This study compared the instrument performance and tissue healing of a steel scalpel with a $CO_2$ laser in an animal uterine surgery model. Five Landrace and Yorkshire mixed breed pigs were used. Two symmetrical incisions were made in the uterine of each pig. One incision was made on the left side of the uterine horn using a steel scalpel, while the other incision was performed on the right side using a $CO_2$ laser with an 8W output power. Each instrument was evaluated clinically for speed, ease of incision, and extent of bleeding. An ovariohysterectomy was performed at 21 days after the surgical procedure for a histological examination. The scalpel was an easier instrument to use in the confines of the uterine tissue, compared with the laser. However, there is no significant difference between the two groups. The amount of bleeding was less in the laser group but the time of the incisions was shorter with the scalpel. Postoperative uterus adhesion in the $CO_2$ laser incisions was lower than the scalpel incisions. Scalpel incisions showed complete restoration of the epithelium and endometrial gland. On the other hand, the laser incisions showed incomplete restoration of the epithelium and endometrial gland. Although the scalpel produced less damage to the uterine tissue and was easier to handle than the $CO_2$ laser, it did not provide hemostasis that was helpful for use on highly vascular tissue. The $CO_2$ laser provided good hemostasis but delayed wound healing.
Huh-Im(許任, 1570~1647) was an acupuncture doctor of Chosun(朝鮮) era through the late 16th century and early 17th century. Even though he was a person of low birth, he participated in the loyal medication through three loyal generations, Sunjo(宣祖), Kwanghaegun(光海君) and Injo(仁祖). He was recognized of his services and became an official, 'Dangsanggwan'(堂上官) and Kyunggi(京畿) district official several times. In the early Chosun era, acupuncture medicine was focused. During the late 16th century, Imjin(壬辰) war aroused more needs about acupuncture medicine, and acupuncture doctors showed remarkable work. Under these circumstances, Huh-Im(許任)'s fame spread throughout the country. Huh-Im(許任) wrote ChimGuKyungHumBang("鍼灸經驗方") in 1644 based on his lifetime clinical acupuncture & moxibustion experience. It was the first specialized book of acupuncture in Chosun era. This event took place 30 years after DongEuiBoGam - Acupuncture Chapter("東醫寶鑑-鍼灸篇") was published. But it was not influenced much by DongEuiBoGam - Acupuncture Chapter("東醫寶 鑑-鍼灸篇") in the form or contents. ChimGuKyungHumBang("鍼灸經驗方") and Huh-Jun(許浚)'s DongEuiBo- Gam - Acupuncture Chapter("東醫寶鑑-鍼灸篇") were the fruits of the middle Chosun, and they are complementary to each other in theory and practice. The chief distinctions of ChimGuKyungHumBang("鍼灸經驗方") are in it's compact and practical edition and a lot of his clinical acupuncture prescriptions mentioned in the book. Huh-Im(許任) not only accepted the existing books such as NaeKyung("內經"), DongInSuHyulChimGuDoKyung and Shin- Eung Kyung("神應經") with his point of view and clinical experience, but also showed creative operation of studies. Indicating incorrect acupuncture points(訛穴), acupuncture remedy based on the visceral pathogenesis(臟腑病機) and the channel pathogenesis, research on new acupuncture points, sorting out plenty of outer meridian acupuncture points(經外奇穴), creating supplementary and purging acupuncture method(鍼補瀉法) which is a change of hand treatment of KiHyoYangBang("奇效良方"), operating variety of acupuncture and moxibustion treatments, and application of acupuncture treatments on surgery field such as intumescences and emergency cases are the examples. Huh-Im(許任)'s ChimGuKyungHumBang("鍼灸經驗方") influenced on the folk remedy books(民間經驗方書) in the late Chosun era. Compact and practical characteristics of the book let acupuncture treatment be freindly to the people. It can be confirmed in JeungBoSanRimKyungJe-Emergency Chapter("增補山林經濟-救急篇") or the formation of SaAmChimBob(舍巖鍼法). ChimGuKyungHumBang("鍼灸經驗方") was introduced to Japan in 18th century and published twice. ChimGuJibSung("鍼灸集成"), known as an acupuncture medical book of late Qing dynasty(淸末, 1874), is confirmed to be an plagiarization of DongEuiBoGam-Acupuncture Chapter("東醫寶鑑-鍼灸篇") and ChimGuKyungHum- Bang("鍼灸經驗方") of 17th century Chosun. Confusions and errors arouse from mistaken editional trend of ChimGuJIbSung("鍼灸集成") which had not disclosed it's original author and the title of the book must be reformed. In this way, fruits of acupuncture of the middle Chosun era including Huh-Im(許任)'s ChimGuKyungHumBang("鍼灸經驗方") will take a right place in acupuncture medicine history.
Han, Mi Ra;Kang, Eun Hyoung;Lee, Yong Suk;Chang, Eun Ju;Lee, Su Jeong;Heo, Yoon A;Namgung, Seo Hwa;Seo, Seo Hee
Journal of Korean Clinical Nursing Research
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v.26
no.2
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pp.198-206
/
2020
Purpose: The rapid response team is a patient safety system that detects symptoms and signs of deteriorating inpatients and provides intervention and treatment. This study analyzed the factors influencing the activation time of the team. Methods: This is a descriptive correlation study that analyzed the electronic medical records of patients activated by the rapid response team. The collection period was from January 2014 to December 2017. We analyzed 278 pieces of data activated by the rapid response team for patients aged 16 years or older at C University S Hospital in Seoul. We employed the SPSS 23.0 program for data analysis. Results: The reasons for activation of the rapid response team were oxygen saturation of less than 90.0%, other causes, and change in consciousness. The most common diagnosis of activated patients was respiratory failure (32.4%). The average activation time was 153.43±286.05 min. The activation time was shortest during convulsions (13.29±7.32 min). For patients with a history of kidney disease (B=0.58, p=.008), in case of surgery (B=0.55, p<.001), if the first symptom is mediated by the physician (B=0.53, p=.007) the active time is often extended. On the other hand, activation time is reduced when consciousness changes (B=-0.51, p=.002), especially when oxygen saturation is below 90.0% (B=-0.64, p<.001). Conclusion: Based on the results of the study, it is expected that patients deteriorating in the general ward would be recognized early, which will help in the effective activation of the rapid response team.
Purpose: This study was conducted to investigate the changes in distance refractive power and reading addition that occur after wearing corrective glasses for prebyopia. Methods: The subjects aged 42 to 75 years who had no ophthalmologic diseases and did not undergo cataract or retina surgery, had a corrected visual acuity of 20/20 and did not have a previous history of wearing corrective glasses for presbyopia. These subjects were divided into 3 groups: the control, reading spectacles and multifocals wearing group and they were measured for distance refractive power and reading addition at their visit. The maximum follow-up period was 73 months. Results: As for distance refractive power, the power tends to shift to hyperopia depending on age (r=0.486, p<.001) and 50.0% of the subjects increased plus power during this study period. Plus power Increments per year in distance refractive power in the reading spectacle wearing group were significantly different with control and multifocals wearing group (p<.05). On the other hand, the multifocals wearing group's increments were not different with control. Increments in reading addition were also increased in the reading spectacles group than in the control and multifocals wearing groups (p<.05). Conclusions: The age related hyperopic shift could be occurred in the elderly people, routine refraction is mandatory. And reading spectacles could induce an age related hyperopic shift and the additional need for reading addition that the prescription of multifocals may reduce changes in distance refractive power and reading addition.
Cho, Minjae;Joo, Jin-Deok;Kim, In Ah;Han, Jung Ho;Oh, Chang Wan;Kim, Chae-Yong
Journal of Korean Neurosurgical Society
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v.60
no.5
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pp.527-533
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2017
Objective : To investigate the efficacy of adjuvant treatment in patients with high-grade meningioma. Methods : A retrospective analysis was performed for patients with high-grade meningioma, World Health Organization grade 2 or 3, in a single center between 2003 and 2014. The patients were reviewed according to age at diagnosis, sex, the location of meningioma, degree of tumor resection, histological features, and type of adjuvant treatment. These factors were analyzed by Firth logistic regression analyses. Results : Fifty-three patients with high-grade meningioma were enrolled. Thirty-four patients received adjuvant treatment; conventional radiotherapy or radiosurgery. Clinical follow-up ranged from 13-113 months with a median follow-up of 35.5 months. Gross total removal (GTR), Simpson grade 1 or 2, was achieved in 29 patients and, among them, 13 patients received adjuvant treatment. In the other 24 patients with non-GTR, conventional adjuvant radiotherapy and radiosurgery were performed in 11 and 10 patients, respectively. The other 3 patients did not receive any adjuvant treatment. Radiation-related complications did not occur. Of the 53 patients, 19 patients had suffered from recurrence. The recurrence rate in the adjuvant treatment group was 23.5% (8 out of 34). On the other hand, the rate for the non-adjuvant treatment group was 57.9% (11 out of 19) (odds ratio [OR]=0.208, p=0.017). In the GTR group, the recurrence rate was 7.5% (1 out of 13) for patients with adjuvant treatment and 50% (8 out of 16) for patients without adjuvant treatment (OR=0.121, p=0.04). Conclusion : Adjuvant treatment appears to be safe and effective, and could lead to a lower recurrence rate in high-grade meningioma, regardless of the extent of removal. Our results might be used as a reference for making decisions when planning adjuvant treatments for patients with high-grade meningioma after surgery.
Woo, Jun Hyuk;Lee, Hyun Woo;Choi, Hong June;Kwon, Young Min
Journal of Korean Neurosurgical Society
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v.64
no.6
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pp.944-949
/
2021
Objective : The stability is an important factor to decide the treatment plan in thoracolumbar burst fracture patients. Patients with an unstable burst fracture generally need operative management. Decrease in vertebral body height, local kyphosis, involvement of posterior column, and/or canal compromise are considered important factors to determine the treatment plan. On the other hand, in thoracolumbar injury classification system (TLICS), surgery is recommended in patients with TLICS of more than 5 points. The purpose of this study was to apply the TLICS score in patients with thoracolumbar burst fractures and to distinguish the differences of treatment plan on burst fracture. Methods : All patients, diagnosed as a thoracolumbar burst fracture between January 2006 and February 2019 were included in this study. Unstable thoracolumbar burst fracture was defined as burst fracture with neurologic deficit, three-column injury, kyphosis over 30 degrees, decrease of anterior body height over 40 percent and canal comprise more than 50%. TLICS score was measured with morphology, neurological involvement and posterior ligamentous complex integrity. The existence of instability was compared with TLICS score. Results : Total 233 patients (131 men, 102 women) were included in this study. In Denis classification, 51 patients (21.9%) diagnosed as stable burst fracture while 182 patients (78.1%) had unstable burst fracture. According to TLICS, 72 patients (30.9%) scored less than 4, while 161 patients (69.1%) scored 4 or more. All the patients with stable burst fracture scored 2 in TLICS. Twenty-one patients (9.0) scored 2 in TLICS but diagnosed as unstable burst fracture. Thirteen patients had over 40% of vertebra body compression, four patients had more than 50% of canal compromise, three patients had both body compression over 40% and kyphosis over 30 degrees, one patients had both body compression and canal compromise. Fifteen patients presented kyphosis over 30 degrees, and three (20%) of them scored 2 in TLICS. Seventy-three patients presented vertebral body compression over 40% and 17 (23.3%) of them scored 2 in TLICS. Fifty-three patients presented spinal canal compromise more than 50%, and five (9.4%) of them scored 2 in TLICS. Conclusion : Although the instability of thoracolumbar burst fracture was regarded as a critical factor for operability, therapeutic strategies by TLICS do not exactly match with the concept of instability. According to the concept of TLICS, it should be reconsidered whether the unstable burst fracture truly unstable to do operation.
Kim, Dae Jin;Mun, Sue Jean;Choi, Jeong Su;Lee, Min Woo;Cho, Jae Wook
Korean Journal of Clinical Laboratory Science
/
v.51
no.1
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pp.119-123
/
2019
Obstructive sleep apnea (OSA) is a sleep disorder with no breathing symptoms due to repetitive upper airway resistance. OSA is a disease that can have significant effects on the cerebral cardiovascular system. Active treatment is needed to prevent these complications. The use of continuous positive airway pressure (CPAP), the standard therapy of OSA, has comparative therapeutic effects. On the other hand, there is no comparison report of the polysomnography (PSG) results before and after CPAP therapy without using a mask. This paper reports a patient who was diagnosed as OSA and used CPAP every night for more than 2 years. The patient showed a decrease in the apnea-hypopnea index from 64.7/h to 12.9/h. In addition, other sleep-related indicators improved significantly. The daily use of CPAP as a treatment for OSA for more than 2 years may improve the PSG results. Constant follow up of PSG will be needed to adjust the appropriate CPAP pressure to patients because there might be a change in the Apnea-Hypopnea Index and other sleep-related indicators for constant CPAP users for at least 2 years.
Choi, Kyung Hwa;Kim, Mi Sun;Nam, Ok Hyung;Lee, Hyo-Seol;Choi, Sung Chul;Kim, Kwangchul
The Journal of Korea Assosiation for Disability and Oral Health
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v.15
no.1
/
pp.29-34
/
2019
Prader-Willi Syndrome (PWS) is a rare neurologic disorder with a prevalence 1/10,000-30,000. The cause of PWS is an abnormalities of chromosome 15q11.2-q13 which is an imprinting gene. Obesity and hyperphagia are characteristic features on a PWS adult. On the other hand, the birth weight, height and body mass index (BMI) of PWS infants are 15-20% lower than those of normal babies and there is a failure to thrive until 24-month-old. Most of PWS patients are treated under general anesthesia and conscious sedation. This case is a treatment of severe caries in a PWS 46 month-old child without general anesthesia and conscious sedation. He came to the Department of Pediatric Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea with a trauma history. He had a medical history with heart surgery and needed to take antibiotics prophylaxis. The luxated left upper primary tooth were removed and caries treatment were done as an outpatient without general anesthesia, conscious sedation.
The Journal of Korea Institute of Information, Electronics, and Communication Technology
/
v.12
no.4
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pp.336-342
/
2019
With the entry of an aging society, the average life span of accreditation has been extended. Therefore, interest in the appearance of men and women in modern society has increased. It is the wrinkles of the face that can judge the most outwardly. People tend to have various kinds of treatments to have a clean, wrinkle-free and resilient healthy skin regardless of sex. There is a lot of practice of lifting procedures in one of the procedures. A suture using a melting thread is a method of lifting by squeezing it into the skin as a non-incision type centering on a region where the thread can be fixed in the skin by injecting it into the subcutaneous fat layer. To evaluate the lifting efficacy of Cog - type suture for the improvement of skin wrinkles, preclinical experiments were conducted. We developed a wrinkle evaluation program using Labview. Data from preclinical experiments were used at 8 weeks after suturing. The average wrinkle depth was 415.6 mm in the control group. At 8 weeks, the depth of wrinkles was deepened to 888.3mm due to the aging process of the control group. On the other hand, the depth of the wrinkles before surgery was 640.3 mm in the suture group. It was confirmed that the depth of wrinkles decreased to 566.5mm at 8th week after the suture operation.
Journal of The Korean Society of Emergency Medicine
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v.29
no.5
/
pp.485-492
/
2018
Objective: This paper reports the status of the advanced cardiac life support (ACLS) according to the guidelines by residents belonging to other departments other than the department of emergency medicine. The differences in status between the junior group and senior group was also investigated according to grades of residents. Methods: The ACLS performance for in-hospital cardiac arrest cases of one academic hospital, except for the cases occurring in intensive care unit between November 2015 and October 2017, were analyzed retrospectively. Data included the characteristics of residents, patients' outcomes, ACLS performance, and conventional treatment having discordance with the ACLS guidelines. Leaders during cardiopulmonary resuscitation (CPR) were divided into a junior group and senior group. Results: A total of 152 cases were enrolled in this study. Of these, 131 cases (86.2%) showed at least one treatment with inconsistency from the guidelines and the incidence of discordant treatment was similar in the two groups (55 [85.9%] vs. 76 [88.4%], P=0.657). Implicit use of sodium bicarbonate was more frequent in the senior residents group (odds ratio [OR], 3.04; 95% confidence interval [CI], 1.36-6.81). On the other hand, no use of a defibrillator was less frequent in the senior residents group (OR, 0.14; 95% CI, 0.03-0.81). Conclusion: In both groups, the rate of discordance with the ACLS guidelines during CPR were high. The rate of implicit use of sodium bicarbonate and no use of defibrillator were significantly different in the two groups. A customized education strategy for ACLS is needed for each group.
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