• Journal of Chest Surgery
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• 제21권3호
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• pp.479-487
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• 1988

Valve replacements in 82 children, aging up to 15 years[mean 11.67 years] were done at Seoul National University Hospital during 13 years period from 1974 to 1986. The patients were composed of 5] males and 31 females and 50 patients had acquired heart disease and 32 patients congenital heart disease. 75 patients received single valve replacements, 6 patients double valve replacements, 1 patient triple valve replacement, and among all of them, 11 patients redo-replacements. The bioprosthetic valves have been applied to 58 patients and prosthetic valve to 24 patients and the latter was the main artificial valve since 1984. Among the 69 patients who had definite post-operative records, the overall mortality was 27.5%[20.3% was early mortality and 7.2% late mortality] and the overall mortality was lowered to 4.3% since 1984. There were early post-operative complication rate of 26.1% and late complication rate 34.8%, and among the latter, the valve failure rate was 11.4% patient-year, and the thrombo-embolism rate 1.76%/patient-year. 55 patients among the survivals after post-operative 1 month, were received follow-up with various anticoagulating medication for total 2046 patient-months[mini-mum 1 month to maximum 90 month, mean 37.2*25.44 months] and actuarial survival rate was 82*8% at 5 years and valve failure free and thrombo-embolic free survival rate were 61*8% and 90*3% respectively. And among them, valve failure free survival `rate of tissue valve were 91*6% at post-operative 2 years, 78*3% at 3 years, 59*9% at 4 years, 54*10% at 5 years, 53*15% at 6 years, so markedly decreased at 3-5 years post-operatively. These results suggest that cardiac valve replacement in children have been effective therapeutic method though various problems are still remained, and the choice of valve should be prosthetic valve mainly due to its durability at the present.

• 대한한방소아과학회지
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• 제32권2호
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• pp.43-63
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• 2018

Objectives The purpose of this study is to evaluate the efficacy and safety of herbal medication for the treatment of nocturnal enuresis in children by analyzing randomized controlled trials conducted in China. Methods We searched literatures from China National Knowledge Infrastructure published up to 19 January, 2018. Selected literatures were collected and analyzed in order of publication year, and then demographic information, treatment method, duration of illness, duration of treatment, follow-up period, outcome measurement and adverse events. Results A total of 34 studies were selected for the analysis. In most studies, the total efficacy of the treatment group was reported to be higher than that of the control group, and the recurrence rate and complete cure rate were also found to be more effective in the herbal medicine treatment group. The most frequently used medical herb was Alpiniae Fructus (益智仁), and the use of medical herbs belong to tonifying yang (補陽藥), tonifying qi (補氣藥), and astringing essence strengthening collapse medicine (澁精縮尿止帶藥) were relatively high. The adverse events rate for the herbal medicine treatment group were significantly lower than those in the Western medicine treatment group. Conclusions This study showed that a herbal medicine treatment can be effective and safe option for treating pediatric nocturnal enuresis. However, additional well-designed clinical studies need to be performed to establish a basis.

• Clinics in Shoulder and Elbow
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• 제20권1호
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• pp.18-23
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• 2017

Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.417-426
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• 2001

Objectives : To analyse the psychosocial factors associated with hypertension management(drug treatment and life style modification) of newly detected cases and to understand and assess their behavioral intention or behaviors. Methods : The survey area was a combined urban and rural area in Chungnam province, Korea, and the sampling method was cluster sampling. Study subjects included 541 newly detected cases of hypertension rated above stage 2 by JNC-VI from a community survey. The first survey was applied to 383 of these patients in order to discern their psychosocial characteristics. A follow-up survey was given to 345 persons with an 11-month interval following monthly telephone counseling concerning medication and life style modification by trained nurses. The final study subjects for analysis comprised 271 persons after excluding cases of incomplete data and change of address. Results : Among the 85(33.2%) new patients who had intended to undergo drug treatment, 30(35.3%) persons were treated with antihypertensive agent after 11 - month interval, while among the patients with no intention to receive treatment, only 36(21.1%) persons were treated. Hypertensive patients with a high intention score revealed a high score in life style modification compliance as well. Seventy three percent of the variance of behavioral intention to undergo hypertension management was explained by the patients attitude toward performing the behavior and subjective norm associated with behaviors related to the theory of reasoned action in structural modeling. Actual behaviors related positively with behavioral intention. The coefficient of determination was 0.255. Conclusion : Improving the compliance level of hypertensive patients in respect to drug treatment or life style modification requires a build up of positive behavioral intention, and caregivers must pay more attention to eventually converting behavioral intention to actual behaviors.

• Journal of Korean Neurosurgical Society
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• 제41권6호
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• pp.387-390
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• 2007

Objective : To determine the presentation, incidence, and risk factors of seizures in patients treated for brain tumors. Methods : One hundred patients who consecutively underwent a craniotomy for the treatment of supratentorial brain tumors were assessed. The pathologies of the patients enrolled in the study included glioma [n=56], meningioma [n=31], metastatic brain tumor [n=7], primary central nervous system lymphoma [n=4], and central neurocytoma [n=2]. Anti-epileptic drugs [AEDs] were administered to all patients for up to six months after the surgery. Pre-defined variables for outcome analysis included tumor grade and location, extent of tumor resection, number of seizures, age at tumor diagnosis, adjuvant therapy, medication and radiological abnormalities. Results : Thirty patients [30%] presented at least a single episode of seizure at the time of admission. Five of these patients [16.7%] developed the seizure during the follow-up period. Newly developed seizure was noticed in six out of seventy patients [8.6%] without prior seizure. Histopathology was malignant gliomas in 10 and supratentorial meningioma in one. Early seizure developed only in two patients. Conclusion : Compared with patients without seizure, patients with seizure at the time of admission showed younger age [p=0.003], a higher portion of low-grade glioma [p=0.001], tumor location in the frontal and temporal lobes [p=0.003] and cortical involvement [p=0.017]. Our study suggestes that tumor progression is considered a significant risk factor for seizure development in glioma patients.

• Korean Circulation Journal
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• 제52권10호
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• pp.785-794
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• 2022

Background and Objectives: Self-monitoring of blood pressure (SMBP) is a reliable method used to assess BP accurately. However, patients do not often know how to respond to the measured BP value. We developed a mobile application-based feed-back algorithm (SMBP-App) for tailored recommendations. In this study, we aim to evaluate whether SMBP-App is superior to SMBP alone in terms of BP reduction and drug adherence improvement in patients with hypertension. Methods: Self-Monitoring of blood pressure and Feed-back using APP in Treatment of UnconTrolled Hypertension (SMART-BP) is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App compared with SMBP alone. Patients with uncomplicated essential hypertension will be randomly assigned to the SMBP-App (90 patients) and SMBP alone (90 patients) groups. In the SMBP group, the patients will perform home BP measurement and receive the standard care, whereas in the SMBP-App group, the patients will receive additional recommendations from the application in response to the obtained BP value. Follow-up visits will be scheduled at 12 and 24 weeks after randomization. The primary endpoint of the study is the mean home systolic BP. The secondary endpoints include the drug adherence, the home diastolic BP, home and office BP. Conclusions: SMART-BP is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App. If we can confirm its efficacy, SMBP-App may be scaled-up to improve the treatment of hypertension.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제6권1호
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• pp.10-16
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• 2003

목 적: 아스피린을 비롯한 NSAID의 사용이 위장관 출혈 등 여러 가지 위 장관합병증의 위험성을 증가시키는 것은 이미 잘 알려진 사실이다. 소아에서 염증성 질환이나 해열제로 사용하는 통상용량의 아스피린보다 10분의 1정도의 소용량을 사용하는 경우가 종종 있으나, 이와 연관된 위 장관 출혈의 위험성에 대한 연구는 거의 없다. 이에 저자들은 Kawasaki병으로 아스피린을 사용한 소아들을 대상으로 소용량 아스피린의 장기적 사용에 의한 위 장관 출혈의 위험성을 평가하고자 하였다. 방 법: 1995년부터 2001년 5월까지 을지병원 소아과에서 Kawasaki병으로 진단받고 입원 치료하였던 소아가운데, 임상 기록을 확인하고 보호자와 전화통화를 하여 위장관 출혈 여부를 확인할 수 있었던 소아 100명을 대상으로 하였다. 위 장관 출혈 여부는 환아의 임상 기록을 확인하고, 보호자와 직접 전화 인터뷰를 하여 소용량 아스피린 투여시 육안적 토혈, 혈변의 유무를 물어서 확인하였다. 결 과: 모두 100명의 환아가 연구 대상에 포함되었으며, 남아 63명, 여아 37명으로 이들이 아스피린 투약을 시작할 때 연령은 4~118개월이었으며, 약 75%의 환아가 3세 미만이었다. 아스피린 투약기간은 0.5~17개월로 나타났으며, 약 70%의 환아가 2~3개월 간의 투약을 시행하였다. 한 명의 환아에서 육안적 혈변이 발생하였는데, 환아는 투약 당시 18개월된 여아로 투약 1개월경 하루 한번 씩 약 1주일간 육안적 혈변을 보았으나, 복통이나 다른 증상은 동반되지 않았다. 혈변은 씨메티딘을 약 1주일간 사용한 후 호전되었으며, 이후 씨메티딘을 사용하지 않으며, 아스피린 투약을 약 3개월 가량 더 지속하였으나 더 이상의 출혈은 없었다. 100명의 환아가 총 341.5개월 동안 아스피린을 투여하였으며, 이 가운데 한 명만이 육안적 장출혈을 보여, 이를 100명의 환아가 일년동안 소용량 아스피린을 먹은 것으로 환산하면 3.5회/100명/1년의 비율로 장출혈이 발생하는 것을 의미하게 된다. 결 론: 소아에서 소용량 아스피린의 장기적 사용은 안전하나, 위 장관 출혈의 위험성을 높일 수 있으므로 해당 환아에 대한 세심한 추적관찰이 필요하며, 위 장관 출혈의 위험성을 감소시켜주기 위한 다양한 노력이 병행되어야 할 것이다.

• Journal of Korean Neurosurgical Society
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• 제30권11호
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• pp.1314-1319
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• 2001

Objects : Because of the nonspecific nature of symptoms in tuberculous spondylitis, a delay in the diagnosis can result in progressive neurologic deficits. The authors evaluate the clinical and the radiological results of the 10 cases of surgically treated tuberculous spondylitis. Clinical materials & Methods : We retrospectively analyzed the medical records of 10 patients with tuberculous spondylitis who were treated between February 1996 and March 2000. Six patients were female, and four were male. Mean age was 43 years old, and mean follow-up period was 20.5 months. All patients were treated with 12 months of antituberculous medication postoperatively, and were followed by complete blood count, ESR, spine X-ray and MRI. Results : The lumbar spine was involved in 5 patients, the thoracic in 4, and the thoracolumbar in one. The infected vertebral bodies were 2.8 in average. The associated lesions were pulmonary tuberculosis in 3 cases, and renal tuberculosis in one. Five patients were treated by anterior debridement and fusion with bone graft using anterior instrumentation, 2 with anterior debridement and fusion with bone graft(Hong Kong procedure only), 1 with Hong Kong procedure with posterior spinal instrumentation, and 2 were managed with posterior debridement and posterior spinal instrumentation. All patients improved after operation, and the average kyphotic angle decreased postoperatively. Postoperatively, one patient had a fistula at the operative site. Conclusion : The debridement and minimal level fusion of motion segment with instrument fixation is one of surgical option for tuberculous spondyltis to preserve the spine motion segment as much as possible. Spine instability and kyphosis were prevented by anterior and posterior spinal instrumentation. But, large number of cases and longer period follow-up study in future will be needed to confirm the long term results.

• Tuberculosis and Respiratory Diseases
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• 제69권1호
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• pp.43-47
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• 2010

We report a case of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule (SPN). A 35-year-old male was admitted due to a SPN in the right upper lobe which was detected on the chest radiography being examed due to recurrent cough for 1 year. The computed tomography (CT) revealed a spiculated nodule containing air-bronchogram, which was suspicious of malignancy. We performed transbronchial biopsy and the pathology showed granulomatous inflammation with caseous necrosis. Under the presumptive diagnosis of pulmonary tuberculosis, we started anti-tuberculous medication including isoniazid, rifampin, ethambutol, and pyrazinamide. In one month, however, the sputum culture was positive for Mycobacterium intracellulare. The follow-up chest CT showed slight aggravation of the previous lesions. Under the final diagnosis of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule, we changed the regimen to rifampin, ethambutol, and clarithromycin. The follow-up chest CT after the completion of treatment, revealed resolution of the previous lesions.

• Tuberculosis and Respiratory Diseases
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• 제64권4호
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• pp.298-302
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• 2008

결핵은 다양한 양상으로 나타나며 결핵성 대동맥 가성 동맥류는 아주 드문 질환으로 알려져 있고 급성호흡곤란 증후군 또한 드물지만 생명을 위협하는 결핵의 합병이다. 저자들은 결핵성 대동맥 가성동맥류와 급성호흡곤란증후군이 동시에 발현해서 항결핵화학요법과 혈관내 스텐트 삽입술로 성공적으로 치료한 환자를 경험하였다. 치명적인 결핵의 합병이 조기 진단과 빠른 항결핵제의 투여로 치료되었다고 생각된다. 따라서 결핵의 합병증을 치료하는 데 조기 진단이 중요하고 이를 위해 결핵에 대한 임상적인 의심을 높게 유지하는 것이 중요하다는 것을 보고하 참는 바이다.