• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권2호
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• pp.100-106
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• 2013

There are many challenges for reconstruction after intraoral tumor resection. Especially, palatomaxillary reconstruction has two primary goals: closure of the oronasal communication and re-creation of proper myomucosal function. Prosthodontic treatment using obturator and several surgical procedures are selected depending on the size and site of the defect, the difficulty of operative procedure, operation time and donor site problem. Above all, it is considered that radial forearm free flap is the first choice for palatal reconstruction. Our department introduces a novel method using tunnelized-facial artery myomucosal island flap for palatomaxillary defect reconstruction, which can successfully reduce donor-site morbidity, and duration of surgery and hospitalization.

• 대한두개안면성형외과학회지
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• 제22권3호
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• pp.168-172
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• 2021

Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.

• Journal of Hospice and Palliative Care
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• 제24권1호
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• pp.66-68
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• 2021

The World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak to be a pandemic on March 12, 2020. In Korea, there have been 24,027 confirmed cases of COVID-19 and 420 deaths as of October 3, 2020. The clinical spectrum of COVID-19 ranges from asymptomatic infection to death. Cancer care in this pandemic has radically changed. The literature was reviewed. The COVID-19 pandemic has made it urgently necessary to profoundly re-organize cancer patients' care without compromising cancer outcomes. Several important questions in regard to COVID-19 infection in cancer patients have emerged. Are patients with cancer at a higher risk of COVID-19 infection? Are they at an increased risk of mortality and severe illness when infected with COVID-19? Does anticancer treatment affect the course of COVID-19? Based on the existing research, cancer patients with immunosuppression are vulnerable to COVID-19 infection, and cancer patients are more likely to experience severe COVID-19. However, chemotherapy and major surgery do not seem to be predictors of hospitalization or severe disease. Korean background data on patients with cancer and COVID-19 are lacking. Prospective multicenter studies on the outcomes of patients with cancer and COVID-19 should be conducted.

• International Journal of Heart Failure
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• 제6권1호
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• pp.1-10
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• 2024

Heart failure (HF) stands as a prevalent chronic ailment, imposing a substantial burden on global healthcare systems due to recurrent hospitalizations, intricate management, persistent symptoms, and polypharmacy challenges. The augmentation of patient safety and treatment efficacy across various care stages, facilitated by a multidisciplinary HF team inclusive of a clinical pharmacist, emerges as paramount. Evidence underscores that the collaborative engagement of a physician and a clinical pharmacist engenders proficient and secure management, forestalling avoidable adversities stemming from drug reactions and prescription inaccuracies. This synergistic approach tailors treatments optimally to individual patients. Post-discharge, the vulnerability of HF patients to re-hospitalization looms large, historically holding sway as the foremost cause of 30-day readmissions. Diverse strategies have been instituted to fortify patient well-being, leading to the formulation of specialized transitional care programs that shepherd patients effectively from hospital to outpatient settings. These initiatives have demonstrably curtailed readmission rates. This review outlines a spectrum of roles assumed by clinical pharmacists within the healthcare cohort, spanning inpatient care, transitional phases, and outpatient services. Moreover, it traverses a compendium of studies spotlighting the affirmative impact instigated by integrating clinical pharmacists into these fields.

• Advances in pediatric surgery
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• 제16권2호
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• pp.108-116
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• 2010

Air reduction is a safe, effective, and fast initial treatment for pediatric intussusception. There is low dose radiation exposure. Factors affecting outcomes of air reduction were analyzed by reviewing the clinical features and results of treatment. A total of 399 out of 485 patients with pediatric intussusceptions were treated at the Seoul National University Children's Hospital from 1996 to 2009. All of the patients received air reduction as the first line of treatment. Clinical features such as gender, age, seasonal variation, symptoms, signs, types, pathologic leading point, and treatment results including success rate, complication, recurrence, NPO time, and duration of hospitalization were reviewed. The Pearson chi-square, student T-, and logistic regression tests were used for statistical analysis. P-value less than 0.05 was considered to be statistically significant. The prevalent clinical features were: male (65.4 %), under one-year of age (40.3 %), ileocolic type (71.9 %), abdominal pain (85.4 %), and accompanying mesentery lymph node enlargement (2.2 %). The overall success rate for air reduction was 78.4 % (313 of 399 patients), and the perforation rate during reduction was 1.5 %. There were 23 recurrent cases over 21.6 months. All were successfully treated with re-do air reduction. Reduction failures had longer overall NPO times (27.067hrs vs. 43.0588hrs; p=0.000) and hospitalization durations (1.738d vs. 6.975d; p=0.000) compared to the successful cases. The factors affecting success rates were fever (p=0.002), abdominal distension (p=0.000), lethargy (p=0.000) and symptom duration (p=0.000) on univariate analysis. Failure rates were higher in patients with symptom durations greater than 24 hours (p=0.023), and lethargy (p=0.003) on multivariate analysis. Air reduction showed high success rates and excellent treatment outcomes as the initial treatment for pediatric intussusception in this study. Symptom duration and lethargy were significantly associated with reduced success rates.

• 한방재활의학과학회지
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• 제30권3호
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• pp.151-162
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• 2020

Objectives This study aimed to evaluate the effectiveness of postoperative Korean rehabilitation treatment for patients with musculoskeletal disorders. Methods The medical records of patients undergoing Korean medical rehabilitation after a musculoskeletal surgery, from January 1, 2016, to December 31, 2019, were analyzed retrospectively. The effect of treatment was evaluated by using a numeric rating scale (NRS) and questionnaire for each surgical site. When the same patient was re-admitted after discharge, it was treated as the same case if it was within 7 days from the discharge date; otherwise, it was treated separately. If the period of hospitalization was within 7 days or the chief complaint was not related to musculoskeletal surgeries, the case was excluded. Results In total, 480 cases were included in this study. Acupuncture (99.8%), moxibustion (95.6%), cupping (97.5%), Chuna manual therapy (81.5%), Korean medical physiotherapy (61.0%), Daoyin exercise therapy (26.3%), and herbal medicine (87.7%) were used as the Korean medical rehabilitation treatments. A significant improvement was noted when comparing the NRS and questionnaire results for each surgical site at the time of admission and discharge. Conclusions Korean medical rehabilitation can be effectively used for patients who have undergone musculoskeletal surgeries, to relieve pain and enable returning to daily activities. However, further research with a high level of evidence is necessary to support this finding.

• 한국인터넷방송통신학회논문지
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• 제12권5호
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• pp.39-54
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• 2012

오늘날 의료정보화 수준향상과 디지털 병원화의 흐름에 따라 PACS는 의료기관의 핵심 인프라 중 하나로 자리매김하였다. 이와 함께 생산되는 디지털 의료영상의 종류 및 의료영상 데이터가 양적으로 급증하고 있으며, 이는 의료영상 데이터의 효과적인 보관을 위한 의료영상 압축을 중요한 요소로 부각시킨다. 현재 의료영상에 관한 사실상의 표준인 DICOM 규격에서는 의료영상 압축을 위하여 무손실 압축기법인 RLE를 명시하고 있으나, 무손실 범용 압축기법인 RLE는 인체의 대칭성을 가지는 많은 의료영상에 적용하면 높은 압축율 기대하기 힘들다. 이 논문에서는 다양한 의료영상 중 대칭 특성을 크게 내포하는 뇌 CT 영상을 대상으로 하여 영상 내 관심영역을 검출하고 대칭특성에 따라 영상의 픽셀 값을 재코딩하는 전처리 하고 영상을 압축하는 기법을 제안한다. 실험에 의하면, 제안한 기법은 RLE 압축과 영상 내 관심영역을 검출하지 않고 압축할 때와 비교하여 높은 압축률을 보인다.

• Journal of Gastric Cancer
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• 제15권4호
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• pp.262-269
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• 2015

Purpose: Intraabdominal abscess is one of the most common reasons for re-hospitalization after gastrectomy. This study aimed to develop a model for estimating the probability of intraabdominal abscesses that can be used during the postoperative period. Materials and Methods: We retrospectively reviewed the clinicopathological data of 1,564 patients who underwent gastrectomy for gastric cancer between 2010 and 2012. Twenty-six related markers were analyzed, and multivariate logistic regression analysis was used to develop the probability estimation model for intraabdominal abscess. Internal validation using a bootstrap approach was employed to correct for bias, and the model was then validated using an independent dataset comprising of patients who underwent gastrectomy between January 2008 and March 2010. Discrimination and calibration abilities were checked in both datasets. Results: The incidence of intraabdominal abscess in the development set was 7.80% (122/1,564). The surgical approach, operating time, pathologic N classification, body temperature, white blood cell count, C-reactive protein level, glucose level, and change in the hemoglobin level were significant predictors of intraabdominal abscess in the multivariate analysis. The probability estimation model that was developed on the basis of these results showed good discrimination and calibration abilities (concordance index=0.828, Hosmer-Lemeshow chi-statistic P=0.274). Finally, we combined both datasets to produce a nomogram that estimates the probability of intraabdominal abscess. Conclusions: This nomogram can be useful for identifying patients at a high risk of intraabdominal abscess. Patients at a high risk may benefit from further evaluation or treatment before discharge.

• International Journal of Heart Failure
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• 제6권1호
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• pp.22-27
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• 2024

Body fluid monitoring and management are essential to control dyspnea and prevent re-hospitalization in patients with chronic heart failure (HF). There are several methods to estimate and monitor patient's volume status, such as symptoms, signs, body weight, and implantable devices. However, these methods might be difficult to use for reasons that are slow to reflect body water change, inaccurate in specific patients' condition, or invasive. Bioelectrical impedance analysis (BIA) is a novel method for body water monitoring in patients with HF, and the value in prognosis has been proven in previous studies. We aim to determine the efficacy and safety of home BIA body water monitoring-guided HF treatment in patients with chronic HF. This multi-center, open-label, randomized control trial will enroll patients with HF who are taking loop diuretics. The home BIA group patients will be monitored for body water using a home BIA device and receive messages regarding their edema status and direction of additional diuretics usage or behavioral changes through the linked application system once weekly. The control group patients will receive the usual HF management. The primary endpoint is the change in N-terminal prohormone of brain natriuretic peptide levels from baseline after 12 weeks. This trial will provide crucial evidence for patient management with a novel home BIA body water monitoring system in patients with HF.

• Journal of Yeungnam Medical Science
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• 제15권2호
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• pp.297-305
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• 1998

최근에 Roller loop electrode를 이용한 경요도전립선전기기화술에 관심이 집중되고 있다. 저자들은 전립선비대증에서 전립선전기기화술의 가치를 알아보기 위해 Roller loop electrode를 이용한 전립선전기기화술(TEVP, 17례)을 레이저전립선절제술(VLAP, 39례)과 전통적 경요도전립선절제술(TURP, 59례)과 비교 분석해 보았다. TEVP는 효과 면에서는 전통적인 경요도전립선절제술에는 미치진 못하지만 VLAP과는 유사한 효과를 보였으며 안전성면과 경제적인 면에서는 VLAP을 능가하는 치료법으로 사료된다. 본 연구가 적은 환자를 대상으로 10개월까지 관찰한 결과이고 경요도전립선전기기화술의 초기 경험이라 명확한 결론을 내리기에는 다소 성급한 면이 있으나 전통적인 전립선절제술에 비해 짧은 입원기간, 짧은 요도관유치 기간 및 적은 출혈 등을 보여주며 레이저 시술의 단점인 고가장비가 필요 없다는 점에서는 전통적 전립선절제술의 대체 술기로 높이 평가되어진다.