• 대한물리치료과학회지
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• 제6권1호
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• pp.879-887
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• 1999

The purpose of this study was to know the state of rehabilitation treatment of stroke, to compare treatment with Bobath therapy or not, establish what factors have influence on treatment effect and hospitalization period and to be a great help for guide of treatment and education of patient and family We analyzed 87 stroke patients retrospectively for the patient's age, the subtype of diagnosis, the period at the start of treatment, the duration of treatment, the duration of hospitalization, the speech problem the co-morbid complication and the ambulatory function at discharge These patients visited the department of rehabilitation medicine, Holy Family Hospital, Catholic university of Korea from June 1993 to June 1998. The patients were classified into two groups. One group (47 patients) was treated by Bobath trerapy and the other (40 patients) was not. The results were as follow ; 1) The period at the start of treatment was 15.3 days and the duration of treatment was 32.4 days 2) The shorter the period at the start of treatment, the shorter the duration of admission 3) There was no significant difference between two groups for the duration of hospitalization, seventy two percent of patients with Bobath treatment was walked compared with 25% of patients without Bobath treatment was. 4) There was no relation between the speech problem and the duration of admission, but the group with no speech problem showed better results in ambulation than those with speech problem. On conclusion, as soon as possible early rehabilitation treatment of the stroke patients should be performed in order to reduce the duration of hospitalization. Special(or professonal) treatment with Bobath therapy show more improved funtional recovery than that without Bobath therapy. Therefore actualization of Bobath therapy is also required.

• 대한암한의학회지
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• 제14권1호
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• pp.45-52
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• 2009

Lung cancer is the most common primary tumor of brain metastasis. Metastasis to the brain is a frequent complication of non-small cell lung cancer (NSCLC) occuring in 12 ~ 18% of patient. The incidence of brain metastasis is rising because of longer survival of cancer patients as a result of the increase in early diagnosis of primary tumors and aggressive management, and improvements in imaging quality and accessibility such as widespread use of MRI. The most common symptoms are gradual onset of headache, focal weakness, and mental changes. Surgery, chemotherapy, radiotherapy and steroid therapy are treatment of NSCLC with brain metastasis. We report a patient with NSCLC metastasis to the brain. This patient underwent chemotherapy, radiotherapy and steroidtherapy. However, the patient requested oriental medical treatment for the patient's continuous headache and disease. We administered Banhabaekchulchoenma-tang gagambang with Allergen-removed Rhus Verniciflua Stokes(aRVS). The patient showed remarkable improvement in terms of frequency and severity of headache. Further study will be needed in order to determine the long-term effectiveness of oriental medical treatment on cancer patient with headache.

• Clinical and Experimental Pediatrics
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• 제58권10호
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• pp.374-379
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• 2015

Purpose: Incomplete Kawasaki disease (KD) is frequently associated with delayed diagnosis and treatment. Delayed diagnosis leads to increasing risk of coronary artery aneurysm. Anterior uveitis is an important ocular signs of KD. The purpose of this study was to assess differences in laboratory findings, including echocardiographic measurements, clinical characteristics such as fever duration and treatment responses between KD patients with and those without uveitis. Methods: We conducted a prospective study with 110 KD patients from January 2008 to June 2013. The study group (n=32, KD with uveitis) was compared with the control group (n=78, KD without uveitis). Laboratory data were obtained from each patient including complete blood count (CBC), erythrocyte sedimentation rate (ESR), platelet count, and level of alanine aminotransferase, aspartate aminotransferase, serum total protein, albumin, C-reactive protein (CRP), and N-terminal probrain natriuretic peptide (NT-pro BNP). Echocardiographic measurements and intravenous immunoglobulin responses were compared between the two groups. Results: The incidence of uveitis was 29.0%. Neutrophil counts and patient age were higher in the uveitis group than in the control group. ESR and CRP level were slightly increased in the uveitis group compared with the control group, but the difference between the two groups was not significant. No significant differences in coronary arterial complication and treatment responses were observed between the two groups. Conclusion: Uveitis is an important ocular sign in the diagnosis of incomplete KD. It is significantly associated with patient age and neutrophil count.

• 한국생활과학회지
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• 제17권1호
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• pp.159-170
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• 2008

This study was carried out for the prevalence of metabolic syndrome in obese middle school students. The subjects were 104 obese adolescents of 4 middle schools in Namwon city, Jeonbuk. Average age of the subjects was 12.2 years old, BMI of mild obesity group, moderate obesity group and severe obesity group were 24.6kg/m2, 27.5kg/m2, and 31.8 kg/m2, respectively. Prevalence of metabolic syndrome in obese students was 2.9%. And the person who has more than 2 out of 5 symptoms was 22.1%, and more than 1 was 39.4%. The prevalence of each symptoms were abdomen obesity(46.2%), hyper triglyceride(23.1%), high blood pressure(20.2%), high HDLcholesterol(2.9%), but the hyper glycemia had not been found. Nutrient intakes of 3 groups were not significantly different, energy was 1817.9kcal, carbohydrate was 265.7g, protein was 72.2g, and fat was 51.9g. Nutrient adequacy ratio(NAR) of protein, phosphorus, iron, vitamin A, vitamin B1, vitamin B1, niacin, vitamin C was proper, except calcium. Seventy point two percent of the obese students knew 'obesity is a disease', and 49.0% of the subjects didn't know the complication of the obesity. Only 27.9% of the obese adolescents took nutrition education class, but 51.9% of them thought nutrition education was necessary. We suggest that the nation enforce the policy for early detection and treatment of obesity for adolescents. Obese students and their parents should take nutrition education.

• Journal of Korean Neurosurgical Society
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• 제42권2호
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• pp.83-88
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• 2007

Objective : Pituitary apoplexy, resulting from an acute infarction or hemorrhage mainly in pituitary adenomas, is a rare yet major clinical event with neurological, ophthalmological and hormonal emergent consequences. The authors review our surgical experience with a series of 16 cases of pituitary apoplexy. Methods : The cases of pituitary apoplexy, operated via trans-sphenoidal approach in our hospital between 1998-2005, were retrospectively analyzed in terms of their clinicoradiological features, pathological findings and surgical outcomes. Results : The mean age of patients (9 male and 7 female) was 47.1 years. The average time of presentation after onset of symptom was 8.9 days. Pituitary apoplexy occurred as an initial manifestation of pituitary adenoma in all patients. Headache was the most common presenting symptom (94%). Visual disturbance was found in 56% of patients. Thirty-one percent of the patients had hypopituitarism. On magnetic resonance imaging, this entire catastrophic event accompanied with macroadenoma in a mean size of 22.5 mm. Only four patients needed postoperative hormone replacement therapy. Three of them showed preoperative hypopituitary function, and one patient in normal pituitary function. There was no specific complication in any of these patients. Conclusion : Early trans-sphenoidal decompression with high-dose corticosteroid replacement showed good outcomes of pituitary apoplexy.

• Journal of Korean Neurosurgical Society
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• 제30권12호
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• pp.1369-1374
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• 2001

Objectives : The rates of pseudarthrosis for two- and three level fusion have been reported to be 17-63 and 50% without anterior cervical plating. The purpose of this study is to assess the effects of anterior cervical plating in the treatment of multilevel degenerative cervical disease such mostly the additional risks associated with hardware implants and its benefits, fusion rate and radiographic results, and clinical outcomes. Methods : Forty-seven patients who underwent operations between 1993 and 1997 were retrospectively reviewed. The technique for operation was same for both groups(Smith Robinson with autologous iliac bone graft). Group I consisted of 35 consecutive patients treated with anterior cervical decompression and fusion with anterior cervical plate fixation. Group II consisted of 12 consecutive patients treated without plate fixation. We compared clinical outcomes by Prolo score, radiographic results in the rate of fusion, cervical lordosis by Gore angle, disc height by Farfan method, and surgical complications between two groups. Results : The favorable clinical outcomes(excellent and good) by Prolo score were observed with the use of anterior cervical plate fixation(89% vs 75%). The successful fusion rate of multilevel cervical fusion was as seen with anterior cervical plate fixation(97% vs 75%). The overall graft complication rate in multilevel fusions was decreased, with anterior cervical plate fixation, and the hardware related complications were relatively minimal without serious consequences. Conclusion : Anterior cervical plate fixation in the treatment of multilevel cervical disorders is an effective stabilizing method which provides increased bony fusion rate, decreased graft complications, maintained cervical lordosis, early mobilization of the these patients without serious hardware related complications.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.730-737
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• 2017

Objective : Postoperative hydrocephalus is a common complication following craniectomy in patients with traumatic brain injury, and affects patients' long-term outcomes. This study aimed to verify the risk factors associated with the development of hydrocephalus after craniectomy in patients with acute traumatic subdural hemorrhage (tSDH). Methods : Patients with acute traumatic SDH who had received a craniectomy between December 2005 and January 2016 were retrospectively assessed by reviewing the coexistence of other types of hemorrahges, measurable variables on computed tomography (CT) scans, and the development of hydrocephalus during the follow-up period. Results : Data from a total of 63 patients who underwent unilateral craniectomy were analyzed. Postoperative hydrocephalus was identified in 34 patients (54%) via brain CT scans. Preoperative intraventricular hemorrhage (IVH) was associated with the development of hydrocephalus. Furthermore, the thickness of SDH (p=0.006) and the extent of midline shift before craniectomy (p=0.001) were significantly larger in patients with postoperative hydrocephalus. Indeed, multivariate analyses showed that the thickness of SDH (p=0.019), the extent of midline shift (p<0.001) and the coexistence of IVH (p=0.012) were significant risk factors for the development of postoperative hydrocephalus. However, the distance from the midline to the craniectomy margin was not an associated risk factor for postoperative hydrocephalus. Conclusion : In patients with acute traumatic SDH with coexisting IVH, a large amount of SDH, and a larger midline shift, close follow-up is necessary for the early prediction of postoperative hydrocephalus. Furthermore, craniectomy margin need not be limited in acute traumatic SDH patients for the reason of postoperative hydrocephalus.

• Journal of Chest Surgery
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• 제48권6호
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• pp.381-386
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• 2015

Background: Postinfarction ventricular septal defects (pVSDs) are a serious complication of acute myocardial infarctions. The aim of this study was to analyze the clinical outcomes of the surgical treatment of pVSDs. Methods: The medical records of 23 patients who underwent operations (infarct exclusion in 21 patients and patch closure in two patients) to treat acute pVSDs from 2001 to 2011 were analyzed. Intra-aortic balloon counterpulsation was performed in 19 patients (82.6%), one of whom required extracorporeal membrane support due to cardiogenic shock. The mean follow-up duration was $26.2{\pm}18.6months$. Results: The in-hospital mortality rate was 4.3% (1/23). Residual shunts were found in seven patients and three patients required reoperation. One patient needed reoperation due to the transformation of an intracardiac hematoma into an abscess. No patients required reoperation due to recurrence of a ventricular septal defect during the follow-up period. The cumulative survival rate was 95.5% at one year, 82.0% at five years, and 65.6% at seven years. Conclusion: The use of a multiple-patch technique with sealants appears to be a reliable method of reducing early mortality and the risk of significant residual shunting in patients with pVSDs.

• Journal of Chest Surgery
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• 제49권3호
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• pp.157-164
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• 2016

Background: Heart-lung transplantation (HLT) has provided hope to patients with end-stage lung disease and irreversible heart dysfunction. We reviewed the clinical outcomes of 10 patients who underwent heart-lung transplantation at Asan Medical Center. Methods: Between July 2010 and August 2014, a total of 11 patients underwent HLT at Asan Medical Center. After excluding one patient who underwent concomitant liver transplantation, 10 patients were enrolled in our study. We reviewed the demographics of the donors and the recipients' baseline information, survival rate, cause of death, and postoperative complications. All patients underwent follow-up, with a mean duration of $26.1{\pm}16.7months$. Results: Early death occurred in two patients (20%) due to septic shock. Late death occurred in three patients (38%) due to bronchiolitis obliterans (n=2) and septic shock (n=1), although these patients survived for 22, 28, and 42 months, respectively. The actuarial survival rates at one year, two years, and three years after HLT were 80%, 67%, and 53%, respectively. Conclusion: HLT is a procedure that is rarely performed in Korea, even in medical centers with large heart and lung transplant programs. In order to achieve acceptable clinical outcomes, it is critical to carefully choose the donor and the recipient and to be certain that all aspects of the transplant procedure are planned in advance with the greatest care.

• Advances in pediatric surgery
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• 제13권1호
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• pp.52-60
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• 2007

Pediatric laparoscopic appendectomy is controversial particularly in complicated appendicitis. We evaluated the outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) in simple appendicitis and complicated appendicitis respectively. Since June 2004, initial LA has been our policy in all appendicitis including complicated ones. A total of 160 patients were included in this study, consisting of 80 OA (August 2001 - August 2003) and 80 LA (June 2004 - June 2006). We compared the operating time, the length of hospital stay, the length of antibiotics use, and the postoperative complications between LA and OA. In simple appendicitis (73), there were no differences between LA and OA. However in the 87 patients with complicated appendicitis, the operating time was longer in LA (64.8 min vs. 50.2 min) but the length of hospital stay was shorter in LA than OA (8.5 days vs. 9.6 days). There was one complication in simple appendicitis group and six in complicated appendicitis group (3 cases in LA, 3 cases in OA). There was no difference in the results of LA versus OA in simple appendicitis. Therefore for simple appendicitis, LA is recommended in consideration of the cosmetic effect (fewer scar). In complicated appendicitis, early discharge was an advantage and there were no differences in complications in LA despite a longer operative time. So we conclude LA can be considered as the first choice of treatment for all pediatric appendicitis including complicated appendicitis. To confirm our impressions, more well controlled randomized prospective studied need to be done.