• Title, Summary, Keyword: 손 추적

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Complications of transcatheter closure of atrial septal defects using the amplatzer septal occluder (심방 중격 결손의 경피적 폐쇄술 후 발생한 합병증에 관한 연구)

  • Jea, Seo Jin;Kwon, Hyo Jin;Jang, Gi Young;Lee, Jae Young;Kim, Soo Jin;Son, Chang Sung;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.401-408
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    • 2008
  • Purpose : Transcatheter closure of atrial septal defects (ASD) is currently established therapy as an alternative to surgery. But rarely, complications are reported in some studies. We report early and intermediate term complications associated with transcatheter closure of atrial septal defects using the Amplatzer septal occluder (ASO). Methods : From June 2003 to May 2006, 64 patients underwent transcatheter closure of secundum ASD or patent foramen ovale using the ASO. The ratio of male to female was 1:2.4, the median age was 17 years (range: 2.6-64 years) and their median weight was 47.5 kg (range: 2.6-64 kg). Results : The median diameter of ASD measured with transthoracic or transesophageal echocardiography was 15 mm (range: 6-28 mm), the median balloon stretched diameter was 18 mm (range: 6.5-34 mm), and the median size of device was 19.5 mm (range: 6-36 mm), was little difference with balloon stretched diameter. There were 10 cases of complications: arrhythmia (2), device malformation (2), aorta to right atrial fistula (1), hemolytic anemia (1), mitral valve encroachment (1), malposition (1), residual shunt (1), and inferior vena cava perforation (1). Conclusion : Transcatheter closure of ASD using ASO is effective and safe therapy. However, significant complications such as aorta to atrial fistula, atrial erosion, or device embolization can happen, so an appropriate selection of patient and device in relevance to size and anatomy of ASD is important for successful closure.

Delirium after Head Trauma at Psychiatric Consultation (두부 외상 후 섬망의 자문 정신 의학적 고찰)

  • Kim, Hyon-Chul;Lee, Sang-Chul;Kim, Do-Hoon;Lee, Sang-Kyu;Hong, Seung-Gwan;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.15-22
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    • 2004
  • Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest. Result: There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01). Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.

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Treatment of Pectus Carinatum with a Compressive Brace (압박 교정기를 이용한 새가슴의 치료)

  • Son, Jin-Sung;Jeon, Cheol-Woo;Lee, Seong-Jin;Lee, Chol-Sae;Lee, Kihl-Rho;Lee, Seock-Yeol
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.40 no.5
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    • pp.369-375
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    • 2007
  • Background: Patients suffering with pectus carinatum complain of cosmetic problems when they stand and this in spite of wearing cloths. The standard surgical treatment of pectus carinatum is resection of the deformed cartilages, but the wide operative scar, post-operative pain and complications related with such an operation can occur. Therefore, we have peformed compressive brace therapy as a non-operative treatment for pectus carinatum and we observed the effects and the efficiency of this treatment. Material and Method: From January, 2001 to December, 2006, 109 patients wore the compressive brace for all day. The degree of satisfaction was evaluated after $6\sim9$ months of wearing the compressive brace. The degree of satisfaction was evaluated by a score of from $1\sim4$. A score of 1 was assigned when the status was worse, 2 when it was the same, 3 when there was partial improvement and 4 when remarkable improvement was observed. The degree of satisfaction was assessed subjectively by the parent if the patient was a child younger than middle school age, and the patients older than middle school age assessed the score themselves. Result: The mean score of the overall degree of satisfaction was $3.93{\pm}0.33$. Recurrence of pectus carinatum after removal of compressive brace occurred in 6 patients (5.5%) of the total 109 patients. But 4 patients of the total 6 recurred patients stopped wearing of compressive brace against our advice. The 6 recurred patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed the compressive brace. The complications were discomfort with initially wearing the compressive brace, which occurred in all patients, skin rash due to the compressive brace for 76 patients (69.7%) and skin discolorization with excessive compression for f6 patients (5.5%). The skin rash and discolorization returned to normal within a few months after removal of the compressive brace. Conclusion: This study demonstrated that non-surgical treatment with using the compressive brace for patients with pectus carinatum was effective, and especially for children and teenagers. Non-surgical treatment with using a compressive brace would be helpful for the patients suffering with pectus carinatum and who dislike surgical operations because of their fear about general anesthesia and operation-related complications. Yet long-term follow up is necessary to accurately evaluate the effectiveness of this compressive brace and the recurrences after removal of the compressive brace.

Video-assisted Talc Poudrage for the Treatment of Malignant Pleural Effusion: Analysis of Effects and Benefits (악성 늑막 삼출증에서의 비디오 흉강경하 탈크 분무의 효과 및 장점 분석)

  • Song, In-Hag;Chang, Won-Ho;Choi, Chang-Woo;Son, Jin-Sung;Kim, Dong-Hyun;Baek, Kang-Seok;Youm, Wook;Kim, Hyun-Jo
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.40 no.7
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    • pp.492-498
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    • 2007
  • Background: Malignant pleural effusion is a common condition in neoplastic patients and palliative therapy is the usual treatment. Talc has been generally accepted to be the most effective sclerosant for chemical pleurodesis, but the optimal route of administration remains controversy. We compared the results of video-assisted thoracoscopic talc poudrage (VTP) with administering a bedside talc slurry through a chest tube (BTS) for the treatment of malignant pleural effusion. Material and Method: From December 2004 to May 2006, 20 patients with malignant pleural effusion underwent chemical pleurodesis via VTP (group A, n=10), and BTS (group B, n=10). Result: The durations of chest tube placement after the procedure were $7.0{\pm}4.0$ days (group A) and $6.7{\pm}3.6$ days (group B). The hospital stays were $24.3{\pm}9.4$ days (group A) and $30.7{\pm}21.5$ days (group B), respectively. The symptoms of dyspnea were much more improved in group A (p-value=0.014) after discharge (mean f/u group $A=8.5{\pm}2.2$ months, group B $8.0{\pm}7.4$ months). The collapsed portions of lung were better expanded in group A than in group B (p-value=0.011). Conclusion: We recommend VTP for the selected patients with malignant pleural effusion because of the advantages of dissecting the fibrous peel to relieve the atelectasis and dyspnea, and excising the pleura for diagnosis with direct viewing of the lesion.

The Effect of Antipsychotic Drug Treatment on Serum VEGF, sVEGFR-1, and sVEGFR-2 Level in Schizophrenia - A Preliminary Study - (정신분열병 환자에서 항정신병약물 치료가 혈청 VEGF, sVEGFR-1 및 sVEGFR-2의 농도에 미치는 영향 - 예 비 연 구 -)

  • Kim, Tae Hyun;Kim, Do Hoon;Lee, Sang Kyu;Son, Bong Ki;Jung, Jun Sub
    • Korean Journal of Biological Psychiatry
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    • v.14 no.4
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    • pp.232-240
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    • 2007
  • Objectives : Vascular endothelial growth factor(VEGF), one of potent cytokines, and its receptors were related with various biological functions and pathological conditions. The purpose of this study was to investigate the changes of serum level of free VEGF, soluble VEGFR-1, and soluble VEGFR-2 after treatment with atypical antipsychotic drug in schizophrenia. Method : The schizophrenic patients were diagnosed with DSM-IV and were prospectively followed up for 4 and 8 weeks. Thirteen schizophrenic patients were evaluated their clinical assessment with serum levels of free VEGF, sVEGFR-1, sVEGFR-2, and positive and negative symptom scale(PANSS) at baseline, 4 weeks, and 8 weeks after treatment with atypical antipsychotic drug. Thirteen normal control subjects were recruited and matched with the patient group by age and sex. Result : The serum level of free VEGF($295.2{\pm}43.7$pg/ml)and sVEGFR-2($8259{\pm}336.7$) at baseline(before treatment) in schizophrenic patients were not significantly different, compared with the control group($199.0{\pm}28.8$ and $8481{\pm}371.9$) respectively. However, the serum level of sVEGFR-1($86.2{\pm}10.3$, p<0.05) was significantly increased in the schizophrenic patients compared with the control group($59.0{\pm}6.4$). After treatment with antipsychotic drug, the serum levels of free VEGF at 4 weeks($338.9{\pm}56.5$) and 8 weeks($309.5{\pm}58.7$) were not significantly, different compared with baseline. But the serum levels of sVEGFR-1 was significantly decreased at 8 weeks ($57.3{\pm}6.3$, p<0.05) after antipsychotic drug treatment. The serum levels of sVEGFR-2 were decreased at 4 weeks ($7761{\pm}403.0$, p<0.05) and 8 weeks($7435{\pm}333.5$, p<0.05) compared with baseline. Conclusion : The decreased serum level of sVEGFR-1 and sVEGFR-2 might be affected by dopaminergic system which was influenced by antipsychotic drug.

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Comparative Analysis of Fracture Angulation between Parallel Pinning and Plate Fixation Techniques in the Management of 5th Metacarpal Fractures (제 5 수지 중수골 골절에서 평행 핀 또는 플레이트 고정술 이후 골절각 변화에 대한 비교 연구)

  • Lee, Myungchul;Shin, Hyojung;Choi, Hyungon;Kim, Jeenam;Shin, Donghyeok
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.230-238
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    • 2018
  • Purpose: Metacarpal fractures are common injuries of the hand. They are treated using closed reduction (CR) or open reduction (OR) techniques. The management strategy depends on fracture site characteristic and fixation methods. In this study, we evaluated pre- and postoperative fracture angulation, when metacarpal fractures bad been treated using two different techniques: CR with parallel transverse pinning and OR with plate fixation. Methods: Forty-six patients undergoing anatomic reduction to treat extra-articular metacarpal fractures were recruited. They were included in one of two therapeutic groups: Group 1, CR with parallel transverse pinning (n=21); Group 2, OR with plate fixation (n=25). Fracture angulation values have been measured on pre- and postoperative radiologic images. Values were compared between pre- and postoperative states, and between corresponding measurements of each group. Results: All extra-articular metacarpal fractures were successfully treated without wound related complications or the limit of joint motion. Both groups demonstrated adequate reduction at immediate postoperative period (postoperative angulation of group 1, $20^{\circ}{\pm}7^{\circ}$; group 2, $19^{\circ}{\pm}5^{\circ}$). During the observation at follow-up period, Group 1 exhibited slight recurrence (follow-up angulation of group 1, $24^{\circ}{\pm}10^{\circ}$). Nonetheless, Group 2 showed adequate reduction state in both immediate postoperative and long-term follow-up periods (follow-up angulation of group 2, $18^{\circ}{\pm}6^{\circ}$). Conclusion: Extra-articular metacarpal fractures were successfully restored without functional complications. CR with parallel transverse pinning method exhibited recurrence after pin removal, which necessitates cautious postoperative exercise and monitoring.

Analysis of Twitter for 2012 South Korea Presidential Election by Text Mining Techniques (텍스트 마이닝을 이용한 2012년 한국대선 관련 트위터 분석)

  • Bae, Jung-Hwan;Son, Ji-Eun;Song, Min
    • Journal of Intelligence and Information Systems
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    • v.19 no.3
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    • pp.141-156
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    • 2013
  • Social media is a representative form of the Web 2.0 that shapes the change of a user's information behavior by allowing users to produce their own contents without any expert skills. In particular, as a new communication medium, it has a profound impact on the social change by enabling users to communicate with the masses and acquaintances their opinions and thoughts. Social media data plays a significant role in an emerging Big Data arena. A variety of research areas such as social network analysis, opinion mining, and so on, therefore, have paid attention to discover meaningful information from vast amounts of data buried in social media. Social media has recently become main foci to the field of Information Retrieval and Text Mining because not only it produces massive unstructured textual data in real-time but also it serves as an influential channel for opinion leading. But most of the previous studies have adopted broad-brush and limited approaches. These approaches have made it difficult to find and analyze new information. To overcome these limitations, we developed a real-time Twitter trend mining system to capture the trend in real-time processing big stream datasets of Twitter. The system offers the functions of term co-occurrence retrieval, visualization of Twitter users by query, similarity calculation between two users, topic modeling to keep track of changes of topical trend, and mention-based user network analysis. In addition, we conducted a case study on the 2012 Korean presidential election. We collected 1,737,969 tweets which contain candidates' name and election on Twitter in Korea (http://www.twitter.com/) for one month in 2012 (October 1 to October 31). The case study shows that the system provides useful information and detects the trend of society effectively. The system also retrieves the list of terms co-occurred by given query terms. We compare the results of term co-occurrence retrieval by giving influential candidates' name, 'Geun Hae Park', 'Jae In Moon', and 'Chul Su Ahn' as query terms. General terms which are related to presidential election such as 'Presidential Election', 'Proclamation in Support', Public opinion poll' appear frequently. Also the results show specific terms that differentiate each candidate's feature such as 'Park Jung Hee' and 'Yuk Young Su' from the query 'Guen Hae Park', 'a single candidacy agreement' and 'Time of voting extension' from the query 'Jae In Moon' and 'a single candidacy agreement' and 'down contract' from the query 'Chul Su Ahn'. Our system not only extracts 10 topics along with related terms but also shows topics' dynamic changes over time by employing the multinomial Latent Dirichlet Allocation technique. Each topic can show one of two types of patterns-Rising tendency and Falling tendencydepending on the change of the probability distribution. To determine the relationship between topic trends in Twitter and social issues in the real world, we compare topic trends with related news articles. We are able to identify that Twitter can track the issue faster than the other media, newspapers. The user network in Twitter is different from those of other social media because of distinctive characteristics of making relationships in Twitter. Twitter users can make their relationships by exchanging mentions. We visualize and analyze mention based networks of 136,754 users. We put three candidates' name as query terms-Geun Hae Park', 'Jae In Moon', and 'Chul Su Ahn'. The results show that Twitter users mention all candidates' name regardless of their political tendencies. This case study discloses that Twitter could be an effective tool to detect and predict dynamic changes of social issues, and mention-based user networks could show different aspects of user behavior as a unique network that is uniquely found in Twitter.