• Title/Summary/Keyword: Contraindications

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General Treatment Strategy for Intervention in Lower Extremity Arterial Disease (하지동맥 질환의 인터벤션: 전반적 치료 계획 수립)

  • Je Hwan Won
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.500-511
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    • 2021
  • The prevalence of lower extremity disease is increasing with age. With recent technological advancements, endovascular treatment is being performed more frequently. The treatment goal of intermittent claudication is to improve walking and reduce claudication. To achieve these goals, anatomical durability and patency are important. In patients with critical limb ischemia, the lesions are diffuse and particularly severe in below-the-knee arteries. The treatment goal of critical limb ischemia is to promote wound healing and to prevent major amputation, which is evaluated by the limb salvage rate. Primary stenting using covered or bare metal stents is a widely accepted endovascular treatment. While drug-eluting technologies with or without atherectomy are widely used in the treatment of femoropopliteal disease, balloon angioplasty is the mainstay treatment for below-the-knee intervention. CT angiography provides a road map for planning endovascular treatment in patients without absolute contraindications.

Analysis of Korean Medicine Education for Vaccination of Korean Medical Doctors (한의사 예방접종을 위한 한의학 교육 분석)

  • Suyeon Cho;Hyein Jeong;Young-shin Shim;Minhui Hong;Kyeong Han Kim
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.2
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    • pp.1-18
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    • 2024
  • Objectives : This study aimed to analyze the College of Korean Medicine's education related to vaccination to examine the feasibility of Korean medical doctors administering vaccines. Methods : We conducted a comprehensive review of the guidelines from the Korea Disease Control and Prevention Agency (KDCP) and the U.S. Advisory Committee on Immunization Practices (ACIP), along with the educational standards of Korean medical colleges. From these sources, key knowledge areas essential for vaccination were identified and distilled into 12 core items, creating a checklist used to evaluate the vaccination-related education. The curricula of Korean medical colleges and online continuing education courses for Korean medical doctors were analyzed using this checklist. Additionally, we reviewed the compulsory education course for vaccination providers for comparative purposes. Results : The analysis of common textbooks from colleges of Korean medicine revealed that while basic concepts of vaccination are widely covered, practical guidance on vaccine administration is less comprehensive. Continuing education for Korean medical doctors emphasizes basic epidemiological knowledge, vaccination contraindications and treating adverse reactions, but lacks details on patient education and the vaccination process. Compulsory education for vaccination providers covers extensive administrative content and comprehensively addresses essential vaccination knowledge, including patient education and practical vaccination procedures. Conclusion : The College of Korean Medicine's curriculum covers basic vaccination theories but lacks specific training in vaccine management. Additional training can improve Korean medical doctors' vaccination skills, enhancing the healthcare system's emergency response.

The study of clinical usefulness of Si-Zong-Sue-Ge(四總穴歌) (사총혈가(四總穴歌)에 관(關)한 연구(硏究))

  • Yang, Gi-Joong;Bae, Geyn-Tae;Yoon, Jong-Hwa
    • Journal of Acupuncture Research
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    • v.17 no.1
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    • pp.1-12
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    • 2000
  • Ge-Fu(歌賦) means prose and poetry individually, and they both have a meaning of all the rhythmical poetrical compositions making it ease for people to remember the content. All the Ge-Fus used in oriental medicine are made in Yuan(元), Mine(明)and Qing(靑)dynasty, and they have been largely used in most of all the fields of medicine such as Ben-Cao(本草), Tang-Ye(湯液), Zhen-Jiu(鍼灸), Zhen-Duan(診斷). Zhen-Jiu-Ge-Fu(鍼灸歌賦) has about 90 poetries and 10 proses and they contain the names of meridian; courses of meridian streams; accurate positions of acupuncture points; functions; effects; meanings of the name of acupuncture points; usages and effects of special points; manipulations of reinforcing and reducing method; contraindications of acupuncturing; principles of selections and orders of acupuncture points in therapy; and eight diadgoses. Zhen-Jiu-Ge-Fu is subdivided into Jing-Xue(經穴歌), Zhi-Jiu-Ge(刺灸歌), Shu-Xue-Ge(輸穴歌), Zhi-Liao-Ge(治療歌). And In Zhi-Liao-Ge, the most brief and essential Ge-Fu-Si-Zong-Sue-Ge- contains theraputic designs using far apart acpuncture points from the right painful areas in the body. In this study, the author opinionated the Si-Zong-Sue-Ge can be the prototype of the distant needling; the research on this can open the importance of Ge-Fus. On conclusion, 1. "Upper and lower Abdomen - Zu-San-Li($S_{36}$) (肚腹三里留)" means when there are problems and disorders in upper and lower abdomen, distinctively, such as gastric pain, maldigestion, flatulence, abdominal pain, constipation, diarrhea, vomiting, menstrual disorer, knee pain and tonic functioning, 족삼리 can be a right choice for distant needling point for treating. 2. "Face and Eye-He-Gu($Li_4$) (面目合谷收)" means when there are problems and disorders in facial, eye, ear, nose, throat, mouth regions, distinctively, such as facial edema, toothache, headache, sore throat, rhinorrhea, frontal headache, abdominal pain, dizziness, He-Gu can be a right choice for distant needling point for treating. 3. "Upper and lower back - Wei-Zhong($B_{40}$) (腰背委中求)" means when there are problems and disorders in upper and lower back, distinctively, such as upper back pain, lumbargo, hamstring muscle pain, popliteal region pain, lower extremity compartment syndrom, Inguinal region pain, muscle twitch, vomiting and diarrhea, hemorrhoidal bleeding, skin rash, Wei-Zhong can be a right choice for distant needling point for treating. 4. "Head and neck - Lie-Que($L_7$) (頭項審列缺)" means when there are problems and disorders in capital and nuchal area, distinctively, such as migraine, frontal headache, rhinorrhea, asthmatic dyspnea, aphasia, coughing, neck stiffness, occipital headache, upper extremity pain, Lie-Que can be a right choice for distant needling point for treating.

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A RETROSPECTIVE ANALYSIS OF THE MEDIOPROXIMAL TIBIAL BONE GRAFT FOR ORAL AND MAXILLOFACIAL RECONSTRUCTION (구강악안면 영역의 재건을 위한 경골 근위부 내측 골이식술의 후향적 분석)

  • Baek, Min-Kyu;Kim, Il-Kyu;Cho, Hyun-Young;Chang, Keum-Soo;Park, Seung-Hoon;Park, Jong-Won;So, Kyung-Mo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.3
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    • pp.241-248
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    • 2008
  • Tibial bone grafts provide an adequate volume of cancellous bone with cortical bone, high biologic value of bone, minimal gait disturbance and complications, and no special contraindications, and offer a superior clinical results than any other donor sites. Lateral appoach in tibial bone graft was used to gain large bone volume traditionally, but medial approach provides low morbidity associated with the tibial anatomic structure, simple and safety surgical procedure, and better comfortable to patients recently. We have undertaken clinical and retrospective studies on patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from April 2004 to January 2008. 50 patients have maxillofacial bony defect as resection of bening tumor, cyst enucleation, alveolar bone resorption, sinus pneumatization were received the tibial proximal autogenous particulated cancellous bone grafts. They were analyzed sex, age, diagnosis of recipient site, lesion size, dornor site, cortical bone repositioning, complications and we concluded favorable following results. 1. Medial approach for proximal tibia is safer and technically easier than lateral approach, associated with the proximal tibial anatomic structures, and short operative times. 2. Proximal tibia provides an adequate bone volume with predictability for oral and maxillofacial reconstruction. 3. Patients rarely complain of pain, swelling, discomfort and dysfunction such as gait disturbance. In conclusion, medial approach for proximal tibial graft seems to be a valuable tool for oral and maxillofacial reconstruction.

Treatment of Blow-out Fractures Using Both Titanium Mesh Plate and Porous Polyethylene (Medpor®) (광범위한 안와파열골절에서 Titanium Mesh Plate와 Porous Polyethylene (Medpor®) 동시 사용의 유용성)

  • Gu, Ja Hea;Won, Chang Hoon;Dhong, Eun-Sang;Yoon, Eul-Sik
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.85-90
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    • 2010
  • Purpose: The goals of a blow-out fracture reconstruction are to restore the osseous continuity, provide support for the orbital contents and prevent functional and anatomic defects. Over the past several years, a range of autogenous and synthetic implants have been used extensively in orbital reconstructions. None of these implants have any absolute indications or contraindications in certain clinical settings. However, in extensive blow-out fractures, it is difficult to restore support of the orbital contents, which can cause more complications, such as enophthalmos. This study examined the clinical outcomes of extensive or comminuted blow-out fractures that were reconstructed by the simultaneous use of a titanium mesh plate and $Medpor^{(R)}$. Methods: Eighty six patients with extensive orbital fractures, who were admitted between March 1999 and February 2007, were reviewed retrospectively. The patients' chart and CT were inspected for review. Twenty three patients were operated on with both a titanium mesh plate (Matrix MIDFACE pre-formed orbital plate, Synthes, USA) and $Medpor^{(R)}$ (Porex, GA, USA). The patients underwent pre-operative CT scans to evaluate the fracture site and measure the area of the fracture. A transconjunctival approach was used, and titanium mesh plates were inserted subperiosteally with screw fixation. $Medpor^{(R)}$ was inserted above the titanium mesh plate. The patients were evaluated post-operatively for enophthalmos, diplopia, sensory disturbances and eyeball movement for a period of at least 6 months. Results: No implant-related complications were encountered during the follow-up period. Enophthalmos occurred in 1 patient, 1 patient had permanent sensory disturbance, and 3 patients complained of ocular pain and fatigue, which recovered without treatment. Although there were no significance differences between groups, the use of 2 implants had fewer complications. Therefore, it can be an alternative method for treating blow out fractures. Conclusion: The use of both a titanium mesh plate and $Medpor^{(R)}$ simultaneously may be a safe and acceptable technique in the reconstruction of extensive blow-out fractures.

Trends and Future Direction of the Clinical Decision Support System in Traditional Korean Medicine

  • Sung, Hyung-Kyung;Jung, Boyung;Kim, Kyeong Han;Sung, Soo-Hyun;Sung, Angela-Dong-Min;Park, Jang-Kyung
    • Journal of Pharmacopuncture
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    • v.22 no.4
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    • pp.260-268
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    • 2019
  • Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

Clinical Considerations of the Surgical Closure of the PDA in the Premature Infants (미숙아 동맥관 개존증의 외과적 교정에 관한 임상적 고찰)

  • 김상익;박철현;현성열;김정철;권진형;박국양
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.702-708
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    • 1999
  • Background: Surgical closure of the PDA in premature infants with complications or contraindications to indomethacin use, or recurrence of symptomatic PDA is a safe and effective procedure with low operative risk and minimal complications. Material and Method: From April 1996 to August 1998, 11 premature infants with body weight under 1.5 kg at operation underwent operation for a symptomatic PDA (male:5, female: 6). Associated dise ases were congenital heart disease(7), hyaline membrane disease(6), intraventricular hemor rhage(4), pneumonia(4), pneumothorax(3), hyperbilirubinemia(2), necrotizing enterocolitis(2), renal failure(1), epilepsy(1), and hydrocephalus(1). Surgical techniques are hemoclipping(8) and ligation(3). The size of PDA was 3~6 mm (5.0$\pm$1.2). Result: Systolic and diastolic blood pressure rised and heart rates decreased after PDA closure. ABGA improved postoperatively. There were no surgical complications. Six infants with improved ABGA data were weaned from mechanical ventilatory support. The follow-up durations after discharge were 3 month to 12 month. Five deaths were not related to operation. The causes of death were hyaline membrane disease(2), bronchopulmonary dysplasia with pneumonia(1), sepsis(1), and con gestive heart failure with respiratory distress syndrome(1). Conclusion: Early operative closure is the treatment of choice in most premature infants with a hemodynamically significant shunt(PDA), recurrence of symptomatic PDA, complications of Indomethacin, or contraindi cations to Indomethacin.

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A Study about Characteristics of literature of acupuncture and moxibustion in "Chimgujasaenggyeong(鍼灸資生經)" ("침구자생경(鍼灸資生經)"의 침구 문헌적 특징에 관한 연구)

  • Park, Hyun-Guk;Kim, Ki-Wook
    • Journal of Korean Medical classics
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    • v.21 no.4
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    • pp.61-74
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    • 2008
  • The acupuncture and moxibustion documentary characteristics of "Chimgujasaenggyeong" can be summarized into 6 parts such as the follwing 1. "Chimgujasaenggyeong" was written at about 1180-1195 during the Southern Song period. It contains 7 volumes in all. The acupuncture points and their variations in volume 1 were all directly recorded from Wang-yuil(王維一)'s "Dong-insuhyeolchimgudogyeong(銅人腧穴鍼灸圖經)" and 11 points were added from volumes 99 and 100 of "Taepyeongseonghyebang(太平聖惠方)", bringing the total to 365 points, which was different from the 360 that the people knew. Volume 2 is the actual collection of theses on acupuncture and moxibustion by Wangjipjung(王執中) and shows his unique views on the basic problems of acupuncture and moxibustion such as selection of points[取穴], application of moxas[施灸], aftercare of moxibustion[灸後護理] and acupuncture and moxibustion contraindications[鍼灸禁忌]. Volumes 3${\sim}$7 mostly divide the indications(主治) from "Dong-insuhyeolchimgudogyeong", "Taepyeongseonghyebang", "Cheon-geumyobang(千金要方)" by disease into chapters. 2. Of the remaining editions the 'Cheonryeok Guanggeunseodang Inbon(天曆 廣勤書堂 印本)' of the Won dynasty is the first, and the Jeongtong(正統) new edition is a reprint based on the Cheonryeok(天曆) edition, and the Jeongtong edition reprinted in the 9th year of Guanmun(寬文) of Japan has many missing and wrong characters compared to the original copy. 3. The big letters[大字] under the line in the current editions are all postscripts[按語] of Wangjipjung and the 5 verses quoted from other books that do not have their origin listed and have the qualities of rules for treatment in the first chapter of volume 3 'Heoson(虛損)' were put together by Wang. 4. In the annotations in small print of the current edition of "Jasaenggyeong" there are Wisegeol(衛世傑)'s added annotations in addition to Wangjipjung's original ones. 5. Some of the many medical books quoted by the "Jasaenggyeong" that are from before the Song dynasty have been lost completely and only can be seen here in this important text. 6. The quotations said to be from 'Myeongdanggyeong(明堂經)'(or 'Myeongdang(明堂)', 'Myeong(明)') in "Jasaenggyeong" are directly from volume 77 'Chimgyeong(鍼經)' and volume 100 'Myeongdang' of "Taepyeongseonghyebang" and not another book. The quotes from 'Myeongdang' in accupuncture and moxibustion books after the Song dynasty were directly or indirectly copied from "Jasaenggyeong".

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A Study on Traditional Korean Medical Countermeasures of Influenza A by Case Histories (의안(醫案)을 통한 신종 인플루엔자의 한의학적 대처방안)

  • Ahn, Sang-Young;Han, Chang-Hyun;Kwon, Oh-Min;Park, Sang-Young;Ahn, Sang-Woo
    • Journal of Korean Medical classics
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    • v.22 no.4
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    • pp.221-239
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    • 2009
  • Background: The recent outbreak of the novel strain of influenza A (H1N1) virus has raised a global concern of the future risk of pandemic. Traditional Korean Medicine(TKM) has been combatting against contagious diseases and developed its own particular and efficient way in treating those diseases. Objectives: Provide a distinctive and effective TKM method in understanding the principles of treatment, prevention, and contraindications against influenza A through case histories. Method: We revised case histories of eminent doctors of Ming and Qing dynasties according to their clinical manifestations similar to those of influenza A. We also verified prescriptions of the "Dong-uibogam(東醫寶鑑)" through examining clinical practices of China today. Results: 1. The subtypes of Warm disease; Wind Warmth and Pestilence has the most similar clinical manifestation in comparison to Influenza A. Specifying these terms is important in recognizing and classifying various diseases under the name of Warm disease. 2. TKM considered not only external factors but also individual factors like general condition, diet, emotion, constitutional types, etc in the treatment of febrile diseases. 3. TKM developed a new way in the treatment of contagious diseases. considering the characteristics of each pathogen. TKM described the Warm pathogen being light as a feather, which enters through the nose, principally affecting the Lung. Therefore, they emphasized treatment with Pungent Sweet Cooling Moistening[辛甘凉潤] method. 4. As the conservation of fluid and humor is the primordial concern in the treatment of Warm disease, they restricted release of the exterior with pungent-warm and purgation method. The purgation methods was used exclusively to decrease fever and preserve fluid and humor. 5. The only differentiating characteristics of Influenza A with seasonal influenza are vomiting and diarrhea. Case research revealed the possibility of these manifestations to be a mechanism of restoration. 6. TKM provides alimento prevention method like Mint Pear Porridge, mung bean, and etc also combination of herbal medicine. Also emphasized in the conservation of essence for the prevention of contagious diseases. Conclusions: TKM developed its unique way in understanding the pathogenesis, diagnosis, treatment, and prevention of contagious diseases and formed its independent scheme of Warm Disease. This knowledge in febrile contagious disease is relevant today in providing diverse treatment and prevention for influenza A.

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Significance of Cerebral Venography in Surgery of Petroclival Meningiomas (추체사대 수막종의 수술과 관련하여 뇌 정맥조영상의 의미)

  • Hwang, Sung-Kyun;Gwak, Ho-Shin;Paek, Sun Ha;Oh, Chang-Wan;Lee, Sang Hyung;Kim, Dong Gyu;Kim, Hyun Jib;Jung, Hee-Won
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1200-1209
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    • 2001
  • Objective : A thorough understanding of the related venous structure is mandatory for successful removal of the petroclival meningiomas. This study was planned to investigate the guideline for safe ligation and incision of transverse or sigmoid sinuses and the importance of drainage pattern of vein of $Labb{\acute{e}}$ in surgical removal of petroclival meningiomas. Patients and Methods : The authors reviewed the venogram of the consecutive 37 cases of petroclival meningiomas and retrospectively analyzed their surgical findings. The drainage pattern of confluence of Herophili was classified as Type A(confluent & equal on both sides), Type B(confluent & non-dominant on tumor side), Type C(confluent & dominant on tumor side) and Type D(unilateral drainage only) as these findings gave the information on safe ligation and resection of the sinus. Usefulness of intraoperative test clamping of sinus for safe ligation was also reviewed. The vein of $Labb{\acute{e}}$ was analyzed with respect to its draining point and its collaterals to other superficial veins. Results : Contraindications of the sinus ligation and resection according to the drainage pattern at the confluence of Herophili were Type C(n=10, 27%)and Type D(n=4, 11%). Patients with Type A(n=12, 32%)and Type B(n=11, 30%) were tolerable to sinus ligation ipsilateral to tumor, if the test clamping proved to be safe. Identification of no brain swelling, after intraoperative test clamping of the sinus for more than 30 minutes performed in 7 out of 11 cases, was a reliable indicator of safe sinus ligation. The drainage pattern of the vein of $Labb{\acute{e}}$, especially low-lying type, could predict the possibility of postoperative hemorrhage and infarction. Its drainage into tentorium or superior petrosal sinus, however, made the transtentorial approach impossible, leading to restricted operative field. Conclusion : For a successful removal of the petroclival meningiomas preoperative venogram should be examined carefully. The extent of exposure in a planned approach can be estimated by analyzing the variation of sinuses and the drainage pattern of vein of $Labb{\acute{e}}$.

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