• International Neurourology Journal
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• v.22 no.4
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• pp.275-286
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• 2018

Purpose: OnabotulinumtoxinA (BoNT-A) is a promising therapy for treating neurogenic detrusor overactivity (NDO) in individuals with spinal cord injury (SCI). This systematic review and meta-analysis aimed to carry out an in-depth review and to make an objective estimation of the efficacy and safety of BoNT-A on NDO after SCI. Methods: The PubMed, Embase, and Cochrane databases were searched for all relevant articles published from 2001 to 2016 that referred to NDO, SCI, and BoNT-A or botulinum toxin A. All data were recorded in an Excel spreadsheet by 2 individual reviewers. Review Manager version 5.3 was used to carry out the meta-analysis. Results: This analysis included 17 studies involving 1,455 patients. Compared with placebo and baseline, BoNT-A was effective in increasing maximum cystometric capacity, volume at first involuntary detrusor contraction, cystometric bladder capacity (all P<0.00001), compliance (P=0.001), and the number of patients with complete dryness (P=0.0003), and decreasing detrusor pressure, the number of patients with no involuntary detrusor contractions, the maximum flow rate, the incidence of detrusor overactivity (all P<0.00001), and the number of urinary incontinence episodes (P=0.001). There were no statistically significant differences between doses of 200 U and 300 U or between injections into the detrusor and submucosa. There were no life-threatening adverse events. Conclusions: BoNT-A is effective and safe in treating NDO after SCI. There were no statistically significant differences between doses of 200 U and 300 U or between injecting into the detrusor and submucosa. However, more high-quality randomized controlled trials are still needed.

• Journal of Trauma and Injury
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• v.35 no.4
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• pp.268-276
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• 2022

Purpose: Rib fractures are common injuries that can lead to morbidity and mortality. Methods: Data on all patients with rib fractures admitted to a single trauma center between January 1, 2008 and December 31, 2018 were reviewed. Results: A total of 1,671 admissions for rib fracture were examined. Patients' median age was 57 years, the median Injury Severity Score (ISS) was 14, and the median number of fractured ribs was three. The in-hospital mortality rate was 4%. Age, the number of rib fractures, and Charlson Comorbidity Index scores were poor predictors of mortality, while the ISS was a slightly better predictor, with area under the receiver operating characteristic curve values of 0.60, 0.55, 0.58, and 0.74, respectively. Multivariate regression showed that age, ISS, and Charlson Comorbidity Index score, but not the number of rib fractures, were associated with significantly elevated adjusted odds ratios for mortality (1.03, 1.14, and 1.28, respectively). Conclusions: Age, ISS, and comorbidities were independently associated with the risk of mortality; however, they were not accurate predictors of death. The factors associated with rib fracture mortality are complex and cannot be explained by a single variable. Interventions to improve outcomes must be multifaceted.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.4
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• pp.189-196
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• 2024

Objectives: This study aimed to evaluate the association between use of direct oral anticoagulants (DOACs) and post-extraction bleeding and to quantify bleeding risk in patients receiving DOACs. Materials and Methods: The study included 293 patients who were taking DOACs and underwent tooth extraction (414 teeth). The patients were divided into those who had the extraction while taking DOACs and those who discontinued DOACs before the extraction. Bleeding complications were recorded and compared between the patient groups and types of DOACs. Results: Of the 293 patients, 12 patients (6.9%) had post-extraction bleeding. Post-extraction bleeding occurred in 12 of the 414 tooth extraction sites. Among the 246 patients who underwent dental extraction while continuing DOAC therapy, 12 patients (8.5%) had post-extraction bleeding. Among the 47 patients who underwent dental extraction after discontinuing the administration of DOACs, none reported post-extraction bleeding. There was no significant difference in the number of patients with post-extraction bleeding between the two groups (P=0.122). Conclusion: Continuing DOAC therapy during dental extraction does not increase post-extraction bleeding tendency. These results are consistent with those of previous studies.

• Phonetics and Speech Sciences
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• v.11 no.4
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• pp.109-116
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• 2019

This study was conducted to identify the characteristics of pauses and breath groups made by normal adults and patients with voice disorders while reading a paragraph. Forty normal female adults and forty female patients with a functional voice disorder (18-45 yrs.) read the "Gaeul" paragraph with the "Running Speech" protocol of the Phonatory Aerodynamic System (PAS), by which the pauses with or without inspiration and between or within syntactic words and breath groups were analyzed. The number of pauses with inspiration was found to be higher in the patient group, but the number of pauses without inspiration was higher in the normal group. The rate of syntactic word boundaries with pauses with inspiration was higher in the patient group, while the number of syllables per breath group was higher in the normal group. As these results can be explained by patients' poor breath support due to glottal insufficiency, the question of whether voice disorder patients use their pauses and breath groups properly should be considered carefully in evaluation and intervention.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.151-155
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• 2005

Background: A significant number of patients complain of persistent pain or neurologic symptoms after lower back surgery. It is reported that facet joint pain plays a role in failed back surgery syndrome. To the best of our knowledge, there are few studies that have investigated the outcome of radiofrequency neurotomy in the patients with failed back surgery syndrome. Methods: The study group was composed of thirteen patients who were operated on due to their low back pain, and they displayed no postoperative improvement. All the patients underwent double diagnostic block of the lumbar medial branch of the dorsal rami with using 0.5% bupivacaine. The patients who revealed a positive response to the double diagnostic block were then treated with percutaneous radiofrequency neurotomy. The effect on their pain was evaluated with using a 4 point Likert scale. Results: Eleven patients revealed a positive response to the double diagnostic block. Ten patients were given percutaneous radiofrequency neurotomy. Nine patients showed sustained pain relief for 3 months after the percutaneous radiofrequency neurotomy. Conclusions: We found lumbar facet joint syndrome in the patients with failed back surgery syndrome by performing double diagnostic block and achieving pain relief during the short term follow-up after percutaneous radiofrequency neurotomy of the lumbar zygapophysial joints. This suggested that facet joint pain should be included in failed back surgery syndrome.

• Journal of Arbitration Studies
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• v.29 no.2
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• pp.225-237
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• 2019

Recently, it has been argued that it is necessary to attract foreign patients outside domestic insurers and to allow foreign doctors to treat in domestic hospitals in order to develop the insurance industry and revitalize the medical industry. Currently, large medical institutions in Korea are attracting foreign patients in connection with foreign insurance companies. It is desirable to increase the number of overseas patients who want excellent medical services in Korea, and to provide opportunities for domestic insurance companies to attract overseas patients by expanding job creation through a revitalization of the medical industry. Therefore, this study suggests the development direction for insurers who aim to attract foreign patients through the side effects of attracting foreign patients in accordance with the Financial Services Commission's plan to strengthen the competitiveness of the financial industry. In addition, this study intends to contribute to the strengthening of the competitiveness of attracting foreign patients, through domestic insurance business, to the insurance direct payment market for overseas patients using domestic medical institutions that are concentrated in foreign insurance companies and in the blind spot of domestic law application.

• Clinical and Experimental Reproductive Medicine
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• v.28 no.4
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• pp.265-270
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• 2001

Objective : The aim of this study was to evaluate the outcome the GnRH antagonist (Cetrotide) short protocol in controlled ovarian hyperstimulation comparing with GnRH agonist long protocol. Materials and Method: From July 2000 to November 2001, 26 patients, 28 cycles were performed in controlled ovarian hyperstimulation by GnRH antagonist and GnRH agonist. GnRH antagonist (Cetrotide) was administered in 12 patients (14 cycles, Group 1) and GnRH agonist (Lucrin, Sub Q, Group 2) in 14 patients (14 cycles). Ovulation induction was performed by hMG (Pergonal) in group 1, and by Combo (Metrodine HP + Pergonal) in group 2. We compared the fertilization rate, good quality embryo, and clinical pregnancy rate between the two groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: Ovarian hyperstimulation syndrome did not occurred in which estradiol (E2) level was $3874{\pm}809\;pg/ml$ and the number of retrieved oocytes was $18.4{\pm}2.4$. The number of used gonadotropin ampules was significantly decreased in Group 1 (26.0 vs. 33.1, p<0.04). There were no significant difference in the number of preovulatory oocyte ($10.6{\pm}6.9$ vs. $10.0{\pm}6.1$), fertilization rate ($74.8{\pm}23.4$ vs. $72.2{\pm}21.8$), good quality embryo ($58.7{\pm}23.6$ vs. $38.7{\pm}36.6$), and embryo transfer ($4.3{\pm}1.6$ vs. $4.4{\pm}1.6$). Although the age of the group 1 was older than the group 2 (34.4 vs. 30.8), there was no significant difference in clinical pregnancy rate (50.0% vs. 57.1%). Conclusions: We suggest that GnRH antagonist was a safe, effective, and alternative method in the controlled ovarian hyperstimulation, especially in PCOD patients who will be develop the ovarian hyperstimulation syndrome.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.21 no.2
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• pp.112-119
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• 2008

Objective : The quantification of pulse diagnosis is an important subject utilizing as a modernization of Oriental medical diagnosis and as a basic data for collaborative access between East and West Medicine. This study was to observe the tendency of pulse diagnosis in atopic dermatitis patients as measured by pulse diagnostic apparatus. Methods : We did pulse diagnostic test about 11 new outpatients who had visited the department of ophthalmology, otolaryngology, dermatology in Kyunghee oriental medical center from March 1, 2007 to October 31, 2007 and had atopic dermatitis. Results : The results were as follows. 1. Among the 11 outpatients, the total number of male patients were 5 and female patients were 6, and the age distribution, the most frequently visited age groups were 10-19 years old and 20-29 years old(each 4 patients). 2. The most common period of onset to first examination were 3 years${\leq}$ (7 patients). 3. There were 8 patients who had emphasized T-wave. 4. There were 7 patients who had repeated pulse wave pattern. Conclusion : In 11 cases who had atopic dermatitis, 8 patients had emphasized T-wave and 7 patients had repeated pulse wave pattern.

• Journal of Korean Physical Therapy Science
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• v.5 no.4
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• pp.785-794
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• 1998

We have made a survey of 40 patients in the university hospitals and oriental medical centers in Seoul from Sep. 1, 1997 to Mar. 1, 1998. We sampled 25 of them and the result shows that there were 12 MCA damaged patients(48%), 5 SAH(20%), 5 ACA(20%), 2 PCA (8%), 1 PCOA(4%). The number of MCA patients were the most. 1. As the cause of each disease, 4 of the 12 MCA damaged patients(33.35%) have infarction and cerebral hemorrhage, 2 of 5 SAH patients(40%) have cerebral hemorrhage and head injury, 3 ACA damaged patients have cerebral hemorrhage. 11 of 25 brain bloodvessel damaged patients(44%) were hemorrhage patients. 2. Rt. hemiparesis was the main symptom of 6 of 12 MCA damaged patients(50%) and 3 of 5 SAH patients(60%), and the main symptom of 3 of 5 ACA patients(60%) was Lt. hemiparesis. The main symptom of 13 of 25 brain bloodvessel damaged patients(52%) was Lt. hemiparesis 11 of them(44%) Rt. hemiparesis, and 1 of them(8.3%) Quadriplegia. 3. Language was the most well preserved function. 12 MCA damaged patients could understand language. 4. Retraction of shoulder girdle, among VIE flexor synergy, was the most frequent element because 9 of 12 MCA damaged patients had it. Among VIE flexor synergy, 5 SAH patient's most frequent synergy was Elbow flexion because all of them had it. All of 5 ACA damaged patients have shoulder girdle elevation, shoulder joint, hyperextension, abduction, and external rotation among VIE flexor synergy. 5. 7 of 12 MCA damaged patients(58.3%) were stereognosis handicapped patients, 3 of 5 SAH patients(60%) have handicap of position sense, light touch, and temperature, 3 of 5 ACA patients(60%) have position handicap. 13 of brain bloodvessel damaged patients(52%) have light touch handicap. 6. 8 of MCA damaged patients(66.7%) have facial palsy, 4 of SAH damaged patients(80%) have memory and action decline, and 3 of ACA damaged patients(60%) have action decline and facial palsy. The problem of Hemiplegia is very extensive from muscle weakness, atrophy, or deformation to psychical problems. Therefore physical therapists should have sufficient interest in psychological handicap as well as physical handicap as they deal with adult hemiplegia.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.3
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• pp.184-191
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• 2010

Purpose: Examine changes in the aspect and state of patient with infertility who admitted to Korean oriental hospital. Look at the changes in last 8 years and seek how oriental medicine can approach to infertility patients who admitted to Korean oriental hospital in last 8 years. Methods: Total of 7434 new patients with infertility who admitted to Gynecology of Oriental Hospital, $\bigcirc\bigcirc$ University Medical Center, from October 2002 to December 2009 was compared to infertility patients based on bottom collected data in this study, total of 1061 infertility patients were targeted for this study. Results: 1.There is no distinct increases in age between women who admitted to oriental medicine and patient's average age, it has shown constantly increasing trend in their age though. However, the average age of infertility patients have shown significant increasing range than average age of all infertility patients. 2. After analysis the result of infertility patient's rate of overall patients, the rate of infertility patients are remaining the same or slowing down in 2005, as the starting year(Table 2). The significant relationship was found in diagnosis and treatment of gynecology(Table 4~5) for infertility patients. In 2005 as the starting year, as patients who admitted to oriental hospital after diagnosed or treated at gynecology are increasing, the rate of infertility patients of overall patients admitted to hospital is slowing down, which is decreasing. 3. There is increasing number of patient diagnosed with "unknown cause" who admitted to Gynecology of Oriental Hospital after year of 2005. 4. The increasing number of patient diagnosed with "unknown cause" who admitted to oriental hospital has a tendency to be important factor in infertility treatment of oriental medicine. Conclusion: Unknown causes of infertility patients who admitted to oriental hospital will continuously increase as senses of society, economic, and social climate change.