• Title/Summary/Keyword: additional therapy

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The Considerations of Stroke in Oidaibiyo(外臺秘要) (${\ll}$외대비요(外臺秘要)${\gg}$의 중풍(中風)에 관(關)한 고찰(考察))

  • Cho, Gyu-Seon;Kyun, Jung-Nam;Shin, Gil-Jo;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.18 no.2
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    • pp.112-130
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    • 1997
  • This study has been carried out to investigate the cause, pathological mechanism and treatment of stroke in Oidaibiyo(外臺秘要), written by Wangdo(王燾). The results were follows : 1. Oidaibiyo(外臺秘要), which is written by Wangdo gives an account of the symptomatic degree of intensity and diachronic procedure in the chapter of stroke. 2. The cause of stroke is quoted mainly from External Wind(外來風邪), and the hyper-sexual intercourse, hyperalimentation, hyper -consciousness, excessive lavour and so forth as additional. And personal character and external effect, like the climate conditions are also much affected the outbreak of stroke. 3 With respect to the diagnosis of stroke, pulse means here quoted from its conception in Chungumyobang(千金要方) Jebungwonhuron(諸病源候論), and pulse plays an important role in diagnosis of stroke. 4. The treatment for stroke generally attaches much importance to medicine therapy. The concrete cure, BalhanGeopungbub(發汗祛風法) has been mainly available, and the usage of Cheongyulyak(淸熱樂) has been increased, contray to formal.

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Alk3/Alk3b and Smad5 Mediate BMP Signaling during Lymphatic Development in Zebrafish

  • Kim, Jun-Dae;Kim, Jongmin
    • Molecules and Cells
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    • v.37 no.3
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    • pp.270-274
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    • 2014
  • Lymphatic vessels are essential to regulate interstitial fluid homeostasis and diverse immune responses. A number of crucial factors, such as VEGFC, SOX18, PROX1, FOX2C, and GJC2, have been implicated in differentiation and/or maintenance of lymphatic endothelial cells (LECs). In humans, dysregulation of these genes is known to cause lymphedema, a debilitating condition which adversely impacts the quality of life of affected individuals. However, there are no currently available pharmacological treatments for lymphedema, necessitating identification of additional factors modulating lymphatic development and function which can be targeted for therapy. In this report, we investigate the function of genes associated with Bone Morphogenetic Protein (BMP) signaling in lymphatic development using zebrafish embryos. The knock-down of BMP type II receptors, Bmpr2a and Bmpr2b, and type I receptors, Alk3 and Alk3b, as well as SMAD5, an essential cellular mediator of BMP signaling, led to distinct lymphatic defects in developing zebrafish. Therefore, it appears that each constituent of the BMP signaling pathway may have a unique function during lymphatic development. Taken together, our data demonstrate that BMP signaling is essential for normal lymphatic vessel development in zebrafish.

A Case of Malignant Peripheral Nerve Sheath Tumor with Neurofibromatosis Type 1

  • Choi, Sang Kyu;Kim, Cheol Keun;Kim, Soon Heum;Jo, Dong In
    • Archives of Reconstructive Microsurgery
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    • v.26 no.1
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    • pp.23-25
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    • 2017
  • The malignant peripheral nerve sheath tumor (MPNST) originates from neurofibromatosis type 1 (NF1). Because NF1 patients have many accompaniments with growth of additional masses, they usually overlook potential malignant changes in their masses. Our patient had two growing mass near the left elbow for several months; however, she ignored these masses until 7 days prior to writing this article, at which time they began bleeding. Traditionally, sarcoma including MPNST treatment consisted of amputation of the involved extremity. However, treatment now consists of surgical resection with adjuvant therapy. Therefore, we conducted resection of the mass and subsequent coverage with a local advancement flap. We believe that the most effective treatment for MPNST is early diagnosis and fast surgery, coupled with notification that there is always potential for malignant change in NF1 patient's masses.

Clinical Review of Total Thyroidectomy (갑상선 전절제술의 임상분석)

  • Kno Yoon-Hoi;Kim Cheong-Hoon;Ahn Byung-Kweon;Kim Joong-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.45-50
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    • 1997
  • Total thyroidectomy has been advocated as the treatment of choice for most well differentiated thyroid carcinomas. Many surgeons have an aversion to total thyroidectomy, however, because of an allegedly high frequency of complications as compared with those resulting from other operation methods. In this report we reviewed our experience with 37 consecutive total thyroidectomy(January 1995 to December 1996). The clinical features are similar to other studies. The sex ratio is 1 : 3.1(M : F), third decade occupies 33% of cases. The anterior neck mass is the most frequent symptom(95%). In the duration of symptom, 35% of patients was within 3 months. Thirty five cases are cancer, and two cases are Hashimoto's thyroditis. The papillary carcinoma is the most common pathologic type(86%). Total thyroidectomy was done in 20 cases, and total thyroidectomy with modified neck dissection was done in 17 cases. The five postoperative complications occurred in 3 patients among 37 patients: postoperative bleeding in 1, transient hoarseness in 2, transient hypoparathyroidism in 2. Thirty four cases received $I^{131}$ scan and therapy, two cases received thyroid hormone replacement, and one case received chemotherapy. We think that total thyroidectomy can be done without additional risk compared with other thyroid operation methods, with meticulous and careful surgical technique.

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Six-year Experience of Endovascular Embolization for Intracranial Aneurysms

  • Jung, Yeun-Ho;Park, Seong-Hyun;Kim, Yong-Sun;Hamm, In-Suk
    • Journal of Korean Neurosurgical Society
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    • v.38 no.3
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    • pp.190-195
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    • 2005
  • Objective : This study is performed to evaluate the procedural complications, aneurysm occlusion rate, and mid-term outcome of endovascular treatments in intracranial aneurysms. Methods : We retrospectively investigated 135 patients with 161 cerebral aneurysms who were treated by endovascular means at our institute from March 1999 to December 2004. We statistically analyzed overall outcome, occlusion rate, and occurrence of complications according to the location, size, rupture history, and neck size of aneurysms. Results : Forty-nine patients [36.3%] had experienced acute intracranial or extracranial complications related to the procedure. Among these, there were 13cases of perforation of the aneurysm, 9 of local vasospasm, 8 of thromboembolism, 4 of coil migration, 3 of occlusion of parent vessels due to coil protrusion, and 1 of seizure. Extracranial complications occurred in 14cases including alopecia [9cases], femoral artery thrombosis [2cases], acute renal failure [2cases], and hypovolemic shock [1case]. One hundred twenty-six aneurysms [78.3%] had complete occlusion of the aneurysm and 35 [21.7%] incomplete occlusion at 6months angiographic follow-up. Postembolization clinical follow-up ranged from 1 to 60months [mean, 14.2months]. Seven of the 161 aneurysms underwent additional embolization and 2 incomplete embolized aneurysms required subsequent surgery. Conclusion : The procedural complications and incomplete occlusion rates are substantial. Therefore, endovascular treatment needs close and continued neurosurgical and neuroradiological concerns for the therapy of intracranial aneurysms.

Coexistence of Radiation-induced Meningiomas and Shunt Related Pneumocephalus in a Patient with Successfully Treated Medulloblastoma

  • Kim, Young-Hoon;Kim, Chae-Yong
    • Journal of Korean Neurosurgical Society
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    • v.41 no.6
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    • pp.403-407
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    • 2007
  • The authors encountered a case of simultaneous radiation-induced multiple meningiomas and ventriculoperitoneal [VP] shunt-related pneumocephalus. A 35-year-old man, who had undergone surgery for medulloblastoma 21 years previously and subsequently received high dose craniospinal irradiation with adjuvant chemotherapy and later underwent a VP shunt because of hydrocephalus, presented with a severe headache and weakness of both lower extremities. Computed tomography showed an air pocket lesion in the left temporal lobe and a large amount of pneumocephalus with a bony defect of the left tegmen tympani. In addition, a 3 cm sized well enhancing mass was noted in the in the right middle cranial fossa and additional small enhancing nodule in the left frontal pole. He was treated by left temporal craniotomy and repair of the bony and dural defects of the left tegmentum tympanum through extradural and intradural approaches, respectively. Afterwards, he underwent right temporal craniotomy and gross total removal of a rapidly growing right middle fossa mass and a left frontal mass. The histological examination was consistent with atypical meningioma, WHO grade II. In conclusion, physicians have to consider the serious long term complications of high dose radiation therapy and VP shunt placement and need to perform the neuroradiologic follow-up after such treatments for several decades.

Starting Current Application for Magnetic Stimulation

  • Choi, Sun-Seob;Bo, Gak-Hwang;Kim, Whi-Young
    • Journal of Magnetics
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    • v.16 no.1
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    • pp.51-57
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    • 2011
  • A power supply for magnetic-stimulation devices was designed via a control algorithm that involved a start current application based on a resonant converter. In this study, a new power supply for magnetic-stimulation devices was designed by controlling the pulse repetition frequency and pulse width. The power density could be controlled using the start-current-compensation and ZCS (zero-current switching) resonant converter. The results revealed a high-repetition-frequency, high-power magnetic-stimulation device. It was found that the stimulation coil current pulse width and that pulse repetition frequency could be controlled within the range of 200-450 ${\mu}S$ and 200-900 pps, respectively. The magnetic-stimulation device in this study consisted of a stimulation coil device and a power supply system. The maximum power of the stimulation coil from one discharge was 130 W, which was increased to 260 W using an additional reciprocating discharge. The output voltage was kept stable in a sinusoidal waveform regardless of the load fluctuations by forming voltage and current control using a deadbeat controller without increasing the current rating at the starting time. This paper describes this magnetic-stimulation device to which the start current was applied.

Total Ankylosis by Heterotopic Ossification in an Adolescent Anterior Trans-olecranon Fracture Dislocation: A Case Report

  • Kim, Beom-Soo;Song, Kwang-Soon;Bae, Ki-Cheor;Lee, Si-Wook;Um, Sang-Hyun;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.154-158
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    • 2019
  • The incidence of heterotopic ossification in adolescents appears to be lower than in adults. There exist very few reports of heterotopic ossification with total bony ankylosis in child or adolescent populations. We describe a case of total bony ankylosis of the elbow secondary to heterotopic ossification, in a 14-year-old female. Total ankylosis of the elbow at 45 degrees of flexion was noted 6 months postsurgery, and complete surgical excision of the heterotopic mass was performed. After an additional one-time dose of radiation therapy and nonsteroidal anti-inflammatory drug medication, full range of motion was obtained without any recurrence or other complications, up to the last follow-up of 30 months.

Pharmacotherapy for dementia (치매의 약물요법)

  • Youn, HyunChul;Jeong, Hyun-Ghang
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.758-764
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    • 2018
  • Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors-donepezil, rivastigmine, galantamine-and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.

Successful engraftment after infusion of multiple low doses of CD34+ cells from a poorly matched sibling donor in a patient with severe aplastic anemia

  • Kum, Chang Dae;Lee, Mi Jin;Park, Jun Eun
    • Journal of Yeungnam Medical Science
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    • v.36 no.2
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    • pp.148-151
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    • 2019
  • The dose of CD34+ cells is known to influence the outcome of allogeneic peripheral blood stem cell (PBSC) and/or T-cell-depleted transplantation. A previous study proposed that $2{\times}10^6\;CD34+\;cells/kg$ is the ideal minimum dose for allogeneic transplantation, although lower doses did not preclude successful therapy. In the case we present here, CD34+ cells were collected from a matched sibling donor on the day of allogeneic hematopoietic stem cell transplantation; however, the number of cells was not sufficient for transplantation. Consequently, PBSCs were collected three additional times and were infused along with cord blood cells from the donor that were cryopreserved at birth. The cumulative dose of total nuclear cells and CD34+ cells was $15.9{\times}10^8\;cells/kg$ and $0.95{\times}10^6\;cells/kg$, respectively. White blood cells from this patient were engrafted on day 12. In summary, we report successful engraftment after infusion of multiple low doses of CD34+ cells in a patient with severe aplastic anemia.