• 대한두경부종양학회지
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• 제15권2호
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• pp.189-193
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• 1999

Objectives: Fine needle aspiration cytology(FNAC) is a well established preoperative diagnostic procedure in the thyroid nodules. However, diagnostic accuracy of FNAC varies according to the size and the structural characteristics of thyroid nodule. We performed the ultrasound guided FNAC(US-guided FNAC) for impalpable thyroid nodule, and estimated the sampling accuracy rate through a comparison study between the cytologic diagnosis and the final histologic diagnosis of the postoperative specimens in order to determine clinical efficacy of the US-guided FNAC. Materials and Methods: We evaluated 117 patients underwent US-guided FNAC from January 1997 to December 1998. These patients had 129 thyroid nodules to need cytologic examination. Whereas the nodules were so no graphically classified into cystic, solid, and mixed type according to echo pattern, the aspirated thyroid specimens were classified into benign, malignant, suspicious, and insufficient. Results: Positive sampling for diagnositc examination was achieved in 75 nodules(58.1%), and US-guided FNAC in our study showed the accuracy rate of 95.2%, false positivity rate of 0%, and false negativity rate of 5.5%. Conclusions: US-guided FNAC is a powerful techniques for evaluating cytologic characterics and allowing a reliable diagnositc result in the impalpable thyroid nodule. However, the experienced technique is recommanded in order to obtain the sufficient samples for reliable results.

• Advances in pediatric surgery
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• 제3권1호
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• pp.15-23
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• 1997

During a 6-year period, from January 1990 to December 1995, 101 neonates with congenital anomalies were admitted to the division of Pediatric Surgery of Youngdong Severance Hospital. All of them had prenatal screening more than once with ultrasound. Fifty eight of them had prenatally detectable anomalies by ultrasonography. However abnormalities were prenatally detected in 24 neonates(41%). The detection rate was 70% in patientws who had the prenatal screening at our hospital, whereas, the rate was 24% when it was performed at other medical facilities. Duodenal and jejuno-ileal atresia showed the highest detection rate(86%) followed by abdominal mass. Esophageal atresia was suggested by maternal polyhydramnios in 3 patients (25%). Only one patient with diaphragmatic hernia(1.75%) was prenatally detected and none with gastroschisis. The mean interval from birth to operation was 32 hours in the prenatally detected patients and 50 hours in the non detected. The complication rate and the mortality after emergency operation were 20% and 7% in the detected group, and 58% and 23% in the nondetected, respectively. The average period of the hospitalization was 20 days in the detected group and 39 days in the nondetected. We conclude that the prenatal detection of anomalies is necessary to ensure adequate care for the mothers and the babies with congenital anomalies. This includes early transfer, timing of optimal delivery and operation.

• Korean Journal of Acupuncture
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• 제24권1호
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• pp.27-41
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• 2007

Objectives : The aim of this study was to investigate the antihypertensive effect of Korean Gogoon Acupuncture in hypertensive patients. Methods : We measured the blood pressure of 17 patients who were admitted in the Oriental Medical Clinic of Gogoon Institute from 14th April 2006 to 29th August 2006. Eligible participants had systolic blood pressure ${\geq}120$ mmHg or diastolic blood $pressure{\geq}80$ mmHg. Blood pressure and pulse rate measurements were after the patient had been in bed rest for at least 30 min. Six sessions of Gogoon Acupuncture treatment over three weeks were performed in the patients. Blood pressure and pulse rate were measured twice before and after each acupuncture treatment. Results : After 3 weeks, there were significant decreases in systolic blood pressure(p=0.0028), diastolic blood pressure (p=0.0111) and pulse rate (p=0.0150). The effects of Gogoon Acupuncture by measuring time on blood pressure were as follows : In a systolic blood pressure (p<.0001) and diastolic blood pressure (p=0.0028) was gradually deceased significantly from 1st to 6th but pulse rate was not significantly decreased. Conclusions : Controlled trials investigating the efficacy of Gogoon acupuncture for lowering blood pressure are warranted.

• Clinical and Experimental Reproductive Medicine
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• 제41권1호
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• pp.33-36
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• 2014

Objective: To estimate the failure rate of medical treatment and to identify variables associated with treatment failure in patients with tubal pregnancy and an initial serum level of human chorionic gonadotropin (HCG) over 10,000 IU/L. Methods: The inclusion criteria were tubal pregnancy diagnosed using ultrasonography, primary treatment of intramuscular methotrexate injection at one of the four institutions between January 2003 and December 2011, a serum HCG level within two days before treatment >10,000 IU/L, and follow-up data to determine treatment success or failure. Exclusion criteria were other primary treatments besides intramuscular methotrexate injection. The clinicopathologic data of 36 patients were collected and analyzed. Results: Medical treatment failed and surgery was performed in 19 (53%) patients. In univariable analysis, age, parity, and size of the gestational sac were associated with treatment failure, but none of the variables were associated with treatment failure in multivariable analysis. The failure rate in the subgroup with age<33 years and size of gestational sac ${\geq}1.1cm$ was significantly higher than those of the other subgroups (82% vs. 41% [mean of the other subgroups], respectively). Conclusion: Patients with a serum HCG level >10,000 IU/L who received medical treatment had a high failure rate. Among them, patients aged<33 year and with a gestational sac ${\geq}1.1cm$ had an extremely high failure rate.

• Journal of Preventive Medicine and Public Health
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• 제19권2호
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• pp.184-192
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• 1986

Since the wide spread application of hyperbaric oxygenation in clinical setting, the problems of oxygen toxicity have been attracting a deep interest from the researchers on hyperbaric medicine as a practical issue. Among extensive research trials, the study on the protective agents against oxygen toxicity occupied one of the most challenging field. As the mechanisms of oxygen toxicity, the role of the oxygen free radicals produced by peroxidation process are strongly accepted by the leading researchers on oxygen toxicity, the probable protective effects of antioxidant against oxygen toxicity are sustaining a sufficient rationale. In this study, the author attempted to evaluate the effect of vitamin E as a protective agent against oxygen toxicity through the observation of death rate, convulsion rate, time to convulsion, and macroscopic and microscopic pathological changes of experimental rats exposed to 100% oxygen at 5 ATA for 120 minutes. The findings observed are as follows: 1) The death rate, convulsion rate, time to convulsion, organ/body weight ratio and microscopic pathological findings were identified as reliable objective and quantitative indices for oxygen toxicity. 2) Vitamin E showed excellent protective effects against CNS and pulmonary oxygen toxicity as a strong antioxidant. The most effective dose seemed to be around 400 mg/kg 3) The results of this study are supporting the oxygen free radical hypothesis on oxygen toxicity.

• Journal of Genetic Medicine
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• 제9권1호
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• pp.11-16
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• 2012

Purpose: To determine a method to improve the efficacy and accuracy of preimplantation genetic diagnosis (PGD) - polymerase chain reaction (PCR), we compared hot start PCR and conventional multiplex nested PCR. Materials and Methods: This study was performed with single lymphocyte isolated from whole blood samples that were obtained from two couples with osteogenesis imperfecta (OI). We proceeded with conventional multiplex nested PCR and hot start PCR in which essential reaction components were physically removed, and we compared the amplification rate, allele dropout rate and nonspecific products. Afterward, we used selective method for PGD. Results: In the two couples, the respective amplification rate were 93.5% and 80.0% using conventional multiplex nested PCR and 95.5% and 92.0% using hot start PCR. The respective mean allele dropout rates for the two couples were 42.0% and 14.0% with conventional multiplex nested PCR and 36.0% and 6.0% with hot start PCR. Conclusion: The results demonstrate that the hot start PCR procedure provides higher amplification rates and lower allele dropout rate than the conventional method and that it decreased the nonspecific band in multiplex nested PCR. The hot start method is more efficient for analyzing a single blastomere in clinical PGD.

• Gut and Liver
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• 제12권6호
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• pp.704-713
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• 2018

Background/Aims: Gastric varices (GVs) are a major cause of upper gastrointestinal bleeding in patients with liver cirrhosis. The current treatments of choice are balloon-occluded retrograde transvenous obliteration (BRTO) and the placement of a transjugular intrahepatic portosystemic shunt (TIPS). We aimed to compare the efficacy and outcomes of these two methods for the management of GV bleeding. Methods: This retrospective study included consecutive patients who received BRTO (n=157) or TIPS (n=19) to control GV bleeding from January 2005 to December 2014 at a single tertiary hospital in Korea. The overall survival (OS), immediate bleeding control rate, rebleeding rate and complication rate were compared between patients in the BRTO and TIPS groups. Results: Patients in the BRTO group showed higher immediate bleeding control rates (p=0.059, odds ratio [OR]=4.72) and lower cumulative rebleeding rates (logrank p=0.060) than those in the TIPS group, although the difference failed to reach statistical significance. There were no significant differences in the rates of complications, including pleural effusion, aggravation of esophageal varices, portal hypertensive gastropathy, and portosystemic encephalopathy, although the rate of the progression of ascites was significantly higher in the BRTO group (p=0.02, OR=7.93). After adjusting for several confounding factors using a multivariate Cox analysis, the BRTO group had a significantly longer OS (adjusted hazard ratio [aHR]=0.44, p=0.01) and a longer rebleeding-free survival (aHR=0.34, p=0.001) than the TIPS group. Conclusions: BRTO provides better bleeding control, rebleeding-free survival, and OS than TIPS for patients with GV bleeding.

• 대한기관식도과학회지
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• 제15권1호
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• pp.28-34
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• 2009

Background and Objectives: Foreign bodies of upper aerodigestive tract are common problem for primary care physicians. Delayed diagnosis or failure of removal might cause fatal problemsand complications. Therefore proper diagnosis and management is imperative. In this study, we described clinical features of upper aerodigestive tract foreign body, and analyzed efficacy of different management modality. Materials and Methods: 250 cases of foreign bodies in the esophagus and trachea, between Jan. 1998 through Jan. 2009 has been retrospectively analyzed. A total of 24 cases and 226 cases had been found each as airway foreign bodies and esophageal foreign bodies. The clinical features are described and treatment outcomes, prognosis, and rate of complications of each management modality have been compared. Results: In airway foreign bodies, ventilating bronchoscopy yielded better results, 19 success out of 19 trials than fiberoptic bronchoscopy, 3 success out of 5 trials. Hospitalization days after removal of foreign body didn't show difference between two treatment modalities, although patients who had ventilating bronchoscopy had gone through general anesthesia. And there was no complication after removal of foreign body. In esophageal foreign bodies, rigid esophagoscope yielded better results, 99% of successful removal rate, compared to the EGD, only 78% of successful removal rate. There was no difference of hospitalization days between two modalities. And complication rate was even low in patients who had done rigid esophagoscopic foreign body removal. Conclusion: In upper aerodigestivetract foreign body. Rapid diagnosis and successful foreign body removal is important. Removal by rigid scope(ventilating bronchoscope, rigid esophagoscope) revealed less failure in both airway and esophageal foreign bodies.

• Clinical and Experimental Reproductive Medicine
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• 제48권3호
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• pp.203-210
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• 2021

We performed a systematic review and meta-analysis to evaluate whether intralipid administration improved the outcomes of in vitro fertilization. Online databases (PubMed, Cochrane Library, Medline, and Embase) were searched until March 2020. Only randomized controlled trials (RCTs) that assessed the role of intralipid administration during in vitro fertilization were considered. We analyzed the rates of clinical pregnancy and live birth as primary outcomes. Secondary outcomes included the rates of chemical pregnancy, ongoing pregnancy, and missed abortion. We reviewed and assessed the eligibility of 180 studies. Five RCTs including 840 patients (3 RCTs: women with repeated implantation failure, 1 RCT: women with recurrent spontaneous abortion, 1 RCT: women who had experienced implantation failure more than once) met the selection criteria. When compared with the control group, intralipid administration significantly improved the clinical pregnancy rate (risk ratio [RR], 1.48; 95% confidence interval [CI], 1.23-1.79), ongoing pregnancy rate (RR, 1.82; 95% CI, 1.31-2.53), and live birth rate (RR, 1.85; 95% CI, 1.44-2.38). However, intralipid administration had no beneficial effect on the miscarriage rate (RR, 0.75; 95% CI, 0.48-1.17). A funnel plot analysis revealed no publication bias. Our findings suggest that intralipid administration may benefit women undergoing in vitro fertilization, especially those who have experienced repeated implantation failure or recurrent spontaneous abortion. However, larger, well-designed studies are needed to confirm these findings.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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• pp.441-449
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• 2021

Background: The efficacy of local anesthesia decreases in patients with symptomatic irreversible pulpitis. Therefore, it was proposed that the use of premedication with an anti-inflammatory drug might increase the success rate of pulpal anesthesia in mandibular posterior teeth with vital inflamed pulp. Methods: One hundred thirty-four patients who were actively experiencing pain willingly participated in this study. The Heft Parker (HP) visual analog scale (VAS) was used to record the initial pain intensity. Patients were randomly allocated to receive a placebo, 10 mg of ketorolac, and 650 mg of paracetamol. The standard inferior alveolar nerve block (IANB) was administered to all patients using 2% lidocaine with 1:200,000 adrenaline after one hour of medication. After 15 min, the patient was instructed to rate the discomfort during each step of the treatment procedure, such as access to remaining dentin, access to the pulp chamber, and during canal instrumentation on the HP VAS. IANB was considered successful if the patient reported no or mild pain during access preparation and instrumentation. Moderate or severe pain was classified as a failure of IANB and another method of anesthesia was used before continuing the treatment. Results: The rate of successful anesthesia in the placebo, paracetamol, and ketorolac groups was 29%, 33%, and 43%, respectively, and no statistically significant difference was found between the groups. Conclusion: Preoperative administration of paracetamol or ketorolac did not significantly affect the success rate of IANB in patients with irreversible pulpitis. No significant difference was observed between the paracetamol and ketorolac groups.