• 대한임상독성학회지
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• 제19권1호
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• pp.1-7
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• 2021

Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a costeffective model.

• Journal of Chest Surgery
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• 제33권8호
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• pp.638-642
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• 2000

Background: In an effort t enhance long term patency of coronary bypass grafts, utilization of arterial conduits have been on an icrease. With the same objective, we have been using the right gastroepiploic artery(RGEA)in coronary artery bypass procedures since 1998. The current paper has been undertaken with the aim of assessing the apropriateness, problems, and short term results of using the RGEA as an arterial graft conduit by studying the postoperative clinical results of 100 patients than received coronary artery bypass grafting (CARG) with this artery. Material and Method: Between May of 1998 and May of 1999, an analysis of the mortality, postoperative myocardial infarction, and the need for IABP insertion as a result of low cardiac output were made between 100 consecutive patients undergoing CABG with the RGEA. Result: There was one postoperative death due to cerebral infarction. Postoperative complications/morbidity comprised myocardial infarction in 2, cerebral infarct in 3, reoperation due to bleeding in 1, mediastinitis in 1, and low cardiac output syndrome necessitating IABP in 3 patients. Complicatons related to harvesting of the arterial grafts were not experienced in any of the patients. Conclusion: The results of the current data show that utilization of the RGEA in CABG is not associated with increased mortality/morbidity and demonstrates satisfactory short term results suggesting the usefulnessof this conduit as an arterial graft.

• 한국정밀공학회지
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• 제26권7호
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• pp.142-149
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• 2009

The aim of this study was to identify both the mechanical and reflex properties associated with spasticity in hemiplegic patients. Ten hemiplegic patients were included in this study. Multiple pendulum tests were executed for each subject, and knee joint angle and EMG of Rectus Femoris muscle were measured. The neuromusculoskeletal system model was developed from generally accepted mechanism and identified through minimization of the error in the model-predicted pendulum trajectories. The identification was successful in terms of small error in simulated kinematics and high sensitivity and precision of simulated torque against EMG activity. The reflex threshold showed significant difference between different clinical scores (p<0.01) and significant negative correlation (r=-0.93) with the EMG duration. It is expected that the suggested method may help in understanding mechanisms underlying spasticity.

• 대한수의학회지
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• 제47권1호
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• pp.95-98
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• 2007

Rehabilitation Research was presented to Veterinary Medical Center of Chungbuk National Universitywith anorexia and lameness for 5 days. Bilateral intertarsal joint swellings were observed in physicalexamination. The radiographic findings indicated degenerative changes of joint cartilage and suroundingbones. In cytologic examination of synovial fluids, mononuclear leukocytic inflammation was identified.on Sabroud dextrose agar. From all of examinations, this patient was diagnosed as a degenerative jointdisease with systemic mycoses.

• 대한한의학회지
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• 제37권2호
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• pp.93-103
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• 2016

Objectives: The purpose of this study was to report Four cases of Failed Back Surgery Syndrome (FBSS) patients after spinal fusion surgery who showed significant improvement in pain and function with Complex Korean medical treatment. Methods: This study was a retrospective observational study. We reviewed medical records of Four patients with lumbar pain or radiating leg pain, who have received spinal fusion surgery in the past. All Four patients took complex treatments of Mokhuri Neck and Back hospital which involes Acupuncture, Pharmaco-acupuncture, Gangchuk herbal medicine, Chuna and Physical therapy during about four-week of admission treatment. Visual Analogue Scale (VAS), Oswestry disability index (ODI), Pain Free Walking Distance (PFWD) scores were assessed before and after treatments. Results: The average of hospitalization period was 28.5 days. Mean VAS scores decreased from 6.5 to 2.3, Oswestry Disability Index (ODI) scores decreased from 56.25 to 38.25 and Pain Free Walking Distance (PFWD) also improved from 10m to 166.6m. Conclusion: This study implies that a combination of Korean medical treatments might be effective in relieving pain, and improving the functional status of FBSS patients. Further studies are needed to fully understand the mechanisms underlying the effects.

• Radiation Oncology Journal
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• 제36권3호
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• pp.182-191
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• 2018

Purpose: To investigate the clinical outcome of proton therapy (PT) in patients with chordoma. Materials and Methods: Fifty-eight patients with chordoma treated with PT between June 2007 and December 2015 at the National Cancer Center, Korea, were retrospectively analyzed. The median total dose was 69.6 cobalt gray equivalent (CGE; range, 64.8 to 79.2 CGE). Local progression-free survival (LPFS), distant metastasis-free survival (DMFS), overall survival (OS), and disease-specific survival (DSS) rates were calculated by the Kaplan-Meier method. Results: With the median follow-up of 42.8 months (range, 4 to 174 months), the 5-year LPFS, DMFS, OS, and DSS rates were 87.9%, 86.7%, 88.3%, and 92.9%, respectively. The tumor location was associated with the patterns of failure: the LPFS rates were lower for cervical tumors (57.1%) than for non-cervical tumors (93.1%) (p = 0.02), and the DMFS rates were lower for sacral tumors (53.5%) than for non-sacral tumors (100%) (p = 0.001). The total dose was associated with both the LPFS rate and DMFS rate. The initial tumor size was associated with the DMFS rate, but was not associated with the LPFS rate. Three patients had grade 3 late toxicity with none ≥grade 4. Conclusion: PT is an effective and safe treatment in patients with chordomas. The tumor location was associated with the patterns of failure: local failure was common in cervical tumors, and distant failure was common in sacral tumors. Further refinement of PT, such as the utilization of intensity modulated PT for cervical tumors, is warranted to improve the outcome.

• Radiation Oncology Journal
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• 제22권2호
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• pp.130-137
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• 2004

목적 : 자궁경부암의 방사선치료 시 3차원입체조형방사선치료(3D-CRT)와 세기조절방사선치료(IMRT)는 소장의 방사선 조사선량을 감소시킬 수 있으며, 소장전위장치(SBDS)는 골반강 내의 소장 용적을 감소시킬 수 있다고 알려져 있다. 본 연구는 SBDS를 사용한 3D-CRT와 IMRT 계획을 SBDS를 사용하지 않은 계획과 비교하여, SBDS의 소장 조사선량에 대한 영향을 평가하였다 대상 및 방법 : 자궁경부암으로 근치적 방사선치료를 받은 10명의 환자를 대상으로 하였다. 각 환자에 대하여 스티로폼 압박기구와 환자에게 개별적으로 제작되는 고정기구로 구성된 SBDS를 제작하였고, SBDS가 있는 상태와 없는 상태로 복와위에서 전산화단층촬영(CT)을 시행하였다 3D-CRT는 4-field box technique을, IMRT는 15 MV X-선 7 조사문을 이용하여 계획하였으며, 회전중심점에 50 Gy (25회 분할)를 처방하였다. 비교 분석은 SBDS의 사용에 따른 소장 용적의 변화와 네 가지 계획의 소장의 선량체적히스토그람의 차이를 10 Gy 단위로 paired f-test를 이용하여 분석하였다. 결과 : 소장의 용적은 SBDS를 사용하였을 때 평균 522 cm$^{3}$에서 262 cm$^{3}$로 49.8$\%$ 감소되었다. 10 Gy부터 50 Gy까지 10 Gy 간격으로 일정한 조사선량을 받는 소장의 용적은 SBDS를 사용하였을 때 3D-CRT에서65$\~$80$\%$, IMRT에서 54$\~$67$\%$ 감소하였다. 3D-CRT와 IMRT를 서로 비교하면, 20 Gy부터 50 Gy까지 10 Gy간격으로 일정한 조사선량을 받는 소장 용적은 SBDS를 사용하지 않은 경우에는 IMRT가 6$\~$7$\%$ 정도 유의하게 적었으나 SBDS를 사용한 경우에는 1$\%$ 이내로 차이가 없었다. 결론 : 3D-CRT와 IMRT에서 SBDS를 사용할 때 소장의 조사선량을 더 감소시킬 수 있었으므로, SBDS를 치료에 이용하면 소장의 부작용을 더 감소시킬 수 있을 것이다.

• Journal of Chest Surgery
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• 제54권1호
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• pp.2-8
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• 2021

Since the first reported case of coronavirus disease 2019 (COVID-19) in December 2019, the numbers of confirmed cases and deaths have continued to increase exponentially despite multi-factorial efforts. Although various attempts have been made to improve the level of evidence for extracorporeal membrane oxygenation (ECMO) treatment over the past 10 years, most experts still hesitate to take an active position on whether to apply ECMO in COVID-19 patients. Several ECMO management guidelines have been published recently, but they reflect some important differences from the Korean medical system and aspects of real-world medical practice in Korea. We aimed to find evidence on the efficacy of ECMO for COVID-19 patients by reviewing the published literature and to propose expert recommendations by analyzing the Korean COVID-19 ECMO registry data.

• Radiation Oncology Journal
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• 제22권1호
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• pp.11-16
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• 2004

목적: 유방 관상피내암 환자들의 유방 보존술 및 방사선 치료 후 생존율과 국소 재발률, 재발 양상 및 국소 재발에 영향을 준 인자들을 분석하고, 적절한 치료법을 결정하고자 하였다. 대상 및 방법: 1995년 6월부터 2001년 12월까지 유방 관상피내암으로 유방 보존술 후 방사선 치료를 받았던 96명의 환자를 대상으로 후향적 분석을 시행하였다. 수술은 국소 절제 또는 광범위 절제가 시행되었고, 일부에서 액와 림프절 곽청술이 시행되었다. 방사선 치료는 전 유방에 50.4 Gy /28회를 조사하였고, 절단면에 종양이 있거나 절단면에서 종양이 가까웠던 경우($\leq$ 2 mm) 일부에서 종양이 있었던 부위에 $10\~14$ Gy를 추가 조사하였다. 전체 환자의 중앙 추적 관찰기간은 43개월($12\~102$개월)이었다. 결과: 5년 국소 무병생존율, 생존율은 각각 $91\%,\;100\%$였다. 국소 재발은 6명($6.3\%$)에서 발생하였고, 이 중 침윤성 유방암으로 재발한 환자는 1명이었다. 수술에서 재발까지의 기간은 1명을 제외하고는 모두 2년 이상이었다. 주위 림프절 재발이나 원격전이는 없었다. 재발한 환자 중 5명은 유방 전절제술 후 무병생존 중이고, 1명은 구제 치료예정이다. 국소 재발에 영향을 준 인자들에 대해 분석했을 때, 연령, 절단면 상태, comedo type, 핵분화도 모두 국소 재발에 영향을 주지 않는 것으로 나타났다. 수술 범위에 따라서도 국소 재발에 차이를 보이지 않았고(p=0.30), 절단면이 종양에서 가까웠던 경우 초기 종양 부위에 추가 조사도 국소 재발에 영향을 주지 않았다(p=1.0). 결론: 유방 관상피내암의 치료로 유방 보존술 및 방사선 치료 시행 후 높은 국소 제어율과 생존율을 얻을 수 있었다. 종양이 절단면을 침범하지 않는 한 절단면과 종양과의 거리와 추가 방사선 조사는 국소 재발에 영향을 주지 않는 것으로 나타났으나 향후 더 많은 환자로 장기적인 추적관찰이 필요할 것으로 생각된다.

• Archives of Plastic Surgery
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• 제45권4호
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• pp.325-332
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• 2018

Background Zygomaticomaxillary complex (ZMC) fractures mostly occur in the form of tripod fractures. The surgical field is accessed using a combination of three classic approaches. However, the subciliary incision may have unfavorable aesthetic results. Herein, the authors report the advantages of the extended transconjunctival approach (ETA) combined with T-bar screw reduction in minimizing scarring and complications for the treatment of ZMC fractures. Methods A total of 26 patients underwent ZMC reduction through the ETA and intraoral approach. A skin incision measuring roughly 5 to 8 mm in length was placed following the lateral canthal skin crease. After releasing the inferior crus of the lateral canthal tendon for canthotomy, the medial periosteum of the lateral orbital rim was preserved for canthal reattachment. A limited subperiosteal dissection and partial relaxing incision of the orbicularis oculi were performed to expose the fracture line of the inferior orbital rim and zygomaticofrontal suture. Reduction was performed using a T-bar screw through the transconjunctival incision and an elevator through the intraoral incision. Results The aesthetic and functional results were excellent. Successful reduction was achieved and the skin incision was less than 8 mm in 20 cases (76.9%). Only six patients had an additional skin incision (less than 5 mm) to achieve reduction. No cases of ectropion, entropion, or excessive scarring were noted. Conclusions The ETA using a T-bar screw is a useful method for maximizing aesthetic results in ZMC fractures, with the advantages of minimal scarring, faster recovery, and maintenance of pretarsal fullness.