• Archives of Plastic Surgery
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• 제48권4호
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• pp.361-365
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• 2021

Background Pain in the postoperative body contouring patient has traditionally been managed with narcotic medication. In an effort to minimize side effects and prevent addiction, plastic surgeons are searching for novel ways to provide adequate analgesia, one of which is nerve blocks. This study was conducted with a meta-analysis that evaluates the efficacy of these blocks for patients who undergo breast surgery. Methods A search of the PubMed/MEDLINE database for articles including the terms "post-operative analgesia" OR "postoperative pain management" AND "in plastic surgery" OR "in cosmetic surgery" OR "in elective surgery" in February 2019 generated five studies on elective breast augmentation and reduction mammoplasty that reported pain scores and quantities of opioids consumed. Independent samples t-tests, one-way analysis of variance, and a random effects model were implemented for evaluation. Results A total of 317 patients were identified as having undergone body contouring of the breast, about half of which received a nerve block. Pain scores on a 1-10 scale and opioid dose-equivalents were calculated. Those who were blocked had an average score of 2.40 compared to 3.64 for those who did not (P<0.001), and required an average of 5.20 less narcotic doses (P<0.001). Pain relief following subpectoral augmentation was best achieved with type-II blocks as opposed to type-I and type-II with serratus plane (P<0.001). Conclusions The opioid epidemic has extended to all surgical specialties. Implementation of a nerve block seems to be an efficacious and cost-effective mechanism to not only help with post-operative pain, but also lower the need for narcotics, especially in subpectoral augmentation.

• Korean Journal of Acupuncture
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• 제39권3호
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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.

• Journal of Korean Biological Nursing Science
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• 제24권1호
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• pp.1-16
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• 2022

Purpose: Recently, oxytocin has been introduced experimentally as a pharmacological treatment for post-traumatic stress disorder (PTSD). This study attempted to investigate the possibility of oxytocin as a treatment option for patients with PTSD by examining its dose, interval, and effectiveness in patients with PTSD. Methods: A systematic review was done on articles published from 1967 to 2020 using the PubMed, PsycINFO, and Cochrane databases. Our inclusion criteria were 1) subjects 18 years of age or older diagnosed with PTSD or exposed to a traumatic event that met criterion A of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for PTSD, 2) oxytocin was administered at least once, 3) clinical trials, and 4) studies published in Korean or English. Two independent researchers reviewed 22 articles and recorded the contents. The risk of bias was evaluated to determine the quality of the reviewed article. Results: The parameters for evaluating the effectiveness of oxytocin were identified as socio-behavioral measures in 11 articles, neuronal imaging in 9, and biomarkers in 4. In 5 papers, oxytocin was administered multiple times. Socio-behavioral measures were improved in 3 out of 5 studies in which oxytocin was administered multiple times. In 2 studies in which prolonged exposure treatment and nasal oxytocin administration were combined for 10 weeks, patient symptoms were decreased compared to the control group. Conclusion: The possibility of oxytocin as an adjuvant treatment for PTSD psychotherapy was confirmed. Further studies are necessary to evaluate the long term effectiveness of administering oxytocin multiple times combined with psychotherapy.

• 대한이식학회지
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• 제28권3호
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• pp.165-168
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• 2014

The recipient candidate was a 51-year-old male with end-stage renal disease owing to diabetes mellitus. The initial immunosuppressive regimen included basiliximab for induction and tacrolimus, mycophenolate mofetil, and steroids. Urine output was 413 mL/day on the operative day and 100 mL/day on the postoperative day (POD) 1. There was no definite stenosis of the ureter or vessels. He had anuria on POD 2~4 and he had undergone hemodialysis. His serum creatinine level did not decrease. Therefore, a graft biopsy was performed on POD 4. The pathologic finding was consistent with acute calcineurin inhibitor (CNI) toxicity. There was no evidence of rejection or acute tubular necrosis. Anuria continued on POD 6; therefore, we started sirolimus instead of a CNI based regimen. Graft function was gradually recovered 1 day after reduction of CNI dose and hemodialysis was stopped. The serum creatinine level was normalized on POD 10. He was discharged on POD 21.

• 대한방사선기술학회지:방사선기술과학
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• 제46권2호
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• pp.89-97
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• 2023

With the introduction of the D.R system, the grid with high removal rate of scattered radiation is selected and used without considering the grid performance evaluation. Despite the high removal rate of scattered radiation belonging to high grid ratio, it is also possible to see the cut-off phenomenon in which the primary ray involved in the formation of image could be removed as well. Thus, the purpose of this study is to provide the basic data for researches on the usefulness of using the grid by presenting the appropriate grid ratio in the D.R system through the measurement of image in grid such as non-grid, 6:1, 8:1, 10:1, 12:1. The equipments used for this study were radiation generator with grid in 12:1, 10:1, 8:1, 6:1, indirect-type detector, and acryl phantom. As the study for image evaluation, this study measured the SNR, PSNR, MSE, and Entropy. In the results of this study, the PSNR was the highest in 6:1 and the lowest in 8:1. The SNR was high in 6:1 and 8:1, and the lowest in 12:1. In case of Entropy, it was high in 8:1 and 10:1, and the lowest in 12:1. Therefore, when the grid is used, it would be more proper to choose the grid in 8:1 or 10:1 with less loss in information content of primary ray rather than the high grid ratio showing the increased patient exposure dose.

• 한국방사선학회논문지
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• 제17권5호
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• pp.717-723
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• 2023

간 질환을 포함한 여러 복부 질환은 사망에 영향을 줄 수 있다. 복부 질환 진료 시 전산화단층검사는(CT; Computed Tomography) 필수적으로 사용되고 있다. 판독에 유리한 영상을 만들기 위해서 높은 방사선 노출이 따르는데, 이에 대한 화질관리와 환자의 피폭 관리를 위한 다양한 노력이 필요하다. 복부 CT 영상의 화질개선을 위해서 후처리 방식의 웨이블릿(Wavelet) 알고리즘을 제안하였다. 웨이블릿은 입력 영상의 종류에 따라 역치(Threshold) 값을 설정해 주어야 하는 단점이 있기 때문에 본 연구에서는 역치 값을 실험적으로 제안하였고 화질 평가도 하였다. 실험결과, 복부 CT 영상의 최적 역치 값은 50으로 계산되었다. 실험영상 1의 경우 49%, 실험 영상 2의 경우 29% 노이즈가 개선되었고, 대조도도 크게 상승 하였다. 본 연구 결과를 저선량 복부 CT 영상을 획득 후 후처리 방법으로 적용한다면, 화질을 개선시킬 수 있어 질병 판독에 도움을 줄 것으로 판단한다.

• 한국방사선학회논문지
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• 제17권6호
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• pp.897-902
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• 2023

본 논문에서는 휴대용 X-ray 검출기의 방사선 고감도 검출에 대한 실현 가능 여부를 확인하기 위한 SiPM의 특성 분석을 목적으로 한다. 휴대용 X-ray 검출기는 환자의 위치에 빠르게 접근하여 실시간 이미지를 획득함으로써 의사들은 신속하게 진단을 수행할 수 있는 장점이 있지만 이러한 이동성은 선량 감지의 어려움을 동반한다. 기존 검출기에서는 SiPM을 X-ray Trigger를 판별하는 단순한 용도로 사용하고 있다. SiPM을 통한 X-ray의 고감도 검출 가능 여부를 확인하기 위해 7종의 SiPM Sensor를 비교 선정하고 특성 분석을 진행하였다. 최종 시험에 사용한 SiPM은 10 nGy 수준의 극저선량 조사 조건에서 Signal 구분이 가능하며, 관전압에 따라 Signal 상승곡선의 기울기가 변하는 것이 확인되었다. X-ray 선량에 따라 SiPM의 signal level 및 지속시간이 변화되는 특성을 이용한 고감도 측정이 가능할 것으로 보인다.

• 셀메드
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• 제13권14호
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• pp.18.1-18.13
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• 2023

Background and objectives: Bacterial vaginosis (BV) is recognized as the most prevalent type of vaginal infection, impacting approximately 19-24% of women in their reproductive years. The recurrence rate of BV is significant, negatively impacting the well-being of affected women. This study aimed to compare the therapeutic effects of a polyherbal Unani formulation and metronidazole in treating bacterial vaginosis. Methodology: In this prospective patient blinded standard controlled trial, a total of 40 individuals with a clinical diagnosis of bacterial vaginosis were randomly assigned to receive either an active control treatment (n = 20) or a test drug (n = 20). In the test drug combination of Acacia catechu, Azadirachta indica and Quercus infectoria in tablet (1g) form in the dose of 2 tablets orally twice daily with water was administered for 3 weeks. In the active control standard drug, metronidazole 400 mg tablet, orally twice daily was given for one week. The primary outcome measure was clinical cure; H. negative Amsel's criteria and a reduction in subjective symptoms, while the secondary outcome measure was an improvement in SF-36 quality of life (QOL). Results and conclusion: Both the experimental treatment and the metronidazole demonstrated a significant clinical cure for bacterial vaginosis as well as an increase in health-related quality of life. Based on these findings, it appears that the test medication is a potent Unani formulation for the treatment of bacterial vaginosis. A well conducted trial with a bigger sample size is required to corroborate these findings.

• 대한두경부종양학회지
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• 제40권1호
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• pp.49-53
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• 2024

Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma, with an incidence of about 0.8% to 5% per million people per year, accounting for 1% of soft tissue sarcomas. In its early stage, DFSP is typically found as a violet or pinkish macule or patch, and it can develop into a palpable mass with ulceration or bleeding. The standard treatment for DFSP is wide local excision of the tumor with a 2- to 3-cm negative margin, and radiation therapy or chemotherapy can be conducted with surgical treatment. A 35-year-old man had a palpable mass on the left side of his occipital scalp without color change, ulceration, or bleeding, which typically are present in malignancy. A magnetic resonance imaging (MRI) scan showed a 3-cm homogenous enhanced mass without adhesion between the scalp and the mass. Unexpectedly, a biopsy revealed the round mass to be DFSP. A wide excision and rotation of the scalp flap were performed. The patient recovered without any complications and received adjuvant radiotherapy at a dose of 60 Gray (Gy) for six weeks. There was no recurrence through six months of follow-up. Here we report this unique case of DFSP with atypical presentation.

• Journal of Acupuncture Research
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• 제41권2호
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• pp.107-114
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• 2024

Background: Low back pain (LBP) is a common musculoskeletal disorder worldwide, with a lifetime prevalence of up to 80%. Among nonsurgical treatments for chronic LBP, Korean medicine treatments are highly preferred, and pharmacopuncture therapy combining acupuncture and herbal medicine is widely used. However, no evidence-based study has focused on the use of various types of pharmacopuncture. Methods: The pragmatic randomized controlled clinical trial will include 44 participants; recruitment will start in July 2023. All participants will receive integrated Korean medicine treatment including acupuncture, cupping, and infrared therapy, and the intervention group will also receive pharmacopuncture. After 16 treatment sessions, twice a week for 8 weeks, follow-up assessments will be performed at week 9. As a pragmatic randomized controlled clinical protocol, the type, dose, and acupoints of acupuncture and pharmacopuncture are not determined in advance but are selected and recorded according to the clinical judgment of the Korean medicine doctor. Results: The primary outcome will be measured using a visual analog scale score, and the secondary outcomes include the Oswestry disability index, patient global impression of change, no worse than mild pain, and range of motion. Safety will be assessed by examining participants' self-reported adverse events and vital signs and conducting blood tests before and after the test. Conclusion: This study aims to provide clinical evidence of the effectiveness and safety of pharmacopuncture for chronic LBP.