• 대한한방내과학회지
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• 제22권3호
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• pp.477-482
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• 2001

Tremor refers to rhythmic shaking of a body part. Tremor is a symptom of many disorders, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy and alcohol withdrawal. Tremors may be classified as postural, rest or action tremors. Symptomatic treatment is tailored to the tremor type. Because Dansambohyul-tang has been used to treat patients differentiated with an insufficiency of the heart and the spleen(心脾兩虛) in oriental medicine, we treated a 78 year-old female patient who suffered from tremor in mouth, chin and hand and insomnia, with improvement of general condition, who was differentiated with an insufficiency of the heart and the spleen(心脾兩虛) with Dansambohyul-tang, herb complex. After 78 days of treatment with Dansambohyul-tang and some other herb complex, we observed improvement of tremor, insomnia and general condition So Dansambohyul-tang shows therapeutic effects on tremor.

• Molecular & Cellular Toxicology
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• 제2권1호
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• pp.67-73
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• 2006

In previous studies, it has been discovered that cancer cells not only overexpress regulatory subunit I (Rl)/protein kinase type I (PKA-I) but also secrete outside the cell an extracellular form of PKA (ECPKA) and that the ECPKA secretion detected in patients' serum is obviously greater than that found in non-cancer patients or healthy subjects. We now found that ECPKA elicits the formation of serum autoantibodies that can serve as a cancer diagnostic and prognostic marker. To measure the presence of anti-ECPKA autoantibody in the human sera, basic methodology for ECPKA assay was established an enzyme-linked immunosorbent assay (ELISA). We obtained serum samples from 199 patients with different types of cancer, and also obtained 31 serum samples to compare with ECPKA concentrations from non-cancer patients and 119 normal volunteers. Compared with normal or non-cancer patient sera, we found that the frequency of anti-ECPKA autoantibody was significantly higher in cancer patients (88%) than in those without cancer (17%). Furthermore the presence of anti-ECPKA autoantibodies in the serum of cancer patients was highly correlated with the site of metastasis. The immunoassay developed for anti-ECPKA antibodies is highly sensitive and specific. Therefore, this discovery of an autoantibody-based cancer diagnostic may have serious clinical application and may become an important advance over current technology.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권1호
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• pp.20-28
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• 2016

Purpose: Foreign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children. Methods: We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications. Results: Coins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (${\geq}1.5cm$, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (<1.5 cm, 1.5 V) (p=0.001). All endoscopies were conducted within 24 hours after ingestion. Conclusion: The type and voltage of the battery should be considered when determining whether endoscopy is required to remove a BB in the stomach. For lithium battery ingestion in young children, urgent endoscopic removal might be important in order to prevent complications, even if the child is asymptomatic and the battery is smaller than 2 cm.

• 대한두경부종양학회지
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• 제19권1호
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• pp.67-70
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• 2003

Out of entire salivary tumor, 1.7% are malignant lymphoma developed in salivary gland and it is usually mucosa associated lymphoid tissue (MALT) lymphoma developed in salivary gland. In the case of Non-Hodgkin lymphoma, the most frequently involved extanodal sites of diffuse large B cell lymphoma are bone, skin, thyroid, gastrointestinal tract, and lung. Development in salivary gland is very rare. A 69 years old male patient who have found Lt. submandibular gland (SMG) mass a month ago is suspected of malignancy from his FNA result, so histologic exam by SMG resection was operated. According to histopathologic exam, large B cell lymphocyte infiltratration were generally shown as diffuse and lymphoepitheliallesion were not found. In immunostaining, CD79a showed positive and CD3, CAM5.2 showed negative which diagnosed as diffuse large B cell lymphoma. As Ann Arbor stage I, CEOP-B chemotherapy was used 3 times as treatment without any recurrence. In the case of malignant lymphoma in salivary gland, it develops as painless mass in ipsilateral side. If found in parotid gland, it is rare to have facial nerve falsy and pathologically diagnosed as lymphocytes of abnormal type of monoclonal immunostaining must be provided as evidence. Combined therapy is known as most effective treatment for intermediate grade.

• 대한두경부종양학회지
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• 제21권1호
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• pp.48-52
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• 2005

Objectives: Castleman's disease(CD) is a lymphoproliferative disorder of unknown etiology. To elucidate the clinicopathologic characteristics of CD, we retrospectively reviewed our experience. Methods: Fifteen patients with CD of the neck and mediastinum were identified. Patients were divided into two groups: group I had an unicentric CD and group II had multicentric CD. The histology of CD was divided into 3 subtypes: hyaline-vascular(HV), plasma cell(PC), and mixed. Results: The study included 12 cases of group I, 3 cases of group II in the clinical aspect and 10 cases with HV, 3 cases with PC, 2 cases with mixed type in the histologic aspect. Of group I patients who underwent complete surgical excision, all are currently free of disease. The clinical course of group II patients was variable. Of two patients with multicentric plasma cell CD who were treated, one remain free from disease and the other had a local recurrence in the neck. One patient with multicentric mixed CD died of disease after 30 months of presentation. Conclusion: Surgical resection is recommend for patients with the unicentric CD, regardless of histologic subtype. Patients with multicentric disease do not benefit from surgical resection and should be candidates for multimodality therapy.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.364-367
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• 2001

A 4-month-old female patient admitted because of hydrocephalus. She was premature infant with germinal matrix hemorrhage at gestational period 27 wks. A ventriculoperitoneal shunt with a low-pressure type valve was placed. Follow-up CT scan obtained 3 months after VP shunt placement, revealed a new Lt. middle cranial fossa cyst. The girl was readmitted to hospital at 7 months after VP shunt placement, complaining of lethargy and vomiting. A CT scan was demonstrated a increase in size of a cyst, She subsequently underwent a left-sided pterional craniotomy with partial excision of membrane and cyst fenestration into the basal cisterns. Follow-up CT scan after 18 months revealed reaccumulation of cyst, the girl was reoperated on. After 2 months, the size of cyst was not decreased. Finally, She underwent a cystoperitoneal shunt. Follow-up CT scan after 5 months was demonstrated disappeared cyst and reexpansion of brain parenchyma. We report the development of a symptomatic sylvian fissure arachnoid cyst developed after ventriculoperitoneal shunt.

• Journal of Korean Neurosurgical Society
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• 제59권1호
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• pp.17-25
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• 2016

Objective : Treatment of intracranial dural arteriovenous fistulas (dAVFs) remains a challenge. However, after introduction of Onyx, transarterial approach is the preferred treatment option in many centers. We report our experience of dAVFs embolization with special emphasis on transarterial approach. Methods : Seventeen embolization procedures were performed in 13 patients with dAVFs between Jan 2009 and Oct 2014. Clinical symptoms, location and type of fistulas, embolization methods, complications, radiological and clinical outcomes were evaluated using charts and PACS images. Results : All 13 patients had symptomatic lesions. The locations of fistulas were transverse-sigmoid sinus in 6, middle fossa dura in 4, cavernous sinus in 2, and superior sagittal sinus in 1 patient. Cognard types were as follows : I in 4, IIa in 2, IIa+IIb in 5, and IV in 2. Embolization procedures were performed ${\geq}2$ times in 3 patients. Nine patients were treated with transarterial Onyx embolization alone. One of these required direct surgical puncture of middle meningeal artery. Complete obliteration of fistulas was achieved in 11/13 (85%) patients. There were no complications except for 1 case of Onyx migration in cavernous dAVF. Modified Rankin scale score at post-operative 3 months were 0 in 11, and 3 in 2 patients. Conclusion : Transarterial Onyx embolization can be a first line therapeutic option in patients with dAVFs. However, transvenous approach should be tried first in cavernous sinus dAVF because of the risk of intracranial migration of liquid embolic materials. Furthermore, combined surgical endovascular approach can be considered as a useful option in inaccessible route.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.3007-3013
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• 2016

Background: Gastrointestinal cancers are common malignancies associated with high mortality rates. Healthcare systems are always faced with high costs of treatment of gastrointestinal cancers including stomach cancer. Identification and prioritization of these costs can help determine economic burden and then improve of health planning by policy-makers. This study was performed in 2015 in Kerman City aimed at estimating the direct hospital costs for patients with gastric cancer. Materials and Methods: In this cross-sectional study, the medical records of 160 patients with stomach cancer admitted from 2011 to 2014 to Shafa Hospital were examined, the current stage of the disease and the patients' health status were identified, and the direct costs related to the type of treatment in the public and private sectors were calculated. SPSS-19 was used for statistical analysis of the data. Results: Of the patients studied, 103 (65%) were men and 57 (35%) were women. The mean age of patients was 65 years. Distribution into four stages of the disease was 5%, 20%, 30%, and 45%, respectively. Direct costs in four stages of the disease were calculated as 2191.07, 2642.93, 2877, and 2674.07 USD (63,045,879, 76,047,934, 82,783,019, and 76,943,800 IRR), respectively. The highest percentage of costs was related to surgery in Stage I and to medication in Stages II, III, and IV. According to the results of direct costs of treatment for stomach cancer in Kerman, the mean total cost of treating a patient in the public sector was estimated at 74,705,158 IRR, of which averages of 60,141,384 IRR and 14,563,774 IRR were the shares of insurance and patients, respectively. Conclusions: The high prevalence and diagnosis of disease in old age and at advanced stages of disease impose great costs on the patients and the health system. Early diagnosis through screening and selecting an appropriate treatment method might largely ameliorate the economic burden of the disease.

• 임상간호연구
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• 제25권3호
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• pp.237-250
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• 2019

Purpose: The aim of this study was to investigate the satisfaction of newly graduated nurses with educational programs and their experiences in role transition. Methods: Data were collected from November 1 to December 15, 2018 and 483 new graduate nurses working at 15 tertiary hospitals and 10 general hospitals participated. For data collection, self-report questionnaires including the Casey-Fink Graduate Nurse Experience Survey tool and satisfaction with education were used. Data were analyzed using descriptive statistics, t-test, and one-way analysis of variance. Results: Satisfaction with education ranged from 3.09 to 3.27, and satisfaction with preceptors was 3.45(maximum 4). The skill that new nurses ranked as most difficult during the first 3 months was charting/documentation, and throughout a whole year, the top 4 difficult skills were cardiopulmonary resuscitation/emergency response, ventilator care, end-of-life care, and prioritization/time management. In comfort/confidence, new graduates felt most comfortable with support and least comfortable with patient safety. More than 50 percent of new graduates experienced stress during role transition, and the most frequently experienced stressors were related to job performance and personal life. Levels of satisfaction with education and comfort/confidence differed according to the hospital type and number of preceptors for new nurses. Conclusion: In order to facilitate the transition of new graduate nurses to professional nurse, an extended period of education, systematic and standardized transition programs, and continuous support during the first year of practice are required.

• 대한두개안면성형외과학회지
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• 제16권1호
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• pp.17-23
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• 2015

Background: Treatment of skull base tumors is challenging due to limited access and presence of important neurovascular structures nearby. The success of a complete tumor resection depends on the extent of tumor exposure and secure field of view. While these tumors are often removed by transcranial endoscopic access, transfacial approach is sometimes required depending on the location and size of the tumor. This study describes various transfacial approaches in patients undergoing skull base tumor resection. Methods: From March to November 2013, 15 patients underwent skull base tumor resection via transfacial accesses at a tertiary institution. Data were reviewed for patient demographics, type of access used, completeness of tumor resection, surgical outcome, and postoperative complications. Results: Two clivus tumor patients underwent transmaxillary approach; three tuberculum-sellae and suprasellar-hypothalamus tumor patients underwent transbasal approach; three clinoid and retrobulbar intraconal orbital tumor patients underwent orbitozygomatic approach; and seven petroclival-area, pons, cavernous sinus, and lateral-sphenoid-wing tumor patients underwent zygomatic approach. In all cases, the upper and lower margins of the tumor were visible. Complete tumor removal consisted of 10 cases, and partial tumor removal in 5. There were no immediate major complications observed for the transfacial portion of the operations. The overall cosmetic results were satisfactory. Conclusion: Plastic surgeons can use various transfacial approaches according to the location and size of skull base tumors to secure a sufficient field of view for neurosurgeons.