• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.210-214
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• 2012

Objective : This retrospective study aimed to compare clinical outcomes in terms of pain relief and recurrence rate between fragmentectomies and conventional microdiscectomies in patients with lumbar disc herniation (LDH). Methods : Between January 2008 and May 2011, a total of 175 patients met the inclusion criteria of this study. The visual analogue scale (VAS) scores of back and radicular pains were recorded before surgery, 2 and 6 weeks after surgery. Recurrence was defined when a patient had the same pattern of preoperative symptoms and was confirmed with magnetic resonance imaging. Results : Seventy-four patients (42.3%) were suitable for fragmentectomy, and 101 patients underwent conventional microdiscectomy. There were no significant differences in VAS scores between the fragmentectomy and conventional microdiscectomy groups 2 and 6 weeks after surgery. During the follow-up period, 3 patients (4.05%) in the fragmentectomy group and 7 patients (6.93%) in the conventional microdiscectomy group relapsed. Conclusion : If patients are selected according to well-defined criteria, fragmentectomy can be a good surgical option for LDH, in the physiological aspect of preserving healthy intervertebral disc materials.

• Archives of Plastic Surgery
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• 제35권1호
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• pp.78-85
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• 2008

Purpose: The capsular contracture has been the most common complication of augmentation with breast implant, a side effect quite difficult to treat. The latest trends in the correction of capsular contracture include total capsulectomy or conversion of implant pocket. In this study, in an attempt to correct capsular contracture, the authors performed reoperation which involved capsulectomy through peri-areolar approach and dual-plane conversion. The authors hereby report the clinical results of such correction of capsular contracture and examine the efficacy. Methods: The authors selected 46 patients who were admitted to the clinic from January 2004 to January 2007 (37 months), and performed dual-plane conversion through solely peri-areolar approach. Two types of operation were done: dual-plane conversion from subglandular plane or from submuscular plane. Results: The average follow-up time after conversion to the dual-plane position was 10 months. During the follow-up period, 83.1% of patients recovered from capsular contracture and were Baker class I, and in 10.9% the condition had relapsed into Baker class II or III contracture. Conclusion: This study has proven the effectiveness of the dual-plane conversion operation for correcting established capsular contracture after previous augmentation mammaplasty. In this study, all cases of dual-plane conversion operation was performed through peri-areolar approach, which can prevent the occurrence of visible scar on inframammary fold.

• Journal of Yeungnam Medical Science
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• 제40권1호
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• pp.12-22
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• 2023

Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient's drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.

• 한국임상약학회지
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• 제10권3호
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• pp.111-119
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• 2000

The objective of this study was to evaluate the efficacy and the pattern of regimens prescribed for the treatment of peptic ulcer disease in a regional community hospital. 226 patients were treated as an outpatient and followed for one year. 88 patients $(38.9\%)$ had gastric ulcer (GU) alone, 6 patients $(2.7\%)$ had duodenal ulcer (DV) alone, 5 patients $(2.2\%)$ had gastroesophageal reflux disease (GERD) alone, 25 patients $(11.1\%)$ had both GU and DU, 88 patients $(38.9\%)$ had both GU and GERD, and 14 patients $(6.2\%)$ had both DU and GERD. During this study period no one was treated for Zollinger-Ellison Syndrome. The disease showed higher occurrence in male population (139 patients, $61.5\%$) and among the ages of 30 and 40 $(62.4\%)$. The average age of these patients was 41.3 years and there was no difference between the genders. $81.4\%$ of these patients underwent CLO test to check for the existence of Helicobacter and $66.3\%$ of these Patients showed the positive response. $65.6\%$ of patients with GU and $80\%$ of patients with DU showed the positive response and there was no difference between the genders $(65.4\%\;vs.\;67.6\%)$. 184 patients $(81.4\%)$ were deemed to be cured based on the disappearance of their symptoms after completing the regimens. Compliance rate did not differ for gender or different diseases, while showing a difference in age. Patients between the ages of 20 to 30 years old showed the worst compliance rate. In addition, the compliance was lower among the patients who had previous occurrence of the disease, and this was more evident among female patients. Although 184 patients out of the total 226 patients were deemed to be cured, 36 patients $(20.65\%)$ of these returned to the hospital for relapsed diseases within one year. The factors that affected for patients to relapse were the diseases accompanied by ulcer and social environments, such as smoking, alcohol consumption, and previous history of the diseases (smoking P<0.001, alcohol consumption P<0.02, previous history of disease P<0.05). The regimen using $H_2$ receptor antagonists+tripotassium dicitrato bismuthate+clarithromycin showed the lower rate of relapse, and the regimens of omeprazole (OMP)+amoxicillin+tripotassium dicitrato bismuthate and OMP+amoxicillin+metronidazole showed better compliance rate. Patient education by pharmacists on the importance of compliance to regimens and the risk factors fer relapse can provide a better patient care. This would ultimately result in more cost-effective treatments by preventing additional cost for treating relapsed symptoms in approximately $20\%$ of patients.

• 대한치과교정학회지
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• 제14권1호
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• pp.173-183
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• 1984

The author has observed the effects of collagenase on the relapse phenomenon and the histochemical changes during the relapse period. 50 rats were used. : 3rats as a normal group, 15rats as control groups, and 32rats as experimental groups. Rat's teeth were moved for 10days with helical spring applied, followed by injection of "collagenase in Hank's sol." to the experimental groups and the "Hank's sol." to the control group in the interdental gingiva on the 10th day, and the spring was removed on the 11th day. After injection, the experimental animals were sacrificed on the 11th, 13th, 15th, 17th, 20th, and 24th day and prepared histochemically for the Hematoxylin-Eosin, Van-Gieson, and Methyl Green-pyronin staining. The results are as follows: 1. Group I (11th day): In the control group the supracrestal fibers were stretched and the metabolic rate was high. Experimental group showed that supracrestal fibers were resor, bed, disarrayed, and the metabolic rate was low. 2. Group II (13th day): In the control group, the supracrestal fibers began to change from the vertical direction to tooth-axis to the parallel. Experimental group showed that supracrestal fibers were completely resorbed. 3. Group IV (17th day): The control group showed almost normal structure. Form this group the metabolic rates were low. Experimental group showed the most destructive pattern. 4. Group VI (24th day): Experimental group showed almost normal structure. It follows that experimental groups were relapsed less than the control groups, and collagenase was effective in the prevention of relapse after rat's experimental tooth movement.

• Journal of Preventive Medicine and Public Health
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• 제42권1호
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• pp.42-48
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• 2009

Objectives : This study was conducted to examine the factors implicated when people start smoking again after a 6 month cessation, and was carried out at the smoking cessation clinic of a public health center. Methods : The study subjects were 191 males who had attended the smoking cessation clinic of a public health center for 6 months in an attempt to quit smoking. Data was collected, by phone interview, regarding individual smoking habits, if any, over the 6 month study period. The factors which may have caused an individual to smoke again were examined. This study employed a health belief model as it theoretical basis. Results : Following a 6 month cessation, 24.1% of the study group began to smoke again during the 6 month test period. In a simple analysis, the factors related to individuals relapsing and smoking again included barriers of stress reduction, body weight gain and induction of smoking by surroundings among perceived barriers factor of our health belief model(p<0.05). In multiple logistic regression analysis for relapsed smoking, significant factors included barriers of stress reduction and induction of smoking by surroundings(p<0.05). The most important reason of for an individual to relapse into smoking was stress(60.9%) and the most likely place for a relapse to occur was a drinking establishment(39.1%). Conclusions : Our results indicate that both regular consultations and a follow-up management program are important considerations in a public health center program geared towards maintaining smoking cessation.

• Tuberculosis and Respiratory Diseases
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• 제85권3호
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• pp.227-236
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• 2022

Background: The use of low-dose inhaled corticosteroid-formoterol as reliever monotherapy has recently been recommended in the asthma treatment guidelines. However, the efficacy of this treatment strategy has not yet been determined during the stepping-down period in moderate asthma. This study aimed to evaluate the feasibility of reducing treatment to as-needed budesonide-formoterol (BFM) in moderate asthma with complete remission. Methods: We randomly assigned 31 patients (8 males and 23 females with a mean age of 57.2 years) with complete remission of asthma by inhaled BFM (160/4.5 ㎍) twice daily to receive BFM (160/4.5 ㎍) as needed (16 patients), or budesonide (BUD) (200 ㎍) twice daily (15 patients). The study was an open-label study done for 48 weeks, with the primary outcome as the cumulative percentages of patients with treatment failure (asthma exacerbation or loss of asthma control or lack of satisfaction after using medications) in the two groups. Results: Six patients (42%) using as-needed BFM had treatment failure, as compared with three patients (21.4%) using BUD maintenance (hazards ratio for as-needed BFM, 1.77; 95% confidential interval, 0.44-7.12; p=0.41). The changes in forced expiratory volume in 1 second were -211.3 mL with as-needed BFM versus -97.8 mL with BUD maintenance (difference, 113.5 mL; p=0.75) and the change in fractional exhaled nitric oxide was significantly higher in both groups, at 8.68 parts per billion (ppb) in the as-needed BFM group and 2.5 ppb. in the BUD maintenance group (difference, 6.18 ppb; p=0.049). Conclusion: Compared with BUD maintenance, there were no significant differences in treatment failure rate in patients who received as-needed BFM during the stepping down period in moderate asthma. However, they showed reduced lung function and relapsed airway inflammation. The results are limited by imprecision, and further large RCTs are needed.

• 한국임상약학회지
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• 제25권3호
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• pp.166-170
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• 2015

Background: Primary warm autoimmune hemolytic anemia (AIHA) is a relatively rare hematologic disorder resulting from autoantibody production against red blood cells. There has been very few studies about primary warm AIHA in South Korea because of its low incidence. We retrospectively analyzed the treatment outcome of primary warm AIHA. Method: We reviewed retrospectively the medical records of 9 primary warm AIHA patients from December 2002 to January 2015. We analyzed the causes and clinical characteristics of primary warm AIHA patients. We retrospectively analyzed the clinical data in electronic medical records for 9 Korean patients with AIHA patients who were diagnosed during the period from December 2002 to January 2015 at the Regional University Hospital in Korea. The study protocol was approved by the Institutional Review Board (IRB #2015-08-007, Chosun University Hospital IRB). Results: The mean age was 52 years (range 27~78), the mean hemoglobin level was 5.0 g/dL (range 2.5~6.4 g/dL). All patients received steroids at therapeutic dosages (corticosteroid 1 mg/Kg) as first line treatment. Eight of them showed complete response (5/8, 62.5%) and partial response (3/8, 37.5%), one patient required second-line treatment with rituximab. Two patients who responded first line treatment were relapsed at 86 weeks and 24 weeks after response, respectively. Only one patient of them was retreated with corticosteroid because of anemic symptoms. Conclusion: This study indicates that oral corticosteroid is an effective therapy for primary warm AIHA.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.329-332
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• 2011

Purpose: In developed countries, vesicovaginal fistula occur from various pelvic operations including total hysterectomy, leading to urinary leakage and incontinence. Although various methods have been proposed for adequate tissue coverage in fistula repair, the surgical treatment of is not simple and still controversial. We report a case of neobladder-vaginal fistula repair using modified Martius fat pad flap. Methods: A 62-year-old female patient underwent radical cystectomy with total abdominal hysterectomy and neobladder formation due to invasive bladder tumor 5 years ago. For 3 years following the operation, urine leakage was observed. Exploration demonstrated neobladder-vaginal fistula and primary repair including fistulectomy and direct closure was performed. Urinary incontinence relapsed 2 years after primary repair, and after demonstrating the recurrence of fistula on urography, repair of recurrent fistula was performed. After dissection of vagina and neobladder and closure of fistula by urologic surgeon, fibroadipose flap was elevated, rotated and advanced through the tunnel at vaginal sidewall, and interpositioned to the fistula site between neobladder and vagina. Results: There was no acute complication after the surgery and urethral catheter was extracted on the 8th day after the operation. During six month follow-up period after the operation, there is no clinical evidence of fistula recurrence. Conclusion: From our clinical experience and literature review, we think Martius fat pad flap is a useful technique in management of neobladder-vaginal fistula, for it provides enough vascularity, major epithelization surface and better lymphatic drainage, and also prevents overlapping of vesical, vaginal suture lines at the same time.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권1호
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• pp.25-34
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• 1997

This study was made with lateral cephalometric radiography of 28 skeletal class III malocclusion patients that were performed to setback surgery of mandible. The 28 patients were selected by four standards as follows. 1) Set-back amount of mandible is below 10 mm 2) No extrusion and intrusion of posterior tooth or alteration of interincisial angle at period of postoperative orthodontic treatment. 3) Change of mesial segment location of mandible on lateral cephalometrics 4) No genioplasty And 28 patients were divided to three group(1,2,3 group) by degree of preoperative occlusal plane angle to Burstone's horizontal plane. The preoperative occlusal plane angle, which of 1 group was smaller than $7^{\circ}$ and 2 group was between $7^{\circ}$ to $15^{\circ}$ and 3 group was larger than $15^{\circ}$. The results were as follows : 1. As the preoperative occlusal plane angle was larger, the degree of mandibular prognathism was not severe. 2. On comparsion of preoperative and immediate postoperative cephalometric analysis, specific relationship of occlusal plane angle and set-back amount of mandible was not present. 3. As the preoperative occlusal plane angle was smaller, the alteration of postoperative occlusal plane angle was increased tendency. As the preoperative occlusal plane angle was larger, the alteration of postoperative occlusal plane angle was decreased tendency. 4. The relapsed degree of B point distance to Vertical plane was not relationship to the degree of preoperative occlusal plane angle.