• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.2
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• pp.126-130
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• 2007

Metformin is antihyperglycemic, not hypoglycemic. It causes neither insulin release from the pancreas nor hypo glycemia, even when taken in large doses. But, there are several reports of metformin-associated lactic acidosis (MALT). We present a case report of severe lactic acidosis most probably resulting from high doses of metformin in a patient with no known contraindications for metformin. A 43-year-old female was admitted to the emergency department due to a metformin overdose. She had diabetes for 6 years, well-controlled with metformin and novolet. One hour before admission, she impulsively took 50g metformin (100 mg or 100 tablets). Physical examination for symptoms revealed only irritability, and laboratory evaluation revealed only mild leukocytosis. After one hour the patient was drowsy, and arterial blood gas analysis showed severe lactic acidemia Seven hours after ED arrival, she commenced hemofiltration treatment and was admitted to the intensive care unit. Continuous venovenous hemodiafiltration was initiated. Forty-eight hours later, full clinical recovery was observed, with return to a normal serum lactate level. The patient was discharged from the intensive care unit on the third day. A progressive recovery was observed and she was discharged from the general word on the thirteenth day.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.1
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• pp.1-8
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• 2013

Gastric lavage is one of gastrointestinal decontamination methods which have been controversial in the clinical toxicology field for a long time. Expert groups of American and European clinical toxicologists have published the position papers regarding gastric lavage three times since 1997. They recommended that gastric lavage should not be used as a routine procedure in the management of acute intoxication, because they thought that there is no certain evidence of improving clinical outcome by its use. However, the studies they reviewed were not well-controlled randomized trials, which cannot be conducted in the clinical toxicology field due to variability of patients and ethical problems. Therefore, the results from these studies should be interpreted with caution. They also insisted that gastric lavage can be undertaken within 60 minutes of ingestion. The limitation of one hour after ingestion is too arbitrary and may cause a lot of misunderstanding. Formation of pharmacobezoar or gastric hypomotility after ingestion may significantly delay the gastric emptying time so that gastric lavage can be useful even after several hours or more in case of highly toxic substances or severe intoxication. Furthermore, as there are a number of serious intoxication by toxic pesticides with large amount in suicidal attempts in Korea, it seems that gastric lavage may be used more frequently in Korea than in Western countries. When deciding whether or not to use gastric lavage, all the indications, contraindications, and possible adverse effects should be taken into account on the basis of risk-benefit analysis. If the procedure is decided to be done, it should only be performed by well-trained experts.

• Herbal Formula Science
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• v.23 no.2
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• pp.209-224
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• 2015

Objective : The main purpose of this study is to find a reasonable solutions for utilization of herbal formulas based on the medical classics. Methods : We used official Ten 'Selected Korean Medical Classics(SKMC)'. For input of formulas from SKMC, we had to select proper editions of them. After consultations with experts of 'The Korean Medicine Society for the Herbal Formula Study' and 'Korean Society of Medical History', we chose the proper editions of SKMC, and according to those books, we built formulas database using microsoft office excel sheets, respectively. Results : After whole input procedures, we requested several experts to inspect the results and also, to correct errors in them. Input categories were name of formula, name of classic, classification, original source, composition herb, weight, unit of weight, weight conversion index, converted weight, basic formula, indications, reason for modification, preparing method, taking method and contraindications. Final number of whole formulas in DB was 32,882. Conclusions : We used SKMC and built database using excel program. Through this procedure, we can provide a developmental ways to make a foundation for herbal formulas from the medical classics, so that we can make herbal formulas be standardized or industrialized more efficiently.

• Journal of Chest Surgery
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• v.25 no.7
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• pp.685-692
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• 1992

In spite of multiple technical advances, large amount of homologous blood transfusions usually required for open heart surgery. Because the complications associated with transfusion are increased as the number of homologous transfusion increase, especially as transfusion related acquired immunodeficiency syndrome has appeared in recent years, such risks have stimulated recent interest in the use of autologous blood. This is a report concerning 23 consecutive adult autologous donors[autologous group] who had elective cardiac surgery at the Yonsei Cardiovascular Center, Yonsei University College of Medicine, from march, 1990 to august, 1991. A similar group of 23 patients operated during the same periods without autologous blood donation was used for comparison [control group] to investigate the effect of predonated autologous blood in decreasing the need of homologous transfusion and to investigate predonation related adverse effect. Autologous group consisted of 15 men and 8 women. Control group consisted of 7 men and 16 women. There were no significant differences in mean age, hemoglobin, hematocrit, RBC count, platelet count and prothrombin time on admission between the two groups. The mean autologous blood donation in autologous group was 2.2 units. In 10[43.5%] of the 23 atuologous group patients, no homologous RBC products transfusion was required. However, all patients required homologous transfusion in control group. In autologous group, patients required less homologous RBC products than control patients[2.1 units versus 5.3 units; p<0.001]. There were no significant differences in hemoglobin, hematocrit, RBC count and platelet count between the two groups before discharge. There were no serious complications related to preoperative blood donation, although 3 patients complained of mild dizziness during donation We conclude that preoperative autologous predonation of blood is a safe and effective method for reducing homologous transfusion and is recomended in all patients undergoing elective cardiac surgery except limited contraindications such as severe aortic valve stenosis or unstable angina pectoris.

• Journal of Sasang Constitutional Medicine
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• v.33 no.3
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• pp.29-53
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• 2021

Objective The purpose of this review was to investigate exercise therapy by sasang constitution and to offer information for further research. Method The literature was investigated from KMBASE, KISS, ScienceON, JSCM, DBpia, Pubmed. The searching term were sasang, sasang constituion, sasang type, taeyangin, taeeumin, soyangin, soeumin, exercise, physical therapy, physical activity, and so on. Studies were extracted and analyzed exercise by sasang constitution, in addition, were also collected physiological differences related to sasang constitution, exercise ability, exercise response and effects, and exercise contraindications. Result & Conclusion It is helpful for Taeyangin to lower the energy through exercises that train the lower body and deep breathing, and there is no need to exercise excessively. Taeeumin tend to be obese compared to other constitutions. In order to be physically healthy, it is good to sweat a lot through regular exercise. It is good to do aerobic exercise that burns a lot of calories every day. Soyangin has a weak lower body, so it is good to exercise to reinforce the lower body. Soyangin has weak stamina, and since static exercise easily loses interest, it is helpful to do exciting exercise, and it can be performed at normal intensity. Soeumin are statistically less physically active. So soeumin need to improve exercise habits, but because physical strength is on the weak side, it is more appropriate to do an exercise that activates the body parts evenly rather than a strong one.

• Annals of Coloproctology
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• v.34 no.6
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• pp.306-311
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• 2018

Purpose: Hartmann operation is widely recognized as a useful procedure, especially in emergencies involving the rectosigmoid colon. One of the surgeon's foremost concerns after Hartmann operation is future colostomy reversal, as colostomy reversal after a Hartmann procedure is associated with relatively high morbidity and mortality. Laparoscopic surgical techniques continue to prove useful for an ever-increasing variety of indications. We analyzed the outcomes of laparoscopic Hartmann colostomy reversals at our center. Methods: We retrospectively analyzed the hospital records of 170 patients who had undergone Hartmann operation between January 2010 and June 2017 at Wonkwang University Hospital. Among 68 Hartmann colostomy reversals, we evaluated and compared the outcomes of 3 groups of patients: 29 patients in the open colostomy reversal group (OG) who had undergone laparotomies for Hartmann reversals, 19 patients in the conversion group (CG) whose laparoscopic procedures had required conversion to a laparotomy, and 20 patients in the laparoscopy group (LG). Results: The overall reversal rate for Hartmann colostomies was 40.5% during this time period. The duration of hospital stay was significantly shorter among LG patients ($10.15{\pm}2.94days$) than among OG patients ($16{\pm}9.5days$). The overall complication rate among OG patients was higher than that among LG patients (adjusted odds ratio, 8.78; P = 0.01). The most common complication was postoperative ileus (19.1%). Conclusion: If no contraindications to laparoscopy exist, surgeons should favor a laparoscopic reversal of Hartmann operation over an open reversal.

• The Journal of Internal Korean Medicine
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• v.42 no.3
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• pp.403-411
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• 2021

Background: This case report shows the effect of Hyulbuchuko-tang on a patient with a contraindication to anticoagulants who complained about dyspnea caused by pulmonary embolism (PE). Case report: A PE patient with dyspnea was treated with herbal medication, Hyulbuchuko-tang, for 28 days. Evaluations took place by assessing time for oxygen application time per day, follow-up chest CT, and D-dimer test results. Oxygen application time per day decreased, and oxygen therapy ended on the 14th day of Hyulbuchuko-tang treatment. Follow-up chest CT showed resolution of PE. The D-dimer level decreased on the 24th day and decreased more after 1 month later. Conclusion: This clinical case study suggests that Hyulbuchuko-tang might be effective in the resolution of PE and can be an option as a treatment for PE patients with contraindications to anticoagulants.

• Archives of Plastic Surgery
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• v.50 no.4
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• pp.361-369
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• 2023

The latissimus dorsi (LD) flap is a reliable option for breast reconstruction. This is particularly true in patients with contraindications to abdominally based autologous breast reconstruction. A systematic review of patient satisfaction and health related quality of life following LD breast reconstruction using the BREAST-Q survey was conducted. The scope of the review was to determine the degree of patient satisfaction following the procedure and to examine how patient satisfaction from the pedicled LD flap compares to other breast reconstructive procedures. A literature search on BREAST-Q in LD flap reconstruction was performed. Only articles written in English and in published peer-reviewed journals were included. Studies with less than 20 patients in their sample and those with a follow-up period of less than 1 year were excluded. Five articles representing 331 patients were reviewed, including one case-control study and four retrospective cohort studies. Level of evidence was either III (4) or IV (1). The average age was 53 with average body mass index of 25. Most reconstructions were delayed (67%) and unilateral (88%), and most patients required radiation (79%). The average length of follow-up was 36 months, and the response rate was 75%. Overall, patients who underwent LD flap reconstruction reported favorable outcomes in satisfaction domains and quality of life domains with few complications. A meta-analysis also demonstrated higher satisfaction in LD flap without implants compared with LD flap with implants. Patient-reported outcomes following LD breast reconstruction compare favorably with other techniques of breast reconstruction.

• Journal of Sasang Constitutional Medicine
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• v.13 no.3
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• pp.145-150
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• 2001

Aconitine has much Heat and Toxicity in its property, so many consideration is needed during its use. And there are many contraindications of its use. In the book of Dongyisusebowon, it has to be used when Soeumin has extreme Cold accompanied by Heat of deficiency type. In this case report, a 84 year-old male patient who had taken drugs containing Aconitine had severe Yin-Deficiency-Midday-Fever(陰虛午熱). And he had been treated with Sukjiwhanggosamtang(熟地黃苦參湯) and Dokwhaljiwhangtang(獨活地黃湯). Four conclusions can be made through this case. 1. Soyangin(少陽人) patients may have many side effects or adverse effects when they take drugs containing Aconitine even at a little volume. 2. Soyangin may have chest discomfort when they are constipated. This patient also complained chest discomfort after stroke and toxicosis of Aconitine. 3. Between Sukjiwhanggosamtang(熟地黃苦參湯) and Dokwhaljiwhangtang(獨活地黃湯), Sukjiwhanghosamtang is more effective for this patient who has been skin psoriasis and lower diabetes(下消) for a long time. 4. Although Sukjiwhanghosamtang does not include any antidote drug of Aconitine, it may be used only when defferenciation of symdrome is proper on Sasang Constituional Medicine.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.500-511
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• 2021

The prevalence of lower extremity disease is increasing with age. With recent technological advancements, endovascular treatment is being performed more frequently. The treatment goal of intermittent claudication is to improve walking and reduce claudication. To achieve these goals, anatomical durability and patency are important. In patients with critical limb ischemia, the lesions are diffuse and particularly severe in below-the-knee arteries. The treatment goal of critical limb ischemia is to promote wound healing and to prevent major amputation, which is evaluated by the limb salvage rate. Primary stenting using covered or bare metal stents is a widely accepted endovascular treatment. While drug-eluting technologies with or without atherectomy are widely used in the treatment of femoropopliteal disease, balloon angioplasty is the mainstay treatment for below-the-knee intervention. CT angiography provides a road map for planning endovascular treatment in patients without absolute contraindications.