• Title/Summary/Keyword: Kwan Soo Lee

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A Study on the Clinical Usefulness of MMSE and BCRS for Cognitive Function Test in Patients with Non-Traumatic Subcortical Cerebrovascular Disease (비외상성 피질하 뇌혈관질환 환자에서 인지평가도구로서 정신상태소검사(MMSE)와 간이인지평가척도(BCRS)의 임상적 유용성에 대한 연구)

  • Choi, Hong;Lee, Young-Ho;Choi, Young-Hee;Ko, Dae-Kwan;Chung, Young-Cho;Park, Byoung-Kwan;Kim, Soo-Ji;Chung, Sook-Haui;Ko, Byoung-Hee;Song, Il-Byoung;Park, Kun-Woo;Lee, Dae-Hie
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.68-78
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    • 1996
  • Objective : The Mini-Mental State Examination(MMSE) and Brief Cognitive Rating Scale(BCRS) are frequently using screening tests fur evaluating the cognitive function in clinical practice and research. The authors tried to evaluate the clinical usefulness of these tests for the patients with non-traumatic subcortical cerebrovascular disease. Method : We administered the MMSE and BCRS to 85 patients and 195 normal control group. In order to compare the test results according to the lesion site, we divided patients into left sided lesion group(21 patients), right sided lesion group(31 patients) and both sided lesion group(13 patients). Their cognitive function was evaluated by the BNA and daily living functional activity was examined by the IADLs(Instrumental Activities of Daily Living Scale)and GERRI(Geriatric Evaluation by Relative's Rating Instrument). Results : The results are as follows : 1) In the BNA, the patients scored significantly lower than control group at all items(except Right-Left Orientation and Motor Impersistence), but there were no difference in the MMSE(total score and all 5 items), and only 2 items(recent memory and self-care) were significantly different between two groups in the BCRS. 2) In the comparison by lateralization, there were significant differences among three groups at 3 items(Left Tactile Form Perception, Left Finger Localization and Right Finger Localization) in the BNA. But, there were no difference in the MMSE and BCRS. 3) In the correlation between daily living functioning and the MMSE/BCRS, control group showed no relation(except item of cognitive functioning), but patient group was significantly correlated with 3 items(social functioning, instrumental activities of daily living and cognitive functioning). Conclusions : These findings suggest that MMSE and BCRS are not useful as the test for cognitive function and discrimination of lateralization in patients with non-traumatic subcortical cerebrovascular disease. However, scores of these tests may be related with the functional level(such as daily living function) of patients.

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Endocrinological Results of the Transsphenoidal Microsurgery for Cushing's Disease (쿠싱병에 대한 경접형동접근법의 내분비학적 결과)

  • Kim, Joon Soo;Kim, Chang Jin;Ha, Sang Soo;Kim, Jung Hoon;Lee, Jung Gyo;Kwun, Byung Duk;Hong, Sung Kwan;Lee, Ki Up;Lee, Bong Jae;Kim, Yong Jae;Choi, Choong Kon;Lee, Ho Gyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.611-621
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    • 2001
  • Objective : We analyzed the clinical and endocrinological results of the transsphenoidal microsurgery for ACTH secreting pituitary adenomas. Marerials and Methods : From October 1995 to August 2000, 18 patients underwent transsphenoidal microsurgery for Cushing's disease. We analyzed the surgical results of 17 patients, one patient who was previously operated from other hospital was excluded. Age of the patients were 18 to 61 years old(mean 37.7), male to female ratio was 1 : 3.3, and follow-up period was 3 to 50 months(mean 20.3). The selection of candidates for transsphenoidal exploration was based on endocrinologic criteria. Magnetic resonance imaging was the preferred radiologic test. Selective inferior petrosal sinus sampling of adrenocorticotropic hormone futher refined the diagnosis when endocrinologic and radiologic procedures were not definitive. Results : Results of the preoperative endocrinological test were : level of serum ACTH 29.4 to $225{\mu}g/dL$(mean $93.88{\mu}g/dL$) ; serum cortisol 11.9 to $47.5{\mu}g/dL$(mean $27.49{\mu}g/dL$) ; 24-hour urine free cortisol 235 to $1019{\mu}g/day$(mean $571.0{\mu}g/day$). Inferior petrosal sinus sampling for ACTH was performed in 11 patients and all were confirmed by Cushing's disease and we could predict the laterality of the tumor in 9 of 11 patients. We performed transsphenoidal selective adenomectomy in 5 patients, adenomectomy and subtotal hypophysectomy in 2 patients, adenomectomy and partial hypophysectomy in 9 patients, and in the remaining one patient, hemihypophysectomy followed by total hypophysectomy due to remission failure. Fifteen of 17 patients(88.2%) showed endocrinological remission. Glucocorticoid replacement therapy was performed in all the patients who showed remission for 1 to 24 months(mean 5.9 months), and 6 patients received steroid over 6 months. Conclusion : We conclude that the direct demonstration of a tumor in the pituitary gland by MRI is the most important and definitive diagnostic tool and the location of a mass should be confirmed with increased level of ACTH by the inferior petrosal sinus sampling. Transsphenoidal microsurgery is effective treatment modality for Cushing's disease and the immediate postoperative evaluation of the surgical resection of the tumor is very important. The patients should show hypocortisolism, decreased, subnormal serum ACTH and cortisol levels and 24-hours urine free cortisol. We performed 18 transsphenoidal microsurgery for Cushing's disease in 17 patients and 15 patients(88.2%) showed endocrinological remission.

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Effect of Supplementary Feeding Levels on Productivity and Grazing Intensity in Grazing Elk stags(Cervus canadensis) (보충사료 급여수준이 엘크 수사슴의 생산성 및 방목강도에 미치는 영향)

  • Lee, Jinwook;Lee, Sang Hoon;Lee, Sung Soo;Jeon, Dayeon;Kim, Sung Woo;Yun, Yeong Sik;Kim, Sang Woo;Park, Hyung Soo;Kim, Kwan Woo
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.39 no.2
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    • pp.61-67
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    • 2019
  • This study was conducted to investigate the effect of supplementary feeding levels on livestck and forage productivity and grazing intensity in Elk stags (Cervus canadensis). A fifteen 2-year-old Elk stags about 195 kg were randomly assigned to one of three dietary treatments (five animals per treatment). The dietary treatments consisted of a feeding concentrate of 1.0% of body weight (T1), 1.5% of body weight (T2) and 2.0% of body weight. Total dry matter intake (TDMI) was increased with increased with an increasing supplementary feeding levels. Average daily gain (ADG) were significantly increased with an increasing supplementary feeding levels (p<0.05) and reached a maximum on July and was lower in spring than autumn. The velvet antler production was no differences among treatment groups. Forage productivity of pasture and crude protein content were highest on May and decreased thereafter, however, crude fiber content was the reversed. The grazing intensity of Elk stags was increased in spring (38 to 59 head per ha) than summer and autumn (13 to 32 head per ha). The average grazing intensity of Elk stags ranged from 21 to 34 head per ha, which is affected by supplementary feeding levels. This result suggests that feeding supplementary diet at 1.5 % of body weight was needed to maintain the stable wight gain in antler growing periods and control the proper grazing intensity of Elk deer stags.

Visual Disturbance following Autologous Fat Injection into Periorbital Area (안와부 자가지방이식술 후 시력 저하에 대한 증례보고)

  • Jeon, Young Woo;Kim, Sung Soo;Ha, Sang Wook;Lee, Young Dae;Seul, Chul Hwan;Tark, Kwan Chul;Cho, Eul Jae;Yoo, Won Min
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.663-666
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    • 2007
  • Purpose: Autologous fat injection into the facial area is a frequently used technique in aesthetic plastic surgery for augmentation of the soft tissue. Fat injection is a very safe procedure because of the advantage of being autologous tissue. Minimal foreign body reaction or infections are noted after fat injection. However, there may be some complications including those as severe as blindness. There have been some case reports on visual disturbances after autologous fat injection reported in the literature. Methods: A 21-year-old female patient underwent autologous fat injection into left eyebrow area to correct depression of soft tissue. Immediately after injection of autologous fat, she complained sudden visual loss on the left eye. She had come to our emergency room and ophthalmologic evaluation showed that the patient could only recognize hand motion. There was no abnormality of the optic nerve on magnetic resonance imaging. Suspecting an ischemic optic neuritis from fat embolism of the central retinal artery, the patient was treated conservatively with occular massage, antiglaucomatic agent, anti-inflammatory drugs and antibiotics. Visual field examination showed visual defect of half the lower hemisphere. Results: While maintaining antiglaucomatic agents and non steroidal anti inflammatory drugs, fundoscopic examination showed no abnormalities on the second day of admission. Visual field examination showed an improvement on the fourth day along with decreased eyeball pain. Significant improvement of vision was noted and the patient was discharged on the fifth day of admission. The patient was followed-up 2 days afterwards with improved vision and visual field defect. Conclusion: We describe an unusual case of sudden unilateral visual disturbance following autologous fat injection into periorbital area.

Anticoagulant Therapy for Left Ventricular Thrombosis after Dor Procedure (Dor 술식 후 좌심실 혈전증에서의 항응고제의 역할)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kang, Ho-Kyong;Moon, Hyun-Soo;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.518-522
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    • 2003
  • Left ventricular thrombosis is a frequent and potentially dangerous complication in acute myocardiac infarction, but its occurrence and adequate therapy has not been known in patients with Dor procedure for the ischemic cardiomyopathy. We report a patient, 45 year-old male, who had a new left ventricular thrombus developed after coronary arterial bypass graft, Dor procedure, and removal of the left ventricular thrombus for ischemic car-diomyopathy. Left ventricular thrombus was disappeared on the follow-up cardiac MRI following intravenous heparin injection and oral coumadin therapy. This case suggest that anticoagulation therapy may prevent patients with the severe left ventricular dysfunction and apical aneurysm and dyskinesia from developing the left ventricular thrombus, and that thrombi will resolve without clinical evidence of systemic embolism.

Correlation of bone quality in radiographic images with clinical bone quality classification (방사선사진에서의 골질과 임상적으로 평가한 골질 분류의 상관관계)

  • Kim Hyun-Woo;Huh Kyung-Hoe;Park Kwan-Soo;Kim Jeong-Hwa;Yi Won-Jin;Heo Min-Suk;Lee Sam-Sun;Choi Soon-Chul
    • Imaging Science in Dentistry
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    • v.36 no.1
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    • pp.25-32
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    • 2006
  • Purpose : To investigate the validity of digital image processing on panoramic radiographs in estimating bone quality before endosseous dental implant installation by correlating bone quality in radiographic images with clinical bone quality classification. Materials and Methods : An experienced surgeon assessed and classified bone quality for implant sites with tactile sensation at the time of implant placement. Including fractal dimension eighteen morphologic features of trabecular pattern were examined In each anatomical sites on panoramic radiographs. Finally bone quality of 67 implant sites were evaluated in 42 patients. Results : Pearson correlation analysis showed that three morphologic parameters had weak linear negative correlation with clinical bone quality classification showing correlation coefficients of -0.276, -0.280, and - 0.289, respectively (p<0.05). And other three morphologic parameters had obvious linear negative correlation with clinical bone quality classification showing correlation coefficients of -0.346, -0.488, and -0.343 respectively (p<0.05). Fractal dimension also had a linear correlation with clinical bone quality classification with correlation coefficients -0.506 significantly (p<0.05). Conclusion : This study suggests that fractal and morphometric analysis using digital panoramic radiographs can be used to evaluate bone quality for implant recipient sites.

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A Study on Ecological Niche of Pinus densiflora Forests according to the Environmental Factors (환경인자에 따른 소나무림의 생태적 지위에 관한 연구)

  • Seo, Dong-Jin;Oh, Chang-Young;Woo, Kwan-Soo;Lee, Jae-Cheon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.15 no.3
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    • pp.153-160
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    • 2013
  • This study was conducted to investigate the effect of ecological factors affecting Pinus densiflora forest distribution associated with climate change in the future. Ecological niche is used as a method to quantify the position occupied in biological communities, space, influence and all ecological factors. Ecological niche breadth was analyzed on meteorological and growth factors of P. densiflora. Nine sites (i.e., Gangneung, Jeongseon, Pyeongchang, Hamyang, Bonghwa, Yeongyang, Uljin, Uiseong and Boseong) were selected to set $20m{\times}20m$ quadrat from September to October 2010. The height, DBH, clearlength, crown width and basal area were measured at each quadrat and used as growth factors. In addition, the measured values from the closest weather stations of each survey area of the maximum, mean and minimum temperature, humidity and precipitation were used as meteorological factors. The ecological niche breadth of the five meteorological factors except humidity was low. It is considered that precipitation could effect on the distribution of P. densiflora forest. In particular, maximum temperature showed low ecological niche breadth less than 0.4 in most of the survey areas. However, the ecological niche breadth of the five growth factors was high in all survey areas.

A Case of Cerebral Metastasis from Malignant Fibrous Histiocytoma (뇌로 전이한 악성 섬유성 조직구종 1례)

  • Kang, Kwan-Soo;Lee, Jung-Il;Suh, Yeon Lim
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1340-1344
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    • 2001
  • This is a rare case of cerebral metastasis from malignant fibrous histiocytoma(MFH) of the soft tissue. A 62-year-old man underwent craniotomy for resection of multiple intracerebral masses under the impression of metastatic brain tumor with unknown primary site. Preoperative investigation failed to detect any extracranial lesion. At six months after the operation and whole brain radiotherapy, right shoulder mass was detected to grow and excised. Specimen from the brain and shoulder lesions revealed identical pathological findings of malignant fibrous histiocytoma except existence of glial fibrillary acidic protein(GFAP)-positive cells only in brain lesions. Palliative radiotherapy was performed for subsequently developing metastatic lesions in skeletal system. At twelve months after initial diagnosis recurrent lesion at right shoulder was detected and chemotherapy is given. This case is unique because metastatic brain lesion from MFH is rare and also cerebral metastasis as an initial manifestaion of MFH has not been reported before. Another important finding is that there was expression of GFAP only in brain lesions but not in extracranial primary site lesion. Although the presence of GFAP-positive cells is thought as one of characteristic histological findings of primary intracrainal MFH, our observation supports the hypothesis that GFAP-positive cells in primary intracranial MFH may be nonneoplastic astrocytes secondarily involved by MFH.

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Clinical Evaluation of Surgical Treatments for Ten Cases of Tuberculous Spondylitis (결핵성 척추염 10례의 수술적 치료에 관한 임상적 고찰)

  • Whee, Sung Mock;Eoh, Whan;Nam, Do Hyun;Lee, Jung Il;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Park, Kwan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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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.

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Radiological Findings and Treatment Period of Acute Low Back Pain Patients Diagnosed as Having Lumbar Sprain and Strain - with Focus on X-ray and CT Findings - (요천추부 염좌로 진단된 급성 요통 환자의 방사선학적 소견과 치료기간에 대한 임상적 고찰 - X-ray와 CT 소견 분석 -)

  • Koh, Pil-Seong;Yi, Won-Il;Joh, Byung-Jin;Kwon, Sin-Ae;Lee, Jung-Woo;Kim, Min-Jung;Seo, Byung-Kwan;Woo, Hyun-Soo;Baek, Yong-Hyun;Kim, Jae-Kyu;Park, Dong-Suk
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.19-28
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    • 2010
  • Objectives : To demonstrate the need for differential diagnosis between discogenic pain and lumbar sprain and strain in acute low-back pain patients. Methods : Outpatients who made their first visits during May 1, 2009 to Oct. 30, 2009(n=53) were examined by history taking, physical examination, X-rays, and CT imaging. Disorders found on lumbosacral spine X-ray cuts and those on lumbosacral spine CT images were separately recorded. The relationship between treatment period, disc space narrowing and disc degeneration on X-rays, and HIVD on CT images was examined. Results : 1. Correlation between disc space narrowing on X-rays and HIVD found on CT images was analyzed. 21(72.41%) out of 29 patients having disc space narrowing on X-rays and HIVD on CT at the same level required treatment for over 8 weeks. 2. 2(50%) out of 4 Lawrence classification grade I patients, 8(66.67%) out of 12 grade II patients, and 14(70%) out of 20 grade III patients needed treatment for over 8 weeks. Conclusions : Disc space narrowing on X-ray and HIVD on CT at the same level, or disc space narrowing and disc degeneration on X-ray image alone indicate a tendency for treatment periods over 8 weeks, which is longer than the conventional treatment period for lumbar strain and sprain.