• Journal of Trauma and Injury
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• 제36권1호
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• pp.3-7
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• 2023

Purpose: As resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in an extremely emergent situation, achieving competent clinical practice is mandatory. Although there are several educational courses that teach the REBOA procedure, there have been no reports evaluating the impact of training on clinical practice. Therefore, this study is aimed to evaluate the effects of the course on procedural performance during resuscitation and on clinical outcomes. Methods: Patients who were managed at a regional trauma center in Dankook University Hospital from August 2016 to February 2018 were included and were grouped as precourse (August 2016-August 2017, n=9) and postcourse (September 2017- February 2018, n=9). Variables regarding injury, parameters regarding REBOA procedure, morbidity, and mortality were prospectively collected and reviewed for comparison between the groups. Results: Demographics and REBOA variables did not differ between groups. The time required from arterial puncture to balloon inflation was significantly shortened from 9.0 to 5.0 minutes (P=0.003). There were no complications associated with REBOA after the course. Mortality did not show any statistical difference before and after the course. Conclusions: The endovascular training for REBOA pilot course, which uses a modified form of flipped learning, realistic simulation of ultrasound-guided catheter insertion and balloon manipulation, and competence assessment, significantly improved procedural performance during resuscitation of trauma patients.

• Korean Journal of Radiology
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• 제2권4호
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• pp.204-209
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• 2001

Objective: To determine the feasibility of transcaval transjugular intrahepatic portosystemic shunt (TIPS) in patients with occluded previous TIPS. Materials and Methods: Between February 1996 and December 2000 we performed five transcaval TIPS procedures in four patients with recurrent gastric cardiac variceal bleeding. All four had occluded TIPS, which was between the hepatic and portal vein. The interval between initial TIPS placement and revisional procedures with transcaval TIPS varied between three and 31 months; one patient underwent transcaval TIPS twice, with a 31-month interval. After revision of the occluded shunt failed, direct cavoportal puncture at the retrohepatic segment of the IVC was attempted. Results: Transcaval TIPS placement was technically successful in all cases. In three, tractography revealed slight leakage of contrast materials into hepatic subcapsular or subdiaphragmatic pericaval space. There was no evidence of propagation of extravasated contrast materials through the retroperitoneal space or spillage into the peritoneal space. After the tract was dilated by a bare stent, no patient experienced trans-stent bleeding and no serious procedure-related complications occurred. After successful shunt creation, variceal bleeding ceased in all patients. Conclusion: Transcaval TIPS placement is an effective and safe alternative treatment in patients with occluded previous TIPS and no hepatic veins suitable for new TIPS.

• 대한영상의학회지
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• 제85권3호
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• pp.596-606
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• 2024

Purpose To examine the technical considerations of endovascular treatment for aortoiliac occlusive disease (AIOD) based on a 10-year experience in Songklanagarind Hospital. Materials and Methods This retrospective cohort study included 210 patients who underwent endovascular treatment for symptomatic AIOD between January 2010 and December 2020. The patients' clinical and lesion characteristics, including technical considerations of the procedure, were collected, analyzed, and stratified using the Transatlantic Inter-Society Consensus (TASC). Results Most patients (80%) in this study had chronic limb-threatening ischemia lesions, with an occlusion rate of 37%. The technical success rate of TASC C & D was lower than that of TASC A & B, 84.4% vs. 99.2% p ≤ 0.001. A technical success rate of 93.3% (14/15) was found for the femoral and brachial approach, compared with a success rate of 89.0% (57/64) for the unibifemoral approach in TASC C & D, without a statistically significant difference (p = 0.076). However, the puncture site complications in this route were up to 17.6%, which is the highest rate compared with other techniques. These complications could be treated either conservatively or minimally invasively. Conclusion In cases of failed femoral access, simultaneous femoral and brachial approaches improved the technical success rate of endovascular recanalization of TASC C & D aortoiliac occlusions.

• Clinical Endoscopy
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• 제55권4호
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• pp.520-524
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• 2022

Background/Aims: Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopic submucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is used to directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluated its efficacy and safety. Methods: Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissection for superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence of stenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment. Results: Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosis in these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tube were observed. Conclusions: Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventing stenosis (clinical trial number, UMIN000037567).

• Journal of Acupuncture Research
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• 제18권4호
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• pp.91-100
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• 2001

Background and Objective : Most diagnostic method for numbness were invasive and complex. So we need to simplify and objectify diagnostic method for numbness. Some study with EAV which is one of Physiological Signal Measuring Instruments, report significantly result as objective diagnostic method for other clinical symptom. By using EAV, we have obtained some physiological signal data from meridian-acupoints of 58 numbness cases. Objective and Methods : This study researched into the clinical statistics for 58 case who ware in numbness, and they ware treated with oriental medical care at the Dong-shin university oriental hospital during 1 year from April 3 2000 to March 30 2001. The data were analyzed and interpreted to compare with traditional differentiation of symptom-complexes, then further evaluated as the Five Evolutive Phases to make them differentiated. The EAV valus of Five Evolutive Phases were identified with the sequence of wood(木), fire(火), earth(土), steel(金), water(水). Results and Conclusion : These values of physiological signal were identical with standard differentiation of symptom-complexes of numbness which is the main cause of dishannonious flow of Qi and blood of the in the liver and deficiency of Qi and blood of the bladder with stagnancy of dampness. Among Five Evolutive Phases, Earth and wood values were increased, steel, fire and water were decreased significantly. This data imply the possibility of somewhat generalization from measuring instruments.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권2호
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• pp.171-179
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• 1995

The conservative treatment of the condylar fracture has been used for a long time because of its simplicity, good prognosis and less complication. Traditionally the conservative treatment has been carried out by maxillomandibular fixation using arch bar and wire. But a simplified technique of maxillomandibular fixation introduced here is a procedure that 4 bone screws are placed above the apecies of the maxillary and mandibular canines and then ipsilaterally placed maxillary and mandibular bone screws are linked by a loop of wire each other. This procedure has several advantages compared with the traditional maxillomandibular fixation method. 1) it provides simplicity for the operators. 2) it sustains maxillomandibular fixation more rigidly compared with arch bar technique. 3) it keeps stable maxillomandibular fixation in the region of the anterior teeth so that anterior open bite tendency can be remarkably minimized. 4) it does not injure the periodontal tissue because the teeth are not engaged and causes less discomfort to the patient. 5) it decreases the possibility of operator's AIDS infection through inadvertent skin puncture. 6) it is highly recommended for the patients whose teeth are available for maxillomandibular fixation. The two male patients were diagnosed as bilateral condylar and symphyseal fracture of the mandible. They restored stable occlusion and functional mandibular movement only by a simplified technique of maxillomandibular fixation.

• 한방재활의학과학회지
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• 제20권4호
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• pp.17-31
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• 2010

Objectives : Ganoderma Lucidum has been used in traditional oriental medicine to treat various conditions including chronic fatigue and cough. This experimental study was designed to investigate the effects of yeast-fermented Ganoderma Lucidum extract on the fatigue of rats elicited by forced swimming. Materials and methods : The rat subjects were divided into 4 groups: normal group, control group administered with 0.9% normal saline, experimental I(Exp I) group administered with yeast-fermented Ganoderma lucidum extract and experimental II(Exp II) group administered with Ganoderma lucidum extract for 4 weeks. All the serum samples collected by heart puncture were used to measure biochemical factors such as glucose, lactate, lactate dehydrogenase(LDH), creatine kinase(CK), inorganic phosphorus, ammonia, total cholesterol(TC), triglycerides(TG), high-density lipoprotein(HDL), low-density lipoprotein(LDL), aspartate transaminase(AST), alanine transaminase(ALT). Results : 1. Weight change and swimming time were not significantly different in the experimental groups as compared with control group. 2. Lactate was significantly decreased in the experimental groups as compared with control group. Inorganic phosphorus was also significantly decreased in the Exp I group as compared with control group(p<0.05). 3. Serum lipid concentration was not significantly different in the experimental groups as compared with control group. 4. AST and ALT were significantly decrease in the experimental groups as compared with control group. Conclusions : Yeast-fermented Ganoderma lucidum in forced swimming rats would appear to reduce fatigue-related factors, AST, ALT of serum and promote anti-fatigue effect.

• 임상간호연구
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• 제22권3호
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• pp.336-344
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• 2016

Purpose: The purpose of this study was to compare and analyze differences in effects of postoperative daily activity on headaches in patients who underwent surgery under spinal anesthesia. Methods: The study was conducted with 219 adults, 20 years or older. Official approval (Approval number: KMC IRB 1434-01) was received from K university hospital clinical trials review board. The research design was a nonequivalent control group non-synchronized design with a daily activities group and the bed rest group. Data was collected after receiving written consent from the participants. Results: There were no participants in either group who experienced headaches. Changes in a physiological index were also not significantly different between the daily activities group and the bed rest group. Conclusion: The results indicate that allowing daily activities in the ward, rather than maintaining bed rest for 6 hours, the existing method of nursing care for the prevention of postoperative headaches, in spinal anesthesia patients, is not detrimental to these patients post operatively.

• Journal of Acupuncture Research
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• 제27권4호
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• pp.9-18
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• 2010

Objectives : This study will broaden understanding of acupotomy therapy through comparison of side effects and complication which can be caused by the mechanism of treatment, surgical methods, and procedure by acupotomy therapy and epidural neuroplasty. Moreover, through an in-depth analysis of headache affected by two procedures, this research is supposed to find prospective cures for headache after acupotomy therapy. Methods : To compare acupotomy therapy with epidural neuroplasty this research was done using a comparative analysis eight theses about acupotomy therapy since 1995, as well as eleven theses about epidural neuroplasty since 2000. Other theses and data were used as references in the process of comparative analysis. Results : Acupotomy therapy and epidural neuroplasty, new treatments of damaged discs in the spine and stenosis made in 1990s, have the mechanism of treatment in common in that adhesion, a node or scar caused by the soft tissue damage is removed by putting catheter or acupuncture into the lesions. Epidural neuroplasty has additional injection into the lesions, which is different from acupotomy therapy in the process of surgical procedure. There are various reports of positive effects about curative effect in these two treatments. The two procedures may cause various complications. Headache may be a complication after surgery. The headache after acupotomy therapy is characterized as being an ache in the body, which is similar to that of post-dural puncture headache in the outbreaks and symptom. Headache after percutaneous epidural neuroplasty appears in general, which is similar to a headache as a result of the increased pressure of the brain spinal cord regardless of posture. Conclusions : Although they are alike in the mechanism of treatment, surgical methods and side effects, and complication after they are carried out as a result of analyzing theses related to acupotomy therapy and percutaneous epidural neuroplasty, there is a difference in aspects and mechanism of headaches experienced after the procedure.

• 농촌의학ㆍ지역보건
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• 제20권2호
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• pp.169-174
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• 1995

The case was described of a 31 year old female who developed fusiform swelling of the right third finger at the site of puncture by sea urchin spine. We observed a radiopaque linear material suggesting a remnant spine which the size was 2.4 mm in sonography and mammography. We confirmed that it exhibits a urchin spine and distinct caseous necrosis with central calcification. Sea urchins(Echinoidea) are ubiquitous marine creatures that resemble pincushions and are covered by calcareous skeletons surrounded by numerous movable calcium carbonate spines. The sharp spines are brittle and easily detach when touched by the victim. Contact with sea urchin spines produces intense pain, some localized erythema and edema. Inflammation develops in response to retained fragments. Granulomas 1-5 mm in diameter develop rarely 2-12 months after envenomation. In treatment, hot water immersion and thorough wound cleansing are advisable. Analgesics may, be necessary after hot water immersion. Attempts to remove these spines should be performed with good lighting sources, preferably with radiological direction. Chronic granulomas usually require complete excision. Acetone has been suggested for rapid resolution of pain. No antidotes are available.