• Journal of Chest Surgery
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• v.29 no.6
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• pp.614-620
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• 1996

The method of treatment in lung cancer patients with invasion to parietal pleura, diaphragm, peri- cardium or vertebra is controversial, and resection of these invasion together with pneumonectomy is called "complex pneumonectomy" From March 1990 to February 1994 we performed 18 cases of "complex pneumonectomy". Seven patients had resection of chest wall, 10 patients had pericardial re- section, and one patient had resection of diaphragm Right pneumonectomy was done in 8 cases and left pneumonectomy was done in 10 cases. The age of patients were from 40 to 70 years(mean 58 years) with male to female ratio of 17 to 1. The chief complaints of the patients on admission were cough (13), dyspnea on exertion (11), chest pain (10), weight loss (9), general fatigue (9), and sputum production (4 . Postoperative pathology were 13 squamous cell carcinoma, 3 adenocarcinoma, and one case each of adenosquamous carcinoma and small cell carcinoma. The postoperative pathologic stages were 2 T3NO MO, 4 TIWIMO, 6 T3N2MO, 5 T4N2MO, and 1 TIWIMO. There was one operative mortality(5.5%). Excluding one follow up loss, 14 patients expired during the follow-up and the mean survival was 9.07 $\pm$ 4.82 months. One patient with stage TINOMO who had chest wall resection is alive at 35 months follow-up and a patient with T3N2MO who had diaphragm resection is alive at 36 months follow-up. Therefore, selection of patients for "complex pneumonec- tomy" is very important, and a long term survival is possible.ong term survival is possible.

• Tuberculosis and Respiratory Diseases
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• v.40 no.4
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• pp.404-409
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• 1993

Background: There are many retreatment failure patients admitted in National Kongju Tuberculosis Hospital. But there is not satisfactory treatment method for them at present. We think that more attentions and active measures for them are needed. Method: We reviewed sex and age, duration of illness, previously used antituberculosis drugs, drug resistance, extent of disease, reasons for early stopping or irregular medication and schooling of 50 retreatment failure patients admitted in National Kongju Tuberculosis Hospital from April 1992 to February 1993. Results: 1) The male to female ratio was 3:2 and 62% of the patients were between 21 and 40 years of age. 2) Twenty eight cases (56%) had the duration of illness over 10 years. 3) All cases had used most of the antituberculosis drugs. 4) Drug sensitivity test showed resistance to RMP in 46 cases (96%), INH in 40 cases (83%) and other drugs in 3-32 cases (6-67%). 5) Forty eight cases (96%) had far advanced disease on chest P-A film. 6) Twenty eight cases (56%) in primary chemotherapy and twenty one cases (42%) in retreatment had the histories of premature stopping or irregular ingestion of the drug. The reasons for premature stopping or irregular ingestion of the drug were as follows; in primary chemotherapy, 29 cases (75%) were due to 'having no symptoms', while in retreatment, 6 cases (29%) were due to 'having no symtoms', 6 cases (29%) were 'too, busy' and 3 cases (14%) were for 'financial problem'. 7) Twenty seven cases (54%) had at least graduated from high school. Conclusion: Greater efforts are needed to prevent tratment failure. More supports and admission treatment for retreatment failure patients are needed to prevent infection and to treat properly.

• Journal of Acupuncture Research
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• v.27 no.5
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• pp.97-104
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• 2010

Objectives : The purpose of this study is to understand the characteristics of the musculoskeletal patients who visited the emergency room of an oriental medicine hospital and provide better first-aid medical service. Methods : We performed a retrospective study of 1,472 patients who visited the emergency room of an oriental medicine hospital, from June 1st, 2007 to May 31st, 2010. Results : Of 1,472 total patients, the male to female ratio was 1.06:1 and people in their 30s were the peak age group. The majority of patients visited the emergency room between 10:00 to 24:00(midnight). Most patients visited the emergency room from Saturday to Sunday. By monthly distribution, the patients increased slightly during February, April, September and October. The majority of patients visited the emergency room within 24hours of onset. The patients were categorized as follows : low back pain 64.81%, cervical pain 11.82%, ankle pain 10.67%. 27.51% of patients used stretcher cars when visiting the emergency room. The admission rate was 22.96%. Conclusions : Of the patients who visited the emergency room of an Oriental hospital, low back pain, cervical pain and ankle pain was the most frequent, in this order. By meticulously preparing for the continued increase in musculoskeletal treatment demand, we can further assist and speed the specialization and popularization of Oriental medical services.

• Korea journal of population studies
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• v.28 no.2
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• pp.205-217
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• 2005

Purpose: To evaluate the factors affecting hospital utilization for respiratory diseases by ecological study design and GIS tool. To raise the social concern for respiratory disease by the result. Methods: Hospital admission data supported by national health insurance cooperation were transformed to spread sheet data format and combined with air monitoring dataset. Air pollution data were collected from the annual report of air monitoring published by Korea Ministry of Environment. Socioeconomic statistics including population density, age distribution, forest ratio etc.. were filed using Korea National Statistical Office database. Multiple linear regression analysis was performed to evaluate the factors affecting hospital utilization for respiratory diseases. Analytical unit was 52 cities. Results: The factors affecting hospital utilization for respiratory diseases were the proportion of population 60 years and over, seaside city, $O_3$ level, smoking rate. Conclusions: However, outdoor pollutants monitoring data and smoking rate have weakness in reflecting individual exposure. Further research is required to propose more illustrative means to evaluate causal relationship between air pollution and respiratory health effect factors.

• The Journal of Korean Physical Therapy
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• v.2 no.1
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• pp.21-33
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• 1990

The purpose of this study is to investigated the occurrence properties of the cerebrovascular accidents. Clinical observations were done 252 cases, were carried from June, 1989 to May, 1990 at 4 general hospital in Taegu, Korea. The following results have been obtained ; 1. Among the 252 cases of cerebrovascular accidents, males was noted in $51.6\%$ and females in $48.4\%$. The ratio between males and females was 1.1 : 1 in whole groups of cerebrovascular accidents, and in aging distribution, it was showed variety distribution in age groups, fifties, sixties and forties were in order of frequency, particulary, more than half was shelved from 50 to 69. 2. Among the 252 cases of cerebrovascular accidents, cerebral hemorrhage was rioted in $64.3\%$, cerebral infarction in $25.8\%$, cerebral thrombosis in $6.3\%$, subarachnoid hemorrhage in $2.4\%$ and cerebral embolism in $1.2\%$. 3. In distribution of academic career, high school level was noted in $37.7\%$, elementary school level in $30.5\%$, middle school level in $17.1\%$, elementary school level in $30.5\%$, middle school level in $17.1\%$ arid college level in $14.7\%$. 4. In distribution of occupation, office worker was noted in $21.8\%$, housewife in $20.2\%$, the others in $19.1\%$, physical laborer in $18.3\%$ and inoccupation in $18.3\%$. 5. In seasonal distribution, spring was noted in $34.9\%$, winter in $32.5\%$, autumn in $20.3\%$ and summer in $12.3\%$. 6. Among the preceding diseases at the onset of cerebrovascular accidents, hypertension was noted in $51.6\%$, no preceding disease in $20.2\%$, other disease in $10.3\%$ and diabetes mellitus in $9.5\%$ and cardiovalvular disease in $6.0\%$. 7. In systolic blood pressure on admission, 160-199mmHg was noted in $32.2\%$, 200-239mmHg in $23.4\%$, 140-159mmHg in $19.4\%$, below 140mmHg in $16.3\%$, and above 240mmHg in $8.7\%$, While, in diastolic blood pressure, above 130mmHg noted in $24.6\%$, below 90 mmHg in $17.1\%$, 120-129mmHg in $13.1\%$ and was 90-99mmHg in $11.1\%$. 8. In major predisposing factors of patients, emotional stress was noted in $20.2\%$, physical action in $17.9\%$, rest in $16.9\%$, while sleeping in $10.7\%$, drinking in $9.9\%$ and defecation in $7.9\%$. 9. In distribution of affected side, left was noted in $48.4\%$, right in 42.1 and both $9.5\%$. 10. In rates of recurrent cases, first attach was noted in $79.0\%$, 1st recurrence in $17.0\%$, 2nd recurrence in $3.6\%$ and 3rd recurrence in $0.4\%$.

• The Journal of Internal Korean Medicine
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• v.18 no.2
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• pp.236-245
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• 1997

The subjects of this clinical study are 17 patients with ALS(Amyotrophic Lateral Sclerosis), who were diagnosed in other or our hospital from January 1987 to Nomember 1997. The age of onset, clinical signs, type of ALS, methods of treatment and outcomes, etc. were studied and analyzed. The data are summarized as follows ; 1) The mean age was $52.4{\pm}11.5$ years old, and the ratio of male to female was 2.4:1. There is increasing frequency with rising age. 2) Pseudopolyneuritic type(67%) is the most in male patients, bulbar type(60%) is the most in female patients, and totaly Pseudopolyneuritic type(54%) is the most. 3) In the period of hospitalization after onset, 1 year(11 cases, 64.8%) is the most frequent, and 2 year(2 cases, 11.7%), 1 month(2 cases, 11.7%), 4 years(1 case, 5.9%) and 6 months(1 case, 5.9%) in orders. 4) In the duration of admission, 10 days(8 cases, 47.2%) is the most frequent, and 30 days(4 cases 23.5%), 2 months(2 cases, 11.7%), 20 days(2 cases, 11.7%) and 3 months(1 case, 5.9%) in orders. 5) In the signs of patients, muscle weakness(17 cases, 100%), bulbar signs(14 cases, 82.4%), increased reflex of deep tendon(10 case, 58.8%), muscle atrophy (7 cases, 41.2%) and fasciculations(7 cases, 41.2%) were in orders. 6) In the methods of treatment, herb-medication(17 cases, 100%), acupuncture therapy(16 cases, 94.1%), physical therapy(7 cases, 41.2%), moxibustion therapy(5 cases, 29.4%), cupping therapy(4 case, 23.5%) and moxa-pack(1 case 5.9%) were administered in orders. 7) As to the outcome of treatment, 8(47.1%) were no changed, 4(23.5%) improved, 4(23.5%) aggravated, 1(5.9%) expired in orders.

• Clinical and Experimental Emergency Medicine
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• v.5 no.4
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• pp.219-229
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• 2018

Objective We compared the predictive value of the National Early Warning Score+Lactate (NEWS+L) score with those of other parameters such as the pre-endoscopic Rockall score (PERS), Glasgow-Blatchford score (GBS), and albumin, international normalized ratio, altered mental status, systolic blood pressure, age older than 65 years score (AIMS65) among patients with upper gastrointestinal bleeding (UGIB). Methods We conducted a retrospective study of patients with UGIB during 2 consecutive years. The primary outcome was the composite of in-hospital death, intensive care unit admission, and the need for ${\geq}5$ packs of red blood cell transfusion within 24 hours. Results Among 530 included patients, the composite outcome occurred in 59 patients (19 inhospital deaths, 13 intensive care unit admissions, and 40 transfusions of ${\geq}5$ packs of red blood cells within 24 hours). The area under the receiver operating characteristic curve of the NEWS+L score for the composite outcome was 0.76 (95% confidence interval, 0.70 to 0.82), which demonstrated a significant difference compared to PERS (0.66, 0.59-0.73, P=0.004), but not to GBS (0.70, 0.64-0.77, P=0.141) and AIMS65 (0.76, 0.70-0.83, P=0.999). The sensitivities of NEWS+L scores of 3 (n=34, 6.4%), 4 (n=92, 17.4%), and 5 (n=171, 32.3%) were 100%, 98.3%, and 96.6%, respectively, while the sensitivity of an AIMS65 score of 0 (n=159, 30.0%) was 91.5%. Conclusion The NEWS+L score showed better discriminative performance than the PERS and comparable discriminative performance to the GBS and AIMS65. The NEWS+L score may be used to identify low-risk patients among patients with UGIB.

• Tuberculosis and Respiratory Diseases
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• v.85 no.1
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• pp.74-79
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• 2022

Background: The effect of underlying chronic obstructive pulmonary disease (COPD) on coronavirus disease 2019 (COVID-19) during a pandemic is controversial. The purpose of this study was to examine the prognosis of COVID-19 according to the underlying COPD. Methods: COVID-19 patients were assessed using nationwide health insurance data. Comorbidities were evaluated using the modified Charlson Comorbidity Index (mCCI) which excluded COPD from conventional CCI scores. Baseline characteristics were assessed. Univariable and multiple logistic and linear regression analyses were performed to determine effects of variables on clinical outcomes. Ages, sex, mCCI, socioeconomic status, and underlying COPD were selected as variables. Results: COPD patients showed older age (71.3±11.6 years vs. 47.7±19.1 years, p<0.001), higher mCCI (2.6±1.9 vs. 0.8±1.3, p<0.001), and higher mortality (22.9% vs. 3.2%, p<0.001) than non-COPD patients. The intensive care unit admission rate and hospital length of stay were not significantly different between the two groups. All variables were associated with mortality in univariate analysis. However, underlying COPD was not associated with mortality unlike other variables in the adjusted analysis. Older age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.11-1.14; p<0.001), male sex (OR, 2.29; 95% CI, 1.67-3.12; p<0.001), higher mCCI (OR, 1.30; 95% CI, 1.20-1.41; p<0.001), and medical aid insurance (OR, 1.55; 95% CI, 1.03-2.32; p=0.035) were associated with mortality. Conclusion: Underlying COPD is not associated with a poor prognosis of COVID-19.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.128-135
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• 2021

Objectives : The aim of the present study is to investigate the impact of COVID-19 on the incidence and severity of childhood and adolescent self-harm. Methods : Medical records were retrospectively reviewed for patients under the age of 18 who visited the emergency room of Konyang University Hospital to compare the rate of self-harm attempts and the demographic, clinical, and self-harm-related of self-harm attempters aspects before and after the COVID-19 outbreak. Results : During 11 months after the COVID-19 outbreak, the proportion of the number of children and adolescents patients with self-harm and their episodes increased significantly compared to that during 11 months before the COVID-19 outbreak (𝛘²=14.397, p<0.001; 𝛘²=24.156, p<0.001). Between about the year before and after the outbreak of COVID-19, there was a significant difference in the prior self-harm history and psychiatric history among children and adolescents who visited the emergency room and the ratio of hospitalization to other departments than department of psychiatry (p<0.05; p<0.05; p<0.05). Conclusions : In the COVID-19 situation, the proportion of children and adolescents who visited the emergency room due to self-harm and admission to other departments are increasing. And it has been shown that the incidence of self-harm has significantly increased in children and adolescents with a history of prior self-harm and psychiatric past history. These findings underscore the need for the psychiatric evaluation and intervention of self-harm related high-risk groups among children and adolescents in pandemic situations.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.316-323
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• 2023

Objective : Owing to advances in critical care treatment, the overall survival rate of preterm infants born at a gestational age (GA) <32 weeks has consistently improved. However, the incidence of severe intraventricular hemorrhage (IVH) has persisted, and there are few reports on in-hospital morbidity and mortality. Therefore, the aim of the present study was to investigate trends surrounding in-hospital morbidity and mortality of preterm infants with severe IVH over a 14-year period. Methods : This single-center retrospective study included 620 infants born at a GA <32 weeks, admitted between January 2007 and December 2020. After applying exclusion criteria, 596 patients were included in this study. Infants were grouped based on the most severe IVH grade documented on brain ultrasonography during their admission, with grades 3 and 4 defined as severe. We compared in-hospital mortality and clinical outcomes of preterm infants with severe IVH for two time periods : 2007-2013 (phase I) and 2014-2020 (phase II). Baseline characteristics of infants who died and survived during hospitalization were analyzed. Results : A total of 54 infants (9.0%) were diagnosed with severe IVH over a 14-year period; overall in-hospital mortality rate was 29.6%. Late in-hospital mortality rate (>7 days after birth) for infants with severe IVH significantly improved over time, decreasing from 39.1% in phase I to 14.3% in phase II (p=0.043). A history of hypotension treated with vasoactive medication within 1 week after birth (adjusted odds ratio, 7.39; p=0.025) was found to be an independent risk factor for mortality. When comparing major morbidities of surviving infants, those in phase II were significantly more likely to have undergone surgery for necrotizing enterocolitis (NEC) (29.2% vs. 0.0%; p=0.027). Additionally, rates of late-onset sepsis (45.8% vs. 14.3%; p=0.049) and central nervous system infection (25.0% vs. 0.0%; p=0.049) were significantly higher in phase II survivors than in phase I survivors. Conclusion : In-hospital mortality in preterm infants with severe IVH decreased over the last decade, whereas major neonatal morbidities increased, particularly surgical NEC and sepsis. This study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe IVH.