• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.38
• /
• pp.20.1-20.6
• /
• 2016

Background: Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. Case presentation: A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. Conclusions: The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.

• Journal of Pharmaceutical Investigation
• /
• v.35 no.6
• /
• pp.445-451
• /
• 2005

As a selective ${\alpha}_{1A}-adrenoreceptor$ antagonist, tamsulosin has been used clinically for urinary obstructed patients with benign prostatic hyperplasia. The single and multi-layered pellets containing tamsulosin hydrochloride were prepared in an effort to control the drug release, avoiding dose-dependent side effects of tamsulosin hydrochloride upon oral administration. The drug release from multi-layered pellets was substantially controlled, compared with single layered pellets. The drug release from coated pellets with single or multi layer was affected by the nature of coating agent, the percentage of coating level and the presence of hydrophilic material in coating layer. In conclusion, the controlled release oral delivery system using multi-layered pellet is very useful for tamsulosin hydrochloride, resulting in improvement of patient compliance and therapeutic drug levels for a longer period of time.

• Journal of Korean Medical classics
• /
• v.24 no.1
• /
• pp.85-93
• /
• 2011

Wasting-thirst(消渴) occurs due mainly to dryness-heat(燥熱) which by depleting 'Fluid and Humor'(津液) make symptoms of thirst(口渴) swift digestion with rapid hungering(消穀善饑) frequent urination(小便頻數) according to "Internal Classic"(內經). However, the doctors of those days had a tendency to manage wasting-thirst with herbal drugs of dryness-heat or with drugs that tonifies the kidney. Liu Wansu(劉完素) thought that those kinds of drugs intensify gatro-intestinal dryness-heat and consequently could not be suitable for the patients with wasting-thirst. He said that they had mistaken about the relation between five viscera(五臟) and six climate condition(六氣) and that they did not know thoroughly on the theory of branch and root(標本). For preventing the disease of wasting-thirst, Liu Wansu(劉完素) recommended avoiding gatro-intestinal drying caused by the intake of dryness-heat diet, and warned not to deplete 'Fluid and Humor' due to stress-induced fire(火), not to damage yin qi(陰氣) through severe diseases.

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.5
• /
• pp.401-408
• /
• 2012

Cardiopulmonary resuscitation (CPR) is a series of life-saving actions that improve the chances of survival, following cardiac arrest. Successful resuscitation, following cardiac arrest, requires an integrated set of coordinated actions represented by the links in the Chain of Survival. The links include the following: immediate recognition of cardiac arrest and activation of the emergency response system, early CPR with an emphasis on chest compressions, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care. The newest development in the CPR guideline is a change in the basic life support sequence of steps from "A-B-C" (Airway, Breathing, Chest compressions) to "C-A-B" (Chest compressions, Airway, Breathing) for adults. Also, "Hands-Only (compression only) CPR" is emphasized for the untrained lay rescuer. On the basis of the strength of the available evidence, there was unanimous support for continuous emphasis on high-quality CPR with compressions of adequate rate and depth, which allows for complete chest recoil, minimizing interruptions in chest compressions and avoiding excessive ventilation. High-quality CPR is the cornerstone of a system of care that can optimize outcomes beyond return of spontaneous circulation (ROSC). There is an increased emphasis on physiologic monitoring to optimize CPR quality, and to detect ROSC. A comprehensive, structured, integrated, multidisciplinary system of care should be implemented in a consistent manner for the treatment of post-cardiac arrest care patients. The return to a prior quality and functional state of health is the ultimate goal of a resuscitation system of care.

• Microbiology and Biotechnology Letters
• /
• v.47 no.2
• /
• pp.173-182
• /
• 2019

The use of double lumen catheters as a means of hemodialysis access is commonly accompanied with the use of gentamicin as an antibiotic lock. Other antibiotics and anticoagulants are often added to increase the efficacy of gentamicin in order to reduce catheter-related infection and to prevent biofilm formation. This review aimed to evaluate the following: 1) the use of gentamicin in eliminating catheter-related infection and reducing biofilm formation in hemodialysis catheters, 2) the efficacy of additional antibiotics in combination with gentamicin, and 3) the effect of additional anticoagulants to complement the efficacy of gentamicin as the main prophylactic antibiotic lock. We sorted through data from 242 PubMed and ScienceDirect studies, which were then short-listed to 33 studies. Next, they were grouped, extracted, and analyzed qualitatively to fulfil the objectives of this review. Consequently, the use of a gentamicin-lock solution was shown to reduce the incidence of bacteremia; however, it was not strong enough to inhibit the growth of infectious microbes and formation of biofilms. Several bacteria, such as Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Klebsiella pneumoniae, have been reported as infectious agents. Combination with other antibiotics also provided no effect in reducing bacterial growth and biofilm formation in catheters. Furthermore, the additional anticoagulants (trisodium citrate and EDTA) were reported to be effective in enhancing the efficacy of gentamicin in avoiding catheter-related infection, bacterial growth, and biofilm formation; thus, the use of gentamicin can be rationalized.

• Journal of the Korean Medical Association
• /
• v.61 no.11
• /
• pp.655-661
• /
• 2018

Incidence of basal and squamous cell carcinoma is increasing among Korean. With increasing this incidence we need to attend the management and prevention of these cutaneous malignancies. Basal cell carcinoma (BCC) is the most common skin malignancy. Sun exposure is the most important environmental cause of BCC. Daily sun protection especially avoiding sun exposure between 10 a.m. and 4 p.m. provides most effective prevention against chronic ultraviolet-induced skin damage. Hedgehog pathway inhibitors are used locally advanced and metastatic BCC lesions in Korea. Until recently, there are no reports whether it developed resistance of Hedgehog pathway inhibitors with advanced BCC in Korean patients. Among malignant skin tumors, 19.1% were squamous cell carcinoma (SCC). The incidence of SCC was rapidly increased over the past years. However, the incidence rate of SCC in Japan has not been changed from the period 1976-1980 to 1986-1990. Sentinel lymph node biopsy for SCC did not provide diagnostic value. Bowen's disease and Erythroplasia of Queyrat are considered as carcinoma in situ of the skin. Erythroplasia of Queyrat have worse prognosis with a higher rate of malignant degeneration. Dermoscopy may helpful tool in assisting the noninvasive diagnosis of carcinoma in situ of the skin.

• The Journal of Korean Medicine
• /
• v.41 no.4
• /
• pp.41-51
• /
• 2020

Objectives: Eight Constitution Medicine (ECM) categorizes individuals into eight constitutions based on physiological differences in organ relations and recommends different diets for different constitutions. This study presents a preliminary analysis of the effect of following constitutional food regimens on quality of life and health outcomes for different constitutions. Methods: This cross-sectional, comparative study used subjects recruited from Essen University Hospital Traditional Chinese Medicine Center in Germany. From a convenience sample of 243 Germans, those in the groups Hepatonia/Cholecystonia (n = 95) and Pulmotonia/Colonotonia (n = 26) were analyzed for health outcomes in relation to their dietary habits of either including or avoiding meat. Health outcomes were measured with SF-36, self-reported survey. Results: The two groups had no significant differences in the health outcomes of SF-36. However, subjects in Hepatonia/Cholecystonia who had followed their dietary habit for more than 20 years had significantly better scores on general health, social functioning, mental health, emotional role functioning, and mental component scores than those in Pulmotonia/Colonotonia, regardless of their meat intake. Conclusions: This study established initial groundwork for considering patients' constitutions when evaluating health outcomes and their relation to diet. Further studies are warranted on the effects of regulating food intake according to individual constitution.

• Korean Journal of Radiology
• /
• v.25 no.1
• /
• pp.86-102
• /
• 2024

Early diagnosis, accurate assessment, and localization of peritoneal metastasis (PM) are essential for the selection of appropriate treatments and surgical guidance. However, available imaging modalities (computed tomography [CT], conventional magnetic resonance imaging [MRI], and 18fluorodeoxyglucose positron emission tomography [PET]/CT) have limitations. The advent of new imaging techniques and novel molecular imaging agents have revealed molecular processes in the tumor microenvironment as an application for the early diagnosis and assessment of PM as well as real-time guided surgical resection, which has changed clinical management. In contrast to clinical imaging, which is purely qualitative and subjective for interpreting macroscopic structures, radiomics and artificial intelligence (AI) capitalize on high-dimensional numerical data from images that may reflect tumor pathophysiology. A predictive model can be used to predict the occurrence, recurrence, and prognosis of PM, thereby avoiding unnecessary exploratory surgeries. This review summarizes the role and status of different imaging techniques, especially new imaging strategies such as spectral photon-counting CT, fibroblast activation protein inhibitor (FAPI) PET/CT, near-infrared fluorescence imaging, and PET/MRI, for early diagnosis, assessment of surgical indications, and recurrence monitoring in patients with PM. The clinical applications, limitations, and solutions for fluorescence imaging, radiomics, and AI are also discussed.

• Radiation Oncology Journal
• /
• v.37 no.4
• /
• pp.259-264
• /
• 2019

Purpose: Accurate localization of the lumpectomy cavity during accelerated partial breast radiation (APBR) is essential for daily setup to ensure the prescribed dose encompasses the target and avoids unnecessary irradiation to surrounding normal tissues. Three-dimensional ultrasound (3D-US) allows direct visualization of the lumpectomy cavity without additional radiation exposure. The purpose of this study was to evaluate the feasibility of 3D-US in daily target localization for APBR. Materials and methods: Forty-seven patients with stage I breast cancer who underwent breast conserving surgery were treated with a 2-week course of APBR. Patients with visible lumpectomy cavities on high quality 3D-US images were included in this analysis. Prior to each treatment, X-ray and 3D-US images were acquired and compared to images from simulation to confirm accurate position and determine shifts. Volume change of the lumpectomy cavity was determined daily with 3D-US. Results: A total of 118 images of each modality from 12 eligible patients were analyzed. The average change in cavity volume was 7.8% (range, -24.1% to 14.4%) on 3D-US from simulation to the end-of-treatment. Based on 3D-US, significantly larger shifts were necessary compared to portal films in all three dimensions: anterior/posterior (p = 7E-11), left/right (p = 0.002), and superior/inferior (p = 0.004). Conclusion: Given that the lumpectomy cavity is not directly visible via X-ray images, accurate positioning may not be fully achieved by X-ray images. Therefore, when the lumpectomy cavity is visible on US, 3D-US can be considered as an alternative to X-ray imaging during daily positioning for selected patients treated with APBR, thus avoiding additional exposure to ionizing radiation.

• Journal of Chest Surgery
• /
• v.39 no.8 s.265
• /
• pp.598-603
• /
• 2006

Background: High thoracic epidural anesthesia allows awake coronary artery bypass grafting, avoiding the drawbacks of mechanical ventilation and general anesthesia. Materian and Method: From April, 2005 to September, 2005, 12 patients were underwent awake coronary artery bypass grafting using high thoracic epidural anesthesia. There were 1 female and 11 male patients, with a mean age of $66{\pm}6$ years. Off pump coronary artery. bypass grafting was performed through a median sternotomy using arterial grafts. Result: There were no mortality. Pneumothorax was developed during surgery in 8 patients. Five patients required secondary intubation because of pneumothorax (n=3), bowel herniation (n=1), and hemothorax after chest tube insertion (n=1). Postoperative coronary angiography was performed before discharge in all patients and all the grafts were patent. Conclusion: Our intial experience demonstrated the feasibility of awake off-pump coronary artery bypass grafting. Further study is required to define the indications, advantages and limitations of this strategy.