• 대한한방내과학회지
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• 제36권4호
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• pp.561-569
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• 2015

Objectives The purpose of this study was to improve the knowledge of the low-level laser therapy (LLLT) field and to review research reports on LLLT to understand the current situation with respect to the clinical indication and current research trends.Methods A survey was carried out on the subject of low-level laser therapy to September 2012, using the PubMed search engine. Selected literature was checked by two reviewers and was classified according to the International Classification of Diseases 10th (ICD-10) over 10 years.Results We selected 469 studies in total, of which 142 were case reports, 118 were case-controlled trials, and 209 were randomized controlled trials of LLLT. According to the ICD-10 classification of diseases, the K code and M code being the most common, 399 studies have been published in the last 10 years. This shows that the study and clinical indications of low-level laser therapy have rapidly increased over the past 10 years.Conclusions Low-level laser therapy has been used most frequently with respect to dentistry and pain and musculoskeletal disorders. Recently, interest in and research into LLLT has increased for various diseases. With the establishment of standard conditions for low-level laser therapy, supported by aggressive clinical utilization and systematic clinical research, LLLT will be a very useful treatment and a useful alternative method in many medical fields.

• 대한임상독성학회지
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• 제11권1호
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• pp.1-8
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• 2013

Gastric lavage is one of gastrointestinal decontamination methods which have been controversial in the clinical toxicology field for a long time. Expert groups of American and European clinical toxicologists have published the position papers regarding gastric lavage three times since 1997. They recommended that gastric lavage should not be used as a routine procedure in the management of acute intoxication, because they thought that there is no certain evidence of improving clinical outcome by its use. However, the studies they reviewed were not well-controlled randomized trials, which cannot be conducted in the clinical toxicology field due to variability of patients and ethical problems. Therefore, the results from these studies should be interpreted with caution. They also insisted that gastric lavage can be undertaken within 60 minutes of ingestion. The limitation of one hour after ingestion is too arbitrary and may cause a lot of misunderstanding. Formation of pharmacobezoar or gastric hypomotility after ingestion may significantly delay the gastric emptying time so that gastric lavage can be useful even after several hours or more in case of highly toxic substances or severe intoxication. Furthermore, as there are a number of serious intoxication by toxic pesticides with large amount in suicidal attempts in Korea, it seems that gastric lavage may be used more frequently in Korea than in Western countries. When deciding whether or not to use gastric lavage, all the indications, contraindications, and possible adverse effects should be taken into account on the basis of risk-benefit analysis. If the procedure is decided to be done, it should only be performed by well-trained experts.

• Journal of Acupuncture Research
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• 제25권5호
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• pp.77-87
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• 2008

Objectives : We would like to look into the understanding and errors of the changes in the 'Suhyeoljuchijeung' of acupuncture and moxibustion through the documentary study of Gomu's(高武) $\ll$Chimgujeolyochiyeong$\gg$ today. Methods : Based on Hwangyongsang(黃龍祥)'s study, the author of the $\ll$Chimgujeolyochiyeong$\gg$, date it was written, the number of volumes and edition, basic contents, basic constitution, referenced books and characteristics, influence on posterity, the documentary research results will be arranged. Results & Conclusions : 1. $\ll$Chimgujeolyochiyung$\gg$ was first printed in the 16th year of the Gajung(嘉靖) era during the Myeong(明) dynasty(1537). It has a total of 7 volumes and is divided into 3 books(帙). The first book is three volumes of $\ll$Chimgujeolyo(鍼灸節要)$\gg$, and the second and third books are 4 volumes of $\ll$Chimguchiyung(鍼灸聚英)$\gg$. 2. The main content of this book is 'Suhyeoljuchijeung' of volume 1, and was written based mainly on Wangjipjung(王執中)'s $\ll$Chimgujasenggyeong(鍼灸資生經)$\gg$. also it was the first to systematically arrange the indications of acupuncture points after $\ll$Myeongdanggyeong(明堂經)$\gg$. 3. The author, Gomu was influenced by the 'literary restoration movement(文學複古運動)' of the time, resulting in the 'Jongyeongsunggo(尊經崇古)' ideology being reflected in $\ll$Chimgujeolyochiyung$\gg$.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권1호
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• pp.53-62
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• 1991

기관절제술은 기도확보를 위해 다양한 임상적 상황에서 행해지는 술식으로 1546년에 Brasabola에 의해 처음 성공적으로 시행되었다. 기관절제술의 적응증으로는 상기도 폐쇄의 완화, pulmonary toilet의 촉진, dead space의 감소 및 mechanical ventilation의 장기 사용시 등을 들 수 있겠다. 그동안 term에도 변화가 있었는데, 1718년 까지는 "bronchotomy"란 term 이 사용되었고 그후 "tracheotomy"란 term 이 사용되었으나 1820년 이후에는 "tracheostomy"란 term 이 나오게 되어 현재 이 두가지 term 이 구별없이 사용되고 있다. 기도폐쇄를 야기시킬 수 있는 악안면 부위의 외상 혹은 여러가지 질병의 증가 추세로인해 구강외과의사가 기관절제술을 시행해야할 상황을빈번히 맞게 된다. 이에, 본 교실에서 기관절제술을 시행한 31 명의 환자에 대한 임상적 고찰을 통해 숙련된 기관절제술 및 그 처치능력의 중요성을 보고하는 바이다.

• 한방재활의학과학회지
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• 제20권2호
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• pp.175-181
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• 2010

Objectives : The purpose of this study is to investigate interaction and safety in administering herb-medicine with warfarin. Methods : For this study, we selected 19 patients who have been taking warfarin, from the ones that have been transferred from western hospital to oriental hospital. During their stay in the oriental hospital, we gave herb-medicine in addition to warfarin. Then we gathered informations and data on sex, age, main indications, and International Normalized Ratio(INR) values of selected patients through Electronic Medical Records(EMR) of Dong-Guk university hospital. Accordingly, we compiled all of the above data for a period of 10 days prior and 10 days post admission(western hospital period and oriental hospital period, respectively). Results and Conclusions : The statistical analysis of the data have revealed that there was no significant change of INR values after giving herb-medicine with warfarin(p=0.586). The result shows that administration of herb-medicine with warfarin is safe and has little drug interaction. However, this study was carried out on small sample size and the interaction with other drugs and various kinds of herb-medicine was not considered. Although we attained a restrictive result from this study, we are able to suggest the safety about co-administration of herb-medicine and warfarin.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.642-648
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• 2011

Purpose: The recent advances in microsurgical techniques and their refinement over the past decade have greatly expanded the indications for digital replantations and have enabled us to salvage severed fingers more often. Many studies have reported greater than 80% viability rates in replantation surgery with functional results. However, replantation of multi-level amputations still remain a challenging problem and the decision of whether or not to replant an amputated part is difficult even for an experienced reconstructive surgeon because the ultimate functional result is unpredictable. Methods: Between January of 2002 and May of 2008, we treated 10 multi-level amputated digits of 7 patients. After brachial plexus block, meticulous replantation procedure was performed under microscopic magnification. Postoperatively, hand elevation, heat lamp, drug therapy and hyperbaric oxygen therapy were applied with careful observation of digital circulation. Early rehabilitation protocol was performed for functional improvement. Results: Among the 19 amputated segments of 10 digits, 16 segments survived completely without any complications. Overall survival rate was 84%. Complete necrosis of one finger tip segment and partial necrosis of two distal amputated segments developed and subsequent surgical interventions such as groin flap, local advancement flap and skin graft were performed. The overall result was functionally and aesthetically satisfactory. Conclusion: We experienced successful replantations of multi-level amputated digits. When we encounter a multi-level amputation, the key question is whether or not it is a contraindication to replantation. Despite the demand for skillful microsurgical technique and longer operative time, the authors' results prove it is worth attempting replantations in multi-level amputation because of the superiority in aesthetic and functional results.

• Journal of Genetic Medicine
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• 제17권1호
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• pp.21-26
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• 2020

Purpose: To evaluate the additive value of prenatal chromosomal microarray analysis (CMA) in assessing increased nuchal translucency (NT) (≥3.5 mm) with normal karyotype and the possibility of detecting clinically significant genomic imbalance, based on specific indications. Materials and Methods: Invasive samples from 494 pregnancies with NT ≥3.5 mm, obtained from the Research Center of Fertility & Genetics of Hamchoon Women's Clinic between January 2019 and February 2020, were included in this study and CMA was performed in addition to a standard karyotype. Results: In total, 494 cases were subjected to both karyotype and CMA analyses. Among these, 199 cases of aneuploidy were excluded. CMA was performed on the remaining 295 cases (59.7%), which showed normal (231/295, 78.3%) or non-significant copy number variation (CNV), such as benign CNV or variants of uncertain clinical significance likely benign (53/295, 18.0%). Clinically significant CNVs were detected in 11 cases (11/295, 3.7%). Conclusion: Prenatal CMA resulted in a 3% to 4% higher CNV diagnosis rate in fetuses exhibiting increased NT (≥3.5 mm) without other ultrasound detected anomalies and normal karyotype. Therefore, we suggest using high resolution, non- targeting CMA to provide valuable additional information for prenatal diagnosis. Further, we recommend that a genetics specialist should be consulted to interpret the information appropriately and provide counseling and follow-up services after prenatal CMA.

• Nuclear Medicine and Molecular Imaging
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• 제40권2호
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• pp.82-89
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• 2006

Bone metastasis is a common sequelae of solid malignant tumors such as prostate, breast, lung, and renal cancers, which can lead to various complications, including fractures, hypercalcemia, and bone pain, as well as reduced performance status and quality of life it occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. Several sequelae occur as a result of osseous metastases and resulting bone pain can lead to significant debilitation. A multidisciplinary approach is usually required not only to address the etiology of the pain and its complicating factors but also to treat the patient appropriately. Pharmaceutical therapy of bone pain, includes non-steroidal analgesics, opiates, steroids, hormones, bisphosphonates, and chemotherapy. While external beam radiation therapy remains the mainstay of pain palliation of a solitary lesions, bone seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions. $^{32}P,\;^{89}SrCl,\;^{153}Sm-EDTMP,\;^{188}Re/^{186}Re-HEDP,\;and\;^{177}Lu-EDTMP$ can be used to treat painful osseous metastases. These various radiopharmaceuticals have shown good efficacy in relieving bone pain secondary to bone metastasis. This systemic form of metabolic radiotherapy is simple to administer and complements other treatment options. This has been associated with improved mobility in many patients, reduced dependence on narcotic and non-narcotic analgesics, improved performance status and quality of life, and, in some studios, improved survival. All of these agents, although comprising different physical and chemical characteristics, offer certain advantages in that they are simple to administer, are well tolerated by the patient if used appropriately, and can be used alone or in combination with the other forms of treatment. This article illustrates the salient features of these radiopharmaceuticals, including the usual therapuetic dose, method of administration, and indications for use and also describe about the pre-management checklists, and jndication/contraindication and follow-up protocol.

• Journal of Trauma and Injury
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• 제34권3호
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• pp.162-169
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• 2021

Purpose: For severe lung injuries or acute respiratory distress syndrome that occurs during critical care due to trauma, extracorporeal membrane oxygenation (ECMO) may be used as a salvage treatment. This study aimed to describe the experiences at a single center with the use of ECMO in trauma patients. Methods: We enrolled a total of 25 trauma patients who were treated with ECMO between January 2015 and December 2019 at a regional trauma center. We analyzed and compared patients' characteristics between survivors and non-survivors through a medical chart review. We also compared the characteristics of patients between direct and indirect lung injury groups. Results: The mean age of the 25 patients was 45.9±19.5 years, and 19 patients (76.0%) were male. The mean Injury Severity Score was 26.1±10.1. Ten patients (40.0%) had an Abbreviated Injury Scale (AIS) 3 score of 4, and six patients (24.0%) had an AIS 3 score of 5. There were 19 cases (76.6%) of direct lung injury. The mortality rate was 60.0% (n=15). Sixteen patients (64.0%) received a loading dose of heparin for the initiation of ECMO. There was no significant difference in heparin use between the survivors and non-survivors (70% in survivors vs. 60% in non-survivors, p=0.691). When comparing the direct and indirect lung injury groups, there were no significant differences in variables other than age and ECMO onset time. Conclusions: If more evidence is gathered, risk factors and indications will be identified and we expect that more trauma patients will receive appropriate treatment with ECMO.

• Annals of Coloproctology
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• 제34권6호
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• pp.299-305
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• 2018

Purpose: Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea. Methods: Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. Results: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%. Conclusion: The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.