• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.523-527
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• 2012

Objective : The incidence of spontaneous spinal epidural hematoma (SSEH) is rare. Patients with SSEH, however, present disabling neurologic deficits. Clinical outcomes are variable among patients. To evaluate the adequate treatment method according to initial patients' neurological status and clinical outcome with comparison of variables affecting the clinical outcome. Methods : We included 15 patients suffered from SSEH. Patients were divided into two groups by treatment method. Initial neurological status and clinical outcomes were assessed by the American Spinal Injury Association (ASIA) impairment scale. Also sagittal hematoma location and length of involved segment was analyzed with magnetic resonance images. Other factors such as age, sex, premorbid medication and duration of hospital stay were reviewed with medical records. Nonparametric statistical analysis and subgroup analysis were performed to overcome small sample size. Results : Among fifteen patients, ten patients underwent decompressive surgery, and remaining five were treated with conservative therapy. Patients showed no different initial neurologic status between treatment groups. Initial neurologic status was strongly associated with neurological recovery (p=0.030). Factors that did not seem to affect clinical outcomes included : age, sex, length of the involved spinal segment, sagittal location of hematoma, premorbid medication of antiplatelets or anticoagulants, and treatment methods. Conclusion : For the management of SSEH, early decompressive surgery is usually recommended. However, conservative management can also be feasible in selective patients who present neurologic status as ASIA scale E or in whom early recovery of function has initiated with ASIA scale C or D.

• Korean Journal of Bronchoesophagology
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• v.15 no.1
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• pp.41-49
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• 2009

Background and Objectives : Proton pump inhibitors(PPIs) improve the symptoms of laryngopharyngeal reflux(LPR). But there is little reports about the changes of each items in reflux symptom index (RSI) and reflux finding score (RFS) after PPIstreatment. The purpose of this study is to analyze the changes of pre- and post-treatment score in each RSI and RFS items after 8 weeks medication with proton pump inhibitors in laryngopharyngeal reflux patients. Methods : Prospective study. Among the patients who had visited the department of otolaryngology from January 2007 to December 2008, 91 patients who had shown scores greater than 13 on the RSI and/or 7 on the RFS were studied. All patients received PPIs once daily before breakfast for 8 weeks. RSI and RFS were assessed at initial, four weeks and eight weeks after medication. Result: All RSI items were improved (p < 0.05). The globus sense followed by throat clearing, heartburns and hoarseness showed high initial RSI score than other items. And globus sense, throat clearing, hoarseness and heartburn were improved significantly more than others items. But only posterior commissure hypertrophy of RFS was improved significantly more than others items. Conclusion: Empiric PPIs therapy reduced the RSI scores and more effective for symptoms such as globus sense, throat clearing, hoarseness and heartburn among suspected LPR patients. In RFS, only posterior commissure hypertrophy has improved significantly. However, the changes of each categories of RFS were minimal (average: 0.16), therefore clinical significance is restricted in RFS.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.245-253
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• 2016

Objective: This study was conducted to evaluate payer-driven medication adherence intervention program from the patient's and counselor's perspectives. Methods: Target patients for intervention were selected by retrospective adherence measures based on national health insurance claims data for hypertension, diabetes and hyperlipidemia. As a serial intervention for higher risk groups of medication non-adherence, initial direct mailing, the first direct telephone call and the second direct call or a home visit were followed. Interview approach to qualitative inquiry was used to evaluate intervention results. Results: Participants including 4 patients received telephone calls, and 4 National Health Insurance Service staff and 4 pharmacists participated as counselors were interviewed regarding their impression of the intervention program. Three major themes arose: overall perception; necessities; and suggestions for success, of the intervention. Despite short period of intervention, educational intervention by telephone counseling involving pharmacists shows potential to improve self-management of chronic disease, and pharmacist-involvement. But more sophisticated selection of target patients requiring the intervention and complementation of electronic database system would be necessary. In addition, personal disposition of counselor was revealed to be an important factor for achieving successful outcome of intervention. Conclusion: The findings suggest that the individualized counseling intervention would be an efficient option for improved medication adherence. Further researches should include longer periods of interventions, a quantitative analysis using adherence measures based on claims data and consideration of clinical benefits associated with the intervention.

• Journal of Oriental Medical Thermology
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• v.2 no.1
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• pp.63-66
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• 2003

Background and Purpose : Ceramic based infra-red Therapy has been effective on derma system. The purpose of this case was to know the effect of ceramic based infra-red therap therapy on atopic dematitis. Material and Methods Among initial 25 outpatients with atopic detmatitis who visited Kangnam KyungHee Oriental hospital from Mar. 2000 to Sep. 2002, we excluded 4 outpatients that quited treatment after 1st treatment. We treated ceramic based infra-red therapy, herb medication treatment and Acupuncture women patients. Ceramic based infra-red therapy using GI-2000 system was lighted to under for 30 minutes. SoPungSan(消風散) was one of the effective herb medication on atopic dermatitis in oriental. In acupuncture treatment. We activated Kokchi(LI11, 曲池), Choksamni(S36, 足三里) and inhibited Yanggye(LI5, 陽谿), Yanggok(SI5, 陽谷). Results and Conclusions Ceramic based infra-red therapy, herb medication treatment and acupuncture therapy showed usfull effect on atopic dermatitis.

• Journal of Korean Neurosurgical Society
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• v.44 no.1
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• pp.19-25
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• 2008

Objective : To analyze the relationship of concomitant foraminallumbar disc herniation (FLDH) with postoperative leg pain after microdecompression for extraforaminallumbar disc herniation (EFLDH) at the L5-S1 level. Methods : Sixty-five patients who underwent microdecompression for symptomatic EFLDH at the L5-S1 level were enrolled, According to the severity of accompanying FLDH, EFLDH was classified into four categories (Class I : no FLDH; Class II : mild to moderate FLDH confined within a lateral foraminal zone; Class III : severe FLDH extending to a medial foraminal zone; Class IV : Class III with intracanalicular disc herniation). The incidence of postoperative leg pain, dysesthesia, analgesic medication, epidural block, and requirement for revision surgery due to leg pain were evaluated and compared at three months after initial surgery. Results : The incidences of postoperative leg pain and dysesthesia were 36.9% and 26.1%, respectively. Pain medication and epidural block was performed on 40% and 41.5%, respectively, Revision surgery was recommended in six patients (9.2%) due to persistent leg pain, The incidences of leg pain, dysesthesia, and requirement for epidural block were higher in Class III/IV, compared with Class I/II. The incidence of requirement for analgesic medication was significantly higher in Class III/IV, compared with Class I/II (p=0,02, odds ratio=9,82). All patients who required revision surgery due to persistent leg pain were included in Class III/IV. Conclusion : Concomitant FLDH seems related to postoperative residual leg pain after microdecompression for EFLDH at the L5-S1 level.

• Restorative Dentistry and Endodontics
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• v.48 no.2
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• pp.17.1-17.8
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• 2023

The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.

• Journal of Acupuncture Research
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• v.23 no.4
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• pp.219-224
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• 2006

Idiopathic thrombocytopenic purpura(ITP) is characterized by the development of a specific anti-platelet autoantibody immune response mediating the development of thrombocytopenia. Systemic lupus erythematosus(SLE) is an autoimmune disease characterized by the production of a wide variety of autoantibodies. We experienced SLE patient whose initial symptoms were related to idiopathic thrombocytopenic purpura(ITP). She has a thrombocytopenia after Splenectomy and Steroid therapy on ITP and SLE. After she took Eight constitution Acupuncture treatment, thrombocytopenia has improved. We think Acupuncture will be effective treatment at autoimmune disease.

• Journal of Oral Medicine and Pain
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• v.43 no.1
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• pp.16-20
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• 2018

Graft-versus-host disease (GVHD) is frequent complications of hematopoietic stem cell transplantation. In the chronic GVHD (cGVHD), the oral cavity is the most commonly affected region. The clinical manifestations include erythema, ulceration, lichenoid-hyperkeratotic change in oral mucosa, dry mouth, and limitation of mouth opening. The initial treatment strategy of oral cGVHD patients is topical corticosteroid therapy in various formulation. However, corticosteroid resistance appears in some patients. We report a case of a 25-year-old male patient with oral cGVHD, who has resistance to topical corticosteroid medication, treated with 0.03% tacrolimus ointment and low-dose doxycycline. The patient showed subjective and objective improvement without side effect.

• Journal of Yeungnam Medical Science
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• v.41 no.3
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• pp.158-165
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• 2024

Over the past few decades, there has been a notable increase in the incidence of pediatric obesity, which is a significant public health concern. Children who are obese have a greater risk of type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is typically the initial approach to treat pediatric obesity. For patients who do not achieve success with lifestyle modification therapy alone, pharmacotherapy is the next logical treatment option. When selecting an anti-obesity medication (AOM), it is essential to first ascertain the medical background of the patient, including current medications and obesity-associated comorbidities. Evaluation of obesity phenotypes in patients may also be beneficial. AOMs for pediatric obesity include metformin, orlistat, glucagon-like peptide 1 agonists, phentermine, and the phentermine/topiramate combination. Sufficient lifestyle modification therapy should be administered before considering pharmacotherapy and continued after the initiation of AOM. To ensure healthy development, monitoring growth and puberty development during anti-obesity treatments is essential.

• Anxiety and mood
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• v.2 no.2
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• pp.108-114
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• 2006

Objectives : Only a few prospective studies of panic disorder are available. This study investigated naturalistic outcome of panic disorder patients at twelve months after the initial diagnosis. Methods : A total of 84 subjects were diagnosed with panic disorder by diagnostic interview, Structured Clinical Interview for DSM-IV (SCID-IV) and Anxiety Disorder Interview Schedule for DSM-IV (ADISIV). Among them, 80 subjects could be evaluated by means of Panic Disorder Severity Scale (PDSS) at follow-up interview after twelve months. Treatment continuation was also examined at follow-up interview. Results : At initial intake, 80 patients were classified into 22% with mild, 33% with moderate-to-marked, and 45% with severe symptoms on the basis of their PDSS total score. At twelve months, 20% of patients reached remission, 65% had mild and 15% had moderate-to-marked symptoms. Initial panic symptom severity, presence of agoraphobia, panic symptom duration before diagnosis, number of comorbid Axis I disorders were associated with significantly higher PDSS total score at twelve months. Forty six percent of total patients continued medication and 23% have stopped treatment by clinician's recommendation and 31% have selfdiscontinued their medication. At twelve months, all three groups were improved but self-discontinuation group had significantly higher PDSS total score. Conclusion : In the one-year naturalistic outcome study of panic disorder patients, high percentage of patients achieved remission or had mild symptoms.