• 한국임상약학회지
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• 제31권3호
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• pp.205-215
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• 2021

Background: The treatment of primary open-angle glaucoma (POAG) or ocular hypertension (OHT) for intraocular pressure (IOP) reduction is recommended to proceed with the use of the compound. Therefore, this study aimed to evaluate the efficacy and safety of brinzolamide combination therapy on POAG and OHT following the subgroup analysis among types of brinzolamide combined medications. Methods: By June 2019, PubMed, EMBASE and Cochrane Library were searched to find a study that met our inclusion criteria. Based on randomized control trials (RCTs), we collected studies that tested the brinzolamide combination therapy in POAG and OHT patients, and analyzed the literature identified by the results of the study on IOP reduction and adverse reactions. Results: A total of 13 literature was collected to conduct an analysis including 2,197 patients. The intervention included brinzolamide combination therapies, combined with timolol, brimonidine, PGA or combined with both brimonidine and PGA. The analysis showed significant decreasing tendency for values at morning and end treatment per day in the use of brinzolamide combination therapy in the absolute IOP change (mean difference (MD) -1.41; 95% CI -1.92, -0.90; p<0.001 vs. MD -1.46; 95% CI -2.03, -0.89; p<0.00001, respectively). We could see higher adverse reactions in the brinzolamide combination group using intervention (odds ratio 1.43; 95% CI 1.20, 1.71; p<0.0001). Conclusion: Regarding IOP reduction in POAG and OHT patients, brinzolamide combination therapy is more effective but less safe than control treatment, which diverse among types of combined medications. Thus, more individualized therapy should be applied in real-world practice.

• Archives of Plastic Surgery
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• 제48권3호
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• pp.246-253
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• 2021

In order to provide a physiological solution for patients with breast cancer-related lymphedema (BCRL), the surgeon must understand where and how the pathology of lymphedema occurred. Based on each patient's pathology, the treatment plan should be carefully decided and individualized. At the authors' institution, the treatment plan is made individually based on each patient's symptoms and relative factors. Most early-stage patients first undergo decongestive therapy and then, depending on the efficacy of the treatment, a surgical approach is suggested. If the patient is indicated for surgery, all the points of lymphatic flow obstruction are carefully examined. Thus a BCRL patient can be considered for lymphaticovenous anastomosis (LVA), a lymph node flap, scar resection, or a combination thereof. LVA targets ectatic superficial collecting lymphatics, which are located within the deep fat layer, and preoperative mapping using ultrasonography is critical. If there is contracture on the axilla, axillary scar removal is indicated to relieve the vein pressure and allow better drainage. Furthermore, removing the scars and reconstructing the fat layer will allow a better chance for the lymphatics to regenerate. After complete removal of scar tissue, a regional fat flap or a superficial circumflex iliac artery perforator flap with lymph node transfer is performed. By deciding the surgical planning for BCRL based on each patient's pathophysiology, optimal outcomes can be achieved. Depending on each patient's pathophysiology, LVA, scar removal, vascularized lymph node transfer with a sufficient adipocutaneous flap, and simultaneous breast reconstruction should be planned.

• 대한두개안면성형외과학회지
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• 제16권3호
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• pp.147-150
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• 2015

Impalement injury is the subset of penetrating trauma, defined as fixed, elongated objects penetrate and remain in the human body cavity or region by relatively low velocity. We report an unusual case of facial and neck impalement where two dirty rusted iron bars penetrated forehead bilaterally and exited neck and ear respectively without causing major organ injuries. After thorough radiologic and physical evaluation, the patient got medical and surgical treatment. The patient was discharged without complication after four day of delayed wound closure. There have been no complications and sequelaes related with trauma, wound infection and scar contracture at 3-year follow-up. According to affected organs and pattern of impalement, individualized and multidisciplinary surgical approach should be considered. Following these guidelines as in this case, it was possible to achieve excellent clinical outcome in impalement injury.

• Child Health Nursing Research
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• 제13권3호
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• pp.247-256
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• 2007

Purpose: This study was done to examine the experience of school health instructors in applying complimentary and alternative medicine (CAM). Method: The participants were 215 health instructors working in elementary schools in Busan. Data were collected from Dec. 1, 2004 to Mar. 10, 2005 and were analyzed using SPSS WIN 10.0. Results: Most of the health instructors had knowledge about CAM. Among the various CAM methods, acupuncture was the most widely known at 78.6%. While 53.5% had no experience in CAM education, 46.5% had been trained. Slightly over half (52.1%) had used CAM at school and based their decision on personal experience. As to applicability of CAM at school, 72.1% thought CAM was applicable, and 78.7% of this group considered alleviation of symptoms and assistance in the treatment process as the reasons for their answer. There were significant differences in responses as to the applicability of CAM according to age (p=.002), work experience (p=.004) and educational background (p=.002). Conclusions: The above results suggest that there is a need to develop a professional education program on complimentary and alternative medicine to assist school health instructorsto plan nursing interventions using CAM which are individualized and practical.

• Annals of Clinical Neurophysiology
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• 제1권1호
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• pp.76-79
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• 1999

The most significant factor in pathogenesis of vascular headaches like migraine and cluster headache is dynamic changes of diameters of the cerebral arteries. TCD is a valuable noninvasive tool to assess the cerebral hemodynamic status by measuring the flow velocities of the intracranial cerebral arteries around the circle of Willis. TCD can evaluate flow velocities and vasoreactivity of the patients with a vascular headache during the ictal phase as well as during intericatal phase. Distribution of the changes recorded differ between types of headaches and also between the major ictal symptoms. The changes suggest the presence of prolonged vasospasm interictally and more marked relaxation of the cerebral arteries. TCD can be used to monitor the long-term clinical course of patients with vascular headache by correlation the symptomatic improvement and TCD data before and after long-term pharmacological prophylactic treatments. During the ictal phases large intervention. The results may be used in selecting and evaluating the agents for abortive therapy for acute attacks. In conclusion TCD can quantitatively evaluate vascular headaches when making diagnosis and classification and can provide guidelines to choose more individualized therapeutic options for both acute and long-term treatment.

• Journal of Korean Neurosurgical Society
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• 제61권3호
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• pp.292-301
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• 2018

Medulloblastoma is the most common malignant brain tumor of childhood and remains a major cause of cancer related mortality in children. Significant scientific advancements have transformed the understanding of medulloblastoma, leading to the recognition of four distinct clinical and molecular subgroups, namely wingless (WNT), sonic hedgehog, group 3, and group 4. Subgroup classification combined with the recognition of subgroup specific molecular alterations has also led to major changes in risk stratification of medulloblastoma patients and these changes have begun to alter clinical trial design, in which the newly recognized subgroups are being incorporated as individualized treatment arms. Despite these recent advancements, identification of effective targeted therapies remains a challenge for several reasons. First, significant molecular heterogeneity exists within the four subgroups, meaning this classification system alone may not be sufficient to predict response to a particular therapy. Second, the majority of novel agents are currently tested at the time of recurrence, after which significant selective pressures have been exerted by radiation and chemotherapy. Recent studies demonstrate selection of tumor sub-clones that exhibit genetic divergence from the primary tumor, exist within metastatic and recurrent tumor populations. Therefore, tumor resampling at the time of recurrence may become necessary to accurately select patients for personalized therapy.

• Clinical and Experimental Reproductive Medicine
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• 제39권2호
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• pp.46-51
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• 2012

Fertility preservation (FP) is an effort to retain the fertility of cancer patients, and as an emerging discipline, it plays a central role in cancer care. Because of improvement in diagnostic and therapeutic strategies, an increasingly large number of patients are surviving with cancer. FP specialists should make an effort to spread the significance of FP among reproductive women with cancer and provide appropriate education both for associated physicians and for cancer patients who wish to preserve their fertility. Physicians who take part in the initial diagnosis and management of cancer should consider the importance of early referral of young cancer patients to FP specialists and take care of those patients by providing timely information and appropriate counseling. Individualized treatment strategies should be delivered depending on the patient's situation with appropriate team approach.

• 대한치과의사협회지
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• 제54권2호
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• pp.134-141
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• 2016

Use of ready-made orthodontic appliance can lead to inefficiencies in the final stages of the orthodontic treatment. Because patients' teeth have anatomic variations, brackets that have been designed to fit on average tooth surface may result in positional discrepancies when leveling and alignment is completed. As a result, additional steps such as rebonding, wire bending and use of auxiliaries may be needed. Even in patients who have normal tooth anatomy and proper tooth size relationships, precise bracket placement is crucial in order to efficiently control the tooth positions. Digital models can provide advantages in clinical orthodontics as virtual tooth setup could be performed, and clinicians can easily visualize the predicted final occlusion. Through this setup model, customized brackets with individualized prescription and archwires that optimally fit with the patients' dental arches can be produced using CAD/CAM technology. Also, the brackets can be accurately placed with an aid of 3D-printed jigs. The purpose of this article is to introduce the commonly used labial and lingual customized orthodontic appliance systems using digital technology.

• 대한치과의사협회지
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• 제51권8호
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• pp.442-450
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• 2013

It is well known that the majority of dental injuries occur in children and adolescent. An injury to the teeth can have serious and long-term consequences, leading to their discoloration, malformation, or possible loss. The emotional impact of such an injury can be far reaching. The majority of dental injuries in the primary and permanent dentitions involve the anterior teeth, especially the maxillary central incisors. Concussion, subluxation, and luxation are the commonest injuries in the primary dentition, while uncomplicated crown fractures are commonest in the permanent dentition. If it is decided to preserve a traumatized primary tooth, it should be carefully observed for clinical and radiographic signs of pulpal or periodontal complications. Radiographs are also examined closely to disclose any damage to the permanent successor. The intervals between reexaminations should be individualized depending on the severity of trauma, the expected type of complications and the age of the patient. Most complications are observed within the first year of the trauma. However, the follow-up evaluation of permanent teeth should continue until treatment of all complications is completed, or until a lost or extracted permanent tooth has been adequately replaced. It is important that the dentist and the other members of the dental team are well prepared to meet the many complex and challenging problems in the care of dental emergencies.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권2호
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• pp.224-227
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• 2000

Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.