• Journal of Chest Surgery
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• 제14권3호
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• pp.247-253
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• 1981

A total and consecutive 46 patients have undergone cardiac valvular surgery including 8 open mitral commissurotomy and 38 mitral, aortic, mitral-aortic, mitral-tricuspid, tricuspid valve replacements using 46 artificial valves in a period between September 1976 and July 1981. They were 19 males and 27 females with the age ranging from 16 to 50 (mean 32.6) years. Out of 46 valves replaced, 6 were prosthetic valves and 40 were tissue valves, and 33 were replaced in mitral, 9 in aortic and 3 In tricuspid position. Isolated replacements were 33 mitral valves, 6 aortic valves and 1 tricuspid valve; double valve replacements were 6 mitral-aortic valves and 2 mitral-tricuspid valves. . Early mortality within 30 days after operation was noted in 4 cases; 3 after MVR and 1 after open mitral commissurotomy. Causes of death were thrombus obstruction of Beall-Surgitool, Cerebral air embolism, acute renal shut down due to low output syndrome, and left upper pUlmonary vein rupture after open mitral commissurotomy (early mortality 8.7%). 3 late deaths were noted during the follow-up period from 2 to 59 months; 1 due to cerebral hemorrhage from warfarin overdose 3 months, 1 due to miliary tuberculosis 9 months, and another 1 due to cardiac failure after open mitral commissurotomy 42 months postoperatively. Total survival rate 59 months after valvular surgery was 84.8%; there were no early and late death in the group of AVR, TVR and double valve replacements. Preoperative NYHA Class III & IV were 35 cases (76%) out of total 46 cases, and 38 cases (94.8%) out of 39 survival cases were included In NYHA Class I & II during the follow-up period.

• Neonatal Medicine
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• 제18권2호
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• pp.409-411
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• 2011

In Korea, pulmonary surfactant (PS) replacement therapy in respiratory distress syndrome (RDS) was started in 1991 since when Surfacten$^{(R)}$ was imported from Japan. At the present time, Surfacten$^{(R)}$, Newfactan$^{(R)}$, Curosurf$^{(R)}$, and Infasurf$^{(R)}$ are available in Korea. The governmental health insurance covers the expense for multiple dose treatment since 2002 and the early prophylactic treatment (BW: <1,250 g or GP: <30 wks) since 2011. We undertook a multi-institutional collective study to evaluate the outcomes of PS over past 20 years in Korea (Period-I; 1990/91, P-II; 1996, P-III; 2002, and P-IV; 2007, P-V; 2010). There were 60 RDS neonates with PS treatment in P-I (16 hospitals), 1,179 in P-II (64), 1,595 in P-III (62), 1,921 in P-IV (57), and 3,160 in P-V (72). Decreased mortality rate, defined as the percentage of neonates who died within 28 days of birth, was seen between periods, P-V vs P-I, II, III, and IV (mortality rate: 10.1% vs. 40.0%, 30.0%, 18.7%, and 14.3%). We conclude that PS therapy contributed to improve remarkable outcome in RDS neonates over the last 20 years in Korea. However, more efforts should be made to optimize PS therapy for better outcome. Multiple PS doses for relapse and poor response, early prophylactic use, and better supportive care for pre-term infants are mandatory.

• 한국어병학회지
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• 제28권1호
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• pp.1-7
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• 2015

In 2009 outbreaks of an emerging disease in shrimp farms were first reported in China. The disease was known as early mortality syndrome (EMS), or acute hepatopancreatic necrosis disease (AHPND). Since 2009, the disease has been spread to Vietnam, Malaysia, Thailand and Mexico. The causative agent of the disease was identified as Vibrio parahaemolyticus. It is a common seawater inhabitant bacterium, and the pathogen can sometimes contaminate seafood. The disease has caused mass mortality of cultivated shrimp, and huge economic losses in the countries named above. In order to prevent the introduction and establishment of AHPND, emergency measures, such as strengthening of import conditions and even import bans, were put in place by many other countries. In Korea, on the other hand, there are large quantities of shrimp imports from countries, such as Thailand and Vietnam. Transportation of live and fresh dead shrimp is highly likely, and could be a transmission pathway if the shrimp are sourced from populations in AHPND endemic areas. It is important to recognize that importing countries may provisionally adopt sanitary or phytosanitary measures on the basis of available pertinent information, including that from the relevant international organizations, as well as from sanitary or phytosanitary measures applied by other countries based on "Agreement on Application of Sanitary and Phytosanitary Measures". It is pertinent that Korea also takes proper emergent measures to keep out diseases and provide safe seafood.

• 수면정신생리
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• 제29권1호
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• pp.4-8
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• 2022

Obesity hypoventilation syndrome (OHS) is defined as the triad of obesity (body mass index, [BMI] ≥ 30 kg/m²), daytime hypercapnia (PaCO2 ≥ 45 mm Hg), and sleep breathing disorder, after excluding other causes for hypoventilation. As the obese population increases worldwide, the prevalence of OHS is also on the rise. Patients with OHS have poor quality of life, high risk of frequent hospitalization and increased cardiopulmonary mortality. However, most patients with OHS remain undiagnosed and untreated. The diagnosis typically occurs during the 5th and 6th decades of life and frequently first diagnosed in emergency rooms as a result of acute-on-chronic hypercapnic respiratory failure. Due to the high mortality rate in patients with OHS who do not receive treatment or have developed respiratory failure, early recognition and effective treatment is essential for improving outcomes. Positive airway pressure (PAP) therapy including continuous PAP (CPAP) or noninvasive ventilation (NIV) is the primary management option for OHS. Changes in lifestyle, rehabilitation program, weight loss and bariatric surgery should be also considered.

• Childhood Kidney Diseases
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• 제9권1호
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• pp.108-111
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• 2005

세균성 복막염은 신증후군 환아의 생명을 위협하는 중요한 감염성 합병증으로 초기에 광범위한 항생제 병용치료가 이루어져야한다. 저자들은 신증후군 진단 후 치료가 지연된 환아에서 발생한 복막염 및 복부농양 증례를 경험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제46권6호
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• pp.426-432
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• 2013

Background: Heart transplantation has become a widely accepted surgical option for end-stage heart failure in Korea since its first success in 1992. We reviewed early postoperative complications and mortality in 239 patients who underwent heart transplantation using bicaval technique in Asan Medical Center. Methods: Between January 1999 and December 2011, a total of 247 patients aged over 17 received heart transplantation using bicaval technique in Asan Medical Center. After excluding four patients with concomitant kidney transplantation and four with heart-lung transplantation, 239 patients were enrolled in this study. We evaluated their early postoperative complications and mortality. Postoperative complications included primary graft failure, cerebrovascular accident, mediastinal bleeding, renal failure, low cardiac output syndrome requiring intra-aortic balloon pump or extracorporeal membrane oxygenation insertion, pericardial effusion, and inguinal lymphocele. Follow-up was 100% complete with a mean follow-up duration of $58.4{\pm}43.6$ months. Results: Early death occurred in three patients (1.3%). The most common complications were pericardial effusion (61.5%) followed by arrhythmia (41.8%) and mediastinal bleeding (8.4%). Among the patients complicated with pericardial effusion, only 13 (5.4%) required window operation. The incidence of other significant complications was less than 5%: stroke (1.3%), low cardiac output syndrome (2.5%), renal failure requiring renal replacement (3.8%), sternal wound infection (2.0%), and inguinal lymphocele (4.6%). Most of complications did not result in the extended length of hospital stay except mediastinal bleeding (p=0.034). Conclusion: Heart transplantation is a widely accepted option of surgical treatment for end-stage heart failure with good early outcomes and relatively low catastrophic complications.

• Advances in pediatric surgery
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• 제10권2호
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• pp.112-116
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• 2004

Midgut volvulus secondary to intestinal malrotation usually presents within the first month of life. Diagnostic delay may result in midgut infarction and mortality. In this retrospective study, we review seventeen cases of midgut volvulus to assess the importance of early recognition for midgut volvulus in pediatric patients of any age.. These patients were diagnosed as having a midgut volvulus by operation at Ewha Womans University Hospital. Eleven patients (64.7 %) were less than 1 month of age, and fifteen were boys (88.2 %). The mean gestational age was 38.3 weeks and the birth weight was 3.1 kg. Eight patients (47.1 %) had one or more combined anomalies such as heart malformation, brain ischemia, Down's syndrome or duodenal atresia. Vomiting was the most common symptom. Only thirteen patients underwent preoperative diagnostic procedures; 13 abdominal sonography demonstrated the whirlpool sign in 8 patients, upper gastrointestinal tract roentgenography showed a cork-screw pattern in 7 patients, and barium enema or small bowel series demonstrated positive findings in 7 patients. A Ladd's procedure was was formed on all patients.. There was no mortality or severe morbidity such as short bowel syndrome. Midgut volvulus should be included in the differential diagnosis in any infant or child who presents with the symptoms of acute abdomen, especially with vomiting.

• 보험의학회지
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• 제30권2호
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• pp.20-27
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• 2011

Lung diseases are common in general population and they are also important in insurance medicine. According to current textbook of insurance medicine, there are references of western research which performed at 1980s and early 2000. It's necessary to update the reference. In this article, several respiratory disorders such as Kartagener's syndrome, bronchial asthma, drug-resistant tuberculosis, etc are reviewed in terms of insurance medicine. Reference articles were used in Korean study, if possible. I hope this article being a role of helping many insurance doctors and underwriters in Korea.

• Journal of Chest Surgery
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• 제20권4호
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• pp.706-709
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• 1987

From December 1981 to June 1987, thirty one patients suffering from low output syndrome after cardiac operation received cardiac assist with intraaortic balloon pump. Fifteen patients survived [survival rate 48.4%]. After receiving assist with IABP, urine output increased, heart rate and central venous pressure decreased, reflecting improved myocardial performance. Poor preoperative hemodynamic and functional status resulted in poor survival despite of assist with IABP. Poor pre-IABP hemodynamic status also resulted in high mortality after assist with IABP. Our experience suggests that IABP should be introduced early in the course of worsening to get good result.

• 한국건강관리협회지
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• 제4권1호
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• pp.85-94
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• 2006

Background Cardiovascular disease is becoming an important national health issue since its recent increase in incidence and mortality. The study was conducted to find out the prevalence of metabolic syndrome according to the clinical identification criteria by NCEP-ATP3 and Asia-Pacific criteria. Meterials & Methods: The subjects were 759 people -male 375 and female 384 after twenties age - who had undergone medical examinations at Korea Association of Health, Daejeon- Chungnam Branch. The prevalence of metabolic syndrome was assessed as defined by the NCEP ATP3, while abdominal obesity was assessed according to the Asia-Pacific guidelines. Anthropometric variables and cardiovascular risk factors were measured, and Associated factors with metabolic syndroms was analyzed by logistic regression analysis. Results The prevalence of metabotic syndrome was 24.O% for male and 27.1% for female The high blood pressure was the highest prevalent risk factors of metabolic syndrome. In the age group of thirties, the prevalence of metabolic syndrome was higher in men than in women, however it was significantly higher in women than in men in fifties and six ties. The metabolic syndrome was more prevalent in aged people over 50 years. and .significantly associated with BMI index(odds ratio 2.58 in male, 9.87 in female)Conclusions The prevalence of metabolic syndrome is over 20%.Early detection and intervention of risk factors by health examination and promotion are needed for prevention of metabolic syndrome.