• The Korean Journal of Pain
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• 제11권1호
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• pp.150-154
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• 1998

Epidural steroid injection have become one of the most frequently applied conservative option for the management of acute and chronic back pain. As the indications for epidural steroid injections increase so do the adverse responses associated with this procedure. This study reports the succession of 3 patients who developed galactorrhea and hyperprolactinemia after recieving an epidural steroid injection for lumbar radiculopathy and low back pain. Serum prolactin level was elevated in accordance with epidural injection of corticosteroid. We measured the serum prolactin level by immunoradiometric assay method and peak serum prolactin level at above 500, 144.2, 150.3 ng/ml respectively. Also we found the serum prolactin level decreased to normal values 3 wks after corticosteroid injection. Galactorrhra ceased in advance of decrease of serum prolactin level. That "Hyperprolactinemia and galactorrhea can occur following epidural steroid injection", requires a much larger prospective investigation.

• 한국마린엔지니어링학회:학술대회논문집
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• 한국마린엔지니어링학회 2002년도 춘계학술대회논문집
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• pp.239-244
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• 2002

Even though, tanks are used at the many industry plants, it is very difficult to control the tank level without any overflow and shortage; moreover, cause of its complication of dynamics and nonlinearity, it's impossible to realize the accurate control using the mathematical model which can be applied to the various operation modes. However, the sliding mode controller(SMC) is known as having the robust variable structures for the nonlinear control systems with the parametric perturbations and with the sudden disturbances, but the auto-tuning of parameters was a problem. Therefore, in this paper, a Genetic Algorithm based Sliding Mode Controller (GA-SMC) for the precise control of the coupled tank level was tried. GA optimized the SMCs switching parameters easily and rapidly. The simulation results are shown that the tank level could be satisfactorily controlled with less overshoot and steady-stale error by the proposed GA-SMC.

• Journal of Chest Surgery
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• 제28권10호
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• pp.892-899
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• 1995

Pancreatitis is a known complication of cardiac surgery with cardiopulmonary bypass. Although ischemia is believed to be a factor, the exact cause of pancreatitis after cardiopulmonary bypass remains unknown.We prospectively studied 67 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass for evaluation of the pancreatic injury after cardiopulmonary bypas. Serial measurement of amylase level in serum and urine was done postoperatively. Hyperamylasemia was detected in 15 patients[22.4% , of whom no patient had pancreatitis. There was no significant difference between serum amylase level and parameters such as cardiopulmonay bypass time, aortic cross clamp time, mean blood pressure, rectal temperature, flow rate, and use of circulatory arrest during cardiopulmonary bypass. Hyperamylasuria was detected in 8 patients[11.9% , and urine amylase level was elevated significantly in the groups with prolonged cardiopulmonary bypass, mean blood pressure more than 40mmHg, and rectal temperature more than 20 $^{\circ}$C. We recommend that serum amylase level and/or amylase-creatinine clearance ratio is measured for ealy detection and management of pancreatitis after cardiopulmonary bypass.

• Journal of Nutrition and Health
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• 제34권8호
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• pp.912-919
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• 2001

The increased oxidative stress may play an important role on the pathogenesis of diabetes and diabetic complications, and the blood level of vitamin C and lipid peroxidation in NIDDM patients may be used as an indicator for oxidative stress. However there is only scanty evidence on the blood level of vitamin C in NIDDM patients with or without diabetic complications. The study population consisted of 90 NIDDM patients(diabetes without complication, 48, and diabetes with complications, 42) and 41 normal subjects. The 42 diabetic complications were divided into 3 groups : 15 diabetic nephropathy, 18 diabetic neuropathy, 9 diabetic retinopathy. The anthropometric data and blood biochemical data were studied. The dietary intake was determined by 24 hour recall methods and food frequency questionnaire. The plasma concentrations of MDA and vitamin C were determined by fluorophotometer and HPLC respectively. 1) In blood lipoprotein study, diabetes with complication had higher level of TG than diabetes without complications, while no significant differences in total cholesterol, HDL, and LDL were shown. Diabetic neuropathy had the highest TG level among diabetic complication groups. 2) The intakes of vitamin B complexes(vitamin B$_2$, vitamin B$_{6}$, not vitamin B$_1$) and antioxidant vitamins(vitamin A and vitamin E, not vitamin C) and certain minerals such as iron and calcium in diabetes were not sufficient but the intakes of energy, protein, niacin, and phosphorus in diabetes were sufficient. The dietary intakes between diabetes with-and without complications were not significantly different. Among diabetic complications, the diabetic retinopathy had the lowest intake of vitamin B$_2$ and B$_{6}$(p < 0.05). the diabetic neuropathy or nephropathy consumed extremely low amount of vitamin A. 3) The MDA concentrations of NIDDM was significantly higher than that in controls(p < 0. 05) while no significant difference in the MDA concentration between with and without complications was shown. Although there were no statistical differences, the diabetic nephropathy and diabetic neuropathy showed the higher concentration of MDA than the diabetes without complications or diabetic retinopathy. 4) The plasma concentration of vitamin C in controls was higher than that in diabetes(p < 0.05) while the plasma vitamin C in diabetes with and without complications were similar. In diabetic complications, no differences in plasma vitamin C concentration of three groups were shown. This study showed that the oxidative stress in NIDDM patients was highly increased and the vitamin C reserve was significantly depleted, as compared with normals, although their intakes of vitamin C met korean RDA, which means that diabetes need more vitamin C intake to decrease oxidative stress in NIDDM patients.nts.

• Journal of Korean Neurosurgical Society
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• 제48권5호
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• pp.412-418
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• 2010

Objective : To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods : One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (361%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results : The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A. perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in both groups A (p = 0.035) and B (p = 0.044) increased with an increasing number of comorbidities. Conclusion : Elderly patients with comorbidities are at a high risk for complications and adverse outcomes after lumbar spine surgery. In our study, clinical outcomes, fusion rates, and perioperative complication rates in older patients were comparable with those in younger populations. The number of comorbidities and the extent of fusion level were significant factors in predicting the occurrence of postoperative complications. However, proper perioperative general supportive care with a thorough fusion strategy during the operation could improve the overall postoperative outcomes in lumbar fusion surgery for elderly patients.

• International Journal of Contents
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• 제14권3호
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• pp.39-45
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• 2018

Purpose: Food Allergen Immunotherapy (Oral) is a form of immunotherapy administered to patients who are allergic to foods such as egg, milk, and peanut. The food allergen is orally administered to the patient in an escalating dose for desensitization or tolerance development. The safety and effectiveness of the therapy were assessed using a systematic literature review and meta-analysis. Methods: For a literature search, 8 national databases and a number of international databases including Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library were used; and 13 articles (all from international databases) were selected. The target of Food Allergen Immunotherapy (Oral) included patients with food allergy, and the intervention was food allergen immunotherapy without limiting the food type. The safety and effectiveness of Food Allergen Immunotherapy (Oral) were assessed by reviewing all the articles reporting on the therapy. The control group received standard therapies including aversion therapy, no treatment, anti-histamine treatment, and placebo. Safety was assessed through the incidence of complication and emergency medication. Effectiveness was assessed based on therapy success rate, symptomatic improvement, and quality of life. Results: Although Food Allergen Immunotherapy (Oral) was shown to have successful desensitization in patients with food allergy, the safety of the technique has not yet reached an acceptable level; the possible reason is due to the high rate of complication and frequency of emergency medication. Also, each study employed varying protocols while relying on a small number of participants and a short monitoring period. Conclusion: The results of assessment suggest that the level of evidence from current literature review is low and further research is necessitated for the verification of the safety and effectiveness of the therapy (Grade of Recommendation: A; Level of Technology: II-b).

• Hip & pelvis
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• 제36권1호
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• pp.70-75
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• 2024

We report on the case of a 52-year-old female who presented with a stress fracture after undergoing an endoscopic resection of the lesser trochanter in ischiofemoral impingement, which was resistant to maximal conservative treatment. To the best of our knowledge, this complication has not been previously described. Non-weight-bearing and intravenous alendronic acid were prescribed for management. No additional surgery was required. The patient was pain free with the ability to perform sports on the same level as before and had no complaints.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권3호
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• pp.160-167
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• 2015

Purpose: We aimed to analyze the effectiveness and safety of low-dose midazolam and ketamine combination for upper gastrointestinal endoscopy (UGIE) in children. Methods: The study included the children (n=425, $10.78{\pm}3.81years$) who underwent UGIE for diagnostic purpose during 1 year period. All children were sedated with low dose midazolam (0.1 mg/kg) and ketamine (0.5 mg/kg) intravenously. Effectiveness of the sedation and complications during the procedure and recovery period were recorded. Results: Endoscopic procedure was successfully completed in 414 patients (97.4%; 95% confidence interval, 95.8-98.9). $Mean{\pm}standard$ deviation (SD) duration of procedure was $6.36{\pm}1.64minutes$ (median, 6.0 minutes; range, 4-12 minutes). Minor complications occurred during the procedure in 39.2% of the patients. The most common complication was increased oral secretion (33.1%). No major complications were observed in any patient. Age and Ramsay sedation scores of patients with complications during the procedure were lower than the others ($9.49{\pm}4.05years$ vs. $11.61{\pm}3.43years$, p=0.002 and $2.10{\pm}1.46$ vs. $4.37{\pm}1.16$, p=0.001). Mean recovery time was 22 minutes (range, 10-90 minutes; $mean{\pm}SD$, $25{\pm}12.32minutes$). Minor complications developed during recovery in 60.1% of the patients. The most common complication was transient double vision (n=127, 30.7%). Emergence reaction was observed in 5 patients (1.2%). Conclusion: The procedure was completed with high level of success without any major complication in our study. Combination of low-dose midazolam and ketamine is a suitable sedation protocol for pediatric endoscopists in UGIE.

• 대한치과의사협회지
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• 제54권12호
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• pp.1024-1034
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• 2016

Purpose. The purpose of this study was to compare the type and frequency of prosthetic complications associated with attachment types for implant overdenture. Material and methods. In this retrospective study, 38 patients (mean age, 63.5 years) have been treated with implant overdentures from 2007 to 2014. Ten patients received a bar-clip attachment. Eleven patients had received a milled bar with Locator attachment. Seventeen patients had received a Locator attachment. The mean follow-up period was 36.9 months (range, 15-83 months). The type and frequency of prosthetic complications was recorded. The frequency was analyzed to determine the statistical difference among the 3 different attachments by using one-way ANOVA (${\alpha}=.05$) and Bonferroni post hoc method at a 5% level of significance. Results. The total number of prosthetic complications was higher in the bar-clip attachment (55 events) than in the milled bar with Locator attachment (39 events) and the Locator attachment (34 events). There were no statistically significant differences, and the most common prosthetic complication was the loss of retention. In the bar-clip attachment group, the average frequency of prosthetic complications was 3.0 events per prosthesis during the first year. In the milled bar with Locator attachment and Locator attachment groups, the average frequencies were 1.45 events and 2.35 events, respectively. Statistically significant differences were observed in the frequency of the complication. (p = .043) Conclusions. Compared to the bar-clip attachment, implant overdentures that use milled bars with the Locator attachment have a significantly lower incidence of prosthetic complications in the first year of follow-up after placement.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.247-253
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• 2001

Objective : In general, to perform posterior lumbar interbody fusion(PLIF), it has been used more invasive procedure than simple discectomy. However we try to perform PLIF with TFC with smaller invasion almost same as in simple discectomy. This study is about its procedure and clinical results. Materials and Methods : The authors retrospectively analyzed 43 cases of minimally invasive PLIF with TFC from July 1998 to May 2000. Operative procedure, operative complication, change of disc height, blood loss, ambulation time, hospitalization period, clinical success rate, and bony fusion rate were analyzed. Results : 40 patients were capable to walk on the 2nd day of the post-operation. The average hospitalization period is 5.6 days. The average blood loss was 0.19L/level with no transfusion or wound drainage. The height of disc changed from 8.84mm to 13.54mm. Clinical success rate is 95% when evaluated by the Prolo's scale. The complication was delayed wound infection(2) and transient paresthesis(1). The bony fusion was shown in 17 patients (94.4%) out of 18 patients who passed one year. Conclusion : As a result of minimally invasive PLIF, pain was decreased and early ambulation and short hospitalization was possible. Complication was similar or lower than other studies, and the bony fusion rate and clinical success rate were also similar during follow-up.