• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.112-118
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• 2010

Objective : There have been no clinical studies regarding the epidemiology and treatment outcome for unruptured intracranial aneurysm (UIA) in South Korea yet. Thus, The Korean Society of Cerebrovascular Surgery (KSCVS) decided to evaluate the clinical and epidemiological characteristics, and outcome of the treatment of UIA in 2006, using the nationwide multicenter survey in South Korea. Methods : A total of 1,696 cases were enrolled retrospectively over one year at 48 hospitals. The following data were obtained from all patients : age, sex, presence of symptoms, location and size of the aneurysm, treatment modality, presence of risk factors for stroke, and the postoperative 3D-day morbidity and mortality. Results : The demographic data showed female predominance and peak age of seventh and sixth decades. Supraclinoid internal carotid artery was the most common site of aneurysms with a mean size of 5.6 mm. Eight-hundred-forty-six patients (49.9%) were treated with clipping, 824 (48.6%) with coiling, and 26 with combined method. The choice of the treatment modalities was related to hospital (p=0.000), age (p=0.000), presence of symptom (p=0.003), and location of aneurysm (p=0.000). The overall 30-day morbidity and mortality were 7.4% and 0.3%, respectively. The 30-day mortality was 0.4% for clipping and 0.2% for coiling, and morbidity was 8.4% for clipping and 6.3% for coiling. Age (p=0.010), presence of symptoms (p=0.034), size (p=0.000) of aneurysm, and diabetes mellitus (p=0.000) were significant prognostic factors, while treatment modality was not. Conclusion : This first nation-wide multicenter survey on UIAs demonstrates the epidemiological and clinical characteristics, outcome and the prognostic factors of the treatment of UIAs in South Korea. The 30-day postoperative outcome for UIAs seems to be reasonable morbidity and mortality in South Korea.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.925-928
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• 2014

Background: Gestational trophoblastic neoplasia (GTN) is a spectrum of disease with abnormal trophoblastic proliferation. Treatment is based on FIGO stage and WHO risk factor scores. Patients whose score is 12 or more are considered as at extremely high risk with a high likelihood of resistance to first line treatment. Optimal therapy is therefore controversial. Objective: This study was conducted in order to summarize the regimen used for extremely high risk or resistant GTN patients in our institution the in past 10 years. Materials and Methods: All the charts of GTN patients classified as extremely high risk, recurrent or resistant during 1 January 2002 to 31 December 2011 were reviewed. Criteria for diagnosis of GTN were also assessed to confirm the diagnosis. FIGO stage and WHO risk prognostic score were also re-calculated to ensure the accuracy of the information. Patient characteristics were reviewed in the aspects of age, weight, height, BMI, presenting symptoms, metastatic area, lesions, FIGO stage, WHO risk factor score, serum hCG level, treatment regimen, adjuvant treatments, side effects and response to treatment, including disease free survival. Results: Eight patients meeting the criteria of extremely high risk or resistant GTN were included in this review. Mean age was 33.6 years (SD=13.5, range 17-53). Of the total, 3 were stage III (37.5%) and 5 were stage IV (62.5%). Mean duration from previous pregnancies to GTN was 17.6 months (SD 9.9). Mean serum hCG level was 864,589 mIU/ml (SD 98,151). Presenting symptoms of the patients were various such as hemoptysis, abdominal pain, headache, heavy vaginal bleeding and stroke. The most commonly used first line chemotherapeutic regimen in our institution was the VAC regimen which was given to 4 of 8 patients in this study. The most common second line chemotherapy was EMACO. Adjuvant radiation was given to most of the patients who had brain metastasis. Most of the patients have to delay chemotherapy for 1-2 weeks due to grade 2-3 leukopenia and require G-CSF to rescue from neutropenia. Five form 8 patients were still survived. Mean of disease free survival was 20.4 months. Two patients died of the disease, while another one patient died from sepsis of pressure sore wound. None of surviving patients developed recurrence of disease after complete treatment. Conclusions: In extremely high risk GTN patients, main treatment is multi-agent chemotherapy. In our institution, we usually use VAC as a first line treatment of high risk GTN, but since resistance is quite common, this may not suitable for extremely high risk GTN patients. The most commonly used second line multi-agent chemotherapy in our institution is EMA-CO. Adjuvant brain radiation was administered to most of the patients with brain metastasis in our institution. The survival rate is comparable to previous reviews. Our treatment demonstrated differences from other institutions but the survival is comparable. The limitation of this review is the number of cases is small due to rarity of the disease. Further trials or multicenter analyses may be considered.

• 한국산학기술학회논문지
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• 제12권1호
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• pp.294-300
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• 2011

본 연구는 연하장애에 대한 병식이 없는 뇌졸중 환자들에서 연하장애의 유무와 양상을 알아보고자 시행되었다. 부산시에 소재하고 있는 P 재활의학병원을 내원한 뇌졸중 환자들 중 설문지 조사를 통하여 병식이 없다고 응답한 11명의 환자(남자 4명, 여자 7명)들을 최종대상으로 선정하였다. 설문지 조사, 비디오 투시 연하 조영 검사(video-fluoroscopic swallowing study, VFSS), 기능적 연하곤란 척도, 신경행동학적 인지상태 검사(neuro- behavioral cognitive status examination, NCSE)를 실시하였다. 결과 분석은 SPSS12.0을 사용하여 기술통계와 피어슨 상관분석을 하였다. 본 연구의 대상 뇌졸중 환자들 중 연하장애에 대한 병식이 없다고 응답한 환자들은 모두 연하장애를 동반하였다. 동반되는 연하장애의 양상으로는 구강기의 문제들과 인두기의 삼킴반사 지연이 있으며 인지적 특성에 있어서는 NCSE 항목 중 구성력, 기억력, 유사성이 다른 항목들보다 더 낮은 것으로 나타났다. 기능적 연하곤란 척도와 NCSE 항목들 간의 상관관계를 살펴본 결과 지남력과 판단력이 삼킴반사 지연과 언어이해가 구강 내 식괴의 잔여정도와 유의한 상관관계가 있었다. 본 연구의 결과에 의하면 연하장애에 대한 병식이 없는 뇌졸중 환자들이 연하장애를 가질확률이 높다. 따라서 연하장애로 인한 합병증을 예방하고 작업치료의 효과를 높이기 위해 뇌졸중 환자들에게 조기에 연하장애 평가가 이루어져야 할 것이다.

• 동의생리병리학회지
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• 제22권1호
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• pp.222-225
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• 2008

Hiccup is one of common symptoms that remains poorly understood. The hiccups coordinating center is located in the brain-stem reticular formation. Hiccups may be derived from 400 medical origins. Stroke is an infrequent cause of intractable hiccups. Intractable hiccups in pontine infarction remain poorly understood. As for treatments of hiccups, physical stimulating methods, pharmacological therapies and surgery are occidental conventional methods. In Pharmacological therapies, antidepressants, gastric motility stimulants, antispastic drugs are commonly used. Oriental medicines and acupuncture are also used frequently to treat hiccups. We have treated a case of intractable hiccup induced by pontine infarction with herbal medication; Gwakhyangjeonggi-san gami, acupuncture and moxibustion, and successfully improved. This case showed oriental medicine therapy is effective in intractable hiccup induced by pontine infarction.

• Journal of Korean Neurosurgical Society
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• 제55권3호
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• pp.148-151
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• 2014

Objective : Posture-induced radial neuropathy, known as Saturday night palsy, occurs because of compression of the radial nerve. The clinical symptoms of radial neuropathy are similar to stroke or a herniated cervical disk, which makes it difficult to diagnose and sometimes leads to inappropriate evaluations. The purpose of our study was to establish the clinical characteristics and diagnostic assessment of compressive radial neuropathy. Methods : Retrospectively, we reviewed neurophysiologic studies on 25 patients diagnosed with radial nerve palsy, who experienced wrist drop after maintaining a certain posture for an extended period. The neurologic presentations, clinical prognosis, and electrophysiology of the patients were obtained from medical records. Results : Subjects were 19 males and 6 females. The median age at diagnosis was 46 years. The right arm was affected in 13 patients and the left arm in 12 patients. The condition was induced by sleeping with the arms hanging over the armrest of a chair because of drunkenness, sleeping while bending the arm under the pillow, during drinking, and unknown. The most common clinical presentation was a wrist drop and paresthesia on the dorsum of the 1st to 3rd fingers. Improvement began after a mean of 2.4 weeks. Electrophysiologic evaluation was performed after 2 weeks that revealed delayed nerve conduction velocity in all patients. Conclusion : Wrist drop is an entrapment syndrome that has a good prognosis within several weeks. Awareness of its clinical characteristics and diagnostic assessment methods may help clinicians make diagnosis of radial neuropathy and exclude irrelevant evaluations.

• Journal of Acupuncture Research
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• 제26권2호
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• pp.41-48
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• 2009

Objectives : The conventional direct and indirect moxibustion therapies for prostate treatment could not been applied to the acupuncture point of $CV_1$(Conception Vessel Meridian 1, 會陰) because of its boring body region. The position of $CV_1$(會陰) is the back side of hard part between the anus and the genital organ. The conventional moxibustion methods have many troubles in operating to the acupuncture point of $CV_1$(會陰). In order to get rid of these problems, we have suggested the special heat generating terminal especially for prostate. The features of the special heat generating terminal for prostate are the low temperature infrared heater and the adhesive moxa-pad. These features are no burnt, no fiery and especially suitable for the point of $CV_1$(會陰). Methods: The heat generating terminal which is a part of the moxa-extract moxibustion cauterizer is composed of a PTC(Positive Temperature Coefficients) ceramic heater and the adhesive moxa-pad We had got the experimental demonstrations by the stimulating the acupuncture points which are $CV_1$(會陰), $BL_{28}$(Bladder Meridian 28, 膀胱兪), and $CV_3$(Conception Vessel Meridian 3, 中極) with the special heat generating terminal for the prostatitis and the benign prosthetic hypertrophy. And the stimulation level was 43$^{\circ}C$ infrared heat for one hour. The type of thermography is IRIS-5000. Results : With one subject suffering the prostatitis and another subject suffering the benign prosthetic hypertrophy, we cauterized the acupuncture points $CV_1$(會陰), $BL_{28}$(膀胱兪) and $CV_3$(中極) with the special heat generating terminal for prostate. We measured the temperature variations by the thermography before and after stimulations. Finally we estimated the tendency of temperature decreasing in the region of post-stroke urinary symptoms and the improvement of nocturnal enuresis after the stimulations. Conclusions : We suggest that the special heat generating terminal of moxa-extract moxibustion cauterizer proposed herein is effective for the treatment of prostate by NIH-CPSI and IPSS.

• 대한한방내과학회지
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• 제30권2호
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• pp.438-449
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• 2009

Objectives: Deep vein thrombosis (DVT) is a common complication among stroke patients. The implication of DVT progressing into a fatal pulmonary embolism is one of the main reasons treatment cannot be delayed. However, when there is a contradiction for anticoagulants, such intracranial hemorrhage (ICH), it is difficult to determine the course of treatment. Our team reports a case with both acute DVT and ICH who improved with herbal medicine Hyulbuchuko-tang. Methods : A patient with a variety of thrombosis risk factors (atrial fibrillation, DVT, Cb-inf with intracranial hemorrhage due to thrombolytic complications) showed classic symptoms of DVT (pain, edema, discoloration), disorientation and chest discomfort. The patient was administered Hyulbuchuko-tang three times a day for 24 days without any anticoagulants. Conservative therapy including elastic stocking and leg elevation was co-administered. Laboratory tests and extremity vascular Doppler sonography were carried out 3 times during the treatment period. Results : After our treatment period, both popliteal vein DVT and calf vein DVT were not discovered by sonography, and thrombosis derived factors (eg. D-dimer, fibrinogen) decreased. There was no sign of edema or discoloration after treatment, and the patient no longer complained of leg pain, disorientation or chest discomfort. Conclusion : From these results, we suggest that there is a positive effect of Hyulbuchuko-tang on DVT. Hyulbuchuko-tang should be considered as a treatment option when western medical procedures are unavailable.

• 동의신경정신과학회지
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• 제23권3호
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• pp.117-128
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• 2012

Objectives : The purpose of this study is to evaluate the effects of Joganiknoe-tang on diplopia and ptosis from cerebrovascular disease. Methods : We recruited 2 patients who have diplopia and ptosis because of cerebrovascular disease. In addition, the patients had been administrated by Joganiknoe-tang. Diplopia and ptosis of patients had been estimated with VAS (Visual Analogue Scale) and difference of both eye's interpalpebral fissure. We measured VAS (Visual Analogue Scale) and difference of both eye's interpalpebral fissure for every five days Results : After the treatments, symptoms were decreased and almost disappeared. In both cases, diplopia patients complained decreased from VAS 10 to VAS 1, and difference of both eye's interpalpebral fissure disappeared Conclusions : This study suggests that Joganiknoe-tang is significantly effective on diplopia and ptosis because of cerebrovascular disease.

• Journal of Chest Surgery
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• 제55권1호
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• pp.55-60
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• 2022

Background: Robot-assisted repair of atrial septal defect (ASD) can be performed under either beating-heart or non-beating-heart conditions. However, the risk of cerebral air embolism (i.e., stroke) is a concern in the beating-heart approach. This study aimed to compare the outcomes of beating- and non-beating-heart approaches in robot-assisted ASD repair. Methods: From 2010 to 2019, a total of 45 patients (mean age, 43.4±14.6 years; range, 19-79 years) underwent ASD repair using the da Vinci robotic surgical system. Twenty-seven of these cases were performed on a beating heart (beating-heart group, n=27) and the other cases were performed on an arrested or fibrillating heart (non-beating-heart group, n=18). Cardiopulmonary bypass (CPB) was achieved via cannulation of the femoral vessels and the right internal jugular vein in all patients. Results: Complete ASD closure was verified using intraoperative transesophageal echocardiography in all patients. Conversion to open surgery was not performed in any cases, and there were no major complications. All patients recovered from anesthesia without any immediate postoperative neurologic symptoms. In a subgroup analysis of isolated ASD patch repair (beating-heart group: n=22 vs. non-beating-heart group: n=5), the operation time and CPB time were shorter in the beating-heart group (234±38 vs. 253±29 minutes, p=0.133 and 113±28 vs. 143±29 minutes, p=0.034, respectively). Conclusion: Robot-assisted ASD repair can be safely performed with the beating-heart approach. No additional risk in terms of cerebral embolism was found in the beating-heart group.

• Journal of Yeungnam Medical Science
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• 제15권2호
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• pp.371-380
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• 1998

저자들은 최근 루푸스가 뇌 혈관계를 침범하여 신경 정신과적 이상 증상을 보였으며 면역 검사, 뇌파 검사 및 뇌 자기공명사진에서 중추 신경 루푸스의 소견에 부합되는 양상을 보였고 고용량의 부신피질 호르몬 충격 요법에 반응이 좋았던 2례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.