• Journal of Society of Preventive Korean Medicine
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• v.21 no.3
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• pp.1-10
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• 2017

Objectives : The purpose of this study is to investigate the practice patterns of traditional Korean medicine (TKM) doctors and the acceptance of payment model in order to develop a new TKM health insurance payment model linked with TKM clinical practice guidelines (CPGs). Methods : Lumbar herniated intervertebral disc (HIVD) and idiopathic facial palsy (IFP) were selected as a test diseases to develop a new TKM payment model. The level of benefit coverage in the National Health Insurance (NHI) was designed. The survey asked 228 TKM doctors about their practice patterns in HIVD and IFP patients and acceptance of new payment model. Results : Mean of medical cost for treatment of HIVD was 441,000 KW, mean of treatment period ranged from 4.9 to 17.5 weeks, and mean of number of treatment ranged from 14.6 to 50.4 HIVD patients. In the case of IFP, mean of medical cost for treatment of IFP was 468,000 KW, mean of treatment period was at least 4.2 and up to 15.9 weeks and mean of number of treatment ranged from 14.2 to 52 IFP patients. Conclusions : Current study suggests that mixed payment model of per-visit and episode-based model seem to be proper. The model 1 bundles both items which were covered and not covered by NHI in a rational way. The model 2 is based on the development and application of critical pathway. Lastly, model 3 suggests bundling of items covered by current NHI. Acceptance of TKM doctors is expected to be highest in the model 3.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.6
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• pp.1611-1618
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• 2007

In this study we investigated the effect of medical history on the incidence of stroke in Korean population. 217 stroke patients were enrolled as a case group. 160 non-stroke patients and 146 normal and non-stroke patients were enrolled as a control and a normal group, respectively, from Jul. 2005 to Mar. 2007. Stroke patients were hospitalized within 2 weeks after the onset of stroke. Medical history was gathered by interviewing each patient. Clinical data were analyzed using SAS software (ver 9.1). Hypertension and diabetes mellitus (DM) were statistically significant in a case group when compared with control and normal groups. Other parameters, such as transient ischemic attack, hyperlipidemia, ischemic heart disease, facial palsy, migraine, and hypochondria, did not show any statistical significance. The same association pattern was observed in the ischemic stroke patients of case group. On the other hand, hemorrhagic stroke patients of case group showed a significant difference in DM when compared with other subject groups. More efficient therapeutic strategy should be considered for patients with medical history, especially hypertensin and DM, to reduce the stroke incidence in Korean population.

• Journal of Pharmacopuncture
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• v.9 no.2
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• pp.49-65
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• 2006

Objective : The purpose of this study is to investigate nucleotide sequence and extract cytotoxicity of Scolopendrae corpus. The nature and taste of Scolopendrae corpus is hot, Warm and toxic, and the effect of this is dispelling wind, anti-spasmodic action and detoxication so it has been used for C.V.A, facial palsy, sensory disorder at extremities, wounds and arthritis. Methods : Scolopendrae corpus were collected by locality on the market. They were morphologically classified. Their nucleotide sequence was investigated and compared among them. In addition, the water-alcohol extract cytotoxicity of them was studied by MTT-based cytotoxicity assay. Results : It was shown that the each Scolopendrae corpus by locality is almost identical at genetic result and is identified as Scolopendra subspinipes mutilans L. Koch. Nucleotide sequence of Scolopendra subspinipes mutilans L. Koch in this study will help to discriminate other species of Scolopendrae corpus. The water-alcohol extract of Scolopendra subspinipes mutilans L. Koch did not induce cytotoxicity on Hep G2, L929 cell and peritoneal macrophages. Besides, it did not influence nitrite production of peritoneal macrophages. These results can be used as basic data for genetic discrimination with another species of scolopendrae corpus.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.891-900
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• 2021

Objective : Vertebral artery dissecting aneurysm (VADA) is a very rare subtype of intracranial aneurysms; when ruptured, it is associated with significantly high rates of morbidity and mortality. Despite several discussions and debates, the optimal treatment for VADA has not yet been established. In the last 10 years, flow diverter devices (FDD) have emerged as a challenging and new treatment method, and various clinical and radiological results have been reported about their safety and effectiveness. The aim of our study was to evaluate the clinical and radiological results with the use of FDD in the treatment of unruptured VADA. Methods : We retrospectively evaluated the data of all patients with unruptured VADA treated with FDD between January 2018 and February 2021 at our hybrid operating room. Nine patients with unruptured VADA, deemed hemodynamically unstable, were treated with FDD. Among other parameters, the technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcomes were evaluated. Results : Successful FDD deployment was achieved in all cases, and the immediate follow-up angiography showed intra-aneurysmal contrast stasis with parent artery preservation. A temporary episode of facial numbness and palsy was noted in one patient; however, the symptoms had completely disappeared when followed up at the outpatient clinic 2 weeks after the procedure. The 3-6 months follow-up angiography (n=9) demonstrated complete/near-complete obliteration of the aneurysm in seven patients, and partial obliteration and segmental occlusion in one patient each. In the patient who achieved only partial obliteration, there was a sac 13 mm in size, and there was no change in the 1-year follow-up angiography. In the patient with segmental occlusion, the cause could not be determined. The clinical outcome was modified Rankin Scale 0 in all patients. Conclusion : Our preliminary study using FDD to treat hemodynamically unstable unruptured VADA showed that FDD is safe and effective. Our study has limitations in that the number of cases is small, and it is not a prospective study. However, we believe that the study contributes to evidence regarding the safety and effectiveness of FDD in the treatment of unruptured VADA.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.14.1-14.11
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• 2020

Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond^® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

• CELLMED
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• v.11 no.3
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• pp.13.1-13.9
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• 2021

Background and Objective: Nux-vomica based traditional Unani formulation, Habb-e-Azaraqi (HAZ) is an important drug used by Unani physicians since several decades. It possesses Muqawwi-i-A'sab (nervine tonic), Muharrik-i-A'sab (nervine stimulant) properties and is an effective treatment option for diseases like Laqwa (facial palsy), Falij (paralysis), Niqris (gout) and Waja'al-Mafasil (arthritis) etc. The aim of the study is to access and provide information of HAZ for its TLC, HPTLC Fingerprinting defining its clear qualitative perspective and acute oral toxicity evaluation for its safety assessment which was not done earlier, thus contributing in the field of research. Materials and Methods: The chief ingredient, nux-vomica was detoxified as per method mentioned in Unani Pharmacopeia before its use in formulation. TLC and HPTLC was developed under four detection system i.e., UV 366nm, UV 254nm, exposure to iodine vapours and after derivatization with anisaldehyde sulphuric acid. Acute toxicity studies were performed as per OECD Guidelines 425 at a limit dose of 2000 mg/kg. Observations were done for signs of toxicity, body weight, and feed consumption at regular intervals followed by haematological and biochemistry evaluation. Results: The generated data proved the authenticity and established the TLC and HPTLC profile of the formulation. Acute toxicity revealed no significant differences in HAZ-treated animals with respect to body weight gain, feed consumption, haematology, clinical biochemistry evaluation. No significant gross pathological observation was noticed in necropsy. Conclusion: Data of the present study is substantial and scientific proof of HAZ in terms of standardization and toxicity study that can be utilize in future research activities.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.891-895
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• 2007

Purpose : Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system and mostly develops after viral illness or vaccinations. We investigated the clinical differences and neurologic outcomes according to the distribution of the lesions on brain MRI. Methods : The study group was composed of 21 patients from January 1995 to August 2003 in Kyunghee University hospital. We grouped the patients according to the MRI findings as follows. Group I (14 cases): Multi- or unifocal lesions only in the cerebral white matter. Group II (7 cases): lesions in the gray matter with or without white matter involvement. Results : 1. Preceding events were as follows: no defined prodrome (38.1%), upper respiratory tract infection (28.6%), nonspecific febrile illness (19.0%), gastointestinal disturbance and vaccination. 2. Presenting symptoms were as follows: seizures (76.2%), headache/vomiting (47.6%), altered consciousness (38.1%), hemiparesis, cerebellar ataxia, visual disturbance and facial nerve palsy. 3. Laboratory findings were as follows: CSF pleocytosis (76.2%), leucocytosis (38.1%) and elevated CSF protein (28.6%). 4. Fifteen patients were recovered completely without neurological sequelae. Three patients in group I and 1 patient in group II had intractable seizures. Two patients in group I and 2 patients in group II had motor disturbance. Conclusion : There were no statistically significant differences in preceding events, presenting symptoms, and neurological outcomes according to the distribution of the lesions on brain MRI. However, the ADEM have quite diverse clinical manifestations and neuroimage findings. MRI plays an important role in making diagnosis of the patients who are suspected of ADEM.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.131-136
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• 2005

Purpose: The aim of this study was to evaluate the clinical results of postoperative radiotherapy for parotid gland malignancy, and determine prognostic factors for locoregional control and survival. Materials and Methods: Between 1980 and 2002, 130 patients with parotid malignancy were registered In the database of the Department of Radiation Oncology, Seoul National University Hospital. The subjects of this analysis were the 72 of these 130 patients who underwent postoperative Irradiation, There were 42 males and 30 females, with a median age of 46.5 years. The most common histological type was a mucoepidermoid carcinoma. There were 6, 23, 23 and 20 patients in Stages I, II, III and IV, respectively. The median dose to the tumor bed was 60 Gy, with a median fraction size of 1.8 Gy. Results: The overall 5 and 10 year survival rates were 85 and $76\%$, respectively, The five-year locoregional control rate was $85\%$, which reached a plateau phase after 6 years. Sex and histological type were found to be statistically significant for overall survival from a multivariate analysis. No other factors, Including age, facial nerve palsy and stage, were related to overall survival. For locoregional control, nodal involvement and positive resection margin were associated with poor local control. Histological type, tumor size, perineural invasion and type of surgery were not significant for locoregional control. Conclusion: A high survival rate of parotid gland malignancies, with surgery and postoperative radiotherapy, was confirmed. Sex and histological type were significant prognostic factors for overall survival. Nodal Involvement and a positive resection margin were associated with poor locoregional control.