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Bahk, Yong-Whee,Kim, Sung-Hoon,Chung, Yong-An,Bahk, Won-Jong,Park, Jung-Mee,Kang, You-Mee,Choi, Woo-Hee,Park, Young-Ha,Sohn, Hyung-Sun,Kim, Byung-Ki,Chung, Soo-Kyo The Korea Society of Nuclear Medicine 2011 핵의학 분자영상 Vol.45 No.1
Purpose For the precise imaging diagnosis of osteoid osteoma (OO), the identification of the nidus and fibrovascular zone (FVZ) is essential. However, the latter sign has received little attention because it is difficult to demonstrate. We applied the recently introduced gamma correction (GC) to depict the FVZ on pinhole bone scan (PBS), conventional radiography (CR), and computed tomography (CT). Nongamma correction MRI was also analyzed for reference. Methods Ten patients with histologically proven diagnoses of OO were enrolled in this retrospective study. PBS, CR, and CTwere processed by GC to demonstrate the nidi and FVZ as distinct yet integrating components of OO. PBS was performed using a 4-mm pinhole collimator 3 h after iv injection of 925 to 1,110MBq (25 to 30mCi) of Tc-99mHDP, and anteroposterior and mediolateral CR and transverse CT were taken according to the standard technique. MRI sequences included T1- and T2-weighted images. For gamma correction, we utilized the Photo Correction Wizard program of ACD Photo Editor v3.1. A team of three qualified nuclear physician-radiologists, two nuclear physicians, and one MRI specialist read bone scans, radiographs, and MRIs of OO according to each specialty, and orthopaedic aspects and histology were reviewed by one qualified orthopedic surgeon and two qualified pathologists, respectively. Each observer first read the images separately with basic information about the aim of the study given and then in concert. Interpretive disagreement was settled by discussion and consensus. Results On pinhole scan, nidi were presented as areas of intense tracer uptake in all cases, and, importantly after GC, a thin ring-like zone with lower tracer uptake became visible in seven out of ten cases. GCCR also revealed a thin lucent zone that circumscribed the nidi in six out of ten cases and GCCT in two of four cases.MRI, without GC, presented nidi with high signal in the center and a thin ring-like zone with low signal in the periphery in five out of six cases. Ring-like zones were 1-2 mm in thickness and circumscribed the nidus as an integrated part and, hence, were morphologically interpreted as FVZ. Histologically, the presence of a variously mineralized FVZ was confirmed in four cases, but individual locusby- locus image-histology correlation could not be accompolished because specimens were fragmentary. In the FVZ, tracer uptake was lower than in nidi, presumably reflecting that bone metabolism in the two parts differs as in their histology. Statistically, no significant correlation existed between the duration of symptoms and imaging demonstrability of the FVZ (Spearman's test r=-0.057, p=0.877), but parallelism existed in the demonstrability of the FVZ among GC PBS, CR, and CT, and non-correction MRI. Conclusions GC was useful to enhance the resolution of PBS, CR, and CT in OO so that both the nidi and FVZ were separately imaged. The use of CG PBS and CR in combination is recommended for the specific diagnosis of OO with information about bone metabolism and anatomical characteristics. PBS and CR are economical and widely available.
Jong-Hyun Jeong(Jong-Hyun Jeong),Won-Myong Bahk(Won-Myong Bahk),Young Sup Woo(Young Sup Woo),Bo-Hyun Yoon(Bo-Hyun Yoon),Jung Goo Lee(Jung Goo Lee),Won Kim(Won Kim),InKi Sohn(InKi Sohn),Sung-Yong Park( 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.1
The objective of this study was to compare recommendations of the Korean Medication Algorithm Project for Bipolar Disorder 2022 (KMAP-BP 2022) with other recently published guidelines for treating bipolar disorder. We reviewed a total of six recently published global treatment guidelines and compared treatment recommendation of the KMAP-BP 2022 with those of other guidelines. For initial treatment of mania, there were no significant differences across treatment guidelines. All guidelines recommended mood stabilizer (MS) or atypical antipsychotic (AAP) monotherapy or a combination of an MS with an AAP as a first-line treatment strategy in a same degree for mania. However, the KMAP-BP 2022 recommended MS + AAP combination therapy for psychotic mania, mixed mania and psychotic depression as treatment of choice. Aripiprazole, quetiapine and olanzapine were the first-line AAPs for nearly all phases of bipolar disorder across guidelines. Some guideline suggested olanzapine is a second-line options during maintenance treatment, related to concern about long-term tolerability. Most guidelines advocated newer AAPs (asenapine, cariprazine, long-acting injectable risperidone, and aripiprazole once monthly) as first-line treatment options for all phases while lamotrigine was recommended for depressive and maintenance phases. Lithium and valproic acid were commonly used as MSs in all phases of bipolar disorder. KMAP-BP 2022 guidelines were similar to other guidelines, reflecting current changes in prescription patterns for bipolar disorder based on accumulated research data. Strong preference for combination therapy was characteristic of KMAP-BP 2022, predominantly in the treatment of psychotic mania, mixed mania and psychotic depression.
Korean Medication Algorithm for Bipolar Disorder 2018: Comparisons with Other Treatment Guidelines
Jong Hyun Jeong,Won-Myong Bahk,Young Sup Woo,이정구,Moon Doo Kim,Inki Sohn,Se-Hoon Shim,전덕인,Jeong Seok Seo,Won Kim,Hoo-Rim Song,Kyung Joon Min,Bo-Hyun Yoon 대한정신약물학회 2019 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.17 No.2
The objective of this study was to compare recommendations of the Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018) with other recently published guidelines for treating bipolar disorder. We reviewed a total of five recently published global treatment guidelines and compared treatment recommendation of the KMAP-BP 2018 with those of other guidelines. For initial treatment of mania, there were no significant differences across treatment guidelines. All guidelines recommended mood stabilizer (MS) or atypical antipsychotic (AAP) monotherapy or a combination of an MS with an AAP as a first-line treatment strategy for mania. However, the KMAP-BP 2018 did not prefer monotherapy with MS or AAP for psychotic mania. Quetiapine, olanzapine and aripiprazole were the first-line AAPs for nearly all phases of bipolar disorder across guidelines. Most guidelines advocated newer AAPs as first-line treatment options for all phases while lamotrigine was recommended for depressive and maintenance phases. Lithium and valproic acid were commonly used as MSs in all phases of bipolar disorder. As research evidence accumulated over time, recommendations of newer AAPs (such as asenapine, cariprazine, paliperidone, lurasidine, long-acting injectable risperidone and aripiprazole once monthly) became prominent. KMAP-BP 2018 guidelines were similar to other guidelines, reflecting current changes in prescription patterns for bipolar disorder based on accumulated research data. Strong preference for combination therapy was characteristic of KMAP-BP 2018, predominantly in the treatment of psychotic mania and severe depression. Further studies were needed to address several issues identified in our review.
Bahk, Won-Jong,Chang, Han,Park, Jong-Beom,Yoo, Jong-Uk 가톨릭 의과학연구원 1997 가톨릭 의과학연구원 국제학술대회 Vol.1 No.-
This combined procedure safely and effectively resulted in compression of the spinal cord and good functional recovery in patients with 1) anterior and posterior pathology. 2) congenital narrow spinal canal and large spondylotic bar or herniated disc encroaching the spinal canal more than 5mm. 3) congenital narrow spinal canal and kyphotic deformity. 4) congenital narrow spinal canal and segmental instability 5) multisegmental cord compression and severe radicuopathy.
수부 및 족부 단관골에 발생한 단발성 내연골종의 동종골 및 합성골 이식술을 이용한 치료 결과
박원종(Won-Jong Bahk),김남혁(Nam-Hyuk Kim),박광선(Kwang-Sun Park),김주영(Ju-Young Kim) 대한정형외과학회 2016 대한정형외과학회지 Vol.51 No.1
목적: 수부 및 족부 단관골의 내연골종을 소파술 후 동종골 혹은 합성골 이식술로 치료한 결과를 평가하고자 하였다. 대상 및 방법: 22명의 환자(동종골 15명, 합성골 7명)를 대상으로 임상적 결과는 통증, 미용상 문제, 운동범위 및 파악력 정도에 따라 우수, 양호, 보통, 불량으로 분류하였고, 방사선적 결과는 신생골 형성 정도에 따라 1, 2, 3군으로 하였. 다 결과: 임상적 결과는 우수가 19예, 양호가 3예였다. 관절 운동범위는 19명에서 정상이었고, 3명에서 경미한 제한이 있었다. K-강선고정을 시행한 3명에서 자극에 의한 약한 염증소견이 있었으나 K-강선 제거로 치료되었다. 지연유합, 불유합, 감염 혹은 술 후 재골절 등의 합병증은 발생하지 않았다. 방사선적 결과는 골결손이 없거나 3 ㎜ 이하인 1군이 20예, 골결손이 4-10 ㎜인 2군이 2예였으며, 3군은 없었다. 결론: 수부 및 족부의 단관골에 발생한 내연골종의 소파술 후 동종골 및 합성골 이식술은 만족할 만한 방사선적 및 임상적 결과를 보였다. 병적 골절을 동반한 경우 골절 후 바로 수술을 하여 고정기간을 줄일 수 있으며, 족지골에 발생된 경우에는 통증이 없는 경우도 병적 골절이 흔하게 동반되므로 조기에 수술적 치료를 고려해 볼 수 있다고 생각된다. Purpose: We analyzed outcomes after management of enchondroma involving short tubular bones of the hand and foot by curettage and grafting using allogenic bone or bone substitutes. Materials and Methods: Twenty-two patients (allogenic bone 15 and bone substitutes 7 patients) were recruited. Clinical results were assessed by pain, cosmetic problem, range of motion of joint and the power of grasp. Radiographic outcomes were analyzed by degree of bone defect. Results: Clinically, 19 patients were classified as excellent and 3 patients as good. Three patients with K-wire fixation had pain with local irritation, which was easily controlled by removal of the K-wires. There were no complications including deep infection, delayed or nonunion, refracture. Radiographically, 20 cases were classified as group 1 (bone defect smaller than 3 ㎜) and the 2 remaining cases were classified as group 2 (bone defect 4-10 ㎜). Conclusion: Curettage and graft using allogenic bone or bone substitute is an effective modality of treatment for enchondroma involving short tubular bones of the hand and foot. When combined with pathologic fracture, early surgical management could shorten duration of immobilization. Surgical management might be considered for the lesion involving the foot when discovered because of high incidence of pathologic fracture.
한국형 우울장애 약물치료 알고리듬 2021 (VI) : 비약물학적 생물치료
정종현(Jong-Hyun Jeong),우영섭(Young Sup Woo),박원명(Won-Myong Bahk),왕성민(Sheng-Min Wang),서정석(Jeong Seok Seo),박영민(Young-Min Park),김원(Won Kim),심세훈(Se-Hoon Shim),이정구(Jung Goo Lee),장승호(Seung-Ho Jang),양찬모(Chan-Mo Y 대한신경정신의학회 2021 신경정신의학 Vol.60 No.4
Objectives The Korean Medication Algorithm Project for Depressive Disorder 2021 (KMAP-DD 2021) was made to update new researches and data. This study focused on non-pharmacological biological treatments. Methods Ninety-seven psychiatrists with extensive clinical experience in the non-pharmacological biological treatment of depressive disorder were primary selected and a questionnaire was sent to each of them by mail, 65 of the 97 replied. Results Electroconvulsive therapy (ECT) was recommended as an initial strategy for major depressive disorder, severe depressive disorder with/without psychotic features with urgent suicidal risk, or a severe depressive episode with psychotic features in pregnant patients, for non-responders on pharmacotherapy for a moderate depressive episode, and as a second strategy for non-responders on antidepressant monotherapy or combination therapy combined with physical illness. For pregnant women with a severe episode of major depressive disorder, repetitive transcranial magnetic stimulation (rTMS) was preferred as a first-line strategy, and as a second strategy for non-responders on combined antipsychotic and antidepressant therapy and non-responders with comorbidity and physical illness. Complementary or novel treatment was not recommended as the first-line treatment strategy for depressive disorder, but transcranial direct current stimulation (tDCS), vagus nerve stimulation (VNS), deep brain stimulation (DBS), light therapy, and omega-3 fatty acid nutritional therapy were second-line treatment strategies. Conclusion ECT and rTMS are initial strategies in specific clinical situations. Preferences for complementary or novel treatments such as tDCS, light therapy, and omega-3 fatty acid nutritional therapy have increased gradually, but in practice, their usages are still limited.