• Tuberculosis and Respiratory Diseases
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• v.49 no.6
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• pp.760-773
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• 2000

Background : Hemoptysis is a common clinical symptom responsible for 11% of admission to the hospital chest service. In KOREA pulmonary tuberculosis is still the most common cause of hemoptysis and the incidence of hemoptysis due to neoplasia has increased. Bronchoscopy and high resonance CT are essential for diagnosis of the cause of hemoptysis. We studied the causes, diagnostic tools and treament treatment of hemoptysis Methods : We conducted a retrospective analysis of clinical profiles, radiologic and bronchoscopy findings and treatments of hemoptysis for 220 patients who were admitted to our hospital with hemoptysis between 1994 and 1998. Results : The mean age at diagnosis was 49.3 years and male to female ratio was 2.1 : 1. The main causes were active pulmonary pulmonary tuberculosis in 72 cases(32.7%), inactive pulmonary tuberculosis with sequlae in 69 cases(31.4%) lung cancer in 43 cases(19.5%), bronchiectasis in 10 cases(4.5%), and chronic bronchitis in 10 cases(4.5%). The mean amount of hemoptysis for 24hrs was 120cc. The mean duration of bleeding was 25 days. The number of cases with a past history of pulmonary tuberculosis were 128 cases, in which 24 were relapsed tuberculosis cases, 25 chronic tuberculosis cases, 69 inactive tuberculosis cases, and 10 lung cancer cases. High resonance CT was the most useful method for structural etiologic evaluation of hemoptysis developed in patients with inactive tuberculosis, bronchiectasis and aspergilloma. Sputum study and bronchofiberscopy were the confirmative diagnostic tools for active pulmonary tuberculosis and lung cancer. The treatments of hemoptysis medical in 152 cases(71.7%), bronchial arteη embolization in 39 cases(17.8%), and operation in 9 cases(4.0%). The mean following up duration was 22.4 months. The overall outcomes of hemoptysis were controlled in 77 cases(43.5%), rebleeding in 100 cases (56.5%) and expired in 9 cases (4.0%). The outcomes of hemoptysis in pulmonary tuberculosis were controlled in 21.6%, rebleeding in 78.4%, and expire in 14.7%. Conculsion : The most common cause of hemoptysis was related with pulmonary tuberculosis. HRCT was an important diagnostic tool in AFB smear negative active pulmonary tuberculosis and inactive tuberculosis with sequelae. Early, proper management of pulmonary tuberculosis is important for prevention of hemoptysis in Korea.

• Journal of Yeungnam Medical Science
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• v.24 no.1
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• pp.41-54
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• 2007

Background : The causes of chest pain vary but the leading cause of chest pain is ischemic heart disease. Mortality from ischemic chest pain has increased more than two fold over the last ten years. The purpose of this study was to determine the data necessary for rapid treatment of patients with signs and symptoms of ischemic chest pain in the emergency department (ED). Materials and Methods : We interviewed 170 patients who had ischemic chest pain in the emergency department of Yeungnam University Hospital over 6 months with a protocol developed for the evaluation. The protocol used included gender, age, arriving time, prior hospital visits, methods of transportation to the hospital, past medical history, final diagnosis, and outcome information from follow up. Results : Among 170 patients, there were 118 men (69.4%) and the mean age was 63 years. The patients diagnosed with acute myocardial infarction (AMI) were 106 (62.4%) and with angina pectoris (AP) were 64 (37.6%). The patients who had visited another hospital were 68.8%, twice the number that came directly to this hospital (p<0.05). The ratio of patients who visited another hospital were higher for the AMI (75.5%) than the AP (59.4%) patients (p<0.05). The median time spent deciding whether to go to hospital was 521 minutes and for transportation was 40 minutes. With regard to patients that visited another hospital first, the median time spent at the other hospital was 40 minutes. The total median time spent before arriving at our hospital was 600 minutes (p>0.05). The patients who had a total time delay of over 6 hours was similar 54.8% in the AMI group and 57.9% in the AP group (p>0.05). As a result, only 12.2% of the patients with an AMI received thrombolytics, and 48.8% of them had a simultaneous percutaneous coronary intervention (PCI). In the emergency department 8.5% of the patients with an AMI died. Conclusion : Timing is an extremely important factor for the treatment of ischemic heart disease. Most patients arrive at the hospital after a long time lapse from the onset of chest pain. In addition, most patients present to a different hospital before they arrive at the final hospital for treatment. Therefore, important time is lost and opportunities for treatment with thrombolytics and/or PCI are diminished leading to poor outcomes for many patients in the ED. The emergency room treatment must improve for the identification and treatment of ischemic heart disease so that patients can present earlier and treatment can be started as soon as they present to an emergency room.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.480-486
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• 2009

Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.

• Korean Journal of Heritage: History & Science
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• v.53 no.4
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• pp.150-169
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• 2020

Surveys of Buddhist ruins at Namsan in Gyeongju began in earnest during the Japanese colonial era, undertaken by Japanese scholars. These surveys of Buddhist remains in Namsan made during the colonial period should be seen as previous research which cannot be ignored in any in-depth study of Buddhist ruins in Gyeongju. Full-scale surveys of Buddhist ruins at Namsan began in the 1920s. Previous surveys conducted around the time of the Japanese annexation of Korea in 1910 are generally viewed as only representing preliminary investigations and, thus, have not received much attention. However, these early surveys are significant in that they led to the Buddhist ruins on Namsan becoming widely known in the 1910s and served as the foundations for later studies. The removal of the Seated Medicine Buddha from Samneung Valley in Gyeongju in 1915 and its subsequent exhibition at the Joseon Local Products Expo, which marked the fifth anniversary of the Japanese administration of Korea, was especially important in garnering attention for Namsan's wealth of Buddhist artifacts, as the statue was placed in the main hall of the art museum and attracted a great deal of interest from visitors. It is typically thought that this Seated Medicine Buddha was exhibited in 1915 because it was the most beautiful and well-preserved statue from Namsan. However, the removal of this statue was closely related to the proposed move of the Seokguram statue to Seoul around the time of Korea's annexation. The plan to move Seokguram to Seoul was primarily devised by Terauchi Masatake, and the plan, based on Ilseontongjo-ron ('日鮮同祖論'), a historical theory that prehistoric Korean and Japanese people were of the same blood, and Joseon Jeongcheasoeng-ron ('朝鮮停滯性論'), a historical theory arguing that development had stagnated in Korea, was intended to be a visual demonstration of a new era for Korea. This new era was to proceed under the rule of the Japanese Empire through the dissolution of Gyeongbokgung, the symbol of the Joseon Dynasty, which would be replaced with past glories as symbolized by the statue of Buddha. However, as the plan floundered, the replacement for Seokguram in Seoul ended up being none other than the Seated Medicine Buddha of Samneung Valley. Surveys of the Seated Medicine Buddha began in 1911, administered by Sekino Tadashi, but he likely learned of the statue's location from Moroga Hideo or Kodaira Ryozo, Japanese residents of Gyeongju. It is also probable that these Japanese residents received a request from the Japanese Government General of Korea to find a Buddha statue that was worthy of being displayed at exhibitions. In this way, we can say that the transfer of the Seated Medicine Buddha to Seoul was the result of close cooperation between the Government General, Sekino Tadashi, and Japanese residents of Gyeongju. This also had the effect of removing the magical veil which had shrouded the Buddhist ruins of Namsan. In other words, while the early surveys of Buddhist ruins on Namsan are significant, it is difficult to argue that the surveys were undertaken for purely academic purposes, as they were deeply related to the imperial ambitions of Governor-General Terauchi which encompassed the plans to move Seokguram to Seoul and the successful hosting of the 1915 Expo. It should also be pointed out that the failure of the plan to move Seokguram to Seoul and the preservation of the Seated Stone Buddha of Mireuggok at Namsan was in no small part due to resistance from Korean residents in Gyeongju. Although it is not described in detail in the paper, research is needed which shows that the Korean residents of Gyeongju were not simple bystanders, but agents of history.

• Pediatric Infection and Vaccine
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• v.15 no.1
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• pp.36-44
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• 2008

Purpose : Orbital cellulitis is rare, but it could be from the serious complication of sinusitis in children. It is often difficult to distinguish periorbital cellulitis from orbital cellulitis. The purpose of this study is to describe the clinical features of orbital and periorbital cellulitis in a pediatric population and to assess the predisposing factors and their complications. Methods : Forty-one patients aged 18 years and younger who were admitted between January 2000 and December 2006 to Hanil General Hospital and Kyunghee University Hospital with orbital or periorbital cellulitis. The retrospective analyses included clinical characteristics of orbital and periorbital cellulitis, dermographics, past history, predisposing factors, clinical presentations, treatments, and complications. Results : Among 41 patients, 34 patients had periorbital cellulitis, 7 patients had orbital cellulitis. While paranasal sinus disease was the most common predisposing cause in orbital cases, skin lesion, insect bite, dacrocystitis and conjunctivitis were the common causes in periorbital cases. In comparison with periorbital cases, orbital cases had higher level of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. Blood cultures were taken in 23 patients, but only one had Staphylococcus aureus from blood. Only one case had surgical incision and drainage and recovered without complications. Conclusion : From the results of our data, when patient shows erythematous swelling of periorbital area with opthalmoplegia, chemosis and proptosis, orbital CT scan is required to make diagnosis of orbital cellulitis. Most cases of orbital cellulitis can be treated successfully without surgical intervention. If there is no clinical improvement, repeated CT scan and/or surgical intervention should be considered.

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.1-9
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• 2009

Liver transplantation is definitive treatment for the patients suffering from hepatitis, severe liver cirrhosis and liver cancer. In these patients, systemic infections under immunosuppression may occur easily. Therefore, primary object of dental treatments before liver transplantation is absolute removal of oral infection source. In addition, comprehensive dental management plan is essential for success of liver transplantation. The present study has been performed to investigate decayed, missing and filled permanent teeth index(DMFT index), degree of oral hygiene, past medical history, need of dental treatment, completion of dental treatment need and time interval between dental visit and operation date of liver transplantation in liver transplant candidates. Obtained results were as follows; 1. Decayed teeth of the patients were 2.68, missing teeth were 4.02 and filled teeth were 3.42. DMFT index was 10.12. 2. Twenty percents of patients showed moderate to severe food impactions, 42.2% of patients had moderate to heavy calculus and 37.8% of patients displayed gingival inflammation with swelling. 3. Patients needed periodontal treatments more than any other dental treatments. Periodontal treatments were needed for 88.9% of patients, operative & endodontic treatments were 46.7% of patients and 33.3% of patients needed for oral & maxillofacial surgical treatments. 4. Among 90 patients, time interval between scheduled operation date of liver transplantation and dental visit was within 2 weeks for 32.2% of patients, within 1 week for 20.0% of patients. In conclusion, most liver transplant candidates needed dental treatments for removal of potential infection sources. However because of insufficient interval between dental visit and operation date, they had taken liver transplantation procedures without comprehensive dental management. Development of preventive and comprehensive dental management program is mandatory for these patients. Cooperative interdisciplinary management will play a positive role for successful liver transplantation.

• Parasites, Hosts and Diseases
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• v.21 no.2
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• pp.246-256
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• 1983

As epidemiological parameters of human paragonimiasis, the positive rates of intradermal test and the sputum/stool ekaminations have long been employed in population surveys. However, both the specificity of the intradermal test and the sensitivity of sputumjstool examination have been gradually declined as the endemicity was lowered; thus the gap between above two parameters widened. In such context, the development of a new epidemiologic parameter or tool which makes it possible to accurately discriminate the active paragonimiasis cases was necessary. In the present study, the detection rate of Paragonimus-speclac IgG antibody by micro-ELISA was evaluated as an indicator of epidemiologic status of human paragonimiasis in a population. A total of 4, 285 students and inhabitants living in Bukpyeong Myeon and Bukil Myeon, Haenam Gun, Jeonlanam Do was surveyed in October, 1983 by intradermal test first. Out of them, 244 cases (5.7%) were found positively reacted to VBS antigen of F. westermani. Out of 168 positive reactors, 7 cases (4.2%) were egg positive either by two times of sputum examination or by one stool examination. That indicated that only 0. 16% of total surveyed were confirmed as active paragonimiasis by egg detection. When sera collected from 239 positive reactors of Intradermal test were tested by micro-ELISA for their specific IgG antibody, 40 cases(16.7%) were found to be positive. All of 7 egg positive cases were again positive for specific IgG antibody. Among remaining 232 intradermal test positive cases, 33 cases were positive for IgG antibody. In contrast to those, none of 42 positive reactors to intradermal test for Cloncrchis and of 128 intradermal test negative cases showed positive for Paragcnimus-specIfic IgG antibody. The rate of specific IgG antibody as detected by micro-ELISA appeared to be increased with the wheal size of the intradermal test. When the wheal sixte was over 13mm in diameter, about 50% of them were positive for specific IgG antibody. Thirty-one specific antibody positive cases were clinically evaluated by laboratory examinations (repeated sputum examination, peripheral eosinophil count and chest roentgenogram) and by history taking. Out of them 24 cases were associated with one or more positive laboratory findings: thus considered as active paragonimiasis cases. Out of 7 lab. finding-free cases 3 revealed past history of typical paragonimiasis symptoms, suggesting that they were in chronic or in convalescent stages. The remaining 4 cases were considered as either mild or ectopic infection cases; the possibility of cross-reaction with other helminthiases could not be ruled out. From the above results, it was inferred that the detection of Paragonimus-specIfic IgG antibody by micro-ELISA was very much helpful in detecting the active cases as well as in proper evaluation of the endemicity of human paragonimiasis in a population. The convenience of mass haildling of sera in micro-ELISA was considered another superiority as an epidemiologic tool.

• Journal of agricultural medicine and community health
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• v.18 no.2
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• pp.141-151
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• 1993

This study was done about 371 tuberculosis(TB) patients composed 195 newly registered at Kyungju Gun Health Center from May 1989 to April 1990 (Group A) and 176 being treated at hospitals or private clinics from January 1988 to November 1989(Group B). When Group A patients visited and newly registered at Health Center, data was obtained by interviewing with a prepared questionnaire paper. And well trained inquirer visited Group B patients and obtained data by the same method from February 1990 to April 1990. The results are as follows ; Group A was generally lower than Group B in socioeconomic status and in family history of TB, the rate of Group A was 24.1% and higher than 11.9% in Group B(p<0.05). Knowledge about TB was improved more than past, but those who answered that TB is 'a communicable disease' were 59.5% in Group A and 51.7% in Group B(p<0.05). Those answered that TB is 'a inherited disease' were 9.2% and 11.4% each. And 1.7% of Group B answered that TB is 'a incurable disease'. Knowledge about TB treatment also was improved more than past, but in the rate of those who answered that TB is a curable disease provided by well treatment Group B(77.8%) was worse than Group A(91.3%). The rate of those who answered that TB were been able to cure by regularly anti-TB medication were 98.0% in Group A and 89.8% in Group B. Its difference was statistically significant. The rate that patients took the first diagnosis and wanted to receive treatments at the same organ were 34.9% of Group A at Health Center and 72.2% of Group B at hospitals or private clinics. And its difference was statistically significant. In the reasons that Group B knew Health Center treated pulmonary TB but they was treated at hospitals or private clinics, unreliability to Health Center was 48.1%. The reasons that Group A was treated at Health Center were 'because of trust' 63.1%, 'because of low cost' 50.3%, 'because of low cost except trust' 9.3%, 'no specific reasons' 27.7%. In the courses of knowing that TB was controlled at Health Center, 'by neighborhood, health worker and doctors' were 84.9% in Group A and 69.0% in Group B. But 'by TV or radio' were 8.2% in Group A and 14.7% in Group B, 'by school education' 2.5% in Group A and 6.2% in Group B. Conclusively, Group A patients were lower than Group B in socioeconomic status, but better than in knowledge about TB. Its reasons was suggested that Health Center had controlled TB patients better than hospitals and private clinics. But considering, that difference in the rate of the same organ for the first diagnosis and treatment, that the only 63.0% of Group A have treated due to 'reliability to Health Center', and that 48.1% of Group B knew that Health Center treated pulmonary TB but didn't visit it due to 'unreliability to Health Center', that public relations(PR) about use Health Center for pulmonary TB and health education for TB was thought to have to strengthened.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.92-100
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• 1997

Objective：The objective of this study is to examine the clinical characteristics and behavioral comorbidity of patients with Tourette’s disorder. Method：Subjects consisted of 157 patients with Tourette’ disorder diagnosed by DSM-IIIR, who were examined and diagnosed from Jan. 1988 to May 1994 at the Tourette’s Clinic of Yonsei University Medical Center. Characteristics and behavioral comorbidity of Patients were assessed by a semi-structured interview schedule. Behavioral problems like hyperactivity, obsession-compulsion, self destructiveness, enuresis, sleep problem were assessed by global clinical impression. Results：The mean age of patients was 14.49(${\pm}7.99$) years. Patients consisted of 138 males (87.9%) and 19 females(12.1%). The sex ratio was 7：1, showing a male preponderance. The number of right-handers was 133(84.7%), and the number of non-right handers was 24(15.3%). Mean age of onset was 8.85(${\pm}4.56$) years, ranging from 2-to-16 years. More than half of the patients had their age of onset at 6-10 years. Bimodal peak in age of onset was observed；the first peak was around 6 and the second peak was around 10 years. There was no sex difference in bimodal age of onset. The most common initial symptom was eye blinking. More than 55% of patients reported eye blinking as their first symptom. The second common initial symptom was head turning and the third was vocal tic. The most common symptoms that patients reported on their first visit since onset were eye blinking(82.2%), head turning or nodding(57.9%), shoulder shrugging(52.7%) and forearm movement(32.6%). Of 157 cases, 101(64.3%) patients showed downward progression of symptoms, and 25(15.9%) showed upward progression of symptoms. Nineteen fathers(12%) of patients had a past history of obsessive-compulsive disorder(OCD). Seventeen fathers(10.6%) had a history of tic disorder. SSevenmothers(4.5%) had OCD, 4 mothers (2.5%) had tic disorder. One hundred and eighteen patients(75.1%) had comorbid hyperactivity, 95 patients(60.5%) had obsession, 55 patiens(35.0%) had self destructiveness, 46 patients(29.3%) had impulsivity, and 35 patients(22.3%) had enuresis. Age of onset had a significant positive correlation with age, duration, and the global severity of obsession；and a negative correlation with the severity of hyperactivity. Hyperactivity had a significant positive correlation with impulsivity, obsession-compulsion, enuresis, and self destructiveness. Obsession-compulsion had a significant positive correlation with hyperactivity, sleep problems, and self destructiveness. Conclusion：These data suggest that clinical characteristcs and behavioral comorbidity of patients with Tourette’ disorder in this study are similar to previous research findings in Korea and other contries. The younger the age of onset was, the more severe hyperactivity was, and the less severe obsession-compulsion was. And severity of hyperactivity had a positive correlation with the severity of obsession-compulsion, impulsivity, enuresis, and self destructiveness.

• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.205-212
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• 2009

Purpose : Chronic urticaria is a disorder characterized by the appearance of wheals for more than 6 weeks; in most cases, the etiology is unknown. This study was aimed to discover the clinical aspects, the etiologic factors, and the course of chronic urticaria. Methods : 51 children who were diagnosed with chronic urticaria in the past 4 years, and who had had follow-ups more than 6 months after diagnosis in the pediatric department of Soonchunhyang University Hospital in Bucheon, were enrolled in the study. The laboratory findings, clinical aspects, and courses were retrospectively investigated by medical record review and telephone interview. Results : The median age of children with chronic urticaria was 4 years (8 months to 16 years) and the ratio of male to female was 1.4:1. Of the total, 39.2% of patients had a history of atopy. Angioedema occurred concurrently with urticaria in 11.8% of patients, and dermographism was seen in 41.2%. Results of thyroid function tests were normal and thyroid autoantibodies were absent in all cases. Regarding etiology, most cases (74.5%) were forms of idiopathic urticaria. Urticaria was induced by physical factors in 19.6% of patients. Open challenge tests revealed that 3 patients were allergic to food additives (glutamate 2, glutamate, and sulfite 1). In this study, most of the patients reported good response after medication of 1st- or 2nd-generation antihistamines alone. Follow-up at 6 months revealed that 70.6% of patients had experienced remission, and 84.8% of children who had follow-up at 1 year presented remission. Conclusion : Chronic urticaria in most patients was idiopathic. Remission occurred within 1 year of diagnosis, in most cases so chronic urticaria in children seems to have good prognosis.