• Korean Journal of Radiology
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• v.24 no.3
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• pp.204-223
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• 2023

Currently, various types of transarterial treatments are performed for hepatocellular carcinoma from the early to advanced stages. Its indications and efficacy have been widely investigated. However, procedure-related complications have not been updated in the literature, although new types of transarterial treatments, such as drug-eluting bead transarterial chemoembolization and transarterial radioembolization, are common in daily practice. Herein, a comprehensive literature review was carried out, and complications were organized according to the organs affected and treatment modalities.

• The Journal of the Korean dental association
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• v.49 no.7
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• pp.389-397
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• 2011

Bisphosphonate inhibits the function of osteoclast, so they are widely used for multiple myeloma, Paget's disease, metastatic malignant bone disease, and severe osteoporosis. This drug is very effective for preventing severe complication of osteoporosis, some unpredictable complication occurred such as esophageal malignancy, atypical fracture of femur, and osteonecrosis of the jaw. Bisphosphonate related osteonecrosis of the jaw (BRONJ) is closely related with invasive, open bone surgery like tooth extraction. BRONJ associated with dental implant is rare, however, as the use of bisphosphonate increase, BRONJ cases with dental implant are increasing. In this article, we will describe the considerations during dental implant treatment for patient under bisphosphonate therapy.

• Journal of Korean Neurosurgical Society
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• v.63 no.4
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• pp.415-426
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• 2020

Arteriovenous malformations (AVMs) are congenital anomalies of the cerebrovascular system. AVM harbors 2.2% annual hemorrhage risk in unruptured cases and 4.5% annual hemorrhage risk of previously ruptured cases. Stereotactic radiosurgery (SRS) have been shown excellent treatment outcomes for patients with small- to moderated sized AVM which can be achieved in 80-90% complete obliteration rate with a 2-3 years latency period. The most important factors are associated with obliteration after SRS is the radiation dose to the AVM. In our institutional clinical practice, now 22 Gy (50% isodose line) dose of radiation has been used for treatment of cerebral AVM in single-session radiosurgery. However, dose-volume relationship can be unfavorable for large AVMs when treated in a single-session radiosurgery, resulting high complication rates for effective dose. Thus, various strategies should be considered to treat large AVM. The role of pre-SRS embolization is permanent volume reduction of the nidus and treat high-risk lesion such as AVM-related aneurysm and high-flow arteriovenous shunt. Various staging technique of radiosurgery including volume-staged radiosurgery, hypofractionated radiotherapy and dose-staged radiosurgery are possible option for large AVM. The incidence of post-radiosurgery complication is varied, the incidence rate of radiological post-radiosurgical complication has been reported 30-40% and symptomatic complication rate was reported from 8.1% to 11.8%. In the future, novel therapy which incorporate endovascular treatment using liquid embolic material and new radiosurgical technique such as gene or cytokine-targeted radio-sensitization should be needed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.3
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• pp.130-134
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• 2014

Objectives: The goal of this study was to estimate the overall satisfaction level of dental implant patients and further evaluate factors influencing satisfaction. Materials and Methods: Self-administered questionnaires were mailed to patients who received dental implant therapy at Seoul National University Bundang Hospital (Seongnam, Korea) from October 2003 to April 2005. The main portion of the questionnaire was shared to evaluate the level of satisfaction with implant therapy. The questionnaires contained evaluations of influencing factors, which were classified as pain-related, service-related, and complication-related. Results: The responses from 93 patients (41 males, 52 females) with a total of 325 implants were included in the analysis, and the mean score for overall satisfaction level with implant therapy was 8.26. Female patients showed higher visual analogue scale (VAS) scores for both pain during (P=0.000) and after implant surgery (P=0.016). Male patients showed more 'negative' values for the reasonability of treatment cost (P=0.008) and the adequacy of the treatment period (P=0.022). Conclusion: The subjective satisfaction of patients was influenced by various factors, especially complication-related factors.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.511-517
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• 2019

Background Cleft treatment is frequently performed in Indonesia, mostly in charity missions, but without a postoperative protocol it is difficult to establish the risks and complications of cleft treatment. The present study was designed to give an overview of current cleft lip and palate treatment strategies in Indonesia and to assess the complication rates during and after surgery. Methods This prospective study evaluated anesthetic, intraoperative surgical, and short-term postoperative complications in patients undergoing primary, secondary, or corrective surgery for cleft lip and palate deformities. The population consisted of 98 non-syndromic cleft patients. The main anesthetic complication that occurred during general anesthesia was high blood pressure, whereas the main intraoperative surgical complication was excessive bleeding and the main early postoperative complication was extremely poor wound hygiene. Results In this study, there were no cases of perioperative or postoperative mortality. However, in 23 (23.4%) of the 98 operations performed, at least one perioperative complication related to anesthesia occurred. The intraoperative and early postoperative complications following cleft lip and/or palate were assessed. There was a significant difference in the complication rate between procedure types (χ²=0.02; P<0.05). However, no relationship was found between perioperative complications related to anesthesia and the occurrence of postoperative complications (χ²=1.00; P>0.05). Nonetheless, a significant difference was found between procedure types regarding perioperative complications and the occurrence of postoperative complications (χ²=0.031; P<0.05). Conclusions Further evaluation of these outcomes would help direct patient management toward decreasing the complication rate.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.166-177
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• 1991

Uterine cervical cancer is the most common malignancy in korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications can not be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analized to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that our treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1113-1120
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• 2000

Objectives : Despite advance in the surgical treatment of the intracranial aneurysm, we have to be surgical complication. The aim of this report is to evaluate the complication and its management in intracranial aneurysm operation. Methods : We reviewed our exprience with interesting cases of surgical complication of intracranial aneurysm : 1) rebleeding, 2) intra-operative premature rupture, 3) missed aneurysm in angiography, 4) vasospasm. Results : The risk of rebleeding was not related to the patients' initial comdition, but all other intracranial complications occurred significantly more often in patients graded poor compared with patients in good clinical condition. Rebleeding before early surgery remains as major cause of unfavorable outcome. The causes of intraoperative premature ruptures were as follows : 1) dural opening and arachnoid opening(8.3%), 2) hematoma removal(12.5%), 3) brain retraction(16.7%) 4) aneurysm dissection(62.5%). The double suction technique and primary hemostasis using a small piece of cotton or temporary clip resulted in good outcome even in cases with premature rupture. The incidence of missed aneurysm in angiography occurred in 10%. The causes were as thrombosed aneurysm, vasospasm on feeder artery. The most common missed aneurysm is also the most common aneurysm(anterior communicating artery aneurysm). The repeated angiography were documented in missed aneurysm. Balloon angioplasty is superior topapaverine for treatment of proximal vessel vasospasm by viture of a more sustained effect on the vessel. Papaverine can be useful as an adjunct to ballon angioplasty and also for the treatment of distal vessels that are not accessible for ballon angioplasty. Conclusion : The minimization of the complications and active treatment can reduced the mortality and morbidity of ruptured aneurysm patients.

• Korean Journal of Head & Neck Oncology
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• v.8 no.1
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• pp.14-20
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• 1992

To clarify the safety of both total and near-total thyroidectomy, and to guide a selectionof an adequate type of surgical treatment of thyroid diseases, 192 consecutive total or near-total thyroidectomy cases were reviewed. They were divided into two groups: ont, the total thyroidectomy group(Group T,N=111) and the other, the near-total thyroidectomy group (Group NT, N=81). In both groups, complication rates, associations of complication rates with extents of surgery and stage of lesion were observed. Complication rate was significantly higher in Group T (53.6% vs 12.3%, p<0.05). But the rate of permanent complications such as permanent hypoparathyroidism and recurrent laryngeal nerve injury was remarkably low(4.5% in Group T, 6.0% in Group NT) and shows no significant difference in both groups. There was no permanent complication in cases where any type of neck dissection had not been performed regardless of the type thyroidectomy. But among whom underwent central compartmental neck dissection(CCND) and functional neck dissection(FND), 4(4.4%) and 4(6.4%) cases showed permanent complications. There was no statistical significance in differences between Group I and NT. In cases who underwent concomittant classical radical neck dissection(RND), 3(25.5%) showed permament complications. In this subgroups, complications were significantly higher in Group T(p<0.005). Complications were also directly related to the stage of the lesion. Only one patient showed permanent complication in 74 intracapsular lesions but 9 permanent complications were observed in 118 advanced lesions. We could clarify both total and near-total thyroidectomy were safe operations and the complications were related to accompanying neck dissections and the disease status rather than total or near-total thyroidectomy itself. Thus, we think that for the cases where higher complication rates are expected, such as locally advanced thryoid cancers or the cases which required wider neck dissection, the near-total thyroidectomy would be a preferrable method.

• Health Policy and Management
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• v.4 no.1
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• pp.25-48
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• 1994

Noncompliance with treatment is a serious problem in the management of hypertension. We explored self-reported medication taking compliance behavior of 194 high blood pressure patients using modified health belief model hypothesizing interaction between model components. Data were collected from patients resistered hwachon community hypertension control program during February, 1993. Bivariate analysis showed perceived severity of complication, present symptom experience(p<0.05), perceived severity of hypertension and education leve(p<0.01) were significantly related to treatment experience. Logit analysis revealed that perceived severity of hypertension, perceived benefits of treatment, perceived barriers to treatment and interaction term between perceived severity of hypertension and perceived benefits of treatment contributed treatment experience. Health education from mass media was siglificantly related to continuity of treatment. We also concluded that the inclusion of interaction effects between health belief model components and the use of patient group as analysis unit lead to better study results.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.164-167
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• 2006

Background: There have been an increasing number of reports about infection-related complications after epidural block, and the analysis of these previous reports may offer valuable information for the prevention and treatment of such complications. Methods: We searched for complications about infection that was related to epidural blockade procedures by using the Medline Search program. We analyzed the types of infection-related complications as well as the potential risk factors, the time course from symptom development to treatment, the causative organisms and the treatment outcomes. Results: Seventeen cases were identified. The types of complications were epidural abscess, subdural abscess, spinal arachnoiditis, bacterial meningitis and aseptic meningitis. Five patients received a single block and twelve patients received a continuous block with catheterization. The most common site of epidural catheterization was the lumbar area and eight patients had indwelling catheters for less than fifteen days. Eight patients had a diabetes mellitus as a risk factor and fourteen patients showed less than seven days from the development of symptoms to treatment. Eleven patients received laminectomy and intravenous antibiotics as a treatment and eight patients had full recovery without neurological deficit. Conclusions: Early diagnosis and treatment is essential for the favorable outcome of infection-related complication after epidural block. In addition, absolute sterile technique should always be performed and patient education concerning these potential complications must be accompanied.