• 대한한방내과학회지
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• 제42권5호
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• pp.808-819
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• 2021

Objectives: This study considered the effectiveness of integrative Korean medical treatment for stress-induced hypertensive patients without the use of conventional medication. Methods: A 62-year-old female with stress-induced hypertension (HTN) was hospitalized for 33 days. Her pattern identification was ascendant hyperactivity of liver yang (Ganyangsanghang)-type HTN. Herbal medicine and acupuncture were used for the treatment: Cheonggansoyo-san for 33 days and Chunwangbosim-dan for 15 days, together with acupuncture for 20 minutes twice a day. Blood pressure was checked daily during hospitalization with a digital sphygmomanometer in the brachial artery. Results: After 33 days of treatment, blood pressure decreased. The Handicap Inventory (DHI) scale and Pittsburg Sleep Quality Index (PSQI) scores both decreased. The patient also reported fewer complaints. A five-month follow-up after discharge, with no further treatment, confirmed stable blood pressure. Symptom improvements continued with no significant side effects. Conclusions: This study indicates that Korean medical treatment is effective for stress-induced hypertensive patients.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제26권1호
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• pp.58-64
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• 2024

The Pipeline Embolization Device (PED) is a flow-diverting intraluminal device that is approved for use in adults 18 years or older with internal carotid artery aneurysms. However, it can also be used off-label in pediatric patients with aneurysms that cannot be resolved with traditional endovascular treatments. Herein, we present two cases of flow diversion in the pediatric population with complete obliteration of the aneurysm and excellent outcomes. Flow diversion has been shown to be a safe endovascular option in treating complex aneurysms in children. Larger-sized, multicenter trials are encouraged to compare outcomes between flow diversion and other aneurysm treatment options given the rarity of pediatric aneurysms.

• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.42-49
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• 2015

Objective : The cervicothoracic junction (CTJ) is a biomechanically and anatomically complex region that has traditionally posed problems for surgical access. In this retrospective study, we describe our clinical experiences of the treatment of metastatic spinal tumors at the CTJ and the results. Methods : From June 2006 to December 2011, 23 patients who underwent surgery for spinal tumors involving the CTJ were enrolled in our study. All of the patients were operated on through the posterior approach, and extent of resection was classified as radical, debulking, and simple neural decompression. Adjuvant radiation therapy (RT) was also considered. Visual analog scale score for pain assessment and Medical Research Council (MRC) grade for motor weakness were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Almost all of the patients were operated using palliative surgical methods (91.3%, 21/23). Ten complications following surgery occurred and revision was performed in four patients. Of the 23 patients of this study, 22 showed significant pain relief according to their visual analogue scale scores. Concerning the aspect of neurological and functional recovery, mean MRC grade and ECOG score was significantly improved after surgery (p<0.05). In terms of survival, radiation therapy had a significant role. Median overall survival was 124 days after surgery, and the adjuvant-RT group (median 214 days) had longer survival times than prior-RT (63 days) group. Conclusion : Although surgical procedure in CTJ may be difficult, we expect good clinical results by adopting a palliative posterior surgical method with appropriate preoperative preparation and postoperative treatment.

• 응용통계연구
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• 제30권3호
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• pp.453-462
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• 2017

성향점수 매칭은 관찰연구에서 처리효과 추정 시 혼란변수에 의한 편의를 줄이기 위해 자주 사용되는 방법이다. 매칭을 위해 처리군에 대응되는 대조군 선정 시 처리군의 일부가 탈락되는 경우가 발생할 수 있는데, 이로 인해 편의가 발생할 수 있다. 최근, Austin (2017)의 연구에서 이중 성향점수 보정(double propensity score adjustment)방법을 사용하는 것이 이에 대한 해결책이 될 수 있음을 제시하였다. 하지만, 처리효과 추정치의 표준오차는 이론적 추정치가 제시되지 않아 추정에 어려움이 있다. 본 연구에서는 이중 성향점수 보정 방법을 이용한 처리효과 추정치의 표준오차 추정을 위하여 두 가지 붓스트랩 방법을 제안한다. 첫 번째는 원 자료에서 성향점수 매칭 후 매칭 된 표본에서 붓스트랩 표본을 얻는 방법(simple 붓스트랩)이고, 두 번째는 원 자료에서 붓스트랩을 먼저 시행하고 각 붓 스트랩 표본에서 성향점수 매칭을 하는 방법(complex 붓스트랩)이다. 두 방법의 성능을 비교하기 위하여 다양한 상황을 가정하여 모의실험을 시행한 결과 complex 붓스트랩 방법이 경험적 표준오차와 더 가까운 값으로 추정함을 알 수 있었다. 95% 신뢰구간의 포함확률도 complex 방법을 사용했을 때 0.95에 훨씬 가까웠다. 실제 자료에 적용하였을 때에도 simple 방법은 complex 방법에 비해 표준오차를 작게 추정하였다.

• Journal of Acupuncture Research
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• 제33권2호
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• pp.181-187
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• 2016

Objectives : The purpose of this report is to introduce a case of osteochondral lesions of the left talus caused by ankle sprain and suggest complex traditional Korean medical care with warm needling therapy as a possible method of conservative treatment. Methods : A 20-year-old male with osteochondral lesions of the left talus complaining of ankle pain and restricted range of movement was treated mainly with warm needling therapy and other combined Korean medicine therapy from January 5, 2015 to January 12, 2015. Improvements of symptoms were measured by American Orthopaedic Foot & Ankle Society Score (AOFAS Score), Visual Analog Scale (VAS) and Range of movement (ROM). Results : During 8 days of treatment, the patient showed gradual improvement in AOFAS score, VAS at rest and at weight bearing position, as well as ROM of the ankle. Conclusion : According to the result, warm needling therapy is a possible conservative treatment for osteochondral lesions of the talus. Further studies are needed regarding possible longterm effects.

• 한방안이비인후피부과학회지
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• 제28권2호
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• pp.45-53
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• 2015

Objective : This study was performed to investigate the effect of Needle-Embedding Therapy on peripheral facial paralysis. Method : We investigated 60 cases of patients with peripheral facial paralysis, and devided patients into two groups : We treated one group by complex korean medical treatment with Needle-Embedding therapy, and did the other group by complex korean medical treatment without Needle-Embedding therapy. Yanagihara grading system at baseline and final were used for evaluating the effect of the treatment. Results : 1. In Needle-Embedding therapy group and non Needle-Embedding therapy group, compared with baseline, at final, Y score was significantly increased.2. At final, there was significant difference in improvement between Needle-Embedding therapy group and non Needle-Embedding therapy group. Conclusions : Needle-Embedding therapy seem to be effective to improve symptoms of peripheral facial paralysis. Further studies will be needed to identify the beneficial of Needle-Embedding therapy on peripheral facial paralysis.

• Clinical and Experimental Pediatrics
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• 제55권11호
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• pp.403-407
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• 2012

Noninferiority trials test whether a new experimental treatment is not unacceptably less efficacious than an active control treatment already in use. With continuous improvements in health technologies, standard care, and clinical outcomes, the incremental benefits of newly developed treatments may be only marginal over existing treatments. Sometimes assigning patients to a placebo is unethical. In such circumstances, there has been increasing emphasis on the use of noninferiority trial designs. Noninferiority trials are more complex to design, conduct, and interpret than typical superiority trials. This paper reviews the concept of noninferiority trials and discusses some important issues related to them.

• Korean Circulation Journal
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• 제53권3호
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• pp.113-133
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• 2023

Owing to a large-jeopardized myocardium, left main coronary artery disease (LMCAD) represents the substantial high-risk anatomical subset of obstructive coronary artery disease. For several decades, coronary artery bypass grafting (CABG) has been the "gold standard" treatment for LMCAD. Along with advances in CABG, percutaneous coronary intervention (PCI) has also dramatically evolved over time in conjunction with advances in the stent or device technology, adjunct pharmacotherapy, accumulated experiences, and practice changes, establishing its position as a safe, reasonable treatment option for such a complex disease. Until recently, several randomized clinical trials, meta-analyses, and observational registries comparing PCI and CABG for LMCAD have shown comparable long-term survival with tradeoffs between early and late risk-benefit of each treatment. Despite this, there are still several unmet issues for revascularization strategy and management for LMCAD. This review article summarized updated knowledge on evolution and clinical evidence on the treatment of LMCAD, with a focus on the comparison of state-of-the-art PCI with CABG.

• 한국의학물리학회지:의학물리
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• 제28권1호
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• pp.33-38
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• 2017

Creating individualized build-up material for superficial photon beam radiation therapy at irregular surface is complex with rice or commonly used flat shape bolus. In this study, we implemented a workflow using 3D printed patient specific bolus and describe our clinical experience. To provide better fitted build-up to irregular surface, the 3D printing technique was used. The PolyLactic Acid (PLA) which processed with nontoxic plant component was used for 3D printer filament material for clinical usage. The 3D printed bolus was designed using virtual bolus structure delineated on patient CT images. Dose distributions were generated from treatment plan for bolus assigned uniform relative electron density and bolus using relative electron density from CT image and compared to evaluate the inhomogeneity effect of bolus material. Pretreatment QA is performed to verify the relative electron density applied to bolus structure by gamma analysis. As an in-vivo dosimetry, Optically Stimulated Luminescent Dosimeters (OSLD) are used to measure the skin dose. The plan comparison result shows that discrepancies between the virtual bolus plan and printed bolus plan are negligible. (0.3% maximum dose difference and 0.2% mean dose difference). The dose distribution is evaluated with gamma method (2%, 2 mm) at the center of GTV and the passing rate was 99.6%. The OSLD measurement shows 0.3% to 2.1% higher than expected dose at patient treatment lesion. In this study, we treated Mycosis fungoides patient with patient specific bolus using 3D printing technique. The accuracy of treatment plan was verified by pretreatment QA and in-vivo dosimetry. The QA results and 4 month follow up result shows the radiation treatment using 3D printing bolus is feasible to treat irregular patient skin.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.784-787
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• 2009

Purpose: Reduction mammaplasty is one of the most commonly performed operations in plastic surgery. Although secondary surgery is occasionally required for minor aesthetic problems or for treatment of the complications of the primary surgery, there are no clear operative guidelines of management. We report here two cases of secondary reduction mammaplasty using differrent pedicle from the initial ones. Methods: One case of secondary reduction mammaplasty were performed using medial pedicle after central (19 years) pedicle reduction mammaplasty because of subsequent breast ptosis and asymmetry. The other case were performed using medial pedicle after superior (4 years) pedicle reduction mammaplasty with contralateral immediate breast reconstruction with TRAM flap because of subsequent breast ptosis and asymmetry. Care was taken to include sufficient width of pedicle and adequate soft tissue attachment beneath the nipple - areolar complex. Results: There was no significant complication such as nipple - areolar necrosis or fat necrosis. The results were well maintained throughout the follow - up period. Conclusion: Medial pedicle reduction mammaplasty can be safely performed after central or superior pedicle reduction mammaplasty when sufficient width of pedicle and adequate soft tissue attachment beneath the nipple - areolar complex are maintained.