• Journal of Pharmacopuncture
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• v.11 no.1
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• pp.201-209
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• 2008

Objectives : This study was designed to make beneficial proposal for clinical application on some of the most common disorders treated by Oriental medicine by analyzing treatment process and prognosis. Methods : Number of peculiar attributes pertaining to a specific disorder were analyzed and based on those attributes, patterns associated with process and prognosis were interpreted in reference with classical literatures. Results : 1. Factors which can influence the progression and prognosis include time of onset, intensity of symptoms, course of passage, effects of risk factors, condition of the patient's righteous qi(正氣), accuracy of differential diagnosis made by the practitioner, accuracy of treatment methods, and other unexpected external influences. 2. Correlation between the condition of disorders and treatment progression is closely associated with proper treatment procedures and performances. The time of onset and intensity play critical roles in the treatment process and prognosis and showed pattern tendency with mutual interactions. 3. When there is complication of various disorders, it is ideal to give priority to more urgent illness and take care of moderate illness later. If there isn't any correlation between disorders, treat them in the order of acute to chronic disorders. The approach is reversed when disorders are related, treating in the order of most chronic to most acute. 4. In a case of complication of various disorders, depending on the disorder being acute or chronic, intensity, and accuracy of treatments, either a domino effect or gradual fade out of symptoms were witnessed. 5. The concept of "Five Evils Theory" according to Nan Jing(Difficult Classic) is essential in grasping disease progression due to interrelationships between zangfu organs. Conclusions : Predicting of disease process and prognosis for vast array of disorders treated by Oriental medicine is a very difficult task, yet evaluating the disorder's peculiar properties and influential factors resulted in few principles which can be effectively applied into clinical applications.

• Journal of Chest Surgery
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• v.33 no.2
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• pp.139-145
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• 2000

Background: The purpose of this study is to review the clinical course after the correction of noncomplicated ventricular septal defect and to analyze the morbidity and risk factors of postoperative complications and evaluate residual defect during the follow-up period. Material and Method: From September 1994 to June 1998 24 patients(median age 10 months) underwent surgery under the diagnosis of ventricular septal defect. We made a retrospective review of the clinical records including the operation notes critical care unit records echocardiography results and the follow-up records. Result: There was no early mortality nd late mortality. There was no postoperative complete conduction block. Respiratory complication was the most common complication. The body weight age type of ventricular septal defect associated anomalies and operative procedure were not related to the incidence of complications. residual ventricular septal defects aortic valve regurgitation and tricuspid valve regurgitation were insignificant in postoperative hemodynamics, Conclusions: Correction of the noncomplicated ventricular septal defect was done without mortality and complete heart block. Aggressive preoperative medical treatment and early surgical treatment may decrease postoperative complications. Postoperative residual shunt and tricuspid regurgitation were not problematic during the follow-up

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.858-879
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• 2009

Objectives : The object of this study was to investigate the effects of Daeboeum-hwan (DBEH) aqueous extracts on Streptozotocin (STZ)-induced rat diabetes and related complications. Methods : SD rats were divided into 6 groups (n =8) : 50 mM citrate buffer and vehicle (distilled water 5 ml/kg) administered group (Intact control), STZ treatment (60 mg/kg, single intraperitoneally administered) and vehicle administered group (STZ control), STZ treatment and silymarin 100 mg/kg administered group (Reference), and STZ treatment and DBEH extracts 50, 100 and 200 mg/kg administered groups. DBEH extracts were orally administered once a day for 28 days from 3 weeks after STZ treatment. The results were compared with silymarin 100 mg/kg. Results : Decreases in the body weights, increase of kidney and liver weights, blood glucose, BUN, creatinine, AST, ALT, LDL, triglyceride and total cholesterol levels with decreases of HD L levels, increases of pancreatic MDA contents and decreases of GSH contents were detected in STZ control as compared with intact control. These diabetes and related complications were inhibited by treatment with 100 and 200 mg/kg of DBEH extracts. Conclusion : DBEH extracts showed favorable effects on STZ-induced diabetes and related complications mediated by their antioxidant effects as similar to silymarin. Because the lowest dosage (50 mg/kg) of DBEH treated group did not show any favorable effects as compared with STZ control, the effective dosages of DBEH is considered as about 100 mg/kg, while DBEH extracts at 200 mg/kg showed similar effects as compared with 100 mg/kg of silymarin. It, therefore, is expected that DBEH will show favorable effects on diabetes and various diabetic complications.

• The korean journal of orthodontics
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• v.29 no.1 s.72
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• pp.1-22
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• 1999

As people are more concerned about their health and medical care, there have been an increasing number of medical disputes due to increased medical demand. In order to prevent and provide solution to currently surging medical accidents and disputes related to orthodontic treatment, in July 1998, the Korean Association Of Orthdontists surveyed 2,200 members of Korean Association of orthodontists on 30 items to recognize the pattern of medical accidents and prevent them. The survey was about accident-related items including personal profiles of members and patients who have undergone medical accidents or disputes, the cause and solution to the accidents, cautions related to members orthodontic treatment, and medical recording and archival. Based on the survey result, we analyzed characteristics of medical accidents and disputes in orthodontic area. It is more important to predict and prevent possible medical accidents or disputes based on current situation than to solve them after disputes occur. For this, we should not be negligent in raising treatment proficiency level based on patient-doctor trust and in obtaining new medical information. We should also provide medical environment where Patients themselves can decide whether to get treatment after they are offered detailed explanation on diagnosis, treatment procedure, complication, and possible hazard. We should take caution when treating patients and pay attention to charting and maintenance, which is the most fundamental, as well. Also at the Korean Association of orthodontists level, it is desired to provide education program on prevention and solution to medical accidents and disputes, and actions and organizations that can help when accidents and disputes occur.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.61-69
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• 1998

Objectives: The response rate of the radioactive iodine(RI) therapy with low dose was variable. Only a few studies reported the response and complication rate with high dose. The goal of this study was to access the ablation and complication rate after high dose of RI therapy (more than 100mCi) and to evaluate the factors affect the results. Material and Methods: During a period of 12 years, 225 patients received high dose of RI from 100 to 200mCi depending on the RI uptake in the whole body after total thyroidectomy. 100mCi of RI was given to 123 patients for ablation who showed the uptake only in the thyroid bed. 150mCi was given to another 84 patients for ablation who had uptake confined to the neck. The other 21 patients took more than 200mCi of RI because the whole body scan showed distant metastasis. Among these patients, the ablation and the complication rate was investigated. Results: Elevated level of the serum thyroglobulin(Tg) decreased less than 5ng/ml after RI therapy in all patients except two in the first group. The second group showed reduction of the serum Tg in 93%. Eighteen of the 21 patients in the third group are still alive after RI therapy. There were no fatal complications after high dose RI therapy and most of the complications were minimal and transient. The complication rate was not related with the dose of RI, age, sex, DNA flowcytometry, serum thyroglobulin level and the extent of node dissection. Conclusion: We concluded that RI therapy with high dose was very effective for thyroid ablation after operation and it also showed excellent results with minimal complications for treatment of metastatic lesions.

• Advances in pediatric surgery
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• v.10 no.1
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• pp.9-16
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• 2004

Intestinal duplication is a rare congenital anomaly. The diagnostic approach is difficult because of the differences in its location and clinical presentation. To evaluate the diagnostic as well as the therapeutic approaches in children, the medical records of 20 patients with intestinal duplications which had been operated upon from July 1980 to October 2002 were analyzed, retrospectively. The range of age was from 1 day to 11 years. The variables, such as age, sex, clinical presentation, diagnostic method, localization, anatomic type, treatment, complication, and combined anomalies were analyzed. Most of the cases were presented as incidental finding. The majority of the duplications except hindgut were cystic type. Treatment included segmental intestinal resection, excision of the lesion without intestinal resection, and septotomy. Seventy-five percent of the patients were detected before 1 year of age. The anatomic type of the lesion was closely related with its location. The cases of hindgut were almost always tubular type except 1 case. Clinical presentation was related to age, location, and anatomic type. There were no specific diagnostic methods. Perfect localization and application of appropriate operation are the most important requirements for successful treatment.

• Journal of Chest Surgery
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• v.53 no.4
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• pp.184-190
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• 2020

Radiation therapy (RT) has improved patient outcomes, but treatment-related complication rates remain high. In the conventional 2-dimensional and 3-dimensional conformal RT (3D-CRT) era, there was little room for toxicity reduction because of the need to balance the estimated toxicity to organs at risk (OARs), derived from dose-volume histogram data for organs including the lung, heart, spinal cord, and liver, with the planning target volume (PTV) dose. Intensity-modulated RT (IMRT) is an advanced form of conformal RT that utilizes computer-controlled linear accelerators to deliver precise radiation doses to the PTV. The dosimetric advantages of IMRT enable better sparing of normal tissues and OARs than is possible with 3D-CRT. A major breakthrough in the treatment of esophageal cancer (EC), whether early or locally advanced, is the use of proton beam therapy (PBT). Protons deposit their highest dose of radiation at the tumor, while leaving none behind; the resulting effective dose reduction to healthy tissues and OARs considerably reduces acute and delayed RT-related toxicity. In recent studies, PBT has been found to alleviate severe lymphopenia resulting from combined chemo-radiation, opening up the possibility of reducing immune suppression, which might be associated with a poor prognosis in cases of locally advanced EC.

• Korean Journal of Clinical Laboratory Science
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• v.37 no.2
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• pp.96-101
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• 2005

Status epilepticus is a medical emergency, so that rapid and vigorous treatment is required to prevent neuronal damage and systemic complication. Status epilepticus is generally defined as a continuous or intermittent seizure or an unconscious condition after the onset of seizure, lasting for 30 minutes or more. We report here the outcome of status epilepticus. We retrospectively reviewed medical record of 15 patients who were diagnosed with status epilepticus at the Asan Medical Center from January 2003 to February 2004. This outcome was evaluated considering various factors such as age of patients, history of seizures, neurologic impairment, etiology, mortality, return to baseline and initial electroencephalogram (EEG) findings. The range of age was between 1 to 79 years old and the longest duration of treatment was 118 days. Most patients were treated by using pentobarbital, midazolam, phenobarbital and other antiepileptic drugs. The overall mortality was 5 (33%) out of 15 patients. The mortality was related to etiology, underlying other medical conditions and initial EEG findings. 5 (55%) out of the 9 patients with acute etiology, 5 (71%) out of the 7 patients with a multifocal or burst-suppression EEG activity, and 3 (60%) out of the 5 patients with other medical disease were related to mortality. This data demonstrate high mortality due to status epilepticus. Mortality is related to etiology, other medical conditions and abnormalities on the initial EEG.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.703-709
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• 2006

Since the advent of growth hormone(GH), children with a wide variety of growth disorders have received GH treatment. In GH deficiency(GHD), Turner syndrome, chronic renal failure, children born small for gestational age, Prader-Willi syndrome, and idiopathic short stature, the therapeutic effects and safety profile of GH are reviewed. GH therapy has been clearly shown to improve height velocity and final adult height in a variety of pediatric conditions in which growth is compromised irrespective of GHD. Early initiation and individualization of GH treatment has the potential to normalize childhood growth. The supra-physiological doses of GH have been shown to increase height velocity during childhood and final height in non-GHD conditions. Adverse events during GH therapy are uncommon and often not drug related. However continued surveillance into adult life is crucial, especially in children receiving supra-physiological doses or whose underlying condition increases their risk of adverse effects.

• The Journal of Korean Society for Radiation Therapy
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• v.3 no.1
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• pp.11-18
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• 1989

Brachytherapy is known to be a good modality to achieve local control as a boost treatment following limited external irradiation, which may reduce the external beam related complication particularly in head and neck cancer. The authors developed iridium-192 ribbons recently to replace the radium needles in the field of brachytherapy. Total of 48 cases of head and neck and pelvic-perineal cancer patients had been treated with Ir-192 ribbons during last two years from October 1986 to September 1988, and the results were analyzed to assess the applicability of the fabricated sources. The conclusion is as follows; 1. Iridium implant resulted excellent tumor control effect in clinical application. 2. Iridium is superior than radium and cecium in brachytherapy because of easier to use and lesser exposure to the personnel. 3. Afterloading technique is useful to modify dose distribution, to expand treatment site and method, and to develop interstitial hyperthermia.