• Journal of Korean Neurosurgical Society
• /
• v.45 no.5
• /
• pp.284-288
• /
• 2009

Objective : Our retrospective study aimed to determine whether 16-slice computerized tomography (CT) angiography optimized sharp kernel is suitable for the evaluation of visibility, luminal patency and re-stenosis of intracranial stents in comparison with conventional angiography. Methods : Fifteen patients with symptomatic intracranial stenotic lesions underwent balloon expandable stent deployment of these lesions (10 middle cerebral arteries, 2 intracranial vertebral arteries, and 3 intracranial internal carotid arteries). CT angiography follow-up ranged from 6 to 15 months (mean follow-up, 8 months) after implantation of intracranial stents and conventional angiography was confirmed within 2 days. Curved multiplanar reformations with maximal intensity projection (MIP) with optimal window settings for assessment of lumen of intracranial stents were evaluated for visible lumen diameter, stent patency (contrast distal to the stent as an indirect sign), and re-stenosis by two experienced radiologists who blinded to the reports from the conventional angiography. Results : All of stents deployed into symptomatic stenotic lesions. All stents were classified as patent and no re-stenosis, which was correlated with results of conventional angiography. Parts of the stent lumen could be visualized in all cases. On average, 57% of the stent lumen diameter was visible using optimized sharp kernel. Significant improvement of lumen visualization (22%, p<0.01) was observed using the optimized sharp kernel compared with the standard sharp kernel. Inter-observer agreements on the measurement of lumen diameter and density were judged as good, respectively (p<0.05). Conclusion : Sixteen-slice CT using the optimized sharp kernel may provide a useful information for evaluation of lumen diameter patency, and re-stenosis of intracranial stents.

• Journal of Chest Surgery
• /
• v.57 no.4
• /
• pp.399-407
• /
• 2024

Background: Pump-controlled retrograde trial off (PCRTO) is a safe, simple, and reversible method for weaning patients from veno-arterial extracorporeal membrane oxygenation (VA-ECMO). However, few studies have compared PCRTO to conventional weaning methods. This retrospective study aimed to compare PCRTO to non-PCRTO methods. Methods: This study included patients who were weaned from VA-ECMO from January 2016 to December 2022 at our medical center. Demographic data, ECMO management, ECMO complications, survival to discharge, and cardiogenic shock after VA-ECMO weaning were compared between the 2 groups. Results: Seventy patients who were weaned from VA-ECMO using PCRTO and 85 patients who were weaned with conventional methods were compared. Patient characteristics were not significantly different between the 2 groups. The rate of survival to discharge was significantly higher in the PCRTO group than in the non-PCRTO group (90% vs. 72%, p=0.01). The rates of freedom from all-cause mortality at 10, 30, and 50 days after weaning from ECMO were 75%, 55%, and 35% in the non-PCRTO group and 62%, 60%, and 58% in the PCRTO group, respectively (p=0.1). The incidence of cardiogenic shock after weaning from VA-ECMO was significantly higher in the non-PCRTO group (16% vs. 5%, p=0.04). In logistic regression analysis, PCRTO was a significant factor for survival to discharge (odds ratio, 2.42; 95% confidence interval, 1.29-5.28; p=0.02). Conclusion: Compared to conventional methods, PCRTO is a feasible and reversible method, and it serves as a useful predictor of successful VA-ECMO weaning through a preload stress test.

• Journal of Chest Surgery
• /
• v.48 no.4
• /
• pp.265-271
• /
• 2015

Background: Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery. Methods: Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics. Results: Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction (1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068). Conclusion: The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.

• The Korean Journal of Cytopathology
• /
• v.18 no.2
• /
• pp.119-125
• /
• 2007

Urine cytology is an important screening tool for urinary tract neoplasms. Liquid-based preparation methods, such as $ThinPrep^{(R)}$, have been introduced for non-gynecological samples. We aimed to assess the diagnostic accuracy of liquid-based preparations in urine cytology by comparing the results of the conventional Cytospin preparation method for the same samples. A total of 236 cases subject to urine cytology were enrolled in this study from January 2005 to December 2005. All cases were subjected to cystoscopy and if a malignancy was suspected, a biopsy was performed. Urine cytology slides were made using the $ThinPrep^{(R)}$ preparation method and the conventional Cytospin and/or direct smear method from the individual samples. The results of urine cytology were compared with the final cystoscopic or histological diagnoses. We analyzed the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both cytology preparation methods. A total of 236 slides made using the liquid based method were satisfactory for slide quality, whereas 5 slides (2.1%) prepared by conventional methods were unsatisfactory because of air-drying, a thick smear, or a bloody or inflammatory background. The $ThinPrep^{(R)}$ method showed 53.1% sensitivity, 92.6% specificity, a 92,6% positive predictive value, a 94.1% negative predictive value and 85,6% accuracy, while the conventional method showed 51% sensitivity, 98.4% specificity, a 92.6% positive predictive value, a 98.4% negative predictive value and 88,6% accuracy. Although the diagnostic values were equivalent between the use of the two methods, the quality of the cytology slides and the time consumed during the microscopic examination for a diagnosis were superior for the $ThinPrep^{(R)}$ method than for the conventional method. In conclusion, our limited studies have shown that the use of the liquid based preparation method is beneficial to improve the quality of slides and reduce the duration for a microscopic examination, but did not show better sensitivity, accuracy and predictive values.

• The Journal of Korean Medicine
• /
• v.38 no.1
• /
• pp.8-20
• /
• 2017

Objectives: Traditional oriental herbal medicine is used in cancer care to alleviate symptoms. Anorexia is a symptom which is frequently observed in patients with cancer and impairs their quality of life. The objective of this systematic review is to summarize current available evidence to evaluate the effect of traditional oriental herbal medicine on anorexia in cancer patients. Methods: The review evaluated randomized controlled trials (RCTs) measuring the effect of any types of herbal medicine on anorexia in cancer patients within 4 electronic databases and manual search up to December 2015. The Cochrane risk of bias tool (ROB) was used to assess the quality of RCTs. Results: In total, 11 RCTs met the inclusion criteria. All of the studies reported the rate or severity of anorexia improved after treatment in herbal-conventional medicine combined group compared to conventional medicine group. 7 of 11 studies showed between-group statistical differences. The methodological quality of RCTs was insufficient with unclear and high ROB. Conclusions: Traditional oriental herbal medicine may have a potential to improve anorexia in patients with cancer. To confirm the clinical recommendation, further researches with rigorous study design are required to support the effects of herbal medicine.

• The Journal of Korean Medicine
• /
• v.43 no.4
• /
• pp.89-101
• /
• 2022

Objectives: The purpose of this systematic review was to evaluate the effects of herbal medicine on Chemo-Radiotherapy-induced oral mucositis. Methods: Electronic databases were used to search for studies published through 10 years until October 2022, and a randomized controlled study was conducted to evaluate efficacy of herbal medicine on chemo-radiotherapy-induced oral mucositis. Study quality was assessed using the Cochran's risk bias tool. Results: Two-hundred and three articles were initially searched, and 11 studies (head and neck cancer, breast cancer, colorectal cancer, esophageal cancer etc. undergoing radio-chemotherapy were included in analysis. The effect of herbal medicine on chemo-radiotherapy-induced oral mucositis, 9 studies reported that herbal medicine was more effective than the placebo group or conventional treatment. One study reported that the effect of the herbal compound treatment group was similar to that of the conventional herbal medicine, and one study reported that there was no difference in effect between the two herbal medicines and the group without treatment. Conclusion: This study suggests that herbal medicine effectively relieves the symptoms of chemo-radiotherapy-induced oral mucositis. However, there is limited evidence that herbal medicine may relief chemo-radiotherapy-induced oral mucositis, so further investigation is needed.

• The Korean Society of Law and Medicine
• /
• v.7 no.1
• /
• pp.323-386
• /
• 2006

A combination of information technology and medical care has given rise to a new type of medicine, i.e., telemedicine. Broadly defined, telemedicine is the transfer of electronic medical data from one location to another. Both at home and abroad, telemedicine has come to success in establishing appropriate equipment and solutions for such non-conventional medicine. Sooner or later, telemedicine is believed to find itself as one of the universal treatments. In order to facilitate the full-fledged development of telemedicine, a number of legal and institutional problems have to be settled. In Korea, the Medical Act was amended to include such provisions as telemedicine, electronic medical records, electronic prescriptions, etc. and the Act came into force on March 31, 2002. Telemedicine is in common with the conventional medicine in that a physician treats a patient. However, telemedicine is basically differentiated in the followings: - The offer and acceptance of treatment and medication are usually made on-line; - Telemedicine is inherently dangerous because a physician cannot meet face-to-face with a patient; and - Joint and several liability is borne by all the physicians involved in a telemedical consultation. As a result, telemedicine is vulnerable in nature to medical malpractice. Accordingly, there must be some new theories and arguments in the formation of contract and torts. The discussion on the civil liability covers the above-mentioned issues, and would give an insight or guidelines in the concerted operation of provisions with respect to telemedicine. This study delves into the civil liability of physicians involved in telemedical consultations and treatments based upon the conventional malpractice theory.

• Journal of Haehwa Medicine
• /
• v.21 no.1
• /
• pp.79-85
• /
• 2012

Objective : This study was aimed to report a patient accompanied by alcoholic derogation acute abdominal pain treated with oriental medicine combined with conventional treatment. Methods : A 36 year old female patient complained of acute abdominal pain for one year from Apr. 2009. She had treated at local general hospital. But the symptom was not reduced. Instead, it was aggravated on Jul. 2010. The main symptoms were left flank pain, chest discomfort, nausea and anorexia. The patient was treated by oriental medicine (herbal medicine (Chunggan-plus), acupuncture, moxibustion, etc) combined with conventional medicine from Jul. 10th, 2010 to Jul. 17th, 2010. We observed the patient with evaluation of laboratory test and imaging scan. Results : Most of the symptoms of the patient were improved. Especially, the abdominal pain were disappeared from grade 3 to grade 0. No side effects were noted during treatment. Conclusion : This results suggest that the oriental medicine combined with western medicine may effective to treat alcoholic derogation acute abdominal pain.

• Journal of Korean Medicine Rehabilitation
• /
• v.32 no.2
• /
• pp.95-103
• /
• 2022

Objectives This study was conducted to assess the effect of chuna manual therapy after hip arthroplasty. Methods We searched across 9 electronic databases (PubMed, Cochrane Library, Wangfang data, China National Knowledge Infrastructure [CNKI], Oriental Medicine Advanced Searching Integrated System [OASIS], National Digital Science Library [NDSL], Korean Medical Database [KMBASE], Koreanstudies Information Service System [KISS], Research Information Sharing Service [RISS]) to find randomized controlled clinical trials for chuna manual therapy after hip arthroplasty. Results On inclusion criteria, 11 appropriate studies were included and analyzed. The deep vein thrombosis incidence of the chuna manual therapy group was statistically lower than the conventional treatment group (p=0.0002). Chuna manual therapy significantly improved the Harris hip score compared with conventional treatment (p<0.00001). Also, chuna manual therapy combined with herbal fumigation therapy significantly elevated the hip joint function score of Harris hip score compared with the conventional therapy group (p<0.00001). Conclusions The systematic review showed that chuna manual therapy had significant effects on hip arthroplasty. Nonetheless, considering the high risk of bias and geographic bias, further research with well-designed studies is required to support the effectiveness of chuna manual therapy.

• Journal of Preventive Medicine and Public Health
• /
• v.56 no.5
• /
• pp.481-484
• /
• 2023

Epidemiological models, also known as host-agent-vector-environment models, are utilized in public health to gain insights into disease occurrence and to formulate intervention strategies. In this paper, we propose an epidemiological model that incorporates both conventional measures and tobacco endgame policies. Our model suggests that conventional measures focus on relationships among agent-vector-host-environment components, whereas endgame policies inherently aim to change or eliminate those components at a fundamental level. We also found that the vector (tobacco industry) and environment (physical and social surroundings) components were insufficiently researched or controlled by both conventional measures and tobacco endgame policies. The use of an epidemiological model for tobacco control and the tobacco endgame is recommended to identify areas that require greater effort and to develop effective intervention measures.