• Title/Summary/Keyword: 확장 적응증

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Extended indications of Four-Constitution Medicinal formula analyzing composition on Dongeuibogam formula II (『동의보감(東醫寶鑑)』 처방(處方)의 약재 용량 분석을 통한 사상방(四象方) 적응증 확장 연구 II)

  • Baek, Jin-Ung;Lee, Byung-Wook
    • The Journal of Korean Medical History
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    • v.26 no.2
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    • pp.23-29
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    • 2013
  • Objectives : The purpose of this study is to extend indications of Four-Constitution Medicinal formulas by comparing with formulas on Dongeuibogam(東醫寶鑑), focusing on their composition. Methods : 1. We analyzed the composition of Four-Constitution Medicine formula which are mentioned on Donguisusebowon(東醫壽世保元), focusing on their composition. 2. We analyzed the composition of formulas on Dongeuibogam(東醫寶鑑) comparing with 24 formulas for So-Eum type, 17 formulas for So-Yang type, 24 formulas for Tae-Eum type, 2 formulas for Tae-Yang type. Results & Conclusions : 1. We finally selected 14 formulas and its effect as similar formulas with Bojungyikgi-tang, Insamjinpi-tang, Cheongunggyeji-tang, Palmulgunja-tang, Hwanggigyejibuja-tang, Hwanggigyeji-tang for So-Eum type. 2. We finally selected 4 formulas and its effect as similar formulas with Dokwaljihwang-tang, Sukjihwanggosam-tang for So-Yang type.

Extended indications of Soyang-type Hyeongbangpaedok-san using "Dongeuibogam" (동의보감(東醫寶鑑)을 이용한 소양인(少陽人) 형방패독산(荊防敗毒散)의 적응증(適應證) 확장 연구(硏究))

  • Park, Jin-Woo;Lee, Byung-Wook;Baek, Jin-Ung
    • Journal of Korean Medical classics
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    • v.25 no.1
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    • pp.17-29
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    • 2012
  • Indications of Hyeongbangpaedok-san for Soyang-type on "Donguisusebowon" are small. Therefore, indications of Hyeongbangpaedok-san for Soyang-type need to be extended for broader clinical use. There would be some methods to do that, and we could review "Dongeuibogam" that Four-Constitution Medicine formulas are based on. We reviewed Hyeongbangpaedok-san, Insampaedok-san which is the origin of Hyeongbangpaedok-san, and their modified formula(加減方) on "Dongeuibogam". As a result, we supposed 12 indications of non-classical formula(後世方) Hyeongbangpaedok-san, 2 indications of modified formula of non-classical formula Hyeongbangpaedok-san, and 12 indications of Insampaedok-san and its modified formula as possible indications of Hyeongbangpaedok for Soyang-type.

Management Strategy and Surveillance of Intraductal Papillary Mucinous Neoplasm-Gastroenterologist's Viewpoint (췌관 내 유두상 점액종양의 치료 전략과 추적 관찰-소화기내과의 관점)

  • Kim, Tae Hyeon;Chon, Hyung Ku
    • Journal of Digestive Cancer Research
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    • v.9 no.1
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    • pp.1-7
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    • 2021
  • The length, the frequency, and the methods of surveillance for intraductal papillary mucinous neoplasm (IPMN) of the pancreas are still debating. According to the recent guidelines, IPMN is stratified into "high-risk stigmata" or absolute indication and "worrisome features" or relative indication as a guide in managing these patients, either those with resection of the lesion or those under surveillance. The risk of malignant transformation was quite low for branch duct-IPMNs without worrisome features or high risk stigmata. However, because the incidence rate of pancreatic cancer in these patients increase linearly with time, continued long-term surveillance is therefore important for patients with low-risk, as well as higher-risk, IPMN. Considering the high prevalence of malignancy, main duct-IPMN should be treated by surgical resection. Among patients with these type IPMNs, segmental dilatation of the main pancreatic duct without any mural nodules and larger than 10 mm of main pancreatic duct might not be immediately resected and need very careful examination and observation. The risk related to a major pancreatic resection must balance the risk of surveillance in patients with IPMN of the pancreas who have co-morbidity and are elderly.

Conversion of Total Atrio-pulmonary Connection to Total Cavo-pulmonary Connection - Review of Indications and Hemodynamic Characteristics - (심방-폐동맥 문합술 후 총 체정맥-폐동맥 문합술로의 전환 - 수술 적응증 및 혈역학적 특징의 검토 -)

  • Seo, Jung Ho;Lee, Jong Kyun;Choi, Jae Young;Sul, Jun Hee;Lee, Sung Kyu;Park, Young Whan;Cho, Bum Koo
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.199-207
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    • 2002
  • Purpose : Since the successful application of total atrio-pulmonary connection(TAPC) to patients with various types of physiologic single ventricles in 1971, post-operative survival rates have reached more than 90%. However some patients have been shown to present with late complications such as right atrial thrombosis, atrial fibrillation and protein losing enteropathy eventually leading to re-operation to control the long-term complications. The aim of this study is to review the results of total cavo-pulmonary connection(TCPC) in cases with late complications after TAPC. Methods : Between Jan. 1995 and Dec. 2000, 6 patients(5 males and 1 female) underwent cardiac catheterization $11{\pm}3$ months after conversion of previous TAPC to TCPC. We compared the hemodynamic and morphologic parameters before and after TCPC and also assessed the clinical outcomes. The indications for TAPC were tricuspid atresia in 4 cases and complex double-outlet right ventricle with single ventricle physiology in 2 cases. Results : There was no peri-operative mortality and all patients were clinically and hemodynamically improved at a mean follow-up of 11 months(range : 4 to 13). However, protein losing enteropathy recurred in 2 patients; this was were successfully treated with subcutaneous administration of heparin. Right atrial pressure before TCPC was $18.0{\pm}3.6mmHg$, but baffle pressure, corresponding to right atrial pressure decreased to $14.8{\pm}3.6mmHg$ after TCPC. The size of the pulmonary arteries did not regress after TCPC. Conclusion : The conversion of TAPC to TCPC improves clinical and hemodynamic status by decreasing the right atrial pressure and by providing a laminar cavo-pulmonary flow which enhances the effective pulmonary circulation in the so-called Fontan circulation.

Surgical Complications in Heart Transplant Recipients - A Single Center Experience - (심장이식후에 발생한 외과적 합병증 - 단일 센터 경험 -)

  • Park, Kook-Yang;Park, Chul-Hyun;Jeon, Yang-Bin;Choi, Chang-Hyu;Lee, Jae-Ik
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.719-724
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    • 2009
  • Background: As the patients who undergo heart transplantation have achieved better survival in recent years, growing number of recipients are at a risk for experiencing surgical complications in addition to rejection and infection. In this paper, we report on our experience with the surgical complications that occurred in heart transplant recipients. Material and Method: From April 1994 to September 2003, 37 heart transplantations were performed at our center by a single surgeon. The indications for transplantation were dilated cardiomyopathy, ischemic cardiomyopathy, valvular cardiomyopathy and familial hypertrophic cardiomyopathy. Result: Twenty postoperative complications required surgeries in 15 patients (41%). The types of operations required were; redo-sternotomy for bleeding (5), pericardiostomy for effusion (4), implantation of a permanent pacemaker (1), right lower lobe lobectomy for aspergilloma (1), removal of urinary stone (1), cholecystectomy for gall bladder stone (1), drainage of a perianal abscess (1), paranasal sinus drainage (1), total hip replacement (1), partial gingivectomy due to gingival hypertrophy (1), urethrostomy (1), herniated intervertebral disc operation (1) and total hysterectomy for myoma uteri (1). The locations of the complications were mediastinal in 10 (27%) cases and extramediastihalin 10 (27%) cases. Conclusion: The relatively high incidence of extrathoracic complications associated with heart transplantation emphasizes the importance of a multidisciplinary approach to the improve long-term survival when managing those complex patients.

A study on the indications of Five Viscera Source Point Acupuncture extended from Taegeuk Acupuncture : Focused on Yeoungchu(靈樞) (태극침법(太極鍼法)의 확장형인 오장원혈침법(五臟原穴鍼法)의 적응증 연구 - "황제내경(黃帝內經).영추(靈樞)"를 중심으로 -)

  • Moh, Han Young;Lim, Gyo-Min;Baek, Jin-Ung
    • Journal of Korean Medical classics
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    • v.25 no.4
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    • pp.123-147
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    • 2012
  • Objective : By establishing the Five Viscera Source Point Acupuncture as the targeted acupuncture treatment for stadardization, as the first step, this study was conducted to sort the indications of each acupuncture remedies, which can be referred as one of the most important factors in acupuncture treatment, based on Yeoungchu. Method : This study selected only the contents related to indications of five viscera, by extracting the relevant sentences from Yeoungchu using the search words Liver(Liver Meridian, First Yin), Heart(Pericardium, Heart Meridian, Second Yin), Spleen(Spleen meridian, Third Yin), Lung(Lung Meridian, Third Yin), and Kidney(Kidney Meridian, Second Yin). Result & Conclusion : 1. We selected and extracted text related to liver disease from Chapter 16, heart (pericardium) disease from Chapter 16, spleen disease from Chapter 19, lung disease from Chapter 17, and finally kidney disease from Chapter 17 of Yeoungchu. 2. The basic theory of applying Five Viscera Source Point Acupuncture to five viscera diseases is first assorting the diseases according to its state (i.e. deficiency or excess), then draining the source point of the appropriate viscus in case of excess, or supplementing the source point of the appropriate viscus in case of deficiency. 3. For the correct application of Five Viscera Source Point Acupuncture, the classification of the disease, not only the judgement on its state, must be presented systematically and synthetically in combination with Four Examinations. Therefore the follow-up studies needs to be conducted.

Extended indications of Four-Constitution Medicine formula using "Dongeuibogam" - The case of Bojungyikgi-tang - ("동의보감(東醫寶鑑)"을 이용한 "동의수세보원(東醫壽世保元)" 수록(收錄) 사상방(四象方)의 적응증(適應證) 확장에 관한 연구(硏究) - 보중익기탕(補中益氣湯)을 예(例)로 들어 -)

  • Hong, Jin-Woo;Lee, Myeong-Ryeol;Lee, Byung-Wook;Baek, Jin-Ung
    • Journal of Korean Medical classics
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    • v.24 no.3
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    • pp.27-47
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    • 2011
  • Donguisusebowon(東醫壽世保元) doesn't have pretty large quantity of contents, so indications of Four-Constitution Medicine formulas on that medical book are small. Therefore, indications of Four-Constitution Medicine formula need to be extended for broader clinical use of Four-Constitution Medicine. There would be some methods to do that, and we could review the literatures that Four-Constitution Medicine formulas are based on. We reviewed Bojungyikgi-tang on "Dongeuibogam(東醫寶鑑)", and we found that if the Four-Constitution Medicine formula is based on Sanghan formula(傷寒方) or non-classical formula(後世方), it is worth adding more indications of base formulas to those of Four-Constitution Medicine formula. For exmaple, Indications of Bojungyikgi-tang for So-Eum type could be extended by indications of non-classical formula(後世方) Bojungyikgi-tang and modified formula(加減方) Bojungyikgi-tang on Dongeuibogam, We supposed 23 indications of non-classical formula(後世方) Bojungyikgi-tang, and 20 indications of modified formula(加減方) Bojungyikgi-tang as possible indications of Bojungyikgi-tang for So-Eum type.

Tracheal Reconstruction with Perichondrial Graft - An Experimental Study in Rabbits - (연골피막편 이식후 기관 결손부위의 재생에 관한 실험적 연구(제 1 보))

  • 이원상;서장수;이성은;홍원표;박찬일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.10.3-11
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    • 1982
  • Recently through the advancement of medical and surgical managements and the development of low pressure cuffed endotracheal tube, incidence of tracheal stenosis was decreased significantly. Though its incidence was decreased markedly, stenosis was developted unfortunately in the situations such as long term use of respirator, heavy infection, trauma of the trachea and long term intubation etc. Tracheal stenosis had been handled with various methods such as mechanical dilatation, tissue graft techniques, luminal augumentation and end to end anastomosis due to their individual advantages but their effects were not satisfactory. In 1959 Lester had been found the regenerated cartilage from the perichondrium of the rib incidentaly. Since then Skoog, Sohn and Ohlsen were reported chondrogenic potential of perichondrium through the animal experiments. Though many different materials have been tried to rebuild stenosis and gaping defect of trachea, tracheal reconstruction has been a perplexing clinical problems. We choose the perichondrium as the graft material because cartilage is the normal supporting matrix of that structure and it will be an obvious advantage to be able to position perichondrium over a defect and obtain new cartilage there. The young rabbits, which were selected as our experimental animals, were sacrified from two to eight weeks after surgery. The results of our experiment were as follows; 1) In control group, the defect site of trachea was covered with fibrosis and vessels but graft site was covered with hypertrophied perichondrium and vessels. 2) Respiratory mucosa was completely regenerated in defect sites both control and grafted groups. 3) The histologic changes of the grafted sites were as follows: 2 weeks- microvessel dilatation, inflammatory reaction, initiation of fibrosis 4 weeks- decreased microvessel engorgement, submucosal fibrosis, decreased inflammatory reaction immatured cartilage island was noted in the grafted perichondrium (one specimen) 6 weeks- mild degree vascular engorgement submucosal fibrosis. chronic inflamatory reaction cartilage island and endochondrial ossification was noted in the grafted perichondrium (Two specimens) 8 weeks- minute vascular engorgement dense submucosal fibrosis. loss of inflammatory reaction. cartilage island was noted in the grafted perichondrium (two specimens) 4) There was no significant differences in regeneration between active surface in and out groups. 5) We observed immatured cartilage islands and endochondrial ossification in the perichondrial grafted groups where as such findings were not noted in control groups except fibrosis. We concluded that perichondrium was the adequate material for the reconstruction of defected trachea but our results was not sufficient in the aspect of chondrogenic potential of perichondrium. So further research has indicated possibility of chondrogenic potential of perichondrium.

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Evaluation of the Risk Factors Predicting Morbidity and Mortality after Major Pulmonary Resection (주요 폐절제술시 이환율과 사망률을 예견하는 위험인자의 평가)

  • Choi, Ho;Lee, Cheol-Joo;Soh, Dong-Moon;Kim, Jung-Tae;Hong, Jun-Wha;Ryu, Han-Young;Park, Jae-Beom
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.549-555
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    • 1999
  • Background: Patients who are considered for major pulmonary resection are generally evaluated by spirometry and clinical assessment to predict morbidity and mortality. Despite this, none has yet proved to be a convenient and reliable estimate of risk. Material and Method: A retrospective analysis was performed in 167 patients who were diagnosed for lung cancer, bronchiectasis, pulmonary tuberculosis, and other benign pulmonary disease, and who underwent major lung resections. The relationship of 25 preoperative or postoperative variables to 19 postoperative events were classified into categories as operative mortality, pulmonary or cardiovascular morbidity, and other morbidity was assessed. Logistic regression analysis and $\chi$2 analysis were used to identify the relationship of the operative risk factors to the grouped postoperative complications. Result: The best single predictor of complications was the percent predicted postoperative diffusing capacity (pulmonary morbidity, p<0.009; cardiovascular morbidity, p<0.003: overall morbidity, p<0.004). Conclusion: The diffusing capacity of the lung for carbon monoxide was an important predictor of postoperative complications than the spirometry, and it usually should be a part of the evaluation of patients being considered for pulmonary resection.

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The Clinical Study on the Characteristics of Pulmonary Lesions Which Should Be Differentiated from Pulmonary Tuberculosis in Lung Resection Cases (폐절제 예에서 결핵과 구별해야 할 질환의 특성에 관한 임상적 고찰)

  • 정황규;정성운;박서완
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1232-1240
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    • 1996
  • From January 1990 through June 1995, we operated on 121 patients who were suspected for pulmonary tuberculosis without definite final diagnosis. After operation the final pathologic diagnoses were as follows: 68 pulmonary tuberculosis in which 29 were tuberculoma, 23 lung cancer, 16 bronchiectasis, 6 aspergilloma, 2 lung abscess, 2 benign cyst and 4 others. In 121 cases, 81 were male and 40 were female and the peak age incidence was 4th decade in tuberculosis (39.7%) and 6th and 7th decade in lung cancer (69.6%). The diagnoses in 44 cases presented roentgenographically as pulmonary nodules were pulmonary tuberculosis(29 cases) and lung cancer(15 cases). Tuberculous nodules tended to be smaller in size with calcification and satellite lesions compared to carcinomas. Indications for operation were solitary nodules 44 cases (36.4%); destroyed lobe 31(25.6%); hemoptysis 25 (20.7%); cavitary lesion 11(9.1 %); bronchostenosis 3 (2.5%); destroyed lung 5(4.1 %) and destroyed lung with empyema 2(1.7%). We conclude that preoperatively suspected pulmonary tuberculosis should be distinguished from various pulmonary lesions such as carcinoma, bronchiectasis, aspergilloma, lung abscess and benign cyst. For the possibility of carcinoma, pulmonary nodules of size greater than 3cm, non-calcified, non satellite lesion, newly developed nodule even under the anti-tuberculous medication, negative PPD skin test with elevated CEA level are recommended for an early resectional surgery and follow-up and delayed surgery is recommended in cases such as pulmonary nodules less than 3 cm in size with calcification, satellite lesion, positive PPD skin reaction and elevated ESR, CRP, ALP levels.

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