• Advances in pediatric surgery
• /
• 제11권2호
• /
• pp.141-149
• /
• 2005

Ulcerative colitis, an inflammatory bowel disease, is primarily managed medically with a combination of 5-ASA and steroids. However, this chronic disease requires surgical management if symptoms persist or complications develop despite medical management. The clinical course, indications and outcome of surgical management of 21 patients under the age of 15 who were endoscopically diagnosed with ulcerative colitis at the Seoul National University Children's Hospital between January, 1988 and January, 2003 were reviewed. Mean follow up period was 3 years and 10 months. The mean age was 10.3 years old. All patients received medical management after diagnosis and 8 patients (38 %) eventually required surgical management. Of 13 patients who received medical management only, 7 patients (53 %) showed remission, 4 patients are still on medical management, and 2 patients expired due to congenital immune deficiency and hepatic failure as a result of sclerosing cholangitis. In 8 patients who received surgical management, the indications for operation were, 1 patient sigmoid colon perforation and 7 patients intractability despite medical management. The perforated case had a segmental colon resection and the other 7 patients underwent total colectomy with ileal pouch-anal anastomosis. One patient expired postoperatively due to pneumonia and sepsis. and 1 is still on medical management because of mild persistent hematochezia after surgery. Six other operated patients are doing well without medical therapy. Pediatric ulcerative colitis patients can be surgically managed if the patient is intractable to medical management or if complications such as perforation are present. Total colectomy & ileal pouch-anal anastomosis is thought to be the adequate surgical method.

• Journal of Chest Surgery
• /
• 제44권2호
• /
• pp.169-177
• /
• 2011

Background: Video-assisted thoracic surgery (VATS) lobectomy has been performed with increasing frequency over the last decade. However, there is still controversy as to its indications, safety, and feasibility. Especially regarding lung cancer surgery, it is not certain whether it can reduce local recurrences and improve overall survival. Materials and Methods: We retrospectively reviewed 1,067 cases of VATS lobectomy performed between 2003 and 2009, including the indications, postoperative morbidity, mortality, recurrence, and survival rate. Results: One thousand and sixty seven patients underwent VATS lobectomy for the following indications: non-small cell lung cancer (NSCLC) (n=832), carcinoid tumors (n=12), metastatic lung cancer (n=48), and benign or other diseases (n=175). There were 63 cases (5.9%) of conversion to open thoracotomy during VATS lobectomy. One hundred thirty one (15.7%) of the 832 NSCLC patients experienced pathologic upstaging postoperatively. The hospital mortality rate was 0.84% (9 patients), and all of them died of acute respiratory distress syndrome. One hundred forty-nine patients (14.0%) experienced postoperative complications. The median follow-up was 22.9 months for patients with NSCLC. During follow-up, 120 patients had a recurrence and 55 patients died. For patients with pathologic stage I, the overall survival rate and disease-free survival rate at 3 years was $92.2{\pm}1.5%$ and $86.2{\pm}1.9%$, respectively. For patients with pathologic stage II disease, the overall survival rate and disease-free survival rate at 3 years was $79.2{\pm}6.5%$ and $61.9{\pm}6.6%$, respectively. Conclusion: Our results suggest that VATS lobectomy is a technically feasible and safe operation, which can be applied to various lung diseases. In patients with early-stage lung cancer, excellent survival can be also achieved.

• 대한예방한의학회지
• /
• 제17권2호
• /
• pp.129-138
• /
• 2013

Objectives : The discussion of enlargement of Korean Medical insurance has been existed since 1987. But it had less effects. For better discussion, we compared insured herbal extracts and clinical prescriptions. Methods : The database of insured herbal extracts and clinical prescriptions bas set up to compare the ratios of herbal weight and analyze indications of insured herbal extracts and diagnosis and chief complain of clinical prescriptions. Results & Conclusions : The most frequent insured herbal extract is Bojungiki-tang. Analysis about indications of insured herbal extracts and diagnosis and chief complain of clinical prescriptions is that Bojungiki-tang is used frequently for gastrointestinal diseases, pulmonary diseases, and not for diseases. Bojungikgi-tang is also used for muscloskeletal dieases, hemorrhage, and ischemia.

• 대한한의학원전학회지
• /
• 제33권4호
• /
• pp.107-130
• /
• 2020

Objectives : This paper aims to lay out the meaning of Gongjindan, its indications and mechanisms based on relevant contents in the 『Donguibogam』, for better clinical application. Methods : First, Gongjindan related contents were searched in the medical classics database. Next, contents from the 『Shizhaibaiyixuanfang』 and the 『Donguibogam』 were analyzed. Finally, the properties of the Gongjindan ingredients were examined based on the 『Donguibogam』 and the 『Zhongyaodacidian』. Results & Conclusions : Examination of its indications according to the 『Donguibogam』 in terms of applicable age and viscera/bowels, Gongjindan could be applied to children with constitutional insufficiency and elder generations, but it could not be said to be most appropriate for older generations. In regards to viscera/bowels, Gongjindan sends water upwards into fire in the water-rising-fire-descending mechanism, which makes it applicable to symptoms of anxiety and fear by tonifying the consumed Jing and Blood caused by Liver deficiency. To summarize, those who would most benefit from Gongjindan are young adults in weak, fearful and lethargic conditions.

• Journal of Trauma and Injury
• /
• 제35권4호
• /
• pp.291-296
• /
• 2022

The therapeutic approach for colon injury has changed continuously with the evolution of management strategies for trauma patients. In general, immediate laparotomy can be considered in hemodynamically unstable patients with positive findings on extended focused assessment with sonography for trauma. However, in the case of hemodynamically stable patients, an additional evaluation like computed tomography (CT) is required. Surgical treatment is often required if prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation are observed. However, immediate intervention in hemodynamically stable patients without indications for surgical treatment remains questionable. Three patients with colon and mesocolon injuries caused by blunt trauma were treated by nonoperative management. At the time of admission, they were alert and their vital signs were stable. Colon and mesocolon injuries, large hematoma, colon wall edema, and/or ischemia were revealed on CT. However, no prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation were observed. In two cases, conservative treatment was performed without worsening abdominal pain or laboratory tests. Follow-up CT showed improvement without additional treatment. In the third case, follow-up CT and percutaneous drainage were performed in considering the persistent left abdominal discomfort, fever, and elevated inflammatory markers of the patient. After that, outpatient CT showed improvement of the hematoma. In conclusion, nonoperative management can be considered as a therapeutic option for mesocolon and colon injuries caused by blunt trauma of selected cases, despite the presence of large hematoma and ischemia, if there are no clear indications for immediate intervention.

• 대한한의학원전학회지
• /
• 제25권4호
• /
• pp.123-147
• /
• 2012

Objective : By establishing the Five Viscera Source Point Acupuncture as the targeted acupuncture treatment for stadardization, as the first step, this study was conducted to sort the indications of each acupuncture remedies, which can be referred as one of the most important factors in acupuncture treatment, based on Yeoungchu. Method : This study selected only the contents related to indications of five viscera, by extracting the relevant sentences from Yeoungchu using the search words Liver(Liver Meridian, First Yin), Heart(Pericardium, Heart Meridian, Second Yin), Spleen(Spleen meridian, Third Yin), Lung(Lung Meridian, Third Yin), and Kidney(Kidney Meridian, Second Yin). Result & Conclusion : 1. We selected and extracted text related to liver disease from Chapter 16, heart (pericardium) disease from Chapter 16, spleen disease from Chapter 19, lung disease from Chapter 17, and finally kidney disease from Chapter 17 of Yeoungchu. 2. The basic theory of applying Five Viscera Source Point Acupuncture to five viscera diseases is first assorting the diseases according to its state (i.e. deficiency or excess), then draining the source point of the appropriate viscus in case of excess, or supplementing the source point of the appropriate viscus in case of deficiency. 3. For the correct application of Five Viscera Source Point Acupuncture, the classification of the disease, not only the judgement on its state, must be presented systematically and synthetically in combination with Four Examinations. Therefore the follow-up studies needs to be conducted.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제25권4호
• /
• pp.332-339
• /
• 2022

Purpose: Although endoscopic retrograde cholangiopancreatography (ERCP) has been used for more than five decades, its applicability in Bangladeshi children has recently become more common. Therefore, this manuscript aims to describe our experience in performing ERCPs in Bangladeshi children with hepatopancreaticobiliary diseases, focusing on presenting diseases, as well as the diagnostic and therapeutic efficacy. Methods: Between 2018 and 2021, 20 children underwent 30 ERCP procedures at the Bangladesh Specialized Hospital, Dhaka. A single trained adult gastroenterologist performed all procedures using a therapeutic video duodenoscope. The indications for ERCP, diagnostic findings, therapeutic procedures, and complications were documented. Results: The median age of the study patients was 10 years (range, 1.7-15 years). Successful cannulation of the papilla was achieved in 28 procedures and failed in 2 cases. Repeated ERCP was required in seven patients. Nine patients had biliary indications and 11 had pancreatic indications. Choledocholithiasis was the most common indication for ERCP in patients with biliary disease, while chronic pancreatitis was common among patients with pancreatic indications. Pancreatic divisum was observed in only one patient. Pancreatic and biliary sphincterotomy was performed in 14 and 9 cases, respectively. A single pigtail or straight therapeutic stent was inserted in seven cases and removed in five cases. Stone extraction was performed in six procedures, and balloon dilatation was performed in five procedures. The post-procedural period for these patients was uneventful. Conclusion: We found that ERCP is a practical and successful therapeutic intervention for treating hepatopancreaticobiliary disorders in children when performed by experienced endoscopists.

• 대한한의학회지
• /
• 제44권1호
• /
• pp.1-15
• /
• 2023

Objectives: National health insurance herbal prescription of Korean medicine has been serving important role in public healthcare in spite of continuous demand on revision of system. However, the categories of insurance herbal prescriptions are not equally distributed throughout the KCD-based major disease categories. We analyzed statistical database of claimed national health insurance classified as major disease categories by years. We classified all 56 herbal prescriptions as per their total medical indications into 22 major disease categories to analyze their distribution. Significant increase of M and S-T code claims were found, whereas decrease of U code claims by years. We figured out that the 56 prescriptions were unequally distributed along with enrichment of certain codes such as K and J. Meanwhile, the insurance claim of each prescription was positively correlated with number of code types of their indications. As a result, we believe that the reform of national health insurance herbal prescription list is necessary to promote use of it in clinic.

• 혜화의학회지
• /
• 제26권1호
• /
• pp.1-10
• /
• 2017

Objectives: The aim of this study is (1) to investigate the historic changes and pharmacological efficacies of Woohwangchungsim-won and (2) to discuss the necessities for Woohwangchungsim-won's clinical applications. Methods: This study was performed through (1) investigating the ancient literature records related with Woohwangchungsim-won and analyzing Woohwangchungsim-won's composition, dosage and indications, (2) searching articles about Woohwangchungsim-won on 10 major Korean web and 3 major foreign web article search engines and analyzing Woohwangchungsim-won's pharmacological efficacies and indications. Results: Woohwangchungsim-wom has been used for cerebrovascular diseases such as stroke and palpitation. Also, there are some ancient literature records of Woohwangchungsim-won's clinical applications in neuropsychiatric disorders such as depression and bipolar disorder. In addition, there have been a number of experimental studies which demonstrate Woohwangchungsim-won's neuroprotective effect on cerebral cortex and hippocampus injury. So, it is possible to infer that Woohwangchungsim-won can be used for the treatments of neuropsychiatric disorders associated with neuronal cell death in cerebral cortex and hippocampus. But there have been no or less experimental studies which demonstrate the pharmacological efficacy of Woohwangchungsim-won on such disease. Conclusion: It is necessary that further experimental studies which demonstrate Woohwangchungsim-won's pharmacological efficacy on neuropsychiatric disorders should be done and Woohwangchungsim-won's clinical applications should be expanded on the basis of those related experimental results.

• Journal of Yeungnam Medical Science
• /
• 제35권1호
• /
• pp.17-26
• /
• 2018

Transcatheter aortic valve implantation (TAVI) has evolved from a challenging intervention to a standardized, simple, and streamlined procedure with over 350,000 procedures performed in over 70 countries. It is now a novel alternative to surgical aortic valve replacement in patients with intermediate surgical risk and its indications have been expanded to cohorts with bicuspid aortic valves, low surgical risk, and younger age and fewer comorbidities. Attention should be paid to further reducing remaining complications, such as paravalvular aortic regurgitation, conduction abnormalities, cardiac tamponade, and stroke. The aim of this review is to provide an overview on the rapidly changing field of TAVI treatment and to explore past achievements, current issues, and future perspectives of this treatment modality.