• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.710-718
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• 2022

Objective : Although endovascular treatment for intracranial aneurysms is considered effective and safe, its durability is still debated. Also, few studies have described angiographic follow-up plan after endovascular treatment of intracranial aneurysm, especially in ruptured cases. Hence, we report the long-term results of follow-up angiography protocol. Methods : Radiological records of 639 cases of coil embolization with ruptured aneurysms from March 2003 to December 2016 were retrospectively reviewed. Patients who received treatment of a saccular aneurysm less than 7 mm resulted with near complete occlusion were included. Two hundred thirty-eight aneuryms which received the follow-up angiography at least once were enrolled. We classified four periods of follow-up as follows : post-treatment 1 year (defined as the first period), from 1 to 2 years (the second period), 2 to 5 years (the third period), and over 5 years (long-term). Results : We identified 14 cases (6.4%) of recurrence from 218 aneurysms in follow-up angiography in the first period. Among 143 aneurysms in the second period, five cases (3.5%) of recurrence were identified. There were no findings suspicious of recanalization in 97 patients in the third period. Of the total 238 cases, there were 19 recurrences, for a recurrence rate of 8.0%. Six (31.6%) out of 19 recurrences showed a tendency toward repeat recurrences even after additional treatment. Twenty-eight received long-term follow-up over 5 years and there was no recurrence. Conclusion : Most of the recurrence were found during the first and the second year. We suggest that at least one digital subtraction angiography examination may be necessary around post-treatment 2 years, especially in ruptured cases. If the angiographic results are favorable at 2 years post-treatment, long-term result should be favorable.

• Journal of Oral Medicine and Pain
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• 제19권1호
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• pp.93-103
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• 1994

In order to evaluate thelong-term results of conservative treatment on TMJ closed lock, a follow-up study of thirst-two patients was performed 2 to 7 year after treatment. Evaluating method included the questionnaire, clinical examination, transcranial radiograph and mandibular kinesiography. The results were as follows : Seventy-eight percents of patients reported that symptoms were reduced completely or considerably. Recurrent headache was improved after treatment (72 percents of success rate). There was a significant decrease in VAS after treatment and at follow-up comparing with that of before treatment(p<0.01). Most common variable of Helkimo's clinical dysfunction index at follow-up was impared TMJ function. There was a significant decrease in Fricton's craniomandibular index and dysfunction index(p<0.01) Mean interincisal distance was increased by 14.07mm after treatment and was also increased at follow-up by 2.80mm comparing with that of after treatment(p<0.01). Before treatment, condylar translation measurements of affected and non-affected sides on the transcranial radiograph were 4.89±3.20mm and 9.09±3.73mm respectively and at follow- up examination, those were 14.98±4.77 and 17.05±4.35mm respectively. At follow-up, condylar translation were increased significantly comparing with those of before treatment(p<0.01). In 93.1% of patients, the condylar position of affected side at maximum mouth opening was behind the articular eminence before treatment but the percentage was decreased to 13.8% at follow-up(p<0.01). The pattern and range of mandibular movements at follow-up examination were similar to the typical normal movements. And in 16 cases showing lateral deviation of opening path, the deviation was directed to the affected and non-affected sides with the same frequency.

• Restorative Dentistry and Endodontics
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• 제46권2호
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• pp.27.1-27.10
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• 2021

This study describes 6 cases of endodontic overfilling with successful clinical outcomes during long-term (up to 35 years) radiographic follow-up. Successful endodontic treatment depends on proper shaping, disinfection, and obturation of root canals. Filling materials should completely fill the root canal space without exceeding the anatomical apex. Overfilling may occur when the filling material extrudes into the periapical tissues beyond the apex. The present case series describes 6 root canal treatments in which overfilling of root canal sealer and gutta-percha accidentally occurred. Patients' teeth were periodically checked with periapical radiographs in order to evaluate the outcomes during long-term follow-up. All cases showed healing and progressive resorption of the extruded materials in the periapex. The present cases showed that if a 3-dimensional seal was present at the apical level, overfilling did not negatively affect the long-term outcomes of root canal treatment.

• Archives of Plastic Surgery
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• 제44권4호
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• pp.324-331
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• 2017

Background Lipedema is a condition consisting of painful bilateral increases in subcutaneous fat and interstitial fluid in the limbs with secondary lymphedema and fibrosis during later stages. Combined decongestive therapy (CDT) is the standard of care in most countries. Since the introduction of tumescent technique, liposuction has been used as a surgical treatment option. The aim of this study was to determine the outcome of liposuction used as treatment for lipedema. Methods Twenty-five patients who received 72 liposuction procedures for the treatment of lipedema completed a standardized questionnaire. Lipedema-associated complaints and the need for CDT were assessed for the preoperative period and during 2 separate postoperative follow-ups using a visual analog scale and a composite CDT score. The mean follow-up times for the first postoperative follow-up and the second postoperative follow-up were 16 months and 37 months, respectively. Results Patients showed significant reductions in spontaneous pain, sensitivity to pressure, feeling of tension, bruising, cosmetic impairment, and general impairment to quality of life from the preoperative period to the first postoperative follow-up, and these results remained consistent until the second postoperative follow-up. A comparison of the preoperative period to the last postoperative follow-up, after 4 patients without full preoperative CDT were excluded from the analysis, indicated that the need for CDT was reduced significantly. An analysis of the different stages of the disease also indicated that better and more sustainable results could be achieved if patients were treated in earlier stages. Conclusions Liposuction is effective in the treatment of lipedema and leads to an improvement in quality of life and a decrease in the need for conservative therapy.

• Korean Journal of Radiology
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• 제23권4호
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• pp.479-487
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• 2022

Objective: To prospectively evaluate the efficacy of lauromacrogol injection for ablation (LIA) of benign predominantly cystic thyroid nodules and its related factors. Materials and Methods: A total of 142 benign predominantly cystic thyroid nodules (median volume, 12.5 mL; range, 0.4-156 mL) in 137 patients (male:female sex ratio, 36:101; mean age ± standard deviation [SD], 49 ± 13 years) were treated with LIA after being confirmed as benign via cytology. The volume reduction rate (VRR) of the nodules and cosmetic score were evaluated during follow-up at 1, 3, and 6 months after treatment and every 6 months thereafter. A VRR of ≥ 50% at the 12-month follow-up was considered to indicate effective treatment. The associations between the clinical factors and nodular ultrasound features, including the initial nodule volume, proportion of solid components, vascularity grade and ineffective treatment (VRR of < 50% at the 12-month follow-up), and regrowth were analyzed. Results: All patients completed follow-up for at least 12 months. The average ± SD follow-up period was 32 ± 11 months (range, 12-54 months). The effective treatment rate was 73.2% (104/142), while the regrowth rate was 12.0% (17/142) at the last follow-up. Grade 2-3 intranodular vascularity in the solid components of the nodules was the only independent factor associated with ineffective treatment, with an odds ratio (reference category, grade 0-1) of 3.054 (95% confidence interval, 1.148-8.127) (p = 0.025). Conclusion: LIA is an effective treatment for predominantly cystic thyroid nodules. Grade 2-3 intranodular vascularity in the solid components of nodules is the only independent risk factor for ineffective LIA.

• 대한소아치과학회지
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• 제36권3호
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• pp.420-426
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• 2009

본 연구의 목적은 유치열기 3급 부정 교합 환아에서 facemask를 이용한 악정형 치료 후 골격적 변화와 치료 후 나타나는 재발 양상을 평가하는 것이다. 유치열기 3급 부정교합 환아 15명을 대상으로 구내장치로 bonded expander, 구외장치로 facemask를 이용한 악정형 치료를 평균 12 개월 동안 시행하였으며, 1년 간의 follow-up 기간 동안 유지 장치는 사용되지 않았다. 치료 시작 전, 치료 직후, 치료 1년 후에 측면두부방사선사진을 촬영하고 전후방 및 수직적 골격관계와 연조직의 변화를 비교분석하였다. 모든 환아에서 치료 직후, 유의할 만한 골격적 전후방 관계의 변화를 보였고 1년 간의 follow-up 기간 동안 재발되는 경향을 보였으나 치료 시작 전과 비교하여 치료 효과는 유지되었다. 수직적 골격적 변화는 치료 직후 증가되었으나 1년 간의 follow-up 기간 동안 다시 감소하여 치료 시작 전과 비교하여 차이를 보이지 않았다. 연조직의 변화는 facial convexity 및 상순의 위치가 치료 직후 개선됨을 보였고 1년 간의 follow-up 기간 동안에도 치료 전과 비교하여 치료효과는 유지되었다. 하순의 위치는 치료 직후에 유의할 만한 변화를 보이지 않았다. Facemask는 유치열기 3급 부정교합에 있어서 효과적인 치료 방법이며, 안정적인 치료 결과를 위해서는 적절한 형태의 유지장치가 고려되는 것이 바람직하다.

• 대한소아치과학회지
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• 제45권3호
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• pp.324-333
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• 2018

유년기는 치열변화, 치아우식 등 전반적으로 변화가 많은 시기로, 구강질환 예방 및 조기치료를 위해 정기적 내원이 필요하다. 본 연구는 진정법 하 치과치료 후 정기검진 패턴에 영향을 미치는 요인을 파악하고자 했다. 2009년부터 2013년까지 이대목동병원 소아치과에서 진정법 하 치과치료를 받은 환자 562명을 3년간 내원 횟수에 따라 4개의 군으로 분류한 뒤, Chi-square test를 이용하여 정기검진에 영향을 미치는 요인을 파악했다. 내원 기간 동안 주치의 변경, 진정법 하 치료한 치아 개수, 총 치료시간, 수복치료, 소수술, 예방적 치료는 재내원 그룹과 통계적으로 유의한 차이가 있었다(p < 0.05). 소수술을 받은 환자 및 우식 이환 치아 개수가 적거나 중등도인 환자의 경우 재내원 가능성이 낮으므로, 보호자에게 치료의 예후관찰 및 구강질환 예방을 위해 정기검진이 필요함을 강조해야 할 것이다.

• 한방재활의학과학회지
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• 제21권2호
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• pp.253-263
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• 2011

Objectives : To analyze the therapeutic outcomes of back pain modalities in patients with disc herniation according to the change of magnetic imaging(MRI) at one year after conservative treatment. Methods : Clinical outcomes of 35 patients diagnosed with lumbar disc herniation by MRI examination, treated conservatively, were analyzed according to MRI follow-up change; improved, unchanged, worsened. Patients underwent MRI examination at baseline and after 24 week of treatment. After 1 year, we followed up 30 patients. The patients' clinical outcomes were assessed at baseline, 24 week, 1 year by visual analogue scale(VAS), oswestry disability index (ODI), and analyzed by each of it's correlation. Results : 1. VAS of sciatica and ODI of disability of daily activities showed significant decrease in patients after 1 year follow up(p<0.05). 2. VAS(low back pain and sciatica) and ODI of disability of daily activities showed significant decrease in "improved" group and VAS(sciatica) and ODI showed significant decrease in "unchanged" group. "worsened" group showed no statistic significance(p<0.05). 3. The 1 year follow-up of VAS(low back pain and sciatica) and ODI change showed relationship with MRI follow-up change(p<0.05). Conclusions : This study suggests that "improved" groups compared to "unchanged" and "worsened" group on MRI follow-up in patients with lumbar disc herniation were more effective at 1 year after conservative treatment. MRI follow-up change affect clinical changes in patients with lumbar disc herniation after 1 year.

• Clinical and Experimental Pediatrics
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• 제58권1호
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• pp.1-7
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• 2015

Gonadotropin-releasing hormone analogs (GnRHa) are widely used to treat central precocious puberty (CPP). The efficacy and safety of GnRHa treatment are known, but concerns regarding long-term complications are increasing. Follow-up observation results after GnRHa treatment cessation in female CPP patients up to adulthood showed that treatment (especially <6 years) was beneficial for final adult height relative to that of pretreated or untreated patients. Puberty was recovered within 1 year after GnRHa treatment discontinuation, and there were no abnormalities in reproductive function. CPP patients had a relatively high body mass index (BMI) at the time of CPP diagnosis, but BMI standard deviation score maintenance during GnRHa treatment seemed to prevent the aggravation of obesity in many cases. Bone mineral density decreases during GnRHa treatment but recovers to normal afterwards, and peak bone mass formation through bone mineral accretion during puberty is not affected. Recent studies reported a high prevalence of polycystic ovarian syndrome in CPP patients after GnRHa treatment, but it remains unclear whether the cause is the reproductive mechanism of CPP or GnRHa treatment itself. Studies of the psychosocial effects on CPP patients after GnRHa treatment are very limited. Some studies have reported decreases in psychosocial problems after GnRHa treatment. Overall, GnRHa seems effective and safe for CPP patients, based on long-term follow-up studies. There have been only a few long-term studies on GnRHa treatment in CPP patients in Korea; therefore, additional long-term follow-up investigations are needed to establish the efficacy and safety of GnRHa in the Korean population.

• 대한소아치과학회지
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• 제43권2호
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• pp.145-150
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• 2016

장애인 환자는 구강질환의 높은 유병률과 그 심각성으로 인하여 치료 후 정기적인 검진을 통한 관리가 필요하다. 본 연구의 목적은 전신마취하에 치과치료를 받은 장애인환자의 정기검진 패턴에 따른 결과를 평가하고자 함이다. 2006년부터 2014년까지 경희대학교 치과병원 소아치과를 초진 내원한 장애인 환자 중 전신마취하에 치과 치료 시행 후 재내원한 환자 총 53명을 대상으로 재내원 패턴에 따라 정기적 그룹 33명과 비정기적 그룹 20명으로 나누어 검진 기간 동안 시행된 치과 치료를 조사하였다. 그 결과, 비정기적으로 재내원한 그룹에서 치수치료, 보철치료, 발치치료와 같이 상대적으로 침습적인 치료가 많이 시행되었다(p < 0.05). 또한, 전신마취하에 치과 치료를 재시행 받은 환자군은 모두 비정기적 그룹에 해당하였다(p < 0.05). 본 연구의 결과는 정기적인 검진의 중요성을 제시하며, 치과의사들의 보호자와 환자 교육에 대한 책임감을 강조하고 있다.