• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.14 no.2
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• pp.134-145
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• 2001

Introduction: Noises in the ear, whether real or imagined, are called tinnitus. Subjective causes of tinnitus(which is heard only by the patient) are extremely common and the majority of them are treated conservatively. For certain individuals their tinnitus is a major handicap; for others a trivial concern. The most common from of subjective tinnitus is a rushing, hissing or buzzing noise; it is frequently associated with sensorineural heanng loss. The patient may be unaware of the hearing loss, especially if it is a high frequency deficit of moderate severity. The character of the tinnitus may give a clue to the etiology. But the patient often has difficulty in explaining his/her tinnitus in absolute terms, as they have no other tinnitus with which to compare it but their own Tinnitus, like pain, is a subjective state and trying to objectively assess the severity is problematic. Audiological techniques to match subjective loudness to machine-produced noise may offer some help, in that sound intensity matches can bear little correspondence to subjective complaint. In spite of many studies, most patients presently seen complaining of tinnitus are told by their doctors that there is no treatment and that they will have to learn to live with this symptom. Objectives: To perform a clinical analysis of tinnitus and estimate the efficacy of Oriental Medical treatment according to the Byeonjeung(辨證). Subject: We studied 34 patients with complaints of tinnitus who had visited Pundang Cha Oriental Medicine Hospital Department of Otorhinolaryngology from March 1998 to February 2000. All of them had been treated 2 or 3 times a week with acupuncture treatment and had taken herbs according to the Byeonjeung(辨證) method. It was therefore possible for me to know whether their symptoms improved or not. Parameters Observed and Method: We treated them with acupuncture & herb-medication. Sometimes we gave them moxibustion or negative therapy with bloodletting at the acupuncture points(耳門, 聽宮, 聽會). Parameters Observed 1) Distribution of age & sex 2) Chief complaints 3) The sites of tinnitus 4) The quality of tinnitu 5) The duration of disease 6) The problem induced tinnitus 7) Factors increasing disease severity 8) The classification of the Byeonjeung(辨證) 9) The efficacy of treatments Results: 1. Age and sex distribution: The most common occurrence was found in males in their twenties: 6 males($17.7\%$), and in females in their thirties and over sixty: 8 females($23.5\%$). Total patient numbers for men and women were 20 men($58.8\%$), 14 women ($41.2\%$). 2. The most frequent major complaints were hearing disturbances related to tinnitus; and dizziness with tinnitus; each comprising 10 cases($29.4\%$). There were also 7 patients($20.6\%$) with only tinnitus. 3. Tinnitus sites: 13($38.2\%$) said that they felt tinnitus in both ears, equally. In the right ear, 9($26.5\%$), in the left, 6($17.7\%$). 4. The most frequent descriptive symptoms of tinnitus were: humming, hissing, buzzing etc. 5. The duration of disease. 14cases($41.2\%$) had a duration of less than 1 year. 6. 15cases($44.1\%$) complained that it was hard to watch TV or make a phone call because of tinnitus. 10 cases($29.4\%$) complained about depression. 7. Factors increasing severity of tinnitus: ⅰ) fatigue: 18cases($52.9\%$) ⅱ) stress/ tension: 10 cases($29.4\%$) ⅲ) alcohol and tobacco: 5cases($l4.7\%$) 8. Classification through Byeonjeung : ⅰ) 19 cases($55.9\%$) were classified as showing Deficiency syndrome. ⅱ) 15 cases($44.l\%$) were classified as showing Excess syndrome. The deficiency of Qi was 7($20.6\%$), deficiency of Xue, 8($23.5\%$) and insufficiency of the Kidney Yin & Yang, 4($11.8\%$). The flare of Liver fire was 8($23.5\%$) and phlegm-fire, 7($20.6\%$), 9. The efficacy of treatments showed: an improvement in 17cases($50.0\%$); no real improvement or changes in 13 cases($38.2\%$); and some worsening in 4 cases($11.8\%$). In the group with deficiency in Qi, 4($57.1\%$) improved, 1($14.3\%$) showed no change and 2($28.6\%$) were aggravated. In the cases of deficiency in Xue, 6($75.0\%$) improved, 2($25.0\%$) showed no change. In the cases of insufficiency of Kidney Yin & Yang, 3($75.0\%$) showed no change and 1($25.0\%$) were aggravated. In the group of flare of Liver fire, 4($50.0\%$) improved, 3($37.5\%$) no change and 1($12.5\%$) were aggravated. In the cases of phlegm-fire, 3($42.9\%$) improved, 4($57.1\%$) showed no change. Conclusion: We would recommend that any further studies of tinnitus utilize trial treatments of longer than 2 months duration, as any positive effects observed in our study showed that improvement occurred fairly slowly. And we suggest that this study could be utilized as a reference for clinical Oriental Medical treatment of tinnitus. If we try to apply music or sound therapy treatment properly combined with ours, we expect it to provide psycological stability in addition to inducing masking effects, even though it may not directly decrease or completely remove tinnitus.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.115-123
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• 2003

Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.497-503
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• 2003

Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

• Journal of Sasang Constitutional Medicine
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• v.9 no.2
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• pp.39-55
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• 1997

Purpose : Dong-Mu(東武) Lee Je-Ma(李濟馬) was designated as a member of fifty persons 'The Wise Ancestors of Korean Culture and Art' in 1984 and the december of 1996 was appointed as 'The Month of Lee Je-Ma'. Though his achivements was valued like this, some historian criticized that he suppressed the righteous army. So this study was for clarifing the background, the motive, and the course of 'The Rising of Choi Moon-Hwan' occurred in Hamhung on february in 1896, and for the correct appraisement about this event. And also through this, author tried to make clear the origin of Lee Je-Ma's thought. Method : After studing the background of the end of Chosun dynasty and the righteous army in 1895(乙未義兵). Author made a comparative study through the historical materials of the goverment side, the Choi Moon-Hwan side, and the Lee Je-Ma side about 'The Rising of Choi Moon-Hwan' occurred in Hamhung on februrary in 1896. Results & Conclusion : The event occurred in Hamhung on february in 1896 was a part of rebellion of the righteous army in 1895 which had risen against The startling Occurrence of 1895'(乙未義兵) and 'The Royal Commands To Cut Off People's Hair'(斷髮令). Lee Je-Ma suppressed the Rising and put Choi Moon-Hwan in the prison, and which was criticized that he suppressed the righteous army later day. That time was a conflict period between conservatism and civilization, and the Lee Je-Ma's act was the best way to protect the security of residents from the attack which maybe occurred by Japanese army in Wonsan. Judging from this events, author could find Lee Je-Ma's thought was quite different from righteous army's neo-confucianism and conservatism. In the aspect of the history of 'Korean National Movement', further study about Choi Moon-Hwan, the chief of righteous army will be need.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.1
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• pp.13-25
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• 1998

Aim：We think that the most important etiology in parent abuse is the psychodynamic and psychopathology in the family. So, we investigated the adolescents being admitted in SNMH, whose chief complaints were parent abuse. We were trying to explore families psychodynamic and psychopathology, especially mother-child interaction and to differentiate them in according to developmental psychopathology. Method：Our objects were the adolescent patients admitted in SNMH from 1987 to 1997 because they attacked parents verbally and physically. We examined 21 adolescents except those with psychosis, organic mental disorder, autism and mental retardation by means of interview or chart review. Result and Conclusion：The number of male patients was 14 and the number of female patients was 7. The most common diagnosis was conduct disorder and borderline personality disorder. The mean age was in the mid-teens. We observed 4 subgroups that were divided developmentally in object relation. 1) Symbiotic group with mother：(1) They did not separate and remain in symbiotic relationships with their mothers based on insecure attachment. Fathers were abscent emotionally and physically, and their mothers were prominent in close relationships with the patients in their family , where as the patients were the only man in the family. Adolescents entered the second separation-individuation. They expressed anger and internal tension involved with the close attachment with their mothers and also attempted separation from their mothers through physically attacking them. (2) These patients had suffered from physical illness and developmental delay since birth. Therefore the parents overprotected their children. The children had persistent infantile omnipotence and fantasies of power, so they could not deal with unrealistic states, adapt to reality, and depended on their parents overtly. They easily acted out unless their demands were fulfilled. 2) Borderline personality disorder：We observed deficiencies in care taking. Their parents had personality problems and immaturity. They coulden’t help their children to be separated in the rapproachment phase. Their conflict about dependence-independence was revived in the second separation-individuation adolescent period. We understand parent abuse as an attempt to overcome the conflict. 3) Conduct disorder：They did not build up basic attachment with their parents. They think of their parents as only a means of fulfilling their needs. When patients’ need were not fulfilled and remained in a conflicted state, they attacked their parents, unable to control their aggressions and impulses.

• Tuberculosis and Respiratory Diseases
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• v.52 no.6
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• pp.608-615
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• 2002

Background : ADA is an enzyme found in most cells, and is involved in purine metabolism, but its chief role concerns the proliferation and differentiation of lymphocytes, especially T-lymphocytes. For that reason ADA has been looked on as a marker of cell-mediate immunity, which is the key mechanism of the tuberculous pleural effusion. Thus, the pleural fluid ADA activity is increased in the tuberculous pleural effusion. Age associated immune decline is characterized by decreases in both B and T-lymphocyte function and the former may be largely a result of the latter. Therefore, the pleural fluid ADA activity would be lower in old rather than in young, patients with tuberculous pleural effusion. We studied the relationship between age, and pleural fluid ADA activity, in patients with tuberculous pleural effusion. Materials and Methods : In the 46 patients with tuberculous pleural effusion enroll in this study, the pleural fluid ADA activities were measured by means of an automated kinetic method. Results : The mean age of the patients was $53.0{\pm}22.0$ years, with a male to female ratio of 30:16. The patients were divided into two groups, young patients, regarded as < 65 and old regarded as ${\geq}65$ years with 28 and 18 patients, respectively. The pleural fluid ADA activity in both groups show significant differences : $99.4{\pm}22.6$ IU/L(young patients) Vs. $75.8{\pm}30.9$ IU/L(old patients)(p<0.05), but a negative correlation with age (r=-0.311, p<0.05). Conclusion : Although pleural fluid ADA activity was not adequately increased, tuberculous pleural effusion, in older patients, would have to be considered clinically suspicious tuberculous pleural effusion.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.584-594
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• 1993

Background: Among the respiratory diseases, there are a lot of cases of pleural effusion. The most common cause is tuberculosis. But the other cause such as lung malignancy is in an increasing tendency because of the development of diagnostic procedure, the decrease of the prevalence of the tuberculosis and the increase of the longevity. We need to know the accurate diagnosis as soon as possible for the correct therapy. Method: A clinical observation was made on 315 cases of pleural effusion seen at Pusan Adventist Hospital, from Jan, 1989 to Dec, 1992. For diagnostic procedure, thoracentesis, lymph node biopsy, bronchoscopy and percutaneous biopsy of the parietal pleura with Cope needle were performed. The following are parameters used in seperating the exudate from the transudate: pleural protein 3.0 g/dl, pleural protein/serum protein ratio 0.5, pleural LDH 200 IU, pleural LDH/serum LDH ratio 0.6, pleural cholesterol 60 mg/dl and pleural cholesterol/serum cholesterol ratio 0.3. Each parameters were compared, and misclassified rate and diagnostic efficiency were calculated. Results: The most common cause of exudate pleurisy was tuberculosis (82.3%) and malignancy was next (12.2%). The chief complaints of pleural effusion were noted as dyspnea (58.7%), chest pain (54.9%), coughing (50.2%) and fever (36.2%). Location of pleural effusion was noted as right side (51.4%), left side (41.3%) and both sides (7.3%). Amount of pleural effusion of the chest X-ray was minimum (46.8%), moderate (40.5%) and maximum (12.7%). Misclassified rates for each parameters in seperating the exudates from the transudates were as follows; protein: 5.2%, pleural protein/serum protein:7.6%, LDH: 13.9%, pleural LDH/serum LDH: 6.9%, cholesterol: 8.0%, pleural cholesterol/serum cholesterol: 5.6%. On the pleural biopsy, the tuberculosis granuloma was 60.8%, malignancy was 13.6%, infection was 2.3% and nonspecific inflammatory reaction was 23.3%. Conclusion: on the basis of the above results, the most common cause of exudative pleurisy was tuberculosis. We think that the plerual cholesterol/serum cholesterol ratio is the most useful supportive parameter in separating the exudates from the transudates. For accurate diagnosis, the pleural biopsy is the first procedure and repeated pleural biopsy of nonspedcific inflammatory reaction is required.

• Tuberculosis and Respiratory Diseases
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• v.49 no.4
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• pp.432-440
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• 2000

Background : The prevalence of pulmonary tuberculosis among the elderly is increasing in Korea and in the developed countries due to the increased elderly population and their predispositions to chronic disease, poverty and decreased immunity. To define the characteristics of pulmonary tuberculosis in the elderly, we evaluated the clinical spectrum of pulmonary tuberculosis. Method : We analyzed 92 patients retrospectively that were diagnosed as active pulmonary tuberculosis over the age of 65. The analysis involved patient's profiles, clinical manifestations, coexisting diseases, diagnostic methods, anti-TB medications and their side effects, and treatment outcomes. Results : The results were as follows : - 1) The ratio of male to female was 2.1:1(62:30 cases) 2) Chief complaints were a cough (47.8%), dyspnea (40.2%), sputum (38.0%), chest pain (12.0%), anorexia (10.9%), and fever (9.8%). 3) 38 (41.3%) of cases had a past history of pulmonary tuberculosis. 4) The coexisting diseases were : -COPD, 25 cases (27.2%); pneumonia, 17 cases (18.5%); DM. 13 cases (14.1%); and malignancy, 10 cases (10.9%). 5) The positivity of Mantoux test (5 TU, PPD-S) was 82.7%. 6) Pulmonary tuberculosis was diagnosed using the following methods : sputum AFB (Acid Fast Bacillus) smear 42.4%, sputum TB (M. Tuberculosis) culture 15.2%, sputum TB PCR (Polymerase Chain Reaction) 10.9%, bronchial washing AFB smear 2.1%, chest radiology only 25.0%. 7) Locations of radiologic lesions were RULF, 50 cases; RLLF, 50 cases, mostly, then LLLF ; 26 cases were leastly involved. 8) The coexisting tuberculosis were endobronchial TB(8.7%), TB pleurisy(7.6%) miliary TB(5.4%), intestinal TB(2.2%), renal TB(1.1%) 9) The proportion of treatment regimen with 1st line drug and 2nd line drug were 92.3% and 7.6%, respectively. 10) The outcome of treatment were as follows : cured 31.5%, expired 13.0%, no return 47.8%, follow-up now 7.6%. Conclusion : The pulmonary tuberculosis in the elderly has atypical patterns with chronic coexisting diseases. Therefore, the possibility of pulmonary tuberculosis should be considered in elderly patients with pulmonary symptoms.

• Korean Journal of Veterinary Research
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• v.40 no.4
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• pp.653-660
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• 2000

In order to study the regional distribution and relative frequency of the immunoreactive endocrine cells in the gastrointestinal tract of the Mongolian gerbil, Meriones unguiculatus, the gastrointestinal tract was divided into 9 portions (cardia, fundus, pylorus, duodenum, jejunum, ileum, cecum, colon and rectum) and immunostained by immunohistochemical (PAP) method using 8 types of specific antisera against cholecystokinin (CCK)-8, gastrin, secretin, pancreatic polypeptide(PP), somatostatin, serotonin, glucagon and insulin. CCK-8-, gastrin-, somatostatin- and serotonin-immunoreactive cells were demonstrated in this study. These immunoreactive cells were found in the gastric gland regions of the pylorus or between parietal and chief cells of the fundus with round to spherical shaped, and in the interepithelial regions of the intestinal tract with spherical to spindle shaped except for jejunum where some of immunoreactive cells were also observed in the intestinal glands with round to spherical shaped. CCK-8-immunoreactive cells were restricted to the pylorus and duodenum with numerous and a few frequency, respectively. Gastrin-immunoreactive cells were restricted to the pylorus with numerous frequency. Similar to those of gastrin-immunoreactive cells, somatostatin-immunoreactive cells were restricted to pylorus with moderate frequency. Serotonin-immunoreactive cells were detected throughout whole gastrointestinal tract except for cardia and cecum with moderate or numerous frequency. However, no secretin-, PP-, glucagon- and insulin-immunoreactive cells were observed in this study. From these results, the appearance type, regional distribution and relative frequency of immunoreactive endocrine cells in the gastrointestinal tract of the Mongolian gerbils were somewhat lowered or restricted compared to those of other mammals and these differences were might be caused by feeding habits and species specification.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.169-179
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• 2004

The purpose of this study was to discriminate clinically and radiographically among the three groups of dentigerous cysts studied. First, Group I, involved area of dentigerous cyst was successive permanent tooth area beneath deciduous tooth. Second, Group II, involved permanent molar area, and the last, Group III involved maxillary anterior supernumerary tooth area. The author observed and compared the clinico-radiographic features of 49 cases of Group I, 36 cases of Group II, and 15 cases of Group III of dentigerous cyst and this observation and comparison had been done by based on the charts and panoramic films. The obtained results were as follows: 1. The cases of Group I were 29 cases and, those of Group II were 36 and those of Group III were 15. 2. The incidence of dentigerous cyst is high in first decade. In Group I, before first decade and early first decade was 87.8%, in Group II and Group III, was discovered more lately. 3. The frequency of dentigerous cyst is 2.5 times higher in male than in female. 4. The sequence of chief complaint was swelling(50%), routine examination(32%), and pain(9%). 5. When considering the type of the cyst, lateral type is many most in Group I (71.4%) and central type is many most in Group II (94.4%) and Group III (100%). 6. The most size of dentigerous cyst was 2 crown size in Group I, 1 crown size in Group II, above of 4 crown size in Group III. 7. Almost involved teeth showed displacement and some tooth of displaced teeth showed delayed root development and dilaceration of root. 8. The most many response of alveolar bone was buccal bone expansion in Group I (67.3%), no bone expansion in Group II(66.7%) and palatal bone expansion in Group III (60.0%). 9. The percentage of involved teeth were as follows : The mandibular third molar was 31% and many most. The mandibular second premolar was 30%. Mesiodens of maxillary anterior area was 15%. The maxillary canine was 8%. The mandibular first premolar was 5%. 10. In the Group I, causes suggesting of dentigeous cyst are pulpotomized deciduous tooth(59.2%), severe dental caries of deciduous tooth, untreated traumatic history on the deciduous tooth etc. 11. The treatment method of dentigerous was marsupialization in 61.2% of cases of Group I and that was enucleation in 61.1% of cases of Group II and in 80.0% of cases of Group III.