Creatine/blood ; Female ; Hemoglobins/analysis ; Hepatitis A/complications/*diagnosis ; Humans ; Hypoalbuminemia/complications ; Liver Transplantation ; Male ; Middle Aged ; Odds Ratio ; Platelet Count ; Predictive Value of Tests ; Prognosis ; Prothrombin Time ; Serum Albumin/analysis ; Thrombocytopenia/complications

BACKGROUND: The molecular profile of peritumoral non-neoplastic liver parenchyma (PNLP) has recently been suggested as predictive factor of early and late recurrence of hepatocellular carcinoma (HCC). However, there is no definite cut-off point for tumor-free PNLP in terms of either histological or molecular changes. Therefore, our aim is to determine the numerical cut-off point for separating adjacent PNLP and remote PNLP in histopathologic perspective. METHODS: Peritumoral tissues from 20 resected HCC patients were sampled from 0 to 40 mm distance from the tumor border (divided into 5-mm columns). Histopathologic parameters such as necroinflammatory activity, fibrosis, bile ductular reaction, hepatic venulitis, peliosis, and steatosis were compared between each column. RESULTS: The morphologic changes just adjacent to the tumor were notably severe and faded with distance. The parenchyma within 10 mm of the tumor showed significantly severe inflammation, fibrosis, peliosis and hepatic venulitis compared with those from farther areas. The histopathologic changes of the parenchyma became stable beyond 20 mm. CONCLUSIONS: Results of this study revealed that the parenchyma within 10 mm distance from the tumor, or adjacent PNLP, has histopathologic changes that are directly affected by the tumor, and the parenchyma beyond 20 mm as the remote PNLP without tumor effect.
Bile ; Carcinoma, Hepatocellular ; Fibrosis ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Inflammation ; Liver ; Recurrence

PURPOSE: To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) followed by radiotherapy (RT) in treatment-naive patients with locally advanced hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Eligibility criteria were as follows: newly diagnosed with HCC, the Barcelona Clinic Liver Cancer stage C, Child-Pugh class A or B, and no prior treatment for HCC. Patients with extrahepatic spread were excluded. A total of 59 patients were retrospectively enrolled. All patients were treated with TACE followed by RT. The time interval between TACE and RT was 2 weeks as per protocol. A median RT dose was 47.25 Gy10 as the biologically effective dose using the alpha/beta = 10 (range, 39 to 65.25 Gy10). RESULTS: At 1 month, complete response was obtained in 3 patients (5%), partial response in 27 patients (46%), stable disease in 13 patients (22%), and progressive disease in 16 patients (27%). The actuarial one- and two-year OS rates were 60.1% and 47.2%, respectively. The median OS was 17 months (95% confidence interval, 5.6 to 28.4 months). The median time to progression was 4 months (range, 1 to 35 months). Grade 3 or greater liver enzyme elevation occurred in only two patients (3%) after RT. Grade 3 gastroduodenal toxicity developed in two patients (3%). CONCLUSION: The combination treatment of TACE followed by RT with two-week interval was safe and it showed favorable outcomes in treatment-naive patients with locally advanced HCC. A prospective randomized trial is needed to validate these results.
Carcinoma, Hepatocellular* ; Humans ; Liver ; Liver Neoplasms ; Radiotherapy ; Retrospective Studies