• Journal of Chest Surgery
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• 제23권5호
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• pp.976-986
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• 1990

We experienced 12 patients with the abdominal aortic aneurysm during last 31 years [Dec. 1958 \ulcornerSep. 1989]. Among them, 10 patients were reviewed. They were all male. The age ranged from 34 to 80 years with the mean age of 59.4 years. The etiology of the aneurysm was atherosclerotic in 8, mycotic in 1, and aortitis in 1. The location of the aneurysm was infrarenal in 8, and suprarenal in 2 cases. Aneurysmectomy and Dacron Y-graft interposition in 8 cases, and lease with Teflon Y-graft were made. In another 1 case, long thoracoabdominal bypass surgery was made. The operative mortality was 30%[3cases]. The postoperative complications were respiratory complications[3cases], acute renal failure[2cases], bleeding[lease], mechanical ileus[ lease], and peritonitis[lease].

• 대한한의학회지
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• 제25권1호
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• pp.111-116
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• 2004

Objective : To assess the clinical efficacy of Yangkyuksanwha-tang on acute stroke Methods : We prescribed Yangkyuksanwha-tang to 83 acute stroke patients without thrombolytic treatment. Results : The rate of progressive stroke type was 1.2%, it was remarkably lower than previous reports. 3.6% felt an itching sensation, 3.6% complained headache, dizziness and powerless, 2.4% complained indigestion and diarrhea, 1.2% appeared hematuria and G-I bleeding. Yangkyuksanwha-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale(NIHSS), and increased Modified Barthel Index(MBI). So we could suggest that this medicine have desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, all results were within the normal value, which showed no hepatic or renal toxicity. Conclusion : We could suggest that Yangkyuksanwha-tang is a useful medicine which has clinical efficacy for acute stroke, but further investigation for an administration of more than 2 weeks is necessary.

• Journal of Ginseng Research
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• 제39권2호
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• pp.89-93
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• 2015

Ginseng has long been used as a functional food or therapeutic supplement and it is empirically known to be safe and nontoxic. During recent decades, a number of in vitro and in vivo experiments, as well as human studies have been conducted to prove the safety of various types of ginseng samples and their components. Clinical trials, case reports, and in vitro and in vivo research articles addressing the safety, toxicity, and other adverse events of ginseng application were selected and reviewed. Patient risks associated with ginseng abuse and misuse such as affective disorder, allergy, cardiovascular and renal toxicity, genital organ bleeding, gynecomastia, hepatotoxicity, hypertension, reproductive toxicity, and anticoagulant-ginseng interaction were reviewed and summarized. There are some cases of patient risk associated with ginseng abuse and misuse depending on patients' conditions although further investigation in more cases is required to clarify these issues.

• Journal of Acupuncture Research
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• 제25권4호
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• pp.117-125
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• 2008

Objectives : Analyze according to types of event causing the adverse outcome due to acupotomy, and discuss problems and safety reqirements to using this therapy in Korea. Methods : Based upon the indication, contraindication, treatment procedures, clinical obsevations, acupotomy-related adverse outcome case reports, the factors of damaging event were classified. Results : The main factors of adverse outcome by acupotomy were anatomical ignorance, contamination of device or hospital staff, failure to notice preexisting disease(cardiovascular disease, hypertension, renal failure, hemophilia, chronic Liver Disease, etc.), unskilled treatment procedures(massive bleeding) and techniques(nerve injury, hepatic and splenic injury, Pneumothorax). Conclusions : It is mandatory to prepare adequate sterilie aseptic technique. The clinician should ensure understand genernal health state of patient and anatomical direction.

• Journal of Chest Surgery
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• 제16권3호
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• pp.337-341
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• 1983

The experience with operative treatment for total correction of Tetralogy of Fallot at the department of Thoracic and Cardiovascular Surgery, Korea University Hospital from January, 1977, through April, 1983 was reviewed. Of the 29 patients reviewed, male to female occurrence ratio was 22:7 Type of V.S.D. was type II in 26 cases[90%] and total conus defect in 3 cases[10%]. Average size of V.S.D. was 19 mm. Type of Right ventricular outflow tract stenosis was highest frequency with pulmonary valvular and infundibular stenosis combined type in 21 cases[72%], and there were 8 deaths In this group. Type of R.V.O.T. reconstruction contains 2 cases of infundibulectomy only, 1 case of infundibulectomy with valvular commissurotomy, 2 cases of pericardial patch, 23 Cases of pericardial patch with Teflon or Dacron felt reinforced and 1 case of pulmonary valved conduit reconstruction. Operative mortality was higher in outflow patch through pulmonary valve ring. Overall mortality was 31%. Major causes of death and postoperative complications were low output syndrome, complete A-V block acute renal failure, ventricular fibrillation, bleeding brain abscess, and sudden cardiac arrest.

• Journal of Periodontal and Implant Science
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• 제25권1호
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• pp.14-23
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• 1995

Cyclosporin A is a powerful immunosuppressive agent commonly used for patients receiving organ transplants. Like phenytoin and the calcium channel blockers, the drug is associated with gingival overgrowth. The purpose of this study was to compare the correlation with gingival overgrowth score and clinical indices(i.e, : plaque index, papillary bleeding index, probing depth) and correlation with gingival overgrowth score and microorganism distribution in use of phase contrast microscope. After renal tranplant, taking cyclosporin A 40 patients participating in this investigation. Post - transplatation cyclosporin medication period was average $17.53{\pm}15.75$ months. In previous study reported that gingival overgrowth is an adverse side - effects seen in about 25-81% of patient taking cyclosporin A. The results were as follows : 1. Gingival overgrowth prevalence in taking cyclosporin A patients was 77.5%. Prevalence rate of region was anterior region(26 teeth, 55.3%), molar region(14 teeth, 29.8%), premolar region(7 teeth, 14.8%) in turns. Gingival overgrowth score by Angelopoulos & Goaz method was molar region($1.56{\pm}0.81$), anterior region($1.52{\pm}0.75$), premolar region($1.14{\pm}0.90$) in turns. 2. Medication period was not correlation with gingival overgrowth score. 3. Clinical indices and gingival overgrowth score were as follows. 1) Plaque index and gingival overgrowth score was significantly correlated(p

• Journal of Chest Surgery
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• 제56권5호
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• pp.346-352
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• 2023

Background: A significant proportion of cardiac surgery intensive care unit (CSICU) patients require long-term ventilation, necessitating tracheostomy placement. The goal of this study was to evaluate the long-term postoperative outcomes and complications associated with percutaneous dilatational tracheostomy (PDT) in CSICU patients. Methods: All patients undergoing PDT after cardiac, thoracic, or vascular operations in the CSICU between January 1, 2013 and January 1, 2021 were identified. They were evaluated for mortality, decannulation time, and complications including bleeding, infection, and need for surgical intervention. Multivariable regression models were used to identify predictors of early decannulation and the complication rate. Results: Ninety-three patients were identified for this study (70 [75.3%] male and 23 [24.7%] female). Furthermore, 18.3% of patients had chronic obstructive pulmonary disease (COPD), 21.5% had history of stroke, 7.5% had end-stage renal disease, 33.3% had diabetes, and 59.1% were current smokers. The mean time from PDT to decannulation was 39 days. Roughly one-fifth (20.4%) of patients were on dual antiplatelet therapy and 81.7% had anticoagulation restarted 8 hours post-tracheostomy. Eight complications were noted, including 5 instances of bleeding requiring packing and 1 case of mediastinitis. There were no significant predictors of decannulation prior to discharge. Only COPD was identified as a negative predictor of decannulation at any point in time (hazard ratio, 0.28; 95% confidence interval, 0.08-0.95; p=0.04). Conclusion: Percutaneous tracheostomy is a safe and viable alternative to surgical tracheostomy in cardiac surgery ICU patients. Patients who undergo PDT have a relatively short duration of tracheostomy and do not have major post-procedural complications.

• International Journal of Heart Failure
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• 제6권2호
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• pp.76-81
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• 2024

Background and Objectives: Real-world clinical data, outside of clinical trials and expert centers, on adverse events related to the use of SyncCardia total artificial heart (TAH) remain limited. We aim to analyze adverse events related to the use of SynCardia TAH reported to the Food and Drug Administration (FDA)'s Manufacturers and User Defined Experience (MAUDE) database. Methods: We reviewed the FDA's MAUDE database for any adverse events involving the use of SynCardia TAH from 1/01/2012 to 9/30/2020. All the events were independently reviewed by three physicians. Results: A total of 1,512 adverse events were identified in 453 "injury and death" reports in the MAUDE database. The most common adverse events reported were infection (20.2%) and device malfunction (20.1%). These were followed by bleeding events (16.5%), respiratory failure (10.1%), cerebrovascular accident (CVA)/other neurological dysfunction (8.7%), renal dysfunction (7.5%), hepatic dysfunction (2.2%), thromboembolic events (1.8%), pericardial effusion (1.8%), and hemolysis (1%). Death was reported in 49.4% of all the reported cases (n=224/453). The most common cause of death was multiorgan failure (n=73, 32.6%), followed by CVA/other non-specific neurological dysfunction (n=44, 19.7%), sepsis (n=24, 10.7%), withdrawal of support (n=20, 8.9%), device malfunction (n=11, 4.9%), bleeding (n=7, 3.1%), respiratory failure (n=7, 3.1%), gastrointestinal disorder (n=6, 2.7%), and cardiomyopathy (n=3, 1.3%). Conclusions: Infection was the most common adverse event following the implantation of TAH. Most of the deaths reported were due to multiorgan failure. Early recognition and management of any possible adverse events after the TAH implantation are essential to improve the procedural outcome and patient survival.

• 구강회복응용과학지
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• 제40권2호
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• pp.46-54
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• 2024

목적: 투석을 받고 있으며 신장 이식 수술 전 구내 평가를 위해 의뢰된 말기 신장 질환자의 치주 상태를 신장 기능이 정상인 대상자들과 비교 평가하고자 함이다. 연구 재료 및 방법: 말기 신장 질환으로 투석을 받고 있으면서 신장 이식 수술 전 구강내 평가를 위해 대학병원 신장 내과에서 치과진료센터로 의뢰된 환자들을 대상으로 하였다. 치주 상태의 비교를 위해 신장 기능에 이상이 없으면서, 나이와 성별이 부합하는 대상자를 추출하여 건강한 대조군으로 선정하였다. 신장내과 진료 기록을 통해 환자의 연령, 성별, 동반질병, 받고 있는 투석의 종류, 투석 기간을 조사하였으며, 치주과 진료 기록을 통해 치주 상태에 대한 자료를 분석하였다. 결과: 투석을 받는 환자 51명 및 건강한 대조군에 속한 51명을 합하여 모두 102명이 본 연구에 포함되었다. 신장 이식 수술을 받기 전까지 투석을 받은 말기 신장 질환자들에서 건강한 대상자들에 비해 치주낭 깊이, 임상적 부착수준, 치주낭 깊이가 5 mm 이상 되는 부위의 백분율, 임상적 부착수준이 4 mm 이상 되는 부위의 백분율, 탐침시 출혈이 일어나는 치아의 백분율, 상실치 수 등이 유의하게 크게 나타났다. 또한 투석을 받는 환자 그룹에서 중등도에서 중도 치주염을 지닌 비율이 건강한 대조군에 비해 더 높은 것으로 나타났다. 결론: 본 연구에서 투석을 받고 있으며 신장 이식 수술 전 구강내 평가를 위해 의뢰된 말기 신장 질환자의 치주 상태는 연령과 성별이 유사한 건강한 대조군에 속한 대상자들에 비해 악화된 상태였다.

• Journal of Chest Surgery
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• 제32권11호
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• pp.1017-1022
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• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.