• Journal of Chest Surgery
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• v.31 no.11
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• pp.1049-1055
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• 1998

Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.148-153
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• 2005

Purpose: To analyze the clinical result of the arthroscopic reduction and fixation for the displaced tibial spine fractures in children and report the utility of the arthroscopic treatment with the review of the literature. Methods: Between December 2000 and July 2004, five patients (average age 9.1 years) received an arthroscopic reduction and fixation of displaced tibial spine fracture. A male-to-female ratio was 3:2 and mean follow-up was 38.2$(13{\sim}56)$ months. All five patients were classified type III by Movers and McKeever classification. The average period from injury to operation was 4.8 days $(3{\sim}8days)$, the avulsed fragment was reduced by operative arthroscopy and fixated by pull-out suture in 3 patients and by cannulated screw in 2 patients. Postoperatively long leg cast was applied for 2 weeks, and then gradual range-of-motion exercise was permitted. Full weight-bearing ambulation was permitted after 6 weeks. The clinical evaluation was performed by range of motion, Lachman and pivot shift test, KT-1000 arthrometer, Lysholm knee score and the modified Feagin score. Results: All five patients had no symptom and recovered full range of motion of the affected knees. Lachman test was positive finding of 1+ laxity in one patient, the others were negative, and all patients were negative findings for pivot shift test. The result of KT-1000 arthrometric assessment is mean maximum side-to-side differences 1.9 mm. Average Lysholm knee score was 99.4. All patients had excellent results in modified Feagin score. Conclusion: Arthroscopic reduction and fixation of displaced tibial spine fracture in children showed excellent result without complication. Both pull-out suture fixation and cannulated fixation provide an effective treatment option for fixation of the displaced anterior tibial spine fracture.

• Tuberculosis and Respiratory Diseases
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• v.53 no.5
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• pp.510-518
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• 2002

Background : Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. Methods : We reviewed the patients' charts retrospectiely and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. Results : Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). Conclusion : Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.35-41
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• 1999

Background: Sleeve lobectomy of the main bronchus has been proposed to spare lung tissue in patients who cannot tolerate pneumonectomy because of impaired lung function. The purpose of this study was to evaluate whether sleeve lobectomy can preserve lung function as expected from preoperative evaluation of lung function in patients with non-small cell lung cancer. Method: Between January 1995 and March 1998, 15 patients with non-small cell lung cancer who underwent sleeve resection were evaluated. Preoperative evaluations included spirometry and quantitative lung perfusion scan, from which predicted postoperative $FEV_1$ was calculated. At least 3 months after operation follow up spirometry and bronchoscopy were performed. Predicted FEVj was compared with measured postoperative $FEV_1$. Result: Fourteen men and one woman, with median age of 58 years, were reviewed. The diagnosis was squamous cell carcinoma in 13 patients and adenocarcinoma of lung in 2 patients. Our results showed a excellent preservation of pulmonary function after sleeve lobectomy. Correlation between the predicted (mean, $2180{\pm}570mL$) and measured $FEV_1$ (mean, $2293{\pm}499mL$) was good(r=0.67, P<0.05). Furthermore, patient with low $FEV_1$ (<2L) showed improved lung function after sleeve lobectomy. Conclusion: These findings indicated a complete recovery of the reimplanted lung lobes after sleeve lobectomy. Therefore, this technique could be safely used in lung cancer patients with impaired lung function.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.84-92
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• 2003

Purpose: To report two cases of bone tumors other than osteoid osteoma in the proximal femur and treated with percutaneous high frequency radioablation method. Cases: We reviewed two cases with intracortical chondroma and enchondroma in the femoral head retrospectively. The patient with intracortical chondroma was a thirty one year old woman and had suffered right hip pain of 1 year duration. The lesion was located in the head of right femur and treated with CT guided percutaneous high frequency radioablation after needle biopsy under general anesthesia. The symptom was gone immediately after the procedure and was discharged postop. 1 day. 15 months has passed without symptom recurrence. Second case having enchondroma, was 56 year old woman complaining of gluteal area pain for 3 months. Radiologic evaluation showed osteolytic lesion with sclerotic rim on the inferior portion of the left femoral head. She received a same therapy with CT guided radiofrequency ablation following needle biopsy. She reported dramatic pain relief after the procedure and was discharged postop. 1 day. No symptom has occurred for 3 months until now. Conclusion: We present 2 cases of bone tumor occurred in the hip joint area other than osteoid osteoma which were treated with CT guided radiofrequency ablation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2329-2337
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• 2013

This study was done objected to the chronic stroke patients in order to evaluate change in brain wave activity and cognitive performance when Neurofeedback training. The subjects were over 6 months ago in chronic stroke patients screened-test through the 20 patients, 10 persons in each group were randomly placed. This was carried out in 4 weeks in total, with control group(n=10) on general physical therapy and experimental group(n=10) on general physical therapy along with Neurofeedback training. The general physical therapy was applied 5 times a week, 30 minutes at once, Neurofeedback training was applied as equally as the general physical therapy, which makes 20 times in total. To learn about the effect before the training, after training, and 2 weeks after the training in electric physiological measurement method of the brain, electroencephalogram(EEG) to examine challenges by calculating the absolute spectrum power for standard EEG change(%), followed by evaluation with clinical assessment tool MMSE-K, Stroop Test, Digit Span Test. As a result of comparing the change in brain wave through EEG, after training and 2 weeks after training showed that absolute ${\alpha}$-power and absolute ${\beta}$-SMR power of experimental group have increased and absolute ${\theta}$-power decreased significantly compared to experimental group I. Moreover, the MMSE-K score in trial appraisal has increased significantly, and the error in Stroop Test and Digit Span Test has decreased significantly. such results, with the chronic stroke patient's brain wave control, Neurofeedback training was determined to improve the cognitive performance. this study suggests a new training possibility of stroke patients by identifying the training effects of Neurofeedback training that trains the brain directly with brain wave control.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.1
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• pp.48-57
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• 2010

Purpose: To compare the incidence and risk factors for osteoarthritis after anterior cruciate ligament (ACL) reconstruction between two groups using bone-patellar tendon-bone (BPTB) and hamstring tendon (HT) autograft. Materials and Methods: 53 cases of ACL reconstruction using patellar tendon and 40 cases using hamstring tendon were followed up at least 8 years. Radiographic evaluation was done according to the Kellgren and Lawrence's classification. Clinical functional testing (Lysholm Knee Scores, the Tegner activity scores) and laxity testing (Lachman, pivot shift tests), and the instrumented laxity testing with $Telos^{(R)}$ were all examined in relation to the development of osteoarthritis. Results: Radiographic osteoarthritic changes were detected in 24 patients (45.3%) in BPTB group and 14 patients (35.0%) in HT group. Accompanying meniscal injury (BPTB p<0.001; HT p=0.091), intervals from the injury to reconstruction of > 12 months (BPTB p=0.037; HT p=0.021), and patient's age at reconstruction of > 25 years (BPTB p=0.003; HT p=0.048) were found to be significant independent predictors of osteoarthritis. However, no statistically significant correlations were found between the development of osteoarthritis and the clinical outcome or the radiographic stability in both groups. Conclusion: Although ACL reconstruction using BPTB or HT autograft had good clinical results at an average follow-up of 10 years, considerable incidence of radiographic osteoarthritic changes were noted. Various factors such as accompanying meniscal injury, protracted time from injury to reconstruction, more than 25 years old at the time of reconstruction were related to radiographic osteoarthritic changes.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.653-658
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• 2006

Purpose : Because voiding cystourethrography(VCUG) is an invasive method, we studied whether VCUG could be postponed through evaluation of alternative non-invasive tests including renal ultrasonography and $^{99m}Tc$-DMSA renal scan. Methods : We reviewed the medical records of 175 patients initially diagnosed with febrile urinary tract infection during the one year period of 1999, and compared 3-tests : renal ultrasongraphy, $^{99m}Tc$-DMSA renal scan, and VCUG. Results : Renal ultrasonography didn't contribute to the prognostication of pyelonephritis(photopenic areas) or vesicoureteral reflux(VUR). Presentation of photopenic areas in $^{99m}Tc$-DMSA renal scan was related to VUR. If both findings of renal ultrasonography and $^{99m}Tc$-DMSA renal scans were normal, this condition was closely related to normal results in VCUG. And if both examinations were abnormal, the condition was closely related to VUR. But this state could not always guarantee the normal result from VCUG because of low sensitivity in finding VUR. Conclusion : In cases in which acute phyelonephritis is demonstrated by $^{99m}Tc$-DMSA renal scan, VCUG is required. In addition to this, if the conditions of hydronephrosis, vesicoureteral dilatation, increases of renal volume, and changes of echogenesity are shown by renal ultrasonography, VCUG should be performed. If a patient has difficulty undergoing VCUG, temporary postponement of VCUG can be taken into consideration, but only in cases where both examinations of renal ultrasonography and $^{99m}Tc$-DMSA renal scan are normal. Nevertheless, close observation is be advised even in this case.

• Journal of radiological science and technology
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• v.31 no.2
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• pp.161-169
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• 2008

Since measuring the size of kidney with sonography becomes an important index for diagnosis, treatment, and prognostic prediction in kidney disease, the accurate measurement and evaluation on this are clinically very important. Accordingly, the purpose of this study was to increase reproducibility and objectivity in measuring the size of kidney by enumerating factors that have an impact for measurement. It targeted 44 adults in Korea at the age of 21-27. It measured in order for both kidneys to be seen most largely while changing a subject-examiner's position in a state of fasting for 8 hours and a transducer's approaching direction. It compared a size of kidney by measuring, respectively, with the same method in 30 minutes and in 1 hour after drinking water in 700-1,000cc. In case of the lateral approach scan in decubitus position, the average length of the kidney both to the right and the left and the deviation of measurement to be the largest. In NPO(None Per Oral) state, the average length in the right kidney was 10.19cm, and the average length in the left kidney was 10.33cm. In 60 minutes after taking moisture, the average length in the right kidney was 10.94cm, and the average length in the left kidney was 11.13cm. In comparing the average length of the kidney in NPO state and its average length in 60 minutes after taking moisture, the size swelled by 7.3% for the length in the right kidney and by 7.7% in the left, thereby having been indicated to be statistically significant(P<0.003). The measurement in a size of kidney by using ultrasound may be measured differently depending on a patient's state of taking moisture and a transducer's approaching direction. It is thought that when the measurement in a size of kidney is especially important clinically, the intake and intake time in moisture need to be considered and that measuring with the posterior approach in prone position is a good method aiming to increase reproducibility in measuring length of the kidney.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.28-35
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• 2008

Purpose: The aim of this study is to report the efficacy of infliximab, a monoclonal antibody directed against tumor necrosis factor alpha which is used for both treatment of refractory pediatric Crohn disease (CD) and induction of remission. Methods: Among pediatric patients who were diagnosed with CD at Samsung Medical Center between March 2001 and August 2007, a total of 16 patients were given infliximab to treat conventional therapyresistant refractory CD and severe active CD for induction of remission. Patients needing maintenance therapy were treated with an infliximab infusion every 8 weeks, and fistulizing CD patients occasionally received the infusion upon the condition that a fistula developed. The efficacy of treatment was assessed by comparing the Pediatric Crohn Disease Activity Index (PCDAI), Hct, ESR, CRP, and serum albumin levels using paired t-test. Results: The male/female ratio was 13:3, and the median age was 13 years (range, 21 months~15 years). The patients included 7 cases of therapy-resistant refractory CD, 7 cases of severe active CD, and 2 cases of fistulizing CD. Mean PCDAI before infliximab therapy was 34.19${\pm}$14.96, and mean follow-up PCDAI within 2 to 4 weeks after the last infusion was significantly lower, at 6.88${\pm}$10.31 (p=0.000). Hematological markers such as ESR (p=0.000), serum albumin (p=0.016), and CRP (p=0.009) also improved significantly after infusion. Remission was achieved in 2 of 4 patients refractory to conventional therapy. Among 3 steroid-dependent patients, 2 were able to discontinue steroid therapy, and dose reduction was possible in 1 patient. Remission after top-down therapy without prior use of other immunomodulators was achieved in 6 weeks in all 7 of the patients who had severe CD. Nine of ten refractory fistulizing CD patients also showed improvement after infliximab therapy. Conclusion: Infliximab was effective in pediatric refractory CD for induction of remission and maintenance therapy, as well as in severe CD for top-down induction therapy. Furthermore, infliximab has contributed to steroid cessation and dose reduction. Long-term follow-up evaluation is needed to determine safety and efficacy of infliximab in the future.