• Journal of Korean Neurosurgical Society
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• 제58권6호
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• pp.518-527
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• 2015

Objective : The treatment of complex intracranial aneurysms remains challenging. One approach is the application of surgical flow alteration to treat aneurysms that are neither clippable, trappable, or coilable. The efficacy and limitations of surgical flow alteration have not yet been established. Methods : Cases of complex aneurysms treated with surgical flow alteration (proximal occlusion with or without bypass, distal occlusion with or without bypass and bypass only) were included in this retrospective study. Results : Among a total of 16 cases, there were 7 giant aneurysms (${\geq}25mm$ diameter) and 9 large aneurysms (>10 mm diameter); 15 of 16 aneurysms were unruptured. There were 8 aneurysms located in the anterior circulation, while the other 8 were in the posterior circulation. Aneurysms were treated with proximal occlusion in 10 cases and distal occlusion in 5 cases; in 1 case, the aneurysm occluded spontaneously after bypass without parent artery occlusion. All but 2 cases underwent prior or concurrent bypass surgery. Complete obliteration of the aneurysm at the latest imaging follow-up was shown in 12 of 16 cases (75.0%). Bypass patency was confirmed in 13 of 15 cases (86.7%). Surgery-related morbidity developed in 3 cases (18.8%, Glasgow outcome scale of 4) and all were perforator infarctions. There were no mortalities. Conclusion : Surgical flow alteration resulted in a high rate of aneurysmal obliteration with acceptable morbidity. Although several limitations remained, it could represent an alternative method for treating complex aneurysms.

• Journal of Korean Neurosurgical Society
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• 제48권2호
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• pp.177-180
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• 2010

Giant serpentine aneurysms are rare and have distinct angiographic findings. The rarity, large size, complex anatomy and hemodynamic characteristics of giant serpentine aneurysms make treatment difficult. We report a case of a giant serpentine aneurysm of the right middle cerebral artery (MCA) that presented as headache. Treatment involved a superficial temporal artery (STA)-MCA bypass followed by aneurysm resection. The patient was discharged without neurological deficits, and early and late follow-up angiography disclosed successful removal of the aneurysm and a patent bypass graft. We conclude that STA-MCA bypass and aneurysm excision is a successful treatment method for a giant serpentine aneurysm.

• 대한상부위장관⦁헬리코박터학회지
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• 제18권3호
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• pp.150-156
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• 2018

Precision medicine stands for 4Ps - precise, preventive, participatory, and personal; in which "precision" is important because the current modern medicine starts from "trial and error," and "one does not fit all". Current targeted therapies for cancer have changed treatment approaches and led the precision medicine; however, clinical use of liquid biopsy, using blood or other liquid specimens to characterize circulating tumor cells (CTC) or tumor genes instead of biopsies of tumor tissues, still awaits availability of more information regarding non-invasive cancer detection and characterization, prediction of treatment response, monitoring the disease course and relapse possibilities, identification of mechanisms of drug resistance, and newer pathogenesis. In this review, we will introduce the basic concept of CTC, circulating cell free DNA, and exosomes and their possible application for gastric cancer relevant with Helicobacter pylori infection.

• 한국산업융합학회 논문집
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• 제25권6_2호
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• pp.1083-1090
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• 2022

Since renal cell carcinoma(RCC) has various examination and treatment methods according to clinical stage and histopathological characteristics, it is required to determine accurate and efficient treatment methods in the clinical field. However, the process of collecting and processing RCC medical data is difficult and complex, so there is currently no AI-based clinical decision support system for RCC treatments worldwide. In this study, we propose a clinical decision support system that helps clinicians decide on a precision treatment to each patient. RCC standard big database is built by collecting structured and unstructured data from the standard common data model and electronic medical information system. Based on this, various machine learning classification algorithms are applied to support a better clinical decision making.

• 동의생리병리학회지
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• 제35권5호
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• pp.193-198
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• 2021

The purpose of this study is to observe the effect of Cordyceps Militaris(CM) complex extract treatment on patients diagnosed with rheumatoid arthritis(RA). We reviewed medical records of 9 rheumatoid arthritis patients who visited the pain & rehabilitation center, Daejeon Korean Medicine Hospital of Daejeon University and were treated with CM complex extract from October 14, 2019 to October 14, 2020. We analyzed the records of DAS 28(Disease Activity Score 28), CDAI(Clinical Disease Activity Index), SDAI(Simplified Disease Activity Index), VAS(Visual analogue Scale), and KHAQ-D(Korean Health Assesment Questionnaire-Disability Index) before and after treatment to evaluate the effects of CM complex extract on RA. As a result, the scores of DAS 28(p<0.05), CDAI(p<0.01), SDAI(p<0.01) and VAS(p<0.01) were statistically significantly decreased, after 8 weeks of taking CM complex extract in RA patients. In conclusion, CM complex extract treatment may have potential effects of reducing disease activity and pain and improving quality of life in patients diagnosed with RA.

• 동의생리병리학회지
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• 제33권4호
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• pp.219-225
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• 2019

The objective of this study is to observe the effectiveness of complex Korean Medicine treatments on pain reduction of patients after meniscal surgery. We analyzed 16 patients who have been diagnosed as Meniscal injury on Magnetic Resonance Imaging(MRI) scan and had admitted to Dunsan Korean Medical hospital from January 30, 2014 to April 30, 2019. The analysis was conducted as retrospective study which analyzes patient's medical records. Statistical analysis was performed using the IBM SPSS statistics 25 program. We used Numeric Rating Scale to evaluate pain reduction, Five-point likert scale to asses treatment satisfaction. The result showed that there were statistically significant pain reduction on the postoperative meniscal injury patients treated with complex Korean Medicine treatments. In conclusion, we found that the complex Korean Medicine treatments showed a positive effect on pain reduction of postoperative meniscal injury patients. Further research is required to confirm the effectiveness of Korean Medicine treatment.

• 대한치과의사협회지
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• 제48권1호
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• pp.27-37
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• 2010

Current trend of aging society suggests that many patients are at risk for various preoperative preparations and postoperative complications during and following invasive dental procedures, due to an acquired medically compromised conditions from systemic disease and/or from medications. The medical history is critical for the identification of patients potentially at risk for medically compromised and old aged patients' factors from dental treatment. The proper dental management requires an understanding of certain principles of pathophysiology for these medical conditions and some standard laboratory tests. Polypharmacy in old age, besides representing a risk in and of itself, points to the potential risk the underlying diseases that necessitated the drugs can present in the dental office. These diseases and medications can also present a risk to oral health. A sequence for categorizing drugs in a medication list is presented here to aid in the identification of potential risks in the dental treatment and management of patients with complex medical histories and drug regimens. Specific patient populations, such as pediatric, may have specific drugs or additional criteria that need to be considered. Practitioners must use the health history and the medication list in concert, using one to make sense of the other and utilizing all the information available from reviewing each one carefully in order to manage their increasingly complex patients safely and effectively.

• 대한한방내과학회지
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• 제26권2호
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• pp.489-497
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• 2005

Conversion disorder lacks temperamental grounds and is a type of somatoform disorder that includes alteration or loss of physical functions implicated in physical deficit suggestive psychological conflict. There is high incidence of return of conversion disorder and difficulty in producing exact approaches of cure and apparent effects of remedy with symptomatic treatment alone because of its complex clinical symptoms. The approach of Oriental Medicine in treatment of conversion disorder is to apprehend relative symptoms from the syndrome combined with several annexational symptoms centering around sequential symptoms. Thereupon, author made a Ganyanghwapung comprehensive diagnosis was conducted using Oriental Medicine measures by differential diagnostic methods in psychosomatic patients whose cases are diagnosed as conversion disorder. Then, Cheonmagudeungeum Gagambang was prescribed for them and it brought on satisfactory effects from the first or second treatment. There have been many cases reporting the application of Oriental Medicine treatment to conversion disorder to date and outcomes have also been favorable. Results of this study likewise suggest that this Oriental Medicine treatment for conversion disorder is effective.

• 의료법학
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• 제5권1호
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• pp.622-660
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• 2004

Medical services aren't done by doctors only but by different medical personnels. If any medical accident takes place, to what extent doctors, nurses and other personnels should respectively be liable for that should be determined. And when an employed doctor does any illegal medical act, his or her employer also should be responsible for that as a user. If a medical accident occurs, the victim or patient usually claims against the employer of the doctor sho causes the accident for compensation. And those who assist medical treatment, including nurses, should be liable for their own acts, but in case their doctor doesn't give any appropriate directions, the doctor should shoulder the liability. This indicates that nurses are also professional medical personnels, and that they should share the liability as well. There are lots of different medical personnels, but doctors and nurses are the pivot of team treatment, and nurses should also take responsibility for their services. Doctors and nurses are equal, as they are in pursuit of the same, namely, helping patients recover their health. Only their roles are different. If they respect each other and see each other as being responsible for their own roles, they will be able to consult together. Medical information on patients and nursing information should be shared by both of them, and patients should be provided accurate treatment and nursing services. If those who offer nursing services are unaware of required information due to conflicts with doctors, it might result in threatening the safety of patients. And in case any important information isn't properly conveyed between them, it might trigger a medical accident. Sophisticated and complex medical science requires medical personnels to be professional, and nurses as well as doctors need to be an expert. The fact treatment-related accidents take place often indicates that treatment is basically attended with danger. Furthermore, patients respond to all sorts of investigation and medicine in a different manner. They should be professional and knowledgeable to predict how they might respond and prevent any possible hazardous situations, and they are expected to have more knowledge in the future. Nonetheless, there aren't yet enough studies on the legal liability of nurses, and this study is expected to pave the way for future research on nurse liability against medical accidents.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권4호
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• pp.434-439
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• 2023

Pseudoaneurysms are rare but devastating complications of penetrating head traumas. They require rapid surgical or endovascular intervention due to their high risk of rupture; however, complex presentations may limit treatment options. Our objective is to report a case of severe vasospasm, flow diversion, and in-stent stenosis complicating the treatment of a middle cerebral artery pseudoaneurysm following a gunshot wound. A 33-year-old woman presented with multiple calvarial and bullet fragments within the right frontotemporal lobes and a large right frontotemporal intraparenchymal hemorrhage with significant cerebral edema. She underwent an emergent right hemicraniectomy for decompression, removal of bullet fragments, and evacuation of hemorrhage. Once stable enough for diagnostic cerebral angiography, she was found to have an M1 pseudoaneurysm with severe vasospasm that precluded endovascular treatment until the vasospasm resolved. The pseudoaneurysm was treated with flow diversion and in-stent stenosis was found at 4-month follow-up angiography that resolved by 8 months post-embolization. We report the successful flow diversion of an middle cerebral artery (MCA) pseudoaneurysm complicated by severe vasospasm and later in-stent stenosis. The presence of asymptomatic stenosis is believed to be reversible intimal hyperplasia and a normal aspect of endothelial healing. We suggest careful observation and dual-antiplatelet therapy as a justified approach.