• Clinical and Experimental Pediatrics
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• 제50권9호
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• pp.901-904
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• 2007

목 적 : 가역성 후두부 백질 뇌증 증후군은 두정-후두엽의 백질 혹은 회질을 침범하는 특징을 가지는 복합 증후군이다. 이번 연구에서는 이 증후군의 임상적, 방사선학적 특징을 분석하였다. 방 법 : 총 15명의 환아를 대상으로 하였으며. 각 환아에서 급성기 동안의 평균 동맥압을 측정하고 신경학적 사건이 발생하기 수일에서 수주 전 안정 상태의 평균 동맥압을 조사하여 비교하였다. 그리고 이들의 뇌자기 공명 영상을 분석 비교하였으며 모든 연구는 후향적으로 이루어졌다. 결 과 : 15명의 환아(남아 : 9명, 여아 : 6명)의 연령은 2-20세(평균 연령:10세)였다. 뇌 자기공명 영상은 두정-후두엽의 백질 및 피질에 T2-weighted image에서 신호 강도의 증가를 보였다. 대개의 경우에서 스테로이드나 싸이클로스포린 복용 혹은 급격하게 혈압이 증가하는 사건과 관련성을 보였다. 결 론 : 가역성 후두부 백질 뇌증 증후군은 복합적인 신경학적 질환으로 이 복합 증후군에 대한 더 많은 연구를 함으로써 불필요한 검사를 줄이고 즉각적이고 합당한 치료를 환아에게 행할 수 있을 것으로 생각한다.

• 대한치과마취과학회지
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• 제14권4호
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• pp.237-241
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• 2014

Acquired Immune Deficiency Syndrome is the state which develops after complications with the infection from HIV. Irrespective of their state, all HIV infections have infectivity. According to a 2013 U.N. AIDS global report, the number of reported newly infected with HIV is constantly falling, while that of Korea has been increasing over recent years and it surpassed 10,000 in 2013. This phenomenon might be attributed to the unusualness of the blood test for early detection of HIV infection. From this fact, we can assume that we have strong possibilities for encounters with infections in the office. But many misconceptions about the disease makes patients try to hide their medical history, which can lead to a nationwide spread of the infection without proper management. Even though it may be difficult to take care of HIV patients in smaller dental offices, large scale hospitals have the means to arrange protocols to treat them. We present a case about dental treatment of a patient with AIDS that has a history of cerebral infarction and hepatitis type B under general anesthesia. The purpose of this case report was to discuss the special considerations of dental care for patients with HIV.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.122-126
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• 2015

Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a monoclonal plasma cell disorder. Patients with POEMS syndrome also have various clinical manifestations including generalized edema, pleural effusion, ascites, papilledema, and sclerotic bone lesions. These manifestations can lead to a misdiagnosis or delayed diagnosis. We recently experienced a 51-year-old male patient with POEMS syndrome whose sclerotic bone lesion was misdiagnosed as malignant bone metastasis of papillary thyroid carcinoma. We reassessed the patient and found polyneuropathy, hepatosplenomegaly, hypothyroidism, partial hypopituitarism, immunoglobulin G lambda-type monoclonal gammopathy, hypertrichosis, ascites, and multiple sclerotic bone lesions, all of which led us to a diagnosis of POEMS syndrome. Treatment with thalidomide and dexamethasone resulted in clinical and radiological improvement. The patient has remained in remission after peripheral blood stem cell transplantation.

• 대한한의학원전학회지
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• 제20권4호
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• pp.187-210
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• 2007

Dunong(鈍翁), Yun-Ji had born by a concubine, and his dream didn't come true for the restraint of his social position, so he tried to train younger men. His writings still remain 4 volumes of "Dunongyeonsocheonjimundap" and "Dunongdongmongmundap(鈍翁童蒙問答)", which may be called its primer. "Dunongyeonsocheonjimundap" is written in question-and-answer form between Chal-Hye-Ja(察慧子) who has a meager knowledge and Sim-Gyeong-Ong(心耕翁) who search for the truth. It is progressed from the law of nature to human's cultivation of the mind so as to reconfirm the recognition of the unity between the heaven and human beings and lead the interpretation and practice of the metaphysical proposition. It is characterized by making use of metrical compositions to induce plain tone of argument. "Dunongdongmongmundap", whereas, uses archaic writings to describe natural science including astronomy to the beginners. Dunong's scholarship is characterized by these: He explained the metaphysical propositions by approaching usual things including oriental medicine practically; He comprised the Confucian concepts intensively to examine the Oriental studies closely; He groped for the outlooks on the world of taking serious view of human being or human body. And his medical thought is characterized by these: He attached importance to the theory of viscera and bowels based on yin-yang and five phase theory; He suggested the concrete yin-yang theory with a viewpoint of qi-blood theory; He considered the concept of 'six' only as mutual rooting of yin and yang and five visceras and six vowels, and denied the traditional six qi concepts; He explained the ghost theories of the metaphysics based on the yin-yang theory to analogize points of sameness between the oriental medicine and the metaphysics; He emphasized restore yang theory. Therefore, we can say that he regarded the human body as small heaven-earth and grafted the abstract propositions into the actuals so as to put the metaphysical propositions in practice.

• Journal of Chest Surgery
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• 제39권10호
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• pp.791-794
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• 2006

슬와동맥 포착증후군은 젊은 남성군에서 슬와동맥과 비복근, 섬유띠, 슬와근 간의 이상 관계로 하지의 파행과 혈류 장애를 유발하는 드문 질환이다. 명확한 진단이 어려우며, 대부분의 경우 수술적 치료가 병변의 결정적인 진단을 제공하며, 환자의 회복에 필수적이다. 34세 남자가 좌측 하지의 파행과 동통을 주소로 입원하였다. 상하지 지수, 혈관 초음파, 전산화 단층 혈관 조영술, 자기 공명 영상 검사상 좌측 슬와동맥 근위부의 폐쇄소견이 관찰되었다. 환자는 수술장에서 슬와동맥이 슬와근 주변의 섬유띠에 의해 둘러 싸여 폐쇄된 4형 슬와동맥 포착증후군으로 확인되었다. 완전히 폐쇄된 슬와동맥을 제거하고 동측의 대복재정맥을 이용한 치환 수술을 시행하였다. 수술 후 환자의 증상은 호전되었다.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.95-101
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• 2010

Objective : Clinical, radiographic, and outcomes assessments, focusing on complications, were performed in patients who underwent pedicle subtraction osteotomy (PSO) to assess correction effectiveness, fusion stability, procedural safety, neurological outcomes, complication rates, and overall patient outcomes. Methods : We analyzed data obtained from 13 consecutive PSO-treated patients presenting with fixed sagittal imbalances from 1999 to 2006. A single spine surgeon performed all operations. The median follow-up period was 73 months (range 41-114 months). Events during peri operative course and complications were closely monitored and carefully reviewed. Radiographs were obtained and measurements were done before surgery, immediately after surgery, and at the most recent follow-up examinations. Clinical outcomes were assessed using the Oswestry Disability Index and subjective satisfaction evaluation. Results : Following surgery, lumbar lordosis increased from $-14.1^{\circ}{\pm}20.5^{\circ}$ to $-46.3^{\circ}{\pm}12.8^{\circ}$ (p<0.0001). and the C7 plumb line improved from $115{\pm}43\;mm$ to $32{\pm}38\;mm$ (p<0.0001). There were 16 surgery-related complications in 8 patients; 3 intraoperative, 3 perioperative, and 10 late-onset postoperative. The prevalence of proximal junctional kyphosis (PJK) was 23% (3 of 13 patients). However, clinical outcomes were not adversely affected by PJK. Intraoperative blood loss averaged 2,984 mL. The C7 plumb line values and postoperative complications were closely correlated with clinical results. Conclusion : Intraoperative or postoperative complications are relatively common following PSO. Most late-onset complications in PSO patients were related to PJK and instrumentation failure. Correcting the C7 plumb line value with minimal operative complications seemed to lead to better clinical results.

• Restorative Dentistry and Endodontics
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• 제22권2호
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• pp.739-750
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• 1997

Treatment of root perforation elicits special considerations due to its blood-contaminated circumstances. It is known that conventional dental restorative materials are all leaking. Calcium sulfate is the material which react with water to become chemically set. This study, therefore, was performed to develop a new compound containing calcium sulfate and to evaluate its physical and biological characteristics. Three materials were used, IRM, calcium sulfate, calcium sulfate-hydroxyapatite compound. The composition of the calcium sulfate-hydroxyapatite compound was basically 50 % of calcium sulfate and 50 % of hydroxyapatite mixed with guajacol. The materials were mixed in conventional way and underwent four physical test procedures, setting time, solubility test, compressive strength, and marginal leakage test. All materials were evaluated under the scanning electron microscope to examine the marginal sealing ability. Animal experiment was also performed to test the materials' tissue response. Twenty-four dog's premolars were tested with either furcation perforations or apical retro-fillings. From the results, we found that calcium sulfate possess the good marginal sealing ability. However, calcium sulfate creates many voids which is caused by crystal thrusting action when it reacts with water. It seemed that the voids caused disintegration of the material which eventually lead to tissue reaction. By compounding calcium sulfate and hydroxyapatite, we were able to obtain the better physical properties but it showed larger marginal gap between the material and the root surface. Within the six weeks observation period, both IRM and calcium sulfate-hydroxyapatite compound showed good tissue responses in animal experiment. It is concluded that calcium sulfate would be the material of choice in root perforation repair, but the physical property needs to be further improved.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.531-534
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• 2011

Purpose: The rectus abdominis myocutaneous flap is currently the most commonly used donor site of immediate and delayed breast reconstruction surgery, for its versatility and ease of handling, as well as sufficient blood supply. Despite many advantages of rectus abdominis flap, morbidity of donor site is considered as inevitable shortcoming. The authors recently faced a devastating complication, small bowel obstruction that led to strangulation, after delayed breast reconstruction with free transverses rectus abdominis myocutaneous (TRAM) flap. And we would like to report it, because abdominal pain after TRAM flap is a common symptom and can be overlooked easily. Methods: A 56-year-old female patient who had history of receiving total abdominal hysterectomy 20 years ago underwent delayed breast reconstruction with TRAM flap transfer. She complained abdominal discomfort and pain from third postoperative day, postoperative small bowel obstruction that arose from strangulated bowel and prompt emergency operation was done. Results: After resection of the strangulated bowel and reanastomosis, quickly her symptoms were relieved, and there were no further problems during her hospital stay. 7 days after her emergency operation she was discharged. Conclusion: In patients with previous abdominal surgical history, prolonged ileus can lead to bowel strangulation, so surgeons should always consider the possibility, and must be aware of abdominal symptoms in patients who receive free TRAM flap operations.

• 여성건강간호학회지
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• 제27권2호
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• pp.75-92
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• 2021

Purpose: This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). Methods: The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. Results: Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. Conclusion: Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.

• 대한영상의학회지
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• 제82권3호
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• pp.541-550
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• 2021

발을 향해 가는 혈류의 중요한 길목인 무릎 밑 동맥은 다리 혈관 중 가장 가늘며, 협착 등의 병변이 발생하거나 폐쇄가 발생하게 되면 중증하지허혈을 유발할 수 있다. 중증하지허혈이란 말초동맥 질환의 가장 심한 임상 양상 중 하나로서 휴지기 동통, 족부궤양 또는 괴저의 형태로 나타난다. 일반적으로 동맥경화 질환의 진행은 미만성으로 나타나며 대다수의 환자에서 무릎 밑 동맥을 침범한다. 치료의 목표는 동맥혈류 재개통과 사지구제이다. 기술적으로 가능한 경우, 그리고 환자가 걷지 못하는 상태가 아니라면 중증하지허혈이 있는 환자는 혈관의 재개통이 즉시 이루어져야 한다. 따라서 혈관 내 치료는 무릎 밑 동맥을 포함한 모든 환자의 표준 치료가 될 것이며, 혈관재건술을 시행하는 외과의의 임상적 역할은 줄어들 것이다.