• Childhood Kidney Diseases
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• v.28 no.2
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• pp.59-65
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• 2024

Hydronephrosis, characterized by dilation of the renal pelvis and calyces due to urine flow obstruction, poses a significant clinical challenge. Although often asymptomatic and capable of spontaneous resolution, surgical intervention is necessary for specific scenarios such as febrile urinary tract infections, deteriorating hydronephrosis, or declining renal function. The efficacy of continuous antibiotic prophylaxis in preventing urinary tract infections remains controversial. Yet, it may benefit high-risk patients, emphasizing the importance of individualized patient selection, as surgical treatment methods for patients with hydronephrosis have become less invasive than in previous decades. However, long-term follow-up outcomes are lacking, necessitating further clarification. This review presents an overview of the etiology, natural progression, and modern management of hydronephrosis, encompassing advancements in minimally invasive procedures.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.346-352
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• 2020

Background: We aimed to assess the clinical outcomes of patients who underwent surgical repair of Kommerell diverticulum (KD) with individualized surgical methods. Methods: A retrospective analysis was performed of adult patients (aged ≥17 years) who underwent surgery to treat KD between June 2008 and October 2019. Results: Nine patients (median age, 45 years; range, 19-67 years; 7 men) underwent surgical repair. The indications for surgical therapy were acute aortic dissection in 2 patients, the presence of compressive symptoms due to dilated KD in 4 patients, and aneurysm growth in 3 patients. Various surgical techniques were used: (1) resection of the diverticulum stump and revascularization of the aberrant subclavian artery (n=3), (2) one-stage total-arch replacement including the diverticulum segment (n=3), and (3) hybrid repair (n=3). Early mortality occurred in 1 case of hybrid repair. Transient paraparesis occurred in a patient who underwent total arch repair as part of complicated acute aortic dissection. During follow-up (median duration, 30 months; range, 7-130 months), no late death or associated aortic complications were documented. All survivors were free from symptoms and had no abnormal findings on follow-up computed tomography. Conclusion: With a customized surgical approach and appropriate consideration of patient-specific anatomy and associated comorbidities, KD can be repaired with favorable outcomes.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.323-328
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• 2012

Background Among the various methods for correcting nasal deformity, the composite graft is suitable for the inner and outer reconstruction of the nose in a single stage. In this article, we present our technique for reconstructing the ala and columella using the auricular chondrocutaneous composite graft. Methods From 2004 to 2011, 15 cases of alar and 2 cases of columellar reconstruction employing the chondrocutaneous composite graft were studied, all followed up for 3 to 24 months (average, 13.5 months). All of the patients were reviewed retrospectively for the demographics, graft size, selection of the donor site and outcomes including morbidity and complications. Results The reasons for the deformity were burn scar (n=7), traumatic scar (n=4), smallpox scar (n=4), basal cell carcinoma defect (n=1), and scar contracture (n=1) from implant induced infection. In 5 cases of nostril stricture and 6 cases of alar defect and notching, composite grafts from the helix were used ($8.9{\times}12.5$ mm). In 4 cases of retracted ala, grafts from the posterior surface of the concha were matched ($5{\times}15$ mm). For the reconstruction of the columella, we harvested the graft from the posterior scapha ($9{\times}13.5$ mm). Except one case with partial necrosis and delayed healing due to smoking, the grafts were successful in all of the cases and there was no deformity of the donor site. Conclusions An alar and columellar defect can be reconstructed successfully with a relatively large composite graft without donor site morbidity. The selection of the donor site should be individualized according to the 3-dimensional configuration of the defect.

• Advances in pediatric surgery
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• v.13 no.2
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• pp.144-154
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• 2007

Liver tumors in children are rare, relatively complex, and encompass a broad spectrum of disease processes. This study reviews our experience of liver tumors during the last 10 years. Medical records of 36 cases of liver tumors in children, treated at Samsung Medical Centers, from October 1994 to December 2005, were reviewed in this study. We analyzed disease characters and survival rates as a whole and by specific disease. The median age was 3.6 years. Male and female ratio was 1:1. The most common symptom was the palpable mass in 15 cases. Others were abdominal distension in 9 cases, jaundice in 2, vomiting in 2, weight loss in 2, and pubic hair growth in 1. CT or US and liver biopsy were performed for diagnosis. There were 28 malignant tumors: malignant rhabdoid tumor (1 case), hepatocellular carcinoma (3 cases), hemangioendothelioma type II (3 cases), angiosarcoma (1 case), and hepatoblastoma (20 cases). Eight tumors were benign; hepatic adenoma (1 case), focal nodular hyperplasia (2 cases), hemangioendothelioma type I (2 cases), mesenchymal hamartoma (3 cases). In this study the clinical characteristics were not different from the other reports. Liver transplantation was performed in 3 cases-1 with hepatoblastoma and 2 with hepatocelleular carcinoma. Accurate and early diagnosis, and individualized multimodality therapeutic approaches might be important for better outcome.

• Clinical and Experimental Pediatrics
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• v.61 no.12
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• pp.397-402
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• 2018

Purpose: Transcatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old. Methods: We performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6-12 months in the same study period were reviewed. Results: A total of 22 patients underwent transcatheter PDA closure during the study period. Patient mean age was $3.3{\pm}1.5months$, and weight was $5.7{\pm}1.3kg$. The duct diameter at the narrowest point was $3.0{\pm}0.8mm$ as measured by angiography. The most common duct type was C in the Krichenko classification. Procedural success was achieved in 19 patients (86.3%). Major complications occurred in 5 patients (22.7%), including device embolization (n=1), acquired aortic coarctation (n=2), access-related vascular injury requiring surgery (n=1), and acute deterioration requiring intubation during the procedure (n=1). Two patients had minor complications (9.1%). Twenty-four infants aged 6-12 months received transcatheter device closure. The procedural success rate was 100%, and there were no major complications. The major complication rate was significantly higher in the group less than 6 months of age (P=0.045). There was a trend toward increased major complication and procedural failure rates in the younger age group (P<0.01). Conclusion: A relatively higher incidence of major complications was observed in infants less than 6 months of age. The decision regarding treatment modality should be individualized.

• Korean Journal of Acupuncture
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• v.39 no.3
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• pp.91-96
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• 2022

Objectives : The purpose of this study was to characterize the stimulation intensity in acupuncture manipulation techniques for tonification and sedation therapy. Methods : To describe the level of stimulation used in acupuncture manipulation techniques for tonification and sedation therapy, we reviewed the acupuncture manipulation techniques described in classical medical textbooks. Results : Based on the patients' conditions and pattern identification, acupuncture manipulation strategies for tonification and sedation therapy were chosen. For example, the excess condition was treated with sedative therapy, and the deficiency condition was treated with tonification therapy. For tonification therapy, weak to modest stimulation was applied in acupuncture manipulation techniques, whereas intense stimulation was applied for sedative therapy. Even though the intensity of acupuncture stimulation was chosen based on the clinical examination, deqi sensation is a crucial component of acupuncture treatment, and during acupuncture practice, the practitioner should choose the right intensity of acupuncture stimulation based on deqi response in each patient. Conclusions : We concluded that the tonifying and sedative effects of acupuncture treatment are related to the stimulation intensity of acupuncture manipulation techniques. For individualized medicine, the right amount of acupuncture stimulation should be administered based on the patients' conditions and responses, such as deqi responses.

• The Korean Journal of Rehabilitation Nursing
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• v.18 no.1
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• pp.46-56
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• 2015

Purpose: The purpose of this study was to identify health status and the use of complementary and alternative therapies in the community dwelling pre-elderly and elderly. Methods: A total of 193 subjects participated in this study. They were recruited from one senior welfare center, four senior citizen centers and subjects' home in two cities. Data were collected with self-reported questionnaires to measure health status and the use of complementary and alternative therapies. Data were analyzed by t-test, ANOVA using SPSS/WIN 22.0. Results: Health status in this subjects was different depending on their age, sex, education, religion, type of family, and average monthly living expenses. Most used items as complementary and alternative medicine are diet therapy, herbal medicine such as health supplement food therapy, vitamin therapy, and Korean folk remedies. There were statistically significant differences in using complementary and alternative therapies according to one's current health status (F=7.09, p<.001), comparing health status to peers (F=3.67, p=.013), and chronic disease having more than three months (t=-2.50, p=.013). Conclusion: This study suggest that individualized health care should be continued for the pre-elderly and elderly. Moreover, we need to prepare long term care plans such as educations for applying complementary and alternative therapies.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.3
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• pp.193-200
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• 2009

Purpose：In this study is to verify the effects postural control training based on Bobath approach for body schema and visual perception on Middle Cerebral Artery(MCA) Infarcts. Methods：The subject was a 46 years old man with MCA infaction, lives in B city. An AB design for a single-subject research was used for this study. The procedures consisted of 1 time of baseline phase(A), 20 times of treatment phase(B). We applied the Bobath approach at the subject. Treatments included to facilitate trunk alignment and stability, and to train weight bearing and shifting, to facilitate pelvis movement, and to train walk especially stance phase and assist up-down stairs locomotion in environment similar to actual daily life. Results：With this treatment, the majority of body schema and visual perception and postural control was improved in treatment phase compared with in baseline phase. Therefore, this study supported the effectiveness of postural control training based on Bobath approach for body sechma and visual perception of hemiplegia. Conculusion：This study is integrated postural control training with Bobath approach that are widespread for hemiplegia and measured outcomes based on individualized therapy goals. Consequently the study is suggested the meaning of quality effectiveness of Bobath approach.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.76-79
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• 1999

The most significant factor in pathogenesis of vascular headaches like migraine and cluster headache is dynamic changes of diameters of the cerebral arteries. TCD is a valuable noninvasive tool to assess the cerebral hemodynamic status by measuring the flow velocities of the intracranial cerebral arteries around the circle of Willis. TCD can evaluate flow velocities and vasoreactivity of the patients with a vascular headache during the ictal phase as well as during intericatal phase. Distribution of the changes recorded differ between types of headaches and also between the major ictal symptoms. The changes suggest the presence of prolonged vasospasm interictally and more marked relaxation of the cerebral arteries. TCD can be used to monitor the long-term clinical course of patients with vascular headache by correlation the symptomatic improvement and TCD data before and after long-term pharmacological prophylactic treatments. During the ictal phases large intervention. The results may be used in selecting and evaluating the agents for abortive therapy for acute attacks. In conclusion TCD can quantitatively evaluate vascular headaches when making diagnosis and classification and can provide guidelines to choose more individualized therapeutic options for both acute and long-term treatment.

• Korean Journal of Biological Psychiatry
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• v.11 no.2
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• pp.77-87
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• 2004

Due to the high population prevalence of major depression and the strong emphasis on pharmacotherapy for this disorder, antidepressants are among the most frequently prescribed pharmacological agents. But the clinicians are still unable to predict accurately the response of their depressed patients to medication. This article reviews the biological predictors of treatment response including monoamine, neuroendocrine, pharmacogenetic, and psychophysiologic markers. The biological predictors of response, despite some interesting leads that may in the long term be of considerable importance, are not yet sufficiently established to be of routine clinical usefulness. Many of the predictive factors explored in this article are examples of mediators and moderators that affect outcomes. Each one alone may not provide definitive answers for predicting response to treatment, but each must be taken into account at the outset of treatment. It is clear that treatments must be individualized for each patient. It would be necessary to develop the algorithm in order to predict the responsiveness of antidepressant treatment with integration of the results from the previous studies.