• Journal of Korean Neurosurgical Society
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• v.67 no.2
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• pp.237-248
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• 2024

Objective : Postoperative data on Cushing's disease (CD) are equivocal in the literature. These discrepancies may be attributed to different series with different criteria for remission and variable follow-up durations. Additional data from experienced centers may address these discrepancies. In this study, we present the results obtained from 96 endoscopic transsphenoidal surgeries (ETSSs) for CD conducted in a well-experienced center. Methods : Pre- and postoperative data of 96 ETSS in 87 patients with CD were included. All cases were handled by the same neurosurgical team between 2014 and 2022. We obtained data on remission status 3-6 months postoperatively (medium-term) and during the latest follow-up (long-term). Additionally, magnetic resonance imaging (MRI) and pathology results were obtained for each case. Results : The mean follow-up duration was 39.5±3.2 months. Medium and long-term remission rates were 77% and 82%, respectively. When only first-time operations were considered, the medium- and long-term remission rates were 78% and 82%, respectively. The recurrence rate in this series was 2.5%. Patients who showed remission between 3-6 months had higher long-term remission rates than did those without initial remission. Tumors >2 cm and extended tumor invasion of the cavernous sinus (Knosp 4) were associated with lower postoperative remission rates. Conclusion : Adenoma size and the presence/absence of cavernous sinus invasion on preopera-tive MRI may predict long-term postoperative remission. A tumor size of 2 cm may be a supporting criterion for predicting remission in Knosp 4 tumors. Further studies with larger patient populations are necessary to support this finding.

• Journal of Korean Medicine for Obesity Research
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• v.24 no.1
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• pp.94-101
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• 2024

Herbal medicine (HM)-containing Ephedra Sinica (ES) has been associated with false-positive amphetamine immunoassay (FP IA) results. This study retrospectively evaluated the effects of dose, duration, and withdrawal instructions on FP IA and the safety of HM-containing ES at a clinic in Seoul from 2022 to 2023. The study included 6 patients in the FP IA group and 5 patients in the withdrawal instruction negative (Neg) group. The pre-test ephedrine alkaloids dose in the FP IA group was 95.17±31.90 mg, compared with 88.6±20.43 mg in the Neg group. The FP IA group had taken HM for 226.67±152.87 days before testing, and testing was performed while taking HM. In contrast, the Neg group had taken HM for 147.6±23.49 days and had 5.4±1.50 days of withdrawal period before the test following instructions of Korean medicine doctors. All adverse events (AEs) were moderate in severity, and the number of occurrences was similar: 5 in the FP IA group and 7 in the Neg group. AEs included constipation, insomnia (3 cases each), and palpitations (2 cases). The results of this study show that ES-induced FP IA can be resolved with withdrawal instructions and ES can be safely prescribed and administered by Korean medicine doctors. Further studies are needed to determine how to prevent FP IA after taking ES.

• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.46-49
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• 2007

Soft tissue implantation of thyroid tissue is a very rare event. Needle tract implantation of thyroid carcinoma after fine-needle aspiration (FNA) biopsy has been occasionally reported, but implantation of benign thyroid tumor tissue is extremely rare. Rupture of thyroid tissues during surgery or trauma may cause the thyroid tissue to be implanted and result in multiple palpable nodules in soft tissue of the neck. Several reports have shown the possibility of implantation of normal or hyperplastic thyroid tissues in soft tissue. We herein report a case of implantation of adenomatous hyperplastic tissue in the neck along the trochar and previous operation site after endoscopic thyroid surgery, which was successfully treated by complete excision.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.77-81
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• 1997

Background : We studied the effects of lumbar spinal root block (RB) prospectively in 21 patients who had suffered from low back pain with radiating pain even treated epidural steroid injection three times. Method : RB was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we confirmed the needle placement and expected drug spreading by injection of contrast medium ($Isovist^{(R)}$-300, Sobering, Germany). Next 2% mepivacaine 1 ml mixed to 40 mg of Depomedrol was injected. Pain assessment was carried out 7 days after RB by numeric pain score regarding the pain just before RB was 10. Remained pain after RB was graded as excellent; 0-2, good; 3-5, bad; 6-8 and poor 9-10. Results : Mean age of the patients was 52.3 years. 38.1% and 47.6% of the patients showed excellent and goo dresults after RB, respectively. Conclusion : We concluded that RB is easy and safe procedure to perfirm and effective for the treatment of remnant pain following epidural steroid injection, especially in the patients who had spinal stenosis.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.191-194
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• 1999

Background: Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the failed back surgery syndrome (FBSS). We studied to evaluate outcome for 10 patients with failed back surgery syndrome treated with spinal nerve root block using corticosteroids, hyaluronidase, and local anesthetics. Methods: The affected nerve roots are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. A small retrospective pilot group of 10 patients with FBSS was treated. The success rate is evaluated using a visual analogue scale at 1 week and 3 month interval after the last injection. Results: Initially, 7 patients experienced good pain relief; 5 patients suspained pain relief for 3 months. No complications were observed. Conclusions: This technique is worthwhile for patients with FBSS and where epidural fibrosis is suspected to be the pain origin.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.246-249
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• 1999

Postherpetic neuralgia (PHN) is defined as the persistence of pain after recovery from herpes zoster (HZ), when the rash has healed, usually after about 4 weeks. PHN is the most feared complication of herpes zoster and remains one of the most common and intractable chronic pain disorders. Recent evidence has shed some light on the possible mechanism of pain, and on the prophylactic and treatment approaches to PHN, but there is no secure therapy. This report is a case of a 70-year-old male with PHN, affecting the 8th to 10th thoracic dermatomes. Patient complains of allodynia and hyperalgesia on the affected skins. After sympathectomy, antidepressant, anticonvulsant, and capsaicin ointment application, much pain relief was achieved, but allodynia remained at the subcostal area about $7\times3 cm^2$ in size. We decided to remove the painful area. Skin excision was done under local anesthesia. After skin excision, the pain was decreased and patient did not complain of pain for 10 months.

• Women's Health Nursing
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• v.21 no.2
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• pp.115-127
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• 2015

Purpose: The purpose of this study was to explore the experiences of nursing college students who attended delivery practices at midwifery clinic. Methods: This was a qualitative study using focus groups. Data were collected by group interviews with a total of 12 students who observed natural childbirth at midwifery clinic. Data were analyzed through Colaizzi's method in which meaningful statements were extracted. Results: The meanings of experiences were identified five theme clusters from thirteen themes and thirty-one sub-themes. The five theme clusters were 'ultimate process of natural childbirth', 'allowed birth', 'role recognition of the midwife', 'positively changed perception', and 'barriers'. Conclusion: This study showed that observation of delivery at midwifery clinic was helpful for nursing students in terms of positive impression about natural childbirth with maternal and baby being centered. Nursing students expressed value and concern about delivery at midwifery clinic. Further in-depth study of natural childbirth in terms of husband and family perspective is required. For quality improvement of maternity nursing care, natural childbirth process needs to be included in nursing care at hospitals as well as students' clinical practicum.

• 대한상한금궤의학회지
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• v.5 no.1
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• pp.61-73
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• 2013

Objective : The purpose of this report is to submit a case study on a patient of developmental disabilities with ADHD by taking "Sihogayonggolmoryeo-tang". Methods : We gave herbal medicine to a patient and observe the progress as the way of Cornners Abbreviated Rating Scale(CARS), ADHD Rating Scale (K-ARS), The ADD-H Comprehensive Teacher's Rating Scale(ACTeRS), Child Attention Problem(CAP), IOWA Conners Rating Scale, Conners Teacher Rating Scale(CTRS), Conners Parents Rating Scale (CPRS), Home Situation Questionnaire(HSQ), School Situation Questionnaire(SSQ). Results : The total score of CARS, ACTeRS and other scales were decreased by taking herbal medicine, and especially hyperactive scores were significantly decreased. Conclusions : Patient's symptom was significantly improved by using "diagnostic system based on Shanghanlun six meridian patterns and provisions" and analyzing patient's psychological and physical conditions.

• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.242-246
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• 2016

Craniosynostosis is the premature fusion of calvarial sutures, resulting in deformed craniofacial appearance. Hence, for a long time, it has been considered an aesthetic disorder. Fused sutures restrict growth adjacent to the suture, but compensatory skull growth occurs to accommodate the growing brain. The primary goal for the management of this craniofacial deformity has been to release the constricted skull and reform the distorted shape of the skull vault. However, the intellectual and behavioral prognosis of affected children has also been taken into consideration since the beginning of the modern era of surgical management of craniosynostosis. A growing body of literature indicates that extensive surgery, such as the whole-vault cranioplasty approach, would result in better outcomes. In addition, the age at treatment is becoming a major concern for optimal outcome in terms of cosmetic results as well as neurodevelopment. This review will discuss major concerns regarding neurodevelopmental issues and related factors.

• Journal of Oral Medicine and Pain
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• v.22 no.2
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• pp.373-381
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• 1997

The anxiety and depression level of new outpatients wert studied clinically by means of The Hospital Anxiety and Depression Scale(HAD). 64 males and 97 females were subjected at local dental clinic and also 6l male and 91 females were studied at the Dept. of Oral Medicine, PNUH, during period from 1996 to 1997 The obtained results were as follows : 1. Anxiety disorder was 17.76% in the new dental outpatients of university hospital and 13.66% in the local dental Clinic find depression disorder was 7.23% In the University hospital and 3.72% in the local dental clinic. 2. Mean values of depression and anxiety level were within normal range. 3. Anxiety level in female was significantly higher than that in male at the local dental clinic (p<0.05). 4. Anxiety and depression level in university hospital outpatients decreased in order of clerk, housewife and student(p<0.01). 5. The outpatients of university hospital with lower education level showed more anxious and depressed. 6. Anxiety and depression of unmarried group of new outpatients in university hospital was higher than that of married group. Through the above results, proper treatment plans will be demanded In the dental procedure, because psychologic 야sorders as anxiety and depression were included in the 25% of new outpatients of university hospital and 17% at local dental clinic.