• Childhood Kidney Diseases
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• v.18 no.1
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• pp.51-55
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• 2014

Primary renal artery aneurysm has been estimated to account for an incidence of 0.015-1% with associated morbidities including renovascular hypertension and rupture. Renovascular hypertension associated renal artery aneurysms in children is not a common disease. In patients with complicated renal vascular disease, renal autotransplantation has been used as an alternative to percutaneous transluminal angioplasty, which may be hazardous in these situations. We report a case of a renal artery aneurysm in a 13-year-old Korean child presenting hypertension detected during school health examination. Preoperative workup demonstrated a $2.8{\times}2.1{\times}1.9$ cm saccular aneurysm in the right renal hilum that was not amendable to endovascular repair. A surgical strategy including extracorporeal renal artery reconstruction with autotransplantation was applied in order to restore renal artery anatomy and to treat renovascular hypertension. Immediately he complained of severe right flank pain and postoperative doppler sonography revealed lack of perfusion. On the 5th day after autotransplantation, the patient underwent a transplant nephrectomy. He was well postoperatively and was found to have a normal kidney function and stable blood pressure control without antihypertensive medication. This is the first pediatric case of renal artery aneurysm in Korea who underwent extracorporeal repair followed by autotransplantation failure. More pediatric cases with renal artery aneurysm should be reported to identify therapeutic outcome and long term prognosis.

• Journal of Oriental Neuropsychiatry
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• v.26 no.4
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• pp.383-406
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• 2015

Objectives: People with tension-type headache generally take pain relievers, but long term dependency causes problems as well as side effects. The present study aimed to provide clinical evidence of herbal medicine for tension-type headache by systematic review of randomized controlled trials on the effect of herbal medicine for tension-type headache. Methods: Randomized or quasi-randomized controlled trials that verified effects of herbal medicine intervention on patients with tension-type headache were included in the study. A literature search of English, Japanese, Chinese, Korean databases was performed. The selected literature were assessed by Jadad scale and Risk of Bias. Results: Herein, 40 reports were selected from a total of 157. Meta-analyses of 2 trials indicated that the effective rate was significantly higher in the herbal medicine treatment group, as compared to the placebo control (risk ratio: 1.49, 95% confidence interval (CI): 1.23 to 1.80, p<0.0001, I²=0%). Four trials that compared herbal medicine with routine care with routine care only group showed a significantly higher effective rate of benefits for herbal medicine with routine care, as compared to routine care only (RR: 1.57, 95% CI: 1.18 to 2.10, p=0.002, I²=0%). Conclusions: The effective rate was significantly higher than control and adverse events were less in the treatment group. Pattern analysis (辨證) indicated that the studies on wind-fire pattern (風火證) were highest. Yougeun-bang (柔筋方) in prescription and Paeoniae Radix Alba (白芍藥) in medicinal herbs were most used. This finding could be widely utilized in future clinical practice and form the basis for the development of clinical practice guidelines in advance.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.6
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• pp.1681-1684
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• 2005

Gastric cancer is the most common disease which is the highest genetic rate, chemotherapy is the only known way to treat, especially advanced gastric cancer. Although, it is the remedy, the harmful side-effects are an obstacle of the sustaining treatment and negative effect on immunologic ability of patients prologed. Consequently, it is surely necessary that effective control for sequele of anti-cancer treatment, and remedy which can improve the quality of patients life. 1, the writer, medicate patients, diagnose as gastric cancer in 4th stage, with Sohap-hyangwon and Chungwoolhyadamjen who complained of pain in sequele of anti-cancer treatment. The size of the metastastic liver tumor is decreasing in patients and the immunologic abilities are maintaining stable. This clinical cases are shown that the oriental medical care in long-term can improve the quality of life of the patients who has sequele of anti-cancer treatment.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.170-177
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• 2013

Total elbow arthroplasty is still in its infancy compared with other arthroplasties, such as knee or hip arthroplasties. Implant design has been evolving with clinical experiences; however, there are only limited data on the long-term clinical outcome of elbow arthroplasty in the literature. The design of total elbow prostheses can be divided into three categories: linked (constrained or semi-constrained), unlinked (unconstrained), and convertible types. The choice between an unlinked (unconstrained) implant and a linked (semi-constrained) implant depends on joint stability and adequacy of the bone stock. Linked elbow arthroplasty has provided high patient satisfaction, and pain relief thanks to proper patient selection, advancement of implant design, improvement in cement techniques, meticulous surgical technique, and appropriate postoperative rehabilitation. Concerns remain about the use of this implant in young or high-demand patients. This article focuses on the linked (semi-constrained) prostheses, which provides an overview of the current state of linked total elbow arthroplasty.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.127-133
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• 1998

An impacted tooth is defined pathologically as a tooth that remains under the mucosa of inside bone without eruption of the crown after a specific period of eruption. Clinically, the term includes those teeth, even before eruption period, that are not expected to erupt due to shape, position and alignment of tooth and lack of space. Canine is prone to impaction more than other teeth because it has the longest time to develop and a complex route from the place of formation to the site of eruption. The impaction incidence of maxillary canine is repoted 0.92$\sim$3.3% (Ferguson, 1990). In 1995 Orton reported that the incidence was 0.92$\sim$2.2% and palatal impaction was more frequent than labial impaction(85%:15%). In 1969 Johnston presented it was more common to woman than to man(3:1). The etiology includes systemic disease such as endocrine disorder, cleidocranial dysostosis, irradiation, Crouzon syndrome, ricketts, facial hemihypertrophy and hereditary and local problems such as ectopic position of the tooth, distance of tooth from its place of eruption, malformation of the tooth, presence of supernumerary teeth, trauma of tooth germ, infection of tooth germ, displacement of tooth germ or tooth by a neoplasm, ankylosis, overretention of deciduous predecessor, lack of space for the tooth in the dental arch and mucosal barrier due to gingival fibrosis. The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and assumes an important role esthetically as it is located at mouth angle. If left untreated, it may cause migration and external, internal resorption of adjacent teeth, loss of arch length, formation of dentigerous cyst or tumors, infection and referred pain as well as malposition of the tooth. Therefore, periodic examination of the development and eruption of the maxillary canine is especially important in a growing child. This case study presents the results of treatment of palatally impacted maxillary canine utilizing surgical exposure and orthodontic tooth movement on patients visiting SNUDH dept. of pediatric dentistry.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.212-219
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• 2009

Medially retracted large-sized rotator cuff tears includes large-sized tears, massive tears and irreparable tears. Generally arthroscopic repair or open repair of rotator cuff tears is used in reparable tears. However, arthroscopic repair requires long period practice and endurance. In irreparable tears, arthroscopic debridement, partial repair, latissimus dorsi transfer and retrograde arthroplasty can be the option. Arthoscopic debridement gives temporal relief who experienced improvement in pain and increase in range of motion after subacromial local anesthetic injection. Also arthroscopic partial repair gives good results in irreparable cases, especially in suprascapular nerve traction neurapraxia. Tendon transfer can be used in mild to moderate muscle weakness in shoulder abduction for long term treatment. Pectoralis major transfer can be used in anterosupeior tears and latissimus dorsi transfer can be used in posterosuperior tears. Reverse shoulder prosthesis is used in extreamly weakened shoulder pseudoparalysis. The authors discussed the method of arthroscopic repair in irreparable tears. The debridement, partial repair, and tendon transfer could be used in medially retracted large-sized rotator cuff tears.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.59-66
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• 2001

Background: The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. Materials and Methods: From January 1998 to December 1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication. success rate and patient's satisfaction were evaluated. Results: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication. bladder perforation occurred in one patient(2.4%). residual urine sensation developed in seven patients(16.7%), and suprapubic pain was complained in five patients(11.9%), which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instability were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. Conclusion: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence, but a longer follow-up is necessary to determine long term effect.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.5
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• pp.413-429
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• 2021

Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.22-29
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• 2022

Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

• Journal of Korean Dental Science
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• v.16 no.2
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• pp.128-148
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• 2023

Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.