• The Journal of Internal Korean Medicine
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• v.15 no.1
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• pp.22-44
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• 1994

Clinical observations were done on 67 cases with Diabetes Mellitus in CVA patients who were confirmed by CT scan and observed for over 1 week, admitted to the Dept. of Internal Medicine in Oriental Medical Hospital of Dongguk University from January 1992 to December 1993. The results were as follows; 1. 86 patients (15.3%) with Diabetes Mellitus were found in 561 CVA patients, the 6th decade of age was 40.2%, the ratio of male to female was 0.72:1. 2. The local distribution of CVA was similar to common CVA, and occlusive CVD was 83.6%, cerebral hemorrhage was 16.4% in this study. 3. The association between blood glucose and years were not significant. The largest ratio of fasting blood glucose were 140-199 mg/dl (44.6%) in admission, below 139 mg/dl (51.8%) in discharge in case of occlusive CVD. In cerebral hemorrhage, that were 140-199 mg/dl(45.5%) in dmission, below 139 mg/dl (45.5%) in discharge. The largest ratio of pp2hrs blood glucose were 200-299mg/dl in admission and discharge both occlusive CVD and cerebral hemorrhage. 4. The total sensitivity of urine glucose was 71.6%, and sensitivity of urine glucose in cerebral hemorrhage (81.8%) was more higher than that of occlusive CVD (69.6%). 5. Below 4 years had the highest prevalence(44.8%) in duration of diabetes mellitus. Patients usually used oral hypoglycemic agents(41.8%), insulin injection(23.9%) treatment and non-therapeutic was 17.9% in this study. 6. Predisposing factors and symptoms in admissin were similar to common CVA. The conscious disturbance on attacck was 41.1% in occlusive CVD, and that was 63.7% in cerebral hemorrhage. 7. The most common ratio of the season's attack was spring (44.8%), 8. The frequency of post history was as follows, hypertension (44.8%), heart disease (10.4%), and they were in below 199 mg/dl (83.3%) of fasting blood glucose. 9. The family history of CVA was 46.3%, and they was higher than nondiabetic patients. 10. The recurrence rate of CVA was 28.4%, and that of occlusive CVD(28.6%) was higer than cerebral hemorrhage's (18.2%). 11. The smoker was 52.2%, the drinker was 38.9%. 12. The complications was occured in 10 cases (14.9%) after admission, and they frequently occured than common CVA. 13. In admission, the ratio of systolic blood pressure in over l60mmHg was 42.9%, that of diastolic blood pressure in over l00mmHg was 12.5% in occlusive CVD. In cerebral hemorrhage, the ratio of systolic blood pressure in over l60mmHg was 54.5%, that of diastolic blood pressure in over l00mmHg was 27.3%. 14. The average beginned time of physical theraphy was, generally lated, 8.3 days in occlusive CVD, 11.2 days in cerebral hemorrhage. Average admitted period was longer than common CVA, and was 29.2 days in occlusive CVD, 11.2 days in cerebral hemorrhage. 15. The degree of recovery were 82.1% in occlusive CVD, 72.7% in cerebral hemorrhage. 16. The herb medications were various Sunghyanggeonggisans, Sopungtang, Ganghwalyupungtang, Yanggyuksan etc. were used most frequently, and Yukmijihwangtang, Gamidaebotang, Mangeumtang etc. were used as discharge.

• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.65-74
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• 1999

Background : Open lung biopsy(OLB) has conventionally been regarded as the gold standard for the diagnosis in interstitial lung disease. With recent advances in diagnostic technique such as high resolution computed tomography(HRCT), and transbronchial lung biopsy(TBLB) which provide relatively accurate diagnosis of ILD, it is necessary to reevaluate the role of these methods in the diagnosis of ILD. Methods: We carried out a retrospective analysis of nineteen patients who underwent OLB at Dankook University Hospital for the diagnosis of acute and chronic ILD, between May 1995 and June 1998. By reviewing the medical records, the demographic findings, underlying conditions, HRCT and TBLB findings, OLB diagnosis, therapy after OLB, and complication of OLB were evaluated. Results: Thirteen patients(68.4%) had chronic ILD(symptom duration over 2 weeks prior to OLB), and six patients(31.6%) had acute ILD(symptom duration less than 2 weeks). Specific diagnosis were reached in 92%(12/13) of chronic ILD(5 bronchiolitis obliterans organizing pneumonia(BOOP), 2 constrictive bronchiolitis, 3 usual interstitial pneumonia, 1 hypersensitivity pneumonitis, 1 eosinophilic pneumonia), and in all patients of acute ILD(5 acute interstitial pneumonia, 1 pneumocystis carinii pneumonia). HRCT were performed in all patients and a correct first choice diagnosis rate of HRCT was 42%(5/12) in chronic ILD. In chronic ILD patients, 62%(8/13) received specific therapy(steroid therapy in 7 patients and moving in one patient), after OLB, but in acute ILD, all patients received specific therapy(steroid therapy in 5 patients and steroid and antibiotic therapy in one patient) after OLB. The in-hospital mortality after OLB was 5.3%(1/19). Conclusion: OLB is an excellent diagnostic technique with relatively low complications in patients with ILD. Therefore OLB should be considered in patients with ILD when the specific diagnosis is important for the treatment, especially in patients with acute ILD.

• Tuberculosis and Respiratory Diseases
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• v.55 no.6
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• pp.560-569
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• 2003

Background : A large number of pollutants such as sulfur dioxide, nitric oxide, carbon monoxide, particulate matter, and ozone influence on the body. These pollutants put a burden on the lung and the sequelae resulting from the oxidative stress are thought to contribute to the development of fibrotic lung disease, emphysema, chronic bronchitis and lung cancer. Also, carbon monoxide generated from the incomplete combustion of carbon-containing compounds is an important component of air pollution caused by traffic exhaust fumes and has the toxic effect of tissue hypoxia and produce various systemic and neurologic complications. The objective of this study is to compare the difference of pulmonary function and serum carboxyhemoglobin(CO-Hb) level between the traffic policemen and clerk policemen. Method : Three hundred and twenty-nine of traffic policemen, and one hundred and thirty clerk policemen were included between 2001 May and 2002 August. The policemen who took part in this study were asked to fill out a questionnaire which included questions on age, smoking, drinking, years of working, work-related symptoms and past medical history. The serum CO-Hb level was measured by using carboxyoximeter. Pulmonary function test was done by using automated spirometer. Additional tests, such as elecrocardiogram, urinalysis, chest radiography, blood chemistry, and CBC, were also done. Results : $FEV_1(%)$ was $97.1{\pm}0.85%$, and $105.7{\pm}1.21%$(p<0.05). FVC(%) was $94.6{\pm}0.67%$, and $102.1{\pm}1.09%$, respectively(p<0.05). Serum CO-Hb level was $2.4{\pm}0.06%$, and $1.8{\pm}0.08%$(p<0.05). After correction of confounding factors (age, smoking), significant variables were FVC(%), $FEV_1(%)$ and serum CO-Hb level(%)(p<0.05). Conclusion : Long exposure to air pollution may influence the pulmonary function and serum CO-Hb level. But, further prospective cohort study will be needed to elucidate detailed influences of specific pollutants on pulmonary function and serum carboxyhemoglobin level.

• Tuberculosis and Respiratory Diseases
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• v.59 no.4
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• pp.380-388
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• 2005

Background : Acute drug intoxication has recently become an important issue in the social and clinical areas. There are various complications associated with acute drug intoxication such as pneumonia, but the process is was not fully understood. The aim of this study was to analyze our cases of pneumonia associated with acute drug intoxication and to determine the associated risk factors. Methods : Forty four cases out of 237 patients, who were acute drug intoxicated from May 2000 to Feb. 2005, were diagnosed with pneumonia at the Konyang University hospital. These cases were analyzed by a retrospective review of their medical records. Results : The incidence of pneumonia in acute drug intoxication was 18.6%. There was no gender difference in terms of the incidence, but the age group with the highest incidence was in the $5^{th}$ decade (22.5%) followed by the $7^{th}$ decade (17.9%). Most common drug of associated with pneumonia was organophosphate insecticides, and the others were herbicides. Suicidal attempts were the most common motive of intoxication. The incidence of pneumonia was increased in old age (${\beta}=0.128$, p<0.05). A drowsy or comatous mental status was an independent risk factors of pneumonia (${\beta}=-0.209$, p=0.006). A longer hospital duration was also a risk factor for pneumonia (${\beta}=0.361$, p<0.001). The intubated state, intensive care unit care and longer duration of admission correlated with the course of pneumonia in acute drug intoxicated patients (p<0.05). The culture study revealed MRSA to be most common pathogen. Conclusion : The incidence of pneumonia associated with acute drug intoxication was higher in the older aged patients, those with a decreased initial mental status and a longer hospital duration. The number of days in the intensive care unit and intubation were associated prognostic factors for pneumonia in acute drug intoxication patients.

• Journal of Genetic Medicine
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• v.8 no.1
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• pp.71-75
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• 2011

A male infant was diagnosed with obstetric brachial plexus injury, congenital muscular torticollis and cleft palate 17 days after birth. His mother presented with gestational diabetes and premature rupture of membranes. Although it is possible that these three disorders arose independently, it is very likely that all three have the same etiologic cause, and we propose that a possible mechanism for this concurrence is related to maternal gestational diabetes. Maternal hyperglycemia mostly affects fetal structures deriving from the neural crest, including the palatine bone, and may have caused the cleft palate observed in this case. Gestational diabetes is also associated with increased frequency of large for gestational age infants and, by extension, with increased risk of birth injuries such as obstetric brachial plexus injury or congenital muscular torticollis associated with large for gestational age infants. Since the children of mothers with gestational diabetes are at increased risk for congenital defects such as cleft palate as well as being large for gestational age, precautions indicated for each respective disorder must be taken during prenatal testing and during birth. However, further studies of more cases are required to evaluate whether the concurrence of obstetric brachial plexus injury, congenital muscular torticollis and cleft palate in this case are complications specifically associated with gestational diabetes or just a simple coincidence.

• Clinical and Experimental Pediatrics
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• v.45 no.5
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• pp.646-653
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• 2002

Purpose : The incidence of type 2 diabetes mellitus in children has been increasing worldwide recently, which is thought to be related to the increasing prevalence of obesity. We investigated to evaluate the incidence and the characteristics of type 2 diabetes mellitus in children and also analysed the relationship between intrauterine growth retardation and type 2 diabetes mellitus. Methods : We investigated 25 children diagnosed as type 2 diabetes mellitus between March 1990 and December 2000. The analysis was performed retrospectively with medical records based on the clinical characteristics and laborotory findings. Results : Incidence of type 1 and type 2 diabetes mellitus in children has been increasing since 1990. We demonstrated an increase in the percentage of type 2 diabetes mellitus children from 5.3% in 1990 to 21.0% in 2000. Sixty eight percent of patients(17/25) were classified as obese group. Initial symptoms at first visit were polyuria, polydipsia and polyphagia 48%(12/25), asymptomatic glycosuria 40% (10/25), weight loss 8%(2/25) and obesity 4%(1/25). The mean age at diagnosis was $12.9{\pm}1.8$ years. 64%(16/25) of patients had positive family history of type 2 diabetes mellitus. Autoanti-bodies were positive in 18.1%(4/22) of patients. Twenty eight percent (7/25) of patients had an associated disease and two patients had fatty liver in association with obesity. Treatment consisted of diet, exercise, education and oral hypoglycemic agents. Three patients were treated with insulin as well as oral hypoglycemic agents because of poor blood glucose control. Long-term diabetic complications occurred in 4 patients. Intrauterine growth retardtion was found in 34.6%(9/25); 88.9% (8/9) of these patients were non-obese group. Conclusion : The increase in the incidence of type 2 diabetes mellitus in children is thought to be related to the increasing prevalence of obesity. The non-obese group of patients might be associated with intrauterine growth retardation.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.740-745
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• 2007

Purpose : There is a dominant opinion that in vitro fertilization (IVF) leads to an increased incidence of twins, low birth weight (LBW) infants, prematurity and mortality. On the other hand, technical development of IVF and improvement of neonatal intensive care have increased the survival rate of neonates. The purpose of this study was to verify the tendency by comparing the clinical aspects of IVF and spontaneously conceived twins, and to establish methods to increase the survival rate of neonates after IVF. Methods : Retrospective reviews were performed on all twin infants who were admitted to the nursery and NICU at Kangnam Sacred Heart Hospital, Hallym University from January 1, 2000 to December 31, 2006. Medical records of IVF twins (study group, n=92) and spontaneously conceived twins (control group, n=265) were analyzed and compared. Neonatal outcomes and complications, as well as obstetric outcomes, were analyzed and compared. Results : Mean gestational age and birth weight of the study group ($34.6{\pm}3.5$ weeks, $2,203.9{\pm}617.2g$) were considerably lower than those of the control group ($36.3{\pm}2.4$ weeks, $2,367.0{\pm}517.9g$). The frequency of prematurity less than 37 weeks (68.5% vs 51.3%) and extremely LBW (15.2% vs 6.4%) were also significantly higher in the study group. Other neonatal outcomes were all insignificant. The obstetric characteristics, maternal age ($32.6{\pm}3.3$ years vs $30.3{\pm}3.9$ years) and the frequency of cesarean delivery(95.7% vs 79.9%) were significantly higher in the study group. Other obstetric outcomes were insignificant except for the frequency of incompetent internal os of cervix (36.2% vs 3.6%) and cerclage operation (38.3% vs 4.3%). Conclusion : Based on the above results, clinical outcomes of twin infants will be further improved by careful attention and thorough antenatal care of the IVF twins.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.44 no.3
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• pp.1-8
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• 2007

PDiabetic neuropathy is one of the most common diabetes related complications including diabetic nephropathy and retinopahty. In clinical practices, nerve conduction velocity (NCV) has been used as a standard method for diagnosing diabetic neuropathy. However, it applies maximum current of 100mA to nerves causing stress and pain to patients. In this study, as a non-invasive method, $TcpO_2$ was utilized to investigate the difference and relationship between $TcpO_2$ and $SpO_2$ of normal and diabetic neuropathy subjects. In addition, a new method of diagnosing diabetic neuropathy using $TcpO_2$ is suggested. 50 normal subjects and 50 diabetic patients with neuropathy diagnosed by NCV participated in this study. Parameters used in this study were $TcpO_2$, $TcpCO_2$, and $SpO_2$. As a result of the $TcpO_2$ measurements, statistical significances were found from $TcpO_2$ of hands and feet from normal and patients group(p<0.01). $SpO_2$ measured from index finger of normal and patient groups showed no statistical significance(p>0.05). On the other hand, $SpO_2$ measured from great toes of normal and patient groups showed statistical significance(p<0.01). Correlation coefficient between $SpO_2$ of finger and $TcpO_2$ of hand was 0.400 (p<0.01) and $SpO_2$ of toe and $TcpO_2$ of foot was 0.471(p<0.01). Both correlation values were statistically significant. Sensitivities and specificities of the $TcpO_2$ method were found to be 66 % and 92 %, respectively. If the suggested $TcpO_2$ method is used periodically, prevention and early diagnosis of diabetic neuropathy would be possible.

• Tuberculosis and Respiratory Diseases
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• v.40 no.4
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• pp.390-394
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• 1993

Background: Bronchiectasis is characterized by chronic sputum production and complications such as hemoptysis and repeated infections. Even though some patients are cured by surgical resection of bronchiectatic lesions, most bronchiectasis patients can not be treated surgically because of multiple site involvement, and they are treated by medical measures such as postura1 drainage and antibiotics when indicated. Recently there have been some reports that low-dose longterm erythromycin treatment is effective on bronchiectsis, and it is well known that low-dose longterm erythromycin treatment is the treatment of choice in diffuse panbronchiolitis which is characterized by chronic sputum production and dyspnea. To evaluate the efficacy of erythromycin, we tried erythromycin on twenty five stable bronchiectasis patients for more than six months. Methods: We tried erythromycin 250 mg b.i.d. for more than 6 months. We checked respiratory symptoms, chest PA, spirometry, and side effects before treatment and after 3 and 6 months of treatment. Results: 1) 32% of the patients showed marked improvement of symptoms and PFT. 32% showed slight improvement of symptoms with little change of PFT, and 36% showed no change of symptoms and signs. 2) Analysis of the patients showing marked improvement revealed that most of them had diffuse bronchiectasis and paranasal sinus involvement. Conclusion: These results suggest that low-dose longterm erythromycin treatment can be tried on diffuse bronchiectasis patients with sinus involvement. And further studies will be followed on the mechanism of erythromycin in bronchiectasis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.1
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• pp.54-59
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• 1999

This study was based on a series of 164 patients with zygomatic bone fracture treated at Department of Oral and Maxillofacial Surgery of Chonnam University Hospital from January 1992 to December 1996. The male-to-female ratio was 7:1. Their ages ranged from 8 to 78 years, with a median age of 35.6 years. The age frequency was highest in the second decade (30.5%), and third decade (23.8%), fifth decade (16.5%) in orders. The monthly distrbution of incidence showed October to be the month in which the greatest percentage occured (14.0%). The major cause of zygomatic bone fracture was alleged traffic accidents (53.7%). The incidence of concomitant facial bone fractures was 69,5%, and maxilla fracture (52.4%) was most frequently combined. The admission route was through emergency room (72.3%) and through outpatient department (26.8%). The incidence of associated injuries was 37.2%. The intraoral approach was the major method of treatment in zygomatic bone fracture (57.1%). The most frequent type of zygoma fracture was class IV (33.5%), and class III (25.6%) was next in order of frequency. Complications were enophthalmos (7.3%), facial asymmetry (6.7%), paresthesia (6.1%), and diplopia (2.4%) These results suggest that correct diagnosis and treatment of severity of fracture, concomitant fracture, and associated injuries are necessary, and co-operative treatment with medical department should be performed to reduce postoperative complication.